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

AVERA HOLY FAMILY HOSPITAL

Estherville, IA · CCN 161351 · Rates published

Your selected procedure

You selected 93306 (CPT)

TTE W Doppler Complete

This hospital’s price: $2,210 across 6 payers · range $586-$3,158

Source: https://www.avera.org/app/files/public/613f57be-d5e6-4ac9-84b7-e886a47e46a2/420680370_avera-holy-family-hospital_standardcharges.csv · observed 2026-07-18

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.

1,137 distinct procedures filed
6 distinct payers
24,569 rate rows
2026-07-18 last MRF observed
Data quality

24,467 of 24,569 rate rows are consumer-grade (99.6%)

102 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
percent-of-charges filed in the dollar field — excluded from medians 41
placeholder amount (≤ $0.02) — excluded from medians 28
exceeds 10× this hospital's gross charge — excluded from medians 20
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 9
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/613f57be-d5e6-4ac9-84b7-e886a47e46a2/420680370_avera-holy-family-hospital_standardcharges.csv
Found on page https://www.avera.org/patients-visitors/price-transparency/
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-23
Content fingerprint 5fdd00b4feada39d… · 5,180,358 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J2350
HCPCS 		Ocrelizumab 300 Mg/10 Ml 6 $6.09 $84,715.95 $49,937.82 nat. median
$470
outlier · 106.3×
J2329
HCPCS 		Ublituximab-xiiy 150 Mg/6 Ml 6 $6.87 $44,817.44 $26,418.70 nat. median
$177
outlier · 149.2×
J3380
HCPCS 		Vedolizumab 300 Mg Vial 6 $21.16 $38,163.10 $22,496.14 nat. median
$162
outlier · 138.8×
884
MS_DRG 		Ms-DRG 884 1 $20,812.46 $20,812.46 $20,812.46 nat. median
$14,244
1.5× median
897
MS_DRG 		Ms-DRG 897 1 $19,773.81 $19,773.81 $19,773.81 nat. median
$8,349
outlier · 2.4×
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 6 $0.41 $30,005.60 $17,687.51 nat. median
$3,820
outlier · 4.6×
521
APR_DRG 		Apr-DRG 521 1 $17,041.91 $17,041.91 $17,041.91 nat. median
$4,892
outlier · 3.5×
291
MS_DRG 		Ms-DRG 291 1 $14,875.62 $14,875.62 $14,875.62 nat. median
$12,770
1.2× median
871
MS_DRG 		Ms-DRG 871 1 $14,875.62 $14,875.62 $14,875.62 nat. median
$18,642
0.8× median
J0717
HCPCS 		Certolizumab Pegol 400 Mg Kit 6 $3.42 $24,592.04 $14,496.36 nat. median
$1,598
outlier · 9.1×
J9271
HCPCS 		Pembrolizumab 100 Mg/4 Ml Vial 6 $13.37 $24,490.20 $14,436.33 nat. median
$276
outlier · 52.4×
1392
APR_DRG 		Apr-DRG 1392 1 $13,762.56 $13,762.56 $13,762.56 nat. median
$5,416
outlier · 2.5×
864
MS_DRG 		Ms-DRG 864 1 $13,557.52 $13,557.52 $13,557.52 nat. median
$9,220
1.5× median
6633
APR_DRG 		Apr-DRG 6633 1 $13,276.47 $13,276.47 $13,276.47 nat. median
$8,537
1.6× median
J9312
HCPCS 		Rituximab 500 Mg/50 Ml Vial 6 $83.64 $20,272.24 $11,949.95 nat. median
$1,071
outlier · 11.2×
682
MS_DRG 		Ms-DRG 682 1 $11,907.20 $11,907.20 $11,907.20 nat. median
$14,434
0.8× median
481
MS_DRG 		Ms-DRG 481 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$20,302
0.5× median
690
MS_DRG 		Ms-DRG 690 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$8,376
1.2× median
195
MS_DRG 		Ms-DRG 195 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$6,818
1.5× median
191
MS_DRG 		Ms-DRG 191 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$8,846
1.2× median
872
MS_DRG 		Ms-DRG 872 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$10,401
1.0× median
309
MS_DRG 		Ms-DRG 309 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$7,903
1.3× median
194
MS_DRG 		Ms-DRG 194 1 $10,176.52 $10,176.52 $10,176.52 nat. median
$8,516
1.2× median
1332
APR_DRG 		Apr-DRG 1332 1 $10,072.88 $10,072.88 $10,072.88 nat. median
$6,423
1.6× median
179
MS_DRG 		Ms-DRG 179 1 $8,938.78 $8,938.78 $8,938.78 nat. median
$8,191
1.1× median
310
MS_DRG 		Ms-DRG 310 1 $8,938.78 $8,938.78 $8,938.78 nat. median
$6,284
1.4× median
200
MS_DRG 		Ms-DRG 200 1 $8,938.78 $8,938.78 $8,938.78 nat. median
$11,057
0.8× median
177
MS_DRG 		Ms-DRG 177 1 $8,938.78 $8,938.78 $8,938.78 nat. median
$15,388
0.6× median
J1306
HCPCS 		Inclisiran 284mg/1.5ml Syringe 6 $5.81 $14,744.10 $8,691.26 nat. median
$44
outlier · 196.8×
90375
HCPCS 		Rabies Ig (Human) 300 U/Ml 5Ml 6 $146.90 $13,288.86 $7,833.43 nat. median
$1,056
outlier · 7.4×
J2182
HCPCS 		Mepolizumab 100 Mg Vial 6 $6.38 $12,758.71 $7,520.92 nat. median
