Price Transparency Hospital negotiated rates

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

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Hospital

GARFIELD COUNTY HEALTH CENTER

Jordan, MT · CCN 271310 · Rates published

468 distinct procedures filed
5 distinct payers
2,340 rate rows
2026-05-18 last MRF observed
Data quality

2,310 of 2,340 rate rows are consumer-grade (98.7%)

30 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 30
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://garfieldcountymt.gov/wp-content/uploads/2026/01/816001366_garfield-county-health-center_standardcharges.csv
Found on page https://garfieldcountymt.gov/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-19
Content fingerprint 5ef9e71ff5e83b96… · 680,743 bytes · first seen 2026-05-18

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
74183
CPT 		MRI Abdomen W/wo Contrast 5 $2,943.59 $2,943.59 $2,943.59 nat. median
$1,101
outlier · 2.7×
70543
CPT 		MRI Orbit Or Stn W/wo Contrast 5 $2,942.84 $2,942.84 $2,942.84 nat. median
$1,077
outlier · 2.7×
72147
CPT 		MRI T Spine W/contrast 5 $2,754.37 $2,754.37 $2,754.37 nat. median
$963
outlier · 2.9×
72149
CPT 		MRI Lumbar Spine W Contrast 5 $2,480.49 $2,480.49 $2,480.49 nat. median
$970
outlier · 2.6×
72142
CPT 		MRI C Spine W/contrast 5 $2,480.49 $2,480.49 $2,480.49 nat. median
$958
outlier · 2.6×
72159
CPT 		MRI C Spine(neck) Angio With Contras 5 $2,480.49 $2,480.49 $2,480.49 nat. median
$1,136
outlier · 2.2×
72156
CPT 		MRI C Spine W/wo Contrast 5 $2,480.49 $2,480.49 $2,480.49 nat. median
$1,092
outlier · 2.3×
70553
CPT 		MRI Brain W/wo Contrast 5 $2,415.39 $2,415.39 $2,415.39 nat. median
$1,122
outlier · 2.2×
74182
CPT 		MRI Abdomen W/contrast 5 $2,351.78 $2,351.78 $2,351.78 nat. median
$990
outlier · 2.4×
70542
CPT 		MRI Stn W/contrast 5 $2,350.91 $2,350.91 $2,350.91 nat. median
$905
outlier · 2.6×
72157
CPT 		MRI T Spine W/wo Contrast 5 $2,335.72 $2,335.72 $2,335.72 nat. median
$1,093
outlier · 2.1×
72146
CPT 		MRI T Spine Wo Contrast 5 $2,211.57 $2,211.57 $2,211.57 nat. median
$772
outlier · 2.9×
74181
CPT 		MRI Abdomen Wo Contrast 5 $2,129.75 $2,129.75 $2,129.75 nat. median
$820
outlier · 2.6×
70540
CPT 		MRI Orbit Or Stn Wo Contrast 5 $2,128.88 $2,128.88 $2,128.88 nat. median
$784
outlier · 2.7×
73220
CPT 		MRI Scapula W/wo Contrast R Or L 5 $2,102.93 $2,102.93 $2,102.93 nat. median
$1,185
1.8× median
70545
CPT 		MRI Brain Mrv With Contrast 5 $2,100.66 $2,100.66 $2,100.66 nat. median
$903
outlier · 2.3×
70546
CPT 		MRI Brain MRA W/wo Contrast 5 $2,100.66 $2,100.66 $2,100.66 nat. median
$1,043
outlier · 2.0×
71550
CPT 		MRI Sc Joint Wo Contrast 5 $2,077.95 $2,077.95 $2,077.95 nat. median
$809
outlier · 2.6×
72197
CPT 		MRI Pelvis Angio W/wo Contrast 5 $2,047.79 $2,047.79 $2,047.79 nat. median
$1,064
1.9× median
73223
CPT 		MRI Any Jnt Upper Extrem W/wo Cont 5 $2,032.32 $2,032.32 $2,032.32 nat. median
$1,223
1.7× median
71552
CPT 		MRI Chest W/wo Contrast 5 $1,973.43 $1,973.43 $1,973.43 nat. median
$1,093
1.8× median
70552
CPT 		MRI Brain W/contrast 5 $1,958.20 $1,958.20 $1,958.20 nat. median
$959
outlier · 2.0×
72148
CPT 		MRI Lumbar Spine Without Contrast 5 $1,886.89 $1,886.89 $1,886.89 nat. median
$770
outlier · 2.5×
72141
CPT 		MRI C Spine Without Contrast 5 $1,886.89 $1,886.89 $1,886.89 nat. median
$765
outlier · 2.5×
73221
CPT 		MRI Shoulder, Elbow Or Wrist Without 5 $1,844.72 $1,844.72 $1,844.72 nat. median
$879
outlier · 2.1×
73222
CPT 		MRI Shoulder, Elbow Or Wrist With 5 $1,844.72 $1,844.72 $1,844.72 nat. median
$1,312
1.4× median
73219
CPT 		MRI Clavicle W Contrast R Or L 5 $1,844.72 $1,844.72 $1,844.72 nat. median
$959
1.9× median
73723
CPT 		MRI Hip,knee Or Ankle Without & W Cont 5 $1,758.97 $1,758.97 $1,758.97 nat. median
$1,263
1.4× median
73720
CPT 		MRI Thigh, Lower Leg Or Foot 5 $1,758.97 $1,758.97 $1,758.97 nat. median
$1,189
1.5× median
73721
CPT 		MRI Hip, Knee Or Ankle Wo Contrast 5 $1,758.97 $1,758.97 $1,758.97 nat. median
$899
2.0× median
72196
CPT 		MRI Pelvis Or Sacrum W/contrast 5 $1,751.97 $1,751.97 $1,751.97 nat. median
