Hospital

RAWLINS COUNTY HEALTH CENTER

Atwood, KS · CCN 171307 · Rates published

Your selected procedure

You selected 93306 (CPT)

ECHO 2D W/SPEC/CLR FLOW M-MODE COMP

This hospital’s price: $1,532 across 1 payer

Source: https://rchc.slicedhealth.io/pricer/48-0545181_RawlinsCountyHealthCenter_StandardCharges.csv · observed 2025-07-29

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.

1,520 distinct procedures filed

2 distinct payers

6,022 rate rows

2025-07-29 last MRF observed · ⚠ 15 mo old

Data quality

6,010 of 6,022 rate rows are consumer-grade (99.8%)

12 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
exceeds 10× this hospital's gross charge — excluded from medians	8
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	2
placeholder amount (≤ $0.02) — excluded from medians	2

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://rchc.slicedhealth.io/pricer/48-0545181_RawlinsCountyHealthCenter_StandardCharges.csv
Found on page	https://rchc.slicedhealth.io/home
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-09-21
Content fingerprint	de2bf018f0ca16ad… · 1,627,897 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
J2506 HCPCS	Pegfilgrastim (neulasta) 6mg	1	$10,050.58	$10,050.58	$10,050.58	nat. median $1,659 outlier · 6.1×
J2997 HCPCS	Alteplase 1mg	2	$112.88	$13,781.37	$6,947.13	nat. median $500 outlier · 13.9×
J3101 HCPCS	Tenecteplase(tnkase)	2	$184.78	$12,258.02	$6,221.40	nat. median $3,787 1.6× median
J2505 HCPCS	Nyvepria 6 Mg/0.6 Ml Syringe 6 Mg, 0.6 Ml	1	$6,146.55	$6,146.55	$6,146.55	nat. median $6,279 1.0× median
28820 CPT	ER Amputation/toe	2	$4,298.56	$7,405.44	$5,852.00	nat. median $3,394 1.7× median
27301 CPT	ER I&d Deep Abscess Thigh Or Knee	2	$3,669.33	$6,321.42	$4,995.38	nat. median $2,904 1.7× median
26735 CPT	ER Open Treatmnt Phalangeal Shaft	2	$3,638.02	$6,267.48	$4,952.75	nat. median $3,745 1.3× median
28008 CPT	Fasciotomy, Foot And/or Toe	2	$3,595.00	$6,255.30	$4,925.15	nat. median $3,309 1.5× median
J7168 HCPCS	Kcentra 1,000 Unit Vial 1000 Unit, 1 Each	1	$4,671.90	$4,671.90	$4,671.90	nat. median $20 outlier · 229.7×
0250 RC		1	$4,646.12	$4,646.12	$4,646.12	nat. median $40 outlier · 115.6×
J0517 HCPCS	Injection, Benralizumab, 1 Mg (fasenra)	2	$209.27	$8,889.79	$4,549.53	nat. median $919 outlier · 5.0×
J0717 HCPCS	Cimzia 2x200 Mg/ml Syringe Kit 200 Mg, 1 Each	2	$6.51	$8,956.26	$4,481.39	nat. median $1,635 outlier · 2.7×
J0896 HCPCS	Reblozyl 25 Mg Vial 0.25 Mg, 1 Each	2	$47.34	$8,770.67	$4,409.01	nat. median $4,569 1.0× median
J2796 HCPCS	Romiplostim Inj 10mcg	2	$112.26	$8,211.84	$4,162.05	nat. median $1,463 outlier · 2.8×
23660 CPT	ER Shoulder Dislocation Trmt	2	$2,993.64	$5,157.36	$4,075.50	nat. median $6,841 0.6× median
44950 CPT	Md1 Appendectomy	2	$1,953.98	$5,906.48	$3,930.23	nat. median $5,994 0.7× median
47562 CPT	Md2 Cholecystectomy Laparascopy	2	$1,246.93	$6,517.52	$3,882.23	nat. median $5,988 0.6× median
J0840 HCPCS	Crotalidae Poly Immune Fab Up To 1g	2	$2,598.83	$5,008.07	$3,803.45	nat. median $3,452 1.1× median
0110 RC		1	$3,480.00	$3,480.00	$3,480.00	nat. median $961 outlier · 3.6×
27562 CPT	ER Clsd Tx Patellar Dslc	2	$2,526.01	$4,351.74	$3,438.88	nat. median $660 outlier · 5.2×
26742 CPT	ER Clsd Trmt Art Rx W/manip Ea.	2	$2,515.91	$4,334.34	$3,425.12	nat. median $1,604 outlier · 2.1×
0120 RC		1	$3,045.00	$3,045.00	$3,045.00	nat. median $986 outlier · 3.1×
12036 CPT	ER Intmd Rpr S/a/t/ext 20.1-30	2	$2,204.83	$3,798.42	$3,001.62	nat. median $857 outlier · 3.5×
28505 CPT	ER Open Tx Great Toe Fx	2	$2,157.36	$3,716.64	$2,937.00	nat. median $3,524 0.8× median
49520 CPT	Md2 Rep Recurr Inguinal Hernia	2	$1,371.16	$4,485.41	$2,928.28	nat. median $3,788 0.8× median
J2182 HCPCS	Injection, Mepolizumab, 1 Mg (nucala)	2	$37.68	$5,776.71	$2,907.19	nat. median $2,791 1.0× median
74174 CPT	Computed Tomographic Angiography, Abdomen And Pelvis, With Contrast Material(s),…	2	$1,704.15	$4,075.95	$2,890.05	nat. median $998 outlier · 2.9×
36571 CPT	Md2 Insert Cvp W/port Over 5 Yrs	2	$1,807.82	$3,830.93	$2,819.38	nat. median $3,393 0.8× median
43236 CPT	Or Egd W/submcosal Inj	2	$998.76	$4,596.21	$2,797.48	nat. median $1,359 outlier · 2.1×
13160 CPT	Secondary Closure Of Surgical Wound Or Dehiscence, Extensive Or Complicated	2	$2,038.18	$3,545.25	$2,791.72	nat. median $2,654 1.1× median
21315 CPT	ER Clsd Trmt Nasal Fx Without Stablztn	2	$1,955.36	$3,368.64	$2,662.00	nat. median $1,683 1.6× median
11646 CPT	Or Excis Mal Les Fel Over 4.0 Cm	2	$1,896.78	$3,399.96	$2,648.37	nat. median $2,852 0.9× median
27818 CPT	ER Clsd Tx Ankle Trimoll W/mani	2	$1,915.97	$3,300.78	$2,608.38	nat. median $1,668 1.6× median
36561 CPT	Md1 Insert Tunnel Centrl Venous Acc	2	$1,626.03	$3,585.46	$2,605.74	nat. median $3,751 0.7× median
J0897 HCPCS	Denosumab (xgeva) 120mg/1.7ml Vial	2	$29.68	$5,145.04	$2,587.36	nat. median $1,982 1.3× median
49505 CPT	Md1 Rep Inguinal Hernia Over 5yr	2	$1,266.11	$3,811.74	$2,538.93	nat. median $3,855 0.7× median
19120 CPT	Md1 Excis Cyst-breast 1 Or More Les	2	$894.32	$4,142.99	$2,518.65	nat. median $3,667 0.7× median
11420 CPT	Or Excis Ben Les Shf 0.5cm Or Less	2	$1,805.43	$3,140.70	$2,473.07	nat. median $1,519 1.6× median
11424 CPT	Or Excis Ben Les Shf 3.1 To 4.0cm	2	$1,801.84	$3,132.00	$2,466.92	nat. median $1,696 1.5× median
C9132 HCPCS	Kcentra Inj Per Iu	1	$2,335.95	$2,335.95	$2,335.95	nat. median $21 outlier · 112.7×
78452 CPT	Myocardial Spect Multi Studies	2	$1,468.08	$3,192.90	$2,330.49	nat. median $1,822 1.3× median
J9217 HCPCS	Eligard Inj 45mg	2	$242.26	$4,244.07	$2,243.16	nat. median $1,573 1.4× median
28495 CPT	ER Clsd Tx Great Toe Fx W/man	2	$1,617.01	$2,785.74	$2,201.38	nat. median $360 outlier · 6.1×
28475 CPT	ER Clsd Tx Metatarsal Fx W Mn	2	$1,617.01	$2,785.74	$2,201.38	nat. median $392 outlier · 5.6×
22310 CPT	ER Closed Treatment Of Vertebral Body Fracture(s), Without Manipulation, Requiri…	1	$2,192.40	$2,192.40	$2,192.40	nat. median $413 outlier · 5.3×
27767 CPT	ER Clsd Tx Post Mall Fx Wo Manip	1	$2,192.40	$2,192.40	$2,192.40	nat. median $431 outlier · 5.1×
36590 CPT	Tr Remove Central Ven Dev W/pmp-prt	2	$1,906.88	$2,463.84	$2,185.36	nat. median $1,778 1.2× median
43245 CPT	Or Egd, Flexible, Transoral; With Dilation Of Gastric/duodenal Stricture(s) (eg,…	2	$1,580.65	$2,749.20	$2,164.93	nat. median $2,201 1.0× median
43249 CPT	Or Egd Esoph Dilate <30mm	2	$1,566.51	$2,723.10	$2,144.80	nat. median $2,124 1.0× median
24077 CPT	Md2 Rad Resect Arm/elbow Tum <5cm	2	$1,922.92	$2,356.33	$2,139.62	nat. median $3,069 0.7× median

