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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

TRINITY HEALTH GRAND HAVEN HOSPITAL

Grand Haven, MI · CCN 230174 · Rates published

882 distinct procedures filed
32 distinct payers
6,345 rate rows
2025-11-21 last MRF observed
Data quality

5,997 of 6,345 rate rows are consumer-grade (94.5%)

348 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
professional (physician) fee — not the facility price 328
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 9
exceeds 10× this hospital's gross charge — excluded from medians 8
placeholder amount (≤ $0.02) — excluded from medians 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://machine-readable-files.com/trinity-health-grand-haven/383330803_Trinity-Health-Grand-Haven-Hospital_standardcharges.csv
Found on page https://www.trinityhealthmichigan.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-01
Content fingerprint 78b54e2083f39d8b… · 3,859,667 bytes · first seen 2026-05-17

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
55874
CPT 		Transperineal Plmt Bio Matrl 2 $4,492.41 $4,494.91 $4,493.66 nat. median
$5,654
0.8× median
10180
CPT 		I&d Complex Post-op Wnd Infect 1 $2,754.60 $2,754.60 $2,754.60 nat. median
$2,862
1.0× median
V2787
HCPCS 		Toric Lens Sn60t3 21.0 1 $2,410.00 $2,410.00 $2,410.00 nat. median
$583
outlier · 4.1×
10004
CDM 		ICU 6 $901.75 $4,710.00 $2,244.09 nat. median
$782
outlier · 2.9×
15275
CPT 		App Skn Sub F H F Frst 25 Scm 3 $980.47 $1,888.26 $1,768.94 nat. median
$1,713
1.0× median
15271
CPT 		App Skn Sub T A L Frst 25 Scm 4 $379.67 $1,842.76 $1,763.83 nat. median
$1,725
1.0× median
10140
CPT 		I&d Hematoma Seroma 1 $1,567.07 $1,567.07 $1,567.07 nat. median
$1,660
0.9× median
70546
CPT 		MRA Angio Head W Wo Contrast 1 $1,561.06 $1,561.06 $1,561.06 nat. median
$1,073
1.5× median
70470
CPT 		CT Head W Wo Contrast 5 $95.42 $3,371.00 $1,502.46 nat. median
$629
outlier · 2.4×
36569
CPT 		Picc Line Midline Placement 5 1 $1,491.59 $1,491.59 $1,491.59 nat. median
$1,726
0.9× median
73220
CPT 		MRI Upper Ext W Wo Contrast 1 $1,436.12 $1,436.12 $1,436.12 nat. median
$1,136
1.3× median
19083
CPT 		Sc US Perc Ndle Core Biopsy 6 $868.45 $1,598.01 $1,410.98 nat. median
$2,147
0.7× median
78816
CPT 		PET With CT Whole Body 11 $1,401.09 $1,873.94 $1,407.02 nat. median
$2,793
0.5× median
78815
CPT 		PET W CT Skull Base To Midthig 23 $781.80 $3,857.00 $1,406.23 nat. median
$2,822
outlier · 0.5×
72157
CPT 		MRI Thoracic Sp W Wo Contrast 5 $343.61 $1,436.12 $1,396.14 nat. median
$1,114
1.3× median
70549
CPT 		MRA Angio Neck W Wo Contrast 1 $1,307.29 $1,307.29 $1,307.29 nat. median
$1,063
1.2× median
73222
CPT 		MRI Upper Joint With Contrast 4 $1,144.01 $1,337.13 $1,290.41 nat. median
$1,282
1.0× median
10011
CDM 		Fb Semi Private 17 $561.27 $5,460.00 $1,237.87 nat. median
$0
10001
CDM 		Semi Private 17 $561.27 $5,460.00 $1,237.87 nat. median
$159
outlier · 7.8×
10012
CDM 		ICU Intermediate Care 17 $561.27 $5,460.00 $1,237.87 nat. median
$0
10013
CDM 		Med Surg Intermediate Care 17 $561.27 $5,460.00 $1,237.87 nat. median
$44
outlier · 27.8×
10005
CDM 		ICU Floor Care 17 $561.27 $5,460.00 $1,237.87 nat. median
$1,365
0.9× median
78452
CPT 		Nm Tomo Myo R S Multi 14 $351.64 $1,617.45 $1,237.03 nat. median
$1,822
0.7× median
73722
CPT 		MRI Lower Joint With Contrast 3 $1,052.45 $1,221.96 $1,221.95 nat. median
$1,282
1.0× median
95805
CPT 		Mslt Or Mwt 2 $1,213.51 $1,213.51 $1,213.51 nat. median
$1,233
1.0× median
72133
CPT 		CT Lumbar W Wo Contrast 1 $1,087.38 $1,087.38 $1,087.38 nat. median
$637
1.7× median
72197
CPT 		MRI Pelvis W O And W Contrast 4 $344.31 $1,561.06 $987.02 nat. median
$1,074
0.9× median
77049
CPT 		MRI Breast Bil W Wo Contrast 2 $293.00 $1,680.54 $986.77 nat. median
$976
1.0× median
C1776
HCPCS 		Implant Femoral Head 32mm 5 $128.58 $4,815.00 $981.77 nat. median
$3,390
outlier · 0.3×
95811
CPT 		Split Night Polysonography 12 $544.91 $1,905.86 $977.63 nat. median
$1,894
0.5× median
70544
CPT 		MRA Angio Head Wo 2 $964.63 $990.60 $977.62 nat. median
$829
1.2× median
73223
CPT 		MRI Upper Joint W Wo Contrast 2 $336.67 $1,561.06 $948.87 nat. median
$1,158
