Hospital

TROY COMMUNITY HOSPITAL

Troy, PA · CCN 391305 · Rates published

206 distinct procedures filed

28 distinct payers

353,138 rate rows

2026-05-08 last MRF observed

Data quality

352,606 of 353,138 rate rows are consumer-grade (99.8%)

532 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	193
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	115
percent-of-charges filed in the dollar field — excluded from medians	76
placeholder amount (≤ $0.02) — excluded from medians	74
template filing: same amount across many unrelated codes — excluded	54
per-diem day rate — not a per-procedure price	20

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

Source MRF file	https://rca.centaurihs.com/ptapp/api/cdm/export/oneclick?recno=363308ed28b6cde5eff1389501df9f4e2bb14309b95d91b3b4138f5f7fff26a8
Found on page	https://www.guthrie.org/about-us/hospital-price-transparency
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	511e3544129fe37c… · 104,865,371 bytes · first seen 2026-05-08

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
0681 OTHER	Full Trauma Team Resp W/Prehosp, W/30 Min Critical Care	27	$545.29	$22,482.00	$4,249.10	nat. median $6,742 0.6× median
0404 OTHER	Brain Pet; Metabolic Eval	27	$410.41	$15,387.82	$3,621.82	nat. median $3,351 1.1× median
0256 OTHER	Fecal Microbiota Preparation	27	$776.00	$7,251.30	$3,589.39	nat. median $3,626 1.0× median
0684 OTHER	Trauma Team Resp W/Prehosp, W/30 Min Critical Care	27	$1,146.38	$7,039.25	$3,584.33	nat. median $2,393 1.5× median
0323 OTHER	Abd A-gram & Follow Down	27	$382.20	$13,897.00	$3,313.80	nat. median $2,997 1.1× median
0637 OTHER	Potassium Iodide (expectorant) 1 Gm/ml Po Soln	27	$712.67	$5,629.50	$2,758.45	nat. median $23 outlier · 118.9×
0720 OTHER	Delivery Of Placenta	27	$151.20	$8,999.55	$2,191.03	nat. median $1,061 outlier · 2.1×
0612 OTHER	MRI Cervical Spine W/Contrast	27	$333.00	$7,626.51	$2,073.52	nat. median $1,591 1.3× median
0618 OTHER	MRA Without Contrast Upper Extr	27	$505.00	$5,840.00	$1,974.74	nat. median $1,462 1.4× median
0750 OTHER	Hc Fac Esophageal Motility Studies	27	$2.72	$17,107.00	$1,933.13	nat. median $1,747 1.1× median
0619 OTHER	MRA Abdomen, With Contrast	27	$55.49	$5,974.00	$1,917.00	nat. median $1,607 1.2× median
0360 OTHER	Insert Uteri Tandems/Ovoids	27	$0.14	$118,024.37	$1,850.18	nat. median $2,271 0.8× median
0616 OTHER	MRA Lextrem Wo Contr	27	$530.25	$3,489.50	$1,727.30	nat. median $1,208 1.4× median
0340 OTHER	Intra Arterial Rpharm Rx	27	$266.63	$8,641.08	$1,481.25	nat. median $892 1.7× median
0333 OTHER	Special Physics Consult	27	$20.21	$36,119.00	$1,456.06	nat. median $1,230 1.2× median
0610 OTHER	MRI Breast Bilateral Wo/w Contrast	27	$7.97	$10,469.25	$1,320.02	nat. median $1,272 1.0× median
0361 OTHER	Bronch W/Ther Asp Br	27	$25.22	$33,711.50	$1,211.92	nat. median $1,125 1.1× median
0391 OTHER	Granulocytes Pheresis Unit	27	$57.93	$8,697.00	$1,195.67	nat. median $929 1.3× median
0611 OTHER	MRI Brain Inc Brain Stem WO/Contrast	27	$438.89	$5,256.75	$1,159.66	nat. median $1,201 1.0× median
