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

POWER COUNTY HOSPITAL DISTRICT

American Falls, ID · CCN 131304 · Rates published

1,012 distinct procedures filed
26 distinct payers
42,094 rate rows
2026-07-15 last MRF observed
Data quality

728 of 42,094 rate rows are consumer-grade (1.7%)

41,366 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 41,366
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.pchd.net/wp-content/uploads/2026/04/826000431_power-county-hospital-district_standardcharges.csv
Found on page https://www.pchd.net/notices-releases
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint 79a2495470167d82… · 4,463,695 bytes · first seen 2026-05-09

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
J3380
HCPCS 		Vedolizumab 300mg Vial (entyvio) 1 $9,370.75 $9,370.75 $9,370.75 nat. median
$162
outlier · 57.8×
74177
HCPCS 		CT Abd Pelvis W/contrast 2 $2,252.50 $2,597.00 $2,424.75 nat. median
$974
outlier · 2.5×
71275
HCPCS 		CT Angio Chest 1 $2,283.40 $2,283.40 $2,283.40 nat. median
$754
outlier · 3.0×
74178
HCPCS 		CT Abd Pelvis W Without Contrast 1 $2,215.78 $2,215.78 $2,215.78 nat. median
$1,024
outlier · 2.2×
70498
HCPCS 		CT Angio NECK,Technical Component 1 $2,156.00 $2,156.00 $2,156.00 nat. median
$739
outlier · 2.9×
70496
HCPCS 		CT Angio HEAD,Technical Component 1 $2,156.00 $2,156.00 $2,156.00 nat. median
$747
outlier · 2.9×
0120
RC 		3 $1,691.50 $3,379.00 $1,950.20 nat. median
$983
2.0× median
70491
HCPCS 		CT Soft Tiss Neck W/contrast 1 $1,839.46 $1,839.46 $1,839.46 nat. median
$627
outlier · 2.9×
J0897
HCPCS 		Denosumab Inj 60 Mg/ml(prolia) 1 $1,772.56 $1,772.56 $1,772.56 nat. median
$1,972
0.9× median
Q0138
HCPCS 		Feraheme Inj 30mg/ml(ferumoxytol) 1 $1,755.81 $1,755.81 $1,755.81 nat. median
$176
outlier · 10.0×
75635
HCPCS 		CT Abd Aorta Angio W/contrast 1 $1,464.18 $1,464.18 $1,464.18 nat. median
$722
outlier · 2.0×
71260
HCPCS 		CT Chest W/contrast 2 $1,424.85 $1,462.13 $1,443.49 nat. median
$648
outlier · 2.2×
72125
HCPCS 		CT C-spine Without Contrast 1 $1,318.10 $1,318.10 $1,318.10 nat. median
$472
outlier · 2.8×
71271
HCPCS 		CT Thorax Low Dose For Lung Cancer 1 $1,245.58 $1,245.58 $1,245.58 nat. median
$213
outlier · 5.8×
70450
HCPCS 		CT Head/brain Without Contrast 3 $928.05 $1,258.00 $1,159.94 nat. median
$450
outlier · 2.6×
93306
HCPCS 		US Echo 2d Comp W/color Dopp 1 $1,151.50 $1,151.50 $1,151.50 nat. median
$991
1.2× median
74176
HCPCS 		CT Abd Pelvis Without Contrast 2 $1,074.36 $1,135.74 $1,105.05 nat. median
$694
1.6× median
73700
HCPCS 		CT Lower Ext Without Contrast Lt 3 $961.86 $1,179.58 $1,084.81 nat. median
$500
outlier · 2.2×
93925
HCPCS 		US Scan Lowr Ext Bilat Compl 1 $1,061.34 $1,061.34 $1,061.34 nat. median
$523
outlier · 2.0×
71250
HCPCS 		CT Chest Without Contrast 2 $961.86 $1,087.82 $1,024.84 nat. median
$465
outlier · 2.2×
99285
HCPCS 		Emergency Services 5 3 $867.33 $982.91 $965.88 nat. median
$1,186
0.8× median
72192
HCPCS 		CT Pelvis Without Contrast 1 $961.86 $961.86 $961.86 nat. median
$459
outlier · 2.1×
93970
HCPCS 		US Venous Extremity Bilat 1 $929.04 $929.04 $929.04 nat. median
$564
1.6× median
93880
HCPCS 		US Carotids Cp 1 $787.99 $787.99 $787.99 nat. median
$530
1.5× median
76770
HCPCS 		US Retroperitoneal Cp 2 $679.65 $893.76 $786.70 nat. median
$300
outlier · 2.6×
76700
HCPCS 		US Abdomen Complete 1 $745.78 $745.78 $745.78 nat. median
$311
outlier · 2.4×
87507
HCPCS 		Gi Panel Pcr 1 $741.86 $741.86 $741.86 nat. median
$549
1.4× median
99284
HCPCS 		Emergency Services 4 3 $120.84 $858.48 $638.78 nat. median
$754
0.8× median
76830
HCPCS 		US Endovaginal 1 $620.34 $620.34 $620.34 nat. median
$250
outlier · 2.5×
76856
HCPCS 		US Pelvic Non OB Cp 1 $607.60 $607.60 $607.60 nat. median
$271
outlier · 2.2×
76870
HCPCS 		US Scrotum And Contents 1 $606.62 $606.62 $606.62 nat. median
$251
outlier · 2.4×
87799
HCPCS 		Bk Virus Quantitative 1 $551.90 $551.90 $551.90 nat. median
$173
outlier · 3.2×
93971
