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Hospital

ROOSEVELT MEDICAL CENTER

Culbertson, MT · CCN 271308 · Rates published

908 distinct procedures filed
8 distinct payers
15,976 rate rows
2024-11-30 last MRF observed · ⚠ 19 mo old
Data quality

15,937 of 15,976 rate rows are consumer-grade (99.8%)

39 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
percent-of-charges filed in the dollar field — excluded from medians 39

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 19 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://rooseveltmedical.org/wp-content/uploads/2025/03/810373589_Roosevelt-Medical-Center_standardcharges_MRF.txt
Found on page https://rooseveltmedical.org/services/
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-17
Content fingerprint 0c74c99ee1c09e95… · 160,609 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
G0378
HCPCS 		Observation 1 Hr 8 $830.70 $13,183.68 $7,915.21 nat. median
$103
outlier · 77.0×
0120
RC 		8 $5,450.40 $6,592.00 $6,056.00 nat. median
$1,017
outlier · 6.0×
74174
CPT 		CTA Abdomen And Pelvis 8 $3,769.20 $4,188.00 $4,104.24 nat. median
$958
outlier · 4.3×
71552
CPT 		MRI Chest (clavicle) Without &w Contrast 8 $3,098.70 $3,443.00 $3,374.14 nat. median
$1,093
outlier · 3.1×
74178
CPT 		CT Abdomen And Pelvis With And Without Contrast 8 $3,002.40 $3,336.00 $3,269.28 nat. median
$977
outlier · 3.3×
73220
CPT 		MRI Upper Extremity, Non-joint Without & With Contrast 8 $2,693.70 $2,993.00 $2,933.14 nat. median
$1,185
outlier · 2.5×
72126
CPT 		CT Cervical Spine With Contrast 8 $2,587.50 $2,875.00 $2,817.50 nat. median
$753
outlier · 3.7×
74170
CPT 		CT Abdomen With And Without Contrast 8 $2,574.90 $2,861.00 $2,803.78 nat. median
$702
outlier · 4.0×
59409
CPT 		Vaginal Delivery Of Baby 8 $2,556.90 $2,841.00 $2,784.18 nat. median
$3,185
0.9× median
59414
CPT 		Delivery Of Placenta 8 $2,556.00 $2,840.00 $2,783.20 nat. median
$2,876
1.0× median
75630
CPT 		CTA Abdominal Aorta & Bilateral Iliofemoral Lower Ext. Runoff 8 $2,555.10 $2,839.00 $2,782.22 nat. median
$3,277
0.8× median
73223
CPT 		MRI Upper Extremity, Joint Without & With Contrast 8 $2,544.30 $2,827.00 $2,770.46 nat. median
$1,223
outlier · 2.3×
71275
CPT 		CTA Chest 8 $2,538.00 $2,820.00 $2,763.60 nat. median
$735
outlier · 3.8×
73723
CPT 		MRI Lower Extremity, Joint Without & With Contrast 8 $2,534.40 $2,816.00 $2,759.68 nat. median
$1,263
outlier · 2.2×
71270
CPT 		CT Chest With And Without Contrast 8 $2,455.20 $2,728.00 $2,673.44 nat. median
$661
outlier · 4.0×
70496
CPT 		CTA Head 8 $2,322.00 $2,580.00 $2,528.40 nat. median
$729
outlier · 3.5×
70498
CPT 		CTA Neck 8 $2,320.20 $2,578.00 $2,526.44 nat. median
$722
outlier · 3.5×
71550
CPT 		MRI Chest (clavicle) Without Contrast 8 $2,309.40 $2,566.00 $2,514.68 nat. median
$809
outlier · 3.1×
74177
CPT 		CT Abdomen And Pelvis With Contrast 8 $2,234.70 $2,483.00 $2,433.34 nat. median
$928
outlier · 2.6×
70543
CPT 		MRI Orbit, Face, & Neck Without & With Contrast 8 $2,228.40 $2,476.00 $2,426.48 nat. median
$1,077
outlier · 2.3×
74183
CPT 		MRI Abdomen Without & W Contrast 8 $2,221.20 $2,468.00 $2,418.64 nat. median
$1,101
outlier · 2.2×
73720
CPT 		MRI Lower Extremity, Non-joint Without & W Contrast 8 $2,214.90 $2,461.00 $2,411.78 nat. median
$1,189
outlier · 2.0×
72197
CPT 		MRI Pelvis Without & W Contrast 8 $2,212.20 $2,458.00 $2,408.84 nat. median
$1,064
outlier · 2.3×
72193
CPT 		CT Pelvis With Contrast 8 $2,151.90 $2,391.00 $2,343.18 nat. median
$629
outlier · 3.7×
72157
CPT 		MRI Thoracic Spine Without & W Contrast 8 $2,106.00 $2,340.00 $2,293.20 nat. median
$1,093
outlier · 2.1×
72156
CPT 		MRI Cervical Spine Without & With Contrast 8 $2,101.50 $2,335.00 $2,288.30 nat. median
$1,092
outlier · 2.1×
72158
CPT 		MRI Lumbar Spine Without & W Contrast 8 $2,097.90 $2,331.00 $2,284.38 nat. median
$1,080
outlier · 2.1×
70553
CPT 		MRI Brain Without & With Contrast 8 $2,091.60 $2,324.00 $2,277.52 nat. median
$1,122
outlier · 2.0×
73722
CPT 		MRI Lower Extremity, Joint With Contrast 8 $2,061.00 $2,290.00 $2,244.20 nat. median
$1,302
1.7× median
71260
CPT 		CT Chest With Contrast 8 $2,060.10 $2,289.00 $2,243.22 nat. median
$646
outlier · 3.5×
73222
CPT 		MRI Upper Extremity, Joint With Contrast 8 $2,059.20 $2,288.00 $2,242.24 nat. median
$1,312
1.7× median
70488
CPT 		CT Maxillofacial With And Without Contrast 8 $2,034.90 $2,261.00 $2,215.78 nat. median
$634
outlier · 3.5×
73218
CPT 		MRI Upper Extremity, Non-joint Without Contrast 8 $1,995.30 $2,217.00 $2,172.66 nat. median
$896
outlier · 2.4×
74176
CPT 		CT Abdomen And Pelvis Without Contrast 8 $1,965.60 $2,184.00 $2,140.32 nat. median
$685
outlier · 3.1×
99291
CPT 		Critical Care First 30-74 Minutes 8 $347.05 $2,389.00 $2,122.68 nat. median
$1,611
1.3× median
G0390
HCPCS 		Trauma Team With Critical Care 8 $1,890.00 $2,100.00 $2,058.00 nat. median
