Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Export CSV
Hospital

MORTON COUNTY HOSPITAL

Elkhart, KS · CCN 171386 · Rates published

1,969 distinct procedures filed
4 distinct payers
8,353 rate rows
2025-09-25 last MRF observed
Data quality

8,353 of 8,353 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/TAIU-1724338504629/machine-readable/48-0818854_morton-county-health-system_standardcharges.json
Found on page https://mchswecare.com/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-11
Content fingerprint 170c6f8586d6e78f… · 1,925,463 bytes · first seen 2026-05-17

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
109881610
CDM 		Tenecteplase 50 Mg Intravenous Injection[mort] 4 $8,172.00 $28,179.00 $26,065.50 nat. median
$26,066
1.0× median
109863473
CDM 		Antivenin (Crotalidae Ovine) Polyvalent Intravenous Injection[mort] 4 $3,369.00 $11,618.00 $10,746.50 nat. median
$10,746
1.0× median
36556
CPT 		36556-central Line Greater Than/equal To 5 Years 4 $3,045.00 $10,500.00 $9,187.50 nat. median
$2,458
outlier · 3.7×
59409
CPT 		59409-vaginal Delivery Only 4 $2,053.00 $7,080.00 $6,195.00 nat. median
$3,157
2.0× median
74177
CPT 		CT Scan Of Abdomen And Pelvis With Contrast 4 $1,993.00 $6,873.00 $6,014.00 nat. median
$968
outlier · 6.2×
74174
CPT 		CT Angio Abdomen And Pelvis 4 $1,974.00 $6,806.00 $5,955.00 nat. median
$982
outlier · 6.1×
109866884
CDM 		Denosumab (Prolia) 60 Mg/ml Subcutaneous Solution 1 Ml[mort] 4 $1,865.00 $6,430.00 $5,948.00 nat. median
$5,948
1.0× median
25605
CPT 		25605-distal Radial With Manipulation 4 $1,887.00 $6,506.00 $5,692.50 nat. median
$1,654
outlier · 3.4×
109870025
CDM 		Ferric Carboxymaltose (As Elemental Iron) 50 Mg/ml Intravenous Solution 15 Ml[mo… 4 $1,555.00 $5,361.00 $4,959.00 nat. median
$4,959
1.0× median
25600
CPT 		25600-distal Radial Without Manipulation 4 $1,638.00 $5,649.00 $4,943.00 nat. median
$441
outlier · 11.2×
27786
CPT 		27786-distal Fibular Without Manipulation 4 $1,638.00 $5,649.00 $4,943.00 nat. median
$437
outlier · 11.3×
28470
CPT 		28470metatarsal Without Manipulation 4 $1,638.00 $5,649.00 $4,943.00 nat. median
$378
outlier · 13.1×
75635
CPT 		CT Angio Abdomen Aorta + Iliofemoral 4 $1,459.00 $5,032.00 $4,403.00 nat. median
$719
outlier · 6.1×
73706
CPT 		CT Angio Lower Extremity Bilateral 4 $1,388.00 $4,785.00 $4,187.00 nat. median
$756
outlier · 5.5×
73206
CPT 		CT Angio Upper Extremity Bilateral 4 $1,388.00 $4,785.00 $4,187.00 nat. median
$696
outlier · 6.0×
74175
CPT 		CT Angio Abdomen 4 $1,388.00 $4,785.00 $4,187.00 nat. median
$721
outlier · 5.8×
70496
CPT 		CT Angio Brain/head 4 $1,356.00 $4,676.00 $4,091.50 nat. median
$760
outlier · 5.4×
71275
CPT 		CT Angio Chest Pe Protocol 4 $1,339.00 $4,618.00 $4,040.50 nat. median
$754
outlier · 5.4×
74178
CPT 		74178 CT Abdomen And Pelvis With + Without Contrast: Addon 4 $1,290.00 $4,447.00 $3,891.00 nat. median
$1,024
outlier · 3.8×
36569
CPT 		36569-picc Line Insertion Greater Than/equal To 5 Years 4 $1,283.00 $4,425.00 $3,872.00 nat. median
$1,713
outlier · 2.3×
12031
CPT 		12031-scalp/trunk/extremity Less Than/equal To 2.5 Cm 4 $1,265.00 $4,362.00 $3,817.00 nat. median
$485
outlier · 7.9×
26725
CPT 		26725-phalanx Shaft With Manipulation 4 $1,262.00 $4,350.00 $3,806.50 nat. median
$430
outlier · 8.9×
25500
CPT 		25500-radial Shaft Without Manipulation 4 $1,253.00 $4,320.00 $3,780.00 nat. median
$408
outlier · 9.3×
25560
CPT 		25560-radial & Ulnar Shaft Without Manipulation 4 $1,253.00 $4,320.00 $3,780.00 nat. median
$433
outlier · 8.7×
25530
CPT 		25530ulnar Shaft Without Manipulation 4 $1,253.00 $4,320.00 $3,780.00 nat. median
$401
outlier · 9.4×
28430
CPT 		28430talus Without Manipulation 4 $1,253.00 $4,320.00 $3,780.00 nat. median
$420
outlier · 9.0×
74176
CPT 		74176 CT Abdomen And Pelvis Without Contrast: Addon 4 $1,217.00 $4,195.00 $3,671.00 nat. median
$697
outlier · 5.3×
62321
CPT 		62321 Epidural Lumbar W/guid Imag 4 $1,165.00 $4,017.00 $3,514.50 nat. median
$1,091
outlier · 3.2×
13132
CPT 		13132-face/neck/hand/feet/genital 2.6-7.5 Cm 4 $1,131.00 $3,900.00 $3,412.50 nat. median
$863
outlier · 4.0×
12053
CPT 		12053-face/ear/eye/nose/lip 5.1-7.5 Cm 4 $1,088.00 $3,752.00 $3,283.00 nat. median
$579
outlier · 5.7×
36589
CPT 		Removal Tunneled Central Venou 4 $1,088.00 $3,750.00 $3,281.50 nat. median
$942
outlier · 3.5×
64405
CPT 		64405 Greater Occipital Nerve Block Mort 4 $1,083.00 $3,735.00 $3,268.50 nat. median
$480
outlier · 6.8×
10140
CPT 		10140-i&d Hematoma/seroma/fluid 4 $1,022.00 $3,525.00 $3,084.50 nat. median
$1,655
1.9× median
70498
CPT 		70498 CT Angio Neck With Contrast: Addon 4 $1,009.00 $3,479.00 $3,044.00 nat. median
$747
