Hospital

HACKENSACK MERIDIAN HEALTH PASCACK VALLEY MEDICAL

Westwood, NJ · CCN 310130 · Rates published

Your selected procedure

You selected 93306 (CPT)

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This hospital’s price: $1,744 across 7 payers · range $675-$1,744

Source: https://coc.ardenthealthservices.com/newjersey/26-4051248_Hackensack-Meridian-at-Pascack-Valley_standardchanges.csv · observed 2025-04-05

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.

6,004 distinct procedures filed

68 distinct payers

535,360 rate rows

2025-04-05 last MRF observed · ⚠ 18 mo old

Data quality

145,635 of 535,360 rate rows are consumer-grade (27.2%)

389,725 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	378,932
template filing: same amount across many unrelated codes — excluded	5,512
exceeds 10× this hospital's gross charge — excluded from medians	3,728
per-diem day rate — not a per-procedure price	1,542
placeholder amount (≤ $0.02) — excluded from medians	7
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	4

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 18 months old.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://coc.ardenthealthservices.com/newjersey/26-4051248_Hackensack-Meridian-at-Pascack-Valley_standardchanges.csv
Found on page	https://pascackmedicalcenter.com/policies-and-disclosures/pricing-transparency/
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-20
Content fingerprint	6acca021b3cf19ea… · 469,851,523 bytes · first seen 2026-05-08

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
J7189 HCPCS	Coagulation Factor Viia Recomb 8 Mg (8,000 Mcg) Intravenous Solution	68	$2,139.45	$27,410.40	$22,263.00	nat. median $3,590 outlier · 6.2×
C9773 HCPCS	Hc Revasc Lithotr-stent Tib/Per	60	$6,876.00	$18,009.00	$12,442.50	nat. median $19,390 0.6× median
C9772 HCPCS	Hc Revasc Lithotrip Tibi/Perone	60	$6,876.00	$18,009.00	$12,442.50	nat. median $13,478 0.9× median
C9767 HCPCS	Hc Lithotrip-ather-stent Other Lower Ext Artery	60	$6,876.00	$18,009.00	$12,442.50	nat. median $20,608 0.6× median
C9766 HCPCS	Hc Lithotrip & Ather Other Lower Ext Artery	60	$6,876.00	$18,009.00	$12,442.50	nat. median $19,268 0.6× median
C9775 HCPCS	Hc Revasc Lith-sten-ath Tib/Per	60	$6,876.00	$18,009.00	$12,442.50	nat. median $19,784 0.6× median
C9774 HCPCS	Hc Revasc Lithotr-ather Tib/Per	60	$6,876.00	$18,009.00	$12,442.50	nat. median $19,561 0.6× median
C9765 HCPCS	Hc Lithotripsy & Stent Other Lower Ext Artery	60	$6,876.00	$18,009.00	$12,442.50	nat. median $19,139 0.7× median
C9764 HCPCS	Hc Lithotripsy Other Lower Ext Artery	60	$6,876.00	$18,009.00	$12,442.50	nat. median $12,463 1.0× median
G0260 HCPCS	Hc Si Jt Anes/Ster Inj W/wo Arthr	57	$6,876.00	$10,541.50	$10,541.50	nat. median $1,107 outlier · 9.5×
81443 CPT	Genomic Sequence Analysis Panel For Severe Inherited Conditions With Sequencing…	68	$1,224.28	$19,417.08	$10,320.68	nat. median $2,449 outlier · 4.2×
J2327 HCPCS	Risankizumab-rzaa 60 Mg/ml Intravenous Solution	68	$7,462.32	$12,994.56	$10,228.44	nat. median $2,076 outlier · 4.9×
36831 CPT	Removal Of Blood Clot From Hemodialysis Graft	57	$5,983.00	$10,095.00	$10,095.00	nat. median $5,811 1.7× median
51600 CPT	Injection Procedure For Imaging Of Bladder During Voiding	57	$4,362.00	$9,284.50	$9,284.50	nat. median $477 outlier · 19.5×
29581 CPT	Application Of Vein Wound Compression Bandages On Lower Leg, Ankle, And Foot	61	$4,362.00	$9,284.50	$9,284.50	nat. median $249 outlier · 37.3×
27093 CPT	Hc Inj Arthrogram Hip Without Anes	57	$4,362.00	$9,284.50	$9,284.50	nat. median $558 outlier · 16.6×
10120 CPT	Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Simple	56	$4,362.00	$9,284.50	$9,284.50	nat. median $445 outlier · 20.9×
62284 CPT	Injection Of Contrast For Imaging Of Lower Spinal Canal	57	$4,362.00	$9,284.50	$9,284.50	nat. median $767 outlier · 12.1×
