Hospital

BUNKIE GENERAL HOSPITAL

Bunkie, LA · CCN 191311 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

US ECHO CARDIOGRAM 2/D

This hospital’s price: $231 across 14 payers · range $84-$595

Source: https://www.bunkiegeneral.com/images/bunkie/documents/720697593_Hospital-Service-District-No-1-Parish-of-Avoyelles-State-of-Louisiana_standardcharges--6826a0e0.csv · observed 2026-03-16

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.

1,440 distinct procedures filed

15 distinct payers

37,791 rate rows

2026-03-16 last MRF observed

Data quality

34,231 of 37,791 rate rows are consumer-grade (90.6%)

3,560 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	2,981
percent-of-charges filed in the dollar field — excluded from medians	550
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	15
per-diem day rate — not a per-procedure price	14

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

Source MRF file	https://www.bunkiegeneral.com/wp-content/uploads/2026/03/720697593_Hospital-Service-District-No-1-Parish-of-Avoyelles-State-of-Louisiana_standardcharges-.csv
Found on page	https://www.bunkiegeneral.com/about/legal-policies/price-transparency/
Discovered via	CMS hospital list
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-23
Content fingerprint	edce298dbaf15ac1… · 18,174,343 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
J1299 HCPCS	EculizuMAB Vial 300mg / 30mL	14	$3,080.00	$4,900.00	$3,220.00	nat. median $2,911 1.1× median
81229 HCPCS	Chromsome 5 Cell Cnt & Cma	14	$2,538.36	$4,060.00	$2,653.74	nat. median $1,322 outlier · 2.0×
J2993 HCPCS	Reteplase (retavase) Dose 18.1mg	14	$2,357.52	$3,750.60	$2,464.68	nat. median $3,460 0.7× median
Q4197 HCPCS	Puraply Xt 5x5	14	$2,167.00	$3,447.50	$2,265.50	nat. median $210 outlier · 10.8×
J9312 HCPCS	Rituxan Vial 500mg (inj)	14	$2,094.40	$3,332.00	$2,189.60	nat. median $1,071 outlier · 2.0×
81420 HCPCS	Maternit Genome	14	$1,661.13	$2,642.70	$1,736.63	nat. median $787 outlier · 2.2×
J1950 HCPCS	Leuprolide Acetate (lupron) Kit 7.5mg	14	$583.44	$3,990.00	$1,718.10	nat. median $3,902 outlier · 0.4×
J2997 HCPCS	Alteplase (activase) Vial 50mg	14	$1,603.69	$2,551.32	$1,676.59	nat. median $500 outlier · 3.4×
J0840 HCPCS	Antivenin,crot (crofab) One Vial	14	$1,529.55	$2,433.38	$1,599.08	nat. median $3,445 outlier · 0.5×
81292 HCPCS	Vista Seq Lynch Syndrome Panel	14	$1,061.72	$2,450.00	$1,540.00	nat. median $675 outlier · 2.3×
J3101 HCPCS	TNKase Kit Acute Mi 50mg	14	$1,437.35	$2,286.69	$1,502.68	nat. median $3,820 outlier · 0.4×
J0401 HCPCS	Arpiprazole (aristada) ER Inj 882mg IM	14	$1,408.00	$2,240.00	$1,472.00	nat. median $1,939 0.8× median
J3262 HCPCS	Actemra (mab) Vial 400mg / 20mL	14	$1,276.00	$2,030.00	$1,334.00	nat. median $1,416 0.9× median
0360 RC		14	$1,100.00	$1,750.00	$1,150.00	nat. median $2,000 0.6× median
11047 HCPCS	Wound Care Debrid Bone Each Additional	14	$1,093.27	$1,739.29	$1,142.96	nat. median $937 1.2× median
49451 HCPCS	Replacement Of Jejunostomy Tube Contrast	14	$880.00	$1,400.00	$920.00	nat. median $1,191 0.8× median
45398 HCPCS	Colonoscope W/band Ligation	14	$880.00	$1,400.00	$920.00	nat. median $1,638 0.6× median
33016 HCPCS	Pericardiocentesis	14	$880.00	$1,400.00	$920.00	nat. median $2,006 outlier · 0.5×
J0897 HCPCS	Denosumab (prolia) 60mg/1ml Single Dose,zero Drug Wasted	14	$12.87	$1,400.00	$920.00	nat. median $1,972 outlier · 0.5×
73722 HCPCS	MRI Low Jt Rt W	14	$869.00	$1,382.50	$908.50	nat. median $1,279 0.7× median
74178 HCPCS	CT Abd/pelvis W/wo,technical Component	14	$117.48	$2,786.00	$900.99	nat. median $1,024 0.9× median
11012 HCPCS	Debridement Including Removal Of Fb @ Si	14	$853.27	$1,357.48	$892.06	nat. median $2,790 outlier · 0.3×
15273 HCPCS	Wound Care Aply Skin Substitue- Legs Fi	14	$853.16	$1,357.30	$891.94	nat. median $3,108 outlier · 0.3×
15276 HCPCS	Wound Care Aply Skin Substitue- Feet Ea	14	$853.16	$1,357.30	$891.94	nat. median $369 outlier · 2.4×
15272 HCPCS	Wound Care Aply Skin Substitue- Legs Ea	14	$853.16	$1,357.30	$891.94	nat. median $397 outlier · 2.2×
15278 HCPCS	Wound Care Aply Skin Substitue- Feet Ea	14	$853.16	$1,357.30	$891.94	nat. median $854 1.0× median
15277 HCPCS	Wound Care Aply Skin Substitue- Feet Fi	14	$853.16	$1,357.30	$891.94	nat. median $2,073 outlier · 0.4×
15274 HCPCS	Wound Care Aply Skin Substitue- Legs Ea	14	$853.16	$1,357.30	$891.94	nat. median $797 1.1× median
95811 HCPCS	Titration Sleep Study	14	$800.73	$1,273.88	$837.12	nat. median $1,894 outlier · 0.4×
P9035 HCPCS	Platelet Pheresis Unit, Leukoreduced	14	$794.64	$1,264.20	$830.76	nat. median $804 1.0× median
45384 HCPCS	45384 Colonscopy With Rml Of Polyp W/hot	14	$774.00	$1,260.00	$828.00	nat. median $1,584 0.5× median
45378 HCPCS	45378 Colonoscopy Without Biopsy	14	$792.00	$1,260.00	$828.00	nat. median $1,342 0.6× median
G0105 HCPCS	G0105 Colonoscopy Without Biopsy High Risk	14	$670.32	$1,260.00	$828.00	nat. median $1,305 0.6× median
G0121 HCPCS	Colonoscope Without Biopsy (medicare Only)	14	$723.24	$1,260.00	$828.00	nat. median $1,292 0.6× median
44388 HCPCS	Colonoscopy Through Stoma; Diagnostic	14	$792.00	$1,260.00	$828.00	nat. median $1,353 0.6× median
45385 HCPCS	45385 Colonscopy W/rml Of Polyp By Snare	14	$730.44	$1,260.00	$828.00	nat. median $1,669 outlier · 0.5×
45380 HCPCS	45380 Colonoscope W/biopsy	14	$792.00	$1,260.00	$828.00	nat. median $1,565 0.5× median
74177 HCPCS	CT Abd/pelvis W/only,technical Component	14	$106.92	$2,625.00	$809.18	nat. median $974 0.8× median
J1561 HCPCS	Immune Globulin IV (gamunex)10% 5gm	14	$220.88	$2,558.50	$804.10	nat. median $1,093 0.7× median
49561 HCPCS	Repair Initial Incisional Hernia; Reduic	14	$768.12	$1,222.00	$803.03	nat. median $3,187 outlier · 0.3×
43251 HCPCS	43251 Egd W/removal Of Polyp By Snare Te	14	$748.00	$1,190.00	$782.00	nat. median $2,125 outlier · 0.4×
43246 HCPCS	43246 Peg Insertion	14	$748.00	$1,190.00	$782.00	nat. median $2,130 outlier · 0.4×
43239 HCPCS	43239 Gastroscopy Egd W/biopsy	14	$748.00	$1,190.00	$782.00	nat. median $1,375 0.6× median
43250 HCPCS	43250 Egd W/removal Of Polyp By Hot Biop	14	$748.00	$1,190.00	$782.00	nat. median $2,044 outlier · 0.4×
43235 HCPCS	43235 Upper Gastrointestinal Endoscopy	14	$748.00	$1,190.00	$782.00	nat. median $1,313 0.6× median
45382 HCPCS	Colonoscopy With Control Of Bleeding	14	$746.72	$1,187.97	$780.67	nat. median $1,744 outlier · 0.4×
J0875 HCPCS	Dalbavancin (dalvance) Vial 500mg	14	$744.92	$1,185.10	$778.78	nat. median $390 2.0× median
95810 HCPCS	Diagnostic Sleep Study	14	$720.69	$1,146.56	$753.45	nat. median $1,825 outlier · 0.4×
Q4160 HCPCS	Nu Shield (3x4) 12 Sq Cm	14	$139.92	$4,200.00	$746.24	nat. median $319 outlier · 2.3×
74176 HCPCS	CT Abd/pelvis W/o,technical Component	14	$101.64	$2,506.00	$743.15	nat. median $694 1.1× median

