Hospital

THOREK MEMORIAL HOSPITAL

Chicago, IL · CCN 140115 · Rates published

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You selected 93306 (CPT)

Tte W/Doppler Complete

This hospital’s price: $532 across 3 payers · range $495-$532

Source: https://3003156.fs1.hubspotusercontent-na1.net/hubfs/3003156/files/366000085_Thorek-Memorial-Hospital_standardcharges.csv · observed 2026-05-21

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.

1,007 distinct procedures filed

10 distinct payers

23,060 rate rows

2026-05-21 last MRF observed

Data quality

16,682 of 23,060 rate rows are consumer-grade (72.3%)

6,378 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 — reason	Rows
exceeds 10× this hospital's gross charge — excluded from medians	6,304
per-diem day rate — not a per-procedure price	58
placeholder amount (≤ $0.02) — excluded from medians	16

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://3003156.fs1.hubspotusercontent-na1.net/hubfs/3003156/files/366000085_Thorek-Memorial-Hospital_standardcharges.csv
Found on page	https://www.thorek.org/patients-and-visitors/patient-financial-services/price-transparency
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-21
Content fingerprint	219db93c5f826cb6… · 579,104 bytes · first seen 2026-05-06

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
250 OTHER	Cochlear Device Implantation	6	$38,539.37	$38,539.37	$38,539.37	nat. median $47 outlier · 815.6×
97 OTHER	Aicd Implant	6	$32,655.22	$32,655.22	$32,655.22	nat. median $36,789 0.9× median
224 OTHER	Level IV Nerve Procedures	6	$31,889.37	$31,889.37	$31,889.37	nat. median $37,501 0.9× median
465 OTHER	Class Xiii Combined Chemotherapy And Pharmacotherapy	6	$26,721.23	$26,721.23	$26,721.23	nat. median $17,981 1.5× median
907 OTHER	Other O.r. Procedures For Injuries With Mcc	4	$22,061.88	$24,513.18	$24,513.18	nat. median $7,366 outlier · 3.3×
223 OTHER	Level Iii Nerve Procedures	6	$17,616.87	$17,616.87	$17,616.87	nat. median $32,911 0.5× median
82 OTHER	Traumatic Stupor And Coma >1 Hour With Mcc	6	$16,954.21	$16,954.21	$16,954.21	nat. median $24,132 0.7× median
52 OTHER	Spinal Disorders And Injuries With Cc/mcc	5	$11,533.63	$26,250.75	$15,240.02	nat. median $21,581 0.7× median
101 OTHER	Seizures Without Mcc	9	$5,395.21	$15,190.97	$15,190.97	nat. median $7,318 outlier · 2.1×
336 OTHER	Peritoneal Adhesiolysis With Cc	4	$12,487.40	$13,874.87	$13,874.87	nat. median $20,264 0.7× median
47 OTHER	Level Ii Arthroplasty	6	$12,354.55	$12,354.55	$12,354.55	nat. median $2,892 outlier · 4.3×
27447 CPT	Total Knee Arthroplasty	5	$2,834.00	$17,719.00	$12,254.12	nat. median $12,734 1.0× median
99 OTHER	Coronary Angioplasty And Related Procedures	6	$12,168.39	$12,168.39	$12,168.39	nat. median $14,518 0.8× median
186 OTHER	Pleural Effusion With Mcc	5	$9,206.14	$16,762.68	$11,795.96	nat. median $14,293 0.8× median
915 OTHER	Allergic Reactions With Mcc	5	$10,522.32	$15,167.70	$11,691.46	nat. median $176 outlier · 66.4×
922 OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc	4	$10,349.72	$13,261.24	$11,499.68	nat. median $711 outlier · 16.2×
58 OTHER	Multiple Sclerosis And Cerebellar Ataxia With Mcc	5	$10,248.88	$14,773.55	$11,387.64	nat. median $18,842 0.6× median
86 OTHER	Pacemaker And Other Cardiovascular Device Insertion And Replacement	6	$11,384.22	$11,384.22	$11,384.22	nat. median $13,958 0.8× median
334 OTHER	Rectal Resection Without Cc/mcc	5	$9,520.51	$13,723.61	$10,578.33	nat. median $15,741 0.7× median
435 OTHER	Malignancy Of Hepatobiliary System Or Pancreas With Mcc	1	$10,438.69	$10,438.69	$10,438.69	nat. median $15,414 0.7× median
580 OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Cc	1	$10,359.80	$10,359.80	$10,359.80	nat. median $14,324 0.7× median
464 OTHER	Class Xii Combined Chemotherapy And Pharmacotherapy	6	$9,994.44	$9,994.44	$9,994.44	nat. median $23,801 outlier · 0.4×
349 OTHER	Anal And Stomal Procedures Without Cc/mcc	10	$5,787.87	$21,985.95	$9,904.37	nat. median $9,099 1.1× median
148 OTHER	Level IV Laparoscopy	6	$9,558.95	$9,558.95	$9,558.95	nat. median $7,253 1.3× median
175 OTHER	Pulmonary Embolism With Mcc Or Acute Cor Pulmonale	4	$8,321.77	$9,246.40	$9,246.40	nat. median $13,641 0.7× median
308 OTHER	Cardiac Arrhythmia And Conduction Disorders With Mcc	5	$7,130.74	$12,983.76	$9,136.72	nat. median $11,364 0.8× median
388 OTHER	Gastrointestinal Obstruction With Mcc	1	$8,621.30	$8,621.30	$8,621.30	nat. median $13,872 0.6× median
502 OTHER	Soft Tissue Procedures Without Cc/mcc	2	$8,201.36	$8,839.23	$8,520.30	nat. median $11,808 0.7× median
355 OTHER	Hernia Procedures Except Inguinal And Femoral Without Cc/mcc	10	$624.37	$12,944.70	$8,396.43	nat. median $13,217 0.6× median
416 OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc	10	$325.11	$12,722.40	$8,252.24	nat. median $13,471 0.6× median
87 OTHER	Traumatic Stupor And Coma <1 Hour Without Cc/mcc	6	$8,239.69	$8,239.69	$8,239.69	nat. median $9,657 0.9× median
989 OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc	5	$6,407.70	$11,667.24	$8,210.28	nat. median $571 outlier · 14.4×
189 OTHER	Pulmonary Edema And Respiratory Failure	5	$7,307.50	$10,348.80	$8,119.43	nat. median $11,897 0.7× median
182 OTHER	Respiratory Neoplasms Without Cc/mcc	10	$4,738.01	$17,164.99	$8,107.82	nat. median $8,184 1.0× median
489 OTHER	Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc	10	$168.99	$13,367.16	$7,912.28	nat. median $11,765 0.7× median
697 OTHER	Urethral Stricture	5	$6,602.25	$10,574.45	$7,897.69	nat. median $9,833 0.8× median
187 OTHER	Pleural Effusion With Cc	5	$5,909.46	$13,450.05	$7,808.50	nat. median $9,590 0.8× median
689 OTHER	Kidney And Urinary Tract Infections With Mcc	4	$6,965.85	$7,739.82	$7,739.82	nat. median $11,051 0.7× median
947 OTHER	Signs And Symptoms With Mcc	2	$7,423.75	$8,001.14	$7,712.44	nat. median $8,014 1.0× median
923 OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc	5	$5,999.03	$10,923.12	$7,686.64	nat. median $8,707 0.9× median
216 OTHER	Level Ii Revision Or Removal Of Neurological Device	6	$7,552.16	$7,552.16	$7,552.16	nat. median $73,813 outlier · 0.1×
819 OTHER	Other Antepartum Diagnoses With O.r. Procedures Without Cc/mcc	1	$6,894.72	$8,618.40	$7,541.10	nat. median $1,081 outlier · 7.0×
96 OTHER	Atrial And Ventricular Recording And Pacing	6	$7,390.62	$7,390.62	$7,390.62	nat. median $24,509 outlier · 0.3×
22 OTHER	Level Iii Breast Procedures	6	$7,354.79	$7,354.79	$7,354.79	nat. median $38,052 outlier · 0.2×
812 OTHER	Red Blood Cell Disorders Without Mcc	1	$6,845.32	$7,700.99	$7,273.15	nat. median $361 outlier · 20.2×
743 OTHER	Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc	10	$180.21	$11,039.00	$7,160.33	nat. median $1 outlier · 6629.9×
572 OTHER	Skin Debridement Without Cc/mcc	10	$252.04	$10,826.20	$7,022.30	nat. median $11,213 0.6× median
85 OTHER	Level Ii Peripheral Vascular And Transcatheter Procedures	6	$7,002.87	$7,002.87	$7,002.87	nat. median $23,687 outlier · 0.3×
79 OTHER	Level I Peripheral Vascular And Transcatheter Procedures	6	$7,002.87	$7,002.87	$7,002.87	nat. median $7,407 0.9× median
218 OTHER	Level Ii Nerve Procedures	6	$6,938.75	$6,938.75	$6,938.75	nat. median $48,723 outlier · 0.1×

