Hospital

GORDON MEMORIAL HOSPITAL DISTRICT

Gordon, NE · CCN 281358 · Rates published

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You selected 59400 (CPT)

Obstetric care, planned vaginal delivery

This hospital’s price: $3,282 across 4 payers · range $1,676-$3,317

Source: https://secure.claraprice.net/price-transparency/FSVG-1715881425274/machine-readable/470533032_gordon-memorial-hospital_standardcharges.json · observed 2026-06-09

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.

3,489 distinct procedures filed

4 distinct payers

20,092 rate rows

2026-06-09 last MRF observed

Data quality

19,969 of 20,092 rate rows are consumer-grade (99.4%)

123 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
template filing: same amount across many unrelated codes — excluded	61
per-diem day rate — not a per-procedure price	39
exceeds 10× this hospital's gross charge — excluded from medians	23

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

Source MRF file	https://cochranmemorial.com/pricing/751255846_cochran-memorial-hospital_standardcharges.csv
Found on page	https://cochranmemorial.com/pricing.html
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-08-11
Content fingerprint	57f7fe99683c2b04… · 7,827,423 bytes · first seen 2026-05-15

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
2501216 CDM	Ocrelizumab 300mg/10ml Vial	4	$20,012.00	$39,606.00	$39,190.00	nat. median $816 outlier · 48.0×
57265 CPT	Combine A/p Colporrhapy Enterocele Rpr	4	$19,200.00	$38,000.00	$37,600.00	nat. median $5,071 outlier · 7.4×
27137 CPT	Revise Hip Joint Replacement	4	$18,720.00	$37,050.00	$36,660.00	nat. median $7,922 outlier · 4.6×
23472 CPT	Arthroplasty Total Shoulder Glenohumeral	4	$2,902.00	$36,100.00	$35,720.00	nat. median $16,588 outlier · 2.2×
27415 CPT	Pr Osteochondral Knee Allograft	4	$16,320.00	$32,300.00	$31,960.00	nat. median $11,910 outlier · 2.7×
27130 CPT	Arthroplasty Total Hip	4	$2,702.00	$31,825.00	$31,490.00	nat. median $13,040 outlier · 2.4×
27447 CPT	Arthroplasty Total Knee	4	$2,701.00	$31,825.00	$31,490.00	nat. median $12,699 outlier · 2.5×
43282 CPT	Laparoscopy Para Hernia Fundoplasty Mesh	4	$15,600.00	$30,875.00	$30,550.00	nat. median $10,348 outlier · 3.0×
58292 CPT	Vag Hyst Uterus>250g Rmv&rpr Enterocele	4	$15,360.00	$30,400.00	$30,080.00	nat. median $7,399 outlier · 4.1×
58285 CPT	Vaginal Hysterectomy Radical	4	$14,400.00	$28,500.00	$28,200.00	nat. median $3,448 outlier · 8.2×
58263 CPT	Vag Hystomy Uter<250g Rmv&rpr Enterocele	4	$14,400.00	$28,500.00	$28,200.00	nat. median $5,285 outlier · 5.3×
43281 CPT	Laparoscopy Para Hernia With Fundoplasty	4	$3,041.00	$27,550.00	$27,260.00	nat. median $10,128 outlier · 2.7×
29827 CPT	Arthroscopy Rotator Cuff Rpr	4	$2,123.00	$25,650.00	$25,380.00	nat. median $7,177 outlier · 3.5×
58294 CPT	Vag Hyst Uterus>250g Repair Enterocele	4	$12,960.00	$25,650.00	$25,380.00	nat. median $5,245 outlier · 4.8×
58553 CPT	Lavh > 250g With Removal Of Tubes/ovaries	4	$12,000.00	$23,750.00	$23,500.00	nat. median $9,690 outlier · 2.4×
58270 CPT	Vag Hystomy Uterus<250g Rpr Enterocele	4	$12,000.00	$23,750.00	$23,500.00	nat. median $5,328 outlier · 4.4×
29888 CPT	Knee Arthro/surg Aid Acl Rpr/augmn/recon	4	$1,961.00	$23,275.00	$23,030.00	nat. median $7,307 outlier · 3.2×
25609 CPT	Pr Distal Radius Fx, Intra-artic 3+frag	4	$11,760.00	$23,275.00	$23,030.00	nat. median $7,267 outlier · 3.2×
58660 CPT	Laparoscopy Lysis	4	$11,520.00	$22,800.00	$22,560.00	nat. median $5,940 outlier · 3.8×
58551 CPT	Lavh < 250g With Removal Of Tubes/ovaries	4	$11,040.00	$21,850.00	$21,620.00	nat. median $5,968 outlier · 3.6×
29828 CPT	Arthroscopy Biceps Tenodesis	4	$10,800.00	$21,375.00	$21,150.00	nat. median $7,144 outlier · 3.0×
58552 CPT	Lavh > 250g	4	$1,979.00	$20,900.00	$20,680.00	nat. median $9,808 outlier · 2.1×
23412 CPT	Repair Ruptured Rotator Cuff	4	$1,698.00	$19,475.00	$19,270.00	nat. median $7,013 outlier · 2.7×
74501 CPT	Skyrizi 600mg/10ml Vial	4	$9,798.00	$19,392.00	$19,188.00	nat. median $25,502 0.8× median
58550 CPT	Lavh < 250g	4	$9,600.00	$19,000.00	$18,800.00	nat. median $6,121 outlier · 3.1×
27822 CPT	Open Fx Tx Trimall Ankle Fx	4	$9,360.00	$18,525.00	$18,330.00	nat. median $7,144 outlier · 2.6×
25608 CPT	Open Fx Tx Radial 2 Fragments	4	$9,120.00	$18,050.00	$17,860.00	nat. median $7,144 outlier · 2.5×
25447 CPT	Repair Wrist Joints	4	$9,120.00	$18,050.00	$17,860.00	nat. median $3,840 outlier · 4.7×
47600 CPT	Open Cholecystectomy	4	$9,120.00	$18,050.00	$17,860.00	nat. median $2,613 outlier · 6.8×
58562 CPT	Hysteroscopy Rmvl Impacted Foreign Body	4	$8,640.00	$17,100.00	$16,920.00	nat. median $3,319 outlier · 5.1×
27524 CPT	Open Tx Fx Patellar With	4	$8,640.00	$17,100.00	$16,920.00	nat. median $6,994 outlier · 2.4×
58267 CPT	Vag Hyst Uter<250g Multi-pexy Endo Cnrl	4	$8,640.00	$17,100.00	$16,920.00	nat. median $3,605 outlier · 4.7×
58291 CPT	Vag Hystomy Uterus>250g Rmvl Tube/ovary	4	$8,640.00	$17,100.00	$16,920.00	nat. median $5,394 outlier · 3.1×
23430 CPT	Tenodesis Of Long Tendon Of Biceps	4	$1,484.00	$16,625.00	$16,450.00	nat. median $6,975 outlier · 2.4×
27310 CPT	Arthrotomy Knee With Exploration	4	$8,160.00	$16,150.00	$15,980.00	nat. median $3,583 outlier · 4.5×
25607 CPT	Treat Fx Rad Extra-articul	4	$7,920.00	$15,675.00	$15,510.00	nat. median $7,029 outlier · 2.2×
58661 CPT	Lap Salpingectomy Or Oophorectomy	4	$1,306.00	$15,675.00	$15,510.00	nat. median $5,935 outlier · 2.6×
29882 CPT	Pr Knee Scope,med Or Lat Menis Repair	4	$1,389.00	$15,675.00	$15,510.00	nat. median $3,932 outlier · 3.9×
23515 CPT	Open Fx Tx Clavicle	4	$7,920.00	$15,675.00	$15,510.00	nat. median $7,011 outlier · 2.2×
44180 CPT	Laparoscopic Surgical Enterolysis	4	$1,818.00	$15,675.00	$15,510.00	nat. median $5,888 outlier · 2.6×
58671 CPT	Laparoscopic Tubal Ligation Occlude Ovi	4	$7,680.00	$15,200.00	$15,040.00	nat. median $5,834 outlier · 2.6×
58290 CPT	Vaginal Hysterectomy Uterus>250g	4	$7,680.00	$15,200.00	$15,040.00	nat. median $7,325 outlier · 2.1×
27650 CPT	Pr Repair Achilles Tendon, Primary	4	$7,680.00	$15,200.00	$15,040.00	nat. median $6,655 outlier · 2.3×
58262 CPT	Vag Hystomy Uterus<250g Rmvl Tube/ovary	4	$1,855.00	$15,200.00	$15,040.00	nat. median $5,383 outlier · 2.8×
29824 CPT	Arthroscopy Shoulder With Clavicle	4	$7,440.00	$14,725.00	$14,570.00	nat. median $3,760 outlier · 3.9×
24359 CPT	Repair Elbow Deb/attch Open	4	$7,440.00	$14,725.00	$14,570.00	nat. median $3,655 outlier · 4.0×
29879 CPT	Knee Arthro/surg Abrasion Chondroplasty	4	$7,440.00	$14,725.00	$14,570.00	nat. median $3,765 outlier · 3.9×
49402 CPT	Rmvl Peritoneal Fb From Pertionealcavity	4	$7,440.00	$14,725.00	$14,570.00	nat. median $3,633 outlier · 4.0×
57260 CPT	Combined A/p Colporrhapy With Cysto	4	$1,548.00	$14,250.00	$14,100.00	nat. median $5,022 outlier · 2.8×
27792 CPT	Treatment Of Ankle Fracture	4	$7,200.00	$14,250.00	$14,100.00	nat. median $6,928 outlier · 2.0×