36200 CPT	Insertion Of Tube Into Aorta	57	$4,362.00	$9,284.50	$9,284.50	nat. median $1,370 outlier · 6.8×
36561 CPT	Insertion Of Central Venous Tube With Port (5 Years Or Older)	57	$3,107.00	$9,197.00	$8,657.00	nat. median $3,741 outlier · 2.3×
33222 CPT	Relocation Of Pacemaker Skin Pocket	57	$3,107.00	$9,197.00	$8,657.00	nat. median $2,641 outlier · 3.3×
26951 CPT	Amputation Of Finger Or Thumb With Direct Closure	57	$3,107.00	$9,197.00	$8,657.00	nat. median $3,320 outlier · 2.6×
26952 CPT	Amputation Of Finger Or Thumb With Tissue Flap	57	$3,107.00	$9,197.00	$8,657.00	nat. median $3,363 outlier · 2.6×
26350 CPT	Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm…	57	$3,107.00	$9,197.00	$8,657.00	nat. median $3,390 outlier · 2.6×
26418 CPT	Repair Of Tendon On Top Side Of Finger	57	$3,107.00	$9,197.00	$8,657.00	nat. median $2,008 outlier · 4.3×
21320 CPT	Closed Treatment Of Broken Nose Bone With Placement Of Stabilizing Device	57	$3,107.00	$9,197.00	$8,657.00	nat. median $3,109 outlier · 2.8×
21337 CPT	Closed Treatment Of Broken Bone Separating Nose Airways	57	$3,107.00	$9,197.00	$8,657.00	nat. median $3,235 outlier · 2.7×
20225 CPT	Deep Biopsy Of Bone Using Needle Or Trocar	57	$3,107.00	$9,197.00	$8,657.00	nat. median $1,964 outlier · 4.4×
21315 CPT	Closed Treatment Of Broken Nose Bone With Manipulation	57	$3,107.00	$9,197.00	$8,657.00	nat. median $1,683 outlier · 5.1×
46040 CPT	Drainage Of Deep Abscess In Rectum	57	$3,107.00	$9,197.00	$8,657.00	nat. median $1,693 outlier · 5.1×
28192 CPT	Removal Of Foreign Body Of Foot Tissue, Deep	57	$3,107.00	$9,197.00	$8,657.00	nat. median $1,857 outlier · 4.7×
29445 CPT	Application Of Walking Cast Covering Foot, Ankle, And Lower Leg	61	$2,713.00	$8,460.00	$8,460.00	nat. median $389 outlier · 21.8×
29405 CPT	Application Of Short Leg Cast	61	$2,713.00	$8,460.00	$8,460.00	nat. median $320 outlier · 26.4×
29505 CPT	Application Of Long Leg Splint From Thigh To Ankle Or Toe	61	$2,713.00	$8,460.00	$8,460.00	nat. median $232 outlier · 36.5×
29125 CPT	Application Of Nonmoveable Forearm To Hand Splint	62	$2,713.00	$8,460.00	$8,460.00	nat. median $191 outlier · 44.3×
10005 CPT	Hc Fine Needle Aspiration Bx W/us Gdn 1st Lesion	57	$2,713.00	$9,197.00	$8,460.00	nat. median $930 outlier · 9.1×
29130 CPT	Application Of Nonmoveable Finger Splint	61	$2,713.00	$8,460.00	$8,460.00	nat. median $164 outlier · 51.5×
29515 CPT	Application Of Short Leg Splint From Calf To Foot	61	$2,713.00	$8,460.00	$8,460.00	nat. median $214 outlier · 39.6×
29085 CPT	Application Of Hand And Lower Forearm Cast	61	$2,713.00	$8,460.00	$8,460.00	nat. median $211 outlier · 40.1×
11105 CPT	Hc Punch Biopsy Skin Ea Sep/Addl Lesion	55	$2,713.00	$8,460.00	$8,460.00	nat. median $167 outlier · 50.7×
29105 CPT	Application Of Lower And Upper Arm Splint	61	$2,713.00	$8,460.00	$8,460.00	nat. median $221 outlier · 38.3×
29065 CPT	Application Of Shoulder To Hand Cast	62	$2,713.00	$8,460.00	$8,460.00	nat. median $320 outlier · 26.4×
11102 CPT	Hc Tangential Biopsy Skin Single Lesion	55	$2,713.00	$8,460.00	$8,460.00	nat. median $278 outlier · 30.5×
29075 CPT	Application Of Elbow To Finger Cast	61	$2,713.00	$8,460.00	$8,460.00	nat. median $313 outlier · 27.0×
29580 CPT	Strapping, Unna Boot	61	$2,713.00	$8,460.00	$8,460.00	nat. median $220 outlier · 38.4×
34707 CPT	Hc Evasc Rpr Dplmnt Ilio-iliac Endogrft	57	$2,713.00	$9,197.00	$8,460.00	nat. median $4,869 1.7× median
33224 CPT	Insertion Of Left Lower Heart Electrode And Attachment To Pacemaker Or Defibrill…	57	$2,713.00	$9,197.00	$8,460.00	nat. median $11,136 0.8× median
10009 CPT	Hc Fine Needle Aspiration Bx W/ct Gdn 1st Lesion	57	$2,713.00	$9,197.00	$8,460.00	nat. median $996 outlier · 8.5×
11104 CPT	Hc Punch Biopsy Skin Single Lesion	61	$2,713.00	$8,460.00	$8,460.00	nat. median $402 outlier · 21.1×
10030 CPT	Drainage Of Fluid Collection In Soft Tissue Using Imaging Guidance	57	$2,713.00	$9,197.00	$8,460.00	nat. median $962 outlier · 8.8×

