Hospital

EASTERN OKLAHOMA MEDICAL CENTER

Poteau, OK · CCN 371337 · Rates published

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You selected 93306 (CPT)

US ECHO 2D W/ OR W/O M-MODE COMPLETE

This hospital’s price: $365 across 1 payer

Source: https://eomchospital.com/wp-content/uploads/2026/03/736060835_eastern-oklahoma-medical-center_standardcharges.csv · observed 2026-05-23

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.

1,660 distinct procedures filed

1 distinct payers

2,055 rate rows

2026-05-23 last MRF observed

Data quality

1,882 of 2,055 rate rows are consumer-grade (91.6%)

173 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
exceeds 10× this hospital's gross charge — excluded from medians	173

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

Source MRF file	https://eomchospital.com/wp-content/uploads/2026/03/736060835_eastern-oklahoma-medical-center_standardcharges.csv
Found on page	https://eomchospital.com/price-transparency/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-22
Content fingerprint	095c1f3512341d90… · 114,264 bytes · first seen 2026-05-09

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
121 OTHER	Medsurg Rm	1	$11,840.00	$11,840.00	$11,840.00	nat. median $10,120 1.2× median
112 OTHER	Ob/private	1	$11,840.00	$11,840.00	$11,840.00	nat. median $2,666 outlier · 4.4×
28289 CPT	Bunion Correction Without Implant	1	$365.75	$365.75	$365.75	nat. median $3,519 outlier · 0.1×
28899 CPT	Unlisted Procedure Toes/foot	1	$365.75	$365.75	$365.75	nat. median $571 0.6× median
49591 CPT	Laproscopic Cholecystectomy	1	$365.75	$365.75	$365.75	nat. median $3,840 outlier · 0.1×
28298 CPT	Correction Of Bunion With Bone Removal	1	$365.75	$365.75	$365.75	nat. median $6,631 outlier · 0.1×
23075 CPT	Excision Tumor Shoulder >3cm	1	$365.75	$365.75	$365.75	nat. median $1,725 outlier · 0.2×
11102 CPT	Tangent Biospy Single Skin Lesion	1	$365.75	$365.75	$365.75	nat. median $277 1.3× median
28080 CPT	Excis Interdigital Morton Neuroma Single	1	$365.75	$365.75	$365.75	nat. median $2,050 outlier · 0.2×
28750 CPT	Arthrodesis Great Toe Metatarsophalanhea	1	$365.75	$365.75	$365.75	nat. median $6,992 outlier · 0.1×
45385 CPT	Colonoscopy Removal Of Lesions With Snar	1	$365.00	$365.75	$365.75	nat. median $1,663 outlier · 0.2×
58600 CPT	Ligation Or Transection Fallopian Tubes	1	$365.75	$365.75	$365.75	nat. median $3,224 outlier · 0.1×
11400 CPT	Excision Of Benign Lesion <.5 Cm	1	$365.75	$365.75	$365.75	nat. median $711 0.5× median
45378 CPT	Colonoscopy Screening High Risk	1	$365.00	$365.75	$365.75	nat. median $1,339 outlier · 0.3×
23066 CPT	Biopsy Shoulder Tissues Deep	1	$365.75	$365.75	$365.75	nat. median $2,939 outlier · 0.1×
23071 CPT	Exc Shoulder Les Sc 3 Cm/>	1	$365.75	$365.75	$365.75	nat. median $1,906 outlier · 0.2×
11103 CPT	Tangent Biospy Skin Les Each Additional	1	$365.75	$365.75	$365.75	nat. median $143 outlier · 2.6×
11104 CPT	Punch Biopsy Of Skin Single Lesion	1	$365.75	$365.75	$365.75	nat. median $402 0.9× median
11105 CPT	Punch Skin Biopsy Add Lesion	1	$365.75	$365.75	$365.75	nat. median $167 outlier · 2.2×
27324 CPT	Biopsy Thigh Soft Tissues Deep	1	$365.75	$365.75	$365.75	nat. median $2,990 outlier · 0.1×
28285 CPT	Repair Of Hammertoe	1	$365.75	$365.75	$365.75	nat. median $3,607 outlier · 0.1×
28470 CPT	Cl Tx Metatarsal Fx; Wo Manip Each	1	$365.75	$365.75	$365.75	nat. median $379 1.0× median
45330 CPT	Diagnostic Sigmoidoscopy	1	$365.75	$365.75	$365.75	nat. median $1,083 outlier · 0.3×
45388 CPT	Colonoscopy With Ablation Of Lesion	1	$365.00	$365.75	$365.75	nat. median $1,879 outlier · 0.2×
45338 CPT	Sigmoidscopy	1	$365.75	$365.75	$365.75	nat. median $1,498 outlier · 0.2×
49593 CPT	Laparascop Repair Ventral Hernia 3-10 Cm	1	$365.75	$365.75	$365.75	nat. median $5,961 outlier · 0.1×
23076 CPT	Excision Tumor Shoulder >5cm	1	$365.75	$365.75	$365.75	nat. median $2,900 outlier · 0.1×
360 OTHER	Abd Paracentesis With Imaging	1	$365.75	$365.75	$365.75	nat. median $3,248 outlier · 0.1×
36589 CPT	Removal Tunneled Cv Cath Wo Subcutanous	1	$365.75	$365.75	$365.75	nat. median $929 outlier · 0.4×
45380 CPT	Colonoscopy Diagnostic	1	$365.00	$365.75	$365.75	nat. median $1,565 outlier · 0.2×
20816 CPT	Replacement Digit/ Amputation	1	$365.75	$365.75	$365.75	nat. median $3,784 outlier · 0.1×
23065 CPT	Biopsy Shoulder Tissues	1	$365.75	$365.75	$365.75	nat. median $1,687 outlier · 0.2×
11444 CPT	Excis Lesion Benign 3.1-4 Cm Face Ears E	1	$365.75	$365.75	$365.75	nat. median $1,624 outlier · 0.2×
11446 CPT	Excis Lesion Benign >4 Cm Face Ear Eyeli	1	$365.75	$365.75	$365.75	nat. median $2,812 outlier · 0.1×
11600 CPT	Excision Malignant Lesion <.5 Cm	1	$365.75	$365.75	$365.75	nat. median $725 0.5× median
11601 CPT	Excision Malignant Lesion .6-1.0 Cm	1	$365.75	$365.75	$365.75	nat. median $717 0.5× median
11602 CPT	Excision Malignant Lesion 1.1-2.0 Cm	1	$365.75	$365.75	$365.75	nat. median $498 0.7× median
11603 CPT	Excision Malignant Lesion 2.1-3.0 Cm	1	$365.75	$365.75	$365.75	nat. median $793 outlier · 0.5×
11604 CPT	Excision Malignant Lesion 3.1-4.0 Cm	1	$365.75	$365.75	$365.75	nat. median $859 outlier · 0.4×
11606 CPT	Excision Malignant Lesion >4.0 Cm	1	$365.75	$365.75	$365.75	nat. median $1,802 outlier · 0.2×
11106 CPT	Biopsy Single Skin Lesion	1	$365.75	$365.75	$365.75	nat. median $638 0.6× median
27323 CPT	Biopsy Thigh Soft Tissues Superficial	1	$365.75	$365.75	$365.75	nat. median $1,728 outlier · 0.2×
11107 CPT	Biopsy Of Skin Each Separate Add Lesion	1	$365.75	$365.75	$365.75	nat. median $218 1.7× median
28124 CPT	Partial Excision Bone; Phalanx Of Toe	1	$365.75	$365.75	$365.75	nat. median $3,324 outlier · 0.1×
11406 CPT	Excision Benign Lesion >4.0 Cm	1	$365.00	$365.75	$365.38	nat. median $1,750 outlier · 0.2×
45381 CPT	Colonoscopy W/polypectomy	1	$365.00	$365.75	$365.38	nat. median $1,566 outlier · 0.2×
11404 CPT	Excision Benign Lesion 3.1-4.0 Cm	1	$365.00	$365.75	$365.38	nat. median $1,620 outlier · 0.2×
11403 CPT	Excision Benign Lesion 2.1-3.0 Cm	1	$365.00	$365.75	$365.38	nat. median $774 outlier · 0.5×
45379 CPT	Colonoscopy Flexible W/removal Foreign	1	$365.00	$365.75	$365.38	nat. median $1,563 outlier · 0.2×
45384 CPT	Colonoscopy With Rem Of Lesion By Forceps	1	$365.00	$365.75	$365.38	nat. median $1,582 outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 1,660 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

