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 MA 01 00 $500.00 02/16/16
0359T MA 04 00 $500.00 02/16/16
0360T MA 01 00 $62.50 02/16/16
0360T MA 04 00 $62.50 02/16/16
0361T MA 01 00 $62.50 02/16/16
0361T MA 04 00 $62.50 02/16/16
0364T MA 01 00 $62.50 05/24/17
0364T MA 04 00 $62.50 05/24/17
0365T MA 01 00 $62.50 02/16/16
0365T MA 04 00 $62.50 02/16/16
0368T MA 01 00 $62.50 02/16/16
0368T MA 04 00 $62.50 02/16/16
0369T MA 01 00 $62.50 02/16/16
0369T MA 04 00 $62.50 02/16/16
0370T MA 01 00 $125.00 02/16/16
0370T MA 04 00 $125.00 02/16/16
15824 MA 01 00 $343.40 05/24/17
15824 MA 04 00 $343.40 05/24/17
15825 MA 01 00 $343.40 05/24/17
15825 MA 04 00 $343.40 05/24/17
15826 MA 01 00 $343.40 05/24/17
15826 MA 04 00 $343.40 05/24/17
15828 MA 01 00 $343.40 05/24/17
15828 MA 04 00 $343.40 05/24/17
15829 MA 01 00 $343.40 05/24/17
15829 MA 04 00 $343.40 05/24/17
15876 MA 01 00 $343.40 05/24/17
15876 MA 04 00 $343.40 05/24/17
15878 MA 01 00 $343.40 05/24/17
15878 MA 04 00 $343.40 05/24/17
15879 MA 01 00 $343.40 05/24/17
15879 MA 04 00 $343.40 05/24/17
17380 MA 01 00 $343.40 02/16/16
17380 MA 04 00 $343.40 02/16/16
21088 MA 01 00 $343.40 02/16/16
21088 MA 04 00 $343.40 02/16/16
21089 MA 01 00 $343.40 05/24/17
21089 MA 04 00 $343.40 05/24/17
22841 MA 01 00 $343.40 05/24/17
22841 MA 04 00 $343.40 05/24/17
24940 MA 01 00 $343.40 05/24/17
24940 MA 04 00 $343.40 05/24/17
26989 MA 01 00 $343.40 05/24/17
26989 MA 04 00 $343.40 05/24/17
32850 MA 01 00 $343.40 05/24/17
32850 MA 04 00 $343.40 05/24/17
33930 MA 01 00 $343.40 05/24/17
33930 MA 04 00 $343.40 05/24/17
33940 MA 01 00 $343.40 05/24/17
33940 MA 04 00 $343.40 05/24/17
41821 MA 01 00 $343.40 05/24/17
41821 MA 04 00 $343.40 05/24/17
41870 MA 01 00 $343.40 05/24/17
41870 MA 04 00 $343.40 05/24/17
43496 MA 01 00 $343.40 05/24/17
43496 MA 04 00 $343.40 05/24/17
47133 MA 01 00 $343.40 05/24/17
47133 MA 04 00 $343.40 05/24/17
48160 MA 01 00 $343.40 05/24/17
48160 MA 04 00 $343.40 05/24/17
48550 MA 01 00 $343.40 05/24/17
48550 MA 04 00 $343.40 05/24/17
49906 MA 01 00 $343.40 05/24/17
49906 MA 04 00 $343.40 05/24/17
50300 MA 01 00 $343.40 05/24/17
50300 MA 04 00 $343.40 05/24/17
55970 MA 01 00 $343.40 05/24/17
55970 MA 04 00 $343.40 05/24/17
55980 MA 01 00 $343.40 05/24/17
55980 MA 04 00 $343.40 05/24/17
58974 MA 01 00 $343.40 02/16/16
58974 MA 04 00 $343.40 02/16/16
65767 MA 01 00 $343.40 05/24/17
65767 MA 04 00 $343.40 05/24/17
65771 MA 01 00 $343.40 02/16/16
65771 MA 04 00 $343.40 02/16/16
69090 MA 01 00 $343.40 02/16/16
69090 MA 04 00 $343.40 02/16/16
69710 MA 01 00 $343.40 02/16/16
69710 MA 04 00 $343.40 02/16/16
69949 MA 01 00 $343.40 05/24/17
69949 MA 04 00 $343.40 05/24/17
69979 MA 01 00 $343.40 05/24/17
69979 MA 04 00 $343.40 05/24/17
75894 MA 01 00 $9,570.00 05/24/17
75894 MA 01 TC $9,500.51 05/24/17
75894 MA 04 00 $9,570.00 05/24/17
75894 MA 04 TC $9,500.51 05/24/17
76001 MA 01 00 $1,630.00 04/20/17
76001 MA 01 TC $705.95 05/24/17
76001 MA 04 00 $742.00 04/20/17
76001 MA 04 TC $705.95 05/24/17
77385 MA 01 00 $2,693.03 02/16/16
77385 MA 04 00 $2,693.03 02/16/16
77386 MA 01 00 $1,523.00 02/16/16
77386 MA 04 00 $1,523.00 02/16/16
77520 MA 01 00 $2,330.00 05/24/17
77520 MA 04 00 $2,330.00 05/24/17
78609 MA 01 00 $343.40 05/24/17
78609 MA 04 00 $343.40 05/24/17
79300 MA 01 00 $343.40 05/24/17
79300 MA 04 00 $343.40 05/24/17
80300 MA 01 00 $56.00 02/16/16
80300 MA 04 00 $56.00 02/16/16
80301 MA 01 00 $275.00 02/16/16
80301 MA 04 00 $275.00 02/16/16
80302 MA 01 00 $106.00 02/16/16
80302 MA 04 00 $106.00 02/16/16
80320 MA 01 00 $102.00 02/16/16
80320 MA 04 00 $102.00 02/16/16
80325 MA 01 00 $99.00 02/16/16
80325 MA 04 00 $99.00 02/16/16
80346 MA 01 00 $88.10 02/16/16
