Hospital

DUNDY COUNTY HOSPITAL

Benkelman, NE · CCN 281340 · Rates published

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You selected 93306 (CPT)

Echo 2d Complete

This hospital’s price: $904 across 10 payers · range $686-$1,943

Source: https://secure.claraprice.net/price-transparency/GGVV-1725057844241/machine-readable/47-0487831_dundy-county-hospital_standardcharges.json · observed 2025-09-22

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.

3,632 distinct procedures filed

10 distinct payers

64,480 rate rows

2025-09-22 last MRF observed · ⚠ 13 mo old

Data quality

64,139 of 64,480 rate rows are consumer-grade (99.5%)

341 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
exceeds 10× this hospital's gross charge — excluded from medians	183
template filing: same amount across many unrelated codes — excluded	158

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 13 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://secure.claraprice.net/price-transparency/GGVV-1725057844241/machine-readable/47-0487831_dundy-county-hospital_standardcharges.json
Found on page	https://secure.claraprice.net/price-transparency/dundy-county-ne
Discovered via	Discovered by HANK
Last fetch	success · 2026-09-25
Content fingerprint	a1ebf4ec62a5c822… · 11,952,756 bytes · first seen 2026-07-31

Top 50 most expensive offerings

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

Code	Description	Payers	Min $	Max $	Avg median	vs national
Q4205 HCPCS	Membrane Wrap 2 X 3	10	$13,908.00	$39,415.00	$18,351.50	nat. median $1,160 outlier · 15.8×
J3101 HCPCS	Tnkase Inj [50 Mg]	10	$10,336.00	$29,291.00	$13,638.00	nat. median $3,787 outlier · 3.6×
J9217 HCPCS	Eligard 22.5 Mg Inj Kit	10	$6,665.00	$25,506.00	$11,700.00	nat. median $1,573 outlier · 7.4×
J0517 HCPCS	Fasenra Pen Subq Soln 30mg/1ml	10	$7,096.00	$20,110.00	$9,363.00	nat. median $919 outlier · 10.2×
J2353 HCPCS	Sandostatin Syr [30mg] Kit	10	$6,930.00	$19,640.00	$9,144.00	nat. median $5,623 1.6× median
J3380 HCPCS	Entyvio 300mg 20ml Vl	10	$6,793.00	$19,250.00	$8,963.00	nat. median $155 outlier · 58.0×
J2506 HCPCS	Neulasta Onpro Kit 6mg/0.6ml	10	$4,459.00	$20,943.00	$8,828.00	nat. median $1,659 outlier · 5.3×
J2997 HCPCS	Activase Tpa 100 Mg58 Mil Iu Vial	10	$231.00	$37,410.00	$8,709.00	nat. median $500 outlier · 17.4×
J2356 HCPCS	Tezspire 210mg Pfs 1.91ml	10	$6,241.00	$17,686.00	$8,234.50	nat. median $76 outlier · 108.7×
J2323 HCPCS	Tysabri Inj 300mg/15ml15ml Sdv	10	$6,087.00	$17,251.00	$8,031.50	nat. median $180 outlier · 44.7×
J1162 HCPCS	Digifab Inj 40 Mg	10	$5,958.00	$16,885.00	$7,861.50	nat. median $7,165 1.1× median
J9271 HCPCS	Keytruda 100mg/4ml Sdv	10	$4,301.00	$12,188.00	$5,674.50	nat. median $275 outlier · 20.7×
J2357 HCPCS	Omalizumab (Xolair) 300 Mg/2ml Pfs	10	$4,248.00	$12,039.00	$5,605.50	nat. median $1,249 outlier · 4.5×
J1602 HCPCS	Simponi 100 Mg Pfs 1ml Syr	10	$2,191.00	$14,153.00	$5,256.00	nat. median $261 outlier · 20.1×
800023 CDM	Oper Rm 300-315min	10	$3,729.00	$10,567.00	$4,920.00	nat. median $15 outlier · 334.7×
800012 CDM	Oper Rm 286-300min	10	$3,591.00	$10,177.00	$4,738.50	nat. median $129 outlier · 36.9×
800011 CDM	Oper Rm 271-285min	10	$3,457.00	$9,796.00	$4,560.50	nat. median $96 outlier · 47.4×
J9312 HCPCS	Rituxan 100mg/10ml Vl	10	$1,373.00	$13,980.00	$4,412.00	nat. median $1,063 outlier · 4.2×
800022 CDM	Oper Rm 256-270min	10	$3,321.00	$9,410.00	$4,381.50	nat. median $2 outlier · 2679.8×
J0840 HCPCS	Nf- Crofab Antivenin Inj 1 Gm	10	$3,265.00	$9,252.00	$4,307.50	nat. median $3,452 1.2× median
J1561 HCPCS	Gamunex-c 10% 10gm Vl 100ml	10	$1,500.00	$11,299.00	$4,300.50	nat. median $1,094 outlier · 3.9×
800010 CDM	Oper Rm 241-255min	10	$3,186.00	$9,028.00	$4,203.50	nat. median $70 outlier · 59.8×
J9202 HCPCS	Zoladex Implant 10.8 Mg (3 Mo. Implant)	10	$3,159.00	$8,951.00	$4,167.50	nat. median $1,833 outlier · 2.3×
800021 CDM	Oper Rm 226-240min	10	$3,048.00	$8,637.00	$4,021.00	nat. median $1
J3262 HCPCS	Tocilizumab (Actemra) 400mg/20ml	10	$3,044.00	$8,625.00	$4,016.00	nat. median $1,413 outlier · 2.8×
74178 CPT	CT Abdomen/pelvis W/wo	10	$2,940.00	$8,332.00	$3,879.00	nat. median $1,027 outlier · 3.8×
J7168 HCPCS	Kcentra 1096iu Vial	10	$2,938.00	$8,325.00	$3,876.00	nat. median $20 outlier · 190.6×
800020 CDM	Oper Rm 211-225min	10	$2,915.00	$8,260.00	$3,846.00	nat. median $6 outlier · 651.9×
73223 CPT	MRI Elbow W/wo Left	10	$2,162.00	$8,108.00	$3,719.00	nat. median $1,158 outlier · 3.2×
800019 CDM	Oper Rm 196-210min	10	$2,775.00	$7,864.00	$3,662.00	nat. median $76 outlier · 48.2×
73722 CPT	MRI Ankle W Left	10	$2,482.00	$7,744.00	$3,570.00	nat. median $1,282 outlier · 2.8×
800018 CDM	Oper Rm 181-195min	10	$2,640.00	$7,482.00	$3,483.50	nat. median $26 outlier · 135.9×
73220 CPT	MRI Forearm W/wo Left	10	$2,463.00	$7,514.00	$3,464.00	nat. median $1,136 outlier · 3.0×
73723 CPT	MRI Ankle W/wo Left	10	$2,040.00	$7,744.00	$3,463.50	nat. median $1,199 outlier · 2.9×
J0897 HCPCS	Prolia Inj Syr 60 Mg/ml	10	$2,336.00	$7,307.00	$3,369.00	nat. median $1,982 1.7× median
74177 CPT	CT Scan Of Abdomen And Pelvis With Contrast	10	$2,520.00	$7,140.00	$3,324.50	nat. median $976 outlier · 3.4×
78452 CPT	Nm Myocardial Spec Stress Test	10	$2,517.00	$7,133.00	$3,321.50	nat. median $1,822 1.8× median
J9035 HCPCS	Avastin Inj 100 Mg / 4ml Vl	10	$1,183.00	$9,254.00	$3,309.50	nat. median $727 outlier · 4.5×
800017 CDM	Oper Rm 166-180min	10	$2,503.00	$7,094.00	$3,302.50	nat. median $131 outlier · 25.2×
73720 CPT	MRI Femur W/wo Left	10	$2,025.00	$6,980.00	$3,202.00	nat. median $1,135 outlier · 2.8×
70553 CPT	MRI Scan	10	$2,391.00	$6,775.00	$3,154.50	nat. median $1,136 outlier · 2.8×
72156 CPT	MRI C Spine W/wo	10	$2,372.00	$6,721.00	$3,129.50	nat. median $1,110 outlier · 2.8×
72158 CPT	MRI L Spine W/wo	10	$2,372.00	$6,721.00	$3,129.50	nat. median $1,097 outlier · 2.9×
800016 CDM	Oper Rm 151-165min	10	$2,368.00	$6,709.00	$3,124.00	nat. median $35 outlier · 88.9×
J3032 HCPCS	Eptinezumab-jjmr (Vyepti) 100mg/ml	10	$2,360.00	$6,688.00	$3,114.00	nat. median $73 outlier · 42.9×
72157 CPT	MRI T Spine W/wo	10	$2,353.00	$6,668.00	$3,104.50	nat. median $1,114 outlier · 2.8×
59510 CPT	Obstetric Care, Planned Cesarean Delivery	10	$2,322.00	$6,579.00	$3,063.00	nat. median $3,631 0.8× median
75635 CPT	CT Angio Aorta W Runoff	10	$2,310.00	$6,545.00	$3,047.00	nat. median $727 outlier · 4.2×
800015 CDM	Oper Rm 136-150min	10	$2,233.00	$6,328.00	$2,946.50	nat. median $46 outlier · 64.4×
74183 CPT	MRI Abdomen W/wo	10	$2,233.00	$6,327.00	$2,945.50	nat. median $1,105 outlier · 2.7×

