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

SMP HEALTH ST ALOISIUS

Harvey, ND · CCN 351327 · Rates published

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 — reasonRows
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 viaCMS 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 		Reconstruct Ankle Joint 1 $13,165.00 $13,165.00 $13,165.00 nat. median
$15,864
0.8× median
27385
CPT 		Repair Of Thigh Muscle 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,708
1.2× median
28310
CPT 		Revision Of Big Toe 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,166
1.3× median
27691
CPT 		Revise Lower Leg Tendon 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,958
1.2× median
28300
CPT 		Incision Of Heel Bone 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,697
1.2× median
24342
CPT 		Repair Of Ruptured Tendon 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,962
1.2× median
27381
CPT 		Repair/graft Kneecap Tendon 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,822
1.2× median
28304
CPT 		Incision Of Midfoot Bones 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,733
1.2× median
26531
CPT 		Revise Knuckle With Implant 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$7,051
1.2× median
28297
CPT 		Cor Hlx Vlgs Jt Arthrd 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$7,585
1.1× median
28740
CPT 		Fusion Of Foot Bones 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,866
1.2× median
29807
CPT 		Sho Arthrs Srg Rpr Slap Les 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$7,098
1.1× median
27766
CPT 		Optx Medial Ankle Fx 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,986
1.2× median
28309
CPT 		Incision Of Metatarsals 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,889
1.2× median
27698
CPT 		Repair Of Ankle Ligament 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,552
1.2× median
27696
CPT 		Repair Of Ankle Ligaments 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,752
1.2× median
28750
CPT 		Fusion Of Big Toe Joint 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,995
1.2× median
26390
CPT 		Revise Hand/finger Tendon 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,931
1.2× median
29806
CPT 		Sho Arthrs Srg Capsulorraphy 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$7,171
1.1× median
29827
CPT 		Sho Arthrs Srg Rt8tr Cuf Rpr 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$7,184
1.1× median
28298
CPT 		Cor Hlx Vlgs Prx Phlx Osteot 1 $8,128.00 $8,128.00 $8,128.00 nat. median
$6,628
1.2× median
31296
CPT 		Nsl/sins Ndsc Surg Frnt Sins 1 $7,207.00 $7,207.00 $7,207.00 nat. median
$6,695
1.1× median
31295
CPT 		Nsl/sins Ndsc Surg Max Sins 1 $7,207.00 $7,207.00 $7,207.00 nat. median
$6,521
1.1× median
31298
CPT 		Nsl/sins Ndsc Surg Frnt&sphn 1 $7,207.00 $7,207.00 $7,207.00 nat. median
$6,800
1.1× median
31297
CPT 		Nsl/sins Ndsc Surg Sphn Sins 1 $7,207.00 $7,207.00 $7,207.00 nat. median
$6,417
1.1× median
42820
CPT 		Remove Tonsils And Adenoids 1 $6,977.00 $6,977.00 $6,977.00 nat. median
$5,527
1.3× median
42825
CPT 		Removal Of Tonsils 1 $6,977.00 $6,977.00 $6,977.00 nat. median
$5,616
1.2× median
49593
CPT 		Rpr Aa Hrn 1st 3-10 Rdc 1 $5,085.00 $5,085.00 $5,085.00 nat. median
$5,968
0.9× median
49591
CPT 		Rpr Aa Hrn 1st < 3 Cm Rdc 1 $4,717.00 $4,717.00 $4,717.00 nat. median
$3,848
1.2× median
J3301
HCPCS 		Triamcinolone Acet Inj Nos 1 $4,682.00 $4,682.00 $4,682.00 nat. median
$25
outlier · 185.9×
49521
CPT 		Rerepair Ing Hernia Blocked 1 $4,367.00 $4,367.00 $4,367.00 nat. median
$5,928
0.7× median
40886
CPT 		1 $2,254.00 $6,277.00 $4,265.50 nat. median
$4,344
1.0× median
69421
CPT 		Incision Of Eardrum 1 $4,163.00 $4,163.00 $4,163.00 nat. median
$3,282
1.3× median
55040
CPT 		Removal Of Hydrocele 1 $4,035.00 $4,035.00 $4,035.00 nat. median
$3,679
1.1× median
55041
CPT 		Removal Of Hydroceles 1 $4,035.00 $4,035.00 $4,035.00 nat. median
$3,906
1.0× median
19120
CPT 		Removal Of Breast Lesion 1 $4,003.00 $4,003.00 $4,003.00 nat. median
$3,671
1.1× median
19125
CPT 		Excision Breast Lesion 1 $4,002.00 $4,002.00 $4,002.00 nat. median
$3,920
1.0× median
28285
CPT 		Repair Of Hammertoe 1 $3,867.00 $3,867.00 $3,867.00 nat. median
$3,607
1.1× median
28113
CPT 		Part Removal Of Metatarsal 1 $3,867.00 $3,867.00 $3,867.00 nat. median
$3,417
1.1× median
26123
CPT 		Release Palm Contracture 1 $3,782.00 $3,782.00 $3,782.00 nat. median
$3,840
1.0× median
C9781
HCPCS 		1 $3,782.00 $3,782.00 $3,782.00 nat. median
$12,888
outlier · 0.3×
42831
CPT 		Removal Of Adenoids 1 $3,754.00 $3,754.00 $3,754.00 nat. median
$3,437
1.1× median
42830
CPT 		Removal Of Adenoids 1 $3,754.00 $3,754.00 $3,754.00 nat. median
$3,387
1.1× median
42826
CPT 		Removal Of Tonsils 1 $3,754.00 $3,754.00 $3,754.00 nat. median
$3,387
1.1× median
42821
CPT 		Remove Tonsils And Adenoids 1 $3,754.00 $3,754.00 $3,754.00 nat. median
$3,397
1.1× median
26860
CPT 		Fusion Of Finger Joint 1 $3,678.00 $3,678.00 $3,678.00 nat. median
$3,508
1.0× median
28119
CPT 		Removal Of Heel Spur 1 $3,672.00 $3,672.00 $3,672.00 nat. median
$3,464
1.1× median
29823
CPT 		Sho Arthrs Srg Xtnsv Dbrdmt 1 $3,672.00 $3,672.00 $3,672.00 nat. median
$3,950
0.9× median
26608
CPT 		Treat Metacarpal Fracture 1 $3,672.00 $3,672.00 $3,672.00 nat. median
$3,575
1.0× median
28270
CPT 		Release Of Foot Contracture 1 $3,672.00 $3,672.00 $3,672.00 nat. median
$3,343
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.

