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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

Hospital For Special Care

New Britain, CT · CCN 072004 · Rates published

891 distinct procedures filed
6 distinct payers
9,436 rate rows
2026-04-01 last MRF observed
Data quality

9,434 of 9,436 rate rows are consumer-grade (100.0%)

2 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 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/EDXA-1712339327696/machine-readable/060646766_hospital-for-special-care_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/hospital-for-special-care
Discovered viaDiscovered by HANK
Last fetch success · 2026-09-25
Content fingerprint 62fa7edfa9926755… · 40,000 bytes · first seen 2026-05-19

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
7000080
CDM 		R&b Autism 6 $1,716.00 $4,080.00 $3,328.00 —
7000010
CDM 		R&b Ventilator 6 $1,276.00 $3,032.00 $2,682.50 nat. median
$4
outlier · 631.2×
7000050
CDM 		R&b Cmplx Cardiac 6 $1,230.00 $2,924.00 $2,635.00 —
7000020
CDM 		R&b Med Complex 6 $1,025.00 $2,690.00 $2,200.00 —
7000018
CDM 		R&b Vent Rdcd 6 $942.00 $2,690.00 $2,068.00 —
7000040
CDM 		R&b Neuro 6 $927.00 $2,690.00 $2,034.00 nat. median
$9
outlier · 217.5×
7000030
CDM 		R&b Rehabilitation 6 $880.00 $2,690.00 $1,931.00 —
64642
CPT 		Chemodenerv 1 Extr 1-4 6 $850.00 $2,021.00 $1,649.00 nat. median
$770
outlier · 2.1×
H0035
HCPCS 		Mh Part Hosp Tx Under 24 6 $718.00 $1,706.00 $1,391.50 nat. median
$192
outlier · 7.3×
95911
CPT 		Tc Nvr Condj 9-10 Stdy 6 $642.00 $1,525.00 $1,292.50 nat. median
$523
outlier · 2.5×
95913
CPT 		Tc Nvr Condj =>13 Stdy 6 $642.00 $1,525.00 $1,292.50 nat. median
$541
outlier · 2.4×
95912
CPT 		Tc Nvr Condj 11-12 Stdy 6 $642.00 $1,525.00 $1,292.50 nat. median
$520
outlier · 2.5×
64644
CPT 		Chemodenerv 1 Ext 5/>m 6 $414.00 $983.00 $802.50 nat. median
$762
1.1× median
95908
CPT 		Tc Nvr Condj 3-4 Stdy 6 $387.00 $919.00 $779.00 nat. median
$302
outlier · 2.6×
95869
CPT 		Tc EMG-thor Paraspinal Mu 6 $387.00 $919.00 $779.00 nat. median
$261
outlier · 3.0×
95868
CPT 		Tc EMG-cranial Muscles Bi 6 $387.00 $919.00 $779.00 nat. median
$287
outlier · 2.7×
43239
CPT 		Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 6 $402.00 $955.00 $779.00 nat. median
$1,161
0.7× median
94375
CPT 		Spirometry 6 $387.00 $919.00 $779.00 nat. median
$222
outlier · 3.5×
95909
CPT 		Tc Nvr Condj 5-6 Stdy 6 $386.00 $918.00 $778.00 nat. median
$311
outlier · 2.5×
95910
CPT 		Tc Nvr Condj 7-8 Stdy 6 $386.00 $918.00 $778.00 nat. median
$383
outlier · 2.0×
95867
CPT 		Tc EMG-cranial Muscles U 6 $385.00 $916.00 $776.00 nat. median
$276
outlier · 2.8×
1102926
CDM 		Prism 1.9 Dressing 6 $392.00 $933.00 $761.00 —
52000
CPT 		Fc Cystoscopy 6 $263.00 $923.00 $752.50 nat. median
$802
0.9× median
1104893
CDM 		Hydroferra Blu Ready Foam 6 $346.00 $823.00 $671.00 —
62328
CPT 		Fc Lumbar Punct W/ct/fluo 6 $263.00 $816.00 $665.50 nat. median
$903
0.7× median
62270
CPT 		Fc Lumbar Puncture Diag 6 $263.00 $816.00 $665.50 nat. median
$741
0.9× median
64647
CPT 		Chemodenerv Trunk 6 $330.00 $785.00 $640.00 nat. median
$773
0.8× median
96116
CPT 		Fc Neurobehavior Status 6 $263.00 $773.00 $630.50 nat. median
$276
outlier · 2.3×
64646
CPT 		Chemodenerv Ext Or Trk 6 $317.00 $753.00 $614.50 nat. median
$711
0.9× median
43235
CPT 		Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 6 $307.00 $730.00 $595.50 nat. median
$1,071
0.6× median
51726
CPT 		Complex Cystometrogram 6 $263.00 $729.00 $594.50 nat. median
$543
1.1× median
1102801
CDM 		Flexiseal Fecal Collect 6 $287.00 $681.00 $555.50 —
1102680
CDM 		Trach 9tts 104mm 6 $280.00 $667.00 $543.50 —
62322
CPT 		Injection(s) Of Therapeutic Substance 6 $144.00 $1,762.00 $542.00 nat. median
$1,018
0.5× median
94660
CPT 		Cpap/bipap Init/mgt 6 $263.00 $625.00 $529.50 nat. median
$275
1.9× median
94664
CPT 		Mdi Demo, Evaluation 6 $261.00 $621.00 $526.50 nat. median
$194
outlier · 2.7×
1102982
CDM 		5.0 Cuffed Bivona Trach 6 $267.00 $634.00 $517.50 —
1102844
CDM 		4.5tts Pedi Flextend 6 $267.00 $634.00 $517.50 —
