Hospital

JOHNSON COUNTY HOSPITAL

Tecumseh, NE · CCN 281350 · Rates published

Your selected procedure

You selected 59400 (CPT)

Obstetric care, planned vaginal delivery

This hospital’s price: $3,209 across 9 payers · range $2,447-$4,011

Source: https://secure.claraprice.net/price-transparency/OPIU-1673956354318/machine-readable/476000874_johnson-county-hospital_standardcharges.json · observed 2025-07-09

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.

2,756 distinct procedures filed

9 distinct payers

30,535 rate rows

2025-07-09 last MRF observed · ⚠ 13 mo old

Data quality

30,518 of 30,535 rate rows are consumer-grade (99.9%)

17 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	16
per-diem day rate — not a per-procedure price	1

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 13 months old.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/OPIU-1673956354318/machine-readable/476000874_johnson-county-hospital_standardcharges.json
Found on page	https://secure.claraprice.net/price-transparency/johnson-county-ne
Discovered via	Discovered by HANK
Last fetch	success · 2026-08-03
Content fingerprint	6686163d8abe7836… · 145,658 bytes · first seen 2026-05-18

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
96600589 CDM	Interstim X Neurostimulator #97800	9	$18,104.00	$29,679.00	$23,743.00	nat. median $23,743 1.0× median
96600619 CDM	Axonics F15 Neurostimulator	9	$14,823.00	$24,300.00	$19,440.00	nat. median $19,440 1.0× median
C1734 HCPCS	Knee Implant Conformis Custom	9	$8,583.00	$47,789.00	$15,201.00	nat. median $2,582 outlier · 5.9×
96609003 CDM	Itotal Cr Ipoly Knee With Patella & Stem Ext Implant	9	$11,345.00	$18,598.00	$14,878.00	nat. median $14,878 1.0× median
96609010 CDM	Itotal Identity Cr Femoral Implant With Tibial	9	$10,858.00	$17,800.00	$14,240.00	nat. median $14,240 1.0× median
96609007 CDM	Itotal Cr Ipoly Xe Knee Implant With Patel	9	$10,492.00	$17,200.00	$13,760.00	nat. median $13,760 1.0× median
96609006 CDM	Itotal Cr Ipoly Xe Knee Implant Without Pate	9	$10,491.00	$17,198.00	$13,758.00	nat. median $13,758 1.0× median
96609004 CDM	Itotal Ps Ipoly Knee Implant Without Patella	9	$10,004.00	$16,400.00	$13,120.00	nat. median $13,120 1.0× median
96609005 CDM	Itotal Ps Ipoly Knee Implant With Patella	9	$10,004.00	$16,400.00	$13,120.00	nat. median $13,120 1.0× median
96600414 CDM	Mesh Phasix St 15cm	9	$7,126.00	$11,682.00	$9,346.00	nat. median $9,346 1.0× median
96600588 CDM	Interstim X Lead Kit Is2 28cm #978b128	9	$6,515.00	$10,681.00	$8,545.00	nat. median $8,545 1.0× median
96609001 CDM	Iduo Ipoly Knee Implant Without Patella	9	$6,039.00	$9,900.00	$7,920.00	nat. median $7,920 1.0× median
96609002 CDM	Iduo Ipoly Knee Implant With Patella	9	$6,039.00	$9,900.00	$7,920.00	nat. median $7,920 1.0× median
96609000 CDM	Iuni Ipoly Knee Implant	9	$5,902.00	$9,675.00	$7,740.00	nat. median $7,740 1.0× median
96600620 CDM	Axonics F15 Tined Lead Kit	9	$5,338.00	$8,750.00	$7,000.00	nat. median $7,000 1.0× median
55040 CPT	55040 Excision Of Hydrocele; Unilateral	9	$4,904.00	$8,039.00	$6,431.00	nat. median $3,669 1.8× median
55041 CPT	55041 Excision Of Hydrocele; Bilateral	9	$4,784.00	$7,842.00	$6,274.00	nat. median $3,926 1.6× median
78814 CPT	PET CT Limited Area	9	$4,685.00	$7,681.00	$6,145.00	nat. median $2,317 outlier · 2.7×
78816 CPT	PET CT Whole Body	9	$4,230.00	$6,935.00	$5,548.00	nat. median $2,751 outlier · 2.0×
78815 CPT	PET CT Skull Base To Midthigh	9	$3,740.00	$6,131.00	$4,905.00	nat. median $2,791 1.8× median
74174 CPT	CT Angio Abdomen And Pelvis	9	$3,510.00	$5,754.00	$4,603.00	nat. median $982 outlier · 4.7×
96600598 CDM	Interstim X Handset With Communicator #Th90q01	9	$3,435.00	$5,631.00	$4,505.00	nat. median $4,505 1.0× median
74178 CPT	CT Abdomen And Pelvis With + Without Contrast	9	$3,432.00	$5,627.00	$4,502.00	nat. median $1,024 outlier · 4.4×
27447 CPT	27447 Arthroplasty, Knee, Condyle And Plateau; Medial And Lateral Compartments	9	$3,156.00	$5,174.00	$4,139.00	nat. median $12,699 outlier · 0.3×
74177 CPT	CT Scan Of Abdomen And Pelvis With Contrast	9	$3,091.00	$5,068.00	$4,054.00	nat. median $968 outlier · 4.2×
96600590 CDM	Interstim X Smart Programmer Kit #Th90p01	9	$2,974.00	$4,875.00	$3,900.00	nat. median $3,900 1.0× median
78608 CPT	PET Brain Imaging Metabolic Evaluation	9	$2,882.00	$4,725.00	$3,780.00	nat. median $2,413 1.6× median
95811 CPT	95811 Polysomnography W/cpap Charge	9	$2,774.00	$4,547.00	$3,638.00	nat. median $1,923 1.9× median
72156 CPT	MRI Spine Cervical With + Without Contrast	9	$2,724.00	$4,465.00	$3,572.00	nat. median $1,111 outlier · 3.2×
59510 CPT	Obstetric Care, Planned Cesarean Delivery	9	$2,669.00	$4,375.00	$3,500.00	nat. median $3,552 1.0× median
78452 CPT	Nm Myocardial Spect Rest And Stress	9	$2,655.00	$4,353.00	$3,482.00	nat. median $1,777 2.0× median
72158 CPT	MRI Spine Lumbar With + Without Contrast	9	$2,643.00	$4,333.00	$3,466.00	nat. median $1,103 outlier · 3.1×
74183 CPT	MRA Abdomen With + Without Contrast	9	$2,625.00	$4,304.00	$3,443.00	nat. median $1,106 outlier · 3.1×
72157 CPT	MRI Spine Thoracic With + Without Contrast	9	$2,621.00	$4,296.00	$3,437.00	nat. median $1,116 outlier · 3.1×
95810 CPT	Sleep Study	9	$2,619.00	$4,293.00	$3,434.00	nat. median $1,777 1.9× median
74176 CPT	CT Abdomen And Pelvis Without Contrast	9	$2,611.00	$4,281.00	$3,425.00	nat. median $697 outlier · 4.9×
96600432 CDM	Mesh Ventralight W/echo 2 7x9	9	$2,585.00	$4,238.00	$3,390.00	nat. median $3,390 1.0× median
75563 CPT	MRI Cardiac Morph Fnct W/stress W/wo Cnt	9	$2,505.00	$4,107.00	$3,286.00	nat. median $993 outlier · 3.3×
78451 CPT	Nm Myocardial Spect Single Study	9	$2,497.00	$4,094.00	$3,275.00	nat. median $1,548 outlier · 2.1×
96600150 CDM	Mesh Composix Kugel 8x10	9	$2,488.00	$4,078.00	$3,262.00	nat. median $3,262 1.0× median
70546 CPT	MRA Brain/head With + Without Contrast	9	$2,477.00	$4,060.00	$3,248.00	nat. median $1,051 outlier · 3.1×
72197 CPT	72197	9	$2,473.00	$4,054.00	$3,243.00	nat. median $1,074 outlier · 3.0×
20102 CPT	20102 Expl Penetrating Wound Spx Abdomen/flank/back Techfee	9	$2,472.00	$4,052.00	$3,242.00	nat. median $2,190 1.5× median
72142 CPT	MRI Spine Cervical With Contrast	9	$2,456.00	$4,027.00	$3,222.00	nat. median $973 outlier · 3.3×
59400 CPT	Obstetric Care, Planned Vaginal Delivery	9	$2,447.00	$4,011.00	$3,209.00	nat. median $3,099 1.0× median
73223 CPT	MRI Ue Joint With + Without Contrast Left	9	$2,428.00	$3,980.00	$3,184.00	nat. median $1,177 outlier · 2.7×
70553 CPT	MRI Scan	9	$2,414.00	$3,957.00	$3,166.00	nat. median $1,137 outlier · 2.8×
75561 CPT	MRI Cardiac Morph Fnct With + Without Cnt	9	$2,409.00	$3,949.00	$3,159.00	nat. median $756 outlier · 4.2×
70543 CPT	MRI Orbits With + Without Contrast	9	$2,398.00	$3,931.00	$3,145.00	nat. median $1,083 outlier · 2.9×
72127 CPT	CT Spine Cervical With + Without Contrast	9	$2,396.00	$3,928.00	$3,142.00	nat. median $616 outlier · 5.1×

