Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Export CSV
Hospital

Kpc Promise Hospital Of Phoenix, Llc

Mesa, AZ · CCN 032006 · Rates published

981 distinct procedures filed
9 distinct payers
5,763 rate rows
2026-07-18 last MRF observed
Data quality

5,665 of 5,763 rate rows are consumer-grade (98.3%)

98 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
exceeds 10× this hospital's gross charge — excluded from medians 84
placeholder amount (≤ $0.02) — excluded from medians 9
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 5
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://phoenix.kpcph.com/wp-content/uploads/sites/5/2024/01/83-4169286_KPC-Promise-Hospital-of-Phoenix_standardcharges.csv
Found on page https://phoenix.kpcph.com/cms-price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-01
Content fingerprint ee1e244bce75a1b1… · 1,050,002 bytes · first seen 2026-06-16

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
50590
CPT 		Lithotripsy Unilateral 1 $10,967.25 $10,967.25 $10,967.25 nat. median
$4,399
outlier · 2.5×
36902
CPT 		Intro Ndl/cath Dial Cir W/ball 1 $7,297.50 $7,297.50 $7,297.50 nat. median
$6,597
1.1× median
36558
CPT 		Insrt Tnnld Cvc 1 $2,332.50 $6,438.73 $4,385.61 nat. median
$3,467
1.3× median
36556
CPT 		Cc-ins Nt Cvc Gt 5yr 1 $4,063.50 $4,063.50 $4,063.50 nat. median
$2,885
1.4× median
28291
CPT 		Corr Of Bunion W/impl 1st Mpj 1 $3,713.25 $3,713.25 $3,713.25 nat. median
$6,913
0.5× median
74176
CPT 		CT Abd & Pelvis Without Contrast 1 $3,600.00 $3,600.00 $3,600.00 nat. median
$333
outlier · 10.8×
74177
CPT 		CT Abd & Pelvis With Contrast 1 $3,490.50 $3,490.50 $3,490.50 nat. median
$501
outlier · 7.0×
15100
CPT 		Skin Splt Grft Trnk/arm/leg 1 $3,311.25 $3,311.25 $3,311.25 nat. median
$2,243
1.5× median
36901
CPT 		Intro Ndl/cath 1 $3,163.82 $3,163.82 $3,163.82 nat. median
$1,826
1.7× median
206
OTHER 		Room & Board High Observation 4 $2,362.50 $3,150.00 $3,150.00 nat. median
$2,808
1.1× median
28296
CPT 		Bunionectomy, Chevron 1 $3,131.25 $3,131.25 $3,131.25 nat. median
$3,714
0.8× median
32550
CPT 		Insert Cath Pleural W/cuff 1 $2,970.75 $2,970.75 $2,970.75 nat. median
$3,931
0.8× median
49406
CPT 		Image Cath Fluid Peri/retro 1 $2,812.50 $2,812.50 $2,812.50 nat. median
$1,917
1.5× median
74183
CPT 		Kidney, W/wo Contrast 1 $2,785.50 $2,785.50 $2,785.50 nat. median
$611
outlier · 4.6×
72158
CPT 		MRI Lumbar Spine W/wo Contrast 1 $2,628.75 $2,628.75 $2,628.75 nat. median
$616
outlier · 4.3×
72157
CPT 		MRI Thoracic Spine W/wo Cont 1 $2,628.75 $2,628.75 $2,628.75 nat. median
$624
outlier · 4.2×
70553
CPT 		MRI Brain Wo/w Contrast 1 $2,628.75 $2,628.75 $2,628.75 nat. median
$616
outlier · 4.3×
72156
CPT 		MRI Cervical Spine W/wo Cont 1 $2,628.75 $2,628.75 $2,628.75 nat. median
$625
outlier · 4.2×
90935
CPT 		Hemodialysis 7 $395.00 $2,475.00 $2,475.00 nat. median
$850
outlier · 2.9×
73723
CPT 		Lower Ext Joint Rt W/wo Cont 1 $2,456.25 $2,456.25 $2,456.25 nat. median
$756
outlier · 3.2×
73223
CPT 		MRI Left Upper Ext W/wo Cont 1 $2,443.50 $2,443.50 $2,443.50 nat. median
$757
outlier · 3.2×
75635
CPT 		CTA Abdominal Aorta W/runoff 1 $2,430.00 $2,430.00 $2,430.00 nat. median
$355
outlier · 6.8×
70549
CPT 		MRA Neck W/wo Contrast 1 $2,406.75 $2,406.75 $2,406.75 nat. median
$606
outlier · 4.0×
15734
CPT 		Muscle-skin Graft, Trunk 1 $2,381.25 $2,381.25 $2,381.25 nat. median
$3,867
0.6× median
43246
CPT 		Egd W/placement G-tube 1 $2,370.75 $2,370.75 $2,370.75 nat. median
$2,046
1.2× median
71552
CPT 		MRI Chest W/wo Contrast 1 $2,355.75 $2,355.75 $2,355.75 nat. median
$691
outlier · 3.4×
72197
CPT 		MRI Pelvis W/wo Contrast 1 $2,354.25 $2,354.25 $2,354.25 nat. median
$606
outlier · 3.9×
74178
CPT 		CT Abd & Pelvis W/wo Contrast 1 $2,343.00 $2,343.00 $2,343.00 nat. median
$539
outlier · 4.4×
58563
CPT 		Hysteroscopy Ablation 1 $2,246.25 $2,246.25 $2,246.25 nat. median
$5,302
outlier · 0.4×
95811
CPT 		Polysomnography With Cpap 1 $2,211.00 $2,211.00 $2,211.00 nat. median
$1,412
1.6× median
76498
CPT 		Carotid Artery 1 $2,097.75 $2,097.75 $2,097.75 nat. median
$110
outlier · 19.1×
31624
CPT 		Bronchoscopy Dx W/lavage 3 $1,556.25 $2,075.00 $2,075.00 nat. median
$2,076
1.0× median
93306
CPT 		Echo 2d W/spec/color Complete 1 $2,073.00 $2,073.00 $2,073.00 nat. median
$804
outlier · 2.6×
31622
CPT 		Bronch Dx W/fluoro/wash 2 $1,770.00 $2,360.00 $2,065.00 nat. median
