Hospital

MOREHOUSE GENERAL HOSPITAL

Bastrop, LA · CCN 190116 · Rates published

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You selected 93306 (HCPCS)

ECHO COMPLETE

This hospital’s price: $455 across 13 payers · range $164-$1,806

Source: https://morehousegeneralhospital.pg.quadax.revenuemasters.com/cdm-files/726011528_morehouse-general-hospital_standardcharges.csv · observed 2026-07-15

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.

1,432 distinct procedures filed

17 distinct payers

30,745 rate rows

2026-07-15 last MRF observed

Data quality

30,681 of 30,745 rate rows are consumer-grade (99.8%)

64 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
percent-of-charges filed in the dollar field — excluded from medians	40
placeholder amount (≤ $0.02) — excluded from medians	13
per-diem day rate — not a per-procedure price	7
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	4

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

Source MRF file	https://morehousegeneralhospital.pg.quadax.revenuemasters.com/cdm-files/726011528_morehouse-general-hospital_standardcharges.csv
Found on page	https://morehousegeneralhospital.pg.quadax.revenuemasters.com/disclaimer?
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-18
Content fingerprint	4ba14fc55498c5af… · 21,853,749 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J7330 HCPCS	Maci Membrane	5	$24,225.50	$52,000.00	$24,225.50	nat. median $75,037 outlier · 0.3×
C1767 HCPCS	Interstim Ipg 3058	5	$10,882.84	$23,360.00	$10,882.84	nat. median $23,881 outlier · 0.5×
58356 HCPCS	Curretage	12	$502.05	$7,367.20	$4,101.02	nat. median $5,029 0.8× median
Q4133 HCPCS	Stravix Pl Ps61036	5	$3,043.84	$6,533.60	$3,043.84	nat. median $454 outlier · 6.7×
15273 HCPCS	Skn Grft T/a/l 100sq	12	$274.46	$6,008.71	$2,958.02	nat. median $3,119 0.9× median
0100 RC		3	$2,076.00	$3,907.00	$2,945.00	nat. median $4,407 0.7× median
36556 HCPCS	Insert Cv Cath >5yr	12	$118.73	$3,760.00	$2,628.10	nat. median $2,483 1.1× median
59414 HCPCS	Deliver Placenta Onl	12	$130.98	$4,000.00	$2,577.69	nat. median $2,860 0.9× median
C9352 HCPCS	Neuroflex Cncf2025	5	$2,316.33	$4,972.00	$2,316.33	nat. median $3,023 0.8× median
L8699 HCPCS	Imp Tri Fem 5517f601	6	$291.08	$7,700.00	$2,306.08	nat. median $2,008 1.1× median
Q0222 HCPCS	Bebtelovimab 175 Mg	11	$1,080.08	$2,318.40	$2,071.67	nat. median $2,564 0.8× median
J0135 HCPCS	Humira 20mg Inj	11	$862.13	$1,850.56	$1,834.49	nat. median $3,420 0.5× median
J1950 HCPCS	Lupron Depot 3.75mg	11	$447.43	$11,362.52	$1,764.49	nat. median $3,921 outlier · 0.5×
C1762 HCPCS	Allograft Evp841ff	5	$867.65	$6,270.40	$1,762.87	nat. median $2,930 0.6× median
J0840 HCPCS	Crofab (1gm=1vial)	11	$1,762.35	$4,487.76	$1,762.35	nat. median $3,452 0.5× median
C1776 HCPCS	Depuy Femoral Head	6	$122.10	$19,800.00	$1,720.94	nat. median $3,390 0.5× median
81162 HCPCS	Brca1/2 Comp Analysi	12	$1,368.66	$3,649.60	$1,700.26	nat. median $1,825 0.9× median
54150 HCPCS	Circumcision	13	$134.97	$2,444.00	$1,679.37	nat. median $1,707 1.0× median
0610 RC		5	$1,570.56	$3,371.20	$1,570.56	nat. median $1,917 0.8× median
0200 RC		1	$1,556.80	$1,556.80	$1,556.80	nat. median $3,916 outlier · 0.4×
15271 HCPCS	Apligraf Leg 1st 25	12	$117.52	$3,425.18	$1,503.59	nat. median $1,725 0.9× median
Q4139 HCPCS	Amniofix 100mg Al-51	5	$1,501.98	$3,224.00	$1,501.98	nat. median $1,504 1.0× median
C1734 HCPCS	Pediguard P2he1000	5	$102.49	$14,300.00	$1,486.33	nat. median $2,559 0.6× median
15275 HCPCS	Apligraf Foot 1st 25	16	$96.04	$3,096.00	$1,442.35	nat. median $1,713 0.8× median
15277 HCPCS	Skn Grft F/s/e/m/f	16	$96.04	$3,096.00	$1,442.35	nat. median $2,073 0.7× median
C1777 HCPCS	Imp Tri Tibial 55368	5	$512.46	$5,280.00	$1,386.00	nat. median $5,525 outlier · 0.3×
11044 HCPCS	Deb Bone 20 Sq Cm/<	12	$317.20	$2,966.64	$1,336.76	nat. median $1,752 0.8× median
19083 HCPCS	US Guide Breast Bx 1	12	$214.35	$3,095.20	$1,336.76	nat. median $2,147 0.6× median
99291 HCPCS	Crit Care 30-74 Min	13	$600.00	$1,511.20	$1,331.64	nat. median $1,530 0.9× median
73225 HCPCS	MRA Upper Ext W Or W	6	$344.26	$2,851.20	$1,328.30	nat. median $1,211 1.1× median
36569 HCPCS	ICU Picc Sterile Tec	13	$133.08	$2,160.00	$1,304.91	nat. median $1,726 0.8× median
Q4186 HCPCS	Amniofix 3x3 Implant	5	$1,160.22	$2,790.40	$1,299.98	nat. median $448 outlier · 2.9×
C1874 HCPCS	Rx Bil Stent 4cm	5	$1,216.49	$2,611.20	$1,216.49	nat. median $4,814 outlier · 0.3×
J0630 HCPCS	Miacalcin 200iu/ml	11	$1,173.06	$4,769.68	$1,173.06	nat. median $1,896 0.6× median
78452 HCPCS	Nm Cardio Stress Ms	13	$455.98	$2,560.00	$1,170.77	nat. median $1,822 0.6× median
C1771 HCPCS	Solyx Mid Urth Sling	5	$680.55	$2,500.00	$1,164.69	nat. median $2,432 outlier · 0.5×
C1778 HCPCS	Bearing 159577	5	$721.17	$7,112.00	$1,127.42	nat. median $4,400 outlier · 0.3×
73725 HCPCS	MRA Lower Ext W Cont	6	$332.01	$2,412.80	$1,124.06	nat. median $1,252 0.9× median
74185 HCPCS	MRA Abdomen Without Cons	6	$334.11	$2,412.80	$1,124.06	nat. median $1,253 0.9× median
C1787 HCPCS	Interstim Progrmr	5	$1,108.78	$2,380.00	$1,108.78	nat. median $2,051 0.5× median
J2325 HCPCS	Natrecor 1.5mg/5ml V	5	$1,073.53	$2,304.32	$1,073.53	nat. median $212 outlier · 5.1×
0206 RC		1	$1,037.60	$1,037.60	$1,037.60	nat. median $3,150 outlier · 0.3×
0722 RC		5	$894.48	$5,911.20	$1,017.20	nat. median $3,302 outlier · 0.3×
J9217 HCPCS	Lupron Depot 30mg	11	$176.51	$23,660.44	$972.01	nat. median $1,573 0.6× median
93016 HCPCS	Nm Cardia Str Superv	7	$29.03	$2,000.00	$931.75	nat. median $58 outlier · 16.0×
A4641 HCPCS	Indium-iii 3 Mc	5	$922.43	$1,980.00	$922.43	nat. median $359 outlier · 2.6×
0114 RC		3	$900.00	$1,680.00	$900.00	nat. median $941 1.0× median
99285 HCPCS	ER Care Level 5	13	$418.17	$1,129.59	$897.60	nat. median $1,187 0.8× median
36410 HCPCS	Oss Midline Insert	6	$12.75	$1,920.00	$894.48	nat. median $105 outlier · 8.5×
95810 HCPCS	Polysonogram Complt	12	$570.23	$1,224.00	$862.05	nat. median $1,827 outlier · 0.5×