Other procedures at this hospital

Browse this hospital's 6,004 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

J7189	HCPCS	Coagulation Factor Viia Recomb 8 Mg (8,000 Mcg) Intravenous Solution	106	68	$76,032.80	$76,032.80	$2,139.45	$27,410.40	$22,263.00	2025-04-05
C9772	HCPCS	Hc Revasc Lithotrip Tibi/Perone	73	60	$37,104.00	$37,104.00	$6,876.00	$18,009.00	$12,442.50	2025-04-05
C9765	HCPCS	Hc Lithotripsy & Stent Other Lower Ext Artery	73	60	$59,325.00	$59,325.00	$6,876.00	$18,009.00	$12,442.50	2025-04-05
C9767	HCPCS	Hc Lithotrip-ather-stent Other Lower Ext Artery	73	60	$65,257.00	$65,257.00	$6,876.00	$18,009.00	$12,442.50	2025-04-05
C9766	HCPCS	Hc Lithotrip & Ather Other Lower Ext Artery	73	60	$59,325.00	$59,325.00	$6,876.00	$18,009.00	$12,442.50	2025-04-05
C9773	HCPCS	Hc Revasc Lithotr-stent Tib/Per	73	60	$59,325.00	$59,325.00	$6,876.00	$18,009.00	$12,442.50	2025-04-05
C9775	HCPCS	Hc Revasc Lith-sten-ath Tib/Per	73	60	$65,257.00	$65,257.00	$6,876.00	$18,009.00	$12,442.50	2025-04-05
C9764	HCPCS	Hc Lithotripsy Other Lower Ext Artery	73	60	$37,104.00	$37,104.00	$6,876.00	$18,009.00	$12,442.50	2025-04-05
C9774	HCPCS	Hc Revasc Lithotr-ather Tib/Per	73	60	$59,325.00	$59,325.00	$6,876.00	$18,009.00	$12,442.50	2025-04-05
G0260	HCPCS	Hc Si Jt Anes/Ster Inj W/wo Arthr	138	57	$2,900.00	$1,057.62 64% off	$6,876.00	$10,541.50	$10,541.50	2025-04-05
81443	CPT	Genomic Sequence Analysis Panel For Severe Inherited Conditions With Sequencing …	88	68	$7,346.00	$7,346.00	$1,224.28	$19,417.08	$10,320.68	2025-04-05
J2327	HCPCS	Risankizumab-rzaa 60 Mg/ml Intravenous Solution	88	68	$64,462.56	$11,610.49 82% off	$7,462.32	$12,994.56	$10,228.44	2025-04-05
36831	CPT	Removal Of Blood Clot From Hemodialysis Graft	69	57	$7,613.00	$7,613.00	$5,983.00	$10,095.00	$10,095.00	2025-04-05
27093	CPT	Hc Inj Arthrogram Hip Without Anes	69	57	$1,943.00	$1,943.00	$4,362.00	$9,284.50	$9,284.50	2025-04-05
51600	CPT	Injection Procedure For Imaging Of Bladder During Voiding	69	57	$1,221.00	$1,221.00	$4,362.00	$9,284.50	$9,284.50	2025-04-05
10120	CPT	Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Simple	67	56	$884.00	$884.00	$4,362.00	$9,284.50	$9,284.50	2025-04-05
36200	CPT	Insertion Of Tube Into Aorta	69	57	$2,353.00	$2,353.00	$4,362.00	$9,284.50	$9,284.50	2025-04-05
29581	CPT	Application Of Vein Wound Compression Bandages On Lower Leg, Ankle, And Foot	137	61	$574.50	$361.47 37% off	$4,362.00	$9,284.50	$9,284.50	2025-04-05
62284	CPT	Injection Of Contrast For Imaging Of Lower Spinal Canal	69	57	$2,192.00	$2,192.00	$4,362.00	$9,284.50	$9,284.50	2025-04-05
21337	CPT	Closed Treatment Of Broken Bone Separating Nose Airways	69	57	$6,521.07	$6,521.07	$3,107.00	$9,197.00	$8,657.00	2025-04-05
26951	CPT	Amputation Of Finger Or Thumb With Direct Closure	69	57	$9,253.00	$9,253.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
46040	CPT	Drainage Of Deep Abscess In Rectum	69	57	$4,154.00	$4,154.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
26952	CPT	Amputation Of Finger Or Thumb With Tissue Flap	69	57	$3,964.00	$3,964.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
21320	CPT	Closed Treatment Of Broken Nose Bone With Placement Of Stabilizing Device	69	57	$4,042.00	$4,042.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
21315	CPT	Closed Treatment Of Broken Nose Bone With Manipulation	69	57	$4,850.70	$4,850.70	$3,107.00	$9,197.00	$8,657.00	2025-04-05
36561	CPT	Insertion Of Central Venous Tube With Port (5 Years Or Older)	69	57	$12,550.00	$12,550.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
26418	CPT	Repair Of Tendon On Top Side Of Finger	69	57	$4,355.00	$4,355.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
26350	CPT	Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm…	69	57	$6,082.00	$6,082.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
20225	CPT	Deep Biopsy Of Bone Using Needle Or Trocar	69	57	$2,222.00	$2,222.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
33222	CPT	Relocation Of Pacemaker Skin Pocket	69	57	$5,142.00	$5,142.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
28192	CPT	Removal Of Foreign Body Of Foot Tissue, Deep	69	57	$3,536.00	$3,536.00	$3,107.00	$9,197.00	$8,657.00	2025-04-05
36247	CPT	Insertion Of Tube Into Abdominal, Pelvic, Or Leg Artery, Initial Third Order Bra…	93	57	$4,013.00	$4,013.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
10080	CPT	Simple Drainage Of Cyst Of Tailbone	69	57	$2,255.00	$2,255.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36510	CPT	Insertion Of Tube Into Umbilical Vein, Newborn	62	55	$400.00	$400.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
36904	CPT	Hc Avf-declot Circuit-s/r	69	57	$9,771.00	$9,771.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
33285	CPT	Hc Insertion Subq Cardiac Rhythm Monitor W/Prgrmg	69	57	$26,015.00	$26,015.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
10005	CPT	Hc Fine Needle Aspiration Bx W/us Gdn 1st Lesion	69	57	$1,021.00	$1,021.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36245	CPT	Insertion Of Tube Into Abdominal, Pelvic, Or Leg Artery, Each First Order Branch	69	57	$2,514.75	$2,514.75	$2,713.00	$9,197.00	$8,460.00	2025-04-05
G0259	HCPCS	Hc Inj Arthrogr Sacroiliac Jnt	69	57	$3,087.00	$3,087.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37222	CPT	Balloon Dilation Of Groin Artery, Each Additional Vessel	69	57	$13,544.00	$13,544.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
29085	CPT	Application Of Hand And Lower Forearm Cast	69	61	$520.00	$520.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
36222	CPT	Hc Place Cath Carotid/Ext Cranial	69	57	$6,539.00	$6,539.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
22513	CPT	Treatment Of Broken Middle Spine Bone With Placement Of Stabilizing Device Using…	69	57	$14,317.00	$14,317.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
11102	CPT	Hc Tangential Biopsy Skin Single Lesion	63	55	$529.35	$306.18 42% off	$2,713.00	$8,460.00	$8,460.00	2025-04-05
PX-36001264	CDM	Hc Or Acuity Lvl 5 1st 30 Min	75	63	$7,700.00	$7,700.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001288	CDM	Hc Robotic Or Acuity Lvl 6 1st 30 Min	75	63	$9,700.00	$9,700.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001148	CDM	Hc Or Acuity Lvl 2 Ea Addl 30 Min	75	63	$3,500.00	$3,500.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001273	CDM	Hc Or Acuity Lvl 5 Ea Addl 30 Min	75	63	$4,500.00	$4,500.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
11104	CPT	Hc Punch Biopsy Skin Single Lesion	69	61	$530.00	$530.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
37191	CPT	Hc Insert Ivc Filtr W/Acces/Image	69	57	$17,289.00	$17,289.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
44404	CPT	Injection Beneath Lining Of Large Bowel Using An Endoscope Inserted Through Surg…	69	57	$3,831.00	$3,831.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37224	CPT	Balloon Dilation Of Artery Of Leg	69	57	$12,797.00	$12,797.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37221	CPT	Insertion Of Stent In Groin Artery, Initial Vessel	69	57	$12,797.00	$12,797.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37220	CPT	Balloon Dilation Of Groin Artery, Initial Vessel	69	57	$18,309.00	$8,741.36 52% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37184	CPT	Primary Removal And Dissolving Of Blood Clot From Artery Or Artery Graft Using F…	69	57	$36,399.00	$36,399.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36680	CPT	Insertion Of Needle For Infusion Into Bone	63	55	$464.00	$464.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
