Hospital

AVERA MERRILL PIONEER HOSPITAL

Rock Rapids, IA · CCN 161321 · Rates published

795 distinct procedures filed

6 distinct payers

12,429 rate rows

2026-05-06 last MRF observed

Data quality

12,385 of 12,429 rate rows are consumer-grade (99.6%)

44 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
percent-of-charges filed in the dollar field — excluded from medians	18
placeholder amount (≤ $0.02) — excluded from medians	14
exceeds 10× this hospital's gross charge — excluded from medians	12

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

Source MRF file	https://www.avera.org/app/files/public/7aa7f6a3-0114-4d9f-8a0e-2db3ad03c7dd/460224743_avera-merrill-pioneer-hospital_standardcharges.csv
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-05-17
Content fingerprint	a0ca33b14ebefb95… · 2,930,931 bytes · first seen 2026-05-05

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
J9144 OTHER	Daratumumab Hyaluronida 1800Mg	5	$57.99	$43,804.76	$35,597.13	nat. median $58 outlier · 610.1×
J3101 OTHER	Tenecteplase 50 Mg/10 Ml Syrng	5	$0.41	$30,005.60	$24,383.50	nat. median $195 outlier · 125.0×
J1299 OTHER	Eculizumab 300 Mg/30 Ml Vial	5	$44.81	$29,315.74	$24,378.35	nat. median $47 outlier · 515.6×
309 OTHER	Ms-DRG 309	1	$20,481.22	$20,481.22	$20,481.22	nat. median $643 outlier · 31.9×
193 OTHER	Ms-DRG 193	1	$18,197.82	$18,197.82	$18,197.82	nat. median $12,881 1.4× median
Q5120 OTHER	Pegfilgrastim-bmez 6 Mg/0.6 Ml	5	$24.71	$16,922.86	$13,752.05	nat. median $90 outlier · 152.9×
683 OTHER	Ms-DRG 683	1	$12,302.14	$12,302.14	$12,302.14	nat. median $9,135 1.3× median
690 OTHER	Ms-DRG 690	1	$12,302.14	$12,302.14	$12,302.14	nat. median $8,286 1.5× median
J1306 OTHER	Inclisiran 284mg/1.5ml Syringe	5	$5.81	$14,792.78	$12,021.08	nat. median $13 outlier · 902.5×
872 OTHER	Ms-DRG 872	1	$10,932.10	$10,932.10	$10,932.10	nat. median $8,903 1.2× median
J3111 OTHER	Romosozumab-aqqg 210 Mg/2.34Ml	5	$1.56	$11,305.59	$9,187.28	nat. median $13 outlier · 702.4×
15271 OTHER	Skin Substitute Graft 25 Sq Cm	5	$149.40	$11,589.00	$8,326.70	nat. median $1,419 outlier · 5.9×
179 OTHER	Ms-DRG 179	1	$8,212.60	$8,212.60	$8,212.60	nat. median $8,079 1.0× median
J0401 OTHER	Aripiprazole 400 Mg Vial	5	$0.77	$9,754.54	$7,926.85	nat. median $8 outlier · 1037.5×
Q5130 OTHER	Pegfilgrastim-pbbk 6 Mg/0.6 Ml	5	$0.54	$9,625.01	$7,821.59	nat. median $186 outlier · 42.0×
2471 OTHER	Apr-DRG 2471	1	$7,460.18	$7,460.18	$7,460.18	nat. median $3,909 1.9× median
Q5111 OTHER	Pegfilgrastim-cbqv 6 Mg/0.6 Ml	5	$163.60	$8,478.75	$6,890.10	nat. median $164 outlier · 42.1×
J1602 OTHER	Golimumab 50 Mg/4 Ml Vial	5	$10.77	$8,471.23	$6,883.99	nat. median $14 outlier · 497.4×
J0897 OTHER	Denosumab 60 Mg/ml Syringe	5	$9.69	$13,047.40	$6,770.36	nat. median $32 outlier · 212.8×
1351 OTHER	Apr-DRG 1351	1	$6,627.48	$6,627.48	$6,627.48	nat. median $5,786 1.1× median
Q5122 OTHER	Pegfilgrastim 6 Mg/0.6 Ml Syr	5	$134.25	$7,459.14	$6,061.54	nat. median $146 outlier · 41.4×
73720 OTHER	MRI Le Wwo Dye Lt	5	$233.96	$5,597.40	$4,690.03	nat. median $553 outlier · 8.5×
73723 OTHER	MRI Joint Le Wwo Dye Rt	5	$657.06	$5,330.45	$4,601.02	nat. median $583 outlier · 7.9×
72158 OTHER	MRI Lumbar Spine Wwo Dye	5	$340.97	$5,597.40	$4,548.62	nat. median $576 outlier · 7.9×
72197 OTHER	MRI Pelvis Wwo Dye	5	$618.17	$4,975.15	$4,294.34	nat. median $627 outlier · 6.8×
72156 OTHER	MRI Neck Spine Wwo Dye	5	$340.05	$4,921.95	$4,156.00	nat. median $564 outlier · 7.4×
72157 OTHER	MRI Chest Spine Wwo Dye	5	$535.35	$5,037.85	$4,156.00	nat. median $630 outlier · 6.6×
70553 OTHER	MRI Brain Wwo Contrast	5	$729.77	$4,895.35	$4,101.79	nat. median $596 outlier · 6.9×
72148 OTHER	MRI Lumbar Spine Wo Dye	5	$315.18	$4,145.80	$3,578.48	nat. median $383 outlier · 9.3×
73721 OTHER	MRI Joint Le Wo Dye Lt	6	$212.71	$4,156.00	$3,578.48	nat. median $442 outlier · 8.1×
73221 OTHER	MRI Joint Ue Wo Dye Rt	6	$212.71	$4,364.00	$3,578.48	nat. median $396 outlier · 9.0×
73718 OTHER	MRI Le Wo Dye Rt	5	$56.39	$4,364.00	$3,578.48	nat. median $401 outlier · 8.9×
47379 OTHER	Unlisted Lap Proc Liver	5	$2,823.60	$4,126.80	$3,562.08	nat. median $6,384 0.6× median
72141 OTHER	MRI Neck Spine Wo Dye	5	$233.96	$4,145.80	$3,473.74	nat. median $372 outlier · 9.3×
J1439 OTHER	Ferric Carboxymalt 750mg/15ml	5	$1.13	$4,236.77	$3,442.93	nat. median $1 outlier · 2799.1×
74174 OTHER	CTA Abd&Pelv Wwo Dye	5	$71.13	$3,974.80	$3,430.88	nat. median $502 outlier · 6.8×
78452 OTHER	Myocard Perf Spect Rest Stress	5	$2,150.17	$4,079.30	$3,392.26	nat. median $1,353 outlier · 2.5×
J9217 OTHER	Leuprolide Acetate Sq 45mg Syr	5	$1.47	$6,077.93	$3,381.00	nat. median $222 outlier · 15.2×
72146 OTHER	MRI Chest Spine Wo Dye	5	$390.63	$4,145.80	$3,369.01	nat. median $372 outlier · 9.1×
72195 OTHER	MRI Pelvis Wo Dye	5	$53.64	$4,145.80	$3,369.01	nat. median $414 outlier · 8.1×
70551 OTHER	MRI Brain Wo Contrast	5	$447.03	$4,145.80	$3,369.01	nat. median $394 outlier · 8.6×
74170 OTHER	CT Abdomen Wwo Dye	5	$58.22	$3,974.80	$3,330.47	nat. median $308 outlier · 10.8×
Q4159 OTHER	Graft Skn Affinity 2.25 Sq Cm	5	$2,632.50	$3,847.50	$3,321.00	nat. median $342 outlier · 9.7×
70492 OTHER	CT Soft Tissue Neck Wwo Cont	5	$422.85	$3,784.80	$3,266.88	nat. median $255 outlier · 12.8×
74178 OTHER	CT Abd & Pelv Wwo Contrast	5	$479.88	$3,403.85	$2,997.18	nat. median $495 outlier · 6.1×
70487 OTHER	CT Maxillofacial W Contrast	5	$268.29	$3,385.80	$2,922.48	nat. median $272 outlier · 10.8×
73701 OTHER	CT Le W Dye Lt	5	$268.01	$3,295.55	$2,844.58	nat. median $290 outlier · 9.8×
71260 OTHER	CT Thorax W Contrast	6	$80.31	$3,364.90	$2,819.43	nat. median $260 outlier · 10.8×
74177 OTHER	CT Abd & Pelv W Contrast	6	$227.52	$3,354.45	$2,810.68	nat. median $458 outlier · 6.1×
70496 OTHER	CT Angiography Head W Cont	5	$246.84	$3,320.25	$2,782.02	nat. median $325 outlier · 8.6×