80346 MA 04 00 $88.10 02/16/16
80347 MA 01 00 $429.00 02/16/16
80347 MA 04 00 $429.00 02/16/16
80348 MA 01 00 $92.68 02/16/16
80348 MA 04 00 $92.68 02/16/16
80349 MA 01 00 $33.00 02/16/16
80349 MA 04 00 $33.00 02/16/16
80354 MA 01 00 $92.68 02/16/16
80354 MA 04 00 $92.68 02/16/16
80356 MA 01 00 $33.00 02/16/16
80356 MA 04 00 $33.00 02/16/16
80359 MA 01 00 $99.00 02/16/16
80359 MA 04 00 $99.00 02/16/16
80365 MA 01 00 $92.68 02/16/16
80365 MA 04 00 $92.68 02/16/16
80372 MA 01 00 $92.68 02/16/16
80372 MA 04 00 $92.68 02/16/16
81201 MA 01 00 $750.00 02/16/16
81201 MA 04 00 $750.00 02/16/16
81244 MA 01 00 $307.00 05/24/17
81244 MA 04 00 $207.03 05/24/17
81257 MA 01 00 $1,199.00 02/16/16
81257 MA 04 00 $1,199.00 02/16/16
81405 MA 01 00 $6,840.00 02/16/16
81405 MA 04 00 $6,840.00 02/16/16
81406 MA 01 00 $2,990.00 02/16/16
81406 MA 04 00 $2,990.00 02/16/16
86860 MA 01 00 $60.00 05/24/17
86860 MA 04 00 $60.00 05/24/17
86891 MA 01 00 $100.00 05/24/17
86891 MA 04 00 $100.00 05/24/17
86930 MA 01 00 $10.00 05/24/17
86930 MA 04 00 $10.00 05/24/17
86931 MA 01 00 $10.00 05/24/17
86931 MA 04 00 $10.00 05/24/17
86932 MA 01 00 $10.00 05/24/17
86932 MA 04 00 $10.00 05/24/17
86950 MA 01 00 $50.00 05/24/17
86950 MA 04 00 $50.00 05/24/17
86970 MA 01 00 $160.00 05/24/17
86970 MA 04 00 $160.00 05/24/17
86971 MA 01 00 $160.00 05/24/17
86971 MA 04 00 $160.00 05/24/17
86972 MA 01 00 $160.00 05/24/17
86972 MA 04 00 $160.00 05/24/17
86975 MA 01 00 $160.00 05/24/17
86975 MA 04 00 $160.00 05/24/17
86976 MA 01 00 $160.00 05/24/17
86976 MA 04 00 $160.00 05/24/17
86977 MA 01 00 $160.00 05/24/17
86977 MA 04 00 $160.00 05/24/17
86978 MA 01 00 $160.00 05/24/17
86978 MA 04 00 $160.00 05/24/17
89353 MA 01 00 $118.00 02/16/16
89353 MA 04 00 $118.00 02/16/16
90736 MA 01 00 $254.35 07/20/17
90736 MA 04 00 $254.35 07/20/17
90993 MA 01 00 $343.40 05/24/17
90993 MA 04 00 $343.40 05/24/17
92993 MA 01 00 $343.40 05/24/17
92993 MA 04 00 $343.40 05/24/17
93299 MA 01 00 $157.00 04/20/17
93299 MA 04 00 $152.00 05/24/17
93531 MA 01 00 $11,224.00 05/24/17
93531 MA 01 TC $11,697.10 05/24/17
93531 MA 04 00 $11,224.00 05/24/17
93531 MA 04 TC $11,697.10 05/24/17
93609 MA 01 00 $5,193.00 05/24/17
93609 MA 01 TC $4,898.54 05/24/17
93609 MA 04 00 $5,193.00 05/24/17
93609 MA 04 TC $4,898.54 05/24/17
93620 MA 01 00 $10,914.00 05/24/17
93620 MA 01 TC $3,962.64 05/24/17
93620 MA 04 00 $4,659.00 05/24/17
93620 MA 04 TC $3,962.64 05/24/17
93621 MA 01 00 $4,355.00 05/24/17 $3,755.00 08/27/15
93621 MA 01 TC $3,415.47 05/24/17
93621 MA 04 00 $3,540.00 05/24/17
93621 MA 04 TC $3,415.47 05/24/17
99000 MA 01 00 $25.00 04/20/17
99000 MA 04 00 $25.00 04/20/17
99001 MA 01 00 $68.41 04/20/17
99001 MA 04 00 $43.00 05/24/17
99071 MA 01 00 $2.30 02/16/16
99071 MA 04 00 $2.30 02/16/16
99075 MA 01 00 $2.30 02/16/16
99075 MA 04 00 $2.30 02/16/16
99082 MA 01 00 $63.75 05/24/17
99082 MA 04 00 $63.75 05/24/17
99455 MA 01 00 $343.40 02/16/16
99455 MA 04 00 $343.40 02/16/16
99606 MA 01 00 $148.49 02/16/16
99606 MA 04 00 $148.49 02/16/16
A0225 MA 01 00 $383.00 05/24/17
A0225 MA 04 00 $383.00 05/24/17
A0431 MA 01 00 $2,192.43 04/09/18 $2,579.33 12/07/16
A0431 MA 01 00 $3,034.50 12/10/15
A0431 MA 04 00 $2,192.43 04/09/18 $2,579.33 12/07/16
A0431 MA 04 00 $3,034.50 12/10/15
A0436 MA 01 00 $29.23 04/09/18 $34.39 12/08/16
A0436 MA 01 00 $40.46 12/10/15
A0436 MA 04 00 $29.23 04/09/18 $34.39 12/08/16
A0436 MA 04 00 $40.46 12/10/15
A4206 MA 01 00 $6.00 05/24/17
A4206 MA 04 00 $6.00 05/24/17
A4208 MA 01 00 $4.00 05/24/17
A4208 MA 04 00 $4.00 05/24/17
A4209 MA 01 00 $.28 05/24/17
A4209 MA 04 00 $.28 05/24/17
A4210 MA 01 00 $20.00 05/24/17
A4210 MA 04 00 $20.00 05/24/17
A4211 MA 01 00 $60.72 05/24/17
A4211 MA 04 00 $60.72 05/24/17