36906	CPT	Removal And/or Dissolving Of Blood Clot In Hemodialysis Circuit And Balloon Dila…	69	57	$21,271.00	$21,271.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36901	CPT	Hc Sp Intro Cath Dialysis Circuit	69	57	$5,356.00	$2,449.35 54% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
43233	CPT	Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…	69	57	$5,183.52	$5,183.52	$2,713.00	$9,197.00	$8,460.00	2025-04-05
38222	CPT	Hc Bone Marrow Biopsy(S) & Aspiration(S)	69	57	$7,750.00	$7,750.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36625	CPT	Insertion Of Artery Tube For Blood Sampling Or Infusion Through Artery Incision	69	57	$1,604.00	$1,604.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36248	CPT	Insertion Of Tube Into Abdominal, Pelvic, Or Leg Artery, Additional Second, Thir…	69	57	$4,092.00	$4,092.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001132	CDM	Hc Or Acuity Lvl 2 1st 30 Min	75	63	$5,200.00	$5,200.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001174	CDM	Hc Or Acuity Lvl 3 1st 30 Min	75	63	$5,700.00	$5,700.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001193	CDM	Hc Or Acuity Lvl 3 Ea Addl 30 Min	75	63	$3,500.00	$3,500.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
10030	CPT	Drainage Of Fluid Collection In Soft Tissue Using Imaging Guidance	69	57	$2,825.94	$2,825.94	$2,713.00	$9,197.00	$8,460.00	2025-04-05
29445	CPT	Application Of Walking Cast Covering Foot, Ankle, And Lower Leg	138	61	$550.00	$480.36	$2,713.00	$8,460.00	$8,460.00	2025-04-05
29405	CPT	Application Of Short Leg Cast	69	61	$631.00	$631.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
97602	CPT	Removal Of Tissue From Wound Gradually	69	61	$294.00	$294.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
29580	CPT	Strapping, Unna Boot	137	61	$625.50	$361.47 42% off	$2,713.00	$8,460.00	$8,460.00	2025-04-05
29515	CPT	Application Of Short Leg Splint From Calf To Foot	69	61	$514.00	$514.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
23350	CPT	Hc Inj Arthrogram Shoulder	63	55	$566.00	$566.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
97606	CPT	Therapy Procedure Using A Special Bandage And Vacuum Pump, Surface Area More Tha…	69	61	$579.08	$579.08	$2,713.00	$8,460.00	$8,460.00	2025-04-05
PX-36001222	CDM	Hc Or Acuity Lvl 4 1st 30 Min	75	63	$6,700.00	$6,700.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
29505	CPT	Application Of Long Leg Splint From Thigh To Ankle Or Toe	69	61	$547.00	$547.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
29130	CPT	Application Of Nonmoveable Finger Splint	69	61	$489.00	$489.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
50431	CPT	Injection Procedure For Imaging Of Kidney And Ureter Through Already Existing Sk…	69	57	$1,957.00	$1,957.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
49406	CPT	Drainage Of Fluid Collection Of Abdominal Cavity By Tube Using Imaging Guidance	69	57	$3,600.00	$3,600.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
62326	CPT	Insertion Of Tube And Injection Of Substance Into Lower Spine Canal	69	57	$2,557.00	$2,557.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
50435	CPT	Replacement Of Kidney Drainage Tube Using Imaging Guidance With Review By Radiol…	69	57	$5,220.00	$5,220.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
62323	CPT	Hc Inj Epidural Lumb/Caud W/Imaging	138	57	$2,320.00	$1,688.81 27% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
62322	CPT	Injection Of Substance Into Lower Spine Canal	69	57	$1,924.00	$1,924.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
62329	CPT	Removal Of Cerebrospinal Fluid With Lower Back Spinal Tap Using Imaging Guidance	69	57	$1,934.00	$1,934.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
97605	CPT	Therapy Procedure Using A Special Bandage And Vacuum Pump, Surface Area 50.0 Sq …	69	61	$651.00	$306.18 53% off	$2,713.00	$8,460.00	$8,460.00	2025-04-05
97597	CPT	Removal Of Tissue From Wound, 20.0 Sq Cm Or Less	98	64	$352.90	$306.18	$33.78	$8,460.00	$8,460.00	2025-04-05
97598	CPT	Removal Of Tissue From Wound, Each Additional 20.0 Sq Cm	77	54	$235.27	$235.27	$23.31	$8,460.00	$8,460.00	2025-04-05
97607	CPT	Therapy Procedure Using A Special Bandage, Vacuum Pump And Disposable Medical Eq…	75	63	$1,124.00	$609.82 46% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37241	CPT	Occlusion Of Vein With Review By Radiologist	69	57	$38,207.00	$38,207.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
50432	CPT	Placement Of Tube Of Kidney Using Imaging Guidance With Review By Radiologist	69	57	$3,605.00	$3,605.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
G0104	HCPCS	Hc Sigmoidoscopy Flexi Ca Screen	69	57	$2,234.67	$1,397.78 37% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001095	CDM	Hc Or Acuity Lvl 1 1st 30 Min	75	63	$4,200.00	$4,200.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001108	CDM	Hc Or Acuity Lvl 1 Ea Addl 30min	75	63	$2,000.00	$2,000.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
29075	CPT	Application Of Elbow To Finger Cast	69	61	$520.00	$520.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
29105	CPT	Application Of Lower And Upper Arm Splint	69	61	$513.00	$513.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
47531	CPT	Injection Of Bile Duct For X-ray Through Already Existing Skin Access Using Imag…	69	57	$11,538.00	$5,291.10 54% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
47536	CPT	Replacement Of Liver Duct Drainage Tube Using Imaging Guidance With Review By Ra…	69	57	$11,538.00	$11,538.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
22515	CPT	Treatment Of Broken Spine Bone With Stabilizing Device, Each Additional Segment	69	57	$7,158.00	$7,158.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
10009	CPT	Hc Fine Needle Aspiration Bx W/ct Gdn 1st Lesion	69	57	$2,299.00	$1,076.02 53% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001293	CDM	Hc Robotic Or Acuity Lvl 6 Ea Addl 30 Min	75	63	$4,991.00	$4,991.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37248	CPT	Balloon Dilation Of Vein With Review By Radiologist, Initial Vein	69	57	$13,712.00	$13,712.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37239	CPT	Insertion Of Stent In Vein With Review By Radiologist, Each Additional Vein	69	57	$19,672.00	$19,672.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37233	CPT	Removal Of Plaque In Artery Of Leg, Each Additional Vessel	69	57	$26,472.00	$26,472.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37238	CPT	Insertion Of Stent In Vein With Review By Radiologist, Initial Vein	69	57	$36,399.00	$16,824.82 54% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37232	CPT	Balloon Dilation Of Artery Of Leg, Each Additional Vessel	69	57	$12,797.00	$12,797.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37228	CPT	Balloon Dilation Of Artery Of Leg, Initial Vessel	69	57	$12,797.00	$12,797.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37225	CPT	Removal Of Plaque In Arteries Of Leg	69	57	$26,472.00	$26,472.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37230	CPT	Insertion Of Stent In Artery Of Leg, Initial Vessel	69	57	$27,169.00	$26,817.64	$2,713.00	$9,197.00	$8,460.00	2025-04-05