0352 OTHER	CT Thorax Without Contrast	27	$75.75	$7,082.68	$1,154.99	nat. median $1,143 1.0× median
0278 OTHER	Cordis Smart Stent 12x60x121	27	$0.56	$75,936.26	$1,138.16	nat. median $1,993 0.6× median
0922 OTHER	Visual Evoked Potential (Vep) 95930	27	$40.07	$11,702.81	$1,044.85	nat. median $388 outlier · 2.7×
0342 OTHER	Radioph Rx By IV Admin	25	$141.35	$2,635.00	$1,019.50	nat. median $480 outlier · 2.1×
0350 OTHER	CT Angio Abd&Pelv W/O&with Contrast	27	$78.12	$3,893.25	$998.37	nat. median $712 1.4× median
0341 OTHER	Hepatobiliary System Imaging	27	$22.78	$6,874.25	$943.22	nat. median $907 1.0× median
0722 OTHER	Tubal During C Section	27	$330.75	$1,837.50	$918.75	nat. median $1,488 0.6× median
0820 OTHER	Non Esrd Hemodialysis One Evaluation (685)	27	$279.90	$1,555.00	$875.15	nat. median $828 1.1× median
0880 OTHER	Dialysis One Evaluation Crrt	27	$309.74	$1,720.80	$860.40	nat. median $1,205 0.7× median
0614 OTHER	Cardiac MRI W/Stress Img	27	$20.29	$10,469.25	$844.56	nat. median $1,195 0.7× median
278 OTHER	Aspira Pleural Drainage Cath With Kit	1	$808.13	$808.13	$808.13	nat. median $1,931 outlier · 0.4×
0351 OTHER	CT Hd Without & W/Contrast	27	$121.20	$4,081.50	$800.28	nat. median $1,039 0.8× median
0761 OTHER	Bronch, Diagnostic With Or Without Cell Washing	27	$15.03	$14,708.00	$776.00	nat. median $630 1.2× median
0801 OTHER	Acute Hemodialysis	27	$235.03	$1,938.60	$734.86	nat. median $1,207 0.6× median
0450 OTHER	Additional Hours Of Hydration	27	$7.80	$15,707.75	$696.20	nat. median $715 1.0× median
0509 OTHER	Femto Laser Utilization	27	$194.79	$1,082.16	$541.08	nat. median $902 0.6× median
0413 OTHER	Hbot, Full Body Chamber, 30m	27	$57.06	$1,049.75	$524.88	nat. median $722 0.7× median
0483 OTHER	Cardiac Doppler	27	$6.62	$4,169.25	$512.14	nat. median $785 0.7× median
0841 OTHER	Capd Training	27	$120.06	$2,360.00	$495.60	nat. median $667 0.7× median
0280 OTHER	Chemo Extend IV Infus W/Pum	1	$495.16	$495.16	$495.16	nat. median $150 outlier · 3.3×
340 OTHER	Tumor Loc Whole Body 2 Or More Days Imaging	1	$481.69	$481.69	$481.69	nat. median $991 outlier · 0.5×
0390 OTHER	Packed RBC,Each Unit	27	$35.33	$9,131.75	$468.46	nat. median $464 1.0× median
0851 OTHER	Ccpd Daily	27	$120.06	$2,224.00	$467.04	nat. median $667 0.7× median
323 OTHER	Abd A-gram & Follow Down	1	$382.18	$382.18	$382.18	nat. median $31,081 outlier · 0.0×
0740 OTHER	Blink Reflex Testing	27	$26.65	$3,606.00	$371.65	nat. median $647 0.6× median
0343 OTHER	Myoview Per Dose (Tetrofosmin)	27	$6.89	$12,787.75	$359.25	nat. median $443 0.8× median
0320 OTHER	Gi Double Contrast	27	$13.27	$16,273.00	$336.55	nat. median $333 1.0× median
0514 OTHER	Fetal Non-stress Test	27	$15.15	$1,134.84	$325.27	nat. median $375 0.9× median
740 OTHER	EEG Recording Awake And Asleep	1	$82.74	$364.02	$318.04	nat. median $1,846 outlier · 0.2×
0540 OTHER	Als Emergency	27	$3.52	$1,282.65	$315.69	nat. median $319 1.0× median
0981 OTHER	Rad. Head. Sub Child	27	$6.26	$26,344.00	$303.01	nat. median $492 0.6× median

