Hospital

SMP HEALTH ST ALOISIUS

Harvey, ND · CCN 351327 · Rates published

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You selected 93306 (CPT)

Us Echocardiogram Complete

This hospital’s price: $584 across 1 payer

Source: https://secure.claraprice.net/price-transparency/KPBN-1760641089324/machine-readable/450226729_smp-health---st-aloisius_standardcharges.json · observed 2026-01-07

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

2,082 distinct procedures filed

1 distinct payers

2,966 rate rows

2026-01-07 last MRF observed

Data quality

2,397 of 2,966 rate rows are consumer-grade (80.8%)

569 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 — reason	Rows
per-diem day rate — not a per-procedure price	296
exceeds 10× this hospital's gross charge — excluded from medians	273

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://secure.claraprice.net/price-transparency/KPBN-1760641089324/machine-readable/450226729_smp-health---st-aloisius_standardcharges.json
Found on page	https://secure.claraprice.net/price-transparency/smp-health-st-aloisius-nd
Discovered via	CMS hospital list
Last fetch	success · 2026-09-25
Content fingerprint	cc0610a2c303538e… · 1,455,650 bytes · first seen 2026-07-31

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
27702 CPT	Arthroplasty Ankle	1	$13,165.00	$13,165.00	$13,165.00	nat. median $15,864 0.8× median
27696 CPT	Repair, Primary, Disrupted Ligament, Ankle, Both Collateral Ligaments 27696	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,752 1.2× median
27385 CPT	Repair Quadriceps	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,708 1.2× median
28300 CPT	Osteotomy; Calcaneus, With Or Without Internal Fixation 28300	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,697 1.2× median
27691 CPT	Transfer Or Transplant Of Single Tendon, Deep 27691	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,958 1.2× median
28310 CPT	Osteotomy, Shortening, Angular Or Rotational Correction, Proximal Phalanx, First…	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,166 1.3× median
28304 CPT	Osteotomy, Tarsal Bones, Other Than Calcaneus Or Talus 28304	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,733 1.2× median
27698 CPT	Repair, Secondary, Disrupted Ligament, Ankle, Collateral 27698	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,552 1.2× median
29806 CPT	Arthroscopy Shoulder	1	$8,128.00	$8,128.00	$8,128.00	nat. median $7,171 1.1× median
29827 CPT	Arthroscopy Shoulder With Rotator Cuff Repair	1	$8,128.00	$8,128.00	$8,128.00	nat. median $7,184 1.1× median
24342 CPT	Repair Biceps Muscle	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,962 1.2× median
27381 CPT	Repair Tendon Lower Extremity	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,822 1.2× median
28298 CPT	Bunionectomy/ Osteotomy	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,628 1.2× median
28740 CPT	28740 Arthrodesis, Midtarsal/tarsometatarsal, Single Joint	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,866 1.2× median
28297 CPT	Correction, Hallux Valgus, With Or Without Sesamoidectomy, Lapidus-type Procedur…	1	$8,128.00	$8,128.00	$8,128.00	nat. median $7,585 1.1× median
29807 CPT	29807 Arthroscopy Shoulder Surg Repair Of Slap Lesion	1	$8,128.00	$8,128.00	$8,128.00	nat. median $7,098 1.1× median
28750 CPT	28750 Surgical Repair Of The Metatarsophalangeal Joint Or Big Toe	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,995 1.2× median
27766 CPT	Ankle Fracture, Orif	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,986 1.2× median
26531 CPT	26531 Arthroplasty, Metacarpophalangeal Joint; With Prosthetic Implant, Each Joi…	1	$8,128.00	$8,128.00	$8,128.00	nat. median $7,051 1.2× median
26390 CPT	26390 Excision Flexor Tendon, With Implantation Of Synthetic Rod For Delayed Ten…	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,931 1.2× median
28309 CPT	Osteotomy, With Or Without Lengthening, Shortening Or Angular Correction, Metata…	1	$8,128.00	$8,128.00	$8,128.00	nat. median $6,889 1.2× median
31297 CPT	Excision Tissue Endoscopy Sphenoid Sinus	1	$7,207.00	$7,207.00	$7,207.00	nat. median $6,417 1.1× median
31296 CPT	Excision Tissue Endoscopy Frontal Sinus	1	$7,207.00	$7,207.00	$7,207.00	nat. median $6,695 1.1× median
31298 CPT	Endoscopy Sinus	1	$7,207.00	$7,207.00	$7,207.00	nat. median $6,800 1.1× median
31295 CPT	Excision Tissue Endoscopy Maxillary Sinus	1	$7,207.00	$7,207.00	$7,207.00	nat. median $6,521 1.1× median
42825 CPT	42825 Tonsillectomy, Primary Or Secondary; < Than Age 12	1	$6,977.00	$6,977.00	$6,977.00	nat. median $5,616 1.2× median
42820 CPT	Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12	1	$6,977.00	$6,977.00	$6,977.00	nat. median $5,527 1.3× median
49593 CPT	49593 Repair Ant Abd Hernia(s) 3-10cm, Reducible	1	$5,085.00	$5,085.00	$5,085.00	nat. median $5,968 0.9× median
49591 CPT	Repair Hernia Umbilical	1	$4,717.00	$4,717.00	$4,717.00	nat. median $3,848 1.2× median
J3301 HCPCS	160mg Triamcinoloneamb Triamcinolone Acetonide Charge	1	$4,682.00	$4,682.00	$4,682.00	nat. median $25 outlier · 185.9×
49521 CPT	49521 Repair Recurrent Inguinal Hernia, Any Age Incarcerated Or Strangulated	1	$4,367.00	$4,367.00	$4,367.00	nat. median $5,928 0.7× median
40886 CPT	16mg/2ml (Synvisc)amb Hylan G-f 20 Charge	1	$2,254.00	$6,277.00	$4,265.50	nat. median $4,344 1.0× median
69421 CPT	Myringotomy	1	$4,163.00	$4,163.00	$4,163.00	nat. median $3,282 1.3× median
55040 CPT	Excision Of Hydrocele, Unilateral 55040	1	$4,035.00	$4,035.00	$4,035.00	nat. median $3,679 1.1× median
55041 CPT	Excision Of Hydrocele, Bilateral 55041	1	$4,035.00	$4,035.00	$4,035.00	nat. median $3,906 1.0× median
19120 CPT	Removal Of One Or More Breast Growth, Open Procedure	1	$4,003.00	$4,003.00	$4,003.00	nat. median $3,671 1.1× median
19125 CPT	19125 Exc Of Breast Lesion Identified By Preoperative Placement Of Radiological…	1	$4,002.00	$4,002.00	$4,002.00	nat. median $3,920 1.0× median
28285 CPT	Repair Hammer Toe	1	$3,867.00	$3,867.00	$3,867.00	nat. median $3,607 1.1× median
28113 CPT	Osteotomy Tarsal	1	$3,867.00	$3,867.00	$3,867.00	nat. median $3,417 1.1× median
26123 CPT	26123 Contracture Release Fasciotomy With Digit Release	1	$3,782.00	$3,782.00	$3,782.00	nat. median $3,840 1.0× median
C9781 HCPCS	Shoulder Arthroscopy	1	$3,782.00	$3,782.00	$3,782.00	nat. median $12,888 outlier · 0.3×
42826 CPT	42826 Tonsillectomy, Primary Or Secondary; Age 12 Or >	1	$3,754.00	$3,754.00	$3,754.00	nat. median $3,387 1.1× median
42830 CPT	Adenoidectomy, Primary; Younger Than Age 12	1	$3,754.00	$3,754.00	$3,754.00	nat. median $3,387 1.1× median
42821 CPT	42821 Tonsillectomy/adenoidectomy Age 12 And Over	1	$3,754.00	$3,754.00	$3,754.00	nat. median $3,397 1.1× median
42831 CPT	Adenoidectomy, Primary, Age 12 Or Over 42831	1	$3,754.00	$3,754.00	$3,754.00	nat. median $3,437 1.1× median
26860 CPT	Arthrodesis, Interphalangeal Joint, With Or Without Internal Fixation 26860	1	$3,678.00	$3,678.00	$3,678.00	nat. median $3,508 1.0× median
28270 CPT	28270 Capsulotomy; Metatarsophalangeal Joint, With Or Without Tenorrhaphy, Each…	1	$3,672.00	$3,672.00	$3,672.00	nat. median $3,343 1.1× median
26765 CPT	Open Treatment Of Distal Phalangeal Fracture, Finger Or Thumb, Includes Internal…	1	$3,672.00	$3,672.00	$3,672.00	nat. median $3,496 1.1× median
28200 CPT	Repair, Tendon, Flexor, Foot, Primary Or Secondary, Without Free Graft, Each Ten…	1	$3,672.00	$3,672.00	$3,672.00	nat. median $3,412 1.1× median
28008 CPT	Fasciotomy, Foot And/or Toe 28008	1	$3,672.00	$3,672.00	$3,672.00	nat. median $3,307 1.1× median

