Hospital

AVERA ST ANTHONY'S HOSPITAL

O' Neill, NE · CCN 281329 · Rates published

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You selected 93306 (CPT)

TTE W Doppler Complete

This hospital’s price: $2,525 across 5 payers · range $223-$3,183

Source: https://www.avera.org/app/files/public/2ee985f1-c8f5-4aff-9e24-196f8b6c838b/470463911_avera-st-anthonys-hospital_standardcharges.csv · observed 2026-05-09

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.

1,323 distinct procedures filed

5 distinct payers

19,836 rate rows

2026-05-09 last MRF observed

Data quality

19,783 of 19,836 rate rows are consumer-grade (99.7%)

53 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	20
exceeds 10× this hospital's gross charge — excluded from medians	16
placeholder amount (≤ $0.02) — excluded from medians	9
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	8

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.avera.org/app/files/public/2ee985f1-c8f5-4aff-9e24-196f8b6c838b/470463911_avera-st-anthonys-hospital_standardcharges.csv
Discovered via	Discovered by HANK (automated)
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-21
Content fingerprint	6c2c74f4ac50ad51… · 5,384,505 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J9347 HCPCS	Tremelimumab-actl 300 Mg/15 Ml	5	$199.38	$167,010.00	$142,837.50	nat. median $2,868 outlier · 49.8×
862 OTHER	Ms-DRG 862	1	$84,076.84	$84,076.84	$84,076.84	nat. median $2,877 outlier · 29.2×
314 OTHER	Ms-DRG 314	1	$74,245.41	$74,245.41	$74,245.41	nat. median $19,077 outlier · 3.9×
326 OTHER	Ms-DRG 326	1	$60,310.30	$60,310.30	$60,310.30	nat. median $40,064 1.5× median
J2350 HCPCS	Ocrelizumab 300 Mg/10 Ml	5	$6.09	$65,621.56	$56,123.71	nat. median $470 outlier · 119.5×
J9334 HCPCS	Efgart-hyalu-qvfc 1008Mg/5.6Ml	5	$560.66	$54,893.01	$46,947.98	nat. median $83 outlier · 566.8×
347 OTHER	Ms-DRG 347	1	$46,761.62	$46,761.62	$46,761.62	nat. median $23,078 outlier · 2.0×
580 OTHER	Ms-DRG 580	1	$44,614.89	$44,614.89	$44,614.89	nat. median $14,324 outlier · 3.1×
J9272 HCPCS	Dostarlimab-gxly 500 Mg/10 Ml	5	$8,526.00	$50,176.04	$42,913.71	nat. median $786 outlier · 54.6×
J9022 HCPCS	Atezolizumab 1200 Mg/20 Ml Vl	5	$1.26	$46,985.49	$40,184.96	nat. median $6,785 outlier · 5.9×
J9203 HCPCS	Gemtuzumab Ozogamicin 4.5 Mg	5	$97.98	$42,592.79	$36,428.05	nat. median $687 outlier · 53.0×
323 OTHER	Ms-DRG 323	1	$35,650.87	$35,650.87	$35,650.87	nat. median $6,578 outlier · 5.4×
133 OTHER	Ms-DRG 133	1	$34,672.12	$34,672.12	$34,672.12	nat. median $6,244 outlier · 5.6×
J9042 HCPCS	Brentuximab Vedotin 50 Mg Vial	5	$8,327.21	$40,300.14	$34,467.22	nat. median $951 outlier · 36.2×
J3357 HCPCS	Ustekinumab 45 Mg/0.5 Ml Syr	5	$8.96	$39,712.59	$33,964.72	nat. median $14,744 outlier · 2.3×
J9043 HCPCS	Cabazitaxel 60 Mg/1.5 Ml Vial	5	$7.02	$39,669.58	$33,927.93	nat. median $735 outlier · 46.2×
248 OTHER	Ms-DRG 248	1	$32,953.66	$32,953.66	$32,953.66	nat. median $19,537 1.7× median
J9144 HCPCS	Daratumumab Hyaluronida 1800Mg	5	$382.98	$33,610.25	$31,265.46	nat. median $211 outlier · 147.9×
542 OTHER	Ms-DRG 542	1	$29,182.97	$29,182.97	$29,182.97	nat. median $14,203 outlier · 2.1×
283 OTHER	Ms-DRG 283	1	$28,486.19	$28,486.19	$28,486.19	nat. median $18,684 1.5× median
249 OTHER	Ms-DRG 249	1	$28,286.14	$28,286.14	$28,286.14	nat. median $12,128 outlier · 2.3×
J1930 HCPCS	Lanreotide Acet 120mg/0.5ml Sy	5	$2.24	$32,541.75	$27,831.76	nat. median $5,088 outlier · 5.5×
787 OTHER	Ms-DRG 787	1	$27,745.35	$27,745.35	$27,745.35	nat. median $9,980 outlier · 2.8×
897 OTHER	Ms-DRG 897	1	$26,837.34	$26,837.34	$26,837.34	nat. median $26,484 1.0× median
55 OTHER	Ms-DRG 55	1	$26,176.79	$26,176.79	$26,176.79	nat. median $11,551 outlier · 2.3×
J3380 HCPCS	Vedolizumab 300 Mg Vial	5	$72.63	$30,299.73	$25,914.25	nat. median $162 outlier · 159.9×
617 OTHER	Ms-DRG 617	2	$12,962.88	$25,889.84	$25,889.84	nat. median $18,479 1.4× median
J3101 HCPCS	Tenecteplase 50 Mg/10 Ml Syrng	5	$0.41	$30,005.60	$25,662.68	nat. median $3,820 outlier · 6.7×
J2323 HCPCS	Natalizumab 300 Mg/15 Ml Vial	5	$0.11	$28,998.37	$24,801.24	nat. median $197 outlier · 125.7×
J9306 HCPCS	Pertuzumab 420 Mg/14 Ml Vial	5	$508.34	$26,202.87	$24,113.98	nat. median $80 outlier · 302.9×
J9063 HCPCS	Mirvetuximab Soravtansine-gynx	5	$20.18	$28,011.81	$23,957.47	nat. median $210 outlier · 113.9×
J9228 HCPCS	Ipilimumab 5 Mg/ml 10 Ml Vial	5	$1,054.59	$27,929.41	$23,886.99	nat. median $9,003 outlier · 2.7×
139 OTHER	Ms-DRG 139	1	$23,521.65	$23,521.65	$23,521.65	nat. median $11,790 2.0× median
551 OTHER	Ms-DRG 551	1	$22,657.80	$22,657.80	$22,657.80	nat. median $15,030 1.5× median
140 OTHER	Ms-DRG 140	1	$22,529.07	$22,529.07	$22,529.07	nat. median $29,006 0.8× median
J9332 HCPCS	Efgartigimod Alfa-fcab 400 Mg	5	$7.91	$25,992.48	$22,230.41	nat. median $112 outlier · 197.7×
536 OTHER	Ms-DRG 536	1	$21,883.40	$21,883.40	$21,883.40	nat. median $7,918 outlier · 2.8×
426 OTHER	Ms-DRG 426	1	$21,852.78	$21,852.78	$21,852.78	nat. median $74,767 outlier · 0.3×
J0717 HCPCS	Certolizumab Pegol 400 Mg Kit	5	$3.42	$24,592.04	$20,532.01	nat. median $1,598 outlier · 12.9×
539 OTHER	Ms-DRG 539	1	$19,947.00	$19,947.00	$19,947.00	nat. median $16,424 1.2× median
948 OTHER	Ms-DRG 948	2	$9,729.64	$19,392.24	$19,392.24	nat. median $68 outlier · 285.9×
J0517 HCPCS	Benralizumab 30 Mg/ml Syringe	5	$3.11	$21,515.55	$18,401.46	nat. median $919 outlier · 20.0×
J2353 HCPCS	Octreotide (Depot) 20 Mg Syr	5	$17.33	$24,782.58	$18,086.50	nat. median $5,573 outlier · 3.2×
540 OTHER	Ms-DRG 540	1	$17,908.80	$17,908.80	$17,908.80	nat. median $9,559 1.9× median
425 OTHER	Ms-DRG 425	1	$17,135.53	$17,135.53	$17,135.53	nat. median $13,012 1.3× median
J9271 HCPCS	Pembrolizumab 100 Mg/4 Ml Vial	5	$13.37	$19,580.11	$16,746.15	nat. median $276 outlier · 60.7×
871 OTHER	Ms-DRG 871	1	$16,679.18	$16,679.18	$16,679.18	nat. median $8,145 outlier · 2.0×
694 OTHER	Ms-DRG 694	1	$16,385.12	$16,385.12	$16,385.12	nat. median $7,533 outlier · 2.2×
541 OTHER	Ms-DRG 541	1	$16,375.61	$16,375.61	$16,375.61	nat. median $7,287 outlier · 2.2×
179 OTHER	Ms-DRG 179	1	$16,193.72	$16,193.72	$16,193.72	nat. median $7,960 outlier · 2.0×

