Price Transparencybeta Hospital negotiated rates

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

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Hospital

LAKES REGIONAL HEALTHCARE

Spirit Lake, IA · CCN 160124 · Rates published

1,138 distinct procedures filed
6 distinct payers
24,551 rate rows
2026-05-08 last MRF observed
Data quality

24,458 of 24,551 rate rows are consumer-grade (99.6%)

93 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
percent-of-charges filed in the dollar field — excluded from medians 41
placeholder amount (≤ $0.02) — excluded from medians 28
exceeds 10× this hospital's gross charge — excluded from medians 20
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/613f57be-d5e6-4ac9-84b7-e886a47e46a2/420680370_avera-holy-family-hospital_standardcharges.csv
Found on page https://www.avera.org/patients-visitors/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 5fdd00b4feada39d… · 5,180,358 bytes · first seen 2026-05-08

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
J2350
OTHER 		Ocrelizumab 300 Mg/10 Ml 6 $6.09 $84,715.95 $49,937.82 nat. median
$65
outlier · 769.8×
J2329
OTHER 		Ublituximab-xiiy 150 Mg/6 Ml 6 $6.87 $44,817.44 $26,418.70 nat. median
$73
outlier · 360.2×
J3380
OTHER 		Vedolizumab 300 Mg Vial 6 $21.16 $38,163.10 $22,496.14 nat. median
$24
outlier · 953.2×
884
OTHER 		Ms-DRG 884 1 $20,812.46 $20,812.46 $20,812.46 nat. median
$12,103
1.7× median
897
OTHER 		Ms-DRG 897 1 $19,773.81 $19,773.81 $19,773.81 nat. median
$9,577
outlier · 2.1×
J3101
OTHER 		Tenecteplase 50 Mg/10 Ml Syrng 6 $0.41 $30,005.60 $17,687.51 nat. median
$195
outlier · 90.7×
521
OTHER 		Apr-DRG 521 1 $17,041.91 $17,041.91 $17,041.91 nat. median
$3,507
outlier · 4.9×
291
OTHER 		Ms-DRG 291 1 $14,875.62 $14,875.62 $14,875.62 nat. median
$13,078
1.1× median
871
OTHER 		Ms-DRG 871 1 $14,875.62 $14,875.62 $14,875.62 nat. median
$16,181
0.9× median
J0717
OTHER 		Certolizumab Pegol 400 Mg Kit 6 $3.42 $24,592.04 $14,496.36 nat. median
$5
outlier · 2864.9×
J9271
OTHER 		Pembrolizumab 100 Mg/4 Ml Vial 6 $13.37 $24,490.20 $14,436.33 nat. median
$64
outlier · 224.8×
1392
OTHER 		Apr-DRG 1392 1 $13,762.56 $13,762.56 $13,762.56 nat. median
$4,422
outlier · 3.1×
864
OTHER 		Ms-DRG 864 1 $13,557.52 $13,557.52 $13,557.52 nat. median
$7,202
1.9× median
6633
OTHER 		Apr-DRG 6633 1 $13,276.47 $13,276.47 $13,276.47 nat. median
$9,182
1.4× median
J9312
OTHER 		Rituximab 500 Mg/50 Ml Vial 6 $83.64 $20,272.24 $11,949.95 nat. median
$84
outlier · 142.9×
682
OTHER 		Ms-DRG 682 1 $11,907.20 $11,907.20 $11,907.20 nat. median
$14,531
0.8× median
309
OTHER 		Ms-DRG 309 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$643
outlier · 15.8×
194
OTHER 		Ms-DRG 194 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$8,630
1.2× median
690
OTHER 		Ms-DRG 690 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$8,286
1.2× median
481
OTHER 		Ms-DRG 481 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$11,210
0.9× median
191
OTHER 		Ms-DRG 191 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$8,914
1.1× median
195
OTHER 		Ms-DRG 195 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$6,715
1.5× median
872
OTHER 		Ms-DRG 872 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$8,903
1.1× median
1332
OTHER 		Apr-DRG 1332 1 $10,072.88 $10,072.88 $10,072.88 nat. median
$6,419
1.6× median
200
OTHER 		Ms-DRG 200 1 $8,938.78 $8,938.78 $8,938.78 nat. median
$10,206
0.9× median
177
OTHER 		Ms-DRG 177 1 $8,938.78 $8,938.78 $8,938.78 nat. median
$16,359
0.5× median
179
OTHER 		Ms-DRG 179 1 $8,938.78 $8,938.78 $8,938.78 nat. median
$8,079
1.1× median
310
OTHER 		Ms-DRG 310 1 $8,938.78 $8,938.78 $8,938.78 nat. median
$452
outlier · 19.8×
J1306
OTHER 		Inclisiran 284mg/1.5ml Syringe 6 $5.81 $14,744.10 $8,691.26 nat. median
$13
outlier · 652.5×
J2182
OTHER 		Mepolizumab 100 Mg Vial 6 $6.38 $12,758.71 $7,520.92 nat. median
$34
outlier · 222.8×
J2426
OTHER 		Paliperidone Palm 234mg/1.5ml 6 $14.74 $12,135.38 $7,153.48 nat. median
$16
outlier · 450.8×
J9202
OTHER 		Goserelin 10.8 Mg Implant 6 $77.09 $11,629.14 $6,855.07 nat. median
$780
outlier · 8.8×
683
OTHER 		Ms-DRG 683 1 $6,795.52 $6,795.52 $6,795.52 nat. median
$9,135
0.7× median
66
OTHER 		Ms-DRG 66 1 $6,795.52 $6,795.52 $6,795.52 nat. median
$7,556
0.9× median
178