Other procedures at this hospital

Browse this hospital's 1,440 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

J1299	HCPCS	EculizuMAB Vial 300mg / 30mL	15	14	$7,000.00	$7,000.00	$3,080.00	$4,900.00	$3,220.00	2026-03-16
81229	HCPCS	Chromsome 5 Cell Cnt & Cma	30	14	$5,800.00	$5,800.00	$2,538.36	$4,060.00	$2,653.74	2026-03-16
J2993	HCPCS	Reteplase (retavase) Dose 18.1mg	15	14	$5,358.00	$5,358.00	$2,357.52	$3,750.60	$2,464.68	2026-03-16
Q4197	HCPCS	Puraply Xt 5x5	15	14	$4,925.00	$4,925.00	$2,167.00	$3,447.50	$2,265.50	2026-03-16
J9312	HCPCS	Rituxan Vial 500mg (inj)	15	14	$4,760.00	$4,760.00	$2,094.40	$3,332.00	$2,189.60	2026-03-16
81420	HCPCS	Maternit Genome	15	14	$3,775.29	$3,775.29	$1,661.13	$2,642.70	$1,736.63	2026-03-16
J1950	HCPCS	Leuprolide Acetate (lupron) Kit 7.5mg	30	14	$1,326.00	$1,326.00	$583.44	$3,990.00	$1,718.10	2026-03-16
J2997	HCPCS	Alteplase (activase) Vial 50mg	15	14	$3,644.75	$3,644.75	$1,603.69	$2,551.32	$1,676.59	2026-03-16
J0840	HCPCS	Antivenin,crot (crofab) One Vial	15	14	$3,476.25	$3,476.25	$1,529.55	$2,433.38	$1,599.08	2026-03-16
81292	HCPCS	Vista Seq Lynch Syndrome Panel	30	14	$2,413.00	$2,413.00	$1,061.72	$2,450.00	$1,540.00	2026-03-16
J3101	HCPCS	TNKase Kit Acute Mi 50mg	15	14	$3,266.70	$3,266.70	$1,437.35	$2,286.69	$1,502.68	2026-03-16
J0401	HCPCS	Arpiprazole (aristada) ER Inj 882mg IM	15	14	$3,200.00	$3,200.00	$1,408.00	$2,240.00	$1,472.00	2026-03-16
J3262	HCPCS	Actemra (mab) Vial 400mg / 20mL	15	14	$2,900.00	$2,900.00	$1,276.00	$2,030.00	$1,334.00	2026-03-16
0360	RC	—	15	14	$2,500.00	$2,500.00	$1,100.00	$1,750.00	$1,150.00	2026-03-16
11047	HCPCS	Wound Care Debrid Bone Each Additional	15	14	$2,484.70	$2,484.70	$1,093.27	$1,739.29	$1,142.96	2026-03-16
J0897	HCPCS	Denosumab (prolia) 60mg/1ml Single Dose,zero Drug Wasted	15	14	$2,000.00	$2,000.00	$12.87	$1,400.00	$920.00	2026-03-16
49451	HCPCS	Replacement Of Jejunostomy Tube Contrast	15	14	$2,000.00	$2,000.00	$880.00	$1,400.00	$920.00	2026-03-16
45398	HCPCS	Colonoscope W/band Ligation	15	14	$2,000.00	$2,000.00	$880.00	$1,400.00	$920.00	2026-03-16
33016	HCPCS	Pericardiocentesis	15	14	$2,000.00	$2,000.00	$880.00	$1,400.00	$920.00	2026-03-16
73722	HCPCS	MRI Low Jt Rt W	15	14	$1,975.00	$1,975.00	$869.00	$1,382.50	$908.50	2026-03-16
74178	HCPCS	CT Abd/pelvis W/wo,technical Component	30	14	$2,123.50	$2,123.50	$117.48	$2,786.00	$900.99	2026-03-16
11012	HCPCS	Debridement Including Removal Of Fb @ Si	15	14	$1,939.26	$1,939.26	$853.27	$1,357.48	$892.06	2026-03-16
15278	HCPCS	Wound Care Aply Skin Substitue- Feet Ea	15	14	$1,939.00	$1,939.00	$853.16	$1,357.30	$891.94	2026-03-16
15274	HCPCS	Wound Care Aply Skin Substitue- Legs Ea	15	14	$1,939.00	$1,939.00	$853.16	$1,357.30	$891.94	2026-03-16
15277	HCPCS	Wound Care Aply Skin Substitue- Feet Fi	15	14	$1,939.00	$1,939.00	$853.16	$1,357.30	$891.94	2026-03-16
15272	HCPCS	Wound Care Aply Skin Substitue- Legs Ea	15	14	$1,939.00	$1,939.00	$853.16	$1,357.30	$891.94	2026-03-16
15276	HCPCS	Wound Care Aply Skin Substitue- Feet Ea	15	14	$1,939.00	$1,939.00	$853.16	$1,357.30	$891.94	2026-03-16
15273	HCPCS	Wound Care Aply Skin Substitue- Legs Fi	15	14	$1,939.00	$1,939.00	$853.16	$1,357.30	$891.94	2026-03-16
95811	HCPCS	Titration Sleep Study	15	14	$1,819.83	$1,819.83	$800.73	$1,273.88	$837.12	2026-03-16
P9035	HCPCS	Platelet Pheresis Unit, Leukoreduced	15	14	$1,806.00	$1,806.00	$794.64	$1,264.20	$830.76	2026-03-16
G0105	HCPCS	G0105 Colonoscopy Without Biopsy High Risk	15	14	$1,800.00	$1,800.00	$670.32	$1,260.00	$828.00	2026-03-16
45378	HCPCS	45378 Colonoscopy Without Biopsy	15	14	$1,800.00	$1,800.00	$792.00	$1,260.00	$828.00	2026-03-16
45385	HCPCS	45385 Colonscopy W/rml Of Polyp By Snare	15	14	$1,800.00	$1,800.00	$730.44	$1,260.00	$828.00	2026-03-16
G0121	HCPCS	Colonoscope Without Biopsy (medicare Only)	15	14	$1,800.00	$1,800.00	$723.24	$1,260.00	$828.00	2026-03-16
44388	HCPCS	Colonoscopy Through Stoma; Diagnostic	15	14	$1,800.00	$1,800.00	$792.00	$1,260.00	$828.00	2026-03-16
45380	HCPCS	45380 Colonoscope W/biopsy	15	14	$1,800.00	$1,800.00	$792.00	$1,260.00	$828.00	2026-03-16
45384	HCPCS	45384 Colonscopy With Rml Of Polyp W/hot	15	14	$1,800.00	$1,800.00	$774.00	$1,260.00	$828.00	2026-03-16
74177	HCPCS	CT Abd/pelvis W/only,technical Component	30	14	$1,996.50	$1,996.50	$106.92	$2,625.00	$809.18	2026-03-16
J1561	HCPCS	Immune Globulin IV (gamunex)10% 5gm	60	14	$1,586.75	$1,586.75	$220.88	$2,558.50	$804.10	2026-03-16
