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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.

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