Price Transparencybeta 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

GARDEN COUNTY HEALTH SERVICES

Oshkosh, NE · CCN 281310 · Rates published

Your selected procedure

You selected 93350 (HCPCS)

Ultrasound of heart during rest, exercise and/or drug-induced stress with report

This hospital’s price: $1,001 across 5 payers · range $777-$1,657

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbGCHSOshkoshNE&type=CDMWithoutLabel&fileType=CSV · observed 2025-11-08

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.

2,287 distinct procedures filed
9 distinct payers
13,302 rate rows
2025-11-08 last MRF observed
Data quality

13,182 of 13,302 rate rows are consumer-grade (99.1%)

120 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-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 38
percent-of-charges filed in the dollar field — excluded from medians 34
per-diem day rate — not a per-procedure price 22
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 16
exceeds 10× this hospital's gross charge — excluded from medians 8
exceeds 3× this hospital's gross charge for a DRG stay — excluded 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbGCHSOshkoshNE&type=CDMWithoutLabel&fileType=CSV
Found on page http://gchealth.org/about-your-bill/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-18
Content fingerprint 596b1220f9275594… · 5,517,347 bytes · first seen 2026-05-06

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
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 2 $9,951.97 $9,951.97 $9,951.97 nat. median
$19,268
0.5× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 $8,420.90 $8,420.90 $8,420.90 nat. median
$10,410
0.8× median
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 5 $6,003.90 $12,808.32 $7,738.36 nat. median
$3,452
outlier · 2.2×
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 5 $5,866.20 $12,514.56 $7,560.88 nat. median
$1,659
outlier · 4.6×
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 $7,127.10 $7,127.10 $7,127.10 nat. median
$8,186
0.9× median
176
MS_DRG 		Pulmonary Embolism Without Mcc 2 $7,069.51 $7,069.51 $7,069.51 nat. median
$8,596
0.8× median
291
MS_DRG 		Heart Failure And Shock With Mcc 2 $6,870.17 $6,870.17 $6,870.17 nat. median
$12,775
0.5× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 2 $6,829.19 $6,829.19 $6,829.19 nat. median
$12,851
0.5× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 $6,829.19 $6,829.19 $6,829.19 nat. median
$8,119
0.8× median
682
MS_DRG 		Renal Failure With Mcc 2 $6,653.38 $6,653.38 $6,653.38 nat. median
$14,443
outlier · 0.5×
179
MS_DRG 		Respiratory Infections And Inflammations Without Cc/mcc 2 $6,482.00 $6,482.00 $6,482.00 nat. median
$8,200
0.8× median
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 2 $6,482.00 $6,482.00 $6,482.00 nat. median
$15,405
outlier · 0.4×
536
MS_DRG 		Fractures Of Hip And Pelvis Without Mcc 2 $6,421.92 $6,421.92 $6,421.92 nat. median
$8,438
0.8× median
948
MS_DRG 		Signs And Symptoms Without Mcc 2 $6,234.21 $6,234.21 $6,234.21 nat. median
$7,971
0.8× median
951
MS_DRG 		Other Factors Influencing Health Status 2 $6,234.21 $6,234.21 $6,234.21 nat. median
$6,229
1.0× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 2 $5,946.27 $5,946.27 $5,946.27 nat. median
$6,821
0.9× median
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 2 $5,946.27 $5,946.27 $5,946.27 nat. median
$8,522
0.7× median
603
MS_DRG 		Cellulitis Without Mcc 2 $5,870.68 $5,870.68 $5,870.68 nat. median
$8,991
0.7× median
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 2 $5,786.79 $5,786.79 $5,786.79 nat. median
$8,379
0.7× median
309
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Cc 2 $5,726.16 $5,726.16 $5,726.16 nat. median
$7,903
0.7× median
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 5 $2,763.45 $5,895.36 $3,561.78 nat. median
$998
outlier · 3.6×
74178
HCPCS 		CT Scan Of Abdomen And Pelvis Before And After Contrast 5 $2,762.10 $5,892.48 $3,560.04 nat. median
$1,027
outlier · 3.5×
J1162
HCPCS 		Injection, Digoxin Immune Fab (ovine), Per Vial 5 $2,593.35 $5,532.48 $3,342.54 nat. median
$7,165
outlier · 0.5×
90375
HCPCS 		Rabies Immune Globulin For Injection 5 $2,579.85 $5,503.68 $3,325.14 nat. median
$1,052
outlier · 3.2×
70553
HCPCS 		MRI Scan Of Brain Before And After Contrast 5 $2,456.55 $5,240.64 $3,166.22 nat. median
$1,136
outlier · 2.8×
4659100
CDM 		Rabies Immune Globulin 10 Ml IM 5 $2,436.30 $5,197.44 $3,140.12 nat. median
$3,140
1.0× median
3056202
CDM 		Rabies Immunie Globulin 10 Ml IM 5 $2,436.30 $5,197.44 $3,140.12 nat. median
$3,140
1.0× median
74177
HCPCS 		CT Scan Of Abdomen And Pelvis With Contrast 5 $2,358.45 $5,031.36 $3,039.78 nat. median
$976
outlier · 3.1×
72157
HCPCS 		MRI Scan Of Middle Spinal Canal Before And After Contrast 5 $2,306.25 $4,920.00 $2,972.50 nat. median
$1,114
outlier · 2.7×
72156
HCPCS 		MRI Scan Of Upper Spinal Canal Before And After Contrast 5 $2,251.35 $4,802.88 $2,901.74 nat. median
$1,110
outlier · 2.6×
72158
HCPCS 		MRI Scan Of Lower Spinal Canal Before And After Contrast 5 $2,232.45 $4,762.56 $2,877.38 nat. median
$1,097
outlier · 2.6×
4659128
CDM 		Nucala 100 Mg/ml Powder Vial 5 $2,232.45 $4,762.56 $2,877.38 nat. median
$2,877
1.0× median
74170
HCPCS 		CT Scan Of Abdomen Before And After Contrast 5 $2,209.95 $4,714.56 $2,848.38 nat. median