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
             
10080 CPT I&d Pilonidal Cyst Simple 1 1 $1,257.00 $1,131.00 $784.00 $784.00 $784.00 2026-01-07
10121 CPT Inc&rmvl Fb Subq Tiss Comp 2 1 $1,707.00 $1,536.00 $491.00 $1,639.00 $1,065.00 2026-01-07
10140 CPT I&d Hmtma Seroma/fluid Collj 3 1 $2,627.00 $2,364.00 $311.00 $1,784.00 $1,639.00 2026-01-07
10180 CPT I&d Complex Po Wound Infctj 2 1 $2,693.50 $2,424.50 $357.00 $3,003.00 $1,680.00 2026-01-07
11012 CPT Deb Skin Bone At Fx Site 1 1 $4,814.00 $4,333.00 $3,003.00 $3,003.00 $3,003.00 2026-01-07
11044 CPT Dbrdmt Bone 1st 20 Sq Cm/< 2 1 $2,845.00 $2,560.50 $1,767.00 $1,783.00 $1,775.00 2026-01-07
11420 CPT Exc H-f-nk-sp B9+marg 0.5/< 2 1 $1,498.00 $1,348.00 $230.00 $1,639.00 $934.50 2026-01-07
11441 CPT Exc Face-mm B9+marg 0.6-1 Cm 2 1 $1,211.50 $1,090.50 $727.00 $785.00 $756.00 2026-01-07
11446 CPT Exc Face-mm B9+marg >4 Cm 1 1 $1,131.00 $1,018.00 $706.00 $706.00 $706.00 2026-01-07
11606 CPT Exc Tr-ext Mal+marg >4 Cm 1 1 $1,342.00 $1,208.00 $837.00 $837.00 $837.00 2026-01-07
11626 CPT Exc S/n/h/f/g Mal+mrg >4 Cm 1 1 $1,179.00 $1,061.00 $736.00 $736.00 $736.00 2026-01-07
11644 CPT Exc F/e/e/n/l Mal+mrg 3.1-4 1 1 $1,137.00 $1,023.00 $709.00 $709.00 $709.00 2026-01-07
11646 CPT Exc F/e/e/n/l Mal+mrg >4 Cm 1 1 $1,483.00 $1,335.00 $925.00 $925.00 $925.00 2026-01-07
12036 CPT Intmd Rpr S/a/t/ext 20.1-30 2 1 $1,245.00 $1,120.50 $765.00 $789.00 $777.00 2026-01-07
12037 CPT Intmd Rpr S/tr/ext >30.0 Cm 2 1 $2,487.50 $2,238.50 $866.00 $2,238.00 $1,552.00 2026-01-07
12045 CPT Intmd Rpr N-hf/genit12.6-20 1 1 $1,195.00 $1,076.00 $746.00 $746.00 $746.00 2026-01-07
12046 CPT Intmd Rpr N-hf/genit20.1-30 1 1 $1,440.00 $1,296.00 $898.00 $898.00 $898.00 2026-01-07
12047 CPT Intmd Rpr N-hf/genit >30.0cm 1 1 $1,582.00 $1,424.00 $987.00 $987.00 $987.00 2026-01-07
12055 CPT Intmd Rpr Face/mm 12.6-20 Cm 2 1 $1,063.50 $957.50 $469.00 $858.00 $663.50 2026-01-07
12056 CPT Intmd Rpr Face/mm 20.1-30.0 1 1 $1,668.00 $1,501.00 $1,041.00 $1,041.00 $1,041.00 2026-01-07
12057 CPT Intmd Rpr Face/mm >30.0 Cm 1 1 $1,768.00 $1,591.00 $1,103.00 $1,103.00 $1,103.00 2026-01-07
13101 CPT Cmplx Rpr Trunk 2.6-7.5 Cm 2 1 $1,165.50 $1,049.00 $720.00 $734.00 $727.00 2026-01-07
13120 CPT Cmplx Rpr S/a/l 1.1-2.5 Cm 1 1 $1,047.00 $942.00 $653.00 $653.00 $653.00 2026-01-07
13121 CPT Cmplx Rpr S/a/l 2.6-7.5 Cm 2 1 $1,139.50 $1,025.50 $653.00 $769.00 $711.00 2026-01-07
13132 CPT Cmplx Rpr F/c/c/m/n/ax/g/h/f 2 1 $1,267.00 $1,140.00 $734.00 $847.00 $790.50 2026-01-07
13151 CPT Cmplx Rpr E/n/e/l 1.1-2.5 Cm 1 1 $1,177.00 $1,059.00 $734.00 $734.00 $734.00 2026-01-07
13152 CPT Cmplx Rpr E/n/e/l 2.6-7.5 Cm 1 1 $1,067.00 $960.00 $666.00 $666.00 $666.00 2026-01-07
14040 CPT Tis Trnfr F/c/c/m/n/a/g/h/f 1 1 $3,485.00 $3,137.00 $2,174.00 $2,174.00 $2,174.00 2026-01-07
19020 CPT Mastotomy Expl DRG Absc Dp 1 1 $1,409.00 $1,268.00 $879.00 $879.00 $879.00 2026-01-07
19120 CPT Removal Of Breast Lesion 1 1 $6,416.00 $5,774.00 $4,003.00 $4,003.00 $4,003.00 2026-01-07
19125 CPT Excision Breast Lesion 1 1 $6,415.00 $5,774.00 $4,002.00 $4,002.00 $4,002.00 2026-01-07
20103 CPT Expl Pentrg Wound Extremity 2 1 $1,324.50 $1,192.50 $814.00 $839.00 $826.50 2026-01-07
20680 CPT Removal Of Implant Deep 1 1 $4,928.00 $4,435.00 $3,075.00 $3,075.00 $3,075.00 2026-01-07
21011 CPT Exc Face Les Sc <2 Cm 1 1 $2,926.00 $2,633.00 $1,826.00 $1,826.00 $1,826.00 2026-01-07
21012 CPT Exc Face Les Sbq 2 Cm/> 1 1 $2,926.00 $2,633.00 $1,826.00 $1,826.00 $1,826.00 2026-01-07
21315 CPT Clsd Tx Nsl Fx Mnpj Wo Stblj 1 1 $2,790.00 $2,511.00 $1,741.00 $1,741.00 $1,741.00 2026-01-07
21337 CPT Closed Tx Septal&nose Fx 1 1 $4,143.00 $3,729.00 $2,585.00 $2,585.00 $2,585.00 2026-01-07
21400 CPT Closed Tx Orbit Without Manipulj 1 1 $1,130.00 $1,017.00 $705.00 $705.00 $705.00 2026-01-07
21450 CPT Cltx Mndblr Fx Without Mnpj 1 1 $1,130.00 $1,017.00 $705.00 $705.00 $705.00 2026-01-07
21552 CPT Exc Neck Les Sc 3 Cm/> 1 1 $4,928.00 $4,435.00 $3,075.00 $3,075.00 $3,075.00 2026-01-07
21930 CPT Exc Back Les Sc < 3 Cm 1 1 $3,155.00 $2,840.00 $1,968.00 $1,968.00 $1,968.00 2026-01-07
22902 CPT Exc Abd Les Sc < 3 Cm 1 1 $2,742.00 $2,468.00 $1,711.00 $1,711.00 $1,711.00 2026-01-07