A4212 MA 01 00 $14.88 05/24/17
A4212 MA 04 00 $14.88 05/24/17
A4213 MA 01 00 $7.00 05/24/17 $7.00 07/14/15
A4213 MA 01 00 $7.00 05/24/17 $7.00 02/09/16
A4213 MA 04 00 $7.00 05/24/17 $7.00 07/14/15
A4213 MA 04 00 $7.00 05/24/17 $7.00 02/09/16
A4215 MA 01 00 $15.00 04/20/17
A4215 MA 04 00 $15.00 04/20/17
A4218 MA 01 00 $13.79 04/20/17
A4218 MA 04 00 $13.79 04/20/17
A4220 MA 01 00 $75.00 05/24/17
A4220 MA 04 00 $75.00 05/24/17
A4223 MA 01 00 $500.00 04/20/17 $355.09 08/28/15
A4223 MA 01 NU $500.00 05/24/17 $355.09 08/28/15
A4223 MA 04 00 $500.00 04/20/17 $355.09 08/28/15
A4223 MA 04 NU $500.00 05/24/17 $355.09 08/28/15
A4230 MA 01 00 $20.00 05/24/17
A4230 MA 04 00 $20.00 05/24/17
A4232 MA 01 00 $3.10 05/24/17
A4232 MA 04 00 $3.10 05/24/17
A4245 MA 01 00 $6.00 05/24/17
A4245 MA 04 00 $6.00 05/24/17
A4250 MA 01 00 $5.00 05/24/17
A4250 MA 04 00 $5.00 05/24/17
A4262 MA 01 00 $50.00 05/24/17
A4262 MA 04 00 $50.00 05/24/17
A4263 MA 01 00 $100.00 05/24/17
A4263 MA 04 00 $100.00 05/24/17
A4270 MA 01 00 $46.00 05/24/17
A4270 MA 04 00 $46.00 05/24/17
A4281 MA 01 00 $20.00 05/24/17
A4281 MA 04 00 $20.00 05/24/17
A4283 MA 01 00 $10.00 05/24/17
A4283 MA 04 00 $10.00 05/24/17
A4284 MA 01 00 $15.00 04/20/17
A4284 MA 04 00 $15.00 04/20/17
A4285 MA 01 00 $16.00 04/20/17
A4285 MA 04 00 $16.00 04/20/17
A4301 MA 01 00 $246.00 05/24/17
A4301 MA 04 00 $246.00 05/24/17
A4305 MA 01 00 $50.00 05/24/17
A4305 MA 04 00 $50.00 05/24/17
A4490 MA 01 00 $11.27 05/24/17
A4490 MA 04 00 $11.27 05/24/17
A4550 MA 01 00 $80.00 04/20/17
A4550 MA 04 00 $80.00 04/20/17
A4570 MA 01 00 $100.00 04/20/17 $84.00 08/29/15
A4570 MA 04 00 $100.00 04/20/17 $84.00 08/29/15
A4580 MA 01 00 $60.00 05/24/17
A4580 MA 04 00 $60.00 05/24/17
A4590 MA 01 00 $48.00 04/20/17
A4590 MA 04 00 $48.00 04/20/17
A4606 MA 01 00 $262.50 05/24/17 $210.00 08/29/15
A4606 MA 04 00 $262.50 05/24/17 $210.00 08/29/15
A4627 MA 01 00 $71.00 04/20/17 $67.00 08/29/15
A4627 MA 04 00 $71.00 04/20/17 $67.00 08/29/15
A4648 MA 01 00 $495.00 04/20/17
A4648 MA 04 00 $495.00 04/20/17
A4657 MA 01 00 $61.21 05/24/17 $55.64 08/31/15
A4657 MA 04 00 $61.21 05/24/17 $55.64 08/31/15
A4770 MA 01 00 $160.00 05/24/17
A4770 MA 04 00 $160.00 05/24/17
A4927 MA 01 00 $14.52 04/20/17
A4927 MA 04 00 $14.52 04/20/17
A4930 MA 01 00 $11.16 05/24/17
A4930 MA 04 00 $11.16 05/24/17
A6025 MA 01 00 $49.44 05/24/17
A6025 MA 04 00 $49.44 05/24/17
A6208 MA 01 00 $67.11 05/24/17
A6208 MA 04 00 $67.11 05/24/17
A6213 MA 01 00 $9.80 05/24/17
A6213 MA 04 00 $9.80 05/24/17
A6250 MA 01 00 $48.00 05/24/17
A6250 MA 04 00 $48.00 05/24/17
A6411 MA 01 00 $15.00 05/24/17
A6411 MA 04 00 $15.00 05/24/17
A6450 MA 01 00 $11.00 05/24/17
A6450 MA 04 00 $11.00 05/24/17
A6451 MA 01 00 $1.99 05/24/17
A6451 MA 04 00 $1.99 05/24/17
A6530 MA 01 00 $70.00 05/24/17
A6530 MA 04 00 $70.00 05/24/17
A6533 MA 01 00 $58.97 05/24/17
A6533 MA 04 00 $58.97 05/24/17
A6534 MA 01 00 $67.50 05/24/17
A6534 MA 04 00 $67.50 05/24/17
A6536 MA 01 00 $89.99 05/24/17
A6536 MA 04 00 $89.99 05/24/17
A6537 MA 01 00 $100.00 05/24/17
A6537 MA 04 00 $100.00 05/24/17
A6539 MA 01 00 $155.00 05/24/17
A6539 MA 04 00 $155.00 05/24/17
A6540 MA 01 00 $140.00 05/24/17
A6540 MA 04 00 $140.00 05/24/17
A9274 MA 01 00 $45.00 04/20/17
A9274 MA 04 00 $45.00 04/20/17
A9276 MA 01 00 $19.00 05/24/17
A9276 MA 04 00 $19.00 05/24/17
A9277 MA 01 00 $999.00 05/24/17
A9277 MA 04 00 $999.00 05/24/17
A9282 MA 01 00 $2,000.00 05/24/17
A9282 MA 04 00 $2,000.00 05/24/17
A9500 MA 01 00 $540.00 04/20/17
A9500 MA 04 00 $250.00 05/24/17
A9502 MA 01 00 $444.60 04/20/17
A9502 MA 04 00 $185.00 05/24/17
A9503 MA 01 00 $160.00 04/20/17 $137.00 09/02/15
A9503 MA 04 00 $132.00 05/24/17
A9505 MA 01 00 $31.74 05/24/17
