|
4085130
|
CDM
|
Lanreotide 60 Mg/0.2 Ml Sol
|
6
|
5
|
$45,690.00
|
$41,121.00
|
$21,931.00
|
$43,406.00
|
$34,827.00
|
2025-11-12
|
|
4082770
|
CDM
|
Lanreotide 120 Mg/0.5 Ml Sol
|
6
|
5
|
$14,373.00
|
$12,936.00
|
$6,899.00
|
$13,654.00
|
$10,956.00
|
2025-11-12
|
|
4080066
|
CDM
|
Alteplase 100 Mg Pow
|
6
|
5
|
$13,231.00
|
$11,908.00
|
$6,351.00
|
$12,569.00
|
$10,085.50
|
2025-11-12
|
|
4084925
|
CDM
|
Vedolizumab 300 Mg Pow
|
6
|
5
|
$13,030.00
|
$11,727.00
|
$6,254.00
|
$12,379.00
|
$9,932.00
|
2025-11-12
|
|
4089062
|
CDM
|
Tenecteplase 50 Mg Pow
|
6
|
5
|
$12,476.00
|
$11,228.00
|
$5,988.00
|
$11,852.00
|
$9,510.00
|
2025-11-12
|
|
4082620
|
CDM
|
Lanreotide 90.
|
6
|
5
|
$12,192.00
|
$10,973.00
|
$5,852.00
|
$11,582.00
|
$9,293.50
|
2025-11-12
|
|
4084631
|
CDM
|
Romiplostim 500 Mcg Pow
|
6
|
5
|
$7,185.00
|
$6,467.00
|
$3,449.00
|
$6,826.00
|
$5,477.00
|
2025-11-12
|
|
4082120
|
CDM
|
Rituximab 500.
|
6
|
5
|
$7,076.00
|
$6,368.00
|
$3,396.00
|
$6,722.00
|
$5,393.50
|
2025-11-12
|
|
4085240
|
CDM
|
Alteplase 50 Mg Pow
|
6
|
5
|
$6,630.00
|
$5,967.00
|
$3,182.00
|
$6,299.00
|
$5,054.00
|
2025-11-12
|
|
4083190
|
CDM
|
Octreotide 20. Mg Powder-inj ER
|
6
|
5
|
$6,555.00
|
$5,900.00
|
$3,146.00
|
$6,227.00
|
$4,996.50
|
2025-11-12
|
|
4083678
|
CDM
|
Pegfilgrastim Apgf 6 Mg/0.6 Ml Sol
|
6
|
5
|
$5,918.00
|
$5,326.00
|
$2,841.00
|
$5,622.00
|
$4,511.00
|
2025-11-12
|
|
4080046
|
CDM
|
Darbepoetin Alfa 500.
|
6
|
5
|
$5,835.00
|
$5,252.00
|
$2,801.00
|
$5,543.00
|
$4,448.00
|
2025-11-12
|
|
4082517
|
CDM
|
Immune Globulin Intravenous And Subcutaneous 10% Sol
|
6
|
5
|
$5,830.00
|
$5,247.00
|
$2,798.00
|
$5,539.00
|
$4,443.50
|
2025-11-12
|
|
70549
|
CPT
|
MRA Neck With + Without Contrast
|
6
|
5
|
$5,739.00
|
$5,165.00
|
$2,755.00
|
$5,452.00
|
$4,374.50
|
2025-11-12
|
|
70546
|
CPT
|
MRA Brain/head With + Without Contrast
|
6
|
5
|
$5,430.00
|
$4,887.00
|
$2,606.00
|
$5,159.00
|
$4,139.00
|
2025-11-12
|
|
71552
|
CPT
|
MRI Chest With + Without Contrast
|
6
|
5
|
$5,249.00
|
$4,724.00
|
$2,520.00
|
$4,987.00
|
$4,001.00
|
2025-11-12
|
|
59409
|
CPT
|
59409-vaginal Delivery Only
|
8
|
5
|
$6,212.00
|
$5,591.00
|
$642.00
|
$5,901.00
|
$3,511.50
|
2025-11-12
|
|
73720
|
CPT
|
MRI Lower Extremity With + Without Cnt Left
|
6
|
5
|
$4,424.00
|
$3,982.00
|
$2,124.00
|
$4,203.00
|
$3,372.50
|
2025-11-12
|
|
73220
|
CPT
|
MRI Upper Extremity With + Without Cnt Left
|
12
|
5
|
$4,419.50
|
$3,978.00
|
$2,119.00
|
$4,203.00
|
$3,368.50
|
2025-11-12
|
|
74183
|
CPT
|
MRI Abdomen With + Without Contrast
|
6
|
5
|
$4,407.00
|
$3,966.00
|
$2,115.00
|
$4,187.00
|
$3,359.50
|
2025-11-12
|
|
72197
|
CPT
|
MRI Pelvis With + Without Contrast
|
6
|
5
|
$4,395.00
|
$3,956.00
|
$2,110.00
|
$4,175.00
|
$3,350.00
|
2025-11-12
|
|
71551
|
CPT
|
MRI Chest With Contrast
|
6
|
5
|
$4,205.00
|
$3,785.00
|
$2,018.00
|
$3,995.00
|
$3,205.00
|
2025-11-12
|
|
74182
|
CPT
|
MRI Abdomen With Contrast
|
6
|
5
|
$4,121.00
|
$3,709.00
|
$1,978.00
|
$3,915.00
|
$3,141.50
|
2025-11-12
|
|
4083530
|
CDM
|
Leuprolide 45 Mg/6 Months Pow
|
6
|
5
|
$4,095.00
|
$3,686.00
|
$1,966.00
|
$3,890.00
|
$3,121.50
|
2025-11-12
|
|
73223
|
CPT
|
MRI Elbow With + Without Contrast Left
|
6
|
5
|
$4,083.00
|
$3,675.00
|
$1,960.00
|
$3,879.00
|
$3,112.50
|
2025-11-12
|
|
73723
|
CPT
|
MRI Ankle With + Without Contrast Left
|
6
|
5
|
$4,080.00
|
$3,672.00
|
$1,958.00
|
$3,876.00
|
$3,110.00
|
2025-11-12
|
|
4084928
|
CDM
|
Aflibercept Ophthalmic 114.3 Mg/ml Sol
|
6
|
5
|
$3,968.00
|
$3,571.00
|
$1,905.00
|
$3,770.00
|
$3,024.50
|
2025-11-12
|
|
70543
|
CPT
|
MRI Face Neck Orbit With + Without Contrast
|
6
|
5
|
$3,968.00
|
$3,571.00
|
$1,905.00
|
$3,770.00
|
$3,024.50
|
2025-11-12
|
|
70548
|
CPT
|
MRA Neck With Contrast
|
6
|
5
|
$3,959.00
|
$3,563.00
|
$1,900.00
|
$3,761.00
|
$3,017.50
|
2025-11-12
|
|
71550
|
CPT
|
MRI Chest Without Contrast
|
6
|
5
|
$3,850.00
|
$3,465.00
|
$1,848.00
|
$3,658.00
|
$2,934.50
|
2025-11-12
|
|
12037
|
CPT
|
12037-scalp/trunk/extremity Greater Than 30.0 Cm
|
12
|
5
|
$3,824.00
|
$3,441.50
|
$286.00
|
$3,770.00
|
$2,898.50
|
2025-11-12
|
|
4083585
|
CDM
|
Romosozumab 105 Mg/1.17 Ml Sol
|
6
|
5
|
$3,786.00
|
$3,407.00
|
$1,817.00
|
$3,597.00
|
$2,886.00
|
2025-11-12
|
|
70547
|
CPT
|
MRA Neck Without Contrast
|
6
|
5
|
$3,743.00
|
$3,369.00
|
$1,797.00
|
$3,556.00
|
$2,853.00
|
2025-11-12
|
|
70544
|
CPT
|
MRA Brain/head Without Contrast
|
6
|
5
|
$3,723.00
|
$3,351.00
|
$1,787.00
|
$3,537.00
|
$2,838.00
|
2025-11-12
|
|
72196
|
CPT
|
MRI Pelvis With Contrast
|
6
|
5
|
$3,628.00
|
$3,265.00
|
$1,741.00
|
$3,447.00
|
$2,765.50
|
2025-11-12
|
|
73719
|
CPT
|
MRI Lower Extremity With Contrast Left
|
6
|
5
|
$3,628.00
|
$3,265.00
|
$1,741.00
|
$3,447.00
|
$2,765.50
|
2025-11-12
|
|
74174
|
CPT
|
CT Angio Abdomen And Pelvis
|
6
|
5
|
$3,626.00
|
$3,263.00
|
$1,740.00
|
$3,445.00
|
$2,764.00
|
2025-11-12
|
|
73219
|
CPT
|
MRI Upper Extremity With Contrast Left
|
6
|
5
|
$3,624.00
|
$3,262.00
|
$1,740.00
|
$3,443.00
|
$2,762.00
|
2025-11-12
|
|
4084630
|
CDM
|
Romiplostim 250 Mcg Pow
|
6
|
5
|
$3,607.00
|
$3,246.00
|
$1,731.00
|
$3,427.00
|
$2,749.50
|
2025-11-12
|
|
4080197
|
CDM
|
Darbepoetin Alfa 300.
