Price Transparency Hospital negotiated rates

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

Export CSV
Hospital

CALLAWAY DISTRICT HOSPITAL

Callaway, NE · CCN 281335 · Rates published

1,550 distinct procedures filed
8 distinct payers
14,949 rate rows
2025-08-20 last MRF observed
Data quality

14,949 of 14,949 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/IHDY-1698614401401/machine-readable/470533576_callaway-district-hospital_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/callaway-district-ne
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-06-16
Content fingerprint 8e66114d987f640e… · 2,794,358 bytes · first seen 2026-06-16

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
4001726
CDM 		Tenecteplase 50 Mg IV Inj[cdh] 8 $10,134.00 $18,739.00 $13,908.44 nat. median
$10,641
1.3× median
4000188
CDM 		Cygnus Dual 4x6cm 24 Units 8 $9,699.00 $17,934.00 $13,311.22 nat. median
$306
outlier · 43.5×
4000073
CDM 		Leuprolide 22.5 Mg/3 Months Intramuscular Kit 8 $8,137.00 $15,045.00 $11,167.00 nat. median
$113
outlier · 99.1×
4002223
CDM 		Certolizumab 200 Mg Subcutaneous Kit [Cdh] 8 $7,044.00 $13,025.00 $9,667.44 nat. median
$41
outlier · 236.1×
4001385
CDM 		Pegfilgrastim 6 Mg/0.6 Ml Subq Inj[cdh] 8 $6,939.00 $12,831.00 $9,523.44 nat. median
$1,181
outlier · 8.1×
4000187
CDM 		Cyngus 4x4cm 16 Units 8 $6,766.00 $12,511.00 $9,285.89 nat. median
$202
outlier · 46.1×
4000008
CDM 		Immune Globulin 10% IV Sol 400 Ml[cdh] 8 $6,495.00 $12,009.00 $8,913.56 nat. median
$59
outlier · 150.8×
4000293
CDM 		Eflapegrastim Xnst 13.2 Mg/0.6 Ml Sol [Cdh] 8 $5,152.00 $9,526.00 $7,070.44 nat. median
$458
outlier · 15.5×
4000569
CDM 		Antivenin (Crotalidae) Polyvalentpow[cdh] 8 $4,881.00 $9,026.00 $6,699.22 nat. median
$206
outlier · 32.5×
4000053
CDM 		Tocilizumab 20 Mg/ml Sol [Cdh] 8 $3,861.00 $7,139.00 $5,299.00 nat. median
$132
outlier · 40.1×
73725
CPT 		MRA Lower Extremity With + Without Cnt Left 8 $3,208.00 $7,414.00 $4,952.44 nat. median
$1,228
outlier · 4.0×
4000294
CDM 		Via Matrix 2 X 3 2/3 Cm Film 8 $3,583.00 $6,625.00 $4,917.33 nat. median
$749
outlier · 6.6×
4001851
CDM 		Denosumab 120 Mg/1.7 Ml[cdh] 8 $3,456.00 $6,391.00 $4,743.33 nat. median
$115
outlier · 41.2×
71555
CPT 		MRA Chest With + Without Contrast 8 $3,210.00 $5,936.00 $4,405.78 nat. median
$1,139
outlier · 3.9×
72157
CPT 		MRI Spine Thoracic With + Without Contrast 8 $3,190.00 $5,898.00 $4,377.67 nat. median
$1,093
outlier · 4.0×
74174
CPT 		CT Angio Abdomen And Pelvis 8 $3,159.00 $5,842.00 $4,335.89 nat. median
$958
outlier · 4.5×
74178
CPT 		CT Abdomen And Pelvis With + Without Contrast 8 $2,998.00 $5,544.00 $4,114.78 nat. median
$977
outlier · 4.2×
4000186
CDM 		Cygnus Dual 2x3cm 6 Units 8 $2,745.00 $5,076.00 $3,767.67 nat. median
$240
outlier · 15.7×
4000057
CDM 		Dupilumab 300 Mg/2 Ml Subcutaneous Solution 2 Ml 8 $2,691.00 $4,975.00 $3,692.89 nat. median
$30
outlier · 121.5×
74177
CPT 		CT Scan Of Abdomen And Pelvis With Contrast 8 $2,601.00 $4,809.00 $3,569.56 nat. median
$928
outlier · 3.8×
74183
CPT 		MRI Abdomen With + Without Contrast 8 $2,572.00 $4,756.00 $3,530.00 nat. median
$1,101
outlier · 3.2×
73223
CPT 		MRI Ue Joint With + Without Contrast Left 8 $2,285.00 $5,282.00 $3,528.61 nat. median
$1,223
outlier · 2.9×
72158
CPT 		MRI Spine Lumbar With + Without Contrast 8 $2,462.00 $4,553.00 $3,379.22 nat. median
$1,080
outlier · 3.1×
74175
CPT 		CT Angio Abdomen 8 $2,435.00 $4,503.00 $3,342.11 nat. median
$710
outlier · 4.7×
4000168
CDM 		Novachor [Cdh] 8 $2,412.00 $4,459.00 $3,309.89 nat. median
$567
outlier · 5.8×
72149
CPT 		MRI Spine Lumbar With Contrast 8 $2,408.00 $4,452.00 $3,304.56 nat. median
$970
outlier · 3.4×
70553
CPT 		MRI Scan 8 $2,388.00 $4,416.00 $3,277.67 nat. median
$1,122
outlier · 2.9×
72156
CPT 		MRI Spine Cervical With + Without Contrast 8 $2,365.00 $4,373.00 $3,245.78 nat. median
$1,092
outlier · 3.0×
72198
CPT 		MRA Pelvis With + Without Contrast 8 $2,306.00 $4,263.00 $3,164.44 nat. median
$1,148
outlier · 2.8×
4001949
CDM 		Denosumab 60 Mg/ml[cdh] 8 $2,272.00 $4,201.00 $3,118.33 nat. median
$2,386
1.3× median
73720
CPT 		MRI Lower Extremity With + Without Cnt Left 8 $1,893.00 $4,899.00 $3,116.83 nat. median
$1,189
outlier · 2.6×
74176
CPT 		CT Abdomen And Pelvis Without Contrast 8 $2,234.00 $4,131.00 $3,066.00 nat. median
$685
outlier · 4.5×
71551
CPT 		MRI Chest With Contrast 8 $2,233.00 $4,130.00 $3,065.00 nat. median
$1,144
outlier · 2.7×
4000166
CDM 		Puraply Xt 4.91 Cm X 4.91 Cm 24.11 Each 8 $2,096.00 $3,876.00 $2,876.78 nat. median
$721
outlier · 4.0×
72146
CPT 		MRI Spine Thoracic Without Contrast 8 $2,095.00 $3,873.00 $2,874.78 nat. median
$772
outlier · 3.7×
4000050
CDM 		Romosozumab-aqqg 105 Mg/1.17 Ml Subcut Soln 1.17 Ml [Cdh] 8 $2,070.00 $3,828.00 $2,841.22 nat. median
$80
outlier · 35.7×
73220
CPT 		MRI Upper Extremity With + Without Cnt Left 8 $1,720.00 $4,452.00 $2,832.50 nat. median
$1,185
outlier · 2.4×
71550
CPT 		MRI Chest Without Contrast 8 $2,036.00 $3,764.00 $2,794.00 nat. median
$809
outlier · 3.5×
74185
CPT 		MRA Abdomen With + Without Contrast 8 $2,035.00 $3,763.00 $2,793.00 nat. median
