Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

SILVER HILL HOSPITAL INC

New Canaan, CT · CCN 074014 · Rates published

526 distinct procedures filed
31 distinct payers
15,612 rate rows
2026-09-01 last MRF observed
Data quality

3,002 of 15,612 rate rows are consumer-grade (19.2%)

12,610 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 1,800
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 · 2026-11-05
Content fingerprint 44759735931477ea… · 816,036 bytes · first seen 2026-11-03

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
39501
CDM 		Argent Full Program 1 $21,506.40 $21,506.40 $21,506.40 nat. median
$533
outlier · 40.4×
96130
HCPCS 		Evaluation Of Psychological Test, First Hour 6 $3,000.00 $3,600.00 $3,600.00 nat. median
$301
outlier · 11.9×
5100400
CDM 		Rev - Ihs-moa Clinic Visit 6 $2,760.00 $3,312.00 $3,312.00 nat. median
$3,312
1.0× median
9000070
CDM 		Rev - Bh/treatments 6 $2,760.00 $3,312.00 $3,312.00 nat. median
$3,312
1.0× median
39019
CDM 		Prof Program Private 1 $3,182.70 $3,182.70 $3,182.70 nat. median
$1,440
outlier · 2.2×
321163
CDM 		Aftercare Support Level 3 1 $2,781.00 $2,781.00 $2,781.00 nat. median
$383
outlier · 7.3×
9000060
CDM 		Rev - Bh/treatments 6 $2,250.00 $2,700.00 $2,700.00 nat. median
$2,700
1.0× median
110
CDM 		ICU Room D 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$367
outlier · 6.9×
5
CDM 		Acu Care Room P 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$469
outlier · 5.4×
11
CDM 		Inpatient D 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$223
outlier · 11.3×
10
CDM 		Inpatient P 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$1,066
outlier · 2.4×
60
CDM 		Acu Room D 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$2,520
1.0× median
6
CDM 		Acute Care Room D 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$50
outlier · 50.9×
100
CDM 		ICU Room P 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$3
outlier · 736.8×
50
CDM 		Acu Room P 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$21
outlier · 118.9×
39017
CDM 		Prof Tlp Private 1 $2,472.00 $2,472.00 $2,472.00 nat. median
$1,443
1.7× median
32519
CDM 		Barrett Program Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$4,592
outlier · 0.5×
36009
CDM 		Tlp-dbt S Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$844
outlier · 2.5×
30019
CDM 		River Dbt Program Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$1,067
1.9× median
30009
CDM 		River Dbt Program Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$12
outlier · 176.9×
31009
CDM 		Dbt-s @ Scavetta Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$2,584
0.8× median
31019
CDM 		Scavetta Program Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$190
outlier · 10.9×
32509
CDM 		Dbt @ Barrett Pro Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$810
outlier · 2.6×
37019
CDM 		Edo Program Private 1 $2,002.32 $2,002.32 $2,002.32 nat. median
$41
outlier · 49.2×
H0017
HCPCS 		Behavioral Health; Residential (hospital Residential Treatment Program), Without… 1 $1,325.00 $2,625.00 $1,975.00 nat. median
$380
outlier · 5.2×
38019
CDM 		Adol Edo Tlp Prog Priv 1 $1,955.35 $1,955.35 $1,955.35 nat. median
$1,955
1.0× median
33019
CDM 		Michaels House Priv Prog 1 $1,946.70 $1,946.70 $1,946.70 nat. median
$6,049
outlier · 0.3×
33009
CDM 		Michaels House Prog Priv 1 $1,946.70 $1,946.70 $1,946.70 nat. median
$11
outlier · 173.0×
36007
CDM 		Tlp-dbt S Private 1 $1,922.60 $1,922.60 $1,922.60 nat. median
$75
outlier · 25.6×
30007
CDM 		River Dbt Private 1 $1,922.60 $1,922.60 $1,922.60 nat. median
$794
outlier · 2.4×
31007
CDM 		Dbt-s @ Scavetta Private 1 $1,922.60 $1,922.60 $1,922.60 nat. median
$273
outlier · 7.0×
32507
CDM 		Dbt @ Barrett Private 1 $1,922.60 $1,922.60 $1,922.60 nat. median