Other procedures at this hospital

Browse this hospital's 3,632 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

Q4205	HCPCS	Membrane Wrap 2 X 3	14	10	$27,816.00	$25,034.00	$13,908.00	$39,415.00	$18,351.50	2025-09-22
J3101	HCPCS	Tnkase Inj [50 Mg]	14	10	$20,671.00	$18,604.00	$10,336.00	$29,291.00	$13,638.00	2025-09-22
J9217	HCPCS	Eligard 22.5 Mg Inj Kit	28	10	$15,665.00	$14,098.50	$6,665.00	$25,506.00	$11,700.00	2025-09-22
J0517	HCPCS	Fasenra Pen Subq Soln 30mg/1ml	14	10	$14,192.00	$12,773.00	$7,096.00	$20,110.00	$9,363.00	2025-09-22
J2353	HCPCS	Sandostatin Syr [30mg] Kit	14	10	$13,860.00	$12,474.00	$6,930.00	$19,640.00	$9,144.00	2025-09-22
J3380	HCPCS	Entyvio 300mg 20ml Vl	14	10	$13,585.00	$12,227.00	$6,793.00	$19,250.00	$8,963.00	2025-09-22
J2506	HCPCS	Neulasta Onpro Kit 6mg/0.6ml	28	10	$11,848.50	$10,663.50	$4,459.00	$20,943.00	$8,828.00	2025-09-22
J2997	HCPCS	Activase Tpa 100 Mg58 Mil Iu Vial	42	10	$13,201.00	$11,881.00	$231.00	$37,410.00	$8,709.00	2025-09-22
J2356	HCPCS	Tezspire 210mg Pfs 1.91ml	14	10	$12,481.00	$11,233.00	$6,241.00	$17,686.00	$8,234.50	2025-09-22
J2323	HCPCS	Tysabri Inj 300mg/15ml15ml Sdv	14	10	$12,174.00	$10,957.00	$6,087.00	$17,251.00	$8,031.50	2025-09-22
J1162	HCPCS	Digifab Inj 40 Mg	14	10	$11,916.00	$10,724.00	$5,958.00	$16,885.00	$7,861.50	2025-09-22
J9271	HCPCS	Keytruda 100mg/4ml Sdv	14	10	$8,601.00	$7,741.00	$4,301.00	$12,188.00	$5,674.50	2025-09-22
J2357	HCPCS	Omalizumab (Xolair) 300 Mg/2ml Pfs	14	10	$8,496.00	$7,646.00	$4,248.00	$12,039.00	$5,605.50	2025-09-22
J1602	HCPCS	Simponi 100 Mg Pfs 1ml Syr	28	10	$7,184.50	$6,466.00	$2,191.00	$14,153.00	$5,256.00	2025-09-22
800023	CDM	Oper Rm 300-315min	14	10	$7,457.00	$6,711.00	$3,729.00	$10,567.00	$4,920.00	2025-09-22
800012	CDM	Oper Rm 286-300min	14	10	$7,182.00	$6,464.00	$3,591.00	$10,177.00	$4,738.50	2025-09-22
800011	CDM	Oper Rm 271-285min	14	10	$6,913.00	$6,222.00	$3,457.00	$9,796.00	$4,560.50	2025-09-22
J9312	HCPCS	Rituxan 100mg/10ml Vl	28	10	$6,306.00	$5,675.00	$1,373.00	$13,980.00	$4,412.00	2025-09-22
800022	CDM	Oper Rm 256-270min	14	10	$6,641.00	$5,977.00	$3,321.00	$9,410.00	$4,381.50	2025-09-22
J0840	HCPCS	Nf- Crofab Antivenin Inj 1 Gm	14	10	$6,529.00	$5,876.00	$3,265.00	$9,252.00	$4,307.50	2025-09-22
J1561	HCPCS	Gamunex-c 10% 10gm Vl 100ml	56	10	$6,250.00	$5,625.00	$1,500.00	$11,299.00	$4,300.50	2025-09-22
800010	CDM	Oper Rm 241-255min	14	10	$6,371.00	$5,734.00	$3,186.00	$9,028.00	$4,203.50	2025-09-22
J9202	HCPCS	Zoladex Implant 10.8 Mg (3 Mo. Implant)	14	10	$6,317.00	$5,685.00	$3,159.00	$8,951.00	$4,167.50	2025-09-22
800021	CDM	Oper Rm 226-240min	14	10	$6,095.00	$5,486.00	$3,048.00	$8,637.00	$4,021.00	2025-09-22
J3262	HCPCS	Tocilizumab (Actemra) 400mg/20ml	14	10	$6,087.00	$5,478.00	$3,044.00	$8,625.00	$4,016.00	2025-09-22
74178	CPT	CT Abdomen/pelvis W/wo	14	10	$5,880.00	$5,292.00	$2,940.00	$8,332.00	$3,879.00	2025-09-22
J7168	HCPCS	Kcentra 1096iu Vial	14	10	$5,875.00	$5,288.00	$2,938.00	$8,325.00	$3,876.00	2025-09-22
800020	CDM	Oper Rm 211-225min	14	10	$5,829.00	$5,246.00	$2,915.00	$8,260.00	$3,846.00	2025-09-22
73223	CPT	MRI Elbow W/wo Left	28	10	$5,023.00	$4,521.00	$2,162.00	$8,108.00	$3,719.00	2025-09-22
800019	CDM	Oper Rm 196-210min	14	10	$5,550.00	$4,995.00	$2,775.00	$7,864.00	$3,662.00	2025-09-22
73722	CPT	MRI Ankle W Left	28	10	$5,214.50	$4,693.50	$2,482.00	$7,744.00	$3,570.00	2025-09-22
800018	CDM	Oper Rm 181-195min	14	10	$5,280.00	$4,752.00	$2,640.00	$7,482.00	$3,483.50	2025-09-22
73220	CPT	MRI Forearm W/wo Left	28	10	$5,114.50	$4,603.00	$2,463.00	$7,514.00	$3,464.00	2025-09-22
73723	CPT	MRI Ankle W/wo Left	42	10	$4,964.00	$4,468.00	$2,040.00	$7,744.00	$3,463.50	2025-09-22
J0897	HCPCS	Prolia Inj Syr 60 Mg/ml	28	10	$4,914.50	$4,423.00	$2,336.00	$7,307.00	$3,369.00	2025-09-22
74177	CPT	CT Scan Of Abdomen And Pelvis With Contrast	14	10	$5,039.00	$4,535.00	$2,520.00	$7,140.00	$3,324.50	2025-09-22
78452	CPT	Nm Myocardial Spec Stress Test	14	10	$5,034.00	$4,531.00	$2,517.00	$7,133.00	$3,321.50	2025-09-22
J9035	HCPCS	Avastin Inj 100 Mg / 4ml Vl	28	10	$4,448.50	$4,003.50	$1,183.00	$9,254.00	$3,309.50	2025-09-22
800017	CDM	Oper Rm 166-180min	14	10	$5,006.00	$4,505.00	$2,503.00	$7,094.00	$3,302.50	2025-09-22
73720	CPT	MRI Femur W/wo Left	28	10	$4,487.50	$4,038.50	$2,025.00	$6,980.00	$3,202.00	2025-09-22
