Hospital

UNITY PHYSICIANS HOSPITAL

Mishawaka, IN · CCN 150177 · Rates published

700 distinct procedures filed

35 distinct payers

18,775 rate rows

2026-07-19 last MRF observed

Data quality

17,227 of 18,775 rate rows are consumer-grade (91.8%)

1,548 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
template filing: same amount across many unrelated codes — excluded	1,544
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	4

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

Source MRF file	https://clariti-health.com/csp/clariti/machinereadable/v2/352194353_United-Surgeons-LLC-DBA-Unity-Physicians-Hospital_standardcharges.csv
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-12
Content fingerprint	3074dbc5d36e3780… · 1,394,571 bytes · first seen 2026-05-15

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
82150 CPT	Assay Of Amylase	35	$6.48	$100,000.00	$36,350.77	nat. median $18 outlier · 2038.2×
83690 CPT	Assay Of Lipase	35	$5.18	$100,000.00	$36,350.77	nat. median $13 outlier · 2866.8×
84145 CPT	Procalcitonin (pct)	35	$27.22	$75,952.50	$36,220.23	nat. median $44 outlier · 831.7×
87502 CPT	Influenza DNA Amp Probe	35	$95.80	$75,952.50	$36,220.23	nat. median $110 outlier · 328.8×
27599 CPT	Unlisted Procedure Femur/knee	31	$183.79	$66,812.50	$31,861.55	nat. median $503 outlier · 63.3×
85025 CPT	Complete Cbc W/auto Diff Wbc	35	$7.77	$100,000.00	$28,559.15	nat. median $12 outlier · 2297.6×
83036 CPT	Glycosylated Hemoglobin Test	35	$9.71	$49,158.75	$23,442.82	nat. median $14 outlier · 1672.1×
95940 CPT	Ionm In Operatng Room 15 Min	31	$2,700.00	$49,158.75	$23,442.82	nat. median $142 outlier · 165.1×
85027 CPT	Complete Cbc Automated	35	$6.47	$44,702.50	$21,317.73	nat. median $11 outlier · 1955.8×
86140 CPT	C-reactive Protein	35	$5.18	$44,702.50	$21,317.73	nat. median $10 outlier · 2057.7×
87075 CPT	Cultr Bacteria Except Blood	35	$8.48	$44,702.50	$21,317.73	nat. median $17 outlier · 1250.3×
87070 CPT	Culture Othr Specimn Aerobic	35	$8.62	$44,702.50	$21,317.73	nat. median $33 outlier · 648.0×
87076 CPT	Culture Anaerobe Ident Each	35	$8.08	$44,702.50	$21,317.73	nat. median $15 outlier · 1447.7×
85652 CPT	Rbc Sed Rate Automated	35	$2.70	$44,702.50	$21,317.73	nat. median $4 outlier · 4914.8×
80053 CPT	Comprehen Metabolic Panel	35	$10.56	$44,702.50	$21,317.73	nat. median $18 outlier · 1187.0×
87186 CPT	Microbe Susceptible Mic	35	$8.65	$44,702.50	$21,317.73	nat. median $21 outlier · 998.7×
87077 CPT	Culture Aerobic Identify	35	$8.08	$44,702.50	$21,317.73	nat. median $18 outlier · 1188.3×
87205 CPT	Smear Gram Stain	35	$4.27	$44,702.50	$21,317.73	nat. median $14 outlier · 1482.5×
89051 CPT	Body Fluid Cell Count	35	$5.16	$44,702.50	$21,317.73	nat. median $11 outlier · 1910.2×
82565 CPT	Assay Of Creatinine	35	$5.12	$44,702.50	$21,317.73	nat. median $9 outlier · 2481.7×
87102 CPT	Fungus Isolation Culture	35	$8.41	$44,702.50	$21,317.73	nat. median $17 outlier · 1255.5×
93654 CPT	Ep & Ablate Ventric Tachy	35	$5,765.00	$49,044.65	$19,132.09	nat. median $26,477 0.7× median
93656 CPT	Tx Atrial Fib Pulm Vein Isol	35	$5,765.00	$49,044.65	$19,132.09	nat. median $26,469 0.7× median
93653 CPT	Ep & Ablate Supravent Arrhyt	35	$5,765.00	$49,044.65	$19,132.09	nat. median $25,502 0.8× median
74177 CPT	CT Abd & Pelv W/contrast	35	$162.17	$100,000.00	$18,988.14	nat. median $501 outlier · 37.9×
84300 CPT	Assay Of Urine Sodium	35	$4.70	$39,423.75	$18,800.40	nat. median $10 outlier · 1857.7×
71275 CPT	CT Angiography Chest	35	$159.15	$100,000.00	$18,649.24	nat. median $365 outlier · 51.1×
27766 CPT	Open Treatment Medial Malleolus Fracture	35	$488.57	$38,555.00	$18,386.11	nat. median $7,011 outlier · 2.6×
27698 CPT	Repair Secondary Disrupted Ligament Ankl	35	$443.28	$98,655.58	$18,386.11	nat. median $6,466 outlier · 2.8×
27638 CPT	Exc/curettage Cyst/tumor Tibia/fibula With	35	$488.57	$38,555.00	$18,386.11	nat. median $6,220 outlier · 3.0×
28725 CPT	Arthrodesis Subtalar	35	$582.98	$46,361.45	$18,386.11	nat. median $9,062 outlier · 2.0×
80202 CPT	Assay Of Vancomycin	35	$13.54	$37,181.25	$17,730.99	nat. median $25 outlier · 707.8×
27299 CPT	Unlisted Procedure Pelvis/hip Joint	35	$183.79	$44,702.50	$17,345.71	nat. median $443 outlier · 39.2×
82330 CPT	Assay Of Calcium	35	$9.62	$35,050.00	$16,714.64	nat. median $21 outlier · 789.9×
95938 CPT	Somatosensory Testing	31	$434.78	$31,752.50	$15,142.13	nat. median $792 outlier · 19.1×
82310 CPT	Assay Of Calcium	35	$5.16	$29,828.75	$14,224.73	nat. median $10 outlier · 1448.5×
80051 CPT	Electrolyte Panel	35	$4.50	$29,828.75	$14,224.73	nat. median $11 outlier · 1263.9×
64718 CPT	Neuroplasty &/transposition Ulnar Nerve	35	$443.28	$34,640.50	$14,224.73	nat. median $2,428 outlier · 5.9×
29882 CPT	Arthroscopy Knee W/meniscus Rpr Medial/l	35	$488.57	$40,946.76	$14,224.73	nat. median $3,592 outlier · 4.0×
88311 CPT	Decalcify Tissue	35	$7.42	$29,388.75	$14,014.91	nat. median $26 outlier · 544.3×
27814 CPT	Open Treatment Bimalleolar Ankle Fractur	35	$488.57	$29,065.00	$13,860.52	nat. median $7,169 1.9× median
97168 CPT	Ot Re-eval Est Plan Care	31	$75.00	$26,193.75	$12,491.28	nat. median $87 outlier · 143.1×
72131 CPT	CT Aorta	35	$97.13	$49,158.75	$11,990.06	nat. median $212 outlier · 56.6×
73562 CPT	Xray Exam Hips Bi 5/> Views	35	$19.24	$49,158.75	$11,830.61	nat. median $111 outlier · 106.2×
72220 CPT	Xray Knees Standing Ap	35	$14.28	$49,158.75	$11,822.08	nat. median $104 outlier · 113.5×
72100 CPT	Xray Sacrum & Coccyx Min 2 Vw	35	$17.01	$49,158.75	$11,820.35	nat. median $126 outlier · 93.6×
72070 CPT	Xray Si Jnts <3 Vw	35	$15.77	$49,158.75	$11,818.54	nat. median $115 outlier · 102.8×
88341 CPT	Immunohisto Antb Addl Slide	31	$162.14	$24,682.50	$11,770.59	nat. median $90 outlier · 130.6×
27350 CPT	Patellectomy/hemipatellectomy	35	$582.98	$40,666.24	$11,770.59	nat. median $6,293 1.9× median
88304 CPT	Tissue Exam By Pathologist	35	$23.59	$49,158.75	$11,765.76	nat. median $74 outlier · 159.0×

