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 →

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Hospital

PREVOST MEMORIAL HOSPITAL

Donaldsonville, LA · CCN 191308 · Rates published

408 distinct procedures filed
20 distinct payers
2,137 rate rows
2025-01-01 last MRF observed · ⚠ 22 mo old
Data quality

2,132 of 2,137 rate rows are consumer-grade (99.8%)

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

Excluded — reasonRows
professional (physician) fee — not the facility price 5

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 22 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://machine-readable-files.com/West-Ascension-Parish-Hospital/720637478_west-ascension-parish-hospital_standardcharges.csv
Found on page https://ezcost.info/West-Ascension-Parish-Hospital
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-23
Content fingerprint 0e138e0829f3c0a7… · 678,921 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
74177
CPT 		CT Abd & Pelvis With Contrast 12 $275.00 $3,050.00 $2,816.37 nat. median
$972
outlier · 2.9×
74160
CPT 		CT Abdomen With Contrast 1 $2,456.00 $2,456.00 $2,456.00 nat. median
$650
outlier · 3.8×
71275
CPT 		CTA Chest Pe Protocal 8 $1,680.70 $2,499.00 $2,262.33 nat. median
$753
outlier · 3.0×
74178
CPT 		CT Abd & Pelvis W/wo Contrast 1 $2,196.07 $2,196.07 $2,196.07 nat. median
$1,024
outlier · 2.1×
74170
CPT 		CT Abdomen W/wo Contrast 5 $275.00 $2,557.80 $1,819.17 nat. median
$710
outlier · 2.6×
72193
CPT 		CT Pelvis With Contrast 1 $1,790.00 $1,790.00 $1,790.00 nat. median
$637
outlier · 2.8×
71260
CPT 		CT Thorax With Contrast 6 $1,066.35 $1,825.80 $1,790.00 nat. median
$648
outlier · 2.8×
74176
CPT 		CT Abd & Pelvis Without Contrast 14 $275.00 $2,000.00 $1,782.00 nat. median
$694
outlier · 2.6×
70460
CPT 		CT Head/brain With Contrast 1 $1,558.50 $1,558.50 $1,558.50 nat. median
$575
outlier · 2.7×
73702
CPT 		CT Left Lower Extremity W/wo Contrast 1 $1,515.77 $1,515.77 $1,515.77 nat. median
$700
outlier · 2.2×
73701
CPT 		CT Left Lower Extremity With Contrast 1 $1,480.00 $1,480.00 $1,480.00 nat. median
$668
outlier · 2.2×
11044
CPT 		Debride Bone-first 20cm 2 $468.30 $2,450.00 $1,459.15 nat. median
$1,751
0.8× median
70487
CPT 		CT Facials With Contrast 2 $1,090.74 $1,621.80 $1,356.27 nat. median
$604
outlier · 2.2×
70491
CPT 		CT Soft Tissue Neck With Contrast 3 $1,024.34 $1,670.00 $1,276.55 nat. median
$627
outlier · 2.0×
72131
CPT 		CT L-spine Without Contrast 9 $996.72 $1,326.00 $1,268.04 nat. median
$457
outlier · 2.8×
72128
CPT 		CT T-spine Without Contrast 3 $867.89 $1,400.00 $1,185.52 nat. median
$458
outlier · 2.6×
70470
CPT 		CT Head/brain W/wo Contrast 1 $1,108.15 $1,108.15 $1,108.15 nat. median
$619
1.8× median
99291
CPT 		Critical Care First Hour 2 $1,023.12 $1,176.00 $1,099.56 nat. median
$1,530
0.7× median
71250
CPT 		CT Thorax Without Contrast 10 $694.31 $1,142.40 $1,056.94 nat. median
$464
outlier · 2.3×
70490
CPT 		CT Soft Tissue Neck Without Contrast 5 $600.23 $1,040.00 $1,040.00 nat. median
$448
outlier · 2.3×
74150
CPT 		CT Abdomen Without Contrast 1 $1,000.00 $1,000.00 $1,000.00 nat. median
$448
outlier · 2.2×
72192
CPT 		CT Pelvis Without Contrast 6 $846.80 $1,020.00 $990.00 nat. median
$458
outlier · 2.2×
72125
CPT 		CT C-spine Without Contrast 9 $350.00 $1,020.00 $980.00 nat. median
$472
outlier · 2.1×
70450
CPT 		CT Head/brain Without Contrast 14 $275.00 $2,000.00 $920.70 nat. median
$450
outlier · 2.0×
11046
CPT 		Debride Muscle/fascia-each Addtl 20cm 1 $900.00 $900.00 $900.00 nat. median
$480
1.9× median
77075
CPT 		Bone Survey - Metastatic Series 1 $882.00 $882.00 $882.00 nat. median
$238
outlier · 3.7×
93880
CPT 		Carotid/vertebral U/s 2 $720.00 $891.56 $805.78 nat. median
$530
1.5× median
73700
CPT 		CT Left Lower Extremity Without Contrast 3 $790.00 $1,126.02 $790.00 nat. median
$498
1.6× median
70486
CPT 		CT Facials Without Contrast 9 $513.62 $920.00 $779.06 nat. median
$477
1.6× median
73200
CPT 		CT Left Upper Extremity Without Contrast 4 $420.38 $805.80 $733.36 nat. median
$518
1.4× median
97602
