Price Transparency 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

WEST CARROLL MEMORIAL HOSPITAL

Oak Grove, LA · CCN 191327 · Rates published

515 distinct procedures filed
88 distinct payers
10,848 rate rows
2026-03-26 last MRF observed
Data quality

10,524 of 10,848 rate rows are consumer-grade (97.0%)

324 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
placeholder amount (≤ $0.02) — excluded from medians 320
percent-of-charges filed in the dollar field — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://wchsystems.com/562300247_west-carroll-health-systems-llc_standardcharges.csv
Found on page https://wchsystems.com/charges-billing-and-insurance/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 382171bdda029a68… · 1,951,901 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
43453
CPT 		Egd W/dilation Via Sav 1 $2,178.00 $2,178.00 $2,178.00 nat. median
$1,972
1.1× median
72194
CPT 		CT Pelvis W Wo Contrast P 2 $1,263.00 $1,263.00 $1,263.00 nat. median
$657
1.9× median
70481
CPT 		CT Orbit With Contrast P 1 $1,126.00 $1,126.00 $1,126.00 nat. median
$630
1.8× median
72132
CPT 		CT L Spine With Contrast P 1 $1,089.00 $1,089.00 $1,089.00 nat. median
$760
1.4× median
74160
CPT 		CT Abdomen W Contrast P 3 $326.43 $1,053.00 $1,053.00 nat. median
$645
1.6× median
45380
CPT 		Colonoscopy With Biopsy 5 $60.76 $2,178.00 $1,050.01 nat. median
$1,566
0.7× median
74178
CPT 		CT Abd/pelvis W Wo Contrast P 6 $250.00 $1,815.00 $978.11 nat. median
$977
1.0× median
D5213
HCPCS 		Max Partial Denture(ca 1 $882.54 $882.54 $882.54 nat. median
$1,182
0.7× median
D5214
HCPCS 		Mand Partial Denture(c 1 $882.54 $882.54 $882.54 nat. median
$1,182
0.7× median
D5120
HCPCS 		Complete Denture (mand 1 $815.41 $815.41 $815.41 nat. median
$1,064
0.8× median
D5110
HCPCS 		Complete Denture (max) 1 $815.41 $815.41 $815.41 nat. median
$1,064
0.8× median
74170
CPT 		CT Abdomen W Wo Contrast P 3 $404.16 $1,263.00 $752.37 nat. median
$702
1.1× median
43239
CPT 		Egd W/biopsy 8 $24.35 $2,178.00 $729.63 nat. median
$1,377
0.5× median
73201
CPT 		CT Upper Ext With Contrast Left P 4 $349.06 $1,126.00 $704.14 nat. median
$827
0.9× median
43213
CPT 		Egd W/dilation Via Dil 7 $37.20 $2,178.00 $696.96 nat. median
$2,201
outlier · 0.3×
J3489
HCPCS 		Zoledronic Acid 'premix' Ivpb 5mg/100ml 1 $685.10 $685.10 $685.10 nat. median
$116
outlier · 5.9×
45378
CPT 		Colonoscopy Diagnostic 9 $24.35 $2,178.00 $675.18 nat. median
$1,330
0.5× median
45385
CPT 		Colonoscopy W/removal 11 $21.69 $2,178.00 $675.18 nat. median
$1,686
outlier · 0.4×
D5212
HCPCS 		Mand Partial Denture 4 $666.85 $850.00 $666.85 nat. median
$891
0.7× median
71275
CPT 		CT Angiogram Chest Pe Study P 10 $272.40 $1,362.00 $656.62 nat. median
$735
0.9× median
74177
CPT 		CT Abd/pelvis With Contrast P 24 $143.54 $1,271.00 $625.71 nat. median
$928
0.7× median
76811
CPT 		US Ob>/=14 Weeks Complex P 2 $620.92 $620.92 $620.92 nat. median
$325
1.9× median
73200
CPT 		CT Upper Ext Wo Contrast Left P 6 $188.80 $944.00 $618.32 nat. median
$548
1.1× median
70490
CPT 		CT St Neck Wo Contrast P 4 $320.85 $1,035.00 $616.55 nat. median
$441
1.4× median
70470
CPT 		CT Head W Wo Contrast P 6 $391.53 $1,263.00 $608.89 nat. median
$618
1.0× median
G0121
HCPCS 		Colonoscopy Screening Low Risk 5 $24.35 $1,542.75 $580.80 nat. median
$1,368
outlier · 0.4×
G0105
HCPCS 		Colonoscopy Screening High Risk 3 $60.76 $1,815.00 $580.80 nat. median
$1,410
outlier · 0.4×
82525
CPT 		Copper Urine 1 $552.00 $552.00 $552.00 nat. median
$35
outlier · 15.8×
11042
CPT 		Debride Subq/tissue 1st 3 $345.00 $1,725.00 $534.75 nat. median
$537
1.0× median
72192
CPT 		CT Pelvis Wo Contrast P 6 $306.90 $990.00 $533.51 nat. median
$455
1.2× median
70491
CPT 		CT St Neck With Contrast P 8 $320.85 $1,035.00 $509.53 nat. median
$617
0.8× median
J3101