Other procedures at this hospital

Browse this hospital's 3,489 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

2501216	CDM	Ocrelizumab 300mg/10ml Vial	5	4	$41,691.00	$41,691.00	$20,012.00	$39,606.00	$39,190.00	2026-06-09
57265	CPT	Combine A/p Colporrhapy Enterocele Rpr	5	4	$40,000.00	$40,000.00	$19,200.00	$38,000.00	$37,600.00	2026-06-09
27137	CPT	Revise Hip Joint Replacement	5	4	$39,000.00	$39,000.00	$18,720.00	$37,050.00	$36,660.00	2026-06-09
23472	CPT	Arthroplasty Total Shoulder Glenohumeral	5	4	$38,000.00	$38,000.00	$2,902.00	$36,100.00	$35,720.00	2026-06-09
27415	CPT	Pr Osteochondral Knee Allograft	5	4	$34,000.00	$34,000.00	$16,320.00	$32,300.00	$31,960.00	2026-06-09
27130	CPT	Arthroplasty Total Hip	5	4	$33,500.00	$33,500.00	$2,702.00	$31,825.00	$31,490.00	2026-06-09
27447	CPT	Arthroplasty Total Knee	5	4	$33,500.00	$33,500.00	$2,701.00	$31,825.00	$31,490.00	2026-06-09
43282	CPT	Laparoscopy Para Hernia Fundoplasty Mesh	5	4	$32,500.00	$32,500.00	$15,600.00	$30,875.00	$30,550.00	2026-06-09
58292	CPT	Vag Hyst Uterus>250g Rmv&rpr Enterocele	5	4	$32,000.00	$32,000.00	$15,360.00	$30,400.00	$30,080.00	2026-06-09
58263	CPT	Vag Hystomy Uter<250g Rmv&rpr Enterocele	5	4	$30,000.00	$30,000.00	$14,400.00	$28,500.00	$28,200.00	2026-06-09
58285	CPT	Vaginal Hysterectomy Radical	5	4	$30,000.00	$30,000.00	$14,400.00	$28,500.00	$28,200.00	2026-06-09
43281	CPT	Laparoscopy Para Hernia With Fundoplasty	5	4	$29,000.00	$29,000.00	$3,041.00	$27,550.00	$27,260.00	2026-06-09
29827	CPT	Arthroscopy Rotator Cuff Rpr	5	4	$27,000.00	$27,000.00	$2,123.00	$25,650.00	$25,380.00	2026-06-09
58294	CPT	Vag Hyst Uterus>250g Repair Enterocele	5	4	$27,000.00	$27,000.00	$12,960.00	$25,650.00	$25,380.00	2026-06-09
58553	CPT	Lavh > 250g With Removal Of Tubes/ovaries	5	4	$25,000.00	$25,000.00	$12,000.00	$23,750.00	$23,500.00	2026-06-09
58270	CPT	Vag Hystomy Uterus<250g Rpr Enterocele	5	4	$25,000.00	$25,000.00	$12,000.00	$23,750.00	$23,500.00	2026-06-09
25609	CPT	Pr Distal Radius Fx, Intra-artic 3+frag	5	4	$24,500.00	$24,500.00	$11,760.00	$23,275.00	$23,030.00	2026-06-09
29888	CPT	Knee Arthro/surg Aid Acl Rpr/augmn/recon	5	4	$24,500.00	$24,500.00	$1,961.00	$23,275.00	$23,030.00	2026-06-09
58660	CPT	Laparoscopy Lysis	5	4	$24,000.00	$24,000.00	$11,520.00	$22,800.00	$22,560.00	2026-06-09
58551	CPT	Lavh < 250g With Removal Of Tubes/ovaries	5	4	$23,000.00	$23,000.00	$11,040.00	$21,850.00	$21,620.00	2026-06-09
29828	CPT	Arthroscopy Biceps Tenodesis	5	4	$22,500.00	$22,500.00	$10,800.00	$21,375.00	$21,150.00	2026-06-09
58552	CPT	Lavh > 250g	5	4	$22,000.00	$22,000.00	$1,979.00	$20,900.00	$20,680.00	2026-06-09
23412	CPT	Repair Ruptured Rotator Cuff	5	4	$20,500.00	$20,500.00	$1,698.00	$19,475.00	$19,270.00	2026-06-09
74501	CPT	Skyrizi 600mg/10ml Vial	5	4	$20,413.00	$20,413.00	$9,798.00	$19,392.00	$19,188.00	2026-06-09
58550	CPT	Lavh < 250g	5	4	$20,000.00	$20,000.00	$9,600.00	$19,000.00	$18,800.00	2026-06-09
27822	CPT	Open Fx Tx Trimall Ankle Fx	5	4	$19,500.00	$19,500.00	$9,360.00	$18,525.00	$18,330.00	2026-06-09
25447	CPT	Repair Wrist Joints	5	4	$19,000.00	$19,000.00	$9,120.00	$18,050.00	$17,860.00	2026-06-09
25608	CPT	Open Fx Tx Radial 2 Fragments	5	4	$19,000.00	$19,000.00	$9,120.00	$18,050.00	$17,860.00	2026-06-09
47600	CPT	Open Cholecystectomy	5	4	$19,000.00	$19,000.00	$9,120.00	$18,050.00	$17,860.00	2026-06-09
58562	CPT	Hysteroscopy Rmvl Impacted Foreign Body	5	4	$18,000.00	$18,000.00	$8,640.00	$17,100.00	$16,920.00	2026-06-09
27524	CPT	Open Tx Fx Patellar With	5	4	$18,000.00	$18,000.00	$8,640.00	$17,100.00	$16,920.00	2026-06-09
58267	CPT	Vag Hyst Uter<250g Multi-pexy Endo Cnrl	5	4	$18,000.00	$18,000.00	$8,640.00	$17,100.00	$16,920.00	2026-06-09
58291	CPT	Vag Hystomy Uterus>250g Rmvl Tube/ovary	5	4	$18,000.00	$18,000.00	$8,640.00	$17,100.00	$16,920.00	2026-06-09
23430	CPT	Tenodesis Of Long Tendon Of Biceps	5	4	$17,500.00	$17,500.00	$1,484.00	$16,625.00	$16,450.00	2026-06-09
27310	CPT	Arthrotomy Knee With Exploration	5	4	$17,000.00	$17,000.00	$8,160.00	$16,150.00	$15,980.00	2026-06-09
29882	CPT	Pr Knee Scope,med Or Lat Menis Repair	5	4	$16,500.00	$16,500.00	$1,389.00	$15,675.00	$15,510.00	2026-06-09
23515	CPT	Open Fx Tx Clavicle	5	4	$16,500.00	$16,500.00	$7,920.00	$15,675.00	$15,510.00	2026-06-09
25607	CPT	Treat Fx Rad Extra-articul	5	4	$16,500.00	$16,500.00	$7,920.00	$15,675.00	$15,510.00	2026-06-09
58661	CPT	Lap Salpingectomy Or Oophorectomy	5	4	$16,500.00	$16,500.00	$1,306.00	$15,675.00	$15,510.00	2026-06-09
