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

GRUNDY COUNTY MEMORIAL HOSPITAL

Grundy Center, IA · CCN 161303 · Rates published

Your selected procedure

You selected 93306 (CPT)

TTE W/ DOPPLER COMPLETE

This hospital’s price: $474 across 9 payers · range $457-$839

Source: https://grundycounty.unitypoint.org/media/393efd55aec6430c9c0ca7b6e444d955/426006485_grundy-county-memorial-hospital_standardcharges.csv · observed 2026-05-08

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

2,295 distinct procedures filed
9 distinct payers
40,853 rate rows
2026-05-08 last MRF observed
Data quality

40,737 of 40,853 rate rows are consumer-grade (99.7%)

116 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 86
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 30
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://grundycounty.unitypoint.org/media/393efd55aec6430c9c0ca7b6e444d955/426006485_grundy-county-memorial-hospital_standardcharges.csv
Found on page https://grundycounty.unitypoint.org/for-patients/payment-insurance/patient-charges-and-costs
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint bfc6fb39a6f10589… · 8,013,953 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
HCPCS 		Ocrelizumab 300 Mg/10ml IV Soln 9 $21,338.80 $39,121.13 $22,129.12 nat. median
$414
outlier · 53.4×
V2632
HCPCS 		Lens, Intraocular Posterior Lvl 1 9 $11,188.80 $20,512.79 $11,603.20 nat. median
$257
outlier · 45.1×
Q9969
HCPCS 		Non-heu Tc-99m Add-on/dose 7 $9,787.50 $17,943.75 $10,965.62 nat. median
$10
outlier · 1096.6×
V2630
HCPCS 		Lens, Intraocular Anterior Lvl 3 9 $9,956.25 $19,181.25 $10,850.00 nat. median
$214
outlier · 50.6×
Q4282
HCPCS 		Cygnus Dual Per Sq Cm Lvl 7 7 $9,281.25 $17,015.62 $10,398.43 nat. median
$638
outlier · 16.3×
Q4196
HCPCS 		Puraply Am Per Sq Cm Lvl 11 7 $8,677.26 $16,706.25 $10,020.31 nat. median
$311
outlier · 32.2×
J0896
HCPCS 		Luspatercept-aamt 75 Mg Sc Solr 9 $4,151.14 $22,658.03 $9,984.67 nat. median
$4,569
outlier · 2.2×
Q9966
HCPCS 		Locm 200-299 Mg/ml Iodine 1ml 9 $9,618.75 $17,634.37 $9,975.00 nat. median
$57
outlier · 175.9×
Q4160
HCPCS 		Nushield Per Sq Cm Lvl 2 7 $8,606.25 $15,778.12 $9,642.18 nat. median
$319
outlier · 30.2×
Q4159
HCPCS 		Affinity Per Sq Cm Lvl 6 7 $8,437.50 $15,778.12 $9,547.65 nat. median
$643
outlier · 14.9×
Q4133
HCPCS 		Grafix Prime Pl/stravix Per 1 Sq Cm Lvl 3 7 $8,268.75 $15,159.37 $9,264.06 nat. median
$454
outlier · 20.4×
Q4132
HCPCS 		Grafix Core, Grafixpl Core Per Sq Cm Lvl 3 7 $7,931.25 $14,540.62 $8,885.93 nat. median
$415
outlier · 21.4×
Q4121
HCPCS 		Theraskin Per Sq Cm Lvl 4 7 $7,256.25 $14,231.25 $8,507.81 nat. median
$182
outlier · 46.8×
J3101
HCPCS 		Tenecteplase 50 Mg IV Kit 9 $8,015.78 $14,695.60 $8,312.66 nat. median
$3,787
outlier · 2.2×
Q4101
HCPCS 		Apligraf Per Sq Cm Lvl 1 7 $7,256.25 $13,303.12 $8,129.68 nat. median
$118
outlier · 68.9×
Q4106
HCPCS 		Dermagraft Per Sq Cm Lvl 1 7 $7,256.25 $13,303.12 $8,129.68 nat. median
$91
outlier · 89.7×
Q4100
HCPCS 		Skin Substitute Nos Lvl 6 7 $6,918.75 $12,684.37 $7,751.56 nat. median
$2,019
outlier · 3.8×
J2506
HCPCS 		Pegfilgrastim 6 Mg/0.6ml Sc Sosy 9 $6,978.69 $12,794.26 $7,237.16 nat. median
$1,659
outlier · 4.4×
C9364
HCPCS 		Porcine Implant Permacol Per Sq Cm Lvl 5 9 $6,243.75 $12,684.37 $7,175.00 nat. median
$4,884
1.5× median
Q3014
HCPCS 		Telehealth Facility Fee 9 $6,918.75 $12,684.37 $7,175.00 nat. median
$60
outlier · 119.6×
C8937
HCPCS 		Cad Breast MRI 9 $6,243.75 $11,446.87 $6,475.00 nat. median
$116
outlier · 56.1×
C1788
HCPCS 		Impl Indwelling Port Lvl 11 9 $4,893.75 $11,446.87 $6,243.75 nat. median
$662
outlier · 9.4×
J0875
HCPCS 		Dalbavancin Hcl 500 Mg IV Solr 9 $5,811.64 $10,654.67 $6,026.88 nat. median
$435
outlier · 13.9×
J2353
HCPCS 		Octreotide Acetate 30 Mg IM Kit 9 $3,704.80 $13,773.52 $5,825.04 nat. median
$5,623
1.0× median
J1569
HCPCS 		Gammagard 30 Gm/300ml Ij Soln 9 $3,534.57 $9,590.12 $5,230.98 nat. median
$1,074
outlier · 4.9×
J7168
HCPCS 		Prothrombin Complex Conc Human 500 Units Kit 9 $4,874.85 $8,937.22 $5,055.40 nat. median
$20
outlier · 248.5×
C1781
HCPCS 		Mesh (implantable) Lvl 14 9 $4,218.75 $8,971.87 $4,926.32 nat. median
$1,410
outlier · 3.5×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6ml Sc Sosy 9 $4,556.25 $8,353.12 $4,725.00 nat. median
$1,984
outlier · 2.4×
Q5122
HCPCS 		Pegfilgrastim-apgf 6 Mg/0.6ml Sc Sosy 9 $4,286.27 $7,858.17 $4,445.02 nat. median
$561
outlier · 7.9×
Q5112
HCPCS 		Trastuzumab-dttb 420 Mg IV Solr 9 $4,053.02 $7,430.54 $4,203.13 nat. median
$69
outlier · 60.9×
Q5119
HCPCS 		Rituximab-pvvr 500 Mg/50ml IV Soln 9 $3,866.18 $7,088.00 $4,009.37 nat. median
$831
outlier · 4.8×
C1776
HCPCS 		Joint Device (implantable) Lvl 35 9 $2,868.75 $7,734.37 $3,841.60 nat. median
$3,390
1.1× median
J1306
HCPCS 		Inclisiran Sodium 284 Mg/1.5ml Sc Sosy 9 $3,690.54 $6,766.00 $3,827.23 nat. median
$44
outlier · 87.5×
C1713
HCPCS 		Anchor/screw Bn/bn,tis/bn Lvl 32 9 $2,193.75 $5,259.37 $2,712.64 nat. median
$862
outlier · 3.1×
J1559
HCPCS 		Immune Globulin (human) 4 Gm/20ml Sc Sosy 9 $1,029.59 $4,588.94 $2,503.06 nat. median
$31
outlier · 81.8×
J1572