HCPCS 		Tenecteplase Inj [50 Mg] 3 $507.89 $20,375.00 $507.89 nat. median
$5,949
outlier · 0.1×
72131
CPT 		CT L Spine Wo Contrast P 14 $61.01 $944.00 $506.72 nat. median
$448
1.1× median
J1165
HCPCS 		Phenytoin Inj 100mg/2ml 2 $21.69 $986.48 $504.08 nat. median
$6
outlier · 88.1×
73701
CPT 		CT Lower Ext W Contrast Left P 8 $156.85 $990.00 $477.28 nat. median
$710
0.7× median
43235
CPT 		Egd 1 $470.00 $470.00 $470.00 nat. median
$1,340
outlier · 0.4×
73700
CPT 		CT Lower Ext Wo Contrast Left P 4 $264.74 $854.00 $460.22 nat. median
$555
0.8× median
72128
CPT 		CT T Spine Wo Contrast P 11 $61.01 $944.00 $455.10 nat. median
$449
1.0× median
70487
CPT 		CT Facial Bones W/contrast P 1 $455.10 $455.10 $455.10 nat. median
$596
0.8× median
12014
CPT 		Sp Face\ear\5.1-7.5cm 1 $454.00 $454.00 $454.00 nat. median
$348
1.3× median
70480
CPT 		CT Orbit Wo Contrast P 7 $86.81 $545.00 $452.25 nat. median
$473
1.0× median
70486
CPT 		CT Facial Bones Wo Contrast P 13 $170.80 $854.00 $411.71 nat. median
$463
0.9× median
71260
CPT 		CT Chest With Contrast P 17 $71.40 $1,035.00 $405.00 nat. median
$646
0.6× median
70450
CPT 		CT Head Wo Contrast P 23 $180.00 $900.00 $405.00 nat. median
$454
0.9× median
93978
CPT 		US Inferior Vena Cava P 2 $132.00 $660.00 $396.00 nat. median
$470
0.8× median
74176
CPT 		CT Abd/pelvis Wo Contrast P 23 $106.31 $1,271.00 $394.01 nat. median
$685
0.6× median
84146
CPT 		Prolactin 1 $382.00 $382.00 $382.00 nat. median
$48
outlier · 7.9×
72193
CPT 		CT Pelvis With Contrast P 3 $363.32 $698.16 $375.00 nat. median
$629
0.6× median
29580
CPT 		App Of Unna Boot/multi 3 $112.53 $363.00 $363.00 nat. median
$222
1.6× median
C1751
HCPCS 		Picc Kit 6 $232.50 $750.00 $361.58 nat. median
$271
1.3× median

Other procedures at this hospital

Browse this hospital's 515 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
             
J3489 HCPCS Zoledronic Acid 'premix' Ivpb 5mg/100ml 2 1 $2,210.00 — $685.10 $685.10 $685.10 2026-03-26
73110 CPT Xr Wrist 3 Views Left P 32 16 $271.00 — $23.00 $271.00 $114.11 2026-03-26
73100 CPT Xr Wrist 2 Views Left P 4 2 $182.00 — $56.42 $182.00 $119.21 2026-03-26
73092 CPT Xr Upper Ext Ped Left P 2 1 $200.00 — $96.42 $96.42 $96.42 2026-03-26
73660 CPT Xr Toe Left 2nd P 16 8 $253.00 — $78.43 $253.00 $136.34 2026-03-26
73590 CPT Xr Tibia/fibula Left P 26 13 $261.00 — $52.20 $261.00 $155.48 2026-03-26
72070 CPT Xr Thoracic Spine Ap/lateral View P 12 6 $334.00 — $198.96 $334.00 $198.96 2026-03-26
72072 CPT Xr T Spine 3 View Routine P 24 12 $363.00 — $13.95 $363.00 $175.00 2026-03-26
71120 CPT Xr Sternum P 4 2 $327.00 — $101.37 $327.00 $214.19 2026-03-26
70360 CPT Xr Soft Tissue Neck P 14 7 $260.00 — $80.60 $260.00 $154.88 2026-03-26
70260 CPT Xr Skull 4+ Views P 2 1 $405.00 — $195.25 $195.25 $195.25 2026-03-26
70250 CPT Xr Skull 2 Views Routine P 8 4 $359.00 — $71.80 $359.00 $197.13 2026-03-26
70210 CPT Xr Sinuses 2 Views P 2 1 $301.00 — $145.11 $145.11 $145.11 2026-03-26
70220 CPT Xr Sinus 3 Views Routine P 32 15 $373.00 — $13.50 $373.00 $183.62 2026-03-26
73030 CPT Xr Shoulder Left 2v P 40 20 $330.00 — $11.69 $330.00 $103.56 2026-03-26
72082 CPT Xr Scoliosis Survey 2-3v P 14 7 $738.00 — $19.56 $439.63 $355.79 2026-03-26
73010 CPT Xr Scapula Left P 6 3 $235.00 — $72.85 $139.99 $139.99 2026-03-26
72220 CPT Xr Sacrum/coccyx Min 2v P 16 8 $273.00 — $54.60 $273.00 $131.61 2026-03-26
71100 CPT Xr Ribs Left 2v P 24 12 $362.00 — $114.97 $362.00 $174.52 2026-03-26
71110 CPT Xr Ribs Bilateral 3v P 4 2 $449.00 — $139.19 $449.00 $294.10 2026-03-26
72170 CPT Xr Pelvis P 16 8 $243.00 — $74.80 $243.00 $117.15 2026-03-26
70160 CPT Xr Nasal Bones P 2 1 $75.00 — $75.00 $75.00 $75.00 2026-03-26
70110 CPT Xr Mandible Complete P 4 2 $342.00 — $24.35 $106.02 $65.19 2026-03-26
72110 CPT Xr L Spine W Obliq P 14 7 $349.00 — $108.19 $349.00 $207.90 2026-03-26