$1,893
1.1× median
14301
CPT 		Skin Tiss Tran Any 30.1-60.0cm 1 $2,055.00 $2,055.00 $2,055.00 nat. median
$3,686
0.6× median
28090
CPT 		Exc Foot Lesion W/synovectomy 1 $2,022.75 $2,022.75 $2,022.75 nat. median
$1,866
1.1× median
58558
CPT 		Hysteroscopy W/biopsy 1 $2,017.50 $2,017.50 $2,017.50 nat. median
$3,316
0.6× median
74170
CPT 		CT Abdomen W/wo Contrast 1 $2,012.25 $2,012.25 $2,012.25 nat. median
$366
outlier · 5.5×
72146
CPT 		MRI Thoracic Spine Without Cont 1 $2,011.50 $2,011.50 $2,011.50 nat. median
$421
outlier · 4.8×
72148
CPT 		MRI Lumbar Spine Without Contrast 1 $2,011.50 $2,011.50 $2,011.50 nat. median
$408
outlier · 4.9×
72141
CPT 		CT Cervical Spine Without Contrast 1 $2,011.50 $2,011.50 $2,011.50 nat. median
$429
outlier · 4.7×
72126
CPT 		CT Cervical Spine W/contrast 1 $1,935.00 $1,935.00 $1,935.00 nat. median
$475
outlier · 4.1×
72133
CPT 		CT Lumbar Spine W/wo Cont 1 $1,933.50 $1,933.50 $1,933.50 nat. median
$346
outlier · 5.6×
70552
CPT 		MRI Brain With Contrast 1 $1,926.00 $1,926.00 $1,926.00 nat. median
$597
outlier · 3.2×
74181
CPT 		MRI Abdomen Without Contrast 1 $1,908.75 $1,908.75 $1,908.75 nat. median
$428
outlier · 4.5×
72132
CPT 		CT Lumbar Spine With Contrast 1 $1,899.00 $1,899.00 $1,899.00 nat. median
$475
outlier · 4.0×
128
OTHER 		Room & Board Rehab 8 $1,417.50 $1,890.00 $1,890.00 nat. median
$1,052
1.8× median
164
OTHER 		Room & Board Isolation 5 $1,417.50 $1,890.00 $1,890.00 nat. median
$102
outlier · 18.6×
28043
CPT 		Exc Foot/toe Tumor Sc <1.5cm 1 $1,875.00 $1,875.00 $1,875.00 nat. median
$1,969
1.0× median
95810
CPT 		Polysomnography 1 $1,852.50 $1,852.50 $1,852.50 nat. median
$1,446
1.3× median

Other procedures at this hospital

Browse this hospital's 981 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
100 OTHER All Incl R&b/anc 1 1 $1,600.00 $1,600.00 $1,200.00 $1,200.00 $1,200.00 2026-07-18
101 OTHER All Incl R&b 1 1 $1,300.00 $1,300.00 $975.00 $975.00 $975.00 2026-07-18
10121 CPT Remove Foreign Body,complicatd 1 1 $2,177.00 $2,177.00 $774.00 $774.00 $774.00 2026-07-18
10140 CPT I&d Hematoma/seroma/fluid Coll 1 1 $1,219.00 $1,219.00 $914.25 $914.25 $914.25 2026-07-18
10180 CPT I&d Complex Postop Wnd Infect 1 1 $2,177.00 $2,177.00 $1,632.75 $1,632.75 $1,632.75 2026-07-18
110 OTHER Room & Board Private 6 6 $1,890.00 $1,890.00 $1,181.25 $1,575.00 $1,575.00 2026-07-18
11043 CPT Debride Muscle/fascia 20 Sq Cm 1 1 $790.00 $790.00 $592.50 $592.50 $592.50 2026-07-18
11044 CPT Debride Bone 20 Sq Cm/< 1 1 $1,286.00 $1,286.00 $964.50 $964.50 $964.50 2026-07-18
11400 CPT Exc Trk/ext B9 Lesion.5cm/< 1 1 $1,192.00 $1,192.00 $894.00 $894.00 $894.00 2026-07-18
11403 CPT Exc Trnk/ext B9 2.1-3.0cm 1 1 $1,148.00 $1,148.00 $861.00 $861.00 $861.00 2026-07-18
11420 CPT Exc Lesn B Sclp <0.5cm 1 1 $837.00 $837.00 $627.75 $627.75 $627.75 2026-07-18
11426 CPT Exc Benign Lesions > 4.0cm 1 1 $2,374.00 $2,374.00 $1,780.50 $1,780.50 $1,780.50 2026-07-18
11750 CPT Exc Nail & Matrix 1 1 $1,525.00 $1,525.00 $1,143.75 $1,143.75 $1,143.75 2026-07-18
12020 CPT Dehiscense Clean Without Packing 1 1 $518.00 $518.00 $388.50 $388.50 $388.50 2026-07-18
128 OTHER Room & Board Rehab 8 8 $1,575.00 $1,575.00 $1,417.50 $1,890.00 $1,890.00 2026-07-18
14301 CPT Skin Tiss Tran Any 30.1-60.0cm 1 1 $1,507.00 $1,507.00 $2,055.00 $2,055.00 $2,055.00 2026-07-18
15002 CPT Prep Wnd Trk/arm/lg 1st 100cm 1 1 $1,339.00 $1,339.00 $1,004.25 $1,004.25 $1,004.25 2026-07-18
15003 CPT Prep Wnd Trk/arm/lg Add 100cm 1 1 $750.00 $750.00 $562.50 $562.50 $562.50 2026-07-18
15100 CPT Skin Splt Grft Trnk/arm/leg 1 1 $2,710.00 $2,710.00 $3,311.25 $3,311.25 $3,311.25 2026-07-18
15120 CPT Skn Splt A-grft Fac/nck/hf/g 1 1 $2,740.00 $2,740.00 $400.50 $400.50 $400.50 2026-07-18
15271 CPT Skn Sub Grft T/a/l 1st 25 Sq 1 1 $503.00 $503.00 $1,200.00 $1,200.00 $1,200.00 2026-07-18
15273 CPT Skin Sub Grft T/a/l 1st 100 Sq 1 1 $786.00 $786.00 $1,130.25 $1,130.25 $1,130.25 2026-07-18
15734 CPT Muscle-skin Graft, Trunk 1 1 $3,175.00 $3,175.00 $2,381.25 $2,381.25 $2,381.25 2026-07-18
164 OTHER Room & Board Isolation 5 5 $2,100.00 $2,100.00 $1,417.50 $1,890.00 $1,890.00 2026-07-18
200 OTHER Room & Board Intensive Care 2 2 $3,150.00 $3,150.00 $1,575.00 $2,100.00 $1,837.50 2026-07-18
201 OTHER Icu/surgical 1 1 $1,600.00 $1,600.00 $1,200.00 $1,200.00 $1,200.00 2026-07-18
206 OTHER Room & Board High Observation 4 4 $3,150.00 $3,150.00 $2,362.50 $3,150.00 $3,150.00 2026-07-18