Other procedures at this hospital

Browse this hospital's 1,432 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

J7330	HCPCS	Maci Membrane	5	5	$65,000.00	$52,000.00 20% off	$24,225.50	$52,000.00	$24,225.50	2026-07-15
C1767	HCPCS	Interstim Ipg 3058	5	5	$29,200.00	$23,360.00 20% off	$10,882.84	$23,360.00	$10,882.84	2026-07-15
58356	HCPCS	Curretage	12	12	$9,209.00	$7,367.20 20% off	$502.05	$7,367.20	$4,101.02	2026-07-15
Q4133	HCPCS	Stravix Pl Ps61036	5	5	$8,167.00	$6,533.60	$3,043.84	$6,533.60	$3,043.84	2026-07-15
15273	HCPCS	Skn Grft T/a/l 100sq	12	12	$7,510.89	$6,008.71 20% off	$274.46	$6,008.71	$2,958.02	2026-07-15
0100	RC	—	9	3	—	—	$2,076.00	$3,907.00	$2,945.00	2026-07-15
36556	HCPCS	Insert Cv Cath >5yr	12	12	$4,700.00	$3,760.00 20% off	$118.73	$3,760.00	$2,628.10	2026-07-15
59414	HCPCS	Deliver Placenta Onl	12	12	$5,000.00	$4,000.00 20% off	$130.98	$4,000.00	$2,577.69	2026-07-15
C9352	HCPCS	Neuroflex Cncf2025	5	5	$6,215.00	$4,972.00 20% off	$2,316.33	$4,972.00	$2,316.33	2026-07-15
L8699	HCPCS	Imp Tri Fem 5517f601	66	6	$6,187.00	$4,949.60	$291.08	$7,700.00	$2,306.08	2026-07-15
Q0222	HCPCS	Bebtelovimab 175 Mg	11	11	$2,898.00	$2,318.40	$1,080.08	$2,318.40	$2,071.67	2026-07-15
J0135	HCPCS	Humira 20mg Inj	11	11	$2,313.20	$1,850.56	$862.13	$1,850.56	$1,834.49	2026-07-15
J1950	HCPCS	Lupron Depot 3.75mg	26	11	$4,734.35	$3,787.48 20% off	$447.43	$11,362.52	$1,764.49	2026-07-15
C1762	HCPCS	Allograft Evp841ff	20	5	$4,487.00	$3,589.60 20% off	$867.65	$6,270.40	$1,762.87	2026-07-15
J0840	HCPCS	Crofab (1gm=1vial)	11	11	$5,609.70	$4,487.76	$1,762.35	$4,487.76	$1,762.35	2026-07-15
C1776	HCPCS	Depuy Femoral Head	331	6	$4,200.00	$3,360.00 20% off	$122.10	$19,800.00	$1,720.94	2026-07-15
81162	HCPCS	Brca1/2 Comp Analysi	12	12	$4,562.00	$3,649.60 20% off	$1,368.66	$3,649.60	$1,700.26	2026-07-15
54150	HCPCS	Circumcision	13	13	$3,055.00	$2,444.00 20% off	$134.97	$2,444.00	$1,679.37	2026-07-15
0610	RC	—	5	5	$4,214.00	$3,371.20 20% off	$1,570.56	$3,371.20	$1,570.56	2026-07-15
0200	RC	—	1	1	$1,946.00	$1,556.80 20% off	$1,556.80	$1,556.80	$1,556.80	2026-07-15
15271	HCPCS	Apligraf Leg 1st 25	12	12	$4,281.48	$3,425.18 20% off	$117.52	$3,425.18	$1,503.59	2026-07-15
Q4139	HCPCS	Amniofix 100mg Al-51	5	5	$4,030.00	$3,224.00 20% off	$1,501.98	$3,224.00	$1,501.98	2026-07-15
C1734	HCPCS	Pediguard P2he1000	15	5	$3,988.00	$3,190.40 20% off	$102.49	$14,300.00	$1,486.33	2026-07-15
15277	HCPCS	Skn Grft F/s/e/m/f	16	16	$3,870.00	$3,096.00 20% off	$96.04	$3,096.00	$1,442.35	2026-07-15
15275	HCPCS	Apligraf Foot 1st 25	16	16	$3,870.00	$3,096.00 20% off	$96.04	$3,096.00	$1,442.35	2026-07-15
C1777	HCPCS	Imp Tri Tibial 55368	25	5	$3,465.00	$2,772.00 20% off	$512.46	$5,280.00	$1,386.00	2026-07-15
11044	HCPCS	Deb Bone 20 Sq Cm/<	12	12	$3,708.30	$2,966.64 20% off	$317.20	$2,966.64	$1,336.76	2026-07-15
19083	HCPCS	US Guide Breast Bx 1	12	12	$3,869.00	$3,095.20 20% off	$214.35	$3,095.20	$1,336.76	2026-07-15
99291	HCPCS	Crit Care 30-74 Min	26	13	$1,889.00	$1,511.20 20% off	$600.00	$1,511.20	$1,331.64	2026-07-15
73225	HCPCS	MRA Upper Ext W Or W	6	6	$3,564.00	$2,851.20 20% off	$344.26	$2,851.20	$1,328.30	2026-07-15
36569	HCPCS	ICU Picc Sterile Tec	14	13	$2,700.00	$2,160.00 20% off	$133.08	$2,160.00	$1,304.91	2026-07-15
Q4186	HCPCS	Amniofix 3x3 Implant	10	5	$3,300.50	$2,640.40 20% off	$1,160.22	$2,790.40	$1,299.98	2026-07-15
C1874	HCPCS	Rx Bil Stent 4cm	5	5	$3,264.00	$2,611.20 20% off	$1,216.49	$2,611.20	$1,216.49	2026-07-15
J0630	HCPCS	Miacalcin 200iu/ml	11	11	$5,962.10	$4,769.68 20% off	$1,173.06	$4,769.68	$1,173.06	2026-07-15
78452	HCPCS	Nm Cardio Stress Ms	13	13	$3,200.00	$2,560.00 20% off	$455.98	$2,560.00	$1,170.77	2026-07-15
C1771	HCPCS	Solyx Mid Urth Sling	10	5	$2,475.50	$1,980.40	$680.55	$2,500.00	$1,164.69	2026-07-15
C1778	HCPCS	Bearing 159577	20	5	$2,887.50	$2,310.00 20% off	$721.17	$7,112.00	$1,127.42	2026-07-15
74185	HCPCS	MRA Abdomen Without Cons	6	6	$3,016.00	$2,412.80	$334.11	$2,412.80	$1,124.06	2026-07-15
73725	HCPCS	MRA Lower Ext W Cont	6	6	$3,016.00	$2,412.80	$332.01	$2,412.80	$1,124.06	2026-07-15
C1787	HCPCS	Interstim Progrmr	5	5	$2,975.00	$2,380.00 20% off	$1,108.78	$2,380.00	$1,108.78	2026-07-15