72114 CPT Xr L Spine W Bending P 2 1 $486.00 — $150.66 $150.66 $150.66 2026-03-26
72100 CPT Xr L Spine Ap/lat Routine P 42 21 $388.00 — $13.89 $388.00 $155.00 2026-03-26
73562 CPT Xr Knee 3 Views Right P 36 18 $266.00 — $35.00 $266.00 $130.95 2026-03-26
73560 CPT Xr Knee 2 Views Left P 14 7 $253.00 — $25.00 $253.00 $91.08 2026-03-26
73060 CPT Xr Humerus Left P 20 10 $192.00 — $10.00 $192.00 $98.48 2026-03-26
73522 CPT Xr Hip Bil/pelvis P 16 8 $375.00 — $75.00 $375.00 $202.09 2026-03-26
73502 CPT Xr Hip 2 Views Left P 40 19 $319.00 — $13.89 $319.00 $111.25 2026-03-26
73650 CPT Xr Heel Os Calcis Left P 12 6 $253.00 — $78.43 $253.00 $152.86 2026-03-26
73130 CPT Xr Hand 3 Views Left Routine P 32 16 $260.00 — $52.00 $260.00 $142.76 2026-03-26
73120 CPT Xr Hand 2 Views Left P 16 8 $225.00 — $21.70 $225.00 $123.55 2026-03-26
73090 CPT Xr Forearm Right P 22 11 $208.00 — $66.06 $208.00 $123.91 2026-03-26
73630 CPT Xr Foot 3 Views Left Routine P 42 20 $261.00 — $10.46 $261.00 $125.83 2026-03-26
73620 CPT Xr Foot 2 Views Left P 12 6 $225.00 — $69.75 $225.00 $225.00 2026-03-26
73140 CPT Xr Finger Left 2nd P 28 14 $253.00 — $50.60 $253.00 $121.97 2026-03-26
73552 CPT Xr Femur 2 Views Left P 16 8 $279.00 — $86.49 $279.00 $150.35 2026-03-26
70150 CPT Xr Facial Bones Complete P 16 8 $337.00 — $18.00 $337.00 $162.47 2026-03-26
73080 CPT Xr Elbow Left 3v P 30 15 $266.00 — $10.85 $266.00 $155.62 2026-03-26
73000 CPT Xr Clavicle Left P 8 4 $240.00 — $74.40 $142.97 $142.97 2026-03-26
71046 CPT Xr Chest 2 Views Routine P 52 25 $255.00 — $13.50 $255.00 $122.94 2026-03-26
71045 CPT Xr Chest 1 View P 56 28 $281.00 — $8.11 $281.00 $87.11 2026-03-26
72050 CPT Xr C Spine 4+ View P 2 1 $393.00 — $121.83 $121.83 $121.83 2026-03-26
72040 CPT Xr C Spine 2 Views Routine P 26 13 $370.00 — $74.00 $370.00 $185.93 2026-03-26
73610 CPT Xr Ankle 3 Views Left P 36 18 $263.00 — $10.85 $263.00 $143.58 2026-03-26
73600 CPT Xr Ankle 2 Views Left P 8 4 $222.00 — $71.04 $222.00 $177.12 2026-03-26
74018 CPT Xr Abdomen Kub P 48 24 $253.00 — $11.30 $253.00 $95.95 2026-03-26
74019 CPT Xr Abdomen Flat And Upright P 40 20 $344.00 — $24.26 $344.00 $169.35 2026-03-26
97602 CPT Wound Care 20 10 $923.00 — $73.19 $923.00 $310.35 2026-03-26
J3430 HCPCS Vit- K Inj 10 MG/mL 10 5 $225.00 — $6.77 $225.00 $69.75 2026-03-26
J3373 HCPCS Vancomycin 1000mg Inj 12 6 $125.00 — $40.00 $125.00 $60.26 2026-03-26
90714 CPT Vaccine- Td Tenivac Inj 0.5ml 4 2 $90.00 — $27.90 $90.00 $58.95 2026-03-26
90732 CPT Vaccine- Pneumococcal 23 Inj 0.5ml 8 3 $57.00 — $57.00 $57.00 $57.00 2026-03-26
93971 CPT US Venous Upper Right P 32 16 $743.00 — $29.10 $743.00 $230.33 2026-03-26
93970 CPT US Venous Lower Bilateral P 24 12 $825.00 — $125.00 $825.00 $347.37 2026-03-26
76830 CPT US Transvaginal P 10 5 $330.00 — $159.09 $196.58 $165.83 2026-03-26
76536 CPT US Thyroid P 38 18 $273.00 — $34.41 $273.00 $100.00 2026-03-26
76870 CPT US Testicle Bilateral P 16 8 $273.00 — $30.00 $273.00 $131.61 2026-03-26
76705 CPT US Single Organ P 32 16 $495.00 — $35.76 $495.00 $208.42 2026-03-26
76770 CPT US Retroperitoneum Complete P 28 14 $454.00 — $45.32 $454.00 $244.66 2026-03-26
76856 CPT US Pelvis P 20 10 $454.00 — $41.84 $454.00 $249.29 2026-03-26
76811 CPT US Ob>/=14 Weeks Complex P 4 2 $743.00 — $620.92 $620.92 $620.92 2026-03-26
76801 CPT US OB 1st Trimester P 12 6 $660.00 — $42.75 $393.16 $318.19 2026-03-26
93978 CPT US Inferior Vena Cava P 4 2 $660.00 — $132.00 $660.00 $396.00 2026-03-26
76881 CPT US Extremity Superficial Complete P 28 14 $248.00 — $49.60 $248.00 $104.42 2026-03-26
93306 CPT US Echocardiogram P 16 8 $375.00 — $115.42 $375.00 $180.79 2026-03-26
76604 CPT US Chest P 4 2 $438.00 — $34.97 $260.92 $147.94 2026-03-26
93880 CPT US Carotid P 24 12 $743.00 — $148.60 $743.00 $279.47 2026-03-26
76642 CPT US Breast Limited Right P 30 14 $375.00 — $41.82 $375.00 $135.00 2026-03-26
