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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

HELEN HAYES HOSPITAL

West Haverstraw, NY · CCN 330405 · Rates published

476 distinct procedures filed
11 distinct payers
10,185 rate rows
2026-08-01 last MRF observed
Data quality

478 of 10,185 rate rows are consumer-grade (4.7%)

9,707 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
per-diem day rate — not a per-procedure price 9,442
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 252
exceeds 10× this hospital's gross charge — excluded from medians 13
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://shop.helenhayeshosp.org/00-0432000_Helen-Hayes-Hospital_standardcharges.csv
Found on page https://shop.helenhayeshosp.org/
Discovered viaDiscovered by HANK
Last fetch success · 2026-08-11
Content fingerprint 94466ef80ba331a9… · 106,459 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
88309
CPT 		Surgical Pathology Level Vi 3 $710.67 $753.05 $753.05 nat. median
$777
1.0× median
95824
CPT 		EEG Cerebral Death 2 $559.81 $559.81 $559.81 nat. median
$601
0.9× median
93312
CPT 		Echo 2d 3 $455.69 $554.20 $554.20 nat. median
$966
0.6× median
70553
CPT 		MRI Brain W & Without Contrast 3 $422.48 $662.18 $422.48 nat. median
$1,137
outlier · 0.4×
72149
CPT 		MRI L-spine W/contrast 3 $422.48 $566.87 $422.48 nat. median
$979
outlier · 0.4×
70552
CPT 		M.r Brain W/contrast 3 $422.48 $562.33 $422.48 nat. median
$970
outlier · 0.4×
72147
CPT 		MRI T-spine W/contrast 3 $422.48 $572.05 $422.48 nat. median
$976
outlier · 0.4×
88307
CPT 		Surgical Pathology Level V 3 $334.27 $470.58 $334.27 nat. median
$397
0.8× median
72146
CPT 		MRI T-spine Without Contrast 3 $264.11 $392.18 $264.11 nat. median
$791
outlier · 0.3×
73221
CPT 		MRI Upper Extremity Joint 3 $264.11 $418.82 $264.11 nat. median
$843
outlier · 0.3×
72148
CPT 		M.r. Lumbar Spine 3 $264.11 $392.83 $264.11 nat. median
$797
outlier · 0.3×
70551
CPT 		MRI Brain Without Contrast 3 $264.11 $402.04 $264.11 nat. median
$791
outlier · 0.3×
73721
CPT 		MRI Lower Extrmity Joint 3 $264.11 $417.52 $264.11 nat. median
$866
outlier · 0.3×
87901
CPT 		HIV-1 Geno, Pr And Rt 1 $244.58 $244.58 $244.58 nat. median
$310
0.8× median
96365
CPT 		IV Infusion Up To 1 Hour 3 $137.93 $233.55 $233.55 nat. median
$318
0.7× median
99253
CPT 		Init Inpt Consult,3key Comp Lo 1 $207.50 $207.50 $207.50 nat. median
$210
1.0× median
70470
CPT 		CT Scan Brain Unenhanced & Enh 3 $204.92 $349.29 $204.92 nat. median
$634
outlier · 0.3×
70460
CPT 		CT Brain/skull W/contrast 3 $204.92 $297.46 $204.92 nat. median
$586
outlier · 0.3×
72193
CPT 		CT Scan Pelvis With Contrast 3 $204.92 $465.06 $204.92 nat. median
$637
outlier · 0.3×
71260
CPT 		CT Thorax With Contrast 3 $204.92 $336.71 $204.92 nat. median
$650
outlier · 0.3×
74160
CPT 		CT Abdomen With Contrast 3 $204.92 $472.45 $204.92 nat. median
$655
outlier · 0.3×
51705
CPT 		Cystostomy Tube Change Tech 5 $60.02 $305.44 $175.00 nat. median
$342
0.5× median
92587
CPT 		Evoked Acoustgic Emission 5 $40.42 $303.50 $175.00 nat. median
$236
0.7× median
92950
CPT 		Code 99 5 $124.07 $303.50 $175.00 nat. median
$589
outlier · 0.3×
50740
CPT 		Diagnostic Casts 1 $175.00 $175.00 $175.00 nat. median
$3,063
outlier · 0.1×
64616
CPT 		Chemodenerv Neck Muscle (s) 5 $64.89 $299.74 $175.00 nat. median
$421
outlier · 0.4×
64644
CPT 		Chemodenerv 1 Extrem 5+musc 5 $63.35 $728.30 $167.50 nat. median
$756
outlier · 0.2×
64642
CPT 		Chemodenerv 1extrem 1-4 Musc 5 $58.09 $728.30 $167.50 nat. median
$761
outlier · 0.2×
92582
CPT 		Condi Play Audi 5 $109.80 $175.00 $160.16 nat. median
$194
0.8× median
92557
CPT 		Comp Aud Thres Eval&speech Rec 5 $25.00 $175.00 $160.16 nat. median
$177
0.9× median
92553
CPT 		Pure Tone Air And Bone 5 $10.00 $175.00 $160.16 nat. median
