Hospital

LUCAS COUNTY HEALTH CENTER

Chariton, IA · CCN 161341 · Rates published

1,335 distinct procedures filed

12 distinct payers

47,568 rate rows

2026-03-19 last MRF observed

Data quality

43,255 of 47,568 rate rows are consumer-grade (90.9%)

4,313 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	4,254
placeholder amount (≤ $0.02) — excluded from medians	41
per-diem day rate — not a per-procedure price	12
exceeds 10× this hospital's gross charge — excluded from medians	6

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

Source MRF file	https://linkprotect.cudasvc.com/url?a=https%3a%2f%2flchcia.slicedhealth.io%2fpricer%2f42-6039708-1538466842_LucasCountyHealthCenter_standardcharges.CSV&c=E,1,69fYJwSwVOEGc1_XSZVwYJTOlnMg4x_UDSzAcd_l3wyy7h2oK_6DwLK65o-3zolMrcm_sOD_Ao8KVU6tXw97SJx-tLKA5809vQ55XLZkLGPzHNWyW14sbQ,,&typo=1
Found on page	https://linkprotect.cudasvc.com/url?a=https%3a%2f%2flchcia.slicedhealth.io%2fhome&c=E,1,KmtEhSGiw_iXqG3NaQ0NxWrUFy9sCfytApQV7NgI21ve3MUc71jO9BkCAuE9fgCXON_yv-4F8Ml2IP2q4CHh9ca9eVGKXIb_cyc9xlxA6b4,&typo=1
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	a8ab7d0661fb28aa… · 15,599,267 bytes · first seen 2026-05-09

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
V2790 HCPCS	Hc Amniotic Membrane Lvl 11	12	$5,060.00	$8,740.00	$6,072.00	nat. median $1,695 outlier · 3.6×
Q4139 HCPCS	Hc Amnio Or Biodmatrix, Inj Per 1 Cc Lvl 8	12	$3,465.00	$5,985.00	$4,158.00	nat. median $1,528 outlier · 2.7×
78815 CPT	Hc Nm PET Image W CT Skull Thigh	12	$2,640.00	$4,560.00	$3,168.00	nat. median $2,793 1.1× median
78816 CPT	Hc Nm PET Image W CT Whole Body	12	$2,530.00	$4,370.00	$3,036.00	nat. median $2,707 1.1× median
73720 CPT	Hc MRI Low Extr Not Joint W Wo Contr	12	$1,870.00	$5,780.00	$2,939.30	nat. median $1,190 outlier · 2.5×
74177 CPT	Hc CT Abdomen & Pelvis W Contrast	12	$2,280.85	$3,939.65	$2,737.02	nat. median $928 outlier · 2.9×
74178 CPT	Hc CT Abd & Pelvis W Wo Contr 1+ Reg/sec	12	$2,200.00	$3,800.00	$2,640.00	nat. median $979 outlier · 2.7×
44160 CPT	Pr Colectomy Partial W Rem Ilium	12	$2,200.00	$3,800.00	$2,640.00	nat. median $3,050 0.9× median
70553 CPT	Hc MRI Brain W Wo Contrast	12	$2,200.00	$3,800.00	$2,640.00	nat. median $1,122 outlier · 2.4×
58563 CPT	Pr Hysteroscopy; W Endometrial Ablation	12	$2,035.00	$3,515.00	$2,442.00	nat. median $5,183 outlier · 0.5×
74176 CPT	Hc CT Abd & Pelvis Wo Contrast	12	$2,013.00	$3,477.00	$2,415.60	nat. median $685 outlier · 3.5×
72158 CPT	Hc MRI Spine Lumbar W Wo Contrast	12	$1,952.50	$3,372.50	$2,343.00	nat. median $1,081 outlier · 2.2×
74183 CPT	Hc MRI Abdomen W Wo Contrast	12	$1,925.00	$3,325.00	$2,310.00	nat. median $1,102 outlier · 2.1×
78452 CPT	Hc Nm Heart Muscle Spect Mult	12	$1,870.00	$3,230.00	$2,244.00	nat. median $1,767 1.3× median
72156 CPT	Hc MRI Spine Cervical W Wo Contrast	12	$1,848.55	$3,192.95	$2,218.26	nat. median $1,092 outlier · 2.0×
72197 CPT	Hc MRI Pelvis W Wo Contrast	12	$1,848.55	$3,192.95	$2,218.26	nat. median $1,065 outlier · 2.1×
72157 CPT	Hc MRI Spine Thoracic W Wo Contrast	12	$1,848.55	$3,192.95	$2,218.26	nat. median $1,094 outlier · 2.0×
70549 CPT	Hc MRA Neck W Wo Contrast	12	$1,815.00	$3,135.00	$2,178.00	nat. median $1,051 outlier · 2.1×
95811 CPT	Hc Pss W 4/> Param W Cpap/bipap 6+ Yrs	12	$1,760.00	$3,040.00	$2,112.00	nat. median $2,026 1.0× median
58571 CPT	Pr Tlh W/t/o 250 G Or Less	12	$1,705.00	$2,945.00	$2,046.00	nat. median $9,808 outlier · 0.2×
C1886 HCPCS	Hc Catheter, Ablation Lvl 3	12	$1,702.80	$2,941.20	$2,043.36	nat. median $2,850 0.7× median
73723 CPT	Hc MRI Low Extr Any Joint W Wo Contr	12	$1,650.00	$2,850.00	$1,980.00	nat. median $1,264 1.6× median
95810 CPT	Hc Pss W 4/> Param W Tech 6+ Yrs	12	$1,650.00	$2,850.00	$1,980.00	nat. median $1,870 1.1× median
75635 CPT	Hc CT Angiography Aorta Iliofemoral Runoff	12	$1,650.00	$2,850.00	$1,980.00	nat. median $706 outlier · 2.8×
74174 CPT	Hc CT Angio Abd And Pelv Wo W Contrast	12	$1,650.00	$2,850.00	$1,980.00	nat. median $959 outlier · 2.1×
0761 RC		12	$1,650.00	$2,850.00	$1,980.00	nat. median $656 outlier · 3.0×
27652 CPT	Pr Primary Repr Rupt Achilles Tndn W Grft	12	$1,650.00	$2,850.00	$1,980.00	nat. median $7,011 outlier · 0.3×
C1776 HCPCS	Hc Joint Device (implantable) Lvl 3	12	$329.32	$3,907.73	$1,755.60	nat. median $3,432 0.5× median
73721 CPT	Hc MRI Low Extr Any Joint Wo Contrast	12	$1,375.00	$3,895.00	$1,750.00	nat. median $899 1.9× median
74182 CPT	Hc MRI Abdomen W Contrast	12	$1,402.50	$2,422.50	$1,683.00	nat. median $991 1.7× median
72149 CPT	Hc MRI Spine Lumbar W Contrast	12	$1,391.50	$2,403.50	$1,669.80	nat. median $970 1.7× median
49616 CPT	Pr Rpr Aa Hrn Rcr 3-10 Ncr/strn	12	$1,375.00	$2,375.00	$1,650.00	nat. median $4,452 outlier · 0.4×
