Price Transparencybeta Hospital negotiated rates

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

UNITY MEDICAL CENTER

Grafton, ND · CCN 351320 · Rates published

621 distinct procedures filed
14 distinct payers
4,234 rate rows
2026-03-05 last MRF observed
Data quality

4,084 of 4,234 rate rows are consumer-grade (96.5%)

150 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
professional (physician) fee — not the facility price 148
exceeds 10× this hospital's gross charge — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://machine-readable-files.com/unity-medical-center/450310159_Christian-Unity-Hospital-Corporation_standardcharges.csv
Found on page https://www.unitymedcenter.com/about-us/price-transparency.html
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-23
Content fingerprint d585b11c4ad26dc5… · 2,008,350 bytes · first seen 2026-05-14

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
70549
CPT 		Hc MRA Neck W/wo Dye 3 $3,950.94 $4,114.05 $4,018.73 nat. median
$1,055
outlier · 3.8×
1210000
CDM 		Hc Room & Nursing Sp 1 $3,861.75 $3,861.75 $3,861.75 nat. median
$2,176
1.8× median
1211000
CDM 		Cah Room & Nursing Telemetry Or Isolation 1 $3,861.75 $3,861.75 $3,861.75 nat. median
$8
outlier · 454.3×
73720
CPT 		Hc MRI-lower Ext W/wo Dye 1 $3,524.34 $3,524.34 $3,524.34 nat. median
$1,129
outlier · 3.1×
72197
CPT 		Hc MRI Pelvis W/wo Dye 2 $3,021.48 $3,146.22 $3,083.85 nat. median
$1,063
outlier · 2.9×
73718
CPT 		Hc MRI Lower Ext Without Contrast 3 $2,804.22 $2,919.99 $2,852.30 nat. median
$870
outlier · 3.3×
70543
CPT 		Hc MRI Orbit/face/neck W/wo Dye 1 $2,834.63 $2,834.63 $2,834.63 nat. median
$1,083
outlier · 2.6×
75635
CPT 		Hc CTA Abdominal Arteries 1 $2,718.61 $2,718.61 $2,718.61 nat. median
$722
outlier · 3.8×
73218
CPT 		Hc MRI Upper Ext Without Contrast 1 $2,706.79 $2,706.79 $2,706.79 nat. median
$864
outlier · 3.1×
C1776
HCPCS 		Um Reverse Humeral Stem 7 $2,435.53 $5,756.25 $2,635.61 nat. median
$3,394
0.8× median
70544
CPT 		Hc MRA Head Without Contrast 4 $2,545.23 $2,608.72 $2,564.66 nat. median
$826
outlier · 3.1×
1200002
CDM 		Hc Respite Care 1 $2,549.17 $2,549.17 $2,549.17 nat. median
$371
outlier · 6.9×
1200000
CDM 		Hc Swing Bed 1 $2,549.17 $2,549.17 $2,549.17 nat. median
$804
outlier · 3.2×
74174
CPT 		Hc CTA Abdomen/pelvis W/contrast 5 $2,394.54 $2,542.36 $2,454.27 nat. median
$988
outlier · 2.5×
74181
CPT 		Hc MRI-abdomen Without Contrast 3 $2,002.09 $2,036.26 $2,036.26 nat. median
$820
outlier · 2.5×
31500
CPT 		Hc Insert Emergency Airway 1 $2,035.19 $2,035.19 $2,035.19 nat. median
$454
outlier · 4.5×
71275
CPT 		Hc CTA Chest 7 $1,901.04 $1,974.79 $1,974.79 nat. median
$754
outlier · 2.6×
73721
CPT 		Hc MRI-lower Ext Joint Without Contrast 5 $1,780.51 $1,854.02 $1,811.12 nat. median
$856
outlier · 2.1×
73221
CPT 		Hc MRI-upper Ext Joint Without Contrast 5 $1,718.72 $1,854.02 $1,811.12 nat. median
$844
outlier · 2.1×
20985
CPT 		Hc Cptr-asst Surgical Navigation Image-less 5 $1,708.57 $1,824.95 $1,731.85 nat. median
$687
outlier · 2.5×
99291
CPT 		Hc Critical Care 1st Hour 4 $1,420.81 $1,542.08 $1,499.12 nat. median
$1,530
1.0× median
73706
CPT 		Hc CTA Lower Extremity 1 $1,439.12 $1,439.12 $1,439.12 nat. median
$743
1.9× median
72129
CPT 		Hc CT Spine Thoracic With Contrast 1 $1,185.22 $1,185.22 $1,185.22 nat. median
$584
outlier · 2.0×
P9035
HCPCS 		Um Platelets, Pher, Leuko Re 1 $1,175.87 $1,175.87 $1,175.87 nat. median
$804
1.5× median
62323
CPT 		Hc Njx Interlaminar Lmbr/sac W/img 3 $1,115.07 $1,191.02 $1,161.10 nat. median
$1,120
1.0× median
49083
CPT 		Hc Abd Paracentesis W/imaging 2 $1,122.26 $1,198.70 $1,160.48 nat. median
$1,222
0.9× median
86366
CPT 		Um Musk Antibody 1 $1,100.00 $1,100.00 $1,100.00 nat. median
$41
outlier · 26.6×
72132
CPT 		Hc CT Spine Lumbar With Contrast 2 $852.92 $1,166.00 $1,009.46 nat. median
$766
1.3× median
93970
CPT 		Hc Venous Imaging 4 $886.30 $965.08 $912.11 nat. median
$564
1.6× median
20606
CPT 		Hc Poct US Injection Medium Joint 1 $874.72 $874.72 $874.72 nat. median
$821
1.1× median
99285
CPT 		Hc Ed Level V 9 $809.32 $1,125.00 $864.45 nat. median
$1,186
0.7× median
V2632
HCPCS 		Um Lens 7 $791.34 $1,100.00 $845.24 nat. median
$258
outlier · 3.3×
93971
CPT 		Hc Unilat/ltd Venous 7 $769.60 $1,087.00 $795.29 nat. median
$345
outlier · 2.3×
P9040