Other procedures at this hospital

Browse this hospital's 1,520 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

J2506	HCPCS	Pegfilgrastim (neulasta) 6mg	2	1	$11,552.39	$9,819.53	$10,050.58	$10,050.58	$10,050.58	2025-07-29
J2997	HCPCS	Alteplase 1mg	4	2	$15,840.65	$13,464.55	$112.88	$13,781.37	$6,947.13	2025-07-29
J3101	HCPCS	Tenecteplase(tnkase)	4	2	$14,089.68	$11,976.23	$184.78	$12,258.02	$6,221.40	2025-07-29
J2505	HCPCS	Nyvepria 6 Mg/0.6 Ml Syringe 6 Mg, 0.6 Ml	2	1	$7,065.00	$6,005.25	$6,146.55	$6,146.55	$6,146.55	2025-07-29
28820	CPT	ER Amputation/toe	4	2	$8,512.00	$7,235.20	$4,298.56	$7,405.44	$5,852.00	2025-07-29
27301	CPT	ER I&d Deep Abscess Thigh Or Knee	4	2	$7,266.00	$6,176.10	$3,669.33	$6,321.42	$4,995.38	2025-07-29
26735	CPT	ER Open Treatmnt Phalangeal Shaft	4	2	$7,204.00	$6,123.40	$3,638.02	$6,267.48	$4,952.75	2025-07-29
28008	CPT	Fasciotomy, Foot And/or Toe	4	2	$7,190.00	$6,111.50	$3,595.00	$6,255.30	$4,925.15	2025-07-29
J7168	HCPCS	Kcentra 1,000 Unit Vial 1000 Unit, 1 Each	2	1	$5,370.00	$4,564.50	$4,671.90	$4,671.90	$4,671.90	2025-07-29
0250	RC	—	2	1	$5,340.37	$4,539.31	$4,646.12	$4,646.12	$4,646.12	2025-07-29
J0517	HCPCS	Injection, Benralizumab, 1 Mg (fasenra)	4	2	$10,218.15	$8,685.43	$209.27	$8,889.79	$4,549.53	2025-07-29
J0717	HCPCS	Cimzia 2x200 Mg/ml Syringe Kit 200 Mg, 1 Each	4	2	$10,294.55	$8,750.37	$6.51	$8,956.26	$4,481.39	2025-07-29
J0896	HCPCS	Reblozyl 25 Mg Vial 0.25 Mg, 1 Each	4	2	$10,081.23	$8,569.05	$47.34	$8,770.67	$4,409.01	2025-07-29
J2796	HCPCS	Romiplostim Inj 10mcg	4	2	$9,438.90	$8,023.07	$112.26	$8,211.84	$4,162.05	2025-07-29
23660	CPT	ER Shoulder Dislocation Trmt	4	2	$5,928.00	$5,038.80	$2,993.64	$5,157.36	$4,075.50	2025-07-29
44950	CPT	Md1 Appendectomy	4	2	$2,245.95	$1,909.06	$1,953.98	$5,906.48	$3,930.23	2025-07-29
47562	CPT	Md2 Cholecystectomy Laparascopy	4	2	$1,433.25	$1,218.26	$1,246.93	$6,517.52	$3,882.23	2025-07-29
J0840	HCPCS	Crotalidae Poly Immune Fab Up To 1g	4	2	$5,756.40	$4,892.94	$2,598.83	$5,008.07	$3,803.45	2025-07-29
0110	RC	—	2	1	$4,000.00	$3,400.00	$3,480.00	$3,480.00	$3,480.00	2025-07-29
27562	CPT	ER Clsd Tx Patellar Dslc	4	2	$5,002.00	$4,251.70	$2,526.01	$4,351.74	$3,438.88	2025-07-29
26742	CPT	ER Clsd Trmt Art Rx W/manip Ea.	4	2	$4,982.00	$4,234.70	$2,515.91	$4,334.34	$3,425.12	2025-07-29
0120	RC	—	2	1	$3,500.00	$2,975.00	$3,045.00	$3,045.00	$3,045.00	2025-07-29
12036	CPT	ER Intmd Rpr S/a/t/ext 20.1-30	4	2	$4,366.00	$3,711.10	$2,204.83	$3,798.42	$3,001.62	2025-07-29
28505	CPT	ER Open Tx Great Toe Fx	4	2	$4,272.00	$3,631.20	$2,157.36	$3,716.64	$2,937.00	2025-07-29
49520	CPT	Md2 Rep Recurr Inguinal Hernia	4	2	$1,576.05	$1,339.64	$1,371.16	$4,485.41	$2,928.28	2025-07-29
J2182	HCPCS	Injection, Mepolizumab, 1 Mg (nucala)	4	2	$6,639.90	$5,643.92	$37.68	$5,776.71	$2,907.19	2025-07-29
74174	CPT	Computed Tomographic Angiography, Abdomen And Pelvis, With Contrast Material(s),…	4	2	$4,685.00	$3,982.25	$1,704.15	$4,075.95	$2,890.05	2025-07-29
36571	CPT	Md2 Insert Cvp W/port Over 5 Yrs	4	2	$2,077.95	$1,766.26	$1,807.82	$3,830.93	$2,819.38	2025-07-29
43236	CPT	Or Egd W/submcosal Inj	4	2	$5,283.00	$4,490.55	$998.76	$4,596.21	$2,797.48	2025-07-29
13160	CPT	Secondary Closure Of Surgical Wound Or Dehiscence, Extensive Or Complicated	4	2	$4,075.00	$3,463.75	$2,038.18	$3,545.25	$2,791.72	2025-07-29
21315	CPT	ER Clsd Trmt Nasal Fx Without Stablztn	4	2	$3,872.00	$3,291.20	$1,955.36	$3,368.64	$2,662.00	2025-07-29
11646	CPT	Or Excis Mal Les Fel Over 4.0 Cm	4	2	$3,908.00	$3,321.80	$1,896.78	$3,399.96	$2,648.37	2025-07-29
27818	CPT	ER Clsd Tx Ankle Trimoll W/mani	4	2	$3,794.00	$3,224.90	$1,915.97	$3,300.78	$2,608.38	2025-07-29
36561	CPT	Md1 Insert Tunnel Centrl Venous Acc	4	2	$1,869.00	$1,588.65	$1,626.03	$3,585.46	$2,605.74	2025-07-29
J0897	HCPCS	Denosumab (xgeva) 120mg/1.7ml Vial	4	2	$5,913.84	$5,026.76	$29.68	$5,145.04	$2,587.36	2025-07-29
49505	CPT	Md1 Rep Inguinal Hernia Over 5yr	4	2	$1,455.30	$1,237.01	$1,266.11	$3,811.74	$2,538.93	2025-07-29
19120	CPT	Md1 Excis Cyst-breast 1 Or More Les	4	2	$1,027.95	$873.76	$894.32	$4,142.99	$2,518.65	2025-07-29
11420	CPT	Or Excis Ben Les Shf 0.5cm Or Less	4	2	$3,610.00	$3,068.50	$1,805.43	$3,140.70	$2,473.07	2025-07-29
11424	CPT	Or Excis Ben Les Shf 3.1 To 4.0cm	4	2	$3,600.00	$3,060.00	$1,801.84	$3,132.00	$2,466.92	2025-07-29
C9132	HCPCS	Kcentra Inj Per Iu	2	1	$2,685.00	$2,282.25	$2,335.95	$2,335.95	$2,335.95	2025-07-29
78452	CPT	Myocardial Spect Multi Studies	4	2	$3,670.00	$3,119.50	$1,468.08	$3,192.90	$2,330.49	2025-07-29
J9217	HCPCS	Eligard Inj 45mg	4	2	$4,878.24	$4,146.50	$242.26	$4,244.07	$2,243.16	2025-07-29
