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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

SILVER HILL HOSPITAL INC

New Canaan, CT · CCN 074014 · Rates published

315 distinct procedures filed
30 distinct payers
15,643 rate rows
2026-09-01 last MRF observed
Data quality

3,002 of 15,643 rate rows are consumer-grade (19.2%)

12,641 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 10,795
per-diem day rate — not a per-procedure price 1,831
percent-of-charges filed in the dollar field — excluded from medians 13
exceeds 10× this hospital's gross charge — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSHHINEWCANAANCT&type=CDMWithoutLabel&fileType=CSV
Found on page https://silverhillhospital.org/resources/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-07
Content fingerprint 32f477460e3d94e2… · 834,806 bytes · first seen 2026-09-21

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
96130
HCPCS 		Evaluation Of Psychological Test, First Hour 6 $3,000.00 $3,600.00 $3,600.00 nat. median
$256
outlier · 14.0×
9000070
CDM 		Rev - Bh/treatments 6 $2,760.00 $3,312.00 $3,312.00 nat. median
$3,312
1.0× median
5100400
CDM 		Rev - Ihs-moa Clinic Visit 6 $2,760.00 $3,312.00 $3,312.00 nat. median
$3,312
1.0× median
9000060
CDM 		Rev - Bh/treatments 6 $2,250.00 $2,700.00 $2,700.00 nat. median
$2,700
1.0× median
H0017
HCPCS 		Behavioral Health; Residential (hospital Residential Treatment Program), Without… 1 $1,325.00 $2,625.00 $1,975.00 nat. median
$348
outlier · 5.7×
9000050
CDM 		Rev - Bh/treatments 6 $1,500.00 $1,800.00 $1,800.00 nat. median
$1,800
1.0× median
90870
HCPCS 		Electroshock Therapy Op 7 $192.00 $1,642.85 $1,466.00 nat. median
$778
1.9× median
90885
HCPCS 		Psychological Test Report 6 $925.00 $1,110.00 $1,110.00 nat. median
$70
outlier · 15.9×
9000040
CDM 		Rev - Bh/treatments 6 $750.00 $900.00 $900.00 nat. median
$900
1.0× median
3000630
CDM 		Lab 6 $678.00 $813.60 $813.60 nat. median
$814
1.0× median
96125
HCPCS 		Cognitive Test By Hc Pro 6 $500.00 $600.00 $600.00 nat. median
$143
outlier · 4.2×
5100430
CDM 		Rev - Ihs-moa Clinic Visit 6 $500.00 $600.00 $600.00 nat. median
$600
1.0× median
S9480
HCPCS 		Tp Aetna Iop Psych 2 $556.12 $556.12 $556.12 nat. median
$296
1.9× median
3002300
CDM 		Abeta 42/40 & Ptau217 Eval 6 $420.00 $504.00 $504.00 nat. median
$504
1.0× median
81226
HCPCS 		HILOmet 2d6 Ver 2 6 $418.95 $502.74 $502.74 nat. median
$453
1.1× median
3002500
CDM 		Flu A/b Rsv RNA Ql,rt-pcr 6 $400.29 $480.35 $480.35 nat. median
$480
1.0× median
9050040
CDM 		Telehealth Op Psy 4 $381.00 $556.12 $468.56 nat. median
$469
1.0× median
9050030
CDM 		Tp Iop Psych 4 $381.00 $556.12 $468.56 nat. median
$469
1.0× median
9060020
CDM 		Telehealth Iop Sub 4 $381.00 $556.12 $468.56 nat. median
$469
1.0× median
3002600
CDM 		Lup Pan 2 W/ana W/refl Tit/pat 6 $325.04 $390.05 $390.05 nat. median
$390
1.0× median
3002580
CDM 		Jak2 V617f Mutation Analysis 6 $300.30 $360.36 $360.36 nat. median
$360
1.0× median
90839
HCPCS 		Urgent Care Initial 60min 6 $161.00 $360.00 $360.00 nat. median
$216
1.7× median
9000020
CDM 		Rev - Bh/treatments 6 $300.00 $360.00 $360.00 nat. median
$360
1.0× median
3002650
CDM 		Nmda Receptor Antibody Test 6 $275.60 $330.72 $330.72 nat. median
$331
1.0× median
81225
HCPCS 		HILOmet 2c19 6 $256.50 $307.80 $307.80 nat. median
$303
1.0× median
5100090
CDM 		Rev - Ihs-moa Clinic Visit 6 $250.00 $300.00 $300.00 nat. median
$232
1.3× median
87522
HCPCS 		Hepatitis C Viral DNA Qua 6 $211.00 $253.20 $253.20 nat. median
$73
outlier · 3.5×
3002330
CDM 		Apoe Iso, Plasma 6 $210.00 $252.00 $252.00 nat. median
$252
1.0× median
80076
HCPCS 		Hepatic Function Panel 6 $16.50 $562.98 $244.47 nat. median
$13
outlier · 18.7×
5100420
CDM 		Rev - Ihs-moa Clinic Visit 6 $200.00 $240.00 $240.00 nat. median
$240
1.0× median
87902
HCPCS 		Hep C Genotype 6 $200.00 $240.00 $240.00 nat. median
$309
0.8× median