$953
1.8× median
70544
CPT 		MRI Brain MRA Wo Contrast 5 $1,729.96 $1,729.96 $1,729.96 nat. median
$816
outlier · 2.1×
72195
CPT 		MRI Pelvis Angio Wo Contrast 5 $1,488.38 $1,488.38 $1,488.38 nat. median
$787
1.9× median
73722
CPT 		MRI Ankle,knee Or Ankle W/contrast 5 $1,484.62 $1,484.62 $1,484.62 nat. median
$1,302
1.1× median
73718
CPT 		MRI Thigh, Lower Leg, Or Foot 5 $1,210.38 $1,210.38 $1,210.38 nat. median
$916
1.3× median
73218
CPT 		MRI Upper Ext Wo Humerus,foream,hd 5 $1,151.72 $1,151.72 $1,151.72 nat. median
$896
1.3× median
99285
CPT 		E.r. - Level V 5 $1,054.38 $1,054.38 $1,054.38 nat. median
$1,228
0.9× median
87507
CPT 		Gi Pathogen Panel Pcr (mayo) 5 $734.42 $734.42 $734.42 nat. median
$549
1.3× median
93307
CPT 		Echocardiology- 2d Complete 5 $662.20 $662.20 $662.20 nat. median
$551
1.2× median
87633
CPT 		Respiratory Panel 5 $625.37 $625.37 $625.37 nat. median
$563
1.1× median
99284
CPT 		E.r. - Level IV 5 $590.62 $590.62 $590.62 nat. median
$781
0.8× median
0070U
CPT 		Gyp2d6 Genotype Cascade V Mayo 5 $568.88 $568.88 $568.88 nat. median
$676
0.8× median
93325
CPT 		Echocardiology- Color Flow Doppler 5 $502.43 $502.43 $502.43 nat. median
$385
1.3× median
99283
CPT 		E.r. - Level Iii 5 $459.38 $459.38 $459.38 nat. median
$475
1.0× median
81225
CPT 		Cyp2c19 Genotype, V,mayo 5 $448.61 $448.61 $448.61 nat. median
$320
1.4× median
A0429QNYY
CPT 		Amb - Bls, Emergent 5 $437.50 $437.50 $437.50 —
72052
CPT 		Cervical With Flexion & Extentsion 5 $426.56 $426.56 $426.56 nat. median
$205
outlier · 2.1×
87535
CPT 		Hiv1 Dna/rna Qual 5 $381.88 $381.88 $381.88 nat. median
$74
outlier · 5.2×
70130TC
CPT 		Mastoid - Min 3 Per Side 5 $377.27 $377.27 $377.27 —
70260
CPT 		Skull - Complete 4 Views 5 $374.06 $374.06 $374.06 nat. median
$185
outlier · 2.0×

Other procedures at this hospital

Browse this hospital's 468 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
             
86160 CPT C3 Complement 5 5 $40.79 $40.79 $35.69 $35.69 $35.69 2026-05-18
82397 CPT Pth Related Protein 5 5 $42.04 $42.04 $36.78 $36.78 $36.78 2026-05-18
83036 CPT Glycosolate Hemoglobin 5 5 $42.13 $42.13 $36.87 $36.87 $36.87 2026-05-18
85018 CPT Hgb 5 5 $42.33 $42.33 $37.04 $37.04 $37.04 2026-05-18
84270 CPT Sex Hormone Biling Globulin Serun 5 5 $42.35 $42.35 $37.05 $37.05 $37.05 2026-05-18
82507 CPT Citrate Excretion, Ur 5 5 $42.90 $42.90 $37.53 $37.53 $37.53 2026-05-18
84442 CPT Tbg Functional 5 5 $43.04 $43.04 $37.66 $37.66 $37.66 2026-05-18
84207 CPT Pyridoxal 5-phosphate (vit B6) 5 5 $43.04 $43.04 $37.66 $37.66 $37.66 2026-05-18
82652 CPT Vit D 1 25 Dihydroxy 5 5 $43.04 $43.04 $37.66 $37.66 $37.66 2026-05-18
86803 CPT Hep C Ab 5 5 $43.04 $43.04 $37.66 $37.66 $37.66 2026-05-18
82550 CPT Cpk 5 5 $43.89 $43.89 $38.41 $38.41 $38.41 2026-05-18
86885 CPT Coombs, Indirect 5 5 $44.56 $44.56 $38.99 $38.99 $38.99 2026-05-18
80164 CPT Valproic Acid 5 5 $45.05 $45.05 $39.42 $39.42 $39.42 2026-05-18
88304 CPT Surg Path Level Iii 5 5 $45.05 $45.05 $39.42 $39.42 $39.42 2026-05-18
88175 CPT Psp Lb Suto + Manual Screen 5 5 $45.05 $45.05 $39.42 $39.42 $39.42 2026-05-18
83835 CPT Metanephrines, Fract 5 5 $45.55 $45.55 $39.85 $39.85 $39.85 2026-05-18
86255 CPT Anca Screen 5 5 $45.63 $45.63 $39.92 $39.92 $39.92 2026-05-18
84703 CPT Pregnancy, Serum 5 5 $45.80 $45.80 $40.08 $40.08 $40.08 2026-05-18
86665 CPT Viral Capsid Ab Igg 5 5 $46.55 $46.55 $40.73 $40.73 $40.73 2026-05-18
81000 CPT Urinalysis 5 5 $46.60 $46.60 $40.77 $40.77 $40.77 2026-05-18
82077 CPT Etoh Blood 5 5 $47.05 $47.05 $41.17 $41.17 $41.17 2026-05-18
87040 CPT Culture, Blood 5 5 $47.05 $47.05 $41.17 $41.17 $41.17 2026-05-18
82274 CPT Occult Bloot, Immunoassary, Stool 5 5 $47.05 $47.05 $41.17 $41.17 $41.17 2026-05-18
82542 CPT Keppra Level (mayo 83140) 5 5 $47.12 $47.12 $41.23 $41.23 $41.23 2026-05-18
85380 CPT D-dimer 5 5 $48.02 $48.02 $42.02 $42.02 $42.02 2026-05-18
87480 CPT Candida Species 5 5 $49.05 $49.05 $42.92 $42.92 $42.92 2026-05-18
87510 CPT Gardnerella 5 5 $49.05 $49.05 $42.92 $42.92 $42.92 2026-05-18
