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Hospital

MEADE DISTRICT HOSPITAL

Meade, KS · CCN 171321 · Rates published

1,335 distinct procedures filed
7 distinct payers
9,347 rate rows
2024-12-31 last MRF observed · ⚠ 18 mo old
Data quality

4,600 of 9,347 rate rows are consumer-grade (49.2%)

4,747 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4,118
placeholder amount (≤ $0.02) — excluded from medians 620
per-diem day rate — not a per-procedure price 9

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 18 months old.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://a9a4b96f-06fd-48d5-afab-60ad79a55e97.filesusr.com/ugd/3293c1_b634e2c6081e4736bc6956dddef01d94.json?dn=480966086_Meade%20District%20Hospital_standardcharges%20(3).json
Found on page https://www.avhealthsystem.com/pricing-information
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 1696e10f03dc48ff… · 6,005,167 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
470
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without… 6 $19,388.28 $29,074.55 $19,388.28 nat. median
$20,059
1.0× median
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 6 $15,247.07 $24,820.14 $15,247.07 nat. median
$16,235
0.9× median
33228
CPT 		Pacemaker Battery Exchange 7 $14,932.63 $23,441.03 $14,932.63 nat. median
$11,435
1.3× median
2744750
CPT 		Arthroplasty Knee Bilateral 7 $12,076.93 $20,688.86 $12,076.93 —
27446
CPT 		Arthroplast Knee Condyle Plateau 7 $12,038.14 $20,688.86 $12,038.14 nat. median
$12,481
1.0× median
27447
CPT 		Arthroplasty Knee 7 $11,773.29 $20,688.86 $11,773.29 nat. median
$12,648
0.9× median
23472
CPT 		Total Shoulder Arthroplasty 7 $11,394.43 $20,688.86 $11,394.43 nat. median
$16,400
0.7× median
27130
CPT 		Arthroplasty Hip 7 $11,219.43 $20,688.86 $11,219.43 nat. median
$13,091
0.9× median
58262
CPT 		Vaginal Hyst With Rmvl Tubes/overay 7 $7,937.84 $9,502.02 $9,502.02 nat. median
$5,512
1.7× median
58150
CPT 		Total Hysterectomy 7 $8,786.08 $8,786.08 $8,786.08 nat. median
$3,280
outlier · 2.7×
292
MS_DRG 		Heart Failure And Shock With Cc 6 $8,294.38 $9,509.26 $8,294.38 nat. median
$9,636
0.9× median
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 6 $7,560.84 $11,690.98 $7,560.84 nat. median
$9,125
0.8× median
58260
CPT 		Vaginal Hysterectomy 7 $6,288.76 $7,528.38 $7,528.38 nat. median
$5,272
1.4× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 6 $6,906.88 $8,934.24 $6,906.88 nat. median
$7,339
0.9× median
23430
CPT 		Tenodesis Of Long Tendon Biceps 7 $6,462.84 $10,475.68 $6,462.84 nat. median
$6,990
0.9× median
24516
CPT 		IM Nailing Of Humerus 7 $6,446.62 $10,119.82 $6,446.62 nat. median
$11,435
0.6× median
603
MS_DRG 		Cellulitis Without Mcc 6 $6,403.27 $10,216.55 $6,403.27 nat. median
$9,571
0.7× median
29827
CPT 		Arthroscopy Shoulder With Rotator Cup Rpr 7 $6,371.99 $10,433.98 $6,371.99 nat. median
$7,155
0.9× median
192
MS_DRG 		Chronic Obstructive Pulmonary Disease Without Cc/mcc 6 $6,240.41 $9,481.32 $6,240.41 nat. median
$7,581
0.8× median
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 6 $6,112.97 $9,556.13 $6,112.97 nat. median
$8,979
0.7× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 6 $5,775.74 $8,996.49 $5,775.74 nat. median
$8,665
0.7× median
58353
CPT 		Endometr Ablate Thermal 7 $5,401.35 $7,345.05 $5,401.35 nat. median
$5,021
1.1× median
58600
CPT 		Division Of Fallopian Tube 7 $4,503.15 $5,389.52 $5,389.52 nat. median
$3,265
1.7× median
47562
CPT 		Laparoscopy Cholecystectomy 7 $5,290.55 $8,554.25 $5,290.55 nat. median
$5,956
0.9× median
J1162
HCPCS 		Digifab Inj 40mg 7 $4,079.01 $6,145.65 $4,079.01 nat. median
$7,316
0.6× median
52630
CPT 		Transurethral Resect; Residual Regrowth 7 $4,045.44 $7,455.83 $4,045.44 nat. median
$5,155
0.8× median
38510
CPT 		Biopsy Or Excision Deep Cervical Nodes 7 $3,310.30 $5,196.45 $3,310.30 nat. median
$3,856
0.9× median
23120
CPT 		Claviculectomy; Partial 7 $3,246.53 $5,093.05 $3,246.53 nat. median
$3,601
0.9× median
29877
CPT 		Arthroscopy Knee Debrid/shave Art Carti 7 $3,209.80 $5,038.70 $3,209.80 nat. median
$3,961
0.8× median
49505
CPT 		Bilat Hernia Repr; Reducible Age > 5 7 $3,187.00 $5,002.91 $3,187.00 nat. median
$3,829
0.8× median
52234
CPT 		Cysto With Fulberation Tumor .5 To 2.0 Cm 7 $2,808.40 $4,391.80 $2,808.40 nat. median
$3,489
0.8× median
55040
CPT 		Excision Hydrocele; Unilateral 7 $2,655.06 $2,655.06 $2,655.06 nat. median
$3,652
0.7× median
33285
