Hospital

BEACON BEHAVIORAL HOSPITAL - NORTHSHORE, LLC

Lacombe, LA · CCN 194080 · Rates published

223 distinct procedures filed

29 distinct payers

260 rate rows

2025-10-01 last MRF observed

Data quality

260 of 260 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

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

Source MRF file	https://beaconbh.com/wp-content/uploads/2026/04/853294015-473632529-1508819202_northshore-hospital_standardcharges_2026.csv
Found on page	https://www.beaconbh.com/price-transparency/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	db6f8a15b89b8ac5… · 199,748 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
126 MS_DRG	Semi Private Detox Room And Board, All Inclusive Except Prof. Fees	13	$1,545.00	$1,545.00	$1,545.00	nat. median $1,545 1.0× median
124 MS_DRG	Semi Private Psychiatric Room And Board, All Inclusive Except Prof. Fees	19	$1,545.00	$1,545.00	$1,545.00	nat. median $13,810 outlier · 0.1×
J8499 HCPCS	Sofosbuvir/Velpatasvir	1	$1,545.00	$1,545.00	$1,545.00	nat. median $83 outlier · 18.7×
S9480 HCPCS	Intensive Op Tx All Inclusive	1	$900.00	$900.00	$900.00	nat. median $319 outlier · 2.8×
90839 CPT	Psych Crisis Tx First 60 Mins	1	$825.00	$825.00	$825.00	nat. median $220 outlier · 3.7×
90837 CPT	Individual Psych Tx 53 + Mins	1	$825.00	$825.00	$825.00	nat. median $218 outlier · 3.8×
90846 CPT	Family Psych Tx No Pt Present	1	$750.00	$750.00	$750.00	nat. median $195 outlier · 3.9×
90847 CPT	Family Psych Tx Patient Presen	1	$750.00	$750.00	$750.00	nat. median $206 outlier · 3.6×
90834 CPT	Individual Psych Tx 38-52 Mins	1	$750.00	$750.00	$750.00	nat. median $198 outlier · 3.8×
90832 CPT	Individual Psych Tx 16-37 Mins	1	$600.00	$600.00	$600.00	nat. median $176 outlier · 3.4×
J1610 HCPCS	Glucagon Emergency Kit	1	$552.54	$552.54	$552.54	nat. median $371 1.5× median
G0480 HCPCS	Blood Alcohol Concentration	1	$343.29	$343.29	$343.29	nat. median $114 outlier · 3.0×
80320 CPT	Alcohol Level	1	$343.29	$343.29	$343.29	nat. median $86 outlier · 4.0×
93971 CPT	US Lower Ext Venous Doppler	1	$308.34	$308.34	$308.34	nat. median $361 0.9× median
90853 CPT	Group Psych Tx	1	$300.00	$300.00	$300.00	nat. median $148 outlier · 2.0×
87502 CPT	Influenza A+b Alere I	1	$287.40	$287.40	$287.40	nat. median $146 2.0× median
90653 CPT	Flu Vacc Ts2024-25(6mos Up)/Pf	1	$250.47	$250.47	$250.47	nat. median $98 outlier · 2.6×
J0750 HCPCS	Emtricitabine/Tenofovir (Tdf)	1	$194.43	$194.43	$194.43	nat. median $3 outlier · 57.0×
80305 CPT	Urine Drug Screen (Send Out)	1	$186.42	$186.42	$186.42	nat. median $24 outlier · 7.6×
86480 CPT	TB Gold Plus-quantiferon	1	$185.94	$185.94	$185.94	nat. median $103 1.8× median
87480 CPT	Urine BV/Trichomoniasis (naat)	1	$180.45	$180.45	$180.45	nat. median $33 outlier · 5.5×
87510 CPT	Gardnerella Vaginalis, Direct	1	$180.45	$180.45	$180.45	nat. median $34 outlier · 5.3×
87660 CPT	Trichomonoas Vaginalis, Direct	1	$180.45	$180.45	$180.45	nat. median $34 outlier · 5.3×