$1,240
outlier · 2.3×
73718
CPT 		MRI Lower Extremity Without Contrast Left 8 $1,686.00 $4,364.00 $2,776.39 nat. median
$916
outlier · 3.0×
70551
CPT 		MRI Brain Without Contrast 8 $2,021.00 $3,738.00 $2,774.00 nat. median
$772
outlier · 3.6×
71552
CPT 		MRI Chest With + Without Contrast 8 $2,007.00 $3,710.00 $2,754.11 nat. median
$1,093
outlier · 2.5×
400026
CDM 		Infliximab 100 Mg IV Inj[cdh] 8 $2,006.00 $3,708.00 $2,752.67 nat. median
$136
outlier · 20.3×
73723
CPT 		MRI Le Joint With + Without Contrast Left 8 $1,886.00 $3,917.00 $2,747.94 nat. median
$1,263
outlier · 2.2×
75635
CPT 		CT Angio Abdominal Aorta With Runoff 8 $1,998.00 $3,694.00 $2,741.78 nat. median
$705
outlier · 3.9×
72148
CPT 		MRI Scan Of Lower Spinal Canal 8 $1,980.00 $3,660.00 $2,717.00 nat. median
$770
outlier · 3.5×
72141
CPT 		MRI Spine Cervical Without Contrast 8 $1,976.00 $3,653.00 $2,711.78 nat. median
$765
outlier · 3.5×
4001535
CDM 		Rabies Immune Globulin, Human 150 Intl Units/ml IM Soln 10 Ml [Cdh] 8 $1,976.00 $3,653.00 $2,711.78 nat. median
$10,165
outlier · 0.3×
74182
CPT 		MRI Abdomen With Contrast 8 $1,969.00 $3,642.00 $2,702.78 nat. median
$990
outlier · 2.7×
71275
CPT 		CT Angio Chest Pe Protocol 8 $1,932.00 $3,572.00 $2,651.33 nat. median
$735
outlier · 3.6×

Other procedures at this hospital

Browse this hospital's 1,550 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
10061 CPT 10061 I&d Abscess Compl Or Multiple 9 8 $602.00 $542.00 $319.00 $590.00 $437.89 2025-08-20
10080 CPT 10080 Clinic Incision & Drainage Of Polonidal Cyst 9 8 $610.00 $549.00 $323.00 $598.00 $443.67 2025-08-20
10121 CPT 10121 Incision & Removal Foreign Body Subq Tiss Compl Profee 9 8 $671.00 $604.00 $356.00 $658.00 $488.22 2025-08-20
11010 CPT 11010 Debride Incl Remvl Foreign Matl At Site Of Open Fx/open Disloc; Skn/subq T… 9 8 $872.00 $785.00 $462.00 $855.00 $634.22 2025-08-20
11406 CPT 11406 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 9 8 $760.00 $684.00 $403.00 $745.00 $553.00 2025-08-20
11426 CPT 11426 Excision, Benign Lesion Including Margins; Scalp, Neck, Hands, Feet, Genit… 9 8 $792.00 $713.00 $420.00 $776.00 $576.11 2025-08-20
11602 CPT 11602 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; 1.1-2.… 9 8 $595.00 $536.00 $315.00 $583.00 $432.56 2025-08-20
11603 CPT 11603 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; 2.1-3.… 9 8 $676.00 $608.00 $358.00 $662.00 $491.44 2025-08-20
11604 CPT 11604 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; 3.1-4.… 9 8 $752.00 $677.00 $399.00 $737.00 $547.11 2025-08-20
11606 CPT 11606 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; >4.0cm 9 8 $1,071.00 $964.00 $568.00 $1,050.00 $779.22 2025-08-20
11622 CPT 11622 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge… 9 8 $614.00 $553.00 $325.00 $602.00 $446.44 2025-08-20
11623 CPT 11623 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge… 9 8 $717.00 $645.00 $380.00 $703.00 $521.56 2025-08-20
11624 CPT 11624 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge… 9 8 $814.00 $733.00 $431.00 $798.00 $591.89 2025-08-20
11626 CPT 11626 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge… 9 8 $975.00 $878.00 $517.00 $956.00 $709.44 2025-08-20
11641 CPT 11641 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 9 8 $575.00 $518.00 $305.00 $564.00 $418.44 2025-08-20
11642 CPT 11642 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 9 8 $650.00 $585.00 $345.00 $637.00 $473.11 2025-08-20
11643 CPT 11643 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 9 8 $762.00 $686.00 $404.00 $747.00 $554.44 2025-08-20
11644 CPT 11644 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 9 8 $937.00 $843.00 $497.00 $918.00 $681.67 2025-08-20
11646 CPT 11646 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 9 8 $1,213.00 $1,092.00 $643.00 $1,189.00 $882.33 2025-08-20
12031 CPT 12031 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; <2.5cm 18 8 $640.00 $576.00 $297.00 $627.00 $436.67 2025-08-20
12032 CPT 12032 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; 2.6-7.… 18 8 $739.00 $665.00 $375.00 $724.00 $526.28 2025-08-20
12034 CPT 12034 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; 7.6-12… 18 8 $810.00 $729.00 $400.00 $794.00 $568.94 2025-08-20
12035 CPT 12035 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; 12.6-2… 9 8 $934.00 $841.00 $495.00 $915.00 $679.33 2025-08-20
12041 CPT 12041 Repair, Intermediate, Wounds Of Neck, Hands, Feet And/or External Genitali… 18 8 $642.00 $578.00 $285.00 $629.00 $428.78 2025-08-20
12042 CPT 12042 Repair, Intermediate, Wounds Of Neck, Hands, Feet And/or External Genitali… 18 8 $754.00 $679.00 $384.00 $739.00 $538.00 2025-08-20
12044 CPT 12044 Repair, Intermediate, Wounds Of Neck, Hands, Feet And/or External Genitali… 18 8 $924.00 $832.00 $414.00 $906.00 $620.44 2025-08-20
12051 CPT 12051 Repair Intermediate F/e/e/n/l&/muc 2.5 Cm/< Techfee 18 8 $689.00 $620.00 $331.00 $675.00 $477.56 2025-08-20
12052 CPT 12052 Repair Intermediate F/e/e/n/l&/muc 2.6-5.0 Cm Techfee 18 8 $768.00 $691.00 $391.00 $753.00 $547.44 2025-08-20
