Price Transparencybeta Hospital negotiated rates

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

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Hospital

JOHNSON COUNTY HOSPITAL

Tecumseh, NE · CCN 281350 · Rates published

2,756 distinct procedures filed
9 distinct payers
30,535 rate rows
2025-07-09 last MRF observed · ⚠ 15 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 — reasonRows
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⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old.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 viaDiscovered by HANK
Last fetch success · 2026-09-25
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
$2,559
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
$3,679
1.7× median
55041
CPT 		55041 Excision Of Hydrocele; Bilateral 9 $4,784.00 $7,842.00 $6,274.00 nat. median
$3,911
1.6× median
78814
CPT 		PET CT Limited Area 9 $4,685.00 $7,681.00 $6,145.00 nat. median
$2,379
outlier · 2.6×
78816
CPT 		PET CT Whole Body 9 $4,230.00 $6,935.00 $5,548.00 nat. median
$2,793
2.0× median
78815
CPT 		PET CT Skull Base To Midthigh 9 $3,740.00 $6,131.00 $4,905.00 nat. median
$2,822
1.7× median
74174
CPT 		CT Angio Abdomen And Pelvis 9 $3,510.00 $5,754.00 $4,603.00 nat. median
$998
outlier · 4.6×
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
$1,027
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
$12,739
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
$976
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
$2,454
1.5× median
95811
CPT 		95811 Polysomnography W/cpap Charge 9 $2,774.00 $4,547.00 $3,638.00 nat. median
$1,894
1.9× median
72156
CPT 		MRI Spine Cervical With + Without Contrast 9 $2,724.00 $4,465.00 $3,572.00 nat. median
$1,110
outlier · 3.2×
59510
CPT 		Obstetric Care, Planned Cesarean Delivery 9 $2,669.00 $4,375.00 $3,500.00 nat. median
$3,631
1.0× median
78452
CPT 		Nm Myocardial Spect Rest And Stress 9 $2,655.00 $4,353.00 $3,482.00 nat. median
$1,822
1.9× median
72158
CPT 		MRI Spine Lumbar With + Without Contrast 9 $2,643.00 $4,333.00 $3,466.00 nat. median
$1,097
outlier · 3.2×
74183
CPT 		MRA Abdomen With + Without Contrast 9 $2,625.00 $4,304.00 $3,443.00 nat. median
$1,105
outlier · 3.1×
72157
CPT 		MRI Spine Thoracic With + Without Contrast 9 $2,621.00 $4,296.00 $3,437.00 nat. median
$1,114
outlier · 3.1×
95810
CPT 		Sleep Study 9 $2,619.00 $4,293.00 $3,434.00 nat. median
$1,827
1.9× median
74176
CPT 		CT Abdomen And Pelvis Without Contrast 9 $2,611.00 $4,281.00 $3,425.00 nat. median
$694
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
$999
outlier · 3.3×
78451
CPT 		Nm Myocardial Spect Single Study 9 $2,497.00 $4,094.00 $3,275.00 nat. median
$1,550
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
$1,073
outlier · 3.0×
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
$2,182
1.5× median
72142
CPT 		MRI Spine Cervical With Contrast 9 $2,456.00 $4,027.00 $3,222.00 nat. median
$978
outlier · 3.3×
59400
CPT 		Obstetric Care, Planned Vaginal Delivery 9 $2,447.00 $4,011.00 $3,209.00 nat. median
$3,129
1.0× median
73223
CPT 		MRI Ue Joint With + Without Contrast Left 9 $2,428.00 $3,980.00 $3,184.00 nat. median
$1,158
outlier · 2.7×
70553
CPT 		MRI Scan 9 $2,414.00 $3,957.00 $3,166.00 nat. median
$1,136
outlier · 2.8×
75561
CPT 		MRI Cardiac Morph Fnct With + Without Cnt 9 $2,409.00 $3,949.00 $3,159.00 nat. median
$766
outlier · 4.1×
70543
CPT 		MRI Orbits With + Without Contrast 9 $2,398.00 $3,931.00 $3,145.00 nat. median
$1,087
outlier · 2.9×
72127
CPT 		CT Spine Cervical With + Without Contrast 9 $2,396.00 $3,928.00 $3,142.00 nat. median
$617
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.

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
             
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
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
10000003 CDM Room/bed: Swingbedskilled 9 9 $1,540.00 $1,540.00 $939.00 $1,540.00 $1,232.00 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
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
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
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
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
12000100 CDM Delivery Service 9 9 $1,875.00 $1,875.00 $1,144.00 $1,875.00 $1,500.00 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
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
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
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
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
13200146 CDM Sigmoidoscopy Flexible 9 9 $1,671.00 $1,671.00 $1,019.00 $1,671.00 $1,337.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
43460 CPT Esophagogastroduodenoscopy Balloon Dilatation 9 9 $1,172.00 $1,172.00 $715.00 $1,172.00 $938.00 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
45300 CPT Proctosigmoidoscopy Diagnostic 9 9 $2,228.00 $2,228.00 $1,359.00 $2,228.00 $1,782.00 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
45331 CPT Sigmoidoscopy Biopsy 9 9 $1,678.00 $1,678.00 $1,024.00 $1,678.00 $1,342.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
70336 CPT MRI Tmj 9 9 $2,334.00 $2,334.00 $1,424.00 $2,334.00 $1,867.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
70553 CPT MRI Scan 9 9 $3,957.00 $3,957.00 $2,414.00 $3,957.00 $3,166.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
72197 CPT 72197 9 9 $4,054.00 $4,054.00 $2,473.00 $4,054.00 $3,243.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
78070 CPT Nm Parathyroid Imaging 9 9 $1,361.00 $1,361.00 $830.00 $1,361.00 $1,089.00 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
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
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
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
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
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
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
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
78290 CPT Nm Intestine Imaging Meckels 9 9 $1,245.00 $1,245.00 $759.00 $1,245.00 $996.00 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
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
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
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
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
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
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
78580 CPT Nm Lung Perfusion Imaging 9 9 $1,198.00 $1,198.00 $731.00 $1,198.00 $958.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
93041 CPT Telemetry Charge 9 9 $1,150.00 $1,150.00 $702.00 $1,150.00 $920.00 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
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
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
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
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
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
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
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
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
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
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
95810 CPT Sleep Study 9 9 $4,293.00 $4,293.00 $2,619.00 $4,293.00 $3,434.00 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
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
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
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
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
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
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
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
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
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
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
96600167 CDM Port-a-cath 8fr 9 9 $1,238.00 $1,238.00 $755.00 $1,238.00 $990.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
96600614 CDM Halo Wand 9 9 $1,082.00 $1,082.00 $660.00 $1,082.00 $866.00 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
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
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
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
96608017 CDM Cement Mixer 9 9 $1,408.00 $1,408.00 $859.00 $1,408.00 $1,126.00 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
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
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
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
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
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
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
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
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
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
99285 CPT 99285level 5 9 9 $1,191.00 $1,191.00 $727.00 $1,191.00 $953.00 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
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
A0426 HCPCS A0426 Als Nonemergency 9 9 $1,330.00 $1,330.00 $811.00 $1,330.00 $1,064.00 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
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
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
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
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
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
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
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
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
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
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