CPT 		Implantation Cardiac Event Monitor 7 $2,513.02 $2,513.02 $2,513.02 nat. median
$8,842
outlier · 0.3×
29893
CPT 		Endoscopic Plantar Fasciotomy 7 $2,507.07 $3,929.15 $2,507.07 nat. median
$3,475
0.7× median
2984850
CPT 		Carpal Tunnel Bilateral 7 $2,500.00 $3,551.35 $2,500.00 —
J0840
HCPCS 		Crofab Per Vial 7 $2,404.75 $2,436.16 $2,404.75 nat. median
$3,427
0.7× median
46260
CPT 		Hemorrhoidectomy; Intrnal/ext 2 Or More 7 $2,399.12 $3,766.10 $2,399.12 nat. median
$3,137
0.8× median
29848
CPT 		Carpal Tunnel Unilateral 7 $2,388.18 $3,551.35 $2,388.18 nat. median
$2,297
1.0× median
49203
CPT 		Excis Or Destr Open Intra Abd Tumors 7 $2,300.68 $3,551.35 $2,300.68 nat. median
$3,342
0.7× median
95811
CPT 		Sleep Stgng 4 Pra W Cpap/bipap(abn)95811 7 $1,386.60 $2,045.62 $2,045.62 nat. median
$2,026
1.0× median
90375
CPT 		Kedrab (rabies Immune) Inj 10ml 7 $398.51 $2,041.51 $2,041.51 nat. median
$1,039
2.0× median
26842
CPT 		Fusion Of Joint(s); Fingers Or Hand 7 $2,000.00 $2,000.00 $2,000.00 nat. median
$6,887
outlier · 0.3×
49585
CPT 		Umbilical Hernia 7 $1,929.38 $1,929.38 $1,929.38 nat. median
$3,235
0.6× median
70549
CPT 		MRA Of Neck W &without Cont (abn)(babn)70549 7 $1,900.59 $1,900.59 $1,900.59 nat. median
$1,050
1.8× median
36563
CPT 		Insert Tunnel Centrl Venous Access Devic 7 $1,733.92 $1,888.64 $1,888.64 nat. median
$5,439
outlier · 0.3×
J2353
HCPCS 		SandoSTAT Lar (octreotide) Inj 30mg 7 $259.42 $1,877.89 $1,877.89 nat. median
$5,975
outlier · 0.3×
72158
CPT 		MRI L-spine With & Without Contrast 7 $1,830.33 $1,830.33 $1,830.33 nat. median
$1,080
1.7× median
72141
CPT 		MRI C-spine With & Without Contrast 7 $1,830.33 $1,830.33 $1,830.33 nat. median
$765
outlier · 2.4×
70553
CPT 		MRI Brain With & Without Contrast 7 $1,830.33 $1,830.33 $1,830.33 nat. median
$1,122
1.6× median
25000
CPT 		Incision Flexor Tendon Sheath Wrist 7 $1,810.53 $2,842.14 $1,810.53 nat. median
$2,120
0.9× median

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.

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
             
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 6 6 $27,720.00 $27,720.00 $19,388.28 $29,074.55 $19,388.28 2024-12-31
177 MS_DRG Respiratory Infections And Inflammations With Mcc 6 6 $16,211.00 $16,211.00 $15,247.07 $24,820.14 $15,247.07 2024-12-31
33228 CPT Pacemaker Battery Exchange 7 7 $18,354.95 $18,354.95 $14,932.63 $23,441.03 $14,932.63 2024-12-31
2744750 CPT Arthroplasty Knee Bilateral 7 7 $9,900.00 $9,900.00 $12,076.93 $20,688.86 $12,076.93 2024-12-31
27446 CPT Arthroplast Knee Condyle Plateau 7 7 $9,678.31 $9,678.31 $12,038.14 $20,688.86 $12,038.14 2024-12-31
27447 CPT Arthroplasty Knee 7 7 $8,164.91 $8,164.91 $11,773.29 $20,688.86 $11,773.29 2024-12-31
23472 CPT Total Shoulder Arthroplasty 7 7 $6,000.00 $6,000.00 $11,394.43 $20,688.86 $11,394.43 2024-12-31
27130 CPT Arthroplasty Hip 7 7 $5,000.00 $5,000.00 $11,219.43 $20,688.86 $11,219.43 2024-12-31
58262 CPT Vaginal Hyst With Rmvl Tubes/overay 7 7 $15,203.00 $15,203.00 $7,937.84 $9,502.02 $9,502.02 2024-12-31
58150 CPT Total Hysterectomy 7 7 $14,078.00 $14,078.00 $8,786.08 $8,786.08 $8,786.08 2024-12-31
292 MS_DRG Heart Failure And Shock With Cc 6 6 $13,271.00 $13,271.00 $8,294.38 $9,509.26 $8,294.38 2024-12-31
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 6 6 $9,802.00 $9,802.00 $7,560.84 $11,690.98 $7,560.84 2024-12-31
58260 CPT Vaginal Hysterectomy 7 7 $12,045.00 $12,045.00 $6,288.76 $7,528.38 $7,528.38 2024-12-31
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 6 6 $11,051.00 $11,051.00 $6,906.88 $8,934.24 $6,906.88 2024-12-31
23430 CPT Tenodesis Of Long Tendon Biceps 7 7 $7,000.00 $7,000.00 $6,462.84 $10,475.68 $6,462.84 2024-12-31
24516 CPT IM Nailing Of Humerus 7 7 $7,924.09 $7,924.09 $6,446.62 $10,119.82 $6,446.62 2024-12-31
603 MS_DRG Cellulitis Without Mcc 6 6 $7,400.00 $7,400.00 $6,403.27 $10,216.55 $6,403.27 2024-12-31
29827 CPT Arthroscopy Shoulder With Rotator Cup Rpr 7 7 $6,600.00 $6,600.00 $6,371.99 $10,433.98 $6,371.99 2024-12-31
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 6 6 $8,570.00 $8,570.00 $6,240.41 $9,481.32 $6,240.41 2024-12-31
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 6 6 $7,628.00 $7,628.00 $6,112.97 $9,556.13 $6,112.97 2024-12-31
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 6 6 $7,300.00 $7,300.00 $5,775.74 $8,996.49 $5,775.74 2024-12-31
58353 CPT Endometr Ablate Thermal 7 7 $8,642.00 $8,642.00 $5,401.35 $7,345.05 $5,401.35 2024-12-31