CPT 		Active Wound Mgmt.non-sel Debridement 4 $557.93 $900.00 $729.45 nat. median
$212
outlier · 3.4×
97597
CPT 		Removal Devi Tiss;derm;epid;first 20cm 4 $555.66 $900.00 $727.29 nat. median
$234
outlier · 3.1×
93970
CPT 		Venous U/s Bilateral 5 $493.92 $1,440.00 $720.00 nat. median
$564
1.3× median
11045
CPT 		Debride Subq Tissue-each Addtl 20cm 3 $501.27 $900.00 $687.96 nat. median
$370
1.9× median
29580
CPT 		Application Of Unna Boot 1 $687.96 $687.96 $687.96 nat. median
$221
outlier · 3.1×
11043
CPT 		Debride /muscle Fascia- First 20cm 2 $468.30 $900.00 $684.15 nat. median
$782
0.9× median
99285
CPT 		ER Level V 11 $400.00 $800.00 $682.08 nat. median
$1,186
0.6× median
93306
CPT 		Echocardiogram 5 $391.46 $1,260.00 $630.00 nat. median
$993
0.6× median
11042
CPT 		Debride Subq Tissue-first 20cm 9 $341.00 $900.00 $556.36 nat. median
$523
1.1× median
93925
CPT 		Arterial Duplex U/s Bilateral 3 $444.53 $556.45 $552.27 nat. median
$523
1.1× median
82656
CPT 		Elastase Stool 2 $470.49 $567.51 $519.00 nat. median
$22
outlier · 23.4×
96360
CPT 		IV Hydration Infusion Init 31 Min To An Hr 7 $390.61 $511.00 $511.00 nat. median
$284
1.8× median
96374
CPT 		IV Push Ther/proph/daig 13 $357.70 $1,022.00 $511.00 nat. median
$226
outlier · 2.3×
96365
CPT 		IV Inf Init, Ther/proph/diag 9 $390.61 $511.00 $511.00 nat. median
$317
1.6× median
36430
CPT 		Transfusion Administration 4 $495.50 $1,000.00 $500.00 nat. median
$708
0.7× median
87522
CPT 		Hcv Rt-pcr, Quant (graph) 2 $42.84 $836.53 $439.68 nat. median
$108
outlier · 4.1×
87507
CPT 		Gastro Panel Pcr 3 $416.78 $514.50 $416.78 nat. median
$549
0.8× median
93922
CPT 		Upper/lower Arterial 2 Levels U/s 5 $162.90 $450.00 $416.16 nat. median
$252
1.6× median
83993
CPT 		Calprotectin, Fecal 3 $343.00 $452.14 $383.76 nat. median
$54
outlier · 7.1×
77066
CPT 		Bilateral Diagnostic Mammogram 5 $337.86 $375.00 $375.00 nat. median
$234
1.6× median

Other procedures at this hospital

Browse this hospital's 408 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
             
74177 CPT CT Abd & Pelvis With Contrast 12 12 $3,050.00 $3,050.00 $275.00 $3,050.00 $2,816.37 2025-01-01
74160 CPT CT Abdomen With Contrast 1 1 $1,785.00 $1,785.00 $2,456.00 $2,456.00 $2,456.00 2025-01-01
71275 CPT CTA Chest Pe Protocal 8 8 $2,499.00 $2,499.00 $1,680.70 $2,499.00 $2,262.33 2025-01-01
74178 CPT CT Abd & Pelvis W/wo Contrast 1 1 $3,621.00 $3,621.00 $2,196.07 $2,196.07 $2,196.07 2025-01-01
74170 CPT CT Abdomen W/wo Contrast 5 5 $2,091.00 $2,091.00 $275.00 $2,557.80 $1,819.17 2025-01-01
72193 CPT CT Pelvis With Contrast 1 1 $1,825.80 $1,825.80 $1,790.00 $1,790.00 $1,790.00 2025-01-01
71260 CPT CT Thorax With Contrast 6 6 $1,825.80 $1,825.80 $1,066.35 $1,825.80 $1,790.00 2025-01-01
74176 CPT CT Abd & Pelvis Without Contrast 14 14 $1,836.00 $1,836.00 $275.00 $2,000.00 $1,782.00 2025-01-01
70460 CPT CT Head/brain With Contrast 1 1 $1,621.80 $1,621.80 $1,558.50 $1,558.50 $1,558.50 2025-01-01
73702 CPT CT Left Lower Extremity W/wo Contrast 1 1 $1,825.80 $1,825.80 $1,515.77 $1,515.77 $1,515.77 2025-01-01
73701 CPT CT Left Lower Extremity With Contrast 1 1 $1,509.60 $1,509.60 $1,480.00 $1,480.00 $1,480.00 2025-01-01
11044 CPT Debride Bone-first 20cm 2 2 $2,022.38 $2,022.38 $468.30 $2,450.00 $1,459.15 2025-01-01
70487 CPT CT Facials With Contrast 2 2 $1,621.80 $1,621.80 $1,090.74 $1,621.80 $1,356.27 2025-01-01
70491 CPT CT Soft Tissue Neck With Contrast 3 3 $1,703.40 $1,703.40 $1,024.34 $1,670.00 $1,276.55 2025-01-01
72131 CPT CT L-spine Without Contrast 9 9 $1,326.00 $1,326.00 $996.72 $1,326.00 $1,268.04 2025-01-01
72128 CPT CT T-spine Without Contrast 3 3 $1,428.00 $1,428.00 $867.89 $1,400.00 $1,185.52 2025-01-01
70470 CPT CT Head/brain W/wo Contrast 1 1 $1,825.80 $1,825.80 $1,108.15 $1,108.15 $1,108.15 2025-01-01
99291 CPT Critical Care First Hour 2 2 $1,200.00 $1,200.00 $1,023.12 $1,176.00 $1,099.56 2025-01-01
71250 CPT CT Thorax Without Contrast 10 10 $1,142.40 $1,142.40 $694.31 $1,142.40 $1,056.94 2025-01-01
70490 CPT CT Soft Tissue Neck Without Contrast 5 5 $1,060.80 $1,060.80 $600.23 $1,040.00 $1,040.00 2025-01-01
