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
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 · 2026-10-12
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
39501
CDM 		Argent Full Program 1 $21,506.40 $21,506.40 $21,506.40 —
96130
HCPCS 		Evaluation Of Psychological Test, First Hour 6 $3,000.00 $3,600.00 $3,600.00 nat. median
$256
outlier · 14.0×
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 —
321163
CDM 		Aftercare Support Level 3 1 $2,781.00 $2,781.00 $2,781.00 —
9000060
CDM 		Rev - Bh/treatments 6 $2,250.00 $2,700.00 $2,700.00 nat. median
$2,700
1.0× median
11
CDM 		Inpatient D 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$4
outlier · 630.0×
110
CDM 		ICU Room D 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$399
outlier · 6.3×
50
CDM 		Acu Room P 1 $2,520.00 $2,520.00 $2,520.00 —
100
CDM 		ICU Room P 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$4
outlier · 578.0×
5
CDM 		Acu Care Room P 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$1,478
1.7× median
6
CDM 		Acute Care Room D 1 $2,520.00 $2,520.00 $2,520.00 —
60
CDM 		Acu Room D 1 $2,520.00 $2,520.00 $2,520.00 —
10
CDM 		Inpatient P 1 $2,520.00 $2,520.00 $2,520.00 nat. median
$1,173
outlier · 2.1×
39017
CDM 		Prof Tlp Private 1 $2,472.00 $2,472.00 $2,472.00 nat. median
$175
outlier · 14.1×
36009
CDM 		Tlp-dbt S Private 1 $2,070.30 $2,070.30 $2,070.30 —
30009
CDM 		River Dbt Program Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$76
outlier · 27.2×
31009
CDM 		Dbt-s @ Scavetta Private 1 $2,070.30 $2,070.30 $2,070.30 —
31019
CDM 		Scavetta Program Private 1 $2,070.30 $2,070.30 $2,070.30 —
30019
CDM 		River Dbt Program Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$1,266
1.6× median
32509
CDM 		Dbt @ Barrett Pro Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$12,103
outlier · 0.2×
32519
CDM 		Barrett Program Private 1 $2,070.30 $2,070.30 $2,070.30 nat. median
$7,055
outlier · 0.3×
37019
CDM 		Edo Program Private 1 $2,002.32 $2,002.32 $2,002.32 nat. median
$13,351
outlier · 0.1×
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×
38019
CDM 		Adol Edo Tlp Prog Priv 1 $1,955.35 $1,955.35 $1,955.35 —
33009
CDM 		Michaels House Prog Priv 1 $1,946.70 $1,946.70 $1,946.70 nat. median
$328
outlier · 5.9×
33019
CDM 		Michaels House Priv Prog 1 $1,946.70 $1,946.70 $1,946.70 nat. median
$9,351
outlier · 0.2×
32507
CDM 		Dbt @ Barrett Private 1 $1,922.60 $1,922.60 $1,922.60 nat. median
$12,103
outlier · 0.2×
30007
CDM 		River Dbt Private 1 $1,922.60 $1,922.60 $1,922.60 —
36007
CDM 		Tlp-dbt S Private 1 $1,922.60 $1,922.60 $1,922.60 —
31007
CDM 		Dbt-s @ Scavetta Private 1 $1,922.60 $1,922.60 $1,922.60 nat. median
$23,943
outlier · 0.1×
35019
CDM 		Cprc Program Private 1 $1,909.62 $1,909.62 $1,909.62 —
321162
CDM 		Aftercare Support Level 2 1 $1,854.00 $1,854.00 $1,854.00 —
31017
CDM 		Scavetta Private 1 $1,841.64 $1,841.64 $1,841.64 nat. median
$23,943
outlier · 0.1×
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
$854
outlier · 2.1×
34017
CDM 		Adol Tlp Private 1 $1,792.82 $1,792.82 $1,792.82 —
39500
CDM 		Argent Program Daily 1 $1,792.20 $1,792.20 $1,792.20 —
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
$4,738
outlier · 0.4×
175104
CDM 		Crisis Intervene/l 4 Hr 7 $226.81 $1,747.00 $1,747.00 —
175108
CDM 		Crisis Intervene/l 8 Hr 7 $302.82 $1,747.00 $1,747.00 —
175112
CDM 		Crisis Intervene/l 12hr 7 $379.45 $1,747.00 $1,747.00 nat. median
$17
outlier · 104.0×
175123
CDM 		Crisis Intervene/l 23hr 7 $590.19 $1,747.00 $1,747.00 —
175004
CDM 		Crisis Intervene/o 4 Hr 7 $215.06 $1,747.00 $1,747.00 —
99235
HCPCS 		Crisis Intervene/o 12hr 7 $334.96 $1,747.00 $1,747.00 nat. median
$301
outlier · 5.8×
175020
CDM 		Crisis Intervene/o 20hr 7 $454.23 $1,747.00 $1,747.00 —
175008
CDM 		Crisis Intervene/o 8 Hr 7 $274.39 $1,747.00 $1,747.00 —
175016
CDM 		Crisis Intervene/o 16hr 7 $394.28 $1,747.00 $1,747.00 —

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.