A9505 MA 04 00 $31.74 05/24/17
A9507 MA 01 00 $3,244.35 05/24/17
A9507 MA 04 00 $3,244.35 05/24/17
A9510 MA 01 00 $167.00 05/24/17 $118.62 09/03/15
A9510 MA 04 00 $167.00 04/20/17
A9512 MA 01 00 $99.00 05/24/17
A9512 MA 04 00 $89.00 05/24/17
A9516 MA 01 00 $478.74 05/24/17
A9516 MA 04 00 $68.45 05/24/17
A9517 MA 01 00 $33.31 05/24/17
A9517 MA 04 00 $33.31 05/24/17
A9521 MA 01 00 $567.61 05/24/17
A9521 MA 04 00 $567.61 05/24/17
A9530 MA 01 00 $28.91 05/24/17
A9530 MA 04 00 $28.91 05/24/17
A9537 MA 01 00 $324.00 05/24/17 $266.00 09/03/15
A9537 MA 04 00 $59.54 05/24/17
A9538 MA 01 00 $24.70 05/24/17
A9538 MA 04 00 $24.70 05/24/17
A9539 MA 01 00 $93.00 05/24/17
A9539 MA 04 00 $16.25 05/24/17
A9540 MA 01 00 $566.67 04/20/17
A9540 MA 04 00 $95.90 05/24/17
A9541 MA 01 00 $632.00 04/20/17
A9541 MA 04 00 $75.35 05/24/17
A9542 MA 01 00 $2,769.63 05/24/17
A9542 MA 04 00 $2,769.63 05/24/17
A9551 MA 01 00 $126.63 05/24/17
A9551 MA 04 00 $126.63 05/24/17
A9552 MA 01 00 $1,101.00 04/20/17
A9552 MA 04 00 $900.00 04/20/17
A9556 MA 01 00 $32.04 05/24/17
A9556 MA 04 00 $32.04 05/24/17
A9558 MA 01 00 $191.50 05/24/17
A9558 MA 04 00 $38.96 05/24/17
A9560 MA 01 00 $114.00 05/24/17
A9560 MA 04 00 $114.00 05/24/17
A9561 MA 01 00 $34.56 05/24/17
A9561 MA 04 00 $34.56 05/24/17
A9562 MA 01 00 $1,076.51 04/20/17
A9562 MA 04 00 $445.51 05/24/17
A9582 MA 01 00 $6,050.00 05/24/17
A9582 MA 04 00 $6,050.00 05/24/17
A9584 MA 01 00 $5,010.00 05/24/17
A9584 MA 04 00 $5,010.00 05/24/17
A9600 MA 01 00 $1,014.13 05/24/17
A9600 MA 04 00 $1,014.13 05/24/17
B4100 MA 01 00 $4.26 02/16/16
B4100 MA 04 00 $4.26 02/16/16
B4102 MA 01 00 $250.00 05/24/17
B4102 MA 04 00 $250.00 05/24/17
B4103 MA 01 00 $7.89 05/24/17
B4103 MA 04 00 $7.89 05/24/17
B4157 MA 01 00 $3.50 05/24/17
B4157 MA 04 00 $3.50 05/24/17
B4158 MA 01 00 $20.00 05/24/17 $2.30 09/16/15
B4158 MA 04 00 $20.00 05/24/17 $2.30 09/16/15
B4160 MA 01 00 $12.74 05/24/17
B4160 MA 04 00 $12.74 05/24/17
B4161 MA 01 00 $29.05 05/24/17
B4161 MA 04 00 $29.05 05/24/17
B4162 MA 01 00 $8.47 05/24/17
B4162 MA 04 00 $8.47 05/24/17
B4172 MA 01 00 $195.00 05/24/17
B4172 MA 04 00 $195.00 05/24/17
B5200 MA 01 00 $4.94 05/24/17
B5200 MA 04 00 $4.94 05/24/17
C1713 MA 01 00 $1,107.06 05/24/17
C1713 MA 04 00 $1,107.06 05/24/17
C1717 MA 01 00 $834.00 05/24/17
C1717 MA 04 00 $834.00 05/24/17
C1725 MA 01 00 $1,064.00 05/24/17
C1725 MA 04 00 $1,064.00 05/24/17
C1726 MA 01 00 $2,542.00 05/24/17
C1726 MA 04 00 $2,542.00 05/24/17
C1729 MA 01 00 $738.15 05/24/17
C1729 MA 04 00 $738.15 05/24/17
C1730 MA 01 00 $1,665.00 05/24/17 $1,198.88 09/17/15
C1730 MA 04 00 $1,665.00 05/24/17 $1,198.88 09/17/15
C1731 MA 01 00 $2,821.50 05/24/17
C1731 MA 04 00 $2,821.50 05/24/17
C1732 MA 01 00 $5,400.00 05/24/17
C1732 MA 04 00 $5,400.00 05/24/17
C1733 MA 01 00 $1,600.00 05/24/17
C1733 MA 04 00 $1,600.00 05/24/17
C1751 MA 01 00 $720.00 05/24/17
C1751 MA 04 00 $720.00 05/24/17
C1758 MA 01 00 $366.62 05/24/17
C1758 MA 04 00 $366.62 05/24/17
C1759 MA 01 00 $6,250.00 05/24/17
C1759 MA 04 00 $6,250.00 05/24/17
C1760 MA 01 00 $1,146.00 05/24/17
C1760 MA 04 00 $1,146.00 05/24/17
C1762 MA 01 00 $4,964.60 05/24/17
C1762 MA 04 00 $4,964.60 05/24/17
C1763 MA 01 00 $8,580.01 05/24/17
C1763 MA 04 00 $8,580.01 05/24/17
C1766 MA 01 00 $2,600.00 05/24/17
C1766 MA 04 00 $2,600.00 05/24/17
C1767 MA 01 00 $28,930.60 05/24/17
C1767 MA 04 00 $28,930.60 05/24/17
C1769 MA 01 00 $422.00 05/24/17
C1769 MA 04 00 $422.00 05/24/17
C1770 MA 01 00 $602.00 05/24/17
C1770 MA 04 00 $602.00 05/24/17
C1771 MA 01 00 $2,801.00 05/24/17
C1771 MA 04 00 $2,801.00 05/24/17
C1776 MA 01 00 $4,489.10 05/24/17
C1776 MA 04 00 $4,489.10 05/24/17
C1778 MA 01 00 $10,810.48 05/24/17
C1778 MA 04 00 $10,810.48 05/24/17