87539 CPT	HIV 2	1	$175.86	$175.86	$175.86	nat. median $63 outlier · 2.8×
87635 CPT	Covid Test (send-out) Nasal Sw	1	$153.93	$153.93	$153.93	nat. median $85 1.8× median
80074 CPT	Hepatitis Iii	1	$142.89	$142.89	$142.89	nat. median $124 1.2× median
J7644 HCPCS	Ipratropium Bromide	1	$136.89	$136.89	$136.89	nat. median $2 outlier · 63.7×
80307 CPT	Urine Drug Screen 80307	1	$135.33	$135.33	$135.33	nat. median $120 1.1× median
73502 CPT	Xr Hip Complete 2 Views	1	$124.98	$124.98	$124.98	nat. median $155 0.8× median
70260 CPT	Xr SKull Complete Min 4 Views	1	$117.99	$117.99	$117.99	nat. median $185 0.6× median
83880 CPT	Brain Natriuretic Peptide(BNP)	1	$117.78	$117.78	$117.78	nat. median $99 1.2× median
90715 CPT	Adacel Tdap	1	$115.89	$115.89	$115.89	nat. median $86 1.4× median
87493 CPT	C. Difficile Toxin Gene, Naa	1	$111.81	$111.81	$111.81	nat. median $86 1.3× median
73521 CPT	Xr Hip B/l Including Pelvis	1	$108.75	$108.75	$108.75	nat. median $173 0.6× median
73110 CPT	Xr Wrist Complete Min 3 Views	1	$108.18	$108.18	$108.18	nat. median $165 0.7× median
73562 CPT	Xr Knee Complete 3 Views	1	$106.56	$106.56	$106.56	nat. median $165 0.6× median
87563 CPT	Mycoplasma Genitalium	1	$105.27	$105.27	$105.27	nat. median $53 2.0× median
87591 CPT	Neisseria Gonorrhoeae Amplifie	1	$105.27	$105.27	$105.27	nat. median $68 1.5× median
87661 CPT	Trichomonas Vaginalis, Naa	1	$105.27	$105.27	$105.27	nat. median $63 1.7× median
87491 CPT	Chlamydia/Gonococcus, Naa Swab	1	$105.27	$105.27	$105.27	nat. median $69 1.5× median
72100 CPT	Xr Lumbar Spine AP/Lat	1	$104.46	$104.46	$104.46	nat. median $170 0.6× median
73130 CPT	Xr Hand Complete Min 3 Views	1	$97.92	$97.92	$97.92	nat. median $163 0.6× median
74019 CPT	Xr Abdomen Ant/post View	1	$97.74	$97.74	$97.74	nat. median $171 0.6× median
86696 CPT	Herpes Simplex Type 2 Test	1	$97.62	$97.62	$97.62	nat. median $38 outlier · 2.6×
86695 CPT	Herpes Simplex Type 1 Test	1	$97.62	$97.62	$97.62	nat. median $30 outlier · 3.2×
71100 CPT	Radiology Order - Other	1	$96.78	$96.78	$96.78	nat. median $143 0.7× median
73610 CPT	Xr Ankle Complete Min 3 Views	1	$95.34	$95.34	$95.34	nat. median $164 0.6× median
J3230 HCPCS	chlorproMAZINE Hcl	1	$91.44	$91.44	$91.44	nat. median $74 1.2× median
73030 CPT	Xr Shoulder Compl Min 2 Views	1	$91.20	$91.20	$91.20	nat. median $167 0.5× median
73630 CPT	Xr Foot Complete Min 3 Views	1	$89.37	$89.37	$89.37	nat. median $161 0.6× median

Other procedures at this hospital

Browse this hospital's 223 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

124	MS_DRG	Semi Private Psychiatric Room And Board, All Inclusive Except Prof. Fees	21	19	$1,545.00	$825.00 47% off	$1,545.00	$1,545.00	$1,545.00	2025-10-01
126	MS_DRG	Semi Private Detox Room And Board, All Inclusive Except Prof. Fees	17	13	$1,545.00	$800.00 48% off	$1,545.00	$1,545.00	$1,545.00	2025-10-01
36415	CPT	Blood Culture & Specimen	1	1	$27.27	—	$27.27	$27.27	$27.27	2025-10-01
