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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

ST LUKE HOSPITAL & LIVING CENTER

Marion, KS · CCN 171356 · Rates published

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You selected 93306 (CPT)

US ECHO 2D COMP

This hospital’s price: $1,142 across 9 payers · range $1,142-$1,154

Source: https://stlukehospital.slicedhealth.io/pricer/81-0657542-1326087966_StLukeHospital_standardcharges.CSV · observed 2026-02-24

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.

1,683 distinct procedures filed
9 distinct payers
33,815 rate rows
2026-02-24 last MRF observed
Data quality

33,797 of 33,815 rate rows are consumer-grade (99.9%)

18 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
placeholder amount (≤ $0.02) — excluded from medians 18
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stlukehospital.slicedhealth.io/pricer/81-0657542-1326087966_StLukeHospital_standardcharges.CSV
Found on page https://www.slhmarion.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-01
Content fingerprint 2fd5e075b821f3b0… · 12,310,377 bytes · first seen 2026-08-01

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
J3101
HCPCS 		Tnk Vial 50mg IV 9 $7,140.00 $7,211.40 $7,140.00 nat. median
$3,820
1.9× median
C1785
HCPCS 		Pacemaker Model #1280 9 $5,159.93 $7,713.11 $6,599.91 nat. median
$6,720
1.0× median
J0717
HCPCS 		Cimzia (certolizumab ) 200mg/ml1 Ml 9 $5,610.00 $5,666.10 $5,610.00 nat. median
$1,598
outlier · 3.5×
0275
RC 		9 $659.94 $7,629.66 $5,605.84 nat. median
$9,910
0.6× median
J2506
HCPCS 		Neulasta 6 Mg:inj 9 $3,224.73 $5,666.10 $4,433.49 nat. median
$1,646
outlier · 2.7×
J2997
HCPCS 		Activase (alteplase) 100 Mg: IV 9 $279.99 $8,390.98 $4,295.35 nat. median
$500
outlier · 8.6×
C1898
HCPCS 		Pacemaker Meridian #1276 9 $4,200.11 $4,242.11 $4,200.11 nat. median
$858
outlier · 4.9×
C1786
HCPCS 		Fineline Ii Sterox Bipolar Aj Is-1 9 $790.76 $8,235.93 $3,960.15 nat. median
$7,852
0.5× median
J1306
HCPCS 		Leqvio (inclisivan) 284 Mg/1.5 Ml Sq 9 $3,441.48 $3,475.89 $3,441.48 nat. median
$44
outlier · 77.9×
15275
CPT 		App Of Gaft Ft 1st 25 Sq Cm Or Ls-wc 9 $3,024.30 $3,054.54 $3,024.30 nat. median
$1,713
1.8× median
J2182
HCPCS 		Nucala 100 Mg Vial Inj 9 $2,738.70 $2,766.09 $2,738.70 nat. median
$2,791
1.0× median
81162
CPT 		Brca 1/2 Comprehensive Analysis 9 $2,705.55 $2,732.61 $2,705.55 nat. median
$1,825
1.5× median
10180
CPT 		I & D Complex Post Op Wound Infection-wc 9 $2,676.48 $2,703.24 $2,676.48 nat. median
$2,863
0.9× median
J0897
HCPCS 		Prolia 60 Mg/ 1ml Inj 9 $1,581.00 $3,245.13 $2,404.90 nat. median
$1,972
1.2× median
J0875
HCPCS 		Dalvance (dalbavancin) 500 Mg IV 9 $2,397.00 $2,420.97 $2,397.00 nat. median
$390
outlier · 6.2×
J9218
HCPCS 		Lupron Depot 22.5 Mg:inj 9 $2,040.00 $2,060.40 $2,040.00 nat. median
$322
outlier · 6.3×
J1602
HCPCS 		Simponi Aria IV 50 Mg /4 Ml IV 9 $1,989.00 $2,008.89 $1,989.00 nat. median
$273
outlier · 7.3×
64625
CPT 		Rfa Sacroiliac Joint-pm 9 $1,950.24 $1,969.74 $1,950.24 nat. median
$2,481
0.8× median
64624
CPT 		Rfa Genicular Nerve-pm 9 $1,950.24 $1,969.74 $1,950.24 nat. median
$2,301
0.8× median
Q5108
HCPCS 		Fulphila Inj Pfs 6 Mg/0.6 Ml 9 $1,813.56 $1,831.70 $1,813.56 nat. median
$1,244
1.5× median
15271
CPT 		App Of Skin Sub Trunk Up To 100 Sq Cm-wc 9 $1,785.51 $1,803.37 $1,785.51 nat. median
$1,725
1.0× median
0191T
CPT 		I-stent Micro-bypass 9 $1,785.00 $1,802.85 $1,785.00 nat. median
$5,960
outlier · 0.3×
70553
CPT 		MRI Brain W/o+w/cont 9 $1,784.49 $1,802.33 $1,784.49 nat. median
$1,133
1.6× median
70552
CPT 		MRI Brain W/cont 9 $1,649.34 $1,665.83 $1,649.34 nat. median
$962
1.7× median
95805
CPT 		Multiple Sleep Latency Test 9 $1,632.00 $1,648.32 $1,632.00 nat. median
$1,233
1.3× median
J3240
HCPCS 		Thyrogen 1.1 Mg:inj 9 $1,615.68 $1,631.84 $1,615.68 nat. median
$2,980
0.5× median
33300
CPT 		Repair Cardiac Wound-ER 9 $1,602.42 $2,162.39 $1,602.42 nat. median
$4,112
outlier · 0.4×
71552
CPT 		MRI Chest Wo+w Cont 9 $1,596.81 $1,612.78 $1,596.81 nat. median
$1,097
1.5× median
70546
CPT 		MRA Head Wo+w Cont 9 $1,596.81 $1,612.78 $1,596.81 nat. median
$1,070
1.5× median
70543
CPT 		MRI Orb/fac/nck/w+wo Cont 9 $1,596.81 $1,612.78 $1,596.81 nat. median
