Hospital

BEACON BEHAVIORAL HOSPITAL- NEW ORLEANS, LLC

New Orleans, LA · CCN 194084 · Rates published

235 distinct procedures filed

57 distinct payers

1,123 rate rows

2025-10-01 last MRF observed

Data quality

797 of 1,123 rate rows are consumer-grade (71.0%)

326 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	281
percent-of-charges filed in the dollar field — excluded from medians	45

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

Source MRF file	https://beaconbh.com/wp-content/uploads/2026/04/853294023-273977201-1760437131_new-orleans-hospital_standardcharges_2026_westbank.csv
Found on page	https://www.beaconbh.com/price-transparency/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	393c6d05e2be7c56… · 175,502 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
J8499 HCPCS	Sofosbuvir/Velpatasvir	1	$1,545.00	$1,545.00	$1,545.00	nat. median $83 outlier · 18.7×
126 MS_DRG	Semi Private Detox Room And Board, All Inclusive Except Prof. Fees	17	$740.00	$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	35	$700.00	$1,545.00	$1,545.00	nat. median $13,810 outlier · 0.1×
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×
90834 CPT	Individual Psych Tx 38-52 Mins	1	$750.00	$750.00	$750.00	nat. median $198 outlier · 3.8×
90847 CPT	Family Psych Tx Patient Presen	1	$750.00	$750.00	$750.00	nat. median $206 outlier · 3.6×
90846 CPT	Family Psych Tx No Pt Present	1	$750.00	$750.00	$750.00	nat. median $195 outlier · 3.9×
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
80320 CPT	Alcohol Level	1	$1.26	$343.29	$343.29	nat. median $86 outlier · 4.0×
G0480 HCPCS	Blood Alcohol Concentration	1	$1.26	$343.29	$343.29	nat. median $114 outlier · 3.0×
S9480 HCPCS	Intensive Outpatient Mental Health, Per Diem	8	$309.00	$900.00	$309.00	nat. median $319 1.0× median
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	$1.14	$287.40	$287.40	nat. median $146 2.0× median
90832 HCPCS	Psychotherapy, 30 Minutes With Patient And/or Family Member�(16 To 37 Minutes)	1	$283.25	$283.25	$283.25	nat. median $176 1.6× median
90837 HCPCS	Psychotherapy, 60 Minutes With Patient And/or Family Member�(53 Minutes Or Longe…	9	$283.25	$283.25	$283.25	nat. median $218 1.3× median
90834 HCPCS	Psychotherapy, 45 Minutes With Patient And/or Family Member�(38 To 52 Minutes)	9	$257.50	$257.50	$257.50	nat. median $198 1.3× median
90839 HCPCS	Psychotherapy For Crisis, First 60 Minutes	9	$257.50	$257.50	$257.50	nat. median $220 1.2× median
90653 CPT	Flu Vacc Ts2024-25(6mos Up)/Pf	1	$0.09	$250.47	$250.47	nat. median $98 outlier · 2.6×
J0750 HCPCS	Emtricitabine/Tenofovir (Tdf)	1	$194.43	$384.69	$194.43	nat. median $3 outlier · 57.0×
80305 CPT	Urine Drug Screen (Send Out)	1	$0.90	$186.42	$186.42	nat. median $24 outlier · 7.6×
86480 CPT	TB Gold Plus-quantiferon	1	$0.84	$185.94	$185.94	nat. median $103 1.8× median
87480 CPT	Urine BV/Trichomoniasis (naat)	1	$0.51	$180.45	$180.45	nat. median $33 outlier · 5.5×
87660 CPT	Trichomonoas Vaginalis, Direct	1	$0.54	$180.45	$180.45	nat. median $34 outlier · 5.3×
87510 CPT	Gardnerella Vaginalis, Direct	1	$0.57	$180.45	$180.45	nat. median $34 outlier · 5.3×
87539 CPT	HIV 2	1	$0.42	$175.86	$175.86	nat. median $63 outlier · 2.8×
90846 HCPCS	Family Psychotherapy (without The Patient Present), 50 Minutes	9	$154.50	$154.50	$154.50	nat. median $195 0.8× median
87635 CPT	Covid Test (send-out) Nasal Sw	1	$0.36	$153.93	$153.93	nat. median $85 1.8× median
80074 CPT	Hepatitis Iii	1	$0.30	$142.89	$142.89	nat. median $124 1.2× median
J7644 HCPCS	Ipratropium Bromide	1	$136.89	$200.40	$136.89	nat. median $2 outlier · 63.7×
80307 CPT	Urine Drug Screen 80307	1	$0.27	$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	$0.24	$117.78	$117.78	nat. median $99 1.2× median
90715 CPT	Adacel Tdap	1	$115.89	$182.28	$115.89	nat. median $86 1.4× median
87493 CPT	C. Difficile Toxin Gene, Naa	1	$0.21	$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	$0.18	$105.27	$105.27	nat. median $53 2.0× median
87591 CPT	Neisseria Gonorrhoeae Amplifie	1	$0.18	$105.27	$105.27	nat. median $68 1.5× median
87661 CPT	Trichomonas Vaginalis, Naa	1	$0.18	$105.27	$105.27	nat. median $63 1.7× median
87491 CPT	Chlamydia/Gonococcus, Naa Swab	1	$0.21	$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
90853 HCPCS	Group Psychotherapy (other Than Of A Multiple-family Group)	17	$103.00	$309.00	$103.00	nat. median $148 0.7× 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	$0.15	$97.62	$97.62	nat. median $38 outlier · 2.6×