49561	HCPCS	Repair Initial Incisional Hernia; Reduic	15	14	$1,745.72	$1,745.72	$768.12	$1,222.00	$803.03	2026-03-16
43235	HCPCS	43235 Upper Gastrointestinal Endoscopy	15	14	$1,700.00	$1,700.00	$748.00	$1,190.00	$782.00	2026-03-16
43239	HCPCS	43239 Gastroscopy Egd W/biopsy	15	14	$1,700.00	$1,700.00	$748.00	$1,190.00	$782.00	2026-03-16
43246	HCPCS	43246 Peg Insertion	15	14	$1,700.00	$1,700.00	$748.00	$1,190.00	$782.00	2026-03-16
43251	HCPCS	43251 Egd W/removal Of Polyp By Snare Te	15	14	$1,700.00	$1,700.00	$748.00	$1,190.00	$782.00	2026-03-16
43250	HCPCS	43250 Egd W/removal Of Polyp By Hot Biop	15	14	$1,700.00	$1,700.00	$748.00	$1,190.00	$782.00	2026-03-16
45382	HCPCS	Colonoscopy With Control Of Bleeding	15	14	$1,697.10	$1,697.10	$746.72	$1,187.97	$780.67	2026-03-16
J0875	HCPCS	Dalbavancin (dalvance) Vial 500mg	15	14	$1,693.00	$1,693.00	$744.92	$1,185.10	$778.78	2026-03-16
95810	HCPCS	Diagnostic Sleep Study	15	14	$1,637.94	$1,637.94	$720.69	$1,146.56	$753.45	2026-03-16
Q4160	HCPCS	Nu Shield (3x4) 12 Sq Cm	90	14	$1,272.00	$1,272.00	$139.92	$4,200.00	$746.24	2026-03-16
74176	HCPCS	CT Abd/pelvis W/o,technical Component	30	14	$1,905.50	$1,905.50	$101.64	$2,506.00	$743.15	2026-03-16
45388	HCPCS	45383 Colonscopy W Ablation Of Lesion	15	14	$1,615.20	$1,615.20	$710.69	$1,130.64	$742.99	2026-03-16
70486	HCPCS	CT Sinus Without Contrast,technical Component	45	14	$1,625.00	$1,625.00	$50.16	$1,193.50	$722.96	2026-03-16
J1459	HCPCS	Immune Globulin IV (privigen) 10% 20gm	45	14	$1,530.00	$1,530.00	$336.60	$2,142.00	$703.80	2026-03-16
74185	HCPCS	MRA Abdomen W	30	14	$1,519.00	$1,519.00	$104.72	$1,960.00	$699.30	2026-03-16
46040	HCPCS	I & D Perirectal Abscess	15	14	$1,500.00	$1,500.00	$660.00	$1,050.00	$690.00	2026-03-16
93241	HCPCS	Holter 7 Days	15	14	$1,500.00	$1,500.00	$645.00	$1,050.00	$690.00	2026-03-16
36569	HCPCS	Insrtion Of Pic Venous Catheter Age 5 Ol	30	14	$682.20	$682.20	$300.17	$1,400.00	$678.77	2026-03-16
11044	HCPCS	Wound Care Debrid Skin Into Bone	30	14	$2,484.70	$2,484.70	$154.00	$1,739.29	$669.13	2026-03-16
J0881	HCPCS	Darbepoetin (aranesp) 100mcg Syr	30	14	$1,320.00	$1,320.00	$580.80	$1,050.00	$660.00	2026-03-16
73220	HCPCS	MRI Forearm Lt W/wo	45	14	$1,425.00	$1,425.00	$126.28	$1,120.00	$655.50	2026-03-16
73219	HCPCS	MRI Forearm Lt W	45	14	$1,400.00	$1,400.00	$94.60	$1,382.50	$644.00	2026-03-16
45379	HCPCS	45379 Colonscopy W Removal Of Foreign Bo	15	14	$1,400.00	$1,400.00	$616.00	$980.00	$644.00	2026-03-16
28192	HCPCS	Removal Fb; Foot; Ddep	15	14	$1,345.89	$1,345.89	$592.19	$942.12	$619.11	2026-03-16
15271	HCPCS	Wound Care Aply Skin Substitue- Legs Fi	60	14	$1,939.00	$1,939.00	$110.00	$1,403.45	$619.08	2026-03-16
15004	HCPCS	Wound Care Skin Replacement Surgery	30	14	$1,939.00	$1,939.00	$220.00	$1,357.30	$601.58	2026-03-16
G0416	HCPCS	Gross Microscopic Exam For Prostate 1-20	15	14	$1,285.83	$1,285.83	$565.77	$900.08	$591.48	2026-03-16
15002	HCPCS	Wound Care Skin Replacement Surgery	30	14	$1,939.00	$1,939.00	$176.00	$1,357.30	$566.58	2026-03-16
81220	HCPCS	Cystic Fibrosis	15	14	$1,220.00	$1,220.00	$536.80	$854.00	$561.20	2026-03-16
J2426	HCPCS	Invega Sustenna ER Inj 156mg charge	60	14	$1,265.75	$1,265.75	$316.36	$1,307.95	$556.93	2026-03-16
92611	HCPCS	Mbs	15	14	$1,200.00	$1,200.00	$40.53	$840.00	$552.00	2026-03-16
73218	HCPCS	MRI Forearm Rt Without	45	14	$1,200.00	$1,200.00	$79.20	$1,120.00	$552.00	2026-03-16
70548	HCPCS	MRA Neck W/contrast	30	14	$1,187.50	$1,187.50	$88.00	$1,522.50	$548.50	2026-03-16
74170	HCPCS	CT Abdm W/wo Oral And Iv,technical Component	30	14	$1,180.00	$1,180.00	$81.40	$1,522.50	$532.38	2026-03-16
95807	HCPCS	Pap Nap	15	14	$1,153.38	$1,153.38	$507.49	$807.37	$530.55	2026-03-16
J1162	HCPCS	Digoxin Immune Fab (digibind) 38mg	15	14	$1,137.50	$1,137.50	$500.50	$796.25	$523.25	2026-03-16
11603	HCPCS	Excis Malig Lesion 2.1	15	14	$1,090.00	$1,090.00	$479.60	$763.00	$501.40	2026-03-16
12035	HCPCS	Repair Intermediate Scalp, Axilla Trunk	15	14	$1,074.27	$1,074.27	$472.68	$751.99	$494.16	2026-03-16
74160	HCPCS	CT Abdomen W/only,technical Component	30	14	$1,072.00	$1,072.00	$74.36	$1,382.50	$493.65	2026-03-16
70482	HCPCS	CT Orbit Sella/post Fossa W/wo,technical Component	30	14	$1,071.50	$1,071.50	$73.92	$1,382.50	$493.30	2026-03-16
70544	HCPCS	MRA Head W0	30	14	$1,067.00	$1,067.00	$69.96	$1,382.50	$490.15	2026-03-16
70481	HCPCS	CT Orbit Sella/post Fossa W,technical Component	30	14	$1,062.50	$1,062.50	$66.00	$1,382.50	$487.00	2026-03-16
