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

SOUTH CENTRAL HEALTH

Wishek, ND · CCN 351321 · Rates published

1,349 distinct procedures filed
12 distinct payers
22,010 rate rows
2026-09-14 last MRF observed
Data quality

8,869 of 22,010 rate rows are consumer-grade (40.3%)

13,141 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 13,126
per-diem day rate — not a per-procedure price 8
exceeds 10× this hospital's gross charge — excluded from medians 7
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/PRXC-1787598939915/machine-readable/450358986_south-central-health_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/south-central-health-nd
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-25
Content fingerprint 3852eb5a86c8ae5f… · 1,990,955 bytes · first seen 2026-09-21

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
p00155
CDM 		Leuprolide 45 Mg/6 Months Kit [Wish] 6 $32,099.00 $45,856.00 $35,309.00 nat. median
$35,309
1.0× median
P00740
CDM 		Alteplase 100 Mg IV Inj[wish] 6 $10,350.00 $14,785.00 $11,384.50 nat. median
$11,384
1.0× median
P00133
CDM 		Tenecteplase 50 Mg Pow [Wish] 6 $10,051.00 $14,358.00 $11,056.00 nat. median
$11,056
1.0× median
P00793
CDM 		Immune Globulin Intravenous 10% Sol [Wish] 6 $9,297.00 $13,281.00 $10,226.50 nat. median
$10,226
1.0× median
37191
CPT 		37191 Insertion Of Intravascular Vena Cava Filter, Endovascular Approach Includi… 6 $9,100.00 $13,000.00 $10,010.00 nat. median
$5,831
1.7× median
P00155
CDM 		Leuprolide 22.5 Mg/3 Months Kit [Wish] 6 $7,951.00 $11,359.00 $8,746.50 nat. median
$8,746
1.0× median
p00714
CDM 		Immune Globulin Intravenous And Subcutaneous 10% Sol [Wish] 6 $6,376.00 $9,109.00 $7,014.00 nat. median
$7,014
1.0× median
P00804
CDM 		Mepolizumab 100 Mg Pow[wish] 6 $4,322.00 $6,174.00 $4,754.00 nat. median
$4,754
1.0× median
P00714
CDM 		Immune Globulin Intravenous And Subcutaneous 10% Sol 6 $4,251.00 $6,073.00 $4,676.50 nat. median
$4,676
1.0× median
P00731
CDM 		Denosumab 120 Mg/1.7 Ml[wish] 6 $4,179.00 $5,970.00 $4,597.00 nat. median
$4,597
1.0× median
73220
CPT 		MRI Forearm With + Without Contrast Bilat 6 $2,488.00 $7,107.00 $4,264.50 nat. median
$737
outlier · 5.8×
73720
CPT 		MRI Femur With + Without Contrast Bilat 6 $2,379.00 $6,797.00 $4,078.50 nat. median
$754
outlier · 5.4×
73223
CPT 		MRI Elbow With + Without Contrast Bilat 6 $2,344.00 $6,697.00 $4,018.50 nat. median
$757
outlier · 5.3×
73723
CPT 		MRI Ankle With + Without Contrast Left 6 $2,329.00 $6,654.00 $3,992.50 nat. median
$756
outlier · 5.3×
73706
CPT 		CT Angio Lower Extremity Bilateral 6 $2,336.00 $6,468.00 $3,932.50 nat. median
$416
outlier · 9.4×
P00905
CDM 		Denosumab Kyqq 120 Mg/1.7 Ml Sol 6 $3,528.00 $5,040.00 $3,881.00 nat. median
$3,881
1.0× median
73219
CPT 		MRI Forearm With Contrast Bilat 6 $2,194.00 $6,269.00 $3,761.00 nat. median
$622
outlier · 6.0×
P00751
CDM 		Leuprolide Acetate 45 Mg/6 Months Pow 6 $3,188.00 $4,554.00 $3,507.00 nat. median
$3,507
1.0× median
40812
CPT 		40812 Excision Of Lesion Of Mucosa And Submucosa, Vestibule Of Mouth; With Simpl… 6 $3,119.00 $4,456.00 $3,431.00 nat. median
$1,766
1.9× median
11426
CPT 		11426 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed… 6 $3,011.00 $4,301.00 $3,312.00 nat. median
$2,896
1.1× median
11646
CPT 		11646 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 6 $3,011.00 $4,301.00 $3,312.00 nat. median
$2,549
1.3× median
73719
CPT 		MRI Femur With Contrast Bilat 6 $1,918.00 $5,480.00 $3,288.00 nat. median
$575
outlier · 5.7×
73218
CPT 		MRI Forearm Without Contrast Bilat 6 $1,900.00 $5,429.00 $3,257.50 nat. median
$553
outlier · 5.9×
73222
CPT 		MRI Elbow With Contrast Bilat 6 $1,889.00 $5,395.00 $3,237.00 nat. median
$1,026
outlier · 3.2×
73206
CPT 		CT Angio Upper Extremity Bilateral 6 $1,856.00 $5,305.00 $3,182.50 nat. median
$340
outlier · 9.4×
73722
CPT 		MRI Hip With Contrast Bilat 6 $1,846.00 $5,274.00 $3,164.50 nat. median
$1,003
outlier · 3.2×
73718
CPT 		MRI Femur Without Contrast Bilat 6 $1,786.00 $5,103.00 $3,061.50 nat. median
$505
outlier · 6.1×
70546
CPT 		MRA Brain/head With + Without Contrast 6 $2,491.00 $3,558.00 $2,740.00 nat. median
$625
outlier · 4.4×
70549
CPT 		MRA Neck With + Without Contrast 6 $2,440.00 $3,486.00 $2,684.50 nat. median
$606
outlier · 4.4×
74183
CPT 		MRI Abdomen With + Without Contrast 6 $2,426.00 $3,466.00 $2,669.00 nat. median
$611
outlier · 4.4×
72197
CPT 		Add On MRI Pelvis With + Without Contrast 6 $2,361.00 $3,373.00 $2,597.50 nat. median
$606
outlier · 4.3×
73202
CPT 		CT Shoulder With + Without Contrast Bilat 6 $1,502.00 $4,291.00 $2,574.50 nat. median
$399
outlier · 6.5×
73702
CPT 		CT Ankle With + Without Contrast Bilat 6 $1,476.00 $4,220.00 $2,531.00 nat. median
$369
outlier · 6.9×
71552
CPT 		MRI Chest With + Without Contrast 6 $2,272.00 $3,245.00 $2,499.00 nat. median
$691
outlier · 3.6×
70545
CPT 		MRA Brain/head With Contrast 6 $2,238.00 $3,197.00 $2,462.00 nat. median
$524
outlier · 4.7×