Other procedures at this hospital

Browse this hospital's 235 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

126	MS_DRG	Semi Private Detox Room And Board, All Inclusive Except Prof. Fees	25	17	$1,545.00	$800.00 48% off	$740.00	$1,545.00	$1,545.00	2025-10-01
124	MS_DRG	Semi Private Psychiatric Room And Board, All Inclusive Except Prof. Fees	64	35	$1,545.00	$825.00 47% off	$700.00	$1,545.00	$1,545.00	2025-10-01
J8499	HCPCS	Sofosbuvir/Velpatasvir	3	1	$733.93	—	$1,545.00	$1,545.00	$1,545.00	2025-10-01
90839	CPT	Psych Crisis Tx First 60 Mins	2	1	$825.00	—	$825.00	$825.00	$825.00	2025-10-01
90837	CPT	Individual Psych Tx 53 + Mins	2	1	$825.00	—	$825.00	$825.00	$825.00	2025-10-01
90846	CPT	Family Psych Tx No Pt Present	2	1	$750.00	—	$750.00	$750.00	$750.00	2025-10-01
90834	CPT	Individual Psych Tx 38-52 Mins	2	1	$750.00	—	$750.00	$750.00	$750.00	2025-10-01
90847	CPT	Family Psych Tx Patient Presen	2	1	$750.00	—	$750.00	$750.00	$750.00	2025-10-01
90832	CPT	Individual Psych Tx 16-37 Mins	2	1	$600.00	—	$600.00	$600.00	$600.00	2025-10-01
J1610	HCPCS	Glucagon Emergency Kit	2	1	$552.54	—	$552.54	$552.54	$552.54	2025-10-01
G0480	HCPCS	Blood Alcohol Concentration	3	1	$343.29	—	$1.26	$343.29	$343.29	2025-10-01
80320	CPT	Alcohol Level	3	1	$343.29	—	$1.26	$343.29	$343.29	2025-10-01
S9480	HCPCS	Intensive Outpatient Mental Health, Per Diem	16	8	$309.00	$175.00 43% off	$309.00	$900.00	$309.00	2025-10-01
93971	CPT	US Lower Ext Venous Doppler	2	1	$308.34	—	$308.34	$308.34	$308.34	2025-10-01
90853	CPT	Group Psych Tx	2	1	$300.00	—	$300.00	$300.00	$300.00	2025-10-01
87502	CPT	Influenza A+b Alere I	3	1	$287.40	—	$1.14	$287.40	$287.40	2025-10-01
90832	HCPCS	Psychotherapy, 30 Minutes With Patient And/or Family Member�(16 To 37 Minutes)	1	1	$206.00	$200.00	$283.25	$283.25	$283.25	2025-10-01
90837	HCPCS	Psychotherapy, 60 Minutes With Patient And/or Family Member�(53 Minutes Or Longe…	13	9	$283.25	$275.00	$283.25	$283.25	$283.25	2025-10-01
90839	HCPCS	Psychotherapy For Crisis, First 60 Minutes	20	9	$257.50	$250.00	$257.50	$257.50	$257.50	2025-10-01
90834	HCPCS	Psychotherapy, 45 Minutes With Patient And/or Family Member�(38 To 52 Minutes)	20	9	$257.50	$250.00	$257.50	$257.50	$257.50	2025-10-01
90653	CPT	Flu Vacc Ts2024-25(6mos Up)/Pf	3	1	$250.47	—	$0.09	$250.47	$250.47	2025-10-01
J0750	HCPCS	Emtricitabine/Tenofovir (Tdf)	3	1	$194.43	—	$194.43	$384.69	$194.43	2025-10-01
80305	CPT	Urine Drug Screen (Send Out)	3	1	$186.42	—	$0.90	$186.42	$186.42	2025-10-01
86480	CPT	TB Gold Plus-quantiferon	3	1	$185.94	—	$0.84	$185.94	$185.94	2025-10-01
87510	CPT	Gardnerella Vaginalis, Direct	3	1	$180.45	—	$0.57	$180.45	$180.45	2025-10-01
87480	CPT	Urine BV/Trichomoniasis (naat)	3	1	$180.45	—	$0.51	$180.45	$180.45	2025-10-01
