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 →

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Hospital

SEDGWICK COUNTY MEMORIAL HOSPITAL

Julesburg, CO · CCN 061310 · Rates published

4,090 distinct procedures filed
7 distinct payers
17,455 rate rows
2026-07-30 last MRF observed
Data quality

15,104 of 17,455 rate rows are consumer-grade (86.5%)

2,351 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,297
exceeds 10× this hospital's gross charge — excluded from medians 48
per-diem day rate — not a per-procedure price 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/KWNF-1755280847857/machine-readable/840816593_sedgwick-county-health-center_standardcharges.json
Found on page https://schealth.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch success · 2026-10-23
Content fingerprint 2ac3fc53e4bdbcd4… · 3,144,575 bytes · first seen 2026-06-08

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
C1788
HCPCS 		Implantable Port 6 $2,965.00 $12,848.00 $8,895.00 nat. median
$663
outlier · 13.4×
74174
CPT 		CT Angio Abdomen And Pelvis 6 $2,541.00 $11,010.00 $7,622.00 nat. median
$988
outlier · 7.7×
70470
CPT 		CT Brain/head With + Without Contrast 6 $2,210.00 $9,576.00 $6,629.00 nat. median
$622
outlier · 10.7×
74178
CPT 		CT Abdomen And Pelvis With + Without Contrast 6 $2,145.00 $9,296.00 $6,436.00 nat. median
$1,024
outlier · 6.3×
70498
CPT 		70498 CT Angio Neck 6 $2,115.00 $9,164.00 $6,344.00 nat. median
$739
outlier · 8.6×
71275
CPT 		CT Angio Chest 6 $2,115.00 $9,164.00 $6,344.00 nat. median
$754
outlier · 8.4×
70496
CPT 		CT Angio Brain/head 6 $2,115.00 $9,164.00 $6,344.00 nat. median
$747
outlier · 8.5×
74175
CPT 		CT Angio Abdomen 6 $2,115.00 $9,164.00 $6,344.00 nat. median
$714
outlier · 8.9×
78452
CPT 		Nm Myocardial Spect Multiple Studies 6 $1,701.00 $7,370.00 $5,102.00 nat. median
$1,816
outlier · 2.8×
70546
CPT 		MRA Brain/head With + Without Contrast 6 $1,668.00 $7,228.00 $5,004.00 nat. median
$1,070
outlier · 4.7×
70549
CPT 		MRA Neck With + Without Contrast 6 $1,668.00 $7,228.00 $5,004.00 nat. median
$1,055
outlier · 4.7×
1168665-RT
CDM 		MRA Lower Extremity With + Without Cnt Right 6 $1,668.00 $7,228.00 $5,004.00 nat. median
$5,004
1.0× median
73725
CPT 		MRA Lower Extremity With + Without Cnt Left 6 $1,668.00 $7,228.00 $5,004.00 nat. median
$1,248
outlier · 4.0×
72198
CPT 		MRA Pelvis With + Without Contrast 6 $1,668.00 $7,228.00 $5,004.00 nat. median
$1,128
outlier · 4.4×
73225
CPT 		MRA Upper Extremity With + Without Cnt Left 6 $1,668.00 $7,228.00 $5,004.00 nat. median
$1,206
outlier · 4.1×
71555
CPT 		MRA Chest With + Without Contrast 6 $1,668.00 $7,228.00 $5,004.00 nat. median
$1,143
outlier · 4.4×
70460
CPT 		CT Brain/head With Contrast 6 $1,626.00 $7,045.00 $4,877.00 nat. median
$576
outlier · 8.5×
74177
CPT 		CT Scan Of Abdomen And Pelvis With Contrast 6 $1,626.00 $7,045.00 $4,877.00 nat. median
$974
outlier · 5.0×
72157
CPT 		MRI Spine Thoracic With + Without Contrast 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,105
outlier · 4.4×
72158
CPT 		MRI Spine Lumbar With + Without Contrast 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,093
outlier · 4.4×
72156
CPT 		MRI Spine Cervical With + Without Contrast 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,103
outlier · 4.4×
73720
CPT 		MRI Femur With + Without Contrast Lt 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,129
outlier · 4.3×
74183
CPT 		MRI Abdomen With + Without Contrast 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,100
outlier · 4.4×
70553
CPT 		MRI Scan 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,133
outlier · 4.3×
72197
CPT 		MRI Pelvis With + Without Contrast 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,063
outlier · 4.6×
73220
CPT 		MRI Forearm With + Without Contrast Left 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,130
outlier · 4.3×
73723
CPT 		MRI Ankle With + Without Contrast Left 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,192
outlier · 4.1×
71552
CPT 		MRI Chest With + Without Contrast 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,097
outlier · 4.4×
70543
CPT 		MRI Face Neck Orbit With + Without Contrast 6 $1,620.00 $7,020.00 $4,860.00 nat. median
$1,083
outlier · 4.5×
73206
CPT 		CT Angio Upper Extremity Left 6 $1,602.00 $6,943.00 $4,807.00 nat. median
$689
outlier · 7.0×
73702
CPT 		CT Lower Extremity W/+without Contrast Left 6 $1,602.00 $6,943.00 $4,807.00 nat. median
$703
outlier · 6.8×
78598
CPT 		Nm Lung Vent/perf Imaging 6 $1,460.00 $6,326.00 $4,379.00 nat. median
$792
outlier · 5.5×
74176
CPT 		CT Abdomen And Pelvis Without Contrast 6 $1,381.00 $5,985.00 $4,144.00 nat. median
$694
outlier · 6.0×
72191
CPT 		CT Angio Pelvis 6 $1,271.00 $5,506.00 $3,812.00 nat. median
$632
outlier · 6.0×
71270
CPT 		CT Chest With + Without Contrast 6 $1,271.00 $5,506.00 $3,812.00 nat. median
$672
outlier · 5.7×
72127