HCPCS 		Um Rbc's, Irrad, Leuko Reduc 1 $729.98 $729.98 $729.98 nat. median
$422
1.7× median
71271
CPT 		Hc Ldct For Lung Cancer Screen 6 $675.16 $978.00 $716.13 nat. median
$213
outlier · 3.4×
36430
CPT 		Hc Blood Admin 2+ Hrs 5 $576.07 $615.95 $607.04 nat. median
$708
0.9× median
99284
CPT 		Hc Ed Level IV 8 $561.13 $780.00 $592.06 nat. median
$754
0.8× median
86362
CPT 		Um Mog Igg, Quest 1 $566.62 $566.62 $566.62 nat. median
$24
outlier · 23.5×
86052
CPT 		Um Aquaporin-4 Antibody, Quest 1 $566.62 $566.62 $566.62 nat. median
$24
outlier · 23.9×
96413
CPT 		Hc Chemo,iv Infusion,1 Hr 5 $510.77 $553.58 $545.56 nat. median
$491
1.1× median
93880
CPT 		Hc Carotid Doppler 6 $525.16 $546.85 $534.69 nat. median
$530
1.0× median
77066
CPT 		Hc Diagnostic Mammo Cad Bilateral 4 $498.93 $518.88 $507.12 nat. median
$235
outlier · 2.2×
P9016
HCPCS 		Um Rbc's Leukocytes Reduced 4 $487.04 $520.21 $500.61 nat. median
$331
1.5× median
76805
CPT 		Hc US Pregnancy >=14wks Sngl Fetus 1 $488.80 $488.80 $488.80 nat. median
$259
1.9× median
76536
CPT 		Hc US Exam Head/neck 5 $483.32 $664.00 $483.32 nat. median
$261
1.8× median
76830
CPT 		Hc US Transvaginal 5 $470.82 $527.52 $482.56 nat. median
$250
1.9× median
76706
CPT 		Hc Ultrasound Exam Aaa Screen 5 $467.16 $509.44 $467.16 nat. median
$200
outlier · 2.3×
83519
CPT 		Um Pth Related Protein 1 $460.96 $460.96 $460.96 nat. median
$96
outlier · 4.8×
76700
CPT 		Hc US Exam Abdomen Complete 3 $441.71 $459.94 $455.64 nat. median
$311
1.5× median
A4649
HCPCS 		Um Bipolar Sealer 2 $54.55 $854.14 $454.35 nat. median
$239
1.9× median

Other procedures at this hospital

Browse this hospital's 621 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
             
70549 CPT Hc MRA Neck W/wo Dye 6 3 $5,492.00 $5,492.00 $3,950.94 $4,114.05 $4,018.73 2026-03-05
1211000 CDM Cah Room & Nursing Telemetry Or Isolation 2 1 $1,865.00 $1,865.00 $3,861.75 $3,861.75 $3,861.75 2026-03-05
1210000 CDM Hc Room & Nursing Sp 2 1 $1,425.00 $1,425.00 $3,861.75 $3,861.75 $3,861.75 2026-03-05
73720 CPT Hc MRI-lower Ext W/wo Dye 2 1 $4,899.00 $4,899.00 $3,524.34 $3,524.34 $3,524.34 2026-03-05
72197 CPT Hc MRI Pelvis W/wo Dye 4 2 $4,200.00 $4,200.00 $3,021.48 $3,146.22 $3,083.85 2026-03-05
73718 CPT Hc MRI Lower Ext Without Contrast 6 3 $3,898.00 $3,898.00 $2,804.22 $2,919.99 $2,852.30 2026-03-05
70543 CPT Hc MRI Orbit/face/neck W/wo Dye 2 1 $3,874.00 $3,874.00 $2,834.63 $2,834.63 $2,834.63 2026-03-05
75635 CPT Hc CTA Abdominal Arteries 2 1 $3,779.00 $3,779.00 $2,718.61 $2,718.61 $2,718.61 2026-03-05
73218 CPT Hc MRI Upper Ext Without Contrast 2 1 $4,045.00 $4,045.00 $2,706.79 $2,706.79 $2,706.79 2026-03-05
C1776 HCPCS Um Reverse Humeral Stem 14 7 $3,727.50 $3,727.50 $2,435.53 $5,756.25 $2,635.61 2026-03-05
70544 CPT Hc MRA Head Without Contrast 8 4 $3,565.00 $3,565.00 $2,545.23 $2,608.72 $2,564.66 2026-03-05
1200000 CDM Hc Swing Bed 2 1 $580.00 $580.00 $2,549.17 $2,549.17 $2,549.17 2026-03-05
1200002 CDM Hc Respite Care 2 1 $385.00 $385.00 $2,549.17 $2,549.17 $2,549.17 2026-03-05
74174 CPT Hc CTA Abdomen/pelvis W/contrast 10 5 $3,534.00 $3,534.00 $2,394.54 $2,542.36 $2,454.27 2026-03-05
74181 CPT Hc MRI-abdomen Without Contrast 6 3 $2,783.00 $2,783.00 $2,002.09 $2,036.26 $2,036.26 2026-03-05
31500 CPT Hc Insert Emergency Airway 2 1 $410.00 $410.00 $2,035.19 $2,035.19 $2,035.19 2026-03-05
71275 CPT Hc CTA Chest 14 7 $2,699.00 $2,699.00 $1,901.04 $1,974.79 $1,974.79 2026-03-05
73221 CPT Hc MRI-upper Ext Joint Without Contrast 10 5 $2,475.00 $2,475.00 $1,718.72 $1,854.02 $1,811.12 2026-03-05
73721 CPT Hc MRI-lower Ext Joint Without Contrast 10 5 $2,475.00 $2,475.00 $1,780.51 $1,854.02 $1,811.12 2026-03-05
20985 CPT Hc Cptr-asst Surgical Navigation Image-less 10 5 $2,494.00 $2,494.00 $1,708.57 $1,824.95 $1,731.85 2026-03-05
99291 CPT Hc Critical Care 1st Hour 8 4 $2,074.00 $2,074.00 $1,420.81 $1,542.08 $1,499.12 2026-03-05
73706 CPT Hc CTA Lower Extremity 2 1 $1,840.00 $1,840.00 $1,439.12 $1,439.12 $1,439.12 2026-03-05
72129 CPT Hc CT Spine Thoracic With Contrast 2 1 $1,542.45 $1,542.45 $1,185.22 $1,185.22 $1,185.22 2026-03-05
P9035 HCPCS Um Platelets, Pher, Leuko Re 2 1 $1,578.00 $1,578.00 $1,175.87 $1,175.87 $1,175.87 2026-03-05
62323 CPT Hc Njx Interlaminar Lmbr/sac W/img 6 3 $1,628.00 $1,628.00 $1,115.07 $1,191.02 $1,161.10 2026-03-05