72148 CPT	Hc MRI Spine Lumbar Wo Contrast	12	$1,375.00	$2,375.00	$1,650.00	nat. median $770 outlier · 2.1×
70551 CPT	Hc MRI Brain Wo Contrast	12	$1,375.00	$2,375.00	$1,650.00	nat. median $772 outlier · 2.1×
73221 CPT	Hc MRI Up Extr Any Joint Wo Contrast	12	$1,375.00	$2,375.00	$1,650.00	nat. median $880 1.9× median
28299 CPT	Pr Correction Hallux Valgus	12	$1,375.00	$2,375.00	$1,650.00	nat. median $6,822 outlier · 0.2×
71275 CPT	Hc CT Angiography Chest W Wo Contrast	12	$1,339.25	$2,313.25	$1,607.10	nat. median $736 outlier · 2.2×
72141 CPT	Hc MRI Spine Cervical Wo Contrast	12	$1,320.00	$2,280.00	$1,584.00	nat. median $766 outlier · 2.1×
70496 CPT	Hc CT Angiography Head W Wo Contrast	12	$1,320.00	$2,280.00	$1,584.00	nat. median $729 outlier · 2.2×
74175 CPT	Hc CT Angiography Abdomen W Wo Contrast	12	$1,320.00	$2,280.00	$1,584.00	nat. median $710 outlier · 2.2×
0278 RC		12	$115.50	$7,600.00	$1,566.20	nat. median $1,035 1.5× median
C1726 HCPCS	Hc Non-vasc Balloon Dilatn Cath Lvl 6	12	$1,279.99	$2,210.89	$1,535.99	nat. median $554 outlier · 2.8×
70544 CPT	Hc MRA Head Wo Contrast	12	$1,265.00	$2,185.00	$1,518.00	nat. median $817 1.9× median
70540 CPT	Hc MRI Orbit Face Neck Wo Contrast	12	$1,265.00	$2,185.00	$1,518.00	nat. median $785 1.9× median
J9202 HCPCS	Goserelin Acetate 3.6 Mg Sc Impl	12	$1,230.02	$2,124.58	$1,476.02	nat. median $1,879 0.8× median
28805 CPT	Pr Amputate Foot; Transmetatarsal	12	$1,210.00	$2,090.00	$1,452.00	nat. median $3,760 outlier · 0.4×
72146 CPT	Hc MRI Spine Thoracic Wo Contrast	12	$1,210.00	$2,090.00	$1,452.00	nat. median $772 1.9× median
73718 CPT	Hc MRI Low Extr Not Joint Wo Contrast	12	$1,210.00	$2,090.00	$1,452.00	nat. median $917 1.6× median
70498 CPT	Hc CT Angiography Neck W Wo Contrast	12	$1,210.00	$2,090.00	$1,452.00	nat. median $722 outlier · 2.0×
27654 CPT	Pr Secondry Repr Rupt Achilles Tendon	12	$1,210.00	$2,090.00	$1,452.00	nat. median $6,809 outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 1,335 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

V2790	HCPCS	Hc Amniotic Membrane Lvl 11	12	12	$9,200.00	$8,280.00	$5,060.00	$8,740.00	$6,072.00	2026-03-19
Q4139	HCPCS	Hc Amnio Or Biodmatrix, Inj Per 1 Cc Lvl 8	12	12	$6,300.00	$5,670.00	$3,465.00	$5,985.00	$4,158.00	2026-03-19
78815	CPT	Hc Nm PET Image W CT Skull Thigh	36	12	$4,800.00	$4,320.00	$2,640.00	$4,560.00	$3,168.00	2026-03-19
78816	CPT	Hc Nm PET Image W CT Whole Body	12	12	$4,600.00	$4,140.00	$2,530.00	$4,370.00	$3,036.00	2026-03-19
73720	CPT	Hc MRI Low Extr Not Joint W Wo Contr	24	12	$5,100.00	$4,590.00	$1,870.00	$5,780.00	$2,939.30	2026-03-19
74177	CPT	Hc CT Abdomen & Pelvis W Contrast	12	12	$4,147.00	$3,732.30	$2,280.85	$3,939.65	$2,737.02	2026-03-19
44160	CPT	Pr Colectomy Partial W Rem Ilium	12	12	$4,000.00	$3,600.00	$2,200.00	$3,800.00	$2,640.00	2026-03-19
70553	CPT	Hc MRI Brain W Wo Contrast	12	12	$4,000.00	$3,600.00	$2,200.00	$3,800.00	$2,640.00	2026-03-19
74178	CPT	Hc CT Abd & Pelvis W Wo Contr 1+ Reg/sec	12	12	$4,000.00	$3,600.00	$2,200.00	$3,800.00	$2,640.00	2026-03-19
58563	CPT	Pr Hysteroscopy; W Endometrial Ablation	12	12	$3,700.00	$3,330.00	$2,035.00	$3,515.00	$2,442.00	2026-03-19
74176	CPT	Hc CT Abd & Pelvis Wo Contrast	24	12	$3,660.00	$3,294.00	$2,013.00	$3,477.00	$2,415.60	2026-03-19
72158	CPT	Hc MRI Spine Lumbar W Wo Contrast	12	12	$3,550.00	$3,195.00	$1,952.50	$3,372.50	$2,343.00	2026-03-19
74183	CPT	Hc MRI Abdomen W Wo Contrast	12	12	$3,500.00	$3,150.00	$1,925.00	$3,325.00	$2,310.00	2026-03-19
78452	CPT	Hc Nm Heart Muscle Spect Mult	12	12	$3,400.00	$3,060.00	$1,870.00	$3,230.00	$2,244.00	2026-03-19
72157	CPT	Hc MRI Spine Thoracic W Wo Contrast	12	12	$3,361.00	$3,024.90	$1,848.55	$3,192.95	$2,218.26	2026-03-19
72197	CPT	Hc MRI Pelvis W Wo Contrast	12	12	$3,361.00	$3,024.90	$1,848.55	$3,192.95	$2,218.26	2026-03-19
72156	CPT	Hc MRI Spine Cervical W Wo Contrast	12	12	$3,361.00	$3,024.90	$1,848.55	$3,192.95	$2,218.26	2026-03-19
70549	CPT	Hc MRA Neck W Wo Contrast	12	12	$3,300.00	$2,970.00	$1,815.00	$3,135.00	$2,178.00	2026-03-19
95811	CPT	Hc Pss W 4/> Param W Cpap/bipap 6+ Yrs	12	12	$3,200.00	$2,880.00	$1,760.00	$3,040.00	$2,112.00	2026-03-19
58571	CPT	Pr Tlh W/t/o 250 G Or Less	12	12	$3,100.00	$2,790.00	$1,705.00	$2,945.00	$2,046.00	2026-03-19
C1886	HCPCS	Hc Catheter, Ablation Lvl 3	12	12	$3,096.00	$2,786.40	$1,702.80	$2,941.20	$2,043.36	2026-03-19
95810	CPT	Hc Pss W 4/> Param W Tech 6+ Yrs	12	12	$3,000.00	$2,700.00	$1,650.00	$2,850.00	$1,980.00	2026-03-19
0761	RC	—	12	12	$3,000.00	$2,700.00	$1,650.00	$2,850.00	$1,980.00	2026-03-19
73723	CPT	Hc MRI Low Extr Any Joint W Wo Contr	12	12	$3,000.00	$2,700.00	$1,650.00	$2,850.00	$1,980.00	2026-03-19