$3,172
0.6× median
73701
CPT 		CT Lower Extremity With Contrast 8 $1,869.30 $2,077.00 $2,035.46 nat. median
$710
outlier · 2.9×
74160
CPT 		CT Abdomen With Contrast 8 $1,850.40 $2,056.00 $2,014.88 nat. median
$645
outlier · 3.1×
87632
CPT 		Respiratory Virus Panel, Pcr Q 8 $1,842.79 $2,047.54 $2,006.59 nat. median
$267
outlier · 7.5×
70491
CPT 		CT Neck Soft Tissue With Contrast 8 $1,815.30 $2,017.00 $1,976.66 nat. median
$617
outlier · 3.2×
71250
CPT 		CT Chest Without Contrast High Resolution 8 $1,496.70 $2,443.00 $1,930.85 nat. median
$473
outlier · 4.1×
73206
CPT 		CTA Upper Extremity 8 $1,772.10 $1,969.00 $1,929.62 nat. median
$696
outlier · 2.8×
72129
CPT 		CT Thoracic Spine With Contrast 8 $1,771.20 $1,968.00 $1,928.64 nat. median
$584
outlier · 3.3×
72142
CPT 		MRI Cervical Spine With Contrast 8 $1,743.30 $1,937.00 $1,898.26 nat. median
$958
2.0× median
70336
CPT 		MRI Tmj 8 $1,735.20 $1,928.00 $1,889.44 nat. median
$755
outlier · 2.5×
72132
CPT 		CT Lumbar With Contrast 8 $1,728.90 $1,921.00 $1,882.58 nat. median
$760
outlier · 2.5×
J2357
HCPCS 		Xolair 150 Mg/1.2 Ml Powder Vl 150 Mg, 1 Each 8 $1,718.10 $1,909.00 $1,870.82 nat. median
$1,303
1.4× median
86711
CPT 		Jc Virus Ab With Reflex Inhibition Assay - Q 8 $1,699.97 $1,888.85 $1,851.07 nat. median
$30
outlier · 61.7×
70470
CPT 		CT Head/brain With & Without Contrast 8 $1,673.10 $1,859.00 $1,821.82 nat. median
$618
outlier · 2.9×
70490
CPT 		CT Neck Soft Tissue Without Contrast 8 $1,656.90 $1,841.00 $1,804.18 nat. median
$441
outlier · 4.1×

Other procedures at this hospital

Browse this hospital's 908 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
             
G0378 HCPCS Observation 1 Hr 826 8 $8,172.78 $8,172.78 $830.70 $13,183.68 $7,915.21 2024-11-30
0120 RC — 24 8 $6,324.00 $6,324.00 $5,450.40 $6,592.00 $6,056.00 2024-11-30
74174 CPT CTA Abdomen And Pelvis 12 8 $4,188.00 $4,188.00 $3,769.20 $4,188.00 $4,104.24 2024-11-30
71552 CPT MRI Chest (clavicle) Without &w Contrast 12 8 $3,443.00 $3,443.00 $3,098.70 $3,443.00 $3,374.14 2024-11-30
74178 CPT CT Abdomen And Pelvis With And Without Contrast 12 8 $3,336.00 $3,336.00 $3,002.40 $3,336.00 $3,269.28 2024-11-30
73220 CPT MRI Upper Extremity, Non-joint Without & With Contrast 12 8 $2,993.00 $2,993.00 $2,693.70 $2,993.00 $2,933.14 2024-11-30
72126 CPT CT Cervical Spine With Contrast 12 8 $2,875.00 $2,875.00 $2,587.50 $2,875.00 $2,817.50 2024-11-30
74170 CPT CT Abdomen With And Without Contrast 12 8 $2,861.00 $2,861.00 $2,574.90 $2,861.00 $2,803.78 2024-11-30
59409 CPT Vaginal Delivery Of Baby 12 8 $2,841.00 $2,841.00 $2,556.90 $2,841.00 $2,784.18 2024-11-30
59414 CPT Delivery Of Placenta 12 8 $2,840.00 $2,840.00 $2,556.00 $2,840.00 $2,783.20 2024-11-30
75630 CPT CTA Abdominal Aorta & Bilateral Iliofemoral Lower Ext. Runoff 12 8 $2,839.00 $2,839.00 $2,555.10 $2,839.00 $2,782.22 2024-11-30
73223 CPT MRI Upper Extremity, Joint Without & With Contrast 12 8 $2,827.00 $2,827.00 $2,544.30 $2,827.00 $2,770.46 2024-11-30
71275 CPT CTA Chest 12 8 $2,820.00 $2,820.00 $2,538.00 $2,820.00 $2,763.60 2024-11-30
73723 CPT MRI Lower Extremity, Joint Without & With Contrast 12 8 $2,816.00 $2,816.00 $2,534.40 $2,816.00 $2,759.68 2024-11-30
71270 CPT CT Chest With And Without Contrast 12 8 $2,728.00 $2,728.00 $2,455.20 $2,728.00 $2,673.44 2024-11-30
70496 CPT CTA Head 12 8 $2,580.00 $2,580.00 $2,322.00 $2,580.00 $2,528.40 2024-11-30
70498 CPT CTA Neck 12 8 $2,578.00 $2,578.00 $2,320.20 $2,578.00 $2,526.44 2024-11-30
71550 CPT MRI Chest (clavicle) Without Contrast 12 8 $2,566.00 $2,566.00 $2,309.40 $2,566.00 $2,514.68 2024-11-30
74177 CPT CT Abdomen And Pelvis With Contrast 12 8 $2,483.00 $2,483.00 $2,234.70 $2,483.00 $2,433.34 2024-11-30
70543 CPT MRI Orbit, Face, & Neck Without & With Contrast 12 8 $2,476.00 $2,476.00 $2,228.40 $2,476.00 $2,426.48 2024-11-30
74183 CPT MRI Abdomen Without & W Contrast 12 8 $2,468.00 $2,468.00 $2,221.20 $2,468.00 $2,418.64 2024-11-30
73720 CPT MRI Lower Extremity, Non-joint Without & W Contrast 12 8 $2,461.00 $2,461.00 $2,214.90 $2,461.00 $2,411.78 2024-11-30
72197 CPT MRI Pelvis Without & W Contrast 12 8 $2,458.00 $2,458.00 $2,212.20 $2,458.00 $2,408.84 2024-11-30
72193 CPT CT Pelvis With Contrast 12 8 $2,391.00 $2,391.00 $2,151.90 $2,391.00 $2,343.18 2024-11-30
72157 CPT MRI Thoracic Spine Without & W Contrast 12 8 $2,340.00 $2,340.00 $2,106.00 $2,340.00 $2,293.20 2024-11-30
72156 CPT MRI Cervical Spine Without & With Contrast 12 8 $2,335.00 $2,335.00 $2,101.50 $2,335.00 $2,288.30 2024-11-30
72158 CPT MRI Lumbar Spine Without & W Contrast 12 8 $2,331.00 $2,331.00 $2,097.90 $2,331.00 $2,284.38 2024-11-30
70553 CPT MRI Brain Without & With Contrast 12 8 $2,324.00 $2,324.00 $2,091.60 $2,324.00 $2,277.52 2024-11-30
73722 CPT MRI Lower Extremity, Joint With Contrast 12 8 $2,290.00 $2,290.00 $2,061.00 $2,290.00 $2,244.20 2024-11-30