$1,083
1.5× median
70545
CPT 		MRA Head W/cont 9 $1,596.81 $1,612.78 $1,596.81 nat. median
$889
1.8× median
71555
CPT 		MRA Chest 9 $1,596.81 $1,612.78 $1,596.81 nat. median
$1,143
1.4× median
81420
CPT 		Maternit21 Plus Core + Sca 9 $1,584.06 $1,599.90 $1,584.06 nat. median
$787
outlier · 2.0×
70549
CPT 		MRA Neck Wo+w Cont 9 $1,569.27 $1,584.96 $1,569.27 nat. median
$1,055
1.5× median
73225
CPT 		MRA Upr Extrm W/o-w/cont Left 9 $1,569.27 $1,584.96 $1,569.27 nat. median
$1,206
1.3× median
73220
CPT 		MRI Up Ext Non W+wo Left 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,130
1.3× median
72197
CPT 		MRI Pelvis W/o+w Cont 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,063
1.4× median
73723
CPT 		MRI Low Ext Jnt Wo+w Cont Left 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,192
1.3× median
72157
CPT 		MRI Spine Thor W/o+w/cont 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,105
1.4× median
72158
CPT 		MRI Spine Lmbr W/o+w/cont 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,093
1.4× median
73720
CPT 		MRI Low Ext Non W+without Con Left 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,129
1.3× median
72156
CPT 		MRI Spine Cerv W/o+w Cont 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,103
1.4× median
74183
CPT 		MRI Abdomen W/o+w Cont 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,100
1.4× median
73223
CPT 		MRI Upp Ext Jnt Wo+w Cont Left 9 $1,515.21 $1,530.36 $1,515.21 nat. median
$1,158
1.3× median
71551
CPT 		MRI Chest W/cont 9 $1,467.78 $1,482.46 $1,467.78 nat. median
$1,158
1.3× median
70548
CPT 		MRA Neck W/cont 9 $1,461.15 $1,475.76 $1,461.15 nat. median
$922
1.6× median
50386
CPT 		Remov Stent Via Transurethra 9 $1,452.99 $1,467.52 $1,452.99 nat. median
$2,239
0.6× median
70544
CPT 		MRA Head Without Cont 9 $1,434.12 $1,448.46 $1,434.12 nat. median
$826
1.7× median
70551
CPT 		MRI Brain Without Cont 9 $1,427.49 $1,441.76 $1,427.49 nat. median
$784
1.8× median
73218
CPT 		MRI Upp Ext Nonjt Wo Left 9 $1,298.97 $1,530.36 $1,413.59 nat. median
$864
1.6× median

Other procedures at this hospital

Browse this hospital's 1,683 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
J3101 HCPCS Tnk Vial 50mg IV 9 9 $14,000.00 — $7,140.00 $7,211.40 $7,140.00 2026-02-24
C1785 HCPCS Pacemaker Model #1280 45 9 $12,941.00 — $5,159.93 $7,713.11 $6,599.91 2026-02-24
J0717 HCPCS Cimzia (certolizumab ) 200mg/ml1 Ml 9 9 $11,000.00 — $5,610.00 $5,666.10 $5,610.00 2026-02-24
0275 RC — 72 9 $10,941.25 — $659.94 $7,629.66 $5,605.84 2026-02-24
J2506 HCPCS Neulasta 6 Mg:inj 18 9 $8,661.50 — $3,224.73 $5,666.10 $4,433.49 2026-02-24
J2997 HCPCS Activase (alteplase) 100 Mg: IV 18 9 $8,419.50 — $279.99 $8,390.98 $4,295.35 2026-02-24
C1898 HCPCS Pacemaker Meridian #1276 9 9 $8,235.50 — $4,200.11 $4,242.11 $4,200.11 2026-02-24
C1786 HCPCS Fineline Ii Sterox Bipolar Aj Is-1 45 9 $7,765.00 — $790.76 $8,235.93 $3,960.15 2026-02-24
J1306 HCPCS Leqvio (inclisivan) 284 Mg/1.5 Ml Sq 9 9 $6,748.00 — $3,441.48 $3,475.89 $3,441.48 2026-02-24
15275 CPT App Of Gaft Ft 1st 25 Sq Cm Or Ls-wc 9 9 $5,930.00 — $3,024.30 $3,054.54 $3,024.30 2026-02-24
J2182 HCPCS Nucala 100 Mg Vial Inj 9 9 $5,370.00 — $2,738.70 $2,766.09 $2,738.70 2026-02-24
81162 CPT Brca 1/2 Comprehensive Analysis 9 9 $5,305.00 — $2,705.55 $2,732.61 $2,705.55 2026-02-24
10180 CPT I & D Complex Post Op Wound Infection-wc 9 9 $5,248.00 — $2,676.48 $2,703.24 $2,676.48 2026-02-24
J0897 HCPCS Prolia 60 Mg/ 1ml Inj 18 9 $4,700.00 — $1,581.00 $3,245.13 $2,404.90 2026-02-24
J0875 HCPCS Dalvance (dalbavancin) 500 Mg IV 9 9 $4,700.00 — $2,397.00 $2,420.97 $2,397.00 2026-02-24
J9218 HCPCS Lupron Depot 22.5 Mg:inj 9 9 $4,000.00 — $2,040.00 $2,060.40 $2,040.00 2026-02-24
J1602 HCPCS Simponi Aria IV 50 Mg /4 Ml IV 9 9 $3,900.00 — $1,989.00 $2,008.89 $1,989.00 2026-02-24
64624 CPT Rfa Genicular Nerve-pm 9 9 $3,824.00 — $1,950.24 $1,969.74 $1,950.24 2026-02-24
64625 CPT Rfa Sacroiliac Joint-pm 9 9 $3,824.00 — $1,950.24 $1,969.74 $1,950.24 2026-02-24
Q5108 HCPCS Fulphila Inj Pfs 6 Mg/0.6 Ml 9 9 $3,556.00 — $1,813.56 $1,831.70 $1,813.56 2026-02-24
15271 CPT App Of Skin Sub Trunk Up To 100 Sq Cm-wc 9 9 $3,501.00 — $1,785.51 $1,803.37 $1,785.51 2026-02-24
0191T CPT I-stent Micro-bypass 9 9 $3,500.00 — $1,785.00 $1,802.85 $1,785.00 2026-02-24