0.8× median
95810
CPT 		Polysomnography 4 Or More 15 $522.07 $1,455.47 $908.99 nat. median
$1,827
outlier · 0.5×
49082
CPT 		Puncture Peritoneal Cavity 1 $903.03 $903.03 $903.03 nat. median
$1,057
0.9× median
74175
CPT 		CT Angio Abdomen W Wo 4 $267.15 $951.40 $897.25 nat. median
$718
1.2× median
73720
CPT 		MRI Lower Ext No Joint W Wo Co 4 $200.43 $1,561.06 $889.11 nat. median
$1,135
0.8× median
C8929
HCPCS 		Echocardiogram W Contrast 4 $417.30 $1,344.81 $879.60 nat. median
$1,358
0.6× median
A0434
HCPCS 		Specialty Care Transport 11 $290.00 $1,391.00 $849.86 nat. median
$1,267
0.7× median
11044
CPT 		Dbrdmt Bone First 20 Scm 1 $844.98 $844.98 $844.98 nat. median
$1,752
outlier · 0.5×
72191
CPT 		CT Angio Pelvis W Wo Contrast 1 $843.11 $843.11 $843.11 nat. median
$640
1.3× median
72194
CPT 		CT Pelvis W Wo Contrast 3 $162.62 $1,065.81 $838.39 nat. median
$672
1.2× median
70543
CPT 		MRI Orbit W Wo Contrast 5 $200.43 $1,568.47 $830.15 nat. median
$1,087
0.8× median
99291
CPT 		Crit Care E M; 30 74 Min 9 $451.64 $1,142.63 $809.06 nat. median
$1,530
0.5× median
73201
CPT 		CT Upper Extr W Contrast 3 $333.67 $878.25 $787.60 nat. median
$805
1.0× median
62304
CPT 		Myelo Lumbar Spine 2 $764.10 $765.60 $764.85 nat. median
$1,285
0.6× median
C8923
HCPCS 		Echocardiogram W Contrast 9 $758.60 $1,292.91 $761.60 nat. median
$1,052
0.7× median
A0433
HCPCS 		Als Emergency Level 2 12 $409.40 $790.88 $712.55 nat. median
$1,091
0.7× median
A9596
HCPCS 		Nm Rad Gallium 68 10 $467.85 $977.05 $666.75 nat. median
$1,434
outlier · 0.5×
70488
CPT 		CT Facial W Wo Contrast 2 $162.67 $1,163.34 $663.00 nat. median
$639
1.0× median
49083
CPT 		US Guided Paracentesis 2 $502.53 $792.29 $647.41 nat. median
$1,222
0.5× median

Other procedures at this hospital

Browse this hospital's 882 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
55874 CPT Transperineal Plmt Bio Matrl 2 2 $6,010.00 $6,010.00 $4,492.41 $4,494.91 $4,493.66 2025-11-21
10180 CPT I&d Complex Post-op Wnd Infect 1 1 $3,607.00 $3,607.00 $2,754.60 $2,754.60 $2,754.60 2025-11-21
V2787 HCPCS Toric Lens Sn60t3 21.0 1 1 $1,529.00 $1,529.00 $2,410.00 $2,410.00 $2,410.00 2025-11-21
10004 CDM ICU 6 6 $4,710.00 $4,710.00 $901.75 $4,710.00 $2,244.09 2025-11-21
15275 CPT App Skn Sub F H F Frst 25 Scm 3 3 $4,027.00 $4,027.00 $980.47 $1,888.26 $1,768.94 2025-11-21
15271 CPT App Skn Sub T A L Frst 25 Scm 4 4 $4,027.00 $4,027.00 $379.67 $1,842.76 $1,763.83 2025-11-21
10140 CPT I&d Hematoma Seroma 1 1 $2,583.00 $2,583.00 $1,567.07 $1,567.07 $1,567.07 2025-11-21
70546 CPT MRA Angio Head W Wo Contrast 1 1 $2,787.00 $2,787.00 $1,561.06 $1,561.06 $1,561.06 2025-11-21
70470 CPT CT Head W Wo Contrast 5 5 $1,770.00 $1,770.00 $95.42 $3,371.00 $1,502.46 2025-11-21
36569 CPT Picc Line Midline Placement 5 1 1 $1,967.00 $1,967.00 $1,491.59 $1,491.59 $1,491.59 2025-11-21
73220 CPT MRI Upper Ext W Wo Contrast 1 1 $2,955.00 $2,955.00 $1,436.12 $1,436.12 $1,436.12 2025-11-21
19083 CPT Sc US Perc Ndle Core Biopsy 6 6 $1,704.00 $1,704.00 $868.45 $1,598.01 $1,410.98 2025-11-21
78816 CPT PET With CT Whole Body 11 11 $3,857.00 $3,857.00 $1,401.09 $1,873.94 $1,407.02 2025-11-21
78815 CPT PET W CT Skull Base To Midthig 23 23 $3,857.00 $3,857.00 $781.80 $3,857.00 $1,406.23 2025-11-21
72157 CPT MRI Thoracic Sp W Wo Contrast 5 5 $3,051.00 $3,051.00 $343.61 $1,436.12 $1,396.14 2025-11-21
70549 CPT MRA Angio Neck W Wo Contrast 1 1 $2,719.00 $2,719.00 $1,307.29 $1,307.29 $1,307.29 2025-11-21
73222 CPT MRI Upper Joint With Contrast 4 4 $2,862.00 $2,862.00 $1,144.01 $1,337.13 $1,290.41 2025-11-21
10011 CDM Fb Semi Private 17 17 $1,502.00 $1,502.00 $561.27 $5,460.00 $1,237.87 2025-11-21
10005 CDM ICU Floor Care 17 17 $1,502.00 $1,502.00 $561.27 $5,460.00 $1,237.87 2025-11-21
10001 CDM Semi Private 17 17 $1,502.00 $1,502.00 $561.27 $5,460.00 $1,237.87 2025-11-21
10012 CDM ICU Intermediate Care 17 17 $2,234.00 $2,234.00 $561.27 $5,460.00 $1,237.87 2025-11-21
10013 CDM Med Surg Intermediate Care 17 17 $2,234.00 $2,234.00 $561.27 $5,460.00 $1,237.87 2025-11-21
78452 CPT Nm Tomo Myo R S Multi 14 14 $3,462.00 $3,462.00 $351.64 $1,617.45 $1,237.03 2025-11-21
73722 CPT MRI Lower Joint With Contrast 3 3 $2,710.00 $2,710.00 $1,052.45 $1,221.96 $1,221.95 2025-11-21