CPT 		CT Spine Cervical With + Without Contrast 6 $1,271.00 $5,506.00 $3,812.00 nat. median
$612
outlier · 6.2×
78597
CPT 		Nm Lung Perfusion Differential Imaging 6 $1,178.00 $5,105.00 $3,534.00 nat. median
$568
outlier · 6.2×
70488
CPT 		CT Maxillofacial With + Without Contrast 6 $1,143.00 $4,954.00 $3,430.00 nat. median
$637
outlier · 5.4×
72133
CPT 		CT Spine Lumbar With + Without Contrast 6 $1,143.00 $4,954.00 $3,430.00 nat. median
$633
outlier · 5.4×
72130
CPT 		CT Spine Thoracic With + Without Contrast 6 $1,143.00 $4,954.00 $3,430.00 nat. median
$600
outlier · 5.7×
70482
CPT 		CT Orbits Sella With + Without Contrast 6 $1,143.00 $4,954.00 $3,430.00 nat. median
$656
outlier · 5.2×
74170
CPT 		CT Abdomen With + Without Contrast 6 $1,143.00 $4,954.00 $3,430.00 nat. median
$710
outlier · 4.8×
72194
CPT 		CT Pelvis With + Without Contrast 6 $1,143.00 $4,954.00 $3,430.00 nat. median
$664
outlier · 5.2×
70492
CPT 		CT Neck Soft Tissue With + Without Contrast 6 $1,143.00 $4,954.00 $3,430.00 nat. median
$647
outlier · 5.3×
75635
CPT 		CT Angio Abdominal Aorta With Runoff 6 $1,143.00 $4,954.00 $3,430.00 nat. median
$722
outlier · 4.7×
78579
CPT 		Nm Lung Ventilation Imaging 6 $1,127.00 $4,883.00 $3,380.00 nat. median
$576
outlier · 5.9×
78580
CPT 		Nm Lung Perfusion Imaging 6 $1,127.00 $4,883.00 $3,380.00 nat. median
$626
outlier · 5.4×
95810
CPT 		Sleep Study 6 $1,124.00 $4,871.00 $3,372.00 nat. median
$1,825
1.8× median
95811
CPT 		Diagnostic Split Sleep Study 6 $1,124.00 $4,871.00 $3,372.00 nat. median
$1,894
1.8× median
73202
CPT 		CT Upper Extremity W/+without Contrast Left 6 $1,105.00 $4,788.00 $3,315.00 nat. median
$711
outlier · 4.7×

Other procedures at this hospital

Browse this hospital's 4,090 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
             
10030 CPT 10030 Image Guided Catheter Fluir Collection Drainage 7 6 $1,076.00 $1,076.00 $323.00 $1,399.00 $968.00 2025-10-21
10121 CPT 10121 Incision And Removal Of Foreign Body, Subcutaneous Tissues; Complicated 7 6 $782.00 $782.00 $235.00 $1,017.00 $704.00 2025-10-21
10160 CPT 10160-aspiration Abscess/cyst/hematoma 7 6 $786.00 $786.00 $236.00 $1,022.00 $707.00 2025-10-21
11444 CPT 11444 Excision, Benign Lesion Including Margins; Face, Ears, Eyelids, Nose, Lips… 7 6 $994.00 $994.00 $298.00 $1,292.00 $895.00 2025-10-21
11446 CPT 11446 Excision, Benign Lesion Including Margins; Face, Ears, Eyelids, Nose, Lips… 7 6 $1,224.00 $1,224.00 $367.00 $1,591.00 $1,102.00 2025-10-21
11450 CPT 11450 Excision Of Skin/subcutaneous Tissue For Hidradenitis, Axillary; With Simple… 14 6 $1,031.50 $1,031.50 $277.00 $1,482.00 $831.00 2025-10-21
11604 CPT 11604excise Trunk/arms/legs;3.1-4.0 14 6 $1,064.50 $1,064.50 $249.00 $1,689.00 $747.00 2025-10-21
11606 CPT 11606 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; >4.0cm 7 6 $992.00 $992.00 $298.00 $1,290.00 $893.00 2025-10-21
11622 CPT 11622 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge… 14 6 $748.50 $748.50 $221.00 $991.00 $662.00 2025-10-21
11624 CPT 11624excise Scalp/neck/hands/feet/gen;3.1-4.0 14 6 $947.50 $947.50 $269.00 $1,300.00 $806.00 2025-10-21
11626 CPT 11626excise Scalp/neck/hands/feet/gen; >4.0 14 6 $1,179.50 $1,179.50 $329.00 $1,639.00 $988.00 2025-10-21
11643 CPT 11643excise Face/ear/eyelids/nose/lip;2.1-3.0 14 6 $907.00 $907.00 $240.00 $1,318.00 $720.00 2025-10-21
11646 CPT 11646 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 7 6 $1,659.00 $1,659.00 $498.00 $2,157.00 $1,493.00 2025-10-21
1168319-RT CDM CT Upper Extremity W/+without Contrast Right 7 6 $3,683.00 $3,683.00 $1,105.00 $4,788.00 $3,315.00 2025-10-21
1168665-RT CDM MRA Lower Extremity With + Without Cnt Right 7 6 $5,560.00 $5,560.00 $1,668.00 $7,228.00 $5,004.00 2025-10-21
11771 CPT 11771 Excision Of Pilonidal Cyst Or Sinus; Extensive Profee 14 6 $1,027.00 $1,027.00 $221.00 $1,713.00 $662.00 2025-10-21
12047 CPT 12047-neck/hand/feet/genital Greater Than 30.0 Cm 14 6 $818.50 $818.50 $233.00 $1,119.00 $698.00 2025-10-21
12055 CPT 12055-face/ear/eye/nose/lip 12.6-20.0 Cm 14 6 $1,023.00 $1,023.00 $228.00 $1,671.00 $685.00 2025-10-21
12057 CPT 12057-face/ear/eye/nose/lip Greater Than 30.0 Cm 14 6 $966.50 $966.50 $241.00 $1,468.00 $724.00 2025-10-21
13132 CPT 13132-face/neck/hand/feet/genital 2.6-7.5 Cm 14 6 $1,308.50 $1,308.50 $309.00 $2,063.00 $927.00 2025-10-21
13152 CPT 13152-eye/ear/nose/lip 2.6-7.5 Cm 14 6 $1,159.50 $1,159.50 $342.00 $1,531.00 $1,027.00 2025-10-21
13160 CPT 13160 Secondary Closure Of Surgical Wound Dehiscence Extensive/complicated Profe… 14 6 $1,234.00 $1,234.00 $341.00 $1,732.00 $1,022.00 2025-10-21
14060 CPT 14060 Adjacent Tissue Transfer Or Rearrangement, Eyelids, Nose, Ears And/or Lips… 7 6 $2,003.00 $2,003.00 $601.00 $2,604.00 $1,803.00 2025-10-21
14061 CPT 14061 Adj Tissue Transfer/rearrangement, Eyelids/nose/ears And/or Lips; Defect 1… 7 6 $1,404.00 $1,404.00 $421.00 $1,825.00 $1,264.00 2025-10-21
