Price Transparencybeta 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

ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CTR

Fort Washington, MD · CCN 210060 · Rates published

3,171 distinct procedures filed
3 distinct payers
6,145 rate rows
2025-12-31 last MRF observed
Data quality

6,130 of 6,145 rate rows are consumer-grade (99.8%)

15 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 13
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.adventisthealthcare.com/app/files/public/91919297-0df2-4ab4-b788-71160672291c/FWMC-Billing-StandardCharges.csv
Found on page https://www.adventisthealthcare.com/patients-visitors/billing-financial/price-transparency/
Discovered viaDiscovered by HANK
Last fetch success · 2026-09-21
Content fingerprint b84a0da436947d20… · 1,519,171 bytes · first seen 2026-05-08

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
50242-0085-27
NDC 		Alteplase 100 Mg Inj Soln 1 $36,644.69 $36,644.69 $36,644.69 nat. median
$30,625
1.2× median
50242-0120-47
NDC 		Tenecteplase 50 Mg Inj Soln 1 $34,549.79 $34,549.79 $34,549.79 nat. median
$15,569
outlier · 2.2×
50242-0176-01
NDC 		Tenecteplase 50 Mg Inj Soln 1 $34,549.79 $34,549.79 $34,549.79 nat. median
$28,874
1.2× median
44206-0439-40
NDC 		Immune Globulin (ivig) 10%, 40 G/400 Ml (Privigen) Inj Soln 1 $31,359.92 $31,359.92 $31,359.92 nat. median
$12,001
outlier · 2.6×
50242-0120-01
NDC 		Tenecteplase 50 Mg Inj Soln 1 $28,007.73 $28,007.73 $28,007.73 nat. median
$23,407
1.2× median
50633-0120-11
NDC 		Digoxin Immune Fab 40 Mg Inj Soln 1 $20,711.74 $20,711.74 $20,711.74 nat. median
$9,660
outlier · 2.1×
50242-0044-13
NDC 		Alteplase 50 Mg Inj Soln 1 $18,322.36 $18,322.36 $18,322.36 nat. median
$5,549
outlier · 3.3×
44206-0438-20
NDC 		Immune Globulin (ivig) 10%, 20 G/200 Ml (Privigen) Inj Soln 1 $15,679.96 $15,679.96 $15,679.96 nat. median
$4,897
outlier · 3.2×
13533-0318-05
NDC 		Rabies Immune Glob, Human 1,500 Intl_Units/5 Ml Inj Soln 1 $13,958.60 $13,958.60 $13,958.60 nat. median
$7,890
1.8× median
50633-0110-12
NDC 		Antivenin (crotalidae-snake Ovine) Polyvalent Inj 1 $13,316.47 $13,316.47 $13,316.47 nat. median
$4,547
outlier · 2.9×
78831
CPT 		Nm Octreo Scan Spect 1 $12,519.45 $12,519.45 $12,519.45 nat. median
$1,671
outlier · 7.5×
50242-0037-06
NDC 		Tenecteplase 50 Mg Inj Soln 1 $12,249.10 $12,249.10 $12,249.10 nat. median
$10,237
1.2× median
43598-0051-11
NDC 		Calcitonin 400 Intl_Units/2 Ml (mdv) Inj Soln 1 $11,081.86 $11,081.86 $11,081.86 nat. median
$9,262
1.2× median
50242-0137-01
NDC 		Tocilizumab 400 Mg/20 Ml Inj Soln 1 $11,058.83 $11,058.83 $11,058.83 nat. median
$4,876
outlier · 2.3×
00597-0197-05
NDC 		idaruCIZUmab 2.5 G/ 50 Ml Inj Soln 1 $10,623.22 $10,623.22 $10,623.22 nat. median
$2,449
outlier · 4.3×
78804
CPT 		Nm Tumor Localization/Whole Body 2+ Days 1 $10,550.10 $10,550.10 $10,550.10 nat. median
$1,561
outlier · 6.8×
0636
RC 		1 $4,771.07 $21,419.13 $9,107.67 nat. median
$82
outlier · 111.6×
78266
CPT 		Nm Gastric Emptying Study W/small Bowel&colon Transit Multi Days 1 $8,651.08 $8,651.08 $8,651.08 nat. median
$662
outlier · 13.1×
81540
CPT 		81540 Oncology, Mrna, Gene Expression Profiling By Real0time Rt-pcr Of 92 Genes 1 $8,416.29 $8,416.29 $8,416.29 nat. median
$3,938
outlier · 2.1×
78075
CPT 		Nm Adrenal Imaging 1 $8,369.75 $8,369.75 $8,369.75 nat. median
$1,352
outlier · 6.2×
78227
CPT 		Nm Hida Scan With Intervention 1 $8,299.41 $8,299.41 $8,299.41 nat. median
$940
outlier · 8.8×
78452
CPT 		Nm Heart Muscle Spect Multiple 1 $8,088.41 $8,088.41 $8,088.41 nat. median
$1,822
outlier · 4.4×
44206-0437-10
NDC 		Immune Globulin (ivig) 10%, 10 G/100 Ml (Privigen) Inj Soln 1 $7,839.98 $7,839.98 $7,839.98 nat. median
$2,457
outlier · 3.2×
63833-0386-02
NDC 		Prothrombin Complex Concentrate (human) 500 Units (range) Inj Soln 1 $7,680.50 $7,680.50 $7,680.50 nat. median
$6,504
1.2× median
81519
CPT 		Oncotype Dx Breast Cancer Assay 1 $7,345.59 $7,345.59 $7,345.59 nat. median
$4,067
1.8× median
00517-0710-01
NDC 		Fomepizole 1.5 G/1.5 Ml Inj Soln 1 $7,210.42 $7,210.42 $7,210.42 nat. median
$3,540
outlier · 2.0×
78265
CPT 		Nm Gastric Emptying Study W/small Bowel Transit 1 $7,174.07 $7,174.07 $7,174.07 nat. median
$510
outlier · 14.1×
0037U
CPT 		Trgt Gen Seq DNA 324 Genes 1 $6,912.21 $6,912.21 $6,912.21 nat. median
$3,570
1.9× median
78630
CPT 		Nm Cisternography/Cerebrospinal 1 $6,259.73 $6,259.73 $6,259.73 nat. median
$803
outlier · 7.8×
70710-1478-01
NDC 		Fomepizole 1.5 G/1.5 Ml Inj Soln 1 $6,246.00 $6,246.00 $6,246.00 nat. median
$3,103
outlier · 2.0×
78650
CPT 		Nm Cerebrospinal Fluid Leakage Detection 1 $6,189.39 $6,189.39 $6,189.39 nat. median
$1,323
outlier · 4.7×
78278
CPT 		Nm Bleeding Scan-gi 1 $6,189.39 $6,189.39 $6,189.39 nat. median
$704
outlier · 8.8×
78195
CPT 		Nm Lymphatic Imaging 1 $6,119.06 $6,119.06 $6,119.06 nat. median
$825
outlier · 7.4×
78606
CPT 		Nm Brain Imaging Comp With Vascular Flow 1 $6,119.06 $6,119.06 $6,119.06 nat. median
$736
outlier · 8.3×
78071
CPT 		Nm Parathyroid Planar Imaging W/spect 1 $6,119.06 $6,119.06 $6,119.06 nat. median
$641
outlier · 9.5×
78290
CPT 		Nm Meckel's Scan 1 $6,119.06 $6,119.06 $6,119.06 nat. median