Other procedures at this hospital

Browse this hospital's 700 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

82150	CPT	Assay Of Amylase	39	35	$100,000.00	—	$6.48	$100,000.00	$36,350.77	2026-07-19
83690	CPT	Assay Of Lipase	39	35	$100,000.00	—	$5.18	$100,000.00	$36,350.77	2026-07-19
87502	CPT	Influenza DNA Amp Probe	39	35	$75,952.50	—	$95.80	$75,952.50	$36,220.23	2026-07-19
84145	CPT	Procalcitonin (pct)	39	35	$75,952.50	—	$27.22	$75,952.50	$36,220.23	2026-07-19
27599	CPT	Unlisted Procedure Femur/knee	60	31	$66,812.50	—	$183.79	$66,812.50	$31,861.55	2026-07-19
85025	CPT	Complete Cbc W/auto Diff Wbc	39	35	$100,000.00	—	$7.77	$100,000.00	$28,559.15	2026-07-19
95940	CPT	Ionm In Operatng Room 15 Min	35	31	$49,158.75	—	$2,700.00	$49,158.75	$23,442.82	2026-07-19
83036	CPT	Glycosylated Hemoglobin Test	39	35	$49,158.75	—	$9.71	$49,158.75	$23,442.82	2026-07-19
89051	CPT	Body Fluid Cell Count	39	35	$44,702.50	—	$5.16	$44,702.50	$21,317.73	2026-07-19
87077	CPT	Culture Aerobic Identify	39	35	$44,702.50	—	$8.08	$44,702.50	$21,317.73	2026-07-19
82565	CPT	Assay Of Creatinine	39	35	$44,702.50	—	$5.12	$44,702.50	$21,317.73	2026-07-19
85027	CPT	Complete Cbc Automated	39	35	$44,702.50	—	$6.47	$44,702.50	$21,317.73	2026-07-19
85652	CPT	Rbc Sed Rate Automated	39	35	$44,702.50	—	$2.70	$44,702.50	$21,317.73	2026-07-19
87205	CPT	Smear Gram Stain	39	35	$44,702.50	—	$4.27	$44,702.50	$21,317.73	2026-07-19
87075	CPT	Cultr Bacteria Except Blood	39	35	$44,702.50	—	$8.48	$44,702.50	$21,317.73	2026-07-19
86140	CPT	C-reactive Protein	39	35	$44,702.50	—	$5.18	$44,702.50	$21,317.73	2026-07-19
87186	CPT	Microbe Susceptible Mic	39	35	$44,702.50	—	$8.65	$44,702.50	$21,317.73	2026-07-19
87070	CPT	Culture Othr Specimn Aerobic	39	35	$44,702.50	—	$8.62	$44,702.50	$21,317.73	2026-07-19
87102	CPT	Fungus Isolation Culture	39	35	$44,702.50	—	$8.41	$44,702.50	$21,317.73	2026-07-19
87076	CPT	Culture Anaerobe Ident Each	39	35	$44,702.50	—	$8.08	$44,702.50	$21,317.73	2026-07-19
80053	CPT	Comprehen Metabolic Panel	39	35	$44,702.50	—	$10.56	$44,702.50	$21,317.73	2026-07-19
93656	CPT	Tx Atrial Fib Pulm Vein Isol	35	35	$61,305.81	—	$5,765.00	$49,044.65	$19,132.09	2026-07-19
93654	CPT	Ep & Ablate Ventric Tachy	35	35	$61,305.81	—	$5,765.00	$49,044.65	$19,132.09	2026-07-19
93653	CPT	Ep & Ablate Supravent Arrhyt	35	35	$61,305.81	—	$5,765.00	$49,044.65	$19,132.09	2026-07-19
74177	CPT	CT Abd & Pelv W/contrast	58	35	$100,000.00	—	$162.17	$100,000.00	$18,988.14	2026-07-19
84300	CPT	Assay Of Urine Sodium	39	35	$39,423.75	—	$4.70	$39,423.75	$18,800.40	2026-07-19
71275	CPT	CT Angiography Chest	58	35	$100,000.00	—	$159.15	$100,000.00	$18,649.24	2026-07-19
27698	CPT	Repair Secondary Disrupted Ligament Ankl	65	35	$123,319.47	—	$443.28	$98,655.58	$18,386.11	2026-07-19
28725	CPT	Arthrodesis Subtalar	65	35	$57,951.81	—	$582.98	$46,361.45	$18,386.11	2026-07-19
27766	CPT	Open Treatment Medial Malleolus Fracture	65	35	$38,186.95	—	$488.57	$38,555.00	$18,386.11	2026-07-19
27638	CPT	Exc/curettage Cyst/tumor Tibia/fibula With	65	35	$34,977.55	—	$488.57	$38,555.00	$18,386.11	2026-07-19
80202	CPT	Assay Of Vancomycin	39	35	$37,181.25	—	$13.54	$37,181.25	$17,730.99	2026-07-19
27299	CPT	Unlisted Procedure Pelvis/hip Joint	64	35	$26,685.71	—	$183.79	$44,702.50	$17,345.71	2026-07-19
82330	CPT	Assay Of Calcium	39	35	$35,050.00	—	$9.62	$35,050.00	$16,714.64	2026-07-19
95938	CPT	Somatosensory Testing	54	31	$31,752.50	—	$434.78	$31,752.50	$15,142.13	2026-07-19
82310	CPT	Assay Of Calcium	39	35	$29,828.75	—	$5.16	$29,828.75	$14,224.73	2026-07-19
80051	CPT	Electrolyte Panel	39	35	$29,828.75	—	$4.50	$29,828.75	$14,224.73	2026-07-19
64718	CPT	Neuroplasty &/transposition Ulnar Nerve	66	35	$43,300.63	—	$443.28	$34,640.50	$14,224.73	2026-07-19
29882	CPT	Arthroscopy Knee W/meniscus Rpr Medial/l	66	35	$51,183.45	—	$488.57	$40,946.76	$14,224.73	2026-07-19
88311	CPT	Decalcify Tissue	39	35	$29,388.75	—	$7.42	$29,388.75	$14,014.91	2026-07-19
27814	CPT	Open Treatment Bimalleolar Ankle Fractur	66	35	$24,506.17	—	$488.57	$29,065.00	$13,860.52	2026-07-19
97168	CPT	Ot Re-eval Est Plan Care	35	31	$26,193.75	—	$75.00	$26,193.75	$12,491.28	2026-07-19
72131	CPT	CT Aorta	58	35	$49,158.75	—	$97.13	$49,158.75	$11,990.06	2026-07-19