1102944
CDM 		Bivona C 9.5 Fome Cuffed 6 $267.00 $634.00 $517.50 —
1102796
CDM 		Trach Custom 9.0tts 104mm 6 $267.00 $634.00 $517.50 —
1102843
CDM 		3.5tts Pedi Flexstend 6 $267.00 $634.00 $517.50 —
94625
CPT 		Plrh Wo Continous Monitor 6 $211.00 $520.00 $452.50 nat. median
$91
outlier · 5.0×
92523
CPT 		Eval Sp Sd Prod/w Lang Co 6 $134.00 $611.00 $446.00 nat. median
$252
1.8× median
64616
CPT 		Fc Chemodenerv M Neck Dys 6 $229.00 $544.00 $443.50 nat. median
$398
1.1× median
1104056
CDM 		Mickey J Tub 16-45 6 $223.00 $530.00 $432.50 —
1104051
CDM 		Mic Tube 12-1.5 6 $220.00 $522.00 $426.00 —
94060
CPT 		Spirom Pre & Post Broncho 6 $180.00 $918.00 $411.00 nat. median
$350
1.2× median
1104074
CDM 		Trach C, 4.5tts Flextend 6 $209.00 $497.00 $405.50 —
99205
CPT 		New Patient Office Or Other Outpatient Visit, 60 Min 6 $194.00 $541.00 $405.50 nat. median
$274
1.5× median
1104113
CDM 		Trach 3.5 Neonatal Flx Tt 6 $209.00 $497.00 $405.50 —

Other procedures at this hospital

Browse this hospital's 891 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
7000080 CDM R&b Autism 10 6 $4,186.00 $4,186.00 $1,716.00 $4,080.00 $3,328.00 2026-04-01
7000010 CDM R&b Ventilator 10 6 $3,111.00 $3,111.00 $1,276.00 $3,032.00 $2,682.50 2026-04-01
7000050 CDM R&b Cmplx Cardiac 10 6 $3,000.00 $3,000.00 $1,230.00 $2,924.00 $2,635.00 2026-04-01
7000020 CDM R&b Med Complex 10 6 $2,500.00 $2,500.00 $1,025.00 $2,690.00 $2,200.00 2026-04-01
7000018 CDM R&b Vent Rdcd 10 6 $2,298.00 $2,298.00 $942.00 $2,690.00 $2,068.00 2026-04-01
7000040 CDM R&b Neuro 10 6 $2,260.00 $2,260.00 $927.00 $2,690.00 $2,034.00 2026-04-01
7000030 CDM R&b Rehabilitation 10 6 $2,146.00 $2,146.00 $880.00 $2,690.00 $1,931.00 2026-04-01
64642 CPT Chemodenerv 1 Extr 1-4 10 6 $2,074.00 $2,074.00 $850.00 $2,021.00 $1,649.00 2026-04-01
H0035 HCPCS Mh Part Hosp Tx Under 24 10 6 $1,750.00 $1,750.00 $718.00 $1,706.00 $1,391.50 2026-04-01
95912 CPT Tc Nvr Condj 11-12 Stdy 10 6 $1,565.00 $1,565.00 $642.00 $1,525.00 $1,292.50 2026-04-01
95913 CPT Tc Nvr Condj =>13 Stdy 10 6 $1,565.00 $1,565.00 $642.00 $1,525.00 $1,292.50 2026-04-01
95911 CPT Tc Nvr Condj 9-10 Stdy 10 6 $1,565.00 $1,565.00 $642.00 $1,525.00 $1,292.50 2026-04-01
64644 CPT Chemodenerv 1 Ext 5/>m 10 6 $1,009.00 $1,009.00 $414.00 $983.00 $802.50 2026-04-01
95908 CPT Tc Nvr Condj 3-4 Stdy 10 6 $943.00 $943.00 $387.00 $919.00 $779.00 2026-04-01
95869 CPT Tc EMG-thor Paraspinal Mu 10 6 $943.00 $943.00 $387.00 $919.00 $779.00 2026-04-01
43239 CPT Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 10 6 $980.00 $980.00 $402.00 $955.00 $779.00 2026-04-01
94375 CPT Spirometry 10 6 $943.00 $943.00 $387.00 $919.00 $779.00 2026-04-01
95868 CPT Tc EMG-cranial Muscles Bi 10 6 $943.00 $943.00 $387.00 $919.00 $779.00 2026-04-01
95910 CPT Tc Nvr Condj 7-8 Stdy 10 6 $942.00 $942.00 $386.00 $918.00 $778.00 2026-04-01
95909 CPT Tc Nvr Condj 5-6 Stdy 10 6 $942.00 $942.00 $386.00 $918.00 $778.00 2026-04-01
95867 CPT Tc EMG-cranial Muscles U 10 6 $940.00 $940.00 $385.00 $916.00 $776.00 2026-04-01
1102926 CDM Prism 1.9 Dressing 10 6 $957.00 $957.00 $392.00 $933.00 $761.00 2026-04-01
52000 CPT Fc Cystoscopy 10 6 $947.00 $947.00 $263.00 $923.00 $752.50 2026-04-01
1104893 CDM Hydroferra Blu Ready Foam 10 6 $844.00 $844.00 $346.00 $823.00 $671.00 2026-04-01
62328 CPT Fc Lumbar Punct W/ct/fluo 10 6 $837.00 $837.00 $263.00 $816.00 $665.50 2026-04-01
62270 CPT Fc Lumbar Puncture Diag 10 6 $837.00 $837.00 $263.00 $816.00 $665.50 2026-04-01
64647 CPT Chemodenerv Trunk 10 6 $805.00 $805.00 $330.00 $785.00 $640.00 2026-04-01
96116 CPT Fc Neurobehavior Status 10 6 $793.00 $793.00 $263.00 $773.00 $630.50 2026-04-01
64646 CPT Chemodenerv Ext Or Trk 10 6 $773.00 $773.00 $317.00 $753.00 $614.50 2026-04-01
43235 CPT Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 10 6 $749.00 $749.00 $307.00 $730.00 $595.50 2026-04-01
51726 CPT Complex Cystometrogram 10 6 $748.00 $748.00 $263.00 $729.00 $594.50 2026-04-01
1102801 CDM Flexiseal Fecal Collect 10 6 $699.00 $699.00 $287.00 $681.00 $555.50 2026-04-01