Other procedures at this hospital

Browse this hospital's 2,082 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

27702	CPT	Arthroplasty Ankle	1	1	$21,101.00	$18,991.00	$13,165.00	$13,165.00	$13,165.00	2026-01-07
27385	CPT	Repair Quadriceps	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
28310	CPT	Osteotomy, Shortening, Angular Or Rotational Correction, Proximal Phalanx, First…	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
27691	CPT	Transfer Or Transplant Of Single Tendon, Deep 27691	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
28300	CPT	Osteotomy; Calcaneus, With Or Without Internal Fixation 28300	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
24342	CPT	Repair Biceps Muscle	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
27381	CPT	Repair Tendon Lower Extremity	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
28304	CPT	Osteotomy, Tarsal Bones, Other Than Calcaneus Or Talus 28304	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
26531	CPT	26531 Arthroplasty, Metacarpophalangeal Joint; With Prosthetic Implant, Each Joi…	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
28297	CPT	Correction, Hallux Valgus, With Or Without Sesamoidectomy, Lapidus-type Procedur…	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
28740	CPT	28740 Arthrodesis, Midtarsal/tarsometatarsal, Single Joint	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
29807	CPT	29807 Arthroscopy Shoulder Surg Repair Of Slap Lesion	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
27766	CPT	Ankle Fracture, Orif	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
28309	CPT	Osteotomy, With Or Without Lengthening, Shortening Or Angular Correction, Metata…	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
27698	CPT	Repair, Secondary, Disrupted Ligament, Ankle, Collateral 27698	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
27696	CPT	Repair, Primary, Disrupted Ligament, Ankle, Both Collateral Ligaments 27696	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
28750	CPT	28750 Surgical Repair Of The Metatarsophalangeal Joint Or Big Toe	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
26390	CPT	26390 Excision Flexor Tendon, With Implantation Of Synthetic Rod For Delayed Ten…	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
29806	CPT	Arthroscopy Shoulder	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
29827	CPT	Arthroscopy Shoulder With Rotator Cuff Repair	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
28298	CPT	Bunionectomy/ Osteotomy	1	1	$13,027.00	$11,724.00	$8,128.00	$8,128.00	$8,128.00	2026-01-07
31296	CPT	Excision Tissue Endoscopy Frontal Sinus	1	1	$11,552.00	$10,397.00	$7,207.00	$7,207.00	$7,207.00	2026-01-07
31295	CPT	Excision Tissue Endoscopy Maxillary Sinus	1	1	$11,552.00	$10,397.00	$7,207.00	$7,207.00	$7,207.00	2026-01-07
31298	CPT	Endoscopy Sinus	1	1	$11,552.00	$10,397.00	$7,207.00	$7,207.00	$7,207.00	2026-01-07
31297	CPT	Excision Tissue Endoscopy Sphenoid Sinus	1	1	$11,552.00	$10,397.00	$7,207.00	$7,207.00	$7,207.00	2026-01-07
42820	CPT	Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12	1	1	$11,183.00	$10,065.00	$6,977.00	$6,977.00	$6,977.00	2026-01-07
42825	CPT	42825 Tonsillectomy, Primary Or Secondary; < Than Age 12	1	1	$11,183.00	$10,065.00	$6,977.00	$6,977.00	$6,977.00	2026-01-07
49593	CPT	49593 Repair Ant Abd Hernia(s) 3-10cm, Reducible	1	1	$8,150.00	$7,335.00	$5,085.00	$5,085.00	$5,085.00	2026-01-07
49591	CPT	Repair Hernia Umbilical	1	1	$7,560.00	$6,804.00	$4,717.00	$4,717.00	$4,717.00	2026-01-07
J3301	HCPCS	160mg Triamcinoloneamb Triamcinolone Acetonide Charge	1	1	$7,504.00	$6,754.00	$4,682.00	$4,682.00	$4,682.00	2026-01-07
49521	CPT	49521 Repair Recurrent Inguinal Hernia, Any Age Incarcerated Or Strangulated	1	1	$7,000.00	$6,300.00	$4,367.00	$4,367.00	$4,367.00	2026-01-07
40886	CPT	16mg/2ml (Synvisc)amb Hylan G-f 20 Charge	2	1	$6,837.00	$6,153.50	$2,254.00	$6,277.00	$4,265.50	2026-01-07
69421	CPT	Myringotomy	1	1	$6,672.00	$6,005.00	$4,163.00	$4,163.00	$4,163.00	2026-01-07
55040	CPT	Excision Of Hydrocele, Unilateral 55040	1	1	$6,468.00	$5,821.00	$4,035.00	$4,035.00	$4,035.00	2026-01-07
55041	CPT	Excision Of Hydrocele, Bilateral 55041	1	1	$6,468.00	$5,821.00	$4,035.00	$4,035.00	$4,035.00	2026-01-07
19120	CPT	Removal Of One Or More Breast Growth, Open Procedure	1	1	$6,416.00	$5,774.00	$4,003.00	$4,003.00	$4,003.00	2026-01-07
19125	CPT	19125 Exc Of Breast Lesion Identified By Preoperative Placement Of Radiological …	1	1	$6,415.00	$5,774.00	$4,002.00	$4,002.00	$4,002.00	2026-01-07
28285	CPT	Repair Hammer Toe	1	1	$6,198.00	$5,578.00	$3,867.00	$3,867.00	$3,867.00	2026-01-07
28113	CPT	Osteotomy Tarsal	1	1	$6,198.00	$5,578.00	$3,867.00	$3,867.00	$3,867.00	2026-01-07
26123	CPT	26123 Contracture Release Fasciotomy With Digit Release	1	1	$6,062.00	$5,456.00	$3,782.00	$3,782.00	$3,782.00	2026-01-07
C9781	HCPCS	Shoulder Arthroscopy	1	1	$6,062.00	$5,456.00	$3,782.00	$3,782.00	$3,782.00	2026-01-07