HCPCS 		Immune Globulin (human) 20 Gm/200ml IV Soln 9 $2,334.25 $4,279.47 $2,420.71 nat. median
$144
outlier · 16.8×
Q5108
HCPCS 		Pegfilgrastim-jmdb 6 Mg/0.6ml Sc Sosy 9 $2,301.77 $4,219.92 $2,387.02 nat. median
$1,244
1.9× median
A9537
HCPCS 		Tc99m Mebrofenin To 15 Mci 9 $2,193.75 $4,021.87 $2,275.00 nat. median
$157
outlier · 14.5×
A9579
HCPCS 		Contrast Gadolinium Nos Per Ml 9 $2,193.75 $4,021.87 $2,275.00 nat. median
$60
outlier · 37.9×
A9541
HCPCS 		Tc99m Sulfur Colloid To 20 Mci 9 $2,193.75 $4,021.87 $2,275.00 nat. median
$264
outlier · 8.6×
A9582
HCPCS 		Iodine I-123 Iobenguane To 15 Mci 9 $2,193.75 $4,021.87 $2,275.00 nat. median
$5,065
outlier · 0.4×
A9561
HCPCS 		Tc99m Oxidronate To 30 Mci 9 $2,193.75 $4,021.87 $2,275.00 nat. median
$123
outlier · 18.5×
A9577
HCPCS 		Multihance Inj Per Ml 9 $2,193.75 $4,021.87 $2,275.00 nat. median
$42
outlier · 54.3×
A9552
HCPCS 		F18 Fdg To 45 Mci 9 $2,193.75 $4,021.87 $2,275.00 nat. median
$659
outlier · 3.5×
A9512
HCPCS 		Tc99m Pertechnetate Per Mci 9 $2,178.90 $3,994.65 $2,259.60 nat. median
$35
outlier · 65.1×
A9500
HCPCS 		Tc99m Sestamibi Per Study Dose 9 $2,167.01 $3,972.86 $2,247.28 nat. median
$280
outlier · 8.0×
A4648
HCPCS 		Implantable Tiss Marker Lvl 6 9 $2,017.98 $3,830.30 $2,166.64 nat. median
$219
outlier · 9.9×
99080
CPT 		Special Reports/forms 1 $1,954.70 $2,150.17 $2,052.43 nat. median
$20
outlier · 102.9×
99075
CPT 		Medical Deposition Per Hour 1 $1,953.60 $2,148.96 $2,051.28 nat. median
$333
outlier · 6.2×
J0897
HCPCS 		Denosumab 60 Mg/ml Sc Sosy 9 $1,976.26 $3,623.15 $2,049.46 nat. median
$1,982
1.0× median

Other procedures at this hospital

Browse this hospital's 2,295 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
             
J2350 HCPCS Ocrelizumab 300 Mg/10ml IV Soln 15 9 $39,516.30 $31,613.04 20% off $21,338.80 $39,121.13 $22,129.12 2026-05-08
V2632 HCPCS Lens, Intraocular Posterior Lvl 1 15 9 $20,720.00 $16,576.00 20% off $11,188.80 $20,512.79 $11,603.20 2026-05-08
Q9969 HCPCS Non-heu Tc-99m Add-on/dose 13 7 $18,125.00 $14,500.00 20% off $9,787.50 $17,943.75 $10,965.62 2026-05-08
V2630 HCPCS Lens, Intraocular Anterior Lvl 3 30 9 $18,906.25 $15,125.00 20% off $9,956.25 $19,181.25 $10,850.00 2026-05-08
Q4282 HCPCS Cygnus Dual Per Sq Cm Lvl 7 13 7 $17,187.50 $13,750.00 20% off $9,281.25 $17,015.62 $10,398.43 2026-05-08
Q4196 HCPCS Puraply Am Per Sq Cm Lvl 11 39 7 $16,562.50 $13,250.00 20% off $8,677.26 $16,706.25 $10,020.31 2026-05-08
J0896 HCPCS Luspatercept-aamt 75 Mg Sc Solr 30 9 $15,287.10 $15,287.10 $4,151.14 $22,658.03 $9,984.67 2026-05-08
Q9966 HCPCS Locm 200-299 Mg/ml Iodine 1ml 15 9 $17,812.50 $14,250.00 20% off $9,618.75 $17,634.37 $9,975.00 2026-05-08
Q4160 HCPCS Nushield Per Sq Cm Lvl 2 13 7 $15,937.50 $12,750.00 20% off $8,606.25 $15,778.12 $9,642.18 2026-05-08
Q4159 HCPCS Affinity Per Sq Cm Lvl 6 26 7 $15,781.25 $12,625.00 20% off $8,437.50 $15,778.12 $9,547.65 2026-05-08
Q4133 HCPCS Grafix Prime Pl/stravix Per 1 Sq Cm Lvl 3 13 7 $15,312.50 $12,250.00 20% off $8,268.75 $15,159.37 $9,264.06 2026-05-08
Q4132 HCPCS Grafix Core, Grafixpl Core Per Sq Cm Lvl 3 13 7 $14,687.50 $11,750.00 20% off $7,931.25 $14,540.62 $8,885.93 2026-05-08
Q4121 HCPCS Theraskin Per Sq Cm Lvl 4 39 7 $14,062.50 $11,250.00 20% off $7,256.25 $14,231.25 $8,507.81 2026-05-08
J3101 HCPCS Tenecteplase 50 Mg IV Kit 15 9 $14,844.05 $14,844.05 $8,015.78 $14,695.60 $8,312.66 2026-05-08
Q4101 HCPCS Apligraf Per Sq Cm Lvl 1 13 7 $13,437.50 $10,750.00 20% off $7,256.25 $13,303.12 $8,129.68 2026-05-08
Q4106 HCPCS Dermagraft Per Sq Cm Lvl 1 13 7 $13,437.50 $10,750.00 20% off $7,256.25 $13,303.12 $8,129.68 2026-05-08
Q4100 HCPCS Skin Substitute Nos Lvl 6 13 7 $12,812.50 $10,250.00 20% off $6,918.75 $12,684.37 $7,751.56 2026-05-08
J2506 HCPCS Pegfilgrastim 6 Mg/0.6ml Sc Sosy 15 9 $12,923.50 $12,923.50 $6,978.69 $12,794.26 $7,237.16 2026-05-08
Q3014 HCPCS Telehealth Facility Fee 15 9 $12,812.50 $10,250.00 20% off $6,918.75 $12,684.37 $7,175.00 2026-05-08
C9364 HCPCS Porcine Implant Permacol Per Sq Cm Lvl 5 45 9 $12,187.50 $9,750.00 20% off $6,243.75 $12,684.37 $7,175.00 2026-05-08
C8937 HCPCS Cad Breast MRI 15 9 $11,562.50 $9,250.00 20% off $6,243.75 $11,446.87 $6,475.00 2026-05-08
C1788 HCPCS Impl Indwelling Port Lvl 11 75 9 $10,312.50 $8,250.00 20% off $4,893.75 $11,446.87 $6,243.75 2026-05-08
J0875 HCPCS Dalbavancin Hcl 500 Mg IV Solr 15 9 $10,762.30 $10,762.30 $5,811.64 $10,654.67 $6,026.88 2026-05-08
J2353 HCPCS Octreotide Acetate 30 Mg IM Kit 45 9 $8,961.60 $8,961.60 $3,704.80 $13,773.52 $5,825.04 2026-05-08
J1569 HCPCS Gammagard 30 Gm/300ml Ij Soln 30 9 $8,116.25 $8,116.25 $3,534.57 $9,590.12 $5,230.98 2026-05-08
J7168 HCPCS Prothrombin Complex Conc Human 500 Units Kit 15 9 $9,027.50 $9,027.50 $4,874.85 $8,937.22 $5,055.40 2026-05-08
C1781 HCPCS Mesh (implantable) Lvl 14 105 9 $8,437.50 $6,750.00 20% off $4,218.75 $8,971.87 $4,926.32 2026-05-08
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6ml Sc Sosy 15 9 $8,437.50 $8,437.50 $4,556.25 $8,353.12 $4,725.00 2026-05-08
Q5122 HCPCS Pegfilgrastim-apgf 6 Mg/0.6ml Sc Sosy 15 9 $7,937.55 $7,937.55 $4,286.27 $7,858.17 $4,445.02 2026-05-08