70553 CPT MRI Brain W/o+w/cont 9 9 $3,499.00 — $1,784.49 $1,802.33 $1,784.49 2026-02-24
70552 CPT MRI Brain W/cont 9 9 $3,234.00 — $1,649.34 $1,665.83 $1,649.34 2026-02-24
95805 CPT Multiple Sleep Latency Test 9 9 $3,200.00 — $1,632.00 $1,648.32 $1,632.00 2026-02-24
J3240 HCPCS Thyrogen 1.1 Mg:inj 9 9 $3,168.00 — $1,615.68 $1,631.84 $1,615.68 2026-02-24
33300 CPT Repair Cardiac Wound-ER 27 9 $3,142.00 — $1,602.42 $2,162.39 $1,602.42 2026-02-24
70545 CPT MRA Head W/cont 9 9 $3,131.00 — $1,596.81 $1,612.78 $1,596.81 2026-02-24
71555 CPT MRA Chest 9 9 $3,131.00 — $1,596.81 $1,612.78 $1,596.81 2026-02-24
70546 CPT MRA Head Wo+w Cont 9 9 $3,131.00 — $1,596.81 $1,612.78 $1,596.81 2026-02-24
70543 CPT MRI Orb/fac/nck/w+wo Cont 9 9 $3,131.00 — $1,596.81 $1,612.78 $1,596.81 2026-02-24
71552 CPT MRI Chest Wo+w Cont 9 9 $3,131.00 — $1,596.81 $1,612.78 $1,596.81 2026-02-24
81420 CPT Maternit21 Plus Core + Sca 9 9 $3,106.00 — $1,584.06 $1,599.90 $1,584.06 2026-02-24
73225 CPT MRA Upr Extrm W/o-w/cont Left 18 9 $3,077.00 — $1,569.27 $1,584.96 $1,569.27 2026-02-24
70549 CPT MRA Neck Wo+w Cont 9 9 $3,077.00 — $1,569.27 $1,584.96 $1,569.27 2026-02-24
72156 CPT MRI Spine Cerv W/o+w Cont 9 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
73220 CPT MRI Up Ext Non W+wo Left 18 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
73723 CPT MRI Low Ext Jnt Wo+w Cont Left 18 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
73223 CPT MRI Upp Ext Jnt Wo+w Cont Left 18 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
74183 CPT MRI Abdomen W/o+w Cont 9 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
73720 CPT MRI Low Ext Non W+without Con Left 18 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
72158 CPT MRI Spine Lmbr W/o+w/cont 9 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
72157 CPT MRI Spine Thor W/o+w/cont 9 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
72197 CPT MRI Pelvis W/o+w Cont 9 9 $2,971.00 — $1,515.21 $1,530.36 $1,515.21 2026-02-24
71551 CPT MRI Chest W/cont 9 9 $2,878.00 — $1,467.78 $1,482.46 $1,467.78 2026-02-24
70548 CPT MRA Neck W/cont 9 9 $2,865.00 — $1,461.15 $1,475.76 $1,461.15 2026-02-24
50386 CPT Remov Stent Via Transurethra 9 9 $2,849.00 — $1,452.99 $1,467.52 $1,452.99 2026-02-24
70544 CPT MRA Head Without Cont 9 9 $2,812.00 — $1,434.12 $1,448.46 $1,434.12 2026-02-24
70551 CPT MRI Brain Without Cont 9 9 $2,799.00 — $1,427.49 $1,441.76 $1,427.49 2026-02-24
73218 CPT MRI Upp Ext Nonjt Wo Left 18 9 $2,759.00 — $1,298.97 $1,530.36 $1,413.59 2026-02-24
73719 CPT MRI Low Ext Nonjt W/cont Left 18 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
77058 CPT MRI Breast Uni Left 18 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
72142 CPT MRI Spine Cerv With Cont 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
72196 CPT MRI Pelvis With Cont 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
74185 CPT MRA Abdomen Without Or W/cont 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
77059 CPT MRI Breast Bilat 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
73722 CPT MRI Low Ext Joint W/cont Left 18 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
74182 CPT MRI Abdomen W/cont 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
70542 CPT MRI Orb Fac Neck W/cont 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
72141 CPT MRI Spine Cerv Without 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
72147 CPT MRI Spine Thor W/cont 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
72149 CPT MRI Spine Lumbar W/cont 9 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
73222 CPT MRI Upper Ext Jnt W/cont Left 18 9 $2,759.00 — $1,407.09 $1,421.16 $1,407.09 2026-02-24
72148 CPT MRI Spine Lumbar Without Cont 9 9 $2,746.00 — $1,400.46 $1,414.46 $1,400.46 2026-02-24
64633 CPT Rfa Neurolyt Cerv Or Thor 1st Jnt-pm 9 9 $2,720.00 — $1,387.20 $1,401.07 $1,387.20 2026-02-24
59409 CPT Vaginal Delivery Only-ER 9 9 $2,670.00 — $1,361.70 $1,375.32 $1,361.70 2026-02-24
70547 CPT MRA Neck Without Cont 9 9 $2,653.00 — $1,353.03 $1,366.56 $1,353.03 2026-02-24
74177 CPT CT Abd Pelvis W Cont 9 9 $2,650.00 — $1,351.50 $1,365.02 $1,351.50 2026-02-24
64520 CPT Ganglion Impar Block-pm 9 9 $2,627.00 — $1,339.77 $1,353.17 $1,339.77 2026-02-24