49083 CPT Hc Abd Paracentesis W/imaging 4 2 $1,638.00 $1,638.00 $1,122.26 $1,198.70 $1,160.48 2026-03-05
86366 CPT Um Musk Antibody 2 1 $1,155.00 $1,155.00 $1,100.00 $1,100.00 $1,100.00 2026-03-05
72132 CPT Hc CT Spine Lumbar With Contrast 4 2 $1,166.00 $1,166.00 $852.92 $1,166.00 $1,009.46 2026-03-05
93970 CPT Hc Venous Imaging 8 4 $1,294.00 $1,294.00 $886.30 $965.08 $912.11 2026-03-05
20606 CPT Hc Poct US Injection Medium Joint 2 1 $1,215.90 $1,215.90 $874.72 $874.72 $874.72 2026-03-05
99285 CPT Hc Ed Level V 18 9 $1,182.00 $1,182.00 $809.32 $1,125.00 $864.45 2026-03-05
V2632 HCPCS Um Lens 14 7 $1,100.00 $1,100.00 $791.34 $1,100.00 $845.24 2026-03-05
93971 CPT Hc Unilat/ltd Venous 14 7 $1,142.00 $1,142.00 $769.60 $1,087.00 $795.29 2026-03-05
P9040 HCPCS Um Rbc's, Irrad, Leuko Reduc 2 1 $998.00 $998.00 $729.98 $729.98 $729.98 2026-03-05
71271 CPT Hc Ldct For Lung Cancer Screen 12 6 $978.00 $978.00 $675.16 $978.00 $716.13 2026-03-05
36430 CPT Hc Blood Admin 2+ Hrs 10 5 $830.00 $830.00 $576.07 $615.95 $607.04 2026-03-05
99284 CPT Hc Ed Level IV 16 8 $819.00 $819.00 $561.13 $780.00 $592.06 2026-03-05
86052 CPT Um Aquaporin-4 Antibody, Quest 2 1 $805.00 $805.00 $566.62 $566.62 $566.62 2026-03-05
86362 CPT Um Mog Igg, Quest 2 1 $805.00 $805.00 $566.62 $566.62 $566.62 2026-03-05
96413 CPT Hc Chemo,iv Infusion,1 Hr 10 5 $710.00 $710.00 $510.77 $553.58 $545.56 2026-03-05
93880 CPT Hc Carotid Doppler 12 6 $767.00 $767.00 $525.16 $546.85 $534.69 2026-03-05
77066 CPT Hc Diagnostic Mammo Cad Bilateral 8 4 $699.00 $699.00 $498.93 $518.88 $507.12 2026-03-05
P9016 HCPCS Um Rbc's Leukocytes Reduced 8 4 $711.00 $711.00 $487.04 $520.21 $500.61 2026-03-05
76805 CPT Hc US Pregnancy >=14wks Sngl Fetus 2 1 $685.00 $685.00 $488.80 $488.80 $488.80 2026-03-05
76536 CPT Hc US Exam Head/neck 10 5 $664.00 $664.00 $483.32 $664.00 $483.32 2026-03-05
76830 CPT Hc US Transvaginal 10 5 $660.00 $660.00 $470.82 $527.52 $482.56 2026-03-05
76706 CPT Hc Ultrasound Exam Aaa Screen 10 5 $653.00 $653.00 $467.16 $509.44 $467.16 2026-03-05
83519 CPT Um Pth Related Protein 2 1 $226.00 $226.00 $460.96 $460.96 $460.96 2026-03-05
76700 CPT Hc US Exam Abdomen Complete 6 3 $614.00 $614.00 $441.71 $459.94 $455.64 2026-03-05
A4649 HCPCS Um Bipolar Sealer 4 2 $1,497.50 $1,497.50 $54.55 $854.14 $454.35 2026-03-05
76770 CPT Hc US Retroperit (renal Laaa) 12 6 $630.00 $630.00 $354.24 $491.61 $453.22 2026-03-05
93976 CPT Hc Duplex Abd Organ Follow Up 2 1 $624.00 $624.00 $444.96 $444.96 $444.96 2026-03-05
77065 CPT Hc Diagnostic Mammo Cad Unilateral 16 8 $583.00 $583.00 $327.32 $454.56 $426.00 2026-03-05
88307 CPT Um Surgical Path. Level 5 4 2 $591.00 $591.00 $421.02 $421.03 $421.02 2026-03-05
72084 CPT Hc Xray Exam Of Spine,minimum Of 6 Views 2 1 $560.00 $560.00 $419.50 $419.50 $419.50 2026-03-05
76856 CPT Hc US Pelvic Complete 10 5 $569.00 $569.00 $405.59 $454.44 $415.70 2026-03-05
76870 CPT Hc US Scrotum 4 2 $554.00 $554.00 $415.00 $415.01 $415.00 2026-03-05
87631 CPT Um Rsv & Influenza 3-5 Targets 2 1 $569.00 $569.00 $405.26 $405.26 $405.26 2026-03-05
99212 CPT Pr Office/outpatient Established Sf Mdm 10 Min 8 4 $126.00 $126.00 $110.16 $521.55 $403.89 2026-03-05
76816 CPT Hc Follow Up/repeat OB 2 1 $536.00 $536.00 $401.52 $401.52 $401.52 2026-03-05
99213 CPT Pr Office/outpatient Established Low Mdm 20 Min 10 5 $210.00 $210.00 $178.36 $853.43 $399.64 2026-03-05
76801 CPT Hc US OB Complete(<14 Wks) 2 1 $551.00 $551.00 $392.85 $392.85 $392.85 2026-03-05
92960 CPT Hc Cardioversion 4 1 $522.50 $522.50 $307.97 $467.81 $387.89 2026-03-05
76775 CPT Hc US Retroperit Ltd (renal,laaa) 6 3 $520.00 $520.00 $380.36 $399.57 $380.66 2026-03-05
11601 CPT Pr Excision Mal Lesion Trunk/arm/leg 0.6-1.0 Cm 2 1 $615.00 $615.00 $380.55 $380.55 $380.55 2026-03-05
87636 CPT Um Covid / Influenza, 3-5 Targets Pcr 12 6 $522.00 $522.00 $360.42 $497.00 $379.91 2026-03-05
Q5108 HCPCS Pegfilgrastim-jmdb Soln Prefilled Syringe 6 Mg/0.6ml 4 2 $6,948.70 $6,948.70 $336.84 $422.25 $379.54 2026-03-05
99283 CPT Hc Ed Level Iii 14 7 $525.00 $525.00 $359.70 $392.04 $374.85 2026-03-05
99496 CPT Pr Transj Care Mgmt High Mdm F2f 7 Cal D Discharge 12 6 $693.00 $693.00 $270.59 $395.56 $369.89 2026-03-05
29581 CPT Pr Appl Mltlayr Cmprn Sys Leg Belw Kne W/ankle&foot 2 1 $237.00 $237.00 $368.65 $368.65 $368.65 2026-03-05