44180	CPT	Laparoscopic Surgical Enterolysis	5	4	$16,500.00	$16,500.00	$1,818.00	$15,675.00	$15,510.00	2026-06-09
27650	CPT	Pr Repair Achilles Tendon, Primary	5	4	$16,000.00	$16,000.00	$7,680.00	$15,200.00	$15,040.00	2026-06-09
58290	CPT	Vaginal Hysterectomy Uterus>250g	5	4	$16,000.00	$16,000.00	$7,680.00	$15,200.00	$15,040.00	2026-06-09
58671	CPT	Laparoscopic Tubal Ligation Occlude Ovi	5	4	$16,000.00	$16,000.00	$7,680.00	$15,200.00	$15,040.00	2026-06-09
58262	CPT	Vag Hystomy Uterus<250g Rmvl Tube/ovary	5	4	$16,000.00	$16,000.00	$1,855.00	$15,200.00	$15,040.00	2026-06-09
29824	CPT	Arthroscopy Shoulder With Clavicle	5	4	$15,500.00	$15,500.00	$7,440.00	$14,725.00	$14,570.00	2026-06-09
29879	CPT	Knee Arthro/surg Abrasion Chondroplasty	5	4	$15,500.00	$15,500.00	$7,440.00	$14,725.00	$14,570.00	2026-06-09
49402	CPT	Rmvl Peritoneal Fb From Pertionealcavity	5	4	$15,500.00	$15,500.00	$7,440.00	$14,725.00	$14,570.00	2026-06-09
24359	CPT	Repair Elbow Deb/attch Open	5	4	$15,500.00	$15,500.00	$7,440.00	$14,725.00	$14,570.00	2026-06-09
57260	CPT	Combined A/p Colporrhapy With Cysto	5	4	$15,000.00	$15,000.00	$1,548.00	$14,250.00	$14,100.00	2026-06-09
27792	CPT	Treatment Of Ankle Fracture	5	4	$15,000.00	$15,000.00	$7,200.00	$14,250.00	$14,100.00	2026-06-09
24685	CPT	Open Fx Tx Ulnar Proximal	5	4	$14,500.00	$14,500.00	$6,960.00	$13,775.00	$13,630.00	2026-06-09
29823	CPT	Arthroscopy Shoulder Debridement	5	4	$14,000.00	$14,000.00	$1,243.00	$13,300.00	$13,160.00	2026-06-09
58260	CPT	Vaginal Hysterectomy, Uterus <250g	5	4	$14,000.00	$14,000.00	$1,668.00	$13,300.00	$13,160.00	2026-06-09
22513	CPT	Per Vert Aug Cavt Creat Mech Thorac Sngl	5	4	$13,500.00	$13,500.00	$1,037.00	$12,825.00	$12,690.00	2026-06-09
2500009	CDM	Activase 100mg Vial	5	4	$13,201.00	$13,201.00	$6,336.00	$12,541.00	$12,409.00	2026-06-09
74334	CPT	Leuprolide Acetate 22.5mg Syringe Kit	5	4	$13,135.00	$13,135.00	$6,305.00	$12,478.00	$12,347.00	2026-06-09
2502137	CDM	Neulasta Onpro Kit 6mg/0.6ml	5	4	$13,093.00	$13,093.00	$6,285.00	$12,438.00	$12,307.00	2026-06-09
2500383	CDM	Neulasta 6 Mg/0.6 Ml Inj	5	4	$13,093.00	$13,093.00	$6,285.00	$12,438.00	$12,307.00	2026-06-09
27380	CPT	Repair Of Kneecap Tendon	5	4	$13,000.00	$13,000.00	$6,240.00	$12,350.00	$12,220.00	2026-06-09
2500538	CDM	Tnkase 50mg Vial	5	4	$12,944.00	$12,944.00	$6,213.00	$12,297.00	$12,167.00	2026-06-09
2500380	CDM	Natalizumab 300mg/15ml Vial	5	4	$12,807.00	$12,807.00	$6,147.00	$12,167.00	$12,039.00	2026-06-09
2501807-#N	CDM	Gamunex-c 10% 400ml Vial	5	4	$12,501.00	$12,501.00	$6,000.00	$11,876.00	$11,751.00	2026-06-09
22514	CPT	Per Vert Aug Cavt Creat Mech Lumbar Sngl	5	4	$12,500.00	$12,500.00	$966.00	$11,875.00	$11,750.00	2026-06-09
47563	CPT	Cholecystectomy With Cholangiography	5	4	$12,500.00	$12,500.00	$1,411.00	$11,875.00	$11,750.00	2026-06-09
64718	CPT	Revise Ulnar Nerve At Elbow	5	4	$12,500.00	$12,500.00	$1,181.00	$11,875.00	$11,750.00	2026-06-09
29822	CPT	Shoulder Arthroscopy/surgery	5	4	$12,000.00	$12,000.00	$1,142.00	$11,400.00	$11,280.00	2026-06-09
21933	CPT	Exc Tumor Subfas Back/flank >5cm	5	4	$12,000.00	$12,000.00	$5,760.00	$11,400.00	$11,280.00	2026-06-09
26480	CPT	Transplant Hand Tendon	5	4	$12,000.00	$12,000.00	$5,760.00	$11,400.00	$11,280.00	2026-06-09
29881	CPT	Removal Of One Knee Cartilage Using An Endoscope	5	4	$12,000.00	$12,000.00	$1,079.00	$11,400.00	$11,280.00	2026-06-09
31017	CPT	Fasenra 30mg/ml Syringe	5	4	$11,928.00	$11,928.00	$5,725.00	$11,332.00	$11,212.00	2026-06-09
27695	CPT	Repair Of Ankle Ligament	5	4	$11,500.00	$11,500.00	$5,520.00	$10,925.00	$10,810.00	2026-06-09
47562	CPT	Removal Of Gallbladder Using An Endoscope	5	4	$11,500.00	$11,500.00	$1,298.00	$10,925.00	$10,810.00	2026-06-09
22511	CPT	Perc Vertebroplasty Lumbo Sacral Single	5	4	$11,500.00	$11,500.00	$5,520.00	$10,925.00	$10,810.00	2026-06-09
24358	CPT	Repair Elbow With Deb Open	5	4	$11,500.00	$11,500.00	$5,520.00	$10,925.00	$10,810.00	2026-06-09
63650	CPT	Per Imp Neurostim Elctrode	5	4	$11,300.00	$11,300.00	$848.00	$10,735.00	$10,622.00	2026-06-09
57240	CPT	Anterior Colporrhapy With Cysto	5	4	$11,000.00	$11,000.00	$5,280.00	$10,450.00	$10,340.00	2026-06-09
57520	CPT	Conization Cervix Cone Biopsy	5	4	$11,000.00	$11,000.00	$5,280.00	$10,450.00	$10,340.00	2026-06-09
22901	CPT	Excision Of Lipoma	5	4	$11,000.00	$11,000.00	$5,280.00	$10,450.00	$10,340.00	2026-06-09
49593	CPT	Repair Antr Abd Hernia Any Reduce 3-10cm	5	4	$11,000.00	$11,000.00	$5,280.00	$10,450.00	$10,340.00	2026-06-09