|
6
|
5
|
$3,513.00
|
$3,162.00
|
$1,686.00
|
$3,337.00
|
$2,677.50
|
2025-11-12
|
|
70545
|
CPT
|
MRA Brain/head With Contrast
|
6
|
5
|
$3,508.00
|
$3,157.00
|
$1,684.00
|
$3,333.00
|
$2,674.00
|
2025-11-12
|
|
4083041
|
CDM
|
Faricimab Ophthalmic Svoa 6 Mg/0.05 Ml Sol
|
6
|
5
|
$3,464.00
|
$3,118.00
|
$1,663.00
|
$3,291.00
|
$2,640.50
|
2025-11-12
|
|
72195
|
CPT
|
MRI Pelvis Without Contrast
|
6
|
5
|
$3,385.00
|
$3,047.00
|
$1,625.00
|
$3,216.00
|
$2,580.00
|
2025-11-12
|
|
73722
|
CPT
|
MRI Knee With Contrast Left
|
6
|
5
|
$3,381.00
|
$3,043.00
|
$1,623.00
|
$3,212.00
|
$2,577.00
|
2025-11-12
|
|
73218
|
CPT
|
MRI Upper Extremity Without Contrast Left
|
6
|
5
|
$3,361.00
|
$3,025.00
|
$1,613.00
|
$3,193.00
|
$2,562.00
|
2025-11-12
|
|
73222
|
CPT
|
MRI Shoulder With Contrast Left
|
6
|
5
|
$3,353.00
|
$3,018.00
|
$1,609.00
|
$3,185.00
|
$2,556.00
|
2025-11-12
|
|
27752
|
CPT
|
27752-tibial Shaft With Manipulation
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
25565
|
CPT
|
25565-radial&ulnar Shaft With Manipulation
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
24505
|
CPT
|
24505-humeral Shaft With Manipulation
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
24655
|
CPT
|
24655radial Head/neck With Manipulation
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
23505
|
CPT
|
23505 Clavicle Fx With Manipulat
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
25505
|
CPT
|
25505-radial Shaft With Manipulation
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
27510
|
CPT
|
27510-femoral Distal With Manipulation
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
24675
|
CPT
|
24675-ulna Proximal End With Manipulation
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
23655
|
CPT
|
23655-shoulder With Anesthesia
|
6
|
5
|
$3,337.00
|
$3,003.00
|
$1,602.00
|
$3,170.00
|
$2,544.00
|
2025-11-12
|
|
73718
|
CPT
|
MRI Lower Extremity Without Contrast Left
|
6
|
5
|
$3,330.00
|
$2,997.00
|
$1,598.00
|
$3,164.00
|
$2,538.00
|
2025-11-12
|
|
70542
|
CPT
|
MRI Face Neck Orbit With Contrast
|
6
|
5
|
$3,310.00
|
$2,979.00
|
$1,589.00
|
$3,145.00
|
$2,523.00
|
2025-11-12
|
|
74178
|
CPT
|
CT Abdomen And Pelvis With + Without Contrast
|
6
|
5
|
$3,285.00
|
$2,957.00
|
$1,577.00
|
$3,121.00
|
$2,504.00
|
2025-11-12
|
|
21315
|
CPT
|
21315nasal Bone Fx Without Stabilization
|
6
|
5
|
$3,249.00
|
$2,924.00
|
$1,560.00
|
$3,087.00
|
$2,476.50
|
2025-11-12
|
|
81162
|
CPT
|
Brca1/brca2 Genes, Full Gene Analysis Mayo Trin
|
6
|
5
|
$3,225.00
|
$2,903.00
|
$1,548.00
|
$3,064.00
|
$2,458.50
|
2025-11-12
|
|
4084040
|
CDM
|
Pegfilgrastim Jmdb 6 Mg/0.6 Ml Sol
|
6
|
5
|
$3,161.00
|
$2,845.00
|
$1,517.00
|
$3,003.00
|
$2,409.50
|
2025-11-12
|
|
70540
|
CPT
|
MRI Face Neck Orbit Without Contrast
|
6
|
5
|
$3,015.00
|
$2,714.00
|
$1,447.00
|
$2,864.00
|
$2,298.00
|
2025-11-12
|
|
32556
|
CPT
|
32556drainage, Percutaneous Without Guidance
|
12
|
5
|
$3,125.50
|
$2,813.00
|
$105.00
|
$3,488.00
|
$2,287.50
|
2025-11-12
|
|
72157
|
CPT
|
MRI Spine Thoracic With + Without Contrast
|
6
|
5
|
$2,999.00
|
$2,699.00
|
$1,440.00
|
$2,849.00
|
$2,286.00
|
2025-11-12
|
|
72156
|
CPT
|
MRI Spine Cervical With + Without Contrast
|
6
|
5
|
$2,990.00
|
$2,691.00
|
$1,435.00
|
$2,841.00
|
$2,279.00
|
2025-11-12
|
|
72158
|
CPT
|
MRI Spine Lumbar With + Without Contrast
|
6
|
5
|
$2,979.00
|
$2,681.00
|
$1,430.00
|
$2,830.00
|
$2,271.00
|
2025-11-12
|
|
70553
|
CPT
|
MRI Scan
|
6
|
5
|
$2,968.00
|
$2,671.00
|
$1,425.00
|
$2,820.00
|
$2,262.50
|
2025-11-12
|
|
4080810
|
CDM
|
Ranibizumab Ophthalmic 10 Mg/ml Sol
|
6
|
5
|
$2,955.00
|
$2,660.00
|
$1,418.00
|
$2,807.00
|
$2,252.50
|
2025-11-12
|
|
4080206
|
CDM
|
Leuprolide 7.5 Mg/month Kit [Stan]
|
6
|
5
|
$2,950.00
|
$2,655.00
|
$1,416.00
|
$2,803.00
|
$2,248.50
|
2025-11-12
|
|
4081825
|
CDM
|
Immune Globulin Intravenous And Subcutaneous 10% Sol
|
6
|
5
|
$2,930.00
|
$2,637.00
|
$1,406.00
|
$2,784.00
|
$2,233.50
|
2025-11-12
|
|
74181
|
CPT
|
MRI Abdomen Without Contrast
|
6
|
5
|
$2,911.00
|
$2,620.00
|
$1,397.00
|
$2,765.00
|
$2,219.00
|
2025-11-12
|
|
74177
|
CPT
|
CT Scan Of Abdomen And Pelvis With Contrast
|
6
|
5
|
$2,907.00
|
$2,616.00
|
$1,395.00
|
$2,762.00
|
$2,216.00
|
2025-11-12
|
|
78227
|
CPT
|
Nm Hepatobiliary Imaging With Drug
|
6
|
5
|
$2,835.00
|
$2,552.00
|
$1,361.00
|
$2,693.00
|
$2,161.00
|
2025-11-12
|
|
4080840
|
CDM
|
Aflibercept Ophthalmic 2mg/0.05ml Sol
|
6
|
5
|
$2,805.00
|
$2,525.00
|
$1,346.00
|
$2,665.00
|
$2,138.50
|
2025-11-12
|
|
78452
|
CPT
|
Nm Myocardial Spect Rest And Stress
|
6
|
5
|
$2,757.00
|
$2,481.00
|
$1,323.00
|
$2,619.00
|
$2,101.50
|
2025-11-12
|
|
4080743
|
CDM
|
Fulvestrant 250.