Other procedures at this hospital

Browse this hospital's 795 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

J9144	OTHER	Daratumumab Hyaluronida 1800Mg	11	5	$46,110.00	$44,726.96	$57.99	$43,804.76	$35,597.13	2026-05-06
J3101	OTHER	Tenecteplase 50 Mg/10 Ml Syrng	11	5	$31,584.00	$30,637.29	$0.41	$30,005.60	$24,383.50	2026-05-06
J1299	OTHER	Eculizumab 300 Mg/30 Ml Vial	11	5	$30,858.00	$29,932.91	$44.81	$29,315.74	$24,378.35	2026-05-06
309	OTHER	Ms-DRG 309	2	1	—	—	$20,481.22	$20,481.22	$20,481.22	2026-05-06
193	OTHER	Ms-DRG 193	2	1	—	—	$18,197.82	$18,197.82	$18,197.82	2026-05-06
Q5120	OTHER	Pegfilgrastim-bmez 6 Mg/0.6 Ml	11	5	$17,813.00	$17,279.13	$24.71	$16,922.86	$13,752.05	2026-05-06
690	OTHER	Ms-DRG 690	2	1	—	—	$12,302.14	$12,302.14	$12,302.14	2026-05-06
683	OTHER	Ms-DRG 683	2	1	—	—	$12,302.14	$12,302.14	$12,302.14	2026-05-06
J1306	OTHER	Inclisiran 284mg/1.5ml Syringe	11	5	$15,571.00	$15,104.21	$5.81	$14,792.78	$12,021.08	2026-05-06
872	OTHER	Ms-DRG 872	2	1	—	—	$10,932.10	$10,932.10	$10,932.10	2026-05-06
J3111	OTHER	Romosozumab-aqqg 210 Mg/2.34Ml	11	5	$11,900.00	$11,543.60	$1.56	$11,305.59	$9,187.28	2026-05-06
15271	OTHER	Skin Substitute Graft 25 Sq Cm	18	5	$11,589.00	$11,241.33	$149.40	$11,589.00	$8,326.70	2026-05-06
179	OTHER	Ms-DRG 179	2	1	—	—	$8,212.60	$8,212.60	$8,212.60	2026-05-06
J0401	OTHER	Aripiprazole 400 Mg Vial	11	5	$10,267.00	$9,959.90	$0.77	$9,754.54	$7,926.85	2026-05-06
Q5130	OTHER	Pegfilgrastim-pbbk 6 Mg/0.6 Ml	11	5	$10,131.00	$9,827.64	$0.54	$9,625.01	$7,821.59	2026-05-06
2471	OTHER	Apr-DRG 2471	2	1	—	—	$7,460.18	$7,460.18	$7,460.18	2026-05-06
Q5111	OTHER	Pegfilgrastim-cbqv 6 Mg/0.6 Ml	11	5	$8,925.00	$8,657.25	$163.60	$8,478.75	$6,890.10	2026-05-06
J1602	OTHER	Golimumab 50 Mg/4 Ml Vial	11	5	$8,917.00	$8,649.57	$10.77	$8,471.23	$6,883.99	2026-05-06
J0897	OTHER	Denosumab 60 Mg/ml Syringe	18	5	$7,637.00	$7,408.06	$9.69	$13,047.40	$6,770.36	2026-05-06
1351	OTHER	Apr-DRG 1351	2	1	—	—	$6,627.48	$6,627.48	$6,627.48	2026-05-06
Q5122	OTHER	Pegfilgrastim 6 Mg/0.6 Ml Syr	11	5	$7,851.00	$7,616.18	$134.25	$7,459.14	$6,061.54	2026-05-06
73720	OTHER	MRI Le Wwo Dye Lt	20	5	$5,892.00	$5,715.24	$233.96	$5,597.40	$4,690.03	2026-05-06
73723	OTHER	MRI Joint Le Wwo Dye Rt	9	5	$5,611.00	$5,442.67	$657.06	$5,330.45	$4,601.02	2026-05-06
72158	OTHER	MRI Lumbar Spine Wwo Dye	11	5	$5,892.00	$5,715.24	$340.97	$5,597.40	$4,548.62	2026-05-06
72197	OTHER	MRI Pelvis Wwo Dye	9	5	$5,237.00	$5,079.89	$618.17	$4,975.15	$4,294.34	2026-05-06
72156	OTHER	MRI Neck Spine Wwo Dye	11	5	$5,181.00	$5,025.57	$340.05	$4,921.95	$4,156.00	2026-05-06
72157	OTHER	MRI Chest Spine Wwo Dye	11	5	$5,303.00	$5,143.91	$535.35	$5,037.85	$4,156.00	2026-05-06
70553	OTHER	MRI Brain Wwo Contrast	12	5	$5,153.00	$4,998.41	$729.77	$4,895.35	$4,101.79	2026-05-06
73221	OTHER	MRI Joint Ue Wo Dye Rt	24	6	$4,364.00	$4,233.08	$212.71	$4,364.00	$3,578.48	2026-05-06
72148	OTHER	MRI Lumbar Spine Wo Dye	13	5	$4,364.00	$4,233.08	$315.18	$4,145.80	$3,578.48	2026-05-06
73718	OTHER	MRI Le Wo Dye Rt	20	5	$4,364.00	$4,233.08	$56.39	$4,364.00	$3,578.48	2026-05-06
73721	OTHER	MRI Joint Le Wo Dye Lt	27	6	$4,364.00	$4,233.08	$212.71	$4,156.00	$3,578.48	2026-05-06
47379	OTHER	Unlisted Lap Proc Liver	7	5	$4,344.00	$4,213.68	$2,823.60	$4,126.80	$3,562.08	2026-05-06
72141	OTHER	MRI Neck Spine Wo Dye	12	5	$4,364.00	$4,233.08	$233.96	$4,145.80	$3,473.74	2026-05-06
J1439	OTHER	Ferric Carboxymalt 750mg/15ml	11	5	$4,459.00	$4,325.97	$1.13	$4,236.77	$3,442.93	2026-05-06
74174	OTHER	CTA Abd&Pelv Wwo Dye	9	5	$4,184.00	$4,058.48	$71.13	$3,974.80	$3,430.88	2026-05-06
78452	OTHER	Myocard Perf Spect Rest Stress	11	5	$4,294.00	$4,165.18	$2,150.17	$4,079.30	$3,392.26	2026-05-06
J9217	OTHER	Leuprolide Acetate Sq 45mg Syr	20	5	$3,675.00	$3,564.75	$1.47	$6,077.93	$3,381.00	2026-05-06
72146	OTHER	MRI Chest Spine Wo Dye	11	5	$4,364.00	$4,233.08	$390.63	$4,145.80	$3,369.01	2026-05-06
72195	OTHER	MRI Pelvis Wo Dye	11	5	$4,364.00	$4,233.08	$53.64	$4,145.80	$3,369.01	2026-05-06
70551	OTHER	MRI Brain Wo Contrast	11	5	$4,364.00	$4,233.08	$447.03	$4,145.80	$3,369.01	2026-05-06