C1781 HCPCS Um 3d Max Light Mesh Large 2 1 $488.00 $488.00 $365.57 $365.57 $365.57 2026-03-05
87637 CPT Um Sars-cov-2, Influenza A And B, And Rsv By Amp Probe 8 4 $498.00 $498.00 $356.27 $388.29 $364.66 2026-03-05
93308 CPT Hc Echo Exam Of Heart Lmtd 4 2 $519.00 $519.00 $355.38 $361.15 $358.26 2026-03-05
96365 CPT Hc Ther/proph/diag IV Inf,init 18 9 $460.00 $460.00 $330.92 $460.00 $353.46 2026-03-05
96374 CPT Hc Ther/proph/diag Inj,iv Push 18 9 $460.00 $460.00 $330.92 $460.00 $353.46 2026-03-05
96360 CPT Hc Hydration IV Infusion,init 12 6 $460.00 $460.00 $330.92 $358.66 $353.46 2026-03-05
76857 CPT Hc US Pelvic Limited 6 3 $471.00 $471.00 $326.68 $471.00 $352.82 2026-03-05
76642 CPT Hc US Breast Unilat W/axilla Limited 16 8 $483.00 $483.00 $344.87 $376.58 $351.87 2026-03-05
82656 CPT Um Pancreatic Elastase, Fecal 2 1 $368.00 $368.00 $350.00 $350.00 $350.00 2026-03-05
99397 CPT Pr Periodic Preventive Med Est Patient 65yrs& Older 2 1 $363.00 $363.00 $345.02 $345.02 $345.02 2026-03-05
12002 CPT Pr Smpl Repair Scalp/neck/ax/genit/trunk 2.6-7.5cm 2 1 $310.00 $310.00 $344.55 $344.55 $344.55 2026-03-05
76705 CPT Hc US Echo Exam Of Abdomen 14 7 $466.00 $466.00 $323.04 $363.33 $340.40 2026-03-05
90791 CPT Pr Psychiatric Diagnostic Evaluation 8 4 $425.00 $425.00 $325.05 $348.55 $339.63 2026-03-05
Q5122 HCPCS Pegfilgrastim-apgf Soln Prefilled Syringe 6 Mg/0.6ml 2 1 $5,299.05 $5,299.05 $339.32 $339.32 $339.32 2026-03-05
99215 CPT Pr Office/outpatient Established High Mdm 40 Min 6 3 $384.00 $384.00 $336.55 $353.56 $336.55 2026-03-05
99308 CPT Pr Sbsq Nursing Facility Care Low Mdm 20 Minutes 2 1 $200.00 $200.00 $331.55 $331.55 $331.55 2026-03-05
99310 CPT Pr Sbsq Nursing Facility Care High Mdm 45 Minutes 2 1 $394.00 $394.00 $329.63 $329.63 $329.63 2026-03-05
99305 CPT Pr Initial Nursing Facility Care Mod Mdm 35 Minutes 4 2 $357.00 $357.00 $322.63 $331.55 $327.09 2026-03-05
87517 CPT Um Hepatitis B Virus DNA Quant 2 1 $457.00 $457.00 $325.60 $325.60 $325.60 2026-03-05
0241U OTHER Um Sars-cov-2. Flu A & B, Rsv 10 5 $441.00 $441.00 $314.87 $327.47 $321.05 2026-03-05
92522 CPT Hc Eval Of Speech Production 4 2 $459.00 $459.00 $314.38 $327.36 $320.87 2026-03-05
76815 CPT Hc US Pregnancy Lmtd 2 1 $427.00 $427.00 $319.87 $319.87 $319.87 2026-03-05
99306 CPT Pr Initial Nursing Facility Care Hi Mdm 50 Minutes 4 2 $441.00 $441.00 $296.23 $340.16 $318.20 2026-03-05
76817 CPT Hc US Transvaginal(ob) 2 1 $445.00 $445.00 $317.12 $317.12 $317.12 2026-03-05
99495 CPT Pr Transj Care Mgmt Mod Mdm F2f 14 Cal D Discharge 12 6 $525.00 $525.00 $283.28 $322.18 $312.23 2026-03-05
90677 CPT Pr Pcv20 Vaccine For Intramuscular Use 8 4 $330.00 $330.00 $249.50 $306.64 $306.64 2026-03-05
97161 CPT Hc Pt Eval Low Complex 20 Min 16 8 $410.00 $410.00 $282.83 $390.00 $299.68 2026-03-05
97162 CPT Hc Pt Eval Mod Complex 30 Min 14 7 $410.00 $410.00 $292.14 $390.00 $299.68 2026-03-05
82805 CPT Um Blood Gases W/o2 Sat 8 4 $406.00 $406.00 $285.79 $295.22 $291.42 2026-03-05
99204 CPT Pr Office/outpatient New Moderate Mdm 45 Minutes 4 2 $384.00 $384.00 $285.23 $289.34 $287.28 2026-03-05
0352U CPT Um Amplified Probe Detection For Bacterial Vaginosis, Candiada Species, And Tric… 6 3 $399.00 $399.00 $275.58 $347.70 $284.88 2026-03-05
81515 CPT Um Amplified Probe Detection For Bacterial Vaginosis, Candiada Species, And Tric… 12 6 $399.00 $399.00 $271.85 $380.00 $280.62 2026-03-05
97163 CPT Hc Pt Eval High Complex 45 Min 2 1 $410.00 $410.00 $279.85 $279.85 $279.85 2026-03-05
G0438 HCPCS Pr Ppps, Initial Visit 8 4 $289.00 $289.00 $270.59 $275.00 $275.00 2026-03-05
11301 CPT Pr Shvg Skin Lesion 1 Trunk/arm/leg Diam 0.6-1.0 Cm 2 1 $326.00 $326.00 $274.23 $274.23 $274.23 2026-03-05
87502 CPT Um Influenzae DNA Amp Probe 8 4 $315.00 $315.00 $224.91 $300.00 $270.37 2026-03-05
76819 CPT Hc Bio Profile 2 1 $359.00 $359.00 $268.92 $268.92 $268.92 2026-03-05
99214 CPT Pr Office/outpatient Established Mod Mdm 30 Min 10 5 $294.00 $294.00 $268.23 $270.59 $268.23 2026-03-05
G0402 HCPCS Pr Ippe 10 5 $289.00 $289.00 $239.45 $265.29 $265.29 2026-03-05
77085 CPT Hc Dexa 1 Or More Sties,axial Skeleton,w/vfa 10 5 $348.00 $348.00 $240.04 $271.33 $253.02 2026-03-05
99396 CPT Pr Periodic Preventive Med Est Patient 40-64yrs 2 1 $336.00 $336.00 $252.08 $252.08 $252.08 2026-03-05
C1713 HCPCS Um Peripheral Screw- Non Locking-asst 14 7 $360.00 $360.00 $185.95 $522.59 $250.00 2026-03-05