95805 CPT Mslt Or Mwt 2 2 $2,692.00 $2,692.00 $1,213.51 $1,213.51 $1,213.51 2025-11-21
72133 CPT CT Lumbar W Wo Contrast 1 1 $1,881.00 $1,881.00 $1,087.38 $1,087.38 $1,087.38 2025-11-21
72197 CPT MRI Pelvis W O And W Contrast 4 4 $2,983.00 $2,983.00 $344.31 $1,561.06 $987.02 2025-11-21
77049 CPT MRI Breast Bil W Wo Contrast 2 2 $2,735.00 $2,735.00 $293.00 $1,680.54 $986.77 2025-11-21
C1776 HCPCS Implant Femoral Head 32mm 5 5 $1,272.00 $1,272.00 $128.58 $4,815.00 $981.77 2025-11-21
95811 CPT Split Night Polysonography 12 12 $3,229.00 $3,229.00 $544.91 $1,905.86 $977.63 2025-11-21
70544 CPT MRA Angio Head Wo 2 2 $2,108.00 $2,108.00 $964.63 $990.60 $977.62 2025-11-21
73223 CPT MRI Upper Joint W Wo Contrast 2 2 $3,423.00 $3,423.00 $336.67 $1,561.06 $948.87 2025-11-21
95810 CPT Polysomnography 4 Or More 15 15 $3,229.00 $3,229.00 $522.07 $1,455.47 $908.99 2025-11-21
49082 CPT Puncture Peritoneal Cavity 1 1 $845.00 $845.00 $903.03 $903.03 $903.03 2025-11-21
74175 CPT CT Angio Abdomen W Wo 4 4 $2,137.00 $2,137.00 $267.15 $951.40 $897.25 2025-11-21
73720 CPT MRI Lower Ext No Joint W Wo Co 4 4 $3,183.00 $3,183.00 $200.43 $1,561.06 $889.11 2025-11-21
C8929 HCPCS Echocardiogram W Contrast 4 4 $2,151.00 $2,151.00 $417.30 $1,344.81 $879.60 2025-11-21
A0434 HCPCS Specialty Care Transport 11 11 $1,391.00 $1,391.00 $290.00 $1,391.00 $849.86 2025-11-21
11044 CPT Dbrdmt Bone First 20 Scm 1 1 $1,490.00 $1,490.00 $844.98 $844.98 $844.98 2025-11-21
72191 CPT CT Angio Pelvis W Wo Contrast 1 1 $1,710.00 $1,710.00 $843.11 $843.11 $843.11 2025-11-21
72194 CPT CT Pelvis W Wo Contrast 3 3 $1,872.00 $1,872.00 $162.62 $1,065.81 $838.39 2025-11-21
70543 CPT MRI Orbit W Wo Contrast 5 5 $2,934.00 $2,934.00 $200.43 $1,568.47 $830.15 2025-11-21
99291 CPT Crit Care E M; 30 74 Min 9 9 $2,497.00 $2,497.00 $451.64 $1,142.63 $809.06 2025-11-21
73201 CPT CT Upper Extr W Contrast 3 3 $1,480.00 $1,480.00 $333.67 $878.25 $787.60 2025-11-21
62304 CPT Myelo Lumbar Spine 2 2 $1,640.00 $1,640.00 $764.10 $765.60 $764.85 2025-11-21
C8923 HCPCS Echocardiogram W Contrast 9 9 $2,151.00 $2,151.00 $758.60 $1,292.91 $761.60 2025-11-21
A0433 HCPCS Als Emergency Level 2 12 12 $1,231.00 $1,231.00 $409.40 $790.88 $712.55 2025-11-21
A9596 HCPCS Nm Rad Gallium 68 10 10 $1,240.00 $1,240.00 $467.85 $977.05 $666.75 2025-11-21
70488 CPT CT Facial W Wo Contrast 2 2 $1,685.00 $1,685.00 $162.67 $1,163.34 $663.00 2025-11-21
49083 CPT US Guided Paracentesis 2 2 $1,877.00 $1,877.00 $502.53 $792.29 $647.41 2025-11-21
92960 CPT Cardioversion 9 9 $1,357.00 $1,357.00 $566.98 $1,009.11 $630.83 2025-11-21
10005 CPT US Sc Bx Thyroid 9 9 $1,100.00 $1,100.00 $377.12 $689.36 $614.94 2025-11-21
73702 CPT CT Lower Extr W Wo Contrast 2 2 $1,848.00 $1,848.00 $160.56 $1,044.24 $602.40 2025-11-21
32555 CPT US Guided Thoracentesis 1 1 $758.00 $758.00 $600.14 $600.14 $600.14 2025-11-21
0042T OTHER Cerebral Blood Flow 1 1 $1,315.00 $1,315.00 $592.69 $592.69 $592.69 2025-11-21
99285 CPT ER Hosp Fee Level 5 28 28 $1,990.00 $1,990.00 $45.86 $1,105.20 $591.14 2025-11-21
11106 CPT Incisional Bx Single 2 2 $413.00 $413.00 $587.75 $590.15 $588.95 2025-11-21
P9073 HCPCS Platelet Pheresis-path Reduced 4 4 $2,097.00 $2,097.00 $540.26 $678.95 $577.03 2025-11-21
32551 CPT Thoracostomy (sep Proc) 1 1 $1,211.00 $1,211.00 $545.80 $545.80 $545.80 2025-11-21
11043 CPT Dbrdmt Muscle First 20 Scm 4 4 $620.00 $620.00 $327.32 $547.13 $544.91 2025-11-21
78315 CPT Nm 3-phrase Bone Scan 2 2 $1,343.00 $1,343.00 $386.23 $673.95 $530.09 2025-11-21
93306 CPT Echocardiogram Complete 24 24 $2,101.00 $2,101.00 $287.52 $2,020.00 $529.54 2025-11-21
78227 CPT Nm Hepatolbiliary Scan 6 6 $1,751.00 $1,751.00 $288.51 $686.00 $522.02 2025-11-21
70220 CPT Sinuses 3+ Views 1 1 $814.00 $814.00 $511.11 $511.11 $511.11 2025-11-21
A0427 HCPCS Als Emergency Level 1 23 23 $1,043.00 $1,043.00 $275.00 $652.08 $498.87 2025-11-21
70553 CPT MRI Brain W Wo Contrast 20 20 $3,155.00 $3,155.00 $191.42 $1,561.06 $486.22 2025-11-21
70460 CPT CT Head W Contrast 2 2 $1,521.00 $1,521.00 $95.42 $869.12 $482.27 2025-11-21
75571 CPT CTA Coronary Arteries W Score 2 2 $1,967.00 $1,967.00 $419.67 $521.11 $470.39 2025-11-21