29065	CPT	Application Of Shoulder To Hand Cast	71	62	$707.00	$707.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
37231	CPT	Removal Of Plaque And Insertion Of Stents In Artery Of Leg, Initial Vessel	69	57	$58,220.00	$58,220.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
50434	CPT	Conversion Of Kidney Tube To Nephroureteral Tube Using Imaging Guidance And Stud…	69	57	$5,220.00	$3,115.04 40% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
45393	CPT	Decompression Of Twisted Or Abnormally Dilated Large Bowel Using A Flexible Endo…	69	57	$3,443.00	$3,443.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37229	CPT	Removal Of Plaque In Artery Of Leg, Initial Vessel	71	57	$26,472.00	$26,472.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36908	CPT	Insertion Of Stent In Dialysis Segment With Review By Radiologist	69	57	$13,060.00	$13,060.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36010	CPT	Insertion Of Tube Into Vena Cava	69	57	$1,353.00	$1,353.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36140	CPT	Insertion Of Needle Or Tube Into Artery Of Arm Or Leg	69	57	$2,781.00	$2,781.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36905	CPT	Removal And/or Dissolving Of Blood Clot In Hemodialysis Circuit And Balloon Dila…	69	57	$24,318.00	$24,318.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36903	CPT	Insertion Of Needle And/or Tube Into Hemodialysis Circuit And Insertion Of Stent…	69	57	$13,420.00	$13,420.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36902	CPT	Insertion Of Needle And/or Tube Into Hemodialysis Circuit And Balloon Dilation O…	69	57	$16,467.00	$16,467.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
11105	CPT	Hc Punch Biopsy Skin Ea Sep/Addl Lesion	63	55	$489.00	$489.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
37243	CPT	Occlusion Of Growths Or Obstructed Vessels With Review By Radiologist	69	57	$38,207.00	$16,824.82 56% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
33208	CPT	Insertion Of Pacemaker And Upper And Lower Heart Chamber Electrode	69	57	$26,072.00	$26,072.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36246	CPT	Insertion Of Tube Into Abdominal, Pelvic, Or Leg Artery, Initial Second Order Br…	69	57	$4,092.00	$4,092.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36573	CPT	Hc Insj Picc W/Rs&I 5 Yr+	69	57	$3,280.89	$2,449.35 25% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
43275	CPT	Removal Of Stent From Pancreatic Or Bile Duct Using A Flexible Endoscope	75	63	$10,545.00	$2,910.12 72% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
PX-36001238	CDM	Hc Or Acuity Lvl 4 Ea Addl 30 Min	75	63	$4,000.00	$4,000.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36253	CPT	Insertion Of Tube Into Second Or Third Order Branches Of Arteries Of Kidney For …	69	57	$18,500.00	$18,500.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
33207	CPT	Insertion Of Pacemaker And Lower Heart Chamber Electrode	69	57	$19,884.00	$19,884.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
33215	CPT	Repositioning Of Pacemaker Or Defibrillator Electrode	69	57	$9,744.00	$9,744.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
33227	CPT	Removal And Replacement Of Single Lead Permanent Pacemaker	69	57	$18,307.00	$18,307.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
33210	CPT	Insertion Of Temporary Pacemaker Lead In Single Heart Chamber	69	57	$29,547.00	$29,547.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37226	CPT	Insertion Of Stent In Arteries Of Leg	69	57	$27,169.00	$27,169.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36909	CPT	Permanent Blockage Of Hemodialysis Circuit With Review By Radiologist	69	57	$12,500.00	$12,500.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36907	CPT	Balloon Dilation Of Dialysis Segment With Review By Radiologist	69	57	$11,255.00	$11,255.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
34713	CPT	Hc Perq Access & Clsr Fem Art Endograft Unilat	69	57	$5,371.00	$5,371.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
10006	CPT	Hc Fine Ndl Aspiration Bx W/us Gdn Ea Addl Lesion	69	57	$1,573.00	$1,573.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
33228	CPT	Removal And Replacement Of Dual Lead Permanent Pacemaker	69	57	$20,079.00	$20,079.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
33224	CPT	Insertion Of Left Lower Heart Electrode And Attachment To Pacemaker Or Defibrill…	69	57	$30,016.00	$30,016.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36002	CPT	Injection To Cause Blood Clot In Diseased Or Pseudoaneurysm Of Arm Or Leg	67	56	$775.00	$775.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
43270	CPT	Destruction Of Polyp Or Growth Of Esophagus, Stomach, And/or Upper Small Bowel U…	75	63	$4,451.00	$4,451.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
43274	CPT	Insertion Of Stent Into Pancreatic Or Bile Duct Using A Flexible Endoscope	75	63	$16,809.00	$16,809.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
43277	CPT	Balloon Dilation Of Pancreatic Or Bile Duct Or Sphincter Using A Flexible Endosc…	75	63	$11,166.00	$11,166.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
43762	CPT	Hc Perq Replacement Gtube Not Req Revj Gstrst Trc	65	56	$695.00	$695.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
10021	CPT	Fine Needle Aspiration Biopsy, First Growth	63	55	$564.00	$564.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
45350	CPT	Banding Of Hemorrhoids Using A Flexible Endoscope (sigmoidoscope)	75	63	$3,531.00	$3,531.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
50433	CPT	Placement Of Tube Of Kidney And Urinary Tube Through New Skin Access Using Imagi…	69	57	$11,150.00	$11,150.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37242	CPT	Occlusion Of Artery With Review By Radiologist	69	57	$34,838.00	$26,817.64 23% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37246	CPT	Balloon Dilation Of Artery With Review By Radiologist, Initial Artery	69	57	$13,712.00	$13,712.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
45390	CPT	Removal Of Large Bowel Tissue Using A Flexible Endoscope	69	57	$3,443.00	$3,443.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
45388	CPT	Destruction Of Polyp Or Growth Of Large Bowel Using A Flexible Endoscope	69	57	$2,939.37	$1,804.76 39% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
32408	CPT	Core Needle Biopsy Of Lung Or Center Cavity Of Chest (mediastinum), Accessed Thr…	69	57	$5,100.00	$5,100.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36005	CPT	Injection For X-ray Imaging Procedure Into Vein Of Arm Or Leg	91	56	$835.00	$835.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
37187	CPT	Removal And Dissolving Of Blood Clot From Vein Using Fluoroscopic Guidance, Init…	69	57	$17,418.00	$16,824.82	$2,713.00	$9,197.00	$8,460.00	2025-04-05