G2083
HCPCS 		Office Or Other Outpatient Visit For The Evaluation And Management Of An Establi… 6 $187.50 $225.00 $225.00 nat. median
$1,650
outlier · 0.1×
G2082
HCPCS 		Office Or Other Outpatient Visit For The Evaluation And Management Of An Establi… 6 $187.50 $225.00 $225.00 nat. median
$1,159
outlier · 0.2×
81227
HCPCS 		HILOmet 2c9 6 $179.55 $215.46 $215.46 nat. median
$180
1.2× median
90792
HCPCS 		Psych Diag Eval 6 $150.00 $300.00 $215.00 nat. median
$225
1.0× median
90834
HCPCS 		Individual Therapy 45min 6 $105.00 $300.00 $210.00 nat. median
$192
1.1× median
3002550
CDM 		HIV 1 Rna, Quantitative Pcr 6 $170.97 $205.16 $205.16 nat. median
$205
1.0× median
3002480
CDM 		Factor V/leiden Analysis 6 $169.80 $203.75 $203.75 nat. median
$204
1.0× median
3002670
CDM 		Quest Ad Detect Ptau181,plasma 6 $163.80 $196.56 $196.56 nat. median
$197
1.0× median
99205
HCPCS 		Md Pain Assessment 6 $150.00 $199.08 $180.00 nat. median
$274
0.7× median
90840
HCPCS 		Urgent Care Add'l 30min 6 $79.00 $180.00 $180.00 nat. median
$114
1.6× median
3003001
CDM 		Pharmacogenomics Panel 6 $150.00 $180.00 $180.00 nat. median
$180
1.0× median
90791
HCPCS 		Psychological Evaluation 6 $150.00 $180.00 $180.00 nat. median
$213
0.8× median
99255
HCPCS 		Inpatient Or Observation Consultation With High Level Of Medical Decision Making… 6 $150.00 $180.00 $180.00 nat. median
$330
0.5× median
90847
HCPCS 		Family Therapy W/pt 4 $125.00 $300.00 $165.00 nat. median
$200
0.8× median
90846
HCPCS 		Family Therapy Without Pt 4 $150.00 $180.00 $165.00 nat. median
$196
0.8× median
99254
HCPCS 		Inpatient Or Observation Consultation With Moderate Level Of Medical Decision Ma… 6 $137.50 $165.00 $165.00 nat. median
$283
0.6× median
3002370
CDM 		Catecholamines, Plasma 6 $130.03 $156.04 $156.04 nat. median
$156
1.0× median
99204
HCPCS 		E&m New Pt Level 4 6 $125.00 $150.00 $150.00 nat. median
$210
0.7× median
99253
HCPCS 		Inpatient Or Observation Consultation With Low Level Of Medical Decision Making,… 6 $125.00 $150.00 $150.00 nat. median
$198
0.8× median

Other procedures at this hospital

Browse this hospital's 315 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
             
96130 HCPCS Evaluation Of Psychological Test, First Hour 6 6 $6,000.00 $6,000.00 $3,000.00 $3,600.00 $3,600.00 2026-09-01
5100400 CDM Rev - Ihs-moa Clinic Visit 6 6 $5,520.00 $5,520.00 $2,760.00 $3,312.00 $3,312.00 2026-09-01
9000070 CDM Rev - Bh/treatments 6 6 $5,520.00 $5,520.00 $2,760.00 $3,312.00 $3,312.00 2026-09-01
9000060 CDM Rev - Bh/treatments 6 6 $4,500.00 $4,500.00 $2,250.00 $2,700.00 $2,700.00 2026-09-01
H0017 HCPCS Behavioral Health; Residential (hospital Residential Treatment Program), Without… 2 1 $3,950.00 $3,950.00 $1,325.00 $2,625.00 $1,975.00 2026-09-01
9000050 CDM Rev - Bh/treatments 6 6 $3,000.00 $3,000.00 $1,500.00 $1,800.00 $1,800.00 2026-09-01
90870 HCPCS Electroshock Therapy Op 7 7 $3,400.00 $3,400.00 $192.00 $1,642.85 $1,466.00 2026-09-01
90885 HCPCS Psychological Test Report 6 6 $1,850.00 $1,850.00 $925.00 $1,110.00 $1,110.00 2026-09-01
9000040 CDM Rev - Bh/treatments 6 6 $1,500.00 $1,500.00 $750.00 $900.00 $900.00 2026-09-01
3000630 CDM Lab 6 6 $1,356.00 $1,356.00 $678.00 $813.60 $813.60 2026-09-01
96125 HCPCS Cognitive Test By Hc Pro 6 6 $1,000.00 $1,000.00 $500.00 $600.00 $600.00 2026-09-01
5100430 CDM Rev - Ihs-moa Clinic Visit 6 6 $1,000.00 $1,000.00 $500.00 $600.00 $600.00 2026-09-01
S9480 HCPCS Tp Aetna Iop Psych 2 2 $635.00 $635.00 $556.12 $556.12 $556.12 2026-09-01
3002300 CDM Abeta 42/40 & Ptau217 Eval 6 6 $840.00 $840.00 $420.00 $504.00 $504.00 2026-09-01
81226 HCPCS HILOmet 2d6 Ver 2 6 6 $837.90 $837.90 $418.95 $502.74 $502.74 2026-09-01
3002500 CDM Flu A/b Rsv RNA Ql,rt-pcr 6 6 $800.58 $800.58 $400.29 $480.35 $480.35 2026-09-01
9060020 CDM Telehealth Iop Sub 4 4 $635.00 $635.00 $381.00 $556.12 $468.56 2026-09-01