74170	OTHER	CT Abdomen Wwo Dye	12	5	$4,184.00	$4,058.48	$58.22	$3,974.80	$3,330.47	2026-05-06
Q4159	OTHER	Graft Skn Affinity 2.25 Sq Cm	9	5	$4,050.00	$3,928.50	$2,632.50	$3,847.50	$3,321.00	2026-05-06
70492	OTHER	CT Soft Tissue Neck Wwo Cont	9	5	$3,984.00	$3,864.48	$422.85	$3,784.80	$3,266.88	2026-05-06
74178	OTHER	CT Abd & Pelv Wwo Contrast	12	5	$3,583.00	$3,475.51	$479.88	$3,403.85	$2,997.18	2026-05-06
70487	OTHER	CT Maxillofacial W Contrast	9	5	$3,564.00	$3,457.08	$268.29	$3,385.80	$2,922.48	2026-05-06
73701	OTHER	CT Le W Dye Lt	18	5	$3,469.00	$3,364.93	$268.01	$3,295.55	$2,844.58	2026-05-06
71260	OTHER	CT Thorax W Contrast	14	6	$3,542.00	$3,435.74	$80.31	$3,364.90	$2,819.43	2026-05-06
74177	OTHER	CT Abd & Pelv W Contrast	14	6	$3,531.00	$3,425.07	$227.52	$3,354.45	$2,810.68	2026-05-06
70496	OTHER	CT Angiography Head W Cont	12	5	$3,495.00	$3,390.15	$246.84	$3,320.25	$2,782.02	2026-05-06
70491	OTHER	CT Soft Tissue Neck W Cont	11	5	$3,542.00	$3,435.74	$357.53	$3,364.90	$2,734.42	2026-05-06
70544	OTHER	MRA Head Wo Contrast	9	5	$3,304.00	$3,204.88	$408.12	$3,138.80	$2,709.28	2026-05-06
J0881	OTHER	Darbepoe Alfa 200mcg/0.4ml Syr	18	5	$2,975.00	$2,886.28	$2.92	$4,168.91	$2,703.49	2026-05-06
74176	OTHER	CT Abd & Pelvis Wo Contrast	13	5	$3,099.00	$3,006.03	$95.04	$2,944.05	$2,541.18	2026-05-06
73200	OTHER	CT Ue Wo Dye Rt	21	6	$3,099.00	$3,006.03	$70.19	$3,099.00	$2,541.18	2026-05-06
73700	OTHER	CT Le Wo Dye Lt	24	6	$3,099.00	$3,006.03	$76.65	$2,951.00	$2,541.18	2026-05-06
70490	OTHER	CT Soft Tissue Neck Wo Cont	11	5	$3,099.00	$3,006.03	$277.47	$2,951.00	$2,541.18	2026-05-06
70486	OTHER	CT Maxillofacial Wo Contrast	13	5	$3,099.00	$3,006.03	$187.95	$2,944.05	$2,541.18	2026-05-06
70450	OTHER	CT Head/Brain Wo Contrast	14	6	$3,099.00	$3,006.03	$24.20	$2,944.05	$2,466.80	2026-05-06
71275	OTHER	CTA Chest Wwo Contrast	12	5	$3,099.00	$3,006.03	$65.60	$2,944.05	$2,466.80	2026-05-06
71250	OTHER	CT Thorax Wo Contrast	12	5	$3,099.00	$3,006.03	$71.13	$2,944.05	$2,466.80	2026-05-06
72131	OTHER	CT Lumbar Spine Wo Contrast	12	5	$3,099.00	$3,006.03	$234.87	$2,944.05	$2,466.80	2026-05-06
73201	OTHER	CT Ue W Dye Lt	10	5	$2,951.00	$2,862.47	$90.44	$2,803.45	$2,419.82	2026-05-06
72128	OTHER	CT Thoracic Spine Wo Contrast	11	5	$3,099.00	$3,006.03	$107.93	$2,944.05	$2,392.43	2026-05-06
72125	OTHER	CT Cervical Spine Wo Contrast	13	6	$3,099.00	$3,006.03	$93.58	$2,944.05	$2,392.43	2026-05-06
70498	OTHER	CT Angiography Neck W Cont	12	5	$2,960.00	$2,871.20	$278.39	$2,812.00	$2,356.16	2026-05-06
75635	OTHER	CTA Abdominal Arteries	11	5	$2,951.00	$2,862.47	$592.68	$2,803.45	$2,278.17	2026-05-06
111	OTHER	Room Medical Unit Priv	7	5	$2,772.00	$2,688.84	$1,801.80	$2,633.40	$2,273.04	2026-05-06
750	OTHER	Colonoscopy	36	5	$2,873.00	$2,786.81	$1,413.10	$3,238.55	$2,241.42	2026-05-06
11011	OTHER	Debride Open Fx Disloc Muscle	9	5	$2,705.00	$2,623.85	$1,758.25	$2,569.75	$2,218.10	2026-05-06
90375	OTHER	Rabies Imm Glob (Human) 300u/m	11	5	$2,852.00	$2,766.61	$146.90	$2,709.57	$2,201.88	2026-05-06
J0248	OTHER	Remdesivir 100 Mg Vial	11	5	$2,835.00	$2,750.11	$6.35	$2,693.40	$2,188.74	2026-05-06
Q5103	OTHER	Infliximab-dyyb 100 Mg Vial	11	5	$2,587.00	$2,510.30	$40.50	$3,013.05	$2,122.11	2026-05-06
71271	OTHER	Ldct For Lung Cancer Screen	13	5	$2,396.00	$2,324.12	$101.48	$2,276.20	$1,964.72	2026-05-06
87154	OTHER	Culture Id By Amp Prb 6 Or 6+	9	5	$2,374.00	$2,302.78	$1,543.10	$2,255.30	$1,946.68	2026-05-06
J1561	OTHER	Immune Glob 10% 40 Gm/400 Ml	29	5	$3,612.00	$3,504.22	$3.60	$13,322.16	$1,894.37	2026-05-06
C8929	OTHER	Echo M Mode 2d W Contrast	18	5	$2,546.00	$2,469.62	$110.50	$2,424.00	$1,829.30	2026-05-06
11043	OTHER	Debride Muscle/Fascia 20 Cm	18	5	$2,529.00	$2,453.13	$273.90	$2,408.00	$1,817.09	2026-05-06
70480	OTHER	CT Orbit Wo Contrast	9	5	$2,197.00	$2,131.09	$192.56	$2,087.15	$1,801.54	2026-05-06
Q5121	OTHER	Infliximab-axxq 100 Mg Vial	11	5	$2,179.00	$2,114.48	$35.88	$4,302.83	$1,787.50	2026-05-06
120	OTHER	Room Medical Unit Semi Private	7	5	$2,053.00	$1,991.41	$1,334.45	$1,950.35	$1,683.46	2026-05-06
93306	OTHER	Tte W Doppler Complete	19	5	$2,546.00	$2,469.62	$105.90	$2,418.70	$1,654.90	2026-05-06