74150 CPT CT Abdomen Without Contrast 1 1 $1,020.00 $1,020.00 $1,000.00 $1,000.00 $1,000.00 2025-01-01
72192 CPT CT Pelvis Without Contrast 6 6 $1,020.00 $1,020.00 $846.80 $1,020.00 $990.00 2025-01-01
72125 CPT CT C-spine Without Contrast 9 9 $1,020.00 $1,020.00 $350.00 $1,020.00 $980.00 2025-01-01
70450 CPT CT Head/brain Without Contrast 14 14 $948.60 $948.60 $275.00 $2,000.00 $920.70 2025-01-01
11046 CPT Debride Muscle/fascia-each Addtl 20cm 1 1 $900.00 $900.00 $900.00 $900.00 $900.00 2025-01-01
77075 CPT Bone Survey - Metastatic Series 1 1 $918.00 $918.00 $882.00 $882.00 $882.00 2025-01-01
93880 CPT Carotid/vertebral U/s 2 2 $720.00 $720.00 $720.00 $891.56 $805.78 2025-01-01
73700 CPT CT Left Lower Extremity Without Contrast 3 3 $805.80 $805.80 $790.00 $1,126.02 $790.00 2025-01-01
70486 CPT CT Facials Without Contrast 9 9 $938.40 $938.40 $513.62 $920.00 $779.06 2025-01-01
73200 CPT CT Left Upper Extremity Without Contrast 4 4 $805.80 $805.80 $420.38 $805.80 $733.36 2025-01-01
97602 CPT Active Wound Mgmt.non-sel Debridement 4 4 $900.00 $900.00 $557.93 $900.00 $729.45 2025-01-01
97597 CPT Removal Devi Tiss;derm;epid;first 20cm 4 4 $900.00 $900.00 $555.66 $900.00 $727.29 2025-01-01
93970 CPT Venous U/s Bilateral 5 5 $720.00 $720.00 $493.92 $1,440.00 $720.00 2025-01-01
11045 CPT Debride Subq Tissue-each Addtl 20cm 3 3 $900.00 $900.00 $501.27 $900.00 $687.96 2025-01-01
29580 CPT Application Of Unna Boot 1 1 $900.00 $900.00 $687.96 $687.96 $687.96 2025-01-01
11043 CPT Debride /muscle Fascia- First 20cm 2 2 $900.00 $900.00 $468.30 $900.00 $684.15 2025-01-01
99285 CPT ER Level V 11 11 $800.00 $800.00 $400.00 $800.00 $682.08 2025-01-01
93306 CPT Echocardiogram 5 5 $1,260.00 $1,260.00 $391.46 $1,260.00 $630.00 2025-01-01
11042 CPT Debride Subq Tissue-first 20cm 11 9 $900.00 $900.00 $341.00 $900.00 $556.36 2025-01-01
93925 CPT Arterial Duplex U/s Bilateral 3 3 $720.00 $720.00 $444.53 $556.45 $552.27 2025-01-01
82656 CPT Elastase Stool 2 2 $613.00 $613.00 $470.49 $567.51 $519.00 2025-01-01
96360 CPT IV Hydration Infusion Init 31 Min To An Hr 7 7 $511.00 $511.00 $390.61 $511.00 $511.00 2025-01-01
96374 CPT IV Push Ther/proph/daig 13 13 $511.00 $511.00 $357.70 $1,022.00 $511.00 2025-01-01
96365 CPT IV Inf Init, Ther/proph/diag 9 9 $511.00 $511.00 $390.61 $511.00 $511.00 2025-01-01
36430 CPT Transfusion Administration 4 4 $1,000.00 $1,000.00 $495.50 $1,000.00 $500.00 2025-01-01
87522 CPT Hcv Rt-pcr, Quant (graph) 2 2 $950.00 $950.00 $42.84 $836.53 $439.68 2025-01-01
87507 CPT Gastro Panel Pcr 3 3 $750.00 $750.00 $416.78 $514.50 $416.78 2025-01-01
93922 CPT Upper/lower Arterial 2 Levels U/s 5 5 $450.00 $450.00 $162.90 $450.00 $416.16 2025-01-01
83993 CPT Calprotectin, Fecal 3 3 $500.00 $500.00 $343.00 $452.14 $383.76 2025-01-01
77066 CPT Bilateral Diagnostic Mammogram 5 5 $382.50 $382.50 $337.86 $375.00 $375.00 2025-01-01
93971 CPT Venous U/s Unilateral 5 5 $720.00 $720.00 $224.76 $360.00 $360.00 2025-01-01
P9016 HCPCS Leuko-reduced Blood 4 4 $710.00 $710.00 $302.12 $710.00 $355.00 2025-01-01
83835 CPT Metanephrines Fx Plasma 1 1 $1,428.00 $1,428.00 $317.54 $317.54 $317.54 2025-01-01
71110 CPT Ribs (bilateral) 1 1 $310.00 $310.00 $310.00 $310.00 $310.00 2025-01-01
87536 CPT HIV Viral Load (graph) 1 1 $500.00 $500.00 $308.70 $308.70 $308.70 2025-01-01
87493 CPT C Diff Naa (pcr) 1 1 $624.00 $624.00 $305.76 $305.76 $305.76 2025-01-01
99214 CPT Established Pt Visit Level 4 5 5 $920.00 $920.00 $57.00 $460.00 $299.00 2025-01-01
99292 CPT Critical Care Each Additional 30 1 1 $300.00 $300.00 $294.00 $294.00 $294.00 2025-01-01
82024 CPT Acth 1 1 $300.00 $300.00 $294.00 $294.00 $294.00 2025-01-01
87338 CPT H. Pylori Stool Ag 2 2 $920.00 $920.00 $276.00 $310.76 $293.38 2025-01-01
J1610 HCPCS Glucagon 1 Mg Vial 1 Mg, 1 Each 1 1 $394.00 $394.00 $275.80 $275.80 $275.80 2025-01-01
99203 CPT New Pt Visit Level 3 1 1 $634.00 $634.00 $268.44 $268.44 $268.44 2025-01-01
17250 CPT Chemical Cautery,tissue 1 1 $450.00 $450.00 $262.39 $262.39 $262.39 2025-01-01
83529 CPT Interleukin-6, Serum 1 1 $305.00 $305.00 $257.05 $257.05 $257.05 2025-01-01
