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 →

Export CSV
Hospital

Carle Richland Memorial Hospital

Olney, IL · CCN 140147 · Rates published

3,242 distinct procedures filed
5 distinct payers
24,751 rate rows
2026-07-17 last MRF observed
Data quality

24,651 of 24,751 rate rows are consumer-grade (99.6%)

100 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
placeholder amount (≤ $0.02) — excluded from medians 100
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://carle.org/getmedia/5c207f8b-d328-4d56-875e-6f132c54b77a/371363001_Carle-Richland-Hospital_standardcharges_2022.csv
Found on page https://carle.org/Patients-Visitors/Transparent-Pricing-and-Estimates
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-01
Content fingerprint c3089f23457bf39e… · 8,449,764 bytes · first seen 2026-07-17

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
8409592
OTHER 		Copper Cu-64, Dotatate, Diagnostic, 1 Millicurie 5 $12,720.60 $14,652.00 $14,152.50 nat. median
$12,721
1.1× median
27059
OTHER 		Rad Resection Tumor Soft Tiss Pelvis&hip 5 Cm/> 5 $10,245.24 $11,800.80 $11,398.50 nat. median
$2,562
outlier · 4.4×
27364
OTHER 		Rad Resection Tumor Soft Tis Thigh/knee 5 Cm/> 5 $9,244.40 $10,648.00 $10,285.00 nat. median
$2,620
outlier · 3.9×
27049
OTHER 		Rad Resect Tumor Soft Tissue Pelvis & Hip <5 Cm 5 $8,755.44 $10,084.80 $9,741.00 nat. median
$1,840
outlier · 5.3×
8409569
OTHER 		Ceretec Auto Wbcs/study Dose 5 $8,457.48 $9,741.60 $9,409.50 nat. median
$8,457
1.1× median
58565
OTHER 		Hysteroscopy, Sterilize W Implants 5 $8,228.28 $9,477.60 $9,154.50 nat. median
$4,298
outlier · 2.1×
23078
OTHER 		Rad Resection Tumor Soft Tissue Shoulder 5 Cm/> 5 $7,945.60 $9,152.00 $8,840.00 nat. median
$2,481
outlier · 3.6×
21936
OTHER 		Rad Resection Tumor Soft Tissue Back/flank 5cm/> 5 $7,831.00 $9,020.00 $8,712.50 nat. median
$2,472
outlier · 3.5×
27329
OTHER 		Rad Resect Tumor Soft Tissue Thigh/knee <5cm 5 $7,387.88 $8,509.60 $8,219.50 nat. median
$2,400
outlier · 3.4×
8100075
OTHER 		Laser Lithotripsy 5 $7,364.96 $8,483.20 $8,194.00 nat. median
$7,365
1.1× median
27616
OTHER 		Rad Resection Tumor Soft Tissue Leg/ankle 5 Cm/> 5 $7,334.40 $8,448.00 $8,160.00 nat. median
$2,502
outlier · 3.3×
59618
OTHER 		Rout OB Care,c-sec,prev C-sec 5 $7,273.28 $8,377.60 $8,092.00 nat. median
$2,721
outlier · 3.0×
52441
OTHER 		Cysto Insertion Transprostatic Implant Single 5 $7,227.44 $8,324.80 $8,041.00 nat. median
$671
outlier · 12.0×
24079
OTHER 		Rad Resect Tumor Soft Tiss Upper Arm/elbow 5cm/> 5 $7,181.60 $8,272.00 $7,990.00 nat. median
$2,546
outlier · 3.1×
8478815
OTHER 		PET Scan Skull Base To Midthigh 5 $7,158.68 $8,245.60 $7,964.50 nat. median
$7,159
1.1× median
8478816
OTHER 		Pet/ct Scan Whole Body 5 $7,158.68 $8,245.60 $7,964.50 nat. median
$7,159
1.1× median
23077
OTHER 		Rad Resection Tumor Soft Tissue Shoulder <5cm 5 $6,914.20 $7,964.00 $7,692.50 nat. median
$2,373
outlier · 3.2×
21558
OTHER 		Rad Resect Tumor Soft Tiss Neck/ant Thorax 5cm/> 5 $6,791.96 $7,823.20 $7,556.50 nat. median
$2,602
outlier · 2.9×
25078
OTHER 		Rad Rescj Tum Soft Tissue Forearm&/wrist 3 Cm/> 5 $6,692.64 $7,708.80 $7,446.00 nat. median
$2,481
outlier · 3.0×
59510
OTHER 		Full Rout Obste Care,cesarean Deliv 5 $6,593.32 $7,594.40 $7,335.50 nat. median
$2,765
outlier · 2.7×
59610
OTHER 		Rout OB Care,vag Deliv,prev C-sec 5 $6,310.64 $7,268.80 $7,021.00 nat. median
$2,539
outlier · 2.8×
8474178
OTHER 		CT Abd & Pelvis With & Without Contrast 5 $6,173.12 $7,110.40 $6,868.00 nat. median
$6,173
1.1× median
27615
OTHER 		Rad Resection Tumor Soft Tissue Leg/ankle <5cm 5 $6,012.68 $6,925.60 $6,689.50 nat. median
$2,395
outlier · 2.8×
8233741
OTHER 		Tas Congenital Cardiac Anomalies Any Method 5 $5,806.40 $6,688.00 $6,460.00 nat. median
$6,460
1.0× median
8973741
OTHER 		Tas Congenital Cardiac Anomalies Any Method 5 $5,806.40 $6,688.00 $6,460.00 nat. median
$6,460
1.0× median
25077
OTHER 		Rad Resect Tumor Soft Tiss Forearm&/wrist <3 Cm 5 $5,737.64 $6,608.80 $6,383.50 nat. median
$2,472
outlier · 2.6×
21935
OTHER 		Rad Resection Tumor Soft Tissue Back/flank <5cm 5 $5,714.72 $6,582.40 $6,358.00 nat. median
$2,472
outlier · 2.6×
59400
OTHER 		Full Rout Obste Care,vaginal Deliv 5 $5,653.60 $6,512.00 $6,290.00 nat. median
$2,406
outlier · 2.6×
32557
OTHER 		Perq Drainage Pleura Insert Cath W/imaging 5 $5,645.96 $6,503.20 $6,281.50 nat. median
$1,539
outlier · 4.1×
8474177
OTHER 		CT Abd & Pelvis With Contrast 5 $5,615.40 $6,468.00 $6,247.50 nat. median
$5,615
1.1× median
22905
OTHER 		Rad Resection Tumor Soft Tissue Abdl Wall 5 Cm/> 5 $5,615.40 $6,468.00 $6,247.50 nat. median
$2,481
outlier · 2.5×
52442
OTHER 		Cysto Insertion Transprostatic Implant Ea Addl 5 $5,584.84 $6,432.80 $6,213.50 nat. median
$307
outlier · 20.3×
24077
OTHER 		Rad Resect Tumor Soft Tiss Upper Arm/elbow <5cm 5 $5,302.16 $6,107.20 $5,899.00 nat. median
$2,435
outlier · 2.4×
8419081
OTHER 		Brst Bx W/plc Lcl Dvc Stereotactic Guide, 1rst Lsn 5 $5,111.16 $5,887.20 $5,686.50 nat. median
$5,111
1.1× median
21016
OTHER 		Rad Resection Tumor Soft Tiss Face/scalp 2 Cm/> 5 $5,111.16 $5,887.20 $5,686.50 nat. median
$2,373