$714
outlier · 4.0×
73702
HCPCS 		CT Scan Of Leg Before And After Contrast 5 $2,172.60 $4,634.88 $2,800.24 nat. median
$708
outlier · 4.0×
74176
HCPCS 		CT Scan Of Abdomen And Pelvis Without Contrast 5 $2,149.20 $4,584.96 $2,770.08 nat. median
$694
outlier · 4.0×
78452
HCPCS 		Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 5 $2,127.60 $4,538.88 $2,742.24 nat. median
$1,822
1.5× median
70543
HCPCS 		MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 5 $2,103.75 $4,488.00 $2,711.50 nat. median
$1,087
outlier · 2.5×
74183
HCPCS 		MRI Scan Of Abdomen Before And After Contrast 5 $2,095.65 $4,470.72 $2,701.06 nat. median
$1,105
outlier · 2.4×
70552
HCPCS 		MRI Scan Of Brain With Contrast 5 $2,080.35 $4,438.08 $2,681.34 nat. median
$965
outlier · 2.8×
72197
HCPCS 		MRI Scan Of Pelvis Before And After Contrast 5 $1,982.25 $4,228.80 $2,554.90 nat. median
$1,074
outlier · 2.4×
73223
HCPCS 		MRI Scan Of Arm Joint Before And After Contrast 5 $1,972.35 $4,207.68 $2,542.14 nat. median
$1,158
outlier · 2.2×
70549
HCPCS 		MRI Scan Of Blood Vessels Of Neck Before And After Contrast 5 $1,966.50 $4,195.20 $2,534.60 nat. median
$1,063
outlier · 2.4×
72147
HCPCS 		MRI Scan Of Middle Spinal Canal With Contrast 5 $1,958.85 $4,178.88 $2,524.74 nat. median
$972
outlier · 2.6×
71550
HCPCS 		MRI Scan Of Chest Without Contrast 5 $1,945.80 $4,151.04 $2,507.92 nat. median
$820
outlier · 3.1×
72142
HCPCS 		MRI Scan Of Upper Spinal Canal With Contrast 5 $1,915.20 $4,085.76 $2,468.48 nat. median
$978
outlier · 2.5×
72149
HCPCS 		MRI Scan Of Lower Spinal Canal With Contrast 5 $1,898.55 $4,050.24 $2,447.02 nat. median
$979
outlier · 2.5×
74160
HCPCS 		CT Scan Of Abdomen With Contrast 5 $1,886.40 $4,024.32 $2,431.36 nat. median
$655
outlier · 3.7×
70551
HCPCS 		MRI Scan Of Brain Without Contrast 5 $1,881.90 $4,014.72 $2,425.56 nat. median
$787
outlier · 3.1×
70546
HCPCS 		MRI Scan Of Blood Vessels Of Head Before And After Contrast 5 $1,876.05 $4,002.24 $2,418.02 nat. median
$1,073
outlier · 2.3×
78451
HCPCS 		Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 5 $1,829.70 $3,903.36 $2,358.28 nat. median
$1,550
1.5× median

Other procedures at this hospital

Browse this hospital's 2,287 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 2 2 $24,076.00 $21,186.88 $9,951.97 $9,951.97 $9,951.97 2025-11-08
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 2 $13,136.00 $11,559.68 $8,420.90 $8,420.90 $8,420.90 2025-11-08
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 5 5 $13,342.00 $11,740.96 $6,003.90 $12,808.32 $7,738.36 2025-11-08
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 5 5 $13,036.00 $11,471.68 $5,866.20 $12,514.56 $7,560.88 2025-11-08
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 2 $8,906.50 $7,837.72 $7,127.10 $7,127.10 $7,127.10 2025-11-08
176 MS_DRG Pulmonary Embolism Without Mcc 2 2 $10,487.00 $9,228.56 $7,069.51 $7,069.51 $7,069.51 2025-11-08
291 MS_DRG Heart Failure And Shock With Mcc 2 2 $19,843.75 $17,462.50 $6,870.17 $6,870.17 $6,870.17 2025-11-08
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 2 2 $31,310.00 $27,552.80 $6,829.19 $6,829.19 $6,829.19 2025-11-08
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 2 $14,420.00 $12,689.60 $6,829.19 $6,829.19 $6,829.19 2025-11-08
682 MS_DRG Renal Failure With Mcc 2 2 $8,155.00 $7,176.40 $6,653.38 $6,653.38 $6,653.38 2025-11-08
177 MS_DRG Respiratory Infections And Inflammations With Mcc 2 2 $34,933.00 $30,741.04 $6,482.00 $6,482.00 $6,482.00 2025-11-08
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 2 2 $15,467.00 $13,610.96 $6,482.00 $6,482.00 $6,482.00 2025-11-08
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 2 2 $4,754.00 $4,183.52 $6,421.92 $6,421.92 $6,421.92 2025-11-08
951 MS_DRG Other Factors Influencing Health Status 2 2 $2,139.00 $1,882.32 $6,234.21 $6,234.21 $6,234.21 2025-11-08
948 MS_DRG Signs And Symptoms Without Mcc 2 2 $7,287.00 $6,412.56 $6,234.21 $6,234.21 $6,234.21 2025-11-08
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 2 2 $15,392.00 $13,544.96 $5,946.27 $5,946.27 $5,946.27 2025-11-08
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 2 2 $21,384.67 $18,818.51 $5,946.27 $5,946.27 $5,946.27 2025-11-08
603 MS_DRG Cellulitis Without Mcc 2 2 $16,014.00 $14,092.32 $5,870.68 $5,870.68 $5,870.68 2025-11-08
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 2 2 $8,332.00 $7,332.16 $5,786.79 $5,786.79 $5,786.79 2025-11-08
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 2 2 $11,766.00 $10,354.08 $5,726.16 $5,726.16 $5,726.16 2025-11-08
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 5 5 $6,141.00 $5,404.08 $2,763.45 $5,895.36 $3,561.78 2025-11-08
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 5 5 $6,138.00 $5,401.44 $2,762.10 $5,892.48 $3,560.04 2025-11-08
J1162 HCPCS Injection, Digoxin Immune Fab (ovine), Per Vial 5 5 $5,763.00 $5,071.44 $2,593.35 $5,532.48 $3,342.54 2025-11-08
90375 HCPCS Rabies Immune Globulin For Injection 5 5 $5,733.00 $5,045.04 $2,579.85 $5,503.68 $3,325.14 2025-11-08
70553 HCPCS MRI Scan Of Brain Before And After Contrast 5 5 $5,459.00 $4,803.92 $2,456.55 $5,240.64 $3,166.22 2025-11-08
4659100 CDM Rabies Immune Globulin 10 Ml IM 5 5 $5,414.00 $4,764.32 $2,436.30 $5,197.44 $3,140.12 2025-11-08