$160
1.0× median
92570
CPT 		Acoustic Immittance Testing 5 $11.97 $175.00 $160.16 nat. median
$163
1.0× median
92550
CPT 		Tymp And Reflex Threshold Bund 5 $12.76 $175.00 $160.16 nat. median
$159
1.0× median
92572
CPT 		Staggered Spondaic Word Teest 5 $52.60 $175.00 $160.16 nat. median
$157
1.0× median
92579
CPT 		Visual Reinforcement Audiomete 5 $25.70 $175.00 $160.16 nat. median
$201
0.8× median
99211
CPT 		Est Pt Brief Visit 3 $4.32 $175.00 $160.00 nat. median
$92
1.7× median
99201
CPT 		Hepatitis Vaccine 3 $38.60 $175.00 $160.00 nat. median
$85
1.9× median
81207
CPT 		Bcr/abl1 Gene Rearrange,qn Pcr 1 $137.60 $137.60 $137.60 nat. median
$200
0.7× median
99204
CPT 		Comprehensive-mdrt Cmplxty 45m 2 $90.95 $175.00 $132.97 nat. median
$220
0.6× median
92552
CPT 		Pure Tone Audiometry Air Only 5 $5.00 $175.00 $128.48 nat. median
$129
1.0× median
36600
CPT 		Arterial Blood Gases 3 $56.53 $135.24 $128.48 nat. median
$134
1.0× median
73700
CPT 		CT Scan Lwr Exmty W/out Cntrs 3 $125.06 $259.78 $125.06 nat. median
$524
outlier · 0.2×
73200
CPT 		CT Scan Upper Extmty W/out Cntrs 3 $125.06 $332.38 $125.06 nat. median
$533
outlier · 0.2×
72192
CPT 		CT Scan Pelvis W/out Contrast 3 $125.06 $266.07 $125.06 nat. median
$467
outlier · 0.3×
70450
CPT 		CT Brain/skull Without Contrast 3 $125.06 $211.79 $125.06 nat. median
$456
outlier · 0.3×
72125
CPT 		CT Cervical Spine Without Contrast 3 $125.06 $261.08 $125.06 nat. median
$483
outlier · 0.3×
71250
CPT 		CT Scan,thorax Without Contr Matl 3 $125.06 $265.52 $125.06 nat. median
$470
outlier · 0.3×
74150
CPT 		CT Abdomen Without Contrast 3 $125.06 $272.26 $125.06 nat. median
$448
outlier · 0.3×
70490
CPT 		CT Soft Tissue Neck Without Contra 3 $125.06 $298.64 $125.06 nat. median
$455
outlier · 0.3×
87900
CPT 		HIV-1 Virtual Phenotype 1 $123.83 $123.83 $123.83 nat. median
$169
0.7× median

Other procedures at this hospital

Browse this hospital's 476 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
             
88309 CPT Surgical Pathology Level Vi 3 3 $546.00 $546.00 $710.67 $753.05 $753.05 2024-07-01
95824 CPT EEG Cerebral Death 2 2 $476.00 $476.00 $559.81 $559.81 $559.81 2024-07-01
93312 CPT Echo 2d 3 3 $1,174.00 $1,174.00 $455.69 $554.20 $554.20 2024-07-01
70553 CPT MRI Brain W & Without Contrast 3 3 $1,849.00 $1,849.00 $422.48 $662.18 $422.48 2024-07-01
70552 CPT M.r Brain W/contrast 3 3 $2,248.00 $2,248.00 $422.48 $562.33 $422.48 2024-07-01
72149 CPT MRI L-spine W/contrast 3 3 $2,261.00 $2,261.00 $422.48 $566.87 $422.48 2024-07-01
72147 CPT MRI T-spine W/contrast 3 3 $2,282.00 $2,282.00 $422.48 $572.05 $422.48 2024-07-01
88307 CPT Surgical Pathology Level V 3 3 $422.00 $422.00 $334.27 $470.58 $334.27 2024-07-01
70551 CPT MRI Brain Without Contrast 3 3 $1,663.00 $1,663.00 $264.11 $402.04 $264.11 2024-07-01
72148 CPT M.r. Lumbar Spine 3 3 $1,578.00 $1,578.00 $264.11 $392.83 $264.11 2024-07-01
73721 CPT MRI Lower Extrmity Joint 3 3 $1,664.00 $1,664.00 $264.11 $417.52 $264.11 2024-07-01
72146 CPT MRI T-spine Without Contrast 3 3 $1,575.00 $1,575.00 $264.11 $392.18 $264.11 2024-07-01
73221 CPT MRI Upper Extremity Joint 3 3 $1,667.00 $1,667.00 $264.11 $418.82 $264.11 2024-07-01
87901 CPT HIV-1 Geno, Pr And Rt 1 1 $550.00 $550.00 $244.58 $244.58 $244.58 2024-07-01
96365 CPT IV Infusion Up To 1 Hour 3 3 $531.00 $531.00 $137.93 $233.55 $233.55 2024-07-01
99253 CPT Init Inpt Consult,3key Comp Lo 1 1 $239.00 $239.00 $207.50 $207.50 $207.50 2024-07-01
71260 CPT CT Thorax With Contrast 3 3 $1,424.00 $1,424.00 $204.92 $336.71 $204.92 2024-07-01
74160 CPT CT Abdomen With Contrast 3 3 $1,801.00 $1,801.00 $204.92 $472.45 $204.92 2024-07-01
72193 CPT CT Scan Pelvis With Contrast 3 3 $1,763.00 $1,763.00 $204.92 $465.06 $204.92 2024-07-01
