Hospital

DALLAS COUNTY MEDICAL CENTER

Fordyce, AR · CCN 041317 · Rates published

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You selected 93306 (HCPCS)

ECHOCARDIOGRAM COMPL

This hospital’s price: $459 across 12 payers · range $210-$570

Source: https://dallascountymedicalcenter.pg.quadax.revenuemasters.com/cdm-files/270029542_dallas-county-medical-center_standardcharges.csv · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

770 distinct procedures filed

14 distinct payers

28,740 rate rows

2026-07-15 last MRF observed

Data quality

17,781 of 28,740 rate rows are consumer-grade (61.9%)

10,959 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 — reason	Rows
per-diem day rate — not a per-procedure price	10,857
percent-of-charges filed in the dollar field — excluded from medians	67
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	22
exceeds 10× this hospital's gross charge — excluded from medians	13

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://dallascountymedicalcenter.pg.quadax.revenuemasters.com/cdm-files/270029542_dallas-county-medical-center_standardcharges.csv
Found on page	https://dallascountymedicalcenter.pg.quadax.revenuemasters.com/disclaimer?
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-20
Content fingerprint	d6bca5b916efe004… · 8,581,889 bytes · first seen 2026-05-09

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
J2505 HCPCS	Neulasta	11	$5,285.06	$10,120.32	$5,285.06	nat. median $6,279 0.8× median
15274 HCPCS	Ap Sknsub Ea Add 100	9	$462.00	$5,248.06	$4,197.98	nat. median $799 outlier · 5.3×
15273 HCPCS	Ap Sknsub Gr Lg100c	14	$1,302.00	$5,248.06	$4,197.98	nat. median $3,119 1.3× median
92977 HCPCS	Tnkase	11	$339.36	$4,807.45	$3,845.96	nat. median $488 outlier · 7.9×
C5274 HCPCS	Ap Sknsbs Tal>=100cmwadl 100cm	12	$462.00	$4,489.40	$2,637.52	nat. median $1,322 2.0× median
15272 HCPCS	Ap Skn Sub Ea Add 25	9	$462.00	$2,930.64	$2,344.46	nat. median $404 outlier · 5.8×
C5273 HCPCS	Ap Skn Sbs Tal>=100cmw1sr100cm	14	$620.00	$4,489.40	$2,344.46	nat. median $2,427 1.0× median
15271 HCPCS	Ap Sknsub Gr Lg25cm	14	$620.00	$2,930.64	$2,344.46	nat. median $1,725 1.4× median
15275 HCPCS	Ap Sknsub Ft 1st 25c	14	$620.00	$2,930.64	$2,344.46	nat. median $1,713 1.4× median
15276 HCPCS	Ap Sknsub Ft Eaad 25	9	$462.00	$2,930.64	$2,344.46	nat. median $373 outlier · 6.3×
0167 RC		3	$2,235.00	$2,277.00	$2,277.00	nat. median $854 outlier · 2.7×
0160 RC		2	$2,235.00	$2,277.00	$2,256.00	nat. median $858 outlier · 2.6×
0113 RC		2	$2,235.00	$2,277.00	$2,256.00	nat. median $898 outlier · 2.5×
0120 RC		2	$2,235.00	$2,277.00	$2,256.00	nat. median $986 outlier · 2.3×
11044 HCPCS	Debrid Skin Into Bon	14	$475.00	$2,375.74	$1,643.40	nat. median $1,752 0.9× median
74176 HCPCS	CT Abd/pelv W/ocont	14	$87.38	$1,720.32	$1,376.25	nat. median $694 2.0× median
74178 HCPCS	CT Abd/pelv W/wo Con	14	$155.01	$1,662.48	$1,329.98	nat. median $1,027 1.3× median
15277 HCPCS	Ap Sknsub Gr Ft1st	14	$620.00	$2,930.58	$1,325.04	nat. median $2,073 0.6× median
A2019 HCPCS	Kerecis Omega3 Shield 1 Sq Cm	11	$1,053.27	$2,016.90	$1,316.59	nat. median $573 outlier · 2.3×
32551 HCPCS	Chest Tube Placement	14	$445.29	$1,783.04	$1,309.42	nat. median $1,573 0.8× median
10140 HCPCS	I&d Hem,ser,fluid Co	14	$89.57	$1,623.53	$1,298.82	nat. median $1,660 0.8× median
11047 HCPCS	Debride Bone Eaaddl	9	$462.00	$1,569.21	$1,255.37	nat. median $948 1.3× median
Q4159 HCPCS	Affinity 1 Sq.cm	11	$930.60	$1,782.00	$1,163.25	nat. median $643 1.8× median
26742 HCPCS	Clsd Trmt Artclr Fract Finger	13	$603.08	$1,481.76	$1,130.35	nat. median $1,604 0.7× median
74177 HCPCS	CT Abd/pelv W Contrs	14	$155.01	$1,287.51	$1,030.01	nat. median $976 1.1× median
74170 HCPCS	CT Abdomen W&without Contrst	14	$75.19	$1,219.47	$975.58	nat. median $714 1.4× median
25260 HCPCS	Repair Ten/muscle	13	$767.98	$2,991.52	$959.98	nat. median $3,452 outlier · 0.3×
71270 HCPCS	Chest CT W&without Const	14	$75.19	$1,149.68	$919.74	nat. median $684 1.3× median
15278 HCPCS	Ap Sksb Ft Ea Ad 100	9	$462.00	$2,930.58	$876.00	nat. median $856 1.0× median
71250 HCPCS	CT Chest Without Cntrst	14	$45.83	$1,093.34	$874.67	nat. median $469 1.9× median
70470 HCPCS	Head CT W&without Cntrst	14	$75.19	$1,084.08	$867.27	nat. median $629 1.4× median
70492 HCPCS	CT Neck W&without Cntrst	14	$75.19	$1,056.91	$845.53	nat. median $650 1.3× median
73702 HCPCS	CT Lo Ex W&without Left	14	$75.19	$1,045.16	$836.13	nat. median $708 1.2× median
72194 HCPCS	CT Pelvis W&w/ocntr	14	$75.19	$1,007.56	$806.05	nat. median $672 1.2× median
70488 HCPCS	CT Facial W/wo Cont	14	$75.19	$985.53	$788.43	nat. median $639 1.2× median
C5272 HCPCS	Ap Sbs Skn Tal 100cm Adl 25cm	12	$462.00	$1,341.95	$788.40	nat. median $712 1.1× median
C5276 HCPCS	App Sjub Sub/ea Addl 25 Cm	12	$462.00	$1,341.95	$788.40	nat. median $700 1.1× median
G0379 HCPCS	Direct Obs Admit	13	$132.93	$1,648.00	$780.95	nat. median $568 1.4× median
72130 HCPCS	CT Tho Spine W/wo	14	$75.19	$970.55	$776.44	nat. median $604 1.3× median
72127 HCPCS	CT Serv Spine W/wocont	14	$75.19	$970.55	$776.44	nat. median $617 1.3× median
73202 HCPCS	CT Up Ex W&without Cont Lt	14	$75.19	$970.55	$776.44	nat. median $714 1.1× median
72131 HCPCS	CT Lumbar Spinew/o	14	$45.83	$944.11	$755.29	nat. median $460 1.6× median
99291 HCPCS	Critical Care 1st Hr	12	$596.43	$2,000.00	$745.54	nat. median $1,530 outlier · 0.5×
70450 HCPCS	Head CT Without Contrst	14	$45.83	$917.79	$734.23	nat. median $454 1.6× median
72128 HCPCS	CT Thor Spine Without	14	$45.83	$903.58	$722.86	nat. median $462 1.6× median
72192 HCPCS	CT Pelvis Without Cntrst	14	$45.83	$903.58	$722.86	nat. median $463 1.6× median
70482 HCPCS	CT Orbit/iac/sell W/woc	14	$75.19	$895.94	$716.75	nat. median $663 1.1× median
72133 HCPCS	CT Lumb Spine W+without	14	$75.19	$895.94	$716.75	nat. median $637 1.1× median
C5271 HCPCS	Ap Sbs Skn Tal 100cm 1st 25cm	14	$220.47	$1,341.95	$700.80	nat. median $1,017 0.7× median
C5275 HCPCS	Sbssknfshndftgen100cmw1st25cm	14	$220.47	$1,341.95	$700.80	nat. median $1,015 0.7× median