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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
             
S9480 HCPCS Tp Aetna Iop Psych 37 20 $576.00 $576.00 $355.97 $556.12 $475.00 2026-09-01
S9470 HCPCS Nutritional Counseling, Dietitian Visit 6 6 $200.00 $200.00 $100.00 $120.00 $120.00 2026-09-01
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
H0015 HCPCS Tp Aetna Iop Sub 35 18 $576.00 $576.00 $355.97 $556.00 $472.50 2025-12-24
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
99263 HCPCS Medical Consult Extensive 1 1 $68.00 $68.00 $42.02 $42.02 $42.02 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
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
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
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
99235 HCPCS Crisis Intervene/o 12hr 13 7 $542.00 $542.00 $334.96 $1,747.00 $1,747.00 2025-12-24
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
99215 HCPCS E&m Estab Pt Level 5 13 7 $215.00 $215.00 $102.38 $132.87 $122.85 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
99213 HCPCS E&m Estab Pt Level 3 13 7 $150.00 $150.00 $75.00 $100.80 $90.00 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
99205 HCPCS Md Pain Assessment 20 7 $300.00 $300.00 $150.00 $199.08 $182.70 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
99203 HCPCS E&m New Pt Level 3 13 7 $180.00 $180.00 $90.00 $199.08 $111.24 2026-09-01
99202 HCPCS E&m New Pt Level 2 13 7 $120.00 $120.00 $60.00 $199.08 $74.16 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
99070 HCPCS Ect Supplies 7 7 $89.00 $89.00 $44.50 $55.00 $53.40 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
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
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
96365 HCPCS Amb Ketamine Infusion 1 1 $600.00 $600.00 $370.80 $370.80 $370.80 2025-12-24
96150 HCPCS Biopsychosocial Eval 1 1 $150.00 $150.00 $92.70 $92.70 $92.70 2025-12-24
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
96125 HCPCS Cognitive Test By Hc Pro 7 7 $1,000.00 $1,000.00 $500.00 $618.00 $600.00 2026-09-01
96119 HCPCS Neuropsych Testing By Tec 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
96116 HCPCS Neurobehavioral Status Ex 1 1 $1,000.00 $1,000.00 $618.00 $618.00 $618.00 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
96102 HCPCS Psych Test By Technician 1 1 $400.00 $400.00 $247.20 $247.20 $247.20 2025-12-24
96101 HCPCS Psychological Testing 1 1 $800.00 $800.00 $494.40 $494.40 $494.40 2025-12-24
93000 HCPCS Electrocardiogrm EKG 7 7 $101.50 $101.50 $50.75 $62.73 $60.90 2026-09-01
90889 HCPCS Report Preparation 1 1 $93.50 $93.50 $57.78 $57.78 $57.78 2025-12-24
90885 HCPCS Psychological Test Report 7 7 $1,850.00 $1,850.00 $925.00 $1,143.30 $1,110.00 2026-09-01
90882 HCPCS Crisis Intervention 7 7 $170.00 $170.00 $85.00 $105.06 $102.00 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
90853 HCPCS Iop 3hr Psych 60 28 $250.00 $200.00 20% off $29.00 $556.12 $430.00 2026-09-01
90849 HCPCS Multi Family Group Ther 2 2 $125.00 $125.00 $29.00 $77.25 $53.12 2025-12-24
90847 HCPCS Family Therapy W/pt 13 5 $206.00 $206.00 $125.00 $300.00 $150.00 2026-09-01
90846 HCPCS Family Therapy Without Pt 7 6 $206.00 $206.00 $101.97 $180.00 $150.00 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