99284 CPT ER Level IV 13 13 $500.00 $500.00 $171.50 $500.00 $250.00 2025-01-01
76700 CPT US Abdomen Complete 12 12 $580.00 $580.00 $179.05 $290.00 $246.41 2025-01-01
77067 CPT Bilateral Screening Mammogram 15 15 $306.00 $306.00 $64.55 $391.17 $245.00 2025-01-01
83520 CPT Atn Profile Component 1 1 $386.00 $386.00 $238.32 $238.32 $238.32 2025-01-01
82232 CPT Beta-2 Microglobulin 2 2 $520.00 $520.00 $219.13 $254.80 $236.97 2025-01-01
83519 CPT Musk Abs 2 2 $2,260.00 $2,260.00 $202.84 $267.60 $235.22 2025-01-01
93926 CPT Arterial Duplex U/s Unilateral 2 2 $720.00 $720.00 $222.26 $246.96 $234.61 2025-01-01
84630 CPT Zinc Quant 1 1 $466.00 $466.00 $228.34 $228.34 $228.34 2025-01-01
84425 CPT Vitamin B1 (thiamine) Whole Blood 2 2 $492.00 $492.00 $207.33 $241.08 $224.21 2025-01-01
76705 CPT US Abdominal Hernia 3 3 $300.00 $300.00 $170.00 $340.00 $216.09 2025-01-01
99213 CPT Established Pt Visit Level 3 10 10 $634.00 $634.00 $38.00 $317.00 $211.76 2025-01-01
83704 CPT Nmr Particle Study 5 5 $616.00 $616.00 $184.80 $259.58 $211.29 2025-01-01
86255 CPT Anti-parietal Cell 1 1 $108.00 $108.00 $210.70 $210.70 $210.70 2025-01-01
51702 CPT Insert Foley Catheter 2 2 $300.00 $300.00 $114.66 $294.00 $204.33 2025-01-01
86341 CPT Antipancreatic Islet Cells 2 2 $704.00 $704.00 $196.00 $211.20 $203.60 2025-01-01
76830 CPT US Pelvis Transvaginal (non O.b.) 7 7 $400.00 $400.00 $144.80 $200.00 $200.00 2025-01-01
99212 CPT Established Pt Visit Level 2 7 6 $580.00 $580.00 $33.00 $580.00 $198.94 2025-01-01
31500 CPT Intub Endotrch Emer Proc 1 1 $579.00 $579.00 $198.70 $198.70 $198.70 2025-01-01
29505 CPT Appl Long Leg Splint Thigh Ankle/toes 1 1 $200.00 $200.00 $196.00 $196.00 $196.00 2025-01-01
86361 CPT Cd4 Helper T-lymph Count 1 1 $400.00 $400.00 $196.00 $196.00 $196.00 2025-01-01
85549 CPT Lysozyme 1 1 $250.00 $250.00 $195.01 $195.01 $195.01 2025-01-01
94660 CPT Bipap Sub 4 4 $203.22 $203.22 $84.68 $340.00 $194.94 2025-01-01
87328 CPT Cryptosporidium Detection 1 1 $500.00 $500.00 $191.88 $191.88 $191.88 2025-01-01
11055 CPT Trim Skin Lesion 1 1 $381.50 $381.50 $190.75 $190.75 $190.75 2025-01-01
76770 CPT US Retroperitoneal Renal With Bladder 4 4 $380.00 $380.00 $117.31 $190.00 $190.00 2025-01-01
76856 CPT US Pelvis Transabdominal (non O.b.) 7 7 $380.00 $380.00 $137.56 $190.00 $190.00 2025-01-01
76536 CPT US Soft Tissue Neck 6 6 $300.00 $300.00 $123.48 $308.38 $180.00 2025-01-01
92950 CPT Cpr-ER 1 1 $500.00 $500.00 $171.50 $171.50 $171.50 2025-01-01
76815 CPT US O.b. (limited - Fetal Size, Position, Heartbeat) 1 1 $340.00 $340.00 $170.00 $170.00 $170.00 2025-01-01
73000 CPT Left Clavicle (2 View) 1 1 $170.00 $170.00 $170.00 $170.00 $170.00 2025-01-01
76641 CPT US Abus Bilateral Screening Ultrasound 11 10 $700.00 $700.00 $25.31 $340.00 $170.00 2025-01-01
90715 CPT Boostrix Pfs Tip Lok 0.5ml 10 5 5 $169.20 $169.20 $58.38 $169.20 $169.20 2025-01-01
82652 CPT Vitamin D 1,25 Dioh 2 2 $400.00 $400.00 $137.20 $200.00 $168.60 2025-01-01
96367 CPT IV Inf Addl Seq Tx/proph/dg 7 7 $168.00 $168.00 $128.42 $168.00 $168.00 2025-01-01
82525 CPT Copper, Plasma 1 1 $336.00 $336.00 $164.64 $164.64 $164.64 2025-01-01
84154 CPT Psa Total + Free 1 1 $438.00 $438.00 $163.11 $163.11 $163.11 2025-01-01
77065 CPT Diagnostic Right Breast Mammogram 8 8 $350.00 $350.00 $114.90 $200.00 $161.75 2025-01-01
71111 CPT Ribs Bilateral With Epa Chest 4 4 $320.00 $320.00 $156.80 $274.11 $160.00 2025-01-01
12001 CPT Smpl Rpr S/n/ax/gen/trnk 2.5cm/< 2 2 $240.00 $240.00 $82.32 $235.20 $158.76 2025-01-01
29125 CPT Appl Short Arm Splint Static 1 1 $200.00 $200.00 $156.69 $156.69 $156.69 2025-01-01
72114 CPT Lumbar Spine (7 Views - Complete With Flexion & Extension) 2 2 $370.00 $370.00 $141.99 $167.38 $154.69 2025-01-01
72050 CPT Cervical Spine Series (5view Ap, Lat, Open Mouth & Obliques) 12 12 $310.00 $310.00 $106.33 $155.00 $153.45 2025-01-01
77078 CPT Bone Density 6 6 $400.00 $400.00 $123.48 $400.00 $152.88 2025-01-01
83789 CPT Iodine 24hr Urine 1 1 $308.00 $308.00 $151.90 $151.90 $151.90 2025-01-01
82330 CPT Calcium Ionized 1 1 $154.00 $154.00 $150.92 $150.92 $150.92 2025-01-01