70496 CPT CT Angio Head 9 9 $2,625.00 — $1,338.75 $1,352.14 $1,338.75 2026-02-24
74174 CPT CT Angio Abd/pel 9 9 $2,625.00 — $1,338.75 $1,352.14 $1,338.75 2026-02-24
72191 CPT CT Pelvis Angio 9 9 $2,605.00 — $1,328.55 $1,341.84 $1,328.55 2026-02-24
74175 CPT CT Abd Angio 9 9 $2,591.00 — $1,321.41 $1,334.62 $1,321.41 2026-02-24
74176 CPT CT Abdomen Pelvis Without Contrast 9 9 $2,576.00 — $1,313.76 $1,326.90 $1,313.76 2026-02-24
26418 CPT Rpr Extensor Tendon Finger - ER 9 9 $2,554.00 — $1,302.54 $1,315.57 $1,302.54 2026-02-24
73721 CPT MRI Low Ext Jnt Without Cont Left 18 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
73718 CPT MRI Low Ext Nonjt Without Con Left 18 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
72146 CPT MRI Spine Thor Without Cont 9 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
71550 CPT MRI Chest Without Cont 9 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
77084 CPT MRI Bone Marrow 9 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
87483 CPT Meningitis Panel, Csf 9 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
72195 CPT MRI Pelvis Without Cont 9 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
73221 CPT MRI Upp Ext Jnt Without Cont Rt 18 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
74181 CPT MRI Abdomen Without Cont 9 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
70540 CPT MRI Orb Fac Neck Without Cont 9 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
70336 CPT MRI Tmj (s) 9 9 $2,547.00 — $1,298.97 $1,311.96 $1,298.97 2026-02-24
23605 CPT Trt Proximal Humerus Frac With Man - ER 9 9 $2,516.00 — $1,283.16 $1,295.99 $1,283.16 2026-02-24
64510 CPT Stellate Ganglion Inj-pm 9 9 $2,472.00 — $1,260.72 $1,273.33 $1,260.72 2026-02-24
75554 CPT MRI Cardiac Funct Comp 9 9 $2,469.00 — $1,259.19 $1,271.78 $1,259.19 2026-02-24
75555 CPT MRI Cardiac Funct Ltd 9 9 $2,469.00 — $1,259.19 $1,271.78 $1,259.19 2026-02-24
75553 CPT MRI Cardac W/cont 9 9 $2,469.00 — $1,259.19 $1,271.78 $1,259.19 2026-02-24
95811 CPT Polysomnography W Cpap/bi-lv Titration 9 9 $2,440.00 — $1,244.40 $1,256.84 $1,244.40 2026-02-24
95810 CPT Polysomnography 9 9 $2,440.00 — $1,244.40 $1,256.84 $1,244.40 2026-02-24
73706 CPT CT Lower Ext Angio 9 9 $2,428.00 — $1,238.28 $1,250.66 $1,238.28 2026-02-24
73206 CPT CT Upper Ext Angio 9 9 $2,428.00 — $1,238.28 $1,250.66 $1,238.28 2026-02-24
74178 CPT CT Abd Pelvis W/wo Cont 9 9 $2,426.00 — $1,237.26 $1,249.63 $1,237.26 2026-02-24
74170 CPT CT Abdomen Without +w/cont 9 9 $2,377.00 — $1,212.27 $1,224.39 $1,212.27 2026-02-24
0376T CPT I-stent Micro-bypass Ea Adl 9 9 $2,364.00 — $1,205.64 $1,217.70 $1,205.64 2026-02-24
J2357 HCPCS Xolair (omalizumab) 150 Mg Pfs:inj 9 9 $2,334.00 — $1,190.34 $1,202.24 $1,190.34 2026-02-24
52000 CPT Cystourethroscopy 9 9 $2,334.00 — $1,190.34 $1,202.24 $1,190.34 2026-02-24
75556 CPT MRI Cardiac Vel Map 9 9 $2,293.00 — $1,169.43 $1,181.12 $1,169.43 2026-02-24
75552 CPT MRI Cardiac Without Cont 9 9 $2,293.00 — $1,169.43 $1,181.12 $1,169.43 2026-02-24
75635 CPT CT Aorta/femorals 9 9 $2,293.00 — $1,169.43 $1,181.12 $1,169.43 2026-02-24
62321 CPT Cervical Or Thoracic Epidural Inj-pm 9 9 $2,241.00 — $1,142.91 $1,154.34 $1,142.91 2026-02-24
93306 CPT US Echo 2d Comp 9 9 $2,240.00 — $1,142.40 $1,153.82 $1,142.40 2026-02-24
72194 CPT CT Pelvis W/wo Cont 9 9 $2,191.00 — $1,117.41 $1,128.58 $1,117.41 2026-02-24
71260 CPT CT Chest W/cont 9 9 $2,166.00 — $1,104.66 $1,115.71 $1,104.66 2026-02-24
71270 CPT CT Chest W/wo Cont 9 9 $2,122.00 — $1,082.22 $1,093.04 $1,082.22 2026-02-24
26410 CPT Rpr Extensor Tendon Hand - ER 9 9 $2,112.00 — $1,077.12 $1,087.89 $1,077.12 2026-02-24
20101 CPT Explore Wound Chest- ER 9 9 $2,089.00 — $1,065.39 $1,076.04 $1,065.39 2026-02-24
49561 CPT Repair Initial Ventral Hernia -phy Or 9 9 $2,076.00 — $1,058.76 $1,069.35 $1,058.76 2026-02-24
70491 CPT CT Neck W/cont 9 9 $2,067.00 — $1,054.17 $1,064.71 $1,054.17 2026-02-24
64640 CPT Rfa Peripheral Nerve Or Branch Inj-pm 9 9 $2,060.00 — $1,050.60 $1,061.11 $1,050.60 2026-02-24
64635 CPT Rfa Neurolyt Lumb Or Sacral 1st Jnt-pm 9 9 $2,060.00 — $1,050.60 $1,061.11 $1,050.60 2026-02-24
81490 CPT Vector With Cv Risk 9 9 $2,059.00 — $1,050.09 $1,060.59 $1,050.09 2026-02-24