219 OTHER Ccu/other 1 1 $1,800.00 $1,800.00 $1,350.00 $1,350.00 $1,350.00 2026-07-18
276 OTHER Med Supply-intraocular Lens 1 1 $375.00 $375.00 $281.25 $281.25 $281.25 2026-07-18
278 OTHER Tube Gastrost Replace Ponsky 29 2 $653.00 $653.00 $5.25 $4,215.75 $347.25 2026-07-18
28043 CPT Exc Foot/toe Tumor Sc <1.5cm 1 1 $2,500.00 $2,500.00 $1,875.00 $1,875.00 $1,875.00 2026-07-18
28090 CPT Exc Foot Lesion W/synovectomy 1 1 $2,697.00 $2,697.00 $2,022.75 $2,022.75 $2,022.75 2026-07-18
28120 CPT Part Excision Bone Ankle/heel 1 1 $2,243.00 $2,243.00 $1,682.25 $1,682.25 $1,682.25 2026-07-18
28291 CPT Corr Of Bunion W/impl 1st Mpj 1 1 $4,951.00 $4,951.00 $3,713.25 $3,713.25 $3,713.25 2026-07-18
28296 CPT Bunionectomy, Chevron 1 1 $4,175.00 $4,175.00 $3,131.25 $3,131.25 $3,131.25 2026-07-18
28308 CPT Osteotomy Oth Metatarsal 1 1 $1,393.00 $1,393.00 $1,044.75 $1,044.75 $1,044.75 2026-07-18
29445 CPT Apply Tot Contact Leg Cast 1 1 $392.00 $392.00 $294.00 $294.00 $294.00 2026-07-18
31500 CPT Intubation Endotrach Emergency 3 3 $600.00 $600.00 $450.00 $600.00 $600.00 2026-07-18
31525 CPT Laryngnoscopy Dx Except N-born 1 1 $1,404.00 $1,404.00 $1,053.00 $1,053.00 $1,053.00 2026-07-18
31622 CPT Bronch Dx W/fluoro/wash 2 2 $2,360.00 $2,360.00 $1,770.00 $2,360.00 $2,065.00 2026-07-18
31624 CPT Bronchoscopy Dx W/lavage 3 3 $2,075.00 $2,075.00 $1,556.25 $2,075.00 $2,075.00 2026-07-18
31635 CPT Bronchoscopy W/fb Removal 1 1 $1,425.00 $1,425.00 $1,068.75 $1,068.75 $1,068.75 2026-07-18
31645 CPT Bronchoscopy, Clear Airways 1 1 $783.00 $783.00 $587.25 $587.25 $587.25 2026-07-18
32550 CPT Insert Cath Pleural W/cuff 1 1 $3,961.00 $3,961.00 $2,970.75 $2,970.75 $2,970.75 2026-07-18
32551 CPT Chest Tube Insertion 1 1 $979.00 $979.00 $734.25 $734.25 $734.25 2026-07-18
32554 CPT Thoracentesis For Aspiration 1 1 $765.00 $765.00 $1,280.07 $1,280.07 $1,280.07 2026-07-18
360 OTHER Biopsy-skin/subq Addl Lesion 8 1 $1,497.00 $1,497.00 $93.75 $8,692.50 $1,122.75 2026-07-18
36200 CPT Aorta Cath Placement 1 1 $1,461.00 $1,461.00 $1,095.75 $1,095.75 $1,095.75 2026-07-18
36556 CPT Cc-ins Nt Cvc Gt 5yr 1 1 $5,418.00 $5,418.00 $4,063.50 $4,063.50 $4,063.50 2026-07-18
36558 CPT Insrt Tnnld Cvc 2 1 $5,847.49 $5,847.49 $2,332.50 $6,438.73 $4,385.61 2026-07-18
36569 CPT Insert Picc Cath 7 6 $1,190.00 $1,190.00 $892.50 $2,105.25 $1,190.00 2026-07-18
36901 CPT Intro Ndl/cath 1 1 $4,218.42 $4,218.42 $3,163.82 $3,163.82 $3,163.82 2026-07-18
36902 CPT Intro Ndl/cath Dial Cir W/ball 1 1 $9,730.00 $9,730.00 $7,297.50 $7,297.50 $7,297.50 2026-07-18
381 OTHER Packed Rbc 1 1 $1,017.00 $1,017.00 $762.75 $762.75 $762.75 2026-07-18
38220 CPT Bone Marrow, Aspiration Only 1 1 $374.00 $374.00 $280.50 $280.50 $280.50 2026-07-18
38221 CPT Bone Marrow Biopsy 1 1 $408.00 $408.00 $306.00 $306.00 $306.00 2026-07-18
384 OTHER Platelet Pack 3 1 $767.00 $767.00 $230.25 $928.50 $575.25 2026-07-18
413 OTHER Hyperbaric O2 15 Min (mcd) 2 1 $422.50 $422.50 $211.50 $422.25 $316.88 2026-07-18
43213 CPT Dilate Esophagus By Balloon 1 1 $721.00 $721.00 $540.75 $540.75 $540.75 2026-07-18
43235 CPT Egd Diagnostic Brush Wash 1 1 $2,014.00 $2,014.00 $1,510.50 $1,510.50 $1,510.50 2026-07-18
43246 CPT Egd W/placement G-tube 1 1 $3,161.00 $3,161.00 $2,370.75 $2,370.75 $2,370.75 2026-07-18
43251 CPT Upper Gi Endoscopy/operative 1 1 $1,435.00 $1,435.00 $447.00 $447.00 $447.00 2026-07-18
43260 CPT Ercp Diagnostic 1 1 $2,348.00 $2,348.00 $1,761.00 $1,761.00 $1,761.00 2026-07-18
43261 CPT Ercp W/biopsy; Single 1 1 $1,435.00 $1,435.00 $1,076.25 $1,076.25 $1,076.25 2026-07-18
43264 CPT Ercp W Remove Calculus 1 1 $1,026.00 $1,026.00 $769.50 $769.50 $769.50 2026-07-18
43265 CPT Ercp W Lithotripsy Any Method 1 1 $1,026.00 $1,026.00 $769.50 $769.50 $769.50 2026-07-18
43450 CPT Dilate Esophogus 1 1 $781.00 $781.00 $585.75 $585.75 $585.75 2026-07-18
43753 CPT Gastro Intubation Tx W/asp 1 1 $644.00 $644.00 $483.00 $483.00 $483.00 2026-07-18
44361 CPT Endoscopy Sm Intestine W/bx 1 1 $1,344.00 $1,344.00 $1,008.00 $1,008.00 $1,008.00 2026-07-18
44372 CPT Endoscopy Sm Bowel W/j Tube 1 1 $1,079.00 $1,079.00 $809.25 $809.25 $809.25 2026-07-18
444 OTHER Outside Services St Eval 1 1 $379.00 $379.00 $284.25 $284.25 $284.25 2026-07-18
45331 CPT Sigmoidoscopy W/biopsy 1 1 $1,184.00 $1,184.00 $918.75 $918.75 $918.75 2026-07-18