28495	CPT	ER Clsd Tx Great Toe Fx W/man	4	2	$3,202.00	$2,721.70	$1,617.01	$2,785.74	$2,201.38	2025-07-29
28475	CPT	ER Clsd Tx Metatarsal Fx W Mn	4	2	$3,202.00	$2,721.70	$1,617.01	$2,785.74	$2,201.38	2025-07-29
22310	CPT	ER Closed Treatment Of Vertebral Body Fracture(s), Without Manipulation, Requiri…	2	1	$2,520.00	$2,142.00	$2,192.40	$2,192.40	$2,192.40	2025-07-29
27767	CPT	ER Clsd Tx Post Mall Fx Wo Manip	2	1	$2,520.00	$2,142.00	$2,192.40	$2,192.40	$2,192.40	2025-07-29
36590	CPT	Tr Remove Central Ven Dev W/pmp-prt	4	2	$2,832.00	$2,407.20	$1,906.88	$2,463.84	$2,185.36	2025-07-29
43245	CPT	Or Egd, Flexible, Transoral; With Dilation Of Gastric/duodenal Stricture(s) (eg,…	4	2	$3,160.00	$2,686.00	$1,580.65	$2,749.20	$2,164.93	2025-07-29
43249	CPT	Or Egd Esoph Dilate <30mm	4	2	$3,130.00	$2,660.50	$1,566.51	$2,723.10	$2,144.80	2025-07-29
24077	CPT	Md2 Rad Resect Arm/elbow Tum <5cm	4	2	$2,210.25	$1,878.71	$1,922.92	$2,356.33	$2,139.62	2025-07-29
75635	CPT	Computed Tomographic Angiography, Abdominal Aorta And Bilateral Iliofemoral Lowe…	4	2	$3,440.00	$2,924.00	$1,249.77	$2,992.80	$2,121.28	2025-07-29
12006	CPT	ER Rpr Simp S/n/a/gn/trk20.1-30.0cm	4	2	$3,046.00	$2,589.10	$1,538.23	$2,650.02	$2,094.12	2025-07-29
70498	CPT	CTA Computed Tomographic Angiography, Neck, With Contrast Material(s), Including…	4	2	$3,480.00	$2,958.00	$1,159.64	$3,027.60	$2,093.62	2025-07-29
70496	CPT	CTA Computed Tomographic Angiography, Head, With Contrast Material(s), Includin…	4	2	$3,475.00	$2,953.75	$1,158.71	$3,023.25	$2,090.98	2025-07-29
58600	CPT	Md2 Tubal Ligation	4	2	$850.50	$722.93	$739.94	$3,430.97	$2,085.45	2025-07-29
78815	CPT	PET Scan Skull Base To Mid Thigh	4	2	$3,250.00	$2,762.50	$1,313.00	$2,827.50	$2,070.25	2025-07-29
10121	CPT	ER I&r Frgn Body Subcu Tiss Comp	4	2	$3,004.00	$2,553.40	$1,517.02	$2,613.48	$2,065.25	2025-07-29
71275	CPT	CTA Chest W/wo Contrast	4	2	$3,430.00	$2,915.50	$1,143.85	$2,984.10	$2,063.97	2025-07-29
45385	CPT	Or Colonoscopy W/rem Snare	4	2	$2,975.00	$2,528.75	$1,486.72	$2,588.25	$2,037.49	2025-07-29
19300	CPT	Md1 Mastectomy For Gynecomastia	4	2	$904.05	$768.44	$786.52	$3,245.13	$2,015.83	2025-07-29
74175	CPT	CTA Abdomen W/wo Contrast	4	2	$3,265.00	$2,775.25	$1,186.59	$2,840.55	$2,013.57	2025-07-29
25565	CPT	Closed Treatment Of Radial And Ulnar Shaft Fractures; With Manipulation	4	2	$2,910.00	$2,473.50	$1,454.40	$2,531.70	$1,993.05	2025-07-29
25660	CPT	ER Clsd Trmt Rad/int Carpal W Man	4	2	$2,880.00	$2,448.00	$1,454.40	$2,505.60	$1,980.00	2025-07-29
27762	CPT	ER Clsd Tx Med Mall Frac W Man	4	2	$2,880.00	$2,448.00	$1,454.40	$2,505.60	$1,980.00	2025-07-29
27810	CPT	ER Clsd Tx Ankle Bimall Fx W Mn	4	2	$2,880.00	$2,448.00	$1,454.40	$2,505.60	$1,980.00	2025-07-29
25530	CPT	ER Clsd Trmt Ulnar Shaft Wo Manip	4	2	$2,880.00	$2,448.00	$1,454.40	$2,505.60	$1,980.00	2025-07-29
27502	CPT	ER Clsd Tx Femoral Shaft W Man	4	2	$2,880.00	$2,448.00	$1,454.40	$2,505.60	$1,980.00	2025-07-29
27520	CPT	ER Clsd Tx Patellar Fx Wo Man	4	2	$2,880.00	$2,448.00	$1,454.40	$2,505.60	$1,980.00	2025-07-29
25560	CPT	ER Clsd Trmt Rad/uln Wo Man	4	2	$2,880.00	$2,448.00	$1,454.40	$2,505.60	$1,980.00	2025-07-29
27780	CPT	ER Clsd Tx Prox Fib/shaft Wo Mn	4	2	$2,880.00	$2,448.00	$1,454.40	$2,505.60	$1,980.00	2025-07-29
41112	CPT	Erd1 Excis Lesion Tongue	4	2	$591.15	$502.48	$514.30	$3,439.30	$1,976.80	2025-07-29
J3111	HCPCS	Injection, Romosozumab-aqqg, 1 Mg (evenity)	4	2	$4,506.74	$3,830.73	$12.80	$3,920.86	$1,966.83	2025-07-29
93306	CPT	Echo 2d W/spec/clr Flow M-mode Comp	4	2	$2,760.00	$2,346.00	$1,532.17	$2,401.20	$1,966.68	2025-07-29
C8929	HCPCS	Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi	4	2	$2,760.00	$2,346.00	$1,532.17	$2,401.20	$1,966.68	2025-07-29
25605	CPT	ER Clsd Trmt Distal Radial W Man	4	2	$2,870.00	$2,439.50	$1,434.20	$2,496.90	$1,965.55	2025-07-29
27266	CPT	Ml1 Cls Trt Hip Arthroplasty W/an	4	2	$3,195.00	$2,715.75	$1,077.67	$2,779.65	$1,928.66	2025-07-29
36573	CPT	Picc Insertion	2	1	$2,100.00	$1,785.00	$1,827.00	$1,827.00	$1,827.00	2025-07-29
45378	CPT	Or Colonoscopy Dx W/wo Specimen	4	2	$2,640.00	$2,244.00	$1,321.08	$2,296.80	$1,808.94	2025-07-29
45381	CPT	Or Colonoscopy W/direct Submuc Inj	4	2	$2,640.00	$2,244.00	$1,321.08	$2,296.80	$1,808.94	2025-07-29
43247	CPT	Or Egd With Removal Of Foreign Body	4	2	$2,620.00	$2,227.00	$1,308.96	$2,279.40	$1,794.18	2025-07-29
44392	CPT	Or Colonoscopy Stoma W /polypectomy	4	2	$2,530.00	$2,150.50	$1,265.53	$2,201.10	$1,733.32	2025-07-29
11604	CPT	Or Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excised D…	4	2	$3,065.00	$2,605.25	$783.57	$2,666.55	$1,725.06	2025-07-29