$48
outlier · 40.1×
35019
CDM 		Cprc Program Private 1 $1,909.62 $1,909.62 $1,909.62 nat. median
$91
outlier · 21.0×
321162
CDM 		Aftercare Support Level 2 1 $1,854.00 $1,854.00 $1,854.00 nat. median
$1,822
1.0× median
31017
CDM 		Scavetta Private 1 $1,841.64 $1,841.64 $1,841.64 nat. median
$52
outlier · 35.4×
9000050
CDM 		Rev - Bh/treatments 6 $1,500.00 $1,800.00 $1,800.00 nat. median
$1,800
1.0× median
0123
RC 		7 $1,567.00 $2,030.00 $1,794.45 nat. median
$912
2.0× median
34017
CDM 		Adol Tlp Private 1 $1,792.82 $1,792.82 $1,792.82 nat. median
$1,793
1.0× median
39500
CDM 		Argent Program Daily 1 $1,792.20 $1,792.20 $1,792.20 nat. median
$1,792
1.0× median
37017
CDM 		Edo Private 1 $1,779.84 $1,779.84 $1,779.84 nat. median
$4,675
outlier · 0.4×
32517
CDM 		Barrett Private 1 $1,779.84 $1,779.84 $1,779.84 nat. median
$3,910
outlier · 0.5×
175116
CDM 		Crisis Intervene/l 16hr 7 $455.47 $1,747.00 $1,747.00 nat. median
$1,747
1.0× median
175016
CDM 		Crisis Intervene/o 16hr 7 $394.28 $1,747.00 $1,747.00 nat. median
$1
175023
CDM 		Crisis Intervene/o 23hr 7 $506.76 $1,747.00 $1,747.00 nat. median
$38,016
outlier · 0.0×
175112
CDM 		Crisis Intervene/l 12hr 7 $379.45 $1,747.00 $1,747.00 nat. median
$1,747
1.0× median
175108
CDM 		Crisis Intervene/l 8 Hr 7 $302.82 $1,747.00 $1,747.00 nat. median
$1,747
1.0× median
99235
HCPCS 		Crisis Intervene/o 12hr 7 $334.96 $1,747.00 $1,747.00 nat. median
$269
outlier · 6.5×
175020
CDM 		Crisis Intervene/o 20hr 7 $454.23 $1,747.00 $1,747.00 nat. median
$1,747
1.0× median
175120
CDM 		Crisis Intervene/l 20hr 7 $531.48 $1,747.00 $1,747.00 nat. median
$48,318
outlier · 0.0×
175104
CDM 		Crisis Intervene/l 4 Hr 7 $226.81 $1,747.00 $1,747.00 nat. median
$1,747
1.0× median

Other procedures at this hospital

Browse this hospital's 526 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
0123 RC — 14 7 — — $1,567.00 $2,030.00 $1,794.45 2025-12-24
0190 RC — 12 6 — — $1,511.00 $1,617.00 $1,617.00 2025-12-24
300000 CDM 2 Hours Education Service 1 1 $200.00 $200.00 $123.60 $123.60 $123.60 2025-12-24
3002300 CDM Abeta 42/40 & Ptau217 Eval 6 6 $840.00 $840.00 $420.00 $504.00 $504.00 2026-09-01
82003 HCPCS Acetaminophen 1 1 $84.00 $84.00 $51.91 $51.91 $51.91 2025-12-24
3000880 CDM Acetaminophen 6 6 $84.00 $84.00 $42.00 $50.40 $50.40 2026-09-01
82024 HCPCS Acth 7 7 $159.00 $159.00 $79.50 $98.26 $95.40 2026-09-01
5 CDM Acu Care Room P 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
60 CDM Acu Room D 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
50 CDM Acu Room P 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
6 CDM Acute Care Room D 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
80074 HCPCS Acute Hepatitus Panel 14 7 $156.00 $156.00 $32.50 $96.41 $59.09 2026-09-01
38016 CDM Adol Edo Tlp 1 1 $1,267.00 $1,267.00 $783.01 $783.01 $783.01 2024-12-24
38020 CDM Adol Edo Tlp Obs 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 2024-12-24
38017 CDM Adol Edo Tlp Private 1 1 $2,824.00 $2,824.00 $1,745.23 $1,745.23 $1,745.23 2024-12-24
38019 CDM Adol Edo Tlp Prog Priv 1 1 $3,164.00 $3,164.00 $1,955.35 $1,955.35 $1,955.35 2024-12-24
38018 CDM Adol Edo Tlp Program 1 1 $1,607.00 $1,607.00 $993.13 $993.13 $993.13 2024-12-24
34016 CDM Adol Tlp 1 1 $1,276.00 $1,276.00 $788.57 $788.57 $788.57 2024-12-24
34006 CDM Adol Tlp 1 1 $985.00 $985.00 $608.73 $608.73 $608.73 2025-12-24
34020 CDM Adol Tlp Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
34017 CDM Adol Tlp Private 1 1 $2,901.00 $2,901.00 $1,792.82 $1,792.82 $1,792.82 2024-12-24
34007 CDM Adol Tlp Private 1 1 $2,260.00 $2,260.00 $1,396.68 $1,396.68 $1,396.68 2025-12-24
34019 CDM Adol Tlp Prog Private 1 1 $2,750.00 $2,750.00 $1,699.50 $1,699.50 $1,699.50 2025-12-24