HCPCS 		US Venous Extremity Unila 1 $535.32 $535.32 $535.32 nat. median
$345
1.5× median
76705
HCPCS 		US Abdomen Ltd 2 $460.35 $590.94 $525.64 nat. median
$277
1.9× median
76536
HCPCS 		US Soft Tissue Neck 1 $524.30 $524.30 $524.30 nat. median
$261
outlier · 2.0×
93926
HCPCS 		US Scan Lower Ext Uni Lmtd 1 $475.24 $475.24 $475.24 nat. median
$323
1.5× median
93922
HCPCS 		US Bil Ext Single Level 1 $457.89 $457.89 $457.89 nat. median
$253
1.8× median
76775
HCPCS 		US Retroperitoneal Limited 1 $448.84 $448.84 $448.84 nat. median
$233
1.9× median
72050
HCPCS 		Xr Cervical Spine; 4-5 View 1 $419.44 $419.44 $419.44 nat. median
$192
outlier · 2.2×
73522
HCPCS 		Xr Hip Bilateral W/pelvis; 3-4 View 1 $412.58 $412.58 $412.58 nat. median
$183
outlier · 2.3×
99283
HCPCS 		Emergency Services 3 3 $70.96 $544.88 $389.20 nat. median
$460
0.8× median
87536
HCPCS 		HIV Quantative Ultra Sensitive RNA By Pc 2 $380.03 $388.65 $384.34 nat. median
$149
outlier · 2.6×
76857
HCPCS 		US Pelvic Non OB Ltd 2 $323.60 $395.92 $359.76 nat. median
$200
1.8× median
87631
HCPCS 		Respiratory Mini Panel 3 $320.16 $441.00 $359.23 nat. median
$207
1.7× median
72070
HCPCS 		Xr T-spine; 2 View 1 $346.92 $346.92 $346.92 nat. median
$153
outlier · 2.3×
72110
HCPCS 		Xr L-spine Complete; 4+ View 1 $334.18 $334.18 $334.18 nat. median
$197
1.7× median
Q9967
HCPCS 		Omnipaque IV Sol 350 Mg/ml(iohexol) 2 $291.22 $371.42 $331.32 nat. median
$64
outlier · 5.1×
80050
HCPCS 		General Health Panel 1 $324.38 $324.38 $324.38 nat. median
$181
1.8× median
87177
HCPCS 		Ova And Parasite #1 1 $311.89 $311.89 $311.89 nat. median
$21
outlier · 14.5×
G0378
HCPCS 		Observation/ 1st Hour 1 $309.57 $309.57 $309.57 nat. median
$113
outlier · 2.7×

Other procedures at this hospital

Browse this hospital's 1,012 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
             
J3380 HCPCS Vedolizumab 300mg Vial (entyvio) 1 1 $14.00 $12.60 $9,370.75 $9,370.75 $9,370.75 2026-07-15
74177 HCPCS CT Abd Pelvis W/contrast 2 2 $52.00 $46.80 $2,252.50 $2,597.00 $2,424.75 2026-07-15
71275 HCPCS CT Angio Chest 1 1 $52.00 $46.80 $2,283.40 $2,283.40 $2,283.40 2026-07-15
74178 HCPCS CT Abd Pelvis W Without Contrast 1 1 $52.00 $46.80 $2,215.78 $2,215.78 $2,215.78 2026-07-15
70496 HCPCS CT Angio HEAD,Technical Component 1 1 $2,420.00 $2,419.90 $2,156.00 $2,156.00 $2,156.00 2026-07-15
70498 HCPCS CT Angio NECK,Technical Component 1 1 $2,420.00 $2,419.90 $2,156.00 $2,156.00 $2,156.00 2026-07-15
0120 RC — 3 3 $1,990.00 $1,791.00 $1,691.50 $3,379.00 $1,950.20 2026-07-15
70491 HCPCS CT Soft Tiss Neck W/contrast 1 1 $52.00 $46.80 $1,839.46 $1,839.46 $1,839.46 2026-07-15
J0897 HCPCS Denosumab Inj 60 Mg/ml(prolia) 1 1 $2,230.00 $2,229.90 $1,772.56 $1,772.56 $1,772.56 2026-07-15
Q0138 HCPCS Feraheme Inj 30mg/ml(ferumoxytol) 1 1 $2,250.00 $2,249.90 $1,755.81 $1,755.81 $1,755.81 2026-07-15
75635 HCPCS CT Abd Aorta Angio W/contrast 1 1 $52.00 $46.80 $1,464.18 $1,464.18 $1,464.18 2026-07-15
71260 HCPCS CT Chest W/contrast 2 2 $50.00 $45.00 $1,424.85 $1,462.13 $1,443.49 2026-07-15
72125 HCPCS CT C-spine Without Contrast 1 1 $52.00 $46.80 $1,318.10 $1,318.10 $1,318.10 2026-07-15
71271 HCPCS CT Thorax Low Dose For Lung Cancer 1 1 $50.63 $45.57 $1,245.58 $1,245.58 $1,245.58 2026-07-15
70450 HCPCS CT Head/brain Without Contrast 3 3 $51.00 $45.90 $928.05 $1,258.00 $1,159.94 2026-07-15
93306 HCPCS US Echo 2d Comp W/color Dopp 1 1 $55.00 $49.50 $1,151.50 $1,151.50 $1,151.50 2026-07-15
74176 HCPCS CT Abd Pelvis Without Contrast 2 2 $52.00 $46.80 $1,074.36 $1,135.74 $1,105.05 2026-07-15
73700 HCPCS CT Lower Ext Without Contrast Lt 3 3 $51.75 $46.58 $961.86 $1,179.58 $1,084.81 2026-07-15
93925 HCPCS US Scan Lowr Ext Bilat Compl 1 1 $56.00 $50.40 $1,061.34 $1,061.34 $1,061.34 2026-07-15
71250 HCPCS CT Chest Without Contrast 2 2 $50.00 $45.00 $961.86 $1,087.82 $1,024.84 2026-07-15
99285 HCPCS Emergency Services 5 3 3 $1,330.00 $1,329.90 $867.33 $982.91 $965.88 2026-07-15
72192 HCPCS CT Pelvis Without Contrast 1 1 $52.00 $46.80 $961.86 $961.86 $961.86 2026-07-15