J2325	HCPCS	Natrecor 1.5mg/5ml V	5	5	$2,880.40	$2,304.32	$1,073.53	$2,304.32	$1,073.53	2026-07-15
0206	RC	—	1	1	$1,297.00	$1,037.60 20% off	$1,037.60	$1,037.60	$1,037.60	2026-07-15
0722	RC	—	15	5	$2,543.00	$2,034.40	$894.48	$5,911.20	$1,017.20	2026-07-15
J9217	HCPCS	Lupron Depot 30mg	16	11	$2,608.02	$2,086.42	$176.51	$23,660.44	$972.01	2026-07-15
93016	HCPCS	Nm Cardia Str Superv	7	7	$2,500.00	$2,000.00 20% off	$29.03	$2,000.00	$931.75	2026-07-15
A4641	HCPCS	Indium-iii 3 Mc	5	5	$2,475.00	$1,980.00 20% off	$922.43	$1,980.00	$922.43	2026-07-15
0114	RC	—	3	3	$2,100.00	$1,680.00 20% off	$900.00	$1,680.00	$900.00	2026-07-15
99285	HCPCS	ER Care Level 5	26	13	$1,122.00	$897.60 20% off	$418.17	$1,129.59	$897.60	2026-07-15
36410	HCPCS	Oss Midline Insert	7	6	$2,400.00	$1,920.00 20% off	$12.75	$1,920.00	$894.48	2026-07-15
95810	HCPCS	Polysonogram Complt	12	12	$1,530.00	$1,224.00 20% off	$570.23	$1,224.00	$862.05	2026-07-15
C1880	HCPCS	Greenfield Filter	5	5	$2,297.00	$1,837.60 20% off	$856.09	$1,837.60	$856.09	2026-07-15
49082	HCPCS	Paracentesis	12	12	$1,038.00	$830.40 20% off	$102.05	$830.40	$747.40	2026-07-15
19084	HCPCS	US Guide Brst Bx Add	6	6	$1,935.00	$1,548.00 20% off	$106.89	$1,548.00	$721.17	2026-07-15
36620	HCPCS	Art Line Insertion	6	6	$1,907.00	$1,525.60 20% off	$62.10	$1,525.60	$710.74	2026-07-15
88319	HCPCS	Enzyme Histochem Gp3	12	12	$1,081.92	$865.54	$140.62	$865.54	$708.98	2026-07-15
88333	HCPCS	Intraop Cyto Pth Co1	12	12	$1,081.92	$865.54	$40.72	$865.54	$708.98	2026-07-15
90677	HCPCS	Prevnar-20	5	5	$1,891.20	$1,512.96 20% off	$704.85	$1,512.96	$704.85	2026-07-15
0110	RC	—	2	1	$875.50	$700.40 20% off	$622.40	$778.40	$700.40	2026-07-15
0112	RC	—	2	1	$849.00	$679.20	$519.20	$839.20	$679.20	2026-07-15
J9202	HCPCS	Zoladex Ij Per 3.6mg	11	11	$1,381.23	$1,104.98 20% off	$514.78	$1,104.98	$674.77	2026-07-15
71551	HCPCS	MRI Chest W Contrast	12	12	$3,290.00	$2,632.00 20% off	$385.15	$2,632.00	$660.16	2026-07-15
73222	HCPCS	MRI Upper Ext W/cont	12	12	$3,290.00	$2,632.00 20% off	$312.42	$2,632.00	$660.16	2026-07-15
73722	HCPCS	MRI Ankle W Contrast	12	12	$3,290.00	$2,632.00 20% off	$313.27	$2,632.00	$660.16	2026-07-15
72265	HCPCS	Myelogram Lumbar	12	12	$2,226.00	$1,780.80 20% off	$88.49	$1,780.80	$660.16	2026-07-15
99284	HCPCS	ER Care Level 4	26	13	$785.00	$628.00 20% off	$292.57	$965.18	$628.00	2026-07-15
C9290	HCPCS	Exparel 1.3% Inj	5	5	$1,644.40	$1,315.52 20% off	$612.87	$1,315.52	$612.87	2026-07-15
90670	HCPCS	Prevnar 13	5	5	$1,634.80	$1,307.84 20% off	$609.29	$1,307.84	$609.29	2026-07-15
99283	HCPCS	ER Care Level 3	27	13	$590.00	$472.00 20% off	$99.06	$835.24	$600.00	2026-07-15
99282	HCPCS	ER Care Level 2	26	13	$365.00	$292.00 20% off	$34.62	$734.85	$600.00	2026-07-15
99281	HCPCS	ER Care Lvl 1 W Proc	26	13	$224.00	$179.20 20% off	$10.53	$673.20	$600.00	2026-07-15
99292	HCPCS	Crit Care Ea Addl 30	12	12	$850.00	$680.00 20% off	$316.80	$680.00	$600.00	2026-07-15
77012	HCPCS	CT Guided Needle Plc	6	6	$1,596.00	$1,276.80 20% off	$89.76	$1,276.80	$594.83	2026-07-15
88309	HCPCS	Surg Path Mircex Lv6	12	12	$574.00	$459.20 20% off	$213.93	$708.98	$584.09	2026-07-15
11047	HCPCS	Deb Bone Ea Add 20	6	6	$1,567.00	$1,253.60 20% off	$137.07	$1,253.60	$584.02	2026-07-15
J1670	HCPCS	Tetanus Immune Globu	11	11	$2,344.80	$1,875.84 20% off	$581.78	$1,875.84	$581.78	2026-07-15
60100	HCPCS	US Guided Thyroid Bx	12	12	$1,710.00	$1,368.00 20% off	$107.08	$1,368.00	$580.10	2026-07-15
10005	HCPCS	US Guide Ndl Asp Bx	12	12	$1,710.00	$1,368.00 20% off	$102.12	$1,368.00	$580.10	2026-07-15
62273	HCPCS	Blood Patch	12	12	$2,921.00	$2,336.80	$158.20	$2,336.80	$570.17	2026-07-15
SURG	OTHER	Minor Surg Proc Iii	170	5	$1,358.00	$1,086.40	$53.67	$4,981.60	$565.20	2026-07-15
P9036	HCPCS	Platelets Pheresis I	11	11	$1,343.00	$1,074.40	$500.54	$1,074.40	$559.94	2026-07-15
C1781	HCPCS	Hernia Patch Kugel L	200	5	$1,311.00	$1,048.80	$79.01	$4,224.80	$558.89	2026-07-15
J2690	HCPCS	Procainamide Inj Vl	11	11	$376.70	$301.36	$140.40	$546.07	$546.07	2026-07-15
G0379	HCPCS	Opce Med Direct Admt	16	11	$3,983.00	$3,186.40 20% off	$484.51	$3,186.40	$529.59	2026-07-15