$645
outlier · 9.5×
78709
CPT 		Nm Kidney Imaging With Flow With + Without Pharm 1 $6,119.06 $6,119.06 $6,119.06 nat. median
$741
outlier · 8.3×
78315
CPT 		Nm Bone Three Phase Study 1 $6,119.06 $6,119.06 $6,119.06 nat. median
$786
outlier · 7.8×
78264
CPT 		Nm Gastric Emptying Study, Solid, Liquid Or Both 1 $6,119.06 $6,119.06 $6,119.06 nat. median
$716
outlier · 8.5×
78645
CPT 		Nm Cerebro Fluid Flow Shunt Evaluation 1 $6,119.06 $6,119.06 $6,119.06 nat. median
$698
outlier · 8.8×
A9572
HCPCS 		In-111 Octreoscan / 6mCi 1 $6,095.41 $6,095.41 $6,095.41 nat. median
$4,712
1.3× median
78226
CPT 		Nm Hida Scan Without Intervention 1 $6,048.73 $6,048.73 $6,048.73 nat. median
$752
outlier · 8.0×
78803
CPT 		Nm Abscess Imaging Spect 1 $5,978.39 $5,978.39 $5,978.39 nat. median
$1,394
outlier · 4.3×
70549
CPT 		Fwmc Mr Charges -> Fwmc MRA Neck W/wo Contrast 1 $5,773.28 $5,773.28 $5,773.28 nat. median
$1,063
outlier · 5.4×
78802
CPT 		Nm Abscess Imaging Whole Body 1 $5,767.39 $5,767.39 $5,767.39 nat. median
$1,332
outlier · 4.3×
78582
CPT 		Nm Vq Scan Complete 1 $5,767.39 $5,767.39 $5,767.39 nat. median
$854
outlier · 6.8×
70546
CPT 		Fwmc Mr Charges -> Fwmc MRA Head W/wo Contrast 1 $5,733.19 $5,733.19 $5,733.19 nat. median
$1,073
outlier · 5.3×
78451
CPT 		Nm Heart Muscle Spect Single 1 $5,626.72 $5,626.72 $5,626.72 nat. median
$1,550
outlier · 3.6×
81420
CPT 		Fetal Aneupoidy Genomic Sequence 1 $5,572.01 $5,572.01 $5,572.01 nat. median
$786
outlier · 7.1×
78018
CPT 		Nm Thyroid Ca Met Imaging-body 1 $5,556.39 $5,556.39 $5,556.39 nat. median
$788
outlier · 7.1×

Other procedures at this hospital

Browse this hospital's 3,171 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
             
00005-2000-02 NDC Pneumococcal 20-valent Conjugate Vaccine, 0.5 Ml Inj Susp 1 1 $1,176.16 $1,152.64 $1,176.16 $1,176.16 $1,176.16 2025-12-31
00005-2000-10 NDC Pneumococcal 20-valent Conjugate Vaccine, 0.5 Ml Inj Susp 1 1 $1,140.32 $1,117.51 $1,140.32 $1,140.32 $1,140.32 2025-12-31
00006-3822-10 NDC Caspofungin 50 Mg Inj Soln 1 1 $1,406.22 $1,378.10 $1,406.22 $1,406.22 $1,406.22 2025-12-31
00006-3823-10 NDC Caspofungin 70 Mg Inj Soln 1 1 $1,461.08 $1,431.86 $1,461.08 $1,461.08 $1,461.08 2025-12-31
00023-1145-01 NDC onabotulinumtoxinA 100 Units Inj Soln 1 1 $2,710.76 $2,656.54 $2,710.76 $2,710.76 $2,710.76 2025-12-31
00069-1311-10 NDC Epoetin Alfa-epbx 20,000 units/mL (esrd And On Dialysis) Inj Soln (mdv) 1 1 $918.58 $900.21 $918.58 $918.58 $918.58 2025-12-31
00143-9288-01 NDC Argatroban 250 Mg/2.5 Ml Inj Soln 1 1 $995.58 $975.67 $995.58 $995.58 $995.58 2025-12-31
00143-9564-01 NDC Phentolamine 5 Mg Inj Soln 1 1 $1,856.38 $1,819.25 $1,856.38 $1,856.38 $1,856.38 2025-12-31
00143-9564-10 NDC Phentolamine 5 Mg Inj Soln 1 1 $2,040.20 $1,999.40 $2,040.20 $2,040.20 $2,040.20 2025-12-31
00169-7065-15 NDC Glucagon Recombinant 1 Mg Inj 1 1 $1,281.26 $1,255.63 $1,281.26 $1,281.26 $1,281.26 2025-12-31
0037U CPT Trgt Gen Seq DNA 324 Genes 1 1 $6,912.21 $6,773.97 $6,912.21 $6,912.21 $6,912.21 2025-12-31
00409-1103-01 NDC Cisatracurium 200 Mg/20 Ml Inj Soln 1 1 $1,137.63 $1,114.88 $1,137.63 $1,137.63 $1,137.63 2025-12-31
00409-1140-01 NDC Argatroban 250 Mg/2.5 Ml Inj Soln 1 1 $1,131.32 $1,108.69 $1,131.32 $1,131.32 $1,131.32 2025-12-31
00409-3670-10 NDC Cisatracurium 200 Mg/20 Ml Inj Soln 1 1 $1,137.63 $1,114.88 $1,137.63 $1,137.63 $1,137.63 2025-12-31
00456-2700-10 NDC Ceftazidime-avibactam 2.5 G (2g-0.5g) Inj Soln 2 1 $1,688.40 $1,654.63 $1,647.22 $1,729.58 $1,688.40 2025-12-31
00469-6501-89 NDC Regadenoson 0.4 Mg/5 Ml Inj Soln 1 1 $1,073.31 $1,051.84 $1,073.31 $1,073.31 $1,073.31 2025-12-31
00517-0374-05 NDC Methylene Blue 50 Mg/10 Ml Inj Soln 1 1 $976.00 $956.48 $976.00 $976.00 $976.00 2025-12-31
00517-0381-05 NDC Methylene Blue 50 Mg/10 Ml Inj Soln 1 1 $976.00 $956.48 $976.00 $976.00 $976.00 2025-12-31
00517-0710-01 NDC Fomepizole 1.5 G/1.5 Ml Inj Soln 1 1 $7,210.42 $7,066.21 $7,210.42 $7,210.42 $7,210.42 2025-12-31
00548-5850-00 NDC Glucagon Recombinant 1 Mg Inj 1 1 $1,165.92 $1,142.60 $1,165.92 $1,165.92 $1,165.92 2025-12-31
00597-0197-05 NDC idaruCIZUmab 2.5 G/ 50 Ml Inj Soln 1 1 $10,623.22 $10,410.76 $10,623.22 $10,623.22 $10,623.22 2025-12-31
00703-2045-03 NDC Cisatracurium 200 Mg/20 Ml Inj Soln 1 1 $1,126.36 $1,103.83 $1,126.36 $1,126.36 $1,126.36 2025-12-31
00781-3182-73 NDC Fomepizole 1.5 G/1.5 Ml Inj Soln 1 1 $4,736.03 $4,641.31 $4,736.03 $4,736.03 $4,736.03 2025-12-31
00781-3182-84 NDC Fomepizole 1.5 G/1.5 Ml Inj Soln 1 1 $4,736.03 $4,641.31 $4,736.03 $4,736.03 $4,736.03 2025-12-31
00781-3204-70 NDC niCARdipine 25 Mg/ 10 Ml Inj Soln 1 1 $877.70 $860.15 $877.70 $877.70 $877.70 2025-12-31
00781-3204-95 NDC niCARdipine 25 Mg/ 10 Ml Inj Soln 1 1 $877.70 $860.15 $877.70 $877.70 $877.70 2025-12-31
0121 RC — 1 1 $1,437.92 $1,409.16 $1,437.92 $1,437.92 $1,437.92 2025-12-31
0123 RC — 1 1 $1,437.92 $1,409.16 $1,437.92 $1,437.92 $1,437.92 2025-12-31
0152U CPT Infectious Disease DNA Pcr Ngs 1 1 $3,820.29 $3,743.88 $3,820.29 $3,820.29 $3,820.29 2025-12-31
0202 RC — 1 1 $3,284.95 $3,219.25 $3,284.95 $3,284.95 $3,284.95 2025-12-31