76641 CPT US Breast Complete Right P 10 5 $438.00 — $100.00 $438.00 $260.92 2026-03-26
93926 CPT US Arterial Lower Left P 20 10 $578.00 — $32.03 $578.00 $152.09 2026-03-26
93925 CPT US Arterial Lower Bilateral P 18 9 $495.00 — $99.00 $495.00 $238.64 2026-03-26
76700 CPT US Abdomen Complete P 38 18 $636.00 — $49.25 $636.00 $195.76 2026-03-26
87086 CPT Urine Culture 8 4 $78.00 — $24.18 $78.00 $78.00 2026-03-26
D2150 HCPCS Two Surface Amalgam 6 3 $172.00 — $86.94 $172.00 $86.94 2026-03-26
G0127 HCPCS Trim Dystrophic Nails 20 10 $188.00 — $3.39 $157.00 $52.59 2026-03-26
84480 CPT Triiodothyronine Hormone Total T3 4 2 $80.00 — $24.80 $80.00 $52.40 2026-03-26
20552 CPT Trigger Point Inj 1-2 Muscles 6 3 $313.00 — $313.00 $313.00 $313.00 2026-03-26
G0463 HCPCS Treatment Rm Extended 36 18 $189.00 — $21.69 $189.00 $54.30 2026-03-26
J3260 HCPCS Tobramycin 40mg/ml 2ml Vial 4 2 $152.00 — $41.04 $48.64 $44.84 2026-03-26
99195 CPT Therapeutic Phlebotomy 10 5 $124.00 — $38.44 $124.00 $99.20 2026-03-26
80198 CPT Theophylline 2 1 $50.00 — $50.00 $50.00 $50.00 2026-03-26
84403 CPT Testosterone Total Lc/ms 4 2 $258.00 — $79.98 $206.40 $143.19 2026-03-26
J3101 HCPCS Tenecteplase Inj [50 Mg] 6 3 $20,375.00 — $507.89 $20,375.00 $507.89 2026-03-26
H2020 HCPCS Telemed Medicaid Bh Encounter 22 11 $283.03 — $12.90 $283.03 $249.81 2026-03-26
D7210 HCPCS Surgical Extraction 12 6 $200.00 — $141.96 $161.00 $141.96 2026-03-26
J3030 HCPCS Sumatriptan Inj 6 Mg/0.5ml 2 1 $318.00 — $153.31 $153.31 $153.31 2026-03-26
D2930 HCPCS Stainless Steel Crn Primary 2 1 $210.00 — $210.00 $210.00 $210.00 2026-03-26
92526 CPT St Treatment/swallowing D 14 7 $410.00 — $82.00 $410.00 $244.24 2026-03-26
92507 CPT St Treatment Of Speech In 20 10 $410.00 — $33.00 $410.00 $51.50 2026-03-26
92610 CPT St Evaluation Of Swallowing 12 6 $319.00 — $37.33 $319.00 $210.54 2026-03-26
92521 CPT St Evaluation Of Speech Fluency 14 7 $527.00 — $77.70 $527.00 $77.70 2026-03-26
29130 CPT Splint App Finger 10 5 $236.00 — $73.16 $93.40 $93.40 2026-03-26
A4570 HCPCS Splint 12 6 $154.00 — $47.74 $154.00 $91.74 2026-03-26
94060 CPT Spirometry Bronchodilation Response 8 4 $250.00 — $77.50 $250.00 $120.53 2026-03-26
12004 CPT Sp Scalp\ext\trk 7.6-12.5cm 12 6 $187.00 — $21.69 $85.44 $68.87 2026-03-26
12002 CPT Sp Scalp\ext\trk 2.6-7.5cm 20 10 $454.00 — $68.24 $454.00 $163.44 2026-03-26
12001 CPT Sp Scalp\ext\trk 2.5cm Or Less 26 12 $454.00 — $25.90 $166.60 $120.23 2026-03-26
12005 CPT Sp Scalp\ext\trk 12.6-20cm 2 1 $207.00 — $138.88 $138.88 $138.88 2026-03-26
12014 CPT Sp Face\ear\5.1-7.5cm 2 1 $454.00 — $454.00 $454.00 $454.00 2026-03-26
12011 CPT Sp Face\ear\2.5cm Or Less 36 16 $104.00 — $10.48 $104.00 $64.36 2026-03-26
12013 CPT Sp Face\ear\ 2.6-5cm 20 9 $173.00 — $10.96 $124.08 $67.64 2026-03-26
A4565 HCPCS Sling Arm 12 6 $91.00 — $18.20 $91.00 $54.21 2026-03-26
D7140 HCPCS Simple Extraction 14 7 $115.00 — $70.43 $115.00 $70.43 2026-03-26
D2335 HCPCS Resin Based Composite D2335 6 3 $216.00 — $130.96 $216.00 $130.96 2026-03-26
D2332 HCPCS Resin Based Composite D2332 4 2 $175.00 — $119.95 $119.95 $119.95 2026-03-26
12032 CPT Repair Inter 2.6-7.5cm 2 1 $187.00 — $178.27 $178.27 $178.27 2026-03-26
11302 CPT Remove Les Shaved 1.1-2cm 8 4 $282.00 — $24.35 $282.00 $71.91 2026-03-26
11301 CPT Remove Les Shaved .6-1cm 4 2 $250.00 — $24.35 $80.00 $52.17 2026-03-26
11201 CPT Removal Of Skin Tags Each Add 10 Lesions 2 1 $188.00 — $111.99 $111.99 $111.99 2026-03-26
11200 CPT Removal Of Skin Tag <15 10 4 $250.00 — $77.50 $120.53 $94.00 2026-03-26
69209 CPT Removal Impacted Cerum - Irrigation 4 2 $182.00 — $182.00 $182.00 $182.00 2026-03-26
30300 CPT Removal Foreign Body N 2 1 $454.00 — $218.87 $218.87 $218.87 2026-03-26
69200 CPT Removal Foreign Body E 4 2 $104.00 — $42.39 $71.04 $56.72 2026-03-26