45378 CPT Colonoscopy Flexible Dx 1 1 $1,798.00 $1,798.00 $1,348.50 $1,348.50 $1,348.50 2026-07-18
45381 CPT Colonoscopy, Submucous Inj 1 1 $1,073.00 $1,073.00 $804.75 $804.75 $804.75 2026-07-18
45384 CPT Polipectomy By Cautery 1 1 $2,179.00 $2,179.00 $1,634.25 $1,634.25 $1,634.25 2026-07-18
45385 CPT Colonoscopy Legion Removal 1 1 $1,734.00 $1,734.00 $1,300.50 $1,300.50 $1,300.50 2026-07-18
460 OTHER Outside Srv Pulmonary Function 1 1 $2,103.00 $2,103.00 $1,577.25 $1,577.25 $1,577.25 2026-07-18
46946 CPT Hemorrhoid Ligation Multiple 1 1 $1,986.00 $1,986.00 $1,489.50 $1,489.50 $1,489.50 2026-07-18
47000 CPT Biopsy Of Liver, Needle 1 1 $1,059.00 $1,059.00 $794.25 $794.25 $794.25 2026-07-18
481 OTHER Cardiac Cath Lab Room Setup 1 1 $2,341.00 $2,341.00 $1,755.75 $1,755.75 $1,755.75 2026-07-18
49082 CPT Paracentesis Abdominal Initial 1 1 $594.00 $594.00 $445.50 $445.50 $445.50 2026-07-18
49406 CPT Image Cath Fluid Peri/retro 1 1 $3,750.00 $3,750.00 $2,812.50 $2,812.50 $2,812.50 2026-07-18
49446 CPT Chg G-tube To G-j Tube 1 1 $2,075.00 $2,075.00 $1,556.25 $1,556.25 $1,556.25 2026-07-18
50590 CPT Lithotripsy Unilateral 1 1 $14,623.00 $14,623.00 $10,967.25 $10,967.25 $10,967.25 2026-07-18
542 OTHER Ambulance Als 1 4 1 $388.00 $388.00 $9.00 $366.75 $291.00 2026-07-18
58558 CPT Hysteroscopy W/biopsy 1 1 $2,690.00 $2,690.00 $2,017.50 $2,017.50 $2,017.50 2026-07-18
58563 CPT Hysteroscopy Ablation 1 1 $2,995.00 $2,995.00 $2,246.25 $2,246.25 $2,246.25 2026-07-18
616 OTHER MRA Lower Ext W/wo Contrast 1 1 $1,414.00 $1,414.00 $1,060.50 $1,060.50 $1,060.50 2026-07-18
618 OTHER MRA Abd Wo/w Contrast 1 1 $1,760.00 $1,760.00 $1,320.00 $1,320.00 $1,320.00 2026-07-18
62322 CPT Inj Epidrl Subarac L/s Without Img 1 1 $603.00 $603.00 $452.25 $452.25 $452.25 2026-07-18
70150 CPT X-ray Exam Of Facial Bone 3+ V 1 1 $250.00 $250.00 $303.75 $303.75 $303.75 2026-07-18
70210 CPT X-ray Sinus 2-3 Views 1 1 $281.00 $281.00 $337.50 $337.50 $337.50 2026-07-18
70260 CPT Skull Complete 4+ Views 1 1 $534.00 $534.00 $817.50 $817.50 $817.50 2026-07-18
70332 CPT Arthrogram Tmj 1 1 $432.00 $432.00 $324.00 $324.00 $324.00 2026-07-18
70360 CPT X-ray Neck, Soft Tissue 1 1 $298.00 $298.00 $340.50 $340.50 $340.50 2026-07-18
70450 CPT CT Head Without Contrast 2 2 $1,725.00 $1,725.00 $1,293.75 $1,725.00 $1,509.38 2026-07-18
70460 CPT CT Head With Contrast 1 1 $1,859.00 $1,859.00 $1,394.25 $1,394.25 $1,394.25 2026-07-18
70470 CPT CT Head W/wo Contrast 1 1 $2,434.00 $2,434.00 $1,825.50 $1,825.50 $1,825.50 2026-07-18
70480 CPT CT Orbit/ear/fossa Without Contrast 1 1 $1,675.00 $1,675.00 $1,256.25 $1,256.25 $1,256.25 2026-07-18
70481 CPT CT Mastoids W/contrast 1 1 $2,006.00 $2,006.00 $1,504.50 $1,504.50 $1,504.50 2026-07-18
70482 CPT CT Mastoids W/wo Contrast 1 1 $1,910.00 $1,910.00 $1,432.50 $1,432.50 $1,432.50 2026-07-18
70486 CPT CT Maxillofacial Without Contrast 2 1 $2,194.00 $2,194.00 $39.20 $2,208.75 $1,123.98 2026-07-18
70487 CPT CT Maxillofacial W/contrast 2 1 $1,687.00 $1,687.00 $1,265.25 $1,337.25 $1,301.25 2026-07-18
70488 CPT CT Maxillofacial Wo/w Contrast 2 1 $1,783.00 $1,783.00 $78.40 $1,337.25 $707.82 2026-07-18
70490 CPT CT Soft Tissue Neck Without Cont 1 1 $1,843.00 $1,843.00 $1,382.25 $1,382.25 $1,382.25 2026-07-18
70491 CPT CT Soft Tissue Neck With Cont 1 1 $1,776.00 $1,776.00 $1,332.00 $1,332.00 $1,332.00 2026-07-18
70492 CPT CT Soft Tissue Neck W/wo Cont 1 1 $1,791.00 $1,791.00 $1,343.25 $1,343.25 $1,343.25 2026-07-18
70540 CPT MRA Neck Without Contrast 1 1 $2,286.00 $2,286.00 $1,714.50 $1,714.50 $1,714.50 2026-07-18
70544 CPT MRA Head Without Contrast 1 1 $1,604.00 $1,604.00 $1,203.00 $1,203.00 $1,203.00 2026-07-18
70547 CPT MRA Neck Without Contrast 1 1 $1,689.00 $1,689.00 $1,266.75 $1,266.75 $1,266.75 2026-07-18
70548 CPT MRA Neck W/contrast 1 1 $1,459.00 $1,459.00 $1,094.25 $1,094.25 $1,094.25 2026-07-18
70549 CPT MRA Neck W/wo Contrast 1 1 $3,209.00 $3,209.00 $2,406.75 $2,406.75 $2,406.75 2026-07-18
70551 CPT MRI Brain Without Contrast 1 1 $2,418.00 $2,418.00 $1,813.50 $1,813.50 $1,813.50 2026-07-18
70552 CPT MRI Brain With Contrast 1 1 $2,568.00 $2,568.00 $1,926.00 $1,926.00 $1,926.00 2026-07-18
70553 CPT MRI Brain Wo/w Contrast 1 1 $3,505.00 $3,505.00 $2,628.75 $2,628.75 $2,628.75 2026-07-18
710 OTHER Pacu 1st Hr 2 1 $665.00 $665.00 $457.50 $540.00 $498.75 2026-07-18
71045 CPT Xr Chest 1 View 2 1 $356.50 $356.50 $420.26 $1,431.79 $926.02 2026-07-18