Other procedures at this hospital

Browse this hospital's 1,323 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

J9347	HCPCS	Tremelimumab-actl 300 Mg/15 Ml	8	5	$175,800.00	$170,526.00	$199.38	$167,010.00	$142,837.50	2026-05-09
862	OTHER	Ms-DRG 862	2	1	—	—	$84,076.84	$84,076.84	$84,076.84	2026-05-09
314	OTHER	Ms-DRG 314	2	1	—	—	$74,245.41	$74,245.41	$74,245.41	2026-05-09
326	OTHER	Ms-DRG 326	2	1	—	—	$60,310.30	$60,310.30	$60,310.30	2026-05-09
J2350	HCPCS	Ocrelizumab 300 Mg/10 Ml	8	5	$69,075.00	$67,003.07	$6.09	$65,621.56	$56,123.71	2026-05-09
J9334	HCPCS	Efgart-hyalu-qvfc 1008Mg/5.6Ml	8	5	$57,782.00	$56,048.66	$560.66	$54,893.01	$46,947.98	2026-05-09
347	OTHER	Ms-DRG 347	2	1	—	—	$46,761.62	$46,761.62	$46,761.62	2026-05-09
580	OTHER	Ms-DRG 580	1	1	—	—	$44,614.89	$44,614.89	$44,614.89	2026-05-09
J9272	HCPCS	Dostarlimab-gxly 500 Mg/10 Ml	8	5	$52,816.00	$51,232.37	$8,526.00	$50,176.04	$42,913.71	2026-05-09
J9022	HCPCS	Atezolizumab 1200 Mg/20 Ml Vl	8	5	$49,458.00	$47,974.66	$1.26	$46,985.49	$40,184.96	2026-05-09
J9203	HCPCS	Gemtuzumab Ozogamicin 4.5 Mg	8	5	$44,834.00	$43,489.48	$97.98	$42,592.79	$36,428.05	2026-05-09
323	OTHER	Ms-DRG 323	2	1	—	—	$35,650.87	$35,650.87	$35,650.87	2026-05-09
133	OTHER	Ms-DRG 133	2	1	—	—	$34,672.12	$34,672.12	$34,672.12	2026-05-09
J9042	HCPCS	Brentuximab Vedotin 50 Mg Vial	8	5	$42,421.00	$41,148.56	$8,327.21	$40,300.14	$34,467.22	2026-05-09
J3357	HCPCS	Ustekinumab 45 Mg/0.5 Ml Syr	8	5	$41,802.00	$40,548.65	$8.96	$39,712.59	$33,964.72	2026-05-09
J9043	HCPCS	Cabazitaxel 60 Mg/1.5 Ml Vial	8	5	$41,757.00	$40,504.73	$7.02	$39,669.58	$33,927.93	2026-05-09
248	OTHER	Ms-DRG 248	2	1	—	—	$32,953.66	$32,953.66	$32,953.66	2026-05-09
J9144	HCPCS	Daratumumab Hyaluronida 1800Mg	10	5	$34,681.00	$33,641.14	$382.98	$33,610.25	$31,265.46	2026-05-09
542	OTHER	Ms-DRG 542	2	1	—	—	$29,182.97	$29,182.97	$29,182.97	2026-05-09
283	OTHER	Ms-DRG 283	2	1	—	—	$28,486.19	$28,486.19	$28,486.19	2026-05-09
249	OTHER	Ms-DRG 249	2	1	—	—	$28,286.14	$28,286.14	$28,286.14	2026-05-09
J1930	HCPCS	Lanreotide Acet 120mg/0.5ml Sy	8	5	$34,254.00	$33,226.84	$2.24	$32,541.75	$27,831.76	2026-05-09
787	OTHER	Ms-DRG 787	1	1	—	—	$27,745.35	$27,745.35	$27,745.35	2026-05-09
897	OTHER	Ms-DRG 897	1	1	—	—	$26,837.34	$26,837.34	$26,837.34	2026-05-09
55	OTHER	Ms-DRG 55	2	1	—	—	$26,176.79	$26,176.79	$26,176.79	2026-05-09
J3380	HCPCS	Vedolizumab 300 Mg Vial	8	5	$31,894.00	$30,937.62	$72.63	$30,299.73	$25,914.25	2026-05-09
617	OTHER	Ms-DRG 617	3	2	—	—	$12,962.88	$25,889.84	$25,889.84	2026-05-09
J3101	HCPCS	Tenecteplase 50 Mg/10 Ml Syrng	10	5	$31,584.00	$30,637.29	$0.41	$30,005.60	$25,662.68	2026-05-09
J2323	HCPCS	Natalizumab 300 Mg/15 Ml Vial	8	5	$30,524.00	$29,608.86	$0.11	$28,998.37	$24,801.24	2026-05-09
J9306	HCPCS	Pertuzumab 420 Mg/14 Ml Vial	10	5	$26,748.00	$25,946.27	$508.34	$26,202.87	$24,113.98	2026-05-09
J9063	HCPCS	Mirvetuximab Soravtansine-gynx	8	5	$29,486.00	$28,601.54	$20.18	$28,011.81	$23,957.47	2026-05-09
J9228	HCPCS	Ipilimumab 5 Mg/ml 10 Ml Vial	8	5	$29,399.00	$28,517.40	$1,054.59	$27,929.41	$23,886.99	2026-05-09
139	OTHER	Ms-DRG 139	2	1	—	—	$23,521.65	$23,521.65	$23,521.65	2026-05-09
551	OTHER	Ms-DRG 551	2	1	—	—	$22,657.80	$22,657.80	$22,657.80	2026-05-09
140	OTHER	Ms-DRG 140	2	1	—	—	$22,529.07	$22,529.07	$22,529.07	2026-05-09
J9332	HCPCS	Efgartigimod Alfa-fcab 400 Mg	8	5	$27,360.00	$26,539.69	$7.91	$25,992.48	$22,230.41	2026-05-09
536	OTHER	Ms-DRG 536	2	1	—	—	$21,883.40	$21,883.40	$21,883.40	2026-05-09
426	OTHER	Ms-DRG 426	2	1	—	—	$21,852.78	$21,852.78	$21,852.78	2026-05-09
J0717	HCPCS	Certolizumab Pegol 400 Mg Kit	14	5	$22,189.00	$21,523.52	$3.42	$24,592.04	$20,532.01	2026-05-09
539	OTHER	Ms-DRG 539	2	1	—	—	$19,947.00	$19,947.00	$19,947.00	2026-05-09
948	OTHER	Ms-DRG 948	3	2	—	—	$9,729.64	$19,392.24	$19,392.24	2026-05-09
J0517	HCPCS	Benralizumab 30 Mg/ml Syringe	8	5	$22,647.00	$21,968.51	$3.11	$21,515.55	$18,401.46	2026-05-09
J2353	HCPCS	Octreotide (Depot) 20 Mg Syr	17	5	$19,038.00	$18,467.27	$17.33	$24,782.58	$18,086.50	2026-05-09