93970 HCPCS US Venous Extremity Bilat 1 1 $55.00 $49.50 $929.04 $929.04 $929.04 2026-07-15
93880 HCPCS US Carotids Cp 1 1 $55.00 $49.50 $787.99 $787.99 $787.99 2026-07-15
76770 HCPCS US Retroperitoneal Cp 2 2 $53.00 $47.70 $679.65 $893.76 $786.70 2026-07-15
76700 HCPCS US Abdomen Complete 1 1 $53.00 $47.70 $745.78 $745.78 $745.78 2026-07-15
87507 HCPCS Gi Panel Pcr 1 1 $110.00 $99.00 $741.86 $741.86 $741.86 2026-07-15
99284 HCPCS Emergency Services 4 6 3 $925.00 $924.90 $120.84 $858.48 $638.78 2026-07-15
76830 HCPCS US Endovaginal 1 1 $54.00 $48.60 $620.34 $620.34 $620.34 2026-07-15
76856 HCPCS US Pelvic Non OB Cp 1 1 $53.00 $47.70 $607.60 $607.60 $607.60 2026-07-15
76870 HCPCS US Scrotum And Contents 1 1 $54.50 $49.05 $606.62 $606.62 $606.62 2026-07-15
87799 HCPCS Bk Virus Quantitative 1 1 $95.00 $85.50 $551.90 $551.90 $551.90 2026-07-15
93971 HCPCS US Venous Extremity Unila 1 1 $55.00 $49.50 $535.32 $535.32 $535.32 2026-07-15
76705 HCPCS US Abdomen Ltd 2 2 $185.00 $184.90 $460.35 $590.94 $525.64 2026-07-15
76536 HCPCS US Soft Tissue Neck 1 1 $54.00 $48.60 $524.30 $524.30 $524.30 2026-07-15
93926 HCPCS US Scan Lower Ext Uni Lmtd 1 1 $55.00 $49.50 $475.24 $475.24 $475.24 2026-07-15
93922 HCPCS US Bil Ext Single Level 1 1 $55.00 $49.50 $457.89 $457.89 $457.89 2026-07-15
76775 HCPCS US Retroperitoneal Limited 1 1 $56.63 $50.97 $448.84 $448.84 $448.84 2026-07-15
72050 HCPCS Xr Cervical Spine; 4-5 View 1 1 $43.00 $38.70 $419.44 $419.44 $419.44 2026-07-15
73522 HCPCS Xr Hip Bilateral W/pelvis; 3-4 View 1 1 $45.00 $40.50 $412.58 $412.58 $412.58 2026-07-15
99283 HCPCS Emergency Services 3 5 3 $575.00 $574.90 $70.96 $544.88 $389.20 2026-07-15
87536 HCPCS HIV Quantative Ultra Sensitive RNA By Pc 2 2 $98.00 $88.20 $380.03 $388.65 $384.34 2026-07-15
76857 HCPCS US Pelvic Non OB Ltd 2 2 $53.00 $47.70 $323.60 $395.92 $359.76 2026-07-15
87631 HCPCS Respiratory Mini Panel 3 3 $163.00 $146.70 $320.16 $441.00 $359.23 2026-07-15
72070 HCPCS Xr T-spine; 2 View 1 1 $45.00 $40.50 $346.92 $346.92 $346.92 2026-07-15
72110 HCPCS Xr L-spine Complete; 4+ View 1 1 $42.00 $37.80 $334.18 $334.18 $334.18 2026-07-15
Q9967 HCPCS Omnipaque IV Sol 350 Mg/ml(iohexol) 2 2 $10.00 $9.00 $291.22 $371.42 $331.32 2026-07-15
80050 HCPCS General Health Panel 1 1 $76.80 $69.12 $324.38 $324.38 $324.38 2026-07-15
87177 HCPCS Ova And Parasite #1 1 1 $60.00 $54.00 $311.89 $311.89 $311.89 2026-07-15
G0378 HCPCS Observation/ 1st Hour 1 1 $391.00 $390.90 $309.57 $309.57 $309.57 2026-07-15
76706 HCPCS US Abd Aorta Screen 1 1 $56.00 $50.40 $302.00 $302.00 $302.00 2026-07-15
71101 HCPCS Xr Ribs; 3 View Lt 2 2 $48.00 $43.20 $294.97 $305.27 $300.12 2026-07-15
72100 HCPCS Xr L-spine; 2-3 View 2 2 $42.00 $37.80 $253.23 $333.20 $293.21 2026-07-15
72072 HCPCS Xr T-spine; 3 View 1 1 $44.50 $40.05 $290.46 $290.46 $290.46 2026-07-15
92523 HCPCS St Eval Lanuage Comprehension & Express 3 3 $189.50 $170.55 $272.37 $343.00 $288.75 2026-07-15
83993 HCPCS Anser Ifx (promethius) 2 2 $94.00 $84.60 $249.29 $315.56 $282.43 2026-07-15
0100 RC — 1 1 $278.00 $250.20 $278.00 $278.00 $278.00 2026-07-15
92610 HCPCS St Speech Eval- Swallow Function 2 2 $189.50 $170.55 $275.09 $279.37 $277.23 2026-07-15
73110 HCPCS Xr Wrist Comp; 3 View Lt 4 2 $49.00 $44.10 $261.26 $359.66 $273.91 2026-07-15
96365 HCPCS IV Infus Initial 1st Hr 5 3 $350.00 $349.90 $202.33 $401.80 $272.37 2026-07-15
76816 HCPCS US Pelvic OB Follow Up 1 1 $53.00 $47.70 $270.48 $270.48 $270.48 2026-07-15
73503 HCPCS Xr Hip Unilateral W/pelvis; 4+ View Lt 1 1 $49.00 $44.10 $269.71 $269.71 $269.71 2026-07-15
G0402 HCPCS Mc- Initial Preventative Exam 6mos 1 1 $268.00 $241.20 $267.76 $267.76 $267.76 2026-07-15
73562 HCPCS Xr Knee; 3 View Lt 5 3 $48.00 $43.20 $225.08 $323.40 $253.57 2026-07-15
99204 HCPCS New Pt Level 4 1 1 $293.00 $263.70 $252.44 $252.44 $252.44 2026-07-15
74019 HCPCS Xr Abdomen; 2 View 2 2 $41.00 $36.90 $231.20 $266.56 $248.88 2026-07-15
