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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

MERCY HOSPITAL MARIETTA

Marietta, OK · CCN 371306 · Rates published

2,282 distinct procedures filed
55 distinct payers
464,476 rate rows
2026-06-12 last MRF observed
Data quality

463,156 of 464,476 rate rows are consumer-grade (99.7%)

1,320 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
percent-of-charges filed in the dollar field — excluded from medians 1,206
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 72
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 32
exceeds 10× this hospital's gross charge — excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.mercy.net/content/dam/mercy/en/web-assets/charge-files/237037718_mercy-health-love-county_standardcharges.zip
Found on page https://www.mercy.net/forms/items-and-services-files/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-01
Content fingerprint 9a5475400beb4ebb… · 7,759,597 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
J2997
HCPCS 		Alteplase 100 Mg Intravenous Solution 53 $9,147.00 $32,473.33 $21,944.76 nat. median
$500
outlier · 43.9×
J3101
HCPCS 		Tenecteplase 50 Mg Intravenous Solution 53 $8,121.50 $31,535.41 $21,310.93 nat. median
$3,787
outlier · 5.6×
C1721
HCPCS 		Dev Icd Current Plus Dr Rf 36j Gen 49 $9,853.20 $26,082.00 $17,625.64 nat. median
$22,368
0.8× median
93461
CPT 		Rt&Lt Heart Art/Ventricle Angio W/Cath Plcmt Bypass Gft 53 $1,147.56 $16,245.90 $10,978.62 nat. median
$6,222
1.8× median
93457
CPT 		Rt Heart Art/Grft Angio 53 $1,026.32 $15,538.50 $10,500.57 nat. median
$6,040
1.7× median
93459
CPT 		Lt Heart Art/Grft Angio 53 $2,864.26 $14,874.30 $10,051.72 nat. median
$6,122
1.6× median
93460
CPT 		Rt&Lt Heart Art/Ventricle Angio 53 $1,040.16 $14,842.80 $10,030.43 nat. median
$6,070
1.7× median
93456
CPT 		Rt Heart Coronary Artery Angio 53 $941.09 $13,965.30 $9,437.44 nat. median
$5,938
1.6× median
93458
CPT 		Lt Heart Artery/Ventricle Angio 53 $870.51 $13,734.00 $9,281.13 nat. median
$6,209
1.5× median
93455
CPT 		Coronary Art/Grft Angio S/i 53 $842.66 $13,539.60 $9,149.76 nat. median
$5,597
1.6× median
93454
CPT 		Cath Plcmt Coronary Angio,With Inj Coronary Angio,S/I 53 $755.78 $12,779.10 $8,635.83 nat. median
$5,564
1.6× median
93453
CPT 		Rt&Lt Heart Cath Including Inj Lt Ventriculography,S/I 53 $957.20 $11,805.30 $7,977.76 nat. median
$5,621
1.4× median
33224
CPT 		Insert Electrode And Connect 49 $4,022.88 $10,648.80 $7,196.22 nat. median
$11,120
0.6× median
93452
CPT 		Lt Heart Cath Including Inj Lt Ventriculography, S/i 53 $749.56 $10,583.10 $7,151.82 nat. median
$5,120
1.4× median
33225
CPT 		Insert Electrode At Init Implant 49 $3,682.88 $9,748.80 $6,588.02 nat. median
$8,068
0.8× median
37216
CPT 		Perq Transcath Plcmt Stent Cca Wo Protect 49 $3,223.20 $8,532.00 $5,765.74 nat. median
$5,470
1.1× median
37215
CPT 		Transcath Plcmt Stent Cca W Protect 49 $3,217.08 $8,515.80 $5,754.79 nat. median
$5,766
1.0× median
PX-100001672
CDM 		Abd Washout In Icu/Level 3/1st 30min 49 $3,167.10 $8,383.50 $5,665.38 nat. median
$5,665
1.0× median
78816
CPT 		Nm PET W CT Imaging Whole Body 53 $1,226.22 $7,990.20 $5,399.60 nat. median
$2,793
1.9× median
PX-500001176
CDM 		Litho Level 3 Initial 30 Minutes 49 $2,950.18 $7,809.30 $5,277.35 nat. median
$4,856
1.1× median
78815
CPT 		Nm PET Imag W CT Skl Base Mid Thg 53 $1,226.22 $7,647.30 $5,167.88 nat. median
$2,822
1.8× median
78814
CPT 		Nm PET W CT Imaging Ltd Area 53 $1,226.22 $7,435.80 $5,024.95 nat. median
$2,379
outlier · 2.1×
A9572
HCPCS 		Nm In111 Pentetreotide Up To 6mci 53 $1,704.99 $7,331.40 $4,954.40 nat. median
$4,712
1.1× median
C1785
HCPCS 		Dev Pm Identity Adx Dr 49 $2,067.20 $12,852.00 $4,803.12 nat. median
$6,717
0.7× median
L2320
HCPCS 		Low Ext N-mold Lacer 49 $2,663.22 $7,049.70 $4,764.03 nat. median
$281
outlier · 16.9×
37187
CPT 		Perc Venous Thrombec Mech 49 $2,597.26 $6,875.10 $4,646.04 nat. median
$10,002
outlier · 0.5×
33249
CPT 		Insert Or Replace Icd W Transv Lead,Sngl Or Dual Ch 49 $2,507.84 $6,638.40 $4,486.08 nat. median
$31,584
outlier · 0.1×
37184
CPT 		Pat Prim Proc Mech Init Ves 49 $2,493.90 $6,601.50 $4,461.15 nat. median
$11,037
outlier · 0.4×
33211
CPT 		Ins/Repl Temp Tv Pacemkr Dual 49 $2,470.44 $6,539.40 $4,419.18 nat. median
$8,238
0.5× median
33210
CPT 		Ins/Repl Temp Tv Pacemkr Sgl 49 $2,470.44 $6,539.40 $4,419.18 nat. median
$8,289
0.5× median
63650
CPT 		Percut Implant Neurostim El Epid 49 $2,386.12 $6,316.20 $4,268.35 nat. median
$7,298
0.6× median
93451
CPT 		Rt Heart Cath Including Measurements 53 $715.41 $6,304.50 $4,260.44 nat. median
$4,834
0.9× median
33214
CPT 		Upgrade Imp Pacemakr Sngl To Dual 49 $2,319.48 $6,139.80 $4,149.14 nat. median
$11,413
outlier · 0.4×
78812
CPT 		PET Tumor Img Skl Base 53 $1,226.22 $5,880.60 $3,973.98 nat. median
$1,877