71046 CPT Chest X-ray 2 View 2 1 $405.18 $405.18 $187.50 $452.25 $319.88 2026-07-18
71250 CPT CT Chest Without Contrast 1 1 $1,934.00 $1,934.00 $1,450.50 $1,450.50 $1,450.50 2026-07-18
71260 CPT CT Chest With Contrast 1 1 $1,980.00 $1,980.00 $1,485.00 $1,485.00 $1,485.00 2026-07-18
71270 CPT CT Chest W/wo Contrast 1 1 $2,160.00 $2,160.00 $1,620.00 $1,620.00 $1,620.00 2026-07-18
71275 CPT CT Angiography Chest 1 1 $1,490.00 $1,490.00 $1,117.50 $1,117.50 $1,117.50 2026-07-18
71550 CPT MRI Chest Without Contrast 1 1 $2,250.00 $2,250.00 $1,687.50 $1,687.50 $1,687.50 2026-07-18
71551 CPT MRI Chest With Contrast 1 1 $2,189.00 $2,189.00 $1,641.75 $1,641.75 $1,641.75 2026-07-18
71552 CPT MRI Chest W/wo Contrast 1 1 $3,141.00 $3,141.00 $2,355.75 $2,355.75 $2,355.75 2026-07-18
72040 CPT Cervical Spine, Ap & Lateral 2 1 $290.50 $290.50 $248.25 $633.75 $441.00 2026-07-18
72050 CPT Xr Cervical 2 View 1 1 $250.00 $250.00 $299.25 $299.25 $299.25 2026-07-18
72125 CPT CT Cervical Spine Without Contras 1 1 $2,003.00 $2,003.00 $1,502.25 $1,502.25 $1,502.25 2026-07-18
72126 CPT CT Cervical Spine W/contrast 1 1 $2,580.00 $2,580.00 $1,935.00 $1,935.00 $1,935.00 2026-07-18
72127 CPT CT Cervical Spine W/wo Dye 1 1 $2,187.00 $2,187.00 $1,640.25 $1,640.25 $1,640.25 2026-07-18
72128 CPT CT Thoracic Spine Without Contrast 1 1 $1,843.00 $1,843.00 $1,382.25 $1,382.25 $1,382.25 2026-07-18
72129 CPT CT Thoracic Spine With Contrast 1 1 $2,078.00 $2,078.00 $1,558.50 $1,558.50 $1,558.50 2026-07-18
72131 CPT CT Lumbar Spine Without Contrast 1 1 $2,067.00 $2,067.00 $1,550.25 $1,550.25 $1,550.25 2026-07-18
72132 CPT CT Lumbar Spine With Contrast 1 1 $2,532.00 $2,532.00 $1,899.00 $1,899.00 $1,899.00 2026-07-18
72133 CPT CT Lumbar Spine W/wo Cont 1 1 $2,578.00 $2,578.00 $1,933.50 $1,933.50 $1,933.50 2026-07-18
72141 CPT CT Cervical Spine Without Contrast 1 1 $2,682.00 $2,682.00 $2,011.50 $2,011.50 $2,011.50 2026-07-18
72142 CPT CT Cervical Spine With Contrast 1 1 $1,920.00 $1,920.00 $1,440.00 $1,440.00 $1,440.00 2026-07-18
72146 CPT MRI Thoracic Spine Without Cont 1 1 $2,682.00 $2,682.00 $2,011.50 $2,011.50 $2,011.50 2026-07-18
72147 CPT MRI Thoracic Spine With Contrast 1 1 $1,882.00 $1,882.00 $1,411.50 $1,411.50 $1,411.50 2026-07-18
72148 CPT MRI Lumbar Spine Without Contrast 1 1 $2,682.00 $2,682.00 $2,011.50 $2,011.50 $2,011.50 2026-07-18
72149 CPT MRI Lumbar Spine With Contrast 1 1 $2,267.00 $2,267.00 $1,700.25 $1,700.25 $1,700.25 2026-07-18
72156 CPT MRI Cervical Spine W/wo Cont 1 1 $3,505.00 $3,505.00 $2,628.75 $2,628.75 $2,628.75 2026-07-18
72157 CPT MRI Thoracic Spine W/wo Cont 1 1 $3,505.00 $3,505.00 $2,628.75 $2,628.75 $2,628.75 2026-07-18
72158 CPT MRI Lumbar Spine W/wo Contrast 1 1 $3,505.00 $3,505.00 $2,628.75 $2,628.75 $2,628.75 2026-07-18
72192 CPT CT Pelvis Without Contrast 1 1 $2,307.00 $2,307.00 $1,730.25 $1,730.25 $1,730.25 2026-07-18
72193 CPT CT Pelvis With Contrast 1 1 $2,037.00 $2,037.00 $1,527.75 $1,527.75 $1,527.75 2026-07-18
72194 CPT CT Pelvis W/wo Contrast 1 1 $2,172.00 $2,172.00 $1,629.00 $1,629.00 $1,629.00 2026-07-18
72195 CPT MRI Abd & Pelvis Without Contrast 1 1 $2,153.00 $2,153.00 $1,614.75 $1,614.75 $1,614.75 2026-07-18
72196 CPT MRI Pelvis With Contrast 1 1 $2,426.00 $2,426.00 $1,819.50 $1,819.50 $1,819.50 2026-07-18
72197 CPT MRI Pelvis W/wo Contrast 1 1 $3,139.00 $3,139.00 $2,354.25 $2,354.25 $2,354.25 2026-07-18
73060 CPT Xr Humerus 1 View 1 1 $250.00 $250.00 $299.25 $299.25 $299.25 2026-07-18
73115 CPT Arthrogram Wrist Right 1 1 $430.00 $430.00 $322.50 $322.50 $322.50 2026-07-18
73200 CPT CT Upper Ext Without Contrast 1 1 $1,574.00 $1,574.00 $1,180.50 $1,180.50 $1,180.50 2026-07-18
73201 CPT CT Upper Ext Without Contrast 1 1 $1,890.00 $1,890.00 $1,417.50 $1,417.50 $1,417.50 2026-07-18
73202 CPT CT Upper Ext W/wo Contrast 1 1 $1,944.00 $1,944.00 $1,458.00 $1,458.00 $1,458.00 2026-07-18
73218 CPT MRI Left Upper Ext Without Cont 1 1 $2,292.00 $2,292.00 $1,719.00 $1,719.00 $1,719.00 2026-07-18
73221 CPT MRI Right Upper Ext Without Cont 2 1 $2,306.00 $2,306.00 $1,076.25 $1,729.50 $1,402.88 2026-07-18
73222 CPT MRI Left Upper Ext With Contrast 1 1 $2,130.00 $2,130.00 $1,597.50 $1,597.50 $1,597.50 2026-07-18
73223 CPT MRI Left Upper Ext W/wo Cont 1 1 $3,258.00 $3,258.00 $2,443.50 $2,443.50 $2,443.50 2026-07-18
73503 CPT X-ray Exam Of Hips 5v 1 1 $250.00 $250.00 $281.25 $281.25 $281.25 2026-07-18
