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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

Shirley Ryan Abilitylab

Chicago, IL · CCN 143026 · Rates published

9,594 distinct procedures filed
40 distinct payers
455,420 rate rows
2026-05-22 last MRF observed
Data quality

424,476 of 455,420 rate rows are consumer-grade (93.2%)

30,944 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
per-diem day rate — not a per-procedure price 30,936
exceeds 10× this hospital's gross charge — excluded from medians 8
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.sralab.org/sites/default/files/downloads/2026-03/362256036_Shirley-Ryan-Ability-Lab_standardcharges.csv
Found on page https://www.sralab.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-18
Content fingerprint 400d7999dfa0610e… · 28,163,945 bytes · first seen 2026-05-14

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
809881
OTHER 		00173-0696-00 - Fluticasone-salmeterol 250 Mcg-50 15 $60,327.12 $108,588.82 $95,316.86 nat. median
$95,317
1.0× median
728495
OTHER 		Electronic Elbow Microproc Simultaneous Control O 40 $25,587.13 $120,983.45 $68,896.89 nat. median
$68,897
1.0× median
6664211
OTHER 		Powered Ue Orthosis Elbow Wrist Hand Finger Cust 40 $21,198.22 $100,860.55 $67,700.88 nat. median
$67,701
1.0× median
6680449
OTHER 		L2006 Kafo Microprocessor Swing And/or Stance 34 $21,466.54 $102,090.80 $65,284.38 nat. median
$65,284
1.0× median
728494
OTHER 		Electronic Elbow Microproc Sequential Control Of 40 $23,094.30 $109,554.00 $63,426.00 nat. median
$63,426
1.0× median
6060818
OTHER 		L6880 Elec Hand Ind Art Digits 40 $17,217.49 $82,609.15 $47,826.35 nat. median
$47,826
1.0× median
728726
OTHER 		Addition To Le Pros Endo Knee-shin Sys Microproc 40 $17,068.31 $81,925.15 $47,430.35 nat. median
$47,430
1.0× median
6112049
OTHER 		Gk Delivery Complex Nmh 15 $26,549.00 $47,788.20 $41,947.42 nat. median
$41,947
1.0× median
1309227
OTHER 		59627-0002-05 - Interferon Beta-1a 30 Mcg/0.5 Ml K 15 $25,344.22 $45,619.60 $40,043.88 nat. median
$40,044
1.0× median
6664210
OTHER 		Powered Ue Orthosis Elbow Wrist Hand Custom 40 $10,745.18 $52,934.00 $34,410.61 nat. median
$34,411
1.0× median
7852522
OTHER 		Addition Ue Pattern Recognition System 40 $10,820.60 $53,279.80 $31,126.62 nat. median
$31,127
1.0× median
6369615
OTHER 		Ak/ft Power Asst Incl Motors (l5969) 34 $9,299.34 $46,304.90 $29,610.76 nat. median
$29,611
1.0× median
728578
OTHER 		Shoulder Disarticulation External Power Myo Cont 40 $10,498.41 $51,802.55 $29,500.19 nat. median
$29,500
1.0× median
5272317
OTHER 		Ank-foot Sys Dors-plant Flex 40 $10,140.37 $50,160.95 $29,040.55 nat. median
$29,041
1.0× median
728581
OTHER 		Interscapular-thoracic Ext Power Molded Inner So 40 $9,980.41 $49,427.55 $28,615.95 nat. median
$28,616
1.0× median
728728
OTHER 		L5858 Add To Le Pros Endo Knee-shin Sys Micropro 40 $9,940.00 $49,242.30 $28,508.70 nat. median
$28,509
1.0× median
728580
OTHER 		Intrerscapular-thoracic Ext Power Molded Inner S 40 $8,979.63 $44,839.05 $25,959.45 nat. median
$25,959
1.0× median
6445587
OTHER 		Revise/Remove Imp Spinal Neurostim Gen W/detach El 38 $13,051.62 $57,677.86 $25,120.86 nat. median
$25,121
1.0× median
728579
OTHER 		Shoulder Disarticulation External Power Switch C 40 $8,642.93 $43,295.30 $24,655.53 nat. median
$24,656
1.0× median
6577830
OTHER 		Addition To Le Pros Endo Knee-shin Sys Powered 40 $8,186.47 $41,202.45 $23,854.05 nat. median
$23,854
1.0× median
4526304
OTHER 		Imrt Planning Nmh 15 $13,585.00 $24,453.00 $21,464.30 nat. median
$21,464
1.0× median
728497
OTHER 		Electronic Elbow Child Variety Village Or Equal 40 $7,272.51 $37,012.00 $21,428.00 nat. median
$21,428
1.0× median
728577
OTHER 		Above Elbow External Power Switch Control 40 $7,018.90 $35,849.20 $20,754.80 nat. median
$20,755
1.0× median
7781366
OTHER 		Addition Le Ext Osseointegrated Connector 40 $6,399.79 $33,010.60 $19,285.14 nat. median
$19,285
1.0× median
728576
OTHER 		Above Elbow External Power Myo Control 40 $6,531.98 $33,616.70 $19,143.82 nat. median
$1
outlier · 16574.7×
7801410
OTHER 		50242-0137-01 - Tocilizumab 20 mg/mL Soln 20 $1,500.00 $25,513.83 $18,866.06 nat. median
$18,866
1.0× median
728574
OTHER 		Elbow Disartic External Power Myo Control 40 $6,266.76 $32,400.70 $18,758.30 nat. median
$18,758
1.0× median
6781389
OTHER 		Insert/rplcmt Periphl/sacral/gast Neurostim Gen With 38 $9,544.59 $57,677.86 $18,370.77 nat. median
$18,371
1.0× median
728499
OTHER 		Electronic Elbow Child Variety Village Or Equal 40 $6,066.19 $31,481.10 $18,225.90 nat. median
$18,226
1.0× median
728573
OTHER 		Be Ext Power Self-susp Inner Socket Remov Shell 40 $6,029.31 $31,312.00 $17,831.36 nat. median
$17,831
1.0× median
728575
OTHER 		Elbow Disartic External Power Switch Control 40 $5,534.10 $29,041.50 $16,813.50 nat. median
$16,814
1.0× median
7824292
OTHER 		Graft EpiEffect 7cm X 7cm 34 $6,429.95 $37,553.70 $16,657.74 nat. median
$16,658
1.0× median
6297612
OTHER 		00944-2700-07 - Immune Globulin Intravenous And Su 20 $2,586.00 $20,550.15 $15,195.69 nat. median
$15,196
1.0× median
728571
OTHER 		Wrist Disartic Ext Power Self-susp Inner Socket 40 $4,640.24 $24,943.20 $14,440.80 nat. median
$14,441
1.0× median
728489
OTHER 		All Le Prosthesis Shank Foot System With Vertical 40 $4,997.87 $26,582.90 $14,410.73 nat. median
$14,411
1.0× median
728498
OTHER 		Electronic Elbow Adolescent Variety Village Or E 40 $4,351.82 $23,620.80 $13,675.20 nat. median
$13,675
1.0× median
728727
OTHER 		Addition To Le Pros Endo Knee-shin Sys Microproc 40 $4,327.37 $23,508.70 $13,610.30 nat. median
$13,610
1.0× median
728569
OTHER 		Wrist Disartic Ext Power Self-susp Inner Socket 40 $4,292.98 $23,351.00 $13,519.00 nat. median
$13,519
1.0× median
5272315