69209 HCPCS Removal Cerumen Irrigation- Lavage 1 1 $209.00 $191.25 $248.81 $248.81 $248.81 2026-07-15
99306 HCPCS Nh Nonskill Initial/hi 1 1 $303.00 $280.30 $248.61 $248.61 $248.61 2026-07-15
99310 HCPCS Nh Nonskill Subs/hi 1 1 $318.00 $300.80 $248.61 $248.61 $248.61 2026-07-15
99304 HCPCS Nh Nonskill Initial/low 1 1 $239.00 $223.95 $248.61 $248.61 $248.61 2026-07-15
99316 HCPCS Nh Skilld Dischg >30min 1 1 $400.00 $360.00 $248.61 $248.61 $248.61 2026-07-15
99215 HCPCS Estab Pt Level 5 2 2 $298.00 $268.20 $247.01 $248.81 $247.91 2026-07-15
J0878 HCPCS Cubicin Inj 500 MG(DAPTOmycin) 1 1 $300.00 $299.90 $245.00 $245.00 $245.00 2026-07-15
71100 HCPCS Xr Ribs Unilateral; 2 View Lt 1 1 $48.00 $43.20 $242.06 $242.06 $242.06 2026-07-15
99397 HCPCS Estab Pt Prev Care >65 1 1 $320.00 $288.00 $240.02 $240.02 $240.02 2026-07-15
99203 HCPCS New Pt Level 3 2 2 $291.00 $261.90 $229.94 $248.81 $239.38 2026-07-15
73565 HCPCS Xr Knee Bilateral; Weight Bearing 1 1 $46.00 $41.40 $239.12 $239.12 $239.12 2026-07-15
99214 HCPCS Estab Pt Level 4 2 2 $298.00 $268.20 $229.15 $248.81 $238.98 2026-07-15
99305 HCPCS Nh Nonskill Initial/mod 3 2 $282.00 $266.85 $231.70 $248.61 $237.38 2026-07-15
86255 HCPCS Anti Endomysial Ab 1 1 $63.00 $56.70 $233.48 $233.48 $233.48 2026-07-15
G0439 HCPCS Mc Awv - Subsequent 3 3 $267.00 $240.30 $148.96 $233.85 $233.44 2026-07-15
G0438 HCPCS Mc Awv - Initial 1 1 $267.00 $240.30 $233.44 $233.44 $233.44 2026-07-15
99202 HCPCS New Pt Level 2 2 2 $291.00 $261.90 $217.39 $248.81 $233.10 2026-07-15
73502 HCPCS Xr Hip Unilateral W/pelvis; 2-3 View Lt 5 3 $48.00 $43.20 $205.62 $315.56 $232.54 2026-07-15
99309 HCPCS Nh Nonskill Subs/mod 3 2 $269.50 $254.00 $228.17 $248.61 $231.11 2026-07-15
71046 HCPCS Xr Chest; 2 View 3 3 $41.00 $36.90 $222.18 $292.04 $228.98 2026-07-15
99212 HCPCS Treatment Room/level 2 2 2 $115.00 $114.90 $208.57 $248.81 $228.69 2026-07-15
92526 HCPCS St Tx Of Swallow Dysfunction 3 3 $189.00 $170.10 $228.01 $241.73 $228.64 2026-07-15
99308 HCPCS Nh Nonskill Subs/low 2 1 $254.00 $238.55 $203.62 $248.61 $226.12 2026-07-15
92507 HCPCS St Tx Speech Therapy, Individual 3 3 $188.00 $169.20 $212.45 $267.54 $225.23 2026-07-15
73552 HCPCS Xr Femur; 2 View Lt 2 1 $46.50 $41.85 $224.12 $224.12 $224.12 2026-07-15
71045 HCPCS Xr Chest; 1 View 2 2 $41.00 $36.90 $184.92 $262.64 $223.78 2026-07-15
73100 HCPCS Xr Wrist; 2 Views Lt 2 1 $49.00 $44.10 $195.09 $245.00 $220.05 2026-07-15
73590 HCPCS Xr Tib Fib 2 View Lt 2 2 $49.00 $44.10 $202.33 $236.18 $219.25 2026-07-15
99213 HCPCS Estab Pt Level 3 3 3 $296.00 $266.40 $163.87 $248.81 $216.41 2026-07-15
87661 HCPCS Trichomonas RNA Urine 1 1 $203.00 $202.90 $215.60 $215.60 $215.60 2026-07-15
83918 HCPCS Methylmalonic Acid (mma) 3 3 $92.00 $82.80 $193.89 $275.38 $214.80 2026-07-15
72040 HCPCS Xr C-spine; 2-3 View 1 1 $46.00 $41.40 $214.38 $214.38 $214.38 2026-07-15
99282 HCPCS Emergency Services 2 7 4 $330.00 $329.90 $41.89 $302.82 $213.21 2026-07-15
73030 HCPCS Xr Shoulder Comp; 2 View Lt 5 3 $48.00 $43.20 $173.19 $245.98 $210.89 2026-07-15
73080 HCPCS Xr Elbow Complete; 3 Views Lt 3 3 $46.00 $41.40 $202.86 $288.12 $209.00 2026-07-15
73610 HCPCS Xr Ankle Complete; 3 Views Lt 3 2 $46.00 $41.40 $198.25 $273.42 $208.36 2026-07-15
73600 HCPCS Xr Ankle; 2 View Lt 1 1 $49.00 $44.10 $207.78 $207.78 $207.78 2026-07-15
73660 HCPCS Xr Toes; 2 View Lt 1 1 $49.00 $44.10 $207.76 $207.76 $207.76 2026-07-15
73630 HCPCS Xr Foot Complete; 3 View Lt 4 2 $46.50 $41.85 $161.36 $222.46 $199.56 2026-07-15
90834 HCPCS Psych Therapy Pt 45min 1 1 $191.00 $171.90 $199.51 $199.51 $199.51 2026-07-15
87502 HCPCS Influenza Pcr 2 1 $156.00 $140.40 $196.00 $196.00 $196.00 2026-07-15
87150 HCPCS Bacterial Culture With Isolation/presump 3 3 $250.00 $249.90 $193.55 $200.25 $195.09 2026-07-15
86812 HCPCS Hla B27 1 1 $79.00 $71.10 $193.06 $193.06 $193.06 2026-07-15
J1335 HCPCS INVanz Inj 1 Gm (ertapenem Sodium) 3 3 $5.00 $4.50 $171.12 $243.04 $192.99 2026-07-15
73140 HCPCS Xr Finger; 2 View Lt 2 1 $46.50 $41.85 $183.26 $197.96 $190.61 2026-07-15