85730 CPT Ptt 5 5 $50.30 $50.30 $44.02 $44.02 $44.02 2026-05-18
87209 CPT Trichrome Stain 5 5 $50.90 $50.90 $44.53 $44.53 $44.53 2026-05-18
86231 CPT Endomysial Ab 5 5 $51.55 $51.55 $45.10 $45.10 $45.10 2026-05-18
82607 CPT Cyanocobalamin (vit B-12) 5 5 $52.60 $52.60 $46.02 $46.02 $46.02 2026-05-18
96376 CPT IV Push Same Drug 5 5 $53.00 $53.00 $46.38 $46.38 $46.38 2026-05-18
80055 CPT Prenatal Panel 5 5 $53.05 $53.05 $46.42 $46.42 $46.42 2026-05-18
84410 CPT Testosterone Bio-avail 5 5 $54.05 $54.05 $47.30 $47.30 $47.30 2026-05-18
86337 CPT Insulin Ab 5 5 $54.65 $54.65 $47.82 $47.82 $47.82 2026-05-18
80069 CPT Renal Panel 5 5 $54.70 $54.70 $47.86 $47.86 $47.86 2026-05-18
7303026 CPT Wrist 3 Views 5 5 $55.00 $55.00 $48.12 $48.12 $48.12 2026-05-18
97542GP CPT Removal Devital Tissue 20 Cm 5 5 $56.00 $56.00 $49.00 $49.00 $49.00 2026-05-18
86038 CPT Ana Screen 5 5 $56.21 $56.21 $49.19 $49.19 $49.19 2026-05-18
82017 CPT Acylcamitine Prof 5 5 $58.06 $58.06 $50.80 $50.80 $50.80 2026-05-18
83516 CPT Tissue Transglutaminase Ab 5 5 $58.81 $58.81 $51.46 $51.46 $51.46 2026-05-18
87529 CPT Hsv 2 DNA Amp Probe 5 5 $59.06 $59.06 $51.68 $51.68 $51.68 2026-05-18
86364 CPT Tissue Transg Ab Iga 5 5 $59.06 $59.06 $51.68 $51.68 $51.68 2026-05-18
83605 CPT Lactic Acid 5 5 $59.06 $59.06 $51.68 $51.68 $51.68 2026-05-18
96361 CPT IV Infusion Addt Hour Hydration 5 5 $60.00 $60.00 $52.50 $52.50 $52.50 2026-05-18
86769 CPT Sars Coronavirus 2 Igg Ab 5 5 $60.06 $60.06 $52.55 $52.55 $52.55 2026-05-18
86617 CPT Lyme Igg Band 5 5 $60.06 $60.06 $52.55 $52.55 $52.55 2026-05-18
87798 CPT H Pylori Clarith Mayo 5 5 $60.06 $60.06 $52.55 $52.55 $52.55 2026-05-18
87045 CPT Culture, Stool 5 5 $61.78 $61.78 $54.06 $54.06 $54.06 2026-05-18
J7050 CPT IV - .9% Nacl (ns) 500ml 5 5 $62.43 $62.43 $54.62 $54.62 $54.62 2026-05-18
J7040 CPT IV - .9% Nacl (ns) 1000ml 5 5 $62.43 $62.43 $54.62 $54.62 $54.62 2026-05-18
81025 CPT Hcg 5 5 $62.69 $62.69 $54.85 $54.85 $54.85 2026-05-18
84466 CPT Transferrin 5 5 $63.91 $63.91 $55.92 $55.92 $55.92 2026-05-18
87046 CPT Aerobic Bacteria, Each 5 5 $64.06 $64.06 $56.05 $56.05 $56.05 2026-05-18
83919 CPT Organic Acids 5 5 $65.07 $65.07 $56.94 $56.94 $56.94 2026-05-18
82378 CPT Cea 5 5 $65.28 $65.28 $57.12 $57.12 $57.12 2026-05-18
84144 CPT Progesterone 5 5 $66.32 $66.32 $58.03 $58.03 $58.03 2026-05-18
87807 CPT Rsv Rapid Test 5 5 $67.07 $67.07 $58.69 $58.69 $58.69 2026-05-18
87338 CPT Helicobactor Pylori Antigen, F 5 5 $67.57 $67.57 $59.12 $59.12 $59.12 2026-05-18
87624 CPT Hpv High Risk 5 5 $69.07 $69.07 $60.44 $60.44 $60.44 2026-05-18
86235 CPT Jo1 Ab's Igg 5 5 $71.07 $71.07 $62.19 $62.19 $62.19 2026-05-18
94010 CPT EKG 5 5 $73.95 $73.95 $64.70 $64.70 $64.70 2026-05-18
93041 CPT Cardiac Monitor 5 5 $74.80 $74.80 $65.45 $65.45 $65.45 2026-05-18
97014GP CPT Pt - Therapy Procedure 5 5 $75.00 $75.00 $65.62 $65.62 $65.62 2026-05-18
96523 CPT Picc Line Irrigation 5 5 $75.00 $75.00 $65.62 $65.62 $65.62 2026-05-18
88312 CPT Special Stains, Grup 1 5 5 $75.08 $75.08 $65.69 $65.69 $65.69 2026-05-18
86684 CPT H Influ B Ab Igg 5 5 $77.83 $77.83 $68.10 $68.10 $68.10 2026-05-18
82553 CPT Ck Mb 5 5 $77.93 $77.93 $68.19 $68.19 $68.19 2026-05-18
86304 CPT Ca125 5 5 $79.08 $79.08 $69.19 $69.19 $69.19 2026-05-18
80184 CPT Phenobarbital 5 5 $79.21 $79.21 $69.31 $69.31 $69.31 2026-05-18
97760GP CPT Orthotic Mgmnt Training (lower) 5 5 $79.25 $79.25 $69.34 $69.34 $69.34 2026-05-18
97763GP CPT Pt - Educ & Training For Self Man 5 5 $79.25 $79.25 $69.34 $69.34 $69.34 2026-05-18
87426 CPT Covid 19 Rapid Test 5 5 $80.08 $80.08 $70.07 $70.07 $70.07 2026-05-18
84403 CPT Testosterone, Total 5 5 $81.08 $81.08 $70.94 $70.94 $70.94 2026-05-18
84305 CPT Smc Insulin Like Gfi 5 5 $81.33 $81.33 $71.17 $71.17 $71.17 2026-05-18
86317 CPT Strep Pneum Igg Ab-23 5 5 $82.08 $82.08 $71.82 $71.82 $71.82 2026-05-18
87498 CPT Enterovirus Pcr 5 5 $82.08 $82.08 $71.82 $71.82 $71.82 2026-05-18
86161 CPT Ch Complement Functional 5 5 $82.08 $82.08 $71.82 $71.82 $71.82 2026-05-18
85610 CPT Istat - Prothrombin Time 5 5 $83.08 $83.08 $72.69 $72.69 $72.69 2026-05-18