540	OTHER	Ms-DRG 540	2	1	—	—	$17,908.80	$17,908.80	$17,908.80	2026-05-09
425	OTHER	Ms-DRG 425	2	1	—	—	$17,135.53	$17,135.53	$17,135.53	2026-05-09
J9271	HCPCS	Pembrolizumab 100 Mg/4 Ml Vial	8	5	$20,610.00	$19,992.32	$13.37	$19,580.11	$16,746.15	2026-05-09
871	OTHER	Ms-DRG 871	1	1	—	—	$16,679.18	$16,679.18	$16,679.18	2026-05-09
694	OTHER	Ms-DRG 694	2	1	—	—	$16,385.12	$16,385.12	$16,385.12	2026-05-09
541	OTHER	Ms-DRG 541	2	1	—	—	$16,375.61	$16,375.61	$16,375.61	2026-05-09
179	OTHER	Ms-DRG 179	2	1	—	—	$16,193.72	$16,193.72	$16,193.72	2026-05-09
834	OTHER	Ms-DRG 834	2	1	—	—	$16,193.72	$16,193.72	$16,193.72	2026-05-09
645	OTHER	Ms-DRG 645	2	1	—	—	$16,193.72	$16,193.72	$16,193.72	2026-05-09
292	OTHER	Ms-DRG 292	2	1	—	—	$16,160.20	$16,160.20	$16,160.20	2026-05-09
563	OTHER	Ms-DRG 563	3	2	—	—	$16,160.20	$22,657.80	$16,160.20	2026-05-09
469	OTHER	Ms-DRG 469	2	1	—	—	$16,133.73	$16,133.73	$16,133.73	2026-05-09
194	OTHER	Ms-DRG 194	2	1	—	—	$15,482.98	$15,482.98	$15,482.98	2026-05-09
J9173	HCPCS	Durvalumab 500 Mg/10 Ml Vial	8	5	$18,675.00	$18,115.28	$16.91	$17,741.77	$15,173.88	2026-05-09
J9047	HCPCS	Carfilzomib 60 Mg Vial	17	5	$15,722.00	$15,251.12	$81.21	$28,285.05	$14,936.66	2026-05-09
Q5120	HCPCS	Pegfilgrastim-bmez 6 Mg/0.6 Ml	8	5	$17,813.00	$17,279.13	$4,279.65	$16,922.86	$14,473.50	2026-05-09
340	OTHER	Ms-DRG 340	2	1	—	—	$14,448.34	$14,448.34	$14,448.34	2026-05-09
463	OTHER	Ms-DRG 463	2	1	—	—	$13,753.90	$13,753.90	$13,753.90	2026-05-09
349	OTHER	Ms-DRG 349	2	1	—	—	$13,645.94	$13,645.94	$13,645.94	2026-05-09
137	OTHER	Ms-DRG 137	2	1	—	—	$13,634.90	$13,634.90	$13,634.90	2026-05-09
872	OTHER	Ms-DRG 872	2	1	—	—	$12,961.68	$12,961.68	$12,961.68	2026-05-09
373	OTHER	Ms-DRG 373	2	1	—	—	$12,961.68	$12,961.68	$12,961.68	2026-05-09
83	OTHER	Ms-DRG 83	2	1	—	—	$12,961.68	$12,961.68	$12,961.68	2026-05-09
690	OTHER	Ms-DRG 690	2	1	—	—	$12,928.16	$12,928.16	$12,928.16	2026-05-09
470	OTHER	Ms-DRG 470	2	1	—	—	$12,537.44	$12,537.44	$12,537.44	2026-05-09
308	OTHER	Ms-DRG 308	2	1	—	—	$12,504.80	$12,504.80	$12,504.80	2026-05-09
291	OTHER	Ms-DRG 291	2	1	—	—	$12,504.80	$12,504.80	$12,504.80	2026-05-09
J9299	HCPCS	Nivolumab 240 Mg/24 Ml Vial	14	5	$29,002.00	$28,132.67	$6.84	$27,552.61	$12,284.26	2026-05-09
807	OTHER	Ms-DRG 807	1	1	—	—	$11,494.09	$11,494.09	$11,494.09	2026-05-09
90375	CPT	Rabies Ig (Human) 300 U/Ml 5Ml	8	5	$14,033.00	$13,612.27	$146.90	$13,331.61	$11,402.03	2026-05-09
J2426	HCPCS	Paliperidone Palm 234mg/1.5ml	8	5	$13,509.00	$13,104.45	$793.38	$12,834.25	$10,976.67	2026-05-09
J2182	HCPCS	Mepolizumab 100 Mg Vial	8	5	$13,430.00	$13,027.31	$6.38	$12,758.71	$10,912.06	2026-05-09
J9317	HCPCS	Sacituzumab Gov-hziy 180Mg	8	5	$13,365.00	$12,964.15	$4,156.37	$12,696.85	$10,859.15	2026-05-09
J3111	HCPCS	Romosozumab-aqqg 210 Mg/2.34Ml	10	5	$11,243.00	$10,906.13	$1.56	$11,611.99	$10,135.95	2026-05-09
J9352	HCPCS	Trabectedin 1 Mg Vial	8	5	$12,058.00	$11,696.30	$95.82	$11,455.14	$9,797.16	2026-05-09
375	OTHER	Ms-DRG 375	2	1	—	—	$9,729.64	$9,729.64	$9,729.64	2026-05-09
195	OTHER	Ms-DRG 195	2	1	—	—	$9,729.64	$9,729.64	$9,729.64	2026-05-09
389	OTHER	Ms-DRG 389	2	1	—	—	$9,696.12	$9,696.12	$9,696.12	2026-05-09
552	OTHER	Ms-DRG 552	2	1	—	—	$9,696.12	$9,696.12	$9,696.12	2026-05-09
310	OTHER	Ms-DRG 310	2	1	—	—	$9,696.12	$9,696.12	$9,696.12	2026-05-09
522	OTHER	Ms-DRG 522	2	1	—	—	$9,412.12	$9,412.12	$9,412.12	2026-05-09
418	OTHER	Ms-DRG 418	1	1	—	—	$9,412.12	$9,412.12	$9,412.12	2026-05-09
689	OTHER	Ms-DRG 689	2	1	—	—	$9,412.12	$9,412.12	$9,412.12	2026-05-09
641	OTHER	Ms-DRG 641	2	1	—	—	$9,378.60	$9,378.60	$9,378.60	2026-05-09
J1569	HCPCS	Immune Glob Gamagar 20gr/200ml	14	5	$9,803.00	$9,509.65	$21.77	$12,792.79	$9,313.57	2026-05-09
240	OTHER	Ms-DRG 240	2	1	—	—	$9,283.17	$9,283.17	$9,283.17	2026-05-09
383	OTHER	Ms-DRG 383	2	1	—	—	$9,183.02	$9,183.02	$9,183.02	2026-05-09
J1459	HCPCS	Immune Glob Privige 20gr/200ml	14	5	$9,521.00	$9,236.07	$0.29	$16,988.72	$9,045.63	2026-05-09
561	OTHER	Ms-DRG 561	2	1	—	—	$8,563.92	$8,563.92	$8,563.92	2026-05-09
Q5111	HCPCS	Pegfilgrastim-cbqv 6 Mg/0.6 Ml	14	5	$8,925.00	$8,657.25	$1,112.40	$14,309.98	$8,478.75	2026-05-09