34009 CDM Adol Tlp Prog Private 1 1 $2,750.00 $2,750.00 $1,699.50 $1,699.50 $1,699.50 2025-12-24
34008 CDM Adol Tlp Program 1 1 $1,400.00 $1,400.00 $865.20 $865.20 $865.20 2025-12-24
34018 CDM Adol Tlp Program 1 1 $1,400.00 $1,400.00 $865.20 $865.20 $865.20 2025-12-24
321162 CDM Aftercare Support Level 2 1 1 $3,000.00 $3,000.00 $1,854.00 $1,854.00 $1,854.00 2025-12-24
321163 CDM Aftercare Support Level 3 1 1 $4,500.00 $4,500.00 $2,781.00 $2,781.00 $2,781.00 2025-12-24
321161 CDM Aftercare Support Service 1 1 $1,500.00 $1,500.00 $927.00 $927.00 $927.00 2025-12-24
3002340 CDM Aldosterone/pra Ratio,lc/ms/ms 6 6 $81.57 $81.57 $40.79 $48.94 $48.94 2026-09-01
3002310 CDM Alpha Subunit 6 6 $109.18 $109.18 $54.59 $65.51 $65.51 2026-09-01
96365 HCPCS Amb Ketamine Infusion 1 1 $600.00 $600.00 $370.80 $370.80 $370.80 2025-12-24
80152 HCPCS Amitriptyline 1 1 $72.00 $72.00 $44.50 $44.50 $44.50 2025-12-24
3000720 CDM Amitriptyline 6 6 $72.00 $72.00 $36.00 $43.20 $43.20 2026-09-01
3002320 CDM Amphetamines Expanded, Qn,u 6 6 $132.53 $132.53 $66.27 $79.52 $79.52 2026-09-01
86146 HCPCS Antiphospholipid Ab Panel 7 7 $105.00 $105.00 $52.50 $64.89 $63.00 2026-09-01
3002330 CDM Apoe Iso, Plasma 6 6 $420.00 $420.00 $210.00 $252.00 $252.00 2026-09-01
39501 CDM Argent Full Program 1 1 $34,800.00 $34,800.00 $21,506.40 $21,506.40 $21,506.40 2024-12-24
39500 CDM Argent Program Daily 1 1 $2,900.00 $2,900.00 $1,792.20 $1,792.20 $1,792.20 2024-12-24
3001611 CDM Arsenic 24-hour Urine 6 6 $87.68 $87.68 $43.84 $52.61 $52.61 2026-09-01
3004050 CDM Babesia Microti Ab, Ifa 6 6 $134.00 $134.00 $67.00 $80.40 $80.40 2026-09-01
86753 HCPCS Babesia Microtic Igg,igm 7 7 $51.00 $51.00 $25.50 $31.52 $30.60 2026-09-01
32516 CDM Barrett 1 1 $1,285.00 $1,285.00 $794.13 $794.13 $794.13 2025-12-24
32517 CDM Barrett Private 1 1 $2,880.00 $2,880.00 $1,779.84 $1,779.84 $1,779.84 2024-12-24
32518 CDM Barrett Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 2025-12-24
32519 CDM Barrett Program Private 1 1 $3,350.00 $3,350.00 $2,070.30 $2,070.30 $2,070.30 2024-12-24
3002380 CDM Bartonella Species Ab W/refl 6 6 $209.68 $209.68 $104.84 $125.81 $125.81 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
96150 HCPCS Biopsychosocial Eval 1 1 $150.00 $150.00 $92.70 $92.70 $92.70 2025-12-24
3002360 CDM Bnp 6 6 $154.03 $154.03 $77.02 $92.42 $92.42 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
82378 HCPCS Carcinoembryonic Antigen 7 7 $78.00 $78.00 $39.00 $48.20 $46.80 2026-09-01
3002370 CDM Catecholamines, Plasma 6 6 $260.06 $260.06 $130.03 $156.04 $156.04 2026-09-01
3002390 CDM Catecholamines, W/creat 6 6 $149.13 $149.13 $74.57 $89.48 $89.48 2026-09-01
3002400 CDM Celiac Disease Comp Panel 6 6 $105.76 $105.76 $52.88 $63.46 $63.46 2026-09-01
87490 HCPCS Chlamydia 7 7 $81.00 $81.00 $40.50 $50.06 $48.60 2026-09-01
82553 HCPCS Ckmb 7 7 $48.00 $48.00 $29.66 $50.40 $50.40 2026-09-01
80154 HCPCS Clonazepam Urine 1 1 $171.00 $171.00 $105.68 $105.68 $105.68 2025-12-24
3000670 CDM Clonazepam Urine 6 6 $171.00 $171.00 $85.50 $102.60 $102.60 2026-09-01
80159 HCPCS Clozapine (clozaril) 7 7 $75.00 $75.00 $37.50 $46.35 $45.00 2026-09-01
96125 HCPCS Cognitive Test By Hc Pro 7 7 $1,000.00 $1,000.00 $500.00 $618.00 $600.00 2026-09-01
80053 HCPCS Comp Metabolic Panel 7 7 $56.00 $56.00 $28.00 $34.61 $33.60 2026-09-01
35016 CDM Cprc 1 1 $1,230.00 $1,230.00 $760.14 $760.14 $760.14 2025-12-24
35020 CDM Cprc Obs 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 2025-12-24
35017 CDM Cprc Private 1 1 $2,750.00 $2,750.00 $1,699.50 $1,699.50 $1,699.50 2025-12-24
35018 CDM Cprc Program 1 1 $1,570.00 $1,570.00 $970.26 $970.26 $970.26 2025-12-24
35019 CDM Cprc Program Private 1 1 $3,090.00 $3,090.00 $1,909.62 $1,909.62 $1,909.62 2025-12-24