75635	CPT	Hc CT Angiography Aorta Iliofemoral Runoff	12	12	$3,000.00	$2,700.00	$1,650.00	$2,850.00	$1,980.00	2026-03-19
27652	CPT	Pr Primary Repr Rupt Achilles Tndn W Grft	12	12	$3,000.00	$2,700.00	$1,650.00	$2,850.00	$1,980.00	2026-03-19
74174	CPT	Hc CT Angio Abd And Pelv Wo W Contrast	12	12	$3,000.00	$2,700.00	$1,650.00	$2,850.00	$1,980.00	2026-03-19
C1776	HCPCS	Hc Joint Device (implantable) Lvl 3	48	12	$2,285.67	$2,057.10	$329.32	$3,907.73	$1,755.60	2026-03-19
73721	CPT	Hc MRI Low Extr Any Joint Wo Contrast	36	12	$2,500.00	$2,250.00	$1,375.00	$3,895.00	$1,750.00	2026-03-19
74182	CPT	Hc MRI Abdomen W Contrast	12	12	$2,550.00	$2,295.00	$1,402.50	$2,422.50	$1,683.00	2026-03-19
72149	CPT	Hc MRI Spine Lumbar W Contrast	12	12	$2,530.00	$2,277.00	$1,391.50	$2,403.50	$1,669.80	2026-03-19
73221	CPT	Hc MRI Up Extr Any Joint Wo Contrast	36	12	$2,500.00	$2,250.00	$1,375.00	$2,375.00	$1,650.00	2026-03-19
49616	CPT	Pr Rpr Aa Hrn Rcr 3-10 Ncr/strn	12	12	$2,500.00	$2,250.00	$1,375.00	$2,375.00	$1,650.00	2026-03-19
72148	CPT	Hc MRI Spine Lumbar Wo Contrast	12	12	$2,500.00	$2,250.00	$1,375.00	$2,375.00	$1,650.00	2026-03-19
70551	CPT	Hc MRI Brain Wo Contrast	12	12	$2,500.00	$2,250.00	$1,375.00	$2,375.00	$1,650.00	2026-03-19
28299	CPT	Pr Correction Hallux Valgus	12	12	$2,500.00	$2,250.00	$1,375.00	$2,375.00	$1,650.00	2026-03-19
71275	CPT	Hc CT Angiography Chest W Wo Contrast	12	12	$2,435.00	$2,191.50	$1,339.25	$2,313.25	$1,607.10	2026-03-19
74175	CPT	Hc CT Angiography Abdomen W Wo Contrast	12	12	$2,400.00	$2,160.00	$1,320.00	$2,280.00	$1,584.00	2026-03-19
70496	CPT	Hc CT Angiography Head W Wo Contrast	12	12	$2,400.00	$2,160.00	$1,320.00	$2,280.00	$1,584.00	2026-03-19
72141	CPT	Hc MRI Spine Cervical Wo Contrast	12	12	$2,400.00	$2,160.00	$1,320.00	$2,280.00	$1,584.00	2026-03-19
0278	RC	—	72	12	$3,056.00	$2,750.40	$115.50	$7,600.00	$1,566.20	2026-03-19
C1726	HCPCS	Hc Non-vasc Balloon Dilatn Cath Lvl 6	12	12	$2,327.25	$2,094.53	$1,279.99	$2,210.89	$1,535.99	2026-03-19
70540	CPT	Hc MRI Orbit Face Neck Wo Contrast	12	12	$2,300.00	$2,070.00	$1,265.00	$2,185.00	$1,518.00	2026-03-19
70544	CPT	Hc MRA Head Wo Contrast	24	12	$2,300.00	$2,070.00	$1,265.00	$2,185.00	$1,518.00	2026-03-19
J9202	HCPCS	Goserelin Acetate 3.6 Mg Sc Impl	12	12	$2,236.40	$2,012.76	$1,230.02	$2,124.58	$1,476.02	2026-03-19
27654	CPT	Pr Secondry Repr Rupt Achilles Tendon	12	12	$2,200.00	$1,980.00	$1,210.00	$2,090.00	$1,452.00	2026-03-19
73718	CPT	Hc MRI Low Extr Not Joint Wo Contrast	24	12	$2,200.00	$1,980.00	$1,210.00	$2,090.00	$1,452.00	2026-03-19
58542	CPT	Pr Lsh W/t/o Ut 250 G Or Less	12	12	$2,200.00	$1,980.00	$1,210.00	$2,090.00	$1,452.00	2026-03-19
28805	CPT	Pr Amputate Foot; Transmetatarsal	12	12	$2,200.00	$1,980.00	$1,210.00	$2,090.00	$1,452.00	2026-03-19
72195	CPT	Hc MRI Pelvis Wo Contrast	12	12	$2,200.00	$1,980.00	$1,210.00	$2,090.00	$1,452.00	2026-03-19
70498	CPT	Hc CT Angiography Neck W Wo Contrast	12	12	$2,200.00	$1,980.00	$1,210.00	$2,090.00	$1,452.00	2026-03-19
72146	CPT	Hc MRI Spine Thoracic Wo Contrast	12	12	$2,200.00	$1,980.00	$1,210.00	$2,090.00	$1,452.00	2026-03-19
74181	CPT	Hc MRI Abdomen Wo Contrast	12	12	$2,200.00	$1,980.00	$1,210.00	$2,090.00	$1,452.00	2026-03-19
Q4309	CPT	Hc Via Matrix, Per Sq Cm Lvl 5	12	12	$2,167.00	$1,950.30	$1,191.85	$2,058.65	$1,430.22	2026-03-19
A9537	HCPCS	Hc Tc99m Mebrofenin To 15 Mci	12	12	$2,163.00	$1,946.70	$1,189.65	$2,054.85	$1,427.58	2026-03-19
73706	CPT	Hc CT Angiography Lower Extr W Wo Contrast	12	12	$2,100.00	$1,890.00	$1,155.00	$1,995.00	$1,386.00	2026-03-19
C1713	HCPCS	Hc Anchor/screw Bn/bn,tis/bn Lvl 1	108	12	$2,055.00	$1,849.50	$63.16	$7,266.08	$1,356.30	2026-03-19
0200	RC	—	6	6	$1,885.00	$1,696.50	$1,131.00	$1,790.75	$1,356.26	2026-03-19
71260	CPT	Hc CT Chest W Contrast Diag	24	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
74160	CPT	Hc CT Abdomen W Contrast	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
28300	CPT	Pr Osteotomy Calcaneu	24	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
45382	CPT	Pr Colonoscopy W/control Bleed	24	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
49594	CPT	Pr Rpr Aa Hrn 1st 3-10 Ncr/strn	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
72131	CPT	Hc CT Lumbar Spine Wo Contrast	24	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
70470	CPT	Hc CT Head Or Brain W Wo Contrast	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
73218	CPT	Hc MRI Up Extr Not Joint Wo Contrast	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
74170	CPT	Hc CT Abdomen W Wo Contrast	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
71270	CPT	Hc CT Chest W Wo Contrast Diag	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