560	OTHER	Ms-DRG 560	2	1	—	—	$7,994.36	$7,994.36	$7,994.36	2026-05-09
806	OTHER	Ms-DRG 806	1	1	—	—	$7,742.77	$7,742.77	$7,742.77	2026-05-09
J3032	HCPCS	Eptinezumab-jjmr 100Mg/Ml Vial	10	5	$8,470.00	$8,215.91	$90.03	$24,358.03	$7,635.72	2026-05-09
Q5108	HCPCS	Pegfilgrastim-jmdb 6 Mg/0.6 Ml	10	5	$8,047.00	$7,806.07	$5,230.88	$7,645.13	$7,254.83	2026-05-09
J0897	HCPCS	Denosumab 60 Mg/ml Syringe	17	5	$7,589.00	$7,362.20	$9.69	$12,955.30	$7,210.41	2026-05-09
Q5122	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Syr	10	5	$7,949.00	$7,710.76	$3,939.75	$7,551.78	$7,142.57	2026-05-09
78451	CPT	Myocard Perf Spect Rest Or Str	10	5	$7,593.00	$7,365.21	$4,935.45	$7,231.00	$6,845.09	2026-05-09
683	OTHER	Ms-DRG 683	2	1	—	—	$6,497.60	$6,497.60	$6,497.60	2026-05-09
74174	CPT	CTA Abd&Pelv Wwo Dye	8	5	$6,802.00	$6,597.94	$4,421.30	$6,461.90	$6,461.90	2026-05-09
392	OTHER	Ms-DRG 392	2	1	—	—	$6,285.92	$6,285.92	$6,285.92	2026-05-09
190	OTHER	Ms-DRG 190	2	1	—	—	$6,285.92	$6,285.92	$6,285.92	2026-05-09
581	OTHER	Ms-DRG 581	2	1	—	—	$6,279.80	$6,279.80	$6,279.80	2026-05-09
74183	CPT	MRI Abdomen Wwo Dye	11	5	$7,332.00	$7,112.04	$619.08	$6,965.40	$6,254.20	2026-05-09
74178	CPT	CT Abd & Pelv Wwo Contrast	12	5	$7,221.00	$7,004.37	$479.88	$6,877.00	$6,159.51	2026-05-09
78452	CPT	Myocard Perf Spect Rest Stress	12	5	$7,177.00	$6,961.69	$1,435.40	$6,818.15	$5,895.90	2026-05-09
95811	CPT	Polysomnogram W CPap	12	5	$6,706.00	$6,504.82	$1,277.20	$6,370.70	$5,720.22	2026-05-09
J9264	HCPCS	Paclitaxel Protein-bd 100mg Vl	8	5	$7,032.00	$6,821.54	$17.39	$6,680.89	$5,713.92	2026-05-09
74177	CPT	CT Abd & Pelv W Contrast	13	5	$6,536.00	$6,339.92	$227.52	$6,224.00	$5,575.21	2026-05-09
70553	CPT	MRI Brain Wwo Contrast	20	5	$6,023.00	$5,842.31	$729.77	$6,007.80	$5,394.37	2026-05-09
74176	CPT	CT Abd & Pelvis Wo Contrast	12	5	$5,962.00	$5,783.14	$95.04	$5,678.00	$5,374.74	2026-05-09
72158	CPT	MRI Lumbar Spine Wwo Dye	11	5	$5,649.00	$5,479.53	$340.97	$5,649.00	$5,366.55	2026-05-09
81210	CPT	Braf C Kit	8	5	$6,463.00	$6,269.11	$4,200.95	$6,139.85	$5,309.35	2026-05-09
J0129	HCPCS	Abatacept 250 Mg Vial	8	5	$6,467.00	$6,273.62	$588.00	$6,144.27	$5,254.97	2026-05-09
73223	CPT	MRI Joint Ue Wwo Dye Rt	18	5	$6,107.00	$5,923.79	$597.27	$5,801.65	$5,209.27	2026-05-09
95810	CPT	Polysomnogram	12	5	$6,040.00	$5,858.80	$1,208.00	$5,738.00	$5,152.12	2026-05-09
72157	CPT	MRI Chest Spine Wwo Dye	11	5	$5,320.00	$5,160.40	$535.35	$5,320.00	$5,054.00	2026-05-09
73220	CPT	MRI Ue Wwo Dye Rt	18	5	$5,750.00	$5,577.50	$319.79	$5,462.50	$4,904.75	2026-05-09
72156	CPT	MRI Neck Spine Wwo Dye	11	5	$5,320.00	$5,160.40	$340.05	$5,320.00	$4,812.70	2026-05-09
74181	CPT	MRI Abdomen Wo Dye	10	5	$5,431.00	$5,268.07	$544.29	$5,159.45	$4,773.02	2026-05-09
J2357	HCPCS	Omalizumab 150 Mg Vial	8	5	$5,462.00	$5,298.57	$9.26	$5,189.32	$4,438.23	2026-05-09
72149	CPT	MRI Lumbar Spine W Dye	8	5	$5,447.00	$5,283.59	$386.03	$5,174.65	$4,425.68	2026-05-09
70551	CPT	MRI Brain Wo Contrast	12	5	$4,870.00	$4,723.90	$447.03	$4,870.00	$4,390.31	2026-05-09
J7298	HCPCS	Levonorgestrel 20 MCG/24Hr IUD	10	5	$5,355.00	$5,194.89	$217.08	$5,087.78	$4,351.39	2026-05-09
70549	CPT	MRA Neck Wwo Contrast	11	5	$5,027.00	$4,876.19	$666.92	$5,431.00	$4,288.03	2026-05-09
70546	CPT	MRA Head Wwo Contrast	8	5	$5,276.00	$5,117.72	$545.48	$5,012.20	$4,286.75	2026-05-09
72148	CPT	MRI Lumbar Spine Wo Dye	12	5	$5,245.00	$5,087.65	$315.18	$4,982.75	$4,261.56	2026-05-09
72141	CPT	MRI Neck Spine Wo Dye	11	5	$4,890.00	$4,743.30	$233.96	$4,645.50	$4,171.17	2026-05-09
73720	CPT	MRI Le Wwo Dye Lt	21	5	$4,376.00	$4,244.72	$233.96	$4,167.00	$4,157.20	2026-05-09
73222	CPT	MRI Joint Ue W Dye Rt	8	5	$5,003.00	$4,852.91	$530.75	$4,752.85	$4,064.94	2026-05-09
72129	CPT	CT Thoracic Spine W Contrast	8	5	$4,898.00	$4,751.06	$128.15	$4,653.10	$3,979.62	2026-05-09
72197	CPT	MRI Pelvis Wwo Dye	8	5	$4,881.00	$4,734.57	$618.17	$4,636.95	$3,965.81	2026-05-09
75635	CPT	CTA Abdominal Arteries	11	5	$4,612.00	$4,473.64	$592.68	$4,381.40	$3,934.04	2026-05-09