0244U CPT 0244u Oncotype Map Pan-cancer Tissue Test 1 1 $5,451.83 $5,342.80 $5,451.83 $5,451.83 $5,451.83 2025-12-31
0278 RC — 813 1 $1,934.48 $1,895.79 $24.45 $59,666.31 $1,934.48 2025-12-31
0279 RC — 2 1 $4,575.60 $4,484.09 $213.75 $8,937.45 $4,575.60 2025-12-31
0300 RC — 1 1 $2,062.86 $2,021.60 $2,062.86 $2,062.86 $2,062.86 2025-12-31
0636 RC — 3 1 $9,107.67 $8,925.52 $4,771.07 $21,419.13 $9,107.67 2025-12-31
0710 RC — 1 1 $1,416.84 $1,388.50 $1,416.84 $1,416.84 $1,416.84 2025-12-31
08065-1830-85 NDC Sodium Hyaluronate 10 mg/mL, 0.85 Ml Oph Inj 1 1 $1,021.67 $1,001.24 $1,021.67 $1,021.67 $1,021.67 2025-12-31
08065-1831-50 NDC Chondroitin-hyaluronate 1.05 Ml Oph Inj Kit 1 1 $1,147.63 $1,124.68 $1,147.63 $1,147.63 $1,147.63 2025-12-31
10019-0670-10 NDC Pm Esmolol 2,500 Mg/ Ns 250 Ml IV 1 1 $1,947.40 $1,908.45 $1,947.40 $1,947.40 $1,947.40 2025-12-31
10122-0620-10 NDC Cangrelor 50 Mg Inj Soln 1 1 $4,168.99 $4,085.61 $4,168.99 $4,168.99 $4,168.99 2025-12-31
13533-0318-01 NDC Rabies Immune Glob, Human 300 Intl_Units/mL Inj Soln 1 1 $2,956.93 $2,897.79 $2,956.93 $2,956.93 $2,956.93 2025-12-31
13533-0318-05 NDC Rabies Immune Glob, Human 1,500 Intl_Units/5 Ml Inj Soln 1 1 $13,958.60 $13,679.43 $13,958.60 $13,958.60 $13,958.60 2025-12-31
13533-0634-02 NDC Tetanus Immune Globulin 250 units/mL Inj Soln 1 1 $2,316.85 $2,270.51 $2,316.85 $2,316.85 $2,316.85 2025-12-31
14789-0015-05 NDC Isoproterenol 1 Mg/5 Ml Inj Soln 1 1 $2,498.40 $2,448.43 $2,498.40 $2,498.40 $2,498.40 2025-12-31
16714-0892-01 NDC DAPTOmycin 500 Mg Inj 1 1 $1,719.77 $1,685.37 $1,719.77 $1,719.77 $1,719.77 2025-12-31
16729-0435-05 NDC DAPTOmycin 500 Mg Inj 1 1 $1,854.85 $1,817.75 $1,854.85 $1,854.85 $1,854.85 2025-12-31
16729-0477-31 NDC Regadenoson 0.4 Mg/5 Ml Inj Soln 1 1 $1,042.04 $1,021.20 $1,042.04 $1,042.04 $1,042.04 2025-12-31
24201-0400-02 NDC Calcitonin 400 Intl_Units/2 Ml (mdv) Inj Soln 1 1 $3,331.20 $3,264.58 $3,331.20 $3,331.20 $3,331.20 2025-12-31
31722-0102-10 NDC DAPTOmycin 500 Mg Inj 1 1 $1,854.85 $1,817.75 $1,854.85 $1,854.85 $1,854.85 2025-12-31
42023-0182-01 NDC Argatroban 250 Mg/2.5 Ml Inj Soln 1 1 $2,123.64 $2,081.17 $2,123.64 $2,123.64 $2,123.64 2025-12-31
42023-0182-89 NDC Argatroban 250 Mg/2.5 Ml Inj Soln 1 1 $2,123.64 $2,081.17 $2,123.64 $2,123.64 $2,123.64 2025-12-31
42023-0205-01 NDC Calcitonin 400 Intl_Units/2 Ml (mdv) Inj Soln 1 1 $3,331.20 $3,264.58 $3,331.20 $3,331.20 $3,331.20 2025-12-31
43598-0051-11 NDC Calcitonin 400 Intl_Units/2 Ml (mdv) Inj Soln 1 1 $11,081.86 $10,860.22 $11,081.86 $11,081.86 $11,081.86 2025-12-31
44206-0436-05 NDC Immune Globulin (ivig) 10%, 5 G/50 Ml (Privigen) Inj Soln 1 1 $3,919.99 $3,841.59 $3,919.99 $3,919.99 $3,919.99 2025-12-31
44206-0437-10 NDC Immune Globulin (ivig) 10%, 10 G/100 Ml (Privigen) Inj Soln 1 1 $7,839.98 $7,683.18 $7,839.98 $7,839.98 $7,839.98 2025-12-31
44206-0438-20 NDC Immune Globulin (ivig) 10%, 20 G/200 Ml (Privigen) Inj Soln 1 1 $15,679.96 $15,366.36 $15,679.96 $15,679.96 $15,679.96 2025-12-31
44206-0439-40 NDC Immune Globulin (ivig) 10%, 40 G/400 Ml (Privigen) Inj Soln 1 1 $31,359.92 $30,732.72 $31,359.92 $31,359.92 $31,359.92 2025-12-31
50242-0037-06 NDC Tenecteplase 50 Mg Inj Soln 1 1 $12,249.10 $12,004.12 $12,249.10 $12,249.10 $12,249.10 2025-12-31
50242-0044-13 NDC Alteplase 50 Mg Inj Soln 1 1 $18,322.36 $17,955.91 $18,322.36 $18,322.36 $18,322.36 2025-12-31
50242-0085-27 NDC Alteplase 100 Mg Inj Soln 1 1 $36,644.69 $35,911.80 $36,644.69 $36,644.69 $36,644.69 2025-12-31
50242-0120-01 NDC Tenecteplase 50 Mg Inj Soln 1 1 $28,007.73 $27,447.58 $28,007.73 $28,007.73 $28,007.73 2025-12-31
50242-0120-47 NDC Tenecteplase 50 Mg Inj Soln 1 1 $34,549.79 $33,858.79 $34,549.79 $34,549.79 $34,549.79 2025-12-31
50242-0137-01 NDC Tocilizumab 400 Mg/20 Ml Inj Soln 1 1 $11,058.83 $10,837.65 $11,058.83 $11,058.83 $11,058.83 2025-12-31
50242-0176-01 NDC Tenecteplase 50 Mg Inj Soln 1 1 $34,549.79 $33,858.79 $34,549.79 $34,549.79 $34,549.79 2025-12-31
50590 CPT Extracorporeal Shock Wave Lithotripsy 1 1 $4,912.93 $4,814.67 $4,912.93 $4,912.93 $4,912.93 2025-12-31
50632-0010-01 NDC Rabies Vaccine, Purified Chick Embryo 2.5 Int_Unit/mL Inj Soln 1 1 $1,809.71 $1,773.52 $1,809.71 $1,809.71 $1,809.71 2025-12-31
50633-0110-12 NDC Antivenin (crotalidae-snake Ovine) Polyvalent Inj 1 1 $13,316.47 $13,050.14 $13,316.47 $13,316.47 $13,316.47 2025-12-31
50633-0120-11 NDC Digoxin Immune Fab 40 Mg Inj Soln 1 1 $20,711.74 $20,297.51 $20,711.74 $20,711.74 $20,711.74 2025-12-31
53276-1010-02 NDC Collagen Hemostat Flour, 1 G 1 1 $1,006.30 $986.17 $1,006.30 $1,006.30 $1,006.30 2025-12-31
55150-0241-10 NDC Pm Argatroban 50 Mg/ NaCl 50 Ml IV 1 1 $1,014.97 $994.67 $1,014.97 $1,014.97 $1,014.97 2025-12-31
55150-0317-10 NDC Isoproterenol 1 Mg/5 Ml Inj Soln 1 1 $2,269.38 $2,223.99 $2,269.38 $2,269.38 $2,269.38 2025-12-31
58160-0964-12 NDC Rabies Vaccine, Purified Chick Embryo 2.5 Int_Unit/mL Inj Soln 1 1 $1,578.33 $1,546.76 $1,578.33 $1,578.33 $1,578.33 2025-12-31
60505-6229-04 NDC DAPTOmycin 500 Mg Inj 1 1 $1,854.85 $1,817.75 $1,854.85 $1,854.85 $1,854.85 2025-12-31
60793-0701-10 NDC Penicillin G Benzathine 1,200,000 Units/2 Ml Inj Susp 1 1 $1,536.67 $1,505.94 $1,536.67 $1,536.67 $1,536.67 2025-12-31