87660	CPT	Trichomonoas Vaginalis, Direct	3	1	$180.45	—	$0.54	$180.45	$180.45	2025-10-01
87539	CPT	HIV 2	3	1	$175.86	—	$0.42	$175.86	$175.86	2025-10-01
90846	HCPCS	Family Psychotherapy (without The Patient Present), 50 Minutes	10	9	$154.50	$150.00	$154.50	$154.50	$154.50	2025-10-01
87635	CPT	Covid Test (send-out) Nasal Sw	3	1	$153.93	—	$0.36	$153.93	$153.93	2025-10-01
80074	CPT	Hepatitis Iii	3	1	$142.89	—	$0.30	$142.89	$142.89	2025-10-01
J7644	HCPCS	Ipratropium Bromide	3	1	$136.89	—	$136.89	$200.40	$136.89	2025-10-01
80307	CPT	Urine Drug Screen 80307	3	1	$135.33	—	$0.27	$135.33	$135.33	2025-10-01
73502	CPT	Xr Hip Complete 2 Views	2	1	$124.98	—	$124.98	$124.98	$124.98	2025-10-01
70260	CPT	Xr SKull Complete Min 4 Views	2	1	$117.99	—	$117.99	$117.99	$117.99	2025-10-01
83880	CPT	Brain Natriuretic Peptide(BNP)	3	1	$117.78	—	$0.24	$117.78	$117.78	2025-10-01
90715	CPT	Adacel Tdap	3	1	$115.89	—	$115.89	$182.28	$115.89	2025-10-01
87493	CPT	C. Difficile Toxin Gene, Naa	3	1	$111.81	—	$0.21	$111.81	$111.81	2025-10-01
73521	CPT	Xr Hip B/l Including Pelvis	2	1	$108.75	—	$108.75	$108.75	$108.75	2025-10-01
73110	CPT	Xr Wrist Complete Min 3 Views	2	1	$108.18	—	$108.18	$108.18	$108.18	2025-10-01
73562	CPT	Xr Knee Complete 3 Views	2	1	$106.56	—	$106.56	$106.56	$106.56	2025-10-01
87661	CPT	Trichomonas Vaginalis, Naa	3	1	$105.27	—	$0.18	$105.27	$105.27	2025-10-01
87563	CPT	Mycoplasma Genitalium	3	1	$105.27	—	$0.18	$105.27	$105.27	2025-10-01
87591	CPT	Neisseria Gonorrhoeae Amplifie	3	1	$105.27	—	$0.18	$105.27	$105.27	2025-10-01
87491	CPT	Chlamydia/Gonococcus, Naa Swab	3	1	$105.27	—	$0.21	$105.27	$105.27	2025-10-01
72100	CPT	Xr Lumbar Spine AP/Lat	2	1	$104.46	—	$104.46	$104.46	$104.46	2025-10-01
90853	HCPCS	Group Psychotherapy (other Than Of A Multiple-family Group)	25	17	$103.00	$100.00	$103.00	$309.00	$103.00	2025-10-01
73130	CPT	Xr Hand Complete Min 3 Views	2	1	$97.92	—	$97.92	$97.92	$97.92	2025-10-01
74019	CPT	Xr Abdomen Ant/post View	2	1	$97.74	—	$97.74	$97.74	$97.74	2025-10-01
86695	CPT	Herpes Simplex Type 1 Test	3	1	$97.62	—	$0.15	$97.62	$97.62	2025-10-01
86696	CPT	Herpes Simplex Type 2 Test	3	1	$97.62	—	$0.15	$97.62	$97.62	2025-10-01
71100	CPT	Radiology Order - Other	2	1	$96.78	—	$96.78	$96.78	$96.78	2025-10-01
73610	CPT	Xr Ankle Complete Min 3 Views	2	1	$95.34	—	$95.34	$95.34	$95.34	2025-10-01
J3230	HCPCS	chlorproMAZINE Hcl	3	1	$91.44	—	$91.44	$170.25	$91.44	2025-10-01
73030	CPT	Xr Shoulder Compl Min 2 Views	2	1	$91.20	—	$91.20	$91.20	$91.20	2025-10-01
73630	CPT	Xr Foot Complete Min 3 Views	2	1	$89.37	—	$89.37	$89.37	$89.37	2025-10-01
71046	CPT	Xr Chest Ap/lat 2 Views	2	1	$89.07	—	$89.07	$89.07	$89.07	2025-10-01
72070	CPT	Xr Thoracic Spine AP/Lat	2	1	$87.15	—	$87.15	$87.15	$87.15	2025-10-01
