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

FRANKLIN COUNTY MEDICAL CENTER

Preston, ID · CCN 131322 · Rates published

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You selected 27447 (CPT)

ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS

This hospital’s price: $28,830 across 5 payers · range $15,884-$29,746

Source: https://machine-readable-files.com/franklin-county-medical-center/826003449_Franklin-County-Medical-Center_standardcharges.csv · observed 2025-11-12

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

710 distinct procedures filed
34 distinct payers
4,495 rate rows
2025-11-12 last MRF observed
Data quality

4,287 of 4,495 rate rows are consumer-grade (95.4%)

208 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
professional (physician) fee — not the facility price 201
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://machine-readable-files.com/franklin-county-medical-center/826003449_Franklin-County-Medical-Center_standardcharges.csv
Found on page https://ezcost.info/franklin-county-medical-center
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-07-18
Content fingerprint e26fd0ea18634656… · 4,115,005 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
63685
CPT 		Insj/rplcmt Spinal Npg/rcvr Pocket Crtj&connj 2 $22,510.98 $37,279.20 $29,895.09 nat. median
$21,025
1.4× median
27447
CPT 		Arthrp Kne Condyle&platu Medial&lat Compartments 5 $15,883.62 $29,745.96 $28,829.65 nat. median
$12,699
outlier · 2.3×
22612
CPT 		Arthrodesis Posterior/pstlat Tq 1ntrspc Lumbar 1 $23,105.46 $23,105.46 $23,105.46 nat. median
$15,238
1.5× median
64590
CPT 		Insertion Or Replacement Of Peripheral Or Gastric Neurostimulator Pulse Generato… 2 $12,744.15 $26,807.87 $19,776.01 nat. median
$17,900
1.1× median
C1822
HCPCS 		Boston Scientific Wavewriter Alpha 16 Implantable Pulse Generator Kit 3 $16,279.30 $42,385.00 $16,279.30 nat. median
$32,176
0.5× median
64628
CPT 		Thermal Dstrj Intraosseous Bvn 1st 2 Lmbr/sac 5 $10,856.13 $28,265.16 $15,095.90 nat. median
$12,628
1.2× median
C1767
HCPCS 		Inspire Pule Generator 2 $10,162.80 $17,149.91 $13,656.35 nat. median
$23,668
0.6× median
47563
CPT 		Laps Surg Cholecystectomy W/cholangiography 9 $6,497.49 $12,932.08 $12,852.90 nat. median
$6,018
outlier · 2.1×
24342
CPT 		Rinsj Rptd Biceps/triceps Tdn Dstl W/wo Tdn Grf 1 $12,455.45 $12,455.45 $12,455.45 nat. median
$6,967
1.8× median
49614
CPT 		Rpr Aa Hernia Recr < 3 Cm Ncrc8/strangulated 1 $12,391.12 $12,391.12 $12,391.12 nat. median
$5,971
outlier · 2.1×
47562
CPT 		Laparoscopy Surg Cholecystectomy 1 $12,333.30 $12,333.30 $12,333.30 nat. median
$5,954
outlier · 2.1×
29916
CPT 		Arthroscopy Hip W/labral Repair 1 $12,268.62 $12,268.62 $12,268.62 nat. median
$7,413
1.7× median
49594
CPT 		Rpr Aa Hernia 1st 3-10 Cm Ncrc8/strangulated 4 $6,617.87 $12,391.12 $12,201.46 nat. median
$5,951
outlier · 2.1×
27130
CPT 		Arthrp Acetblr/prox Fem Prostc Agrft/algrft 3 $8,663.98 $23,018.00 $12,143.90 nat. median
$13,040
0.9× median
29888
CPT 		Arthrs Aided Ant Cruciate Ligm Rpr/agmntj/rcnstj 2 $12,046.16 $12,046.16 $12,046.16 nat. median
$7,307
1.6× median
44970
CPT 		Laparoscopic Appendectomy 4 $10,278.00 $11,896.22 $11,714.13 nat. median
$5,994
2.0× median
63663
CPT 		Revj Incl Rplcmt Nstim Eltrd Prq Ra Incl Fluor 1 $11,516.96 $11,516.96 $11,516.96 nat. median
$6,699
1.7× median
27650
CPT 		Repair Primary Open/prq Ruptured Achilles Tendon 2 $11,416.00 $11,416.00 $11,416.00 nat. median
$6,655
1.7× median
27033
CPT 		Arthrotomy Hip Exploration/removal Foreign Body 1 $11,351.42 $11,351.42 $11,351.42 nat. median
$6,632
1.7× median
52284
CPT 		Cysto W/dilat Rx Balo Cath Urtl Strix/sten Male 1 $11,112.22 $11,112.22 $11,112.22 nat. median
$5,386
outlier · 2.1×
64582
CPT 		Open Impltj Hpglsl Nrv Nstim Ra Pg&respir Sensor 4 $4,397.86 $11,380.22 $11,076.19 nat. median
$28,070
outlier · 0.4×
63650
CPT 		Prq Impltj Nstim Electrode Array Epidural 3 $4,096.36 $18,414.62 $10,665.34 nat. median
$7,255
1.5× median
27279
CPT 		Arthrodesis Si Joint Percutaneous/min Invasive 1 $10,652.50 $10,652.50 $10,652.50 nat. median
$17,233
0.6× median
23412
CPT 		Open Repair Of Rotator Cuff Chronic 1 $10,645.00 $10,645.00 $10,645.00 nat. median
$7,013
1.5× median
27829
CPT 		Open Tx Distal Tibiofibular Joint Disruption 1 $10,413.48 $10,413.48 $10,413.48 nat. median
$6,818
1.5× median
23472
CPT 		Arthroplasty Glenohumeral Joint Total Shoulder 1 $10,149.00 $10,149.00 $10,149.00 nat. median
$16,588
0.6× median
49320
CPT 		Laps Abd Prtm&omentum Dx W/wo Spec Br/wa Spx 2 $10,065.32 $10,065.32 $10,065.32 nat. median
$5,640
1.8× median
29807
CPT 		Surgical Arthroscopy Shoulder Repair Slap Lesion 1 $9,893.10 $9,893.10 $9,893.10 nat. median
$7,107
1.4× median
29828
CPT 		Surgical Arthroscopy Shoulder Biceps Tenodesis 1 $9,718.66 $9,718.66 $9,718.66 nat. median
$7,144
1.4× median
50590
CPT 		Lithotripsy, Extracorporeal Shock Wave 7 $4,013.63 $20,629.98 $9,551.00 nat. median
$4,399
outlier · 2.2×
52601
CPT 		Transurethral Electrosurgical Resection Of Prostate, Including Control Of Postop… 2 $8,037.51 $10,876.04 $9,456.78 nat. median
$5,323
1.8× median
29827