10120 CPT Removal Foreign Body 12 6 $69.00 — $47.74 $69.00 $62.10 2026-03-26
20520 CPT Rem Foreign Body Mus\t 2 1 $69.00 — $69.00 $69.00 $69.00 2026-03-26
23650 CPT Reduction Of Shoulder 2 1 $104.00 — $104.00 $104.00 $104.00 2026-03-26
86481 CPT Quantiferon TB Gold Plus 2 1 $313.00 — $87.22 $87.22 $87.22 2026-03-26
94760 CPT Pulse Oximetry 36 18 $137.00 — $25.73 $137.00 $57.69 2026-03-26
97110 CPT Pt Therapeutic Ex 15 Min 44 22 $438.00 — $33.00 $438.00 $87.60 2026-03-26
97164 CPT Pt Re-evaluation 12 6 $192.00 — $39.88 $192.00 $111.36 2026-03-26
97761 CPT Pt Prosthetic Training Initial 15 Mins 6 3 $146.00 — $19.37 $146.00 $45.26 2026-03-26
97112 CPT Pt Neuromuscular Re-education 30 15 $146.00 — $29.20 $146.00 $93.44 2026-03-26
97116 CPT Pt Gait Training 15 Min 6 3 $109.00 — $33.79 $109.00 $109.00 2026-03-26
97161 CPT Pt Evaluation Low 34 17 $236.00 — $47.20 $236.00 $58.94 2026-03-26
97032 CPT Pt Electrical Stimulati 26 13 $109.00 — $21.80 $109.00 $70.00 2026-03-26
D1110 HCPCS Prophylaxis-adult (12- 18 9 $67.00 — $50.62 $67.00 $50.62 2026-03-26
84146 CPT Prolactin 2 1 $382.00 — $382.00 $382.00 $382.00 2026-03-26
P9058 HCPCS Processing/storage Rbcs Leuko Red Cmv 6 3 $175.00 — $21.69 $175.00 $175.00 2026-03-26
P9016 HCPCS Processing/storage Per Unit Rbc Given 18 9 $806.00 — $161.20 $806.00 $249.86 2026-03-26
P9035 HCPCS Platelet Pheresis Leukocyte Re 4 2 $175.00 — $175.00 $175.00 $175.00 2026-03-26
36589 CPT Picc Line Removal 12 6 $200.00 — $24.35 $200.00 $79.21 2026-03-26
C1751 HCPCS Picc Kit 12 6 $750.00 — $232.50 $750.00 $361.58 2026-03-26
36573 CPT Picc 5 Yrs Or Older 6 3 $625.00 — $26.97 $225.00 $77.20 2026-03-26
J1165 HCPCS Phenytoin Inj 100mg/2ml 4 2 $1,035.00 — $21.69 $986.48 $504.08 2026-03-26
99393 CPT Periodic Wellchild 5-11 16 7 $250.00 — $107.60 $122.40 $121.98 2026-03-26
99395 CPT Periodic Wellchild 18-20 28 12 $250.00 — $85.93 $250.00 $137.08 2026-03-26
99394 CPT Periodic Wellchild 12-17 24 10 $250.00 — $53.05 $134.16 $69.23 2026-03-26
99392 CPT Periodic Wellchild 1-4 14 7 $250.00 — $100.12 $122.35 $107.20 2026-03-26
11057 CPT Paring/cutting Corn/callus 4+ 2 1 $138.00 — $77.50 $77.50 $77.50 2026-03-26
D0330 HCPCS Panoramic Film 6 3 $78.00 — $60.53 $78.00 $60.53 2026-03-26
97168 CPT Ot Reevaluation 6 3 $192.00 — $37.65 $192.00 $122.88 2026-03-26
97165 CPT Ot Evaluation Low 30 15 $236.00 — $47.20 $236.00 $57.26 2026-03-26
97535 CPT Ot Adl 15 Minutes 8 4 $292.00 — $90.52 $292.00 $192.37 2026-03-26
D2140 HCPCS One Surface Amalgam 4 2 $135.00 — $75.93 $135.00 $105.47 2026-03-26
G0378 HCPCS Obs Services Per Hour 42 21 $480.00 — $16.95 $480.00 $192.84 2026-03-26
99223 CPT Obs Direct Admission 48 22 $242.00 — $32.34 $205.70 $161.72 2026-03-26
99307 CPT Nh Straight Forward Visit Jm 36 17 $219.00 — $21.69 $219.00 $52.51 2026-03-26
99205 CPT New Pt Visit 5 2 1 $300.00 — $60.76 $60.76 $60.76 2026-03-26
99204 CPT New Pt Visit 4 52 24 $288.00 — $18.07 $288.00 $183.68 2026-03-26
99203 CPT New Pt Visit 3 32 15 $275.00 — $21.69 $275.00 $95.13 2026-03-26
99202 CPT New Pt Visit 2 26 11 $263.00 — $21.69 $263.00 $67.31 2026-03-26
30905 CPT Nasal Hem Pos Initial 2 1 $636.00 — $203.52 $203.52 $203.52 2026-03-26
30903 CPT Nasal Hem Ant Complex 4 2 $454.00 — $145.28 $163.44 $154.36 2026-03-26
99309 CPT N/h Mod Visit 40 19 $219.00 — $7.67 $219.00 $66.09 2026-03-26
99232 CPT Mod Rnd To 66 31 $104.00 — $14.76 $104.00 $64.05 2026-03-26
J2185 HCPCS Meropenem 500mg Inj 26 13 $250.00 — $28.23 $250.00 $97.57 2026-03-26
99215 CPT Medical Visit Level 5 24 11 $288.00 — $24.35 $288.00 $94.91 2026-03-26
99214 CPT Medical Visit Level 4 118 57 $275.00 — $1.61 $275.00 $76.60 2026-03-26
99213 CPT Medical Visit Level 3 94 45 $263.00 — $1.61 $263.00 $73.97 2026-03-26
99212 CPT Medical Visit Level 2 46 21 $250.00 — $21.69 $250.00 $49.86 2026-03-26
99222 CPT Med Rd Admit En 58 27 $207.00 — $24.26 $175.95 $119.36 2026-03-26
