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 — reason	Rows
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 via	Discovered 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.

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

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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
8000200	OTHER	ICU	4	4	$3,480.00	$3,480.00	$2,658.72	$3,062.40	$2,992.80	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
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
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
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
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
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
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
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
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
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
8100075	OTHER	Laser Lithotripsy	5	5	$9,640.00	$9,640.00	$7,364.96	$8,483.20	$8,194.00	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
8470336	OTHER	MRI Tmj	5	5	$3,830.00	$3,830.00	$2,926.12	$3,370.40	$3,255.50	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
8478700	OTHER	Kidney Imaging	5	5	$2,860.00	$2,860.00	$2,185.04	$2,516.80	$2,431.00	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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

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