Other procedures at this hospital

Browse this hospital's 206 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

0681	OTHER	Full Trauma Team Resp W/Prehosp, W/30 Min Critical Care	169	27	$11,305.00	$9,044.00 20% off	$545.29	$22,482.00	$4,249.10	2026-05-08
0404	OTHER	Brain Pet; Metabolic Eval	310	27	$7,975.25	$6,380.20 20% off	$410.41	$15,387.82	$3,621.82	2026-05-08
0256	OTHER	Fecal Microbiota Preparation	51	27	$7,251.30	$5,801.04 20% off	$776.00	$7,251.30	$3,589.39	2026-05-08
0684	OTHER	Trauma Team Resp W/Prehosp, W/30 Min Critical Care	99	27	$7,039.25	$5,631.40 20% off	$1,146.38	$7,039.25	$3,584.33	2026-05-08
0323	OTHER	Abd A-gram & Follow Down	419	27	$6,622.00	$5,297.60	$382.20	$13,897.00	$3,313.80	2026-05-08
0637	OTHER	Potassium Iodide (expectorant) 1 Gm/ml Po Soln	54	27	$5,629.50	$4,503.60	$712.67	$5,629.50	$2,758.45	2026-05-08
0720	OTHER	Delivery Of Placenta	488	27	$6,131.00	$4,904.80 20% off	$151.20	$8,999.55	$2,191.03	2026-05-08
0612	OTHER	MRI Cervical Spine W/Contrast	396	27	$6,197.25	$4,957.80 20% off	$333.00	$7,626.51	$2,073.52	2026-05-08
0618	OTHER	MRA Without Contrast Upper Extr	104	27	$5,840.00	$4,672.00 20% off	$505.00	$5,840.00	$1,974.74	2026-05-08
0750	OTHER	Hc Fac Esophageal Motility Studies	3,654	27	$5,046.25	$4,037.00 20% off	$2.72	$17,107.00	$1,933.13	2026-05-08
0619	OTHER	MRA Abdomen, With Contrast	375	27	$4,891.75	$3,913.40 20% off	$55.49	$5,974.00	$1,917.00	2026-05-08
0360	OTHER	Insert Uteri Tandems/Ovoids	18,828	27	$3,460.75	$2,768.60 20% off	$0.14	$118,024.37	$1,850.18	2026-05-08
0616	OTHER	MRA Lextrem Wo Contr	51	27	$3,489.50	$2,791.60 20% off	$530.25	$3,489.50	$1,727.30	2026-05-08
0340	OTHER	Intra Arterial Rpharm Rx	105	27	$1,481.25	$1,185.00 20% off	$266.63	$8,641.08	$1,481.25	2026-05-08
0333	OTHER	Special Physics Consult	2,514	27	$3,571.53	$2,857.23	$20.21	$36,119.00	$1,456.06	2026-05-08
0610	OTHER	MRI Breast Bilateral Wo/w Contrast	1,788	27	$5,314.68	$4,251.74 20% off	$7.97	$10,469.25	$1,320.02	2026-05-08
0361	OTHER	Bronch W/Ther Asp Br	5,131	27	$2,936.40	$2,349.12 20% off	$25.22	$33,711.50	$1,211.92	2026-05-08
0391	OTHER	Granulocytes Pheresis Unit	201	27	$2,037.00	$1,629.60 20% off	$57.93	$8,697.00	$1,195.67	2026-05-08
0611	OTHER	MRI Brain Inc Brain Stem WO/Contrast	147	27	$3,874.25	$3,099.40 20% off	$438.89	$5,256.75	$1,159.66	2026-05-08
0352	OTHER	CT Thorax Without Contrast	1,223	27	$3,100.50	$2,480.40 20% off	$75.75	$7,082.68	$1,154.99	2026-05-08
0278	OTHER	Cordis Smart Stent 12x60x121	17,584	27	$2,477.48	$1,981.98 20% off	$0.56	$75,936.26	$1,138.16	2026-05-08
0922	OTHER	Visual Evoked Potential (Vep) 95930	553	27	$4,594.97	$3,675.98	$40.07	$11,702.81	$1,044.85	2026-05-08
0342	OTHER	Radioph Rx By IV Admin	104	25	$2,635.00	$2,108.00 20% off	$141.35	$2,635.00	$1,019.50	2026-05-08
0350	OTHER	CT Angio Abd&Pelv W/O&with Contrast	971	27	$2,650.50	$2,120.40	$78.12	$3,893.25	$998.37	2026-05-08
0341	OTHER	Hepatobiliary System Imaging	2,330	27	$2,161.00	$1,728.80 20% off	$22.78	$6,874.25	$943.22	2026-05-08
0722	OTHER	Tubal During C Section	51	27	$1,837.50	$1,470.00 20% off	$330.75	$1,837.50	$918.75	2026-05-08
0820	OTHER	Non Esrd Hemodialysis One Evaluation (685)	63	27	$1,555.00	$1,244.00 20% off	$279.90	$1,555.00	$875.15	2026-05-08
0880	OTHER	Dialysis One Evaluation Crrt	51	27	$1,720.80	$1,376.64	$309.74	$1,720.80	$860.40	2026-05-08
0614	OTHER	Cardiac MRI W/Stress Img	302	27	$3,489.50	$2,791.60 20% off	$20.29	$10,469.25	$844.56	2026-05-08
278	OTHER	Aspira Pleural Drainage Cath With Kit	1	1	$173.25	$138.60 20% off	$808.13	$808.13	$808.13	2026-05-08
0351	OTHER	CT Hd Without & W/Contrast	597	27	$2,564.25	$2,051.40	$121.20	$4,081.50	$800.28	2026-05-08