90838 HCPCS Psytherapy E&m Op 60min 7 7 $210.00 $210.00 $105.00 $129.78 $126.00 2026-09-01
90837 HCPCS Individual Therapy 60min 7 7 $210.00 $210.00 $105.00 $129.78 $126.00 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
90834 HCPCS Individual Therapy 45min 19 7 $210.00 $210.00 $105.00 $300.00 $210.00 2026-09-01
90833 HCPCS Psytherapy E&m Op 30min 7 7 $135.00 $135.00 $67.50 $83.43 $81.00 2026-09-01
90832 HCPCS Individual Therapy 30min 10 8 $110.00 $110.00 $24.10 $153.00 $66.00 2026-09-01
90821 HCPCS Php Edo 6 Hr 1 1 $450.00 $450.00 $278.10 $278.10 $278.10 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
90816 HCPCS Dietary Consult 1:1 30min 3 2 $60.50 $60.50 $23.79 $153.00 $37.39 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
90806 HCPCS Psychologist 1:1 45 Min 6 2 $150.00 $150.00 $33.99 $153.00 $56.08 2025-12-24
90804 HCPCS Rn Consult 1:1 30 Min 4 2 $60.00 $60.00 $17.00 $153.00 $30.59 2025-12-24
90792 HCPCS Psych Diag Eval 14 7 $300.00 $300.00 $150.00 $309.00 $217.70 2026-09-01
90791 HCPCS Psychological Evaluation 7 7 $300.00 $300.00 $150.00 $185.40 $180.00 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
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
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
87490 HCPCS Chlamydia 7 7 $81.00 $81.00 $40.50 $50.06 $48.60 2026-09-01
86753 HCPCS Babesia Microtic Igg,igm 7 7 $51.00 $51.00 $25.50 $31.52 $30.60 2026-09-01
86695 HCPCS Hsv 1/2 Igg Ab 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
86663 HCPCS Epstein Barr Virus 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
86376 HCPCS Thyroid Peroxidase 7 7 $51.00 $51.00 $25.50 $31.52 $30.60 2026-09-01
86360 HCPCS T&b Cells 7 7 $85.31 $85.31 $42.66 $52.72 $51.19 2026-09-01
86235 HCPCS Sjogren's Antibodies 7 7 $72.00 $72.00 $36.00 $44.50 $43.20 2026-09-01
86146 HCPCS Antiphospholipid Ab Panel 7 7 $105.00 $105.00 $52.50 $64.89 $63.00 2026-09-01
84585 HCPCS Vma, 24 Hr Urine 7 7 $63.00 $63.00 $31.50 $38.93 $37.80 2026-09-01
84482 HCPCS T3 Reverse 7 7 $66.00 $66.00 $33.00 $40.79 $39.60 2026-09-01
84481 HCPCS T3 Free 14 7 $69.00 $69.00 $27.50 $42.64 $34.25 2026-09-01
84443 HCPCS Tsh 7 7 $69.00 $69.00 $34.50 $42.64 $41.40 2026-09-01
84403 HCPCS Testosterone Free & Total 7 7 $105.00 $105.00 $52.50 $64.89 $63.00 2026-09-01
84207 HCPCS Vitamin B6 7 7 $102.00 $102.00 $51.00 $63.04 $61.20 2026-09-01
84153 HCPCS Prostate Specific Ag 7 7 $75.00 $75.00 $37.50 $46.35 $45.00 2026-09-01
84144 HCPCS Progesterone 7 7 $84.00 $84.00 $42.00 $51.91 $50.40 2026-09-01
84134 HCPCS Prealbumin 7 7 $60.00 $60.00 $30.00 $37.08 $36.00 2026-09-01
83789 HCPCS Trileptal/oxycarbazepine 7 7 $57.00 $57.00 $28.50 $35.23 $34.20 2026-09-01
83655 HCPCS Lead 7 7 $51.00 $51.00 $25.50 $31.52 $30.60 2026-09-01
83090 HCPCS Homocysteine 7 7 $69.00 $69.00 $34.50 $42.64 $41.40 2026-09-01
83021 HCPCS Hgb Electrophoresis 7 7 $75.00 $75.00 $37.50 $46.35 $45.00 2026-09-01
82728 HCPCS Ferrtin 7 7 $57.00 $57.00 $28.50 $35.23 $34.20 2026-09-01
82672 HCPCS Estrogen 7 7 $90.00 $90.00 $45.00 $55.62 $54.00 2026-09-01
82670 HCPCS Estradiol 7 7 $114.00 $114.00 $57.00 $70.45 $68.40 2026-09-01
82627 HCPCS Dhea-sulfate 7 7 $55.50 $55.50 $27.75 $34.30 $33.30 2026-09-01
82553 HCPCS Ckmb 7 7 $48.00 $48.00 $29.66 $50.40 $50.40 2026-09-01