outlier · 4.1×
64479
CPT 		64479 Epidural Lumbar Subarach, C Or 4 $928.00 $3,201.00 $2,801.00 nat. median
$1,311
outlier · 2.1×
26641
CPT 		26641-carpometacarpal Thumb 4 $928.00 $3,201.00 $2,801.00 nat. median
$416
outlier · 6.7×
26720
CPT 		26720-phalanx Shaft Without Manipulation 4 $928.00 $3,201.00 $2,801.00 nat. median
$367
outlier · 7.6×
23500
CPT 		23500clavicular Without Manipulation 4 $928.00 $3,201.00 $2,801.00 nat. median
$392
outlier · 7.1×
26770
CPT 		26770-interphalangeal Hand Without Anesthesia 4 $916.00 $3,159.00 $2,764.00 nat. median
$404
outlier · 6.8×
12016
CPT 		12016-face/ear/eyelid/nose/lip 12.6-20.0 Cm 4 $905.00 $3,120.00 $2,730.00 nat. median
$532
outlier · 5.1×
74185
CPT 		MRA Abdomen With + Without Contrast 4 $891.00 $3,071.00 $2,687.00 nat. median
$1,279
outlier · 2.1×
70547
CPT 		MRA Neck Without Contrast 4 $891.00 $3,071.00 $2,687.00 nat. median
$763
outlier · 3.5×
70549
CPT 		MRA Neck With + Without Contrast 4 $891.00 $3,071.00 $2,687.00 nat. median
$1,063
outlier · 2.5×
70548
CPT 		MRA Neck With Contrast 4 $891.00 $3,071.00 $2,687.00 nat. median
$922
outlier · 2.9×
70544
CPT 		MRA Brain/head Without Contrast 4 $891.00 $3,071.00 $2,687.00 nat. median
$820
outlier · 3.3×
70546
CPT 		MRA Brain/head With + Without Contrast 4 $891.00 $3,071.00 $2,687.00 nat. median
$1,051
outlier · 2.6×
70545
CPT 		MRA Brain/head With Contrast 4 $891.00 $3,071.00 $2,687.00 nat. median
$903
outlier · 3.0×
32551
CPT 		32551-insertion Chest Tube 4 $870.00 $3,000.00 $2,625.00 nat. median
$1,569
1.7× median
87507
CPT 		Gi Profile, Stool, Pcr Lc 4 $866.00 $2,985.00 $2,612.00 nat. median
$558
outlier · 4.7×
55022020
CDM 		Room/bed: Inpatient 4 $826.00 $2,850.00 $2,494.00 nat. median
$2,494
1.0× median

Other procedures at this hospital

Browse this hospital's 1,969 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
             
109881610 CDM Tenecteplase 50 Mg Intravenous Injection[mort] 4 4 $28,179.00 $25,361.00 $8,172.00 $28,179.00 $26,065.50 2025-09-25
109863473 CDM Antivenin (Crotalidae Ovine) Polyvalent Intravenous Injection[mort] 4 4 $11,618.00 $10,456.00 $3,369.00 $11,618.00 $10,746.50 2025-09-25
36556 CPT 36556-central Line Greater Than/equal To 5 Years 4 4 $10,500.00 $9,450.00 $3,045.00 $10,500.00 $9,187.50 2025-09-25
59409 CPT 59409-vaginal Delivery Only 4 4 $7,080.00 $6,372.00 $2,053.00 $7,080.00 $6,195.00 2025-09-25
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 4 4 $6,873.00 $6,186.00 $1,993.00 $6,873.00 $6,014.00 2025-09-25
74174 CPT CT Angio Abdomen And Pelvis 4 4 $6,806.00 $6,125.00 $1,974.00 $6,806.00 $5,955.00 2025-09-25
25605 CPT 25605-distal Radial With Manipulation 4 4 $6,506.00 $5,855.00 $1,887.00 $6,506.00 $5,692.50 2025-09-25
109866884 CDM Denosumab (Prolia) 60 Mg/ml Subcutaneous Solution 1 Ml[mort] 4 4 $6,430.00 $5,787.00 $1,865.00 $6,430.00 $5,948.00 2025-09-25
25600 CPT 25600-distal Radial Without Manipulation 4 4 $5,649.00 $5,084.00 $1,638.00 $5,649.00 $4,943.00 2025-09-25
28470 CPT 28470metatarsal Without Manipulation 4 4 $5,649.00 $5,084.00 $1,638.00 $5,649.00 $4,943.00 2025-09-25
27786 CPT 27786-distal Fibular Without Manipulation 4 4 $5,649.00 $5,084.00 $1,638.00 $5,649.00 $4,943.00 2025-09-25
109870025 CDM Ferric Carboxymaltose (As Elemental Iron) 50 Mg/ml Intravenous Solution 15 Ml[mo… 4 4 $5,361.00 $4,825.00 $1,555.00 $5,361.00 $4,959.00 2025-09-25
75635 CPT CT Angio Abdomen Aorta + Iliofemoral 4 4 $5,032.00 $4,529.00 $1,459.00 $5,032.00 $4,403.00 2025-09-25
74175 CPT CT Angio Abdomen 4 4 $4,785.00 $4,307.00 $1,388.00 $4,785.00 $4,187.00 2025-09-25
73206 CPT CT Angio Upper Extremity Bilateral 4 4 $4,785.00 $4,307.00 $1,388.00 $4,785.00 $4,187.00 2025-09-25
73706 CPT CT Angio Lower Extremity Bilateral 4 4 $4,785.00 $4,307.00 $1,388.00 $4,785.00 $4,187.00 2025-09-25
70496 CPT CT Angio Brain/head 4 4 $4,676.00 $4,208.00 $1,356.00 $4,676.00 $4,091.50 2025-09-25
71275 CPT CT Angio Chest Pe Protocol 4 4 $4,618.00 $4,156.00 $1,339.00 $4,618.00 $4,040.50 2025-09-25
74178 CPT 74178 CT Abdomen And Pelvis With + Without Contrast: Addon 4 4 $4,447.00 $4,002.00 $1,290.00 $4,447.00 $3,891.00 2025-09-25
36569 CPT 36569-picc Line Insertion Greater Than/equal To 5 Years 4 4 $4,425.00 $3,983.00 $1,283.00 $4,425.00 $3,872.00 2025-09-25
12031 CPT 12031-scalp/trunk/extremity Less Than/equal To 2.5 Cm 4 4 $4,362.00 $3,926.00 $1,265.00 $4,362.00 $3,817.00 2025-09-25
26725 CPT 26725-phalanx Shaft With Manipulation 4 4 $4,350.00 $3,915.00 $1,262.00 $4,350.00 $3,806.50 2025-09-25
28430 CPT 28430talus Without Manipulation 4 4 $4,320.00 $3,888.00 $1,253.00 $4,320.00 $3,780.00 2025-09-25
25560 CPT 25560-radial & Ulnar Shaft Without Manipulation 4 4 $4,320.00 $3,888.00 $1,253.00 $4,320.00 $3,780.00 2025-09-25