|
6
|
5
|
$2,757.00
|
$2,481.00
|
$1,323.00
|
$2,619.00
|
$2,101.50
|
2025-11-12
|
|
4084995
|
CDM
|
Leuprolide 30 Mg/4 Months Pow
|
6
|
5
|
$2,740.00
|
$2,466.00
|
$1,315.00
|
$2,603.00
|
$2,088.50
|
2025-11-12
|
|
4080057
|
CDM
|
Denosumab 60 Mg/ml Sol
|
6
|
5
|
$2,709.00
|
$2,438.00
|
$1,300.00
|
$2,574.00
|
$2,065.00
|
2025-11-12
|
|
4085012
|
CDM
|
Dalbavancin 500 Mg Pow
|
6
|
5
|
$2,699.00
|
$2,429.00
|
$1,296.00
|
$2,564.00
|
$2,057.50
|
2025-11-12
|
|
72142
|
CPT
|
MRI Spine Cervical With Contrast
|
6
|
5
|
$2,665.00
|
$2,399.00
|
$1,279.00
|
$2,532.00
|
$2,031.50
|
2025-11-12
|
|
72147
|
CPT
|
MRI Spine Thoracic With Contrast
|
6
|
5
|
$2,644.00
|
$2,380.00
|
$1,269.00
|
$2,512.00
|
$2,015.50
|
2025-11-12
|
|
70482
|
CPT
|
CT Orbits Sella With + Without Contrast
|
6
|
5
|
$2,623.00
|
$2,361.00
|
$1,259.00
|
$2,492.00
|
$1,999.50
|
2025-11-12
|
|
72149
|
CPT
|
MRI Spine Lumbar With Contrast
|
6
|
5
|
$2,618.00
|
$2,356.00
|
$1,257.00
|
$2,487.00
|
$1,995.50
|
2025-11-12
|
|
70552
|
CPT
|
MRI Brain With Contrast
|
6
|
5
|
$2,601.00
|
$2,341.00
|
$1,248.00
|
$2,471.00
|
$1,982.50
|
2025-11-12
|
|
72194
|
CPT
|
CT Pelvis With + Without Contrast
|
6
|
5
|
$2,598.00
|
$2,338.00
|
$1,247.00
|
$2,468.00
|
$1,980.50
|
2025-11-12
|
|
45380
|
CPT
|
Biopsy Exam Of Large Bowel Using An Endoscope
|
6
|
5
|
$2,597.00
|
$2,337.00
|
$1,247.00
|
$2,467.00
|
$1,979.50
|
2025-11-12
|
|
45385
|
CPT
|
Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope
|
6
|
5
|
$2,597.00
|
$2,337.00
|
$1,247.00
|
$2,467.00
|
$1,979.50
|
2025-11-12
|
|
73202
|
CPT
|
CT Upper Extremity W/+without Contrast Left
|
6
|
5
|
$2,594.00
|
$2,335.00
|
$1,245.00
|
$2,464.00
|
$1,977.00
|
2025-11-12
|
|
74170
|
CPT
|
CT Abdomen With + Without Contrast
|
6
|
5
|
$2,589.00
|
$2,330.00
|
$1,243.00
|
$2,460.00
|
$1,973.50
|
2025-11-12
|
|
71275
|
CPT
|
CT Angio Chest
|
6
|
5
|
$2,553.00
|
$2,298.00
|
$1,225.00
|
$2,425.00
|
$1,946.00
|
2025-11-12
|
|
73702
|
CPT
|
CT Lower Extremity W/+without Contrast Bilat
|
6
|
5
|
$2,451.00
|
$2,206.00
|
$1,176.00
|
$2,328.00
|
$1,868.00
|
2025-11-12
|
|
27552
|
CPT
|
27552-closed Treatment Of Knee Dislocation; Requiring Anesthesia
|
8
|
5
|
$3,297.00
|
$2,967.00
|
$573.00
|
$3,132.00
|
$1,864.00
|
2025-11-12
|
|
12047
|
CPT
|
12047-neck/hand/feet/genital Greater Than 30.0 Cm
|
12
|
5
|
$2,942.00
|
$2,647.50
|
$320.00
|
$3,770.00
|
$1,862.50
|
2025-11-12
|
|
4085394
|
CDM
|
Denosumab Bbdz 60 Mg/ml Solution[stan]
|
6
|
5
|
$2,436.00
|
$2,192.00
|
$1,169.00
|
$2,314.00
|
$1,857.00
|
2025-11-12
|
|
70481
|
CPT
|
CT Orbits Sella With Contrast
|
6
|
5
|
$2,377.00
|
$2,139.00
|
$1,141.00
|
$2,258.00
|
$1,811.50
|
2025-11-12
|
|
3020040
|
CDM
|
Telemetry Chargeinpatient
|
6
|
5
|
$2,372.00
|
$2,135.00
|
$1,139.00
|
$2,253.00
|
$1,808.00
|
2025-11-12
|
|
4080343
|
CDM
|
Darbepoetin Alfa 200.
|
6
|
5
|
$2,352.00
|
$2,117.00
|
$1,129.00
|
$2,234.00
|
$1,793.00
|
2025-11-12
|
|
10180
|
CPT
|
10180-i&d Postop Wound Infection Complex
|
12
|
5
|
$3,277.50
|
$2,949.50
|
$166.00
|
$5,367.00
|
$1,786.50
|
2025-11-12
|
|
71270
|
CPT
|
CT Chest With + Without Contrast
|
6
|
5
|
$2,307.00
|
$2,076.00
|
$1,107.00
|
$2,192.00
|
$1,758.50
|
2025-11-12
|
|
70492
|
CPT
|
CT Neck Soft Tissue With + Without Contrast
|
6
|
5
|
$2,297.00
|
$2,067.00
|
$1,103.00
|
$2,182.00
|
$1,751.00
|
2025-11-12
|
|
72193
|
CPT
|
CT Scan Of Pelvis With Contrast
|
6
|
5
|
$2,293.00
|
$2,064.00
|
$1,101.00
|
$2,178.00
|
$1,748.00
|
2025-11-12
|
|
74160
|
CPT
|
CT Abdomen With Contrast
|
6
|
5
|
$2,285.00
|
$2,057.00
|
$1,097.00
|
$2,171.00
|
$1,741.50
|
2025-11-12
|
|
27825
|
CPT
|
27825-distal Tibia With Traction Or Manipulation
|
12
|
5
|
$2,590.00
|
$2,331.00
|
$452.00
|
$3,132.00
|
$1,670.50
|
2025-11-12
|
|
25605
|
CPT
|
25605 Cltx Dstl Rdl Fx/epiphysl Sep W/manj When Perf Techfee
|
12
|
5
|
$2,586.50
|
$2,327.50
|
$522.00
|
$3,132.00
|
$1,664.00
|
2025-11-12
|
|
3020020
|
CDM
|
Room/bed: Acute
|
6
|
5
|
$2,158.00
|
$1,942.00
|
$1,036.00
|
$2,050.00
|
$1,645.00
|
2025-11-12
|
|
59414
|
CPT
|
59414delivery Of Placenta
|
12
|
5
|
$3,263.50
|
$2,937.50
|
$72.00
|
$5,901.00
|
$1,640.50
|
2025-11-12
|
|
78803
|
CPT
|
Nm Bone Spect
|
6
|
5
|
$2,125.00
|
$1,913.00
|
$1,020.00
|
$2,019.00
|
$1,619.50
|
2025-11-12
|
|
78315
|
CPT
|
Nm Bone Three Phase Study
|
6
|
5
|
$2,076.00
|
$1,868.00
|
$996.00
|
$1,972.00
|
$1,582.00
|
2025-11-12
|
|
4084932
|
CDM
|
Ranibizumab Ophthalmic Eqrn 10 Mg/ml Sol
|
6
|
5
|
$2,070.00
|
$1,863.00
|
$994.00
|
$1,967.00
|
$1,578.00
|
2025-11-12
|
|
27762
|
CPT
|
27762-medial Malleolus With Manipulation
|
12
|
5
|
$2,476.50
|
$2,228.50
|
$467.00
|
$3,132.00
|
$1,578.00
|
2025-11-12
|
|
27810
|
CPT
|
27810-bimalleolar Ankle With Manipulation
|
12
|
5
|
$2,484.50
|
$2,236.00
|
$441.00
|
$3,170.00
|
$1,576.00
|
2025-11-12
|
|
78226
|
CPT
|
Nm Hepatobiliary Imaging
|
6
|
5
|
$2,064.00
|
$1,858.00
|
$991.00
|
$1,961.00
|
$1,573.50
|
2025-11-12
|
|
43239
|
CPT
|
Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope
|
6
|
5
|
$2,028.00
|
$1,825.00
|
$973.00
|
$1,927.00
|
$1,545.50
|
2025-11-12
|
|
43235
|
CPT
|
Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope
|
6
|
5
|
$2,028.00
|
$1,825.00
|
$973.00
|
$1,927.00
|
$1,545.50
|
