Hospital

FOREST HEALTH MEDICAL CENTER

Ypsilanti, MI · CCN 230144 · Rates published

549 distinct procedures filed

8 distinct payers

6,948 rate rows

2026-02-26 last MRF observed

Data quality

6,938 of 6,948 rate rows are consumer-grade (99.9%)

10 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
exceeds 10× this hospital's gross charge — excluded from medians	5
per-diem day rate — not a per-procedure price	4
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	1

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

Source MRF file	https://www.fhmc-mi.com/sites/default/files/staff/383527511_forest-health-medical-center_standardcharges.csv
Found on page	www.fhmc-mi.com/standardcharges
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	8c9ee8484a85ecef… · 1,177,613 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
43659 OTHER	Revision Bypass Lap	3	$8,459.82	$74,652.77	$74,652.77	nat. median $6,315 outlier · 11.8×
43775 OTHER	Bariatric Sleeve Lap	2	$71,701.02	$71,701.02	$71,701.02	nat. median $3,755 outlier · 19.1×
43644 OTHER	Bariatric Bypass Lap Short	2	$71,701.02	$71,701.02	$71,701.02	nat. median $5,003 outlier · 14.3×
43645 OTHER	Bariatric Bypass Lap Long	2	$71,701.02	$71,701.02	$71,701.02	nat. median $6,377 outlier · 11.2×
15830\|21620 MS_DRG	Panni Vertical With Xyphoid Removal	1	$60,862.28	$60,862.28	$60,862.28	—
10005 MS_DRG	Abd Wnd Infection	1	$48,013.16	$48,013.16	$48,013.16	—
99222 MS_DRG	Med Malnutrition	1	$46,854.07	$46,854.07	$46,854.07	—
43659 MS_DRG	Revision Bypass Lap Wo Comp	7	$11,620.57	$84,116.73	$17,649.47	—
21620 OTHER	Remove Sternum Inpt Per Mcr	4	$671.56	$27,588.76	$15,845.61	nat. median $3,178 outlier · 5.0×
43644 MS_DRG	Bariatric Bypass Lap Short Wo Comp	7	$11,620.57	$84,116.73	$14,032.08	—
43645 MS_DRG	Bariatric Bypass Lap Long Wo Comp	7	$11,620.57	$84,116.73	$13,798.93	—
43775 MS_DRG	Bariatric Sleeve Lap Wo Comp	7	$11,269.37	$84,116.73	$13,798.93	—
43770 OTHER	Lap Place Gastr Adj Device	8	$10,411.22	$40,689.53	$12,952.30	nat. median $8,260 1.6× median
11005 MS_DRG	Abd Wnd Inf	1	$11,998.90	$11,998.90	$11,998.90	—
15730\|21620 MS_DRG	Panni W Sternum	1	$11,998.90	$11,998.90	$11,998.90	—
43281 OTHER	Lap Repair Paraesophageal Hernia	1	$10,411.22	$10,411.22	$10,411.22	nat. median $9,063 1.1× median
13105 OTHER	Debride Wound Infection	8	$7,800.00	$55,817.03	$9,972.83	nat. median $158 outlier · 63.0×
11005 OTHER	Debride Necrotic Wound Vac	7	$7,800.00	$66,062.58	$8,676.28	nat. median $1,611 outlier · 5.4×
15830\|21620 OTHER	Panni Vertical With Xyphoid Removal	6	$7,800.00	$60,862.28	$8,676.28	nat. median $8,676 1.0× median
43773 OTHER	Lap Replace Gastr Adj Device	8	$5,834.36	$40,689.53	$7,258.35	nat. median $5,469 1.3× median
58661 OTHER	Laparoscopy Remove Adnexa	8	$5,834.36	$21,208.59	$7,258.35	nat. median $6,059 1.2× median
47562 OTHER	Laparoscopic Cholecystectomy	8	$3,804.53	$46,292.16	$7,258.35	nat. median $5,844 1.2× median
58671 OTHER	Laparoscopy Tubal Block	8	$5,834.36	$21,208.59	$7,258.35	nat. median $5,336 1.4× median
15830 OTHER	Pannectulectomy Abdominoplasty	8	$2,652.38	$55,388.63	$6,770.19	nat. median $6,274 1.1× median
19318 OTHER	Breast Reduction Bilateral	8	$5,552.46	$59,741.26	$6,770.19	nat. median $6,403 1.1× median
19300 OTHER	Removal Breast Tissue Male	8	$3,829.28	$32,782.33	$4,763.90	nat. median $3,280 1.5× median
43774 OTHER	Lap Rmvl Gastr Adj All Parts	8	$3,804.53	$74,652.77	$4,733.10	nat. median $3,776 1.3× median
43772 OTHER	Lap Rmvl Gastr Adj Device	8	$3,804.53	$34,355.78	$4,733.10	nat. median $3,722 1.3× median
19120 OTHER	Removal Breast Growth	8	$3,829.28	$22,400.00	$4,641.88	nat. median $3,868 1.2× median
10180 CPT	I & D Complex Po Wound	8	$2,234.62	$4,293.08	$2,916.63	nat. median $2,867 1.0× median
43233 OTHER	Egd Balloon Dilatation	8	$1,896.99	$6,147.24	$2,359.99	nat. median $1,871 1.3× median
43250 OTHER	Egd Cautery Tumor Polyp	8	$1,896.99	$7,634.26	$2,359.99	nat. median $1,827 1.3× median
43245 OTHER	Egd Dilate Stricture	8	$1,896.99	$6,896.08	$2,359.99	nat. median $1,887 1.3× median
15823 OTHER	Revision Of Upper Eyelid Blepharoplasty	8	$1,829.23	$14,788.42	$2,275.69	nat. median $2,173 1.0× median
43251 CPT	Bar Egd W Rem Tum Les Hot Forceps	8	$1,896.99	$2,845.49	$2,261.95	nat. median $2,145 1.1× median
43250 CPT	Bar Egd W Polyp Tum Les Hot Bx	8	$1,896.99	$2,845.49	$2,261.95	nat. median $2,087 1.1× median
72295 CPT	Discography Lumbar X	8	$1,952.77	$2,929.16	$2,084.18	nat. median $2,005 1.0× median
72285 CPT	Discography Crv Thor Xray	8	$1,952.77	$2,929.16	$2,084.18	nat. median $1,956 1.1× median
10140 OTHER	I&d Hematoma Seroma	8	$1,620.24	$20,986.81	$2,015.69	nat. median $1,559 1.3× median
43245 CPT	Bar Endoscopy W Dil	8	$1,299.53	$2,845.49	$1,933.16	nat. median $2,226 0.9× median
15877\|15879 OTHER	Suction Assisted Lipectomy	7	$1,917.00	$4,444.62	$1,917.00	nat. median $1,917 1.0× median
15847 OTHER	Vertical Diastasis Recti Apo	8	$1,917.00	$8,889.03	$1,917.00	nat. median $3,011 0.6× median
19350 OTHER	Breast Reconstruction Unilateral	8	$1,917.00	$32,782.33	$1,917.00	nat. median $3,515 0.5× median
15877 \|15879 OTHER	Suction Assisted Lipectomy	1	$1,917.00	$1,917.00	$1,917.00	nat. median $1,917 1.0× median
19325 OTHER	Breast Augmentation	8	$1,917.00	$53,612.05	$1,917.00	nat. median $8,060 outlier · 0.2×
15832 OTHER	Excise Excessive Skin Thigh	8	$1,917.00	$53,612.05	$1,917.00	nat. median $2,712 0.7× median
15835 OTHER	Excise Excessive Skin Buttck	8	$1,917.00	$24,056.24	$1,917.00	nat. median $2,867 0.7× median
15836 OTHER	Excise Excessive Skin Arm	8	$1,917.00	$31,112.35	$1,917.00	nat. median $2,774 0.7× median
15839 OTHER	Excise Excess Skin & Tissue	8	$1,917.00	$22,223.11	$1,917.00	nat. median $2,744 0.7× median
19328 OTHER	Removal Breast Implant Unilateral	8	$1,917.00	$32,782.33	$1,917.00	nat. median $3,758 0.5× median