70553	CPT	MRI Scan	14	10	$4,781.00	$4,303.00	$2,391.00	$6,775.00	$3,154.50	2025-09-22
72158	CPT	MRI L Spine W/wo	14	10	$4,743.00	$4,269.00	$2,372.00	$6,721.00	$3,129.50	2025-09-22
72156	CPT	MRI C Spine W/wo	14	10	$4,743.00	$4,269.00	$2,372.00	$6,721.00	$3,129.50	2025-09-22
800016	CDM	Oper Rm 151-165min	14	10	$4,735.00	$4,262.00	$2,368.00	$6,709.00	$3,124.00	2025-09-22
J3032	HCPCS	Eptinezumab-jjmr (Vyepti) 100mg/ml	14	10	$4,720.00	$4,248.00	$2,360.00	$6,688.00	$3,114.00	2025-09-22
72157	CPT	MRI T Spine W/wo	14	10	$4,706.00	$4,235.00	$2,353.00	$6,668.00	$3,104.50	2025-09-22
59510	CPT	Obstetric Care, Planned Cesarean Delivery	14	10	$4,643.00	$4,179.00	$2,322.00	$6,579.00	$3,063.00	2025-09-22
75635	CPT	CT Angio Aorta W Runoff	14	10	$4,619.00	$4,157.00	$2,310.00	$6,545.00	$3,047.00	2025-09-22
800015	CDM	Oper Rm 136-150min	14	10	$4,466.00	$4,019.00	$2,233.00	$6,328.00	$2,946.50	2025-09-22
74183	CPT	MRI Abdomen W/wo	14	10	$4,465.00	$4,019.00	$2,233.00	$6,327.00	$2,945.50	2025-09-22
29826	CPT	Shaving Of Shoulder Bone Using Endoscope	14	10	$4,381.00	$3,943.00	$2,191.00	$6,208.00	$2,890.50	2025-09-22
29881	CPT	Removal Of One Knee Cartilage Using An Endoscope	14	10	$4,381.00	$3,943.00	$2,191.00	$6,208.00	$2,890.50	2025-09-22
72197	CPT	MRI Pelvis W/wo	14	10	$4,324.00	$3,892.00	$2,162.00	$6,127.00	$2,853.00	2025-09-22
71552	CPT	MRI-chest-w & Without Cont	14	10	$4,324.00	$3,892.00	$2,162.00	$6,127.00	$2,853.00	2025-09-22
70543	CPT	MRI Orbit/face/neck W/wo	14	10	$4,324.00	$3,892.00	$2,162.00	$6,127.00	$2,853.00	2025-09-22
70549	CPT	Mr Angio Neck W/wo	14	10	$4,249.00	$3,824.00	$2,125.00	$6,021.00	$2,803.00	2025-09-22
70548	CPT	Mr Angio Neck W	14	10	$4,210.00	$3,789.00	$2,105.00	$5,966.00	$2,777.50	2025-09-22
800014	CDM	Oper Rm 121-135min	14	10	$4,195.00	$3,776.00	$2,098.00	$5,944.00	$2,767.50	2025-09-22
72142	CPT	MRI C Spine W	14	10	$4,156.00	$3,740.00	$2,078.00	$5,889.00	$2,741.50	2025-09-22
73222	CPT	MRI Elbow W Left	42	10	$4,059.00	$3,653.00	$1,811.00	$5,923.00	$2,716.50	2025-09-22
72147	CPT	MRI T Spine W	14	10	$4,106.00	$3,695.00	$2,053.00	$5,818.00	$2,709.00	2025-09-22
74176	CPT	CT Abdomen/pelvis Wo	14	10	$4,104.00	$3,694.00	$2,052.00	$5,815.00	$2,707.50	2025-09-22
72148	CPT	MRI Scan Of Lower Spinal Canal	14	10	$4,079.00	$3,671.00	$2,040.00	$5,780.00	$2,691.00	2025-09-22
59400	CPT	Obstetric Care, Planned Vaginal Delivery	14	10	$4,079.00	$3,671.00	$2,040.00	$5,780.00	$2,691.00	2025-09-22
73219	CPT	MRI Forearm W Left	28	10	$4,061.00	$3,655.00	$2,025.00	$5,771.00	$2,679.00	2025-09-22
70552	CPT	MRI Brain W	14	10	$4,049.00	$3,644.00	$2,025.00	$5,737.00	$2,671.00	2025-09-22
73719	CPT	MRI Femur W Left	28	10	$3,847.00	$3,462.50	$1,811.00	$5,771.00	$2,660.50	2025-09-22
72141	CPT	MRI C Spine Wo	14	10	$3,957.00	$3,561.00	$1,979.00	$5,607.00	$2,610.50	2025-09-22
800013	CDM	Oper Rm 106-120min	14	10	$3,921.00	$3,529.00	$1,961.00	$5,556.00	$2,587.00	2025-09-22
72198	CPT	Mr Angio Pelvis W/wo	14	10	$3,901.00	$3,511.00	$1,951.00	$5,528.00	$2,573.50	2025-09-22
74185	CPT	Mr Angio Abdomen W/wo	14	10	$3,901.00	$3,511.00	$1,951.00	$5,528.00	$2,573.50	2025-09-22
70498	CPT	CT Angio Neck	14	10	$3,894.00	$3,505.00	$1,947.00	$5,518.00	$2,569.00	2025-09-22
47562	CPT	Removal Of Gallbladder Using An Endoscope	28	10	$3,706.00	$3,335.50	$1,754.00	$5,532.00	$2,550.50	2025-09-22
70542	CPT	MRI Orbit/face/neck W	14	10	$3,857.00	$3,471.00	$1,929.00	$5,465.00	$2,544.50	2025-09-22
72146	CPT	MRI T Spine Wo	14	10	$3,857.00	$3,471.00	$1,929.00	$5,465.00	$2,544.50	2025-09-22
72149	CPT	MRI L Spine W	14	10	$3,830.00	$3,447.00	$1,915.00	$5,427.00	$2,526.50	2025-09-22
70551	CPT	MRI Brain Wo	14	10	$3,814.00	$3,433.00	$1,907.00	$5,404.00	$2,516.50	2025-09-22
74182	CPT	MRI Abdomen W	28	10	$3,477.50	$3,129.50	$1,550.00	$5,464.00	$2,506.00	2025-09-22
95811	CPT	Dia Polysonogram 11	14	10	$3,791.00	$3,412.00	$1,896.00	$5,372.00	$2,501.00	2025-09-22
71275	CPT	CT Angio Chest W	14	10	$3,765.00	$3,389.00	$1,883.00	$5,335.00	$2,484.00	2025-09-22
73225	CPT	MRI Up Extrem W Or Without	14	10	$3,758.00	$3,382.00	$1,879.00	$5,325.00	$2,479.50	2025-09-22
70544	CPT	Mr Angio Brain	14	10	$3,753.00	$3,378.00	$1,877.00	$5,318.00	$2,476.00	2025-09-22
74174	CPT	CT Angio Abdomen/pelvis	14	10	$3,751.00	$3,376.00	$1,876.00	$5,315.00	$2,475.00	2025-09-22
73718	CPT	MRI Femur Wo Left	28	10	$3,448.50	$3,104.00	$1,587.00	$5,277.00	$2,421.00	2025-09-22