72193 CPT CT Pelvis With Cont 9 9 $2,019.00 — $1,029.69 $1,039.99 $1,029.69 2026-02-24
70470 CPT CT Head Without + W/cont 9 9 $2,013.00 — $1,026.63 $1,036.90 $1,026.63 2026-02-24
23620 CPT Trt Greater Humerus Fracture - ER 9 9 $2,003.00 — $1,021.53 $1,031.75 $1,021.53 2026-02-24
23600 CPT Trt Proximal Humerus Frac Without Man - ER 9 9 $1,957.00 — $998.07 $1,008.05 $998.07 2026-02-24
J1569 HCPCS Gammagard 10% Liquid 30 Gm IV 45 9 $1,956.00 — $145.86 $3,183.32 $997.56 2026-02-24
25505 CPT Clsd Trmt Rad Hsaft With Man- ER 9 9 $1,946.00 — $992.46 $1,002.38 $992.46 2026-02-24
70498 CPT CT Neck Angio W Contrast 9 9 $1,945.00 — $991.95 $1,001.87 $991.95 2026-02-24
28193 CPT Removal Foreign Body Foot Complicated-ER 9 9 $1,928.00 — $983.28 $993.11 $983.28 2026-02-24
71275 CPT CT Chest Angiography 18 9 $1,909.50 — $742.56 $1,217.18 $977.56 2026-02-24
78452 CPT Nm Myocardial Spect S/r-single 9 9 $1,913.00 — $975.63 $985.39 $975.63 2026-02-24
23930 CPT Incision Drainage Upper Arm Elbow 9 9 $1,912.00 — $975.12 $984.87 $975.12 2026-02-24
J1439 HCPCS Injectafer 750 Mg IV 9 9 $1,900.00 — $969.00 $978.69 $969.00 2026-02-24
74160 CPT CT Abdomen Aorta 18 9 $1,885.00 — $935.85 $996.72 $966.03 2026-02-24
31231 CPT Rhinoscopy-ac 9 9 $1,891.00 — $964.41 $974.05 $964.41 2026-02-24
72192 CPT CT Pelvis Without Cont 9 9 $1,890.00 — $963.90 $973.54 $963.90 2026-02-24
15273 CPT App Gft Legs 1st 100 Sq Cm Or Ls -phy Wc 18 9 $1,872.50 — $213.18 $1,713.74 $956.04 2026-02-24
J0585 HCPCS Botox 100 Units 18 9 $1,866.00 — $651.78 $1,264.06 $954.92 2026-02-24
70460 CPT CT Head W Contrast 9 9 $1,865.00 — $951.15 $960.66 $951.15 2026-02-24
25535 CPT Clsd Trmt Ulna Shaft With Man- ER 9 9 $1,860.00 — $948.60 $958.09 $948.60 2026-02-24
27825 CPT Trt Clsd Art Dis Tib With Manip - ER 9 9 $1,858.00 — $947.58 $957.06 $947.58 2026-02-24
Q5103 HCPCS Inflectra 100 Mg Vial 9 9 $1,833.00 — $934.83 $944.18 $934.83 2026-02-24
J1745 HCPCS Infliximab( Remicade) 100 Mg/10 Ml IV 18 9 $1,824.00 — $503.88 $1,370.17 $932.76 2026-02-24
24670 CPT Clsd Trmt Ulna Prox Without Man- ER 9 9 $1,813.00 — $924.63 $933.88 $924.63 2026-02-24
36590 CPT Removal Of Tunnel Picc Line W/pump 9 9 $1,766.00 — $900.66 $909.67 $900.66 2026-02-24
72132 CPT CT Spine Lumbar With Cont 9 9 $1,762.00 — $898.62 $907.61 $898.62 2026-02-24
74150 CPT CT Abdomen Without Cont 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
27824 CPT Trt Clsd Art Dis Tib W/0 Manip - ER 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
27818 CPT Trt Clsd Trimal Ank Frac W/manip - ER 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
27762 CPT Trt Clsd Med Malleolus With Manip- ER 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
27760 CPT Trt Clsd Med Malleolus Without Manip- ER 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
27550 CPT Trt Clsd Tibia Without Manip- ER 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
27508 CPT Trt Clsd Femur Head Without Man- ER 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
27503 CPT Trt Clsd Femur Sp/tran With Man- ER 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
27510 CPT Trt Clsd Femur Head With Man- ER 9 9 $1,760.00 — $897.60 $906.58 $897.60 2026-02-24
64421 CPT Intercostal Nerve Inj Ea Adl-pm 9 9 $1,751.00 — $893.01 $901.94 $893.01 2026-02-24
70450 CPT CT Head Without Cont 9 9 $1,746.00 — $890.46 $899.36 $890.46 2026-02-24
78496 CPT Nm Cardiac Blood Pool 1st Pa 9 9 $1,740.00 — $887.40 $896.27 $887.40 2026-02-24
78472 CPT Nm Cardiac Blood Pool (muga) 9 9 $1,740.00 — $887.40 $896.27 $887.40 2026-02-24
25530 CPT Clsd Trmt Ulna Shaft W/0 Man- ER 9 9 $1,721.00 — $877.71 $886.49 $877.71 2026-02-24
24675 CPT Clsd Trmt Ulna Prox With Man- ER 9 9 $1,721.00 — $877.71 $886.49 $877.71 2026-02-24
25500 CPT Clsd Trmt Rad Shaft W/0 Man- ER 9 9 $1,721.00 — $877.71 $886.49 $877.71 2026-02-24
78594 CPT Nm Lung Vent Multi View 9 9 $1,720.00 — $877.20 $885.97 $877.20 2026-02-24
27810 CPT Trt Clsd Bimalleolar With Man- ER 9 9 $1,709.00 — $871.59 $880.31 $871.59 2026-02-24
27808 CPT Trt Clsd Bimalleolar Without Man- ER 9 9 $1,709.00 — $871.59 $880.31 $871.59 2026-02-24
81406 CPT Paraplegin (spg7) DNA Sequencing Test 9 9 $1,706.00 — $870.06 $878.76 $870.06 2026-02-24