72192	OTHER	CT Pelvis Wo Dye	11	5	$2,015.00	$1,954.55	$186.00	$1,914.25	$1,555.58	2026-05-06
10121	OTHER	I&r Foreign Body Comp	9	5	$1,886.00	$1,829.42	$1,225.90	$1,791.70	$1,546.52	2026-05-06
27045	OTHER	Exc Tumor Pelvis/Hip >5cm Lt	7	5	$1,729.00	$1,677.13	$1,434.30	$2,012.56	$1,526.48	2026-05-06
81268	OTHER	Chimer Post Trans Sorted Cells	9	5	$1,835.00	$1,779.95	$1,192.75	$1,743.25	$1,504.70	2026-05-06
49594	OTHER	Rpr Aa Hrn 1st 3-10 Ncr/Strn	7	5	$1,875.00	$1,818.75	$1,414.86	$2,038.26	$1,477.09	2026-05-06
J0666	OTHER	Bupivac Liposome 1.3% Pf 20 Ml	11	5	$1,779.00	$1,725.92	$1.42	$1,713.62	$1,459.03	2026-05-06
47563	OTHER	Lap Chole With Cholangiography	7	5	$1,813.00	$1,758.61	$1,391.27	$1,935.98	$1,458.45	2026-05-06
80230	OTHER	Infliximab Qn w/Reflex To Ab,S	9	5	$1,773.00	$1,719.81	$1,152.45	$1,684.35	$1,453.86	2026-05-06
Q5104	OTHER	Infliximab-abda 100 Mg Vial	11	5	$1,751.00	$1,699.28	$27.85	$5,119.19	$1,436.51	2026-05-06
Q4101	OTHER	Graft Skin Apligraf	18	5	$2,063.00	$2,001.45	$59.60	$3,833.25	$1,354.93	2026-05-06
58661	OTHER	Laparoscopy Remove Adnexa Bi	7	5	$1,782.00	$1,728.54	$1,238.80	$1,790.85	$1,348.88	2026-05-06
27238	OTHER	Fx Inter/Peri/Sub Femur Wo Lt	9	5	$1,643.00	$1,593.71	$1,067.95	$1,560.85	$1,347.26	2026-05-06
710	OTHER	Recovery Phase 1 Per 15 Min	27	5	$1,658.00	$1,608.26	$266.50	$1,889.55	$1,309.82	2026-05-06
75571	OTHER	CT Heart Wo Dye W Ca Test	9	5	$1,596.00	$1,548.12	$140.03	$1,516.20	$1,308.72	2026-05-06
25605	OTHER	Fx Distal Radius W Man Rt	27	5	$1,643.00	$1,593.71	$522.00	$1,560.85	$1,268.40	2026-05-06
C8924	OTHER	Tte 2d W Contrast Limited	9	5	$1,523.00	$1,477.31	$989.95	$1,446.85	$1,248.86	2026-05-06
J9155	OTHER	Degarelix 80 Mg Vial	11	5	$1,612.00	$1,564.32	$4.77	$1,532.07	$1,245.00	2026-05-06
76813	OTHER	OB US Nuchal Meas 1 Gest	10	5	$1,502.00	$1,456.94	$976.30	$1,426.90	$1,231.64	2026-05-06
74300	OTHER	X-ray Bile Ducts/Pancreas	10	5	$1,427.00	$1,384.19	$927.55	$1,355.65	$1,170.14	2026-05-06
684	OTHER	Trauma Team Evaluation Level 4	11	5	$1,392.00	$1,350.24	$904.80	$17,668.72	$1,141.44	2026-05-06
G0390	OTHER	Trauma Team Level 4	9	5	$1,392.00	$1,350.24	$904.80	$1,322.40	$1,141.44	2026-05-06
49593	OTHER	Rpt Aa Hrn 1st 3-10 Rdc	7	5	$581.00	$563.57	$1,089.04	$1,568.59	$1,137.36	2026-05-06
76811	OTHER	OB US Detailed Single Fetus	12	5	$1,407.00	$1,364.79	$297.83	$1,336.65	$1,132.63	2026-05-06
82397	OTHER	Infliximab Ab, S	9	5	$1,360.00	$1,319.20	$884.00	$1,292.00	$1,115.20	2026-05-06
49505	OTHER	Prp I/Hern Init Reduc >5 Yr Lt	14	5	$1,353.00	$1,312.41	$1,022.06	$1,412.24	$1,073.16	2026-05-06
11042	OTHER	Debride Skin Subq 20 Cm	19	5	$1,614.00	$1,565.58	$107.90	$1,533.30	$1,049.10	2026-05-06
90675	OTHER	Rabies Vacc Chx Post-ex Immun	11	5	$1,347.00	$1,307.03	$125.24	$1,280.08	$1,040.23	2026-05-06
21931	OTHER	Exc Soft Tumor Back 3 Cm	7	5	$464.00	$450.08	$922.20	$1,276.04	$976.15	2026-05-06
761	OTHER	Anoscopy	45	5	$1,260.00	$1,222.20	$166.40	$2,868.05	$972.72	2026-05-06
55520	OTHER	Removal Sperm Cord Lesion Lt	7	5	$1,184.00	$1,148.48	$882.60	$1,237.43	$950.45	2026-05-06
49592	OTHER	Rpt Aa Hrn 1st <3 Ncr/Strn	7	5	$444.00	$430.68	$904.88	$1,301.08	$945.08	2026-05-06
J0174	OTHER	Lecanemab-irmb 200 Mg/2Ml Vial	11	5	$1,221.00	$1,184.99	$0.08	$1,160.56	$943.11	2026-05-06
78306	OTHER	Bone Scan Whole Body	9	5	$1,128.00	$1,094.16	$733.20	$1,071.60	$924.96	2026-05-06
J0561	OTHER	Pen G Benzathine 1200000Un/2ML	11	5	$1,191.00	$1,155.52	$26.98	$1,131.70	$919.65	2026-05-06
360	OTHER	Or Level 1	54	5	$1,078.50	$1,046.14	$436.15	$3,211.95	$894.75	2026-05-06
49650	OTHER	Lap Ing Hernia Repair Init Rt	7	5	$1,091.00	$1,058.27	$848.40	$1,166.70	$893.67	2026-05-06
Q0138	OTHER	Ferumoxy 510mg/17ml (non-esrd)	11	5	$1,145.00	$1,111.35	$0.33	$1,088.43	$884.50	2026-05-06
83519	OTHER	Pinp	9	5	$1,065.00	$1,033.05	$692.25	$1,011.75	$873.30	2026-05-06
87529	OTHER	Hsv DNA Amp Probe	9	5	$1,063.00	$1,031.11	$690.95	$1,009.85	$871.66	2026-05-06
93971	OTHER	Extremity Study Lt	24	5	$1,029.00	$998.13	$668.85	$1,034.00	$860.76	2026-05-06
84252	OTHER	Vitamin B2 (Riboflavin)	9	5	$1,002.00	$971.94	$651.30	$951.90	$821.64	2026-05-06