70543	CPT	MRI Orbit Face Neck Wwo Cont	9	5	$4,608.00	$4,469.76	$335.45	$4,377.60	$3,930.62	2026-05-09
J1439	HCPCS	Ferric Carboxymalt 750mg/15ml	10	5	$4,350.00	$4,219.78	$11.91	$4,424.13	$3,921.79	2026-05-09
73723	CPT	MRI Joint Le Wwo Dye Lt	8	5	$4,678.00	$4,537.66	$657.06	$4,444.10	$3,800.88	2026-05-09
71270	CPT	CT Thorax Wwo Contrast	9	5	$4,410.00	$4,277.70	$82.17	$4,189.50	$3,761.73	2026-05-09
74160	CPT	CT Abdomen W Dye	10	5	$4,156.00	$4,031.32	$706.77	$3,958.00	$3,746.64	2026-05-09
74170	CPT	CT Abdomen Wwo Dye	12	5	$4,572.00	$4,434.84	$58.22	$4,343.40	$3,714.75	2026-05-09
Q5115	HCPCS	Rituximab-abbs 100Mg/10Ml Via	17	5	$2,282.00	$2,213.81	$1,483.48	$15,001.78	$3,708.00	2026-05-09
73221	CPT	MRI Joint Ue Wo Dye Lt	22	5	$3,899.00	$3,782.03	$408.12	$3,899.00	$3,704.05	2026-05-09
Q5116	HCPCS	Trastuzumab Qyyp 150Mg Vial	17	5	$3,848.00	$3,732.73	$2,501.32	$10,885.89	$3,655.77	2026-05-09
71260	CPT	CT Thorax W Contrast	13	5	$4,126.00	$4,002.22	$80.31	$3,919.70	$3,519.48	2026-05-09
C8929	HCPCS	Echo M Mode 2d W Contrast	12	5	$3,997.00	$3,877.09	$2,598.05	$3,806.00	$3,512.57	2026-05-09
72194	CPT	CT Pelvis Wwo Dye	8	5	$4,288.00	$4,159.36	$719.64	$4,073.60	$3,484.00	2026-05-09
252	OTHER	Ms-DRG 252	2	1	—	—	$3,444.25	$3,444.25	$3,444.25	2026-05-09
J9217	HCPCS	Leuprolide Acetate 45 Mg Syr	26	5	$4,281.00	$4,152.89	$1.47	$6,077.93	$3,417.46	2026-05-09
J7318	HCPCS	HyaluronateStablized 60Mg/3Ml	8	5	$4,171.00	$4,046.03	$3.30	$3,962.60	$3,389.07	2026-05-09
95805	CPT	Multiple Sleep Latency Test	8	5	$4,104.00	$3,980.88	$2,667.60	$3,898.80	$3,371.43	2026-05-09
72146	CPT	MRI Chest Spine Wo Dye	12	5	$3,737.00	$3,624.89	$390.63	$5,138.00	$3,368.90	2026-05-09
640	OTHER	Ms-DRG 640	2	1	—	—	$3,326.83	$3,326.83	$3,326.83	2026-05-09
73721	CPT	MRI Joint Le Wo Dye Lt	23	5	$3,899.00	$3,782.03	$315.18	$3,704.05	$3,325.85	2026-05-09
72125	CPT	CT Cervical Spine Wo Contrast	12	5	$3,641.00	$3,531.77	$172.58	$3,467.00	$3,282.36	2026-05-09
70470	CPT	CT Head/Brain Wwo Contrast	10	5	$3,641.00	$3,531.77	$241.32	$3,467.00	$3,282.36	2026-05-09
71250	CPT	CT Thorax Wo Contrast	12	5	$3,842.00	$3,726.74	$71.13	$3,649.90	$3,277.23	2026-05-09
73702	CPT	CT Le Wwo Dye Lt	8	5	$4,027.00	$3,906.19	$57.30	$3,825.65	$3,271.94	2026-05-09
395	OTHER	Ms-DRG 395	2	1	—	—	$3,265.56	$3,265.56	$3,265.56	2026-05-09
374	OTHER	Ms-DRG 374	2	1	—	—	$3,265.56	$3,265.56	$3,265.56	2026-05-09
554	OTHER	Ms-DRG 554	2	1	—	—	$3,265.56	$3,265.56	$3,265.56	2026-05-09
794	OTHER	Ms-DRG 794	1	1	—	—	$3,249.82	$3,249.82	$3,249.82	2026-05-09
Q5107	HCPCS	Bevacizumab Awwb 100Mg/4Ml Vil	14	5	$3,269.00	$3,171.38	$2,125.15	$11,426.28	$3,232.47	2026-05-09
813	OTHER	Ms-DRG 813	2	1	—	—	$3,232.04	$3,232.04	$3,232.04	2026-05-09
603	OTHER	Ms-DRG 603	1	1	—	—	$3,232.04	$3,232.04	$3,232.04	2026-05-09
637	OTHER	Ms-DRG 637	2	1	—	—	$3,232.04	$3,232.04	$3,232.04	2026-05-09
72193	CPT	CT Pelvis W Dye	8	5	$3,962.00	$3,843.14	$593.33	$3,763.90	$3,219.12	2026-05-09
70492	CPT	CT Soft Tissue Neck Wwo Cont	11	5	$3,773.00	$3,659.81	$422.85	$3,584.35	$3,218.37	2026-05-09
844	OTHER	Ms-DRG 844	2	1	—	—	$3,159.72	$3,159.72	$3,159.72	2026-05-09
951	OTHER	Ms-DRG 951	2	1	—	—	$3,159.72	$3,159.72	$3,159.72	2026-05-09
70491	CPT	CT Soft Tissue Neck W Cont	11	5	$3,544.00	$3,437.68	$357.53	$3,366.80	$3,128.35	2026-05-09
71271	CPT	Ldct For Lung Cancer Screen	12	5	$3,467.00	$3,362.99	$101.48	$3,301.00	$3,125.50	2026-05-09
70544	CPT	MRA Head Wo Contrast	10	5	$3,458.00	$3,354.26	$408.12	$4,626.50	$3,117.39	2026-05-09
73718	CPT	MRI Le Wo Dye Lt	19	5	$3,650.00	$3,540.50	$56.39	$3,467.50	$3,113.45	2026-05-09
70496	CPT	CT Angiography Head W Cont	11	5	$3,641.00	$3,531.77	$246.84	$3,458.95	$3,105.77	2026-05-09
72131	CPT	CT Lumbar Spine Wo Contrast	12	5	$3,641.00	$3,531.77	$234.87	$3,458.95	$3,105.77	2026-05-09
23472	CPT	Arthroplasty Total Shoulder Lt	12	5	$1,472.00	$1,427.84	$1,398.40	$3,971.97	$3,003.59	2026-05-09
73701	CPT	CT Le W Dye Rt	8	5	$3,671.00	$3,560.87	$268.01	$3,487.45	$2,982.69	2026-05-09
73218	CPT	MRI Ue Wo Dye Lt	16	5	$3,650.00	$3,540.50	$79.40	$3,467.50	$2,965.62	2026-05-09