1102680 CDM Trach 9tts 104mm 10 6 $684.00 $684.00 $280.00 $667.00 $543.50 2026-04-01
62322 CPT Injection(s) Of Therapeutic Substance 20 6 $1,080.00 $1,080.00 $144.00 $1,762.00 $542.00 2026-04-01
94660 CPT Cpap/bipap Init/mgt 10 6 $641.00 $641.00 $263.00 $625.00 $529.50 2026-04-01
94664 CPT Mdi Demo, Evaluation 10 6 $637.00 $637.00 $261.00 $621.00 $526.50 2026-04-01
1102796 CDM Trach Custom 9.0tts 104mm 10 6 $651.00 $651.00 $267.00 $634.00 $517.50 2026-04-01
1102844 CDM 4.5tts Pedi Flextend 10 6 $651.00 $651.00 $267.00 $634.00 $517.50 2026-04-01
1102843 CDM 3.5tts Pedi Flexstend 10 6 $651.00 $651.00 $267.00 $634.00 $517.50 2026-04-01
1102982 CDM 5.0 Cuffed Bivona Trach 10 6 $651.00 $651.00 $267.00 $634.00 $517.50 2026-04-01
1102944 CDM Bivona C 9.5 Fome Cuffed 10 6 $651.00 $651.00 $267.00 $634.00 $517.50 2026-04-01
94625 CPT Plrh Wo Continous Monitor 10 6 $514.00 $514.00 $211.00 $520.00 $452.50 2026-04-01
92523 CPT Eval Sp Sd Prod/w Lang Co 10 6 $627.00 $627.00 $134.00 $611.00 $446.00 2026-04-01
64616 CPT Fc Chemodenerv M Neck Dys 10 6 $558.00 $558.00 $229.00 $544.00 $443.50 2026-04-01
1104056 CDM Mickey J Tub 16-45 10 6 $544.00 $544.00 $223.00 $530.00 $432.50 2026-04-01
1104051 CDM Mic Tube 12-1.5 10 6 $536.00 $536.00 $220.00 $522.00 $426.00 2026-04-01
94060 CPT Spirom Pre & Post Broncho 27 6 $457.00 $457.00 $180.00 $918.00 $411.00 2026-04-01
1104074 CDM Trach C, 4.5tts Flextend 10 6 $510.00 $510.00 $209.00 $497.00 $405.50 2026-04-01
99205 CPT New Patient Office Or Other Outpatient Visit, 60 Min 20 6 $513.50 $513.50 $194.00 $541.00 $405.50 2026-04-01
1104113 CDM Trach 3.5 Neonatal Flx Tt 10 6 $510.00 $510.00 $209.00 $497.00 $405.50 2026-04-01
1104028 CDM Trach, Pedi 3.0tts 10 6 $504.00 $504.00 $207.00 $491.00 $400.50 2026-04-01
94762 CPT Oximetry-continuous 10 6 $469.00 $469.00 $192.00 $457.00 $387.00 2026-04-01
95872 CPT Tc EMG-single Fiber Elect 10 6 $469.00 $469.00 $192.00 $457.00 $387.00 2026-04-01
95875 CPT Tc Ischemic Limb Exer Tes 10 6 $468.00 $468.00 $192.00 $456.00 $386.50 2026-04-01
95907 CPT Tc Nvr Condj 1-2 Stdy 10 6 $468.00 $468.00 $192.00 $456.00 $386.50 2026-04-01
95863 CPT Tc EMG-3 Extremities 10 6 $468.00 $468.00 $192.00 $456.00 $386.50 2026-04-01
95937 CPT Tc Repetitive Stim Ea Ner 10 6 $468.00 $468.00 $192.00 $456.00 $386.50 2026-04-01
94799 CPT Rt Eval Or Reval 10 6 $468.00 $468.00 $192.00 $456.00 $386.50 2026-04-01
95866 CPT Tc Muscle Test Hemidiaphr 10 6 $468.00 $468.00 $192.00 $456.00 $386.50 2026-04-01
95864 CPT Tc EMG-4 Extremities 10 6 $468.00 $468.00 $192.00 $456.00 $386.50 2026-04-01
1102525 CDM Dextro 2.5 Ultrabag 1.5ml 10 6 $475.00 $475.00 $195.00 $463.00 $378.00 2026-04-01
99245 CPT Fc Consult, Level 5 10 6 $472.00 $472.00 $194.00 $460.00 $375.50 2026-04-01
1102390 CDM 5.0 Tts Pediatric Bivona 10 6 $462.00 $462.00 $189.00 $450.00 $367.00 2026-04-01
1102524 CDM Dextro 1.5 Ultrabag 1.5ml 10 6 $462.00 $462.00 $189.00 $450.00 $367.00 2026-04-01
92612 CPT Flex Fibop Endoscop Swall 10 6 $500.00 $500.00 $134.00 $487.00 $356.00 2026-04-01
1102766 CDM Bivona 3.5 Tts Pedi 10 6 $445.00 $445.00 $182.00 $434.00 $354.00 2026-04-01
1104098 CDM 6.0 Hyperflex Flange Adj. 10 6 $445.00 $445.00 $182.00 $434.00 $354.00 2026-04-01
1102724 CDM Bivona 4.0 Tts Pedi 10 6 $445.00 $445.00 $182.00 $434.00 $354.00 2026-04-01
1102740 CDM Trach 4.5 Pedi Tts 10 6 $445.00 $445.00 $182.00 $434.00 $354.00 2026-04-01
1102831 CDM Trach Mr Hyperflex 9mm 10 6 $445.00 $445.00 $182.00 $434.00 $354.00 2026-04-01
1101235 CDM Trach Tube Fomecuf 8mm 10 6 $445.00 $445.00 $182.00 $434.00 $354.00 2026-04-01
11104 CPT Fc Punch Bx Skin Sing Les 10 6 $444.00 $444.00 $182.00 $433.00 $353.00 2026-04-01
1102889 CDM Trach, Mr Hyperflex 7.0 10 6 $440.00 $440.00 $180.00 $429.00 $349.50 2026-04-01
95990 CPT Fc Refill/mnt Implnt P Rn 10 6 $440.00 $440.00 $180.00 $429.00 $349.50 2026-04-01
90792 CPT Fc Psych Diag Eval W/med 10 6 $440.00 $440.00 $180.00 $429.00 $349.50 2026-04-01
1102830 CDM Trach Mr Hyperflex 8mm 10 6 $440.00 $440.00 $180.00 $429.00 $349.50 2026-04-01