C1781 HCPCS Implant Permacol 101828 4 4 $14,890.00 $14,890.00 $99.88 $2,521.60 $466.19 2025-11-21
70498 CPT CT Angio Neck W Wo Contrast 8 8 $1,908.00 $1,908.00 $95.42 $843.11 $455.53 2025-11-21
62270 CPT Lumbar Puncture 4 4 $1,023.00 $1,023.00 $371.19 $667.15 $425.38 2025-11-21
78701 CPT Nm Renal Scan Flow 1 1 $834.00 $834.00 $422.01 $422.01 $422.01 2025-11-21
C1713 HCPCS Stryker Lock Screw 3.5 X 30mm 7 7 $502.00 $502.00 $144.04 $1,830.68 $421.75 2025-11-21
72129 CPT CT Thoracic Spine W Contrast 1 1 $1,654.00 $1,654.00 $419.29 $419.29 $419.29 2025-11-21
70496 CPT CT Angio Head W And Wo Contras 11 11 $1,884.00 $1,884.00 $195.49 $899.35 $417.79 2025-11-21
A0429 HCPCS Bls Emergency 19 19 $766.00 $766.00 $222.61 $478.90 $414.58 2025-11-21
99284 CPT ER Hosp Fee Level 4 28 28 $1,166.00 $1,166.00 $44.92 $748.56 $411.37 2025-11-21
71260 CPT CT Thorax W Contrast 20 20 $1,701.00 $1,701.00 $95.42 $972.03 $404.56 2025-11-21
87507 CPT Gi Pathogen Panel Pcr 2 2 $400.00 $400.00 $400.00 $408.44 $404.22 2025-11-21
74740 CPT Hysterosalpingography 2 2 $526.00 $526.00 $281.34 $526.00 $403.67 2025-11-21
78306 CPT Nm Bone Scan Wb 7 7 $1,283.00 $1,283.00 $215.38 $673.95 $391.10 2025-11-21
58340 CPT Sc Inj Proc Hysterosalpingogra 2 2 $762.00 $762.00 $245.23 $520.44 $382.84 2025-11-21
36430 CPT Admin Of Blood Products 12 12 $873.00 $873.00 $226.24 $419.77 $376.64 2025-11-21
99292 CPT Crit Care E M; Add 30 Min 2 2 $1,200.00 $1,200.00 $223.22 $520.95 $372.09 2025-11-21
10061 CPT I&d Abscess Complct Multiple 2 2 $399.00 $399.00 $346.67 $391.45 $369.06 2025-11-21
93356 CPT Myocardial Strain Imaging Echo 3 3 $819.00 $819.00 $12.27 $369.02 $369.02 2025-11-21
64450 CPT Peripheral Nerve Block 6 6 $562.00 $562.00 $253.21 $415.93 $361.27 2025-11-21
94002 CPT Vent Setup Initial Day 1 1 $798.00 $798.00 $354.35 $354.35 $354.35 2025-11-21
74177 CPT CT Abdomen And Pelvis With 27 27 $3,500.00 $3,500.00 $191.42 $1,914.05 $348.34 2025-11-21
11104 CPT Punch Bx Single 1 1 $442.00 $442.00 $348.29 $348.29 $348.29 2025-11-21
74178 CPT CT Abdomen And Pelvis W And Wo 12 11 $3,525.00 $3,525.00 $200.43 $2,436.40 $347.56 2025-11-21
74174 CPT CT Angio Abo Pelvis W Wo 16 16 $3,065.00 $3,065.00 $191.42 $2,769.32 $347.11 2025-11-21
A9520 HCPCS Nm Tilmanocept Tc99m 1 1 $742.00 $742.00 $346.67 $346.67 $346.67 2025-11-21
72132 CPT CT Lumbar W Contrast 2 2 $1,654.00 $1,654.00 $344.91 $346.51 $345.71 2025-11-21
88184 CPT Flow Cytometry-fetal Cell 1st 1 1 $37.15 $37.15 $345.60 $345.60 $345.60 2025-11-21
72156 CPT MRI Cervical Sp W Wo Contrast 9 9 $3,051.00 $3,051.00 $191.42 $1,561.06 $344.91 2025-11-21
72158 CPT MRI Lumbar Sp W Wo Contrast 14 14 $3,051.00 $3,051.00 $200.43 $1,561.06 $344.31 2025-11-21
74183 CPT MRI Abdomen W Wo Contrast 9 9 $3,039.00 $3,039.00 $340.48 $1,519.24 $344.31 2025-11-21
73723 CPT MRI Lower Joint W Wo Contrast 3 3 $4,315.00 $4,315.00 $337.17 $1,945.47 $343.05 2025-11-21
72126 CPT CT Cervical W Contrast 1 1 $1,654.00 $1,654.00 $342.91 $342.91 $342.91 2025-11-21
C8908 HCPCS MRI Breast Bil W Wo Contrast 5 5 $2,735.00 $2,735.00 $333.67 $349.91 $335.03 2025-11-21
A0426 HCPCS Als Non-emergency Level 1 16 16 $993.00 $993.00 $306.44 $328.31 $318.10 2025-11-21
70490 CPT CT Soft Tissue Neck W O Contra 4 4 $1,118.00 $1,118.00 $57.00 $978.59 $314.49 2025-11-21
V2632 HCPCS Lens B L Li61u L-13 Po 2 2 $318.00 $318.00 $314.16 $314.17 $314.17 2025-11-21
90675 CPT Rabavert Rabies Vaccine 1ml 8 8 $1,302.65 $1,302.65 $167.25 $580.15 $306.29 2025-11-21
93978 CPT US Pelvic Doppler Complete 2 2 $618.00 $618.00 $268.14 $341.83 $304.99 2025-11-21
11042 CPT Dbrdmt Sq First 20 Scm 10 10 $557.00 $557.00 $172.98 $389.42 $303.93 2025-11-21
92977 CPT Thrombolysis By IV Infusion 1 1 $563.00 $563.00 $302.30 $302.30 $302.30 2025-11-21
78014 CPT Nm Thy Upt Scan Sing 2 2 $542.00 $542.00 $214.95 $386.53 $300.74 2025-11-21
93017 CPT Nm Stress EKG 12 12 $875.00 $875.00 $166.91 $547.05 $300.61 2025-11-21
19000 CPT US Cyst Puncture 1 1 $846.00 $846.00 $300.03 $300.03 $300.03 2025-11-21
94726 CPT Thoracic Gas Vol Airway Mech 14 14 $387.00 $387.00 $166.91 $308.97 $299.14 2025-11-21
94060 CPT Spirometry Pre & Post 15 15 $387.00 $387.00 $166.91 $300.22 $299.00 2025-11-21