26641	HCPCS	Closed Treatment Of Carpometacarpal Disl	15	14	$1,029.42	$1,029.42	$452.94	$720.59	$473.53	2026-03-16
72127	HCPCS	CT C Spine W/wo,technical Component	30	14	$1,009.50	$1,009.50	$74.36	$1,295.00	$466.15	2026-03-16
71270	HCPCS	CT Chest W/wo,technical Component	30	14	$1,008.00	$1,008.00	$73.04	$1,295.00	$465.10	2026-03-16
0110	RC	—	4	2	$650.00	$650.00	$300.00	$720.00	$465.00	2026-03-16
26742	HCPCS	Closed Treatment Of Articular Fracture I	15	14	$1,003.80	$1,003.80	$441.67	$702.66	$461.75	2026-03-16
70491	HCPCS	CT St Neck W,technical Component	30	14	$994.00	$994.00	$80.52	$1,263.50	$461.15	2026-03-16
93224	HCPCS	Holter 48 Hours	15	14	$1,000.00	$1,000.00	$440.00	$700.00	$460.00	2026-03-16
27510	HCPCS	Closed Treatment Of Femoral Fracture With	15	14	$1,000.00	$1,000.00	$440.00	$700.00	$460.00	2026-03-16
45300	HCPCS	Proctosigmmoidoscopy; Rigid; Diagnostic	15	14	$1,000.00	$1,000.00	$440.00	$700.00	$460.00	2026-03-16
59409	HCPCS	Vaginal Delivery	15	14	$1,000.00	$1,000.00	$440.00	$700.00	$460.00	2026-03-16
27752	HCPCS	Closed Treatment Of Tibia W Or Without Fibul	15	14	$1,000.00	$1,000.00	$440.00	$700.00	$460.00	2026-03-16
72158	HCPCS	MRI Lumbar W/wo	30	14	$953.00	$953.00	$134.64	$1,120.00	$459.10	2026-03-16
72156	HCPCS	MRI Cervical Spine W/wo	30	14	$953.00	$953.00	$134.64	$1,120.00	$459.10	2026-03-16
72157	HCPCS	MRI Thoracic Spine W/wo	30	14	$953.00	$953.00	$134.64	$1,120.00	$459.10	2026-03-16
70488	HCPCS	CT Maxillofacial W/wo Contrast,technical Component	30	14	$986.50	$986.50	$73.92	$1,263.50	$455.90	2026-03-16
72197	HCPCS	MRI Pelvis W/wo	30	14	$946.50	$946.50	$128.92	$1,120.00	$454.55	2026-03-16
74183	HCPCS	MRI Abdomen Wo/w	30	14	$946.50	$946.50	$128.92	$1,120.00	$454.55	2026-03-16
70492	HCPCS	CT St Neck W/wo,technical Component	30	14	$969.50	$969.50	$94.16	$1,207.50	$454.40	2026-03-16
90375	HCPCS	Rabies Immune Glob(imogam Rig) 300u/2ml	15	14	$986.25	$986.25	$433.95	$690.38	$453.68	2026-03-16
72194	HCPCS	CT Pelvis W/wo,technical Component	30	14	$983.00	$983.00	$70.84	$1,263.50	$453.45	2026-03-16
46221	HCPCS	Hemorrhoidectomy, Internal, Band Ligatio	15	14	$985.00	$985.00	$433.40	$689.50	$453.10	2026-03-16
72132	HCPCS	CT Lumbar Spine W/contrast,technical Component	30	14	$981.00	$981.00	$71.28	$1,260.00	$452.70	2026-03-16
99291	HCPCS	ER Level #6	30	14	$1,500.00	$1,500.00	$154.00	$1,050.00	$452.50	2026-03-16
73720	HCPCS	MRI Tib Fib Rt W/wo	30	14	$943.50	$943.50	$126.28	$1,120.00	$452.45	2026-03-16
70543	HCPCS	MRI Soft Tissue Neck W/wo	60	14	$943.50	$943.50	$125.84	$1,951.60	$452.45	2026-03-16
73723	HCPCS	MRI Knee Rt W/wo	30	14	$943.50	$943.50	$126.28	$1,120.00	$452.45	2026-03-16
73223	HCPCS	MRI Elbow Rt W/wo	30	14	$943.50	$943.50	$126.28	$1,120.00	$452.45	2026-03-16
95805	HCPCS	Multiple Sleep Latency Or Maintenance	15	14	$977.85	$977.85	$430.25	$684.50	$449.81	2026-03-16
45331	HCPCS	Sigmoidoscope (flex) W	15	14	$971.00	$971.00	$427.24	$679.70	$446.66	2026-03-16
88275	HCPCS	Cml Profile Chromosome Analysis, Fish	15	14	$970.00	$970.00	$426.80	$679.00	$446.20	2026-03-16
70547	HCPCS	MRA Neck Wo	30	14	$967.00	$967.00	$69.96	$1,242.50	$446.15	2026-03-16
72193	HCPCS	CT Pelvis W,technical Component	30	14	$964.50	$964.50	$67.76	$1,242.50	$444.40	2026-03-16
71275	HCPCS	CTA Chest With Contrast,technical Component	30	14	$1,046.00	$1,046.00	$106.48	$1,295.00	$441.94	2026-03-16
87633	HCPCS	Respiratory Profile, Pcr	15	14	$960.00	$960.00	$348.10	$672.00	$441.60	2026-03-16
Q4196	HCPCS	Puraply 2x4	15	14	$960.00	$960.00	$422.40	$672.00	$441.60	2026-03-16
70546	HCPCS	MRA Head Wo/w	30	14	$935.50	$935.50	$86.24	$1,172.50	$437.10	2026-03-16
26725	HCPCS	Closed Treat Of Phalangeal Fracture Pros	15	14	$941.79	$941.79	$414.39	$659.25	$433.22	2026-03-16
87507	HCPCS	Gi Profile Stool Pcr	15	14	$940.00	$940.00	$413.60	$658.00	$432.40	2026-03-16
70553	HCPCS	MRI Brain Wo/w	30	14	$952.50	$952.50	$134.20	$1,120.00	$431.39	2026-03-16
25605	HCPCS	Treat Fract Radi	30	14	$1,000.00	$1,000.00	$264.00	$700.00	$430.00	2026-03-16
25680	HCPCS	Closed Treatment Of Fx Wrist With Manipula	15	14	$930.00	$930.00	$409.20	$651.00	$427.80	2026-03-16
81279	HCPCS	Jak2 E12-15 Panel	15	14	$922.00	$922.00	$405.68	$645.40	$424.12	2026-03-16
81329	HCPCS	Spinal Muscular Atrophy	15	14	$920.00	$920.00	$404.80	$644.00	$423.20	2026-03-16
81270	HCPCS	Jak-2 Mutation	15	14	$920.00	$920.00	$404.80	$644.00	$423.20	2026-03-16
70490	HCPCS	CT St Neck Wo,technical Component	30	14	$910.50	$910.50	$75.24	$1,155.00	$422.85	2026-03-16
