Hospital

SYRACUSE AREA HEALTH

Syracuse, NE · CCN 281309 · Rates published

Your selected procedure

You selected 93306 (CPT)

Us Echo Bubble Study Eo

This hospital’s price: $2,574 across 6 payers · range $2,323-$2,747

Source: https://secure.claraprice.net/price-transparency/QYRW-1687963942986/machine-readable/470761817_syracuse-area-health-ne_standardcharges.json · observed 2025-10-03

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

1,778 distinct procedures filed

6 distinct payers

11,004 rate rows

2025-10-03 last MRF observed · ⚠ 12 mo old

Data quality

10,851 of 11,004 rate rows are consumer-grade (98.6%)

153 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
template filing: same amount across many unrelated codes — excluded	153

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old.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://secure.claraprice.net/price-transparency/QYRW-1687963942986/machine-readable/470761817_syracuse-area-health-ne_standardcharges.json
Found on page	https://syracuseareahealth.com/cms-hpt.txt
Discovered via	Discovered by HANK (automated)
Last fetch	success · 2026-10-01
Content fingerprint	7d8d547c505fd692… · 2,263,581 bytes · first seen 2026-07-31

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
3702595 CDM	Lanreotide 120 Mg/0.5 Ml Inj Depot Deep Subq [Cmh]	6	$15,147.00	$16,868.00	$16,524.00	nat. median $16,524 1.0× median
3702269 CDM	Vedolizumab 300 Mg Inj [Cmh]	6	$14,826.00	$16,511.00	$16,174.00	nat. median $16,174 1.0× median
29826 CPT	Shaving Of Shoulder Bone Using Endoscope	6	$14,080.00	$15,680.00	$15,360.00	nat. median $3,079 outlier · 5.0×
3702088 CDM	Alteplase 100 Mg Inj [Cmh]	6	$13,940.00	$15,524.00	$15,207.00	nat. median $15,207 1.0× median
3702512 CDM	Immune Globulin Intravenous Privigen 10% Sol 40 Gram [Cmh]	6	$11,928.00	$13,283.00	$13,012.00	nat. median $1,236 outlier · 10.5×
3702447 CDM	Octreotide 30 Mg Inj Depot IM Kit [Cmh]	6	$10,950.00	$12,194.00	$11,945.00	nat. median $11,945 1.0× median
42820 CPT	Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12	6	$10,560.00	$11,760.00	$11,520.00	nat. median $5,527 outlier · 2.1×
3701239 CDM	Leuprolide 22.5 Mg/3 Months Inj Kit [Cmh]	6	$10,199.00	$11,358.00	$11,126.00	nat. median $381 outlier · 29.2×
3701385 CDM	Pegfilgrastim Pfs 6 Mg/0.6 Ml Inj [Cmh]	6	$10,167.00	$11,322.00	$11,091.00	nat. median $219 outlier · 50.5×
29881 CPT	Removal Of One Knee Cartilage Using An Endoscope	6	$10,120.00	$11,270.00	$11,040.00	nat. median $3,830 outlier · 2.9×
78816 CPT	PET CT Whole Body	6	$9,409.00	$10,478.00	$10,264.00	nat. median $2,788 outlier · 3.7×
78815 CPT	PET CT Skull Base To Midthigh	6	$8,811.00	$9,812.00	$9,612.00	nat. median $2,820 outlier · 3.4×
3702562 CDM	Romiplostim 500 Mcg/ml Inj [Cmh]	6	$8,722.00	$9,713.00	$9,515.00	nat. median $9,515 1.0× median
66984 CPT	Removal Of Cataract With Insertion Of Lens	6	$8,008.00	$8,918.00	$8,736.00	nat. median $2,919 outlier · 3.0×
3600974 CDM	Tightrope Xp Buttress Plate-ar-8959tds	6	$7,911.00	$8,810.00	$8,630.00	nat. median $3,977 outlier · 2.2×
3702695 CDM	Octreotide 20 Mg Inj Depot IM Kit [Cmh]	6	$7,313.00	$8,144.00	$7,978.00	nat. median $240 outlier · 33.3×
3702698 CDM	Alteplase 50 Mg Inj [Cmh]	6	$6,970.00	$7,763.00	$7,604.00	nat. median $7,604 1.0× median
43235 CPT	Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	6	$6,442.00	$7,174.00	$7,027.00	nat. median $1,313 outlier · 5.4×
40510 CPT	40510 Excision Of Lip; Transverse Wedge Excision With Primary Closure	6	$6,407.00	$7,135.00	$6,990.00	nat. median $3,353 outlier · 2.1×
3702474 CDM	Pegfilgrastim Bmez Pfs 6 Mg/0.6 Ml Inj [Cmh]	6	$5,804.00	$6,463.00	$6,331.00	nat. median $6,331 1.0× median
74174 CPT	CT Angio Abdomen And Pelvis	6	$5,796.00	$6,454.00	$6,323.00	nat. median $988 outlier · 6.4×
3701054 CDM	Darbepoetin Alfa Pfs 500 Mcg/ml Inj [Cmh]	6	$5,722.00	$6,372.00	$6,242.00	nat. median $6,242 1.0× median
83519 CPT	.Musk Abs, Serum Lc	6	$5,709.00	$6,357.00	$6,228.00	nat. median $96 outlier · 64.9×
73725 CPT	MRA Lower Extremity With + Without Cnt Left	6	$5,684.00	$6,330.00	$6,201.00	nat. median $1,248 outlier · 5.0×
3702449 CDM	Mepolizumab 100 Mg/ml Inj [Cmh]	6	$5,673.00	$6,318.00	$6,189.00	nat. median $6,189 1.0× median
74178 CPT	CT Abdomen And Pelvis With + Without Contrast	6	$5,658.00	$6,301.00	$6,173.00	nat. median $1,024 outlier · 6.0×
3702513 CDM	Immune Globulin Intravenous Privigen 10% Sol 20 Gram [Cmh]	6	$5,567.00	$6,199.00	$6,073.00	nat. median $219 outlier · 27.7×
93229 CPT	93229 Mobile Cardiac Telemetry Charge	6	$5,140.00	$5,724.00	$5,607.00	nat. median $634 outlier · 8.8×
3702454 CDM	Denosumab 120 Mg/1.7 Ml Inj [Cmh]	6	$5,100.00	$5,680.00	$5,564.00	nat. median $5,564 1.0× median
3702635 CDM	Inclisiran 284 Mg/1.5 Ml Inj [Cmh]	6	$4,988.00	$5,555.00	$5,441.00	nat. median $5,441 1.0× median
3600670 CDM	Univers Apex Humeral Stem 9mm-ar-9100-09s	6	$4,961.00	$5,524.00	$5,412.00	nat. median $5,412 1.0× median
3600635 CDM	Univers Apex Humeral Stem 11mm-ar-9100-11s	6	$4,961.00	$5,524.00	$5,412.00	nat. median $5,412 1.0× median
3600707 CDM	Univers Apex Humeral Stem 10mm-ar-9100-10s	6	$4,961.00	$5,524.00	$5,412.00	nat. median $2,491 outlier · 2.2×
3702477 CDM	Paliperidone ER 234 Mg/1.5 Ml Inj [Cmh]	6	$4,950.00	$5,513.00	$5,400.00	nat. median $20 outlier · 263.7×
72157 CPT	MRI Spine Thoracic With + Without Contrast	6	$4,866.00	$5,418.00	$5,308.00	nat. median $1,105 outlier · 4.8×
71552 CPT	MRI Chest With + Without Contrast	6	$4,790.00	$5,334.00	$5,225.00	nat. median $1,097 outlier · 4.8×
72156 CPT	MRI Spine Cervical With + Without Contrast	6	$4,748.00	$5,288.00	$5,180.00	nat. median $1,103 outlier · 4.7×
74177 CPT	CT Scan Of Abdomen And Pelvis With Contrast	6	$4,643.00	$5,489.00	$5,144.00	nat. median $974 outlier · 5.3×
3555837 CDM	Triathlon X3 Tibial Bearing Sz.2 16mm-5531-g-216	6	$4,690.00	$5,222.00	$5,116.00	nat. median $5,116 1.0× median
77049 CPT	MRI Breast With + Without Contrast Bilateral	6	$4,686.00	$5,219.00	$5,112.00	nat. median $967 outlier · 5.3×
3702622 CDM	Calcitonin Mdv 200 Intl Units/ml Inj 1x2ml [Cmh]	6	$4,631.00	$5,157.00	$5,052.00	nat. median $5,052 1.0× median
45385 CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope	6	$4,598.00	$5,121.00	$5,016.00	nat. median $1,669 outlier · 3.0×
95811 CPT	95811 Polysomnography; 6 Yrs Or Older, With C-pap Therapy Or Bilevel Ventilation,…	6	$4,579.00	$5,099.00	$4,995.00	nat. median $1,894 outlier · 2.6×
72197 CPT	MRI Pelvis With + Without Contrast	6	$4,504.00	$5,016.00	$4,913.00	nat. median $1,063 outlier · 4.6×
78452 CPT	4100003 Nm Mult Studies Rest/stress 78452	6	$4,485.00	$4,995.00	$4,893.00	nat. median $1,816 outlier · 2.7×
72158 CPT	MRI Spine Lumbar With + Without Contrast	6	$4,464.00	$4,972.00	$4,870.00	nat. median $1,093 outlier · 4.5×
74176 CPT	CT Of Abdomen And Pelvis	6	$4,329.00	$4,821.00	$4,722.00	nat. median $694 outlier · 6.8×
70336 CPT	MRI Tmj	6	$4,258.00	$4,742.00	$4,645.00	nat. median $756 outlier · 6.1×
74183 CPT	MRI Abdomen With + Without Contrast	6	$4,250.00	$4,732.00	$4,636.00	nat. median $1,100 outlier · 4.2×
71550 CPT	MRI Chest Without Contrast	6	$4,238.00	$4,720.00	$4,623.00	nat. median $820 outlier · 5.6×