87400 CPT Antigen Detect- Influenza A/b 5 5 $84.08 $84.08 $73.57 $73.57 $73.57 2026-05-18
87661 CPT Trichomonas Vaginalis RNA 5 5 $84.33 $84.33 $73.79 $73.79 $73.79 2026-05-18
87497 CPT Cmv DNA Qn By Pcr 5 5 $85.09 $85.09 $74.45 $74.45 $74.45 2026-05-18
86403 CPT Strep Screen 5 5 $86.09 $86.09 $75.33 $75.33 $75.33 2026-05-18
87493 CPT C Difficile By Pcr 5 5 $86.09 $86.09 $75.33 $75.33 $75.33 2026-05-18
83874 CPT Myoglobin Assay 5 5 $86.34 $86.34 $75.55 $75.55 $75.55 2026-05-18
86258 CPT Gliadin Ab,iga 5 5 $86.44 $86.44 $75.64 $75.64 $75.64 2026-05-18
87640 CPT Mssa 5 5 $89.84 $89.84 $78.61 $78.61 $78.61 2026-05-18
87641 CPT Mrsa 5 5 $89.84 $89.84 $78.61 $78.61 $78.61 2026-05-18
87581 CPT Mycoplasma Pneum 5 5 $90.09 $90.09 $78.83 $78.83 $78.83 2026-05-18
87486 CPT Chlamydophila Pneum 5 5 $90.09 $90.09 $78.83 $78.83 $78.83 2026-05-18
84484 CPT Istat - Troponin, Quant (ctnl) 5 5 $91.04 $91.04 $79.66 $79.66 $79.66 2026-05-18
82670 CPT Estradiol 5 5 $93.09 $93.09 $81.45 $81.45 $81.45 2026-05-18
97535GP CPT Wheel Chair Mgmnt Training 15 Mins 5 5 $94.00 $94.00 $82.25 $82.25 $82.25 2026-05-18
84425 CPT Vitamin B1 5 5 $95.85 $95.85 $83.87 $83.87 $83.87 2026-05-18
97140GP CPT Pt - Low Complex Evaluation 5 5 $101.60 $101.60 $88.90 $88.90 $88.90 2026-05-18
96375 CPT IV Push Each Add'l Push New Drug 5 5 $104.00 $104.00 $91.00 $91.00 $91.00 2026-05-18
96372 CPT IM Push ER Single Med 5 5 $104.00 $104.00 $91.00 $91.00 $91.00 2026-05-18
12001 CPT Lac Superf Nonfacial < 2.5 5 5 $106.00 $106.00 $92.75 $92.75 $92.75 2026-05-18
97110GP CPT Pt -therp Proced 1 Or More 5 5 $106.10 $106.10 $92.84 $92.84 $92.84 2026-05-18
97116GP CPT Pt - Manual Therapy Very 15 Mins 5 5 $106.10 $106.10 $92.84 $92.84 $92.84 2026-05-18
97530GP CPT Self Care Mgmnt Training 5 5 $106.10 $106.10 $92.84 $92.84 $92.84 2026-05-18
87522 CPT Hep C RNA (rt-pcr) 5 5 $107.06 $107.06 $93.68 $93.68 $93.68 2026-05-18
98960GP CPT Shoulder Min Of 2 Views 5 5 $108.85 $108.85 $95.25 $95.25 $95.25 2026-05-18
97112GP CPT Pt - Gait Training 15 Mins 5 5 $108.85 $108.85 $95.25 $95.25 $95.25 2026-05-18
95992GP CPT Pt - Electric Stimuation Unattende 5 5 $110.00 $110.00 $96.25 $96.25 $96.25 2026-05-18
97164GP CPT Therapeutice Activities Per 15 Min 5 5 $110.00 $110.00 $96.25 $96.25 $96.25 2026-05-18
86671 CPT Sacc Ab Lga & Lgg 5 5 $111.11 $111.11 $97.22 $97.22 $97.22 2026-05-18
88112 CPT Cytopath Liquid Based 5 5 $111.11 $111.11 $97.22 $97.22 $97.22 2026-05-18
96366 CPT IV Infusion Additional Hours 5 5 $115.00 $115.00 $100.62 $100.62 $100.62 2026-05-18
96360 CPT IV Infusion 1st Hour Hydration 5 5 $115.50 $115.50 $101.06 $101.06 $101.06 2026-05-18
12011 CPT Lac Superfic Facial < 2.5 5 5 $116.00 $116.00 $101.50 $101.50 $101.50 2026-05-18
76816 CPT OB Sonogram Followup/repeat 5 5 $118.80 $118.80 $103.95 $103.95 $103.95 2026-05-18
12002 CPT Lac Superfic Nonfacial 2.6 - 7.5 5 5 $120.00 $120.00 $105.00 $105.00 $105.00 2026-05-18
0077U CPT Quantitative M-protein 5 5 $120.12 $120.12 $105.11 $105.11 $105.11 2026-05-18
12013 CPT Lac Superfic Facial 2.6 - 5 Cm 5 5 $121.00 $121.00 $105.88 $105.88 $105.88 2026-05-18
72020 CPT Spine 1 View Of Any Section 5 5 $124.60 $124.60 $109.03 $109.03 $109.03 2026-05-18
93225 CPT EKG Professional 5 5 $125.00 $125.00 $109.38 $109.38 $109.38 2026-05-18
99211 CPT Outpt/trmt Svc - 1st Hour 5 5 $125.00 $125.00 $109.38 $109.38 $109.38 2026-05-18
93321 CPT Echocardiology- Cardiac Doppler Li 5 5 $125.40 $125.40 $109.72 $109.72 $109.72 2026-05-18
86677 CPT Helicobacter Pylori - Immunoassay 5 5 $129.13 $129.13 $112.99 $112.99 $112.99 2026-05-18
80074 CPT Hep Profile, Acute 5 5 $130.13 $130.13 $113.86 $113.86 $113.86 2026-05-18
93308 CPT Echocardiology- 2d Limited 5 5 $132.00 $132.00 $115.50 $115.50 $115.50 2026-05-18
83090 CPT Homocysteine 5 5 $133.13 $133.13 $116.49 $116.49 $116.49 2026-05-18
87230 CPT Tissue Culture, Toxin/antitoxin 5 5 $134.59 $134.59 $117.77 $117.77 $117.77 2026-05-18
12004 CPT Lac Superfic Nonfacial 7.6 - 12.5 5 5 $136.00 $136.00 $119.00 $119.00 $119.00 2026-05-18