74150	CPT	CT Abdomen Wo Dye	8	5	$3,641.00	$3,531.77	$791.13	$3,458.95	$2,958.31	2026-05-09
72192	CPT	CT Pelvis Wo Dye	8	5	$3,641.00	$3,531.77	$597.02	$3,458.95	$2,958.31	2026-05-09
71275	CPT	CTA Chest Wwo Contrast	10	5	$3,302.00	$3,202.94	$672.62	$3,136.90	$2,890.31	2026-05-09
351	OTHER	Ms-DRG 351	2	1	—	—	$2,883.32	$2,883.32	$2,883.32	2026-05-09
59412	CPT	External Version	8	5	$3,484.00	$3,379.48	$2,264.60	$3,309.80	$2,862.11	2026-05-09
795	OTHER	Ms-DRG 795	1	1	—	—	$2,861.14	$2,861.14	$2,861.14	2026-05-09
72128	CPT	CT Thoracic Spine Wo Contrast	11	5	$3,342.00	$3,241.74	$107.93	$6,131.30	$2,850.73	2026-05-09
73700	CPT	CT Le Wo Dye Lt	23	5	$3,315.00	$3,215.55	$76.65	$3,157.00	$2,827.70	2026-05-09
70450	CPT	CT Head/Brain Wo Contrast	11	5	$2,971.00	$2,881.87	$1,440.40	$2,829.00	$2,822.45	2026-05-09
70460	CPT	CT Head/Brain W Contrast	10	5	$3,306.00	$3,206.82	$61.91	$3,140.70	$2,821.23	2026-05-09
70482	CPT	CT Orbit Wwo Contrast	8	5	$3,467.00	$3,362.99	$261.57	$3,293.65	$2,816.93	2026-05-09
70498	CPT	CT Angiography Neck W Cont	12	5	$3,248.00	$3,150.56	$278.39	$3,085.60	$2,796.49	2026-05-09
27130	CPT	Arthroplasty Total Hip Lt	12	5	$3,492.00	$3,387.24	$1,517.31	$3,699.72	$2,743.14	2026-05-09
74175	CPT	CTA Abdom Wwo Dye	10	5	$3,120.00	$3,026.40	$82.17	$2,964.00	$2,741.90	2026-05-09
27447	CPT	Total Knee Arthroplasty Lt	12	5	$3,394.00	$3,292.18	$1,515.73	$3,695.94	$2,739.20	2026-05-09
J0585	HCPCS	Botul Tox Type A 100 Unit Vial	10	5	$3,035.00	$2,944.34	$59.81	$2,904.15	$2,736.41	2026-05-09
70480	CPT	CT Orbit Wo Contrast	10	5	$3,075.00	$2,982.75	$192.56	$2,921.25	$2,702.29	2026-05-09
70487	CPT	CT Maxillofacial W Contrast	8	5	$3,270.00	$3,171.90	$268.29	$3,106.50	$2,656.88	2026-05-09
70481	CPT	CT Orbit W Contrast	8	5	$3,270.00	$3,171.90	$80.31	$3,106.50	$2,656.88	2026-05-09
C1776	HCPCS	Comp Fem 2 Kn Lt Crcte RTn	262	5	$2,900.00	$2,813.00	$390.00	$7,975.25	$2,642.40	2026-05-09
27245	CPT	Fx Inter/Peri/Sub Fem W Imp Lt	6	5	$1,189.00	$1,153.33	$1,129.55	$3,360.59	$2,561.05	2026-05-09
38505	CPT	Needle Biopsy Lymph Nodes Lt	8	5	$3,080.00	$2,987.60	$2,002.00	$2,926.00	$2,530.22	2026-05-09
93306	CPT	Tte W Doppler Complete	18	5	$3,351.00	$3,250.47	$222.88	$3,183.45	$2,525.16	2026-05-09
72195	CPT	MRI Pelvis Wo Dye	8	5	$2,652.00	$2,572.44	$1,723.80	$3,876.00	$2,519.40	2026-05-09
G0416	HCPCS	Prostate Sat Biopsy	8	5	$3,060.00	$2,968.20	$1,989.00	$2,907.00	$2,513.79	2026-05-09
Q5118	HCPCS	Bevacizumab/BVZR 100Mg/4Ml	14	5	$2,163.00	$2,098.69	$1,406.34	$7,465.58	$2,510.63	2026-05-09
J3304	HCPCS	Triamcinolone Acetonide 32 Mg	8	5	$3,037.00	$2,946.00	$520.65	$2,885.25	$2,467.65	2026-05-09
Q5103	HCPCS	Infliximab-dyyb 100 Mg Vial	10	5	$2,590.00	$2,513.24	$1,684.13	$9,862.65	$2,461.42	2026-05-09
94002	CPT	Vent Assist & Mgmt First Day	8	5	$2,995.00	$2,905.15	$1,946.75	$2,845.25	$2,460.39	2026-05-09
70486	CPT	CT Maxillofacial Wo Contrast	12	5	$2,808.00	$2,723.76	$187.95	$2,667.60	$2,395.22	2026-05-09
27446	CPT	Revision Of Knee Joint Lt	6	5	$1,278.00	$1,239.66	$1,214.10	$3,164.50	$2,394.89	2026-05-09
73200	CPT	CT Ue Wo Dye Rt	21	5	$2,768.00	$2,684.96	$70.19	$2,636.00	$2,361.10	2026-05-09
J0248	HCPCS	Remdesivir 100 Mg Vial	8	5	$2,874.00	$2,787.96	$70.71	$2,730.48	$2,335.27	2026-05-09
47564	CPT	Lap Cholecystectomy/Explr	6	5	$2,750.00	$2,667.50	$1,297.98	$3,008.15	$2,328.91	2026-05-09
29827	CPT	Arthro Rotator Cuff Repair Lt	12	5	$2,661.00	$2,581.17	$1,270.13	$2,933.17	$2,306.86	2026-05-09
J1670	HCPCS	Tetanus Imm Glob (Hum) 250u/ml	10	5	$2,499.00	$2,424.90	$8.27	$2,374.91	$2,253.66	2026-05-09
29807	CPT	Shoulder Arthroscopy Lt	6	5	$2,661.00	$2,581.17	$1,229.55	$2,837.02	$2,239.32	2026-05-09
113	OTHER	Room Pediatric Unit	8	5	$2,343.00	$2,272.71	$1,522.95	$19,097.61	$2,225.85	2026-05-09
J7326	HCPCS	Hyaluronate Crosslink 30mg/3ml	10	5	$2,655.00	$2,575.63	$1,175.00	$2,522.53	$2,157.42	2026-05-09
87154	CPT	Culture Id By Amp Prb 6 Or 6+	11	5	$2,496.00	$2,421.12	$1,622.40	$2,371.20	$2,129.09	2026-05-09
112	OTHER	Room Womens Ctr	6	5	$2,343.00	$2,272.71	$1,522.95	$2,225.85	$2,112.22	2026-05-09