12053 CPT 12053 Repair Intermediate F/e/e/n/l&/muc 5.1-7.5 Cm Techfee 18 8 $884.00 $796.00 $420.00 $866.00 $609.89 2025-08-20
12055 CPT 12055 Repair Intermediate F/e/e/n/l&/muc 12.6-20.0cm Techfee 18 8 $1,220.00 $1,098.00 $223.00 $1,196.00 $596.72 2025-08-20
12056 CPT 12056 Repair Intermediate F/e/e/n/l&/muc 20.1-30.0cm Techfee 18 8 $1,394.00 $1,255.00 $316.00 $1,366.00 $724.00 2025-08-20
13101 CPT 13101 Repair, Complex, Trunk; 2.6 Cm To 7.5 Cm 18 8 $967.00 $870.00 $205.00 $948.00 $492.33 2025-08-20
13120 CPT 13120 Repair, Complex, Scalp, Arms, And/or Legs; 1.1 Cm To 2.5 Cm 18 8 $864.00 $778.00 $195.00 $847.00 $448.17 2025-08-20
13121 CPT 13121 Repair, Complex, Scalp, Arms, And/or Legs; 2.6 Cm To 7.5 Cm 18 8 $1,036.00 $932.00 $192.00 $1,015.00 $508.72 2025-08-20
13131 CPT 13131 Repair, Complex, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, … 18 8 $944.00 $850.00 $181.00 $925.00 $467.50 2025-08-20
13132 CPT 13132 Repair, Complex, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, … 18 8 $1,147.00 $1,032.00 $588.00 $1,124.00 $820.61 2025-08-20
13151 CPT 13151 Repair, Complex, Eyelids, Nose, Ears And/or Lips; 1.1 Cm To 2.5 Cm 9 8 $1,029.00 $926.00 $545.00 $1,008.00 $748.33 2025-08-20
13152 CPT 13152 Repair Complex Eyelid/nose/ear/lip 2.6-7.5 Cm Profee 9 8 $1,224.00 $1,102.00 $649.00 $1,200.00 $890.56 2025-08-20
13160 CPT 13160 Secondary Closure Of Surgical Wound Or Dehiscence, Extensive Or Complicate… 9 8 $1,890.00 $1,701.00 $1,002.00 $1,852.00 $1,374.89 2025-08-20
15271 CPT 15271 Op App Skin Sub With Puraply Mz 9 8 $825.00 $743.00 $437.00 $809.00 $600.11 2025-08-20
20103 CPT 20103 Clinic Exploration Of Penetrating Wound; Extremity 9 8 $1,363.00 $1,227.00 $722.00 $1,336.00 $991.33 2025-08-20
20670 CPT 20670 Removal Of Implant; Superficial (Buried Wire, Pin Or Rod) 9 8 $880.00 $792.00 $466.00 $862.00 $639.89 2025-08-20
21930 CPT 21930 Excision, Tumor, Soft Tissue Of Back Or Flank, Subcutaneous; Less Than 3 C… 9 8 $1,199.00 $1,079.00 $635.00 $1,175.00 $871.89 2025-08-20
23650 CPT 23650 Clsd Tx Shoulder Dislc W/manipulation Without Anes Profee 9 8 $1,135.00 $1,022.00 $602.00 $1,112.00 $825.78 2025-08-20
23930 CPT 23930 Incision And Drainage, Upper Arm Or Elbow Area; Deep Abscess Or Hematoma 9 8 $863.00 $777.00 $457.00 $846.00 $627.56 2025-08-20
23931 CPT 23931 Incision And Drainage, Upper Arm Or Elbow Area; Bursa 9 8 $734.00 $661.00 $389.00 $719.00 $533.78 2025-08-20
25111 CPT 25111 Excision Of Ganglion, Wrist (Dorsal Or Volar); Primary 9 8 $787.00 $708.00 $417.00 $771.00 $572.44 2025-08-20
25535 CPT 25535 Closed Treatment Of Ulnar Shaft Fracture; With Manual Manipulation Pc Prof… 9 8 $1,711.00 $1,540.00 $907.00 $1,677.00 $1,244.67 2025-08-20
25605 CPT 25605 Ed Pf/tech Closed Treatment Of Distal Radial Fracture 9 8 $1,895.00 $1,706.00 $1,004.00 $1,857.00 $1,378.22 2025-08-20
25635 CPT 25635 Cltx Carpal Bone Fx W/manj Each Bone Profee 9 8 $1,595.00 $1,436.00 $845.00 $1,563.00 $1,160.00 2025-08-20
26070 CPT 26070 Arthrotomy W/explor, Drain/rem Of Loose Or Fb Carpometacarpal Jnt 9 8 $608.00 $547.00 $322.00 $596.00 $442.22 2025-08-20
26605 CPT 26605 Cltx Metacarpal Fx W/manipulation Each Bone Profee 9 8 $1,134.00 $1,021.00 $601.00 $1,111.00 $824.78 2025-08-20
26641 CPT 26641 Cltx Carpo/metacarpal Dislocation Thumb W/manj Profee 9 8 $1,444.00 $1,300.00 $765.00 $1,415.00 $1,050.22 2025-08-20
26670 CPT 26670 Cltx Carpo/metacarpl Dislc Thmb Manj Ea Without Anes Profee 9 8 $1,187.00 $1,068.00 $629.00 $1,163.00 $863.44 2025-08-20
26700 CPT 26700 Cltx Metacarpophalangeal Dislc W/manj Without Anes Profee 9 8 $1,184.00 $1,066.00 $628.00 $1,160.00 $861.44 2025-08-20
26725 CPT 26725 Cltx Phlngl Fx Prox/middle Px/f/t W/manj Ea Profee 9 8 $1,156.00 $1,040.00 $613.00 $1,133.00 $841.00 2025-08-20
26742 CPT 26742 Cltx Artclr Fx Invg Mtcarphlngl/iphal Jt W/manj Profee 9 8 $1,264.00 $1,138.00 $670.00 $1,239.00 $919.44 2025-08-20
26770 CPT 26770 Cltx Iphal Jt Dislc W/manj Without Anes Profee 9 8 $998.00 $898.00 $529.00 $978.00 $725.89 2025-08-20
27301 CPT 27301 Incision And Drainage Of Deep Abscess Of Knee Region 9 8 $1,426.00 $1,283.00 $756.00 $1,397.00 $1,037.33 2025-08-20
27345 CPT 27345 Excision Of Synovial Cyst Of Popliteal Space (Eg, Baker's Cyst) Techfee 9 8 $855.00 $770.00 $453.00 $838.00 $621.89 2025-08-20
27560 CPT 27560 Closed Tx Patellar Dislocation Without Anesthesia Profee 9 8 $1,277.00 $1,149.00 $677.00 $1,251.00 $928.89 2025-08-20
28190 CPT 28190 Removal Of Foreign Body, Foot; Subcutaneous 9 8 $613.00 $552.00 $325.00 $601.00 $445.89 2025-08-20
28285 CPT 28285 Correction Hammertoe 9 8 $2,800.00 $2,520.00 $1,484.00 $2,744.00 $2,036.67 2025-08-20
30101 CDM Room/bed: Inpatient 9 8 $1,461.00 $1,315.00 $774.00 $1,432.00 $1,062.67 2025-08-20
30102 CDM Room/bed: Monitored 9 8 $1,827.00 $1,644.00 $968.00 $1,790.00 $1,328.78 2025-08-20
30106 CDM Room/bed: Swing Bed 9 8 $1,242.00 $1,118.00 $658.00 $1,217.00 $903.22 2025-08-20
30905 CPT 30905 Nasal Hem Cont Post&ant Techfee 18 8 $853.00 $768.00 $197.00 $836.00 $445.50 2025-08-20
3300122 CDM Regadenoson 0.4 Mg/5 Ml Intravenous Solution 5 Ml 9 8 $862.00 $776.00 $457.00 $845.00 $627.22 2025-08-20