17004 CPT 17004 Destruction, Premalignant Lesions, 15 Or More Lesions 7 6 $779.00 $779.00 $234.00 $1,013.00 $701.00 2025-10-21
17108 CPT 17108 Destruction Of Cutaneous Vascular Proliferative Lesions (Eg, Laser Techniq… 7 6 $888.00 $888.00 $266.00 $1,154.00 $799.00 2025-10-21
17274 CPT 17274 Destruction Malignant Lesion S/n/h/f/g 3.1-4.0cm 7 6 $743.00 $743.00 $223.00 $966.00 $669.00 2025-10-21
17283 CPT 17283 Destruction Malignant Lesion F/e/e/n/l/m 2.1-3.0cm 7 6 $744.00 $744.00 $223.00 $967.00 $670.00 2025-10-21
17286 CPT 17286 Destruction Mal Lesion F/e/e/n/l/m >4.0 Cm 7 6 $1,178.00 $1,178.00 $353.00 $1,531.00 $1,060.00 2025-10-21
19125 CPT 19125excision Breast Lesion 7 6 $1,077.00 $1,077.00 $323.00 $1,400.00 $969.00 2025-10-21
2120847 CDM Room/bed: Telemetry 7 6 $2,768.00 $2,768.00 $830.00 $3,598.00 $2,491.00 2025-10-21
21315 CPT 21315 Closed Tx Nasal Fracture Without Stabilization 7 6 $2,670.00 $2,670.00 $801.00 $3,471.00 $2,403.00 2025-10-21
21451 CPT 21451-clsd Tx Mandibularfracture W/manip 7 6 $1,359.00 $1,359.00 $408.00 $1,767.00 $1,223.00 2025-10-21
23600 CPT 23600proximal Humeral Without Manipulation 7 6 $842.00 $842.00 $253.00 $1,095.00 $758.00 2025-10-21
23650 CPT 23650-shoulder Without Anesthesia 7 6 $1,001.00 $1,001.00 $300.00 $1,301.00 $901.00 2025-10-21
23655 CPT 23655-shoulder With Anesthesia 7 6 $932.00 $932.00 $280.00 $1,212.00 $839.00 2025-10-21
24586 CPT 24586 Open Treatment Of Periarticular Fracture And/or Dislocation Of The Elbow 7 6 $1,527.00 $1,527.00 $458.00 $1,985.00 $1,374.00 2025-10-21
24587 CPT 24587 Open Treatment Of Periarticular Fracture And/or Dislocation Of The Elbow (… 7 6 $1,540.00 $1,540.00 $462.00 $2,002.00 $1,386.00 2025-10-21
24605 CPT 24605 Treatment Closed Elbow Dislocation Req Anes Profee 7 6 $1,482.00 $1,482.00 $445.00 $1,927.00 $1,334.00 2025-10-21
24615 CPT 24615 Open Treatment Of Acute Or Chronic Elbow Dislocation 7 6 $999.00 $999.00 $300.00 $1,299.00 $899.00 2025-10-21
24620 CPT 24620 Closed Tx Monteggia Fx Dislocation Elbow W/manj Profee 7 6 $1,157.00 $1,157.00 $347.00 $1,504.00 $1,041.00 2025-10-21
24635 CPT 24635 Orif Monteggia Fx Profee 7 6 $949.00 $949.00 $285.00 $1,234.00 $854.00 2025-10-21
24655 CPT 24655 Closed Tx Radial Head/neck Fx W/manipulation Profee 14 6 $1,024.50 $1,024.50 $277.00 $1,463.00 $832.00 2025-10-21
24666 CPT 24666 Radial Head Replacement Profee 7 6 $1,032.00 $1,032.00 $310.00 $1,342.00 $929.00 2025-10-21
24685 CPT 24685 Orif Prox Ulna Profee 7 6 $921.00 $921.00 $276.00 $1,197.00 $829.00 2025-10-21
25248 CPT 25248exploration, Forearm/wrist 7 6 $2,843.00 $2,843.00 $853.00 $3,696.00 $2,559.00 2025-10-21
25500 CPT 25500 Treat Fracture Of Radius Profee 7 6 $906.00 $906.00 $272.00 $1,178.00 $815.00 2025-10-21
25505 CPT 25505 Closed Tx Radial Shaft Fracture W/manipulation Profee 14 6 $1,320.00 $1,320.00 $327.00 $2,014.00 $982.00 2025-10-21
25515 CPT 25515 Open Treatmentradial Shaft Fracture Includes Internal Fixation Profee 7 6 $943.00 $943.00 $283.00 $1,226.00 $849.00 2025-10-21
25520 CPT 25520 Clx Rdl Shft Fx/clx Dislc Profee 7 6 $796.00 $796.00 $239.00 $1,035.00 $716.00 2025-10-21
25525 CPT 25525 Open Treatment Of Radius Shft W Int Fix Profee 7 6 $1,105.00 $1,105.00 $332.00 $1,437.00 $995.00 2025-10-21
25526 CPT 25526 Open Tx Radial Shaft Fx, Open Tx Joint Dislocation, Includes Repair Of Fib… 7 6 $1,350.00 $1,350.00 $405.00 $1,755.00 $1,215.00 2025-10-21
25545 CPT 25545 Open Tmt Shaft Fracture Includes Internal Fixation When Performed Profee 7 6 $878.00 $878.00 $263.00 $1,141.00 $790.00 2025-10-21
25565 CPT 25565 Closed Tx Radialulnar Shaft Fractures W/manj 14 6 $1,617.00 $1,617.00 $389.00 $2,519.00 $1,166.00 2025-10-21
25574 CPT 25574 Open Tx Radial And Ulnar Shaft Fx, With Internal Fixation; Of Radius Or Ul… 7 6 $950.00 $950.00 $285.00 $1,235.00 $855.00 2025-10-21
25575 CPT 25575 Radius And Ulna Orif Profee 7 6 $1,268.00 $1,268.00 $380.00 $1,648.00 $1,141.00 2025-10-21
25600 CPT 25600 Cltx Dstl Radial Fx/epiphysl Sep Without Manj Profee 14 6 $901.50 $901.50 $237.00 $1,316.00 $712.00 2025-10-21
25605 CPT 25605-distal Radial With Manipulation 14 6 $1,588.50 $1,588.50 $365.00 $2,548.00 $1,095.00 2025-10-21
25606 CPT 25606 Perq Skel Fixj Distal Radial Fx/epiphysl Sep Profee 7 6 $933.00 $933.00 $280.00 $1,213.00 $840.00 2025-10-21
25607 CPT 25607 Trt Open Fx Radial Distal Profee 7 6 $1,032.00 $1,032.00 $310.00 $1,342.00 $929.00 2025-10-21
25608 CPT 25608 Open Treatment Distal Fracture Profee 7 6 $1,158.00 $1,158.00 $347.00 $1,505.00 $1,042.00 2025-10-21
25609 CPT 25609 Trt Open Distal Radial Profee 7 6 $1,469.00 $1,469.00 $441.00 $1,910.00 $1,322.00 2025-10-21
25628 CPT 25628 Open Trmt Of Carpal Scaphoid Fracture, Includes Internal Fixation Profee 7 6 $1,011.00 $1,011.00 $303.00 $1,314.00 $910.00 2025-10-21
25645 CPT 25645 Open Treatment Of Carpal Bone Fracture Each Bone. Profee 7 6 $801.00 $801.00 $240.00 $1,041.00 $721.00 2025-10-21
25675 CPT 25675-clsd Treat Distal Radioulnar Disloc With Manip 7 6 $852.00 $852.00 $256.00 $1,108.00 $767.00 2025-10-21