J9217 HCPCS Leuprolide Acetate (6 Month) For Inj Kit 45 Mg 4 2 $33,038.95 $33,038.95 $233.99 $249.92 $241.95 2026-03-05
92610 CPT Hc Clinic Eval/swallow 2 1 $352.00 $352.00 $241.00 $241.00 $241.00 2026-03-05
72052 CPT Hc Cervical Spine 6 Or More Views 2 1 $315.00 $315.00 $235.97 $235.97 $235.97 2026-03-05
77067 CPT Hc Screening Mammo Cad Bilateral 16 8 $616.00 $616.00 $87.65 $456.82 $234.50 2026-03-05
92507 CPT Hc Speech/hearing Therapy Indiv 10 5 $320.00 $320.00 $227.72 $237.62 $233.59 2026-03-05
L4386 HCPCS Um Cam Walker 2 1 $231.90 $231.90 $231.90 $231.90 $231.90 2026-03-05
77080 CPT Hc Dexascan 12 6 $307.00 $307.00 $219.63 $307.00 $225.44 2026-03-05
99203 CPT Pr Office/outpatient New Low Mdm 30 Minutes 2 1 $258.00 $258.00 $225.40 $225.40 $225.40 2026-03-05
G0439 HCPCS Pr Ppps, Subseq Visit 8 4 $237.00 $237.00 $225.00 $225.00 $225.00 2026-03-05
80074 CPT Um Hepatitis (acute) Panel 4 2 $315.00 $315.00 $214.62 $229.32 $221.97 2026-03-05
86870 CPT Um Antibody Identifica Pan 2 1 $302.00 $302.00 $220.92 $220.92 $220.92 2026-03-05
99282 CPT Pr Emergency Department Visit Straightforward Mdm 8 4 $305.00 $305.00 $208.63 $290.00 $220.13 2026-03-05
80179 CPT Um Salicylate 4 2 $315.00 $315.00 $214.62 $224.73 $219.68 2026-03-05
80143 CPT Um Acetaminophen 4 2 $315.00 $315.00 $214.62 $224.73 $219.68 2026-03-05
82507 CPT Um Citrate 2 1 $301.00 $301.00 $214.73 $214.73 $214.73 2026-03-05
E0218 HCPCS Um Polar Care Wave 2 1 $285.01 $285.01 $213.50 $213.50 $213.50 2026-03-05
88312 CPT Um Special Stains/microrgani 4 2 $305.00 $305.00 $211.47 $211.47 $211.47 2026-03-05
99070 CPT Um Drain Tube Attachment 4 2 $58.38 $58.38 $179.92 $240.00 $209.96 2026-03-05
76802 CPT Hc Multiple Gestation(<14 Wks) 2 1 $279.00 $279.00 $208.99 $208.99 $208.99 2026-03-05
83970 CPT Um Pth-intact 16 8 $286.00 $286.00 $40.45 $272.00 $202.60 2026-03-05
97164 CPT Hc Pt Re-eval Est Plan Of Care 2 1 $281.00 $281.00 $200.01 $200.01 $200.01 2026-03-05
72110 CPT Hc Lumbar Spine Com 2 1 $268.00 $268.00 $198.82 $198.82 $198.82 2026-03-05
91323 CPT Pr Sarscov2 Vaccine 10 Mcg/0.2 Ml For IM Use 12 6 $210.00 $210.00 $30.00 $197.87 $197.87 2026-03-05
82652 CPT Um Vit D, 1, 25 Oh 8 4 $269.00 $269.00 $150.53 $256.00 $197.64 2026-03-05
76641 CPT Hc US Breast Unilat W/axilla Complete 2 1 $525.00 $525.00 $196.64 $196.64 $196.64 2026-03-05
76882 CPT Hc US Xtr Non-vasc Lmtd 10 5 $263.00 $263.00 $189.20 $263.00 $189.20 2026-03-05
84425 CPT Um Vit B-1/thiamine,plasma 4 2 $220.00 $220.00 $156.56 $209.00 $182.78 2026-03-05
95992 CPT Hc Canalith Repos,per Tx Day 12 6 $243.00 $243.00 $168.45 $231.00 $177.50 2026-03-05
88342 CPT Um Special Stain 10 5 $242.00 $242.00 $172.43 $230.00 $176.73 2026-03-05
86336 CPT Um Inhibin A Tm 2 1 $247.00 $247.00 $176.18 $176.18 $176.18 2026-03-05
73502 CPT Hc X-ray Exam Hip Uni 2-3 Vw 14 7 $241.00 $241.00 $169.46 $241.00 $175.96 2026-03-05
87591 CPT Um N. Gonorrhoeae, Dna, Amb Probe 6 3 $184.00 $184.00 $160.13 $175.00 $175.00 2026-03-05
87491 CPT Um Chlamydia DNA Probe 6 3 $184.00 $184.00 $160.13 $175.00 $175.00 2026-03-05
J2997 HCPCS Alteplase For Inj 2 Mg 4 2 $457.20 $457.20 $171.38 $175.66 $173.52 2026-03-05
87624 CPT Um Hpv - High Risk Types 6 3 $243.00 $243.00 $167.52 $231.00 $173.18 2026-03-05
70150 CPT Hc Facial Bones Min 3 Views 2 1 $229.00 $229.00 $171.55 $171.55 $171.55 2026-03-05
99211 CPT Um Scheduled Dressing Change 10 5 $63.00 $63.00 $43.16 $235.00 $171.36 2026-03-05
83880 CPT Um Bnp(natriuretic Peptide) 14 7 $236.00 $236.00 $160.25 $174.65 $171.23 2026-03-05
80307 CPT Um Acetaminophen 12 6 $315.00 $315.00 $74.91 $801.00 $171.22 2026-03-05
87150 CPT Um Culture, Typing, Id By Dna/rna Ampl Probe Per Organism 2 1 $243.00 $243.00 $170.87 $170.87 $170.87 2026-03-05
73521 CPT Hc X-ray Exam Hip Bil 2 Vw 10 5 $233.00 $233.00 $163.77 $174.55 $169.82 2026-03-05
87641 CPT Um Mrsa Screen,pcr 10 5 $243.00 $243.00 $165.26 $231.00 $167.52 2026-03-05
73564 CPT Hc Knee 4 Or More Views 14 7 $229.00 $229.00 $161.56 $229.00 $167.51 2026-03-05
86920 CPT Um Crossmatch Immediate Spin 10 5 $224.00 $224.00 $153.23 $213.00 $163.67 2026-03-05
86922 CPT Um Crossmatch, Antiglob Tech 10 5 $224.00 $224.00 $152.38 $213.00 $162.82 2026-03-05
88305 CPT Um Surgical Path Level 4 16 8 $225.00 $225.00 $125.83 $214.00 $162.44 2026-03-05