82378 HCPCS Carcinoembryonic Antigen 7 7 $78.00 $78.00 $39.00 $48.20 $46.80 2026-09-01
82306 HCPCS Vitamin D, 25-hydroxy 7 7 $120.00 $120.00 $60.00 $74.16 $72.00 2026-09-01
82175 HCPCS Heavy Metal Panel 7 7 $78.00 $78.00 $39.00 $48.20 $46.80 2026-09-01
82024 HCPCS Acth 7 7 $159.00 $159.00 $79.50 $98.26 $95.40 2026-09-01
82003 HCPCS Acetaminophen 1 1 $84.00 $84.00 $51.91 $51.91 $51.91 2025-12-24
81291 HCPCS Mthfr Gene 7 7 $50.00 $50.00 $25.00 $30.90 $30.00 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
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
81225 HCPCS HILOmet 2c19 7 7 $513.00 $513.00 $256.50 $317.03 $307.80 2026-09-01
80306 HCPCS Drug Abuse Screen 7 7 $144.00 $144.00 $72.00 $88.99 $86.40 2026-09-01
80299 HCPCS Lamotrigine 21 7 $57.00 $57.00 $28.50 $46.35 $37.50 2026-09-01
80174 HCPCS Imipramine 1 1 $69.00 $69.00 $42.64 $42.64 $42.64 2025-12-24
80173 HCPCS Haloperidol 7 7 $145.00 $145.00 $72.50 $89.61 $87.00 2026-09-01
80164 HCPCS Valproic Acid 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
80162 HCPCS Digoxin 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
80159 HCPCS Clozapine (clozaril) 7 7 $75.00 $75.00 $37.50 $46.35 $45.00 2026-09-01
80154 HCPCS Clonazepam Urine 1 1 $171.00 $171.00 $105.68 $105.68 $105.68 2025-12-24
80152 HCPCS Amitriptyline 1 1 $72.00 $72.00 $44.50 $44.50 $44.50 2025-12-24
80101 HCPCS Mdma 2 1 $93.55 $93.55 $57.81 $152.65 $105.23 2025-12-24
80091 HCPCS Thyroid Function Panel 1 1 $90.64 $90.64 $56.02 $56.02 $56.02 2025-12-24
80074 HCPCS Acute Hepatitus Panel 14 7 $156.00 $156.00 $32.50 $96.41 $59.09 2026-09-01
80069 HCPCS Renal Function Panel 7 7 $81.56 $81.56 $40.78 $50.40 $48.94 2026-09-01
80061 HCPCS Lipid Profile 7 7 $54.00 $54.00 $27.00 $33.37 $32.40 2026-09-01
80053 HCPCS Comp Metabolic Panel 7 7 $56.00 $56.00 $28.00 $34.61 $33.60 2026-09-01
63901 CDM Lab 1 1 $1,356.00 $1,356.00 $838.01 $838.01 $838.01 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
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
5100470 CDM Rev - Ihs-moa Clinic Visit 6 6 $150.00 $150.00 $75.00 $90.00 $90.00 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
5100420 CDM Rev - Ihs-moa Clinic Visit 6 6 $400.00 $400.00 $200.00 $240.00 $240.00 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
5100130 CDM Rev - Ihs-moa Clinic Visit 6 6 $70.00 $70.00 $35.00 $42.00 $42.00 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
5100070 CDM Rev - Ihs-moa Clinic Visit 6 6 $150.00 $150.00 $75.00 $90.00 $90.00 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
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
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
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
39800 CDM Trauma Tlp 1 1 $2,175.00 $2,175.00 $1,344.15 $1,344.15 $1,344.15 2024-12-24
39600 CDM Program Evaluation 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
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
39020 CDM Prof Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
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
39018 CDM Prof Program 1 1 $2,750.00 $2,750.00 $1,699.50 $1,699.50 $1,699.50 2025-12-24
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
38020 CDM Adol Edo Tlp Obs 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 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