25680 CPT 25680trans-scaphoperilunar Type; W/manip 7 6 $1,067.00 $1,067.00 $320.00 $1,387.00 $960.00 2025-10-21
26075 CPT 26075arthorotomy, Removal Of Foreign Body, Mcp 7 6 $970.00 $970.00 $291.00 $1,261.00 $873.00 2025-10-21
26615 CPT 26615 Open Trt Fx Metacarpal Profee 7 6 $805.00 $805.00 $242.00 $1,047.00 $725.00 2025-10-21
26765 CPT 26765-distal Phalangeal Open 7 6 $968.00 $968.00 $290.00 $1,258.00 $871.00 2025-10-21
27230 CPT 27230femoral Proximal End/neck Without Manipulation 7 6 $1,077.00 $1,077.00 $323.00 $1,400.00 $969.00 2025-10-21
27250 CPT 27250-hip Traumatic Without Anesthesia 7 6 $1,233.00 $1,233.00 $370.00 $1,603.00 $1,110.00 2025-10-21
27266 CPT 27266-hip Post Arthroplasty W/anesthesia 7 6 $3,139.00 $3,139.00 $942.00 $4,081.00 $2,825.00 2025-10-21
27372 CPT 27372deep, Thigh Region/knee Area 7 6 $1,061.00 $1,061.00 $318.00 $1,379.00 $955.00 2025-10-21
27508 CPT 27508-femoral Without Manipulation 7 6 $1,258.00 $1,258.00 $377.00 $1,635.00 $1,132.00 2025-10-21
27550 CPT 27550-knee Without Anesthesia 7 6 $1,145.00 $1,145.00 $344.00 $1,489.00 $1,031.00 2025-10-21
27562 CPT 27562-patella W/anethesia 7 6 $896.00 $896.00 $269.00 $1,165.00 $806.00 2025-10-21
27824 CPT 27824-distal Tibia Without Manip 7 6 $822.00 $822.00 $247.00 $1,069.00 $740.00 2025-10-21
27842 CPT 27842ankle With Anesthesia 14 6 $1,515.00 $1,515.00 $380.00 $2,293.00 $1,139.00 2025-10-21
28475 CPT 28475metatarsal W/manipulation 7 6 $853.00 $853.00 $256.00 $1,109.00 $768.00 2025-10-21
28810 CPT 28810 -amputation, Metatarsal; Toe 7 6 $1,273.00 $1,273.00 $382.00 $1,655.00 $1,146.00 2025-10-21
30906 CPT 30906 Ctrl Nsl Hem Pst Nsl Pk Q Profee 7 6 $911.00 $911.00 $273.00 $1,184.00 $820.00 2025-10-21
32551 CPT 32551-insertion Chest Tube 7 6 $827.00 $827.00 $248.00 $1,075.00 $744.00 2025-10-21
32554 CPT 32554-thoracentesis Without Imaging Guidance 7 6 $1,110.00 $1,110.00 $333.00 $1,443.00 $999.00 2025-10-21
32556 CPT 32556drainage, Percutaneous Without Guidance 14 6 $1,612.50 $1,612.50 $232.00 $3,188.00 $870.50 2025-10-21
36556 CPT 36556-central Line Greater Than/equal To 5 Years 7 6 $1,558.00 $1,558.00 $467.00 $2,025.00 $1,402.00 2025-10-21
36561 CPT 36561 Insertion Of Tunneled Centrally Inserted Central Venous Access Device, Wit… 14 6 $3,481.00 $3,481.00 $193.00 $8,215.00 $1,366.00 2025-10-21
37501110 CDM Endopath Xcel Bladeless Trocars 12mm 7 6 $798.00 $798.00 $239.00 $1,037.00 $718.00 2025-10-21
37505011 CDM Ligasure Curved, Small Jaw, Open Sealer/divider 7 6 $855.00 $855.00 $257.00 $1,112.00 $770.00 2025-10-21
37506011 CDM Zzendopath Xcel Bladeless Trocars 11mm 7 6 $871.00 $871.00 $261.00 $1,132.00 $784.00 2025-10-21
37506015 CDM Ligasure Maryland Jaw Laparoscopic Sealer/divider 7 6 $1,019.00 $1,019.00 $306.00 $1,325.00 $917.00 2025-10-21
40812 CPT 40812excision Lesion Vestibule Of Mouth 7 6 $1,632.00 $1,632.00 $490.00 $2,122.00 $1,469.00 2025-10-21
43752 CPT 43752 Naso-or Oro-gastric Tube 7 6 $801.00 $801.00 $240.00 $1,041.00 $721.00 2025-10-21
45378 CPT Diagnostic Exam Of Large Bowel Using An Endoscope 21 6 $903.00 $903.00 $135.00 $4,940.00 $813.00 2025-10-21
45385 CPT Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope 21 6 $1,498.00 $1,498.00 $159.00 $4,940.00 $1,140.00 2025-10-21
47562 CPT Removal Of Gallbladder Using An Endoscope 7 6 $1,508.00 $1,508.00 $452.00 $1,960.00 $1,357.00 2025-10-21
49505 CPT Repair Of Groin Hernia Patient Age 5 Years Or Older 7 6 $861.00 $861.00 $258.00 $1,119.00 $775.00 2025-10-21
52648 CPT 52648vasectomy 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
5412974 CDM Room/bed: Pediatrics 7 6 $2,191.00 $2,191.00 $657.00 $2,848.00 $1,972.00 2025-10-21
56740 CPT 56740excision On Vulva/perineum/intrioitus 7 6 $959.00 $959.00 $288.00 $1,247.00 $863.00 2025-10-21
62323 CPT Injection(s) Of Therapeutic Substance 21 6 $1,323.00 $1,323.00 $219.00 $1,772.00 $657.00 2025-10-21
64450 CDM 64450injection, Anesthetic Agent; Other Peripheral Nerve Or Branch 7 6 $1,363.00 $1,363.00 $409.00 $1,772.00 $1,227.00 2025-10-21
64479 CDM 64479 Inj, Anesthetic Agent/steroid, Transforaminal Epidural With Image Guidance; … 7 6 $1,796.00 $1,796.00 $539.00 $2,335.00 $1,616.00 2025-10-21
64479 CPT 64479 Injection(s), Anesthetic Agent(s) And/or Steroid; Transforaminal Epidural,… 21 6 $1,744.00 $1,744.00 $118.00 $2,335.00 $736.00 2025-10-21
64483 CPT Injection(s) Of Anesthetic Into Lower Spine Using Imaging Guidance 21 6 $1,796.00 $1,796.00 $203.00 $4,534.00 $1,046.00 2025-10-21
64490 CPT 64490 Bilat Injection,diagnostic Or Therapeutic Agent, Paravertebral Facet Joint… 21 6 $1,744.00 $1,744.00 $70.00 $2,335.00 $715.00 2025-10-21
64491 CDM 64491 Injection Paravertebral Facet Jointsecond Level 7 6 $1,363.00 $1,363.00 $409.00 $1,772.00 $1,227.00 2025-10-21
64493 CPT 64493 Bilateral Injection(s), Diagnostic Or Therapeutic Agent, Paravertebral Fa… 21 6 $1,744.00 $1,744.00 $66.00 $2,335.00 $715.00 2025-10-21