26055	CPT	Incise Finger Tendon Sheath	5	4	$11,000.00	$11,000.00	$620.00	$10,450.00	$10,340.00	2026-06-09
900024	CDM	Or D 256-270	5	4	$10,680.00	$10,680.00	$5,126.00	$10,146.00	$10,039.00	2026-06-09
20680	CPT	Removal Of Support Implant	5	4	$10,500.00	$10,500.00	$847.00	$9,975.00	$9,870.00	2026-06-09
44970	CPT	Appendectomy	5	4	$10,500.00	$10,500.00	$1,186.00	$9,975.00	$9,870.00	2026-06-09
900023	CDM	Or D 241-255	5	4	$10,230.00	$10,230.00	$4,910.00	$9,719.00	$9,616.00	2026-06-09
2500483	CDM	Rituximab 500mg/50ml Vial	5	4	$10,147.00	$10,147.00	$4,871.00	$9,640.00	$9,538.00	2026-06-09
58670	CPT	Laparoscopic Tubal Ligation Transection	5	4	$10,000.00	$10,000.00	$735.00	$9,500.00	$9,400.00	2026-06-09
58558	CPT	Vag Hyst Uterus>250g Repair Enterocele	5	4	$10,000.00	$10,000.00	$471.00	$9,500.00	$9,400.00	2026-06-09
57250	CPT	Posterior Colporrhapy With Cysto	5	4	$10,000.00	$10,000.00	$4,800.00	$9,500.00	$9,400.00	2026-06-09
78082	CPT	Nf-sandostatin Lar Depot Kit 30mg	5	4	$9,962.00	$9,962.00	$4,782.00	$9,464.00	$9,364.00	2026-06-09
2501655	CDM	Eligard 22.5mg Syringe	5	4	$9,566.00	$9,566.00	$4,592.00	$9,088.00	$8,992.00	2026-06-09
49592	CPT	Int Rpr Antr Abd Hernia With Ttl Defect <3	5	4	$9,500.00	$9,500.00	$4,560.00	$9,025.00	$8,930.00	2026-06-09
27425	CPT	Lateral Retinacular Release Open	5	4	$9,500.00	$9,500.00	$4,560.00	$9,025.00	$8,930.00	2026-06-09
26727	CPT	Treat Finger Fracture Each	5	4	$9,500.00	$9,500.00	$4,560.00	$9,025.00	$8,930.00	2026-06-09
66982	CPT	Cataract Complex Extracapsular Intraocul	15	4	$11,000.00	$11,000.00	$3,360.00	$10,925.00	$8,800.00	2026-06-09
900022	CDM	Or D 226-240	5	4	$9,310.00	$9,310.00	$4,469.00	$8,845.00	$8,751.00	2026-06-09
900021	CDM	Or D 211-225	5	4	$9,160.00	$9,160.00	$4,397.00	$8,702.00	$8,610.00	2026-06-09
900097	CDM	Or C 231-245	5	4	$9,160.00	$9,160.00	$4,397.00	$8,702.00	$8,610.00	2026-06-09
2501292	CDM	Udenyca 6mg/0.6ml Syringe	5	4	$9,018.00	$9,018.00	$4,329.00	$8,567.00	$8,477.00	2026-06-09
900124	CDM	Or D 196-210	5	4	$9,010.00	$9,010.00	$4,325.00	$8,560.00	$8,469.00	2026-06-09
49651	CPT	Laparoscopic Surg Repair Rec Ing Hernia	5	4	$9,000.00	$9,000.00	$4,320.00	$8,550.00	$8,460.00	2026-06-09
58673	CPT	Laparoscopic Salpingostomy	5	4	$9,000.00	$9,000.00	$4,320.00	$8,550.00	$8,460.00	2026-06-09
900096	CDM	Or C 216-230	5	4	$8,940.00	$8,940.00	$4,291.00	$8,493.00	$8,404.00	2026-06-09
900095	CDM	Or C 211-215	5	4	$8,730.00	$8,730.00	$4,190.00	$8,294.00	$8,206.00	2026-06-09
900123	CDM	Or D 181-195	5	4	$8,710.00	$8,710.00	$4,181.00	$8,275.00	$8,187.00	2026-06-09
900122	CDM	Or D 166-180	5	4	$8,550.00	$8,550.00	$4,104.00	$8,123.00	$8,037.00	2026-06-09
900059	CDM	Or Major Level 5 First Hour	5	4	$8,530.00	$8,530.00	$4,094.00	$8,104.00	$8,018.00	2026-06-09
900094	CDM	Or C 196-210	5	4	$8,510.00	$8,510.00	$4,085.00	$8,085.00	$7,999.00	2026-06-09
49320	CPT	Diagnostic Laparoscopy	5	4	$8,500.00	$8,500.00	$649.00	$8,075.00	$7,990.00	2026-06-09
64721	CPT	Carpal Tunnel Surgery	5	4	$8,500.00	$8,500.00	$853.00	$8,075.00	$7,990.00	2026-06-09
46261	CPT	Hemorrhoidectomy With Fissurectomy	5	4	$8,500.00	$8,500.00	$4,080.00	$8,075.00	$7,990.00	2026-06-09
63685	CPT	Ins/replace Neurostim Gen/receiver	5	4	$8,300.00	$8,300.00	$717.00	$7,885.00	$7,802.00	2026-06-09
900093	CDM	Or C 181-195	5	4	$8,290.00	$8,290.00	$3,979.00	$7,876.00	$7,793.00	2026-06-09
63661	CPT	Rmv Spinal Neurostim Electrode Perc	5	4	$8,200.00	$8,200.00	$3,936.00	$7,790.00	$7,708.00	2026-06-09
900092	CDM	Or C 166-180	5	4	$8,090.00	$8,090.00	$3,883.00	$7,686.00	$7,605.00	2026-06-09
74366	CPT	Lupron Depot 11.25mg Syringe Kit	5	4	$8,028.00	$8,028.00	$3,853.00	$7,627.00	$7,546.00	2026-06-09
49613	CPT	Repair Recurrent Antr Abd Hernia <3cm	5	4	$8,000.00	$8,000.00	$3,840.00	$7,600.00	$7,520.00	2026-06-09
66984	CPT	Removal Of Cataract With Insertion Of Lens	5	4	$8,000.00	$8,000.00	$3,840.00	$7,600.00	$7,520.00	2026-06-09
29880	CPT	Arthroscopy Knee Medial And Menisci	5	4	$8,000.00	$8,000.00	$1,120.00	$7,600.00	$7,520.00	2026-06-09
11772	CPT	Excisional Pilondial Cyst Or Sinus-compl	5	4	$8,000.00	$8,000.00	$3,840.00	$7,600.00	$7,520.00	2026-06-09
58555	CPT	Hysteroscopy Corpus Uteri Diagnostic	5	4	$8,000.00	$8,000.00	$3,840.00	$7,600.00	$7,520.00	2026-06-09
900091	CDM	Or C 151-165	5	4	$7,870.00	$7,870.00	$3,778.00	$7,477.00	$7,398.00	2026-06-09
900064	CDM	Or B 196-210	5	4	$7,860.00	$7,860.00	$3,773.00	$7,467.00	$7,388.00	2026-06-09
78100	CPT	Leqvio 284mg/1.5ml Syringe	5	4	$7,750.00	$7,750.00	$3,720.00	$7,363.00	$7,285.00	2026-06-09