73562	CPT	Xray Exam Hips Bi 5/> Views	58	35	$49,158.75	—	$19.24	$49,158.75	$11,830.61	2026-07-19
72220	CPT	Xray Knees Standing Ap	58	35	$49,158.75	—	$14.28	$49,158.75	$11,822.08	2026-07-19
72100	CPT	Xray Sacrum & Coccyx Min 2 Vw	58	35	$49,158.75	—	$17.01	$49,158.75	$11,820.35	2026-07-19
72070	CPT	Xray Si Jnts <3 Vw	58	35	$49,158.75	—	$15.77	$49,158.75	$11,818.54	2026-07-19
88341	CPT	Immunohisto Antb Addl Slide	35	31	$24,682.50	—	$162.14	$24,682.50	$11,770.59	2026-07-19
27350	CPT	Patellectomy/hemipatellectomy	66	35	$50,832.80	—	$582.98	$40,666.24	$11,770.59	2026-07-19
88304	CPT	Tissue Exam By Pathologist	58	35	$49,158.75	—	$23.59	$49,158.75	$11,765.76	2026-07-19
70450	CPT	CT Angiograph Low Extrem Lt	58	35	$48,110.00	—	$56.64	$48,110.00	$11,740.00	2026-07-19
20694	CPT	Removal External Fixation System Under A	66	35	$43,655.22	—	$318.54	$34,924.18	$11,164.36	2026-07-19
27685	CPT	Lngth/shrt Tendon Leg/ankle 1 Tendon Spx	66	35	$126,529.19	—	$488.57	$101,223.35	$11,039.18	2026-07-19
27130	CPT	Arthrp Acetblr/prox Fem Prostc Agrft/alg	37	35	$91,984.76	—	$6,693.20	$73,587.81	$10,976.64	2026-07-19
27446	CPT	Arthrp Knee Condyle&plateau Medial/lat C	37	35	$124,137.42	—	$800.42	$99,309.94	$10,976.64	2026-07-19
27438	CPT	Arthroplasty Patella W/prosthesis	37	35	$86,324.46	—	$800.42	$69,059.57	$10,976.64	2026-07-19
24366	CPT	Arthroplasty Radial Head W/implant	35	35	$64,465.32	—	$800.42	$51,572.26	$10,976.64	2026-07-19
23615	CPT	Open Treatment Proximal Humeral Fracture	35	35	$38,368.57	—	$582.98	$30,694.86	$10,976.64	2026-07-19
27447	CPT	Arthrp Kne Condyle&platu Medial&lat Comp	37	35	$99,419.03	—	$6,693.20	$79,535.22	$10,976.64	2026-07-19
27442	CPT	Arthroplasty Fem Condyles/tibial Plateau	37	35	$112,340.91	—	$800.42	$89,872.73	$10,976.64	2026-07-19
25111	CPT	Excision Ganglion Wrist Dorsal/volar Pri	66	35	$28,117.84	—	$488.57	$22,494.27	$10,401.95	2026-07-19
99157	CPT	Mod Sed Other Phys/qhp Ea	4	4	$16,108.00	—	$9,664.80	$12,886.40	$10,067.50	2026-07-19
29875	CPT	Arthroscopy Knee Synovectomy Limited Spx	66	35	$39,496.00	—	$582.98	$31,596.80	$9,777.83	2026-07-19
73522	CPT	Xray Chest 1 Vw	58	35	$39,302.50	—	$23.20	$39,302.50	$9,468.42	2026-07-19
29824	CPT	Surgical Arthroscopy Shoulder Dstl Clavi	66	35	$39,476.23	—	$800.42	$31,580.98	$9,276.51	2026-07-19
29826	CPT	Surgical Arthroscopy Sho W/coracoacrm Li	47	35	$52,770.98	—	$488.57	$42,216.78	$9,276.51	2026-07-19
29823	CPT	Surgical Arthroscopy Shoulder Xtnsv Dbrd	66	35	$16,161.70	—	$488.57	$19,452.50	$9,276.51	2026-07-19
29827	CPT	Surgical Arthroscopy Shoulder W/rotator	66	35	$88,145.94	—	$488.57	$70,516.75	$9,276.51	2026-07-19
88331	CPT	Path Consult Intraop 1 Bloc	58	35	$35,050.00	—	$35.39	$35,050.00	$8,490.27	2026-07-19
86880	CPT	Coombs Test Direct	58	35	$35,050.00	—	$5.39	$35,050.00	$8,406.93	2026-07-19
88305	CPT	Tissue Exam By Pathologist	58	35	$35,050.00	—	$44.35	$35,050.00	$8,406.26	2026-07-19
64708	CPT	Neurp Major Prph Nrv Arm/leg Opn Oth/thn	66	35	$13,140.23	—	$443.28	$24,682.50	$8,212.65	2026-07-19
11044	CPT	Debridement Bone Muscle &/fascia 20 Sq C	66	35	$13,122.32	—	$443.28	$39,423.75	$8,201.45	2026-07-19
12020	CPT	Tx Superficial Wound Dehiscence Simple C	66	35	$12,823.73	—	$318.54	$17,182.50	$7,944.11	2026-07-19
86431	CPT	Rheumatoid Factor Quant	39	35	$16,635.00	—	$5.67	$16,635.00	$7,932.90	2026-07-19
89060	CPT	Exam Synovial Fluid Crystals	39	35	$16,635.00	—	$5.16	$16,635.00	$7,932.90	2026-07-19
86200	CPT	Ccp Antibody	39	35	$16,635.00	—	$12.95	$16,635.00	$7,932.90	2026-07-19
27405	CPT	Rpr Primary Torn Ligm&/capsule Knee Coll	66	35	$69,995.06	—	$582.98	$55,996.05	$7,738.57	2026-07-19
72050	CPT	Xray Ribs Bilat W/1 Vw Chest	58	35	$31,752.50	—	$22.95	$31,752.50	$7,727.86	2026-07-19
72040	CPT	Xray Ribs 2 Vw Uni Lt	58	35	$31,752.50	—	$17.01	$31,752.50	$7,674.12	2026-07-19
87015	CPT	Specimen Infect Agnt Concntj	39	35	$15,748.75	—	$6.68	$15,748.75	$7,510.26	2026-07-19
11042	CPT	Debridement Subcutaneous Tissue 20 Sq Cm	66	35	$16,090.35	—	$308.26	$15,748.75	$7,510.26	2026-07-19
87206	CPT	Smear Fluorescent/acid Stai	39	35	$15,748.75	—	$5.39	$15,748.75	$7,510.26	2026-07-19
88307	CPT	Tissue Exam By Pathologist	58	35	$29,388.75	—	$94.45	$29,388.75	$7,267.07	2026-07-19