22903 CPT Exc Abd Les Sc 3 Cm/> 1 1 $4,928.00 $4,435.00 $3,075.00 $3,075.00 $3,075.00 2026-01-07
23071 CPT Exc Shoulder Les Sc 3 Cm/> 1 1 $2,925.00 $2,633.00 $1,825.00 $1,825.00 $1,825.00 2026-01-07
23075 CPT Exc Shoulder Les Sc < 3 Cm 1 1 $2,926.00 $2,633.00 $1,826.00 $1,826.00 $1,826.00 2026-01-07
23505 CPT Cltx Clavicular Fx W/mnpj 2 1 $2,641.50 $2,377.50 $1,623.00 $1,673.00 $1,648.00 2026-01-07
23520 CPT Cltx Strnclav Dislc Without Mnpj 2 1 $2,641.50 $2,377.50 $1,623.00 $1,673.00 $1,648.00 2026-01-07
23605 CPT Cltx Prx Hmrl Fx Mnpj+-tract 1 1 $1,355.00 $1,220.00 $845.00 $845.00 $845.00 2026-01-07
23625 CPT Cltx Gr Hmrl Tbrs Fx W/mnpj 1 1 $1,130.00 $1,017.00 $705.00 $705.00 $705.00 2026-01-07
23655 CPT Cltx Sho Dslc W/mnpj W/anes 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
23665 CPT Cltx Sho Dslc Fx Gr Hmrl Tbr 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
24200 CPT Rmvl Fb Upper Arm/elbw Subq 2 1 $2,767.50 $2,490.50 $1,701.00 $1,753.00 $1,727.00 2026-01-07
24342 CPT Repair Of Ruptured Tendon 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
24535 CPT Cltx Sprcndylr Humeral Fx With 1 1 $1,814.00 $1,633.00 $1,132.00 $1,132.00 $1,132.00 2026-01-07
24605 CPT Tx Clsd Elbow Dislc Req Anes 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
24620 CPT Cltx Monteggia Fx Dislc Elbw 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
24655 CPT Cltx Rdl Head/nck Fx W/mnpj 1 1 $1,275.00 $1,148.00 $795.00 $795.00 $795.00 2026-01-07
24675 CPT Cltx Ulnar Fx Prox W/mnpj 1 1 $1,327.00 $1,194.00 $828.00 $828.00 $828.00 2026-01-07
25028 CPT I&d F/arm&/wrst Dp Absc/hmtm 1 1 $5,356.00 $4,820.00 $3,342.00 $3,342.00 $3,342.00 2026-01-07
25071 CPT Exc Forearm Les Sc 3 Cm/> 1 1 $2,925.00 $2,633.00 $1,825.00 $1,825.00 $1,825.00 2026-01-07
25111 CPT Remove Wrist Tendon Lesion 1 1 $2,895.00 $2,606.00 $1,806.00 $1,806.00 $1,806.00 2026-01-07
25301 CPT Fusion Of Tendons At Wrist 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
25505 CPT Cltx Rdl Shft Fx W/mnpj 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
25565 CPT Cltx Rdl&uln Shft Fx W/mnpj 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
25605 CPT Cltx Dst Rdl Fx/ephys Sep With 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
25635 CPT Cltx Carpl Fx W/mnpj Ea B1 1 1 $1,284.00 $1,156.00 $801.00 $801.00 $801.00 2026-01-07
26055 CPT Incise Finger Tendon Sheath 1 1 $2,895.00 $2,606.00 $1,806.00 $1,806.00 $1,806.00 2026-01-07
26113 CPT Exc Hand Tum Deep 1.5 Cm/> 1 1 $3,013.00 $2,712.00 $1,880.00 $1,880.00 $1,880.00 2026-01-07
26116 CPT Exc Hand Tum Deep < 1.5 Cm 1 1 $3,013.00 $2,712.00 $1,880.00 $1,880.00 $1,880.00 2026-01-07
26123 CPT Release Palm Contracture 1 1 $6,062.00 $5,456.00 $3,782.00 $3,782.00 $3,782.00 2026-01-07
26160 CPT Remove Tendon Sheath Lesion 1 1 $2,895.00 $2,606.00 $1,806.00 $1,806.00 $1,806.00 2026-01-07
26236 CPT Partial Removal Finger Bone 1 1 $2,982.00 $2,684.00 $1,860.00 $1,860.00 $1,860.00 2026-01-07
26370 CPT Repair Finger/hand Tendon 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
26390 CPT Revise Hand/finger Tendon 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
26410 CPT Repair Hand Tendon 2 1 $2,788.50 $2,510.00 $1,673.00 $1,806.00 $1,739.50 2026-01-07
26418 CPT Repair Finger Tendon 2 1 $2,788.50 $2,510.00 $1,673.00 $1,806.00 $1,739.50 2026-01-07
26531 CPT Revise Knuckle With Implant 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
26608 CPT Treat Metacarpal Fracture 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
26645 CPT Treat Thumb Fracture 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
26727 CPT Treat Finger Fracture Each 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
26735 CPT Treat Finger Fracture Each 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
26756 CPT Pin Finger Fracture Each 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
26765 CPT Treat Finger Fracture Each 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
26860 CPT Fusion Of Finger Joint 1 1 $5,895.00 $5,306.00 $3,678.00 $3,678.00 $3,678.00 2026-01-07
26951 CPT Amputation Of Finger/thumb 2 1 $5,278.00 $4,750.00 $3,244.00 $3,342.00 $3,293.00 2026-01-07