Other procedures at this hospital

Browse this hospital's 770 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J2505	HCPCS	Neulasta	11	11	$11,244.80	$11,244.80	$5,285.06	$10,120.32	$5,285.06	2026-07-15
15273	HCPCS	Ap Sknsub Gr Lg100c	30	14	$8,931.87	$8,931.87	$1,302.00	$5,248.06	$4,197.98	2026-07-15
15274	HCPCS	Ap Sknsub Ea Add 100	25	9	$8,931.87	$8,931.87	$462.00	$5,248.06	$4,197.98	2026-07-15
92977	HCPCS	Tnkase	11	11	$8,182.90	$8,182.90	$339.36	$4,807.45	$3,845.96	2026-07-15
C5274	HCPCS	Ap Sknsbs Tal>=100cmwadl 100cm	12	12	$4,988.22	$4,988.22	$462.00	$4,489.40	$2,637.52	2026-07-15
15272	HCPCS	Ap Skn Sub Ea Add 25	25	9	$4,988.22	$4,988.22	$462.00	$2,930.64	$2,344.46	2026-07-15
15271	HCPCS	Ap Sknsub Gr Lg25cm	30	14	$4,988.22	$4,988.22	$620.00	$2,930.64	$2,344.46	2026-07-15
C5273	HCPCS	Ap Skn Sbs Tal>=100cmw1sr100cm	14	14	$4,988.22	$4,988.22	$620.00	$4,489.40	$2,344.46	2026-07-15
15275	HCPCS	Ap Sknsub Ft 1st 25c	30	14	$4,988.22	$4,988.22	$620.00	$2,930.64	$2,344.46	2026-07-15
15276	HCPCS	Ap Sknsub Ft Eaad 25	25	9	$4,988.22	$4,988.22	$462.00	$2,930.64	$2,344.46	2026-07-15
0167	RC	—	3	3	$1.00	$1.00	$2,235.00	$2,277.00	$2,277.00	2026-07-15
0113	RC	—	2	2	—	—	$2,235.00	$2,277.00	$2,256.00	2026-07-15
0160	RC	—	2	2	$764.00	$764.00	$2,235.00	$2,277.00	$2,256.00	2026-07-15
0120	RC	—	2	2	$576.00	$576.00	$2,235.00	$2,277.00	$2,256.00	2026-07-15
11044	HCPCS	Debrid Skin Into Bon	22	14	$3,040.00	$3,040.00	$475.00	$2,375.74	$1,643.40	2026-07-15
74176	HCPCS	CT Abd/pelv W/ocont	14	14	$2,928.20	$2,928.20	$87.38	$1,720.32	$1,376.25	2026-07-15
74178	HCPCS	CT Abd/pelv W/wo Con	14	14	$2,829.75	$2,829.75	$155.01	$1,662.48	$1,329.98	2026-07-15
15277	HCPCS	Ap Sknsub Gr Ft1st	22	14	$4,988.22	$4,988.22	$620.00	$2,930.58	$1,325.04	2026-07-15
A2019	HCPCS	Kerecis Omega3 Shield 1 Sq Cm	11	11	$2,241.00	$2,241.00	$1,053.27	$2,016.90	$1,316.59	2026-07-15
32551	HCPCS	Chest Tube Placement	14	14	$2,786.00	$2,786.00	$445.29	$1,783.04	$1,309.42	2026-07-15
10140	HCPCS	I&d Hem,ser,fluid Co	14	14	$2,763.45	$2,763.45	$89.57	$1,623.53	$1,298.82	2026-07-15
11047	HCPCS	Debride Bone Eaaddl	9	9	$2,671.00	$2,671.00	$462.00	$1,569.21	$1,255.37	2026-07-15
Q4159	HCPCS	Affinity 1 Sq.cm	11	11	$1,980.00	$1,980.00	$930.60	$1,782.00	$1,163.25	2026-07-15
26742	HCPCS	Clsd Trmt Artclr Fract Finger	13	13	$2,405.00	$2,405.00	$603.08	$1,481.76	$1,130.35	2026-07-15
74177	HCPCS	CT Abd/pelv W Contrs	14	14	$2,191.50	$2,191.50	$155.01	$1,287.51	$1,030.01	2026-07-15
74170	HCPCS	CT Abdomen W&without Contrst	14	14	$2,075.70	$2,075.70	$75.19	$1,219.47	$975.58	2026-07-15
25260	HCPCS	Repair Ten/muscle	13	13	$1,634.00	$1,634.00	$767.98	$2,991.52	$959.98	2026-07-15
71270	HCPCS	Chest CT W&without Const	14	14	$1,956.90	$1,956.90	$75.19	$1,149.68	$919.74	2026-07-15
15278	HCPCS	Ap Sksb Ft Ea Ad 100	17	9	$4,988.22	$4,988.22	$462.00	$2,930.58	$876.00	2026-07-15
71250	HCPCS	CT Chest Without Cntrst	14	14	$1,861.00	$1,861.00	$45.83	$1,093.34	$874.67	2026-07-15
70470	HCPCS	Head CT W&without Cntrst	14	14	$1,845.25	$1,845.25	$75.19	$1,084.08	$867.27	2026-07-15
70492	HCPCS	CT Neck W&without Cntrst	14	14	$1,799.00	$1,799.00	$75.19	$1,056.91	$845.53	2026-07-15
73702	HCPCS	CT Lo Ex W&without Left	28	14	$1,779.00	$1,779.00	$75.19	$1,045.16	$836.13	2026-07-15
72194	HCPCS	CT Pelvis W&w/ocntr	14	14	$1,715.00	$1,715.00	$75.19	$1,007.56	$806.05	2026-07-15
70488	HCPCS	CT Facial W/wo Cont	14	14	$1,677.50	$1,677.50	$75.19	$985.53	$788.43	2026-07-15
C5276	HCPCS	App Sjub Sub/ea Addl 25 Cm	12	12	$1,491.06	$1,491.06	$462.00	$1,341.95	$788.40	2026-07-15
C5272	HCPCS	Ap Sbs Skn Tal 100cm Adl 25cm	12	12	$1,491.06	$1,491.06	$462.00	$1,341.95	$788.40	2026-07-15
G0379	HCPCS	Direct Obs Admit	13	13	$1,661.60	$1,661.60	$132.93	$1,648.00	$780.95	2026-07-15
73202	HCPCS	CT Up Ex W&without Cont Lt	28	14	$1,652.00	$1,652.00	$75.19	$970.55	$776.44	2026-07-15
72130	HCPCS	CT Tho Spine W/wo	14	14	$1,652.00	$1,652.00	$75.19	$970.55	$776.44	2026-07-15