outlier · 2.4×
8233745
OTHER 		Tis Crtj St Congenital Cardiac Anomal 1st Shunt 5 $5,080.60 $5,852.00 $5,652.50 nat. median
$5,652
1.0× median
8973745
OTHER 		Tis Crtj St Congenital Cardiac Anomal 1st Shunt 5 $5,080.60 $5,852.00 $5,652.50 nat. median
$5,652
1.0× median
8478452
OTHER 		Ht Muscle Image Spect Mult 5 $5,019.48 $5,781.60 $5,584.50 nat. median
$5,019
1.1× median
8230468
OTHER 		Rpr Nsl Vlv Collapse Subq/sbmcsl Lat Wall Implt 5 $4,988.92 $5,746.40 $5,550.50 nat. median
$5,550
1.0× median
59622
OTHER 		C-sec+postpartum Care,prev C-sec 5 $4,950.72 $5,702.40 $5,508.00 nat. median
$1,448
outlier · 3.8×
22904
OTHER 		Rad Resection Tumor Soft Tissue Abdl Wall <5cm 5 $4,698.60 $5,412.00 $5,227.50 nat. median
$2,443
outlier · 2.1×
26117
OTHER 		Rad Resect Tumor Soft Tissue Hand/finger <3cm 5 $4,690.96 $5,403.20 $5,219.00 nat. median
$2,596
outlier · 2.0×
28046
OTHER 		Rad Resection Tumor Soft Tissue Foot/toe <3cm 5 $4,645.12 $5,350.40 $5,168.00 nat. median
$2,453
outlier · 2.1×
21557
OTHER 		Rad Resect Tumor Soft Tiss Neck/ant Thorax <5cm 5 $4,606.92 $5,306.40 $5,125.50 nat. median
$2,481
outlier · 2.1×
32554
OTHER 		Thoracentesis Needle/cath Pleura Without Imaging 5 $4,538.16 $5,227.20 $5,049.00 nat. median
$586
outlier · 8.6×
15260
OTHER 		Full Thick Grft Nos,ear,lid <20 Sqcm 5 $4,507.60 $5,192.00 $5,015.00 nat. median
$1,716
outlier · 2.9×
7453072
OTHER 		Cautery Essure System 5 $4,469.40 $5,148.00 $4,972.50 nat. median
$4,876
1.0× median
8472158
OTHER 		MRI L Spine Without & W/contrast 5 $4,393.00 $5,060.00 $4,887.50 nat. median
$4,666
1.0× median
8472156
OTHER 		MRI C Spine Without & W/contrast 5 $4,339.52 $4,998.40 $4,828.00 nat. median
$4,666
1.0× median
59515
OTHER 		Cesarean Delivery+postpartum Care 5 $4,286.04 $4,936.80 $4,768.50 nat. median
$1,533
outlier · 3.1×

Other procedures at this hospital

Browse this hospital's 3,242 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
8409592 OTHER Copper Cu-64, Dotatate, Diagnostic, 1 Millicurie 5 5 $16,650.00 $16,650.00 $12,720.60 $14,652.00 $14,152.50 2026-07-17
27059 OTHER Rad Resection Tumor Soft Tiss Pelvis&hip 5 Cm/> 5 5 $13,410.00 $13,410.00 $10,245.24 $11,800.80 $11,398.50 2026-07-17
27364 OTHER Rad Resection Tumor Soft Tis Thigh/knee 5 Cm/> 5 5 $12,100.00 $12,100.00 $9,244.40 $10,648.00 $10,285.00 2026-07-17
27049 OTHER Rad Resect Tumor Soft Tissue Pelvis & Hip <5 Cm 5 5 $11,460.00 $11,460.00 $8,755.44 $10,084.80 $9,741.00 2026-07-17
8409569 OTHER Ceretec Auto Wbcs/study Dose 5 5 $11,070.00 $11,070.00 $8,457.48 $9,741.60 $9,409.50 2026-07-17
58565 OTHER Hysteroscopy, Sterilize W Implants 5 5 $10,770.00 $10,770.00 $8,228.28 $9,477.60 $9,154.50 2026-07-17
23078 OTHER Rad Resection Tumor Soft Tissue Shoulder 5 Cm/> 5 5 $10,400.00 $10,400.00 $7,945.60 $9,152.00 $8,840.00 2026-07-17
21936 OTHER Rad Resection Tumor Soft Tissue Back/flank 5cm/> 5 5 $10,250.00 $10,250.00 $7,831.00 $9,020.00 $8,712.50 2026-07-17
27329 OTHER Rad Resect Tumor Soft Tissue Thigh/knee <5cm 5 5 $9,670.00 $9,670.00 $7,387.88 $8,509.60 $8,219.50 2026-07-17
8100075 OTHER Laser Lithotripsy 5 5 $9,640.00 $9,640.00 $7,364.96 $8,483.20 $8,194.00 2026-07-17
27616 OTHER Rad Resection Tumor Soft Tissue Leg/ankle 5 Cm/> 5 5 $9,600.00 $9,600.00 $7,334.40 $8,448.00 $8,160.00 2026-07-17
59618 OTHER Rout OB Care,c-sec,prev C-sec 5 5 $9,520.00 $9,520.00 $7,273.28 $8,377.60 $8,092.00 2026-07-17
52441 OTHER Cysto Insertion Transprostatic Implant Single 5 5 $9,460.00 $9,460.00 $7,227.44 $8,324.80 $8,041.00 2026-07-17
24079 OTHER Rad Resect Tumor Soft Tiss Upper Arm/elbow 5cm/> 5 5 $9,400.00 $9,400.00 $7,181.60 $8,272.00 $7,990.00 2026-07-17
8478815 OTHER PET Scan Skull Base To Midthigh 5 5 $9,370.00 $9,370.00 $7,158.68 $8,245.60 $7,964.50 2026-07-17
8478816 OTHER Pet/ct Scan Whole Body 5 5 $9,370.00 $9,370.00 $7,158.68 $8,245.60 $7,964.50 2026-07-17
23077 OTHER Rad Resection Tumor Soft Tissue Shoulder <5cm 5 5 $9,050.00 $9,050.00 $6,914.20 $7,964.00 $7,692.50 2026-07-17
21558 OTHER Rad Resect Tumor Soft Tiss Neck/ant Thorax 5cm/> 5 5 $8,890.00 $8,890.00 $6,791.96 $7,823.20 $7,556.50 2026-07-17
25078 OTHER Rad Rescj Tum Soft Tissue Forearm&/wrist 3 Cm/> 5 5 $8,760.00 $8,760.00 $6,692.64 $7,708.80 $7,446.00 2026-07-17
59510 OTHER Full Rout Obste Care,cesarean Deliv 5 5 $8,630.00 $8,630.00 $6,593.32 $7,594.40 $7,335.50 2026-07-17
59610 OTHER Rout OB Care,vag Deliv,prev C-sec 5 5 $8,260.00 $8,260.00 $6,310.64 $7,268.80 $7,021.00 2026-07-17
8474178 OTHER CT Abd & Pelvis With & Without Contrast 5 5 $8,080.00 $8,080.00 $6,173.12 $7,110.40 $6,868.00 2026-07-17
27615 OTHER Rad Resection Tumor Soft Tissue Leg/ankle <5cm 5 5 $7,870.00 $7,870.00 $6,012.68 $6,925.60 $6,689.50 2026-07-17
8233741 OTHER Tas Congenital Cardiac Anomalies Any Method 5 5 $7,600.00 $7,600.00 $5,806.40 $6,688.00 $6,460.00 2026-07-17
8973741 OTHER Tas Congenital Cardiac Anomalies Any Method 5 5 $7,600.00 $7,600.00 $5,806.40 $6,688.00 $6,460.00 2026-07-17
25077 OTHER Rad Resect Tumor Soft Tiss Forearm&/wrist <3 Cm 5 5 $7,510.00 $7,510.00 $5,737.64 $6,608.80 $6,383.50 2026-07-17
21935 OTHER Rad Resection Tumor Soft Tissue Back/flank <5cm 5 5 $7,480.00 $7,480.00 $5,714.72 $6,582.40 $6,358.00 2026-07-17