86001 CPT Um Allergen Specific Igg Quantitative/semi Quant Ea. Allergen 2 1 $28.00 $28.00 $159.90 $159.90 $159.90 2026-03-05
82024 CPT Um Acth 4 2 $226.00 $226.00 $153.85 $164.39 $159.12 2026-03-05
72190 CPT Hc Pelvis Minimum 3 Views 2 1 $218.00 $218.00 $159.06 $159.06 $159.06 2026-03-05
73650 CPT Hc Heel Min 2 Views 2 1 $210.00 $210.00 $157.32 $157.32 $157.32 2026-03-05
73562 CPT Hc Knee Min 3 Views 14 7 $210.00 $210.00 $151.07 $210.00 $156.24 2026-03-05
80050 CPT Um General Health Panel 8 4 $187.00 $187.00 $90.00 $178.00 $155.72 2026-03-05
G0463 HCPCS Hc Office Visit-est Patient Level 1 2 1 $42.00 $42.00 $155.14 $155.14 $155.14 2026-03-05
20610 CPT Pr Arthrocentesis Aspir&/inj Major Jt/bursa Without US 2 1 $163.00 $163.00 $155.00 $155.00 $155.00 2026-03-05
73110 CPT Hc Wrist Comp Min 3 Views 8 4 $210.00 $210.00 $153.68 $157.32 $153.68 2026-03-05
82103 CPT Um Alpha-1-antitrypsin 4 2 $216.00 $216.00 $146.66 $153.56 $150.11 2026-03-05
82306 CPT Um Vitamin D 25-hydroxy 14 7 $205.00 $205.00 $114.66 $195.00 $149.06 2026-03-05
73140 CPT Hc Finger Min 2 Views 10 5 $202.00 $202.00 $143.94 $157.80 $147.53 2026-03-05
87493 CPT Um Clostridium Difficile 2 1 $206.00 $206.00 $146.38 $146.38 $146.38 2026-03-05
94626 CPT Hc Phys/qhp Svcs Op Pulm Rehab W/cont Oximtry Mntr 10 5 $210.00 $210.00 $143.88 $200.00 $145.84 2026-03-05
87468 CPT Um A Phgcytophlm Amp Probe 2 1 $200.00 $200.00 $143.08 $143.08 $143.08 2026-03-05
87484 CPT Um E Chaffenis Amp Probe 2 1 $200.00 $200.00 $143.08 $143.08 $143.08 2026-03-05
72100 CPT Hc Lumbar Spine 2 Views 12 6 $193.00 $193.00 $137.20 $193.00 $140.62 2026-03-05
72040 CPT Hc Cervical Spine 2/3 Views 10 5 $193.00 $193.00 $133.44 $193.00 $140.62 2026-03-05
72202 CPT Hc Sacroiliac Joints 6 3 $193.00 $193.00 $137.20 $140.62 $140.62 2026-03-05
73610 CPT Hc Ankle Min 3 Views 14 7 $186.00 $186.00 $133.81 $186.00 $139.34 2026-03-05
36600 CPT Um Arterial Blood Draw 10 5 $194.00 $194.00 $136.31 $141.54 $138.09 2026-03-05
82670 CPT Um Estradiol 4 2 $194.00 $194.00 $137.83 $137.83 $137.83 2026-03-05
87506 CPT Um Enteric Pathogen Panel 2 1 $200.00 $200.00 $137.79 $137.79 $137.79 2026-03-05
84145 CPT Um Procalcitonin 8 4 $187.00 $187.00 $133.33 $136.06 $136.06 2026-03-05
73130 CPT Hc Hand Min 3 Views 12 6 $186.00 $186.00 $131.23 $186.00 $134.91 2026-03-05
73552 CPT Hc X-ray Exam Femur 2/> 10 5 $184.00 $184.00 $129.75 $184.00 $134.47 2026-03-05
73560 CPT Hc Knee 1 Or 2 Views 10 5 $181.00 $181.00 $132.16 $181.00 $134.40 2026-03-05
72170 CPT Hc Pelvis 8 4 $184.00 $184.00 $129.50 $134.47 $133.42 2026-03-05
84403 CPT Um Testosterone, Total 6 3 $179.00 $179.00 $127.44 $170.00 $132.54 2026-03-05
73100 CPT Hc Wrist 2 Views 4 2 $178.00 $178.00 $129.86 $133.33 $131.60 2026-03-05
G0108 HCPCS Hc Diabetes Train/indiv 30 Min 12 6 $179.00 $179.00 $127.35 $132.55 $130.63 2026-03-05
96523 CPT Hc Pic/port Flush 4 2 $184.00 $184.00 $125.89 $134.47 $130.18 2026-03-05
73501 CPT Hc X-ray Exam Hip Uni 1 Vw 2 1 $162.00 $162.00 $129.36 $129.36 $129.36 2026-03-05
74019 CPT Hc Xray Abdomen 2 Views 10 5 $175.00 $175.00 $124.45 $129.73 $127.55 2026-03-05
87651 CPT Um Strep A DNA Amplified Probe 16 8 $175.00 $175.00 $124.45 $157.70 $126.89 2026-03-05
87635 CPT Um Infectious Agent Detection By Nucleic Acid, Sars-cov-2 12 6 $175.00 $175.00 $118.76 $166.00 $126.89 2026-03-05
72070 CPT Hc Spine Thoracic 2 Views 14 7 $174.00 $174.00 $125.18 $174.00 $126.79 2026-03-05
99281 CPT Hc Ed Level I 2 1 $174.00 $174.00 $126.79 $126.79 $126.79 2026-03-05
84402 CPT Um Testosterone, Free 2 1 $177.00 $177.00 $125.84 $125.84 $125.84 2026-03-05
80299 CPT Um Neurontin (gabapentin) 4 2 $70.00 $70.00 $59.49 $191.10 $125.29 2026-03-05
94060 CPT Hc Pre/post Spiro 4 2 $174.00 $174.00 $123.60 $126.79 $125.19 2026-03-05
91322 CPT Pr Sarscov2 Vaccine 50 Mcg/0.5 Ml For IM Use 2 1 $145.00 $145.00 $124.75 $124.75 $124.75 2026-03-05
83630 CPT Um Lactoferrin (stool Wbgs) 4 2 $179.00 $179.00 $121.62 $127.35 $124.48 2026-03-05
73630 CPT Hc Foot Min 3 Views 14 7 $171.00 $171.00 $121.46 $171.00 $124.48 2026-03-05
36591 CPT Hc Collect Blood Venous Device 4 2 $179.00 $179.00 $122.30 $125.75 $124.03 2026-03-05
86335 CPT Um Immunofixation, Urine 4 2 $172.00 $172.00 $122.47 $124.98 $123.72 2026-03-05
73660 CPT Hc Toe Min 2 Views 8 4 $167.00 $167.00 $120.14 $130.51 $123.64 2026-03-05
93798 CPT Hc Cardiac Rehab/phase I Non-monitored 10 5 $108.00 $108.00 $121.58 $129.86 $123.26 2026-03-05