Other procedures at this hospital

Browse this hospital's 2,756 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

96600589	CDM	Interstim X Neurostimulator #97800	9	9	$29,679.00	$29,679.00	$18,104.00	$29,679.00	$23,743.00	2025-07-09
96600619	CDM	Axonics F15 Neurostimulator	9	9	$24,300.00	$24,300.00	$14,823.00	$24,300.00	$19,440.00	2025-07-09
C1734	HCPCS	Knee Implant Conformis Custom	45	9	$17,200.00	$17,200.00	$8,583.00	$47,789.00	$15,201.00	2025-07-09
96609003	CDM	Itotal Cr Ipoly Knee With Patella & Stem Ext Implant	9	9	$18,598.00	$18,598.00	$11,345.00	$18,598.00	$14,878.00	2025-07-09
96609010	CDM	Itotal Identity Cr Femoral Implant With Tibial	9	9	$17,800.00	$17,800.00	$10,858.00	$17,800.00	$14,240.00	2025-07-09
96609007	CDM	Itotal Cr Ipoly Xe Knee Implant With Patel	9	9	$17,200.00	$17,200.00	$10,492.00	$17,200.00	$13,760.00	2025-07-09
96609006	CDM	Itotal Cr Ipoly Xe Knee Implant Without Pate	9	9	$17,198.00	$17,198.00	$10,491.00	$17,198.00	$13,758.00	2025-07-09
96609004	CDM	Itotal Ps Ipoly Knee Implant Without Patella	9	9	$16,400.00	$16,400.00	$10,004.00	$16,400.00	$13,120.00	2025-07-09
96609005	CDM	Itotal Ps Ipoly Knee Implant With Patella	9	9	$16,400.00	$16,400.00	$10,004.00	$16,400.00	$13,120.00	2025-07-09
96600414	CDM	Mesh Phasix St 15cm	9	9	$11,682.00	$11,682.00	$7,126.00	$11,682.00	$9,346.00	2025-07-09
96600588	CDM	Interstim X Lead Kit Is2 28cm #978b128	9	9	$10,681.00	$10,681.00	$6,515.00	$10,681.00	$8,545.00	2025-07-09
96609002	CDM	Iduo Ipoly Knee Implant With Patella	9	9	$9,900.00	$9,900.00	$6,039.00	$9,900.00	$7,920.00	2025-07-09
96609001	CDM	Iduo Ipoly Knee Implant Without Patella	9	9	$9,900.00	$9,900.00	$6,039.00	$9,900.00	$7,920.00	2025-07-09
96609000	CDM	Iuni Ipoly Knee Implant	9	9	$9,675.00	$9,675.00	$5,902.00	$9,675.00	$7,740.00	2025-07-09
96600620	CDM	Axonics F15 Tined Lead Kit	9	9	$8,750.00	$8,750.00	$5,338.00	$8,750.00	$7,000.00	2025-07-09
55040	CPT	55040 Excision Of Hydrocele; Unilateral	9	9	$8,039.00	$8,039.00	$4,904.00	$8,039.00	$6,431.00	2025-07-09
55041	CPT	55041 Excision Of Hydrocele; Bilateral	9	9	$7,842.00	$7,842.00	$4,784.00	$7,842.00	$6,274.00	2025-07-09
78814	CPT	PET CT Limited Area	9	9	$7,681.00	$7,681.00	$4,685.00	$7,681.00	$6,145.00	2025-07-09
78816	CPT	PET CT Whole Body	9	9	$6,935.00	$6,935.00	$4,230.00	$6,935.00	$5,548.00	2025-07-09
78815	CPT	PET CT Skull Base To Midthigh	9	9	$6,131.00	$6,131.00	$3,740.00	$6,131.00	$4,905.00	2025-07-09
74174	CPT	CT Angio Abdomen And Pelvis	9	9	$5,754.00	$5,754.00	$3,510.00	$5,754.00	$4,603.00	2025-07-09
96600598	CDM	Interstim X Handset With Communicator #Th90q01	9	9	$5,631.00	$5,631.00	$3,435.00	$5,631.00	$4,505.00	2025-07-09
74178	CPT	CT Abdomen And Pelvis With + Without Contrast	9	9	$5,627.00	$5,627.00	$3,432.00	$5,627.00	$4,502.00	2025-07-09
27447	CPT	27447 Arthroplasty, Knee, Condyle And Plateau; Medial And Lateral Compartments	9	9	$5,174.00	$5,174.00	$3,156.00	$5,174.00	$4,139.00	2025-07-09
74177	CPT	CT Scan Of Abdomen And Pelvis With Contrast	9	9	$5,068.00	$5,068.00	$3,091.00	$5,068.00	$4,054.00	2025-07-09
96600590	CDM	Interstim X Smart Programmer Kit #Th90p01	9	9	$4,875.00	$4,875.00	$2,974.00	$4,875.00	$3,900.00	2025-07-09
78608	CPT	PET Brain Imaging Metabolic Evaluation	9	9	$4,725.00	$4,725.00	$2,882.00	$4,725.00	$3,780.00	2025-07-09
95811	CPT	95811 Polysomnography W/cpap Charge	9	9	$4,547.00	$4,547.00	$2,774.00	$4,547.00	$3,638.00	2025-07-09
72156	CPT	MRI Spine Cervical With + Without Contrast	9	9	$4,465.00	$4,465.00	$2,724.00	$4,465.00	$3,572.00	2025-07-09
59510	CPT	Obstetric Care, Planned Cesarean Delivery	9	9	$4,375.00	$4,375.00	$2,669.00	$4,375.00	$3,500.00	2025-07-09
78452	CPT	Nm Myocardial Spect Rest And Stress	9	9	$4,353.00	$4,353.00	$2,655.00	$4,353.00	$3,482.00	2025-07-09
72158	CPT	MRI Spine Lumbar With + Without Contrast	9	9	$4,333.00	$4,333.00	$2,643.00	$4,333.00	$3,466.00	2025-07-09
74183	CPT	MRA Abdomen With + Without Contrast	9	9	$4,304.00	$4,304.00	$2,625.00	$4,304.00	$3,443.00	2025-07-09
72157	CPT	MRI Spine Thoracic With + Without Contrast	9	9	$4,296.00	$4,296.00	$2,621.00	$4,296.00	$3,437.00	2025-07-09
95810	CPT	Sleep Study	9	9	$4,293.00	$4,293.00	$2,619.00	$4,293.00	$3,434.00	2025-07-09
74176	CPT	CT Abdomen And Pelvis Without Contrast	9	9	$4,281.00	$4,281.00	$2,611.00	$4,281.00	$3,425.00	2025-07-09
96600432	CDM	Mesh Ventralight W/echo 2 7x9	9	9	$4,238.00	$4,238.00	$2,585.00	$4,238.00	$3,390.00	2025-07-09
75563	CPT	MRI Cardiac Morph Fnct W/stress W/wo Cnt	9	9	$4,107.00	$4,107.00	$2,505.00	$4,107.00	$3,286.00	2025-07-09
78451	CPT	Nm Myocardial Spect Single Study	9	9	$4,094.00	$4,094.00	$2,497.00	$4,094.00	$3,275.00	2025-07-09
96600150	CDM	Mesh Composix Kugel 8x10	9	9	$4,078.00	$4,078.00	$2,488.00	$4,078.00	$3,262.00	2025-07-09
70546	CPT	MRA Brain/head With + Without Contrast	9	9	$4,060.00	$4,060.00	$2,477.00	$4,060.00	$3,248.00	2025-07-09