61958-2901-02 NDC Remdesivir 100 Mg Inj Soln 2 1 $2,404.40 $2,356.31 $2,165.28 $2,643.52 $2,404.40 2025-12-31
63323-0356-10 NDC Caspofungin 50 Mg Inj Soln 1 1 $1,403.27 $1,375.20 $1,403.27 $1,403.27 $1,403.27 2025-12-31
63323-0371-19 NDC DAPTOmycin 500 Mg Inj 1 1 $1,854.99 $1,817.89 $1,854.99 $1,854.99 $1,854.99 2025-12-31
63323-0418-20 NDC Cisatracurium 200 Mg/20 Ml Inj Soln 1 1 $1,126.36 $1,103.83 $1,126.36 $1,126.36 $1,126.36 2025-12-31
63323-0526-03 NDC Argatroban 250 Mg/2.5 Ml Inj Soln 1 1 $1,344.97 $1,318.07 $1,344.97 $1,344.97 $1,344.97 2025-12-31
63323-0582-82 NDC Glucagon Recombinant 1 Mg Inj 1 1 $1,165.09 $1,141.79 $1,165.09 $1,165.09 $1,165.09 2025-12-31
63323-0593-03 NDC Glucagon Recombinant 1 Mg Inj 1 1 $1,052.16 $1,031.12 $1,052.16 $1,052.16 $1,052.16 2025-12-31
63323-0596-13 NDC Glucagon Recombinant 1 Mg Inj 1 1 $1,052.16 $1,031.12 $1,052.16 $1,052.16 $1,052.16 2025-12-31
63323-0865-02 NDC Calcitonin 400 Intl_Units/2 Ml (mdv) Inj Soln 1 1 $3,331.20 $3,264.58 $3,331.20 $3,331.20 $3,331.20 2025-12-31
63833-0386-02 NDC Prothrombin Complex Concentrate (human) 500 Units (range) Inj Soln 1 1 $7,680.50 $7,526.89 $7,680.50 $7,680.50 $7,680.50 2025-12-31
63851-0501-02 NDC Rabies Vaccine, Purified Chick Embryo 2.5 Int_Unit/mL Inj Soln 1 1 $1,147.28 $1,124.33 $1,147.28 $1,147.28 $1,147.28 2025-12-31
67457-0211-02 NDC Fomepizole 1.5 G/1.5 Ml Inj Soln 1 1 $4,275.60 $4,190.09 $4,275.60 $4,275.60 $4,275.60 2025-12-31
67457-0212-02 NDC Argatroban 250 Mg/2.5 Ml Inj Soln 1 1 $2,123.64 $2,081.17 $2,123.64 $2,123.64 $2,123.64 2025-12-31
67457-0657-25 NDC Pm Esmolol 2,500 Mg/ Ns 250 Ml IV 1 1 $1,750.75 $1,715.74 $1,750.75 $1,750.75 $1,750.75 2025-12-31
67457-0675-02 NDC Calcitonin 400 Intl_Units/2 Ml (mdv) Inj Soln 1 1 $4,164.00 $4,080.72 $4,164.00 $4,164.00 $4,164.00 2025-12-31
68094-0101-20 NDC Phentolamine 5 Mg Inj Soln 1 1 $1,748.05 $1,713.09 $1,748.05 $1,748.05 $1,748.05 2025-12-31
68682-0433-05 NDC Isoproterenol 1 Mg/5 Ml Inj Soln 1 1 $2,040.36 $1,999.55 $2,040.36 $2,040.36 $2,040.36 2025-12-31
69097-0522-35 NDC Isoproterenol 1 Mg/5 Ml Inj Soln 1 1 $2,040.36 $1,999.55 $2,040.36 $2,040.36 $2,040.36 2025-12-31
70069-0151-10 NDC Cisatracurium 200 Mg/20 Ml Inj Soln 1 1 $1,126.36 $1,103.83 $1,126.36 $1,126.36 $1,126.36 2025-12-31
70100-0424-02 NDC Indocyanine Green 25 Mg Inj Kit 1 1 $883.76 $866.08 $883.76 $883.76 $883.76 2025-12-31
70100-0725-01 NDC Indocyanine Green 25 Mg Inj Kit 1 1 $883.76 $866.08 $883.76 $883.76 $883.76 2025-12-31
70121-1570-07 NDC Filgrastim-ayow 480 Mcg/0.8 Ml Inj Soln 1 1 $1,059.32 $1,038.13 $1,059.32 $1,059.32 $1,059.32 2025-12-31
70121-1605-07 NDC Isoproterenol 1 Mg/5 Ml Inj Soln 1 1 $1,468.43 $1,439.06 $1,468.43 $1,468.43 $1,468.43 2025-12-31
70336 CPT Fwmc Mr Charges -> Fwmc MRA Head With Contrast 1 1 $2,806.46 $2,750.33 $2,806.46 $2,806.46 $2,806.46 2025-12-31
70377-0093-91 NDC DAPTOmycin 500 Mg Inj 1 1 $1,852.98 $1,815.92 $1,852.98 $1,852.98 $1,852.98 2025-12-31
70540 CPT Fwmc Mr Charges -> Fwmc Mr Orbit Face Neck 1 1 $2,646.09 $2,593.16 $2,646.09 $2,646.09 $2,646.09 2025-12-31
70542 CPT Fwmc Mr Charges -> Fwmc MRI Orbit,Face,Neck With Contrast 1 1 $2,886.64 $2,828.91 $2,886.64 $2,886.64 $2,886.64 2025-12-31
70543 CPT Fwmc Mr Charges -> Fwmc MRI Orbit,Face,Neck W/wo Contrast 1 1 $3,488.02 $3,418.26 $3,488.02 $3,488.02 $3,488.02 2025-12-31
70544 CPT Fwmc Mr Charges -> Fwmc MRA Head Without Contrast 1 1 $3,728.58 $3,654.00 $3,728.58 $3,728.58 $3,728.58 2025-12-31
70546 CPT Fwmc Mr Charges -> Fwmc MRA Head W/wo Contrast 1 1 $5,733.19 $5,618.52 $5,733.19 $5,733.19 $5,733.19 2025-12-31
70547 CPT Fwmc Mr Charges -> Fwmc MRA Neck Without Contrast 1 1 $3,768.67 $3,693.29 $3,768.67 $3,768.67 $3,768.67 2025-12-31
70548 CPT Fwmc Mr Charges -> Fwmc MRA Neck With Contrast 1 1 $3,969.13 $3,889.75 $3,969.13 $3,969.13 $3,969.13 2025-12-31
70549 CPT Fwmc Mr Charges -> Fwmc MRA Neck W/wo Contrast 1 1 $5,773.28 $5,657.81 $5,773.28 $5,773.28 $5,773.28 2025-12-31
70551 CPT Fwmc Mr Charges -> Fwmc MRI Brain Without Contrast 1 1 $1,764.06 $1,728.78 $1,764.06 $1,764.06 $1,764.06 2025-12-31
70552 CPT Fwmc Mr Charges -> Fwmc MRI Brain With Contrast 1 1 $2,605.99 $2,553.87 $2,605.99 $2,605.99 $2,605.99 2025-12-31
70553 CPT Fwmc Mr Charges -> Fwmc MRI Brain W/wo Contrast 1 1 $2,966.82 $2,907.49 $2,966.82 $2,966.82 $2,966.82 2025-12-31
70710-1478-01 NDC Fomepizole 1.5 G/1.5 Ml Inj Soln 1 1 $6,246.00 $6,121.08 $6,246.00 $6,246.00 $6,246.00 2025-12-31
70710-1838-05 NDC Methylene Blue 50 Mg/10 Ml Inj Soln 1 1 $975.99 $956.47 $975.99 $975.99 $975.99 2025-12-31
70860-0107-10 NDC Caspofungin 70 Mg Inj Soln 1 1 $1,020.18 $999.78 $1,020.18 $1,020.18 $1,020.18 2025-12-31
71288-0713-21 NDC Cisatracurium 200 Mg/20 Ml Inj Soln 1 1 $957.72 $938.57 $957.72 $957.72 $957.72 2025-12-31
71550 CPT Fwmc Mr Charges -> Fwmc Mr Chest 1 1 $3,848.85 $3,771.88 $3,848.85 $3,848.85 $3,848.85 2025-12-31
71551 CPT Fwmc Mr Charges -> Fwmc MRI Chest With Contrast 1 1 $4,209.68 $4,125.49 $4,209.68 $4,209.68 $4,209.68 2025-12-31
71552 CPT Fwmc Mr Charges -> Fwmc MRI Chest W/wo Contrast 1 1 $5,252.08 $5,147.04 $5,252.08 $5,252.08 $5,252.08 2025-12-31
