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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

TIOGA MEDICAL CENTER

Tioga, ND · CCN 351300 · Rates published

3,760 distinct procedures filed
1 distinct payers
4,188 rate rows
2026-05-27 last MRF observed
Data quality

4,188 of 4,188 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

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Source MRF file https://secure.claraprice.net/price-transparency/CKCV-1764013429670/machine-readable/450308484_tioga-medical-center_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/tioga-medical-center-nd
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 3988dd56100b6050… · 108,842 bytes · first seen 2026-05-18

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
28725
CPT 		Hc Fusion Foot Bones,subtalar 1 $25,986.00 $25,986.00 $25,986.00 nat. median
$10,168
outlier · 2.6×
27702
CPT 		Arthroplasty Ankle W/implant 1 $24,984.00 $25,986.00 $25,485.00 nat. median
$15,707
1.6× median
CP17679084990107649
CDM 		Ustekinumab 90 Mg/ml Sc Sosy 1 $14,097.00 $14,097.00 $14,097.00 nat. median
$14,097
1.0× median
129288
CDM 		Ustekinumab 90 Mg/ml Sc Sosy 1 $14,097.00 $14,097.00 $14,097.00 nat. median
$906
outlier · 15.6×
CP17679084990144474
CDM 		Tenecteplase 50 Mg IV Kit 1 $13,587.00 $13,587.00 $13,587.00 nat. median
$13,587
1.0× median
600948
CDM 		Tenecteplase 50mg IV For Cardiac / Pe 1 $13,587.00 $13,587.00 $13,587.00 nat. median
$407
outlier · 33.4×
600949
CDM 		Tenecteplase 50mg IV For Stroke 1 $13,587.00 $13,587.00 $13,587.00 nat. median
$8,276
1.6× median
28530
CDM 		Tenecteplase 50 Mg IV Kit 1 $13,587.00 $13,587.00 $13,587.00 nat. median
$230
outlier · 59.0×
27654
CPT 		Hc Rpr Achilles Tendon 1 $13,553.00 $13,553.00 $13,553.00 nat. median
$6,809
2.0× median
28740
CPT 		Hc Fusion Of Foot Bones 1 $13,553.00 $13,553.00 $13,553.00 nat. median
$6,930
2.0× median
28750
CPT 		Hc Fusion Big Toe,mt-p Jt 1 $13,548.00 $13,548.00 $13,548.00 nat. median
$6,945
2.0× median
28322
CPT 		Hc Repair Of Metatarsals 1 $13,548.00 $13,548.00 $13,548.00 nat. median
$6,601
outlier · 2.1×
28755
CPT 		Hc Fusion Big Toe,i-p Joint 1 $13,548.00 $13,548.00 $13,548.00 nat. median
$6,217
outlier · 2.2×
27691
CPT 		Hc Revis Lower Leg Tendon 1 $13,548.00 $13,548.00 $13,548.00 nat. median
$6,967
1.9× median
28297
CPT 		Hc Correct Bunion,lapidus Type 1 $13,548.00 $13,548.00 $13,548.00 nat. median
$7,349
1.8× median
28298
CPT 		Hc Correct Bunion,phalanx Osteotomy 1 $13,548.00 $13,548.00 $13,548.00 nat. median
$6,732
outlier · 2.0×
27822
CPT 		Hc Open Rx Trimalleolar Fx 1 $13,548.00 $13,548.00 $13,548.00 nat. median
$7,144
1.9× median
28306
CPT 		Hc Osteotomy 1st Metatarsal,base/shaft 1 $13,548.00 $13,548.00 $13,548.00 nat. median
$6,554
outlier · 2.1×
28291
CPT 		Hc Corrj Halux Rigdus W/implt 1 $13,419.00 $13,419.00 $13,419.00 nat. median
$7,230
1.9× median
27814
CPT 		Hc Open Rx Bimalleolar Fx 1 $13,419.00 $13,419.00 $13,419.00 nat. median
$7,021
1.9× median
27695
CPT 		Hc Repair 1 Collat Ankle Ligmnt,primary 1 $13,419.00 $13,419.00 $13,419.00 nat. median
$6,486
outlier · 2.1×
27700
CPT 		Hc Revision Of Ankle Joint 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$7,048
1.9× median
28615
CPT 		Hc Repair Foot Dislocation 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$6,825
1.9× median
28310
CPT 		Hc Revision Of Big Toe 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$6,355
outlier · 2.1×
28309
CPT 		Hc Incision Of Metatarsals 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$6,889
1.9× median
28070
CPT 		Hc Removal Of Foot Joint Lining 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$6,350
outlier · 2.1×
28107
CPT 		Hc Remove/graft Foot Lesion 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$6,948
1.9× median
28299
CPT 		Hc Correct Bunion,othr Methods 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$6,821
1.9× median
28300
CPT 		Hc Incision Of Heel Bone 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$6,701
2.0× median
28302
CPT 		Hc Incision Of Ankle Bone 1 $13,220.00 $13,220.00 $13,220.00 nat. median
$6,615
2.0× median
27698
CPT 		Hc Repair Collat Ankle Ligmnt,secondar 1 $13,219.00 $13,220.00 $13,219.50 nat. median
$6,624
2.0× median
28415
CPT 		Open Treatment Calcaneal Fracture 1 $13,219.00 $13,219.00 $13,219.00 nat. median
$7,447
1.8× median
27696
CPT 		Hc Repair Of Ankle Ligaments 1 $13,219.00 $13,219.00 $13,219.00 nat. median
$6,809
1.9× median
28238
CPT 		Hc Revision Of Foot Tendon 1 $13,219.00 $13,219.00 $13,219.00 nat. median
$6,828
1.9× median
28305
CPT 		Hc Osteotomy Midtarsal,autograft 1 $12,710.00 $12,710.00 $12,710.00 nat. median
$6,968
1.8× median
27659