3056202 CDM Rabies Immunie Globulin 10 Ml IM 5 5 $5,414.00 $4,764.32 $2,436.30 $5,197.44 $3,140.12 2025-11-08
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 5 5 $5,241.00 $4,612.08 $2,358.45 $5,031.36 $3,039.78 2025-11-08
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 5 5 $5,125.00 $4,510.00 $2,306.25 $4,920.00 $2,972.50 2025-11-08
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 5 5 $5,003.00 $4,402.64 $2,251.35 $4,802.88 $2,901.74 2025-11-08
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 5 5 $4,961.00 $4,365.68 $2,232.45 $4,762.56 $2,877.38 2025-11-08
4659128 CDM Nucala 100 Mg/ml Powder Vial 5 5 $4,961.00 $4,365.68 $2,232.45 $4,762.56 $2,877.38 2025-11-08
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 5 5 $4,911.00 $4,321.68 $2,209.95 $4,714.56 $2,848.38 2025-11-08
73702 HCPCS CT Scan Of Leg Before And After Contrast 5 5 $4,828.00 $4,248.64 $2,172.60 $4,634.88 $2,800.24 2025-11-08
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 5 5 $4,776.00 $4,202.88 $2,149.20 $4,584.96 $2,770.08 2025-11-08
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 5 5 $4,728.00 $4,160.64 $2,127.60 $4,538.88 $2,742.24 2025-11-08
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 5 5 $4,675.00 $4,114.00 $2,103.75 $4,488.00 $2,711.50 2025-11-08
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 5 5 $4,657.00 $4,098.16 $2,095.65 $4,470.72 $2,701.06 2025-11-08
70552 HCPCS MRI Scan Of Brain With Contrast 5 5 $4,623.00 $4,068.24 $2,080.35 $4,438.08 $2,681.34 2025-11-08
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 5 5 $4,405.00 $3,876.40 $1,982.25 $4,228.80 $2,554.90 2025-11-08
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 5 5 $4,383.00 $3,857.04 $1,972.35 $4,207.68 $2,542.14 2025-11-08
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 5 5 $4,370.00 $3,845.60 $1,966.50 $4,195.20 $2,534.60 2025-11-08
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 5 5 $4,353.00 $3,830.64 $1,958.85 $4,178.88 $2,524.74 2025-11-08
71550 HCPCS MRI Scan Of Chest Without Contrast 5 5 $4,324.00 $3,805.12 $1,945.80 $4,151.04 $2,507.92 2025-11-08
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 5 5 $4,256.00 $3,745.28 $1,915.20 $4,085.76 $2,468.48 2025-11-08
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 5 5 $4,219.00 $3,712.72 $1,898.55 $4,050.24 $2,447.02 2025-11-08
74160 HCPCS CT Scan Of Abdomen With Contrast 5 5 $4,192.00 $3,688.96 $1,886.40 $4,024.32 $2,431.36 2025-11-08
70551 HCPCS MRI Scan Of Brain Without Contrast 5 5 $4,182.00 $3,680.16 $1,881.90 $4,014.72 $2,425.56 2025-11-08
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 5 5 $4,169.00 $3,668.72 $1,876.05 $4,002.24 $2,418.02 2025-11-08
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 5 5 $4,066.00 $3,578.08 $1,829.70 $3,903.36 $2,358.28 2025-11-08
73720 HCPCS MRI Scan Of Leg Before And After Contrast 10 5 $3,602.50 $3,170.20 $1,418.85 $3,889.92 $2,350.16 2025-11-08
73220 HCPCS MRI Scan Of Arm Before And After Contrast 5 5 $4,051.00 $3,564.88 $1,822.95 $3,888.96 $2,349.58 2025-11-08
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 5 5 $3,952.00 $3,477.76 $1,778.40 $3,793.92 $2,292.16 2025-11-08
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 5 5 $3,934.00 $3,461.92 $1,770.30 $3,776.64 $2,281.72 2025-11-08
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 5 5 $3,912.00 $3,442.56 $1,760.40 $3,755.52 $2,268.96 2025-11-08
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 5 5 $3,857.00 $3,394.16 $1,735.65 $3,702.72 $2,237.06 2025-11-08
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 5 5 $3,835.00 $3,374.80 $1,725.75 $3,681.60 $2,224.30 2025-11-08
74150 HCPCS CT Scan Of Abdomen Without Contrast 5 5 $3,820.00 $3,361.60 $1,719.00 $3,667.20 $2,215.60 2025-11-08
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 5 5 $3,820.00 $3,361.60 $1,719.00 $3,667.20 $2,215.60 2025-11-08
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 5 5 $3,815.00 $3,357.20 $1,716.75 $3,662.40 $2,212.70 2025-11-08
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 5 5 $3,779.00 $3,325.52 $1,700.55 $3,627.84 $2,191.82 2025-11-08
72196 HCPCS MRI Scan Of Pelvis With Contrast 5 5 $3,770.00 $3,317.60 $1,696.50 $3,619.20 $2,186.60 2025-11-08
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 5 5 $3,753.00 $3,302.64 $1,688.85 $3,602.88 $2,176.74 2025-11-08
74181 HCPCS MRI Scan Of Abdomen Without Contrast 5 5 $3,581.00 $3,151.28 $1,611.45 $3,437.76 $2,076.98 2025-11-08
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 5 5 $3,569.00 $3,140.72 $1,606.05 $3,426.24 $2,070.02 2025-11-08
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 5 5 $3,511.00 $3,089.68 $1,579.95 $3,370.56 $2,036.38 2025-11-08
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 5 5 $3,507.00 $3,086.16 $1,578.15 $3,366.72 $2,034.06 2025-11-08
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 5 5 $3,423.00 $3,012.24 $1,540.35 $3,286.08 $1,985.34 2025-11-08
73200 HCPCS CT Scan Of Arm Without Contrast 10 5 $2,827.00 $2,487.76 $1,008.45 $3,276.48 $1,979.54 2025-11-08
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 5 5 $3,390.00 $2,983.20 $1,525.50 $3,254.40 $1,966.20 2025-11-08
71250 HCPCS CT Scan Of Chest Without Contrast 10 5 $2,987.50 $2,629.00 $1,175.40 $3,228.48 $1,950.54 2025-11-08