175112 CDM Crisis Intervene/l 12hr 13 7 $614.00 $614.00 $379.45 $1,747.00 $1,747.00 2025-12-24
175116 CDM Crisis Intervene/l 16hr 13 7 $737.00 $737.00 $455.47 $1,747.00 $1,747.00 2025-12-24
175120 CDM Crisis Intervene/l 20hr 13 7 $860.00 $860.00 $531.48 $1,747.00 $1,747.00 2025-12-24
175123 CDM Crisis Intervene/l 23hr 13 7 $955.00 $955.00 $590.19 $1,747.00 $1,747.00 2025-12-24
175104 CDM Crisis Intervene/l 4 Hr 13 7 $367.00 $367.00 $226.81 $1,747.00 $1,747.00 2025-12-24
175108 CDM Crisis Intervene/l 8 Hr 13 7 $490.00 $490.00 $302.82 $1,747.00 $1,747.00 2025-12-24
99235 HCPCS Crisis Intervene/o 12hr 13 7 $542.00 $542.00 $334.96 $1,747.00 $1,747.00 2025-12-24
175016 CDM Crisis Intervene/o 16hr 13 7 $638.00 $638.00 $394.28 $1,747.00 $1,747.00 2025-12-24
175020 CDM Crisis Intervene/o 20hr 13 7 $735.00 $735.00 $454.23 $1,747.00 $1,747.00 2025-12-24
175023 CDM Crisis Intervene/o 23hr 13 7 $820.00 $820.00 $506.76 $1,747.00 $1,747.00 2025-12-24
175004 CDM Crisis Intervene/o 4 Hr 13 7 $348.00 $348.00 $215.06 $1,747.00 $1,747.00 2025-12-24
175008 CDM Crisis Intervene/o 8 Hr 13 7 $444.00 $444.00 $274.39 $1,747.00 $1,747.00 2025-12-24
90882 HCPCS Crisis Intervention 7 7 $170.00 $170.00 $85.00 $105.06 $102.00 2026-09-01
32506 CDM Dbt @ Barrett 1 1 $1,381.00 $1,381.00 $853.46 $853.46 $853.46 2025-12-24
32507 CDM Dbt @ Barrett Private 1 1 $3,111.00 $3,111.00 $1,922.60 $1,922.60 $1,922.60 2024-12-24
32509 CDM Dbt @ Barrett Pro Private 1 1 $3,350.00 $3,350.00 $2,070.30 $2,070.30 $2,070.30 2024-12-24
32508 CDM Dbt @ Barrett Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 2025-12-24
31006 CDM Dbt-s @ Scavetta 1 1 $1,381.00 $1,381.00 $853.46 $853.46 $853.46 2025-12-24
31009 CDM Dbt-s @ Scavetta Private 1 1 $3,350.00 $3,350.00 $2,070.30 $2,070.30 $2,070.30 2025-12-24
31007 CDM Dbt-s @ Scavetta Private 1 1 $3,111.00 $3,111.00 $1,922.60 $1,922.60 $1,922.60 2025-12-24
31008 CDM Dbt-s @ Scavetta Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 2025-12-24
82627 HCPCS Dhea-sulfate 7 7 $55.50 $55.50 $27.75 $34.30 $33.30 2026-09-01
161000 CDM Diagnostic Admission Eval 1 1 $324.00 $324.00 $200.23 $200.23 $200.23 2025-12-24
90816 HCPCS Dietary Consult 1:1 30min 3 2 $60.50 $60.50 $23.79 $153.00 $37.39 2025-12-24
90818 HCPCS Dietary Consult 1:1 60min 3 2 $99.00 $99.00 $50.98 $153.00 $61.18 2025-12-24
80162 HCPCS Digoxin 7 7 $54.00 $54.00 $27.00 $33.37 $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
80306 HCPCS Drug Abuse Screen 7 7 $144.00 $144.00 $72.00 $88.99 $86.40 2026-09-01
99212 HCPCS E&m Estab Pt Level 2 13 7 $110.00 $110.00 $55.00 $110.88 $67.98 2026-09-01
99213 HCPCS E&m Estab Pt Level 3 13 7 $150.00 $150.00 $75.00 $100.80 $90.00 2026-09-01
99214 HCPCS E&m Estab Pt Level 4 19 7 $195.00 $195.00 $92.40 $300.00 $117.00 2026-09-01
99215 HCPCS E&m Estab Pt Level 5 13 7 $215.00 $215.00 $102.38 $132.87 $122.85 2026-09-01
99201 HCPCS E&m New Pt Level 1 1 1 $70.00 $70.00 $43.26 $43.26 $43.26 2025-12-24
99202 HCPCS E&m New Pt Level 2 13 7 $120.00 $120.00 $60.00 $199.08 $74.16 2026-09-01
99203 HCPCS E&m New Pt Level 3 13 7 $180.00 $180.00 $90.00 $199.08 $111.24 2026-09-01
99204 HCPCS E&m New Pt Level 4 7 7 $250.00 $250.00 $125.00 $154.50 $150.00 2026-09-01
161700 CDM Ect Inpatient (Explode) 5 3 — — $372.67 $372.67 $372.67 2025-12-24
162005 CDM Ect Md Fee 1 1 $400.00 $400.00 $247.20 $247.20 $247.20 2025-12-24
99070 HCPCS Ect Supplies 7 7 $89.00 $89.00 $44.50 $55.00 $53.40 2026-09-01
37016 CDM Edo 1 1 $1,285.00 $1,285.00 $794.13 $794.13 $794.13 2024-12-24
37020 CDM Edo Obs 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 2024-12-24
37017 CDM Edo Private 1 1 $2,880.00 $2,880.00 $1,779.84 $1,779.84 $1,779.84 2024-12-24
37018 CDM Edo Program 1 1 $1,645.00 $1,645.00 $1,016.61 $1,016.61 $1,016.61 2024-12-24