72197	CPT	72197	9	9	$4,054.00	$4,054.00	$2,473.00	$4,054.00	$3,243.00	2025-07-09
20102	CPT	20102 Expl Penetrating Wound Spx Abdomen/flank/back Techfee	9	9	$4,052.00	$4,052.00	$2,472.00	$4,052.00	$3,242.00	2025-07-09
72142	CPT	MRI Spine Cervical With Contrast	9	9	$4,027.00	$4,027.00	$2,456.00	$4,027.00	$3,222.00	2025-07-09
59400	CPT	Obstetric Care, Planned Vaginal Delivery	9	9	$4,011.00	$4,011.00	$2,447.00	$4,011.00	$3,209.00	2025-07-09
73223	CPT	MRI Ue Joint With + Without Contrast Left	9	9	$3,980.00	$3,980.00	$2,428.00	$3,980.00	$3,184.00	2025-07-09
70553	CPT	MRI Scan	9	9	$3,957.00	$3,957.00	$2,414.00	$3,957.00	$3,166.00	2025-07-09
75561	CPT	MRI Cardiac Morph Fnct With + Without Cnt	9	9	$3,949.00	$3,949.00	$2,409.00	$3,949.00	$3,159.00	2025-07-09
70543	CPT	MRI Orbits With + Without Contrast	9	9	$3,931.00	$3,931.00	$2,398.00	$3,931.00	$3,145.00	2025-07-09
72127	CPT	CT Spine Cervical With + Without Contrast	9	9	$3,928.00	$3,928.00	$2,396.00	$3,928.00	$3,142.00	2025-07-09
71552	CPT	MRI Chest With + Without Contrast	9	9	$3,910.00	$3,910.00	$2,385.00	$3,910.00	$3,128.00	2025-07-09
72147	CPT	MRI Spine Thoracic With Contrast	9	9	$3,865.00	$3,865.00	$2,358.00	$3,865.00	$3,092.00	2025-07-09
70545	CPT	MRA Brain/head With Contrast	9	9	$3,779.00	$3,779.00	$2,305.00	$3,779.00	$3,023.00	2025-07-09
70549	CPT	MRA Neck With + Without Contrast	9	9	$3,724.00	$3,724.00	$2,272.00	$3,724.00	$2,979.00	2025-07-09
75635	CPT	CT Angio Abdominal Aorta With Runoff	9	9	$3,690.00	$3,690.00	$2,251.00	$3,690.00	$2,952.00	2025-07-09
70552	CPT	MRI Brain With Contrast	9	9	$3,684.00	$3,684.00	$2,247.00	$3,684.00	$2,947.00	2025-07-09
72146	CPT	MRI Spine Thoracic Without Contrast	9	9	$3,651.00	$3,651.00	$2,227.00	$3,651.00	$2,921.00	2025-07-09
70548	CPT	MRA Neck With Contrast	9	9	$3,647.00	$3,647.00	$2,225.00	$3,647.00	$2,918.00	2025-07-09
71551	CPT	MRI Chest With Contrast	9	9	$3,602.00	$3,602.00	$2,197.00	$3,602.00	$2,882.00	2025-07-09
72141	CPT	MRI Spine Cervical Without Contrast	9	9	$3,590.00	$3,590.00	$2,190.00	$3,590.00	$2,872.00	2025-07-09
71275	CPT	CT Angio Chest	9	9	$3,571.00	$3,571.00	$2,178.00	$3,571.00	$2,857.00	2025-07-09
74182	CPT	MRA Abdomen With Contrast	9	9	$3,507.00	$3,507.00	$2,139.00	$3,507.00	$2,806.00	2025-07-09
70551	CPT	MRI Brain Without Contrast	9	9	$3,508.00	$3,508.00	$2,140.00	$3,508.00	$2,806.00	2025-07-09
73723	CPT	MRI Le Joint With + Without Contrast Left	9	9	$3,491.00	$3,491.00	$2,130.00	$3,491.00	$2,793.00	2025-07-09
20101	CPT	20101 Exploration Penetrating Wound Spx Chest Techfee	9	9	$3,466.00	$3,466.00	$2,114.00	$3,466.00	$2,773.00	2025-07-09
70544	CPT	MRA Brain/head Without Contrast	9	9	$3,465.00	$3,465.00	$2,114.00	$3,465.00	$2,772.00	2025-07-09
74175	CPT	CT Angio Abdomen	9	9	$3,428.00	$3,428.00	$2,091.00	$3,428.00	$2,742.00	2025-07-09
72148	CPT	MRI Scan Of Lower Spinal Canal	9	9	$3,422.00	$3,422.00	$2,087.00	$3,422.00	$2,738.00	2025-07-09
73720	CPT	MRI Lower Extremity With + Without Cnt Left	9	9	$3,403.00	$3,403.00	$2,076.00	$3,403.00	$2,722.00	2025-07-09
72149	CPT	MRI Spine Lumbar With Contrast	9	9	$3,403.00	$3,403.00	$2,076.00	$3,403.00	$2,722.00	2025-07-09
73220	CPT	MRI Upper Extremity With + Without Cnt Left	9	9	$3,384.00	$3,384.00	$2,064.00	$3,384.00	$2,707.00	2025-07-09
27762	CPT	27762 Closed Tx Of Medial Malleolus Fx With Manipulation	9	9	$3,377.00	$3,377.00	$2,060.00	$3,377.00	$2,702.00	2025-07-09
96600613	CDM	Urolift Ul2 Atc Implant Cartridge	9	9	$3,375.00	$3,375.00	$2,059.00	$3,375.00	$2,700.00	2025-07-09
71550	CPT	MRI Chest Without Contrast	9	9	$3,363.00	$3,363.00	$2,051.00	$3,363.00	$2,690.00	2025-07-09
72191	CPT	CT Angio Pelvis	9	9	$3,345.00	$3,345.00	$2,040.00	$3,345.00	$2,676.00	2025-07-09
70542	CPT	MRI Face Neck Orbit With Contrast	9	9	$3,301.00	$3,301.00	$2,014.00	$3,301.00	$2,641.00	2025-07-09
74181	CPT	MRI Abdomen Without Contrast	9	9	$3,261.00	$3,261.00	$1,989.00	$3,261.00	$2,609.00	2025-07-09
45334	CPT	45334 Sigmoidoscopy, Flexible With Control Of Bleeding, Any Method	9	9	$3,245.00	$3,245.00	$1,979.00	$3,245.00	$2,596.00	2025-07-09
70496	CPT	CT Angio Brain/head	9	9	$3,228.00	$3,228.00	$1,969.00	$3,228.00	$2,582.00	2025-07-09
74170	CPT	CT Abdomen With + Without Contrast	9	9	$3,213.00	$3,213.00	$1,960.00	$3,213.00	$2,570.00	2025-07-09
72196	CPT	MRI Pelvis With Contrast	9	9	$3,190.00	$3,190.00	$1,946.00	$3,190.00	$2,552.00	2025-07-09
A0434	HCPCS	A0434 Specialty Care Transport	9	9	$3,126.00	$3,126.00	$1,907.00	$3,126.00	$2,501.00	2025-07-09
72195	CPT	MRI Pelvis Without Contrast	9	9	$3,126.00	$3,126.00	$1,907.00	$3,126.00	$2,501.00	2025-07-09
72194	CPT	CT Pelvis With + Without Contrast	9	9	$3,092.00	$3,092.00	$1,886.00	$3,092.00	$2,474.00	2025-07-09
70498	CPT	CT Angio Neck	9	9	$3,050.00	$3,050.00	$1,861.00	$3,050.00	$2,440.00	2025-07-09
96600390	CDM	Eea Stapler #Trieea28mt	9	9	$3,033.00	$3,033.00	$1,850.00	$3,033.00	$2,426.00	2025-07-09