Other procedures at this hospital

Browse this hospital's 1,778 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

3702595	CDM	Lanreotide 120 Mg/0.5 Ml Inj Depot Deep Subq [Cmh]	6	6	$17,212.00	$17,212.00	$15,147.00	$16,868.00	$16,524.00	2025-10-03
3702269	CDM	Vedolizumab 300 Mg Inj [Cmh]	6	6	$16,848.00	$16,848.00	$14,826.00	$16,511.00	$16,174.00	2025-10-03
29826	CPT	Shaving Of Shoulder Bone Using Endoscope	6	6	$16,000.00	$16,000.00	$14,080.00	$15,680.00	$15,360.00	2025-10-03
3702088	CDM	Alteplase 100 Mg Inj [Cmh]	6	6	$15,841.00	$15,841.00	$13,940.00	$15,524.00	$15,207.00	2025-10-03
3702512	CDM	Immune Globulin Intravenous Privigen 10% Sol 40 Gram [Cmh]	6	6	$13,554.00	$13,554.00	$11,928.00	$13,283.00	$13,012.00	2025-10-03
3702447	CDM	Octreotide 30 Mg Inj Depot IM Kit [Cmh]	6	6	$12,443.00	$12,443.00	$10,950.00	$12,194.00	$11,945.00	2025-10-03
42820	CPT	Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12	6	6	$12,000.00	$12,000.00	$10,560.00	$11,760.00	$11,520.00	2025-10-03
3701239	CDM	Leuprolide 22.5 Mg/3 Months Inj Kit [Cmh]	6	6	$11,590.00	$11,590.00	$10,199.00	$11,358.00	$11,126.00	2025-10-03
3701385	CDM	Pegfilgrastim Pfs 6 Mg/0.6 Ml Inj [Cmh]	6	6	$11,553.00	$11,553.00	$10,167.00	$11,322.00	$11,091.00	2025-10-03
29881	CPT	Removal Of One Knee Cartilage Using An Endoscope	6	6	$11,500.00	$11,500.00	$10,120.00	$11,270.00	$11,040.00	2025-10-03
78816	CPT	PET CT Whole Body	6	6	$10,692.00	$10,692.00	$9,409.00	$10,478.00	$10,264.00	2025-10-03
78815	CPT	PET CT Skull Base To Midthigh	6	6	$10,012.00	$10,012.00	$8,811.00	$9,812.00	$9,612.00	2025-10-03
3702562	CDM	Romiplostim 500 Mcg/ml Inj [Cmh]	6	6	$9,911.00	$9,911.00	$8,722.00	$9,713.00	$9,515.00	2025-10-03
66984	CPT	Removal Of Cataract With Insertion Of Lens	6	6	$9,100.00	$9,100.00	$8,008.00	$8,918.00	$8,736.00	2025-10-03
3600974	CDM	Tightrope Xp Buttress Plate-ar-8959tds	6	6	$8,990.00	$8,990.00	$7,911.00	$8,810.00	$8,630.00	2025-10-03
3702695	CDM	Octreotide 20 Mg Inj Depot IM Kit [Cmh]	6	6	$8,310.00	$8,310.00	$7,313.00	$8,144.00	$7,978.00	2025-10-03
3702698	CDM	Alteplase 50 Mg Inj [Cmh]	6	6	$7,921.00	$7,921.00	$6,970.00	$7,763.00	$7,604.00	2025-10-03
43235	CPT	Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	6	6	$7,320.00	$7,320.00	$6,442.00	$7,174.00	$7,027.00	2025-10-03
40510	CPT	40510 Excision Of Lip; Transverse Wedge Excision With Primary Closure	6	6	$7,281.00	$7,281.00	$6,407.00	$7,135.00	$6,990.00	2025-10-03
3702474	CDM	Pegfilgrastim Bmez Pfs 6 Mg/0.6 Ml Inj [Cmh]	6	6	$6,595.00	$6,595.00	$5,804.00	$6,463.00	$6,331.00	2025-10-03
74174	CPT	CT Angio Abdomen And Pelvis	6	6	$6,586.00	$6,586.00	$5,796.00	$6,454.00	$6,323.00	2025-10-03
3701054	CDM	Darbepoetin Alfa Pfs 500 Mcg/ml Inj [Cmh]	6	6	$6,502.00	$6,502.00	$5,722.00	$6,372.00	$6,242.00	2025-10-03
83519	CPT	.Musk Abs, Serum Lc	6	6	$6,487.00	$6,487.00	$5,709.00	$6,357.00	$6,228.00	2025-10-03
73725	CPT	MRA Lower Extremity With + Without Cnt Left	6	6	$6,459.00	$6,459.00	$5,684.00	$6,330.00	$6,201.00	2025-10-03
3702449	CDM	Mepolizumab 100 Mg/ml Inj [Cmh]	6	6	$6,447.00	$6,447.00	$5,673.00	$6,318.00	$6,189.00	2025-10-03
74178	CPT	CT Abdomen And Pelvis With + Without Contrast	6	6	$6,430.00	$6,430.00	$5,658.00	$6,301.00	$6,173.00	2025-10-03
3702513	CDM	Immune Globulin Intravenous Privigen 10% Sol 20 Gram [Cmh]	6	6	$6,326.00	$6,326.00	$5,567.00	$6,199.00	$6,073.00	2025-10-03
93229	CPT	93229 Mobile Cardiac Telemetry Charge	6	6	$5,841.00	$5,841.00	$5,140.00	$5,724.00	$5,607.00	2025-10-03
3702454	CDM	Denosumab 120 Mg/1.7 Ml Inj [Cmh]	6	6	$5,796.00	$5,796.00	$5,100.00	$5,680.00	$5,564.00	2025-10-03
3702635	CDM	Inclisiran 284 Mg/1.5 Ml Inj [Cmh]	6	6	$5,668.00	$5,668.00	$4,988.00	$5,555.00	$5,441.00	2025-10-03
3600670	CDM	Univers Apex Humeral Stem 9mm-ar-9100-09s	6	6	$5,637.00	$5,637.00	$4,961.00	$5,524.00	$5,412.00	2025-10-03
3600707	CDM	Univers Apex Humeral Stem 10mm-ar-9100-10s	6	6	$5,637.00	$5,637.00	$4,961.00	$5,524.00	$5,412.00	2025-10-03
3600635	CDM	Univers Apex Humeral Stem 11mm-ar-9100-11s	6	6	$5,637.00	$5,637.00	$4,961.00	$5,524.00	$5,412.00	2025-10-03
3702477	CDM	Paliperidone ER 234 Mg/1.5 Ml Inj [Cmh]	6	6	$5,625.00	$5,625.00	$4,950.00	$5,513.00	$5,400.00	2025-10-03
72157	CPT	MRI Spine Thoracic With + Without Contrast	6	6	$5,529.00	$5,529.00	$4,866.00	$5,418.00	$5,308.00	2025-10-03
71552	CPT	MRI Chest With + Without Contrast	6	6	$5,443.00	$5,443.00	$4,790.00	$5,334.00	$5,225.00	2025-10-03
72156	CPT	MRI Spine Cervical With + Without Contrast	6	6	$5,396.00	$5,396.00	$4,748.00	$5,288.00	$5,180.00	2025-10-03
74177	CPT	CT Scan Of Abdomen And Pelvis With Contrast	12	6	$5,438.50	$5,438.50	$4,643.00	$5,489.00	$5,144.00	2025-10-03
3555837	CDM	Triathlon X3 Tibial Bearing Sz.2 16mm-5531-g-216	6	6	$5,329.00	$5,329.00	$4,690.00	$5,222.00	$5,116.00	2025-10-03
77049	CPT	MRI Breast With + Without Contrast Bilateral	6	6	$5,325.00	$5,325.00	$4,686.00	$5,219.00	$5,112.00	2025-10-03
3702622	CDM	Calcitonin Mdv 200 Intl Units/ml Inj 1x2ml [Cmh]	6	6	$5,262.00	$5,262.00	$4,631.00	$5,157.00	$5,052.00	2025-10-03