9050040 CDM Telehealth Op Psy 4 4 $635.00 $635.00 $381.00 $556.12 $468.56 2026-09-01
9050030 CDM Tp Iop Psych 4 4 $635.00 $635.00 $381.00 $556.12 $468.56 2026-09-01
3002600 CDM Lup Pan 2 W/ana W/refl Tit/pat 6 6 $650.08 $650.08 $325.04 $390.05 $390.05 2026-09-01
3002580 CDM Jak2 V617f Mutation Analysis 6 6 $600.60 $600.60 $300.30 $360.36 $360.36 2026-09-01
90839 HCPCS Urgent Care Initial 60min 6 6 $600.00 $600.00 $161.00 $360.00 $360.00 2026-09-01
9000020 CDM Rev - Bh/treatments 6 6 $600.00 $600.00 $300.00 $360.00 $360.00 2026-09-01
3002650 CDM Nmda Receptor Antibody Test 6 6 $551.20 $551.20 $275.60 $330.72 $330.72 2026-09-01
81225 HCPCS HILOmet 2c19 6 6 $513.00 $513.00 $256.50 $307.80 $307.80 2026-09-01
5100090 CDM Rev - Ihs-moa Clinic Visit 6 6 $500.00 $500.00 $250.00 $300.00 $300.00 2026-09-01
87522 HCPCS Hepatitis C Viral DNA Qua 6 6 $422.00 $422.00 $211.00 $253.20 $253.20 2026-09-01
3002330 CDM Apoe Iso, Plasma 6 6 $420.00 $420.00 $210.00 $252.00 $252.00 2026-09-01
80076 HCPCS Hepatic Function Panel 12 6 $485.65 $485.65 $16.50 $562.98 $244.47 2026-09-01
87902 HCPCS Hep C Genotype 6 6 $400.00 $400.00 $200.00 $240.00 $240.00 2026-09-01
5100420 CDM Rev - Ihs-moa Clinic Visit 6 6 $400.00 $400.00 $200.00 $240.00 $240.00 2026-09-01
G2083 HCPCS Office Or Other Outpatient Visit For The Evaluation And Management Of An Establi… 6 6 $375.00 $375.00 $187.50 $225.00 $225.00 2026-09-01
G2082 HCPCS Office Or Other Outpatient Visit For The Evaluation And Management Of An Establi… 6 6 $375.00 $375.00 $187.50 $225.00 $225.00 2026-09-01
81227 HCPCS HILOmet 2c9 6 6 $359.10 $359.10 $179.55 $215.46 $215.46 2026-09-01
90792 HCPCS Psych Diag Eval 12 6 $400.00 $400.00 $150.00 $300.00 $215.00 2026-09-01
90834 HCPCS Individual Therapy 45min 18 6 $350.00 $350.00 $105.00 $300.00 $210.00 2026-09-01
3002550 CDM HIV 1 Rna, Quantitative Pcr 6 6 $341.93 $341.93 $170.97 $205.16 $205.16 2026-09-01
3002480 CDM Factor V/leiden Analysis 6 6 $339.59 $339.59 $169.80 $203.75 $203.75 2026-09-01
3002670 CDM Quest Ad Detect Ptau181,plasma 6 6 $327.60 $327.60 $163.80 $196.56 $196.56 2026-09-01
3003001 CDM Pharmacogenomics Panel 6 6 $300.00 $300.00 $150.00 $180.00 $180.00 2026-09-01
99255 HCPCS Inpatient Or Observation Consultation With High Level Of Medical Decision Making… 6 6 $300.00 $300.00 $150.00 $180.00 $180.00 2026-09-01
90791 HCPCS Psychological Evaluation 6 6 $300.00 $300.00 $150.00 $180.00 $180.00 2026-09-01
90840 HCPCS Urgent Care Add'l 30min 6 6 $300.00 $300.00 $79.00 $180.00 $180.00 2026-09-01
99205 HCPCS Md Pain Assessment 18 6 $315.00 $315.00 $150.00 $199.08 $180.00 2026-09-01
99254 HCPCS Inpatient Or Observation Consultation With Moderate Level Of Medical Decision Ma… 6 6 $275.00 $275.00 $137.50 $165.00 $165.00 2026-09-01
90847 HCPCS Family Therapy W/pt 12 4 $300.00 $300.00 $125.00 $300.00 $165.00 2026-09-01
90846 HCPCS Family Therapy Without Pt 4 4 $300.00 $300.00 $150.00 $180.00 $165.00 2026-09-01
3002370 CDM Catecholamines, Plasma 6 6 $260.06 $260.06 $130.03 $156.04 $156.04 2026-09-01
99253 HCPCS Inpatient Or Observation Consultation With Low Level Of Medical Decision Making,… 6 6 $250.00 $250.00 $125.00 $150.00 $150.00 2026-09-01
99204 HCPCS E&m New Pt Level 4 6 6 $250.00 $250.00 $125.00 $150.00 $150.00 2026-09-01
3002620 CDM Metanephrines, Plasma 6 6 $247.67 $247.67 $123.84 $148.60 $148.60 2026-09-01
3001140 CDM Suboxone 6 6 $247.00 $247.00 $123.50 $148.20 $148.20 2026-09-01
99203 HCPCS E&m New Pt Level 3 12 6 $255.90 $255.90 $90.00 $199.08 $136.95 2026-09-01
90837 HCPCS Individual Therapy 60min 6 6 $210.00 $210.00 $105.00 $126.00 $126.00 2026-09-01
90838 HCPCS Psytherapy E&m Op 60min 6 6 $210.00 $210.00 $105.00 $126.00 $126.00 2026-09-01
3002380 CDM Bartonella Species Ab W/refl 6 6 $209.68 $209.68 $104.84 $125.81 $125.81 2026-09-01
99215 HCPCS E&m Estab Pt Level 5 12 6 $209.88 $209.88 $102.38 $129.00 $122.85 2026-09-01
90853 HCPCS Iop 3hr Psych 18 8 $200.00 $200.00 $30.00 $556.12 $120.00 2026-09-01