OTHER 		Endo Poly Hip Pneu/hyd/rot 40 $4,286.35 $23,320.60 $13,501.40 nat. median
$13,501
1.0× median
4277297
OTHER 		Implant Neuroelectrodes Epidural (63650) 38 $6,720.15 $20,160.90 $13,313.19 nat. median
$13,313
1.0× median
728572
OTHER 		Be Ext Power Self-susp Inner Socket Remov Shell 40 $4,105.67 $22,492.20 $13,021.80 nat. median
$13,022
1.0× median
1517297
OTHER 		00186-0372-20 - Budesonide 80 Mcg/fomoterol Fumara 15 $8,176.72 $14,718.11 $12,919.23 nat. median
$12,919
1.0× median
6724732
OTHER 		Implant Neuroelectrodes Peripheral Nrv (64555) 38 $6,720.15 $17,964.86 $12,832.08 nat. median
$12,832
1.0× median
7793332
OTHER 		Insert/replace Perq Electrode Array Pn W/intgd Neu 37 $10,952.15 $22,375.35 $12,832.08 nat. median
$5,388
outlier · 2.4×
728241
OTHER 		Knee-ankle-foot Orthosis Single Or Double Upright 40 $3,796.00 $21,564.05 $12,484.45 nat. median
$12,484
1.0× median
7852514
OTHER 		Addition Endo Knee-shin System Electromechanical S 40 $3,528.20 $19,844.55 $11,593.40 nat. median
$11,593
1.0× median
7824286
OTHER 		Graft EpiFix 7cm X 7cm 34 $6,429.95 $26,962.68 $11,353.75 nat. median
$11,354
1.0× median
728894
OTHER 		Electric Hand Switch Or Myo Pediatric 40 $3,415.90 $19,329.65 $11,190.85 nat. median
$11,191
1.0× median
6759209
OTHER 		68982-0850-05 - Immune Globulin Intravenous 10 So 20 $2,376.00 $14,209.20 $10,550.81 nat. median
$10,551
1.0× median
5706340
OTHER 		Ir Cva Port Place Nmh 15 $6,566.50 $11,819.70 $10,375.07 nat. median
$10,375
1.0× median

Other procedures at this hospital

Browse this hospital's 9,594 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
809881 OTHER 00173-0696-00 - Fluticasone-salmeterol 250 Mcg-50 32 15 $120,654.25 $72,392.55 40% off $60,327.12 $108,588.82 $95,316.86 2026-05-22
728495 OTHER Electronic Elbow Microproc Simultaneous Control O 88 40 $127,351.00 $76,410.60 40% off $25,587.13 $120,983.45 $68,896.89 2026-05-22
6664211 OTHER Powered Ue Orthosis Elbow Wrist Hand Finger Cust 96 40 $106,169.00 $63,701.40 40% off $21,198.22 $100,860.55 $67,700.88 2026-05-22
6680449 OTHER L2006 Kafo Microprocessor Swing And/or Stance 80 34 $107,464.00 $64,478.40 40% off $21,466.54 $102,090.80 $65,284.38 2026-05-22
728494 OTHER Electronic Elbow Microproc Sequential Control Of 96 40 $115,320.00 $69,192.00 40% off $23,094.30 $109,554.00 $63,426.00 2026-05-22
6060818 OTHER L6880 Elec Hand Ind Art Digits 96 40 $86,957.00 $52,174.20 40% off $17,217.49 $82,609.15 $47,826.35 2026-05-22
728726 OTHER Addition To Le Pros Endo Knee-shin Sys Microproc 96 40 $86,237.00 $51,742.20 40% off $17,068.31 $81,925.15 $47,430.35 2026-05-22
6112049 OTHER Gk Delivery Complex Nmh 32 15 $53,098.00 $31,858.80 40% off $26,549.00 $47,788.20 $41,947.42 2026-05-22
1309227 OTHER 59627-0002-05 - Interferon Beta-1a 30 Mcg/0.5 Ml K 32 15 $50,688.45 $30,413.07 40% off $25,344.22 $45,619.60 $40,043.88 2026-05-22
6664210 OTHER Powered Ue Orthosis Elbow Wrist Hand Custom 96 40 $55,720.00 $33,432.00 40% off $10,745.18 $52,934.00 $34,410.61 2026-05-22
7852522 OTHER Addition Ue Pattern Recognition System 96 40 $56,084.00 $33,650.40 40% off $10,820.60 $53,279.80 $31,126.62 2026-05-22
6369615 OTHER Ak/ft Power Asst Incl Motors (l5969) 80 34 $48,742.00 $29,245.20 40% off $9,299.34 $46,304.90 $29,610.76 2026-05-22
728578 OTHER Shoulder Disarticulation External Power Myo Cont 88 40 $54,529.00 $32,717.40 40% off $10,498.41 $51,802.55 $29,500.19 2026-05-22
5272317 OTHER Ank-foot Sys Dors-plant Flex 96 40 $52,801.00 $31,680.60 40% off $10,140.37 $50,160.95 $29,040.55 2026-05-22
728581 OTHER Interscapular-thoracic Ext Power Molded Inner So 96 40 $52,029.00 $31,217.40 40% off $9,980.41 $49,427.55 $28,615.95 2026-05-22
728728 OTHER L5858 Add To Le Pros Endo Knee-shin Sys Micropro 96 40 $51,834.00 $31,100.40 40% off $9,940.00 $49,242.30 $28,508.70 2026-05-22
728580 OTHER Intrerscapular-thoracic Ext Power Molded Inner S 96 40 $47,199.00 $28,319.40 40% off $8,979.63 $44,839.05 $25,959.45 2026-05-22
6445587 OTHER Revise/Remove Imp Spinal Neurostim Gen W/detach El 84 38 $28,068.00 $16,840.80 40% off $13,051.62 $57,677.86 $25,120.86 2026-05-22
728579 OTHER Shoulder Disarticulation External Power Switch C 88 40 $45,574.00 $27,344.40 40% off $8,642.93 $43,295.30 $24,655.53 2026-05-22
6577830 OTHER Addition To Le Pros Endo Knee-shin Sys Powered 96 40 $43,371.00 $26,022.60 40% off $8,186.47 $41,202.45 $23,854.05 2026-05-22
4526304 OTHER Imrt Planning Nmh 32 15 $27,170.00 $16,302.00 40% off $13,585.00 $24,453.00 $21,464.30 2026-05-22
728497 OTHER Electronic Elbow Child Variety Village Or Equal 96 40 $38,960.00 $23,376.00 40% off $7,272.51 $37,012.00 $21,428.00 2026-05-22
728577 OTHER Above Elbow External Power Switch Control 96 40 $37,736.00 $22,641.60 40% off $7,018.90 $35,849.20 $20,754.80 2026-05-22
7781366 OTHER Addition Le Ext Osseointegrated Connector 96 40 $34,748.00 $20,848.80 40% off $6,399.79 $33,010.60 $19,285.14 2026-05-22
728576 OTHER Above Elbow External Power Myo Control 88 40 $35,386.00 $21,231.60 40% off $6,531.98 $33,616.70 $19,143.82 2026-05-22
7801410 OTHER 50242-0137-01 - Tocilizumab 20 mg/mL Soln 44 20 $28,348.70 $17,009.22 40% off $1,500.00 $25,513.83 $18,866.06 2026-05-22
728574 OTHER Elbow Disartic External Power Myo Control 96 40 $34,106.00 $20,463.60 40% off $6,266.76 $32,400.70 $18,758.30 2026-05-22
6781389 OTHER Insert/rplcmt Periphl/sacral/gast Neurostim Gen With 84 38 $20,526.00 $12,315.60 40% off $9,544.59 $57,677.86 $18,370.77 2026-05-22
728499 OTHER Electronic Elbow Child Variety Village Or Equal 96 40 $33,138.00 $19,882.80 40% off $6,066.19 $31,481.10 $18,225.90 2026-05-22
728573 OTHER Be Ext Power Self-susp Inner Socket Remov Shell 88 40 $32,960.00 $19,776.00 40% off $6,029.31 $31,312.00 $17,831.36 2026-05-22