71555 CPT Fwmc Mr Charges -> Fwmc MRA Chest (Excl Myocard) W/wo Contrast 1 1 $3,488.02 $3,418.26 $3,488.02 $3,488.02 $3,488.02 2025-12-31
71839-0107-01 NDC DAPTOmycin 500 Mg Inj 1 1 $1,854.85 $1,817.75 $1,854.85 $1,854.85 $1,854.85 2025-12-31
72141 CPT Fwmc Mr Charges -> Fwmc MRI Cervical Spine Without Contrast 1 1 $1,683.87 $1,650.20 $1,683.87 $1,683.87 $1,683.87 2025-12-31
72142 CPT Fwmc Mr Charges -> Fwmc MRI Cervical Spine With Contrast 1 1 $2,646.09 $2,593.16 $2,646.09 $2,646.09 $2,646.09 2025-12-31
72146 CPT Fwmc Mr Charges -> Fwmc Mr Thoracic Spine 1 1 $1,683.87 $1,650.20 $1,683.87 $1,683.87 $1,683.87 2025-12-31
72147 CPT Fwmc Mr Charges -> Fwmc MRI Spinal Thoracic With Contrast 1 1 $2,646.09 $2,593.16 $2,646.09 $2,646.09 $2,646.09 2025-12-31
72148 CPT Fwmc Mr Charges -> Fwmc MRI Lumbar Without Contrast 1 1 $1,683.87 $1,650.20 $1,683.87 $1,683.87 $1,683.87 2025-12-31
72149 CPT Fwmc Mr Charges -> Fwmc MRI Spinal Lumbar With Contrast 1 1 $2,605.99 $2,553.87 $2,605.99 $2,605.99 $2,605.99 2025-12-31
72156 CPT Fwmc Mr Charges -> Fwmc MRI Spinal Canal W/wo Contrast 1 1 $2,966.82 $2,907.49 $2,966.82 $2,966.82 $2,966.82 2025-12-31
72157 CPT Fwmc Mr Charges -> Fwmc MRI Thoracic W/wo Contrast 1 1 $3,006.92 $2,946.78 $3,006.92 $3,006.92 $3,006.92 2025-12-31
72158 CPT Fwmc Mr Charges -> Fwmc MRI Lumbar W/wo Contrast 1 1 $2,966.82 $2,907.49 $2,966.82 $2,966.82 $2,966.82 2025-12-31
72159 CPT Fwmc Mr Charges -> Fwmc MRA Spinal Canal And Contents W/wo Contrast 1 1 $3,688.48 $3,614.71 $3,688.48 $3,688.48 $3,688.48 2025-12-31
72195 CPT Fwmc Mr Charges -> Fwmc MRI Pelvis Without Contrast 1 1 $3,407.84 $3,339.68 $3,407.84 $3,407.84 $3,407.84 2025-12-31
72196 CPT Fwmc Mr Charges -> Fwmc Mr Pelvis 1 1 $3,648.39 $3,575.42 $3,648.39 $3,648.39 $3,648.39 2025-12-31
72197 CPT Fwmc Mr Charges -> Fwmc MRI Pelvis W/wo Contrast 1 1 $4,410.14 $4,321.94 $4,410.14 $4,410.14 $4,410.14 2025-12-31
72198 CPT Fwmc Mr Charges -> Fwmc MRA Pelvis W/wo Contrast 1 1 $3,528.12 $3,457.55 $3,528.12 $3,528.12 $3,528.12 2025-12-31
72603-0152-01 NDC DAPTOmycin 500 Mg Inj 1 1 $1,719.77 $1,685.37 $1,719.77 $1,719.77 $1,719.77 2025-12-31
73218 CPT Fwmc Mr Charges -> Fwmc MRI Upper Ext Without Contrast Bilateral 3 1 $3,367.75 $3,300.39 $3,367.75 $3,367.75 $3,367.75 2025-12-31
73219 CPT Fwmc Mr Charges -> Fwmc MRI Upper Ext w/Contrast Bilateral 3 1 $3,608.30 $3,536.13 $3,608.30 $3,608.30 $3,608.30 2025-12-31
73220 CPT Fwmc Mr Charges -> Fwmc Mr Upper Ext Bilateral 3 1 $4,410.14 $4,321.94 $4,410.14 $4,410.14 $4,410.14 2025-12-31
73221 CPT Fwmc Mr Charges -> Fwmc Mr Any Joint Lower Ext Bilateral 3 1 $1,884.33 $1,846.65 $1,884.33 $1,884.33 $1,884.33 2025-12-31
73222 CPT Fwmc Mr Charges -> Fwmc MRI Joint Upper Ext With Contrast Left 2 1 $3,327.65 $3,261.10 $3,327.65 $3,327.65 $3,327.65 2025-12-31
73223 CPT Fwmc Mr Charges -> Fwmc MRI Joint Upper Ext W/wo Contrast Left 2 1 $4,089.41 $4,007.62 $4,089.41 $4,089.41 $4,089.41 2025-12-31
73225 CPT Fwmc Mr Charges -> Fwmc MRA Upper Ext W/wo Contrast Bilateral 3 1 $3,648.39 $3,575.42 $3,648.39 $3,648.39 $3,648.39 2025-12-31
73718 CPT Fwmc Mr Charges -> Fwmc MRI Lower Ext Without Contrast Left 2 1 $3,327.65 $3,261.10 $3,327.65 $3,327.65 $3,327.65 2025-12-31
73720 CPT Fwmc Mr Charges -> Fwmc Mr Lower Ext W/wo Contrast Left 2 1 $4,450.24 $4,361.23 $4,450.24 $4,450.24 $4,450.24 2025-12-31
73721 CPT Fwmc Mr Charges -> Fwmc Mr Any Joint Upper Ext Bilateral 3 1 $1,884.33 $1,846.65 $1,884.33 $1,884.33 $1,884.33 2025-12-31
73722 CPT Fwmc Mr Charges -> Fwmc MRI Joint Lower Ext Without Contrast Left 2 1 $3,367.75 $3,300.39 $3,367.75 $3,367.75 $3,367.75 2025-12-31
73723 CPT Fwmc Mr Charges -> Fwmc MRI Joint Lower Ext W/wo Contrast Left 2 1 $4,089.41 $4,007.62 $4,089.41 $4,089.41 $4,089.41 2025-12-31
73725 CPT Fwmc Mr Charges -> Fwmc MRA Lower Extremity W/wo Contrast 1 1 $3,488.02 $3,418.26 $3,488.02 $3,488.02 $3,488.02 2025-12-31
74181 CPT Fwmc Mr Charges -> Fwmc Mr Abdomen 1 1 $2,926.73 $2,868.20 $2,926.73 $2,926.73 $2,926.73 2025-12-31
74182 CPT Fwmc Mr Charges -> Fwmc MRI Abdomen With Contrast 1 1 $4,129.50 $4,046.91 $4,129.50 $4,129.50 $4,129.50 2025-12-31
74183 CPT Fwmc Mr Charges -> Fwmc MRI Abdomen W/wo Contrast 1 1 $4,450.24 $4,361.23 $4,450.24 $4,450.24 $4,450.24 2025-12-31
74185 CPT Fwmc Mr Charges -> Fwmc MRA Abdomen W/wo Contrast 1 1 $3,528.12 $3,457.55 $3,528.12 $3,528.12 $3,528.12 2025-12-31
74230 CPT Xr Modified Barium Swallow W/video 1 1 $1,037.52 $1,016.77 $1,037.52 $1,037.52 $1,037.52 2025-12-31
74246 CPT Xr Upper Gi With Small Bowel 1 1 $963.41 $944.14 $963.41 $963.41 $963.41 2025-12-31
74270 CPT Xr Barium Enema Complete 2 1 $1,185.73 $1,162.02 $1,185.73 $1,185.73 $1,185.73 2025-12-31
74280 CPT Xr Barium Enema With Air Complete 1 1 $1,704.49 $1,670.40 $1,704.49 $1,704.49 $1,704.49 2025-12-31
74283 CPT Xr Barium Enema Therapeutic 1 1 $1,111.63 $1,089.39 $1,111.63 $1,111.63 $1,111.63 2025-12-31
74410 CPT Xr Urography With Infusion Without Tomography 1 1 $889.30 $871.51 $889.30 $889.30 $889.30 2025-12-31
74415 CPT Xr Urography With Nephrotomography 1 1 $1,148.68 $1,125.71 $1,148.68 $1,148.68 $1,148.68 2025-12-31