58600 CPT Division Of Fallopian Tube 7 7 $8,623.00 $8,623.00 $4,503.15 $5,389.52 $5,389.52 2024-12-31
47562 CPT Laparoscopy Cholecystectomy 7 7 $5,791.00 $5,791.00 $5,290.55 $8,554.25 $5,290.55 2024-12-31
J1162 HCPCS Digifab Inj 40mg 7 7 $5,749.60 $5,749.60 $4,079.01 $6,145.65 $4,079.01 2024-12-31
52630 CPT Transurethral Resect; Residual Regrowth 7 7 $1,814.42 $1,814.42 $4,045.44 $7,455.83 $4,045.44 2024-12-31
38510 CPT Biopsy Or Excision Deep Cervical Nodes 7 7 $4,068.96 $4,068.96 $3,310.30 $5,196.45 $3,310.30 2024-12-31
23120 CPT Claviculectomy; Partial 7 7 $4,000.00 $4,000.00 $3,246.53 $5,093.05 $3,246.53 2024-12-31
29877 CPT Arthroscopy Knee Debrid/shave Art Carti 7 7 $3,945.44 $3,945.44 $3,209.80 $5,038.70 $3,209.80 2024-12-31
49505 CPT Bilat Hernia Repr; Reducible Age > 5 7 7 $3,917.41 $3,917.41 $3,187.00 $5,002.91 $3,187.00 2024-12-31
52234 CPT Cysto With Fulberation Tumor .5 To 2.0 Cm 7 7 $3,500.00 $3,500.00 $2,808.40 $4,391.80 $2,808.40 2024-12-31
55040 CPT Excision Hydrocele; Unilateral 7 7 $4,248.10 $4,248.10 $2,655.06 $2,655.06 $2,655.06 2024-12-31
33285 CPT Implantation Cardiac Event Monitor 7 7 $5,112.27 $5,112.27 $2,513.02 $2,513.02 $2,513.02 2024-12-31
29893 CPT Endoscopic Plantar Fasciotomy 7 7 $3,100.00 $3,100.00 $2,507.07 $3,929.15 $2,507.07 2024-12-31
2984850 CPT Carpal Tunnel Bilateral 7 7 $4,000.00 $4,000.00 $2,500.00 $3,551.35 $2,500.00 2024-12-31
J0840 HCPCS Crofab Per Vial 7 7 $3,847.60 $3,847.60 $2,404.75 $2,436.16 $2,404.75 2024-12-31
46260 CPT Hemorrhoidectomy; Intrnal/ext 2 Or More 7 7 $2,948.96 $2,948.96 $2,399.12 $3,766.10 $2,399.12 2024-12-31
29848 CPT Carpal Tunnel Unilateral 7 7 $3,500.00 $3,500.00 $2,388.18 $3,551.35 $2,388.18 2024-12-31
49203 CPT Excis Or Destr Open Intra Abd Tumors 7 7 $3,000.00 $3,000.00 $2,300.68 $3,551.35 $2,300.68 2024-12-31
95811 CPT Sleep Stgng 4 Pra W Cpap/bipap(abn)95811 7 7 $3,273.00 $3,273.00 $1,386.60 $2,045.62 $2,045.62 2024-12-31
90375 CPT Kedrab (rabies Immune) Inj 10ml 7 7 $4,093.89 $4,093.89 $398.51 $2,041.51 $2,041.51 2024-12-31
26842 CPT Fusion Of Joint(s); Fingers Or Hand 7 7 $3,200.00 $3,200.00 $2,000.00 $2,000.00 $2,000.00 2024-12-31
49585 CPT Umbilical Hernia 7 7 $3,087.01 $3,087.01 $1,929.38 $1,929.38 $1,929.38 2024-12-31
70549 CPT MRA Of Neck W &without Cont (abn)(babn)70549 7 7 $3,300.00 $3,300.00 $1,900.59 $1,900.59 $1,900.59 2024-12-31
36563 CPT Insert Tunnel Centrl Venous Access Devic 7 7 $3,021.83 $3,021.83 $1,733.92 $1,888.64 $1,888.64 2024-12-31
J2353 HCPCS SandoSTAT Lar (octreotide) Inj 30mg 7 7 $3,884.84 $3,884.84 $259.42 $1,877.89 $1,877.89 2024-12-31
72141 CPT MRI C-spine With & Without Contrast 7 7 $3,300.00 $3,300.00 $1,830.33 $1,830.33 $1,830.33 2024-12-31
72158 CPT MRI L-spine With & Without Contrast 7 7 $3,300.00 $3,300.00 $1,830.33 $1,830.33 $1,830.33 2024-12-31
70553 CPT MRI Brain With & Without Contrast 7 7 $3,300.00 $3,300.00 $1,830.33 $1,830.33 $1,830.33 2024-12-31
25000 CPT Incision Flexor Tendon Sheath Wrist 7 7 $2,225.47 $2,225.47 $1,810.53 $2,842.14 $1,810.53 2024-12-31
95810 CPT Sleep Ltncy Stdy Psg 1(abn)(babn)95810 7 7 $2,783.00 $2,783.00 $1,386.60 $1,739.38 $1,739.38 2024-12-31
J0630 HCPCS Miacalcin (calcitonin) Inj 400 Iu/2ml 7 7 $2,750.19 $2,750.19 $1,417.27 $1,718.87 $1,718.87 2024-12-31
74174 CPT CT Angiography Abdomen And Pelvis 7 7 $2,736.56 $2,736.56 $1,710.35 $1,710.35 $1,710.35 2024-12-31
23071 CPT Excise Tumor Shoulder >3cm 7 7 $1,989.85 $1,989.85 $1,618.84 $2,541.22 $1,618.84 2024-12-31
J3240 HCPCS Thyrogen (thyrotropin Alfa) Inj 0.9mg 7 7 $1,385.80 $1,385.80 $1,540.83 $2,596.62 $1,540.83 2024-12-31
93306 CPT US Echocardiogram Complete 7 7 $2,460.38 $2,460.38 $1,537.74 $2,010.97 $1,537.74 2024-12-31
70470 CPT CT Head W/of/u W/contrast 7 7 $2,475.00 $2,475.00 $1,414.01 $1,414.01 $1,414.01 2024-12-31
70492 CPT CT Neck Soft Tissue Without Fu With 7 7 $2,475.00 $2,475.00 $1,414.01 $1,414.01 $1,414.01 2024-12-31
71270 CPT CT Chest W/of/u W/contrast 7 7 $2,475.00 $2,475.00 $1,414.01 $1,414.01 $1,414.01 2024-12-31
74178 CPT CT Abd & Pelvis Without Fu With Contrast 7 7 $2,475.00 $2,475.00 $1,414.01 $1,414.01 $1,414.01 2024-12-31
43249 CPT Egd W Balloon Dilation <30mm 7 7 $2,000.00 $2,000.00 $1,378.02 $2,056.04 $1,378.02 2024-12-31
73222 CPT MRI Upper Extrem Joint W/contrast Lt Sid 7 7 $2,200.00 $2,200.00 $1,335.33 $1,335.33 $1,335.33 2024-12-31