112	OTHER	Ob/private	1	1	$1,789.00	$1,789.00	$11,840.00	$11,840.00	$11,840.00	2026-05-23
121	OTHER	Medsurg Rm	1	1	$1,590.00	$1,590.00	$11,840.00	$11,840.00	$11,840.00	2026-05-23
36589	CPT	Removal Tunneled Cv Cath Wo Subcutanous	1	1	$3,100.05	$3,100.05	$365.75	$365.75	$365.75	2026-05-23
45338	CPT	Sigmoidscopy	1	1	$2,919.29	$2,919.29	$365.75	$365.75	$365.75	2026-05-23
28899	CPT	Unlisted Procedure Toes/foot	1	1	$621.03	$621.03	$365.75	$365.75	$365.75	2026-05-23
28124	CPT	Partial Excision Bone; Phalanx Of Toe	1	1	$6,489.22	$6,489.22	$365.75	$365.75	$365.75	2026-05-23
49591	CPT	Laproscopic Cholecystectomy	1	1	$7,058.12	$7,058.12	$365.75	$365.75	$365.75	2026-05-23
49593	CPT	Laparascop Repair Ventral Hernia 3-10 Cm	1	1	$12,479.50	$12,479.50	$365.75	$365.75	$365.75	2026-05-23
360	OTHER	Abd Paracentesis With Imaging	1	1	$1,673.01	$1,673.01	$365.75	$365.75	$365.75	2026-05-23
45385	CPT	Colonoscopy Removal Of Lesions With Snar	3	1	$2,165.82	$2,165.82	$365.00	$365.75	$365.75	2026-05-23
28298	CPT	Correction Of Bunion With Bone Removal	1	1	$3,534.54	$3,534.54	$365.75	$365.75	$365.75	2026-05-23
45330	CPT	Diagnostic Sigmoidoscopy	1	1	$2,484.11	$2,484.11	$365.75	$365.75	$365.75	2026-05-23
23071	CPT	Exc Shoulder Les Sc 3 Cm/>	1	1	$3,240.48	$3,240.48	$365.75	$365.75	$365.75	2026-05-23
27324	CPT	Biopsy Thigh Soft Tissues Deep	1	1	$5,724.10	$5,724.10	$365.75	$365.75	$365.75	2026-05-23
23066	CPT	Biopsy Shoulder Tissues Deep	1	1	$3,240.48	$3,240.48	$365.75	$365.75	$365.75	2026-05-23
11103	CPT	Tangent Biospy Skin Les Each Additional	1	1	$600.00	$600.00	$365.75	$365.75	$365.75	2026-05-23
11107	CPT	Biopsy Of Skin Each Separate Add Lesion	1	1	$2,000.00	$2,000.00	$365.75	$365.75	$365.75	2026-05-23
23065	CPT	Biopsy Shoulder Tissues	1	1	$3,240.48	$3,240.48	$365.75	$365.75	$365.75	2026-05-23
27323	CPT	Biopsy Thigh Soft Tissues Superficial	1	1	$5,724.10	$5,724.10	$365.75	$365.75	$365.75	2026-05-23
11105	CPT	Punch Skin Biopsy Add Lesion	1	1	$378.00	$378.00	$365.75	$365.75	$365.75	2026-05-23
11104	CPT	Punch Biopsy Of Skin Single Lesion	1	1	$1,198.59	$1,198.59	$365.75	$365.75	$365.75	2026-05-23
11102	CPT	Tangent Biospy Single Skin Lesion	1	1	$596.10	$596.10	$365.75	$365.75	$365.75	2026-05-23
28750	CPT	Arthrodesis Great Toe Metatarsophalanhea	1	1	$5,306.32	$5,306.32	$365.75	$365.75	$365.75	2026-05-23
45378	CPT	Colonoscopy Screening High Risk	3	1	$2,608.32	$2,608.32	$365.00	$365.75	$365.75	2026-05-23
23075	CPT	Excision Tumor Shoulder >3cm	1	1	$3,240.48	$3,240.48	$365.75	$365.75	$365.75	2026-05-23
45388	CPT	Colonoscopy With Ablation Of Lesion	3	1	$2,608.32	$2,608.32	$365.00	$365.75	$365.75	2026-05-23
58600	CPT	Ligation Or Transection Fallopian Tubes	1	1	$1,191.52	$1,191.52	$365.75	$365.75	$365.75	2026-05-23
11603	CPT	Excision Malignant Lesion 2.1-3.0 Cm	1	1	$1,407.18	$1,407.18	$365.75	$365.75	$365.75	2026-05-23
11606	CPT	Excision Malignant Lesion >4.0 Cm	1	1	$3,240.48	$3,240.48	$365.75	$365.75	$365.75	2026-05-23
11106	CPT	Biopsy Single Skin Lesion	1	1	$1,591.54	$1,591.54	$365.75	$365.75	$365.75	2026-05-23
11602	CPT	Excision Malignant Lesion 1.1-2.0 Cm	1	1	$1,198.59	$1,198.59	$365.75	$365.75	$365.75	2026-05-23
11444	CPT	Excis Lesion Benign 3.1-4 Cm Face Ears E	1	1	$3,089.50	$3,089.50	$365.75	$365.75	$365.75	2026-05-23
11600	CPT	Excision Malignant Lesion <.5 Cm	1	1	$1,407.18	$1,407.18	$365.75	$365.75	$365.75	2026-05-23
45380	CPT	Colonoscopy Diagnostic	3	1	$1.00	$1.00	$365.00	$365.75	$365.75	2026-05-23
11446	CPT	Excis Lesion Benign >4 Cm Face Ear Eyeli	1	1	$5,414.70	$5,414.70	$365.75	$365.75	$365.75	2026-05-23
11601	CPT	Excision Malignant Lesion .6-1.0 Cm	1	1	$1,407.18	$1,407.18	$365.75	$365.75	$365.75	2026-05-23
28285	CPT	Repair Of Hammertoe	1	1	$3,406.68	$3,406.68	$365.75	$365.75	$365.75	2026-05-23
11604	CPT	Excision Malignant Lesion 3.1-4.0 Cm	1	1	$1,407.18	$1,407.18	$365.75	$365.75	$365.75	2026-05-23
28289	CPT	Bunion Correction Without Implant	1	1	$5,224.66	$5,224.66	$365.75	$365.75	$365.75	2026-05-23
28470	CPT	Cl Tx Metatarsal Fx; Wo Manip Each	1	1	$531.00	$531.00	$365.75	$365.75	$365.75	2026-05-23
28080	CPT	Excis Interdigital Morton Neuroma Single	1	1	$3,200.82	$3,200.82	$365.75	$365.75	$365.75	2026-05-23