Other procedures at this hospital

Browse this hospital's 549 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

43659	OTHER	Revision Bypass Lap	3	3	$106,646.81	$106,646.81	$8,459.82	$74,652.77	$74,652.77	2026-02-26
43644	OTHER	Bariatric Bypass Lap Short	2	2	$102,430.03	$23,350.00 77% off	$71,701.02	$71,701.02	$71,701.02	2026-02-26
43645	OTHER	Bariatric Bypass Lap Long	2	2	$102,430.03	$102,430.01	$71,701.02	$71,701.02	$71,701.02	2026-02-26
43775	OTHER	Bariatric Sleeve Lap	2	2	$102,430.03	$22,250.00 78% off	$71,701.02	$71,701.02	$71,701.02	2026-02-26
15830\|21620	MS_DRG	Panni Vertical With Xyphoid Removal	1	1	$86,946.12	$86,946.12	$60,862.28	$60,862.28	$60,862.28	2026-02-26
10005	MS_DRG	Abd Wnd Infection	1	1	$68,590.23	$68,590.23	$48,013.16	$48,013.16	$48,013.16	2026-02-26
99222	MS_DRG	Med Malnutrition	1	1	$66,934.38	$66,934.38	$46,854.07	$46,854.07	$46,854.07	2026-02-26
43659	MS_DRG	Revision Bypass Lap Wo Comp	12	7	$120,166.75	$120,166.75	$11,620.57	$84,116.73	$17,649.47	2026-02-26
21620	OTHER	Remove Sternum Inpt Per Mcr	4	4	$39,412.52	$39,412.52	$671.56	$27,588.76	$15,845.61	2026-02-26
43644	MS_DRG	Bariatric Bypass Lap Short Wo Comp	13	7	$120,166.75	$23,350.00 81% off	$11,620.57	$84,116.73	$14,032.08	2026-02-26
43775	MS_DRG	Bariatric Sleeve Lap Wo Comp	12	7	$120,166.75	$22,250.00 81% off	$11,269.37	$84,116.73	$13,798.93	2026-02-26
43645	MS_DRG	Bariatric Bypass Lap Long Wo Comp	11	7	$120,166.75	$120,166.75	$11,620.57	$84,116.73	$13,798.93	2026-02-26
43770	OTHER	Lap Place Gastr Adj Device	8	8	$58,127.90	$58,127.90	$10,411.22	$40,689.53	$12,952.30	2026-02-26
15730\|21620	MS_DRG	Panni W Sternum	1	1	$79,095.64	$79,095.64	$11,998.90	$11,998.90	$11,998.90	2026-02-26
11005	MS_DRG	Abd Wnd Inf	1	1	$86,124.69	$86,124.69	$11,998.90	$11,998.90	$11,998.90	2026-02-26
43281	OTHER	Lap Repair Paraesophageal Hernia	1	1	$58,127.90	$58,127.90	$10,411.22	$10,411.22	$10,411.22	2026-02-26
13105	OTHER	Debride Wound Infection	8	8	$79,738.61	$79,738.61	$7,800.00	$55,817.03	$9,972.83	2026-02-26
11005	OTHER	Debride Necrotic Wound Vac	7	7	$94,375.11	$94,375.11	$7,800.00	$66,062.58	$8,676.28	2026-02-26
15830\|21620	OTHER	Panni Vertical With Xyphoid Removal	6	6	$86,946.12	$86,946.12	$7,800.00	$60,862.28	$8,676.28	2026-02-26
58671	OTHER	Laparoscopy Tubal Block	8	8	$30,297.99	$7,260.00 76% off	$5,834.36	$21,208.59	$7,258.35	2026-02-26
47562	OTHER	Laparoscopic Cholecystectomy	8	8	$66,131.66	$66,131.66	$3,804.53	$46,292.16	$7,258.35	2026-02-26
58661	OTHER	Laparoscopy Remove Adnexa	8	8	$30,297.99	$7,260.00 76% off	$5,834.36	$21,208.59	$7,258.35	2026-02-26
43773	OTHER	Lap Replace Gastr Adj Device	8	8	$58,127.90	$58,127.90	$5,834.36	$40,689.53	$7,258.35	2026-02-26
19318	OTHER	Breast Reduction Bilateral	8	8	$85,344.66	$85,344.66	$5,552.46	$59,741.26	$6,770.19	2026-02-26
15830	OTHER	Pannectulectomy Abdominoplasty	8	8	$79,126.61	$79,126.61	$2,652.38	$55,388.63	$6,770.19	2026-02-26
19300	OTHER	Removal Breast Tissue Male	8	8	$46,831.90	$46,831.90	$3,829.28	$32,782.33	$4,763.90	2026-02-26
43772	OTHER	Lap Rmvl Gastr Adj Device	8	8	$49,079.69	$49,079.69	$3,804.53	$34,355.78	$4,733.10	2026-02-26
43774	OTHER	Lap Rmvl Gastr Adj All Parts	8	8	$106,646.81	$106,646.81	$3,804.53	$74,652.77	$4,733.10	2026-02-26
19120	OTHER	Removal Breast Growth	8	8	$32,000.00	$32,000.00	$3,829.28	$22,400.00	$4,641.88	2026-02-26
10180	CPT	I & D Complex Po Wound	8	8	$3,192.32	$3,192.32	$2,234.62	$4,293.08	$2,916.63	2026-02-26
43245	OTHER	Egd Dilate Stricture	8	8	$9,851.54	$9,851.54	$1,896.99	$6,896.08	$2,359.99	2026-02-26
43233	OTHER	Egd Balloon Dilatation	8	8	$8,781.77	$1,200.00 86% off	$1,896.99	$6,147.24	$2,359.99	2026-02-26
43250	OTHER	Egd Cautery Tumor Polyp	8	8	$10,906.09	$10,906.09	$1,896.99	$7,634.26	$2,359.99	2026-02-26
15823	OTHER	Revision Of Upper Eyelid Blepharoplasty	8	8	$21,126.32	$21,126.32	$1,829.23	$14,788.42	$2,275.69	2026-02-26