64494 CDM 64494 Bil Injection(s), Diagnostic Or Therapeutic Agent, Paravertebral Facet (z… 7 6 $1,363.00 $1,363.00 $409.00 $1,772.00 $1,227.00 2025-10-21
65220 CPT 65220-corneal Without Slit Lamp 7 6 $840.00 $840.00 $252.00 $1,092.00 $756.00 2025-10-21
65420 CPT 65420removal Of Lesion Cornea Of Eye 7 6 $1,027.00 $1,027.00 $308.00 $1,335.00 $924.00 2025-10-21
67700 CPT 67700-drain Abscess Blepharotomy/eyelid 7 6 $1,564.00 $1,564.00 $469.00 $2,033.00 $1,408.00 2025-10-21
70336 CPT MRI Tmj 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
70450 CPT CT Scan 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
70460 CPT CT Brain/head With Contrast 7 6 $5,419.00 $5,419.00 $1,626.00 $7,045.00 $4,877.00 2025-10-21
70470 CPT CT Brain/head With + Without Contrast 7 6 $7,366.00 $7,366.00 $2,210.00 $9,576.00 $6,629.00 2025-10-21
70480 CPT CT Orbits Sella Without Contrast 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
70481 CPT CT Orbits Sella With Contrast 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
70482 CPT CT Orbits Sella With + Without Contrast 7 6 $3,811.00 $3,811.00 $1,143.00 $4,954.00 $3,430.00 2025-10-21
70486 CPT CT Maxillofacial Without Contrast 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
70487 CPT CT Maxillofacial With Contrast 14 6 $3,624.00 $3,624.00 $1,021.00 $4,999.00 $3,063.00 2025-10-21
70488 CPT CT Maxillofacial With + Without Contrast 7 6 $3,811.00 $3,811.00 $1,143.00 $4,954.00 $3,430.00 2025-10-21
70490 CPT CT Neck Soft Tissue Without Contrast 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
70491 CPT CT Neck Soft Tissue With Contrast 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
70492 CPT CT Neck Soft Tissue With + Without Contrast 7 6 $3,811.00 $3,811.00 $1,143.00 $4,954.00 $3,430.00 2025-10-21
70496 CPT CT Angio Brain/head 7 6 $7,049.00 $7,049.00 $2,115.00 $9,164.00 $6,344.00 2025-10-21
70498 CPT 70498 CT Angio Neck 7 6 $7,049.00 $7,049.00 $2,115.00 $9,164.00 $6,344.00 2025-10-21
70540 CPT MRI Face Neck Orbit Without Contrast 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
70542 CPT MRI Face Neck Orbit With Contrast 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
70543 CPT MRI Face Neck Orbit With + Without Contrast 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
70544 CPT MRA Brain/head Without Contrast 7 6 $3,428.00 $3,428.00 $1,028.00 $4,456.00 $3,085.00 2025-10-21
70545 CPT MRA Brain/head With Contrast 7 6 $3,503.00 $3,503.00 $1,051.00 $4,554.00 $3,153.00 2025-10-21
70546 CPT MRA Brain/head With + Without Contrast 7 6 $5,560.00 $5,560.00 $1,668.00 $7,228.00 $5,004.00 2025-10-21
70547 CPT MRA Neck Without Contrast 7 6 $3,428.00 $3,428.00 $1,028.00 $4,456.00 $3,085.00 2025-10-21
70548 CPT MRA Neck With Contrast 7 6 $3,503.00 $3,503.00 $1,051.00 $4,554.00 $3,153.00 2025-10-21
70549 CPT MRA Neck With + Without Contrast 7 6 $5,560.00 $5,560.00 $1,668.00 $7,228.00 $5,004.00 2025-10-21
70551 CPT MRI Brain Without Contrast 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
70552 CPT MRI Brain With Contrast 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
70553 CPT MRI Scan 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
71250 CPT CT Chest High Resolution 14 6 $2,198.00 $2,198.00 $628.00 $2,995.00 $1,883.00 2025-10-21
71260 CPT CT Chest With Contrast 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
71270 CPT CT Chest With + Without Contrast 7 6 $4,235.00 $4,235.00 $1,271.00 $5,506.00 $3,812.00 2025-10-21
71271 CPT CT Low Dose Lung Screening 7 6 $2,092.00 $2,092.00 $628.00 $2,720.00 $1,883.00 2025-10-21
71275 CPT CT Angio Chest 7 6 $7,049.00 $7,049.00 $2,115.00 $9,164.00 $6,344.00 2025-10-21
71550 CPT MRI Chest Without Contrast 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
71551 CPT MRI Chest With Contrast 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
71552 CPT MRI Chest With + Without Contrast 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
71555 CPT MRA Chest With + Without Contrast 7 6 $5,560.00 $5,560.00 $1,668.00 $7,228.00 $5,004.00 2025-10-21
72074 CPT Xr Spine Thoracic 4+ Views 7 6 $784.00 $784.00 $235.00 $1,019.00 $706.00 2025-10-21
72082 CPT Xr Spine Entire 7 6 $844.00 $844.00 $253.00 $1,097.00 $760.00 2025-10-21
72125 CPT CT Spine Cervical Without Contrast 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
72126 CPT CT Spine Cervical With Contrast 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
72127 CPT CT Spine Cervical With + Without Contrast 7 6 $4,235.00 $4,235.00 $1,271.00 $5,506.00 $3,812.00 2025-10-21
72128 CPT CT Spine Thoracic Without Contrast 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
72129 CPT CT Spine Thoracic With Contrast 7 6 $3,683.00 $3,683.00 $1,105.00 $4,788.00 $3,315.00 2025-10-21
72130 CPT CT Spine Thoracic With + Without Contrast 7 6 $3,811.00 $3,811.00 $1,143.00 $4,954.00 $3,430.00 2025-10-21
72131 CPT CT Spine Lumbar Without Contrast 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