D5213 HCPCS Max Partial Denture(ca 2 1 $1,200.00 — $882.54 $882.54 $882.54 2026-03-26
D5214 HCPCS Mand Partial Denture(c 2 1 $1,200.00 — $882.54 $882.54 $882.54 2026-03-26
D5212 HCPCS Mand Partial Denture 8 4 $850.00 — $666.85 $850.00 $666.85 2026-03-26
77063 CPT Ma Screening 3d Bilateral P 34 17 $375.00 — $63.28 $375.00 $188.44 2026-03-26
77067 CPT Ma Mammo Screening Bilateral Tomo P 40 19 $188.00 — $31.72 $188.00 $92.55 2026-03-26
77065 CPT Ma Mammo Diagnostic Left Tomo P 24 12 $169.00 — $34.68 $169.00 $94.44 2026-03-26
77066 CPT Ma Mammo Diagnostic Bilateral Tomo P 22 11 $250.00 — $34.52 $250.00 $120.53 2026-03-26
G0279 HCPCS Ma Diagnostic Screening 3d Bilateral P 28 14 $294.00 — $60.48 $294.00 $211.16 2026-03-26
J2020 HCPCS Linezolid Premix Inj 600mg/300ml 6 3 $453.00 — $140.43 $218.39 $140.43 2026-03-26
12041 CPT Lc Neck\hand\ft 2.5 Or 2 1 $454.00 — $140.74 $140.74 $140.74 2026-03-26
L1830 HCPCS Knee Immobilizer 4 2 $327.00 — $101.37 $182.32 $141.84 2026-03-26
96376 CPT IV Push Repeat Med 42 21 $113.00 — $12.32 $113.00 $54.48 2026-03-26
96375 CPT IV Push Add Med 50 25 $137.00 — $21.91 $137.00 $81.61 2026-03-26
96374 CPT IV Push 1st/initial 56 28 $137.00 — $19.36 $137.00 $77.65 2026-03-26
96365 CPT IV Medication Up To 1 Hour 56 28 $255.00 — $28.79 $255.00 $122.94 2026-03-26
96366 CPT IV Medication Each Additional Hour 52 26 $60.00 — $4.30 $60.00 $58.92 2026-03-26
96360 CPT IV Hydration Up To 1 H 36 18 $255.00 — $18.29 $255.00 $140.02 2026-03-26
96361 CPT IV Hydration Each Add 36 18 $360.00 — $21.60 $360.00 $130.16 2026-03-26
96523 CPT Irrigation Of Access Device 38 19 $164.00 — $26.23 $164.00 $164.00 2026-03-26
36680 CPT Intraocceous Line 4 2 $375.00 — $21.69 $232.50 $127.09 2026-03-26
20550 CPT Injection Plantar Fascia 6 3 $500.00 — $217.44 $340.00 $278.72 2026-03-26
99382 CPT Initial Wellchild 1-4 10 5 $250.00 — $76.96 $76.96 $76.96 2026-03-26
99381 CPT Initial Wellchild 0-1 14 7 $250.00 — $74.72 $85.00 $74.72 2026-03-26
G0438 HCPCS Initial Medicare Annual Wellness 8 4 $525.00 — $12.90 $382.00 $288.91 2026-03-26
11765 CPT Ingrown Nail Removal 8 4 $94.00 — $24.35 $94.00 $60.48 2026-03-26
J1750 HCPCS Infed/ns Ivpb : 1000mg/1000ml 20 10 $144.00 — $18.07 $144.00 $49.11 2026-03-26
94010 CPT Incentive Spirometer 4 2 $101.00 — $60.17 $101.00 $80.59 2026-03-26
J0743 HCPCS Imipenem/cilastatin 500 Mg Inj 2 1 $227.00 — $70.37 $70.37 $70.37 2026-03-26
10060 CPT I & D Simple 26 12 $69.00 — $65.58 $69.00 $69.00 2026-03-26
J1644 HCPCS Heparin Inj 5000 Un/ml Vial 12 6 $125.00 — $17.31 $125.00 $125.00 2026-03-26
J1630 HCPCS Haloperidol Inj 5 MG/mL 12 6 $85.00 — $30.60 $85.00 $50.63 2026-03-26
49450 CPT Gastrostomy Tube Repla 4 2 $1,089.00 — $21.69 $348.48 $185.09 2026-03-26
D2160 HCPCS Four Surface Amalgam 2 1 $200.00 — $105.65 $105.65 $105.65 2026-03-26
51702 CPT Foley Catheter Insertion Procedure 18 9 $119.00 — $36.89 $119.00 $93.52 2026-03-26
A4346 HCPCS Foley Catheter 3-way 2 1 $182.00 — $58.24 $58.24 $58.24 2026-03-26
A4314 HCPCS Foley Cath Tray 30 15 $101.00 — $11.38 $101.00 $48.69 2026-03-26
J3535 HCPCS Fluticasone Hfa Mdi 110mcg 4 2 $855.00 — $59.56 $265.05 $162.31 2026-03-26
0101T HCPCS Extracorporeal Shock Musculoskeletal 4 2 $200.00 — $24.35 $200.00 $112.18 2026-03-26
11402 CPT Excision Bn Lesion 1.1-2 2 1 $908.00 — $290.56 $290.56 $290.56 2026-03-26
99397 CPT Est Pt Wellness 65+ 16 6 $250.00 — $118.89 $157.28 $157.28 2026-03-26
99396 CPT Est Pt Wellness 40-64 44 20 $250.00 — $75.05 $212.50 $145.00 2026-03-26
G0439 HCPCS Est Medicare Annual Wellness 10 5 $275.00 — $21.69 $275.00 $250.00 2026-03-26
J1650 HCPCS Enoxaparin *subq* 100 Mg / Ml 16 8 $102.00 — $61.58 $102.00 $74.37 2026-03-26
99285 CPT Emergency Room Level 5 14 7 $275.00 — $102.34 $275.00 $168.95 2026-03-26
99284 CPT Emergency Room Level 4 64 30 $454.00 — $22.82 $454.00 $168.64 2026-03-26