71260 CPT CT Chest With Contrast 12 8 $2,289.00 $2,289.00 $2,060.10 $2,289.00 $2,243.22 2024-11-30
73222 CPT MRI Upper Extremity, Joint With Contrast 12 8 $2,288.00 $2,288.00 $2,059.20 $2,288.00 $2,242.24 2024-11-30
70488 CPT CT Maxillofacial With And Without Contrast 12 8 $2,261.00 $2,261.00 $2,034.90 $2,261.00 $2,215.78 2024-11-30
73218 CPT MRI Upper Extremity, Non-joint Without Contrast 12 8 $2,217.00 $2,217.00 $1,995.30 $2,217.00 $2,172.66 2024-11-30
74176 CPT CT Abdomen And Pelvis Without Contrast 12 8 $2,184.00 $2,184.00 $1,965.60 $2,184.00 $2,140.32 2024-11-30
99291 CPT Critical Care First 30-74 Minutes 36 8 $2,166.00 $2,166.00 $347.05 $2,389.00 $2,122.68 2024-11-30
G0390 HCPCS Trauma Team With Critical Care 12 8 $2,100.00 $2,100.00 $1,890.00 $2,100.00 $2,058.00 2024-11-30
73701 CPT CT Lower Extremity With Contrast 12 8 $2,077.00 $2,077.00 $1,869.30 $2,077.00 $2,035.46 2024-11-30
74160 CPT CT Abdomen With Contrast 12 8 $2,056.00 $2,056.00 $1,850.40 $2,056.00 $2,014.88 2024-11-30
87632 CPT Respiratory Virus Panel, Pcr Q 12 8 $2,047.54 $2,047.54 $1,842.79 $2,047.54 $2,006.59 2024-11-30
70491 CPT CT Neck Soft Tissue With Contrast 12 8 $2,017.00 $2,017.00 $1,815.30 $2,017.00 $1,976.66 2024-11-30
71250 CPT CT Chest Without Contrast High Resolution 24 8 $2,053.00 $2,053.00 $1,496.70 $2,443.00 $1,930.85 2024-11-30
73206 CPT CTA Upper Extremity 12 8 $1,969.00 $1,969.00 $1,772.10 $1,969.00 $1,929.62 2024-11-30
72129 CPT CT Thoracic Spine With Contrast 12 8 $1,968.00 $1,968.00 $1,771.20 $1,968.00 $1,928.64 2024-11-30
72142 CPT MRI Cervical Spine With Contrast 12 8 $1,937.00 $1,937.00 $1,743.30 $1,937.00 $1,898.26 2024-11-30
70336 CPT MRI Tmj 12 8 $1,928.00 $1,928.00 $1,735.20 $1,928.00 $1,889.44 2024-11-30
72132 CPT CT Lumbar With Contrast 12 8 $1,921.00 $1,921.00 $1,728.90 $1,921.00 $1,882.58 2024-11-30
J2357 HCPCS Xolair 150 Mg/1.2 Ml Powder Vl 150 Mg, 1 Each 12 8 $1,909.00 $1,909.00 $1,718.10 $1,909.00 $1,870.82 2024-11-30
86711 CPT Jc Virus Ab With Reflex Inhibition Assay - Q 12 8 $1,888.85 $1,888.85 $1,699.97 $1,888.85 $1,851.07 2024-11-30
70470 CPT CT Head/brain With & Without Contrast 12 8 $1,859.00 $1,859.00 $1,673.10 $1,859.00 $1,821.82 2024-11-30
70490 CPT CT Neck Soft Tissue Without Contrast 12 8 $1,841.00 $1,841.00 $1,656.90 $1,841.00 $1,804.18 2024-11-30
J1745 HCPCS Remicade 100 Mg Vial 100 Mg, 1 Each 12 8 $1,825.00 $1,825.00 $1,642.50 $1,825.00 $1,788.50 2024-11-30
74150 CPT CT Abdomen Without Contrast 12 8 $1,779.00 $1,779.00 $1,601.10 $1,779.00 $1,743.42 2024-11-30
73200 CPT CT Upper Extermity Without Contrast 12 8 $1,775.00 $1,775.00 $1,597.50 $1,775.00 $1,739.50 2024-11-30
72125 CPT CT Cervical Spine Without Contrast 12 8 $1,768.00 $1,768.00 $1,591.20 $1,768.00 $1,732.64 2024-11-30
73700 CPT CT Lower Extremity Without Contrast 12 8 $1,761.00 $1,761.00 $1,584.90 $1,761.00 $1,725.78 2024-11-30
70460 CPT CT Head/brain With Contrast 12 8 $1,760.00 $1,760.00 $1,584.00 $1,760.00 $1,724.80 2024-11-30
72131 CPT CT Lumbar Spine Without Contrast 12 8 $1,759.00 $1,759.00 $1,583.10 $1,759.00 $1,723.82 2024-11-30
72128 CPT CT Thoracic Spine Without Contrast 12 8 $1,753.00 $1,753.00 $1,577.70 $1,753.00 $1,717.94 2024-11-30
72195 CPT MRI Pelvis Without Contrast 12 8 $1,673.00 $1,673.00 $1,505.70 $1,673.00 $1,639.54 2024-11-30
71271 CPT CT Low Dose For Lung Cancer Screening, Without Contrast 12 8 $1,663.00 $1,663.00 $1,496.70 $1,663.00 $1,629.74 2024-11-30
70540 CPT MRI Orbit, Face, & Neck Without Contrast 12 8 $1,652.00 $1,652.00 $1,486.80 $1,652.00 $1,618.96 2024-11-30
70487 CPT CT Maxillofacial With Contrast 12 8 $1,650.00 $1,650.00 $1,485.00 $1,650.00 $1,617.00 2024-11-30
73718 CPT MRI Lower Extremity, Non-joint Without Contrast 12 8 $1,630.00 $1,630.00 $1,467.00 $1,630.00 $1,597.40 2024-11-30
72192 CPT CT Pelvis Without Contrast 12 8 $1,625.00 $1,625.00 $1,462.50 $1,625.00 $1,592.50 2024-11-30
77049 CPT MRI Breast 12 8 $1,597.00 $1,597.00 $1,437.30 $1,597.00 $1,565.06 2024-11-30
70450 CPT CT Head/brain Without Contrast 12 8 $1,483.00 $1,483.00 $1,334.70 $1,483.00 $1,453.34 2024-11-30
73221 CPT MRI Upper Extremity, Joint Without Contrast 12 8 $1,481.00 $1,481.00 $1,332.90 $1,481.00 $1,451.38 2024-11-30
70480 CPT CT Orbit, Sella Or Posterior Fossa Or Outer, Middle Or Inner Ear Without Contrast 12 8 $1,481.00 $1,481.00 $1,332.90 $1,481.00 $1,451.38 2024-11-30
A0427,QN HCPCS Ambulance Als Emergency 12 8 $1,480.00 $1,480.00 $1,332.00 $1,480.00 $1,450.40 2024-11-30
73721 CPT MRI Lower Extremity, Joint Without Contrast 12 8 $1,479.00 $1,479.00 $1,331.10 $1,479.00 $1,449.42 2024-11-30
P9035 HCPCS Plateletpherisis, Leuko Reduced 12 8 $1,455.00 $1,455.00 $1,309.50 $1,455.00 $1,425.90 2024-11-30
70551 CPT MRI Brain Without Contrast 12 8 $1,431.00 $1,431.00 $1,287.90 $1,431.00 $1,402.38 2024-11-30