OTHER 		Ms-DRG 178 1 $6,795.52 $6,795.52 $6,795.52 nat. median
$10,321
0.7× median
Q5123
OTHER 		Rituximab-arrx 500 Mg/50 Ml Vl 6 $33.09 $10,599.49 $6,248.12 nat. median
$41
outlier · 150.8×
10180
OTHER 		I&d Postop Wound Complex 6 $210.58 $10,908.00 $6,108.48 nat. median
$2,683
outlier · 2.3×
69
OTHER 		Ms-DRG 69 1 $5,970.36 $5,970.36 $5,970.36 nat. median
$8,623
0.7× median
193
OTHER 		Ms-DRG 193 2 $5,970.36 $20,724.14 $5,970.36 nat. median
$12,881
outlier · 0.5×
281
OTHER 		Ms-DRG 281 1 $5,970.36 $5,970.36 $5,970.36 nat. median
$9,942
0.6× median
390
OTHER 		Ms-DRG 390 1 $5,970.36 $5,970.36 $5,970.36 nat. median
$1,469
outlier · 4.1×
15271
OTHER 		Skin Substitute Graft 25 Sq Cm 6 $98.98 $10,511.00 $5,886.16 nat. median
$1,419
outlier · 4.1×
J3247
OTHER 		Secukinumab 125 Mg/5 Ml Vial 6 $17.73 $9,190.72 $5,417.69 nat. median
$19
outlier · 291.1×
J0349
OTHER 		Rezafungin 200 Mg Vial 6 $3.78 $8,659.96 $5,104.82 nat. median
$11
outlier · 464.1×
Q5111
OTHER 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 6 $163.60 $8,478.75 $4,998.00 nat. median
$164
outlier · 30.6×
J1602
OTHER 		Golimumab 50 Mg/4 Ml Vial 6 $10.77 $8,389.99 $4,945.68 nat. median
$14
outlier · 357.3×
J3032
OTHER 		Eptinezumab-jjmr 100Mg/Ml Vial 6 $19.32 $7,956.48 $4,690.13 nat. median
$21
outlier · 219.9×
74174
OTHER 		CTA Abd&Pelv Wwo Dye 6 $71.13 $6,982.00 $4,538.30 nat. median
$502
outlier · 9.0×
Q5122
OTHER 		Pegfilgrastim 6 Mg/0.6 Ml Syr 6 $134.25 $7,504.44 $4,423.67 nat. median
$146
outlier · 30.2×
J3262
OTHER 		Tocilizumab 200 Mg/10 Ml Vial 6 $2.72 $11,435.06 $4,313.77 nat. median
$7
outlier · 605.9×

Other procedures at this hospital

Browse this hospital's 1,138 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J2350 OTHER Ocrelizumab 300 Mg/10 Ml 15 6 $89,174.00 $86,499.44 $6.09 $84,715.95 $49,937.82 2026-05-08
J2329 OTHER Ublituximab-xiiy 150 Mg/6 Ml 15 6 $47,176.00 $45,760.96 $6.87 $44,817.44 $26,418.70 2026-05-08
J3380 OTHER Vedolizumab 300 Mg Vial 16 6 $40,171.00 $38,966.53 $21.16 $38,163.10 $22,496.14 2026-05-08
884 OTHER Ms-DRG 884 2 1 — — $20,812.46 $20,812.46 $20,812.46 2026-05-08
897 OTHER Ms-DRG 897 1 1 — — $19,773.81 $19,773.81 $19,773.81 2026-05-08
J3101 OTHER Tenecteplase 50 Mg/10 Ml Syrng 15 6 $31,584.00 $30,637.29 $0.41 $30,005.60 $17,687.51 2026-05-08
521 OTHER Apr-DRG 521 2 1 — — $17,041.91 $17,041.91 $17,041.91 2026-05-08
871 OTHER Ms-DRG 871 2 1 — — $14,875.62 $14,875.62 $14,875.62 2026-05-08
291 OTHER Ms-DRG 291 2 1 — — $14,875.62 $14,875.62 $14,875.62 2026-05-08
J0717 OTHER Certolizumab Pegol 400 Mg Kit 15 6 $25,886.00 $25,109.77 $3.42 $24,592.04 $14,496.36 2026-05-08
J9271 OTHER Pembrolizumab 100 Mg/4 Ml Vial 15 6 $25,779.00 $25,005.79 $13.37 $24,490.20 $14,436.33 2026-05-08
1392 OTHER Apr-DRG 1392 2 1 — — $13,762.56 $13,762.56 $13,762.56 2026-05-08
864 OTHER Ms-DRG 864 2 1 — — $13,557.52 $13,557.52 $13,557.52 2026-05-08
6633 OTHER Apr-DRG 6633 2 1 — — $13,276.47 $13,276.47 $13,276.47 2026-05-08
J9312 OTHER Rituximab 500 Mg/50 Ml Vial 15 6 $21,339.00 $20,699.02 $83.64 $20,272.24 $11,949.95 2026-05-08
682 OTHER Ms-DRG 682 2 1 — — $11,907.20 $11,907.20 $11,907.20 2026-05-08
195 OTHER Ms-DRG 195 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-05-08
191 OTHER Ms-DRG 191 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-05-08
872 OTHER Ms-DRG 872 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-05-08
194 OTHER Ms-DRG 194 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-05-08
481 OTHER Ms-DRG 481 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-05-08
690 OTHER Ms-DRG 690 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-05-08
309 OTHER Ms-DRG 309 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-05-08
1332 OTHER Apr-DRG 1332 2 1 — — $10,072.88 $10,072.88 $10,072.88 2026-05-08
200 OTHER Ms-DRG 200 2 1 — — $8,938.78 $8,938.78 $8,938.78 2026-05-08
177 OTHER Ms-DRG 177 2 1 — — $8,938.78 $8,938.78 $8,938.78 2026-05-08
310 OTHER Ms-DRG 310 2 1 — — $8,938.78 $8,938.78 $8,938.78 2026-05-08
179 OTHER Ms-DRG 179 2 1 — — $8,938.78 $8,938.78 $8,938.78 2026-05-08
J1306 OTHER Inclisiran 284mg/1.5ml Syringe 15 6 $15,520.00 $15,054.51 $5.81 $14,744.10 $8,691.26 2026-05-08
J2182 OTHER Mepolizumab 100 Mg Vial 15 6 $13,430.00 $13,027.31 $6.38 $12,758.71 $7,520.92 2026-05-08
J2426 OTHER Paliperidone Palm 234mg/1.5ml 15 6 $12,774.00 $12,390.86 $14.74 $12,135.38 $7,153.48 2026-05-08