72127	HCPCS	CT Serv Spine W/wocont	14	14	$1,652.00	$1,652.00	$75.19	$970.55	$776.44	2026-07-15
72131	HCPCS	CT Lumbar Spinew/o	14	14	$1,607.00	$1,607.00	$45.83	$944.11	$755.29	2026-07-15
99291	HCPCS	Critical Care 1st Hr	12	12	$1,269.00	$1,269.00	$596.43	$2,000.00	$745.54	2026-07-15
70450	HCPCS	Head CT Without Contrst	14	14	$1,562.20	$1,562.20	$45.83	$917.79	$734.23	2026-07-15
72192	HCPCS	CT Pelvis Without Cntrst	14	14	$1,538.00	$1,538.00	$45.83	$903.58	$722.86	2026-07-15
72128	HCPCS	CT Thor Spine Without	14	14	$1,538.00	$1,538.00	$45.83	$903.58	$722.86	2026-07-15
70482	HCPCS	CT Orbit/iac/sell W/woc	14	14	$1,525.00	$1,525.00	$75.19	$895.94	$716.75	2026-07-15
72133	HCPCS	CT Lumb Spine W+without	14	14	$1,525.00	$1,525.00	$75.19	$895.94	$716.75	2026-07-15
C5275	HCPCS	Sbssknfshndftgen100cmw1st25cm	14	14	$1,491.06	$1,491.06	$220.47	$1,341.95	$700.80	2026-07-15
C5277	HCPCS	Ssfdhndftgeb>=100cmw 1st100cm	14	14	$1,491.06	$1,491.06	$220.47	$1,341.95	$700.80	2026-07-15
C5271	HCPCS	Ap Sbs Skn Tal 100cm 1st 25cm	14	14	$1,491.06	$1,491.06	$220.47	$1,341.95	$700.80	2026-07-15
70481	HCPCS	CT Orbit/iac/sellaw Co	14	14	$1,467.40	$1,467.40	$75.19	$862.10	$689.68	2026-07-15
72193	HCPCS	CT Pelvis W/cntrst	14	14	$1,461.00	$1,461.00	$75.19	$858.34	$686.67	2026-07-15
70491	HCPCS	CT Neck W/contrast	14	14	$1,461.00	$1,461.00	$75.19	$858.34	$686.67	2026-07-15
74160	HCPCS	CT Abdomenw/cntrst	14	14	$1,461.00	$1,461.00	$75.19	$858.34	$686.67	2026-07-15
72129	HCPCS	CT Thoracic Spine With	14	14	$1,461.00	$1,461.00	$75.19	$858.34	$686.67	2026-07-15
10121	HCPCS	Rem Fb Comp Sq&incsn	13	13	$1,447.00	$1,447.00	$494.68	$1,500.80	$680.09	2026-07-15
74150	HCPCS	CT Abdomen Without Cntrst	14	14	$1,398.00	$1,398.00	$45.83	$821.33	$657.06	2026-07-15
11045	HCPCS	Debride Sub Tisea A	18	10	$1,095.00	$1,095.00	$462.00	$860.40	$643.31	2026-07-15
Q4196	HCPCS	Puraply Am 1.6	22	11	$1,038.00	$1,038.00	$320.07	$1,255.50	$634.27	2026-07-15
35207	HCPCS	Repair Bld Ves-finger/hand	13	13	$1,072.49	$1,072.49	$504.07	$3,028.48	$630.09	2026-07-15
73201	HCPCS	CT Upper Ex W Cont Left	28	14	$1,401.00	$1,401.00	$127.25	$962.78	$626.98	2026-07-15
72126	HCPCS	CT C-sp W/contrast	14	14	$1,334.00	$1,334.00	$96.13	$962.78	$626.98	2026-07-15
72132	HCPCS	CT Lumbar W/contrast	14	14	$1,334.00	$1,334.00	$96.13	$962.78	$626.98	2026-07-15
73701	HCPCS	CT Lo Ex With Cont Lt	28	14	$1,334.00	$1,334.00	$75.19	$783.73	$626.98	2026-07-15
74174	HCPCS	CTA ABD/Pel W/wo Cont.	22	14	$2,191.50	$2,191.50	$155.01	$1,287.51	$616.88	2026-07-15
73700	HCPCS	CT Lo Ex Without Cont Lt	28	14	$1,301.00	$1,301.00	$45.83	$764.34	$611.47	2026-07-15
73200	HCPCS	CT Upper Ex Rt Without	28	14	$1,365.60	$1,365.60	$45.83	$840.24	$611.47	2026-07-15
99285	HCPCS	Level V	23	12	$1,294.00	$1,294.00	$372.76	$1,800.00	$608.18	2026-07-15
99284	HCPCS	Level IV	13	13	$1,035.00	$1,035.00	$110.00	$1,698.00	$608.06	2026-07-15
16030	HCPCS	Dres/debr Burn Large	22	14	$1,132.20	$1,132.20	$145.50	$1,623.53	$598.65	2026-07-15
70490	HCPCS	CT Neck Without Contrast	14	14	$1,260.80	$1,260.80	$45.83	$740.72	$592.58	2026-07-15
72125	HCPCS	CT Cervcl Spinew/o	14	14	$1,257.30	$1,257.30	$45.83	$738.66	$590.93	2026-07-15
23675	HCPCS	Red Shoulder Dislocat W Fract	13	13	$985.00	$985.00	$462.95	$1,481.76	$578.69	2026-07-15
26665	HCPCS	Open Txfx/disl Thumb	13	13	$979.00	$979.00	$460.13	$2,991.52	$575.16	2026-07-15
11043	HCPCS	Debrid Skin Into Mus	22	14	$1,029.25	$1,029.25	$220.47	$860.40	$573.94	2026-07-15
70460	HCPCS	Head-CT W/contrast	14	14	$1,220.00	$1,220.00	$75.19	$716.75	$573.40	2026-07-15
75635	HCPCS	CTA Femoral Runoff	13	13	$1,220.00	$1,220.00	$174.94	$716.75	$573.40	2026-07-15
70487	HCPCS	CT Facial W Contrast	14	14	$1,207.00	$1,207.00	$75.19	$709.11	$567.29	2026-07-15
71260	HCPCS	CT Chest W/cntrst	14	14	$1,173.70	$1,173.70	$75.19	$689.55	$551.64	2026-07-15