11400	CPT	Excision Of Benign Lesion <.5 Cm	1	1	$1,829.33	$1,829.33	$365.75	$365.75	$365.75	2026-05-23
20816	CPT	Replacement Digit/ Amputation	1	1	$4,877.93	$4,877.93	$365.75	$365.75	$365.75	2026-05-23
23076	CPT	Excision Tumor Shoulder >5cm	1	1	$5,724.10	$5,724.10	$365.75	$365.75	$365.75	2026-05-23
G0463	HCPCS	Hospital Outpatient Clinic Visit	2	1	$220.12	$220.12	$365.00	$365.75	$365.38	2026-05-23
99308	CPT	Sbsq Nur Fac Care/day Minor Compl 15 Min	2	1	$260.56	$260.56	$365.00	$365.75	$365.38	2026-05-23
99315	CPT	Nurs Facility Disc Magmnt 30 Or Less	2	1	$274.72	$274.72	$365.00	$365.75	$365.38	2026-05-23
99255	CPT	Initial Ip Or Obs Consult New/estab Pt	2	1	$575.61	$575.61	$365.00	$365.75	$365.38	2026-05-23
99418	CPT	Prolonged Ip/obs E/m Ea 15 Min	2	1	$344.96	$344.96	$365.00	$365.75	$365.38	2026-05-23
97803	CPT	Med Nutrition Re-assmt&ivntj Indiv E 15	2	1	$105.92	$105.92	$365.00	$365.75	$365.38	2026-05-23
43239	CPT	Egd Biopsy Single/multiple	2	1	$1,020.91	$1,020.91	$365.00	$365.75	$365.38	2026-05-23
99306	CPT	Initial Nursing Facility Care/day 45 Min	2	1	$471.12	$471.12	$365.00	$365.75	$365.38	2026-05-23
99199	CPT	Abi After Hours Tech Fee	2	1	$181.07	$181.07	$365.00	$365.75	$365.38	2026-05-23
10120	CPT	Incision And Removal Foreign Body Simple	2	1	$667.08	$667.08	$365.00	$365.75	$365.38	2026-05-23
11401	CPT	Excision Benign Lesion .6-1.0 Cm	2	1	$911.64	$911.64	$365.00	$365.75	$365.38	2026-05-23
11403	CPT	Excision Benign Lesion 2.1-3.0 Cm	2	1	$913.63	$913.63	$365.00	$365.75	$365.38	2026-05-23
11406	CPT	Excision Benign Lesion >4.0 Cm	2	1	$1,970.05	$1,970.05	$365.00	$365.75	$365.38	2026-05-23
11402	CPT	Excision Benign Lesion 1.1-2.0 Cm	2	1	$758.02	$758.02	$365.00	$365.75	$365.38	2026-05-23
99211	CPT	Other Op Visit Phys Presence Not Require	2	1	$669.50	$669.50	$365.00	$365.75	$365.38	2026-05-23
99310	CPT	Sbsq Nur Fac Care/day Unstabl 35 Min	2	1	$380.64	$380.64	$365.00	$365.75	$365.38	2026-05-23
G0105	HCPCS	Colonoscopy Screening High Risk	2	1	$1,565.27	$1,565.27	$365.00	$365.75	$365.38	2026-05-23
99309	CPT	Sbsq Nur Fac Care/day New Problem 25 Min	2	1	$343.68	$343.68	$365.00	$365.75	$365.38	2026-05-23
45384	CPT	Colonoscopy With Rem Of Lesion By Forceps	2	1	$1,678.89	$1,678.89	$365.00	$365.75	$365.38	2026-05-23
45379	CPT	Colonoscopy Flexible W/removal Foreign	2	1	$1,641.84	$1,641.84	$365.00	$365.75	$365.38	2026-05-23
43249	CPT	Egd With Dilation	2	1	$1,134.89	$1,134.89	$365.00	$365.75	$365.38	2026-05-23
G0121	HCPCS	Colonoscopy Screening Not High Risk	2	1	$1,565.27	$1,565.27	$365.00	$365.75	$365.38	2026-05-23
99316	CPT	Nurs Facility Disc Magmnt 30 Or More	2	1	$394.44	$394.44	$365.00	$365.75	$365.38	2026-05-23
43235	CPT	Egd	2	1	$876.94	$876.94	$365.00	$365.75	$365.38	2026-05-23
46320	CPT	Excision Of Thrombosed Hemorrhoid Extern	2	1	$1,442.45	$1,442.45	$365.00	$365.75	$365.38	2026-05-23
99304	CPT	Initial Nursing Facility Care/day 25 Min	2	1	$169.46	$169.46	$365.00	$365.75	$365.38	2026-05-23
55250	CPT	Pro Fee Vasectomy Uni Or Bilateral	2	1	$907.31	$907.31	$365.00	$365.75	$365.38	2026-05-23
45381	CPT	Colonoscopy W/polypectomy	2	1	$1,587.68	$1,587.68	$365.00	$365.75	$365.38	2026-05-23
99307	CPT	Sbsq Nursing Fac Care/day Stable 10 Min	2	1	$150.84	$150.84	$365.00	$365.75	$365.38	2026-05-23
97802	CPT	Medical Nutrition Assmt&ivntj Indiv Eac	2	1	$110.48	$110.48	$365.00	$365.75	$365.38	2026-05-23
58661	CPT	Laparoscopy W/rmvl Adnexal Structures	2	1	$6,385.06	$6,385.06	$365.00	$365.75	$365.38	2026-05-23
47562	CPT	Laproscopic Cholecystectomy	2	1	$1,272.61	$1,272.61	$365.00	$365.75	$365.38	2026-05-23
92613	CPT	Endoscopy Swallow (fees) I&r	2	1	$102.56	$102.56	$365.00	$365.75	$365.38	2026-05-23
11404	CPT	Excision Benign Lesion 3.1-4.0 Cm	2	1	$1,014.90	$1,014.90	$365.00	$365.75	$365.38	2026-05-23
99305	CPT	Initial Nursing Facility Care/day 35 Min	2	1	$214.00	$214.00	$365.00	$365.75	$365.38	2026-05-23
12020	CPT	Trtmt Superficial Wound Dehiscence Smpl	1	1	$692.29	$692.29	$365.00	$365.00	$365.00	2026-05-23
12018	CPT	ER Lac Repair Face/ear > 30.0 Cm	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
11423	CPT	Excis Benign Lesion Scalp Neck 2.1-3. Cm	1	1	$1,050.05	$1,050.05	$365.00	$365.00	$365.00	2026-05-23
12017	CPT	ER Repair 20.1-30.0 Cm (facial)	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