73130 HCPCS Xr Hand; 3 View Lt 4 3 $48.00 $43.20 $175.87 $221.48 $189.63 2026-07-15
84207 HCPCS Vitamin B6 (pyridoxal 5 Phosphate) 1 1 $90.00 $81.00 $186.17 $186.17 $186.17 2026-07-15
80197 HCPCS Tacrolimus 2 2 $124.00 $111.60 $159.76 $211.68 $185.72 2026-07-15
73060 HCPCS Xr Humerus; 2 View Lt 2 2 $48.00 $43.20 $182.70 $183.85 $183.27 2026-07-15
73592 HCPCS Xr Lower Ext Infant; 2 View Lt 1 1 $48.00 $43.20 $183.26 $183.26 $183.26 2026-07-15
80307 HCPCS Acetaminophen Level (gn#) 1 1 $66.00 $59.40 $183.26 $183.26 $183.26 2026-07-15
73501 HCPCS Xr Hip Unilateral W/pelvis; 1 View Lt 1 1 $48.00 $43.20 $182.80 $182.80 $182.80 2026-07-15
97162 HCPCS Pt Evaluation-mod Complex 30min 4 4 $178.00 $160.20 $149.73 $199.92 $182.09 2026-07-15
73560 HCPCS Xr Knee; 1-2 View Lt 3 2 $49.93 $44.94 $165.97 $211.68 $181.32 2026-07-15
97163 HCPCS Pt Evaluation-hi Complex 45min 3 3 $178.00 $160.20 $158.70 $191.00 $176.73 2026-07-15
87493 HCPCS C Diff Pcr 2 2 $110.00 $99.00 $160.65 $185.22 $172.94 2026-07-15
73010 HCPCS Xr Scapula Complete Lt 1 1 $48.00 $43.20 $171.98 $171.98 $171.98 2026-07-15
82803 HCPCS Arterial Blood Gas 3 3 $87.00 $78.30 $147.66 $199.23 $171.10 2026-07-15
84146 HCPCS Prolactin 1 1 $82.00 $73.80 $170.52 $170.52 $170.52 2026-07-15
87338 HCPCS H Pylori Ag Stool 1 1 $91.00 $81.90 $169.54 $169.54 $169.54 2026-07-15
82627 HCPCS Dhea Sulfate 2 2 $75.00 $67.50 $160.20 $174.44 $167.32 2026-07-15
99281 HCPCS Emergency Services 1 4 4 $203.00 $202.90 $135.93 $193.06 $164.34 2026-07-15
82656 HCPCS Elastase Pancreatic Fecal 1 1 $138.00 $124.20 $163.86 $163.86 $163.86 2026-07-15
82088 HCPCS Aldosterone 2 2 $67.00 $60.30 $147.10 $180.32 $163.71 2026-07-15
86304 HCPCS Cancer Ag 125 1 1 $115.00 $103.50 $160.72 $160.72 $160.72 2026-07-15
82626 HCPCS Dhea 1 1 $75.00 $67.50 $159.74 $159.74 $159.74 2026-07-15
86481 HCPCS Tspot 2 2 $110.00 $99.00 $157.94 $159.74 $158.84 2026-07-15
87040 HCPCS Culture Blood 3 3 3 $59.91 $53.92 $142.45 $180.32 $156.40 2026-07-15
80299 HCPCS Keppra Level (levetiracetam) 1 1 $81.00 $72.90 $155.82 $155.82 $155.82 2026-07-15
80377 HCPCS Doa 12 Panel 1 1 $65.00 $58.50 $153.86 $153.86 $153.86 2026-07-15
73120 HCPCS Xr Hand; 2 View Lt 2 2 $49.50 $44.55 $146.71 $157.97 $152.34 2026-07-15
80074 HCPCS Hepatitis Panel Acute 1 1 $79.00 $71.10 $151.90 $151.90 $151.90 2026-07-15
76882 HCPCS US Extrem Nonvasc, Limited 1 1 $55.00 $49.50 $151.39 $151.39 $151.39 2026-07-15
83002 HCPCS Luteinizing Hormone (lh) 1 1 $81.00 $72.90 $147.98 $147.98 $147.98 2026-07-15
84244 HCPCS Renin Activity 2 2 $90.00 $81.00 $123.10 $172.48 $147.79 2026-07-15
97161 HCPCS Pt Evaluation-low Complex 20min 1 1 $178.00 $160.20 $146.30 $146.30 $146.30 2026-07-15
87591 HCPCS N Gonorrhoeae DNA Urine 2 2 $96.00 $86.40 $130.07 $159.74 $144.91 2026-07-15
96125 HCPCS St Standardized Cognitive Testing Per Hr 2 2 $190.00 $171.00 $143.97 $144.52 $144.25 2026-07-15
83880 HCPCS Bnp Nt Pro (gn#) 3 3 $129.00 $116.10 $127.65 $144.36 $143.23 2026-07-15
82679 HCPCS Estrone 1 1 $80.00 $72.00 $143.08 $143.08 $143.08 2026-07-15
96374 HCPCS IV Push Initial Or Single 5 3 $158.00 $157.90 $99.36 $152.17 $141.12 2026-07-15
83001 HCPCS Follicle Stimulating Hormone 2 2 $76.00 $68.40 $135.00 $147.00 $141.00 2026-07-15
84402 HCPCS Testosterone Free 3 3 $117.00 $105.30 $119.25 $147.98 $140.40 2026-07-15
87522 HCPCS Hepatitis C Quantitation 1 1 $122.00 $109.80 $140.08 $140.08 $140.08 2026-07-15
84144 HCPCS Progesterone 2 2 $82.00 $73.80 $134.10 $146.02 $140.06 2026-07-15
72200 HCPCS Xr S.i. Joints; 3 Views 1 1 $44.00 $39.60 $139.68 $139.68 $139.68 2026-07-15
99195 HCPCS Phlebotomy Therapeutic 1 1 $88.00 $79.20 $139.30 $139.30 $139.30 2026-07-15
73070 HCPCS Xr Elbow; 2 View Lt 1 1 $49.00 $44.10 $138.66 $138.66 $138.66 2026-07-15
99222 HCPCS Ip/obs Hosp Care Initial 55m 1 1 $283.00 $254.70 $133.56 $133.56 $133.56 2026-07-15
84484 HCPCS Troponin I Hs (gn#) 5 4 $91.00 $81.90 $108.33 $153.86 $133.45 2026-07-15
86664 HCPCS Ebv Ab To Na Igg 1 1 $130.00 $117.00 $133.28 $133.28 $133.28 2026-07-15