728575 OTHER Elbow Disartic External Power Switch Control 96 40 $30,570.00 $18,342.00 40% off $5,534.10 $29,041.50 $16,813.50 2026-05-22
7824292 OTHER Graft EpiEffect 7cm X 7cm 76 34 $29,327.00 $17,596.20 40% off $6,429.95 $37,553.70 $16,657.74 2026-05-22
6297612 OTHER 00944-2700-07 - Immune Globulin Intravenous And Su 44 20 $22,833.50 $13,700.10 40% off $2,586.00 $20,550.15 $15,195.69 2026-05-22
728571 OTHER Wrist Disartic Ext Power Self-susp Inner Socket 96 40 $26,256.00 $15,753.60 40% off $4,640.24 $24,943.20 $14,440.80 2026-05-22
728489 OTHER All Le Prosthesis Shank Foot System With Vertical 88 40 $27,982.00 $16,789.20 40% off $4,997.87 $26,582.90 $14,410.73 2026-05-22
728498 OTHER Electronic Elbow Adolescent Variety Village Or E 96 40 $24,864.00 $14,918.40 40% off $4,351.82 $23,620.80 $13,675.20 2026-05-22
728727 OTHER Addition To Le Pros Endo Knee-shin Sys Microproc 96 40 $24,746.00 $14,847.60 40% off $4,327.37 $23,508.70 $13,610.30 2026-05-22
728569 OTHER Wrist Disartic Ext Power Self-susp Inner Socket 96 40 $24,580.00 $14,748.00 40% off $4,292.98 $23,351.00 $13,519.00 2026-05-22
5272315 OTHER Endo Poly Hip Pneu/hyd/rot 96 40 $24,548.00 $14,728.80 40% off $4,286.35 $23,320.60 $13,501.40 2026-05-22
4277297 OTHER Implant Neuroelectrodes Epidural (63650) 84 38 $21,222.00 $12,733.20 40% off $6,720.15 $20,160.90 $13,313.19 2026-05-22
728572 OTHER Be Ext Power Self-susp Inner Socket Remov Shell 96 40 $23,676.00 $14,205.60 40% off $4,105.67 $22,492.20 $13,021.80 2026-05-22
1517297 OTHER 00186-0372-20 - Budesonide 80 Mcg/fomoterol Fumara 32 15 $16,353.45 $9,812.07 40% off $8,176.72 $14,718.11 $12,919.23 2026-05-22
6724732 OTHER Implant Neuroelectrodes Peripheral Nrv (64555) 84 38 $18,494.00 $11,096.40 40% off $6,720.15 $17,964.86 $12,832.08 2026-05-22
7793332 OTHER Insert/replace Perq Electrode Array Pn W/intgd Neu 82 37 $23,553.00 $14,131.80 40% off $10,952.15 $22,375.35 $12,832.08 2026-05-22
728241 OTHER Knee-ankle-foot Orthosis Single Or Double Upright 96 40 $22,699.00 $13,619.40 40% off $3,796.00 $21,564.05 $12,484.45 2026-05-22
7852514 OTHER Addition Endo Knee-shin System Electromechanical S 96 40 $20,889.00 $12,533.40 40% off $3,528.20 $19,844.55 $11,593.40 2026-05-22
7824286 OTHER Graft EpiFix 7cm X 7cm 76 34 $19,989.00 $11,993.40 40% off $6,429.95 $26,962.68 $11,353.75 2026-05-22
728894 OTHER Electric Hand Switch Or Myo Pediatric 96 40 $20,347.00 $12,208.20 40% off $3,415.90 $19,329.65 $11,190.85 2026-05-22
6759209 OTHER 68982-0850-05 - Immune Globulin Intravenous 10 So 44 20 $15,788.00 $9,472.80 40% off $2,376.00 $14,209.20 $10,550.81 2026-05-22
5706340 OTHER Ir Cva Port Place Nmh 32 15 $13,133.00 $7,879.80 40% off $6,566.50 $11,819.70 $10,375.07 2026-05-22
728520 OTHER Hip Disart Canadian Type Molded Socket Endo Sys 96 40 $18,799.00 $11,279.40 40% off $3,095.15 $17,859.05 $10,339.45 2026-05-22
6781392 OTHER Sprint Pns Dual Lead C1778 70 33 $17,899.00 $10,739.40 40% off $2,908.67 $17,004.05 $10,309.82 2026-05-22
728496 OTHER Electronic Elbow Adolescent Variety Village Or E 96 40 $18,743.00 $11,245.80 40% off $3,083.55 $17,805.85 $10,308.65 2026-05-22
728535 OTHER Prep Hip Disartic Or Hemipel Pylon No Cover Sa 96 40 $18,734.00 $11,240.40 40% off $3,081.68 $17,797.30 $10,303.70 2026-05-22
6385588 OTHER Ins Endvas Venacavafiltr Nmh 32 15 $12,827.00 $7,696.20 40% off $6,413.50 $11,544.30 $10,133.33 2026-05-22
7795336 OTHER Ak 4 Bar Fluid Swing/stance 88 40 $18,377.00 $11,026.20 40% off $3,007.71 $17,458.15 $10,107.35 2026-05-22
728493 OTHER Electronic Elbow Hosmer Or Equal Switch Controll 96 40 $17,824.00 $10,694.40 40% off $2,893.13 $16,932.80 $9,803.20 2026-05-22
6591730 OTHER 55513-0221-01 - romiPLOStim 250 Mcg Rec I 32 15 $12,383.20 $7,429.92 40% off $6,191.60 $11,144.88 $9,782.73 2026-05-22
6297613 OTHER 00944-2700-06 - Immune Globulin Intravenous And Su 44 20 $14,358.00 $8,614.80 40% off $1,724.00 $12,922.20 $9,555.25 2026-05-22
728518 OTHER Hip Disartic Tilt Table Type Molded Socket Lock 96 40 $17,258.00 $10,354.80 40% off $2,775.86 $16,395.10 $9,491.90 2026-05-22
728515 OTHER Above Knee For Proximal Femoral Focal Deficiency 96 40 $17,127.00 $10,276.20 40% off $2,748.71 $16,270.65 $9,419.85 2026-05-22
728519 OTHER Hemipelvectomy Canadian Type Molded Socket Hip 96 40 $16,781.00 $10,068.60 40% off $2,677.02 $15,941.95 $9,229.55 2026-05-22
962469 OTHER L7499 - Ue Prosthesis Not Otherwise Specified 72 34 $15,616.52 $9,369.91 40% off $2,435.74 $14,835.69 $9,190.33 2026-05-22
7928510 OTHER Prosthetic Thumb Mechanical Initial Or Replaceme 80 34 $15,013.00 $9,007.80 40% off $2,310.69 $14,262.35 $9,120.40 2026-05-22
728534 OTHER Prep Hip Disartic - Hemipel Pylon No Cover Sac 96 40 $16,464.00 $9,878.40 40% off $2,611.34 $15,640.80 $9,055.20 2026-05-22
6821242 OTHER Exchange Nephrostomy Cath Nmh 32 15 $11,383.00 $6,829.80 40% off $5,691.50 $10,244.70 $8,992.57 2026-05-22
728548 OTHER Shoulder Disartic Molded Socket Shoulder Bulkhea 88 40 $16,107.00 $9,664.20 40% off $2,537.37 $15,301.65 $8,713.89 2026-05-22
6601755 OTHER 67457-0675-02 - Calcitonin INJection 200 Unit(s) / 32 15 $10,940.45 $6,564.27 40% off $5,470.22 $9,846.41 $8,642.95 2026-05-22
6805246 OTHER 59676-0820-01 - Hyaluronan 88 Mg/4 Ml Soln 84 38 $15,939.80 $9,563.88 40% off $564.77 $15,142.81 $8,631.40 2026-05-22
728886 OTHER Automatic Grasp Feature Addition To Upper-limb Pr 88 40 $15,904.00 $9,542.40 40% off $2,495.31 $15,108.80 $8,604.07 2026-05-22
728521 OTHER Hemipel Canadian Type Molded Socket Endo System 96 40 $15,514.00 $9,308.40 40% off $2,414.50 $14,738.30 $8,532.70 2026-05-22
728517 OTHER Hip Disartic Canadian Type Molded Socket Hip Jt 96 40 $15,490.00 $9,294.00 40% off $2,409.53 $14,715.50 $8,519.50 2026-05-22
728841 OTHER Addition Vacuum Pump Residual Limb Volume Manage 96 40 $15,151.00 $9,090.60 40% off $2,339.29 $14,393.45 $8,333.05 2026-05-22