47534	CPT	Placement Of Internal-external Drainage Tube Of Biliary Duct Using Imaging Guida…	69	57	$11,538.00	$11,538.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
27369	CPT	Hc Njx Px Cntrst Kne Arthg Cntrst Enhncd Ct/mri Kn	67	56	$910.00	$910.00	$2,713.00	$8,460.00	$8,460.00	2025-04-05
47537	CPT	Removal Of Biliary Drainage Tube Using Imaging Guidance With Review By Radiologi…	69	57	$2,764.00	$2,764.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
49405	CPT	Drainage Of Fluid Collection By Tube Through Skin Using Imaging Guidance	69	57	$3,600.00	$2,479.54 31% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
50387	CPT	Removal And Replacement Of Stent In Kidney And Ureter Using Fluoroscopic Guidanc…	69	57	$6,229.00	$3,115.04 50% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
49423	CPT	Exchange Of Abdominal Cavity Drainage Tube Using Imaging Guidance	69	57	$5,476.00	$2,910.12 47% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
34707	CPT	Hc Evasc Rpr Dplmnt Ilio-iliac Endogrft	69	57	$12,797.00	$12,797.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36011	CPT	Insertion Of Tube Into Vein, First Order Branch	69	57	$3,404.00	$3,404.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36216	CPT	Insertion Of Tube Into Chest Or Arm Artery, Initial Second Order Branch	69	57	$5,985.00	$5,985.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
50693	CPT	Placement Of Stent Of Ureter Through Existing Skin Access Using Imaging Guidance…	69	57	$7,627.68	$5,331.62 30% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
45346	CPT	Destruction Of Polyp Or Growth Of Lower Large Bowel Using A Flexible Endoscope	75	63	$2,939.37	$2,939.37	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37253	CPT	Ultrasound Evaluation Of Blood Vessel With Review By Radiologist, Each Additiona…	69	57	$5,850.00	$5,850.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
36215	CPT	Hc Sel Cath Plc 1st Ord Thor/Brac	69	57	$5,401.00	$5,401.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
37227	CPT	Removal Of Plaque And Insertion Of Stents In Arteries Of Leg	69	57	$45,847.00	$26,817.64 42% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
19281	CPT	Placement Of Locating Device In Breast Using Imaging Guidance, First Growth	69	57	$4,635.00	$4,635.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
62328	CPT	Removal Of Spinal Fluid With Lower Back Spinal Tap For Diagnostic Test Using Ima…	69	57	$2,960.00	$1,057.62 64% off	$2,713.00	$9,197.00	$8,460.00	2025-04-05
19285	CPT	Placement Of Locating Device In Breast Using Ultrasound Guidance, First Growth	69	57	$2,012.00	$2,012.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
64488	CPT	Injection Of Local Anesthetic For Abdominal Wall Pain Control On Both Sides Usin…	94	57	$5,260.11	$5,260.11	$2,713.00	$9,197.00	$8,460.00	2025-04-05
69209	CPT	Removal Of Impacted Ear Wax By Washing	122	54	$209.77	$209.77	$8,460.00	$8,460.00	$8,460.00	2025-04-05
37252	CPT	Ultrasound Evaluation Of Blood Vessel With Review By Radiologist, Initial Vessel	69	57	$5,060.00	$5,060.00	$2,713.00	$9,197.00	$8,460.00	2025-04-05
29125	CPT	Application Of Nonmoveable Forearm To Hand Splint	142	62	$757.50	$757.50	$2,713.00	$8,460.00	$8,460.00	2025-04-05
36558	CPT	Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older)	69	57	$11,409.00	$11,409.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
36581	CPT	Hc Replace Compl Tun Cvc Without Subq Port/Pump	69	57	$7,081.80	$7,081.80	$2,710.00	$9,197.00	$8,458.50	2025-04-05
40652	CPT	Repair Of Vertical Lip Wound Extending To Half Of Lip	69	57	$2,168.00	$2,168.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
24620	CPT	Closed Treatment Of Broken And Dislocated Forearm Bones At Elbow With Manipulati…	69	57	$4,594.00	$4,594.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
24605	CPT	Repair Of Dislocated Elbow Under Anesthesia	69	57	$4,594.00	$4,594.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
37214	CPT	Removal Of Tube Into Artery Or Vein With Review By Radiologist	69	57	$10,575.00	$10,575.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
37212	CPT	Insertion Of Tube Into Vein For Drug Infusion For Blood Clot With Review By Radi…	69	57	$10,575.00	$4,874.85 54% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
10180	CPT	Complex Drainage Of Wound Infection After Surgery	69	57	$4,024.00	$4,024.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
23931	CPT	Drainage Of Fluid Filled Sac In Elbow Joint	69	57	$4,499.00	$4,499.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
37211	CPT	Insertion Of Tube Into Artery For Drug Infusion For Blood Clot With Review By Ra…	69	57	$17,616.00	$17,616.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
23605	CPT	Closed Treatment Of Broken Top Of Upper Arm Bone With Manipulation	69	57	$3,638.00	$3,638.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
31628	CPT	Biopsy Of Lobe Of Lung Using An Endoscope, 1 Lobe	75	63	$11,228.00	$5,727.24 49% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
31625	CPT	Biopsy Of Lung Airway Using An Endoscope	75	63	$5,966.00	$2,595.75 56% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
31624	CPT	Irrigation And Suction Of Lung Airways To Obtain Cells Using An Endoscope	150	63	$7,457.50	$2,595.75 65% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
31623	CPT	Exam Of Lung Airways Using An Endoscope	75	63	$5,966.00	$2,595.75 56% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
31622	CPT	Diagnostic Exam Of Lung Airway Using An Endoscope	75	63	$5,424.00	$2,595.75 52% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
G0105	HCPCS	Hc Colonoscopy Screening High Risk	69	57	$2,234.67	$1,397.78 37% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
G0121	HCPCS	Hc Colonoscopy Screen Not High Risk	69	57	$2,234.67	$1,397.78 37% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
27825	CPT	Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint With Manipula…	69	57	$3,772.00	$3,772.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
64635	CPT	Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,…	69	57	$6,470.00	$6,470.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
59871	CPT	Removal Of Suture Of Cervix Under Anesthesia	69	57	$3,986.00	$3,986.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
57135	CPT	Removal Of Cyst Or Growth Of Vaginal	69	57	$8,937.00	$4,781.37 46% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
55700	CPT	Biopsy Of Prostate Gland	69	57	$6,229.00	$3,115.04 50% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
59412	CPT	Turning Of Fetus Through External Manipulation	75	63	$4,235.00	$4,235.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
40654	CPT	Repair Of Vertical Lip Wound Extending To Over Half Of Lip	69	57	$4,903.00	$4,903.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
41252	CPT	Repair Of Lacerated Tongue Or Floor Of Mouth, More Than 2.6 Cm	67	56	$880.00	$880.00	$2,710.00	$8,458.50	$8,458.50	2025-04-05
55100	CPT	Drainage Of Abscess Of Scrotum	69	57	$4,535.00	$4,535.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