72220	CPT	Xr Sacrum & Coccyx Min 2 Views	2	1	$85.95	—	$85.95	$85.95	$85.95	2025-10-01
73060	CPT	Xr Humerus Min 2 Views	2	1	$84.12	—	$84.12	$84.12	$84.12	2025-10-01
73600	CPT	Xr Ankle 2 Views	2	1	$84.12	—	$84.12	$84.12	$84.12	2025-10-01
73590	CPT	Xr Tibia/Fibula	2	1	$83.25	—	$83.25	$83.25	$83.25	2025-10-01
73120	CPT	Xr Hand	2	1	$82.41	—	$82.41	$82.41	$82.41	2025-10-01
J1815	HCPCS	Tresiba Flextouch U-200	3	1	$81.35	—	$81.35	$115.89	$81.35	2025-10-01
J0561	HCPCS	Bicillin L-a	3	1	$80.46	—	$80.46	$96.33	$80.46	2025-10-01
74018	CPT	Xr Abdomen 1 View	2	1	$79.23	—	$79.23	$79.23	$79.23	2025-10-01
84443	CPT	Tsh Reflex To Free T4	3	1	$77.46	—	$0.15	$77.46	$77.46	2025-10-01
73090	CPT	Xr Forearm 2 Views	2	1	$77.28	—	$77.28	$77.28	$77.28	2025-10-01
90875	CPT	Psych Interactive Tx Add On	2	1	$75.00	—	$75.00	$75.00	$75.00	2025-10-01
73620	CPT	Xr Foot 2 Views	2	1	$74.70	—	$74.70	$74.70	$74.70	2025-10-01
J2799	HCPCS	risperiDONE	3	1	$74.16	—	$74.16	$89.61	$74.16	2025-10-01
87389	CPT	HIV Ag/Ab W/reflex-qualitative	3	1	$72.24	—	$0.15	$72.24	$72.24	2025-10-01
71045	CPT	Xr Chest 1 View Frontal	2	1	$68.97	—	$68.97	$68.97	$68.97	2025-10-01
87205	CPT	Gram/Giemsa Stain On A Primary	3	1	$67.08	—	$0.12	$67.08	$67.08	2025-10-01
87070	CPT	Body Fluid Cx- Aer/Ana/GS	3	1	$67.08	—	$0.12	$67.08	$67.08	2025-10-01
83550	CPT	Iron Binding Test	3	1	$65.04	—	$0.12	$65.04	$65.04	2025-10-01
83540	CPT	Iron Level & Total Iron (tibc)	3	1	$65.04	—	$0.09	$65.04	$65.04	2025-10-01
80159	CPT	Clozapine Level	3	1	$60.45	—	$0.09	$60.45	$60.45	2025-10-01
84146	CPT	Prolactin Level	3	1	$58.14	—	$0.09	$58.14	$58.14	2025-10-01
80143	CPT	Acetaminophen Level	3	1	$55.92	—	$0.09	$55.92	$55.92	2025-10-01
90471	CPT	Admin Influenza Virus Vac	2	1	$55.08	—	$55.08	$55.08	$55.08	2025-10-01
87209	CPT	Stool Specimen 87209	3	1	$53.94	—	$0.06	$53.94	$53.94	2025-10-01
84481	CPT	Free T3	3	1	$50.82	—	$0.06	$50.82	$50.82	2025-10-01
J0515	HCPCS	Benztropine Mesylate	3	1	$50.67	—	$50.67	$61.71	$50.67	2025-10-01
82607	CPT	Vitamin B12 Level	3	1	$45.24	—	$0.06	$45.24	$45.24	2025-10-01
84702	CPT	Hcg Serum	3	1	$45.15	—	$0.06	$45.15	$45.15	2025-10-01
J2426	HCPCS	Invega Sustenna	3	1	$44.19	—	$44.19	$50.76	$44.19	2025-10-01
82746	CPT	Folate (Folic Acid) Level	3	1	$44.10	—	$0.06	$44.10	$44.10	2025-10-01
84134	CPT	Prealbumin Level	3	1	$43.77	—	$0.06	$43.77	$43.77	2025-10-01
80156	CPT	Carbamazepine Level (Tegretol)	3	1	$43.71	—	$0.06	$43.71	$43.71	2025-10-01
82140	CPT	Ammonia Level	3	1	$43.71	—	$0.06	$43.71	$43.71	2025-10-01
80369	CPT	Urine Drug Screen 80369	3	1	$43.56	—	$43.56	$97.62	$43.56	2025-10-01
80370	CPT	Urine Drug Screen 80370	3	1	$43.56	—	$43.56	$97.62	$43.56	2025-10-01
80371	CPT	Urine Drug Screen 80371	3	1	$43.56	—	$43.56	$77.46	$43.56	2025-10-01
80372	CPT	Urine Drug Screen 80372	3	1	$43.56	—	$43.56	$72.24	$43.56	2025-10-01