outlier · 2.1×
49000
CPT 		Exp Lap In Icu/Level 3/1st 30min 49 $2,217.14 $5,868.90 $3,966.07 nat. median
$2,442
1.6× median
73720
CPT 		MRI Extr Lwr Non Jt W/wo Cont Bi 53 $205.15 $6,891.30 $3,951.90 nat. median
$1,135
outlier · 3.5×
PX-500001261
CDM 		Bronchoscopy W/8 Procedures 49 $2,206.26 $5,840.10 $3,946.61 nat. median
$3,009
1.3× median
37188
CPT 		Perc Venous Thromb Mech Subsq 49 $2,182.12 $5,776.20 $3,903.43 nat. median
$4,103
1.0× median
C1786
HCPCS 		Dev Pm Identity Adx 49 $2,142.00 $5,670.00 $3,831.66 nat. median
$7,842
outlier · 0.5×
C1724
HCPCS 		Crown Diamondback Classic 1.5 49 $2,138.60 $5,661.00 $3,825.58 nat. median
$4,549
0.8× median
C1885
HCPCS 		Cath Laser 1.7 Otw Turbo 49 $1,745.90 $5,661.00 $3,825.58 nat. median
$4,550
0.8× median
73723
CPT 		MRI Extr Lwr Jt W/wo Cont Bi 53 $246.53 $5,994.00 $3,742.38 nat. median
$1,199
outlier · 3.1×
95811
CPT 		Polysom Attended W Cpap 6/> Yrs 53 $551.66 $5,518.80 $3,729.48 nat. median
$1,894
2.0× median
73220
CPT 		MRI Extr Uppr Non Jt W/wo Cont Bi 53 $267.35 $5,715.00 $3,699.50 nat. median
$1,136
outlier · 3.3×
PX-500001260
CDM 		Bronchoscopy W/7 Procedures 49 $2,019.94 $5,346.90 $3,613.32 nat. median
$2,813
1.3× median
33206
CPT 		Ins New Or Repl Perm Pacemaker Atrial 49 $2,015.18 $5,334.30 $3,604.80 nat. median
$11,252
outlier · 0.3×
95810
CPT 		Polysom Attended >3 Chn 6/> Yrs 53 $527.77 $5,238.00 $3,539.72 nat. median
$1,827
1.9× median
C1714
HCPCS 		Cath Periph Silverhawk Ex Sm 49 $1,924.40 $5,188.50 $3,506.27 nat. median
$4,745
0.7× median
73721
CPT 		MRI Extr Lwr Jt Wo Cont Bi 53 $120.47 $5,477.40 $3,461.50 nat. median
$856
outlier · 4.0×
PX-500001259
CDM 		Bronchoscopy W/6 Procedures 49 $1,915.56 $5,070.60 $3,426.60 nat. median
$2,522
1.4× median

Other procedures at this hospital

Browse this hospital's 2,282 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
             
J2997 HCPCS Alteplase 100 Mg Intravenous Solution 144 53 $36,081.48 $36,081.48 $9,147.00 $32,473.33 $21,944.76 2026-06-12
J3101 HCPCS Tenecteplase 50 Mg Intravenous Solution 144 53 $35,039.34 $35,039.34 $8,121.50 $31,535.41 $21,310.93 2026-06-12
C1721 HCPCS Dev Icd Current Plus Dr Rf 36j Gen 136 49 $28,980.00 $28,980.00 $9,853.20 $26,082.00 $17,625.64 2026-06-12
93461 CPT Rt&Lt Heart Art/Ventricle Angio W/Cath Plcmt Bypass Gft 144 53 $18,051.00 $18,051.00 $1,147.56 $16,245.90 $10,978.62 2026-06-12
93457 CPT Rt Heart Art/Grft Angio 144 53 $17,265.00 $17,265.00 $1,026.32 $15,538.50 $10,500.57 2026-06-12
93459 CPT Lt Heart Art/Grft Angio 144 53 $16,527.00 $16,527.00 $2,864.26 $14,874.30 $10,051.72 2026-06-12
93460 CPT Rt&Lt Heart Art/Ventricle Angio 144 53 $16,492.00 $16,492.00 $1,040.16 $14,842.80 $10,030.43 2026-06-12
93456 CPT Rt Heart Coronary Artery Angio 144 53 $15,517.00 $15,517.00 $941.09 $13,965.30 $9,437.44 2026-06-12
93458 CPT Lt Heart Artery/Ventricle Angio 144 53 $15,260.00 $15,260.00 $870.51 $13,734.00 $9,281.13 2026-06-12
93455 CPT Coronary Art/Grft Angio S/i 144 53 $15,044.00 $15,044.00 $842.66 $13,539.60 $9,149.76 2026-06-12
93454 CPT Cath Plcmt Coronary Angio,With Inj Coronary Angio,S/I 144 53 $14,199.00 $14,199.00 $755.78 $12,779.10 $8,635.83 2026-06-12
93453 CPT Rt&Lt Heart Cath Including Inj Lt Ventriculography,S/I 144 53 $13,117.00 $13,117.00 $957.20 $11,805.30 $7,977.76 2026-06-12
33224 CPT Insert Electrode And Connect 136 49 $11,832.00 $11,832.00 $4,022.88 $10,648.80 $7,196.22 2026-06-12
93452 CPT Lt Heart Cath Including Inj Lt Ventriculography, S/i 144 53 $11,759.00 $11,759.00 $749.56 $10,583.10 $7,151.82 2026-06-12
33225 CPT Insert Electrode At Init Implant 136 49 $10,832.00 $10,832.00 $3,682.88 $9,748.80 $6,588.02 2026-06-12
37216 CPT Perq Transcath Plcmt Stent Cca Wo Protect 136 49 $9,480.00 $9,480.00 $3,223.20 $8,532.00 $5,765.74 2026-06-12
37215 CPT Transcath Plcmt Stent Cca W Protect 136 49 $9,462.00 $9,462.00 $3,217.08 $8,515.80 $5,754.79 2026-06-12
PX-100001672 CDM Abd Washout In Icu/Level 3/1st 30min 136 49 $9,315.00 $9,315.00 $3,167.10 $8,383.50 $5,665.38 2026-06-12
78816 CPT Nm PET W CT Imaging Whole Body 144 53 $8,878.00 $8,878.00 $1,226.22 $7,990.20 $5,399.60 2026-06-12
PX-500001176 CDM Litho Level 3 Initial 30 Minutes 136 49 $8,677.00 $8,677.00 $2,950.18 $7,809.30 $5,277.35 2026-06-12
78815 CPT Nm PET Imag W CT Skl Base Mid Thg 144 53 $8,497.00 $8,497.00 $1,226.22 $7,647.30 $5,167.88 2026-06-12
78814 CPT Nm PET W CT Imaging Ltd Area 144 53 $8,262.00 $8,262.00 $1,226.22 $7,435.80 $5,024.95 2026-06-12
A9572 HCPCS Nm In111 Pentetreotide Up To 6mci 144 53 $8,146.00 $8,146.00 $1,704.99 $7,331.40 $4,954.40 2026-06-12
C1785 HCPCS Dev Pm Identity Adx Dr 544 49 $6,867.00 $6,867.00 $2,067.20 $12,852.00 $4,803.12 2026-06-12
L2320 HCPCS Low Ext N-mold Lacer 136 49 $7,833.00 $7,833.00 $2,663.22 $7,049.70 $4,764.03 2026-06-12
37187 CPT Perc Venous Thrombec Mech 136 49 $7,639.00 $7,639.00 $2,597.26 $6,875.10 $4,646.04 2026-06-12