J9202 OTHER Goserelin 10.8 Mg Implant 15 6 $12,241.00 $11,873.96 $77.09 $11,629.14 $6,855.07 2026-05-08
66 OTHER Ms-DRG 66 2 1 — — $6,795.52 $6,795.52 $6,795.52 2026-05-08
683 OTHER Ms-DRG 683 2 1 — — $6,795.52 $6,795.52 $6,795.52 2026-05-08
178 OTHER Ms-DRG 178 2 1 — — $6,795.52 $6,795.52 $6,795.52 2026-05-08
Q5123 OTHER Rituximab-arrx 500 Mg/50 Ml Vl 15 6 $11,157.00 $10,822.64 $33.09 $10,599.49 $6,248.12 2026-05-08
10180 OTHER I&d Postop Wound Complex 22 6 $10,908.00 $10,580.76 $210.58 $10,908.00 $6,108.48 2026-05-08
69 OTHER Ms-DRG 69 2 1 — — $5,970.36 $5,970.36 $5,970.36 2026-05-08
281 OTHER Ms-DRG 281 2 1 — — $5,970.36 $5,970.36 $5,970.36 2026-05-08
193 OTHER Ms-DRG 193 3 2 — — $5,970.36 $20,724.14 $5,970.36 2026-05-08
390 OTHER Ms-DRG 390 2 1 — — $5,970.36 $5,970.36 $5,970.36 2026-05-08
15271 OTHER Skin Substitute Graft 25 Sq Cm 22 6 $10,511.00 $10,195.67 $98.98 $10,511.00 $5,886.16 2026-05-08
J3247 OTHER Secukinumab 125 Mg/5 Ml Vial 15 6 $9,674.00 $9,384.21 $17.73 $9,190.72 $5,417.69 2026-05-08
J0349 OTHER Rezafungin 200 Mg Vial 15 6 $9,115.00 $8,842.28 $3.78 $8,659.96 $5,104.82 2026-05-08
Q5111 OTHER Pegfilgrastim-cbqv 6 Mg/0.6 Ml 15 6 $8,925.00 $8,657.25 $163.60 $8,478.75 $4,998.00 2026-05-08
J1602 OTHER Golimumab 50 Mg/4 Ml Vial 15 6 $8,831.00 $8,566.62 $10.77 $8,389.99 $4,945.68 2026-05-08
J3032 OTHER Eptinezumab-jjmr 100Mg/Ml Vial 15 6 $8,375.00 $8,123.98 $19.32 $7,956.48 $4,690.13 2026-05-08
74174 OTHER CTA Abd&Pelv Wwo Dye 15 6 $6,982.00 $6,772.54 $71.13 $6,982.00 $4,538.30 2026-05-08
Q5122 OTHER Pegfilgrastim 6 Mg/0.6 Ml Syr 15 6 $7,899.00 $7,662.43 $134.25 $7,504.44 $4,423.67 2026-05-08
J3262 OTHER Tocilizumab 200 Mg/10 Ml Vial 24 6 $5,901.00 $5,724.15 $2.72 $11,435.06 $4,313.77 2026-05-08
15275 OTHER Skin Substitute Graft 25 Sq Cm 20 6 $10,511.00 $10,195.67 $112.27 $9,985.45 $3,870.15 2026-05-08
J0129 OTHER Abatacept 250 Mg Vial 15 6 $6,460.00 $6,266.80 $43.38 $6,137.59 $3,617.95 2026-05-08
J9217 OTHER Leuprolide Acetate Sq 22.5Mg 15 6 $6,397.00 $6,205.89 $1.47 $6,077.93 $3,582.78 2026-05-08
78452 OTHER Myocard Perf Spect Rest Stress 16 6 $4,860.00 $4,714.20 $857.30 $5,417.00 $3,552.66 2026-05-08
95811 OTHER Polysomnogram W CPap 15 6 $5,068.00 $4,915.96 $894.00 $4,814.60 $3,496.92 2026-05-08
74178 OTHER CT Abd & Pelv Wwo Contrast 15 6 $6,134.00 $5,949.98 $479.88 $5,827.30 $3,435.04 2026-05-08
948 OTHER Ms-DRG 948 2 1 — — $3,415.72 $3,415.72 $3,415.72 2026-05-08
312 OTHER Ms-DRG 312 2 1 — — $3,414.52 $3,414.52 $3,414.52 2026-05-08
811 OTHER Ms-DRG 811 2 1 — — $3,414.52 $3,414.52 $3,414.52 2026-05-08
J1569 OTHER Immune Glob Gammagard 5gr/50ml 42 6 $5,026.00 $4,876.03 $21.77 $13,396.56 $3,367.98 2026-05-08
95810 OTHER Polysomnogram 15 6 $4,862.00 $4,716.14 $857.66 $4,618.90 $3,354.78 2026-05-08
J2357 OTHER Omalizumab 150 Mg/Ml Syringe 15 6 $5,846.00 $5,671.20 $9.26 $5,554.27 $3,274.10 2026-05-08
750 OTHER Colonoscopy 22 6 $4,631.50 $4,492.56 $786.57 $4,563.80 $3,254.71 2026-05-08
72158 OTHER MRI Lumbar Spine Wwo Dye 15 6 $4,965.00 $4,816.05 $340.97 $4,728.00 $3,227.25 2026-05-08
73720 OTHER MRI Le Wwo Dye Rt 28 6 $5,584.00 $5,416.48 $233.96 $5,304.80 $3,127.04 2026-05-08
73220 OTHER MRI Ue Wwo Dye Rt 15 6 $4,792.00 $4,648.24 $319.79 $4,653.00 $3,114.80 2026-05-08
Q5135 OTHER Tocilizumab-aazg 200 Mg/10 Ml 24 6 $4,208.00 $4,081.97 $4.40 $8,003.48 $3,076.21 2026-05-08
6632 OTHER Apr-DRG 6632 2 1 — — $3,074.67 $3,074.67 $3,074.67 2026-05-08
354 OTHER Ms-DRG 354 1 1 — — $3,001.94 $3,001.94 $3,001.94 2026-05-08
70553 OTHER MRI Brain Wwo Contrast 24 6 $4,773.00 $4,629.81 $729.77 $4,761.40 $2,954.59 2026-05-08
73222 OTHER MRI Joint Ue W Dye Rt 13 6 $4,182.00 $4,056.54 $530.75 $3,972.90 $2,885.58 2026-05-08
70543 OTHER MRI Orbit Face Neck Wwo Cont 13 6 $5,067.00 $4,914.99 $335.45 $4,813.65 $2,837.52 2026-05-08
74177 OTHER CT Abd & Pelv W Contrast 17 6 $4,937.00 $4,788.89 $227.52 $4,690.15 $2,764.72 2026-05-08
72156 OTHER MRI Neck Spine Wwo Dye 13 6 $4,934.00 $4,785.98 $340.05 $4,687.30 $2,763.04 2026-05-08
72157 OTHER MRI Chest Spine Wwo Dye 13 6 $4,934.00 $4,785.98 $535.35 $4,687.30 $2,763.04 2026-05-08
73723 OTHER MRI Joint Le Wwo Dye Lt 30 6 $4,688.00 $4,547.36 $657.06 $4,453.60 $2,625.28 2026-05-08
73223 OTHER MRI Joint Ue Wwo Dye Lt 13 6 $4,653.00 $4,513.41 $597.27 $4,420.35 $2,605.68 2026-05-08