728840 OTHER Addition Vacuum Pump Residual Limb Volume Manage 96 40 $15,111.00 $9,066.60 40% off $2,331.00 $14,355.45 $8,311.05 2026-05-22
6538052 OTHER Part Hand Myo Exclu Term Dev (l6026) 88 40 $14,710.00 $8,826.00 40% off $2,247.91 $13,974.50 $8,090.50 2026-05-22
6012897 OTHER Rem Endvas Venacava Filter Nmh 32 15 $10,164.00 $6,098.40 40% off $5,082.00 $9,147.60 $8,029.56 2026-05-22
5836305 OTHER CT Ab/pelvis Wwo Contrast Nmh 32 15 $10,151.00 $6,090.60 40% off $5,075.50 $9,135.90 $8,019.29 2026-05-22
728713 OTHER Addition Endo Knee-shin Sys Polycentric Hydraul 96 40 $14,452.00 $8,671.20 40% off $2,194.45 $13,729.40 $7,948.60 2026-05-22
7928509 OTHER Single Prosthetic Digit Mechanical Initial Or Re 80 34 $13,022.00 $7,813.20 40% off $1,898.16 $12,370.90 $7,910.86 2026-05-22
728654 OTHER All Le Prostheses Flex-foot System 96 40 $14,346.00 $8,607.60 40% off $2,172.49 $13,628.70 $7,890.30 2026-05-22
728558 OTHER L6570 Shoulder Disartic Molded Socket Endo Sys 96 40 $14,223.00 $8,533.80 40% off $2,147.01 $13,511.85 $7,822.65 2026-05-22
6391586 OTHER Knee Disart Sach Ft Endo (l5312) 96 40 $14,040.00 $8,424.00 40% off $2,109.09 $13,338.00 $7,722.00 2026-05-22
728721 OTHER Addition Endo Knee-shin Sys 4-bar Linkage Or Mul 96 40 $14,010.00 $8,406.00 40% off $2,102.87 $13,309.50 $7,705.50 2026-05-22
728509 OTHER Knee Disartic (or Through Knee) Molded Socket Ex 96 40 $14,006.00 $8,403.60 40% off $2,102.04 $13,305.70 $7,703.30 2026-05-22
728617 OTHER Replacement Socket Hip Disartic Incl Hip Joint 96 40 $13,933.00 $8,359.80 40% off $2,086.92 $13,236.35 $7,663.15 2026-05-22
7793331 OTHER Insert/replace Perq Electrode Array Pn W/intgd Neu 66 31 $11,776.00 $7,065.60 40% off $5,475.84 $12,832.08 $7,654.40 2026-05-22
6581094 OTHER CT Abdomen/Pelvis With Without Contrast 32 15 $9,665.00 $5,799.00 40% off $4,832.50 $8,698.50 $7,635.35 2026-05-22
4277299 OTHER Revj/rmvl Implnt Spinal Neurostim Gen W/detach Cnn 82 37 $14,324.00 $8,594.40 40% off $3,686.55 $13,607.80 $7,620.37 2026-05-22
728507 OTHER Below Knee Plastic Socket Joints And Thigh Lacer 96 40 $13,831.00 $8,298.60 40% off $2,065.78 $13,139.45 $7,607.05 2026-05-22
728551 OTHER Interscapular Thoracic Molded Socket Shoulder Bu 96 40 $13,810.00 $8,286.00 40% off $2,061.43 $13,119.50 $7,595.50 2026-05-22
6521605 OTHER Electronic Wrist Rotator Any 88 40 $13,701.00 $8,220.60 40% off $2,038.85 $13,015.95 $7,535.55 2026-05-22
728616 OTHER Replacement Socket AK/knee Disartic Incl Attach 96 40 $13,670.00 $8,202.00 40% off $2,032.42 $12,986.50 $7,518.50 2026-05-22
728890 OTHER Electric Hand Switch Or Myo Adult 88 40 $13,857.00 $8,314.20 40% off $2,071.17 $13,164.15 $7,496.64 2026-05-22
728895 OTHER Electric Hook Switch Or Myo Adult 96 40 $13,558.00 $8,134.80 40% off $2,009.22 $12,880.10 $7,456.90 2026-05-22
6623718 OTHER 00003-0371-13 - Belatacept 250 Mg Rec I 32 15 $9,218.20 $5,530.92 40% off $4,609.10 $8,296.38 $7,282.38 2026-05-22
728512 OTHER Above Knee Molded Socket Single Axis Constant Fr 96 40 $13,058.00 $7,834.80 40% off $1,905.62 $12,405.10 $7,181.90 2026-05-22
728510 OTHER Knee Disarticulation Molded Socket Bent Knee Con 96 40 $13,017.00 $7,810.20 40% off $1,897.12 $12,366.15 $7,159.35 2026-05-22
728557 OTHER Shoulder Disartic Molded Socket Endo Sys Incl S 96 40 $12,979.00 $7,787.40 40% off $1,889.25 $12,330.05 $7,138.45 2026-05-22
728655 OTHER All Le Prostheses Flex-walk System Or Equal 96 40 $12,888.00 $7,732.80 40% off $1,870.39 $12,243.60 $7,088.40 2026-05-22
728516 OTHER Above Knee Molded Socket Open End Sach Foot En 96 40 $12,838.00 $7,702.80 40% off $1,860.03 $12,196.10 $7,060.90 2026-05-22
6759211 OTHER 68982-0850-04 - Immune Globulin Intravenous 10 So 44 20 $10,552.00 $6,331.20 40% off $1,584.00 $9,496.80 $7,042.94 2026-05-22
6797241 OTHER Cath Exchange Central Tunneled Nmh 32 15 $8,903.00 $5,341.80 40% off $4,451.50 $8,012.70 $7,033.37 2026-05-22
7824301 OTHER Graft MirraSurg 10 Cm X 10 Cm 88 34 $9,660.00 $5,796.00 40% off $4,491.90 $39,344.76 $7,003.50 2026-05-22
728556 OTHER Ae Molded Socket Endo Sys Incl Soft Prosthetic 96 40 $12,671.00 $7,602.60 40% off $1,825.43 $12,037.45 $6,969.05 2026-05-22
728546 OTHER Elbow Disartic Molded Socket With Expandable Inte 96 40 $12,630.00 $7,578.00 40% off $1,816.94 $11,998.50 $6,946.50 2026-05-22
5218303 OTHER CT Abdomen Pelvis W/Contrast Nmh 32 15 $8,642.00 $5,185.20 40% off $4,321.00 $7,777.80 $6,827.18 2026-05-22
7824285 OTHER Graft EpiFix 5cm X 6cm 76 34 $11,946.00 $7,167.60 40% off $3,936.70 $16,507.76 $6,785.33 2026-05-22
6581093 OTHER CT Abdomen/Pelvis With Contrast 32 15 $8,553.00 $5,131.80 40% off $4,276.50 $7,697.70 $6,756.87 2026-05-22
728730 OTHER Addition Endo Sys High Activity Knee Control Fra 96 40 $12,094.00 $7,256.40 40% off $1,705.88 $11,489.30 $6,651.70 2026-05-22
6581280 OTHER MRI Orbits W Without Contrast 32 15 $8,384.00 $5,030.40 40% off $4,192.00 $7,545.60 $6,623.36 2026-05-22
6781393 OTHER Sprint Pns Single Lead C1778 70 33 $11,359.00 $6,815.40 40% off $1,553.58 $10,791.05 $6,542.78 2026-05-22
728552 OTHER Interscapular Thoracic Passive Restoration (compl 96 40 $11,817.00 $7,090.20 40% off $1,648.48 $11,226.15 $6,499.35 2026-05-22
728785 OTHER Ue Addition Shoulder Lock Mechanism External Pow 88 40 $11,918.00 $7,150.80 40% off $1,669.41 $11,322.10 $6,447.64 2026-05-22
983249 OTHER MRA Head W Without Contrast Nmh 32 15 $8,158.00 $4,894.80 40% off $4,079.00 $7,342.20 $6,444.82 2026-05-22
728615 OTHER Replacement Socket Bk Molded To Patient Model 96 40 $11,586.00 $6,951.60 40% off $1,600.62 $11,006.70 $6,372.30 2026-05-22
6581095 OTHER CT Abdomen/Pelvis Without Contrast 32 15 $8,018.00 $4,810.80 40% off $4,009.00 $7,216.20 $6,334.22 2026-05-22