25500 CPT 25500-radial Shaft Without Manipulation 4 4 $4,320.00 $3,888.00 $1,253.00 $4,320.00 $3,780.00 2025-09-25
25530 CPT 25530ulnar Shaft Without Manipulation 4 4 $4,320.00 $3,888.00 $1,253.00 $4,320.00 $3,780.00 2025-09-25
74176 CPT 74176 CT Abdomen And Pelvis Without Contrast: Addon 4 4 $4,195.00 $3,776.00 $1,217.00 $4,195.00 $3,671.00 2025-09-25
62321 CPT 62321 Epidural Lumbar W/guid Imag 4 4 $4,017.00 $3,615.00 $1,165.00 $4,017.00 $3,514.50 2025-09-25
13132 CPT 13132-face/neck/hand/feet/genital 2.6-7.5 Cm 4 4 $3,900.00 $3,510.00 $1,131.00 $3,900.00 $3,412.50 2025-09-25
12053 CPT 12053-face/ear/eye/nose/lip 5.1-7.5 Cm 4 4 $3,752.00 $3,377.00 $1,088.00 $3,752.00 $3,283.00 2025-09-25
36589 CPT Removal Tunneled Central Venou 4 4 $3,750.00 $3,375.00 $1,088.00 $3,750.00 $3,281.50 2025-09-25
64405 CPT 64405 Greater Occipital Nerve Block Mort 4 4 $3,735.00 $3,362.00 $1,083.00 $3,735.00 $3,268.50 2025-09-25
10140 CPT 10140-i&d Hematoma/seroma/fluid 4 4 $3,525.00 $3,173.00 $1,022.00 $3,525.00 $3,084.50 2025-09-25
70498 CPT 70498 CT Angio Neck With Contrast: Addon 4 4 $3,479.00 $3,131.00 $1,009.00 $3,479.00 $3,044.00 2025-09-25
26641 CPT 26641-carpometacarpal Thumb 4 4 $3,201.00 $2,881.00 $928.00 $3,201.00 $2,801.00 2025-09-25
23500 CPT 23500clavicular Without Manipulation 4 4 $3,201.00 $2,881.00 $928.00 $3,201.00 $2,801.00 2025-09-25
64479 CPT 64479 Epidural Lumbar Subarach, C Or 4 4 $3,201.00 $2,881.00 $928.00 $3,201.00 $2,801.00 2025-09-25
26720 CPT 26720-phalanx Shaft Without Manipulation 4 4 $3,201.00 $2,881.00 $928.00 $3,201.00 $2,801.00 2025-09-25
26770 CPT 26770-interphalangeal Hand Without Anesthesia 4 4 $3,159.00 $2,843.00 $916.00 $3,159.00 $2,764.00 2025-09-25
12016 CPT 12016-face/ear/eyelid/nose/lip 12.6-20.0 Cm 4 4 $3,120.00 $2,808.00 $905.00 $3,120.00 $2,730.00 2025-09-25
70545 CPT MRA Brain/head With Contrast 4 4 $3,071.00 $2,764.00 $891.00 $3,071.00 $2,687.00 2025-09-25
70544 CPT MRA Brain/head Without Contrast 4 4 $3,071.00 $2,764.00 $891.00 $3,071.00 $2,687.00 2025-09-25
70549 CPT MRA Neck With + Without Contrast 4 4 $3,071.00 $2,764.00 $891.00 $3,071.00 $2,687.00 2025-09-25
74185 CPT MRA Abdomen With + Without Contrast 4 4 $3,071.00 $2,764.00 $891.00 $3,071.00 $2,687.00 2025-09-25
70547 CPT MRA Neck Without Contrast 4 4 $3,071.00 $2,764.00 $891.00 $3,071.00 $2,687.00 2025-09-25
70546 CPT MRA Brain/head With + Without Contrast 4 4 $3,071.00 $2,764.00 $891.00 $3,071.00 $2,687.00 2025-09-25
70548 CPT MRA Neck With Contrast 4 4 $3,071.00 $2,764.00 $891.00 $3,071.00 $2,687.00 2025-09-25
32551 CPT 32551-insertion Chest Tube 4 4 $3,000.00 $2,700.00 $870.00 $3,000.00 $2,625.00 2025-09-25
87507 CPT Gi Profile, Stool, Pcr Lc 4 4 $2,985.00 $2,687.00 $866.00 $2,985.00 $2,612.00 2025-09-25
62323 CPT Injection(s) Of Therapeutic Substance 6 3 $2,914.00 $2,622.50 $493.00 $3,715.00 $1,487.50 2025-09-25
64483 CPT Injection(s) Of Anesthetic Into Lower Spine Using Imaging Guidance 6 3 $2,905.00 $2,614.50 $493.00 $3,699.00 $1,487.50 2025-09-25
55022020 CDM Room/bed: Inpatient 4 4 $2,850.00 $2,565.00 $826.00 $2,850.00 $2,494.00 2025-09-25
33209000 CDM E8342 Aph Plt Acda>pasc Lr Psoralen 2 4 4 $2,818.00 $2,536.00 $817.00 $2,818.00 $2,465.50 2025-09-25
10160 CPT 10160-aspiration Abscess/cyst/hematoma 4 4 $2,814.00 $2,533.00 $816.00 $2,814.00 $2,462.50 2025-09-25
10348001 CDM Rt Ventilator Services Initial Charge 4 4 $2,796.00 $2,516.00 $811.00 $2,796.00 $2,446.50 2025-09-25
36430 CPT 36430 Tr Blood Adm 0-16 Hours Mort 16 4 $2,787.50 $2,509.00 $371.00 $3,578.00 $2,242.00 2025-09-25
65220 CPT 65220-corneal Without Slit Lamp 4 4 $2,636.00 $2,372.00 $764.00 $2,636.00 $2,306.50 2025-09-25
65222 CPT 65222-corneal W/slit Lamp 4 4 $2,636.00 $2,372.00 $764.00 $2,636.00 $2,306.50 2025-09-25
94002 CPT Rt Bipap Charge 4 4 $2,636.00 $2,372.00 $764.00 $2,636.00 $2,306.50 2025-09-25
62329 CPT 62329 Lumbar Puncture/csf With Fluoro 4 4 $2,625.00 $2,363.00 $761.00 $2,625.00 $2,297.00 2025-09-25
93306 CPT US Echocardiogram Complete With Color 4 4 $2,588.00 $2,329.00 $751.00 $2,588.00 $2,264.50 2025-09-25
70552 CPT MRI Brain With Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73722 CPT MRI Le Joint With Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72148 CPT MRI Scan Of Lower Spinal Canal 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
70542 CPT MRI Face Neck Orbit With Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
70540 CPT MRI Face Neck Orbit Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