90791 CPT Fc Np Diagnostic Eval 10 6 $424.00 $424.00 $174.00 $413.00 $337.50 2026-04-01
96132 CPT Fc Neurpsy Tst Evl 1st Hr 10 6 $424.00 $424.00 $174.00 $413.00 $337.50 2026-04-01
96130 CPT Fc Psych Test Eval 1st Hr 10 6 $424.00 $424.00 $174.00 $413.00 $337.50 2026-04-01
1102799 CDM Pouch Seal Wnd 9.7"x6.3" 10 6 $424.00 $424.00 $174.00 $413.00 $337.50 2026-04-01
94667 CPT Init Postural Drainage 20 6 $402.00 $402.00 $157.00 $409.00 $331.50 2026-04-01
1104887 CDM Dreamwear Full Face Fit 10 6 $415.00 $415.00 $170.00 $404.00 $330.00 2026-04-01
1102202 CDM 4.0 Air Cuff Pedi Bivona 10 6 $413.00 $413.00 $169.00 $403.00 $328.00 2026-04-01
1102272 CDM Trache Tube 4.otts Neo 10 6 $413.00 $413.00 $169.00 $403.00 $328.00 2026-04-01
99244 CPT Patient Office Consultation, 60 Min 30 6 $450.00 $450.00 $142.00 $476.00 $326.50 2026-04-01
90837 CPT Psychotherapy, 60 Min 20 6 $388.50 $388.50 $157.00 $384.00 $320.50 2026-04-01
1102448 CDM 2.5 Utrabg Baxter 2.0 Ml 10 6 $399.00 $399.00 $164.00 $389.00 $317.00 2026-04-01
95870 CPT Tc EMG-limited Study Musc 10 6 $384.00 $384.00 $157.00 $374.00 $317.00 2026-04-01
95861 CPT Tc EMG-2 Extremities 10 6 $384.00 $384.00 $157.00 $374.00 $317.00 2026-04-01
94618 CPT 6 Minute Walk Test 10 6 $384.00 $384.00 $81.00 $374.00 $317.00 2026-04-01
94668 CPT Postural Drainage 10 6 $384.00 $384.00 $157.00 $374.00 $317.00 2026-04-01
95860 CPT EMG-1 Extremity 10 6 $383.00 $383.00 $157.00 $373.00 $316.00 2026-04-01
95923 CPT Tc Sympathetic Skin Respo 10 6 $383.00 $383.00 $157.00 $373.00 $316.00 2026-04-01
92607 CPT Eval Speech Gen Dev 10 6 $438.00 $438.00 $134.00 $427.00 $311.50 2026-04-01
99204 CPT New Patient Office Or Other Outpatient Visit, 45 Min 20 6 $389.50 $389.50 $142.00 $422.00 $311.00 2026-04-01
20553 CPT Fc Trigger Pt Inj=>3 Musc 10 6 $391.00 $391.00 $160.00 $381.00 $310.50 2026-04-01
20552 CPT Fc Inj Trg Pt 1or2 Muscl 10 6 $391.00 $391.00 $160.00 $381.00 $310.50 2026-04-01
96112 CPT Fc Devlpmntl Test 1st Hr 10 6 $390.00 $390.00 $160.00 $380.00 $310.00 2026-04-01
95970 CPT Fc Analy Neurostim No Prg 10 6 $383.00 $383.00 $157.00 $373.00 $304.50 2026-04-01
1102881 CDM Quattro Fx Mask Sm 10 6 $381.00 $381.00 $156.00 $371.00 $303.00 2026-04-01
1102882 CDM Quattro Fx Mask Med 10 6 $381.00 $381.00 $156.00 $371.00 $303.00 2026-04-01
1102883 CDM Quattro Fx Mask Lrg 10 6 $381.00 $381.00 $156.00 $371.00 $303.00 2026-04-01
20551 CPT Fc Inj Tendon Origin 10 6 $380.00 $380.00 $156.00 $370.00 $302.00 2026-04-01
20550 CPT Fc Inj S Tend Sheath Liga 10 6 $380.00 $380.00 $156.00 $370.00 $302.00 2026-04-01
64611 CPT Fc Chemodenerv Saliv Gls 10 6 $378.00 $378.00 $155.00 $368.00 $300.50 2026-04-01
62370 CPT Fc Anly Refill Pump Md 10 6 $376.00 $376.00 $154.00 $366.00 $298.50 2026-04-01
62369 CPT Fc Anlyz Refill Pump Non 10 6 $376.00 $376.00 $154.00 $366.00 $298.50 2026-04-01
62368 CPT Fc Analyz Implnt Pump W/r 10 6 $376.00 $376.00 $154.00 $366.00 $298.50 2026-04-01
62367 CPT Fc Analyz Implnt Pump Without 10 6 $376.00 $376.00 $154.00 $366.00 $298.50 2026-04-01
1102461 CDM 8tts 94 Mm Bivona Trach 10 6 $373.00 $373.00 $153.00 $364.00 $296.50 2026-04-01
1102798 CDM Pouch Seal Wnd 6.9"x4.3" 10 6 $370.00 $370.00 $152.00 $361.00 $294.00 2026-04-01
99215 CPT Fc Office O/p Est Hi 40 M 10 6 $370.00 $370.00 $152.00 $361.00 $294.00 2026-04-01
95991 CPT Fc Refill/mnt Implnt P Md 10 6 $367.00 $367.00 $150.00 $358.00 $292.00 2026-04-01
1104892 CDM Hydroferra Blu Foam Dress 10 6 $366.00 $366.00 $150.00 $357.00 $291.00 2026-04-01
64612 CPT Fc Destroy Nerve Face Mus 10 6 $364.00 $364.00 $149.00 $355.00 $289.50 2026-04-01
1102476 CDM Dextro 1.5 Utrabg 2.0 Ml 10 6 $357.00 $357.00 $146.00 $348.00 $284.00 2026-04-01
1102038 CDM Peg J Tube 10 6 $356.00 $356.00 $146.00 $347.00 $283.00 2026-04-01
90846 CPT Family Psychotherapy, Not Including Patient, 50 Min 20 6 $344.00 $344.00 $132.00 $358.00 $282.50 2026-04-01
99213 CPT Fc Office O/p Est Low 20 10 6 $344.00 $344.00 $141.00 $335.00 $279.50 2026-04-01
99212 CPT Fc Office O/p Est Sf 10 M 10 6 $344.00 $344.00 $141.00 $335.00 $279.50 2026-04-01