59400 OTHER Full Rout Obste Care,vaginal Deliv 5 5 $7,400.00 $7,400.00 $5,653.60 $6,512.00 $6,290.00 2026-07-17
32557 OTHER Perq Drainage Pleura Insert Cath W/imaging 5 5 $7,390.00 $7,390.00 $5,645.96 $6,503.20 $6,281.50 2026-07-17
8474177 OTHER CT Abd & Pelvis With Contrast 5 5 $7,350.00 $7,350.00 $5,615.40 $6,468.00 $6,247.50 2026-07-17
22905 OTHER Rad Resection Tumor Soft Tissue Abdl Wall 5 Cm/> 5 5 $7,350.00 $7,350.00 $5,615.40 $6,468.00 $6,247.50 2026-07-17
52442 OTHER Cysto Insertion Transprostatic Implant Ea Addl 5 5 $7,310.00 $7,310.00 $5,584.84 $6,432.80 $6,213.50 2026-07-17
24077 OTHER Rad Resect Tumor Soft Tiss Upper Arm/elbow <5cm 5 5 $6,940.00 $6,940.00 $5,302.16 $6,107.20 $5,899.00 2026-07-17
8419081 OTHER Brst Bx W/plc Lcl Dvc Stereotactic Guide, 1rst Lsn 5 5 $6,690.00 $6,690.00 $5,111.16 $5,887.20 $5,686.50 2026-07-17
21016 OTHER Rad Resection Tumor Soft Tiss Face/scalp 2 Cm/> 5 5 $6,690.00 $6,690.00 $5,111.16 $5,887.20 $5,686.50 2026-07-17
8233745 OTHER Tis Crtj St Congenital Cardiac Anomal 1st Shunt 5 5 $6,650.00 $6,650.00 $5,080.60 $5,852.00 $5,652.50 2026-07-17
8973745 OTHER Tis Crtj St Congenital Cardiac Anomal 1st Shunt 5 5 $6,650.00 $6,650.00 $5,080.60 $5,852.00 $5,652.50 2026-07-17
8478452 OTHER Ht Muscle Image Spect Mult 5 5 $6,570.00 $6,570.00 $5,019.48 $5,781.60 $5,584.50 2026-07-17
8230468 OTHER Rpr Nsl Vlv Collapse Subq/sbmcsl Lat Wall Implt 5 5 $6,530.00 $6,530.00 $4,988.92 $5,746.40 $5,550.50 2026-07-17
59622 OTHER C-sec+postpartum Care,prev C-sec 5 5 $6,480.00 $6,480.00 $4,950.72 $5,702.40 $5,508.00 2026-07-17
22904 OTHER Rad Resection Tumor Soft Tissue Abdl Wall <5cm 5 5 $6,150.00 $6,150.00 $4,698.60 $5,412.00 $5,227.50 2026-07-17
26117 OTHER Rad Resect Tumor Soft Tissue Hand/finger <3cm 5 5 $6,140.00 $6,140.00 $4,690.96 $5,403.20 $5,219.00 2026-07-17
28046 OTHER Rad Resection Tumor Soft Tissue Foot/toe <3cm 5 5 $6,080.00 $6,080.00 $4,645.12 $5,350.40 $5,168.00 2026-07-17
21557 OTHER Rad Resect Tumor Soft Tiss Neck/ant Thorax <5cm 5 5 $6,030.00 $6,030.00 $4,606.92 $5,306.40 $5,125.50 2026-07-17
32554 OTHER Thoracentesis Needle/cath Pleura Without Imaging 5 5 $5,940.00 $5,940.00 $4,538.16 $5,227.20 $5,049.00 2026-07-17
15260 OTHER Full Thick Grft Nos,ear,lid <20 Sqcm 5 5 $5,900.00 $5,900.00 $4,507.60 $5,192.00 $5,015.00 2026-07-17
7453072 OTHER Cautery Essure System 5 5 $5,850.00 $5,850.00 $4,469.40 $5,148.00 $4,972.50 2026-07-17
8472158 OTHER MRI L Spine Without & W/contrast 5 5 $5,750.00 $5,750.00 $4,393.00 $5,060.00 $4,887.50 2026-07-17
8472156 OTHER MRI C Spine Without & W/contrast 5 5 $5,680.00 $5,680.00 $4,339.52 $4,998.40 $4,828.00 2026-07-17
59515 OTHER Cesarean Delivery+postpartum Care 5 5 $5,610.00 $5,610.00 $4,286.04 $4,936.80 $4,768.50 2026-07-17
14301 OTHER Adj Tiss Xfer Any Area,30.1-60 Sqcm 5 5 $5,470.00 $5,470.00 $4,179.08 $4,813.60 $4,649.50 2026-07-17
15240 OTHER Full Thick Grft Head,fac,hand <20sqc 5 5 $5,440.00 $5,440.00 $4,156.16 $4,787.20 $4,624.00 2026-07-17
59614 OTHER Vag Deliv+postpartum Care,prev C-sec 5 5 $5,330.00 $5,330.00 $4,072.12 $4,690.40 $4,530.50 2026-07-17
14061 OTHER Adj Tiss Xfer Lid,nos,ear 10.1-30 Sqcm 5 5 $5,280.00 $5,280.00 $4,033.92 $4,646.40 $4,488.00 2026-07-17
8419508 OTHER 131 Iobenguane Sulfate 5 5 $5,240.00 $5,240.00 $4,003.36 $4,611.20 $4,454.00 2026-07-17
8409508 OTHER Mibg Per Dose 5 5 $5,240.00 $5,240.00 $4,003.36 $4,611.20 $4,454.00 2026-07-17
8030197 OTHER Arctic Sun (sm) 5 5 $5,202.00 $5,202.00 $3,974.33 $4,577.76 $4,421.70 2026-07-17
8030198 OTHER Arctic Sun (lg) 5 5 $5,202.00 $5,202.00 $3,974.33 $4,577.76 $4,421.70 2026-07-17
8935810 OTHER All Night Polysomnography 5 5 $5,170.00 $5,170.00 $3,949.88 $4,549.60 $4,394.50 2026-07-17
8472197 OTHER MRI Pelvis Without & W/contrast 5 5 $5,120.00 $5,120.00 $3,911.68 $4,505.60 $4,352.00 2026-07-17
8470549 OTHER MRA Neck Without & W/contrast 5 5 $5,020.00 $5,020.00 $3,835.28 $4,417.60 $4,267.00 2026-07-17
25608 OTHER Open Rx Distal Radius Fx, Intra-articular, 2 Frag 5 5 $4,990.00 $4,990.00 $3,812.36 $4,391.20 $4,241.50 2026-07-17
61210 OTHER Burr Hole Implant Cath/device 5 5 $4,960.00 $4,960.00 $3,789.44 $4,364.80 $4,216.00 2026-07-17
8472142 OTHER MRI C Spine W/contrast 5 5 $4,950.00 $4,950.00 $3,781.80 $4,356.00 $4,207.50 2026-07-17
19085 OTHER Bx Breast W Device 1st Lesion Magnetic Res Guide 5 5 $4,920.00 $4,920.00 $3,758.88 $4,329.60 $4,182.00 2026-07-17
8255880 OTHER Transrectal Abltj Mal Prst8 Tissue Hifu W/us 5 5 $4,880.00 $4,880.00 $3,728.32 $4,294.40 $4,148.00 2026-07-17
8455880 OTHER Transrectal Abltj Mal Prst8 Tissue Hifu W/us 5 5 $4,880.00 $4,880.00 $3,728.32 $4,294.40 $4,148.00 2026-07-17
15220 OTHER Full Thick Grft Scalp,arm,leg <20sqc 5 5 $4,830.00 $4,830.00 $3,690.12 $4,250.40 $4,105.50 2026-07-17
8030191 OTHER Metabolt Kit Codman 5 5 $4,820.00 $4,820.00 $3,682.48 $4,241.60 $4,097.00 2026-07-17
8470553 OTHER MRI Brain Without & W/contrast 5 5 $4,790.00 $4,790.00 $3,659.56 $4,215.20 $4,071.50 2026-07-17
8472157 OTHER MRI T Spine Without & W/contrast 5 5 $4,750.00 $4,750.00 $3,629.00 $4,180.00 $4,037.50 2026-07-17
59410 OTHER Obste Care,vag Deliv+postpartum 5 5 $4,750.00 $4,750.00 $3,629.00 $4,180.00 $4,037.50 2026-07-17