43250	CPT	Bar Egd W Polyp Tum Les Hot Bx	8	8	$3,649.38	$3,649.38	$1,896.99	$2,845.49	$2,261.95	2026-02-26
43251	CPT	Bar Egd W Rem Tum Les Hot Forceps	8	8	$3,649.38	$3,649.38	$1,896.99	$2,845.49	$2,261.95	2026-02-26
72295	CPT	Discography Lumbar X	8	8	$3,058.72	$2,715.00	$1,952.77	$2,929.16	$2,084.18	2026-02-26
72285	CPT	Discography Crv Thor Xray	8	8	$3,058.72	$3,058.72	$1,952.77	$2,929.16	$2,084.18	2026-02-26
10140	OTHER	I&d Hematoma Seroma	8	8	$29,981.16	$29,981.16	$1,620.24	$20,986.81	$2,015.69	2026-02-26
43245	CPT	Bar Endoscopy W Dil	8	8	$1,856.47	$1,856.47	$1,299.53	$2,845.49	$1,933.16	2026-02-26
15877 \|15879	OTHER	Suction Assisted Lipectomy	1	1	$6,349.46	$6,349.46	$1,917.00	$1,917.00	$1,917.00	2026-02-26
15877\|15879	OTHER	Suction Assisted Lipectomy	7	7	$6,349.46	$6,349.46	$1,917.00	$4,444.62	$1,917.00	2026-02-26
15835	OTHER	Excise Excessive Skin Buttck	8	8	$34,366.05	$6,972.00 80% off	$1,917.00	$24,056.24	$1,917.00	2026-02-26
19325	OTHER	Breast Augmentation	8	8	$76,588.64	$6,219.00 92% off	$1,917.00	$53,612.05	$1,917.00	2026-02-26
19328	OTHER	Removal Breast Implant Unilateral	8	8	$46,831.90	$5,466.00 88% off	$1,917.00	$32,782.33	$1,917.00	2026-02-26
19350	OTHER	Breast Reconstruction Unilateral	8	8	$46,831.90	$5,466.00 88% off	$1,917.00	$32,782.33	$1,917.00	2026-02-26
15832	OTHER	Excise Excessive Skin Thigh	8	8	$76,588.64	$6,972.00 91% off	$1,917.00	$53,612.05	$1,917.00	2026-02-26
15839	OTHER	Excise Excess Skin & Tissue	8	8	$31,747.30	$31,747.30	$1,917.00	$22,223.11	$1,917.00	2026-02-26
15847	OTHER	Vertical Diastasis Recti Apo	8	8	$12,698.62	$1,917.00 85% off	$1,917.00	$8,889.03	$1,917.00	2026-02-26
15836	OTHER	Excise Excessive Skin Arm	8	8	$44,446.22	$6,972.00 84% off	$1,917.00	$31,112.35	$1,917.00	2026-02-26
14061	OTHER	Tis Trnfr E N E L10.1 30sqcm	8	8	$32,872.07	$32,872.07	$887.59	$23,010.45	$1,899.00	2026-02-26
11406	OTHER	Exc Benign Lesion Trk >4cm	8	8	$22,265.39	$22,265.39	$1,020.21	$15,585.77	$1,682.03	2026-02-26
10140	CPT	I & D Hematoma	8	8	$1,758.75	$1,758.75	$1,231.13	$2,430.36	$1,651.13	2026-02-26
36569	CPT	Picc Line Insertion	8	8	$1,708.65	$1,708.65	$1,196.06	$1,675.52	$1,608.25	2026-02-26
43239	CPT	Bar Endoscopy W Bx	8	8	$1,994.20	$1,994.20	$937.56	$1,406.34	$1,166.39	2026-02-26
43239	OTHER	Egd Biopsy	8	8	$9,022.65	$1,600.00 82% off	$937.56	$6,315.86	$1,166.39	2026-02-26
43247	CPT	Bar Endoscopy W Fb Rem	8	8	$1,994.20	$1,994.20	$937.56	$1,406.34	$1,166.39	2026-02-26
43235	OTHER	Egd Diagnostic	8	8	$8,781.77	$1,200.00 86% off	$937.56	$6,147.24	$1,166.39	2026-02-26
43235	CPT	Bar Endoscopy Diag	8	8	$1,313.07	$1,313.07	$919.15	$1,406.34	$955.44	2026-02-26
10007	CPT	Ndl Aspirate W Fluor Guide	8	8	$1,293.04	$1,293.04	$703.59	$1,055.39	$817.77	2026-02-26
11403	OTHER	Exc Benign Lesion Trk 2.1 3cm	8	8	$44,530.27	$44,530.27	$703.59	$31,171.19	$809.00	2026-02-26
94003	CPT	Ventilator Per Add Day	8	8	$425.39	$425.39	$297.77	$991.65	$673.70	2026-02-26
94002	CPT	Ventilator Setup	8	8	$469.65	$469.65	$328.76	$991.65	$673.70	2026-02-26
36556	CPT	IV Access W US Guide	10	8	$375.00	$375.00	$262.50	$3,267.55	$644.84	2026-02-26
11043	OTHER	Debride Musc Fas 1st 20cm	8	8	$44,032.15	$44,032.15	$579.32	$30,822.51	$635.47	2026-02-26
13101\|13102	OTHER	Cmplx Rpr Trunk 1.1 2.5 Cm	8	8	$64,678.66	$64,678.66	$579.32	$45,275.06	$635.47	2026-02-26
P9073	CPT	Transfus Pltlets Phere Per Un	8	8	$293.66	$293.66	$205.56	$880.92	$598.48	2026-02-26
12032	OTHER	Intmd Rpr S A T Ext 2.6 7.5	8	8	$9,756.26	$9,756.26	$399.53	$6,829.38	$507.03	2026-02-26
11042	OTHER	Debride Subq Tiss 1st 20cm	8	8	$46,505.42	$46,505.42	$399.53	$32,553.79	$507.03	2026-02-26
36430	CPT	Admin Bld Transfusion Per Day	10	8	$93.10	$93.10	$65.17	$920.91	$453.85	2026-02-26
73525	CPT	Hip Arthrography Bilateral	24	8	$764.85	$764.85	$357.13	$535.70	$444.30	2026-02-26