111	OTHER	Room Medical Unit Priv	6	5	$2,343.00	$2,272.71	$1,522.95	$2,225.85	$2,112.22	2026-05-09
36556	CPT	Insert Non-tunnel Cv Catheter	15	5	$3,226.00	$3,129.22	$99.69	$3,064.70	$2,096.90	2026-05-09
78227	CPT	Hida With Ef w/Pharm	11	5	$2,408.00	$2,335.76	$1,565.20	$2,287.60	$2,054.02	2026-05-09
78226	CPT	Hepatobiliary Scan Without Ef	8	5	$2,419.00	$2,346.43	$1,572.35	$2,298.05	$1,987.21	2026-05-09
29828	CPT	Arthroscopy Bicep Tenodesis Lt	6	5	$2,362.00	$2,291.14	$1,090.90	$2,518.94	$1,984.94	2026-05-09
J1745	HCPCS	Infliximab 100 Mg Vial	14	5	$4,417.00	$4,284.51	$1.46	$4,196.17	$1,960.73	2026-05-09
93880	CPT	Extracranial Bilat Study	13	5	$2,043.00	$1,981.71	$1,327.95	$1,945.00	$1,940.85	2026-05-09
93351	CPT	Stress Tte Complete	14	5	$2,894.00	$2,807.18	$260.45	$2,749.30	$1,902.80	2026-05-09
360	OTHER	Cataract	112	5	$2,362.00	$2,291.14	$529.10	$5,952.70	$1,850.60	2026-05-09
10005	CPT	Fna Biopsy W US 1st Lesion	10	5	$2,100.00	$2,037.00	$1,365.00	$1,995.00	$1,845.65	2026-05-09
750	OTHER	Colonoscopy	24	5	$2,237.00	$2,169.89	$928.85	$3,363.00	$1,837.70	2026-05-09
C8930	HCPCS	Stress Echo W Contrast	12	5	$2,144.00	$2,079.68	$408.20	$2,036.80	$1,828.83	2026-05-09
25608	CPT	Fx Distal Radius Open Rt	6	5	$2,056.00	$1,994.32	$988.36	$2,270.16	$1,821.33	2026-05-09
78582	CPT	Lung Perfusion & Ventilation	8	5	$2,188.00	$2,122.36	$1,422.20	$2,078.60	$1,797.44	2026-05-09
99291	CPT	Critical Care 1st 30-74 Min	17	5	$2,643.00	$2,563.71	$228.45	$2,510.85	$1,757.60	2026-05-09
19083	CPT	Biopsy Breast 1st Lesion Lt	18	5	$2,133.00	$2,069.01	$1,386.45	$2,026.35	$1,752.26	2026-05-09
J0666	HCPCS	Bupivac Liposome 1.3% Pf 20 Ml	11	5	$1,773.00	$1,720.10	$1,152.64	$1,713.62	$1,684.64	2026-05-09
19084	CPT	Biopsy Breast Addl Lesion Rt	8	5	$2,031.00	$1,970.07	$1,320.15	$1,929.45	$1,668.47	2026-05-09
27814	CPT	Open Fx Bimalleolar Ankle Rt	6	5	$1,932.00	$1,874.04	$914.90	$2,109.80	$1,668.23	2026-05-09
29887	CPT	Knee Arthroscopy/Drainage Rt	6	5	$1,919.00	$1,861.43	$897.62	$2,062.03	$1,647.10	2026-05-09
C1771	HCPCS	Sling Urth .3mm Thk Retropubic	8	5	$1,996.00	$1,936.12	$1,297.40	$1,896.20	$1,639.71	2026-05-09
25607	CPT	Fx Distal Radius Open Lt	6	5	$1,886.00	$1,829.42	$885.05	$2,027.31	$1,637.37	2026-05-09
23430	CPT	Tenodesis Long Tendon Bicep Lt	12	5	$1,867.00	$1,810.99	$889.69	$2,047.70	$1,627.92	2026-05-09
272	OTHER	Catheter Cecostomy 10.2Fr 24cm	72	5	$1,776.00	$1,723.03	$121.90	$4,123.00	$1,536.76	2026-05-09
J9155	HCPCS	Degarelix 80 Mg Vial	14	5	$1,612.00	$1,564.32	$135.29	$2,088.22	$1,532.07	2026-05-09
80230	CPT	Infliximab Qn w/Reflex To Ab,S	8	5	$1,862.00	$1,806.14	$1,210.30	$1,768.90	$1,529.63	2026-05-09
93017	CPT	Cardiovascular Stress Test	12	5	$1,783.00	$1,729.51	$356.60	$1,693.85	$1,520.90	2026-05-09
78306	CPT	Bone Scan Whole Body	11	5	$1,675.00	$1,624.75	$1,088.75	$1,675.00	$1,515.25	2026-05-09
78315	CPT	Bone Scan 3 Phase	10	5	$1,669.00	$1,618.93	$1,084.85	$1,834.45	$1,504.61	2026-05-09
47563	CPT	Lap Cholecystectomy/Graph	6	5	$1,768.00	$1,714.96	$835.38	$1,935.98	$1,500.93	2026-05-09
29824	CPT	Shoulder Arthroscopy Rt	6	5	$1,679.00	$1,628.63	$809.89	$1,857.88	$1,485.74	2026-05-09
27405	CPT	Repair Collateral Knee Lig Rt	6	5	$1,689.00	$1,638.33	$809.04	$1,858.08	$1,483.70	2026-05-09
78071	CPT	Parathyroid Planar Img W Spect	8	5	$1,771.00	$1,717.87	$1,151.15	$1,682.45	$1,454.88	2026-05-09
78708	CPT	Renal Imaging Func Pharm Inter	8	5	$1,760.00	$1,707.20	$1,144.00	$1,672.00	$1,445.84	2026-05-09
29876	CPT	Knee Arthroscopy/Drainage Rt	6	5	$1,690.00	$1,639.30	$780.27	$1,796.23	$1,428.54	2026-05-09
J7323	HCPCS	Hyaluronate (Euflexxa)20MG/2ML	8	5	$1,501.00	$1,456.40	$975.94	$1,787.24	$1,426.37	2026-05-09
36573	CPT	Insert Picc >5 Yrs W Img Gde	17	5	$2,170.00	$2,104.90	$99.83	$2,061.50	$1,410.50	2026-05-09
52310	CPT	Cystoscopy And Treatment	14	5	$2,136.00	$2,071.92	$161.50	$2,029.20	$1,404.42	2026-05-09
J7325	HCPCS	Hylan Polymer A&b 48mg/6ml Syr	17	5	$2,147.00	$2,083.07	$20.80	$2,040.13	$1,395.88	2026-05-09
47562	CPT	Laparoscopic Cholecystectomy	6	5	$1,628.00	$1,579.16	$767.72	$1,779.51	$1,382.34	2026-05-09