43251
CPT 		43251 Esophagogastroduodenoscopy, Flexible, Transoral; With Removal Of Tumor(s),… 6 $2,212.00 $3,160.00 $2,433.00 nat. median
$2,031
1.2× median
P00692
CDM 		Denosumab 60 Mg/ml Sdv[wish] 6 $2,206.00 $3,151.00 $2,426.00 nat. median
$2,426
1.0× median
75635
CPT 		CT Angio Abdominal Aorta With Runoff 6 $2,199.00 $3,142.00 $2,419.50 nat. median
$355
outlier · 6.8×
70548
CPT 		MRA Neck With Contrast 6 $2,188.00 $3,125.00 $2,406.50 nat. median
$544
outlier · 4.4×
70543
CPT 		MRI Face Neck Orbit With + Without Contrast 6 $2,181.00 $3,116.00 $2,399.50 nat. median
$605
outlier · 4.0×
P00900
CDM 		Denosumab Bnht 60 Mg/ml Sol 6 $2,140.00 $3,057.00 $2,354.00 nat. median
$2,354
1.0× median
74174
CPT 		CT Angio Abdomen And Pelvis 6 $2,133.00 $3,047.00 $2,346.00 nat. median
$549
outlier · 4.3×
72196
CPT 		Add On MRI Pelvis With Contrast 6 $2,106.00 $3,009.00 $2,317.00 nat. median
$562
outlier · 4.1×
P00901
CDM 		Denosumab Bmwo 60 Mg/ml Sol[wish] 6 $2,096.00 $2,994.00 $2,305.50 nat. median
$2,306
1.0× median
71551
CPT 		MRI Chest With Contrast 6 $2,091.00 $2,987.00 $2,300.00 nat. median
$921
outlier · 2.5×
70544
CPT 		MRA Brain/head Without Contrast 6 $2,058.00 $2,940.00 $2,264.00 nat. median
$435
outlier · 5.2×
70547
CPT 		MRA Neck Without Contrast 6 $2,037.00 $2,910.00 $2,241.00 nat. median
$402
outlier · 5.6×
74182
CPT 		MRI Abdomen And Pelvis With Contrast 6 $2,024.00 $2,891.00 $2,226.00 nat. median
$580
outlier · 3.8×
73721
CPT 		MRI Scan Of Leg Joint 6 $1,262.00 $3,554.00 $2,145.50 nat. median
$509
outlier · 4.2×
71550
CPT 		MRI Chest Without Contrast 6 $1,947.00 $2,781.00 $2,141.50 nat. median
$476
outlier · 4.5×

Other procedures at this hospital

Browse this hospital's 1,349 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
             
p00155 CDM Leuprolide 45 Mg/6 Months Kit [Wish] 6 6 $45,856.00 $41,270.00 $32,099.00 $45,856.00 $35,309.00 2026-09-14
P00740 CDM Alteplase 100 Mg IV Inj[wish] 6 6 $14,785.00 $13,307.00 $10,350.00 $14,785.00 $11,384.50 2026-09-14
P00133 CDM Tenecteplase 50 Mg Pow [Wish] 6 6 $14,358.00 $12,922.00 $10,051.00 $14,358.00 $11,056.00 2026-09-14
P00793 CDM Immune Globulin Intravenous 10% Sol [Wish] 6 6 $13,281.00 $11,953.00 $9,297.00 $13,281.00 $10,226.50 2026-09-14
37191 CPT 37191 Insertion Of Intravascular Vena Cava Filter, Endovascular Approach Includi… 6 6 $13,000.00 $11,700.00 $9,100.00 $13,000.00 $10,010.00 2026-09-14
P00155 CDM Leuprolide 22.5 Mg/3 Months Kit [Wish] 6 6 $11,359.00 $10,223.00 $7,951.00 $11,359.00 $8,746.50 2026-09-14
p00714 CDM Immune Globulin Intravenous And Subcutaneous 10% Sol [Wish] 6 6 $9,109.00 $8,198.00 $6,376.00 $9,109.00 $7,014.00 2026-09-14
P00804 CDM Mepolizumab 100 Mg Pow[wish] 6 6 $6,174.00 $5,557.00 $4,322.00 $6,174.00 $4,754.00 2026-09-14
P00714 CDM Immune Globulin Intravenous And Subcutaneous 10% Sol 6 6 $6,073.00 $5,466.00 $4,251.00 $6,073.00 $4,676.50 2026-09-14
P00731 CDM Denosumab 120 Mg/1.7 Ml[wish] 6 6 $5,970.00 $5,373.00 $4,179.00 $5,970.00 $4,597.00 2026-09-14
73220 CPT MRI Forearm With + Without Contrast Bilat 12 6 $5,330.50 $4,797.50 $2,488.00 $7,107.00 $4,264.50 2026-09-14
73720 CPT MRI Femur With + Without Contrast Bilat 12 6 $5,098.00 $4,588.00 $2,379.00 $6,797.00 $4,078.50 2026-09-14
P00905 CDM Denosumab Kyqq 120 Mg/1.7 Ml Sol 6 6 $5,040.00 $4,536.00 $3,528.00 $5,040.00 $3,881.00 2026-09-14
73223 CPT MRI Elbow With + Without Contrast Bilat 12 6 $5,023.00 $4,520.50 $2,344.00 $6,697.00 $4,018.50 2026-09-14
73723 CPT MRI Ankle With + Without Contrast Left 12 6 $4,990.50 $4,491.50 $2,329.00 $6,654.00 $3,992.50 2026-09-14
73706 CPT CT Angio Lower Extremity Bilateral 12 6 $4,902.50 $4,412.00 $2,336.00 $6,468.00 $3,932.50 2026-09-14
73219 CPT MRI Forearm With Contrast Bilat 12 6 $4,701.50 $4,231.50 $2,194.00 $6,269.00 $3,761.00 2026-09-14
P00751 CDM Leuprolide Acetate 45 Mg/6 Months Pow 6 6 $4,554.00 $4,099.00 $3,188.00 $4,554.00 $3,507.00 2026-09-14
40812 CPT 40812 Excision Of Lesion Of Mucosa And Submucosa, Vestibule Of Mouth; With Simpl… 6 6 $4,456.00 $4,010.00 $3,119.00 $4,456.00 $3,431.00 2026-09-14
11646 CPT 11646 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 6 6 $4,301.00 $3,871.00 $3,011.00 $4,301.00 $3,312.00 2026-09-14
11426 CPT 11426 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $4,301.00 $3,871.00 $3,011.00 $4,301.00 $3,312.00 2026-09-14
73719 CPT MRI Femur With Contrast Bilat 12 6 $4,110.00 $3,699.00 $1,918.00 $5,480.00 $3,288.00 2026-09-14
73218 CPT MRI Forearm Without Contrast Bilat 12 6 $4,072.00 $3,665.00 $1,900.00 $5,429.00 $3,257.50 2026-09-14
73222 CPT MRI Elbow With Contrast Bilat 12 6 $4,046.50 $3,642.00 $1,889.00 $5,395.00 $3,237.00 2026-09-14
73206 CPT CT Angio Upper Extremity Bilateral 12 6 $3,978.50 $3,581.00 $1,856.00 $5,305.00 $3,182.50 2026-09-14
73722 CPT MRI Hip With Contrast Bilat 12 6 $3,955.50 $3,560.00 $1,846.00 $5,274.00 $3,164.50 2026-09-14
73718 CPT MRI Femur Without Contrast Bilat 12 6 $3,827.00 $3,444.50 $1,786.00 $5,103.00 $3,061.50 2026-09-14