74181 CPT MRI Abdomen Without Contrast 12 8 $1,429.00 $1,429.00 $1,286.10 $1,429.00 $1,400.42 2024-11-30
72148 CPT MRI Lumbar Spine Without Contrast 12 8 $1,396.00 $1,396.00 $1,256.40 $1,396.00 $1,368.08 2024-11-30
72141 CPT MRI Cervical Spine Without Contrast 12 8 $1,391.00 $1,391.00 $1,251.90 $1,391.00 $1,363.18 2024-11-30
72146 CPT MRI Thoracic Spine Without Contrast 12 8 $1,389.00 $1,389.00 $1,250.10 $1,389.00 $1,361.22 2024-11-30
70486 CPT CT Maxillofacial Area Without Contrast 12 8 $1,274.00 $1,274.00 $1,146.60 $1,274.00 $1,248.52 2024-11-30
J0885 HCPCS Aranesp 100mcg 12 8 $1,210.00 $1,210.00 $1,089.00 $1,210.00 $1,185.80 2024-11-30
J0881 HCPCS Aranesp 100 Mcg/0.5 Ml Syringe 100 Mcg, 0.5 Ml 12 8 $1,161.00 $1,161.00 $1,044.90 $1,161.00 $1,137.78 2024-11-30
A0433,QN HCPCS Ambulance Als Level Ii 12 8 $1,144.00 $1,144.00 $1,029.60 $1,144.00 $1,121.12 2024-11-30
25605 CPT Closed Treatment Distal Radial Or Ulnar Styloid Fracture With Manipulation 36 8 $1,096.00 $1,096.00 $920.70 $1,381.00 $1,074.08 2024-11-30
36430 CPT Blood Transfusion 12 8 $1,061.00 $1,061.00 $954.90 $1,061.00 $1,039.78 2024-11-30
25565 CPT Closed Treatment Radial And Ulnar Shaft Fracture With Manipulation 36 8 $1,045.00 $1,045.00 $880.20 $1,336.00 $1,024.10 2024-11-30
A0428 HCPCS Ambulance Bls Non-emergency 12 8 $1,017.00 $1,017.00 $915.30 $1,017.00 $996.66 2024-11-30
A0429,QN HCPCS Ambulance Bls Emergency 12 8 $1,015.00 $1,015.00 $913.50 $1,015.00 $994.70 2024-11-30
11642 CPT Excision Malignant Lesion Face, Ears,eyelids, Nose Lips 1.1 Cm To 2.0cm 12 8 $956.00 $956.00 $860.40 $956.00 $936.88 2024-11-30
28192 CPT Removal Foreign Body Foot: Deep 12 8 $950.00 $950.00 $855.00 $950.00 $931.00 2024-11-30
24605 CPT Treatment Of Closed Elbow Dislocation; Requiring Anesthesia 21 8 $959.00 $959.00 $697.53 $959.00 $901.46 2024-11-30
99285 CPT Emergency Room Level 5 24 8 $948.50 $948.50 $246.08 $1,525.00 $868.53 2024-11-30
49083 CPT Abdominal Paracentesis With Imaging 24 8 $901.50 $901.50 $541.80 $1,201.00 $841.45 2024-11-30
26725 CPT Closed Treatment Phalangeal Shaft Fracture: With Manipulation, With Or Without Traction:… 24 8 $829.00 $829.00 $617.40 $972.00 $780.40 2024-11-30
76942 CPT Guided Needle Plcmt US 12 8 $786.00 $786.00 $707.40 $786.00 $770.28 2024-11-30
P9040 HCPCS Irradiation With P.c. Per Unit 12 8 $782.00 $782.00 $703.80 $782.00 $766.36 2024-11-30
26775 CPT Closed Treatment Interphalangeal Dislocation: SINGLE:with MANIPULATION;with Anesthe… 12 8 $777.00 $777.00 $699.30 $777.00 $761.46 2024-11-30
32551 CPT Tube Thoracostomy (insertion Chest Tube) Includes Connection And Drainage 24 8 $803.50 $803.50 $340.20 $1,229.00 $742.05 2024-11-30
27560 CPT Closed Treatment Patellar Dislocation: Without Anesthesia 12 8 $755.00 $755.00 $679.50 $755.00 $739.90 2024-11-30
27257 CPT Closed Treatment Of Hip Dislocation, Spontaneou:by Abduction, Splint Or Traction… 24 8 $725.50 $725.50 $645.30 $734.00 $709.83 2024-11-30
92950 CPT Cardiopulmonary Resuscitation 24 8 $755.00 $755.00 $295.90 $866.00 $705.26 2024-11-30
P9016 HCPCS Packed Cells - Leuko-reduced 12 8 $706.00 $706.00 $635.40 $706.00 $691.88 2024-11-30
27750 CPT Closed Treatment Tibial Shaft Fracture, Proximal: Without Manipulation 12 8 $697.00 $697.00 $627.30 $697.00 $683.06 2024-11-30
24600 CPT Closed Tx Elbow Dislocation; Without Manipulation 24 8 $737.50 $737.50 $557.45 $735.00 $681.50 2024-11-30
62270 CPT Spinal Puncture, Lumbar, Diagnostic 12 8 $690.00 $690.00 $621.00 $690.00 $676.20 2024-11-30
12015 CPT Pf Laceration Repair Superficial 7.6 To 12.5 Cm: Face, Ears, Eyelids, Nose, Lip… 24 8 $719.00 $719.00 $154.00 $1,055.00 $662.42 2024-11-30
31500 CPT Intubation, Endotracheal, Emergency Procedure 24 8 $708.50 $708.50 $399.60 $973.00 $659.85 2024-11-30
73523 CPT Bil Hips With Pelvis Min 5 Views 12 8 $673.00 $673.00 $605.70 $673.00 $659.54 2024-11-30
27808 CPT Closed Treatment Bimalleolar Ankle Fracture 12 8 $673.00 $673.00 $605.70 $673.00 $659.54 2024-11-30
27760 CPT Closed Treatment Medial Malleolus Fracture: Without Manipulation 12 8 $672.00 $672.00 $604.80 $672.00 $658.56 2024-11-30
12032 CPT Intermediate Lac Scalp, Neck, Trunk, Extm; 2.6-7.5cm 24 8 $697.00 $697.00 $310.20 $790.00 $651.46 2024-11-30
27520 CPT Closed Treatment Of Patellar Fracture: Without Manipulation 12 8 $651.00 $651.00 $585.90 $651.00 $637.98 2024-11-30
99284 CPT Emergency Room Level 4 24 8 $691.50 $691.50 $169.88 $1,130.00 $632.47 2024-11-30
72052 CPT C-spine 6 Or More Views/flex/ext 12 8 $637.00 $637.00 $573.30 $637.00 $624.26 2024-11-30
24500 CPT Pf Closed Treatment Humeral Shaft Fracture Without Manipulation 12 8 $723.00 $723.00 $538.52 $708.54 $623.56 2024-11-30
13121 CPT Complex Laceration 2.6-7.5 Cm 36 8 $861.00 $861.00 $415.80 $1,010.00 $617.54 2024-11-30
32555 CPT Thoracentesis; Aspiration Of Pleural Space With Imaging; Needle Or Cath 12 8 $622.00 $622.00 $559.80 $622.00 $609.56 2024-11-30