45385	CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope	6	6	$5,225.00	$5,225.00	$4,598.00	$5,121.00	$5,016.00	2025-10-03
95811	CPT	95811 Polysomnography; 6 Yrs Or Older, With C-pap Therapy Or Bilevel Ventilation, …	6	6	$5,203.00	$5,203.00	$4,579.00	$5,099.00	$4,995.00	2025-10-03
72197	CPT	MRI Pelvis With + Without Contrast	6	6	$5,118.00	$5,118.00	$4,504.00	$5,016.00	$4,913.00	2025-10-03
78452	CPT	4100003 Nm Mult Studies Rest/stress 78452	6	6	$5,097.00	$5,097.00	$4,485.00	$4,995.00	$4,893.00	2025-10-03
72158	CPT	MRI Spine Lumbar With + Without Contrast	6	6	$5,073.00	$5,073.00	$4,464.00	$4,972.00	$4,870.00	2025-10-03
74176	CPT	CT Of Abdomen And Pelvis	6	6	$4,919.00	$4,919.00	$4,329.00	$4,821.00	$4,722.00	2025-10-03
70336	CPT	MRI Tmj	6	6	$4,839.00	$4,839.00	$4,258.00	$4,742.00	$4,645.00	2025-10-03
74183	CPT	MRI Abdomen With + Without Contrast	6	6	$4,829.00	$4,829.00	$4,250.00	$4,732.00	$4,636.00	2025-10-03
71550	CPT	MRI Chest Without Contrast	6	6	$4,816.00	$4,816.00	$4,238.00	$4,720.00	$4,623.00	2025-10-03
72147	CPT	MRI Spine Thoracic With Contrast	6	6	$4,788.00	$4,788.00	$4,213.00	$4,692.00	$4,596.00	2025-10-03
73223	CPT	MRI Ue Joint With + Without Contrast Lt	6	6	$4,724.00	$4,724.00	$4,157.00	$4,630.00	$4,535.00	2025-10-03
70543	CPT	MRI Face Neck Orbit With + Without Contrast	6	6	$4,668.00	$4,668.00	$4,108.00	$4,575.00	$4,481.00	2025-10-03
95810	CPT	Sleep Study	6	6	$4,664.00	$4,664.00	$4,104.00	$4,571.00	$4,477.00	2025-10-03
72196	CPT	MRI Pelvis With Contrast	6	6	$4,646.00	$4,646.00	$4,088.00	$4,553.00	$4,460.00	2025-10-03
70553	CPT	MRI Scan	6	6	$4,643.00	$4,643.00	$4,086.00	$4,550.00	$4,457.00	2025-10-03
72149	CPT	MRI Spine Lumbar With Contrast	6	6	$4,626.00	$4,626.00	$4,071.00	$4,533.00	$4,441.00	2025-10-03
72142	CPT	MRI Spine Cervical With Contrast	6	6	$4,604.00	$4,604.00	$4,052.00	$4,512.00	$4,420.00	2025-10-03
70549	CPT	MRA Neck With + Without Contrast	6	6	$4,574.00	$4,574.00	$4,025.00	$4,483.00	$4,391.00	2025-10-03
74185	CPT	MRA Abdomen With + Without Contrast	6	6	$4,545.00	$4,545.00	$4,000.00	$4,454.00	$4,363.00	2025-10-03
3702706	CDM	Tocilizumab 20 Mg/ml Inj 1x20ml [Cmh]	6	6	$4,462.00	$4,462.00	$3,927.00	$4,373.00	$4,284.00	2025-10-03
30110	CPT	30110 Excision, Nasal Polyp(s), Simple	6	6	$4,399.00	$4,399.00	$3,871.00	$4,311.00	$4,223.00	2025-10-03
73723	CPT	MRI Le Joint With + Without Contrast Lt	6	6	$4,389.00	$4,389.00	$3,862.00	$4,301.00	$4,213.00	2025-10-03
72146	CPT	MRI Spine Thoracic Without Contrast	6	6	$4,360.00	$4,360.00	$3,837.00	$4,273.00	$4,186.00	2025-10-03
70546	CPT	MRA Brain/head With + Without Contrast	6	6	$4,354.00	$4,354.00	$3,832.00	$4,267.00	$4,180.00	2025-10-03
70552	CPT	MRI Brain With Contrast	6	6	$4,341.00	$4,341.00	$3,820.00	$4,254.00	$4,167.00	2025-10-03
73220	CPT	MRI Ue Non Joint With + Without Contrast Lt	6	6	$4,293.00	$4,293.00	$3,778.00	$4,207.00	$4,121.00	2025-10-03
70540	CPT	MRI Face Neck Orbit Without Contrast	6	6	$4,290.00	$4,290.00	$3,775.00	$4,204.00	$4,118.00	2025-10-03
3702272	CDM	Idarucizumab 2.5 G/50 Ml Inj [Cmh]	6	6	$4,287.00	$4,287.00	$3,773.00	$4,201.00	$4,116.00	2025-10-03
70551	CPT	MRI Brain Without Contrast	6	6	$4,259.00	$4,259.00	$3,748.00	$4,174.00	$4,089.00	2025-10-03
45378	CPT	Diagnostic Exam Of Large Bowel Using An Endoscope	6	6	$4,250.00	$4,250.00	$3,740.00	$4,165.00	$4,080.00	2025-10-03
81420	CPT	Maternit21 Plus Core Lc	6	6	$4,207.00	$4,207.00	$3,702.00	$4,123.00	$4,039.00	2025-10-03
3702652	CDM	Pegfilgrastim Pbbk Pfs 6 Mg/0.6 Ml Inj [Cmh]	6	6	$4,200.00	$4,200.00	$3,696.00	$4,116.00	$4,032.00	2025-10-03
75635	CPT	CT Angio Abdomen Aorta + Iliofemoral	6	6	$4,195.00	$4,195.00	$3,692.00	$4,111.00	$4,027.00	2025-10-03
73720	CPT	MRI Le Non Joint With + Without Contrast Lt	6	6	$4,177.00	$4,177.00	$3,676.00	$4,093.00	$4,010.00	2025-10-03
74175	CPT	CT Angio Abdomen	6	6	$4,094.00	$4,094.00	$3,603.00	$4,012.00	$3,930.00	2025-10-03
74181	CPT	MRI Abdomen Without Contrast	6	6	$4,084.00	$4,084.00	$3,594.00	$4,002.00	$3,921.00	2025-10-03
72195	CPT	MRI Pelvis Without Contrast	6	6	$4,042.00	$4,042.00	$3,557.00	$3,961.00	$3,880.00	2025-10-03
3702491	CDM	Immune Globulin 10% 30 Gm/300 Ml Inj [Cmh]	6	6	$3,999.00	$3,999.00	$3,519.00	$3,919.00	$3,839.00	2025-10-03
70544	CPT	MRA Brain/head Without Contrast	6	6	$3,995.00	$3,995.00	$3,516.00	$3,915.00	$3,835.00	2025-10-03
72141	CPT	MRI Spine Cervical Without Contrast	6	6	$3,979.00	$3,979.00	$3,502.00	$3,899.00	$3,820.00	2025-10-03
72148	CPT	MRI Scan Of Lower Spinal Canal	6	6	$3,953.00	$3,953.00	$3,479.00	$3,874.00	$3,795.00	2025-10-03
71275	CPT	CT Angio Chest	6	6	$3,936.00	$3,936.00	$3,464.00	$3,857.00	$3,779.00	2025-10-03
72127	CPT	CT Spine Cervical With + Without Contrast	6	6	$3,882.00	$3,882.00	$3,416.00	$3,804.00	$3,727.00	2025-10-03
72194	CPT	CT Pelvis With + Without Contrast	6	6	$3,842.00	$3,842.00	$3,381.00	$3,765.00	$3,688.00	2025-10-03
73202	CPT	CT Upper Extremity W/+without Contrast Left	6	6	$3,809.00	$3,809.00	$3,352.00	$3,733.00	$3,657.00	2025-10-03
84120	CPT	Maternit21 Plus Core No Gender Lc	6	6	$3,805.00	$3,805.00	$3,348.00	$3,729.00	$3,653.00	2025-10-03