CPT 		Hc Repair Flex Leg Tendon,second,ea 1 $12,710.00 $12,710.00 $12,710.00 nat. median
$5,920
outlier · 2.1×
28307
CPT 		Hc Osteotomy 1st Metatarsal,autograft 1 $12,710.00 $12,710.00 $12,710.00 nat. median
$6,623
1.9× median
28103
CPT 		Hc Remove/graft Foot Lesion 1 $12,710.00 $12,710.00 $12,710.00 nat. median
$6,849
1.9× median
81162
CPT 		Th Brca1&2 Seq & Full Dup/del/tlo 1 $11,606.00 $11,606.00 $11,606.00 nat. median
$1,825
outlier · 6.4×
15830
CPT 		Hc Abdominoplasty 1 $11,409.00 $11,409.00 $11,409.00 nat. median
$6,586
1.7× median
L8642
HCPCS 		Or-implant-cartiva-10-US 1 $7,901.00 $7,901.00 $7,901.00 nat. median
$416
outlier · 19.0×
49507
CPT 		Hc Rpr Initial Hernia >5 Yrs Strang 1 $7,245.00 $7,245.00 $7,245.00 nat. median
$3,957
1.8× median
49525
CPT 		Hc Repair Ing Hernia,slidin 1 $7,234.00 $7,234.00 $7,234.00 nat. median
$3,761
1.9× median
70559
CPT 		MRI Brain Without & With Contrast 1 $6,937.00 $6,937.00 $6,937.00 nat. median
$327
outlier · 21.2×
3240269
CDM 		Or-augment Inj. Kit 1 $6,868.00 $6,868.00 $6,868.00 nat. median
$6,868
1.0× median
47562
CPT 		Removal Of Gallbladder Using An Endoscope 1 $2,119.00 $11,291.00 $6,705.00 nat. median
$5,956
1.1× median
133089
CDM 		Pegfilgrastim 6 Mg/0.6ml Sc Sosy 1 $6,350.00 $6,350.00 $6,350.00 nat. median
$6,350
1.0× median
CP17679084990109498
CDM 		Pegfilgrastim 6 Mg/0.6ml Sc Sosy 1 $6,350.00 $6,350.00 $6,350.00 nat. median
$6,350
1.0× median
28285
CPT 		Hc Repair Of Hammertoe 1 $6,238.00 $6,238.00 $6,238.00 nat. median
$3,551
1.8× median
29882
CPT 		Hc Knee Scope,med Or Lat Menis Repair 1 $6,238.00 $6,238.00 $6,238.00 nat. median
$3,993
1.6× median

Other procedures at this hospital

Browse this hospital's 3,760 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
             
28725 CPT Hc Fusion Foot Bones,subtalar 1 1 $25,986.00 $25,986.00 $25,986.00 $25,986.00 $25,986.00 2026-05-27
27702 CPT Arthroplasty Ankle W/implant 2 1 $25,485.00 $25,485.00 $24,984.00 $25,986.00 $25,485.00 2026-05-27
129288 CDM Ustekinumab 90 Mg/ml Sc Sosy 1 1 $14,097.00 $14,097.00 $14,097.00 $14,097.00 $14,097.00 2026-05-27
CP17679084990107649 CDM Ustekinumab 90 Mg/ml Sc Sosy 1 1 $14,097.00 $14,097.00 $14,097.00 $14,097.00 $14,097.00 2026-05-27
CP17679084990144474 CDM Tenecteplase 50 Mg IV Kit 1 1 $13,587.00 $13,587.00 $13,587.00 $13,587.00 $13,587.00 2026-05-27
600949 CDM Tenecteplase 50mg IV For Stroke 1 1 $13,587.00 $13,587.00 $13,587.00 $13,587.00 $13,587.00 2026-05-27
600948 CDM Tenecteplase 50mg IV For Cardiac / Pe 1 1 $13,587.00 $13,587.00 $13,587.00 $13,587.00 $13,587.00 2026-05-27
28530 CDM Tenecteplase 50 Mg IV Kit 1 1 $13,587.00 $13,587.00 $13,587.00 $13,587.00 $13,587.00 2026-05-27
27654 CPT Hc Rpr Achilles Tendon 1 1 $13,553.00 $13,553.00 $13,553.00 $13,553.00 $13,553.00 2026-05-27
28740 CPT Hc Fusion Of Foot Bones 1 1 $13,553.00 $13,553.00 $13,553.00 $13,553.00 $13,553.00 2026-05-27
28322 CPT Hc Repair Of Metatarsals 1 1 $13,548.00 $13,548.00 $13,548.00 $13,548.00 $13,548.00 2026-05-27
28298 CPT Hc Correct Bunion,phalanx Osteotomy 1 1 $13,548.00 $13,548.00 $13,548.00 $13,548.00 $13,548.00 2026-05-27
28750 CPT Hc Fusion Big Toe,mt-p Jt 1 1 $13,548.00 $13,548.00 $13,548.00 $13,548.00 $13,548.00 2026-05-27
28297 CPT Hc Correct Bunion,lapidus Type 1 1 $13,548.00 $13,548.00 $13,548.00 $13,548.00 $13,548.00 2026-05-27
27822 CPT Hc Open Rx Trimalleolar Fx 1 1 $13,548.00 $13,548.00 $13,548.00 $13,548.00 $13,548.00 2026-05-27
28755 CPT Hc Fusion Big Toe,i-p Joint 1 1 $13,548.00 $13,548.00 $13,548.00 $13,548.00 $13,548.00 2026-05-27
28306 CPT Hc Osteotomy 1st Metatarsal,base/shaft 1 1 $13,548.00 $13,548.00 $13,548.00 $13,548.00 $13,548.00 2026-05-27
27691 CPT Hc Revis Lower Leg Tendon 1 1 $13,548.00 $13,548.00 $13,548.00 $13,548.00 $13,548.00 2026-05-27
27814 CPT Hc Open Rx Bimalleolar Fx 1 1 $13,419.00 $13,419.00 $13,419.00 $13,419.00 $13,419.00 2026-05-27
27695 CPT Hc Repair 1 Collat Ankle Ligmnt,primary 1 1 $13,419.00 $12,748.00 $13,419.00 $13,419.00 $13,419.00 2026-05-27
28291 CPT Hc Corrj Halux Rigdus W/implt 1 1 $13,419.00 $13,419.00 $13,419.00 $13,419.00 $13,419.00 2026-05-27
28107 CPT Hc Remove/graft Foot Lesion 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
28299 CPT Hc Correct Bunion,othr Methods 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
28300 CPT Hc Incision Of Heel Bone 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
28070 CPT Hc Removal Of Foot Joint Lining 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
28615 CPT Hc Repair Foot Dislocation 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
28310 CPT Hc Revision Of Big Toe 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
27700 CPT Hc Revision Of Ankle Joint 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