70546 CPT MRA Brain/head With + Without Contrast 6 6 $3,558.00 $3,202.00 $2,491.00 $3,558.00 $2,740.00 2026-09-14
70549 CPT MRA Neck With + Without Contrast 6 6 $3,486.00 $3,137.00 $2,440.00 $3,486.00 $2,684.50 2026-09-14
74183 CPT MRI Abdomen With + Without Contrast 6 6 $3,466.00 $3,119.00 $2,426.00 $3,466.00 $2,669.00 2026-09-14
72197 CPT Add On MRI Pelvis With + Without Contrast 6 6 $3,373.00 $3,036.00 $2,361.00 $3,373.00 $2,597.50 2026-09-14
71552 CPT MRI Chest With + Without Contrast 6 6 $3,245.00 $2,921.00 $2,272.00 $3,245.00 $2,499.00 2026-09-14
73202 CPT CT Shoulder With + Without Contrast Bilat 12 6 $3,218.00 $2,896.50 $1,502.00 $4,291.00 $2,574.50 2026-09-14
70545 CPT MRA Brain/head With Contrast 6 6 $3,197.00 $2,877.00 $2,238.00 $3,197.00 $2,462.00 2026-09-14
73702 CPT CT Ankle With + Without Contrast Bilat 12 6 $3,164.00 $2,847.50 $1,476.00 $4,220.00 $2,531.00 2026-09-14
43251 CPT 43251 Esophagogastroduodenoscopy, Flexible, Transoral; With Removal Of Tumor(s),… 6 6 $3,160.00 $2,844.00 $2,212.00 $3,160.00 $2,433.00 2026-09-14
P00692 CDM Denosumab 60 Mg/ml Sdv[wish] 6 6 $3,151.00 $2,836.00 $2,206.00 $3,151.00 $2,426.00 2026-09-14
75635 CPT CT Angio Abdominal Aorta With Runoff 6 6 $3,142.00 $2,828.00 $2,199.00 $3,142.00 $2,419.50 2026-09-14
70548 CPT MRA Neck With Contrast 6 6 $3,125.00 $2,813.00 $2,188.00 $3,125.00 $2,406.50 2026-09-14
70543 CPT MRI Face Neck Orbit With + Without Contrast 6 6 $3,116.00 $2,804.00 $2,181.00 $3,116.00 $2,399.50 2026-09-14
P00900 CDM Denosumab Bnht 60 Mg/ml Sol 6 6 $3,057.00 $2,751.00 $2,140.00 $3,057.00 $2,354.00 2026-09-14
74174 CPT CT Angio Abdomen And Pelvis 6 6 $3,047.00 $2,742.00 $2,133.00 $3,047.00 $2,346.00 2026-09-14
72196 CPT Add On MRI Pelvis With Contrast 6 6 $3,009.00 $2,708.00 $2,106.00 $3,009.00 $2,317.00 2026-09-14
P00901 CDM Denosumab Bmwo 60 Mg/ml Sol[wish] 6 6 $2,994.00 $2,695.00 $2,096.00 $2,994.00 $2,305.50 2026-09-14
71551 CPT MRI Chest With Contrast 6 6 $2,987.00 $2,688.00 $2,091.00 $2,987.00 $2,300.00 2026-09-14
70544 CPT MRA Brain/head Without Contrast 6 6 $2,940.00 $2,646.00 $2,058.00 $2,940.00 $2,264.00 2026-09-14
70547 CPT MRA Neck Without Contrast 6 6 $2,910.00 $2,619.00 $2,037.00 $2,910.00 $2,241.00 2026-09-14
74182 CPT MRI Abdomen And Pelvis With Contrast 6 6 $2,891.00 $2,602.00 $2,024.00 $2,891.00 $2,226.00 2026-09-14
70553 CPT MRI Scan 6 6 $2,781.00 $2,503.00 $1,947.00 $2,781.00 $2,141.50 2026-09-14
72158 CPT MRI Spine Lumbar With + Without Contrast 6 6 $2,781.00 $2,503.00 $1,947.00 $2,781.00 $2,141.50 2026-09-14
71550 CPT MRI Chest Without Contrast 6 6 $2,781.00 $2,503.00 $1,947.00 $2,781.00 $2,141.50 2026-09-14
70542 CPT MRI Face Neck Orbit With Contrast 6 6 $2,738.00 $2,464.00 $1,917.00 $2,738.00 $2,108.50 2026-09-14
P00890 CDM Abatacept 250 Mg Pow[wish] 6 6 $2,696.00 $2,426.00 $1,887.00 $2,696.00 $2,076.00 2026-09-14
73721 CPT MRI Scan Of Leg Joint 12 6 $2,678.50 $2,411.00 $1,262.00 $3,554.00 $2,145.50 2026-09-14
72157 CPT MRI Spine Thoracic With + Without Contrast 6 6 $2,678.00 $2,410.00 $1,875.00 $2,678.00 $2,062.50 2026-09-14
74178 CPT CT Abdomen And Pelvis With + Without Contrast 6 6 $2,669.00 $2,402.00 $1,868.00 $2,669.00 $2,055.50 2026-09-14
24200 CPT 24200-upper Arm/elbow Subcutaneous 6 6 $2,661.00 $2,395.00 $1,863.00 $2,661.00 $2,049.00 2026-09-14
87633 CPT Respiratory Panel By Pcr Npl 6 6 $2,652.00 $2,387.00 $1,856.00 $2,652.00 $2,042.00 2026-09-14
72195 CPT MRI Pelvis Without Contrast 6 6 $2,645.00 $2,381.00 $1,851.00 $2,645.00 $2,037.00 2026-09-14
73221 CPT MRI Elbow Without Contrast Bilat 12 6 $2,626.50 $2,364.00 $1,226.00 $3,502.00 $2,101.00 2026-09-14
P00838 CDM Omalizumab 150 Mg/ml Sol [Wish] 6 6 $2,611.00 $2,350.00 $1,828.00 $2,611.00 $2,010.50 2026-09-14
72156 CPT MRI Spine Cervical With + Without Contrast 6 6 $2,601.00 $2,341.00 $1,821.00 $2,601.00 $2,003.00 2026-09-14
11443 CPT 11443 Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless L… 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11643 CPT 11643 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11606 CPT 11606 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excise… 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11404 CPT 11404 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11422 CPT 11422 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11424 CPT 11424 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11423 CPT 11423 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11420 CPT 11420 Excision, Benign, Lesion Including Margins; Scalp, Nexk, Hands, Feet, Geni… 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11406 CPT 11406 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11644 CPT 11644 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
10140 CPT 10140 I D Of Hematoma Seroma Or Fluidcollect Charge 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
11623 CPT 11623 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge… 6 6 $2,528.00 $2,275.00 $1,770.00 $2,528.00 $1,946.50 2026-09-14