36416	CPT	Miscellaneous Culture 36416	1	1	$27.27	—	$27.27	$27.27	$27.27	2025-10-01
70260	CPT	Xr SKull Complete Min 4 Views	1	1	$117.99	—	$117.99	$117.99	$117.99	2025-10-01
71045	CPT	Xr Chest 1 View Frontal	1	1	$68.97	—	$68.97	$68.97	$68.97	2025-10-01
71046	CPT	Xr Chest Ap/lat 2 Views	1	1	$89.07	—	$89.07	$89.07	$89.07	2025-10-01
71100	CPT	Radiology Order - Other	1	1	$96.78	—	$96.78	$96.78	$96.78	2025-10-01
72070	CPT	Xr Thoracic Spine AP/Lat	1	1	$87.15	—	$87.15	$87.15	$87.15	2025-10-01
72100	CPT	Xr Lumbar Spine AP/Lat	1	1	$104.46	—	$104.46	$104.46	$104.46	2025-10-01
72220	CPT	Xr Sacrum & Coccyx Min 2 Views	1	1	$85.95	—	$85.95	$85.95	$85.95	2025-10-01
73030	CPT	Xr Shoulder Compl Min 2 Views	1	1	$91.20	—	$91.20	$91.20	$91.20	2025-10-01
73060	CPT	Xr Humerus Min 2 Views	1	1	$84.12	—	$84.12	$84.12	$84.12	2025-10-01
73090	CPT	Xr Forearm 2 Views	1	1	$77.28	—	$77.28	$77.28	$77.28	2025-10-01
73110	CPT	Xr Wrist Complete Min 3 Views	1	1	$108.18	—	$108.18	$108.18	$108.18	2025-10-01
73120	CPT	Xr Hand	1	1	$82.41	—	$82.41	$82.41	$82.41	2025-10-01
73130	CPT	Xr Hand Complete Min 3 Views	1	1	$97.92	—	$97.92	$97.92	$97.92	2025-10-01
73502	CPT	Xr Hip Complete 2 Views	1	1	$124.98	—	$124.98	$124.98	$124.98	2025-10-01
73521	CPT	Xr Hip B/l Including Pelvis	1	1	$108.75	—	$108.75	$108.75	$108.75	2025-10-01
73562	CPT	Xr Knee Complete 3 Views	1	1	$106.56	—	$106.56	$106.56	$106.56	2025-10-01
73590	CPT	Xr Tibia/Fibula	1	1	$83.25	—	$83.25	$83.25	$83.25	2025-10-01
73600	CPT	Xr Ankle 2 Views	1	1	$84.12	—	$84.12	$84.12	$84.12	2025-10-01
73610	CPT	Xr Ankle Complete Min 3 Views	1	1	$95.34	—	$95.34	$95.34	$95.34	2025-10-01
73620	CPT	Xr Foot 2 Views	1	1	$74.70	—	$74.70	$74.70	$74.70	2025-10-01
73630	CPT	Xr Foot Complete Min 3 Views	1	1	$89.37	—	$89.37	$89.37	$89.37	2025-10-01
74018	CPT	Xr Abdomen 1 View	1	1	$79.23	—	$79.23	$79.23	$79.23	2025-10-01
74019	CPT	Xr Abdomen Ant/post View	1	1	$97.74	—	$97.74	$97.74	$97.74	2025-10-01
80048	CPT	Basic Metabolic Panel (bmp)	1	1	$25.38	—	$25.38	$25.38	$25.38	2025-10-01
80053	CPT	Comprehensive Metabolic Panel	1	1	$31.68	—	$31.68	$31.68	$31.68	2025-10-01
80061	CPT	Lipid Panel	1	1	$40.17	—	$40.17	$40.17	$40.17	2025-10-01
80074	CPT	Hepatitis Iii	1	1	$142.89	—	$142.89	$142.89	$142.89	2025-10-01
80076	CPT	Hepatic Function Panel (lft)	1	1	$24.51	—	$24.51	$24.51	$24.51	2025-10-01
80143	CPT	Acetaminophen Level	1	1	$55.92	—	$55.92	$55.92	$55.92	2025-10-01
80156	CPT	Carbamazepine Level (Tegretol)	1	1	$43.71	—	$43.71	$43.71	$43.71	2025-10-01
80159	CPT	Clozapine Level	1	1	$60.45	—	$60.45	$60.45	$60.45	2025-10-01
80162	CPT	Digoxin Level	1	1	$39.84	—	$39.84	$39.84	$39.84	2025-10-01
80164	CPT	Valproic Acid Level (Depakote)	1	1	$40.62	—	$40.62	$40.62	$40.62	2025-10-01
80175	CPT	Lamotrigine Level (Lamictal)	1	1	$39.75	—	$39.75	$39.75	$39.75	2025-10-01
80177	CPT	Keppra Level (Levetiracetam)	1	1	$39.75	—	$39.75	$39.75	$39.75	2025-10-01
80178	CPT	Lithium Drug Level	1	1	$19.83	—	$19.83	$19.83	$19.83	2025-10-01