CPT 		Surgical Arthroscopy Shoulder W/rotator Cuff Rpr 4 $7,980.43 $11,389.56 $9,391.17 nat. median
$7,177
1.3× median
27698
CPT 		Repair Secondary Disrupted Ligament Ankle Coltrl 1 $9,378.40 $9,378.40 $9,378.40 nat. median
$6,623
1.4× median
52630
CPT 		Trurl Rescj Residual/regrowth Obstr Prstate Tiss 1 $9,264.92 $9,264.92 $9,264.92 nat. median
$5,191
1.8× median
31253
CPT 		Nasal/sinus Ndsc Tot W/frnt Sins Expl Tiss Rmvl 1 $9,226.40 $9,226.40 $9,226.40 nat. median
$6,925
1.3× median
27536
CPT 		Optx Tibial Fx Prox Bicondylar W/wo Int Fixj 1 $9,180.64 $9,180.64 $9,180.64 nat. median
$5,144
1.8× median
22514
CPT 		Perq Vert Agmntj Cavity Crtj Uni/bi Cannulj Lmbr 2 $5,093.82 $13,262.34 $9,178.08 nat. median
$8,313
1.1× median
31255
CPT 		Nasal/sinus Ndsc W/total Ethoidectomy 1 $9,066.80 $9,066.80 $9,066.80 nat. median
$6,760
1.3× median
30420
CPT 		Rhinoplasty Primary W/major Septal Repair 1 $8,876.99 $8,876.99 $8,876.99 nat. median
$6,179
1.4× median
49592
CPT 		Rpr Aa Hernia 1st < 3 Cm Ncrc8/strangulated 3 $6,274.52 $11,748.24 $8,641.47 nat. median
$5,856
1.5× median
49507
CPT 		Repair Initial Inguinal Hernia, Age 5 Years Or Older; Incarcerated Or Strangulat… 1 $8,624.10 $8,624.10 $8,624.10 nat. median
$3,900
outlier · 2.2×
27792
CPT 		Open Tx Distal Fibular Fracture Lat Malleolus 2 $4,933.93 $12,208.84 $8,571.39 nat. median
$6,928
1.2× median
27486
CPT 		Revj Total Knee Arthrp W/wo Algrft 1 Component 1 $8,361.00 $8,361.00 $8,361.00 nat. median
$8,769
1.0× median
30465
CPT 		Repair Nasal Vestibular Stenosis 1 $8,169.28 $8,169.28 $8,169.28 nat. median
$6,110
1.3× median
66991
CPT 		Xcapsl Ctrc Rmvl Insj Io Lens Prosth Insj 1+ 2 $6,723.00 $9,575.26 $8,149.13 nat. median
$5,612
1.5× median
11771
CPT 		Excision Pilonidal Cyst/sinus Extensive 2 $7,653.80 $7,653.80 $7,653.80 nat. median
$2,950
outlier · 2.6×
0619T
CPT 		Cysto W/trurl Ant Prst8 Commissurotomy & Rx Dlvr 1 $7,396.69 $7,396.69 $7,396.69 nat. median
$8,979
0.8× median
29880
CPT 		Arthrs Knee W/meniscectomy Med&lat W/shaving 1 $7,136.36 $7,136.36 $7,136.36 nat. median
$3,891
1.8× median
29881
CPT 		Arthrs Kne Surg W/meniscectomy Med/lat W/shvg 2 $7,026.60 $7,026.60 $7,026.60 nat. median
$3,840
1.8× median
28286
CPT 		Correction Cock-up 5th Toe W/plastic Closure 2 $6,908.58 $6,908.58 $6,908.58 nat. median
$3,436
outlier · 2.0×

Other procedures at this hospital

Browse this hospital's 710 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
             
63685 CPT Insj/rplcmt Spinal Npg/rcvr Pocket Crtj&connj 2 2 $41,844.00 $41,844.00 $22,510.98 $37,279.20 $29,895.09 2025-11-12
27447 CPT Arthrp Kne Condyle&platu Medial&lat Compartments 5 5 $25,460.00 $25,460.00 $15,883.62 $29,745.96 $28,829.65 2025-11-12
22612 CPT Arthrodesis Posterior/pstlat Tq 1ntrspc Lumbar 1 1 $25,935.00 $25,935.00 $23,105.46 $23,105.46 $23,105.46 2025-11-12
64590 CPT Insertion Or Replacement Of Peripheral Or Gastric Neurostimulator Pulse Generato… 2 2 $30,041.00 $30,041.00 $12,744.15 $26,807.87 $19,776.01 2025-11-12
C1822 HCPCS Boston Scientific Wavewriter Alpha 16 Implantable Pulse Generator Kit 3 3 $43,250.00 $43,250.00 $16,279.30 $42,385.00 $16,279.30 2025-11-12
64628 CPT Thermal Dstrj Intraosseous Bvn 1st 2 Lmbr/sac 5 5 $29,594.00 $29,594.00 $10,856.13 $28,265.16 $15,095.90 2025-11-12
C1767 HCPCS Inspire Pule Generator 2 2 $45,563.00 $45,563.00 $10,162.80 $17,149.91 $13,656.35 2025-11-12
47563 CPT Laps Surg Cholecystectomy W/cholangiography 9 9 $13,419.00 $13,419.00 $6,497.49 $12,932.08 $12,852.90 2025-11-12
24342 CPT Rinsj Rptd Biceps/triceps Tdn Dstl W/wo Tdn Grf 1 1 $14,422.00 $14,422.00 $12,455.45 $12,455.45 $12,455.45 2025-11-12
49614 CPT Rpr Aa Hernia Recr < 3 Cm Ncrc8/strangulated 1 1 $13,419.00 $13,419.00 $12,391.12 $12,391.12 $12,391.12 2025-11-12
47562 CPT Laparoscopy Surg Cholecystectomy 1 1 $13,419.00 $13,419.00 $12,333.30 $12,333.30 $12,333.30 2025-11-12
29916 CPT Arthroscopy Hip W/labral Repair 1 1 $15,023.00 $15,023.00 $12,268.62 $12,268.62 $12,268.62 2025-11-12
49594 CPT Rpr Aa Hernia 1st 3-10 Cm Ncrc8/strangulated 4 4 $13,419.00 $13,419.00 $6,617.87 $12,391.12 $12,201.46 2025-11-12
27130 CPT Arthrp Acetblr/prox Fem Prostc Agrft/algrft 3 3 $25,320.00 $25,320.00 $8,663.98 $23,018.00 $12,143.90 2025-11-12
29888 CPT Arthrs Aided Ant Cruciate Ligm Rpr/agmntj/rcnstj 2 2 $14,750.00 $14,750.00 $12,046.16 $12,046.16 $12,046.16 2025-11-12
44970 CPT Laparoscopic Appendectomy 4 4 $13,419.00 $13,419.00 $10,278.00 $11,896.22 $11,714.13 2025-11-12
63663 CPT Revj Incl Rplcmt Nstim Eltrd Prq Ra Incl Fluor 1 1 $14,102.00 $14,102.00 $11,516.96 $11,516.96 $11,516.96 2025-11-12
27650 CPT Repair Primary Open/prq Ruptured Achilles Tendon 2 2 $13,699.00 $13,699.00 $11,416.00 $11,416.00 $11,416.00 2025-11-12
27033 CPT Arthrotomy Hip Exploration/removal Foreign Body 1 1 $13,843.00 $13,843.00 $11,351.42 $11,351.42 $11,351.42 2025-11-12
52284 CPT Cysto W/dilat Rx Balo Cath Urtl Strix/sten Male 1 1 $11,692.00 $11,692.00 $11,112.22 $11,112.22 $11,112.22 2025-11-12
64582 CPT Open Impltj Hpglsl Nrv Nstim Ra Pg&respir Sensor 4 4 $14,021.00 $14,021.00 $4,397.86 $11,380.22 $11,076.19 2025-11-12