Q5112 HCPCS Trastuzumab-dttb 420 Mg IV Solr 15 9 $7,505.60 $7,505.60 $4,053.02 $7,430.54 $4,203.13 2026-05-08
Q5119 HCPCS Rituximab-pvvr 500 Mg/50ml IV Soln 15 9 $7,159.60 $5,727.68 20% off $3,866.18 $7,088.00 $4,009.37 2026-05-08
C1776 HCPCS Joint Device (implantable) Lvl 35 270 9 $6,136.00 $4,908.80 20% off $2,868.75 $7,734.37 $3,841.60 2026-05-08
J1306 HCPCS Inclisiran Sodium 284 Mg/1.5ml Sc Sosy 15 9 $6,834.35 $5,467.48 20% off $3,690.54 $6,766.00 $3,827.23 2026-05-08
C1713 HCPCS Anchor/screw Bn/bn,tis/bn Lvl 32 315 9 $4,623.00 $3,698.40 20% off $2,193.75 $5,259.37 $2,712.64 2026-05-08
J1559 HCPCS Immune Globulin (human) 4 Gm/20ml Sc Sosy 45 9 $4,547.80 $4,547.80 $1,029.59 $4,588.94 $2,503.06 2026-05-08
J1572 HCPCS Immune Globulin (human) 20 Gm/200ml IV Soln 15 9 $4,322.70 $4,322.70 $2,334.25 $4,279.47 $2,420.71 2026-05-08
Q5108 HCPCS Pegfilgrastim-jmdb 6 Mg/0.6ml Sc Sosy 15 9 $4,262.55 $4,262.55 $2,301.77 $4,219.92 $2,387.02 2026-05-08
A9552 HCPCS F18 Fdg To 45 Mci 15 9 $4,062.50 $3,250.00 20% off $2,193.75 $4,021.87 $2,275.00 2026-05-08
A9537 HCPCS Tc99m Mebrofenin To 15 Mci 15 9 $4,062.50 $3,250.00 20% off $2,193.75 $4,021.87 $2,275.00 2026-05-08
A9579 HCPCS Contrast Gadolinium Nos Per Ml 15 9 $4,062.50 $3,250.00 20% off $2,193.75 $4,021.87 $2,275.00 2026-05-08
A9541 HCPCS Tc99m Sulfur Colloid To 20 Mci 15 9 $4,062.50 $3,250.00 20% off $2,193.75 $4,021.87 $2,275.00 2026-05-08
A9577 HCPCS Multihance Inj Per Ml 15 9 $4,062.50 $3,250.00 20% off $2,193.75 $4,021.87 $2,275.00 2026-05-08
A9561 HCPCS Tc99m Oxidronate To 30 Mci 15 9 $4,062.50 $3,250.00 20% off $2,193.75 $4,021.87 $2,275.00 2026-05-08
A9582 HCPCS Iodine I-123 Iobenguane To 15 Mci 15 9 $4,062.50 $3,250.00 20% off $2,193.75 $4,021.87 $2,275.00 2026-05-08
A9512 HCPCS Tc99m Pertechnetate Per Mci 15 9 $4,035.00 $3,228.00 20% off $2,178.90 $3,994.65 $2,259.60 2026-05-08
A9500 HCPCS Tc99m Sestamibi Per Study Dose 15 9 $4,013.00 $3,210.40 20% off $2,167.01 $3,972.86 $2,247.28 2026-05-08
A4648 HCPCS Implantable Tiss Marker Lvl 6 75 9 $3,779.00 $3,023.20 20% off $2,017.98 $3,830.30 $2,166.64 2026-05-08
99080 CPT Special Reports/forms 2 1 $3,554.00 $2,843.20 20% off $1,954.70 $2,150.17 $2,052.43 2026-05-08
99075 CPT Medical Deposition Per Hour 2 1 $3,552.00 $2,841.60 20% off $1,953.60 $2,148.96 $2,051.28 2026-05-08
J0897 HCPCS Denosumab 60 Mg/ml Sc Sosy 15 9 $3,659.75 $2,927.80 $1,976.26 $3,623.15 $2,049.46 2026-05-08
97804 CPT Grp Nutrition Therapy; Ea 30m 15 9 $3,494.00 $2,795.20 20% off $1,886.76 $3,459.05 $1,956.64 2026-05-08
97533 CPT Sensory Integration Ea 15m 15 9 $3,494.00 $2,795.20 20% off $1,886.76 $3,459.05 $1,956.64 2026-05-08
96366 CPT Ther/proph/dx IV Inf Ea Addtl Hr 15 9 $3,492.00 $2,793.60 20% off $1,885.68 $3,457.07 $1,955.52 2026-05-08
94726 CPT Pulm Funct Tst Plethysmograp 15 9 $3,491.00 $2,792.80 $1,885.14 $3,456.09 $1,954.96 2026-05-08
94640 CPT Mdi Airway Inhalation Tx Subq 60 9 $3,470.50 $2,776.40 20% off $1,868.94 $3,450.15 $1,951.60 2026-05-08
93798 CPT Cardiac Rehab W Cont ECG Phase Ii 15 9 $3,443.00 $2,754.40 20% off $1,859.22 $3,408.57 $1,928.08 2026-05-08
93226 CPT ECG 0-48 Hrs Scanning Analysis Report 15 9 $3,437.50 $2,750.00 20% off $1,856.25 $3,403.12 $1,925.00 2026-05-08
93005 CPT 12 Lead Ekg; Tracing Only 15 9 $3,437.50 $2,750.00 20% off $1,856.25 $3,403.12 $1,925.00 2026-05-08
93225 CPT ECG Monitor 0-48 Hrs Recording 15 9 $3,437.50 $2,750.00 20% off $1,856.25 $3,403.12 $1,925.00 2026-05-08
93788 CPT Abp Monitoring 24+ Hrs; Scanning Analysis 15 9 $3,437.50 $2,750.00 20% off $1,856.25 $3,403.12 $1,925.00 2026-05-08
93246 CPT Ext ECG 7 To 15 Day Recording 15 9 $3,437.50 $2,750.00 20% off $1,856.25 $3,403.12 $1,925.00 2026-05-08
88311 CPT Decalcification 15 9 $3,437.50 $2,750.00 20% off $1,856.25 $3,403.12 $1,925.00 2026-05-08
78816 CPT Nm PET Image W CT Whole Body 15 9 $3,382.00 $2,705.60 20% off $1,826.28 $3,348.17 $1,893.92 2026-05-08
77063 CPT Breast Tomosynthesis Dig Screen Bilat 14 9 $3,240.00 $2,592.00 20% off $1,749.60 $3,207.59 $1,887.30 2026-05-08
78815 CPT Nm PET Image W CT Skull Thigh 15 9 $3,363.00 $2,690.40 20% off $1,816.02 $3,329.36 $1,883.28 2026-05-08
78452 CPT Nm Heart Muscle Spect Mult 15 9 $3,357.00 $2,685.60 20% off $1,812.78 $3,323.42 $1,879.92 2026-05-08
78264 CPT Nm Gastric Emptying Study 15 9 $3,327.00 $2,661.60 20% off $1,796.58 $3,293.73 $1,863.12 2026-05-08
78306 CPT Nm Bone Imaging Whole Body 15 9 $3,327.00 $2,661.60 20% off $1,796.58 $3,293.73 $1,863.12 2026-05-08
78227 CPT Nm Hepatobil Syst Image W/drug 15 9 $3,265.00 $2,612.00 20% off $1,763.10 $3,232.34 $1,828.40 2026-05-08
78226 CPT Nm Hepatobiliary System Imaging 15 9 $3,248.00 $2,598.40 20% off $1,753.92 $3,215.51 $1,818.88 2026-05-08
77062 CPT Breast Tomosynthesis Dig Dx Bilat 15 9 $3,237.50 $2,590.00 20% off $1,748.25 $3,205.12 $1,813.00 2026-05-08
77061 CPT Breast Tomosynthesis Dig Dx Unil 15 9 $3,232.00 $2,585.60 20% off $1,745.28 $3,199.67 $1,809.92 2026-05-08
77049 CPT MRI Breast W Wo Contrast W/cad Bilat 15 9 $3,197.00 $2,557.60 20% off $1,726.38 $3,165.02 $1,790.32 2026-05-08
J0485 HCPCS Belatacept 250 Mg IV Solr 15 9 $3,191.15 $3,191.15 $1,723.22 $3,159.23 $1,787.04 2026-05-08