42831	CPT	Adenoidectomy, Primary, Age 12 Or Over 42831	1	1	$6,017.00	$5,415.00	$3,754.00	$3,754.00	$3,754.00	2026-01-07
42830	CPT	Adenoidectomy, Primary; Younger Than Age 12	1	1	$6,017.00	$5,415.00	$3,754.00	$3,754.00	$3,754.00	2026-01-07
42826	CPT	42826 Tonsillectomy, Primary Or Secondary; Age 12 Or >	1	1	$6,017.00	$5,415.00	$3,754.00	$3,754.00	$3,754.00	2026-01-07
42821	CPT	42821 Tonsillectomy/adenoidectomy Age 12 And Over	1	1	$6,017.00	$5,415.00	$3,754.00	$3,754.00	$3,754.00	2026-01-07
26860	CPT	Arthrodesis, Interphalangeal Joint, With Or Without Internal Fixation 26860	1	1	$5,895.00	$5,306.00	$3,678.00	$3,678.00	$3,678.00	2026-01-07
28119	CPT	28119 Ostectomy, Calcaneus; For Spur, With Or Without Plantar	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
29823	CPT	29823 Arthroscopy Shoulder Surg Debridement, Ext 3+ Discrete Struct	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
26608	CPT	26608 Percutaneous Pinning Finger	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28270	CPT	28270 Capsulotomy; Metatarsophalangeal Joint, With Or Without Tenorrhaphy, Each …	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28200	CPT	Repair, Tendon, Flexor, Foot, Primary Or Secondary, Without Free Graft, Each Ten…	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28308	CPT	Osteotomy, With Or Without Lengthening, Shortening Or Angular Correction, Other …	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
25301	CPT	25301 Tenodesis At Wrist Extensors Of Fingers	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28122	CPT	Partial Excision, Bone; Tarsal Or Metatarsal Bone, Except Talus Or Calcaneus 281…	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
26765	CPT	Open Treatment Of Distal Phalangeal Fracture, Finger Or Thumb, Includes Internal…	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
26370	CPT	Repair Or Advancement Of Profundus Tendon, With Intact Superficialis Tendon, Pri…	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
29882	CPT	Arthroscopy Knee With Meniscal Repair	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
27658	CPT	Repair, Flexor Tendon, Leg, Primary, Without Graft, Each Tendon 27658	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
26756	CPT	Percutaneous Skeletal Fixation Of Distal Phalangeal Fracture, Finger Or Thumb, E…	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
26727	CPT	26727 Treat Finger Fracture Each	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28296	CPT	Correction, Hallux Valgus, With Or Without Sesamoidectomy, With Metatarsal Osteo…	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28110	CPT	Ostectomy, Partial Excision, Fifth Metatarsal Head 28110	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28820	CPT	Amputation, Toe, Metatarsophalangeal Joint 28820	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
29880	CPT	Arthroscopy Knee With Meniscectomy	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
26735	CPT	Open Treatment Of Phalangeal Shaft Fracture, Proximal Or Middle Phalanx, Finger …	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28288	CPT	28288 Ostectomy, Partial, Ea Metatarsal Hd	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
28008	CPT	Fasciotomy, Foot And/or Toe 28008	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
29888	CPT	Arthroscopy Knee With Acl Reconstruction	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
29881	CPT	Removal Of One Knee Cartilage Using An Endoscope	1	1	$5,885.00	$5,297.00	$3,672.00	$3,672.00	$3,672.00	2026-01-07
59409	CPT	59409-vaginal Delivery Only	2	1	$5,805.50	$5,225.00	$3,568.00	$3,676.00	$3,622.00	2026-01-07
66982	CPT	Extraction Cataract With Intraocular Lens Insertion	1	1	$5,636.00	$5,072.00	$3,516.00	$3,516.00	$3,516.00	2026-01-07
66984	CPT	Removal Of Cataract With Insertion Of Lens	1	1	$5,636.00	$5,072.00	$3,516.00	$3,516.00	$3,516.00	2026-01-07
30520	CPT	30520 Septoplasty/submucous Resect W-without Cartilage Scoring/contour/repl W/gft	1	1	$5,428.00	$4,885.00	$3,387.00	$3,387.00	$3,387.00	2026-01-07
46260	CPT	46260 Hemorrhoidectomy Internal And External, 2 Or More Columns/groups	1	1	$5,373.00	$4,836.00	$3,352.00	$3,352.00	$3,352.00	2026-01-07
25028	CPT	Smph 25028 Inc/drainage Deep Absc/he	1	1	$5,356.00	$4,820.00	$3,342.00	$3,342.00	$3,342.00	2026-01-07
26951	CPT	26951 Amp F/th 1/2 Jt/phalanx W/neurect W/dir Clsr Profee	2	1	$5,278.00	$4,750.00	$3,244.00	$3,342.00	$3,293.00	2026-01-07
27337	CPT	Excision, Tumor, Soft Tissue Of Thigh Or Knee Area, Subcutaneous, 3 Cm Or Greate…	1	1	$4,928.00	$4,435.00	$3,075.00	$3,075.00	$3,075.00	2026-01-07
28039	CPT	Excision, Tumor, Soft Tissue Of Foot Or Toe, Subcutaneous, 1.5 Cm Or Greater 280…	1	1	$4,928.00	$4,435.00	$3,075.00	$3,075.00	$3,075.00	2026-01-07
22903	CPT	Excision, Tumor, Soft Tissue Of Abdominal Wall, Subcutaneous, 3 Cm Or Greater 22…	1	1	$4,928.00	$4,435.00	$3,075.00	$3,075.00	$3,075.00	2026-01-07
21552	CPT	Excision, Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subcutaneous, 3 Cm Or G…	1	1	$4,928.00	$4,435.00	$3,075.00	$3,075.00	$3,075.00	2026-01-07
