State prevailing rates

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

Latest update: 09-14-2018
CPT code State Provider class Modifier Current pricing Effective date Past pricing Past effective date
0359T DC 04 00 $500.00 02/04/16
0359T DC 01 00 $500.00 02/04/16
0360T DC 04 00 $62.50 02/04/16
0360T DC 01 00 $62.50 02/04/16
0361T DC 04 00 $62.50 02/04/16
0361T DC 01 00 $62.50 02/04/16
0364T DC 01 00 $62.50 07/12/18
0364T DC 04 00 $62.50 07/12/18
0365T DC 01 00 $62.50 02/04/16
0365T DC 04 00 $62.50 02/04/16
0368T DC 04 00 $62.50 02/04/16
0368T DC 01 00 $62.50 02/04/16
0369T DC 01 00 $62.50 02/04/16
0369T DC 04 00 $62.50 02/04/16
0370T DC 04 00 $125.00 02/04/16
0370T DC 01 00 $125.00 02/04/16
44135 DC 04 00 $36,969.00 07/12/18
44135 DC 01 00 $36,969.00 07/12/18
50323 DC 01 00 $2,227.00 07/12/18
50323 DC 04 00 $2,227.00 07/12/18
74340 DC 04 TC $614.16 07/12/18
74340 DC 04 00 $643.00 07/12/18
74340 DC 01 TC $614.16 07/12/18
74340 DC 01 00 $643.00 07/12/18
77425 DC 04 00 $255.00 07/12/18
77425 DC 01 00 $255.00 07/12/18
77425 DC 04 26 $255.00 07/12/18
77425 DC 01 26 $255.00 07/12/18
86921 DC 01 00 $5.62 07/12/18
86921 DC 04 00 $5.62 07/12/18
88155 DC 04 26 $25.50 07/12/18
88155 DC 01 26 $25.50 07/12/18
89250 DC 04 00 $2,700.00 02/04/16
89250 DC 01 00 $2,700.00 02/04/16
89254 DC 04 00 $2,850.00 02/04/16
89254 DC 01 00 $2,850.00 02/04/16
90736 DC 01 NU $235.51 10/19/16 $208.09 05/07/15
90736 DC 04 NU $235.51 10/19/16 $208.09 05/07/15
90736 DC 04 00 $254.35 07/20/17
90736 DC 04 00 $235.51 07/19/17
90736 DC 01 00 $254.35 07/20/17
90736 DC 01 00 $235.51 07/19/17
93299 DC 01 00 $100.00 07/12/18
93299 DC 04 00 $100.00 07/12/18
93531 DC 01 00 $2,263.00 07/12/18
93531 DC 04 TC $1,772.87 07/12/18
93531 DC 04 00 $2,263.00 07/12/18
93531 DC 01 TC $1,772.87 07/12/18
93533 DC 01 TC $2,372.16 07/12/18
93533 DC 01 00 $2,787.00 07/12/18
93533 DC 04 TC $2,372.16 07/12/18
93533 DC 04 00 $2,787.00 07/12/18
93620 DC 01 00 $6,393.30 07/12/18
93620 DC 04 TC $5,700.12 07/12/18
93620 DC 04 00 $6,393.30 07/12/18
93620 DC 01 TC $5,700.12 07/12/18
94772 DC 01 TC $233.75 07/12/18
94772 DC 04 TC $233.75 07/12/18
94774 DC 01 00 $289.00 07/12/18
94774 DC 04 00 $289.00 07/12/18
94776 DC 04 00 $108.00 07/12/18
94776 DC 01 00 $108.00 07/12/18
99000 DC 04 00 $6.00 07/12/18
99000 DC 01 00 $6.00 07/12/18
99001 DC 04 00 $6.00 07/12/18
99001 DC 01 00 $6.00 07/12/18
A0431 DC 01 00 $1,786.83 04/09/18 $2,102.15 12/07/16
A0431 DC 04 00 $1,786.83 04/09/18 $2,102.15 12/07/16
A0431 DC 04 00 $2,473.12 12/10/15
A0431 DC 01 00 $2,473.12 12/10/15