728540 OTHER Wrist Disarticulation Molded Socket Flexible Elb 96 40 $11,505.00 $6,903.00 40% off $1,583.84 $10,929.75 $6,327.75 2026-05-22
728014 OTHER Lower Extremity Addition Pelvic Control Reciproc 96 40 $11,494.00 $6,896.40 40% off $1,581.56 $10,919.30 $6,321.70 2026-05-22
6581097 OTHER CT Angiography Abd/Pel With Without Contrast 32 15 $7,995.00 $4,797.00 40% off $3,997.50 $7,195.50 $6,316.05 2026-05-22
728783 OTHER Ue Addition Shoulder Jt Multipositional Lock Fl 88 40 $11,672.00 $7,003.20 40% off $1,618.44 $11,088.40 $6,314.55 2026-05-22
728547 OTHER Ae Molded Double Wall Socket Internal Locking El 88 40 $11,669.00 $7,001.40 40% off $1,617.82 $11,085.55 $6,312.93 2026-05-22
7395320 OTHER 23155-0216-31 - Cidofovir 75 mg/mL Soln 32 15 $7,938.80 $4,763.28 40% off $3,969.40 $7,144.92 $6,271.65 2026-05-22
728334 OTHER Thoracic-lumbar-sacral Orthosis 2-piece Rigid She 96 40 $11,339.00 $6,803.40 40% off $1,549.44 $10,772.05 $6,236.45 2026-05-22
728549 OTHER Shoulder Disartic Passive Restoration (complete P 96 40 $11,256.00 $6,753.60 40% off $1,532.24 $10,693.20 $6,190.80 2026-05-22
1083375 OTHER L6885 Replacement Socketshoulder Disarticulation/ 96 40 $11,217.00 $6,730.20 40% off $1,524.16 $10,656.15 $6,169.35 2026-05-22
6513744 OTHER CT Angiography Abdomen/pelvis Nmh (74174 32 15 $7,743.00 $4,645.80 40% off $3,871.50 $6,968.70 $6,116.97 2026-05-22
983254 OTHER Mr Brain W Without Contrast Nmh 32 15 $7,693.00 $4,615.80 40% off $3,846.50 $6,923.70 $6,077.47 2026-05-22
7852518 OTHER Replacement Socket Partial Hand 72 34 $10,300.00 $6,180.00 40% off $1,334.16 $9,785.00 $6,061.55 2026-05-22
2995297 OTHER Upper Extremity Addition Flexion/extension And Ro 88 40 $11,160.00 $6,696.00 40% off $1,512.35 $10,602.00 $6,037.56 2026-05-22
728887 OTHER Microproc Control Feature Addtion To Upper-limb P 88 40 $11,140.00 $6,684.00 40% off $1,508.21 $10,583.00 $6,026.74 2026-05-22
728245 OTHER L2034 Knee-ankle-foot Orthosis Full Plastic Sing 96 40 $10,925.00 $6,555.00 40% off $1,463.66 $10,378.75 $6,008.75 2026-05-22
728394 OTHER Wrist-hand-finger Orthosis Electric External Pow 96 40 $10,811.00 $6,486.60 40% off $1,440.04 $10,270.45 $5,946.05 2026-05-22
728492 OTHER Ue Addition External Locking Elbow Forearm Count 88 40 $10,934.00 $6,560.40 40% off $1,465.52 $10,387.30 $5,915.30 2026-05-22
983105 OTHER Therapeutic Radiology 3d Nmh 32 15 $7,417.00 $4,450.20 40% off $3,708.50 $6,675.30 $5,859.43 2026-05-22
728719 OTHER Addition Endo Knee-shin Sys Single Axis Fluid S 96 40 $10,587.00 $6,352.20 40% off $1,393.63 $10,057.65 $5,822.85 2026-05-22
728484 OTHER All Le Prosthesis Ankle Multiaxial Shock Absorbi 96 40 $10,559.00 $6,335.40 40% off $1,387.82 $10,031.05 $5,807.45 2026-05-22
983178 OTHER Mr Cervical Spine W Without Contrast Nmh 32 15 $7,347.00 $4,408.20 40% off $3,673.50 $6,612.30 $5,804.13 2026-05-22
728533 OTHER Prep Ak Or Knee Disartic Ischial Level Socket N 96 40 $10,533.00 $6,319.80 40% off $1,382.44 $10,006.35 $5,793.15 2026-05-22
1083265 OTHER L6883 Replacement Socketbelow Elbow/wrist Disarti 88 40 $10,705.00 $6,423.00 40% off $1,418.08 $10,169.75 $5,791.41 2026-05-22
7824253 OTHER Theraskin 7.6cm X 15.24cm 76 34 $7,550.00 $4,530.00 40% off $3,016.00 $22,273.16 $5,775.75 2026-05-22
7781365 OTHER Hip Orthosis Bilat Hip Abduction Adjust Flexion Ex 96 40 $10,382.00 $6,229.20 40% off $1,351.15 $9,862.90 $5,762.01 2026-05-22
983247 OTHER MRI Face/Neck W Without Contrast Nmh 32 15 $7,265.00 $4,359.00 40% off $3,632.50 $6,538.50 $5,739.35 2026-05-22
728372 OTHER Hip Orthosis Adduction Control 96 40 $10,402.00 $6,241.20 40% off $1,355.29 $9,881.90 $5,721.10 2026-05-22
6307582 OTHER Skn Splt A-grft Fac/nck/hf/g 100 Sq Cm/1 Ba (1512 84 38 $9,116.00 $5,469.60 40% off $3,736.76 $8,660.20 $5,702.06 2026-05-22
728513 OTHER Above Knee Short Prosthesis No Knee Joint (""stub 96 40 $10,367.00 $6,220.20 40% off $1,348.04 $9,848.65 $5,701.85 2026-05-22
728247 OTHER Knee-ankle-foot Orthosis Double Upright Free Kne 96 40 $10,270.00 $6,162.00 40% off $1,327.94 $9,756.50 $5,648.50 2026-05-22
728503 OTHER Ankle Symes Molded Socket Sach Foot 96 40 $10,236.00 $6,141.60 40% off $1,320.90 $9,724.20 $5,629.80 2026-05-22
981143 OTHER Polysomnogram With Cpap Nmh 32 15 $7,113.00 $4,267.80 40% off $3,556.50 $6,401.70 $5,619.27 2026-05-22
728531 OTHER L5580 Prep Ak Or Knee Disartic Ischial Level Soc 96 40 $10,195.00 $6,117.00 40% off $1,312.40 $9,685.25 $5,607.25 2026-05-22
728333 OTHER Thoracic-lumbar-sacral Orthosis 2-piece Rigid She 96 40 $10,095.00 $6,057.00 40% off $1,291.68 $9,590.25 $5,552.25 2026-05-22
6521606 OTHER Term Device Multi Art Digit 88 40 $10,249.00 $6,149.40 40% off $1,323.59 $9,736.55 $5,544.71 2026-05-22
728563 OTHER Prep Shoulder Disartic Or Interscapular Thoracic 96 40 $10,039.00 $6,023.40 40% off $1,280.08 $9,537.05 $5,521.45 2026-05-22
728555 OTHER Elbow Disartic Molded Socket Endo Sys Incl Soft 96 40 $10,021.00 $6,012.60 40% off $1,276.35 $9,519.95 $5,511.55 2026-05-22
7928508 OTHER Partial Hand Transmetacarpal Incl Flex Or Non-fl 80 34 $9,064.00 $5,438.40 40% off $1,078.06 $8,610.80 $5,506.38 2026-05-22
6512985 OTHER Pln Iso Complex W/calc Nmh (77307) 32 15 $6,949.00 $4,169.40 40% off $3,474.50 $6,254.10 $5,489.71 2026-05-22
728554 OTHER Be Molded Socket Endo Sys Incl Soft Prosthetic 96 40 $9,968.00 $5,980.80 40% off $1,265.37 $9,469.60 $5,482.40 2026-05-22
6680454 OTHER Destruction Neurolytic Agt Genicular Nerve W/img B 82 37 $10,282.00 $6,169.20 40% off $2,059.10 $9,767.90 $5,470.02 2026-05-22
728506 OTHER Below Knee Molded Socket Shin Sach Foot (exo) 96 40 $9,891.00 $5,934.60 40% off $1,249.42 $9,396.45 $5,440.05 2026-05-22
960473 OTHER L5999 - Lower Extremity Prosthesis Not Otherwise 80 34 $8,953.48 $5,372.09 40% off $1,055.16 $8,505.81 $5,439.24 2026-05-22
5176304 OTHER CT Ab/pelvis Wo Contras Nmh 32 15 $6,860.00 $4,116.00 40% off $3,430.00 $6,174.00 $5,419.40 2026-05-22