Other procedures at this hospital

Browse this hospital's 1,007 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

250	OTHER	Cochlear Device Implantation	20	6	—	—	$38,539.37	$38,539.37	$38,539.37	2026-05-21
97	OTHER	Aicd Implant	20	6	—	—	$32,655.22	$32,655.22	$32,655.22	2026-05-21
224	OTHER	Level IV Nerve Procedures	20	6	—	—	$31,889.37	$31,889.37	$31,889.37	2026-05-21
465	OTHER	Class Xiii Combined Chemotherapy And Pharmacotherapy	20	6	—	—	$26,721.23	$26,721.23	$26,721.23	2026-05-21
907	OTHER	Other O.r. Procedures For Injuries With Mcc	12	4	$2,473.00	—	$22,061.88	$24,513.18	$24,513.18	2026-05-21
223	OTHER	Level Iii Nerve Procedures	20	6	—	—	$17,616.87	$17,616.87	$17,616.87	2026-05-21
82	OTHER	Traumatic Stupor And Coma >1 Hour With Mcc	20	6	—	—	$16,954.21	$16,954.21	$16,954.21	2026-05-21
52	OTHER	Spinal Disorders And Injuries With Cc/mcc	28	5	—	—	$11,533.63	$26,250.75	$15,240.02	2026-05-21
101	OTHER	Seizures Without Mcc	34	9	$724.26	—	$5,395.21	$15,190.97	$15,190.97	2026-05-21
336	OTHER	Peritoneal Adhesiolysis With Cc	12	4	$1,516.24	—	$12,487.40	$13,874.87	$13,874.87	2026-05-21
47	OTHER	Level Ii Arthroplasty	20	6	—	—	$12,354.55	$12,354.55	$12,354.55	2026-05-21
27447	CPT	Total Knee Arthroplasty	16	5	$4,360.00	$4,360.00	$2,834.00	$17,719.00	$12,254.12	2026-05-21
99	OTHER	Coronary Angioplasty And Related Procedures	20	6	—	—	$12,168.39	$12,168.39	$12,168.39	2026-05-21
186	OTHER	Pleural Effusion With Mcc	26	5	$1,826.00	—	$9,206.14	$16,762.68	$11,795.96	2026-05-21
915	OTHER	Allergic Reactions With Mcc	20	5	$1,521.00	—	$10,522.32	$15,167.70	$11,691.46	2026-05-21
922	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc	14	4	$1,365.00	—	$10,349.72	$13,261.24	$11,499.68	2026-05-21
58	OTHER	Multiple Sclerosis And Cerebellar Ataxia With Mcc	20	5	$1,577.00	—	$10,248.88	$14,773.55	$11,387.64	2026-05-21
86	OTHER	Pacemaker And Other Cardiovascular Device Insertion And Replacement	20	6	—	—	$11,384.22	$11,384.22	$11,384.22	2026-05-21
334	OTHER	Rectal Resection Without Cc/mcc	20	5	$1,375.00	—	$9,520.51	$13,723.61	$10,578.33	2026-05-21
435	OTHER	Malignancy Of Hepatobiliary System Or Pancreas With Mcc	2	1	$1,078.39	—	$10,438.69	$10,438.69	$10,438.69	2026-05-21
580	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Cc	2	1	$1,062.00	—	$10,359.80	$10,359.80	$10,359.80	2026-05-21
464	OTHER	Class Xii Combined Chemotherapy And Pharmacotherapy	20	6	—	—	$9,994.44	$9,994.44	$9,994.44	2026-05-21
349	OTHER	Anal And Stomal Procedures Without Cc/mcc	48	10	$1,485.67	—	$5,787.87	$21,985.95	$9,904.37	2026-05-21
148	OTHER	Level IV Laparoscopy	20	6	—	—	$9,558.95	$9,558.95	$9,558.95	2026-05-21
175	OTHER	Pulmonary Embolism With Mcc Or Acute Cor Pulmonale	12	4	$932.00	—	$8,321.77	$9,246.40	$9,246.40	2026-05-21
308	OTHER	Cardiac Arrhythmia And Conduction Disorders With Mcc	26	5	$1,367.00	—	$7,130.74	$12,983.76	$9,136.72	2026-05-21
388	OTHER	Gastrointestinal Obstruction With Mcc	2	1	$893.00	—	$8,621.30	$8,621.30	$8,621.30	2026-05-21
502	OTHER	Soft Tissue Procedures Without Cc/mcc	4	2	$887.00	—	$8,201.36	$8,839.23	$8,520.30	2026-05-21
355	OTHER	Hernia Procedures Except Inguinal And Femoral Without Cc/mcc	44	10	$1,363.13	—	$624.37	$12,944.70	$8,396.43	2026-05-21
416	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc	44	10	$1,375.00	—	$325.11	$12,722.40	$8,252.24	2026-05-21
87	OTHER	Traumatic Stupor And Coma <1 Hour Without Cc/mcc	20	6	—	—	$8,239.69	$8,239.69	$8,239.69	2026-05-21
989	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc	26	5	$1,400.00	—	$6,407.70	$11,667.24	$8,210.28	2026-05-21
189	OTHER	Pulmonary Edema And Respiratory Failure	18	5	$1,047.00	—	$7,307.50	$10,348.80	$8,119.43	2026-05-21
182	OTHER	Respiratory Neoplasms Without Cc/mcc	48	10	$1,282.00	—	$4,738.01	$17,164.99	$8,107.82	2026-05-21
489	OTHER	Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc	46	10	$1,369.00	—	$168.99	$13,367.16	$7,912.28	2026-05-21
697	OTHER	Urethral Stricture	24	5	$1,104.50	—	$6,602.25	$10,574.45	$7,897.69	2026-05-21
187	OTHER	Pleural Effusion With Cc	28	5	$1,658.26	—	$5,909.46	$13,450.05	$7,808.50	2026-05-21
689	OTHER	Kidney And Urinary Tract Infections With Mcc	12	4	$776.00	—	$6,965.85	$7,739.82	$7,739.82	2026-05-21
947	OTHER	Signs And Symptoms With Mcc	4	2	$815.00	—	$7,423.75	$8,001.14	$7,712.44	2026-05-21
923	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc	26	5	$1,124.00	—	$5,999.03	$10,923.12	$7,686.64	2026-05-21