70543 CPT MRI Face Neck Orbit With + Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72197 CPT MRI Pelvis With + Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72156 CPT MRI Spine Cervical With + Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73220 CPT MRI Upper Extremity With + Without Cnt Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73222 CPT MRI Ue Joint With Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73218 CPT MRI Upper Extremity Without Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
70551 CPT MRI Brain Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72196 CPT MRI Pelvis With Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73221 CPT MRI Ue Joint Without Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73223 CPT MRI Ue Joint With + Without Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73721 CPT MRI Scan Of Leg Joint 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72146 CPT MRI Spine Thoracic Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73720 CPT MRI Lower Extremity With + Without Cnt Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
74182 CPT MRI Abdomen With Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72147 CPT MRI Spine Thoracic With Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73719 CPT MRI Lower Extremity With Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73219 CPT MRI Upper Extremity With Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72141 CPT MRI Spine Cervical Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
74181 CPT MRI Abdomen Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72195 CPT MRI Pelvis Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73718 CPT MRI Lower Extremity Without Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72142 CPT MRI Spine Cervical With Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
74183 CPT MRI Abdomen With + Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72157 CPT MRI Spine Thoracic With + Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72149 CPT MRI Spine Lumbar With Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
73723 CPT MRI Le Joint With + Without Contrast Left 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
72158 CPT MRI Spine Lumbar With + Without Contrast 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
70553 CPT MRI Scan 4 4 $2,562.00 $2,306.00 $743.00 $2,562.00 $2,242.00 2025-09-25
31720 CPT N/t Suctioning 4 4 $2,470.00 $2,223.00 $716.00 $2,470.00 $2,161.50 2025-09-25
26700 CPT 26700-metacarpophalangeal/knuckle 4 4 $2,403.00 $2,163.00 $697.00 $2,403.00 $2,103.00 2025-09-25
12015 CPT 12015-face/ear/eyelid/nose/lip 7.6-12.5 Cm 4 4 $2,403.00 $2,163.00 $697.00 $2,403.00 $2,103.00 2025-09-25
11106 CPT 11106 Incal Bx Skn Single Lesion Mort 4 4 $2,400.00 $2,160.00 $696.00 $2,400.00 $2,100.00 2025-09-25
93975 CPT US Renal Artery Duplex Bilateral 4 4 $2,330.00 $2,097.00 $676.00 $2,330.00 $2,039.00 2025-09-25
12014 CPT 12014-face/ear/eyelid/nose/lip 5.1-7.5 Cm 4 4 $2,304.00 $2,074.00 $668.00 $2,304.00 $2,016.00 2025-09-25
93923 CPT US Abi Complete Bilateral 8 4 $2,233.00 $2,009.50 $619.00 $2,330.00 $1,951.50 2025-09-25
70491 CPT CT Neck Soft Tissue With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
71260 CPT CT Chest With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
73702 CPT CT Lower Extremity W/+without Contrast Left 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70481 CPT CT Iac With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
74170 CPT CT Abdomen With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70492 CPT CT Neck Soft Tissue With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70490 CPT CT Neck Soft Tissue Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70488 CPT CT Maxillofacial With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70487 CPT CT Maxillofacial With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70482 CPT CT Iac With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70480 CPT CT Iac Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70460 CPT CT Head With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
74160 CPT CT Abdomen With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72193 CPT CT Scan Of Pelvis With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72132 CPT CT Spine Lumbar With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
71270 CPT CT Chest With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72192 CPT CT Pelvis Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72131 CPT CT Spine Lumbar Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70470 CPT CT Head With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
73700 CPT CT Lower Extremity Without Contrast Left 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