27238 CPT Treat Thigh Fracture 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
27337 CPT Exc Thigh/knee Les Sc 3 Cm/> 1 1 $4,928.00 $4,435.00 $3,075.00 $3,075.00 $3,075.00 2026-01-07
27381 CPT Repair/graft Kneecap Tendon 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
27385 CPT Repair Of Thigh Muscle 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
27618 CPT Exc Leg/ankle Tum < 3 Cm 1 1 $1,514.00 $1,363.00 $945.00 $945.00 $945.00 2026-01-07
27658 CPT Repair Of Leg Tendon Each 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
27685 CPT Revision Of Lower Leg Tendon 1 1 $4,850.00 $4,365.00 $3,026.00 $3,026.00 $3,026.00 2026-01-07
27691 CPT Revise Lower Leg Tendon 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
27696 CPT Repair Of Ankle Ligaments 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
27698 CPT Repair Of Ankle Ligament 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
27702 CPT Reconstruct Ankle Joint 1 1 $21,101.00 $18,991.00 $13,165.00 $13,165.00 $13,165.00 2026-01-07
27766 CPT Optx Medial Ankle Fx 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
27810 CPT Treatment Of Ankle Fracture 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
27825 CPT Treat Lower Leg Fracture 1 1 $2,682.00 $2,414.00 $1,673.00 $1,673.00 $1,673.00 2026-01-07
28008 CPT Incision Of Foot Fascia 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28010 CPT Incision Of Toe Tendon 1 1 $2,895.00 $2,606.00 $1,806.00 $1,806.00 $1,806.00 2026-01-07
28035 CPT Decompression Of Tibia Nerve 1 1 $3,649.00 $3,284.00 $2,277.00 $2,277.00 $2,277.00 2026-01-07
28039 CPT Exc Foot/toe Tum Sc 1.5 Cm/> 1 1 $4,928.00 $4,435.00 $3,075.00 $3,075.00 $3,075.00 2026-01-07
28043 CPT Exc Foot/toe Tum Sc < 1.5 Cm 1 1 $2,925.00 $2,633.00 $1,825.00 $1,825.00 $1,825.00 2026-01-07
28055 CPT Neurectomy Foot 1 1 $3,649.00 $3,284.00 $2,277.00 $2,277.00 $2,277.00 2026-01-07
28080 CPT Removal Of Foot Lesion 1 1 $2,895.00 $2,606.00 $1,806.00 $1,806.00 $1,806.00 2026-01-07
28092 CPT Removal Of Toe Lesions 1 1 $1,248.00 $1,123.00 $779.00 $779.00 $779.00 2026-01-07
28110 CPT Part Removal Of Metatarsal 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28113 CPT Part Removal Of Metatarsal 1 1 $6,198.00 $5,578.00 $3,867.00 $3,867.00 $3,867.00 2026-01-07
28119 CPT Removal Of Heel Spur 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28122 CPT Partial Removal Of Foot Bone 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28190 CPT Removal Of Foot Foreign Body 2 1 $1,324.50 $1,192.50 $814.00 $839.00 $826.50 2026-01-07
28192 CPT Removal Of Foot Foreign Body 1 1 $2,809.00 $2,528.00 $1,753.00 $1,753.00 $1,753.00 2026-01-07
28193 CPT Removal Of Foot Foreign Body 2 1 $2,090.50 $1,881.50 $856.00 $1,753.00 $1,304.50 2026-01-07
28200 CPT Repair Of Foot Tendon 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28232 CPT Incision Of Toe Tendon 1 1 $2,895.00 $2,606.00 $1,806.00 $1,806.00 $1,806.00 2026-01-07
28234 CPT Incision Of Foot Tendon 1 1 $2,895.00 $2,606.00 $1,806.00 $1,806.00 $1,806.00 2026-01-07
28270 CPT Release Of Foot Contracture 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28285 CPT Repair Of Hammertoe 1 1 $6,198.00 $5,578.00 $3,867.00 $3,867.00 $3,867.00 2026-01-07
28288 CPT Partial Removal Of Foot Bone 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28296 CPT Cor Hlx Vlgs Dstl Mtar Osteo 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28297 CPT Cor Hlx Vlgs Jt Arthrd 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
28298 CPT Cor Hlx Vlgs Prx Phlx Osteot 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
28300 CPT Incision Of Heel Bone 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
28304 CPT Incision Of Midfoot Bones 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
28308 CPT Incision Of Metatarsal 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
28309 CPT Incision Of Metatarsals 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
28310 CPT Revision Of Big Toe 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
28740 CPT Fusion Of Foot Bones 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
28750 CPT Fusion Of Big Toe Joint 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