63650 CPT Prq Impltj Nstim Electrode Array Epidural 3 3 $13,060.00 $13,060.00 $4,096.36 $18,414.62 $10,665.34 2025-11-12
27279 CPT Arthrodesis Si Joint Percutaneous/min Invasive 1 1 $31,131.00 $31,131.00 $10,652.50 $10,652.50 $10,652.50 2025-11-12
23412 CPT Open Repair Of Rotator Cuff Chronic 1 1 $12,774.00 $12,774.00 $10,645.00 $10,645.00 $10,645.00 2025-11-12
27829 CPT Open Tx Distal Tibiofibular Joint Disruption 1 1 $12,751.00 $12,751.00 $10,413.48 $10,413.48 $10,413.48 2025-11-12
23472 CPT Arthroplasty Glenohumeral Joint Total Shoulder 1 1 $21,573.00 $21,573.00 $10,149.00 $10,149.00 $10,149.00 2025-11-12
49320 CPT Laps Abd Prtm&omentum Dx W/wo Spec Br/wa Spx 2 2 $12,401.00 $12,401.00 $10,065.32 $10,065.32 $10,065.32 2025-11-12
29807 CPT Surgical Arthroscopy Shoulder Repair Slap Lesion 1 1 $12,114.00 $12,114.00 $9,893.10 $9,893.10 $9,893.10 2025-11-12
29828 CPT Surgical Arthroscopy Shoulder Biceps Tenodesis 1 1 $11,900.00 $11,900.00 $9,718.66 $9,718.66 $9,718.66 2025-11-12
50590 CPT Lithotripsy, Extracorporeal Shock Wave 7 7 $3,691.00 $3,691.00 $4,013.63 $20,629.98 $9,551.00 2025-11-12
52601 CPT Transurethral Electrosurgical Resection Of Prostate, Including Control Of Postop… 2 2 $4,001.00 $4,001.00 $8,037.51 $10,876.04 $9,456.78 2025-11-12
29827 CPT Surgical Arthroscopy Shoulder W/rotator Cuff Rpr 4 4 $13,946.00 $13,946.00 $7,980.43 $11,389.56 $9,391.17 2025-11-12
27698 CPT Repair Secondary Disrupted Ligament Ankle Coltrl 1 1 $11,846.00 $11,846.00 $9,378.40 $9,378.40 $9,378.40 2025-11-12
52630 CPT Trurl Rescj Residual/regrowth Obstr Prstate Tiss 1 1 $11,345.00 $11,345.00 $9,264.92 $9,264.92 $9,264.92 2025-11-12
31253 CPT Nasal/sinus Ndsc Tot W/frnt Sins Expl Tiss Rmvl 1 1 $11,654.00 $11,654.00 $9,226.40 $9,226.40 $9,226.40 2025-11-12
27536 CPT Optx Tibial Fx Prox Bicondylar W/wo Int Fixj 1 1 $9,368.00 $9,368.00 $9,180.64 $9,180.64 $9,180.64 2025-11-12
22514 CPT Perq Vert Agmntj Cavity Crtj Uni/bi Cannulj Lmbr 2 2 $14,886.00 $14,886.00 $5,093.82 $13,262.34 $9,178.08 2025-11-12
31255 CPT Nasal/sinus Ndsc W/total Ethoidectomy 1 1 $11,453.00 $11,453.00 $9,066.80 $9,066.80 $9,066.80 2025-11-12
30420 CPT Rhinoplasty Primary W/major Septal Repair 1 1 $12,146.00 $12,146.00 $8,876.99 $8,876.99 $8,876.99 2025-11-12
49592 CPT Rpr Aa Hernia 1st < 3 Cm Ncrc8/strangulated 3 3 $13,419.00 $13,419.00 $6,274.52 $11,748.24 $8,641.47 2025-11-12
49507 CPT Repair Initial Inguinal Hernia, Age 5 Years Or Older; Incarcerated Or Strangulat… 1 1 $3,820.00 $3,820.00 $8,624.10 $8,624.10 $8,624.10 2025-11-12
27792 CPT Open Tx Distal Fibular Fracture Lat Malleolus 2 2 $14,950.00 $14,950.00 $4,933.93 $12,208.84 $8,571.39 2025-11-12
27486 CPT Revj Total Knee Arthrp W/wo Algrft 1 Component 1 1 $8,361.00 $8,361.00 $8,361.00 $8,361.00 $8,361.00 2025-11-12
30465 CPT Repair Nasal Vestibular Stenosis 1 1 $10,003.00 $10,003.00 $8,169.28 $8,169.28 $8,169.28 2025-11-12
66991 CPT Xcapsl Ctrc Rmvl Insj Io Lens Prosth Insj 1+ 2 2 $8,964.00 $8,964.00 $6,723.00 $9,575.26 $8,149.13 2025-11-12
11771 CPT Excision Pilonidal Cyst/sinus Extensive 2 2 $7,810.00 $7,810.00 $7,653.80 $7,653.80 $7,653.80 2025-11-12
0619T CPT Cysto W/trurl Ant Prst8 Commissurotomy & Rx Dlvr 1 1 $12,113.00 $12,113.00 $7,396.69 $7,396.69 $7,396.69 2025-11-12
29880 CPT Arthrs Knee W/meniscectomy Med&lat W/shaving 1 1 $7,463.00 $7,463.00 $7,136.36 $7,136.36 $7,136.36 2025-11-12
29881 CPT Arthrs Kne Surg W/meniscectomy Med/lat W/shvg 2 2 $7,463.00 $7,463.00 $7,026.60 $7,026.60 $7,026.60 2025-11-12
28286 CPT Correction Cock-up 5th Toe W/plastic Closure 2 2 $7,463.00 $7,463.00 $6,908.58 $6,908.58 $6,908.58 2025-11-12
63688 CPT Revj/rmvl Impl Spi Npg/rcvr Dtch Connj Eltrd Ra 1 1 $7,910.00 $7,910.00 $6,754.16 $6,754.16 $6,754.16 2025-11-12
52332 CPT Cystourethroscopy, With Insertion Of Indwelling Ureteral Stent (eg, Gibbons Or D… 2 2 $7,933.00 $7,933.00 $6,547.38 $6,547.38 $6,547.38 2025-11-12
24359 CPT Tnot Elbow Lateral/medial Debride Open Tdn Rpr 1 1 $7,463.00 $7,463.00 $6,474.86 $6,474.86 $6,474.86 2025-11-12
64561 CPT Percutaneous Implantation Of Neurostimulator Electrode Array; Sacral Nerve (tran… 3 3 $6,001.00 $6,001.00 $2,464.67 $12,744.15 $6,417.04 2025-11-12
28296 CPT Corrj Hallux Valgus W/sesmdc W/dist Metar Osteot 1 1 $7,463.00 $7,463.00 $6,416.30 $6,416.30 $6,416.30 2025-11-12
57287 CPT Rmvl/revj Sling Stress Incontinence 1 1 $7,313.00 $7,313.00 $6,400.38 $6,400.38 $6,400.38 2025-11-12
49505 CPT Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible 4 4 $8,872.00 $8,872.00 $2,243.96 $8,694.56 $6,387.84 2025-11-12
26123 CPT Fasct Prtl Palmar 1 Dgt Prox Iphal Jt W/wo Rpr 1 1 $7,463.00 $7,463.00 $6,315.12 $6,315.12 $6,315.12 2025-11-12
42830 CPT Adenoidectomy Primary <age 12 2 2 $7,459.00 $7,459.00 $6,216.80 $6,413.12 $6,314.96 2025-11-12
52352 CPT Cysto W/ureteroscopy W/rmvl/manj Stones 2 2 $7,608.00 $7,608.00 $6,023.00 $6,213.20 $6,118.10 2025-11-12
20680 CPT Removal Implant Deep 2 2 $6,583.00 $6,583.00 $5,787.76 $6,445.46 $6,116.61 2025-11-12
26727 CPT Prq Skel Fixj Phlngl Shft Fx Prox/middle Px/f/t 1 1 $7,463.00 $7,463.00 $6,106.14 $6,106.14 $6,106.14 2025-11-12
27630 CPT Excision Lesion Tendon Sheath/capsule Leg&/ank 1 1 $7,463.00 $7,463.00 $6,092.66 $6,092.66 $6,092.66 2025-11-12