A4206 DC 04 00 $0.40 07/12/18
A4206 DC 01 00 $0.40 07/12/18
A4207 DC 04 00 $0.40 07/12/18
A4207 DC 01 00 $0.40 07/12/18
A4208 DC 04 00 $0.40 07/12/18
A4208 DC 01 00 $0.40 07/12/18
A4209 DC 01 00 $1.05 07/12/18
A4209 DC 04 00 $1.05 07/12/18
A4210 DC 01 00 $12.95 07/12/18
A4210 DC 04 00 $12.95 07/12/18
A4213 DC 04 00 $2.00 07/12/18
A4213 DC 01 00 $2.00 07/12/18
A4215 DC 01 00 $0.30 07/12/18
A4215 DC 04 00 $0.30 07/12/18
A4218 DC 04 00 $0.58 07/12/18
A4218 DC 01 00 $0.58 07/12/18
A4244 DC 04 00 $1.80 07/12/18
A4244 DC 01 00 $1.80 07/12/18
A4245 DC 04 00 $3.50 07/12/18
A4245 DC 01 00 $3.50 07/12/18
A4246 DC 01 00 $8.00 07/12/18
A4246 DC 04 00 $8.00 07/12/18
A4247 DC 01 00 $5.00 07/12/18
A4247 DC 04 00 $5.00 07/12/18
A4250 DC 04 00 $41.30 07/12/18
A4250 DC 01 00 $41.30 07/12/18
A4263 DC 01 00 $80.00 07/12/18
A4263 DC 04 00 $80.00 07/12/18
A4284 DC 01 00 $19.95 07/12/18
A4284 DC 04 00 $19.95 07/12/18
A4285 DC 04 00 $12.19 07/12/18
A4285 DC 01 00 $12.19 07/12/18
A4300 DC 04 00 $10.00 07/12/18
A4300 DC 01 00 $10.00 07/12/18
A4305 DC 04 00 $15.00 07/12/18
A4305 DC 01 00 $15.00 07/12/18
A4306 DC 01 00 $876.51 07/12/18
A4306 DC 04 00 $876.51 07/12/18
A4465 DC 01 00 $4.95 07/12/18
A4465 DC 04 00 $4.95 07/12/18
A4466 DC 04 00 $105.00 07/12/18
A4466 DC 01 00 $105.00 07/12/18
A4470 DC 01 00 $4.95 07/12/18
A4470 DC 04 00 $4.95 07/12/18
A4490 DC 04 00 $24.20 07/12/18
A4490 DC 01 00 $24.20 07/12/18
A4495 DC 01 00 $36.90 07/12/18
A4495 DC 04 00 $36.90 07/12/18
A4500 DC 04 00 $35.00 07/12/18
A4500 DC 01 00 $35.00 07/12/18
A4510 DC 04 00 $80.00 07/12/18
A4510 DC 01 00 $80.00 07/12/18
A4550 DC 04 00 $65.00 07/12/18
A4550 DC 01 00 $65.00 07/12/18
A4570 DC 01 00 $25.00 07/12/18
A4570 DC 04 00 $25.00 07/12/18
A4580 DC 04 00 $43.50 07/12/18
A4580 DC 01 00 $43.50 07/12/18
A4590 DC 01 00 $48.00 07/12/18
A4590 DC 04 00 $48.00 07/12/18
A4627 DC 04 00 $25.00 07/12/18
A4627 DC 01 00 $25.00 07/12/18
A4648 DC 04 00 $39.00 07/12/18
A4648 DC 01 00 $39.00 07/12/18
A4657 DC 01 00 $67.50 07/12/18
A4657 DC 04 00 $67.50 07/12/18
A4660 DC 04 00 $79.95 07/12/18
A4660 DC 01 00 $79.95 07/12/18
A4663 DC 04 00 $34.00 07/12/18
A4663 DC 01 00 $34.00 07/12/18
A4680 DC 04 00 $21.55 07/12/18
A4680 DC 01 00 $21.55 07/12/18
A4690 DC 04 00 $461.25 07/12/18
A4690 DC 01 00 $461.25 07/12/18
A4750 DC 01 00 $6.00 07/12/18
A4750 DC 04 00 $6.00 07/12/18
A4755 DC 04 00 $10.25 07/12/18
A4755 DC 01 00 $10.25 07/12/18
A4760 DC 04 00 $7.00 07/12/18
A4760 DC 01 00 $7.00 07/12/18
A4765 DC 01 00 $2.00 07/12/18
A4765 DC 04 00 $2.00 07/12/18