71270	CPT	CT Chest With + Without Contrast	6	6	$3,760.00	$3,760.00	$3,309.00	$3,685.00	$3,610.00	2025-10-03
70496	CPT	CT Angio Brain And Neck	6	6	$3,667.00	$3,667.00	$3,227.00	$3,594.00	$3,520.00	2025-10-03
74170	CPT	CT Abdomen With + Without Contrast	6	6	$3,643.00	$3,643.00	$3,206.00	$3,570.00	$3,497.00	2025-10-03
72133	CPT	CT Spine Lumbar With + Without Contrast	6	6	$3,601.00	$3,601.00	$3,169.00	$3,529.00	$3,457.00	2025-10-03
11424	CPT	11424 Exc B9 Lesion Mrgn Xcp Sk Tg S/n/h/f/g 3.1-4.0cm Techfee	6	6	$3,587.00	$3,587.00	$3,157.00	$3,515.00	$3,444.00	2025-10-03
3702532	CDM	Pegfilgrastim Jmdb Pfs 6 Mg/0.6 Ml Inj [Cmh]	6	6	$3,507.00	$3,507.00	$3,086.00	$3,437.00	$3,367.00	2025-10-03
3600648	CDM	Univers Revers Humeral Stem Sz.8 Shoulder-ar-9501-08p	6	6	$3,479.00	$3,479.00	$3,062.00	$3,409.00	$3,340.00	2025-10-03
3555694	CDM	Univers Revers Humeral Stem Sz.13-ar-9501-13p	6	6	$3,479.00	$3,479.00	$3,062.00	$3,409.00	$3,340.00	2025-10-03
3600136	CDM	Univers Revers Humeral Stem Sz.9-ar-9501-09p	6	6	$3,479.00	$3,479.00	$3,062.00	$3,409.00	$3,340.00	2025-10-03
3600532	CDM	Univers Revers Humeral Stem Sz.7-ar-9501-07p	6	6	$3,479.00	$3,479.00	$3,062.00	$3,409.00	$3,340.00	2025-10-03
73702	CPT	CT Lower Extremity W/+without Contrast Left	6	6	$3,478.00	$3,478.00	$3,061.00	$3,408.00	$3,339.00	2025-10-03
73718	CPT	MRI Le Non Joint Without Contrast Lt	6	6	$3,382.00	$3,382.00	$2,976.00	$3,314.00	$3,247.00	2025-10-03
3701941	CDM	Denosumab 60 Mg/ml Inj [Cmh]	6	6	$3,376.00	$3,376.00	$2,971.00	$3,308.00	$3,241.00	2025-10-03
72126	CPT	CT Spine Cervical With Contrast	6	6	$3,375.00	$3,375.00	$2,970.00	$3,308.00	$3,240.00	2025-10-03
70482	CPT	CT Orbits Sella With + Without Contrast	6	6	$3,339.00	$3,339.00	$2,938.00	$3,272.00	$3,205.00	2025-10-03
81279	CPT	.Jak2 Exons 12-15 Lc	6	6	$3,332.00	$3,332.00	$2,932.00	$3,265.00	$3,199.00	2025-10-03
70488	CPT	CT Maxillofacial With + Without Contrast	6	6	$3,298.00	$3,298.00	$2,902.00	$3,232.00	$3,166.00	2025-10-03
74160	CPT	CT Abdomen With Contrast	6	6	$3,285.00	$3,285.00	$2,891.00	$3,219.00	$3,154.00	2025-10-03
73218	CPT	MRI Ue Non Joint Without Contrast Lt	6	6	$3,245.00	$3,245.00	$2,856.00	$3,180.00	$3,115.00	2025-10-03
70492	CPT	CT Neck Soft Tissue With + Without Contrast	6	6	$3,236.00	$3,236.00	$2,848.00	$3,171.00	$3,107.00	2025-10-03
3555906	CDM	Univers Revers Glenosphere 39 +4 Lat/24-ar-9564-2439-lat	6	6	$3,220.00	$3,220.00	$2,834.00	$3,156.00	$3,091.00	2025-10-03
3600708	CDM	Univers Revers Glenoid System Glenosphere 42/24, Shoulder Implant-ar-9564-2442	6	6	$3,220.00	$3,220.00	$2,834.00	$3,156.00	$3,091.00	2025-10-03
3555712	CDM	Univers Revers Modular Glenoid Baseplate 24mm +4 Lat-ar-9560-24-4	6	6	$3,200.00	$3,200.00	$2,816.00	$3,136.00	$3,072.00	2025-10-03
70481	CPT	CT Orbits Sella With Contrast	6	6	$3,182.00	$3,182.00	$2,800.00	$3,118.00	$3,055.00	2025-10-03
72129	CPT	CT Spine Thoracic With Contrast	6	6	$3,166.00	$3,166.00	$2,786.00	$3,103.00	$3,039.00	2025-10-03
72130	CPT	CT Spine Thoracic With + Without Contrast	6	6	$3,135.00	$3,135.00	$2,759.00	$3,072.00	$3,010.00	2025-10-03
71260	CPT	CT Chest With Contrast	6	6	$3,121.00	$3,121.00	$2,746.00	$3,059.00	$2,996.00	2025-10-03
70470	CPT	CT Brain/head With + Without Contrast	6	6	$3,110.00	$3,110.00	$2,737.00	$3,048.00	$2,986.00	2025-10-03
72132	CPT	CT Spine Lumbar With Contrast	6	6	$3,106.00	$3,106.00	$2,733.00	$3,044.00	$2,982.00	2025-10-03
72193	CPT	CT Scan Of Pelvis With Contrast	6	6	$3,083.00	$3,083.00	$2,713.00	$3,021.00	$2,960.00	2025-10-03
73721	CPT	MRI Scan Of Leg Joint	6	6	$3,080.00	$3,080.00	$2,710.00	$3,018.00	$2,957.00	2025-10-03
3702598	CDM	Immune Globulin 10% 20 Gm/200 Ml Inj [Cmh]	6	6	$3,047.00	$3,047.00	$2,681.00	$2,986.00	$2,925.00	2025-10-03
11626	CPT	11626 Exc.mal.scalp/neck > 4.0 Cm Techfee	6	6	$3,040.00	$3,040.00	$2,675.00	$2,979.00	$2,918.00	2025-10-03
70491	CPT	CT Neck Soft Tissue With Contrast	6	6	$2,994.00	$2,994.00	$2,635.00	$2,934.00	$2,874.00	2025-10-03
73701	CPT	CT Lower Extremity With Contrast Left	6	6	$2,982.00	$2,982.00	$2,624.00	$2,922.00	$2,863.00	2025-10-03
73221	CPT	MRI Ue Joint Without Contrast Lt	6	6	$2,978.00	$2,978.00	$2,621.00	$2,918.00	$2,859.00	2025-10-03
78582	CPT	Nm Lung Vent/perf Imaging	6	6	$2,968.00	$2,968.00	$2,612.00	$2,909.00	$2,849.00	2025-10-03
3702120	CDM	Ferric Carboxymaltose (Elemental Iron) 750 Mg/15 Ml Inj [Cmh]	6	6	$2,946.00	$2,946.00	$2,592.00	$2,887.00	$2,828.00	2025-10-03
11406	CPT	11406 Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l >4.0 Cm Techfee	6	6	$2,926.00	$2,926.00	$2,575.00	$2,867.00	$2,809.00	2025-10-03
72128	CPT	CT Spine Thoracic Without Contrast	6	6	$2,917.00	$2,917.00	$2,567.00	$2,859.00	$2,800.00	2025-10-03
3702623	CDM	Abatacept 250 Mg Inj 1x1ea [Cmh]	6	6	$2,907.00	$2,907.00	$2,558.00	$2,849.00	$2,791.00	2025-10-03
70480	CPT	CT Orbits Sella Without Contrast	6	6	$2,888.00	$2,888.00	$2,541.00	$2,830.00	$2,772.00	2025-10-03
3702303	CDM	Hyaluronan Pfs 88 Mg/4 Ml Syr [Cmh]	6	6	$2,880.00	$2,880.00	$2,534.00	$2,822.00	$2,765.00	2025-10-03