73030	CPT	Xray Myelogram Cervical	58	35	$29,828.75	—	$14.78	$29,828.75	$7,206.35	2026-07-19
73020	CPT	Xray Mandible Min 4 Vw	58	35	$29,828.75	—	$11.31	$29,828.75	$7,188.66	2026-07-19
71045	CPT	Xray Ac Jnts Bilat	58	35	$29,828.75	—	$62.12	$29,828.75	$7,184.48	2026-07-19
73590	CPT	Xray Spine 1 Vw Any Level	58	35	$29,065.00	—	$13.29	$29,065.00	$7,027.12	2026-07-19
73060	CPT	Xray Exam Hip Uni 4/> Views	58	35	$29,065.00	—	$14.28	$29,065.00	$7,012.43	2026-07-19
73660	CPT	Xray Spine Cerv 2-3 Vw	58	35	$29,065.00	—	$16.76	$29,065.00	$7,002.37	2026-07-19
74178	CPT	CT Orbit/sella/etc W/cont	58	35	$24,682.50	—	$192.64	$24,682.50	$6,698.05	2026-07-19
93000	CPT	Electrocardiogram Complete	4	4	$10,194.00	—	$6,116.40	$8,155.20	$6,371.25	2026-07-19
77012	CPT	CT Scan For Needle Biopsy	39	35	$13,305.00	—	$49.46	$13,305.00	$6,344.89	2026-07-19
71260	CPT	CT Abdo/pelvis Without Cont	58	35	$24,682.50	—	$123.28	$24,682.50	$6,305.99	2026-07-19
64721	CPT	Neuroplasty &/transpos Median Nrv Carpal	66	35	$10,084.99	—	$443.28	$29,828.75	$6,303.11	2026-07-19
26145	CPT	Synvct Tdn Shth Rad Flxr Tdn Palm&/fngr	66	35	$10,005.19	—	$488.57	$21,812.50	$6,253.24	2026-07-19
73718	CPT	MRI Brain W & Without Cont	58	35	$22,173.75	—	$205.12	$22,173.75	$5,760.89	2026-07-19
88312	CPT	Special Stains Group 1	58	35	$23,411.25	—	$8.85	$23,411.25	$5,629.69	2026-07-19
23515	CPT	Open Tx Clavicular Fracture Internal Fix	35	35	$42,363.18	—	$488.57	$33,890.54	$5,584.20	2026-07-19
29892	CPT	Arthrs Aid Rpr Les/talar Dome Fx/tibl Pl	35	35	$24,709.18	—	$488.57	$19,767.34	$5,584.20	2026-07-19
29888	CPT	Arthrs Aided Ant Cruciate Ligm Rpr/agmnt	35	35	$74,548.07	—	$488.57	$59,638.46	$5,584.20	2026-07-19
29862	CPT	Arthrs Hip Debridement/shaving Articular	35	35	$36,812.42	—	$582.98	$29,449.94	$5,584.20	2026-07-19
24685	CPT	Open Treatment Ulnar Fracture Proximal E	35	35	$33,915.99	—	$488.57	$27,132.79	$5,584.20	2026-07-19
25575	CPT	Open Tx Radial&ulnar Shaft Fx W/fixj Rad	35	35	$35,723.25	—	$488.57	$28,578.60	$5,584.20	2026-07-19
25400	CPT	Rpr Nonunion/malunion Radius/ulna Without Au	35	35	$35,918.03	—	$488.57	$28,734.42	$5,584.20	2026-07-19
29807	CPT	Surgical Arthroscopy Shoulder Repair Sla	35	35	$31,052.02	—	$488.57	$24,841.62	$5,584.20	2026-07-19
27509	CPT	Prq Skeletal Fixj Femoral Fx Distal End	35	35	$31,389.38	—	$318.54	$25,111.50	$5,584.20	2026-07-19
22513	CPT	Perq Vert Agmntj Cavity Crtj Uni/bi Cann	35	35	$43,267.65	—	$3,346.60	$34,614.12	$5,584.20	2026-07-19
24342	CPT	Rinsj Rptd Biceps/triceps Tdn Dstl W/wo	35	35	$32,323.49	—	$488.57	$25,858.79	$5,584.20	2026-07-19
27822	CPT	Open Tx Trimalleolar Ankle Fx Without Fixj P	35	35	$33,631.00	—	$488.57	$26,904.80	$5,584.20	2026-07-19
27792	CPT	Open Tx Distal Fibular Fracture Lat Mall	35	35	$42,311.42	—	$488.57	$33,849.14	$5,584.20	2026-07-19
27385	CPT	Suture Quadriceps/hamstring Rupture Prim	35	35	$17,249.87	—	$488.57	$13,799.90	$5,584.20	2026-07-19
24341	CPT	Repair Tendon/muscle Upper Arm/elbow Ea	35	35	$27,952.08	—	$1,079.83	$22,361.66	$5,584.20	2026-07-19
25337	CPT	Rcnstj Stablj Dstl U/dstl Jt 2 Soft Tiss	35	35	$20,939.14	—	$1,079.83	$16,751.31	$5,584.20	2026-07-19
25805	CPT	Arthrodesis Wrist W/sliding Graft	35	35	$64,266.19	—	$800.42	$51,412.95	$5,584.20	2026-07-19
27695	CPT	Rpr Primary Disrupted Ligament Ankle Col	35	35	$35,756.39	—	$443.28	$28,605.11	$5,584.20	2026-07-19
27691	CPT	Tr/trnspl 1 Tdn W/musc Redirion/reroutin	35	35	$16,214.80	—	$582.98	$12,971.84	$5,584.20	2026-07-19
25609	CPT	Optx Dstl Radl I-artic Fx/epiphysl Sep 3	35	35	$30,715.71	—	$800.42	$24,572.57	$5,584.20	2026-07-19
27652	CPT	Rpr Primary Open/prq Ruptured Achilles W	35	35	$24,768.34	—	$488.57	$19,814.67	$5,584.20	2026-07-19
25608	CPT	Optx Dstl Radl I-artic Fx/epiphysl Sep 2	35	35	$30,799.66	—	$800.42	$24,639.73	$5,584.20	2026-07-19
27650	CPT	Repair Primary Open/prq Ruptured Achille	35	35	$17,632.55	—	$488.57	$14,106.04	$5,584.20	2026-07-19
29828	CPT	Surgical Arthroscopy Shoulder Biceps Ten	35	35	$20,450.00	—	$1,106.60	$16,360.00	$5,584.20	2026-07-19
25607	CPT	Optx Dstl Radl X-artic Fx/epiphysl Sep	35	35	$31,186.12	—	$800.42	$24,948.90	$5,584.20	2026-07-19
25350	CPT	Osteotomy Radius Distal Third	35	35	$37,667.86	—	$488.57	$30,134.29	$5,584.20	2026-07-19