2500125	CDM	Crotalidae Polyvalent Immune Fab Vial	5	4	$7,675.00	$7,675.00	$3,684.00	$7,291.00	$7,215.00	2026-06-09
900090	CDM	Or C 136-150	5	4	$7,660.00	$7,660.00	$3,677.00	$7,277.00	$7,200.00	2026-06-09
59409	CPT	Vaginal Delivery Only	5	4	$7,650.00	$7,650.00	$1,244.00	$7,268.00	$7,191.00	2026-06-09
2501202	CDM	Trelstar 22.5 Mg Injection	5	4	$7,612.00	$7,612.00	$3,654.00	$7,231.00	$7,155.00	2026-06-09
2501762	CDM	Cimzia 200mg Syringe	5	4	$7,559.00	$7,559.00	$3,628.00	$7,181.00	$7,105.00	2026-06-09
21931	CPT	Exc Tumor Subq Back/flank >3	5	4	$7,500.00	$7,500.00	$928.00	$7,125.00	$7,050.00	2026-06-09
58563	CPT	Hysteroscopy With Endometrial Ablation	5	4	$7,500.00	$7,500.00	$502.00	$7,125.00	$7,050.00	2026-06-09
46260	CPT	Hemorrhoidectomy Internal External 2<	5	4	$7,500.00	$7,500.00	$3,600.00	$7,125.00	$7,050.00	2026-06-09
900120	CDM	Or D 136-150	5	4	$7,490.00	$7,490.00	$3,595.00	$7,116.00	$7,041.00	2026-06-09
900063	CDM	Or B 181-195	5	4	$7,450.00	$7,450.00	$3,576.00	$7,078.00	$7,003.00	2026-06-09
900089	CDM	Or C 121-135	5	4	$7,440.00	$7,440.00	$3,571.00	$7,068.00	$6,994.00	2026-06-09
2501364-JA	CDM	Gamunex-c 10% 200ml Vial	5	4	$7,354.00	$7,354.00	$3,530.00	$6,986.00	$6,913.00	2026-06-09
900119	CDM	Or D 121-135	5	4	$7,340.00	$7,340.00	$3,523.00	$6,973.00	$6,900.00	2026-06-09
900088	CDM	Or C 106-120	5	4	$7,220.00	$7,220.00	$3,466.00	$6,859.00	$6,787.00	2026-06-09
900118	CDM	Or D 106-120	5	4	$7,190.00	$7,190.00	$3,451.00	$6,831.00	$6,759.00	2026-06-09
900057	CDM	Or Major Level 4 First Hour	5	4	$7,110.00	$7,110.00	$3,413.00	$6,755.00	$6,683.00	2026-06-09
70471	CPT	CT Angio Head And Neck With	5	4	$7,100.00	$7,100.00	$3,408.00	$6,745.00	$6,674.00	2026-06-09
900117	CDM	Or D 91-105	5	4	$7,030.00	$7,030.00	$3,374.00	$6,679.00	$6,608.00	2026-06-09
900087	CDM	Or C 91-105	5	4	$7,020.00	$7,020.00	$3,370.00	$6,669.00	$6,599.00	2026-06-09
22903	CPT	Excision Tumor Abd Wall >3cm	5	4	$7,000.00	$7,000.00	$3,360.00	$6,650.00	$6,580.00	2026-06-09
49650	CPT	Laparoscopic Repair Intl Inguinal Hernia	5	4	$7,000.00	$7,000.00	$3,360.00	$6,650.00	$6,580.00	2026-06-09
11771	CPT	Excision Pilonidal Cyst Or Sinus-extensi	5	4	$7,000.00	$7,000.00	$3,360.00	$6,650.00	$6,580.00	2026-06-09
900116	CDM	Or D 76-90	5	4	$6,880.00	$6,880.00	$3,302.00	$6,536.00	$6,467.00	2026-06-09
900086	CDM	Or C 76-90	5	4	$6,800.00	$6,800.00	$3,264.00	$6,460.00	$6,392.00	2026-06-09
900062	CDM	Or B 166-180	5	4	$6,800.00	$6,800.00	$3,264.00	$6,460.00	$6,392.00	2026-06-09
900115	CDM	Or D 61-75	5	4	$6,730.00	$6,730.00	$3,230.00	$6,394.00	$6,326.00	2026-06-09
900085	CDM	Or C 61-75	5	4	$6,590.00	$6,590.00	$3,163.00	$6,261.00	$6,195.00	2026-06-09
900061	CDM	Or B 151-165	5	4	$6,590.00	$6,590.00	$3,163.00	$6,261.00	$6,195.00	2026-06-09
900114	CDM	Or D 46-60	5	4	$6,580.00	$6,580.00	$3,158.00	$6,251.00	$6,185.00	2026-06-09
69032	CPT	Nyvepria 6mg/0.6ml Syringe	5	4	$6,513.00	$6,513.00	$3,126.00	$6,187.00	$6,122.00	2026-06-09
2501389	CDM	Ziextenzo 6mg/0.6ml Syringe	5	4	$6,513.00	$6,513.00	$3,126.00	$6,187.00	$6,122.00	2026-06-09
25000	CPT	Incision Of Tendon Sheath	5	4	$6,500.00	$6,500.00	$3,120.00	$6,175.00	$6,110.00	2026-06-09
24105	CPT	Pr Removal Elbow Bursa	5	4	$6,500.00	$6,500.00	$3,120.00	$6,175.00	$6,110.00	2026-06-09
23071	CPT	Exc Tumor Sof Tissue Subq Shoulder >3cm	5	4	$6,500.00	$6,500.00	$3,120.00	$6,175.00	$6,110.00	2026-06-09
36561	CPT	Insrt Tunld Cntral Insrted Vad W Sq Port	5	4	$6,500.00	$6,500.00	$681.00	$6,175.00	$6,110.00	2026-06-09
22515	CPT	Per Vert Augumen With Each Add Vertebrae	5	4	$6,500.00	$6,500.00	$3,120.00	$6,175.00	$6,110.00	2026-06-09
49591	CPT	Repair Antr Abd Hernia Any App Mesh < 3	5	4	$6,500.00	$6,500.00	$3,120.00	$6,175.00	$6,110.00	2026-06-09
27337	CPT	Ex Tx Thigh/knee Subq >3	5	4	$6,500.00	$6,500.00	$3,120.00	$6,175.00	$6,110.00	2026-06-09
26160	CPT	Removal Lesion Of Tendon Sheath Or Joint	5	4	$6,500.00	$6,500.00	$668.00	$6,175.00	$6,110.00	2026-06-09
900113	CDM	Or D 31-45	5	4	$6,420.00	$6,420.00	$3,082.00	$6,099.00	$6,035.00	2026-06-09
90009901	CDM	Pilotgraft Btb Tendon	5	4	$6,408.00	$6,408.00	$3,076.00	$6,088.00	$6,024.00	2026-06-09
2500542-JA	CDM	Tocilizumab 400mg/20ml Vial	5	4	$6,374.00	$6,374.00	$3,060.00	$6,055.00	$5,992.00	2026-06-09
900084	CDM	Or C 46-60	5	4	$6,370.00	$6,370.00	$3,058.00	$6,052.00	$5,988.00	2026-06-09
900083	CDM	Or C 31-45	5	4	$6,150.00	$6,150.00	$2,952.00	$5,843.00	$5,781.00	2026-06-09