C1780 MA 01 00 $843.76 05/24/17
C1780 MA 04 00 $843.76 05/24/17
C1781 MA 01 00 $1,099.00 05/24/17 $878.63 09/21/15
C1781 MA 04 00 $1,099.00 05/24/17 $878.63 09/21/15
C1785 MA 01 00 $17,926.00 05/24/17
C1785 MA 04 00 $17,926.00 05/24/17
C1788 MA 01 00 $1,977.50 05/24/17
C1788 MA 04 00 $1,977.50 05/24/17
C1789 MA 01 00 $1,750.00 05/24/17
C1789 MA 04 00 $1,750.00 05/24/17
C1820 MA 01 00 $38,750.00 05/24/17
C1820 MA 04 00 $38,750.00 05/24/17
C1874 MA 01 00 $5,600.00 05/24/17 $6,143.00 09/21/15
C1874 MA 04 00 $5,600.00 05/24/17 $6,143.00 09/21/15
C1876 MA 01 00 $4,938.00 05/24/17
C1876 MA 04 00 $4,938.00 05/24/17
C1877 MA 01 00 $3,386.00 05/24/17
C1877 MA 04 00 $3,386.00 05/24/17
C1887 MA 01 00 $583.03 05/24/17
C1887 MA 04 00 $583.03 05/24/17
C1892 MA 01 00 $300.00 05/24/17
C1892 MA 04 00 $300.00 05/24/17
C1893 MA 01 00 $315.00 05/24/17
C1893 MA 04 00 $315.00 05/24/17
C1894 MA 01 00 $255.00 05/24/17 $183.00 09/22/15
C1894 MA 04 00 $255.00 05/24/17 $183.00 09/22/15
C1897 MA 01 00 $66.50 05/24/17
C1897 MA 04 00 $66.50 05/24/17
C2617 MA 01 00 $583.03 05/24/17
C2617 MA 04 00 $583.03 05/24/17
C2618 MA 01 00 $2,522.00 05/24/17
C2618 MA 04 00 $2,522.00 05/24/17
C2625 MA 01 00 $1,780.00 05/24/17
C2625 MA 04 00 $1,780.00 05/24/17
C2630 MA 01 00 $7,623.00 05/24/17
C2630 MA 04 00 $7,623.00 05/24/17
C2639 MA 01 00 $162.00 05/24/17
C2639 MA 04 00 $162.00 05/24/17
C8906 MA 01 00 $3,592.00 05/24/17
C8906 MA 04 00 $3,592.00 05/24/17
C8908 MA 01 00 $5,264.00 05/24/17
C8908 MA 04 00 $4,675.17 05/24/17
C8928 MA 01 00 $2,721.00 05/24/17
C8928 MA 04 00 $2,721.00 05/24/17
C8929 MA 01 00 $1,334.00 05/24/17
C8929 MA 04 00 $1,334.00 05/24/17
C8957 MA 01 00 $206.00 05/24/17
C8957 MA 04 00 $206.00 05/24/17
C9113 MA 01 00 $22.07 05/24/17
C9113 MA 04 00 $22.07 05/24/17
C9285 MA 01 00 $32.00 05/24/17
C9285 MA 04 00 $32.00 05/24/17
C9600 MA 01 00 $24,278.00 05/24/17
C9600 MA 04 00 $24,278.00 05/24/17
D0120 MA 01 00 $75.00 05/24/17
D0120 MA 04 00 $35.00 05/24/17
D0140 MA 01 00 $132.00 05/24/17
D0140 MA 04 00 $99.86 05/24/17
D0150 MA 01 00 $111.21 04/20/17
D0150 MA 04 00 $111.21 04/20/17
D0210 MA 01 00 $172.09 05/24/17
D0210 MA 04 00 $172.09 05/24/17
D0220 MA 01 00 $40.00 05/24/17 $37.66 09/23/15
D0220 MA 04 00 $37.66 05/24/17
D0230 MA 01 00 $30.96 05/24/17
D0230 MA 04 00 $30.96 05/24/17
D0272 MA 01 00 $53.00 05/24/17
D0272 MA 04 00 $53.00 05/24/17
D0274 MA 01 00 $80.26 05/24/17
D0274 MA 04 00 $80.26 05/24/17
D0330 MA 01 00 $160.65 04/20/17
D0330 MA 04 00 $142.44 05/24/17
D0340 MA 01 00 $168.00 05/24/17
D0340 MA 04 00 $168.00 05/24/17
D0470 MA 01 00 $148.18 05/24/17
D0470 MA 04 00 $148.18 05/24/17
D1110 MA 01 00 $114.81 04/20/17
D1110 MA 04 00 $101.00 05/24/17
D1120 MA 01 00 $82.00 05/24/17
D1120 MA 04 00 $82.00 05/24/17
D1206 MA 01 00 $63.86 04/20/17
D1206 MA 04 00 $63.86 04/20/17
D1351 MA 01 00 $343.90 05/24/17
D1351 MA 04 00 $343.90 05/24/17
D2330 MA 01 00 $200.70 05/24/17
D2330 MA 04 00 $200.70 05/24/17
D2391 MA 01 00 $250.00 05/24/17
D2391 MA 04 00 $250.00 05/24/17
D2392 MA 01 00 $245.00 05/24/17
D2392 MA 04 00 $245.00 05/24/17
D4341 MA 01 00 $328.72 05/24/17
D4341 MA 04 00 $328.72 05/24/17
D4910 MA 01 00 $188.75 05/24/17
D4910 MA 04 00 $188.75 05/24/17
D7140 MA 01 00 $405.00 04/20/17
D7140 MA 04 00 $225.00 05/24/17
D7210 MA 01 00 $457.00 04/20/17
D7210 MA 04 00 $260.00 05/24/17
D7220 MA 01 00 $584.00 05/24/17
D7220 MA 04 00 $584.00 05/24/17
D7230 MA 01 00 $600.00 04/20/17
D7230 MA 04 00 $385.00 05/24/17
D7240 MA 01 00 $750.00 04/20/17 $650.00 09/23/15
D7240 MA 04 00 $750.00 04/20/17
D7241 MA 01 00 $725.00 05/24/17
D7241 MA 04 00 $725.00 05/24/17
D7880 MA 01 00 $3,200.00 05/24/17
D7880 MA 04 00 $3,200.00 05/24/17
D7953 MA 01 00 $459.16 05/24/17