75557 CPT Fwmc Mr Charges -> Fwmc MRI Cardiac Without Contrast 1 1 $2,285.26 $2,239.55 $2,285.26 $2,285.26 $2,285.26 2025-12-31
75561 CPT Fwmc Mr Charges -> Fwmc MRI Cardiac W/wo Contrast 1 1 $3,327.65 $3,261.10 $3,327.65 $3,327.65 $3,327.65 2025-12-31
76506 CPT US Neonatal Head 1 1 $889.30 $871.51 $889.30 $889.30 $889.30 2025-12-31
76536 CPT US Node Mapping 1 1 $926.35 $907.83 $926.35 $926.35 $926.35 2025-12-31
76700 CPT US Abdomen Complete 1 1 $852.25 $835.20 $852.25 $852.25 $852.25 2025-12-31
76776 CPT US Kidney Transplant Duplex 3 1 $1,259.84 $1,234.65 $1,259.84 $1,259.84 $1,259.84 2025-12-31
76805 CPT US OB/Pregnancy After 1st Tri (> 14 Wks) 1 1 $963.41 $944.14 $963.41 $963.41 $963.41 2025-12-31
76830 CPT US Transvaginal Non-OB 1 1 $926.35 $907.83 $926.35 $926.35 $926.35 2025-12-31
76881 CPT US Extremity Non-vascular Bilateral 4 1 $926.35 $907.83 $926.35 $926.35 $926.35 2025-12-31
76885 CPT US Hips Infant Dynamic 1 1 $1,148.68 $1,125.71 $1,148.68 $1,148.68 $1,148.68 2025-12-31
77046 CPT Fwmc Mr Charges -> Fwmc MRI Breast W/wo Contrast Left 2 1 $5,171.90 $5,068.46 $5,171.90 $5,171.90 $5,171.90 2025-12-31
77047 CPT Fwmc Mr Charges -> Fwmc MRI Breast W/wo Contrast Bilat 1 1 $5,131.80 $5,029.17 $5,131.80 $5,131.80 $5,131.80 2025-12-31
77084 CPT Fwmc Mr Charges -> Fwmc MRI Bone Marrow 1 1 $3,488.02 $3,418.26 $3,488.02 $3,488.02 $3,488.02 2025-12-31
78012 CPT Nm Thyroid Single Uptake 1 1 $1,477.01 $1,447.47 $1,477.01 $1,477.01 $1,477.01 2025-12-31
78013 CPT Nm Thyroid Imaging Only 1 1 $3,516.70 $3,446.37 $3,516.70 $3,516.70 $3,516.70 2025-12-31
78014 CPT Nm Thyroid Imaging With Uptake Multiple 1 1 $4,431.04 $4,342.42 $4,431.04 $4,431.04 $4,431.04 2025-12-31
78018 CPT Nm Thyroid Ca Met Imaging-body 1 1 $5,556.39 $5,445.26 $5,556.39 $5,556.39 $5,556.39 2025-12-31
78020 CPT Nm Thyroid Mets Uptake - Bill Only 1 1 $1,125.34 $1,102.84 $1,125.34 $1,125.34 $1,125.34 2025-12-31
78070 CPT Nm Parathyroid Study 1 1 $5,345.38 $5,238.48 $5,345.38 $5,345.38 $5,345.38 2025-12-31
78071 CPT Nm Parathyroid Planar Imaging W/spect 1 1 $6,119.06 $5,996.68 $6,119.06 $6,119.06 $6,119.06 2025-12-31
78075 CPT Nm Adrenal Imaging 1 1 $8,369.75 $8,202.35 $8,369.75 $8,369.75 $8,369.75 2025-12-31
78102 CPT Nm Bone Marrow Imaging Limited 1 1 $2,954.03 $2,894.95 $2,954.03 $2,954.03 $2,954.03 2025-12-31
78103 CPT Nm Bone Marrow Imaging Multiple Areas 1 1 $3,798.04 $3,722.08 $3,798.04 $3,798.04 $3,798.04 2025-12-31
78104 CPT Nm Bone Marrow Imaging Whole Body 1 1 $4,290.37 $4,204.57 $4,290.37 $4,290.37 $4,290.37 2025-12-31
78185 CPT Nm Spleen Imaging With Or Without Flow 1 1 $3,938.70 $3,859.93 $3,938.70 $3,938.70 $3,938.70 2025-12-31
78195 CPT Nm Lymphatic Imaging 1 1 $6,119.06 $5,996.68 $6,119.06 $6,119.06 $6,119.06 2025-12-31
78201 CPT Nm Liver Imaging Static Only 1 1 $3,446.37 $3,377.44 $3,446.37 $3,446.37 $3,446.37 2025-12-31
78215 CPT Nm Liver Spleen Scan 1 1 $3,516.70 $3,446.37 $3,516.70 $3,516.70 $3,516.70 2025-12-31
78216 CPT Nm Liver/Spleen Image With Flow 1 1 $2,039.69 $1,998.89 $2,039.69 $2,039.69 $2,039.69 2025-12-31
78226 CPT Nm Hida Scan Without Intervention 1 1 $6,048.73 $5,927.75 $6,048.73 $6,048.73 $6,048.73 2025-12-31
78227 CPT Nm Hida Scan With Intervention 1 1 $8,299.41 $8,133.43 $8,299.41 $8,299.41 $8,299.41 2025-12-31
78230 CPT Nm Salivary Gland Imaging 1 1 $3,094.70 $3,032.80 $3,094.70 $3,094.70 $3,094.70 2025-12-31
78231 CPT Nm Salivary Gland Imaging/Flow 1 1 $2,110.02 $2,067.82 $2,110.02 $2,110.02 $2,110.02 2025-12-31
78232 CPT Nm Salivary Gland Function 1 1 $1,617.68 $1,585.33 $1,617.68 $1,617.68 $1,617.68 2025-12-31
78262 CPT Nm Gastroesophageal Reflux Exam 1 1 $4,290.37 $4,204.57 $4,290.37 $4,290.37 $4,290.37 2025-12-31
78264 CPT Nm Gastric Emptying Study, Solid, Liquid Or Both 1 1 $6,119.06 $5,996.68 $6,119.06 $6,119.06 $6,119.06 2025-12-31
78265 CPT Nm Gastric Emptying Study W/small Bowel Transit 1 1 $7,174.07 $7,030.59 $7,174.07 $7,174.07 $7,174.07 2025-12-31
78266 CPT Nm Gastric Emptying Study W/small Bowel&colon Transit Multi Days 1 1 $8,651.08 $8,478.06 $8,651.08 $8,651.08 $8,651.08 2025-12-31
78278 CPT Nm Bleeding Scan-gi 1 1 $6,189.39 $6,065.61 $6,189.39 $6,189.39 $6,189.39 2025-12-31
78290 CPT Nm Meckel's Scan 1 1 $6,119.06 $5,996.68 $6,119.06 $6,119.06 $6,119.06 2025-12-31
78291 CPT Nm Peritoneal-venous Shunt Patency 1 1 $4,360.71 $4,273.49 $4,360.71 $4,360.71 $4,360.71 2025-12-31
78300 CPT Nm Bone Imaging Limited 1 1 $3,094.70 $3,032.80 $3,094.70 $3,094.70 $3,094.70 2025-12-31
78305 CPT Nm Bone Imaging Limited Multiple Areas 1 1 $3,938.70 $3,859.93 $3,938.70 $3,938.70 $3,938.70 2025-12-31
78306 CPT Nm Bone Imaging Whole Body 1 1 $4,290.37 $4,204.57 $4,290.37 $4,290.37 $4,290.37 2025-12-31
78315 CPT Nm Bone Three Phase Study 1 1 $6,119.06 $5,996.68 $6,119.06 $6,119.06 $6,119.06 2025-12-31
78451 CPT Nm Heart Muscle Spect Single 1 1 $5,626.72 $5,514.19 $5,626.72 $5,626.72 $5,626.72 2025-12-31
78452 CPT Nm Heart Muscle Spect Multiple 1 1 $8,088.41 $7,926.64 $8,088.41 $8,088.41 $8,088.41 2025-12-31
78469 CPT Nm Myo Infarct Spect 1 1 $3,727.70 $3,653.15 $3,727.70 $3,727.70 $3,727.70 2025-12-31