82340 HCPCS Calcium 24 Hour Urine 2 2 $71.00 $63.90 $120.78 $145.24 $133.01 2026-07-15
82378 HCPCS Carcinoembryonic Ag 1 1 $71.00 $63.90 $132.24 $132.24 $132.24 2026-07-15
84702 HCPCS Hcg Quant (gn#) 3 3 $78.00 $70.20 $120.78 $147.10 $130.35 2026-07-15
84403 HCPCS Testosterone 4 4 $88.00 $79.20 $116.19 $141.12 $127.80 2026-07-15
80164 HCPCS Valproic Acid Level 2 2 $89.00 $80.10 $110.71 $140.14 $125.42 2026-07-15
83970 HCPCS Pth W/calcium 3 3 $60.00 $54.00 $113.16 $146.02 $125.36 2026-07-15
73620 HCPCS Xr Foot; 2 View Lt 1 1 $49.00 $44.10 $123.71 $123.71 $123.71 2026-07-15
82670 HCPCS Estradiol Level 3 3 $75.00 $67.50 $120.15 $135.00 $122.50 2026-07-15
96360 HCPCS IV Hydration 1st Hr 5 3 $180.00 $162.00 $17.64 $348.88 $122.18 2026-07-15
87641 HCPCS Mrsa Pcr 1 1 $102.00 $91.80 $121.34 $121.34 $121.34 2026-07-15
82105 HCPCS Alpha 1 Fetoprotein 2 2 $67.00 $60.30 $109.31 $133.13 $121.22 2026-07-15
82677 HCPCS Estriol 1 1 $61.50 $55.35 $119.56 $119.56 $119.56 2026-07-15
99239 HCPCS Hosp Disch Day >30m 1 1 $288.00 $259.20 $117.81 $117.81 $117.81 2026-07-15
82533 HCPCS Cortisol 1 1 $73.00 $65.70 $114.66 $114.66 $114.66 2026-07-15
89060 HCPCS Crystal Identification 1 1 $122.00 $109.80 $111.72 $111.72 $111.72 2026-07-15
80053 HCPCS Cmp (gn#) 6 5 $92.00 $82.80 $86.94 $123.48 $110.25 2026-07-15
85378 HCPCS D-dimer Quant 3 3 $117.00 $105.30 $106.43 $110.81 $109.94 2026-07-15
83090 HCPCS Homocysteine 1 1 $95.00 $85.50 $109.71 $109.71 $109.71 2026-07-15
97164 HCPCS Pt Re-evaluation 1 1 $176.00 $158.40 $109.03 $109.03 $109.03 2026-07-15
84154 HCPCS Psa Free 2 2 $98.00 $88.20 $97.55 $119.56 $108.56 2026-07-15
86301 HCPCS Cancer Antigen 19 9 1 1 $136.00 $122.40 $108.48 $108.48 $108.48 2026-07-15
J3030 HCPCS SUMAtriptan Inj 6 Mg/0.5 Ml(imitrex) 1 1 $12.00 $10.80 $107.31 $107.31 $107.31 2026-07-15
84443 HCPCS Tsh 5 5 $88.00 $79.20 $86.94 $123.48 $107.10 2026-07-15
87635 HCPCS Covid 19 Pcr 3 3 $157.00 $141.30 $51.31 $120.00 $106.95 2026-07-15
10060 HCPCS I&d Abscess- Simple/single 1 1 $217.00 $207.60 $106.76 $106.76 $106.76 2026-07-15
82306 HCPCS Vitamin D 25oh (gn) 4 4 $61.00 $54.90 $87.63 $114.30 $105.51 2026-07-15
82705 HCPCS Fecal Fat Qualitative Sudan 1 1 $62.00 $55.80 $105.20 $105.20 $105.20 2026-07-15
80185 HCPCS Dilantin Level 1 1 $75.00 $67.50 $104.72 $104.72 $104.72 2026-07-15
84432 HCPCS Thyroglobulin 1 1 $74.00 $66.60 $104.52 $104.52 $104.52 2026-07-15
80162 HCPCS Digoxin Level 1 1 $75.00 $67.50 $102.97 $102.97 $102.97 2026-07-15
86141 HCPCS Crp-hs (gn#) 1 1 $117.00 $105.30 $102.90 $102.90 $102.90 2026-07-15
84481 HCPCS Triiodothyronine Free (freet3) 3 3 $87.00 $78.30 $92.46 $131.32 $102.43 2026-07-15
84165 HCPCS Protein Electrophoresis 1 1 $83.00 $74.70 $102.30 $102.30 $102.30 2026-07-15
83930 HCPCS Osmolality Blood 2 2 $96.00 $86.40 $92.13 $110.79 $101.46 2026-07-15
84703 HCPCS Hcg Pregnancy Test [qual S] 1 1 $82.00 $73.80 $99.96 $99.96 $99.96 2026-07-15
86677 HCPCS H. Pylori Igg Ab 3 3 $90.00 $81.00 $87.72 $126.42 $99.87 2026-07-15
86850 HCPCS Blood Group Antib Screen 1 1 $92.00 $82.80 $97.76 $97.76 $97.76 2026-07-15
J3373 HCPCS Vancomycin IV 1 Gm Vial (vancocin) 1 1 $125.00 $124.90 $97.27 $97.27 $97.27 2026-07-15
84270 HCPCS Sex Binding Hormone 1 1 $136.00 $122.40 $97.02 $97.02 $97.02 2026-07-15
82728 HCPCS Ferritin (gn#) 3 3 $75.31 $67.78 $86.25 $99.54 $96.77 2026-07-15
82784 HCPCS Gammaglobulin Iga 1 1 $60.00 $54.00 $96.04 $96.04 $96.04 2026-07-15
80202 HCPCS Vancomycin Peak 1 1 $64.00 $57.60 $95.23 $95.23 $95.23 2026-07-15
87389 HCPCS HIV (rapid) 1/2 Antibody Antigen 1 1 $105.00 $94.50 $95.06 $95.06 $95.06 2026-07-15
84153 HCPCS Psa Total (gn#) 4 4 $84.00 $75.60 $86.38 $110.74 $94.64 2026-07-15
90715 HCPCS Tdap IM Susp 0.5 Ml(adacel) 2 2 $114.00 $113.90 $87.60 $101.43 $94.52 2026-07-15
84480 HCPCS Triiodothyronine (total T3) 2 2 $90.00 $81.00 $77.97 $110.74 $94.35 2026-07-15
86147 HCPCS Cardiolipin Ab Iga 1 1 $124.00 $111.60 $93.68 $93.68 $93.68 2026-07-15