76377 CPT 3d Render W Postprocess 15 9 $3,169.00 $2,535.20 20% off $1,711.26 $3,137.30 $1,774.64 2026-05-08
75635 CPT CT Angiography Aorta Iliofemoral Runoff 15 9 $3,126.00 $2,500.80 $1,688.04 $3,094.73 $1,750.56 2026-05-08
74183 CPT MRI Abdomen W Wo Contrast 15 9 $3,068.00 $2,454.40 20% off $1,656.72 $3,037.32 $1,718.08 2026-05-08
74181 CPT MRI Abdomen Wo Contrast 15 9 $3,062.50 $2,450.00 20% off $1,653.75 $3,031.87 $1,715.00 2026-05-08
74178 CPT CT Abd & Pelvis W Wo Contr 1+ Reg/sec 15 9 $3,049.00 $2,439.20 20% off $1,646.46 $3,018.50 $1,707.44 2026-05-08
74177 CPT CT Abdomen & Pelvis W Contrast 15 9 $3,036.00 $2,428.80 $1,639.44 $3,005.63 $1,700.16 2026-05-08
J1561 HCPCS Immune Globulin (human 10%)(gamunex-c) 5 Gm/50ml Soln 50 Ml Vial 45 9 $3,007.50 $3,007.50 $835.65 $5,617.16 $1,684.20 2026-05-08
74176 CPT CT Abd & Pelvis Wo Contrast 15 9 $2,984.00 $2,387.20 20% off $1,611.36 $2,954.15 $1,671.04 2026-05-08
74175 CPT CT Angiography Abdomen W Wo Contrast 15 9 $2,972.00 $2,377.60 20% off $1,604.88 $2,942.28 $1,664.32 2026-05-08
74174 CPT CT Angio Abd And Pelv Wo W Contrast 15 9 $2,962.00 $2,369.60 20% off $1,599.48 $2,932.38 $1,658.72 2026-05-08
74170 CPT CT Abdomen W Wo Contrast 15 9 $2,956.00 $2,364.80 $1,596.24 $2,926.44 $1,655.36 2026-05-08
74160 CPT CT Abdomen W Contrast 15 9 $2,952.00 $2,361.60 20% off $1,594.08 $2,922.48 $1,653.12 2026-05-08
74150 CPT CT Abdomen Wo Contrast 15 9 $2,952.00 $2,361.60 20% off $1,594.08 $2,922.48 $1,653.12 2026-05-08
73723 CPT MRI Low Extr Any Joint W Wo Contr 15 9 $2,900.00 $2,320.00 20% off $1,566.00 $2,871.00 $1,624.00 2026-05-08
73720 CPT MRI Low Extr Not Joint W Wo Contr 15 9 $2,887.50 $2,310.00 20% off $1,559.25 $2,858.62 $1,617.00 2026-05-08
73718 CPT MRI Low Extr Not Joint Wo Contrast 15 9 $2,875.00 $2,300.00 20% off $1,552.50 $2,846.25 $1,610.00 2026-05-08
73701 CPT CT Lower Extr W Contrast 15 9 $2,874.00 $2,299.20 20% off $1,551.96 $2,845.25 $1,609.44 2026-05-08
J1439 HCPCS Ferric Carboxymaltose 750 Mg/15ml IV Soln 15 9 $2,863.65 $2,863.65 $1,546.37 $2,835.01 $1,603.64 2026-05-08
73700 CPT CT Lower Extr Wo Contrast 15 9 $2,851.00 $2,280.80 $1,539.54 $2,822.48 $1,596.56 2026-05-08
73600 CPT Ankle 2 Views 15 9 $2,847.00 $2,277.60 20% off $1,537.38 $2,818.53 $1,594.32 2026-05-08
73590 CPT Tibia Fibula 2 Views 15 9 $2,832.00 $2,265.60 20% off $1,529.28 $2,803.67 $1,585.92 2026-05-08
J7325 HCPCS Hylan G-f 20 48 Mg/6ml Ix Sosy 15 9 $2,826.75 $2,826.75 $1,526.44 $2,798.48 $1,582.98 2026-05-08
73522 CPT X-ray Exam Hips Bi 3-4 Views 15 9 $2,820.00 $2,256.00 20% off $1,522.80 $2,791.80 $1,579.20 2026-05-08
73503 CPT X-ray Exam Hip Uni 4/> Views 15 9 $2,812.50 $2,250.00 20% off $1,518.75 $2,784.37 $1,575.00 2026-05-08
73502 CPT X-ray Exam Hip Uni 2-3 Views 15 9 $2,812.50 $2,250.00 20% off $1,518.75 $2,784.37 $1,575.00 2026-05-08
73223 CPT MRI Up Extr Any Joint W Wo Contr 15 9 $2,812.50 $2,250.00 20% off $1,518.75 $2,784.37 $1,575.00 2026-05-08
73200 CPT CT Upper Extr Wo Contrast 15 9 $2,812.50 $2,250.00 20% off $1,518.75 $2,784.37 $1,575.00 2026-05-08
73220 CPT MRI Up Extr Not Joint W Wo Contr 15 9 $2,812.50 $2,250.00 20% off $1,518.75 $2,784.37 $1,575.00 2026-05-08
73221 CPT MRI Up Extr Any Joint Wo Contrast 15 9 $2,812.50 $2,250.00 20% off $1,518.75 $2,784.37 $1,575.00 2026-05-08
73218 CPT MRI Up Extr Not Joint Wo Contrast 15 9 $2,812.50 $2,250.00 20% off $1,518.75 $2,784.37 $1,575.00 2026-05-08
73201 CPT CT Upper Extr W Contrast 15 9 $2,812.50 $2,250.00 20% off $1,518.75 $2,784.37 $1,575.00 2026-05-08
73130 CPT Hand Min 3 Views 15 9 $2,765.00 $2,212.00 20% off $1,493.10 $2,737.34 $1,548.40 2026-05-08
73120 CPT Hand 2 Views 15 9 $2,765.00 $2,212.00 20% off $1,493.10 $2,737.34 $1,548.40 2026-05-08
72197 CPT MRI Pelvis W Wo Contrast 15 9 $2,752.00 $2,201.60 20% off $1,486.08 $2,724.48 $1,541.12 2026-05-08
72195 CPT MRI Pelvis Wo Contrast 15 9 $2,748.00 $2,198.40 $1,483.92 $2,720.51 $1,538.88 2026-05-08
72193 CPT CT Pelvis W Contrast 15 9 $2,712.50 $2,170.00 20% off $1,464.75 $2,685.37 $1,519.00 2026-05-08
72192 CPT CT Pelvis Wo Contrast 15 9 $2,709.00 $2,167.20 20% off $1,462.86 $2,681.90 $1,517.04 2026-05-08
72170 CPT Pelvis 1 Or 2 Views 15 9 $2,704.00 $2,163.20 20% off $1,460.16 $2,676.96 $1,514.24 2026-05-08
72158 CPT MRI Spine Lumbar W Wo Contrast 15 9 $2,704.00 $2,163.20 20% off $1,460.16 $2,676.96 $1,514.24 2026-05-08
72157 CPT MRI Spine Thoracic W Wo Contrast 15 9 $2,699.00 $2,159.20 20% off $1,457.46 $2,672.00 $1,511.44 2026-05-08
72156 CPT MRI Spine Cervical W Wo Contrast 15 9 $2,697.00 $2,157.60 20% off $1,456.38 $2,670.03 $1,510.32 2026-05-08
72148 CPT MRI Spine Lumbar Wo Contrast 15 9 $2,696.00 $2,156.80 $1,455.84 $2,669.03 $1,509.76 2026-05-08
72146 CPT MRI Spine Thoracic Wo Contrast 15 9 $2,681.00 $2,144.80 $1,447.74 $2,654.19 $1,501.36 2026-05-08
72141 CPT MRI Spine Cervical Wo Contrast 15 9 $2,661.00 $2,128.80 $1,436.94 $2,634.38 $1,490.16 2026-05-08
72133 CPT CT Lumbar Spine W Wo Contrast 15 9 $2,646.00 $2,116.80 $1,428.84 $2,619.53 $1,481.76 2026-05-08
72131 CPT CT Lumbar Spine Wo Contrast 15 9 $2,635.00 $2,108.00 20% off $1,422.90 $2,608.65 $1,475.60 2026-05-08