97803 HCPCS Therapy Procedure Reassessment For Nutrition Management, Each 15 Minutes 6 6 $200.00 $200.00 $100.00 $120.00 $120.00 2026-09-01
S9470 HCPCS Nutritional Counseling, Dietitian Visit 6 6 $200.00 $200.00 $100.00 $120.00 $120.00 2026-09-01
99252 HCPCS Inpatient Or Observation Consultation With Straightforward Medical Decision Maki… 6 6 $200.00 $200.00 $100.00 $120.00 $120.00 2026-09-01
97802 HCPCS Therapy Procedure For Nutrition Management, Each 15 Minutes 6 6 $200.00 $200.00 $100.00 $120.00 $120.00 2026-09-01
90836 HCPCS Psytherapy E&m Op 45min 6 6 $200.00 $200.00 $100.00 $120.00 $120.00 2026-09-01
99202 HCPCS E&m New Pt Level 2 12 6 $225.90 $225.90 $60.00 $199.08 $118.95 2026-09-01
99214 HCPCS E&m Estab Pt Level 4 18 6 $195.00 $195.00 $92.40 $300.00 $117.00 2026-09-01
3002730 CDM Toxoplasma Ab (igg,igm) 6 6 $190.03 $190.03 $95.02 $114.02 $114.02 2026-09-01
3003010 CDM Vitb1 (thiamine), Serum/plasma 6 6 $173.79 $173.79 $86.90 $104.27 $104.27 2026-09-01
3000670 CDM Clonazepam Urine 6 6 $171.00 $171.00 $85.50 $102.60 $102.60 2026-09-01
90882 HCPCS Crisis Intervention 6 6 $170.00 $170.00 $85.00 $102.00 $102.00 2026-09-01
99211 HCPCS E&m Estab Pt Level 1 12 6 $188.40 $188.40 $22.50 $199.08 $96.45 2026-09-01
3002610 CDM Metanephrines 24 Hr Urine 6 6 $159.44 $159.44 $79.72 $95.66 $95.66 2026-09-01
82024 HCPCS Acth 6 6 $159.00 $159.00 $79.50 $95.40 $95.40 2026-09-01
3002360 CDM Bnp 6 6 $154.03 $154.03 $77.02 $92.42 $92.42 2026-09-01
99213 HCPCS E&m Estab Pt Level 3 12 6 $159.00 $159.00 $75.00 $100.80 $90.00 2026-09-01
5100070 CDM Rev - Ihs-moa Clinic Visit 6 6 $150.00 $150.00 $75.00 $90.00 $90.00 2026-09-01
5100470 CDM Rev - Ihs-moa Clinic Visit 6 6 $150.00 $150.00 $75.00 $90.00 $90.00 2026-09-01
3002390 CDM Catecholamines, W/creat 6 6 $149.13 $149.13 $74.57 $89.48 $89.48 2026-09-01
80173 HCPCS Haloperidol 6 6 $145.00 $145.00 $72.50 $87.00 $87.00 2026-09-01
80306 HCPCS Drug Abuse Screen 6 6 $144.00 $144.00 $72.00 $86.40 $86.40 2026-09-01
90833 HCPCS Psytherapy E&m Op 30min 6 6 $135.00 $135.00 $67.50 $81.00 $81.00 2026-09-01
3004050 CDM Babesia Microti Ab, Ifa 6 6 $134.00 $134.00 $67.00 $80.40 $80.40 2026-09-01
3002320 CDM Amphetamines Expanded, Qn,u 6 6 $132.53 $132.53 $66.27 $79.52 $79.52 2026-09-01
99212 HCPCS E&m Estab Pt Level 2 12 6 $147.40 $147.40 $55.00 $110.88 $79.20 2026-09-01
3002510 CDM Fluoxetine 6 6 $127.79 $127.79 $63.90 $76.67 $76.67 2026-09-01
82306 HCPCS Vitamin D, 25-hydroxy 6 6 $120.00 $120.00 $60.00 $72.00 $72.00 2026-09-01
99223 HCPCS Hosp Physical Exam 6 6 $120.00 $120.00 $60.00 $72.00 $72.00 2026-09-01
3002640 CDM Mycoplasma Pneumoniae Ab 6 6 $117.62 $117.62 $58.81 $70.57 $70.57 2026-09-01
82670 HCPCS Estradiol 6 6 $114.00 $114.00 $57.00 $68.40 $68.40 2026-09-01
84432 HCPCS Culture, Stool 12 6 $128.64 $128.64 $21.50 $128.57 $66.48 2026-09-01
90832 HCPCS Individual Therapy 30min 6 6 $110.00 $110.00 $55.00 $66.00 $66.00 2026-09-01
3002310 CDM Alpha Subunit 6 6 $109.18 $109.18 $54.59 $65.51 $65.51 2026-09-01
3002400 CDM Celiac Disease Comp Panel 6 6 $105.76 $105.76 $52.88 $63.46 $63.46 2026-09-01
84403 HCPCS Testosterone Free & Total 6 6 $105.00 $105.00 $52.50 $63.00 $63.00 2026-09-01
86146 HCPCS Antiphospholipid Ab Panel 6 6 $105.00 $105.00 $52.50 $63.00 $63.00 2026-09-01
3004060 CDM C.diff W/rfx Toxin B, Pcr 6 6 $103.63 $103.63 $51.82 $62.18 $62.18 2026-09-01
84207 HCPCS Vitamin B6 6 6 $102.00 $102.00 $51.00 $61.20 $61.20 2026-09-01
3003000 CDM Vitb12/folate, Serum Panel 6 6 $101.78 $101.78 $50.89 $61.07 $61.07 2026-09-01
93000 HCPCS Electrocardiogrm EKG 6 6 $101.50 $101.50 $50.75 $60.90 $60.90 2026-09-01
3002980 CDM Valproic Acid, Total & Free 6 6 $101.20 $101.20 $50.60 $60.72 $60.72 2026-09-01
80074 HCPCS Acute Hepatitus Panel 12 6 $110.50 $110.50 $32.50 $93.60 $58.50 2026-09-01
3000650 CDM Mdma 6 6 $93.55 $93.55 $46.78 $56.13 $56.13 2026-09-01