78472 CPT Nm Cardiac Blood Pool Gated Single 1 1 $3,727.70 $3,653.15 $3,727.70 $3,727.70 $3,727.70 2025-12-31
78483 CPT Nm Cardiac Blood Pool Multi Rest/Stress 1 1 $3,516.70 $3,446.37 $3,516.70 $3,516.70 $3,516.70 2025-12-31
78579 CPT Nm Lung Scan Vent Only 1 1 $3,305.70 $3,239.58 $3,305.70 $3,305.70 $3,305.70 2025-12-31
78580 CPT Nm Lung Perfusion Imaging 1 1 $4,149.71 $4,066.71 $4,149.71 $4,149.71 $4,149.71 2025-12-31
78582 CPT Nm Vq Scan Complete 1 1 $5,767.39 $5,652.04 $5,767.39 $5,767.39 $5,767.39 2025-12-31
78597 CPT Nm Quantitative Lung Perfusion Only 1 1 $3,446.37 $3,377.44 $3,446.37 $3,446.37 $3,446.37 2025-12-31
78598 CPT Nm Quantitative Lung Complete 1 1 $5,415.72 $5,307.40 $5,415.72 $5,415.72 $5,415.72 2025-12-31
78601 CPT Nm Brain Imaging Ltd Static With Vascular 1 1 $3,868.37 $3,791.00 $3,868.37 $3,868.37 $3,868.37 2025-12-31
78605 CPT Nm Brain Imaging Complete Study Static 1 1 $3,587.03 $3,515.29 $3,587.03 $3,587.03 $3,587.03 2025-12-31
78606 CPT Nm Brain Imaging Comp With Vascular Flow 1 1 $6,119.06 $5,996.68 $6,119.06 $6,119.06 $6,119.06 2025-12-31
78610 CPT Nm Brain Imaging Vascular Flow Only 1 1 $3,305.70 $3,239.58 $3,305.70 $3,305.70 $3,305.70 2025-12-31
78630 CPT Nm Cisternography/Cerebrospinal 1 1 $6,259.73 $6,134.53 $6,259.73 $6,259.73 $6,259.73 2025-12-31
78645 CPT Nm Cerebro Fluid Flow Shunt Evaluation 1 1 $6,119.06 $5,996.68 $6,119.06 $6,119.06 $6,119.06 2025-12-31
78650 CPT Nm Cerebrospinal Fluid Leakage Detection 1 1 $6,189.39 $6,065.61 $6,189.39 $6,189.39 $6,189.39 2025-12-31
78700 CPT Nm DMSA/Kidney Static Imaging 1 1 $3,094.70 $3,032.80 $3,094.70 $3,094.70 $3,094.70 2025-12-31
78701 CPT Nm Kidney Imaging With Flow 1 1 $3,868.37 $3,791.00 $3,868.37 $3,868.37 $3,868.37 2025-12-31
78707 CPT Nm Kidney Imaging With Flow Without Pharm 1 1 $3,798.04 $3,722.08 $3,798.04 $3,798.04 $3,798.04 2025-12-31
78708 CPT Nm Kidney Imaging With Flow With Pharm 1 1 $2,391.36 $2,343.53 $2,391.36 $2,391.36 $2,391.36 2025-12-31
78709 CPT Nm Kidney Imaging With Flow With + Without Pharm 1 1 $6,119.06 $5,996.68 $6,119.06 $6,119.06 $6,119.06 2025-12-31
78740 CPT Nm Ureteral Reflux Study 1 1 $3,938.70 $3,859.93 $3,938.70 $3,938.70 $3,938.70 2025-12-31
78761 CPT Nm Testicular Scan With Vascular Flow 1 1 $3,657.37 $3,584.22 $3,657.37 $3,657.37 $3,657.37 2025-12-31
78800 CPT Nm Abscess Imaging Limited Area 1 1 $3,235.36 $3,170.66 $3,235.36 $3,235.36 $3,235.36 2025-12-31
78801 CPT Nm Octreoscan 1 1 $4,571.71 $4,480.28 $4,571.71 $4,571.71 $4,571.71 2025-12-31
78802 CPT Nm Abscess Imaging Whole Body 1 1 $5,767.39 $5,652.04 $5,767.39 $5,767.39 $5,767.39 2025-12-31
78803 CPT Nm Abscess Imaging Spect 1 1 $5,978.39 $5,858.82 $5,978.39 $5,978.39 $5,978.39 2025-12-31
78804 CPT Nm Tumor Localization/Whole Body 2+ Days 1 1 $10,550.10 $10,339.10 $10,550.10 $10,550.10 $10,550.10 2025-12-31
78831 CPT Nm Octreo Scan Spect 1 1 $12,519.45 $12,269.07 $12,519.45 $12,519.45 $12,519.45 2025-12-31
79005 CPT Nm Radionuc Ablat Glnd/thyr 1 1 $984.68 $964.98 $984.68 $984.68 $984.68 2025-12-31
79101 CPT Nm Therapy IV Admin 1 1 $984.68 $964.98 $984.68 $984.68 $984.68 2025-12-31
79403 CPT Nm Rp/tx Radiolbld Monoclonal IV 1 1 $1,617.68 $1,585.33 $1,617.68 $1,617.68 $1,617.68 2025-12-31
81220 CPT Cystic Fibrosis Screen(XCYFIB) 6120010 1 1 $1,653.39 $1,620.33 $1,653.39 $1,653.39 $1,653.39 2025-12-31
81229 CPT Interrogation Of Genomic Regions, Etc 6220003 1 1 $4,319.22 $4,232.84 $4,319.22 $4,319.22 $4,319.22 2025-12-31
81270 CPT Jak2 V617F,Qual w/rfl(XJAKQ) 6120017 1 1 $1,252.79 $1,227.74 $1,252.79 $1,252.79 $1,252.79 2025-12-31
81272 CPT 81272 Kit Gene Analysis, Targeted Dequence Analysis 1 1 $1,343.84 $1,316.96 $1,343.84 $1,343.84 $1,343.84 2025-12-31
81314 CPT 81314 PDGFRa Mutation Analysis 1 1 $910.46 $892.25 $910.46 $910.46 $910.46 2025-12-31
81352 CPT 81352 Tp53 Mutation Analysis 1 1 $1,817.28 $1,780.93 $1,817.28 $1,817.28 $1,817.28 2025-12-31
81372 CPT Hla-a,b,c Class I Dna(xhlai) 6120015 1 1 $895.89 $877.97 $895.89 $895.89 $895.89 2025-12-31
81401 CPT Molecular Pathology Procedure, Level 2 (eg, 2-10) 1 1 $2,013.94 $1,973.66 $2,013.94 $2,013.94 $2,013.94 2025-12-31
81405 CPT Molecular Pathology Procedure, Level 6 1 1 $1,868.26 $1,830.90 $1,868.26 $1,868.26 $1,868.26 2025-12-31
81420 CPT Fetal Aneupoidy Genomic Sequence 1 1 $5,572.01 $5,460.57 $5,572.01 $5,572.01 $5,572.01 2025-12-31
81445 CPT 81445 Targeted Genomic Sequence Analysis Panel, Solid Organ Neoplasm 1 1 $863.12 $845.85 $863.12 $863.12 $863.12 2025-12-31
81455 CPT 81455 Targeted Genomic Sequence Analysis Panel, DNA Analysis 1 1 $4,344.71 $4,257.82 $4,344.71 $4,344.71 $4,344.71 2025-12-31
81511 CPT Alpha Fetoprotein Quad Screen Prof Quest 1 1 $1,118.04 $1,095.68 $1,118.04 $1,118.04 $1,118.04 2025-12-31
81519 CPT Oncotype Dx Breast Cancer Assay 1 1 $7,345.59 $7,198.68 $7,345.59 $7,345.59 $7,345.59 2025-12-31
81540 CPT 81540 Oncology, Mrna, Gene Expression Profiling By Real0time Rt-pcr Of 92 Genes 1 1 $8,416.29 $8,247.96 $8,416.29 $8,416.29 $8,416.29 2025-12-31
86362 CPT Myelin Oligodendrocyte Glycoprotein 1 1 $1,125.33 $1,102.82 $1,125.33 $1,125.33 $1,125.33 2025-12-31