70470 OTHER CT Head/Brain Wwo Contrast 16 6 $3,882.00 $3,765.54 $241.32 $3,687.90 $2,600.94 2026-05-08
19083 OTHER Biopsy Breast 1st Lesion Rt 25 6 $3,363.00 $3,262.11 $593.23 $3,194.85 $2,596.24 2026-05-08
J7336 OTHER Capsaicin 8% W/Cleanser Gel 15 6 $3,888.00 $3,771.39 $3.38 $28,800.00 $2,527.22 2026-05-08
J1439 OTHER Ferric Carboxymalt 750mg/15ml 15 6 $4,509.00 $4,373.79 $1.13 $4,283.61 $2,525.07 2026-05-08
19084 OTHER Biopsy Breast Addl Lesion Rt 13 6 $3,202.00 $3,105.94 $564.83 $3,202.00 $2,471.94 2026-05-08
C1776 OTHER Head Fem ) 26mm Hip Tpr 211 6 $3,594.00 $3,486.18 $158.76 $27,360.00 $2,410.80 2026-05-08
72146 OTHER MRI Chest Spine Wo Dye 15 6 $4,278.00 $4,149.66 $390.63 $4,064.10 $2,395.68 2026-05-08
73718 OTHER MRI Le Wo Dye Lt 28 6 $4,228.00 $4,101.16 $56.39 $4,016.60 $2,367.68 2026-05-08
74176 OTHER CT Abd & Pelvis Wo Contrast 16 6 $4,224.00 $4,097.28 $95.04 $4,012.80 $2,365.44 2026-05-08
C8929 OTHER Echo M Mode 2d W Contrast 16 6 $3,437.00 $3,333.89 $606.29 $3,265.15 $2,328.57 2026-05-08
11044 OTHER Debride Bone 20 Cm 21 6 $4,112.00 $3,988.64 $264.04 $3,906.40 $2,302.72 2026-05-08
59409 OTHER Obstetrical Care 11 6 $3,308.00 $3,208.76 $583.53 $3,142.60 $2,282.52 2026-05-08
73218 OTHER MRI Ue Wo Dye Lt 13 6 $4,026.00 $3,905.22 $79.40 $3,824.70 $2,254.56 2026-05-08
93306 OTHER Tte W Doppler Complete 17 6 $3,324.00 $3,224.28 $586.35 $3,157.80 $2,210.46 2026-05-08
72148 OTHER MRI Lumbar Spine Wo Dye 17 6 $3,943.00 $3,824.71 $315.18 $3,745.85 $2,208.08 2026-05-08
73701 OTHER CT Le W Dye Lt 29 6 $3,375.00 $3,273.75 $268.01 $3,206.25 $2,193.75 2026-05-08
72141 OTHER MRI Neck Spine Wo Dye 15 6 $3,881.00 $3,764.57 $233.96 $3,686.95 $2,173.36 2026-05-08
72130 OTHER CT Thoracic Spine Wwo Cont 13 6 $3,756.00 $3,643.32 $82.17 $3,568.20 $2,103.36 2026-05-08
73721 OTHER MRI Joint Le Wo Dye Lt 32 6 $3,723.00 $3,611.31 $315.18 $3,536.85 $2,084.88 2026-05-08
90375 OTHER Rabies Imm Glob (Human) 300u/m 26 6 $2,847.00 $2,761.75 $146.90 $13,288.86 $2,081.28 2026-05-08
73221 OTHER MRI Joint Ue Wo Dye Lt 30 6 $3,711.00 $3,599.67 $408.12 $3,534.00 $2,078.16 2026-05-08
Q5115 OTHER Rituximab-abbs 100Mg/10Ml Via 24 6 $2,255.00 $2,188.25 $34.76 $10,715.55 $2,032.59 2026-05-08
J9055 OTHER Cetuximab 100 Mg/50 Ml Vial 15 6 $3,592.00 $3,484.47 $84.84 $3,412.63 $2,011.65 2026-05-08
70498 OTHER CT Angiography Neck W Cont 16 6 $3,495.00 $3,390.15 $278.39 $3,320.25 $1,957.20 2026-05-08
70496 OTHER CT Angiography Head W Cont 16 6 $3,495.00 $3,390.15 $246.84 $3,320.25 $1,957.20 2026-05-08
70487 OTHER CT Maxillofacial W Contrast 15 6 $3,477.00 $3,372.69 $268.29 $3,303.15 $1,947.12 2026-05-08
72132 OTHER CT Lumbar Spine W Contrast 14 6 $3,102.00 $3,008.94 $313.35 $2,946.90 $1,925.15 2026-05-08
72133 OTHER CT Lumbar Spine Wwo Contrast 13 6 $3,427.00 $3,324.19 $385.11 $3,255.65 $1,919.12 2026-05-08
81229 OTHER Acgh Whole Genome 13 6 $2,843.00 $2,757.71 $501.51 $2,700.85 $1,890.60 2026-05-08
Q5119 OTHER Rituximab-pvvr 100Mg/10Ml Vial 24 6 $2,311.00 $2,242.03 $24.94 $10,453.28 $1,862.70 2026-05-08
70544 OTHER MRA Head Wo Contrast 13 6 $3,302.00 $3,202.94 $408.12 $3,136.90 $1,849.12 2026-05-08
36573 OTHER Insert Picc >5 Yrs W Img Gde 13 6 $2,382.00 $2,310.54 $420.18 $3,110.25 $1,838.90 2026-05-08
70551 OTHER MRI Brain Wo Contrast 15 6 $3,259.00 $3,161.23 $447.03 $3,096.05 $1,825.04 2026-05-08
70460 OTHER CT Head/Brain W Contrast 13 6 $3,258.00 $3,160.26 $61.91 $3,095.10 $1,824.48 2026-05-08
71275 OTHER CTA Chest Wwo Contrast 16 6 $3,135.00 $3,040.95 $65.60 $2,978.25 $1,755.60 2026-05-08
32555 OTHER Aspirate Pleura W Imaging Rt 24 6 $2,573.00 $2,495.81 $453.88 $2,444.35 $1,743.21 2026-05-08
71260 OTHER CT Thorax W Contrast 15 6 $3,103.00 $3,009.91 $80.31 $2,947.85 $1,737.68 2026-05-08
72129 OTHER CT Thoracic Spine W Contrast 13 6 $3,102.00 $3,008.94 $128.15 $2,946.90 $1,737.12 2026-05-08
P9035 OTHER Platelet Pheresis Leuko Reduc 11 6 $2,508.00 $2,432.76 $442.41 $2,382.60 $1,730.52 2026-05-08
120 OTHER Room Medical Unit Semi Private 9 6 $2,505.00 $2,429.85 $441.88 $2,379.75 $1,728.45 2026-05-08
70486 OTHER CT Maxillofacial Wo Contrast 16 6 $3,070.00 $2,977.90 $187.95 $2,916.50 $1,719.20 2026-05-08
J1561 OTHER Immune Glob 10% 40 Gm/400 Ml 39 6 $3,711.00 $3,599.83 $3.60 $13,328.79 $1,700.94 2026-05-08
72125 OTHER CT Cervical Spine Wo Contrast 17 6 $3,021.00 $2,930.37 $172.58 $2,869.95 $1,691.76 2026-05-08