216	OTHER	Level Ii Revision Or Removal Of Neurological Device	20	6	—	—	$7,552.16	$7,552.16	$7,552.16	2026-05-21
819	OTHER	Other Antepartum Diagnoses With O.r. Procedures Without Cc/mcc	8	1	$893.00	—	$6,894.72	$8,618.40	$7,541.10	2026-05-21
96	OTHER	Atrial And Ventricular Recording And Pacing	20	6	—	—	$7,390.62	$7,390.62	$7,390.62	2026-05-21
22	OTHER	Level Iii Breast Procedures	20	6	—	—	$7,354.79	$7,354.79	$7,354.79	2026-05-21
812	OTHER	Red Blood Cell Disorders Without Mcc	6	1	$836.00	—	$6,845.32	$7,700.99	$7,273.15	2026-05-21
743	OTHER	Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc	44	10	$1,185.00	—	$180.21	$11,039.00	$7,160.33	2026-05-21
572	OTHER	Skin Debridement Without Cc/mcc	44	10	$1,193.00	—	$252.04	$10,826.20	$7,022.30	2026-05-21
79	OTHER	Level I Peripheral Vascular And Transcatheter Procedures	20	6	—	—	$7,002.87	$7,002.87	$7,002.87	2026-05-21
85	OTHER	Level Ii Peripheral Vascular And Transcatheter Procedures	20	6	—	—	$7,002.87	$7,002.87	$7,002.87	2026-05-21
218	OTHER	Level Ii Nerve Procedures	20	6	—	—	$6,938.75	$6,938.75	$6,938.75	2026-05-21
38	OTHER	Level Ii Arthroscopy	20	6	—	—	$6,933.40	$6,933.40	$6,933.40	2026-05-21
920	OTHER	Complications Of Treatment With Cc	16	4	$850.00	—	$6,131.89	$8,347.94	$6,813.21	2026-05-21
167	OTHER	Level Ii Urethra And Prostate Procedures	20	6	—	—	$6,736.03	$6,736.03	$6,736.03	2026-05-21
699	OTHER	Other Kidney And Urinary Tract Diagnoses With Cc	14	4	$816.27	—	$6,054.78	$7,758.08	$6,727.53	2026-05-21
445	OTHER	Disorders Of The Biliary Tract With Cc	4	2	$704.00	—	$6,446.26	$6,947.62	$6,696.94	2026-05-21
600	OTHER	Non-malignant Breast Disorders With Cc/mcc	46	10	$1,185.00	—	$160.32	$11,075.40	$6,555.74	2026-05-21
147	OTHER	Level Iii Laparoscopy	20	6	—	—	$6,547.23	$6,547.23	$6,547.23	2026-05-21
144	OTHER	Level Ii Gastrointestinal Procedures	20	6	—	—	$6,450.34	$6,450.34	$6,450.34	2026-05-21
346	OTHER	Radiosurgery	20	6	—	—	$6,434.14	$6,434.14	$6,434.14	2026-05-21
55	OTHER	Nervous System Neoplasms Without Mcc	2	1	$647.00	—	$6,365.59	$6,365.59	$6,365.59	2026-05-21
43	OTHER	Open Or Percutaneous Treatment Of Fractures	20	6	—	—	$6,343.02	$6,343.02	$6,343.02	2026-05-21
221	OTHER	Laminotomy And Laminectomy	20	6	—	—	$6,286.17	$6,286.17	$6,286.17	2026-05-21
463	OTHER	Class Xi Combined Chemotherapy And Pharmacotherapy	20	6	—	—	$6,274.78	$6,274.78	$6,274.78	2026-05-21
442	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc	12	4	$650.50	—	$5,643.74	$6,270.81	$6,270.81	2026-05-21
864	OTHER	Fever And Inflammatory Conditions	24	5	$909.01	—	$5,236.25	$8,386.60	$6,263.66	2026-05-21
36	OTHER	Level Ii Foot Procedures	20	6	—	—	$6,210.83	$6,210.83	$6,210.83	2026-05-21
687	OTHER	Kidney And Urinary Tract Neoplasms With Cc	2	1	$644.50	—	$6,200.10	$6,200.10	$6,200.10	2026-05-21
158	OTHER	Dental And Oral Diseases With Cc	20	5	$815.00	—	$5,566.63	$8,024.18	$6,185.14	2026-05-21
197	OTHER	Interstitial Lung Disease With Cc	44	10	$1,035.00	—	$3,966.01	$9,476.25	$6,146.66	2026-05-21
714	OTHER	Transurethral Prostatectomy Without Cc/mcc	46	10	$1,261.67	—	$178.10	$10,351.80	$6,127.43	2026-05-21
74	OTHER	Cranial And Peripheral Nerve Disorders Without Mcc	2	1	$612.00	—	$6,086.81	$6,086.81	$6,086.81	2026-05-21
728	OTHER	Inflammation Of The Male Reproductive System Without Mcc	26	5	$973.00	—	$4,745.72	$8,641.08	$6,080.76	2026-05-21
866	OTHER	Viral Illness Without Mcc	14	4	$698.00	—	$5,443.25	$6,974.52	$6,048.06	2026-05-21
81	OTHER	Nontraumatic Stupor And Coma Without Mcc	48	10	$1,994.00	—	$686.57	$12,278.25	$5,904.10	2026-05-21
32	OTHER	Level Iii Musculoskeletal Procedures Excluding Hand And Foot	20	6	—	—	$5,808.80	$5,808.80	$5,808.80	2026-05-21
153	OTHER	Otitis Media And Uri Without Mcc	28	5	$1,372.50	—	$4,358.40	$9,919.80	$5,758.99	2026-05-21
918	OTHER	Poisoning And Toxic Effects Of Drugs Without Mcc	12	4	$582.00	—	$5,106.35	$5,673.72	$5,673.72	2026-05-21
188	OTHER	Pleural Effusion Without Cc/mcc	26	5	$1,002.00	—	$4,427.80	$8,062.20	$5,673.40	2026-05-21
389	OTHER	Gastrointestinal Obstruction With Cc	24	5	$776.00	—	$4,723.77	$7,565.80	$5,650.64	2026-05-21
89	OTHER	Level Ii Cardiothoracic Procedures W Or Without Vascular Device	20	6	—	—	$5,634.20	$5,634.20	$5,634.20	2026-05-21
198	OTHER	Level Iii Female Reproductive Procedures	20	6	—	—	$5,582.78	$5,582.78	$5,582.78	2026-05-21
