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 — reason	Rows
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 via	CMS hospital list
Last fetch	not_modified · 2026-10-08
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.

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

86762	HCPCS	Rubella Virus Ab	6	6	$10.89	$10.89	$5.45	$6.53	$6.53	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
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
3002160	CDM	Lab Hepatitis B Antigen	6	6	$11.15	$11.15	$5.58	$6.69	$6.69	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
82962	HCPCS	Glucose-poct	6	6	$11.35	$11.35	$5.68	$6.81	$6.81	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
86706	HCPCS	Hepatitis BsAB	6	6	$11.91	$11.91	$5.96	$7.15	$7.15	2026-09-01
87081	HCPCS	N-culture, Strep	12	6	$13.76	$13.76	$2.76	$13.20	$7.15	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
87340	HCPCS	Hepatitis BsAG	12	6	$13.46	$13.46	$5.96	$9.00	$7.33	2026-09-01
82390	HCPCS	Ceruloplasmin	6	6	$12.55	$12.55	$6.28	$7.53	$7.53	2026-09-01
3002740	CDM	Transferrin	6	6	$12.60	$12.60	$6.30	$7.56	$7.56	2026-09-01
3002350	CDM	Anti-streptolysin O	6	6	$12.98	$12.98	$6.49	$7.79	$7.79	2026-09-01
3001300	CDM	Salicylate	6	6	$13.27	$13.27	$6.64	$7.96	$7.96	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
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
83735	HCPCS	Magnesium	12	6	$18.00	$18.00	$4.50	$16.20	$9.45	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
3002660	CDM	Progesterone, Lc/ms	6	6	$16.12	$16.12	$8.06	$9.67	$9.67	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
87040	HCPCS	Culture, Blood	6	6	$16.58	$16.58	$8.29	$9.95	$9.95	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
3003070	CDM	Culture Throat	6	6	$17.15	$17.15	$8.58	$10.29	$10.29	2026-09-01
80198	HCPCS	Theophylline	6	6	$17.53	$17.53	$8.77	$10.52	$10.52	2026-09-01
81000	HCPCS	Urinalysis	12	6	$19.46	$19.46	$8.97	$12.60	$10.76	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
80185	HCPCS	Phenytoin (dilantin)	12	6	$20.12	$20.12	$9.12	$13.20	$10.97	2026-09-01
3003020	CDM	Zinc	6	6	$19.05	$19.05	$9.53	$11.43	$11.43	2026-09-01
86708	HCPCS	Hepatitis A Ab	6	6	$19.66	$19.66	$9.83	$11.80	$11.80	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
3002430	CDM	D-dimer, Quantitative	6	6	$20.80	$20.80	$10.40	$12.48	$12.48	2026-09-01
86704	HCPCS	Hepatitis BcAB	6	6	$20.98	$20.98	$10.49	$12.59	$12.59	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
82465	HCPCS	Cholesterol	12	6	$23.69	$23.69	$9.00	$17.62	$12.75	2026-09-01
83001	HCPCS	Fsh	6	6	$21.32	$21.32	$10.66	$12.79	$12.79	2026-09-01
85730	HCPCS	Ptt	12	6	$25.50	$25.50	$5.38	$24.15	$13.29	2026-09-01
84295	HCPCS	Sodium	12	6	$24.69	$24.69	$10.50	$17.03	$13.39	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
86765	HCPCS	Rubeola Virus Ab	6	6	$23.84	$23.84	$11.92	$14.30	$14.30	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
83036	HCPCS	Hemoglobin A1c W/mpg	12	6	$27.50	$27.50	$8.00	$23.40	$14.55	2026-09-01
3001000	CDM	Desipramine	6	6	$24.30	$24.30	$12.15	$14.58	$14.58	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
86617	HCPCS	Lyme Ab-western Blot	6	6	$24.56	$24.56	$12.28	$14.74	$14.74	2026-09-01
80335	HCPCS	Nortiptyline	6	6	$25.50	$25.50	$12.75	$15.30	$15.30	2026-09-01
82435	HCPCS	Chloride	12	6	$27.87	$27.87	$12.87	$18.00	$15.44	2026-09-01