80183	CPT	Oxcarbazepine(Trileptal) LeveL	1	1	$39.75	—	$39.75	$39.75	$39.75	2025-10-01
80305	CPT	Urine Drug Screen (Send Out)	1	1	$186.42	—	$186.42	$186.42	$186.42	2025-10-01
80306	CPT	Urine Drug Screen 80306	1	1	$37.32	—	$37.32	$37.32	$37.32	2025-10-01
80307	CPT	Urine Drug Screen 80307	1	1	$135.33	—	$135.33	$135.33	$135.33	2025-10-01
80320	CPT	Alcohol Level	1	1	$343.29	—	$343.29	$343.29	$343.29	2025-10-01
80321	CPT	Urine Drug Screen 80321	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80322	CPT	Urine Drug Screen 80322	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80323	CPT	Urine Drug Screen 80323	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80324	CPT	Urine Drug Screen 80324	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80325	CPT	Urine Drug Screen 80325	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80326	CPT	Urine Drug Screen 80326	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80327	CPT	Urine Drug Screen 80327	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80328	CPT	Urine Drug Screen 80328	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80329	CPT	Urine Drug Screen 80329	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80330	CPT	Urine Drug Screen 80330	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80331	CPT	Urine Drug Screen 80331	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80332	CPT	Urine Drug Screen 80332	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80333	CPT	Urine Drug Screen 80333	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80334	CPT	Urine Drug Screen 80334	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80335	CPT	Urine Drug Screen 80335	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80336	CPT	Urine Drug Screen 80336	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80337	CPT	Urine Drug Screen 80337	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80338	CPT	Urine Drug Screen 80338	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80339	CPT	Urine Drug Screen 80339	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80340	CPT	Urine Drug Screen 80340	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80341	CPT	Urine Drug Screen 80341	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80342	CPT	Urine Drug Screen 80342	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80343	CPT	Urine Drug Screen 80343	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80344	CPT	Urine Drug Screen 80344	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80345	CPT	Urine Drug Screen 80345	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80346	CPT	Urine Drug Screen 80346	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80347	CPT	Urine Drug Screen 80347	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80348	CPT	Urine Drug Screen 80348	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80349	CPT	Urine Drug Screen 80349	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80350	CPT	Urine Drug Screen 80350	