36593	CPT	Declot Picc Line W Activase	8	8	$683.65	$683.65	$331.69	$497.54	$411.45	2026-02-26
11042	CPT	Debridemnt Subq Less 20sq	8	8	$496.21	$496.21	$347.35	$599.30	$407.15	2026-02-26
10160	CPT	Punctre Asp Abs Hema Cyst	8	8	$502.19	$502.19	$351.53	$599.30	$407.15	2026-02-26
10120	CPT	Inc Rem Fb Subq Tissue Si	8	8	$509.11	$509.11	$356.38	$599.30	$407.15	2026-02-26
73580	CPT	Knee Arthrography Bilateral	24	8	$619.72	$619.72	$357.13	$535.70	$402.27	2026-02-26
73040	CPT	Shoulder Arthrography Bilateral	24	8	$597.94	$597.94	$357.13	$535.70	$394.65	2026-02-26
92950	CPT	Code Blue	8	8	$628.81	$628.81	$311.40	$467.10	$381.72	2026-02-26
86870	CPT	Ab Identification Ea Panel	8	8	$548.44	$548.44	$86.13	$539.58	$359.72	2026-02-26
86905	CPT	Phenotype	8	8	$548.44	$548.44	$56.91	$539.58	$359.72	2026-02-26
94375	CPT	Flow Meter Peak	8	8	$61.47	$61.47	$43.03	$467.10	$317.33	2026-02-26
94060	CPT	Pre & Post Bronchodilator	8	8	$240.53	$240.53	$168.37	$467.10	$317.33	2026-02-26
10060	CPT	Inc Asp Hematoma Cyst	8	8	$509.11	$509.11	$204.98	$1,020.21	$281.33	2026-02-26
96374	CPT	Ther Proph Inj Ivp	8	8	$467.95	$467.95	$210.69	$327.57	$262.11	2026-02-26
96360	CPT	Hydration Therapy Init	8	8	$467.95	$467.95	$210.69	$327.57	$262.11	2026-02-26
76000	CPT	Fluoroscopy	8	8	$312.58	$155.00 50% off	$218.81	$362.58	$250.94	2026-02-26
12001	CPT	Suture Rep Trunk Under 2.5	8	8	$361.72	$361.72	$198.70	$298.05	$229.74	2026-02-26
74240	CPT	Ugi	8	8	$469.25	$200.00 57% off	$178.02	$328.48	$221.47	2026-02-26
96366	CPT	Infusion Therapy Add Hr	8	8	$78.57	$78.57	$55.00	$316.04	$214.70	2026-02-26
96365	CPT	Infusion Therapy 1st Hr	8	8	$285.85	$285.85	$200.10	$316.04	$214.70	2026-02-26
94640	CPT	Deep Breathing Cough Ex	9	8	$133.33	$133.33	$93.33	$305.09	$211.15	2026-02-26
94664	CPT	Incentive Spiro Setup	9	8	$69.11	$69.11	$48.38	$305.09	$211.15	2026-02-26
94660	CPT	Pap Device Setup	8	8	$133.33	$133.33	$93.33	$305.09	$207.27	2026-02-26
P9016	CPT	Transfus Prc Per Unit	8	8	$293.66	$293.66	$182.00	$273.00	$197.25	2026-02-26
86886	CPT	Coombs Test Indir Titerea	8	8	$318.41	$318.41	$171.36	$257.04	$197.12	2026-02-26
73521	CPT	Hips 2v Bilat W Pelvis	8	8	$308.95	$140.00 55% off	$106.34	$250.94	$187.89	2026-02-26
86860	CPT	Antibody Elution Rbc Each	8	8	$289.46	$289.46	$171.36	$521.59	$186.99	2026-02-26
86885	CPT	Coombs Test Indirect	8	8	$289.46	$289.46	$171.36	$257.04	$186.99	2026-02-26
86920	CPT	Bb Crossmatch Per Unit	8	8	$289.46	$289.46	$171.36	$257.04	$186.99	2026-02-26
86927	CPT	Ffp Thaw	8	8	$289.46	$289.46	$171.36	$257.04	$186.99	2026-02-26
74250	CPT	Small Bowel Series	8	8	$123.31	$123.31	$86.32	$267.03	$181.42	2026-02-26
86890	CPT	Transfusion, Autologous	8	8	$317.12	$317.12	$171.36	$257.04	$179.13	2026-02-26
99204	OTHER	Pre Op Exam	1	1	$255.57	$255.57	$178.90	$178.90	$178.90	2026-02-26
88346	CPT	Epstein Barr Virus	8	8	$293.60	$293.60	$77.47	$257.04	$171.36	2026-02-26
86971	CPT	Pre Tre Rbc Incuba W Enzy	8	8	$548.44	$548.44	$14.96	$383.91	$171.36	2026-02-26
80050	CPT	Gen Hlth Cmp Cbc Tsh	3	3	$244.54	$244.54	$10.52	$171.18	$171.18	2026-02-26
94010	CPT	Simple Spiro Pft	8	8	$202.96	$202.96	$142.07	$234.69	$159.44	2026-02-26
36591	CPT	Bld Draw Imp Ven Access Dev	8	8	$249.29	$249.29	$128.90	$193.35	$154.16	2026-02-26
36592	CPT	Bld Draw Cent Peri Ven Cath	8	8	$246.29	$246.29	$128.90	$193.35	$153.11	2026-02-26
G0463	OTHER	Pre Op Exam	6	6	$255.57	$255.57	$128.87	$193.31	$133.78	2026-02-26
70200	CPT	Orbits Comp Mini 4 Views Lt	16	8	$275.00	$275.00	$106.34	$192.50	$132.30	2026-02-26
70150	CPT	Facial Bones Complete	8	8	$221.60	$221.60	$106.34	$159.51	$132.30	2026-02-26
72114	CPT	L Spine Complete 6 V Min	8	8	$355.24	$355.24	$106.34	$248.67	$132.30	2026-02-26
72072	CPT	T Spine 3 View	8	8	$311.20	$311.20	$106.34	$217.84	$132.30	2026-02-26
72052	CPT	C Spine 6 Or More Views	8	8	$320.73	$320.73	$106.34	$224.51	$132.30	2026-02-26