12057 CPT Rpr Imtermed Face >30- ER 9 9 $1,705.00 — $869.55 $878.25 $869.55 2026-02-24
70488 CPT CT Maxillofacial With Wo(sinuses) 9 9 $1,689.00 — $861.39 $870.00 $861.39 2026-02-24
71250 CPT CT Chest Without Cont 9 9 $1,680.00 — $856.80 $865.37 $856.80 2026-02-24
28192 CPT Removal Foreign Body Foot Deep-ER 9 9 $1,678.00 — $855.78 $864.34 $855.78 2026-02-24
70482 CPT CT Orbit W/wo Cont 9 9 $1,655.00 — $844.05 $852.49 $844.05 2026-02-24
32160 CPT Manual Cardiac Massage-aprn ER 18 9 $1,630.00 — $735.42 $936.45 $834.97 2026-02-24
32110 CPT Thoracotomy Cntrl Bleed-aprn ER 18 9 $1,630.00 — $735.42 $936.45 $834.97 2026-02-24
32100 CPT Thoracotomy-ER 18 9 $1,630.00 — $735.42 $936.45 $834.97 2026-02-24
70481 CPT CT Iac Mastoid With Cont 18 9 $1,613.00 — $756.84 $897.30 $826.41 2026-02-24
27750 CPT Clsd Trmt Tibia Without Man-ER 9 9 $1,617.00 — $824.67 $832.92 $824.67 2026-02-24
27552 CPT Clsd Trmt Of Knee Disl W Anest - ER 18 9 $1,608.00 — $742.56 $906.58 $823.80 2026-02-24
73202 CPT CT Upper Extrem Lt W/wo Cont 18 9 $1,607.00 — $819.57 $827.77 $819.57 2026-02-24
72131 CPT CT Spine Lumbar Without Cont 9 9 $1,607.00 — $819.57 $827.77 $819.57 2026-02-24
27816 CPT Trt Clsd Trimal Ank Frac Without Man - ER 9 9 $1,598.00 — $814.98 $823.13 $814.98 2026-02-24
64495 CPT Inj Diag/therap Lumb Vertebral Lev 3-pm 9 9 $1,591.00 — $811.41 $819.52 $811.41 2026-02-24
27788 CPT Trt Clsd Distal Fib Frac With Man- ER 9 9 $1,582.00 — $806.82 $814.89 $806.82 2026-02-24
24500 CPT Trt Humerus Shaft Fract Without Manip - ER 9 9 $1,571.00 — $801.21 $809.22 $801.21 2026-02-24
70486 CPT CT Maxi/fac Without Cont(sinuses) 9 9 $1,559.00 — $795.09 $803.04 $795.09 2026-02-24
55700 CPT Prostate Biopsy 9 9 $1,558.00 — $794.58 $802.53 $794.58 2026-02-24
73701 CPT CT Lower Extrem Rt W/cont 9 9 $1,553.00 — $792.03 $799.95 $792.03 2026-02-24
73201 CPT CT Upper Extrem Lt With Cont 9 9 $1,553.00 — $792.03 $799.95 $792.03 2026-02-24
64634 CPT Rfa Neurolyt Cerv Or Thor Ea Adl Jnt-pm 9 9 $1,545.00 — $787.95 $795.83 $787.95 2026-02-24
64483 CPT Lumbar /sacral Transform Epidural Inj-pm 9 9 $1,545.00 — $787.95 $795.83 $787.95 2026-02-24
72126 CPT CT Spine Cerv With Cont 9 9 $1,545.00 — $787.95 $795.83 $787.95 2026-02-24
64636 CPT Rfa Neurolyt Lumb Or Sac Ea Adl Jnt-pm 9 9 $1,545.00 — $787.95 $795.83 $787.95 2026-02-24
24535 CPT Trt Clsd Supra/trans Hum Frac W/tap - ER 18 9 $1,533.50 — $564.57 $1,009.60 $784.91 2026-02-24
33020 CPT Sternotomy-aprn ER 18 9 $1,521.50 — $687.48 $873.09 $779.40 2026-02-24
25565 CPT Trt Clsd Frac Rad & Ulna With Manip-ER 9 9 $1,509.00 — $769.59 $777.29 $769.59 2026-02-24
12056 CPT Rpr Imtermed Face 20.1-30- ER 9 9 $1,509.00 — $769.59 $777.29 $769.59 2026-02-24
78227 CPT Nm Hepatobiliary Scan 9 9 $1,504.00 — $767.04 $774.71 $767.04 2026-02-24
27781 CPT Trt Clsd Prox Fib With Manip- ER 9 9 $1,501.00 — $765.51 $773.17 $765.51 2026-02-24
27538 CPT Clsd Trmt Of Tuberosity Frac Knee - ER 9 9 $1,484.00 — $756.84 $764.41 $756.84 2026-02-24
94002 CPT Ventilater First Day 9 9 $1,484.00 — $756.84 $764.41 $756.84 2026-02-24
70487 CPT CT Maxi/fac With Cont(sinuses) 9 9 $1,483.00 — $756.33 $763.89 $756.33 2026-02-24
74270 CPT Barium Enema 9 9 $1,463.00 — $746.13 $753.59 $746.13 2026-02-24
74280 CPT Barium Enema W/air 9 9 $1,463.00 — $746.13 $753.59 $746.13 2026-02-24
78585 CPT Nm Lung Perf/vent 9 9 $1,461.00 — $745.11 $752.56 $745.11 2026-02-24
28665 CPT Trt Clsd Interphal Jnt Dis W/anes - ER 9 9 $1,451.00 — $740.01 $747.41 $740.01 2026-02-24
28635 CPT Trt Clsd Metat Jnt Dis W/anes - ER 9 9 $1,451.00 — $740.01 $747.41 $740.01 2026-02-24
27502 CPT Trt Clsd Femur Shaft Without Man- ER 9 9 $1,451.00 — $740.01 $747.41 $740.01 2026-02-24
27501 CPT Trt Clsd Supra Femur Without Man- ER 9 9 $1,451.00 — $740.01 $747.41 $740.01 2026-02-24
27500 CPT Trt Clsd Femur Without Man- ER 9 9 $1,451.00 — $740.01 $747.41 $740.01 2026-02-24
27266 CPT Treat Post Hip Dislocation With Anes- ER 9 9 $1,451.00 — $740.01 $747.41 $740.01 2026-02-24
27842 CPT Trt Clsd Ankle Disloc With Anes - ER 9 9 $1,448.00 — $738.48 $745.86 $738.48 2026-02-24
72128 CPT CT Spine Thor Without Cont 9 9 $1,445.00 — $736.95 $744.32 $736.95 2026-02-24
27780 CPT Trt Clsd Prox Fib W/0 Manip- ER 9 9 $1,445.00 — $736.95 $744.32 $736.95 2026-02-24
27768 CPT Trt Clsd Pst Mlaleolus With Manip- ER 9 9 $1,445.00 — $736.95 $744.32 $736.95 2026-02-24