37019 CDM Edo Program Private 1 1 $3,240.00 $3,240.00 $2,002.32 $2,002.32 $2,002.32 2024-12-24
93000 HCPCS Electrocardiogrm EKG 7 7 $101.50 $101.50 $50.75 $62.73 $60.90 2026-09-01
90870 HCPCS Electroshock Therapy Op 55 27 $1,800.00 $1,800.00 $192.00 $1,836.00 $1,469.00 2026-09-01
86663 HCPCS Epstein Barr Virus 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
3002470 CDM Erythropoietin 6 6 $89.72 $89.72 $44.86 $53.83 $53.83 2026-09-01
82670 HCPCS Estradiol 7 7 $114.00 $114.00 $57.00 $70.45 $68.40 2026-09-01
82672 HCPCS Estrogen 7 7 $90.00 $90.00 $45.00 $55.62 $54.00 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
3002480 CDM Factor V/leiden Analysis 6 6 $339.59 $339.59 $169.80 $203.75 $203.75 2026-09-01
90846 HCPCS Family Therapy Without Pt 7 6 $206.00 $206.00 $101.97 $180.00 $150.00 2026-09-01
90847 HCPCS Family Therapy W/pt 13 5 $206.00 $206.00 $125.00 $300.00 $150.00 2026-09-01
82728 HCPCS Ferrtin 7 7 $57.00 $57.00 $28.50 $35.23 $34.20 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
3002510 CDM Fluoxetine 6 6 $127.79 $127.79 $63.90 $76.67 $76.67 2026-09-01
80173 HCPCS Haloperidol 7 7 $145.00 $145.00 $72.50 $89.61 $87.00 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
82175 HCPCS Heavy Metal Panel 7 7 $78.00 $78.00 $39.00 $48.20 $46.80 2026-09-01
87902 HCPCS Hep C Genotype 7 7 $400.00 $400.00 $200.00 $247.20 $240.00 2026-09-01
87522 HCPCS Hepatitis C Viral DNA Qua 7 7 $422.00 $422.00 $211.00 $260.80 $253.20 2026-09-01
83021 HCPCS Hgb Electrophoresis 7 7 $75.00 $75.00 $37.50 $46.35 $45.00 2026-09-01
81225 HCPCS HILOmet 2c19 7 7 $513.00 $513.00 $256.50 $317.03 $307.80 2026-09-01
81227 HCPCS HILOmet 2c9 7 7 $359.10 $359.10 $179.55 $221.92 $215.46 2026-09-01
81226 HCPCS HILOmet 2d6 Ver 2 7 7 $837.90 $837.90 $418.95 $517.82 $502.74 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
3002530 CDM Hla-b27 Antigen 6 6 $90.37 $90.37 $45.19 $54.22 $54.22 2026-09-01
83090 HCPCS Homocysteine 7 7 $69.00 $69.00 $34.50 $42.64 $41.40 2026-09-01
99223 HCPCS Hosp Physical Exam 7 7 $120.00 $120.00 $60.00 $74.16 $72.00 2026-09-01
99221 HCPCS Hosp Physical Exam 1 1 $80.00 $80.00 $49.44 $49.44 $49.44 2025-12-24
86695 HCPCS Hsv 1/2 Igg Ab 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
110 CDM ICU Room D 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
100 CDM ICU Room P 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
3002560 CDM Igf 1, Lc/ms 6 6 $89.82 $89.82 $44.91 $53.89 $53.89 2026-09-01
80174 HCPCS Imipramine 1 1 $69.00 $69.00 $42.64 $42.64 $42.64 2025-12-24
3001090 CDM Imipramine 6 6 $69.00 $69.00 $34.50 $41.40 $41.40 2026-09-01
90832 HCPCS Individual Therapy 30min 10 8 $110.00 $110.00 $24.10 $153.00 $66.00 2026-09-01
90834 HCPCS Individual Therapy 45min 19 7 $210.00 $210.00 $105.00 $300.00 $210.00 2026-09-01
90837 HCPCS Individual Therapy 60min 7 7 $210.00 $210.00 $105.00 $129.78 $126.00 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
11 CDM Inpatient D 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
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
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
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
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
10 CDM Inpatient P 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
90853 HCPCS Iop 3hr Psych 60 28 $250.00 $200.00 20% off $29.00 $556.12 $430.00 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
3002580 CDM Jak2 V617f Mutation Analysis 6 6 $600.60 $600.60 $300.30 $360.36 $360.36 2026-09-01
320115 CDM Ketmaine Med Chrg 3 2 $50.00 $50.00 $30.90 $250.00 $250.00 2025-12-24
63901 CDM Lab 1 1 $1,356.00 $1,356.00 $838.01 $838.01 $838.01 2025-12-24
3000630 CDM Lab 6 6 $1,356.00 $1,356.00 $678.00 $813.60 $813.60 2026-09-01