C1052	HCPCS	Imp Hemost Vist 10ml	5	5	$1,392.00	$1,113.60 20% off	$518.80	$1,113.60	$518.80	2026-07-15
36589	HCPCS	Remove Picc/cntrl Li	12	12	$1,285.00	$1,028.00 20% off	$188.43	$1,028.00	$517.96	2026-07-15
11043	HCPCS	Deb Mus/fas20 Sqcm/<	12	12	$1,358.73	$1,086.98 20% off	$214.98	$1,086.98	$517.83	2026-07-15
94002	HCPCS	Vent Initial Day	13	13	$758.00	$606.40 20% off	$128.14	$606.40	$516.69	2026-07-15
C1779	HCPCS	Imp Tri Pat 5552l381	5	5	$1,375.00	$1,100.00 20% off	$512.46	$1,100.00	$512.46	2026-07-15
94003	HCPCS	Vent Sub Day	12	12	$617.00	$493.60	$89.94	$516.69	$505.15	2026-07-15
0172	RC	—	1	1	$613.00	$490.40 20% off	$490.40	$490.40	$490.40	2026-07-15
0278	RC	—	205	5	$1,173.00	$938.40 20% off	$16.40	$15,015.00	$467.60	2026-07-15
93306	HCPCS	Echo Complete	13	13	$2,257.00	$1,805.60 20% off	$164.01	$1,805.60	$454.86	2026-07-15
78227	HCPCS	Nm Hida W/cck	12	12	$1,335.00	$1,068.00 20% off	$445.65	$1,068.00	$449.48	2026-07-15
78707	HCPCS	Nm Mag 3 Renal Scan	12	12	$936.00	$748.80 20% off	$218.27	$748.80	$445.65	2026-07-15
78582	HCPCS	Nm Lung Vent Perf	12	12	$1,335.00	$1,068.00 20% off	$323.25	$1,068.00	$445.65	2026-07-15
95824	HCPCS	EEG Cerebral Death E	11	11	$848.00	$678.40 20% off	$316.05	$678.40	$441.92	2026-07-15
C1713	HCPCS	Imp Hammertoe Md	1,526	6	$1,018.00	$814.40 20% off	$5.96	$18,627.20	$435.69	2026-07-15
81220	HCPCS	Cystic Fibr DNA Prof	12	12	$1,113.20	$890.56 20% off	$414.89	$890.56	$417.45	2026-07-15
J1442	HCPCS	Neupogen 480mcg/136m	16	11	$1,708.10	$1,366.48	$1.00	$1,366.48	$399.80	2026-07-15
71552	HCPCS	MRI Chest W/wo Cont	12	12	$3,564.00	$2,851.20 20% off	$317.08	$2,851.20	$399.38	2026-07-15
Q4101	HCPCS	Apligraf	11	5	$495.00	$396.00 20% off	$60.22	$1,057.60	$396.00	2026-07-15
11046	HCPCS	Deb Mus/fas Eaadd 20	6	6	$1,036.00	$828.80 20% off	$77.53	$828.80	$386.12	2026-07-15
J1410	HCPCS	Premarin 25mg Inj	11	11	$663.00	$530.40 20% off	$247.10	$530.40	$382.79	2026-07-15
J2760	HCPCS	Phentolamine 5mg Inj	11	11	$1,769.70	$1,415.76 20% off	$367.12	$1,415.76	$367.12	2026-07-15
73220	HCPCS	MRI Upext Nojnt W/wo	12	12	$3,564.00	$2,851.20 20% off	$317.08	$2,851.20	$362.31	2026-07-15
C1788	HCPCS	Imp Medi Port Power	20	5	$908.50	$726.80 20% off	$217.66	$1,265.60	$360.40	2026-07-15
36430	HCPCS	Medsurg Blood Transf	13	13	$1,034.00	$827.20	$54.09	$827.20	$357.92	2026-07-15
J1205	HCPCS	Diuril 0.5gm Inj	10	5	$943.18	$754.54 20% off	$4.73	$1,498.92	$354.24	2026-07-15
90675	HCPCS	Rabavert Rabies Vacc	11	11	$1,182.20	$945.76 20% off	$350.14	$945.76	$350.14	2026-07-15
73723	HCPCS	MRI Knee W&wo Cont	12	12	$3,564.00	$2,851.20 20% off	$317.08	$2,851.20	$346.46	2026-07-15
78278	HCPCS	Nm Tagged Red Blood	12	12	$936.00	$748.80 20% off	$340.06	$748.80	$343.56	2026-07-15
74174	HCPCS	CTA Abd&pelvis W/wo	12	12	$3,016.00	$2,412.80	$317.08	$2,412.80	$341.45	2026-07-15
78315	HCPCS	Nm 3 Phase Bone Scan	12	12	$936.00	$748.80 20% off	$340.06	$748.80	$341.44	2026-07-15
78472	HCPCS	Nm Muga Scan	12	12	$1,562.00	$1,249.60 20% off	$210.22	$1,249.60	$340.06	2026-07-15
78580	HCPCS	Nm Lung Perf Only	12	12	$833.00	$666.40 20% off	$232.22	$666.40	$340.06	2026-07-15
78579	HCPCS	Nm Lung Scn Vent Oly	12	12	$958.00	$766.40 20% off	$190.65	$766.40	$340.06	2026-07-15
78300	HCPCS	Nm Bone Scan Partial	12	12	$785.00	$628.00 20% off	$226.17	$628.00	$340.06	2026-07-15
78290	HCPCS	Nm Abd Scan Mickels	12	12	$785.00	$628.00 20% off	$292.57	$628.00	$340.06	2026-07-15
78601	HCPCS	Nm Brain Per W/vf	12	12	$1,495.00	$1,196.00 20% off	$225.03	$1,196.00	$340.06	2026-07-15
78306	HCPCS	Nm Bone Scan Body	12	12	$1,414.00	$1,131.20	$292.25	$1,131.20	$340.06	2026-07-15
78264	HCPCS	Nm Gastric Emptying	14	14	$936.00	$748.80 20% off	$91.51	$748.80	$340.06	2026-07-15
78226	HCPCS	Nm Hida Without	12	12	$963.00	$770.40 20% off	$333.40	$770.40	$340.06	2026-07-15
78070	HCPCS	Nm Parathyroid Scan	12	12	$1,121.00	$896.80 20% off	$295.35	$896.80	$340.06	2026-07-15
78215	HCPCS	Nm Liver & Spleen Sc	12	12	$785.00	$628.00 20% off	$203.04	$628.00	$340.06	2026-07-15
70549	HCPCS	MRA Neck W&wo Cont	12	12	$3,564.00	$2,851.20 20% off	$317.08	$2,851.20	$330.88	2026-07-15
11042	HCPCS	Deb Subq 20 Sqcm/<	12	12	$877.47	$701.98	$84.25	$701.98	$328.76	2026-07-15