70480	HCPCS	CT Orbit/iac/sellawo C	14	14	$1,146.20	$1,146.20	$45.83	$673.39	$538.71	2026-07-15
11446	HCPCS	Excision Benign>4.0	13	13	$911.00	$911.00	$428.17	$2,534.56	$535.21	2026-07-15
11057	HCPCS	Pair/cut Over 4lesn	14	14	$1,132.20	$1,132.20	$54.88	$665.17	$532.13	2026-07-15
11055	HCPCS	Pair/cut Sngl Lesion	12	12	$1,132.20	$1,132.20	$191.52	$665.17	$532.13	2026-07-15
16000	HCPCS	Intl Trt 1st Dgburn	12	12	$1,132.20	$1,132.20	$191.52	$665.17	$532.13	2026-07-15
11056	HCPCS	Pair/cut 2-4 Lesions	12	12	$1,132.20	$1,132.20	$191.52	$665.17	$532.13	2026-07-15
70486	HCPCS	Facial CT Without Contr	22	14	$1,040.00	$1,040.00	$45.83	$673.42	$513.77	2026-07-15
16025	HCPCS	Dres/debr Burn Med	22	14	$1,132.20	$1,132.20	$75.60	$665.17	$507.94	2026-07-15
71275	HCPCS	CT Chest (pe Protocol)	22	14	$1,173.70	$1,173.70	$75.19	$689.55	$483.20	2026-07-15
11046	HCPCS	Debr Musfas Ea Addl	9	9	$995.00	$995.00	$462.00	$584.56	$467.65	2026-07-15
25605	HCPCS	Closd Reduction Radius/ulna Fx	13	13	$794.00	$794.00	$373.18	$1,481.76	$466.48	2026-07-15
70498	HCPCS	CTA Carotids	14	14	$990.00	$990.00	$75.19	$581.63	$465.30	2026-07-15
70496	HCPCS	CTA Head	14	14	$990.00	$990.00	$75.19	$581.63	$465.30	2026-07-15
Q4160	HCPCS	Nushield 1.6 Disc	22	11	$804.75	$804.75	$180.95	$1,102.05	$461.01	2026-07-15
93306	HCPCS	Echocardiogram Compl	12	12	$971.00	$971.00	$210.00	$570.46	$459.36	2026-07-15
11760	HCPCS	Nailbed Repair	21	13	$356.00	$356.00	$103.77	$569.20	$455.36	2026-07-15
0361	RC	—	22	11	$837.50	$837.50	$346.63	$843.75	$440.63	2026-07-15
11042	HCPCS	Debrid Skin Fulthkn	31	14	$932.34	$932.34	$35.25	$665.17	$438.20	2026-07-15
97608	HCPCS	Npwt Tx > 50 C	11	11	$932.34	$932.34	$306.74	$547.75	$438.20	2026-07-15
97607	HCPCS	Npwt Tx 1/=50 S	11	11	$932.34	$932.34	$306.74	$547.75	$438.20	2026-07-15
54670	HCPCS	Rp Lac Testicles/scr	13	13	$719.00	$719.00	$337.93	$1,936.48	$422.41	2026-07-15
97606	HCPCS	Ng Pre Wd Thy>or=50s	11	11	$895.00	$895.00	$306.74	$525.81	$420.65	2026-07-15
97605	HCPCS	Ng Pre Wd Thy,or=50s	11	11	$895.00	$895.00	$167.75	$525.81	$420.65	2026-07-15
97598	HCPCS	Ac Wn C Sel >or=20sq	27	9	$895.00	$895.00	$37.60	$584.56	$420.65	2026-07-15
29581	HCPCS	Multilayer Cmp Appli	14	14	$895.00	$895.00	$55.70	$525.81	$420.65	2026-07-15
M0245	HCPCS	Bamlanivimab	2	2	—	—	$385.00	$385.00	$385.00	2026-07-15
27842	HCPCS	Cl Red Dis/an/ane ER	13	13	$647.25	$647.25	$304.21	$1,481.76	$380.26	2026-07-15
57010	HCPCS	I&d Vag Abcess	13	13	$632.60	$632.60	$297.32	$2,730.56	$371.65	2026-07-15
45378	HCPCS	Colonoscopy	14	14	$694.50	$694.50	$326.42	$835.52	$371.04	2026-07-15
74430	HCPCS	Cystography	12	12	$617.00	$617.00	$289.99	$962.78	$362.49	2026-07-15
73706	HCPCS	CTA Lower Ext Unilateral	14	14	$765.00	$765.00	$75.19	$467.02	$359.55	2026-07-15
26645	HCPCS	Cl Fx/thumb W/manip	13	13	$610.00	$610.00	$286.70	$1,481.76	$358.38	2026-07-15
93880	HCPCS	U/s Duplex Cartoid	11	11	$762.00	$762.00	$223.73	$447.68	$358.14	2026-07-15
25248	HCPCS	Fb Remove, F/arm(er)	13	13	$608.32	$608.32	$285.91	$1,481.76	$357.39	2026-07-15
10160	HCPCS	Pun Asp Abc (er)	22	14	$135.35	$135.35	$63.61	$547.75	$349.44	2026-07-15
Q4158	HCPCS	Kerecis Omega3 Marigen 1 Sq Cm	13	13	$594.00	$594.00	$142.56	$2,090.88	$348.98	2026-07-15
99215	HCPCS	Est Pt Vt Levelv	11	11	$731.00	$731.00	$145.47	$429.46	$343.57	2026-07-15
29445	HCPCS	Application Of Ridid Cast Tcc	14	14	$711.78	$711.78	$48.88	$462.00	$334.54	2026-07-15
24300	HCPCS	Clsd Redt Elboww An	13	13	$569.35	$569.35	$267.59	$1,481.76	$334.49	2026-07-15
73206	HCPCS	CTA Upper Ext Unilateral	14	14	$710.00	$710.00	$75.19	$467.02	$333.70	2026-07-15
M0243	HCPCS	Casirivi & Imdevi Infusion	11	11	$707.00	$707.00	$30.00	$415.36	$332.29	2026-07-15
99283	HCPCS	Level Iii	24	13	$716.00	$716.00	$110.00	$739.00	$327.11	2026-07-15
27562	HCPCS	Clsd Redctn Patella W Anes	13	13	$689.50	$689.50	$86.76	$405.08	$324.07	2026-07-15
23665	HCPCS	Cl Shd Red W Fractur	13	13	$551.05	$551.05	$258.99	$1,481.76	$323.74	2026-07-15