23500	CPT	Cl Tx Clavicular Fx; Wo Manip	1	1	$220.60	$220.60	$365.00	$365.00	$365.00	2026-05-23
12016	CPT	ER Repair 12.6-20.0 Cm (facial)	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
11043	CPT	Debr Skin/subq Tissue/muscle	1	1	$762.76	$762.76	$365.00	$365.00	$365.00	2026-05-23
12015	CPT	ER Repair 7.6-12.5 Cm (facial)	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
29700	CPT	Rem Gauntlet Boot Or Body Cast	1	1	$53.63	$53.63	$365.00	$365.00	$365.00	2026-05-23
12014	CPT	ER Repair 5.1-7.5 Cm (facial)	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
12013	CPT	ER Repair 2.6-5.0 Cm (facial)	1	1	$222.87	$222.87	$365.00	$365.00	$365.00	2026-05-23
20611	CPT	Drain/inj Joint/bursa W/us	1	1	$511.72	$511.72	$365.00	$365.00	$365.00	2026-05-23
12011	CPT	ER Repair Up To 2.5 Cm (facial)	1	1	$198.43	$198.43	$365.00	$365.00	$365.00	2026-05-23
11042	CPT	Debr Skin/subq Tissue	1	1	$547.55	$547.55	$365.00	$365.00	$365.00	2026-05-23
10121	CPT	Inc & Rem Fb Sq; Compl	1	1	$460.95	$460.95	$365.00	$365.00	$365.00	2026-05-23
12007	CPT	ER Lac Repair Trunk/neck >30.0 C	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
20553	CPT	Inj Trigger Points 3/>	1	1	$483.17	$483.17	$365.00	$365.00	$365.00	2026-05-23
12006	CPT	ER Repair 20.0-30.0 Cm	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
12005	CPT	ER Repair 12.6-20.0 Cm	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
28630	CPT	Cl Tx Mtp Jnt Disloc; Wo Anesth	1	1	$138.40	$138.40	$365.00	$365.00	$365.00	2026-05-23
20520	CPT	Rem Fb Muscle; Smpl	1	1	$229.96	$229.96	$365.00	$365.00	$365.00	2026-05-23
12004	CPT	ER Repair 7.6-12.5 Cm	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
11012	CPT	Debridement Skin Bone At Fx Site	1	1	$1,508.75	$1,508.75	$365.00	$365.00	$365.00	2026-05-23
20103	CPT	Exploration Penetrating Wound Ext	1	1	$1,069.99	$1,069.99	$365.00	$365.00	$365.00	2026-05-23
20525	CPT	Rem Fb Muscle; Deep	1	1	$759.59	$759.59	$365.00	$365.00	$365.00	2026-05-23
20550	CPT	Inj Trigger Point Tendon Sheath/ligament	1	1	$659.31	$659.31	$365.00	$365.00	$365.00	2026-05-23
20552	CPT	Inj Trigger Point 1-2 Muscles	1	1	$483.01	$483.01	$365.00	$365.00	$365.00	2026-05-23
29130	CPT	ER Applicatn Finger Splint Stati	1	1	$116.19	$116.19	$365.00	$365.00	$365.00	2026-05-23
20600	CPT	ER Arthrocentesis Sm Joint	1	1	$122.79	$122.79	$365.00	$365.00	$365.00	2026-05-23
20605	CPT	ER Arthrocentesis Intermed Joint	1	1	$140.32	$140.32	$365.00	$365.00	$365.00	2026-05-23
20610	CPT	ER Arthrocentesis Major Joint	1	1	$409.20	$409.20	$365.00	$365.00	$365.00	2026-05-23
29425	CPT	Apply Wlkr Sh Leg Cast	1	1	$85.20	$85.20	$365.00	$365.00	$365.00	2026-05-23
29515	CPT	Apply Short Leg Splint	1	1	$132.50	$132.50	$365.00	$365.00	$365.00	2026-05-23
21480	CPT	Cl Tx Tmj Dislocation; Initial	1	1	$137.29	$137.29	$365.00	$365.00	$365.00	2026-05-23
21485	CPT	Reset Dislocated Jaw	1	1	$2,336.66	$2,336.66	$365.00	$365.00	$365.00	2026-05-23
29740	CPT	Wedging Cast Except Clubfoot	1	1	$100.61	$100.61	$365.00	$365.00	$365.00	2026-05-23
30300	CPT	ER Remove Nasal Fb	1	1	$45.79	$45.79	$365.00	$365.00	$365.00	2026-05-23
30903	CPT	ER Cntrl Nosebleed Anterior Cmplx	1	1	$130.81	$130.81	$365.00	$365.00	$365.00	2026-05-23
30906	CPT	Ctrl Post Epistax Sq	1	1	$88.04	$88.04	$365.00	$365.00	$365.00	2026-05-23
31502	CPT	Tracheotomy Tube Chnge	1	1	$144.69	$144.69	$365.00	$365.00	$365.00	2026-05-23
31515	CPT	Laryngoscopy Direct; For Asp	1	1	$1,196.23	$1,196.23	$365.00	$365.00	$365.00	2026-05-23
23540	CPT	Cl Tx Aclav Disloc; Wo Manip	1	1	$442.91	$442.91	$365.00	$365.00	$365.00	2026-05-23
23600	CPT	Cl Tx Prox Humeral Fx; Wo Manip	1	1	$697.03	$697.03	$365.00	$365.00	$365.00	2026-05-23
23650	CPT	ER Closed Tx Shoulder Dislocatio	1	1	$252.11	$252.11	$365.00	$365.00	$365.00	2026-05-23
23655	CPT	Cl Tx Shldr Disl W Manip; W Anesth	1	1	$2,796.05	$2,796.05	$365.00	$365.00	$365.00	2026-05-23
24500	CPT	Cl Tx Humerus Fx Wo Manip	1	1	$138.40	$138.40	$365.00	$365.00	$365.00	2026-05-23
24505	CPT	Cl Tx Humerus Fx W Manip	1	1	$513.46	$513.46	$365.00	$365.00	$365.00	2026-05-23
20102	CPT	Expl P Wnd; Abd/flank	1	1	$3,090.54	$3,090.54	$365.00	$365.00	$365.00	2026-05-23
12002	CPT	ER Repair 2.6-7.5 Cm	1	1	$225.76	$225.76	$365.00	$365.00	$365.00	2026-05-23