74250	OTHER	Gastrografin Challenge	9	5	$990.00	$960.30	$206.36	$940.50	$811.80	2026-05-06
29445	OTHER	Rigid Total Contact Leg Cast	16	5	$1,231.00	$1,194.07	$189.30	$1,169.45	$809.38	2026-05-06
99285	OTHER	Emergency Room Visit Level 5	21	6	$1,235.00	$1,197.95	$125.11	$1,173.25	$802.75	2026-05-06
99291	OTHER	Critical Care 1st 30-74 Min	18	5	$1,762.00	$1,709.14	$318.50	$1,673.90	$794.90	2026-05-06
76801	OTHER	OB US < 14 Wks Single Fetus	13	5	$945.00	$916.65	$276.59	$897.75	$774.90	2026-05-06
93925	OTHER	Arterial Duplex Le Bi	18	5	$1,063.00	$1,031.11	$56.41	$1,063.00	$763.76	2026-05-06
93880	OTHER	Extracranial Bilat Study	18	5	$1,063.00	$1,031.11	$57.48	$1,063.00	$763.76	2026-05-06
76770	OTHER	Ultrasound Abdo Back Wall Comp	12	5	$945.00	$916.65	$434.78	$897.75	$760.72	2026-05-06
76819	OTHER	Fetal Biophys Profil Wo Nst	12	5	$932.00	$904.04	$135.56	$885.40	$750.26	2026-05-06
0202U	OTHER	Respir Path 22 Targets Biofire	9	5	$914.00	$886.58	$594.10	$868.30	$749.48	2026-05-06
93975	OTHER	Vascular Study	10	5	$911.00	$883.67	$592.15	$865.45	$747.02	2026-05-06
93970	OTHER	Venous Duplex	9	5	$887.00	$860.39	$576.55	$842.65	$727.34	2026-05-06
93017	OTHER	Cardiovascular Stress Test	11	5	$918.00	$890.46	$466.92	$872.10	$725.22	2026-05-06
36569	OTHER	Insert Picc Catheter	18	5	$1,805.00	$1,750.85	$174.60	$1,714.75	$718.82	2026-05-06
J2997	OTHER	Alteplase 2 Mg Vial	11	5	$916.00	$889.03	$37.08	$870.70	$707.56	2026-05-06
76700	OTHER	Ultrasound Abdomen Complete	9	5	$840.00	$814.80	$546.00	$798.00	$688.80	2026-05-06
78227	OTHER	Hida With Ef w/Pharm	9	5	$831.00	$806.07	$540.15	$789.45	$681.42	2026-05-06
46250	OTHER	Remove Ext Hem Groups 2	7	5	$670.00	$649.90	$626.30	$878.19	$679.32	2026-05-06
93926	OTHER	Arterial Duplex Le Lt	18	5	$796.00	$772.12	$517.40	$756.20	$652.72	2026-05-06
77080	OTHER	Dexa Scan	13	5	$793.00	$769.21	$88.61	$753.35	$650.26	2026-05-06
129	OTHER	Room Swing Bed Skilled	7	5	$788.00	$764.36	$512.20	$748.60	$646.16	2026-05-06
A9585	OTHER	Gadobutrol Inj 10 Mm/10 Ml Vl	20	5	$1,000.00	$970.00	$2.69	$950.00	$644.88	2026-05-06
51720	OTHER	Bladder Instillation Chemo	9	5	$761.00	$738.17	$494.65	$722.95	$624.02	2026-05-06
J1611	OTHER	Glucagon (Fresenius Kabi) Vial	11	5	$794.00	$770.88	$81.80	$754.98	$613.52	2026-05-06
Q4186	OTHER	Soft Tissue Graft Epifix 2x2	9	5	$739.00	$716.96	$480.43	$702.17	$606.09	2026-05-06
73523	OTHER	X-ray Hips 5 Views Bi	10	5	$705.00	$683.85	$458.25	$690.20	$601.37	2026-05-06
76856	OTHER	Ultrasound Pelvic Complete	11	5	$761.00	$738.17	$434.78	$722.95	$601.19	2026-05-06
76376	OTHER	3d Render W Intrp Postproc CT	9	5	$733.00	$711.01	$96.87	$696.35	$601.06	2026-05-06
99284	OTHER	Emergency Room Visit Level 4	21	6	$924.00	$896.28	$77.81	$877.80	$600.60	2026-05-06
84591	OTHER	Vitamin B5 (Pantothanic Acid)	18	5	$759.00	$736.23	$429.00	$815.10	$588.88	2026-05-06
J1610	OTHER	Glucagon 1 Mg/ml Vial	11	5	$758.00	$735.63	$98.91	$720.46	$585.47	2026-05-06
73110	OTHER	X-ray Wrist 3 Views Lt	22	5	$754.00	$731.38	$23.79	$716.30	$582.09	2026-05-06
99292	OTHER	Critical Care Ea Addl 30 Min	16	5	$885.00	$858.45	$164.83	$840.75	$581.88	2026-05-06
99281	OTHER	Sane Exam	9	5	$706.00	$684.82	$458.90	$670.70	$578.92	2026-05-06
37195	OTHER	Thrombolytic Therapy Stroke	9	5	$706.00	$684.82	$458.90	$670.70	$578.92	2026-05-06
17250	OTHER	Chemical Cauterization Tissue	16	5	$878.00	$851.66	$67.00	$834.10	$577.29	2026-05-06
31500	OTHER	Insert Emergency Airway	18	5	$802.00	$777.94	$260.70	$2,135.48	$576.24	2026-05-06
J9030	OTHER	Bcg Live 50 Mg Vial	11	5	$744.00	$722.51	$0.27	$707.62	$575.03	2026-05-06
93246	OTHER	Ext ECG >7 Days Hook Up	13	5	$691.00	$670.27	$361.90	$656.45	$566.62	2026-05-06
76830	OTHER	Ultrasound Transvaginal	12	5	$700.00	$679.00	$284.63	$665.00	$563.50	2026-05-06
76815	OTHER	OB US Limited Fetus(s)	12	5	$700.00	$679.00	$271.11	$665.00	$563.50	2026-05-06
76805	OTHER	OB US >14 Wk Tvta Single Fetus	12	5	$700.00	$679.00	$297.83	$665.00	$563.50	2026-05-06
76536	OTHER	Ultrasound Head And Neck	12	5	$700.00	$679.00	$284.63	$665.00	$563.50	2026-05-06
76816	OTHER	OB US Follow-up Per Fetus	12	5	$700.00	$679.00	$297.83	$665.00	$563.50	2026-05-06