23655	HCPCS	Cl/tr/sh Manp/wanes	13	13	$549.00	$549.00	$258.03	$1,481.76	$322.54	2026-07-15
93925	HCPCS	Du Art Bil Low Extre	11	11	$677.00	$677.00	$223.73	$397.74	$318.19	2026-07-15
74175	HCPCS	CTA Kidney/renal	14	14	$675.00	$675.00	$75.19	$467.02	$317.25	2026-07-15
17250	HCPCS	Chem Cautr Grantiss	12	12	$670.45	$670.45	$191.52	$462.00	$315.11	2026-07-15
29580	HCPCS	Applction Unna Boot	13	13	$670.45	$670.45	$34.68	$393.89	$315.11	2026-07-15
43239	HCPCS	Egd W Biopsy Sin/mul	14	14	$535.00	$535.00	$251.45	$859.04	$314.31	2026-07-15
99205	HCPCS	New Pt Vst Level V	11	11	$664.10	$664.10	$164.48	$390.16	$312.13	2026-07-15
37212	HCPCS	Inj Fee Tpa Admin	13	13	$530.41	$530.41	$249.29	$3,028.48	$311.62	2026-07-15
75820	HCPCS	Venogram Ext.unilat	12	12	$520.00	$520.00	$244.40	$3,676.58	$305.50	2026-07-15
36430	HCPCS	Blood Administration	14	14	$564.00	$564.00	$30.31	$424.48	$298.22	2026-07-15
13152	HCPCS	Rp Cxp Enel 2.6-7.5	13	13	$622.25	$622.25	$220.47	$543.20	$292.46	2026-07-15
77078	HCPCS	CT Bone Densityaxil	14	14	$621.00	$621.00	$34.05	$364.84	$291.87	2026-07-15
65220	HCPCS	Remove Fb Ext Eye	19	11	$620.00	$620.00	$29.59	$397.60	$291.40	2026-07-15
76380	HCPCS	CT Lim F/up Local	12	12	$597.00	$597.00	$76.62	$350.74	$280.59	2026-07-15
93926	HCPCS	Dup Art Uni Lowextr	11	11	$587.40	$587.40	$107.60	$345.10	$276.08	2026-07-15
74245	HCPCS	Sm Bowel Series-4	11	11	$468.00	$468.00	$219.96	$421.20	$274.95	2026-07-15
76805	HCPCS	U/s Ob> 14 Wks	14	14	$572.00	$572.00	$45.83	$336.05	$268.84	2026-07-15
12037	HCPCS	Int Rp T/ext >30cm	13	13	$451.00	$451.00	$211.97	$1,774.08	$264.96	2026-07-15
43246	HCPCS	Tray Peg Placement	14	14	$450.00	$450.00	$211.50	$1,702.40	$264.38	2026-07-15
75984	HCPCS	G Tube Change S&i	11	11	$561.00	$561.00	$60.22	$329.59	$263.67	2026-07-15
93930	HCPCS	Dup Art Bil Up Extre	11	11	$559.00	$559.00	$223.73	$328.41	$262.73	2026-07-15
20103	HCPCS	Expl Of Penetrating Wound	13	13	$508.20	$508.20	$238.85	$667.52	$261.96	2026-07-15
12047	HCPCS	Int Rp Nhf > 30cm	13	13	$445.00	$445.00	$209.15	$1,774.08	$261.44	2026-07-15
74400	HCPCS	Ivp	14	14	$552.00	$552.00	$75.19	$467.02	$259.44	2026-07-15
12032	HCPCS	Int Rep Otf 2.6-7.5	21	13	$295.07	$295.07	$138.68	$349.44	$256.62	2026-07-15
12016	HCPCS	S Rp Lac F 12.6-20.0	13	13	$546.00	$546.00	$145.50	$349.44	$256.62	2026-07-15
12005	HCPCS	S Rp Lac Otf12.6-20.	14	14	$546.00	$546.00	$145.50	$349.44	$256.62	2026-07-15
93971	HCPCS	Dup Ext Vein Unilat	11	11	$537.00	$537.00	$107.60	$315.49	$252.39	2026-07-15
93979	HCPCS	U/s Duplex Aorta Lim	11	11	$534.00	$534.00	$107.60	$313.73	$250.98	2026-07-15
93970	HCPCS	Duplex Ext Veinbil	11	11	$533.50	$533.50	$223.73	$313.43	$250.75	2026-07-15
93975	HCPCS	US Vascular Abdcomp	11	11	$533.00	$533.00	$223.73	$313.14	$250.51	2026-07-15
93978	HCPCS	U/s Dup Aorta Ivc Co	11	11	$533.00	$533.00	$223.73	$313.14	$250.51	2026-07-15
86615	HCPCS	Bordetella Pertussis Antibodie	12	12	$526.00	$526.00	$10.68	$309.03	$247.22	2026-07-15
99213	HCPCS	Est Pt Vt Leveliii	13	13	$503.00	$503.00	$24.00	$295.51	$236.41	2026-07-15
12056	HCPCS	Int Rp Face 20.1-30.	13	13	$500.40	$500.40	$145.50	$349.44	$235.19	2026-07-15
20525	HCPCS	Remove Fb Complicate	13	13	$399.00	$399.00	$187.53	$2,534.56	$234.41	2026-07-15
Q4195	HCPCS	Puraply 1 Sq.cm	11	11	$391.88	$391.88	$184.18	$352.69	$230.23	2026-07-15
46230	HCPCS	Excision External Hemorrhoid	14	14	$390.89	$390.89	$183.72	$2,561.44	$229.65	2026-07-15
92950	HCPCS	Cpr	12	12	$433.00	$433.00	$90.00	$276.64	$228.95	2026-07-15
93976	HCPCS	US Vascular Limi	11	11	$485.00	$485.00	$107.60	$284.94	$227.95	2026-07-15
27560	HCPCS	Cl Treat Knee Disl	13	13	$481.95	$481.95	$86.76	$283.15	$226.52	2026-07-15
93224	HCPCS	Holter Monitor Compl	12	12	$385.00	$385.00	$180.95	$346.50	$226.19	2026-07-15
13121	HCPCS	Rp Com Sa/leg 2.6 +	14	14	$476.20	$476.20	$65.48	$543.20	$223.81	2026-07-15
13132	HCPCS	Rp Cmpx 2.6 To 7.5 Cm	13	13	$475.95	$475.95	$220.47	$543.20	$223.70	2026-07-15