28296	CPT	Pr Bunion Correct W Mtrsl Bone Inc	24	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
58661	CPT	Pr Lap W Rem Adnexal Structures	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
28111	CPT	Pr Compl Exc 1st Metatrsl Head	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
70487	CPT	Hc CT Maxillofacial W Contrast	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
44950	CPT	Pr Appendectomy	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
58543	CPT	Pr Lsh Uterus Above 250 G	12	12	$2,000.00	$1,800.00	$1,100.00	$1,900.00	$1,320.00	2026-03-19
36573	CPT	Hc Ins Picc Rs&i 5 Yr+	24	12	$2,600.00	$2,340.00	$660.00	$2,470.00	$1,285.00	2026-03-19
P9033	HCPCS	Hc Platelets Leukocytes Reduced Irr Ea Unit	13	12	$1,920.00	$1,728.00	$205.39	$1,824.00	$1,267.20	2026-03-19
72125	CPT	Hc CT Cervical Spine Wo Contrast	12	12	$1,900.00	$1,710.00	$1,045.00	$1,805.00	$1,254.00	2026-03-19
28740	CPT	Pr Arthrodesis Mt Or Tme; Sgl Joint	12	12	$1,900.00	$1,710.00	$1,045.00	$1,805.00	$1,254.00	2026-03-19
28322	CPT	Pr Rep Nu/mu; Metatarsal	12	12	$1,900.00	$1,710.00	$1,045.00	$1,805.00	$1,254.00	2026-03-19
A0433	HCPCS	Hc Als 2	72	12	$1,822.00	$1,639.80	$1,002.10	$1,730.90	$1,202.52	2026-03-19
70492	CPT	Hc CT Soft Tissue Neck W Wo Contrast	12	12	$1,800.00	$1,620.00	$990.00	$1,710.00	$1,188.00	2026-03-19
72132	CPT	Hc CT Lumbar Spine W Contrast	12	12	$1,800.00	$1,620.00	$990.00	$1,710.00	$1,188.00	2026-03-19
72193	CPT	Hc CT Pelvis W Contrast	12	12	$1,800.00	$1,620.00	$990.00	$1,710.00	$1,188.00	2026-03-19
28750	CPT	Pr Arthrodesis Great Toe Mtp Joint	36	12	$1,800.00	$1,620.00	$990.00	$1,710.00	$1,188.00	2026-03-19
71250	CPT	Hc CT Chest Wo Contrast Diag	24	12	$1,800.00	$1,620.00	$990.00	$1,710.00	$1,188.00	2026-03-19
70486	CPT	Hc CT Maxillofacial Wo Contrast	12	12	$1,800.00	$1,620.00	$990.00	$1,710.00	$1,188.00	2026-03-19
73701	CPT	Hc CT Lower Extr W Contrast	12	12	$1,700.00	$1,530.00	$935.00	$1,615.00	$1,122.00	2026-03-19
70491	CPT	Hc CT Soft Tissue Neck W Contrast	12	12	$1,700.00	$1,530.00	$935.00	$1,615.00	$1,122.00	2026-03-19
28140	CPT	Pr Remove Metatarsal	12	12	$1,700.00	$1,530.00	$935.00	$1,615.00	$1,122.00	2026-03-19
45398	CPT	Pr Colonoscopy W/band Ligation	24	12	$2,000.00	$1,800.00	$797.50	$1,900.00	$1,100.00	2026-03-19
73201	CPT	Hc CT Upper Extr W Contrast	12	12	$1,650.00	$1,485.00	$907.50	$1,567.50	$1,089.00	2026-03-19
27685	CPT	Pr Length/short Tendon Leg/ankle Sgl	12	12	$1,600.00	$1,440.00	$880.00	$1,520.00	$1,056.00	2026-03-19
78708	CPT	Hc Nm Kidney Flow Funct W Drug	12	12	$1,600.00	$1,440.00	$880.00	$1,520.00	$1,056.00	2026-03-19
72128	CPT	Hc CT Thoracic Spine Wo Contrast	12	12	$1,600.00	$1,440.00	$880.00	$1,520.00	$1,056.00	2026-03-19
70450	CPT	Hc CT Head Or Brain Wo Contrast	36	12	$1,580.00	$1,422.00	$869.00	$1,501.00	$1,042.80	2026-03-19
0360	RC	—	108	12	$1,575.00	$1,417.50	$195.25	$5,505.25	$1,039.50	2026-03-19
0164	RC	—	6	6	$1,442.00	$1,297.80	$865.20	$1,369.90	$1,037.52	2026-03-19
64451	CPT	Pr Inj Anesth/ster Si Joint Nrv Nrvtg	24	12	$1,525.00	$1,372.50	$838.75	$1,448.75	$1,006.50	2026-03-19
72192	CPT	Hc CT Pelvis Wo Contrast	12	12	$1,520.00	$1,368.00	$836.00	$1,444.00	$1,003.20	2026-03-19
78227	CPT	Hc Nm Hepatobil Syst Image W/drug	12	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
58662	CPT	Pr Lap W Exc/destr Ovary/pelv/perit Les	12	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
49507	CPT	Pr Repair Init Ing Hernia Block 5+ Yr	12	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
70490	CPT	Hc CT Soft Tissue Neck Wo Contrast	12	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
Q4159	HCPCS	Hc Affinity Per Sq Cm Lvl 6	12	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
28485	CPT	Pr Open Tx Metatarsal Fx Ea	12	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
28119	CPT	Pr Remove Heel Spur	12	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
V2787	HCPCS	Hc Astigmatism-correct Function Lvl 3	12	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
73200	CPT	Hc CT Upper Extr Wo Contrast	24	12	$1,500.00	$1,350.00	$825.00	$1,425.00	$990.00	2026-03-19
27650	CPT	Pr Primary Repair Rupt Achilles Tendon	12	12	$1,480.00	$1,332.00	$814.00	$1,406.00	$976.80	2026-03-19
28755	CPT	Pr Fusion Of Big Toe Joint	24	12	$1,475.00	$1,327.50	$770.00	$1,330.00	$976.50	2026-03-19
49651	CPT	Pr Lap Ing Hernia Repair Recur	24	12	$1,450.00	$1,305.00	$797.50	$1,377.50	$957.00	2026-03-19
70480	CPT	Hc CT Orbit Sella Mid Inner Ear Wo Contr	12	12	$1,450.00	$1,305.00	$797.50	$1,377.50	$957.00	2026-03-19
49650	CPT	Pr Lap Ing Hernia Repair Init	72	12	$1,442.00	$1,297.80	$770.00	$1,369.90	$951.72	2026-03-19