20680	CPT	20680 Removal Of Orthopedic Hardware	1	1	$4,928.00	$4,435.00	$3,075.00	$3,075.00	$3,075.00	2026-01-07
27685	CPT	Repair Achilles Tendon	1	1	$4,850.00	$4,365.00	$3,026.00	$3,026.00	$3,026.00	2026-01-07
11012	CPT	11012 Debride Incl Remvl Forn Matl At Site Of Open Fx/open Disloc; Skn/subq Tiss…	1	1	$4,814.00	$4,333.00	$3,003.00	$3,003.00	$3,003.00	2026-01-07
67923	CPT	Repair Entropion	1	1	$4,519.00	$4,067.00	$2,819.00	$2,819.00	$2,819.00	2026-01-07
64718	CPT	64718 Neuroplasty And/or Transposition Ulnar Nerve At Elbow	1	1	$4,405.00	$3,965.00	$2,748.00	$2,748.00	$2,748.00	2026-01-07
71552	CPT	MRI Chest With + Without Contrast	1	1	$4,349.00	$3,914.00	$2,713.00	$2,713.00	$2,713.00	2026-01-07
64721	CPT	64721, Neuroplasty And/or Transposition Median Nerve At Carpal Tunnel	1	1	$4,278.00	$3,850.00	$2,669.00	$2,669.00	$2,669.00	2026-01-07
67914	CPT	Repair Ectropion	1	1	$4,210.00	$3,789.00	$2,627.00	$2,627.00	$2,627.00	2026-01-07
67921	CPT	Excision Lesion Eyelid	1	1	$4,210.00	$3,789.00	$2,627.00	$2,627.00	$2,627.00	2026-01-07
21337	CPT	21337-nasal Septal	1	1	$4,143.00	$3,729.00	$2,585.00	$2,585.00	$2,585.00	2026-01-07
73220	CPT	MRI Ue Joint With + Without Contrast Left	1	1	$4,122.00	$3,710.00	$2,572.00	$2,572.00	$2,572.00	2026-01-07
J7318	HCPCS	60mg/3ml Sodium Hyaluronate Injamb Sodium Hyaluronate Charge	1	1	$4,029.00	$3,626.00	$2,514.00	$2,514.00	$2,514.00	2026-01-07
78452	CPT	Nm Myocardial Spect Multiple Studies	1	1	$3,902.00	$3,512.00	$2,434.00	$2,434.00	$2,434.00	2026-01-07
73223	CPT	MRI Upper Extremity With + Without Cnt Left	1	1	$3,817.00	$3,435.00	$2,381.00	$2,381.00	$2,381.00	2026-01-07
73720	CPT	MRI Lower Extremity With + Without Cnt Left	1	1	$3,813.00	$3,432.00	$2,379.00	$2,379.00	$2,379.00	2026-01-07
73723	CPT	MRI Le Joint With + Without Contrast Left	1	1	$3,806.00	$3,425.00	$2,375.00	$2,375.00	$2,375.00	2026-01-07
74183	CPT	MRI Abdomen With + Without Contrast	1	1	$3,801.00	$3,421.00	$2,371.00	$2,371.00	$2,371.00	2026-01-07
72197	CPT	MRI Pelvis With + Without Contrast	1	1	$3,792.00	$3,413.00	$2,366.00	$2,366.00	$2,366.00	2026-01-07
70543	CPT	MRI Face Neck Orbit With + Without Contrast	1	1	$3,768.00	$3,391.00	$2,351.00	$2,351.00	$2,351.00	2026-01-07
75635	CPT	CT Angio Abdominal Aorta With Runoff	1	1	$3,717.00	$3,345.00	$2,319.00	$2,319.00	$2,319.00	2026-01-07
70553	CPT	MRI Scan	1	1	$3,664.00	$3,298.00	$2,286.00	$2,286.00	$2,286.00	2026-01-07
28055	CPT	28055 Neurectomy, Intrinsic Musculature Of Foot Profee	1	1	$3,649.00	$3,284.00	$2,277.00	$2,277.00	$2,277.00	2026-01-07
28035	CPT	Release, Tarsal Tunnel 28035	1	1	$3,649.00	$3,284.00	$2,277.00	$2,277.00	$2,277.00	2026-01-07
43249	CPT	43249esophagogastroduodenoscopy	1	1	$3,619.00	$3,257.00	$2,258.00	$2,258.00	$2,258.00	2026-01-07
72156	CPT	MRI Spine Cervical With + Without Contrast	1	1	$3,607.00	$3,246.00	$2,250.00	$2,250.00	$2,250.00	2026-01-07
72158	CPT	MRI Spine Lumbar With + Without Contrast	1	1	$3,600.00	$3,240.00	$2,246.00	$2,246.00	$2,246.00	2026-01-07
74178	CPT	Smph CT Abdomen And Pelvis With + Without Contrast	1	1	$3,508.00	$3,157.00	$2,189.00	$2,189.00	$2,189.00	2026-01-07
14040	CPT	14040 Adjacent Tissue Transfer Or Rearrangement, F/ck/cn/m/n/ax/gen/h/ft; Defect…	1	1	$3,485.00	$3,137.00	$2,174.00	$2,174.00	$2,174.00	2026-01-07
74174	CPT	Smph CT Angio Abdomen And Pelvis	1	1	$3,439.00	$3,095.00	$2,146.00	$2,146.00	$2,146.00	2026-01-07
73219	CPT	MRI Upper Extremity With Contrast Left	1	1	$3,385.00	$3,047.00	$2,112.00	$2,112.00	$2,112.00	2026-01-07
72157	CPT	MRI Spine Thoracic With + Without Contrast	1	1	$3,368.00	$3,031.00	$2,101.00	$2,101.00	$2,101.00	2026-01-07
95811	CPT	95811 Sleep Study C-pap Attended Charge	1	1	$3,323.00	$2,991.00	$2,073.00	$2,073.00	$2,073.00	2026-01-07
70548	CPT	MRA Neck With Contrast	1	1	$3,317.00	$2,985.00	$2,069.00	$2,069.00	$2,069.00	2026-01-07
69436	CPT	Myringotomy With Tympanostomy Tubes	1	1	$3,298.00	$2,968.00	$2,058.00	$2,058.00	$2,058.00	2026-01-07
45385	CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope	1	1	$3,258.00	$2,932.00	$2,033.00	$2,033.00	$2,033.00	2026-01-07
71550	CPT	MRI Chest Without Contrast	1	1	$3,218.00	$2,896.00	$2,008.00	$2,008.00	$2,008.00	2026-01-07
45384	CPT	Colonoscopy Excision Lesion	1	1	$3,178.00	$2,860.00	$1,983.00	$1,983.00	$1,983.00	2026-01-07
73218	CPT	MRI Upper Extremity Without Contrast Left	1	1	$3,177.00	$2,859.00	$1,982.00	$1,982.00	$1,982.00	2026-01-07
21930	CPT	Excision Lesion Skin Benign Torso	1	1	$3,155.00	$2,840.00	$1,968.00	$1,968.00	$1,968.00	2026-01-07
37609	CPT	37609ligation/biopsy, Temporal Artery	1	1	$3,141.00	$2,827.00	$1,960.00	$1,960.00	$1,960.00	2026-01-07
95810	CPT	Sleep Study	1	1	$3,140.00	$2,826.00	$1,959.00	$1,959.00	$1,959.00	2026-01-07
43246	CPT	43246esophagogastroduodenoscopy	1	1	$3,127.00	$2,814.00	$1,951.00	$1,951.00	$1,951.00	2026-01-07
70544	CPT	MRA Brain/head Without Contrast	1	1	$3,121.00	$2,809.00	$1,947.00	$1,947.00	$1,947.00	2026-01-07
45380	CPT	Biopsy Exam Of Large Bowel Using An Endoscope	1	1	$3,094.00	$2,785.00	$1,930.00	$1,930.00	$1,930.00	2026-01-07