3702667	CDM	Eptinezumab Jjmr 100 Mg/ml Inj 1 Ml [Cmh]	6	6	$2,871.00	$2,871.00	$2,526.00	$2,814.00	$2,756.00	2025-10-03
72192	CPT	CT Pelvis Without Contrast	6	6	$2,859.00	$2,859.00	$2,516.00	$2,802.00	$2,745.00	2025-10-03
3600543	CDM	Univers Revers Suturecup 36 Neutral-ar-9502f-36cpc	6	6	$2,856.00	$2,856.00	$2,513.00	$2,799.00	$2,742.00	2025-10-03
3600709	CDM	Univers Revers Suturecup 42 Neutral, Shoulder Implant-ar-9502f-42cpc	6	6	$2,856.00	$2,856.00	$2,513.00	$2,799.00	$2,742.00	2025-10-03
3600535	CDM	Univers Revers Suturecup 36 +2 Rt-ar-9502f-36rcpc	6	6	$2,856.00	$2,856.00	$2,513.00	$2,799.00	$2,742.00	2025-10-03
36573	CPT	Picc Line Insertion With US (Older Than 5yr)	6	6	$2,847.00	$2,847.00	$2,505.00	$2,790.00	$2,733.00	2025-10-03
72125	CPT	CT Spine Cervical Without Contrast	6	6	$2,832.00	$2,832.00	$2,492.00	$2,775.00	$2,719.00	2025-10-03
74150	CPT	CT Abdomen Without Contrast	6	6	$2,812.00	$2,812.00	$2,475.00	$2,756.00	$2,700.00	2025-10-03
3600636	CDM	Univers Ii Humeral Head 54/21 Shoulder-ar-9154-21p	6	6	$2,800.00	$2,800.00	$2,464.00	$2,744.00	$2,688.00	2025-10-03
3600706	CDM	Univers Ii Humeral Head 52/22-ar-9152-22p	6	6	$2,800.00	$2,800.00	$2,464.00	$2,744.00	$2,688.00	2025-10-03
3600644	CDM	Univers Humeral Head 50/21 Shoulder Implant-ar-9150-21p	6	6	$2,800.00	$2,800.00	$2,464.00	$2,744.00	$2,688.00	2025-10-03
70460	CPT	CT Head With Contrast	6	6	$2,778.00	$2,778.00	$2,445.00	$2,722.00	$2,667.00	2025-10-03
81270	CPT	Jak2 V617f Qual, Rfx E12-15 Lc	6	6	$2,756.00	$2,756.00	$2,425.00	$2,701.00	$2,646.00	2025-10-03
72131	CPT	CT Spine Lumbar Without Contrast	6	6	$2,750.00	$2,750.00	$2,420.00	$2,695.00	$2,640.00	2025-10-03
78315	CPT	Nm Bone Three Phase Study	6	6	$2,742.00	$2,742.00	$2,413.00	$2,687.00	$2,632.00	2025-10-03
52005	CPT	52005 Cysto With Retrograde Pyelograms	6	6	$2,728.00	$2,728.00	$2,401.00	$2,673.00	$2,619.00	2025-10-03
71250	CPT	CT Chest High Resolution	6	6	$2,725.00	$2,725.00	$2,398.00	$2,671.00	$2,616.00	2025-10-03
3600130	CDM	Uni Tibial Insert Lt Med/rt Lat 9mm Sz.1-2-71422242	6	6	$2,720.00	$2,720.00	$2,394.00	$2,666.00	$2,611.00	2025-10-03
73201	CPT	CT Upper Extremity With Contrast Left	6	6	$2,717.00	$2,717.00	$2,391.00	$2,663.00	$2,608.00	2025-10-03
3555491	CDM	Universal Vaultlock Glenoid-small-ar-9106-01	6	6	$2,700.00	$2,700.00	$2,376.00	$2,646.00	$2,592.00	2025-10-03
3555818	CDM	Univers Vaultlock Glenoid Extra Large-ar-9106-04	6	6	$2,700.00	$2,700.00	$2,376.00	$2,646.00	$2,592.00	2025-10-03
3600578	CDM	Univers Vaultlockglenoid Lg Shoulder-ar-9106-03	6	6	$2,700.00	$2,700.00	$2,376.00	$2,646.00	$2,592.00	2025-10-03
93306	CPT	US Echo 2d Comp With Color Flow Doppler	12	6	$2,721.50	$2,721.50	$2,323.00	$2,747.00	$2,574.00	2025-10-03
70490	CPT	CT Neck Soft Tissue Without Contrast	6	6	$2,657.00	$2,657.00	$2,338.00	$2,604.00	$2,551.00	2025-10-03
73700	CPT	CT Lower Extremity Without Contrast Left	6	6	$2,646.00	$2,646.00	$2,328.00	$2,593.00	$2,540.00	2025-10-03
70450	CPT	CT Scan	6	6	$2,631.00	$2,631.00	$2,315.00	$2,578.00	$2,526.00	2025-10-03
3701882	CDM	Hylan Intra-articular 20 Pfs 48 Mg/6 Ml Inj [Cmh]	6	6	$2,630.00	$2,630.00	$2,314.00	$2,577.00	$2,525.00	2025-10-03
73200	CPT	CT Upper Extremity Without Contrast Right	6	6	$2,619.00	$2,619.00	$2,305.00	$2,567.00	$2,514.00	2025-10-03
3702448	CDM	Leuprolide ER 22.5 Mg/3 Months Sc Inj Kit [Cmh]	6	6	$2,602.00	$2,602.00	$2,290.00	$2,550.00	$2,498.00	2025-10-03
70487	CPT	CT Maxillofacial With Contrast	6	6	$2,597.00	$2,597.00	$2,285.00	$2,545.00	$2,493.00	2025-10-03
62323	CPT	Injection(s) Of Therapeutic Substance	12	6	$2,637.00	$2,637.00	$2,177.00	$2,744.00	$2,444.50	2025-10-03
3702565	CDM	Romosozumab 105 Mg/1.17 Ml Inj [Cmh]	6	6	$2,524.00	$2,524.00	$2,221.00	$2,474.00	$2,423.00	2025-10-03
27096	CPT	27096 Si Joint Injection W/fluro Charge	6	6	$2,503.00	$2,503.00	$2,203.00	$2,453.00	$2,403.00	2025-10-03
3702633	CDM	Levonorgestrel 52 Mg IUD (Mirena) [Cmh]	6	6	$2,478.00	$2,478.00	$2,181.00	$2,428.00	$2,379.00	2025-10-03
3702422	CDM	Etonogestrel 68 Mg Sc Implant [Cmh]	6	6	$2,478.00	$2,478.00	$2,181.00	$2,428.00	$2,379.00	2025-10-03
7950245	CDM	Cliniclevonorgestrel 19.5 Mg Dev (Kyleena) [Cmh]	6	6	$2,478.00	$2,478.00	$2,181.00	$2,428.00	$2,379.00	2025-10-03
7950235	CDM	Cliniclevonorgestrel 52 Mg Dev (Mirena) [Cmh]	6	6	$2,478.00	$2,478.00	$2,181.00	$2,428.00	$2,379.00	2025-10-03
26055	CPT	26055 Tendon Sheath Incision (Trigger Finger) (Tech)	6	6	$2,474.00	$2,474.00	$2,177.00	$2,425.00	$2,375.00	2025-10-03
11644	CPT	11644 Remove Malig Lision, Face/nose/lips 3.14.0cm	6	6	$2,458.00	$2,458.00	$2,163.00	$2,409.00	$2,360.00	2025-10-03
20670	CPT	20670 Removal Of Implant; Superficial (E.g. Buried Wire, Pin Or Rod)	6	6	$2,455.00	$2,455.00	$2,160.00	$2,406.00	$2,357.00	2025-10-03
11604	CPT	11604 Excise, Malign Lesion W/margins, Trunk, Arms, Or Legs; Excised Diam 3.1 To…	6	6	$2,443.00	$2,443.00	$2,150.00	$2,394.00	$2,345.00	2025-10-03
88341	CPT	Bill Only Immunohisto Ab Stain, Add'tl	6	6	$2,423.00	$2,423.00	$2,132.00	$2,375.00	$2,326.00	2025-10-03