70547	CPT	MRA Neck Without Contrast	9	9	$3,030.00	$3,030.00	$1,848.00	$3,030.00	$2,424.00	2025-07-09
72133	CPT	CT Spine Lumbar Without Contrast	9	9	$3,007.00	$3,007.00	$1,834.00	$3,007.00	$2,406.00	2025-07-09
70492	CPT	CT Neck Soft Tissue With + Without Contrast	9	9	$2,982.00	$2,982.00	$1,819.00	$2,982.00	$2,386.00	2025-07-09
75557	CPT	MRI Cardiac Morph Fnct Without Cnt	9	9	$2,970.00	$2,970.00	$1,812.00	$2,970.00	$2,376.00	2025-07-09
75559	CPT	MRI Cardiac Morph Fnct W/stress Without Cnt	9	9	$2,968.00	$2,968.00	$1,810.00	$2,968.00	$2,374.00	2025-07-09
73206	CPT	CT Angio Upper Extremity Left	9	9	$2,965.00	$2,965.00	$1,809.00	$2,965.00	$2,372.00	2025-07-09
73706	CPT	CT Angio Lower Extremity Left	9	9	$2,965.00	$2,965.00	$1,809.00	$2,965.00	$2,372.00	2025-07-09
71270	CPT	CT Chest With + Without Contrast	9	9	$2,947.00	$2,947.00	$1,798.00	$2,947.00	$2,358.00	2025-07-09
70540	CPT	MRI Face Neck Orbit Without Contrast	9	9	$2,940.00	$2,940.00	$1,793.00	$2,940.00	$2,352.00	2025-07-09
73219	CPT	MRI Upper Extremity With Contrast Left	9	9	$2,875.00	$2,875.00	$1,754.00	$2,875.00	$2,300.00	2025-07-09
96600611	CDM	Urolift Handle Kit With Implant	9	9	$2,875.00	$2,875.00	$1,754.00	$2,875.00	$2,300.00	2025-07-09
96600612	CDM	Urolift 2 Implant Cartridge	9	9	$2,875.00	$2,875.00	$1,754.00	$2,875.00	$2,300.00	2025-07-09
L8606	HCPCS	Bulkamid Urethral Bulking System (2ml Total)	9	9	$2,875.00	$2,875.00	$1,754.00	$2,875.00	$2,300.00	2025-07-09
96600453	CDM	Lynx Urethral Sling System	9	9	$2,871.00	$2,871.00	$1,751.00	$2,871.00	$2,297.00	2025-07-09
73721	CPT	MRI Scan Of Leg Joint	9	9	$2,867.00	$2,867.00	$1,749.00	$2,867.00	$2,294.00	2025-07-09
64561	CPT	64561 Percutaneous Implantation Of Neuro Electrode Array;sacral Nerve Incl. Imag…	18	9	$2,855.00	$2,855.00	$1,724.00	$2,884.00	$2,284.00	2025-07-09
70482	CPT	CT Orbits Sella With + Without Contrast	9	9	$2,819.00	$2,819.00	$1,720.00	$2,819.00	$2,255.00	2025-07-09
59515	CPT	59515 Cesarean Delivery Only; Including Postpartum Care	9	9	$2,815.00	$2,815.00	$1,717.00	$2,815.00	$2,252.00	2025-07-09
73702	CPT	CT Lower Extremity W/+without Contrast Left	9	9	$2,807.00	$2,807.00	$1,712.00	$2,807.00	$2,246.00	2025-07-09
78803	CPT	Nm Tumor Loc Spect	9	9	$2,807.00	$2,807.00	$1,712.00	$2,807.00	$2,246.00	2025-07-09
73222	CPT	MRI Ue Joint With Contrast Left	9	9	$2,807.00	$2,807.00	$1,712.00	$2,807.00	$2,246.00	2025-07-09
74160	CPT	CT Abdomen With Contrast	9	9	$2,780.00	$2,780.00	$1,696.00	$2,780.00	$2,224.00	2025-07-09
71260	CPT	CT Chest With Contrast	9	9	$2,765.00	$2,765.00	$1,687.00	$2,765.00	$2,212.00	2025-07-09
73722	CPT	MRI Le Joint With Contrast Left	9	9	$2,764.00	$2,764.00	$1,686.00	$2,764.00	$2,211.00	2025-07-09
43247	CPT	Esophagogastroduodenoscopy Foreign Body Removal	9	9	$2,764.00	$2,764.00	$1,686.00	$2,764.00	$2,211.00	2025-07-09
43239	CPT	Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	9	9	$2,764.00	$2,764.00	$1,686.00	$2,764.00	$2,211.00	2025-07-09
73725	CPT	MRA Lower Extremity With + Without Cnt Left	9	9	$2,752.00	$2,752.00	$1,679.00	$2,752.00	$2,202.00	2025-07-09
96608015	CDM	Navigation Unit Orthalign (S&n)	9	9	$2,750.00	$2,750.00	$1,678.00	$2,750.00	$2,200.00	2025-07-09
72129	CPT	CT Spine Thoracic With Contrast	9	9	$2,749.00	$2,749.00	$1,677.00	$2,749.00	$2,199.00	2025-07-09
96600524	CDM	Prolene Hernia System 2 5/32 X 4 15/16	9	9	$2,741.00	$2,741.00	$1,672.00	$2,741.00	$2,193.00	2025-07-09
73719	CPT	MRI Lower Extremity With Contrast Left	9	9	$2,729.00	$2,729.00	$1,665.00	$2,729.00	$2,183.00	2025-07-09
73221	CPT	MRI Ue Joint Without Contrast Left	9	9	$2,725.00	$2,725.00	$1,662.00	$2,725.00	$2,180.00	2025-07-09
73718	CPT	MRI Lower Extremity Without Contrast Left	9	9	$2,703.00	$2,703.00	$1,649.00	$2,703.00	$2,162.00	2025-07-09
73218	CPT	MRI Upper Extremity Without Contrast Left	9	9	$2,701.00	$2,701.00	$1,648.00	$2,701.00	$2,161.00	2025-07-09
59409	CPT	59409 Vaginal Delivery Only Techfee	18	9	$2,919.00	$2,919.00	$1,186.00	$3,893.00	$2,160.00	2025-07-09
70470	CPT	CT Head With + Without Contrast	9	9	$2,699.00	$2,699.00	$1,646.00	$2,699.00	$2,159.00	2025-07-09
72132	CPT	CT Spine Lumbar With Contrast	9	9	$2,692.00	$2,692.00	$1,642.00	$2,692.00	$2,154.00	2025-07-09
96600279	CDM	Mesh Vicryl Woven 15 X 15	9	9	$2,691.00	$2,691.00	$1,642.00	$2,691.00	$2,153.00	2025-07-09
72193	CPT	CT Scan Of Pelvis With Contrast	9	9	$2,679.00	$2,679.00	$1,634.00	$2,679.00	$2,143.00	2025-07-09
96600151	CDM	Mesh Ventrio 5 X 7 Lg Oval	9	9	$2,668.00	$2,668.00	$1,627.00	$2,668.00	$2,134.00	2025-07-09
44389	CPT	Colonoscopy Stoma	9	9	$2,660.00	$2,660.00	$1,623.00	$2,660.00	$2,128.00	2025-07-09
72126	CPT	CT Spine Cervical With Contrast	9	9	$2,655.00	$2,655.00	$1,620.00	$2,655.00	$2,124.00	2025-07-09
72130	CPT	CT Spine Thoracic With + Without Contrast	9	9	$2,644.00	$2,644.00	$1,613.00	$2,644.00	$2,115.00	2025-07-09
72125	CPT	CT Spine Cervical Without Contrast	9	9	$2,619.00	$2,619.00	$1,598.00	$2,619.00	$2,095.00	2025-07-09