74175	CPT	CT Angio Abd Aorta	14	10	$3,670.00	$3,303.00	$1,835.00	$5,200.00	$2,421.00	2025-09-22
73218	CPT	MRI Forearm Wo Left	42	10	$3,615.00	$3,254.00	$1,587.00	$5,277.00	$2,409.00	2025-09-22
1100025	CDM	Procedure Colonoscopy/egd	14	10	$3,650.00	$3,285.00	$1,825.00	$5,172.00	$2,408.00	2025-09-22
800009	CDM	Oper Rm 91-105min	14	10	$3,649.00	$3,284.00	$1,825.00	$5,171.00	$2,407.50	2025-09-22
70547	CPT	Mr Angio Neck Wo	14	10	$3,647.00	$3,282.00	$1,824.00	$5,168.00	$2,406.00	2025-09-22
72196	CPT	MRI Pelvis W	14	10	$3,621.00	$3,259.00	$1,811.00	$5,131.00	$2,389.00	2025-09-22
74181	CPT	MRI Abdomen Wo	14	10	$3,621.00	$3,259.00	$1,811.00	$5,131.00	$2,389.00	2025-09-22
71550	CPT	MRI Chest Without Contrast	14	10	$3,621.00	$3,259.00	$1,811.00	$5,131.00	$2,389.00	2025-09-22
75557	CPT	MRI Myocardium Wo Contrast	14	10	$3,621.00	$3,259.00	$1,811.00	$5,131.00	$2,389.00	2025-09-22
71551	CPT	MRI-chest-with Contrast	14	10	$3,621.00	$3,259.00	$1,811.00	$5,131.00	$2,389.00	2025-09-22
71555	CPT	MRI Chest Wo/w Contrast	14	10	$3,618.00	$3,256.00	$1,809.00	$5,127.00	$2,387.00	2025-09-22
70540	CPT	MRI Orbit/face/neck Wo	14	10	$3,618.00	$3,256.00	$1,809.00	$5,127.00	$2,387.00	2025-09-22
95810	CPT	Sleep Study	14	10	$3,611.00	$3,250.00	$1,806.00	$5,117.00	$2,382.50	2025-09-22
70496	CPT	CT Angio Head	14	10	$3,468.00	$3,121.00	$1,734.00	$4,914.00	$2,288.00	2025-09-22
73721	CPT	MRI Scan Of Leg Joint	28	10	$3,332.50	$2,999.50	$1,587.00	$4,948.00	$2,281.00	2025-09-22
73221	CPT	MRI Elbow Wo Left	56	10	$3,415.00	$3,073.50	$1,587.00	$4,948.00	$2,270.00	2025-09-22
71270	CPT	CT Chest W/wo	14	10	$3,433.00	$3,090.00	$1,717.00	$4,865.00	$2,265.00	2025-09-22
64493	CPT	Oper Rm 76-90min	14	10	$3,371.00	$3,034.00	$1,686.00	$4,777.00	$2,224.00	2025-09-22
Q5118	HCPCS	Zirabev 100mg Sdv 4ml	28	10	$3,205.00	$2,884.50	$663.00	$7,204.00	$2,210.50	2025-09-22
72195	CPT	MRI Pelvis Wo	14	10	$3,294.00	$2,965.00	$1,647.00	$4,668.00	$2,173.50	2025-09-22
74170	CPT	CT Abdomen W/wo	14	10	$3,271.00	$2,944.00	$1,636.00	$4,635.00	$2,158.00	2025-09-22
72132	CPT	CT L Spine W	14	10	$3,253.00	$2,928.00	$1,627.00	$4,610.00	$2,146.50	2025-09-22
72194	CPT	CT Pelvis W/wo	14	10	$3,196.00	$2,876.00	$1,598.00	$4,529.00	$2,108.50	2025-09-22
9901895	CDM	Ventralex Hernia Patch Circle Lg	14	10	$3,174.00	$2,857.00	$1,587.00	$4,498.00	$2,094.00	2025-09-22
J0841	HCPCS	Crotalidae Immune F(ab')2 (Equine)	14	10	$3,168.00	$2,851.00	$1,584.00	$4,489.00	$2,090.00	2025-09-22
45380	CPT	Biopsy Exam Of Large Bowel Using An Endoscope	28	10	$3,011.00	$2,710.00	$1,425.00	$4,495.00	$2,072.00	2025-09-22
800007	CDM	Oper Rm 61-75min	14	10	$3,052.00	$2,747.00	$1,526.00	$4,325.00	$2,013.50	2025-09-22
71260	CPT	CT Chest W	14	10	$3,045.00	$2,741.00	$1,523.00	$4,315.00	$2,009.00	2025-09-22
9901950	CDM	Tkl Spdbrg Imp Sys W/bs Swvlk &Ndl	14	10	$3,010.00	$2,709.00	$1,505.00	$4,265.00	$1,986.00	2025-09-22
70492	CPT	CT Soft Tissue Neck W/wo	14	10	$2,992.00	$2,693.00	$1,496.00	$4,240.00	$1,974.00	2025-09-22
1100018	CDM	Procedure Gastroscopy	14	10	$2,976.00	$2,678.00	$1,488.00	$4,217.00	$1,963.50	2025-09-22
74160	CPT	CT Abdomen W	14	10	$2,972.00	$2,675.00	$1,486.00	$4,211.00	$1,960.50	2025-09-22
J1439	HCPCS	Injectafer 750mg/100ml	28	10	$2,768.00	$2,491.50	$1,272.00	$4,240.00	$1,945.00	2025-09-22
70336	CPT	MRI Tempromandibular Joint	14	10	$2,927.00	$2,634.00	$1,464.00	$4,148.00	$1,931.50	2025-09-22
70482	CPT	CT Orbit Iac W/wo	14	10	$2,915.00	$2,624.00	$1,458.00	$4,131.00	$1,923.50	2025-09-22
73702	CPT	CT Lower Extrem W/wo Left	14	10	$2,915.00	$2,624.00	$1,458.00	$4,131.00	$1,923.50	2025-09-22
70470	CPT	CT Head W/wo	14	10	$2,892.00	$2,603.00	$1,446.00	$4,098.00	$1,908.00	2025-09-22
J9395	HCPCS	Faslodex 250mg/5ml Syr	14	10	$2,891.00	$2,602.00	$1,446.00	$4,097.00	$1,907.50	2025-09-22
72130	CPT	CT T Spine W/wo	14	10	$2,877.00	$2,589.00	$1,439.00	$4,077.00	$1,898.00	2025-09-22
49654	CPT	Laparoscopy/rpr Hernia	14	10	$2,871.00	$2,584.00	$1,436.00	$4,068.00	$1,894.00	2025-09-22
9901894	CDM	Ventralex Hernia Patch Circle Med	14	10	$2,853.00	$2,568.00	$1,427.00	$4,043.00	$1,882.50	2025-09-22
70481	CPT	CT Orbit Iac W	14	10	$2,843.00	$2,559.00	$1,422.00	$4,029.00	$1,875.50	2025-09-22
70488	CPT	CT Facial Bone/sinuses W/wo	14	10	$2,843.00	$2,559.00	$1,422.00	$4,029.00	$1,875.50	2025-09-22
72193	CPT	CT Scan Of Pelvis With Contrast	14	10	$2,823.00	$2,541.00	$1,412.00	$4,000.00	$1,862.50	2025-09-22