2025-11-12
|
|
45378
|
CPT
|
Diagnostic Exam Of Large Bowel Using An Endoscope
|
6
|
5
|
$1,988.00
|
$1,789.00
|
$954.00
|
$1,889.00
|
$1,515.50
|
2025-11-12
|
|
73201
|
CPT
|
CT Upper Extremity With Contrast Left
|
6
|
5
|
$1,968.00
|
$1,771.00
|
$945.00
|
$1,870.00
|
$1,500.00
|
2025-11-12
|
|
4081666
|
CDM
|
Ferric Carboxymaltose
|
6
|
5
|
$1,954.00
|
$1,759.00
|
$938.00
|
$1,856.00
|
$1,489.50
|
2025-11-12
|
|
4080635
|
CDM
|
Omalizumab
|
6
|
5
|
$1,953.00
|
$1,758.00
|
$937.00
|
$1,855.00
|
$1,488.50
|
2025-11-12
|
|
70480
|
CPT
|
CT Orbits Sella Without Contrast
|
6
|
5
|
$1,941.00
|
$1,747.00
|
$932.00
|
$1,844.00
|
$1,479.50
|
2025-11-12
|
|
99291
|
CPT
|
99291critical Care, 30-74
|
8
|
5
|
$2,613.00
|
$2,352.00
|
$190.00
|
$2,482.00
|
$1,477.00
|
2025-11-12
|
|
73701
|
CPT
|
CT Lower Extremity With Contrast Bilat
|
6
|
5
|
$1,930.00
|
$1,737.00
|
$926.00
|
$1,834.00
|
$1,471.00
|
2025-11-12
|
|
78451
|
CPT
|
Nm Myocardial Spect Single Study
|
6
|
5
|
$1,920.00
|
$1,728.00
|
$922.00
|
$1,824.00
|
$1,463.50
|
2025-11-12
|
|
72132
|
CPT
|
CT Spine Lumbar With Contrast
|
6
|
5
|
$1,917.00
|
$1,725.00
|
$920.00
|
$1,821.00
|
$1,461.00
|
2025-11-12
|
|
72126
|
CPT
|
CT Spine Cervical With Contrast
|
6
|
5
|
$1,913.00
|
$1,722.00
|
$918.00
|
$1,817.00
|
$1,458.00
|
2025-11-12
|
|
73721
|
CPT
|
MRI Scan Of Leg Joint
|
6
|
5
|
$1,905.00
|
$1,715.00
|
$914.00
|
$1,810.00
|
$1,452.00
|
2025-11-12
|
|
73221
|
CPT
|
MRI Elbow Without Contrast Left
|
6
|
5
|
$1,905.00
|
$1,715.00
|
$914.00
|
$1,810.00
|
$1,452.00
|
2025-11-12
|
|
78582
|
CPT
|
Nm Lung Vent/perf Imaging
|
6
|
5
|
$1,886.00
|
$1,697.00
|
$905.00
|
$1,792.00
|
$1,437.50
|
2025-11-12
|
|
P9034
|
HCPCS
|
E3087 Aph Plt Acda Lr 1
|
6
|
5
|
$1,874.00
|
$1,687.00
|
$900.00
|
$1,780.00
|
$1,428.50
|
2025-11-12
|
|
71260
|
CPT
|
CT Chest With Contrast
|
6
|
5
|
$1,872.00
|
$1,685.00
|
$899.00
|
$1,778.00
|
$1,427.00
|
2025-11-12
|
|
70491
|
CPT
|
CT Neck Soft Tissue With Contrast
|
6
|
5
|
$1,860.00
|
$1,674.00
|
$893.00
|
$1,767.00
|
$1,418.00
|
2025-11-12
|
|
4084220
|
CDM
|
Romiplostim 125 Mcg Pow[stan]
|
6
|
5
|
$1,819.00
|
$1,637.00
|
$873.00
|
$1,728.00
|
$1,386.50
|
2025-11-12
|
|
4081762
|
CDM
|
Ranibizumab Ophthalmic 6 Mg/ml Sol
|
6
|
5
|
$1,785.00
|
$1,607.00
|
$857.00
|
$1,696.00
|
$1,360.50
|
2025-11-12
|
|
70551
|
CPT
|
MRI Brain Without Contrast
|
6
|
5
|
$1,762.00
|
$1,586.00
|
$846.00
|
$1,674.00
|
$1,343.00
|
2025-11-12
|
|
72146
|
CPT
|
MRI Spine Thoracic Without Contrast
|
6
|
5
|
$1,695.00
|
$1,526.00
|
$814.00
|
$1,610.00
|
$1,292.00
|
2025-11-12
|
|
72148
|
CPT
|
MRI Scan Of Lower Spinal Canal
|
6
|
5
|
$1,692.00
|
$1,523.00
|
$812.00
|
$1,607.00
|
$1,290.00
|
2025-11-12
|
|
72141
|
CPT
|
MRI Spine Cervical Without Contrast
|
6
|
5
|
$1,692.00
|
$1,523.00
|
$812.00
|
$1,607.00
|
$1,290.00
|
2025-11-12
|
|
70488
|
CPT
|
CT Maxillofacial With + Without Contrast
|
6
|
5
|
$1,671.00
|
$1,504.00
|
$802.00
|
$1,587.00
|
$1,273.50
|
2025-11-12
|
|
78306
|
CPT
|
Nm Bone Imaging Whole Body
|
6
|
5
|
$1,661.00
|
$1,495.00
|
$797.00
|
$1,578.00
|
$1,266.00
|
2025-11-12
|
|
31603
|
CPT
|
31603-tracheostomy Transtracheal
|
12
|
5
|
$2,082.00
|
$1,873.50
|
$257.00
|
$2,904.00
|
$1,259.50
|
2025-11-12
|
|
81208
|
CPT
|
Stan Bcr/abl1 Other Bp
|
6
|
5
|
$1,640.00
|
$1,476.00
|
$787.00
|
$1,558.00
|
$1,250.00
|
2025-11-12
|
|
4080191
|
CDM
|
Epoetin Alfa
|
6
|
5
|
$1,634.00
|
$1,471.00
|
$784.00
|
$1,552.00
|
$1,245.50
|
2025-11-12
|
|
73200
|
CPT
|
CT Upper Extremity Without Contrast Left
|
6
|
5
|
$1,541.00
|
$1,387.00
|
$740.00
|
$1,464.00
|
$1,174.50
|
2025-11-12
|
|
78305
|
CPT
|
Nm Bone Imaging Multiple Areas
|
6
|
5
|
$1,528.00
|
$1,375.00
|
$733.00
|
$1,452.00
|
$1,164.50
|
2025-11-12
|
|
70470
|
CPT
|
CT Head With + Without Contrast
|
6
|
5
|
$1,512.00
|
$1,361.00
|
$726.00
|
$1,436.00
|
$1,152.50
|
2025-11-12
|
|
20606
|
CPT
|
20606arthrocentesis Aspiration/inj W/us
|
6
|
5
|
$1,503.00
|
$1,353.00
|
$721.00
|
$1,428.00
|
$1,146.00
|
2025-11-12
|
|
72125
|
CPT
|
CT Spine Cervical Without Contrast
|
6
|
5
|
$1,503.00
|
$1,353.00
|
$721.00
|
$1,428.00
|
$1,146.00
|
2025-11-12
|
|
72128
|
CPT
|
CT Spine Thoracic Without Contrast
|
6
|
5
|
$1,499.00
|
$1,349.00
|
$720.00
|
$1,424.00
|
$1,142.50
|
2025-11-12
|
|
72131
|
CPT
|
CT Spine Lumbar Without Contrast
|
6
|
5
|
$1,491.00
|
$1,342.00
|
$716.00
|
$1,416.00
|
$1,136.50
|
2025-11-12
|
|
73700
|
CPT
|
CT Lower Extremity Without Contrast Bilat
|
6
|
5
|
$1,491.00
|
$1,342.00
|
$716.00
|
$1,416.00
|
$1,136.50
|
2025-11-12
|
|
4085330
|
CDM
|
Immune Globulin Intravenous And Subcutaneous 10% Solution[stan](nf)
|
6
|
5
|
$1,480.00
|
$1,332.00
|
$710.00
|
$1,406.00
|
$1,128.50
|
2025-11-12
|
|
4085374
|
CDM
|
Semaglutide 8 Mg/3 Ml (2 Mg Dose) Sol
|
6
|
5
|
$1,453.00
|
$1,308.00
|
$697.00
|
$1,380.00
|
$1,107.50
|
2025-11-12
|
|
71250
|
CPT
|
CT Chest Without Contrast
|
6
|
5
|
$1,450.00
|
$1,305.00
|
$696.00
|
$1,378.00
|
$1,105.00
|
2025-11-12
|
|
4083590
|
CDM
|
Infliximab Dyyb 100 Mg Pow[stan]
|
6
|
5
|
$1,449.00
|
$1,304.00
|
$696.00
|
$1,377.00
|
$1,104.50
|
2025-11-12
|
|
70490
|
CPT
|
CT Neck Soft Tissue Without Contrast
|
6
|
5
|
$1,441.00
|
$1,297.00
|
$692.00
|
$1,369.00
|
$1,098.00
|
2025-11-12
|
|