Q5108	HCPCS	Injection, Pegfilgrastim-jmdb, Biosimilar, (fulphila)	4	2	$3,757.50	$3,193.88	$177.88	$3,269.03	$1,723.45	2025-07-29
J0875	HCPCS	Dalvance 500 Mg Vial 500 Mg, 1 Each	4	2	$3,916.15	$3,328.73	$19.71	$3,407.05	$1,713.38	2025-07-29
Q4101	HCPCS	Apligraf 44cm2	2	1	$1,945.00	$1,653.25	$1,692.15	$1,692.15	$1,692.15	2025-07-29
J0885,EC	OTHER	Procrit Inj 40,000u Non Esrd	2	1	$1,924.20	$1,635.57	$1,674.05	$1,674.05	$1,674.05	2025-07-29
12037	CPT	Md1 Layer Closure Sat Over 30.0cm	4	2	$832.65	$707.75	$724.41	$2,606.81	$1,665.61	2025-07-29
99285	CPT	ER Visit Level 5 99285	4	2	$2,575.00	$2,188.75	$1,080.54	$2,240.25	$1,660.39	2025-07-29
87633	CPT	Rl Infectious Agent Detection By Nucleic Acid (dna Or Rna); Respiratory Virus (e…	4	2	$2,100.00	$1,785.00	$1,398.85	$1,827.00	$1,612.92	2025-07-29
43250	CPT	Or Egd Cautery Tumor Polyp	4	2	$2,345.00	$1,993.25	$1,172.61	$2,040.15	$1,606.38	2025-07-29
26990	CPT	Incision And Drainage, Pelvis Or Hip Joint Area, Deep Abscess Or Hematoma	2	1	$1,835.00	$1,559.75	$1,596.45	$1,596.45	$1,596.45	2025-07-29
43239	CPT	Or Egd Bx Single/multi	4	2	$2,305.00	$1,959.25	$1,153.42	$2,005.35	$1,579.38	2025-07-29
99291	CPT	ER Critical 30-75 Min	4	2	$2,435.00	$2,069.75	$1,021.79	$2,118.45	$1,570.12	2025-07-29
26725	CPT	ER Clsd Trmt Finger Shaft W Or Wo	4	2	$2,252.00	$1,914.20	$1,137.26	$1,959.24	$1,548.25	2025-07-29
Q4137	HCPCS	Amnioexcel Allograft 3.5 X 3.5 Cm	2	1	$1,755.00	$1,491.75	$1,526.85	$1,526.85	$1,526.85	2025-07-29
J9395	HCPCS	Fulvestrant 25mg	4	2	$3,490.29	$2,966.75	$16.28	$3,036.55	$1,526.41	2025-07-29
36556	CPT	Ml1 Insert Nt Cent Venous Acc Dv 5+	8	2	$407.40	$346.29	$354.44	$2,666.40	$1,510.42	2025-07-29
10061	CPT	Ml2 Incis & Drain Abscess Comp	8	2	$1,665.50	$1,415.68	$314.07	$2,583.90	$1,484.70	2025-07-29
12045	CPT	ER Layer Closure Nhf 12.6 To 20cm	4	2	$2,152.00	$1,829.20	$1,086.76	$1,872.24	$1,479.50	2025-07-29
12035	CPT	Ml1 Layer Closure Sat 12.6 To 20cm	4	2	$1,300.00	$1,105.00	$1,131.00	$1,824.06	$1,477.53	2025-07-29
27842	CPT	ER Clsd Tx Ankle Dislocation; Requiring Anesthesia, With Or Without Percutaneous…	4	2	$2,134.00	$1,813.90	$1,077.67	$1,856.58	$1,467.12	2025-07-29
27252	CPT	Ml1 Closed Treatment Of Hip Dislocation, Requiring Anesthesia	4	2	$2,134.00	$1,813.90	$1,077.67	$1,856.58	$1,467.12	2025-07-29
38500	CPT	Md2 Biopsy Lymph Nodes Superficial	4	2	$812.70	$690.80	$707.05	$2,227.05	$1,467.05	2025-07-29
26160	CPT	Md2 Excis Les Tendon Sheath Hnd/fng	4	2	$985.95	$838.06	$857.78	$2,074.54	$1,466.16	2025-07-29
15273	CPT	Ml2 Skin Sub Grft T/arm/lg Child	4	2	$520.80	$442.68	$453.10	$2,471.47	$1,462.28	2025-07-29
J3590	HCPCS	Avastin Inj 400mg	2	1	$1,673.58	$1,422.54	$1,456.01	$1,456.01	$1,456.01	2025-07-29
12054	CPT	ER Intmd Rpr Face/mm 7.6-12.5cm	4	2	$2,100.00	$1,785.00	$1,060.50	$1,827.00	$1,443.75	2025-07-29
25111	CPT	Md1 Excis Ganglion Wrist Primary	4	2	$602.70	$512.30	$524.35	$2,330.07	$1,427.21	2025-07-29
13132	CPT	ER Repair Cmplx Fnh 2.6-7.5cm	4	2	$2,020.00	$1,717.00	$1,008.99	$1,757.40	$1,383.20	2025-07-29
44405	CPT	Colonoscopy Through Stoma: With Transendoscopic Balloon Dilation	4	2	$2,015.00	$1,712.75	$1,006.97	$1,753.05	$1,380.01	2025-07-29
73706	CPT	CTA , Lower Extremity, With Contrast Material(s), Including Noncontrast Images, …	2	1	$1,580.00	$1,343.00	$1,374.60	$1,374.60	$1,374.60	2025-07-29
A9567	HCPCS	Tc99m Pentet Aero/dose To 75mci	2	1	$1,566.00	$1,331.10	$1,362.42	$1,362.42	$1,362.42	2025-07-29
13152	CPT	Md1 Repair Comp Enl 2.6 To 7.5cm	4	2	$1,269.00	$1,078.65	$1,104.03	$1,618.02	$1,361.03	2025-07-29
11406	CPT	Md1 Excis Ben Les Tal Over 4.0cm	4	2	$696.15	$591.73	$605.65	$2,077.57	$1,341.61	2025-07-29
11606	CPT	Md2 Excis Mal Les Tal Over 4.0cm	4	2	$782.25	$664.91	$680.56	$1,998.79	$1,339.67	2025-07-29
45384	CPT	Md2 Colonoscopy W/rem Forceps/caut	4	2	$1,531.00	$1,301.35	$1,321.08	$1,331.97	$1,326.53	2025-07-29
28190	CPT	Removal Of Foreign Body, Foot; Subcutaneous	4	2	$745.00	$633.25	$648.15	$1,991.72	$1,319.93	2025-07-29
43246	CPT	Md1 Egd Place Gastro Tube	4	2	$506.10	$430.19	$440.31	$2,134.13	$1,287.22	2025-07-29
40650	CPT	Ml1 Repair Lip, Full Thickness, Vermilion Only	4	2	$595.00	$505.75	$517.65	$2,008.89	$1,263.27	2025-07-29
45380	CPT	Md2 Colonoscopy With Biopsy	4	2	$1,306.00	$1,110.10	$1,136.22	$1,363.50	$1,249.86	2025-07-29
78708	CPT	Renal Imaging W/pharmacy Intervention	4	2	$1,890.00	$1,606.50	$840.00	$1,644.30	$1,242.15	2025-07-29
81450	CPT	Myeloproliferative Neoplasm Panel	2	1	$1,410.00	$1,198.50	$1,226.70	$1,226.70	$1,226.70	2025-07-29