78452 CPT Stress & Rest W/wo Ejection Frac(abn) 7 7 $2,000.00 $2,000.00 $1,313.43 $1,313.43 $1,313.43 2024-12-31
45385 CPT Colonoscopy With Biopsy Snare Technique 7 7 $1,750.00 $1,750.00 $1,281.91 $1,951.32 $1,281.91 2024-12-31
45398 CPT Colonoscopy With Hemorrhoid Banding 7 7 $1,750.00 $1,750.00 $1,261.37 $1,910.23 $1,261.37 2024-12-31
26055 CPT Incision Of Tendon Trig Finger Release 7 7 $1,528.97 $1,528.97 $1,243.89 $1,952.65 $1,243.89 2024-12-31
25605 CPT Closed Tx Of Radial Fracture 7 7 $1,728.00 $1,728.00 $1,243.60 $1,882.39 $1,243.60 2024-12-31
27380 CPT Suture Infrapatellar Tendon; Primary 7 7 $1,975.00 $1,975.00 $1,234.38 $1,234.38 $1,234.38 2024-12-31
45380 CPT Colonoscopy With Biopsy 7 7 $1,750.00 $1,750.00 $1,201.05 $1,789.59 $1,201.05 2024-12-31
45384 CPT Colonoscopy With Biopsy; Hot Biopsy Forcep 7 7 $1,750.00 $1,750.00 $1,173.21 $1,733.92 $1,173.21 2024-12-31
70551 CPT MRI Brain Without Contrast (abn) 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
70544 CPT MRA Of Head Without Contrast(abn)(babn)70544 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
72195 CPT MRI Pelvis Without Contrast 7 7 $1,770.00 $1,770.00 $690.65 $1,106.25 $1,106.25 2024-12-31
73221 CPT MRI Upper Ext Joint Without Contrast Rt Side 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
72148 CPT MRI L-spine Without Contrast 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
78227 CPT Hepatobiliary Ductal System Imaging 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
73721 CPT MRI Low Extremity Jt Wo Contrast Rt Side 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
73718 CPT MRI Low Ext Non Joint Without Contrast Rt 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
73218 CPT MRI Upper Extremities Without Contrast Rt 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
72146 CPT MRI T-spine Without Contrast 7 7 $1,770.00 $1,770.00 $1,106.25 $1,106.25 $1,106.25 2024-12-31
43239 CPT Egd With Biopsy Single Or Multiple 7 7 $1,750.00 $1,750.00 $1,093.75 $1,513.86 $1,093.75 2024-12-31
99285 CPT ER Level 5 7 7 $1,735.15 $1,735.15 $1,084.46 $1,418.21 $1,084.46 2024-12-31
J7298 HCPCS Levonorgestrel-releasing IUD (mirena) 52 7 7 $1,322.04 $1,322.04 $1,057.31 $1,651.90 $1,057.31 2024-12-31
43251 CPT Egd With Polypectomy-secondary 7 7 $874.50 $874.50 $1,041.20 $1,776.34 $1,041.20 2024-12-31
74177 CPT CT Abd & Pelvis With Contrast 7 7 $1,650.00 $1,650.00 $1,031.25 $1,031.25 $1,031.25 2024-12-31
10140 CPT I&d Hematoma 7 7 $1,425.00 $1,425.00 $1,028.18 $1,557.61 $1,028.18 2024-12-31
45378 CPT Colonoscopy 7 7 $899.50 $899.50 $1,024.37 $1,733.92 $1,024.37 2024-12-31
12032 CPT Intermed Suture Wound 2.6-7.5cm 7 7 $1,600.00 $1,600.00 $592.16 $1,000.00 $1,000.00 2024-12-31
62323 CPT Epidural; Lumbar With Imaging Guidance 7 7 $1,419.00 $1,419.00 $997.63 $1,498.61 $997.63 2024-12-31
62321 CPT Epidural; C Or T Spine With Imaging Guide 7 7 $1,419.00 $1,419.00 $997.63 $1,498.61 $997.63 2024-12-31
71275 CPT CT Angiography Chest 7 7 $1,375.00 $1,375.00 $991.27 $991.27 $991.27 2024-12-31
12031 CPT Intermed Suture 2.5 Cm Or Less 7 7 $1,500.00 $1,500.00 $592.16 $937.50 $937.50 2024-12-31
11982 CPT Rmvl Drug Delivery Implant Non-biodegra 7 7 $1,440.00 $1,440.00 $900.00 $900.00 $900.00 2024-12-31
70491 CPT CT Neck Soft Tissue W/contrast 7 7 $1,375.00 $1,375.00 $859.38 $859.38 $859.38 2024-12-31
70460 CPT CT Head W/contrast 7 7 $1,375.00 $1,375.00 $859.38 $859.38 $859.38 2024-12-31
74160 CPT CT Upper Abd Only With Contrast 7 7 $1,375.00 $1,375.00 $859.38 $859.38 $859.38 2024-12-31
71260 CPT CT Chest With Contr 7 7 $1,375.00 $1,375.00 $859.38 $859.38 $859.38 2024-12-31
72193 CPT CT Pelvis W/contrast 7 7 $1,375.00 $1,375.00 $859.38 $859.38 $859.38 2024-12-31
52000 CPT Cystourethroscopy 7 7 $1,339.00 $1,339.00 $836.88 $994.03 $836.88 2024-12-31
99291 CPT Critical Care First Hour 7 7 $767.50 $767.50 $804.87 $1,341.10 $804.87 2024-12-31
43235 CPT Egd 7 7 $704.50 $704.50 $801.34 $1,356.11 $801.34 2024-12-31
64494 CPT Facet Joint Injection Bilateral 7 7 $852.20 $852.20 $795.33 $1,292.39 $795.33 2024-12-31
78071 CPT Parathyroid Planar Imaging W Spect 7 7 $1,250.00 $1,250.00 $781.25 $781.25 $781.25 2024-12-31
J9217 HCPCS Lupron Depot Inj 7.5 Mg 7 7 $1,410.57 $1,410.57 $238.83 $754.17 $754.17 2024-12-31
12053 CPT Interm Closure Face 5.1-7.5 Cm 7 7 $655.50 $655.50 $753.66 $1,277.90 $753.66 2024-12-31
92977 CPT Thrombolysis Coronary; By IV Infusion 7 7 $1,192.08 $1,192.08 $745.05 $974.33 $745.05 2024-12-31