3450005 CDM Bill Only P9031 Platelets Leuko Reduced 9 8 $983.00 $885.00 $521.00 $963.00 $715.00 2025-08-20
3450006 CDM Bill Only P9033 Platelets Leuko Reduced, Irradiated 9 8 $1,035.00 $932.00 $549.00 $1,014.00 $753.00 2025-08-20
36430 CPT Bill Only Blood Administration, 17-23 Hrs 9 8 $1,160.00 $1,044.00 $615.00 $1,137.00 $844.00 2025-08-20
36589 CPT 36589 Op Removal Tunneled Cv Catheter 9 8 $1,208.00 $1,087.00 $640.00 $1,184.00 $878.67 2025-08-20
4000008 CDM Immune Globulin 10% IV Sol 400 Ml[cdh] 9 8 $12,254.00 $11,029.00 $6,495.00 $12,009.00 $8,913.56 2025-08-20
4000011 CDM Etonogestrel 68 Mg Subcut Implant [Cdh] 9 8 $2,622.00 $2,360.00 $1,390.00 $2,570.00 $1,907.44 2025-08-20
40000240 CDM Epoetin Alfa Epbx 40,000 Units/ml Preservative-free Sol [Cdh] 9 8 $1,503.00 $1,353.00 $797.00 $1,473.00 $1,093.44 2025-08-20
4000050 CDM Romosozumab-aqqg 105 Mg/1.17 Ml Subcut Soln 1.17 Ml [Cdh] 9 8 $3,906.00 $3,515.00 $2,070.00 $3,828.00 $2,841.22 2025-08-20
4000053 CDM Tocilizumab 20 Mg/ml Sol [Cdh] 9 8 $7,285.00 $6,557.00 $3,861.00 $7,139.00 $5,299.00 2025-08-20
4000057 CDM Dupilumab 300 Mg/2 Ml Subcutaneous Solution 2 Ml 9 8 $5,077.00 $4,569.00 $2,691.00 $4,975.00 $3,692.89 2025-08-20
4000063 CDM Remdesivir 100 Mg Inj [Cdh] 9 8 $1,768.00 $1,591.00 $937.00 $1,733.00 $1,286.11 2025-08-20
4000073 CDM Leuprolide 22.5 Mg/3 Months Intramuscular Kit 9 8 $15,352.00 $13,817.00 $8,137.00 $15,045.00 $11,167.00 2025-08-20
4000109 CDM Rabies Immune Globulin, Human 150 Intl Units/ml Intramuscular Solution 2 Ml 9 8 $2,793.00 $2,514.00 $1,480.00 $2,737.00 $2,031.33 2025-08-20
4000149 CDM Pneumococcal 15-valent Conjugate Vaccinesus 9 8 $1,472.00 $1,325.00 $780.00 $1,443.00 $1,070.67 2025-08-20
4000165 CDM Puraply Am 1.6 Cm Disc [Cdh] 9 8 $900.00 $810.00 $477.00 $882.00 $654.67 2025-08-20
4000166 CDM Puraply Xt 4.91 Cm X 4.91 Cm 24.11 Each 9 8 $3,955.00 $3,560.00 $2,096.00 $3,876.00 $2,876.78 2025-08-20
4000167 CDM Puraply Am 2 Cm X 4 Cm [Cdh] 9 8 $1,785.00 $1,607.00 $946.00 $1,749.00 $1,298.33 2025-08-20
4000168 CDM Novachor [Cdh] 9 8 $4,550.00 $4,095.00 $2,412.00 $4,459.00 $3,309.89 2025-08-20
4000169 CDM Affinity 1.5 X 1.5 Cm [Cdh] 9 8 $2,295.00 $2,066.00 $1,216.00 $2,249.00 $1,669.11 2025-08-20
4000170 CDM Affinity 2.5 X 2.5 Cm [Cdh] 9 8 $2,880.00 $2,592.00 $1,526.00 $2,822.00 $2,094.67 2025-08-20
4000171 CDM Infliximab 100 Mg Pow [Cdh] 9 8 $1,617.00 $1,455.00 $857.00 $1,585.00 $1,176.22 2025-08-20
4000186 CDM Cygnus Dual 2x3cm 6 Units 9 8 $5,180.00 $4,662.00 $2,745.00 $5,076.00 $3,767.67 2025-08-20
4000187 CDM Cyngus 4x4cm 16 Units 9 8 $12,766.00 $11,489.00 $6,766.00 $12,511.00 $9,285.89 2025-08-20
4000188 CDM Cygnus Dual 4x6cm 24 Units 9 8 $18,300.00 $16,470.00 $9,699.00 $17,934.00 $13,311.22 2025-08-20
4000223 CDM Acetylcysteine 20% IV Sol 30 Ml[cdh] 9 8 $653.00 $588.00 $346.00 $640.00 $474.89 2025-08-20
4000243 CDM Epinephrine Top 1:1000 Sol[cdh] 9 8 $601.00 $541.00 $319.00 $589.00 $437.33 2025-08-20
4000251 CDM Zoledronic Acid 4 Mg/100 Ml Soln [Cdh] 9 8 $626.00 $563.00 $332.00 $613.00 $455.33 2025-08-20
400026 CDM Infliximab 100 Mg IV Inj[cdh] 9 8 $3,784.00 $3,406.00 $2,006.00 $3,708.00 $2,752.67 2025-08-20
4000283 CDM Atovaquone 750 Mg/5 Ml Sus[cdh] 9 8 $2,523.00 $2,271.00 $1,337.00 $2,473.00 $1,835.22 2025-08-20
4000287 CDM Apligraf 44 Units Topical [Cdh] 9 8 $2,690.00 $2,421.00 $1,426.00 $2,636.00 $1,956.78 2025-08-20
4000293 CDM Eflapegrastim Xnst 13.2 Mg/0.6 Ml Sol [Cdh] 9 8 $9,720.00 $8,748.00 $5,152.00 $9,526.00 $7,070.44 2025-08-20
4000294 CDM Via Matrix 2 X 3 2/3 Cm Film 9 8 $6,760.00 $6,084.00 $3,583.00 $6,625.00 $4,917.33 2025-08-20
4000569 CDM Antivenin (Crotalidae) Polyvalentpow[cdh] 9 8 $9,210.00 $8,289.00 $4,881.00 $9,026.00 $6,699.22 2025-08-20
4000590 CDM Daptomycin 500 Mg IV Inj[cdh] 9 8 $1,518.00 $1,366.00 $805.00 $1,488.00 $1,104.44 2025-08-20
4000601 CDM Darbepoetin Alfa 40 Mcg/ml Inj Sol[cdh] 9 8 $743.00 $669.00 $394.00 $728.00 $540.44 2025-08-20
4000866 CDM Glucagon Recombinant 1 Mg Inj [Cdh] 9 8 $766.00 $689.00 $406.00 $751.00 $557.22 2025-08-20
4000902 CDM Heparin 100 Units/ml-nacl 0.45% Sol 9 8 $757.00 $681.00 $401.00 $742.00 $550.56 2025-08-20
4000971 CDM Eptifibatide 0.75 Mg/ml IV Sol[cdh] 9 8 $1,334.00 $1,201.00 $707.00 $1,307.00 $970.22 2025-08-20
4001385 CDM Pegfilgrastim 6 Mg/0.6 Ml Subq Inj[cdh] 9 8 $13,093.00 $11,784.00 $6,939.00 $12,831.00 $9,523.44 2025-08-20
4001499 CDM Epoetin Alfa 40,000 Units/ml Preservative-free[cdh] 9 8 $3,464.00 $3,118.00 $1,836.00 $3,395.00 $2,519.78 2025-08-20
4001535 CDM Rabies Immune Globulin, Human 150 Intl Units/ml IM Soln 10 Ml [Cdh] 9 8 $3,728.00 $3,355.00 $1,976.00 $3,653.00 $2,711.78 2025-08-20
4001558 CDM Rabies Immune Globulin, Human 300 Intl Units/ml[cdh] 9 8 $2,414.00 $2,173.00 $1,279.00 $2,366.00 $1,755.67 2025-08-20
4001700 CDM Tetanus Immune Globulin 250 Units/ml[cdh] 9 8 $668.00 $601.00 $354.00 $655.00 $486.00 2025-08-20
4001726 CDM Tenecteplase 50 Mg IV Inj[cdh] 9 8 $19,121.00 $17,209.00 $10,134.00 $18,739.00 $13,908.44 2025-08-20
4001851 CDM Denosumab 120 Mg/1.7 Ml[cdh] 9 8 $6,521.00 $5,869.00 $3,456.00 $6,391.00 $4,743.33 2025-08-20