72132 CPT CT Lumbar Spine W Contrast 15 9 $2,635.00 $2,108.00 20% off $1,422.90 $2,608.65 $1,475.60 2026-05-08
72128 CPT CT Thoracic Spine Wo Contrast 15 9 $2,628.00 $2,102.40 $1,419.12 $2,601.71 $1,471.68 2026-05-08
72129 CPT CT Thoracic Spine W Contrast 15 9 $2,628.00 $2,102.40 $1,419.12 $2,601.71 $1,471.68 2026-05-08
72130 CPT CT Thoracic Spine W Wo Contrast 15 9 $2,628.00 $2,102.40 $1,419.12 $2,601.71 $1,471.68 2026-05-08
72125 CPT CT Cervical Spine Wo Contrast 15 9 $2,625.00 $2,100.00 20% off $1,417.50 $2,598.75 $1,470.00 2026-05-08
72100 CPT Lumbosacr Spine 2 Or 3 Views 15 9 $2,620.00 $2,096.00 20% off $1,414.80 $2,593.80 $1,467.20 2026-05-08
72072 CPT Thoracic Spine 3 Views 15 9 $2,620.00 $2,096.00 20% off $1,414.80 $2,593.80 $1,467.20 2026-05-08
71552 CPT MRI Chest W Wo Contrast 15 9 $2,592.00 $2,073.60 20% off $1,399.68 $2,566.07 $1,451.52 2026-05-08
J2997 HCPCS Alteplase 2 Mg Ij Solr 45 9 $2,552.15 $2,041.72 20% off $237.70 $14,200.65 $1,429.20 2026-05-08
71550 CPT MRI Chest Wo Contrast 15 9 $2,551.00 $2,040.80 20% off $1,377.54 $2,525.48 $1,428.56 2026-05-08
71270 CPT CT Chest W Wo Contrast Diag 15 9 $2,537.50 $2,030.00 20% off $1,370.25 $2,512.12 $1,421.00 2026-05-08
71260 CPT CT Chest W Contrast Diag 15 9 $2,533.00 $2,026.40 $1,367.82 $2,507.67 $1,418.48 2026-05-08
99285 CPT Ed Level 5 Init Assess 30 9 $2,278.00 $1,822.40 $450.90 $3,683.78 $1,417.99 2026-05-08
71250 CPT CT Chest Wo Contrast Diag 15 9 $2,512.00 $2,009.60 20% off $1,356.48 $2,486.88 $1,406.72 2026-05-08
71046 CPT X-ray Exam Chest 2 Views 15 9 $2,507.00 $2,005.60 20% off $1,353.78 $2,481.92 $1,403.92 2026-05-08
70544 CPT MRA Head Wo Contrast 15 9 $2,503.00 $2,002.40 $1,351.62 $2,477.96 $1,401.68 2026-05-08
70551 CPT MRI Brain Wo Contrast 15 9 $2,503.00 $2,002.40 $1,351.62 $2,477.96 $1,401.68 2026-05-08
70553 CPT MRI Brain W Wo Contrast 15 9 $2,503.00 $2,002.40 $1,351.62 $2,477.96 $1,401.68 2026-05-08
70498 CPT CT Angiography Neck W Wo Contrast 15 9 $2,503.00 $2,002.40 $1,351.62 $2,477.96 $1,401.68 2026-05-08
70547 CPT MRA Neck Wo Contrast 15 9 $2,503.00 $2,002.40 $1,351.62 $2,477.96 $1,401.68 2026-05-08
70546 CPT MRA Head W Wo Contrast 15 9 $2,503.00 $2,002.40 $1,351.62 $2,477.96 $1,401.68 2026-05-08
70549 CPT MRA Neck W Wo Contrast 15 9 $2,503.00 $2,002.40 $1,351.62 $2,477.96 $1,401.68 2026-05-08
70543 CPT MRI Orbit Face Neck W Wo Contrast 15 9 $2,503.00 $2,002.40 $1,351.62 $2,477.96 $1,401.68 2026-05-08
70496 CPT CT Angiography Head W Wo Contrast 15 9 $2,489.00 $1,991.20 20% off $1,344.06 $2,464.11 $1,393.84 2026-05-08
64999 CPT Unlisted Procedure Nervous System 2 1 $2,410.00 $1,928.00 20% off $1,325.50 $1,458.04 $1,391.77 2026-05-08
70491 CPT CT Soft Tissue Neck W Contrast 15 9 $2,479.00 $1,983.20 20% off $1,338.66 $2,454.21 $1,388.24 2026-05-08
70490 CPT CT Soft Tissue Neck Wo Contrast 15 9 $2,466.00 $1,972.80 20% off $1,331.64 $2,441.34 $1,380.96 2026-05-08
70487 CPT CT Maxillofacial W Contrast 15 9 $2,457.00 $1,965.60 20% off $1,326.78 $2,432.42 $1,375.92 2026-05-08
70486 CPT CT Maxillofacial Wo Contrast 15 9 $2,452.00 $1,961.60 20% off $1,324.08 $2,427.48 $1,373.12 2026-05-08
70482 CPT CT Orbit Sella Mid Inner Ear W Wo Contr 15 9 $2,446.00 $1,956.80 20% off $1,320.84 $2,421.53 $1,369.76 2026-05-08
70480 CPT CT Orbit Sella Mid Inner Ear Wo Contr 15 9 $2,418.00 $1,934.40 $1,305.72 $2,393.82 $1,354.08 2026-05-08
64636 CPT Destroy L/s Facet Jnt Addl Bilat 32 9 $2,401.00 $1,920.80 20% off $363.00 $2,385.90 $1,349.60 2026-05-08
Q0138 HCPCS Ferumoxytol 510 Mg/17ml IV Soln 15 9 $2,405.25 $1,924.20 20% off $1,298.83 $2,381.19 $1,346.94 2026-05-08
64635 CPT Destroy Lumb/sac Facet Jnt Bilat 32 9 $2,379.00 $1,903.20 20% off $554.95 $2,360.15 $1,335.04 2026-05-08
64634 CPT Destroy C/th Facet Jnt Addl Bilat 32 9 $2,375.00 $1,900.00 20% off $375.65 $2,351.25 $1,330.00 2026-05-08
64484 CPT Inj(s) Foramen Epid L/s Addtl Lev Bilat 34 9 $2,362.50 $1,890.00 20% off $128.70 $2,346.30 $1,325.10 2026-05-08
99284 CPT Ed Level 4 Init Assess 30 9 $2,164.50 $1,731.60 20% off $363.42 $3,619.44 $1,320.25 2026-05-08
J9202 HCPCS Goserelin 3.6 Mg Impl 15 9 $2,347.70 $2,347.70 $1,267.75 $2,324.22 $1,314.71 2026-05-08
64480 CPT Inj(s) Foramen Epid C/t Addtl Lev Bilat 30 9 $2,324.50 $1,859.60 20% off $1,251.18 $2,308.67 $1,305.92 2026-05-08
J0881 HCPCS Darbepoetin Alfa 60 Mcg/0.3ml Sosy 90 9 $2,022.50 $2,022.50 $381.61 $7,749.22 $1,301.13 2026-05-08
64405 CPT Inj Anesth/ster Greater Occipital Nerve 17 9 $2,315.00 $1,852.00 20% off $239.80 $2,291.84 $1,296.40 2026-05-08
62321 CPT Inj Interlam C/t W Img 15 9 $2,312.00 $1,849.60 20% off $1,248.48 $2,288.88 $1,294.72 2026-05-08
J3111 HCPCS Romosozumab-aqqg 105 Mg/1.17ml Sc Sosy 15 9 $2,276.25 $1,821.00 20% off $1,229.17 $2,253.48 $1,274.70 2026-05-08
0219U CPT HIV-1 Geno Rfx Mhivdr F1 15 9 $2,240.25 $1,792.20 20% off $1,209.73 $2,217.84 $1,254.54 2026-05-08
36415 CPT Gmh Outpatient Venipuncture 45 9 $2,292.00 $1,833.60 20% off $13.90 $2,274.03 $1,240.38 2026-05-08
20561 CPT Ndl Insj Without Njx 3+ Musc 15 9 $2,200.00 $1,760.00 20% off $1,188.00 $2,178.00 $1,232.00 2026-05-08
27096 CPT Sij Anesth/steriod Inj Pain Bilat 45 9 $2,274.00 $1,819.20 20% off $429.84 $2,255.21 $1,230.12 2026-05-08