1000025	CDM	Procedure Colon/gastro	14	10	$2,808.00	$2,527.00	$1,404.00	$3,979.00	$1,852.50	2025-09-22
72125	CPT	CT C Spine Wo	14	10	$2,803.00	$2,523.00	$1,402.00	$3,972.00	$1,849.00	2025-09-22
1100017	CDM	Procedure Rm Colonscopy	14	10	$2,801.00	$2,521.00	$1,401.00	$3,969.00	$1,848.00	2025-09-22
70460	CPT	CT Head W	14	10	$2,787.00	$2,508.00	$1,394.00	$3,949.00	$1,839.00	2025-09-22
73202	CPT	CT Upper Extrem W/wo Left	14	10	$2,766.00	$2,489.00	$1,383.00	$3,919.00	$1,825.00	2025-09-22
72129	CPT	CT T Spine W	14	10	$2,765.00	$2,489.00	$1,383.00	$3,918.00	$1,824.00	2025-09-22
72127	CPT	CT C Spine W/wo	14	10	$2,765.00	$2,489.00	$1,383.00	$3,918.00	$1,824.00	2025-09-22
72133	CPT	CT L Spine W/wo	14	10	$2,765.00	$2,489.00	$1,383.00	$3,918.00	$1,824.00	2025-09-22
73706	CPT	CT Angio Lower Extremity	14	10	$2,756.00	$2,480.00	$1,378.00	$3,905.00	$1,818.00	2025-09-22
9901971	CDM	Biocomposite Meniscal Root Repair Kit	14	10	$2,720.00	$2,448.00	$1,360.00	$3,854.00	$1,794.50	2025-09-22
77059	CPT	MRI Breast Bil W &Or Wo	14	10	$2,715.00	$2,444.00	$1,358.00	$3,847.00	$1,791.00	2025-09-22
72126	CPT	CT C Spine W	14	10	$2,694.00	$2,425.00	$1,347.00	$3,817.00	$1,777.50	2025-09-22
9901893	CDM	Ventralex Hernia Patch Circle Small	14	10	$2,683.00	$2,415.00	$1,342.00	$3,802.00	$1,770.00	2025-09-22
800006	CDM	Oper Rm 46-60min	14	10	$2,669.00	$2,402.00	$1,335.00	$3,782.00	$1,761.00	2025-09-22
72128	CPT	CT T Spine Wo	14	10	$2,623.00	$2,361.00	$1,312.00	$3,717.00	$1,730.50	2025-09-22
70491	CPT	CT Soft Tissue Neck W	14	10	$2,619.00	$2,357.00	$1,310.00	$3,711.00	$1,727.50	2025-09-22
J0585	HCPCS	Botox Inj 100 U/vl	28	10	$2,445.00	$2,200.50	$815.00	$4,619.00	$1,715.50	2025-09-22
70487	CPT	CT Facial Bone/sinuses W	14	10	$2,578.00	$2,320.00	$1,289.00	$3,653.00	$1,700.50	2025-09-22
72131	CPT	CT L Spine Wo	14	10	$2,572.00	$2,315.00	$1,286.00	$3,645.00	$1,697.00	2025-09-22
73725	CPT	MRI Lw Extremity W Or Without	14	10	$2,572.00	$2,315.00	$1,286.00	$3,645.00	$1,697.00	2025-09-22
71250	CPT	CT Chest Wo	14	10	$2,554.00	$2,299.00	$1,277.00	$3,619.00	$1,685.00	2025-09-22
72192	CPT	CT Pelvis Wo	14	10	$2,541.00	$2,287.00	$1,271.00	$3,601.00	$1,676.50	2025-09-22
74150	CPT	CT Abdomen Wo	14	10	$2,480.00	$2,232.00	$1,240.00	$3,514.00	$1,636.00	2025-09-22
77058	CPT	MRI Breast Unil W &/Or Wo	14	10	$2,449.00	$2,204.00	$1,225.00	$3,470.00	$1,616.00	2025-09-22
9908037	CDM	Txb Procdure Pack	14	10	$2,448.00	$2,203.00	$1,224.00	$3,469.00	$1,615.00	2025-09-22
70480	CPT	CT Orbit Iac Wo	14	10	$2,443.00	$2,199.00	$1,222.00	$3,462.00	$1,612.00	2025-09-22
G0390	HCPCS	ER Dept Full Act Trauma	28	10	$2,118.00	$1,906.00	$804.00	$3,724.00	$1,592.00	2025-09-22
78315	CPT	Nm Bone Scan/3 Phs Tech	14	10	$2,399.00	$2,159.00	$1,200.00	$3,399.00	$1,583.00	2025-09-22
90378	CPT	Synagis 100mg	28	10	$2,169.00	$1,952.50	$758.00	$4,000.00	$1,537.50	2025-09-22
73701	CPT	CT Lower Extrem W Left	14	10	$2,322.00	$2,090.00	$1,161.00	$3,290.00	$1,531.50	2025-09-22
70450	CPT	CT Scan	14	10	$2,320.00	$2,088.00	$1,160.00	$3,287.00	$1,530.50	2025-09-22
73201	CPT	CT Upper Extremity W Left	14	10	$2,320.00	$2,088.00	$1,160.00	$3,287.00	$1,530.50	2025-09-22
J9055	HCPCS	Cetuximab Inj 100 Mg/50ml	28	10	$2,097.50	$1,888.00	$648.00	$4,109.00	$1,526.00	2025-09-22
800005	CDM	Oper Rm 31-45min	14	10	$2,230.00	$2,007.00	$1,115.00	$3,160.00	$1,471.00	2025-09-22
73200	CPT	CT Upper Extrem Wo Left	14	10	$2,221.00	$1,999.00	$1,111.00	$3,147.00	$1,465.50	2025-09-22
J9000	HCPCS	Doxorubicin Hcl 50mg Sdv 25ml	14	10	$2,208.00	$1,987.00	$1,104.00	$3,129.00	$1,457.00	2025-09-22
70490	CPT	CT Soft Tissue Neck Wo	14	10	$2,165.00	$1,949.00	$1,083.00	$3,068.00	$1,428.00	2025-09-22
J1572	HCPCS	Flebogamma Dif 10% 10gm/100ml Vl	28	10	$1,996.50	$1,797.00	$697.00	$3,683.00	$1,415.00	2025-09-22
78803	CPT	Nm Bone Spect	14	10	$2,113.00	$1,902.00	$1,057.00	$2,994.00	$1,394.00	2025-09-22
78306	CPT	Nm Bone Scan Whole Body	14	10	$2,082.00	$1,874.00	$1,041.00	$2,950.00	$1,373.50	2025-09-22
70486	CPT	CT Facial Bone/sinuses Wo	14	10	$2,080.00	$1,872.00	$1,040.00	$2,947.00	$1,372.50	2025-09-22
78264	CPT	Nm Gastric Emptying Study	14	10	$2,057.00	$1,851.00	$1,029.00	$2,915.00	$1,357.00	2025-09-22
1000018	CDM	Procedure Gastroscopy	14	10	$2,036.00	$1,832.00	$1,018.00	$2,885.00	$1,343.50	2025-09-22