4001876 CDM Budesonide-formoterol 160 Mcg-4.5 Mcg/inh Inh Aer W/adapter[cdh] 9 8 $618.00 $556.00 $328.00 $606.00 $449.78 2025-08-20
4001944 CDM Zoledronic Acid 5 Mg/100 Ml Sol 9 8 $3,512.00 $3,161.00 $1,861.00 $3,442.00 $2,554.44 2025-08-20
4001949 CDM Denosumab 60 Mg/ml[cdh] 9 8 $4,287.00 $3,858.00 $2,272.00 $4,201.00 $3,118.33 2025-08-20
4002223 CDM Certolizumab 200 Mg Subcutaneous Kit [Cdh] 9 8 $13,291.00 $11,962.00 $7,044.00 $13,025.00 $9,667.44 2025-08-20
40650 CPT 40650 Repair Lip, Full Thickness; Vermilion Only 9 8 $1,157.00 $1,041.00 $613.00 $1,134.00 $841.56 2025-08-20
41252 CPT 41252 Tongue Laceration Ed Tech Fee 9 8 $757.00 $681.00 $401.00 $742.00 $550.56 2025-08-20
43235 CPT Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 9 8 $1,839.00 $1,655.00 $975.00 $1,802.00 $1,337.67 2025-08-20
43239 CPT Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 9 8 $2,704.00 $2,434.00 $1,433.00 $2,650.00 $1,966.89 2025-08-20
43250 CPT 43250 Esophagogastroduodenoscopy, Flexible, Transoral; With Removal Of Tumor(s),… 9 8 $2,164.00 $1,948.00 $1,147.00 $2,121.00 $1,574.11 2025-08-20
43251 CPT 43251 Esophagogastroduodenoscopy, Flexible, Transoral; With Removal Of Tumor(s),… 9 8 $1,623.00 $1,461.00 $860.00 $1,591.00 $1,180.56 2025-08-20
43255 CPT 43255 Esophagogastroduodenoscopy, Flexible, Transoral; With Control Of Bleeding;… 9 8 $1,839.00 $1,655.00 $975.00 $1,802.00 $1,337.67 2025-08-20
45300 CPT 45300â Proctosigmoidoscopy, Rigid; Diagnostic, With Or Without Collection Of Spe… 9 8 $853.00 $768.00 $452.00 $836.00 $620.44 2025-08-20
45330 CPT 45330 Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(s) B… 9 8 $1,043.00 $939.00 $553.00 $1,022.00 $758.67 2025-08-20
45331 CPT 45331 Sigmoidoscopy, Flexible With Biopsy, Single Or Multiple 9 8 $1,623.00 $1,461.00 $860.00 $1,591.00 $1,180.56 2025-08-20
45333 CPT 45333 Sigmoidoscopy, Flexible; With Removal Of Tumor(s), Polyp(s), Or Other Lesi… 9 8 $1,028.00 $925.00 $545.00 $1,007.00 $747.78 2025-08-20
45378 CPT Diagnostic Exam Of Large Bowel Using An Endoscope 9 8 $1,839.00 $1,655.00 $975.00 $1,802.00 $1,337.67 2025-08-20
45380 CPT Biopsy Exam Of Large Bowel Using An Endoscope 9 8 $2,272.00 $2,045.00 $1,204.00 $2,227.00 $1,652.56 2025-08-20
45384 CPT 45384 Colonoscopy W/lesion Removal 9 8 $2,407.00 $2,166.00 $1,276.00 $2,359.00 $1,751.00 2025-08-20
45385 CPT Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope 9 8 $1,623.00 $1,461.00 $860.00 $1,591.00 $1,180.56 2025-08-20
45398 CPT 45398 Colonoscopy, Flexible; With Band Ligation(s) 9 8 $716.00 $644.00 $379.00 $702.00 $520.56 2025-08-20
46040 CPT 46040 I&d Of Ischiorectal And/or Perirectal Abscess 9 8 $1,284.00 $1,156.00 $681.00 $1,258.00 $934.22 2025-08-20
46221 CPT 46221 Hemorrhoidectomy, Internal, By Rubber Band Ligation 9 8 $704.00 $634.00 $373.00 $690.00 $512.11 2025-08-20
46230 CPT 46230 Excision Of Multiple External Papillae Or Tags, Anus 9 8 $754.00 $679.00 $400.00 $739.00 $548.67 2025-08-20
46255 CPT 46255 Hemorrhoidectomy Internal And External, Single Column/group 9 8 $3,152.00 $2,837.00 $1,671.00 $3,089.00 $2,292.89 2025-08-20
46606 CPT 46606 Anoscopy With Biopsy; Single Or Multiple 9 8 $866.00 $779.00 $459.00 $849.00 $630.00 2025-08-20
46945 CPT 46945 Hemorrhoidectomy, Internal, By Ligation Other Than Rubber Band; Single Hem… 9 8 $698.00 $628.00 $370.00 $684.00 $507.67 2025-08-20
4900352 CDM Human Papillomavirus Vaccine 9-valent Intramuscular Suspension 0.5 Ml 9 8 $871.00 $784.00 $462.00 $854.00 $633.78 2025-08-20
49083 CPT 49083 Op Abdominal Paracentesis With Imaging Guidance 9 8 $1,157.00 $1,041.00 $613.00 $1,134.00 $841.56 2025-08-20
62270 CPT 62270 Lumbar Puncture 9 8 $741.00 $667.00 $393.00 $726.00 $539.00 2025-08-20
70450 CPT CT Scan 9 8 $2,247.00 $2,022.00 $1,191.00 $2,202.00 $1,634.44 2025-08-20
70460 CPT CT Brain/head With Contrast 9 8 $2,534.00 $2,281.00 $1,343.00 $2,483.00 $1,843.11 2025-08-20
70470 CPT CT Brain/head With + Without Contrast 9 8 $2,973.00 $2,676.00 $1,576.00 $2,914.00 $2,162.67 2025-08-20
70480 CPT CT Orbits Sella Without Contrast 9 8 $2,082.00 $1,874.00 $1,103.00 $2,040.00 $1,514.22 2025-08-20
70481 CPT CT Orbits Sella With Contrast 9 8 $2,805.00 $2,525.00 $1,487.00 $2,749.00 $2,040.56 2025-08-20
70482 CPT CT Orbits Sella With + Without Contrast 9 8 $2,447.00 $2,202.00 $1,297.00 $2,398.00 $1,780.00 2025-08-20
70486 CPT CT Maxillofacial Without Contrast 9 8 $2,033.00 $1,830.00 $1,077.00 $1,992.00 $1,478.44 2025-08-20
70487 CPT CT Maxillofacial With Contrast 9 8 $2,507.00 $2,256.00 $1,329.00 $2,457.00 $1,823.78 2025-08-20
70488 CPT CT Maxillofacial With + Without Contrast 9 8 $2,306.00 $2,075.00 $1,222.00 $2,260.00 $1,677.33 2025-08-20
70490 CPT CT Neck Soft Tissue Without Contrast 9 8 $2,237.00 $2,013.00 $1,186.00 $2,192.00 $1,627.33 2025-08-20
70491 CPT CT Neck Soft Tissue With Contrast 9 8 $2,653.00 $2,388.00 $1,406.00 $2,600.00 $1,929.67 2025-08-20
70492 CPT CT Neck Soft Tissue With + Without Contrast 9 8 $3,576.00 $3,218.00 $1,895.00 $3,504.00 $2,600.89 2025-08-20
70496 CPT CT Angio Brain/head 9 8 $3,344.00 $3,010.00 $1,772.00 $3,277.00 $2,432.22 2025-08-20