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
38016 CDM Adol Edo Tlp 1 1 $1,267.00 $1,267.00 $783.01 $783.01 $783.01 2024-12-24
37020 CDM Edo Obs 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 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
37018 CDM Edo Program 1 1 $1,645.00 $1,645.00 $1,016.61 $1,016.61 $1,016.61 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
37016 CDM Edo 1 1 $1,285.00 $1,285.00 $794.13 $794.13 $794.13 2024-12-24
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
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
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
36006 CDM Tlp-dbt S 1 1 $1,381.00 $1,381.00 $853.46 $853.46 $853.46 2025-12-24
35020 CDM Cprc Obs 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 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
35018 CDM Cprc Program 1 1 $1,570.00 $1,570.00 $970.26 $970.26 $970.26 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
35016 CDM Cprc 1 1 $1,230.00 $1,230.00 $760.14 $760.14 $760.14 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
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
34018 CDM Adol Tlp Program 1 1 $1,400.00 $1,400.00 $865.20 $865.20 $865.20 2025-12-24
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
34016 CDM Adol Tlp 1 1 $1,276.00 $1,276.00 $788.57 $788.57 $788.57 2024-12-24
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
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
34006 CDM Adol Tlp 1 1 $985.00 $985.00 $608.73 $608.73 $608.73 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
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
33018 CDM Michaels House Program 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 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
33015 CDM Michaels House 1 1 $1,066.00 $1,066.00 $658.79 $658.79 $658.79 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
33008 CDM Michaels House Program 1 1 $1,600.00 $1,600.00 $988.80 $988.80 $988.80 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
33006 CDM Michaels House 1 1 $985.00 $985.00 $608.73 $608.73 $608.73 2024-12-24
328000 CDM Personal Trainer 1 1 $80.00 $80.00 $49.44 $49.44 $49.44 2025-12-24
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
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
32518 CDM Barrett Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 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
32516 CDM Barrett 1 1 $1,285.00 $1,285.00 $794.13 $794.13 $794.13 2025-12-24
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
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
32506 CDM Dbt @ Barrett 1 1 $1,381.00 $1,381.00 $853.46 $853.46 $853.46 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
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
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
321161 CDM Aftercare Support Service 1 1 $1,500.00 $1,500.00 $927.00 $927.00 $927.00 2025-12-24
321160 CDM Recovery Support Service 1 1 $1,200.00 $1,200.00 $741.60 $741.60 $741.60 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
321130 CDM Srvc Chrg Payment Plan 1 1 1 $500.00 $500.00 $309.00 $309.00 $309.00 2025-12-24
321120 CDM Supervised Meal 1 1 $150.00 $150.00 $92.70 $92.70 $92.70 2025-12-24
320115 CDM Ketmaine Med Chrg 3 2 $50.00 $50.00 $30.90 $250.00 $250.00 2025-12-24