36680	HCPCS	Placement Io Needle	12	12	$726.00	$580.80 20% off	$84.85	$580.80	$328.51	2026-07-15
0170	RC	—	1	1	$408.00	$326.40 20% off	$326.40	$326.40	$326.40	2026-07-15
P9034	HCPCS	Platelets Pheresis P	11	11	$1,239.00	$991.20	$321.86	$991.20	$321.86	2026-07-15
78014	HCPCS	Nm Thyroid Scan	12	12	$378.00	$302.40 20% off	$140.88	$340.06	$321.23	2026-07-15
75561	HCPCS	MRI Heart W/wout Con	12	12	$1,878.00	$1,502.40	$317.08	$1,502.40	$319.40	2026-07-15
72149	HCPCS	MRI Lumbar Spine W/c	12	12	$3,290.00	$2,632.00 20% off	$247.31	$2,632.00	$317.08	2026-07-15
74430	HCPCS	Cystogram 3+ Vws	12	12	$584.00	$467.20 20% off	$33.52	$467.20	$317.08	2026-07-15
74182	HCPCS	MRI Abdomen W/contr	12	12	$3,290.00	$2,632.00 20% off	$292.55	$2,632.00	$317.08	2026-07-15
74178	HCPCS	CT Abd + Pelv Wo/w	13	13	$3,564.00	$2,851.20 20% off	$256.96	$2,851.20	$317.08	2026-07-15
74177	HCPCS	CT Ab + Pelv W	13	13	$3,290.00	$2,632.00 20% off	$287.35	$2,632.00	$317.08	2026-07-15
72142	HCPCS	MRI Cervical W Cont	12	12	$3,290.00	$2,632.00 20% off	$253.23	$2,632.00	$317.08	2026-07-15
73720	HCPCS	MRI Lowext Nojt W/wo	12	12	$3,564.00	$2,851.20 20% off	$312.84	$2,851.20	$317.08	2026-07-15
73719	HCPCS	MRI Lowext No Jnt W	12	12	$3,290.00	$2,632.00 20% off	$247.73	$2,632.00	$317.08	2026-07-15
70553	HCPCS	MRI Brain W&wo Cont	13	13	$3,564.00	$2,851.20 20% off	$49.09	$2,851.20	$317.08	2026-07-15
70552	HCPCS	MRI Brain W Contrast	12	12	$3,290.00	$2,632.00 20% off	$247.31	$2,632.00	$317.08	2026-07-15
70543	HCPCS	MRI Orb Face Neckwwo	12	12	$3,564.00	$2,851.20 20% off	$314.95	$2,851.20	$317.08	2026-07-15
73223	HCPCS	MRI Upper Ext W&without	13	13	$3,564.00	$2,851.20 20% off	$93.81	$2,851.20	$317.08	2026-07-15
73201	HCPCS	CT Extrem Upper (w)	12	12	$2,124.00	$1,699.20 20% off	$192.63	$1,699.20	$317.08	2026-07-15
74183	HCPCS	MRI Abdomen W/wo	13	13	$3,564.00	$2,851.20 20% off	$311.16	$2,851.20	$317.08	2026-07-15
72197	HCPCS	MRI Pelvis W&wo	13	13	$3,564.00	$2,851.20 20% off	$309.46	$2,851.20	$317.08	2026-07-15
72196	HCPCS	MRI Pelvis W Cont	12	12	$3,290.00	$2,632.00 20% off	$248.15	$2,632.00	$317.08	2026-07-15
72158	HCPCS	MRI Lumbar W&wo Cont	12	12	$3,564.00	$2,851.20 20% off	$280.71	$2,851.20	$317.08	2026-07-15
72157	HCPCS	MRI Thoracic W&wo	12	12	$3,564.00	$2,851.20 20% off	$282.40	$2,851.20	$317.08	2026-07-15
72156	HCPCS	MRI Cervical W&wo	12	12	$3,564.00	$2,851.20 20% off	$281.56	$2,851.20	$317.08	2026-07-15
C8914	HCPCS	MRA Lower Ext Wo & W	11	11	$3,564.00	$2,851.20 20% off	$317.08	$2,851.20	$317.08	2026-07-15
72147	HCPCS	MRI Thoracic Sp W/co	12	12	$3,290.00	$2,632.00 20% off	$250.69	$2,632.00	$317.08	2026-07-15
73218	HCPCS	MRI Up Ext Nojoin Wo	13	13	$3,016.00	$2,412.80	$202.03	$2,412.80	$315.81	2026-07-15
90732	HCPCS	Pneumococcal Vaccine	5	5	$845.75	$676.60 20% off	$315.21	$676.60	$315.21	2026-07-15
92523	HCPCS	Eval Sp Snd Prod Art	12	12	$531.00	$424.80 20% off	$197.90	$424.80	$313.48	2026-07-15
87507	HCPCS	Gastroint Prof 12-25	12	12	$700.00	$560.00 20% off	$260.89	$560.00	$312.59	2026-07-15
88307	HCPCS	Surg Path Mircex Lv5	12	12	$419.00	$335.20 20% off	$156.16	$335.20	$296.36	2026-07-15
86902	HCPCS	Antigen Scn Per Unit	12	12	$430.86	$344.69	$6.35	$344.69	$296.36	2026-07-15
Q4183	HCPCS	Surgigraft Per Sq Cm	5	5	$781.00	$624.80 20% off	$291.08	$624.80	$291.08	2026-07-15
90375	HCPCS	Rabies Immune Glob	11	11	$2,963.65	$2,370.92 20% off	$287.70	$2,370.92	$287.70	2026-07-15
95819	HCPCS	EEG Awake/asleep	12	12	$825.00	$660.00 20% off	$258.79	$660.00	$283.13	2026-07-15
J1050	HCPCS	Depo-provera 150mg S	5	5	$754.00	$603.20	$281.02	$603.20	$281.02	2026-07-15
10006	HCPCS	US Gu Ndl Asp Bx Add	6	6	$750.00	$600.00 20% off	$69.85	$600.00	$279.53	2026-07-15
81479	HCPCS	Shox-dnadx	5	5	$750.00	$600.00 20% off	$279.53	$600.00	$279.53	2026-07-15
96413	HCPCS	IV Infusion Entyvio	12	12	$526.00	$420.80 20% off	$166.63	$420.80	$279.23	2026-07-15
36593	HCPCS	Picc Line Declotting	13	12	$475.00	$380.00 20% off	$44.23	$380.00	$279.23	2026-07-15
71550	HCPCS	MRI Chest Wo Cont	12	12	$3,016.00	$2,412.80	$202.03	$2,412.80	$278.37	2026-07-15
75635	HCPCS	CT Angio Aorto-ilio	12	12	$2,400.00	$1,920.00 20% off	$151.48	$1,920.00	$273.09	2026-07-15