73525 CPT Arthrogram Hip, Right 1 1 $490.00 $490.00 $367.50 $367.50 $367.50 2026-07-18
73551 CPT Xr Femur 1 View 1 1 $322.00 $322.00 $333.75 $333.75 $333.75 2026-07-18
73560 CPT Xr Knee 1 View 6 2 $399.00 $399.00 $187.50 $469.00 $300.88 2026-07-18
73600 CPT Xr Ankle 1 View 2 1 $278.00 $278.00 $187.50 $486.75 $337.12 2026-07-18
73700 CPT CT Lower Ext Without Contrast 1 1 $1,661.00 $1,661.00 $1,245.75 $1,245.75 $1,245.75 2026-07-18
73701 CPT CT Lower Ext With Contrast 1 1 $1,556.00 $1,556.00 $1,167.00 $1,167.00 $1,167.00 2026-07-18
73702 CPT CT Lower Ext W/wo Contrast 1 1 $1,944.00 $1,944.00 $1,458.00 $1,458.00 $1,458.00 2026-07-18
73718 CPT Lower Extr Rt Without Contrast 1 1 $2,241.00 $2,241.00 $1,680.75 $1,680.75 $1,680.75 2026-07-18
73721 CPT Hip, Left 2 1 $2,236.00 $2,236.00 $1,492.50 $1,861.50 $1,677.00 2026-07-18
73722 CPT MRI Right Lower Ext With Cont 1 1 $1,990.00 $1,990.00 $1,492.50 $1,492.50 $1,492.50 2026-07-18
73723 CPT Lower Ext Joint Rt W/wo Cont 1 1 $3,275.00 $3,275.00 $2,456.25 $2,456.25 $2,456.25 2026-07-18
74018 CPT Xr Abdomen 1 View 2 1 $324.50 $324.50 $187.50 $420.26 $303.88 2026-07-18
74150 CPT CT Abdomen Without Contrast 1 1 $1,910.00 $1,910.00 $1,432.50 $1,432.50 $1,432.50 2026-07-18
74160 CPT CT Abdomen With Contrast 2 1 $2,170.00 $2,170.00 $1,473.00 $1,782.00 $1,627.50 2026-07-18
74170 CPT CT Abdomen W/wo Contrast 1 1 $2,683.00 $2,683.00 $2,012.25 $2,012.25 $2,012.25 2026-07-18
74176 CPT CT Abd & Pelvis Without Contrast 1 1 $4,800.00 $4,800.00 $3,600.00 $3,600.00 $3,600.00 2026-07-18
74177 CPT CT Abd & Pelvis With Contrast 1 1 $4,654.00 $4,654.00 $3,490.50 $3,490.50 $3,490.50 2026-07-18
74178 CPT CT Abd & Pelvis W/wo Contrast 1 1 $3,124.00 $3,124.00 $2,343.00 $2,343.00 $2,343.00 2026-07-18
74181 CPT MRI Abdomen Without Contrast 1 1 $2,545.00 $2,545.00 $1,908.75 $1,908.75 $1,908.75 2026-07-18
74182 CPT Kidney, W/contrast 1 1 $2,199.00 $2,199.00 $1,649.25 $1,649.25 $1,649.25 2026-07-18
74183 CPT Kidney, W/wo Contrast 1 1 $3,714.00 $3,714.00 $2,785.50 $2,785.50 $2,785.50 2026-07-18
74230 CPT Modified Barium Swallow Study 1 1 $473.00 $473.00 $354.75 $354.75 $354.75 2026-07-18
74425 CPT Nephrostogram 1 1 $512.00 $512.00 $384.00 $384.00 $384.00 2026-07-18
74455 CPT Xr Cystourethrogram Void S&i 1 1 $603.00 $603.00 $388.50 $388.50 $388.50 2026-07-18
750 OTHER Change Gastrostomy Tube 1 1 $585.00 $585.00 $438.75 $438.75 $438.75 2026-07-18
75557 CPT Cardiac For Morphology Without Con 1 1 $1,579.00 $1,579.00 $1,184.25 $1,184.25 $1,184.25 2026-07-18
75635 CPT CTA Abdominal Aorta W/runoff 1 1 $3,240.00 $3,240.00 $2,430.00 $2,430.00 $2,430.00 2026-07-18
75827 CPT Venogram Superior Vena Cava 4 4 $1,892.00 $1,892.00 $726.00 $968.00 $968.00 2026-07-18
75984 CPT Xr Change Tube/drainage Cath 8 8 $845.00 $845.00 $235.50 $314.00 $314.00 2026-07-18
75989 CPT CT Abscess Drainage Specimen 1 1 $1,693.00 $1,693.00 $1,269.75 $1,269.75 $1,269.75 2026-07-18
76380 CPT CT Abdomen Limited 1 1 $662.00 $662.00 $496.50 $496.50 $496.50 2026-07-18
76498 CPT Carotid Artery 1 1 $2,797.00 $2,797.00 $2,097.75 $2,097.75 $2,097.75 2026-07-18
76506 CPT US Encephalogram 1 1 $293.00 $293.00 $867.75 $867.75 $867.75 2026-07-18
76604 CPT US Chest 1 1 $387.00 $387.00 $342.00 $342.00 $342.00 2026-07-18
76700 CPT Abdominal Ultrasound, Complete 1 1 $987.00 $987.00 $740.25 $740.25 $740.25 2026-07-18
76705 CPT Abdominal Ultrasound, Limited 2 1 $642.00 $642.00 $438.00 $525.00 $481.50 2026-07-18
76770 CPT US Abdomen, Multi Organ Comp 5 3 $624.00 $624.00 $141.00 $387.00 $290.25 2026-07-18
76775 CPT US Abdomen, Multi Organ Limitd 2 1 $758.00 $758.00 $219.75 $390.75 $305.25 2026-07-18
76800 CPT US Spinal Canal/contents 1 1 $301.00 $301.00 $401.25 $401.25 $401.25 2026-07-18
76811 CPT US OB Detailed Single Fetus 1 1 $582.00 $582.00 $318.00 $318.00 $318.00 2026-07-18
76856 CPT US Pelvic Complete (non Ob) 1 1 $826.00 $826.00 $459.75 $459.75 $459.75 2026-07-18
76857 CPT US Pelvic Limited (non Ob) 1 1 $424.00 $424.00 $585.00 $585.00 $585.00 2026-07-18
76872 CPT US Transrectal Prostate 1 1 $521.00 $521.00 $396.00 $396.00 $396.00 2026-07-18
76881 CPT Extremity Non Vasc With Document 2 1 $452.50 $452.50 $336.75 $553.50 $445.12 2026-07-18
76937 CPT US Guided Vasc Access 1 1 $322.00 $322.00 $619.50 $619.50 $619.50 2026-07-18
76942 CPT US Guided Needle Place S&i 1 1 $738.00 $738.00 $436.50 $436.50 $436.50 2026-07-18
77003 CPT Fluoroguide For Spine Inject 1 1 $625.00 $625.00 $468.75 $468.75 $468.75 2026-07-18