87900 CPT HIV 1 Susceptibility 1 1 $1,238.23 $1,213.46 $1,238.23 $1,238.23 $1,238.23 2025-12-31
87901 CPT HIV 1 Genotyping Pr Rt Quest 1 1 $1,238.23 $1,213.46 $1,238.23 $1,238.23 $1,238.23 2025-12-31
87902 CPT Hepatitis C Genotyping Quest 1 1 $1,238.23 $1,213.46 $1,238.23 $1,238.23 $1,238.23 2025-12-31
88239 CPT Tissue Cult-tumor/neoplas Eval 6228239 1 1 $910.46 $892.25 $910.46 $910.46 $910.46 2025-12-31
88249 CPT Chromosome Analysis 100 6128250 1 1 $1,693.45 $1,659.59 $1,693.45 $1,693.45 $1,693.45 2025-12-31
88262 CPT Chromosome Analalysis Blood No Growth Quest 1 1 $1,165.39 $1,142.08 $1,165.39 $1,165.39 $1,165.39 2025-12-31
88263 CPT Mosaic Study Quest 1 1 $1,456.74 $1,427.60 $1,456.74 $1,456.74 $1,456.74 2025-12-31
88264 CPT Chromosome Analysis Bone Marrow Quest 1 1 1 $1,456.74 $1,427.60 $1,456.74 $1,456.74 $1,456.74 2025-12-31
88269 CPT Chromosome Analysis Amniotic Fluid Quest 1 1 1 $1,092.55 $1,070.70 $1,092.55 $1,092.55 $1,092.55 2025-12-31
88348 CPT Cp Electron Microscopy Lab6428348 1 1 $1,456.74 $1,427.60 $1,456.74 $1,456.74 $1,456.74 2025-12-31
88365 CPT Cp Tissue Situ Hybrid Inter&rpt Lab6428365 1 1 $1,165.39 $1,142.08 $1,165.39 $1,165.39 $1,165.39 2025-12-31
88380 CPT Microdisection Bio Ther 1 6420023 1 1 $1,565.99 $1,534.67 $1,565.99 $1,565.99 $1,565.99 2025-12-31
90935 CPT Ip Dialysis Hemo 1 1 $2,254.88 $2,209.78 $2,254.88 $2,254.88 $2,254.88 2025-12-31
90940 CPT US Hemodialysis Access Patency Study 1 1 $1,333.95 $1,307.27 $1,333.95 $1,333.95 $1,333.95 2025-12-31
91010 CPT Esophageal Motility Study Of Esophagus 1 1 $5,264.16 $5,158.88 $5,264.16 $5,264.16 $5,264.16 2025-12-31
92612 CPT Fees - 15 Minutes 1 1 $1,143.52 $1,120.65 $1,143.52 $1,143.52 $1,143.52 2025-12-31
93880 CPT US Carotid Duplex Bilateral 1 1 $1,704.49 $1,670.40 $1,704.49 $1,704.49 $1,704.49 2025-12-31
93886 CPT US Transcranial Doppler Complete 1 1 $2,408.52 $2,360.35 $2,408.52 $2,408.52 $2,408.52 2025-12-31
93923 CPT Transcutaneous O2 Tension M 2 1 1 $1,185.73 $1,162.02 $1,185.73 $1,185.73 $1,185.73 2025-12-31
93924 CPT US Pvr W/stress-lower Extremity 1 1 $1,519.22 $1,488.84 $1,519.22 $1,519.22 $1,519.22 2025-12-31
93925 CPT US Arterial Duplex Le Bilateral 1 1 $2,297.36 $2,251.41 $2,297.36 $2,297.36 $2,297.36 2025-12-31
93926 CPT US Arterial Duplex Le Left 2 1 $1,333.95 $1,307.27 $1,333.95 $1,333.95 $1,333.95 2025-12-31
93930 CPT US Arterial Duplex Ue Bilateral 1 1 $1,741.55 $1,706.72 $1,741.55 $1,741.55 $1,741.55 2025-12-31
93931 CPT US Arterial Duplex Ue Left 2 1 $1,074.57 $1,053.08 $1,074.57 $1,074.57 $1,074.57 2025-12-31
93970 CPT US Vein Mapping Bilateral 1 1 $1,704.49 $1,670.40 $1,704.49 $1,704.49 $1,704.49 2025-12-31
93971 CPT US Vein Mapping 3 1 $1,037.52 $1,016.77 $1,037.52 $1,037.52 $1,037.52 2025-12-31
93975 CPT US Art/Vein Abd/Pelvic Complete - Vas 1 1 $2,334.41 $2,287.73 $2,334.41 $2,334.41 $2,334.41 2025-12-31
93976 CPT US Abdomen Limited - Vascular 1 1 $1,296.90 $1,270.96 $1,296.90 $1,296.90 $1,296.90 2025-12-31
93978 CPT US Aorta Duplex Complete 1 1 $1,593.33 $1,561.46 $1,593.33 $1,593.33 $1,593.33 2025-12-31
93979 CPT US Aorta Duplex Limited 1 1 $1,000.46 $980.45 $1,000.46 $1,000.46 $1,000.46 2025-12-31
93990 CPT US Hemodialysis Access 1 1 $1,037.52 $1,016.77 $1,037.52 $1,037.52 $1,037.52 2025-12-31
94002 CPT Vent Mgmt Adult/Peds Chrg -> Initial 1 1 $1,829.88 $1,793.28 $1,829.88 $1,829.88 $1,829.88 2025-12-31
94003 CPT Vent Mgmt Adult/Peds Chrg -> Subsequent 1 1 $1,829.88 $1,793.28 $1,829.88 $1,829.88 $1,829.88 2025-12-31
94640 CPT Aerosol Sputum Induction Chrg -> Initial Treatment: Inpatient 2 1 $1,903.07 $1,865.01 $292.78 $3,513.36 $1,903.07 2025-12-31
94660 CPT Cpap /Day Chrg 1 1 $878.34 $860.77 $878.34 $878.34 $878.34 2025-12-31
95819 CPT EEG Awake And Asleep 1 1 $953.44 $934.37 $953.44 $953.44 $953.44 2025-12-31
A0428 HCPCS Ambulance Base Charge 1 1 $3,127.10 $3,064.56 $3,127.10 $3,127.10 $3,127.10 2025-12-31
A9521 HCPCS Tc-99m Ceretec / 25mCi 1 1 $2,085.41 $2,043.70 $2,085.41 $2,085.41 $2,085.41 2025-12-31
A9548 HCPCS In-111 Dtpa Cister / 0.5mCi 1 1 $2,874.47 $2,816.98 $2,874.47 $2,874.47 $2,874.47 2025-12-31
A9569 HCPCS Tc-99m Ceretec Wbc / Per Study 1 1 $2,127.19 $2,084.65 $2,127.19 $2,127.19 $2,127.19 2025-12-31
A9570 HCPCS In-111 Wbc / Per Study 1 1 $3,060.57 $2,999.36 $3,060.57 $3,060.57 $3,060.57 2025-12-31
A9572 HCPCS In-111 Octreoscan / 6mCi 1 1 $6,095.41 $5,973.50 $6,095.41 $6,095.41 $6,095.41 2025-12-31
G0257 HCPCS Dialysis Out-pt Emerg Basis 1 1 $2,254.88 $2,209.78 $2,254.88 $2,254.88 $2,254.88 2025-12-31
G0416 HCPCS Surgical Path Gross And Micro Ex For Prostate Biop Any Meth Any Number Spec 6420… 1 1 $874.04 $856.56 $874.04 $874.04 $874.04 2025-12-31
P9035 HCPCS Plate Pheres-leuko Reducd/unit 6816393 1 1 $1,820.92 $1,784.50 $1,820.92 $1,820.92 $1,820.92 2025-12-31
P9037 HCPCS Platelets Pheresis Lr Irr Each 6819037 1 1 $2,112.27 $2,070.02 $2,112.27 $2,112.27 $2,112.27 2025-12-31
P9052 HCPCS Platelets Hla-m L/r Unit 6822000 1 1 $2,276.15 $2,230.63 $2,276.15 $2,276.15 $2,276.15 2025-12-31
P9073 HCPCS Platelets, Pheresis, Pathogen Reduced, Each Unit. 1 1 $2,185.10 $2,141.40 $2,185.10 $2,185.10 $2,185.10 2025-12-31
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