95816	HCPCS	EEG Awake/drowsey	12	12	$765.00	$612.00 20% off	$258.79	$612.00	$271.96	2026-07-15
J2430	HCPCS	Aredia 90mg Vial	15	5	$728.82	$583.06	$41.18	$676.32	$271.63	2026-07-15
76942	HCPCS	US Guided Needle Plc	6	6	$720.00	$576.00 20% off	$36.06	$576.00	$268.34	2026-07-15
76946	HCPCS	US Amniocentesis	6	6	$720.00	$576.00 20% off	$19.58	$576.00	$268.34	2026-07-15
59070	HCPCS	Amnioinfusion	12	12	$332.00	$265.60	$123.74	$443.58	$264.50	2026-07-15
0370	RC	—	10	5	$599.00	$479.20	$66.34	$816.00	$261.27	2026-07-15
95812	HCPCS	EEG 41-60 Min	12	12	$625.00	$500.00 20% off	$232.94	$500.00	$258.79	2026-07-15
95813	HCPCS	EEG 61-119 Min	12	12	$675.00	$540.00 20% off	$251.57	$540.00	$258.79	2026-07-15
94060	HCPCS	Pf W/lung Vol With Bd	13	13	$561.00	$448.80 20% off	$25.14	$448.80	$258.79	2026-07-15
92950	HCPCS	Cpr Code 4	13	13	$590.00	$472.00 20% off	$219.89	$472.00	$258.79	2026-07-15
93017	HCPCS	Treadmill	12	12	$561.00	$448.80 20% off	$48.02	$448.80	$258.79	2026-07-15
92587	HCPCS	Oae Hearing Scrn Mon	12	12	$547.00	$437.60	$4.77	$437.60	$258.79	2026-07-15
87902	HCPCS	Hepatitis C Genotype	13	13	$1,442.00	$1,153.60 20% off	$193.09	$1,153.60	$257.45	2026-07-15
87912	HCPCS	Hepatitis B Virus	12	12	$1,236.03	$988.82 20% off	$193.09	$988.82	$257.45	2026-07-15
61782	HCPCS	Navigation/sinus Sur	6	6	$683.00	$546.40 20% off	$242.01	$546.40	$254.55	2026-07-15
62284	HCPCS	Myelogram Lumbar-adm	6	6	$675.00	$540.00 20% off	$115.42	$540.00	$251.57	2026-07-15
93320	HCPCS	Echo W/doppler	6	6	$674.00	$539.20	$42.40	$539.20	$251.20	2026-07-15
93325	HCPCS	Echo W/color Flow	6	6	$674.00	$539.20	$25.78	$539.20	$251.20	2026-07-15
43753	HCPCS	Gi Lavage	12	12	$295.00	$236.00 20% off	$30.78	$258.79	$247.40	2026-07-15
88344	HCPCS	Multiplex Antibody	12	12	$239.00	$191.20 20% off	$89.08	$296.36	$243.78	2026-07-15
J3489	HCPCS	Reclast 5mg/100ml Vl	15	5	$636.51	$509.21	$167.83	$520.24	$242.37	2026-07-15
J3243	HCPCS	Tygacil Inj 50mg	5	5	$650.05	$520.04 20% off	$242.27	$520.04	$242.27	2026-07-15
J1742	HCPCS	Corvert Inj (ibutili	11	11	$1,159.15	$927.32 20% off	$241.40	$927.32	$241.40	2026-07-15
97606	HCPCS	Wd Vac Tx >50 W/dme	16	16	$621.60	$497.28 20% off	$37.12	$497.28	$231.67	2026-07-15
73706	HCPCS	CTA Lower Ext W/wo	12	12	$1,645.00	$1,316.00 20% off	$151.49	$1,316.00	$230.33	2026-07-15
70336	HCPCS	MRI Temporoman Wo	12	12	$3,564.00	$2,851.20 20% off	$202.03	$2,851.20	$229.68	2026-07-15
15274	HCPCS	Skn Grft T/a/l Ea100	6	6	$608.00	$486.40 20% off	$62.79	$486.40	$226.60	2026-07-15
74175	HCPCS	CTA Abd Wo/w	12	12	$3,016.00	$2,412.80	$151.49	$2,412.80	$221.18	2026-07-15
72191	HCPCS	CTA Pelvis W/wo	12	12	$1,645.00	$1,316.00 20% off	$151.49	$1,316.00	$220.97	2026-07-15
P9038	HCPCS	Rbc Irradiated Per U	11	11	$427.58	$342.06 20% off	$159.36	$342.06	$216.72	2026-07-15
93975	HCPCS	US Renal Arteries Co	18	13	$787.00	$629.60 20% off	$173.92	$629.60	$216.17	2026-07-15
73206	HCPCS	CTA Upper Ext W/wo	12	12	$1,645.00	$1,316.00 20% off	$151.49	$1,316.00	$216.10	2026-07-15
C1758	HCPCS	Ureteral Stent 7x26	5	5	$579.00	$463.20 20% off	$215.79	$463.20	$215.79	2026-07-15
J2353	HCPCS	Sandostatin Lar 20mg	11	11	$7,377.65	$5,902.12 20% off	$214.88	$5,902.12	$214.88	2026-07-15
75557	HCPCS	MRI Heart W/out Cont	12	12	$1,250.00	$1,000.00 20% off	$202.03	$1,000.00	$213.61	2026-07-15
70547	HCPCS	MRA Neck Wo Cont	13	13	$3,016.00	$2,412.80	$202.03	$2,412.80	$210.95	2026-07-15
76815	HCPCS	US Fetal-limited	18	13	$720.00	$576.00 20% off	$25.15	$576.00	$210.58	2026-07-15
76805	HCPCS	US Preg Transab >/=1	17	12	$720.00	$576.00 20% off	$90.64	$576.00	$210.58	2026-07-15
92506	HCPCS	St/hearing Eval Per	5	5	$561.00	$448.80 20% off	$209.08	$448.80	$209.08	2026-07-15
70540	HCPCS	MRI Orb Face/neck Wo	12	12	$3,016.00	$2,412.80	$202.03	$2,412.80	$208.75	2026-07-15
0311	RC	—	15	5	$558.86	$447.09	$51.81	$550.40	$208.29	2026-07-15
72195	HCPCS	MRI Pelvis Without Cont	12	12	$3,016.00	$2,412.80	$202.03	$2,412.80	$207.06	2026-07-15
73718	HCPCS	MRI Lowext Nojointwo	12	12	$3,016.00	$2,412.80	$202.03	$2,412.80	$206.84	2026-07-15
70544	HCPCS	MRA Head/brain Wo Co	12	12	$3,016.00	$2,412.80	$202.03	$2,412.80	$206.28	2026-07-15
74170	HCPCS	CT Abdomen W&wo Cont	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$205.04	2026-07-15