A0998 HCPCS Ambulance No Transport Als 9 9 $494.00 $494.00 $265.54 $494.00 $293.53 2025-11-21
78264 CPT Nm Gastric Emptying 78264 4 4 $1,076.00 $1,076.00 $215.38 $392.03 $286.81 2025-11-21
A9552 HCPCS Fluordeoxyglusose F-18 5 5 $632.00 $632.00 $285.09 $321.26 $285.09 2025-11-21
92950 CPT Cardiopulmonary Resuscitation- 1 1 $607.00 $607.00 $273.37 $273.37 $273.37 2025-11-21
73525 CPT Hip Arthrography 3 3 $604.00 $604.00 $272.43 $581.00 $272.43 2025-11-21
Q4186 HCPCS Epifix 14mm Disk 2 2 $817.00 $817.00 $164.31 $378.64 $271.48 2025-11-21
99283 CPT ER Hosp Fee Level 3 28 28 $728.00 $728.00 $45.47 $481.31 $268.47 2025-11-21
93979 CPT US Duplex Venous Limited 2 2 $503.00 $503.00 $264.93 $268.14 $266.53 2025-11-21
73040 CPT Shoulder Arthrogram 4 4 $579.00 $579.00 $261.18 $567.00 $265.85 2025-11-21
A0428 HCPCS Bls Non-emergency 15 15 $408.00 $408.00 $242.43 $275.00 $265.54 2025-11-21
P9040 HCPCS Packed Rbc-leuk-red-irrad 2 2 $583.00 $583.00 $250.68 $273.37 $262.02 2025-11-21
97607 CPT Dnpwt =< 50 Scm 2 2 $399.00 $399.00 $177.83 $345.96 $261.89 2025-11-21
90375 CPT Hyperrab 300iu Ml 1ml Vial 7 7 $2,041.50 $2,041.50 $142.81 $1,045.06 $261.11 2025-11-21
76942 CPT Mam US Guided Cyst Aspirat 4 4 $729.00 $729.00 $38.99 $729.00 $259.20 2025-11-21
72195 CPT MRI Pelvis W O Contrast 6 6 $2,064.00 $2,064.00 $232.57 $1,111.76 $249.91 2025-11-21
93926 CPT US Dop Art Ext Lower Uni 2 2 $874.00 $874.00 $103.61 $393.88 $248.75 2025-11-21
A4649 HCPCS Cannula Venom 18g 100mm 10mm 1 1 $178.00 $178.00 $237.95 $237.95 $237.95 2025-11-21
73221 CPT MRI Upper Joint Wo Contrast 17 17 $2,647.00 $2,647.00 $129.56 $1,193.35 $236.83 2025-11-21
72148 CPT MRI Lumbar Spinal Cord W O Con 22 22 $2,379.00 $2,379.00 $129.56 $2,578.00 $236.83 2025-11-21
J1410 HCPCS Premarin Inj 25mg Vial:(1)25mg 2 2 $1,130.65 $1,130.65 $205.23 $268.00 $236.62 2025-11-21
72141 CPT MRI Cervical Sp W O Contrast 20 20 $2,379.00 $2,379.00 $127.71 $1,345.75 $236.46 2025-11-21
11730 CPT Avulsion Nail Plate Single 1 1 $236.00 $236.00 $236.00 $236.00 $236.00 2025-11-21
70551 CPT MRI Brain W O Contrast 13 13 $2,096.00 $2,096.00 $129.56 $990.60 $234.46 2025-11-21
73721 CPT MRI Lower Joint Without Contra 17 17 $2,638.00 $2,638.00 $129.56 $2,537.00 $233.04 2025-11-21
73718 CPT MRI Lower Ext No Joint W O Con 5 5 $2,222.00 $2,222.00 $127.71 $1,076.78 $233.04 2025-11-21
72146 CPT MRI Thoracic Sp W O Contrast 9 9 $2,379.00 $2,379.00 $127.71 $1,189.13 $233.04 2025-11-21
93970 CPT US Dop Ext Vein Bilateral 13 13 $1,098.00 $1,098.00 $127.71 $494.69 $233.04 2025-11-21
93308 CPT Echo Bubble Study 5 5 $385.00 $385.00 $214.77 $236.79 $233.04 2025-11-21
73218 CPT MRI Upr Extrem No Jt Wo Cont 1 1 $2,293.00 $2,293.00 $233.04 $233.04 $233.04 2025-11-21
29445 CPT Application Tc Cast 3 3 $491.00 $491.00 $218.84 $236.50 $233.01 2025-11-21
93925 CPT US Dop Art Ext Lower Bil 8 8 $863.00 $863.00 $129.56 $394.91 $232.09 2025-11-21
74176 CPT CT Abdomen And Pelvis Without 23 23 $2,936.00 $2,936.00 $127.71 $3,598.00 $232.09 2025-11-21
93880 CPT US Extracranial Arteries Comp 13 13 $723.00 $723.00 $127.71 $494.69 $232.09 2025-11-21
76700 CPT US Abdomen Complete 8 8 $770.00 $770.00 $57.00 $361.99 $226.50 2025-11-21
76000 CPT Rad Chest Sniff Test 11 11 $494.00 $494.00 $127.71 $494.00 $224.40 2025-11-21
99195 CPT Therapeutic Phlebotomy 5 5 $639.00 $639.00 $69.09 $287.90 $224.07 2025-11-21
76817 CPT US OB Transvaginal 3 3 $477.00 $477.00 $57.30 $268.14 $222.85 2025-11-21
93975 CPT US Duplex Artery Comp Retro 6 6 $1,032.00 $1,032.00 $212.60 $683.66 $222.34 2025-11-21
71101 CPT Ribs Uni-chest 1 1 $393.00 $393.00 $220.52 $220.52 $220.52 2025-11-21
A9502 HCPCS Nm Radioisotope Indium 111 3 3 $1,447.00 $1,447.00 $136.80 $220.38 $219.58 2025-11-21
76377 CPT CT Wd Recon On Independent Ws 1 1 $872.00 $872.00 $219.45 $219.45 $219.45 2025-11-21
72128 CPT CT Thoracic Spine W O Contrast 7 7 $1,477.00 $1,477.00 $102.11 $698.66 $216.49 2025-11-21
72125 CPT CT Cervical W O Contrast 15 15 $1,477.00 $1,477.00 $57.00 $2,118.00 $215.79 2025-11-21
74246 CPT Rad Ugi W Air 74246 8 8 $509.00 $509.00 $95.42 $309.47 $211.23 2025-11-21
76376 CPT CT 3d Post Processing 5 5 $451.00 $451.00 $103.60 $451.00 $211.01 2025-11-21