99214 CPT Fc Office O/p Est Mod 30 10 6 $344.00 $344.00 $141.00 $335.00 $279.50 2026-04-01
1104090 CDM Amara View Mask Med 10 6 $350.00 $350.00 $144.00 $341.00 $278.50 2026-04-01
1104101 CDM Amara Mask W/headgear Sm 10 6 $350.00 $350.00 $144.00 $341.00 $278.50 2026-04-01
1104091 CDM Amara View Mask Lg 10 6 $350.00 $350.00 $144.00 $341.00 $278.50 2026-04-01
1104061 CDM Circuit, Hl Flow Vapother 10 6 $349.00 $349.00 $143.00 $340.00 $277.50 2026-04-01
1102449 CDM 4.25 Utrabg Baxter 2.0 Ml 10 6 $348.00 $348.00 $143.00 $339.00 $276.50 2026-04-01
1104055 CDM Flextrend Uncuffed Pe 4.5 10 6 $347.00 $347.00 $142.00 $338.00 $275.50 2026-04-01
92520 CPT Laryngeal Funct Studies 10 6 $384.00 $384.00 $134.00 $374.00 $273.00 2026-04-01
31502 CPT Fc Tracheostomy Tube Chg 10 6 $328.00 $328.00 $134.00 $320.00 $272.50 2026-04-01
92521 CPT Eval Speech Fluency 10 6 $378.00 $378.00 $134.00 $368.00 $269.00 2026-04-01
1102931 CDM Cvp Triple Lumen W/cath 10 6 $337.00 $337.00 $138.00 $328.00 $268.00 2026-04-01
42699 CPT Fc Salivary Surg Proc 10 6 $316.00 $316.00 $130.00 $308.00 $267.50 2026-04-01
1102797 CDM Pouch Seal Wnd 4.3" X 3" 10 6 $335.00 $335.00 $137.00 $327.00 $266.50 2026-04-01
1104013 CDM Med Wound Fistula Pouch 10 6 $331.00 $331.00 $136.00 $323.00 $263.50 2026-04-01
1104012 CDM Sm Wound Fistula Pouch 10 6 $331.00 $331.00 $136.00 $323.00 $263.50 2026-04-01
1104014 CDM Lg Wound Fistula Pouch 10 6 $331.00 $331.00 $136.00 $323.00 $263.50 2026-04-01
1102906 CDM Turn & Position System 10 6 $320.00 $320.00 $131.00 $312.00 $254.50 2026-04-01
51701 CPT Fc Insert Bladder Cathete 10 6 $288.00 $288.00 $118.00 $281.00 $253.50 2026-04-01
90834 CPT Psychotherapy, 45 Min 20 6 $326.00 $326.00 $110.00 $373.00 $252.00 2026-04-01
1102487 CDM Dextro 4.5 Utrabg 2.5ml 10 6 $300.00 $300.00 $123.00 $292.00 $238.50 2026-04-01
90847 CPT Family Psychotherapy, Including Patient, 50 Min 20 6 $295.50 $295.50 $109.00 $317.00 $238.00 2026-04-01
1102484 CDM Dextro 2.5 Utrabg 2.5ml 10 6 $294.00 $294.00 $121.00 $287.00 $234.00 2026-04-01
92522 CPT Eval Sp Sound Production 10 6 $325.00 $325.00 $133.00 $317.00 $231.50 2026-04-01
95983 CPT Fc Alys Brn Npgt Prgrmg 10 6 $290.00 $290.00 $119.00 $283.00 $230.50 2026-04-01
1102483 CDM Dextro 1.5 Utrabg 2.5ml 10 6 $285.00 $285.00 $117.00 $278.00 $226.50 2026-04-01
1104030 CDM Circuit, Ipv 10 6 $283.00 $283.00 $116.00 $276.00 $225.00 2026-04-01
97597 CPT Rmvl Dev Tiss Wnd <20cm 17 6 $602.00 $602.00 $102.00 $587.00 $224.00 2026-04-01
92608 CPT Eval Speech Gen Dev + 30 10 6 $314.00 $314.00 $129.00 $306.00 $223.50 2026-04-01
92605 CPT Eval Pt Script Non Sp Dev 10 6 $314.00 $314.00 $129.00 $306.00 $223.50 2026-04-01
92524 CPT Bh/quant Analy Voice/reso 10 6 $314.00 $314.00 $129.00 $306.00 $223.50 2026-04-01
99243 CPT Patient Office Consultation, 40 Min 20 6 $282.50 $282.50 $107.00 $296.00 $223.00 2026-04-01
Q3014 HCPCS Thfc Originating Site 10 6 $252.00 $252.00 $103.00 $263.00 $222.00 2026-04-01
99242 CPT Fc Consult, Level 2 10 6 $252.00 $252.00 $103.00 $263.00 $222.00 2026-04-01
99211 CPT Fc Min Evl Mgt-est Pt 10 6 $252.00 $252.00 $103.00 $263.00 $222.00 2026-04-01
99202 CPT Fc Office O/p New Sf 15 M 10 6 $252.00 $252.00 $103.00 $263.00 $222.00 2026-04-01
99404 CPT Fc Prev Med Cnsl Apprx 60 10 6 $250.00 $250.00 $103.00 $263.00 $220.00 2026-04-01
92611 CPT Modified Barium Swallow 10 6 $308.00 $308.00 $126.00 $300.00 $219.50 2026-04-01
1104057 CDM Pouch, Senura Xpro Convex 10 6 $274.00 $274.00 $112.00 $267.00 $218.00 2026-04-01
99203 CPT New Patient Office Or Other Outpatient Visit, 30 Min 20 6 $275.00 $275.00 $107.00 $282.00 $217.50 2026-04-01
1102850 CDM Dressing Prisma 10 6 $272.00 $272.00 $112.00 $265.00 $216.50 2026-04-01
1104035 CDM Mic Tube 120-12-1.2 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
1104075 CDM Mic Tube 120-14-1.7 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
1104066 CDM Mic Tube 120-20-3.0 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
1104058 CDM Micky 120-12-0.8 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
1104054 CDM Mic Tube 120-16-1.2 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