83690	HCPCS	Lipase	12	6	$30.00	$30.00	$4.50	$30.60	$15.45	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
86592	HCPCS	Rpr/syphilis Igg Screen	12	6	$30.50	$30.50	$3.50	$32.40	$15.60	2026-09-01
86787	HCPCS	Varicella-zoster Ab	6	6	$26.77	$26.77	$13.39	$16.06	$16.06	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
87400	HCPCS	Rapid Influenza	6	6	$27.50	$27.50	$13.75	$16.50	$16.50	2026-09-01
3002410	CDM	Copper, Random Urine	6	6	$27.51	$27.51	$13.76	$16.51	$16.51	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
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
82374	HCPCS	Co2	12	6	$32.19	$32.19	$14.69	$21.00	$17.62	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
84702	HCPCS	Hcg Quantitative	12	6	$34.50	$34.50	$10.50	$28.80	$18.30	2026-09-01
86803	HCPCS	N-hepatitis C Antibody	6	6	$32.00	$32.00	$16.00	$19.20	$19.20	2026-09-01
83718	HCPCS	Hdl	6	6	$33.00	$33.00	$16.50	$19.80	$19.80	2026-09-01
84480	HCPCS	T3 Total	12	6	$39.00	$39.00	$10.50	$34.20	$20.55	2026-09-01
80178	HCPCS	Lithium Level	12	6	$38.55	$38.55	$13.50	$30.07	$20.63	2026-09-01
86804	HCPCS	Hepatitis C Ab	6	6	$35.75	$35.75	$17.88	$21.45	$21.45	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
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
87880	HCPCS	Rapid Strep	6	6	$37.00	$37.00	$18.50	$22.20	$22.20	2026-09-01
84152	HCPCS	N-psa	6	6	$38.00	$38.00	$19.00	$22.80	$22.80	2026-09-01
82607	HCPCS	Vitamin B12	12	6	$44.00	$44.00	$12.50	$37.80	$23.25	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
3002460	CDM	Drug Tox Mon 9 W/conf, Urine	6	6	$40.11	$40.11	$20.06	$24.07	$24.07	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
3002630	CDM	Mmr Ab (igg)panel Immune	6	6	$43.12	$43.12	$21.56	$25.87	$25.87	2026-09-01
85025	HCPCS	Cbc-platelets	12	6	$48.95	$48.95	$21.45	$33.00	$26.62	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
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
3000600	CDM	Long Qt Synd Known Fam	6	6	$49.10	$49.10	$24.55	$29.46	$29.46	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
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
3002440	CDM	Dm Novel Psychoactive Subs, Ql	6	6	$52.00	$52.00	$26.00	$31.20	$31.20	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
3002700	CDM	Sars Cov 2 Ab, Tot Qn	6	6	$54.60	$54.60	$27.30	$32.76	$32.76	2026-09-01
82627	HCPCS	Dhea-sulfate	6	6	$55.50	$55.50	$27.75	$33.30	$33.30	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
84481	HCPCS	T3 Free	12	6	$62.00	$62.00	$27.50	$41.40	$33.75	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
82746	HCPCS	Serum Folate	12	6	$68.79	$68.79	$15.00	$64.55	$35.89	2026-09-01
84134	HCPCS	Prealbumin	6	6	$60.00	$60.00	$30.00	$36.00	$36.00	2026-09-01
80299	HCPCS	Lamotrigine	18	6	$72.79	$72.79	$28.50	$45.00	$37.50	2026-09-01
84585	HCPCS	Vma, 24 Hr Urine	6	6	$63.00	$63.00	$31.50	$37.80	$37.80	2026-09-01
84482	HCPCS	T3 Reverse	6	6	$66.00	$66.00	$33.00	$39.60	$39.60	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
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
5100130	CDM	Rev - Ihs-moa Clinic Visit	6	6	$70.00	$70.00	$35.00	$42.00	$42.00	2026-09-01
3004100	CDM	Lactate Dehydrogenase	6	6	$70.28	$70.28	$35.14	$42.17	$42.17	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
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