12046
|
CPT
|
12046-neck/hand/feet/genital 20.1-30.0 Cm
|
12
|
5
|
$1,482.00
|
$1,334.00
|
$291.00
|
$1,663.00
|
$1,076.00
|
2025-11-12
|
|
13152
|
CPT
|
13152-eye/ear/nose/lip 2.6-7.5 Cm
|
12
|
5
|
$1,475.00
|
$1,327.50
|
$266.00
|
$1,650.00
|
$1,076.00
|
2025-11-12
|
|
13132
|
CPT
|
13132-face/neck/hand/feet/genital 2.6-7.5 Cm
|
12
|
5
|
$1,428.00
|
$1,285.50
|
$241.00
|
$1,561.00
|
$1,064.50
|
2025-11-12
|
|
4085135
|
CDM
|
Ferumoxytol 30 Mg/ml Solution
|
6
|
5
|
$1,388.00
|
$1,249.00
|
$666.00
|
$1,319.00
|
$1,058.00
|
2025-11-12
|
|
78580
|
CPT
|
Nm Lung Perfusion Imaging
|
6
|
5
|
$1,352.00
|
$1,217.00
|
$649.00
|
$1,284.00
|
$1,030.50
|
2025-11-12
|
|
74176
|
CPT
|
CT Abdomen And Pelvis Without Contrast
|
6
|
5
|
$1,339.00
|
$1,205.00
|
$643.00
|
$1,272.00
|
$1,020.50
|
2025-11-12
|
|
12036
|
CPT
|
12036-scalp/trunk/extremity 20.1-30.0 Cm
|
12
|
5
|
$1,360.50
|
$1,224.50
|
$252.00
|
$1,433.00
|
$1,020.50
|
2025-11-12
|
|
32551
|
CPT
|
32551-insertion Chest Tube
|
12
|
5
|
$1,858.50
|
$1,672.50
|
$132.00
|
$3,017.00
|
$1,019.00
|
2025-11-12
|
|
13121
|
CPT
|
13121-scalp/arms/legs 2.6-7.5 Cm
|
12
|
5
|
$1,352.00
|
$1,217.00
|
$207.00
|
$1,416.00
|
$1,015.00
|
2025-11-12
|
|
13151
|
CPT
|
13151-eyes/ears/nose/lip 1.1-2.5 Cm
|
12
|
5
|
$1,344.00
|
$1,210.00
|
$223.00
|
$1,401.00
|
$1,009.50
|
2025-11-12
|
|
92950
|
CPT
|
92950-cardiopulmonary Resuscitation
|
12
|
5
|
$1,408.50
|
$1,268.00
|
$162.00
|
$1,599.00
|
$1,006.00
|
2025-11-12
|
|
70487
|
CPT
|
CT Maxillofacial With Contrast
|
6
|
5
|
$1,314.00
|
$1,183.00
|
$631.00
|
$1,248.00
|
$1,001.50
|
2025-11-12
|
|
12045
|
CPT
|
12045-neck/hand/feet/genital 12.6-20.0 Cm
|
12
|
5
|
$1,311.00
|
$1,180.00
|
$255.00
|
$1,339.00
|
$988.50
|
2025-11-12
|
|
13101
|
CPT
|
13101-trunk 2.6-7.5 Cm
|
12
|
5
|
$1,302.50
|
$1,172.50
|
$202.00
|
$1,322.00
|
$982.50
|
2025-11-12
|
|
24670
|
CPT
|
24670ulnar Proximal End Without Manipulation
|
6
|
5
|
$1,279.00
|
$1,151.00
|
$614.00
|
$1,215.00
|
$975.00
|
2025-11-12
|
|
81206
|
CPT
|
Bcr/abl1-mayo
|
6
|
5
|
$1,278.00
|
$1,150.00
|
$613.00
|
$1,214.00
|
$974.00
|
2025-11-12
|
|
49083
|
CPT
|
Charge: Paracentesis With Imaging Guidance
|
12
|
5
|
$1,542.50
|
$1,388.00
|
$89.00
|
$1,926.00
|
$973.00
|
2025-11-12
|
|
49082
|
CPT
|
Charge: Paracentesis Without Imaging Guidance
|
14
|
5
|
$2,027.00
|
$1,824.00
|
$67.00
|
$1,927.00
|
$973.00
|
2025-11-12
|
|
78300
|
CPT
|
Nm Bone Imaging Limited
|
6
|
5
|
$1,273.00
|
$1,146.00
|
$611.00
|
$1,209.00
|
$970.50
|
2025-11-12
|
|
12044
|
CPT
|
12044-neck/hand/feet/genital 7.6-12.5 Cm
|
12
|
5
|
$1,267.00
|
$1,140.50
|
$182.00
|
$1,255.00
|
$959.50
|
2025-11-12
|
|
70460
|
CPT
|
CT Head With Contrast
|
6
|
5
|
$1,256.00
|
$1,130.00
|
$603.00
|
$1,193.00
|
$957.50
|
2025-11-12
|
|
78707
|
CPT
|
Nm Kidney Morphology With Vascular Flow
|
6
|
5
|
$1,239.00
|
$1,115.00
|
$595.00
|
$1,177.00
|
$944.50
|
2025-11-12
|
|
4084670
|
CDM
|
Bevacizumab 2.75 Mg Injection
|
6
|
5
|
$1,225.00
|
$1,103.00
|
$588.00
|
$1,164.00
|
$934.00
|
2025-11-12
|
|
13120
|
CPT
|
13120-scalp/arms/legs 1.1-2.5 Cm
|
12
|
5
|
$1,227.00
|
$1,104.50
|
$191.00
|
$1,179.00
|
$933.50
|
2025-11-12
|
|
13100
|
CPT
|
13100-trunk 1.1-2.5 Cm
|
12
|
5
|
$1,204.00
|
$1,084.00
|
$164.00
|
$1,152.00
|
$916.50
|
2025-11-12
|
|
78483
|
CPT
|
Nm Cardiac Muga
|
6
|
5
|
$1,196.00
|
$1,076.00
|
$574.00
|
$1,136.00
|
$911.50
|
2025-11-12
|
|
92523
|
CPT
|
Slp Eval Lang Comprehension,express Unit
|
6
|
5
|
$1,168.00
|
$1,051.00
|
$561.00
|
$1,110.00
|
$890.50
|
2025-11-12
|
|
25600
|
CPT
|
25600 Closed Treatment Of Distal Radial Fracture; Without Manipulation
|
6
|
5
|
$1,167.00
|
$1,050.00
|
$560.00
|
$1,109.00
|
$889.50
|
2025-11-12
|
|
32555
|
CPT
|
Charge:thoracentesis With Imaging Guidance
|
12
|
5
|
$1,172.00
|
$1,055.00
|
$89.00
|
$1,162.00
|
$888.00
|
2025-11-12
|
|
76380
|
CPT
|
CT Limited Or Localized F/u Study
|
6
|
5
|
$1,151.00
|
$1,036.00
|
$552.00
|
$1,093.00
|
$877.50
|
2025-11-12
|
|
70486
|
CPT
|
CT Maxillofacial Without Contrast
|
6
|
5
|
$1,151.00
|
$1,036.00
|
$552.00
|
$1,093.00
|
$877.50
|
2025-11-12
|
|
71271
|
CPT
|
CT Lung Cancer Screening
|
6
|
5
|
$1,139.00
|
$1,025.00
|
$547.00
|
$1,082.00
|
$868.00
|
2025-11-12
|
|
78215
|
CPT
|
Nm Liver/spleen Imaging
|
6
|
5
|
$1,136.00
|
$1,022.00
|
$545.00
|
$1,079.00
|
$866.00
|
2025-11-12
|
|
81207
|
CPT
|
Stan Bcr/abl1 Minor Bp
|
6
|
5
|
$1,130.00
|
$1,017.00
|
$542.00
|
$1,074.00
|
$861.50
|
2025-11-12
|
|
12020
|
CPT
|
12020-treatment Superficial Wound Dehiscence
|
12
|
5
|
$1,127.00
|
$1,014.50
|
$170.00
|
$1,152.00
|
$849.50
|
2025-11-12
|
|
4080389
|
CDM
|
Rabies Immune Globulin, Human
|
6
|
5
|
$1,095.00
|
$986.00
|
$526.00
|
$1,040.00
|
$834.50
|
2025-11-12
|
|
27786
|
CPT
|
27786-distal Fibular Without Manipulation
|
6
|
5
|
$1,090.00
|
$981.00
|
$523.00
|
$1,036.00
|
$831.00
|
2025-11-12
|
|
78579
|
CPT
|
Nm Lung Ventilation Imaging
|
6
|
5
|
$1,087.00
|
$978.00
|
$522.00
|
$1,033.00
|
$828.50
|
2025-11-12
|
|
72192
|
CPT
|
CT Pelvis Without Contrast
|
6
|
5
|
$1,082.00
|
$974.00
|
$519.00
|
$1,028.00
|
$825.00
|
2025-11-12
|
|
93975
|
CPT
|
US Renal Artery Duplex Bilateral
|
6
|
5
|
$1,074.00
|
$967.00
|
$516.00
|
$1,020.00
|
$819.00
|
2025-11-12
|
|
27780
|
CPT