28309 CPT Hc Incision Of Metatarsals 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
28302 CPT Hc Incision Of Ankle Bone 1 1 $13,220.00 $13,220.00 $13,220.00 $13,220.00 $13,220.00 2026-05-27
27698 CPT Hc Repair Collat Ankle Ligmnt,secondar 2 1 $13,219.50 $12,889.00 $13,219.00 $13,220.00 $13,219.50 2026-05-27
28238 CPT Hc Revision Of Foot Tendon 1 1 $13,219.00 $13,219.00 $13,219.00 $13,219.00 $13,219.00 2026-05-27
27696 CPT Hc Repair Of Ankle Ligaments 1 1 $13,219.00 $13,219.00 $13,219.00 $13,219.00 $13,219.00 2026-05-27
28415 CPT Open Treatment Calcaneal Fracture 1 1 $13,219.00 $13,219.00 $13,219.00 $13,219.00 $13,219.00 2026-05-27
28307 CPT Hc Osteotomy 1st Metatarsal,autograft 1 1 $12,710.00 $12,710.00 $12,710.00 $12,710.00 $12,710.00 2026-05-27
27659 CPT Hc Repair Flex Leg Tendon,second,ea 1 1 $12,710.00 $12,710.00 $12,710.00 $12,710.00 $12,710.00 2026-05-27
28103 CPT Hc Remove/graft Foot Lesion 1 1 $12,710.00 $12,710.00 $12,710.00 $12,710.00 $12,710.00 2026-05-27
28305 CPT Hc Osteotomy Midtarsal,autograft 1 1 $12,710.00 $12,710.00 $12,710.00 $12,710.00 $12,710.00 2026-05-27
81162 CPT Th Brca1&2 Seq & Full Dup/del/tlo 1 1 $11,606.00 $11,606.00 $11,606.00 $11,606.00 $11,606.00 2026-05-27
15830 CPT Hc Abdominoplasty 1 1 $11,409.00 $11,409.00 $11,409.00 $11,409.00 $11,409.00 2026-05-27
L8642 HCPCS Or-implant-cartiva-10-US 1 1 $7,901.00 $7,901.00 $7,901.00 $7,901.00 $7,901.00 2026-05-27
49507 CPT Hc Rpr Initial Hernia >5 Yrs Strang 1 1 $7,245.00 $7,245.00 $7,245.00 $7,245.00 $7,245.00 2026-05-27
49525 CPT Hc Repair Ing Hernia,slidin 1 1 $7,234.00 $7,234.00 $7,234.00 $7,234.00 $7,234.00 2026-05-27
70559 CPT MRI Brain Without & With Contrast 1 1 $6,937.00 $6,937.00 $6,937.00 $6,937.00 $6,937.00 2026-05-27
3240269 CDM Or-augment Inj. Kit 1 1 $6,868.00 $6,868.00 $6,868.00 $6,868.00 $6,868.00 2026-05-27
47562 CPT Removal Of Gallbladder Using An Endoscope 2 1 $6,705.00 $6,705.00 $2,119.00 $11,291.00 $6,705.00 2026-05-27
CP17679084990109498 CDM Pegfilgrastim 6 Mg/0.6ml Sc Sosy 1 1 $6,350.00 $6,350.00 $6,350.00 $6,350.00 $6,350.00 2026-05-27
133089 CDM Pegfilgrastim 6 Mg/0.6ml Sc Sosy 1 1 $6,350.00 $6,350.00 $6,350.00 $6,350.00 $6,350.00 2026-05-27
23020 CPT Hc Release Shoulder Joint 1 1 $6,238.00 $6,238.00 $6,238.00 $6,238.00 $6,238.00 2026-05-27
28270 CPT Hc Release Of Foot Contracture 1 1 $6,238.00 $6,238.00 $6,238.00 $6,238.00 $6,238.00 2026-05-27
28308 CPT Hc Osteotomy Metatarsal (Not 1st) 1 1 $6,238.00 $6,238.00 $6,238.00 $6,238.00 $6,238.00 2026-05-27
28122 CPT Hc Partial Removal Of Foot Bone 1 1 $6,238.00 $6,238.00 $6,238.00 $6,238.00 $6,238.00 2026-05-27
29882 CPT Hc Knee Scope,med Or Lat Menis Repair 1 1 $6,238.00 $6,238.00 $6,238.00 $6,238.00 $6,238.00 2026-05-27
28285 CPT Hc Repair Of Hammertoe 1 1 $6,238.00 $6,238.00 $6,238.00 $6,238.00 $6,238.00 2026-05-27
29881 CPT Removal Of One Knee Cartilage Using An Endoscope 1 1 $6,238.00 $6,238.00 $6,238.00 $6,238.00 $6,238.00 2026-05-27
28110 CPT Hc Part Excis 5th Metatarsal Head 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
28288 CPT Hc Part Removal Of Foot Bone 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
28022 CPT Hc Explor Metatarso-phalang Jt 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
29893 CPT Hc Ankle Scope,plantar Fasciotomy 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
26860 CPT Hc Fusion Of Finger Joint 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
28292 CPT Hc Correct Bunion,keller/mcbride/mayo 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
28124 CPT Hc Part Remv Phalanx Of Toe 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
28296 CPT Hc Correct Bunion,metatarsal Osteotomy 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
29883 CPT Hc Knee Arthroscopy Surgery 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
28020 CPT Hc Explor Tarsal/tarsometatar Jt 1 1 $6,237.00 $6,237.00 $6,237.00 $6,237.00 $6,237.00 2026-05-27
27640 CPT Hc Partial Removal Of Tibia 1 1 $6,177.00 $6,177.00 $6,177.00 $6,177.00 $6,177.00 2026-05-27
27687 CPT Hc Revision Of Calf Tendon 1 1 $6,177.00 $6,177.00 $6,177.00 $6,177.00 $6,177.00 2026-05-27
28289 CPT Hc Repair Hallux Rigidus 1 1 $6,177.00 $6,177.00 $6,177.00 $6,177.00 $6,177.00 2026-05-27
28118 CPT Hc Remove Heel Bone 1 1 $6,177.00 $6,177.00 $6,177.00 $6,177.00 $6,177.00 2026-05-27
40510 CPT Hc Partial Excis Lip,wedge Prim Clos 1 1 $6,107.00 $6,107.00 $6,107.00 $6,107.00 $6,107.00 2026-05-27
26123 CPT Hc Part Palmar Fasciec,open 1 Digit 1 1 $6,092.00 $6,092.00 $6,092.00 $6,092.00 $6,092.00 2026-05-27
28113 CPT Hc Full Excis 5th Metatarsal Head 1 1 $6,092.00 $6,092.00 $6,092.00 $6,092.00 $6,092.00 2026-05-27