A4770 DC 01 00 $160.00 07/12/18
A4770 DC 04 00 $160.00 07/12/18
A4771 DC 01 00 $10.60 07/12/18
A4771 DC 04 00 $10.60 07/12/18
A4772 DC 04 00 $90.20 07/12/18
A4772 DC 01 00 $90.20 07/12/18
A4773 DC 04 00 $85.00 07/12/18
A4773 DC 01 00 $85.00 07/12/18
A4860 DC 01 00 $3.00 07/12/18
A4860 DC 04 00 $3.00 07/12/18
A4918 DC 04 00 $7.10 07/12/18
A4918 DC 01 00 $7.10 07/12/18
A4927 DC 01 00 $7.95 07/12/18
A4927 DC 04 00 $7.95 07/12/18
A6208 DC 01 00 $67.11 07/12/18
A6208 DC 04 00 $67.11 07/12/18
A6213 DC 04 00 $9.80 07/12/18
A6213 DC 01 00 $9.80 07/12/18
A6530 DC 01 00 $109.64 07/12/18
A6530 DC 04 00 $109.64 07/12/18
A9282 DC 01 00 $2,000.00 07/12/18
A9282 DC 04 00 $2,000.00 07/12/18
A9500 DC 04 00 $120.00 07/12/18
A9500 DC 01 00 $120.00 07/12/18
A9502 DC 01 00 $170.00 07/12/18
A9502 DC 04 00 $170.00 07/12/18
A9503 DC 04 00 $157.00 07/12/18
A9503 DC 01 00 $157.00 07/12/18
A9505 DC 04 00 $31.74 07/12/18
A9505 DC 01 00 $31.74 07/12/18
A9507 DC 04 00 $3,244.35 07/12/18
A9507 DC 01 00 $3,244.35 07/12/18
A9509 DC 04 00 $296.06 07/12/18
A9509 DC 01 00 $296.06 07/12/18
A9516 DC 04 00 $68.45 07/12/18
A9516 DC 01 00 $68.45 07/12/18
A9517 DC 04 00 $33.31 07/12/18
A9517 DC 01 00 $33.31 07/12/18
A9521 DC 01 00 $567.61 07/12/18
A9521 DC 04 00 $567.61 07/12/18
A9528 DC 01 00 $21.62 07/12/18
A9528 DC 04 00 $21.62 07/12/18
A9530 DC 04 00 $28.91 07/12/18
A9530 DC 01 00 $28.91 07/12/18
A9537 DC 01 00 $59.54 07/12/18
A9537 DC 04 00 $59.54 07/12/18
A9538 DC 04 00 $24.70 07/12/18
A9538 DC 01 00 $24.70 07/12/18
A9539 DC 04 00 $16.25 07/12/18
A9539 DC 01 00 $16.25 07/12/18
A9540 DC 01 00 $34.98 07/12/18
A9540 DC 04 00 $34.98 07/12/18
A9541 DC 01 00 $75.35 07/12/18
A9541 DC 04 00 $75.35 07/12/18
A9542 DC 01 00 $2,769.63 07/12/18
A9542 DC 04 00 $2,769.63 07/12/18
A9551 DC 01 00 $126.63 07/12/18
A9551 DC 04 00 $126.63 07/12/18
A9552 DC 01 00 $800.00 07/12/18
A9552 DC 04 00 $800.00 07/12/18
A9556 DC 04 00 $32.04 07/12/18
A9556 DC 01 00 $32.04 07/12/18
A9558 DC 04 00 $38.96 07/12/18
A9558 DC 01 00 $38.96 07/12/18
A9560 DC 04 00 $114.00 07/12/18
A9560 DC 01 00 $114.00 07/12/18
A9561 DC 01 00 $34.56 07/12/18
A9561 DC 04 00 $34.56 07/12/18
A9562 DC 04 00 $445.51 07/12/18
A9562 DC 01 00 $445.51 07/12/18
A9584 DC 01 00 $7,385.49 07/12/18
A9584 DC 04 00 $7,385.49 07/12/18
A9600 DC 01 00 $1,014.13 07/12/18
A9600 DC 04 00 $1,014.13 07/12/18
B4172 DC 01 00 $193.00 07/12/18
B4172 DC 04 00 $193.00 07/12/18
B5200 DC 01 00 $4.94 07/12/18
B5200 DC 04 00 $4.94 07/12/18
C1726 DC 01 00 $1,663.75 07/12/18
C1726 DC 04 00 $1,663.75 07/12/18
C1729 DC 01 00 $87.50 07/12/18