49560	CPT	Md1 Rep Hernia Incis/vent Init Redu	2	1	$1,400.70	$1,190.60	$1,218.61	$1,218.61	$1,218.61	2025-07-29
70547	CPT	MRA Neck Wo/contrast	4	2	$2,060.00	$1,751.00	$633.27	$1,792.20	$1,212.74	2025-07-29
70544	CPT	MRA Head Wo/contrast	4	2	$2,060.00	$1,751.00	$633.27	$1,792.20	$1,212.74	2025-07-29
11421	CPT	Tr Excis Benign Les Shf 0.6-1.0cm	4	2	$1,840.00	$1,564.00	$783.57	$1,600.80	$1,192.18	2025-07-29
42440	CPT	Md1 Excis Submandibular Gland	2	1	$1,369.20	$1,163.82	$1,191.20	$1,191.20	$1,191.20	2025-07-29
78071	CPT	Nm Parathyroid Scan W/spect	2	1	$1,365.00	$1,160.25	$1,187.55	$1,187.55	$1,187.55	2025-07-29
10140	CPT	ER I&d Hematoma Seroma/fluid Coll	8	2	$1,302.00	$1,106.70	$220.98	$2,044.50	$1,186.75	2025-07-29
32555	CPT	ER Aspirate Pleura With Imaging	4	2	$1,725.00	$1,466.25	$862.54	$1,500.75	$1,181.64	2025-07-29
P9053	HCPCS	Plate, Pheresis Leuko Irrad Cmv Neg	2	1	$1,356.60	$1,153.11	$1,180.24	$1,180.24	$1,180.24	2025-07-29
49565	CPT	Md2 Rep Recurr Incis/vent Hernia	2	1	$1,355.55	$1,152.22	$1,179.33	$1,179.33	$1,179.33	2025-07-29
64450	CPT	ER Injection(s), Anesthetic Agent(s) And/or Steroid; Other Peripheral Nerve Or B…	4	2	$1,720.00	$1,462.00	$859.51	$1,496.40	$1,177.95	2025-07-29
11044	CPT	Debridement, Bone (includes Epidermis, Dermis, Subcutaneous Tissue, Muscle And/o	8	2	$520.00	$442.00	$361.05	$1,805.43	$1,174.59	2025-07-29
J1439	HCPCS	Ferric Carboxymaltose(injectafer) 750mg/15ml	4	2	$2,680.70	$2,278.60	$1.42	$2,332.21	$1,166.82	2025-07-29
73206	CPT	CTA Upper Extremity Wo/w Or With	2	1	$1,333.00	$1,133.05	$1,159.71	$1,159.71	$1,159.71	2025-07-29
12018	CPT	Ml1 Repair Simp Fel Over 30.0cm	4	2	$894.60	$760.41	$778.30	$1,538.23	$1,158.26	2025-07-29
78451	CPT	Myocardial Spect Single Rest/stress	4	2	$1,500.00	$1,275.00	$1,010.00	$1,305.00	$1,157.50	2025-07-29
78454	CPT	Myocardial Perf Planar Mult Studies	4	2	$1,500.00	$1,275.00	$1,010.00	$1,305.00	$1,157.50	2025-07-29
78453	CPT	Myocardial Perf Planar 1 St Rst/str	4	2	$1,500.00	$1,275.00	$1,010.00	$1,305.00	$1,157.50	2025-07-29
0612	RC	—	2	1	$1,315.00	$1,117.75	$1,144.05	$1,144.05	$1,144.05	2025-07-29
P9037	HCPCS	Plate, Pheres, Leuko Rdcd Irrad Ea	2	1	$1,304.10	$1,108.49	$1,134.57	$1,134.57	$1,134.57	2025-07-29
11623	CPT	Ml1 Excis Mal Les Shf 2.1 To 3.0cm	4	2	$521.85	$443.57	$454.01	$1,805.43	$1,129.72	2025-07-29
12031	CPT	ER Intrmd Rpr Sate 2.5cm Or Less	4	2	$2,064.00	$1,754.40	$451.17	$1,795.68	$1,123.42	2025-07-29
27603	CPT	ER I&d Leg/ankle Deep Or Hematoma	4	2	$1,620.00	$1,377.00	$818.10	$1,409.40	$1,113.75	2025-07-29
27265	CPT	ER Clsd Tx Hip Arthroplst Wo An	4	2	$1,620.00	$1,377.00	$809.01	$1,409.40	$1,109.20	2025-07-29
26770	CPT	ER Clsd Tx Interphalange Wo Ane	4	2	$1,620.00	$1,377.00	$809.01	$1,409.40	$1,109.20	2025-07-29
26605	CPT	ER Clsd Trmt Metacarpal W/manip	4	2	$1,620.00	$1,377.00	$809.01	$1,409.40	$1,109.20	2025-07-29
45330	CPT	Or Sigmoidoscopy Flexible Diag	4	2	$1,615.00	$1,372.75	$808.00	$1,405.05	$1,106.53	2025-07-29
12017	CPT	Ml1 Repair Simp Fel 20.1 To 30cm	4	2	$774.90	$658.67	$674.16	$1,538.23	$1,106.19	2025-07-29
28660	CPT	ER Clsd Tx Interphalange Disloc	4	2	$1,602.00	$1,361.70	$809.01	$1,393.74	$1,101.38	2025-07-29
27560	CPT	ER Clsd Tx Patellar Dslc Wo Ans	4	2	$1,602.00	$1,361.70	$809.01	$1,393.74	$1,101.38	2025-07-29
12044	CPT	ER Intmd Rpr N-hf/genit7.6-12.5	4	2	$1,602.00	$1,361.70	$809.01	$1,393.74	$1,101.38	2025-07-29
25675	CPT	ER Clsd Trmt Distal Rad Disloc	4	2	$1,602.00	$1,361.70	$809.01	$1,393.74	$1,101.38	2025-07-29
12016	CPT	ER Rpr Simp F/e/e/l/m 12.6-20.0 Cm	4	2	$1,602.00	$1,361.70	$809.01	$1,393.74	$1,101.38	2025-07-29
24600	CPT	ER Clsd Trmt Elbow Disloc Wo Anes	4	2	$1,602.00	$1,361.70	$809.01	$1,393.74	$1,101.38	2025-07-29
36589	CPT	Tr Remove Central Venous Catheter	4	2	$1,424.00	$1,210.40	$958.49	$1,238.88	$1,098.68	2025-07-29
P9055	HCPCS	Plate, Pheresis, Leuko Rdc Cmv Neg	2	1	$1,262.10	$1,072.79	$1,098.03	$1,098.03	$1,098.03	2025-07-29
J0248	HCPCS	Remdesivir 100 Mg Vial	2	1	$1,258.92	$1,070.08	$1,095.26	$1,095.26	$1,095.26	2025-07-29
12007	CPT	Md1 Repair Simp Sthf Over 30cm	4	2	$742.00	$630.70	$645.54	$1,538.23	$1,091.88	2025-07-29
27752	CPT	Ml1 Cld Trt Tibial Shaft Fx W Man	4	2	$825.00	$701.25	$717.75	$1,454.40	$1,086.08	2025-07-29
J7325	HCPCS	Synvisc-one Syringe 8 Mg, 6 Ml	4	2	$2,465.31	$2,095.51	$12.59	$2,144.82	$1,078.70	2025-07-29
11644	CPT	Md2 Excis Mal Les Fel 3.1 To 4.0cm	4	2	$940.80	$799.68	$818.50	$1,315.02	$1,066.76	2025-07-29
73721	CPT	MRI Lower Extremity Joint Wo Contra	4	2	$1,840.00	$1,564.00	$526.21	$1,600.80	$1,063.51	2025-07-29
70553	CPT	MRI Brain Wo/w Contrast	4	2	$1,840.00	$1,564.00	$526.21	$1,600.80	$1,063.51	2025-07-29