24436 CDM Octreotide Acetate 30 Mg IM Kit 1 1 $5,979.00 $5,979.00 $5,979.00 $5,979.00 $5,979.00 2026-05-27
CP17679084990138148 CDM Octreotide Acetate 30 Mg IM Kit 1 1 $5,979.00 $5,979.00 $5,979.00 $5,979.00 $5,979.00 2026-05-27
29898 CPT Hc Ankle Scope,extens Debridemnt 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
27635 CPT Hc Remove Lower Leg Bone Lesion 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
28208 CPT Hc Repair Exten Leg Tendon,prim,ea 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
27625 CPT Hc Explor Ankle Jt+synovectomy 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
28160 CPT Hc Resec Toe At I-p Jt,single,ea 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
28120 CPT Hc Partial Removal Of Ankle/heel 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
29891 CPT Hc Arthroscopy/ankle,surgical 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
27860 CPT Hc Fixation Of Ankle Joint 1 1 $5,972.00 $5,673.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
28060 CPT Hc Partial Removal,foot Fascia 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
27641 CPT Hc Partial Removal Of Fibula 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
27606 CPT Hc Incision Of Achilles Tendon 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
28295 CPT Hc Correction Hallux Valgus 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
27658 CPT Hc Repair Flex Leg Tendon,prim,ea 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
28119 CPT Hc Remove Heel Spur 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
28200 CPT Hc Repair Flex Foot Tendon,ea 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
28225 CPT Hc Release Exten Foot Tendon,single 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
29880 CPT Hc Knee Scope,single Meniscectomy 1 1 $5,972.00 $5,972.00 $5,972.00 $5,972.00 $5,972.00 2026-05-27
27680 CPT Hc Release Lower Leg Tendon 2 1 $5,971.50 $5,971.50 $5,971.00 $5,972.00 $5,971.50 2026-05-27
27630 CPT Hc Remove Tendon Lesion 1 1 $5,971.00 $5,971.00 $5,971.00 $5,971.00 $5,971.00 2026-05-27
28116 CPT Ostectomy Tarsal Coalition 1 1 $5,971.00 $5,971.00 $5,971.00 $5,971.00 $5,971.00 2026-05-27
28820 CPT Amputation Toe Metatarsophalangeal Joint 1 1 $5,971.00 $5,971.00 $5,971.00 $5,971.00 $5,971.00 2026-05-27
27620 CPT Exploration Of Ankle Joint 1 1 $5,971.00 $5,971.00 $5,971.00 $5,971.00 $5,971.00 2026-05-27
27610 CPT Exploration, Drainage, Or Removal Of Foreign Body Of Ankle 1 1 $5,971.00 $5,971.00 $5,971.00 $5,971.00 $5,971.00 2026-05-27
G0289 HCPCS Hc Knee Arthroscopy Add-on 1 1 $5,938.00 $5,938.00 $5,938.00 $5,938.00 $5,938.00 2026-05-27
81407 CPT Mopath Procedure Level 8 Mayo 1 1 $5,766.00 $5,766.00 $5,766.00 $5,766.00 $5,766.00 2026-05-27
46250 CPT Hc Hemorrhoidectomy External 1 1 $5,730.00 $5,730.00 $5,730.00 $5,730.00 $5,730.00 2026-05-27
20680 CPT Hc Removal Deep Implant 1 1 $5,654.00 $5,654.00 $5,654.00 $5,654.00 $5,654.00 2026-05-27
21552 CPT Hc Exe Neck Les Sc=3 Cm 1 1 $5,599.00 $5,599.00 $5,599.00 $5,599.00 $5,599.00 2026-05-27
21108 CDM Leuprolide Acetate (4 Month) 30 Mg IM Kit 1 1 $5,391.00 $5,391.00 $5,391.00 $5,391.00 $5,391.00 2026-05-27
CP17679084990126479 CDM Leuprolide Acetate (4 Month) 30 Mg IM Kit 1 1 $5,391.00 $5,391.00 $5,391.00 $5,391.00 $5,391.00 2026-05-27
71552 CPT Chest Wo/w Dye 1 1 $5,217.00 $5,217.00 $5,217.00 $5,217.00 $5,217.00 2026-05-27
70549 CPT MRA-neck 1 1 $5,103.00 $5,103.00 $5,103.00 $5,103.00 $5,103.00 2026-05-27
74183 CPT MRI Abdomen 1 1 $5,080.00 $5,080.00 $5,080.00 $5,080.00 $5,080.00 2026-05-27
73220 CPT MRI-upper Extremity 1 1 $5,077.00 $5,077.00 $5,077.00 $5,077.00 $5,077.00 2026-05-27
72197 CPT MRI Pelvis 1 1 $5,077.00 $5,077.00 $5,077.00 $5,077.00 $5,077.00 2026-05-27
73720 CPT MRI Lower Extremity 1 1 $5,075.00 $5,075.00 $5,075.00 $5,075.00 $5,075.00 2026-05-27
70546 CPT Hc MRA Head W/wo Dye 1 1 $5,070.00 $5,070.00 $5,070.00 $5,070.00 $5,070.00 2026-05-27
70543 CPT MRI Eye/face/neck 1 1 $5,024.00 $5,024.00 $5,024.00 $5,024.00 $5,024.00 2026-05-27
70553 CPT MRI Scan 1 1 $5,010.00 $5,010.00 $5,010.00 $5,010.00 $5,010.00 2026-05-27
28045 CPT Hc Excis Foot Tumor,deep 1 1 $5,002.00 $5,002.00 $5,002.00 $5,002.00 $5,002.00 2026-05-27
72156 CPT MRI-c-spine 1 1 $4,938.00 $4,938.00 $4,938.00 $4,938.00 $4,938.00 2026-05-27
72158 CPT L-spine 1 1 $4,934.00 $4,934.00 $4,934.00 $4,934.00 $4,934.00 2026-05-27
3245223 CDM Or-implant-system-achilles-ar-8928bcj-cp 1 1 $4,905.00 $4,905.00 $4,905.00 $4,905.00 $4,905.00 2026-05-27
73223 CPT Upper Ext Joint W/wo Dye 1 1 $4,825.00 $4,825.00 $4,825.00 $4,825.00 $4,825.00 2026-05-27
73723 CPT Lower Ext Joint W/wo Dye 1 1 $4,814.00 $4,814.00 $4,814.00 $4,814.00 $4,814.00 2026-05-27