$2,791
outlier · 2.7×
J2426
HCPCS 		Paliperidone Palm 234mg/1.5ml 6 $14.74 $12,135.38 $7,153.48 nat. median
$2,498
outlier · 2.9×
J9202
HCPCS 		Goserelin 10.8 Mg Implant 6 $77.09 $11,629.14 $6,855.07 nat. median
$1,834
outlier · 3.7×
683
MS_DRG 		Ms-DRG 683 1 $6,795.52 $6,795.52 $6,795.52 nat. median
$9,108
0.7× median
178
MS_DRG 		Ms-DRG 178 1 $6,795.52 $6,795.52 $6,795.52 nat. median
$10,198
0.7× median
66
MS_DRG 		Ms-DRG 66 1 $6,795.52 $6,795.52 $6,795.52 nat. median
$7,559
0.9× median
Q5123
HCPCS 		Rituximab-arrx 500 Mg/50 Ml Vl 6 $33.09 $10,599.49 $6,248.12 nat. median
$1,006
outlier · 6.2×
10180
CPT 		I&d Postop Wound Complex 6 $210.58 $10,908.00 $6,108.48 nat. median
$2,863
outlier · 2.1×
281
MS_DRG 		Ms-DRG 281 1 $5,970.36 $5,970.36 $5,970.36 nat. median
$9,714
0.6× median
193
MS_DRG 		Ms-DRG 193 2 $5,970.36 $20,724.14 $5,970.36 nat. median
$12,868
outlier · 0.5×
69
MS_DRG 		Ms-DRG 69 1 $5,970.36 $5,970.36 $5,970.36 nat. median
$8,419
0.7× median
390
MS_DRG 		Ms-DRG 390 1 $5,970.36 $5,970.36 $5,970.36 nat. median
$6,116
1.0× median
15271
CPT 		Skin Substitute Graft 25 Sq Cm 6 $98.98 $10,511.00 $5,886.16 nat. median
$1,725
outlier · 3.4×
J3247
HCPCS 		Secukinumab 125 Mg/5 Ml Vial 6 $17.73 $9,190.72 $5,417.69 nat. median
$49
outlier · 109.9×
J0349
HCPCS 		Rezafungin 200 Mg Vial 6 $3.78 $8,659.96 $5,104.82 nat. median
$18
outlier · 280.0×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 6 $163.60 $8,478.75 $4,998.00 nat. median
$1,982
outlier · 2.5×
J1602
HCPCS 		Golimumab 50 Mg/4 Ml Vial 6 $10.77 $8,389.99 $4,945.68 nat. median
$273
outlier · 18.1×
74174
CPT 		CTA Abd&Pelv Wwo Dye 6 $1,231.62 $6,982.00 $4,817.58 nat. median
$988
outlier · 4.9×
J3032
HCPCS 		Eptinezumab-jjmr 100Mg/Ml Vial 6 $19.32 $7,956.48 $4,690.13 nat. median
$76
outlier · 62.0×
Q5122
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Syr 6 $134.25 $7,504.44 $4,423.67 nat. median
$561
outlier · 7.9×

Other procedures at this hospital

Browse this hospital's 1,137 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml 15 6 $89,174.00 $86,499.44 $6.09 $84,715.95 $49,937.82 2026-07-18
J2329 HCPCS Ublituximab-xiiy 150 Mg/6 Ml 15 6 $47,176.00 $45,760.96 $6.87 $44,817.44 $26,418.70 2026-07-18
J3380 HCPCS Vedolizumab 300 Mg Vial 16 6 $40,171.00 $38,966.53 $21.16 $38,163.10 $22,496.14 2026-07-18
884 MS_DRG Ms-DRG 884 2 1 — — $20,812.46 $20,812.46 $20,812.46 2026-07-18
897 MS_DRG Ms-DRG 897 1 1 — — $19,773.81 $19,773.81 $19,773.81 2026-07-18
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Syrng 15 6 $31,584.00 $30,637.29 $0.41 $30,005.60 $17,687.51 2026-07-18
521 APR_DRG Apr-DRG 521 2 1 — — $17,041.91 $17,041.91 $17,041.91 2026-07-18
291 MS_DRG Ms-DRG 291 2 1 — — $14,875.62 $14,875.62 $14,875.62 2026-07-18
871 MS_DRG Ms-DRG 871 2 1 — — $14,875.62 $14,875.62 $14,875.62 2026-07-18
J0717 HCPCS Certolizumab Pegol 400 Mg Kit 15 6 $25,886.00 $25,109.77 $3.42 $24,592.04 $14,496.36 2026-07-18
J9271 HCPCS Pembrolizumab 100 Mg/4 Ml Vial 15 6 $25,779.00 $25,005.79 $13.37 $24,490.20 $14,436.33 2026-07-18
1392 APR_DRG Apr-DRG 1392 2 1 — — $13,762.56 $13,762.56 $13,762.56 2026-07-18
864 MS_DRG Ms-DRG 864 2 1 — — $13,557.52 $13,557.52 $13,557.52 2026-07-18
6633 APR_DRG Apr-DRG 6633 2 1 — — $13,276.47 $13,276.47 $13,276.47 2026-07-18
J9312 HCPCS Rituximab 500 Mg/50 Ml Vial 15 6 $21,339.00 $20,699.02 $83.64 $20,272.24 $11,949.95 2026-07-18
682 MS_DRG Ms-DRG 682 2 1 — — $11,907.20 $11,907.20 $11,907.20 2026-07-18
194 MS_DRG Ms-DRG 194 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-07-18
690 MS_DRG Ms-DRG 690 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-07-18
309 MS_DRG Ms-DRG 309 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-07-18
481 MS_DRG Ms-DRG 481 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-07-18
195 MS_DRG Ms-DRG 195 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-07-18
191 MS_DRG Ms-DRG 191 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-07-18
872 MS_DRG Ms-DRG 872 2 1 — — $10,176.52 $10,176.52 $10,176.52 2026-07-18
1332 APR_DRG Apr-DRG 1332 2 1 — — $10,072.88 $10,072.88 $10,072.88 2026-07-18
177 MS_DRG Ms-DRG 177 2 1 — — $8,938.78 $8,938.78 $8,938.78 2026-07-18
179 MS_DRG Ms-DRG 179 2 1 — — $8,938.78 $8,938.78 $8,938.78 2026-07-18
310 MS_DRG Ms-DRG 310 2 1 — — $8,938.78 $8,938.78 $8,938.78 2026-07-18