10060 CPT I&d Abscess Simple/single 1 1 $300.00 $300.00 $150.00 $150.00 $150.00 2025-01-01
16020 CPT Drs/dbrd P-thck Burn <5% 1 1 $300.00 $300.00 $150.00 $150.00 $150.00 2025-01-01
93000 CPT Ekg/cardiac Monitoring 6 6 $300.00 $300.00 $147.00 $150.00 $150.00 2025-01-01
30901 CPT Control Nasl Hemor Unilateral 1 1 $300.00 $300.00 $150.00 $150.00 $150.00 2025-01-01
99283 CPT ER Level Iii 17 17 $300.00 $300.00 $102.90 $500.00 $150.00 2025-01-01
94150 CPT Tidal Volumn 1 1 $148.83 $148.83 $148.83 $148.83 $148.83 2025-01-01
90471 CPT Immunization Admin 2 2 $168.00 $168.00 $128.42 $168.00 $148.21 2025-01-01
84402 CPT Testosterone,free 2 2 $400.00 $400.00 $123.74 $168.56 $146.15 2025-01-01
96372 CPT Ed-injection Im/sq 10 10 $168.00 $168.00 $30.00 $168.00 $143.57 2025-01-01
72110 CPT Lumbar Spine (5 Views - Ap, Lateral, Spot & Obliques) 14 14 $310.00 $310.00 $97.65 $310.00 $143.12 2025-01-01
J2997 HCPCS Activase Vial 100mg 100ml 1 1 $19,975.00 $19,975.00 $141.17 $141.17 $141.17 2025-01-01
G0481 HCPCS Pmh Clinical Uds 13 11 $208.00 $208.00 $98.00 $298.12 $140.00 2025-01-01
83921 CPT Methylmalonic Acid (serum) 1 1 $332.00 $332.00 $139.90 $139.90 $139.90 2025-01-01
72040 CPT Cervical Spine (2 Views Min. -ap, Lat, Open Mouth - ) 3 3 $220.00 $220.00 $110.00 $220.00 $138.33 2025-01-01
12006 CPT Smpl Rpr S/n/a/gen/trk20.1- 30.0cm 1 1 $400.00 $400.00 $137.20 $137.20 $137.20 2025-01-01
94060 CPT Brncdilat Rspse Spmtry Pre&post- Brncdilat Admn 3 3 $268.80 $268.80 $134.40 $134.40 $134.40 2025-01-01
86160 CPT C1 Esterace Inh Serum 1 1 $222.00 $222.00 $133.20 $133.20 $133.20 2025-01-01
82088 CPT Aldosterone, Serum 1 1 $270.00 $270.00 $132.30 $132.30 $132.30 2025-01-01
82626 CPT Dhea Serum 1 1 $270.00 $270.00 $132.30 $132.30 $132.30 2025-01-01
84481 CPT T3 Free 2 2 $286.00 $286.00 $120.52 $140.14 $130.33 2025-01-01
73070 CPT Right Elbow (2 Views) 5 5 $130.00 $130.00 $65.00 $130.00 $127.40 2025-01-01
76882 CPT US Inguinal Hernia 4 4 $300.00 $300.00 $125.00 $125.00 $125.00 2025-01-01
70260 CPT Skull (4 Views Or More) 2 2 $250.00 $250.00 $125.00 $125.00 $125.00 2025-01-01
83695 CPT Lipoprotein A 5 5 $342.00 $342.00 $102.60 $167.58 $123.80 2025-01-01
82306 CPT Vitamin D 25 Hydroxy 14 13 $352.00 $352.00 $29.60 $456.00 $121.97 2025-01-01
12002 CPT Smpl Rpr S/n/ax/gen/trnk2. 6-7.5cm 2 2 $260.00 $260.00 $110.84 $129.40 $120.12 2025-01-01
82803 CPT Poct- Blood Gas Analysis 5 5 $312.90 $312.90 $7.10 $306.64 $120.08 2025-01-01
74022 CPT Abdomen (3 View -kub, Erect & Epa Chest) 12 12 $240.00 $240.00 $74.09 $240.00 $120.00 2025-01-01
72082 CPT Spine For Scoliosis (supine & Erect) 3 3 $240.00 $240.00 $120.00 $120.00 $120.00 2025-01-01
72220 CPT Sacruum & Coccyx (2 View Min.) 6 6 $240.00 $240.00 $82.32 $240.00 $120.00 2025-01-01
12051 CPT Intmd Rpr Face/mm 2.5 Cm/< 1 1 $372.92 $372.92 $120.00 $120.00 $120.00 2025-01-01
71101 CPT Right Ribs With Epa Chest 7 7 $280.00 $280.00 $86.44 $140.00 $119.36 2025-01-01
82274 CPT Occult Blood, Immunoassy 1 1 $340.00 $340.00 $119.00 $119.00 $119.00 2025-01-01
12011 CPT Smpl Rpr F/e/e/n/l/m 2.5 Cm/< 1 1 $240.00 $240.00 $117.60 $117.60 $117.60 2025-01-01
87913 CPT Covid 2019 Naat 4 4 $150.00 $150.00 $22.65 $127.50 $117.48 2025-01-01
83002 CPT Luteinizing Hormone 1 1 $118.00 $118.00 $115.64 $115.64 $115.64 2025-01-01
73521 CPT Hip (bilateral - Ap Pelvis , Ap & Lateral Hips) 9 9 $270.00 $270.00 $27.15 $135.00 $114.32 2025-01-01
96375 CPT IV Push New Drug Addon Tx/pro/dx Inj 8 8 $113.00 $113.00 $86.38 $113.00 $113.00 2025-01-01
96361 CPT IV Hydration Infusion Add-on 10 10 $113.00 $113.00 $86.38 $113.00 $113.00 2025-01-01
84305 CPT Igf-1 (insulin-like Growth Factor I) 2 2 $300.00 $300.00 $99.57 $126.42 $113.00 2025-01-01
86800 CPT Thyroglobulin Quant 2 2 $450.00 $450.00 $92.61 $132.30 $112.46 2025-01-01
96366 CPT IV Inf Addon Ther/proph/diag 6 6 $113.00 $113.00 $86.38 $113.00 $111.87 2025-01-01
73564 CPT Right Knee (4 Or More Views) 19 14 $220.00 $220.00 $67.91 $382.80 $110.00 2025-01-01
93005 CPT EKG 15 15 $220.00 $220.00 $55.00 $191.40 $110.00 2025-01-01
72100 CPT Lumbar Spine (2 View Min. - Ap, Lateral, Spot) 8 8 $220.00 $220.00 $77.00 $218.10 $110.00 2025-01-01