1000017	CDM	Procedure Colonscopy	14	10	$2,036.00	$1,832.00	$1,018.00	$2,885.00	$1,343.50	2025-09-22
J7325	HCPCS	Cl Synvisc One 48 Mg/6ml	28	10	$1,780.50	$1,602.50	$757.00	$2,901.00	$1,331.00	2025-09-22
78227	CPT	Nm Hida Hepato W/cck	14	10	$2,016.00	$1,814.00	$1,008.00	$2,857.00	$1,330.50	2025-09-22
78226	CPT	Nm Hida Hepato Wo Cck	14	10	$2,016.00	$1,814.00	$1,008.00	$2,857.00	$1,330.50	2025-09-22
1100007	CDM	Cystoscope Procedure	14	10	$2,009.00	$1,808.00	$1,005.00	$2,847.00	$1,325.50	2025-09-22
13160	CPT	Delayed Closure Of Surg Wound	14	10	$1,983.00	$1,785.00	$992.00	$2,810.00	$1,308.50	2025-09-22
49505	CPT	Repair Of Groin Hernia Patient Age 5 Years Or Older	28	10	$1,895.50	$1,706.00	$897.00	$2,830.00	$1,304.50	2025-09-22
27301	CPT	I & D Abscess Thigh/knee	14	10	$1,922.00	$1,730.00	$961.00	$2,723.00	$1,268.00	2025-09-22
59514	CPT	Cesarean Delivery Only	14	10	$1,913.00	$1,722.00	$957.00	$2,711.00	$1,262.00	2025-09-22
11005	CPT	Debridement Inf Skin Abd Wall	14	10	$1,906.00	$1,715.00	$953.00	$2,701.00	$1,257.50	2025-09-22
45385	CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope	28	10	$1,808.50	$1,628.00	$856.00	$2,699.00	$1,244.50	2025-09-22
900003	CDM	Anes Supplies 6hr	14	10	$1,873.00	$1,686.00	$937.00	$2,654.00	$1,236.00	2025-09-22
9900370	CDM	Thompson Hip 45	14	10	$1,869.00	$1,682.00	$935.00	$2,648.00	$1,233.00	2025-09-22
78451	CPT	Nm Myocard Spec-sng Study	14	10	$1,862.00	$1,676.00	$931.00	$2,638.00	$1,228.50	2025-09-22
81228	CPT	Hereditary Colon Cancer Cgh Array Gene	14	10	$1,862.00	$1,676.00	$931.00	$2,638.00	$1,228.50	2025-09-22
9900324	CDM	Pins Thompson	14	10	$1,861.00	$1,675.00	$931.00	$2,637.00	$1,228.00	2025-09-22
9900467	CDM	Rf 2 Probes Hook	14	10	$1,853.00	$1,668.00	$927.00	$2,626.00	$1,222.50	2025-09-22
27236	CPT	Open Tx Of Femoral Fx	14	10	$1,845.00	$1,661.00	$923.00	$2,614.00	$1,217.00	2025-09-22
9901567	CDM	Low Profile Port	14	10	$1,845.00	$1,661.00	$923.00	$2,614.00	$1,217.00	2025-09-22
73700	CPT	CT Lower Extrem Wo Left	14	10	$1,839.00	$1,655.00	$920.00	$2,606.00	$1,213.00	2025-09-22
J3487	HCPCS	Zometa Inj [4mg/5ml]	14	10	$1,828.00	$1,645.00	$914.00	$2,590.00	$1,206.00	2025-09-22
59410	CPT	Vaginal Delivery W/post Care	14	10	$1,801.00	$1,621.00	$901.00	$2,552.00	$1,188.00	2025-09-22
78709	CPT	Nm Kidney Img/multi Stud	14	10	$1,798.00	$1,618.00	$899.00	$2,548.00	$1,186.00	2025-09-22
9901198	CDM	Arthroscope Surg Sys	14	10	$1,790.00	$1,611.00	$895.00	$2,536.00	$1,181.00	2025-09-22
59426	CPT	Antepartm Care Only	28	10	$1,615.50	$1,454.00	$711.00	$2,565.00	$1,177.00	2025-09-22
78708	CPT	Nm Kidney Func Flo/mag3	28	10	$1,750.00	$1,575.00	$851.00	$2,548.00	$1,174.50	2025-09-22
78582	CPT	Nm Ventil & Perfus-lung	14	10	$1,775.00	$1,598.00	$888.00	$2,515.00	$1,171.00	2025-09-22
76811	CPT	US OB Rare Complex	14	10	$1,758.00	$1,582.00	$879.00	$2,491.00	$1,160.00	2025-09-22
800004	CDM	Oper Rm 16-30min	14	10	$1,745.00	$1,571.00	$873.00	$2,473.00	$1,151.50	2025-09-22
1000015	CDM	Procedure Cystoscope	14	10	$1,739.00	$1,565.00	$870.00	$2,464.00	$1,147.50	2025-09-22
36430	CPT	Bl Admin 1hr	84	10	$1,611.50	$1,450.00	$558.00	$3,177.00	$1,134.00	2025-09-22
1405056	CDM	Remdesivir / Ns Ivpb: 200mg/250ml	14	10	$1,716.00	$1,544.00	$858.00	$2,432.00	$1,132.50	2025-09-22
J3304	HCPCS	Zilretta 32mg Vial	14	10	$1,713.00	$1,542.00	$857.00	$2,427.00	$1,130.50	2025-09-22
93880	CPT	US Carotid Duplex Bil	28	10	$1,690.00	$1,521.00	$829.00	$2,441.00	$1,125.50	2025-09-22
9900369	CDM	Lap-chole Scope	14	10	$1,700.00	$1,530.00	$850.00	$2,409.00	$1,121.50	2025-09-22
9900232	CDM	Power Port	14	10	$1,699.00	$1,529.00	$850.00	$2,407.00	$1,120.50	2025-09-22
J0248	HCPCS	Remdesivir 100mg/20ml Vl	28	10	$1,607.50	$1,446.50	$750.00	$2,432.00	$1,119.50	2025-09-22
11772	CPT	Pilonidal Cystectomy Complicated	28	10	$1,605.00	$1,445.00	$763.00	$2,388.00	$1,100.50	2025-09-22
78707	CPT	Nm Kidney Imaging Func	14	10	$1,632.00	$1,469.00	$816.00	$2,313.00	$1,076.50	2025-09-22
78305	CPT	Nm Bone/joint Mult Area	14	10	$1,621.00	$1,459.00	$811.00	$2,297.00	$1,069.50	2025-09-22
14020	CPT	Adjacent Tissue Trnsf Or Rearran/scalp	14	10	$1,620.00	$1,458.00	$810.00	$2,296.00	$1,069.00	2025-09-22
J0588	HCPCS	Incobotulinumtoxin A (Xeomin)100u/vl	14	10	$1,615.00	$1,454.00	$808.00	$2,288.00	$1,065.50	2025-09-22
93930	CPT	US Arterial Duplex Arms Bilat	14	10	$1,605.00	$1,445.00	$803.00	$2,274.00	$1,059.00	2025-09-22