72050	CPT	C Spine 4 Or 5 Views	8	8	$308.95	$308.95	$106.34	$216.27	$132.30	2026-02-26
71111	CPT	Ribs Bilateral W Chest	16	8	$263.07	$263.07	$106.34	$184.15	$132.30	2026-02-26
71110	CPT	Ribs Bilateral 3 Views	8	8	$263.07	$263.07	$106.81	$184.15	$132.30	2026-02-26
71101	CPT	Ribs Unilateral W Chest Lt	16	8	$223.52	$223.52	$106.34	$159.51	$132.30	2026-02-26
72100	CPT	L Spine 2 Or 3 View	8	8	$223.92	$140.00 37% off	$106.34	$159.51	$132.30	2026-02-26
72110	CPT	L Spine 4 View Minimum	8	8	$263.02	$140.00 47% off	$106.34	$184.11	$132.30	2026-02-26
70260	CPT	Skull Complete	8	8	$311.20	$311.20	$106.34	$217.84	$132.30	2026-02-26
76770	CPT	US Kidney Retroperitoneal Complete	8	8	$560.61	$560.61	$106.34	$392.43	$132.30	2026-02-26
76705	CPT	US Single Organ Quadrant	8	8	$478.99	$140.00 71% off	$106.34	$335.29	$132.30	2026-02-26
76700	CPT	US Abdomen Complete	8	8	$968.00	$140.00 86% off	$106.34	$677.60	$132.30	2026-02-26
74022	CPT	Abdomen Ac Series	8	8	$400.54	$400.54	$106.34	$280.38	$132.30	2026-02-26
72202	CPT	Sacroiliac Joints Bilateral	24	8	$253.16	$140.00 45% off	$106.34	$177.21	$132.30	2026-02-26
73010	CPT	Scapula Bilateral	24	8	$250.00	$250.00	$106.34	$175.00	$132.30	2026-02-26
73564	CPT	Knee 4 View Lt	16	8	$223.92	$140.00 37% off	$106.34	$159.51	$132.30	2026-02-26
36600	CPT	Abg Stick	8	8	$106.61	$106.61	$74.63	$193.35	$131.36	2026-02-26
86900	CPT	Blood Typing Abo	8	8	$191.66	$191.66	$56.91	$193.35	$128.90	2026-02-26
72070	CPT	T Spine 2 View	8	8	$210.45	$140.00 33% off	$106.34	$159.51	$128.86	2026-02-26
77080	CPT	Dxa 1 Or More Sites	8	8	$531.40	$140.00 74% off	$106.34	$371.98	$121.24	2026-02-26
70250	CPT	Skull Pa Lateral	8	8	$187.20	$187.20	$106.34	$159.51	$120.72	2026-02-26
73120	CPT	Hand 2 Views Lt	12	6	$170.40	$170.40	$106.34	$159.51	$119.28	2026-02-26
72170	CPT	Pelvis 1 2 Views	8	8	$174.76	$174.76	$106.34	$159.51	$116.37	2026-02-26
G0480	CPT	Nicou Cotinine Conf Urine	6	6	$156.22	$156.22	$114.43	$171.65	$114.43	2026-02-26
74019	CPT	Abdomen 2 Views	8	8	$349.00	$349.00	$106.34	$244.30	$110.40	2026-02-26
72120	CPT	L Spine Bending 2 Or 3 V	8	8	$210.41	$140.00 33% off	$106.81	$154.19	$110.40	2026-02-26
72082	CPT	Scoliosis Study	8	8	$325.00	$325.00	$106.34	$227.50	$110.40	2026-02-26
76856	CPT	US Pelvic Non OB	8	8	$546.40	$546.40	$106.34	$382.48	$110.40	2026-02-26
73502	CPT	Hip W Pelvis Uni 2 3 Vws Lt	16	8	$196.98	$99.00 50% off	$88.05	$137.89	$109.53	2026-02-26
70030	CPT	Orbits Pre MRI	8	8	$289.37	$289.37	$88.05	$202.56	$109.53	2026-02-26
71045	CPT	Chest 1 View	8	8	$188.00	$188.00	$88.05	$132.08	$109.53	2026-02-26
71046	CPT	Chest 2 Views	8	8	$336.07	$99.00 71% off	$88.05	$235.25	$109.53	2026-02-26
71100	CPT	Ribs Uni 2 Views Lt	8	8	$263.07	$263.07	$88.05	$184.15	$109.53	2026-02-26
71120	CPT	Sternum	8	8	$250.00	$250.00	$88.05	$175.00	$109.53	2026-02-26
71130	CPT	Sternoclavicular Jt S 3 Vws Lt	16	8	$253.52	$253.52	$88.05	$177.46	$109.53	2026-02-26
72040	CPT	C Spine 2 Or 3 Views	8	8	$223.92	$99.00 56% off	$88.05	$156.74	$109.53	2026-02-26
72220	CPT	Coccyx Sacrum	8	8	$196.98	$99.00 50% off	$88.05	$137.89	$109.53	2026-02-26
73030	CPT	Shoulder 2 View Minimum Lt	16	8	$253.52	$99.00 61% off	$88.05	$177.46	$109.53	2026-02-26
73050	CPT	Ac Joints Bilateral Lt	16	8	$200.00	$200.00	$88.05	$140.00	$109.53	2026-02-26
73060	CPT	Humerus 2 View Lt	16	8	$185.43	$185.43	$88.05	$132.08	$109.53	2026-02-26
73080	CPT	Elbow Complete Lt	16	8	$195.30	$99.00 49% off	$88.05	$136.71	$109.53	2026-02-26
73110	CPT	Wrist Complete Lt	16	8	$185.43	$185.43	$88.05	$132.08	$109.53	2026-02-26
73562	CPT	Knee 3 View Lt	16	8	$186.89	$186.89	$88.05	$132.08	$109.53	2026-02-26
73590	CPT	Tib Fib 2 Views Lt	16	8	$184.61	$184.61	$88.05	$132.08	$109.53	2026-02-26
73630	CPT	Foot Complete Bilateral	24	8	$195.30	$195.30	$88.05	$261.65	$109.53	2026-02-26
