Hospital

CASEY COUNTY HOSPITAL

Liberty, KY · CCN 181309 · Rates published

1,085 distinct procedures filed

32 distinct payers

46,547 rate rows

2026-09-21 last MRF observed

Data quality

46,300 of 46,547 rate rows are consumer-grade (99.5%)

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

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	130
template filing: same amount across many unrelated codes — excluded	56
exceeds 10× this hospital's gross charge — excluded from medians	46
per-diem day rate — not a per-procedure price	8
placeholder amount (≤ $0.02) — excluded from medians	7

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

Source MRF file	https://www.caseycountyhospital.com/Content/Uploads/caseycountyhospital.com/files/061705652_Casey-County-Hospital_standardcharges(1).csv
Found on page	https://caseycountyhospital.com/patient-information/price-transparency
Discovered via	CMS hospital list
Last fetch	success · 2026-09-21
Content fingerprint	586ed7f59f96b4a2… · 2,203,069 bytes · first seen 2026-09-21

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
J1162 HCPCS	Digifab 40mg Vial	2	$7,073.58	$11,712.00	$9,392.79	nat. median $6,265 1.5× median
J0840 HCPCS	Crofab Antiven 1gm	2	$5,473.34	$9,062.42	$7,267.88	nat. median $3,496 outlier · 2.1×
44340 CPT	Revision Colostomy S	2	$2,277.65	$3,771.19	$3,024.42	nat. median $3,672 0.8× median
86215 CPT	Antidnase B Strep Ab	3	$10.85	$3,346.13	$2,020.93	nat. median $19 outlier · 108.9×
36573 CPT	Pf Picc Insertion	5	$222.34	$2,174.00	$1,700.00	nat. median $1,965 0.9× median
11624 CPT	Exc Mal Les 3.1-4.0	5	$523.00	$2,174.00	$1,656.64	nat. median $1,670 1.0× median
11426 CPT	Exc Lesion Over 4.0	5	$183.61	$2,288.00	$1,443.50	nat. median $2,896 outlier · 0.5×
27536 CPT	Open Treat/tibial Fx	2	$1,024.80	$1,696.80	$1,360.80	nat. median $5,737 outlier · 0.2×
11424 CPT	Exc Lesion 3.1-4.0	5	$320.86	$2,174.00	$1,352.63	nat. median $1,708 0.8× median
11406 CPT	Exc Lesion Over 4.0	5	$176.90	$2,174.00	$1,348.50	nat. median $1,719 0.8× median
11423 CPT	Exc Lesion 2.1-3.0	5	$183.61	$2,174.00	$1,348.50	nat. median $1,640 0.8× median
J1670 HCPCS	Hep. B 1mm Glob. 5ml	2	$999.88	$1,655.54	$1,327.71	nat. median $753 1.8× median
11011 CPT	Debridement Mus Fascia	4	$196.42	$1,258.00	$1,258.00	nat. median $965 1.3× median
36556 CPT	Cen Line Place >5yrs	5	$391.00	$3,096.66	$1,258.00	nat. median $2,885 outlier · 0.4×
59409 CPT	Vaginal Delivery	2	$911.95	$1,509.95	$1,210.95	nat. median $3,106 outlier · 0.4×
73702 CPT	CT Lower E W&without C B	5	$102.48	$3,593.58	$1,114.01	nat. median $369 outlier · 3.0×
73202 CPT	CT Upper E W&without C B	5	$102.48	$3,377.44	$1,094.36	nat. median $399 outlier · 2.7×
73701 CPT	CT Lower Ex W/con Bi	5	$97.60	$3,236.04	$1,059.01	nat. median $390 outlier · 2.7×
11643 CPT	Exc Mal Les 2.1-3.0	5	$391.00	$1,258.00	$1,046.63	nat. median $1,551 0.7× median
11603 CPT	Exc Mal Les 2.1-3.0	5	$391.00	$1,258.00	$986.04	nat. median $782 1.3× median
11641 CPT	Exc Mal Les 0.6-1.0	5	$391.00	$1,258.00	$978.46	nat. median $737 1.3× median
11640 CPT	Exc Mal Les 0.5-less	5	$391.00	$1,258.00	$970.88	nat. median $716 1.4× median
0110 RC		1	$952.50	$952.50	$952.50	nat. median $855 1.1× median
0120 RC		1	$945.60	$945.60	$945.60	nat. median $856 1.1× median
73201 CPT	CT Upper Ex W/con Bi	5	$97.60	$2,957.28	$941.18	nat. median $516 1.8× median
99291 CPT	Critical Care 30-74 Min	3	$500.00	$1,552.37	$937.57	nat. median $1,120 0.8× median
11622 CPT	Exc Mal Les 1.1-2.0	5	$366.61	$1,258.00	$932.50	nat. median $756 1.2× median
11621 CPT	Exc Mal Les 0.6-1.0	5	$366.61	$1,258.00	$932.50	nat. median $723 1.3× median
73700 CPT	CT Lower Ex Without C Bi	5	$91.50	$2,656.30	$914.08	nat. median $238 outlier · 3.8×
75635 CPT	CTA Abd W/run Off	5	$165.97	$1,157.96	$907.00	nat. median $355 outlier · 2.6×
11600 CPT	Exc Mal Les 0.5-less	5	$320.86	$1,258.00	$894.63	nat. median $731 1.2× median
15050 CPT	Pinch Graft Up To 2cm	5	$50.00	$1,258.00	$884.03	nat. median $744 1.2× median
11620 CPT	Exc Mal Les 0.5-less	5	$275.11	$1,258.00	$856.75	nat. median $1,488 0.6× median
13120 CPT	Complex Rep 1.1-2.5	5	$50.00	$1,138.00	$849.78	nat. median $629 1.4× median
11442 CPT	Exc Lesion 1.1-2.0	5	$247.66	$1,258.00	$834.03	nat. median $750 1.1× median
11441 CPT	Exc Lesion 0.6-1.0	5	$211.06	$1,258.00	$824.50	nat. median $716 1.2× median
11440 CPT	Exc Lesion 0.5-less	5	$100.65	$1,258.00	$824.50	nat. median $723 1.1× median
11421 CPT	Exc Lesion 0.6-1.0	5	$165.31	$1,258.00	$824.50	nat. median $750 1.1× median
11420 CPT	Exc Lesion 2.5-less	5	$109.80	$1,258.00	$824.50	nat. median $1,633 0.5× median
11403 CPT	Exc Lesion 2.1-3.0	5	$183.61	$1,258.00	$824.50	nat. median $740 1.1× median
11402 CPT	Exc Lesion 1.1-2.0	5	$156.16	$1,258.00	$824.50	nat. median $732 1.1× median
11976 CPT	Rem Contraceptives	5	$220.21	$1,258.00	$824.50	nat. median $692 1.2× median
20520 CPT	Rem Foreign Body Mus	5	$124.44	$1,258.00	$824.50	nat. median $1,491 0.6× median
12034 CPT	Intermed Rep 7.6-12.5	5	$50.00	$1,138.00	$811.90	nat. median $520 1.6× median
12052 CPT	Intermed Rep 2.6-5.0	5	$50.00	$1,138.00	$796.75	nat. median $488 1.6× median
12042 CPT	Intermed Rep 2.6-7.5	5	$50.00	$1,138.00	$781.61	nat. median $494 1.6× median
12032 CPT	Intermed Rep 2.6-7.5	5	$50.00	$1,138.00	$758.88	nat. median $519 1.5× median
P9036 HCPCS	Platelet Apheresis Irradiated	4	$571.12	$945.63	$758.38	nat. median $758 1.0× median
49083 CPT	Paracentesis W/image	5	$79.15	$793.36	$743.00	nat. median $1,052 0.7× median
12041 CPT	Intermed Rep 2.5-less	5	$50.00	$1,138.00	$721.00	nat. median $457 1.6× median