144183 CDM Pegfilgrastim-cbqv 6 Mg/0.6ml Sc Sosy 1 1 $4,715.00 $4,715.00 $4,715.00 $4,715.00 $4,715.00 2026-05-27
CP17679084990117303 CDM Pegfilgrastim-cbqv 6 Mg/0.6ml Sc Sosy 1 1 $4,715.00 $4,715.00 $4,715.00 $4,715.00 $4,715.00 2026-05-27
72157 CPT T-spine 1 1 $4,654.00 $4,654.00 $4,654.00 $4,654.00 $4,654.00 2026-05-27
49505 CPT Repair Of Groin Hernia Patient Age 5 Years Or Older 2 1 $4,590.00 $4,590.00 $1,677.00 $7,503.00 $4,590.00 2026-05-27
3240361 CDM Or-implant-system,bio-comp Ach-ar-8928 1 1 $4,492.00 $4,492.00 $4,492.00 $4,492.00 $4,492.00 2026-05-27
64708 CPT Hc Revise Arm/leg Nerve 1 1 $4,431.00 $4,431.00 $4,431.00 $4,431.00 $4,431.00 2026-05-27
64704 CPT Hc Revise Hand/foot Nerve 1 1 $4,431.00 $4,431.00 $4,431.00 $4,431.00 $4,431.00 2026-05-27
64721 CPT Hc Carpal Tunnel Medidan Nerve 1 1 $4,340.00 $4,340.00 $4,340.00 $4,340.00 $4,340.00 2026-05-27
64776 CPT Hc Remove Digit Nerve Lesion 1 1 $4,340.00 $4,340.00 $4,340.00 $4,340.00 $4,340.00 2026-05-27
29877 CPT Arthrs Knee Surg Debridement/shvg Artclr Crtlg 2 1 $4,113.00 $4,113.00 $1,989.00 $6,237.00 $4,113.00 2026-05-27
81249 CPT G6pd Full Gene Sequence/mayo 1 1 $4,089.00 $4,089.00 $4,089.00 $4,089.00 $4,089.00 2026-05-27
49592 CPT Hc Rpr Aa Hernia 1st < 3 Cm Ncrc8/strangulated 2 1 $4,081.50 $4,081.50 $691.00 $7,472.00 $4,081.50 2026-05-27
59409 CPT Hc Vaginal Delivery 2 1 $4,067.50 $4,067.50 $2,599.00 $5,536.00 $4,067.50 2026-05-27
CP17679084990106697 CDM Golimumab 50 Mg/0.5ml Sc Sosy 1 1 $4,004.00 $4,004.00 $4,004.00 $4,004.00 $4,004.00 2026-05-27
129311 CDM Golimumab 50 Mg/0.5ml Sc Sosy 1 1 $4,004.00 $4,004.00 $4,004.00 $4,004.00 $4,004.00 2026-05-27
13100 CPT Hc Repr Cmpl Wnd Trunk 1.1-2.5cm 1 1 $3,949.00 $3,949.00 $3,949.00 $3,949.00 $3,949.00 2026-05-27
12037 CPT Hc Layr Clos Wnd Trunk,arm,leg >30cm 1 1 $3,949.00 $3,949.00 $3,949.00 $3,949.00 $3,949.00 2026-05-27
19120 CPT Removal Of One Or More Breast Growth, Open Procedure 2 1 $3,918.50 $3,918.50 $1,327.00 $6,510.00 $3,918.50 2026-05-27
3249118 CDM Th Bunionettes-implant 1 1 $3,824.00 $3,824.00 $3,824.00 $3,824.00 $3,824.00 2026-05-27
43202 CPT Hc Esophagoscopy W/biopsy 1 1 $3,822.00 $3,822.00 $3,822.00 $3,822.00 $3,822.00 2026-05-27
28008 CPT Fasciotomy Foot&/toe 2 1 $3,814.00 $3,814.00 $1,391.00 $6,237.00 $3,814.00 2026-05-27
74178 CPT CT Abdomen/pelvis 1 1 $3,763.00 $3,763.00 $3,763.00 $3,763.00 $3,763.00 2026-05-27
51102 CPT Drain W/cath Insertion 1 1 $3,739.00 $3,739.00 $3,739.00 $3,739.00 $3,739.00 2026-05-27
28035 CPT Hc Decompression Of Tibia Nerve 1 1 $3,702.00 $3,702.00 $3,702.00 $3,702.00 $3,702.00 2026-05-27
28055 CPT Hc Neurectomy Foot 1 1 $3,701.00 $3,701.00 $3,701.00 $3,701.00 $3,701.00 2026-05-27
28104 CPT Exc/curtg Bone Cyst/b9 Tumortarsal/metatarsal 2 1 $3,690.50 $3,690.50 $1,144.00 $6,237.00 $3,690.50 2026-05-27
124319 CDM Immune Globulin (Human) 40 Gm/400ml IV Soln 1 1 $3,686.00 $3,686.00 $3,686.00 $3,686.00 $3,686.00 2026-05-27
CP17679084990095975 CDM Immune Globulin (Human) 40 Gm/400ml IV Soln 1 1 $3,686.00 $3,686.00 $3,686.00 $3,686.00 $3,686.00 2026-05-27
23655 CPT Hc Closed Rx Shldr Disloc,anesthesia 1 1 $3,679.00 $3,679.00 $3,679.00 $3,679.00 $3,679.00 2026-05-27
C1734 HCPCS Or-ib Kit,bc,w/cc Ft And Jumpstart 1 1 $3,676.00 $3,676.00 $3,676.00 $3,676.00 $3,676.00 2026-05-27
74182 CPT MRI Abdomen 1 1 $3,660.00 $3,660.00 $3,660.00 $3,660.00 $3,660.00 2026-05-27
95811 CPT Sleep Study 1 1 $3,654.00 $3,654.00 $3,654.00 $3,654.00 $3,654.00 2026-05-27
142372 CDM Rabies Immune Globulin 1500 Unit/5ml Inj Soln 1 1 $3,582.00 $3,582.00 $3,582.00 $3,582.00 $3,582.00 2026-05-27
CP17679084990106110 CDM Rabies Immune Globulin 1500 Unit/5ml Inj Soln 1 1 $3,582.00 $3,582.00 $3,582.00 $3,582.00 $3,582.00 2026-05-27
27842 CPT Hc Treat Ankle Dislocation 1 1 $3,581.00 $3,581.00 $3,581.00 $3,581.00 $3,581.00 2026-05-27
14040 CPT Hc Adj Tiss Xfer Head,fac,hand <10sqcm 1 1 $3,537.00 $3,537.00 $3,537.00 $3,537.00 $3,537.00 2026-05-27
14020 CPT Hc Adj Tiss Xfer Scalp,extrem <10sqcm 1 1 $3,537.00 $3,537.00 $3,537.00 $3,537.00 $3,537.00 2026-05-27
12047 CPT Hc Layr Clos Wnd Rest Body >30cm 1 1 $3,537.00 $3,537.00 $3,537.00 $3,537.00 $3,537.00 2026-05-27
70548 CPT Hc MRA Neck With Contrast 1 1 $3,516.00 $3,516.00 $3,516.00 $3,516.00 $3,516.00 2026-05-27
75635 CPT Hc CTA Abdominal Arteries 1 1 $3,491.00 $3,491.00 $3,491.00 $3,491.00 $3,491.00 2026-05-27
95810 CPT Sleep Study 1 1 $3,463.00 $3,463.00 $3,463.00 $3,463.00 $3,463.00 2026-05-27
71275 CPT CT-chest 1 1 $3,426.00 $3,426.00 $3,426.00 $3,426.00 $3,426.00 2026-05-27
27552 CPT Hc Treat Knee Dislocation 1 1 $3,408.00 $3,408.00 $3,408.00 $3,408.00 $3,408.00 2026-05-27