36556 CPT 36556 Insertion Of Non-tunneled Centrally Inserted Central Venous Catheter; Age … 6 6 $2,500.00 $2,250.00 $1,750.00 $2,500.00 $1,925.00 2026-09-14
73701 CPT CT Ankle With Contrast Bilat 12 6 $2,496.00 $2,246.50 $1,165.00 $3,328.00 $1,997.00 2026-09-14
A0433 HCPCS Als Level 2, Emergency Or Non-emergency 6 6 $2,405.00 $2,165.00 $1,684.00 $2,405.00 $1,852.00 2026-09-14
72198 CPT MRA Pelvis With + Without Contrast 6 6 $2,403.00 $2,163.00 $1,682.00 $2,403.00 $1,850.00 2026-09-14
73201 CPT CT Shoulder With Contrast Bilat 12 6 $2,401.00 $2,161.00 $1,121.00 $3,201.00 $1,921.00 2026-09-14
71555 CPT MRA Chest With + Without Contrast 6 6 $2,398.00 $2,158.00 $1,679.00 $2,398.00 $1,846.50 2026-09-14
74185 CPT MRA Abdomen With + Without Contrast 6 6 $2,397.00 $2,157.00 $1,678.00 $2,397.00 $1,846.00 2026-09-14
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 6 6 $2,343.00 $2,109.00 $1,640.00 $2,343.00 $1,804.00 2026-09-14
70552 CPT MRI Brain With Contrast 6 6 $2,324.00 $2,092.00 $1,627.00 $2,324.00 $1,789.50 2026-09-14
74181 CPT MRI Abdomen And Pelvis Without Contrast 6 6 $2,318.00 $2,086.00 $1,623.00 $2,318.00 $1,785.00 2026-09-14
P00607 CDM Hylan G-f 20 48 Mg/6 Ml Sol 6 6 $2,301.00 $2,071.00 $1,611.00 $2,301.00 $1,772.00 2026-09-14
70540 CPT MRI Face Neck Orbit Without Contrast 6 6 $2,279.00 $2,051.00 $1,595.00 $2,279.00 $1,754.50 2026-09-14
70482 CPT CT Orbit Sella Etc. Or Iac With + Without Cont 6 6 $2,278.00 $2,050.00 $1,595.00 $2,278.00 $1,754.50 2026-09-14
78452 CPT Nm Myocardial Spect Multiple Studies 6 6 $2,266.00 $2,039.00 $1,586.00 $2,266.00 $1,745.00 2026-09-14
95811 CPT Polysomnography95811 6 6 $2,243.00 $2,019.00 $1,570.00 $2,243.00 $1,727.00 2026-09-14
70498 CPT CT Angio Neck 6 6 $2,240.00 $2,016.00 $1,568.00 $2,240.00 $1,725.00 2026-09-14
P00879 CDM Romosozumab 105 Mg/1.17 Ml Sol[wish] 6 6 $2,209.00 $1,988.00 $1,546.00 $2,209.00 $1,701.00 2026-09-14
71275 CPT CT Angio Chest Pe Protocol 6 6 $2,148.00 $1,933.00 $1,504.00 $2,148.00 $1,654.00 2026-09-14
78227 CPT Nm Hepatobiliary Imaging With Drug 6 6 $2,143.00 $1,929.00 $1,500.00 $2,143.00 $1,650.00 2026-09-14
P00903 CDM Etonogestrel 68 Mg Imp [Wish] 6 6 $2,143.00 $1,929.00 $1,500.00 $2,143.00 $1,650.00 2026-09-14
74170 CPT CT Abdomen With + Without Contrast 6 6 $2,137.00 $1,923.00 $1,496.00 $2,137.00 $1,645.50 2026-09-14
70496 CPT CT Angio Brain/head 6 6 $2,093.00 $1,884.00 $1,465.00 $2,093.00 $1,611.50 2026-09-14
71270 CPT CT Chest With + Without Contrast 6 6 $2,092.00 $1,883.00 $1,464.00 $2,092.00 $1,611.00 2026-09-14
95810 CPT Sleep Study 6 6 $2,077.00 $1,869.00 $1,454.00 $2,077.00 $1,599.50 2026-09-14
72127 CPT CT Spine Cervical With + Without Contrast 6 6 $2,037.00 $1,833.00 $1,426.00 $2,037.00 $1,568.50 2026-09-14
70481 CPT CT Orbit Sella Etc. Or Iac With Cont 6 6 $2,034.00 $1,831.00 $1,424.00 $2,034.00 $1,566.50 2026-09-14
72133 CPT CT Spine Lumbar With + Without Contrast 6 6 $2,027.00 $1,824.00 $1,419.00 $2,027.00 $1,560.50 2026-09-14
45385 CPT Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope 6 6 $2,016.00 $1,814.00 $1,411.00 $2,016.00 $1,552.50 2026-09-14
45380 CPT Biopsy Exam Of Large Bowel Using An Endoscope 6 6 $2,016.00 $1,814.00 $1,411.00 $2,016.00 $1,552.50 2026-09-14
45384 CPT 45384 Colonoscopy, Flexible; With Removal Of Tumor(s), Polyp(s), Or Other Lesion… 6 6 $2,016.00 $1,814.00 $1,411.00 $2,016.00 $1,552.50 2026-09-14
99291 CPT 99291critical Care, 30-74 6 6 $1,989.00 $1,790.00 $1,392.00 $1,989.00 $1,531.50 2026-09-14
P00076 CDM Infliximab 100 Mg IV Inj[wish] 6 6 $1,962.00 $1,766.00 $1,373.00 $1,962.00 $1,511.00 2026-09-14
73200 CPT CT Shoulder Without Contrast Bilat 12 6 $1,958.50 $1,762.50 $914.00 $2,611.00 $1,567.00 2026-09-14
73700 CPT CT Ankle Without Contrast Bilat 12 6 $1,929.50 $1,736.50 $900.00 $2,573.00 $1,543.50 2026-09-14
70492 CPT CT Neck Soft Tissue With + Without Contrast 6 6 $1,918.00 $1,726.00 $1,343.00 $1,918.00 $1,477.00 2026-09-14
72130 CPT CT Spine Thoracic With + Without Contrast 6 6 $1,863.00 $1,677.00 $1,304.00 $1,863.00 $1,434.50 2026-09-14
500083 CDM Room/bed: Critical Care 6 6 $1,850.00 $1,665.00 $1,295.00 $1,850.00 $1,425.00 2026-09-14
72193 CPT CT Scan Of Pelvis With Contrast 6 6 $1,833.00 $1,650.00 $1,283.00 $1,833.00 $1,411.50 2026-09-14
70551 CPT MRI Brain Without Contrast 6 6 $1,828.00 $1,645.00 $1,280.00 $1,828.00 $1,407.50 2026-09-14
74160 CPT CT Abdomen With Contrast 6 6 $1,827.00 $1,644.00 $1,279.00 $1,827.00 $1,406.50 2026-09-14
P00725 CDM Zoledronic Acid 5 Mg/100 Ml IV Sol[wish] 6 6 $1,821.00 $1,639.00 $1,275.00 $1,821.00 $1,402.50 2026-09-14
P00038 CDM Epoetin Alfa 40,000 Units/ml Preservative-free Sol [Wish] 6 6 $1,796.00 $1,616.00 $1,257.00 $1,796.00 $1,383.00 2026-09-14
72141 CPT MRI Spine Cervical Without Contrast 6 6 $1,725.00 $1,553.00 $1,208.00 $1,725.00 $1,328.50 2026-09-14
72146 CPT MRI Spine Thoracic Without Contrast 6 6 $1,700.00 $1,530.00 $1,190.00 $1,700.00 $1,309.00 2026-09-14