D7953 MA 04 00 $459.16 05/24/17
D8030 MA 01 00 $1,440.00 05/24/17
D8030 MA 04 00 $1,440.00 05/24/17
D8080 MA 01 00 $246.00 05/24/17
D8080 MA 04 00 $246.00 05/24/17
D9219 MA 01 00 $100.00 04/20/17
D9219 MA 04 00 $100.00 04/20/17
D9220 MA 01 00 $495.00 05/24/17
D9220 MA 04 00 $300.00 05/24/17
D9221 MA 01 00 $215.00 05/24/17 $205.00 09/24/15
D9221 MA 04 00 $175.00 05/24/17
D9223 MA 01 00 $300.00 04/20/17
D9223 MA 04 00 $300.00 04/20/17
D9230 MA 01 00 $100.00 05/24/17
D9230 MA 04 00 $100.00 05/24/17
D9241 MA 01 00 $500.00 05/24/17 $490.00 09/24/15
D9241 MA 04 00 $350.00 05/24/17
D9242 MA 01 00 $220.00 05/24/17 $214.00 09/24/15
D9242 MA 04 00 $214.00 05/24/17
D9243 MA 01 00 $375.00 04/20/17
D9243 MA 04 00 $375.00 04/20/17
D9610 MA 01 00 $88.00 04/20/17
D9610 MA 04 00 $88.00 04/20/17
D9940 MA 01 00 $696.00 05/24/17
D9940 MA 04 00 $696.00 05/24/17
E0190 MA 01 00 $57.12 05/24/17
E0190 MA 01 NU $57.12 05/24/17
E0190 MA 04 00 $57.12 05/24/17
E0190 MA 04 NU $57.12 05/24/17
E0240 MA 01 00 $3,395.00 05/24/17
E0240 MA 01 NU $3,395.00 05/24/17
E0240 MA 04 00 $3,395.00 05/24/17
E0240 MA 04 NU $3,395.00 05/24/17
E0245 MA 01 00 $100.88 05/24/17
E0245 MA 01 NU $100.88 05/24/17
E0245 MA 04 00 $100.88 05/24/17
E0245 MA 04 NU $100.88 05/24/17
E0246 MA 01 00 $63.00 02/16/16
E0246 MA 01 RR $5.25 02/16/16
E0246 MA 04 00 $63.00 02/16/16
E0246 MA 04 RR $5.25 02/16/16
E0352 MA 01 00 $45.53 05/24/17
E0352 MA 04 00 $45.53 05/24/17
E0425 MA 01 00 $295.00 05/24/17
E0425 MA 01 NU $295.00 05/24/17
E0425 MA 04 00 $295.00 05/24/17
E0425 MA 04 NU $295.00 05/24/17
E0430 MA 01 00 $275.00 05/24/17
E0430 MA 01 RR $22.92 05/24/17
E0430 MA 04 00 $275.00 05/24/17
E0430 MA 04 RR $22.92 05/24/17
E0435 MA 01 00 $3,700.00 05/24/17
E0435 MA 01 NU $3,700.00 05/24/17
E0435 MA 01 RR $308.33 05/24/17
E0435 MA 04 00 $3,700.00 05/24/17
E0435 MA 04 NU $3,700.00 05/24/17
E0435 MA 04 RR $308.33 05/24/17
E0440 MA 01 00 $3,706.50 05/24/17
E0440 MA 01 NU $3,706.50 05/24/17
E0440 MA 04 00 $3,706.50 05/24/17
E0440 MA 04 NU $3,706.50 05/24/17
E0445 MA 01 RR $1,282.31 04/20/17
E0445 MA 04 RR $1,282.31 04/20/17
E0455 MA 01 00 $2,750.00 05/24/17
E0455 MA 01 RR $229.17 05/24/17
E0455 MA 04 00 $2,750.00 05/24/17
E0455 MA 04 RR $229.17 05/24/17
E0486 MA 01 00 $3,150.00 05/24/17
E0486 MA 01 NU $3,150.00 05/24/17
E0486 MA 04 00 $3,150.00 05/24/17
E0486 MA 04 NU $3,150.00 05/24/17
E0603 MA 01 00 $335.00 05/24/17
E0603 MA 01 NU $335.00 05/24/17
E0603 MA 04 00 $335.00 05/24/17
E0603 MA 04 NU $335.00 05/24/17
E0604 MA 01 00 $100.00 05/24/17
E0604 MA 01 NU $100.00 05/24/17
E0604 MA 04 00 $100.00 05/24/17
E0604 MA 04 NU $100.00 05/24/17
E0619 MA 01 RR $776.16 04/20/17
E0619 MA 04 RR $776.16 04/20/17
E0700 MA 01 00 $32.00 05/24/17
E0700 MA 01 RR $2.67 05/24/17
E0700 MA 04 00 $32.00 05/24/17
E0700 MA 04 RR $2.67 05/24/17
E0710 MA 01 00 $12.00 05/24/17
E0710 MA 01 RR $1.00 05/24/17
E0710 MA 04 00 $12.00 05/24/17
E0710 MA 04 RR $1.00 05/24/17
E0970 MA 01 00 $68.00 05/24/17
E0970 MA 01 RR $5.67 05/24/17
E0970 MA 04 00 $68.00 05/24/17
E0970 MA 04 RR $5.67 05/24/17
E1086 MA 01 00 $850.00 05/24/17
E1086 MA 01 NU $850.00 05/24/17
E1086 MA 01 RR $70.83 05/24/17
E1086 MA 04 00 $850.00 05/24/17
E1086 MA 04 NU $850.00 05/24/17
E1086 MA 04 RR $70.83 05/24/17
E1089 MA 01 00 $783.00 05/24/17
E1089 MA 01 RR $65.25 05/24/17
E1089 MA 04 00 $783.00 05/24/17
E1089 MA 04 RR $65.25 05/24/17
E1090 MA 01 00 $880.00 05/24/17
E1090 MA 01 NU $880.00 05/24/17
E1090 MA 01 RR $73.33 05/24/17
E1090 MA 04 00 $880.00 05/24/17
E1090 MA 04 NU $880.00 05/24/17
E1090 MA 04 RR $73.33 05/24/17
E1130 MA 01 00 $535.00 05/24/17
E1130 MA 01 NU $535.00 05/24/17
E1130 MA 01 RR $44.58 05/24/17
E1130 MA 04 00 $535.00 05/24/17