80169	OTHER	Everolimus	9	5	$680.00	$659.60	$442.00	$646.00	$557.60	2026-05-06
10060	OTHER	I&d Abscess Or Cyst	9	5	$678.00	$657.66	$440.70	$644.10	$555.96	2026-05-06
95250	OTHER	Glucose Monitoring 72 Hrs	12	5	$687.00	$666.39	$130.80	$652.65	$553.04	2026-05-06
76817	OTHER	Transvaginal US Obstetrical	11	5	$700.00	$679.00	$276.59	$665.00	$553.00	2026-05-06
76705	OTHER	Ultrasound Abdomen Limited	11	5	$700.00	$679.00	$284.63	$665.00	$553.00	2026-05-06
96413	OTHER	Chemotherapy Inf Initial	11	5	$698.00	$677.06	$236.78	$663.10	$551.42	2026-05-06
76882	OTHER	US Extremity Nonvasc Limit Rt	20	5	$682.00	$661.54	$267.92	$647.90	$549.01	2026-05-06
76775	OTHER	Ultrasound Aorta	9	5	$666.00	$646.02	$432.90	$632.70	$546.12	2026-05-06
76881	OTHER	US Extremity Nonvasc Comp Rt	9	5	$664.00	$644.08	$431.60	$630.80	$544.48	2026-05-06
27840	OTHER	Treat Ankle Dislocation	16	5	$582.00	$564.54	$378.30	$1,037.29	$544.17	2026-05-06
99204	OTHER	New Patient Level 4	20	5	$814.00	$789.58	$188.80	$773.30	$535.20	2026-05-06
76870	OTHER	Ultrasound Scrotum	12	5	$659.00	$639.23	$267.92	$626.05	$530.50	2026-05-06
76857	OTHER	Ultrasound Pelvic Limited	11	5	$668.00	$647.96	$318.36	$634.60	$527.72	2026-05-06
81376	OTHER	Hla Celiac Dis Mayo	9	5	$643.00	$623.71	$417.95	$610.85	$527.26	2026-05-06
45385	OTHER	Colonoscopy W Lesion Removal	7	5	$911.00	$883.67	$482.00	$709.52	$524.10	2026-05-06
80187	OTHER	Posaconazole	9	5	$637.00	$617.89	$414.05	$605.15	$522.34	2026-05-06
12051	OTHER	Repair Lac Interm <2.5 Cm	16	5	$793.00	$769.21	$302.40	$753.35	$521.40	2026-05-06
12042	OTHER	Repair Lac Interm 2.6-7.5 Cm	18	5	$793.00	$769.21	$350.40	$753.35	$521.40	2026-05-06
C1751	OTHER	Tray Picc Cath 4Fr Sgl Lum	11	5	$659.00	$640.03	$131.96	$626.83	$521.26	2026-05-06
24600	OTHER	Dislocation Elbow Wo Anes Rt	16	5	$554.00	$537.38	$360.10	$926.91	$517.99	2026-05-06
73100	OTHER	X-ray Wrist 2 Views Lt	18	5	$628.00	$609.16	$66.51	$596.60	$514.96	2026-05-06
P9047	OTHER	Albumin Human 25% 25gr/100ml	11	5	$618.00	$600.27	$53.08	$3,118.50	$507.44	2026-05-06
G0379	OTHER	Observation Assess Direct Adm	9	5	$609.00	$590.73	$395.85	$578.55	$499.38	2026-05-06
97606	OTHER	Neg Pressure Wound Dme >50 Cm	16	5	$758.00	$735.26	$25.58	$720.10	$498.38	2026-05-06
11760	OTHER	Repair Nailbed	16	5	$756.00	$733.32	$195.60	$718.20	$497.07	2026-05-06
92950	OTHER	Heart/Lung Resuscitation Cpr	18	5	$852.00	$826.44	$191.00	$809.40	$490.05	2026-05-06
26725	OTHER	Fx Phalange W Manipulation	16	5	$522.00	$506.34	$339.30	$841.29	$488.07	2026-05-06
94625	OTHER	Pulmonary Rehab Without Monitoring	9	5	$595.00	$577.15	$386.75	$565.25	$487.90	2026-05-06
45398	OTHER	Colonoscopy W Band Ligation	7	5	$635.00	$615.95	$447.30	$650.58	$480.65	2026-05-06
71101	OTHER	X-ray Ribs Uni W Chest Rt	21	5	$561.00	$544.17	$364.65	$3,427.98	$478.53	2026-05-06
11045	OTHER	Debride Skin Subq Addl 20 Cm	18	5	$664.00	$644.08	$43.90	$664.00	$477.09	2026-05-06
93922	OTHER	Ankle Arm Screen	18	5	$655.00	$635.35	$17.59	$655.00	$470.62	2026-05-06
P9016	OTHER	Red Blood Cells Lekoreduced	11	5	$573.00	$555.81	$372.45	$545.00	$469.86	2026-05-06
29581	OTHER	Appl Multi Layer Ven Wnd Compr	17	5	$704.00	$682.88	$50.70	$668.80	$468.16	2026-05-06
43233	OTHER	Egd Balloon Dil Esoph30 Mm/>	7	5	$582.00	$564.54	$435.70	$632.55	$466.89	2026-05-06
45384	OTHER	Colonoscopy W Lesion Removal	7	5	$803.00	$778.91	$434.50	$631.18	$465.92	2026-05-06
72072	OTHER	X-ray Spine Thoracic 3 Views	9	5	$542.00	$525.74	$352.30	$697.55	$462.33	2026-05-06
Q9957	OTHER	Perflutren Lip Micro 2.2mg/2ml	11	5	$598.00	$580.54	$47.75	$568.58	$462.04	2026-05-06
J2404	OTHER	Nicardipine/Ns 40 Mg/200ml Bag	11	5	$560.00	$543.26	$0.09	$1,828.74	$459.25	2026-05-06
94660	OTHER	CPap/BiPap First Day	18	5	$564.00	$547.08	$357.50	$549.10	$453.81	2026-05-06
28400	OTHER	Fx Calcaneus Rt	11	5	$549.00	$532.53	$356.85	$2,027.52	$450.18	2026-05-06
27786	OTHER	Fx Distal Fibula Rt	11	5	$549.00	$532.53	$356.85	$2,470.88	$450.18	2026-05-06
27780	OTHER	Treatment Fibula Fracture Lt	18	5	$549.00	$532.53	$356.85	$521.55	$450.18	2026-05-06
27530	OTHER	Treat Knee Fracture Rt	9	5	$549.00	$532.53	$356.85	$521.55	$450.18	2026-05-06