200 MS_DRG Ms-DRG 200 2 1 — — $8,938.78 $8,938.78 $8,938.78 2026-07-18
J1306 HCPCS Inclisiran 284mg/1.5ml Syringe 15 6 $15,520.00 $15,054.51 $5.81 $14,744.10 $8,691.26 2026-07-18
90375 HCPCS Rabies Ig (Human) 300 U/Ml 5Ml 15 6 $13,988.00 $13,568.62 $146.90 $13,288.86 $7,833.43 2026-07-18
J2182 HCPCS Mepolizumab 100 Mg Vial 15 6 $13,430.00 $13,027.31 $6.38 $12,758.71 $7,520.92 2026-07-18
J2426 HCPCS Paliperidone Palm 234mg/1.5ml 15 6 $12,774.00 $12,390.86 $14.74 $12,135.38 $7,153.48 2026-07-18
J9202 HCPCS Goserelin 10.8 Mg Implant 15 6 $12,241.00 $11,873.96 $77.09 $11,629.14 $6,855.07 2026-07-18
178 MS_DRG Ms-DRG 178 2 1 — — $6,795.52 $6,795.52 $6,795.52 2026-07-18
683 MS_DRG Ms-DRG 683 2 1 — — $6,795.52 $6,795.52 $6,795.52 2026-07-18
66 MS_DRG Ms-DRG 66 2 1 — — $6,795.52 $6,795.52 $6,795.52 2026-07-18
Q5123 HCPCS Rituximab-arrx 500 Mg/50 Ml Vl 15 6 $11,157.00 $10,822.64 $33.09 $10,599.49 $6,248.12 2026-07-18
10180 CPT I&d Postop Wound Complex 22 6 $10,908.00 $10,580.76 $210.58 $10,908.00 $6,108.48 2026-07-18
281 MS_DRG Ms-DRG 281 2 1 — — $5,970.36 $5,970.36 $5,970.36 2026-07-18
193 MS_DRG Ms-DRG 193 3 2 — — $5,970.36 $20,724.14 $5,970.36 2026-07-18
69 MS_DRG Ms-DRG 69 2 1 — — $5,970.36 $5,970.36 $5,970.36 2026-07-18
390 MS_DRG Ms-DRG 390 2 1 — — $5,970.36 $5,970.36 $5,970.36 2026-07-18
15271 CPT Skin Substitute Graft 25 Sq Cm 22 6 $10,511.00 $10,195.67 $98.98 $10,511.00 $5,886.16 2026-07-18
J3247 HCPCS Secukinumab 125 Mg/5 Ml Vial 15 6 $9,674.00 $9,384.21 $17.73 $9,190.72 $5,417.69 2026-07-18
J0349 HCPCS Rezafungin 200 Mg Vial 15 6 $9,115.00 $8,842.28 $3.78 $8,659.96 $5,104.82 2026-07-18
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 15 6 $8,925.00 $8,657.25 $163.60 $8,478.75 $4,998.00 2026-07-18
J1602 HCPCS Golimumab 50 Mg/4 Ml Vial 15 6 $8,831.00 $8,566.62 $10.77 $8,389.99 $4,945.68 2026-07-18
74174 CPT CTA Abd&Pelv Wwo Dye 13 6 $6,982.00 $6,772.54 $1,231.62 $6,982.00 $4,817.58 2026-07-18
J3032 HCPCS Eptinezumab-jjmr 100Mg/Ml Vial 15 6 $8,375.00 $8,123.98 $19.32 $7,956.48 $4,690.13 2026-07-18
Q5122 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Syr 15 6 $7,899.00 $7,662.43 $134.25 $7,504.44 $4,423.67 2026-07-18
J3262 HCPCS Tocilizumab 200 Mg/10 Ml Vial 24 6 $5,901.00 $5,724.15 $2.72 $11,435.06 $4,313.77 2026-07-18
15275 CPT Skin Substitute Graft 25 Sq Cm 20 6 $10,511.00 $10,195.67 $112.27 $9,985.45 $3,870.15 2026-07-18
J0129 HCPCS Abatacept 250 Mg Vial 15 6 $6,460.00 $6,266.80 $43.38 $6,137.59 $3,617.95 2026-07-18
J9217 HCPCS Leuprolide Acetate Sq 22.5Mg 15 6 $6,397.00 $6,205.89 $1.47 $6,077.93 $3,582.78 2026-07-18
78452 CPT Myocard Perf Spect Rest Stress 16 6 $4,860.00 $4,714.20 $857.30 $5,417.00 $3,552.66 2026-07-18
95811 CPT Polysomnogram W CPap 15 6 $5,068.00 $4,915.96 $894.00 $4,814.60 $3,496.92 2026-07-18
74178 CPT CT Abd & Pelv Wwo Contrast 15 6 $6,134.00 $5,949.98 $479.88 $5,827.30 $3,435.04 2026-07-18
948 MS_DRG Ms-DRG 948 2 1 — — $3,415.72 $3,415.72 $3,415.72 2026-07-18
811 MS_DRG Ms-DRG 811 2 1 — — $3,414.52 $3,414.52 $3,414.52 2026-07-18
312 MS_DRG Ms-DRG 312 2 1 — — $3,414.52 $3,414.52 $3,414.52 2026-07-18
J1569 HCPCS Immune Glob Gammagard 5gr/50ml 42 6 $5,026.00 $4,876.03 $21.77 $13,396.56 $3,367.98 2026-07-18
95810 CPT Polysomnogram 15 6 $4,862.00 $4,716.14 $857.66 $4,618.90 $3,354.78 2026-07-18
J2357 HCPCS Omalizumab 150 Mg/Ml Syringe 15 6 $5,846.00 $5,671.20 $9.26 $5,554.27 $3,274.10 2026-07-18
750 CDM Colonoscopy 22 6 $4,631.50 $4,492.56 $786.57 $4,563.80 $3,254.71 2026-07-18
72158 CPT MRI Lumbar Spine Wwo Dye 15 6 $4,965.00 $4,816.05 $340.97 $4,728.00 $3,227.25 2026-07-18
73720 CPT MRI Le Wwo Dye Rt 28 6 $5,584.00 $5,416.48 $233.96 $5,304.80 $3,127.04 2026-07-18
73220 CPT MRI Ue Wwo Dye Rt 15 6 $4,792.00 $4,648.24 $319.79 $4,653.00 $3,114.80 2026-07-18
Q5135 HCPCS Tocilizumab-aazg 200 Mg/10 Ml 24 6 $4,208.00 $4,081.97 $4.40 $8,003.48 $3,076.21 2026-07-18
6632 APR_DRG Apr-DRG 6632 2 1 — — $3,074.67 $3,074.67 $3,074.67 2026-07-18
354 MS_DRG Ms-DRG 354 1 1 — — $3,001.94 $3,001.94 $3,001.94 2026-07-18
70553 CPT MRI Brain Wwo Contrast 24 6 $4,773.00 $4,629.81 $729.77 $4,761.40 $2,954.59 2026-07-18
73222 CPT MRI Joint Ue W Dye Rt 13 6 $4,182.00 $4,056.54 $530.75 $3,972.90 $2,885.58 2026-07-18
70543 CPT MRI Orbit Face Neck Wwo Cont 13 6 $5,067.00 $4,914.99 $335.45 $4,813.65 $2,837.52 2026-07-18