33249 CPT Insert Or Replace Icd W Transv Lead,Sngl Or Dual Ch 136 49 $7,376.00 $7,376.00 $2,507.84 $6,638.40 $4,486.08 2026-06-12
37184 CPT Pat Prim Proc Mech Init Ves 136 49 $7,335.00 $7,335.00 $2,493.90 $6,601.50 $4,461.15 2026-06-12
33211 CPT Ins/Repl Temp Tv Pacemkr Dual 136 49 $7,266.00 $7,266.00 $2,470.44 $6,539.40 $4,419.18 2026-06-12
33210 CPT Ins/Repl Temp Tv Pacemkr Sgl 136 49 $7,266.00 $7,266.00 $2,470.44 $6,539.40 $4,419.18 2026-06-12
63650 CPT Percut Implant Neurostim El Epid 136 49 $7,018.00 $7,018.00 $2,386.12 $6,316.20 $4,268.35 2026-06-12
93451 CPT Rt Heart Cath Including Measurements 144 53 $7,005.00 $7,005.00 $715.41 $6,304.50 $4,260.44 2026-06-12
33214 CPT Upgrade Imp Pacemakr Sngl To Dual 136 49 $6,822.00 $6,822.00 $2,319.48 $6,139.80 $4,149.14 2026-06-12
78812 CPT PET Tumor Img Skl Base 144 53 $6,534.00 $6,534.00 $1,226.22 $5,880.60 $3,973.98 2026-06-12
49000 CPT Exp Lap In Icu/Level 3/1st 30min 136 49 $6,521.00 $6,521.00 $2,217.14 $5,868.90 $3,966.07 2026-06-12
73720 CPT MRI Extr Lwr Non Jt W/wo Cont Bi 280 53 $7,657.00 $7,657.00 $205.15 $6,891.30 $3,951.90 2026-06-12
PX-500001261 CDM Bronchoscopy W/8 Procedures 136 49 $6,489.00 $6,489.00 $2,206.26 $5,840.10 $3,946.61 2026-06-12
37188 CPT Perc Venous Thromb Mech Subsq 136 49 $6,418.00 $6,418.00 $2,182.12 $5,776.20 $3,903.43 2026-06-12
C1786 HCPCS Dev Pm Identity Adx 136 49 $6,300.00 $6,300.00 $2,142.00 $5,670.00 $3,831.66 2026-06-12
C1724 HCPCS Crown Diamondback Classic 1.5 136 49 $6,290.00 $6,290.00 $2,138.60 $5,661.00 $3,825.58 2026-06-12
C1885 HCPCS Cath Laser 1.7 Otw Turbo 408 49 $6,090.00 $6,090.00 $1,745.90 $5,661.00 $3,825.58 2026-06-12
73723 CPT MRI Extr Lwr Jt W/wo Cont Bi 280 53 $6,660.00 $6,660.00 $246.53 $5,994.00 $3,742.38 2026-06-12
95811 CPT Polysom Attended W Cpap 6/> Yrs 144 53 $6,132.00 $6,132.00 $551.66 $5,518.80 $3,729.48 2026-06-12
73220 CPT MRI Extr Uppr Non Jt W/wo Cont Bi 280 53 $6,350.00 $6,350.00 $267.35 $5,715.00 $3,699.50 2026-06-12
PX-500001260 CDM Bronchoscopy W/7 Procedures 136 49 $5,941.00 $5,941.00 $2,019.94 $5,346.90 $3,613.32 2026-06-12
33206 CPT Ins New Or Repl Perm Pacemaker Atrial 136 49 $5,927.00 $5,927.00 $2,015.18 $5,334.30 $3,604.80 2026-06-12
95810 CPT Polysom Attended >3 Chn 6/> Yrs 144 53 $5,820.00 $5,820.00 $527.77 $5,238.00 $3,539.72 2026-06-12
C1714 HCPCS Cath Periph Silverhawk Ex Sm 408 49 $5,670.00 $5,670.00 $1,924.40 $5,188.50 $3,506.27 2026-06-12
73721 CPT MRI Extr Lwr Jt Wo Cont Bi 280 53 $6,086.00 $6,086.00 $120.47 $5,477.40 $3,461.50 2026-06-12
PX-500001259 CDM Bronchoscopy W/6 Procedures 136 49 $5,634.00 $5,634.00 $1,915.56 $5,070.60 $3,426.60 2026-06-12
62350 CPT Implant/Rev/Repos Epid Catheter 136 49 $5,577.00 $5,577.00 $1,896.18 $5,019.30 $3,391.93 2026-06-12
PX-400019482 CDM Xpander Kyphopak Tray 15/3 1st 136 49 $5,571.00 $5,571.00 $1,894.14 $5,013.90 $3,388.28 2026-06-12
PX-400019483 CDM Xpander Kyphopak Tray 136 49 $5,571.00 $5,571.00 $1,894.14 $5,013.90 $3,388.28 2026-06-12
36563 CPT Ins Tunneled Vad W Subq Pump 136 49 $5,532.00 $5,532.00 $1,880.88 $4,978.80 $3,364.56 2026-06-12
PX-400013945 CDM Kit Express Kpe1001 136 49 $5,528.00 $5,528.00 $1,879.52 $4,975.20 $3,362.13 2026-06-12
PX-400015608 CDM Kyphx Exp First Fx K / Kpe 1003 136 49 $5,528.00 $5,528.00 $1,879.52 $4,975.20 $3,362.13 2026-06-12
35190 CPT Repair Blood Vessel Lesion 136 49 $5,504.00 $5,504.00 $1,871.36 $4,953.60 $3,347.53 2026-06-12
33208 CPT Ins New Or Repl Perm Pacemaker A And V 136 49 $5,469.00 $5,469.00 $1,859.46 $4,922.10 $3,326.25 2026-06-12
PX-500001029 CDM Or Level 6 Initial 30 Minutes 136 49 $5,443.00 $5,443.00 $1,850.62 $4,898.70 $3,310.43 2026-06-12
72158 CPT MRI Lumbar Spine W/wo Cont 144 53 $5,443.00 $5,443.00 $184.04 $4,898.70 $3,310.43 2026-06-12
36566 CPT Insert Tunneled Cath 136 49 $5,411.00 $5,411.00 $1,839.74 $4,869.90 $3,290.97 2026-06-12
C1874 HCPCS Endopros Viabahn Hep 8x5x120 2,176 49 $4,930.00 $4,930.00 $741.88 $9,546.30 $3,269.68 2026-06-12
70553 CPT MRI Brain W/wo Cont 144 53 $5,327.00 $5,327.00 $183.49 $4,794.30 $3,239.88 2026-06-12
93505 CPT Bx Endomyocardial 144 53 $5,254.00 $5,254.00 $1,786.36 $4,728.60 $3,195.48 2026-06-12
92978 CPT Intravascular US Coronary Vessel 136 49 $5,244.00 $5,244.00 $1,782.96 $4,719.60 $3,189.40 2026-06-12
33233 CPT Removal Perm Pacer Generator 136 49 $5,241.00 $5,241.00 $1,781.94 $4,716.90 $3,187.58 2026-06-12
73221 CPT MRI Extr Uppr Jt Wo Cont Bi 280 53 $5,574.00 $5,574.00 $120.75 $5,016.60 $3,171.88 2026-06-12
72156 CPT MRI Cervical Spine W/wo Cont 144 53 $5,166.00 $5,166.00 $184.60 $4,649.40 $3,141.96 2026-06-12
74178 CPT CT Abd Pelvis Wo Cont Then W Cont 146 54 $5,075.00 $5,075.00 $212.92 $4,567.50 $3,086.62 2026-06-12
PX-500001258 CDM Bronchoscopy W/5 Procedures 136 49 $5,059.00 $5,059.00 $1,720.06 $4,553.10 $3,076.88 2026-06-12