215	OTHER	Level I Revision Or Removal Of Neurological Device	20	6	—	—	$5,575.16	$5,575.16	$5,575.16	2026-05-21
255	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	20	6	—	—	$5,562.72	$5,562.72	$5,562.72	2026-05-21
204	OTHER	Respiratory Signs And Symptoms	20	5	$744.00	—	$4,880.96	$7,035.80	$5,423.28	2026-05-21
206	OTHER	Other Respiratory System Diagnoses Without Mcc	2	1	$582.00	—	$5,418.34	$5,418.34	$5,418.34	2026-05-21
700	OTHER	Other Kidney And Urinary Tract Diagnoses Without Cc/mcc	26	5	$875.50	—	$4,201.22	$7,649.64	$5,383.08	2026-05-21
176	OTHER	Pulmonary Embolism Without Mcc	16	4	$663.00	—	$4,837.66	$6,585.97	$5,375.17	2026-05-21
47562	CPT	Laparoscopic Cholecystectomy	16	5	$2,616.00	$2,616.00	$1,700.40	$5,567.19	$5,372.34	2026-05-21
58661	CPT	Laparoscopy Remove Adnexa	16	5	$2,616.00	$2,616.00	$1,104.00	$5,567.19	$5,372.34	2026-05-21
44970	CPT	Laparoscopy Appendectomy	16	5	$1,744.00	$1,744.00	$970.00	$5,567.19	$5,372.34	2026-05-21
446	OTHER	Disorders Of The Biliary Tract Without Cc/mcc	12	4	$532.00	—	$4,754.03	$5,282.25	$5,282.25	2026-05-21
292	OTHER	Heart Failure And Shock With Cc	44	10	$873.00	—	$587.57	$8,136.75	$5,277.81	2026-05-21
125	OTHER	Other Disorders Of The Eye Without Mcc	16	4	$651.11	—	$4,730.30	$6,439.81	$5,255.88	2026-05-21
146	OTHER	Level Ii Laparoscopy	20	6	—	—	$5,221.58	$5,221.58	$5,221.58	2026-05-21
558	OTHER	Tendonitis, Myositis And Bursitis Without Mcc	2	1	$532.00	—	$5,210.15	$5,210.15	$5,210.15	2026-05-21
641	OTHER	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	14	4	$604.00	—	$4,634.80	$5,938.64	$5,149.78	2026-05-21
156	OTHER	Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc	28	5	$1,655.51	—	$3,888.04	$8,849.25	$5,137.48	2026-05-21
165	OTHER	Level Iii Bladder And Kidney Procedures	20	6	—	—	$5,137.04	$5,137.04	$5,137.04	2026-05-21
482	OTHER	Hip And Femur Procedures Except Major Joint Without Cc/mcc	20	6	—	—	$5,070.28	$5,070.28	$5,070.28	2026-05-21
194	OTHER	Simple Pneumonia And Pleurisy With Cc	44	10	$815.00	—	$2,441.14	$7,810.90	$5,066.45	2026-05-21
544	OTHER	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	14	4	$584.50	—	$4,552.36	$5,833.00	$5,058.17	2026-05-21
645	OTHER	Endocrine Disorders Without Cc/mcc	16	4	$636.00	—	$4,513.21	$6,144.27	$5,014.67	2026-05-21
690	OTHER	Kidney And Urinary Tract Infections Without Mcc	44	10	$814.00	—	$187.65	$7,665.55	$4,972.17	2026-05-21
305	OTHER	Hypertension Without Mcc	12	4	$529.00	—	$4,469.32	$4,965.90	$4,965.90	2026-05-21
921	OTHER	Complications Of Treatment Without Cc/mcc	24	5	$686.50	—	$4,138.94	$6,629.10	$4,951.05	2026-05-21
309	OTHER	Cardiac Arrhythmia And Conduction Disorders With Cc	14	4	$582.00	—	$4,417.12	$5,659.72	$4,907.91	2026-05-21
694	OTHER	Urinary Stones Without Mcc	44	10	$815.00	—	$306.01	$7,435.65	$4,823.05	2026-05-21
297	OTHER	Cardiac Arrest, Unexplained With Cc	48	10	$1,566.50	—	$549.29	$9,836.10	$4,729.77	2026-05-21
72	OTHER	Nonspecific Cerebrovascular Disorders Without Cc/mcc	2	1	$495.00	—	$4,644.29	$4,644.29	$4,644.29	2026-05-21
203	OTHER	Bronchitis And Asthma Without Cc/mcc	12	4	$517.50	—	$4,121.74	$4,579.70	$4,579.70	2026-05-21
462	OTHER	Class X Combined Chemotherapy And Pharmacotherapy	20	6	—	—	$4,556.48	$4,556.48	$4,556.48	2026-05-21
201	OTHER	Pneumothorax Without Cc/mcc	46	10	$888.25	—	$758.93	$7,625.88	$4,513.91	2026-05-21
311	OTHER	Angina Pectoris	46	10	$815.00	—	$152.35	$7,539.48	$4,462.76	2026-05-21
11	OTHER	Level Iii Excision And Biopsy Of Skin And Soft Tissue	20	6	—	—	$4,449.25	$4,449.25	$4,449.25	2026-05-21
88	OTHER	Level I Cardiothoracic Procedures W Or Without Vascular Device	20	6	—	—	$4,409.65	$4,409.65	$4,409.65	2026-05-21
599	OTHER	Malignant Breast Disorders Without Cc/mcc	48	10	$1,648.26	—	$175.83	$9,082.80	$4,367.54	2026-05-21
238	OTHER	Level Ii Posterior Segment Eye Procedures	20	6	—	—	$4,194.49	$4,194.49	$4,194.49	2026-05-21
63	OTHER	Level Ii Endoscopy Of The Upper Airway	20	6	—	—	$4,156.12	$4,156.12	$4,156.12	2026-05-21
184	OTHER	Destruction Or Resection Of Prostate	20	6	—	—	$4,151.39	$4,151.39	$4,151.39	2026-05-21
145	OTHER	Level I Laparoscopy	20	6	—	—	$4,111.96	$4,111.96	$4,111.96	2026-05-21
31	OTHER	Level Ii Musculoskeletal Procedures Excluding Hand And Foot	20	6	—	—	$4,071.93	$4,071.93	$4,071.93	2026-05-21
379	OTHER	Gastrointestinal Hemorrhage Without Cc/mcc	46	10	$738.59	—	$484.02	$6,838.56	$4,047.88	2026-05-21