73202 CPT CT Upper Extremity W/+without Contrast Left 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72194 CPT CT Pelvis With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
73701 CPT CT Lower Extremity With Contrast Left 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
70486 CPT CT Maxillofacial Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
74150 CPT CT Abdomen Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72130 CPT CT Spine Thoracic With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
73200 CPT CT Upper Extremity Without Contrast Left 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
73201 CPT CT Upper Extremity With Contrast Left 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72128 CPT CT Spine Thoracic Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
71250 CPT CT Chest Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72126 CPT CT Spine Cervical With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72133 CPT CT Spine Lumbar With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72129 CPT CT Spine Thoracic With Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72127 CPT CT Spine Cervical With + Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
72125 CPT CT Spine Cervical Without Contrast 4 4 $2,222.00 $2,000.00 $644.00 $2,222.00 $1,944.50 2025-09-25
12036 CPT 12036-scalp/trunk/extremity 20.1-30.0 Cm 4 4 $2,206.00 $1,985.00 $640.00 $2,206.00 $1,930.00 2025-09-25
109879608 CDM Remdesivir 100 Mg Intravenous Injection[mort] 4 4 $2,184.00 $1,966.00 $633.00 $2,184.00 $2,020.50 2025-09-25
109866841 CDM Daptomycin 500 Mg Intravenous Injection[mort] 4 4 $2,138.00 $1,924.00 $620.00 $2,138.00 $1,977.50 2025-09-25
93926 CPT US Lower Ext Arterial Duplex Left 4 4 $2,136.00 $1,922.00 $619.00 $2,136.00 $1,869.00 2025-09-25
93970 CPT US Lower Ext Venous Duplex Bilateral 4 4 $2,136.00 $1,922.00 $619.00 $2,136.00 $1,869.00 2025-09-25
93880 CPT US Carotid Duplex Bilateral 4 4 $2,136.00 $1,922.00 $619.00 $2,136.00 $1,869.00 2025-09-25
93931 CPT US Upper Ext Arterial Duplex Left 4 4 $2,136.00 $1,922.00 $619.00 $2,136.00 $1,869.00 2025-09-25
93930 CPT US Upper Ext Arterial Duplex Bilateral 4 4 $2,136.00 $1,922.00 $619.00 $2,136.00 $1,869.00 2025-09-25
93225 CPT 93225 Holter Complete 24-48 Hr Mort 20 4 $2,100.00 $1,890.00 $213.00 $3,360.00 $964.00 2025-09-25
49083 CPT 49083-abdominal Paracentesis With Imaging Guide 4 4 $2,067.00 $1,860.00 $599.00 $2,067.00 $1,808.50 2025-09-25
11403 CPT 11403 Excision, Benign Lesion Including Margins; Trunk, Arms Or Legs; 2.1-3.0cm 8 4 $2,057.00 $1,851.50 $56.00 $3,921.00 $665.00 2025-09-25
62272 CPT 62272 Lumbar Puncture/csf Without Fluoro 4 4 $2,036.00 $1,832.00 $590.00 $2,036.00 $1,781.50 2025-09-25
70450 CPT CT Scan 4 4 $2,017.00 $1,815.00 $585.00 $2,017.00 $1,764.50 2025-09-25
28515 CPT 28515-phalanx With Manipulation; Not Great Toe 4 4 $1,975.00 $1,778.00 $573.00 $1,975.00 $1,728.50 2025-09-25
99291 CPT 99291 Critical Care, Evaluation And Management Of The Critically Ill Or Critical… 8 4 $1,881.00 $1,693.00 $163.00 $3,200.00 $745.00 2025-09-25
62273 CPT 62273 Epidural Blood Patch 4 4 $1,875.00 $1,688.00 $544.00 $1,875.00 $1,641.00 2025-09-25
13133 CPT 13133-face/neck/hand/feet/genital Each Addl 5 Cm 4 4 $1,845.00 $1,661.00 $535.00 $1,845.00 $1,614.50 2025-09-25
71271 CPT CT Low Dose Lung Screening 4 4 $1,805.00 $1,625.00 $523.00 $1,805.00 $1,579.50 2025-09-25
99285 CPT 99285level 5 4 4 $1,800.00 $1,620.00 $522.00 $1,800.00 $1,575.00 2025-09-25
75571 CPT CT Heart Calcium Scoring 4 4 $1,787.00 $1,608.00 $518.00 $1,787.00 $1,563.50 2025-09-25
32556 CPT 32556 Pleural Drainage, Percutaneous, With Insertion Of Indwelling Catheter; Wit… 8 4 $1,750.00 $1,575.00 $145.00 $3,000.00 $685.00 2025-09-25
65210 CPT 65210external Eye 4 4 $1,749.00 $1,574.00 $507.00 $1,749.00 $1,530.50 2025-09-25
24640 CPT 24640 Closed Treatment Of Radial Head Subluxation In Child, Nursemaid Elbow, Wit… 8 4 $1,735.50 $1,562.00 $108.00 $3,099.00 $635.50 2025-09-25
62270 CPT 62270 Spinal Puncture,lumbar 4 4 $1,730.00 $1,557.00 $502.00 $1,730.00 $1,514.00 2025-09-25
76999 CPT US Soft Tissue 4 4 $1,714.00 $1,543.00 $497.00 $1,714.00 $1,500.00 2025-09-25
76536 CPT US Soft Tissue Head/neck 4 4 $1,714.00 $1,543.00 $497.00 $1,714.00 $1,500.00 2025-09-25
93971 CPT US Lower Ext Venous Duplex Left 4 4 $1,714.00 $1,543.00 $497.00 $1,714.00 $1,500.00 2025-09-25
93922 CPT US Abi Limited Bilateral 4 4 $1,714.00 $1,543.00 $497.00 $1,714.00 $1,500.00 2025-09-25
49082 CPT 49082 Peritoneocentesis, Abdominal P Mort 4 4 $1,707.00 $1,536.00 $495.00 $1,707.00 $1,493.50 2025-09-25
29085 CPT 29085-app Cast Hand And Lower Forearm (Gauntlet) 4 4 $1,696.00 $1,526.00 $492.00 $1,696.00 $1,484.00 2025-09-25