0761	OTHER	Bronch, Diagnostic With Or Without Cell Washing	3,437	27	$1,632.75	$1,306.20 20% off	$15.03	$14,708.00	$776.00	2026-05-08
0801	OTHER	Acute Hemodialysis	147	27	$1,375.92	$1,100.74	$235.03	$1,938.60	$734.86	2026-05-08
0450	OTHER	Additional Hours Of Hydration	14,716	27	$1,465.00	$1,172.00 20% off	$7.80	$15,707.75	$696.20	2026-05-08
0509	OTHER	Femto Laser Utilization	51	27	$1,082.16	$865.73	$194.79	$1,082.16	$541.08	2026-05-08
0413	OTHER	Hbot, Full Body Chamber, 30m	59	27	$1,049.75	$839.80 20% off	$57.06	$1,049.75	$524.88	2026-05-08
0483	OTHER	Cardiac Doppler	1,216	27	$1,883.75	$1,507.00 20% off	$6.62	$4,169.25	$512.14	2026-05-08
0841	OTHER	Capd Training	99	27	$2,360.00	$1,888.00 20% off	$120.06	$2,360.00	$495.60	2026-05-08
0280	OTHER	Chemo Extend IV Infus W/Pum	1	1	$1,456.35	$1,165.08 20% off	$495.16	$495.16	$495.16	2026-05-08
340	OTHER	Tumor Loc Whole Body 2 Or More Days Imaging	1	1	$8,641.08	$6,912.86 20% off	$481.69	$481.69	$481.69	2026-05-08
0390	OTHER	Packed RBC,Each Unit	939	27	$1,177.25	$941.80 20% off	$35.33	$9,131.75	$468.46	2026-05-08
0851	OTHER	Ccpd Daily	99	27	$667.00	$533.60	$120.06	$2,224.00	$467.04	2026-05-08
323	OTHER	Abd A-gram & Follow Down	1	1	$7,539.65	$6,031.72	$382.18	$382.18	$382.18	2026-05-08
0740	OTHER	Blink Reflex Testing	496	27	$929.00	$743.20	$26.65	$3,606.00	$371.65	2026-05-08
0343	OTHER	Myoview Per Dose (Tetrofosmin)	2,024	27	$624.00	$499.20 20% off	$6.89	$12,787.75	$359.25	2026-05-08
0320	OTHER	Gi Double Contrast	7,798	27	$748.50	$598.80 20% off	$13.27	$16,273.00	$336.55	2026-05-08
0514	OTHER	Fetal Non-stress Test	464	27	$467.25	$373.80 20% off	$15.15	$1,134.84	$325.27	2026-05-08
740	OTHER	EEG Recording Awake And Asleep	4	1	$970.19	$776.15 20% off	$82.74	$364.02	$318.04	2026-05-08
0540	OTHER	Als Emergency	150	27	$980.39	$784.31 20% off	$3.52	$1,282.65	$315.69	2026-05-08
0981	OTHER	Rad. Head. Sub Child	15,360	27	$677.25	$541.80 20% off	$6.26	$26,344.00	$303.01	2026-05-08
0921	OTHER	Hc Fac Interrogation Evaluation In Person Ilr System	1,552	27	$735.30	$588.24	$11.15	$2,194.00	$287.30	2026-05-08
333	OTHER	Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel	5	1	$2,689.45	$2,151.56	$126.80	$383.69	$273.30	2026-05-08
750	OTHER	Ugi W Removal Of Fb	1	1	$4,508.00	$3,606.40 20% off	$272.27	$272.27	$272.27	2026-05-08
0444	OTHER	Endoscopy Swallow (Fees) Vid	579	27	$570.00	$456.00 20% off	$28.12	$1,028.25	$271.00	2026-05-08
610	OTHER	Mr Guidance For Needle Placement/Aspiration	5	1	$3,375.75	$2,700.60 20% off	$119.58	$339.53	$265.32	2026-05-08
450	OTHER	Application Ll Cast	23	1	$1,921.00	$1,536.80 20% off	$22.10	$490.40	$253.95	2026-05-08
0402	OTHER	Bladder Scan	3,247	27	$735.30	$588.24	$4.24	$3,619.00	$250.84	2026-05-08
0510	OTHER	Hc Fac Comprehensive Medical Exam	22,905	27	$462.32	$369.86	$2.38	$3,519.18	$249.17	2026-05-08
510	OTHER	Application Of Long Leg Cast	28	1	$685.02	$548.02 20% off	$10.60	$490.40	$246.00	2026-05-08
0335	OTHER	Irrigate Drug Delivery Device	427	27	$429.65	$343.72	$0.19	$2,637.16	$241.81	2026-05-08
619	OTHER	MRA Chest Without And With Contrast	2	1	$4,362.88	$3,490.30	$233.32	$244.99	$239.16	2026-05-08
0310	OTHER	Igh Rearrange Abnormal Clonal Pop Amplified	5,813	27	$580.50	$464.40 20% off	$6.57	$27,745.00	$235.90	2026-05-08
341	OTHER	Bone Scan 3 Phase	20	1	$2,191.03	$1,752.82	$136.08	$649.01	$231.32	2026-05-08
0324	OTHER	Xray Chest 1 View	207	26	$479.25	$383.40 20% off	$24.22	$776.00	$224.00	2026-05-08
0400	OTHER	3d Redner Without Post Processing	97	27	$308.25	$246.60 20% off	$55.49	$919.98	$223.79	2026-05-08
0331	OTHER	Chemo, Im/Sq, Non-hormonal	275	26	$745.50	$596.40 20% off	$20.22	$1,092.00	$216.22	2026-05-08