29916	CPT	Arthroscopy Hip W/labral Repair	35	35	$43,915.46	—	$2,226.60	$35,132.37	$5,584.20	2026-07-19
25515	CPT	Open Treatment Radial Shaft Fracture	35	35	$22,327.43	—	$488.57	$17,861.94	$5,584.20	2026-07-19
23405	CPT	Tenotomy Shoulder Area 1 Tendon	35	35	$19,080.69	—	$443.28	$15,264.55	$5,584.20	2026-07-19
29806	CPT	Surgical Arthroscopy Shoulder Capsulorrh	35	35	$43,125.30	—	$488.57	$34,500.24	$5,584.20	2026-07-19
23550	CPT	Open Tx Acromioclavicular Dislc Acute/ch	35	35	$43,741.30	—	$488.57	$34,993.04	$5,584.20	2026-07-19
27536	CPT	Optx Tibial Fx Prox Bicondylar W/wo Int	35	35	$61,256.34	—	$3,346.60	$49,005.07	$5,584.20	2026-07-19
26115	CPT	Exc Tum/vasc Mal Sft Tiss Hand/fngr Subq	66	35	$8,869.71	—	$443.28	$15,748.75	$5,543.57	2026-07-19
93620	CPT	Electrophysiology Evaluation	35	35	$17,657.13	—	$2,841.00	$14,125.70	$5,417.99	2026-07-19
73630	CPT	Xray Exam Entire Spi 4/5 Vw	58	35	$22,173.75	—	$16.27	$22,173.75	$5,378.02	2026-07-19
73701	CPT	CT C Spine W & Without Cont	58	35	$20,585.00	—	$124.02	$20,585.00	$5,328.98	2026-07-19
73080	CPT	Xray Arthrogram Hip Lt	58	35	$20,585.00	—	$17.51	$20,585.00	$4,998.44	2026-07-19
10140	CPT	I&d Hematoma Seroma/fluid Collection	66	35	$7,902.25	—	$97.73	$26,193.75	$4,938.91	2026-07-19
26455	CPT	Tenotomy Flexor Finger Open Each Tendon	66	35	$7,860.95	—	$488.57	$12,427.50	$4,913.09	2026-07-19
72156	CPT	MRI Neck Spine Without & With Contrast	58	35	$16,855.00	—	$194.13	$16,855.00	$4,766.55	2026-07-19
72125	CPT	CT Abd & Pelv 1/> Regns	58	35	$17,458.75	—	$97.13	$17,458.75	$4,431.51	2026-07-19
72020	CPT	Xray Ribs Uni W/1 Vw Chest Lt	58	35	$17,717.50	—	$10.82	$17,717.50	$4,309.03	2026-07-19
93655	CPT	Ablate Arrhythmia Add On	12	12	$11,506.00	—	$950.00	$9,204.80	$3,357.50	2026-07-19
93657	CPT	Tx L/r Atrial Fib Addl	12	12	$11,027.00	—	$950.00	$8,821.60	$3,357.50	2026-07-19
36556	CPT	Insert Non-tunnel Cv Cath	35	35	$5,101.42	—	$318.54	$5,101.42	$2,550.71	2026-07-19
27334	CPT	Arthrotomy W/synovectomy Knee Anterior/p	35	35	$20,242.06	—	$582.98	$16,193.65	$2,522.85	2026-07-19
29884	CPT	Arthroscopy Knee W/lysis Adhesions W/wo	35	35	$19,449.74	—	$488.57	$15,559.79	$2,522.85	2026-07-19
29880	CPT	Arthrs Knee W/meniscectomy Med&lat W/sha	35	35	$16,108.08	—	$582.98	$12,886.46	$2,522.85	2026-07-19
29879	CPT	Arthrs Knee Abrasion Arthrp/mlt Drlg/mic	35	35	$27,488.50	—	$488.57	$21,990.80	$2,522.85	2026-07-19
27062	CPT	Excision Trochanteric Bursa/calcificatio	35	35	$24,864.05	—	$800.42	$19,891.24	$2,522.85	2026-07-19
29877	CPT	Arthrs Knee Debridement/shaving Artclr C	37	35	$11,669.40	—	$582.98	$9,335.52	$2,522.85	2026-07-19
29873	CPT	Arthroscopy Knee Lateral Release	35	35	$17,883.65	—	$488.57	$14,306.92	$2,522.85	2026-07-19
26860	CPT	Arthrodesis Interphalangeal Jt W/wo Int	35	35	$19,600.21	—	$488.57	$15,680.17	$2,522.85	2026-07-19
26735	CPT	Open Tx Phalangeal Shaft Fracture Prox/m	35	35	$26,458.80	—	$582.98	$21,167.04	$2,522.85	2026-07-19
27630	CPT	Excision Lesion Tendon Sheath/capsule Le	35	35	$16,482.03	—	$488.57	$13,185.62	$2,522.85	2026-07-19
25447	CPT	Arthrp Interpos Intercarpal/metacarpal J	35	35	$42,892.33	—	$800.42	$34,313.86	$2,522.85	2026-07-19
26615	CPT	Open Tx Metacarpal Fracture Single Ea Bo	35	35	$26,358.33	—	$582.98	$21,086.66	$2,522.85	2026-07-19
26540	CPT	Rpr Coltrl Ligm Mtcarphlngl/iphal Jt	35	35	$12,820.71	—	$582.98	$10,256.57	$2,522.85	2026-07-19
29822	CPT	Surgical Arthroscopy Shoulder Lmtd Dbrdm	35	35	$39,156.67	—	$488.57	$31,325.34	$2,522.85	2026-07-19
26535	CPT	Arthroplasty Interphalangeal Joint Each	35	35	$29,410.81	—	$800.42	$23,528.65	$2,522.85	2026-07-19
24359	CPT	Tnot Elbow Lateral/medial Debride Open T	37	35	$18,471.20	—	$1,106.60	$14,776.96	$2,522.85	2026-07-19
29805	CPT	Diagnostic Arthroscopy Shoulder +- Synov	35	35	$12,559.50	—	$488.57	$10,047.60	$2,522.85	2026-07-19
26356	CPT	Rpr/advmnt Flxr Tdn Zone 2 Without Fr Grft E	35	35	$24,080.75	—	$582.98	$19,264.60	$2,522.85	2026-07-19
28285	CPT	Correction Hammertoe	35	35	$18,514.51	—	$488.57	$14,811.61	$2,522.85	2026-07-19
28289	CPT	Hallux Rigidus W/cheilectomy 1st Mp Jt W	35	35	$11,997.80	—	$2,226.60	$9,598.24	$2,522.85	2026-07-19
28112	CPT	Ostectomy Complete Other Metatarsal Head	35	35	$12,520.63	—	$488.57	$10,016.50	$2,522.85	2026-07-19