74177 CPT CT Abd & Pelv W Contrast 17 6 $4,937.00 $4,788.89 $227.52 $4,690.15 $2,764.72 2026-07-18
72157 CPT MRI Chest Spine Wwo Dye 13 6 $4,934.00 $4,785.98 $535.35 $4,687.30 $2,763.04 2026-07-18
72156 CPT MRI Neck Spine Wwo Dye 13 6 $4,934.00 $4,785.98 $340.05 $4,687.30 $2,763.04 2026-07-18
73723 CPT MRI Joint Le Wwo Dye Lt 30 6 $4,688.00 $4,547.36 $657.06 $4,453.60 $2,625.28 2026-07-18
73223 CPT MRI Joint Ue Wwo Dye Lt 13 6 $4,653.00 $4,513.41 $597.27 $4,420.35 $2,605.68 2026-07-18
70470 CPT CT Head/Brain Wwo Contrast 16 6 $3,882.00 $3,765.54 $241.32 $3,687.90 $2,600.94 2026-07-18
19083 CPT Biopsy Breast 1st Lesion Rt 25 6 $3,363.00 $3,262.11 $593.23 $3,194.85 $2,596.24 2026-07-18
J7336 HCPCS Capsaicin 8% W/Cleanser Gel 15 6 $3,888.00 $3,771.39 $3.38 $28,800.00 $2,527.22 2026-07-18
J1439 HCPCS Ferric Carboxymalt 750mg/15ml 15 6 $4,509.00 $4,373.79 $1.13 $4,283.61 $2,525.07 2026-07-18
19084 CPT Biopsy Breast Addl Lesion Rt 13 6 $3,202.00 $3,105.94 $564.83 $3,202.00 $2,471.94 2026-07-18
C1776 HCPCS Head Fem ) 26mm Hip Tpr 211 6 $3,594.00 $3,486.18 $158.76 $27,360.00 $2,410.80 2026-07-18
72146 CPT MRI Chest Spine Wo Dye 15 6 $4,278.00 $4,149.66 $390.63 $4,064.10 $2,395.68 2026-07-18
73718 CPT MRI Le Wo Dye Lt 28 6 $4,228.00 $4,101.16 $56.39 $4,016.60 $2,367.68 2026-07-18
74176 CPT CT Abd & Pelvis Wo Contrast 16 6 $4,224.00 $4,097.28 $95.04 $4,012.80 $2,365.44 2026-07-18
C8929 HCPCS Echo M Mode 2d W Contrast 16 6 $3,437.00 $3,333.89 $606.29 $3,265.15 $2,328.57 2026-07-18
11044 CPT Debride Bone 20 Cm 21 6 $4,112.00 $3,988.64 $264.04 $3,906.40 $2,302.72 2026-07-18
59409 CPT Obstetrical Care 11 6 $3,308.00 $3,208.76 $583.53 $3,142.60 $2,282.52 2026-07-18
73218 CPT MRI Ue Wo Dye Lt 13 6 $4,026.00 $3,905.22 $79.40 $3,824.70 $2,254.56 2026-07-18
93306 CPT Tte W Doppler Complete 17 6 $3,324.00 $3,224.28 $586.35 $3,157.80 $2,210.46 2026-07-18
72148 CPT MRI Lumbar Spine Wo Dye 17 6 $3,943.00 $3,824.71 $315.18 $3,745.85 $2,208.08 2026-07-18
73701 CPT CT Le W Dye Lt 29 6 $3,375.00 $3,273.75 $268.01 $3,206.25 $2,193.75 2026-07-18
72141 CPT MRI Neck Spine Wo Dye 15 6 $3,881.00 $3,764.57 $233.96 $3,686.95 $2,173.36 2026-07-18
72130 CPT CT Thoracic Spine Wwo Cont 13 6 $3,756.00 $3,643.32 $82.17 $3,568.20 $2,103.36 2026-07-18
73721 CPT MRI Joint Le Wo Dye Lt 32 6 $3,723.00 $3,611.31 $315.18 $3,536.85 $2,084.88 2026-07-18
73221 CPT MRI Joint Ue Wo Dye Lt 30 6 $3,711.00 $3,599.67 $408.12 $3,534.00 $2,078.16 2026-07-18
Q5115 HCPCS Rituximab-abbs 100Mg/10Ml Via 24 6 $2,255.00 $2,188.25 $34.76 $10,715.55 $2,032.59 2026-07-18
J9055 HCPCS Cetuximab 100 Mg/50 Ml Vial 15 6 $3,592.00 $3,484.47 $84.84 $3,412.63 $2,011.65 2026-07-18
70498 CPT CT Angiography Neck W Cont 16 6 $3,495.00 $3,390.15 $278.39 $3,320.25 $1,957.20 2026-07-18
70496 CPT CT Angiography Head W Cont 16 6 $3,495.00 $3,390.15 $246.84 $3,320.25 $1,957.20 2026-07-18
70487 CPT CT Maxillofacial W Contrast 15 6 $3,477.00 $3,372.69 $268.29 $3,303.15 $1,947.12 2026-07-18
72132 CPT CT Lumbar Spine W Contrast 14 6 $3,102.00 $3,008.94 $313.35 $2,946.90 $1,925.15 2026-07-18
72133 CPT CT Lumbar Spine Wwo Contrast 13 6 $3,427.00 $3,324.19 $385.11 $3,255.65 $1,919.12 2026-07-18
71275 CPT CTA Chest Wwo Contrast 14 6 $3,135.00 $3,040.95 $553.01 $2,978.25 $1,896.67 2026-07-18
81229 CPT Acgh Whole Genome 13 6 $2,843.00 $2,757.71 $501.51 $2,700.85 $1,890.60 2026-07-18
72195 CPT MRI Pelvis Wo Dye 11 6 $2,866.00 $2,780.02 $505.56 $2,722.70 $1,862.90 2026-07-18
Q5119 HCPCS Rituximab-pvvr 100Mg/10Ml Vial 24 6 $2,311.00 $2,242.03 $24.94 $10,453.28 $1,862.70 2026-07-18
70544 CPT MRA Head Wo Contrast 13 6 $3,302.00 $3,202.94 $408.12 $3,136.90 $1,849.12 2026-07-18
36573 CPT Insert Picc >5 Yrs W Img Gde 13 6 $2,382.00 $2,310.54 $420.18 $3,110.25 $1,838.90 2026-07-18
70551 CPT MRI Brain Wo Contrast 15 6 $3,259.00 $3,161.23 $447.03 $3,096.05 $1,825.04 2026-07-18
70460 CPT CT Head/Brain W Contrast 13 6 $3,258.00 $3,160.26 $61.91 $3,095.10 $1,824.48 2026-07-18
70450 CPT CT Head/Brain Wo Contrast 16 6 $2,634.00 $2,554.98 $464.64 $2,502.30 $1,764.78 2026-07-18
32555 CPT Aspirate Pleura W Imaging Rt 24 6 $2,573.00 $2,495.81 $453.88 $2,444.35 $1,743.21 2026-07-18
71260 CPT CT Thorax W Contrast 15 6 $3,103.00 $3,009.91 $80.31 $2,947.85 $1,737.68 2026-07-18
72129 CPT CT Thoracic Spine W Contrast 13 6 $3,102.00 $3,008.94 $128.15 $2,946.90 $1,737.12 2026-07-18