23655 CPT ER Tx Shoulder W/anesthesia 7 7 $962.00 $962.00 $699.26 $1,061.83 $699.26 2024-12-31
99284 CPT ER Level 4 7 7 $1,116.43 $1,116.43 $697.77 $912.50 $697.77 2024-12-31
71250 CPT CT Chest Without Contr(babn)71250 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
70490 CPT CT Neck Soft Tissue Wo Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
70486 CPT CT Facial Or Sinus Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
70480 CPT CT Mastoids Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
70450 CPT CT Head Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
78306 CPT Nm Total Body Bone Scan 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
74176 CPT CT Abd & Pelvis Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
74150 CPT CT Upper Abd Only Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
73700 CPT CT Lower Ext Rt Side Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
73200 CPT CT Upper Extremities Rt Side 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
72128 CPT CT Thoracic Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
72131 CPT CT Lumbar Spine Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
72192 CPT CT Pelvis Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
72125 CPT CT C-spine Without Contrast 7 7 $1,100.00 $1,100.00 $687.50 $687.50 $687.50 2024-12-31
J9280 HCPCS mitoMYcin 40mg Inj 7 7 $1,425.64 $1,425.64 $86.23 $684.65 $684.65 2024-12-31
12052 CPT Repair Intermediate; 2.6 7 7 $1,050.00 $1,050.00 $592.16 $656.25 $656.25 2024-12-31
12051 CPT Repair Intermediate; 2.5 Or Less 7 7 $950.00 $950.00 $635.52 $938.54 $635.52 2024-12-31
64421 CPT Nerve Block Intercostal Nerves Multiple 7 7 $778.50 $778.50 $633.35 $994.22 $633.35 2024-12-31
92950 CPT Cardiopulmonary Resuscitation 8 7 $970.50 $970.50 $310.62 $606.56 $606.56 2024-12-31
27096 CPT Sacroiliac Injection 7 7 $900.00 $900.00 $600.92 $886.84 $600.92 2024-12-31
12042 CPT Repair Intermediate; 2.6 7 7 $750.00 $750.00 $595.22 $927.94 $595.22 2024-12-31
88230 CPT Tissue Culture Lymphocyte(abn) 7 7 $945.23 $945.23 $590.77 $590.77 $590.77 2024-12-31
62320 CPT Epidural; Lumbar/sacral Without Image Guide 7 7 $945.00 $945.00 $590.62 $772.84 $590.62 2024-12-31
93304 CPT US Echo Limited Or Follow Up 7 7 $930.96 $930.96 $581.85 $760.91 $581.85 2024-12-31
31720 CPT Suctioning 7 7 $712.07 $712.07 $579.30 $909.38 $579.30 2024-12-31
6449350 CPT Facet Joint Injection Bilateral 7 7 $695.00 $695.00 $575.77 $908.29 $575.77 2024-12-31
10060 CPT I&d Abscess;simple Or Single 7 7 $940.00 $940.00 $285.76 $565.88 $565.88 2024-12-31
87902 CPT Hep C Genotype(babn)83912 7 7 $887.10 $887.10 $554.44 $554.44 $554.44 2024-12-31
94002 CPT Vent Assist; Initial Day 7 7 $850.00 $850.00 $531.25 $531.25 $531.25 2024-12-31
88262 CPT Chromosome Analysis 7 7 $842.32 $842.32 $526.45 $526.45 $526.45 2024-12-31
20611 CPT Major Joint Or Bursa Injection 7 7 $820.00 $820.00 $433.82 $512.50 $512.50 2024-12-31
20610 CPT Major Joint Or Bursa Injection 7 7 $820.00 $820.00 $433.82 $512.50 $512.50 2024-12-31
77075 CPT Metastatic Bone Survey 7 7 $813.21 $813.21 $508.25 $508.25 $508.25 2024-12-31
78264 CPT Gastric Emptying Study 7 7 $812.00 $812.00 $507.50 $507.50 $507.50 2024-12-31
78315 CPT Three Phase Bone Scan 7 7 $803.00 $803.00 $501.88 $501.88 $501.88 2024-12-31
93925 CPT US Dup Scan Low Ext Arterial Bil(abn) 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
93971 CPT US Dup Scan Venous Unilt(abn)(babn)93971 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
93321 CPT US Echo F/u Lmted(abn) 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
93922 CPT US A/b Index (abn) 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
93880 CPT US Carotid (abn) 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
93926 CPT US Dup Scan Arter Lwr Ext Unltl Lmt(abn) 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
93970 CPT US Dup Scan Ven Comp Bil(abn)(babn)93970 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
76536 CPT US Head/neck 7 7 $772.01 $772.01 $482.50 $482.50 $482.50 2024-12-31
93924 CPT US Noin Lt Lower Ext Arteries Comp(abn) 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
93931 CPT US Upper Ext Unilat Arterial Dup(abn) 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
93923 CPT US Noin Studies Lwr Or Upr Ext (abn) Rt 7 7 $772.01 $772.01 $482.50 $631.00 $482.50 2024-12-31
92960 CPT Cardioversion Elective 7 7 $758.85 $758.85 $474.28 $474.28 $474.28 2024-12-31