28062	CPT	Fasciotomy Plantar Fascia Radical Spx	35	35	$14,460.61	—	$488.57	$11,568.49	$2,522.85	2026-07-19
26123	CPT	Fasct Prtl Palmar 1 Dgt Prox Iphal Jt With	35	35	$12,503.83	—	$582.98	$10,003.06	$2,522.85	2026-07-19
24358	CPT	Tnot Elbow Lateral/medial Debride Open	35	35	$23,482.75	—	$1,106.60	$18,786.20	$2,522.85	2026-07-19
26121	CPT	Fasct Palm W/wo Z-plasty Tissue Reargmt/	35	35	$9,448.54	—	$582.98	$7,558.83	$2,522.85	2026-07-19
25300	CPT	Tenodesis Wrist Flexors Fingers	35	35	$29,828.38	—	$488.57	$23,862.70	$2,522.85	2026-07-19
24147	CPT	Partial Excision Bone Olecranon Process	35	35	$15,960.00	—	$443.28	$12,768.00	$2,522.85	2026-07-19
27641	CPT	Partial Excision Bone Fibula	35	35	$16,852.80	—	$443.28	$13,482.24	$2,522.85	2026-07-19
27640	CPT	Partial Excision Bone Tibia	35	35	$12,025.60	—	$443.28	$9,620.48	$2,522.85	2026-07-19
24140	CPT	Partial Excision Bone Humerus	35	35	$14,577.53	—	$488.57	$11,662.02	$2,522.85	2026-07-19
24105	CPT	Excision Olecranon Bursa	35	35	$15,698.79	—	$488.57	$12,559.03	$2,522.85	2026-07-19
29881	CPT	Arthrs Kne Surg W/meniscectomy Med/lat W	35	35	$27,974.90	—	$582.98	$22,379.92	$2,522.85	2026-07-19
27301	CPT	I&d Deep Absc Bursa/hematoma Thigh/knee	35	35	$15,766.20	—	$488.57	$12,612.96	$2,112.48	2026-07-19
11626	CPT	Excision Malignant Lesion S/n/h/f/g >4.0	35	35	$4,224.96	—	$443.28	$4,224.96	$2,112.48	2026-07-19
50200	CPT	Renal Biopsy Perq	66	35	$2,508.24	—	$827.00	$13,305.00	$2,000.00	2026-07-19
95955	CPT	EEG During Surgery	4	4	$3,200.00	—	$1,920.00	$2,560.00	$2,000.00	2026-07-19
93621	CPT	Electrophysiology Evaluation	12	12	$8,224.00	—	$950.00	$6,579.20	$1,895.50	2026-07-19
93622	CPT	Electrophysiology Evaluation	12	12	$8,547.00	—	$950.00	$6,837.60	$1,895.50	2026-07-19
28035	CPT	Release Tarsal Tunnel	35	35	$14,197.25	—	$582.98	$11,357.80	$1,563.76	2026-07-19
64776	CPT	Exc Neuroma Digital Nerve 1 Or Both Same	35	35	$10,292.91	—	$488.57	$8,234.33	$1,563.76	2026-07-19
64416	CPT	N Block Cont Infuse B Plex	66	35	$1,466.18	—	$318.54	$29,828.75	$1,400.00	2026-07-19
36430	CPT	Blood Transfusion Service	62	31	$50,887.50	—	$353.92	$100,000.00	$1,286.88	2026-07-19
11420	CPT	Exc B9 Lesion Mrgn Xcp Sk Tg S/n/h/f/g 0	35	35	$9,719.29	—	$97.73	$7,775.43	$1,254.12	2026-07-19
36569	CPT	Insj Picc 5 Yr+ Without Imaging	35	35	$2,841.00	—	$318.54	$2,841.00	$1,253.35	2026-07-19
25115	CPT	Rad Exc Bursa Synva Wrst/f/arm Tdn Shths	35	35	$16,861.95	—	$582.98	$13,489.56	$1,241.06	2026-07-19
29848	CPT	Ndsc Wrst Surg W/rls Transvrs Carpl Ligm	35	35	$10,079.43	—	$488.57	$8,063.54	$1,241.06	2026-07-19
27825	CPT	Cltx Fx W8 Brg Artclr Prtn Dstl Tib W/sk	35	35	$68,187.52	—	$443.28	$54,550.02	$1,241.06	2026-07-19
27842	CPT	Cltx Ankle Dislc Req Anes W/wo Prq Skel	35	35	$10,882.50	—	$318.54	$8,706.00	$1,241.06	2026-07-19
27762	CPT	Cltx Medial Malls Fx W/manj W/wo Skn/ske	35	35	$19,573.70	—	$318.54	$15,658.96	$1,241.06	2026-07-19
26055	CPT	Tendon Sheath Incision	37	35	$10,535.20	—	$443.28	$8,428.16	$1,241.06	2026-07-19
27570	CPT	Manipulation Knee Joint Under General An	35	35	$8,094.63	—	$318.54	$6,475.70	$1,241.06	2026-07-19
25505	CPT	Closed Tx Radial Shaft Fracture W/manipu	35	35	$2,872.00	—	$318.54	$2,482.12	$1,241.06	2026-07-19
23700	CPT	Manj W/anes Shoulder Joint W/fixation Ap	35	35	$5,568.07	—	$318.54	$4,454.46	$1,241.06	2026-07-19
27369	CPT	Njx Cntrst Kne Arthg/ct/mri	12	12	$1,258.00	—	$754.80	$1,006.40	$950.00	2026-07-19
20985	CPT	Cptr-asst Surgical Navigation Image-less	14	14	$92,022.53	—	$318.54	$73,618.02	$950.00	2026-07-19
93613	CPT	Electrophys Map 3d Add-on	10	10	$8,301.00	—	$950.00	$6,640.80	$950.00	2026-07-19
93623	CPT	Stimulation Pacing Heart	10	10	$5,767.00	—	$950.00	$4,613.60	$950.00	2026-07-19
51798	CPT	US Urine Capacity Measure	66	35	$950.00	—	$21.86	$49,158.75	$950.00	2026-07-19
95811	CPT	Polysom 6/>yrs Cpap 4/> Parm	27	27	$4,080.00	—	$819.87	$3,264.00	$819.87	2026-07-19
95810	CPT	Polysom 6/> Yrs 4/> Param	27	27	$5,180.00	—	$819.87	$4,144.00	$819.87	2026-07-19
95939	CPT	C Motor Evoked Upr&lwr Limbs	23	23	$2,400.00	—	$819.87	$1,920.00	$819.87	2026-07-19
95808	CPT	Polysom Any Age 1-3> Param	27	27	$2,408.00	—	$819.87	$1,926.40	$819.87	2026-07-19
73222	CPT	MRI Low Extrem W/jnt W/cont Lt	27	27	$1,525.44	—	$214.93	$1,274.94	$637.47	2026-07-19