20560 CPT Ndl Insj Without Njx 1 Or 2 Musc 15 9 $2,187.50 $1,750.00 20% off $1,181.25 $2,165.62 $1,225.00 2026-05-08
15275 CPT Skin Sub Grft F/nk/hf/g 25 Sq Cm 15 9 $2,187.50 $1,750.00 20% off $1,181.25 $2,165.62 $1,225.00 2026-05-08
11721 CPT Debride Nails 6/> 15 9 $2,187.50 $1,750.00 20% off $1,181.25 $2,165.62 $1,225.00 2026-05-08
11720 CPT Debride Nails 1-5 15 9 $2,187.50 $1,750.00 20% off $1,181.25 $2,165.62 $1,225.00 2026-05-08
11107 CPT Incisional Bx Skn Ea Sep/addl 17 9 $2,185.00 $1,748.00 20% off $8.80 $2,163.15 $1,223.60 2026-05-08
98100744 OTHER Anesthesiologist Per Min 2 1 $2,115.00 $1,692.00 20% off $1,163.25 $1,279.57 $1,221.41 2026-05-08
80080015 OTHER Outside Ambulance Service 15 9 $2,181.00 $1,744.80 20% off $1,177.74 $2,159.19 $1,221.36 2026-05-08
70070018 OTHER Extended Recovery Ea Addtl Hr 15 9 $2,179.00 $1,743.20 20% off $1,176.66 $2,157.21 $1,220.24 2026-05-08
98100323 OTHER Post Op/fracture Care Fu No Charge 2 1 $2,111.00 $1,688.80 20% off $1,161.05 $1,277.15 $1,219.10 2026-05-08
70000664 OTHER Xr Duplicate Film Charge 15 9 $2,176.00 $1,740.80 20% off $1,175.03 $2,154.23 $1,218.56 2026-05-08
40040008 OTHER Anesthesia Minute Incident To Radiology 15 9 $2,168.00 $1,734.40 $1,170.72 $2,146.32 $1,214.08 2026-05-08
98100115 OTHER Crna Per Min 2 1 $2,100.00 $1,680.00 20% off $1,155.00 $1,270.50 $1,212.75 2026-05-08
40040006 OTHER Anesthesia Mac Min 15 9 $2,156.00 $1,724.80 20% off $1,164.24 $2,134.44 $1,207.36 2026-05-08
40040003 OTHER Anesthesia Min 15 9 $2,156.00 $1,724.80 20% off $1,164.24 $2,134.44 $1,207.36 2026-05-08
40040001 OTHER Anesthesia Local Min 15 9 $2,130.00 $1,704.00 20% off $1,150.20 $2,108.69 $1,192.80 2026-05-08
99990011 OTHER Service Per Each 30 Minutes 11 8 $2,127.00 $1,701.60 20% off $1,148.58 $1,595.25 $1,191.12 2026-05-08
99990010 OTHER Visit Count 11 8 $2,125.00 $1,700.00 20% off $1,147.50 $1,593.75 $1,190.00 2026-05-08
99283 CPT Ed Level 3 Init Assess 30 9 $2,020.00 $1,616.00 $220.86 $3,594.69 $1,182.82 2026-05-08
90000687 OTHER Outside Vascular Procedure 15 9 $2,074.00 $1,659.20 20% off $1,119.96 $2,053.25 $1,161.44 2026-05-08
90000677 OTHER Outside MRI Service 15 9 $2,067.00 $1,653.60 20% off $1,116.18 $2,046.32 $1,157.52 2026-05-08
90000676 OTHER Outside Pulmonary Services 15 9 $2,061.00 $1,648.80 20% off $1,112.94 $2,040.38 $1,154.16 2026-05-08
90000675 OTHER Outside Surgery Service 15 9 $2,057.00 $1,645.60 20% off $1,110.77 $2,036.43 $1,151.92 2026-05-08
64633 CPT Destroy Cerv/thor Facet Jnt Unil 32 9 $1,218.75 $975.00 20% off $561.00 $2,347.28 $1,151.71 2026-05-08
90000674 OTHER Outside CT Scan 15 9 $2,055.00 $1,644.00 20% off $1,109.70 $2,034.45 $1,150.80 2026-05-08
90000673 OTHER Outside Xray Services 15 9 $2,052.00 $1,641.60 20% off $1,108.08 $2,031.48 $1,149.12 2026-05-08
27100138 OTHER Misc Implant Charge Level 17 15 9 $2,048.00 $1,638.40 $1,105.92 $2,027.51 $1,146.88 2026-05-08
27100137 OTHER Misc Implant Charge Level 16 15 9 $2,039.00 $1,631.20 20% off $1,101.06 $2,018.60 $1,141.84 2026-05-08
27100136 OTHER Misc Implant Charge Level 15 15 9 $2,036.00 $1,628.80 20% off $1,099.44 $2,015.63 $1,140.16 2026-05-08
27100135 OTHER Misc Implant Charge Level 14 15 9 $2,027.00 $1,621.60 20% off $1,094.58 $2,006.73 $1,135.12 2026-05-08
27100119 OTHER Misc Implant Charge Level 13 15 9 $2,027.00 $1,621.60 20% off $1,094.58 $2,006.73 $1,135.12 2026-05-08
27100118 OTHER Misc Implant Charge Level 12 15 9 $2,012.50 $1,610.00 20% off $1,086.75 $1,992.37 $1,127.00 2026-05-08
27100116 OTHER Misc Implant Charge Level 10 15 9 $2,012.00 $1,609.60 20% off $1,086.48 $1,991.87 $1,126.72 2026-05-08
27100117 OTHER Misc Implant Charge Level 11 15 9 $2,012.00 $1,609.60 20% off $1,086.48 $1,991.87 $1,126.72 2026-05-08
27100115 OTHER Misc Implant Charge Level 9 15 9 $2,011.00 $1,608.80 20% off $1,085.94 $1,990.88 $1,126.16 2026-05-08
27100114 OTHER Misc Implant Charge Level 8 15 9 $2,001.00 $1,600.80 20% off $1,080.53 $1,980.99 $1,120.56 2026-05-08
27100113 OTHER Misc Implant Charge Level 7 15 9 $1,996.00 $1,596.80 20% off $1,077.84 $1,976.03 $1,117.76 2026-05-08
27100112 OTHER Misc Implant Charge Level 6 15 9 $1,982.00 $1,585.60 20% off $1,070.27 $1,962.18 $1,109.92 2026-05-08
27100111 OTHER Misc Implant Charge Level 5 15 9 $1,981.00 $1,584.80 20% off $1,069.74 $1,961.19 $1,109.36 2026-05-08
27100109 OTHER Misc Implant Charge Level 3 15 9 $1,981.00 $1,584.80 20% off $1,069.74 $1,961.19 $1,109.36 2026-05-08
27100110 OTHER Misc Implant Charge Level 4 15 9 $1,981.00 $1,584.80 20% off $1,069.74 $1,961.19 $1,109.36 2026-05-08
27100108 OTHER Misc Implant Charge Level 2 15 9 $1,980.00 $1,584.00 20% off $1,069.20 $1,960.20 $1,108.80 2026-05-08
27100107 OTHER Misc Implant Charge Level 1 15 9 $1,966.00 $1,572.80 20% off $1,061.64 $1,946.33 $1,100.96 2026-05-08
27100106 OTHER Cast Ortho Soft Goods Level 16 15 9 $1,962.00 $1,569.60 20% off $1,059.48 $1,942.37 $1,098.72 2026-05-08
27100104 OTHER Cast Ortho Soft Goods Level 14 15 9 $1,961.00 $1,568.80 20% off $1,058.94 $1,941.38 $1,098.16 2026-05-08
27100105 OTHER Cast Ortho Soft Goods Level 15 15 9 $1,961.00 $1,568.80 20% off $1,058.94 $1,941.38 $1,098.16 2026-05-08