84445 CPT Thyroid Stimulating Immunoglobulins 7 7 $754.51 $754.51 $471.57 $471.57 $471.57 2024-12-31
13121 CPT Repr Scalparmsleg Complx 2.6cm 7 7 $665.00 $665.00 $470.31 $470.31 $470.31 2024-12-31
31505 CPT Laryngoscopy Indirect; Diagnostic 7 7 $750.00 $750.00 $468.75 $468.75 $468.75 2024-12-31
94003 CPT Vent Assist; Subsequent Day 7 7 $735.03 $735.03 $459.39 $459.39 $459.39 2024-12-31
36430 CPT Blood Adm 1-16 Hours 7 7 $650.00 $650.00 $452.17 $676.84 $452.17 2024-12-31
90675 CPT Rabies Vaccine (rabavert) Inj Kit 7 7 $616.60 $616.60 $447.68 $676.59 $447.68 2024-12-31
12041 CPT Intermed Suture Wound 2.5 Cm Or Less 7 7 $547.03 $547.03 $445.03 $698.60 $445.03 2024-12-31
88289 CPT Chromosome Study Additional(abn) 7 7 $679.71 $679.71 $424.82 $555.55 $424.82 2024-12-31
72050 CPT C-spine Aplat With Obliques 7 7 $677.83 $677.83 $423.64 $423.64 $423.64 2024-12-31
99283 CPT ER Level 3 7 7 $654.83 $654.83 $409.27 $535.22 $409.27 2024-12-31
30901 CPT Control Nasal Hemor Anterior Simple 7 7 $502.39 $502.39 $408.72 $641.60 $408.72 2024-12-31
12011 CPT Simp Repair <2.5cm Face 7 7 $488.90 $488.90 $397.74 $624.37 $397.74 2024-12-31
12013 CPT Suture Superficial Wound 2.6 7 7 $488.90 $488.90 $397.74 $624.37 $397.74 2024-12-31
12002 CPT Suture Wound 2.6 7 7 $550.00 $550.00 $396.50 $600.51 $396.50 2024-12-31
20604 CPT Sm Joint Or Bursa Inj With US Guidance 7 7 $475.40 $475.40 $386.76 $607.14 $386.76 2024-12-31
62270 CPT Spinal Puncture Lumbar Diagnostic 7 7 $550.00 $550.00 $380.60 $568.69 $380.60 2024-12-31
29085 CPT Casting Hand & Lower Forearm (gauntlet) 7 7 $535.00 $535.00 $377.31 $567.37 $377.31 2024-12-31
J0490 HCPCS Benlysta Inj 120mg 7 7 $756.76 $756.76 $69.59 $375.33 $375.33 2024-12-31
29075 CPT Application Short Arm Cast; Elbow-finger 7 7 $500.00 $500.00 $371.19 $567.37 $371.19 2024-12-31
93017 CPT ECG Stress Test Tracing Only(abn) 7 7 $572.26 $572.26 $357.67 $467.74 $357.67 2024-12-31
6440550 CPT Nerve Block Bilateral Greater Occipital 7 7 $551.00 $551.00 $344.38 $418.90 $344.38 2024-12-31
31500 CPT Intubation Endotracheal 7 7 $538.00 $538.00 $336.25 $336.25 $336.25 2024-12-31
29065 CPT Long Arm Cast Application 7 7 $273.00 $273.00 $331.46 $567.37 $331.46 2024-12-31
73552 CPT Femur Rt Side 7 7 $528.21 $528.21 $330.13 $330.13 $330.13 2024-12-31
11760 CPT Repair Of Nail Bed 7 7 $475.00 $475.00 $327.04 $487.83 $327.04 2024-12-31
J1610 HCPCS Glucagen Inj 1mg/1ml 7 7 $514.00 $514.00 $244.75 $321.25 $321.25 2024-12-31
43752 CPT N/g Tube Placement With Flouro Guidance 7 7 $501.82 $501.82 $313.64 $313.64 $313.64 2024-12-31
95816 CPT Electroencephalogram Including Awake And 7 7 $500.07 $500.07 $312.55 $408.73 $312.55 2024-12-31
81270 CPT Jak 2 Mutation (v617f) (abn) 7 7 $500.00 $500.00 $312.50 $312.50 $312.50 2024-12-31
12001 CPT Simple Repair Sclp Nck 2.5 7 7 $338.00 $338.00 $310.36 $502.41 $310.36 2024-12-31
76830 CPT US Transvaginal Non OB 7 7 $461.00 $461.00 $161.73 $288.12 $288.12 2024-12-31
30906 CPT Control Nasal Hemor Posterior Initial 7 7 $457.00 $457.00 $275.73 $285.62 $285.62 2024-12-31
83013 CPT H Pylori Analysis Unrease 7 7 $441.41 $441.41 $275.88 $275.88 $275.88 2024-12-31
72052 CPT C-spine W/obliques Flex/ext 7 7 $435.70 $435.70 $272.31 $272.31 $272.31 2024-12-31
94660 CPT Cpap / Bipap 7 7 $434.44 $434.44 $271.52 $355.08 $271.52 2024-12-31
65205 CPT Rmvl Fb Ext Eye 7 7 $375.00 $375.00 $269.11 $406.97 $269.11 2024-12-31
J0561 HCPCS Bicillin La (pcn G Benzat) Inj 1.2 Mmu 7 7 $558.98 $558.98 $32.82 $267.95 $267.95 2024-12-31
99282 CPT ER Level 2 7 7 $426.03 $426.03 $266.27 $348.22 $266.27 2024-12-31
76706 CPT US Abd Aorta 7 7 $422.00 $422.00 $263.75 $263.75 $263.75 2024-12-31
76705 CPT US Abd Limited 7 7 $422.00 $422.00 $263.75 $263.75 $263.75 2024-12-31
76770 CPT US Renal/bladder Complete 7 7 $412.00 $412.00 $257.50 $257.50 $257.50 2024-12-31
20553 CPT Inj Trigger Pnt 3 Or More Muscles 7 7 $215.00 $215.00 $254.53 $433.82 $254.53 2024-12-31
20552 CPT Inj Trigger Pnt 1 Or 2 Muscles 7 7 $200.00 $200.00 $251.91 $433.82 $251.91 2024-12-31
J2997 HCPCS Cathflo Activase (alteplase) IV 2 Mg/2ml 7 7 $433.24 $433.24 $112.88 $251.40 $251.40 2024-12-31
33286 CPT Remove Implanted Cardiac Event Monitor 7 7 $400.02 $400.02 $250.01 $250.01 $250.01 2024-12-31
29540 CPT Strapping; Ankle Or Foot 7 7 $358.00 $358.00 $244.93 $364.55 $244.93 2024-12-31
29240 CPT Splint/strapping Of Shoulder 7 7 $330.00 $330.00 $240.03 $364.55 $240.03 2024-12-31