72157 CPT MRI Thoracic Spine W/wo Cont 144 53 $5,011.00 $5,011.00 $185.15 $4,509.90 $3,047.69 2026-06-12
75716 CPT Angiogram Extremity Bilateral S/i 144 53 $4,979.00 $4,979.00 $59.93 $4,481.10 $3,028.23 2026-06-12
PX-500001027 CDM Or Level 5 Initial 30 Minutes 136 49 $4,974.00 $4,974.00 $1,691.16 $4,476.60 $3,025.19 2026-06-12
74174 CPT CTA Abd Pelvis Wwo Contrast 146 54 $4,949.00 $4,949.00 $239.84 $4,454.10 $3,009.98 2026-06-12
33207 CPT Ins New Or Repl Perm Pacemaker Ventr 136 49 $4,920.00 $4,920.00 $1,672.80 $4,428.00 $2,992.34 2026-06-12
73718 CPT MRI Extr Lwr Non Jt Wo Cont Bi 280 53 $4,885.00 $4,885.00 $138.80 $4,396.50 $2,971.06 2026-06-12
74183 CPT MRI Abdomen W/wo Cont 144 53 $4,856.00 $4,856.00 $204.04 $4,370.40 $2,953.42 2026-06-12
72197 CPT MRI Pelvis W/wo Cont 144 53 $4,850.00 $4,850.00 $202.93 $4,365.00 $2,949.77 2026-06-12
33241 CPT Removal Impl Defib Pulse Gen 136 49 $4,837.00 $4,837.00 $1,644.58 $4,353.30 $2,941.86 2026-06-12
75605 CPT Aortogram Thoracic S/i 144 53 $4,803.00 $4,803.00 $56.88 $4,322.70 $2,921.18 2026-06-12
36565 CPT Insert Tun Cen Ven Device W 2cath 136 49 $4,758.00 $4,758.00 $1,617.72 $4,282.20 $2,893.82 2026-06-12
75630 CPT Aortogram Abd W Bil Iliofem S/i 144 53 $4,749.00 $4,749.00 $53.83 $4,274.10 $2,888.34 2026-06-12
PX-500001257 CDM Bronchoscopy W/4 Procedures 136 49 $4,690.00 $4,690.00 $1,594.60 $4,221.00 $2,852.46 2026-06-12
92973 CPT Cl Coronary Throm Angiojet 144 53 $4,682.00 $4,682.00 $152.36 $4,213.80 $2,847.59 2026-06-12
C8908 HCPCS MRI Breast W/wo Cont Bi 136 49 $4,669.00 $4,669.00 $1,587.46 $4,202.10 $2,839.69 2026-06-12
37186 CPT Pat Secondary Proc Mech 136 49 $4,631.00 $4,631.00 $1,574.54 $4,167.90 $2,816.57 2026-06-12
93610 CPT Intra Atrial Pacing 144 53 $4,464.00 $4,464.00 $1,517.76 $6,757.32 $2,796.70 2026-06-12
93612 CPT Intraventricular Pacing 144 53 $4,464.00 $4,464.00 $1,517.76 $6,757.32 $2,796.70 2026-06-12
93602 CPT Intra Atrial Recording 144 53 $4,464.00 $4,464.00 $1,517.76 $6,757.32 $2,796.70 2026-06-12
C8925 HCPCS Pr 2d Tee W Or Without Fol W/Con,In 136 49 $4,568.00 $4,568.00 $1,553.12 $4,111.20 $2,778.26 2026-06-12
75625 CPT Aortogram Abdominal S/i 144 53 $4,551.00 $4,551.00 $49.96 $4,095.90 $2,767.92 2026-06-12
PX-500001025 CDM Or Level 4 Initial 30 Minutes 136 49 $4,484.00 $4,484.00 $1,524.56 $4,035.60 $2,727.17 2026-06-12
62287 CPT Asp Percut Nucleus Pulp Lumbar 136 49 $4,451.00 $4,451.00 $1,513.34 $4,005.90 $2,707.10 2026-06-12
33217 CPT Insert Dual Electrode Pm-defib 136 49 $4,430.00 $4,430.00 $1,506.20 $3,987.00 $2,694.33 2026-06-12
70549 CPT MRA Neck W/wo Cont 144 53 $4,373.00 $4,373.00 $225.95 $3,935.70 $2,659.66 2026-06-12
C8902 HCPCS MRA Abdomen W/wo Cont 136 49 $4,312.00 $4,312.00 $1,466.08 $3,880.80 $2,622.56 2026-06-12
75743 CPT Angiogram Pulmonary Sel Bi S/i 144 53 $4,289.00 $4,289.00 $59.93 $3,860.10 $2,608.57 2026-06-12
73702 CPT CT Extremity Lower W/wo Cont Bi 282 54 $4,482.00 $4,482.00 $119.64 $4,033.80 $2,601.85 2026-06-12
33216 CPT Insert Sngl Electrode Pm-defib 136 49 $4,254.00 $4,254.00 $1,446.36 $3,828.60 $2,587.28 2026-06-12
59871 CPT Cerclage Removal Under Anesthesia 136 49 $4,220.00 $4,220.00 $1,434.80 $3,798.00 $2,566.60 2026-06-12
PX-500001256 CDM Bronchoscopy W/3 Procedures 136 49 $4,184.00 $4,184.00 $1,422.56 $3,765.60 $2,544.71 2026-06-12
93641 CPT Eval At Time Of Icd Insertion 136 49 $4,180.00 $4,180.00 $1,421.20 $3,762.00 $2,542.28 2026-06-12
73223 CPT MRI Extr Uppr Jt W/wo Cont Lt 144 53 $4,162.00 $4,162.00 $247.64 $3,745.80 $2,531.33 2026-06-12
74177 CPT CT Abd Pelvis With Contrast 146 54 $4,153.00 $4,153.00 $188.51 $3,737.70 $2,525.85 2026-06-12
72127 CPT CT Cervical Spine W/wo Cont 144 53 $4,135.00 $4,135.00 $119.36 $3,721.50 $2,514.91 2026-06-12
C1733 HCPCS Nav Bidirect D/g Curve 4mm 136 49 $4,118.00 $4,118.00 $1,400.12 $3,706.20 $2,504.57 2026-06-12
70546 CPT MRA Head W/wo Cont 144 53 $4,104.00 $4,104.00 $224.84 $3,693.60 $2,496.05 2026-06-12
36511 CPT Therapeutic Apheresis Wbc 144 53 $4,088.00 $4,088.00 $1,389.92 $3,679.20 $2,486.32 2026-06-12
36512 CPT Therapeutic Apheresis Rbc 144 53 $4,088.00 $4,088.00 $1,389.92 $3,679.20 $2,486.32 2026-06-12
93571 CPT Cor Pressure Wire Measure 136 49 $4,071.00 $4,071.00 $1,384.14 $3,663.90 $2,475.98 2026-06-12
81435 CPT Hereditary Colon Cancer, 5 Or More Genes 144 53 $4,065.00 $4,065.00 $1,016.25 $3,658.50 $2,472.33 2026-06-12
93503 CPT Insertion/Place Of Pa Catheter 144 53 $4,040.00 $4,040.00 $1,373.60 $3,636.00 $2,457.13 2026-06-12
20240 CPT Open Bone Biopsy, Superficial 136 49 $4,036.00 $4,036.00 $1,372.24 $3,632.40 $2,454.70 2026-06-12
72149 CPT MRI Lumbar Spine W Cont 144 53 $4,031.00 $4,031.00 $162.10 $3,627.90 $2,451.65 2026-06-12
36561 CPT Insert Tunn Vad W Port > 5 Yrs 136 49 $4,007.00 $4,007.00 $1,362.38 $3,606.30 $2,437.06 2026-06-12
72148 CPT MRI Lumbar Spine Wo Cont 144 53 $4,003.00 $4,003.00 $105.76 $3,602.70 $2,434.62 2026-06-12