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
31020 CDM Scavetta Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
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
31018 CDM Scavetta Program 1 1 $1,700.00 $1,700.00 $1,050.60 $1,050.60 $1,050.60 2025-12-24
31017 CDM Scavetta Private 1 1 $2,980.00 $2,980.00 $1,841.64 $1,841.64 $1,841.64 2025-12-24
31016 CDM Scavetta 1 1 $1,335.00 $1,335.00 $825.03 $825.03 $825.03 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
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
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
31006 CDM Dbt-s @ Scavetta 1 1 $1,381.00 $1,381.00 $853.46 $853.46 $853.46 2025-12-24
3004100 CDM Lactate Dehydrogenase 6 6 $70.28 $70.28 $35.14 $42.17 $42.17 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
3004050 CDM Babesia Microti Ab, Ifa 6 6 $134.00 $134.00 $67.00 $80.40 $80.40 2026-09-01
3003010 CDM Vitb1 (thiamine), Serum/plasma 6 6 $173.79 $173.79 $86.90 $104.27 $104.27 2026-09-01
3003001 CDM Pharmacogenomics Panel 6 6 $300.00 $300.00 $150.00 $180.00 $180.00 2026-09-01
3003000 CDM Vitb12/folate, Serum Panel 6 6 $101.78 $101.78 $50.89 $61.07 $61.07 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
3002980 CDM Valproic Acid, Total & Free 6 6 $101.20 $101.20 $50.60 $60.72 $60.72 2026-09-01
3002760 CDM Tissue Trans Ab, Igg 6 6 $80.99 $80.99 $40.50 $48.59 $48.59 2026-09-01
3002730 CDM Toxoplasma Ab (igg,igm) 6 6 $190.03 $190.03 $95.02 $114.02 $114.02 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
3002700 CDM Sars Cov 2 Ab, Tot Qn 6 6 $54.60 $54.60 $27.30 $32.76 $32.76 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
3002670 CDM Quest Ad Detect Ptau181,plasma 6 6 $327.60 $327.60 $163.80 $196.56 $196.56 2026-09-01
3002650 CDM Nmda Receptor Antibody Test 6 6 $551.20 $551.20 $275.60 $330.72 $330.72 2026-09-01
3002640 CDM Mycoplasma Pneumoniae Ab 6 6 $117.62 $117.62 $58.81 $70.57 $70.57 2026-09-01
3002620 CDM Metanephrines, Plasma 6 6 $247.67 $247.67 $123.84 $148.60 $148.60 2026-09-01
3002610 CDM Metanephrines 24 Hr Urine 6 6 $159.44 $159.44 $79.72 $95.66 $95.66 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
3002590 CDM Lipid Panel With Reflex 6 6 $56.00 $56.00 $28.00 $33.60 $33.60 2026-09-01
3002580 CDM Jak2 V617f Mutation Analysis 6 6 $600.60 $600.60 $300.30 $360.36 $360.36 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
3002560 CDM Igf 1, Lc/ms 6 6 $89.82 $89.82 $44.91 $53.89 $53.89 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
3002540 CDM Hcv Rna, Qn Real Time Pcr 6 6 $88.40 $88.40 $44.20 $53.04 $53.04 2026-09-01
3002530 CDM Hla-b27 Antigen 6 6 $90.37 $90.37 $45.19 $54.22 $54.22 2026-09-01
3002510 CDM Fluoxetine 6 6 $127.79 $127.79 $63.90 $76.67 $76.67 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
3002490 CDM Influenza A And B,pcr 6 6 $75.00 $75.00 $37.50 $45.00 $45.00 2026-09-01
3002480 CDM Factor V/leiden Analysis 6 6 $339.59 $339.59 $169.80 $203.75 $203.75 2026-09-01
3002470 CDM Erythropoietin 6 6 $89.72 $89.72 $44.86 $53.83 $53.83 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
3002400 CDM Celiac Disease Comp Panel 6 6 $105.76 $105.76 $52.88 $63.46 $63.46 2026-09-01
3002390 CDM Catecholamines, W/creat 6 6 $149.13 $149.13 $74.57 $89.48 $89.48 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