27100103 OTHER Cast Ortho Soft Goods Level 13 15 9 $1,957.00 $1,565.60 20% off $1,056.77 $1,937.43 $1,095.92 2026-05-08
27100102 OTHER Cast Ortho Soft Goods Level 12 15 9 $1,953.00 $1,562.40 $1,054.62 $1,933.47 $1,093.68 2026-05-08
99282 CPT Ed Level 2 Init Assess 30 9 $1,924.50 $1,539.60 20% off $119.88 $3,590.73 $1,089.18 2026-05-08
27100101 OTHER Cast Ortho Soft Goods Level 11 15 9 $1,919.00 $1,535.20 20% off $1,036.25 $1,899.80 $1,074.64 2026-05-08
27100100 OTHER Cast Ortho Soft Goods Level 10 15 9 $1,913.00 $1,530.40 $1,033.01 $1,893.86 $1,071.28 2026-05-08
27100099 OTHER Cast Ortho Soft Goods Level 9 15 9 $1,909.00 $1,527.20 20% off $1,030.86 $1,889.91 $1,069.04 2026-05-08
27100098 OTHER Cast Ortho Soft Goods Level 8 15 9 $1,909.00 $1,527.20 20% off $1,030.86 $1,889.91 $1,069.04 2026-05-08
J1555 HCPCS Immune Globulin (human) 4 Gm/20ml Sc Soln 15 9 $1,906.65 $1,906.65 $1,029.59 $1,887.58 $1,067.72 2026-05-08
27100097 OTHER Cast Ortho Soft Goods Level 7 15 9 $1,904.00 $1,523.20 20% off $1,028.16 $1,884.96 $1,066.24 2026-05-08
27100096 OTHER Cast Ortho Soft Goods Level 6 15 9 $1,900.00 $1,520.00 20% off $1,026.00 $1,881.00 $1,064.00 2026-05-08
27100094 OTHER Cast Ortho Soft Goods Level 4 15 9 $1,895.00 $1,516.00 20% off $1,023.30 $1,876.04 $1,061.20 2026-05-08
27100095 OTHER Cast Ortho Soft Goods Level 5 15 9 $1,895.00 $1,516.00 20% off $1,023.30 $1,876.04 $1,061.20 2026-05-08
27100093 OTHER Cast Ortho Soft Goods Level 3 15 9 $1,889.00 $1,511.20 20% off $1,020.06 $1,870.10 $1,057.84 2026-05-08
27100092 OTHER Cast Ortho Soft Goods Level 2 15 9 $1,875.00 $1,500.00 20% off $1,012.50 $1,856.25 $1,050.00 2026-05-08
27100091 OTHER Cast Ortho Soft Goods Level 1 15 9 $1,875.00 $1,500.00 20% off $1,012.50 $1,856.25 $1,050.00 2026-05-08
27100090 OTHER Sterile Med/surg Supply Level 45 15 9 $1,859.00 $1,487.20 20% off $1,003.86 $1,840.41 $1,041.04 2026-05-08
27100089 OTHER Sterile Med/surg Supply Level 44 15 9 $1,858.00 $1,486.40 $1,003.32 $1,839.42 $1,040.48 2026-05-08
27100088 OTHER Sterile Med/surg Supply Level 43 15 9 $1,858.00 $1,486.40 $1,003.32 $1,839.42 $1,040.48 2026-05-08
27100087 OTHER Sterile Med/surg Supply Level 42 15 9 $1,855.00 $1,484.00 20% off $1,001.70 $1,836.45 $1,038.80 2026-05-08
27100086 OTHER Sterile Med/surg Supply Level 41 15 9 $1,845.00 $1,476.00 20% off $996.30 $1,826.54 $1,033.20 2026-05-08
27100085 OTHER Sterile Med/surg Supply Level 40 15 9 $1,841.00 $1,472.80 20% off $994.14 $1,822.58 $1,030.96 2026-05-08
27100084 OTHER Sterile Med/surg Supply Level 39 15 9 $1,837.50 $1,470.00 20% off $992.25 $1,819.12 $1,029.00 2026-05-08
27100083 OTHER Sterile Med/surg Supply Level 38 15 9 $1,837.50 $1,470.00 20% off $992.25 $1,819.12 $1,029.00 2026-05-08
27100082 OTHER Sterile Med/surg Supply Level 37 15 9 $1,833.00 $1,466.40 $989.82 $1,814.67 $1,026.48 2026-05-08
27100081 OTHER Sterile Med/surg Supply Level 36 15 9 $1,832.00 $1,465.60 20% off $989.28 $1,813.68 $1,025.92 2026-05-08
27100080 OTHER Sterile Med/surg Supply Level 35 15 9 $1,830.00 $1,464.00 20% off $988.20 $1,811.70 $1,024.80 2026-05-08
27100079 OTHER Sterile Med/surg Supply Level 34 15 9 $1,828.25 $1,462.60 20% off $987.25 $1,809.96 $1,023.82 2026-05-08
27100078 OTHER Sterile Med/surg Supply Level 33 15 9 $1,824.00 $1,459.20 20% off $984.96 $1,805.75 $1,021.44 2026-05-08
27100077 OTHER Sterile Med/surg Supply Level 32 15 9 $1,824.00 $1,459.20 20% off $984.96 $1,805.75 $1,021.44 2026-05-08
27100076 OTHER Sterile Med/surg Supply Level 31 15 9 $1,823.00 $1,458.40 $984.42 $1,804.76 $1,020.88 2026-05-08
27100075 OTHER Sterile Med/surg Supply Level 30 15 9 $1,822.00 $1,457.60 20% off $983.88 $1,803.77 $1,020.32 2026-05-08
27100074 OTHER Sterile Med/surg Supply Level 29 15 9 $1,809.00 $1,447.20 20% off $976.86 $1,790.91 $1,013.04 2026-05-08
27100073 OTHER Sterile Med/surg Supply Level 28 15 9 $1,805.00 $1,444.00 20% off $974.70 $1,786.95 $1,010.80 2026-05-08
27100072 OTHER Sterile Med/surg Supply Level 27 15 9 $1,794.00 $1,435.20 20% off $968.76 $1,776.05 $1,004.64 2026-05-08
27100071 OTHER Sterile Med/surg Supply Level 26 15 9 $1,790.00 $1,432.00 20% off $966.60 $1,772.09 $1,002.40 2026-05-08
27100070 OTHER Sterile Med/surg Supply Level 25 15 9 $1,781.00 $1,424.80 20% off $961.74 $1,763.19 $997.36 2026-05-08
27100069 OTHER Sterile Med/surg Supply Level 24 15 9 $1,778.00 $1,422.40 $960.12 $1,760.22 $995.68 2026-05-08
27100068 OTHER Sterile Med/surg Supply Level 23 15 9 $1,778.00 $1,422.40 $960.12 $1,760.22 $995.68 2026-05-08
27100067 OTHER Sterile Med/surg Supply Level 22 15 9 $1,777.00 $1,421.60 20% off $959.58 $1,759.23 $995.12 2026-05-08
27100066 OTHER Sterile Med/surg Supply Level 21 15 9 $1,775.00 $1,420.00 20% off $958.50 $1,757.25 $994.00 2026-05-08
27100065 OTHER Sterile Med/surg Supply Level 20 15 9 $1,773.00 $1,418.40 $957.42 $1,755.26 $992.88 2026-05-08
27100064 OTHER Sterile Med/surg Supply Level 19 15 9 $1,772.00 $1,417.60 20% off $956.88 $1,754.27 $992.32 2026-05-08
27100063 OTHER Sterile Med/surg Supply Level 18 15 9 $1,767.00 $1,413.60 20% off $954.18 $1,749.32 $989.52 2026-05-08