900112	CDM	Or D 16-30	5	4	$6,120.00	$6,120.00	$2,938.00	$5,814.00	$5,753.00	2026-06-09
2502104	CDM	Nf-vivitrol IM Pwd For Susp ER 380mg	5	4	$6,085.00	$6,085.00	$2,921.00	$5,781.00	$5,720.00	2026-06-09
C1788	HCPCS	Port Central Venous Access	5	4	$6,000.00	$6,000.00	$2,880.00	$5,700.00	$5,640.00	2026-06-09
900111	CDM	Or D 1-15	5	4	$5,950.00	$5,950.00	$2,856.00	$5,653.00	$5,593.00	2026-06-09
900082	CDM	Or C 16-30	5	4	$5,920.00	$5,920.00	$2,842.00	$5,624.00	$5,565.00	2026-06-09
74174	CPT	CT Angio Abd Pelv W	5	4	$5,850.00	$5,850.00	$795.00	$5,558.00	$5,499.00	2026-06-09
2501454	CDM	Invega Sustenna 234mg/1.5ml Syringe	5	4	$5,844.00	$5,844.00	$2,805.00	$5,552.00	$5,493.00	2026-06-09
2501386	CDM	Synagis 100mg/ml Vial	5	4	$5,776.00	$5,776.00	$2,772.00	$5,487.00	$5,429.00	2026-06-09
900055	CDM	Or Major Level 3 First Hour	5	4	$5,690.00	$5,690.00	$2,731.00	$5,406.00	$5,349.00	2026-06-09
900081	CDM	Or C 1-15	5	4	$5,650.00	$5,650.00	$2,712.00	$5,368.00	$5,311.00	2026-06-09
64625	CPT	Radiofreq Ablation Sacro Jnt W/imag	5	4	$5,600.00	$5,600.00	$2,688.00	$5,320.00	$5,264.00	2026-06-09
64635	CPT	Pm Bilat Dest Neuro,lum/sacr Sng Fct Jnt	9	4	$8,250.00	$8,250.00	$457.00	$7,838.00	$5,170.00	2026-06-09
29826	CPT	Shaving Of Shoulder Bone Using Endoscope	5	4	$5,500.00	$5,500.00	$350.00	$5,225.00	$5,170.00	2026-06-09
45388	CPT	Colonoscopy W/ablation	5	4	$5,500.00	$5,500.00	$2,640.00	$5,225.00	$5,170.00	2026-06-09
64633	CPT	Dest Neuro, Paravert Facet Jnt Sngl	5	4	$5,500.00	$5,500.00	$464.00	$5,225.00	$5,170.00	2026-06-09
90009908	CDM	Microport Cs/cr Fem Size 4 Primary Right	5	4	$5,400.00	$5,400.00	$2,592.00	$5,130.00	$5,076.00	2026-06-09
90009909	CDM	Microport Cs Insrt Impl Sz 5 Right 10mm	5	4	$5,250.00	$5,250.00	$2,520.00	$4,988.00	$4,935.00	2026-06-09
2501846	CDM	Benlysta 400mg Vial	5	4	$5,179.00	$5,179.00	$2,486.00	$4,920.00	$4,868.00	2026-06-09
72156	CPT	Mr Spine Cerv Wo W	5	4	$5,175.00	$5,175.00	$751.00	$4,916.00	$4,865.00	2026-06-09
72157	CPT	Mr Spine Thoracic Wo W	5	4	$5,150.00	$5,150.00	$753.00	$4,893.00	$4,841.00	2026-06-09
2501836	CDM	Stelara 130mg/26ml Vial	5	4	$5,087.00	$5,087.00	$2,442.00	$4,833.00	$4,782.00	2026-06-09
95811	CPT	Sleep Study Thera Titrati	5	4	$5,076.00	$5,076.00	$1,071.00	$4,822.00	$4,771.00	2026-06-09
74183	CPT	Mr Abd Wo W	5	4	$5,030.00	$5,030.00	$802.00	$4,779.00	$4,728.00	2026-06-09
45379	CPT	Colonoscopy Flexible With Fb Rmvl	5	4	$5,000.00	$5,000.00	$2,400.00	$4,750.00	$4,700.00	2026-06-09
24075	CPT	Excision Upper Arm Elbow Subq <3cm	5	4	$5,000.00	$5,000.00	$2,400.00	$4,750.00	$4,700.00	2026-06-09
45385	CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope	5	4	$5,000.00	$5,000.00	$527.00	$4,750.00	$4,700.00	2026-06-09
90000150	CDM	Omni Surgical System	5	4	$5,000.00	$5,000.00	$2,400.00	$4,750.00	$4,700.00	2026-06-09
80009909	CDM	Implant System, Suture Loc	5	4	$5,000.00	$5,000.00	$2,400.00	$4,750.00	$4,700.00	2026-06-09
45398	CPT	Colonoscopy W/band Ligation	5	4	$5,000.00	$5,000.00	$481.00	$4,750.00	$4,700.00	2026-06-09
46250	CPT	Hemorrhoidectomy External <2 Columns	5	4	$5,000.00	$5,000.00	$2,400.00	$4,750.00	$4,700.00	2026-06-09
62290	CPT	Inj Prcd For Discography Ea Lvl Lumbar	5	4	$5,000.00	$5,000.00	$2,400.00	$4,750.00	$4,700.00	2026-06-09
15839	CPT	Labiaplasty Cosmetic	5	4	$5,000.00	$5,000.00	$2,400.00	$4,750.00	$4,700.00	2026-06-09
72158	CPT	Mr Spine Lumbar Wo W	5	4	$4,950.00	$4,950.00	$749.00	$4,703.00	$4,653.00	2026-06-09
81229	CPT	Chromosome Microarray Postnatal (Ref)	5	4	$4,920.00	$4,920.00	$2,362.00	$4,674.00	$4,625.00	2026-06-09
1501000	CDM	C-section Delivery	5	4	$4,910.00	$4,910.00	$2,357.00	$4,665.00	$4,615.00	2026-06-09
64620	CPT	Dest Neurolytic, Intercostal Nrve	5	4	$4,900.00	$4,900.00	$2,352.00	$4,655.00	$4,606.00	2026-06-09
900038	CDM	Or A Minor 106-120	5	4	$4,890.00	$4,890.00	$2,347.00	$4,646.00	$4,597.00	2026-06-09
71552	CPT	Mr Chest Wo W	5	4	$4,850.00	$4,850.00	$2,328.00	$4,608.00	$4,559.00	2026-06-09
90009904	CDM	Microport Tib Base Cocr Non Por Sz 5	5	4	$4,770.00	$4,770.00	$2,290.00	$4,532.00	$4,484.00	2026-06-09
70553	CPT	MRI Scan	5	4	$4,650.00	$4,650.00	$746.00	$4,418.00	$4,371.00	2026-06-09
70546	CPT	Mr Angio Head Wo W	5	4	$4,650.00	$4,650.00	$2,232.00	$4,418.00	$4,371.00	2026-06-09
72197	CPT	Mr Sacrum Wo W	5	4	$4,650.00	$4,650.00	$801.00	$4,418.00	$4,371.00	2026-06-09
2500456-JB	CDM	Prolia 60mg/1ml Injection	5	4	$4,636.00	$4,636.00	$2,225.00	$4,404.00	$4,358.00	2026-06-09
900037	CDM	Or A Minor 91-105	5	4	$4,600.00	$4,600.00	$2,208.00	$4,370.00	$4,324.00	2026-06-09