J0585 OTHER Botul Tox Type A 100 Unit Vial 15 6 $2,982.00 $2,892.54 $6.48 $2,832.90 $1,669.92 2026-05-08
360 OTHER Or Level 1 121 6 $2,171.00 $2,105.87 $79.73 $7,340.65 $1,635.20 2026-05-08
73700 OTHER CT Le Wo Dye Lt 31 6 $2,911.00 $2,823.67 $76.65 $2,765.45 $1,630.16 2026-05-08
J0248 OTHER Remdesivir 100 Mg Vial 15 6 $2,874.00 $2,788.70 $6.35 $2,731.20 $1,609.97 2026-05-08
70491 OTHER CT Soft Tissue Neck W Cont 15 6 $2,866.00 $2,780.02 $357.53 $2,722.70 $1,604.96 2026-05-08
72195 OTHER MRI Pelvis Wo Dye 13 6 $2,866.00 $2,780.02 $53.64 $2,722.70 $1,604.96 2026-05-08
70450 OTHER CT Head/Brain Wo Contrast 18 6 $2,634.00 $2,554.98 $24.20 $2,502.30 $1,593.57 2026-05-08
72128 OTHER CT Thoracic Spine Wo Contrast 15 6 $2,447.00 $2,373.59 $107.93 $2,330.00 $1,590.55 2026-05-08
73200 OTHER CT Ue Wo Dye Rt 31 6 $2,826.00 $2,741.22 $70.19 $2,826.00 $1,582.56 2026-05-08
74170 OTHER CT Abdomen Wwo Dye 15 6 $2,779.00 $2,695.63 $58.22 $2,640.05 $1,556.24 2026-05-08
71250 OTHER CT Thorax Wo Contrast 17 6 $2,778.00 $2,694.66 $71.13 $2,639.10 $1,555.68 2026-05-08
72131 OTHER CT Lumbar Spine Wo Contrast 15 6 $2,777.00 $2,693.69 $234.87 $2,638.15 $1,555.12 2026-05-08
49083 OTHER Abd Paracentesis W Imaging 13 6 $2,338.00 $2,267.86 $412.42 $2,221.10 $1,554.77 2026-05-08
J1745 OTHER Infliximab 100 Mg Vial 24 6 $5,142.00 $4,988.37 $1.46 $4,885.52 $1,544.61 2026-05-08
115 CPT Room Hospice Ip 9 6 $2,216.00 $2,149.52 $390.90 $2,105.20 $1,529.04 2026-05-08
70481 OTHER CT Orbit W Contrast 13 6 $2,551.00 $2,474.47 $80.31 $2,423.45 $1,428.56 2026-05-08
Q5121 OTHER Infliximab-axxq 100 Mg Vial 15 6 $2,179.00 $2,114.48 $35.88 $4,302.83 $1,416.92 2026-05-08
95782 OTHER Polysomnogram < 6 Yrs 11 6 $1,967.00 $1,907.99 $346.98 $1,868.65 $1,357.23 2026-05-08
74160 OTHER CT Abdomen W Dye 13 6 $2,270.00 $2,201.90 $400.43 $2,156.50 $1,271.20 2026-05-08
J0881 OTHER Darbepoe Alfa 200mcg/0.4ml Syr 33 6 $2,269.00 $2,201.07 $2.65 $2,826.77 $1,270.72 2026-05-08
64483 OTHER Inj Foramen Epidural L/s Bi 57 6 $2,165.00 $2,100.05 $134.72 $2,781.60 $1,268.80 2026-05-08
70480 OTHER CT Orbit Wo Contrast 13 6 $2,196.00 $2,130.12 $192.56 $2,086.20 $1,229.76 2026-05-08
99285 OTHER Emergency Room Visit Level 5 24 6 $3,230.00 $3,133.10 $159.07 $3,068.50 $1,189.28 2026-05-08
25605 OTHER Fx Distal Radius W Man Lt 20 6 $1,808.00 $1,753.76 $318.93 $1,717.60 $1,176.99 2026-05-08
93970 OTHER Venous Duplex 14 6 $1,730.00 $1,678.10 $305.17 $1,643.50 $1,172.08 2026-05-08
Q5104 OTHER Infliximab-abda 100 Mg Vial 15 6 $1,775.00 $1,722.66 $27.85 $5,119.19 $1,154.36 2026-05-08
J0666 OTHER Bupivac Liposome 1.3% Pf 20 Ml 15 6 $1,772.00 $1,719.46 $1.42 $1,713.62 $1,152.22 2026-05-08
36569 OTHER Insert Picc Line >5 Without Guide 11 6 $1,658.00 $1,608.26 $292.47 $1,575.10 $1,144.02 2026-05-08
710 OTHER Recovery Phase 1 Per 15 Min 33 6 $1,679.00 $1,628.63 $68.80 $1,913.30 $1,116.54 2026-05-08
32551 OTHER Insertion Chest Tube Rt 11 6 $1,609.00 $1,560.73 $283.83 $1,528.55 $1,110.21 2026-05-08
78315 OTHER Bone Scan 3 Phase 13 6 $1,663.00 $1,613.11 $293.35 $1,579.85 $1,105.89 2026-05-08
25565 OTHER Fx Radial Ulnar Shaft W Man Lt 20 6 $1,643.00 $1,593.71 $289.83 $1,560.85 $1,069.22 2026-05-08
86353 OTHER Lymphocyte Proliferation Antig 13 6 $1,580.00 $1,532.60 $107.39 $1,501.00 $1,050.70 2026-05-08
Q5101 OTHER Filgrastim-sndz 480 Mcg/0.8ml 15 6 $1,584.00 $1,537.32 $0.33 $2,902.40 $1,030.17 2026-05-08
276 OTHER Iol Clareon Vivity Uva 13.5 11 6 $1,492.00 $1,447.72 $263.28 $1,417.88 $1,029.83 2026-05-08
V2787 OTHER Iol Clareon Toric Len 16 44 6 $1,503.50 $1,458.63 $199.24 $1,467.75 $1,005.87 2026-05-08
V2788 OTHER Iol Clareon Strl Uv 16.5 33 6 $1,492.00 $1,447.72 $199.24 $1,439.25 $984.75 2026-05-08
74300 OTHER X-ray Bile Ducts/Pancreas 11 6 $1,427.00 $1,384.19 $251.72 $1,355.65 $965.04 2026-05-08
G0390 OTHER Trauma Team Level 4 11 6 $1,392.00 $1,350.24 $245.55 $1,322.40 $960.48 2026-05-08
684 OTHER Trauma Team Evaluation Level 4 11 6 $1,392.00 $1,350.24 $245.55 $1,322.40 $960.48 2026-05-08
11043 OTHER Debride Muscle/Fascia 20 Cm 20 6 $2,408.00 $2,335.76 $182.22 $2,287.60 $886.67 2026-05-08
J7307 OTHER Female 15 6 $1,130.00 $1,096.10 $7.82 $2,477.86 $872.36 2026-05-08
73040 OTHER Contrast X-ray Shoulder Lt 22 6 $1,327.00 $1,287.19 $210.05 $1,260.65 $862.55 2026-05-08