83970 CPT Pth, Intact 5 5 $144.14 $144.14 $126.12 $126.12 $126.12 2026-05-18
80299 CPT Dexamethasone S 5 5 $146.03 $146.03 $127.78 $127.78 $127.78 2026-05-18
86334 CPT Immunofixation Only, Serum 5 5 $146.15 $146.15 $127.88 $127.88 $127.88 2026-05-18
73650 CPT Calcaneus 5 5 $146.45 $146.45 $128.15 $128.15 $128.15 2026-05-18
84206 CPT Proinsulin 5 5 $148.15 $148.15 $129.63 $129.63 $129.63 2026-05-18
12014 CPT Lac Superfic Facial 5.1 - 7.5 Cm 5 5 $150.00 $150.00 $131.25 $131.25 $131.25 2026-05-18
76010 CPT Babygram 5 5 $150.25 $150.25 $131.47 $131.47 $131.47 2026-05-18
82139 CPT Amino Acids Quant, Plasm 5 5 $155.16 $155.16 $135.76 $135.76 $135.76 2026-05-18
70030TC CPT Eye - Foreign Body 5 5 $157.25 $157.25 $137.59 $137.59 $137.59 2026-05-18
12051 CPT Lac Intermed Truck/limb 2.5 Or Les 5 5 $160.20 $160.20 $140.18 $140.18 $140.18 2026-05-18
86689 CPT Htlv Confiramation Mayo 5 5 $166.17 $166.17 $145.40 $145.40 $145.40 2026-05-18
97597GP CPT Wound Care Non-selective 5 5 $167.75 $167.75 $146.78 $146.78 $146.78 2026-05-18
12017 CPT Lac Superfic Facial 10.1 - 30 Cm 5 5 $169.00 $169.00 $147.88 $147.88 $147.88 2026-05-18
70360 CPT Neck/soft Tissue 5 5 $173.66 $173.66 $151.96 $151.96 $151.96 2026-05-18
12015 CPT Lac Super Facial 7.5 - 12.5 Cm 5 5 $180.00 $180.00 $157.50 $157.50 $157.50 2026-05-18
97161GP CPT Moderate Complexity Evaluation 5 5 $182.80 $182.80 $159.95 $159.95 $159.95 2026-05-18
73020 CPT Shoulder - Limited 1 View 5 5 $186.05 $186.05 $162.79 $162.79 $162.79 2026-05-18
72200 CPT Si Joints 1-2 Views 5 5 $186.05 $186.05 $162.79 $162.79 $162.79 2026-05-18
96374 CPT IV Push Single Or Initial Drug 5 5 $187.18 $187.18 $163.78 $163.78 $163.78 2026-05-18
86361 CPT Cd4 Count 5 5 $189.19 $189.19 $165.54 $165.54 $165.54 2026-05-18
82803 CPT Abg 5 5 $189.28 $189.28 $165.62 $165.62 $165.62 2026-05-18
12005 CPT Lac Superfic Nonfacial 12.6 - 20.0 5 5 $190.00 $190.00 $166.25 $166.25 $166.25 2026-05-18
73140 CPT Finger(s) Min 2 Views 5 5 $190.25 $190.25 $166.47 $166.47 $166.47 2026-05-18
73000 CPT Clavicle - Complete 5 5 $190.56 $190.56 $166.74 $166.74 $166.74 2026-05-18
73590 CPT Tibia/fibula 5 5 $190.56 $190.56 $166.74 $166.74 $166.74 2026-05-18
93005 CPT Rhythm Strip 5 5 $192.50 $192.50 $168.44 $168.44 $168.44 2026-05-18
80306 CPT Drugs Of Abuse, Urine 5 5 $200.20 $200.20 $175.18 $175.18 $175.18 2026-05-18
73100 CPT Wrist - Limited 2 Views 5 5 $200.25 $200.25 $175.22 $175.22 $175.22 2026-05-18
12032 CPT Lac Intermed Truck/limb 2.6 - 7.5 5 5 $201.00 $201.00 $175.88 $175.88 $175.88 2026-05-18
92507 CPT Evaluation Of Speech Sound 5 5 $201.25 $201.25 $176.09 $176.09 $176.09 2026-05-18
70210TC CPT Sinuses - Less Than 3 Views 5 5 $201.84 $201.84 $176.61 $176.61 $176.61 2026-05-18
71045TC CPT Chest - 1 View Frontal & Lateral 5 5 $205.25 $205.25 $179.59 $179.59 $179.59 2026-05-18
71045 CPT Chest - 1 View Frontal 5 5 $205.25 $205.25 $179.59 $179.59 $179.59 2026-05-18
97162GP CPT High Complexity Evaluation 5 5 $206.00 $206.00 $180.25 $180.25 $180.25 2026-05-18
73660 CPT Toe(s) 5 5 $207.05 $207.05 $181.17 $181.17 $181.17 2026-05-18
70250TC CPT Skull - Less Than 4 Views 5 5 $207.46 $207.46 $181.53 $181.53 $181.53 2026-05-18
72170 CPT Pelvis - 1 Or 2 Views 5 5 $207.46 $207.46 $181.53 $181.53 $181.53 2026-05-18
73120 CPT Hand - Limited 2 View 5 5 $209.25 $209.25 $183.09 $183.09 $183.09 2026-05-18
73620 CPT Foot - Limited 2 Views 5 5 $209.25 $209.25 $183.09 $183.09 $183.09 2026-05-18
73600 CPT Ankle - 2 Views 5 5 $210.25 $210.25 $183.97 $183.97 $183.97 2026-05-18
73070 CPT Elbow - 2 Views 5 5 $210.25 $210.25 $183.97 $183.97 $183.97 2026-05-18
73551 CPT Femur - 1 View 5 5 $210.25 $210.25 $183.97 $183.97 $183.97 2026-05-18
74018 CPT Abdomen - 1 View 5 5 $210.25 $210.25 $183.97 $183.97 $183.97 2026-05-18
12052 CPT Lac Intermed Facial 2.6 - 5.0 Cm 5 5 $210.75 $210.75 $184.41 $184.41 $184.41 2026-05-18
12006 CPT Lac Superfic Nonfacial 20.1 - 30 C 5 5 $215.00 $215.00 $188.12 $188.12 $188.12 2026-05-18
73050 CPT A-c Joint Bilateral 5 5 $220.25 $220.25 $192.72 $192.72 $192.72 2026-05-18
12044 CPT Lac Intermed Trunk/limb 7.6 - 12.5 5 5 $227.00 $227.00 $198.62 $198.62 $198.62 2026-05-18