37185 CPT Pat Prim Proc Mech Ea Addl Vess 136 49 $3,964.00 $3,964.00 $1,347.76 $3,567.60 $2,410.90 2026-06-12
36514 CPT Therapeutic Apheresis Plasma 144 53 $3,960.00 $3,960.00 $1,346.40 $3,564.00 $2,408.47 2026-06-12
33215 CPT Reposition Pacer/Lead 136 49 $3,953.00 $3,953.00 $1,344.02 $3,557.70 $2,404.21 2026-06-12
72196 CPT MRI Pelvis W Cont 144 53 $3,952.00 $3,952.00 $162.66 $3,556.80 $2,403.61 2026-06-12
PX-500001108 CDM Gi Ercp W/4 Procedures 136 49 $3,951.00 $3,951.00 $1,343.34 $3,555.90 $2,403.00 2026-06-12
72146 CPT MRI Thoracic Spine Wo Cont 144 53 $3,948.00 $3,948.00 $105.20 $3,553.20 $2,401.17 2026-06-12
PX-500001092 CDM Gi Colonoscopy Via Stoma W/4 Proc 136 49 $3,932.00 $3,932.00 $1,336.88 $3,538.80 $2,391.44 2026-06-12
72133 CPT CT Lumbar Spine W/wo Cont 144 53 $3,897.00 $3,897.00 $119.64 $3,507.30 $2,370.16 2026-06-12
70543 CPT MRI Orbit Face And Neck W/wo Cont 144 53 $3,886.00 $3,886.00 $206.54 $3,497.40 $2,363.47 2026-06-12
73701 CPT CT Extremity Lower W Cont Bi 280 53 $3,857.00 $3,857.00 $97.15 $3,471.30 $2,345.83 2026-06-12
70552 CPT MRI Brain W Cont 144 53 $3,844.00 $3,844.00 $162.10 $3,459.60 $2,337.92 2026-06-12
74170 CPT CT Abdomen W/wo Cont 144 53 $3,839.00 $3,839.00 $143.16 $3,455.10 $2,334.88 2026-06-12
33235 CPT Removal Transven Dual Leads 136 49 $3,831.00 $3,831.00 $1,302.54 $3,447.90 $2,330.01 2026-06-12
PX-500001023 CDM Or Level 3 Initial 30 Minutes 136 49 $3,829.00 $3,829.00 $1,301.86 $3,446.10 $2,328.80 2026-06-12
33220 CPT Repair Two Electrods Perm Pm Or Impl Defib 136 49 $3,823.00 $3,823.00 $1,299.82 $3,440.70 $2,325.15 2026-06-12
L0180 HCPCS Collar Cerv Adj 136 49 $3,807.00 $3,807.00 $1,294.38 $3,426.30 $2,315.42 2026-06-12
L0999 HCPCS Orthosis Spinal Add 136 49 $3,807.00 $3,807.00 $1,294.38 $3,426.30 $2,315.42 2026-06-12
PX-500001107 CDM Gi Ercp W/3 Procedures 136 49 $3,768.00 $3,768.00 $1,281.12 $3,391.20 $2,291.70 2026-06-12
73725 CPT MRA Extr Lwr W Or Wo Cont Bi 280 53 $4,570.00 $4,570.00 $217.62 $4,113.00 $2,290.50 2026-06-12
50382 CPT Perc Remov/Replac Ureteral Stnt 136 49 $3,766.00 $3,766.00 $1,280.44 $3,389.40 $2,290.48 2026-06-12
73202 CPT CT Extremity Upper W/wo Cont Bi 280 53 $3,758.00 $3,758.00 $143.16 $3,382.20 $2,285.62 2026-06-12
36557 CPT Cv Cath Tunnel Wo Sq Port <5 136 49 $3,736.00 $3,736.00 $1,270.24 $3,362.40 $2,272.24 2026-06-12
33213 CPT Insert Pm Pulse Generator W Existing Dual Lead 136 49 $3,722.00 $3,722.00 $1,265.48 $3,349.80 $2,263.72 2026-06-12
72132 CPT CT Lumbar Spine W Cont 144 53 $3,703.00 $3,703.00 $318.03 $3,332.70 $2,252.16 2026-06-12
PX-500001091 CDM Gi Colonoscopy Via Stoma W/3 Proc 136 49 $3,702.00 $3,702.00 $1,258.68 $3,331.80 $2,251.56 2026-06-12
PX-500001255 CDM Bronchoscopy W/2 Procedures 136 49 $3,681.00 $3,681.00 $1,251.54 $3,312.90 $2,238.78 2026-06-12
75736 CPT Angiogram Pelvic Select Each S/i 144 53 $3,659.00 $3,659.00 $76.85 $3,293.10 $2,225.40 2026-06-12
75726 CPT Angiogram Visceral Select Ea S/i 144 53 $3,659.00 $3,659.00 $64.66 $3,293.10 $2,225.40 2026-06-12
74175 CPT CTA Abdomen W/wo Cont 144 53 $3,656.00 $3,656.00 $142.90 $3,290.40 $2,223.58 2026-06-12
73700 CPT CT Extremity Lower Wo Cont Bi 282 54 $4,050.00 $4,050.00 $71.62 $3,645.00 $2,194.70 2026-06-12
33234 CPT Removal Transven Single Lead 136 49 $3,602.00 $3,602.00 $1,224.68 $3,241.80 $2,190.74 2026-06-12
72142 CPT MRI Cervical Spine W Cont 144 53 $3,592.00 $3,592.00 $165.99 $3,232.80 $2,184.65 2026-06-12
PX-500001106 CDM Gi Ercp W/2 Procedures 136 49 $3,587.00 $3,587.00 $1,219.58 $3,228.30 $2,181.61 2026-06-12
33226 CPT Reposition Prev Implanted Lead 136 49 $3,581.00 $3,581.00 $1,217.54 $3,222.90 $2,177.96 2026-06-12
70545 CPT MRA Head W Cont 144 53 $3,564.00 $3,564.00 $147.94 $3,207.60 $2,167.62 2026-06-12
72195 CPT MRI Pelvis Wo Cont 144 53 $3,558.00 $3,558.00 $139.08 $3,202.20 $2,163.98 2026-06-12
73201 CPT CT Extremity Upper W Cont Bi 282 54 $3,852.00 $3,852.00 $126.31 $3,466.80 $2,159.85 2026-06-12
70488 CPT CT Maxillofacial Area W/wo Cont 144 53 $3,537.00 $3,537.00 $107.98 $3,183.30 $2,151.20 2026-06-12
43260 CPT Gi Ercp 136 49 $3,535.00 $3,535.00 $1,201.90 $3,181.50 $2,149.99 2026-06-12
46250 CPT Gi Hemorrhoidectomy, Ext 2 Or More 136 49 $3,518.00 $3,518.00 $1,196.12 $3,166.20 $2,139.65 2026-06-12
58805 CPT Cyst Aspiration-ovarian 136 49 $3,509.00 $3,509.00 $1,193.06 $3,158.10 $2,134.17 2026-06-12
74176 CPT CT Abd Pelvis Without Contrast 146 54 $3,507.00 $3,507.00 $88.54 $3,156.30 $2,132.96 2026-06-12
73222 CPT MRI Extr Uppr Jt W Cont Lt 144 53 $3,495.00 $3,495.00 $204.87 $3,145.50 $2,125.66 2026-06-12
A9521 HCPCS Nm Tc99m Exametazine Up Tp 25mci 136 49 $3,492.00 $3,492.00 $1,187.28 $3,142.80 $2,123.83 2026-06-12
73200 CPT CT Extremity Upper Wo Cont Bi 282 54 $3,842.00 $3,842.00 $85.22 $3,457.80 $2,123.30 2026-06-12
71552 CPT MRI Chest W/wo Cont 144 53 $3,467.00 $3,467.00 $300.57 $3,120.30 $2,108.63 2026-06-12