73700	CPT	Hc CT Lower Extr Wo Contrast	24	12	$1,400.00	$1,260.00	$770.00	$1,330.00	$924.00	2026-03-19
20680	CPT	Pr Rem Implant Deep	36	12	$1,400.00	$1,260.00	$770.00	$1,330.00	$924.00	2026-03-19
24075	CPT	Pr Exc Arm/elbow Les Sc < 3 Cm	12	12	$1,400.00	$1,260.00	$770.00	$1,330.00	$924.00	2026-03-19
28308	CPT	Pr Mt Shorten Not 1st Mt	24	12	$1,400.00	$1,260.00	$770.00	$1,330.00	$924.00	2026-03-19
27814	CPT	Pr Open Tx Bimalleolar Ankle Fracture	12	12	$1,400.00	$1,260.00	$770.00	$1,330.00	$924.00	2026-03-19
P9100	HCPCS	Hc Pathogen Test For Platelets	12	12	$1,400.00	$1,260.00	$770.00	$1,330.00	$924.00	2026-03-19
78582	CPT	Hc Nm Lung Ventilat&perfus Imaging	12	12	$1,400.00	$1,260.00	$770.00	$1,330.00	$924.00	2026-03-19
C1781	HCPCS	Hc Mesh (implantable) Lvl 4	24	12	$1,137.50	$1,023.75	$625.63	$1,586.74	$918.64	2026-03-19
93306	CPT	Hc Tte With Doppler Complete	12	12	$1,388.00	$1,249.20	$763.40	$1,318.60	$916.08	2026-03-19
25505	CPT	Pr Cl Tx Radial Shft Fx W Manip	24	12	$1,300.00	$1,170.00	$715.00	$1,425.00	$905.00	2026-03-19
11044	CPT	Hc Debride Skin & Bone	24	12	$1,411.00	$1,269.90	$724.90	$1,340.45	$896.24	2026-03-19
49592	CPT	Pr Rpr Aa Hrn 1st < 3 Ncr/strn	12	12	$1,350.00	$1,215.00	$742.50	$1,282.50	$891.00	2026-03-19
49613	CPT	Pr Rpr Aa Hrn Rcr < 3 Rdc	12	12	$1,350.00	$1,215.00	$742.50	$1,282.50	$891.00	2026-03-19
93925	CPT	Hc Duplex Le Art/bpg; Bilat	24	12	$1,335.00	$1,201.50	$734.25	$1,268.25	$881.10	2026-03-19
93970	CPT	Hc Duplex Ext Veins; Bilat	12	12	$1,335.00	$1,201.50	$734.25	$1,268.25	$881.10	2026-03-19
78264	CPT	Hc Nm Gastric Emptying Study	12	12	$1,300.00	$1,170.00	$715.00	$1,235.00	$858.00	2026-03-19
45385	CPT	Pr Colonoscopy Flex W Rem Lesion By Snare	48	12	$1,300.00	$1,170.00	$715.00	$1,235.00	$858.00	2026-03-19
45380	CPT	Pr Colonoscopy Flex W Bx Sgl/multi	72	12	$1,300.00	$1,170.00	$715.00	$1,235.00	$858.00	2026-03-19
28039	CPT	Hc Exc Foot/toe Tum Sc 1.5 Cm/>	24	12	$1,300.00	$1,170.00	$715.00	$1,235.00	$858.00	2026-03-19
27687	CPT	Pr Gastrocnemius Recession	24	12	$1,300.00	$1,170.00	$715.00	$1,235.00	$858.00	2026-03-19
45381	CPT	Pr Colonoscopy Flex W Submucous Inj	48	12	$1,300.00	$1,170.00	$715.00	$1,235.00	$858.00	2026-03-19
24073	CPT	Pr Ex Arm/elbow Tum Deep 5 Cm/>	12	12	$1,300.00	$1,170.00	$715.00	$1,235.00	$858.00	2026-03-19
0120	RC	—	18	6	$1,257.00	$1,131.30	$438.00	$1,369.90	$847.41	2026-03-19
A0427	HCPCS	Hc Als 1 Emergent	84	12	$1,259.00	$1,133.10	$692.45	$1,196.05	$830.94	2026-03-19
28810	CPT	Pr Amputate Metatarsal W Toe Sgl	24	12	$1,250.00	$1,125.00	$687.50	$1,187.50	$825.00	2026-03-19
47562	CPT	Pr Laparoscopy Cholecystecomy	12	12	$1,236.00	$1,112.40	$679.80	$1,174.20	$815.76	2026-03-19
46040	CPT	Pr I&d Perirectal Abscess	12	12	$1,200.00	$1,080.00	$266.53	$1,140.00	$792.00	2026-03-19
28315	CPT	Pr Sesamoidectomy First Toe	12	12	$1,200.00	$1,080.00	$660.00	$1,140.00	$792.00	2026-03-19
28285	CPT	Pr Repair Hammertoe Open Ea Toe	48	12	$1,200.00	$1,080.00	$660.00	$1,140.00	$792.00	2026-03-19
28234	CPT	Pr Tenotomy Open Extensor Tendon Ea	24	12	$1,200.00	$1,080.00	$660.00	$1,140.00	$792.00	2026-03-19
28112	CPT	Pr Compl Exc Othr Metatrsl Head	12	12	$1,200.00	$1,080.00	$660.00	$1,140.00	$792.00	2026-03-19
28080	CPT	Pr Exc Interdig (morton) Neuroma Sgl Ea	24	12	$1,200.00	$1,080.00	$660.00	$1,140.00	$792.00	2026-03-19
78226	CPT	Hc Nm Hepatobiliary System Imaging	12	12	$1,200.00	$1,080.00	$660.00	$1,140.00	$792.00	2026-03-19
27781	CPT	Pr Cl Tx Prox Fib/shaft Fx W Manip	12	12	$1,200.00	$1,080.00	$660.00	$1,140.00	$792.00	2026-03-19
62323	CPT	Pr Inj Interlam L/s W Img	60	12	$1,308.00	$1,177.20	$412.50	$1,242.60	$784.80	2026-03-19
46260	CPT	Pr Remove Int/ext Hem 2+ Groups	12	12	$1,180.00	$1,062.00	$649.00	$1,121.00	$778.80	2026-03-19
99291	CPT	Pr Critical Care 30-74 Min	48	12	$604.00	$543.60	$332.20	$1,691.00	$776.40	2026-03-19
28825	CPT	Hc Amputate Toe; Ip Joint	36	12	$1,100.00	$990.00	$605.00	$1,235.00	$748.00	2026-03-19
J9217	HCPCS	Leuprolide Acetate (3 Month) 22.5 Mg Sc Kit	48	12	$974.88	$877.39	$504.10	$3,962.42	$742.19	2026-03-19
64788	CPT	Pr Exc Neurofibrom; Cutaneous Nerve	36	12	$1,000.00	$900.00	$550.00	$1,900.00	$739.50	2026-03-19
93880	CPT	Hc Carotid Duplex Scan; Bilat	24	12	$1,118.00	$1,006.20	$614.90	$1,062.10	$737.88	2026-03-19
93308	CPT	Hc 2-d Echo Limited Or Followup	12	12	$1,118.00	$1,006.20	$614.90	$1,062.10	$737.88	2026-03-19
28200	CPT	Pr Repr Foot Flexor Tendon Ea	24	12	$1,100.00	$990.00	$605.00	$1,045.00	$726.00	2026-03-19
45378	CPT	Pr Colonoscopy Flex Dx	72	12	$1,100.00	$990.00	$605.00	$1,045.00	$726.00	2026-03-19
78306	CPT	Hc Nm Bone Imaging Whole Body	12	12	$1,096.00	$986.40	$602.80	$1,041.20	$723.36	2026-03-19
21931	CPT	Pr Exc Back Les Sc 3 Cm/>	12	12	$1,095.00	$985.50	$602.25	$1,040.25	$722.70	2026-03-19