8030064 OTHER Sensation Plus 50cc Balloon Catheter Kit (619270) 5 5 $4,702.00 $4,702.00 $3,592.33 $4,137.76 $3,996.70 2026-07-17
8030063 OTHER Sensation Plus 40cc Balloon Catheter Kit (618707) 5 5 $4,702.00 $4,702.00 $3,592.33 $4,137.76 $3,996.70 2026-07-17
59514 OTHER Cesarean Delivery Only 5 5 $4,700.00 $4,700.00 $3,590.80 $4,136.00 $3,995.00 2026-07-17
8269705 OTHER Surg Nasopharyngoscopy Dilat Eustachian Tube Uni 5 5 $4,640.00 $4,640.00 $3,544.96 $4,083.20 $3,944.00 2026-07-17
8269706 OTHER Surg Nasopharyngoscopy Dilat Eustachian Tube Bi 5 5 $4,640.00 $4,640.00 $3,544.96 $4,083.20 $3,944.00 2026-07-17
64721 OTHER Revise Median N/carpal Tunnel Surg 5 5 $4,620.00 $4,620.00 $3,529.68 $4,065.60 $3,927.00 2026-07-17
8450435 OTHER Gd Gb Tube Change 5 5 $4,600.00 $4,600.00 $3,514.40 $4,048.00 $3,910.00 2026-07-17
8973997 OTHER Removal Perq R Heart Vad Venous Cannula Sep Insj 5 5 $4,560.00 $4,560.00 $3,483.84 $4,012.80 $3,876.00 2026-07-17
8472149 OTHER MRI L Spine W/contrast 5 5 $4,550.00 $4,550.00 $3,476.20 $4,004.00 $3,867.50 2026-07-17
8474176 OTHER CT Abd & Pelvis Without Contrast 5 5 $4,540.00 $4,540.00 $3,468.56 $3,995.20 $3,859.00 2026-07-17
21932 OTHER Exc Tumor Soft Tiss Back/flank Subfascial <5cm 5 5 $4,530.00 $4,530.00 $3,460.92 $3,986.40 $3,850.50 2026-07-17
14041 OTHER Adj Tiss Xfer Head,fac,hand 10.1-30 Sqcm 5 5 $4,520.00 $4,520.00 $3,453.28 $3,977.60 $3,842.00 2026-07-17
8455700 OTHER Bx Prostate Needle Or Punch, Singl Or Mult 5 5 $4,470.00 $4,470.00 $3,415.08 $3,933.60 $3,799.50 2026-07-17
8935811 OTHER All Night Polysomnogram W/cpap 5 5 $4,460.00 $4,460.00 $3,407.44 $3,924.80 $3,791.00 2026-07-17
8478454 OTHER Ht Musc Image Planar Mult 5 5 $4,430.00 $4,430.00 $3,384.52 $3,898.40 $3,765.50 2026-07-17
8030067 OTHER Quatro Catheter (626269) 5 5 $4,376.00 $4,376.00 $3,343.26 $3,850.88 $3,719.60 2026-07-17
8473221 OTHER MRI Uppr Ext Joint Without Contrast 5 5 $4,350.00 $4,350.00 $3,323.40 $3,828.00 $3,697.50 2026-07-17
8474170 OTHER CT Abdomen W&without Contrast 5 5 $4,350.00 $4,350.00 $3,323.40 $3,828.00 $3,697.50 2026-07-17
25076 OTHER Exc Tumor Soft Tiss Forearm&/wrist Subfasc <3cm 5 5 $4,350.00 $4,350.00 $3,323.40 $3,828.00 $3,697.50 2026-07-17
99468 OTHER Initial Hosp Neonate 28 Day Or Less, Critically Ill 5 5 $4,350.00 $4,350.00 $3,323.40 $3,828.00 $3,697.50 2026-07-17
19287 OTHER Perq Breast Loc Device Placemt 1st Lesio Mr Guid 5 5 $4,330.00 $4,330.00 $3,308.12 $3,810.40 $3,680.50 2026-07-17
39000 OTHER Pr Mediastinotomy, Cerv Approach 5 5 $4,280.00 $4,280.00 $3,269.92 $3,766.40 $3,638.00 2026-07-17
8472196 OTHER MRI Pelvis W/contrast 5 5 $4,270.00 $4,270.00 $3,262.28 $3,757.60 $3,629.50 2026-07-17
8470544 OTHER MRA Head Without Contrast 5 5 $4,240.00 $4,240.00 $3,239.36 $3,731.20 $3,604.00 2026-07-17
8472141 OTHER MRI C Spine Without Contrast 5 5 $4,240.00 $4,240.00 $3,239.36 $3,731.20 $3,604.00 2026-07-17
8470548 OTHER MRA Neck W/contrast 5 5 $4,240.00 $4,240.00 $3,239.36 $3,731.20 $3,604.00 2026-07-17
90954 OTHER Esrd Related Svc Monthly 2-11 Yr Old 4/> Visits 5 5 $4,240.00 $4,240.00 $3,239.36 $3,731.20 $3,604.00 2026-07-17
8470545 OTHER MRA Head W/contrast 5 5 $4,240.00 $4,240.00 $3,239.36 $3,731.20 $3,604.00 2026-07-17
8470546 OTHER MRA Head Without & W/contrast 5 5 $4,240.00 $4,240.00 $3,239.36 $3,731.20 $3,604.00 2026-07-17
8472148 OTHER MRI L Spine Without Contrast 5 5 $4,240.00 $4,240.00 $3,239.36 $3,731.20 $3,604.00 2026-07-17
8474174 OTHER CT Angiography Abd & Pelvis W/contrast 5 5 $4,220.00 $4,220.00 $3,224.08 $3,713.60 $3,587.00 2026-07-17
8493312 OTHER Echo Real Time Transesoph Without Contrast 5 5 $4,190.00 $4,190.00 $3,201.16 $3,687.20 $3,561.50 2026-07-17
27048 OTHER Exc Tumor Soft Tissue Pelvis & Hip Subfasc <5cm 5 5 $4,180.00 $4,180.00 $3,193.52 $3,678.40 $3,553.00 2026-07-17
32556 OTHER Perq Drainage Pleura Insert Cath Without Imaging 5 5 $4,180.00 $4,180.00 $3,193.52 $3,678.40 $3,553.00 2026-07-17
90951 OTHER Esrd Related Svc Monthly & <2 Yr Old 4/> Visits 5 5 $4,140.00 $4,140.00 $3,162.96 $3,643.20 $3,519.00 2026-07-17
8408902 OTHER MRA - Abdomen Without & W/contrast 5 5 $4,060.00 $4,060.00 $3,101.84 $3,572.80 $3,451.00 2026-07-17
8472126 OTHER CT Cervical Spine W/contrast 5 5 $4,060.00 $4,060.00 $3,101.84 $3,572.80 $3,451.00 2026-07-17
8470543 OTHER MRI Orb/face/neck W&without Cntrst 5 5 $4,060.00 $4,060.00 $3,101.84 $3,572.80 $3,451.00 2026-07-17
21015 OTHER Rad Resection Tumor Soft Tiss Face/scalp < 2cm 5 5 $4,040.00 $4,040.00 $3,086.56 $3,555.20 $3,434.00 2026-07-17
14021 OTHER Adj Tiss Xfer Scalp,extrem 10.1-30 Sqcm 5 5 $4,020.00 $4,020.00 $3,071.28 $3,537.60 $3,417.00 2026-07-17
8470470 OTHER CT Head/brain Without & W/contrast 5 5 $3,960.00 $3,960.00 $3,025.44 $3,484.80 $3,366.00 2026-07-17
8470492 OTHER CT Soft Tissue Neck With & Without Contrast 5 5 $3,960.00 $3,960.00 $3,025.44 $3,484.80 $3,366.00 2026-07-17
8474160 OTHER CT Abdomen W/contrast 5 5 $3,960.00 $3,960.00 $3,025.44 $3,484.80 $3,366.00 2026-07-17
8471270 OTHER CT Chest W & Without Contrast 5 5 $3,960.00 $3,960.00 $3,025.44 $3,484.80 $3,366.00 2026-07-17