28820 CPT Amputation Of Toe 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
29000 CPT Appl Halo Type Body Cast 1 1 $1,053.00 $948.00 $657.00 $657.00 $657.00 2026-01-07
29806 CPT Sho Arthrs Srg Capsulorraphy 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
29807 CPT Sho Arthrs Srg Rpr Slap Les 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
29823 CPT Sho Arthrs Srg Xtnsv Dbrdmt 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
29827 CPT Sho Arthrs Srg Rt8tr Cuf Rpr 1 1 $13,027.00 $11,724.00 $8,128.00 $8,128.00 $8,128.00 2026-01-07
29848 CPT Wrist Endoscopy/surgery 1 1 $2,895.00 $2,606.00 $1,806.00 $1,806.00 $1,806.00 2026-01-07
29880 CPT Arthrs Kne Srg Mnisectmy M&l 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
29881 CPT Arthrs Kne Srg Mnisectmy M/l 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
29882 CPT Arthrs Kne Srg Mnisc Rpr M/l 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
29888 CPT Arthrs Aid Acl Rpr/agmntj 1 1 $5,885.00 $5,297.00 $3,672.00 $3,672.00 $3,672.00 2026-01-07
3010010 CDM — 1 1 $1,758.00 $1,582.00 $1,097.00 $1,097.00 $1,097.00 2026-01-07
3020010 CDM — 1 1 $1,758.00 $1,582.00 $1,097.00 $1,097.00 $1,097.00 2026-01-07
3020020 CDM — 1 1 $2,414.00 $2,173.00 $1,506.00 $1,506.00 $1,506.00 2026-01-07
30520 CPT Repair Of Nasal Septum 1 1 $5,428.00 $4,885.00 $3,387.00 $3,387.00 $3,387.00 2026-01-07
3080010 CDM — 1 1 $2,076.00 $1,868.00 $1,295.00 $1,295.00 $1,295.00 2026-01-07
30801 CPT Ablate Inf Turbinate Superf 1 1 $2,684.00 $2,416.00 $1,675.00 $1,675.00 $1,675.00 2026-01-07
31295 CPT Nsl/sins Ndsc Surg Max Sins 1 1 $11,552.00 $10,397.00 $7,207.00 $7,207.00 $7,207.00 2026-01-07
31296 CPT Nsl/sins Ndsc Surg Frnt Sins 1 1 $11,552.00 $10,397.00 $7,207.00 $7,207.00 $7,207.00 2026-01-07
31297 CPT Nsl/sins Ndsc Surg Sphn Sins 1 1 $11,552.00 $10,397.00 $7,207.00 $7,207.00 $7,207.00 2026-01-07
31298 CPT Nsl/sins Ndsc Surg Frnt&sphn 1 1 $11,552.00 $10,397.00 $7,207.00 $7,207.00 $7,207.00 2026-01-07
32551 CPT Insertion Of Chest Tube 1 1 $3,013.00 $2,712.00 $1,880.00 $1,880.00 $1,880.00 2026-01-07
32554 CPT Aspirate Pleura Without Imaging 1 1 $1,339.00 $1,205.00 $835.00 $835.00 $835.00 2026-01-07
32556 CPT Insert Cath Pleura Without Image 1 1 $2,708.00 $2,437.00 $1,690.00 $1,690.00 $1,690.00 2026-01-07
3268052 CDM — 1 1 $1,151.00 $1,036.00 $718.00 $718.00 $718.00 2026-01-07
3268079 CDM — 1 1 $2,440.00 $2,196.00 $1,522.00 $1,522.00 $1,522.00 2026-01-07
3268126 CDM — 1 1 $1,561.00 $1,405.00 $974.00 $974.00 $974.00 2026-01-07
37609 CPT Ligation/bx Temporal Artery 1 1 $3,141.00 $2,827.00 $1,960.00 $1,960.00 $1,960.00 2026-01-07
40650 CPT Rpr Lip Fth Vermilion Only 1 1 $1,166.00 $1,049.00 $727.00 $727.00 $727.00 2026-01-07
40886 CPT — 2 1 $6,837.00 $6,153.50 $2,254.00 $6,277.00 $4,265.50 2026-01-07
42820 CPT Remove Tonsils And Adenoids 1 1 $11,183.00 $10,065.00 $6,977.00 $6,977.00 $6,977.00 2026-01-07
42821 CPT Remove Tonsils And Adenoids 1 1 $6,017.00 $5,415.00 $3,754.00 $3,754.00 $3,754.00 2026-01-07
42825 CPT Removal Of Tonsils 1 1 $11,183.00 $10,065.00 $6,977.00 $6,977.00 $6,977.00 2026-01-07
42826 CPT Removal Of Tonsils 1 1 $6,017.00 $5,415.00 $3,754.00 $3,754.00 $3,754.00 2026-01-07
42830 CPT Removal Of Adenoids 1 1 $6,017.00 $5,415.00 $3,754.00 $3,754.00 $3,754.00 2026-01-07
42831 CPT Removal Of Adenoids 1 1 $6,017.00 $5,415.00 $3,754.00 $3,754.00 $3,754.00 2026-01-07
43235 CPT Egd Diagnostic Brush Wash 2 1 $1,618.00 $1,456.50 $294.00 $1,725.00 $1,009.50 2026-01-07
43239 CPT Egd Biopsy Single/multiple 1 1 $2,850.00 $2,565.00 $1,778.00 $1,778.00 $1,778.00 2026-01-07
43246 CPT Egd Place Gastrostomy Tube 1 1 $3,127.00 $2,814.00 $1,951.00 $1,951.00 $1,951.00 2026-01-07
43247 CPT Egd Remove Foreign Body 2 1 $1,702.00 $1,532.00 $346.00 $1,778.00 $1,062.00 2026-01-07
43249 CPT Esoph Egd Dilation <30 Mm 1 1 $3,619.00 $3,257.00 $2,258.00 $2,258.00 $2,258.00 2026-01-07
44394 CPT Colonoscopy W/snare 1 1 $1,985.00 $1,787.00 $1,238.00 $1,238.00 $1,238.00 2026-01-07
45378 CPT Diagnostic Colonoscopy 1 1 $3,042.00 $2,738.00 $1,898.00 $1,898.00 $1,898.00 2026-01-07
45380 CPT Colonoscopy And Biopsy 1 1 $3,094.00 $2,785.00 $1,930.00 $1,930.00 $1,930.00 2026-01-07