72265	CPT	Xray Finger(s) Min 2 Vw Lt	27	27	$2,046.23	—	$59.62	$1,636.98	$637.47	2026-07-19
72255	CPT	Xray Foot 2 Vw Lt	27	27	$1,730.16	—	$54.41	$1,384.13	$637.47	2026-07-19
73722	CPT	MRI Brain Without Cont	27	27	$1,525.44	—	$218.40	$1,274.94	$637.47	2026-07-19
62304	CPT	Myelography Lumbar Injection	35	35	$2,046.23	—	$614.04	$1,636.98	$637.47	2026-07-19
62305	CPT	Myelography Lumbar Injection	35	35	$3,600.00	—	$614.04	$2,880.00	$637.47	2026-07-19
62303	CPT	Myelography Lumbar Injection	33	33	$2,600.00	—	$614.04	$2,080.00	$637.47	2026-07-19
23350	CPT	Injection For Shoulder X-ray	16	16	$950.00	—	$73.30	$950.00	$623.50	2026-07-19
88309	CPT	Tissue Exam By Pathologist	27	27	$1,169.70	—	$116.92	$1,169.70	$584.85	2026-07-19
62270	CPT	Spinal Fluid Tap Diagnostic	35	35	$1,400.00	—	$318.54	$1,400.00	$565.64	2026-07-19
90682	CPT	Riv4 Vacc Recombinant DNA IM	8	8	$1,710.00	—	$55.51	$1,368.00	$540.75	2026-07-19
27093	CPT	Injection For Hip X-ray	14	14	$950.00	—	$54.89	$950.00	$525.62	2026-07-19
74249	CPT	Contrst X-ray Uppr Gi Tract	5	5	$857.67	—	$420.26	$686.14	$514.60	2026-07-19
92960	CPT	Cardioversion Electric Ext	35	35	$1,400.00	—	$443.28	$1,400.00	$500.85	2026-07-19
93320	CPT	Doppler Echo Exam Heart	4	4	$734.80	—	$440.88	$587.84	$459.25	2026-07-19
95805	CPT	Multiple Sleep Latency Test	23	23	$2,408.00	—	$434.78	$1,926.40	$434.78	2026-07-19
94003	CPT	Vent Mgmt Inpat Subq Day	23	23	$865.06	—	$432.53	$865.06	$432.53	2026-07-19
94002	CPT	Vent Mgmt Inpat Init Day	23	23	$865.06	—	$432.53	$865.06	$432.53	2026-07-19
93312	CPT	Echo Transesophageal	27	27	$1,444.74	—	$430.42	$1,155.79	$430.42	2026-07-19
93306	CPT	Tte W/doppler Complete	23	23	$1,374.73	—	$430.42	$1,099.78	$430.42	2026-07-19
93325	CPT	Doppler Color Flow Add-on	4	4	$652.00	—	$391.20	$521.60	$407.50	2026-07-19
76942	CPT	Echo Guide For Biopsy	10	8	$601.77	—	$27.66	$481.42	$361.06	2026-07-19
73223	CPT	MRI Joint Upr Extr W/O&with Contrast	27	27	$1,869.11	—	$262.00	$1,495.29	$328.12	2026-07-19
73220	CPT	MRI Low Extrem No/jnt W/cont Lt	27	27	$1,869.11	—	$282.31	$1,495.29	$328.12	2026-07-19
73219	CPT	MRI Low Extrem No/jnt Without Cont Lt	27	27	$1,525.44	—	$234.26	$1,220.35	$328.12	2026-07-19
73201	CPT	CT Neck Without Cont	27	27	$1,051.72	—	$122.04	$841.38	$328.12	2026-07-19
73115	CPT	Up Extrem Duplex Art Uni/ltd	27	27	$982.03	—	$58.13	$785.62	$328.12	2026-07-19
73085	CPT	Extrem Veins Duplex Uni/ltd	27	27	$982.03	—	$51.44	$785.62	$328.12	2026-07-19
73040	CPT	Up Extrem Duplex Art Bil Cmplt	27	27	$982.03	—	$54.66	$785.62	$328.12	2026-07-19
72197	CPT	MRI Chest W & Without Cont	27	27	$1,869.11	—	$282.31	$1,495.29	$328.12	2026-07-19
72196	CPT	MRI Chest W/cont	27	27	$1,525.44	—	$235.00	$1,220.35	$328.12	2026-07-19
72158	CPT	MRA Neck Without Cont	27	27	$1,869.11	—	$192.89	$1,495.29	$328.12	2026-07-19
72157	CPT	MRI L Spine W & Without Cont	27	27	$1,869.11	—	$194.37	$1,495.29	$328.12	2026-07-19
72149	CPT	MRI Lumbar Spine With Contrast	27	27	$1,525.44	—	$167.37	$1,220.35	$328.12	2026-07-19
72147	CPT	MRI L Spine W/cont	27	27	$1,525.44	—	$168.36	$1,220.35	$328.12	2026-07-19
72142	CPT	MRA Head W & Without Cont	27	27	$1,525.44	—	$170.59	$1,220.35	$328.12	2026-07-19
72132	CPT	CT Angiograph Up Extrem Lt	27	27	$1,051.72	—	$123.53	$841.38	$328.12	2026-07-19
72126	CPT	CT Abdo Without Cont	27	27	$1,051.72	—	$124.02	$841.38	$328.12	2026-07-19
71552	CPT	MRA Head Without Cont	27	27	$1,869.11	—	$328.12	$1,495.29	$328.12	2026-07-19
70553	CPT	CT Up Extrem W/cont Lt	27	27	$1,869.11	—	$193.88	$1,495.29	$328.12	2026-07-19
70552	CPT	CT Up Extrem Without Cont Lt	27	27	$1,525.44	—	$169.60	$1,220.35	$328.12	2026-07-19
70549	CPT	CT Sinuses W & Without Cont	27	27	$1,869.11	—	$328.12	$1,495.29	$328.12	2026-07-19
70548	CPT	CT Sinuses W/cont	27	27	$1,525.44	—	$255.31	$1,220.35	$328.12	2026-07-19
70546	CPT	CT Pelvis W & Without Cont	27	27	$1,869.11	—	$328.12	$1,495.29	$328.12	2026-07-19
70543	CPT	MRI C Spine Without Cont	27	27	$1,869.11	—	$277.61	$1,495.29	$328.12	2026-07-19
70542	CPT	MRI C Spine W/cont	27	27	$1,525.44	—	$231.04	$1,220.35	$328.12	2026-07-19
74183	CPT	CT T Spine W/cont	27	27	$1,869.11	—	$283.55	$1,495.29	$328.12	2026-07-19
74182	CPT	CT T Spine Without Cont	27	27	$1,525.44	—	$263.24	$1,220.35	$328.12	2026-07-19