99283 CPT Emergency Room Level 3 76 36 $165.00 — $42.88 $165.00 $99.06 2026-03-26
99282 CPT Emergency Room Level 2 70 33 $124.00 — $11.63 $124.00 $58.15 2026-03-26
99281 CPT Emergency Room Level 1 20 10 $182.00 — $4.42 $108.42 $65.52 2026-03-26
31500 CPT Emergency Intubation 10 5 $270.00 — $74.65 $270.00 $115.28 2026-03-26
93005 CPT EKG 70 33 $264.00 — $9.29 $264.00 $72.35 2026-03-26
43453 CPT Egd W/dilation Via Sav 2 1 $2,178.00 — $2,178.00 $2,178.00 $2,178.00 2026-03-26
43213 CPT Egd W/dilation Via Dil 14 7 $2,178.00 — $37.20 $2,178.00 $696.96 2026-03-26
43239 CPT Egd W/biopsy 16 8 $2,178.00 — $24.35 $2,178.00 $729.63 2026-03-26
43235 CPT Egd 2 1 $2,178.00 — $470.00 $470.00 $470.00 2026-03-26
L4350 HCPCS E-z Boot 2 1 $313.00 — $130.76 $130.76 $130.76 2026-03-26
J3360 HCPCS Diazepam 10mg/2ml Inj 6 3 $47.00 — $28.00 $47.00 $47.00 2026-03-26
17110 CPT Destruction Of Lesion-2nd-14th 14 6 $94.00 — $40.00 $94.00 $94.00 2026-03-26
97597 CPT Debride Waterjet/sharps 1st 20 Sq/cm 8 4 $273.00 — $54.60 $273.00 $69.61 2026-03-26
11042 CPT Debride Subq/tissue 1st 6 3 $1,725.00 — $345.00 $1,725.00 $534.75 2026-03-26
11721 CPT Debride Nails 6+ 8 4 $313.00 — $88.39 $313.00 $104.86 2026-03-26
99238 CPT Dc 64 30 $138.00 — $15.03 $87.53 $65.06 2026-03-26
73200 CPT CT Upper Ext Wo Contrast Left P 12 6 $944.00 — $188.80 $944.00 $618.32 2026-03-26
73201 CPT CT Upper Ext With Contrast Left P 8 4 $1,126.00 — $349.06 $1,126.00 $704.14 2026-03-26
72128 CPT CT T Spine Wo Contrast P 22 11 $944.00 — $61.01 $944.00 $455.10 2026-03-26
70490 CPT CT St Neck Wo Contrast P 8 4 $1,035.00 — $320.85 $1,035.00 $616.55 2026-03-26
70491 CPT CT St Neck With Contrast P 16 8 $1,035.00 — $320.85 $1,035.00 $509.53 2026-03-26
72192 CPT CT Pelvis Wo Contrast P 12 6 $990.00 — $306.90 $990.00 $533.51 2026-03-26
72193 CPT CT Pelvis With Contrast P 6 3 $1,172.00 — $363.32 $698.16 $375.00 2026-03-26
72194 CPT CT Pelvis W Wo Contrast P 4 2 $1,263.00 — $1,263.00 $1,263.00 $1,263.00 2026-03-26
70480 CPT CT Orbit Wo Contrast P 14 7 $545.00 — $86.81 $545.00 $452.25 2026-03-26
70481 CPT CT Orbit With Contrast P 2 1 $1,126.00 — $1,126.00 $1,126.00 $1,126.00 2026-03-26
71271 CPT CT Lung Cancer Screening P 24 12 $563.00 — $66.23 $563.00 $271.42 2026-03-26
73700 CPT CT Lower Ext Wo Contrast Left P 8 4 $854.00 — $264.74 $854.00 $460.22 2026-03-26
73701 CPT CT Lower Ext W Contrast Left P 16 8 $990.00 — $156.85 $990.00 $477.28 2026-03-26
72131 CPT CT L Spine Wo Contrast P 28 14 $944.00 — $61.01 $944.00 $506.72 2026-03-26
72132 CPT CT L Spine With Contrast P 2 1 $1,089.00 — $1,089.00 $1,089.00 $1,089.00 2026-03-26
70450 CPT CT Head Wo Contrast P 46 23 $900.00 — $180.00 $900.00 $405.00 2026-03-26
70470 CPT CT Head W Wo Contrast P 12 6 $1,263.00 — $391.53 $1,263.00 $608.89 2026-03-26
70486 CPT CT Facial Bones Wo Contrast P 26 13 $854.00 — $170.80 $854.00 $411.71 2026-03-26
70487 CPT CT Facial Bones W/contrast P 2 1 $944.00 — $455.10 $455.10 $455.10 2026-03-26
71250 CPT CT Chest Wo Contrast P 32 16 $491.00 — $98.20 $491.00 $292.49 2026-03-26
71260 CPT CT Chest With Contrast P 34 17 $1,035.00 — $71.40 $1,035.00 $405.00 2026-03-26
72125 CPT CT C Spine Wo Contrast P 38 19 $944.00 — $61.01 $944.00 $299.81 2026-03-26
77078 CPT CT Bone Density P 22 11 $400.00 — $21.69 $400.00 $155.00 2026-03-26
71275 CPT CT Angiogram Chest Pe Study P 20 10 $1,362.00 — $272.40 $1,362.00 $656.62 2026-03-26
74150 CPT CT Abdomen Wo Contrast P 6 3 $944.00 — $292.64 $455.10 $339.84 2026-03-26
74170 CPT CT Abdomen W Wo Contrast P 6 3 $1,263.00 — $404.16 $1,263.00 $752.37 2026-03-26
74160 CPT CT Abdomen W Contrast P 6 3 $1,053.00 — $326.43 $1,053.00 $1,053.00 2026-03-26
74176 CPT CT Abd/pelvis Wo Contrast P 46 23 $1,271.00 — $106.31 $1,271.00 $394.01 2026-03-26
74177 CPT CT Abd/pelvis With Contrast P 48 24 $1,271.00 — $143.54 $1,271.00 $625.71 2026-03-26