43249	CPT	43249 Esophagogastroduodenoscopy, Flexible, Transoral; With Transendoscopic Ball…	9	9	$2,619.00	$2,619.00	$1,598.00	$2,619.00	$2,095.00	2025-07-09
59514	CPT	59514 Cesarean Delivery Only	9	9	$2,612.00	$2,612.00	$1,593.00	$2,612.00	$2,090.00	2025-07-09
70488	CPT	CT Maxillofacial With + Without Contrast	9	9	$2,590.00	$2,590.00	$1,580.00	$2,590.00	$2,072.00	2025-07-09
96600607	CDM	Hernia Patch Lg #5950009	9	9	$2,588.00	$2,588.00	$1,579.00	$2,588.00	$2,070.00	2025-07-09
73701	CPT	CT Lower Extremity With Contrast Left	9	9	$2,563.00	$2,563.00	$1,563.00	$2,563.00	$2,050.00	2025-07-09
70491	CPT	CT Neck Soft Tissue With Contrast	9	9	$2,532.00	$2,532.00	$1,545.00	$2,532.00	$2,026.00	2025-07-09
43251	CPT	Esophagogastroduodenoscopy Excision Lesion	9	9	$2,526.00	$2,526.00	$1,541.00	$2,526.00	$2,021.00	2025-07-09
27752	CPT	27752 Cltx Tibial Shaft Fx W/manj W/wo Skel Tracj Techfee	9	9	$2,523.00	$2,523.00	$1,539.00	$2,523.00	$2,018.00	2025-07-09
73202	CPT	CT Upper Extremity W/+without Contrast Left	9	9	$2,518.00	$2,518.00	$1,536.00	$2,518.00	$2,014.00	2025-07-09
72131	CPT	CT Spine Lumbar With + Without Contrast	9	9	$2,516.00	$2,516.00	$1,535.00	$2,516.00	$2,013.00	2025-07-09
96608029	CDM	Screw Removal Set	9	9	$2,503.00	$2,503.00	$1,527.00	$2,503.00	$2,002.00	2025-07-09
73201	CPT	CT Upper Extremity With Contrast Left	9	9	$2,500.00	$2,500.00	$1,525.00	$2,500.00	$2,000.00	2025-07-09
70481	CPT	CT Orbits Sella With Contrast	9	9	$2,497.00	$2,497.00	$1,523.00	$2,497.00	$1,998.00	2025-07-09
71250	CPT	CT Chest Without Contrast	9	9	$2,496.00	$2,496.00	$1,523.00	$2,496.00	$1,997.00	2025-07-09
20525	CPT	20525 Rmvl Foreign Body Muscle/tendon Sheath Deep/comp Techfee	9	9	$2,477.00	$2,477.00	$1,511.00	$2,477.00	$1,982.00	2025-07-09
72128	CPT	CT Spine Thoracic Without Contrast	9	9	$2,450.00	$2,450.00	$1,495.00	$2,450.00	$1,960.00	2025-07-09
96600586	CDM	Suture Vicryl Mesh 15cm X 15cm	9	9	$2,445.00	$2,445.00	$1,491.00	$2,445.00	$1,956.00	2025-07-09
96600622	CDM	Axonics F15 Remote Control	9	9	$2,420.00	$2,420.00	$1,476.00	$2,420.00	$1,936.00	2025-07-09
70487	CPT	CT Maxillofacial With Contrast	9	9	$2,417.00	$2,417.00	$1,474.00	$2,417.00	$1,934.00	2025-07-09
70460	CPT	CT Head With Contrast	9	9	$2,418.00	$2,418.00	$1,475.00	$2,418.00	$1,934.00	2025-07-09
64479	CPT	Xr Injection Cerv/thor Transforaminal Eo	18	9	$2,410.00	$2,410.00	$1,456.00	$2,433.00	$1,928.00	2025-07-09
72192	CPT	CT Pelvis Without Contrast	9	9	$2,391.00	$2,391.00	$1,459.00	$2,391.00	$1,913.00	2025-07-09
74150	CPT	CT Abdomen Without Contrast	9	9	$2,375.00	$2,375.00	$1,449.00	$2,375.00	$1,900.00	2025-07-09
96750133	CDM	Cataract Suite With Lens Sightpath	9	9	$2,368.00	$2,368.00	$1,444.00	$2,368.00	$1,894.00	2025-07-09
93307	CPT	93307 Echocardiogram Charge	9	9	$2,355.00	$2,355.00	$1,437.00	$2,355.00	$1,884.00	2025-07-09
78582	CPT	Nm Lung Vent/perf Imaging	9	9	$2,350.00	$2,350.00	$1,434.00	$2,350.00	$1,880.00	2025-07-09
70336	CPT	MRI Tmj	9	9	$2,334.00	$2,334.00	$1,424.00	$2,334.00	$1,867.00	2025-07-09
45380	CPT	Biopsy Exam Of Large Bowel Using An Endoscope	9	9	$2,332.00	$2,332.00	$1,423.00	$2,332.00	$1,866.00	2025-07-09
96600149	CDM	Mesh Ventrio 4x5 Medium Oval	9	9	$2,313.00	$2,313.00	$1,411.00	$2,313.00	$1,850.00	2025-07-09
70490	CPT	CT Neck Soft Tissue Without Contrast	9	9	$2,309.00	$2,309.00	$1,408.00	$2,309.00	$1,847.00	2025-07-09
73700	CPT	CT Lower Extremity Without Contrast Left	9	9	$2,296.00	$2,296.00	$1,401.00	$2,296.00	$1,837.00	2025-07-09
70480	CPT	CT Orbits Sella Without Contrast	9	9	$2,267.00	$2,267.00	$1,383.00	$2,267.00	$1,814.00	2025-07-09
78320	CPT	Nm Bone Spect	9	9	$2,261.00	$2,261.00	$1,379.00	$2,261.00	$1,809.00	2025-07-09
45378	CPT	Diagnostic Exam Of Large Bowel Using An Endoscope	9	9	$2,237.00	$2,237.00	$1,365.00	$2,237.00	$1,790.00	2025-07-09
73200	CPT	CT Upper Extremity Without Contrast Left	9	9	$2,234.00	$2,234.00	$1,363.00	$2,234.00	$1,787.00	2025-07-09
20100	CPT	20100 Exploration Penetrating Wound Spx Neck Techfee	9	9	$2,233.00	$2,233.00	$1,362.00	$2,233.00	$1,786.00	2025-07-09
78315	CPT	Nm Bone Three Phase Study	9	9	$2,227.00	$2,227.00	$1,358.00	$2,227.00	$1,782.00	2025-07-09
43246	CPT	Esophagogastroduodenoscopy With Peg Placement	9	9	$2,228.00	$2,228.00	$1,359.00	$2,228.00	$1,782.00	2025-07-09
43235	CPT	Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	9	9	$2,228.00	$2,228.00	$1,359.00	$2,228.00	$1,782.00	2025-07-09
45300	CPT	Proctosigmoidoscopy Diagnostic	9	9	$2,228.00	$2,228.00	$1,359.00	$2,228.00	$1,782.00	2025-07-09
96600467	CDM	Hernia Patch Small #5950007	9	9	$2,221.00	$2,221.00	$1,355.00	$2,221.00	$1,777.00	2025-07-09
93306	CPT	93306 Echo W/spec And Color Flow Doppler Charge	9	9	$2,206.00	$2,206.00	$1,346.00	$2,206.00	$1,765.00	2025-07-09
96600563	CDM	Iovera 90mm Smart Tip	9	9	$2,199.00	$2,199.00	$1,341.00	$2,199.00	$1,759.00	2025-07-09