70470 CPT CT Scan Brain Unenhanced & Enh 3 3 $1,386.00 $1,386.00 $204.92 $349.29 $204.92 2024-07-01
70460 CPT CT Brain/skull W/contrast 3 3 $1,181.00 $1,181.00 $204.92 $297.46 $204.92 2024-07-01
64616 CPT Chemodenerv Neck Muscle (s) 5 5 $895.00 $895.00 $64.89 $299.74 $175.00 2024-07-01
92950 CPT Code 99 5 5 $1,364.00 $1,364.00 $124.07 $303.50 $175.00 2024-07-01
50740 CPT Diagnostic Casts 1 1 $59.00 $59.00 $175.00 $175.00 $175.00 2024-07-01
51705 CPT Cystostomy Tube Change Tech 5 5 $390.00 $390.00 $60.02 $305.44 $175.00 2024-07-01
92587 CPT Evoked Acoustgic Emission 10 5 $158.00 $158.00 $40.42 $303.50 $175.00 2024-07-01
64642 CPT Chemodenerv 1extrem 1-4 Musc 6 5 $843.00 $843.00 $58.09 $728.30 $167.50 2024-07-01
64644 CPT Chemodenerv 1 Extrem 5+musc 6 5 $916.00 $916.00 $63.35 $728.30 $167.50 2024-07-01
92557 CPT Comp Aud Thres Eval&speech Rec 10 5 $270.00 $270.00 $25.00 $175.00 $160.16 2024-07-01
92572 CPT Staggered Spondaic Word Teest 5 5 $263.00 $263.00 $52.60 $175.00 $160.16 2024-07-01
92582 CPT Condi Play Audi 10 5 $549.00 $549.00 $109.80 $175.00 $160.16 2024-07-01
92579 CPT Visual Reinforcement Audiomete 5 5 $329.00 $329.00 $25.70 $175.00 $160.16 2024-07-01
92550 CPT Tymp And Reflex Threshold Bund 5 5 $158.00 $158.00 $12.76 $175.00 $160.16 2024-07-01
92553 CPT Pure Tone Air And Bone 10 5 $286.00 $286.00 $10.00 $175.00 $160.16 2024-07-01
92570 CPT Acoustic Immittance Testing 5 5 $235.00 $235.00 $11.97 $175.00 $160.16 2024-07-01
99211 CPT Est Pt Brief Visit 11 3 $64.00 $64.00 $4.32 $175.00 $160.00 2024-07-01
99201 CPT Hepatitis Vaccine 3 3 $193.00 $193.00 $38.60 $175.00 $160.00 2024-07-01
81207 CPT Bcr/abl1 Gene Rearrange,qn Pcr 1 1 $767.00 $767.00 $137.60 $137.60 $137.60 2024-07-01
99204 CPT Comprehensive-mdrt Cmplxty 45m 2 2 $930.00 $930.00 $90.95 $175.00 $132.97 2024-07-01
36600 CPT Arterial Blood Gases 3 3 $112.00 $112.00 $56.53 $135.24 $128.48 2024-07-01
92552 CPT Pure Tone Audiometry Air Only 10 5 $237.00 $237.00 $5.00 $175.00 $128.48 2024-07-01
70490 CPT CT Soft Tissue Neck Without Contra 3 3 $1,188.00 $1,188.00 $125.06 $298.64 $125.06 2024-07-01
71250 CPT CT Scan,thorax Without Contr Matl 6 3 $1,143.00 $1,143.00 $125.06 $265.52 $125.06 2024-07-01
73700 CPT CT Scan Lwr Exmty W/out Cntrs 3 3 $1,125.00 $1,125.00 $125.06 $259.78 $125.06 2024-07-01
70450 CPT CT Brain/skull Without Contrast 3 3 $839.00 $839.00 $125.06 $211.79 $125.06 2024-07-01
72125 CPT CT Cervical Spine Without Contrast 3 3 $1,130.00 $1,130.00 $125.06 $261.08 $125.06 2024-07-01
72192 CPT CT Scan Pelvis W/out Contrast 3 3 $1,051.00 $1,051.00 $125.06 $266.07 $125.06 2024-07-01
73200 CPT CT Scan Upper Extmty W/out Cntrs 3 3 $1,301.00 $1,301.00 $125.06 $332.38 $125.06 2024-07-01
74150 CPT CT Abdomen Without Contrast 3 3 $1,188.00 $1,188.00 $125.06 $272.26 $125.06 2024-07-01
87900 CPT HIV-1 Virtual Phenotype 1 1 $550.00 $550.00 $123.83 $123.83 $123.83 2024-07-01
92578 CPT Synthetic Sentence Idenificati 2 2 $361.00 $361.00 $72.20 $175.00 $123.60 2024-07-01
98610 CPT Community Intergration Counsel 2 2 $281.00 $281.00 $56.20 $175.00 $115.60 2024-07-01
99203 CPT Detailed-low Complexity 30min 2 2 $544.00 $544.00 $55.82 $175.00 $115.41 2024-07-01
92591 CPT Hearing Aid Eval Binaural 2 2 $212.00 $212.00 $42.40 $175.00 $108.70 2024-07-01
64645 CPT Chemoden Ea Add Extrem 5+ Musc 4 3 $916.00 $916.00 $44.56 $175.00 $107.30 2024-07-01
64643 CPT Chemoden Ea Add Extr 1-4 Mus 4 3 $554.00 $554.00 $38.84 $175.00 $103.66 2024-07-01
98580 CPT Independent Living Skills/hour 2 2 $140.00 $140.00 $28.00 $175.00 $101.50 2024-07-01
92590 CPT Hearing Aid Eval Set-monaural 2 2 $128.00 $128.00 $25.60 $175.00 $100.30 2024-07-01
98700 CPT Sdp Encounter Note 1 Hr 2 2 $69.00 $69.00 $13.80 $175.00 $94.40 2024-07-01
92593 CPT Hearing Aid Check Binuaral 2 2 $66.00 $66.00 $13.20 $175.00 $94.10 2024-07-01