26750 CPT 26750-distal Phalangeal Without Manipulation 4 4 $1,696.00 $1,526.00 $492.00 $1,696.00 $1,484.00 2025-09-25
26600 CPT 26600clsd Tx Metacarpal Fracture Without Manip 4 4 $1,696.00 $1,526.00 $492.00 $1,696.00 $1,484.00 2025-09-25
29075 CPT 29065 Appl Cast Long Arm Cast Mort 8 4 $1,680.50 $1,512.50 $483.00 $1,696.00 $1,470.50 2025-09-25
29065 CPT 29065 Appl Cast Long Arm Cast 4 4 $1,665.00 $1,499.00 $483.00 $1,665.00 $1,457.00 2025-09-25
55038001 CDM Direct To Obs Charge 4 4 $1,661.00 $1,495.00 $63.00 $1,661.00 $947.00 2025-09-25
17110 CPT 17110 Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery,… 8 4 $1,643.50 $1,479.00 $98.00 $2,949.00 $596.50 2025-09-25
109878230 CDM Penicillin G Benzathine 1,200,000 Units/2 Ml Intramuscular Suspension 2 Ml[mort] 4 4 $1,569.00 $1,412.00 $455.00 $1,569.00 $1,451.50 2025-09-25
99284 CPT 99284level 4 4 4 $1,554.00 $1,399.00 $451.00 $1,554.00 $1,360.00 2025-09-25
12034 CPT 12034-scalp/trunk/extremity 7.6-12.5 Cm 4 4 $1,549.00 $1,394.00 $449.00 $1,549.00 $1,355.50 2025-09-25
12006 CPT 12006-scalp/neck/trunk/genital/extremity 20.1-30 Cm 4 4 $1,539.00 $1,385.00 $446.00 $1,539.00 $1,346.50 2025-09-25
35000451 CDM Pneumothorax Set 4 4 $1,511.00 $1,360.00 $438.00 $1,511.00 $1,322.00 2025-09-25
16030 CPT 16030-burn Dressings/debridement Large 4 4 $1,508.00 $1,357.00 $437.00 $1,508.00 $1,319.50 2025-09-25
16020 CPT 16020 Burn Small Dressing/debridemen Mort 8 4 $1,504.00 $1,353.50 $435.00 $1,508.00 $1,316.00 2025-09-25
10538101 CDM Rt Charge Pft -> Spirometry 4 4 $1,503.00 $1,353.00 $436.00 $1,503.00 $1,315.50 2025-09-25
17250 CPT 17250-chemical Cauterization Granulation Tissue 4 4 $1,500.00 $1,350.00 $435.00 $1,500.00 $1,312.50 2025-09-25
16025 CPT 16025-burn Dressings/debridement Medium 4 4 $1,500.00 $1,350.00 $435.00 $1,500.00 $1,312.50 2025-09-25
55022021 CDM Room/bed: Swing Bed 4 4 $1,500.00 $1,350.00 $435.00 $1,500.00 $1,312.50 2025-09-25
11640 CPT 11640 Excision, Malignant Lesion Fac Mort 4 4 $1,464.00 $1,318.00 $425.00 $1,464.00 $1,281.00 2025-09-25
25650 CPT 25650closed Tx Ulnar Styloid Fracture 4 4 $1,455.00 $1,310.00 $422.00 $1,455.00 $1,273.50 2025-09-25
30901 CPT 30901-anterior Simple 4 4 $1,452.00 $1,307.00 $421.00 $1,452.00 $1,270.50 2025-09-25
77002 CPT 77002 Fluoroscopic Guidance 4 4 $1,440.00 $1,296.00 $418.00 $1,440.00 $1,260.00 2025-09-25
32554 CPT 32554-thoracentesis Without Imaging Guidance 4 4 $1,421.00 $1,279.00 $412.00 $1,421.00 $1,243.50 2025-09-25
109872451 CDM Ioversol 74% Sol[mort] 4 4 $1,395.00 $1,256.00 $405.00 $1,395.00 $1,290.50 2025-09-25
30905 CPT 30905-posterior Initial 4 4 $1,395.00 $1,256.00 $405.00 $1,395.00 $1,221.00 2025-09-25
93017 CPT Stress Test 4 4 $1,392.00 $1,253.00 $404.00 $1,392.00 $1,218.00 2025-09-25
109869020 CDM Epinephrine 0.15 Mg Injectable Kit[mort] 4 4 $1,388.00 $1,249.00 $403.00 $1,388.00 $1,284.00 2025-09-25
12021 CPT 12021-superficial Dehiscence W/packing 4 4 $1,350.00 $1,215.00 $392.00 $1,350.00 $1,181.50 2025-09-25
50020612 CDM M0243 Casirivi And Imdevi Inj Mort 4 4 $1,350.00 $1,215.00 $392.00 $1,350.00 $1,181.50 2025-09-25
12041 CPT 12041-neck/hand/feet/genital Less Than/equal To 2.5 Cm 4 4 $1,319.00 $1,187.00 $383.00 $1,319.00 $1,154.00 2025-09-25
12035 CPT 12035 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; 12.6-2… 8 4 $1,283.00 $1,155.00 $215.00 $1,825.00 $704.00 2025-09-25
109879563 CDM Regadenoson 0.4 Mg/5 Ml Intravenous Solution 5 Ml[mort] 4 4 $1,237.00 $1,113.00 $359.00 $1,237.00 $1,144.00 2025-09-25
94625 CPT 94625 Kxpr -pulmonary Rehabilitation 4 4 $1,227.00 $1,104.00 $356.00 $1,227.00 $1,073.50 2025-09-25
0202U CPT Respiratory Pathogen Panel Lc 4 4 $1,213.00 $1,092.00 $352.00 $1,213.00 $1,061.50 2025-09-25
4100056 CDM E3056 Aph Plt Acda Lr Irr 1 4 4 $1,209.00 $1,088.00 $351.00 $1,209.00 $1,058.00 2025-09-25
50020610 CDM M0245 Bamian $ Etesev Infusion Mort 4 4 $1,200.00 $1,080.00 $348.00 $1,200.00 $1,050.00 2025-09-25
51700 CPT 51700 Irrigation Of Bladder Mort 4 4 $1,200.00 $1,080.00 $348.00 $1,200.00 $1,050.00 2025-09-25
29240 CPT 29240strapping Of Shoulder 8 4 $1,165.00 $1,048.50 $307.00 $1,273.00 $1,004.00 2025-09-25
11760 CPT 11760-repair Of Nail Bed 4 4 $1,104.00 $994.00 $320.00 $1,104.00 $966.00 2025-09-25
72114 CPT Xr Spine Lumbosacral With Bending 6+ Views 4 4 $1,066.00 $959.00 $309.00 $1,066.00 $932.50 2025-09-25
97163 CPT Pt Evaluation Units, High Complexity 4 4 $1,066.00 $959.00 $309.00 $1,066.00 $932.50 2025-09-25
99283 CPT 99283level 3 4 4 $1,058.00 $952.00 $307.00 $1,058.00 $925.50 2025-09-25
96413 CPT 96413 Obs-inf-complex/chemo Initial Mort 4 4 $1,057.00 $951.00 $307.00 $1,057.00 $924.50 2025-09-25
