|
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
|