73222 HCPCS MRI Scan Of Arm Joint With Contrast 5 5 $3,360.00 $2,956.80 $1,512.00 $3,225.60 $1,948.80 2025-11-08
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 5 5 $3,342.00 $2,940.96 $1,503.90 $3,208.32 $1,938.36 2025-11-08
72195 HCPCS MRI Scan Of Pelvis Without Contrast 5 5 $3,329.00 $2,929.52 $1,498.05 $3,195.84 $1,930.82 2025-11-08
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 5 5 $3,324.00 $2,925.12 $1,495.80 $3,191.04 $1,927.92 2025-11-08
71270 HCPCS CT Scan Of Chest Before And After Contrast 5 5 $3,323.00 $2,924.24 $1,495.35 $3,190.08 $1,927.34 2025-11-08
74182 HCPCS MRI Scan Of Abdomen With Contrast 5 5 $3,308.00 $2,911.04 $1,488.60 $3,175.68 $1,918.64 2025-11-08
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 5 5 $3,258.00 $2,867.04 $1,466.10 $3,127.68 $1,889.64 2025-11-08
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 5 5 $3,187.00 $2,804.56 $1,434.15 $3,059.52 $1,848.46 2025-11-08
72126 HCPCS CT Scan Of Upper Spine With Contrast 5 5 $3,158.00 $2,779.04 $1,421.10 $3,031.68 $1,831.64 2025-11-08
72132 HCPCS CT Scan Of Lower Spine With Contrast 5 5 $3,129.00 $2,753.52 $1,408.05 $3,003.84 $1,814.82 2025-11-08
70487 HCPCS CT Scan Of Face With Contrast 20 5 $2,859.00 $2,515.92 $1,120.95 $3,217.92 $1,807.28 2025-11-08
73218 HCPCS MRI Scan Of Arm Without Contrast 5 5 $3,092.00 $2,720.96 $1,391.40 $2,968.32 $1,793.36 2025-11-08
4252007 CDM Operating Room Services - General Classification 5 5 $3,073.00 $2,704.24 $1,382.85 $2,950.08 $1,782.34 2025-11-08
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 5 5 $3,051.00 $2,684.88 $1,372.95 $2,928.96 $1,769.58 2025-11-08
72129 HCPCS CT Scan Of Middle Spine With Contrast 5 5 $3,003.00 $2,642.64 $1,351.35 $2,882.88 $1,741.74 2025-11-08
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 5 5 $2,996.00 $2,636.48 $1,348.20 $2,876.16 $1,737.68 2025-11-08
73701 HCPCS CT Scan Of Leg With Contrast Material 5 5 $2,990.00 $2,631.20 $1,345.50 $2,870.40 $1,734.20 2025-11-08
73202 HCPCS CT Scan Of Arm Before And After Contrast 5 5 $2,978.00 $2,620.64 $1,340.10 $2,858.88 $1,727.24 2025-11-08
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 5 5 $2,967.00 $2,610.96 $1,335.15 $2,848.32 $1,720.86 2025-11-08
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 5 5 $2,954.00 $2,599.52 $1,329.30 $2,835.84 $1,713.32 2025-11-08
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 5 5 $2,948.00 $2,594.24 $1,326.60 $2,830.08 $1,709.84 2025-11-08
73718 HCPCS MRI Scan Of Leg Without Contrast 5 5 $2,898.00 $2,550.24 $1,304.10 $2,782.08 $1,680.84 2025-11-08
71260 HCPCS CT Scan Of Chest With Contrast 5 5 $2,888.00 $2,541.44 $1,299.60 $2,772.48 $1,675.04 2025-11-08
72193 HCPCS CT Scan Of Pelvis With Contrast 5 5 $2,883.00 $2,537.04 $1,297.35 $2,767.68 $1,672.14 2025-11-08
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 5 5 $2,867.00 $2,522.96 $1,290.15 $2,752.32 $1,662.86 2025-11-08
81479 HCPCS Molecular Pathology Procedure 10 5 $2,450.00 $2,156.00 $929.25 $2,721.60 $1,644.30 2025-11-08
4252006 CDM Operating Room Services - General Classification 5 5 $2,787.00 $2,452.56 $1,254.15 $2,675.52 $1,616.46 2025-11-08
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 5 5 $2,756.00 $2,425.28 $1,240.20 $2,645.76 $1,598.48 2025-11-08
72125 HCPCS CT Scan Of Upper Spine Without Contrast 5 5 $2,720.00 $2,393.60 $1,224.00 $2,611.20 $1,577.60 2025-11-08
78472 HCPCS Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit… 5 5 $2,688.00 $2,365.44 $1,209.60 $2,580.48 $1,559.04 2025-11-08
73201 HCPCS CT Scan Of Arm With Contrast 5 5 $2,638.00 $2,321.44 $1,187.10 $2,532.48 $1,530.04 2025-11-08
70460 HCPCS CT Scan Head Or Brain With Contrast 5 5 $2,625.00 $2,310.00 $1,181.25 $2,520.00 $1,522.50 2025-11-08
4651442 CDM Nitropress 50 Mg/2 Ml IV 5 5 $2,620.00 $2,305.60 $1,179.00 $2,515.20 $1,519.60 2025-11-08
72131 HCPCS CT Scan Of Lower Spine Without Contrast 5 5 $2,613.00 $2,299.44 $1,175.85 $2,508.48 $1,515.54 2025-11-08
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 5 5 $2,610.00 $2,296.80 $1,174.50 $2,505.60 $1,513.80 2025-11-08
4552205 CDM Ventilation And Perfusion 5 5 $2,590.00 $2,279.20 $1,165.50 $2,486.40 $1,502.20 2025-11-08
72192 HCPCS CT Scan Of Pelvis Without Contrast 5 5 $2,562.00 $2,254.56 $1,152.90 $2,459.52 $1,485.96 2025-11-08
72128 HCPCS CT Scan Of Middle Spine Without Contrast 5 5 $2,562.00 $2,254.56 $1,152.90 $2,459.52 $1,485.96 2025-11-08
73700 HCPCS CT Scan Of Leg Without Contrast 5 5 $2,549.00 $2,243.12 $1,147.05 $2,447.04 $1,478.42 2025-11-08
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 5 5 $2,516.00 $2,214.08 $1,132.20 $2,415.36 $1,459.28 2025-11-08
59409 HCPCS Vaginal Delivery 5 5 $1,520.00 $1,337.60 $673.63 $1,520.00 $1,459.20 2025-11-08
4252005 CDM Operating Room Services - General Classification 5 5 $2,500.00 $2,200.00 $1,125.00 $2,400.00 $1,450.00 2025-11-08
70486 HCPCS CT Scan Of Face Without Contrast 5 5 $2,439.00 $2,146.32 $1,097.55 $2,341.44 $1,414.62 2025-11-08
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 5 5 $2,327.00 $2,047.76 $1,047.15 $2,233.92 $1,349.66 2025-11-08
78580 HCPCS Nuclear Medicine Study Of Lung Circulation 5 5 $2,326.00 $2,046.88 $1,046.70 $2,232.96 $1,349.08 2025-11-08
70450 HCPCS CT Scan Head Or Brain Without Contrast 5 5 $2,319.00 $2,040.72 $1,043.55 $2,226.24 $1,345.02 2025-11-08