27780 CPT Closed Treatment Proximal Fibula Or Shaft Fracture: Without Manipulation 12 8 $619.00 $619.00 $557.10 $619.00 $606.62 2024-11-30
27530 CPT Closed Treatment Tibial Fracture, Proximal: Without Manipulation 12 8 $612.00 $612.00 $550.80 $612.00 $599.76 2024-11-30
23600 CPT Closed Tx Of Proximal Humeral Fracture; Without Manipulation 24 8 $637.50 $637.50 $494.51 $651.70 $597.44 2024-11-30
26605 CPT Closed Treatment Metacarpal Fracture: Single With Manipulation: Each Bone 24 8 $619.00 $619.00 $523.80 $656.00 $586.20 2024-11-30
24670 CPT Closed Treatment Ulnar Fracture Proximal End Without Manipulation 12 8 $588.00 $588.00 $529.20 $588.00 $576.24 2024-11-30
27767 CPT Closed Treatment Posterior Malleolus Fracture: Without Manipulation 24 8 $582.50 $582.50 $521.10 $586.00 $573.21 2024-11-30
12002 CPT Simple Lac Scalp, Neck, Trunk, Extm; 2.6-7.5cm 48 8 $590.50 $590.50 $96.25 $948.00 $571.52 2024-11-30
23650 CPT Closed Tx Of Shoulder Dislocation With Manipulation; Without Anesth Without Em 36 8 $766.00 $766.00 $493.09 $814.00 $568.67 2024-11-30
12013 CPT Pf Laceration Repair Superficial 2.6 To 5 Cm: Face, Ears, Eyelids, Nose, Lips, M… 36 8 $573.00 $573.00 $95.70 $739.00 $561.54 2024-11-30
25560 CPT Closed Treatment Radial And Ulnar Shaft Fracture Without Manipulation 12 8 $573.00 $573.00 $515.70 $573.00 $561.54 2024-11-30
26600 CPT Closed Treatment Metacarpal Fracture: Single Without Manipulation 24 8 $574.00 $574.00 $495.00 $598.00 $550.00 2024-11-30
25500 CPT Closed Treatment Radial Shaft Fracture Without Manipulation 12 8 $561.00 $561.00 $504.90 $561.00 $549.78 2024-11-30
26770 CPT Closed Treatment Interphalangeal Dislocation: SINGLE:with MANIPULATION;without Anesth… 24 8 $547.50 $547.50 $474.30 $568.00 $527.00 2024-11-30
12011 CPT Simple Lac Face, Ears, Eyelids, Nose, Lips; 2.5cm Or Less 48 8 $544.00 $544.00 $90.20 $886.00 $526.40 2024-11-30
72084 CPT Thorocolumbar Standing Min 6 Views 12 8 $534.00 $534.00 $480.60 $534.00 $523.32 2024-11-30
25530 CPT Closed Treatment Ulnar Shaft Fracture Without Manipulation 12 8 $529.00 $529.00 $476.10 $529.00 $518.42 2024-11-30
12014 CPT Pf Laceration Repair Superficial 5.1 To 7.5 Cm: Face, Ears, Eyelids, Nose, Lips,… 24 8 $562.50 $562.50 $122.10 $844.00 $517.49 2024-11-30
10040 CPT Acne Surgery 24 8 $558.50 $558.50 $84.70 $898.00 $511.41 2024-11-30
12034 CPT Lac. Inter.scalp,trunk,ext 7.6-12.5 12 8 $520.00 $520.00 $468.00 $520.00 $509.60 2024-11-30
73522 CPT Bil Hips With Pelvis 3-4 Views 12 8 $511.00 $511.00 $459.90 $511.00 $500.78 2024-11-30
12001 CPT Laceration Repair Superficial To 2.5 Cm:scalp, Neck, Axillae, External Genitalia… 48 8 $510.00 $510.00 $73.70 $867.00 $493.50 2024-11-30
92523,GN CPT Sp Evaluation Of Language Comprehension 12 8 $499.00 $499.00 $449.10 $499.00 $489.02 2024-11-30
74022 CPT Abdomen Acute Series 12 8 $492.00 $492.00 $442.80 $492.00 $482.16 2024-11-30
81256 CPT Hemochromatosis DNA Analysis Q 12 8 $491.00 $491.00 $441.90 $491.00 $481.18 2024-11-30
72080 CPT Spine, Thoracolumbar Junction 2 View 12 8 $490.00 $490.00 $441.00 $490.00 $480.20 2024-11-30
28430 CPT Closed Treatment Talus Fracture: Without Manipulation 12 8 $482.00 $482.00 $433.80 $482.00 $472.36 2024-11-30
24650 CPT Pf Closed Treatment Radial Head Or Neck Fracture Without Manipulation 12 8 $528.00 $528.00 $393.25 $517.44 $460.53 2024-11-30
0003M CPT Nash - Fibrotest Q 12 8 $469.00 $469.00 $422.10 $469.00 $459.62 2024-11-30
23570 CPT Closed Treatment Of Scapular Fracture; Without Man 21 8 $485.00 $485.00 $349.24 $485.00 $455.90 2024-11-30
23500 CPT Closed Tx Clavicular Fracture; Without Manipulation 36 8 $458.00 $458.00 $332.20 $652.00 $448.84 2024-11-30
74019 CPT Abdomen 2 View 12 8 $451.00 $451.00 $405.90 $451.00 $441.98 2024-11-30
96365,59 CPT IV Infusion Therapy; Initial Hour 12 8 $449.00 $449.00 $404.10 $449.00 $440.02 2024-11-30
96360 CPT IV Hydration Initial 31-60 Min 12 8 $444.00 $444.00 $399.60 $444.00 $435.12 2024-11-30
72114 CPT L-spine Comp W/bending Min. 6 Views 12 8 $441.00 $441.00 $396.90 $441.00 $432.18 2024-11-30
72050 CPT C-spine Complete 4 Or 5 Views 12 8 $438.00 $438.00 $394.20 $438.00 $429.24 2024-11-30
92610,GN CPT Swallow Evaluation Per Visit 12 8 $437.00 $437.00 $393.30 $437.00 $428.26 2024-11-30
87517 CPT Hepatitis B Rna, Pcr - Q 12 8 $431.00 $431.00 $387.90 $431.00 $422.38 2024-11-30
28470 CPT Closed Treatment Metatarsal Fracture: Without Manipulation: Each 24 8 $433.00 $433.00 $383.40 $440.00 $421.74 2024-11-30
72074 CPT T-spine Complete - Minimum 4 Views 12 8 $430.00 $430.00 $387.00 $430.00 $421.40 2024-11-30
81517 CPT Enhanced Liver Fibrosis (elf Score) 12 8 $425.00 $425.00 $382.50 $425.00 $416.50 2024-11-30
32554 CPT Thoracentesis, Needle, Cath Pleural Space; Without Guidance 24 8 $430.50 $430.50 $373.50 $446.00 $415.00 2024-11-30