3702438	CDM	Infliximab 100 Mg Inj [Cmh]	6	6	$2,383.00	$2,383.00	$2,097.00	$2,335.00	$2,288.00	2025-10-03
78227	CPT	Nm Hepatobiliary Imaging With Drug	6	6	$2,371.00	$2,371.00	$2,086.00	$2,324.00	$2,276.00	2025-10-03
78306	CPT	Nm Bone Imaging Whole Body	6	6	$2,329.00	$2,329.00	$2,050.00	$2,282.00	$2,236.00	2025-10-03
7950244	CDM	Copper IUD (Paragard) [Cmh]	6	6	$2,323.00	$2,323.00	$2,044.00	$2,277.00	$2,230.00	2025-10-03
62321	CPT	62321 Cervical Epidural	6	6	$2,301.00	$2,301.00	$2,025.00	$2,255.00	$2,209.00	2025-10-03
70486	CPT	CT Maxillofacial Without Contrast	6	6	$2,279.00	$2,279.00	$2,006.00	$2,233.00	$2,188.00	2025-10-03
3702421	CDM	Sodium Hyaluronate Pfs 20 Mg/ml Inj 3 Ml [Cmh]	6	6	$2,275.00	$2,275.00	$2,002.00	$2,230.00	$2,184.00	2025-10-03
70498	CPT	70498 CTA Neck	12	6	$2,351.50	$2,351.50	$1,073.00	$3,414.00	$2,130.50	2025-10-03
11443	CPT	11443 Remove Lesion, Face/lid/ear/nose/lip 2.1 To 3.0 Cm Charge Techfee	6	6	$2,196.00	$2,196.00	$1,932.00	$2,152.00	$2,108.00	2025-10-03
87633	CPT	Adenovirus- Verigene	6	6	$2,189.00	$2,189.00	$1,926.00	$2,145.00	$2,101.00	2025-10-03
3701120	CDM	Epoetin Alfa Pf 40,000 Units/ml Inj [Cmh]	6	6	$2,181.00	$2,181.00	$1,919.00	$2,137.00	$2,094.00	2025-10-03
11441	CPT	11441 Ex Ben Les Face Techfee	6	6	$2,180.00	$2,180.00	$1,918.00	$2,136.00	$2,093.00	2025-10-03
78226	CPT	Nm Hepatobiliary Imaging	6	6	$2,162.00	$2,162.00	$1,903.00	$2,119.00	$2,076.00	2025-10-03
71271	CPT	CT Lung Cancer Screening	6	6	$2,069.00	$2,069.00	$1,821.00	$2,028.00	$1,986.00	2025-10-03
21012	CPT	21012 Excision, Tumor, Soft Tissue Of Face Or Scalp, Subcutaneous; 2 Cm Or Great…	6	6	$2,058.00	$2,058.00	$1,811.00	$2,017.00	$1,976.00	2025-10-03
64493	CPT	64493 Injection Paravert Facet Lumbar Or Sacral, Single	6	6	$2,013.00	$2,013.00	$1,771.00	$1,973.00	$1,932.00	2025-10-03
36558	CPT	36558 Insert Tunneled Centrally Insert Central Venous Cath,without Subq Port Or Pump…	6	6	$2,008.00	$2,008.00	$1,767.00	$1,968.00	$1,928.00	2025-10-03
3600736	CDM	Univers Revers Humeral Insert Small 36, +6, Shoulder -ar-9503s-06	6	6	$2,000.00	$2,000.00	$1,760.00	$1,960.00	$1,920.00	2025-10-03
3600537	CDM	Univers Revers Humeral Insert Small 36 +3-ar-9503s-03	6	6	$2,000.00	$2,000.00	$1,760.00	$1,960.00	$1,920.00	2025-10-03
3555696	CDM	Univers Revers Humeral Insert Medium/39/+6	6	6	$2,000.00	$2,000.00	$1,760.00	$1,960.00	$1,920.00	2025-10-03
3600710	CDM	Univers Revers Humeral Insert Large, 42, +6, Shoulder-ar-9503l-06	6	6	$2,000.00	$2,000.00	$1,760.00	$1,960.00	$1,920.00	2025-10-03
3600128	CDM	Uni Tibial Base Lt Med/rt Lat-71422422	6	6	$2,000.00	$2,000.00	$1,760.00	$1,960.00	$1,920.00	2025-10-03
78708	CPT	Nm Kidney Imaging Single With Pharm	6	6	$1,969.00	$1,969.00	$1,733.00	$1,930.00	$1,890.00	2025-10-03
93350	CPT	US Stress Echo	6	6	$1,963.00	$1,963.00	$1,727.00	$1,924.00	$1,884.00	2025-10-03
99291	CPT	99291 Facility Level Critical Care Ill/injured Patient Init 30-74 Min	6	6	$1,935.00	$1,935.00	$1,703.00	$1,896.00	$1,858.00	2025-10-03
24605	CPT	24605 Treatment Closed Elbow Dislocation Req Anes Techfee	6	6	$1,917.00	$1,917.00	$1,687.00	$1,879.00	$1,840.00	2025-10-03
88307	CPT	Bill Only Pathology Level 5	6	6	$1,916.00	$1,916.00	$1,686.00	$1,878.00	$1,839.00	2025-10-03
87522	CPT	.Hcv Rt-pcr, Quant (non-graph) Lc	6	6	$1,913.00	$1,913.00	$1,683.00	$1,875.00	$1,836.00	2025-10-03
78216	CPT	Nm Liver/spleen Imaging With Vascular Flow	6	6	$1,901.00	$1,901.00	$1,673.00	$1,863.00	$1,825.00	2025-10-03
3702561	CDM	Levonorgestrel IUD 52 Mg Dev [Cmh]	6	6	$1,901.00	$1,901.00	$1,673.00	$1,863.00	$1,825.00	2025-10-03
78202	CPT	Nm Liver Imaging With Vascular Flow	6	6	$1,901.00	$1,901.00	$1,673.00	$1,863.00	$1,825.00	2025-10-03
3555698	CDM	Univers Revers Glenoid System Central Screw 39+4 Lat/2-ar-9561-35s	6	6	$1,900.00	$1,900.00	$1,672.00	$1,862.00	$1,824.00	2025-10-03
3600647	CDM	Univers Revers Modular Glenoid System Central Screw 20mm Shoulder-ar-9561-20s	6	6	$1,900.00	$1,900.00	$1,672.00	$1,862.00	$1,824.00	2025-10-03
3555713	CDM	Univers Revers Glenoid Central 30mm-ar-9561-30s	6	6	$1,900.00	$1,900.00	$1,672.00	$1,862.00	$1,824.00	2025-10-03
32555	CPT	32002 Thoracentesis Subsequent	12	6	$1,960.50	$1,960.50	$1,234.00	$2,469.00	$1,795.50	2025-10-03
92960	CPT	92960 Cardioversion Charge	6	6	$1,866.00	$1,866.00	$1,642.00	$1,829.00	$1,791.00	2025-10-03
78071	CPT	Nm Parathyroid Imaging With Spect	6	6	$1,857.00	$1,857.00	$1,634.00	$1,820.00	$1,783.00	2025-10-03
3702681	CDM	Ferumoxytol 510 Mg/17 Ml Inj [Cmh]	6	6	$1,847.00	$1,847.00	$1,625.00	$1,810.00	$1,773.00	2025-10-03
10140	CPT	10140 Incision And Drainage Of Hematoma, Seroma, Or Fluid Collection Charge	6	6	$1,841.00	$1,841.00	$1,620.00	$1,804.00	$1,767.00	2025-10-03
23700	CPT	23700 Shoulder Manipulation Under Anesthesia	6	6	$1,816.00	$1,816.00	$1,598.00	$1,780.00	$1,743.00	2025-10-03
46050	CPT	46050 I&d Perianal Abscess Charge	6	6	$1,800.00	$1,800.00	$1,584.00	$1,764.00	$1,728.00	2025-10-03
27570	CPT	27570 Fixate Knee Joint Charge	6	6	$1,792.00	$1,792.00	$1,577.00	$1,756.00	$1,720.00	2025-10-03