72148	CPT	MRI Lumbar Spine Without Contrast	4	2	$1,840.00	$1,564.00	$526.21	$1,600.80	$1,063.51	2025-07-29
70551	CPT	MRI Brain Wo/contrast	4	2	$1,840.00	$1,564.00	$526.21	$1,600.80	$1,063.51	2025-07-29
73221	CPT	MRI Upper Extremity Joint Wo /contrast	4	2	$1,840.00	$1,564.00	$526.21	$1,600.80	$1,063.51	2025-07-29
11422	CPT	Md1 Excis Ben Les Shf 1.1 To 2.0cm	8	2	$358.05	$304.34	$311.50	$1,805.43	$1,058.47	2025-07-29
P9035	HCPCS	Plate, Pheresis, Leuko Rdc Ea Unit	2	1	$1,211.70	$1,029.95	$1,054.18	$1,054.18	$1,054.18	2025-07-29
87507	CPT	Rl Iadna-dna/rna Probe Tq 12-25	4	2	$1,365.00	$1,160.25	$909.47	$1,187.55	$1,048.51	2025-07-29
0450	RC	—	2	1	$1,200.00	$1,020.00	$1,044.00	$1,044.00	$1,044.00	2025-07-29
70336	CPT	MRI Temperomandibular Joint	4	2	$1,795.00	$1,525.75	$526.21	$1,561.65	$1,043.93	2025-07-29
12055	CPT	Md1 Layer Closure Fel 12.6 To 20cm	4	2	$807.45	$686.33	$702.48	$1,363.50	$1,032.99	2025-07-29
11423	CPT	Md2 Excis Ben Les Shf 2.1 To 3.0cm	4	2	$479.85	$407.87	$417.47	$1,640.24	$1,028.86	2025-07-29
27530	CPT	Erm2 Clsd Trmt Tibial Fract Wo Man	4	2	$681.45	$579.23	$592.86	$1,454.40	$1,023.63	2025-07-29
24500	CPT	Md1 Clsd Trmt Humeral Shaft Wo Man	4	2	$679.35	$577.45	$591.03	$1,454.40	$1,022.72	2025-07-29
95913	CPT	Nerve Conduction Studies; 13 Or More Studies	4	2	$1,323.00	$1,124.55	$890.82	$1,151.01	$1,020.91	2025-07-29
G0121	HCPCS	Md1 Col Canc Scrn:col Ind No Hi Rsk	4	2	$1,185.00	$1,007.25	$1,006.97	$1,030.95	$1,018.96	2025-07-29
G0105	HCPCS	Md2 Colorectal Cancer Scrn Indiv Hr	4	2	$1,185.00	$1,007.25	$1,006.97	$1,030.95	$1,018.96	2025-07-29
46221	CPT	Md2 Hemorrhoidectomy By Banding	4	2	$466.20	$396.27	$405.59	$1,632.16	$1,018.88	2025-07-29
32554	CPT	ER Aspirate Pleura Without Imaging	4	2	$1,485.00	$1,262.25	$742.35	$1,291.95	$1,017.15	2025-07-29
12034	CPT	Erd1 Intrmd Rpr Sate 7.6cm-12.5cm	4	2	$539.70	$458.75	$469.54	$1,548.33	$1,008.93	2025-07-29
72158	CPT	MRI Lumbar Spine Wo/w Contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
73218	CPT	MRI Upper Extremity Wo/contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
72146	CPT	MRI Thoracic Spine Wo/contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
72157	CPT	MRI Thoracic Spine Wo/w Contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
72141	CPT	MRI Cervical Spine Wo/contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
74183	CPT	MRI Abdomen Wo/w Contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
73720	CPT	MRI Lower Extremity Wo/w Contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
72149	CPT	MRI Lumbar Spine W/contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
70552	CPT	MRI Brain W/contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
72156	CPT	MRI Cervical Spine Wo/w Contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
72195	CPT	MRI Pelvis Wo/contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
70543	CPT	MRI Orbit Face/neck Wo/ W Contrast	4	2	$1,710.00	$1,453.50	$526.21	$1,487.70	$1,006.96	2025-07-29
70549	CPT	MRA Neck Wo/w Contrast	4	2	$1,585.00	$1,347.25	$633.27	$1,378.95	$1,006.11	2025-07-29
70548	CPT	MRA Neck W/contrast	4	2	$1,585.00	$1,347.25	$633.27	$1,378.95	$1,006.11	2025-07-29
27750	CPT	Md1 Clsd Trmt Tibial Shaft Wo Manp	4	2	$600.60	$510.51	$522.52	$1,454.40	$988.46	2025-07-29
12052	CPT	ER Intmd Rpr Face/mm 2.6-5.0 Cm	4	2	$1,746.00	$1,484.10	$451.17	$1,519.02	$985.10	2025-07-29
46320	CPT	Md1 Enucleation External Hemorrhoid	4	2	$319.20	$271.32	$277.70	$1,691.75	$984.72	2025-07-29
27760	CPT	Erm1 Clsd Trmt Med Mall Rx Without Man	4	2	$577.50	$490.88	$502.43	$1,454.40	$978.41	2025-07-29
13151	CPT	Md1 Repair Comp Enl 1.1 To 2.5cm	4	2	$732.90	$622.97	$637.62	$1,315.02	$976.32	2025-07-29
12051	CPT	ER Intmd Rpr Face/mm 2.5 Cm/<	4	2	$1,416.00	$1,203.60	$715.08	$1,231.92	$973.50	2025-07-29
90375	CPT	Hyperrab 300 Unit/ml Vial 300 Unit, 1 Ml	4	2	$1,774.70	$1,508.50	$398.51	$1,543.99	$971.25	2025-07-29
25650	CPT	Md1 Clsd Trmt Ulnar Styloid Fract	4	2	$553.35	$470.35	$481.41	$1,454.40	$967.90	2025-07-29
27786	CPT	Erd2 Clsd Trmt Dstl Fibula Without Mani	4	2	$547.00	$464.95	$475.89	$1,454.40	$965.14	2025-07-29
11404	CPT	Ml1 Excis Ben Les Tal 3.1 To 4.0cm	4	2	$462.00	$392.70	$401.94	$1,513.99	$957.96	2025-07-29
25500	CPT	Ml1 Clsd Trmt Radial Shaft Wo Manip	4	2	$475.00	$403.75	$413.25	$1,454.40	$933.83	2025-07-29
J1670	HCPCS	Tetanus Immune Globulin/pf(hypertet S-d) 250 Unit Syringe	4	2	$1,363.25	$1,158.76	$676.16	$1,186.03	$931.10	2025-07-29
40831	CPT	ER Repair Mouth Laceration	2	1	$1,070.00	$909.50	$930.90	$930.90	$930.90	2025-07-29