92592 CPT Hearing Aid Check Monaural 2 2 $44.00 $44.00 $8.80 $175.00 $91.90 2024-07-01
87536 CPT HIV Viral Load By Pcr (quantit 1 1 $192.00 $192.00 $80.85 $80.85 $80.85 2024-07-01
99244 CPT Consultation Op 1 1 $336.00 $336.00 $74.87 $74.87 $74.87 2024-07-01
99205 CPT New Pt Comph Visit 1 1 $1,213.00 $1,213.00 $72.86 $72.86 $72.86 2024-07-01
90471 CPT Immunization Administration 3 3 $102.00 $102.00 $30.95 $71.12 $71.12 2024-07-01
96401 CPT Inject Sub-q Or IM Theur 3 3 $589.00 $589.00 $71.12 $154.92 $71.12 2024-07-01
96372 CPT Injection Sub-q Or IM 3 3 $102.00 $102.00 $25.76 $71.12 $71.12 2024-07-01
84235 CPT Thyrotropin Binding Inh Immuno 1 1 $107.00 $107.00 $67.67 $67.67 $67.67 2024-07-01
92556 CPT Speech Audiometry-speech Recog 5 5 $284.00 $284.00 $15.00 $175.00 $63.88 2024-07-01
86480 CPT Quantiferon TB Gold Plus, 1t 1 1 $101.00 $101.00 $58.88 $58.88 $58.88 2024-07-01
88305 CPT Surgical Pathology Level IV 3 3 $135.00 $135.00 $57.11 $112.99 $57.11 2024-07-01
88304 CPT Surgical Pathology Level Iii 3 3 $135.00 $135.00 $57.11 $69.11 $57.11 2024-07-01
99214 CPT Est Pt Extended Vs 6 3 $560.00 $560.00 $33.69 $175.00 $50.16 2024-07-01
87635 CPT Sars-cov-2 RNA 1 1 $192.00 $192.00 $48.74 $48.74 $48.74 2024-07-01
99215 CPT Est Pt Compreh Visit 1 1 $790.00 $790.00 $48.41 $48.41 $48.41 2024-07-01
84445 CPT Thyroid Stimulating Immunoglob 1 1 $133.00 $133.00 $48.32 $48.32 $48.32 2024-07-01
99243 CPT Confirmatory Cns Dtld Lw Comp 2 1 $301.00 $301.00 $47.82 $47.82 $47.82 2024-07-01
96366 CPT IV Infusion Each Add Hr Up 8 3 3 $156.00 $156.00 $40.58 $45.91 $45.91 2024-07-01
80074 CPT Acute Hepatitis Panel 1 1 $286.00 $286.00 $45.25 $45.25 $45.25 2024-07-01
86360 CPT Cd4/cd8 Ratio 1 1 $241.00 $241.00 $44.63 $44.63 $44.63 2024-07-01
87517 CPT Heaptitis B Virus Dna,qn,pcr 2 1 $309.50 $309.50 $40.70 $40.70 $40.70 2024-07-01
87497 CPT Cmv Quantitative By Pcr 1 1 $428.00 $428.00 $40.70 $40.70 $40.70 2024-07-01
87799 CPT Epstein Barr Virus DNA Qn Pcr 1 1 $760.00 $760.00 $40.70 $40.70 $40.70 2024-07-01
86769 CPT Sars-cov-2 Antibody 1 1 $192.00 $192.00 $40.02 $40.02 $40.02 2024-07-01
83970 CPT Parathormone (parathyroid Horm 2 1 $196.50 $196.50 $39.22 $39.22 $39.22 2024-07-01
90656 CPT Flublok Vaccine (egg Free Flu) 2 2 $113.00 $113.00 $22.60 $55.37 $38.98 2024-07-01
92567 CPT Middle Ear Test 5 5 $114.00 $114.00 $10.00 $175.00 $38.84 2024-07-01
92555 CPT Speech Audiometry-threshold 10 5 $176.50 $176.50 $5.00 $175.00 $38.84 2024-07-01
92568 CPT Acoustic Reflex Testing 10 5 $113.00 $113.00 $10.00 $175.00 $38.84 2024-07-01
92565 CPT Staggered Spondaic Word Test 5 5 $119.00 $119.00 $5.00 $175.00 $38.84 2024-07-01
83880 CPT B-type Natriuretic Peptide 1 1 $175.00 $175.00 $37.30 $37.30 $37.30 2024-07-01
86355 CPT Lymphocyte Subset Panel 2 1 1 $196.00 $196.00 $35.84 $35.84 $35.84 2024-07-01
84238 CPT Acetylcholine Receptr Biding 1 1 $207.00 $207.00 $34.74 $34.74 $34.74 2024-07-01
87521 CPT Hepatitis C RNA Qualitative 1 1 $301.00 $301.00 $33.34 $33.34 $33.34 2024-07-01
87798 CPT Influenza A H1n1 2 1 $380.00 $380.00 $33.34 $33.34 $33.34 2024-07-01
99213 CPT Est Pt Intermed Vs 6 3 $366.00 $366.00 $21.54 $175.00 $33.31 2024-07-01
99202 CPT Expanded Straightforward 5 3 $365.00 $365.00 $21.96 $175.00 $32.97 2024-07-01
88302 CPT Surgical Pathology,level Ii 3 3 $84.00 $84.00 $28.31 $53.19 $28.31 2024-07-01
82306 CPT Calcifediol (25-oh Vitamin D-3 1 1 $101.00 $101.00 $28.12 $28.12 $28.12 2024-07-01
86335 CPT Beta-2 Transferrin 2 1 $297.00 $297.00 $27.88 $27.88 $27.88 2024-07-01
82670 CPT Estradiol 2 1 $121.00 $121.00 $26.54 $26.54 $26.54 2024-07-01
86361 CPT Lymphocyte Subset Panel 5 1 1 $63.00 $63.00 $25.44 $25.44 $25.44 2024-07-01
82803 CPT Arterial Blood Gas 1 1 $101.00 $101.00 $24.77 $24.77 $24.77 2024-07-01