|
27780-proximal Fibula/shaft
|
6
|
5
|
$1,071.00
|
$964.00
|
$514.00
|
$1,017.00
|
$816.50
|
2025-11-12
|
|
74150
|
CPT
|
CT Abdomen Without Contrast
|
6
|
5
|
$1,070.00
|
$963.00
|
$514.00
|
$1,017.00
|
$815.50
|
2025-11-12
|
|
36430
|
CPT
|
1-4 Hoursblood Administration Charges
|
18
|
5
|
$1,049.00
|
$944.00
|
$497.00
|
$1,033.00
|
$806.00
|
2025-11-12
|
|
31605
|
CPT
|
31605-tracheostomy,emergency Procedure
|
12
|
5
|
$1,060.50
|
$954.50
|
$275.00
|
$1,085.00
|
$799.50
|
2025-11-12
|
|
26600
|
CPT
|
26600clsd Tx Metacarpal Fracture Without Manip
|
6
|
5
|
$1,040.00
|
$936.00
|
$499.00
|
$988.00
|
$793.00
|
2025-11-12
|
|
4083963
|
CDM
|
Filgrastim 300 Mcg/0.5 Ml Sol
|
6
|
5
|
$1,031.00
|
$928.00
|
$495.00
|
$979.00
|
$786.00
|
2025-11-12
|
|
4081568
|
CDM
|
Filgrastim 480 Mcg/0.8 Ml Sol[stan]
|
6
|
5
|
$1,026.00
|
$923.00
|
$492.00
|
$975.00
|
$782.00
|
2025-11-12
|
|
4083025
|
CDM
|
Fluticasone/umeclidinium/vilanterol 100 Mcg-62.5 Mcg-25 Mcg/inh Pow
|
6
|
5
|
$1,016.00
|
$914.00
|
$488.00
|
$965.00
|
$774.50
|
2025-11-12
|
|
78700
|
CPT
|
Nm Kidney Imaging
|
6
|
5
|
$996.00
|
$896.00
|
$478.00
|
$946.00
|
$759.50
|
2025-11-12
|
|
4080610
|
CDM
|
Omalizumab
|
6
|
5
|
$992.00
|
$893.00
|
$476.00
|
$942.00
|
$756.00
|
2025-11-12
|
|
10080
|
CPT
|
10080 Ed Pf/tech Incision And Drainage Pilonidal Cyst Simpl
|
12
|
5
|
$1,142.00
|
$1,028.00
|
$101.00
|
$1,368.00
|
$749.00
|
2025-11-12
|
|
81219
|
CPT
|
Calreticulin-mayo Trin
|
6
|
5
|
$973.00
|
$876.00
|
$467.00
|
$924.00
|
$741.50
|
2025-11-12
|
|
81339
|
CPT
|
Mpl Exon 10 Mutation Detection, R Trin
|
6
|
5
|
$973.00
|
$876.00
|
$467.00
|
$924.00
|
$741.50
|
2025-11-12
|
|
11603
|
CPT
|
11603 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; 2.1-3.…
|
6
|
5
|
$964.00
|
$868.00
|
$463.00
|
$916.00
|
$735.00
|
2025-11-12
|
|
32554
|
CPT
|
Charge: Thoracentesis Without Imaging Guidance
|
12
|
5
|
$1,014.00
|
$913.00
|
$75.00
|
$1,162.00
|
$714.50
|
2025-11-12
|
|
76872
|
CPT
|
US Prostate Transrectal
|
6
|
5
|
$931.00
|
$838.00
|
$447.00
|
$884.00
|
$710.00
|
2025-11-12
|
|
12035
|
CPT
|
12035-scalp/trunk/extremity 12.6-20.0 Cm
|
12
|
5
|
$1,083.50
|
$975.00
|
$212.00
|
$1,299.00
|
$709.50
|
2025-11-12
|
|
12034
|
CPT
|
12034-scalp/trunk/extremity 7.6-12.5 Cm
|
12
|
5
|
$978.00
|
$880.00
|
$172.00
|
$1,098.00
|
$709.50
|
2025-11-12
|
|
13131
|
CPT
|
13131-face/neck/hand/feet/genital 1.1-2.5 Cm
|
12
|
5
|
$1,078.50
|
$970.50
|
$196.00
|
$1,289.00
|
$709.50
|
2025-11-12
|
|
12057
|
CPT
|
12057-face/ear/eye/nose/lip Greater Than 30.0 Cm
|
12
|
5
|
$1,469.00
|
$1,322.00
|
$361.00
|
$2,031.00
|
$709.50
|
2025-11-12
|
|
12056
|
CPT
|
12056-face/ear/eye/nose/lip 20.1-30.0 Cm
|
12
|
5
|
$1,409.00
|
$1,268.00
|
$330.00
|
$1,917.00
|
$709.50
|
2025-11-12
|
|
12055
|
CPT
|
12055-face/ear/eye/nose/lip 12.6-20.0 Cm
|
12
|
5
|
$1,275.50
|
$1,148.00
|
$277.00
|
$1,663.00
|
$709.50
|
2025-11-12
|
|
12054
|
CPT
|
12054-face/ear/eye/nose/lip 7.6-12.5 Cm
|
12
|
5
|
$1,070.50
|
$963.50
|
$187.00
|
$1,274.00
|
$709.50
|
2025-11-12
|
|
12053
|
CPT
|
12053-face/ear/eye/nose/lip 5.1-7.5 Cm
|
12
|
5
|
$1,035.50
|
$932.00
|
$179.00
|
$1,207.00
|
$709.50
|
2025-11-12
|
|
11642
|
CPT
|
11642 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L…
|
6
|
5
|
$927.00
|
$834.00
|
$445.00
|
$881.00
|
$706.50
|
2025-11-12
|
|
12052
|
CPT
|
12052-face/ear/eye/nose/lip 2.6-5.0 Cm
|
12
|
5
|
$943.00
|
$848.50
|
$166.00
|
$1,032.00
|
$702.50
|
2025-11-12
|
|
12042
|
CPT
|
12042-neck/hand/feet/genital 2.6-7.5 Cm
|
12
|
5
|
$933.50
|
$840.00
|
$162.00
|
$1,014.00
|
$696.50
|
2025-11-12
|
|
12032
|
CPT
|
12032-scalp/trunk/extremity 2.6-7.5cm
|
12
|
5
|
$929.00
|
$836.00
|
$160.00
|
$1,005.00
|
$693.50
|
2025-11-12
|
|
96413
|
CPT
|
Stan 96413 IV Admin Remicade/infliximab 1st Hour
|
6
|
5
|
$878.00
|
$790.00
|
$421.00
|
$834.00
|
$669.00
|
2025-11-12
|
|
12051
|
CPT
|
12051-face/ear/eye/nose/lip Less Than/equal To 2.5 Cm
|
12
|
5
|
$888.50
|
$799.50
|
$144.00
|
$928.00
|
$667.50
|
2025-11-12
|
|
11622
|
CPT
|
11622 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge…
|
6
|
5
|
$875.00
|
$788.00
|
$420.00
|
$831.00
|
$667.00
|
2025-11-12
|
|
70450
|
CPT
|
CT Scan
|
6
|
5
|
$865.00
|
$779.00
|
$415.00
|
$822.00
|
$659.50
|
2025-11-12
|
|
24576
|
CPT
|
24576 Closed Treatment Of Humeral Condylar Fracture, Medial Or Lateral; Without …
|
6
|
5
|
$858.00
|
$772.00
|
$412.00
|
$815.00
|
$654.00
|
2025-11-12
|
|
12041
|
CPT
|
12041-neck/hand/feet/genital Less Than/equal To 2.5 Cm
|
12
|
5
|
$855.50
|
$770.00
|
$124.00
|
$865.00
|
$646.00
|
2025-11-12
|
|
12031
|
CPT
|
12031-scalp/trunk/extremity Less Than/equal To 2.5 Cm
|
12
|
5
|
$854.00
|
$768.50
|
$129.00
|
$863.00
|
$645.00
|
2025-11-12
|
|
4080436
|
CDM
|
Dorzolamide-timolol Ophthalmic 2%-0.5%
|
6
|
5
|
$844.00
|
$760.00
|
$405.00
|
$802.00
|
$643.50
|
2025-11-12
|
|
67028
|
CPT
|
Injection Therapeutic Agent Eye
|
12
|
5
|
$849.00
|
$764.00
|
$389.00
|
$843.00
|
$643.00
|
2025-11-12
|
|
P9016
|
HCPCS
|
E0336 Rbc Cpd As1 500 Lr
|
6
|
5
|
$839.00
|
$755.00
|
$403.00
|
$797.00
|
$639.50
|
2025-11-12
|
|
93306
|
CPT
|
US Echocardiogram Complete
|
6
|
5
|
$836.00
|
$752.00
|
$401.00
|
$794.00
|
$637.50
|
2025-11-12
|
|
4080188
|
CDM
|
Epoetin Alfa 20000.