77012 CPT CT Scan Ndle Guide Biop/aspir 1 1 $1,450.00 $1,450.00 $1,087.50 $1,087.50 $1,087.50 2026-07-18
78013 CPT Thyroid Scan Only, I123 1 1 $451.00 $451.00 $1,137.00 $1,137.00 $1,137.00 2026-07-18
78070 CPT Parathyroid Scan 1 1 $1,373.00 $1,373.00 $1,029.75 $1,029.75 $1,029.75 2026-07-18
78205 CPT Hemangioma W/spect 1 1 $1,290.00 $1,290.00 $967.50 $967.50 $967.50 2026-07-18
78215 CPT Nm Liver And Spleen 1 1 $1,317.00 $1,317.00 $987.75 $987.75 $987.75 2026-07-18
78226 CPT Hepatobiliary Image (gb) 1 1 $1,652.00 $1,652.00 $1,239.00 $1,239.00 $1,239.00 2026-07-18
78264 CPT Gastric Emptying Study 1 1 $1,669.00 $1,669.00 $1,251.75 $1,251.75 $1,251.75 2026-07-18
78278 CPT Acute Gi Blood Loss Imaging 1 1 $1,289.00 $1,289.00 $966.75 $966.75 $966.75 2026-07-18
78300 CPT Bone Scan 1 1 $1,462.00 $1,462.00 $1,096.50 $1,096.50 $1,096.50 2026-07-18
78306 CPT Bone Scan, Whole Body 1 1 $1,879.00 $1,879.00 $1,409.25 $1,409.25 $1,409.25 2026-07-18
78315 CPT Bone Scan, 3-phase 1 1 $2,047.00 $2,047.00 $1,535.25 $1,535.25 $1,535.25 2026-07-18
78320 CPT Bone Spect Scan 1 1 $1,690.00 $1,690.00 $1,267.50 $1,267.50 $1,267.50 2026-07-18
78454 CPT Nm Myocardial Perfusmultiple S 2 1 $2,543.00 $2,543.00 $40.50 $1,907.25 $973.88 2026-07-18
78472 CPT Gated Heart Planar Single 2 1 $1,389.00 $1,389.00 $17.25 $1,041.75 $529.50 2026-07-18
78579 CPT Lung Vent Aero 1 1 $1,415.00 $1,415.00 $1,061.25 $1,061.25 $1,061.25 2026-07-18
78580 CPT Lung Scan, Perfusion 1 1 $1,094.00 $1,094.00 $820.50 $820.50 $820.50 2026-07-18
78582 CPT Lung Scan Vent/perfusion Image 1 1 $1,214.00 $1,214.00 $910.50 $910.50 $910.50 2026-07-18
78607 CPT Brain Spect 1 1 $1,177.00 $1,177.00 $882.75 $882.75 $882.75 2026-07-18
78630 CPT Cysternogram 1 1 $1,436.00 $1,436.00 $1,077.00 $1,077.00 $1,077.00 2026-07-18
78701 CPT Renal Flow 2 2 $2,583.00 $2,583.00 $998.25 $1,331.00 $1,164.62 2026-07-18
78708 CPT Renal Scan W/lasix 1 1 $1,500.00 $1,500.00 $349.50 $349.50 $349.50 2026-07-18
78709 CPT Nm Kidney W Flow & Function Mu 2 1 $1,663.00 $1,663.00 $1,125.00 $1,247.25 $1,186.12 2026-07-18
78803 CPT Nm Tumor Localize Spect 1 1 $2,140.00 $2,140.00 $1,605.00 $1,605.00 $1,605.00 2026-07-18
78805 CPT Indium Abscess Ltd Area 1 1 $1,559.00 $1,559.00 $1,169.25 $1,169.25 $1,169.25 2026-07-18
78806 CPT Abcess Imaging Whole Body 1 1 $2,082.00 $2,082.00 $1,561.50 $1,561.50 $1,561.50 2026-07-18
78999 CPT Nm Radiopharm Unlisted Proc 1 1 $379.00 $379.00 $284.25 $284.25 $284.25 2026-07-18
80053 CPT Cmp 8 8 $415.00 $415.00 $311.25 $415.00 $415.00 2026-07-18
80069 CPT Renal Function Panel 1 1 $236.00 $236.00 $1,247.25 $1,247.25 $1,247.25 2026-07-18
80074 CPT Hepatitis Acute Panel 1 1 $406.00 $406.00 $304.50 $304.50 $304.50 2026-07-18
84311 CPT Spectrophotometry, Analate 1 1 $248.00 $248.00 $469.50 $469.50 $469.50 2026-07-18
86352 CPT Cell Function Assay W/stim 1 1 $380.00 $380.00 $285.00 $285.00 $285.00 2026-07-18
86609 CPT Teichoic Acid Antibody 8 8 $171.00 $171.00 $337.50 $450.00 $450.00 2026-07-18
86800 CPT Thyroglobulin Antibody 1 1 $71.00 $71.00 $338.25 $338.25 $338.25 2026-07-18
86999 CPT Cryoprecipitate Thaw 1 1 $525.00 $525.00 $393.75 $393.75 $393.75 2026-07-18
87154 CPT Gram Negative Bacteria Biofire 3 1 $1,403.60 $1,403.60 $18.75 $1,263.24 $1,052.70 2026-07-18
87497 CPT Cytomegalovirus DNA Quant 1 1 $398.00 $398.00 $298.50 $298.50 $298.50 2026-07-18
87556 CPT M.tuberculo,dna, Amp Probe 1 1 $377.00 $377.00 $282.75 $282.75 $282.75 2026-07-18
87798 CPT Infectious Agt Amp Probe 2 1 $279.00 $279.00 $209.25 $1,194.03 $701.64 2026-07-18
88248 CPT Chromosome Count Fragile X 100 1 1 $403.00 $403.00 $302.25 $302.25 $302.25 2026-07-18
88309 CPT Gross & Microsc Level Vi 1 1 $541.00 $541.00 $405.75 $405.75 $405.75 2026-07-18
90870 CPT Electroconvulsive Therapy 1 1 $1,305.00 $1,305.00 $978.75 $978.75 $978.75 2026-07-18
90935 CPT Hemodialysis 7 7 $2,475.00 $2,475.00 $395.00 $2,475.00 $2,475.00 2026-07-18
90945 CPT Inp Peritoneal Dialysis 2 2 $1,600.00 $1,600.00 $1,200.00 $1,600.00 $1,400.00 2026-07-18
91010 CPT Esophogeal Motility W/report 1 1 $1,037.00 $1,037.00 $777.75 $777.75 $777.75 2026-07-18
91110 CPT Gi Tract Endoscopy W Report 1 1 $1,830.00 $1,830.00 $1,372.50 $1,372.50 $1,372.50 2026-07-18
91122 CPT Anorectal Manometry 1 1 $864.00 $864.00 $648.00 $648.00 $648.00 2026-07-18
92506 CPT St Eval Augmentative Comm 1 1 $379.00 $379.00 $285.00 $285.00 $285.00 2026-07-18