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80351	CPT	Urine Drug Screen 80351	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80352	CPT	Urine Drug Screen 80352	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80353	CPT	Urine Drug Screen 80353	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80354	CPT	Urine Drug Screen 80354	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80355	CPT	Urine Drug Screen 80355	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80356	CPT	Urine Drug Screen 80356	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80357	CPT	Urine Drug Screen 80357	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80358	CPT	Urine Drug Screen 80358	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80359	CPT	Urine Drug Screen 80359	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80360	CPT	Urine Drug Screen 80360	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80361	CPT	Urine Drug Screen 80361	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80362	CPT	Urine Drug Screen 80362	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80363	CPT	Urine Drug Screen 80363	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80364	CPT	Urine Drug Screen 80364	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80365	CPT	Urine Drug Screen 80365	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80366	CPT	Urine Drug Screen 80366	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80367	CPT	Urine Drug Screen 80367	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80368	CPT	Urine Drug Screen 80368	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80369	CPT	Urine Drug Screen 80369	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80370	CPT	Urine Drug Screen 80370	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80371	CPT	Urine Drug Screen 80371	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80372	CPT	Urine Drug Screen 80372	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80373	CPT	Urine Drug Screen 80373	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80374	CPT	Urine Drug Screen 80374	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80375	CPT	Urine Drug Screen 80375	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80376	CPT	Urine Drug Screen 80376	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80377	CPT	Urine Drug Screen 80377	1	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
81000	CPT	Urinalysis	1	1	$12.06	—	$12.06	$12.06	$12.06	2025-10-01
81001	CPT	Ua w/Reflex To Culture-routine	1	1	$9.51	—	$9.51	$9.51	$9.51	2025-10-01
81025	CPT	Hcg Urine (Pregnancy Test)	1	1	$25.83	—	$25.83	$25.83	$25.83	2025-10-01
82140	CPT	Ammonia Level	1	1	$43.71	—	$43.71	$43.71	$43.71	2025-10-01
82150	CPT	Amylase	1	1	$19.44	—	$19.44	$19.44	$19.44	2025-10-01
82270	CPT	Occult Blood (Single)	1	1	$13.14	—	$13.14	$13.14	$13.14	2025-10-01
82310	CPT	Calcium Level	1	1	$15.48	—	$15.48	$15.48	$15.48	2025-10-01