96415 CPT 96415 Tr-inf-complex/chemo Add'l Hour Mort 4 4 $1,057.00 $951.00 $307.00 $1,057.00 $924.50 2025-09-25
29550 CPT Pt Strapping Toes Units 4 4 $1,057.00 $951.00 $307.00 $1,057.00 $924.50 2025-09-25
29580 CPT Pt Unna Boot Units 4 4 $1,057.00 $951.00 $307.00 $1,057.00 $924.50 2025-09-25
29540 CPT Pt Strapping Ankle, Foot Units 4 4 $1,057.00 $951.00 $307.00 $1,057.00 $924.50 2025-09-25
29530 CPT Pt Strapping Knee Units 4 4 $1,057.00 $951.00 $307.00 $1,057.00 $924.50 2025-09-25
29260 CPT Pt Strapping Elbow, Wrist Units 4 4 $1,057.00 $951.00 $307.00 $1,057.00 $924.50 2025-09-25
11248203 CDM Cricothyrotomy Cath Set 4 4 $1,043.00 $939.00 $302.00 $1,043.00 $913.00 2025-09-25
30300 CPT 30300-intranasal 4 4 $1,025.00 $923.00 $297.00 $1,025.00 $897.00 2025-09-25
12052 CPT 12052-face/ear/eye/nose/lip 2.6-5.0 Cm 4 4 $1,022.00 $920.00 $296.00 $1,022.00 $894.50 2025-09-25
12051 CPT 12051-face/ear/eye/nose/lip Less Than/equal To 2.5 Cm 4 4 $1,022.00 $920.00 $296.00 $1,022.00 $894.50 2025-09-25
55037400 CDM Q0081 Adm Infusion Therapy 4-6 Hrs Mort 4 4 $1,017.00 $915.00 $295.00 $1,017.00 $889.50 2025-09-25
31500 CPT 31500-endotracheal Intubation 8 4 $1,013.00 $912.00 $236.00 $1,211.00 $774.50 2025-09-25
31886000 CDM E0332 Drbc Cpd As1 500 Lr Irr 4 4 $993.00 $894.00 $288.00 $993.00 $869.00 2025-09-25
43762 CPT 43762-replacement Of Gastrostomy Tube 4 4 $985.00 $887.00 $286.00 $985.00 $862.00 2025-09-25
72052 CPT Xr Spine Cervical 6+ Views 4 4 $967.00 $870.00 $280.00 $967.00 $846.00 2025-09-25
94660 CPT Rt Cpap Initial Charge 4 4 $964.00 $868.00 $280.00 $964.00 $843.50 2025-09-25
94762 CPT Rt Overnight Oximetry Charge 4 4 $961.00 $865.00 $279.00 $961.00 $841.00 2025-09-25
92950 CPT 92950-cardiopulmonary Resuscitation 4 4 $946.00 $851.00 $274.00 $946.00 $827.50 2025-09-25
29515 CPT 29515-short Leg 4 4 $942.00 $848.00 $273.00 $942.00 $824.50 2025-09-25
74022 CPT Xr Abdomen Series + Chest 1 View 4 4 $941.00 $847.00 $273.00 $941.00 $823.50 2025-09-25
84445 CPT Thyroid Stim Immunoglobulin Lc 4 4 $940.00 $846.00 $273.00 $940.00 $822.50 2025-09-25
64400 CPT 64400-injection Nerve Block Trigeminal 4 4 $936.00 $842.00 $271.00 $936.00 $819.00 2025-09-25
109870765 CDM Gadoterate Meglumine 7.5mmol/15ml (Clariscan) Sol [Mort] 4 4 $891.00 $802.00 $258.00 $891.00 $824.00 2025-09-25
72050 CPT Xr Spine Cervical 4 Or 5 Views 4 4 $884.00 $796.00 $256.00 $884.00 $773.50 2025-09-25
72110 CPT X-ray Of Lower Back 4 4 $884.00 $796.00 $256.00 $884.00 $773.50 2025-09-25
29705 CPT 29705-remove/bivalving Cast Full Arm/leg 4 4 $881.00 $793.00 $255.00 $881.00 $771.00 2025-09-25
109875190 CDM Methylnaltrexone 12 Mg/0.6 Ml Sol [Mort] 4 4 $874.00 $787.00 $253.00 $874.00 $808.50 2025-09-25
71111 CPT Xr Ribs 4+ Views Bilat With Pa Chest 4 4 $874.00 $787.00 $253.00 $874.00 $765.00 2025-09-25
97162 CPT Pt Evaluation Units, Moderate Complexity 4 4 $864.00 $778.00 $251.00 $864.00 $756.00 2025-09-25
10060 CPT 10060 Incision And Drainage Of Abscess; Simple Or Single 12 4 $856.00 $770.00 $52.00 $2,355.00 $705.50 2025-09-25
73564 CPT Xr Knee Complete 4+ Views Bilateral 8 4 $850.50 $765.50 $224.00 $929.00 $733.50 2025-09-25
31885000 CDM E0226 Arbc Cpda1 500 Lr 4 4 $843.00 $759.00 $244.00 $843.00 $738.00 2025-09-25
12004 CPT 12004-scalp/neck/trunk/genital/extremity 7.6-12.5 Cm 4 4 $839.00 $755.00 $243.00 $839.00 $734.00 2025-09-25
12011 CPT 12011-face/ear/eyelid/nose/lip Less Than/equal To 2.5 Cm 4 4 $839.00 $755.00 $243.00 $839.00 $734.00 2025-09-25
55037300 CDM Q0081 Adm Infusion Therapy 2 To 4 Hr Mort 4 4 $828.00 $745.00 $240.00 $828.00 $724.50 2025-09-25
30906 CPT 30906-posterior Subsequent 4 4 $825.00 $743.00 $239.00 $825.00 $722.00 2025-09-25
12005 CPT 12005-scalp/neck/trunk/genital/extremity 12.6-20.0 Cm 4 4 $810.00 $729.00 $235.00 $810.00 $709.00 2025-09-25
29105 CPT 29105 Application Long Arm Splint Mort 8 4 $808.50 $728.00 $186.00 $975.00 $610.00 2025-09-25
13150 CPT 13150 Repair, Complex, Eyelids, Nose, Ears And/or Lips; 1.0 Cm Or Less 4 4 $788.00 $709.00 $229.00 $788.00 $689.50 2025-09-25
70130 CPT Xr Mastoids Complete 4 4 $782.00 $704.00 $227.00 $782.00 $684.50 2025-09-25
10874180 CDM Walker Diabetic Boot Sm/md 4 4 $760.00 $684.00 $220.00 $760.00 $665.00 2025-09-25
94060 CPT Pft 4 4 $756.00 $680.00 $219.00 $756.00 $661.50 2025-09-25
20520 CPT 20520-removal Body Muscle Sheath; Simple 4 4 $754.00 $679.00 $219.00 $754.00 $660.00 2025-09-25
70260 CPT Xr Skull Complete 4 4 $752.00 $677.00 $218.00 $752.00 $658.00 2025-09-25
70110 CPT Xr Mandible Complete 4+ Views 4 4 $752.00 $677.00 $218.00 $752.00 $658.00 2025-09-25
109869068 CDM Epinephrine 0.3 Mg Injectable Kit[mort] 4 4 $750.00 $675.00 $217.00 $750.00 $694.00 2025-09-25