72132 CPT CT Spine Lumbar With Contrast 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
72133 CPT CT Spine Lumbar With + Without Contrast 7 6 $3,811.00 $3,811.00 $1,143.00 $4,954.00 $3,430.00 2025-10-21
72141 CPT MRI Spine Cervical Without Contrast 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
72142 CPT MRI Spine Cervical With Contrast 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
72146 CPT MRI Spine Thoracic Without Contrast 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
72147 CPT MRI Spine Thoracic With Contrast 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
72148 CPT MRI Scan Of Lower Spinal Canal 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
72149 CPT MRI Spine Lumbar With Contrast 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
72156 CPT MRI Spine Cervical With + Without Contrast 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
72157 CPT MRI Spine Thoracic With + Without Contrast 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
72158 CPT MRI Spine Lumbar With + Without Contrast 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
72191 CPT CT Angio Pelvis 7 6 $4,235.00 $4,235.00 $1,271.00 $5,506.00 $3,812.00 2025-10-21
72192 CPT CT Pelvis Without Contrast 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
72193 CPT CT Scan Of Pelvis With Contrast 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
72194 CPT CT Pelvis With + Without Contrast 7 6 $3,811.00 $3,811.00 $1,143.00 $4,954.00 $3,430.00 2025-10-21
72195 CPT MRI Pelvis Without Contrast 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
72196 CPT MRI Pelvis With Contrast 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
72197 CPT MRI Pelvis With + Without Contrast 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
72198 CPT MRA Pelvis With + Without Contrast 7 6 $5,560.00 $5,560.00 $1,668.00 $7,228.00 $5,004.00 2025-10-21
73200 CPT CT Upper Extremity Without Contrast Left 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
73201 CPT CT Upper Extremity With Contrast Left 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
73202 CPT CT Upper Extremity W/+without Contrast Left 7 6 $3,683.00 $3,683.00 $1,105.00 $4,788.00 $3,315.00 2025-10-21
73206 CPT CT Angio Upper Extremity Left 7 6 $5,341.00 $5,341.00 $1,602.00 $6,943.00 $4,807.00 2025-10-21
73218 CPT MRI Forearm Without Contrast Left 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
73219 CPT MRI Forearm With Contrast Left 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
73220 CPT MRI Forearm With + Without Contrast Left 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
73221 CPT MRI Elbow Without Contrast Left 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
73222 CPT MRI Elbow With Contrast Left 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
73223 CPT MRI Elbow With + Without Contrast Left 14 6 $4,401.50 $4,401.50 $1,021.00 $7,020.00 $3,063.00 2025-10-21
73225 CPT MRA Upper Extremity With + Without Cnt Left 7 6 $5,560.00 $5,560.00 $1,668.00 $7,228.00 $5,004.00 2025-10-21
73521 CPT Xr Hips 2 Views W/ap Pelvis Bilat 7 6 $820.00 $820.00 $246.00 $1,066.00 $738.00 2025-10-21
73700 CPT CT Lower Extremity Without Contrast Left 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
73701 CPT CT Lower Extremity With Contrast Left 7 6 $2,428.00 $2,428.00 $728.00 $3,156.00 $2,185.00 2025-10-21
73702 CPT CT Lower Extremity W/+without Contrast Left 7 6 $5,341.00 $5,341.00 $1,602.00 $6,943.00 $4,807.00 2025-10-21
73706 CPT CT Angio Lower Extremity Left 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
73718 CPT MRI Femur Without Contrast Lt 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
73719 CPT MRI Femur With Contrast Left 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
73720 CPT MRI Femur With + Without Contrast Lt 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
73721 CPT MRI Scan Of Leg Joint 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
73722 CPT MRI Hip With Contrast Left 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
73723 CPT MRI Ankle With + Without Contrast Left 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
73725 CPT MRA Lower Extremity With + Without Cnt Left 7 6 $5,560.00 $5,560.00 $1,668.00 $7,228.00 $5,004.00 2025-10-21
74150 CPT CT Abdomen Without Contrast 7 6 $2,304.00 $2,304.00 $691.00 $2,995.00 $2,074.00 2025-10-21
74160 CPT CT Abdomen With Contrast 7 6 $2,994.00 $2,994.00 $898.00 $3,892.00 $2,695.00 2025-10-21
74170 CPT CT Abdomen With + Without Contrast 7 6 $3,811.00 $3,811.00 $1,143.00 $4,954.00 $3,430.00 2025-10-21
74174 CPT CT Angio Abdomen And Pelvis 7 6 $8,469.00 $8,469.00 $2,541.00 $11,010.00 $7,622.00 2025-10-21
74175 CPT CT Angio Abdomen 7 6 $7,049.00 $7,049.00 $2,115.00 $9,164.00 $6,344.00 2025-10-21
74176 CPT CT Abdomen And Pelvis Without Contrast 7 6 $4,604.00 $4,604.00 $1,381.00 $5,985.00 $4,144.00 2025-10-21