Other procedures at this hospital

Browse this hospital's 1,085 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

0110	RC	—	4	1	$1,234.00	$863.80 30% off	$952.50	$952.50	$952.50	2026-09-21
0120	RC	—	4	1	$940.00	$752.00 20% off	$945.60	$945.60	$945.60	2026-09-21
0450	RC	—	12	5	$242.00	$193.60 20% off	$147.62	$732.25	$158.71	2026-09-21
10021	CPT	Fine Needle Aspirat	8	5	$240.00	$192.00 20% off	$146.40	$242.40	$242.00	2026-09-21
10080	CPT	I & D Pilonidal Cyst	4	4	$107.00	$85.60 20% off	$65.27	$391.00	$168.10	2026-09-21
10160	CPT	Puncture Hematoma	8	5	$219.63	$175.70 20% off	$133.97	$221.83	$147.41	2026-09-21
11011	CPT	Debridement Mus Fascia	7	4	$322.00	$257.60	$196.42	$1,258.00	$1,258.00	2026-09-21
11055	CPT	Paring/cutting Lesion	8	5	$150.00	$120.00 20% off	$50.00	$1,138.00	$644.75	2026-09-21
11200	CPT	Exc Skin Tags To 15	8	5	$129.00	$103.20 20% off	$50.00	$1,138.00	$634.14	2026-09-21
11300	CPT	Shaving Les 0.5-less	8	5	$165.00	$132.00 20% off	$50.00	$1,138.00	$652.33	2026-09-21
11305	CPT	Shaving Les 0.5-less	8	5	$165.00	$132.00 20% off	$50.00	$1,138.00	$652.33	2026-09-21
11400	CPT	Exc Lesion 0.5-less	10	5	$211.00	$168.80	$128.71	$1,258.00	$325.43	2026-09-21
11401	CPT	Exc Lesion 0.6-1.0	8	5	$226.00	$180.80	$50.00	$1,138.00	$683.13	2026-09-21
11402	CPT	Exc Lesion 1.1-2.0	8	5	$256.00	$204.80	$156.16	$1,258.00	$824.50	2026-09-21
11403	CPT	Exc Lesion 2.1-3.0	8	5	$301.00	$240.80	$183.61	$1,258.00	$824.50	2026-09-21
11406	CPT	Exc Lesion Over 4.0	8	5	$290.00	$232.00 20% off	$176.90	$2,174.00	$1,348.50	2026-09-21
11420	CPT	Exc Lesion 2.5-less	8	5	$180.00	$144.00 20% off	$109.80	$1,258.00	$824.50	2026-09-21
11421	CPT	Exc Lesion 0.6-1.0	8	5	$271.00	$216.80	$165.31	$1,258.00	$824.50	2026-09-21
11423	CPT	Exc Lesion 2.1-3.0	8	5	$301.00	$240.80	$183.61	$2,174.00	$1,348.50	2026-09-21
11424	CPT	Exc Lesion 3.1-4.0	8	5	$526.00	$420.80 20% off	$320.86	$2,174.00	$1,352.63	2026-09-21
11426	CPT	Exc Lesion Over 4.0	8	5	$301.00	$240.80	$183.61	$2,288.00	$1,443.50	2026-09-21
11440	CPT	Exc Lesion 0.5-less	8	5	$165.00	$132.00 20% off	$100.65	$1,258.00	$824.50	2026-09-21
11441	CPT	Exc Lesion 0.6-1.0	8	5	$346.00	$276.80	$211.06	$1,258.00	$824.50	2026-09-21
11442	CPT	Exc Lesion 1.1-2.0	8	5	$406.00	$324.80 20% off	$247.66	$1,258.00	$834.03	2026-09-21
11600	CPT	Exc Mal Les 0.5-less	8	5	$526.00	$420.80 20% off	$320.86	$1,258.00	$894.63	2026-09-21
11603	CPT	Exc Mal Les 2.1-3.0	8	5	$707.00	$565.60	$391.00	$1,258.00	$986.04	2026-09-21
11620	CPT	Exc Mal Les 0.5-less	8	5	$451.00	$360.80 20% off	$275.11	$1,258.00	$856.75	2026-09-21
11621	CPT	Exc Mal Les 0.6-1.0	8	5	$601.00	$480.80 20% off	$366.61	$1,258.00	$932.50	2026-09-21
11622	CPT	Exc Mal Les 1.1-2.0	8	5	$601.00	$480.80 20% off	$366.61	$1,258.00	$932.50	2026-09-21
11624	CPT	Exc Mal Les 3.1-4.0	8	5	$1,128.00	$789.60 30% off	$523.00	$2,174.00	$1,656.64	2026-09-21
11640	CPT	Exc Mal Les 0.5-less	8	5	$677.00	$541.60	$391.00	$1,258.00	$970.88	2026-09-21
11641	CPT	Exc Mal Les 0.6-1.0	8	5	$692.00	$553.60	$391.00	$1,258.00	$978.46	2026-09-21
11643	CPT	Exc Mal Les 2.1-3.0	8	5	$827.00	$661.60 20% off	$391.00	$1,258.00	$1,046.63	2026-09-21
11750	CPT	Exc Of Nail	8	5	$256.00	$204.80	$50.00	$1,138.00	$698.28	2026-09-21
11765	CPT	Exc Skin Of Nail	8	5	$241.00	$192.80	$50.00	$1,138.00	$690.71	2026-09-21
11976	CPT	Rem Contraceptives	8	5	$361.00	$288.80	$220.21	$1,258.00	$824.50	2026-09-21
12005	CPT	Sut/body 12.5-20.0cm	15	5	$271.00	$216.80	$50.00	$1,138.00	$173.35	2026-09-21
12006	CPT	Sut/body 20.0-30.0cm	8	5	$358.00	$286.40 20% off	$217.29	$361.58	$217.29	2026-09-21
12007	CPT	Sut/body Over 30.0cm	8	5	$450.00	$360.00 20% off	$263.75	$454.50	$263.75	2026-09-21
12013	CPT	Sim/face 2.6-5.0cm	15	5	$307.00	$245.60 20% off	$50.00	$1,138.00	$191.53	2026-09-21
12014	CPT	Sut/face 5.0-7.5cm	8	5	$277.00	$221.60 20% off	$168.97	$279.77	$176.38	2026-09-21
12015	CPT	Sut/face 7.5-12.5cm	8	5	$305.00	$244.00 20% off	$186.05	$308.05	$190.53	2026-09-21