72072 CPT Thoracic Spine (3 View - Ap, Lateral & Swimmers) 10 10 $220.00 $220.00 $75.46 $220.00 $110.00 2025-01-01
72070 CPT Thoracic Spine (2 View - Ap & Lateral) 2 2 $220.00 $220.00 $110.00 $110.00 $110.00 2025-01-01
83970 CPT Parathyroid Hormone (pth) 8 8 $150.00 $150.00 $41.28 $147.00 $108.78 2025-01-01
86615 CPT Bordetella Igg/igm Ab 3 3 $280.00 $280.00 $48.51 $137.20 $107.02 2025-01-01
76775 CPT US Limited Abdomen 3 3 $250.00 $250.00 $90.50 $125.00 $105.85 2025-01-01
83880 CPT Bnp 13 12 $352.00 $352.00 $39.26 $172.48 $105.60 2025-01-01
70250 CPT Skull (3 Views Or Less) 5 5 $210.00 $210.00 $105.00 $105.00 $105.00 2025-01-01
74019 CPT Abdomen (2 View - Kub & Erect Or Decubitus) 9 9 $210.00 $210.00 $10.44 $210.00 $105.00 2025-01-01
70110 CPT Mandible (4v) 5 5 $210.00 $210.00 $29.73 $105.00 $105.00 2025-01-01
70150 CPT Facial Bones(3 Views Or More) 4 4 $210.00 $210.00 $105.00 $210.00 $105.00 2025-01-01
73650 CPT Right Os Calsis - Heel (2 View Min.) 2 2 $140.00 $140.00 $70.00 $139.70 $104.85 2025-01-01
87502 CPT Influenza A & B Naat 15 15 $300.00 $300.00 $92.68 $261.00 $102.90 2025-01-01
84681 CPT C-peptide Serum 3 3 $242.00 $242.00 $72.60 $118.58 $101.98 2025-01-01
73110 CPT Right Wrist (4 Views) 10 9 $170.00 $170.00 $71.98 $170.00 $100.30 2025-01-01
99282 CPT ER Level Ii 14 14 $200.00 $200.00 $76.44 $200.00 $100.00 2025-01-01
51701 CPT Inser Non- Indwellin Bladder Cath 1 1 $200.00 $200.00 $100.00 $100.00 $100.00 2025-01-01
71271 CPT Low Dose Chest (lung Cancer Sdxeening) 5 5 $100.00 $100.00 $61.74 $100.00 $100.00 2025-01-01
82671 CPT Estrogen Fract Ser 1 1 $330.00 $330.00 $99.00 $99.00 $99.00 2025-01-01
80050 CPT Gen. Health Tsh 11 11 $322.00 $322.00 $45.73 $125.36 $98.40 2025-01-01
82627 CPT Dhea Sulfate Serum 1 1 $228.00 $228.00 $96.08 $96.08 $96.08 2025-01-01
83883 CPT Free Light Chain Serum 3 3 $226.00 $226.00 $77.52 $110.74 $95.24 2025-01-01
73560 CPT Right Knee(2 Views) 2 2 $170.00 $170.00 $85.00 $105.19 $95.09 2025-01-01
71100 CPT Left Ribs 6 6 $190.00 $190.00 $73.32 $95.00 $95.00 2025-01-01
71045 CPT Chest (1 View) 13 13 $190.00 $190.00 $65.17 $190.00 $95.00 2025-01-01
73590 CPT Right Tib/fib (2view) 10 10 $190.00 $190.00 $65.17 $190.00 $95.00 2025-01-01
73552 CPT Right Femur (ap & Lateral) 8 8 $190.00 $190.00 $58.65 $190.00 $95.00 2025-01-01
73502 CPT Infant - Pelvis & Hips (2 Views) 12 12 $170.00 $170.00 $55.57 $180.00 $90.00 2025-01-01
74018 CPT K.u.b. 12 12 $180.00 $180.00 $56.70 $180.00 $90.00 2025-01-01
71046 CPT Chest (epa And Lateral - 2 View) 16 16 $210.00 $210.00 $64.83 $210.00 $88.91 2025-01-01
73080 CPT Bilateral Elbow 8 8 $380.00 $380.00 $59.85 $95.00 $87.72 2025-01-01
87635 CPT 2019 Novel Coronavirus (covid-19), Naa 17 17 $255.00 $255.00 $38.48 $127.50 $87.47 2025-01-01
73030 CPT Bilateral Shoulder 17 15 $340.00 $340.00 $53.55 $170.00 $85.00 2025-01-01
73610 CPT Left Ankle (4 Views) 13 12 $170.00 $170.00 $63.75 $170.00 $85.00 2025-01-01
73630 CPT Right Foot (3-4 Views) 15 12 $170.00 $170.00 $52.48 $170.00 $85.00 2025-01-01
73100 CPT Left Wrist (2 Views) 7 7 $130.00 $130.00 $71.98 $85.00 $85.00 2025-01-01
73060 CPT Left Humerus (2 Views) 7 7 $170.00 $170.00 $85.00 $170.00 $85.00 2025-01-01
72170 CPT Pelvis - 1 View 7 7 $170.00 $170.00 $53.55 $170.00 $85.00 2025-01-01
75571 CPT Cardiac / Calcium Scoring 3 3 $100.00 $100.00 $63.00 $85.26 $84.68 2025-01-01
83001 CPT Fsh 2 2 $130.00 $130.00 $39.00 $127.40 $83.20 2025-01-01
82542 CPT Zonisamide (zonegran) Serum 3 3 $450.00 $450.00 $24.09 $1,093.10 $82.59 2025-01-01
94760 CPT Pulse Ox 8 8 $56.70 $56.70 $28.35 $200.00 $81.34 2025-01-01
73501 CPT Right Hip W/pelvis - 1 View Only 1 1 $160.00 $160.00 $80.00 $80.00 $80.00 2025-01-01
73090 CPT Right Forearm (2 Views) 9 9 $160.00 $160.00 $34.12 $160.00 $80.00 2025-01-01
70220 CPT Sinuses (3 Views Or More) 8 8 $210.00 $210.00 $66.15 $105.00 $79.70 2025-01-01
84403 CPT Testosterone, Serum 3 3 $162.00 $162.00 $68.27 $123.83 $79.38 2025-01-01
86480 CPT Quantiferon (client Incubate) 2 2 $280.00 $280.00 $61.98 $96.04 $79.01 2025-01-01