3004100 CDM Lactate Dehydrogenase 6 6 $70.28 $70.28 $35.14 $42.17 $42.17 2026-09-01
80299 HCPCS Lamotrigine 21 7 $57.00 $57.00 $28.50 $46.35 $37.50 2026-09-01
83655 HCPCS Lead 7 7 $51.00 $51.00 $25.50 $31.52 $30.60 2026-09-01
3002590 CDM Lipid Panel With Reflex 6 6 $56.00 $56.00 $28.00 $33.60 $33.60 2026-09-01
80061 HCPCS Lipid Profile 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
81281 HCPCS Long Qt Synd Known Fam 1 1 $49.10 $49.10 $30.34 $30.34 $30.34 2025-12-24
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
99205 HCPCS Md Pain Assessment 20 7 $300.00 $300.00 $150.00 $199.08 $182.70 2026-09-01
80101 HCPCS Mdma 2 1 $93.55 $93.55 $57.81 $152.65 $105.23 2025-12-24
3000650 CDM Mdma 6 6 $93.55 $93.55 $46.78 $56.13 $56.13 2026-09-01
99263 HCPCS Medical Consult Extensive 1 1 $68.00 $68.00 $42.02 $42.02 $42.02 2025-12-24
3002610 CDM Metanephrines 24 Hr Urine 6 6 $159.44 $159.44 $79.72 $95.66 $95.66 2026-09-01
3002620 CDM Metanephrines, Plasma 6 6 $247.67 $247.67 $123.84 $148.60 $148.60 2026-09-01
33015 CDM Michaels House 1 1 $1,066.00 $1,066.00 $658.79 $658.79 $658.79 2025-12-24
33006 CDM Michaels House 1 1 $985.00 $985.00 $608.73 $608.73 $608.73 2024-12-24
33019 CDM Michaels House Priv Prog 1 1 $3,150.00 $3,150.00 $1,946.70 $1,946.70 $1,946.70 2025-12-24
33017 CDM Michaels House Private 1 1 $2,481.00 $2,481.00 $1,533.26 $1,533.26 $1,533.26 2025-12-24
33007 CDM Michaels House Private 1 1 $2,260.00 $2,260.00 $1,396.68 $1,396.68 $1,396.68 2025-12-24
33009 CDM Michaels House Prog Priv 1 1 $3,150.00 $3,150.00 $1,946.70 $1,946.70 $1,946.70 2025-12-24
33018 CDM Michaels House Program 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 2025-12-24
33008 CDM Michaels House Program 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 2025-12-24
33020 CDM Michaels Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
81291 HCPCS Mthfr Gene 7 7 $50.00 $50.00 $25.00 $30.90 $30.00 2026-09-01
90849 HCPCS Multi Family Group Ther 2 2 $125.00 $125.00 $29.00 $77.25 $53.12 2025-12-24
3002640 CDM Mycoplasma Pneumoniae Ab 6 6 $117.62 $117.62 $58.81 $70.57 $70.57 2026-09-01
96116 HCPCS Neurobehavioral Status Ex 1 1 $1,000.00 $1,000.00 $618.00 $618.00 $618.00 2025-12-24
96119 HCPCS Neuropsych Testing By Tec 1 1 $1,000.00 $1,000.00 $618.00 $618.00 $618.00 2025-12-24
120009 CDM Neuropsych Tst Admin W/co 1 1 $1,000.00 $1,000.00 $618.00 $618.00 $618.00 2025-12-24
96118 HCPCS Neuropsych Tst By Psych 1 1 $1,000.00 $1,000.00 $618.00 $618.00 $618.00 2025-12-24
3002650 CDM Nmda Receptor Antibody Test 6 6 $551.20 $551.20 $275.60 $330.72 $330.72 2026-09-01
S9470 HCPCS Nutritional Counseling, Dietitian Visit 6 6 $200.00 $200.00 $100.00 $120.00 $120.00 2026-09-01
32520 CDM Obs Dbt @ Barrett 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
31520 CDM Obs Dbt-s @ Scavetta 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
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
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
185100 CDM Outpatient Detox 1 1 $500.00 $500.00 $309.00 $309.00 $309.00 2025-12-24
328000 CDM Personal Trainer 1 1 $80.00 $80.00 $49.44 $49.44 $49.44 2025-12-24
3003001 CDM Pharmacogenomics Panel 6 6 $300.00 $300.00 $150.00 $180.00 $180.00 2026-09-01
23000 CDM Php Dbt 1 1 $550.00 $550.00 $339.90 $339.90 $339.90 2025-12-24
90821 HCPCS Php Edo 6 Hr 1 1 $450.00 $450.00 $278.10 $278.10 $278.10 2025-12-24
84134 HCPCS Prealbumin 7 7 $60.00 $60.00 $30.00 $37.08 $36.00 2026-09-01
39020 CDM Prof Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
39018 CDM Prof Program 1 1 $2,750.00 $2,750.00 $1,699.50 $1,699.50 $1,699.50 2025-12-24
39019 CDM Prof Program Private 1 1 $5,150.00 $5,150.00 $3,182.70 $3,182.70 $3,182.70 2024-12-24
39017 CDM Prof Tlp Private 1 1 $4,000.00 $4,000.00 $2,472.00 $2,472.00 $2,472.00 2024-12-24