74174	CPT	CT Angio Abd&pelv W/O&with Contrast	27	27	$2,031.89	—	$301.88	$1,625.51	$328.12	2026-07-19
73723	CPT	MRI Brain W/cont	27	27	$1,869.11	—	$262.99	$1,495.29	$328.12	2026-07-19
73720	CPT	MRI Abdo W/cont	27	27	$1,869.11	—	$284.54	$1,495.29	$328.12	2026-07-19
73719	CPT	MRI Abdo Without Cont	27	27	$1,525.44	—	$235.25	$1,220.35	$328.12	2026-07-19
74420	CPT	Contrst X-ray Urinary Tract	27	27	$814.67	—	$65.48	$656.24	$328.12	2026-07-19
73615	CPT	Extrem Veins Duplex Bilat Cmplt	27	27	$982.03	—	$52.43	$785.62	$328.12	2026-07-19
73580	CPT	Low Extrem Duplex Art Uni/ltd	27	27	$982.03	—	$68.78	$785.62	$328.12	2026-07-19
74430	CPT	Contrast X-ray Bladder	27	27	$656.24	—	$18.00	$656.24	$328.12	2026-07-19
73525	CPT	Low Extrem Duplex Art Bil Cmplt	27	27	$982.03	—	$52.43	$785.62	$328.12	2026-07-19
27530	CPT	Cltx Tibial Fx Proximal Without Manipulation	35	35	$34,035.88	—	$183.79	$27,228.70	$318.54	2026-07-19
64505	CPT	N Block Spenopalatine Gangl	35	35	$950.00	—	$232.79	$950.00	$318.54	2026-07-19
99213	CPT	Office/outpatient Visit Est	4	4	$500.00	—	$300.00	$400.00	$312.50	2026-07-19
10120	CPT	Incision & Removal Foreign Body Subq Tis	35	35	$28,326.04	—	$97.73	$22,660.83	$308.26	2026-07-19
92523	CPT	Speech Sound Lang Comprehen	4	4	$490.50	—	$294.30	$392.40	$306.56	2026-07-19
31720	CPT	Clearance Of Airways	35	35	$950.00	—	$167.46	$950.00	$301.43	2026-07-19
96413	CPT	Chemo IV Infusion 1 Hr	27	27	$976.92	—	$83.23	$781.54	$276.98	2026-07-19
25246	CPT	Injection For Wrist X-ray	14	14	$950.00	—	$73.30	$950.00	$272.68	2026-07-19
86870	CPT	Rbc Antibody Identification	29	27	$519.22	—	$50.00	$519.22	$259.61	2026-07-19
92610	CPT	Evaluate Swallowing Function	4	4	$405.00	—	$243.00	$324.00	$253.12	2026-07-19
74300	CPT	X-ray Bile Ducts/pancreas	8	8	$730.00	—	$50.57	$584.00	$244.28	2026-07-19
62252	CPT	Csf Shunt Reprogram	35	35	$2,841.00	—	$97.73	$2,841.00	$242.86	2026-07-19
92524	CPT	Behavral Qualit Analys Voice	4	4	$381.00	—	$228.60	$304.80	$238.12	2026-07-19
94729	CPT	Co/membane Diffuse Capacity	4	4	$378.55	—	$227.13	$302.84	$236.59	2026-07-19
94726	CPT	Pulm Funct Tst Plethysmograp	23	23	$759.30	—	$235.71	$607.44	$235.71	2026-07-19
94621	CPT	Cardiopulm Exercise Testing	23	23	$759.30	—	$235.71	$607.44	$235.71	2026-07-19
94060	CPT	Evaluation Of Wheezing	23	23	$471.42	—	$207.48	$471.42	$235.71	2026-07-19
94375	CPT	Respiratory Flow Volume Loop	23	23	$759.30	—	$235.71	$607.44	$235.71	2026-07-19
92516	CPT	Facial Nerve Function Test	23	23	$471.42	—	$145.32	$471.42	$235.71	2026-07-19
95927	CPT	Somatosensory Testing	27	27	$950.00	—	$23.56	$760.00	$235.71	2026-07-19
96105	CPT	Assessment Of Aphasia	4	4	$377.00	—	$226.20	$301.60	$235.62	2026-07-19
97167	CPT	Ot Eval High Complex 60 Min	4	4	$375.00	—	$225.00	$300.00	$234.38	2026-07-19
97163	CPT	Pt Eval High Complex 45 Min	4	4	$375.00	—	$225.00	$300.00	$234.38	2026-07-19
20610	CPT	Arthrocentesis Aspir&/inj Major Jt/bursa	37	35	$6,259.00	—	$73.30	$5,007.20	$232.79	2026-07-19
97166	CPT	Ot Eval Mod Complex 45 Min	6	4	$350.00	—	$210.00	$280.00	$227.50	2026-07-19
92522	CPT	Evaluate Speech Production	4	4	$354.93	—	$212.96	$283.94	$221.84	2026-07-19
97162	CPT	Pt Eval Mod Complex 30 Min	4	4	$350.00	—	$210.00	$280.00	$218.75	2026-07-19
92521	CPT	Evaluation Of Speech Fluency	4	4	$341.90	—	$205.14	$273.52	$213.69	2026-07-19
97165	CPT	Ot Eval Low Complex 30 Min	6	4	$325.00	—	$195.00	$260.00	$211.25	2026-07-19
97161	CPT	Pt Eval Low Complex 20 Min	6	4	$325.00	—	$195.00	$260.00	$211.25	2026-07-19
73221	CPT	MRI Low Extrem W/jnt Without Cont Lt	27	27	$1,184.44	—	$129.22	$947.55	$205.12	2026-07-19
73218	CPT	MRI Low Extrem W/jnt W & Without Cont Lt	27	27	$1,184.44	—	$205.12	$947.55	$205.12	2026-07-19
72195	CPT	MRI Chest Without Cont	27	27	$1,184.44	—	$205.12	$947.55	$205.12	2026-07-19
72148	CPT	MRI Abdo W & Without Cont	27	27	$1,184.44	—	$117.33	$947.55	$205.12	2026-07-19
72146	CPT	MRI L Spine Without Cont	27	27	$1,184.44	—	$117.33	$947.55	$205.12	2026-07-19
72141	CPT	MRA Head W/cont	27	27	$1,184.44	—	$117.33	$947.55	$205.12	2026-07-19
93970	CPT	US OB Preg Transvag	27	27	$532.46	—	$189.62	$425.97	$205.12	2026-07-19
93978	CPT	US OB Preg => 1 Fetus	27	27	$532.46	—	$97.43	$425.97	$205.12	2026-07-19

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