72126 CPT CT Spine Cervical With Contrast 6 6 $1,683.00 $1,515.00 $1,178.00 $1,683.00 $1,296.00 2026-09-14
70480 CPT CT Iac Without Contrast 6 6 $1,677.00 $1,509.00 $1,174.00 $1,677.00 $1,291.50 2026-09-14
72129 CPT CT Spine Thoracic With Contrast 6 6 $1,666.00 $1,499.00 $1,166.00 $1,666.00 $1,283.00 2026-09-14
A0427 HCPCS Als Level 1, Emergency 6 6 $1,661.00 $1,495.00 $1,163.00 $1,661.00 $1,279.00 2026-09-14
72132 CPT CT Spine Lumbar With Contrast 6 6 $1,656.00 $1,490.00 $1,159.00 $1,656.00 $1,275.00 2026-09-14
500082 CDM Room/bed: Isolation 6 6 $1,650.00 $1,485.00 $1,155.00 $1,650.00 $1,271.00 2026-09-14
72148 CPT MRI Scan Of Lower Spinal Canal 6 6 $1,612.00 $1,451.00 $1,128.00 $1,612.00 $1,241.00 2026-09-14
43239 CPT Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 6 6 $1,574.00 $1,417.00 $1,102.00 $1,574.00 $1,212.00 2026-09-14
43235 CPT Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 6 6 $1,574.00 $1,417.00 $1,102.00 $1,574.00 $1,212.00 2026-09-14
78315 CPT Nm Bone Three Phase Study 6 6 $1,570.00 $1,413.00 $1,099.00 $1,570.00 $1,209.00 2026-09-14
71260 CPT CT Chest/abd/pelvis With Contrast 6 6 $1,563.00 $1,407.00 $1,094.00 $1,563.00 $1,203.50 2026-09-14
70491 CPT CT Neck Soft Tissue With Contrast 6 6 $1,552.00 $1,397.00 $1,086.00 $1,552.00 $1,195.00 2026-09-14
46050 CPT 46050-i&d Perianal Abscess Superficial 6 6 $1,543.00 $1,389.00 $1,080.00 $1,543.00 $1,188.00 2026-09-14
45378 CPT Diagnostic Exam Of Large Bowel Using An Endoscope 6 6 $1,543.00 $1,389.00 $1,080.00 $1,543.00 $1,188.00 2026-09-14
70488 CPT CT Maxillofacial With + Without Contrast 6 6 $1,494.00 $1,345.00 $1,046.00 $1,494.00 $1,150.50 2026-09-14
32554 CPT 32554 Thoracentesis Without Imaging Guidance 6 6 $1,450.00 $1,305.00 $1,015.00 $1,450.00 $1,117.00 2026-09-14
87154 CPT Blood Culture Id By Pcr Npl 6 6 $1,448.00 $1,303.00 $1,014.00 $1,448.00 $1,115.00 2026-09-14
P00906 CDM Denosumab Nxxp 60 Mg/ml Sol [Wish] 6 6 $1,418.00 $1,276.00 $993.00 $1,418.00 $1,092.00 2026-09-14
A0429 HCPCS Bls, Emergency 6 6 $1,400.00 $1,260.00 $980.00 $1,400.00 $1,078.00 2026-09-14
62270 CPT 62270-lumbar Puncture Diagnostic 6 6 $1,368.00 $1,231.00 $958.00 $1,368.00 $1,053.50 2026-09-14
500081 CDM Room/bed: Semi-private 6 6 $1,350.00 $1,215.00 $945.00 $1,350.00 $1,040.00 2026-09-14
69000 CPT 69000-drainage External Ear Abscess/hematoma 6 6 $1,341.00 $1,207.00 $939.00 $1,341.00 $1,032.50 2026-09-14
36589 CPT 36589 Removal Of Tunneled Central Venous Catheter, Wo Subcutaneous Port Or Pump 6 6 $1,341.00 $1,207.00 $939.00 $1,341.00 $1,032.50 2026-09-14
72125 CPT CT Spine Cervical Without Contrast 6 6 $1,339.00 $1,205.00 $937.00 $1,339.00 $1,031.00 2026-09-14
70470 CPT CT Head With + Without Contrast 6 6 $1,329.00 $1,196.00 $930.00 $1,329.00 $1,023.50 2026-09-14
78306 CPT Nm Bone Imaging Whole Body 6 6 $1,303.00 $1,173.00 $912.00 $1,303.00 $1,003.00 2026-09-14
72128 CPT CT Spine Thoracic Without Contrast 6 6 $1,294.00 $1,165.00 $906.00 $1,294.00 $996.50 2026-09-14
72131 CPT CT Spine Lumbar Without Contrast 6 6 $1,286.00 $1,157.00 $900.00 $1,286.00 $990.50 2026-09-14
70487 CPT CT Maxillofacial With Contrast 6 6 $1,255.00 $1,130.00 $879.00 $1,255.00 $966.00 2026-09-14
500084 CDM Room/bed: Swing Bed 6 6 $1,250.00 $1,125.00 $875.00 $1,250.00 $963.00 2026-09-14
92950 CPT 92950-cardiopulmonary Resuscitation 6 6 $1,226.00 $1,103.00 $858.00 $1,226.00 $944.50 2026-09-14
71250 CPT CT Chest Without Contrast 6 6 $1,210.00 $1,089.00 $847.00 $1,210.00 $932.00 2026-09-14
70490 CPT CT Neck Soft Tissue Without Contrast 6 6 $1,204.00 $1,084.00 $843.00 $1,204.00 $927.00 2026-09-14
P00828 CDM Remdesivir 100 Mg Pow [Wish] 6 6 $1,191.00 $1,072.00 $834.00 $1,191.00 $917.00 2026-09-14
74176 CPT CT Abdomen And Pelvis Without Contrast 6 6 $1,185.00 $1,067.00 $830.00 $1,185.00 $912.50 2026-09-14
p00809 CDM Fluticasone/umeclidinium/vilanterol 200 Mcg-62.5 Mcg-25 Mcg/inh Pow 6 6 $1,173.00 $1,056.00 $821.00 $1,173.00 $903.50 2026-09-14
71271 CPT CT Low Dose Lung Screening 6 6 $1,133.00 $1,020.00 $793.00 $1,133.00 $872.50 2026-09-14
600205 CDM Rabies Immune Globulin, Human 300 Intl Units/ml Sol [Wish] 6 6 $1,127.00 $1,014.00 $789.00 $1,127.00 $867.50 2026-09-14
11622 CPT 11622 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11621 CPT 11621 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11604 CPT 11604 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excise… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11603 CPT 11603 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excise… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11601 CPT 11601 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excise… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