74150	HCPCS	CT Abdomen W/o,technical Component	30	14	$981.50	$981.50	$69.52	$1,263.50	$421.53	2026-03-16
71260	HCPCS	CT Chest Super D With Contrast,technical Component	30	14	$977.50	$977.50	$68.20	$1,260.00	$419.47	2026-03-16
J1439	HCPCS	Ferric Carboxym (injectafer) 750mg/15ml	15	14	$907.50	$907.50	$399.30	$635.25	$417.45	2026-03-16
70470	HCPCS	CT Head W/wo,technical Component	30	14	$897.00	$897.00	$74.36	$1,137.50	$416.65	2026-03-16
70480	HCPCS	CT Orbits/sella/post Fossa/ear Wo,technical Component	30	14	$888.00	$888.00	$75.24	$1,123.50	$412.95	2026-03-16
97602	HCPCS	Wound Care Active- Non- Selective	15	14	$895.00	$895.00	$393.80	$626.50	$411.70	2026-03-16
97606	HCPCS	Wound Care Negative Pressure Therapy>=50	15	14	$895.00	$895.00	$393.80	$626.50	$411.70	2026-03-16
70487	HCPCS	CT Maxillofacial W/contrast,technical Component	30	14	$887.50	$887.50	$66.00	$1,137.50	$410.00	2026-03-16
J3246	HCPCS	Tirofib M-hydr (aggrastat) Premix	15	14	$881.50	$881.50	$387.86	$617.05	$405.49	2026-03-16
26700	HCPCS	Closed Treatment Of Mcp, Dislocation, Si	15	14	$870.33	$870.33	$382.95	$609.23	$400.35	2026-03-16
73725	HCPCS	MRA Lower W/wo	30	14	$832.50	$832.50	$105.60	$997.50	$397.50	2026-03-16
72192	HCPCS	CT Pelvis W/o,technical Component	30	14	$924.50	$924.50	$63.36	$1,193.50	$396.35	2026-03-16
70460	HCPCS	CT Head W/contrast,technical Component	30	14	$852.50	$852.50	$66.00	$1,088.50	$394.60	2026-03-16
72149	HCPCS	MRI Lumbar W/contrast	30	14	$819.00	$819.00	$104.72	$980.00	$391.30	2026-03-16
70545	HCPCS	MRA Head W	30	14	$842.00	$842.00	$69.96	$1,067.50	$391.15	2026-03-16
45330	HCPCS	Flexible Sigmoidoscopy, Diagnostic	15	14	$850.00	$850.00	$344.93	$595.00	$391.00	2026-03-16
70552	HCPCS	MRI Brain W/contrast	30	14	$818.50	$818.50	$104.28	$980.00	$390.95	2026-03-16
72147	HCPCS	MRI Thoracic Spine W/contras	30	14	$818.00	$818.00	$103.84	$980.00	$390.60	2026-03-16
J1742	HCPCS	Ibutilide Fumar (corvert) Vl 0.1mg/ml	15	14	$848.25	$848.25	$373.23	$593.77	$390.19	2026-03-16
72142	HCPCS	MRI Cervical Spine W	30	14	$815.00	$815.00	$101.20	$980.00	$388.50	2026-03-16
74182	HCPCS	MRI Abdomen W/contrast	30	14	$814.50	$814.50	$100.76	$980.00	$388.15	2026-03-16
Q0139	HCPCS	Ferumoxytol (feraheme)vl 510mg/17ml	15	14	$841.50	$841.50	$0.73	$589.05	$387.09	2026-03-16
49083	HCPCS	US Abdomen Parocentesis W/image Guidance,technical Component	15	14	$836.70	$836.70	$368.15	$585.69	$384.88	2026-03-16
73222	HCPCS	MRI Elbow Rt W	30	14	$808.00	$808.00	$95.04	$980.00	$383.60	2026-03-16
73719	HCPCS	MRI Femur Rt W	30	14	$807.50	$807.50	$94.60	$980.00	$383.25	2026-03-16
70542	HCPCS	MRI Orbit, Face, Or Neck With Only	30	14	$807.50	$807.50	$94.60	$980.00	$383.25	2026-03-16
90675	HCPCS	Rabies Vaccine 2.5 Units	15	14	$825.76	$825.76	$171.46	$578.03	$379.85	2026-03-16
72131	HCPCS	CT Lumbar Spine W/o,technical Component	30	14	$929.00	$929.00	$58.52	$1,207.50	$379.64	2026-03-16
12036	HCPCS	Repair, Intermediate Scalp, Axillae, Tr	15	14	$825.00	$825.00	$363.00	$577.50	$379.50	2026-03-16
27825	HCPCS	Closed Treatment Of Distal Tibia	15	14	$800.00	$800.00	$352.00	$560.00	$368.00	2026-03-16
27810	HCPCS	Closed Treatment Of Bimalleolar Ankle Fr	15	14	$800.00	$800.00	$352.00	$560.00	$368.00	2026-03-16
0002M	OTHER	Ash Fibrosure	15	14	$800.00	$800.00	$352.00	$560.00	$368.00	2026-03-16
94003	HCPCS	Ventilation Management, Subsequent Day	15	14	$798.00	$798.00	$351.12	$558.60	$367.08	2026-03-16
94002	HCPCS	Ventilation Management , Initiation	15	14	$798.00	$798.00	$351.12	$558.60	$367.08	2026-03-16
74174	HCPCS	CTA Abd/pelvis W/contrast,technical Component	30	14	$747.33	$747.33	$128.92	$841.15	$366.91	2026-03-16
97605	HCPCS	Wound Care Thera Activity	29	14	$895.00	$895.00	$158.40	$626.50	$363.19	2026-03-16
71250	HCPCS	CT Chest Super D Without Contrast,technical Component	30	14	$924.50	$924.50	$63.36	$1,193.50	$362.02	2026-03-16
72128	HCPCS	CT Thoraic Spine W/o,technical Component	30	14	$841.00	$841.00	$58.08	$1,085.00	$360.70	2026-03-16
74280	HCPCS	Barium Enema Air Contrast,technical Component	15	14	$774.00	$774.00	$340.56	$541.80	$356.04	2026-03-16
88377	HCPCS	Quantitative Or Semi Quant Morphometric	15	14	$751.70	$751.70	$330.75	$526.19	$345.78	2026-03-16
72125	HCPCS	CT C Spine W/o,technical Component	30	14	$841.00	$841.00	$58.08	$1,085.00	$345.50	2026-03-16
81338	HCPCS	Mpl Mutation Analysis	15	14	$748.00	$748.00	$329.12	$523.60	$344.08	2026-03-16