29873 CPT Arthroscopy Knee Lateral Release 1 1 $7,463.00 $7,463.00 $6,089.72 $6,089.72 $6,089.72 2025-11-12
47490 CPT Cholecystostomy Prq W/imaging & Catheter Plmt 1 1 $7,628.00 $7,628.00 $6,039.15 $6,039.15 $6,039.15 2025-11-12
29823 CPT Surgical Arthroscopy Shoulder Xtnsv Dbrdmt 3+ 1 1 $7,298.00 $7,298.00 $5,960.36 $5,960.36 $5,960.36 2025-11-12
46250 CPT Hemorrhoidectomy Xtrnl 2/> Column/group 2 2 $6,307.00 $6,307.00 $5,930.96 $5,930.96 $5,930.96 2025-11-12
28119 CPT Ostectomy Calcaneus Spur W/wo Plntar Fascial Rls 1 1 $7,076.00 $7,076.00 $5,897.00 $5,897.00 $5,897.00 2025-11-12
29822 CPT Surgical Arthroscopy Shoulder Lmtd Dbrdmt 1/2 2 2 $7,048.00 $7,048.00 $5,873.00 $5,873.00 $5,873.00 2025-11-12
20912 CPT Cartilage Graft Nasal Septum 1 1 $7,182.00 $7,182.00 $5,865.30 $5,865.30 $5,865.30 2025-11-12
28008 CPT Fasciotomy Foot&/toe 2 2 $7,222.00 $7,222.00 $5,861.53 $5,861.53 $5,861.53 2025-11-12
28810 CPT Amputation Metatarsal W/toe Single 1 1 $7,398.00 $7,398.00 $5,856.75 $5,856.75 $5,856.75 2025-11-12
59812 CPT Tx Incomplete Abortion Any Trimester Surgical 1 1 $7,133.00 $7,133.00 $5,825.12 $5,825.12 $5,825.12 2025-11-12
28118 CPT Ostectomy Calcaneus 1 1 $7,114.00 $7,114.00 $5,809.44 $5,809.44 $5,809.44 2025-11-12
27680 CPT Tenolysis Flxr/xtnsr Tendon Leg&/ankle 1 Each 2 2 $7,034.00 $7,034.00 $5,744.76 $5,862.00 $5,803.38 2025-11-12
38531 CPT Open Biopsy/excision Inguinofemoral Nodes 1 1 $8,807.00 $8,807.00 $5,800.25 $5,800.25 $5,800.25 2025-11-12
28122 CPT Prtl Exc B1 Tarsal/metar B1 Xcp Talus/calcaneus 1 1 $6,936.00 $6,936.00 $5,664.40 $5,664.40 $5,664.40 2025-11-12
23515 CPT Open Tx Clavicular Fracture Internal Fixation 1 1 $16,081.00 $16,081.00 $5,502.59 $5,502.59 $5,502.59 2025-11-12
21014 CPT Exc Tumor Soft Tiss Face&scalp Subfascial 2 Cm/> 1 1 $6,583.00 $6,583.00 $5,381.75 $5,381.75 $5,381.75 2025-11-12
28288 CPT Ostc Prtl Exostc/condylc Metar Head 4 4 $6,569.00 $6,569.00 $2,400.48 $6,148.87 $5,331.68 2025-11-12
53460 CPT Urethromeatoplasty W/prtl Exc Dstl Urtl Sgm 1 1 $6,409.00 $6,409.00 $5,234.18 $5,234.18 $5,234.18 2025-11-12
29824 CPT Surgical Arthroscopy Shoulder Dstl Claviculc 3 3 $6,396.00 $6,396.00 $5,223.40 $8,395.99 $5,223.40 2025-11-12
21320 CPT Closed Tx Nasal Bone Fx W/mnpj W/stabilization 1 1 $6,325.00 $6,325.00 $5,165.58 $5,165.58 $5,165.58 2025-11-12
26608 CPT Prq Skeletal Fixj Metacarpal Fx Each Bone 2 2 $6,280.00 $6,280.00 $5,128.34 $5,128.34 $5,128.34 2025-11-12
30520 CPT Septoplasty/submucous Resecj W/wo Cartilage Grf 9 9 $6,130.00 $6,130.00 $2,502.92 $5,108.00 $4,975.19 2025-11-12
27696 CPT Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms 1 1 $12,073.00 $12,073.00 $4,929.89 $4,929.89 $4,929.89 2025-11-12
54161 CPT Circumcision Age >28 Days 2 2 $5,354.00 $5,354.00 $4,711.52 $5,086.30 $4,898.91 2025-11-12
54840 CPT Excision Spermatocele W/wo Epididymectomy 1 1 $5,484.00 $5,484.00 $4,809.47 $4,809.47 $4,809.47 2025-11-12
64718 CPT Neuroplasty &/transposition Ulnar Nerve Elbow 1 1 $4,827.00 $4,827.00 $4,730.46 $4,730.46 $4,730.46 2025-11-12
52356 CPT Cystourethroscopy, With Ureteroscopy And/or Pyeloscopy; With Lithotripsy Includi… 3 3 $5,390.00 $5,390.00 $4,402.16 $4,679.50 $4,679.50 2025-11-12
25120 CPT Excision/curettage Cyst/tumor Radius/ulna 1 1 $5,548.00 $5,548.00 $4,530.54 $4,530.54 $4,530.54 2025-11-12
64721 CPT Neuroplasty &/transpos Median Nrv Carpal Tunne 5 5 $4,572.00 $4,572.00 $2,286.00 $4,480.56 $4,480.56 2025-11-12
57288 CPT Sling Operation For Stress Incontinence (eg, Fascia Or Synthetic) 1 1 $4,001.00 $4,001.00 $4,422.93 $4,422.93 $4,422.93 2025-11-12
63661 CPT Rmvl Spinal Nstim Eltrd Prq Array Incl Fluor 1 1 $4,491.00 $4,491.00 $4,366.88 $4,366.88 $4,366.88 2025-11-12
29898 CPT Arthroscopy Ankle Surgical Debridement Extensive 2 2 $7,187.00 $7,187.00 $2,934.61 $5,689.55 $4,312.08 2025-11-12
62350 CPT Impltj Revj/rpsg Ithcl/edrl Cath Pmp Without Lam 1 1 $13,319.00 $13,319.00 $4,177.66 $4,177.66 $4,177.66 2025-11-12
28080 CPT Excision Interdigital Morton Neuroma Single Each 3 3 $4,285.00 $4,285.00 $4,173.59 $4,199.30 $4,173.59 2025-11-12
49591 CPT Rpr Aa Hernia 1st < 3 Cm Reducible 2 2 $8,117.00 $8,117.00 $774.06 $7,430.36 $4,102.21 2025-11-12
20930 CPT Allograft For Spine Surgery Only Morselized 2 2 $4,170.00 $4,170.00 $4,100.00 $4,100.00 $4,100.00 2025-11-12
23410 CPT Open Repair Of Rotator Cuff Acute 2 2 $5,998.00 $5,998.00 $4,097.87 $4,098.30 $4,098.09 2025-11-12
29826 CPT Surgical Arthroscopy Sho W/coracoacrm Ligm Rls 4 4 $4,250.00 $4,250.00 $3,798.10 $4,165.00 $4,081.50 2025-11-12
93229 CPT External Mobile Cv Telemetry W/technical Support 2 2 $5,306.00 $5,306.00 $2,855.15 $5,306.00 $4,080.57 2025-11-12
52260 CPT Cystourethroscopy W/dil Bladder General Anesth 1 1 $4,712.00 $4,712.00 $4,043.85 $4,043.85 $4,043.85 2025-11-12
52353 CPT Cystourethroscopy, With Ureteroscopy And/or Pyeloscopy; With Lithotripsy (ureter… 5 5 $4,001.00 $4,001.00 $1,676.27 $4,148.34 $4,021.35 2025-11-12
28285 CPT Correction Hammertoe 4 4 $4,821.00 $4,821.00 $3,993.40 $4,100.00 $4,013.90 2025-11-12
26115 CPT Exc Tum/vasc Mal Sft Tiss Hand/fngr Subq <1.5cm 1 1 $3,809.00 $3,809.00 $3,732.82 $3,732.82 $3,732.82 2025-11-12