C1729 DC 04 00 $87.50 07/12/18
C1730 DC 04 00 $1,760.70 07/12/18
C1730 DC 01 00 $1,760.70 07/12/18
C1731 DC 01 00 $4,462.10 07/12/18
C1731 DC 04 00 $4,462.10 07/12/18
C1732 DC 04 00 $3,392.93 07/12/18
C1732 DC 01 00 $3,392.93 07/12/18
C1733 DC 01 00 $3,563.93 07/12/18
C1733 DC 04 00 $3,563.93 07/12/18
C1751 DC 01 00 $880.12 07/12/18
C1751 DC 04 00 $880.12 07/12/18
C1753 DC 04 00 $2,067.00 07/12/18
C1753 DC 01 00 $2,067.00 07/12/18
C1758 DC 01 00 $421.14 07/12/18
C1758 DC 04 00 $421.14 07/12/18
C1759 DC 04 00 $1,981.99 07/12/18
C1759 DC 01 00 $1,981.99 07/12/18
C1760 DC 01 00 $866.75 07/12/18
C1760 DC 04 00 $866.75 07/12/18
C1762 DC 01 00 $6,766.32 07/12/18
C1762 DC 04 00 $6,766.32 07/12/18
C1763 DC 04 00 $4,887.66 07/12/18
C1763 DC 01 00 $4,887.66 07/12/18
C1766 DC 01 00 $153.17 07/12/18
C1766 DC 04 00 $153.17 07/12/18
C1767 DC 04 00 $85,393.75 07/12/18
C1767 DC 01 00 $85,393.75 07/12/18
C1769 DC 04 00 $251.50 07/12/18
C1769 DC 01 00 $251.50 07/12/18
C1773 DC 01 00 $626.14 07/12/18
C1773 DC 04 00 $626.14 07/12/18
C1776 DC 01 00 $937.99 07/12/18
C1776 DC 04 00 $937.99 07/12/18
C1778 DC 04 00 $21,512.81 07/12/18
C1778 DC 01 00 $21,512.81 07/12/18
C1781 DC 04 00 $678.72 07/12/18
C1781 DC 01 00 $678.72 07/12/18
C1785 DC 04 00 $15,066.35 07/12/18
C1785 DC 01 00 $15,066.35 07/12/18
C1786 DC 04 00 $4,115.66 07/12/18
C1786 DC 01 00 $4,115.66 07/12/18
C1788 DC 04 00 $1,354.79 07/12/18
C1788 DC 01 00 $1,354.79 07/12/18
C1789 DC 04 00 $3,689.60 07/12/18
C1789 DC 01 00 $3,689.60 07/12/18
C1817 DC 01 00 $10,068.00 07/12/18
C1817 DC 04 00 $10,068.00 07/12/18
C1819 DC 04 00 $530.32 07/12/18
C1819 DC 01 00 $530.32 07/12/18
C1820 DC 04 00 $59,342.40 07/12/18
C1820 DC 01 00 $59,342.40 07/12/18
C1874 DC 01 00 $14,604.80 07/12/18
C1874 DC 04 00 $14,604.80 07/12/18
C1876 DC 01 00 $4,025.00 07/12/18
C1876 DC 04 00 $4,025.00 07/12/18
C1877 DC 01 00 $4,237.00 07/12/18
C1877 DC 04 00 $4,237.00 07/12/18
C1887 DC 01 00 $313.00 07/12/18
C1887 DC 04 00 $313.00 07/12/18
C1893 DC 04 00 $532.65 07/12/18
C1893 DC 01 00 $532.65 07/12/18
C1894 DC 04 00 $189.75 07/12/18
C1894 DC 01 00 $189.75 07/12/18
C1898 DC 04 00 $3,723.25 07/12/18
C1898 DC 01 00 $3,723.25 07/12/18
C2616 DC 04 00 $63,558.00 07/12/18
C2616 DC 01 00 $63,558.00 07/12/18
C2617 DC 04 00 $488.00 07/12/18
C2617 DC 01 00 $488.00 07/12/18
C2625 DC 04 00 $455.00 07/12/18
C2625 DC 01 00 $455.00 07/12/18
C2630 DC 04 00 $6,843.69 07/12/18
C2630 DC 01 00 $6,843.69 07/12/18
C8908 DC 01 00 $3,675.00 07/12/18
C8908 DC 04 00 $3,675.00 07/12/18
C8927 DC 04 00 $3,133.59 07/12/18