70498 CPT CTA Neck W And/or Wo Contrast 146 54 $3,466.00 $3,466.00 $143.14 $3,119.40 $2,108.02 2026-06-12
70471 CPT CTA Head&Neck +Cont W/Noncontrast Img 138 50 $3,466.00 $3,466.00 $801.97 $3,119.40 $2,108.02 2026-06-12
70548 CPT MRA Neck W Cont 144 53 $3,459.00 $3,459.00 $152.11 $3,113.10 $2,103.76 2026-06-12
49422 CPT Removal Of Perm Catheter 136 49 $3,455.00 $3,455.00 $1,174.70 $3,109.50 $2,101.33 2026-06-12
72194 CPT CT Pelvis W/wo Cont 144 53 $3,442.00 $3,442.00 $143.16 $3,097.80 $2,093.42 2026-06-12
70551 CPT MRI Brain Wo Cont 144 53 $3,442.00 $3,442.00 $110.20 $3,097.80 $2,093.42 2026-06-12
72295 CPT Xr Discogram Lumbar 144 53 $3,439.00 $3,439.00 $1,169.26 $3,095.10 $2,091.60 2026-06-12
74181 CPT MRI Abdomen Wo Cont 144 53 $3,424.00 $3,424.00 $110.75 $3,081.60 $2,082.48 2026-06-12
36570 CPT Ins Periph Vad W Subq Port <5 136 49 $3,413.00 $3,413.00 $1,160.42 $3,071.70 $2,075.79 2026-06-12
L2036 HCPCS Orthosis Kafo 136 49 $3,406.00 $3,406.00 $1,158.04 $3,065.40 $2,071.53 2026-06-12
PX-500001105 CDM Gi Ercp W/1 Procedure 136 49 $3,403.00 $3,403.00 $1,157.02 $3,062.70 $2,069.70 2026-06-12
C8929 HCPCS Tte W Or Wo Fol W Con,Doppler 136 49 $3,386.00 $3,386.00 $1,151.24 $3,047.40 $2,059.37 2026-06-12
71270 CPT CT Chest Diag W/wo Cont 146 54 $3,374.00 $3,374.00 $119.08 $3,036.60 $2,052.07 2026-06-12
71275 CPT CTA Chest W And/or Wo Cont 146 54 $3,372.00 $3,372.00 $143.19 $3,034.80 $2,050.85 2026-06-12
46040 CPT I/d Ischio/Perirectal Abscess 136 49 $3,369.00 $3,369.00 $1,145.46 $3,032.10 $2,049.03 2026-06-12
33212 CPT Insert Pm Pulse Generator W Existing Sng Lead 136 49 $3,366.00 $3,366.00 $1,144.44 $3,029.40 $2,047.20 2026-06-12
73218 CPT MRI Extr Uppr Non Jt Wo Cont Lt 144 53 $3,346.00 $3,346.00 $191.13 $3,011.40 $2,035.04 2026-06-12
PX-500001090 CDM Gi Colonoscopy Via Stoma W/2 Proc 136 49 $3,346.00 $3,346.00 $1,137.64 $3,011.40 $2,035.04 2026-06-12
PX-500001126 CDM Gi Sigmoidoscopy W/4 Procedures 136 49 $3,343.00 $3,343.00 $1,136.62 $3,008.70 $2,033.21 2026-06-12
PX-500001113 CDM Gi Esophagoscopy W/4 Procedures 136 49 $3,343.00 $3,343.00 $1,136.62 $3,008.70 $2,033.21 2026-06-12
75825 CPT Venogram Ivc S/i 144 53 $3,341.00 $3,341.00 $51.35 $3,006.90 $2,032.00 2026-06-12
75741 CPT Angiogram Pulmonary Sel Lt S/i 144 53 $3,341.00 $3,341.00 $58.82 $3,006.90 $2,032.00 2026-06-12
75710 CPT Angiogram Extremity Lt S/i 144 53 $3,341.00 $3,341.00 $57.44 $3,006.90 $2,032.00 2026-06-12
PX-400019866 CDM Lso Ant/Post/Lat Cust 136 49 $3,326.00 $3,326.00 $1,130.84 $2,993.40 $2,022.87 2026-06-12
70492 CPT CT Soft Tissue Neck W/wo Cont 144 53 $3,324.00 $3,324.00 $158.53 $2,991.60 $2,021.66 2026-06-12
70496 CPT CTA Head W/wo Cont 146 54 $3,303.00 $3,303.00 $143.14 $2,972.70 $2,008.88 2026-06-12
70544 CPT MRA Head Wo Cont 144 53 $3,302.00 $3,302.00 $137.94 $2,971.80 $2,008.28 2026-06-12
26990 CPT I And D Pelvis/Hip Abscess/Hema 136 49 $3,300.00 $3,300.00 $1,122.00 $2,970.00 $2,007.06 2026-06-12
70470 CPT CT Head/Brain W/wo Cont 144 53 $3,282.00 $3,282.00 $98.54 $2,953.80 $1,996.11 2026-06-12
74160 CPT CT Abdomen W Cont 144 53 $3,275.00 $3,275.00 $158.53 $2,947.50 $1,991.86 2026-06-12
36578 CPT Repl Cath Only Cva Device 136 49 $3,275.00 $3,275.00 $1,113.50 $2,947.50 $1,991.86 2026-06-12
72141 CPT MRI Cervical Spine Wo Cont 144 53 $3,259.00 $3,259.00 $105.48 $2,933.10 $1,982.12 2026-06-12
73219 CPT MRI Extr Uppr Non Jt W Cont Lt 144 53 $3,251.00 $3,251.00 $220.70 $2,925.90 $1,977.26 2026-06-12
93642 CPT Eval F/u Not During Icd Insert 144 53 $3,245.00 $3,245.00 $1,081.08 $2,920.50 $1,973.61 2026-06-12
72129 CPT CT Thoracic Spine W Cont 144 53 $3,236.00 $3,236.00 $158.53 $2,912.40 $1,968.14 2026-06-12
71551 CPT MRI Chest W Cont 144 53 $3,232.00 $3,232.00 $252.63 $2,908.80 $1,965.70 2026-06-12
36558 CPT Cv Cath Tunnel Wo Sq Port >5 136 49 $3,220.00 $3,220.00 $1,094.80 $2,898.00 $1,958.40 2026-06-12
33218 CPT Repair Sngl Electrode Perm Pm Or Impl Defib 136 49 $3,215.00 $3,215.00 $1,093.10 $2,893.50 $1,955.36 2026-06-12
C8905 HCPCS MRI Breast W/wo Cont Lt 136 49 $3,207.00 $3,207.00 $1,090.38 $2,886.30 $1,950.50 2026-06-12
70542 CPT MRI Orbit Face And/or Neck W Cont 144 53 $3,205.00 $3,205.00 $166.83 $2,884.50 $1,949.28 2026-06-12
75894 CPT Transcath Embolization S/i 144 53 $3,199.00 $3,199.00 $87.39 $2,879.10 $1,945.63 2026-06-12
71260 CPT CT Chest Diag W Cont 146 54 $3,174.00 $3,174.00 $158.53 $2,856.60 $1,930.43 2026-06-12
PX-500001112 CDM Gi Esophagoscopy W/3 Procedures 136 49 $3,161.00 $3,161.00 $1,074.74 $2,844.90 $1,922.52 2026-06-12
L0638 HCPCS Orthosis Lumbar Sacrl Cust 136 49 $3,150.00 $3,150.00 $1,071.00 $2,835.00 $1,915.83 2026-06-12
72191 CPT CTA Pelvis W/wo Cont 144 53 $3,104.00 $3,104.00 $158.53 $2,793.60 $1,887.85 2026-06-12
70540 CPT MRI Orbit Face And/or Neck Wo Cont 144 53 $3,071.00 $3,071.00 $141.30 $2,763.90 $1,867.78 2026-06-12
78452 CPT Mycrd Perf W Wall Mot&Ejec Frt Mult 144 53 $3,061.00 $3,061.00 $298.61 $2,754.90 $1,861.70 2026-06-12