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 5 5 $2,291.00 $2,016.08 $1,030.95 $2,199.36 $1,328.78 2025-11-08
70336 HCPCS MRI Scan Of Jaw Joint 5 5 $2,246.00 $1,976.48 $1,010.70 $2,156.16 $1,302.68 2025-11-08
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 5 5 $2,195.00 $1,931.60 $987.75 $2,107.20 $1,273.10 2025-11-08
78709 HCPCS Nuclear Medicine Studies Of Kidney, Blood Flow, And Function 5 5 $2,188.00 $1,925.44 $984.60 $2,100.48 $1,269.04 2025-11-08
P9037 HCPCS Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit 5 5 $2,037.00 $1,792.56 $916.65 $1,955.52 $1,181.46 2025-11-08
78707 HCPCS Nuclear Medicine Study Of Kidney, Blood Flow, And Function 5 5 $2,020.00 $1,777.60 $909.00 $1,939.20 $1,171.60 2025-11-08
4659240 CDM Kcentra 500 Unit Vial 5 5 $2,018.00 $1,775.84 $908.10 $1,937.28 $1,170.44 2025-11-08
78215 HCPCS Nuclear Medicine Study Of Liver And Spleen 5 5 $2,009.00 $1,767.92 $904.05 $1,928.64 $1,165.22 2025-11-08
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 5 5 $1,998.00 $1,758.24 $899.10 $1,918.08 $1,158.84 2025-11-08
J9312 HCPCS Injection, Rituximab, 10 Mg 5 5 $1,991.00 $1,752.08 $895.95 $1,911.36 $1,154.78 2025-11-08
78306 HCPCS Nuclear Medicine Study Of Bone And/or Joint Whole Body 5 5 $1,982.00 $1,744.16 $891.90 $1,902.72 $1,149.56 2025-11-08
92960 HCPCS External Shock To Heart To Regulate Heart Beat 5 5 $1,971.00 $1,734.48 $886.95 $1,892.16 $1,143.18 2025-11-08
78264 HCPCS Nuclear Medicine Study Of Stomach To Assess Emptying 5 5 $1,925.00 $1,694.00 $866.25 $1,848.00 $1,116.50 2025-11-08
78708 HCPCS Nuclear Medicine Study Of Kidney, Blood, Flow, And Function With Drug Administra… 5 5 $1,917.00 $1,686.96 $862.65 $1,840.32 $1,111.86 2025-11-08
78305 HCPCS Nuclear Medicine Study Of Bone And/or Joint Multiple Areas 5 5 $1,892.00 $1,664.96 $851.40 $1,816.32 $1,097.36 2025-11-08
4252002 CDM Operating Room Services - General Classification 5 5 $1,881.00 $1,655.28 $846.45 $1,805.76 $1,090.98 2025-11-08
78803 HCPCS Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day … 15 5 $1,823.00 $1,604.24 $507.15 $2,822.40 $1,081.92 2025-11-08
26418 HCPCS Repair Of Tendon On Top Side Of Finger 5 5 $1,092.00 $960.96 $555.66 $1,092.00 $1,048.32 2025-11-08
78278 HCPCS Nuclear Medicine Study To Assess Blood Loss 5 5 $1,796.00 $1,580.48 $808.20 $1,724.16 $1,041.68 2025-11-08
78226 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System 5 5 $1,768.00 $1,555.84 $795.60 $1,697.28 $1,025.44 2025-11-08
93350 HCPCS Ultrasound Of Heart During Rest, Exercise And/or Drug-induced Stress With Report 5 5 $1,726.00 $1,518.88 $776.70 $1,656.96 $1,001.08 2025-11-08
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 5 5 $998.00 $878.24 $464.11 $998.00 $970.70 2025-11-08
4252001 CDM Operating Room Services - General Classification 5 5 $1,652.00 $1,453.76 $743.40 $1,585.92 $958.16 2025-11-08
4001011 CDM Room & Board - Semi-private (two Beds) - General Classification 4 4 $1,487.00 $1,308.56 $468.41 $1,427.52 $940.53 2025-11-08
78466 HCPCS Nuclear Medicine Study Of Heart Muscle Following Heart Attack 5 5 $1,588.00 $1,397.44 $714.60 $1,524.48 $921.04 2025-11-08
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 5 5 $931.00 $819.28 $400.03 $931.00 $893.76 2025-11-08
78070 HCPCS Nuclear Medicine Study Of Parathyroid 5 5 $1,538.00 $1,353.44 $692.10 $1,476.48 $892.04 2025-11-08
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 5 5 $1,517.00 $1,334.96 $682.65 $1,456.32 $879.86 2025-11-08
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 10 5 $1,516.50 $1,334.52 $682.20 $1,456.32 $879.86 2025-11-08
81350 HCPCS Gene Analysis (udp Glucuronosyltransferase 1 Family, Polypeptide A1) For Detecti… 5 5 $1,499.00 $1,319.12 $674.55 $1,439.04 $869.42 2025-11-08
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 5 5 $1,497.00 $1,317.36 $673.65 $1,437.12 $868.26 2025-11-08
78801 HCPCS Nuclear Medicine Study, Multiple Areas 5 5 $1,495.00 $1,315.60 $672.75 $1,435.20 $867.10 2025-11-08
78216 HCPCS Nuclear Medicine Study Of Liver, Spleen, And Blood Flow 5 5 $1,479.00 $1,301.52 $665.55 $1,419.84 $857.82 2025-11-08
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 5 5 $1,469.00 $1,292.72 $661.05 $1,410.24 $852.02 2025-11-08
78800 HCPCS Nuclear Medicine Study, 1 Area 5 5 $1,453.00 $1,278.64 $653.85 $1,394.88 $842.74 2025-11-08
93931 HCPCS Ultrasound Of One Arm Arteries Or Artery Grafts 5 5 $1,448.00 $1,274.24 $651.60 $1,390.08 $839.84 2025-11-08
78290 HCPCS Nuclear Medicine Study Of Intestine 5 5 $1,433.00 $1,261.04 $644.85 $1,375.68 $831.14 2025-11-08
4252000 CDM Operating Room Services - General Classification 5 5 $1,423.00 $1,252.24 $640.35 $1,366.08 $825.34 2025-11-08
4651025 CDM Rabies Imm Globuline 2ml IM 5 5 $1,418.00 $1,247.84 $638.10 $1,361.28 $822.44 2025-11-08
3056203 CDM Rabies Immune Globulin 2ml IM 5 5 $1,418.00 $1,247.84 $638.10 $1,361.28 $822.44 2025-11-08
J1740 HCPCS Injection, Ibandronate Sodium, 1 Mg 5 5 $1,367.00 $1,202.96 $615.15 $1,312.32 $792.86 2025-11-08
93017 HCPCS Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg) 5 5 $1,305.00 $1,148.40 $587.25 $1,252.80 $756.90 2025-11-08
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 5 5 $777.00 $683.76 $369.95 $777.00 $745.92 2025-11-08
93925 HCPCS Ultrasound Of Leg Arteries Or Artery Grafts 5 5 $1,264.00 $1,112.32 $568.80 $1,213.44 $733.12 2025-11-08