636	OTHER	Calcium Gluconate-nacl 1-0.675 Gm/50ml-% IV Soln	166	1	$224.88	$179.90 20% off	$0.53	$352,705.25	$215.50	2026-05-08
0344	OTHER	I 131 Tx Cap Per Mci	148	27	$405.50	$324.40 20% off	$25.07	$6,916.00	$207.31	2026-05-08
981	OTHER	Apply Long Leg Cast	38	1	$1,123.25	$898.60 20% off	$21.42	$490.40	$201.56	2026-05-08
0441	OTHER	St Speech/Hearing Therapy Indiv	103	27	$545.00	$436.00 20% off	$28.21	$545.00	$199.79	2026-05-08
350	OTHER	CT Abd & Pelvis 1+ Section/Regions	8	1	$3,062.28	$2,449.82 20% off	$106.99	$259.72	$199.10	2026-05-08
0274	OTHER	Misc. Med/Surg Supply	2,443	27	$542.00	$433.60	$3.59	$6,216.25	$196.88	2026-05-08
0482	OTHER	Cardiac Stress With Electro Cardiac Monitoring	158	27	$579.92	$463.94	$31.82	$1,056.50	$194.88	2026-05-08
352	OTHER	CT Abdomen W-without Cont	8	1	$2,901.68	$2,321.34 20% off	$80.97	$281.21	$183.24	2026-05-08
483	OTHER	Congenital Transthoracis Echo	2	1	$1,450.50	$1,160.40	$117.97	$246.02	$182.00	2026-05-08
0372	OTHER	Mod Sed Endo Service 5 Years And Older	55	27	$317.00	$253.60 20% off	$57.06	$317.00	$178.41	2026-05-08
761	OTHER	Ins Non Tunnel Cv Cath 5 Years Older	1	1	$6,323.20	$5,058.56	$177.12	$177.12	$177.12	2026-05-08
0732	OTHER	Telemetry Per Day	51	27	$349.00	$279.20 20% off	$62.82	$349.00	$174.50	2026-05-08
481	OTHER	Intro Of Catheter, Aorta	1	1	$1.00	$0.80	$173.66	$173.66	$173.66	2026-05-08
0401	OTHER	Dx Mammo Incl Cad Un	207	27	$751.75	$601.40 20% off	$14.43	$910.25	$169.58	2026-05-08
0636	OTHER	Acetaminophen 1000 Mg/100ml IV (odd Doses)	38,257	27	$348.25	$278.60	$0.06	$793,586.81	$168.11	2026-05-08
351	OTHER	CT - Orbit, Sella, Mid/Inner Ear W & Wo	2	1	$2,897.75	$2,318.20 20% off	$141.37	$182.44	$161.91	2026-05-08
0513	OTHER	Hc Fac Psychiatric Diagnosis Evaluation	53	27	$230.23	$184.18 20% off	$38.55	$214.18	$155.49	2026-05-08
0920	OTHER	Hc Fac Program Eval Implantable In Person Multi Ld Pacer (Muliple Lead)	1,763	27	$317.52	$254.02	$6.48	$6,414.25	$146.45	2026-05-08
0403	OTHER	Breast Tomosynthesis Bi - Screening	114	27	$518.50	$414.80 20% off	$10.72	$829.25	$141.61	2026-05-08
513	OTHER	Hc Fac Psychiatric Diagnosis Evaluation	1	1	$214.18	$171.34 20% off	$141.31	$141.31	$141.31	2026-05-08
0943	OTHER	Cardiac Rehab Phase Ii Op	98	26	$268.25	$214.60 20% off	$16.47	$335.00	$141.12	2026-05-08
0948	OTHER	Phys/Qhp Svcs Op Pulm Rehab Without Cont Oximtry Mntr	102	27	$175.76	$140.61	$31.64	$258.37	$127.75	2026-05-08
921	OTHER	Doppler	14	1	$1,215.35	$972.28 20% off	$28.17	$216.01	$127.34	2026-05-08
0410	OTHER	Nasotracheal Suction Charge	677	27	$301.00	$240.80	$3.18	$3,606.00	$125.60	2026-05-08
0260	OTHER	Ivp, Single Or Initial Substance/Drug	768	27	$261.25	$209.00 20% off	$5.30	$3,606.00	$122.59	2026-05-08
0731	OTHER	Ext Ecg>48hr<7d Recording	298	27	$273.00	$218.40 20% off	$5.02	$643.86	$122.26	2026-05-08
0370	OTHER	Mod Sed Same Phys/Qhp 5 Years Of Age Or Older	469	27	$342.42	$273.94	$0.90	$2,432.28	$120.33	2026-05-08
0961	OTHER	Emergency Dept Visit High Mdm	1,846	27	$269.75	$215.80	$5.37	$3,606.00	$117.08	2026-05-08
0460	OTHER	Incentive Spiromtry Rx	1,441	27	$357.25	$285.80	$2.57	$1,634.00	$114.11	2026-05-08
444	OTHER	Endoscopy Swallow (Fees) Vid	5	1	$600.00	$480.00 20% off	$62.52	$217.75	$105.89	2026-05-08
0272	OTHER	Penumbra Indigo Catd Kit	70,618	27	$230.48	$184.38 20% off	$0.04	$68,427.71	$103.54	2026-05-08
0311	OTHER	Molecular Cytogenetics DNA Probe Each	2,099	27	$193.25	$154.60 20% off	$6.62	$1,932.50	$102.20	2026-05-08
0434	OTHER	Ot Eval Low Complex 30 Min	201	27	$148.50	$118.80 20% off	$22.59	$1,437.00	$97.69	2026-05-08
335	OTHER	Irrigate Drug Delivery Device	2	1	$585.67	$468.54 20% off	$22.10	$170.23	$96.16	2026-05-08
514	OTHER	Antepartum Care 4-6 Visits	4	1	$367.45	$293.97	$18.65	$397.66	$95.40	2026-05-08