12016 CPT Lac Superfic Facial 12.6 - 20 Cm 5 5 $227.00 $227.00 $198.62 $198.62 $198.62 2026-05-18
12053 CPT Lac Intmed Facial 5.1 - 7.5 Cm 5 5 $228.25 $228.25 $199.72 $199.72 $199.72 2026-05-18
73010TC CPT Scapula - Complete 5 5 $229.96 $229.96 $201.22 $201.22 $201.22 2026-05-18
73030 CPT Shoulder - Complete 2 + Views 5 5 $229.96 $229.96 $201.22 $201.22 $201.22 2026-05-18
71046TC CPT Chest - 2 Views Frontal & Lateral 5 5 $229.96 $229.96 $201.22 $201.22 $201.22 2026-05-18
73090 CPT Forearm - 2 View 5 5 $229.96 $229.96 $201.22 $201.22 $201.22 2026-05-18
73060 CPT Humerus - W/joint 5 5 $229.96 $229.96 $201.22 $201.22 $201.22 2026-05-18
76805 CPT OB Sonogram Complete 5 5 $231.00 $231.00 $202.12 $202.12 $202.12 2026-05-18
12054 CPT Lac Intermed Facial 7.6 - 12.5 Cm 5 5 $235.10 $235.10 $205.71 $205.71 $205.71 2026-05-18
71046 CPT Chest - 2 View Frontal & Lateral 5 5 $237.25 $237.25 $207.59 $207.59 $207.59 2026-05-18
70100TC CPT Mandible - Less Than 4 Views 5 5 $237.55 $237.55 $207.85 $207.85 $207.85 2026-05-18
73630 CPT Foot - 3 Views 5 5 $237.55 $237.55 $207.85 $207.85 $207.85 2026-05-18
12007 CPT Lac Superfic Nonfacial Over 30cm 5 5 $240.00 $240.00 $210.00 $210.00 $210.00 2026-05-18
99281 CPT E.r. - Level I 5 5 $240.00 $240.00 $210.00 $210.00 $210.00 2026-05-18
73130 CPT Hand - Complete 3 View 5 5 $240.25 $240.25 $210.22 $210.22 $210.22 2026-05-18
74022 CPT Acute Abdomen Series 5 5 $241.25 $241.25 $211.09 $211.09 $211.09 2026-05-18
73110 CPT Wrist - 3 Views 5 5 $241.25 $241.25 $211.09 $211.09 $211.09 2026-05-18
92523 CPT Behavioral & Qualitative Analysis 5 5 $241.45 $241.45 $211.27 $211.27 $211.27 2026-05-18
72040 CPT Spine Cervical 3 Views Or Less 5 5 $243.12 $243.12 $212.73 $212.73 $212.73 2026-05-18
73610 CPT Ankle - 3 Views 5 5 $245.25 $245.25 $214.59 $214.59 $214.59 2026-05-18
73080 CPT Elbow - 3+ Views 5 5 $245.25 $245.25 $214.59 $214.59 $214.59 2026-05-18
92522 CPT Evaluation Of Seech Sound 5 5 $250.00 $250.00 $218.75 $218.75 $218.75 2026-05-18
73560 CPT Knee - 2 Views 5 5 $250.59 $250.59 $219.26 $219.26 $219.26 2026-05-18
70160 CPT Nasal Bones - Complete 5 5 $250.59 $250.59 $219.26 $219.26 $219.26 2026-05-18
70120TC CPT Mastoid - Less Than 3 Per Side 5 5 $250.59 $250.59 $219.26 $219.26 $219.26 2026-05-18
97602GP CPT Orthotic Mgmnt Training (upper) 5 5 $251.50 $251.50 $220.06 $220.06 $220.06 2026-05-18
97163GP CPT Re-evalucation 5 5 $256.00 $256.00 $224.00 $224.00 $224.00 2026-05-18
12035 CPT Lac Intermed Trunk/limb 12.6 - 20. 5 5 $257.00 $257.00 $224.88 $224.88 $224.88 2026-05-18
73552TC CPT Femur - Min Of 2 Views 5 5 $259.25 $259.25 $226.84 $226.84 $226.84 2026-05-18
83993 CPT Calprotectin, Fecal 5 5 $265.27 $265.27 $232.11 $232.11 $232.11 2026-05-18
72100 CPT L-spine 2 Or 3 Views 5 5 $265.85 $265.85 $232.62 $232.62 $232.62 2026-05-18
71120TC CPT Sternum - Min Of 2 Views 5 5 $265.85 $265.85 $232.62 $232.62 $232.62 2026-05-18
72070 CPT T-spine - 2 Views 5 5 $265.85 $265.85 $232.62 $232.62 $232.62 2026-05-18
70140TC CPT Facial Bones - Less Than 3 Views 5 5 $265.85 $265.85 $232.62 $232.62 $232.62 2026-05-18
72220TC CPT Sacrum/coccyx 5 5 $265.85 $265.85 $232.62 $232.62 $232.62 2026-05-18
73500 CPT Hip - Unilateral Limited 1 View 5 5 $267.67 $267.67 $234.21 $234.21 $234.21 2026-05-18
70328 CPT Tmj Open & Closed 5 5 $271.25 $271.25 $237.34 $237.34 $237.34 2026-05-18
83880 CPT B-type Natriuretic Peptide (bnp) 5 5 $272.08 $272.08 $238.07 $238.07 $238.07 2026-05-18
72190TC CPT Pelvis - Min Of 3 Views 5 5 $272.45 $272.45 $238.40 $238.40 $238.40 2026-05-18
71100 CPT Ribs - Unilateral 2 View 5 5 $275.09 $275.09 $240.71 $240.71 $240.71 2026-05-18
71110 CPT Rib - Bilateral 3 View 5 5 $279.25 $279.25 $244.34 $244.34 $244.34 2026-05-18
73562 CPT Knee - 3 Views 5 5 $279.35 $279.35 $244.43 $244.43 $244.43 2026-05-18
72080 CPT Thoracolumbar 5 5 $280.25 $280.25 $245.22 $245.22 $245.22 2026-05-18
76870 CPT Testicular Sonogram 5 5 $280.50 $280.50 $245.44 $245.44 $245.44 2026-05-18
86359 CPT Cd 3 T Cells & T Cell Total 5 5 $290.28 $290.28 $254.00 $254.00 $254.00 2026-05-18