74181	HCPCS	MRI Abdomen Wo	30	14	$696.50	$696.50	$84.92	$840.00	$331.55	2026-03-16
73721	HCPCS	MRI Knee Lt Without	30	14	$690.00	$690.00	$79.20	$840.00	$327.00	2026-03-16
73718	HCPCS	MRI Femur Lt Without	60	14	$690.00	$690.00	$78.76	$1,242.50	$327.00	2026-03-16
70540	HCPCS	MRI Orbit, Face, Or Neck Wo	30	14	$689.00	$689.00	$78.32	$840.00	$326.30	2026-03-16
70450	HCPCS	CT Head Wo,technical Component	30	14	$759.00	$759.00	$49.72	$983.50	$324.62	2026-03-16
27560	HCPCS	Closed Treatment Of Patellar Dislocation	15	14	$691.72	$691.72	$304.36	$484.20	$318.19	2026-03-16
B4088	HCPCS	Gastro Peg Tube Kit	15	14	$686.00	$686.00	$301.84	$480.20	$315.56	2026-03-16
81401	HCPCS	Apoe Alzheimer's Risk	15	14	$680.00	$680.00	$299.20	$476.00	$312.80	2026-03-16
72141	HCPCS	MRI Cervical Spine Without	30	14	$698.50	$698.50	$86.68	$840.00	$312.43	2026-03-16
70551	HCPCS	MRI Brain Wo	30	14	$698.00	$698.00	$86.24	$840.00	$312.08	2026-03-16
26645	HCPCS	Closed Treat Of Carpmetacarpal Fracture	15	14	$672.70	$672.70	$295.99	$470.89	$309.44	2026-03-16
11043	HCPCS	Wound Care Debrid Skin Into Muscle	30	14	$925.43	$925.43	$132.00	$647.80	$308.60	2026-03-16
P9016	HCPCS	Bb Leuko- Reduced Rbc's	15	14	$668.00	$668.00	$293.92	$467.60	$307.28	2026-03-16
J1441	HCPCS	Filgrastim (neupogen) Vl 480mcg/1.6ml	15	14	$668.00	$668.00	$293.92	$467.60	$307.28	2026-03-16
73221	HCPCS	MRI Elbow Lt Without	30	14	$690.00	$690.00	$79.20	$840.00	$306.48	2026-03-16
92523	HCPCS	St Eval Sound Production W Lang Comp & E	15	14	$665.00	$665.00	$131.19	$465.50	$305.90	2026-03-16
36556	HCPCS	Central Venous L	30	14	$900.00	$900.00	$132.00	$630.00	$303.00	2026-03-16
81373	HCPCS	Hla B51	15	14	$650.00	$650.00	$286.00	$455.00	$299.00	2026-03-16
81170	HCPCS	Bcr-abli Kinase Domain	15	14	$650.00	$650.00	$286.00	$455.00	$299.00	2026-03-16
73202	HCPCS	CT Upper Ext W/wo Lt,left Side, Technical Component	60	14	$625.00	$625.00	$70.84	$762.30	$295.93	2026-03-16
J1301	HCPCS	IV Edaravone (Radicava Ivpb) 30mg/100ml	15	14	$643.00	$643.00	$282.92	$450.10	$295.78	2026-03-16
72148	HCPCS	MRI Lumbar Wo	30	14	$698.50	$698.50	$86.68	$840.00	$294.79	2026-03-16
72146	HCPCS	MRI Thoracic Spine W/out	30	14	$698.50	$698.50	$86.68	$840.00	$294.79	2026-03-16
86362	HCPCS	Anti-mog	15	14	$640.00	$640.00	$281.60	$448.00	$294.40	2026-03-16
J1442	HCPCS	Filgrastim (neupogen) Vl 300mcg/ml	30	14	$419.50	$419.50	$184.58	$467.60	$293.78	2026-03-16
J2794	HCPCS	Risperidone (risperdal Const)inj 25mg	60	14	$452.25	$452.25	$92.73	$632.98	$290.40	2026-03-16
72195	HCPCS	MRI Pelvis Wo	30	14	$697.00	$697.00	$85.36	$840.00	$287.86	2026-03-16
73200	HCPCS	CT Upper Ext Without Lt,left Side, Technical Component	60	14	$610.50	$610.50	$58.08	$762.30	$285.78	2026-03-16
12037	HCPCS	Lay Clos Wound S	30	14	$645.00	$645.00	$198.00	$451.50	$283.80	2026-03-16
26011	HCPCS	Drainage Of Finger Abscess; Complicated	15	14	$614.48	$614.48	$270.37	$430.14	$282.66	2026-03-16
54700	HCPCS	I & D Abscess Of Epididymis, Testis, Scr	15	14	$606.06	$606.06	$266.67	$424.24	$278.79	2026-03-16
46050	HCPCS	I & D Perianal Abscess, Superficial	15	14	$600.00	$600.00	$264.00	$420.00	$276.00	2026-03-16
36430	HCPCS	Blood Aministration And Transfusion	15	14	$600.00	$600.00	$264.00	$420.00	$276.00	2026-03-16
G0481	HCPCS	Drug Conf 8-14 Classes	15	14	$600.00	$600.00	$264.00	$420.00	$276.00	2026-03-16
86052	HCPCS	Anti-aquaporin (aqp4) Serum	15	14	$590.00	$590.00	$259.60	$413.00	$271.40	2026-03-16
99285	HCPCS	ER Level #5 Prol	30	14	$1,000.00	$1,000.00	$99.00	$700.00	$266.95	2026-03-16
17250	HCPCS	Wound Care Chemical Cauterization	45	14	$583.00	$583.00	$41.80	$421.97	$265.24	2026-03-16
82656	HCPCS	Pancreatic Elastare, Fecal	15	14	$575.00	$575.00	$214.13	$402.50	$264.50	2026-03-16
70336	HCPCS	MRI Tmj	30	14	$542.50	$542.50	$85.80	$623.01	$264.05	2026-03-16
0202U	OTHER	Respiratory Pathogen Panel(pcr)	30	14	$600.00	$600.00	$198.00	$420.00	$264.00	2026-03-16
88309	HCPCS	Level Vi- Gross And Microscopic Examinat	15	14	$569.16	$569.16	$250.43	$398.41	$261.81	2026-03-16
80145	HCPCS	Adalimumab And Anti-adalimumab Antibody	15	14	$560.00	$560.00	$246.40	$392.00	$257.60	2026-03-16
24500	HCPCS	Closed Treatment Of Humeral Shaft Without Ma	15	14	$557.66	$557.66	$245.37	$390.36	$256.52	2026-03-16
93925	HCPCS	Rr US Art Lo Ex-bi,professional Component	30	14	$652.00	$652.00	$45.76	$840.00	$256.36	2026-03-16
26720	HCPCS	Closed Treat Of Finger Fracture	15	14	$554.70	$554.70	$244.07	$388.29	$255.16	2026-03-16