12016	CPT	Sut/face 12.5-20.0cm	8	5	$412.00	$329.60	$244.56	$416.12	$244.56	2026-09-21
12017	CPT	Sut/face 20.0-30.0cm	8	5	$361.00	$288.80	$218.81	$364.61	$218.81	2026-09-21
12018	CPT	Sut/face Over 30.0cm	8	5	$450.00	$360.00 20% off	$263.75	$454.50	$263.75	2026-09-21
12031	CPT	Lay/body Up To 2.5cm	15	5	$312.00	$249.60 20% off	$50.00	$1,138.00	$194.06	2026-09-21
12032	CPT	Intermed Rep 2.6-7.5	8	5	$376.00	$300.80 20% off	$50.00	$1,138.00	$758.88	2026-09-21
12034	CPT	Intermed Rep 7.6-12.5	8	5	$481.00	$384.80 20% off	$50.00	$1,138.00	$811.90	2026-09-21
12041	CPT	Intermed Rep 2.5-less	8	5	$301.00	$240.80	$50.00	$1,138.00	$721.00	2026-09-21
12042	CPT	Intermed Rep 2.6-7.5	8	5	$421.00	$336.80 20% off	$50.00	$1,138.00	$781.61	2026-09-21
12051	CPT	Intermed Rep 2.5-less	8	5	$279.00	$223.20 20% off	$50.00	$1,138.00	$709.89	2026-09-21
12052	CPT	Intermed Rep 2.6-5.0	8	5	$451.00	$360.80 20% off	$50.00	$1,138.00	$796.75	2026-09-21
13120	CPT	Complex Rep 1.1-2.5	8	5	$556.00	$444.80 20% off	$50.00	$1,138.00	$849.78	2026-09-21
13121	CPT	Comp/body 2.6-7.5cm	8	5	$725.00	$580.00 20% off	$402.62	$732.25	$402.62	2026-09-21
13131	CPT	Comp/f/n/h/f 1.1-2.5	15	5	$659.00	$527.20	$50.00	$1,138.00	$369.30	2026-09-21
13152	CPT	Complex Face 2.6-7.5	8	5	$715.00	$572.00 20% off	$397.57	$722.15	$397.57	2026-09-21
15050	CPT	Pinch Graft Up To 2cm	8	5	$505.00	$404.00 20% off	$50.00	$1,258.00	$884.03	2026-09-21
17000	CPT	Destr One Lesion	8	5	$120.00	$96.00 20% off	$50.00	$1,138.00	$629.60	2026-09-21
17260	CPT	Destr Mal Les 0.5-less	8	5	$172.00	$137.60 20% off	$50.00	$1,138.00	$655.86	2026-09-21
19083	CPT	U/s Guided Breast Bx	8	5	$313.00	$250.40 20% off	$190.93	$350.00	$211.50	2026-09-21
19084	CPT	Breast Bx Add Lesion	8	5	$151.00	$120.80 20% off	$92.11	$350.00	$211.50	2026-09-21
20520	CPT	Rem Foreign Body Mus	8	5	$204.00	$163.20 20% off	$124.44	$1,258.00	$824.50	2026-09-21
23650	CPT	Disloc/reduc/shoulde	8	5	$504.00	$403.20 20% off	$291.02	$509.04	$291.02	2026-09-21
23655	CPT	Treat Shoulder Dislocation	8	5	$636.00	$508.80 20% off	$357.68	$642.36	$357.68	2026-09-21
24600	CPT	Treat Elbow Dis W/oa	8	5	$757.00	$605.60 20% off	$418.79	$764.57	$418.79	2026-09-21
24605	CPT	Treat Elbow Dislocation	8	5	$786.00	$628.80 20% off	$433.43	$793.86	$433.43	2026-09-21
25565	CPT	Reduc Forearm W/mani	8	5	$885.00	$708.00 20% off	$483.43	$893.85	$483.43	2026-09-21
25680	CPT	Closed Treat Wrist	8	5	$650.00	$520.00 20% off	$364.75	$656.50	$364.75	2026-09-21
26600	CPT	Treat Metacarpal Fx	8	5	$288.00	$230.40 20% off	$175.68	$290.88	$181.94	2026-09-21
26605	CPT	Treat Metacarpal Fx	8	5	$400.40	$320.32 20% off	$238.70	$404.40	$238.70	2026-09-21
26670	CPT	Disloc/reduc/digit	8	5	$558.00	$446.40 20% off	$318.29	$563.58	$318.29	2026-09-21
26750	CPT	Closd Without Manipul	8	5	$323.00	$258.40 20% off	$197.03	$326.23	$199.62	2026-09-21
27530	CPT	App Tibia Splint	8	5	$648.00	$518.40 20% off	$363.74	$654.48	$363.74	2026-09-21
27536	CPT	Open Treat/tibial Fx	2	2	$1,680.00	$1,176.00 30% off	$1,024.80	$1,696.80	$1,360.80	2026-09-21
27560	CPT	Reduction Patellar	8	5	$788.00	$630.40 20% off	$434.44	$795.88	$434.44	2026-09-21
27762	CPT	Clsd Med Malleous Fx	8	5	$1,023.58	$716.51 30% off	$553.41	$1,033.82	$553.41	2026-09-21
27818	CPT	Clsd Trimalleolar A	8	5	$1,030.00	$721.00 30% off	$556.65	$1,040.30	$556.65	2026-09-21
27840	CPT	Closd Ank Dis Wo Ane	8	5	$410.00	$328.00 20% off	$243.55	$414.10	$243.55	2026-09-21
28495	CPT	Closd Tx Toe W/manip	8	5	$264.00	$211.20 20% off	$161.04	$266.64	$169.82	2026-09-21
29435	CPT	App Patellar Cast	8	5	$224.00	$179.20 20% off	$136.64	$226.24	$149.62	2026-09-21
31528	CPT	Dilation Lry Int Dil	8	5	$351.20	$280.96 20% off	$63.00	$354.71	$208.85	2026-09-21
31529	CPT	Subs Dil Inc Laryngy	8	5	$393.12	$314.50	$63.00	$397.05	$230.03	2026-09-21
32421	CPT	Thoracentesis	16	5	$312.00	$249.60 20% off	$190.32	$315.12	$194.06	2026-09-21
32422	CPT	Thoracent/chest Tube	8	5	$343.00	$274.40 20% off	$209.23	$346.43	$209.72	2026-09-21
32551	CPT	Chest Tube Placement	8	5	$690.00	$552.00 20% off	$384.95	$696.90	$384.95	2026-09-21