983189 OTHER MRI Pelvis W Without Contrast Nmh 32 15 $6,808.00 $4,084.80 40% off $3,404.00 $6,127.20 $5,378.32 2026-05-22
6821263 OTHER Stress Tte Complete W Contrast Nmh 32 15 $6,800.00 $4,080.00 40% off $3,400.00 $6,120.00 $5,372.00 2026-05-22
7852515 OTHER Partial Hand Molded Socket Flexible Or Non-flexibl 72 34 $9,064.00 $5,438.40 40% off $1,078.06 $8,610.80 $5,334.16 2026-05-22
983180 OTHER MRI Tl Spine W Without Contrast Nmh 32 15 $6,724.00 $4,034.40 40% off $3,362.00 $6,051.60 $5,311.96 2026-05-22
4650303 OTHER E0770 Fes Complete System Nos 70 27 $8,161.00 $4,896.60 40% off $3,794.87 $7,752.95 $5,304.65 2026-05-22
983179 OTHER MRI Thoracic Spine W Without Contrast Nmh 32 15 $6,709.00 $4,025.40 40% off $3,354.50 $6,038.10 $5,300.11 2026-05-22
728508 OTHER Below Knee Molded Socket Shin Sach Foot Endosk 96 40 $9,624.00 $5,774.40 40% off $1,194.09 $9,142.80 $5,293.20 2026-05-22
7785370 OTHER MRI Neurography Lumb W Without Cont-72197 32 15 $6,676.00 $4,005.60 40% off $3,338.00 $6,008.40 $5,274.04 2026-05-22
6797262 OTHER Insert Tunnel Cv Cath Nmh 32 15 $6,610.00 $3,966.00 40% off $3,305.00 $5,949.00 $5,221.90 2026-05-22
728542 OTHER Be Molded Socket (Muenster Or Northwestern Suspen 88 40 $9,651.00 $5,790.60 40% off $1,199.69 $9,168.45 $5,221.19 2026-05-22
728653 OTHER All Le Prostheses Multi-axial Ankle/foot Dynamic 96 40 $9,419.00 $5,651.40 40% off $1,151.62 $8,948.05 $5,180.45 2026-05-22
2347298 OTHER 49884-0868-02 - Dronabinol 5 Mg Cap 32 15 $6,532.80 $3,919.68 40% off $3,266.40 $5,879.52 $5,160.91 2026-05-22
728504 OTHER Ankle Symes Metal Frame Molded Leather Socket 96 40 $9,357.00 $5,614.20 40% off $1,138.77 $8,889.15 $5,146.35 2026-05-22
728332 OTHER Thoracic-lumbar-sacral Orthosis Triplaner Control 96 40 $9,346.00 $5,607.60 40% off $1,136.49 $8,878.70 $5,140.30 2026-05-22
7824261 OTHER Graft EpiEffect 3cm X 5cm 76 34 $8,978.00 $5,386.80 40% off $1,968.35 $11,496.03 $5,099.51 2026-05-22
728605 OTHER Addition To Le Ischial Containment/narrow M-l Soc 96 40 $9,258.00 $5,554.80 40% off $1,118.26 $8,795.10 $5,091.90 2026-05-22
6787243 OTHER 00378-8117-45 - Doxepin Topical 5 Cream 32 15 $6,416.20 $3,849.72 40% off $3,208.10 $5,774.58 $5,068.80 2026-05-22
6395663 OTHER Stress Echo-pharm Agent Nmh 32 15 $6,415.00 $3,849.00 40% off $3,207.50 $5,773.50 $5,067.85 2026-05-22
728695 OTHER Addition To Le Endo Sys Ak Or Knee Disartic 4-b 96 40 $9,200.00 $5,520.00 40% off $1,106.24 $8,740.00 $5,060.00 2026-05-22
6581227 OTHER MRI Hip W Without Contrast Lt 32 15 $6,382.00 $3,829.20 40% off $3,191.00 $5,743.80 $5,041.78 2026-05-22
6581247 OTHER MRI Sacrum Coccyx With Contrast 32 15 $6,360.00 $3,816.00 40% off $3,180.00 $5,724.00 $5,024.40 2026-05-22
728532 OTHER Prep Ak Or Knee Disartic Ischial Level Socket N 96 40 $9,125.00 $5,475.00 40% off $1,090.70 $8,668.75 $5,018.75 2026-05-22
728539 OTHER Wrist Disartic Molded Socket Flexible Elbow Hing 96 40 $9,099.00 $5,459.40 40% off $1,085.31 $8,644.05 $5,004.45 2026-05-22
728502 OTHER Partial Foot Molded Socket Tibial Tubercle Heigh 96 40 $9,098.00 $5,458.80 40% off $1,085.11 $8,643.10 $5,003.90 2026-05-22
2353297 OTHER MRI Lower Extemity Jt W Without Contrast Nmh 32 15 $6,327.00 $3,796.20 40% off $3,163.50 $5,694.30 $4,998.33 2026-05-22
728718 OTHER Addition Endo Knee-shin Sys Single Axis Hydraul 96 40 $9,074.00 $5,444.40 40% off $1,080.13 $8,620.30 $4,990.70 2026-05-22
6581195 OTHER MRI Chest W Without Contrast 32 15 $6,308.00 $3,784.80 40% off $3,154.00 $5,677.20 $4,983.32 2026-05-22
6578725 OTHER MRI Pelvis With Contrast 32 15 $6,300.00 $3,780.00 40% off $3,150.00 $5,670.00 $4,977.00 2026-05-22
6581107 OTHER CT L-spine With Without Contrast 32 15 $6,279.00 $3,767.40 40% off $3,139.50 $5,651.10 $4,960.41 2026-05-22
728778 OTHER Ue Addition Electric Lock Feature With Manually Po 88 40 $9,163.00 $5,497.80 40% off $1,098.57 $8,704.85 $4,957.18 2026-05-22
983156 OTHER MRI Abdomen W Without Contrast Nmh 32 15 $6,265.00 $3,759.00 40% off $3,132.50 $5,638.50 $4,949.35 2026-05-22
728545 OTHER Elbow Disartic Molded Socket Outside Locking Hin 88 40 $9,125.00 $5,475.00 40% off $1,090.70 $8,668.75 $4,936.62 2026-05-22
728541 OTHER Be Molded Socket Flexible Elbow Hinges Triceps 88 40 $9,121.00 $5,472.60 40% off $1,089.87 $8,664.95 $4,934.46 2026-05-22
983272 OTHER MRI Chest W Without Contrast Nmh 32 15 $6,246.00 $3,747.60 40% off $3,123.00 $5,621.40 $4,934.34 2026-05-22
983252 OTHER MRA Neck W Without Contrast Nmh 32 15 $6,243.00 $3,745.80 40% off $3,121.50 $5,618.70 $4,931.97 2026-05-22
728544 OTHER L6130 Be Molded Socket (Muenster Or Northwestern 96 40 $8,940.00 $5,364.00 40% off $1,052.37 $8,493.00 $4,917.00 2026-05-22
728896 OTHER Prehensile Actuator Hosmer Or Equal Switch Contr 96 40 $8,927.00 $5,356.20 40% off $1,049.67 $8,480.65 $4,909.85 2026-05-22
983104 OTHER Stimulator Assist Complex Nmh 32 15 $6,211.00 $3,726.60 40% off $3,105.50 $5,589.90 $4,906.69 2026-05-22
728248 OTHER Knee-ankle-foot Orthosis Single Upright Full Pla 96 40 $8,920.00 $5,352.00 40% off $1,048.22 $8,474.00 $4,906.00 2026-05-22
728514 OTHER Above Knee Short Prosthesis No Knee Joint (""stub 96 40 $8,872.00 $5,323.20 40% off $1,038.28 $8,428.40 $4,879.60 2026-05-22
1977300 OTHER CT Angiograph Abdomen Nmh 32 15 $6,161.00 $3,696.60 40% off $3,080.50 $5,544.90 $4,867.19 2026-05-22
7235323 OTHER Thrmbc/nfs Dialysis Circuit S I Nmh 32 15 $6,134.00 $3,680.40 40% off $3,067.00 $5,520.60 $4,845.86 2026-05-22
2009297 OTHER MRI Brain With Contrast Nmh 32 15 $6,130.00 $3,678.00 40% off $3,065.00 $5,517.00 $4,842.70 2026-05-22
4980303 OTHER 00944-2700-05 - Immune Globulin Intravenous 10 So 44 20 $7,219.00 $4,331.40 40% off $862.00 $6,497.10 $4,804.25 2026-05-22