12051 CPT Pf Laceration Intermediate Repair Up To 2.5 Cm: Face, Ears, Eyelids, Nose, Lips,… 12 8 $544.00 $544.00 $277.20 $533.12 $412.82 2024-11-30
11042 CPT Debridement, Subq Up To 20 Sq Cm 24 8 $441.50 $441.50 $97.35 $632.00 $407.39 2024-11-30
72072 CPT T-spine W/swimmers 3 Views 12 8 $410.00 $410.00 $369.00 $410.00 $401.80 2024-11-30
96365 CPT IV Infusion Therapy Initial 24 8 $421.50 $421.50 $354.60 $449.00 $399.05 2024-11-30
81403 CPT Jak2 Exons 12 And 13 Q 12 8 $406.00 $406.00 $365.40 $406.00 $397.88 2024-11-30
81270 CPT Jak 2 V617f Mutation 12 8 $406.00 $406.00 $365.40 $406.00 $397.88 2024-11-30
72110 CPT L-spine Complete Minimum 4 Views 12 8 $405.00 $405.00 $364.50 $405.00 $396.90 2024-11-30
72083 CPT Thorocolumbar Standing 4-5 Views 12 8 $405.00 $405.00 $364.50 $405.00 $396.90 2024-11-30
99283 CPT Emergency Room Level 3 24 8 $431.00 $431.00 $99.85 $728.00 $393.26 2024-11-30
26720 CPT Closed Treatment Phalangeal Shaft Fracture: Without Manipulation 12 8 $398.00 $398.00 $358.20 $398.00 $390.04 2024-11-30
46320 CPT Excision Of Thrombosed Hemorrhoid, External 12 8 $397.44 $397.44 $357.70 $397.44 $389.49 2024-11-30
72120 CPT Lumbosacral - Bending Only Views 12 8 $393.00 $393.00 $353.70 $393.00 $385.14 2024-11-30
49082 CPT Abdominal Paracentesis Without Imaging 24 8 $397.00 $397.00 $346.50 $409.00 $384.46 2024-11-30
92522,GN CPT Sp Evaluation Of Sound Production 12 8 $391.00 $391.00 $351.90 $391.00 $383.18 2024-11-30
92521,GN CPT Sp Evaluation Of Fluency 12 8 $391.00 $391.00 $351.90 $391.00 $383.18 2024-11-30
12031 CPT Pf Laceration Intermediate Repair Up To 2.5 Cm: Scalp, Neck, Axillae, External G… 12 8 $504.00 $504.00 $248.05 $493.92 $382.81 2024-11-30
20552 CPT Trigger Point Inj 1-2 Muscles 24 8 $409.00 $409.00 $60.50 $488.00 $381.30 2024-11-30
46083 CPT Incision Of Thrombosed Hemorrhoid, External 12 8 $388.00 $388.00 $349.20 $388.00 $380.24 2024-11-30
87799 CPT Bk Virus Pcr Ua - Q 24 8 $402.50 $402.50 $307.80 $463.00 $379.35 2024-11-30
26750 CPT Closed Treatment Distal Phalangeal Fracture: Finger Or THUMB:without Manipulation: … 24 8 $400.00 $400.00 $336.60 $426.00 $378.70 2024-11-30
87902 CPT Hepatitis C Genotype - Q 12 8 $381.00 $381.00 $342.90 $381.00 $373.38 2024-11-30
30300 CPT Removal Foreign Body, Nose; Office Type 36 8 $380.00 $380.00 $237.60 $458.00 $372.40 2024-11-30
28190 CPT Removal Foreign Body Foot: Sub Q 24 8 $395.50 $395.50 $252.00 $511.00 $369.95 2024-11-30
27250 CPT Closed Treatment Of Hip Dislocation, Traumatic: Without Anesthesia 12 8 $375.00 $375.00 $337.50 $375.00 $367.50 2024-11-30
10120 CPT Incision & Removal Fb, Subq; Simple 48 8 $379.00 $379.00 $172.70 $660.00 $366.60 2024-11-30
73503 CPT Uni Hip With Pelvis Min 4 Views 12 8 $374.00 $374.00 $336.60 $374.00 $366.52 2024-11-30
99236 CPT Same Day Admit-discharge - Observation And Inpatient -high Complexity 12 8 $460.00 $460.00 $292.45 $450.80 $357.20 2024-11-30
99292 CPT Critical Care Additional 30 Minutes 24 8 $384.00 $384.00 $169.42 $523.00 $355.40 2024-11-30
29125 CPT Application Short Arm Splint 48 8 $366.00 $366.00 $115.20 $694.00 $354.38 2024-11-30
25600 CPT Closed Treatment Distal Radial Or Ulnar Styloid Fracture Without Manipulation 36 8 $361.00 $361.00 $291.60 $669.00 $353.78 2024-11-30
86001 CPT Allergy Panel, Food, Igg, Pediatric - Q 12 8 $360.00 $360.00 $324.00 $360.00 $352.80 2024-11-30
13122 CPT Complex Laceration Additional 5 Cm 24 8 $375.00 $375.00 $134.75 $505.00 $347.30 2024-11-30
73502 CPT Uni Hip With Pelvis 2-3 Views 12 8 $350.00 $350.00 $315.00 $350.00 $343.00 2024-11-30
88184 CPT Leukemia/lymphoma Evaluation 1 Of 3 - Q 12 8 $348.00 $348.00 $313.20 $348.00 $341.04 2024-11-30
88189 CPT Leukemia/lymphoma Evaluation 3of 3 - Q 12 8 $348.00 $348.00 $313.20 $348.00 $341.04 2024-11-30
87522 CPT Hepatitis C Rna, Pcr - Q 12 8 $348.00 $348.00 $313.20 $348.00 $341.04 2024-11-30
88185 CPT Leukemia/lymphoma Evaluation 2 Of 3 - Q 12 8 $348.00 $348.00 $313.20 $348.00 $341.04 2024-11-30
70260 CPT Skull Complete Minimum 4 Views 12 8 $345.00 $345.00 $310.50 $345.00 $338.10 2024-11-30
70250 CPT Skull Ltd Less Than 4 Views 12 8 $344.00 $344.00 $309.60 $344.00 $337.12 2024-11-30
73521 CPT Bil Hips With Pelvis 2 Views 12 8 $343.00 $343.00 $308.70 $343.00 $336.14 2024-11-30
70330 CPT Temporomandibular Joints 12 8 $343.00 $343.00 $308.70 $343.00 $336.14 2024-11-30
71048 CPT Chest Ap/pa Lat & Obliqs 12 8 $340.00 $340.00 $306.00 $340.00 $333.20 2024-11-30
12004 CPT Laceration Repair Superficial 7.6 To 12.5 Cm:scalp, Neck, Axillae, External Geni… 36 8 $338.00 $338.00 $119.35 $1,029.00 $331.24 2024-11-30
73050 CPT A-c Joints 12 8 $338.00 $338.00 $304.20 $338.00 $331.24 2024-11-30
72020 CPT Spine - Single View Specify Level 12 8 $338.00 $338.00 $304.20 $338.00 $331.24 2024-11-30
81291 CPT Mther, DNA Analysis---quest 24 8 $347.00 $347.00 $288.90 $373.00 $328.35 2024-11-30