72194	HCPCS	CT Pelvis (wo&w)	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$204.41	2026-07-15
J1626	HCPCS	Kytril Inj 1mg 1ml	5	5	$547.80	$438.24	$204.17	$438.24	$204.17	2026-07-15
43762	HCPCS	Chng Peg Tube/no Ima	12	12	$477.00	$381.60	$53.23	$381.60	$203.77	2026-07-15
70498	HCPCS	CTA Neck W/wo	14	14	$1,645.00	$1,316.00 20% off	$109.21	$1,316.00	$203.42	2026-07-15
93930	HCPCS	US Art Upper Ext Bil	12	12	$1,000.00	$800.00 20% off	$202.03	$800.00	$203.10	2026-07-15
72141	HCPCS	MRI Cervical Wo Cont	13	13	$3,016.00	$2,412.80	$160.92	$2,412.80	$202.03	2026-07-15
76391	HCPCS	MRI Elastography	13	13	$650.00	$520.00 20% off	$173.92	$520.00	$202.03	2026-07-15
93985	HCPCS	US Venous Map Bilat	12	12	$286.00	$228.80	$106.59	$267.73	$202.03	2026-07-15
76000	HCPCS	Fluorosc Up To 1 Hr	13	13	$449.00	$359.20 20% off	$35.64	$359.20	$202.03	2026-07-15
74455	HCPCS	Cystogram-voiding	12	12	$584.00	$467.20 20% off	$112.59	$467.20	$202.03	2026-07-15
74181	HCPCS	MRI Abdomen Wo Cont	12	12	$3,016.00	$2,412.80	$168.95	$2,412.80	$202.03	2026-07-15
74176	HCPCS	CT Abd + Pelv Wo	13	13	$3,016.00	$2,412.80	$135.13	$2,412.80	$202.03	2026-07-15
93970	HCPCS	US Ven Upper Ext Bil	13	13	$1,000.00	$800.00 20% off	$173.92	$800.00	$202.03	2026-07-15
73721	HCPCS	MRI Hip Wo Cont	13	13	$3,016.00	$2,412.80	$116.38	$2,412.80	$202.03	2026-07-15
93880	HCPCS	US Carotid Bi	13	13	$1,714.00	$1,371.20 20% off	$173.92	$1,371.20	$202.03	2026-07-15
70551	HCPCS	MRI Brain Wo Cont	13	13	$3,016.00	$2,412.80	$121.29	$2,412.80	$202.03	2026-07-15
73221	HCPCS	MRI Shoulder Wo Cont	12	12	$3,016.00	$2,412.80	$184.18	$2,412.80	$202.03	2026-07-15
93307	HCPCS	Echo 2-d	12	12	$674.00	$539.20	$119.48	$539.20	$202.03	2026-07-15
C8913	HCPCS	MRA Lower Ext Wo	11	11	$3,016.00	$2,412.80	$202.03	$2,412.80	$202.03	2026-07-15
72148	HCPCS	MRI Lumbar Wo Cont	13	13	$3,016.00	$2,412.80	$161.34	$2,412.80	$202.03	2026-07-15
93925	HCPCS	US Art Lower Ext Bil	13	13	$1,000.00	$800.00 20% off	$173.92	$800.00	$202.03	2026-07-15
72146	HCPCS	MRI Thoracic Wo Cont	12	12	$3,016.00	$2,412.80	$160.50	$2,412.80	$202.03	2026-07-15
73202	HCPCS	CT Upper Ext W/wo	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$201.88	2026-07-15
31502	HCPCS	Tracheotomy Tube Chg	12	12	$554.00	$443.20 20% off	$49.02	$443.20	$201.39	2026-07-15
31500	HCPCS	Resp Intub Et Emer	13	13	$646.00	$516.80 20% off	$199.82	$516.80	$201.39	2026-07-15
C1780	HCPCS	Eye Lens	5	5	$540.00	$432.00 20% off	$201.26	$432.00	$201.26	2026-07-15
J1110	HCPCS	D H E 45amp	10	5	$412.12	$329.69 20% off	$106.86	$430.00	$200.33	2026-07-15
88261	HCPCS	Chromosome Analyses	12	12	$427.50	$342.00 20% off	$159.33	$342.00	$198.26	2026-07-15
J1740	HCPCS	Boniva Inj Per 1 Mg	5	5	$528.75	$423.00 20% off	$197.07	$423.00	$197.07	2026-07-15
J1610	HCPCS	Glucagon Inj 1 Mg	11	11	$1,014.25	$811.40 20% off	$192.30	$811.40	$192.30	2026-07-15
A9562	HCPCS	Mag-3	5	5	$515.00	$412.00 20% off	$191.94	$412.00	$191.94	2026-07-15
72193	HCPCS	CT Pelvis (w)	12	12	$2,124.00	$1,699.20 20% off	$151.49	$1,699.20	$190.45	2026-07-15
74160	HCPCS	CT Abdomen (w)	12	12	$2,124.00	$1,699.20 20% off	$151.49	$1,699.20	$189.82	2026-07-15
11045	HCPCS	Deb Subq Ea Add 20	6	6	$505.00	$404.00 20% off	$35.73	$404.00	$188.21	2026-07-15
A9500	HCPCS	Nm Tc 99m Sestamibi	6	6	$474.00	$379.20 20% off	$176.66	$758.40	$183.13	2026-07-15
J3070	HCPCS	Talwin 30mg/ml	5	5	$491.05	$392.84 20% off	$183.01	$392.84	$183.01	2026-07-15
92521	HCPCS	Eval Sp Fluency	12	12	$314.00	$251.20 20% off	$117.03	$251.20	$182.87	2026-07-15
J1570	HCPCS	Cytovene 500mg	5	5	$486.75	$389.40 20% off	$181.41	$389.40	$181.41	2026-07-15
P9016	HCPCS	Rbc Leukocyte Reduce	24	12	$482.00	$385.60	$74.01	$571.20	$180.82	2026-07-15
J2785	HCPCS	Nm Lexi Inj 0.4/0.1m	6	6	$466.00	$372.80 20% off	$173.68	$1,491.20	$180.04	2026-07-15
A4305	HCPCS	Stryker Pain 2-day I	5	5	$482.00	$385.60	$179.64	$385.60	$179.64	2026-07-15
J0153	HCPCS	Adenosine 6 Mg	10	5	$462.38	$369.91	$9.23	$720.00	$177.62	2026-07-15
J2404	HCPCS	Cardene 20mg Premix	6	6	$459.15	$367.32 20% off	$171.13	$367.32	$177.39	2026-07-15
96365	HCPCS	IV Inf Therapy Int	14	14	$526.00	$420.80 20% off	$81.26	$420.80	$176.72	2026-07-15