39016 CDM Prof Tlp Program 1 1 $2,226.00 $2,226.00 $1,375.67 $1,375.67 $1,375.67 2025-12-24
84144 HCPCS Progesterone 7 7 $84.00 $84.00 $42.00 $51.91 $50.40 2026-09-01
39600 CDM Program Evaluation 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
84153 HCPCS Prostate Specific Ag 7 7 $75.00 $75.00 $37.50 $46.35 $45.00 2026-09-01
90792 HCPCS Psych Diag Eval 14 7 $300.00 $300.00 $150.00 $309.00 $217.70 2026-09-01
96102 HCPCS Psych Test By Technician 1 1 $400.00 $400.00 $247.20 $247.20 $247.20 2025-12-24
96103 HCPCS Psych Test, Computer 1 1 $1,000.00 $1,000.00 $618.00 $618.00 $618.00 2025-12-24
90791 HCPCS Psychological Evaluation 7 7 $300.00 $300.00 $150.00 $185.40 $180.00 2026-09-01
90885 HCPCS Psychological Test Report 7 7 $1,850.00 $1,850.00 $925.00 $1,143.30 $1,110.00 2026-09-01
96101 HCPCS Psychological Testing 1 1 $800.00 $800.00 $494.40 $494.40 $494.40 2025-12-24
90806 HCPCS Psychologist 1:1 45 Min 6 2 $150.00 $150.00 $33.99 $153.00 $56.08 2025-12-24
90808 HCPCS Psychologist 1:1 80 Min 2 2 $225.00 $225.00 $139.05 $153.00 $146.03 2025-12-24
90833 HCPCS Psytherapy E&m Op 30min 7 7 $135.00 $135.00 $67.50 $83.43 $81.00 2026-09-01
90836 HCPCS Psytherapy E&m Op 45min 7 7 $200.00 $200.00 $100.00 $123.60 $120.00 2026-09-01
90838 HCPCS Psytherapy E&m Op 60min 7 7 $210.00 $210.00 $105.00 $129.78 $126.00 2026-09-01
97535 HCPCS Pt Adl Activities 15 Min 1 1 $50.00 $50.00 $30.90 $30.90 $30.90 2025-12-24
97150 HCPCS Pt Exercise Group 1 1 $75.00 $75.00 $46.35 $46.35 $46.35 2025-12-24
97110 HCPCS Pt Indv Treatment 15 Min 1 1 $50.00 $50.00 $30.90 $30.90 $30.90 2025-12-24
324000 CDM Pvt. Room Differential 1 1 $2,400.00 $2,400.00 $1,483.20 $1,483.20 $1,483.20 2025-12-24
3002680 CDM Quantiferon(r)-TB Gold Plus 6 6 $71.49 $71.49 $35.75 $42.89 $42.89 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
321160 CDM Recovery Support Service 1 1 $1,200.00 $1,200.00 $741.60 $741.60 $741.60 2025-12-24
80069 HCPCS Renal Function Panel 7 7 $81.56 $81.56 $40.78 $50.40 $48.94 2026-09-01
90889 HCPCS Report Preparation 1 1 $93.50 $93.50 $57.78 $57.78 $57.78 2025-12-24
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
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
9000040 CDM Rev - Bh/treatments 6 6 $1,500.00 $1,500.00 $750.00 $900.00 $900.00 2026-09-01
9000020 CDM Rev - Bh/treatments 6 6 $600.00 $600.00 $300.00 $360.00 $360.00 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
5100430 CDM Rev - Ihs-moa Clinic Visit 6 6 $1,000.00 $1,000.00 $500.00 $600.00 $600.00 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
5100420 CDM Rev - Ihs-moa Clinic Visit 6 6 $400.00 $400.00 $200.00 $240.00 $240.00 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
5100130 CDM Rev - Ihs-moa Clinic Visit 6 6 $70.00 $70.00 $35.00 $42.00 $42.00 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
5100050 CDM Rev - Ihs-moa Clinic Visit 6 6 $68.00 $68.00 $34.00 $40.80 $40.80 2026-09-01
30006 CDM River Dbt 1 1 $1,381.00 $1,381.00 $853.46 $853.46 $853.46 2025-12-24
30016 CDM River Dbt 1 1 $1,110.00 $1,110.00 $685.98 $685.98 $685.98 2025-12-24
30007 CDM River Dbt Private 1 1 $3,111.00 $3,111.00 $1,922.60 $1,922.60 $1,922.60 2025-12-24
30017 CDM River Dbt Private 1 1 $2,510.00 $2,510.00 $1,551.18 $1,551.18 $1,551.18 2025-12-24
30018 CDM River Dbt Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 2025-12-24
30008 CDM River Dbt Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 2025-12-24
30019 CDM River Dbt Program Private 1 1 $3,350.00 $3,350.00 $2,070.30 $2,070.30 $2,070.30 2025-12-24
30009 CDM River Dbt Program Private 1 1 $3,350.00 $3,350.00 $2,070.30 $2,070.30 $2,070.30 2025-12-24
30020 CDM River Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
90804 HCPCS Rn Consult 1:1 30 Min 4 2 $60.00 $60.00 $17.00 $153.00 $30.59 2025-12-24