3002710 CDM Sodium With Creat, Random Urine 6 6 $92.42 $92.42 $46.21 $55.45 $55.45 2026-09-01
3000040 CDM Thyroid Function Panel 6 6 $90.64 $90.64 $45.32 $54.38 $54.38 2026-09-01
3002530 CDM Hla-b27 Antigen 6 6 $90.37 $90.37 $45.19 $54.22 $54.22 2026-09-01
82672 HCPCS Estrogen 6 6 $90.00 $90.00 $45.00 $54.00 $54.00 2026-09-01
3002560 CDM Igf 1, Lc/ms 6 6 $89.82 $89.82 $44.91 $53.89 $53.89 2026-09-01
3002470 CDM Erythropoietin 6 6 $89.72 $89.72 $44.86 $53.83 $53.83 2026-09-01
99070 HCPCS Ect Supplies 6 6 $89.00 $89.00 $44.50 $53.40 $53.40 2026-09-01
3002570 CDM Iron, Tibc And Ferritin Panel 6 6 $88.49 $88.49 $44.25 $53.09 $53.09 2026-09-01
3002540 CDM Hcv Rna, Qn Real Time Pcr 6 6 $88.40 $88.40 $44.20 $53.04 $53.04 2026-09-01
3001611 CDM Arsenic 24-hour Urine 6 6 $87.68 $87.68 $43.84 $52.61 $52.61 2026-09-01
86360 HCPCS T&b Cells 6 6 $85.31 $85.31 $42.66 $51.19 $51.19 2026-09-01
82553 HCPCS Ckmb 6 6 $84.00 $84.00 $42.00 $50.40 $50.40 2026-09-01
3000880 CDM Acetaminophen 6 6 $84.00 $84.00 $42.00 $50.40 $50.40 2026-09-01
84144 HCPCS Progesterone 6 6 $84.00 $84.00 $42.00 $50.40 $50.40 2026-09-01
3002340 CDM Aldosterone/pra Ratio,lc/ms/ms 6 6 $81.57 $81.57 $40.79 $48.94 $48.94 2026-09-01
80069 HCPCS Renal Function Panel 6 6 $81.56 $81.56 $40.78 $48.94 $48.94 2026-09-01
3002990 CDM Vitb1 (thiamine)blood Lc/ms/ms 6 6 $81.02 $81.02 $40.51 $48.61 $48.61 2026-09-01
87490 HCPCS Chlamydia 6 6 $81.00 $81.00 $40.50 $48.60 $48.60 2026-09-01
3002760 CDM Tissue Trans Ab, Igg 6 6 $80.99 $80.99 $40.50 $48.59 $48.59 2026-09-01
82175 HCPCS Heavy Metal Panel 6 6 $78.00 $78.00 $39.00 $46.80 $46.80 2026-09-01
82378 HCPCS Carcinoembryonic Antigen 6 6 $78.00 $78.00 $39.00 $46.80 $46.80 2026-09-01
3002490 CDM Influenza A And B,pcr 6 6 $75.00 $75.00 $37.50 $45.00 $45.00 2026-09-01
80159 HCPCS Clozapine (clozaril) 6 6 $75.00 $75.00 $37.50 $45.00 $45.00 2026-09-01
83021 HCPCS Hgb Electrophoresis 6 6 $75.00 $75.00 $37.50 $45.00 $45.00 2026-09-01
84153 HCPCS Prostate Specific Ag 6 6 $75.00 $75.00 $37.50 $45.00 $45.00 2026-09-01
3000720 CDM Amitriptyline 6 6 $72.00 $72.00 $36.00 $43.20 $43.20 2026-09-01
86235 HCPCS Sjogren's Antibodies 6 6 $72.00 $72.00 $36.00 $43.20 $43.20 2026-09-01
3002680 CDM Quantiferon(r)-TB Gold Plus 6 6 $71.49 $71.49 $35.75 $42.89 $42.89 2026-09-01
3004100 CDM Lactate Dehydrogenase 6 6 $70.28 $70.28 $35.14 $42.17 $42.17 2026-09-01
5100130 CDM Rev - Ihs-moa Clinic Visit 6 6 $70.00 $70.00 $35.00 $42.00 $42.00 2026-09-01
83090 HCPCS Homocysteine 6 6 $69.00 $69.00 $34.50 $41.40 $41.40 2026-09-01
3001090 CDM Imipramine 6 6 $69.00 $69.00 $34.50 $41.40 $41.40 2026-09-01
84443 HCPCS Tsh 6 6 $69.00 $69.00 $34.50 $41.40 $41.40 2026-09-01
5100050 CDM Rev - Ihs-moa Clinic Visit 6 6 $68.00 $68.00 $34.00 $40.80 $40.80 2026-09-01
5100010 CDM Rev - Ihs-moa Clinic Visit 6 6 $68.00 $68.00 $34.00 $40.80 $40.80 2026-09-01
84482 HCPCS T3 Reverse 6 6 $66.00 $66.00 $33.00 $39.60 $39.60 2026-09-01
84585 HCPCS Vma, 24 Hr Urine 6 6 $63.00 $63.00 $31.50 $37.80 $37.80 2026-09-01
80299 HCPCS Lamotrigine 18 6 $72.79 $72.79 $28.50 $45.00 $37.50 2026-09-01
84134 HCPCS Prealbumin 6 6 $60.00 $60.00 $30.00 $36.00 $36.00 2026-09-01
82746 HCPCS Serum Folate 12 6 $68.79 $68.79 $15.00 $64.55 $35.89 2026-09-01
82728 HCPCS Ferrtin 6 6 $57.00 $57.00 $28.50 $34.20 $34.20 2026-09-01
83789 HCPCS Trileptal/oxycarbazepine 6 6 $57.00 $57.00 $28.50 $34.20 $34.20 2026-09-01
84481 HCPCS T3 Free 12 6 $62.00 $62.00 $27.50 $41.40 $33.75 2026-09-01
3002590 CDM Lipid Panel With Reflex 6 6 $56.00 $56.00 $28.00 $33.60 $33.60 2026-09-01
80053 HCPCS Comp Metabolic Panel 6 6 $56.00 $56.00 $28.00 $33.60 $33.60 2026-09-01
82627 HCPCS Dhea-sulfate 6 6 $55.50 $55.50 $27.75 $33.30 $33.30 2026-09-01
3002700 CDM Sars Cov 2 Ab, Tot Qn 6 6 $54.60 $54.60 $27.30 $32.76 $32.76 2026-09-01
80164 HCPCS Valproic Acid 6 6 $54.00 $54.00 $27.00 $32.40 $32.40 2026-09-01
86663 HCPCS Epstein Barr Virus 6 6 $54.00 $54.00 $27.00 $32.40 $32.40 2026-09-01