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
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
3002760	CDM	Tissue Trans Ab, Igg	6	6	$80.99	$80.99	$40.50	$48.59	$48.59	2026-09-01
87490	HCPCS	Chlamydia	6	6	$81.00	$81.00	$40.50	$48.60	$48.60	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
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
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
86360	HCPCS	T&b Cells	6	6	$85.31	$85.31	$42.66	$51.19	$51.19	2026-09-01
3001611	CDM	Arsenic 24-hour Urine	6	6	$87.68	$87.68	$43.84	$52.61	$52.61	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
3002570	CDM	Iron, Tibc And Ferritin Panel	6	6	$88.49	$88.49	$44.25	$53.09	$53.09	2026-09-01
99070	HCPCS	Ect Supplies	6	6	$89.00	$89.00	$44.50	$53.40	$53.40	2026-09-01
3002470	CDM	Erythropoietin	6	6	$89.72	$89.72	$44.86	$53.83	$53.83	2026-09-01
3002560	CDM	Igf 1, Lc/ms	6	6	$89.82	$89.82	$44.91	$53.89	$53.89	2026-09-01
82672	HCPCS	Estrogen	6	6	$90.00	$90.00	$45.00	$54.00	$54.00	2026-09-01
3002530	CDM	Hla-b27 Antigen	6	6	$90.37	$90.37	$45.19	$54.22	$54.22	2026-09-01
3000040	CDM	Thyroid Function Panel	6	6	$90.64	$90.64	$45.32	$54.38	$54.38	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
3000650	CDM	Mdma	6	6	$93.55	$93.55	$46.78	$56.13	$56.13	2026-09-01
80074	HCPCS	Acute Hepatitus Panel	12	6	$110.50	$110.50	$32.50	$93.60	$58.50	2026-09-01
3002980	CDM	Valproic Acid, Total & Free	6	6	$101.20	$101.20	$50.60	$60.72	$60.72	2026-09-01
93000	HCPCS	Electrocardiogrm EKG	6	6	$101.50	$101.50	$50.75	$60.90	$60.90	2026-09-01
3003000	CDM	Vitb12/folate, Serum Panel	6	6	$101.78	$101.78	$50.89	$61.07	$61.07	2026-09-01
84207	HCPCS	Vitamin B6	6	6	$102.00	$102.00	$51.00	$61.20	$61.20	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
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
3002400	CDM	Celiac Disease Comp Panel	6	6	$105.76	$105.76	$52.88	$63.46	$63.46	2026-09-01
3002310	CDM	Alpha Subunit	6	6	$109.18	$109.18	$54.59	$65.51	$65.51	2026-09-01
90832	HCPCS	Individual Therapy 30min	6	6	$110.00	$110.00	$55.00	$66.00	$66.00	2026-09-01
84432	HCPCS	Culture, Stool	12	6	$128.64	$128.64	$21.50	$128.57	$66.48	2026-09-01
82670	HCPCS	Estradiol	6	6	$114.00	$114.00	$57.00	$68.40	$68.40	2026-09-01
3002640	CDM	Mycoplasma Pneumoniae Ab	6	6	$117.62	$117.62	$58.81	$70.57	$70.57	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
3002510	CDM	Fluoxetine	6	6	$127.79	$127.79	$63.90	$76.67	$76.67	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
3002320	CDM	Amphetamines Expanded, Qn,u	6	6	$132.53	$132.53	$66.27	$79.52	$79.52	2026-09-01
3004050	CDM	Babesia Microti Ab, Ifa	6	6	$134.00	$134.00	$67.00	$80.40	$80.40	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
80306	HCPCS	Drug Abuse Screen	6	6	$144.00	$144.00	$72.00	$86.40	$86.40	2026-09-01
80173	HCPCS	Haloperidol	6	6	$145.00	$145.00	$72.50	$87.00	$87.00	2026-09-01
3002390	CDM	Catecholamines, W/creat	6	6	$149.13	$149.13	$74.57	$89.48	$89.48	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
3002360	CDM	Bnp	6	6	$154.03	$154.03	$77.02	$92.42	$92.42	2026-09-01
82024	HCPCS	Acth	6	6	$159.00	$159.00	$79.50	$95.40	$95.40	2026-09-01
3002610	CDM	Metanephrines 24 Hr Urine	6	6	$159.44	$159.44	$79.72	$95.66	$95.66	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
90882	HCPCS	Crisis Intervention	6	6	$170.00	$170.00	$85.00	$102.00	$102.00	2026-09-01