74178 CPT CT Abd/pelvis W Wo Contrast P 12 6 $1,815.00 — $250.00 $1,815.00 $978.11 2026-03-26
E0114 HCPCS Crutches 18 9 $236.00 — $21.69 $155.81 $84.96 2026-03-26
92950 CPT Cpr 8 4 $385.00 — $145.28 $256.66 $162.54 2026-03-26
E0601 HCPCS Cpap/bipap Wcmc Equipment 4 2 $375.00 — $26.97 $130.00 $78.48 2026-03-26
94660 CPT Cpap/bipap Initiation And Management 4 2 $63.00 — $63.00 $63.00 $63.00 2026-03-26
87637 CPT Cov/flu/rsv 50 25 $250.00 — $75.95 $250.00 $114.00 2026-03-26
D2950 HCPCS Core Buildup 2 1 $195.00 — $135.35 $135.35 $135.35 2026-03-26
82525 CPT Copper Urine 2 1 $552.00 — $552.00 $552.00 $552.00 2026-03-26
86880 CPT Coombs Test Direct 6 3 $107.00 — $33.17 $107.00 $61.38 2026-03-26
D0150 HCPCS Comprehensive Oral Exa 10 5 $68.00 — $36.32 $68.00 $49.00 2026-03-26
D5110 HCPCS Complete Denture (max) 2 1 $1,100.00 — $815.41 $815.41 $815.41 2026-03-26
D5120 HCPCS Complete Denture (mand 2 1 $1,100.00 — $815.41 $815.41 $815.41 2026-03-26
A4377 HCPCS Colostomy Bags 2 1 $47.00 — $47.00 $47.00 $47.00 2026-03-26
45385 CPT Colonoscopy W/removal 22 11 $2,178.00 — $21.69 $2,178.00 $675.18 2026-03-26
45380 CPT Colonoscopy With Biopsy 10 5 $2,178.00 — $60.76 $2,178.00 $1,050.01 2026-03-26
G0121 HCPCS Colonoscopy Screening Low Risk 10 5 $1,815.00 — $24.35 $1,542.75 $580.80 2026-03-26
G0105 HCPCS Colonoscopy Screening High Risk 6 3 $1,815.00 — $60.76 $1,815.00 $580.80 2026-03-26
45378 CPT Colonoscopy Diagnostic 18 9 $2,178.00 — $24.35 $2,178.00 $675.18 2026-03-26
T1015 HCPCS Cmc Medicaid Encounter 38 18 $268.74 — $12.90 $268.74 $80.40 2026-03-26
32556 CPT Chest Tube Insertion 2 1 $636.00 — $197.16 $197.16 $197.16 2026-03-26
L0120 HCPCS Cervical Collar Flex 2 1 $101.00 — $101.00 $101.00 $101.00 2026-03-26
J0692 HCPCS Cefepime 1000mg Inj 10 5 $98.00 — $30.38 $98.00 $64.19 2026-03-26
A4344 HCPCS Catheter Foley 10 5 $83.00 — $21.69 $83.00 $52.99 2026-03-26
93041 CPT Cardiac Monitoring 40 20 $319.00 — $6.00 $319.00 $106.87 2026-03-26
11056 CPT Callus/corn Removal 2-4 30 15 $104.00 — $20.86 $104.00 $59.71 2026-03-26
16020 CPT Burn Dress/debride Sm 2 1 $104.00 — $58.12 $58.12 $58.12 2026-03-26
36430 CPT Blood Administration 20 10 $1,002.00 — $200.40 $1,002.00 $360.72 2026-03-26
86906 CPT Bb Phenotype Patient 2 1 $213.00 — $213.00 $213.00 $213.00 2026-03-26
86920 CPT Bb Crossmatch Spin 22 11 $151.00 — $46.81 $151.00 $108.72 2026-03-26
86921 CPT Bb Crossmatch Incuba 14 7 $129.00 — $21.69 $129.00 $51.59 2026-03-26
86922 CPT Bb Crossmatch 22 11 $208.00 — $49.15 $208.00 $147.45 2026-03-26
86850 CPT Bb Antibody Screen 22 11 $147.00 — $5.21 $147.00 $46.10 2026-03-26
J0456 HCPCS Azithromycin Inj 500mg 24 12 $87.00 — $26.97 $69.60 $49.36 2026-03-26
20605 CPT Aspiration/arthrocentesis Interm Joint 2 1 $375.00 — $116.25 $116.25 $116.25 2026-03-26
20610 CPT Arthrocentesis Major Joint 10 5 $313.00 — $46.70 $313.00 $73.87 2026-03-26
82803 CPT Arterial Blood Gas 34 17 $636.00 — $7.10 $636.00 $197.16 2026-03-26
29580 CPT App Of Unna Boot/multi 6 3 $363.00 — $112.53 $363.00 $363.00 2026-03-26
86870 CPT Antibody Identification Panel 4 2 $263.00 — $81.53 $263.00 $172.26 2026-03-26
J0282 HCPCS Amiodarone Inj 150mg/3ml 12 6 $94.00 — $18.80 $94.00 $64.65 2026-03-26
80307 CPT Alcohol 30 15 $119.00 — $36.89 $119.00 $62.14 2026-03-26
94640 CPT Aerosol Thpy 1st Dly T 50 23 $123.00 — $6.00 $123.00 $44.28 2026-03-26
A4556 HCPCS Aed Pads 4 2 $164.00 — $50.84 $97.69 $74.27 2026-03-26
99235 CPT Admit/dc Same Day 24 11 $173.00 — $0.14 $173.00 $147.76 2026-03-26
J0131 HCPCS Acetaminophen IV Drip 1000mg/100ml 42 21 $158.00 — $17.80 $158.00 $59.42 2026-03-26
D2331 HCPCS 2 Surface Composite 4 2 $143.00 — $102.34 $102.34 $102.34 2026-03-26
D2330 HCPCS 1 Surface Composite 4 2 $115.00 — $81.44 $81.44 $81.44 2026-03-26
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