93930 HCPCS Ultrasound Of Arm Arteries Or Artery Grafts 5 5 $1,236.00 $1,087.68 $556.20 $1,186.56 $716.88 2025-11-08
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 5 5 $1,224.00 $1,077.12 $550.80 $1,175.04 $709.92 2025-11-08
62322 HCPCS Injection Of Substance Into Lower Spine Canal 5 5 $1,208.00 $1,063.04 $543.60 $1,159.68 $700.64 2025-11-08
4653514 CDM Remdesivirr Inj 100mg/vial 5 5 $1,181.00 $1,039.28 $531.45 $1,133.76 $684.98 2025-11-08
81270 HCPCS Gene Analysis (Janus Kinase 2) Variant 5 5 $1,173.00 $1,032.24 $527.85 $1,126.08 $680.34 2025-11-08
99291 HCPCS Critical Care, First 30-74 Minutes 10 5 $1,149.00 $1,011.12 $192.01 $1,651.20 $676.00 2025-11-08
27560 HCPCS Closed Treatment Of Dislocated Kneecap 5 5 $701.00 $616.88 $312.13 $701.00 $672.96 2025-11-08
93971 HCPCS Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers 5 5 $1,148.00 $1,010.24 $516.60 $1,102.08 $665.84 2025-11-08
78740 HCPCS Nuclear Medicine Study To Assess Urine Flow 5 5 $1,127.00 $991.76 $507.15 $1,081.92 $653.66 2025-11-08
78700 HCPCS Nuclear Medicine Study Of Kidney 5 5 $1,127.00 $991.76 $507.15 $1,081.92 $653.66 2025-11-08
78761 HCPCS Nuclear Medicine Study Of Testicle And Blood Flow 5 5 $1,127.00 $991.76 $507.15 $1,081.92 $653.66 2025-11-08
20103 HCPCS Exploration Of Wound Of Arm Or Leg 4 4 $1,118.00 $983.84 $261.74 $1,073.28 $648.44 2025-11-08
78300 HCPCS Nuclear Medicine Study Of Bone And/or Joint Limited Area 5 5 $1,105.00 $972.40 $497.25 $1,060.80 $640.90 2025-11-08
81206 HCPCS Translocation Analysis (bcr/abl1) Major Breakpoint 5 5 $1,097.00 $965.36 $493.65 $1,053.12 $636.26 2025-11-08
4001010 CDM Room & Board - Semi-private (two Beds) - General Classification 4 4 $990.00 $871.20 $311.85 $950.40 $626.17 2025-11-08
84586 HCPCS Vasoactive Intestinal Peptide (intestinal Hormone) Level 5 5 $1,058.00 $931.04 $476.10 $1,015.68 $613.64 2025-11-08
26700 HCPCS Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation 5 5 $629.00 $553.52 $289.46 $629.00 $603.84 2025-11-08
4605340 CDM Lumen 4fr Dual Solo Singi 5 5 $1,030.00 $906.40 $463.50 $988.80 $597.40 2025-11-08
36430 HCPCS Transfusion Of Blood Or Blood Products 40 5 $894.50 $787.16 $257.85 $1,255.68 $596.77 2025-11-08
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 9 5 $728.00 $640.64 $213.44 $728.00 $593.78 2025-11-08
93926 HCPCS Ultrasound Of One Leg Arteries Or Artery Grafts 5 5 $1,019.00 $896.72 $458.55 $978.24 $591.02 2025-11-08
26641 HCPCS Closed Treatment Of Dislocated Thumb At Wrist With Manipulation 9 5 $728.00 $640.64 $261.74 $728.00 $568.04 2025-11-08
78587 HCPCS Pulmonary Ventilation; Mu 5 5 $970.00 $853.60 $436.50 $931.20 $562.60 2025-11-08
21931 HCPCS Removal Of Growth Under Skin Of Back Or Lower Sides, 3.0 Cm Or More 4 4 $945.00 $831.60 $261.74 $907.20 $548.10 2025-11-08
21930 HCPCS Removal Of Growth Under Skin Of Back Or Lower Sides, Less Than 3.0 Cm 4 4 $945.00 $831.60 $261.74 $907.20 $548.10 2025-11-08
12054 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1… 9 5 $693.00 $609.84 $195.94 $693.00 $543.32 2025-11-08
76700 HCPCS Complete Ultrasound Scan Of Abdomen 5 5 $929.00 $817.52 $418.05 $891.84 $538.82 2025-11-08
77075 HCPCS Complete X-ray Of Body Bones 5 5 $927.00 $815.76 $417.15 $889.92 $537.66 2025-11-08
27265 HCPCS Closed Treatment Of Dislocated Hip Prosthesis 4 4 $917.00 $806.96 $261.74 $880.32 $531.86 2025-11-08
4001020 CDM Room & Board - Private (one Bed) - General Classification 4 4 $840.00 $739.20 $264.60 $806.40 $531.30 2025-11-08
76805 HCPCS Ultrasound Scan Of Pregnant Uterus (14 Weeks Or More), Single Or First Fetus 5 5 $899.00 $791.12 $404.55 $863.04 $521.42 2025-11-08
4602045 CDM Quick Trach Adult And Ped 5 5 $882.00 $776.16 $396.90 $846.72 $511.56 2025-11-08
87522 HCPCS Detection Test By Nucleic Acid For Hepatitis C Virus, Quantification 5 5 $876.00 $770.88 $394.20 $840.96 $508.08 2025-11-08
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 9 5 $664.00 $584.32 $193.28 $664.00 $507.28 2025-11-08
76856 HCPCS Complete Ultrasound Scan Of Pelvis 5 5 $859.00 $755.92 $386.55 $824.64 $498.22 2025-11-08
11606 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 4 4 $851.00 $748.88 $261.74 $816.96 $493.58 2025-11-08
93976 HCPCS Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 5 5 $845.00 $743.60 $380.25 $811.20 $490.10 2025-11-08
4102026 CDM Specialty Services - Treatment Room 5 5 $838.00 $737.44 $377.10 $804.48 $486.04 2025-11-08
77074 HCPCS Limited X-ray Of Body Bones 5 5 $832.00 $732.16 $374.40 $798.72 $482.56 2025-11-08
12016 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.… 9 5 $503.00 $442.64 $109.30 $503.00 $479.04 2025-11-08
4601315 CDM Ez Io All Sizes 5 5 $824.00 $725.12 $370.80 $791.04 $477.92 2025-11-08
76770 HCPCS Complete Ultrasound Scan Behind Abdominal Cavity 5 5 $822.00 $723.36 $369.90 $789.12 $476.76 2025-11-08
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 9 5 $610.00 $536.80 $261.74 $610.00 $475.86 2025-11-08
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 9 5 $578.00 $508.64 $171.57 $578.00 $475.38 2025-11-08
76775 HCPCS Limited Ultrasound Scan Behind Abdominal Cavity 5 5 $816.00 $718.08 $367.20 $783.36 $473.28 2025-11-08
12034 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5… 9 5 $600.00 $528.00 $183.85 $600.00 $465.88 2025-11-08
12052 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5… 9 5 $562.00 $494.56 $179.33 $562.00 $464.04 2025-11-08