41899 CPT Hc Dental Surgery Procedure 1 1 $3,404.00 $3,404.00 $3,404.00 $3,404.00 $3,404.00 2026-05-27
32556 CPT Hc Insert Cath Pleura Without Image 1 1 $3,389.00 $3,389.00 $3,389.00 $3,389.00 $3,389.00 2026-05-27
73219 CPT Hc Upper Ext Wdye 1 1 $3,379.00 $3,379.00 $3,379.00 $3,379.00 $3,379.00 2026-05-27
70547 CPT MRA-neck 1 1 $3,321.00 $3,321.00 $3,321.00 $3,321.00 $3,321.00 2026-05-27
28090 CPT Hc Remove Foot Lesion,tendon,shealth,capsule 1 1 $3,311.00 $3,311.00 $3,311.00 $3,311.00 $3,311.00 2026-05-27
70544 CPT MRA-head 1 1 $3,307.00 $3,307.00 $3,307.00 $3,307.00 $3,307.00 2026-05-27
73725 CPT Hc MRA Lower Ext W/wo Dye 1 1 $3,284.00 $3,284.00 $3,284.00 $3,284.00 $3,284.00 2026-05-27
73225 CPT Hc MRA Upper Ext W/wo Dye 1 1 $3,280.00 $3,280.00 $3,280.00 $3,280.00 $3,280.00 2026-05-27
28043 CPT Hc Excis Foot Tumor,subcutaneous 1 1 $3,271.00 $3,271.00 $3,271.00 $3,271.00 $3,271.00 2026-05-27
70545 CPT Hc MRA Head With Contrast 1 1 $3,260.00 $3,260.00 $3,260.00 $3,260.00 $3,260.00 2026-05-27
72196 CPT MRI-pelvis 1 1 $3,233.00 $3,233.00 $3,233.00 $3,233.00 $3,233.00 2026-05-27
74174 CPT Hc CTA Abdomen/pelvis W/contrast 1 1 $3,231.00 $3,231.00 $3,231.00 $3,231.00 $3,231.00 2026-05-27
27043 CPT Excision Tumor Soft Tissue Pelvis&hip Subq 3cm/> 2 1 $3,220.00 $3,220.00 $1,438.00 $5,002.00 $3,220.00 2026-05-27
73719 CPT Hc Lower Ext With Contrast 1 1 $3,219.00 $3,219.00 $3,219.00 $3,219.00 $3,219.00 2026-05-27
70542 CPT MRI Orbit/face/neck 1 1 $3,196.00 $3,196.00 $3,196.00 $3,196.00 $3,196.00 2026-05-27
11446 CPT Exc B9 Lesion Mrgn Xcp Sk Tg F/e/e/n/l/m > 4.0cm 2 1 $3,161.50 $3,161.50 $1,037.00 $5,286.00 $3,161.50 2026-05-27
73722 CPT Lower Ext Joint With Contrast 1 1 $3,150.00 $3,150.00 $3,150.00 $3,150.00 $3,150.00 2026-05-27
73218 CPT Upper Ext Without Contrast 1 1 $3,146.00 $3,146.00 $3,146.00 $3,146.00 $3,146.00 2026-05-27
73222 CPT Upper Ext Joint With Contrast 1 1 $3,129.00 $3,129.00 $3,129.00 $3,129.00 $3,129.00 2026-05-27
28272 CPT Hc Capsulotomy Ip Jnt Sgl Ea Jnt 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
28234 CPT Hc Incision Of Foot Tendon 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
28232 CPT Hc Incision Flex Toe Tendon 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
28092 CPT Hc Remove Toe Lesions 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
28080 CPT Hc Remove Foot Lesion Sngl Ea 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
27752 CPT Hc Closed Rx Tibia Shaft Fx,manipulatn 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
26705 CPT Hc Closed Rx Mc-p Disloc,anesth 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
26160 CPT Hc Remove Tendon Sheath Lesion 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
25605 CPT Hc Closed Rx Dist Rad/ulna Fx,manipul 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
29848 CPT Hc Wrist Endoscopy/surgery 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
28435 CPT Hc Closed Rx Talus Fx,manipulatn 1 1 $3,122.00 $3,122.00 $3,122.00 $3,122.00 $3,122.00 2026-05-27
70552 CPT MRI-brain 1 1 $3,118.00 $3,118.00 $3,118.00 $3,118.00 $3,118.00 2026-05-27
72142 CPT MRI-c-spine 1 1 $3,112.00 $3,112.00 $3,112.00 $3,112.00 $3,112.00 2026-05-27
72149 CPT MRI-lumbar Spine 1 1 $3,111.00 $3,111.00 $3,111.00 $3,111.00 $3,111.00 2026-05-27
CP17679084990118863 CDM Pegfilgrastim-jmdb 6 Mg/0.6ml Sc Sosy 1 1 $3,100.00 $3,100.00 $3,100.00 $3,100.00 $3,100.00 2026-05-27
142968 CDM Pegfilgrastim-jmdb 6 Mg/0.6ml Sc Sosy 1 1 $3,100.00 $3,100.00 $3,100.00 $3,100.00 $3,100.00 2026-05-27
27502 CPT Hc Closed Rx Femur Shaft Fx+manip 1 1 $3,093.00 $3,093.00 $3,093.00 $3,093.00 $3,093.00 2026-05-27
26055 CPT Hc Incise Finger Tendon Sheath 1 1 $3,093.00 $3,093.00 $3,093.00 $3,093.00 $3,093.00 2026-05-27
11426 CPT Exc B9 Lesion Mrgn Xcp Sk Tg S/n/h/f/g > 4.0cm 2 1 $3,084.50 $3,084.50 $883.00 $5,286.00 $3,084.50 2026-05-27
71270 CPT CT Thorax 1 1 $3,046.00 $3,046.00 $3,046.00 $3,046.00 $3,046.00 2026-05-27
72130 CPT CT-thoracic Spine 1 1 $3,046.00 $3,046.00 $3,046.00 $3,046.00 $3,046.00 2026-05-27
72127 CPT CT-cervical Spine 1 1 $3,046.00 $3,046.00 $3,046.00 $3,046.00 $3,046.00 2026-05-27
72133 CPT Hc CT Spine Lumbar W/wo Dye 1 1 $3,046.00 $3,046.00 $3,046.00 $3,046.00 $3,046.00 2026-05-27
87633 CPT Resp Virus 12-25 Targets 1 1 $3,042.00 $3,042.00 $3,042.00 $3,042.00 $3,042.00 2026-05-27
40819 CPT Hc Excise Lip Or Cheek Fold 1 1 $3,019.00 $3,019.00 $3,019.00 $3,019.00 $3,019.00 2026-05-27
41115 CPT Hc Mouth Frenulectmy 1 1 $3,019.00 $3,019.00 $3,019.00 $3,019.00 $3,019.00 2026-05-27
2000000 CDM Hc ICU Room & Nursing 1 1 $3,007.00 $3,007.00 $3,007.00 $3,007.00 $3,007.00 2026-05-27
72195 CPT Pelvis 1 1 $3,004.00 $3,004.00 $3,004.00 $3,004.00 $3,004.00 2026-05-27