32555	CPT	Thoracentesis W/imag	16	5	$205.32	$164.26 20% off	$113.86	$226.24	$155.82	2026-09-21
33010	CPT	Pericardiocentesis	8	5	$298.60	$238.88 20% off	$182.15	$301.59	$187.29	2026-09-21
36430	CPT	Blood Admin Fee	8	5	$346.00	$276.80	$211.06	$349.46	$211.23	2026-09-21
36556	CPT	Cen Line Place >5yrs	8	5	$3,066.00	$2,146.20 30% off	$391.00	$3,096.66	$1,258.00	2026-09-21
36569	CPT	Picc Insertion	10	5	$618.00	$494.40 20% off	$133.59	$624.18	$348.59	2026-09-21
36573	CPT	Pf Picc Insertion	16	5	$1,257.50	$898.65 29% off	$222.34	$2,174.00	$1,700.00	2026-09-21
36584	CPT	Replacement Picc	16	5	$1,023.12	$724.05 29% off	$95.97	$1,907.79	$274.95	2026-09-21
36589	CPT	Pf Picc Removal	10	5	$1,096.35	$784.00 28% off	$201.97	$1,880.22	$203.71	2026-09-21
41250	CPT	Repair Lac Tongue	8	5	$350.00	$280.00 20% off	$213.25	$353.50	$213.25	2026-09-21
41800	CPT	Inc/drain Gum Absces	8	5	$356.50	$285.20 20% off	$216.53	$360.06	$216.53	2026-09-21
42809	CPT	Rem For Body Pharynx	8	5	$295.08	$236.06 20% off	$180.00	$298.03	$185.51	2026-09-21
44340	CPT	Revision Colostomy S	2	2	$3,733.85	$2,613.70 30% off	$2,277.65	$3,771.19	$3,024.42	2026-09-21
46250	CPT	Exc Hemorrhoid Ext	8	5	$262.73	$210.18 20% off	$160.27	$265.36	$169.18	2026-09-21
49081	CPT	Puncture Peritoneal	8	5	$260.00	$208.00 20% off	$45.00	$262.60	$153.80	2026-09-21
49083	CPT	Paracentesis W/image	16	5	$457.62	$366.10	$79.15	$793.36	$743.00	2026-09-21
49422	CPT	Picc Line Removal	8	5	$678.00	$542.40 20% off	$378.89	$684.78	$378.89	2026-09-21
5510095-2	CDM	Bandage Conform 4",2.95"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510101-8	CDM	Bandage Elastic 2",5.79"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510102-6	CDM	Bandage Elastic 3",7.51"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510103-4	CDM	Bandage Elastic 4",9.14"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510104-2	CDM	Bandage Elastic 6",9.17"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510172-9	CDM	Bandage Conform 3",2.46"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510190-1	CDM	Strip Iodoform 1/4",13.66"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510240-4	CDM	Strip Plain 1/4",12.69"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510245-3	CDM	Strip Plain 1/2",12.36"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5510251-1	CDM	Strip Iodoform 1/2",14.06"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5512438-2	CDM	Bandage Conform 2",1.91"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5513092-6	CDM	Wrap Coban 1",7.00"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5513093-4	CDM	Wrap Coban 2",4.44"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5513094-2	CDM	Wrap Coban 4",6.64"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5513115-5	CDM	Wrap Coban 3",5.32"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5513513-1	CDM	Holder Trach Nban 1",14.88"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5513681-6	CDM	Pouch Marlen 7/8",33.12"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5515029-6	CDM	Bandage Conform 1",2.01"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
5515064-3	CDM	Strip Idoform 1",14.53"	8	5	$551.00	$440.80 20% off	$314.75	$556.51	$314.75	2026-09-21
59409	CPT	Vaginal Delivery	2	2	$1,495.00	$1,046.50 30% off	$911.95	$1,509.95	$1,210.95	2026-09-21
62328	CPT	Lumbar Puncture Dx Pro Fee	16	5	$360.85	$288.68 20% off	$123.28	$524.80	$189.56	2026-09-21
64483	CPT	Inj Steroid L/s	8	5	$550.00	$440.00 20% off	$314.25	$555.50	$314.25	2026-09-21
67700	CPT	Blepharotomy Eyelid	8	5	$276.98	$221.58 20% off	$168.96	$279.75	$176.38	2026-09-21
67938	CPT	Rem Embed Fb Eyelid	8	5	$264.92	$211.94	$161.60	$267.57	$170.28	2026-09-21
70190	CPT	Orbit Uni Lt	22	5	$265.00	$212.00 20% off	$17.69	$267.65	$214.65	2026-09-21
70360	CPT	Soft Tissue Neck	16	5	$134.00	$107.20 20% off	$14.64	$246.44	$193.00	2026-09-21
70450	CPT	CT Brain Without Cont	16	5	$490.50	$392.40 20% off	$71.98	$871.63	$513.21	2026-09-21