23620	CPT	Erm2 Closed Treatment Greater Humeral Tubersosity Fracture	4	2	$465.15	$395.38	$404.68	$1,454.40	$929.54	2025-07-29
44388	CPT	Md1 Colonoscopy Through Stoma Diag	4	2	$972.30	$826.46	$845.90	$1,006.97	$926.43	2025-07-29
J2407	HCPCS	Oritavancin (orbactiv) Inj 400mg	4	2	$2,089.46	$1,776.04	$33.45	$1,817.83	$925.64	2025-07-29
43235	CPT	Md2 Egd Dx Brush Wash	4	2	$887.00	$753.95	$771.69	$1,033.23	$902.46	2025-07-29
11641	CPT	Or Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, Lips…	4	2	$1,315.00	$1,117.75	$657.51	$1,144.05	$900.78	2025-07-29
28470	CPT	Erd1 Clsd Trmt Metatarsal Pro Wo Mn	4	2	$382.00	$324.70	$332.34	$1,454.40	$893.37	2025-07-29
54520	CPT	Md2 Orchiectomy Simple	2	1	$1,020.60	$867.51	$887.92	$887.92	$887.92	2025-07-29
32551	CPT	ER Tube Thoracostomy W/wo Water S	2	1	$1,020.00	$867.00	$887.40	$887.40	$887.40	2025-07-29
11443	CPT	Md2 Excis Ben Les Fel 2.1 To 3.0cm	4	2	$402.00	$341.70	$349.74	$1,407.94	$878.84	2025-07-29
95912	CPT	Nerve Conduction Studies; 11-12 Studies	4	2	$1,134.00	$963.90	$763.56	$986.58	$875.07	2025-07-29
64421	CPT	Tr Inj Intercostal Nrve Multi	4	2	$1,125.00	$956.25	$757.50	$978.75	$868.12	2025-07-29
70488	CPT	Computed Tomography, Maxillofacial Area; Wo/w Contrast	4	2	$1,440.00	$1,224.00	$457.53	$1,252.80	$855.16	2025-07-29
71250	CPT	CT Chest Wo/contrast	4	2	$1,440.00	$1,224.00	$457.53	$1,252.80	$855.16	2025-07-29
70481	CPT	CT Orbit/sella W/contrast	4	2	$1,440.00	$1,224.00	$457.53	$1,252.80	$855.16	2025-07-29
71260	CPT	CT Chest W/contrast	4	2	$1,440.00	$1,224.00	$457.53	$1,252.80	$855.16	2025-07-29
70450	CPT	CT Head Wo/contrast	4	2	$1,440.00	$1,224.00	$457.53	$1,252.80	$855.16	2025-07-29
71270	CPT	CT Chest W/wo Contrast	4	2	$1,440.00	$1,224.00	$457.53	$1,252.80	$855.16	2025-07-29
72125	CPT	CT Cervical Spine Wo/contrast	4	2	$1,440.00	$1,224.00	$457.53	$1,252.80	$855.16	2025-07-29
74176	CPT	CT Abdomen & Pelvis Wo/contrast	4	2	$1,440.00	$1,224.00	$457.53	$1,252.80	$855.16	2025-07-29
78707	CPT	Kidney Image W/vasc Flow Wo Phar In	2	1	$966.00	$821.10	$840.42	$840.42	$840.42	2025-07-29
28490	CPT	Md1 Clsd Trmt Great Toe Frac Wo Mn	4	2	$254.10	$215.99	$221.07	$1,454.40	$837.74	2025-07-29
49568	CPT	Md2 Implant Mesh Ventral Hernia Rep	2	1	$962.85	$818.42	$837.68	$837.68	$837.68	2025-07-29
72197	CPT	MRI Pelvis Wo/w Contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
74182	CPT	MRI Abdomen W/contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
72196	CPT	MRI Pelvis With Contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
73718	CPT	MRI Lower Extremity Wo/contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
74181	CPT	MRI Abdomen Wo/contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
73723	CPT	MRI Lower Extremity Joint Wo/w Contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
73220	CPT	MRI Upper Extremity Wo/w Contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
73223	CPT	MRI Upper Extremity Joint Wo/w Contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
70540	CPT	MRI Orbit/face/neck Without Contrast	4	2	$1,315.00	$1,117.75	$526.21	$1,144.05	$835.13	2025-07-29
78582	CPT	Lung Ventilaton & Perfusion Imaging	4	2	$1,120.00	$952.00	$693.18	$974.40	$833.79	2025-07-29
C1781	HCPCS	Mesh Kugel Patch Small	2	1	$956.50	$813.03	$832.16	$832.16	$832.16	2025-07-29
70486	CPT	CT Maxillofacial Wo/contrast	4	2	$1,375.00	$1,168.75	$457.53	$1,196.25	$826.89	2025-07-29
74177	CPT	CT Abdomen & Pelvis W/contrast	4	2	$1,375.00	$1,168.75	$457.53	$1,196.25	$826.89	2025-07-29
30903	CPT	ER Cont Nasl Hemorrhage Ant Comp	4	2	$1,176.00	$999.60	$593.88	$1,023.12	$808.50	2025-07-29
77075	CPT	Bone Survey Complete Skeleton	8	2	$1,265.00	$1,075.25	$506.41	$1,100.55	$803.48	2025-07-29
74150	CPT	CT Abdomen Wo/contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
72193	CPT	CT Pelvis W/contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
72192	CPT	CT Pelvis Wo/contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
74170	CPT	CT Abdomen Wo/w Contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
72129	CPT	Computed Tomography, Thoracic Spine; With Contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
72128	CPT	CT Thoracic Spine Wo/contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
73700	CPT	CT Lower Extremity Wo/contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
73701	CPT	CT Lower Extremity W/contr	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
72130	CPT	Computed Tomography, Thoracic Spine; Without And With Contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
70491	CPT	CT Soft Tissue Neck W/contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