10080 CPT 10080-i&d Pilonidal Cyst Simple 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11600 CPT 11600 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excise… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11442 CPT 11442 Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless L… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11441 CPT 11441 Excision, Other Benign Lesion Including Margins, Except Skin Tag (Unless L… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11440 CPT 11440-excise Lesion Benign Face Less Than/equal To 0.5 Cm 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11421 CPT 11421 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11403 CPT 11403 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11402 CPT 11402-excision Lesion Benign Trunk/extremity 1.1-2.0 Cm 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11400 CPT 11400 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11642 CPT 11642 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11641 CPT 11641 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
11640 CPT 11640 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 6 6 $1,117.00 $1,005.00 $782.00 $1,117.00 $860.00 2026-09-14
99285 CPT 99285level 5 6 6 $1,083.00 $975.00 $758.00 $1,083.00 $834.00 2026-09-14
70486 CPT CT Sinus Without Contrast 6 6 $1,061.00 $955.00 $743.00 $1,061.00 $817.00 2026-09-14
A0426 HCPCS Als Level 1, Non-emergency 6 6 $1,050.00 $945.00 $735.00 $1,050.00 $809.00 2026-09-14
27840 CPT 27840closed Treatment Of Ankle Dislocation; Without Anesthesia 6 6 $1,050.00 $945.00 $735.00 $1,050.00 $809.00 2026-09-14
70460 CPT CT Head With Contrast 6 6 $1,030.00 $927.00 $721.00 $1,030.00 $793.50 2026-09-14
72192 CPT CT Pelvis Without Contrast 6 6 $1,020.00 $918.00 $714.00 $1,020.00 $785.50 2026-09-14
78300 CPT Nm Bone Imaging Limited 6 6 $1,009.00 $908.00 $706.00 $1,009.00 $777.00 2026-09-14
81206 CPT Bcr/abl1 Rflxqual/qnt Npl 6 6 $1,003.00 $903.00 $702.00 $1,003.00 $772.00 2026-09-14
74150 CPT CT Abdomen Without Contrast 6 6 $996.00 $896.00 $697.00 $996.00 $767.00 2026-09-14
11602 CPT 11602 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excise… 6 6 $947.00 $852.00 $663.00 $947.00 $729.00 2026-09-14
17106 CPT 17106 Destruction Of Cutaneous Vascular Proliferative Lesions (Eg, Laser Techniq… 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
13152 CPT 13152-eye/ear/nose/lip 2.6-7.5 Cm 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
13151 CPT 13151-eyes/ears/nose/lip 1.1-2.5 Cm 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
13132 CPT 13132 Repair, Complex, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, … 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
13121 CPT 13121 Repair, Complex, Scalp, Arms, And/or Legs; 2.6 Cm To 7.5 Cm Profee 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
13100 CPT 13100-trunk 1.1-2.5 Cm 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
11106 CPT 11106 Incisional Biopsy Of Skin; Single Lesion 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
12045 CPT 12045-neck/hand/feet/genital 12.6-20.0 Cm 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
12044 CPT 12044-neck/hand/feet/genital 7.6-12.5 Cm 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
12036 CPT 12036-scalp/trunk/extremity 20.1-30.0 Cm 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
12020 CPT 12020-treatment Superficial Wound Dehiscence 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
11000 CPT 11000-extensive Eczematous/infected Skin Less Than 10% 6 6 $942.00 $848.00 $659.00 $942.00 $725.50 2026-09-14
P00891 CDM Tirzepatide 7.5 Mg/0.5 Ml Sol 6 6 $935.00 $842.00 $655.00 $935.00 $720.00 2026-09-14
93306 CPT US Echo 2d Complete 6 6 $927.00 $834.00 $649.00 $927.00 $713.50 2026-09-14
p00797 CDM Filgrastim Sndz 480 Mcg/0.8 Ml Sol[wish] 6 6 $922.00 $830.00 $645.00 $922.00 $710.00 2026-09-14
92960 CPT 92960cardioversion; Elective 6 6 $896.00 $806.00 $627.00 $896.00 $690.00 2026-09-14
P00827 CDM Tiotropium 2.5 Mcg/inh Aer[wish] 6 6 $887.00 $798.00 $621.00 $887.00 $683.00 2026-09-14
40831 CPT 40831-closure Of Laceration, Vestibule Of Mouth 6 6 $875.00 $788.00 $613.00 $875.00 $673.50 2026-09-14
A0428 HCPCS Bls, Non-emergency 6 6 $874.00 $787.00 $612.00 $874.00 $673.00 2026-09-14
P00301 CDM Albuterol-ipratropium 100 Mcg-20 Mcg/inh Aer[wish] 6 6 $873.00 $786.00 $611.00 $873.00 $672.50 2026-09-14
A0998 HCPCS Ambulance Response/trmtno Transport 6 6 $860.00 $774.00 $602.00 $860.00 $662.00 2026-09-14
70450 CPT CT Scan 6 6 $856.00 $770.00 $599.00 $856.00 $659.00 2026-09-14
93970 CPT US Lower Ext Venous Duplex Bilateral 6 6 $849.00 $764.00 $594.00 $849.00 $654.00 2026-09-14
36430 CPT 36430 Blood Transfusion Up To 2 Units Charge 12 6 $839.00 $755.00 $580.00 $850.00 $646.00 2026-09-14
P00206 CDM Fluticasone-salmeterol 500 Mcg-50 Mcg/inh Pow 6 6 $827.00 $744.00 $579.00 $827.00 $636.50 2026-09-14
p00260 CDM Zoster Vaccine, Recombinant Adjuvanted Sus [Wish] 6 6 $816.00 $734.00 $571.00 $816.00 $628.50 2026-09-14
P00871 CDM Olodaterol-tiotropium 2.5 Mcg-2.5 Mcg/inh Aer 6 6 $813.00 $732.00 $569.00 $813.00 $626.00 2026-09-14
93880 CPT US Carotid Duplex Bilateral 6 6 $798.00 $718.00 $559.00 $798.00 $614.50 2026-09-14