348	OTHER	Anal And Stomal Procedures With Cc	20	6	—	—	$4,039.60	$4,039.60	$4,039.60	2026-05-21
195	OTHER	Simple Pneumonia And Pleurisy Without Cc/mcc	46	10	$683.50	—	$2,668.30	$6,756.48	$3,999.29	2026-05-21
21	OTHER	Level Ii Breast Procedures	20	6	—	—	$3,993.78	$3,993.78	$3,993.78	2026-05-21
45	OTHER	Bunion Procedures	20	6	—	—	$3,985.20	$3,985.20	$3,985.20	2026-05-21
140	OTHER	Level Ii Hernia Repair	20	6	—	—	$3,967.24	$3,967.24	$3,967.24	2026-05-21
192	OTHER	Chronic Obstructive Pulmonary Disease Without Cc/mcc	44	10	$636.00	—	$1,196.35	$6,097.10	$3,954.82	2026-05-21
951	OTHER	Other Factors Influencing Health Status	12	4	$395.00	—	$3,499.53	$3,888.37	$3,888.37	2026-05-21
236	OTHER	Level Iii Anterior Segment Eye Procedures	20	6	—	—	$3,879.63	$3,879.63	$3,879.63	2026-05-21
440	OTHER	Disorders Of Pancreas Except Malignancy Without Cc/mcc	44	10	$648.00	—	$953.24	$5,848.20	$3,793.37	2026-05-21
280	OTHER	Acute Myocardial Infarction, Discharged Alive With Mcc	20	6	—	—	$3,786.77	$3,786.77	$3,786.77	2026-05-21
894	OTHER	Alcohol, Drug Abuse Or Dependence, Left Ama	14	5	$496.50	—	$3,407.60	$4,825.80	$3,786.21	2026-05-21
254	OTHER	Level Iii Facial And ENT Procedures	20	6	—	—	$3,773.89	$3,773.89	$3,773.89	2026-05-21
114	OTHER	Level Ii Blood And Blood Product Exchange	20	6	—	—	$3,659.65	$3,659.65	$3,659.65	2026-05-21
378	OTHER	Gastrointestinal Hemorrhage With Cc	40	10	$850.00	—	$1,479.67	$8,411.49	$3,657.49	2026-05-21
160	OTHER	Extracorporeal Shock Wave Lithotripsy	20	6	—	—	$3,644.41	$3,644.41	$3,644.41	2026-05-21
390	OTHER	Gastrointestinal Obstruction Without Cc/mcc	46	10	$607.41	—	$45.56	$6,037.20	$3,573.54	2026-05-21
46	OTHER	Level I Arthroplasty	20	6	—	—	$3,500.56	$3,500.56	$3,500.56	2026-05-21
369	OTHER	Major Esophageal Disorders With Cc	40	10	$850.00	—	$1,119.78	$8,449.97	$3,490.90	2026-05-21
485	OTHER	Corneal Tissue Processing	20	6	—	—	$3,451.76	$3,451.76	$3,451.76	2026-05-21
84	OTHER	Diagnostic Cardiac Catheterization	20	6	—	—	$3,447.82	$3,447.82	$3,447.82	2026-05-21
115	OTHER	Deep Lymph Structure And Thyroid Procedures	20	6	—	—	$3,424.96	$3,424.96	$3,424.96	2026-05-21
91	OTHER	Other Disorders Of Nervous System With Mcc	20	6	—	—	$3,413.48	$3,413.48	$3,413.48	2026-05-21
183	OTHER	Other Penile Procedures	20	6	—	—	$3,385.53	$3,385.53	$3,385.53	2026-05-21
139	OTHER	Level I Hernia Repair	20	6	—	—	$3,301.87	$3,301.87	$3,301.87	2026-05-21
164	OTHER	Level Ii Bladder And Kidney Procedures	20	6	—	—	$3,267.44	$3,267.44	$3,267.44	2026-05-21
138	OTHER	Ercp And Miscellaneous Gi Endoscopy Procedures	20	6	—	—	$3,232.92	$3,232.92	$3,232.92	2026-05-21
19083	CPT	Bx Breast 1St Lesion US Imag	2	1	$4,914.00	$4,914.00	$3,194.10	$3,194.10	$3,194.10	2026-05-21
253	OTHER	Level Ii Facial And ENT Procedures	20	6	—	—	$3,184.65	$3,184.65	$3,184.65	2026-05-21
461	OTHER	Class Ix Combined Chemotherapy And Pharmacotherapy	20	6	—	—	$3,068.14	$3,068.14	$3,068.14	2026-05-21
237	OTHER	Level I Posterior Segment Eye Procedures	20	6	—	—	$3,010.14	$3,010.14	$3,010.14	2026-05-21
58558	CPT	Hysteroscopy Biopsy	16	5	$1,832.00	$1,832.00	$785.00	$3,016.48	$3,008.24	2026-05-21
235	OTHER	Level Ii Anterior Segment Eye Procedures	20	6	—	—	$2,972.91	$2,972.91	$2,972.91	2026-05-21
78	OTHER	Level I Vascular Ligation, Repair And Reconstruction	20	6	—	—	$2,915.35	$2,915.35	$2,915.35	2026-05-21
37	OTHER	Level I Arthroscopy	20	6	—	—	$2,905.54	$2,905.54	$2,905.54	2026-05-21
200	OTHER	Pneumothorax With Cc	32	9	$800.00	—	$2,903.09	$7,097.91	$2,903.09	2026-05-21
142	OTHER	Level Ii Anal And Rectal Procedures	20	6	—	—	$2,803.83	$2,803.83	$2,803.83	2026-05-21
439	OTHER	Disorders Of Pancreas Except Malignancy With Cc	40	10	$780.00	—	$474.65	$7,311.96	$2,773.60	2026-05-21
363	OTHER	Level Iii Dental Restoration	20	6	—	—	$2,769.40	$2,769.40	$2,769.40	2026-05-21
46924	CPT	Destruction Anal Lesion(S)	16	5	$916.00	$916.00	$513.00	$3,000.00	$2,709.11	2026-05-21
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	20	6	—	—	$2,695.72	$2,695.72	$2,695.72	2026-05-21
34	OTHER	Level Ii Hand Procedures	20	6	—	—	$2,693.88	$2,693.88	$2,693.88	2026-05-21
35	OTHER	Level I Foot Procedures	20	6	—	—	$2,670.58	$2,670.58	$2,670.58	2026-05-21
342	OTHER	Level I Afterloading Brachytherapy	20	6	—	—	$2,585.95	$2,585.95	$2,585.95	2026-05-21
256	OTHER	Tonsil And Adenoid Procedures	20	6	—	—	$2,550.39	$2,550.39	$2,550.39	2026-05-21
