| Item Number | Description | Schedule Fee |
|---|---|---|
| 13215 | Transfer of embryos or both ova and sperm to the uterus or fallopian tubes, excluding artificial insemination—only if rendered in connection with a service to which item 13200, 13201 or 13218 applies, being services rendered in one treatment cycle (Anaes.) |
$129.70 |
| Total: | $129.70 | |