C8927 DC 01 00 $3,133.59 07/12/18
C8928 DC 04 00 $2,482.10 07/12/18
C8928 DC 01 00 $2,482.10 07/12/18
C9113 DC 01 00 $30.00 07/12/18
C9113 DC 04 00 $30.00 07/12/18
C9285 DC 01 00 $32.80 07/12/18
C9285 DC 04 00 $32.80 07/12/18
D0120 DC 01 00 $84.00 07/12/18
D0120 DC 04 00 $84.00 07/12/18
D0140 DC 04 00 $101.00 07/12/18
D0140 DC 01 00 $101.00 07/12/18
D0150 DC 04 00 $120.00 07/12/18
D0150 DC 01 00 $120.00 07/12/18
D0220 DC 04 00 $43.00 07/12/18
D0220 DC 01 00 $43.00 07/12/18
D0330 DC 01 00 $123.00 07/12/18
D0330 DC 04 00 $123.00 07/12/18
D0340 DC 01 00 $141.00 07/12/18
D0340 DC 04 00 $141.00 07/12/18
D1110 DC 04 00 $143.00 07/12/18
D1110 DC 01 00 $143.00 07/12/18
D1120 DC 01 00 $79.00 07/12/18
D1120 DC 04 00 $79.00 07/12/18
D1206 DC 04 00 $154.00 07/12/18
D1206 DC 01 00 $154.00 07/12/18
D1330 DC 04 00 $38.00 07/12/18
D1330 DC 01 00 $38.00 07/12/18
D7140 DC 01 00 $268.00 07/12/18
D7140 DC 04 00 $268.00 07/12/18
E0246 DC 04 RR $10.27 02/04/16
E0246 DC 01 00 $123.19 02/04/16
E0246 DC 04 00 $123.19 02/04/16
E0246 DC 01 RR $10.27 02/04/16
E0352 DC 01 00 $45.53 07/12/18
E0352 DC 04 00 $45.53 07/12/18
E0430 DC 01 00 $300.00 07/12/18
E0430 DC 01 RR $60.00 07/12/18
E0430 DC 04 00 $300.00 07/12/18
E0430 DC 04 RR $60.00 07/12/18
E0435 DC 04 RR $118.70 07/12/18
E0435 DC 01 00 $4,417.00 07/12/18
E0435 DC 01 NU $4,417.00 07/12/18
E0435 DC 04 NU $4,417.00 07/12/18
E0435 DC 04 00 $4,417.00 07/12/18
E0435 DC 01 RR $118.70 07/12/18
E0440 DC 04 00 $4,500.00 07/12/18
E0440 DC 04 NU $4,500.00 07/12/18
E0440 DC 01 00 $4,500.00 07/12/18
E0440 DC 01 NU $4,500.00 07/12/18
E0486 DC 04 NU $3,425.00 07/12/18
E0486 DC 01 00 $3,425.00 07/12/18
E0486 DC 01 NU $3,425.00 07/12/18
E0486 DC 04 00 $3,425.00 07/12/18
E0555 DC 01 00 $40.00 07/12/18
E0555 DC 04 RR $3.33 07/12/18
E0555 DC 04 00 $40.00 07/12/18
E0555 DC 01 RR $3.33 07/12/18
E0970 DC 01 00 $185.00 07/12/18
E0970 DC 04 RR $15.42 07/12/18
E0970 DC 04 00 $185.00 07/12/18
E0970 DC 01 RR $15.42 07/12/18
E1085 DC 01 NU $932.00 07/12/18
E1085 DC 04 RR $77.67 07/12/18
E1085 DC 01 RR $77.67 07/12/18
E1085 DC 04 00 $932.00 07/12/18
E1085 DC 04 NU $932.00 07/12/18
E1085 DC 01 00 $932.00 07/12/18
E1086 DC 04 00 $1,133.00 07/12/18
E1086 DC 04 NU $1,133.00 07/12/18
E1086 DC 01 00 $1,133.00 07/12/18
E1086 DC 01 NU $1,133.00 07/12/18
E1086 DC 04 RR $94.42 07/12/18
E1086 DC 01 RR $94.42 07/12/18
E1089 DC 01 00 $1,305.00 07/12/18
E1089 DC 04 RR $108.75 07/12/18
E1089 DC 04 00 $1,305.00 07/12/18
E1089 DC 01 RR $108.75 07/12/18
E1090 DC 01 NU $1,705.00 07/12/18
E1090 DC 04 RR $142.08 07/12/18