30	OTHER	Level I Musculoskeletal Procedures Excluding Hand And Foot	20	6	—	—	$2,519.11	$2,519.11	$2,519.11	2026-05-21
362	OTHER	Level Ii Dental Restorations	20	6	—	—	$2,517.62	$2,517.62	$2,517.62	2026-05-21
15	OTHER	Level IV Skin Repair	20	6	—	—	$2,480.39	$2,480.39	$2,480.39	2026-05-21
64	OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	20	6	—	—	$2,449.99	$2,449.99	$2,449.99	2026-05-21
180	OTHER	Respiratory Neoplasms With Mcc	32	9	$1,177.50	—	$2,426.51	$11,455.52	$2,426.51	2026-05-21
83	OTHER	Placement Of Transvenous Catheters	20	6	—	—	$2,408.81	$2,408.81	$2,408.81	2026-05-21
143	OTHER	Level I Gastrointestinal Procedures	20	6	—	—	$2,382.45	$2,382.45	$2,382.45	2026-05-21
361	OTHER	Level I Dental Restorations	20	6	—	—	$2,324.45	$2,324.45	$2,324.45	2026-05-21
241	OTHER	Level Ii Repair And Plastic Procedures Of Eye	20	6	—	—	$2,296.94	$2,296.94	$2,296.94	2026-05-21
233	OTHER	Cataract Procedures	20	6	—	—	$2,296.85	$2,296.85	$2,296.85	2026-05-21
14	OTHER	Level Iii Skin Repair	20	6	—	—	$2,241.66	$2,241.66	$2,241.66	2026-05-21
301	OTHER	Peripheral Vascular Disorders Without Cc/mcc	40	10	$621.00	—	$196.50	$6,068.79	$2,203.30	2026-05-21
316	OTHER	Other Circulatory System Diagnoses Without Cc/mcc	40	10	$615.78	—	$209.82	$5,922.59	$2,159.25	2026-05-21
193	OTHER	Simple Pneumonia And Pleurisy With Mcc	34	9	$1,066.00	—	$2,139.78	$10,082.16	$2,139.78	2026-05-21
66	OTHER	Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc	40	10	$626.00	—	$181.43	$5,878.13	$2,129.64	2026-05-21
460	OTHER	Spinal Fusion Except Cervical Without Mcc	20	6	—	—	$2,121.99	$2,121.99	$2,121.99	2026-05-21
181	OTHER	Respiratory Neoplasms With Cc	32	9	$803.00	—	$2,121.29	$7,256.74	$2,121.29	2026-05-21
199	OTHER	Dilation And Curettage	20	6	—	—	$2,082.92	$2,082.92	$2,082.92	2026-05-21
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	20	6	—	—	$2,070.04	$2,070.04	$2,070.04	2026-05-21
444	OTHER	Disorders Of The Biliary Tract With Mcc	20	6	—	—	$2,020.90	$2,020.90	$2,020.90	2026-05-21
141	OTHER	Level I Anal And Rectal Procedures	20	6	—	—	$1,982.52	$1,982.52	$1,982.52	2026-05-21
345	OTHER	Hyperthermic Therapies	20	6	—	—	$1,980.68	$1,980.68	$1,980.68	2026-05-21
55700	CPT	Biopsy Of Prostate	16	5	$872.00	$872.00	$687.00	$2,500.00	$1,965.23	2026-05-21
382	OTHER	Complicated Peptic Ulcer Without Cc/mcc	32	9	$568.00	—	$1,880.20	$4,989.63	$1,880.20	2026-05-21
234	OTHER	Level I Anterior Segment Eye Procedures	20	6	—	—	$1,864.87	$1,864.87	$1,864.87	2026-05-21
196	OTHER	Level I Female Reproductive Procedures	20	6	—	—	$1,825.45	$1,825.45	$1,825.45	2026-05-21
10	OTHER	Level Ii Excision And Biopsy Of Skin And Soft Tissue	20	6	—	—	$1,823.96	$1,823.96	$1,823.96	2026-05-21
252	OTHER	Level I Facial And ENT Procedures	20	6	—	—	$1,811.08	$1,811.08	$1,811.08	2026-05-21
15271	CPT	Skin Sub Graft Trnk/Arm/Leg	16	5	$1,425.00	$1,425.00	$513.00	$2,500.00	$1,759.53	2026-05-21
20	OTHER	Level I Breast Procedures	20	6	—	—	$1,744.50	$1,744.50	$1,744.50	2026-05-21
290	OTHER	PET Scans	20	6	—	—	$1,731.53	$1,731.53	$1,731.53	2026-05-21
381	OTHER	Complicated Peptic Ulcer With Cc	20	6	—	—	$1,709.28	$1,709.28	$1,709.28	2026-05-21
8	OTHER	Level Iii Skin Debridement And Destruction	20	6	—	—	$1,694.48	$1,694.48	$1,694.48	2026-05-21
48	OTHER	Hand And Foot Tenotomy	20	6	—	—	$1,689.92	$1,689.92	$1,689.92	2026-05-21
344	OTHER	Minor Small And Large Bowel Procedures With Mcc	20	6	—	—	$1,646.99	$1,646.99	$1,646.99	2026-05-21
33	OTHER	Level I Hand Procedures	20	6	—	—	$1,640.60	$1,640.60	$1,640.60	2026-05-21
185	OTHER	Prostate Needle And Punch Biopsy	20	6	—	—	$1,634.11	$1,634.11	$1,634.11	2026-05-21
450	OTHER	Observation	20	6	—	—	$1,616.07	$1,616.07	$1,616.07	2026-05-21
11406	CPT	Exc Tr-ext B9+Marg >4.0 Cm	16	5	$1,744.00	$1,744.00	$687.00	$2,500.00	$1,564.31	2026-05-21
163	OTHER	Level I Bladder And Kidney Procedures	20	6	—	—	$1,536.08	$1,536.08	$1,536.08	2026-05-21
135	OTHER	Therapeutic Upper Gi Endoscopy Or Intubation	20	6	—	—	$1,528.81	$1,528.81	$1,528.81	2026-05-21
217	OTHER	Level I Nerve Procedures	20	6	—	—	$1,514.18	$1,514.18	$1,514.18	2026-05-21
49650	CPT	Lap Ing Hernia Repair Init	4	1	$2,290.00	$2,290.00	$1,190.80	$1,786.20	$1,488.50	2026-05-21
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	20	6	—	—	$1,483.17	$1,483.17	$1,483.17	2026-05-21
44	OTHER	Bone Or Joint Manipulation Under Anesthesia	20	6	—	—	$1,436.04	$1,436.04	$1,436.04	2026-05-21