80373	CPT	Urine Drug Screen 80373	3	1	$43.56	—	$43.56	$67.08	$43.56	2025-10-01
80374	CPT	Urine Drug Screen 80374	3	1	$43.56	—	$43.56	$67.08	$43.56	2025-10-01
80375	CPT	Urine Drug Screen 80375	3	1	$43.56	—	$43.56	$65.04	$43.56	2025-10-01
80376	CPT	Urine Drug Screen 80376	3	1	$43.56	—	$43.56	$65.04	$43.56	2025-10-01
80377	CPT	Urine Drug Screen 80377	3	1	$43.56	—	$43.56	$60.45	$43.56	2025-10-01
80360	CPT	Urine Drug Screen 80360	3	1	$43.56	—	$43.56	$142.89	$43.56	2025-10-01
80361	CPT	Urine Drug Screen 80361	3	1	$43.56	—	$43.56	$135.33	$43.56	2025-10-01
80362	CPT	Urine Drug Screen 80362	3	1	$43.56	—	$43.56	$117.78	$43.56	2025-10-01
80363	CPT	Urine Drug Screen 80363	3	1	$43.56	—	$43.56	$111.81	$43.56	2025-10-01
80364	CPT	Urine Drug Screen 80364	3	1	$43.56	—	$43.56	$105.27	$43.56	2025-10-01
80365	CPT	Urine Drug Screen 80365	3	1	$43.56	—	$43.56	$105.27	$43.56	2025-10-01
80366	CPT	Urine Drug Screen 80366	3	1	$43.56	—	$43.56	$105.27	$43.56	2025-10-01
80367	CPT	Urine Drug Screen 80367	3	1	$43.56	—	$43.56	$105.27	$43.56	2025-10-01
80368	CPT	Urine Drug Screen 80368	3	1	$43.56	—	$43.56	$105.27	$43.56	2025-10-01
80359	CPT	Urine Drug Screen 80359	3	1	$43.56	—	$43.56	$142.89	$43.56	2025-10-01
80358	CPT	Urine Drug Screen 80358	3	1	$43.56	—	$43.56	$153.93	$43.56	2025-10-01
80357	CPT	Urine Drug Screen 80357	3	1	$43.56	—	$43.56	$175.86	$43.56	2025-10-01
80356	CPT	Urine Drug Screen 80356	3	1	$43.56	—	$43.56	$180.45	$43.56	2025-10-01
80355	CPT	Urine Drug Screen 80355	3	1	$43.56	—	$43.56	$180.45	$43.56	2025-10-01
80354	CPT	Urine Drug Screen 80354	3	1	$43.56	—	$43.56	$180.45	$43.56	2025-10-01
80353	CPT	Urine Drug Screen 80353	3	1	$43.56	—	$43.56	$185.94	$43.56	2025-10-01
80352	CPT	Urine Drug Screen 80352	3	1	$43.56	—	$43.56	$186.42	$43.56	2025-10-01
80351	CPT	Urine Drug Screen 80351	3	1	$43.56	—	$43.56	$287.40	$43.56	2025-10-01
80350	CPT	Urine Drug Screen 80350	3	1	$43.56	—	$43.56	$343.29	$43.56	2025-10-01
80349	CPT	Urine Drug Screen 80349	3	1	$43.56	—	$43.56	$343.29	$43.56	2025-10-01
80348	CPT	Urine Drug Screen 80348	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80347	CPT	Urine Drug Screen 80347	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80346	CPT	Urine Drug Screen 80346	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80345	CPT	Urine Drug Screen 80345	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80344	CPT	Urine Drug Screen 80344	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80343	CPT	Urine Drug Screen 80343	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80342	CPT	Urine Drug Screen 80342	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80341	CPT	Urine Drug Screen 80341	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80340	CPT	Urine