8472133 OTHER CT Lumbar Spine Without & W/cntrst 5 5 $3,960.00 $3,960.00 $3,025.44 $3,484.80 $3,366.00 2026-07-17
8470491 OTHER CT Soft Tissue Neck W/contrast 5 5 $3,940.00 $3,940.00 $3,010.16 $3,467.20 $3,349.00 2026-07-17
8473719 OTHER MRI Lower Extremity W/contrast 5 5 $3,940.00 $3,940.00 $3,010.16 $3,467.20 $3,349.00 2026-07-17
8471552 OTHER MRI Chest Wo & W Contrast 5 5 $3,930.00 $3,930.00 $3,002.52 $3,458.40 $3,340.50 2026-07-17
8473223 OTHER MRI Uppr Ext Joint W & Without Contrast 5 5 $3,930.00 $3,930.00 $3,002.52 $3,458.40 $3,340.50 2026-07-17
8030066 OTHER Icy Catheter (626268) 5 5 $3,909.00 $3,909.00 $2,986.48 $3,439.92 $3,322.65 2026-07-17
8030033 OTHER Catheter Icy 626268 5 5 $3,909.00 $3,909.00 $2,986.48 $3,439.92 $3,322.65 2026-07-17
14060 OTHER Adj Tiss Xfer Lid,nos,ear <10 Sqcm 5 5 $3,880.00 $3,880.00 $2,964.32 $3,414.40 $3,298.00 2026-07-17
59409 OTHER Obstetrical Care,vag Deliv Only 5 5 $3,880.00 $3,880.00 $2,964.32 $3,414.40 $3,298.00 2026-07-17
19086 OTHER Bx Breast W Device Addl Lesion Magnet Res Guide 5 5 $3,870.00 $3,870.00 $2,956.68 $3,405.60 $3,289.50 2026-07-17
8474175 OTHER CT Angiography Abdomen W/contrast 5 5 $3,870.00 $3,870.00 $2,956.68 $3,405.60 $3,289.50 2026-07-17
8470496 OTHER CT Angiography -head 5 5 $3,870.00 $3,870.00 $2,956.68 $3,405.60 $3,289.50 2026-07-17
27501 OTHER Closed Rx Condylar Fx 5 5 $3,850.00 $3,850.00 $2,941.40 $3,388.00 $3,272.50 2026-07-17
8473720 OTHER MRI Lower Extremity Wo&w/contr 5 5 $3,830.00 $3,830.00 $2,926.12 $3,370.40 $3,255.50 2026-07-17
8471551 OTHER MRI Chest W/contrast 5 5 $3,830.00 $3,830.00 $2,926.12 $3,370.40 $3,255.50 2026-07-17
8470336 OTHER MRI Tmj 5 5 $3,830.00 $3,830.00 $2,926.12 $3,370.40 $3,255.50 2026-07-17
32555 OTHER Thoracentesis Needle/cath Pleura W/imaging 5 5 $3,820.00 $3,820.00 $2,918.48 $3,361.60 $3,247.00 2026-07-17
8478630 OTHER Csf Fluid Scan Cisternography 5 5 $3,820.00 $3,820.00 $2,918.48 $3,361.60 $3,247.00 2026-07-17
8472147 OTHER MRI T Spine W/contrast 5 5 $3,810.00 $3,810.00 $2,910.84 $3,352.80 $3,238.50 2026-07-17
26116 OTHER Exc Tum/vas Mal Sft Tis Hand/fngr Subfasc<1.5cm 5 5 $3,810.00 $3,810.00 $2,910.84 $3,352.80 $3,238.50 2026-07-17
8940034 OTHER Picc 4 French Dual Lumen 3cg 5 5 $3,804.00 $3,804.00 $2,906.26 $3,347.52 $3,233.40 2026-07-17
8973995 OTHER Insj Perq Vad W/rs&i R Heart Venous Access Only 5 5 $3,800.00 $3,800.00 $2,903.20 $3,344.00 $3,230.00 2026-07-17
17108 OTHER Destruc Cut/vasc >50 Sqcm 5 5 $3,800.00 $3,800.00 $2,903.20 $3,344.00 $3,230.00 2026-07-17
8233995 OTHER Insj Perq Vad W/rs&i R Heart Venous Access Only 5 5 $3,800.00 $3,800.00 $2,903.20 $3,344.00 $3,230.00 2026-07-17
8020037 OTHER Wound Exploration 5 5 $3,780.00 $3,780.00 $2,887.92 $3,326.40 $3,213.00 2026-07-17
99471 OTHER Initial Ped Critical Care 29 Day Thru 24 Mo 5 5 $3,760.00 $3,760.00 $2,872.64 $3,308.80 $3,196.00 2026-07-17
8472191 OTHER CT Angiography Pelvis 5 5 $3,750.00 $3,750.00 $2,865.00 $3,300.00 $3,187.50 2026-07-17
14040 OTHER Adj Tiss Xfer Head,fac,hand <10 Sqcm 5 5 $3,730.00 $3,730.00 $2,849.72 $3,282.40 $3,170.50 2026-07-17
8940033 OTHER Picc 3 French Single Lumen 3cg 5 5 $3,708.00 $3,708.00 $2,832.91 $3,263.04 $3,151.80 2026-07-17
8474183 OTHER MRI Abdomen Without & W/contrast 5 5 $3,690.00 $3,690.00 $2,819.16 $3,247.20 $3,136.50 2026-07-17
8470552 OTHER MRI Brain W/contrast 5 5 $3,680.00 $3,680.00 $2,811.52 $3,238.40 $3,128.00 2026-07-17
8940035 OTHER Midline 3 French Single Lumen 5 5 $3,647.00 $3,647.00 $2,786.31 $3,209.36 $3,099.95 2026-07-17
8470490 OTHER CT Soft Tissue Neck Without Cntrst 5 5 $3,640.00 $3,640.00 $2,780.96 $3,203.20 $3,094.00 2026-07-17
8472125 OTHER CT Cervical Spine Without Contrast 5 5 $3,640.00 $3,640.00 $2,780.96 $3,203.20 $3,094.00 2026-07-17
8381518 OTHER Respiratory Pathogens Panel (itc Lab) 5 5 $3,630.00 $3,630.00 $2,773.32 $3,194.40 $3,085.50 2026-07-17
24076 OTHER Exc Tumor Soft Tiss Upr Arm/elbow Subfasc <5cm 5 5 $3,620.00 $3,620.00 $2,765.68 $3,185.60 $3,077.00 2026-07-17
8471260 OTHER CT Chest W/contrast 5 5 $3,610.00 $3,610.00 $2,758.04 $3,176.80 $3,068.50 2026-07-17
27328 OTHER Exc Tumor Soft Tissue Thigh/knee Subfasc <5cm 5 5 $3,580.00 $3,580.00 $2,735.12 $3,150.40 $3,043.00 2026-07-17
8473723 OTHER MRI Lwr Ext Joint W & Without Contrast 5 5 $3,570.00 $3,570.00 $2,727.48 $3,141.60 $3,034.50 2026-07-17
8475635 OTHER CT Angio Abd Aorta & Runoff 5 5 $3,560.00 $3,560.00 $2,719.84 $3,132.80 $3,026.00 2026-07-17
8470551 OTHER MRI Brain Without Contrast 5 5 $3,540.00 $3,540.00 $2,704.56 $3,115.20 $3,009.00 2026-07-17
8472146 OTHER MRI T Spine Without Contrast 5 5 $3,540.00 $3,540.00 $2,704.56 $3,115.20 $3,009.00 2026-07-17
27500 OTHER Closed Rx Femur Shaft Fx 5 5 $3,530.00 $3,530.00 $2,696.92 $3,106.40 $3,000.50 2026-07-17
8000200 OTHER ICU 4 4 $3,480.00 $3,480.00 $2,658.72 $3,062.40 $2,992.80 2026-07-17
8474182 OTHER MRI Abdomen W/contrast 5 5 $3,500.00 $3,500.00 $2,674.00 $3,080.00 $2,975.00 2026-07-17
23076 OTHER Exc Tumor Soft Tiss Shoulder Subfasc <5cm 5 5 $3,500.00 $3,500.00 $2,674.00 $3,080.00 $2,975.00 2026-07-17
8400009 OTHER Tte W/doppler, Complete With Contrast 5 5 $3,490.00 $3,490.00 $2,666.36 $3,071.20 $2,966.50 2026-07-17