E1130 MA 04 NU $535.00 05/24/17
E1130 MA 04 RR $44.58 05/24/17
E1140 MA 01 00 $750.00 05/24/17
E1140 MA 01 NU $750.00 05/24/17
E1140 MA 01 RR $192.19 05/24/17
E1140 MA 04 00 $750.00 05/24/17
E1140 MA 04 NU $750.00 05/24/17
E1140 MA 04 RR $192.19 05/24/17
E1250 MA 01 00 $783.00 05/24/17
E1250 MA 01 NU $783.00 05/24/17
E1250 MA 01 RR $65.25 05/24/17
E1250 MA 04 00 $783.00 05/24/17
E1250 MA 04 NU $783.00 05/24/17
E1250 MA 04 RR $65.25 05/24/17
E1260 MA 01 00 $885.00 05/24/17
E1260 MA 01 NU $885.00 05/24/17
E1260 MA 01 RR $73.75 05/24/17
E1260 MA 04 00 $885.00 05/24/17
E1260 MA 04 NU $885.00 05/24/17
E1260 MA 04 RR $73.75 05/24/17
E1285 MA 01 00 $1,500.00 05/24/17
E1285 MA 01 NU $1,500.00 05/24/17
E1285 MA 01 RR $125.00 05/24/17
E1285 MA 04 00 $1,500.00 05/24/17
E1285 MA 04 NU $1,500.00 05/24/17
E1285 MA 04 RR $125.00 05/24/17
E1290 MA 01 00 $1,500.00 05/24/17
E1290 MA 01 NU $1,500.00 05/24/17
E1290 MA 04 00 $1,500.00 05/24/17
E1290 MA 04 NU $1,500.00 05/24/17
E1353 MA 01 RR $4.33 05/24/17
E1353 MA 04 RR $4.33 05/24/17
E1355 MA 01 RR $3.50 05/24/17
E1355 MA 04 RR $3.50 05/24/17
E1610 MA 01 00 $400.00 05/24/17
E1610 MA 01 RR $33.33 05/24/17
E1610 MA 04 00 $400.00 05/24/17
E1610 MA 04 RR $33.33 05/24/17
E2512 MA 01 00 $1,585.00 05/24/17
E2512 MA 01 NU $1,585.00 05/24/17
E2512 MA 04 00 $1,585.00 05/24/17
E2512 MA 04 NU $1,585.00 05/24/17
E2617 MA 01 00 $1,536.00 05/24/17
E2617 MA 04 00 $1,536.00 05/24/17
G0155 MA 01 00 $48.75 02/16/16
G0155 MA 04 00 $48.75 02/16/16
G0176 MA 01 00 $379.00 04/20/17 $222.00 09/29/15
G0176 MA 04 00 $78.00 05/24/17
G0177 MA 01 00 $147.00 04/20/17
G0177 MA 04 00 $147.00 04/20/17
G0260 MA 01 00 $3,408.00 05/24/17
G0260 MA 04 00 $3,408.00 05/24/17
G0340 MA 01 00 $9,384.00 05/24/17
G0340 MA 04 00 $9,384.00 05/24/17
G0378 MA 01 00 $720.00 04/20/17
G0378 MA 04 00 $720.00 04/20/17
G0379 MA 01 00 $141.00 05/24/17
G0379 MA 04 00 $87.24 05/24/17
G0380 MA 01 00 $447.00 04/20/17
G0380 MA 04 00 $447.00 04/20/17
G0381 MA 01 00 $502.00 05/24/17
G0381 MA 04 00 $502.00 05/24/17
G0382 MA 01 00 $558.00 04/20/17
G0382 MA 04 00 $406.00 05/24/17
G0383 MA 01 00 $1,134.00 04/20/17
G0383 MA 04 00 $842.00 05/24/17
G0390 MA 01 00 $3,569.00 05/24/17
G0390 MA 04 00 $3,569.00 05/24/17
G0410 MA 01 00 $125.00 04/20/17
G0410 MA 04 00 $125.00 04/20/17
G0411 MA 01 00 $162.50 04/20/17 $105.00 09/30/15
G0411 MA 04 00 $162.50 04/20/17 $105.00 09/30/15
G0463 MA 01 00 $220.05 04/20/17 $165.00 09/30/15
G0463 MA 04 00 $220.05 04/20/17 $165.00 09/30/15
G8539 MA 01 00 $31.25 05/24/17
G8539 MA 04 00 $31.25 05/24/17
G8542 MA 01 00 $31.25 05/24/17
G8542 MA 04 00 $31.25 05/24/17
H0004 MA 01 00 $31.93 05/24/17
H0004 MA 04 00 $30.55 05/24/17
H0006 MA 01 00 $55.20 02/16/16
H0006 MA 04 00 $55.20 02/16/16
H0015 MA 01 00 $276.00 09/18/17 $467.00 02/24/16
H0015 MA 01 00 $276.00 09/18/17 $262.00 02/24/16
H0015 MA 01 00 $262.00 02/24/16
H0015 MA 04 00 $276.00 09/18/17 $150.00 02/24/16
H0015 MA 04 00 $276.00 09/18/17 $262.00 02/24/16
H0015 MA 04 00 $262.00 02/24/16
H0020 MA 01 00 $30.63 05/24/17
H0020 MA 04 00 $17.87 05/24/17
H0035 MA 01 00 $262.00 09/22/15 $248.00 01/03/14
H0035 MA 01 00 $276.00 09/18/17 $262.00 09/22/15
H0035 MA 04 00 $262.00 09/22/15 $248.00 01/03/14
H0035 MA 04 00 $276.00 09/18/17 $262.00 09/22/15
H0037 MA 01 00 $349.00 09/22/15 $331.00 01/03/14
H0037 MA 01 00 $368.00 09/18/17 $349.00 09/22/15
H0037 MA 04 00 $349.00 09/22/15 $331.00 01/03/14
H0037 MA 04 00 $368.00 09/18/17 $349.00 09/22/15
H2015 MA 01 00 $19.28 02/16/16
H2015 MA 04 00 $19.28 02/16/16
H2019 MA 01 00 $18.75 05/24/17
H2019 MA 04 00 $12.50 05/24/17
K0462 MA 01 RR $395.00 05/24/17
K0462 MA 04 RR $395.00 05/24/17
K0739 MA 01 00 $24.83 12/01/15 $24.30 12/19/13