86704 HCPCS Hepatitis B Core Ab 2 2 $78.00 $70.20 $81.79 $104.86 $93.33 2026-07-15
82951 HCPCS Glucose Tolerance 2 Hour 1 1 $78.00 $70.20 $93.10 $93.10 $93.10 2026-07-15
82672 HCPCS Estrogen 1 1 $75.00 $67.50 $93.10 $93.10 $93.10 2026-07-15
87088 HCPCS Culture Urine Id 3 3 $75.00 $67.50 $82.80 $117.60 $91.73 2026-07-15
82746 HCPCS Folate (gn#) 3 3 $75.55 $68.00 $82.80 $95.38 $91.73 2026-07-15
86360 HCPCS Cd4 T-lymph 2 2 $98.58 $88.72 $89.74 $92.13 $90.94 2026-07-15
86038 HCPCS Anti Nuclear Antibody 3 3 $68.00 $61.20 $84.08 $107.80 $90.75 2026-07-15
82607 HCPCS Vitamin B12 (gn@) Level 3 3 $89.00 $80.10 $83.49 $112.65 $89.43 2026-07-15
87497 HCPCS Culture Cmv Rapid 1 1 $59.00 $53.10 $87.91 $87.91 $87.91 2026-07-15
82610 HCPCS Cystatin C 2 2 $101.00 $100.90 $80.90 $94.03 $87.47 2026-07-15
97112 HCPCS Ot Neuromusc Re-ed 15min 3 3 $170.00 $153.00 $76.59 $91.83 $86.73 2026-07-15
80061 HCPCS Lipid Panel(gn#) 5 5 $78.00 $70.20 $70.38 $98.00 $86.70 2026-07-15
86706 HCPCS Hepatitis B Surface Ab 2 2 $78.20 $70.38 $75.68 $97.02 $86.35 2026-07-15
86663 HCPCS Epstein Barr Igm Early Ag 1 1 $75.00 $67.50 $86.24 $86.24 $86.24 2026-07-15
87651 HCPCS Strep A Pcr 2 2 $157.00 $141.30 $76.65 $94.08 $85.37 2026-07-15
86709 HCPCS Hepatitis A Antibody Igm 1 1 $79.00 $71.10 $84.85 $84.85 $84.85 2026-07-15
83690 HCPCS Lipase (gn#) 4 4 $81.00 $72.90 $72.45 $102.90 $84.75 2026-07-15
88108 HCPCS Urine Cytology Pathology 1 1 $89.00 $88.90 $84.28 $84.28 $84.28 2026-07-15
99221 HCPCS Ip/obs Hosp Care Initial 40m 1 1 $283.00 $254.70 $84.12 $84.12 $84.12 2026-07-15
80076 HCPCS Hepatic Panel (gn#) 3 3 $92.00 $82.80 $78.66 $106.13 $84.08 2026-07-15
83735 HCPCS Magnesium Rbc 4 4 $60.00 $54.00 $71.07 $95.89 $83.64 2026-07-15
97530 HCPCS Ot Therapy Activ 1to1-15min 2 2 $173.00 $155.70 $73.93 $93.10 $83.52 2026-07-15
87070 HCPCS Culture Wound 3 2 2 $58.00 $52.20 $71.85 $95.06 $83.45 2026-07-15
84439 HCPCS T4 Free (gn#) 4 4 $87.00 $78.30 $68.31 $97.02 $82.88 2026-07-15
80048 HCPCS Basic Metabolic Panel 3 3 $92.00 $82.80 $73.83 $95.89 $82.84 2026-07-15
80320 HCPCS Blood Alcohol (gn#) 2 2 $69.00 $62.10 $76.65 $88.20 $82.43 2026-07-15
86376 HCPCS Thyroid Peroxidase 1 1 $128.00 $115.20 $82.11 $82.11 $82.11 2026-07-15
82330 HCPCS Calcium Ionized 1 1 $81.00 $72.90 $81.29 $81.29 $81.29 2026-07-15
86800 HCPCS Thyroglobulin Ab 2 2 $88.00 $79.20 $76.59 $85.94 $81.27 2026-07-15
83516 HCPCS Mitochond Ab 2 2 $68.00 $61.20 $77.97 $83.50 $80.73 2026-07-15
86703 HCPCS HIV 1 And 2 Antibody 2 2 $80.00 $72.00 $72.77 $87.51 $80.14 2026-07-15
96366 HCPCS IV Infus Each Add Hr 1 1 $162.00 $152.85 $78.40 $78.40 $78.40 2026-07-15
83525 HCPCS Insulin 3 3 $80.00 $72.00 $55.04 $81.00 $78.30 2026-07-15
80069 HCPCS Renal Panel (gn#) 3 3 $115.00 $103.50 $69.69 $89.38 $78.19 2026-07-15
87086 HCPCS Culture Urine 4 4 $75.00 $67.50 $65.96 $92.12 $77.50 2026-07-15
96376 HCPCS IV Push Ea Addl Same Drug 1 1 $167.50 $158.30 $77.42 $77.42 $77.42 2026-07-15
86762 HCPCS Rubella Virus Igg Ab 1 1 $86.00 $77.40 $76.34 $76.34 $76.34 2026-07-15
87491 HCPCS Chlamydia DNA Urine 2 2 $71.00 $63.90 $67.36 $85.26 $76.31 2026-07-15
83935 HCPCS Osmolality Urine 2 2 $82.00 $73.80 $68.90 $82.86 $75.88 2026-07-15
82785 HCPCS Gamma Globulin Ige 1 1 $138.00 $124.20 $75.87 $75.87 $75.87 2026-07-15
83605 HCPCS Lactate 4 4 $95.00 $85.50 $61.41 $82.86 $75.76 2026-07-15
97140 HCPCS Ot Manual Therapy 15min 3 3 $170.00 $153.00 $67.62 $86.24 $75.29 2026-07-15
97116 HCPCS Pt Gait Training-15min 3 3 $175.00 $157.50 $62.10 $74.92 $74.71 2026-07-15
83036 HCPCS Glycohemoglobin A1c 5 5 $78.00 $70.20 $60.03 $80.36 $73.95 2026-07-15
86146 HCPCS B2 Glycoprotein Ab Each 1 1 $79.00 $71.10 $73.55 $73.55 $73.55 2026-07-15
82375 HCPCS Carboxyhemoglobin 1 1 $71.00 $63.90 $73.50 $73.50 $73.50 2026-07-15
84425 HCPCS Vitamin B1 (l*&) Thiamine 2 2 $94.00 $84.60 $70.11 $74.25 $72.18 2026-07-15
85730 HCPCS Ptt 3 3 $84.00 $75.60 $67.36 $85.26 $71.78 2026-07-15
82150 HCPCS Amylase 2 2 $67.00 $60.30 $61.88 $81.34 $71.61 2026-07-15