70498 CPT CT Angio Neck 9 8 $3,333.00 $3,000.00 $1,766.00 $3,266.00 $2,424.11 2025-08-20
70540 CPT MRI Face Neck Orbit Without Contrast 9 8 $3,572.00 $3,215.00 $1,893.00 $3,501.00 $2,598.22 2025-08-20
70543 CPT MRI Face Neck Orbit With + Without Contrast 9 8 $3,488.00 $3,139.00 $1,849.00 $3,418.00 $2,537.22 2025-08-20
70544 CPT MRA Brain/head Without Contrast 9 8 $3,574.00 $3,217.00 $1,894.00 $3,503.00 $2,599.67 2025-08-20
70547 CPT MRA Neck Without Contrast 9 8 $2,704.00 $2,434.00 $1,433.00 $2,650.00 $1,966.89 2025-08-20
70549 CPT MRA Neck With + Without Contrast 9 8 $3,375.00 $3,038.00 $1,789.00 $3,308.00 $2,455.11 2025-08-20
70551 CPT MRI Brain Without Contrast 9 8 $3,814.00 $3,433.00 $2,021.00 $3,738.00 $2,774.00 2025-08-20
70553 CPT MRI Scan 9 8 $4,506.00 $4,055.00 $2,388.00 $4,416.00 $3,277.67 2025-08-20
71110 CPT Xr Ribs 3 Views Bilateral 9 8 $625.00 $563.00 $331.00 $613.00 $454.67 2025-08-20
71111 CPT Xr Ribs 4+ Views Bilat With Pa Chest 9 8 $601.00 $541.00 $319.00 $589.00 $437.33 2025-08-20
71250 CPT CT Chest Without Contrast 9 8 $2,566.00 $2,309.00 $1,360.00 $2,515.00 $1,866.56 2025-08-20
71260 CPT CT Chest With Contrast 9 8 $2,853.00 $2,568.00 $1,512.00 $2,796.00 $2,075.22 2025-08-20
71270 CPT CT Chest With + Without Contrast 9 8 $3,184.00 $2,866.00 $1,688.00 $3,120.00 $2,316.22 2025-08-20
71271 CPT CT Low Dose Lung Scan 9 8 $1,897.00 $1,707.00 $1,005.00 $1,859.00 $1,379.67 2025-08-20
71275 CPT CT Angio Chest Pe Protocol 9 8 $3,645.00 $3,281.00 $1,932.00 $3,572.00 $2,651.33 2025-08-20
71550 CPT MRI Chest Without Contrast 9 8 $3,841.00 $3,457.00 $2,036.00 $3,764.00 $2,794.00 2025-08-20
71551 CPT MRI Chest With Contrast 9 8 $4,214.00 $3,793.00 $2,233.00 $4,130.00 $3,065.00 2025-08-20
71552 CPT MRI Chest With + Without Contrast 9 8 $3,786.00 $3,407.00 $2,007.00 $3,710.00 $2,754.11 2025-08-20
71555 CPT MRA Chest With + Without Contrast 9 8 $6,057.00 $5,451.00 $3,210.00 $5,936.00 $4,405.78 2025-08-20
72052 CPT Xr Spine Cervical 6+ Views 9 8 $663.00 $597.00 $351.00 $650.00 $482.11 2025-08-20
72083 CPT Xr Spine Scoliosis 4-5 Views 9 8 $694.00 $625.00 $368.00 $680.00 $504.78 2025-08-20
72110 CPT X-ray Of Lower Back 9 8 $586.00 $527.00 $311.00 $574.00 $426.44 2025-08-20
72114 CPT Xr Spine Lumbosacral With Bending 6+ Views 9 8 $656.00 $590.00 $348.00 $643.00 $477.33 2025-08-20
72125 CPT CT Spine Cervical Without Contrast 9 8 $2,578.00 $2,320.00 $1,366.00 $2,526.00 $1,875.00 2025-08-20
72126 CPT CT Spine Cervical With Contrast 9 8 $3,318.00 $2,986.00 $1,759.00 $3,252.00 $2,413.67 2025-08-20
72127 CPT CT Spine Cervical With + Without Contrast 9 8 $2,756.00 $2,480.00 $1,461.00 $2,701.00 $2,004.89 2025-08-20
72128 CPT CT Spine Thoracic Without Contrast 9 8 $2,570.00 $2,313.00 $1,362.00 $2,519.00 $1,869.44 2025-08-20
72129 CPT CT Spine Thoracic With Contrast 9 8 $2,324.00 $2,092.00 $1,232.00 $2,278.00 $1,690.67 2025-08-20
72130 CPT CT Spine Thoracic With + Without Contrast 9 8 $2,975.00 $2,678.00 $1,577.00 $2,916.00 $2,164.22 2025-08-20
72131 CPT CT Spine Lumbar Without Contrast 9 8 $2,568.00 $2,311.00 $1,361.00 $2,517.00 $1,868.00 2025-08-20
72132 CPT CT Spine Lumbar With Contrast 9 8 $3,135.00 $2,822.00 $1,662.00 $3,072.00 $2,280.56 2025-08-20
72133 CPT CT Spine Lumbar With + Without Contrast 9 8 $2,877.00 $2,589.00 $1,525.00 $2,819.00 $2,092.67 2025-08-20
72141 CPT MRI Spine Cervical Without Contrast 9 8 $3,728.00 $3,355.00 $1,976.00 $3,653.00 $2,711.78 2025-08-20
72146 CPT MRI Spine Thoracic Without Contrast 9 8 $3,952.00 $3,557.00 $2,095.00 $3,873.00 $2,874.78 2025-08-20
72148 CPT MRI Scan Of Lower Spinal Canal 9 8 $3,735.00 $3,362.00 $1,980.00 $3,660.00 $2,717.00 2025-08-20
72149 CPT MRI Spine Lumbar With Contrast 9 8 $4,543.00 $4,089.00 $2,408.00 $4,452.00 $3,304.56 2025-08-20
72156 CPT MRI Spine Cervical With + Without Contrast 9 8 $4,462.00 $4,016.00 $2,365.00 $4,373.00 $3,245.78 2025-08-20
72157 CPT MRI Spine Thoracic With + Without Contrast 9 8 $6,018.00 $5,416.00 $3,190.00 $5,898.00 $4,377.67 2025-08-20
72158 CPT MRI Spine Lumbar With + Without Contrast 9 8 $4,646.00 $4,181.00 $2,462.00 $4,553.00 $3,379.22 2025-08-20
72191 CPT CT Angio Pelvis 9 8 $2,813.00 $2,532.00 $1,491.00 $2,757.00 $2,046.11 2025-08-20
72192 CPT CT Pelvis Without Contrast 9 8 $2,505.00 $2,255.00 $1,328.00 $2,455.00 $1,822.33 2025-08-20
72193 CPT CT Scan Of Pelvis With Contrast 9 8 $2,815.00 $2,534.00 $1,492.00 $2,759.00 $2,047.67 2025-08-20
72194 CPT CT Pelvis With + Without Contrast 9 8 $2,921.00 $2,629.00 $1,548.00 $2,863.00 $2,124.78 2025-08-20
72195 CPT MRI Pelvis Without Contrast 9 8 $3,410.00 $3,069.00 $1,807.00 $3,342.00 $2,480.44 2025-08-20
72196 CPT MRI Pelvis With Contrast 9 8 $3,375.00 $3,038.00 $1,789.00 $3,308.00 $2,455.11 2025-08-20
72197 CPT MRI Pelvis With + Without Contrast 9 8 $3,546.00 $3,191.00 $1,879.00 $3,475.00 $2,579.11 2025-08-20
72198 CPT MRA Pelvis With + Without Contrast 9 8 $4,350.00 $3,915.00 $2,306.00 $4,263.00 $3,164.44 2025-08-20
73200 CPT CT Upper Extremity Without Contrast Left 18 8 $3,242.00 $2,918.00 $1,227.00 $3,177.00 $2,021.22 2025-08-20
73201 CPT CT Upper Extremity With Contrast Left 18 8 $3,242.00 $2,918.00 $1,276.00 $3,177.00 $2,054.50 2025-08-20