70450	CPT	CT Scan	9	9	$2,184.00	$2,184.00	$1,332.00	$2,184.00	$1,747.00	2025-07-09
26951	CPT	26951 Amp F/th 1/2 Jt/phalanx W/neurect W/dir Clsr Techfee	18	9	$2,383.00	$2,383.00	$1,162.00	$2,861.00	$1,745.00	2025-07-09
J7307	HCPCS	J7307 Etonogestrel (Contraceptive) Implant System, Including Implant And Supplie…	9	9	$2,148.00	$2,148.00	$1,310.00	$2,148.00	$1,718.00	2025-07-09
78801	CPT	Nm Tumor Loc Multiple Areas	9	9	$2,141.00	$2,141.00	$1,306.00	$2,141.00	$1,713.00	2025-07-09
78472	CPT	Nm Cardiac Muga	9	9	$2,137.00	$2,137.00	$1,304.00	$2,137.00	$1,710.00	2025-07-09
28092	CPT	28092 Ex Lesion Toe Ea Techfee	9	9	$2,106.00	$2,106.00	$1,285.00	$2,106.00	$1,685.00	2025-07-09
21932	CPT	21932 Excision, Tumor, Soft Tissue Of Back Or Flank, Subfascial (Eg, Intramuscul…	18	9	$2,493.00	$2,493.00	$479.00	$4,201.00	$1,674.00	2025-07-09
41899	CPT	41899 Unlisted Procedure Dentoalveolar Structures Techfee	9	9	$2,059.00	$2,059.00	$1,256.00	$2,059.00	$1,647.00	2025-07-09
J7298	HCPCS	J7298 Levonorgestrel-releasing Intrauterine Contraceptive System, 52 Mg	9	9	$2,046.00	$2,046.00	$1,248.00	$2,046.00	$1,637.00	2025-07-09
13200990	CDM	Cholangiopancreatography Endoscopy Retrograde	9	9	$2,020.00	$2,020.00	$1,232.00	$2,020.00	$1,616.00	2025-07-09
13132	CPT	13132 Repair Complex F/c/c/m/n/ax/g/h/f 2.6-7.5 Cm Techfee	9	9	$1,986.00	$1,986.00	$1,211.00	$1,986.00	$1,589.00	2025-07-09
70486	CPT	CT Maxillofacial Without Contrast	9	9	$1,985.00	$1,985.00	$1,211.00	$1,985.00	$1,588.00	2025-07-09
A9562	HCPCS	John Tc99m Mertiatide Per Dose	9	9	$1,973.00	$1,973.00	$1,204.00	$1,973.00	$1,578.00	2025-07-09
78709	CPT	Nm Kidney Imaging Multiple W/+without Pharm	9	9	$1,973.00	$1,973.00	$1,204.00	$1,973.00	$1,578.00	2025-07-09
78227	CPT	Nm Hepatobiliary Imaging With Drug	9	9	$1,938.00	$1,938.00	$1,182.00	$1,938.00	$1,550.00	2025-07-09
78306	CPT	Nm Bone Imaging Whole Body	9	9	$1,896.00	$1,896.00	$1,157.00	$1,896.00	$1,517.00	2025-07-09
12000100	CDM	Delivery Service	9	9	$1,875.00	$1,875.00	$1,144.00	$1,875.00	$1,500.00	2025-07-09
99291	CPT	99291critical Care, 30-74	9	9	$1,869.00	$1,869.00	$1,140.00	$1,869.00	$1,495.00	2025-07-09
11012	CPT	11012 Dbrdmt Fx&/dislc Subq T/m/f Bone Techfee	9	9	$1,867.00	$1,867.00	$1,139.00	$1,867.00	$1,494.00	2025-07-09
78264	CPT	Nm Gastric Emptying Study	9	9	$1,865.00	$1,865.00	$1,138.00	$1,865.00	$1,492.00	2025-07-09
5000059	CDM	Ulta Veraflo Cleanse Med Dressing Kci Wound Vac	9	9	$1,857.00	$1,857.00	$1,133.00	$1,857.00	$1,486.00	2025-07-09
45338	CPT	Sigmoidoscopy Excision Lesion	9	9	$1,840.00	$1,840.00	$1,122.00	$1,840.00	$1,472.00	2025-07-09
96600108	CDM	Davinci Vessel Sealer Extend	9	9	$1,805.00	$1,805.00	$1,101.00	$1,805.00	$1,444.00	2025-07-09
26236	CPT	26236 Partial Excision Distal Phalanx Of Finger	9	9	$1,802.00	$1,802.00	$1,099.00	$1,802.00	$1,442.00	2025-07-09
5000056	CDM	Ulta Veraflo Cleanse Sm Dressing Kci Wound Vac	9	9	$1,776.00	$1,776.00	$1,083.00	$1,776.00	$1,421.00	2025-07-09
78708	CPT	Nm Kidney Imaging Single With Pharm	9	9	$1,772.00	$1,772.00	$1,081.00	$1,772.00	$1,418.00	2025-07-09
78305	CPT	Nm Bone Imaging Multiple Areas	9	9	$1,762.00	$1,762.00	$1,075.00	$1,762.00	$1,410.00	2025-07-09
78226	CPT	Nm Hepatobiliary Imaging	9	9	$1,734.00	$1,734.00	$1,058.00	$1,734.00	$1,387.00	2025-07-09
78707	CPT	Nm Kidney Imaging Single Without Pharm	9	9	$1,709.00	$1,709.00	$1,042.00	$1,709.00	$1,367.00	2025-07-09
96600413	CDM	Mesh Ventralight St 15.2cm Circle	9	9	$1,702.00	$1,702.00	$1,038.00	$1,702.00	$1,362.00	2025-07-09
27266	CPT	27266 Closed Treatment Of Post Hip Arthroplasty Dislocation; Requiring General A…	9	9	$1,691.00	$1,691.00	$1,032.00	$1,691.00	$1,353.00	2025-07-09
10000002	CDM	Room/bed: Semi-private	9	9	$1,680.00	$1,680.00	$1,025.00	$1,680.00	$1,344.00	2025-07-09
10000001	CDM	Room/bed: Private	9	9	$1,680.00	$1,680.00	$1,025.00	$1,680.00	$1,344.00	2025-07-09
45331	CPT	Sigmoidoscopy Biopsy	9	9	$1,678.00	$1,678.00	$1,024.00	$1,678.00	$1,342.00	2025-07-09
13200146	CDM	Sigmoidoscopy Flexible	9	9	$1,671.00	$1,671.00	$1,019.00	$1,671.00	$1,337.00	2025-07-09
96600424	CDM	Endo Gia Stapler 80mm Tri-staplepurple	9	9	$1,671.00	$1,671.00	$1,019.00	$1,671.00	$1,337.00	2025-07-09
59426	CPT	59426 Antepartum Care Only; 7 Or More Visits	9	9	$1,669.00	$1,669.00	$1,018.00	$1,669.00	$1,335.00	2025-07-09
96600584	CDM	Iovera 85mm Smart Tip	9	9	$1,649.00	$1,649.00	$1,006.00	$1,649.00	$1,319.00	2025-07-09
93350	CPT	93350 Stress Test (Echo) Charge	9	9	$1,638.00	$1,638.00	$999.00	$1,638.00	$1,310.00	2025-07-09
A0433	HCPCS	A0433 Als 2 Techfee	9	9	$1,604.00	$1,604.00	$978.00	$1,604.00	$1,283.00	2025-07-09
78278	CPT	Nm Gastrointestinal Blood Loss Imaging	9	9	$1,596.00	$1,596.00	$974.00	$1,596.00	$1,277.00	2025-07-09
96600431	CDM	Mesh Large Ventralex Hernia Patch	9	9	$1,595.00	$1,595.00	$973.00	$1,595.00	$1,276.00	2025-07-09
78071	CPT	Nm Parathyroid Imaging With Spect	9	9	$1,592.00	$1,592.00	$971.00	$1,592.00	$1,274.00	2025-07-09