70460	CPT	CT Brain W/contrast	16	5	$599.00	$427.10 29% off	$95.16	$1,052.42	$328.78	2026-09-21
70470	CPT	CT Brain W&without Cont	16	5	$680.50	$485.10 29% off	$106.75	$1,197.86	$515.00	2026-09-21
70480	CPT	CT Orbits Without Contr	16	5	$357.50	$286.00 20% off	$107.36	$544.39	$253.28	2026-09-21
70481	CPT	CT Orbits W/contrast	16	5	$455.00	$364.00 20% off	$116.51	$726.19	$315.75	2026-09-21
70482	CPT	CT Orbits W&without Cont	16	5	$260.00	$208.00 20% off	$97.60	$500.00	$190.60	2026-09-21
70486	CPT	CT Facial/sinus Without	16	5	$600.00	$427.80 29% off	$95.16	$1,054.44	$425.00	2026-09-21
70487	CPT	CT Facial/sinus W/co	16	5	$720.00	$513.00 29% off	$109.80	$1,272.60	$340.90	2026-09-21
70488	CPT	CT Facial/sinus W/wo	16	5	$818.00	$582.40 29% off	$119.56	$1,454.40	$348.98	2026-09-21
70490	CPT	CT Neck Without Contrast	16	5	$555.00	$444.00	$107.36	$943.34	$338.88	2026-09-21
70491	CPT	CT Neck W/contrast	16	5	$499.50	$399.60	$116.51	$816.08	$535.50	2026-09-21
70492	CPT	CT Neck W&without Cont	16	5	$684.00	$488.80 29% off	$122.00	$1,179.68	$351.00	2026-09-21
70496	CPT	CTA Brain	16	5	$495.96	$396.77 20% off	$88.91	$854.64	$323.61	2026-09-21
70498	CPT	CTA Neck	16	5	$339.50	$271.60	$103.70	$514.09	$190.50	2026-09-21
71023	CPT	Fluoroscopy Chest	8	5	$199.00	$159.20 20% off	$121.39	$200.99	$161.19	2026-09-21
71046	CPT	Chest 2 Views	16	5	$126.50	$101.20 20% off	$18.30	$225.23	$162.00	2026-09-21
71120	CPT	Sternum Min 2 Views	16	5	$143.50	$114.80 20% off	$17.08	$261.59	$189.00	2026-09-21
71250	CPT	CT Chest Without Cont	16	5	$547.00	$437.60	$97.60	$943.34	$534.87	2026-09-21
71260	CPT	CT Chest W/contrast	16	5	$534.00	$427.20 20% off	$103.09	$907.99	$524.19	2026-09-21
71270	CPT	CT Chest W&without Cont	16	5	$679.50	$485.20 29% off	$116.51	$1,179.68	$606.24	2026-09-21
71271	CPT	CT Chest Low/dose	16	5	$270.53	$216.42 20% off	$77.13	$500.00	$414.00	2026-09-21
71275	CPT	CTA Chest	16	5	$502.62	$402.10	$96.84	$854.97	$515.00	2026-09-21
72050	CPT	C-spine 4 Views	16	5	$133.00	$106.40 20% off	$26.84	$224.22	$155.21	2026-09-21
72072	CPT	Thoracic 3 Views	16	5	$126.50	$101.20 20% off	$18.30	$225.23	$162.00	2026-09-21
72100	CPT	Lumbar 2 Or 3 Views	16	5	$134.50	$107.60 20% off	$18.91	$240.38	$173.00	2026-09-21
72114	CPT	Lumbar Flex/ext Comp	16	5	$183.00	$146.40	$31.72	$317.14	$234.50	2026-09-21
72120	CPT	Lumbar Flx Ext Bending	16	5	$109.50	$87.60	$18.91	$189.88	$188.00	2026-09-21
72125	CPT	CT C-spine Without Cont	16	5	$547.00	$437.60	$97.60	$943.34	$330.80	2026-09-21
72126	CPT	CT C-spine W/cont	16	5	$488.00	$390.40 20% off	$102.48	$816.08	$331.28	2026-09-21
72128	CPT	CT T-spine Without Cont	16	5	$547.00	$437.60	$97.60	$943.34	$330.80	2026-09-21
72129	CPT	CT T-spine W/cont	16	5	$551.00	$440.80	$102.48	$943.34	$334.84	2026-09-21
72130	CPT	CT T-spine W/without Contrast	16	5	$629.71	$503.77 20% off	$198.51	$943.34	$414.34	2026-09-21
72131	CPT	CT L-spine Without Cont	16	5	$547.00	$437.60	$97.60	$943.34	$330.80	2026-09-21
72132	CPT	CT L-spine W/cont	16	5	$497.50	$398.00 20% off	$102.48	$835.27	$334.84	2026-09-21
72133	CPT	CT L-spine W&without Con	16	5	$678.50	$481.05 29% off	$74.42	$1,247.35	$311.61	2026-09-21
72190	CPT	Pelvis Lateral Hip	16	5	$140.00	$112.00	$17.69	$253.51	$183.00	2026-09-21
72192	CPT	CT Pelvis Without Cont	16	5	$542.00	$433.60	$91.50	$943.34	$325.75	2026-09-21
72193	CPT	CT Pelvis W/contrast	16	5	$619.00	$441.30 29% off	$97.60	$1,088.78	$330.80	2026-09-21
72194	CPT	CT Pelvis W&without Cont	16	5	$668.00	$476.00 29% off	$102.48	$1,179.68	$334.84	2026-09-21
72202	CPT	Sacro-iliac >3 Views	16	5	$135.00	$108.00 20% off	$15.86	$246.44	$178.00	2026-09-21
72220	CPT	Sacrum & Coccyx	16	5	$134.00	$107.20 20% off	$14.64	$246.44	$178.00	2026-09-21
73000	CPT	Clavicle Bi	33	5	$197.00	$157.60 20% off	$14.64	$397.94	$159.57	2026-09-21
73030	CPT	Shoulder 2 Views Bi	33	5	$253.00	$202.40 20% off	$15.25	$511.06	$184.00	2026-09-21
73100	CPT	Wrist 2 Views Bi	33	5	$48.00	$38.40 20% off	$14.64	$305.02	$151.00	2026-09-21