72133	CPT	Computed Tomography, Lumbar Spine; Without And With Contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
72131	CPT	CT Lumbar Spine Wo/contrast	4	2	$1,320.00	$1,122.00	$457.53	$1,148.40	$802.97	2025-07-29
69209	CPT	ER Remove Impacted Ear Wax Uni	4	2	$1,170.00	$994.50	$586.49	$1,017.90	$802.19	2025-07-29
88261	CPT	Rl Chromosome Analysis; Count 5 Cells, 1 Karyotype, With Banding	4	2	$1,166.00	$991.10	$588.63	$1,014.42	$801.52	2025-07-29
11643	CPT	Md1 Excis Mal Les Fel 2.1 To 3.0cm	4	2	$637.35	$541.75	$554.49	$1,036.26	$795.38	2025-07-29
11642	CPT	Ml2 Excis Mal Les Fel 1.1 To 2.0cm	8	2	$870.38	$739.82	$488.72	$1,025.73	$793.86	2025-07-29
A9540	HCPCS	Tc99m Macro Albumin /dose To 10mci	4	2	$1,562.00	$1,327.70	$219.72	$1,358.94	$789.33	2025-07-29
93308	CPT	Pocus Electrocardiogram Limited	4	2	$1,140.00	$969.00	$575.70	$991.80	$783.75	2025-07-29
11442	CPT	Md2 Excis Ben Les Fel 1.1 To 2.0cm	4	2	$391.65	$332.90	$340.74	$1,226.14	$783.44	2025-07-29
M0247	HCPCS	Tr Intravenous Infusion, Sotrovimab, Includes Infusion And Post Administration M…	2	1	$900.00	$765.00	$783.00	$783.00	$783.00	2025-07-29
20240	CPT	Biopsy, Bone, Open; Superficial (eg, Sternum, Spinous Process, Rib, Patella, Ole	4	2	$790.00	$671.50	$687.30	$877.69	$782.50	2025-07-29
78227	CPT	Hepatobiliary System Imaging W/drug	4	2	$1,190.00	$1,011.50	$529.64	$1,035.30	$782.47	2025-07-29
72194	CPT	CT Pelvis Wo/w Contrast	4	2	$1,260.00	$1,071.00	$457.53	$1,096.20	$776.87	2025-07-29
71271	CPT	CT Ldct For Lung Ca Screen	4	2	$1,260.00	$1,071.00	$457.53	$1,096.20	$776.87	2025-07-29
74178	CPT	CT Abdomen & Pelvis W/wo Contrast	4	2	$1,260.00	$1,071.00	$457.53	$1,096.20	$776.87	2025-07-29
70480	CPT	CT Orbit/sella Wo/contrast	4	2	$1,260.00	$1,071.00	$457.53	$1,096.20	$776.87	2025-07-29
73200	CPT	CT Upper Extremity Wo/contrast	4	2	$1,260.00	$1,071.00	$457.53	$1,096.20	$776.87	2025-07-29
74160	CPT	CT Abdomen W/contrast	4	2	$1,260.00	$1,071.00	$457.53	$1,096.20	$776.87	2025-07-29
55040	CPT	Md1 Excis Hydrocele Unilateral	2	1	$890.40	$756.84	$774.65	$774.65	$774.65	2025-07-29
49585	CPT	Md2 Rep Umbilical Hernia Over 5y	2	1	$882.00	$749.70	$767.34	$767.34	$767.34	2025-07-29
11401	CPT	Tr Excis Benign Les Tal 0.6cm-1.0cm	4	2	$1,244.00	$1,057.40	$451.17	$1,082.28	$766.72	2025-07-29
93880	CPT	Carotid Doppler Duplex	4	2	$1,200.00	$1,020.00	$480.76	$1,044.00	$762.38	2025-07-29
93970	CPT	Duplex Extremity Veins Comp Bilat	4	2	$1,200.00	$1,020.00	$480.76	$1,044.00	$762.38	2025-07-29
93975	CPT	Renal/visceral Duplex Doppler	4	2	$1,200.00	$1,020.00	$480.76	$1,044.00	$762.38	2025-07-29
93925	CPT	Lower Extremity Arterial Bilateral	4	2	$1,200.00	$1,020.00	$480.76	$1,044.00	$762.38	2025-07-29
93978	CPT	Duplex Scan Of Aorta Complete	4	2	$1,200.00	$1,020.00	$480.76	$1,044.00	$762.38	2025-07-29
93926	CPT	Duplex Lower Ext Arterial Unilat	4	2	$1,200.00	$1,020.00	$480.76	$1,044.00	$762.38	2025-07-29
Q4159	HCPCS	Affinity 1 Sq. Cm.	2	1	$875.00	$743.75	$761.25	$761.25	$761.25	2025-07-29
12053	CPT	Erm2 Intrmd Rpr Face 5.1-7.5cm	4	2	$597.45	$507.83	$519.78	$973.64	$746.71	2025-07-29
26670	CPT	Ml1 Clsd Trmt Hand Disloc W Manip	4	2	$782.25	$664.91	$680.56	$809.01	$744.78	2025-07-29
69210	CPT	ER Remov Impact Ear Wax W Instrmt	4	2	$1,085.00	$922.25	$543.31	$943.95	$743.63	2025-07-29
65220	CPT	ER Removal Of Foreign Body, External Eye; Corneal, Without Slit Lamp	4	2	$1,072.00	$911.20	$541.36	$932.64	$737.00	2025-07-29
26755	CPT	ER Frx Finger W/fixation Ea.	4	2	$1,072.00	$911.20	$541.36	$932.64	$737.00	2025-07-29
78320	CPT	Bone Scan Spect	2	1	$845.00	$718.25	$735.15	$735.15	$735.15	2025-07-29
13131	CPT	Md1 Repair Comp Fnh 1.1cm To 2.5cm	4	2	$780.00	$663.00	$678.60	$787.80	$733.20	2025-07-29
P9016	HCPCS	Leuko Reduced Red Blood Cells Ea Un	4	2	$1,070.00	$909.50	$534.34	$930.90	$732.62	2025-07-29
55060	CPT	Md2 Repair Hydrocele	2	1	$840.00	$714.00	$730.80	$730.80	$730.80	2025-07-29
95911	CPT	Nerve Conduction Studies; 9-10 Studies	4	2	$945.00	$803.25	$636.30	$822.15	$729.22	2025-07-29
73702	CPT	CT Lower Extremity Without & W/contr	4	2	$1,133.00	$963.05	$457.53	$985.71	$721.62	2025-07-29
70492	CPT	CT Soft Tissue Neck W/wo Contrast	4	2	$1,133.00	$963.05	$457.53	$985.71	$721.62	2025-07-29
70470	CPT	CT Head W/wo Contrast	4	2	$1,133.00	$963.05	$457.53	$985.71	$721.62	2025-07-29
73202	CPT	CT Upper Ext W/wo Contrast	4	2	$1,133.00	$963.05	$457.53	$985.71	$721.62	2025-07-29
70482	CPT	Computed Tomography, Orbit, Sella, Or Posterior Fossa Or Outer, Middle, Or Inner…	4	2	$1,133.00	$963.05	$457.53	$985.71	$721.62	2025-07-29

See an error in this hospital's data? Submit a correction