92522 CPT St Eval Speech Production 1 1 $270.00 $270.00 $383.25 $383.25 $383.25 2026-07-18
92585 CPT Auditory Evoke Potent 1 1 $900.00 $900.00 $675.00 $675.00 $675.00 2026-07-18
92607 CPT St Eval Speech Device Rx 1hr 5 5 $194.00 $194.00 $498.00 $664.00 $664.00 2026-07-18
92609 CPT St Augmentative Comm Tx 15 Min 7 6 $145.00 $145.00 $9.72 $428.00 $428.00 2026-07-18
92950 CPT Cardiopulmonary Resuscitation 3 3 $945.00 $945.00 $708.75 $945.00 $945.00 2026-07-18
92960 CPT Cardioversion Electv External 1 1 $1,232.00 $1,232.00 $924.00 $924.00 $924.00 2026-07-18
92961 CPT Cardioversion Electv Internal 1 1 $1,243.00 $1,243.00 $932.25 $932.25 $932.25 2026-07-18
93226 CPT Holter Scan Analysis 24 Hr 1 1 $381.00 $381.00 $285.75 $285.75 $285.75 2026-07-18
93303 CPT Echo, Transthoracic Complete 1 1 $1,292.00 $1,292.00 $969.00 $969.00 $969.00 2026-07-18
93304 CPT Echocardiogram 1 1 $908.00 $908.00 $681.00 $681.00 $681.00 2026-07-18
93306 CPT Echo 2d W/spec/color Complete 1 1 $2,764.00 $2,764.00 $2,073.00 $2,073.00 $2,073.00 2026-07-18
93307 CPT Echo 2d W M-mode & Color Flow 2 1 $1,244.00 $1,244.00 $835.50 $1,030.50 $933.00 2026-07-18
93308 CPT Echo 2d W/without M-mode Ltd 1 1 $805.00 $805.00 $603.75 $603.75 $603.75 2026-07-18
93312 CPT Echo Tee Complete W Pro Fee 1 1 $1,684.00 $1,684.00 $1,263.00 $1,263.00 $1,263.00 2026-07-18
93314 CPT Echo Tee Image With Pro Fee 1 1 $589.00 $589.00 $441.75 $441.75 $441.75 2026-07-18
93320 CPT Cardiac Doppler 2 1 $942.00 $942.00 $382.50 $1,030.50 $706.50 2026-07-18
93325 CPT Echo Color Flow Velocity Mapp 2 1 $476.50 $476.50 $272.25 $442.50 $357.38 2026-07-18
93350 CPT Dobutamine Stress Echo 1 1 $1,088.00 $1,088.00 $816.00 $816.00 $816.00 2026-07-18
93880 CPT Carotid Duplex Scan, Complete 3 1 $815.00 $815.00 $375.00 $887.25 $611.25 2026-07-18
93882 CPT Carotid Ultrasound 1 1 $901.00 $901.00 $675.75 $675.75 $675.75 2026-07-18
93922 CPT Ankle/brachial Indices 1 1 $481.00 $481.00 $360.75 $360.75 $360.75 2026-07-18
93923 CPT Arterial Indirect Upper/lower 1 1 $593.00 $593.00 $444.75 $444.75 $444.75 2026-07-18
93925 CPT Arterial Ultrasound, Lower Ext 2 1 $954.00 $954.00 $648.00 $783.00 $715.50 2026-07-18
93926 CPT Duplx Arterial Lwr Ext Uni/ltd 1 1 $1,009.00 $1,009.00 $756.75 $756.75 $756.75 2026-07-18
93930 CPT Arterial Ultrasound, Upper Ext 2 1 $1,059.50 $1,059.50 $806.25 $1,001.25 $903.75 2026-07-18
93971 CPT Duplex Venous Extrem Unilaterl 2 1 $845.00 $845.00 $541.50 $1,125.00 $833.25 2026-07-18
93976 CPT Doppler, Abdomen, Limited Sty 1 1 $615.00 $615.00 $461.25 $461.25 $461.25 2026-07-18
93978 CPT Duplex Aorta/ivc/graft Complte 1 1 $559.00 $559.00 $419.25 $419.25 $419.25 2026-07-18
93979 CPT Abdominal Aorta Ultrasound 1 1 $539.00 $539.00 $404.25 $404.25 $404.25 2026-07-18
94003 CPT Vent Management Subsq Day 10 6 $601.00 $601.00 $5.25 $1,300.00 $1,137.50 2026-07-18
95805 CPT Multi Latency Sleep Test 1 1 $1,565.00 $1,565.00 $1,173.75 $1,173.75 $1,173.75 2026-07-18
95810 CPT Polysomnography 1 1 $2,470.00 $2,470.00 $1,852.50 $1,852.50 $1,852.50 2026-07-18
95811 CPT Polysomnography With Cpap 1 1 $2,948.00 $2,948.00 $2,211.00 $2,211.00 $2,211.00 2026-07-18
95812 CPT Outside Srvcs EEG 1 1 $802.00 $802.00 $601.50 $601.50 $601.50 2026-07-18
95813 CPT EEG Portable 2 1 $1,600.00 $1,600.00 $281.25 $1,200.00 $740.62 2026-07-18
95816 CPT EEG Awake Drowsy 1 1 $850.00 $850.00 $637.50 $637.50 $637.50 2026-07-18
95819 CPT EEG Awake Asleep 1 1 $920.00 $920.00 $690.00 $690.00 $690.00 2026-07-18
95824 CPT Cerebral Death EEG 1 1 $513.00 $513.00 $384.75 $384.75 $384.75 2026-07-18
95861 CPT Electromyogram 2 Extremity 1 1 $390.00 $390.00 $292.50 $292.50 $292.50 2026-07-18
95864 CPT Electromyogram 4 Extremity 1 1 $403.00 $403.00 $302.25 $302.25 $302.25 2026-07-18
95930 CPT Evoked Potential Visual 1 1 $972.00 $972.00 $729.00 $729.00 $729.00 2026-07-18
97032 CPT St Electric Stim Attend 15min 8 6 $70.00 $70.00 $70.50 $297.00 $297.00 2026-07-18
97167 CPT Ot Eval High Complexity 60 Min 6 6 $300.00 $300.00 $225.00 $300.00 $300.00 2026-07-18
97607 CPT Neg Press Wnd Therapy < 50sqcm 1 1 $485.00 $485.00 $363.75 $363.75 $363.75 2026-07-18
99291 CPT Critical Care 30-74 Min 1 1 $1,851.00 $1,851.00 $1,388.25 $1,388.25 $1,388.25 2026-07-18
P9021 HCPCS Red Blood Cells, Each Unit 1 1 $298.00 $298.00 $438.75 $438.75 $438.75 2026-07-18
See an error in this hospital's data? Submit a correction