73120	CPT	Hand 2 Views Bi	33	5	$151.00	$120.80 20% off	$14.64	$305.02	$171.00	2026-09-21
73200	CPT	CT Upper Ex Without C Bi	38	5	$1,258.00	$880.60 30% off	$91.50	$2,349.26	$623.00	2026-09-21
73201	CPT	CT Upper Ex W/con Bi	38	5	$1,464.00	$1,024.80 30% off	$97.60	$2,957.28	$941.18	2026-09-21
73202	CPT	CT Upper E W&without C B	33	5	$1,672.00	$1,170.40 30% off	$102.48	$3,377.44	$1,094.36	2026-09-21
73206	CPT	CTA Upper Ext W/wo	16	5	$447.75	$358.20 20% off	$29.89	$854.97	$274.75	2026-09-21
73501	CPT	Hip 1 View Lt	22	5	$270.00	$216.00 20% off	$14.64	$272.70	$218.70	2026-09-21
73502	CPT	Hip 2 Views Lt	22	5	$236.00	$188.80	$17.69	$238.36	$172.00	2026-09-21
73521	CPT	Hip 1 View Bi	11	5	$540.00	$432.00 20% off	$29.28	$545.40	$360.20	2026-09-21
73522	CPT	Hip 2 Views Bi	16	5	$265.00	$212.00	$35.38	$476.72	$231.46	2026-09-21
73564	CPT	Knee 4 Views Bi	33	5	$307.00	$245.60 20% off	$18.91	$620.14	$179.00	2026-09-21
73630	CPT	Foot 3 Views Bi	33	5	$214.00	$171.20 20% off	$14.64	$432.28	$156.00	2026-09-21
73700	CPT	CT Lower Ex Without C Bi	33	5	$1,315.00	$920.50 30% off	$91.50	$2,656.30	$914.08	2026-09-21
73701	CPT	CT Lower Ex W/con Bi	33	5	$1,602.00	$1,121.40 30% off	$97.60	$3,236.04	$1,059.01	2026-09-21
73702	CPT	CT Lower E W&without C B	38	5	$1,774.00	$1,241.80 30% off	$102.48	$3,593.58	$1,114.01	2026-09-21
73706	CPT	CTA Lower Ext W/wo	16	5	$502.00	$401.60	$96.08	$854.97	$329.53	2026-09-21
74019	CPT	Abdomen 2 Views	16	5	$122.00	$97.60 20% off	$18.30	$216.14	$156.00	2026-09-21
74022	CPT	Acute Abdomen Series	16	5	$159.50	$127.60	$26.84	$277.75	$160.00	2026-09-21
74150	CPT	CT Abd Without Contrast	16	5	$549.00	$439.20 20% off	$100.04	$943.34	$535.50	2026-09-21
74160	CPT	CT Abd W/contrast	16	5	$661.00	$471.45 29% off	$106.75	$1,158.47	$489.00	2026-09-21
74170	CPT	CT Abd W&without Cont	16	5	$707.50	$504.90 29% off	$117.73	$1,234.22	$347.47	2026-09-21
74175	CPT	CTA Abdomen	16	5	$502.00	$401.60	$96.08	$854.97	$329.53	2026-09-21
74176	CPT	CT Abd/pelvis Without C	16	5	$326.81	$261.45	$103.09	$500.00	$387.00	2026-09-21
74177	CPT	CT Abd/pelvis W/con	16	5	$460.76	$368.61	$104.92	$757.02	$515.00	2026-09-21
74178	CPT	CT Abd/pelvis W&w/oc	16	5	$512.80	$410.24	$115.90	$843.96	$504.86	2026-09-21
74240	CPT	Ugi W/esophagram	16	5	$319.50	$255.60	$57.34	$550.45	$416.50	2026-09-21
74246	CPT	Ac Ugi Without Kub	8	5	$343.00	$274.40 20% off	$175.00	$346.43	$260.71	2026-09-21
74280	CPT	Barium Enema W/air	16	5	$317.50	$254.00 20% off	$83.57	$502.98	$156.69	2026-09-21
75635	CPT	CTA Abd W/run Off	16	5	$709.29	$510.11 28% off	$165.97	$1,157.96	$907.00	2026-09-21
76506	CPT	U/s Head	21	5	$162.00	$129.60 20% off	$37.82	$667.61	$403.21	2026-09-21
76536	CPT	U/s Thyroid	16	5	$385.50	$308.40	$46.97	$700.94	$506.00	2026-09-21
76604	CPT	U/s Chest	16	5	$253.50	$202.80	$44.53	$438.34	$302.00	2026-09-21
76700	CPT	U/s Abd Survey	16	5	$455.50	$364.40 20% off	$53.00	$806.99	$583.00	2026-09-21
76770	CPT	U/s Renal	16	5	$346.00	$276.80	$57.34	$603.98	$436.00	2026-09-21
76830	CPT	U/s Transvaginal	16	5	$253.00	$202.40	$57.34	$416.12	$270.00	2026-09-21
76856	CPT	U/s Pelvic	16	5	$394.00	$315.20	$57.34	$700.94	$506.00	2026-09-21
76857	CPT	Pelvic U/s Limited	16	5	$297.00	$237.60	$57.34	$505.00	$191.97	2026-09-21
76870	CPT	U/s Scrotum	16	5	$310.50	$248.40	$54.29	$537.32	$388.00	2026-09-21
76937	CPT	U/s Guid Picc/cl Ins	8	5	$91.00	$72.80 20% off	$55.51	$350.00	$202.75	2026-09-21
76942	CPT	U/s Guid Ndle Place	16	5	$256.50	$205.20 20% off	$49.41	$436.32	$168.24	2026-09-21
77001	CPT	Flouro Guid Picc/cl	8	5	$99.00	$79.20 20% off	$60.39	$350.00	$205.19	2026-09-21
77012	CPT	CT Guid Needle Place	20	5	$100.00	$80.00 20% off	$49.41	$872.64	$190.75	2026-09-21
77066	CPT	Mammo Diag Bil Dig	11	5	$273.40	$218.72	$62.94	$276.13	$172.06	2026-09-21
77067	CPT	Mammo Screen Bil Dig	36	5	$228.93	$183.14 20% off	$50.56	$231.22	$228.00	2026-09-21
80366	CPT	Pregabalin Urine Confirmation	3	3	$307.53	$246.02 20% off	$12.94	$310.61	$187.59	2026-09-21