11042 OTHER Debride Skin Subq 20 Cm 25 6 $1,537.00 $1,490.89 $71.89 $1,460.15 $860.72 2026-05-08
93975 OTHER Vascular Study 11 6 $1,229.00 $1,192.13 $216.80 $1,167.55 $848.01 2026-05-08
129 OTHER Room Swing Bed Skilled 9 6 $1,213.00 $1,176.61 $213.97 $1,152.35 $836.97 2026-05-08
Q9967 OTHER Iopamidol-370 100 Ml Vial 17 6 $1,470.00 $1,425.90 $0.28 $1,396.50 $823.20 2026-05-08
93925 OTHER Arterial Duplex Le Bi 13 6 $1,063.00 $1,031.11 $187.51 $1,063.00 $820.64 2026-05-08
77075 OTHER X-rays Bone Survey Complete 11 6 $1,257.00 $1,219.29 $221.73 $1,194.15 $817.05 2026-05-08
73523 OTHER X-ray Hips 5 Views Bi 13 6 $1,182.00 $1,146.54 $208.50 $1,125.00 $815.58 2026-05-08
72192 OTHER CT Pelvis Wo Dye 15 6 $1,454.00 $1,410.38 $172.84 $1,381.30 $814.24 2026-05-08
78227 OTHER Hida With Ef w/Pharm 11 6 $1,178.00 $1,142.66 $207.80 $1,119.10 $812.82 2026-05-08
80280 OTHER Vedolizumab 11 6 $1,171.00 $1,135.87 $206.56 $1,112.45 $807.99 2026-05-08
93017 OTHER Cardiovascular Stress Test 16 6 $1,056.00 $1,024.32 $186.28 $1,005.00 $771.93 2026-05-08
62321 OTHER Inj Epidural C/t W Guide 23 6 $1,371.00 $1,329.87 $129.44 $1,548.53 $767.76 2026-05-08
92612 OTHER Eval Endo Swallow Function 11 6 $1,096.00 $1,063.12 $193.33 $1,041.20 $756.24 2026-05-08
90675 OTHER Rabies Vax Pcec/Pf 2.5Unit Vl 16 6 $1,347.00 $1,307.03 $125.24 $1,280.08 $754.57 2026-05-08
84252 OTHER Vitamin B2 (Riboflavin) 11 6 $1,092.00 $1,059.24 $192.63 $1,037.40 $753.48 2026-05-08
93971 OTHER Extremity Study Lt 30 6 $1,086.00 $1,053.42 $191.57 $1,031.70 $749.34 2026-05-08
77001 OTHER Fluoroguide For Vein Device 15 6 $1,151.00 $1,116.47 $99.63 $1,093.45 $748.15 2026-05-08
C1788 OTHER Port Impl Pp MRI 96f 1 Lmn 28 6 $814.00 $790.07 $143.68 $1,273.21 $722.06 2026-05-08
93880 OTHER Extracranial Bilat Study 14 6 $1,063.00 $1,031.11 $187.51 $1,009.85 $720.18 2026-05-08
84591 OTHER Vitamin B5 (Pantothanic Acid) 22 6 $1,012.00 $981.64 $155.23 $1,086.80 $719.40 2026-05-08
76775 OTHER Ultrasound Aorta 13 6 $1,081.00 $1,048.57 $190.69 $1,026.95 $718.87 2026-05-08
74270 OTHER Contrast X-ray Colon 11 6 $1,089.00 $1,056.33 $132.75 $1,034.55 $707.85 2026-05-08
C1781 OTHER Mesh Hernia Umb Spr Md Crc 2.5 72 6 $1,032.00 $1,001.39 $110.49 $2,581.82 $681.62 2026-05-08
76801 OTHER OB US < 14 Wks Single Fetus 15 6 $1,020.00 $989.40 $179.93 $969.00 $678.30 2026-05-08
115 OTHER Room Hospice Respite Care 9 6 $977.00 $947.69 $172.34 $928.15 $674.13 2026-05-08
74250 OTHER X-ray Small Bowel 12 6 $990.00 $960.30 $174.64 $940.50 $663.30 2026-05-08
87529 OTHER Hsv DNA Amp Probe 15 6 $958.00 $929.26 $49.50 $910.10 $661.02 2026-05-08
76000 OTHER Fluoroscope Examination 11 6 $852.00 $826.44 $150.29 $809.40 $657.74 2026-05-08
V2632 OTHER Iol Tecns 1Pc Acrylic 17.5d 81 6 $1,010.00 $980.48 $79.38 $1,073.03 $657.02 2026-05-08
88230 OTHER Tissue Culture Non Neoplastic 11 6 $943.00 $914.71 $166.35 $895.85 $650.67 2026-05-08
88262 OTHER Chromosome Analysis 15-20 Cell 11 6 $943.00 $914.71 $166.35 $895.85 $650.67 2026-05-08
76805 OTHER OB US >14 Wk Tvta Single Fetus 11 6 $932.00 $904.04 $164.40 $885.40 $643.08 2026-05-08
Q0138 OTHER Ferumoxy 510mg/17ml (non-esrd) 15 6 $1,145.00 $1,111.35 $0.33 $1,088.43 $641.60 2026-05-08
0202U OTHER Respir Path 22 Targets Biofire 11 6 $914.00 $886.58 $161.23 $868.30 $630.66 2026-05-08
74221 OTHER Double Contrast Esophagus 13 6 $943.00 $914.71 $166.35 $895.85 $620.03 2026-05-08
90677 OTHER Pneumo 20 Valent Vacc 0.5 Ml 24 6 $965.00 $936.39 $170.29 $1,023.15 $615.30 2026-05-08
76536 OTHER Ultrasound Head And Neck 14 6 $908.00 $880.76 $160.17 $862.60 $615.17 2026-05-08
C1726 OTHER Dil Pebax 180Cm Od12-13.5-15 14 6 $781.00 $758.00 $137.85 $781.44 $610.31 2026-05-08
64445 OTHER Inj Sciatic Single N Block Lt 11 6 $880.00 $853.60 $155.23 $836.00 $607.20 2026-05-08
76770 OTHER Ultrasound Abdo Back Wall Comp 14 6 $879.00 $852.63 $155.06 $835.05 $595.52 2026-05-08
76700 OTHER Ultrasound Abdomen Complete 13 6 $894.00 $867.18 $157.70 $849.30 $594.51 2026-05-08
74246 OTHER Contrast X-ray Upper Gi W Air 14 6 $979.00 $949.63 $172.70 $930.05 $592.30 2026-05-08
90684 OTHER Pneumo Conjugate Vaccine 21 Va 16 6 $1,044.00 $1,013.46 $184.30 $992.56 $585.09 2026-05-08
29445 OTHER Rigid Total Contact Leg Cast 11 6 $833.00 $808.01 $146.94 $791.35 $574.77 2026-05-08
76856 OTHER Ultrasound Pelvic Complete 16 6 $830.00 $805.10 $146.41 $788.50 $572.70 2026-05-08