73600 CPT Hc X-ray Ankle 2 Views 2 1 $171.00 $171.00 $123.02 $123.02 $123.02 2026-03-05
73060 CPT Hc Humerus 2 Views 8 4 $165.00 $165.00 $118.70 $128.64 $122.29 2026-03-05
83088 CPT Um Histamine 2 1 $171.00 $171.00 $121.87 $121.87 $121.87 2026-03-05
82172 CPT Um Apolipoprotein, Each 4 2 $169.00 $169.00 $119.91 $122.36 $121.13 2026-03-05
88304 CPT Um Surgical Path Level 3 12 6 $165.00 $165.00 $114.48 $122.41 $120.64 2026-03-05
Q5104 HCPCS Infliximab-abda For IV Inj 100 Mg 6 3 $1,798.96 $1,798.96 $112.04 $121.93 $119.67 2026-03-05
73000 CPT Hc Clavicle Complete 2 1 $158.00 $158.00 $118.35 $118.35 $118.35 2026-03-05
73590 CPT Hc Tibia Fibula 2 View 6 3 $162.00 $162.00 $116.54 $121.36 $118.33 2026-03-05
72220 CPT Hc Sacrun Coccyx Min 2 Views 8 4 $165.00 $165.00 $114.48 $120.64 $118.20 2026-03-05
J9144 HCPCS Daratumumab-hyaluronidase-fihj Inj 1800-30000 Mg-unit/15ml 2 1 $27,411.41 $27,411.41 $117.02 $117.02 $117.02 2026-03-05
73080 CPT Hc Elbow Min 3 Views 4 2 $158.00 $158.00 $115.26 $118.35 $116.81 2026-03-05
J0129 HCPCS Abatacept For IV Soln 250 Mg 2 1 $4,117.07 $4,117.07 $116.21 $116.21 $116.21 2026-03-05
70030 CPT Hc Orbit Xray For Foreign Body 2 1 $159.00 $159.00 $116.03 $116.03 $116.03 2026-03-05
87305 CPT Um Aspergillus Ag 2 1 $163.00 $163.00 $115.77 $115.77 $115.77 2026-03-05
73120 CPT Hc Hand 2 Views 2 1 $158.00 $158.00 $115.26 $115.26 $115.26 2026-03-05
73030 CPT Hc Shoulder Min 2 Views 14 7 $158.00 $158.00 $111.00 $123.19 $115.26 2026-03-05
A4222 HCPCS Parenteral Therapy Supplies - Misc 2 1 $159.60 $159.60 $114.82 $114.82 $114.82 2026-03-05
G0279 HCPCS Hc Tomo Mammo Diagn Add-on 16 8 $157.00 $157.00 $87.78 $117.60 $114.25 2026-03-05
83498 CPT Um Hydroxyprogesterone, 17-d 2 1 $159.00 $159.00 $113.30 $113.30 $113.30 2026-03-05
G0481 HCPCS Um Definitive Drug Id 8 4 $156.00 $156.00 $105.88 $115.39 $112.00 2026-03-05
84207 CPT Um Vitamin B6/pyridoxal Phos 2 1 $304.00 $304.00 $111.98 $111.98 $111.98 2026-03-05
77063 CPT Hc Tomo Screening Bilat Add-on 16 8 $157.00 $157.00 $50.43 $115.92 $111.47 2026-03-05
96401 CPT Hc Chemo Nonhorm Antineopl,sq/im 2 1 $145.00 $145.00 $111.42 $111.42 $111.42 2026-03-05
A4461 HCPCS Um Tray Picc Line Dressing 2 1 $148.50 $148.50 $111.33 $111.33 $111.33 2026-03-05
86334 CPT Um Immunoe-phoresis, Serum 4 2 $155.00 $155.00 $110.12 $112.37 $111.25 2026-03-05
Q9957 HCPCS Perflutren Lipid Microsphere IV Susp 6.52 Mg/ml 12 6 $287.50 $287.50 $103.42 $143.75 $110.46 2026-03-05
73090 CPT Hc Forearm 2 Views 6 3 $150.00 $150.00 $107.91 $112.36 $109.11 2026-03-05
S8999 HCPCS Um Rususcitator Pulmanex 2 1 $145.27 $145.27 $108.83 $108.83 $108.83 2026-03-05
96415 CPT Hc Chemo,iv Infusion,addl Hr 2 1 $145.00 $145.00 $108.62 $108.62 $108.62 2026-03-05
96402 CPT Hc Chemo Hormon Antineopl Sc IM 4 2 $145.00 $145.00 $104.31 $111.42 $107.87 2026-03-05
86812 CPT Um Hla-b27 Antigen 2 1 $151.00 $151.00 $107.64 $107.64 $107.64 2026-03-05
96367 CPT Hc Ther/prop/dg Addl Seq IV Inf 12 6 $140.00 $140.00 $104.88 $140.00 $107.58 2026-03-05
96372 CPT Hc Ther/proph/diag Inj,sc/im 14 7 $140.00 $140.00 $100.72 $140.00 $107.58 2026-03-05
83001 CPT Um Folicle Stim Hormone, Fsh 4 2 $130.00 $130.00 $92.13 $123.00 $107.56 2026-03-05
74018 CPT Hc Xray Abdomen 1 View 10 5 $146.00 $146.00 $104.21 $108.68 $106.81 2026-03-05
83002 CPT Um Luteinizing Hormone (lh) 4 2 $129.00 $129.00 $91.39 $122.00 $106.69 2026-03-05
J1569 HCPCS Immune Globulin (Human) IV Or Subcutaneous Soln 5 Gm/50ml 2 1 $5,182.93 $5,182.93 $106.43 $106.43 $106.43 2026-03-05
83010 CPT Um Haptoglobin, Quantitative 4 2 $147.00 $147.00 $104.87 $107.02 $105.94 2026-03-05
73620 CPT Hc Foot 2 Views 2 1 $146.00 $146.00 $105.03 $105.03 $105.03 2026-03-05
Q5119 HCPCS Rituximab-pvvr IV Soln 500 Mg/50ml (10 Mg/ml) 2 1 $7,014.40 $7,014.40 $104.63 $104.63 $104.63 2026-03-05
88112 CPT Um Cytopathology,tl,non-GYN 4 2 $150.00 $150.00 $102.15 $106.38 $104.27 2026-03-05
84144 CPT Um Progesterone 2 1 $145.00 $145.00 $103.46 $103.46 $103.46 2026-03-05
76820 CPT Chg Doppler Velocimetry Fetal Umbilical Artery 2 1 $66.80 $66.80 $102.32 $102.32 $102.32 2026-03-05
73070 CPT Hc Elbow 2 Views 6 3 $143.00 $143.00 $99.61 $105.41 $101.96 2026-03-05
Q5103 HCPCS Infliximab-dyyb For IV Inj 100 Mg 2 1 $1,369.85 $1,369.85 $101.28 $101.28 $101.28 2026-03-05
88142 CPT Um Pap Smear - Thin Layer 2 1 $141.00 $141.00 $100.45 $100.45 $100.45 2026-03-05