78451	CPT	Nm Myocardial Spect Single Study	1	1	$3,087.00	$2,778.00	$1,926.00	$1,926.00	$1,926.00	2026-01-07
45378	CPT	Diagnostic Exam Of Large Bowel Using An Endoscope	1	1	$3,042.00	$2,738.00	$1,898.00	$1,898.00	$1,898.00	2026-01-07
26116	CPT	26116 Exc Tumor Soft Tiss/vasc Malform Hand/finger Subfascial Less Than 1.5cm	1	1	$3,013.00	$2,712.00	$1,880.00	$1,880.00	$1,880.00	2026-01-07
26113	CPT	26113 Exc Tumor Soft Tiss/vasc Malform Hand/finger Subfascial 1.5cm Or Greater	1	1	$3,013.00	$2,712.00	$1,880.00	$1,880.00	$1,880.00	2026-01-07
32551	CPT	32551-insertion Chest Tube	1	1	$3,013.00	$2,712.00	$1,880.00	$1,880.00	$1,880.00	2026-01-07
26236	CPT	26236 Partial Excision Distal Phalanx Of Finger	1	1	$2,982.00	$2,684.00	$1,860.00	$1,860.00	$1,860.00	2026-01-07
74185	CPT	MRA Abdomen With + Without Contrast	1	1	$2,946.00	$2,651.00	$1,838.00	$1,838.00	$1,838.00	2026-01-07
23075	CPT	23075 Exc Tumor Soft Tissue Shoulder Area Subcut Less Than 3 Cm	1	1	$2,926.00	$2,633.00	$1,826.00	$1,826.00	$1,826.00	2026-01-07
21012	CPT	21012 Excision, Tumor, Soft Tissue Of Face Or Scalp, Subcutaneous; 2 Cm Or Great…	1	1	$2,926.00	$2,633.00	$1,826.00	$1,826.00	$1,826.00	2026-01-07
21011	CPT	21011 Excision, Tumor, Soft Tissue Of Face Or Scalp, Subcutaneous; Less Than 2 C…	1	1	$2,926.00	$2,633.00	$1,826.00	$1,826.00	$1,826.00	2026-01-07
25071	CPT	25071 Exc Tumor Soft Tissue Forearm/wrist Area Subcutaneous 3 Cm Or Greater	1	1	$2,925.00	$2,633.00	$1,825.00	$1,825.00	$1,825.00	2026-01-07
23071	CPT	23071 Exc Tumor Soft Tissue Shoulder Area Subcut 3 Cm Or Greater	1	1	$2,925.00	$2,633.00	$1,825.00	$1,825.00	$1,825.00	2026-01-07
28043	CPT	28043 Excision, Tumor, Soft Tissue Of Foot Or Toe, Subfascial	1	1	$2,925.00	$2,633.00	$1,825.00	$1,825.00	$1,825.00	2026-01-07
26160	CPT	26160 Excision Of Lesion Of Tendon Sheath Or Joint Capsule, Hand Or Finger;	1	1	$2,895.00	$2,606.00	$1,806.00	$1,806.00	$1,806.00	2026-01-07
26055	CPT	26055 Incise Finger Tendon Sheath	1	1	$2,895.00	$2,606.00	$1,806.00	$1,806.00	$1,806.00	2026-01-07
28234	CPT	Tenotomy, Open, Extensor, Foot Or Toe, Each Tendon 28234	1	1	$2,895.00	$2,606.00	$1,806.00	$1,806.00	$1,806.00	2026-01-07
25111	CPT	25111 Or Exc Of Gangluion Cyst	1	1	$2,895.00	$2,606.00	$1,806.00	$1,806.00	$1,806.00	2026-01-07
29848	CPT	29848 Or Endoscopic Carpal Tunnel Release	1	1	$2,895.00	$2,606.00	$1,806.00	$1,806.00	$1,806.00	2026-01-07
28232	CPT	Tenotomy, Open, Tendon Flexor; Toe, Single Tendon 28232	1	1	$2,895.00	$2,606.00	$1,806.00	$1,806.00	$1,806.00	2026-01-07
28080	CPT	Excision, Interdigital Neuroma, Single, Each 28080	1	1	$2,895.00	$2,606.00	$1,806.00	$1,806.00	$1,806.00	2026-01-07
28010	CPT	28010 Tenotomy, Toe; Single Tendon	1	1	$2,895.00	$2,606.00	$1,806.00	$1,806.00	$1,806.00	2026-01-07
43239	CPT	Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	1	1	$2,850.00	$2,565.00	$1,778.00	$1,778.00	$1,778.00	2026-01-07
72149	CPT	MRI Spine Lumbar With Contrast	1	1	$2,848.00	$2,563.00	$1,777.00	$1,777.00	$1,777.00	2026-01-07
11044	CPT	11044bone, First 20 Cm Or Less	2	1	$2,845.00	$2,560.50	$1,767.00	$1,783.00	$1,775.00	2026-01-07
72195	CPT	MRI Pelvis Without Contrast	1	1	$2,836.00	$2,552.00	$1,769.00	$1,769.00	$1,769.00	2026-01-07
28192	CPT	28192foot Deep	1	1	$2,809.00	$2,528.00	$1,753.00	$1,753.00	$1,753.00	2026-01-07
21315	CPT	21315nasal Bone Fx Without Stabilization	1	1	$2,790.00	$2,511.00	$1,741.00	$1,741.00	$1,741.00	2026-01-07
73718	CPT	MRI Lower Extremity Without Contrast Left	1	1	$2,789.00	$2,510.00	$1,740.00	$1,740.00	$1,740.00	2026-01-07
26418	CPT	26418 Repair Finger Tendon, Primary Or Secondary, Each	2	1	$2,788.50	$2,510.00	$1,673.00	$1,806.00	$1,739.50	2026-01-07
26410	CPT	26410 Repair Extensor Tendon Hand Without Graft, Each	2	1	$2,788.50	$2,510.00	$1,673.00	$1,806.00	$1,739.50	2026-01-07
24200	CPT	24200 Fb Rem Upper Arm/elbow-sq Profee	2	1	$2,767.50	$2,490.50	$1,701.00	$1,753.00	$1,727.00	2026-01-07
74177	CPT	CT Scan Of Abdomen And Pelvis With Contrast	1	1	$2,757.00	$2,481.00	$1,720.00	$1,720.00	$1,720.00	2026-01-07
22902	CPT	Excision, Tumor, Soft Tissue Of Abdominal Wall, Subcutaneous, Less Than 3 Cm 229…	1	1	$2,742.00	$2,468.00	$1,711.00	$1,711.00	$1,711.00	2026-01-07
72142	CPT	MRI Spine Cervical With Contrast	1	1	$2,735.00	$2,462.00	$1,706.00	$1,706.00	$1,706.00	2026-01-07
70552	CPT	MRI Brain With Contrast	1	1	$2,723.00	$2,451.00	$1,699.00	$1,699.00	$1,699.00	2026-01-07
32556	CPT	32556drainage, Percutaneous Without Guidance	1	1	$2,708.00	$2,437.00	$1,690.00	$1,690.00	$1,690.00	2026-01-07
10180	CPT	10180 I&d Complex Postop Wound Infection	2	1	$2,693.50	$2,424.50	$357.00	$3,003.00	$1,680.00	2026-01-07
30801	CPT	Turbinectomy	1	1	$2,684.00	$2,416.00	$1,675.00	$1,675.00	$1,675.00	2026-01-07
27238	CPT	27238clsd Tx Femoral Fracture Without Manip	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
26645	CPT	26645carpometacarpal, Thumb W/manipulation	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