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 7 6 $5,419.00 $5,419.00 $1,626.00 $7,045.00 $4,877.00 2025-10-21
74178 CPT CT Abdomen And Pelvis With + Without Contrast 7 6 $7,151.00 $7,151.00 $2,145.00 $9,296.00 $6,436.00 2025-10-21
74181 CPT MRI Abdomen Without Contrast 7 6 $3,328.00 $3,328.00 $998.00 $4,326.00 $2,995.00 2025-10-21
74182 CPT MRI Abdomen With Contrast 7 6 $3,403.00 $3,403.00 $1,021.00 $4,424.00 $3,063.00 2025-10-21
74183 CPT MRI Abdomen With + Without Contrast 7 6 $5,400.00 $5,400.00 $1,620.00 $7,020.00 $4,860.00 2025-10-21
74185 CPT MRA Abdomen With Contrast 21 6 $5,400.00 $5,400.00 $1,021.00 $7,228.00 $3,063.00 2025-10-21
75635 CPT CT Angio Abdominal Aorta With Runoff 7 6 $3,811.00 $3,811.00 $1,143.00 $4,954.00 $3,430.00 2025-10-21
76536 CPT US Head/neck Soft Tissue 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76641 CPT US Breast Complete Left 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76642 CPT US Breast Limited Left 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76700 CPT Ultrasound Of Abdomen 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76770 CPT US Aorta 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76801 CPT US OB < 14 Weeks 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76802 CPT Sdgw US OB <14 Weeks Addl Fetus 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76810 CPT Sdgw US OB Greater Than 14 Weeks Mult 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76811 CPT US OB Greater Than 14 Weeks 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76815 CPT US OB Limited 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76816 CPT US OB Follow Up 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76817 CPT OB Transvaginal US 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76819 CPT US Fetal Biophysical Profile Without N-str 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76830 CPT Ultrasound Pelvis Through Vagina 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76856 CPT US Pelvic Complete 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76857 CPT US Pelvic Ltd 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76870 CPT US Scrotum (Contents) 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76881 CPT US Upper Ext Nonvascular Limited Left 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76882 CPT US Extremity Nonvascular Limited Left 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
76999 CPT US Unlisted Procedure 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
77075 CPT Xr Bone Survey Complete 7 6 $1,161.00 $1,161.00 $348.00 $1,509.00 $1,045.00 2025-10-21
78013 CPT Nm Thyroid Imaging 7 6 $1,311.00 $1,311.00 $393.00 $1,704.00 $1,180.00 2025-10-21
78014 CPT Nm Thyroid Uptake 7 6 $1,693.00 $1,693.00 $508.00 $2,201.00 $1,524.00 2025-10-21
78070 CPT Nm Parathyroid Imaging 7 6 $1,311.00 $1,311.00 $393.00 $1,704.00 $1,180.00 2025-10-21
78071 CPT Nm Parathyroid Imaging With Spect 7 6 $1,515.00 $1,515.00 $455.00 $1,970.00 $1,364.00 2025-10-21
78215 CPT Nm Liver/spleen Static 7 6 $1,584.00 $1,584.00 $475.00 $2,059.00 $1,426.00 2025-10-21
78216 CPT Nm Liver/spleen Imaging With Vascular Flow 7 6 $2,470.00 $2,470.00 $741.00 $3,211.00 $2,223.00 2025-10-21
78226 CPT Nm Hepatobiliary Imaging 7 6 $2,532.00 $2,532.00 $760.00 $3,292.00 $2,279.00 2025-10-21
78227 CPT Nm Hepatobiliary Imaging With Drug 7 6 $2,826.00 $2,826.00 $848.00 $3,674.00 $2,543.00 2025-10-21
78264 CPT Nm Gastric Emptying Study 7 6 $1,838.00 $1,838.00 $551.00 $2,389.00 $1,654.00 2025-10-21
78278 CPT Nm Gastrointestinal Blood Loss Imaging 7 6 $1,989.00 $1,989.00 $597.00 $2,586.00 $1,790.00 2025-10-21
78290 CPT Nm Intestine Imaging Meckels 7 6 $3,444.00 $3,444.00 $1,033.00 $4,477.00 $3,100.00 2025-10-21
78300 CPT Nm Bone Imaging Limited 7 6 $1,546.00 $1,546.00 $464.00 $2,010.00 $1,391.00 2025-10-21
78305 CPT Nm Bone Imaging Multiple Areas 7 6 $1,724.00 $1,724.00 $517.00 $2,241.00 $1,552.00 2025-10-21
78306 CPT Nm Bone Imaging Whole Body 7 6 $1,838.00 $1,838.00 $551.00 $2,389.00 $1,654.00 2025-10-21
78315 CPT Nm Bone Three Phase Study 7 6 $1,904.00 $1,904.00 $571.00 $2,475.00 $1,714.00 2025-10-21
78451 CPT Nm Myocardial Spect Single Study 7 6 $2,652.00 $2,652.00 $796.00 $3,448.00 $2,387.00 2025-10-21
78452 CPT Nm Myocardial Spect Multiple Studies 7 6 $5,669.00 $5,669.00 $1,701.00 $7,370.00 $5,102.00 2025-10-21
78472 CPT Nm Cardiac Blood Pool Single Rest/stress 7 6 $3,187.00 $3,187.00 $956.00 $4,143.00 $2,868.00 2025-10-21
78579 CPT Nm Lung Ventilation Imaging 7 6 $3,756.00 $3,756.00 $1,127.00 $4,883.00 $3,380.00 2025-10-21
78580 CPT Nm Lung Perfusion Imaging 7 6 $3,756.00 $3,756.00 $1,127.00 $4,883.00 $3,380.00 2025-10-21
78597 CPT Nm Lung Perfusion Differential Imaging 7 6 $3,927.00 $3,927.00 $1,178.00 $5,105.00 $3,534.00 2025-10-21
78598 CPT Nm Lung Vent/perf Imaging 7 6 $4,866.00 $4,866.00 $1,460.00 $6,326.00 $4,379.00 2025-10-21
78700 CPT Nm Kidney Imaging 7 6 $2,377.00 $2,377.00 $713.00 $3,090.00 $2,139.00 2025-10-21