27100062 OTHER Sterile Med/surg Supply Level 17 15 9 $1,763.00 $1,410.40 $952.02 $1,745.36 $987.28 2026-05-08
27100061 OTHER Sterile Med/surg Supply Level 16 15 9 $1,761.00 $1,408.80 20% off $950.94 $1,743.38 $986.16 2026-05-08
27100059 OTHER Sterile Med/surg Supply Level 14 15 9 $1,760.00 $1,408.00 20% off $950.40 $1,742.40 $985.60 2026-05-08
27100060 OTHER Sterile Med/surg Supply Level 15 15 9 $1,760.00 $1,408.00 20% off $950.40 $1,742.40 $985.60 2026-05-08
27100058 OTHER Sterile Med/surg Supply Level 13 15 9 $1,757.50 $1,406.00 20% off $949.05 $1,739.92 $984.20 2026-05-08
27100057 OTHER Sterile Med/surg Supply Level 12 15 9 $1,753.00 $1,402.40 $946.62 $1,735.47 $981.68 2026-05-08
27100056 OTHER Sterile Med/surg Supply Level 11 15 9 $1,752.00 $1,401.60 20% off $946.08 $1,734.48 $981.12 2026-05-08
27100055 OTHER Sterile Med/surg Supply Level 10 15 9 $1,739.00 $1,391.20 20% off $939.06 $1,721.60 $973.84 2026-05-08
27100054 OTHER Sterile Med/surg Supply Level 9 15 9 $1,734.50 $1,387.60 20% off $936.63 $1,717.15 $971.32 2026-05-08
99001 CPT Gmh Employer Drug Screen /g 30 9 $1,786.88 $1,429.50 20% off $13.90 $3,512.51 $970.71 2026-05-08
81229 CPT Chromosml Microarray Mcmap S/d/n/f1/c2/p1/v/y/f/g/pmp/a/x/t/qc/q/w1 30 9 $1,716.40 $1,373.12 20% off $925.45 $1,701.80 $962.64 2026-05-08
86769 CPT Sars Cov2 Ab Spk Nuc L/m/w/s/d/n/f1 30 9 $1,747.36 $1,397.88 20% off $32.78 $3,399.65 $957.23 2026-05-08
27100053 OTHER Sterile Med/surg Supply Level 8 15 9 $1,701.00 $1,360.80 20% off $918.54 $1,683.99 $952.56 2026-05-08
27100052 OTHER Sterile Med/surg Supply Level 7 15 9 $1,700.00 $1,360.00 20% off $918.00 $1,683.00 $952.00 2026-05-08
27100051 OTHER Sterile Med/surg Supply Level 6 15 9 $1,695.00 $1,356.00 20% off $915.30 $1,678.04 $949.20 2026-05-08
27100050 OTHER Sterile Med/surg Supply Level 5 15 9 $1,686.00 $1,348.80 20% off $910.44 $1,669.13 $944.16 2026-05-08
27100049 OTHER Sterile Med/surg Supply Level 4 15 9 $1,679.00 $1,343.20 20% off $906.66 $1,662.21 $940.24 2026-05-08
27100048 OTHER Sterile Med/surg Supply Level 3 15 9 $1,665.00 $1,332.00 20% off $899.10 $1,648.34 $932.40 2026-05-08
27100047 OTHER Sterile Med/surg Supply Level 2 15 9 $1,663.00 $1,330.40 $898.02 $1,646.36 $931.28 2026-05-08
82962 CPT Bedside Glucose A/b/e/g/h/j/l/m/n/o/q/qc/s/t/u/v/w/x/y/z/b1/c1/s1/c2/p1/w1/… 30 9 $1,712.72 $1,370.17 20% off $13.73 $3,366.00 $930.59 2026-05-08
27100046 OTHER Sterile Med/surg Supply Level 1 15 9 $1,659.00 $1,327.20 20% off $895.86 $1,642.41 $929.04 2026-05-08
27100035 OTHER Med/surg Supply Level 35 15 9 $1,654.00 $1,323.20 20% off $893.16 $1,637.46 $926.24 2026-05-08
27100034 OTHER Med/surg Supply Level 34 15 9 $1,651.00 $1,320.80 20% off $891.54 $1,634.49 $924.56 2026-05-08
27100033 OTHER Med/surg Supply Level 33 15 9 $1,650.00 $1,320.00 20% off $891.00 $1,633.50 $924.00 2026-05-08
27100032 OTHER Med/surg Supply Level 32 15 9 $1,646.00 $1,316.80 20% off $888.84 $1,629.53 $921.76 2026-05-08
27100031 OTHER Med/surg Supply Level 31 15 9 $1,642.00 $1,313.60 20% off $886.68 $1,625.57 $919.52 2026-05-08
27100030 OTHER Med/surg Supply Level 30 15 9 $1,640.75 $1,312.60 20% off $886.00 $1,624.34 $918.82 2026-05-08
27100029 OTHER Med/surg Supply Level 29 15 9 $1,640.00 $1,312.00 20% off $885.60 $1,623.59 $918.40 2026-05-08
27100025 OTHER Med/surg Supply Level 25 15 9 $1,636.00 $1,308.80 20% off $883.44 $1,619.63 $916.16 2026-05-08
27100026 OTHER Med/surg Supply Level 26 15 9 $1,636.00 $1,308.80 20% off $883.44 $1,619.63 $916.16 2026-05-08
27100024 OTHER Med/surg Supply Level 24 15 9 $1,636.00 $1,308.80 20% off $883.44 $1,619.63 $916.16 2026-05-08
27100028 OTHER Med/surg Supply Level 28 15 9 $1,636.00 $1,308.80 20% off $883.44 $1,619.63 $916.16 2026-05-08
27100027 OTHER Med/surg Supply Level 27 15 9 $1,636.00 $1,308.80 20% off $883.44 $1,619.63 $916.16 2026-05-08
27100023 OTHER Med/surg Supply Level 23 15 9 $1,631.00 $1,304.80 20% off $880.74 $1,614.69 $913.36 2026-05-08
27100022 OTHER Med/surg Supply Level 22 15 9 $1,628.00 $1,302.40 $879.12 $1,611.72 $911.68 2026-05-08
27100021 OTHER Med/surg Supply Level 21 15 9 $1,626.00 $1,300.80 20% off $878.04 $1,609.74 $910.56 2026-05-08
27100020 OTHER Med/surg Supply Level 20 15 9 $1,625.00 $1,300.00 20% off $877.50 $1,608.75 $910.00 2026-05-08
27100019 OTHER Med/surg Supply Level 19 15 9 $1,621.00 $1,296.80 20% off $875.34 $1,604.78 $907.76 2026-05-08
27100018 OTHER Med/surg Supply Level 18 15 9 $1,618.75 $1,295.00 20% off $874.12 $1,602.56 $906.50 2026-05-08
27100016 OTHER Med/surg Supply Level 16 15 9 $1,610.00 $1,288.00 20% off $869.40 $1,593.90 $901.60 2026-05-08
27100017 OTHER Med/surg Supply Level 17 15 9 $1,610.00 $1,288.00 20% off $869.40 $1,593.90 $901.60 2026-05-08
27100014 OTHER Med/surg Supply Level 14 15 9 $1,609.00 $1,287.20 20% off $868.86 $1,592.91 $901.04 2026-05-08
27100015 OTHER Med/surg Supply Level 15 15 9 $1,609.00 $1,287.20 20% off $868.86 $1,592.91 $901.04 2026-05-08
64483 CPT Inj(s) Foramen Epidural L/s Sgl Lev 34 9 $1,091.00 $872.80 20% off $248.60 $2,314.61 $900.07 2026-05-08
27100013 OTHER Med/surg Supply Level 13 15 9 $1,601.00 $1,280.80 20% off $864.54 $1,584.99 $896.56 2026-05-08
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