20101	CPT	Expl P Wnd; Chest	1	1	$1,879.09	$1,879.09	$365.00	$365.00	$365.00	2026-05-23
28400	CPT	Cl Tx Calcaneal Fx; Wo Manip	1	1	$261.09	$261.09	$365.00	$365.00	$365.00	2026-05-23
17250	CPT	Chem Cauterization Of Granulation Tissue	1	1	$223.22	$223.22	$365.00	$365.00	$365.00	2026-05-23
12001	CPT	ER Repair 2.5 Cm Or Less	1	1	$197.11	$197.11	$365.00	$365.00	$365.00	2026-05-23
16035	CPT	Escharotomy Initial Incision	1	1	$434.52	$434.52	$365.00	$365.00	$365.00	2026-05-23
16030	CPT	Dress/debrid P-thick Burn L	1	1	$129.62	$129.62	$365.00	$365.00	$365.00	2026-05-23
11976	CPT	Prof Fee Removal Implant Contracept Caps	1	1	$675.36	$675.36	$365.00	$365.00	$365.00	2026-05-23
16025	CPT	ER Dress/debr Burn Without Anes Med	1	1	$73.88	$73.88	$365.00	$365.00	$365.00	2026-05-23
27818	CPT	Cl Tx Trimall Ankle Fx; W Manip	1	1	$1,152.03	$1,152.03	$365.00	$365.00	$365.00	2026-05-23
16020	CPT	Dress/debrid P-thick Burn S	1	1	$306.25	$306.25	$365.00	$365.00	$365.00	2026-05-23
11765	CPT	Wedge Excis Skin Of Nail Fold (ingrown T	1	1	$223.22	$223.22	$365.00	$365.00	$365.00	2026-05-23
11300	CPT	Shave Skin Les 1 Trunk/arm/leg Diam 0.5<	1	1	$1,198.59	$1,198.59	$365.00	$365.00	$365.00	2026-05-23
11011	CPT	Debridement Skin Musc At Fx Site	1	1	$1,052.52	$1,052.52	$365.00	$365.00	$365.00	2026-05-23
10061	CPT	I&d Absc; Compl Or Multi	1	1	$135.56	$135.56	$365.00	$365.00	$365.00	2026-05-23
16000	CPT	Init Tx 1st Degr Burn	1	1	$85.15	$85.15	$365.00	$365.00	$365.00	2026-05-23
13160	CPT	Secondary Closure Of Surg Or Dehiscence	1	1	$3,090.54	$3,090.54	$365.00	$365.00	$365.00	2026-05-23
11760	CPT	ER Repair Nail Bed	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
13152	CPT	ER Cmplx Rep 2.6/7.5 Cm Face	1	1	$185.21	$185.21	$365.00	$365.00	$365.00	2026-05-23
13151	CPT	ER Cmplx Rep 1.1/2.5 Cm Face	1	1	$185.21	$185.21	$365.00	$365.00	$365.00	2026-05-23
11750	CPT	Removal Of Nail Bed	1	1	$553.10	$553.10	$365.00	$365.00	$365.00	2026-05-23
11200	CPT	Rem Skin Tags; <=15 Lesions	1	1	$154.01	$154.01	$365.00	$365.00	$365.00	2026-05-23
13133	CPT	Repair Wound/lesion Add'l 5 Cm	1	1	$498.02	$498.02	$365.00	$365.00	$365.00	2026-05-23
13132	CPT	ER Cmplx Repair 2.6-7.5 Cm	1	1	$211.68	$211.68	$365.00	$365.00	$365.00	2026-05-23
11740	CPT	ER Evac Subungal Hematoma	1	1	$39.25	$39.25	$365.00	$365.00	$365.00	2026-05-23
13131	CPT	ER Cmplx Repair 1.1-2.5 Cm	1	1	$185.21	$185.21	$365.00	$365.00	$365.00	2026-05-23
27503	CPT	Cl Tx Sc/tc Femur Fx W Manip	1	1	$1,543.46	$1,543.46	$365.00	$365.00	$365.00	2026-05-23
13122	CPT	Repair Wound Lesion Add On 1-5cm	1	1	$319.03	$319.03	$365.00	$365.00	$365.00	2026-05-23
11732	CPT	Spl Avulse Np; Ea Addtl	1	1	$124.07	$124.07	$365.00	$365.00	$365.00	2026-05-23
11010	CPT	Debride Skin At Fx Site	1	1	$598.97	$598.97	$365.00	$365.00	$365.00	2026-05-23
13121	CPT	ER Cmplx Rep 2.6/7.5 Cm Scalp/ext	1	1	$211.68	$211.68	$365.00	$365.00	$365.00	2026-05-23
13120	CPT	ER Cmplx Rep 1.1/2.5 Cm Scalp/ext	1	1	$211.68	$211.68	$365.00	$365.00	$365.00	2026-05-23
11730	CPT	Spl Avulse Np; Sgl	1	1	$84.44	$84.44	$365.00	$365.00	$365.00	2026-05-23
13102	CPT	Repair Wound/lesion Ad On	1	1	$653.12	$653.12	$365.00	$365.00	$365.00	2026-05-23
27250	CPT	Cl Tx Trauma Hip Dicloc Wo Anesth	1	1	$158.16	$158.16	$365.00	$365.00	$365.00	2026-05-23
13101	CPT	ER Cmplx Repair 2.6-7.5 Cm -trunk	1	1	$185.21	$185.21	$365.00	$365.00	$365.00	2026-05-23
11641	CPT	Excision Malig Lesion 0.6 - 1.0 Cm	1	1	$1,309.68	$1,309.68	$365.00	$365.00	$365.00	2026-05-23
27230	CPT	Cl Tx Prox Fem Fx Wo Manip	1	1	$513.46	$513.46	$365.00	$365.00	$365.00	2026-05-23
27200	CPT	Cl Tx Coccygeal Fracture	1	1	$383.84	$383.84	$365.00	$365.00	$365.00	2026-05-23
13100	CPT	ER Cmplx Repair 1.1-2.5 Cm -trunk	1	1	$185.21	$185.21	$365.00	$365.00	$365.00	2026-05-23
27252	CPT	Closed Treatment Of Hip Dislocation Trau	1	1	$3,981.46	$3,981.46	$365.00	$365.00	$365.00	2026-05-23
27265	CPT	Cl Tx Post Hip Disloc Wo Anesth	1	1	$298.39	$298.39	$365.00	$365.00	$365.00	2026-05-23
27043	CPT	Prof Fee Exc Hip Pelvis Les Sc 3 Cm/>	1	1	$1,300.23	$1,300.23	$365.00	$365.00	$365.00	2026-05-23
26951	CPT	Amputate Fing/th Sgl; W Dir Close	1	1	$2,289.13	$2,289.13	$365.00	$365.00	$365.00	2026-05-23