73202 CPT CT Upper Extremity W/+without Contrast Left 18 8 $3,370.00 $3,033.00 $1,405.00 $3,303.00 $2,189.61 2025-08-20
73206 CPT CT Angio Lower Extremity Bilateral 9 8 $2,166.00 $1,949.00 $1,148.00 $2,123.00 $1,575.56 2025-08-20
73218 CPT MRI Upper Extremity Without Contrast Left 18 8 $4,241.00 $3,817.00 $1,605.00 $4,156.00 $2,644.00 2025-08-20
73220 CPT MRI Upper Extremity With + Without Cnt Left 18 8 $4,543.00 $4,089.00 $1,720.00 $4,452.00 $2,832.50 2025-08-20
73221 CPT MRI Ue Joint Without Contrast Left 18 8 $3,951.00 $3,556.00 $1,496.00 $3,872.00 $2,463.39 2025-08-20
73223 CPT MRI Ue Joint With + Without Contrast Left 18 8 $5,390.00 $4,851.00 $2,285.00 $5,282.00 $3,528.61 2025-08-20
73522 CPT Xr Hips 3-4 Views W/ap Pelvis Bilat 9 8 $621.00 $559.00 $329.00 $609.00 $451.78 2025-08-20
73700 CPT CT Lower Extremity Without Contrast Left 18 8 $4,160.00 $3,744.00 $1,269.00 $4,077.00 $2,384.00 2025-08-20
73701 CPT CT Lower Extremity With Contrast Left 18 8 $3,370.00 $3,033.00 $1,276.00 $3,303.00 $2,101.17 2025-08-20
73702 CPT CT Lower Extremity W/+without Contrast Left 18 8 $4,095.00 $3,686.00 $1,550.00 $4,013.00 $2,553.06 2025-08-20
73718 CPT MRI Lower Extremity Without Contrast Left 18 8 $4,453.00 $4,008.00 $1,686.00 $4,364.00 $2,776.39 2025-08-20
73720 CPT MRI Lower Extremity With + Without Cnt Left 18 8 $4,999.00 $4,499.00 $1,893.00 $4,899.00 $3,116.83 2025-08-20
73721 CPT MRI Scan Of Leg Joint 18 8 $3,997.00 $3,597.00 $1,513.00 $3,917.00 $2,491.89 2025-08-20
73723 CPT MRI Le Joint With + Without Contrast Left 18 8 $3,997.00 $3,597.00 $1,886.00 $3,917.00 $2,747.94 2025-08-20
73725 CPT MRA Lower Extremity With + Without Cnt Left 18 8 $7,565.00 $6,809.00 $3,208.00 $7,414.00 $4,952.44 2025-08-20
74022 CPT Xr Abdomen Series + Chest 1 View 9 8 $595.00 $536.00 $315.00 $583.00 $432.56 2025-08-20
74150 CPT CT Abdomen Without Contrast 9 8 $2,482.00 $2,234.00 $1,315.00 $2,432.00 $1,805.11 2025-08-20
74160 CPT CT Abdomen With Contrast 9 8 $2,737.00 $2,463.00 $1,451.00 $2,682.00 $1,991.00 2025-08-20
74170 CPT CT Abdomen With + Without Contrast 9 8 $3,224.00 $2,902.00 $1,709.00 $3,160.00 $2,345.33 2025-08-20
74174 CPT CT Angio Abdomen And Pelvis 9 8 $5,961.00 $5,365.00 $3,159.00 $5,842.00 $4,335.89 2025-08-20
74175 CPT CT Angio Abdomen 9 8 $4,595.00 $4,136.00 $2,435.00 $4,503.00 $3,342.11 2025-08-20
74176 CPT CT Abdomen And Pelvis Without Contrast 9 8 $4,215.00 $3,794.00 $2,234.00 $4,131.00 $3,066.00 2025-08-20
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 9 8 $4,907.00 $4,416.00 $2,601.00 $4,809.00 $3,569.56 2025-08-20
74178 CPT CT Abdomen And Pelvis With + Without Contrast 9 8 $5,657.00 $5,091.00 $2,998.00 $5,544.00 $4,114.78 2025-08-20
74181 CPT MRI Abdomen Without Contrast 9 8 $3,461.00 $3,115.00 $1,834.00 $3,392.00 $2,517.44 2025-08-20
74182 CPT MRI Abdomen With Contrast 9 8 $3,716.00 $3,344.00 $1,969.00 $3,642.00 $2,702.78 2025-08-20
74183 CPT MRI Abdomen With + Without Contrast 9 8 $4,853.00 $4,368.00 $2,572.00 $4,756.00 $3,530.00 2025-08-20
74185 CPT MRA Abdomen With + Without Contrast 9 8 $3,840.00 $3,456.00 $2,035.00 $3,763.00 $2,793.00 2025-08-20
74220 CPT Xr Esophagus 9 8 $706.00 $635.00 $374.00 $692.00 $513.56 2025-08-20
74400 CPT Xr Ivp 9 8 $845.00 $761.00 $448.00 $828.00 $614.67 2025-08-20
75635 CPT CT Angio Abdominal Aorta With Runoff 9 8 $3,769.00 $3,392.00 $1,998.00 $3,694.00 $2,741.78 2025-08-20
76536 CPT US Thyroid 9 8 $685.00 $617.00 $363.00 $671.00 $498.22 2025-08-20
76641 CPT US Breast Complete Left 9 8 $587.00 $528.00 $311.00 $575.00 $427.00 2025-08-20
76700 CPT Ultrasound Of Abdomen 9 8 $944.00 $850.00 $500.00 $925.00 $686.44 2025-08-20
76705 CPT 76705 US Abdomen Limited 9 8 $753.00 $678.00 $399.00 $738.00 $547.67 2025-08-20
76706 CPT US Aaa Screening 9 8 $665.00 $599.00 $352.00 $652.00 $483.56 2025-08-20
76770 CPT US Aorta 9 8 $869.00 $782.00 $461.00 $852.00 $632.44 2025-08-20
76775 CPT US Retroperitoneal Limited 9 8 $656.00 $590.00 $348.00 $643.00 $477.33 2025-08-20
76830 CPT Ultrasound Pelvis Through Vagina 9 8 $755.00 $680.00 $400.00 $740.00 $549.11 2025-08-20
76856 CPT US Pelvic Complete 9 8 $880.00 $792.00 $466.00 $862.00 $639.89 2025-08-20
76870 CPT US Scrotum (Contents) 9 8 $731.00 $658.00 $387.00 $716.00 $531.44 2025-08-20
76882 CPT US Soft Tissue 9 8 $600.00 $540.00 $318.00 $588.00 $436.44 2025-08-20
77074 CPT Xr Bone Survery (Metastatic) 9 8 $749.00 $674.00 $397.00 $734.00 $544.89 2025-08-20
77075 CPT Xr Bone Survey Complete 9 8 $931.00 $838.00 $493.00 $912.00 $676.89 2025-08-20
77076 CPT Xr Osseous Survey Infant 9 8 $931.00 $838.00 $493.00 $912.00 $676.89 2025-08-20
87507 CPT Gi Pathogen Panel, Pcr (Pspc) 9 8 $1,252.00 $1,127.00 $664.00 $1,227.00 $910.89 2025-08-20
90675 CPT Medication Charge 9 8 $648.00 $583.00 $343.00 $635.00 $471.22 2025-08-20
90677 CPT 90677 Prevnar 20 Pneumococcal 20 Valent 9 8 $776.00 $698.00 $411.00 $760.00 $564.22 2025-08-20
90832 CPT Psychotherapy, 30 Min 9 8 $610.00 $549.00 $323.00 $598.00 $443.67 2025-08-20
90834 CPT Psychotherapy, 45 Min 9 8 $755.00 $680.00 $400.00 $740.00 $549.11 2025-08-20