74019TC CPT Abdomen 2 Views 5 5 $293.25 $293.25 $256.60 $256.60 $256.60 2026-05-18
70150TC CPT Facial Bones - Min Of 3 Views 5 5 $295.25 $295.25 $258.35 $258.35 $258.35 2026-05-18
73564 CPT Knee - Complete 4 Or More Views 5 5 $295.25 $295.25 $258.35 $258.35 $258.35 2026-05-18
71130TC CPT Sternoclavicular Joint Min Of 3 Vw 5 5 $295.85 $295.85 $258.87 $258.87 $258.87 2026-05-18
A0428QNYY CPT Amb - Bls, Non-emerg 5 5 $300.00 $300.00 $262.50 $262.50 $262.50 2026-05-18
12036 CPT Lac Intermed Trunk/limb 20.1 - 30. 5 5 $303.35 $303.35 $265.43 $265.43 $265.43 2026-05-18
73501 CPT Hip Limited 5 5 $307.25 $307.25 $268.85 $268.85 $268.85 2026-05-18
72072TC CPT T-spine - 3 Views 5 5 $310.25 $310.25 $271.47 $271.47 $271.47 2026-05-18
72110 CPT L-spine 4 View 5 5 $310.25 $310.25 $271.47 $271.47 $271.47 2026-05-18
74021 CPT Kub And Upright 5 5 $310.80 $310.80 $271.95 $271.95 $271.95 2026-05-18
86003 CPT Allergen Profile Mayo Seas 5 5 $315.32 $315.32 $275.90 $275.90 $275.90 2026-05-18
74021TC CPT Abdomen 3 Or More View 5 5 $320.25 $320.25 $280.22 $280.22 $280.22 2026-05-18
12055 CPT Lac Intermed Facial 12.6-20.0 Cm 5 5 $321.20 $321.20 $281.05 $281.05 $281.05 2026-05-18
96365 CPT IV Infusion 1st Hour 5 5 $325.00 $325.00 $284.38 $284.38 $284.38 2026-05-18
70220TC CPT Sinuses - Min Of 3 Views 5 5 $335.18 $335.18 $293.28 $293.28 $293.28 2026-05-18
73502TC CPT Hip - Unilater 2 Views 5 5 $336.99 $336.99 $294.87 $294.87 $294.87 2026-05-18
73521TC CPT Hip - Bilateral With Pelvic 5 5 $336.99 $336.99 $294.87 $294.87 $294.87 2026-05-18
73502 CPT Hip - Complete 5 5 $336.99 $336.99 $294.87 $294.87 $294.87 2026-05-18
93320 CPT Echocardiology- Cardiac Dopler Com 5 5 $338.80 $338.80 $296.45 $296.45 $296.45 2026-05-18
12046 CPT Lac Intermed Trunk/limb 20.1 - 30 5 5 $339.00 $339.00 $296.62 $296.62 $296.62 2026-05-18
76856 CPT Pelvic GYN Complete 5 5 $342.10 $342.10 $299.33 $299.33 $299.33 2026-05-18
99282 CPT E.r. - Level Ii 5 5 $350.00 $350.00 $306.25 $306.25 $306.25 2026-05-18
12037 CPT Lac Intermed Truck/limb 30 Cm 5 5 $355.00 $355.00 $310.62 $310.62 $310.62 2026-05-18
73522TC CPT Hip - Bilateral With Pelvis 3-4 Vw 5 5 $360.99 $360.99 $315.87 $315.87 $315.87 2026-05-18
76700 CPT Abd Sonogram Complete 5 5 $361.90 $361.90 $316.67 $316.67 $316.67 2026-05-18
76770 CPT Retroperitoneal Ultrasound Complet 5 5 $363.00 $363.00 $317.62 $317.62 $317.62 2026-05-18
72050 CPT Spine Cervical 4 Or 5 Views 5 5 $370.90 $370.90 $324.54 $324.54 $324.54 2026-05-18
70110 CPT Mandible - Min Of 4 Views 5 5 $370.90 $370.90 $324.54 $324.54 $324.54 2026-05-18
73523TC CPT Hip - Bilateral With Pelvis Min 5 5 5 $385.24 $385.24 $337.08 $337.08 $337.08 2026-05-18
P9010 CPT Blood - Rbc Unit 5 5 $386.07 $386.07 $337.81 $337.81 $337.81 2026-05-18
76830 CPT Pelvic Transvaginal Ultrasound 5 5 $390.50 $390.50 $341.69 $341.69 $341.69 2026-05-18
12056 CPT Lac Intermed Facial 20.1 - 30 Cm 5 5 $410.70 $410.70 $359.36 $359.36 $359.36 2026-05-18
72074 CPT Thoracic 4 Views 5 5 $420.30 $420.30 $367.76 $367.76 $367.76 2026-05-18
70260 CPT Skull - Complete 4 Views 5 5 $427.49 $427.49 $374.06 $374.06 $374.06 2026-05-18
70130TC CPT Mastoid - Min 3 Per Side 5 5 $431.17 $431.17 $377.27 $377.27 $377.27 2026-05-18
87535 CPT Hiv1 Dna/rna Qual 5 5 $436.44 $436.44 $381.88 $381.88 $381.88 2026-05-18
72052 CPT Cervical With Flexion & Extentsion 5 5 $487.50 $487.50 $426.56 $426.56 $426.56 2026-05-18
A0429QNYY CPT Amb - Bls, Emergent 5 5 $500.00 $500.00 $437.50 $437.50 $437.50 2026-05-18
81225 CPT Cyp2c19 Genotype, V,mayo 5 5 $512.70 $512.70 $448.61 $448.61 $448.61 2026-05-18
99283 CPT E.r. - Level Iii 5 5 $525.00 $525.00 $459.38 $459.38 $459.38 2026-05-18
93325 CPT Echocardiology- Color Flow Doppler 5 5 $574.20 $574.20 $502.43 $502.43 $502.43 2026-05-18
0070U CPT Gyp2d6 Genotype Cascade V Mayo 5 5 $650.15 $650.15 $568.88 $568.88 $568.88 2026-05-18
99284 CPT E.r. - Level IV 5 5 $675.00 $675.00 $590.62 $590.62 $590.62 2026-05-18
87633 CPT Respiratory Panel 5 5 $714.71 $714.71 $625.37 $625.37 $625.37 2026-05-18