14040 CPT Adjt Tis Trns/reargmt F/c/c/m/n/a/g/h/f 10sqcm/< 1 1 $4,248.00 $4,248.00 $3,728.24 $3,728.24 $3,728.24 2025-11-12
C1778 HCPCS Inspire Stimulator Lead 6 6 $4,875.00 $4,875.00 $1,411.50 $4,777.50 $3,601.88 2025-11-12
11406 CPT Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l >4.0 Cm 1 1 $3,727.00 $3,727.00 $3,554.46 $3,554.46 $3,554.46 2025-11-12
95811 CPT Sleep Study W/cpap Attended By Tech 6 6 $4,007.00 $4,007.00 $1,512.35 $3,902.82 $3,530.63 2025-11-12
95810 CPT Sleep Study Attended By Tech 9 9 $3,673.00 $3,673.00 $1,382.52 $3,626.86 $3,489.35 2025-11-12
26160 CPT Exc Lesion Tdn Shth/jt Capsl Hand/fngr 2 2 $3,739.00 $3,739.00 $3,279.10 $3,664.22 $3,471.66 2025-11-12
C1776 HCPCS Stryker Acetabular Cup 3 3 $4,730.00 $4,730.00 $2,005.15 $8,502.50 $3,424.86 2025-11-12
46230 CPT Excision Multiple External Papillae/tags Anus 2 2 $6,017.00 $6,017.00 $1,888.32 $4,913.72 $3,401.02 2025-11-12
J0630 HCPCS Calcitonin-salmon 400 Unit/2ml 1 1 $4,133.00 $4,133.00 $3,358.06 $3,358.06 $3,358.06 2025-11-12
64633 CPT Dstr Nrolytc Agnt Parverteb Fct Sngl Crvcl/thora 3 3 $4,491.00 $4,491.00 $2,262.74 $3,734.78 $3,353.68 2025-11-12
22614 CPT Arthrodesis Pst/pstlat Tq 1ntrspc Ea Addl Ntrspc 1 1 $3,302.00 $3,302.00 $3,235.96 $3,235.96 $3,235.96 2025-11-12
26236 CPT Partial Excision Distal Phalanx Finger 1 1 $3,681.00 $3,681.00 $3,156.65 $3,156.65 $3,156.65 2025-11-12
26055 CPT Tendon Sheath Incision 3 3 $3,681.00 $3,681.00 $1,313.26 $3,419.22 $3,059.85 2025-11-12
64635 CPT Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/sacral 8 8 $4,491.00 $4,491.00 $1,991.50 $3,903.34 $3,057.36 2025-11-12
52344 CPT Cysto W/urtroscopy W/tx Ureteral Stricture 1 1 $7,480.00 $7,480.00 $3,054.17 $3,054.17 $3,054.17 2025-11-12
51715 CPT Endoscopic Injection Of Implant Material Into The Submucosal Tissues Of The Uret… 3 3 $3,666.00 $3,666.00 $2,989.65 $3,084.06 $3,046.30 2025-11-12
C1889 HCPCS Implantable/insertable Device, Not Otherwise Classified 2 2 $3,795.00 $3,795.00 $1,413.01 $4,554.00 $2,983.51 2025-11-12
45380 CPT Colonoscopy, Flexible; With Biopsy, Single Or Multiple 18 18 $3,083.00 $3,083.00 $1,157.36 $3,021.34 $2,965.85 2025-11-12
41899 CPT Unlisted Procedure, Dentoalveolar Structures 1 1 $2,994.00 $2,994.00 $2,934.12 $2,934.12 $2,934.12 2025-11-12
42821 CPT Tonsillectomy And Adenoidectomy; Age 12 Or Over 5 5 $3,584.00 $3,584.00 $2,837.65 $2,927.26 $2,909.34 2025-11-12
42820 CPT Tonsillectomy And Adenoidectomy; Under Age 12 6 6 $3,584.00 $3,584.00 $2,619.60 $2,927.26 $2,909.34 2025-11-12
J7323 HCPCS Euflexxa 20 Mg/2 Ml Syringe 1 1 $476.00 $476.00 $2,856.20 $2,856.20 $2,856.20 2025-11-12
72157 CPT MRI T-spine With & Without Contrast 1 1 $2,969.00 $2,969.00 $2,820.55 $2,820.55 $2,820.55 2025-11-12
66984 CPT Xcapsl Ctrc Rmvl Insj Io Lens Prosth Without Ecp 9 9 $5,393.00 $5,393.00 $2,029.93 $5,285.14 $2,777.99 2025-11-12
55100 CPT Drainage Scrotal Wall Abscess 1 1 $3,344.00 $3,344.00 $2,739.06 $2,739.06 $2,739.06 2025-11-12
45378 CPT Colonoscopy; Diagnostic 11 11 $2,766.00 $2,766.00 $1,447.72 $2,710.68 $2,694.08 2025-11-12
42826 CPT Tonsillectomy, Primary Or Secondary, Age 12 Or Over 3 3 $3,386.00 $3,386.00 $2,603.00 $2,765.56 $2,685.20 2025-11-12
26125 CPT Fasct Prtl Palmr Addl Dgt Prox Iphal Jt W/wo Rpr 1 1 $2,728.00 $2,728.00 $2,673.44 $2,673.44 $2,673.44 2025-11-12
31240 CPT Nasal/sinus Ndsc Surg W/concha Bullosa Resection 1 1 $3,617.00 $3,617.00 $2,643.28 $2,643.28 $2,643.28 2025-11-12
25111 CPT Excision Ganglion Wrist Dorsal/volar Primary 2 2 $3,840.00 $3,840.00 $1,881.60 $3,379.20 $2,630.40 2025-11-12
55700 CPT Biopsy, Prostate; Needle Or Punch, Single Or Multiple, Any Approach 7 7 $3,593.00 $3,593.00 $479.12 $2,934.12 $2,625.74 2025-11-12
31256 CPT Nasal/sinus Endoscopy W/maxillary Antrostomy 1 1 $6,517.00 $6,517.00 $2,579.73 $2,579.73 $2,579.73 2025-11-12
72156 CPT MRI C-spine With And Without Contrast 2 2 $3,230.00 $3,230.00 $1,981.90 $3,068.50 $2,525.20 2025-11-12
43247 CPT Egd Flexible Foreign Body Removal 1 1 $2,713.00 $2,713.00 $2,500.96 $2,500.96 $2,500.96 2025-11-12
30140 CPT Submucous Rescj Inferior Turbinate Prtl/compl 8 8 $6,187.00 $6,187.00 $1,289.00 $5,052.88 $2,480.03 2025-11-12
46320 CPT Exc Thrombosed Hemorrhoid Xtrnl 1 1 $3,513.00 $3,513.00 $2,476.14 $2,476.14 $2,476.14 2025-11-12
25605 CPT Cltx Dstl Rdl Fx/epiphysl Sep W/manj When Perf 1 1 $3,085.00 $3,085.00 $2,442.45 $2,442.45 $2,442.45 2025-11-12
70553 CPT MRI Brain With And Without Contrast 8 8 $3,015.00 $3,015.00 $1,599.27 $2,936.61 $2,423.14 2025-11-12
78452 CPT Nm Chemical Stress Cardiac Ex 12 12 $3,326.00 $3,326.00 $1,251.91 $3,326.00 $2,416.87 2025-11-12
28104 CPT Exc/curtg Bone Cyst/b9 Tumortarsal/metatarsal 1 1 $6,958.00 $6,958.00 $2,296.01 $2,296.01 $2,296.01 2025-11-12
52204 CPT Cystourethroscopy With Biopsy 2 2 $5,013.00 $5,013.00 $1,886.89 $2,649.69 $2,268.29 2025-11-12
64530 CPT Injx Anes Celiac Plexus W/wo Radiologic Monitrng 1 1 $2,243.00 $2,243.00 $2,198.14 $2,198.14 $2,198.14 2025-11-12
G0121 HCPCS Colon Ca Scrn Not Hi Rsk Ind 5 5 $2,653.00 $2,653.00 $1,039.98 $2,609.54 $2,172.04 2025-11-12
64483 CPT Transforaminal Esi-lumbar Or Sacrial With Fluoroscopy 1 1 $2,379.00 $2,379.00 $2,141.10 $2,141.10 $2,141.10 2025-11-12