352	OTHER	Inguinal And Femoral Hernia Procedures Without Cc/mcc	20	6	—	—	$1,394.51	$1,394.51	$1,394.51	2026-05-21
78452	CPT	Ht Muscle Image Spect Mult	14	4	$2,616.00	$2,616.00	$1,274.15	$1,592.72	$1,370.06	2026-05-21
168	OTHER	Hemodialysis	20	6	—	—	$1,342.47	$1,342.47	$1,342.47	2026-05-21
77295	CPT	3-d Radiotherapy Plan	10	3	$4,121.00	$4,121.00	$1,243.34	$1,336.92	$1,336.92	2026-05-21
169	OTHER	Peritoneal Dialysis	20	6	—	—	$1,333.45	$1,333.45	$1,333.45	2026-05-21
332	OTHER	Level Iii Diagnostic Nuclear Medicine	20	6	—	—	$1,303.93	$1,303.93	$1,303.93	2026-05-21
443	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C…	34	9	$543.50	—	$1,287.90	$5,431.72	$1,287.90	2026-05-21
73721	CPT	MRI Jnt Of Lwr Extre Without Contrast	4	1	$2,814.00	$2,814.00	$1,250.00	$1,250.00	$1,250.00	2026-05-21
73221	CPT	MRI Joint Upr Extrem Without Contrast	4	1	$2,766.25	$2,766.25	$1,250.00	$1,250.00	$1,250.00	2026-05-21
90	OTHER	Secondary Varicose Veins And Vascular Injection	20	6	—	—	$1,241.99	$1,241.99	$1,241.99	2026-05-21
137	OTHER	Mouth Procedures With Cc/mcc	20	6	—	—	$1,181.63	$1,181.63	$1,181.63	2026-05-21
7	OTHER	Level Ii Skin Debridement And Destruction	20	6	—	—	$1,180.49	$1,180.49	$1,180.49	2026-05-21
343	OTHER	Radiation Treatment Delivery	20	6	—	—	$1,165.86	$1,165.86	$1,165.86	2026-05-21
46930	CPT	Destroy Internal Hemorrhoids	16	5	$2,769.00	$2,769.00	$1,058.89	$1,500.00	$1,138.59	2026-05-21
46505	CPT	Chemodenervation Anal Musc	16	5	$916.00	$916.00	$513.00	$2,500.00	$1,138.59	2026-05-21
45385	CPT	Colonoscopy W/Lesion Removal	18	5	$1,339.00	$1,339.00	$664.95	$2,500.00	$1,138.59	2026-05-21
45381	CPT	Colonoscopy Submucous Njx	18	5	$995.42	$995.42	$607.75	$2,500.00	$1,138.59	2026-05-21
45380	CPT	Colonoscopy And Biopsy	20	5	$2,105.00	$2,105.00	$664.95	$2,500.00	$1,138.59	2026-05-21
310	OTHER	Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc	20	6	—	—	$1,137.13	$1,137.13	$1,137.13	2026-05-21
66984	CPT	Xcapsl Ctrc Rmvl Without Ecp	4	1	$1,744.00	$1,744.00	$1,133.60	$1,133.60	$1,133.60	2026-05-21
220	OTHER	Level Ii Nervous System Injections, Stimulations Or Cranial Tap	20	6	—	—	$1,128.72	$1,128.72	$1,128.72	2026-05-21
133	OTHER	Proctosigmoidoscopy With Excision Or Biopsy	20	6	—	—	$1,126.09	$1,126.09	$1,126.09	2026-05-21
370	OTHER	Major Esophageal Disorders Without Cc/mcc	20	6	—	—	$1,119.78	$1,119.78	$1,119.78	2026-05-21
134	OTHER	Diagnostic Upper Gi Endoscopy Or Intubation	20	6	—	—	$1,107.60	$1,107.60	$1,107.60	2026-05-21
222	OTHER	Sleep Studies	20	6	—	—	$1,085.88	$1,085.88	$1,085.88	2026-05-21
477	OTHER	Level Ii Therapeutic Radiation Treatment Preparation	20	6	—	—	$1,077.47	$1,077.47	$1,077.47	2026-05-21
136	OTHER	Diagnostic Lower Gastrointestinal Endoscopy	20	6	—	—	$1,061.78	$1,061.78	$1,061.78	2026-05-21
67	OTHER	Ventilation Assistance And Management	20	6	—	—	$1,036.38	$1,036.38	$1,036.38	2026-05-21
368	OTHER	Level Ii Oral And Maxillofacial Surgery	20	6	—	—	$1,017.98	$1,017.98	$1,017.98	2026-05-21
66761	CPT	Revision Of Iris	4	1	$1,549.00	$1,549.00	$1,006.85	$1,006.85	$1,006.85	2026-05-21
367	OTHER	Level I Oral And Maxillofacial Surgery	20	6	—	—	$979.08	$979.08	$979.08	2026-05-21
61	OTHER	Needle And Catheter Biopsy, Aspiration, Lavage And Intubation	20	6	—	—	$979.00	$979.00	$979.00	2026-05-21
131	OTHER	Esophageal Dilation Without Endoscopy	20	6	—	—	$978.03	$978.03	$978.03	2026-05-21
65855	CPT	Trabeculoplasty Laser Surg	4	1	$1,487.00	$1,487.00	$966.55	$966.55	$966.55	2026-05-21
149	OTHER	Dysequilibrium	20	6	—	—	$960.42	$960.42	$960.42	2026-05-21
92	OTHER	Other Disorders Of Nervous System With Cc	20	6	—	—	$955.87	$955.87	$955.87	2026-05-21
95	OTHER	Thrombolysis	20	6	—	—	$947.63	$947.63	$947.63	2026-05-21
113	OTHER	Level I Blood And Blood Product Exchange	20	6	—	—	$939.40	$939.40	$939.40	2026-05-21
132	OTHER	Anoscopy With Biopsy And Diagnostic Proctosigmoidoscopy	20	6	—	—	$928.27	$928.27	$928.27	2026-05-21
29820	CPT	Sho Arthrs Srg Prtl Synvct	2	1	$1,410.00	$1,410.00	$916.50	$916.50	$916.50	2026-05-21
9	OTHER	Level I Excision And Biopsy Of Skin And Soft Tissue	20	6	—	—	$911.98	$911.98	$911.98	2026-05-21
45378	CPT	Diagnostic Colonoscopy	20	5	$2,023.00	$2,023.00	$687.00	$2,500.00	$881.83	2026-05-21
49083	CPT	Abd Paracentesis W/Imaging	16	5	$1,543.00	$1,543.00	$513.00	$2,500.00	$874.62	2026-05-21
43239	CPT	Egd Biopsy Single/Multiple	18	5	$1,752.00	$1,752.00	$687.00	$2,500.00	$874.62	2026-05-21