P9035 HCPCS Platelet Pheresis Leuko Reduc 11 6 $2,508.00 $2,432.76 $442.41 $2,382.60 $1,730.52 2026-07-18
120 CDM Room Medical Unit Semi Private 9 6 $2,505.00 $2,429.85 $441.88 $2,379.75 $1,728.45 2026-07-18
70486 CPT CT Maxillofacial Wo Contrast 16 6 $3,070.00 $2,977.90 $187.95 $2,916.50 $1,719.20 2026-07-18
J1561 HCPCS Immune Glob 10% 40 Gm/400 Ml 39 6 $3,711.00 $3,599.83 $3.60 $13,328.79 $1,700.94 2026-07-18
72125 CPT CT Cervical Spine Wo Contrast 17 6 $3,021.00 $2,930.37 $172.58 $2,869.95 $1,691.76 2026-07-18
J0585 HCPCS Botul Tox Type A 100 Unit Vial 15 6 $2,982.00 $2,892.54 $6.48 $2,832.90 $1,669.92 2026-07-18
360 CDM Or Level 1 121 6 $2,171.00 $2,105.87 $79.73 $7,340.65 $1,635.20 2026-07-18
73700 CPT CT Le Wo Dye Lt 31 6 $2,911.00 $2,823.67 $76.65 $2,765.45 $1,630.16 2026-07-18
J0248 HCPCS Remdesivir 100 Mg Vial 15 6 $2,874.00 $2,788.70 $6.35 $2,731.20 $1,609.97 2026-07-18
70491 CPT CT Soft Tissue Neck W Cont 15 6 $2,866.00 $2,780.02 $357.53 $2,722.70 $1,604.96 2026-07-18
90375 CPT Rabies Imm Glob (Human) 300u/m 15 6 $2,847.00 $2,761.75 $146.90 $2,704.81 $1,594.42 2026-07-18
72128 CPT CT Thoracic Spine Wo Contrast 15 6 $2,447.00 $2,373.59 $107.93 $2,330.00 $1,590.55 2026-07-18
73200 CPT CT Ue Wo Dye Rt 31 6 $2,826.00 $2,741.22 $70.19 $2,826.00 $1,582.56 2026-07-18
74170 CPT CT Abdomen Wwo Dye 15 6 $2,779.00 $2,695.63 $58.22 $2,640.05 $1,556.24 2026-07-18
71250 CPT CT Thorax Wo Contrast 17 6 $2,778.00 $2,694.66 $71.13 $2,639.10 $1,555.68 2026-07-18
72131 CPT CT Lumbar Spine Wo Contrast 15 6 $2,777.00 $2,693.69 $234.87 $2,638.15 $1,555.12 2026-07-18
49083 CPT Abd Paracentesis W Imaging 13 6 $2,338.00 $2,267.86 $412.42 $2,221.10 $1,554.77 2026-07-18
J1745 HCPCS Infliximab 100 Mg Vial 24 6 $5,142.00 $4,988.37 $1.46 $4,885.52 $1,544.61 2026-07-18
70481 CPT CT Orbit W Contrast 13 6 $2,551.00 $2,474.47 $80.31 $2,423.45 $1,428.56 2026-07-18
Q5121 HCPCS Infliximab-axxq 100 Mg Vial 15 6 $2,179.00 $2,114.48 $35.88 $4,302.83 $1,416.92 2026-07-18
95782 CPT Polysomnogram < 6 Yrs 11 6 $1,967.00 $1,907.99 $346.98 $1,868.65 $1,357.23 2026-07-18
74160 CPT CT Abdomen W Dye 13 6 $2,270.00 $2,201.90 $400.43 $2,156.50 $1,271.20 2026-07-18
J0881 HCPCS Darbepoe Alfa 200mcg/0.4ml Syr 33 6 $2,269.00 $2,201.07 $2.65 $2,826.77 $1,270.72 2026-07-18
64483 CPT Inj Foramen Epidural L/s Bi 57 6 $2,165.00 $2,100.05 $134.72 $2,781.60 $1,268.80 2026-07-18
70480 CPT CT Orbit Wo Contrast 13 6 $2,196.00 $2,130.12 $192.56 $2,086.20 $1,229.76 2026-07-18
99285 CPT Emergency Room Visit Level 5 24 6 $3,230.00 $3,133.10 $159.07 $3,068.50 $1,189.28 2026-07-18
25605 CPT Fx Distal Radius W Man Lt 20 6 $1,808.00 $1,753.76 $318.93 $1,717.60 $1,176.99 2026-07-18
93970 CPT Venous Duplex 14 6 $1,730.00 $1,678.10 $305.17 $1,643.50 $1,172.08 2026-07-18
Q5104 HCPCS Infliximab-abda 100 Mg Vial 15 6 $1,775.00 $1,722.66 $27.85 $5,119.19 $1,154.36 2026-07-18
J0666 HCPCS Bupivac Liposome 1.3% Pf 20 Ml 15 6 $1,772.00 $1,719.46 $1.42 $1,713.62 $1,152.22 2026-07-18
36569 CPT Insert Picc Line >5 Without Guide 11 6 $1,658.00 $1,608.26 $292.47 $1,575.10 $1,144.02 2026-07-18
710 CDM Recovery Phase 1 Per 15 Min 33 6 $1,679.00 $1,628.63 $68.80 $1,913.30 $1,116.54 2026-07-18
32551 CPT Insertion Chest Tube Rt 11 6 $1,609.00 $1,560.73 $283.83 $1,528.55 $1,110.21 2026-07-18
78315 CPT Bone Scan 3 Phase 13 6 $1,663.00 $1,613.11 $293.35 $1,579.85 $1,105.89 2026-07-18
25565 CPT Fx Radial Ulnar Shaft W Man Lt 20 6 $1,643.00 $1,593.71 $289.83 $1,560.85 $1,069.22 2026-07-18
86353 CPT Lymphocyte Proliferation Antig 13 6 $1,580.00 $1,532.60 $107.39 $1,501.00 $1,050.70 2026-07-18
Q5101 HCPCS Filgrastim-sndz 480 Mcg/0.8ml 15 6 $1,584.00 $1,537.32 $0.33 $2,902.40 $1,030.17 2026-07-18
276 CDM Iol Clareon Vivity Uva 13.5 11 6 $1,492.00 $1,447.72 $263.28 $1,417.88 $1,029.83 2026-07-18
V2787 HCPCS Iol Clareon Toric Len 16 44 6 $1,503.50 $1,458.63 $199.24 $1,467.75 $1,005.87 2026-07-18
V2788 HCPCS Iol Clareon Strl Uv 16.5 33 6 $1,492.00 $1,447.72 $199.24 $1,439.25 $984.75 2026-07-18
74300 CPT X-ray Bile Ducts/Pancreas 11 6 $1,427.00 $1,384.19 $251.72 $1,355.65 $965.04 2026-07-18
684 CDM Trauma Team Evaluation Level 4 11 6 $1,392.00 $1,350.24 $245.55 $1,322.40 $960.48 2026-07-18
G0390 HCPCS Trauma Team Level 4 11 6 $1,392.00 $1,350.24 $245.55 $1,322.40 $960.48 2026-07-18
115 CDM Room Hospice Ip 18 6 $1,596.50 $1,548.61 $172.34 $2,105.20 $913.50 2026-07-18