E1090 DC 01 00 $1,705.00 07/12/18
E1090 DC 04 00 $1,705.00 07/12/18
E1090 DC 01 RR $142.08 07/12/18
E1090 DC 04 NU $1,705.00 07/12/18
E1130 DC 01 00 $560.00 07/12/18
E1130 DC 04 RR $46.67 07/12/18
E1130 DC 01 NU $560.00 07/12/18
E1130 DC 04 NU $560.00 07/12/18
E1130 DC 01 RR $46.67 07/12/18
E1130 DC 04 00 $560.00 07/12/18
E1140 DC 01 RR $101.25 07/12/18
E1140 DC 04 00 $1,215.00 07/12/18
E1140 DC 04 NU $1,215.00 07/12/18
E1140 DC 01 00 $1,215.00 07/12/18
E1140 DC 01 NU $1,215.00 07/12/18
E1140 DC 04 RR $101.25 07/12/18
E1250 DC 04 NU $580.00 07/12/18
E1250 DC 04 00 $580.00 07/12/18
E1250 DC 01 RR $48.33 07/12/18
E1250 DC 01 00 $580.00 07/12/18
E1250 DC 04 RR $48.33 07/12/18
E1250 DC 01 NU $580.00 07/12/18
E1260 DC 01 RR $130.83 07/12/18
E1260 DC 04 00 $1,570.00 07/12/18
E1260 DC 04 NU $1,570.00 07/12/18
E1260 DC 01 00 $1,570.00 07/12/18
E1260 DC 01 NU $1,570.00 07/12/18
E1260 DC 04 RR $130.83 07/12/18
E1290 DC 04 NU $1,265.00 07/12/18
E1290 DC 04 00 $1,265.00 07/12/18
E1290 DC 01 00 $1,265.00 07/12/18
E1290 DC 01 NU $1,265.00 07/12/18
E1353 DC 01 RR $10.46 07/12/18
E1353 DC 04 RR $10.46 07/12/18
E1355 DC 04 RR $1.40 07/12/18
E1355 DC 01 RR $1.40 07/12/18
G0339 DC 04 00 $23,312.90 07/12/18
G0339 DC 01 00 $23,312.90 07/12/18
G0340 DC 01 00 $23,312.90 07/12/18
G0340 DC 04 00 $23,312.90 07/12/18
G0378 DC 01 00 $312.33 07/12/18
G0378 DC 04 00 $312.33 07/12/18
G0379 DC 01 00 $220.27 07/12/18
G0379 DC 04 00 $220.27 07/12/18
G0390 DC 04 00 $3,500.00 07/12/18
G0390 DC 01 00 $3,500.00 07/12/18
G0410 DC 01 00 $195.00 07/12/18
G0410 DC 04 00 $195.00 07/12/18
G0463 DC 01 00 $199.78 07/12/18
G0463 DC 04 00 $199.78 07/12/18
G8539 DC 04 00 $31.25 07/12/18
G8539 DC 01 00 $31.25 07/12/18
G8542 DC 01 00 $31.25 07/12/18
G8542 DC 04 00 $31.25 07/12/18
H0015 DC 01 00 $282.00 09/18/17 $268.00 02/24/16
H0015 DC 04 00 $282.00 09/18/17 $268.00 02/24/16
H0015 DC 04 00 $268.00 02/24/16
H0015 DC 01 00 $268.00 02/24/16
H0035 DC 01 00 $268.00 09/22/15 $254.00 01/03/14
H0035 DC 01 00 $282.00 09/18/17 $268.00 09/22/15
H0035 DC 04 00 $268.00 09/22/15 $254.00 01/03/14
H0035 DC 04 00 $282.00 09/18/17 $268.00 09/22/15
H0037 DC 01 00 $357.00 09/22/15 $339.00 01/03/14
H0037 DC 01 00 $377.00 09/18/17 $357.00 09/22/15
H0037 DC 04 00 $357.00 09/22/15 $339.00 01/03/14
H0037 DC 04 00 $377.00 09/18/17 $357.00 09/22/15
H2019 DC 04 00 $12.50 07/12/18
H2019 DC 01 00 $18.75 07/12/18
K0739 DC 01 00 $14.87 12/01/15 $14.55 12/19/13
K0739 DC 01 00 $15.26 01/24/18 $15.02 12/29/16
K0739 DC 04 00 $14.87 12/01/15 $14.55 12/19/13