28124 CPT Partical Excision Bone Phalanx Toe 1 1 $6,788.00 $6,788.00 $2,129.29 $2,129.29 $2,129.29 2025-11-12
25635 CPT Cltx Carpal Bone Fx W/manj Each Bone 2 2 $2,494.00 $2,494.00 $2,036.44 $2,036.44 $2,036.44 2025-11-12
43248 CPT Egd Insert Guide Wire Dilator Passage Esophagus 8 8 $2,257.00 $2,257.00 $849.53 $2,211.86 $1,956.73 2025-11-12
62273 CPT Injection Epidural Blood/clot Patch 1 1 $4,770.00 $4,770.00 $1,888.92 $1,888.92 $1,888.92 2025-11-12
25000 CPT Incision Extensor Tendon Sheath Wrist 2 2 $4,130.00 $4,130.00 $1,635.48 $2,065.00 $1,850.24 2025-11-12
74177 CPT CT Abdomen Pelvis With 20 19 $2,684.00 $2,684.00 $1,010.26 $2,630.32 $1,841.31 2025-11-12
72197 CPT MRI Pelvis W Without 6 6 $2,501.00 $2,501.00 $941.38 $2,202.11 $1,817.02 2025-11-12
70543 CPT MRI Orbit, Face Or Neck W Without Contrast 4 4 $2,872.00 $2,872.00 $1,137.31 $2,518.74 $1,817.02 2025-11-12
64636 CPT Dstr Nrolytc Agnt Parverteb Fct Addl Lmbr/sacral 5 5 $1,903.00 $1,903.00 $951.50 $1,864.94 $1,807.85 2025-11-12
42975 CPT Drug Induced Sleep Endoscopy With Eval Sleep Disordered Breathing/flexible/diagnos… 3 3 $1,850.00 $1,850.00 $1,200.55 $1,801.90 $1,801.90 2025-11-12
74185 CPT MRI Abdomen Angio With Con 1 1 $2,080.00 $2,080.00 $1,798.31 $1,798.31 $1,798.31 2025-11-12
64634 CPT Dstr Nrolytc Agnt Parverteb Fct Addl Lmbr/sacral 2 2 $1,903.00 $1,903.00 $1,674.64 $1,864.94 $1,769.79 2025-11-12
74176 CPT CT Abdomen Pelvis Without 19 19 $1,987.00 $1,987.00 $747.91 $1,987.00 $1,742.60 2025-11-12
69436 CPT Tympanostomy General Anesthesia 4 4 $3,540.00 $3,540.00 $1,681.50 $3,469.20 $1,734.60 2025-11-12
74183 CPT MRI Abdomen W/wo 6 6 $2,711.00 $2,711.00 $1,020.42 $2,711.00 $1,707.79 2025-11-12
64624 CPT Destruction Neurolytic Agt Genicular Nerve W/img 2 2 $4,491.00 $4,491.00 $1,699.63 $1,699.63 $1,699.63 2025-11-12
72193 CPT CT Pelvis W 5 5 $1,752.00 $1,752.00 $823.95 $1,706.45 $1,664.40 2025-11-12
27570 CPT Manipulation Knee Joint Under General Anesthesia 1 1 $3,681.00 $3,681.00 $1,633.52 $1,633.52 $1,633.52 2025-11-12
52351 CPT Cystourethroscopy, With Ureteroscopy And/or Pyeloscopy; Diagnostic 1 1 $3,691.00 $3,691.00 $1,602.30 $1,602.30 $1,602.30 2025-11-12
43239 CPT Egd Transoral Biopsy Single/multiple 15 15 $2,050.00 $2,050.00 $642.89 $1,798.54 $1,574.86 2025-11-12
20615 CPT Aspiration & Injection Treatment Bone Cyst 1 1 $1,618.00 $1,618.00 $1,565.54 $1,565.54 $1,565.54 2025-11-12
72148 CPT MRI L-spine Without Contrast 13 13 $2,258.00 $2,258.00 $849.91 $2,199.29 $1,521.38 2025-11-12
73718 CPT MRI Lower Extremity Non-joint Wo 9 8 $1,932.00 $1,932.00 $765.07 $1,900.36 $1,521.38 2025-11-12
74181 CPT MRI Abdomen Without 1 1 $1,492.00 $1,492.00 $1,492.00 $1,492.00 $1,492.00 2025-11-12
72158 CPT MRI L-spine With And With Out 4 4 $3,288.00 $3,288.00 $1,237.60 $1,720.94 $1,477.09 2025-11-12
53060 CPT DRG Of Skene's Gland Abscess Or Cyst 1 1 $3,541.00 $3,541.00 $1,445.99 $1,445.99 $1,445.99 2025-11-12
93306 CPT US Echocardiogram Without Contrast 14 14 $1,979.00 $1,979.00 $744.90 $1,939.42 $1,416.45 2025-11-12
74178 CPT CT Abdomen Pelvis Without And With 9 9 $3,565.00 $3,565.00 $1,284.45 $3,208.50 $1,411.74 2025-11-12
C1820 HCPCS Boston Scientific Wavewriter Alpha 32 Ipg Kit 3 3 $43,250.00 $43,250.00 $1,411.50 $3,675.00 $1,411.50 2025-11-12
73721 CPT MRI Lt Knee Without 27 19 $1,851.00 $1,851.00 $151.55 $1,802.87 $1,369.24 2025-11-12
43249 CPT Egd Balloon Dilation Esophagus <30 Mm Diam 2 2 $4,213.00 $4,213.00 $1,321.54 $1,390.36 $1,355.95 2025-11-12
70549 CPT MRA Neck Angio W/wo Contrast 1 1 $1,845.00 $1,845.00 $1,319.11 $1,319.11 $1,319.11 2025-11-12
70551 CPT MRI Brain Without Contrast 14 14 $2,082.00 $2,082.00 $783.66 $2,046.36 $1,309.68 2025-11-12
74174 CPT CT Abd/pelvis Angio With 5 5 $2,328.00 $2,328.00 $921.89 $2,267.47 $1,284.45 2025-11-12
78227 CPT Nm Hida Scan W/ef 5 5 $1,669.00 $1,669.00 $1,204.24 $1,625.61 $1,275.83 2025-11-12
70491 CPT CT Neck Soft Tissue W 8 8 $1,534.00 $1,534.00 $43.24 $1,494.12 $1,258.78 2025-11-12
62323 CPT Njx Dx/ther Sbst Intrlmnr Lmbr/sac W/img Gdn 14 12 $1,995.00 $1,995.00 $419.07 $1,995.00 $1,252.66 2025-11-12
72128 CPT CT T Spine 3 3 $1,330.00 $1,330.00 $526.68 $1,295.42 $1,252.00 2025-11-12
1000012 CDM Inpatient-semi Private 15 15 $1,250.00 $1,250.00 $92.28 $3,763.54 $1,223.60 2025-11-12
1000001 CDM Inpatient Room 15 15 $1,326.00 $1,326.00 $92.28 $3,763.54 $1,223.60 2025-11-12
64490 CPT Facet Diag - Cervical Or Thoracic 4 4 $1,730.00 $1,730.00 $571.03 $1,413.16 $1,222.80 2025-11-12
71275 CPT CT Pulmonary Angio 19 16 $1,877.00 $1,877.00 $683.82 $1,828.20 $1,206.00 2025-11-12
64494 CPT Njx Dx/ther Agt Pvrt Facet Jt Lmbr/sac 2nd Level 10 10 $1,263.00 $1,263.00 $322.54 $1,237.74 $1,199.85 2025-11-12
64491 CPT Njx Dx/ther Agt Pvrt Facet Jt Crv/thrc 2nd Level 1 1 $1,218.00 $1,218.00 $1,193.64 $1,193.64 $1,193.64 2025-11-12
11400 CPT Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 0.5 Cm/< 1 1 $1,429.00 $1,429.00 $1,167.18 $1,167.18 $1,167.18 2025-11-12
20985 CPT Cptr-asst Surgical Navigation Image-less 2 2 $7,202.00 $7,202.00 $1,157.95 $1,157.95 $1,157.95 2025-11-12