94060 CPT Pft Comp Brochospams Eval Spirometry As 7 7 $245.00 $245.00 $237.99 $237.99 $237.99 2024-12-31
76000 CPT Fluro Assist Up To 1st Hr 7 7 $376.02 $376.02 $235.01 $235.01 $235.01 2024-12-31
76775 CPT US Renal 7 7 $375.00 $375.00 $234.38 $234.38 $234.38 2024-12-31
72020 CPT C-spine Lat 7 7 $373.92 $373.92 $233.70 $233.70 $233.70 2024-12-31
51700 CPT Bladder Irrigation; Simple 7 7 $159.78 $159.78 $232.82 $409.72 $232.82 2024-12-31
82306 CPT Vit D Hydroxy(d2d3)(abn)(babn) 7 7 $350.76 $350.76 $219.23 $219.23 $219.23 2024-12-31
72110 CPT Lumbar Sp Ap Lat W/obliques 7 7 $318.72 $318.72 $218.59 $218.59 $218.59 2024-12-31
87497 CPT Cmv DNA Quant Pcr 7 7 $350.00 $350.00 $217.82 $217.82 $217.82 2024-12-31
73564 CPT Zz 7 7 $347.67 $347.67 $217.29 $217.29 $217.29 2024-12-31
83014 CPT H Pylori Adm And Collection 7 7 $347.45 $347.45 $217.16 $217.16 $217.16 2024-12-31
69200 CPT Rmvl Foreign Body Without Anes 7 7 $310.00 $310.00 $212.66 $316.82 $212.66 2024-12-31
70260 CPT Skull Series 4 Views 7 7 $338.71 $338.71 $211.69 $211.69 $211.69 2024-12-31
87529 CPT Hsv I/ii DNA By Pcr(babn)87529 7 7 $350.00 $350.00 $206.93 $206.93 $206.93 2024-12-31
29505 CPT Application Long Leg Splint Thigh To Ank 7 7 $315.00 $315.00 $206.25 $302.24 $206.25 2024-12-31
J2730 HCPCS Protopam (pralidoxime) Inj 1gm 7 7 $328.36 $328.36 $107.66 $201.59 $201.59 2024-12-31
29125 CPT Application Of Short Arm Splint 7 7 $285.00 $285.00 $201.00 $302.24 $201.00 2024-12-31
29105 CPT Application Of Long Arm Splint 7 7 $285.00 $285.00 $201.00 $302.24 $201.00 2024-12-31
29515 CPT Application Short Leg Splint 7 7 $274.00 $274.00 $199.07 $302.24 $199.07 2024-12-31
J3101 HCPCS Tnkase (tenecteplase) Inj Kit 50mg 1 1 $9,129.53 $9,129.53 $196.97 $196.97 $196.97 2024-12-31
J0558 HCPCS Bicillin Cr(pcn G B&p)900/300inj 1.2 Mun 7 7 $407.83 $407.83 $26.55 $196.80 $196.80 2024-12-31
82542 CPT Co Q 10 7 7 $312.00 $312.00 $195.00 $195.00 $195.00 2024-12-31
70220 CPT Sinuses Complete 7 7 $311.85 $311.85 $194.91 $194.91 $194.91 2024-12-31
82379 CPT Carnitine 7 7 $311.16 $311.16 $194.47 $194.47 $194.47 2024-12-31
81291 CPT Methylenetetrahydrofolate DNA(get Auth) 7 7 $310.00 $310.00 $193.75 $193.75 $193.75 2024-12-31
29130 CPT Application Of Finger Splint; Static 7 7 $236.66 $236.66 $192.53 $302.24 $192.53 2024-12-31
81240 CPT Prothrombin Factor Ii DNA (babn)81240 7 7 $305.40 $305.40 $190.88 $190.88 $190.88 2024-12-31
70150 CPT Facial Bones 7 7 $305.00 $305.00 $190.62 $190.62 $190.62 2024-12-31
93225 CPT ECG Holter Mntr-hook Up 24 Hr(abn) 7 7 $302.33 $302.33 $188.96 $247.10 $188.96 2024-12-31
96360 CPT IV Infusion Hydration Initial 31-60mins 7 7 $214.09 $214.09 $188.28 $301.64 $188.28 2024-12-31
93270 CPT Evnt Mntr Hu& Rcrding Dt(abn)(babn)93270 7 7 $299.00 $299.00 $157.40 $186.88 $186.88 2024-12-31
84481 CPT T3 Free 7 7 $285.00 $285.00 $178.12 $178.12 $178.12 2024-12-31
83090 CPT Homocysteine(babn)83090 7 7 $283.55 $283.55 $177.22 $177.22 $177.22 2024-12-31
77080 CPT Osteogram 7 7 $266.50 $266.50 $176.54 $176.54 $176.54 2024-12-31
71101 CPT Ribs 3v 7 7 $256.65 $256.65 $176.02 $176.02 $176.02 2024-12-31
97602 CPT Debridment(abn) 7 7 $254.32 $254.32 $175.88 $262.76 $175.88 2024-12-31
81241 CPT Factor 5 Leiden (abn)(babn)81241 7 7 $281.25 $281.25 $175.78 $175.78 $175.78 2024-12-31
88184 CPT Flow Cytometry Lymes Cd57 Cd3 Cd8 7 7 $280.21 $280.21 $175.13 $175.13 $175.13 2024-12-31
Q5111 HCPCS Udenyca (pegfilgrastim-cbqv) Inj 6mg 1 1 $5,020.00 $5,020.00 $174.29 $174.29 $174.29 2024-12-31
80375 CPT Guanfacine (intuniv) Level 7 7 $300.00 $300.00 $172.35 $172.35 $172.35 2024-12-31
P9046 HCPCS Albumin Ivpb: 25gm/100ml 7 7 $351.94 $351.94 $27.69 $172.22 $172.22 2024-12-31
83835 CPT Metanephrines Plasma 7 7 $285.00 $285.00 $171.41 $171.41 $171.41 2024-12-31
99281 CPT ER Mse/clinic Level 0 8 7 $273.48 $273.48 $170.93 $223.53 $170.93 2024-12-31
88291 CPT Cyto/molecular Report 7 7 $269.00 $269.00 $168.12 $168.12 $168.12 2024-12-31
76870 CPT US Testicular 7 7 $265.00 $265.00 $165.62 $165.62 $165.62 2024-12-31
72190 CPT Pelvis W/lat Hips 7 7 $265.00 $265.00 $165.62 $165.62 $165.62 2024-12-31
87471 CPT Bartonella DNA Qualitative Pcr 7 7 $263.00 $263.00 $164.38 $164.38 $164.38 2024-12-31
96374 CPT IV Push Single Or Initial Inclu Inf <16 7 7 $69.74 $69.74 $163.03 $301.64 $163.03 2024-12-31
83880 CPT Bnp (triage) 7 7 $252.00 $252.00 $157.50 $157.50 $157.50 2024-12-31
73502 CPT Hip 2v Lt (includes Ap Pelvis) 7 7 $247.00 $247.00 $156.92 $156.92 $156.92 2024-12-31