87507 CPT Gastrointestinal Profile, Stool, Pcr 9 9 $1,437.00 — $732.87 $740.20 $732.87 2026-02-24
27562 CPT Clsd Trmt Of Patellar W/anesth-ER 9 9 $1,435.00 — $731.85 $739.17 $731.85 2026-02-24
70492 CPT CT Neck Without + W/cont 9 9 $1,415.00 — $721.65 $728.87 $721.65 2026-02-24
73200 CPT CT Upper Extrem Lt Without Cont 18 9 $1,396.00 — $711.96 $719.08 $711.96 2026-02-24
24655 CPT Clsd Trmt Radial Head With Man- ER 9 9 $1,394.00 — $710.94 $718.05 $710.94 2026-02-24
72125 CPT CT Spine Cerv Without Cont 9 9 $1,391.00 — $709.41 $716.50 $709.41 2026-02-24
28495 CPT Trt Cld Toe Frac With Manip - ER 9 9 $1,386.00 — $706.86 $713.93 $706.86 2026-02-24
C1771 HCPCS Tvt Device 9 9 $1,382.50 — $705.08 $712.13 $705.08 2026-02-24
27257 CPT Clsd Trt Path Hip Dis With Anes - ER 9 9 $1,382.00 — $704.82 $711.87 $704.82 2026-02-24
27252 CPT Clsd Trt Hip Disloc With Anes - ER 9 9 $1,382.00 — $704.82 $711.87 $704.82 2026-02-24
66821 CPT Yag Laser Lt 18 9 $1,379.00 — $703.29 $710.32 $703.29 2026-02-24
78451 CPT Nm Myocardial Spect Rest Only 9 9 $1,373.00 — $700.23 $707.23 $700.23 2026-02-24
0341 RC — 9 9 $1,372.00 — $699.72 $706.72 $699.72 2026-02-24
0720 RC — 9 9 $1,370.00 — $698.70 $705.69 $698.70 2026-02-24
27096 CPT Inj Sacroiliac Jnt - ER 18 9 $1,364.50 — $464.10 $936.97 $698.22 2026-02-24
24505 CPT Treat Clsd Humeral Frac With Manip - ER 18 9 $1,358.50 — $462.57 $932.33 $695.15 2026-02-24
70490 CPT CT Neck W0/cont 9 9 $1,343.00 — $684.93 $691.78 $684.93 2026-02-24
12046 CPT Rpr Intermed Neck Hands 21.30 - ER 9 9 $1,339.00 — $682.89 $689.72 $682.89 2026-02-24
12036 CPT Rpr Inter Trnk 20.1-30 Cm- ER 9 9 $1,339.00 — $682.89 $689.72 $682.89 2026-02-24
12018 CPT Rpr Sim Wnd Face >30 - ER 9 9 $1,339.00 — $682.89 $689.72 $682.89 2026-02-24
12017 CPT Rpr Sim Wnd Face 20.1-30 - ER 9 9 $1,339.00 — $682.89 $689.72 $682.89 2026-02-24
12007 CPT Rpr Sup Wnd Trnk>30cm -ER 9 9 $1,339.00 — $682.89 $689.72 $682.89 2026-02-24
12047 CPT Rpr Intermed Neck Hands >30 - ER 9 9 $1,339.00 — $682.89 $689.72 $682.89 2026-02-24
77012 CPT CT Guided Needle Placement 9 9 $1,334.00 — $680.34 $687.14 $680.34 2026-02-24
62323 CPT Lumbar Or Sacral Epidural Inj-pm 9 9 $1,334.00 — $680.34 $687.14 $680.34 2026-02-24
78802 CPT Nm Tumor Loc Wb 9 9 $1,310.00 — $668.10 $674.78 $668.10 2026-02-24
70480 CPT CT Iac Mastoid Without Contrast 18 9 $1,303.00 — $649.74 $686.11 $667.78 2026-02-24
64484 CPT Lumbar /sacral Trans Epidural Inj Adl-pm 9 9 $1,306.00 — $666.06 $672.72 $666.06 2026-02-24
37244 CPT Vascular Emobilization-aprn ER 27 9 $1,298.00 — $661.98 $769.56 $661.98 2026-02-24
78014 CPT Nm Thyroid Imaging With Uptake 9 9 $1,297.00 — $661.47 $668.08 $661.47 2026-02-24
76380 CPT CT Ltd/fu 9 9 $1,288.00 — $656.88 $663.45 $656.88 2026-02-24
27767 CPT Trt Clsd Pst Mlaleolus Without Manip- ER 9 9 $1,283.00 — $654.33 $660.87 $654.33 2026-02-24
78707 CPT Nm Renal Scan With Renogram 9 9 $1,282.00 — $653.82 $660.36 $653.82 2026-02-24
27786 CPT Trt Clsd Distal Fib Frac Without Man- ER 9 9 $1,273.00 — $649.23 $655.72 $649.23 2026-02-24
20005 CPT Incision/drainage Soft Tissue Absce - ER 18 9 $1,265.00 — $244.80 $1,055.96 $646.38 2026-02-24
78264 CPT Nm Gastric Emptying 9 9 $1,259.00 — $642.09 $648.51 $642.09 2026-02-24
78315 CPT Nm Bone Scan 3 Phase 9 9 $1,257.00 — $641.07 $647.48 $641.07 2026-02-24
78306 CPT Nm Bone Scan Wb 9 9 $1,254.00 — $639.54 $645.94 $639.54 2026-02-24
28190 CPT Removal Foreign Body Foot Sq-ER 9 9 $1,252.00 — $638.52 $644.91 $638.52 2026-02-24
24530 CPT Trt Clsd Supra/trans Humer Frac - ER 18 9 $1,245.00 — $346.80 $932.33 $636.68 2026-02-24
26705 CPT Trmt Clsd Knuckle Dislocat With Anes - ER 9 9 $1,245.00 — $634.95 $641.30 $634.95 2026-02-24
64417 CPT Rfa Axillary Nerve-pm 9 9 $1,236.00 — $630.36 $636.66 $630.36 2026-02-24
64418 CPT Suprascapular Injection-pm 9 9 $1,236.00 — $630.36 $636.66 $630.36 2026-02-24
64492 CPT Inj Diag/therap Cerv Vertebral Lev 3-pm 9 9 $1,233.00 — $628.83 $635.12 $628.83 2026-02-24
75822 CPT Venogram Extrem Bilat 9 9 $1,207.00 — $615.57 $621.73 $615.57 2026-02-24
46608 CPT Anoscopy Remov For Bdy- ER 9 9 $1,205.00 — $614.55 $620.70 $614.55 2026-02-24
46600 CPT Anoscopy - ER 9 9 $1,205.00 — $614.55 $620.70 $614.55 2026-02-24