93970	CPT	US Venous Duplex Bilat Legs	14	10	$1,605.00	$1,445.00	$803.00	$2,274.00	$1,059.00	2025-09-22
800002	CDM	Or Epidural Procedure W/guide	14	10	$1,604.00	$1,444.00	$802.00	$2,273.00	$1,058.00	2025-09-22
800024	CDM	Or Procedure W Guide	14	10	$1,604.00	$1,444.00	$802.00	$2,273.00	$1,058.00	2025-09-22
100004	CDM	Advanced Care Acute	14	10	$1,600.00	$1,440.00	$800.00	$2,267.00	$1,055.50	2025-09-22
59409	CPT	Vaginal Delivery Only	14	10	$1,593.00	$1,434.00	$797.00	$2,257.00	$1,051.00	2025-09-22
93925	CPT	US Arterial Duplex Legs Bilat	28	10	$1,574.00	$1,417.00	$772.00	$2,274.00	$1,048.50	2025-09-22
J9330	HCPCS	Temsirolimus 25mg/ml	14	10	$1,584.00	$1,426.00	$792.00	$2,245.00	$1,045.00	2025-09-22
900024	CDM	Anesthesia Supplies 5hrs	14	10	$1,580.00	$1,422.00	$790.00	$2,239.00	$1,042.50	2025-09-22
78278	CPT	Nm G.i. Bleed	14	10	$1,575.00	$1,418.00	$788.00	$2,232.00	$1,039.00	2025-09-22
900029	CDM	Or Procedure W/guide	14	10	$1,542.00	$1,388.00	$771.00	$2,185.00	$1,017.00	2025-09-22
99291	CPT	Critical Care 30-74 Min	56	10	$1,399.00	$1,259.00	$221.00	$3,066.00	$1,016.50	2025-09-22
78070	CPT	Nm Parathyroid Scan	14	10	$1,529.00	$1,376.00	$765.00	$2,167.00	$1,009.00	2025-09-22
78580	CPT	Nm Pulmonary Perfusion	14	10	$1,528.00	$1,375.00	$764.00	$2,165.00	$1,008.00	2025-09-22
900012	CDM	Anes Supplies 43/4hr	14	10	$1,513.00	$1,362.00	$757.00	$2,144.00	$998.00	2025-09-22
25028	CPT	I & D Deep Abcess Forearm/wrist	14	10	$1,505.00	$1,355.00	$753.00	$2,133.00	$993.00	2025-09-22
78290	CPT	Nm Bowel Imaging Meckels	14	10	$1,504.00	$1,354.00	$752.00	$2,131.00	$992.00	2025-09-22
93350	CPT	Stress Echo	14	10	$1,504.00	$1,354.00	$752.00	$2,131.00	$992.00	2025-09-22
93975	CPT	US Renal Artery Duplex Complete	28	10	$1,483.00	$1,335.00	$727.00	$2,143.00	$988.00	2025-09-22
J9155	HCPCS	Firmagon 80 Mg Kit	14	10	$1,496.00	$1,346.00	$748.00	$2,120.00	$987.00	2025-09-22
11012	CPT	Debridement Open Fracture	14	10	$1,476.00	$1,328.00	$738.00	$2,091.00	$974.00	2025-09-22
9901010	CDM	Lg Mesh Perfix Plug	14	10	$1,469.00	$1,322.00	$735.00	$2,082.00	$969.00	2025-09-22
9901512	CDM	Kit Stabil Shld	14	10	$1,466.00	$1,319.00	$733.00	$2,077.00	$967.00	2025-09-22
Q5103	HCPCS	Inflectra 100mg Vl	14	10	$1,455.00	$1,310.00	$728.00	$2,062.00	$960.00	2025-09-22
9901009	CDM	Med Mesh Perfix Plug	14	10	$1,455.00	$1,310.00	$728.00	$2,062.00	$960.00	2025-09-22
J7307	HCPCS	Cl Nexplanon	14	10	$1,444.00	$1,300.00	$722.00	$2,046.00	$952.50	2025-09-22
900011	CDM	Anes Supplies 41/2hr	14	10	$1,441.00	$1,297.00	$721.00	$2,042.00	$950.50	2025-09-22
11004	CPT	Debridement Ext Genitalia & Peri	14	10	$1,430.00	$1,287.00	$715.00	$2,026.00	$943.50	2025-09-22
20103	CPT	Wound Exploration Extermity	14	10	$1,425.00	$1,283.00	$713.00	$2,019.00	$940.50	2025-09-22
9901530	CDM	Artho Intermediary Tubing	14	10	$1,421.00	$1,279.00	$711.00	$2,014.00	$937.50	2025-09-22
93306	CPT	Echo 2d Complete	14	10	$1,371.00	$1,234.00	$686.00	$1,943.00	$904.50	2025-09-22
900010	CDM	Anes Supplies 41/4hr	14	10	$1,369.00	$1,232.00	$685.00	$1,940.00	$903.50	2025-09-22
15050	CPT	Pinch Graft > 2cm	14	10	$1,325.00	$1,193.00	$663.00	$1,878.00	$874.00	2025-09-22
77001	CPT	US Imaging Guidance	28	10	$1,226.00	$1,103.50	$439.00	$2,232.00	$873.50	2025-09-22
81405	CPT	Tp53 (Tumor Protein 53) Gene	14	10	$1,319.00	$1,187.00	$660.00	$1,869.00	$870.00	2025-09-22
74400	CPT	Xr Ivp Bolis/drip Radiology	14	10	$1,314.00	$1,183.00	$657.00	$1,862.00	$867.00	2025-09-22
Q5101	HCPCS	Zarixo 400mcg 0.8ml	14	10	$1,312.00	$1,181.00	$656.00	$1,859.00	$865.50	2025-09-22
78300	CPT	Nm Bone Joint Img Limt	14	10	$1,305.00	$1,175.00	$653.00	$1,849.00	$861.00	2025-09-22
900002	CDM	Anes Supplies 4hr	14	10	$1,298.00	$1,168.00	$649.00	$1,839.00	$856.50	2025-09-22
G0378	HCPCS	Observation 13-24 Hr Ea	834	10	$1,126.00	$1,013.00	$14.00	$3,534.00	$846.50	2025-09-22
49421	CPT	Insert Permanent Catheter	14	10	$1,276.00	$1,148.00	$638.00	$1,808.00	$842.00	2025-09-22
45378	CPT	Diagnostic Exam Of Large Bowel Using An Endoscope	42	10	$1,286.00	$1,157.00	$416.00	$2,028.00	$840.00	2025-09-22
3500037	CDM	US Venous Duplex	14	10	$1,272.00	$1,145.00	$636.00	$1,802.00	$839.00	2025-09-22
93931	CPT	US Arterial Duplex Arms Left	28	10	$1,247.50	$1,123.00	$612.00	$1,802.00	$831.00	2025-09-22
93926	CPT	US Arterial Duplex Legs Left	28	10	$1,247.50	$1,123.00	$612.00	$1,802.00	$831.00	2025-09-22