78701 CPT Nm Kidney Morphology With Vascular Flow 7 6 $2,692.00 $2,692.00 $808.00 $3,500.00 $2,423.00 2025-10-21
78707 CPT Nm Kidney Imaging Single Without Pharm 7 6 $2,826.00 $2,826.00 $848.00 $3,674.00 $2,543.00 2025-10-21
78708 CPT Nm Kidney Imaging Single With Pharm 7 6 $2,857.00 $2,857.00 $857.00 $3,714.00 $2,571.00 2025-10-21
78709 CPT Nm Kidney Imaging Multiple W/+without Pharm 7 6 $2,880.00 $2,880.00 $864.00 $3,744.00 $2,592.00 2025-10-21
78740 CPT Nm Ureteral Reflux Study 7 6 $1,408.00 $1,408.00 $422.00 $1,830.00 $1,267.00 2025-10-21
78761 CPT Nm Testicular Imaging With Vascular Flow 7 6 $1,311.00 $1,311.00 $393.00 $1,704.00 $1,180.00 2025-10-21
8016157-QZ CDM 00630 Proc In Lumbar Region Not Specified Profee 4 4 $730.00 $730.00 $219.00 $949.00 $657.00 2025-10-21
81206 CPT Bcr::abl By Rt, Qual Pspc 7 6 $1,018.00 $1,018.00 $305.00 $1,323.00 $916.00 2025-10-21
8231157 CDM Room/bed: Inpatient 7 6 $2,191.00 $2,191.00 $657.00 $2,848.00 $1,972.00 2025-10-21
8325078 CDM Room/bed: Hospice 7 6 $2,028.00 $2,028.00 $608.00 $2,636.00 $1,825.00 2025-10-21
86363 CPT Myelin Oligodendrocyte Glycoprotein Igg Assay, Serumpspc 7 6 $1,163.00 $1,163.00 $349.00 $1,512.00 $1,047.00 2025-10-21
87483 CPT Meningitis/encephalitis Panel (Rps) Pspc 7 6 $769.00 $769.00 $231.00 $1,000.00 $692.00 2025-10-21
87497 CPT Cytomegalovirus DNA Detection & Quantitation Pspc 7 6 $1,109.00 $1,109.00 $333.00 $1,442.00 $998.00 2025-10-21
87517 CPT Hepatitis B Virus DNA Quantitative Pspc 7 6 $931.00 $931.00 $279.00 $1,210.00 $838.00 2025-10-21
87902 CPT Hepatitis C Virus Genotyping Pspc 7 6 $783.00 $783.00 $235.00 $1,018.00 $705.00 2025-10-21
92950 CPT 92950-cardiopulmonary Resuscitation 7 6 $2,053.00 $2,053.00 $616.00 $2,669.00 $1,848.00 2025-10-21
92960 CPT 92960 External Electrical Cardioversion 7 6 $1,282.00 $1,282.00 $385.00 $1,667.00 $1,154.00 2025-10-21
93304 CPT US Echo 2d Limited Eo 7 6 $743.00 $743.00 $223.00 $966.00 $669.00 2025-10-21
93306 CPT US Echo Bubble Study Eo 14 6 $1,712.50 $1,712.50 $446.00 $2,521.00 $1,337.00 2025-10-21
93356 CPT Sdgw Myocardial Strain 7 6 $1,088.00 $1,088.00 $326.00 $1,414.00 $979.00 2025-10-21
93880 CPT US Carotid Duplex Bilateral 7 6 $921.00 $921.00 $276.00 $1,197.00 $829.00 2025-10-21
93926 CPT US Lower Ext Arterial Duplex Left 7 6 $813.00 $813.00 $244.00 $1,057.00 $732.00 2025-10-21
93930 CPT US Upper Ext Arterial Duplex Bilateral 7 6 $921.00 $921.00 $276.00 $1,197.00 $829.00 2025-10-21
93931 CPT US Upper Ext Arterial Duplex Left 7 6 $732.00 $732.00 $220.00 $952.00 $659.00 2025-10-21
93970 CPT US Lower Ext Venous Duplex Bilateral 14 6 $967.50 $967.50 $276.00 $1,318.00 $829.00 2025-10-21
93971 CPT US Lower Ext Venous Duplex Left 7 6 $813.00 $813.00 $244.00 $1,057.00 $732.00 2025-10-21
95810 CPT Sleep Study 7 6 $3,747.00 $3,747.00 $1,124.00 $4,871.00 $3,372.00 2025-10-21
95811 CPT Diagnostic Split Sleep Study 7 6 $3,747.00 $3,747.00 $1,124.00 $4,871.00 $3,372.00 2025-10-21
99236 CPT 99236 Obs High Mdm 85 Min Sds Profee 7 6 $884.00 $884.00 $265.00 $1,149.00 $796.00 2025-10-21
99245 CPT 99245 Office Consult New Or Est. L5 Pt 80 Min 7 6 $922.00 $922.00 $277.00 $1,199.00 $830.00 2025-10-21
99285 CPT 99285 Emergency Dept Visit Level 5 Profee 14 6 $1,870.50 $1,870.50 $192.00 $4,031.00 $881.00 2025-10-21
99291 CPT 99291critical Care, 30-74 14 6 $2,329.50 $2,329.50 $283.00 $4,832.00 $1,170.00 2025-10-21
A4301 HCPCS Powerpicc Solo 7 6 $1,332.00 $1,332.00 $400.00 $1,732.00 $1,199.00 2025-10-21
C1781 HCPCS Bg Medical Surgimesh Wn 14 6 $1,255.50 $1,255.50 $241.00 $2,220.00 $723.00 2025-10-21
C1788 HCPCS Implantable Port 7 6 $9,883.00 $9,883.00 $2,965.00 $12,848.00 $8,895.00 2025-10-21
CP17680014017342524 CDM Respiratory Panel 7 6 $1,156.00 $1,156.00 $347.00 $1,503.00 $1,040.00 2025-10-21
G0379 HCPCS Direct To Obs Charge 7 6 $1,266.00 $1,266.00 $380.00 $1,646.00 $1,139.00 2025-10-21
G0390 HCPCS G0390-811 Preactivation Trauma Response 7 6 $1,500.00 $1,500.00 $450.00 $1,950.00 $1,350.00 2025-10-21
J7296 HCPCS J7296 Levonorgestrel-releasing Intrauterine Contraceptive System, (Kyleena), 19.… 7 6 $1,920.00 $1,920.00 $576.00 $2,496.00 $1,728.00 2025-10-21
J7298 HCPCS J7298 Levonorgestrel-releasing Intrauterine Contraceptive System, 52 Mg 7 6 $2,014.00 $2,014.00 $604.00 $2,618.00 $1,813.00 2025-10-21
J7300 HCPCS J7300 Intrauterine Copper Contraceptive 7 6 $2,093.00 $2,093.00 $628.00 $2,721.00 $1,884.00 2025-10-21
J7301 HCPCS 13.5 Mg Levonorgestrelamb Levonorgestrel Charge 7 6 $2,093.00 $2,093.00 $628.00 $2,721.00 $1,884.00 2025-10-21
J7307 HCPCS J7307 Etonogestrel (Contraceptive) Implant System, Including Implant And Supplie… 7 6 $2,093.00 $2,093.00 $628.00 $2,721.00 $1,884.00 2025-10-21
P9040 HCPCS E0332 Rbc Cpd As1 500 Lr Irr 7 6 $777.00 $777.00 $233.00 $1,010.00 $699.00 2025-10-21
P9073 HCPCS E8341 Aph Plt Acda>pasc Lr Psoralen 1 7 6 $1,308.00 $1,308.00 $392.00 $1,700.00 $1,177.00 2025-10-21
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