Drug Screen 80340	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80339	CPT	Urine Drug Screen 80339	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80338	CPT	Urine Drug Screen 80338	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80337	CPT	Urine Drug Screen 80337	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80336	CPT	Urine Drug Screen 80336	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80335	CPT	Urine Drug Screen 80335	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80334	CPT	Urine Drug Screen 80334	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80333	CPT	Urine Drug Screen 80333	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80332	CPT	Urine Drug Screen 80332	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80331	CPT	Urine Drug Screen 80331	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80330	CPT	Urine Drug Screen 80330	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80329	CPT	Urine Drug Screen 80329	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80328	CPT	Urine Drug Screen 80328	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80327	CPT	Urine Drug Screen 80327	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80326	CPT	Urine Drug Screen 80326	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80325	CPT	Urine Drug Screen 80325	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80324	CPT	Urine Drug Screen 80324	2	1	$43.56	—	$43.56	$43.56	$43.56	2025-10-01
80323	CPT	Urine Drug Screen 80323	3	1	$43.56	—	$0.03	$43.56	$43.56	2025-10-01
80322	CPT	Urine Drug Screen 80322	3	1	$43.56	—	$0.03	$43.56	$43.56	2025-10-01
80321	CPT	Urine Drug Screen 80321	3	1	$43.56	—	$0.03	$43.56	$43.56	2025-10-01
86803	CPT	Hcv Ab w/Rflx To Quant. Rt-pcr	3	1	$42.81	—	$42.81	$58.14	$42.81	2025-10-01
80164	CPT	Valproic Acid Level (Depakote)	3	1	$40.62	—	$40.62	$55.92	$40.62	2025-10-01
80061	CPT	Lipid Panel	3	1	$40.17	—	$40.17	$53.94	$40.17	2025-10-01
80162	CPT	Digoxin Level	3	1	$39.84	—	$39.84	$50.82	$39.84	2025-10-01
80175	CPT	Lamotrigine Level (Lamictal)	3	1	$39.75	—	$39.75	$50.40	$39.75	2025-10-01
80183	CPT	Oxcarbazepine(Trileptal) LeveL	3	1	$39.75	—	$39.75	$45.24	$39.75	2025-10-01
80177	CPT	Keppra Level (Levetiracetam)	3	1	$39.75	—	$39.75	$50.82	$39.75	2025-10-01
90472	CPT	Immunization Admin Each Add	2	1	$39.45	—	$39.45	$39.45	$39.45	2025-10-01
93000	CPT	EKG	2	1	$38.91	—	$38.91	$38.91	$38.91	2025-10-01
84466	CPT	Transferrin	3	1	$38.28	—	$38.28	$45.15	$38.28	2025-10-01
J2427	HCPCS	Paliperidone Palmitate	3	1	$37.86	—	$37.86	$43.80	$37.86	2025-10-01
80306	CPT	Urine Drug Screen 80306	3	1	$37.32	—	$37.32	$44.10	$37.32	2025-10-01
J2798	HCPCS	Perseris	3	1	$36.57	—	$36.57	$43.77	$36.57	2025-10-01
86706	CPT	Hepatitis B Surface Antibody	3	1	$32.22	—	$32.22	$43.77	$32.22	2025-10-01