73223	CPT	Mr Joint Lt Upper Wo W	5	4	$4,600.00	$4,600.00	$924.00	$4,370.00	$4,324.00	2026-06-09
2500287	CDM	Leuprolide Acetate 45mg Inj	5	4	$4,553.00	$4,553.00	$2,185.00	$4,325.00	$4,280.00	2026-06-09
70549	CPT	Mr Angio Neck Wo W	5	4	$4,550.00	$4,550.00	$854.00	$4,323.00	$4,277.00	2026-06-09
70543	CPT	Mr Neck Wo W	5	4	$4,550.00	$4,550.00	$796.00	$4,323.00	$4,277.00	2026-06-09
74175	CPT	CT Angio Abd Wo W	5	4	$4,550.00	$4,550.00	$583.00	$4,323.00	$4,277.00	2026-06-09
71551	CPT	Mr Chest W	5	4	$4,550.00	$4,550.00	$2,184.00	$4,323.00	$4,277.00	2026-06-09
45384	CPT	Colonoscopy W/hot Forceps Bx	5	4	$4,500.00	$4,500.00	$469.00	$4,275.00	$4,230.00	2026-06-09
21555	CPT	Exc, Tumor, Neck, Ant Thorax, Subcu <3cm	5	4	$4,500.00	$4,500.00	$2,160.00	$4,275.00	$4,230.00	2026-06-09
49505	CPT	Repair Of Groin Hernia Patient Age 5 Years Or Older	5	4	$4,500.00	$4,500.00	$1,027.00	$4,275.00	$4,230.00	2026-06-09
67914	CPT	Repair Of Entropion; Suture Technique	5	4	$4,500.00	$4,500.00	$2,160.00	$4,275.00	$4,230.00	2026-06-09
78582	CPT	Nm Pulmonary Ventilation And Perfusion	5	4	$4,450.00	$4,450.00	$2,136.00	$4,228.00	$4,183.00	2026-06-09
73220	CPT	Mr Ue W Wo	5	4	$4,450.00	$4,450.00	$978.00	$4,228.00	$4,183.00	2026-06-09
2502011	CDM	Nf-mirena Insert ER 52mg	5	4	$4,372.00	$4,372.00	$2,099.00	$4,153.00	$4,110.00	2026-06-09
72147	CPT	Mr Spine Thoracic W	5	4	$4,350.00	$4,350.00	$2,088.00	$4,133.00	$4,089.00	2026-06-09
70552	CPT	Mr Brain W	5	4	$4,350.00	$4,350.00	$631.00	$4,133.00	$4,089.00	2026-06-09
73723	CPT	Mr Hips Bilat Wo W	5	4	$4,350.00	$4,350.00	$922.00	$4,133.00	$4,089.00	2026-06-09
72149	CPT	Mr Spine Lumbar W	5	4	$4,350.00	$4,350.00	$2,088.00	$4,133.00	$4,089.00	2026-06-09
72142	CPT	Mr Spine Cerv W	5	4	$4,350.00	$4,350.00	$2,088.00	$4,133.00	$4,089.00	2026-06-09
64624	CPT	Des Neur Genicular Nerve Branches	10	4	$5,375.00	$5,375.00	$2,064.00	$6,128.00	$4,063.50	2026-06-09
95810	CPT	Sleep Study	5	4	$4,320.00	$4,320.00	$1,022.00	$4,104.00	$4,061.00	2026-06-09
2502105	CDM	Naltrexone 380mg Syringe	5	4	$4,300.00	$4,300.00	$2,064.00	$4,085.00	$4,042.00	2026-06-09
900053	CDM	Or Major Level 2 First Hour	5	4	$4,270.00	$4,270.00	$2,050.00	$4,057.00	$4,014.00	2026-06-09
2501599	CDM	Dalbavancin 500mg Vial	5	4	$4,270.00	$4,270.00	$2,050.00	$4,057.00	$4,014.00	2026-06-09
71550	CPT	Mr Chest Hilar Mediastein	5	4	$4,250.00	$4,250.00	$2,040.00	$4,038.00	$3,995.00	2026-06-09
70542	CPT	Mr Neck W	5	4	$4,250.00	$4,250.00	$2,040.00	$4,038.00	$3,995.00	2026-06-09
70548	CPT	Mr Angio Neck W	5	4	$4,250.00	$4,250.00	$2,040.00	$4,038.00	$3,995.00	2026-06-09
71555	CPT	Mr Angio Chest W	10	4	$4,400.00	$4,400.00	$2,040.00	$4,323.00	$3,995.00	2026-06-09
24515	CPT	Rasburicase 1.5mg Vial	10	4	$6,974.00	$6,974.00	$1,275.00	$10,726.00	$3,972.00	2026-06-09
2501455	CDM	Invega Sustenna 156mg/1ml Syringe	5	4	$4,175.00	$4,175.00	$2,004.00	$3,966.00	$3,925.00	2026-06-09
73720	CPT	Mr Low Ext Lt Wo W	5	4	$4,150.00	$4,150.00	$799.00	$3,943.00	$3,901.00	2026-06-09
900036	CDM	Or A Minor 76-90	5	4	$4,100.00	$4,100.00	$1,968.00	$3,895.00	$3,854.00	2026-06-09
23590	CPT	Triptorelin 11.25 Mg Injection	5	4	$4,099.00	$4,099.00	$1,968.00	$3,894.00	$3,853.00	2026-06-09
51706	CPT	Injectafer 750mg/15ml Vial	5	4	$4,059.00	$4,059.00	$1,948.00	$3,856.00	$3,815.00	2026-06-09
75635	CPT	CT Angio W Runoff	5	4	$4,050.00	$4,050.00	$642.00	$3,848.00	$3,807.00	2026-06-09
72146	CPT	Mr Spine Thoracic Wo	5	4	$4,050.00	$4,050.00	$445.00	$3,848.00	$3,807.00	2026-06-09
70551	CPT	Mr Brain Wo	5	4	$4,050.00	$4,050.00	$456.00	$3,848.00	$3,807.00	2026-06-09
70544	CPT	Mr Angio Head Wo	5	4	$4,050.00	$4,050.00	$557.00	$3,848.00	$3,807.00	2026-06-09
72196	CPT	Mr Sacrum W	5	4	$4,050.00	$4,050.00	$1,944.00	$3,848.00	$3,807.00	2026-06-09
73222	CPT	Mr Joint Lt Upper W	5	4	$4,050.00	$4,050.00	$744.00	$3,848.00	$3,807.00	2026-06-09
74182	CPT	Mr Abd W	5	4	$4,050.00	$4,050.00	$1,944.00	$3,848.00	$3,807.00	2026-06-09
71275	CPT	CT Pe Angio Chest W	5	4	$4,050.00	$4,050.00	$585.00	$3,848.00	$3,807.00	2026-06-09
72141	CPT	Mr Spine Cerv Wo	5	4	$4,050.00	$4,050.00	$444.00	$3,848.00	$3,807.00	2026-06-09
73722	CPT	Mr Hips Bilat W	5	4	$4,050.00	$4,050.00	$748.00	$3,848.00	$3,807.00	2026-06-09
64479	CPT	Pm Bilt Tfesi Inj Cer/thora Sing Lvl	10	4	$4,925.00	$4,925.00	$1,920.00	$5,558.00	$3,780.00	2026-06-09
45380	CPT	Biopsy Exam Of Large Bowel Using An Endoscope	5	4	$4,000.00	$4,000.00	$415.00	$3,800.00	$3,760.00	2026-06-09
56620	CPT	Labiaplasty	5	4	$4,000.00	$4,000.00	$1,920.00	$3,800.00	$3,760.00	2026-06-09