86147 CPT Anti-cardiolipin 1gg,antibody 1 1 $50.00 $50.00 $24.18 $24.18 $24.18 2024-07-01
86146 CPT Beta 2 Glycoprotein(lga.lgg,ig 1 1 $41.00 $41.00 $24.18 $24.18 $24.18 2024-07-01
20610 CPT Arthrocentesis Major Joint 1 1 $349.00 $349.00 $23.99 $23.99 $23.99 2024-07-01
82384 CPT Catecholamines,fraction,24hr U 1 1 $152.00 $152.00 $23.99 $23.99 $23.99 2024-07-01
84244 CPT Renin Activity, Plasma 2 1 $60.00 $60.00 $20.89 $20.89 $20.89 2024-07-01
86300 CPT Ca27.29 1 1 $177.00 $177.00 $19.77 $19.77 $19.77 2024-07-01
20600 CPT Artrocentesis Small Joint 1 1 $273.00 $273.00 $19.47 $19.47 $19.47 2024-07-01
88142 CPT Cytology,thinprep Pap 1 1 $63.00 $63.00 $19.25 $19.25 $19.25 2024-07-01
92558 CPT Speech Audiometry W/sp Recognt 3 3 $93.00 $93.00 $17.34 $175.00 $18.60 2024-07-01
86696 CPT Herpes Simplex Ab Type 2,igg 1 1 $101.00 $101.00 $18.38 $18.38 $18.38 2024-07-01
86689 CPT Htlv-1/2 Ab Western Blot 1 1 $111.00 $111.00 $18.38 $18.38 $18.38 2024-07-01
85250 CPT Factor Ix Activity 31872p 1 1 $135.00 $135.00 $18.09 $18.09 $18.09 2024-07-01
82668 CPT Erythropoietin 1 1 $56.00 $56.00 $17.85 $17.85 $17.85 2024-07-01
82523 CPT C-telopeptide Serum 2 1 $140.50 $140.50 $17.75 $17.75 $17.75 2024-07-01
99212 CPT Est Pt Limited Vis 6 3 $187.00 $187.00 $11.36 $175.00 $17.71 2024-07-01
80299 CPT Lacosamide Level 2 1 $286.50 $286.50 $17.71 $17.71 $17.71 2024-07-01
83001 CPT Gonadotropin,follicle Stim Hor 1 1 $53.00 $53.00 $17.65 $17.65 $17.65 2024-07-01
83002 CPT Gonadotropin,luteinizing,hormo 1 1 $53.00 $53.00 $17.59 $17.59 $17.59 2024-07-01
83519 CPT Igf Binding Protein 1 1 1 $207.00 $207.00 $17.48 $17.48 $17.48 2024-07-01
84153 CPT Prostate Spec Antigen Diagnstc 1 1 $96.00 $96.00 $17.47 $17.47 $17.47 2024-07-01
86022 CPT Platelet Ab, Heparin Induced 1 1 $110.00 $110.00 $17.45 $17.45 $17.45 2024-07-01
86665 CPT Epstein Barr Capsid Ab Igg 1 1 $154.00 $154.00 $17.23 $17.23 $17.23 2024-07-01
83021 CPT Hemoglobin A2 2 1 $78.50 $78.50 $17.16 $17.16 $17.16 2024-07-01
86235 CPT Amti-smith Antibody 3 1 $51.00 $51.00 $17.03 $17.03 $17.03 2024-07-01
85270 CPT Factor Xi 1 1 $224.00 $224.00 $17.01 $17.01 $17.01 2024-07-01
85260 CPT Factor X Activity 32185p 1 1 $135.00 $135.00 $17.01 $17.01 $17.01 2024-07-01
84166 CPT Protein Electrophoresis,urine 1 1 $83.00 $83.00 $16.94 $16.94 $16.94 2024-07-01
85220 CPT Factor V 1 1 $124.00 $124.00 $16.77 $16.77 $16.77 2024-07-01
83520 CPT Gliadin Iga Antibody 1 1 $105.00 $105.00 $16.41 $16.41 $16.41 2024-07-01
84443 CPT Thyroid Stimulating Hormone (t 1 1 $109.00 $109.00 $15.96 $15.96 $15.96 2024-07-01
86800 CPT Thyrglobulin Antibody 1 1 $57.00 $57.00 $15.11 $15.11 $15.11 2024-07-01
82607 CPT Cyanocobalamin (vitamin B-12) 1 1 $79.00 $79.00 $14.33 $14.33 $14.33 2024-07-01
84134 CPT Pre Albumin 1 1 $56.00 $56.00 $13.86 $13.86 $13.86 2024-07-01
86376 CPT Microsomal Antibody 1 1 $68.00 $68.00 $13.82 $13.82 $13.82 2024-07-01
86644 CPT Cmv Igg Antibody 1 1 $122.00 $122.00 $13.67 $13.67 $13.67 2024-07-01
86762 CPT Rubella Lgg Antibodies 1 1 $122.00 $122.00 $13.67 $13.67 $13.67 2024-07-01
83695 CPT Lipoprotein (a) 1 1 $68.00 $68.00 $13.60 $13.60 $13.60 2024-07-01
86803 CPT Hepatitis C Antibody 1 1 $129.00 $129.00 $13.56 $13.56 $13.56 2024-07-01
84480 CPT Triiodothyronine T3,total(tt-3 1 1 $75.00 $75.00 $13.47 $13.47 $13.47 2024-07-01
80198 CPT Theophylline 1 1 $74.00 $74.00 $13.43 $13.43 $13.43 2024-07-01
80197 CPT Tacrolimus 1 1 $60.00 $60.00 $13.04 $13.04 $13.04 2024-07-01
82728 CPT Ferritin 1 1 $54.00 $54.00 $12.95 $12.95 $12.95 2024-07-01
83883 CPT Free Kappa 1 1 $112.00 $112.00 $12.92 $12.92 $12.92 2024-07-01
80061 CPT Lipid Panel 1 1 $123.00 $123.00 $12.72 $12.72 $12.72 2024-07-01
80177 CPT Levetiracetam 1 1 $129.00 $129.00 $12.59 $12.59 $12.59 2024-07-01