1104068 CDM Mic Button 120-14-2.0 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
1104053 CDM Mic Tube 120-14-2.7 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
1104042 CDM Mic Tube 120-24-3.5 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
1104067 CDM Mic Button 120-14-1.2 10 6 $269.00 $269.00 $110.00 $262.00 $213.50 2026-04-01
51784 CPT Fc EMG Studies Urethral 10 6 $242.00 $242.00 $99.00 $263.00 $213.00 2026-04-01
92610 CPT Bedside Dysphagia Eval 10 6 $296.00 $296.00 $121.00 $288.00 $210.50 2026-04-01
1102984 CDM Mic. Button 120-16-2.0 10 6 $263.00 $263.00 $108.00 $256.00 $209.00 2026-04-01
96125 CPT Fc Cog Testing 20 6 $287.50 $287.50 $95.00 $335.00 $208.00 2026-04-01
1104009 CDM Mickey Button 0120-13-1.7 10 6 $262.00 $262.00 $107.00 $255.00 $208.00 2026-04-01
G0237 HCPCS Proc Improve Strngth 15m 10 6 $249.00 $249.00 $102.00 $243.00 $205.50 2026-04-01
1102702 CDM Trach 7hyperflex Xtra 10 6 $258.00 $258.00 $106.00 $251.00 $205.00 2026-04-01
1102983 CDM Mic. Button 14-14-2.5 10 6 $258.00 $258.00 $106.00 $251.00 $205.00 2026-04-01
92526 CPT Trmnt Ind Dyshagia Rvu 15 10 6 $286.00 $286.00 $117.00 $279.00 $203.50 2026-04-01
1102825 CDM Trach, 6.0 Hyperflex 10 6 $255.00 $255.00 $105.00 $249.00 $202.50 2026-04-01
1104019 CDM Drain Chest Mini 10 6 $254.00 $254.00 $104.00 $248.00 $201.50 2026-04-01
96156 CPT Fc H&b Assmt/reassmt 10 6 $227.00 $227.00 $93.00 $263.00 $199.50 2026-04-01
1104083 CDM Mic Tube 120-14-1.5 10 6 $251.00 $251.00 $103.00 $245.00 $199.50 2026-04-01
1104082 CDM Mic Tube 14.1.0 10 6 $251.00 $251.00 $103.00 $245.00 $199.50 2026-04-01
96105 CPT Assess Aphasia/hr 20 6 $271.00 $271.00 $90.00 $315.00 $197.00 2026-04-01
1102703 CDM Trach 9hyperflex Xtra 10 6 $247.00 $247.00 $101.00 $241.00 $196.00 2026-04-01
1102696 CDM Trach,8.0mm Hyderflex Mr 10 6 $247.00 $247.00 $101.00 $241.00 $196.00 2026-04-01
1102280 CDM Micky Button 120-20-2.5 10 6 $245.00 $245.00 $100.00 $239.00 $195.00 2026-04-01
1104832 CDM Plurogel Wound Burn Drsng 10 6 $245.00 $245.00 $100.00 $239.00 $195.00 2026-04-01
1102884 CDM Mirage Fx Nasal Mask 10 6 $243.00 $243.00 $100.00 $237.00 $193.00 2026-04-01
1102658 CDM Aquacel Ag Rope 10 6 $241.00 $241.00 $99.00 $235.00 $191.50 2026-04-01
1101243 CDM Trach Tube 7mm Fomecuf 10 6 $240.00 $240.00 $98.00 $234.00 $190.50 2026-04-01
1104076 CDM Circuit, Low Flow 10 6 $239.00 $239.00 $98.00 $233.00 $190.00 2026-04-01
1101238 CDM Trach Tube, 9mm Bivona 10 6 $238.00 $238.00 $98.00 $232.00 $189.50 2026-04-01
1102826 CDM Trach, 6.0 Foam Cuffed 10 6 $238.00 $238.00 $98.00 $232.00 $189.50 2026-04-01
1102851 CDM Dressing Aquacel Rope Ag 10 6 $237.00 $237.00 $97.00 $231.00 $188.50 2026-04-01
92507 CPT Trmnt Ind Cd Rvu 15 Min 10 6 $263.00 $263.00 $108.00 $256.00 $187.00 2026-04-01
92609 CPT Thera Svcs Speech 15min 10 6 $261.00 $261.00 $107.00 $254.00 $186.00 2026-04-01
1104111 CDM Circuit Meta Neb 10 6 $234.00 $234.00 $96.00 $228.00 $186.00 2026-04-01
95874 CPT Tc Guide Nerv Destr Needl 10 6 $222.00 $222.00 $91.00 $216.00 $183.50 2026-04-01
90832 CPT Psychotherapy, 30 Min 20 6 $224.50 $224.50 $84.00 $239.00 $181.50 2026-04-01
97167 CPT Eval High Complexity 60mi 10 6 $282.00 $282.00 $116.00 $275.00 $179.50 2026-04-01
97163 CPT Eval High Complexity 45mi 10 6 $282.00 $282.00 $116.00 $275.00 $179.50 2026-04-01
1102679 CDM Promagram Dressing 10 6 $224.00 $224.00 $92.00 $218.00 $178.50 2026-04-01
97162 CPT Eval Mod Complexity 30min 10 6 $272.00 $272.00 $112.00 $265.00 $176.00 2026-04-01
97166 CPT Eval Mod Complexity 45min 10 6 $272.00 $272.00 $112.00 $265.00 $176.00 2026-04-01
97165 CPT Eval Low Complexity 30min 10 6 $261.00 $261.00 $107.00 $254.00 $172.50 2026-04-01
97161 CPT Eval Low Complexity 20min 10 6 $261.00 $261.00 $107.00 $254.00 $172.50 2026-04-01
99497 CPT Fc Advcd Care Plan 30 Min 10 6 $194.00 $194.00 $80.00 $263.00 $171.00 2026-04-01
92606 CPT Thera Svcs Nonspeech 15m 10 6 $238.00 $238.00 $98.00 $232.00 $169.50 2026-04-01
90471 CPT Immunization Fee 19yo And 10 6 $205.00 $205.00 $84.00 $200.00 $169.00 2026-04-01