77081	CPT	Dxa Radius Wrist	8	8	$526.13	$140.00 73% off	$88.05	$368.29	$109.53	2026-02-26
73130	CPT	Hand 3 Views Lt	16	8	$182.15	$182.15	$88.05	$132.08	$109.46	2026-02-26
73552	CPT	Femur 2 Or More Vws Lt	16	8	$182.15	$182.15	$88.05	$132.08	$109.46	2026-02-26
80323	CPT	Nicou Cotinine Conf Urine	2	2	$156.22	$156.22	$109.35	$109.35	$109.35	2026-02-26
73560	CPT	Knee 1 Or 2 Views Lt	16	8	$179.30	$179.30	$88.05	$132.08	$108.46	2026-02-26
70160	CPT	Nasal Bones	8	8	$177.60	$177.60	$88.05	$132.08	$107.86	2026-02-26
73600	CPT	Ankle 2 Views Lt	16	8	$174.76	$174.76	$88.05	$132.08	$106.87	2026-02-26
73070	CPT	Elbow 2 View Lt	16	8	$170.40	$170.40	$88.05	$132.08	$105.34	2026-02-26
73090	CPT	Forearm 2 View Lt	16	8	$170.40	$170.40	$88.05	$132.08	$105.34	2026-02-26
73000	CPT	Clavicle Lt	16	8	$170.40	$170.40	$88.05	$132.08	$105.34	2026-02-26
73501	CPT	Hip W Pelvis Uni 1 View Lt	16	8	$153.90	$153.90	$88.05	$132.08	$99.56	2026-02-26
72020	CPT	Spine 1v Specify Level	8	8	$132.76	$132.76	$88.05	$132.08	$92.17	2026-02-26
77086	CPT	Dxa Vertebral Fract Assess	8	8	$531.40	$140.00 74% off	$20.60	$371.98	$91.40	2026-02-26
70220	CPT	Paranasal Sinus Complete	7	7	$212.80	$212.80	$1.00	$148.96	$91.40	2026-02-26
73610	CPT	Ankle 3 Views Lt	16	8	$186.89	$186.89	$88.05	$130.82	$91.40	2026-02-26
73620	CPT	Foot 2v Lt	16	8	$170.40	$170.40	$88.05	$127.67	$91.40	2026-02-26
74018	CPT	Abdomen 1 View	8	8	$266.60	$266.60	$88.05	$186.62	$91.40	2026-02-26
73140	CPT	Finger 2 View Minimum Lt	16	8	$119.21	$119.21	$83.45	$132.08	$89.72	2026-02-26
73660	CPT	Toe S Lt	16	8	$116.23	$116.23	$81.36	$132.08	$89.72	2026-02-26
73650	CPT	Calcaneus 2 Views Lt	16	8	$126.17	$126.17	$88.05	$127.67	$88.61	2026-02-26
96372	CPT	Ther Proph Inj IM	8	8	$467.95	$467.95	$71.17	$327.57	$88.55	2026-02-26
P9012	CPT	Cryoprecipate Blood	8	8	$263.66	$263.66	$63.57	$184.56	$79.09	2026-02-26
87621	CPT	Hpv DNA Amp Probe	3	3	$109.36	$109.36	$74.40	$76.55	$76.55	2026-02-26
93005	CPT	EKG	8	8	$169.11	$169.11	$59.40	$118.38	$73.89	2026-02-26
51798	CPT	Bladder Scan Pre Post	8	8	$125.07	$125.07	$59.40	$89.10	$73.89	2026-02-26
96523	CPT	Irr Ven Access Dev	8	8	$122.45	$122.45	$59.40	$89.10	$73.69	2026-02-26
81241	CPT	5 Leiden	8	8	$150.88	$150.88	$12.48	$110.06	$73.37	2026-02-26
96367	CPT	Infusion Therapy Add Seq Hr	8	8	$78.57	$78.57	$55.00	$106.76	$72.53	2026-02-26
80307	CPT	Cotinine Screen Urine	9	8	$101.78	$101.78	$62.14	$93.21	$71.25	2026-02-26
87801	CPT	Detect Agent Mult DNA Amp	8	8	$218.72	$218.72	$23.97	$153.10	$70.20	2026-02-26
86850	CPT	Ab Scn Rbc Serum	12	8	$98.22	$98.22	$53.43	$248.47	$68.75	2026-02-26
88305	CPT	Gross & Micro Tiss Exm L4	8	8	$226.60	$226.60	$53.43	$248.47	$66.79	2026-02-26
86480	CPT	TB Gold Quqantiferon	8	8	$93.00	$93.00	$6.38	$92.97	$61.98	2026-02-26
86880	CPT	Coombs Test Direct	8	8	$64.24	$64.24	$44.97	$248.47	$59.40	2026-02-26
96361	CPT	IV Hydration Ther Add Hour	8	8	$94.70	$94.70	$46.14	$69.21	$57.09	2026-02-26
96375	CPT	Ther Proph Inj Ivp New Drug	8	8	$94.70	$94.70	$46.14	$69.21	$57.09	2026-02-26
88173	CPT	Cytopath Eval Fna Report	8	8	$80.98	$80.98	$38.58	$80.15	$53.43	2026-02-26
87635	CPT	Covid19 Agent Detection	8	8	$209.00	$209.00	$50.88	$146.30	$51.31	2026-02-26
84445	CPT	Thyroid Stim Immunoglobln	8	8	$465.75	$465.75	$20.56	$326.03	$50.86	2026-02-26
76937	CPT	US Vascular Access	2	2	$71.79	$71.79	$50.25	$50.25	$50.25	2026-02-26
83880	CPT	Natriuretic Peptide	8	8	$144.43	$144.43	$39.26	$101.10	$48.09	2026-02-26
86906	CPT	Rh Phenotype Complete	8	8	$80.63	$80.63	$39.25	$248.47	$47.84	2026-02-26
80074	CPT	Acute Hepatitis Panel	8	8	$132.07	$132.07	$12.26	$92.45	$47.63	2026-02-26
86769	CPT	Covid19 Igg Antibody	9	8	$92.69	$92.69	$18.68	$64.88	$42.13	2026-02-26
83970	CPT	Parathormone Lvl	8	8	$286.62	$286.62	$14.01	$200.63	$41.28	2026-02-26
82088	CPT	Aldosterone	12	8	$102.56	$102.56	$13.44	$71.79	$40.75	2026-02-26