86215 CPT Anti-streptococcal Dnase Antbd 2 1 $69.00 $69.00 $12.59 $12.59 $12.59 2024-07-01
86780 CPT Fta-abs 1 1 $32.00 $32.00 $12.58 $12.58 $12.58 2024-07-01
85520 CPT Heparin, Anti-xa 1 1 $301.00 $301.00 $12.44 $12.44 $12.44 2024-07-01
85210 CPT Factor Ii 1 1 $219.00 $219.00 $12.33 $12.33 $12.33 2024-07-01
86141 CPT C-reachive Protein (cardiac Ri 1 1 $77.00 $77.00 $12.30 $12.30 $12.30 2024-07-01
86200 CPT Cyclic Citrulline Peptide 1 1 $86.00 $86.00 $12.30 $12.30 $12.30 2024-07-01
86765 CPT Measles Ab (igg) 1 1 $110.00 $110.00 $12.24 $12.24 $12.24 2024-07-01
82951 CPT Lactose Tolerance 1 1 $39.00 $39.00 $12.23 $12.23 $12.23 2024-07-01
84484 CPT Assay Of Troponin Quant 1 1 $62.00 $62.00 $11.85 $11.85 $11.85 2024-07-01
86708 CPT Hepatitis A Ab,total 1 1 $65.00 $65.00 $11.77 $11.77 $11.77 2024-07-01
86671 CPT S Cerevisiae Ab Iga 1 1 $43.00 $43.00 $11.64 $11.64 $11.64 2024-07-01
83655 CPT Lead Test 1 1 $40.00 $40.00 $11.50 $11.50 $11.50 2024-07-01
86038 CPT Ana Screen Eia W/rfl Titer I 2 1 $42.50 $42.50 $11.49 $11.49 $11.49 2024-07-01
86704 CPT Hepatitis B Core Ab,total 1 1 $56.00 $56.00 $11.45 $11.45 $11.45 2024-07-01
86255 CPT Liver/kidney Microsomal Antibd 1 1 $72.00 $72.00 $11.45 $11.45 $11.45 2024-07-01
86256 CPT Mitochondrial Autoantibodies 1 1 $177.00 $177.00 $11.45 $11.45 $11.45 2024-07-01
87449 CPT Cryptoccus Antigen Csf 2 1 $159.50 $159.50 $11.38 $11.38 $11.38 2024-07-01
86705 CPT Hepatitis B Core Lgm Antibody 1 1 $75.00 $75.00 $11.18 $11.18 $11.18 2024-07-01
51798 CPT Measurement Post Void Urine 1 1 $79.00 $79.00 $11.14 $11.14 $11.14 2024-07-01
83605 CPT Lactate 1 1 $55.00 $55.00 $10.99 $10.99 $10.99 2024-07-01
86707 CPT Hepatitis Be Antibody 1 1 $57.00 $57.00 $10.99 $10.99 $10.99 2024-07-01
86403 CPT Cryptococcus Antigen 1 1 $61.00 $61.00 $10.96 $10.96 $10.96 2024-07-01
87350 CPT Hepatitis Be Antigen 1 1 $35.00 $35.00 $10.95 $10.95 $10.95 2024-07-01
83516 CPT Transglutaminase Ab Igg 2 1 $85.00 $85.00 $10.95 $10.95 $10.95 2024-07-01
86709 CPT Hepatitis A Virus Igm Antibodi 1 1 $68.00 $68.00 $10.70 $10.70 $10.70 2024-07-01
86039 CPT Centromere Ab Titer 1 1 $116.00 $116.00 $10.60 $10.60 $10.60 2024-07-01
86706 CPT Hepatitis B Surf Antibody 1 1 $74.00 $74.00 $10.20 $10.20 $10.20 2024-07-01
80053 CPT Comprehensive Metabolic Panel 1 1 $82.00 $82.00 $10.03 $10.03 $10.03 2024-07-01
87340 CPT Hepatitis B Surf Antigen 1 1 $56.00 $56.00 $9.81 $9.81 $9.81 2024-07-01
87040 CPT Culture,bacterial,blood 1 1 $74.00 $74.00 $9.80 $9.80 $9.80 2024-07-01
83036 CPT Hemoglobin, Glycated 1 1 $82.00 $82.00 $9.22 $9.22 $9.22 2024-07-01
82784 CPT Gammaglobulin Iga 1 1 $71.00 $71.00 $8.84 $8.84 $8.84 2024-07-01
86687 CPT Htlv I/ii Antibody Screen 1 1 $48.00 $48.00 $8.64 $8.64 $8.64 2024-07-01
84439 CPT Thyroxine, Free 1 1 $117.00 $117.00 $8.57 $8.57 $8.57 2024-07-01
86701 CPT HIV-1 Antibody 1 1 $52.00 $52.00 $8.45 $8.45 $8.45 2024-07-01
83550 CPT Iron And Tibc 1 1 $45.00 $45.00 $8.30 $8.30 $8.30 2024-07-01
80069 CPT Renal Function Panel 1 1 $46.00 $46.00 $8.25 $8.25 $8.25 2024-07-01
87186 CPT Susceptability Studies, Mic 2 1 $42.50 $42.50 $8.22 $8.22 $8.22 2024-07-01
87070 CPT Culture Eye/ear 1 1 $73.00 $73.00 $8.19 $8.19 $8.19 2024-07-01
81025 CPT Urine Preganacy Test 1 1 $54.00 $54.00 $8.18 $8.18 $8.18 2024-07-01
80048 CPT Basic Metabolic Panel 1 1 $59.00 $59.00 $8.04 $8.04 $8.04 2024-07-01
87102 CPT Fungus Culture,other 1 1 $71.00 $71.00 $7.99 $7.99 $7.99 2024-07-01
83718 CPT Hdl 1 1 $42.00 $42.00 $7.78 $7.78 $7.78 2024-07-01
80076 CPT Diagnostic Casts 1 1 $59.00 $59.00 $7.76 $7.76 $7.76 2024-07-01
87088 CPT Culture,urine,isolation,presum 1 1 $69.00 $69.00 $7.69 $7.69 $7.69 2024-07-01
93010 CPT Electrocadiogram Inter & Repor 1 1 $59.00 $59.00 $7.50 $7.50 $7.50 2024-07-01
85025 CPT Hemogram & Platelet Count,auto 1 1 $66.00 $66.00 $7.38 $7.38 $7.38 2024-07-01