74270	HCPCS	Barium Enema,technical Component	15	14	$550.00	$550.00	$242.00	$385.00	$253.00	2026-03-16
38221	HCPCS	Bone Marrow Biop	15	14	$550.00	$550.00	$242.00	$385.00	$253.00	2026-03-16
12044	HCPCS	Repair Interme Neck, Hands, Feet Externa	15	14	$549.32	$549.32	$241.70	$384.52	$252.69	2026-03-16
93970	HCPCS	Rr US Venous Upper Bil,professional Component	30	14	$645.50	$645.50	$40.04	$840.00	$252.61	2026-03-16
20520	HCPCS	Removal Foreign Body Muscle	15	14	$546.36	$546.36	$240.40	$382.45	$251.33	2026-03-16
73700	HCPCS	CT Lower Ext Without Lt,left Side, Technical Component	60	14	$610.50	$610.50	$58.08	$762.30	$251.15	2026-03-16
Q4124	HCPCS	Oasis Ultra Tri-layer 5x7cm MAtrix	15	14	$540.50	$540.50	$237.82	$378.35	$248.63	2026-03-16
75635	HCPCS	CTA Aorta Bi Runoff,technical Component	30	14	$474.17	$474.17	$138.60	$443.34	$246.42	2026-03-16
83950	HCPCS	Her 2 Quanitative	15	14	$530.34	$530.34	$233.35	$371.24	$243.96	2026-03-16
85246	HCPCS	Von Willebrand Factor Profile	15	14	$525.00	$525.00	$22.94	$367.50	$241.50	2026-03-16
97167	HCPCS	Ot Eval High Complexity 60 Min	15	14	$525.00	$525.00	$231.00	$367.50	$241.50	2026-03-16
97163	HCPCS	Pt Eval High 45 Min	15	14	$525.00	$525.00	$231.00	$367.50	$241.50	2026-03-16
93307	HCPCS	US Echo Follow Up	15	14	$525.00	$525.00	$231.00	$367.50	$241.50	2026-03-16
Q4186	HCPCS	Epifix 18mm	45	14	$522.63	$522.63	$181.24	$559.77	$240.41	2026-03-16
11046	HCPCS	Wound Care Debrid Muscle/ Fascia Each A	30	14	$925.43	$925.43	$45.13	$647.80	$239.49	2026-03-16
93930	HCPCS	Rr US Art Upper Extr Bil,professional Component	30	14	$507.50	$507.50	$46.64	$636.30	$237.08	2026-03-16
12016	HCPCS	12016 Simple Repair Face Ears 12.6 -20.0	15	14	$514.48	$514.48	$226.37	$360.14	$236.66	2026-03-16
81257	HCPCS	Alpha-thalassemia	15	14	$508.00	$508.00	$223.52	$355.60	$233.68	2026-03-16
81375	HCPCS	Hla D/dr Typing	15	14	$504.00	$504.00	$221.76	$352.80	$231.84	2026-03-16
27786	HCPCS	Closed Treatment Of Distal Fibula Without Ma	15	14	$501.70	$501.70	$220.75	$351.19	$230.78	2026-03-16
93306	HCPCS	Rr US Echo Cardigram 2/d,professional Component	30	14	$520.00	$520.00	$83.60	$595.00	$230.63	2026-03-16
27265	HCPCS	Reduction- Closed-post Hip Arthroplasty	15	14	$500.00	$500.00	$220.00	$350.00	$230.00	2026-03-16
54220	HCPCS	Priapism Blood Drainage	15	14	$500.00	$500.00	$220.00	$350.00	$230.00	2026-03-16
G0104	HCPCS	Sigmoidoscopy Flexible Colorectal Screen	15	14	$500.00	$500.00	$220.00	$350.00	$230.00	2026-03-16
40804	HCPCS	Removal Embedded Fb; Vestibule Of Mouth;	15	14	$500.00	$500.00	$220.00	$350.00	$230.00	2026-03-16
40800	HCPCS	I & D Abscess, Vestibule Of Mouth; Simpl	15	14	$500.00	$500.00	$220.00	$350.00	$230.00	2026-03-16
46083	HCPCS	Incision Of Thrombosed Ext Hemorrhoid	15	14	$497.43	$497.43	$218.87	$348.20	$228.82	2026-03-16
74175	HCPCS	CTA Abdomen Wo/w,technical Component	30	14	$437.52	$437.52	$106.04	$443.83	$223.84	2026-03-16
73206	HCPCS	CTA Upper Ext W/wo,technical Component	30	14	$436.21	$436.21	$105.16	$443.39	$223.00	2026-03-16
72191	HCPCS	CTA Pelvis W/wo,technical Component	30	14	$436.21	$436.21	$105.16	$443.39	$223.00	2026-03-16
92609	HCPCS	Treatment For Aac Speech-gen Device	15	14	$480.00	$480.00	$211.20	$336.00	$220.80	2026-03-16
70498	HCPCS	CTA Neck W/wo,technical Component	30	14	$432.52	$432.52	$101.64	$443.83	$220.34	2026-03-16
99204	HCPCS	Outpatient Treatment Room	57	14	$444.93	$444.93	$57.00	$380.00	$220.29	2026-03-16
55100	HCPCS	I & D Of Scrotal Wall Abscess	15	14	$475.00	$475.00	$209.00	$332.50	$218.50	2026-03-16
95819	HCPCS	EEG	15	14	$475.00	$475.00	$209.00	$332.50	$218.50	2026-03-16
29581	HCPCS	Wound Care Multilayer Compression Applic	30	14	$895.00	$895.00	$26.40	$656.21	$217.90	2026-03-16
12017	HCPCS	Simple Repair Of Superficial Wounds Of S	15	14	$470.70	$470.70	$207.11	$329.49	$216.52	2026-03-16
11750	HCPCS	Excision Of Nail,remov	30	14	$591.00	$591.00	$105.60	$413.70	$214.02	2026-03-16
83951	HCPCS	Dcp (des Gamma Carboxy Prothromin)	15	14	$465.00	$465.00	$204.60	$325.50	$213.90	2026-03-16
77075	HCPCS	Bone Survey,technical Component	30	14	$462.00	$462.00	$32.56	$595.00	$212.90	2026-03-16
25600	HCPCS	Closed Treatment Of Distal Radial Fractu	15	14	$460.46	$460.46	$202.60	$322.32	$211.81	2026-03-16
41800	HCPCS	Incision & Drainage Abcess, Gums	15	14	$458.50	$458.50	$201.74	$320.95	$210.91	2026-03-16
15275	HCPCS	Wound Care Aply Skin Substitue- Feet Fi	60	14	$550.00	$550.00	$88.00	$1,357.30	$208.50	2026-03-16
27808	HCPCS	Reduction Ankle Fracture	15	14	$450.00	$450.00	$198.00	$315.00	$207.00	2026-03-16