G0123 HCPCS Um Screening Pap Thin Layer 8 4 $141.00 $141.00 $97.18 $122.61 $100.41 2026-03-05
97535 CPT Hc Self-care/hm Mgmt Tx 15min 6 3 $140.00 $140.00 $95.68 $102.20 $99.63 2026-03-05
86850 CPT Um Antibody Screening 18 8 $137.00 $137.00 $94.28 $130.00 $99.37 2026-03-05
86618 CPT Um Lyme Disease Ab, Wb Conf 4 2 $119.00 $119.00 $84.64 $113.00 $98.82 2026-03-05
J1568 HCPCS Immune Globulin (Human) IV Soln 10 Gm/200ml 2 1 $2,359.46 $2,359.46 $97.49 $97.49 $97.49 2026-03-05
87798 CPT Um Amp Probe, Each Organism 4 2 $202.00 $202.00 $48.69 $145.55 $97.12 2026-03-05
84146 CPT Um Prolactin 8 4 $135.00 $135.00 $91.57 $128.00 $96.86 2026-03-05
84466 CPT Um Tranferrin 2 1 $75.00 $75.00 $96.70 $96.70 $96.70 2026-03-05
97542 CPT Hc Wheelchair Mgmt/prop 15 Min 4 2 $132.00 $132.00 $96.05 $96.05 $96.05 2026-03-05
0077U OTHER Um M-protein Isotype Maldi 6 3 $135.00 $135.00 $75.27 $97.84 $95.88 2026-03-05
84270 CPT Um Sex Hormone Binding Globulin 2 1 $133.00 $133.00 $94.37 $94.37 $94.37 2026-03-05
J9041 HCPCS Bortezomib For Inj 3.5 Mg 2 1 $128.50 $128.50 $93.67 $93.67 $93.67 2026-03-05
82378 CPT Um Cea 6 3 $132.00 $132.00 $89.42 $95.55 $93.63 2026-03-05
86021 CPT Um Mpo (myeloperoxidase) 2 1 $132.00 $132.00 $93.63 $93.63 $93.63 2026-03-05
J9271 HCPCS Pembrolizumab IV Soln 100 Mg/4ml (25 Mg/ml) 4 2 $12,516.52 $12,516.52 $91.04 $95.82 $93.43 2026-03-05
86337 CPT Um Insulin Autoantibodies 2 1 $131.00 $131.00 $92.99 $92.99 $92.99 2026-03-05
86008 CPT Um Allergen Specific Ige Recombined, Each 2 1 $125.00 $125.00 $92.78 $92.78 $92.78 2026-03-05
82627 CPT Um Dehydroepiandosterone 2 1 $131.00 $131.00 $92.74 $92.74 $92.74 2026-03-05
84153 CPT Um Psa 14 7 $128.00 $128.00 $86.56 $121.00 $92.49 2026-03-05
Q5121 HCPCS Infliximab-axxq For IV Inj 100 Mg 2 1 $1,091.81 $1,091.81 $90.74 $90.74 $90.74 2026-03-05
G0103 HCPCS Um Psa Screening 14 7 $128.00 $128.00 $86.56 $121.00 $90.71 2026-03-05
G2025 HCPCS Pr Dis Site Tele Svcs Rhc/fqhc 2 1 $97.00 $97.00 $90.53 $90.53 $90.53 2026-03-05
80306 CPT Um Urine Drug Screen (uds) 12 6 $107.00 $107.00 $72.26 $153.64 $89.88 2026-03-05
83520 CPT Um Immunoassay, Unspec 6 3 $76.00 $76.00 $73.97 $95.51 $89.42 2026-03-05
84166 CPT Um Protein E-phoresis, Urine 6 3 $124.00 $124.00 $69.38 $204.14 $88.39 2026-03-05
83655 CPT Um Lead 2 1 $124.00 $124.00 $88.39 $88.39 $88.39 2026-03-05
73020 CPT Hc Shoulder 1 View 14 7 $121.00 $121.00 $83.86 $121.00 $88.37 2026-03-05
84702 CPT Um Hcg, Quantitative 4 2 $105.00 $105.00 $74.97 $100.00 $87.48 2026-03-05
86762 CPT Um Rubella, Acute Phase, Igm 6 3 $85.00 $85.00 $71.16 $95.00 $86.93 2026-03-05
86301 CPT Um Immunoassay Tumor Ca 19-9 2 1 $122.00 $122.00 $86.90 $86.90 $86.90 2026-03-05
86300 CPT Um Breast Cancer Antigen 27.29 2 1 $122.00 $122.00 $86.82 $86.82 $86.82 2026-03-05
82105 CPT Um Alpha-fetoprotein; Serum 6 3 $117.00 $117.00 $83.21 $111.00 $86.54 2026-03-05
86341 CPT Um Glutamic Acid Autoantibody 2 1 $121.00 $121.00 $85.93 $85.93 $85.93 2026-03-05
86304 CPT Um Ca-125 4 2 $122.00 $122.00 $82.92 $86.90 $84.91 2026-03-05
84443 CPT Um Tsh 20 10 $117.00 $117.00 $65.27 $111.00 $84.85 2026-03-05
84481 CPT Um T3 Free 8 4 $118.00 $118.00 $83.89 $87.33 $84.78 2026-03-05
94668 CPT Hc Chest Physiotherapy,subsequent 2 1 $122.00 $122.00 $84.70 $84.70 $84.70 2026-03-05
85549 CPT Um Lysozyme (muramidase)seru 2 1 $117.00 $117.00 $84.49 $84.49 $84.49 2026-03-05
90653 CPT Pr Iiv Adjuvanted Vaccine For Intramuscular Use 10 5 $85.00 $85.00 $81.82 $83.30 $83.30 2026-03-05
E0114 HCPCS Um Crutches Adj Aluminum 2 1 $83.27 $83.27 $83.27 $83.27 $83.27 2026-03-05
82533 CPT Um Cortisol, Total 8 4 $114.00 $114.00 $80.90 $108.00 $82.56 2026-03-05
82232 CPT Um Beta-2 Microglobulin 2 1 $113.00 $113.00 $81.79 $81.79 $81.79 2026-03-05
80159 CPT Um Clozapine 2 1 $110.00 $110.00 $81.46 $81.46 $81.46 2026-03-05
84432 CPT Um Thyroglobulin 6 3 $112.00 $112.00 $79.41 $83.49 $81.03 2026-03-05
97140 CPT Hc Manual Therapy 15min 2 1 $114.00 $114.00 $80.90 $80.90 $80.90 2026-03-05
J0561 HCPCS Pr Penicillin G Benzathine Inj, 100,000 Units 2 1 $38.00 $38.00 $80.89 $80.89 $80.89 2026-03-05
86317 CPT Um Hep B Surface Ab, Quant. 8 4 $104.00 $104.00 $74.17 $99.00 $79.42 2026-03-05
87116 CPT Um Culture, Mycobacteria 2 1 $32.00 $32.00 $78.69 $78.69 $78.69 2026-03-05
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