8472194 OTHER CT Pelvis Without & W/contrast 5 5 $3,480.00 $3,480.00 $2,658.72 $3,062.40 $2,958.00 2026-07-17
27619 OTHER Exc Tumor Soft Tissue Leg/ankle Subfascial <3cm 5 5 $3,470.00 $3,470.00 $2,651.08 $3,053.60 $2,949.50 2026-07-17
8408900 OTHER MRA Abdomen W Contrast 5 5 $3,460.00 $3,460.00 $2,643.44 $3,044.80 $2,941.00 2026-07-17
8472132 OTHER CT Lumbar Spine W/contrast 5 5 $3,440.00 $3,440.00 $2,628.16 $3,027.20 $2,924.00 2026-07-17
8449406 OTHER Img Guide Cath Fld Clctn Peri/retro, Perq 5 5 $3,420.00 $3,420.00 $2,612.88 $3,009.60 $2,907.00 2026-07-17
27220 OTHER Closed Rx Acetabular Fx 5 5 $3,410.00 $3,410.00 $2,605.24 $3,000.80 $2,898.50 2026-07-17
19288 OTHER Perq Breast Loc Device Placemt Add Lesio Mr Guid 5 5 $3,410.00 $3,410.00 $2,605.24 $3,000.80 $2,898.50 2026-07-17
8470498 OTHER CT Angiography -neck 5 5 $3,380.00 $3,380.00 $2,582.32 $2,974.40 $2,873.00 2026-07-17
59525 OTHER Remove Uterus After Cesarean 5 5 $3,360.00 $3,360.00 $2,567.04 $2,956.80 $2,856.00 2026-07-17
90957 OTHER Esrd Related Svc Monthly 12-19 Yr Old 4/> Visits 5 5 $3,350.00 $3,350.00 $2,559.40 $2,948.00 $2,847.50 2026-07-17
G0121 HCPCS Colon Ca Scrn Not Hi Rsk Ind 5 5 $3,340.00 $3,340.00 $2,551.76 $2,939.20 $2,839.00 2026-07-17
G0105 HCPCS Colorectal Scrn; Hi Risk Ind 5 5 $3,340.00 $3,340.00 $2,551.76 $2,939.20 $2,839.00 2026-07-17
45385 OTHER Colsc Flx W/rmvl Of Tumor Polyp Lesion Snare Tq 5 5 $3,330.00 $3,330.00 $2,544.12 $2,930.40 $2,830.50 2026-07-17
8973746 OTHER Tis Crtj St Congenital Cardiac Anomal Ea Addl 5 5 $3,330.00 $3,330.00 $2,544.12 $2,930.40 $2,830.50 2026-07-17
8470460 OTHER CT Head/brain W/contrast 5 5 $3,330.00 $3,330.00 $2,544.12 $2,930.40 $2,830.50 2026-07-17
8233746 OTHER Tis Crtj St Congenital Cardiac Anomal Ea Addl 5 5 $3,330.00 $3,330.00 $2,544.12 $2,930.40 $2,830.50 2026-07-17
58605 OTHER Ligate Fallopian Tube,postpartum 5 5 $3,320.00 $3,320.00 $2,536.48 $2,921.60 $2,822.00 2026-07-17
21013 OTHER Exc Tumor Soft Tiss Face&scalp Subfascial < 2cm 5 5 $3,310.00 $3,310.00 $2,528.84 $2,912.80 $2,813.50 2026-07-17
19081 OTHER Bx Breast W Device 1st Lesion Stereotactic Guide 5 5 $3,300.00 $3,300.00 $2,521.20 $2,904.00 $2,805.00 2026-07-17
8473702 OTHER CT Lower Extremity With Wo Contrast 5 5 $3,290.00 $3,290.00 $2,513.56 $2,895.20 $2,796.50 2026-07-17
58558 OTHER Hysteroscopy,w/endo Bx 5 5 $3,290.00 $3,290.00 $2,513.56 $2,895.20 $2,796.50 2026-07-17
8472193 OTHER CT Pelvis W/contrast 5 5 $3,290.00 $3,290.00 $2,513.56 $2,895.20 $2,796.50 2026-07-17
8473202 OTHER CT Uppr Ext Without & With Contrast 5 5 $3,290.00 $3,290.00 $2,513.56 $2,895.20 $2,796.50 2026-07-17
8493306 OTHER Tte W/doppler, Complete Without Contrast 5 5 $3,280.00 $3,280.00 $2,505.92 $2,886.40 $2,788.00 2026-07-17
19083 OTHER Bx Breast W Device 1st Lesion Ultrasound Guide 5 5 $3,270.00 $3,270.00 $2,498.28 $2,877.60 $2,779.50 2026-07-17
8408908 OTHER MRI Breast Bilat Wo&w/cntrst 5 5 $3,270.00 $3,270.00 $2,498.28 $2,877.60 $2,779.50 2026-07-17
8478306 OTHER Bone/joint Imaging -whole Body 5 5 $3,270.00 $3,270.00 $2,498.28 $2,877.60 $2,779.50 2026-07-17
8408911 OTHER MRA Chest Wo&w/contrast 5 5 $3,270.00 $3,270.00 $2,498.28 $2,877.60 $2,779.50 2026-07-17
8408920 OTHER MRA Pelvis Without & W/contrast 5 5 $3,270.00 $3,270.00 $2,498.28 $2,877.60 $2,779.50 2026-07-17
8408914 OTHER MRA Without & W/contrast -lwr Extremity 5 5 $3,270.00 $3,270.00 $2,498.28 $2,877.60 $2,779.50 2026-07-17
8478830 OTHER Rp Loclzj Tum Spect W/ct 1 Area 1 Day Imaging 5 5 $3,270.00 $3,270.00 $2,498.28 $2,877.60 $2,779.50 2026-07-17
8473722 OTHER MRI Lwr Ext Joint W/ontrast 5 5 $3,270.00 $3,270.00 $2,498.28 $2,877.60 $2,779.50 2026-07-17
24075 OTHER Exc Tumor Soft Tiss Upper Arm/elbow Subq <3cm 5 5 $3,230.00 $3,230.00 $2,467.72 $2,842.40 $2,745.50 2026-07-17
8471275 OTHER CT Angiography -chest 5 5 $3,230.00 $3,230.00 $2,467.72 $2,842.40 $2,745.50 2026-07-17
14020 OTHER Adj Tiss Xfer Scalp,extrem <10 Sqcm 5 5 $3,210.00 $3,210.00 $2,452.44 $2,824.80 $2,728.50 2026-07-17
27047 OTHER Exc Tumor Soft Tissue Pelvis & Hip Subq <3cm 5 5 $3,210.00 $3,210.00 $2,452.44 $2,824.80 $2,728.50 2026-07-17
8470542 OTHER MRI Orbit/face/neck W/contrast 5 5 $3,200.00 $3,200.00 $2,444.80 $2,816.00 $2,720.00 2026-07-17
8028851 OTHER Rmvl Perct Rt Heart Ventricular Assist Device 5 5 $3,200.00 $3,200.00 $2,444.80 $2,816.00 $2,720.00 2026-07-17
8419521 OTHER Tc 99m Exametazime Up To 25mci 5 5 $3,160.00 $3,160.00 $2,414.24 $2,780.80 $2,686.00 2026-07-17
8409521 OTHER Tc 99m Exametazime Up To 25mci 5 5 $3,160.00 $3,160.00 $2,414.24 $2,780.80 $2,686.00 2026-07-17
8899291 OTHER Emergency Room Level 6 5 5 $3,150.00 $3,150.00 $2,406.60 $2,772.00 $2,677.50 2026-07-17
8099291 OTHER OB Emergency Room Level 6 5 5 $3,150.00 $3,150.00 $2,406.60 $2,772.00 $2,677.50 2026-07-17
59426 OTHER Antepartum Care Only, >7 Visits 5 5 $3,140.00 $3,140.00 $2,398.96 $2,763.20 $2,669.00 2026-07-17
8419083 OTHER Brst Bx W/plc Lcl Dvc US Guide, 1rst Lsn 5 5 $3,130.00 $3,130.00 $2,391.32 $2,754.40 $2,660.50 2026-07-17
99475 OTHER Initial Ped Critical Care 2 Yr Thru 5 Yr 5 5 $3,110.00 $3,110.00 $2,376.04 $2,736.80 $2,643.50 2026-07-17
8474150 OTHER CT Abdomen Without Contrast 5 5 $3,080.00 $3,080.00 $2,353.12 $2,710.40 $2,618.00 2026-07-17