128883 CDM Dantrolene Sodium 250 Mg IV Susr 1 1 $2,984.00 $2,984.00 $2,984.00 $2,984.00 $2,984.00 2026-05-27
CP17679084990108396 CDM Dantrolene Sodium 250 Mg IV Susr 1 1 $2,984.00 $2,984.00 $2,984.00 $2,984.00 $2,984.00 2026-05-27
28264 CPT Hc Release Of Midfoot Joint 1 1 $2,974.00 $2,974.00 $2,974.00 $2,974.00 $2,974.00 2026-05-27
25248 CPT Hc Remove Forearm Foreign Body 1 1 $2,974.00 $2,974.00 $2,974.00 $2,974.00 $2,974.00 2026-05-27
25020 CPT Hc Decompress Of Forearm,1 Space 1 1 $2,974.00 $2,974.00 $2,974.00 $2,974.00 $2,974.00 2026-05-27
24605 CPT Hc Closed Rx Elbow Dislocatn,anesthesi 1 1 $2,974.00 $2,974.00 $2,974.00 $2,974.00 $2,974.00 2026-05-27
21931 CPT Hc Exc Back Lesion Sc=3cm 1 1 $2,973.00 $2,973.00 $2,973.00 $2,973.00 $2,973.00 2026-05-27
21555 CPT Exc Tumor Soft Tissue Neck/ant Thorax Subq <3cm 1 1 $2,969.00 $2,969.00 $2,969.00 $2,969.00 $2,969.00 2026-05-27
23071 CPT Hc Exc Shoulder Les Sc>3cm 1 1 $2,968.00 $2,968.00 $2,968.00 $2,968.00 $2,968.00 2026-05-27
0070U CPT Cyp2d6 Genotype Cascade, B/mayo 1 1 $2,962.00 $2,962.00 $2,962.00 $2,962.00 $2,962.00 2026-05-27
73718 CPT MRI Lower Extremity 1 1 $2,957.00 $2,957.00 $2,957.00 $2,957.00 $2,957.00 2026-05-27
145223 CDM Romosozumab-aqqg 105 Mg/1.17ml Sc Sosy 1 1 $2,955.00 $2,955.00 $2,955.00 $2,955.00 $2,955.00 2026-05-27
CP17679084990119458 CDM Romosozumab-aqqg 105 Mg/1.17ml Sc Sosy 1 1 $2,955.00 $2,955.00 $2,955.00 $2,955.00 $2,955.00 2026-05-27
27818 CPT Hc Closed Rx Trimalleolar Fx,manip 1 1 $2,941.00 $2,941.00 $2,941.00 $2,941.00 $2,941.00 2026-05-27
27605 CPT Tenotomy Prq Achilles Tendon Spx Local Anes 1 1 $2,937.00 $2,937.00 $2,937.00 $2,937.00 $2,937.00 2026-05-27
10180 CPT Hc Wound Drainage,cmplx 2 1 $2,927.00 $2,927.00 $568.00 $5,286.00 $2,927.00 2026-05-27
74170 CPT CT Abdomen 1 1 $2,922.00 $2,922.00 $2,922.00 $2,922.00 $2,922.00 2026-05-27
72194 CPT CT Pelvis 1 1 $2,922.00 $2,922.00 $2,922.00 $2,922.00 $2,922.00 2026-05-27
28230 CPT Hc Incision Flex Foot Tendon(s) 1 1 $2,914.00 $2,914.00 $2,914.00 $2,914.00 $2,914.00 2026-05-27
70540 CPT MRI-eye/face/neck 1 1 $2,907.00 $2,907.00 $2,907.00 $2,907.00 $2,907.00 2026-05-27
72147 CPT MRI-t-spine 1 1 $2,893.00 $2,893.00 $2,893.00 $2,893.00 $2,893.00 2026-05-27
27252 CPT Cltx Hip Dislocation Traumatic Req Anesthesia 1 1 $2,833.00 $2,833.00 $2,833.00 $2,833.00 $2,833.00 2026-05-27
C1776 HCPCS Or-implant System, Cpr Mini Scorpion Dx 1 1 $2,829.00 $2,829.00 $2,829.00 $2,829.00 $2,829.00 2026-05-27
73706 CPT Hc CTA Lower Extremity 1 1 $2,816.00 $2,816.00 $2,816.00 $2,816.00 $2,816.00 2026-05-27
3240709 CDM Or-implant:hammerlock 2 15x7mm/0-lg 1 1 $2,807.00 $2,807.00 $2,807.00 $2,807.00 $2,807.00 2026-05-27
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 1 1 $2,777.00 $2,777.00 $2,777.00 $2,777.00 $2,777.00 2026-05-27
70498 CPT Hc CTA Neck 1 1 $2,757.00 $2,757.00 $2,757.00 $2,757.00 $2,757.00 2026-05-27
74175 CPT Hc CTA Abdomen 1 1 $2,747.00 $2,747.00 $2,747.00 $2,747.00 $2,747.00 2026-05-27
72191 CPT Hc CTA Pelvis 1 1 $2,747.00 $2,747.00 $2,747.00 $2,747.00 $2,747.00 2026-05-27
73721 CPT MRI Scan Of Leg Joint 1 1 $2,699.00 $2,699.00 $2,699.00 $2,699.00 $2,699.00 2026-05-27
133125 CDM Darbepoetin Alfa 300 Mcg/0.6ml Inj Sosy 1 1 $2,695.00 $2,695.00 $2,695.00 $2,695.00 $2,695.00 2026-05-27
CP17679084990101651 CDM Darbepoetin Alfa 300 Mcg/0.6ml Inj Sosy 1 1 $2,695.00 $2,695.00 $2,695.00 $2,695.00 $2,695.00 2026-05-27
3010030 CDM Isolation Room 1 1 $2,685.00 $2,685.00 $2,685.00 $2,685.00 $2,685.00 2026-05-27
72146 CPT MRI-t-spine 1 1 $2,673.00 $2,673.00 $2,673.00 $2,673.00 $2,673.00 2026-05-27
72148 CPT MRI Scan Of Lower Spinal Canal 1 1 $2,673.00 $2,673.00 $2,673.00 $2,673.00 $2,673.00 2026-05-27
73221 CPT MRI-upper Extremity 1 1 $2,646.00 $2,646.00 $2,646.00 $2,646.00 $2,646.00 2026-05-27
3249147 CDM Th Knotless Fibertak Implant Kit 1 1 $2,625.00 $2,625.00 $2,625.00 $2,625.00 $2,625.00 2026-05-27
1210010 CDM Hc Room & Nursing W/telemetry 1 1 $2,594.00 $2,594.00 $2,594.00 $2,594.00 $2,594.00 2026-05-27
74181 CPT MRI-abdomen 1 1 $2,592.00 $2,592.00 $2,592.00 $2,592.00 $2,592.00 2026-05-27
73202 CPT CT Upper Extremity 1 1 $2,559.00 $2,559.00 $2,559.00 $2,559.00 $2,559.00 2026-05-27
73702 CPT CT Lower Extremity 1 1 $2,559.00 $2,559.00 $2,559.00 $2,559.00 $2,559.00 2026-05-27
72141 CPT MRI-c-spine 1 1 $2,514.00 $2,514.00 $2,514.00 $2,514.00 $2,514.00 2026-05-27
3249146 CDM Th Internal Brace Kit 1 1 $2,467.00 $2,467.00 $2,467.00 $2,467.00 $2,467.00 2026-05-27
70482 CPT CT-ear 1 1 $2,454.00 $2,454.00 $2,454.00 $2,454.00 $2,454.00 2026-05-27
70470 CPT CT-brain 1 1 $2,434.00 $2,434.00 $2,434.00 $2,434.00 $2,434.00 2026-05-27
70492 CPT CT-neck 1 1 $2,434.00 $2,434.00 $2,434.00 $2,434.00 $2,434.00 2026-05-27