45384 CPT Colonoscopy W/lesion Removal 1 1 $3,178.00 $2,860.00 $1,983.00 $1,983.00 $1,983.00 2026-01-07
45385 CPT Colonoscopy W/lesion Removal 1 1 $3,258.00 $2,932.00 $2,033.00 $2,033.00 $2,033.00 2026-01-07
46260 CPT Remove In/ex Hem Groups 2+ 1 1 $5,373.00 $4,836.00 $3,352.00 $3,352.00 $3,352.00 2026-01-07
47562 CPT Laparoscopic Cholecystectomy 2 1 $2,139.00 $1,925.00 $1,277.00 $1,392.00 $1,334.50 2026-01-07
49505 CPT Prp I/hern Init Reduc >5 Yr 1 1 $1,611.00 $1,450.00 $1,005.00 $1,005.00 $1,005.00 2026-01-07
49521 CPT Rerepair Ing Hernia Blocked 1 1 $7,000.00 $6,300.00 $4,367.00 $4,367.00 $4,367.00 2026-01-07
49560 CPT Rpr Ventral Hern Init Reduc 1 1 $2,234.00 $2,011.00 $1,394.00 $1,394.00 $1,394.00 2026-01-07
49591 CPT Rpr Aa Hrn 1st < 3 Cm Rdc 1 1 $7,560.00 $6,804.00 $4,717.00 $4,717.00 $4,717.00 2026-01-07
49593 CPT Rpr Aa Hrn 1st 3-10 Rdc 1 1 $8,150.00 $7,335.00 $5,085.00 $5,085.00 $5,085.00 2026-01-07
55040 CPT Removal Of Hydrocele 1 1 $6,468.00 $5,821.00 $4,035.00 $4,035.00 $4,035.00 2026-01-07
55041 CPT Removal Of Hydroceles 1 1 $6,468.00 $5,821.00 $4,035.00 $4,035.00 $4,035.00 2026-01-07
56605 CPT Biopsy Of Vulva/perineum 1 1 $1,211.00 $1,090.00 $756.00 $756.00 $756.00 2026-01-07
59409 CPT Obstetrical Care 2 1 $5,805.50 $5,225.00 $3,568.00 $3,676.00 $3,622.00 2026-01-07
64718 CPT Revise Ulnar Nerve At Elbow 1 1 $4,405.00 $3,965.00 $2,748.00 $2,748.00 $2,748.00 2026-01-07
64721 CPT Carpal Tunnel Surgery 1 1 $4,278.00 $3,850.00 $2,669.00 $2,669.00 $2,669.00 2026-01-07
66821 CPT After Cataract Laser Surgery 1 1 $1,517.00 $1,365.00 $946.00 $946.00 $946.00 2026-01-07
66982 CPT Xcapsl Ctrc Rmvl Cplx Wo Ecp 1 1 $5,636.00 $5,072.00 $3,516.00 $3,516.00 $3,516.00 2026-01-07
66984 CPT Xcapsl Ctrc Rmvl Without Ecp 1 1 $5,636.00 $5,072.00 $3,516.00 $3,516.00 $3,516.00 2026-01-07
67914 CPT Repair Eyelid Defect 1 1 $4,210.00 $3,789.00 $2,627.00 $2,627.00 $2,627.00 2026-01-07
67921 CPT Repair Eyelid Defect 1 1 $4,210.00 $3,789.00 $2,627.00 $2,627.00 $2,627.00 2026-01-07
67923 CPT Repair Eyelid Defect 1 1 $4,519.00 $4,067.00 $2,819.00 $2,819.00 $2,819.00 2026-01-07
69421 CPT Incision Of Eardrum 1 1 $6,672.00 $6,005.00 $4,163.00 $4,163.00 $4,163.00 2026-01-07
69436 CPT Create Eardrum Opening 1 1 $3,298.00 $2,968.00 $2,058.00 $2,058.00 $2,058.00 2026-01-07
70336 CPT Magnetic Image Jaw Joint 1 1 $2,330.00 $2,097.00 $1,454.00 $1,454.00 $1,454.00 2026-01-07
70450 CPT CT Head/brain Without Contrast 1 1 $1,317.00 $1,185.00 $822.00 $822.00 $822.00 2026-01-07
70460 CPT CT Head/brain With Contrast 1 1 $1,382.00 $1,244.00 $862.00 $862.00 $862.00 2026-01-07
70470 CPT CT Head/brain Without & With Contrast 1 1 $1,730.00 $1,557.00 $1,079.00 $1,079.00 $1,079.00 2026-01-07
70480 CPT CT Orbit/ear/fossa Without Contrast 1 1 $1,585.00 $1,427.00 $989.00 $989.00 $989.00 2026-01-07
70481 CPT CT Orbit/ear/fossa With Contrast 1 1 $1,939.00 $1,745.00 $1,210.00 $1,210.00 $1,210.00 2026-01-07
70482 CPT CT Orbit/ear/fossa W/o&with Contrast 1 1 $2,146.00 $1,931.00 $1,339.00 $1,339.00 $1,339.00 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
70487 CPT CT Maxillofacial With Contrast 1 1 $1,392.00 $1,253.00 $868.00 $868.00 $868.00 2026-01-07
70488 CPT CT Maxillofacial Without & With Contrast 1 1 $1,828.00 $1,645.00 $1,140.00 $1,140.00 $1,140.00 2026-01-07
70490 CPT CT Soft Tissue Neck Without Contrast 1 1 $1,374.00 $1,237.00 $857.00 $857.00 $857.00 2026-01-07
70491 CPT CT Soft Tissue Neck With Contrast 1 1 $1,558.00 $1,402.00 $972.00 $972.00 $972.00 2026-01-07
70492 CPT CT Sft Tsue Nck Without & With Contrast 1 1 $1,925.00 $1,733.00 $1,201.00 $1,201.00 $1,201.00 2026-01-07
70496 CPT CT Angiography Head 1 1 $2,391.00 $2,152.00 $1,492.00 $1,492.00 $1,492.00 2026-01-07
70498 CPT CT Angiography Neck 1 1 $2,387.00 $2,148.00 $1,489.00 $1,489.00 $1,489.00 2026-01-07
70540 CPT MRI Orbit/face/neck Without Contrast 1 1 $2,391.00 $2,152.00 $1,492.00 $1,492.00 $1,492.00 2026-01-07
70543 CPT MRI Orbt/fac/nck Without &with Contrast 1 1 $3,768.00 $3,391.00 $2,351.00 $2,351.00 $2,351.00 2026-01-07
70544 CPT Mr Angiography Head Without Contrast 1 1 $3,121.00 $2,809.00 $1,947.00 $1,947.00 $1,947.00 2026-01-07
70548 CPT Mr Angiography Neck With Contrast 1 1 $3,317.00 $2,985.00 $2,069.00 $2,069.00 $2,069.00 2026-01-07