36589 CPT Removal Of Tunneled Central Venous Catheter Without Subcutaneous Port Or Pump 12 8 $335.00 $335.00 $301.50 $335.00 $328.30 2024-11-30
J1610 HCPCS Glucogen/clucagon 1mg Inj 12 8 $333.00 $333.00 $299.70 $333.00 $326.34 2024-11-30
30901 CPT Control Nasal Hemorrhage, Anterior, Simple Any Method 36 8 $332.00 $332.00 $259.20 $586.00 $325.36 2024-11-30
72220 CPT Sacrum-coccyx Minimum 2 Views 12 8 $331.00 $331.00 $297.90 $331.00 $324.38 2024-11-30
81479 CPT Brca Panel Plus 9 Of 9 Q 24 8 $340.25 $340.25 $282.15 $367.00 $321.90 2024-11-30
87486 CPT Respiratory Pathogen Panel 1 Of 3 - Q 12 8 $327.00 $327.00 $294.30 $327.00 $320.46 2024-11-30
87633 CPT Respiratory Pathogen Panel 3 Of 3 - Q 12 8 $327.00 $327.00 $294.30 $327.00 $320.46 2024-11-30
87581 CPT Respiratory Pathogen Panel 2 Of 3 - Q 12 8 $327.00 $327.00 $294.30 $327.00 $320.46 2024-11-30
81241 CPT Factor V Leiden Mutation - Q 12 8 $325.00 $325.00 $292.50 $325.00 $318.50 2024-11-30
20520 CPT Pf Removal Foreign Body In Muscle Or Tendon Sheath; Simple 12 8 $424.00 $424.00 $242.00 $415.52 $318.44 2024-11-30
73565 CPT Knees Bilateral Standing 12 8 $323.00 $323.00 $290.70 $323.00 $316.54 2024-11-30
51703 CPT Insertion Of Temporary Indwelling Bladder Catheter, Complicated 12 8 $322.00 $322.00 $289.80 $322.00 $315.56 2024-11-30
71101 CPT Ribs Unilat. W/chest Min. 3 View 12 8 $320.00 $320.00 $288.00 $320.00 $313.60 2024-11-30
29305 CPT Application Of Hip Spica Cast; 1 Leg 12 8 $318.00 $318.00 $286.20 $318.00 $311.64 2024-11-30
71046 CPT Chest 2 Views 12 8 $317.00 $317.00 $285.30 $317.00 $310.66 2024-11-30
21400 CPT Closed Tx Orbit Fracture; Without Manipulation 12 8 $316.00 $316.00 $284.40 $316.00 $309.68 2024-11-30
72190 CPT Pelvis Comp. Min. 3 Views 12 8 $314.00 $314.00 $282.60 $314.00 $307.72 2024-11-30
81162 CPT Brca Panel Plus 2 Of 9 Q 12 8 $313.50 $313.50 $282.15 $313.50 $307.23 2024-11-30
81321 CPT Brca Panel Plus 3 Of 9 Q 12 8 $313.50 $313.50 $282.15 $313.50 $307.23 2024-11-30
81351 CPT Brca Panel Plus 5 Of 9 Q 12 8 $313.50 $313.50 $282.15 $313.50 $307.23 2024-11-30
81404 CPT Brca Panel Plus 6 Of 9 Q 12 8 $313.50 $313.50 $282.15 $313.50 $307.23 2024-11-30
81307 CPT Brca Panel Plus 1 Of 9 Q 12 8 $313.50 $313.50 $282.15 $313.50 $307.23 2024-11-30
81323 CPT Brca Panel Plus 4 Of 9 Q 12 8 $313.50 $313.50 $282.15 $313.50 $307.23 2024-11-30
81405 CPT Brca Panel Plus 7 Of 9 Q 12 8 $313.50 $313.50 $282.15 $313.50 $307.23 2024-11-30
81406 CPT Brca Panel Plus 8 Of 9 Q 12 8 $313.50 $313.50 $282.15 $313.50 $307.23 2024-11-30
73080 CPT Elbow Complete Min. 3 Views 12 8 $313.00 $313.00 $281.70 $313.00 $306.74 2024-11-30
87497 CPT Cmv, Dna, Pcr-quan - Q 12 8 $313.00 $313.00 $281.70 $313.00 $306.74 2024-11-30
87535 CPT HIV Rna, Pcr 12 8 $313.00 $313.00 $281.70 $313.00 $306.74 2024-11-30
70150 CPT Facial Bones Minimum 3 Views 12 8 $312.00 $312.00 $280.80 $312.00 $305.76 2024-11-30
73501 CPT Uni Hip With Pelvis 1 View 12 8 $310.00 $310.00 $279.00 $310.00 $303.80 2024-11-30
92507,GN CPT Speech Treatment Per Visit 12 8 $309.00 $309.00 $278.10 $309.00 $302.82 2024-11-30
73030 CPT Shoulder, Complete Min. 2 Views 12 8 $306.00 $306.00 $275.40 $306.00 $299.88 2024-11-30
73564 CPT Knee Complete 4 Or More Views 12 8 $305.00 $305.00 $274.50 $305.00 $298.90 2024-11-30
71100 CPT Ribs, Unilateral 2 Views 12 8 $304.00 $304.00 $273.60 $304.00 $297.92 2024-11-30
99223 CPT Hospital Admit - Initial - High Complexity 12 8 $414.00 $414.00 $243.23 $405.72 $297.09 2024-11-30
72070 CPT T-spine 2 Views 12 8 $302.00 $302.00 $271.80 $302.00 $295.96 2024-11-30
74021 CPT Abdomen/ap/w/bi-lat Obl 3+ Views 12 8 $302.00 $302.00 $271.80 $302.00 $295.96 2024-11-30
73610 CPT Ankle Complete Min. 3 Views 12 8 $301.00 $301.00 $270.90 $301.00 $294.98 2024-11-30
83521 CPT Kappa/lambda Light Chains - Q 12 8 $300.00 $300.00 $270.00 $300.00 $294.00 2024-11-30
94010 CPT Spirometry, With Or Without Max Ventilation 12 8 $299.00 $299.00 $269.10 $299.00 $293.02 2024-11-30
99195 CPT Phlebotomy, W/bag 12 8 $297.00 $297.00 $267.30 $297.00 $291.06 2024-11-30
83918 CPT Organic Acid, Quan Ua - Q 12 8 $296.00 $296.00 $266.40 $296.00 $290.08 2024-11-30
73130 CPT Hand Complete Minimum 3 Views 12 8 $294.00 $294.00 $264.60 $294.00 $288.12 2024-11-30
71111 CPT Ribs, Bilat. With Chest Min.4 Views 12 8 $294.00 $294.00 $264.60 $294.00 $288.12 2024-11-30
64450 CPT Injection, Anesthetic Agent Other Peripheral Nerve Or Branch 24 8 $313.00 $313.00 $68.20 $467.00 $288.06 2024-11-30
74018 CPT Abdomen Kub 1 View 12 8 $293.00 $293.00 $263.70 $293.00 $287.14 2024-11-30
70110 CPT Mandible Complete Min Of 4 Views 12 8 $293.00 $293.00 $263.70 $293.00 $287.14 2024-11-30
81372 CPT Hla Class 1 - Q 12 8 $293.00 $293.00 $263.70 $293.00 $287.14 2024-11-30
73562 CPT Knee 3 Views 12 8 $292.00 $292.00 $262.80 $292.00 $286.16 2024-11-30