11043 CPT Debride Muscle/Fascia 20 Cm 20 6 $2,408.00 $2,335.76 $182.22 $2,287.60 $886.67 2026-07-18
J7307 HCPCS Female 15 6 $1,130.00 $1,096.10 $7.82 $2,477.86 $872.36 2026-07-18
73040 CPT Contrast X-ray Shoulder Lt 22 6 $1,327.00 $1,287.19 $210.05 $1,260.65 $862.55 2026-07-18
11042 CPT Debride Skin Subq 20 Cm 25 6 $1,537.00 $1,490.89 $71.89 $1,460.15 $860.72 2026-07-18
93975 CPT Vascular Study 11 6 $1,229.00 $1,192.13 $216.80 $1,167.55 $848.01 2026-07-18
129 CDM Room Swing Bed Skilled 9 6 $1,213.00 $1,176.61 $213.97 $1,152.35 $836.97 2026-07-18
Q9967 HCPCS Iopamidol-370 100 Ml Vial 17 6 $1,470.00 $1,425.90 $0.28 $1,396.50 $823.20 2026-07-18
93925 CPT Arterial Duplex Le Bi 13 6 $1,063.00 $1,031.11 $187.51 $1,063.00 $820.64 2026-07-18
77075 CPT X-rays Bone Survey Complete 11 6 $1,257.00 $1,219.29 $221.73 $1,194.15 $817.05 2026-07-18
73523 CPT X-ray Hips 5 Views Bi 13 6 $1,182.00 $1,146.54 $208.50 $1,125.00 $815.58 2026-07-18
72192 CPT CT Pelvis Wo Dye 15 6 $1,454.00 $1,410.38 $172.84 $1,381.30 $814.24 2026-07-18
78227 CPT Hida With Ef w/Pharm 11 6 $1,178.00 $1,142.66 $207.80 $1,119.10 $812.82 2026-07-18
80280 CPT Vedolizumab 11 6 $1,171.00 $1,135.87 $206.56 $1,112.45 $807.99 2026-07-18
93017 CPT Cardiovascular Stress Test 16 6 $1,056.00 $1,024.32 $186.28 $1,005.00 $771.93 2026-07-18
62321 CPT Inj Epidural C/t W Guide 23 6 $1,371.00 $1,329.87 $129.44 $1,548.53 $767.76 2026-07-18
92612 CPT Eval Endo Swallow Function 11 6 $1,096.00 $1,063.12 $193.33 $1,041.20 $756.24 2026-07-18
90675 CPT Rabies Vax Pcec/Pf 2.5Unit Vl 16 6 $1,347.00 $1,307.03 $125.24 $1,280.08 $754.57 2026-07-18
84252 CPT Vitamin B2 (Riboflavin) 11 6 $1,092.00 $1,059.24 $192.63 $1,037.40 $753.48 2026-07-18
93971 CPT Extremity Study Lt 30 6 $1,086.00 $1,053.42 $191.57 $1,031.70 $749.34 2026-07-18
77001 CPT Fluoroguide For Vein Device 15 6 $1,151.00 $1,116.47 $99.63 $1,093.45 $748.15 2026-07-18
C1788 HCPCS Port Impl Pp MRI 96f 1 Lmn 28 6 $814.00 $790.07 $143.68 $1,273.21 $722.06 2026-07-18
93880 CPT Extracranial Bilat Study 14 6 $1,063.00 $1,031.11 $187.51 $1,009.85 $720.18 2026-07-18
84591 CPT Vitamin B5 (Pantothanic Acid) 22 6 $1,012.00 $981.64 $155.23 $1,086.80 $719.40 2026-07-18
76775 CPT Ultrasound Aorta 13 6 $1,081.00 $1,048.57 $190.69 $1,026.95 $718.87 2026-07-18
74270 CPT Contrast X-ray Colon 11 6 $1,089.00 $1,056.33 $132.75 $1,034.55 $707.85 2026-07-18
C1781 HCPCS Mesh Hernia Umb Spr Md Crc 2.5 72 6 $1,032.00 $1,001.39 $110.49 $2,581.82 $681.62 2026-07-18
76801 CPT OB US < 14 Wks Single Fetus 15 6 $1,020.00 $989.40 $179.93 $969.00 $678.30 2026-07-18
74250 CPT X-ray Small Bowel 12 6 $990.00 $960.30 $174.64 $940.50 $663.30 2026-07-18
87529 CPT Hsv DNA Amp Probe 15 6 $958.00 $929.26 $49.50 $910.10 $661.02 2026-07-18
76000 CPT Fluoroscope Examination 11 6 $852.00 $826.44 $150.29 $809.40 $657.74 2026-07-18
V2632 HCPCS Iol Tecns 1Pc Acrylic 17.5d 91 6 $1,010.00 $980.48 $79.38 $1,073.03 $657.09 2026-07-18
88262 CPT Chromosome Analysis 15-20 Cell 11 6 $943.00 $914.71 $166.35 $895.85 $650.67 2026-07-18
88230 CPT Tissue Culture Non Neoplastic 11 6 $943.00 $914.71 $166.35 $895.85 $650.67 2026-07-18
76805 CPT OB US >14 Wk Tvta Single Fetus 11 6 $932.00 $904.04 $164.40 $885.40 $643.08 2026-07-18
Q0138 HCPCS Ferumoxy 510mg/17ml (non-esrd) 15 6 $1,145.00 $1,111.35 $0.33 $1,088.43 $641.60 2026-07-18
0202U CPT Respir Path 22 Targets Biofire 11 6 $914.00 $886.58 $161.23 $868.30 $630.66 2026-07-18
74221 CPT Double Contrast Esophagus 13 6 $943.00 $914.71 $166.35 $895.85 $620.03 2026-07-18
90677 CPT Pneumo 20 Valent Vacc 0.5 Ml 24 6 $965.00 $936.39 $170.29 $1,023.15 $615.30 2026-07-18
76536 CPT Ultrasound Head And Neck 14 6 $908.00 $880.76 $160.17 $862.60 $615.17 2026-07-18
C1726 HCPCS Dil Pebax 180Cm Od12-13.5-15 14 6 $781.00 $758.00 $137.85 $781.44 $610.31 2026-07-18
64445 CPT Inj Sciatic Single N Block Lt 11 6 $880.00 $853.60 $155.23 $836.00 $607.20 2026-07-18
76770 CPT Ultrasound Abdo Back Wall Comp 14 6 $879.00 $852.63 $155.06 $835.05 $595.52 2026-07-18
76700 CPT Ultrasound Abdomen Complete 13 6 $894.00 $867.18 $157.70 $849.30 $594.51 2026-07-18
74246 CPT Contrast X-ray Upper Gi W Air 14 6 $979.00 $949.63 $172.70 $930.05 $592.30 2026-07-18
90684 CPT Pneumo Conjugate Vaccine 21 Va 16 6 $1,044.00 $1,013.46 $184.30 $992.56 $585.09 2026-07-18