96600258	CDM	Stapler Articulation 45mm Reload Med/thi	9	9	$1,588.00	$1,588.00	$969.00	$1,588.00	$1,270.00	2025-07-09
33286	CPT	Removal Subcutaneous Cardiac Rhythm Monitor	9	9	$1,584.00	$1,584.00	$966.00	$1,584.00	$1,267.00	2025-07-09
5000060	CDM	Veraflo Medium Dressing Kci Wound Vac	9	9	$1,548.00	$1,548.00	$944.00	$1,548.00	$1,238.00	2025-07-09
13121	CPT	13121 Repair Complex Scalp/arm/leg 2.6-7.5 Cm Techfee	9	9	$1,544.00	$1,544.00	$942.00	$1,544.00	$1,235.00	2025-07-09
10000003	CDM	Room/bed: Swingbedskilled	9	9	$1,540.00	$1,540.00	$939.00	$1,540.00	$1,232.00	2025-07-09
96600019	CDM	Davinci Stapler Sureform 60	9	9	$1,530.00	$1,530.00	$933.00	$1,530.00	$1,224.00	2025-07-09
A0427	HCPCS	A0427 Als1-emergency Techfee	9	9	$1,529.00	$1,529.00	$933.00	$1,529.00	$1,223.00	2025-07-09
92960	CPT	92960 Cardioversion Elective Arrhthmia Externa Charge	9	9	$1,512.00	$1,512.00	$922.00	$1,512.00	$1,210.00	2025-07-09
64483	CPT	Injection(s) Of Anesthetic Into Lower Spine Using Imaging Guidance	18	9	$1,508.50	$1,508.50	$911.00	$1,524.00	$1,206.50	2025-07-09
96600505	CDM	Power Port A Cath 8fr	9	9	$1,481.00	$1,481.00	$903.00	$1,481.00	$1,185.00	2025-07-09
78800	CPT	Nm Tumor Loc Single Area	9	9	$1,479.00	$1,479.00	$902.00	$1,479.00	$1,183.00	2025-07-09
96600409	CDM	Endo Gia Stapler Multifire 30 2.5mm	9	9	$1,468.00	$1,468.00	$895.00	$1,468.00	$1,174.00	2025-07-09
78215	CPT	Nm Liver/spleen Static	9	9	$1,467.00	$1,467.00	$895.00	$1,467.00	$1,174.00	2025-07-09
5000051	CDM	Ulta Veraflo Small Dressing Kci Wound Vac	9	9	$1,439.00	$1,439.00	$878.00	$1,439.00	$1,151.00	2025-07-09
28011	CPT	28011 Tenotomy, Percutaneous, Toe; Multiple Tendons.	10	9	$1,627.00	$1,627.00	$992.00	$1,627.00	$1,147.00	2025-07-09
93970	CPT	93970 Venous Duplex Bilateral Charge John	9	9	$1,423.00	$1,423.00	$868.00	$1,423.00	$1,138.00	2025-07-09
46050	CPT	46050 Inc. Of Anal Abscess Ed Tech Fee	9	9	$1,422.00	$1,422.00	$867.00	$1,422.00	$1,138.00	2025-07-09
78598	CPT	Nm Lung Vent/perf Differential Imaging	9	9	$1,412.00	$1,412.00	$861.00	$1,412.00	$1,130.00	2025-07-09
96608017	CDM	Cement Mixer	9	9	$1,408.00	$1,408.00	$859.00	$1,408.00	$1,126.00	2025-07-09
78202	CPT	Nm Liver Imaging With Vascular Flow	9	9	$1,407.00	$1,407.00	$858.00	$1,407.00	$1,126.00	2025-07-09
13120	CPT	13120 Repair Complex Scalp/arm/leg 1.1-2.5 Cm Techfee	9	9	$1,406.00	$1,406.00	$858.00	$1,406.00	$1,125.00	2025-07-09
11501500	CDM	Peripherally Inserted Central Catheter Insertion	9	9	$1,404.00	$1,404.00	$856.00	$1,404.00	$1,123.00	2025-07-09
78597	CPT	Nm Lung Perfusion Differential Imaging	9	9	$1,400.00	$1,400.00	$854.00	$1,400.00	$1,120.00	2025-07-09
96600148	CDM	Mesh Composix Kugel 3x3	9	9	$1,398.00	$1,398.00	$853.00	$1,398.00	$1,118.00	2025-07-09
62323	CPT	Injection(s) Of Therapeutic Substance	18	9	$1,391.00	$1,391.00	$840.00	$1,405.00	$1,113.00	2025-07-09
64999	CPT	Ir Pm Inj Other Peripheral Nerve Block	9	9	$1,389.00	$1,389.00	$847.00	$1,389.00	$1,111.00	2025-07-09
96600574	CDM	Verify External Neurostimulator #353101	9	9	$1,386.00	$1,386.00	$845.00	$1,386.00	$1,109.00	2025-07-09
93880	CPT	93880 Carotid Duplex Bil Charge John	9	9	$1,383.00	$1,383.00	$844.00	$1,383.00	$1,106.00	2025-07-09
64640	CPT	64640 Treatment Rm Iovera Procedure 1 Nerve Charge	72	9	$1,436.00	$1,436.00	$712.00	$1,799.00	$1,106.00	2025-07-09
96600511	CDM	Endo Gi Ultra Stapler 452.5 Reloads	9	9	$1,378.00	$1,378.00	$841.00	$1,378.00	$1,102.00	2025-07-09
11604	CPT	11604 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; 3.1-4.…	18	9	$1,589.50	$1,589.50	$385.00	$2,548.00	$1,092.50	2025-07-09
78070	CPT	Nm Parathyroid Imaging	9	9	$1,361.00	$1,361.00	$830.00	$1,361.00	$1,089.00	2025-07-09
P9036	HCPCS	E3057 Aph Plt Acda Lr Irr 2	9	9	$1,352.00	$1,352.00	$825.00	$1,352.00	$1,082.00	2025-07-09
24605	CPT	24605 Treatment Closed Elbow Dislocation Req Anes Techfee	9	9	$1,345.00	$1,345.00	$820.00	$1,345.00	$1,076.00	2025-07-09
45305	CPT	Proctosigmoidoscopy Biopsy	9	9	$1,341.00	$1,341.00	$818.00	$1,341.00	$1,073.00	2025-07-09
62321	CPT	Xr Injection Cerv/thor Interlaminar Eo	18	9	$1,336.50	$1,336.50	$807.00	$1,350.00	$1,069.00	2025-07-09
11404	CPT	11404 Excision, Benign Lesion Including Margins; Trunk, Arms Or Legs; 3.1-4.0cm	18	9	$1,596.50	$1,596.50	$287.00	$2,723.00	$1,065.50	2025-07-09
A0426	HCPCS	A0426 Als Nonemergency	9	9	$1,330.00	$1,330.00	$811.00	$1,330.00	$1,064.00	2025-07-09
96600303	CDM	Balloon 18-20mm E/c	9	9	$1,311.00	$1,311.00	$800.00	$1,311.00	$1,049.00	2025-07-09
45385	CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope	18	9	$1,586.50	$1,586.50	$249.00	$2,764.00	$1,047.50	2025-07-09
13131	CPT	13131 Repair, Complex, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, …	19	9	$1,704.00	$1,704.00	$438.00	$1,704.00	$1,039.00	2025-07-09
94002	CPT	94002 Mechanical Ventilator Initial Charge	9	9	$1,299.00	$1,299.00	$792.00	$1,299.00	$1,039.00	2025-07-09