71260 CPT CT-thorax 1 1 $2,434.00 $2,434.00 $2,434.00 $2,434.00 $2,434.00 2026-05-27
72126 CPT CT-cervical Spine 1 1 $2,434.00 $2,434.00 $2,434.00 $2,434.00 $2,434.00 2026-05-27
72129 CPT CT-thoracic Spine 1 1 $2,434.00 $2,434.00 $2,434.00 $2,434.00 $2,434.00 2026-05-27
72132 CPT CT-lumbar Spine 1 1 $2,434.00 $2,434.00 $2,434.00 $2,434.00 $2,434.00 2026-05-27
70488 CPT CT-facial Bones 1 1 $2,434.00 $2,434.00 $2,434.00 $2,434.00 $2,434.00 2026-05-27
70558 CPT MRI Brain With Contrast 1 1 $2,426.00 $2,426.00 $2,426.00 $2,426.00 $2,426.00 2026-05-27
27510 CPT Cltx Fem Fx Dstl End Medial/lat Condyle W/manj 2 1 $2,418.50 $2,418.50 $2,012.00 $2,825.00 $2,418.50 2026-05-27
45384 CPT Colonoscopy 1 1 $2,414.00 $2,414.00 $2,414.00 $2,414.00 $2,414.00 2026-05-27
45338 CPT Hc Sigmoidoscopy,tumor,polyp,oth Les W 1 1 $2,414.00 $2,414.00 $2,414.00 $2,414.00 $2,414.00 2026-05-27
137602 CDM Ustekinumab 130 Mg/26ml IV Soln 1 1 $2,375.00 $2,375.00 $2,375.00 $2,375.00 $2,375.00 2026-05-27
CP17679084990100604 CDM Ustekinumab 130 Mg/26ml IV Soln 1 1 $2,375.00 $2,375.00 $2,375.00 $2,375.00 $2,375.00 2026-05-27
1110000 CDM Room & Nursing 1 1 $2,364.00 $2,364.00 $2,364.00 $2,364.00 $2,364.00 2026-05-27
74160 CPT CT Abdomen 1 1 $2,360.00 $2,360.00 $2,360.00 $2,360.00 $2,360.00 2026-05-27
72193 CPT CT Scan Of Pelvis With Contrast 1 1 $2,360.00 $2,360.00 $2,360.00 $2,360.00 $2,360.00 2026-05-27
3240349 CDM Or-plate-curved(40-15013) 1 1 $2,324.00 $2,324.00 $2,324.00 $2,324.00 $2,324.00 2026-05-27
25565 CPT Closed Tx Radial&ulnar Shaft Fractures W/mnpj 2 1 $2,280.50 $2,280.50 $1,439.00 $3,122.00 $2,280.50 2026-05-27
27762 CPT Cltx Medial Malls Fx W/manj W/wo Skn/skel Tracj 2 1 $2,265.50 $2,265.50 $1,409.00 $3,122.00 $2,265.50 2026-05-27
70496 CPT Hc CTA Head 1 1 $2,246.00 $2,246.00 $2,246.00 $2,246.00 $2,246.00 2026-05-27
28730 CPT Hc Fusion Foot Bones,midtarsal,multi 1 1 $2,245.00 $2,245.00 $2,245.00 $2,245.00 $2,245.00 2026-05-27
70481 CPT CT Ear 1 1 $2,223.00 $2,223.00 $2,223.00 $2,223.00 $2,223.00 2026-05-27
81364 CPT Hbb Full Gene Sequence/mayo 1 1 $2,211.00 $2,211.00 $2,211.00 $2,211.00 $2,211.00 2026-05-27
25505 CPT Closed Tx Radial Shaft Fracture W/manipulation 2 1 $2,196.00 $2,196.00 $1,418.00 $2,974.00 $2,196.00 2026-05-27
128552 CDM Dalbavancin Hcl 500 Mg IV Solr 1 1 $2,144.00 $2,144.00 $2,144.00 $2,144.00 $2,144.00 2026-05-27
CP17679084990107104 CDM Dalbavancin Hcl 500 Mg IV Solr 1 1 $2,144.00 $2,144.00 $2,144.00 $2,144.00 $2,144.00 2026-05-27
3240250 CDM Or-plate-curved (40-15011) 1 1 $2,141.00 $2,141.00 $2,141.00 $2,141.00 $2,141.00 2026-05-27
81263 CPT Igh Somatic Hyper B-cl Lymp/mayo 1 1 $2,130.00 $2,130.00 $2,130.00 $2,130.00 $2,130.00 2026-05-27
26340 CPT Hc Manipulate Finger With Anesth 2 1 $2,098.50 $2,098.50 $1,075.00 $3,122.00 $2,098.50 2026-05-27
28737 CPT Hc Revision Of Foot Bones 1 1 $2,083.00 $2,083.00 $2,083.00 $2,083.00 $2,083.00 2026-05-27
81405 CPT Hematologic Neoplasms, Tp53/mayo 1 1 $2,053.00 $2,053.00 $2,053.00 $2,053.00 $2,053.00 2026-05-27
1210000 CDM Room & Nursing 1 1 $2,049.00 $2,049.00 $2,049.00 $2,049.00 $2,049.00 2026-05-27
27685 CPT Hc Revise Lower Leg Tendon 1 1 $2,044.00 $2,044.00 $2,044.00 $2,044.00 $2,044.00 2026-05-27
11606 CPT Excision Malignant Lesion Trunk/arm/leg > 4.0 Cm 2 1 $2,043.00 $2,043.00 $1,029.00 $3,057.00 $2,043.00 2026-05-27
74176 CPT CT Abdomen/pelvis 1 1 $2,039.00 $2,039.00 $2,039.00 $2,039.00 $2,039.00 2026-05-27
72128 CPT CT-thoracic Spine 1 1 $2,039.00 $2,039.00 $2,039.00 $2,039.00 $2,039.00 2026-05-27
73201 CPT CT Upper Extremity 1 1 $2,039.00 $2,039.00 $2,039.00 $2,039.00 $2,039.00 2026-05-27
73701 CPT CT Lower Extremity 1 1 $2,039.00 $2,039.00 $2,039.00 $2,039.00 $2,039.00 2026-05-27
72192 CPT CT Pelvis 1 1 $2,039.00 $2,039.00 $2,039.00 $2,039.00 $2,039.00 2026-05-27
72125 CPT CT-cervical Spine 1 1 $2,039.00 $2,039.00 $2,039.00 $2,039.00 $2,039.00 2026-05-27
72131 CPT CT-lumbar Spine 1 1 $2,039.00 $2,039.00 $2,039.00 $2,039.00 $2,039.00 2026-05-27
71250 CPT CT-thorax 1 1 $2,039.00 $2,039.00 $2,039.00 $2,039.00 $2,039.00 2026-05-27
95807 CPT Hc Sleep Study Attended 1 1 $2,014.00 $2,014.00 $2,014.00 $2,014.00 $2,014.00 2026-05-27
CP17679084990087233 CDM Immune Globulin (Human) 10 Gm/100ml Inj Soln 1 1 $1,981.00 $1,981.00 $1,981.00 $1,981.00 $1,981.00 2026-05-27
110039 CDM Immune Globulin (Human) 10 Gm/100ml Inj Soln 1 1 $1,981.00 $1,981.00 $1,981.00 $1,981.00 $1,981.00 2026-05-27
87902 CPT Genotype Dna,hep C/mayo 2 1 $1,969.00 $1,969.00 $1,879.00 $2,059.00 $1,969.00 2026-05-27
27690 CPT Hc Revise Lower Leg Tendon 1 1 $1,967.00 $1,967.00 $1,967.00 $1,967.00 $1,967.00 2026-05-27
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