25605	CPT	25605-distal Radial With Manipulation	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
25565	CPT	25565-radial&ulnar Shaft With Manipulation	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
25505	CPT	25505-radial Shaft With Manipulation	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
24620	CPT	24620-elbow/ Monteggia With Manipulation	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
24605	CPT	24605-elbow With Anesthesia	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
23665	CPT	23665-shoulder Dislocation With Humeral Fx	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
23655	CPT	23655-shoulder With Anesthesia	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
27810	CPT	27810-bimalleolar Ankle With Manipulation	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
27825	CPT	27825-distal Tibia With Traction Or Manipulation	1	1	$2,682.00	$2,414.00	$1,673.00	$1,673.00	$1,673.00	2026-01-07
23520	CPT	23520-sternoclavicular Without Manipulation	2	1	$2,641.50	$2,377.50	$1,623.00	$1,673.00	$1,648.00	2026-01-07
23505	CPT	23505-clavicular W/manipulation	2	1	$2,641.50	$2,377.50	$1,623.00	$1,673.00	$1,648.00	2026-01-07
10140	CPT	10140-i&d Hematoma/seroma/fluid	3	1	$2,627.00	$2,364.00	$311.00	$1,784.00	$1,639.00	2026-01-07
95805	CPT	95805 Multiple Sleep Latency Or Maintenance Of Wakefulness Testing, Recording, A…	1	1	$2,493.00	$2,244.00	$1,555.00	$1,555.00	$1,555.00	2026-01-07
12037	CPT	12037 Repair, Intermediate, Wounds Of Scalp, Axillae, Trunk And/or Extremities; …	2	1	$2,487.50	$2,238.50	$866.00	$2,238.00	$1,552.00	2026-01-07
70551	CPT	MRI Brain Without Contrast	1	1	$2,477.00	$2,229.00	$1,545.00	$1,545.00	$1,545.00	2026-01-07
74170	CPT	CT Abdomen With + Without Contrast	1	1	$2,456.00	$2,210.00	$1,532.00	$1,532.00	$1,532.00	2026-01-07
72196	CPT	MRI Pelvis With Contrast	1	1	$2,455.00	$2,210.00	$1,532.00	$1,532.00	$1,532.00	2026-01-07
74181	CPT	MRI Abdomen Without Contrast	1	1	$2,439.00	$2,195.00	$1,522.00	$1,522.00	$1,522.00	2026-01-07
71275	CPT	Smph CT Angio Chest	1	1	$2,439.00	$2,195.00	$1,522.00	$1,522.00	$1,522.00	2026-01-07
3268079	CDM	Kit Internalbrace	1	1	$2,440.00	$2,196.00	$1,522.00	$1,522.00	$1,522.00	2026-01-07
3020020	CDM	Telemetry Chargeinpatient	1	1	$2,414.00	$2,173.00	$1,506.00	$1,506.00	$1,506.00	2026-01-07
70496	CPT	CT Angio Brain/head	1	1	$2,391.00	$2,152.00	$1,492.00	$1,492.00	$1,492.00	2026-01-07
70540	CPT	MRI Face Neck Orbit Without Contrast	1	1	$2,391.00	$2,152.00	$1,492.00	$1,492.00	$1,492.00	2026-01-07
73721	CPT	MRI Scan Of Leg Joint	1	1	$2,386.00	$2,147.00	$1,489.00	$1,489.00	$1,489.00	2026-01-07
70498	CPT	Smph CT Angio Neck	1	1	$2,387.00	$2,148.00	$1,489.00	$1,489.00	$1,489.00	2026-01-07
78227	CPT	Nm Hepatobiliary Imaging With Drug	1	1	$2,384.00	$2,146.00	$1,487.00	$1,487.00	$1,487.00	2026-01-07
70336	CPT	MRI Tmj	1	1	$2,330.00	$2,097.00	$1,454.00	$1,454.00	$1,454.00	2026-01-07
73221	CPT	MRI Ue Joint Without Contrast Left	1	1	$2,327.00	$2,094.00	$1,452.00	$1,452.00	$1,452.00	2026-01-07
72146	CPT	MRI Spine Thoracic Without Contrast	1	1	$2,304.00	$2,074.00	$1,437.00	$1,437.00	$1,437.00	2026-01-07
72148	CPT	MRI Scan Of Lower Spinal Canal	1	1	$2,304.00	$2,074.00	$1,437.00	$1,437.00	$1,437.00	2026-01-07
71270	CPT	Smph CT Chest With + Without Contrast	1	1	$2,289.00	$2,060.00	$1,428.00	$1,428.00	$1,428.00	2026-01-07
99291	CPT	99291critical Care, 30-74	2	1	$2,240.50	$2,016.50	$1,377.00	$1,419.00	$1,398.00	2026-01-07
49560	CPT	Repair Hernia Ventral	1	1	$2,234.00	$2,011.00	$1,394.00	$1,394.00	$1,394.00	2026-01-07
72147	CPT	MRI Spine Thoracic With Contrast	1	1	$2,194.00	$1,975.00	$1,369.00	$1,369.00	$1,369.00	2026-01-07
72141	CPT	MRI Spine Cervical Without Contrast	1	1	$2,170.00	$1,953.00	$1,354.00	$1,354.00	$1,354.00	2026-01-07
70482	CPT	CT Orbits Sella With + Without Contrast	1	1	$2,146.00	$1,931.00	$1,339.00	$1,339.00	$1,339.00	2026-01-07
47562	CPT	Removal Of Gallbladder Using An Endoscope	2	1	$2,139.00	$1,925.00	$1,277.00	$1,392.00	$1,334.50	2026-01-07
28193	CPT	28193foot Complicated	2	1	$2,090.50	$1,881.50	$856.00	$1,753.00	$1,304.50	2026-01-07
74175	CPT	CT Angio Abdomen	1	1	$2,078.00	$1,870.00	$1,296.00	$1,296.00	$1,296.00	2026-01-07
72194	CPT	CT Pelvis With + Without Contrast	1	1	$2,077.00	$1,869.00	$1,296.00	$1,296.00	$1,296.00	2026-01-07
3080010	CDM	Room/bed: ICU	1	1	$2,076.00	$1,868.00	$1,295.00	$1,295.00	$1,295.00	2026-01-07
73202	CPT	CT Upper Extremity W/+without Contrast Left	1	1	$2,030.00	$1,827.00	$1,267.00	$1,267.00	$1,267.00	2026-01-07
73702	CPT	CT Lower Extremity W/+without Contrast Bilat	1	1	$1,999.00	$1,799.00	$1,247.00	$1,247.00	$1,247.00	2026-01-07
44394	CPT	Colonoscopy Polypectomy	1	1	$1,985.00	$1,787.00	$1,238.00	$1,238.00	$1,238.00	2026-01-07
70481	CPT	CT Orbits Sella With Contrast	1	1	$1,939.00	$1,745.00	$1,210.00	$1,210.00	$1,210.00	2026-01-07
70492	CPT	CT Neck Soft Tissue With + Without Contrast	1	1	$1,925.00	$1,733.00	$1,201.00	$1,201.00	$1,201.00	2026-01-07
74176	CPT	CT Abdomen And Pelvis Without Contrast	1	1	$1,905.00	$1,715.00	$1,189.00	$1,189.00	$1,189.00	2026-01-07