A0429	HCPCS	Hc Bls Emergency	72	12	$1,066.00	$959.40	$586.30	$1,012.70	$703.56	2026-03-19
27810	CPT	Hc Cl Tx Bimalleolar Ankle Fx W Manip	24	12	$1,000.00	$900.00	$550.00	$1,140.00	$700.00	2026-03-19
45915	CPT	Pr Remove Fecal Impact Or Fb W Anesth	12	12	$1,050.00	$945.00	$577.50	$997.50	$693.00	2026-03-19
44970	CPT	Pr Laparoscopy Appendectomy	12	12	$1,030.00	$927.00	$566.50	$978.50	$679.80	2026-03-19
49083	CPT	Hc Abd Paracentesis W/imaging	24	12	$1,200.00	$1,080.00	$440.00	$1,140.00	$660.00	2026-03-19
28043	CPT	Pr Exc Foot/toe Tum Sc < 1.5 Cm	12	12	$1,000.00	$900.00	$550.00	$950.00	$660.00	2026-03-19
76641	CPT	Hc US Breast Complete	12	12	$1,000.00	$900.00	$550.00	$950.00	$660.00	2026-03-19
28899	CPT	Pr Unlisted Procedure Foot Or Toes	12	12	$1,000.00	$900.00	$550.00	$950.00	$660.00	2026-03-19
28820	CPT	Pr Amputate Toe Mtp Joint	36	12	$1,000.00	$900.00	$550.00	$950.00	$660.00	2026-03-19
28124	CPT	Pr Partial Exc Phalanx Toe Bone	12	12	$1,000.00	$900.00	$550.00	$950.00	$660.00	2026-03-19
64447	CPT	Pr Inj Anesth/ster Femoral Nrv	48	12	$975.00	$877.50	$536.25	$926.25	$643.50	2026-03-19
64445	CPT	Pr Inj Anesth/ster Sciatic Nrv	36	12	$975.00	$877.50	$536.25	$926.25	$643.50	2026-03-19
P9031	HCPCS	Hc Platelets Leukocytes Reduced Ea Unit	13	12	$973.13	$875.82	$125.77	$924.47	$642.27	2026-03-19
90675	CPT	Rabies Vaccine, Pcec IM Susr	36	12	$955.15	$859.64	$511.03	$908.91	$630.40	2026-03-19
11606	CPT	Pr Exc Skin Malig >4cm Trunk,arm,leg	12	12	$952.00	$856.80	$266.53	$904.40	$628.32	2026-03-19
A9509	HCPCS	Hc Iodine I-123 Sod Iodide Mil Per 1 Mci	12	12	$933.00	$839.70	$513.15	$886.35	$615.78	2026-03-19
19120	CPT	Pr Remove Of Breast Lesion 1+	12	12	$927.00	$834.30	$509.85	$880.65	$611.82	2026-03-19
78070	CPT	Hc Nm Parathyroid Imaging	12	12	$900.00	$810.00	$495.00	$855.00	$594.00	2026-03-19
52310	CPT	Pr Cystoscopy, Remv Calculus And/or Stent, Simple	12	12	$900.00	$810.00	$266.53	$855.00	$594.00	2026-03-19
49591	CPT	Pr Rpr Aa Hrn 1st < 3 Cm Rdc	36	12	$900.00	$810.00	$495.00	$855.00	$594.00	2026-03-19
78014	CPT	Hc Thyroid Imag W/blood Flow Sgl/mult Quan	12	12	$900.00	$810.00	$495.00	$855.00	$594.00	2026-03-19
84393	CPT	Hc Tau Phosphorylated Ea	12	12	$900.00	$810.00	$495.00	$855.00	$594.00	2026-03-19
93975	CPT	Hc US Duplex Arterial Flow Compl	24	12	$889.00	$800.10	$488.95	$844.55	$586.74	2026-03-19
93978	CPT	Hc Duplex A Ivc Il/bpg; Compl	12	12	$889.00	$800.10	$488.95	$844.55	$586.74	2026-03-19
G0105	HCPCS	Pr Screen Colonoscopy High Risk Pt	26	12	$866.00	$779.40	$301.99	$822.70	$571.56	2026-03-19
G0121	HCPCS	Pr Screen Colonoscopy Pt Not High Risk	26	12	$866.00	$779.40	$302.14	$822.70	$571.56	2026-03-19
55250	CPT	Pr Removal Of Sperm Duct(s)	12	12	$850.00	$765.00	$266.53	$807.50	$561.00	2026-03-19
0027U	CPT	Hc Jak2 Gene Trgt Seq Alys 12-15	26	12	$850.00	$765.00	$121.91	$807.50	$561.00	2026-03-19
81263	CPT	Hc Igh Vari Regional Mutation	13	12	$838.00	$754.20	$294.52	$796.10	$553.08	2026-03-19
81352	CPT	Hc Tp53 Gene Trgt Sequence Alys	13	12	$838.00	$754.20	$329.51	$796.10	$553.08	2026-03-19
ZB1W8	CPT	Hc Jak2 Gene	12	12	$838.00	$754.20	$460.90	$796.10	$553.08	2026-03-19
81270	CPT	Hc Jak2 Gene	26	12	$838.00	$754.20	$91.66	$796.10	$553.08	2026-03-19
58562	CPT	Pr Hysteroscopy; W Rem Impacted Fb	12	12	$830.00	$747.00	$456.50	$788.50	$547.80	2026-03-19
58558	CPT	Pr Hysteroscopy; W Bx Endom Or Polypect	12	12	$824.00	$741.60	$453.20	$782.80	$543.84	2026-03-19
13132	CPT	Hc Crep F/g/h/f 2.6-7.5 Cm	24	12	$794.50	$715.05	$290.95	$1,007.00	$542.77	2026-03-19
A9552	HCPCS	Hc F18 Fdg To 45 Mci	12	12	$808.00	$727.20	$444.40	$767.60	$533.28	2026-03-19
58120	CPT	Pr D&c Diagnostic Or Therap Not OB	12	12	$800.00	$720.00	$440.00	$760.00	$528.00	2026-03-19
93922	CPT	Hc Upr/l Xtremity Art 2 Levels	36	12	$798.00	$718.20	$438.90	$758.10	$526.68	2026-03-19
64483	CPT	Pr Inj(s) Foramen Epid L/s Sgl Lev	60	12	$645.00	$580.50	$354.75	$918.65	$517.15	2026-03-19
81206	CPT	Hc Bcr/abl1 Gene Major Bp	13	12	$773.00	$695.70	$163.96	$734.35	$510.18	2026-03-19
76700	CPT	Hc US Exam Abdomen Complete	24	12	$763.00	$686.70	$419.65	$724.85	$503.58	2026-03-19
93017	CPT	Hc Cvslr Stress Test; Tracing	12	12	$761.00	$684.90	$418.55	$722.95	$502.26	2026-03-19
93931	CPT	Hc Duplex Ue Art/bpg; Unil/limit	12	12	$751.00	$675.90	$413.05	$713.45	$495.66	2026-03-19
93926	CPT	Hc Duplex Le Art/bpg; Unil/limit	12	12	$751.00	$675.90	$413.05	$713.45	$495.66	2026-03-19
62321	CPT	Pr Inj Interlam C/t W Img	12	12	$750.00	$675.00	$412.50	$712.50	$495.00	2026-03-19
95800	CPT	Hc Sleep Study Unattended	12	12	$750.00	$675.00	$412.50	$712.50	$495.00	2026-03-19
64493	CPT	Pr Inj Paravert F Jnt L/s 1 Lev Bilat	12	12	$750.00	$675.00	$412.50	$712.50	$495.00	2026-03-19