K0739 DC 04 00 $15.26 01/24/18 $15.02 12/29/16
L3201 DC 04 00 $38.00 07/12/18
L3201 DC 01 RR $3.16 07/12/18
L3201 DC 01 00 $38.00 07/12/18
L3201 DC 04 RR $3.16 07/12/18
L3202 DC 01 00 $45.00 07/12/18
L3202 DC 04 RR $3.75 07/12/18
L3202 DC 04 00 $45.00 07/12/18
L3202 DC 01 RR $3.75 07/12/18
L3204 DC 01 00 $34.50 07/12/18
L3204 DC 04 RR $2.86 07/12/18
L3204 DC 01 RR $2.86 07/12/18
L3204 DC 04 00 $34.50 07/12/18
L3206 DC 01 00 $47.00 07/12/18
L3206 DC 04 RR $3.92 07/12/18
L3206 DC 04 00 $47.00 07/12/18
L3206 DC 01 RR $3.92 07/12/18
L3215 DC 01 RR $7.33 02/04/16
L3215 DC 04 00 $88.00 02/04/16
L3215 DC 01 00 $88.00 02/04/16
L3215 DC 04 RR $7.33 02/04/16
L3216 DC 04 RR $10.16 02/04/16
L3216 DC 01 RR $10.16 02/04/16
L3216 DC 04 00 $122.00 02/04/16
L3216 DC 01 00 $122.00 02/04/16
L3217 DC 04 RR $7.92 02/04/16
L3217 DC 01 RR $7.92 02/04/16
L3217 DC 04 00 $95.00 02/04/16
L3217 DC 01 00 $95.00 02/04/16
L3219 DC 04 RR $7.35 02/04/16
L3219 DC 01 RR $7.35 02/04/16
L3219 DC 04 00 $88.16 02/04/16
L3219 DC 01 00 $88.16 02/04/16
L3221 DC 01 RR $13.00 02/04/16
L3221 DC 04 00 $156.00 02/04/16
L3221 DC 01 00 $156.00 02/04/16
L3221 DC 04 RR $13.00 02/04/16
L3222 DC 04 RR $10.62 02/04/16
L3222 DC 04 00 $127.40 02/04/16
L3222 DC 01 RR $10.62 02/04/16
L3222 DC 01 00 $127.40 02/04/16
L3230 DC 01 00 $497.00 02/04/16
L3230 DC 04 00 $497.00 02/04/16
L3230 DC 01 RR $41.42 02/04/16
L3230 DC 04 RR $41.42 02/04/16
L3250 DC 01 00 $231.77 02/04/16
L3250 DC 04 RR $19.31 02/04/16
L3250 DC 01 RR $19.31 02/04/16
L3250 DC 04 00 $231.77 02/04/16
L3251 DC 01 00 $288.00 02/04/16
L3251 DC 04 RR $24.00 02/04/16
L3251 DC 04 00 $288.00 02/04/16
L3251 DC 01 RR $24.00 02/04/16
L3252 DC 01 00 $187.20 02/04/16
L3252 DC 04 RR $15.60 02/04/16
L3252 DC 01 RR $15.60 02/04/16
L3252 DC 04 00 $187.20 02/04/16
L3253 DC 01 RR $7.42 02/04/16
L3253 DC 04 00 $89.00 02/04/16
L3253 DC 01 00 $89.00 02/04/16
L3253 DC 04 RR $7.42 02/04/16
L3260 DC 01 00 $91.52 07/12/18
L3260 DC 04 RR $7.63 07/12/18
L3260 DC 01 RR $7.63 07/12/18
L3260 DC 04 00 $91.52 07/12/18
L3265 DC 01 00 $98.00 02/04/16
L3265 DC 04 RR $8.16 02/04/16
L3265 DC 04 00 $98.00 02/04/16
L3265 DC 01 RR $8.16 02/04/16
L3320 DC 04 00 $90.00 07/12/18
L3320 DC 01 00 $90.00 07/12/18
L3485 DC 01 00 $39.00 07/12/18
L3485 DC 04 RR $3.25 07/12/18
L3485 DC 04 00 $39.00 07/12/18
L3485 DC 01 RR $3.25 07/12/18
L4205 DC 01 00 $22.13 12/01/15 $21.66 12/19/13
L4205 DC 01 00 $22.71 01/24/18 $22.35 12/29/16
L4205 DC 04 00 $22.13 12/01/15 $21.66 12/19/13
L4205 DC 04 00 $22.71 01/24/18 $22.35 12/29/16