82540	CPT	Creatine Kinase	1	1	$13.92	—	$13.92	$13.92	$13.92	2025-10-01
82550	CPT	Creatine Phosphokinase (cpk)	1	1	$19.53	—	$19.53	$19.53	$19.53	2025-10-01
82607	CPT	Vitamin B12 Level	1	1	$45.24	—	$45.24	$45.24	$45.24	2025-10-01
82746	CPT	Folate (Folic Acid) Level	1	1	$44.10	—	$44.10	$44.10	$44.10	2025-10-01
82977	CPT	Gamma Glutamyl Transferase	1	1	$21.60	—	$21.60	$21.60	$21.60	2025-10-01
83036	CPT	Hemoglobin A1c	1	1	$29.13	—	$29.13	$29.13	$29.13	2025-10-01
83540	CPT	Iron Level & Total Iron (tibc)	1	1	$65.04	—	$65.04	$65.04	$65.04	2025-10-01
83550	CPT	Iron Binding Test	1	1	$65.04	—	$65.04	$65.04	$65.04	2025-10-01
83690	CPT	Lipase Level	1	1	$20.67	—	$20.67	$20.67	$20.67	2025-10-01
83735	CPT	Magnesium Serum	1	1	$20.10	—	$20.10	$20.10	$20.10	2025-10-01
83880	CPT	Brain Natriuretic Peptide(BNP)	1	1	$117.78	—	$117.78	$117.78	$117.78	2025-10-01
84132	CPT	Potassium Level	1	1	$14.28	—	$14.28	$14.28	$14.28	2025-10-01
84134	CPT	Prealbumin Level	1	1	$43.77	—	$43.77	$43.77	$43.77	2025-10-01
84146	CPT	Prolactin Level	1	1	$58.14	—	$58.14	$58.14	$58.14	2025-10-01
84439	CPT	Free T4	1	1	$27.06	—	$27.06	$27.06	$27.06	2025-10-01
84443	CPT	Tsh Reflex To Free T4	1	1	$77.46	—	$77.46	$77.46	$77.46	2025-10-01
84450	CPT	Uric Acid Level	1	1	$15.54	—	$15.54	$15.54	$15.54	2025-10-01
84466	CPT	Transferrin	1	1	$38.28	—	$38.28	$38.28	$38.28	2025-10-01
84479	CPT	Thyroid Level (t4)	1	1	$19.41	—	$19.41	$19.41	$19.41	2025-10-01
84481	CPT	Free T3	1	1	$50.82	—	$50.82	$50.82	$50.82	2025-10-01
84702	CPT	Hcg Serum	1	1	$45.15	—	$45.15	$45.15	$45.15	2025-10-01
85014	CPT	Hematocrit	1	1	$28.50	—	$28.50	$28.50	$28.50	2025-10-01
85018	CPT	Hemoglobin & Hematocrit	1	1	$28.50	—	$28.50	$28.50	$28.50	2025-10-01
85025	CPT	Cbc With Diff	1	1	$23.31	—	$23.31	$23.31	$23.31	2025-10-01
85027	CPT	Cbc	1	1	$19.41	—	$19.41	$19.41	$19.41	2025-10-01
85610	CPT	Pt/ptt	1	1	$30.90	—	$30.90	$30.90	$30.90	2025-10-01
85730	CPT	Thromboplastin Time Partial	1	1	$18.03	—	$18.03	$18.03	$18.03	2025-10-01
86140	CPT	C-reactive Protein Non Cardiac	1	1	$15.54	—	$15.54	$15.54	$15.54	2025-10-01
86480	CPT	TB Gold Plus-quantiferon	1	1	$185.94	—	$185.94	$185.94	$185.94	2025-10-01
86593	CPT	Rpr W/reflex-quantitative	1	1	$13.20	—	$13.20	$13.20	$13.20	2025-10-01
86695	CPT	Herpes Simplex Type 1 Test	1	1	$97.62	—	$97.62	$97.62	$97.62	2025-10-01
86696	CPT	Herpes Simplex Type 2 Test	1	1	$97.62	—	$97.62	$97.62	$97.62	2025-10-01
86706	CPT	Hepatitis B Surface Antibody	1	1	$32.22	—	$32.22	$32.22	$32.22	2025-10-01
86803	CPT	Hcv Ab w/Rflx To Quant. Rt-pcr	1	1	$42.81	—	$42.81	$42.81	$42.81	2025-10-01
87070	CPT	Body Fluid Cx- Aer/Ana/GS	1	1	$67.08	—	$67.08	$67.08	$67.08	2025-10-01
87075	CPT	Miscellaneous Culture	1	1	$25.86	—	$25.86	$25.86	$25.86	2025-10-01
87076	CPT	Miscellaneous Culture 87076	1	1	$24.24	—	$24.24	$24.24	$24.24	2025-10-01
87177	CPT	Stool Specimen	1	1	$26.70	—	$26.70	$26.70	$26.70	2025-10-01
87205	CPT	Gram/Giemsa Stain On A Primary	1	1	$67.08	—	$67.08	$67.08	$67.08	2025-10-01