3002700 CDM Sars Cov 2 Ab, Tot Qn 6 6 $54.60 $54.60 $27.30 $32.76 $32.76 2026-09-01
31016 CDM Scavetta 1 1 $1,335.00 $1,335.00 $825.03 $825.03 $825.03 2025-12-24
31020 CDM Scavetta Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
31017 CDM Scavetta Private 1 1 $2,980.00 $2,980.00 $1,841.64 $1,841.64 $1,841.64 2025-12-24
31018 CDM Scavetta Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 2025-12-24
31019 CDM Scavetta Program Private 1 1 $3,350.00 $3,350.00 $2,070.30 $2,070.30 $2,070.30 2025-12-24
86235 HCPCS Sjogren's Antibodies 7 7 $72.00 $72.00 $36.00 $44.50 $43.20 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
321130 CDM Srvc Chrg Payment Plan 1 1 1 $500.00 $500.00 $309.00 $309.00 $309.00 2025-12-24
321135 CDM Srvc Chrg Payment Plan 2 1 1 $400.00 $400.00 $247.20 $247.20 $247.20 2025-12-24
3001140 CDM Suboxone 6 6 $247.00 $247.00 $123.50 $148.20 $148.20 2026-09-01
321120 CDM Supervised Meal 1 1 $150.00 $150.00 $92.70 $92.70 $92.70 2025-12-24
86360 HCPCS T&b Cells 7 7 $85.31 $85.31 $42.66 $52.72 $51.19 2026-09-01
84481 HCPCS T3 Free 14 7 $69.00 $69.00 $27.50 $42.64 $34.25 2026-09-01
84482 HCPCS T3 Reverse 7 7 $66.00 $66.00 $33.00 $40.79 $39.60 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
84403 HCPCS Testosterone Free & Total 7 7 $105.00 $105.00 $52.50 $64.89 $63.00 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
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
80091 HCPCS Thyroid Function Panel 1 1 $90.64 $90.64 $56.02 $56.02 $56.02 2025-12-24
3000040 CDM Thyroid Function Panel 6 6 $90.64 $90.64 $45.32 $54.38 $54.38 2026-09-01
86376 HCPCS Thyroid Peroxidase 7 7 $51.00 $51.00 $25.50 $31.52 $30.60 2026-09-01
3002760 CDM Tissue Trans Ab, Igg 6 6 $80.99 $80.99 $40.50 $48.59 $48.59 2026-09-01
36006 CDM Tlp-dbt S 1 1 $1,381.00 $1,381.00 $853.46 $853.46 $853.46 2025-12-24
36020 CDM Tlp-dbt S Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2025-12-24
36009 CDM Tlp-dbt S Private 1 1 $3,350.00 $3,350.00 $2,070.30 $2,070.30 $2,070.30 2025-12-24
36007 CDM Tlp-dbt S Private 1 1 $3,111.00 $3,111.00 $1,922.60 $1,922.60 $1,922.60 2025-12-24
36008 CDM Tlp-dbt S Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 2025-12-24
3002730 CDM Toxoplasma Ab (igg,igm) 6 6 $190.03 $190.03 $95.02 $114.02 $114.02 2026-09-01
S9480 HCPCS Tp Aetna Iop Psych 37 20 $576.00 $576.00 $355.97 $556.12 $475.00 2026-09-01
H0015 HCPCS Tp Aetna Iop Sub 35 18 $576.00 $576.00 $355.97 $556.00 $472.50 2025-12-24
9050030 CDM Tp Iop Psych 4 4 $635.00 $635.00 $381.00 $556.12 $468.56 2026-09-01
39800 CDM Trauma Tlp 1 1 $2,175.00 $2,175.00 $1,344.15 $1,344.15 $1,344.15 2024-12-24
39820 CDM Trauma Tlp Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
83789 HCPCS Trileptal/oxycarbazepine 7 7 $57.00 $57.00 $28.50 $35.23 $34.20 2026-09-01
84443 HCPCS Tsh 7 7 $69.00 $69.00 $34.50 $42.64 $41.40 2026-09-01
90840 HCPCS Urgent Care Add'l 30min 8 8 $300.00 $300.00 $79.00 $185.40 $180.00 2026-09-01
90839 HCPCS Urgent Care Initial 60min 8 8 $600.00 $600.00 $153.00 $370.80 $360.00 2026-09-01
80164 HCPCS Valproic Acid 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
3002980 CDM Valproic Acid, Total & Free 6 6 $101.20 $101.20 $50.60 $60.72 $60.72 2026-09-01
84207 HCPCS Vitamin B6 7 7 $102.00 $102.00 $51.00 $63.04 $61.20 2026-09-01
82306 HCPCS Vitamin D, 25-hydroxy 7 7 $120.00 $120.00 $60.00 $74.16 $72.00 2026-09-01
3003010 CDM Vitb1 (thiamine), Serum/plasma 6 6 $173.79 $173.79 $86.90 $104.27 $104.27 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
3003000 CDM Vitb12/folate, Serum Panel 6 6 $101.78 $101.78 $50.89 $61.07 $61.07 2026-09-01
84585 HCPCS Vma, 24 Hr Urine 7 7 $63.00 $63.00 $31.50 $38.93 $37.80 2026-09-01
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