920	OTHER	Autism Screenng	6	1	$425.25	$340.20	$10.67	$752.79	$93.75	2026-05-08
440	OTHER	St Assessment Aphasia W/i&r Per Hour	1	1	$277.00	$221.60 20% off	$91.49	$91.49	$91.49	2026-05-08
0949	OTHER	Wound Non-selective Debridement	110	27	$270.90	$216.72	$22.23	$270.90	$89.65	2026-05-08
0923	OTHER	Thin Prep Pap Smear	6	1	$154.75	$123.80	$84.56	$100.28	$89.63	2026-05-08
0940	OTHER	Phlebotomy Therapeutic	559	27	$133.77	$107.02	$10.33	$26,076.00	$89.12	2026-05-08
0729	OTHER	Epidural Initial Chg	21	7	$317.10	$253.68 20% off	$22.90	$219.02	$87.86	2026-05-08
310	OTHER	Egfr Mutation	8	1	$962.62	$770.10 20% off	$32.78	$412.00	$86.77	2026-05-08
0530	OTHER	Omt 1-2 Regions	249	27	$157.29	$125.83 20% off	$14.95	$231.52	$83.05	2026-05-08
434	OTHER	Ot Eval Low Complex 30 Min	2	1	$137.00	$109.60 20% off	$63.66	$97.73	$80.69	2026-05-08
401	OTHER	Breast Tomosynthesis Unilateral/Bilateral	3	1	$751.75	$601.40 20% off	$14.43	$102.69	$80.59	2026-05-08
0912	OTHER	Training Session 45 Minutes Or Over	8	4	$134.00	$107.20 20% off	$45.56	$134.00	$79.90	2026-05-08
0300	OTHER	Unlisted Chemistry Procedure	5,696	27	$182.00	$145.60 20% off	$0.90	$4,286.65	$78.77	2026-05-08
0440	OTHER	Devel Tst Phys/Qhp Ea Addl	677	27	$224.75	$179.80	$0.18	$776.00	$77.81	2026-05-08
0915	OTHER	Group Therapy	47	25	$134.00	$107.20 20% off	$24.12	$134.00	$75.42	2026-05-08
0904	OTHER	Activity Therapy 45 Minutes Or Longer	47	25	$134.00	$107.20 20% off	$24.12	$134.00	$75.42	2026-05-08
0424	OTHER	Pt Eval Low Complex 20 Min	203	27	$155.75	$124.60 20% off	$12.11	$349.75	$73.45	2026-05-08
331	OTHER	Chemo Cns (Intrathecal) W Lumbar Puncture	3	1	$859.30	$687.44	$49.69	$87.84	$71.77	2026-05-08
0918	OTHER	Hc Facalth Risk Assessment, Patient Focused, Per Std Instrument (Chg)	320	27	$264.60	$211.68 20% off	$2.38	$776.00	$71.30	2026-05-08
0762	OTHER	Hourly Observation	97	26	$70.25	$56.20	$12.65	$734.50	$70.25	2026-05-08
0312	OTHER	Iron, Liver Tissue	906	27	$119.00	$95.20 20% off	$5.08	$1,424.78	$68.70	2026-05-08
413	OTHER	Hbot, Full Body Chamber, 30m	1	1	$1,049.75	$839.80 20% off	$68.67	$68.67	$68.67	2026-05-08
424	OTHER	Pt Re-eval Est Plan Care	1	1	$67.25	$53.80 20% off	$67.46	$67.46	$67.46	2026-05-08
0730	OTHER	EKG 12 Lead Tracing Only	108	27	$107.31	$85.85	$5.76	$334.75	$66.28	2026-05-08
402	OTHER	Dup Scan Hemo Compl Bi Std	26	1	$822.62	$658.10 20% off	$19.03	$191.57	$65.28	2026-05-08
922	OTHER	Musc Tst Done W/Nerv Tst Lim	1	1	$584.23	$467.38 20% off	$65.26	$65.26	$65.26	2026-05-08
312	OTHER	Cell Block	15	1	$119.00	$95.20 20% off	$7.60	$265.55	$63.54	2026-05-08
0470	OTHER	Aep Screen Auditory Potential	102	27	$207.93	$166.34 20% off	$15.69	$328.70	$63.27	2026-05-08
0254	OTHER	Omnipaque 240	102	27	$0.26	$0.21	$0.05	$776.00	$60.53	2026-05-08
961	OTHER	Hc IP/Obs Consltj New/Est Pt Sf Mdm 35 Minutes	4	1	$294.00	$235.20	$26.27	$125.08	$60.09	2026-05-08
0420	OTHER	Pt Nsw Debridem Without A Session	2,398	27	$121.50	$98.00	$2.49	$823.50	$59.10	2026-05-08
0306	OTHER	Amplif Na Probe Nos Agent	6,647	27	$140.00	$112.00 20% off	$3.00	$2,322.00	$59.03	2026-05-08
0942	OTHER	Smoke/Tobacco Couns >10min	557	27	$129.00	$103.20 20% off	$4.84	$2,601.00	$58.91	2026-05-08
0924	OTHER	All Tstg Perq&Iq Drugs/Biol	324	27	$82.88	$66.30 20% off	$1.85	$961.20	$58.80	2026-05-08
0302	OTHER	Nuclear Antigen Antibody	9,416	27	$135.25	$108.20 20% off	$3.30	$5,318.50	$58.38	2026-05-08
0301	OTHER	General Health Panel	19,704	27	$146.25	$117.00 20% off	$1.41	$6,165.50	$57.31	2026-05-08
0471	OTHER	Hc Fac Screening Test,Pure Tone,Air On	606	27	$121.80	$97.44 20% off	$5.05	$776.00	$56.26	2026-05-08
311	OTHER	Cp Smr Othr; Scrn & Int	11	1	$147.96	$118.37	$20.19	$295.69	$53.58	2026-05-08