87209	CPT	Stool Specimen 87209	1	1	$53.94	—	$53.94	$53.94	$53.94	2025-10-01
87389	CPT	HIV Ag/Ab W/reflex-qualitative	1	1	$72.24	—	$72.24	$72.24	$72.24	2025-10-01
87480	CPT	Urine BV/Trichomoniasis (naat)	1	1	$180.45	—	$180.45	$180.45	$180.45	2025-10-01
87491	CPT	Chlamydia/Gonococcus, Naa Swab	1	1	$105.27	—	$105.27	$105.27	$105.27	2025-10-01
87493	CPT	C. Difficile Toxin Gene, Naa	1	1	$111.81	—	$111.81	$111.81	$111.81	2025-10-01
87502	CPT	Influenza A+b Alere I	1	1	$287.40	—	$287.40	$287.40	$287.40	2025-10-01
87510	CPT	Gardnerella Vaginalis, Direct	1	1	$180.45	—	$180.45	$180.45	$180.45	2025-10-01
87539	CPT	HIV 2	1	1	$175.86	—	$175.86	$175.86	$175.86	2025-10-01
87563	CPT	Mycoplasma Genitalium	1	1	$105.27	—	$105.27	$105.27	$105.27	2025-10-01
87591	CPT	Neisseria Gonorrhoeae Amplifie	1	1	$105.27	—	$105.27	$105.27	$105.27	2025-10-01
87635	CPT	Covid Test (send-out) Nasal Sw	1	1	$153.93	—	$153.93	$153.93	$153.93	2025-10-01
87660	CPT	Trichomonoas Vaginalis, Direct	1	1	$180.45	—	$180.45	$180.45	$180.45	2025-10-01
87661	CPT	Trichomonas Vaginalis, Naa	1	1	$105.27	—	$105.27	$105.27	$105.27	2025-10-01
89055	CPT	Stool For Wbc	1	1	$12.81	—	$12.81	$12.81	$12.81	2025-10-01
90471	CPT	Admin Influenza Virus Vac	1	1	$55.08	—	$55.08	$55.08	$55.08	2025-10-01
90472	CPT	Immunization Admin Each Add	1	1	$39.45	—	$39.45	$39.45	$39.45	2025-10-01
90653	CPT	Flu Vacc Ts2024-25(6mos Up)/Pf	1	1	$250.47	—	$250.47	$250.47	$250.47	2025-10-01
90715	CPT	Adacel Tdap	1	1	$115.89	—	$115.89	$115.89	$115.89	2025-10-01
90832	CPT	Individual Psych Tx 16-37 Mins	1	1	$600.00	—	$600.00	$600.00	$600.00	2025-10-01
90834	CPT	Individual Psych Tx 38-52 Mins	1	1	$750.00	—	$750.00	$750.00	$750.00	2025-10-01
90837	CPT	Individual Psych Tx 53 + Mins	1	1	$825.00	—	$825.00	$825.00	$825.00	2025-10-01
90839	CPT	Psych Crisis Tx First 60 Mins	1	1	$825.00	—	$825.00	$825.00	$825.00	2025-10-01
90846	CPT	Family Psych Tx No Pt Present	1	1	$750.00	—	$750.00	$750.00	$750.00	2025-10-01
90847	CPT	Family Psych Tx Patient Presen	1	1	$750.00	—	$750.00	$750.00	$750.00	2025-10-01
90853	CPT	Group Psych Tx	1	1	$300.00	—	$300.00	$300.00	$300.00	2025-10-01
90875	CPT	Psych Interactive Tx Add On	1	1	$75.00	—	$75.00	$75.00	$75.00	2025-10-01
93000	CPT	EKG	1	1	$38.91	—	$38.91	$38.91	$38.91	2025-10-01
93971	CPT	US Lower Ext Venous Doppler	1	1	$308.34	—	$308.34	$308.34	$308.34	2025-10-01
96372	CPT	Injection Of Drug/substance Un	1	1	$12.94	—	$12.94	$12.94	$12.94	2025-10-01
G0480	HCPCS	Blood Alcohol Concentration	1	1	$343.29	—	$343.29	$343.29	$343.29	2025-10-01
J0171	HCPCS	EPINEPHrine	1	1	$2.28	—	$2.28	$2.28	$2.28	2025-10-01
J0401	HCPCS	Abilify Maintena	1	1	$21.21	—	$21.21	$21.21	$21.21	2025-10-01
J0515	HCPCS	Benztropine Mesylate	1	1	$50.67	—	$50.67	$50.67	$50.67	2025-10-01
J0561	HCPCS	Bicillin L-a	1	1	$80.46	—	$80.46	$80.46	$80.46	2025-10-01
J0572	HCPCS	Buprenorphine Hcl	1	1	$23.22	—	$23.22	$23.22	$23.22	2025-10-01
J0573	HCPCS	Buprenorphine HCL/Naloxone Hcl	1	1	$26.40	—	$26.40	$26.40	$26.40	2025-10-01