87101 CPT Culture, Fungus 1 1 $66.00 $66.00 $7.32 $7.32 $7.32 2024-07-01
93798 CPT Cardiac Op W/telemetry 1 1 $284.00 $284.00 $7.25 $7.25 $7.25 2024-07-01
84703 CPT Gonadotropin,chorionic Hcg Qua 1 1 $79.00 $79.00 $7.14 $7.14 $7.14 2024-07-01
87184 CPT Susceptibility Study Disc 1 1 $30.00 $30.00 $7.11 $7.11 $7.11 2024-07-01
86060 CPT Antistreptolysin O:titer 1 1 $34.00 $34.00 $6.94 $6.94 $6.94 2024-07-01
80051 CPT Electrolyte Panel 1 1 $97.00 $97.00 $6.66 $6.66 $6.66 2024-07-01
84436 CPT Thyroxine, Total 1 1 $75.00 $75.00 $6.53 $6.53 $6.53 2024-07-01
87081 CPT Legionella Culture 1 1 $56.00 $56.00 $6.30 $6.30 $6.30 2024-07-01
82550 CPT Ck Isoenzymes 2 1 $50.50 $50.50 $6.18 $6.18 $6.18 2024-07-01
85027 CPT Complete Blood Count No Diff 1 1 $51.00 $51.00 $6.15 $6.15 $6.15 2024-07-01
85004 CPT Automated Diff Wbc Count 1 1 $31.00 $31.00 $6.15 $6.15 $6.15 2024-07-01
83540 CPT Iron 1 1 $47.00 $47.00 $6.15 $6.15 $6.15 2024-07-01
82340 CPT Calcium, Urine Quentitative Ti 1 1 $61.00 $61.00 $5.73 $5.73 $5.73 2024-07-01
85730 CPT Ptt-la W/refl Hexagonal 1 1 $75.00 $75.00 $5.71 $5.71 $5.71 2024-07-01
82043 CPT Microalbumin,urine,quantitativ 1 1 $47.00 $47.00 $5.49 $5.49 $5.49 2024-07-01
84460 CPT Alanine Amino (alt) (sgpt) 1 1 $32.00 $32.00 $5.04 $5.04 $5.04 2024-07-01
86140 CPT C-reactive Protein (inflammati 1 1 $33.00 $33.00 $4.92 $4.92 $4.92 2024-07-01
82570 CPT Protein,total,w/cr,rnd Ur 1 1 $48.00 $48.00 $4.92 $4.92 $4.92 2024-07-01
82248 CPT Bilirubin, Direct 1 1 $33.00 $33.00 $4.77 $4.77 $4.77 2024-07-01
84295 CPT Sodium, Serum 1 1 $44.00 $44.00 $4.57 $4.57 $4.57 2024-07-01
82270 CPT Stool Occult Blood X 3 1 1 $40.00 $40.00 $4.16 $4.16 $4.16 2024-07-01
85610 CPT Prothrombin Time 1 1 $33.00 $33.00 $4.08 $4.08 $4.08 2024-07-01
87172 CPT Pinworm Examination 1 1 $32.00 $32.00 $4.06 $4.06 $4.06 2024-07-01
86592 CPT Rpr With Reflex 2 1 $25.50 $25.50 $4.06 $4.06 $4.06 2024-07-01
87205 CPT Fecal Leukocytes 1 1 $36.00 $36.00 $4.06 $4.06 $4.06 2024-07-01
82947 CPT Glucose, Quantitative, Blood 1 1 $33.00 $33.00 $3.73 $3.73 $3.73 2024-07-01
85007 CPT Blood Count Manual Differentia 1 1 $29.00 $29.00 $3.61 $3.61 $3.61 2024-07-01
36415 CPT Venipuncture 1 1 $27.00 $27.00 $2.85 $2.85 $2.85 2024-07-01
81003 CPT Urine Screen Automated Without Mic 1 1 $19.00 $19.00 $2.14 $2.14 $2.14 2024-07-01
99306 CDM Nursing Facility Care High 0 0 $1,175.00 — — — — 2026-08-01
99309 CDM Subsequent Nsg Fac Care Cpx 0 0 $642.00 — — — — 2026-08-01
99315 CDM Nursing Facility Discharge Day 0 0 $521.00 — — — — 2026-08-01
G0281GO CDM E Stim Wnd Care Unatt Stg 3&4 0 0 $99.00 — — — — 2026-08-01
G0281GP CDM E Stim Medicare Wound 0 0 $99.00 — — — — 2026-08-01
G0282GO CDM E Stim Wnd Care Unatt Other 0 0 $80.00 — — — — 2026-08-01
G0283GO CDM E Stim Medicare Unattended 0 0 $99.00 — — — — 2026-08-01
G0283GP CDM E Stim Medicare Unattended Mss 0 0 $99.00 — — — — 2026-08-01
L1831LT CDM Ko,lk Knee Positional Orth,pre 0 0 $383.00 — — — — 2026-08-01
L1833LT CDM Knee Orth Adj Knee Jts L 0 0 $1,601.00 — — — — 2026-08-01
L1833RT CDM Knee Orth Adj Knee Jts R 0 0 $1,601.00 — — — — 2026-08-01
L1843LT CDM Ko Single Upright Cust Fit 0 0 $1,339.00 — — — — 2026-08-01
L1932LT CDM Afo Graphite Ots Left 0 0 $1,147.00 — — — — 2026-08-01
L1932RT CDM Afo Graphite Ots Right 0 0 $1,147.00 — — — — 2026-08-01
L2580RT CDM Pelvic Sling Right 0 0 $828.00 — — — — 2026-08-01
L2622LT CDM Hip Joint Adj Flexi Each Left 0 0 $554.00 — — — — 2026-08-01
L2622RT CDM Hip Joint Adj Flexi Each Right 0 0 $554.00 — — — — 2026-08-01
L3030RT CDM Foot Insert Frmd To Print Foot 0 0 $405.00 — — — — 2026-08-01
L3060RT CDM Arch Spprt Premolded Lng/mttr 0 0 $132.00 — — — — 2026-08-01
L3100RT CDM Hallus Valgus Nght Dymnc Splin 0 0 $43.00 — — — — 2026-08-01