83970 CPT Parathyroid Hormone (intact) 7 7 $248.93 $248.93 $155.57 $155.57 $155.57 2024-12-31
J0834 HCPCS Cortrosyn (cosyntropin) Inj 0.25mg 7 7 $304.49 $304.49 $36.78 $155.41 $155.41 2024-12-31
83520 CPT Immunoassay For Analyte Quant 7 7 $289.00 $289.00 $153.99 $153.99 $153.99 2024-12-31
72100 CPT Lumbar Spine Ap/lat 7 7 $224.42 $224.42 $153.91 $153.91 $153.91 2024-12-31
A9577 HCPCS Multihance (gadobenate Dimglmn)inj 15ml 7 7 $322.54 $322.54 $17.40 $153.84 $153.84 2024-12-31
80307 CPT Drug Profile 9 Serum (abn) 7 7 $240.99 $240.99 $150.62 $150.62 $150.62 2024-12-31
73562 CPT Knee 3 Views Rt Side 7 7 $240.23 $240.23 $150.15 $150.15 $150.15 2024-12-31
94664 CPT Demo/eval Of Pt Aerosolnebmdiippb 7 7 $58.00 $58.00 $148.73 $277.16 $148.73 2024-12-31
70160 CPT Nasal Bones Pa & Lat 7 7 $237.25 $237.25 $148.28 $148.28 $148.28 2024-12-31
88271 CPT Molecular Cytogenics DNA Probe(abn) 7 7 $236.91 $236.91 $148.07 $148.07 $148.07 2024-12-31
88275 CPT Interphase Hybridaztion(abn) 7 7 $236.91 $236.91 $148.07 $193.63 $148.07 2024-12-31
90746 CPT Hepatitis B Vaccine 7 7 $236.69 $236.69 $95.25 $147.93 $147.93 2024-12-31
82024 CPT Acth Plasma 7 7 $235.00 $235.00 $146.88 $146.88 $146.88 2024-12-31
71120 CPT Sternum 7 7 $232.77 $232.77 $145.48 $145.48 $145.48 2024-12-31
70250 CPT Skull 1-3 Views 7 7 $229.79 $229.79 $143.62 $143.62 $143.62 2024-12-31
73110 CPT Wrist 3 Views Rt Side 7 7 $229.79 $229.79 $143.62 $143.62 $143.62 2024-12-31
72220 CPT Sacrum And Coccyx 7 7 $229.79 $229.79 $143.62 $143.62 $143.62 2024-12-31
73590 CPT Tib/fib Rt Side 2 Views 7 7 $228.30 $228.30 $142.69 $142.69 $142.69 2024-12-31
84305 CPT Insulin-like Growth Factor Bp3 7 7 $228.00 $228.00 $142.50 $142.50 $142.50 2024-12-31
86920 CPT Blood Crossmatch 7 7 $248.00 $248.00 $142.00 $142.00 $142.00 2024-12-31
84207 CPT Vitamin B6 7 7 $225.65 $225.65 $141.03 $141.03 $141.03 2024-12-31
99218 CPT Op Observation Low 7 7 $225.50 $225.50 $140.94 $140.94 $140.94 2024-12-31
73030 CPT Shoulder Rt 2-4 Views 7 7 $225.31 $225.31 $140.82 $140.82 $140.82 2024-12-31
72040 CPT C-spine Ap & Lat 7 7 $205.32 $205.32 $140.81 $140.81 $140.81 2024-12-31
73610 CPT Ankle Rt Side With Or Without Stress 7 7 $223.82 $223.82 $139.89 $139.89 $139.89 2024-12-31
80197 CPT Prograf (tacrolimus) 7 7 $223.00 $223.00 $139.38 $139.38 $139.38 2024-12-31
80074 CPT Hepatitis Panel Acute(abn) 7 7 $221.58 $221.58 $138.49 $138.49 $138.49 2024-12-31
73060 CPT Humerus Rt Side 7 7 $220.83 $220.83 $138.02 $138.02 $138.02 2024-12-31
73130 CPT Hand Rt Side 7 7 $219.34 $219.34 $137.09 $137.09 $137.09 2024-12-31
84597 CPT Vitamin K 7 7 $225.00 $225.00 $136.91 $136.91 $136.91 2024-12-31
74019 CPT Abdomen Flat And Upright 7 7 $219.00 $219.00 $136.88 $136.88 $136.88 2024-12-31
72070 CPT Thoracic Spine Xray 2 Views 7 7 $219.00 $219.00 $136.88 $136.88 $136.88 2024-12-31
74018 CPT Kub 7 7 $216.36 $216.36 $135.22 $135.22 $135.22 2024-12-31
73630 CPT Foot Rt Side 7 7 $216.36 $216.36 $135.22 $135.22 $135.22 2024-12-31
J2506 HCPCS Neulasta (pegfilgrastim) Inj 6mg 1 1 $7,487.27 $7,487.27 $135.05 $135.05 $135.05 2024-12-31
94762 CPT Overnight Cnt Pls Ox Noninvas(babn)94762 7 7 $215.00 $215.00 $85.52 $134.38 $134.38 2024-12-31
96366 CPT IV Infusion Ther Addtl/frst Hr Same Drug 7 7 $214.09 $214.09 $133.81 $174.98 $133.81 2024-12-31
96361 CPT IV Infusion Hydration First/addtl Hrs 7 7 $214.09 $214.09 $133.81 $174.98 $133.81 2024-12-31
96367 CPT Infusion Seq New Drug Up To 1 Hr 7 7 $214.09 $214.09 $133.81 $174.98 $133.81 2024-12-31
86480 CPT Quantiferon (r)-TB Gold 7 7 $213.57 $213.57 $133.48 $133.48 $133.48 2024-12-31
71046 CPT Chest Pa & Lat 7 7 $189.29 $189.29 $132.07 $132.07 $132.07 2024-12-31
76882 CPT Zzus Xtr Non Vasc Limited (not Covered) 7 7 $210.00 $210.00 $131.25 $131.25 $131.25 2024-12-31
86256 CPT Anti Neutrophilic Cyto Ab 7 7 $209.00 $209.00 $130.62 $130.62 $130.62 2024-12-31
70360 CPT Neck Soft Tissue/fb 7 7 $207.41 $207.41 $129.62 $129.62 $129.62 2024-12-31
93005 CPT ECG 12 Leads-tracing Only 7 7 $123.00 $123.00 $129.47 $215.88 $129.47 2024-12-31
84270 CPT Sex Hormone Binding Globulin 7 7 $206.92 $206.92 $129.32 $129.32 $129.32 2024-12-31
82679 CPT Estrone 7 7 $206.00 $206.00 $128.75 $128.75 $128.75 2024-12-31
83519 CPT Thyrotropin-binding (tbii) 7 7 $230.00 $230.00 $127.44 $127.44 $127.44 2024-12-31
72170 CPT Pelvis Ap Only 7 7 $202.93 $202.93 $126.83 $126.83 $126.83 2024-12-31
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