13152 OTHER Recmpl Wnd Lid,nos,ear 2.5-7.5 Cm 5 5 $3,060.00 $3,060.00 $2,337.84 $2,692.80 $2,601.00 2026-07-17
8473701 OTHER CT Lower Extremity W/contrast 5 5 $3,040.00 $3,040.00 $2,322.56 $2,675.20 $2,584.00 2026-07-17
8472128 OTHER CT Thoracic Spine Without Contrast 5 5 $3,040.00 $3,040.00 $2,322.56 $2,675.20 $2,584.00 2026-07-17
8232408 OTHER Core Needle Bx Lung/mediastinum Perq W/img 5 5 $3,040.00 $3,040.00 $2,322.56 $2,675.20 $2,584.00 2026-07-17
8473201 OTHER CT Upper Extremity W/contrast 5 5 $3,040.00 $3,040.00 $2,322.56 $2,675.20 $2,584.00 2026-07-17
8972408 OTHER Core Needle Bx Lung/mediastinum Perq W/img 5 5 $3,040.00 $3,040.00 $2,322.56 $2,675.20 $2,584.00 2026-07-17
8432408 OTHER Core Needle Bx Lung/mediastinum Perq W/img 5 5 $3,040.00 $3,040.00 $2,322.56 $2,675.20 $2,584.00 2026-07-17
8472129 OTHER CT Thoracic Spine W/contrast 5 5 $3,040.00 $3,040.00 $2,322.56 $2,675.20 $2,584.00 2026-07-17
12057 OTHER Layr Clos Wnd Face,facial >30 Cm 5 5 $3,020.00 $3,020.00 $2,307.28 $2,657.60 $2,567.00 2026-07-17
8473706 OTHER CT Angiography Lwr Ext W/contrast 5 5 $3,020.00 $3,020.00 $2,307.28 $2,657.60 $2,567.00 2026-07-17
26115 OTHER Exc Tum/vasc Mal Sft Tiss Hand/fngr Subq <1.5cm 5 5 $3,000.00 $3,000.00 $2,292.00 $2,640.00 $2,550.00 2026-07-17
8381232 OTHER CPT-gpp-gi Pathogen, Probe, 12-25 Targets 5 5 $2,990.00 $2,990.00 $2,284.36 $2,631.20 $2,541.50 2026-07-17
8470488 OTHER CT Maxillofacial Without & With Contrast 5 5 $2,990.00 $2,990.00 $2,284.36 $2,631.20 $2,541.50 2026-07-17
21556 OTHER Exc Tumor Soft Tissue Neck/ant Thorax Subfascial <5cm 5 5 $2,960.00 $2,960.00 $2,261.44 $2,604.80 $2,516.00 2026-07-17
45380 OTHER Colonoscopy W/biopsy Single/multiple 5 5 $2,950.00 $2,950.00 $2,253.80 $2,596.00 $2,507.50 2026-07-17
8472192 OTHER CT Pelvis Without Contrast 5 5 $2,900.00 $2,900.00 $2,215.60 $2,552.00 $2,465.00 2026-07-17
8470547 OTHER MRA Neck Without Contrast 5 5 $2,890.00 $2,890.00 $2,207.96 $2,543.20 $2,456.50 2026-07-17
8471550 OTHER MRI Chest Without Contrast 5 5 $2,890.00 $2,890.00 $2,207.96 $2,543.20 $2,456.50 2026-07-17
8473222 OTHER MRI Uppr Ext Joint With Contrast 5 5 $2,890.00 $2,890.00 $2,207.96 $2,543.20 $2,456.50 2026-07-17
8473718 OTHER MRI Lower Extremity Without Cntrst 5 5 $2,890.00 $2,890.00 $2,207.96 $2,543.20 $2,456.50 2026-07-17
22900 OTHER Exc Tumor Soft Tissue Abdl Wall Subfascial <5cm 5 5 $2,890.00 $2,890.00 $2,207.96 $2,543.20 $2,456.50 2026-07-17
8473721 OTHER MRI Lwr Ext Joint Without Contrast 5 5 $2,890.00 $2,890.00 $2,207.96 $2,543.20 $2,456.50 2026-07-17
90963 OTHER Esrd Services, Home Dialysis, Per Month, < 2 Yr Old 5 5 $2,870.00 $2,870.00 $2,192.68 $2,525.60 $2,439.50 2026-07-17
8470482 OTHER CT Orb/pit/pf/iac W/o&w/cntrst 5 5 $2,870.00 $2,870.00 $2,192.68 $2,525.60 $2,439.50 2026-07-17
8478700 OTHER Kidney Imaging 5 5 $2,860.00 $2,860.00 $2,185.04 $2,516.80 $2,431.00 2026-07-17
8382292 OTHER Qnatal(tm) Advanced 5 5 $2,860.00 $2,860.00 $2,185.04 $2,516.80 $2,431.00 2026-07-17
8381694 OTHER CPT-meningitis Panel, Csf 5 5 $2,860.00 $2,860.00 $2,185.04 $2,516.80 $2,431.00 2026-07-17
8471250 OTHER CT Chest Without Contrast 5 5 $2,860.00 $2,860.00 $2,185.04 $2,516.80 $2,431.00 2026-07-17
8400297 OTHER Ldct For Lung Screening 5 5 $2,860.00 $2,860.00 $2,185.04 $2,516.80 $2,431.00 2026-07-17
12056 OTHER Layr Clos Wnd Face,facial 20.1-30 Cm 5 5 $2,830.00 $2,830.00 $2,162.12 $2,490.40 $2,405.50 2026-07-17
8473218 OTHER MRI Upper Extremity Without Cntrst 5 5 $2,830.00 $2,830.00 $2,162.12 $2,490.40 $2,405.50 2026-07-17
31603 OTHER Tracheostomy,emerg,xtrach 5 5 $2,830.00 $2,830.00 $2,162.12 $2,490.40 $2,405.50 2026-07-17
8470487 OTHER CT Maxillofacial W/contrast 5 5 $2,810.00 $2,810.00 $2,146.84 $2,472.80 $2,388.50 2026-07-17
8478018 OTHER Whole Body Imaging 5 5 $2,800.00 $2,800.00 $2,139.20 $2,464.00 $2,380.00 2026-07-17
8478801 OTHER Tumor Localization Mult Areas 5 5 $2,780.00 $2,780.00 $2,123.92 $2,446.40 $2,363.00 2026-07-17
8455876 OTHER US Prostate Fiduciary Marker Placement 5 5 $2,780.00 $2,780.00 $2,123.92 $2,446.40 $2,363.00 2026-07-17
21930 OTHER Excision Tumor Soft Tissue Back/flank Subq <3cm 5 5 $2,780.00 $2,780.00 $2,123.92 $2,446.40 $2,363.00 2026-07-17
10030 OTHER Image-guided Catheter Fluid Collection Drainage 5 5 $2,750.00 $2,750.00 $2,101.00 $2,420.00 $2,337.50 2026-07-17
8473206 OTHER CT Angiography Upper Extrmity 5 5 $2,730.00 $2,730.00 $2,085.72 $2,402.40 $2,320.50 2026-07-17
8478290 OTHER Intestine Imaging (meckel's) 5 5 $2,730.00 $2,730.00 $2,085.72 $2,402.40 $2,320.50 2026-07-17
8654002 OTHER Vent / Per Day 5 5 $2,700.00 $2,700.00 $2,062.80 $2,376.00 $2,295.00 2026-07-17
25075 OTHER Exc Tumor Soft Tissue Forearm &/wrist Subq <3cm 5 5 $2,680.00 $2,680.00 $2,047.52 $2,358.40 $2,278.00 2026-07-17
8493225 OTHER Cardiac Holter 24 Hr Mntr Rcrdng 5 5 $2,680.00 $2,680.00 $2,047.52 $2,358.40 $2,278.00 2026-07-17
11921 OTHER Correct Skin Colr Defct 6.1-20 Sqcm 5 5 $2,670.00 $2,670.00 $2,039.88 $2,349.60 $2,269.50 2026-07-17
99469 OTHER Subsequent Hosp Neonate 28 Day Or Less, Critically Ill 5 5 $2,660.00 $2,660.00 $2,032.24 $2,340.80 $2,261.00 2026-07-17