70488	CPT	CT Maxillofacial With + Without Contrast	1	1	$1,828.00	$1,645.00	$1,140.00	$1,140.00	$1,140.00	2026-01-07
24535	CPT	24535-supracondylar W/manipulation	1	1	$1,814.00	$1,633.00	$1,132.00	$1,132.00	$1,132.00	2026-01-07
78315	CPT	Nm Bone Three Phase Study	1	1	$1,785.00	$1,607.00	$1,114.00	$1,114.00	$1,114.00	2026-01-07
12057	CPT	12057-face/ear/eye/nose/lip Greater Than 30.0 Cm	1	1	$1,768.00	$1,591.00	$1,103.00	$1,103.00	$1,103.00	2026-01-07
3020010	CDM	Room/bed: Acute	1	1	$1,758.00	$1,582.00	$1,097.00	$1,097.00	$1,097.00	2026-01-07
3010010	CDM	Room/bed: Pediatrics	1	1	$1,758.00	$1,582.00	$1,097.00	$1,097.00	$1,097.00	2026-01-07
73201	CPT	CT Upper Extremity With Contrast Bilat	1	1	$1,752.00	$1,577.00	$1,093.00	$1,093.00	$1,093.00	2026-01-07
78226	CPT	Nm Hepatobiliary Imaging	1	1	$1,750.00	$1,575.00	$1,092.00	$1,092.00	$1,092.00	2026-01-07
70470	CPT	CT Head With + Without Contrast	1	1	$1,730.00	$1,557.00	$1,079.00	$1,079.00	$1,079.00	2026-01-07
72132	CPT	CT Spine Lumbar With Contrast	1	1	$1,730.00	$1,557.00	$1,079.00	$1,079.00	$1,079.00	2026-01-07
71260	CPT	Smph CT Chest With Contrast	1	1	$1,730.00	$1,557.00	$1,079.00	$1,079.00	$1,079.00	2026-01-07
72129	CPT	CT Spine Thoracic With Contrast	1	1	$1,730.00	$1,557.00	$1,079.00	$1,079.00	$1,079.00	2026-01-07
72126	CPT	CT Spine Cervical With Contrast	1	1	$1,730.00	$1,557.00	$1,079.00	$1,079.00	$1,079.00	2026-01-07
10121	CPT	10121 Incision And Removal Of Foreign Body, Subcutaneous Tissues; Complicated	2	1	$1,707.00	$1,536.00	$491.00	$1,639.00	$1,065.00	2026-01-07
43247	CPT	43247-egd With Removal Foreign Body	2	1	$1,702.00	$1,532.00	$346.00	$1,778.00	$1,062.00	2026-01-07
74160	CPT	CT Abdomen With Contrast	1	1	$1,677.00	$1,509.00	$1,046.00	$1,046.00	$1,046.00	2026-01-07
72193	CPT	CT Scan Of Pelvis With Contrast	1	1	$1,677.00	$1,509.00	$1,046.00	$1,046.00	$1,046.00	2026-01-07
12056	CPT	12056-face/ear/eye/nose/lip 20.1-30.0 Cm	1	1	$1,668.00	$1,501.00	$1,041.00	$1,041.00	$1,041.00	2026-01-07
43235	CPT	Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	2	1	$1,618.00	$1,456.50	$294.00	$1,725.00	$1,009.50	2026-01-07
49505	CPT	Repair Of Groin Hernia Patient Age 5 Years Or Older	1	1	$1,611.00	$1,450.00	$1,005.00	$1,005.00	$1,005.00	2026-01-07
G0390	HCPCS	G0390-811 Preactivation Trauma Response	1	1	$1,594.00	$1,435.00	$994.00	$994.00	$994.00	2026-01-07
70480	CPT	CT Orbits Sella Without Contrast	1	1	$1,585.00	$1,427.00	$989.00	$989.00	$989.00	2026-01-07
12047	CPT	12047-neck/hand/feet/genital Greater Than 30.0 Cm	1	1	$1,582.00	$1,424.00	$987.00	$987.00	$987.00	2026-01-07
73701	CPT	CT Lower Extremity With Contrast Bilat	1	1	$1,576.00	$1,418.00	$983.00	$983.00	$983.00	2026-01-07
3268126	CDM	Nanoscopic Release System	1	1	$1,561.00	$1,405.00	$974.00	$974.00	$974.00	2026-01-07
70491	CPT	CT Neck Soft Tissue With Contrast	1	1	$1,558.00	$1,402.00	$972.00	$972.00	$972.00	2026-01-07
78306	CPT	Nm Bone Imaging Whole Body	1	1	$1,548.00	$1,393.00	$966.00	$966.00	$966.00	2026-01-07
72128	CPT	CT Spine Thoracic Without Contrast	1	1	$1,530.00	$1,377.00	$955.00	$955.00	$955.00	2026-01-07
72125	CPT	CT Spine Cervical Without Contrast	1	1	$1,530.00	$1,377.00	$955.00	$955.00	$955.00	2026-01-07
72131	CPT	CT Spine Lumbar Without Contrast	1	1	$1,530.00	$1,377.00	$955.00	$955.00	$955.00	2026-01-07
72192	CPT	CT Pelvis Without Contrast	1	1	$1,530.00	$1,377.00	$955.00	$955.00	$955.00	2026-01-07
78803	CPT	Nm Tumor Loc Spect	1	1	$1,531.00	$1,378.00	$955.00	$955.00	$955.00	2026-01-07
66821	CPT	Removal Of Recurring Cataract In Lens Capsule Using Laser	1	1	$1,517.00	$1,365.00	$946.00	$946.00	$946.00	2026-01-07
27618	CPT	Excision Lesion Lower Extremity	1	1	$1,514.00	$1,363.00	$945.00	$945.00	$945.00	2026-01-07
11420	CPT	11420-excise Lesion Bn Scalp/nose/hand/feet/genital <=0.5 Cm	2	1	$1,498.00	$1,348.00	$230.00	$1,639.00	$934.50	2026-01-07
11646	CPT	11646 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L…	1	1	$1,483.00	$1,335.00	$925.00	$925.00	$925.00	2026-01-07
73200	CPT	CT Upper Extremity Without Contrast Left	1	1	$1,462.00	$1,316.00	$912.00	$912.00	$912.00	2026-01-07
71250	CPT	Smph CT Chest Without Contrast	1	1	$1,447.00	$1,302.00	$903.00	$903.00	$903.00	2026-01-07
12046	CPT	12046-neck/hand/feet/genital 20.1-30.0 Cm	1	1	$1,440.00	$1,296.00	$898.00	$898.00	$898.00	2026-01-07
CP17616807779736920	CDM	00259-1610-01incobotulinumtoxina 100 Units Pow	1	1	$1,439.00	$1,295.00	$898.00	$898.00	$898.00	2026-01-07
99285	CPT	99285level 5	1	1	$1,431.00	$1,288.00	$893.00	$893.00	$893.00	2026-01-07
19020	CPT	19020-mastotomy Exploration/drain Abscess Deep	1	1	$1,409.00	$1,268.00	$879.00	$879.00	$879.00	2026-01-07
70487	CPT	CT Maxillofacial With Contrast	1	1	$1,392.00	$1,253.00	$868.00	$868.00	$868.00	2026-01-07
73700	CPT	CT Lower Extremity Without Contrast Bilat	1	1	$1,386.00	$1,247.00	$865.00	$865.00	$865.00	2026-01-07
74150	CPT	CT Abdomen Without Contrast	1	1	$1,384.00	$1,246.00	$863.00	$863.00	$863.00	2026-01-07
70460	CPT	CT Head With Contrast	1	1	$1,382.00	$1,244.00	$862.00	$862.00	$862.00	2026-01-07