76801 HCPCS Ultrasound Scan Of Pregnant Uterus (less Than 14 Weeks), Single Or First Fetus 5 5 $800.00 $704.00 $360.00 $768.00 $464.00 2025-11-08
4251010 CDM Operating Room Services - General Classification 5 5 $783.00 $689.04 $352.35 $751.68 $454.14 2025-11-08
87507 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 5 5 $780.00 $686.40 $351.00 $748.80 $452.40 2025-11-08
12042 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.6-7.5 Cm 9 5 $557.00 $490.16 $176.25 $557.00 $450.26 2025-11-08
80074 HCPCS Acute Hepatitis Panel 5 5 $774.00 $681.12 $348.30 $743.04 $448.92 2025-11-08
93923 HCPCS Complete Ultrasound Study Of Arm And Leg Arteries 5 5 $772.00 $679.36 $347.40 $741.12 $447.76 2025-11-08
12017 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.… 9 5 $524.00 $461.12 $131.70 $524.00 $444.12 2025-11-08
76830 HCPCS Ultrasound Scan Of Uterus, Ovaries, Tubes, Cervix And Pelvic Area Through Vagina 5 5 $761.00 $669.68 $342.45 $730.56 $441.38 2025-11-08
72052 HCPCS X-ray Of Upper Spine, 6 Or More Views 5 5 $759.00 $667.92 $341.55 $728.64 $440.22 2025-11-08
11644 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3.1-… 4 4 $755.00 $664.40 $261.74 $724.80 $437.90 2025-11-08
12020 HCPCS Simple Closure Of Surface Wound Reopening 9 5 $542.00 $476.96 $168.31 $542.00 $437.22 2025-11-08
76705 HCPCS Limited Ultrasound Scan Of Abdomen 5 5 $751.00 $660.88 $337.95 $720.96 $435.58 2025-11-08
78010 HCPCS Thyroid 5 5 $751.00 $660.88 $337.95 $720.96 $435.58 2025-11-08
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 10 5 $750.00 $660.00 $157.05 $1,101.12 $434.57 2025-11-08
76870 HCPCS Ultrasound Scan Of Scrotum 5 5 $749.00 $659.12 $337.05 $719.04 $434.42 2025-11-08
99236 HCPCS Hospital Inpatient Or Observation Care With Admission And Discharge On The Same … 5 5 $450.00 $396.00 $188.01 $450.00 $432.00 2025-11-08
84999 HCPCS Chemistry Procedures 5 5 $739.00 $650.32 $332.55 $709.44 $428.62 2025-11-08
87521 HCPCS Detection Test By Nucleic Acid For Hepatitis C Virus, Amplified Probe Technique 5 5 $735.00 $646.80 $330.75 $705.60 $426.30 2025-11-08
76881 HCPCS Complete Ultrasound Scan Of Joint 5 5 $732.00 $644.16 $329.40 $702.72 $424.56 2025-11-08
72114 HCPCS X-ray Lower And Sacral Spine, Minimum Of 6 Views 5 5 $730.00 $642.40 $328.50 $700.80 $423.40 2025-11-08
4655601 CDM Imovax Rabies IM 5 5 $728.00 $640.64 $327.60 $698.88 $422.24 2025-11-08
12051 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5 C… 9 5 $524.00 $461.12 $151.78 $524.00 $420.00 2025-11-08
11760 HCPCS Repair Of Fingernail Or Toenail Bed 5 5 $429.00 $377.52 $98.69 $429.00 $411.84 2025-11-08
P9040 HCPCS Red Blood Cells, Leukocytes Reduced, Irradiated, Each Unit 5 5 $710.00 $624.80 $319.50 $681.60 $411.80 2025-11-08
J1670 HCPCS Injection, Tetanus Immune Globulin, Human, Up To 250 Units 5 5 $710.00 $624.80 $319.50 $681.60 $411.80 2025-11-08
4102025 CDM Specialty Services - Treatment Room 5 5 $706.00 $621.28 $317.70 $677.76 $409.48 2025-11-08
86022 HCPCS Antibody Identification Test, Platelet Antibodies 5 5 $699.00 $615.12 $314.55 $671.04 $405.42 2025-11-08
12015 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6… 9 5 $450.00 $396.00 $80.73 $450.00 $402.24 2025-11-08
99223 HCPCS Initial Hospital Inpatient Or Observation Care With High Level Of Medical Decisi… 5 5 $417.00 $366.96 $157.20 $417.00 $400.32 2025-11-08
46250 HCPCS Removal Of Multiple External Hemorrhoids 5 5 $688.00 $605.44 $309.60 $660.48 $399.04 2025-11-08
83993 HCPCS Stool Calprotectin (protein) Level 5 5 $681.00 $599.28 $306.45 $653.76 $394.98 2025-11-08
87529 HCPCS Detection Test By Nucleic Acid For Herpes Simplex Virus, Amplified Probe Techniq… 5 5 $668.00 $587.84 $300.60 $641.28 $387.44 2025-11-08
30905 HCPCS Initial Control Of Nose Bleed And Insertion Of Packing 9 5 $618.00 $543.84 $92.77 $618.00 $386.86 2025-11-08
17106 HCPCS Destruction Of Birthmark, Less Than 10.0 Sq Cm 4 4 $664.00 $584.32 $261.74 $637.44 $385.12 2025-11-08
12041 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.5 Cm Or Less 9 5 $455.00 $400.40 $130.80 $455.00 $380.62 2025-11-08
12005 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 9 5 $436.00 $383.68 $81.20 $436.00 $379.96 2025-11-08
J9202 HCPCS Goserelin Acetate Implant, Per 3.6 Mg 5 5 $646.00 $568.48 $290.70 $620.16 $374.68 2025-11-08
3056204 CDM Vaccine, Rabavert Rabies 5 5 $645.00 $567.60 $290.25 $619.20 $374.10 2025-11-08
90675 HCPCS Rabies Vaccine For Injection Into Muscle 5 5 $645.00 $567.60 $290.25 $619.20 $374.10 2025-11-08
4659982 CDM Rabavert 2.5 Unit Vial 5 5 $644.00 $566.72 $289.80 $618.24 $373.52 2025-11-08
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 4 4 $643.00 $565.84 $261.74 $617.28 $372.94 2025-11-08
76376 HCPCS 3d Radiographic Procedure 5 5 $642.00 $564.96 $288.90 $616.32 $372.36 2025-11-08
99235 HCPCS Hospital Inpatient Or Observation Care With Admission And Discharge On The Same … 5 5 $387.00 $340.56 $143.94 $387.00 $371.52 2025-11-08
87799 HCPCS Detection Test By Nucleic Acid For Organism, Quantification 15 5 $626.00 $550.88 $175.05 $662.40 $369.55 2025-11-08
71111 HCPCS X-ray Of Ribs On Both Sides Of Body, Minimum Of 4 Views 5 5 $635.00 $558.80 $285.75 $609.60 $368.30 2025-11-08
85557 HCPCS Red Blood Cell Fragility Measurement, Incubated 5 5 $634.00 $557.92 $285.30 $608.64 $367.72 2025-11-08