80053	CPT	Comprehensive Metabolic Panel	3	1	$31.68	—	$31.68	$43.71	$31.68	2025-10-01
85610	CPT	Pt/ptt	3	1	$30.90	—	$30.90	$43.71	$30.90	2025-10-01
83036	CPT	Hemoglobin A1c	3	1	$29.13	—	$29.13	$43.56	$29.13	2025-10-01
85018	CPT	Hemoglobin & Hematocrit	3	1	$28.50	—	$28.50	$43.56	$28.50	2025-10-01
85014	CPT	Hematocrit	3	1	$28.50	—	$28.50	$43.56	$28.50	2025-10-01
J2680	HCPCS	fluPHENAZine Decanoate	3	1	$28.23	—	$28.23	$34.41	$28.23	2025-10-01
J7626	HCPCS	Budesonide	3	1	$28.23	—	$28.23	$34.80	$28.23	2025-10-01
36415	CPT	Blood Culture & Specimen	3	1	$27.27	—	$27.27	$43.56	$27.27	2025-10-01
36416	CPT	Miscellaneous Culture 36416	3	1	$27.27	—	$27.27	$43.56	$27.27	2025-10-01
84439	CPT	Free T4	3	1	$27.06	—	$27.06	$43.56	$27.06	2025-10-01
87177	CPT	Stool Specimen	3	1	$26.70	—	$26.70	$43.56	$26.70	2025-10-01
J0573	HCPCS	Buprenorphine HCL/Naloxone Hcl	3	1	$26.40	—	$26.40	$30.21	$26.40	2025-10-01
87075	CPT	Miscellaneous Culture	3	1	$25.86	—	$25.86	$43.56	$25.86	2025-10-01
81025	CPT	Hcg Urine (Pregnancy Test)	3	1	$25.83	—	$25.83	$43.56	$25.83	2025-10-01
J3360	HCPCS	diazePAM	3	1	$25.65	—	$25.65	$28.65	$25.65	2025-10-01
80048	CPT	Basic Metabolic Panel (bmp)	3	1	$25.38	—	$25.38	$43.56	$25.38	2025-10-01
80076	CPT	Hepatic Function Panel (lft)	3	1	$24.51	—	$24.51	$43.56	$24.51	2025-10-01
J8611	HCPCS	Methotrexate (Jylamvo)	3	1	$24.30	—	$24.30	$27.06	$24.30	2025-10-01
87076	CPT	Miscellaneous Culture 87076	3	1	$24.24	—	$24.24	$43.56	$24.24	2025-10-01
J7517	HCPCS	Mycophenolate mofetiL	3	1	$23.85	—	$23.85	$26.88	$23.85	2025-10-01
J1380	HCPCS	estradioL Valerate	3	1	$23.82	—	$23.82	$26.88	$23.82	2025-10-01
Q0144	HCPCS	Azithromycin	3	1	$23.34	—	$23.34	$26.82	$23.34	2025-10-01
85025	CPT	Cbc With Diff	3	1	$23.31	—	$23.31	$43.56	$23.31	2025-10-01
J0572	HCPCS	Buprenorphine Hcl	3	1	$23.22	—	$23.22	$26.61	$23.22	2025-10-01
82977	CPT	Gamma Glutamyl Transferase	3	1	$21.60	—	$21.60	$43.56	$21.60	2025-10-01
J3486	HCPCS	Ziprasidone Mesylate	3	1	$21.57	—	$21.57	$24.90	$21.57	2025-10-01
J8612	HCPCS	Methotrexate (Xatmep)	3	1	$21.36	—	$21.36	$23.82	$21.36	2025-10-01
J0401	HCPCS	Abilify Maintena	3	1	$21.21	—	$21.21	$23.40	$21.21	2025-10-01
83690	CPT	Lipase Level	3	1	$20.67	—	$20.67	$43.56	$20.67	2025-10-01
83735	CPT	Magnesium Serum	3	1	$20.10	—	$20.10	$43.56	$20.10	2025-10-01
80178	CPT	Lithium Drug Level	3	1	$19.83	—	$19.83	$43.56	$19.83	2025-10-01
82550	CPT	Creatine Phosphokinase (cpk)	3	1	$19.53	—	$19.53	$43.56	$19.53	2025-10-01
82150	CPT	Amylase	3	1	$19.44	—	$19.44	$43.56	$19.44	2025-10-01
84479	CPT	Thyroid Level (t4)	3	1	$19.41	—	$19.41	$43.56	$19.41	2025-10-01
85027	CPT	Cbc	3	1	$19.41	—	$19.41	$43.56	$19.41	2025-10-01
85730	CPT	Thromboplastin Time Partial	3	1	$18.03	—	$18.03	$43.56	$18.03	2025-10-01