93356 OTHER Myocardial Strain Image Speckl 11 6 $826.00 $801.22 $145.71 $784.70 $569.94 2026-05-08
C1713 OTHER Screw Actb Trilogy 6.5x30mm 222 6 $771.00 $748.60 $11.41 $5,388.21 $561.28 2026-05-08
82610 OTHER Cystatin C 13 6 $721.00 $699.37 $127.18 $686.00 $556.61 2026-05-08
74230 OTHER Cine/Vid X-ray Throat/Esoph 13 6 $649.00 $629.53 $114.48 $657.74 $553.60 2026-05-08
16020 OTHER Dress/Debride Small Burn 11 6 $796.00 $772.12 $140.41 $756.20 $549.24 2026-05-08
73522 OTHER X-ray Hips 3-4 Views Bi 15 6 $788.00 $764.36 $139.00 $793.91 $543.72 2026-05-08
A9585 OTHER Gadobutrol Inj 10 Mm/10 Ml Vl 24 6 $1,000.00 $970.00 $0.56 $950.00 $538.75 2026-05-08
76705 OTHER Ultrasound Abdomen Limited 15 6 $756.00 $733.32 $133.36 $718.20 $521.64 2026-05-08
27560 OTHER Treat Kneecap Dislocation Rt 22 6 $554.00 $537.38 $97.73 $2,470.88 $517.99 2026-05-08
76817 OTHER Transvaginal US Obstetrical 14 6 $761.00 $738.17 $134.24 $722.95 $515.58 2026-05-08
76942 OTHER US Guide Needle Place Sonosite 14 6 $661.00 $641.17 $116.60 $627.95 $513.14 2026-05-08
J2997 OTHER Alteplase 2 Mg Vial 15 6 $907.00 $880.47 $37.08 $862.32 $508.31 2026-05-08
20605 OTHER Asp/Inj Intermediate Joint Rt 13 6 $657.00 $637.29 $115.89 $657.00 $507.20 2026-05-08
93321 OTHER Doppler Echo Exam Heart 13 6 $662.00 $642.14 $116.78 $628.90 $501.17 2026-05-08
62273 OTHER Epidural Blood Patch 11 6 $725.00 $703.25 $127.89 $688.75 $500.25 2026-05-08
77080 OTHER Dexa Scan 15 6 $760.00 $737.20 $88.61 $722.00 $494.00 2026-05-08
80074 OTHER Acute Hepatitis Panel 14 6 $669.00 $648.93 $118.01 $637.00 $489.04 2026-05-08
27808 OTHER Fx Bimalleolar Ankle Lt 20 6 $549.00 $532.53 $96.84 $843.39 $486.69 2026-05-08
761 OTHER Chest Tube Insertion 22 6 $699.50 $678.51 $123.13 $665.95 $482.65 2026-05-08
93226 OTHER ECG Monit/Report Up To 48 Hour 15 6 $696.00 $675.12 $122.77 $661.20 $480.24 2026-05-08
12032 OTHER Repair Lac Interm 2.6-7.5 Cm 22 6 $793.00 $769.21 $139.89 $1,033.90 $479.76 2026-05-08
93922 OTHER Ankle Arm Screen 14 6 $655.00 $635.35 $115.54 $623.00 $478.81 2026-05-08
27786 OTHER Fx Distal Fibula Lt 27 6 $618.00 $599.46 $109.02 $2,068.05 $477.10 2026-05-08
93246 OTHER Ext ECG >7 Days Hook Up 15 6 $691.00 $670.27 $121.89 $656.45 $476.79 2026-05-08
93242 OTHER Ext ECG 48 Hrs -7days Hook Up 15 6 $691.00 $670.27 $121.89 $656.45 $476.79 2026-05-08
76857 OTHER Ultrasound Pelvic Limited 14 6 $702.00 $680.94 $123.83 $666.90 $475.61 2026-05-08
12042 OTHER Repair Lac Interm 2.6-7.5 Cm 20 6 $833.00 $808.01 $146.94 $791.35 $466.48 2026-05-08
76882 OTHER US Extremity Nonvasc Limit Lt 26 6 $674.00 $653.78 $118.89 $664.00 $465.06 2026-05-08
96413 OTHER Chemotherapy Inf Initial 13 6 $698.00 $677.06 $123.13 $663.10 $464.17 2026-05-08
26755 OTHER Fx Phalange W Manipulation 20 6 $522.00 $506.34 $92.08 $756.95 $462.75 2026-05-08
23650 OTHER Dislocation Shoulder Wo AnesLT 31 6 $582.00 $564.54 $102.66 $802.00 $459.78 2026-05-08
J2212 OTHER Methylnaltrexone 12mg/0.6ml Vl 13 6 $812.00 $788.38 $1.42 $772.12 $455.15 2026-05-08
27096 OTHER Inject Sacroiliac Joint Rt 22 6 $2,060.00 $1,998.20 $100.37 $1,957.00 $452.00 2026-05-08
62323 OTHER Inj Epidural L/s W Guide 23 6 $1,440.00 $1,396.80 $119.27 $1,368.00 $452.00 2026-05-08
Q4186 OTHER Soft Tissue Graft Epifix 26 6 $685.00 $664.93 $100.94 $651.23 $448.82 2026-05-08
76870 OTHER Ultrasound Scrotum 14 6 $658.00 $638.26 $116.07 $625.10 $445.79 2026-05-08
J1611 OTHER Glucagon (Fresenius Kabi) Vial 15 6 $794.00 $770.88 $81.80 $754.98 $445.04 2026-05-08
99291 OTHER Critical Care 1st 30-74 Min 22 6 $1,853.00 $1,797.41 $39.69 $1,760.35 $444.51 2026-05-08
12031 OTHER Repair Lac Intermed <2.5 Cm 20 6 $793.00 $769.21 $139.89 $753.35 $434.03 2026-05-08
28490 OTHER Fx Great Toe 11 6 $628.00 $609.16 $110.78 $596.60 $433.32 2026-05-08
28470 OTHER Fx Metatarsal 11 6 $628.00 $609.16 $110.78 $596.60 $433.32 2026-05-08
76604 OTHER Ultrasound Chest 13 6 $648.00 $628.56 $114.31 $615.60 $430.92 2026-05-08
J1610 OTHER Glucagon 1 Mg/ml Vial 15 6 $767.00 $744.95 $98.91 $729.59 $430.07 2026-05-08
46050 OTHER Incision Anal Abscess 20 6 $1,046.00 $1,014.62 $119.60 $993.70 $428.89 2026-05-08
12041 OTHER Repair Lac Interm <2.5 Cm 20 6 $793.00 $769.21 $139.89 $753.35 $426.63 2026-05-08
450 OTHER Dissolve Clot Heart Vessel 11 6 $617.00 $598.49 $108.84 $586.15 $425.73 2026-05-08