24605	CPT	Dislocation Elbow W Anes Lt	8	5	$1,643.00	$1,593.71	$1,067.95	$1,560.85	$1,349.72	2026-05-09
99285	CPT	Emergency Room Visit Level 5	18	5	$1,853.00	$1,797.41	$184.62	$1,760.35	$1,331.38	2026-05-09
129	OTHER	Room Swing Bed Skilled	6	5	$1,461.00	$1,417.17	$949.65	$1,387.95	$1,317.09	2026-05-09
84150	CPT	Prostaglandin F2a	8	5	$1,589.00	$1,541.33	$1,032.85	$1,509.55	$1,305.37	2026-05-09
29823	CPT	Shoulder Arthroscopy Rt	6	5	$1,557.00	$1,510.29	$709.76	$1,726.20	$1,299.74	2026-05-09
49520	CPT	Rerepair Ing Hernia Reduce Bi	6	5	$728.00	$706.16	$691.60	$1,707.97	$1,290.72	2026-05-09
93970	CPT	Venous Duplex	8	5	$1,566.00	$1,519.02	$1,017.90	$1,487.70	$1,286.47	2026-05-09
26615	CPT	Fx Metacarpal Open	6	5	$1,439.00	$1,395.83	$694.62	$1,590.01	$1,284.18	2026-05-09
26055	CPT	Incision Tendon Sheath Finger	15	5	$1,643.00	$1,593.71	$353.70	$1,560.85	$1,268.40	2026-05-09
51600	CPT	Injection For Bladder X-ray	8	5	$1,544.00	$1,497.68	$1,003.60	$1,466.80	$1,268.39	2026-05-09
32551	CPT	Insertion Chest Tube Lt	22	5	$1,609.00	$1,560.73	$181.56	$1,528.55	$1,256.63	2026-05-09
93975	CPT	Vascular Study	9	5	$1,436.00	$1,392.92	$933.40	$1,364.20	$1,224.91	2026-05-09
66821	CPT	Capsulotomy Yag Cataract Lt	22	5	$1,365.00	$1,324.05	$260.00	$1,300.00	$1,199.67	2026-05-09
C1726	HCPCS	Dil Escp 240Cm Od15-18	24	5	$1,456.00	$1,413.10	$450.32	$3,363.00	$1,196.76	2026-05-09
29881	CPT	Knee Arthroscopy/Drainage Lt	6	5	$1,357.00	$1,316.29	$649.46	$1,489.54	$1,191.88	2026-05-09
P9037	HCPCS	Platelet Pheresis Leuk Red Irr	10	5	$1,449.00	$1,405.53	$276.00	$1,376.55	$1,190.36	2026-05-09
27810	CPT	Fx Bimalleolar Ankle W Man Rt	14	5	$1,643.00	$1,593.71	$511.91	$1,560.85	$1,186.30	2026-05-09
25605	CPT	Fx Distal Radius W Man Rt	20	5	$1,456.00	$1,412.32	$616.32	$1,560.85	$1,180.76	2026-05-09
G0390	HCPCS	Trauma Team Level 4	8	5	$1,392.00	$1,350.24	$904.80	$1,322.40	$1,143.53	2026-05-09
684	OTHER	Trauma Team Evaluation Level 4	8	5	$1,392.00	$1,350.24	$904.80	$1,322.40	$1,143.53	2026-05-09
C8924	HCPCS	Tte 2d W Contrast Limited	10	5	$1,265.00	$1,227.05	$822.25	$1,265.00	$1,140.40	2026-05-09
29848	CPT	Wrist Arthroscopy/Surgery Bi	12	5	$1,645.00	$1,595.65	$614.70	$1,875.30	$1,140.39	2026-05-09
J1610	HCPCS	Glucagon 1 Mg Emergency Kit	9	5	$1,327.00	$1,287.61	$98.91	$1,261.06	$1,132.30	2026-05-09
76700	CPT	Ultrasound Abdomen Complete	12	5	$1,373.00	$1,331.81	$273.72	$1,304.35	$1,127.92	2026-05-09
Q5101	HCPCS	Filgrastim-sndz 300 Mcg/0.5 Ml	14	5	$1,046.00	$1,015.41	$680.43	$2,902.40	$1,126.85	2026-05-09
11404	CPT	Exc Ben Lesion 3.1-4.0 Trunk	17	5	$1,688.00	$1,637.36	$194.76	$1,603.60	$1,122.52	2026-05-09
95819	CPT	EEG Wake And Sleep	8	5	$1,366.00	$1,325.02	$887.90	$1,297.70	$1,122.17	2026-05-09
72114	CPT	X-ray Lumbosacral 6 Views	8	5	$1,381.00	$1,339.57	$84.00	$1,311.95	$1,122.06	2026-05-09
95816	CPT	EEG Routine	10	5	$1,240.00	$1,202.80	$806.00	$1,356.60	$1,117.86	2026-05-09
94726	CPT	Pft Plethysmography	12	5	$1,231.00	$1,194.07	$800.15	$1,172.00	$1,109.74	2026-05-09
49505	CPT	Prp I/Hern Init Reduc >5 Yr	18	5	$1,288.00	$1,249.36	$610.57	$1,834.45	$1,103.76	2026-05-09
P9035	HCPCS	Platelet Pheresis Leuko Reduc	8	5	$1,338.00	$1,297.86	$869.70	$1,271.10	$1,099.16	2026-05-09
24655	CPT	Fx Radial Head/Neck W Man Lt	14	5	$1,643.00	$1,593.71	$485.23	$1,560.85	$1,097.91	2026-05-09
82731	CPT	Fetal Fibronectin	8	5	$1,336.00	$1,295.92	$868.40	$1,269.20	$1,097.53	2026-05-09
90675	CPT	Rabies Vax Pcec/Pf 2.5Unit Vl	8	5	$1,347.00	$1,307.03	$125.24	$1,280.08	$1,094.80	2026-05-09
29875	CPT	Knee Arthroscopy/Drainage Lt	6	5	$1,239.00	$1,201.83	$595.16	$1,366.20	$1,093.90	2026-05-09
23675	CPT	Closed Tx Shoulder Dislocate L	6	5	$502.00	$486.94	$476.90	$1,382.00	$1,088.47	2026-05-09
A9562	HCPCS	Radiophar Tc99M Mertiatide	8	5	$1,313.00	$1,273.61	$853.45	$1,247.35	$1,078.63	2026-05-09
49083	CPT	Abd Paracentesis W Imaging	10	5	$1,182.00	$1,146.54	$768.30	$4,237.00	$1,065.58	2026-05-09
46040	CPT	Incision Rectal Abscess	8	5	$1,286.00	$1,247.42	$835.90	$1,221.70	$1,056.45	2026-05-09

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