|
6
|
5
|
$832.00
|
$749.00
|
$399.00
|
$790.00
|
$634.00
|
2025-11-12
|
|
93970
|
CPT
|
US Lower Ext Venous Duplex Bilateral
|
6
|
5
|
$827.00
|
$744.00
|
$397.00
|
$786.00
|
$630.50
|
2025-11-12
|
|
93880
|
CPT
|
US Carotid Duplex Bilateral
|
6
|
5
|
$824.00
|
$742.00
|
$396.00
|
$783.00
|
$628.00
|
2025-11-12
|
|
4087835
|
CDM
|
Proparacaine Ophth 0.5% Sol[stan]
|
6
|
5
|
$821.00
|
$739.00
|
$394.00
|
$780.00
|
$626.00
|
2025-11-12
|
|
4082115
|
CDM
|
Remdesivir 100 Mg Pow
|
6
|
5
|
$810.00
|
$729.00
|
$389.00
|
$770.00
|
$617.50
|
2025-11-12
|
|
11760
|
CPT
|
11760-repair Of Nail Bed
|
12
|
5
|
$941.50
|
$847.50
|
$100.00
|
$1,152.00
|
$594.50
|
2025-11-12
|
|
12016
|
CPT
|
12016-face/ear/eyelid/nose/lip 12.6-20.0 Cm
|
12
|
5
|
$778.50
|
$700.50
|
$110.00
|
$760.00
|
$591.00
|
2025-11-12
|
|
77066
|
CPT
|
Mammography Of Both Breasts
|
6
|
5
|
$772.00
|
$695.00
|
$371.00
|
$733.00
|
$588.50
|
2025-11-12
|
|
78708
|
CPT
|
Nm Kidney Imaging Single With Pharm
|
6
|
5
|
$770.00
|
$693.00
|
$370.00
|
$732.00
|
$587.00
|
2025-11-12
|
|
4080450
|
CDM
|
Tiotropium 2.5 Mcg/inh Aer
|
6
|
5
|
$768.00
|
$691.00
|
$369.00
|
$730.00
|
$585.50
|
2025-11-12
|
|
4081230
|
CDM
|
Degarelix 80 Mg Pow
|
6
|
5
|
$763.00
|
$687.00
|
$366.00
|
$725.00
|
$581.50
|
2025-11-12
|
|
4085325
|
CDM
|
Immune Globulin Intravenous And Subcutaneous 10% Solution
|
6
|
5
|
$755.00
|
$680.00
|
$362.00
|
$717.00
|
$575.50
|
2025-11-12
|
|
28470
|
CPT
|
28470metatarsal Without Manipulation
|
6
|
5
|
$753.00
|
$678.00
|
$361.00
|
$715.00
|
$574.00
|
2025-11-12
|
|
81270
|
CPT
|
Jak2 V617f Trin
|
6
|
5
|
$750.00
|
$675.00
|
$360.00
|
$713.00
|
$572.00
|
2025-11-12
|
|
12006
|
CPT
|
12006-scalp/neck/trunk/genital/extremity 20.1-30 Cm
|
12
|
5
|
$754.00
|
$678.50
|
$99.00
|
$760.00
|
$569.50
|
2025-11-12
|
|
92960
|
CPT
|
92960cardioversion; Elective
|
12
|
5
|
$781.50
|
$703.50
|
$92.00
|
$875.00
|
$569.50
|
2025-11-12
|
|
99285
|
CPT
|
99285 Comprehens. Service Profee
|
14
|
5
|
$604.00
|
$544.00
|
$162.00
|
$1,352.00
|
$559.00
|
2025-11-12
|
|
46083
|
CPT
|
46083-incision Hemorrhoid Thrombosed External
|
6
|
5
|
$726.00
|
$653.00
|
$348.00
|
$690.00
|
$553.50
|
2025-11-12
|
|
16030
|
CPT
|
16030-burn Dressings/debridement Large
|
12
|
5
|
$734.50
|
$661.00
|
$114.00
|
$760.00
|
$552.50
|
2025-11-12
|
|
10140
|
CPT
|
10140-i&d Hematoma/seroma/fluid
|
14
|
5
|
$589.00
|
$530.00
|
$111.00
|
$3,104.00
|
$545.00
|
2025-11-12
|
|
4081995
|
CDM
|
Albuterol-ipratropium 100 Mcg-20 Mcg/inh Aer[stan]
|
6
|
5
|
$713.00
|
$642.00
|
$342.00
|
$677.00
|
$543.50
|
2025-11-12
|
|
4080442
|
CDM
|
Daptomycin 500 Mg Pow
|
6
|
5
|
$698.00
|
$628.00
|
$335.00
|
$663.00
|
$532.00
|
2025-11-12
|
|
26700
|
CPT
|
26700-metacarpophalangeal/knuckle
|
12
|
5
|
$878.00
|
$790.50
|
$286.00
|
$1,103.00
|
$528.00
|
2025-11-12
|
|
27550
|
CPT
|
27550-knee Without Anesthesia
|
12
|
5
|
$1,209.50
|
$1,089.00
|
$286.00
|
$1,733.00
|
$528.00
|
2025-11-12
|
|
99205
|
CPT
|
New Patient Office Or Other Outpatient Visit, 60 Min
|
6
|
5
|
$692.00
|
$623.00
|
$332.00
|
$657.00
|
$527.50
|
2025-11-12
|
|
11623
|
CPT
|
11623-malignant Lesion 2.1cm To 3.0cm
|
6
|
5
|
$688.00
|
$619.00
|
$330.00
|
$654.00
|
$524.50
|
2025-11-12
|
|
12005
|
CPT
|
12005-scalp/neck/trunk/genital/extremity 12.6-20.0 Cm
|
12
|
5
|
$702.50
|
$632.50
|
$81.00
|
$760.00
|
$524.50
|
2025-11-12
|
|
12021
|
CPT
|
12021-superficial Dehiscence W/packing
|
12
|
5
|
$701.00
|
$631.00
|
$128.00
|
$760.00
|
$523.00
|
2025-11-12
|
|
74400
|
CPT
|
Xr Ivp
|
6
|
5
|
$675.00
|
$608.00
|
$324.00
|
$641.00
|
$514.50
|
2025-11-12
|
|
26725
|
CPT
|
26725-phalanx Shaft With Manipulation
|
12
|
5
|
$877.00
|
$789.50
|
$274.00
|
$1,124.00
|
$506.50
|
2025-11-12
|
|
24600
|
CPT
|
24600-elbow Without Anesthesia
|
12
|
5
|
$929.50
|
$836.50
|
$274.00
|
$1,224.00
|
$506.50
|
2025-11-12
|
|
23650
|
CPT
|
23650-shoulder Without Anesthesia
|
12
|
5
|
$845.00
|
$760.50
|
$274.00
|
$1,063.00
|
$506.50
|
2025-11-12
|
|
27840
|
CPT
|
27840-ankle Without Anesthesia
|
12
|
5
|
$940.50
|
$846.50
|
$274.00
|
$1,245.00
|
$506.50
|
2025-11-12
|
|
27560
|
CPT
|
27560-patellar Without Anesthesia
|
12
|
5
|
$937.00
|
$843.50
|
$274.00
|
$1,238.00
|
$506.50
|
2025-11-12
|