1102555 CDM Vapor Cartridge 10 6 $207.00 $207.00 $85.00 $202.00 $164.50 2026-04-01
97598 CPT Rmvl Dev Tiss Wnd >20cm 11 6 $238.00 $238.00 $98.00 $232.00 $161.00 2026-04-01
99498 CPT Fc Advcd Care Addl 30 Min 10 6 $182.00 $182.00 $75.00 $263.00 $160.50 2026-04-01
1104040 CDM Trach, Bivona 4.0 Pedi Fl 10 6 $202.00 $202.00 $83.00 $197.00 $160.50 2026-04-01
1104106 CDM Vest, Wrap Xsmall 10 6 $199.00 $199.00 $82.00 $194.00 $158.00 2026-04-01
1104109 CDM Vest, Wrap Large 10 6 $199.00 $199.00 $82.00 $194.00 $158.00 2026-04-01
1104108 CDM Vest, Wrap Medium 10 6 $199.00 $199.00 $82.00 $194.00 $158.00 2026-04-01
1104107 CDM Vest, Wrap Small 10 6 $199.00 $199.00 $82.00 $194.00 $158.00 2026-04-01
1104110 CDM Vest, X Large 10 6 $199.00 $199.00 $82.00 $194.00 $158.00 2026-04-01
1101230 CDM Trach Tube Fomecuf 7mmbiv 10 6 $197.00 $197.00 $81.00 $192.00 $156.50 2026-04-01
11721 CPT Fc Debridement Nails = >6 10 6 $177.00 $177.00 $73.00 $263.00 $155.50 2026-04-01
1102664 CDM 3.5 Cuffless Flex Bivona 10 6 $193.00 $193.00 $79.00 $188.00 $153.50 2026-04-01
1102929 CDM 4.5 Cuffless Flextend 10 6 $193.00 $193.00 $79.00 $188.00 $153.50 2026-04-01
1102848 CDM Trach Uniperc 8.0mm 10 6 $192.00 $192.00 $79.00 $187.00 $152.50 2026-04-01
1102847 CDM Trach Uniperc 7.0mm 10 6 $192.00 $192.00 $79.00 $187.00 $152.50 2026-04-01
1102849 CDM Trach Uniperc 9.00mm 10 6 $191.00 $191.00 $78.00 $186.00 $151.50 2026-04-01
95933 CPT Tc Blink Relfex Test 10 6 $183.00 $183.00 $75.00 $178.00 $151.00 2026-04-01
1101240 CDM Trach Tube 9.0mm Talk 10 6 $188.00 $188.00 $77.00 $183.00 $149.50 2026-04-01
1102968 CDM Lid, Fistula Maxi 10 6 $187.00 $187.00 $77.00 $182.00 $149.00 2026-04-01
1104085 CDM Dreamwear W/hg Cushion Sm 10 6 $186.00 $186.00 $76.00 $181.00 $148.00 2026-04-01
1104087 CDM Dreamwear W/hg Cushion Lg 10 6 $186.00 $186.00 $76.00 $181.00 $148.00 2026-04-01
1104086 CDM Dreamwear W/h Cushion Med 10 6 $186.00 $186.00 $76.00 $181.00 $148.00 2026-04-01
1104088 CDM Dreamwear W/h Cush Med Wi 10 6 $186.00 $186.00 $76.00 $181.00 $148.00 2026-04-01
1102540 CDM Ureth Dilator Ball Cath 10 6 $185.00 $185.00 $76.00 $180.00 $147.00 2026-04-01
95873 CPT Tc Guide Nerv Dest Elec S 10 6 $178.00 $178.00 $73.00 $173.00 $147.00 2026-04-01
G0238 HCPCS Proc Improve Rt Func 15m 10 6 $177.00 $177.00 $73.00 $173.00 $146.00 2026-04-01
1101840 CDM Trach Tube, Bivona 9 Tts 10 6 $184.00 $184.00 $75.00 $179.00 $146.00 2026-04-01
1102506 CDM 7.0 Air Cuff Mr Bivona 10 6 $182.00 $182.00 $75.00 $177.00 $145.00 2026-04-01
1102507 CDM 8.0 Air Cuff Mr Bivona 10 6 $182.00 $182.00 $75.00 $177.00 $145.00 2026-04-01
1102698 CDM Trach 6mr Air Cuffed 10 6 $182.00 $182.00 $75.00 $177.00 $145.00 2026-04-01
1101232 CDM Trach Tube,8mm Bivona 10 6 $182.00 $182.00 $75.00 $177.00 $145.00 2026-04-01
1102508 CDM 9.0 Air Cuff Mr Bivona 10 6 $181.00 $181.00 $74.00 $176.00 $144.00 2026-04-01
1102293 CDM Headgear Blue Horizon Md 10 6 $180.00 $180.00 $74.00 $175.00 $143.00 2026-04-01
1104084 CDM Lids, Fistula Midi 10 6 $180.00 $180.00 $74.00 $175.00 $143.00 2026-04-01
96167 CPT Fc H&b Intrvtn Fam&pt 30m 10 6 $162.00 $162.00 $66.00 $263.00 $142.50 2026-04-01
97763 CPT Ortho/prosth Mgmt Subsq 11 6 $174.00 $174.00 $71.00 $170.00 $140.00 2026-04-01
97168 CPT Ot Re-evaluation 30 Min 10 6 $181.00 $181.00 $74.00 $176.00 $139.50 2026-04-01
1101236 CDM Trach Tube,5mm Bivona 10 6 $175.00 $175.00 $72.00 $171.00 $139.50 2026-04-01
1101234 CDM Trach Tube, 7mm Bivona 10 6 $175.00 $175.00 $72.00 $171.00 $139.50 2026-04-01
1101233 CDM Trach Tube,6mm Bivona 10 6 $175.00 $175.00 $72.00 $171.00 $139.50 2026-04-01
1101228 CDM Trach Tube, 7.5 Bivona 10 6 $175.00 $175.00 $72.00 $171.00 $139.50 2026-04-01
1104049 CDM Pouch, Sensura 10 6 $174.00 $174.00 $71.00 $170.00 $138.50 2026-04-01
1102967 CDM Lid, Fistula Mini 10 6 $172.00 $172.00 $71.00 $168.00 $137.00 2026-04-01
97164 CPT Pt Re-evaluation 20 Min 10 6 $168.00 $168.00 $69.00 $164.00 $137.00 2026-04-01
1102672 CDM Wound Vac Daily Charge 10 6 $171.00 $171.00 $70.00 $167.00 $136.00 2026-04-01