72141 CPT MRI C-spine Without Contrast 10 10 $2,387.00 $2,387.00 $898.47 $2,324.94 $1,152.35 2025-11-12
72146 CPT MRI T-spine Without Contrast 7 7 $2,197.00 $2,197.00 $826.95 $2,139.88 $1,149.91 2025-11-12
64493 CPT Facet Diag-lumbar Or Sacral 14 14 $2,307.00 $2,307.00 $456.79 $2,191.65 $1,130.43 2025-11-12
27780 CPT Closed Treatment Of Proximal Fibula Or Shaft Fracture; Without Manipulation 1 1 $1,153.00 $1,153.00 $1,129.94 $1,129.94 $1,129.94 2025-11-12
71271 CPT CT Chest Low Dose 5 5 $1,272.00 $1,272.00 $377.10 $1,246.56 $1,119.36 2025-11-12
78264 CPT Nm Gastric Empty Ex 1 1 $1,136.00 $1,136.00 $1,118.17 $1,118.17 $1,118.17 2025-11-12
73722 CPT MRI Lower Joint Arthrogram 2 2 $1,817.00 $1,817.00 $712.80 $1,460.48 $1,086.64 2025-11-12
72195 CPT MRI Pelvis Without Contrast 3 3 $2,076.00 $2,076.00 $979.52 $1,820.65 $1,063.18 2025-11-12
70460 CPT CT Brain With Contrast 1 1 $1,173.00 $1,173.00 $1,060.25 $1,060.25 $1,060.25 2025-11-12
64629 CPT Thermal Dstrj Intraosseous Bvn Ea Addl Lmbr/sac 1 1 $1,040.00 $1,040.00 $1,040.00 $1,040.00 $1,040.00 2025-11-12
12035 CPT Repair Intermediate S/a/t/e 12.6-20.0cm 1 1 $1,017.00 $1,017.00 $996.66 $996.66 $996.66 2025-11-12
73221 CPT MRI Upper Extremity Joint Wo 14 14 $1,924.00 $1,924.00 $300.00 $1,873.98 $970.76 2025-11-12
70498 CPT CT Neck Angio 11 11 $1,826.00 $1,826.00 $687.31 $1,796.48 $962.97 2025-11-12
71260 CPT CT Chest With 10 10 $1,896.00 $1,896.00 $713.65 $1,846.70 $945.83 2025-11-12
74170 CPT CT Abd Without W 3 3 $1,868.00 $1,868.00 $739.73 $1,386.70 $922.41 2025-11-12
95806 CPT Sleep Study Unattended 19 19 $918.00 $918.00 $452.22 $899.64 $872.10 2025-11-12
11404 CPT Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 3.1-4.0 Cm 1 1 $3,727.00 $3,727.00 $847.56 $847.56 $847.56 2025-11-12
73720 CPT MRI Lower Extremity Other Than Joint Without W 3 3 $1,928.00 $1,928.00 $725.70 $2,125.00 $841.50 2025-11-12
73206 CPT CT Angiogram Upper Extremity 2 2 $1,195.00 $1,195.00 $597.50 $1,051.60 $824.55 2025-11-12
70496 CPT CT Head Angio 11 11 $1,540.00 $1,540.00 $579.66 $1,463.00 $812.15 2025-11-12
10061 CPT Incision & Drainage Abscess Complicated/multiple 1 1 $919.00 $919.00 $805.90 $805.90 $805.90 2025-11-12
75635 CPT CT Abdominal Angio With Runoff 3 3 $2,100.00 $2,100.00 $790.44 $831.60 $790.44 2025-11-12
71270 CPT CT Chest With And With Out 3 3 $2,085.00 $2,085.00 $784.79 $825.66 $784.79 2025-11-12
72125 CPT CT C Spine 11 11 $1,452.00 $1,452.00 $410.47 $1,414.25 $780.80 2025-11-12
70486 CPT CT Paranasal 11 11 $1,126.00 $1,126.00 $410.47 $1,096.72 $780.80 2025-11-12
64454 CPT Injection Aa&/strd Genicular Nrv Branches W/img 3 3 $1,947.00 $1,947.00 $366.43 $771.01 $771.01 2025-11-12
62321 CPT Injection Of Substance Into Spinal Canal Of Upper Or Middle Back Using Image Gui… 3 3 $2,022.00 $2,022.00 $419.07 $1,981.56 $761.08 2025-11-12
46930 CPT Destruction Of Internal Anal Hemorrhoids By Het 6 6 $1,878.00 $1,878.00 $589.07 $1,533.70 $759.66 2025-11-12
70450 CPT CT Brain 18 18 $1,066.00 $1,066.00 $401.24 $1,038.28 $741.76 2025-11-12
1000006 CDM Swing Bed Hospital Room 1 1 $775.00 $775.00 $738.75 $738.75 $738.75 2025-11-12
1000006NS CDM Non-skilled Swing Bed 1 1 $600.00 $600.00 $738.75 $738.75 $738.75 2025-11-12
87507 CPT Gastrointestinal Filmarray By Pcr 6 6 $468.00 $468.00 $660.00 $750.00 $735.00 2025-11-12
64640 CPT Treatment Room, Destruction Peripheral Nerve (iovera Injection), 3 Nerves 4 4 $2,812.00 $2,812.00 $371.18 $910.00 $722.74 2025-11-12
93015 CPT Nm Stress Test 2 2 $719.00 $719.00 $683.05 $695.99 $689.52 2025-11-12
64450 CPT Injection Of Anesthetic Agent, Other Peripheral Nerve Or Branch 1 1 $1,593.00 $1,593.00 $686.00 $686.00 $686.00 2025-11-12
71250 CPT CT Chest Without 11 11 $1,363.00 $1,363.00 $410.47 $1,327.56 $671.52 2025-11-12
93970 CPT US Venous Bilateral 2 2 $1,028.00 $1,028.00 $407.09 $919.60 $663.35 2025-11-12
82731 CPT Fetal Fibronectin 2 2 $1,000.00 $1,000.00 $344.85 $974.00 $659.42 2025-11-12
C1781 HCPCS Hernia Mesh Ventralex Large 5 5 $1,304.00 $1,304.00 $248.42 $895.54 $638.88 2025-11-12
27786 CPT Closed Treatment Of Distal Fibular Fracture (lateral Malleolus); Without Manipul… 1 1 $654.00 $654.00 $622.30 $622.30 $622.30 2025-11-12
73218 CPT MRI Rt Hand Without 4 4 $1,600.00 $1,600.00 $555.27 $979.52 $618.01 2025-11-12
26725 CPT Cltx Phlngl Fx Prox/middle Px/f/t W/manj Ea 1 1 $603.00 $603.00 $587.32 $587.32 $587.32 2025-11-12
72131 CPT CT L Spine 7 7 $1,452.00 $1,452.00 $546.53 $1,414.25 $574.99 2025-11-12
80055 CPT Prenatal Lab Charges 8 8 $579.00 $579.00 $266.07 $567.42 $557.00 2025-11-12
93975 CPT US Renal Artery 1 1 $562.00 $562.00 $550.76 $550.76 $550.76 2025-11-12
76942 CPT US Guidance For Needle Placement 4 4 $390.00 $390.00 $156.25 $572.32 $534.36 2025-11-12
1000005 CDM New Born Care 7 7 $558.00 $558.00 $489.37 $1,093.68 $530.10 2025-11-12
70480 CPT CT Temporal Bones 3 3 $1,057.00 $1,057.00 $377.10 $780.80 $528.50 2025-11-12
76856 CPT US Pelvic 12 12 $569.00 $569.00 $297.81 $569.00 $526.33 2025-11-12
72192 CPT CT Pelvis Without 4 4 $1,351.00 $1,351.00 $508.52 $1,330.98 $522.80 2025-11-12
52234 CPT Cysto W/removal Of Tumors Small 1 1 $1,168.00 $1,168.00 $518.12 $518.12 $518.12 2025-11-12