99152 CPT 99152-same Md First 15 Mins Greater Than/equal To 5 Yrs 4 4 $750.00 $675.00 $217.00 $750.00 $656.50 2025-09-25
16000 CPT 16000-initial Treatment First Degree Burn 4 4 $750.00 $675.00 $217.00 $750.00 $656.50 2025-09-25
87801 CPT Nuswab Bv And Candida, Naa Lc 4 4 $744.00 $670.00 $216.00 $744.00 $651.00 2025-09-25
76700 CPT Ultrasound Of Abdomen 4 4 $735.00 $662.00 $213.00 $735.00 $643.50 2025-09-25
109874063 CDM Linezolid 600 Mg Oral Tablet[mort] 4 4 $732.00 $659.00 $212.00 $732.00 $677.00 2025-09-25
109877785 CDM Oseltamivir 6 Mg/ml Oral Suspension 60 Ml[mort] 4 4 $729.00 $656.00 $211.00 $729.00 $674.50 2025-09-25
93226 CPT 93226 Holter Scanning Analysis W/report 24-48 Hr Mort 4 4 $726.00 $653.00 $211.00 $726.00 $635.00 2025-09-25
109862357 CDM Albumin Human 25% Intravenous Solution 100 Ml[mort] 4 4 $720.00 $648.00 $209.00 $720.00 $666.00 2025-09-25
27012345 CDM Rt Oxygen Therapy Subsequent Charge 4 4 $720.00 $648.00 $209.00 $720.00 $630.00 2025-09-25
11114000 CDM Rt Oxygen Therapy Initial Charge 4 4 $720.00 $648.00 $209.00 $720.00 $630.00 2025-09-25
72072 CPT Xr Spine Thoracic 3 Views 4 4 $719.00 $647.00 $209.00 $719.00 $629.00 2025-09-25
71101 CPT Xr Ribs Right With Pa Chest 4 4 $712.00 $641.00 $206.00 $712.00 $623.00 2025-09-25
97161 CPT Pt Evaluation Units, Low Complexity 4 4 $711.00 $640.00 $206.00 $711.00 $622.00 2025-09-25
10611253 CDM Ez-io 15mm Intraosseous Needle Kit Pink 4 4 $710.00 $639.00 $206.00 $710.00 $621.50 2025-09-25
10611255 CDM Ez-io 45mm Intraosseous Needle Set Yello 4 4 $710.00 $639.00 $206.00 $710.00 $621.50 2025-09-25
35001059 CDM Aspiration Sets Pnemo Aspiration 4 4 $706.00 $635.00 $205.00 $706.00 $617.50 2025-09-25
70330 CPT Xr Tmj Open And Closed Bilateral 4 4 $705.00 $635.00 $204.00 $705.00 $617.00 2025-09-25
11263912 CDM Thoracolumbar Support (40-46) Large 4 4 $704.00 $634.00 $204.00 $704.00 $616.00 2025-09-25
11263914 CDM Thoracolumbar Support (32-38) Md 4 4 $704.00 $634.00 $204.00 $704.00 $616.00 2025-09-25
59426 CPT 59426 Antepartum Care Only; 7 Or More Visits 4 4 $700.00 $630.00 $203.00 $700.00 $612.50 2025-09-25
109872357 CDM Iohexol 350 Mg/ml Injectable Solution 50 Ml[mort] 4 4 $696.00 $626.00 $202.00 $696.00 $643.50 2025-09-25
71130 CPT Xr Sternoclavicular Joint(s) 4 4 $695.00 $626.00 $202.00 $695.00 $608.50 2025-09-25
72082 CPT Xr Spine Scoliosis 2-3 Views 4 4 $695.00 $626.00 $202.00 $695.00 $608.50 2025-09-25
72081 CPT Xr Spine Scoliosis 4-5 Views 4 4 $686.00 $617.00 $199.00 $686.00 $600.00 2025-09-25
72080 CPT Xr Spine Thoracolumbar 2+ Views 4 4 $686.00 $617.00 $199.00 $686.00 $600.00 2025-09-25
29505 CPT 29505-long Leg 4 4 $684.00 $616.00 $198.00 $684.00 $598.50 2025-09-25
29126 CPT 29126short Arm (Forearm To Hand) 4 4 $684.00 $616.00 $198.00 $684.00 $598.50 2025-09-25
71110 CPT Xr Ribs 3 Views Bilateral 4 4 $680.00 $612.00 $197.00 $680.00 $595.00 2025-09-25
70150 CPT Xr Facial Bones 3+ Views 4 4 $676.00 $608.00 $196.00 $676.00 $591.50 2025-09-25
96360 CPT 96360 Tr IV Hydration 1st Hour Mort 8 4 $670.50 $603.50 $176.00 $735.00 $575.50 2025-09-25
93015 CPT Stress Test Treadmill Only 4 4 $669.00 $602.00 $194.00 $669.00 $585.50 2025-09-25
96365 CPT 96365 IV Infusion 1st Hour Charge 12 4 $664.00 $598.00 $176.00 $827.00 $581.00 2025-09-25
96409 CPT 96409 Tr Chemo/cmpx IV Push Initial Mort 4 4 $661.00 $595.00 $192.00 $661.00 $578.50 2025-09-25
76705 CPT 76705 US Abdomen Limited 4 4 $661.00 $595.00 $192.00 $661.00 $578.50 2025-09-25
76604 CPT US Chest 4 4 $661.00 $595.00 $192.00 $661.00 $578.50 2025-09-25
92523 CPT Slp Eval Lang Comprehension,express Unit 4 4 $654.00 $589.00 $190.00 $654.00 $572.50 2025-09-25
92611 CPT Slp Fluoroscopic Evaluation Units 4 4 $654.00 $589.00 $190.00 $654.00 $572.50 2025-09-25
70200 CPT Xr Orbits Complete 4 4 $649.00 $584.00 $188.00 $649.00 $568.00 2025-09-25
73521 CPT Xr Hips 2 Views W/ap Pelvis Bilat 4 4 $641.00 $577.00 $186.00 $641.00 $561.00 2025-09-25
73522 CPT Xr Hips 3-4 Views W/ap Pelvis Bilat 4 4 $641.00 $577.00 $186.00 $641.00 $561.00 2025-09-25
10946206 CDM Mask Full Face Vented (Large) 4 4 $640.00 $576.00 $186.00 $640.00 $560.00 2025-09-25
10946205 CDM Mask Full Face Vented (Medium) 4 4 $640.00 $576.00 $186.00 $640.00 $560.00 2025-09-25
55037200 CDM Q0081 Adm Infusion Therapy(other Tha Mort 4 4 $640.00 $576.00 $186.00 $640.00 $560.00 2025-09-25
10946204 CDM Mask Full Vented (Small) 4 4 $640.00 $576.00 $186.00 $640.00 $560.00 2025-09-25
109876392 CDM Multiple Vitamins Intravenous Solution 5 Ml[mort] 4 4 $634.00 $571.00 $184.00 $634.00 $586.50 2025-09-25
99195 CPT 99195 Phlebotomy Mort 4 4 $630.00 $567.00 $183.00 $630.00 $551.50 2025-09-25
See an error in this hospital's data? Submit a correction