80061 HCPCS Lipid Profile 6 6 $54.00 $54.00 $27.00 $32.40 $32.40 2026-09-01
80162 HCPCS Digoxin 6 6 $54.00 $54.00 $27.00 $32.40 $32.40 2026-09-01
86695 HCPCS Hsv 1/2 Igg Ab 6 6 $54.00 $54.00 $27.00 $32.40 $32.40 2026-09-01
3002440 CDM Dm Novel Psychoactive Subs, Ql 6 6 $52.00 $52.00 $26.00 $31.20 $31.20 2026-09-01
86376 HCPCS Thyroid Peroxidase 6 6 $51.00 $51.00 $25.50 $30.60 $30.60 2026-09-01
83655 HCPCS Lead 6 6 $51.00 $51.00 $25.50 $30.60 $30.60 2026-09-01
86753 HCPCS Babesia Microtic Igg,igm 6 6 $51.00 $51.00 $25.50 $30.60 $30.60 2026-09-01
81401 HCPCS Mopath Procedure Level 2 6 6 $50.00 $50.00 $25.00 $30.00 $30.00 2026-09-01
9000030 CDM Ketamine Med Chrg 6 6 $50.00 $50.00 $25.00 $30.00 $30.00 2026-09-01
81291 HCPCS Mthfr Gene 6 6 $50.00 $50.00 $25.00 $30.00 $30.00 2026-09-01
3000600 CDM Long Qt Synd Known Fam 6 6 $49.10 $49.10 $24.55 $29.46 $29.46 2026-09-01
80048 HCPCS Basic Metabolic Panel 6 6 $48.00 $48.00 $24.00 $28.80 $28.80 2026-09-01
83525 HCPCS Insulin 6 6 $48.00 $48.00 $24.00 $28.80 $28.80 2026-09-01
83516 HCPCS Gliadin Celiac Panel 6 6 $48.00 $48.00 $24.00 $28.80 $28.80 2026-09-01
80201 HCPCS Topiramate 6 6 $48.00 $48.00 $24.00 $28.80 $28.80 2026-09-01
80184 HCPCS Phenobarbital 6 6 $48.00 $48.00 $24.00 $28.80 $28.80 2026-09-01
84484 HCPCS N-troponin T 6 6 $48.00 $48.00 $24.00 $28.80 $28.80 2026-09-01
86038 HCPCS Ana 6 6 $48.00 $48.00 $24.00 $28.80 $28.80 2026-09-01
82330 HCPCS Calcium Ionized 6 6 $48.00 $48.00 $24.00 $28.80 $28.80 2026-09-01
84146 HCPCS Prolactn 12 6 $53.00 $53.00 $14.00 $46.80 $27.90 2026-09-01
82533 HCPCS Cortisol 12 6 $52.00 $52.00 $19.00 $39.60 $27.90 2026-09-01
85025 HCPCS Cbc-platelets 12 6 $48.95 $48.95 $21.45 $33.00 $26.62 2026-09-01
3002630 CDM Mmr Ab (igg)panel Immune 6 6 $43.12 $43.12 $21.56 $25.87 $25.87 2026-09-01
82140 HCPCS Ammonia 12 6 $46.00 $46.00 $16.00 $36.00 $24.60 2026-09-01
82747 HCPCS Rbc Folate 12 6 $47.00 $47.00 $11.00 $43.20 $24.60 2026-09-01
3002460 CDM Drug Tox Mon 9 W/conf, Urine 6 6 $40.11 $40.11 $20.06 $24.07 $24.07 2026-09-01
86618 HCPCS Lyme C6 Peptide Ab W/rfx 12 6 $45.50 $45.50 $11.00 $41.40 $23.85 2026-09-01
82607 HCPCS Vitamin B12 12 6 $44.00 $44.00 $12.50 $37.80 $23.25 2026-09-01
84152 HCPCS N-psa 6 6 $38.00 $38.00 $19.00 $22.80 $22.80 2026-09-01
87880 HCPCS Rapid Strep 6 6 $37.00 $37.00 $18.50 $22.20 $22.20 2026-09-01
3002910 CDM Uds, Opiates 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3004040 CDM Uds, Fentanyl 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002930 CDM Uds, Pcp 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002920 CDM Uds, Oxycodone 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002770 CDM Udm, Benzo, W/conf 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002900 CDM Uds, Methadone Metab 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002790 CDM Udm, Marijuana Metab, W/conf 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002890 CDM Uds, Marijuana Metab 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002880 CDM Uds, Fentanyl 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002810 CDM Udm, Opiates, W/conf 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002870 CDM Uds, Cocaine Metab 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002830 CDM Uds, Amphetamine 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002860 CDM Uds, Bup 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002850 CDM Uds, Benzo 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
3002840 CDM Uds, Barbiturate 6 6 $36.85 $36.85 $18.43 $22.11 $22.11 2026-09-01
80156 HCPCS Carbamazepine 12 6 $41.00 $41.00 $11.00 $36.00 $21.60 2026-09-01
83550 HCPCS Tibc 6 6 $36.00 $36.00 $18.00 $21.60 $21.60 2026-09-01
87177 HCPCS Ova+parasites, Feces 6 6 $36.00 $36.00 $18.00 $21.60 $21.60 2026-09-01
84439 HCPCS T4 (thyroxine) Free 6 6 $36.00 $36.00 $18.00 $21.60 $21.60 2026-09-01
86804 HCPCS Hepatitis C Ab 6 6 $35.75 $35.75 $17.88 $21.45 $21.45 2026-09-01