25600	OTHER	Fx Distal Radius Lt	18	5	$549.00	$532.53	$356.85	$521.55	$450.18	2026-05-06
24530	OTHER	Fx Supra/Transcondylar Hum Rt	11	5	$549.00	$532.53	$356.85	$2,027.52	$450.18	2026-05-06
74019	OTHER	X-ray Abdomen	13	5	$525.00	$509.25	$115.05	$660.48	$447.83	2026-05-06
87637	OTHER	Influ/RSV/CoV2 Pcr Ceph	13	5	$524.00	$508.28	$340.60	$497.80	$446.97	2026-05-06
A9500	OTHER	Radiophar Tc99M Sestamibi Dose	11	5	$545.00	$528.65	$354.25	$517.75	$446.90	2026-05-06
76010	OTHER	X-ray Nose To Rectum	10	5	$504.00	$488.88	$327.60	$499.97	$446.80	2026-05-06
C1726	OTHER	Cath Balloon EZDilate	9	5	$542.00	$526.13	$352.56	$515.28	$444.77	2026-05-06
70150	OTHER	X-ray Facial Bones 3 Views	9	5	$532.00	$516.04	$82.17	$505.40	$436.24	2026-05-06
96365	OTHER	Inf Therapy Med Initial	24	5	$549.00	$532.53	$305.50	$521.55	$432.40	2026-05-06
27824	OTHER	Fx Distal Tibia Rt	9	5	$522.00	$506.34	$339.30	$495.90	$428.04	2026-05-06
27760	OTHER	Treatment Medial Ankle Fx Lt	9	5	$522.00	$506.34	$339.30	$495.90	$428.04	2026-05-06
27230	OTHER	Fx Femur Proximal End Lt	9	5	$522.00	$506.34	$339.30	$495.90	$428.04	2026-05-06
25500	OTHER	Fx Radius Lt	9	5	$522.00	$506.34	$339.30	$495.90	$428.04	2026-05-06
23600	OTHER	Fx Prox Humeral Wo Man Lt	9	5	$522.00	$506.34	$339.30	$495.90	$428.04	2026-05-06
88312	OTHER	Special Stain Afb	9	5	$520.00	$504.40	$338.00	$494.00	$426.40	2026-05-06
99283	OTHER	Emergency Room Visit Level 3	21	6	$549.00	$532.53	$108.68	$549.00	$423.83	2026-05-06
110	OTHER	Room Custodial Care	7	5	$513.00	$497.61	$333.45	$487.35	$420.66	2026-05-06
115	OTHER	Room Hospice Respite Care	7	5	$513.00	$497.61	$333.45	$487.35	$420.66	2026-05-06
11046	OTHER	Debride Muscle Addl 20 Cm	16	5	$632.00	$613.04	$96.00	$600.40	$415.54	2026-05-06
11732	OTHER	Avulsion Nail Plate Ea Addl	16	5	$632.00	$613.04	$29.60	$600.40	$415.54	2026-05-06
45381	OTHER	Colonoscopy Submucous Inj	7	5	$1,249.00	$1,211.53	$382.50	$558.91	$414.70	2026-05-06
45380	OTHER	Colonoscopy W Biopsy(s)	7	5	$810.00	$785.70	$382.50	$558.91	$414.70	2026-05-06
72220	OTHER	X-ray Sacrum Tailbone	9	5	$482.00	$467.54	$313.30	$457.90	$411.15	2026-05-06
43246	OTHER	Egd Place Gastrostomy Tube	7	5	$508.00	$492.76	$381.20	$553.53	$408.97	2026-05-06
43251	OTHER	Egd Remove Lesion Snare	7	5	$366.00	$355.02	$372.20	$546.39	$405.01	2026-05-06
93308	OTHER	Echo Limited	19	5	$522.00	$506.34	$38.09	$522.00	$402.98	2026-05-06
96360	OTHER	Inf Therapy Hyd Initial	13	5	$470.00	$455.90	$305.50	$447.00	$400.91	2026-05-06
71046	OTHER	X-ray Chest 2v PA/Lateral	13	5	$470.00	$455.90	$141.08	$783.14	$400.91	2026-05-06
99214	OTHER	Est Patient Level 4 Wound Care	19	5	$612.00	$593.64	$88.83	$581.40	$397.80	2026-05-06
10120	OTHER	I&r Foreign Body Simple	16	5	$595.00	$577.15	$189.70	$565.25	$391.22	2026-05-06
87522	OTHER	Hep C RNA Pcr Quant	10	5	$477.00	$462.69	$310.05	$453.15	$391.14	2026-05-06
Q9967	OTHER	Iopamidol-300 30 Ml Vial	31	5	$475.00	$460.75	$185.25	$902.50	$389.50	2026-05-06
77067	OTHER	Mammography Screening Digital	22	5	$474.00	$459.78	$219.85	$450.30	$388.68	2026-05-06
88342	OTHER	Immunohisto Stain Init Pr Spec	9	5	$473.00	$458.81	$307.45	$449.35	$387.86	2026-05-06
99203	OTHER	New Patient Level 3	20	5	$588.00	$570.36	$74.50	$558.60	$386.61	2026-05-06
G0121	OTHER	Screen Colonoscopy Not Hi Risk	7	5	$682.00	$661.54	$171.02	$514.81	$381.66	2026-05-06
G0105	OTHER	Screening Colonoscopy Hi Risk	14	5	$682.00	$661.54	$170.90	$514.08	$381.44	2026-05-06
45378	OTHER	Colonoscopy Diagnostic	7	5	$682.00	$661.54	$351.70	$514.44	$381.44	2026-05-06
J0283	OTHER	Amiodarone/D5W 360 Mg/200 Ml	11	5	$490.00	$475.86	$2.59	$466.05	$378.73	2026-05-06
C9046	OTHER	Cocaine 4% Solution 4 Ml Bot	12	5	$469.00	$455.21	$1.68	$445.83	$377.78	2026-05-06
87536	OTHER	HIV 1 Na Quan	9	5	$455.00	$441.35	$295.75	$432.25	$373.10	2026-05-06
94060	OTHER	Pft Pre & Post Screen Spirome	9	5	$454.00	$440.38	$295.10	$431.30	$372.28	2026-05-06
Q9956	OTHER	Perflutren Protein-a Microdota	11	5	$478.00	$464.14	$77.76	$454.58	$369.40	2026-05-06
87636	OTHER	Influ & CoV2 Pcr Ceph	9	5	$449.00	$435.53	$291.85	$426.55	$368.18	2026-05-06