76604 CPT US Abdomen Soft Tissue-non Organ 1 1 $250.00 $250.00 $77.49 $77.49 $77.49 2025-01-01
86702 CPT HIV Confirmation 1 1 1 $200.00 $200.00 $76.75 $76.75 $76.75 2025-01-01
86701 CPT HIV Confirmation 2 1 1 $200.00 $200.00 $76.75 $76.75 $76.75 2025-01-01
87177 CPT Stool Ocp (labcorp) 5 5 $180.00 $180.00 $63.00 $153.47 $75.85 2025-01-01
73130 CPT Right Hand (3-4 Views) 12 11 $170.00 $170.00 $54.07 $170.00 $75.34 2025-01-01
J0456 HCPCS Azithromycin I.v. 500 Mg Vial 500 Mg, 1 Each 3 3 $44.15 $44.15 $57.33 $75.00 $75.00 2025-01-01
73660 CPT Left Toe (2-4 Views) 7 7 $150.00 $150.00 $57.56 $150.00 $75.00 2025-01-01
73140 CPT Left Finger (2 - 4 Views, 2 View Min.) 8 8 $150.00 $150.00 $46.30 $75.00 $75.00 2025-01-01
99281 CPT ER Level I 12 12 $150.00 $150.00 $47.25 $150.00 $75.00 2025-01-01
J2360 HCPCS Orphenadrine 60 Mg/2 Ml Vial 2 Ml, 2 Ml 4 4 $74.80 $74.80 $74.80 $74.80 $74.80 2025-01-01
80299 CPT Cordarone Level 2 2 $208.00 $208.00 $18.64 $130.34 $74.49 2025-01-01
86335 CPT Ife Urine, Immunoelectrophoresis Urine 2 2 $162.00 $162.00 $69.06 $79.38 $74.22 2025-01-01
80197 CPT Tacrolimus 1 1 $150.00 $150.00 $73.80 $73.80 $73.80 2025-01-01
84446 CPT Vitamin E 1 1 $150.00 $150.00 $73.50 $73.50 $73.50 2025-01-01
72202 CPT Sacroiliac Joints (ap & Both Obliques) 2 2 $250.00 $250.00 $20.97 $125.00 $72.98 2025-01-01
73010 CPT Left Scapula (3 View) 3 3 $170.00 $170.00 $52.48 $170.00 $72.48 2025-01-01
83021 CPT Electro Hg Fractionation 2 2 $250.00 $250.00 $18.06 $123.00 $70.53 2025-01-01
86695 CPT Herpes Igg 1 2 2 $250.00 $250.00 $13.19 $127.40 $70.30 2025-01-01
87634 CPT Rsv Naat 5 5 $250.00 $250.00 $70.20 $245.00 $70.20 2025-01-01
73020 CPT Left Shoulder (1 View) 1 1 $140.00 $140.00 $70.00 $70.00 $70.00 2025-01-01
86334 CPT Ife Serum 3 3 $162.00 $162.00 $61.92 $79.38 $68.27 2025-01-01
94010 CPT Basic Pft Studies 3 3 $148.83 $148.83 $52.18 $148.83 $68.25 2025-01-01
87329 CPT Giardia Eia 2 2 $162.00 $162.00 $62.17 $73.39 $67.78 2025-01-01
83003 CPT Growth Hormone 1 1 $160.00 $160.00 $67.42 $67.42 $67.42 2025-01-01
87661 CPT Trich Vag Naa 2 2 $200.00 $200.00 $35.09 $96.64 $65.87 2025-01-01
85379 CPT D-dimer Quantitative 10 10 $350.00 $350.00 $10.18 $267.54 $65.12 2025-01-01
73620 CPT Right Foot (ap & Lateral - 2 Views) 4 4 $130.00 $130.00 $40.13 $110.84 $65.00 2025-01-01
73120 CPT Right Hand (2 Views) 5 5 $130.00 $130.00 $48.75 $65.00 $65.00 2025-01-01
73600 CPT Right Ankle (ap & Lateral - 2 Views) 5 5 $130.00 $130.00 $40.95 $65.00 $65.00 2025-01-01
G0103 HCPCS Psa Screening 6 6 $140.00 $140.00 $53.51 $140.00 $64.14 2025-01-01
87252 CPT Viral Culture,general 1 1 $300.00 $300.00 $63.60 $63.60 $63.60 2025-01-01
82670 CPT Estradiol, Sensitive 2 2 $910.00 $910.00 $52.80 $74.17 $63.48 2025-01-01
82105 CPT Alpha Fetopro-maternal Serum 2 2 $168.00 $168.00 $54.37 $71.83 $63.10 2025-01-01
83010 CPT Haptoglobin 1 1 $124.00 $124.00 $60.76 $60.76 $60.76 2025-01-01
82668 CPT Erythropoietin (epo) 1 1 $176.00 $176.00 $60.37 $60.37 $60.37 2025-01-01
70360 CPT Soft Tissue Neck 5 5 $120.00 $120.00 $37.04 $120.00 $60.00 2025-01-01
87651 CPT Strep A Naat 15 15 $200.00 $200.00 $35.09 $174.00 $60.00 2025-01-01
86200 CPT Ccp Antibodies Igg/iga 3 3 $140.00 $140.00 $49.00 $68.88 $59.00 2025-01-01
83516 CPT Anti-gliadin Antibodies 1 1 $188.00 $188.00 $58.80 $58.80 $58.80 2025-01-01
87427 CPT E.coli Serotyping 5 5 $118.00 $118.00 $11.98 $100.61 $57.82 2025-01-01
80053 CPT Chem 12 21 18 $150.00 $150.00 $10.56 $596.51 $57.33 2025-01-01
82164 CPT Angioten 1 Conv Enzy (ace) 1 1 $116.00 $116.00 $56.84 $56.84 $56.84 2025-01-01
G0480 HCPCS Alcohol, Ethyl Serum 5 5 $110.00 $110.00 $53.90 $110.00 $55.00 2025-01-01
86300 CPT Ca 15-3 1 1 $130.00 $130.00 $54.78 $54.78 $54.78 2025-01-01
84134 CPT Prealbumin 3 3 $130.00 $130.00 $7.59 $58.65 $54.78 2025-01-01
71120 CPT Sternum (3 Views - Both Obliques & Lateral) 1 1 $250.00 $250.00 $53.16 $53.16 $53.16 2025-01-01
82172 CPT Apolipoproteins A1 3 3 $100.00 $100.00 $42.00 $58.80 $51.16 2025-01-01
84153 CPT Psa 13 12 $140.00 $140.00 $18.39 $319.11 $50.68 2025-01-01
80069 CPT Renal Function Panel 10 10 $140.00 $140.00 $8.68 $68.60 $50.08 2025-01-01