27372	CPT	Rem Deep Fb Thigh Or Knee	1	1	$61.12	$61.12	$365.00	$365.00	$365.00	2026-05-23
27500	CPT	Cl Tx Femoral Shaft Fx Wo Manip	1	1	$570.30	$570.30	$365.00	$365.00	$365.00	2026-05-23
27502	CPT	Cl Tx Femoral Shaft Fx W Manip	1	1	$2,207.14	$2,207.14	$365.00	$365.00	$365.00	2026-05-23
12057	CPT	Repair Intermediate Over 30.0 Cm-facial	1	1	$688.83	$688.83	$365.00	$365.00	$365.00	2026-05-23
27520	CPT	Closed Tx Patellar Fx Wo Manip	1	1	$634.84	$634.84	$365.00	$365.00	$365.00	2026-05-23
27530	CPT	Cl Tx Prox Tibial Fx Wo Manip	1	1	$836.76	$836.76	$365.00	$365.00	$365.00	2026-05-23
27550	CPT	Closed Tx Knee Disloc Without Anes	1	1	$138.40	$138.40	$365.00	$365.00	$365.00	2026-05-23
27560	CPT	C Tx Patellar Dislocation; Wo Anesth	1	1	$138.39	$138.39	$365.00	$365.00	$365.00	2026-05-23
27562	CPT	Clsd Trmt Patellar Disloc Req Anesthesia	1	1	$2,258.34	$2,258.34	$365.00	$365.00	$365.00	2026-05-23
27580	CPT	Fusion Of Knee Any Technique	1	1	$2,789.31	$2,789.31	$365.00	$365.00	$365.00	2026-05-23
27750	CPT	Cl Tx Tib Shft Fx Wo Manip	1	1	$261.09	$261.09	$365.00	$365.00	$365.00	2026-05-23
27760	CPT	Cltx Medial Ankle Fx Wo Manipulation	1	1	$138.40	$138.40	$365.00	$365.00	$365.00	2026-05-23
27767	CPT	Cltx Post Ankle Fx Wo Manipulation	1	1	$575.13	$575.13	$365.00	$365.00	$365.00	2026-05-23
27780	CPT	Tx Fibula Fx	1	1	$655.66	$655.66	$365.00	$365.00	$365.00	2026-05-23
27786	CPT	Cl Tx Dstl Fib Fx Wo Manip	1	1	$158.16	$158.16	$365.00	$365.00	$365.00	2026-05-23
27788	CPT	Cl Tx Distl Fib Fx W Manip	1	1	$158.16	$158.16	$365.00	$365.00	$365.00	2026-05-23
27808	CPT	Cltx Bimalleolar Ankle Fract Wo Mnp	1	1	$158.16	$158.16	$365.00	$365.00	$365.00	2026-05-23
27810	CPT	Cltx Bimalleolar Ankle Fract W Mnp	1	1	$1,307.09	$1,307.09	$365.00	$365.00	$365.00	2026-05-23
27816	CPT	Tx Ankle Fx	1	1	$513.46	$513.46	$365.00	$365.00	$365.00	2026-05-23
26775	CPT	Clo Trmnt Interphal Joint W/manip & Anes	1	1	$533.82	$533.82	$365.00	$365.00	$365.00	2026-05-23
27824	CPT	Cl Tx Fx Wb Dstl Tib Wo Manip	1	1	$261.09	$261.09	$365.00	$365.00	$365.00	2026-05-23
27840	CPT	Closd Tx Ankle Disloc Without Anes	1	1	$151.16	$151.16	$365.00	$365.00	$365.00	2026-05-23
26770	CPT	Cl Tx Ip Jnt D W Manip Dislocation ; Wo	1	1	$252.11	$252.11	$365.00	$365.00	$365.00	2026-05-23
26755	CPT	Cl Tx Distal Phal Fx Fgrr/thmb; W Manip;	1	1	$554.31	$554.31	$365.00	$365.00	$365.00	2026-05-23
28190	CPT	Remove Fb Foot Subq	1	1	$229.96	$229.96	$365.00	$365.00	$365.00	2026-05-23
26750	CPT	Cl Tx D Phal Fx Fgr/thmb Distal; Wo Mani	1	1	$252.11	$252.11	$365.00	$365.00	$365.00	2026-05-23
12056	CPT	Repair Intermediate 20.1-30.0 Cm-facial	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
12055	CPT	Repair Intermediate 12.6-20.0 Cm-facial	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
11000	CPT	Debr Skin 10% Body Surface	1	1	$87.24	$87.24	$365.00	$365.00	$365.00	2026-05-23
28430	CPT	Tx Ankle Fx	1	1	$506.35	$506.35	$365.00	$365.00	$365.00	2026-05-23
28450	CPT	Tx Tarsal Bone Fx ; Wo Manipu; Ea	1	1	$407.98	$407.98	$365.00	$365.00	$365.00	2026-05-23
10081	CPT	Drainage Pilonidal Cyst	1	1	$235.38	$235.38	$365.00	$365.00	$365.00	2026-05-23
28490	CPT	Cl Tx Fx Gt Phalanx(s); Wo Manip	1	1	$138.40	$138.40	$365.00	$365.00	$365.00	2026-05-23
28510	CPT	Cl Tx Fx Phalnx/phalang Wo Manip Each	1	1	$220.60	$220.60	$365.00	$365.00	$365.00	2026-05-23
28515	CPT	Cl Tx Fx Phalanx/phalang; W Manip Each	1	1	$220.60	$220.60	$365.00	$365.00	$365.00	2026-05-23
26740	CPT	Cl Tx Art Fx Mcp/ip Jnt; Wo Man Ea	1	1	$513.46	$513.46	$365.00	$365.00	$365.00	2026-05-23
28660	CPT	ER Cl Tx Interphlng Jnt Dislc With	1	1	$278.87	$278.87	$365.00	$365.00	$365.00	2026-05-23
26725	CPT	Cl Tx Phalang Shft Fx; W Manip Each	1	1	$79.68	$79.68	$365.00	$365.00	$365.00	2026-05-23
12054	CPT	Repair Intermediate 7.6-12.5 Cm -facial	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
29065	CPT	ER Application Long Arm Cast	1	1	$162.16	$162.16	$365.00	$365.00	$365.00	2026-05-23
29075	CPT	Apply Short Arm Cast	1	1	$100.42	$100.42	$365.00	$365.00	$365.00	2026-05-23
29105	CPT	ER Application Long Arm Splint	1	1	$117.42	$117.42	$365.00	$365.00	$365.00	2026-05-23
29125	CPT	Apply Short Arm Splint; Static	1	1	$110.81	$110.81	$365.00	$365.00	$365.00	2026-05-23