43251	CPT	Egd With Snare Technique	5	4	$4,000.00	$4,000.00	$406.00	$3,800.00	$3,760.00	2026-06-09
9046200	CDM	Fissurectomy W Sphincterotomy When Permd	5	4	$4,000.00	$4,000.00	$1,920.00	$3,800.00	$3,760.00	2026-06-09
57522	CPT	Conization Cervix Leep	5	4	$4,000.00	$4,000.00	$494.00	$3,800.00	$3,760.00	2026-06-09
28825	CPT	Amputation Toe At Interphalangeal Joint	5	4	$4,000.00	$4,000.00	$1,920.00	$3,800.00	$3,760.00	2026-06-09
45381	CPT	Colonoscopy With Directed Submucosal Inj	5	4	$4,000.00	$4,000.00	$415.00	$3,800.00	$3,760.00	2026-06-09
70547	CPT	Mr Angio Neck Wo	5	4	$3,950.00	$3,950.00	$1,896.00	$3,753.00	$3,713.00	2026-06-09
70540	CPT	Mr Neck Wo	5	4	$3,950.00	$3,950.00	$1,896.00	$3,753.00	$3,713.00	2026-06-09
32187	CPT	Nf-orencia Intravenous Pwd For Soln 250m	10	4	$4,557.00	$4,557.00	$1,848.00	$5,001.00	$3,638.50	2026-06-09
78598	CPT	Nm Quant Ventilation And Perfusion	5	4	$3,850.00	$3,850.00	$1,848.00	$3,658.00	$3,619.00	2026-06-09
2502108	CDM	Denosumab-bbdz 60mg/ml Syringe	5	4	$3,850.00	$3,850.00	$1,848.00	$3,658.00	$3,619.00	2026-06-09
74185	CPT	Mr Abdomen W/wo Contrast	5	4	$3,850.00	$3,850.00	$1,848.00	$3,658.00	$3,619.00	2026-06-09
46947	CPT	Pph Stapled Hemorrhoidectomy	5	4	$3,800.00	$3,800.00	$1,824.00	$3,610.00	$3,572.00	2026-06-09
90009910	CDM	Atlas, Dt With Gfs And Drill Bit	5	4	$3,790.00	$3,790.00	$1,819.00	$3,601.00	$3,563.00	2026-06-09
90009911	CDM	Palacose R+g Pro 80 Bone Cement	5	4	$3,790.00	$3,790.00	$1,819.00	$3,601.00	$3,563.00	2026-06-09
900035	CDM	Or A Minor 61-75	5	4	$3,770.00	$3,770.00	$1,810.00	$3,582.00	$3,544.00	2026-06-09
72194	CPT	CT Pelvis Wo W	5	4	$3,750.00	$3,750.00	$1,800.00	$3,563.00	$3,525.00	2026-06-09
74181	CPT	Mr Abd Wo	5	4	$3,750.00	$3,750.00	$491.00	$3,563.00	$3,525.00	2026-06-09
2501179	CDM	Xolair 150mg Syringe	5	4	$3,729.00	$3,729.00	$1,790.00	$3,543.00	$3,505.00	2026-06-09
28810	CPT	Amp Metatar W/toe Single	10	4	$6,505.00	$6,505.00	$725.00	$10,925.00	$3,477.50	2026-06-09
2501363-JA	CDM	Gamunex-c 10% 100ml Vial	5	4	$3,677.00	$3,677.00	$1,765.00	$3,493.00	$3,456.00	2026-06-09
70496	CPT	CT Angio Head W & Wo	5	4	$3,650.00	$3,650.00	$577.00	$3,468.00	$3,431.00	2026-06-09
71270	CPT	CT Thorax Wo W	5	4	$3,650.00	$3,650.00	$468.00	$3,468.00	$3,431.00	2026-06-09
73219	CPT	Mr Upper Ext L W	5	4	$3,650.00	$3,650.00	$1,752.00	$3,468.00	$3,431.00	2026-06-09
72195	CPT	Mr Sacrum Wo	5	4	$3,650.00	$3,650.00	$543.00	$3,468.00	$3,431.00	2026-06-09
36573	CPT	Picc Insert With US >5y	9	4	$3,850.00	$3,850.00	$175.00	$3,658.00	$3,384.00	2026-06-09
2500966	CDM	Simponi Aria 50mg/4ml Vial	5	4	$3,599.00	$3,599.00	$1,728.00	$3,419.00	$3,383.00	2026-06-09
70498	CPT	CT Angio Neck Wo W	5	4	$3,550.00	$3,550.00	$577.00	$3,373.00	$3,337.00	2026-06-09
73719	CPT	Mr Low Ext Lt W	5	4	$3,550.00	$3,550.00	$1,704.00	$3,373.00	$3,337.00	2026-06-09
70488	CPT	CT Sinuses Wo W	5	4	$3,550.00	$3,550.00	$1,704.00	$3,373.00	$3,337.00	2026-06-09
74170	CPT	CT Pancreas Wo W	5	4	$3,550.00	$3,550.00	$541.00	$3,373.00	$3,337.00	2026-06-09
81479	CPT	Snca Alpha Synuclein DNA Seque (Ref)	5	4	$3,532.00	$3,532.00	$1,695.00	$3,355.00	$3,320.00	2026-06-09
64640	CPT	Dest Neurolytic, Peripheral Nerve	10	4	$4,375.00	$4,375.00	$1,680.00	$4,988.00	$3,307.50	2026-06-09
43250	CPT	Egd W/hot Forceps Bx	5	4	$3,500.00	$3,500.00	$1,680.00	$3,325.00	$3,290.00	2026-06-09
62321	CPT	Inj Interlamin Epid/subarac Cerv/thor IM	5	4	$3,500.00	$3,500.00	$222.00	$3,325.00	$3,290.00	2026-06-09
43247	CPT	Egd With Fb Removal	5	4	$3,500.00	$3,500.00	$365.00	$3,325.00	$3,290.00	2026-06-09
G0121	HCPCS	Colonoscopy Screening	5	4	$3,500.00	$3,500.00	$260.00	$3,325.00	$3,290.00	2026-06-09
G0105	HCPCS	Colonoscopy Screening High Risk	5	4	$3,500.00	$3,500.00	$260.00	$3,325.00	$3,290.00	2026-06-09
56605	CPT	Excision Vulva Or Perineum 1 Lesion	5	4	$3,500.00	$3,500.00	$1,680.00	$3,325.00	$3,290.00	2026-06-09
46505	CPT	Chemodenervation Anal Sphincter	5	4	$3,500.00	$3,500.00	$1,680.00	$3,325.00	$3,290.00	2026-06-09
45378	CPT	Diagnostic Exam Of Large Bowel Using An Endoscope	5	4	$3,500.00	$3,500.00	$381.00	$3,325.00	$3,290.00	2026-06-09
59400	CPT	Obstetric Care, Planned Vaginal Delivery	5	4	$3,492.00	$3,492.00	$1,676.00	$3,317.00	$3,282.00	2026-06-09
1100004	CDM	Anesthesia Level 4	5	4	$3,475.00	$3,475.00	$1,668.00	$3,301.00	$3,267.00	2026-06-09
72132	CPT	CT Spine Lumbar W (Do Not Order)	5	4	$3,423.00	$3,423.00	$1,643.00	$3,252.00	$3,218.00	2026-06-09

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