93307 CPT Echocardiology- 2d Complete 5 5 $756.80 $756.80 $662.20 $662.20 $662.20 2026-05-18
87507 CPT Gi Pathogen Panel Pcr (mayo) 5 5 $839.34 $839.34 $734.42 $734.42 $734.42 2026-05-18
99285 CPT E.r. - Level V 5 5 $1,205.00 $1,205.00 $1,054.38 $1,054.38 $1,054.38 2026-05-18
73218 CPT MRI Upper Ext Wo Humerus,foream,hd 5 5 $1,316.25 $1,316.25 $1,151.72 $1,151.72 $1,151.72 2026-05-18
73718 CPT MRI Thigh, Lower Leg, Or Foot 5 5 $1,383.30 $1,383.30 $1,210.38 $1,210.38 $1,210.38 2026-05-18
73722 CPT MRI Ankle,knee Or Ankle W/contrast 5 5 $1,696.70 $1,696.70 $1,484.62 $1,484.62 $1,484.62 2026-05-18
72195 CPT MRI Pelvis Angio Wo Contrast 5 5 $1,701.00 $1,701.00 $1,488.38 $1,488.38 $1,488.38 2026-05-18
70544 CPT MRI Brain MRA Wo Contrast 5 5 $1,977.10 $1,977.10 $1,729.96 $1,729.96 $1,729.96 2026-05-18
72196 CPT MRI Pelvis Or Sacrum W/contrast 5 5 $2,002.25 $2,002.25 $1,751.97 $1,751.97 $1,751.97 2026-05-18
73721 CPT MRI Hip, Knee Or Ankle Wo Contrast 5 5 $2,010.25 $2,010.25 $1,758.97 $1,758.97 $1,758.97 2026-05-18
73720 CPT MRI Thigh, Lower Leg Or Foot 5 5 $2,010.25 $2,010.25 $1,758.97 $1,758.97 $1,758.97 2026-05-18
73723 CPT MRI Hip,knee Or Ankle Without & W Cont 5 5 $2,010.25 $2,010.25 $1,758.97 $1,758.97 $1,758.97 2026-05-18
73221 CPT MRI Shoulder, Elbow Or Wrist Without 5 5 $2,108.25 $2,108.25 $1,844.72 $1,844.72 $1,844.72 2026-05-18
73222 CPT MRI Shoulder, Elbow Or Wrist With 5 5 $2,108.25 $2,108.25 $1,844.72 $1,844.72 $1,844.72 2026-05-18
73219 CPT MRI Clavicle W Contrast R Or L 5 5 $2,108.25 $2,108.25 $1,844.72 $1,844.72 $1,844.72 2026-05-18
72141 CPT MRI C Spine Without Contrast 5 5 $2,156.45 $2,156.45 $1,886.89 $1,886.89 $1,886.89 2026-05-18
72148 CPT MRI Lumbar Spine Without Contrast 5 5 $2,156.45 $2,156.45 $1,886.89 $1,886.89 $1,886.89 2026-05-18
70552 CPT MRI Brain W/contrast 5 5 $2,237.95 $2,237.95 $1,958.20 $1,958.20 $1,958.20 2026-05-18
71552 CPT MRI Chest W/wo Contrast 5 5 $2,255.35 $2,255.35 $1,973.43 $1,973.43 $1,973.43 2026-05-18
73223 CPT MRI Any Jnt Upper Extrem W/wo Cont 5 5 $2,322.65 $2,322.65 $2,032.32 $2,032.32 $2,032.32 2026-05-18
72197 CPT MRI Pelvis Angio W/wo Contrast 5 5 $2,340.33 $2,340.33 $2,047.79 $2,047.79 $2,047.79 2026-05-18
71550 CPT MRI Sc Joint Wo Contrast 5 5 $2,374.80 $2,374.80 $2,077.95 $2,077.95 $2,077.95 2026-05-18
70546 CPT MRI Brain MRA W/wo Contrast 5 5 $2,400.75 $2,400.75 $2,100.66 $2,100.66 $2,100.66 2026-05-18
70545 CPT MRI Brain Mrv With Contrast 5 5 $2,400.75 $2,400.75 $2,100.66 $2,100.66 $2,100.66 2026-05-18
73220 CPT MRI Scapula W/wo Contrast R Or L 5 5 $2,403.35 $2,403.35 $2,102.93 $2,102.93 $2,102.93 2026-05-18
70540 CPT MRI Orbit Or Stn Wo Contrast 5 5 $2,433.00 $2,433.00 $2,128.88 $2,128.88 $2,128.88 2026-05-18
74181 CPT MRI Abdomen Wo Contrast 5 5 $2,434.00 $2,434.00 $2,129.75 $2,129.75 $2,129.75 2026-05-18
72146 CPT MRI T Spine Wo Contrast 5 5 $2,527.50 $2,527.50 $2,211.57 $2,211.57 $2,211.57 2026-05-18
72157 CPT MRI T Spine W/wo Contrast 5 5 $2,669.40 $2,669.40 $2,335.72 $2,335.72 $2,335.72 2026-05-18
70542 CPT MRI Stn W/contrast 5 5 $2,686.75 $2,686.75 $2,350.91 $2,350.91 $2,350.91 2026-05-18
74182 CPT MRI Abdomen W/contrast 5 5 $2,687.75 $2,687.75 $2,351.78 $2,351.78 $2,351.78 2026-05-18
70553 CPT MRI Brain W/wo Contrast 5 5 $2,760.45 $2,760.45 $2,415.39 $2,415.39 $2,415.39 2026-05-18
72159 CPT MRI C Spine(neck) Angio With Contras 5 5 $2,834.85 $2,834.85 $2,480.49 $2,480.49 $2,480.49 2026-05-18
72149 CPT MRI Lumbar Spine W Contrast 5 5 $2,834.85 $2,834.85 $2,480.49 $2,480.49 $2,480.49 2026-05-18
72156 CPT MRI C Spine W/wo Contrast 5 5 $2,834.85 $2,834.85 $2,480.49 $2,480.49 $2,480.49 2026-05-18
72142 CPT MRI C Spine W/contrast 5 5 $2,834.85 $2,834.85 $2,480.49 $2,480.49 $2,480.49 2026-05-18
72147 CPT MRI T Spine W/contrast 5 5 $3,147.85 $3,147.85 $2,754.37 $2,754.37 $2,754.37 2026-05-18
70543 CPT MRI Orbit Or Stn W/wo Contrast 5 5 $3,363.25 $3,363.25 $2,942.84 $2,942.84 $2,942.84 2026-05-18
74183 CPT MRI Abdomen W/wo Contrast 5 5 $3,364.10 $3,364.10 $2,943.59 $2,943.59 $2,943.59 2026-05-18
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