J1944	HCPCS	Aristada	3	1	$17.76	—	$17.76	$21.21	$17.76	2025-10-01
J1631	HCPCS	haloperidoL Decanoate	3	1	$16.65	—	$16.65	$20.16	$16.65	2025-10-01
84450	CPT	Uric Acid Level	3	1	$15.54	—	$15.54	$43.56	$15.54	2025-10-01
86140	CPT	C-reactive Protein Non Cardiac	3	1	$15.54	—	$15.54	$43.56	$15.54	2025-10-01
82310	CPT	Calcium Level	3	1	$15.48	—	$15.48	$43.56	$15.48	2025-10-01
84132	CPT	Potassium Level	3	1	$14.28	—	$14.28	$43.56	$14.28	2025-10-01
82540	CPT	Creatine Kinase	3	1	$13.92	—	$13.92	$43.56	$13.92	2025-10-01
J7507	HCPCS	Tacrolimus	3	1	$13.38	—	$13.38	$15.15	$13.38	2025-10-01
86593	CPT	Rpr W/reflex-quantitative	3	1	$13.20	—	$13.20	$43.56	$13.20	2025-10-01
82270	CPT	Occult Blood (Single)	3	1	$13.14	—	$13.14	$43.56	$13.14	2025-10-01
96372	CPT	Injection Of Drug/substance Un	3	1	$12.94	—	$12.94	$14.73	$12.94	2025-10-01
89055	CPT	Stool For Wbc	3	1	$12.81	—	$12.81	$43.56	$12.81	2025-10-01
J2315	HCPCS	Naltrexone Microspheres	3	1	$12.36	—	$12.36	$13.86	$12.36	2025-10-01
81000	CPT	Urinalysis	3	1	$12.06	—	$12.06	$43.56	$12.06	2025-10-01
81001	CPT	Ua w/Reflex To Culture-routine	3	1	$9.51	—	$9.51	$43.56	$9.51	2025-10-01
J1943	HCPCS	Aristada Initio	3	1	$9.39	—	$9.39	$10.65	$9.39	2025-10-01
J3490	HCPCS	Trulicity	3	1	$9.00	—	$9.00	$10.11	$9.00	2025-10-01
J1438	HCPCS	EnbreL	3	1	$9.00	—	$9.00	$10.11	$9.00	2025-10-01
J7620	HCPCS	Ipratropium/Albuterol Sulfate	3	1	$6.81	—	$6.81	$7.56	$6.81	2025-10-01
J7643	HCPCS	Glycopyrrolate	3	1	$6.60	—	$6.60	$7.23	$6.60	2025-10-01
J2060	HCPCS	LORazepam	3	1	$4.05	—	$4.05	$4.44	$4.05	2025-10-01
J3420	HCPCS	Cyanocobalamin (Vitamin B-12)	3	1	$3.81	—	$3.81	$4.29	$3.81	2025-10-01
J1630	HCPCS	haloperidoL Lactate	3	1	$3.63	—	$3.63	$4.05	$3.63	2025-10-01
S0138	HCPCS	Finasteride	3	1	$2.88	—	$2.88	$3.18	$2.88	2025-10-01
J0171	HCPCS	EPINEPHrine	3	1	$2.28	—	$2.28	$2.43	$2.28	2025-10-01
J1200	HCPCS	diphenhydrAMINE Hcl	3	1	$2.19	—	$2.19	$2.34	$2.19	2025-10-01
J1650	HCPCS	Enoxaparin Sodium	3	1	$1.68	—	$1.68	$1.92	$1.68	2025-10-01
J7627	HCPCS	Budesonide/Formoterol Fumarate	3	1	$1.62	—	$1.62	$1.89	$1.62	2025-10-01
J0696	HCPCS	cefTRIAXone Sodium	3	1	$1.35	—	$1.35	$1.62	$1.35	2025-10-01
J7512	HCPCS	predniSONE	3	1	$0.72	—	$0.72	$0.99	$0.72	2025-10-01
J7609	HCPCS	Symbicort	3	1	$0.60	—	$0.60	$0.78	$0.60	2025-10-01
90656	CPT	Flu Vacc Ts2024-25(6mos Up)/Pf	0	0	$67.05	—	—	—	—	2025-06-16
J0574	HCPCS	Buprenorphine HCL/Naloxone Hcl	0	0	$26.40	—	—	—	—	2025-06-16
J2359	HCPCS	OLANZapine	0	0	$2.25	—	—	—	—	2025-06-16
90847	HCPCS	Family Or Couples Psychotherapy (conjoint Psychotherapy) With The Patient Presen…	0	0	$257.50	$212.50	—	—	—	2025-10-01
J7613	HCPCS	Albuterol Sulfate	0	0	$2.40	—	—	—	—	2025-06-16
J0402	HCPCS	ARIPiprazole	0	0	$17.76	—	—	—	—	2025-06-16

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