7785379 OTHER MRI Neurography Tib W Without Cont Rt-73720 32 15 $6,080.00 $3,648.00 40% off $3,040.00 $5,472.00 $4,803.20 2026-05-22
7785334 OTHER MRI Neurography Femoral W Without Cont Lt-73720 32 15 $6,080.00 $3,648.00 40% off $3,040.00 $5,472.00 $4,803.20 2026-05-22
728564 OTHER Prep Shoulder Disartic Or Interscapular Thoracic 96 40 $8,691.00 $5,214.60 40% off $1,000.78 $8,256.45 $4,780.05 2026-05-22
6050320 OTHER Comprehensive Computer Based Motion Analysis-5 Cha 92 38 $8,779.00 $5,267.40 40% off $278.20 $8,340.05 $4,753.83 2026-05-22
983176 OTHER Mr Cervical Spine Without Contrast Nmh 32 15 $5,959.00 $3,575.40 40% off $2,979.50 $5,363.10 $4,707.61 2026-05-22
983049 OTHER Percutaneous Placement Gastic Tube Under Fluoro Gu 32 15 $5,946.00 $3,567.60 40% off $2,973.00 $5,351.40 $4,697.34 2026-05-22
4672314 OTHER MRI Brain Functional Md/phd Nmh 32 15 $5,946.00 $3,567.60 40% off $2,973.00 $5,351.40 $4,697.34 2026-05-22
728195 OTHER Cervical Halo Procedure Incorporated Into Milwauk 96 40 $8,488.00 $5,092.80 40% off $958.71 $8,063.60 $4,668.40 2026-05-22
728543 OTHER Be Molded Socket (Muenster Or Northwestern Suspen 96 40 $8,481.00 $5,088.60 40% off $957.26 $8,056.95 $4,664.55 2026-05-22
728231 OTHER Knee Orthosis Single Upright Thigh/Calf Adjustab 96 40 $8,439.00 $5,063.40 40% off $948.56 $8,017.05 $4,641.45 2026-05-22
728015 OTHER Lower Extremity Addition Pelvic Control Reciproc 96 40 $8,425.00 $5,055.00 40% off $945.66 $8,003.75 $4,633.75 2026-05-22
1281227 OTHER Colonoscopy W/bx Nmh 32 15 $5,849.00 $3,509.40 40% off $2,924.50 $5,264.10 $4,620.71 2026-05-22
728331 OTHER Thoracic-lumbar-sacral Orthosis Triplaner Control 96 40 $8,369.00 $5,021.40 40% off $934.06 $7,950.55 $4,602.95 2026-05-22
6050319 OTHER Comprehensive Computer Based Motion Analysis-4 Cha 92 38 $8,493.00 $5,095.80 40% off $278.20 $8,068.35 $4,598.96 2026-05-22
6311583 OTHER Skin Splt Grft Trnk/arm/leg 100 Sq Cm/1 Ba (15100 96 38 $7,333.00 $4,399.80 40% off $2,175.67 $6,966.35 $4,586.79 2026-05-22
1083260 OTHER L6621 Upper Extremity Additionsflexion/extension 88 40 $8,462.00 $5,077.20 40% off $953.33 $8,038.90 $4,577.94 2026-05-22
983145 OTHER MRI Lower Extremity W Without Contrast Nmh 32 15 $5,790.00 $3,474.00 40% off $2,895.00 $5,211.00 $4,574.10 2026-05-22
7928511 OTHER Addition To Single Prosthetic Digit Or Thumb Mult 80 34 $7,507.00 $4,504.20 40% off $755.45 $7,131.65 $4,560.51 2026-05-22
6821238 OTHER Insj Picc W/imaging 5 Yr Nmh 32 15 $5,756.00 $3,453.60 40% off $2,878.00 $5,180.40 $4,547.24 2026-05-22
7826337 OTHER 68462-0904-01 - Posaconazole 18 mg/mL Soln 32 15 $5,708.90 $3,425.34 40% off $2,854.45 $5,138.01 $4,510.03 2026-05-22
981142 OTHER Sleep Disorder Study 32 15 $5,700.00 $3,420.00 40% off $2,850.00 $5,130.00 $4,503.00 2026-05-22
1659300 OTHER 58177-0363-22 - Ondansetron 4 Mg Dis Tablet 32 15 $5,657.75 $3,394.65 40% off $2,828.88 $5,091.98 $4,469.62 2026-05-22
1723297 OTHER 58177-3633-75 - Ondansetron 4 Mg Tab 32 15 $5,657.75 $3,394.65 40% off $2,828.88 $5,091.98 $4,469.62 2026-05-22
2593299 OTHER 62576-0240-64 - Ondansetron 4 Mg Tab 32 15 $5,657.75 $3,394.65 40% off $2,828.88 $5,091.98 $4,469.62 2026-05-22
6581204 OTHER MRI Face/Neck W Without Contrast 94 37 $8,384.00 $5,030.40 40% off $367.88 $7,964.80 $4,460.29 2026-05-22
983248 OTHER MRA Head Without Contrast Nmh 32 15 $5,638.00 $3,382.80 40% off $2,819.00 $5,074.20 $4,454.02 2026-05-22
6791276 OTHER 61958-2901-02 - Remdesivir 100 Mg Rec I 32 15 $5,614.90 $3,368.94 40% off $2,807.45 $5,053.41 $4,435.77 2026-05-22
6581102 OTHER CT C-spine With Without Contrast 32 15 $5,608.00 $3,364.80 40% off $2,804.00 $5,047.20 $4,430.32 2026-05-22
983058 OTHER Ivc-gram Nmh 32 15 $5,605.00 $3,363.00 40% off $2,802.50 $5,044.50 $4,427.95 2026-05-22
6581134 OTHER CT Thorax With Without Contrast 32 15 $5,600.00 $3,360.00 40% off $2,800.00 $5,040.00 $4,424.00 2026-05-22
728315 OTHER L0640 Lumbar-sacral Orthosis Sac - T9 Custom Fab 34 17 $5,626.00 $3,375.60 40% off $969.00 $5,063.40 $4,388.28 2026-05-22
6637975 OTHER CT Angiography Chest Pe-71275 32 15 $5,554.00 $3,332.40 40% off $2,777.00 $4,998.60 $4,387.66 2026-05-22
6581098 OTHER CT Angiography Chest 32 15 $5,554.00 $3,332.40 40% off $2,777.00 $4,998.60 $4,387.66 2026-05-22
983253 OTHER Mr Brain Without Contrast Nmh 32 15 $5,553.00 $3,331.80 40% off $2,776.50 $4,997.70 $4,386.87 2026-05-22
6680456 OTHER Radiofrequency Abltj Nrv Nrvtg Si Jt W/img Gdn Bil 82 37 $8,242.00 $4,945.20 40% off $2,059.10 $7,829.90 $4,384.74 2026-05-22
810671 OTHER 55513-0823-10 - Epoetin Alfa 40000 units/mL Soln 32 15 $5,502.40 $3,301.44 40% off $2,751.20 $4,952.16 $4,346.90 2026-05-22
983251 OTHER MRA Neck With Contrast Nmh 32 15 $5,490.00 $3,294.00 40% off $2,745.00 $4,941.00 $4,337.10 2026-05-22
983177 OTHER Mr Ls Spine Without Contrast Nmh 32 15 $5,482.00 $3,289.20 40% off $2,741.00 $4,933.80 $4,330.78 2026-05-22
983146 OTHER MRI Lower Extremity Jt Without Contrast Nmh 32 15 $5,479.00 $3,287.40 40% off $2,739.50 $4,931.10 $4,328.41 2026-05-22
6581131 OTHER CT T-spine With Without Contrast 32 15 $5,457.00 $3,274.20 40% off $2,728.50 $4,911.30 $4,311.03 2026-05-22
983103 OTHER Stimulator Assist Intermed Nmh 32 15 $5,447.00 $3,268.20 40% off $2,723.50 $4,902.30 $4,303.13 2026-05-22
3847297 OTHER MRI T Spine Without Contrast Nmh 32 15 $5,442.00 $3,265.20 40% off $2,721.00 $4,897.80 $4,299.18 2026-05-22
2341297 OTHER CT Angiography Nec Nmh 32 15 $5,440.00 $3,264.00 40% off $2,720.00 $4,896.00 $4,297.60 2026-05-22
6056317 OTHER Comprehensive Computer Based Motion Analysis-3 Cha 92 38 $7,929.00 $4,757.40 40% off $278.20 $7,532.55 $4,293.56 2026-05-22
7809930 OTHER MRA Lower Ext W Without Contrast Lt-73725 80 32 $7,542.00 $4,525.20 40% off $1,002.74 $7,164.90 $4,283.85 2026-05-22
7809933 OTHER MRA Lower Ext W Without Contrast Rt-73725 80 32 $7,542.00 $4,525.20 40% off $1,002.74 $7,164.90 $4,283.85 2026-05-22