76080	HCPCS	Fistulagram	12	12	$377.00	$377.00	$177.19	$1,263.31	$221.49	2026-07-15
12046	HCPCS	Int Rp Nhf 20.1-30.0	13	13	$410.75	$410.75	$193.05	$349.44	$220.47	2026-07-15
12036	HCPCS	Int Rp T/ex20.1-30.0	13	13	$386.80	$386.80	$181.80	$543.20	$220.47	2026-07-15
93308	HCPCS	Echo 2-d	12	12	$375.10	$375.10	$176.30	$420.00	$220.37	2026-07-15
56405	HCPCS	I & D Of Vulva/perineum	13	13	$464.00	$464.00	$74.54	$296.80	$218.08	2026-07-15
76856	HCPCS	Pelvic US	14	14	$462.00	$462.00	$45.83	$284.64	$217.14	2026-07-15
24600	HCPCS	Clsd Ref Elbow W/0 A	13	13	$458.90	$458.90	$86.76	$269.60	$215.68	2026-07-15
99203	HCPCS	New Pt Vst Level Iii	13	13	$457.00	$457.00	$73.58	$268.49	$214.79	2026-07-15
99201	HCPCS	New Pt Visit Level I	11	11	$361.10	$361.10	$169.72	$324.99	$212.15	2026-07-15
20552	HCPCS	Triggering 1-2 Muscl	13	13	$448.00	$448.00	$22.94	$286.72	$210.56	2026-07-15
76700	HCPCS	U/s Abdomen Survey Complete	14	14	$445.00	$445.00	$45.83	$284.64	$209.15	2026-07-15
99212	HCPCS	Est Pt Vt Levelii	13	13	$437.00	$437.00	$16.00	$256.74	$205.39	2026-07-15
26700	HCPCS	Red Of Metarcarpophalangeal Jt	13	13	$436.92	$436.92	$86.76	$256.69	$205.35	2026-07-15
12045	HCPCS	Int Rp Nhf 12.6-20.0	13	13	$348.10	$348.10	$163.61	$543.20	$204.51	2026-07-15
55250	HCPCS	Vasectomy	14	14	$347.10	$347.10	$163.14	$1,936.48	$203.92	2026-07-15
11406	HCPCS	Exc Epidermoid I Cys	14	14	$341.00	$341.00	$160.27	$1,500.80	$200.34	2026-07-15
80051	HCPCS	Profile Electrolite1	12	12	$425.60	$425.60	$5.68	$250.04	$200.03	2026-07-15
26725	HCPCS	Clsd Txfx Finger/thumb	13	13	$422.35	$422.35	$86.76	$248.13	$198.50	2026-07-15
23650	HCPCS	Cl/tr/sh W/manp-ane	21	13	$420.70	$420.70	$86.76	$247.16	$197.73	2026-07-15
54700	HCPCS	I&d Of Scrotum	13	13	$335.00	$335.00	$157.45	$1,936.48	$196.81	2026-07-15
11100	HCPCS	Biopsy Skin Lesion	22	11	$375.15	$375.15	$37.53	$603.41	$193.49	2026-07-15
94060	HCPCS	Pft Pre & Post Study	13	13	$409.00	$409.00	$32.72	$242.98	$192.23	2026-07-15
11200	HCPCS	Skin Tag Rem	11	11	$366.80	$366.80	$172.40	$215.50	$191.52	2026-07-15
P9021	HCPCS	Blood/unit	20	12	$466.00	$466.00	$127.16	$350.00	$191.43	2026-07-15
13131	HCPCS	Cmplx Rpr <2.5cm Otc	13	13	$401.90	$401.90	$145.50	$349.44	$188.89	2026-07-15
43762	HCPCS	G Tube Replacement	13	13	$400.00	$400.00	$112.02	$257.60	$188.00	2026-07-15
74300	HCPCS	Or Cholongiogram	11	11	$318.00	$318.00	$149.46	$286.20	$186.83	2026-07-15
99202	HCPCS	New Pt Vst Level Ii	12	12	$397.20	$397.20	$35.53	$233.36	$186.68	2026-07-15
31720	HCPCS	Suctioning Of Airway	13	13	$315.00	$315.00	$90.00	$250.00	$185.06	2026-07-15
12055	HCPCS	Int Rp F 12.6-20.0cm	13	13	$393.00	$393.00	$145.50	$349.44	$184.71	2026-07-15
83880	HCPCS	Bnp	13	13	$391.00	$391.00	$31.80	$229.71	$183.77	2026-07-15
12044	HCPCS	Int Rp Nhf7.6-12.5cm	13	13	$306.00	$306.00	$143.82	$543.20	$179.78	2026-07-15
12052	HCPCS	Int Rp Face 2.6-5.0	14	14	$381.94	$381.94	$145.50	$349.44	$179.51	2026-07-15
87632	HCPCS	Spotfire Resp. Panel 15 Target	13	13	$381.61	$381.61	$135.48	$260.85	$179.36	2026-07-15
26770	HCPCS	Closed Reduct Finger	13	13	$379.00	$379.00	$86.76	$236.32	$178.13	2026-07-15
12035	HCPCS	Int Rp T/ex12.6-20.0	13	13	$377.30	$377.30	$145.50	$349.44	$177.33	2026-07-15
26755	HCPCS	Closed Red Of Little Finger	13	13	$375.81	$375.81	$86.76	$236.32	$176.63	2026-07-15
76770	HCPCS	U/s Renal Complete	14	14	$375.00	$375.00	$45.83	$284.64	$176.25	2026-07-15
12014	HCPCS	Sim Rp Lac F 5.1-7.5	11	11	$300.00	$300.00	$141.00	$191.52	$176.25	2026-07-15
12013	HCPCS	Sim Rep F 2.6-5.0cm	12	12	$300.00	$300.00	$141.00	$250.00	$176.25	2026-07-15
12011	HCPCS	Sim Rep Lac F 2.5cm	13	13	$300.00	$300.00	$10.00	$250.00	$176.25	2026-07-15
11730	HCPCS	Rem Single Nailw/bl	12	12	$300.00	$300.00	$141.00	$250.00	$176.25	2026-07-15
24640	HCPCS	Reduction Of Elbow	21	13	$370.00	$370.00	$11.75	$236.32	$173.90	2026-07-15
12034	HCPCS	Int Rp T/ex7.6-12.5	13	13	$367.00	$367.00	$145.50	$349.44	$172.49	2026-07-15