81206	CPT	Bcr	8	5	$335.00	$268.00 20% off	$134.21	$338.35	$236.28	2026-09-21
81207	CPT	Abl1	8	5	$296.00	$236.80	$118.55	$298.96	$208.75	2026-09-21
81270	CPT	Jak 2	8	5	$450.00	$360.00 20% off	$75.04	$454.50	$264.77	2026-09-21
82024	CPT	Acth	8	5	$368.00	$294.40 20% off	$31.62	$371.68	$201.65	2026-09-21
82043	CPT	Micro-albumin	8	5	$48.00	$38.40 20% off	$4.73	$389.00	$218.74	2026-09-21
82088	CPT	Aldosterone	8	5	$437.00	$349.60	$33.36	$441.37	$237.37	2026-09-21
82610	CPT	Cystatin-c	3	3	$294.20	$235.36	$11.12	$297.14	$179.46	2026-09-21
82653	CPT	Pancreaticelastase Fecal	8	5	$257.29	$205.83 20% off	$156.95	$259.86	$208.41	2026-09-21
83586	CPT	17-ketosteroids	3	3	$265.00	$212.00 20% off	$10.48	$267.65	$161.65	2026-09-21
83970	CPT	Pth	10	5	$426.00	$340.80 20% off	$33.79	$430.26	$232.03	2026-09-21
86215	CPT	Antidnase B Strep Ab	3	3	$3,313.00	$2,319.10 30% off	$10.85	$3,346.13	$2,020.93	2026-09-21
87252	CPT	Culture, Viral	8	5	$328.00	$262.40 20% off	$21.34	$331.28	$176.31	2026-09-21
87507	CPT	Gi Panel By Pcr	8	5	$383.04	$306.43 20% off	$233.65	$386.87	$310.26	2026-09-21
87517	CPT	Hep B Quant Pcr	8	5	$435.85	$348.68 20% off	$35.06	$440.21	$237.63	2026-09-21
87556	CPT	M Tuberculosis Pcr	8	5	$527.75	$422.20 20% off	$28.72	$533.03	$280.88	2026-09-21
87633	CPT	Respiratory Virus Panel	8	5	$260.49	$208.39 20% off	$158.90	$341.16	$250.03	2026-09-21
87902	CPT	Hcv Genotyping	8	5	$643.63	$514.90 20% off	$210.73	$650.07	$430.40	2026-09-21
87999	CPT	Vit. B-12 & Folate	7	4	$230.00	$184.00 20% off	$140.30	$232.30	$186.30	2026-09-21
88121	CPT	Cytp Urine 3-5 Probe	8	5	$789.08	$631.26 20% off	$107.80	$796.97	$452.38	2026-09-21
88307	CPT	Tissue Ex Pathologis	8	5	$341.80	$273.44 20% off	$36.88	$345.22	$191.05	2026-09-21
88309	CPT	Tissue Ex Pathologis	8	5	$474.40	$379.52 20% off	$107.80	$479.14	$293.47	2026-09-21
88367	CPT	Insitu Hybridiz Auto	3	3	$455.00	$364.00 20% off	$21.92	$459.55	$277.55	2026-09-21
88368	CPT	Insitu Hybridiz Manu	8	5	$367.13	$293.70 20% off	$21.92	$370.80	$196.36	2026-09-21
88374	CPT	M/phntrc Alys Ishqua	8	5	$278.62	$222.90	$110.17	$281.41	$195.79	2026-09-21
90746	CPT	Hepatitis B Vaccine	8	5	$318.00	$254.40 20% off	$193.98	$321.18	$197.09	2026-09-21
90792	CPT	New Patient Eval Psy	8	5	$346.15	$276.92	$211.15	$349.61	$211.31	2026-09-21
90801	CPT	Psy Initial Evaluation	8	5	$397.00	$317.60	$236.99	$400.97	$236.99	2026-09-21
90804	CPT	Individual Psychotherapy (20-30 Min)	8	5	$283.00	$226.40 20% off	$172.63	$285.83	$179.41	2026-09-21
90805	CPT	Med Mgnt 20-30 Min.	8	5	$283.00	$226.40 20% off	$172.63	$285.83	$179.41	2026-09-21
90806	CPT	Individual Psychotherapy (45-50 Min)	8	5	$420.00	$336.00 20% off	$248.60	$424.20	$248.60	2026-09-21
90807	CPT	Med Mgnt 45-50 Min.	8	5	$420.00	$336.00 20% off	$248.60	$424.20	$248.60	2026-09-21
90832	CPT	Ind Psythpy 30 M	8	5	$283.00	$226.40 20% off	$172.63	$285.83	$179.41	2026-09-21
90833	CPT	Ind Psythpy E/m 30 M	8	5	$283.00	$226.40 20% off	$172.63	$285.83	$245.00	2026-09-21
90834	CPT	Ind Psythpy 45 M	8	5	$420.00	$336.00 20% off	$248.60	$424.20	$381.00	2026-09-21
90836	CPT	Ind Psythpy E/m 45 M	8	5	$420.00	$336.00 20% off	$248.60	$424.20	$248.60	2026-09-21
90837	CPT	Ind Psythpy 60 M	8	5	$566.00	$452.80 20% off	$322.33	$571.66	$525.00	2026-09-21
90838	CPT	Ind Psythpy E/m 60 M	8	5	$566.00	$452.80 20% off	$322.33	$571.66	$322.33	2026-09-21
90846	CPT	Family Psychotherapy Without Patient	8	5	$401.00	$320.80 20% off	$239.00	$405.01	$239.00	2026-09-21
90847	CPT	Family Medical Psychotherapy	8	5	$300.00	$240.00 20% off	$183.00	$303.00	$188.00	2026-09-21
92506	CPT	Evaluation Speech	8	5	$300.00	$240.00 20% off	$63.00	$303.00	$183.00	2026-09-21
92507	CPT	Speech Therapy Tx	8	5	$230.00	$184.00 20% off	$63.00	$232.30	$147.65	2026-09-21
92526	CPT	Swallowing Treatment	8	5	$248.00	$198.40 20% off	$63.00	$250.48	$156.74	2026-09-21
92950	CPT	Code 300	8	5	$610.00	$488.00 20% off	$344.55	$616.10	$344.55	2026-09-21