65220 CPT 65220-corneal Without Slit Lamp 6 6 $797.00 $717.00 $558.00 $797.00 $614.00 2026-09-14
p00607 CDM Hylan G-f 20 16 Mg/2 Ml Sol 6 6 $767.00 $690.00 $537.00 $767.00 $590.50 2026-09-14
99284 CPT 99284level 4 6 6 $763.00 $687.00 $534.00 $763.00 $587.50 2026-09-14
600011 CDM Rabies Vaccine, 2.5 Intl Units Pow[wish] 6 6 $760.00 $684.00 $532.00 $760.00 $585.00 2026-09-14
36680 CPT 36680-place Needle Intraosseous Infusion 6 6 $753.00 $678.00 $527.00 $753.00 $580.00 2026-09-14
p00018 CDM Penicillin G Benzathine 1,200,000 Units/2 Ml Sus[wish] 6 6 $751.00 $676.00 $526.00 $751.00 $578.00 2026-09-14
P00716 CDM Daptomycin 500 Mg Pow[wish] 6 6 $749.00 $674.00 $524.00 $749.00 $577.00 2026-09-14
G0480 HCPCS Drug Panel 6 6 $699.00 $629.00 $489.00 $699.00 $538.00 2026-09-14
76881 CPT US Extremity Nonvascular Complete Bilat 12 6 $698.00 $628.00 $326.00 $930.00 $558.50 2026-09-14
11750 CPT 11750 Excision Of Nail And Nail Matrix, Partial Or Complete (Eg, Ingrown Or Defo… 6 6 $690.00 $621.00 $483.00 $690.00 $531.50 2026-09-14
P00792 CDM Fluticasone-vilanterol 200 Mcg-25 Mcg/inh Pow[wish] 6 6 $685.00 $617.00 $479.00 $685.00 $527.50 2026-09-14
96413 CPT 96413 Chemo IV Infusion 1 Hour 6 6 $682.00 $614.00 $477.00 $682.00 $525.50 2026-09-14
M0243 HCPCS Casirivi And Imdevi Infusion 6 6 $680.00 $612.00 $476.00 $680.00 $523.50 2026-09-14
M0245 HCPCS Bamlanivimab/etesevimab Infusion 6 6 $680.00 $612.00 $476.00 $680.00 $523.50 2026-09-14
67938 CPT 67938-eyelid Embedded Foreign Body 6 6 $649.00 $584.00 $454.00 $649.00 $500.00 2026-09-14
67700 CPT 67700-drain Abscess Blepharotomy/eyelid 6 6 $649.00 $584.00 $454.00 $649.00 $500.00 2026-09-14
77066 CPT Mammography Of Both Breasts 6 6 $644.00 $580.00 $451.00 $644.00 $496.00 2026-09-14
10120 CPT 10120 Incision And Removal Of Foreign Body, Subcutaneous Tissues; Simple Profee 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
17282 CPT 17282 Destruction, Malignant Lesion, Face, Ears, Eyelids, Nose, Lips, Lesion Dia… 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
11300 CPT 11300 Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Trunk, Arms Or Legs;… 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
13131 CPT 13131-face/neck/hand/feet/genital 1.1-2.5 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
10061 CPT 10061 Incision And Drainage Of Abscess (Eg, Carbuncle, Suppurative Hidradenitis,… 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12054 CPT 12054-face/ear/eye/nose/lip 7.6-12.5 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12053 CPT 12053-face/ear/eye/nose/lip 5.1-7.5 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12052 CPT 12052-face/ear/eye/nose/lip 2.6-5.0 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12051 CPT 12051-face/ear/eye/nose/lip Less Than/equal To 2.5 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12042 CPT 12042-neck/hand/feet/genital 2.6-7.5 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12041 CPT 12041-neck/hand/feet/genital Less Than/equal To 2.5 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
11104 CPT 11104 Punch Biopsy Of Skin (Including Simple Closure, When Performed); Single Le… 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12034 CPT 12034 Repair, Intermediate, Wounds Of Scalp, Axillae, Trunk And/or Extremities (… 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12032 CPT 12032-scalp/trunk/extremity 2.6-7.5cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12031 CPT 12031-scalp/trunk/extremity Less Than/equal To 2.5 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12016 CPT 12016-face/ear/eyelid/nose/lip 12.6-20.0 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
10021 CPT 10021-aspiration Fine Needle Without Imaging 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
12005 CPT 12005-scalp/neck/trunk/genital/extremity 12.6-20.0 Cm 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
11401 CPT 11401 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
11042 CPT 11042 Debride Skin Tissue First 20cm2 Charge 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
11313 CPT 11313 Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Face, Ears, Eyelids,… 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
11765 CPT 11765-wedge Excision Skin Nail Fold 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
11312 CPT 11312 Shaving Of Lesion; Face, Ears, Eyelids, Nose, Lips, Mucous Membrane; 1.1-2… 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
10160 CPT 10160 Puncture Aspiration Of Abscess, Hematoma, Bulla, Or Cyst Profee 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
11303 CPT 11303 Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Trunk, Arms Or Legs;… 6 6 $621.00 $559.00 $435.00 $621.00 $478.50 2026-09-14
76641 CPT US Breast Complete Bilat 12 6 $618.00 $556.50 $288.00 $824.00 $494.50 2026-09-14
81270 CPT Jak 2 V617f Mutation Detection Npl 6 6 $618.00 $556.00 $433.00 $618.00 $476.00 2026-09-14
P9016 HCPCS Leukopoor Rbc 6 6 $616.00 $554.00 $431.00 $616.00 $474.50 2026-09-14