403	OTHER	Breast Tomosynthesis Bi - Screening	2	1	$518.50	$414.80 20% off	$22.10	$84.96	$53.53	2026-05-08
0771	OTHER	Admin Of Influenza Virus Vaccin	620	27	$122.25	$97.80 20% off	$6.05	$2,601.00	$52.50	2026-05-08
0430	OTHER	Ot Appl Cast; Shoulder To Hand	1,876	27	$108.25	$86.60 20% off	$2.49	$1,107.50	$52.17	2026-05-08
0480	OTHER	Pm Device Program Eval	933	27	$107.01	$85.61	$7.72	$2,881.75	$51.45	2026-05-08
0253	OTHER	Amoxicillin-pot Clavulanate 600-42.9 Mg/5ml Po Susr	444	27	$92.75	$74.20	$0.72	$2,255.75	$50.50	2026-05-08
360	OTHER	Inj Abscess/Cyst Cath	1	1	$1,072.24	$857.79 20% off	$48.81	$48.81	$48.81	2026-05-08
390	OTHER	Ffp 8-24 Hrs Of Collect, Ea Unit	1	1	$317.25	$253.80	$46.94	$46.94	$46.94	2026-05-08
260	OTHER	IV Infusion, For Therapy;Initial, Up To 1 Hour	2	1	$525.75	$420.60	$32.39	$61.48	$46.94	2026-05-08
0309	OTHER	Cell Count W/Diff, Csf	412	27	$108.75	$87.00 20% off	$2.83	$495.50	$46.25	2026-05-08
0490	OTHER	4n Hourly Spu Charge	317	27	$131.25	$105.00 20% off	$0.19	$1,976.00	$44.44	2026-05-08
0305	OTHER	Hematocrit	2,804	27	$108.50	$86.80 20% off	$2.02	$2,601.00	$44.00	2026-05-08
530	OTHER	Omt 1-2 Regions	5	1	$157.29	$125.83 20% off	$21.42	$65.15	$43.29	2026-05-08
949	OTHER	Wound Non-selective Debridement	1	1	$270.90	$216.72	$42.24	$42.24	$42.24	2026-05-08
0250	OTHER	Theraskin Per 1 Sq Cm	19,396	27	$77.00	$61.60 20% off	$0.05	$48,154.75	$41.77	2026-05-08
0770	OTHER	Medicare Annual Depression Screen	249	27	$58.80	$47.04 20% off	$8.05	$165.22	$41.23	2026-05-08
361	OTHER	I & D Simple	1	1	$1,017.90	$814.32	$36.77	$36.77	$36.77	2026-05-08
0255	OTHER	Omnipaque 240mg/ml-50ml Vial	564	27	$117.75	$94.20 20% off	$0.05	$4,553.59	$36.42	2026-05-08
480	OTHER	Interrogation Eval W/Analysis, Per Patient Encounter, Single Dual Or Multiple Le…	2	1	$70.35	$56.28	$32.78	$37.95	$35.37	2026-05-08
482	OTHER	Cv Strs Tst Xers&/or Rx Cont ECG Trcg Only	1	1	$579.92	$463.94	$35.16	$35.16	$35.16	2026-05-08
441	OTHER	St Speech/Hearing Therapy Indiv	1	1	$545.00	$436.00 20% off	$33.95	$33.95	$33.95	2026-05-08
430	OTHER	Hc Fac Self-care/home Mgmt Training Ea 15 Min	3	1	$50.25	$40.20	$31.06	$40.68	$33.50	2026-05-08
320	OTHER	Abd, Multi W/Pa Cxr	50	1	$511.25	$409.00 20% off	$15.28	$143.52	$32.62	2026-05-08
420	OTHER	Pt E-stim Probe Attended 15 Min	2	1	$239.88	$191.90 20% off	$31.29	$33.50	$32.39	2026-05-08
0279	OTHER	O2 Transport	96	27	$57.50	$46.00 20% off	$10.35	$76.50	$32.36	2026-05-08
940	OTHER	Cmt; 1-2 Regions	5	1	$91.14	$72.91 20% off	$19.66	$227.99	$32.10	2026-05-08
614	OTHER	Card MRI Vel Flw Map Add-on	1	1	$377.00	$301.60	$31.00	$31.00	$31.00	2026-05-08
0271	OTHER	Boot, Heel Suspension One Size	2,173	27	$77.70	$62.16 20% off	$1.13	$5,358.94	$30.49	2026-05-08
0259	OTHER	Isoproterenol Hcl 0.2 Mg/ml Ij Soln	1,767	27	$62.25	$49.80 20% off	$0.50	$1,874.50	$29.58	2026-05-08
0270	OTHER	Abg Kit	5,959	27	$71.14	$56.91 20% off	$0.99	$4,004.50	$29.23	2026-05-08
731	OTHER	Hc Xtrnl ECG Up To 48 Hrs Recording	1	1	$561.75	$449.40 20% off	$28.55	$28.55	$28.55	2026-05-08
900	OTHER	Intensive Behavioral Therapy For Obesity	1	1	$45.50	$36.40 20% off	$28.34	$28.34	$28.34	2026-05-08
0900	OTHER	Intensive Behavioral Therapy For Obesity	52	27	$45.50	$36.40 20% off	$8.19	$45.50	$26.95	2026-05-08
942	OTHER	Dm Training, Inidividual, 30 Min	5	1	$63.00	$50.40 20% off	$11.00	$51.55	$25.84	2026-05-08
324	OTHER	Xray Chest 1 View	2	1	$482.88	$386.30 20% off	$24.22	$26.64	$25.43	2026-05-08
0481	OTHER	Cardiac Cath Lab Minutes	280	27	$64.80	$51.84	$0.18	$2,337.00	$24.52	2026-05-08
770	OTHER	Cervical/Vaginal Ca Screen	5	1	$58.80	$47.04 20% off	$8.51	$122.58	$23.67	2026-05-08
460	OTHER	Car Seat Challenge Additional 30 Minutes	5	1	$109.52	$87.62	$7.58	$30.63	$21.46	2026-05-08