29445 CPT Rigid Total Contact Leg Cast 11 6 $833.00 $808.01 $146.94 $791.35 $574.77 2026-07-18
76856 CPT Ultrasound Pelvic Complete 16 6 $830.00 $805.10 $146.41 $788.50 $572.70 2026-07-18
93356 CPT Myocardial Strain Image Speckl 11 6 $826.00 $801.22 $145.71 $784.70 $569.94 2026-07-18
C1713 HCPCS Screw Actb Trilogy 6.5x30mm 222 6 $771.00 $748.60 $11.41 $5,388.21 $561.28 2026-07-18
82610 CPT Cystatin C 13 6 $721.00 $699.37 $127.18 $686.00 $556.61 2026-07-18
74230 CPT Cine/Vid X-ray Throat/Esoph 13 6 $649.00 $629.53 $114.48 $657.74 $553.60 2026-07-18
16020 CPT Dress/Debride Small Burn 11 6 $796.00 $772.12 $140.41 $756.20 $549.24 2026-07-18
73522 CPT X-ray Hips 3-4 Views Bi 15 6 $788.00 $764.36 $139.00 $793.91 $543.72 2026-07-18
A9585 HCPCS Gadobutrol Inj 10 Mm/10 Ml Vl 24 6 $1,000.00 $970.00 $0.56 $950.00 $538.75 2026-07-18
76705 CPT Ultrasound Abdomen Limited 15 6 $756.00 $733.32 $133.36 $718.20 $521.64 2026-07-18
27560 CPT Treat Kneecap Dislocation Rt 22 6 $554.00 $537.38 $97.73 $2,470.88 $517.99 2026-07-18
76817 CPT Transvaginal US Obstetrical 14 6 $761.00 $738.17 $134.24 $722.95 $515.58 2026-07-18
76942 CPT US Guide Needle Place Sonosite 14 6 $661.00 $641.17 $116.60 $627.95 $513.14 2026-07-18
J2997 HCPCS Alteplase 2 Mg Vial 15 6 $907.00 $880.47 $37.08 $862.32 $508.31 2026-07-18
20605 CPT Asp/Inj Intermediate Joint Rt 13 6 $657.00 $637.29 $115.89 $657.00 $507.20 2026-07-18
93321 CPT Doppler Echo Exam Heart 13 6 $662.00 $642.14 $116.78 $628.90 $501.17 2026-07-18
62273 CPT Epidural Blood Patch 11 6 $725.00 $703.25 $127.89 $688.75 $500.25 2026-07-18
77080 CPT Dexa Scan 15 6 $760.00 $737.20 $88.61 $722.00 $494.00 2026-07-18
80074 CPT Acute Hepatitis Panel 14 6 $669.00 $648.93 $118.01 $637.00 $489.04 2026-07-18
27808 CPT Fx Bimalleolar Ankle Lt 20 6 $549.00 $532.53 $96.84 $843.39 $486.69 2026-07-18
761 CDM Chest Tube Insertion 22 6 $699.50 $678.51 $123.13 $665.95 $482.65 2026-07-18
93226 CPT ECG Monit/Report Up To 48 Hour 15 6 $696.00 $675.12 $122.77 $661.20 $480.24 2026-07-18
12032 CPT Repair Lac Interm 2.6-7.5 Cm 22 6 $793.00 $769.21 $139.89 $1,033.90 $479.76 2026-07-18
93922 CPT Ankle Arm Screen 14 6 $655.00 $635.35 $115.54 $623.00 $478.81 2026-07-18
27786 CPT Fx Distal Fibula Lt 27 6 $618.00 $599.46 $109.02 $2,068.05 $477.10 2026-07-18
93246 CPT Ext ECG >7 Days Hook Up 15 6 $691.00 $670.27 $121.89 $656.45 $476.79 2026-07-18
93242 CPT Ext ECG 48 Hrs -7days Hook Up 15 6 $691.00 $670.27 $121.89 $656.45 $476.79 2026-07-18
76857 CPT Ultrasound Pelvic Limited 14 6 $702.00 $680.94 $123.83 $666.90 $475.61 2026-07-18
12042 CPT Repair Lac Interm 2.6-7.5 Cm 20 6 $833.00 $808.01 $146.94 $791.35 $466.48 2026-07-18
76882 CPT US Extremity Nonvasc Limit Lt 26 6 $674.00 $653.78 $118.89 $664.00 $465.06 2026-07-18
96413 CPT Chemotherapy Inf Initial 13 6 $698.00 $677.06 $123.13 $663.10 $464.17 2026-07-18
26755 CPT Fx Phalange W Manipulation 20 6 $522.00 $506.34 $92.08 $756.95 $462.75 2026-07-18
23650 CPT Dislocation Shoulder Wo AnesLT 31 6 $582.00 $564.54 $102.66 $802.00 $459.78 2026-07-18
J2212 HCPCS Methylnaltrexone 12mg/0.6ml Vl 13 6 $812.00 $788.38 $1.42 $772.12 $455.15 2026-07-18
62323 CPT Inj Epidural L/s W Guide 23 6 $1,440.00 $1,396.80 $119.27 $1,368.00 $452.00 2026-07-18
27096 CPT Inject Sacroiliac Joint Rt 22 6 $2,060.00 $1,998.20 $100.37 $1,957.00 $452.00 2026-07-18
Q4186 HCPCS Soft Tissue Graft Epifix 26 6 $685.00 $664.93 $100.94 $651.23 $448.82 2026-07-18
76870 CPT Ultrasound Scrotum 14 6 $658.00 $638.26 $116.07 $625.10 $445.79 2026-07-18
J1611 HCPCS Glucagon (Fresenius Kabi) Vial 15 6 $794.00 $770.88 $81.80 $754.98 $445.04 2026-07-18
99291 CPT Critical Care 1st 30-74 Min 22 6 $1,853.00 $1,797.41 $39.69 $1,760.35 $444.51 2026-07-18
12031 CPT Repair Lac Intermed <2.5 Cm 20 6 $793.00 $769.21 $139.89 $753.35 $434.03 2026-07-18
28490 CPT Fx Great Toe 11 6 $628.00 $609.16 $110.78 $596.60 $433.32 2026-07-18
28470 CPT Fx Metatarsal 11 6 $628.00 $609.16 $110.78 $596.60 $433.32 2026-07-18
76604 CPT Ultrasound Chest 13 6 $648.00 $628.56 $114.31 $615.60 $430.92 2026-07-18
J1610 HCPCS Glucagon 1 Mg/ml Vial 15 6 $767.00 $744.95 $98.91 $729.59 $430.07 2026-07-18
46050 CPT Incision Anal Abscess 20 6 $1,046.00 $1,014.62 $119.60 $993.70 $428.89 2026-07-18
12041 CPT Repair Lac Interm <2.5 Cm 20 6 $793.00 $769.21 $139.89 $753.35 $426.63 2026-07-18