Q4197	HCPCS	Puraply An Xt 1 Sq.cm	8	8	$363.00	$363.00	$170.61	$213.26	$170.61	2026-07-15
12054	HCPCS	Int Rp Face 7.6-12.5	13	13	$361.00	$361.00	$145.50	$349.44	$169.67	2026-07-15
97602	HCPCS	Act Wnd Care Non Sel	20	12	$895.00	$895.00	$128.93	$525.81	$167.75	2026-07-15
87252	HCPCS	Culture Viral	12	12	$354.09	$354.09	$21.11	$208.03	$166.42	2026-07-15
90846	HCPCS	Fam Ther Without Patient	9	9	$352.00	$352.00	$126.11	$206.80	$165.44	2026-07-15
90847	HCPCS	Fam Ther W/patient	9	9	$352.00	$352.00	$126.11	$206.80	$165.44	2026-07-15
90834	HCPCS	Uh Ind Psych 45-50min	9	9	$352.00	$352.00	$126.11	$206.80	$165.44	2026-07-15
93225	HCPCS	Holter Monitor Hookp	12	12	$352.00	$352.00	$104.67	$263.00	$165.44	2026-07-15
90832	HCPCS	Uh Ind Psych 20-30min	11	11	$352.00	$352.00	$55.20	$206.80	$165.44	2026-07-15
90853	HCPCS	Grp Psych	11	11	$352.00	$352.00	$75.40	$211.20	$165.44	2026-07-15
76705	HCPCS	U/s Abd Single Organ	14	14	$350.00	$350.00	$45.83	$284.64	$164.50	2026-07-15
31500	HCPCS	Intubation	14	14	$350.00	$350.00	$89.05	$222.88	$164.50	2026-07-15
80074	HCPCS	Acute Hepatitispan	13	13	$350.00	$350.00	$38.58	$205.63	$164.50	2026-07-15
76817	HCPCS	U/s Transvag (ob)	20	12	$318.00	$318.00	$107.60	$284.64	$164.50	2026-07-15
99281	HCPCS	Level I	13	13	$345.00	$345.00	$110.00	$310.50	$162.15	2026-07-15
85999	HCPCS	Surp,path,frox Sect1	11	11	$272.00	$272.00	$127.84	$244.80	$159.80	2026-07-15
26605	HCPCS	Treat Metacarpal Fracture	13	13	$338.55	$338.55	$86.76	$236.32	$159.12	2026-07-15
26011	HCPCS	I&d Felon Of The Finger	13	13	$270.10	$270.10	$126.95	$1,500.80	$158.68	2026-07-15
83970	HCPCS	Parath Hormone Pth	12	12	$333.00	$333.00	$33.44	$195.64	$156.51	2026-07-15
82672	HCPCS	Estrogen	13	13	$332.00	$332.00	$17.58	$195.05	$156.04	2026-07-15
81241	HCPCS	Factor V Leiden Mutation	12	12	$330.00	$330.00	$59.43	$193.88	$155.10	2026-07-15
96365	HCPCS	IV Inf Drug Initial	13	13	$297.00	$297.00	$57.77	$176.40	$150.00	2026-07-15
96374	HCPCS	Ther Inj Intravenous	13	13	$297.00	$297.00	$59.40	$176.40	$150.00	2026-07-15
96360	HCPCS	IV Inf Hydra Initial	13	13	$297.00	$297.00	$19.01	$176.40	$150.00	2026-07-15
93931	HCPCS	Dup Art Uni Upper Ex	11	11	$318.00	$318.00	$107.60	$186.83	$149.46	2026-07-15
76830	HCPCS	U/s Transvaginal	14	14	$318.00	$318.00	$45.83	$284.64	$149.46	2026-07-15
76885	HCPCS	U/s Infant Hips	12	12	$318.00	$318.00	$76.62	$211.49	$149.46	2026-07-15
76775	HCPCS	Fastscan US	21	13	$275.00	$275.00	$25.44	$284.64	$149.46	2026-07-15
76706	HCPCS	US Abdominal Aorta Screening	12	12	$318.00	$318.00	$107.60	$284.64	$149.46	2026-07-15
76536	HCPCS	U/s Head/neck	13	13	$318.00	$318.00	$47.97	$284.64	$149.46	2026-07-15
76870	HCPCS	U/s Testicular	13	13	$318.00	$318.00	$28.22	$284.64	$149.46	2026-07-15
76801	HCPCS	OB U/s < 14 Wks	14	14	$318.00	$318.00	$45.83	$284.64	$149.46	2026-07-15
12042	HCPCS	Int Rp Nhf 2.6-7.5cm	13	13	$317.90	$317.90	$145.50	$349.44	$149.41	2026-07-15
12053	HCPCS	Int Rp Face 5.1-7.5	13	13	$312.90	$312.90	$145.50	$349.44	$147.06	2026-07-15
12051	HCPCS	Int Rp Face < 2.5 Cm	13	13	$263.80	$263.80	$123.99	$349.44	$145.50	2026-07-15
12041	HCPCS	Int Rp N,h,f<2.5 Cm	13	13	$248.15	$248.15	$116.63	$349.44	$145.50	2026-07-15
12031	HCPCS	Int Rp Tr/ext<2.5cm	13	13	$248.00	$248.00	$116.56	$349.44	$145.50	2026-07-15
12017	HCPCS	S Rp Lac F 20.1-30.0	13	13	$249.00	$249.00	$117.03	$349.44	$145.50	2026-07-15
80053	HCPCS	Chem 14	13	13	$306.15	$306.15	$8.55	$179.86	$143.89	2026-07-15
47531	HCPCS	Post Op T Tube	8	8	$305.00	$305.00	$143.35	$179.19	$143.35	2026-07-15
87631	HCPCS	Spotfire Resp.Panel Mini	13	13	$249.60	$249.60	$115.53	$156.89	$142.63	2026-07-15
10081	HCPCS	I&d Pilonidal Cyt Co	13	13	$241.00	$241.00	$113.27	$667.52	$141.59	2026-07-15
74022	HCPCS	Acute Abd Series	13	13	$300.30	$300.30	$32.00	$284.64	$141.14	2026-07-15
26010	HCPCS	Drain Fing Abs Simpl	13	13	$300.00	$300.00	$75.60	$191.52	$141.00	2026-07-15