86978	OTHER	Warm Auto Absorption	9	5	$448.00	$434.56	$291.20	$425.60	$367.36	2026-05-06
82375	OTHER	Carbon Monoxide Blood	10	5	$448.00	$434.56	$291.20	$425.60	$367.36	2026-05-06
82166	OTHER	Mullerian Inhib Hormone	9	5	$447.00	$433.59	$290.55	$424.65	$366.54	2026-05-06
82610	OTHER	Cystatin C	9	5	$446.00	$432.62	$289.90	$423.70	$365.72	2026-05-06
99236	OTHER	Admit/Discharge Same Day High	7	5	$438.00	$424.86	$322.41	$436.48	$365.04	2026-05-06
10061	OTHER	I&d Abscess Comp/Multiple	16	5	$416.00	$403.52	$270.40	$506.04	$364.14	2026-05-06
36430	OTHER	Blood Administration	11	5	$451.00	$437.47	$293.15	$428.45	$363.00	2026-05-06
80299	OTHER	Apixaban	27	5	$441.00	$427.77	$162.50	$1,105.80	$361.62	2026-05-06
J2791	OTHER	Rho (d) Imm Glob 300mcg/2ml Sy	11	5	$465.00	$451.05	$1.71	$441.75	$358.98	2026-05-06
92610	OTHER	Swallow Eval Non Radiol	11	5	$454.00	$440.38	$212.53	$431.30	$358.66	2026-05-06
23500	OTHER	Fx Clavicle Lt	20	5	$437.00	$423.89	$284.05	$954.95	$358.34	2026-05-06
11055	OTHER	Pare 1 Benign Lesion	16	5	$544.00	$527.68	$27.30	$516.80	$357.68	2026-05-06
11730	OTHER	Avulsion Nail Plate Simp Singl	16	5	$544.00	$527.68	$95.50	$516.80	$357.68	2026-05-06
80074	OTHER	Acute Hepatitis Panel	11	5	$435.00	$421.95	$282.75	$637.00	$356.70	2026-05-06
93242	OTHER	Ext ECG 48 Hrs -7days Hook Up	11	5	$450.00	$436.50	$292.50	$427.50	$355.50	2026-05-06
83010	OTHER	Haptoglobin Quant	11	5	$448.00	$434.56	$68.56	$425.60	$353.92	2026-05-06
11404	OTHER	Exc Ben Lesion 3.1-4.0 Trunk	7	5	$357.00	$346.29	$298.20	$448.53	$353.56	2026-05-06
72070	OTHER	X-ray Spine Thoracic 2 Views	12	5	$420.00	$407.40	$230.50	$1,015.91	$351.33	2026-05-06
73502	OTHER	X-ray Hip Uni 2-3 Views Rt	38	5	$302.00	$292.94	$141.08	$860.42	$341.12	2026-05-06
72082	OTHER	X-ray Spine 2-3 View	9	5	$416.00	$403.52	$130.92	$395.20	$341.12	2026-05-06
70110	OTHER	X-ray Mandible 4 Views	7	5	$414.00	$401.58	$269.10	$393.30	$339.48	2026-05-06
73552	OTHER	X-ray Femur 2 Views Lt	24	5	$409.00	$396.73	$64.21	$389.00	$335.38	2026-05-06
51705	OTHER	Suprapubic Cath Change	20	5	$409.00	$396.73	$265.85	$401.85	$334.77	2026-05-06
73610	OTHER	X-ray Ankle 3 Views Rt	22	5	$407.00	$394.79	$99.63	$386.65	$333.74	2026-05-06
12031	OTHER	Repair Lac Intermed <2.5 Cm	7	5	$366.00	$355.02	$270.90	$423.98	$325.69	2026-05-06
73564	OTHER	X-ray Knee 4 Lt	24	5	$408.00	$395.76	$81.60	$387.60	$324.77	2026-05-06
J3489	OTHER	Zoledron Ac/Man/H2O 5mg/100ml	11	5	$420.00	$407.43	$9.52	$399.03	$324.26	2026-05-06
97163	OTHER	Pt Eval High Complexity	9	5	$395.00	$383.15	$256.75	$375.25	$323.90	2026-05-06
70130	OTHER	X-ray Mastoids 3 Views	9	5	$393.00	$381.21	$115.80	$373.35	$322.26	2026-05-06
73030	OTHER	X-ray Shoulder Lt	25	5	$392.00	$380.24	$74.60	$372.40	$321.44	2026-05-06
80145	OTHER	Adalimumab	9	5	$388.00	$376.36	$252.20	$368.60	$318.16	2026-05-06
43249	OTHER	Esoph Egd Dilation <30 Mm	7	5	$2,946.00	$2,857.62	$292.00	$426.86	$317.67	2026-05-06
73630	OTHER	X-ray Foot 3 Views Rt	25	5	$387.00	$375.39	$65.60	$367.65	$317.34	2026-05-06
A9537	OTHER	Radiophar Tc99M Mebrofenin	9	5	$387.00	$375.39	$251.55	$367.65	$317.34	2026-05-06
72190	OTHER	X-ray Pelvis 3 Views	9	5	$372.00	$360.84	$241.80	$522.48	$317.32	2026-05-06
88305	OTHER	Surg Path L4	11	5	$385.00	$373.45	$250.25	$366.00	$315.70	2026-05-06
73050	OTHER	X-ray Ac Joints	9	5	$384.00	$372.48	$196.25	$364.80	$314.88	2026-05-06
J9025	OTHER	Azacitidine 100 Mg Vial	11	5	$403.00	$391.27	$0.34	$383.20	$311.40	2026-05-06
C1781	OTHER	Mesh Sheet Flat Bard 3X6In	11	5	$376.00	$365.50	$244.92	$357.96	$308.98	2026-05-06
87252	OTHER	Culture Viral	9	5	$376.00	$364.72	$244.40	$357.20	$308.32	2026-05-06
12013	OTHER	Repair Lac Simple 2.6-5.0 Cm	30	5	$393.00	$381.21	$102.60	$602.87	$306.68	2026-05-06
81515	OTHER	Vpp	9	5	$373.00	$361.81	$242.45	$354.35	$305.86	2026-05-06
982	OTHER	Screening Colonoscopy	7	5	$373.00	$361.81	$242.45	$354.35	$305.86	2026-05-06
J3375	OTHER	Vancomycin 2000 Mg/400 Ml Bag	20	5	$382.00	$371.28	$0.13	$363.62	$303.81	2026-05-06
99223	OTHER	IP/Obs Initial High Comp	7	5	$238.00	$230.86	$270.04	$389.40	$303.59	2026-05-06

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