8470481 OTHER CT Orb/pit/pf/iac W/contrast 5 5 $2,650.00 $2,650.00 $2,024.60 $2,332.00 $2,252.50 2026-07-17
59821 OTHER Surg Rx Missed Abortn,2nd Tri 5 5 $2,640.00 $2,640.00 $2,016.96 $2,323.20 $2,244.00 2026-07-17
19082 OTHER Bx Breast W Device Addl Lesion Stereotact Guide 5 5 $2,630.00 $2,630.00 $2,009.32 $2,314.40 $2,235.50 2026-07-17
27238 OTHER Closed Rx Inter/subtroch Femur Fx 5 5 $2,630.00 $2,630.00 $2,009.32 $2,314.40 $2,235.50 2026-07-17
99472 OTHER Subsequent Ped Critical Care 29 Day Thru 24 Mo 5 5 $2,630.00 $2,630.00 $2,009.32 $2,314.40 $2,235.50 2026-07-17
8478014 OTHER Thyroid Imaging W/blood Flow 5 5 $2,630.00 $2,630.00 $2,009.32 $2,314.40 $2,235.50 2026-07-17
8478804 OTHER Tumor Localization Whole Body Mult Day Imaging 5 5 $2,620.00 $2,620.00 $2,001.68 $2,305.60 $2,227.00 2026-07-17
8473700 OTHER CT Lower Extremity Without Contrst 5 5 $2,610.00 $2,610.00 $1,994.04 $2,296.80 $2,218.50 2026-07-17
8478800 OTHER Tumor Localization Limited Area 5 5 $2,610.00 $2,610.00 $1,994.04 $2,296.80 $2,218.50 2026-07-17
8477012 OTHER CT Guidance Needle Plcmnt S&i 5 5 $2,610.00 $2,610.00 $1,994.04 $2,296.80 $2,218.50 2026-07-17
19084 OTHER Bx Breast W Device Addl Lesion Ultrasound Guide 5 5 $2,590.00 $2,590.00 $1,978.76 $2,279.20 $2,201.50 2026-07-17
8478709 OTHER Kidney Imaging W/flow W/wo Pha 5 5 $2,590.00 $2,590.00 $1,978.76 $2,279.20 $2,201.50 2026-07-17
12018 OTHER Resuperf Wnd Face >30 Cm 5 5 $2,580.00 $2,580.00 $1,971.12 $2,270.40 $2,193.00 2026-07-17
17107 OTHER Destruc Cut/vasc 10-50 Sqcm 5 5 $2,570.00 $2,570.00 $1,963.48 $2,261.60 $2,184.50 2026-07-17
27327 OTHER Excision Tumor Soft Tissue Thigh/knee Subq <3cm 5 5 $2,570.00 $2,570.00 $1,963.48 $2,261.60 $2,184.50 2026-07-17
8478580 OTHER Lung Perfusion Imaging 5 5 $2,560.00 $2,560.00 $1,955.84 $2,252.80 $2,176.00 2026-07-17
27618 OTHER Exc Tumor Soft Tissue Leg/ankle Subq <3cm 5 5 $2,550.00 $2,550.00 $1,948.20 $2,244.00 $2,167.50 2026-07-17
8475822 OTHER Venography Bilat Extremity S&i 5 5 $2,540.00 $2,540.00 $1,940.56 $2,235.20 $2,159.00 2026-07-17
8449405 OTHER Img Guide Cath Fld Clctn Visceral, Perq 5 5 $2,540.00 $2,540.00 $1,940.56 $2,235.20 $2,159.00 2026-07-17
33948 OTHER Ecmo/ecls Daily Management Each Day Veno-venous 5 5 $2,520.00 $2,520.00 $1,925.28 $2,217.60 $2,142.00 2026-07-17
11646 OTHER Exc Skin Malig >4 Cm Face,facial 5 5 $2,510.00 $2,510.00 $1,917.64 $2,208.80 $2,133.50 2026-07-17
49411 OTHER Place Interst Rad Ther Guide, Perc,intraabd/intrapelv/retroper,1+ 5 5 $2,500.00 $2,500.00 $1,910.00 $2,200.00 $2,125.00 2026-07-17
8478227 OTHER Hepatobiliary Syst Imgng W/glbldr W/rx 5 5 $2,490.00 $2,490.00 $1,902.36 $2,191.20 $2,116.50 2026-07-17
8478226 OTHER Hepatobiliary Syst Imaging W/glbldr 5 5 $2,490.00 $2,490.00 $1,902.36 $2,191.20 $2,116.50 2026-07-17
45378 OTHER Colonoscopy Flx Dx W/collj Spec When Pfrmd 5 5 $2,470.00 $2,470.00 $1,887.08 $2,173.60 $2,099.50 2026-07-17
8473220 OTHER MRI Upper Extremity Wo&w/contr 5 5 $2,470.00 $2,470.00 $1,887.08 $2,173.60 $2,099.50 2026-07-17
8478278 OTHER Gi Blood Loss Imaging 5 5 $2,420.00 $2,420.00 $1,848.88 $2,129.60 $2,057.00 2026-07-17
8408906 OTHER MRI Breast W/contrast 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
8408909 OTHER MRA Chest W/contrast 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
8408901 OTHER MRA Abdomen Without Contrast 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
8474181 OTHER MRI Abdomen Without Contrast 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
8470540 OTHER MRI Orbit/face/neck Without Cntrst 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
8473219 OTHER MRI Upper Extremity W/cntrst 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
8408918 OTHER MRA Pelvis W/contrast 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
99477 OTHER Initial Hosp Neonate 28 Day Or Less, Not Critically Ill 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
8408912 OTHER MRA W/contrast -lwr Extremity 5 5 $2,410.00 $2,410.00 $1,841.24 $2,120.80 $2,048.50 2026-07-17
13132 OTHER Recmpl Wnd Head,fac,hand 2.6-7.5 Cm 5 5 $2,400.00 $2,400.00 $1,833.60 $2,112.00 $2,040.00 2026-07-17
90964 OTHER Esrd Services, Home Dialysis, Per Month, 2-11 Yr Old 5 5 $2,390.00 $2,390.00 $1,825.96 $2,103.20 $2,031.50 2026-07-17
8470486 OTHER CT Maxillofacial Without Contrast 5 5 $2,380.00 $2,380.00 $1,818.32 $2,094.40 $2,023.00 2026-07-17
28045 OTHER Exc Tumor Soft Tissue Foot/toe Subfasc <1.5cm 5 5 $2,380.00 $2,380.00 $1,818.32 $2,094.40 $2,023.00 2026-07-17
8233997 OTHER Removal Perq R Heart Vad Venous Cannula Sep Insj 5 5 $2,380.00 $2,380.00 $1,818.32 $2,094.40 $2,023.00 2026-07-17
8408910 OTHER MRA Chest Without Contrast 5 5 $2,360.00 $2,360.00 $1,803.04 $2,076.80 $2,006.00 2026-07-17
8473225 OTHER MRA Upper Extremity 5 5 $2,360.00 $2,360.00 $1,803.04 $2,076.80 $2,006.00 2026-07-17
8408919 OTHER MRA Pelvis Without Contrast 5 5 $2,360.00 $2,360.00 $1,803.04 $2,076.80 $2,006.00 2026-07-17
8408913 OTHER MRA-lower Extremity Without Cntrst 5 5 $2,360.00 $2,360.00 $1,803.04 $2,076.80 $2,006.00 2026-07-17
12037 OTHER Layr Clos Wnd Trunk,arm,leg >30 Cm 5 5 $2,350.00 $2,350.00 $1,795.40 $2,068.00 $1,997.50 2026-07-17
See an error in this hospital's data? Submit a correction