74240 CPT Rad Ugi 74240 1 1 $493.00 $493.00 $211.01 $211.01 $211.01 2025-11-21
76604 CPT US Chest 3 3 $397.00 $397.00 $102.11 $268.14 $210.54 2025-11-21
92523 CPT St: Speech Language Eval 2 2 $450.00 $450.00 $208.17 $211.21 $209.69 2025-11-21
72052 CPT Spine Cervical 6 Or More Views 5 5 $277.00 $277.00 $102.11 $210.07 $209.61 2025-11-21
81240 CPT F2 Gene 2 2 $266.54 $266.54 $130.36 $278.00 $204.18 2025-11-21
71270 CPT CT Thorax W Wo Contrast 2 2 $1,884.00 $1,884.00 $174.42 $233.22 $203.82 2025-11-21
96365 CPT Infusion Ther-1st Hr Non-hydra 38 26 $447.50 $447.50 $111.71 $366.23 $203.13 2025-11-21
96374 CPT IV Push Initial 28 28 $361.00 $361.00 $111.71 $366.23 $202.30 2025-11-21
70450 CPT CT Head W O Contrast 28 28 $1,299.00 $1,299.00 $57.00 $1,838.00 $199.22 2025-11-21
73000 CPT Clavicle 6 6 $158.00 $158.00 $47.19 $263.00 $196.88 2025-11-21
16020 CPT Drsg Or Debrdmt Burn Small 1 1 $236.00 $236.00 $194.68 $194.68 $194.68 2025-11-21
76815 CPT Bedside Pregnancy Ultrasound 2 2 $264.00 $264.00 $167.62 $219.92 $193.77 2025-11-21
20600 CPT Drainag Inject Joint Bursa 1 1 $22.00 $22.00 $191.32 $191.32 $191.32 2025-11-21
87517 CPT Hbv DNA Detection Quant 1 1 $100.00 $100.00 $190.74 $190.74 $190.74 2025-11-21
86870 CPT Antibody Id 3 3 $293.00 $293.00 $137.39 $187.34 $187.34 2025-11-21
96360 CPT IV Hydration 1st Hour 31 23 $282.00 $282.00 $111.71 $366.23 $185.96 2025-11-21
76870 CPT US Scrotum 12 12 $566.00 $566.00 $57.00 $505.00 $185.81 2025-11-21
76816 CPT US OB Followup Per Fetus 1 1 $429.00 $429.00 $184.85 $184.85 $184.85 2025-11-21
94660 CPT Bipap Cpap Mgmt Day 2 2 $309.00 $309.00 $139.27 $228.17 $183.72 2025-11-21
71110 CPT Ribs Bilateral W O Cxr 4 4 $369.00 $369.00 $57.00 $232.58 $183.22 2025-11-21
74181 CPT MRI Abdomen Without Contrast 2 2 $2,274.00 $2,274.00 $129.56 $232.09 $180.82 2025-11-21
95806 CPT Sleep Study Unattd Home Study 8 8 $701.00 $701.00 $51.61 $380.00 $176.69 2025-11-21
71120 CPT Sternum 2 Views 1 1 $233.00 $233.00 $175.84 $175.84 $175.84 2025-11-21
70150 CPT Facial Bones Min 3 Vw 2 2 $325.00 $325.00 $146.89 $203.97 $175.43 2025-11-21
97597 CPT Dbrdmt Open Wnd Frst 20 Scm 15 15 $219.00 $219.00 $88.77 $194.68 $175.27 2025-11-21
72193 CPT CT Pelvis W Contrast 7 7 $1,644.00 $1,644.00 $95.42 $1,050.34 $174.42 2025-11-21
74160 CPT CT Abdomen W Contrast 5 5 $1,742.00 $1,742.00 $171.28 $1,557.28 $174.42 2025-11-21
74170 CPT CT Abdomen W Wo Contrast 5 5 $2,019.00 $2,019.00 $159.42 $1,714.30 $172.68 2025-11-21
70491 CPT CT Soft Tissue Neck W Contras 15 15 $1,516.00 $1,516.00 $95.42 $923.89 $171.63 2025-11-21
74220 CPT Esophagus 1 1 $354.00 $354.00 $171.63 $171.63 $171.63 2025-11-21
74221 CPT Esophagus W Air 74221 14 14 $267.00 $267.00 $95.42 $267.00 $171.53 2025-11-21
70492 CPT CT Soft Tissue Neck W Wo Contr 6 6 $1,717.00 $1,717.00 $161.04 $1,030.64 $171.22 2025-11-21
71275 CPT CT Angio Chest W Wo Contrast 22 22 $2,071.00 $2,071.00 $95.42 $1,601.29 $170.93 2025-11-21
73706 CPT CT Angio Lower Ext W Wo Contra 3 3 $2,038.00 $2,038.00 $95.42 $173.43 $170.93 2025-11-21
73701 CPT CT Lower Extr W Contrast 7 7 $1,632.00 $1,632.00 $95.42 $1,509.39 $170.93 2025-11-21
31500 CPT Intubation Endotracheal ER 4 4 $607.00 $607.00 $63.65 $225.37 $169.30 2025-11-21
72114 CPT Spine Ls & Bd Vws 3 3 $269.00 $269.00 $102.52 $361.00 $169.28 2025-11-21
83013 CPT H Pylori Breath Test 2 2 $50.00 $50.00 $120.98 $217.18 $169.08 2025-11-21
J3101 HCPCS Tenecteplase 50mg Vial 4 4 $24,891.80 $24,891.80 $159.18 $220.22 $168.48 2025-11-21
91320 CPT Sarscv2 Pfizer Comirnaty 25-26 4 4 $900.00 $900.00 $117.60 $164.88 $164.05 2025-11-21
88307 CPT Surg Path V:tc 3 3 $345.00 $345.00 $128.04 $161.77 $161.77 2025-11-21
70030 CPT Eye Foreign Body 3 3 $229.00 $229.00 $123.16 $356.00 $160.37 2025-11-21
75635 CPT CT Angio Abd Aorta W Runoff 1 1 $2,174.00 $2,174.00 $160.21 $160.21 $160.21 2025-11-21
70487 CPT CT Facial W Contrast 5 5 $1,486.00 $1,486.00 $95.42 $887.16 $159.42 2025-11-21
86316 CPT Squamous Cell Carcinoma Ag 1 1 $34.20 $34.20 $158.49 $158.49 $158.49 2025-11-21
72084 CPT Rad Comp Spine Ap & Lat 72084 2 2 $412.00 $412.00 $57.00 $253.21 $155.11 2025-11-21
99282 CPT ER Hosp Fee Level 2 25 25 $450.00 $450.00 $45.68 $416.00 $154.56 2025-11-21