3000670	CDM	Clonazepam Urine	6	6	$171.00	$171.00	$85.50	$102.60	$102.60	2026-09-01
3003010	CDM	Vitb1 (thiamine), Serum/plasma	6	6	$173.79	$173.79	$86.90	$104.27	$104.27	2026-09-01
3002730	CDM	Toxoplasma Ab (igg,igm)	6	6	$190.03	$190.03	$95.02	$114.02	$114.02	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
99202	HCPCS	E&m New Pt Level 2	12	6	$225.90	$225.90	$60.00	$199.08	$118.95	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
99215	HCPCS	E&m Estab Pt Level 5	12	6	$209.88	$209.88	$102.38	$129.00	$122.85	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
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
99203	HCPCS	E&m New Pt Level 3	12	6	$255.90	$255.90	$90.00	$199.08	$136.95	2026-09-01
3001140	CDM	Suboxone	6	6	$247.00	$247.00	$123.50	$148.20	$148.20	2026-09-01
3002620	CDM	Metanephrines, Plasma	6	6	$247.67	$247.67	$123.84	$148.60	$148.60	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
3002370	CDM	Catecholamines, Plasma	6	6	$260.06	$260.06	$130.03	$156.04	$156.04	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
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
3002670	CDM	Quest Ad Detect Ptau181,plasma	6	6	$327.60	$327.60	$163.80	$196.56	$196.56	2026-09-01
3002480	CDM	Factor V/leiden Analysis	6	6	$339.59	$339.59	$169.80	$203.75	$203.75	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
90834	HCPCS	Individual Therapy 45min	18	6	$350.00	$350.00	$105.00	$300.00	$210.00	2026-09-01
90792	HCPCS	Psych Diag Eval	12	6	$400.00	$400.00	$150.00	$300.00	$215.00	2026-09-01
81227	HCPCS	HILOmet 2c9	6	6	$359.10	$359.10	$179.55	$215.46	$215.46	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
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
80076	HCPCS	Hepatic Function Panel	12	6	$485.65	$485.65	$16.50	$562.98	$244.47	2026-09-01
3002330	CDM	Apoe Iso, Plasma	6	6	$420.00	$420.00	$210.00	$252.00	$252.00	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
5100090	CDM	Rev - Ihs-moa Clinic Visit	6	6	$500.00	$500.00	$250.00	$300.00	$300.00	2026-09-01
81225	HCPCS	HILOmet 2c19	6	6	$513.00	$513.00	$256.50	$307.80	$307.80	2026-09-01
3002650	CDM	Nmda Receptor Antibody Test	6	6	$551.20	$551.20	$275.60	$330.72	$330.72	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
3002580	CDM	Jak2 V617f Mutation Analysis	6	6	$600.60	$600.60	$300.30	$360.36	$360.36	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
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
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
81226	HCPCS	HILOmet 2d6 Ver 2	6	6	$837.90	$837.90	$418.95	$502.74	$502.74	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
S9480	HCPCS	Tp Aetna Iop Psych	2	2	$635.00	$635.00	$556.12	$556.12	$556.12	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
3000630	CDM	Lab	6	6	$1,356.00	$1,356.00	$678.00	$813.60	$813.60	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
90885	HCPCS	Psychological Test Report	6	6	$1,850.00	$1,850.00	$925.00	$1,110.00	$1,110.00	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
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
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
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
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
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

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