52287 CPT Cystourethroscopy, With Injection(s) For Chemodenervation Of The Bladder 3 3 $918.00 $918.00 $287.95 $759.60 $516.80 2025-11-12
87522 CPT Hepatitis C Quantitative RNA By Pcr 1 1 $531.00 $531.00 $515.55 $515.55 $515.55 2025-11-12
46083 CPT Incision Thrombosed Hemorrhoid External 3 3 $559.00 $559.00 $511.56 $513.65 $511.56 2025-11-12
74150 CPT CT Abd Without 3 3 $1,330.00 $1,330.00 $410.47 $780.80 $501.17 2025-11-12
76801 CPT US OB Limited 11 11 $426.00 $426.00 $443.76 $506.00 $492.84 2025-11-12
25600 CPT Treat Fracture Radius/unla 3 3 $552.00 $552.00 $465.30 $506.66 $491.15 2025-11-12
97597 CPT Pt Wound Care Selecive <20cm 1 1 $498.00 $498.00 $488.04 $488.04 $488.04 2025-11-12
92523 CPT St Eval Of Speech Sound Production 9 9 $496.00 $496.00 $186.69 $486.08 $486.08 2025-11-12
76705 CPT US Abd Limited One Organ 15 15 $550.00 $550.00 $207.12 $535.70 $482.35 2025-11-12
12001 CPT Simple Repair Scalp/neck/ax/genit/trunk 2.5cm/< 1 1 $498.00 $498.00 $482.06 $482.06 $482.06 2025-11-12
59200 CPT Insertion Cervical Dilator Separate Procedure 1 1 $655.00 $655.00 $478.84 $478.84 $478.84 2025-11-12
76805 CPT US OB Complete 10 10 $497.00 $497.00 $435.87 $484.08 $478.12 2025-11-12
20600 CPT Arthrocentesis, Aspiration And/or Injection, Small Joint Or Bursa 1 1 $648.00 $648.00 $475.20 $475.20 $475.20 2025-11-12
73700 CPT CT Lower Extremity Wo 2 2 $863.00 $863.00 $460.34 $484.31 $472.32 2025-11-12
73701 CPT CT Lower Extremity W 2 2 $1,221.00 $1,221.00 $459.58 $483.52 $471.55 2025-11-12
87536 CPT HIV 1 By Quantitative Pcr 1 1 $478.00 $478.00 $465.57 $465.57 $465.57 2025-11-12
76870 CPT US Testicle 5 5 $528.00 $528.00 $446.81 $514.27 $461.19 2025-11-12
76700 CPT US Abdomen Complete 13 13 $649.00 $649.00 $245.64 $649.00 $461.19 2025-11-12
C1780 HCPCS Intraocular Lens 10 9 $2,262.80 $2,262.80 $201.75 $5,285.14 $458.84 2025-11-12
Q5108 HCPCS Fulphila 6 Mg/0.6 Ml Syringe 1 1 $2,755.50 $2,755.50 $457.36 $457.36 $457.36 2025-11-12
93225 CPT Holter Monitor - External ECG & 48 Hr Recording 7 7 $313.00 $313.00 $304.86 $2,391.20 $456.95 2025-11-12
27096 CPT Injection Si Joint With Imagine Guidance 10 10 $537.00 $537.00 $202.16 $526.26 $456.35 2025-11-12
76536 CPT US Neck/thyroid 14 14 $532.00 $532.00 $200.43 $518.17 $454.00 2025-11-12
76000 CPT Xr Time In Surgery Up To 1 Hr. 17 17 $645.00 $645.00 $242.78 $5,812.17 $452.57 2025-11-12
73200 CPT CT Upper Extremity Without 6 6 $1,134.00 $1,134.00 $410.47 $1,104.52 $449.06 2025-11-12
76770 CPT US Retro-peritoneal, Renal 8 8 $562.00 $562.00 $211.54 $533.90 $446.81 2025-11-12
L8699 HCPCS Graft Link Acl Flg 2 2 $5,424.00 $5,424.00 $445.28 $445.28 $445.28 2025-11-12
24600 CPT Dislocated Elbow Adult 2 2 $535.00 $535.00 $434.40 $434.40 $434.40 2025-11-12
94660 CPT Cpap/bipap Per Day 1 1 $805.00 $805.00 $421.34 $421.34 $421.34 2025-11-12
93226 CPT Holter Monitor - External ECG Scanning Analysis Report 7 7 $286.00 $286.00 $278.57 $2,837.10 $418.00 2025-11-12
29580 CPT Pt Unna Boot 1 1 $416.00 $416.00 $407.68 $407.68 $407.68 2025-11-12
76881 CPT US Extremity 5 5 $528.00 $528.00 $264.00 $461.19 $402.13 2025-11-12
93880 CPT US Carotid (bilateral) 4 4 $918.00 $918.00 $345.54 $695.98 $400.36 2025-11-12
64632 CPT Dstrj Neurolytic Plantar Common Digital Nerve 4 4 $490.00 $490.00 $357.82 $399.84 $397.39 2025-11-12
93971 CPT US Lt Venous Unilateral 14 14 $768.00 $768.00 $289.08 $752.64 $393.06 2025-11-12
C1713 HCPCS Ar-7237-7b Fibertape 2mm 8 8 $300.00 $300.00 $75.05 $1,081.10 $393.06 2025-11-12
74300 CPT Xr Cholangiogram 9 9 $745.00 $745.00 $58.75 $730.10 $389.93 2025-11-12
74022 CPT Xr Abd 3 Way 7 7 $438.00 $438.00 $173.45 $429.24 $384.13 2025-11-12
87633 CPT Respiratory Film Array By Pcr 11 11 $468.00 $468.00 $145.24 $390.00 $379.86 2025-11-12
97167 CPT Ot Evaluation High Complexity 1 1 $374.00 $374.00 $374.00 $374.00 $374.00 2025-11-12
29125 CPT Splint Application (short Arm) 8 8 $371.00 $371.00 $171.01 $363.58 $356.90 2025-11-12
77067 CPT Mammo Screening Digital Bilat 24 24 $264.00 $264.00 $79.59 $371.00 $352.45 2025-11-12
94640 CPT Svn/mdi For Airway Obstruction Or Sputum Production 9 9 $356.00 $356.00 $186.33 $487.29 $348.88 2025-11-12
83951 CPT Hepatocellular Carcinoma Tumor Marker Panel 1 1 $325.00 $325.00 $325.00 $325.00 $325.00 2025-11-12
70150 CPT Xr Facial Bones 3 V 1 1 $364.00 $364.00 $324.97 $324.97 $324.97 2025-11-12
77080 CPT Dexa/bone Density 9 9 $371.00 $371.00 $138.16 $361.35 $324.97 2025-11-12
72110 CPT Xr Ls Spine Complete 5v 10 10 $508.00 $508.00 $191.21 $494.79 $318.75 2025-11-12
72050 CPT Xr C Spine Complete 5v 7 7 $374.00 $374.00 $140.77 $366.82 $318.75 2025-11-12
20610 CPT Asperation And/or Injection Of Large Joint Or Joint Capsule Without Ultrasonic G… 14 10 $679.00 $679.00 $148.30 $602.70 $318.01 2025-11-12
71110 CPT Xr Ribs Biilat With Out Cxr 1 1 $317.00 $317.00 $317.00 $317.00 $317.00 2025-11-12
77002 CPT Fluoroscopic Guidance For Needle Placement 6 6 $388.00 $388.00 $146.37 $377.91 $315.16 2025-11-12
73521 CPT Xr Hips Bilateral 2v 6 6 $558.00 $558.00 $292.06 $502.20 $314.07 2025-11-12
96125 CPT St Cognitive Test By Hc Pro 2 2 $537.00 $537.00 $74.07 $537.00 $305.53 2025-11-12
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