70490	CPT	Smph CT Neck Soft Tissue Without Contrast	1	1	$1,374.00	$1,237.00	$857.00	$857.00	$857.00	2026-01-07
23605	CPT	23605-proximal Humeral With Manipulation	1	1	$1,355.00	$1,220.00	$845.00	$845.00	$845.00	2026-01-07
CDM	CDM	Secondary Iol	1	1	$1,353.00	$1,218.00	$844.00	$844.00	$844.00	2026-01-07
78305	CPT	Nm Bone Imaging Multiple Areas	1	1	$1,347.00	$1,212.00	$840.00	$840.00	$840.00	2026-01-07
11606	CPT	11606 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; >4.0cm	1	1	$1,342.00	$1,208.00	$837.00	$837.00	$837.00	2026-01-07
32554	CPT	32554-thoracentesis Without Imaging Guidance	1	1	$1,339.00	$1,205.00	$835.00	$835.00	$835.00	2026-01-07
24675	CPT	24675-ulna Proximal End With Manipulation	1	1	$1,327.00	$1,194.00	$828.00	$828.00	$828.00	2026-01-07
28190	CPT	28190-foot Subcutaneous	2	1	$1,324.50	$1,192.50	$814.00	$839.00	$826.50	2026-01-07
20103	CPT	20103 Exploration Penetrating Wound Spx Extremity Profee	2	1	$1,324.50	$1,192.50	$814.00	$839.00	$826.50	2026-01-07
70486	CPT	CT Maxillofacial Without Contrast	1	1	$1,317.00	$1,185.00	$822.00	$822.00	$822.00	2026-01-07
70450	CPT	CT Scan	1	1	$1,317.00	$1,185.00	$822.00	$822.00	$822.00	2026-01-07
25635	CPT	25635-carpal Bone W/manipulation	1	1	$1,284.00	$1,156.00	$801.00	$801.00	$801.00	2026-01-07
24655	CPT	24655radial Head/neck With Manipulation	1	1	$1,275.00	$1,148.00	$795.00	$795.00	$795.00	2026-01-07
13132	CPT	13132 Repair Complex F/c/c/m/n/ax/g/h/f 2.6-7.5 Cm Techfee	2	1	$1,267.00	$1,140.00	$734.00	$847.00	$790.50	2026-01-07
10080	CPT	10080-i&d Pilonidal Cyst Simple	1	1	$1,257.00	$1,131.00	$784.00	$784.00	$784.00	2026-01-07
28092	CPT	28092 Excision Of Lesion, Tendon, Tendon Sheath, Or Capsule (Including Synovecto…	1	1	$1,248.00	$1,123.00	$779.00	$779.00	$779.00	2026-01-07
12036	CPT	12036 Repair, Intermediate; Wounds Of Scalp, Axillae, Trunk, Extremities; 20.1-3…	2	1	$1,245.00	$1,120.50	$765.00	$789.00	$777.00	2026-01-07
11441	CPT	11441-exc F/e/e/n/l; 0.6-1.0	2	1	$1,211.50	$1,090.50	$727.00	$785.00	$756.00	2026-01-07
56605	CPT	56605-biopsy Of Vulva/perineum	1	1	$1,211.00	$1,090.00	$756.00	$756.00	$756.00	2026-01-07
12045	CPT	12045-neck/hand/feet/genital 12.6-20.0 Cm	1	1	$1,195.00	$1,076.00	$746.00	$746.00	$746.00	2026-01-07
11626	CPT	11626 Excision, Malignant Lesion Including Margins, Scalp, Neck, Hands, Feet, Ge…	1	1	$1,179.00	$1,061.00	$736.00	$736.00	$736.00	2026-01-07
13151	CPT	13151 Repair Complex Eyelid/nose/ear/lip 1.1-2.5 Cm Techfee	1	1	$1,177.00	$1,059.00	$734.00	$734.00	$734.00	2026-01-07
13101	CPT	13101 Repair Complex Trunk 2.6-7.5 Cm Techfee	2	1	$1,165.50	$1,049.00	$720.00	$734.00	$727.00	2026-01-07
40650	CPT	40650-lip Full Thickness Vermilion Only	1	1	$1,166.00	$1,049.00	$727.00	$727.00	$727.00	2026-01-07
P9037	HCPCS	E5030 Aph Plt Acda Lr Bm	1	1	$1,152.00	$1,037.00	$719.00	$719.00	$719.00	2026-01-07
3268052	CDM	Dx Swivelock Anchor	1	1	$1,151.00	$1,036.00	$718.00	$718.00	$718.00	2026-01-07
13121	CPT	13121 Repair Complex Scalp/arm/leg 2.6-7.5 Cm Techfee	2	1	$1,139.50	$1,025.50	$653.00	$769.00	$711.00	2026-01-07
11644	CPT	11644 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L…	1	1	$1,137.00	$1,023.00	$709.00	$709.00	$709.00	2026-01-07
11446	CPT	11446 Excision, Benign Lesion Including Margins; Face, Ears, Eyelids, Nose, Lips…	1	1	$1,131.00	$1,018.00	$706.00	$706.00	$706.00	2026-01-07
23625	CPT	23625 Treat Humerus Fracture	1	1	$1,130.00	$1,017.00	$705.00	$705.00	$705.00	2026-01-07
21450	CPT	21450-clsd Tx Mandibularfracturew/omanip	1	1	$1,130.00	$1,017.00	$705.00	$705.00	$705.00	2026-01-07
21400	CPT	21400-orbit Without Manipulation	1	1	$1,130.00	$1,017.00	$705.00	$705.00	$705.00	2026-01-07
78300	CPT	Nm Bone Imaging Limited	1	1	$1,118.00	$1,006.00	$698.00	$698.00	$698.00	2026-01-07
92523	CPT	Slp Eval Lang Comprehension,express Unit	1	1	$1,109.00	$998.00	$692.00	$692.00	$692.00	2026-01-07
92950	CPT	92950 Cpr Physician Profee	2	1	$1,095.00	$985.50	$370.00	$996.00	$683.00	2026-01-07
88309	CPT	88309 Ap Bill Surgical Pathology Level Vi Complexity	1	1	$1,082.00	$974.00	$675.00	$675.00	$675.00	2026-01-07
13152	CPT	13152 Repair Complex Eyelid/nose/ear/lip 2.6-7.5 Cm Techfee	1	1	$1,067.00	$960.00	$666.00	$666.00	$666.00	2026-01-07
P9035	HCPCS	E2984 Aph Plt Acda Lr Irr Plas Red Open	1	1	$1,067.00	$960.00	$666.00	$666.00	$666.00	2026-01-07
12055	CPT	12055 Intermed Repair Of Wounds; Face, Ears, Eyelids, Nose, Lips, Mucous Membra;…	2	1	$1,063.50	$957.50	$469.00	$858.00	$663.50	2026-01-07
78013	CPT	Nm Thyroid Scan	1	1	$1,058.00	$952.00	$660.00	$660.00	$660.00	2026-01-07
29000	CPT	29000 Application Of Halo Type Body Cast (See 20661-20663 For Insertion) Profee	1	1	$1,053.00	$948.00	$657.00	$657.00	$657.00	2026-01-07
13120	CPT	13120 Repair Complex Scalp/arm/leg 1.1-2.5 Cm Techfee	1	1	$1,047.00	$942.00	$653.00	$653.00	$653.00	2026-01-07
90847	CPT	Family Psychotherapy, Including Patient, 50 Min	1	1	$1,045.00	$941.00	$652.00	$652.00	$652.00	2026-01-07

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