70551 CPT MRI Brain Stem Without Contrast 1 1 $2,477.00 $2,229.00 $1,545.00 $1,545.00 $1,545.00 2026-01-07
70552 CPT MRI Brain Stem With Contrast 1 1 $2,723.00 $2,451.00 $1,699.00 $1,699.00 $1,699.00 2026-01-07
70553 CPT MRI Brain Stem Without & With Contrast 1 1 $3,664.00 $3,298.00 $2,286.00 $2,286.00 $2,286.00 2026-01-07
71250 CPT CT Thorax Dx C- 1 1 $1,447.00 $1,302.00 $903.00 $903.00 $903.00 2026-01-07
71260 CPT CT Thorax Dx C+ 1 1 $1,730.00 $1,557.00 $1,079.00 $1,079.00 $1,079.00 2026-01-07
71270 CPT CT Thorax Dx C-/c+ 1 1 $2,289.00 $2,060.00 $1,428.00 $1,428.00 $1,428.00 2026-01-07
71275 CPT CT Angiography Chest 1 1 $2,439.00 $2,195.00 $1,522.00 $1,522.00 $1,522.00 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
71552 CPT MRI Chest Without & With Contrast 1 1 $4,349.00 $3,914.00 $2,713.00 $2,713.00 $2,713.00 2026-01-07
72125 CPT CT Neck Spine Without Contrast 1 1 $1,530.00 $1,377.00 $955.00 $955.00 $955.00 2026-01-07
72126 CPT CT Neck Spine With Contrast 1 1 $1,730.00 $1,557.00 $1,079.00 $1,079.00 $1,079.00 2026-01-07
72128 CPT CT Chest Spine Without Contrast 1 1 $1,530.00 $1,377.00 $955.00 $955.00 $955.00 2026-01-07
72129 CPT CT Chest Spine With Contrast 1 1 $1,730.00 $1,557.00 $1,079.00 $1,079.00 $1,079.00 2026-01-07
72131 CPT CT Lumbar Spine Without Contrast 1 1 $1,530.00 $1,377.00 $955.00 $955.00 $955.00 2026-01-07
72132 CPT CT Lumbar Spine With Contrast 1 1 $1,730.00 $1,557.00 $1,079.00 $1,079.00 $1,079.00 2026-01-07
72141 CPT MRI Neck Spine Without Contrast 1 1 $2,170.00 $1,953.00 $1,354.00 $1,354.00 $1,354.00 2026-01-07
72142 CPT MRI Neck Spine With Contrast 1 1 $2,735.00 $2,462.00 $1,706.00 $1,706.00 $1,706.00 2026-01-07
72146 CPT MRI Chest Spine Without Contrast 1 1 $2,304.00 $2,074.00 $1,437.00 $1,437.00 $1,437.00 2026-01-07
72147 CPT MRI Chest Spine With Contrast 1 1 $2,194.00 $1,975.00 $1,369.00 $1,369.00 $1,369.00 2026-01-07
72148 CPT MRI Lumbar Spine Without Contrast 1 1 $2,304.00 $2,074.00 $1,437.00 $1,437.00 $1,437.00 2026-01-07
72149 CPT MRI Lumbar Spine With Contrast 1 1 $2,848.00 $2,563.00 $1,777.00 $1,777.00 $1,777.00 2026-01-07
72156 CPT MRI Neck Spine Without & With Contrast 1 1 $3,607.00 $3,246.00 $2,250.00 $2,250.00 $2,250.00 2026-01-07
72157 CPT MRI Chest Spine Without & With Contrast 1 1 $3,368.00 $3,031.00 $2,101.00 $2,101.00 $2,101.00 2026-01-07
72158 CPT MRI Lumbar Spine Without & With Contrast 1 1 $3,600.00 $3,240.00 $2,246.00 $2,246.00 $2,246.00 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
72193 CPT CT Pelvis With Contrast 1 1 $1,677.00 $1,509.00 $1,046.00 $1,046.00 $1,046.00 2026-01-07
72194 CPT CT Pelvis Without & With Contrast 1 1 $2,077.00 $1,869.00 $1,296.00 $1,296.00 $1,296.00 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
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
72197 CPT MRI Pelvis Without & With Contrast 1 1 $3,792.00 $3,413.00 $2,366.00 $2,366.00 $2,366.00 2026-01-07
73200 CPT CT Upper Extremity Without Contrast 1 1 $1,462.00 $1,316.00 $912.00 $912.00 $912.00 2026-01-07
73201 CPT CT Upper Extremity With Contrast 1 1 $1,752.00 $1,577.00 $1,093.00 $1,093.00 $1,093.00 2026-01-07
73202 CPT CT Uppr Extremity W/o&with Contrast 1 1 $2,030.00 $1,827.00 $1,267.00 $1,267.00 $1,267.00 2026-01-07
73218 CPT MRI Upper Extremity Without Contrast 1 1 $3,177.00 $2,859.00 $1,982.00 $1,982.00 $1,982.00 2026-01-07
73219 CPT MRI Upper Extremity With Contrast 1 1 $3,385.00 $3,047.00 $2,112.00 $2,112.00 $2,112.00 2026-01-07
73220 CPT MRI Uppr Extremity W/o&with Contrast 1 1 $4,122.00 $3,710.00 $2,572.00 $2,572.00 $2,572.00 2026-01-07
73221 CPT MRI Joint Upr Extrem Without Contrast 1 1 $2,327.00 $2,094.00 $1,452.00 $1,452.00 $1,452.00 2026-01-07
73223 CPT MRI Joint Upr Extr W/o&with Contrast 1 1 $3,817.00 $3,435.00 $2,381.00 $2,381.00 $2,381.00 2026-01-07
73700 CPT CT Lower Extremity Without Contrast 1 1 $1,386.00 $1,247.00 $865.00 $865.00 $865.00 2026-01-07
73701 CPT CT Lower Extremity With Contrast 1 1 $1,576.00 $1,418.00 $983.00 $983.00 $983.00 2026-01-07
73702 CPT CT Lwr Extremity W/o&with Contrast 1 1 $1,999.00 $1,799.00 $1,247.00 $1,247.00 $1,247.00 2026-01-07