43235	CPT	Withdrawal Of Arterial Blood	18	5	$1,607.00	$1,607.00	$513.00	$2,500.00	$874.62	2026-05-21
93	OTHER	Other Disorders Of Nervous System Without Cc/mcc	22	7	$479.00	—	$862.22	$4,593.28	$862.22	2026-05-21
2	OTHER	Superficial Needle Biopsy And Aspiration	20	6	—	—	$860.82	$860.82	$860.82	2026-05-21
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	20	6	—	—	$858.28	$858.28	$858.28	2026-05-21
284	OTHER	Myelography	20	6	—	—	$857.05	$857.05	$857.05	2026-05-21
481	OTHER	Hip And Femur Procedures Except Major Joint With Cc	20	6	—	—	$856.79	$856.79	$856.79	2026-05-21
130	OTHER	Alimentary Tests And Simple Tube Placement	20	6	—	—	$852.14	$852.14	$852.14	2026-05-21
327	OTHER	Intensive Outpatient Psychiatric Treatment	20	6	—	—	$843.47	$843.47	$843.47	2026-05-21
42	OTHER	Closed Treatment Fx & Dislocation Exc Finger, Toe & Trunk	20	6	—	—	$816.58	$816.58	$816.58	2026-05-21
41	OTHER	Closed Treatment Fx & Dislocation Of Finger, Toe & Trunk	20	6	—	—	$803.52	$803.52	$803.52	2026-05-21
29827	CPT	Sho Arthrs Srg Rt8Tr Cuf Rpr	4	1	$1,223.49	$1,223.49	$718.03	$872.51	$795.27	2026-05-21
29826	CPT	Sho Arthrs Srg Decompression	4	1	$1,223.49	$1,223.49	$718.03	$872.51	$795.27	2026-05-21
232	OTHER	Laser Eye Procedures	20	6	—	—	$774.88	$774.88	$774.88	2026-05-21
270	OTHER	Occupational Therapy	20	6	—	—	$760.77	$760.77	$760.77	2026-05-21
36410	CPT	Non-routine Bl Draw 3/> Yrs	6	1	$1,166.00	$1,166.00	$757.90	$757.90	$757.90	2026-05-21
219	OTHER	Spinal Tap	20	6	—	—	$731.16	$731.16	$731.16	2026-05-21
13	OTHER	Level Ii Skin Repair	20	6	—	—	$701.20	$701.20	$701.20	2026-05-21
73700	CPT	CT Lower Extremity Without Contrast	4	1	$1,614.00	$1,614.00	$700.00	$700.00	$700.00	2026-05-21
73200	CPT	CT Upper Extremity Without Contrast	4	1	$1,422.00	$1,422.00	$700.00	$700.00	$700.00	2026-05-21
347	OTHER	High Energy Neutron Radiation Treatment Delivery	20	6	—	—	$694.37	$694.37	$694.37	2026-05-21
110	OTHER	Pharmacotherapy By Extended Infusion	20	6	—	—	$692.18	$692.18	$692.18	2026-05-21
212	OTHER	Electroconvulsive Therapy	20	6	—	—	$686.04	$686.04	$686.04	2026-05-21
329	OTHER	Major Small And Large Bowel Procedures With Mcc	20	6	—	—	$685.78	$685.78	$685.78	2026-05-21
94	OTHER	Cardiac Rehabilitation	20	6	—	—	$682.01	$682.01	$682.01	2026-05-21
10005	OTHER	Fna Bx W/Us Gdn 1St Les	16	5	$4,011.00	$4,011.00	$513.00	$1,500.00	$678.85	2026-05-21
10009	CPT	Fna Bx W/Ct Gdn 1St Les	16	5	$3,675.00	$3,675.00	$513.00	$1,500.00	$678.85	2026-05-21
90935	CPT	Hemodialysis One Evaluation	10	3	$1,417.00	$1,417.00	$627.04	$674.24	$674.24	2026-05-21
295	OTHER	MRI- Chest	20	6	—	—	$673.95	$673.95	$673.95	2026-05-21
62323	CPT	Njx Interlaminar Lmbr/Sac	16	5	$1,007.00	$1,007.00	$513.00	$1,500.00	$667.24	2026-05-21
62321	CPT	Njx Interlaminar Crv/Thrc	16	5	$1,007.00	$1,007.00	$513.00	$1,500.00	$667.24	2026-05-21
52000	CPT	Cystoscopy	16	5	$872.00	$872.00	$513.00	$1,500.00	$659.10	2026-05-21
455	OTHER	Implanted Tissue Of Any Type	20	6	—	—	$653.89	$653.89	$653.89	2026-05-21
210	OTHER	Extended EEG Studies	20	6	—	—	$648.99	$648.99	$648.99	2026-05-21
283	OTHER	Magnetic Resonance Angiography - Other Sites	20	6	—	—	$633.92	$633.92	$633.92	2026-05-21
214	OTHER	Level I Nervous System Injections, Stimulations Or Cranial Tap	20	6	—	—	$622.35	$622.35	$622.35	2026-05-21
99285	CPT	Emergency Dept Visit Hi Mdm	10	3	$776.00	$776.00	$576.36	$619.74	$619.74	2026-05-21
G0379	HCPCS	Direct Refer Hospital Observ	10	3	—	—	$576.36	$619.74	$619.74	2026-05-21
441	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc	34	9	$1,441.00	—	$607.72	$13,894.32	$607.72	2026-05-21
484	OTHER	Therapeutic Radiology Treatment Planning	20	6	—	—	$605.27	$605.27	$605.27	2026-05-21
94003	CPT	Vent Mgmt Inpat Subq Day	10	3	$801.00	$801.00	$562.31	$604.64	$604.64	2026-05-21
94002	CPT	Vent Mgmt Inpat Init Day	10	3	$1,516.00	$1,516.00	$562.31	$604.64	$604.64	2026-05-21
281	OTHER	Acute Myocardial Infarction, Discharged Alive With Cc	32	9	$679.00	—	$600.19	$6,017.08	$600.19	2026-05-21
331	OTHER	Major Small And Large Bowel Procedures Without Cc/mcc	32	9	$1,225.00	—	$595.55	$11,019.23	$595.55	2026-05-21
29876	CPT	Knee Arthroscopy/Surgery	2	1	$916.00	$916.00	$595.40	$595.40	$595.40	2026-05-21
65820	CPT	Relieve Inner Eye Pressure	4	1	$916.00	$916.00	$595.40	$595.40	$595.40	2026-05-21

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