93971	CPT	US Venous Duplex Leg Left	28	10	$1,247.50	$1,123.00	$612.00	$1,802.00	$831.00	2025-09-22
76700	CPT	Ultrasound Of Abdomen	14	10	$1,260.00	$1,134.00	$630.00	$1,785.00	$831.00	2025-09-22
11646	CPT	Excise Mal Lesion Ovr 4 Cm Face/ears	14	10	$1,259.00	$1,133.00	$630.00	$1,784.00	$831.00	2025-09-22
81450	CPT	Myeloproliferative Neoplasm Panel By Ngs	14	10	$1,260.00	$1,134.00	$630.00	$1,785.00	$831.00	2025-09-22
43239	CPT	Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	28	10	$1,201.50	$1,081.00	$569.00	$1,794.00	$827.00	2025-09-22
78579	CPT	Nm Pulmonary Ventilation	14	10	$1,249.00	$1,124.00	$625.00	$1,770.00	$824.00	2025-09-22
76705	CPT	US Abdomen Single Organ/ Quad	42	10	$1,177.00	$1,059.00	$576.00	$1,790.00	$821.00	2025-09-22
76817	CPT	US OB Vaginal	14	10	$1,233.00	$1,110.00	$617.00	$1,747.00	$813.00	2025-09-22
76604	CPT	US Chest	14	10	$1,233.00	$1,110.00	$617.00	$1,747.00	$813.00	2025-09-22
900021	CDM	Anes Supplies 3 3/4hr	14	10	$1,228.00	$1,105.00	$614.00	$1,740.00	$810.00	2025-09-22
25605	CPT	Clsd Tx W/mnipultn Distl Radial Fx	14	10	$1,225.00	$1,103.00	$613.00	$1,736.00	$808.00	2025-09-22
J2760	HCPCS	Regitine Inj [5 Mg]	14	10	$1,221.00	$1,099.00	$611.00	$1,730.00	$806.00	2025-09-22
800003	CDM	Oper Rm 1-15min	14	10	$1,199.00	$1,079.00	$600.00	$1,699.00	$791.00	2025-09-22
3000350	CDM	Analyzer Panel	14	10	$1,194.00	$1,075.00	$597.00	$1,692.00	$788.00	2025-09-22
100001	CDM	Ip Acute	14	10	$1,190.00	$1,071.00	$595.00	$1,686.00	$785.00	2025-09-22
19120	CPT	Removal Of One Or More Breast Growth, Open Procedure	42	10	$1,128.00	$1,015.00	$507.00	$1,743.00	$780.50	2025-09-22
J1740	HCPCS	Boniva Inj Syr 3 Mg/3 Ml	14	10	$1,182.00	$1,064.00	$591.00	$1,675.00	$780.00	2025-09-22
71271	CPT	CT Low Dose Lung	14	10	$1,174.00	$1,057.00	$587.00	$1,664.00	$774.50	2025-09-22
13132	CPT	Repair Complex 2.6-7.5 Cm F/m/n/a/g/h/f	14	10	$1,167.00	$1,050.00	$584.00	$1,654.00	$770.00	2025-09-22
27768	CPT	Closed Treatment Ankle W Manip	14	10	$1,160.00	$1,044.00	$580.00	$1,644.00	$765.50	2025-09-22
900020	CDM	Anes Supplies 3 1/2hr	14	10	$1,155.00	$1,040.00	$578.00	$1,637.00	$762.00	2025-09-22
25071	CPT	Excise Lesionforearm Or Wrist >3cm	14	10	$1,155.00	$1,040.00	$578.00	$1,637.00	$762.00	2025-09-22
27501	CPT	Clsd Tx Fem Fx W/wo Ext	14	10	$1,154.00	$1,039.00	$577.00	$1,635.00	$761.50	2025-09-22
11771	CPT	Pilonidal Cystectomy Extensive	14	10	$1,153.00	$1,038.00	$577.00	$1,634.00	$760.50	2025-09-22
26951	CPT	Amputate Finger W/direct Closure	14	10	$1,150.00	$1,035.00	$575.00	$1,630.00	$758.50	2025-09-22
93924	CPT	Padnet Arterial Study	28	10	$1,072.50	$965.50	$367.00	$1,999.00	$757.00	2025-09-22
J0256	HCPCS	Hh Prolastin-c Liq 1000mg/20ml Vl	28	10	$1,037.50	$933.50	$260.00	$2,205.00	$756.50	2025-09-22
1405057	CDM	Remdesivir / Ns Ivpb: 100mg/100ml	14	10	$1,144.00	$1,030.00	$572.00	$1,621.00	$754.50	2025-09-22
27372	CPT	Removal Foreign Bodyknee	14	10	$1,140.00	$1,026.00	$570.00	$1,615.00	$752.00	2025-09-22
76818	CPT	US Ob/biophysical Profile	14	10	$1,132.00	$1,019.00	$566.00	$1,604.00	$747.00	2025-09-22
9901799	CDM	PET Slim Port 6fr	14	10	$1,132.00	$1,019.00	$566.00	$1,604.00	$747.00	2025-09-22
P9035	HCPCS	Bb Platelet 1 Unit	14	10	$1,132.00	$1,019.00	$566.00	$1,604.00	$747.00	2025-09-22
28193	CPT	Removal Foreign Bodyfoot, Deep	14	10	$1,126.00	$1,013.00	$563.00	$1,596.00	$743.00	2025-09-22
76805	CPT	Abdomial Ultrasound Of Pregnant Uterus	14	10	$1,125.00	$1,013.00	$563.00	$1,594.00	$742.50	2025-09-22
25075	CPT	Excise Lesionforearm Or Wrist <3cm	14	10	$1,124.00	$1,012.00	$562.00	$1,593.00	$741.50	2025-09-22
43235	CPT	Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	28	10	$1,068.00	$961.50	$506.00	$1,594.00	$735.00	2025-09-22
93271	CPT	Event Monitor Analysis	14	10	$1,112.00	$1,001.00	$556.00	$1,576.00	$733.50	2025-09-22
11606	CPT	Excise Mal Lesion Over 4 Cm Trunk/arm	14	10	$1,097.00	$987.00	$549.00	$1,554.00	$723.50	2025-09-22
93308	CPT	Echo 2d Limited Or F/u	14	10	$1,088.00	$979.00	$544.00	$1,542.00	$717.50	2025-09-22
12045	CPT	Repair Intermediate 12.6-20 Cm N/h/f/g	14	10	$1,084.00	$976.00	$542.00	$1,536.00	$715.50	2025-09-22
900019	CDM	Anes Supplies 3 1/4hr	14	10	$1,083.00	$975.00	$542.00	$1,535.00	$714.50	2025-09-22
J1442	HCPCS	Neupogen Inj 300 Mcg 1ml	28	10	$1,013.50	$912.00	$465.00	$1,556.00	$714.00	2025-09-22

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