93247	CPT	Holter Anlys>7 Days	8	5	$221.30	$177.04 20% off	$134.99	$223.51	$148.25	2026-09-21
93307	CPT	Echo. M-mode/2d	8	5	$1,201.00	$840.70 30% off	$643.00	$1,213.01	$643.00	2026-09-21
93320	CPT	Echo. Doppler Analys	8	5	$1,201.00	$840.70 30% off	$643.00	$1,213.01	$643.00	2026-09-21
93325	CPT	Doppler Color Flow	8	5	$1,201.00	$840.70 30% off	$643.00	$1,213.01	$643.00	2026-09-21
93923	CPT	Abi 3 Or More Ext	8	5	$266.65	$213.32	$80.00	$269.32	$171.16	2026-09-21
93925	CPT	U/s Art Bi Lower Ext	16	5	$214.72	$171.77 20% off	$58.67	$336.58	$182.00	2026-09-21
93930	CPT	U/s Art Bi Upper Ext	16	5	$215.76	$172.61 20% off	$59.54	$350.00	$151.14	2026-09-21
94002	CPT	Vent Mgmt First Day	8	5	$597.00	$477.60	$63.00	$602.97	$332.99	2026-09-21
94003	CPT	Vent Mgmt Addl Day	8	5	$537.00	$429.60	$63.00	$542.37	$302.69	2026-09-21
94060	CPT	Pft Incomplete	16	5	$247.00	$197.60 20% off	$63.00	$249.47	$156.24	2026-09-21
94660	CPT	Cpap/bipap Initial	10	5	$297.00	$237.60 20% off	$63.00	$299.97	$181.49	2026-09-21
96105	CPT	Assessment Of Aphasia	8	5	$257.00	$205.60 20% off	$63.00	$259.57	$161.28	2026-09-21
99204	CPT	New Pt Office 45min	8	5	$220.00	$176.00 20% off	$134.20	$222.20	$147.60	2026-09-21
99205	CPT	New Pt Office 60min	8	5	$284.00	$227.20 20% off	$173.24	$286.84	$246.00	2026-09-21
99215	CPT	Est Pt Office 40min	8	5	$242.00	$193.60 20% off	$147.62	$244.42	$158.71	2026-09-21
99283	CPT	Emerg. Room-level 3	15	5	$239.00	$191.20 20% off	$51.50	$435.00	$191.00	2026-09-21
99284	CPT	Emerg. Room-level 4	15	5	$269.00	$215.20 20% off	$18.00	$607.00	$164.09	2026-09-21
99285	CPT	Emerg. Room-level 5	15	5	$425.00	$340.00 20% off	$128.71	$1,426.00	$320.00	2026-09-21
99291	CPT	Critical Care 30-74 Min	3	3	$1,537.00	$1,075.90 30% off	$500.00	$1,552.37	$937.57	2026-09-21
99292	CPT	Critical Care Ad 30m	8	5	$512.00	$409.60	$295.06	$517.12	$295.06	2026-09-21
99305	CPT	Initial 1-90 Level 2	8	5	$237.00	$189.60 20% off	$144.57	$239.37	$156.19	2026-09-21
99306	CPT	Initial 1-90 Level 3	8	5	$303.00	$242.40 20% off	$184.83	$306.03	$189.51	2026-09-21
99310	CPT	Round>91 Level 4	8	5	$243.00	$194.40 20% off	$148.23	$245.43	$159.22	2026-09-21
G0431	HCPCS	Drug Conf/bupren Mc	8	5	$248.00	$198.40 20% off	$151.28	$250.48	$200.88	2026-09-21
J0714	HCPCS	Avycaz 0.5gm/0.125gm	8	5	$251.68	$201.34 20% off	$153.52	$254.20	$203.86	2026-09-21
J0840	HCPCS	Crofab Antiven 1gm	2	2	$8,972.69	$6,280.88 30% off	$5,473.34	$9,062.42	$7,267.88	2026-09-21
J1162	HCPCS	Digifab 40mg Vial	2	2	$11,596.04	$8,117.23 30% off	$7,073.58	$11,712.00	$9,392.79	2026-09-21
J1610	HCPCS	Glucagon 1mg Inj	16	5	$785.60	$628.48 20% off	$433.23	$793.46	$557.78	2026-09-21
J1670	HCPCS	Hep. B 1mm Glob. 5ml	4	2	$1,639.15	$1,147.41 30% off	$999.88	$1,655.54	$1,327.71	2026-09-21
J2690	HCPCS	Procainamide 1gm IV	8	5	$533.09	$426.47 20% off	$305.71	$538.42	$305.71	2026-09-21
J2760	HCPCS	Phentolamine 5mg Vl	8	5	$1,250.84	$875.59 30% off	$668.17	$1,263.35	$668.17	2026-09-21
J2796	HCPCS	Romiplostim 10 Mcg	8	5	$281.04	$224.83 20% off	$171.43	$283.85	$227.64	2026-09-21
J2997	HCPCS	Activase Per Img Inj	10	5	$246.90	$197.52 20% off	$130.98	$249.37	$161.19	2026-09-21
J3489	HCPCS	Zoledron Ac 5mg Ivpb	8	5	$305.12	$244.10	$186.12	$308.17	$190.59	2026-09-21
L8501	HCPCS	Passy Muir Speak Val	8	5	$350.00	$280.00 20% off	$213.50	$353.50	$283.50	2026-09-21
M0239	HCPCS	Bamlanivimab Adm Mon	8	5	$774.00	$619.20	$427.37	$781.74	$427.37	2026-09-21
M0243	HCPCS	Casirivi\imdevi Ad M	8	5	$774.00	$619.20	$427.37	$781.74	$427.37	2026-09-21
M0245	HCPCS	Bamlan & Etesev Infusion	3	3	$1,125.00	$787.50 30% off	$45.00	$1,136.25	$686.25	2026-09-21
M0247	HCPCS	Sotrovimab Infusion	8	5	$1,125.00	$787.50 30% off	$604.62	$1,136.25	$604.62	2026-09-21
P9016	HCPCS	Rbc's/leuko-reduced	8	5	$256.00	$204.80	$156.16	$258.56	$165.78	2026-09-21
P9035	HCPCS	Platelet Apheresis	7	4	$882.27	$705.82	$538.18	$891.09	$714.63	2026-09-21
P9036	HCPCS	Platelet Apheresis Irradiated	7	4	$936.27	$749.02	$571.12	$945.63	$758.38	2026-09-21

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