K0739 MA 01 00 $25.48 01/24/18 $25.08 12/29/16
K0739 MA 04 00 $24.83 12/01/15 $24.30 12/19/13
K0739 MA 04 00 $25.48 01/24/18 $25.08 12/29/16
L3260 MA 01 00 $48.00 05/24/17 $43.08 09/30/15
L3260 MA 04 00 $48.00 05/24/17 $43.08 09/30/15
L3265 MA 01 00 $28.50 02/16/16
L3265 MA 04 00 $28.50 02/16/16
L4002 MA 01 00 $10.00 05/24/17
L4002 MA 04 00 $10.00 05/24/17
L4205 MA 01 00 $22.13 12/01/15 $21.66 12/19/13
L4205 MA 01 00 $22.71 01/24/18 $22.35 12/29/16
L4205 MA 04 00 $22.13 12/01/15 $21.66 12/19/13
L4205 MA 04 00 $22.71 01/24/18 $22.35 12/29/16
L7520 MA 01 00 $30.08 12/01/15 $29.43 12/19/13
L7520 MA 01 00 $30.87 01/24/18 $30.38 12/29/16
L7520 MA 04 00 $30.08 12/01/15 $29.43 12/19/13
L7520 MA 04 00 $30.87 01/24/18 $30.38 12/29/16
L8010 MA 01 00 $125.00 05/24/17
L8010 MA 04 00 $125.00 05/24/17
P9011 MA 01 00 $1,265.00 04/20/17
P9011 MA 04 00 $816.00 05/24/17
P9016 MA 01 00 $1,316.00 04/20/17
P9016 MA 04 00 $405.00 05/24/17
P9017 MA 01 00 $368.00 05/24/17
P9017 MA 04 00 $368.00 05/24/17
P9021 MA 01 00 $869.00 05/24/17
P9021 MA 04 00 $869.00 05/24/17
P9031 MA 01 00 $765.00 05/24/17
P9031 MA 04 00 $765.00 05/24/17
P9035 MA 01 00 $3,717.00 04/20/17
P9035 MA 04 00 $2,413.45 05/24/17
P9037 MA 01 00 $4,099.00 04/20/17 $3,801.00 10/01/15
P9037 MA 04 00 $2,032.00 05/24/17
P9040 MA 01 00 $1,511.00 04/20/17 $1,162.00 10/01/15
P9040 MA 04 00 $651.00 05/24/17
P9603 MA 01 00 $3.38 05/24/17
P9603 MA 04 00 $3.38 05/24/17
P9604 MA 01 00 $53.00 04/20/17
P9604 MA 04 00 $24.00 05/24/17
Q0081 MA 01 00 $109.52 05/24/17
Q0081 MA 04 00 $109.52 05/24/17
Q9951 MA 01 00 $55.00 05/24/17
Q9951 MA 04 00 $55.00 05/24/17
Q9953 MA 01 00 $181.35 05/24/17
Q9953 MA 04 00 $181.35 05/24/17
Q9954 MA 01 00 $3.62 05/24/17
Q9954 MA 04 00 $3.62 05/24/17
R0070 MA 01 00 $174.00 05/24/17
R0070 MA 04 00 $174.00 05/24/17
R0075 MA 01 00 $91.00 05/24/17
R0075 MA 04 00 $91.00 05/24/17
R0076 MA 01 00 $190.00 05/24/17
R0076 MA 04 00 $190.00 05/24/17
S0302 MA 01 00 $20.00 02/16/16
S0302 MA 04 00 $20.00 02/16/16
S1040 MA 01 00 $2,662.00 05/24/17
S1040 MA 04 00 $2,662.00 05/24/17
S5108 MA 01 00 $31.25 05/24/17
S5108 MA 04 00 $31.25 05/24/17
S5110 MA 01 00 $31.25 05/24/17
S5110 MA 04 00 $31.25 05/24/17
S5115 MA 01 00 $31.25 05/24/17
S5115 MA 04 00 $31.25 05/24/17
S9083 MA 01 00 $135.00 02/16/16
S9083 MA 04 00 $135.00 02/16/16
S9088 MA 01 00 $90.00 02/16/16
S9088 MA 04 00 $90.00 02/16/16
S9430 MA 01 00 $201.25 04/20/17
S9430 MA 04 00 $201.25 05/24/17
S9480 MA 01 00 $276.00 09/18/17 $262.00 02/24/16
S9480 MA 01 00 $262.00 02/24/16
S9480 MA 04 00 $276.00 09/18/17 $262.00 02/24/16
S9480 MA 04 00 $262.00 02/24/16
S9485 MA 01 00 $1,225.00 02/16/16
S9485 MA 04 00 $1,225.00 02/16/16
T1015 MA 01 00 $80.85 05/24/17
T1015 MA 04 00 $64.68 05/24/17
T1016 MA 01 00 $47.56 02/16/16 $46.53 08/14/14
T1016 MA 04 00 $46.53 02/16/16
T1024 MA 01 00 $155.16 05/24/17
T1024 MA 04 00 $77.58 05/24/17
T1027 MA 01 00 $30.00 05/24/17
T1027 MA 04 00 $7.23 05/24/17
T4537 MA 01 00 $25.50 02/16/16
T4537 MA 04 00 $25.50 02/16/16
T4541 MA 01 00 $.68 04/20/17
T4541 MA 04 00 $.68 04/20/17
V2781 MA 01 00 $85.00 05/24/17
V2781 MA 04 00 $85.00 05/24/17
V2785 MA 01 00 $4,827.00 05/24/17
V2785 MA 04 00 $4,827.00 05/24/17
V5060 MA 01 00 $3,000.00 05/24/17
V5060 MA 04 00 $3,000.00 05/24/17
V5140 MA 01 00 $6,000.00 04/20/17
V5140 MA 04 00 $6,000.00 04/20/17
V5257 MA 01 00 $3,370.00 05/24/17
V5257 MA 04 00 $3,370.00 05/24/17
V5261 MA 01 00 $6,800.00 05/24/17
V5261 MA 04 00 $6,800.00 05/24/17
V5264 MA 01 00 $130.00 05/24/17
V5264 MA 04 00 $130.00 05/24/17
V5266 MA 01 00 $1.70 05/24/17
V5266 MA 04 00 $1.70 05/24/17
V5267 MA 01 00 $250.00 05/24/17
V5267 MA 04 00 $250.00 05/24/17
V5275 MA 01 00 $50.00 05/24/17
V5275 MA 04 00 $50.00 05/24/17