26720	CPT	Cl Tx Phal Shaft Fx; Wo Manip Each	1	1	$220.60	$220.60	$365.00	$365.00	$365.00	2026-05-23
29200	CPT	Strapping Of Chest	1	1	$156.39	$156.39	$365.00	$365.00	$365.00	2026-05-23
29240	CPT	Strapping Shoulder	1	1	$91.29	$91.29	$365.00	$365.00	$365.00	2026-05-23
29260	CPT	Strapping Elbow/wrist	1	1	$118.92	$118.92	$365.00	$365.00	$365.00	2026-05-23
29280	CPT	Strapping Hand/finger	1	1	$63.38	$63.38	$365.00	$365.00	$365.00	2026-05-23
29345	CPT	ER Application Long Leg Cast	1	1	$156.08	$156.08	$365.00	$365.00	$365.00	2026-05-23
29358	CPT	Application Long Leg Cast Brace	1	1	$350.49	$350.49	$365.00	$365.00	$365.00	2026-05-23
29405	CPT	ER Application Short Leg Cast	1	1	$141.90	$141.90	$365.00	$365.00	$365.00	2026-05-23
26700	CPT	Closed Tx M-p Disloc Without Anes	1	1	$220.60	$220.60	$365.00	$365.00	$365.00	2026-05-23
29505	CPT	Application Splint Leg Long	1	1	$137.94	$137.94	$365.00	$365.00	$365.00	2026-05-23
12053	CPT	Repair Intermed Face/ear/eye 5.1-7.5cm	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
29530	CPT	Strapping Knee	1	1	$111.75	$111.75	$365.00	$365.00	$365.00	2026-05-23
29540	CPT	ER Strapping Ankle	1	1	$111.96	$111.96	$365.00	$365.00	$365.00	2026-05-23
29550	CPT	Strapping Toes	1	1	$53.63	$53.63	$365.00	$365.00	$365.00	2026-05-23
29581	CPT	Apply Multlay Comprs Lwr Leg	1	1	$227.01	$227.01	$365.00	$365.00	$365.00	2026-05-23
29584	CPT	Apply Multi-layer Compress Arm/hand	1	1	$122.66	$122.66	$365.00	$365.00	$365.00	2026-05-23
26645	CPT	Cl Tx Cmc Fx Disloc Thumb W Manip	1	1	$886.54	$886.54	$365.00	$365.00	$365.00	2026-05-23
26641	CPT	Cl Tx Cmc Disloc Thumb W Manip	1	1	$690.07	$690.07	$365.00	$365.00	$365.00	2026-05-23
26605	CPT	Excis Or Curettage Bone Cyst Or Benign T	1	1	$547.24	$547.24	$365.00	$365.00	$365.00	2026-05-23
30901	CPT	ER Cntrl Nosebleed Anterior Smpl	1	1	$161.50	$161.50	$365.00	$365.00	$365.00	2026-05-23
26600	CPT	Cl Tx Mc Fx Sgl; Wo Manip Ea Bone	1	1	$499.08	$499.08	$365.00	$365.00	$365.00	2026-05-23
30905	CPT	Cntrl Post Epistax Init	1	1	$100.62	$100.62	$365.00	$365.00	$365.00	2026-05-23
12052	CPT	Repair Intermediate 2.6-5.0 Cm -facial	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
31500	CPT	Intubation Endotracheal	1	1	$352.18	$352.18	$365.00	$365.00	$365.00	2026-05-23
12051	CPT	Repair Intermediate 2.5 Cm Or < -facial	1	1	$142.71	$142.71	$365.00	$365.00	$365.00	2026-05-23
31505	CPT	Laryngoscopy Ind; Diagnostic	1	1	$51.23	$51.23	$365.00	$365.00	$365.00	2026-05-23
26410	CPT	Repair Extensor Hand	1	1	$637.85	$637.85	$365.00	$365.00	$365.00	2026-05-23
31530	CPT	Laryngoscopy Operatv W/fb Remv	1	1	$731.58	$731.58	$365.00	$365.00	$365.00	2026-05-23
32550	CPT	Insert Pleural Cath	1	1	$6,105.89	$6,105.89	$365.00	$365.00	$365.00	2026-05-23
32551	CPT	Tube Thoracostomy Includes Water Seal	1	1	$557.90	$557.90	$365.00	$365.00	$365.00	2026-05-23
32555	CPT	US Thoracentesis	1	1	$1,944.72	$250.00 87% off	$365.00	$365.00	$365.00	2026-05-23
33016	CPT	ER Pericardiocentesis Initial	1	1	$220.46	$220.46	$365.00	$365.00	$365.00	2026-05-23
33210	CPT	Insert Cardiac Electrode Sngl	1	1	$1,594.43	$1,594.43	$365.00	$365.00	$365.00	2026-05-23
35207	CPT	Repair Bld Vsl, Direct, Hand/finger	1	1	$1,284.73	$1,284.73	$365.00	$365.00	$365.00	2026-05-23
36000	CPT	ER Intro Needle/cath Vein	1	1	$48.89	$48.89	$365.00	$365.00	$365.00	2026-05-23
36100	CPT	Intro Needle - Artery	1	1	$1,104.87	$1,104.87	$365.00	$365.00	$365.00	2026-05-23
36140	CPT	Artery Needle Introduction	1	1	$1,005.57	$1,005.57	$365.00	$365.00	$365.00	2026-05-23
36420	CPT	ER Venipuncture Cutdown < Age 1	1	1	$5.10	$5.10	$365.00	$365.00	$365.00	2026-05-23
36430	CPT	Transfusion Bld/bld Componts 2h	1	1	$307.81	$307.81	$365.00	$365.00	$365.00	2026-05-23
36513	CPT	Therapeutic Apheresis For Platelets	1	1	$187.78	$187.78	$365.00	$365.00	$365.00	2026-05-23
26075	CPT	Arthromoty W/expl,drainage,or Removal Fb	1	1	$2,384.43	$2,384.43	$365.00	$365.00	$365.00	2026-05-23
12047	CPT	Repair Intermediate Over 30.0 Cm	1	1	$688.83	$688.83	$365.00	$365.00	$365.00	2026-05-23
26011	CPT	Drainage Finger Abscess, Complicated	1	1	$735.31	$735.31	$365.00	$365.00	$365.00	2026-05-23
46040	CPT	I&d Ischio/perirectal Abscess	1	1	$253.39	$253.39	$365.00	$365.00	$365.00	2026-05-23