49418	CPT	Insertion Of Abdominal Tube Using Imaging Guidance With Review By Radiologist	69	57	$8,588.22	$8,588.22	$2,710.00	$9,197.00	$8,458.50	2025-04-05
27266	CPT	Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia	69	57	$5,355.00	$5,355.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
27252	CPT	Closed Treatment Of Dislocated Hip Under Anesthesia	69	57	$4,594.00	$4,594.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
45385	CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S…	75	63	$3,759.00	$1,804.76 52% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
45384	CPT	Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec…	75	63	$2,939.37	$1,804.76 39% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
27041	CPT	Biopsy Of Deep Tissue Of Pelvis And Hip	69	57	$5,100.00	$5,100.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
45382	CPT	Control Of Bleeding Of Upper Large Bowel Using A Flexible Endoscope	150	63	$3,759.00	$2,781.88 26% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
45378	CPT	Diagnostic Exam Of Large Bowel Using A Flexible Endoscope	75	63	$1,850.00	$1,397.78 24% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
45380	CPT	Biopsy Of Large Bowel Using A Flexible Endoscope	75	63	$3,759.00	$1,804.76 52% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
45381	CPT	Injection Beneath Lining Of Large Bowel Using A Flexible Endoscope	75	63	$3,759.00	$1,804.76 52% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
44360	CPT	Diagnostic Exam Of Small Bowel (excluding Lower Small Intestine) Using An Endosc…	75	63	$5,439.00	$5,439.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
44361	CPT	Biopsy Of Small Bowel (except Ileum) Using An Endoscope	75	63	$5,439.00	$2,910.12 46% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43262	CPT	Incision Of Pancreatic Outlet Using A Flexible Endoscope	75	63	$10,545.00	$10,545.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43261	CPT	Biopsy Of Gallbladder, Pancreatic, Liver, And Bile Ducts Using A Flexible Endosc…	69	57	$11,166.00	$11,166.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43264	CPT	Removal Of Stone Or Debris From Bile Or Pancreatic Duct Using A Flexible Endosco…	69	57	$10,545.00	$5,857.11 44% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43251	CPT	Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…	75	63	$5,212.00	$2,910.12 44% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43255	CPT	Control Of Bleeding Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flex…	75	63	$5,890.00	$5,890.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43260	CPT	Diagnostic Exam Of Gallbladder And Pancreatic, Liver, And Bile Ducts Using An En…	69	57	$10,545.00	$10,545.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43265	CPT	Destruction Of Stone Of Bile Or Pancreatic Duct Using A Flexible Endoscope	69	57	$18,225.00	$18,225.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
13160	CPT	Extensive Or Complicated Repair Of Surface Wound Reopening	69	57	$5,686.00	$5,686.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
26011	CPT	Complicated Drainage Of Abscess In Finger	69	57	$2,355.00	$2,355.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43247	CPT	Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using …	75	63	$1,863.40	$1,863.40	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43248	CPT	Insertion Of Guide Wire With Dilation Of Esophagus Using A Flexible Endoscope	75	63	$2,989.00	$1,386.35 54% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43249	CPT	Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…	75	63	$5,212.00	$2,910.12 44% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43244	CPT	Tying Of Dilated Veins Of Stomach And/or Esophagus Using A Flexible Endoscope	75	63	$4,450.05	$2,910.12 35% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43243	CPT	Injection Of Dilated Vein Of Stomach And/or Esophagus Using A Flexible Endoscope	75	63	$5,439.00	$5,439.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43245	CPT	Dilation Of Stomach Outlet Using A Flexible Endoscope	75	63	$5,212.00	$5,212.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43236	CPT	Injection Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endos…	75	63	$2,764.00	$1,386.35 50% off	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43238	CPT	Ultrasound Guided Needle Aspiration Or Biopsy Of Esophagus Using A Flexible Endo…	75	63	$5,225.00	$5,225.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
40650	CPT	Repair Of Lip And Border	69	57	$1,971.00	$1,971.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43239	CPT	Hc Egd Biopsy Single/Multiple	75	63	$1,600.00	$1,386.35	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43246	CPT	Insertion Of Stomach Tube Using A Flexible Endoscope	75	63	$4,450.05	$4,450.05	$2,710.00	$9,197.00	$8,458.50	2025-04-05
43250	CPT	Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…	75	63	$4,005.00	$4,005.00	$2,710.00	$9,197.00	$8,458.50	2025-04-05
26765	CPT	Treatment Of Broken End Of Finger Or Thumb	69	57	$13,846.00	$13,846.00	$2,324.00	$9,197.00	$8,265.50	2025-04-05
25605	CPT	Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit…	69	57	$5,047.00	$5,047.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
25600	CPT	Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb …	67	56	$746.00	$746.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
13133	CPT	Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G…	69	57	$1,011.00	$1,011.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
25565	CPT	Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation	69	57	$2,741.00	$2,741.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
25560	CPT	Closed Treatment Of Broken Midpart Of Both Forearm Bones	63	55	$431.00	$431.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
13132	CPT	Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G…	69	57	$1,283.00	$1,283.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
11740	CPT	Removal Of Blood Accumulation Under Fingernail Or Toenail	62	54	$222.00	$222.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
36556	CPT	Hc Insert Non-tunnl Cvc => 5 Yrs	69	57	$10,372.00	$10,372.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
25535	CPT	Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side With Man…	67	56	$759.00	$759.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
13131	CPT	Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G…	69	57	$1,072.00	$1,072.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
25530	CPT	Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side	67	56	$749.00	$749.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
38792	CPT	Hc Inj Radioactive Tracer For Id Of Sentinel Node	69	57	$1,367.00	$1,367.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
11730	CPT	Simple Separation Of Fingernail Or Toenail From Nail Bed, First Nail	63	55	$620.00	$620.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
25505	CPT	Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati…	69	57	$2,741.00	$2,741.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
36569	CPT	Insertion Of Tube For Infusion (5 Years Or Older)	69	57	$2,231.25	$2,231.25	$2,020.00	$9,197.00	$8,113.50	2025-04-05