97533 CPT Sens Int Tec Enh Sens 15m 11 6 $151.00 $151.00 $62.00 $161.00 $136.00 2026-04-01
1102753 CDM Dressing, Vac Silver Med 10 6 $170.00 $170.00 $70.00 $166.00 $135.00 2026-04-01
1102841 CDM Wound Drng/w Barrier Coll 10 6 $170.00 $170.00 $70.00 $166.00 $135.00 2026-04-01
1102184 CDM Double Cuff Trach 10 6 $168.00 $168.00 $69.00 $164.00 $133.50 2026-04-01
96158 CPT Fc H&b Intervention 30m 10 6 $151.00 $151.00 $62.00 $263.00 $133.00 2026-04-01
97550 CPT Caregiver Traing 1st 30 M 14 6 $138.00 $138.00 $57.00 $163.00 $131.50 2026-04-01
1104872 CDM Surgical Hemostat 10 6 $163.00 $163.00 $67.00 $159.00 $129.50 2026-04-01
96136 CPT Fc Test Adminstrn 1st 30m 10 6 $146.00 $146.00 $60.00 $263.00 $128.50 2026-04-01
1101226 CDM Trach Dblcuffed 8.0 Ptx 10 6 $161.00 $161.00 $66.00 $157.00 $128.00 2026-04-01
95992 CPT Canalith Repositioning 11 6 $130.00 $130.00 $53.00 $161.00 $127.00 2026-04-01
A9279 HCPCS Expiratory Muscle Device 10 6 $156.00 $156.00 $64.00 $152.00 $124.00 2026-04-01
97755 CPT Assist Tech Assessment 11 6 $127.00 $127.00 $52.00 $161.00 $124.00 2026-04-01
1102694 CDM Dressing, Ats Vac Thin 10 6 $155.00 $155.00 $64.00 $151.00 $123.00 2026-04-01
96139 CPT Test Adm&scr Adtl30m Tech 10 6 $138.00 $138.00 $57.00 $263.00 $121.50 2026-04-01
96138 CPT Test Adm&scr 1st 30m Tech 10 6 $138.00 $138.00 $57.00 $263.00 $121.50 2026-04-01
97760 CPT Orthotic Mgt And Training 11 6 $123.00 $123.00 $50.00 $161.00 $120.00 2026-04-01
1102802 CDM Pouch, Flexiseal Fecal 10 6 $150.00 $150.00 $61.00 $146.00 $119.50 2026-04-01
L8501 HCPCS Valve Passy Muir Purple 10 6 $149.00 $149.00 $61.00 $145.00 $118.50 2026-04-01
1102040 CDM Passy Muir Valve For Vent 10 6 $149.00 $149.00 $61.00 $145.00 $118.50 2026-04-01
1102121 CDM Trach Tube, Divona 4.5 Mm 10 6 $149.00 $149.00 $61.00 $145.00 $118.50 2026-04-01
97750 CPT Phys Perf Test, Measure 11 6 $121.00 $121.00 $50.00 $161.00 $118.00 2026-04-01
95851 CPT Range Of Motion Measuremt 11 6 $121.00 $121.00 $50.00 $161.00 $118.00 2026-04-01
L4397 HCPCS Care Solution Afo Med 20 6 $168.50 $168.50 $53.00 $202.00 $117.00 2026-04-01
97542 CPT Whlchr Mgt/propul Trn 15m 11 6 $119.00 $119.00 $49.00 $161.00 $116.00 2026-04-01
97537 CPT Comm/work Integrate 15 M 11 6 $119.00 $119.00 $49.00 $161.00 $116.00 2026-04-01
97535 CPT Self/home Train Adl 15 M 11 6 $119.00 $119.00 $49.00 $161.00 $116.00 2026-04-01
97530 CPT Therapeutic/funct Act 11 6 $119.00 $119.00 $49.00 $161.00 $116.00 2026-04-01
1000011 CDM Daily Oxygen 10 6 $145.00 $145.00 $59.00 $141.00 $115.50 2026-04-01
1102786 CDM Insertion Chest Tray 10 6 $145.00 $145.00 $59.00 $141.00 $115.50 2026-04-01
1104121 CDM Aeroneb Ultra Starter Kit 10 6 $145.00 $145.00 $59.00 $141.00 $115.50 2026-04-01
97761 CPT Pros Fit/trn Up/low 15 M 11 6 $118.00 $118.00 $48.00 $161.00 $115.00 2026-04-01
92551 CPT Screen Tst Pure Tone Air 10 6 $127.00 $127.00 $52.00 $163.00 $114.00 2026-04-01
92508 CPT Group Therapy Rates 10 6 $127.00 $127.00 $52.00 $163.00 $114.00 2026-04-01
1101398 CDM Tubigrip,size F 10 6 $143.00 $143.00 $59.00 $139.00 $113.50 2026-04-01
1104820 CDM Scd Compression Large 10 6 $143.00 $143.00 $59.00 $139.00 $113.50 2026-04-01
90853 CPT Group Psychotherapy 20 6 $136.50 $136.50 $54.00 $138.00 $112.50 2026-04-01
1102948 CDM Pleurx DRG 500ml Vac Bot 10 6 $140.00 $140.00 $57.00 $136.00 $111.00 2026-04-01
1102746 CDM Trach 3.5 Pedi Cuffless 10 6 $140.00 $140.00 $57.00 $136.00 $111.00 2026-04-01
1102138 CDM Trach Divona 4.0cuffless 10 6 $139.00 $139.00 $57.00 $135.00 $110.50 2026-04-01
1101764 CDM Bivona Neontl Trach Tube 10 6 $138.00 $138.00 $57.00 $135.00 $110.00 2026-04-01
97113 CPT Pool Therapy (15min) 11 6 $113.00 $113.00 $46.00 $161.00 $110.00 2026-04-01
1104073 CDM Pouch, Flextend 1-1/2 10 6 $136.00 $136.00 $56.00 $133.00 $108.00 2026-04-01
1102932 CDM Trach, Cuffless 7.0 10 6 $135.00 $135.00 $55.00 $132.00 $107.50 2026-04-01
97140 CPT Manual Therapy Techniques 11 6 $110.00 $110.00 $45.00 $161.00 $107.00 2026-04-01
97116 CPT Gait/stair Train 15 M 11 6 $110.00 $110.00 $45.00 $161.00 $107.00 2026-04-01
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