26010	CPT	Drain Finger Absc; Simple	1	1	$135.56	$135.56	$365.00	$365.00	$365.00	2026-05-23
12046	CPT	Repair Intermediate 20.1-30.0 Cm	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
25675	CPT	Cl Tx Dstl Radioulnar Disloc W Manip	1	1	$866.98	$866.98	$365.00	$365.00	$365.00	2026-05-23
25650	CPT	Closed Tx Of Ulnar Styloid Fx	1	1	$586.89	$586.89	$365.00	$365.00	$365.00	2026-05-23
25630	CPT	Cltx Carpl Bone Fx Wo Mnp Ea Bone	1	1	$261.09	$261.09	$365.00	$365.00	$365.00	2026-05-23
45333	CPT	Pro Fee Sigmoidoscopy And Polypectomy	1	1	$352.20	$352.20	$365.00	$365.00	$365.00	2026-05-23
25622	CPT	Closed Trmt Carpal Scaphoid Fx Without Manip	1	1	$558.97	$558.97	$365.00	$365.00	$365.00	2026-05-23
12045	CPT	Repair Intermediate 12.6-20.0 Cm	1	1	$442.47	$442.47	$365.00	$365.00	$365.00	2026-05-23
12044	CPT	Repair Intermediate 7.6-12.5 Cm	1	1	$123.81	$123.81	$365.00	$365.00	$365.00	2026-05-23
10160	CPT	Asp Abscss/hematoma/bulla/cyst	1	1	$59.46	$59.46	$365.00	$365.00	$365.00	2026-05-23
25605	CPT	Closed Treatment Fx Radius/ulna Manip	1	1	$1,267.36	$1,267.36	$365.00	$365.00	$365.00	2026-05-23
25600	CPT	Clsd Trmt Distal Radius	1	1	$575.47	$575.47	$365.00	$365.00	$365.00	2026-05-23
12042	CPT	Repair Intermediate 2.6-7.5 Cm	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
25565	CPT	Cl Tx Radial & Ulna Shaft Fx W Manip	1	1	$935.13	$935.13	$365.00	$365.00	$365.00	2026-05-23
43251	CPT	Prof Fee Egd Remove Tumor Poly/other Les	1	1	$534.93	$534.93	$365.00	$365.00	$365.00	2026-05-23
25560	CPT	Cl Tx Radial & Ulnar Shft Fx; Wo Manip	1	1	$593.88	$593.88	$365.00	$365.00	$365.00	2026-05-23
12041	CPT	Repair Intermediate 2.5 Cm Or Less	1	1	$202.81	$202.81	$365.00	$365.00	$365.00	2026-05-23
25530	CPT	Cl Tx Ulnar Shaft Fx; Wo Manip	1	1	$138.40	$138.40	$365.00	$365.00	$365.00	2026-05-23
42960	CPT	Control Throat Bleeding	1	1	$404.78	$404.78	$365.00	$365.00	$365.00	2026-05-23
42809	CPT	Remove Fb Pharynx	1	1	$36.59	$36.59	$365.00	$365.00	$365.00	2026-05-23
25505	CPT	Cl Tx Radial Shft Fx W Manip	1	1	$1,273.96	$1,273.96	$365.00	$365.00	$365.00	2026-05-23
41800	CPT	Incision Drainage Abscess Cyst Hematoma	1	1	$222.45	$222.45	$365.00	$365.00	$365.00	2026-05-23
43752	CPT	Place Nasogastric Feeding Tube	1	1	$79.56	$79.56	$365.00	$365.00	$365.00	2026-05-23
43753	CPT	ER Gastric Lavage Suction	1	1	$173.58	$173.58	$365.00	$365.00	$365.00	2026-05-23
43754	CPT	Gastric Lavage With Specimen	1	1	$100.91	$100.91	$365.00	$365.00	$365.00	2026-05-23
43761	CPT	Reposition Of Naso Gastric Feeding Tube	1	1	$1,182.26	$1,182.26	$365.00	$365.00	$365.00	2026-05-23
43763	CPT	ER Change Gastrostomy Tube	1	1	$432.04	$432.04	$365.00	$365.00	$365.00	2026-05-23
41252	CPT	Repair Tongue Laceration	1	1	$1,196.26	$1,196.26	$365.00	$365.00	$365.00	2026-05-23
25500	CPT	Cl Tx Of Radial Shaft Fx; Wo Manip	1	1	$486.59	$486.59	$365.00	$365.00	$365.00	2026-05-23
41250	CPT	Rpr Lac Tongue <=2.5cm/ant 2/3	1	1	$116.17	$116.17	$365.00	$365.00	$365.00	2026-05-23
40831	CPT	Closure Lac, Vestibule Mouth Over 2.5cm	1	1	$456.22	$456.22	$365.00	$365.00	$365.00	2026-05-23
25248	CPT	Removal Foreign Body, Deep, Forearm	1	1	$836.76	$836.76	$365.00	$365.00	$365.00	2026-05-23
12037	CPT	Repair Intermediate Over 30.0 Cm	1	1	$688.83	$688.83	$365.00	$365.00	$365.00	2026-05-23
12036	CPT	Repair Intermediate 20.1-30.0 Cm	1	1	$141.51	$141.51	$365.00	$365.00	$365.00	2026-05-23
40830	CPT	Closure Lac Mouth 2.5 Cm/less	1	1	$101.65	$101.65	$365.00	$365.00	$365.00	2026-05-23
40810	CPT	Excision Of Lesion Of Mouth Without Repair	1	1	$845.87	$845.87	$365.00	$365.00	$365.00	2026-05-23
24670	CPT	Closed Tx Ulnar Fracture Proximal End Wo	1	1	$138.40	$138.40	$365.00	$365.00	$365.00	2026-05-23
40804	CPT	Rem Embedded Fb Mouth Vestib; Simple	1	1	$316.36	$316.36	$365.00	$365.00	$365.00	2026-05-23
46050	CPT	I&d Perianal Abscess Superfic	1	1	$115.26	$115.26	$365.00	$365.00	$365.00	2026-05-23
46083	CPT	Incise Thrombosed Hemorrhoid Ext	1	1	$115.26	$115.26	$365.00	$365.00	$365.00	2026-05-23
38222	CPT	Dx Bone Marrow Bx And Aspiration	1	1	$1,407.82	$1,407.82	$365.00	$365.00	$365.00	2026-05-23
24650	CPT	Clsd Trmt Radial Head/neck Fx Without Manipu	1	1	$499.08	$499.08	$365.00	$365.00	$365.00	2026-05-23

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