83993	CPT	Calprotectin, Fecal Lc	6	6	$1,781.00	$1,781.00	$1,567.00	$1,745.00	$1,710.00	2025-10-03
78305	CPT	Nm Bone Imaging Multiple Areas	6	6	$1,778.00	$1,778.00	$1,565.00	$1,742.00	$1,707.00	2025-10-03
3551243	CDM	Tight Rope Syndesmosis Kit-ar-8926ss	6	6	$1,760.00	$1,760.00	$1,549.00	$1,725.00	$1,690.00	2025-10-03
3600456	CDM	Tissuetak Tendon Anchor-ar-19021tt	6	6	$1,750.00	$1,750.00	$1,540.00	$1,715.00	$1,680.00	2025-10-03
87517	CPT	Hbv Real-time Pcr, Quant Lc	6	6	$1,705.00	$1,705.00	$1,500.00	$1,671.00	$1,637.00	2025-10-03
64483	CPT	Injection(s) Of Anesthetic Into Lower Spine Using Imaging Guidance	6	6	$1,687.00	$1,687.00	$1,485.00	$1,653.00	$1,620.00	2025-10-03
93970	CPT	93970 Uv Upper Venous Bilateral Charge	6	6	$1,685.00	$1,685.00	$1,483.00	$1,651.00	$1,618.00	2025-10-03
94002	CPT	94002 Ventilator Management Initial	6	6	$1,677.00	$1,677.00	$1,476.00	$1,643.00	$1,610.00	2025-10-03
93880	CPT	93880 Bilateral Carotid Duplex Charge	6	6	$1,657.00	$1,657.00	$1,458.00	$1,624.00	$1,591.00	2025-10-03
86255	CPT	86255-myasthenia Gravis Profile, Lc	6	6	$1,655.00	$1,655.00	$1,456.00	$1,622.00	$1,589.00	2025-10-03
86042	CPT	86042-myasthenia Gravis Profile, Lc	6	6	$1,655.00	$1,655.00	$1,456.00	$1,622.00	$1,589.00	2025-10-03
86041	CPT	Myasthenia Gravis Profile, Lc	6	6	$1,655.00	$1,655.00	$1,456.00	$1,622.00	$1,589.00	2025-10-03
86043	CPT	86043-myasthenia Gravis Profile, Lc	6	6	$1,655.00	$1,655.00	$1,456.00	$1,622.00	$1,589.00	2025-10-03
23650	CPT	23650 Clsd Tx Shoulder Dislc W/manipulation Without Anes Techfee	6	6	$1,616.00	$1,616.00	$1,422.00	$1,584.00	$1,551.00	2025-10-03
36590	CPT	36590 Removal Of Tunneled Central Venous Access Device, With Subcu. Port Or Pump, …	12	6	$1,653.50	$1,653.50	$1,330.00	$1,760.00	$1,530.50	2025-10-03
87497	CPT	Cmv Quant DNA Pcr (Plasma) Lc	6	6	$1,591.00	$1,591.00	$1,400.00	$1,559.00	$1,527.00	2025-10-03
3600121	CDM	Volar Distal Radius Plate Narrow Lt 3-hole-ar-8916vnl-03	6	6	$1,590.00	$1,590.00	$1,399.00	$1,558.00	$1,526.00	2025-10-03
3600122	CDM	Volar Distal Radius Plate Standard Lt 3-hole-ar-8916vsl-03	6	6	$1,590.00	$1,590.00	$1,399.00	$1,558.00	$1,526.00	2025-10-03
3555969	CDM	Volar Distal Radial Plate Narrow Rt 3 Hole-ar-8916vnr-03	6	6	$1,590.00	$1,590.00	$1,399.00	$1,558.00	$1,526.00	2025-10-03
3600123	CDM	Volar Distal Plate Standard Rt 3-hole-ar-8916vsr-03	6	6	$1,590.00	$1,590.00	$1,399.00	$1,558.00	$1,526.00	2025-10-03
78580	CPT	Nm Lung Perfusion Imaging	6	6	$1,557.00	$1,557.00	$1,370.00	$1,526.00	$1,495.00	2025-10-03
99285	CPT	99285 Ed Visit E M Patient, Lev 5, Req Med Approp Hstry/exam/high Mdm, Cc	6	6	$1,550.00	$1,550.00	$1,364.00	$1,519.00	$1,488.00	2025-10-03
87902	CPT	.Hepatitis C Genotype Lc	6	6	$1,537.00	$1,537.00	$1,353.00	$1,506.00	$1,476.00	2025-10-03
84445	CPT	Thyroid Stim Immunoglobulin Lc	6	6	$1,526.00	$1,526.00	$1,343.00	$1,495.00	$1,465.00	2025-10-03
13121	CPT	13121 Repair Complex Scalp/arm/leg 2.6-7.5 Cm Techfee	6	6	$1,516.00	$1,516.00	$1,334.00	$1,486.00	$1,455.00	2025-10-03
11423	CPT	11423 Exc B9 Lesion Mrgn Xcp Sk Tg S/n/h/f/g 2.1-3.0cm Techfee	6	6	$1,477.00	$1,477.00	$1,300.00	$1,447.00	$1,418.00	2025-10-03
3702610	CDM	Triamcinolone 32 Mg Pwdr For Recon -ER Inj 1x1 [Cmh]	6	6	$1,428.00	$1,428.00	$1,257.00	$1,399.00	$1,371.00	2025-10-03
3600925	CDM	Tightrope Ii Btb With Fibertape For Internalbrace-ar-1588btb-ib	6	6	$1,419.00	$1,419.00	$1,249.00	$1,391.00	$1,362.00	2025-10-03
78300	CPT	Nm Bone Imaging Limited	6	6	$1,408.00	$1,408.00	$1,239.00	$1,380.00	$1,352.00	2025-10-03
3551225	CDM	Tubular Plate-7 Hole Locking Lateral Third Ss-ar-8943th-07	6	6	$1,400.00	$1,400.00	$1,232.00	$1,372.00	$1,344.00	2025-10-03
3551224	CDM	Tubular Plate-5 Hole Locking Lateral Third Ss-ar-8943th-05	6	6	$1,400.00	$1,400.00	$1,232.00	$1,372.00	$1,344.00	2025-10-03
36589	CPT	36589 Removal Tunneled Cv Cath	6	6	$1,400.00	$1,400.00	$1,232.00	$1,372.00	$1,344.00	2025-10-03
3600500	CDM	Tubular Plate 3-hole Locking Lateral Hook-ar-8943th-03	6	6	$1,400.00	$1,400.00	$1,232.00	$1,372.00	$1,344.00	2025-10-03
3551223	CDM	Tubular Plate-3 Hole Locking Third Ss-	6	6	$1,400.00	$1,400.00	$1,232.00	$1,372.00	$1,344.00	2025-10-03
0086U	CPT	Cmh Acc-ast	6	6	$1,400.00	$1,400.00	$1,232.00	$1,372.00	$1,344.00	2025-10-03
81374	CPT	Hla B 27 Disease Association Lc	6	6	$1,385.00	$1,385.00	$1,219.00	$1,357.00	$1,330.00	2025-10-03
62273	CPT	62273 Blood Patch	6	6	$1,376.00	$1,376.00	$1,211.00	$1,348.00	$1,321.00	2025-10-03
3702481	CDM	Remdesivir 100 Mg Pow [Cmh]	6	6	$1,372.00	$1,372.00	$1,207.00	$1,345.00	$1,317.00	2025-10-03
93925	CPT	93925 Artl Dup Bil Lower Charge	6	6	$1,369.00	$1,369.00	$1,205.00	$1,342.00	$1,314.00	2025-10-03
93017	CPT	93017 Lexiscan Stress Test Charge	6	6	$1,367.00	$1,367.00	$1,203.00	$1,340.00	$1,312.00	2025-10-03
88305	CPT	Bill Only Pathology Level 4	6	6	$1,365.00	$1,365.00	$1,201.00	$1,338.00	$1,310.00	2025-10-03
11440	CPT	11440 Exc B9 Lesion Mrgn Xcp Sk Tg F/e/e/n/l/m 0.5cm/< Techfee	6	6	$1,359.00	$1,359.00	$1,196.00	$1,332.00	$1,305.00	2025-10-03