26700 CPT 26700 Closed Treatment Of Metacarpophalangeal Dislocation, Single, With Manipul… 12 6 $600.00 $540.50 $305.00 $765.00 $485.50 2026-09-14
G0390 HCPCS G0390-811 Preactivation Trauma Response 6 6 $600.00 $540.00 $420.00 $600.00 $462.00 2026-09-14
99496 CPT 99496 Tcm High Complexity & Within 7 Days Of Discharge Wish 6 6 $600.00 $540.00 $420.00 $600.00 $462.00 2026-09-14
40490 CPT 40490 Biopsy Of Lip 6 6 $593.00 $534.00 $415.00 $593.00 $456.50 2026-09-14
P00783 CDM Umeclidinium 62.5 Mcg (0.0625 Mg)/inh Pow 6 6 $578.00 $520.00 $405.00 $578.00 $445.50 2026-09-14
p00833 CDM Formoterol-mometasone 5 Mcg-100 Mcg/inh Aer 6 6 $576.00 $518.00 $403.00 $576.00 $443.50 2026-09-14
P00785 CDM Budesonide-formoterol 160 Mcg-4.5 Mcg/inh Aer 6 6 $565.00 $509.00 $396.00 $565.00 $435.00 2026-09-14
93971 CPT US Lower Ext Venous Duplex Left 6 6 $564.00 $508.00 $395.00 $564.00 $434.50 2026-09-14
G0402 HCPCS G0402 Welcome To Medicare Physical 6 6 $563.00 $507.00 $394.00 $563.00 $433.50 2026-09-14
600291 CDM Rsv Vaccine Pref3, Recombinant Preservative-free 120 Mcg Pow [Wish} 6 6 $540.00 $486.00 $378.00 $540.00 $416.00 2026-09-14
600022 CDM Pneumococcal 20-valent Conjugate Vaccinesus[wish] 6 6 $533.00 $480.00 $373.00 $533.00 $410.50 2026-09-14
99205 CPT New Patient Office Or Other Outpatient Visit, 60 Min 6 6 $528.00 $475.00 $370.00 $528.00 $406.50 2026-09-14
77067 CPT Mammography, Screening, Bilateral 12 6 $525.00 $472.50 $364.00 $530.00 $404.50 2026-09-14
46083 CPT 46083-incision Hemorrhoid Thrombosed External 6 6 $518.00 $466.00 $363.00 $518.00 $399.00 2026-09-14
76700 CPT Ultrasound Of Abdomen 6 6 $517.00 $465.00 $362.00 $517.00 $398.00 2026-09-14
13133 CPT 13133 Repair, Complex, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, … 6 6 $515.00 $464.00 $361.00 $515.00 $396.50 2026-09-14
76830 CPT Ultrasound Pelvis Through Vagina 6 6 $506.00 $455.00 $354.00 $506.00 $390.00 2026-09-14
17261 CPT 17261 Destruction, Malignant Lesion, Trunk, Arms Or Legs; Lesion Diameter 0.6 To… 6 6 $503.00 $453.00 $352.00 $503.00 $387.00 2026-09-14
76536 CPT US Head/neck Soft Tissue 6 6 $503.00 $453.00 $352.00 $503.00 $387.00 2026-09-14
74250 CPT Xr Small Bowel With Multiple Series 6 6 $502.00 $452.00 $351.00 $502.00 $387.00 2026-09-14
P00204 CDM Fluticasone-salmeterol 100 Mcg-50 Mcg Pow 6 6 $501.00 $451.00 $351.00 $501.00 $386.00 2026-09-14
11983 CPT 11983-removal And Reinsertion Non-biodegradable Drug 6 6 $500.00 $450.00 $350.00 $500.00 $385.00 2026-09-14
77065 CPT Mammography Of One Breast 6 6 $489.00 $440.00 $342.00 $489.00 $376.50 2026-09-14
81241 CPT Factor V Leiden (f5) R506q Mutation Npl 6 6 $486.00 $437.00 $340.00 $486.00 $374.50 2026-09-14
51720 CPT 51720 Bladder Instillation Of Anticarcinogenic Agent (Including Retention Time) 6 6 $484.00 $436.00 $339.00 $484.00 $372.50 2026-09-14
51700 CPT 51700 Bladder Irrigation/lavage/inst Charge 6 6 $484.00 $436.00 $339.00 $484.00 $372.50 2026-09-14
20610 CPT 20610 Arthrocentesis, Aspiration And/or Injection, Major Joint Or Bursa (Eg, Sho… 6 6 $479.00 $431.00 $335.00 $479.00 $368.50 2026-09-14
20605 CPT 20605 Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa (… 6 6 $479.00 $431.00 $335.00 $479.00 $368.50 2026-09-14
20600 CPT Arthrocentesis, Inj-small Joint Charge 6 6 $479.00 $431.00 $335.00 $479.00 $368.50 2026-09-14
20552 CPT 20552 Injection(s); Single Or Multiple Trigger Point(s), 1 Or 2 Muscle(s) Profee 6 6 $479.00 $431.00 $335.00 $479.00 $368.50 2026-09-14
99283 CPT 99283level 3 6 6 $478.00 $430.00 $335.00 $478.00 $368.50 2026-09-14
600290 CDM Sars-cov-2 (covid-19) Mrna-lnp Vaccine (Cvx 312) Preservative-free 50 Mcg/0.5 Ml… 6 6 $477.00 $429.00 $334.00 $477.00 $367.50 2026-09-14
P00067 CDM Glucagon 1 Mg Pow [Wish] 6 6 $471.00 $424.00 $330.00 $471.00 $362.50 2026-09-14
76706 CPT US Aaa Screening 6 6 $469.00 $422.00 $328.00 $469.00 $361.50 2026-09-14
99195 CPT Therapeutic Phleb 6 6 $465.00 $419.00 $326.00 $465.00 $358.00 2026-09-14
76642 CPT US Breast Limited Bilat 12 6 $463.50 $417.00 $216.00 $618.00 $371.00 2026-09-14
P00797 CDM Filgrastim Sndz 300 Mcg/0.5 Ml Sol [Wish] 6 6 $461.00 $415.00 $323.00 $461.00 $355.00 2026-09-14
69100 CPT 69100 Biopsy External Ear 6 6 $456.00 $410.00 $319.00 $456.00 $351.00 2026-09-14
29345 CPT 29345-application Of Long Leg Cast Thigh To Toes 6 6 $456.00 $410.00 $319.00 $456.00 $351.00 2026-09-14
29075 CPT 29075 Application, Cast; Elbow To Finger (Short Arm) Profee 6 6 $456.00 $410.00 $319.00 $456.00 $351.00 2026-09-14
29065 CPT 29065-application Cast Shoulder To Hand (Long Arm) 6 6 $456.00 $410.00 $319.00 $456.00 $351.00 2026-09-14
P00708 CDM Ceftaroline 600 Mg Pow[wish] 6 6 $455.00 $410.00 $319.00 $455.00 $350.00 2026-09-14
27786 CPT 27786-distal Fibular Without Manipulation 6 6 $453.00 $408.00 $317.00 $453.00 $349.00 2026-09-14
27750 CPT 27750 Closed Treatment Of Tibial Shaft Fracture; Without Manipulation 6 6 $453.00 $408.00 $317.00 $453.00 $349.00 2026-09-14
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