10060	HCPCS	I&d Abscess Simple	31	14	$300.00	$300.00	$10.00	$462.00	$141.00	2026-07-15
12004	HCPCS	S Rp Lac Otf7.6-12.5	13	13	$300.00	$300.00	$10.00	$191.52	$141.00	2026-07-15
12002	HCPCS	Sim Rp Sp Nk Tnk 2.6	21	13	$102.25	$102.25	$48.06	$250.00	$141.00	2026-07-15
76857	HCPCS	Limited Pelvis US	22	14	$270.00	$270.00	$19.66	$284.64	$140.06	2026-07-15
12001	HCPCS	Sim Rep Scp Ncktruk	28	12	$234.00	$234.00	$37.44	$250.00	$137.48	2026-07-15
70260	HCPCS	Skull 4 Vws	12	12	$288.00	$288.00	$107.60	$284.64	$135.36	2026-07-15
70220	HCPCS	Paranasal Sin 3vw	12	12	$288.00	$288.00	$76.62	$211.49	$135.36	2026-07-15
87045	HCPCS	Stool Culture	13	13	$288.00	$288.00	$7.65	$169.20	$135.36	2026-07-15
77074	HCPCS	Limited Bone Survey	12	12	$286.00	$286.00	$107.60	$284.64	$134.42	2026-07-15
71111	HCPCS	Ribs Bilat 4 Vw	13	13	$284.35	$284.35	$27.38	$284.64	$133.64	2026-07-15
72110	HCPCS	Spine Lumbar 4+view	13	13	$281.60	$281.60	$22.53	$284.64	$132.35	2026-07-15
72050	HCPCS	Spine Cerv 4+ Views	13	13	$281.60	$281.60	$32.00	$284.64	$132.35	2026-07-15
70110	HCPCS	Mandible 4+ Views	13	13	$281.60	$281.60	$26.00	$284.64	$132.35	2026-07-15
0390	RC	—	23	12	$71.00	$71.00	$33.37	$350.00	$129.72	2026-07-15
99211	HCPCS	Treatment Room	21	13	$220.00	$220.00	$17.60	$229.77	$129.25	2026-07-15
11102	HCPCS	Shaved Biopsy Of Skin	13	13	$274.35	$274.35	$63.35	$191.52	$128.94	2026-07-15
86666	HCPCS	Human Granulocytic Ehrlish Hge	20	12	$324.00	$324.00	$8.24	$190.35	$128.13	2026-07-15
27250	HCPCS	Hip Reduction	13	13	$272.00	$272.00	$86.76	$236.32	$127.84	2026-07-15
99292	HCPCS	Crit C Ea Add 30 Min	11	11	$217.00	$217.00	$101.99	$195.30	$127.49	2026-07-15
99204	HCPCS	New Pt Vst Level IV	24	13	$603.75	$603.75	$46.20	$354.70	$127.37	2026-07-15
76815	HCPCS	U/s OB Limited	12	12	$270.00	$270.00	$107.60	$284.64	$126.90	2026-07-15
86922	HCPCS	Crossmatch Ea Unit	13	13	$268.00	$268.00	$95.00	$157.45	$125.96	2026-07-15
87338	HCPCS	H Pylori Stool Ag Ela	12	12	$266.80	$266.80	$11.65	$156.75	$125.40	2026-07-15
16020	HCPCS	Burn Debridement	44	13	$92.50	$92.50	$39.95	$665.17	$125.40	2026-07-15
83835	HCPCS	Metanephrines 24 Hr Urine	12	12	$266.45	$266.45	$13.73	$156.54	$125.23	2026-07-15
12006	HCPCS	S Rp Lac Otf 20.1-30	13	13	$209.00	$209.00	$98.23	$349.44	$122.79	2026-07-15
10061	HCPCS	I&d Abs Comp/multi	13	13	$260.70	$260.70	$96.94	$349.44	$122.53	2026-07-15
69200	HCPCS	Fb Rem Ear Without Anes	11	11	$239.00	$239.00	$112.33	$140.41	$119.84	2026-07-15
41250	HCPCS	Lac To Tongue 2.5cm	11	11	$249.00	$249.00	$117.03	$146.29	$119.84	2026-07-15
30300	HCPCS	Rem Fb Intranasae	19	11	$179.65	$179.65	$84.44	$173.90	$119.84	2026-07-15
76810	HCPCS	US OB Multi Gest>14w	11	11	$254.00	$254.00	$39.77	$149.23	$119.38	2026-07-15
70250	HCPCS	Skull 3 Views	12	12	$254.00	$254.00	$107.60	$284.64	$119.38	2026-07-15
70130	HCPCS	Mastiod-4	12	12	$254.00	$254.00	$107.60	$284.64	$119.38	2026-07-15
12007	HCPCS	S Rp Lac Otf >30cm	13	13	$254.00	$254.00	$75.60	$191.52	$119.38	2026-07-15
76881	HCPCS	US Body Superfcl Lt	14	14	$252.00	$252.00	$22.94	$284.64	$118.44	2026-07-15
36556	HCPCS	Cent Line Placement	13	13	$200.75	$200.75	$94.35	$1,783.04	$117.94	2026-07-15
72190	HCPCS	Xray Pelvis Minimum 3 Views	12	12	$250.00	$250.00	$107.60	$284.64	$117.50	2026-07-15
99214	HCPCS	Uh Ov Est Mod Complexity	19	13	$199.00	$199.00	$39.80	$390.16	$116.91	2026-07-15
71101	HCPCS	Ribs Unilat 3 Vw	13	13	$245.65	$245.65	$17.00	$284.64	$115.46	2026-07-15
94660	HCPCS	Air Compressor Setup	36	12	$67.00	$67.00	$25.85	$176.61	$115.15	2026-07-15
71045	HCPCS	Chest 1 View	14	14	$244.70	$244.70	$13.65	$211.49	$115.01	2026-07-15
28190	HCPCS	Fb Removal Foot	13	13	$194.85	$194.85	$91.58	$667.52	$114.47	2026-07-15
86316	HCPCS	Chromogranin A	12	12	$237.60	$237.60	$16.86	$139.59	$111.67	2026-07-15
84403	HCPCS	Testosterone-serum	13	13	$237.00	$237.00	$20.91	$139.24	$111.39	2026-07-15

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