90837 CPT Psychotherapy, 60 Min 9 8 $770.00 $693.00 $408.00 $755.00 $560.22 2025-08-20
90846 CPT Family Psychotherapy, Not Including Patient, 50 Min 9 8 $805.00 $725.00 $427.00 $789.00 $585.78 2025-08-20
90847 CPT Family Psychotherapy, Including Patient, 50 Min 9 8 $845.00 $761.00 $448.00 $828.00 $614.67 2025-08-20
90853 CPT Group Psychotherapy 9 8 $735.00 $662.00 $390.00 $720.00 $534.78 2025-08-20
92950 CPT 92950 Cpr Physician Profee 9 8 $664.00 $598.00 $352.00 $651.00 $483.11 2025-08-20
93226 CPT EKG Chargesekg -> Holter Scanning Analysis With Report 12-48 Hrs 9 8 $723.00 $651.00 $383.00 $709.00 $525.89 2025-08-20
93271 CPT 93271 ECG Event Monitor Charge 9 8 $1,009.00 $908.00 $535.00 $989.00 $734.22 2025-08-20
93306 CPT US Echo 2d Complete 9 8 $2,412.00 $2,171.00 $1,278.00 $2,364.00 $1,754.33 2025-08-20
93307 CPT 93307 Echocardiogram Charge 9 8 $1,184.00 $1,066.00 $628.00 $1,160.00 $861.44 2025-08-20
93308 CPT US Echo 2d Limited 9 8 $941.00 $847.00 $499.00 $922.00 $684.56 2025-08-20
93312 CPT 93312 Transesophageal Echo Charges 9 8 $2,704.00 $2,434.00 $1,433.00 $2,650.00 $1,966.89 2025-08-20
93350 CPT US Stress Echo Treadmill 9 8 $1,492.00 $1,343.00 $791.00 $1,462.00 $1,085.22 2025-08-20
93880 CPT 93880 Carotid Duplex Bil Charge John 9 8 $1,583.00 $1,425.00 $839.00 $1,551.00 $1,151.44 2025-08-20
93882 CPT 93882 Carotid Duplex Limit Charge John 9 8 $849.00 $764.00 $450.00 $832.00 $617.56 2025-08-20
93922 CPT 93922 Ankle Arm Index Charge John 9 8 $614.00 $553.00 $325.00 $602.00 $446.44 2025-08-20
93923 CPT US Segmental Pressures Le 3+ Lvls Bilat 9 8 $908.00 $817.00 $481.00 $890.00 $660.44 2025-08-20
93924 CPT US Segmental Pressures (Abi) With Exercise 9 8 $1,024.00 $922.00 $543.00 $1,004.00 $745.11 2025-08-20
93925 CPT 93925 Bil Art Graft Scan/abi Charge John 9 8 $1,310.00 $1,179.00 $694.00 $1,284.00 $952.89 2025-08-20
93926 CPT 93926 Lim Art Graft Scan/abi Charge John 9 8 $1,114.00 $1,003.00 $590.00 $1,092.00 $810.11 2025-08-20
93930 CPT 93930 Arterial Duplex Bil Upper Charge John 9 8 $758.00 $682.00 $402.00 $743.00 $551.56 2025-08-20
93931 CPT US Upper Ext Arterial Duplex Left 9 8 $649.00 $584.00 $344.00 $636.00 $472.11 2025-08-20
93970 CPT 93970 Venous Duplex Bilateral Charge John 9 8 $1,578.00 $1,420.00 $836.00 $1,546.00 $1,147.56 2025-08-20
93971 CPT 93971 Venous Duplex Limited Charge John 9 8 $1,166.00 $1,049.00 $618.00 $1,143.00 $848.22 2025-08-20
93975 CPT 93975 Abdominal Organ Vascular Scan Complete Charge John 9 8 $1,196.00 $1,076.00 $634.00 $1,172.00 $870.00 2025-08-20
93978 CPT 93978 Duplex Scan / Aorta/complete Study Charge John 9 8 $1,114.00 $1,003.00 $590.00 $1,092.00 $810.11 2025-08-20
93979 CPT 93979 Dup-scan Arta Ivc Ilic Vasc/bpgs Uni/lmt Charge John 9 8 $790.00 $711.00 $419.00 $774.00 $574.78 2025-08-20
94060 CPT 94060 Pft Complete Charge 9 8 $760.00 $684.00 $403.00 $745.00 $553.00 2025-08-20
99283 CPT 99283 Emergency Department Visit Moderate Severity Tech Fee 9 8 $592.00 $533.00 $314.00 $580.00 $430.56 2025-08-20
99284 CPT 99284 Trauma Evaluation Techfee 9 8 $833.00 $750.00 $441.00 $816.00 $605.67 2025-08-20
99285 CPT 99285 Emergency Dept Visit High Severity&threat Funcj Tech Fee 9 8 $1,298.00 $1,168.00 $688.00 $1,272.00 $944.11 2025-08-20
99291 CPT 99291 Trauma Critical Care E&m First 30-74 Techfee 9 8 $2,075.00 $1,868.00 $1,100.00 $2,034.00 $1,509.56 2025-08-20
99292 CPT 99292 Trauma Critical Care Each Add 30 Mins Techfee 9 8 $1,244.00 $1,120.00 $659.00 $1,219.00 $904.67 2025-08-20
C7900 HCPCS C7900 Psychotherapy, Individual, Remote Services 9 8 $610.00 $549.00 $323.00 $598.00 $443.67 2025-08-20
C7901 HCPCS C7901 Remote Service Group Psychotherapy 9 8 $1,155.00 $1,040.00 $612.00 $1,132.00 $840.11 2025-08-20
C7903 HCPCS Psychothrpy Group 9 8 $735.00 $662.00 $390.00 $720.00 $534.78 2025-08-20
CP17546695781213320 CDM Immediate Spin Crossmatch X4 9 8 $620.00 $558.00 $329.00 $608.00 $451.22 2025-08-20
CP17546695781478219 CDM 43762 Replacement Of Gastrostomy Tube 9 8 $670.00 $603.00 $355.00 $657.00 $487.44 2025-08-20
DELIVERY CDM Obstetrical Delivery 9 8 $1,607.00 $1,446.00 $852.00 $1,575.00 $1,169.11 2025-08-20
G0105 HCPCS G0105 Colorectal Ca Screen High Risk 9 8 $2,878.00 $2,590.00 $1,525.00 $2,820.00 $2,093.22 2025-08-20
G0121 HCPCS G0121 Colonoscopy Screening 9 8 $2,340.00 $2,106.00 $1,240.00 $2,293.00 $1,701.89 2025-08-20
G0176 HCPCS Iop Psychothrpy; Activity; 45 Min 9 8 $650.00 $585.00 $345.00 $637.00 $473.11 2025-08-20
G0177 HCPCS Iop Psychothrpy; Train/educate 45 9 8 $650.00 $585.00 $345.00 $637.00 $473.11 2025-08-20
G0410 HCPCS Iop Psychothrpy Group; 45-50 Min 9 8 $735.00 $662.00 $390.00 $720.00 $534.78 2025-08-20
M0243 HCPCS M0243 Intravenous Infusion Or Subq Injection Casirivimab And Imdevimab 9 8 $754.00 $679.00 $400.00 $739.00 $548.67 2025-08-20
M0245 HCPCS M0245 Intravenous Infusion Bamlanivimab/etesevimab-includes Infusion And Post Ad… 9 8 $754.00 $679.00 $400.00 $739.00 $548.67 2025-08-20
M0247 HCPCS M0247 Intravenous Infusion Sotrovimab, Infusion And Post Admin Monitoring 9 8 $754.00 $679.00 $400.00 $739.00 $548.67 2025-08-20
See an error in this hospital's data? Submit a correction