86780 HCPCS Treponema Pallidum Igg 1 1 $76.00 $68.40 $71.23 $71.23 $71.23 2026-07-15
96375 HCPCS IV Push Add New Drug 2 2 $142.00 $141.90 $70.04 $71.23 $70.64 2026-07-15
81025 HCPCS Cl Lab/pregnancy Urine Test 3 3 $65.00 $58.50 $68.48 $81.34 $70.55 2026-07-15
80195 HCPCS Sirolimus 2 2 $110.00 $99.00 $63.48 $76.44 $69.96 2026-07-15
80178 HCPCS Lithium Level 2 2 $82.00 $73.80 $62.68 $76.34 $69.51 2026-07-15
86140 HCPCS Crp (gn#) 4 4 $69.38 $62.44 $59.34 $84.28 $69.42 2026-07-15
85025 HCPCS Cbc (l*) W / Auto Diff Reflex To Manual 6 5 $69.00 $62.10 $54.51 $77.42 $69.12 2026-07-15
86803 HCPCS Hepatitis C Ab 3 3 $79.00 $71.10 $58.58 $69.58 $68.03 2026-07-15
97110 HCPCS Ot Therapy Exercise 15min 3 3 $170.00 $153.00 $60.72 $86.24 $67.97 2026-07-15
93005 HCPCS Op EKG Tracing Only 5 4 $56.70 $51.03 $37.65 $96.04 $67.62 2026-07-15
82525 HCPCS Copper Urine 2 2 $59.91 $53.92 $62.79 $71.02 $66.91 2026-07-15
84436 HCPCS T4 Total 1 1 $117.00 $105.30 $66.64 $66.64 $66.64 2026-07-15
87340 HCPCS Hepatitis B Surface Ag 3 3 $117.00 $105.30 $55.28 $65.66 $65.03 2026-07-15
J1756 HCPCS Venofer 200mg/10ml (iron Sucrose) 1 1 $14.00 $12.60 $64.91 $64.91 $64.91 2026-07-15
G0283 HCPCS Pt Electric Stimulation 3 3 $72.00 $71.90 $51.48 $65.66 $64.80 2026-07-15
82043 HCPCS Microalbumin (u) Dca 3 3 $96.00 $86.40 $57.27 $81.34 $64.26 2026-07-15
86235 HCPCS Ena-ssa 52 Ab 1 1 $60.00 $54.00 $63.89 $63.89 $63.89 2026-07-15
99211 HCPCS Treatment Room/level 1 2 2 $73.00 $72.90 $56.09 $71.54 $63.82 2026-07-15
87186 HCPCS Sensitivity 2gp 3 3 $61.00 $54.90 $63.48 $71.80 $63.48 2026-07-15
J0165 HCPCS Epinephrin 1 Mg/ml Inj Sol(adrenalin) 1 1 $64.00 $63.90 $62.72 $62.72 $62.72 2026-07-15
J3480 HCPCS Potass Cl 20meq/ns 100ml Prmx (klorcon) 1 1 $10.00 $9.00 $62.62 $62.62 $62.62 2026-07-15
83550 HCPCS Tibc (g) Iron Binding Capacity 4 4 $81.00 $72.90 $53.82 $66.60 $61.25 2026-07-15
84166 HCPCS Urine Protein Electrophoresis 1 1 $90.00 $81.00 $61.05 $61.05 $61.05 2026-07-15
86430 HCPCS Rheumatoid Factor 2 2 $86.00 $77.40 $52.74 $67.62 $60.18 2026-07-15
84482 HCPCS Reverse T3 3 3 $134.00 $120.60 $55.89 $76.44 $59.62 2026-07-15
86592 HCPCS Rpr 1 1 $136.00 $122.40 $57.82 $57.82 $57.82 2026-07-15
97014 HCPCS Pt Electric Stimulation 1 1 $173.00 $155.70 $57.67 $57.67 $57.67 2026-07-15
82550 HCPCS Creatine Kinase (gn#) 3 3 $73.00 $65.70 $51.75 $69.83 $57.33 2026-07-15
12002 HCPCS Repair/smp Snagte 2.6-7.5 1 1 $426.00 $395.85 $57.17 $57.17 $57.17 2026-07-15
83540 HCPCS Iron (gn#) 1 1 $89.00 $80.10 $56.84 $56.84 $56.84 2026-07-15
12013 HCPCS Repair/smp Feenl 2.6-5cm 1 1 $300.50 $283.40 $56.15 $56.15 $56.15 2026-07-15
82248 HCPCS Bilirubin Direct (gn#) 1 1 $69.00 $62.10 $55.45 $55.45 $55.45 2026-07-15
97035 HCPCS Pt Ultrasound-15min 2 2 $68.00 $67.90 $49.18 $59.58 $54.38 2026-07-15
82247 HCPCS Bilirubin Total (gn#) 1 1 $69.00 $62.10 $53.42 $53.42 $53.42 2026-07-15
86901 HCPCS Rh Type 1 1 $85.00 $76.50 $53.07 $53.07 $53.07 2026-07-15
83013 HCPCS H Pylori Breath Test 2 2 $105.00 $94.50 $45.86 $58.80 $52.33 2026-07-15
97012 HCPCS Pt Mechanical Traction 1 1 $176.00 $158.40 $52.25 $52.25 $52.25 2026-07-15
86308 HCPCS Mono Rapid Screen 2 2 $82.00 $73.80 $43.47 $59.78 $51.62 2026-07-15
84133 HCPCS Potassium 24 Hour Urine 1 1 $61.00 $54.90 $50.96 $50.96 $50.96 2026-07-15
94640 HCPCS Nebulizer Treatment 3 3 $132.00 $131.90 $44.85 $51.76 $50.77 2026-07-15
85044 HCPCS Reticulocytes 1 1 $85.00 $76.50 $50.32 $50.32 $50.32 2026-07-15
J3010 HCPCS FentaNYL Inj 100mcg/2ml 2 2 $60.00 $59.90 $40.80 $58.80 $49.80 2026-07-15
85610 HCPCS Protime With Inr 3 3 $58.00 $52.20 $38.64 $54.88 $49.69 2026-07-15
96372 HCPCS Injection Therapeut Im/sq 6 3 $48.00 $47.90 $33.12 $256.20 $49.51 2026-07-15
J0612 HCPCS Calcium Gluconate 10ml Inj 1 1 $63.38 $63.28 $49.46 $49.46 $49.46 2026-07-15
J2919 HCPCS methylPREDNIS Succ 125mg/2ml(solumedrol) 1 1 $34.00 $33.45 $48.99 $48.99 $48.99 2026-07-15
84478 HCPCS Triglyceride (gn#) 1 1 $88.00 $79.20 $48.41 $48.41 $48.41 2026-07-15
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