96374	HCPCS	IV Push Initial	13	13	$495.00	$396.00 20% off	$47.84	$396.00	$176.72	2026-07-15
A9502	HCPCS	Nm Myoview	5	5	$474.00	$379.20 20% off	$176.66	$379.20	$176.66	2026-07-15
31720	HCPCS	Resp Cath Aspiration	12	12	$410.00	$328.00 20% off	$67.83	$328.00	$175.85	2026-07-15
94664	HCPCS	Hnhld Neb Demo/eval	12	12	$410.00	$328.00 20% off	$23.08	$328.00	$175.85	2026-07-15
94660	HCPCS	Polysonogram Cpap	18	13	$565.00	$452.00 20% off	$51.82	$452.00	$175.85	2026-07-15
94640	HCPCS	Ippb Tx Initial	23	12	$410.00	$328.00 20% off	$10.27	$508.00	$175.85	2026-07-15
70482	HCPCS	CT Sella/iac/orb/wow	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$175.44	2026-07-15
88184	HCPCS	Flow Cytometry 1st M	17	12	$430.86	$344.69	$82.37	$344.69	$172.34	2026-07-15
88361	HCPCS	Computer Assis Techn	17	12	$430.86	$344.69	$98.22	$344.69	$172.34	2026-07-15
70492	HCPCS	CT Neck Sft Tis Wo/w	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$171.85	2026-07-15
81210	HCPCS	Braf Gene	12	12	$450.00	$360.00 20% off	$131.55	$360.00	$167.72	2026-07-15
72130	HCPCS	CT Thoracic Sp W/wo	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$167.42	2026-07-15
76001	HCPCS	Fluorosc Ea Addl Hr	5	5	$449.00	$359.20 20% off	$167.34	$359.20	$167.34	2026-07-15
72133	HCPCS	CT Lumbar Sp Wow	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$166.99	2026-07-15
73702	HCPCS	CT Lower Ext W/wo	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$166.99	2026-07-15
72127	HCPCS	CT Cervical Sp Wow	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$166.78	2026-07-15
71270	HCPCS	CT Thorax (wo&w)	12	12	$2,399.00	$1,919.20 20% off	$151.49	$1,919.20	$166.56	2026-07-15
97597	HCPCS	Deb Sel 20sqcm/<	12	12	$440.00	$352.00 20% off	$49.78	$352.00	$165.06	2026-07-15
17250	HCPCS	Chemical Cauteriz	12	12	$459.15	$367.32 20% off	$51.79	$367.32	$165.06	2026-07-15
11056	HCPCS	Callus Reduce 2-4	12	12	$551.00	$440.80 20% off	$30.99	$440.80	$165.06	2026-07-15
59025	HCPCS	Non-stress Test	13	13	$440.00	$352.00 20% off	$25.91	$352.00	$164.29	2026-07-15
81206	HCPCS	Bcr/abl1	12	12	$783.00	$626.40 20% off	$122.97	$626.40	$163.96	2026-07-15
J0834	HCPCS	Cortrosyn 0.25mg Ij	5	5	$439.60	$351.68 20% off	$163.84	$351.68	$163.84	2026-07-15
86905	HCPCS	Antigen Type.grp I	32	12	$225.00	$180.00 20% off	$3.83	$554.40	$160.58	2026-07-15
86870	HCPCS	Lbc Ab Id Select Cel	26	11	$322.00	$257.60	$96.53	$344.69	$160.58	2026-07-15
J2790	HCPCS	Bayrho-d	11	6	$430.15	$344.12	$62.98	$344.12	$160.32	2026-07-15
J3357	HCPCS	Stelara 90mg Inj Sc	11	11	$76,846.25	$61,477.00 20% off	$159.91	$61,477.00	$159.91	2026-07-15
76937	HCPCS	US Vasc Access Guida	6	6	$428.00	$342.40 20% off	$31.41	$342.40	$159.52	2026-07-15
70488	HCPCS	CT Maxfac Sin W/wo	12	12	$1,895.00	$1,516.00 20% off	$151.49	$1,516.00	$158.11	2026-07-15
J3101	HCPCS	Tnkase 50mg Kit	11	11	$432.08	$345.66 20% off	$157.72	$345.66	$157.72	2026-07-15
J1450	HCPCS	Diflucan 400mg/200ml	20	5	$401.02	$320.82 20% off	$84.89	$491.72	$156.74	2026-07-15
88377	HCPCS	Ea Multi Probe Stain	12	12	$461.00	$368.80 20% off	$140.82	$423.62	$156.31	2026-07-15
92522	HCPCS	Eval Sp Sound Prod	12	12	$256.00	$204.80	$95.41	$204.80	$153.61	2026-07-15
80375	HCPCS	Drugs Or Substances	5	5	$411.78	$329.42 20% off	$153.47	$329.42	$153.47	2026-07-15
0301	RC	—	125	5	$377.00	$301.60	$18.26	$1,612.66	$152.43	2026-07-15
92524	HCPCS	Behav-qualitative An	12	12	$267.00	$213.60 20% off	$99.51	$213.60	$151.50	2026-07-15
71275	HCPCS	CTA Chest W/wo	13	13	$2,124.00	$1,699.20 20% off	$131.51	$1,699.20	$151.49	2026-07-15
74400	HCPCS	Pyelogram IV	12	12	$709.00	$567.20	$142.32	$567.20	$151.49	2026-07-15
71260	HCPCS	CT Thorax (w)	13	13	$2,124.00	$1,699.20 20% off	$128.09	$1,699.20	$151.49	2026-07-15
73701	HCPCS	CT Extrem Lower (w)	12	12	$2,124.00	$1,699.20 20% off	$148.23	$1,699.20	$151.49	2026-07-15
70496	HCPCS	CTA Head W/wo Cont	13	13	$1,000.00	$800.00 20% off	$109.21	$800.00	$151.49	2026-07-15
70491	HCPCS	CT Neck (w)	13	13	$2,124.00	$1,699.20 20% off	$128.09	$1,699.20	$151.49	2026-07-15
70487	HCPCS	CT Max-fac Sinus W/c	12	12	$1,645.00	$1,316.00 20% off	$131.33	$1,316.00	$151.49	2026-07-15

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