J0696	HCPCS	cefTRIAXone Sodium	1	1	$1.35	—	$1.35	$1.35	$1.35	2025-10-01
J0750	HCPCS	Emtricitabine/Tenofovir (Tdf)	1	1	$194.43	—	$194.43	$194.43	$194.43	2025-10-01
J1200	HCPCS	diphenhydrAMINE Hcl	1	1	$2.19	—	$2.19	$2.19	$2.19	2025-10-01
J1380	HCPCS	estradioL Valerate	1	1	$23.82	—	$23.82	$23.82	$23.82	2025-10-01
J1438	HCPCS	EnbreL	1	1	$9.00	—	$9.00	$9.00	$9.00	2025-10-01
J1610	HCPCS	Glucagon Emergency Kit	1	1	$552.54	—	$552.54	$552.54	$552.54	2025-10-01
J1630	HCPCS	haloperidoL Lactate	1	1	$3.63	—	$3.63	$3.63	$3.63	2025-10-01
J1631	HCPCS	haloperidoL Decanoate	1	1	$16.65	—	$16.65	$16.65	$16.65	2025-10-01
J1650	HCPCS	Enoxaparin Sodium	1	1	$1.68	—	$1.68	$1.68	$1.68	2025-10-01
J1815	HCPCS	Tresiba Flextouch U-200	1	1	$81.35	—	$81.35	$81.35	$81.35	2025-10-01
J1943	HCPCS	Aristada Initio	1	1	$9.39	—	$9.39	$9.39	$9.39	2025-10-01
J1944	HCPCS	Aristada	1	1	$17.76	—	$17.76	$17.76	$17.76	2025-10-01
J2060	HCPCS	LORazepam	1	1	$4.05	—	$4.05	$4.05	$4.05	2025-10-01
J2315	HCPCS	Naltrexone Microspheres	1	1	$12.36	—	$12.36	$12.36	$12.36	2025-10-01
J2426	HCPCS	Invega Sustenna	1	1	$44.19	—	$44.19	$44.19	$44.19	2025-10-01
J2427	HCPCS	Paliperidone Palmitate	1	1	$37.86	—	$37.86	$37.86	$37.86	2025-10-01
J2680	HCPCS	fluPHENAZine Decanoate	1	1	$28.23	—	$28.23	$28.23	$28.23	2025-10-01
J2798	HCPCS	Perseris	1	1	$36.57	—	$36.57	$36.57	$36.57	2025-10-01
J2799	HCPCS	risperiDONE	1	1	$74.16	—	$74.16	$74.16	$74.16	2025-10-01
J3230	HCPCS	chlorproMAZINE Hcl	1	1	$91.44	—	$91.44	$91.44	$91.44	2025-10-01
J3360	HCPCS	diazePAM	1	1	$25.65	—	$25.65	$25.65	$25.65	2025-10-01
J3420	HCPCS	Cyanocobalamin (Vitamin B-12)	1	1	$3.81	—	$3.81	$3.81	$3.81	2025-10-01
J3486	HCPCS	Ziprasidone Mesylate	1	1	$21.57	—	$21.57	$21.57	$21.57	2025-10-01
J3490	HCPCS	Trulicity	1	1	$9.00	—	$9.00	$9.00	$9.00	2025-10-01
J7507	HCPCS	Tacrolimus	1	1	$13.38	—	$13.38	$13.38	$13.38	2025-10-01
J7512	HCPCS	predniSONE	1	1	$0.72	—	$0.72	$0.72	$0.72	2025-10-01
J7517	HCPCS	Mycophenolate mofetiL	1	1	$23.85	—	$23.85	$23.85	$23.85	2025-10-01
J7609	HCPCS	Symbicort	1	1	$0.60	—	$0.60	$0.60	$0.60	2025-10-01
J7620	HCPCS	Ipratropium/Albuterol Sulfate	1	1	$6.81	—	$6.81	$6.81	$6.81	2025-10-01
J7626	HCPCS	Budesonide	1	1	$28.23	—	$28.23	$28.23	$28.23	2025-10-01
J7627	HCPCS	Budesonide/Formoterol Fumarate	1	1	$1.62	—	$1.62	$1.62	$1.62	2025-10-01
J7643	HCPCS	Glycopyrrolate	1	1	$6.60	—	$6.60	$6.60	$6.60	2025-10-01
J7644	HCPCS	Ipratropium Bromide	1	1	$136.89	—	$136.89	$136.89	$136.89	2025-10-01
J8499	HCPCS	Sofosbuvir/Velpatasvir	1	1	$1,028.58	—	$1,545.00	$1,545.00	$1,545.00	2025-10-01
J8611	HCPCS	Methotrexate (Jylamvo)	1	1	$24.30	—	$24.30	$24.30	$24.30	2025-10-01
J8612	HCPCS	Methotrexate (Xatmep)	1	1	$21.36	—	$21.36	$21.36	$21.36	2025-10-01
Q0144	HCPCS	Azithromycin	1	1	$23.34	—	$23.34	$23.34	$23.34	2025-10-01
S0138	HCPCS	Finasteride	1	1	$2.88	—	$2.88	$2.88	$2.88	2025-10-01
S9480	HCPCS	Intensive Op Tx All Inclusive	1	1	$900.00	—	$900.00	$900.00	$900.00	2025-10-01

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