63500216	CDM	Cardiac Valve Or Cardiothoracic Procedure With Cardiac Catheterization With Mcc	6	6	$1,350.00	$1,350.00	$1,188.00	$1,323.00	$1,296.00	2025-10-03
11442	CPT	Exc Of Benign Lesion	6	6	$1,337.00	$1,337.00	$1,177.00	$1,310.00	$1,284.00	2025-10-03
87798	CPT	4002092 Genital Mycoplasma Profile, Naa, Urine L	12	6	$1,377.50	$1,377.50	$1,055.00	$1,525.00	$1,272.00	2025-10-03
93975	CPT	US Abdomen Doppler Complete Eo	6	6	$1,320.00	$1,320.00	$1,162.00	$1,294.00	$1,267.00	2025-10-03
81515	CPT	Xpress Mvp (Genexpert)	6	6	$1,316.00	$1,316.00	$1,158.00	$1,290.00	$1,263.00	2025-10-03
3600994	CDM	Tightrope Ii Fibertag-ar-1588rtt2	6	6	$1,308.00	$1,308.00	$1,151.00	$1,282.00	$1,256.00	2025-10-03
87040	CPT	Blood Culture, Routine Lc	6	6	$1,305.00	$1,305.00	$1,148.00	$1,279.00	$1,253.00	2025-10-03
80074	CPT	Acute Hepatitis Lc	6	6	$1,302.00	$1,302.00	$1,146.00	$1,276.00	$1,250.00	2025-10-03
3702444	CDM	Onabotulinum Toxin A 100 Unit/vial Inj [Cmh]	6	6	$1,299.00	$1,299.00	$1,143.00	$1,273.00	$1,247.00	2025-10-03
3701993	CDM	Procainamide 500 Mg/ml Inj 2 Ml [Cmh]	6	6	$1,296.00	$1,296.00	$1,140.00	$1,270.00	$1,244.00	2025-10-03
12006	CPT	12006 Smpl Rpr Scalp/neck/ax/genit/trunk 20.1-30.0cm Techfee	6	6	$1,279.00	$1,279.00	$1,126.00	$1,253.00	$1,228.00	2025-10-03
86341	CPT	Antipancreatic Islet Cells Lc	6	6	$1,257.00	$1,257.00	$1,106.00	$1,232.00	$1,207.00	2025-10-03
81291	CPT	Mthfr Lc	6	6	$1,252.00	$1,252.00	$1,102.00	$1,227.00	$1,202.00	2025-10-03
93930	CPT	93930 Artl Dup Bil Upper Charge	6	6	$1,231.00	$1,231.00	$1,083.00	$1,206.00	$1,182.00	2025-10-03
77001	CPT	Xr Fluoro Guide Cva Placement Eo	6	6	$1,229.00	$1,229.00	$1,082.00	$1,204.00	$1,180.00	2025-10-03
93971	CPT	93971 US Lower Ext Venous Duplex Left	6	6	$1,222.00	$1,222.00	$1,075.00	$1,198.00	$1,173.00	2025-10-03
87631	CPT	Respiratory Pathogens Flu (Verigene)	6	6	$1,220.00	$1,220.00	$1,074.00	$1,196.00	$1,171.00	2025-10-03
87149	CPT	.Afb Id By DNA Probe Rflx Ast Lc	6	6	$1,204.00	$1,204.00	$1,060.00	$1,180.00	$1,156.00	2025-10-03
3702685	CDM	Tetanus Immune Globulin 250 Units/ml Pfs Inj [Cmh]	6	6	$1,202.00	$1,202.00	$1,058.00	$1,178.00	$1,154.00	2025-10-03
73206	CPT	73206 CT Angio Upper Extremity Bilateral	6	6	$1,198.00	$1,198.00	$1,054.00	$1,174.00	$1,150.00	2025-10-03
81241	CPT	Factor V Leiden Mutation Lc	6	6	$1,195.00	$1,195.00	$1,052.00	$1,171.00	$1,147.00	2025-10-03
80195	CPT	Sirolimus (Rapamune), Blood Lc	6	6	$1,178.00	$1,178.00	$1,037.00	$1,154.00	$1,131.00	2025-10-03
77002	CPT	Xr Fluoro Guidance Needle Placement Eo	6	6	$1,177.00	$1,177.00	$1,036.00	$1,153.00	$1,130.00	2025-10-03
12015	CPT	12015 Simple Repair F/e/e/n/l/m 7.6cm-12.5 Cm Techfee	6	6	$1,176.00	$1,176.00	$1,035.00	$1,152.00	$1,129.00	2025-10-03
64640	CPT	64640 Destruction By Neurolytic Agent; Other Peripheral Nerve Branch; With Imaging…	12	6	$1,233.00	$1,233.00	$706.00	$1,631.00	$1,125.00	2025-10-03
93978	CPT	93978 Abdominal Aorta Scan Complete Charge	6	6	$1,170.00	$1,170.00	$1,030.00	$1,147.00	$1,123.00	2025-10-03
11402	CPT	11042 Debride Subq Tiss 1st 20cm	6	6	$1,164.00	$1,164.00	$1,024.00	$1,141.00	$1,117.00	2025-10-03
3701121	CDM	Epoetin Alfa Mdv 20,000 Units/ml Inj [Cmh]	6	6	$1,155.00	$1,155.00	$1,016.00	$1,132.00	$1,109.00	2025-10-03
3701138	CDM	Filgrastim Pfs 480 Mcg/0.8 Ml Inj [Cmh]	6	6	$1,148.00	$1,148.00	$1,010.00	$1,125.00	$1,102.00	2025-10-03
12034	CPT	12034 Repair Intermediate S/a/t/e 7.6-12.5 Cm Techfee	6	6	$1,138.00	$1,138.00	$1,001.00	$1,115.00	$1,092.00	2025-10-03
12032	CPT	12032 Repair Intermediate S/a/t/e 2.6-7.5 Cm Techfee	6	6	$1,135.00	$1,135.00	$999.00	$1,112.00	$1,090.00	2025-10-03
93926	CPT	93926 Artl Dup Limit Lower Charge	6	6	$1,128.00	$1,128.00	$993.00	$1,105.00	$1,083.00	2025-10-03
3702678	CDM	Vacnirsevimab (Cvx 306) Alip Pf 50 Mg/0.5 Ml Vac [Cmh]	6	6	$1,123.00	$1,123.00	$988.00	$1,101.00	$1,078.00	2025-10-03
3702677	CDM	Vacnirsevimab (Cvx 307) Alip Pf100 Mg/ml Vac [Cmh]	6	6	$1,123.00	$1,123.00	$988.00	$1,101.00	$1,078.00	2025-10-03
93924	CPT	93924 Artl Seg W Ex Lower Charge	6	6	$1,116.00	$1,116.00	$982.00	$1,094.00	$1,071.00	2025-10-03
87529	CPT	Hsv 1 Naa Lc	6	6	$1,114.00	$1,114.00	$980.00	$1,092.00	$1,069.00	2025-10-03
26700	CPT	26700 Cltx Metacarpophalangeal Dislc W/manj Without Anes Techfee	6	6	$1,113.00	$1,113.00	$979.00	$1,091.00	$1,068.00	2025-10-03
12052	CPT	12052 Repair Intermediate F/e/e/n/l&/muc 2.6-5.0 Cm Techfee	6	6	$1,107.00	$1,107.00	$974.00	$1,085.00	$1,063.00	2025-10-03
32554	CPT	32000 Thoracentesis Initial	6	6	$1,097.00	$1,097.00	$965.00	$1,075.00	$1,053.00	2025-10-03
83970	CPT	Pth, Intact Lc	6	6	$1,093.00	$1,093.00	$962.00	$1,071.00	$1,049.00	2025-10-03
86147	CPT	Cmh Cardiolipin (Phospholipid) Ab, Ig Add On	6	6	$1,090.00	$1,090.00	$959.00	$1,068.00	$1,046.00	2025-10-03
84140	CPT	Pregnenolone, Mass Spectrometry (Endocrine Sciences) Lc	6	6	$1,088.00	$1,088.00	$957.00	$1,066.00	$1,044.00	2025-10-03
85306	CPT	Protein S, Free Lc	6	6	$1,085.00	$1,085.00	$955.00	$1,063.00	$1,042.00	2025-10-03
76700	CPT	Ultrasound Of Abdomen	6	6	$1,083.00	$1,083.00	$953.00	$1,061.00	$1,040.00	2025-10-03

See an error in this hospital's data? Submit a correction