73718 CPT MRI Lower Extremity Without Contrast 1 1 $2,789.00 $2,510.00 $1,740.00 $1,740.00 $1,740.00 2026-01-07
73720 CPT MRI Lwr Extremity W/o&with Contrast 1 1 $3,813.00 $3,432.00 $2,379.00 $2,379.00 $2,379.00 2026-01-07
73721 CPT MRI Jnt Of Lwr Extre Without Contrast 1 1 $2,386.00 $2,147.00 $1,489.00 $1,489.00 $1,489.00 2026-01-07
73723 CPT MRI Joint Lwr Extr W/o&with Contrast 1 1 $3,806.00 $3,425.00 $2,375.00 $2,375.00 $2,375.00 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
74160 CPT CT Abdomen W/contrast 1 1 $1,677.00 $1,509.00 $1,046.00 $1,046.00 $1,046.00 2026-01-07
74170 CPT CT Abd Wo Cntrst Flwd Cntrst 1 1 $2,456.00 $2,210.00 $1,532.00 $1,532.00 $1,532.00 2026-01-07
74174 CPT CTA Abd&plvs W/contrast 1 1 $3,439.00 $3,095.00 $2,146.00 $2,146.00 $2,146.00 2026-01-07
74175 CPT CTA Abdomen W/contrast 1 1 $2,078.00 $1,870.00 $1,296.00 $1,296.00 $1,296.00 2026-01-07
74176 CPT CT Abd & Pelvis Without Contrast 1 1 $1,905.00 $1,715.00 $1,189.00 $1,189.00 $1,189.00 2026-01-07
74177 CPT CT Abd & Pelvis W/contrast 1 1 $2,757.00 $2,481.00 $1,720.00 $1,720.00 $1,720.00 2026-01-07
74178 CPT CT Abd&plv Wo Cntr Flwd Cntr 1 1 $3,508.00 $3,157.00 $2,189.00 $2,189.00 $2,189.00 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
74183 CPT MRI Abd Without Cntr Flwd Cntr 1 1 $3,801.00 $3,421.00 $2,371.00 $2,371.00 $2,371.00 2026-01-07
74185 CPT MRA Abd W Or Without Cntrst 1 1 $2,946.00 $2,651.00 $1,838.00 $1,838.00 $1,838.00 2026-01-07
75635 CPT CT Angio Abdominal Arteries 1 1 $3,717.00 $3,345.00 $2,319.00 $2,319.00 $2,319.00 2026-01-07
78013 CPT Thyroid Imaging W/blood Flow 1 1 $1,058.00 $952.00 $660.00 $660.00 $660.00 2026-01-07
78226 CPT Hepatobiliary System Imaging 1 1 $1,750.00 $1,575.00 $1,092.00 $1,092.00 $1,092.00 2026-01-07
78227 CPT Hepatobil Syst Image W/drug 1 1 $2,384.00 $2,146.00 $1,487.00 $1,487.00 $1,487.00 2026-01-07
78300 CPT Bone Imaging Limited Area 1 1 $1,118.00 $1,006.00 $698.00 $698.00 $698.00 2026-01-07
78305 CPT Bone Imaging Multiple Areas 1 1 $1,347.00 $1,212.00 $840.00 $840.00 $840.00 2026-01-07
78306 CPT Bone Imaging Whole Body 1 1 $1,548.00 $1,393.00 $966.00 $966.00 $966.00 2026-01-07
78315 CPT Bone Imaging 3 Phase 1 1 $1,785.00 $1,607.00 $1,114.00 $1,114.00 $1,114.00 2026-01-07
78451 CPT Ht Muscle Image Spect Sing 1 1 $3,087.00 $2,778.00 $1,926.00 $1,926.00 $1,926.00 2026-01-07
78452 CPT Ht Muscle Image Spect Mult 1 1 $3,902.00 $3,512.00 $2,434.00 $2,434.00 $2,434.00 2026-01-07
78803 CPT Rp Loclzj Tum Spect 1 Area 1 1 $1,531.00 $1,378.00 $955.00 $955.00 $955.00 2026-01-07
88309 CPT Tissue Exam By Pathologist 1 1 $1,082.00 $974.00 $675.00 $675.00 $675.00 2026-01-07
90847 CPT Family Psytx W/pt 50 Min 1 1 $1,045.00 $941.00 $652.00 $652.00 $652.00 2026-01-07
92523 CPT Speech Sound Lang Comprehen 1 1 $1,109.00 $998.00 $692.00 $692.00 $692.00 2026-01-07
92950 CPT Heart/lung Resuscitation Cpr 2 1 $1,095.00 $985.50 $370.00 $996.00 $683.00 2026-01-07
95805 CPT Multiple Sleep Latency Test 1 1 $2,493.00 $2,244.00 $1,555.00 $1,555.00 $1,555.00 2026-01-07
95810 CPT Polysom 6/> Yrs 4/> Param 1 1 $3,140.00 $2,826.00 $1,959.00 $1,959.00 $1,959.00 2026-01-07
95811 CPT Polysom 6/>yrs Cpap 4/> Parm 1 1 $3,323.00 $2,991.00 $2,073.00 $2,073.00 $2,073.00 2026-01-07
99285 CPT Emergency Dept Visit Hi Mdm 1 1 $1,431.00 $1,288.00 $893.00 $893.00 $893.00 2026-01-07
99291 CPT Critical Care First Hour 2 1 $2,240.50 $2,016.50 $1,377.00 $1,419.00 $1,398.00 2026-01-07
C9781 HCPCS — 1 1 $6,062.00 $5,456.00 $3,782.00 $3,782.00 $3,782.00 2026-01-07
CDM CDM — 1 1 $1,353.00 $1,218.00 $844.00 $844.00 $844.00 2026-01-07
CP17616807779736920 CDM — 1 1 $1,439.00 $1,295.00 $898.00 $898.00 $898.00 2026-01-07
G0390 HCPCS Trauma Respons W/hosp Criti 1 1 $1,594.00 $1,435.00 $994.00 $994.00 $994.00 2026-01-07
J3301 HCPCS Triamcinolone Acet Inj Nos 1 1 $7,504.00 $6,754.00 $4,682.00 $4,682.00 $4,682.00 2026-01-07
J7318 HCPCS Inj, Durolane 1 Mg 1 1 $4,029.00 $3,626.00 $2,514.00 $2,514.00 $2,514.00 2026-01-07
P9035 HCPCS Platelet Pheres Leukoreduced 1 1 $1,067.00 $960.00 $666.00 $666.00 $666.00 2026-01-07
P9037 HCPCS Plate Pheres Leukoredu Irrad 1 1 $1,152.00 $1,037.00 $719.00 $719.00 $719.00 2026-01-07
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