80178 HCPCS Lithium Level 12 6 $38.55 $38.55 $13.50 $30.07 $20.63 2026-09-01
84480 HCPCS T3 Total 12 6 $39.00 $39.00 $10.50 $34.20 $20.55 2026-09-01
83718 HCPCS Hdl 6 6 $33.00 $33.00 $16.50 $19.80 $19.80 2026-09-01
86803 HCPCS N-hepatitis C Antibody 6 6 $32.00 $32.00 $16.00 $19.20 $19.20 2026-09-01
84702 HCPCS Hcg Quantitative 12 6 $34.50 $34.50 $10.50 $28.80 $18.30 2026-09-01
82977 HCPCS Gamma-glutamyl Trans 6 6 $30.00 $30.00 $15.00 $18.00 $18.00 2026-09-01
87070 HCPCS Culture, Strep 6 6 $30.00 $30.00 $15.00 $18.00 $18.00 2026-09-01
80051 HCPCS Electrolyte Panel 6 6 $30.00 $30.00 $15.00 $18.00 $18.00 2026-09-01
84703 HCPCS Hcg Qualitative 6 6 $30.00 $30.00 $15.00 $18.00 $18.00 2026-09-01
82374 HCPCS Co2 12 6 $32.19 $32.19 $14.69 $21.00 $17.62 2026-09-01
5100020 CDM Rev - Ihs-moa Clinic Visit 6 6 $29.00 $29.00 $14.50 $17.40 $17.40 2026-09-01
5100060 CDM Rev - Ihs-moa Clinic Visit 6 6 $29.00 $29.00 $14.50 $17.40 $17.40 2026-09-01
86705 HCPCS N-hepatitis B IgM Core An 12 6 $31.50 $31.50 $11.50 $24.00 $16.90 2026-09-01
3002410 CDM Copper, Random Urine 6 6 $27.51 $27.51 $13.76 $16.51 $16.51 2026-09-01
87400 HCPCS Rapid Influenza 6 6 $27.50 $27.50 $13.75 $16.50 $16.50 2026-09-01
83002 HCPCS Lh 6 6 $27.00 $27.00 $13.50 $16.20 $16.20 2026-09-01
84479 HCPCS T3 Uptake 6 6 $27.00 $27.00 $13.50 $16.20 $16.20 2026-09-01
82150 HCPCS Amylase 6 6 $27.00 $27.00 $13.50 $16.20 $16.20 2026-09-01
84436 HCPCS T4 Total 6 6 $27.00 $27.00 $13.50 $16.20 $16.20 2026-09-01
83935 HCPCS Osmolality, Urine 6 6 $27.00 $27.00 $13.50 $16.20 $16.20 2026-09-01
81025 HCPCS Urine Pregnancy 6 6 $27.00 $27.00 $13.50 $16.20 $16.20 2026-09-01
83930 HCPCS Osmolality, Serum 6 6 $27.00 $27.00 $13.50 $16.20 $16.20 2026-09-01
86787 HCPCS Varicella-zoster Ab 6 6 $26.77 $26.77 $13.39 $16.06 $16.06 2026-09-01
86592 HCPCS Rpr/syphilis Igg Screen 12 6 $30.50 $30.50 $3.50 $32.40 $15.60 2026-09-01
3002820 CDM Udm, Tricyclic Antidepress, Qn 6 6 $26.00 $26.00 $13.00 $15.60 $15.60 2026-09-01
3002800 CDM Udm, Marijuana Metab, Qn 6 6 $26.00 $26.00 $13.00 $15.60 $15.60 2026-09-01
3002780 CDM Udm, Cocaine Metab, Qn 6 6 $26.00 $26.00 $13.00 $15.60 $15.60 2026-09-01
83690 HCPCS Lipase 12 6 $30.00 $30.00 $4.50 $30.60 $15.45 2026-09-01
82435 HCPCS Chloride 12 6 $27.87 $27.87 $12.87 $18.00 $15.44 2026-09-01
80335 HCPCS Nortiptyline 6 6 $25.50 $25.50 $12.75 $15.30 $15.30 2026-09-01
86617 HCPCS Lyme Ab-western Blot 6 6 $24.56 $24.56 $12.28 $14.74 $14.74 2026-09-01
3000640 CDM Mutation Ident Ola/sbce/a 6 6 $24.47 $24.47 $12.24 $14.68 $14.68 2026-09-01
3001000 CDM Desipramine 6 6 $24.30 $24.30 $12.15 $14.58 $14.58 2026-09-01
83036 HCPCS Hemoglobin A1c W/mpg 12 6 $27.50 $27.50 $8.00 $23.40 $14.55 2026-09-01
83615 HCPCS Ldh 6 6 $24.00 $24.00 $12.00 $14.40 $14.40 2026-09-01
84478 HCPCS Triglycerides 6 6 $24.00 $24.00 $12.00 $14.40 $14.40 2026-09-01
86431 HCPCS Rheumatoid Factor 6 6 $24.00 $24.00 $12.00 $14.40 $14.40 2026-09-01
86765 HCPCS Rubeola Virus Ab 6 6 $23.84 $23.84 $11.92 $14.30 $14.30 2026-09-01
3004030 CDM Culture, Blood 6 6 $22.46 $22.46 $11.23 $13.48 $13.48 2026-09-01
3003060 CDM Culture, Blood 6 6 $22.46 $22.46 $11.23 $13.48 $13.48 2026-09-01
84295 HCPCS Sodium 12 6 $24.69 $24.69 $10.50 $17.03 $13.39 2026-09-01
85730 HCPCS Ptt 12 6 $25.50 $25.50 $5.38 $24.15 $13.29 2026-09-01
83001 HCPCS Fsh 6 6 $21.32 $21.32 $10.66 $12.79 $12.79 2026-09-01
82465 HCPCS Cholesterol 12 6 $23.69 $23.69 $9.00 $17.62 $12.75 2026-09-01
84450 HCPCS Ast 12 6 $22.77 $22.77 $10.50 $14.72 $12.60 2026-09-01
82565 HCPCS Creatinine 12 6 $21.28 $21.28 $10.50 $12.94 $12.60 2026-09-01
84075 HCPCS Alkaline Phosphatase 6 6 $21.00 $21.00 $10.50 $12.60 $12.60 2026-09-01
82310 HCPCS Calcium 12 6 $21.28 $21.28 $10.50 $12.94 $12.60 2026-09-01
82248 HCPCS Direct Bilirubin 6 6 $21.00 $21.00 $10.50 $12.60 $12.60 2026-09-01
84460 HCPCS Alt 12 6 $21.99 $21.99 $10.50 $13.79 $12.60 2026-09-01