75860 CPT Venogram Sinus/Jugular Cath S/i 144 53 $2,967.00 $2,967.00 $1,008.78 $2,802.90 $1,858.83 2026-06-12
70336 CPT MRI Tmj 144 53 $3,044.00 $3,044.00 $168.79 $2,739.60 $1,851.36 2026-06-12
72126 CPT CT Cervical Spine W Cont 144 53 $3,044.00 $3,044.00 $318.03 $2,739.60 $1,851.36 2026-06-12
PX-500001125 CDM Gi Sigmoidoscopy W/3 Procedures 136 49 $3,039.00 $3,039.00 $1,033.26 $2,735.10 $1,848.32 2026-06-12
72131 CPT CT Lumbar Spine Wo Cont 146 54 $3,020.00 $3,020.00 $94.70 $2,718.00 $1,836.76 2026-06-12
L0464 HCPCS Fa Brace Tlso Ortho America 136 49 $3,012.00 $3,012.00 $1,024.08 $2,710.80 $1,831.90 2026-06-12
C1880 HCPCS Filter Jugular G2 Rf-320j 136 49 $3,010.00 $3,010.00 $1,023.40 $2,709.00 $1,830.68 2026-06-12
PX-500001254 CDM Bronchoscopy W/1 Procedures 136 49 $2,998.00 $2,998.00 $1,019.32 $2,698.20 $1,823.38 2026-06-12
PX-500001111 CDM Gi Esophagoscopy W/2 Procedures 136 49 $2,979.00 $2,979.00 $1,012.86 $2,681.10 $1,811.83 2026-06-12
71550 CPT MRI Chest Wo Cont 144 53 $2,977.00 $2,977.00 $191.13 $2,679.30 $1,810.61 2026-06-12
PX-500001089 CDM Gi Colonoscopy Via Stoma W/1 Proc 136 49 $2,976.00 $2,976.00 $1,011.84 $2,678.40 $1,810.00 2026-06-12
C8928 HCPCS Trans Echo 2d W/wo Mmode W/Cont 136 49 $2,960.00 $2,960.00 $1,006.40 $2,664.00 $1,800.27 2026-06-12
95805 CPT Maintainence Of Wakefulness 144 53 $2,958.00 $2,958.00 $363.59 $2,662.20 $1,799.06 2026-06-12
72193 CPT CT Pelvis W Cont 144 53 $2,956.00 $2,956.00 $158.53 $2,660.40 $1,797.84 2026-06-12
C1884 HCPCS Device Embol 4.0mm 190cm 272 49 $2,547.50 $2,547.50 $678.98 $2,788.20 $1,797.30 2026-06-12
33967 CPT Insert Iabp Percutaneous 136 49 $2,952.00 $2,952.00 $1,003.68 $2,656.80 $1,795.41 2026-06-12
70547 CPT MRA Neck Wo Cont 144 53 $2,925.00 $2,925.00 $138.22 $2,632.50 $1,778.99 2026-06-12
78451 CPT Mycrd Perf W Wall Mot&Ejec Frt Sng 144 53 $2,917.00 $2,917.00 $208.15 $2,625.30 $1,774.12 2026-06-12
PX-500001021 CDM Or Level 2 Initial 30 Minutes 136 49 $2,894.00 $2,894.00 $983.96 $2,604.60 $1,760.13 2026-06-12
72125 CPT CT Cervical Spine Wo Cont 146 54 $2,883.00 $2,883.00 $72.18 $2,594.70 $1,753.44 2026-06-12
70487 CPT CT Maxillofacial Area W Cont 144 53 $2,838.00 $2,838.00 $86.04 $2,554.20 $1,726.07 2026-06-12
70460 CPT CT Head/Brain W Cont 144 53 $2,804.00 $2,804.00 $82.45 $2,523.60 $1,705.39 2026-06-12
PX-500001110 CDM Gi Esophagoscopy W/1 Procedure 136 49 $2,796.00 $2,796.00 $950.64 $2,516.40 $1,700.53 2026-06-12
72128 CPT CT Thoracic Spine Wo Cont 144 53 $2,793.00 $2,793.00 $71.90 $2,513.70 $1,698.70 2026-06-12
75756 CPT Angiogram Internal Mammary S/i 144 53 $2,793.00 $2,793.00 $92.68 $2,513.70 $1,698.70 2026-06-12
36571 CPT Insert Cent Ven Acc Device W Port 136 49 $2,766.00 $2,766.00 $940.44 $2,489.40 $1,682.28 2026-06-12
43200 CPT Gi Esophagoscopy 136 49 $2,738.00 $2,738.00 $930.92 $2,464.20 $1,665.25 2026-06-12
31622 CPT Bronchoscopy 136 49 $2,738.00 $2,738.00 $930.92 $2,464.20 $1,665.25 2026-06-12
36247 CPT Sel Cath Art Abd/Pel 3rd Order 136 49 $2,737.00 $2,737.00 $930.58 $2,463.30 $1,664.64 2026-06-12
PX-500001124 CDM Gi Sigmoidoscopy W/2 Procedures 136 49 $2,735.00 $2,735.00 $929.90 $2,461.50 $1,663.43 2026-06-12
74150 CPT CT Abdomen Wo Cont 146 54 $2,713.00 $2,713.00 $70.23 $2,441.70 $1,650.05 2026-06-12
L2330 HCPCS Low Ext Mold Lacer 136 49 $2,710.00 $2,710.00 $921.40 $2,439.00 $1,648.22 2026-06-12
81450 CPT Ngs Acute Myeloid Leukemia 280 53 $2,251.00 $2,251.00 $562.75 $2,436.30 $1,646.40 2026-06-12
10180 CPT I&d Post Op Wound 136 49 $2,705.00 $2,705.00 $919.70 $2,434.50 $1,645.18 2026-06-12
59412 CPT Ext Cephalic Version 144 53 $2,682.00 $2,682.00 $90.35 $2,413.80 $1,631.19 2026-06-12
36513 CPT Therapeutic Apheresis Platelets 144 53 $2,678.00 $2,678.00 $389.32 $2,410.20 $1,628.76 2026-06-12
90935 CPT Hemodialysis Inpatient 144 53 $2,642.00 $2,642.00 $63.13 $2,377.80 $1,606.86 2026-06-12
92979 CPT Intravascular US Cor Addl Vessel 136 49 $2,638.00 $2,638.00 $896.92 $2,374.20 $1,604.43 2026-06-12
78802 CPT Nm Tumor Loc Inflam Proc Whole Body Sngl Day 144 53 $2,629.00 $2,629.00 $204.01 $2,366.10 $1,598.96 2026-06-12
75746 CPT Angiogram Pulmonary Nonselect S/i 144 53 $2,615.00 $2,615.00 $69.10 $2,353.50 $1,590.44 2026-06-12
78453 CPT Mycrd Planr W Wall Mot&Ejec Frt Sng 144 53 $2,598.00 $2,598.00 $184.55 $2,338.20 $1,580.10 2026-06-12
33222 CPT Relocation Skin Pocket Pacemaker 136 49 $2,596.00 $2,596.00 $882.64 $2,336.40 $1,578.89 2026-06-12
93312 CPT Echo Transesophageal 144 53 $2,581.00 $2,581.00 $488.27 $2,322.90 $1,569.76 2026-06-12
77012 CPT CT Guided Needle Placement Si 144 53 $2,580.00 $2,580.00 $58.85 $2,322.00 $1,569.16 2026-06-12
93351 CPT Echo Stress W Cont ECG Monitor 144 53 $2,571.00 $2,571.00 $198.98 $2,313.90 $1,563.68 2026-06-12
PX-500001177 CDM Litho Level 3 Each Addtl 30 Minutes 136 49 $2,565.00 $2,565.00 $872.10 $2,308.50 $1,560.03 2026-06-12