64454	CPT	Pr Njx Aa&/strd Gnclr Nrv Brnch	12	12	$750.00	$675.00	$412.50	$712.50	$495.00	2026-03-19
A9562	HCPCS	Hc Tc99m Mag3 To 15 Mci	12	12	$730.00	$657.00	$401.50	$693.50	$481.80	2026-03-19
C1751	HCPCS	Hc Infusion Cath, Periph/central/midline Lvl 2	12	12	$726.56	$653.90	$399.61	$690.23	$479.53	2026-03-19
81339	CPT	Hc Mpl Gene Sequence Alysis Exon 10	26	12	$487.50	$438.75	$185.20	$688.75	$478.50	2026-03-19
81256	CPT	Hc Hfe Gene	13	12	$715.00	$643.50	$65.36	$679.25	$471.90	2026-03-19
62270	CPT	Hc Spinal Puncture Lumbar Diag	24	12	$702.00	$631.80	$302.50	$811.30	$469.70	2026-03-19
13120	CPT	Hc C Rep S/a/l 1.1-2.5 Cm	24	12	$640.00	$576.00	$352.00	$807.50	$467.50	2026-03-19
A0428	HCPCS	Hc Bls Non Emergent	84	12	$667.00	$600.30	$366.85	$1,012.70	$466.90	2026-03-19
76805	CPT	Hc US OB Complete Sngl Fetus	12	12	$700.00	$630.00	$385.00	$665.00	$462.00	2026-03-19
46221	CPT	Pr Ligation Of Hemorrhoid(s)	24	12	$700.00	$630.00	$385.00	$665.00	$462.00	2026-03-19
76856	CPT	Hc US Exam Pelvic Comp Transabdominal	12	12	$700.00	$630.00	$385.00	$665.00	$462.00	2026-03-19
28232	CPT	Pr Tenotomy Open Flexor Toe Sgl	24	12	$700.00	$630.00	$385.00	$665.00	$462.00	2026-03-19
87517	CPT	Hc Hep-b, Na Quan	13	12	$690.00	$621.00	$42.84	$655.50	$455.40	2026-03-19
59820	CPT	Pr Surg Tx Missed Abort 1st Trimester	12	12	$689.00	$620.10	$378.95	$654.55	$454.74	2026-03-19
81219	CPT	Hc Calr Gene Com Variants	26	12	$500.00	$450.00	$110.00	$760.00	$440.00	2026-03-19
Q5122	CPT	Pegfilgrastim-apgf 6 Mg/0.6ml Sc Sosy	12	12	$661.46	$595.31	$363.80	$628.39	$436.56	2026-03-19
93226	CPT	Hc ECG 0-48 Hrs Scanning Analysis Report	12	12	$650.00	$585.00	$357.50	$617.50	$429.00	2026-03-19
76770	CPT	Hc US Exam Retroperitoneal Compl	24	12	$650.00	$585.00	$357.50	$617.50	$429.00	2026-03-19
28010	CPT	Pr Incision Subcut Toe Tendon	12	12	$650.00	$585.00	$266.53	$617.50	$429.00	2026-03-19
J1610	HCPCS	Glucagon (rdna) 1 Mg Ij Kit	12	12	$647.50	$582.75	$356.13	$615.13	$427.35	2026-03-19
93246	CPT	Hc Ext ECG 7 To 15 Day Recording	12	12	$640.00	$576.00	$352.00	$608.00	$422.40	2026-03-19
36430	CPT	Hc Transfusion Blood Or Component Per Unit	24	12	$632.86	$569.57	$348.07	$601.22	$417.69	2026-03-19
77075	CPT	Hc Bone Survey Complete	12	12	$630.00	$567.00	$346.50	$598.50	$415.80	2026-03-19
76830	CPT	Hc US Non OB Transvag	24	12	$630.00	$567.00	$346.50	$598.50	$415.80	2026-03-19
P9040	HCPCS	Hc Rbc, Lr, Irradiated, Each Unit	13	12	$622.73	$560.46	$255.80	$591.59	$411.00	2026-03-19
86337	CPT	Hc Insulin Ab	13	12	$620.00	$558.00	$21.41	$589.00	$409.20	2026-03-19
11642	CPT	Pr Exc F/e/e/n/l Mal + Mrg 1.1-2.0 Cm	24	12	$735.00	$661.50	$266.53	$698.25	$408.10	2026-03-19
12031	CPT	Pr Intm Wnd Rpr S/tr/ext 2.5 Cm/<	12	12	$618.00	$556.20	$339.90	$587.10	$407.88	2026-03-19
93971	CPT	Hc Duplex Ext Veins Unil/limit	36	12	$618.00	$556.20	$339.90	$587.10	$407.88	2026-03-19
11406	CPT	Pr Exc Ben Les T/a/l > 4.0 Cm	48	12	$599.00	$539.10	$266.53	$950.00	$405.50	2026-03-19
11603	CPT	Pr Exc Skin Malig 2.1-3cm Trunk,arm,leg	12	12	$606.00	$545.40	$266.53	$575.70	$399.96	2026-03-19
27257	CPT	Pr Tx Spontan Hip Disloc W Anesth	24	12	$400.00	$360.00	$220.00	$712.50	$396.25	2026-03-19
71271	CPT	Hc CT Thorax Lung Cancer Screen	12	12	$600.00	$540.00	$330.00	$570.00	$396.00	2026-03-19
12021	CPT	Pr Tx Superficial Wound Dehiscence W/packing	12	12	$600.00	$540.00	$266.53	$570.00	$396.00	2026-03-19
64644	CPT	Pr Chemodenerv 1 Extrem 5/> Mus	12	12	$600.00	$540.00	$330.00	$570.00	$396.00	2026-03-19
36556	CPT	Pr Ins Non Tunnel Cv Cath 5 Yrs/>	72	12	$564.00	$507.60	$8.25	$1,140.00	$394.74	2026-03-19
93242	CPT	Hc Ext ECG 48hr To 7 Day Recording	12	12	$590.00	$531.00	$324.50	$560.50	$389.40	2026-03-19
11601	CPT	Pr Exc Tr-ext Mal+ Mrg 0.6-1.0 Cm	36	12	$650.00	$585.00	$266.53	$617.50	$389.36	2026-03-19
12051	CPT	Pr Int Rep F/e/n/l/mm 2.5 Cm/<	48	12	$670.00	$603.00	$146.85	$636.50	$385.25	2026-03-19
12032	CPT	Pr Intm Wnd Rpr S/tr/ext 2.6-7.5 Cm	84	12	$700.00	$630.00	$89.10	$665.00	$385.00	2026-03-19
27096	CPT	Pr Sij Anesth/steriod Inj	48	12	$500.00	$450.00	$8.80	$1,995.00	$385.00	2026-03-19
15275	CPT	Hc Skin Sub Grft F/nk/hf/g 25 Sq Cm	24	12	$400.00	$360.00	$220.00	$672.60	$384.70	2026-03-19
76705	CPT	Hc US Exam Abdomen Limited	12	12	$580.00	$522.00	$319.00	$551.00	$382.80	2026-03-19
57460	CPT	Pr Colposcopy,cervix W/adj Vag,w/loop Bx	12	12	$579.00	$521.10	$266.53	$550.05	$382.14	2026-03-19
15271	CPT	Pr Skin Sub Graft T/a/l 25 Sq Cm	24	12	$688.00	$619.20	$220.00	$653.60	$378.40	2026-03-19
90375	CPT	Rabies Immune Globulin 1500 Unit/5ml Ij Soln	60	12	$641.29	$577.16	$189.74	$654.79	$375.82	2026-03-19
87799	CPT	Hc Na Quan, Nos Agent	26	12	$564.00	$507.60	$42.84	$535.80	$372.24	2026-03-19