L3211RT CDM Surgical Boot Each Junior Righ 0 0 $106.00 — — — — 2026-08-01
L3230RT CDM Ortho Ftwr Cstm Shs Depth Inly 0 0 $623.00 — — — — 2026-08-01
L3257LT CDM Orth Ft Add Charge Split S 0 0 $78.00 — — — — 2026-08-01
L3380RT CDM Clubfoot Wedge Right 0 0 $78.00 — — — — 2026-08-01
L3485RT CDM Heel Pad Removable For Spur R 0 0 $43.00 — — — — 2026-08-01
L4360RT CDM Pneumatic Walking Splint Right 0 0 $405.00 — — — — 2026-08-01
L6388LT CDM Post Surg Fitting App Rigd Dre 0 0 $857.00 — — — — 2026-08-01
L8430RT CDM Prosthic Sock Wool Above Knee 0 0 $49.00 — — — — 2026-08-01
ROOM1 CDM Outpatient Services 0 0 $64.00 — — — — 2026-08-01
A5501 HCPCS Shoe,custom Mld,diabetics Only 0 0 $420.00 — — — — 2026-08-01
A6541 HCPCS Grad Comp Stock Waist 40-50 0 0 $383.00 — — — — 2026-08-01
A8001 HCPCS Helmet Hard Prefab 0 0 $383.00 — — — — 2026-08-01
A8003 HCPCS Helmet Hard Custom Molded 0 0 $1,203.00 — — — — 2026-08-01
G0238 HCPCS Resp Monitoring 0 0 $74.00 — — — — 2026-08-01
G0424 HCPCS Op Pulmonary Rehab 0 0 $269.00 — — — — 2026-08-01
L2580 HCPCS Pelvic Sling Left 0 0 $828.00 — — — — 2026-08-01
L3206 HCPCS Ortho Shoe Hightop Child Left 0 0 $125.00 — — — — 2026-08-01
L3211 HCPCS Surgical Boot Each Junior Left 0 0 $106.00 — — — — 2026-08-01
L3250 HCPCS Ortho Ftwr Cstm Mld Prsth Sh L 0 0 $738.00 — — — — 2026-08-01
L3380 HCPCS Clubfoot Wedge Left 0 0 $78.00 — — — — 2026-08-01
L3675 HCPCS Shoulder Orthosis (custom) 0 0 $383.00 — — — — 2026-08-01
L3700 HCPCS Elbw Orthosis Elastic W/stys L 0 0 $125.00 — — — — 2026-08-01
L4360 HCPCS Pneumatic Walking Splint Left 0 0 $405.00 — — — — 2026-08-01
R3206 HCPCS Ortho Shoe Hightop Child Right 0 0 $125.00 — — — — 2026-08-01
R3252 HCPCS Ft Shoe Mld Plstzt Cstm Fab Ri 0 0 $405.00 — — — — 2026-08-01
R3260 HCPCS Abulatory Sandal Each Right 0 0 $43.00 — — — — 2026-08-01
R8430 HCPCS Prosthic Sock Wool Above Knee 0 0 $49.00 — — — — 2026-08-01
14363 CDM Arterial Blood Gas 0 0 $89.00 — — — — 2026-08-01
15150 CDM C-reachive Protein (cardiac Ri 0 0 $77.00 — — — — 2026-08-01
15421 CDM Gases,blood Ph,pco2,po2,co2 0 0 $101.00 — — — — 2026-08-01
15500 CDM Folic Acid Serum 0 0 $78.00 — — — — 2026-08-01
43630RT CDM Foot 3 Views Right Complete 0 0 $743.00 — — — — 2026-08-01
50130 CDM Emer Oral Exam Child 0 0 $68.00 — — — — 2026-08-01
50274 CDM Four Bitewing Imgs 0 0 $72.00 — — — — 2026-08-01
51120 CDM Child Prophylaxis 0 0 $68.00 — — — — 2026-08-01
51701 CDM Insert Bladder Cath 0 0 $68.00 — — — — 2026-08-01
51705 CDM Cystostomy Tube Change Tech 0 0 $390.00 — — — — 2026-08-01
51741 CDM Complex Uroflowmetry 0 0 $109.00 — — — — 2026-08-01
52330 CDM Resin 1 Srf Ant 0 0 $89.00 — — — — 2026-08-01
52920 CDM Recement Crown 0 0 $63.00 — — — — 2026-08-01
52940 CDM Sedative Filling 0 0 $80.00 — — — — 2026-08-01
54910 CDM Periodontal Prophylaxis 0 0 $89.00 — — — — 2026-08-01
55410 CDM Adjustment-complete Denture 0 0 $75.00 — — — — 2026-08-01
55421 CDM Adjustment-partial Denture 0 0 $75.00 — — — — 2026-08-01
59110 CDM Palliative Treatment Of Pain 0 0 $83.00 — — — — 2026-08-01
59430 CDM Office Visit For Observation 0 0 $60.00 — — — — 2026-08-01
59951 CDM Occlusal Adj. Limited 0 0 $109.00 — — — — 2026-08-01
70030TCRT CDM Eye Detection Fb Right 0 0 $166.00 — — — — 2026-08-01
70134 CDM Internal Auditory Meatus 0 0 $409.00 — — — — 2026-08-01
70360 CDM Neck (soft Tissue) 0 0 $563.00 — — — — 2026-08-01
70450 CDM CT Brain/skull Without Contrast 0 0 $839.00 — — — — 2026-08-01
70553 CDM MRI Brain W & Without Contrast 0 0 $7,201.00 — — — — 2026-08-01
71010 CDM Portable X-ray Chest 0 0 $431.00 — — — — 2026-08-01
71020 CDM Chest Ap & Lat 0 0 $548.00 — — — — 2026-08-01
71021 CDM Cxr 2 Views W/apical Lordotic 0 0 $548.00 — — — — 2026-08-01
71100RT CDM Ribs Unilateral 2 Views Rt 0 0 $649.00 — — — — 2026-08-01
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