L0486 HCPCS Tlso 2-pc Rgd Plas Cust 136 49 $2,560.00 $2,560.00 $870.40 $2,304.00 $1,556.99 2026-06-12
C1876 HCPCS Stent Bil Lifestent Flexstar 6 3,672 49 $2,363.00 $2,363.00 $357.00 $4,716.00 $1,556.85 2026-06-12
78306 CPT Nm Bone And Or Jnt Imag Whol Body 144 53 $2,527.00 $2,527.00 $191.52 $2,274.30 $1,536.92 2026-06-12
78315 CPT Nm Bone And Or Jnt Imag 3 Phase 144 53 $2,527.00 $2,527.00 $224.51 $2,274.30 $1,536.92 2026-06-12
A9547 HCPCS Nm 111in Oxyquinoline Per .500mci 144 53 $2,521.00 $2,521.00 $688.05 $2,268.90 $1,533.27 2026-06-12
72192 CPT CT Pelvis Wo Cont 146 54 $2,519.00 $2,519.00 $71.07 $2,267.10 $1,532.06 2026-06-12
93568 CPT Inject Pulm Art Heart Cath 144 53 $2,519.00 $2,519.00 $40.32 $2,267.10 $1,532.06 2026-06-12
71250 CPT CT Chest Diag Wo Cont 146 54 $2,492.00 $2,492.00 $71.34 $2,242.80 $1,515.63 2026-06-12
36217 CPT Sel Cath Art Thor/Brach 3rd Order 136 49 $2,491.00 $2,491.00 $846.94 $2,241.90 $1,515.03 2026-06-12
C8930 HCPCS Tte With Con 2d W/m-mode Stress 136 49 $2,483.00 $2,483.00 $844.22 $2,234.70 $1,510.16 2026-06-12
70482 CPT CT Orbit/Sella/Iac/Fossa W/wo Con 144 53 $2,472.00 $2,472.00 $130.75 $2,224.80 $1,503.47 2026-06-12
93563 CPT Inject Congenital Card Cath 144 53 $2,471.00 $2,471.00 $44.94 $2,223.90 $1,502.86 2026-06-12
PX-500001030 CDM Or Level 6 Ea Addtl 30 Minutes 136 49 $2,469.00 $2,469.00 $839.46 $2,222.10 $1,501.65 2026-06-12
81445 CPT Gen Seq Analys Lung 5-50 Genes 552 53 $2,380.00 $2,380.00 $443.00 $2,870.10 $1,491.07 2026-06-12
93565 CPT Inject Lt Ventr/Atrial Angio 144 53 $2,445.00 $2,445.00 $23.35 $2,200.50 $1,487.05 2026-06-12
PX-500001123 CDM Gi Sigmoidoscopy W/1 Procedure 136 49 $2,431.00 $2,431.00 $826.54 $2,187.90 $1,478.53 2026-06-12
70491 CPT CT Soft Tissue Neck W Cont 146 54 $2,427.00 $2,427.00 $103.53 $2,184.30 $1,476.10 2026-06-12
93567 CPT Inject Supravalvular Aortography 144 53 $2,401.00 $2,401.00 $32.54 $2,160.90 $1,460.29 2026-06-12
93306 CPT Echo 2d W/m-mode & Dopp Comp 146 54 $2,371.00 $2,371.00 $168.33 $2,133.90 $1,442.04 2026-06-12
93303 CPT Transthor Echo Cong Card Anom 144 53 $2,368.00 $2,368.00 $488.27 $2,131.20 $1,440.22 2026-06-12
36569 CPT Picc Plc Wo Sq Port Without Img >5 Yrs 144 53 $2,365.00 $2,365.00 $804.10 $2,128.50 $1,438.39 2026-06-12
26675 CPT Cl Tx Cmc Dis W Man W Anes Ea Mlp 144 53 $2,393.00 $2,393.00 $381.75 $2,153.70 $1,430.49 2026-06-12
45330 CPT Gi Sigmoidiscope Flexible 136 49 $2,335.00 $2,335.00 $793.90 $2,101.50 $1,420.15 2026-06-12
78708 CPT Nm Renal Imag Funct Sngl W Pharm 144 53 $2,334.00 $2,334.00 $99.85 $2,100.60 $1,419.54 2026-06-12
78472 CPT Nm Card Bld Pool Imag Muga Sngl 144 53 $2,330.00 $2,330.00 $137.64 $2,097.00 $1,417.11 2026-06-12
L0632 HCPCS Orthosis Lumbar 136 49 $2,323.00 $2,323.00 $789.82 $2,090.70 $1,412.85 2026-06-12
75774 CPT Angiogram Select Ea Add Vess S/i 144 53 $2,321.00 $2,321.00 $42.46 $2,088.90 $1,411.63 2026-06-12
78195 CPT Nm Lymphatics And Lymph Glnd Imag 144 53 $2,316.00 $2,316.00 $223.96 $2,084.40 $1,408.59 2026-06-12
90677 HCPCS Pneumococcal 20-valent Conj Vaccine-dip Crm (pf) 0.5 Ml IM Syringe 144 53 $2,309.10 $2,309.10 $279.05 $2,078.19 $1,404.39 2026-06-12
PX-400019869 CDM Lso Ant/Post/Lat Cust 136 49 $2,269.00 $2,269.00 $771.46 $2,042.10 $1,380.01 2026-06-12
78264 CPT Nm Gastric Emptying Study 144 53 $2,242.00 $2,242.00 $221.18 $2,017.80 $1,363.58 2026-06-12
PX-500001028 CDM Or Level 5 Ea Addtl 30 Minutes 136 49 $2,241.00 $2,241.00 $761.94 $2,016.90 $1,362.98 2026-06-12
36216 CPT Sel Cath Art Thor/Brach 2nd Order 136 49 $2,240.00 $2,240.00 $761.60 $2,016.00 $1,362.37 2026-06-12
C8923 HCPCS Transthoracic Echo W Contrast 136 49 $2,232.00 $2,232.00 $758.88 $2,008.80 $1,357.50 2026-06-12
92960 CPT Cardioversion Elective Ext 154 53 $2,224.00 $2,224.00 $582.74 $2,001.60 $1,352.64 2026-06-12
43450 CPT Gi Dilate Esophagus Bougie 136 49 $2,210.00 $2,210.00 $751.40 $1,989.00 $1,344.12 2026-06-12
L0639 HCPCS Fa Orthosis Lumbar 136 49 $2,206.00 $2,206.00 $750.04 $1,985.40 $1,341.69 2026-06-12
L0637 HCPCS Fa Orthosis Lumbar 136 49 $2,206.00 $2,206.00 $750.04 $1,985.40 $1,341.69 2026-06-12
70481 CPT CT Orbit/Sella/Iac/Fossa W Cont 144 53 $2,204.00 $2,204.00 $110.20 $1,983.60 $1,340.47 2026-06-12
11044 CPT Debride Bone 1st 20sqcm Or Less 136 49 $2,184.00 $2,184.00 $742.56 $1,965.60 $1,328.31 2026-06-12
78630 CPT Nm Cisternogram 144 53 $2,169.00 $2,169.00 $479.34 $1,952.10 $1,319.19 2026-06-12
PX-500001019 CDM Or Level 1 Initial 30 Minutes 136 49 $2,168.00 $2,168.00 $737.12 $1,951.20 $1,318.58 2026-06-12
70450 CPT CT Head/Brain Wo Cont 146 54 $2,165.00 $2,165.00 $57.46 $1,948.50 $1,316.75 2026-06-12
93350 CPT Echocardiography Stress 144 53 $2,165.00 $2,165.00 $488.27 $1,948.50 $1,316.75 2026-06-12
PX-500001088 CDM Gi Colonoscopy Via Stoma 136 49 $2,154.00 $2,154.00 $732.36 $1,938.60 $1,310.06 2026-06-12
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