86922 CPT X-match 4 4 $300.00 $300.00 $24.58 $294.00 $49.15 2025-01-01
70160 CPT Nasal Bones (3 Views Or More) 2 2 $190.00 $190.00 $2.45 $95.00 $48.73 2025-01-01
82985 CPT Fructosamine 1 1 $114.00 $114.00 $48.60 $48.60 $48.60 2025-01-01
82533 CPT Cortisol Am 3 3 $140.00 $140.00 $16.30 $68.60 $48.02 2025-01-01
84590 CPT Vitamin A 1 1 $98.00 $98.00 $48.02 $48.02 $48.02 2025-01-01
80074 CPT Hepatitis Panel, Acute 4 4 $226.00 $226.00 $47.63 $110.74 $47.63 2025-01-01
85060 CPT Cbc Pathologist Review (labcorp) 1 1 $136.00 $136.00 $47.60 $47.60 $47.60 2025-01-01
84439 CPT T4 Free 9 9 $136.00 $136.00 $9.02 $66.64 $46.65 2025-01-01
86376 CPT Anti-thyroid Peroxidase (tpo) 3 3 $110.00 $110.00 $37.73 $53.90 $46.35 2025-01-01
S0119 HCPCS Ondans Sdv 4mg/2ml Her 25 2 2 $49.45 $49.45 $43.02 $49.45 $46.23 2025-01-01
86038 CPT Ana 12 Plus Reflex 1 5 5 $3,540.00 $3,540.00 $12.09 $2,623.60 $45.00 2025-01-01
84080 CPT Alk Phos Isoenzymes 1 1 $90.00 $90.00 $44.10 $44.10 $44.10 2025-01-01
84146 CPT Prolactin Ria 3 3 $146.00 $146.00 $19.38 $71.54 $43.80 2025-01-01
80076 CPT Hepatic Panel 6 6 $126.00 $126.00 $8.17 $61.74 $43.66 2025-01-01
85014 CPT Hematocrit 1 1 $24.00 $24.00 $43.22 $43.22 $43.22 2025-01-01
J0561 HCPCS Bicill La Pfs 1200mu 2ml 10 5 5 $510.00 $510.00 $32.49 $42.50 $42.50 2025-01-01
82397 CPT Adalimumab Ab 1 1 $529.00 $529.00 $42.16 $42.16 $42.16 2025-01-01
82085 CPT Aldolase 1 1 $84.00 $84.00 $41.16 $41.16 $41.16 2025-01-01
82140 CPT Ammonia 2 2 $136.00 $136.00 $14.57 $66.64 $40.61 2025-01-01
89051 CPT Joint Fluid Analysis 1 1 $80.00 $80.00 $39.20 $39.20 $39.20 2025-01-01
89060 CPT Joint Fluid Analysis 1 1 1 $80.00 $80.00 $39.20 $39.20 $39.20 2025-01-01
84443 CPT Tsh 15 15 $114.00 $114.00 $16.80 $55.86 $39.11 2025-01-01
43762 CPT Gastrostomy Tube Change 1 1 $300.00 $300.00 $38.22 $38.22 $38.22 2025-01-01
83605 CPT Lactate 11 11 $132.00 $132.00 $11.57 $100.90 $36.79 2025-01-01
87324 CPT C Diff Toxin A & B 5 5 $96.00 $96.00 $11.98 $81.85 $36.69 2025-01-01
80048 CPT Chem 7 14 14 $114.00 $114.00 $8.46 $55.86 $36.66 2025-01-01
82378 CPT Carcin Antigen (cea) 2 2 $120.00 $120.00 $20.23 $50.57 $35.40 2025-01-01
87491 CPT Chlamydia Naa 9 9 $120.00 $120.00 $35.09 $117.60 $35.09 2025-01-01
87591 CPT Gc Naa 9 9 $120.00 $120.00 $35.09 $120.00 $35.09 2025-01-01
93225 CPT Holter Monitor 12 12 $500.00 $500.00 $24.01 $35.00 $35.00 2025-01-01
94640 CPT Nebulizer Treatment-sub 9 9 $203.22 $203.22 $26.60 $305.22 $34.65 2025-01-01
94664 CPT Cont Inhalation Tx With Med 1st Hour 8 8 $203.22 $203.22 $27.03 $155.22 $34.65 2025-01-01
84166 CPT Electroph Protein Urine 24hr 3 3 $82.00 $82.00 $24.60 $40.18 $34.55 2025-01-01
82607 CPT Vitamin B12 11 11 $100.00 $100.00 $15.08 $76.75 $34.30 2025-01-01
87046 CPT Camphylobacer C&s 5 5 $70.00 $70.00 $9.44 $59.69 $34.30 2025-01-01
80162 CPT Digoxin 2 2 $82.00 $82.00 $28.13 $40.18 $34.16 2025-01-01
80051 CPT Electrolytes 1 1 $80.00 $80.00 $33.71 $33.71 $33.71 2025-01-01
85025 CPT Cbc&platelet&diff 17 17 $96.00 $96.00 $7.77 $48.00 $33.60 2025-01-01
99211 CPT Established Pt Visit Level 1 1 1 $552.00 $552.00 $33.00 $33.00 $33.00 2025-01-01
82746 CPT Folate Serum 10 10 $100.00 $100.00 $14.70 $85.26 $32.59 2025-01-01
82728 CPT Ferritin 11 11 $92.00 $92.00 $13.63 $45.08 $31.56 2025-01-01
84165 CPT Electroph Protein Se 5 5 $82.00 $82.00 $24.60 $40.18 $31.34 2025-01-01
82043 CPT Microalbumin Urine Random 18 16 $90.00 $90.00 $5.78 $45.00 $31.19 2025-01-01
J0780 HCPCS Prochlorperazine 10 Mg/2 Ml Vl 5 Ml, 2 Ml 5 5 $31.05 $31.05 $31.00 $31.05 $31.05 2025-01-01
82784 CPT Immunoglob-a 3 3 $72.00 $72.00 $27.52 $35.28 $30.34 2025-01-01
83036 CPT Hemoglobin A1c 18 17 $86.00 $86.00 $9.71 $86.00 $29.80 2025-01-01
87045 CPT Culture Stool 5 5 $60.00 $60.00 $9.44 $51.16 $29.40 2025-01-01
80061 CPT Lipid Panel 16 16 $84.00 $84.00 $13.39 $42.00 $29.11 2025-01-01
86140 CPT Crp 11 11 $84.00 $84.00 $5.18 $64.21 $28.82 2025-01-01
80156 CPT Tegretol (carbamazepine) 1 1 $90.00 $90.00 $27.78 $27.78 $27.78 2025-01-01
31720 CPT Cath Aspiration, Nasotrach 1 1 $305.00 $305.00 $27.44 $27.44 $27.44 2025-01-01
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