49083 CPT Abdominal Paracentesis With Guide-ER 18 9 $1,204.50 — $614.04 $620.70 $614.55 2026-02-24
27840 CPT Trt Clsd Ankle Disloc Without Anes - ER 9 9 $1,192.00 — $607.92 $614.00 $607.92 2026-02-24
73700 CPT CT Hip Rt 18 9 $1,177.00 — $581.40 $625.33 $603.17 2026-02-24
49082 CPT Abdominal Paracentesis Without Guide-ER 18 9 $1,168.50 — $595.68 $602.15 $596.19 2026-02-24
87633 CPT .respiratory Virus Profile, Pcr 9 9 $1,167.00 — $595.17 $601.12 $595.17 2026-02-24
86362 CPT Anti-mog, Serum 9 9 $1,150.00 — $586.50 $592.37 $586.50 2026-02-24
64445 CPT Sciatic Nerve Block -pm 9 9 $1,148.00 — $585.48 $591.33 $585.48 2026-02-24
64420 CPT Intercostal Nerve Block Initial -pm 9 9 $1,148.00 — $585.48 $591.33 $585.48 2026-02-24
64425 CPT Ilioinguinal/hypogastric Nerve Block -pm 9 9 $1,148.00 — $585.48 $591.33 $585.48 2026-02-24
J1441 HCPCS Onc Neupogen 480 Mcg 18 9 $1,133.50 — $562.02 $600.09 $580.89 2026-02-24
12006 CPT Rpr Sup Wnd Trnk 21-30cm-ER 9 9 $1,139.00 — $580.89 $586.70 $580.89 2026-02-24
81206 CPT Bcr-abl1 Cml/all, Quant 9 9 $1,133.00 — $577.83 $583.61 $577.83 2026-02-24
86051 CPT Neuromyelitis Optica, Igg Autoab 9 9 $1,133.00 — $577.83 $583.61 $577.83 2026-02-24
64451 CPT Njx/aa&strd Nrv S1 Joint Block Inj-pm 9 9 $1,132.00 — $577.32 $583.09 $577.32 2026-02-24
26641 CPT Trt Dislocat Thumb W /manip- ER 9 9 $1,132.00 — $577.32 $583.09 $577.32 2026-02-24
27560 CPT Trt Clsd Patellar Disloc - ER 9 9 $1,131.00 — $576.81 $582.58 $576.81 2026-02-24
0921 RC — 9 9 $1,123.00 — $572.73 $578.46 $572.73 2026-02-24
64494 CPT Inj Diag/therap Lumb Vertebral Lev 2-pm 9 9 $1,117.00 — $569.67 $575.37 $569.67 2026-02-24
74320 CPT Cholangiogram Ptc 9 9 $1,114.00 — $568.14 $573.82 $568.14 2026-02-24
J9217 HCPCS Eligard Kit 22.5 Mg Inj 18 9 $1,110.00 — $377.40 $762.35 $567.99 2026-02-24
25600 CPT Trt Clsd Frac Distal Rad Without Manip-ER 9 9 $1,113.00 — $567.63 $573.31 $567.63 2026-02-24
26725 CPT Trt Clsd Phalan Shaft Frac W/manip - ER 9 9 $1,104.00 — $563.04 $568.67 $563.04 2026-02-24
23505 CPT Clsd Trmt Clvcl Frac With Man - ER 9 9 $1,100.00 — $561.00 $566.61 $561.00 2026-02-24
23500 CPT Clsd Trmt Clvcl Frac Without Man - ER 9 9 $1,100.00 — $561.00 $566.61 $561.00 2026-02-24
94003 CPT Cont Vent/0subsequent Day 18 9 $1,092.50 — $343.23 $778.83 $558.89 2026-02-24
0750 RC — 117 9 $1,092.00 — $84.66 $2,209.78 $556.92 2026-02-24
24650 CPT Clsd Trmt Radial Head Without Man- ER 9 9 $1,090.00 — $555.90 $561.46 $555.90 2026-02-24
23570 CPT Trt Scapula Without Manipul Fracture - ER 9 9 $1,089.00 — $555.39 $560.94 $555.39 2026-02-24
12045 CPT Rpr Intermed Neck Hands 12.6-20 - ER 9 9 $1,082.00 — $551.82 $557.34 $551.82 2026-02-24
12037 CPT Rpr Intermed Trnk >30- ER 9 9 $1,082.00 — $551.82 $557.34 $551.82 2026-02-24
64491 CPT Inj Diag/therap Cerv Vertebral Lev 2-pm 9 9 $1,082.00 — $551.82 $557.34 $551.82 2026-02-24
23650 CPT Treat Shldr Dislocat W/out Anest-ER 9 9 $1,078.00 — $549.78 $555.28 $549.78 2026-02-24
23333 CPT Remov Deep For Bdy Shoul - ER 9 9 $1,077.00 — $549.27 $554.76 $549.27 2026-02-24
78278 CPT Nm Gi Bleed 9 9 $1,077.00 — $549.27 $554.76 $549.27 2026-02-24
12055 CPT Rpr Imtermed Face 12.6-20- ER 9 9 $1,077.00 — $549.27 $554.76 $549.27 2026-02-24
64493 CPT Inj Diag/therap Lumb Vertebral Lev 1-pm 18 9 $1,067.00 — $400.35 $694.87 $546.17 2026-02-24
32421 CPT Thoracentisis 9 9 $1,063.00 — $542.13 $547.55 $542.13 2026-02-24
78216 CPT Nm Liver/spleen With Flow 9 9 $1,061.00 — $541.11 $546.52 $541.11 2026-02-24
54162 CPT Lysis Or Exc Penile Post Circum-ur 9 9 $1,061.00 — $541.11 $546.52 $541.11 2026-02-24
64490 CPT Inj Diag/therap Cerv Vertebral Lev 1-pm 18 9 $1,050.50 — $310.08 $769.04 $537.30 2026-02-24
G0416 HCPCS Sat Biopsy Prostate 1-20 Spec 9 9 $1,053.00 — $537.03 $542.40 $537.03 2026-02-24
99291 CPT Critical Care 30-74 Min 9 9 $1,048.00 — $534.48 $539.82 $534.48 2026-02-24
26700 CPT Trmt Clsd Knuckle Dislocat Without Anes - ER 9 9 $1,046.00 — $533.46 $538.79 $533.46 2026-02-24
P9035 HCPCS Bb Plateletpheresis Leukored 9 9 $1,033.00 — $526.83 $532.10 $526.83 2026-02-24
64400 CPT Inj Anesthetic Trigeminal Nerve - ER 18 9 $1,024.00 — $256.53 $795.83 $523.53 2026-02-24
71271 CPT CT Low Dose Lung Ca Screening 9 9 $1,019.00 — $519.69 $524.89 $519.69 2026-02-24
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