43752 CPT Naso Oro-gastric Tube Placemen 1 1 $338.00 $338.00 $152.39 $152.39 $152.39 2025-11-21
G0399 HCPCS Sleep Study Unattd Home Study 8 8 $701.00 $701.00 $135.52 $153.30 $150.69 2025-11-21
J0834 HCPCS Cortrosyn 0.25 Mg Ml (1ml) 1 1 $319.75 $319.75 $149.93 $149.93 $149.93 2025-11-21
94010 CPT Spirometry 8 8 $231.00 $231.00 $81.41 $161.52 $149.91 2025-11-21
81256 CPT Hemochromatosis Gene Analysis 2 2 $173.43 $173.43 $94.74 $203.00 $148.87 2025-11-21
77076 CPT Osseo Survey Infant 1 1 $237.00 $237.00 $148.57 $148.57 $148.57 2025-11-21
97605 CPT Npwt =< 50 Scm 2 2 $219.00 $219.00 $102.69 $190.79 $146.74 2025-11-21
76882 CPT US Extremity (limited) 10 10 $560.00 $560.00 $57.00 $291.47 $144.52 2025-11-21
29581 CPT Applic. Multilayer Drsg 4 4 $168.00 $168.00 $82.12 $154.60 $144.39 2025-11-21
72072 CPT Spine Thoracic + Swimmers 2 2 $212.00 $212.00 $123.16 $158.96 $141.06 2025-11-21
87902 CPT Hcv Genotype Resolution 1 1 $86.50 $86.50 $140.83 $140.83 $140.83 2025-11-21
0352U CPT Multiplex Vaginal Panel 2 2 $384.00 $384.00 $139.78 $140.57 $140.18 2025-11-21
87637 CPT Sars-cov-2 Flua Flub Rsv 22 22 $399.00 $399.00 $76.45 $221.79 $139.78 2025-11-21
85397 CPT Vonwillebrand Factor Activity 1 1 $88.83 $88.83 $136.28 $136.28 $136.28 2025-11-21
94729 CPT Diffusing Capacity 3 3 $300.00 $300.00 $96.15 $180.53 $135.04 2025-11-21
73080 CPT Elbow 3 View 11 11 $177.00 $177.00 $35.31 $153.05 $133.64 2025-11-21
72190 CPT Pelvis 3 Views 5 5 $212.00 $212.00 $42.23 $285.00 $133.64 2025-11-21
23350 CPT Sc Inj Proc Shoulder Arthrogra 4 4 $285.00 $285.00 $128.48 $274.00 $130.81 2025-11-21
43762 CPT Replacement Of Gastrotomy 1 1 $794.00 $794.00 $130.36 $130.36 $130.36 2025-11-21
A4648 HCPCS Tissue Marker Implantable 1 1 $278.00 $278.00 $130.35 $130.35 $130.35 2025-11-21
76642 CPT Mm US Breast Unil Limited 1 1 $277.00 $277.00 $129.89 $129.89 $129.89 2025-11-21
93930 CPT US Dop Art Ext Upper Bil 1 1 $786.00 $786.00 $129.56 $129.56 $129.56 2025-11-21
27093 CPT Sc Inj Proc Hip Arthrograph Wo 3 3 $285.00 $285.00 $128.48 $274.00 $128.48 2025-11-21
87502 CPT Flu Rt Pcr First 2 Types 6 6 $299.00 $299.00 $86.42 $216.88 $128.28 2025-11-21
80055 CPT Obstetric P 1 1 $272.00 $272.00 $125.74 $125.74 $125.74 2025-11-21
72202 CPT Si Joints 3 Views 2 2 $187.00 $187.00 $123.16 $128.01 $125.58 2025-11-21
36591 CPT Spec Collect Portacath 1 1 $159.00 $159.00 $123.81 $123.81 $123.81 2025-11-21
G0463 HCPCS Office Outpt Visit New 3 18 18 $68.00 $68.00 $68.89 $142.00 $123.73 2025-11-21
70110 CPT Mandible Min 4 Vw 1 1 $275.00 $275.00 $123.16 $123.16 $123.16 2025-11-21
73010 CPT Scapula 1 1 $170.00 $170.00 $122.13 $122.13 $122.13 2025-11-21
73060 CPT Humerus Min 2 Vw 6 6 $163.00 $163.00 $47.36 $260.00 $121.91 2025-11-21
76805 CPT US OB 14 Wks Ta 2 2 $707.00 $707.00 $57.30 $185.81 $121.55 2025-11-21
11055 CPT Paring Benign Lesion 1 2 2 $219.00 $219.00 $97.61 $143.10 $120.35 2025-11-21
73020 CPT Shoulder 1 View 2 2 $137.00 $137.00 $103.63 $133.87 $118.75 2025-11-21
94640 CPT Svn Initial Breathing Treatme 9 9 $175.00 $175.00 $57.85 $455.40 $118.63 2025-11-21
94664 CPT Metered Dose Inhaler Instructi 3 3 $264.00 $264.00 $57.85 $151.80 $118.63 2025-11-21
C1762 HCPCS Implant Achilles Tendon W Cal 3 3 $2,847.00 $2,847.00 $70.27 $1,188.37 $118.25 2025-11-21
73090 CPT Forearm 2 Vw 7 7 $156.00 $156.00 $31.46 $252.00 $118.16 2025-11-21
70160 CPT Nasal Bones Min 3 Vw 2 2 $223.00 $223.00 $112.13 $123.16 $117.64 2025-11-21
73050 CPT Ac Joints Bilat 1 1 $187.00 $187.00 $117.27 $117.27 $117.27 2025-11-21
72170 CPT Pelvis Ap 1-2 Vw 8 8 $146.00 $146.00 $28.55 $237.00 $117.14 2025-11-21
93270 CPT Event Monitor Hook-up 6 6 $369.00 $369.00 $19.99 $354.00 $115.41 2025-11-21
74248 CPT Small Bowel Add On Code 74248 1 1 $181.00 $181.00 $114.88 $114.88 $114.88 2025-11-21
99152 CPT Mod Sed Init 15 Min 5yrs Ed 3 3 $245.00 $245.00 $110.19 $114.87 $114.46 2025-11-21
87799 CPT Jc Polyoma Virus DNA 2 2 $83.68 $83.68 $90.68 $135.76 $113.22 2025-11-21
76010 CPT Fb Child T Body 2 2 $163.00 $163.00 $103.16 $123.16 $113.16 2025-11-21
G0480 HCPCS Salicylate 18 18 $136.00 $136.00 $61.33 $115.51 $112.14 2025-11-21
36600 CPT Abg Line Draw 5 5 $164.00 $164.00 $42.03 $126.29 $111.96 2025-11-21