450 CDM Dissolve Clot Heart Vessel 11 6 $617.00 $598.49 $108.84 $586.15 $425.73 2026-07-18
36593 CPT Declot/Thrombo Impl Vad 13 6 $550.00 $533.50 $97.02 $522.50 $424.60 2026-07-18
99283 CPT Emergency Room Visit Level 3 27 6 $653.00 $633.41 $74.82 $621.00 $424.45 2026-07-18
25600 CPT Fx Distal Radius Lt 26 6 $549.00 $532.53 $96.84 $2,027.52 $423.83 2026-07-18
93308 CPT Echo Limited 13 6 $549.00 $532.53 $96.84 $1,002.34 $423.83 2026-07-18
P9016 HCPCS Red Blood Cells Lekoreduced 14 6 $573.00 $555.81 $101.08 $545.00 $418.87 2026-07-18
28190 CPT Remove Foreign Body Foot Lt 20 6 $796.00 $772.12 $140.41 $756.20 $410.70 2026-07-18
64635 CPT Destroy Lumb/Sac Facet Jnt Lt 18 6 $4,049.00 $3,927.53 $267.59 $621.35 $410.45 2026-07-18
64633 CPT Destroy Cerv/Thor Facet Jnt Rt 9 6 $4,049.00 $3,927.53 $271.18 $629.16 $409.92 2026-07-18
73110 CPT X-ray Wrist 3 Views Lt 29 6 $628.00 $609.16 $58.22 $596.60 $408.20 2026-07-18
64447 CPT Inj Femoral Nerve Single Lt 44 6 $880.00 $853.60 $63.57 $924.00 $408.10 2026-07-18
G0399 HCPCS Sleep Study Type Iii Portable 16 6 $549.00 $532.53 $96.84 $521.55 $407.00 2026-07-18
92950 CPT Heart/Lung Resuscitation Cpr 22 6 $852.00 $826.44 $150.29 $809.40 $406.91 2026-07-18
87799 CPT Bk Virus Quant Pcr, Serum 22 6 $596.50 $578.61 $85.55 $672.60 $405.10 2026-07-18
64400 CPT Inj Trigeminal N Block Rt 20 6 $1,095.00 $1,062.15 $57.77 $1,040.25 $403.18 2026-07-18
23600 CPT Fx Prox Humeral Wo Man Lt 26 6 $522.00 $506.34 $92.08 $522.00 $402.98 2026-07-18
27824 CPT Fx Distal Tibia Rt 13 6 $522.00 $506.34 $92.08 $497.00 $402.98 2026-07-18
25650 CPT Fx Ulnar Styloid Rt 13 6 $522.00 $506.34 $92.08 $921.13 $402.98 2026-07-18
74220 CPT Contrast X-ray Esophagus 13 6 $584.00 $566.48 $103.02 $898.00 $402.96 2026-07-18
A9500 HCPCS Radiophar Tc99M Sestamibi Dose 16 6 $545.00 $528.65 $96.14 $1,090.00 $398.39 2026-07-18
10061 CPT I&d Abscess Comp/Multiple 33 6 $491.00 $476.27 $74.44 $903.45 $394.43 2026-07-18
11760 CPT Repair Nailbed 20 6 $831.00 $806.07 $136.60 $789.45 $392.19 2026-07-18
81256 CPT Hemochromat Mutation 11 6 $568.00 $550.96 $100.20 $539.60 $391.92 2026-07-18
72110 CPT X-ray Lumbosacral 4 Views 13 6 $693.00 $672.21 $67.44 $658.35 $388.08 2026-07-18
81291 CPT Mthfr Mutation 11 6 $560.00 $543.20 $98.78 $532.00 $386.40 2026-07-18
86361 CPT Cd4 Absolute Count 13 6 $575.00 $557.75 $101.43 $546.25 $382.38 2026-07-18
76642 CPT Ultrasound Breast Limited Lt 43 6 $482.00 $467.54 $85.02 $686.85 $380.78 2026-07-18
92607 CPT Eval Speech Gen Aac Device 11 6 $551.00 $534.47 $97.20 $523.45 $380.19 2026-07-18
110 CDM Room Custodial Care 9 6 $551.00 $534.47 $97.20 $523.45 $380.19 2026-07-18
99236 CPT Admit/Discharge Same Day High 9 6 $438.00 $424.86 $224.38 $436.48 $380.07 2026-07-18
24530 CPT Fx Supra/Transcondylar Hum Rt 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-07-18
27230 CPT Fx Femur Proximal End Lt 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-07-18
26750 CPT Fx Distal Finger/Thumb Wo Man 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-07-18
26720 CPT Fx Finger/Thumb Wo Man 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-07-18
26600 CPT Fx Metacarpal 11 6 $549.00 $532.53 $96.84 $521.55 $378.81 2026-07-18
72050 CPT X-ray Spine Cervical 4-5 Views 14 6 $547.00 $530.59 $96.49 $746.06 $377.43 2026-07-18
94060 CPT Pft Pre & Post Screen Spirome 13 6 $488.00 $473.36 $86.08 $490.88 $376.74 2026-07-18
82088 CPT Aldosterone 11 6 $546.00 $529.62 $96.31 $518.70 $376.74 2026-07-18
71101 CPT X-ray Ribs Uni W Chest Rt 27 6 $545.00 $528.65 $96.14 $3,427.98 $376.05 2026-07-18
96360 CPT Inf Therapy Hyd Initial 15 6 $470.00 $455.90 $82.91 $446.50 $371.30 2026-07-18
11600 CPT Exc Mal Lesion <0.5 Trunk Limb 20 6 $724.00 $702.28 $127.71 $687.80 $370.83 2026-07-18
90837 CPT Psychotherapy 60 Minutes 14 6 $504.00 $488.88 $88.91 $480.00 $368.42 2026-07-18
88342 CPT Immunohisto Stain Init Pr Spec 13 6 $473.00 $458.81 $83.44 $450.00 $365.16 2026-07-18
90834 CPT Psychotherapy 45 Minutes 13 6 $473.00 $458.81 $83.44 $450.00 $365.16 2026-07-18
J2404 HCPCS Nicardipine/Ns 40 Mg/200ml Bag 15 6 $560.00 $543.26 $0.09 $1,828.74 $364.04 2026-07-18
77067 CPT Mammo Screen Implant Bi 44 6 $471.00 $456.87 $83.08 $757.00 $363.61 2026-07-18
70150 CPT X-ray Facial Bones 3 Views 11 6 $559.00 $542.23 $82.17 $531.05 $363.35 2026-07-18
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