82247 HCPCS Bilirubin Total 6 6 $21.00 $21.00 $10.50 $12.60 $12.60 2026-09-01
86140 HCPCS Crp 6 6 $21.00 $21.00 $10.50 $12.60 $12.60 2026-09-01
86308 HCPCS Mono Screen 6 6 $21.00 $21.00 $10.50 $12.60 $12.60 2026-09-01
86704 HCPCS Hepatitis BcAB 6 6 $20.98 $20.98 $10.49 $12.59 $12.59 2026-09-01
3002430 CDM D-dimer, Quantitative 6 6 $20.80 $20.80 $10.40 $12.48 $12.48 2026-09-01
3003030 CDM Strep Group A Ag, W/refl Cultu 6 6 $19.97 $19.97 $9.99 $11.98 $11.98 2026-09-01
3004000 CDM Strep Group A Ag, With Refl Cult 6 6 $19.97 $19.97 $9.99 $11.98 $11.98 2026-09-01
86708 HCPCS Hepatitis A Ab 6 6 $19.66 $19.66 $9.83 $11.80 $11.80 2026-09-01
3003020 CDM Zinc 6 6 $19.05 $19.05 $9.53 $11.43 $11.43 2026-09-01
80185 HCPCS Phenytoin (dilantin) 12 6 $20.12 $20.12 $9.12 $13.20 $10.97 2026-09-01
84133 HCPCS Urine K + Random 6 6 $18.00 $18.00 $9.00 $10.80 $10.80 2026-09-01
84132 HCPCS Potassium 6 6 $18.00 $18.00 $9.00 $10.80 $10.80 2026-09-01
84550 HCPCS Uric Acid 6 6 $18.00 $18.00 $9.00 $10.80 $10.80 2026-09-01
82040 HCPCS Albumin 6 6 $18.00 $18.00 $9.00 $10.80 $10.80 2026-09-01
3001780 CDM N-salicylate 6 6 $18.00 $18.00 $9.00 $10.80 $10.80 2026-09-01
81000 HCPCS Urinalysis 12 6 $19.46 $19.46 $8.97 $12.60 $10.76 2026-09-01
80198 HCPCS Theophylline 6 6 $17.53 $17.53 $8.77 $10.52 $10.52 2026-09-01
3003070 CDM Culture Throat 6 6 $17.15 $17.15 $8.58 $10.29 $10.29 2026-09-01
36415 HCPCS Collection/handling 12 6 $19.25 $19.25 $4.25 $18.00 $10.05 2026-09-01
82550 HCPCS Creatine Kinase 12 6 $19.00 $19.00 $5.50 $16.20 $10.05 2026-09-01
87040 HCPCS Culture, Blood 6 6 $16.58 $16.58 $8.29 $9.95 $9.95 2026-09-01
82947 HCPCS Glucose 12 6 $18.28 $18.28 $7.50 $12.94 $9.89 2026-09-01
84520 HCPCS Bun 12 6 $18.28 $18.28 $7.50 $12.94 $9.89 2026-09-01
3002660 CDM Progesterone, Lc/ms 6 6 $16.12 $16.12 $8.06 $9.67 $9.67 2026-09-01
86703 HCPCS HIV Ab 1/2 W/reflex 18 6 $16.00 $16.00 $7.50 $34.20 $9.60 2026-09-01
83735 HCPCS Magnesium 12 6 $18.00 $18.00 $4.50 $16.20 $9.45 2026-09-01
3001610 CDM Urine Alcohol 6 6 $15.00 $15.00 $7.50 $9.00 $9.00 2026-09-01
85610 HCPCS Pt/inr 12 6 $15.25 $15.25 $7.50 $9.30 $9.00 2026-09-01
84155 HCPCS Total Protein 6 6 $15.00 $15.00 $7.50 $9.00 $9.00 2026-09-01
J0013 HCPCS Esketamine, Nasal Spray, 1 Mg 6 6 $14.25 $14.25 $7.13 $8.55 $8.55 2026-09-01
83540 HCPCS Iron 12 6 $15.75 $15.75 $6.75 $10.80 $8.55 2026-09-01
3001300 CDM Salicylate 6 6 $13.27 $13.27 $6.64 $7.96 $7.96 2026-09-01
3002350 CDM Anti-streptolysin O 6 6 $12.98 $12.98 $6.49 $7.79 $7.79 2026-09-01
3002740 CDM Transferrin 6 6 $12.60 $12.60 $6.30 $7.56 $7.56 2026-09-01
82390 HCPCS Ceruloplasmin 6 6 $12.55 $12.55 $6.28 $7.53 $7.53 2026-09-01
87340 HCPCS Hepatitis BsAG 12 6 $13.46 $13.46 $5.96 $9.00 $7.33 2026-09-01
87086 HCPCS Culture, Urine 18 6 $12.00 $12.00 $4.71 $19.80 $7.20 2026-09-01
82270 HCPCS Occult Blood 6 6 $12.00 $12.00 $6.00 $7.20 $7.20 2026-09-01
85652 HCPCS Sed Rate Westergren 6 6 $12.00 $12.00 $6.00 $7.20 $7.20 2026-09-01
87081 HCPCS N-culture, Strep 12 6 $13.76 $13.76 $2.76 $13.20 $7.15 2026-09-01
86706 HCPCS Hepatitis BsAB 6 6 $11.91 $11.91 $5.96 $7.15 $7.15 2026-09-01
3002750 CDM Tsh W/reflex To Ft4 6 6 $11.44 $11.44 $5.72 $6.86 $6.86 2026-09-01
82962 HCPCS Glucose-poct 6 6 $11.35 $11.35 $5.68 $6.81 $6.81 2026-09-01
3004020 CDM Culture, Urine, Routine 6 6 $11.21 $11.21 $5.61 $6.73 $6.73 2026-09-01
3003050 CDM Culture, Urine, Routine 6 6 $11.21 $11.21 $5.61 $6.73 $6.73 2026-09-01
3002160 CDM Lab Hepatitis B Antigen 6 6 $11.15 $11.15 $5.58 $6.69 $6.69 2026-09-01
84100 HCPCS Phosphorus 12 6 $12.50 $12.50 $3.50 $10.80 $6.60 2026-09-01
85048 HCPCS Wbc 6 6 $11.00 $11.00 $5.50 $6.60 $6.60 2026-09-01
K1034 HCPCS Provision Of Covid-19 Test, Nonprescription Self-administered And Self-collected… 6 6 $10.93 $10.93 $5.47 $6.56 $6.56 2026-09-01
86762 HCPCS Rubella Virus Ab 6 6 $10.89 $10.89 $5.45 $6.53 $6.53 2026-09-01
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