L7520 DC 01 00 $30.08 12/01/15 $29.43 12/19/13
L7520 DC 01 00 $30.87 01/24/18 $30.38 12/29/16
L7520 DC 04 00 $30.08 12/01/15 $29.43 12/19/13
L7520 DC 04 00 $30.87 01/24/18 $30.38 12/29/16
L8010 DC 04 00 $43.43 07/12/18
L8010 DC 01 00 $43.43 07/12/18
P9016 DC 01 00 $617.00 07/12/18
P9016 DC 04 00 $617.00 07/12/18
P9017 DC 01 00 $175.00 07/12/18
P9017 DC 04 00 $175.00 07/12/18
P9035 DC 04 00 $2,100.00 07/12/18
P9035 DC 01 00 $2,100.00 07/12/18
P9040 DC 04 00 $1,109.08 07/12/18
P9040 DC 01 00 $1,109.08 07/12/18
R0070 DC 01 00 $300.00 07/12/18
R0070 DC 04 00 $300.00 07/12/18
S5108 DC 01 00 $31.25 07/12/18
S5108 DC 04 00 $31.25 07/12/18
S5110 DC 04 00 $31.25 07/12/18
S5110 DC 01 00 $31.25 07/12/18
S5115 DC 04 00 $31.25 07/12/18
S5115 DC 01 00 $31.25 07/12/18
S9480 DC 01 00 $282.00 09/18/17 $268.00 02/24/16
S9480 DC 04 00 $282.00 09/18/17 $268.00 02/24/16
S9480 DC 04 00 $268.00 02/24/16
S9480 DC 01 00 $268.00 02/24/16
V2790 DC 01 00 $6,435.00 07/12/18
V2790 DC 04 00 $6,435.00 07/12/18
V5030 DC 01 00 $550.00 07/12/18
V5030 DC 04 00 $550.00 07/12/18
V5040 DC 04 00 $550.00 07/12/18
V5040 DC 01 00 $550.00 07/12/18
V5050 DC 01 00 $597.00 07/12/18
V5050 DC 04 00 $597.00 07/12/18
V5060 DC 04 00 $615.00 07/12/18
V5060 DC 01 00 $615.00 07/12/18
V5070 DC 01 00 $550.00 07/12/18
V5070 DC 04 00 $550.00 07/12/18
V5080 DC 01 00 $550.00 07/12/18
V5080 DC 04 00 $550.00 07/12/18
V5100 DC 04 00 $500.00 07/12/18
V5100 DC 01 00 $500.00 07/12/18
V5120 DC 04 00 $1,100.00 07/12/18
V5120 DC 01 00 $1,100.00 07/12/18
V5130 DC 01 00 $1,600.00 07/12/18
V5130 DC 04 00 $1,600.00 07/12/18
V5140 DC 04 00 $1,000.00 07/12/18
V5140 DC 01 00 $1,000.00 07/12/18
V5150 DC 04 00 $1,100.00 07/12/18
V5150 DC 01 00 $1,100.00 07/12/18
V5160 DC 04 00 $300.00 07/12/18
V5160 DC 01 00 $300.00 07/12/18
V5170 DC 01 00 $650.00 07/12/18
V5170 DC 04 00 $650.00 07/12/18
V5180 DC 04 00 $650.00 07/12/18
V5180 DC 01 00 $650.00 07/12/18
V5190 DC 01 00 $650.00 07/12/18
V5190 DC 04 00 $650.00 07/12/18
V5210 DC 01 00 $1,180.00 07/12/18
V5210 DC 04 00 $1,180.00 07/12/18
V5220 DC 01 00 $1,180.00 07/12/18
V5220 DC 04 00 $1,180.00 07/12/18
V5230 DC 04 00 $1,180.00 07/12/18
V5230 DC 01 00 $1,180.00 07/12/18
V5241 DC 04 00 $300.00 07/12/18
V5241 DC 01 00 $300.00 07/12/18
V5257 DC 04 00 $2,250.00 07/12/18
V5257 DC 01 00 $2,250.00 07/12/18
V5261 DC 04 00 $3,090.00 07/12/18
V5261 DC 01 00 $3,090.00 07/12/18
V5264 DC 04 00 $88.00 07/12/18
V5264 DC 01 00 $88.00 07/12/18
V5267 DC 04 00 $518.00 07/12/18
V5267 DC 01 00 $518.00 07/12/18
V5275 DC 04 00 $30.00 07/12/18
V5275 DC 01 00 $30.00 07/12/18