94760	CPT	Pulse Oximetry Tx	2	2	$57.54	$57.54	$40.28	$40.28	$40.28	2026-02-26
87653	CPT	Streo B DNA Amp Probe	8	8	$109.36	$109.36	$35.09	$76.55	$39.31	2026-02-26
86901	CPT	Blood Typing Rh	8	8	$64.24	$64.24	$4.34	$58.88	$39.25	2026-02-26
85060	CPT	Wbc W Diff	3	3	$55.96	$55.96	$18.82	$39.17	$39.17	2026-02-26
J0897	OTHER	Prolia 60 Mg	8	8	$4,762.94	$1,510.00 68% off	$26.96	$3,334.06	$39.09	2026-02-26
82003	CPT	Acetaminophen Lvl	2	2	$55.67	$55.67	$38.97	$38.97	$38.97	2026-02-26
82652	CPT	Vitamin D Dihydroxy 1.25	8	8	$252.96	$252.96	$27.25	$177.07	$38.50	2026-02-26
82085	CPT	Aldolase	8	8	$54.64	$54.64	$9.71	$40.75	$38.25	2026-02-26
82803	CPT	Abg Analysis Chg	11	8	$178.67	$178.67	$25.56	$125.07	$37.80	2026-02-26
87797	CPT	Chlamydia DNA Probe	11	8	$53.09	$53.09	$30.03	$101.79	$37.16	2026-02-26
84238	CPT	Acetylcholine Recept Ab	8	8	$219.89	$219.89	$31.89	$153.92	$36.57	2026-02-26
82157	CPT	Assay Androstendione	8	8	$91.21	$91.21	$29.28	$63.85	$35.87	2026-02-26
84207	CPT	Vitamin B6 Lvl	8	8	$195.08	$195.08	$28.10	$136.56	$35.12	2026-02-26
82670	CPT	Assay Estradiol	8	8	$87.08	$87.08	$27.94	$60.96	$34.92	2026-02-26
84182	CPT	Protein Western Blot Test	8	8	$56.08	$56.08	$29.21	$43.82	$34.23	2026-02-26
87255	CPT	Genet Virus Isolate Hsv	8	8	$105.53	$105.53	$14.98	$73.87	$33.86	2026-02-26
87252	CPT	Viral Clt	8	8	$57.23	$57.23	$26.07	$49.10	$32.59	2026-02-26
82671	CPT	Estrogens Fractionated	8	8	$44.59	$44.59	$31.21	$48.45	$32.30	2026-02-26
86812	CPT	Hla B27 Gen Marker	8	8	$107.40	$107.40	$25.81	$77.47	$32.27	2026-02-26
86320	CPT	Immunoelectrophoresis	8	8	$70.98	$70.98	$29.92	$49.69	$31.73	2026-02-26
84402	CPT	Assay Testosterone	8	8	$79.35	$79.35	$25.47	$55.55	$31.45	2026-02-26
88175	CPT	Cytopath C V Auto Fluid	8	8	$82.39	$82.39	$26.61	$57.67	$31.06	2026-02-26
83916	CPT	Csf Oligoconal Band	8	8	$46.52	$46.52	$27.39	$41.09	$29.98	2026-02-26
82306	CPT	Calcifediol 25 Oh Vi	14	8	$207.66	$207.66	$7.48	$145.36	$29.60	2026-02-26
83088	CPT	Histamine	8	8	$46.52	$46.52	$25.98	$44.30	$29.53	2026-02-26
86160	CPT	C3 Complement	13	8	$95.15	$95.15	$12.00	$179.63	$29.46	2026-02-26
82626	CPT	Dehydroepiandrostero Dhea S	8	8	$52.89	$52.89	$25.27	$37.91	$28.75	2026-02-26
84255	CPT	Selenium Serum	8	8	$175.50	$175.50	$25.53	$122.85	$28.52	2026-02-26
84403	CPT	Testosterone Total	8	8	$113.36	$113.36	$25.81	$79.35	$28.30	2026-02-26
85245	CPT	Von Willebrnd Fctr Assa	8	8	$901.80	$901.80	$22.94	$631.26	$28.10	2026-02-26
87390	CPT	HIV 1 Antigen	8	8	$92.65	$92.65	$24.06	$64.86	$27.91	2026-02-26
82627	CPT	Dehydoepiandrosterone	8	8	$69.28	$69.28	$22.23	$55.83	$27.79	2026-02-26
86325	CPT	Immunoelectrophoresis Oth	8	8	$69.67	$69.67	$23.13	$48.77	$27.76	2026-02-26
84145	CPT	Procalcitonin	8	8	$122.49	$122.49	$27.22	$85.74	$27.66	2026-02-26
83498	CPT	17 Hydrxprogesterone	8	8	$21.32	$21.32	$14.92	$40.76	$27.17	2026-02-26
87391	CPT	HIV 2 Antigen	8	8	$92.65	$92.65	$21.90	$64.86	$26.83	2026-02-26
86361	CPT	Cd4	8	8	$76.54	$76.54	$21.10	$53.58	$26.78	2026-02-26
86337	CPT	Insulin Ab	8	8	$58.41	$58.41	$21.41	$40.89	$26.77	2026-02-26
83785	CPT	Manganese	8	8	$86.01	$86.01	$24.56	$60.21	$26.65	2026-02-26
86318	CPT	Covid Antigen Test	9	8	$48.71	$48.71	$18.09	$43.38	$26.23	2026-02-26
84144	CPT	Progesterone Lvl	8	8	$70.14	$70.14	$20.86	$49.10	$26.07	2026-02-26
P9047	CPT	Albumin Human IV Soln 25% 50 Ml	8	8	$211.48	$211.48	$21.23	$148.04	$26.01	2026-02-26
86316	CPT	Cancer Ag 125	12	8	$131.97	$131.97	$20.81	$131.51	$25.95	2026-02-26
84244	CPT	Renin Activity	8	8	$72.38	$72.38	$21.99	$50.67	$25.67	2026-02-26
86300	CPT	Alp Fetoprot Tumor Mark	8	8	$66.81	$66.81	$20.81	$46.77	$25.49	2026-02-26
86147	CPT	Cardiolipid	9	8	$222.30	$222.30	$11.70	$155.61	$25.45	2026-02-26
88142	CPT	Cytopath C V Thin Layer	8	8	$63.14	$63.14	$20.26	$77.47	$25.33	2026-02-26
84252	CPT	Vitamin B2 Lvl	8	8	$61.99	$61.99	$20.24	$43.39	$25.30	2026-02-26