3002370 CDM Catecholamines, Plasma 6 6 $260.06 $260.06 $130.03 $156.04 $156.04 2026-09-01
3002360 CDM Bnp 6 6 $154.03 $154.03 $77.02 $92.42 $92.42 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
3002330 CDM Apoe Iso, Plasma 6 6 $420.00 $420.00 $210.00 $252.00 $252.00 2026-09-01
3002320 CDM Amphetamines Expanded, Qn,u 6 6 $132.53 $132.53 $66.27 $79.52 $79.52 2026-09-01
3002310 CDM Alpha Subunit 6 6 $109.18 $109.18 $54.59 $65.51 $65.51 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
30020 CDM River Obs 1 1 $1,800.00 $1,800.00 $1,112.40 $1,112.40 $1,112.40 2024-12-24
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
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
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
3001611 CDM Arsenic 24-hour Urine 6 6 $87.68 $87.68 $43.84 $52.61 $52.61 2026-09-01
30016 CDM River Dbt 1 1 $1,110.00 $1,110.00 $685.98 $685.98 $685.98 2025-12-24
3001140 CDM Suboxone 6 6 $247.00 $247.00 $123.50 $148.20 $148.20 2026-09-01
3001090 CDM Imipramine 6 6 $69.00 $69.00 $34.50 $41.40 $41.40 2026-09-01
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
3000880 CDM Acetaminophen 6 6 $84.00 $84.00 $42.00 $50.40 $50.40 2026-09-01
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
3000720 CDM Amitriptyline 6 6 $72.00 $72.00 $36.00 $43.20 $43.20 2026-09-01
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
3000670 CDM Clonazepam Urine 6 6 $171.00 $171.00 $85.50 $102.60 $102.60 2026-09-01
3000650 CDM Mdma 6 6 $93.55 $93.55 $46.78 $56.13 $56.13 2026-09-01
3000630 CDM Lab 6 6 $1,356.00 $1,356.00 $678.00 $813.60 $813.60 2026-09-01
30006 CDM River Dbt 1 1 $1,381.00 $1,381.00 $853.46 $853.46 $853.46 2025-12-24
3000040 CDM Thyroid Function Panel 6 6 $90.64 $90.64 $45.32 $54.38 $54.38 2026-09-01
300000 CDM 2 Hours Education Service 1 1 $200.00 $200.00 $123.60 $123.60 $123.60 2025-12-24
23000 CDM Php Dbt 1 1 $550.00 $550.00 $339.90 $339.90 $339.90 2025-12-24
185100 CDM Outpatient Detox 1 1 $500.00 $500.00 $309.00 $309.00 $309.00 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
175120 CDM Crisis Intervene/l 20hr 13 7 $860.00 $860.00 $531.48 $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
175112 CDM Crisis Intervene/l 12hr 13 7 $614.00 $614.00 $379.45 $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
175104 CDM Crisis Intervene/l 4 Hr 13 7 $367.00 $367.00 $226.81 $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
175020 CDM Crisis Intervene/o 20hr 13 7 $735.00 $735.00 $454.23 $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
175008 CDM Crisis Intervene/o 8 Hr 13 7 $444.00 $444.00 $274.39 $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
162005 CDM Ect Md Fee 1 1 $400.00 $400.00 $247.20 $247.20 $247.20 2025-12-24
161700 CDM Ect Inpatient (Explode) 5 3 — — $372.67 $372.67 $372.67 2025-12-24
161000 CDM Diagnostic Admission Eval 1 1 $324.00 $324.00 $200.23 $200.23 $200.23 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
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
11 CDM Inpatient 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
10 CDM Inpatient P 1 1 $2,400.00 $2,400.00 $2,520.00 $2,520.00 $2,520.00 2025-12-24
0190 RC — 12 6 — — $1,511.00 $1,617.00 $1,617.00 2025-12-24
0123 RC — 14 7 — — $1,567.00 $2,030.00 $1,794.45 2025-12-24
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