36593 OTHER Declot/Thrombo Impl Vad 13 6 $550.00 $533.50 $97.02 $522.50 $424.60 2026-05-08
99283 OTHER Emergency Room Visit Level 3 27 6 $653.00 $633.41 $74.82 $621.00 $424.45 2026-05-08
93308 OTHER Echo Limited 13 6 $549.00 $532.53 $96.84 $1,002.34 $423.83 2026-05-08
25600 OTHER Fx Distal Radius Lt 26 6 $549.00 $532.53 $96.84 $2,027.52 $423.83 2026-05-08
P9016 OTHER Red Blood Cells Lekoreduced 14 6 $573.00 $555.81 $101.08 $545.00 $418.87 2026-05-08
28190 OTHER Remove Foreign Body Foot Lt 20 6 $796.00 $772.12 $140.41 $756.20 $410.70 2026-05-08
64635 OTHER Destroy Lumb/Sac Facet Jnt Lt 18 6 $4,049.00 $3,927.53 $267.59 $621.35 $410.45 2026-05-08
64633 OTHER Destroy Cerv/Thor Facet Jnt Rt 9 6 $4,049.00 $3,927.53 $271.18 $629.16 $409.92 2026-05-08
73110 OTHER X-ray Wrist 3 Views Lt 29 6 $628.00 $609.16 $58.22 $596.60 $408.20 2026-05-08
64447 OTHER Inj Femoral Nerve Single Lt 44 6 $880.00 $853.60 $63.57 $924.00 $408.10 2026-05-08
G0399 OTHER Sleep Study Type Iii Portable 16 6 $549.00 $532.53 $96.84 $521.55 $407.00 2026-05-08
92950 OTHER Heart/Lung Resuscitation Cpr 22 6 $852.00 $826.44 $150.29 $809.40 $406.91 2026-05-08
87799 OTHER Bk Virus Quant Pcr, Serum 22 6 $596.50 $578.61 $85.55 $672.60 $405.10 2026-05-08
64400 OTHER Inj Trigeminal N Block Rt 20 6 $1,095.00 $1,062.15 $57.77 $1,040.25 $403.18 2026-05-08
27824 OTHER Fx Distal Tibia Rt 13 6 $522.00 $506.34 $92.08 $497.00 $402.98 2026-05-08
25650 OTHER Fx Ulnar Styloid Rt 13 6 $522.00 $506.34 $92.08 $921.13 $402.98 2026-05-08
23600 OTHER Fx Prox Humeral Wo Man Lt 26 6 $522.00 $506.34 $92.08 $522.00 $402.98 2026-05-08
74220 OTHER Contrast X-ray Esophagus 13 6 $584.00 $566.48 $103.02 $898.00 $402.96 2026-05-08
A9500 OTHER Radiophar Tc99M Sestamibi Dose 16 6 $545.00 $528.65 $96.14 $1,090.00 $398.39 2026-05-08
10061 OTHER I&d Abscess Comp/Multiple 33 6 $491.00 $476.27 $74.44 $903.45 $394.43 2026-05-08
11760 OTHER Repair Nailbed 20 6 $831.00 $806.07 $136.60 $789.45 $392.19 2026-05-08
81256 OTHER Hemochromat Mutation 11 6 $568.00 $550.96 $100.20 $539.60 $391.92 2026-05-08
72110 OTHER X-ray Lumbosacral 4 Views 13 6 $693.00 $672.21 $67.44 $658.35 $388.08 2026-05-08
81291 OTHER Mthfr Mutation 11 6 $560.00 $543.20 $98.78 $532.00 $386.40 2026-05-08
86361 OTHER Cd4 Absolute Count 13 6 $575.00 $557.75 $101.43 $546.25 $382.38 2026-05-08
76642 OTHER Ultrasound Breast Limited Lt 43 6 $482.00 $467.54 $85.02 $686.85 $380.78 2026-05-08
110 OTHER Room Custodial Care 9 6 $551.00 $534.47 $97.20 $523.45 $380.19 2026-05-08
92607 OTHER Eval Speech Gen Aac Device 11 6 $551.00 $534.47 $97.20 $523.45 $380.19 2026-05-08
99236 OTHER Admit/Discharge Same Day High 9 6 $438.00 $424.86 $224.38 $436.48 $380.07 2026-05-08
27230 OTHER Fx Femur Proximal End Lt 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-05-08
26750 OTHER Fx Distal Finger/Thumb Wo Man 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-05-08
26720 OTHER Fx Finger/Thumb Wo Man 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-05-08
26600 OTHER Fx Metacarpal 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-05-08
24530 OTHER Fx Supra/Transcondylar Hum Rt 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-05-08
72050 OTHER X-ray Spine Cervical 4-5 Views 14 6 $547.00 $530.59 $96.49 $746.06 $377.43 2026-05-08
82088 OTHER Aldosterone 11 6 $546.00 $529.62 $96.31 $518.70 $376.74 2026-05-08
94060 OTHER Pft Pre & Post Screen Spirome 13 6 $488.00 $473.36 $86.08 $490.88 $376.74 2026-05-08
71101 OTHER X-ray Ribs Uni W Chest Rt 27 6 $545.00 $528.65 $96.14 $3,427.98 $376.05 2026-05-08
96360 OTHER Inf Therapy Hyd Initial 15 6 $470.00 $455.90 $82.91 $446.50 $371.30 2026-05-08
11600 OTHER Exc Mal Lesion <0.5 Trunk Limb 20 6 $724.00 $702.28 $127.71 $687.80 $370.83 2026-05-08
90837 OTHER Psychotherapy 60 Minutes 14 6 $504.00 $488.88 $88.91 $480.00 $368.42 2026-05-08
90834 OTHER Psychotherapy 45 Minutes 13 6 $473.00 $458.81 $83.44 $450.00 $365.16 2026-05-08
88342 OTHER Immunohisto Stain Init Pr Spec 13 6 $473.00 $458.81 $83.44 $450.00 $365.16 2026-05-08
J2404 OTHER Nicardipine/Ns 40 Mg/200ml Bag 15 6 $560.00 $543.26 $0.09 $1,828.74 $364.04 2026-05-08
77067 OTHER Mammo Screen Implant Bi 44 6 $471.00 $456.87 $83.08 $757.00 $363.61 2026-05-08
70150 OTHER X-ray Facial Bones 3 Views 11 6 $559.00 $542.23 $82.17 $531.05 $363.35 2026-05-08
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