471	OTHER	Comprehensive Audiometry Threshold Eval & Speech Recognition	2	1	$106.27	$85.01 20% off	$10.08	$30.01	$20.05	2026-05-08
771	OTHER	Admin Flu Vacc	7	1	$52.50	$42.00 20% off	$8.21	$21.51	$18.32	2026-05-08
300	OTHER	Stone; Ir Spectroscopy	1	1	$116.25	$93.00 20% off	$15.65	$15.65	$15.65	2026-05-08
370	OTHER	Mod Sed Same Phys/Qhp 5 Years Of Age Or Older	1	1	$225.75	$180.60 20% off	$15.49	$15.49	$15.49	2026-05-08
0914	OTHER	Hc Fac Psychotherapy Complex Interactive	147	27	$48.29	$38.63 20% off	$1.35	$71.00	$12.78	2026-05-08
410	OTHER	Cont Vent Int	6	1	$218.13	$174.50	$7.30	$85.66	$11.44	2026-05-08
0307	OTHER	Volume Measure, Urine	553	27	$25.00	$20.00 20% off	$1.98	$69.75	$11.00	2026-05-08
302	OTHER	TB Test Intradermal	1	1	$31.50	$25.20 20% off	$9.14	$9.14	$9.14	2026-05-08
0710	OTHER	Hvc Pvi/Watchman/Tavr Recovery 1;1 Past 60 Mins	532	27	$12.10	$9.68 20% off	$0.25	$954.80	$8.80	2026-05-08
306	OTHER	Beta Lactamase Suceptibility, Ea	1	1	$50.50	$40.40 20% off	$8.21	$8.21	$8.21	2026-05-08
730	OTHER	EKG 12 Lead Tracing Only	1	1	$107.31	$85.85	$5.76	$5.76	$5.76	2026-05-08
918	OTHER	Hc Facalth Risk Assessment, Patient Focused, Per Std Instrument (Chg)	1	1	$13.23	$10.58 20% off	$5.44	$5.44	$5.44	2026-05-08
0258	OTHER	Sterile Saline Sol Per 500 Ml	616	27	$3.75	$3.00 20% off	$0.38	$3,606.00	$2.36	2026-05-08
924	OTHER	Percut Tests (Scratch,Punct,Pri	1	1	$10.29	$8.23 20% off	$2.35	$2.35	$2.35	2026-05-08
0990	OTHER	Guest Tray	99	27	$12.00	$9.60 20% off	$0.18	$12.00	$2.16	2026-05-08
0780	OTHER	Hc Fac Phys/Qhp Telephone Evaluation 5-10 Min	51	27	$61.40	$49.12 20% off	$0.42	$2.32	$1.16	2026-05-08
MODQY	OTHER	50% Payment Adjustment For The Item Or Service To Which The Modifier Is Appended	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MODAD	OTHER	300% (3 Units) Payment Adjustment For The Item Or Service To Which The Modifier …	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MODAS	OTHER	Calculated By Multiplying The Facility Specific Mpfs Amount By 16%, Subtracting …	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MODQK	OTHER	50% Payment Adjustment For The Item Or Service To Which The Modifier Is Appended	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MOD50	OTHER	150% Payment Adjustment For The Item Or Service To Which The Modifier Is Appende…	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MOD51	OTHER	50% Payment Adjustment For The Item Or Service To Which The Modifier Is Appended	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MOD52	OTHER	50% Payment Adjustment For The Item Or Service To Which The Modifier Is Appended	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MOD53	OTHER	120% Payment Adjustment For The CPTs 59400 Or 59610 To Which The Modifier Is App…	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MOD62	OTHER	37.5% Payment Adjustment For The Item Or Service To Which The Modifier Is Append…	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MOD80	OTHER	84% Payment Adjustment For The Item Or Service To Which The Modifier Is Appended	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MOD81	OTHER	84% Payment Adjustment For The Item Or Service To Which The Modifier Is Appended	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
MOD82	OTHER	84% Payment Adjustment For The Item Or Service To Which The Modifier Is Appended	18	15	$1.00	$1.00	$1.00	$1.00	$1.00	2026-05-08
0276	OTHER	Airway Colored Berman 50	50	27	$1.11	$0.89	$0.20	$776.00	$0.74	2026-05-08
0329	OTHER	Hc Clinical Decision Support For Applied Pathways	64	27	$1.00	$0.80	$0.18	$776.00	$0.56	2026-05-08
0999	OTHER	Hg A1c Level <7.0%	0	0	$0.01	—	—	—	—	2026-05-08

See an error in this hospital's data? Submit a correction