11012	CPT	Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A…	69	57	$3,536.00	$3,536.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
36580	CPT	Hc Replace Compl Non-tun Cvc Without Subq Port/Pmp	69	57	$4,464.00	$4,464.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
13122	CPT	Complicated Repair Of Wound Of Scalp, Arms, Or Legs, Each Additional 5.0 Cm Or L…	67	56	$784.00	$784.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
36584	CPT	Replacement Of Peripherally Inserted Central Venous Tube (picc) With Review By R…	69	57	$1,901.00	$1,901.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
36589	CPT	Removal Of Tunneled Central Venous Tube	69	57	$2,500.00	$2,500.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
11010	CPT	Removal Of Foreign Material From Skin And Tissue At Open Broken And/or Dislocate…	69	57	$2,355.00	$2,355.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
40800	CPT	Simple Drainage Of Abscess, Cyst, Or Blood Accumulation Of Mouth	69	57	$2,145.00	$2,145.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
24675	CPT	Closed Treatment Of Broken Forearm Bone On Small Finger Side At Elbow With Manip…	69	57	$2,741.00	$2,741.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
24670	CPT	Closed Treatment Of Broken Forearm Bone On Small Finger Side At Elbow	63	55	$675.00	$675.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
13121	CPT	Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm	69	57	$1,072.00	$1,072.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
24650	CPT	Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow	67	56	$913.00	$913.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
24640	CPT	Closed Treatment Of Dislocated Forearm Bone On Thumb Side At Elbow With Manipula…	63	55	$619.00	$619.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
13120	CPT	Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 1.1-2.5 Cm	69	57	$1,796.00	$1,796.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
11721	CPT	Removal Of Fingernails Or Toenails, 6 Or More Nails	61	54	$150.00	$93.54 38% off	$8,113.50	$8,113.50	$8,113.50	2025-04-05
13102	CPT	Complicated Repair Of Wound Of Trunk, Each Additional 5.0 Cm Or Less	67	56	$775.00	$775.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
35206	CPT	Repair Of Blood Vessel Of Arm	69	57	$5,618.00	$5,618.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
24600	CPT	Repair Of Dislocated Elbow	69	57	$1,003.00	$1,003.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
24565	CPT	Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow With Manipulati…	69	57	$3,652.26	$3,652.26	$2,020.00	$9,197.00	$8,113.50	2025-04-05
13101	CPT	Complicated Repair Of Wound Of Trunk, 2.6-7.5 Cm	69	57	$1,228.00	$1,228.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
11720	CPT	Removal Of Fingernails Or Toenails, 1-5 Nails	63	55	$272.00	$93.54 66% off	$2,020.00	$8,113.50	$8,113.50	2025-04-05
43215	CPT	Removal Of Foreign Bodies In Esophagus Using A Flexible Endoscope	75	63	$4,451.00	$4,451.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
24505	CPT	Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation	69	57	$2,741.00	$2,741.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
24500	CPT	Closed Treatment Of Broken Middle Part Of Upper Arm Bone	63	55	$594.00	$594.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
12054	CPT	Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1…	69	57	$1,104.00	$1,104.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
24200	CPT	Removal Of Foreign Body Of Upper Arm Or Elbow Area, Accessed Beneath The Skin	69	57	$5,100.00	$5,100.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
12053	CPT	Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7…	67	56	$899.00	$899.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
32557	CPT	Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube Using Imag…	69	57	$2,052.39	$2,052.39	$2,020.00	$9,197.00	$8,113.50	2025-04-05
32555	CPT	Hc Thoracentesis With Imaging	69	57	$1,448.49	$1,448.49	$2,020.00	$9,197.00	$8,113.50	2025-04-05
12052	CPT	Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5…	67	56	$906.15	$906.15	$2,020.00	$8,113.50	$8,113.50	2025-04-05
32551	CPT	Hc Insertion Of Chest Tube Open	69	57	$1,824.00	$1,824.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
32550	CPT	Insertion Of Indwelling Tube For Drainage Of Lung Fluid	69	57	$8,588.22	$8,588.22	$2,020.00	$9,197.00	$8,113.50	2025-04-05
23655	CPT	Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia	69	57	$2,741.00	$2,741.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
12051	CPT	Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5 C…	67	56	$806.00	$806.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
31720	CPT	Insertion Of Tube Into Airway For Aspiration Of Secretions	63	55	$681.00	$681.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
23650	CPT	Closed Treatment Of Dislocated Shoulder With Manipulation	69	57	$1,756.00	$1,756.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
11401	CPT	Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm	69	57	$1,120.00	$1,120.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
10061	CPT	Complicated Or Multiple Drainage Of Skin Abscess	65	56	$735.00	$609.82	$2,020.00	$8,113.50	$8,113.50	2025-04-05
23600	CPT	Closed Treatment Of Broken Top Of Upper Arm Bone	67	56	$771.00	$771.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
31500	CPT	Emergent Insertion Of Breathing Tube Into Windpipe Using An Endoscope	69	57	$943.95	$943.95	$2,020.00	$9,197.00	$8,113.50	2025-04-05
23545	CPT	Closed Treatment Of Dislocated Joint Between Collar Bone And Shoulder With Manip…	69	57	$982.00	$982.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
12044	CPT	Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm	69	57	$1,748.00	$1,748.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
30905	CPT	Initial Control Of Nose Bleed And Insertion Of Packing	63	55	$642.00	$642.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
30903	CPT	Complex Control Of Nose Bleed	63	55	$447.00	$447.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
23540	CPT	Closed Treatment Of Dislocated Joint Between Collar Bone And Shoulder	63	55	$522.00	$522.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
30901	CPT	Simple Control Of Nose Bleed	130	56	$763.88	$763.88	$2,020.00	$8,113.50	$8,113.50	2025-04-05
30300	CPT	Removal Of Foreign Body In Nose	63	55	$286.00	$286.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
23500	CPT	Closed Treatment Of Broken Collar Bone	67	56	$873.00	$873.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
12042	CPT	Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.6-7.5 Cm	69	57	$1,100.00	$1,100.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05
30000	CPT	Drainage Of Abscess Or Blood Accumulation Of Nose	63	55	$531.27	$531.27	$2,020.00	$8,113.50	$8,113.50	2025-04-05
21480	CPT	Closed Treatment Of Dislocated Jaw Joint	63	55	$663.00	$663.00	$2,020.00	$8,113.50	$8,113.50	2025-04-05
12041	CPT	Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.5 Cm Or Less	69	57	$1,077.00	$1,077.00	$2,020.00	$9,197.00	$8,113.50	2025-04-05

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