74246	CPT	Hc Ugi W Air W Or Wo Kub	12	12	$558.00	$502.20	$306.90	$530.10	$368.28	2026-03-19
28190	CPT	Pr Remv Foot Foreign Body,subcutaneous	12	12	$553.00	$497.70	$266.53	$525.35	$364.98	2026-03-19
11622	CPT	Pr Exc Skin Malig 1.1-2cm Remaindr Body	12	12	$552.00	$496.80	$266.53	$524.40	$364.32	2026-03-19
76706	CPT	Hc US Abdl Aorta Screen Aaa	12	12	$550.00	$495.00	$302.50	$522.50	$363.00	2026-03-19
76776	CPT	Hc US Exam Kidney Transpl W Doppler	12	12	$550.00	$495.00	$302.50	$522.50	$363.00	2026-03-19
76775	CPT	Hc US Exam Retroperitoneal Ltd	12	12	$550.00	$495.00	$302.50	$522.50	$363.00	2026-03-19
76870	CPT	Hc US Scrotum And Contents	12	12	$546.00	$491.40	$300.30	$518.70	$360.36	2026-03-19
32551	CPT	Hc Insertion Of Chest Tube	36	12	$600.00	$540.00	$275.00	$570.00	$360.00	2026-03-19
43247	CPT	Pr Ugi W Removal Of Fb	12	12	$544.00	$489.60	$299.20	$516.80	$359.04	2026-03-19
43239	CPT	Pr Ugi W Bx Sgl/multiple	24	12	$544.00	$489.60	$299.20	$516.80	$359.04	2026-03-19
43235	CPT	Pr Ugi Diagnostic	36	12	$544.00	$489.60	$299.20	$516.80	$359.04	2026-03-19
86832	CPT	Hc Hla Class I High Defin Qual	13	12	$540.00	$486.00	$297.00	$513.00	$356.40	2026-03-19
11602	CPT	Pr Exc Skin Malig 1.1-2cm Trunk,arm,leg	12	12	$535.00	$481.50	$266.53	$508.25	$353.10	2026-03-19
81222	CPT	Hc Cftr Gene Dup/delet Variants	13	12	$527.00	$474.30	$289.85	$500.65	$347.82	2026-03-19
92950	CPT	Hc Cpr	12	12	$526.00	$473.40	$289.30	$499.70	$347.16	2026-03-19
76536	CPT	Hc US Exam Of Head And Neck	12	12	$520.00	$468.00	$286.00	$494.00	$343.20	2026-03-19
11641	CPT	Pr Exc Skin Malig 0.6-1cm Face,facial	12	12	$518.00	$466.20	$266.53	$492.10	$341.88	2026-03-19
21555	CPT	Pr Exc Neck Les Sc < 3 Cm	12	12	$515.00	$463.50	$283.25	$489.25	$339.90	2026-03-19
11403	CPT	Pr Exc Benign Les T/a/l 2.1-3.0 Cm	24	12	$515.00	$463.50	$283.25	$489.25	$339.90	2026-03-19
11424	CPT	Pr Exc Skin Benig 3.1-4cm Remaindr Body	12	12	$513.00	$461.70	$266.53	$487.35	$338.58	2026-03-19
94660	CPT	Hc Pos Airway Pressure Cpap/bipap Initial	24	12	$710.00	$639.00	$165.00	$674.50	$337.75	2026-03-19
52000	CPT	Pr Cystourethroscopy	12	12	$500.00	$450.00	$266.53	$475.00	$330.00	2026-03-19
76604	CPT	Hc US Exam Chest	12	12	$500.00	$450.00	$275.00	$475.00	$330.00	2026-03-19
42700	CPT	Pr Inc/drain Peritonsil Abscess	12	12	$500.00	$450.00	$266.53	$475.00	$330.00	2026-03-19
36592	CPT	Hc Collect Blood From Picc	12	12	$500.00	$450.00	$275.00	$475.00	$330.00	2026-03-19
36591	CPT	Hc Draw Blood Off Venous Device	12	12	$500.00	$450.00	$275.00	$475.00	$330.00	2026-03-19
94060	CPT	Hc Bronchospasm Pre & Post Bd	12	12	$500.00	$450.00	$275.00	$475.00	$330.00	2026-03-19
11640	CPT	Pr Exc F/e/e/n/l Mal + Mrg 0.5 Cm <	24	12	$500.00	$450.00	$275.00	$475.00	$330.00	2026-03-19
94618	CPT	Hc Pulmonary Stress Testing	12	12	$500.00	$450.00	$275.00	$475.00	$330.00	2026-03-19
26720	CPT	Hc Cl Tx Phal Shaft Fx Wo Manip	12	12	$500.00	$450.00	$275.00	$475.00	$330.00	2026-03-19
74240	CPT	Hc Ugi W Or Wo Kub	12	12	$498.00	$448.20	$273.90	$473.10	$328.68	2026-03-19
27250	CPT	Pr Cl Tx Trauma Hip Disloc Wo Anesth	24	12	$195.00	$175.50	$107.25	$807.50	$326.38	2026-03-19
11443	CPT	Pr Exc Skin Benig 2.1-3cm Face,facial	12	12	$494.00	$444.60	$266.53	$469.30	$326.04	2026-03-19
94762	CPT	Hc Continuous Pulse Ox	24	12	$490.00	$441.00	$269.50	$465.50	$323.40	2026-03-19
11404	CPT	Pr Exc Skin Benig 3.1-4cm Trunk,arm,leg	12	12	$486.00	$437.40	$266.53	$461.70	$320.76	2026-03-19
32555	CPT	Pr Aspirate Pleura With Imaging	24	12	$183.00	$164.70	$100.65	$807.50	$320.67	2026-03-19
I6020	CPT	Hc Debride Skin To Sq Tissue	12	12	$484.00	$435.60	$266.20	$459.80	$319.44	2026-03-19
31500	CPT	Hc Intubation Et Emergent	24	12	$511.50	$460.35	$101.75	$796.10	$318.32	2026-03-19
11042	CPT	Hc Debride Skin To Sq Tissue	108	12	$484.00	$435.60	$165.00	$1,340.45	$317.57	2026-03-19
76801	CPT	Hc US OB Less Than 14 Wks Sngl Fetus	12	12	$480.00	$432.00	$264.00	$456.00	$316.80	2026-03-19
V2632	HCPCS	Hc Lens, Intraocular Posterior Lvl 1	12	12	$479.00	$431.10	$263.45	$455.05	$316.14	2026-03-19
P9016	HCPCS	Hc Leukocyte Poor Blood, Ea Unit	25	12	$478.00	$430.20	$182.00	$456.07	$315.48	2026-03-19
84445	CPT	Hc Thyroid Stimulating Immunoglobulins	13	12	$476.00	$428.40	$50.86	$452.20	$314.16	2026-03-19
26775	CPT	Pr Cl Tx Interphalang Jt Disl W Manip & Anesth	24	12	$168.00	$151.20	$92.40	$807.50	$313.55	2026-03-19
76817	CPT	Hc US OB Transvaginal	12	12	$470.00	$423.00	$258.50	$446.50	$310.20	2026-03-19
76882	CPT	Hc US Xtr Non-vasc Ltd	36	12	$400.00	$360.00	$220.00	$623.20	$310.00	2026-03-19
A9500	HCPCS	Hc Tc99m Sestamibi Per Study Dose	12	12	$469.00	$422.10	$257.95	$445.55	$309.54	2026-03-19

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