86870	HCPCS	Bb Antibody Id	15	14	$450.00	$450.00	$198.00	$315.00	$207.00	2026-03-16
97166	HCPCS	Ot Eval Mod Complexity 45 Min	15	14	$450.00	$450.00	$198.00	$315.00	$207.00	2026-03-16
92950	HCPCS	Cpr Ed Facility Chg	45	14	$450.00	$450.00	$132.00	$378.03	$207.00	2026-03-16
97162	HCPCS	Pt Eval Mod 30 Min	15	14	$450.00	$450.00	$198.00	$315.00	$207.00	2026-03-16
81379	HCPCS	Hla Abc Typing	15	14	$450.00	$450.00	$198.00	$315.00	$207.00	2026-03-16
82107	HCPCS	Alpha Fetoprotein Total And L3%	15	14	$447.00	$447.00	$196.68	$312.90	$205.62	2026-03-16
73706	HCPCS	CTA Lower Ext W/wo Bilateral,bilateral Procedure, Technical Component	90	14	$443.00	$443.00	$110.44	$770.00	$204.25	2026-03-16
94660	HCPCS	Cpap/ Bipap Initiation And Management	15	14	$443.00	$443.00	$194.92	$310.10	$203.78	2026-03-16
99284	HCPCS	ER Level #4 Exte	30	14	$725.00	$725.00	$70.40	$507.50	$203.10	2026-03-16
11045	HCPCS	Wound Care Debrid Skin Into Subq Each A	30	14	$925.43	$925.43	$17.60	$647.80	$201.77	2026-03-16
99283	HCPCS	ER Level # 3 Hig	15	14	$450.00	$450.00	$182.61	$315.00	$200.21	2026-03-16
38220	HCPCS	Bone Marrow Aspiration	15	14	$432.06	$432.06	$190.11	$302.44	$198.75	2026-03-16
73201	HCPCS	CT Upper Ext W/contrast Lt,left Side, Technical Component	60	14	$402.00	$402.00	$67.76	$455.00	$196.90	2026-03-16
99205	HCPCS	Outpatient Treatment Room	58	14	$542.85	$542.85	$88.00	$455.00	$196.35	2026-03-16
28190	HCPCS	Removal Foreign Body F	30	14	$500.00	$500.00	$105.60	$350.00	$194.00	2026-03-16
43760	HCPCS	Gastrostomy Tube Ed Fa	30	14	$345.00	$345.00	$151.80	$308.00	$193.60	2026-03-16
11104	HCPCS	Punch Biopsy Of Skin, Single Lesion	15	14	$420.00	$420.00	$184.80	$294.00	$193.20	2026-03-16
32554	HCPCS	Tube Thoracostom	30	14	$475.00	$475.00	$110.00	$332.50	$192.00	2026-03-16
67700	HCPCS	I & D Abscess Of Eyelid	15	14	$416.88	$416.88	$183.43	$291.82	$191.76	2026-03-16
76805	HCPCS	Rr US OB >14 Weeks,professional Component	30	14	$391.50	$391.50	$58.52	$455.00	$189.55	2026-03-16
J0714	HCPCS	Ceftazidime/Avibactam (avycaz) 2.5gm Vl	15	14	$410.00	$410.00	$180.40	$287.00	$188.60	2026-03-16
73702	HCPCS	CT Lower Ext W/wo Rt,technical Component	30	14	$380.26	$380.26	$70.84	$419.66	$188.25	2026-03-16
88307	HCPCS	Level V- Gross And Microscopic Examinati	15	14	$409.11	$409.11	$180.01	$286.38	$188.19	2026-03-16
J1327	HCPCS	Eptifibatide (integrilin) Vial2mg/ml(10)	30	14	$180.25	$180.25	$79.31	$394.98	$187.22	2026-03-16
85598	HCPCS	Antiphospholid Syndrome(profile)	30	14	$698.00	$698.00	$41.14	$488.60	$186.29	2026-03-16
73701	HCPCS	CT Lower Ext W/contrast Lt,left Side, Technical Component	60	14	$402.00	$402.00	$67.76	$455.00	$185.78	2026-03-16
97530	HCPCS	Ot Therapeutic Activity	60	14	$280.00	$280.00	$61.60	$392.00	$184.80	2026-03-16
87799	HCPCS	Bk Virus Pcr, Quant	30	14	$420.00	$420.00	$132.00	$294.00	$184.80	2026-03-16
M0222	HCPCS	IV Infusion, Bebtelovimab 175 Mg	15	14	$400.00	$400.00	$176.00	$280.00	$184.00	2026-03-16
92610	HCPCS	St Swallowing Eval	15	14	$400.00	$400.00	$176.00	$280.00	$184.00	2026-03-16
M0247	HCPCS	IV Infusion, Sotrovimab	15	14	$400.00	$400.00	$176.00	$280.00	$184.00	2026-03-16
93225	HCPCS	Cardiology Holter 24 To 48 Hours	15	14	$400.00	$400.00	$176.00	$280.00	$184.00	2026-03-16
M0243	HCPCS	Admin Of Monoclonal Antbdy Cov 19 Infus	15	14	$400.00	$400.00	$176.00	$280.00	$184.00	2026-03-16
M0245	HCPCS	IV Infusion, Bamianivimab And Etesevimab	15	14	$400.00	$400.00	$176.00	$280.00	$184.00	2026-03-16
J0558	HCPCS	Pen G Ben/pen G Pro (bicillin-cr) 1.2mu	15	14	$395.00	$395.00	$173.80	$276.50	$181.70	2026-03-16
27250	HCPCS	Closed Treatment Of Hip Dislocation, Tra	15	14	$394.04	$394.04	$173.38	$275.83	$181.26	2026-03-16
81381	HCPCS	Hla-b 1502	15	14	$390.00	$390.00	$171.60	$273.00	$179.40	2026-03-16
87517	HCPCS	Hepatitis B DNA Quant	15	14	$390.00	$390.00	$171.60	$273.00	$179.40	2026-03-16
97165	HCPCS	Ot Eval Low Complexity 30 Min	15	14	$385.00	$385.00	$169.40	$269.50	$177.10	2026-03-16
97161	HCPCS	Pt Eval Low 20 Min	15	14	$385.00	$385.00	$169.40	$269.50	$177.10	2026-03-16
74248	HCPCS	Rr Small Bowel With Ugi,professional Component	30	14	$372.50	$372.50	$41.80	$455.00	$176.25	2026-03-16
13121	HCPCS	Complex Repair Legs 2.	30	14	$365.46	$365.46	$160.80	$280.00	$176.00	2026-03-16
76705	HCPCS	Rr US Abdomen Limited,professional Component	38	14	$385.00	$385.00	$34.76	$315.00	$175.81	2026-03-16

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