80150 CPT Amikacin Trough 1 1 $238.30 $238.30 $111.33 $111.33 $111.33 2025-11-21
94200 CPT Incentive Spirometry 3 3 $164.00 $164.00 $73.62 $119.98 $110.38 2025-11-21
73650 CPT Calcaneus 2 Views 2 2 $140.00 $140.00 $84.94 $133.87 $109.41 2025-11-21
73600 CPT Ankle Ap & Lat 3 3 $143.00 $143.00 $84.94 $123.16 $108.79 2025-11-21
88173 CPT Fna Cytopath Eval 4 4 $297.00 $297.00 $83.54 $138.76 $107.96 2025-11-21
71250 CPT CT Thorax W O Contrast 18 17 $1,405.00 $1,405.00 $57.00 $929.36 $107.36 2025-11-21
73100 CPT Wrist Ap-lat 3 3 $139.00 $139.00 $105.51 $123.16 $107.08 2025-11-21
76981 CPT US Elastography 76981 6 6 $461.00 $461.00 $57.30 $165.00 $104.92 2025-11-21
73200 CPT CT Upper Extr W O Contrast 8 7 $1,628.00 $1,628.00 $103.15 $971.31 $104.32 2025-11-21
70486 CPT CT Sinus Screen W O Contrast 17 16 $1,294.00 $1,294.00 $57.00 $1,879.00 $104.19 2025-11-21
76770 CPT US Retro Renal Compl 15 15 $579.00 $579.00 $57.30 $291.47 $104.19 2025-11-21
72131 CPT CT Lumbar W O Contrast 13 13 $1,477.00 $1,477.00 $57.00 $905.91 $104.19 2025-11-21
76536 CPT US Soft Tis Head Neck 19 19 $533.00 $533.00 $57.00 $291.47 $104.19 2025-11-21
72074 CPT Spine Thoracic 4 Views 3 3 $244.00 $244.00 $104.11 $133.87 $104.19 2025-11-21
74150 CPT CT Abdomen W O Contrast 3 3 $1,370.00 $1,370.00 $104.19 $939.68 $104.19 2025-11-21
72070 CPT Spine Thoracic Ap Lat 9 9 $184.00 $184.00 $57.00 $137.39 $104.19 2025-11-21
76872 CPT US Prostate 4 4 $494.00 $494.00 $102.31 $107.32 $103.67 2025-11-21
73700 CPT CT Lower Extr W O Contrast 16 16 $1,653.00 $1,653.00 $57.00 $956.09 $103.67 2025-11-21
J1610 HCPCS Glucagen Inj Vial 1mg (1) 1 1 $15.00 $15.00 $103.64 $103.64 $103.64 2025-11-21
73070 CPT Elbow Ap & Lat 3 3 $137.00 $137.00 $79.00 $133.87 $103.63 2025-11-21
73522 CPT Rad Hip Bil Ap Lat Pel 73522 6 6 $380.00 $380.00 $57.00 $141.14 $103.35 2025-11-21
77075 CPT Osseous Survey Complete 2 2 $635.00 $635.00 $102.51 $104.19 $103.35 2025-11-21
76801 CPT US Ob<14 Weeks 1st Fetus 13 13 $614.00 $614.00 $57.00 $304.32 $103.34 2025-11-21
73521 CPT Rad Pel & Hips Inf Frog 73521 1 1 $224.00 $224.00 $103.16 $103.16 $103.16 2025-11-21
72110 CPT Spine Lumbar Ap & Obl 11 11 $252.00 $252.00 $54.26 $158.96 $102.92 2025-11-21
72120 CPT Spine Ls Bending Views Only 1 1 $194.00 $194.00 $102.81 $102.81 $102.81 2025-11-21
76856 CPT US Pelvic 20 20 $619.00 $619.00 $28.50 $668.00 $102.66 2025-11-21
76705 CPT US Limited One Organ Quadrant 25 25 $551.00 $551.00 $57.00 $291.47 $102.52 2025-11-21
72100 CPT Spine Lumbosacral Ap & Lateral 18 18 $182.00 $182.00 $40.84 $292.00 $102.52 2025-11-21
74021 CPT Rad Abd Mult 3vw Or More 74021 15 15 $187.00 $187.00 $44.00 $251.00 $102.52 2025-11-21
73564 CPT Knee 4 View Or More 13 13 $223.00 $223.00 $49.64 $184.85 $102.52 2025-11-21
76830 CPT US Transvaginal 20 20 $522.00 $522.00 $57.00 $572.06 $102.31 2025-11-21
76775 CPT US Retroperitoneal Limited 15 15 $526.00 $526.00 $45.93 $291.47 $102.31 2025-11-21
93976 CPT US Duplex Liver Ltd 15 15 $800.00 $800.00 $57.00 $800.00 $102.11 2025-11-21
77080 CPT Bone Density Study (dxa) 18 18 $468.00 $468.00 $41.59 $202.56 $102.11 2025-11-21
72192 CPT CT Pelvis W O Contrast 7 7 $1,372.00 $1,372.00 $57.00 $928.42 $102.11 2025-11-21
76706 CPT US Aaa Screen 76706 12 12 $371.00 $371.00 $57.00 $184.85 $102.11 2025-11-21
71271 CPT CT Lung Screening 19 19 $339.00 $339.00 $57.00 $473.59 $102.11 2025-11-21
93971 CPT US Dop Ext Vein Uni 23 23 $664.00 $664.00 $57.00 $638.00 $102.11 2025-11-21
80050 CPT Gen Health Pnl 2 2 $291.00 $291.00 $32.27 $169.37 $100.82 2025-11-21
A9537 HCPCS Nm Tc 99m Choletec 2 2 $215.00 $215.00 $100.81 $100.81 $100.81 2025-11-21
72081 CPT Rad Scoliosis 1 Vw 72081 2 2 $264.00 $264.00 $60.80 $140.67 $100.73 2025-11-21
77066 CPT Mam Diag Bil W Cad 77066 12 12 $452.00 $452.00 $53.01 $165.52 $100.05 2025-11-21
70480 CPT CT Orbits W O Contrast 8 8 $1,096.00 $1,096.00 $57.00 $957.49 $99.72 2025-11-21
73120 CPT Hand 2 Views 8 8 $148.00 $148.00 $28.50 $187.56 $99.16 2025-11-21
73660 CPT Toe Lt Great Toe Min 2 Vw 6 6 $132.00 $132.00 $47.19 $209.00 $98.00 2025-11-21
J1335 HCPCS Ertapenem 1 Gm Vial 1 1 $15.00 $15.00 $97.63 $97.63 $97.63 2025-11-21
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