|
26770
|
CPT
|
26770-interphalangeal Hand Without Anesthesia
|
12
|
5
|
$778.50
|
$700.50
|
$274.00
|
$937.00
|
$506.50
|
2025-11-12
|
|
86870
|
CPT
|
Bill Only Abid Panel
|
6
|
5
|
$663.00
|
$597.00
|
$318.00
|
$630.00
|
$505.00
|
2025-11-12
|
|
40064
|
CPT
|
Bill Only Hla
|
6
|
5
|
$663.00
|
$597.00
|
$318.00
|
$630.00
|
$505.00
|
2025-11-12
|
|
23500
|
CPT
|
23500clavicular Without Manipulation
|
12
|
5
|
$670.50
|
$603.50
|
$236.00
|
$732.00
|
$500.00
|
2025-11-12
|
|
11750
|
CPT
|
11750-excision Nail & Matrix
|
12
|
5
|
$680.50
|
$612.50
|
$91.00
|
$760.00
|
$497.50
|
2025-11-12
|
|
10061
|
CPT
|
10061-i&d Abscess/cyst/hematoma Complicated
|
14
|
5
|
$725.00
|
$653.00
|
$167.00
|
$760.00
|
$496.00
|
2025-11-12
|
|
26750
|
CPT
|
26750-distal Phalangeal Without Manipulation
|
6
|
5
|
$646.00
|
$581.00
|
$310.00
|
$614.00
|
$492.50
|
2025-11-12
|
|
93976
|
CPT
|
Stan US Limited Arterial Duplex
|
6
|
5
|
$639.00
|
$575.00
|
$307.00
|
$607.00
|
$487.00
|
2025-11-12
|
|
4080324
|
CDM
|
Fluticasone 220. Mcg Aerosol
|
6
|
5
|
$638.00
|
$574.00
|
$306.00
|
$606.00
|
$486.50
|
2025-11-12
|
|
4080386
|
CDM
|
Rabies Vaccine, Purified Chick Embryo Cell 2.5 Intlunit Powder-inj
|
6
|
5
|
$627.00
|
$564.00
|
$301.00
|
$596.00
|
$478.00
|
2025-11-12
|
|
G0480
|
HCPCS
|
Amphetamines Confirmation, Random, Urine
|
6
|
5
|
$623.00
|
$561.00
|
$299.00
|
$592.00
|
$475.00
|
2025-11-12
|
|
51700
|
CPT
|
51700-bladder Irrigation Simple Lavage/instill
|
6
|
5
|
$623.00
|
$561.00
|
$299.00
|
$592.00
|
$475.00
|
2025-11-12
|
|
20611
|
CPT
|
20611arthrocentesis Aspiration/inj W/us
|
6
|
5
|
$620.00
|
$558.00
|
$298.00
|
$589.00
|
$472.50
|
2025-11-12
|
|
20604
|
CPT
|
20604arthrocentesis Aspiration/inj W/us
|
6
|
5
|
$620.00
|
$558.00
|
$298.00
|
$589.00
|
$472.50
|
2025-11-12
|
|
77067
|
CPT
|
Mammography, Screening, Bilateral
|
12
|
5
|
$622.00
|
$559.50
|
$291.00
|
$605.00
|
$472.50
|
2025-11-12
|
|
76805
|
CPT
|
Abdomial Ultrasound Of Pregnant Uterus
|
6
|
5
|
$620.00
|
$558.00
|
$298.00
|
$589.00
|
$472.50
|
2025-11-12
|
|
85366
|
CPT
|
Thrombophilia Profile-mayo
|
6
|
5
|
$615.00
|
$554.00
|
$295.00
|
$584.00
|
$469.00
|
2025-11-12
|
|
12017
|
CPT
|
12017-face/ear/eyelid/nose/lip 20.1-30.0 Cm
|
12
|
5
|
$662.00
|
$596.00
|
$139.00
|
$760.00
|
$465.00
|
2025-11-12
|
|
87507
|
CPT
|
Gastrointestinal (Gi) Panel, Pcr, Biofire Trin
|
6
|
5
|
$603.00
|
$543.00
|
$289.00
|
$573.00
|
$459.50
|
2025-11-12
|
|
77065
|
CPT
|
Mammography Of One Breast
|
6
|
5
|
$603.00
|
$543.00
|
$289.00
|
$573.00
|
$459.50
|
2025-11-12
|
|
29425
|
CPT
|
29425application Short Leg Cast
|
6
|
5
|
$599.00
|
$539.00
|
$288.00
|
$569.00
|
$457.00
|
2025-11-12
|
|
29405
|
CPT
|
29405-app Of Short Leg Cast (Below Knee To Toes)
|
6
|
5
|
$599.00
|
$539.00
|
$288.00
|
$569.00
|
$457.00
|
2025-11-12
|
|
29365
|
CPT
|
29365 Cylinger Cast Thigh/ankle
|
6
|
5
|
$599.00
|
$539.00
|
$288.00
|
$569.00
|
$457.00
|
2025-11-12
|
|
29355
|
CPT
|
29355 Long Leg Cast-ambul Type
|
6
|
5
|
$599.00
|
$539.00
|
$288.00
|
$569.00
|
$457.00
|
2025-11-12
|
|
29345
|
CPT
|
29345-application Of Long Leg Cast Thigh To Toes
|
6
|
5
|
$599.00
|
$539.00
|
$288.00
|
$569.00
|
$457.00
|
2025-11-12
|
|
29075
|
CPT
|
29075-cast Application Elbow To Finger (Short Arm)
|
6
|
5
|
$599.00
|
$539.00
|
$288.00
|
$569.00
|
$457.00
|
2025-11-12
|
|
29065
|
CPT
|
29065-application Cast Shoulder To Hand (Long Arm)
|
6
|
5
|
$599.00
|
$539.00
|
$288.00
|
$569.00
|
$457.00
|
2025-11-12
|
|
76536
|
CPT
|
US Thyroid
|
6
|
5
|
$596.00
|
$536.00
|
$286.00
|
$566.00
|
$454.50
|
2025-11-12
|
|
27788
|
CPT
|
27788-distal Fibular With Manipulation
|
6
|
5
|
$595.00
|
$536.00
|
$286.00
|
$565.00
|
$453.50
|
2025-11-12
|
|
11402
|
CPT
|
11402-excision Lesion Benign Trunk/extremity 1.1-2.0 Cm
|
6
|
5
|
$594.00
|
$535.00
|
$285.00
|
$564.00
|
$452.50
|
2025-11-12
|
|
76830
|
CPT
|
Ultrasound Pelvis Through Vagina
|
6
|
5
|
$592.00
|
$533.00
|
$284.00
|
$562.00
|
$451.00
|
2025-11-12
|
|
13153
|
CPT
|
13153-eye/ear/nose/lip Each Addl 5 Cm
|
12
|
5
|
$589.50
|
$531.00
|
$106.00
|
$621.00
|
$442.00
|
2025-11-12
|
|
83013
|
CPT
|
H Pylori C Urea Breath Test-mayo
|
6
|
5
|
$579.00
|
$521.00
|
$278.00
|
$550.00
|
$441.50
|
2025-11-12
|