24200	CPT	24200 Removal Of Foreign Body, Upper Arm Or Elbow Area; Subcutaneous	18	9	$1,509.50	$1,509.50	$287.00	$2,548.00	$1,012.50	2025-07-09
96600242	CDM	Arista Hemostatic Particles	9	9	$1,260.00	$1,260.00	$769.00	$1,260.00	$1,008.00	2025-07-09
96600510	CDM	Endo Gi Ultra Stapler 303.5 Reloads	9	9	$1,255.00	$1,255.00	$766.00	$1,255.00	$1,004.00	2025-07-09
78290	CPT	Nm Intestine Imaging Meckels	9	9	$1,245.00	$1,245.00	$759.00	$1,245.00	$996.00	2025-07-09
96600429	CDM	Groshong 8fr Cath Only With Introducer	9	9	$1,241.00	$1,241.00	$757.00	$1,241.00	$993.00	2025-07-09
99292	CPT	99292critical Care, Addl 30 Min	9	9	$1,240.00	$1,240.00	$756.00	$1,240.00	$992.00	2025-07-09
96600167	CDM	Port-a-cath 8fr	9	9	$1,238.00	$1,238.00	$755.00	$1,238.00	$990.00	2025-07-09
13152	CPT	13152 Repair Complex Eyelid/nose/ear/lip 2.6-7.5 Cm Techfee	9	9	$1,236.00	$1,236.00	$754.00	$1,236.00	$989.00	2025-07-09
93925	CPT	93925 Arterial Duplex Bil Lower Charge John	9	9	$1,228.00	$1,228.00	$749.00	$1,228.00	$982.00	2025-07-09
28010	CPT	28010 Tenotomy, Percutaneous, Toe; Single Tendon	18	9	$1,223.50	$1,223.50	$739.00	$1,236.00	$979.00	2025-07-09
25635	CPT	25635 Cltx Carpal Bone Fx W/manj Each Bone Techfee	9	9	$1,217.00	$1,217.00	$742.00	$1,217.00	$974.00	2025-07-09
64493	CPT	64493 Injection Paravertebral Facet Jointsingle Level	9	9	$1,203.00	$1,203.00	$734.00	$1,203.00	$962.00	2025-07-09
11624	CPT	11624 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge…	18	9	$1,385.00	$1,385.00	$357.00	$2,184.00	$959.00	2025-07-09
78580	CPT	Nm Lung Perfusion Imaging	9	9	$1,198.00	$1,198.00	$731.00	$1,198.00	$958.00	2025-07-09
99285	CPT	99285level 5	9	9	$1,191.00	$1,191.00	$727.00	$1,191.00	$953.00	2025-07-09
49083	CPT	49083 Incision Procedures On The Abdomen, Peritoneum, And Omentum Techfee	9	9	$1,180.00	$1,180.00	$720.00	$1,180.00	$944.00	2025-07-09
55250	CPT	55250 Vasectomy, Unilateral Or Bilateral, Including Postoperative Semen Examinat…	9	9	$1,177.00	$1,177.00	$718.00	$1,177.00	$942.00	2025-07-09
A0429	HCPCS	Place Of Pickup: Hospital (a0429)	9	9	$1,174.00	$1,174.00	$716.00	$1,174.00	$939.00	2025-07-09
43460	CPT	Esophagogastroduodenoscopy Balloon Dilatation	9	9	$1,172.00	$1,172.00	$715.00	$1,172.00	$938.00	2025-07-09
96600147	CDM	Mesh Small Ventralex Hernia Patch	9	9	$1,170.00	$1,170.00	$714.00	$1,170.00	$936.00	2025-07-09
72084	CPT	Xr Spine Scoliosis 6+ Views	18	9	$1,156.50	$1,156.50	$698.00	$1,168.00	$925.00	2025-07-09
93041	CPT	Telemetry Charge	9	9	$1,150.00	$1,150.00	$702.00	$1,150.00	$920.00	2025-07-09
96600333	CDM	Balloon 15-18mm E/c	9	9	$1,149.00	$1,149.00	$701.00	$1,149.00	$919.00	2025-07-09
96600281	CDM	Balloon 10-12mm E/c	9	9	$1,149.00	$1,149.00	$701.00	$1,149.00	$919.00	2025-07-09
59840	CPT	59840 Induced Abortion, By Dilation And Curettage	9	9	$1,147.00	$1,147.00	$700.00	$1,147.00	$918.00	2025-07-09
26645	CPT	26645 Closed Treatment Of Carpometacarpal Fracture Dislocation, Thumb (Bennett F…	9	9	$1,146.00	$1,146.00	$699.00	$1,146.00	$917.00	2025-07-09
93930	CPT	93930 Arterial Duplex Bil Upper Charge John	9	9	$1,145.00	$1,145.00	$698.00	$1,145.00	$916.00	2025-07-09
25605	CPT	25605 Closed Treatment Of Distal Radial Fracture; With Manipulation	18	9	$1,253.00	$1,253.00	$464.00	$1,746.00	$912.50	2025-07-09
93978	CPT	93978 Duplex Scan / Aorta/complete Study Charge John	9	9	$1,139.00	$1,139.00	$695.00	$1,139.00	$911.00	2025-07-09
78216	CPT	Nm Liver/spleen Imaging With Vascular Flow	9	9	$1,136.00	$1,136.00	$693.00	$1,136.00	$909.00	2025-07-09
93971	CPT	93971 Venous Duplex Limited Charge John	9	9	$1,134.00	$1,134.00	$692.00	$1,134.00	$907.00	2025-07-09
96600103	CDM	Groshong 9.5 Fr Dual Cath	9	9	$1,130.00	$1,130.00	$689.00	$1,130.00	$904.00	2025-07-09
96600441	CDM	Mesh Soft 12 X 12	9	9	$1,125.00	$1,125.00	$686.00	$1,125.00	$900.00	2025-07-09
96600152	CDM	Mesh Easy Plug Patch Surgimesh	9	9	$1,125.00	$1,125.00	$686.00	$1,125.00	$900.00	2025-07-09
46608	CPT	46608 Anoscopy,rmv For. Bd Ed Tech Fee	9	9	$1,125.00	$1,125.00	$686.00	$1,125.00	$900.00	2025-07-09
96600509	CDM	Endo Gi Ultra Stapler 302.5 Reloads	9	9	$1,106.00	$1,106.00	$675.00	$1,106.00	$885.00	2025-07-09
96600118	CDM	Endo Gia Ultra Univ. Stapler	9	9	$1,105.00	$1,105.00	$674.00	$1,105.00	$884.00	2025-07-09
5000054	CDM	Ulta Veratrac Duo Kci Wound Vac	9	9	$1,101.00	$1,101.00	$672.00	$1,101.00	$881.00	2025-07-09
93975	CPT	93975 Abdominal Organ Vascular Scan Complete Charge John	9	9	$1,092.00	$1,092.00	$666.00	$1,092.00	$874.00	2025-07-09
96600443	CDM	Dnr Gold Probe 7fr Bipolar Hemostasis Cath	9	9	$1,092.00	$1,092.00	$666.00	$1,092.00	$874.00	2025-07-09
40650	CPT	40650 Rpr Lip Full Thickness Vermilion Only Techfee	9	9	$1,088.00	$1,088.00	$664.00	$1,088.00	$870.00	2025-07-09
96600614	CDM	Halo Wand	9	9	$1,082.00	$1,082.00	$660.00	$1,082.00	$866.00	2025-07-09

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