71110 CPT Ribs, Bilateral 3 Views 12 8 $292.00 $292.00 $262.80 $292.00 $286.16 2024-11-30
73630 CPT Foot Complete Minimum 3 Views 12 8 $290.00 $290.00 $261.00 $290.00 $284.20 2024-11-30
73600 CPT Ankle 2 Views 12 8 $290.00 $290.00 $261.00 $290.00 $284.20 2024-11-30
73090 CPT Forearm 2 Views 12 8 $289.00 $289.00 $260.10 $289.00 $283.22 2024-11-30
73110 CPT Wrist, Complete Min. 3 Views 12 8 $284.00 $284.00 $255.60 $284.00 $278.32 2024-11-30
72100 CPT L-spine 2 Or 3 Views 12 8 $284.00 $284.00 $255.60 $284.00 $278.32 2024-11-30
73590 CPT Tibia/fibula 2 Views 12 8 $283.00 $283.00 $254.70 $283.00 $277.34 2024-11-30
72040 CPT C-spine 2 Or 3 Views 12 8 $282.00 $282.00 $253.80 $282.00 $276.36 2024-11-30
72202 CPT Si Joints Complete Min 3 Views 12 8 $281.00 $281.00 $252.90 $281.00 $275.38 2024-11-30
83880 CPT Bnp 12 8 $280.00 $280.00 $252.00 $280.00 $274.40 2024-11-30
82656 CPT Pancreatic Elastase - Q 12 8 $280.00 $280.00 $252.00 $280.00 $274.40 2024-11-30
76810 CPT OB Each Add Gestation >14 Weeks 12 8 $279.00 $279.00 $251.10 $279.00 $273.42 2024-11-30
99235 CPT Same Day Admit-discharge - Observation And Inpatient -moderate Complexity 12 8 $370.00 $370.00 $223.83 $362.60 $273.39 2024-11-30
82803 CPT Blood Gases 12 8 $278.00 $278.00 $250.20 $278.00 $272.44 2024-11-30
72082 CPT Thorocolumbar Standing 2-3 12 8 $277.00 $277.00 $249.30 $277.00 $271.46 2024-11-30
70220 CPT Sinuses, Paranasal, Complete Minimum 3 Views 12 8 $276.00 $276.00 $248.40 $276.00 $270.48 2024-11-30
73560 CPT Knee 1 0r 2 Views 12 8 $273.00 $273.00 $245.70 $273.00 $267.54 2024-11-30
86922 CPT Crossmatch 12 8 $273.00 $273.00 $245.70 $273.00 $267.54 2024-11-30
92526,GN CPT Swallow Treatment Per Visit 12 8 $273.00 $273.00 $245.70 $273.00 $267.54 2024-11-30
71130 CPT Sternoclavicular Jt 12 8 $273.00 $273.00 $245.70 $273.00 $267.54 2024-11-30
96374 CPT IV Push, Single Or Initial Drug 12 8 $272.00 $272.00 $244.80 $272.00 $266.56 2024-11-30
71047 CPT Chest - Ap/pa, Lat & Lordotic 12 8 $272.00 $272.00 $244.80 $272.00 $266.56 2024-11-30
29345 CPT Cast Application, Long Leg Cast (thigh To Toes) 12 8 $271.00 $271.00 $243.90 $271.00 $265.58 2024-11-30
36680 CPT Placement Of Needle For Intraosseous Infusion 24 8 $281.00 $281.00 $225.00 $312.00 $265.40 2024-11-30
99215 CPT Cah Clinic - Comprehensive - Established 24 8 $279.50 $279.50 $232.65 $289.00 $264.60 2024-11-30
80050 CPT General Health Panel 36 8 $270.00 $270.00 $227.70 $290.00 $264.60 2024-11-30
71045 CPT Chest 1 View 12 8 $268.00 $268.00 $241.20 $268.00 $262.64 2024-11-30
72170 CPT Pelvis, 1 Or 2 Views 12 8 $267.00 $267.00 $240.30 $267.00 $261.66 2024-11-30
73120 CPT Hand 2 Views 12 8 $266.00 $266.00 $239.40 $266.00 $260.68 2024-11-30
80230 CPT Infliximab (remicade) Trough - Q 12 8 $266.00 $266.00 $239.40 $266.00 $260.68 2024-11-30
20610 CPT Arthrocentesis-aspiration/injection Major: Shoulder, Hip, Knee Without Image 36 8 $266.00 $266.00 $73.70 $624.00 $260.68 2024-11-30
83789 CPT Bile Acids - Q 24 8 $277.00 $277.00 $197.10 $335.00 $260.25 2024-11-30
29515 CPT Application Short Leg Splint 12 8 $265.00 $265.00 $238.50 $265.00 $259.70 2024-11-30
81375 CPT Hla Class 2 - Q 12 8 $264.00 $264.00 $237.60 $264.00 $258.72 2024-11-30
96125,GN CPT Sp Cognitive Evaluation Per Hour 12 8 $264.00 $264.00 $237.60 $264.00 $258.72 2024-11-30
12005 CPT Pf Laceration Repair Superficial 12.6 To 20 Cm:scalp, Neck, Axillae, External Ge… 12 8 $350.00 $350.00 $154.55 $343.00 $258.44 2024-11-30
84445 CPT Thyroid Stimulating Immune Globulins - Q 12 8 $262.00 $262.00 $235.80 $262.00 $256.76 2024-11-30
73552 CPT Femur Min 2 Views 12 8 $262.00 $262.00 $235.80 $262.00 $256.76 2024-11-30
28490 CPT Closed Treatment Great Toe, Phalanx Or Phalanges Fracture: Without Manipulation 24 8 $268.50 $268.50 $225.90 $286.00 $254.20 2024-11-30
87536 CPT HIV-RNA-viral Load Pcr - Q 12 8 $256.00 $256.00 $230.40 $256.00 $250.88 2024-11-30
10160 CPT Pf Puncture Aspiration Of Abscess, Hematoma, Bulla, Or Cyst 24 8 $251.50 $251.50 $158.40 $313.00 $250.52 2024-11-30
73660 CPT Toes Minimum 2 Views 12 8 $254.00 $254.00 $228.60 $254.00 $248.92 2024-11-30
96368 CPT IV Infusion Concurrent 12 8 $254.00 $254.00 $228.60 $254.00 $248.92 2024-11-30
51700 CPT Bladder Irrigation Simple Lavage 12 8 $252.00 $252.00 $226.80 $252.00 $246.96 2024-11-30
84145 CPT Procalcitonin Q 12 8 $250.00 $250.00 $225.00 $250.00 $245.00 2024-11-30
11104 CPT Punch Biopsy Of Skin Single 12 8 $250.00 $250.00 $225.00 $250.00 $245.00 2024-11-30
99204 CPT Cah Clinic-moderate Complexity New 12 8 $325.00 $325.00 $216.70 $318.50 $243.76 2024-11-30
87529 CPT Hsv 1 And 2, Pcr - Q 24 8 $261.00 $261.00 $129.60 $378.00 $242.10 2024-11-30
73060 CPT Humerus Min. 2 Views 12 8 $246.00 $246.00 $221.40 $246.00 $241.08 2024-11-30
72200 CPT Sacro-il Jt Less Than 3 Views 12 8 $246.00 $246.00 $221.40 $246.00 $241.08 2024-11-30
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