85246	CPT	Von Willebrnd Fctr Ag	8	8	$130.12	$130.12	$22.94	$91.08	$25.27	2026-02-26
82384	CPT	Assay 3 Cathecholamines	8	8	$78.67	$78.67	$15.57	$55.07	$25.25	2026-02-26
85576	CPT	Platelet Function Test	8	8	$148.00	$148.00	$6.22	$103.60	$24.91	2026-02-26
87389	CPT	HIV 1 Antigen With HIV 1 & 2 Ab	7	7	$92.65	$92.65	$24.08	$64.86	$24.80	2026-02-26
87230	CPT	C Diff Toxin Assay Stool	8	8	$126.59	$126.59	$19.74	$88.61	$24.67	2026-02-26
88300	CPT	Surg Path Gross Exam Only	8	8	$24.55	$24.55	$17.19	$77.47	$24.49	2026-02-26
82677	CPT	Estriol Level	8	8	$89.48	$89.48	$24.18	$62.64	$24.27	2026-02-26
83918	CPT	Organic Acid Profile	8	8	$240.35	$240.35	$9.58	$168.25	$23.60	2026-02-26
82668	CPT	Erythropoietin Lvl	8	8	$43.44	$43.44	$18.79	$40.51	$23.49	2026-02-26
84146	CPT	Prolactin Lvl	8	8	$92.07	$92.07	$19.38	$64.45	$23.02	2026-02-26
83001	CPT	Follicle Stim Hormone	8	8	$68.36	$68.36	$18.58	$47.85	$22.71	2026-02-26
84153	CPT	Prostate Specific Ag	8	8	$78.88	$78.88	$18.39	$55.22	$22.53	2026-02-26
85250	CPT	Factor Ix Assay	8	8	$55.82	$55.82	$19.04	$39.07	$22.50	2026-02-26
86334	CPT	Imminofix Electro S	8	8	$121.50	$121.50	$22.34	$85.05	$22.48	2026-02-26
85240	CPT	Factor Viii Assay	8	8	$44.65	$44.65	$17.90	$33.26	$22.38	2026-02-26
85270	CPT	Factor Xi Assay	8	8	$128.76	$128.76	$17.90	$90.13	$22.38	2026-02-26
84166	CPT	Protein E Phoresis Urine	8	8	$55.57	$55.57	$17.83	$42.35	$22.29	2026-02-26
80170	CPT	Gentamicin Lvl Peak	9	8	$62.62	$62.62	$16.38	$43.83	$22.04	2026-02-26
85230	CPT	Factor Vii Assay	8	8	$87.55	$87.55	$17.90	$61.29	$21.93	2026-02-26
85260	CPT	Factor X Assay	8	8	$44.20	$44.20	$17.90	$30.94	$21.93	2026-02-26
85220	CPT	Factor V Leiden	8	8	$58.39	$58.39	$17.65	$40.87	$21.80	2026-02-26
84270	CPT	Assay Sex Hormone Globul	8	8	$61.47	$61.47	$6.97	$43.03	$21.73	2026-02-26
85280	CPT	Factor Xii Assay	8	8	$128.76	$128.76	$19.35	$90.13	$21.52	2026-02-26
83002	CPT	Luteinizing Hormone	8	8	$59.85	$59.85	$18.52	$41.90	$21.34	2026-02-26
84681	CPT	C Peptide	8	8	$95.57	$95.57	$20.81	$66.90	$21.31	2026-02-26
84425	CPT	Vitamin B1 Lvl	8	8	$147.46	$147.46	$16.86	$103.22	$21.23	2026-02-26
84443	CPT	Tsh	8	8	$123.00	$123.00	$16.80	$86.10	$21.00	2026-02-26
82710	CPT	Fecal Fat Quant	8	8	$75.15	$75.15	$16.80	$52.61	$21.00	2026-02-26
82985	CPT	Fructosamine	8	8	$97.21	$97.21	$16.76	$68.05	$20.95	2026-02-26
86304	CPT	Immunoassay Tumor Ca125	8	8	$64.86	$64.86	$7.51	$45.40	$20.81	2026-02-26
82139	CPT	Amno Acid Scn	8	8	$249.07	$249.07	$16.87	$174.35	$20.66	2026-02-26
86162	CPT	Ch50	8	8	$171.45	$171.45	$18.78	$120.02	$20.32	2026-02-26
80200	CPT	Tobramycin Lvl Peak	9	8	$62.62	$62.62	$16.13	$43.83	$20.31	2026-02-26
86689	CPT	Htlv HIV Confirm Test	8	8	$60.30	$60.30	$19.35	$42.21	$20.11	2026-02-26
82131	CPT	Methymalonic Acid	8	8	$215.70	$215.70	$16.77	$150.99	$19.93	2026-02-26
84481	CPT	T3 Free	8	8	$43.75	$43.75	$16.94	$30.63	$19.90	2026-02-26
80202	CPT	Vancomycin Lvl Peak	9	8	$94.32	$94.32	$13.54	$66.02	$19.63	2026-02-26
86696	CPT	Herpes Simplex Test 2	8	8	$60.30	$60.30	$19.35	$42.21	$19.62	2026-02-26
87110	CPT	Chlamydia Clt	8	8	$53.19	$53.19	$15.66	$37.23	$19.60	2026-02-26
86336	CPT	Inhibin A	8	8	$48.55	$48.55	$15.59	$33.99	$19.49	2026-02-26
86200	CPT	Ccp Antibody	11	8	$40.35	$40.35	$12.95	$66.46	$19.43	2026-02-26
80061	CPT	Lipid Panel	7	7	$120.00	$120.00	$13.39	$84.00	$19.40	2026-02-26
86617	CPT	Lyme Disease Antibody	8	8	$48.27	$48.27	$15.49	$33.79	$19.36	2026-02-26
82725	CPT	Fatty Acid Free	8	8	$121.42	$121.42	$18.77	$84.99	$19.27	2026-02-26
87109	CPT	Mycoplasma	8	8	$47.94	$47.94	$15.39	$33.56	$19.24	2026-02-26
82378	CPT	Carcinoembryonic Ag	8	8	$68.20	$68.20	$13.37	$47.74	$18.96	2026-02-26
80305	CPT	Drug Scrn Qual Sngl Class	13	8	$202.40	$202.40	$12.60	$141.68	$18.90	2026-02-26
82607	CPT	Vitamin B12 Lvl	8	8	$118.48	$118.48	$15.08	$82.94	$18.85	2026-02-26

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