76604 HCPCS Ultrasound Scan Of Chest 5 5 $633.00 $557.04 $284.85 $607.68 $367.14 2025-11-08
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 5 5 $630.00 $554.40 $283.50 $604.80 $365.40 2025-11-08
72110 HCPCS X-ray Of Lower And Sacral Spine, Minimum Of 4 Views 5 5 $629.00 $553.52 $283.05 $603.84 $364.82 2025-11-08
72082 HCPCS X-ray Of Entire Middle And Lower Spine, 2-3 Views 5 5 $627.00 $551.76 $282.15 $601.92 $363.66 2025-11-08
J7321 HCPCS Hyaluronan Or Derivative, Hyalgan, Supartz Or Visco-3, For Intra-articular Injec… 5 5 $624.00 $549.12 $280.80 $599.04 $361.92 2025-11-08
72120 HCPCS X-ray Lower And Sacral Spine, 2-3 Views Bending Views 5 5 $618.00 $543.84 $278.10 $593.28 $358.44 2025-11-08
72084 HCPCS X-ray Of Entire Middle And Lower Spine, Minimum Of 6 Views 5 5 $617.00 $542.96 $277.65 $592.32 $357.86 2025-11-08
12031 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 9 5 $455.00 $400.40 $136.16 $455.00 $357.56 2025-11-08
A9500 HCPCS Technetium Tc-99m Sestamibi, Diagnostic, Per Study Dose 5 5 $613.00 $539.44 $275.85 $588.48 $355.54 2025-11-08
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 5 5 $609.00 $535.92 $274.05 $584.64 $353.22 2025-11-08
72083 HCPCS X-ray Of Entire Middle And Lower Spine, 4-5 Views 5 5 $607.00 $534.16 $273.15 $582.72 $352.06 2025-11-08
4602900 CDM Kit; Safety Peg 20fr 5 5 $607.00 $534.16 $273.15 $582.72 $352.06 2025-11-08
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 4 4 $600.00 $528.00 $261.74 $576.00 $348.00 2025-11-08
4454762 CDM Biofire Resp W Sars Cov 2 5 5 $593.00 $521.84 $266.85 $569.28 $343.94 2025-11-08
76882 HCPCS Limited Ultrasound Scan Of Joint Or Other Extremity Structure Except Blood Vesse… 10 5 $509.00 $447.92 $191.25 $569.28 $343.94 2025-11-08
84244 HCPCS Renin (kidney Enzyme) Level 5 5 $591.00 $520.08 $265.95 $567.36 $342.78 2025-11-08
93225 HCPCS Electrocardiogram (ecg) 2-day Continuous 5 5 $585.00 $514.80 $263.25 $561.60 $339.30 2025-11-08
11750 HCPCS Permanent Removal Fingernail Or Toenail 9 5 $415.00 $365.20 $92.73 $415.00 $338.50 2025-11-08
12014 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1… 9 5 $387.00 $340.56 $64.12 $387.00 $335.36 2025-11-08
26770 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation 4 4 $578.00 $508.64 $261.74 $554.88 $335.24 2025-11-08
74022 HCPCS X-ray Series Of Abdomen With Single X-ray Of Chest 5 5 $575.00 $506.00 $258.75 $552.00 $333.50 2025-11-08
4102024 CDM Specialty Services - Treatment Room 5 5 $573.00 $504.24 $257.85 $550.08 $332.34 2025-11-08
41800 HCPCS Drainage Of Abscess, Cyst, Or Blood Accumulation Of Dental Bone 4 4 $567.00 $498.96 $261.74 $544.32 $328.86 2025-11-08
72050 HCPCS X-ray Of Upper Spine, 4-5 Views 5 5 $563.00 $495.44 $253.35 $540.48 $326.54 2025-11-08
85540 HCPCS White Blood Cell Alkaline Phosphatase (enzyme) Measurement With Cell Count 5 5 $557.00 $490.16 $250.65 $534.72 $323.06 2025-11-08
76817 HCPCS Vaginal Ultrasound Of Pregnant Uterus 5 5 $557.00 $490.16 $250.65 $534.72 $323.06 2025-11-08
83835 HCPCS Metanephrines Level 10 5 $546.00 $480.48 $135.00 $760.32 $322.20 2025-11-08
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 8 5 $335.00 $294.80 $134.39 $335.00 $320.00 2025-11-08
J2248 HCPCS Injection, Micafungin Sodium, 1 Mg 5 5 $547.00 $481.36 $246.15 $525.12 $317.26 2025-11-08
11603 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 4 4 $545.00 $479.60 $261.74 $523.20 $316.10 2025-11-08
87798 HCPCS Detection Test By Nucleic Acid For Organism, Amplified Probe Technique 10 5 $462.50 $407.00 $171.90 $521.28 $314.94 2025-11-08
71110 HCPCS X-ray Of Ribs On Both Sides Of Body, 3 Views 5 5 $541.00 $476.08 $243.45 $519.36 $313.78 2025-11-08
11444 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3… 4 4 $541.00 $476.08 $261.74 $519.36 $313.78 2025-11-08
72072 HCPCS X-ray Of Middle Spine, 3 Views 5 5 $540.00 $475.20 $243.00 $518.40 $313.20 2025-11-08
86804 HCPCS Confirmation Test For Hepatitis C Antibody 5 5 $538.00 $473.44 $242.10 $516.48 $312.04 2025-11-08
83491 HCPCS Hydroxycorticosteroids, 17 (adrenal Gland Hormone) Level 5 5 $536.00 $471.68 $241.20 $514.56 $310.88 2025-11-08
76880 HCPCS Extremity, Non-vascular 5 5 $534.00 $469.92 $240.30 $512.64 $309.72 2025-11-08
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 4 4 $534.00 $469.92 $261.74 $512.64 $309.72 2025-11-08
76818 HCPCS Ultrasound And Monitoring Of Heart Of Fetus 5 5 $525.00 $462.00 $236.25 $504.00 $304.50 2025-11-08
84445 HCPCS Thyroid Stimulating Immune Globulins (thyroid Related Protein) Level 5 5 $525.00 $462.00 $236.25 $504.00 $304.50 2025-11-08
70150 HCPCS X-ray Of Face Bones, Minimum Of 3 Views 5 5 $523.00 $460.24 $235.35 $502.08 $303.34 2025-11-08
71047 HCPCS X-ray Of Chest, 3 Views 5 5 $520.00 $457.60 $234.00 $499.20 $301.60 2025-11-08
11642 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1.1-… 4 4 $520.00 $457.60 $261.74 $499.20 $301.60 2025-11-08
12004 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 9 5 $341.00 $300.08 $63.27 $341.00 $301.44 2025-11-08
72074 HCPCS X-ray Of Middle Spine, Minimum Of 4 Views 5 5 $519.00 $456.72 $233.55 $498.24 $301.02 2025-11-08
86334 HCPCS Immunologic Analysis Technique On Serum (immunofixation) 5 5 $516.00 $454.08 $232.20 $495.36 $299.28 2025-11-08
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