6575740 OTHER 68462-0501-65 - Calcipotriene Topical 0.005 Cream 32 15 $5,417.00 $3,250.20 40% off $2,708.50 $4,875.30 $4,279.43 2026-05-22
728179 OTHER Cranial Cervical Orthosis Congenital Torticolous 96 40 $7,752.00 $4,651.20 40% off $806.21 $7,364.40 $4,263.60 2026-05-22
983241 OTHER CT Brain W Without Contrast Nmh 32 15 $5,367.00 $3,220.20 40% off $2,683.50 $4,830.30 $4,239.93 2026-05-22
7928512 OTHER Passive Prosthetic Digit Or Thumb Custom Made Pe 80 34 $6,946.00 $4,167.60 40% off $639.21 $6,598.70 $4,219.69 2026-05-22
6581112 OTHER CT Lower Extremity With Without Contrast Bil 94 37 $7,911.00 $4,746.60 40% off $452.99 $7,515.45 $4,208.65 2026-05-22
6581114 OTHER CT Lower Extremity With Without Contrast Rt 32 15 $5,300.00 $3,180.00 40% off $2,650.00 $4,770.00 $4,187.00 2026-05-22
728550 OTHER Shoulder Disartic Passive Restoration (shoulder C 96 40 $7,608.00 $4,564.80 40% off $776.38 $7,227.60 $4,184.40 2026-05-22
6297603 OTHER MRA Abd Without Contrast Nmh 32 15 $5,286.00 $3,171.60 40% off $2,643.00 $4,757.40 $4,175.94 2026-05-22
6581091 OTHER CT Abdomen With Without Contrast 32 15 $5,281.00 $3,168.60 40% off $2,640.50 $4,752.90 $4,171.99 2026-05-22
6311580 OTHER Skin Full Grft Face/genit/hf < 20 Sq Cm (15240) 84 38 $6,568.00 $3,940.80 40% off $2,175.67 $6,239.60 $4,154.41 2026-05-22
5760304 OTHER Hook/hand Hvy Dty Vol Clos 96 40 $7,509.00 $4,505.40 40% off $755.86 $7,133.55 $4,129.95 2026-05-22
983155 OTHER CT Abdomen W Without Contrast Nmh 32 15 $5,227.00 $3,136.20 40% off $2,613.50 $4,704.30 $4,129.33 2026-05-22
809349 OTHER 99207-0010-10 - Ciclopirox Topical 1 Shamp 32 15 $5,225.40 $3,135.24 40% off $2,612.70 $4,702.86 $4,128.06 2026-05-22
983246 OTHER CT Angiograph Head With And/or Without Contrast Nm 32 15 $5,223.00 $3,133.80 40% off $2,611.50 $4,700.70 $4,126.17 2026-05-22
7793330 OTHER Revise/remove Neurostim Electrode Array Pn W/intgr 82 37 $7,353.00 $4,411.80 40% off $3,419.14 $7,003.11 $4,117.68 2026-05-22
6050321 OTHER Dynamic Plantar Pressure Meas During Walk-5 Charge 92 38 $7,593.00 $4,555.80 40% off $278.20 $7,213.35 $4,111.61 2026-05-22
6821244 OTHER CT Angio Hrt W/3d Image Nmh 32 15 $5,202.00 $3,121.20 40% off $2,601.00 $4,681.80 $4,109.58 2026-05-22
6578758 OTHER MRI Spine Cervical W Without Contrast 94 37 $7,724.00 $4,634.40 40% off $367.88 $7,337.80 $4,109.17 2026-05-22
6581255 OTHER MRI Spine Thoracic W Without Contrast 94 37 $7,712.00 $4,627.20 40% off $367.88 $7,326.40 $4,102.78 2026-05-22
728525 OTHER Prep Bk ""ptb"" Type Socket Non-align Sys Pylon 96 40 $7,454.00 $4,472.40 40% off $744.47 $7,081.30 $4,099.70 2026-05-22
728527 OTHER Prep Bk ""ptb"" Type Socket Non-alignable Sys Pyl 96 40 $7,431.00 $4,458.60 40% off $739.70 $7,059.45 $4,087.05 2026-05-22
983188 OTHER MRI Pelvis Without Contrast Nmh 32 15 $5,165.00 $3,099.00 40% off $2,582.50 $4,648.50 $4,080.35 2026-05-22
6309580 OTHER Skin Full Graft Sclp/arm/leg < 20 Sq Cm (15220) 84 38 $6,205.00 $3,723.00 40% off $2,175.67 $5,894.75 $4,074.76 2026-05-22
1421304 OTHER 58406-0435-04 - Etanercept 50 mg/mL Soln 32 15 $5,146.30 $3,087.78 40% off $2,573.15 $4,631.67 $4,065.57 2026-05-22
6581258 OTHER MRI Spine Lumbar W Without Contrast 94 37 $7,642.00 $4,585.20 40% off $367.88 $7,259.90 $4,065.54 2026-05-22
983111 OTHER MRI Upper Extremity Joint Without Contrast Nmh 32 15 $5,131.00 $3,078.60 40% off $2,565.50 $4,617.90 $4,053.49 2026-05-22
6581104 OTHER CT Head/Brain With Without Contrast 32 15 $5,118.00 $3,070.80 40% off $2,559.00 $4,606.20 $4,043.22 2026-05-22
160 OTHER Non-traumatic Spinal Cord A0503 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
23 OTHER Replacement Of Lower Extremity A0803 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
67 OTHER Traumatic Spinal Cord D0403 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
16 OTHER Fracture Of Lower Extremity B0704 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
171 OTHER Stroke D0103 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
230 OTHER Non-traumatic Spinal Cord D0504 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
170 OTHER Miscellaneous C2001 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
224 OTHER Non-traumatic Brain Injury A0304 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
20 OTHER Fracture Of Lower Extremity A0702 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
246 OTHER Other Orthopedic B0904 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
237 OTHER Non-traumatic Brain Injury A0305 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
128 OTHER Cardiac A1402 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
21 OTHER Traumatic Spinal Cord A0401 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
25 OTHER Miscellaneous A2001 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
108 OTHER Traumatic Spinal Cord B0403 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
107 OTHER Major Multi-trauma With Tbi Or Sci A1805 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
17 OTHER Amputation Of Non-lower Extremity A1101 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
71 OTHER Major Multi-trauma With Tbi Or Sci C1802 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
106 OTHER Major Multi-trauma With Tbi Or Sci D1805 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
210 OTHER Cardiac C1404 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
161 OTHER Fracture Of Lower Extremity A0703 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
105 OTHER Amputation Of Non-lower Extremity D1102 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
172 OTHER Non-traumatic Spinal Cord B0501 16 8 — — $4,040.85 $4,087.89 $4,040.85 2026-05-22
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