Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

PRESBYTERIAN COMMUNITY HOSPITAL

San Juan, PR · CCN 400001 · Rates published

949 distinct procedures filed
25 distinct payers
8,979 rate rows
2026-08-05 last MRF observed
Data quality

8,808 of 8,979 rate rows are consumer-grade (98.1%)

171 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 96
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 37
exceeds 10× this hospital's gross charge — excluded from medians 37
placeholder amount (≤ $0.02) — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hpt.inmediata.com/?handler=DF&d=06E635CC-A020-4C15-80ED-931CA6EFCC3A
Found on page https://www.presbypr.com/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-13
Content fingerprint 7b34bf9001c37f3c… · 1,374,257 bytes · first seen 2026-08-11

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
60600891
LOCAL 		Tenecteplase 50 Mg/kit 13 $7,947.12 $7,947.12 $7,947.12 —
60601218
LOCAL 		Digoxin Immune Fab 40 Mg Vial 13 $4,764.10 $4,764.10 $4,764.10 —
60906831
LOCAL 		Alteplase 50mg Vial 14 $4,214.50 $4,214.50 $4,214.50 —
50590
CPT 		Litotripcia 6 $2,100.00 $4,680.00 $4,000.00 nat. median
$4,399
0.9× median
43260
CPT 		Ercp Endo Ret Chola Pancrea 6 $700.00 $3,700.00 $3,000.00 nat. median
$3,884
0.8× median
55873
CPT 		Mc Cryosurgical Ablation 1 $2,800.00 $2,800.00 $2,800.00 nat. median
$9,617
outlier · 0.3×
J2997
HCPCS 		Activase 50 Mg 1 $1,991.54 $1,991.54 $1,991.54 nat. median
$428
outlier · 4.7×
A9521
HCPCS 		Tec 99 & Ceretec Wbc - X Dose 11 $200.00 $3,094.00 $1,547.00 nat. median
$2,065
0.7× median
36511
CPT 		Leukocytapheresis Wbc Reducido 2 $1,200.00 $1,412.00 $1,306.00 nat. median
$1,951
0.7× median
19318
CPT 		Mamoplastia Post Bariatrica 7 $850.00 $2,200.00 $1,260.00 nat. median
$6,870
outlier · 0.2×
36514
CPT 		Plasmaferresis 6 $1,200.00 $1,455.00 $1,220.00 nat. median
$1,993
0.6× median
36513
CPT 		Plaquetaferesis 5 $1,000.00 $1,200.00 $1,200.00 nat. median
$571
outlier · 2.1×
78816
CPT 		PET W Concurrency (whole) 6 $635.00 $950.00 $900.00 nat. median
$1,696
0.5× median
P9073
HCPCS 		Platelet, Pheresis, Pathogen 7 $706.67 $828.00 $828.00 nat. median
$665
1.2× median
78815
CPT 		PET W Concurrently (skull) 7 $635.00 $945.00 $800.00 nat. median
$1,679
outlier · 0.5×
P9052
HCPCS 		Platelets Hla-mached Leukocyte 7 $531.67 $759.00 $759.00 nat. median
$854
0.9× median
78813
CPT 		PET Chest,head,neck (whole) 5 $600.00 $950.00 $756.84 nat. median
$1,497
0.5× median
78814
CPT 		PET W Concurrently (limited) 7 $600.00 $950.00 $755.92 nat. median
$1,613
outlier · 0.5×
59012
CPT 		Cordocentesis Pubs 59012 1 $748.00 $748.00 $748.00 nat. median
$360
outlier · 2.1×
78811
CPT 		PET Chest,head,neck(limited) 7 $600.00 $900.00 $746.88 nat. median
$1,344
0.6× median
78812
CPT 		PET Chest,head,neck (skull) 7 $600.00 $900.00 $746.88 nat. median
$1,489
0.5× median
32555
CPT 		Thoracentesis Aspirat W/guide 1 $700.00 $700.00 $700.00 nat. median
$806
0.9× median
49083
CPT 		Sono Abd Paracent Guided 3 $661.00 $1,400.00 $700.00 nat. median
$1,052
0.7× median
P9053
HCPCS 		Platelets, Pheresis, Leukocyte 7 $546.67 $690.00 $690.00 nat. median
$676
1.0× median
P9037
HCPCS 		Plaq/pheresis/leuk Reducidos 7 $500.00 $690.00 $665.63 nat. median
$896
0.7× median
86965
CPT 		Pooling Of Platelets Or Other 5 $28.00 $661.25 $661.25 nat. median
$152
outlier · 4.3×
60601567
LOCAL 		Remdesivir 100mg Vial 13 $650.72 $650.72 $650.72 —
60600039
LOCAL 		Calfactant 35 Mg/ml 6vial 13 $643.70 $643.70 $643.70 —
60600800
LOCAL 		Calcitonin,salmon,synthetic 400 Unit/2ml 13 $621.62 $621.62 $621.62 —
P9035
HCPCS 		Plaquetaferesis Leucoreducidas 7 $481.00 $661.25 $610.62 nat. median
$732
0.8× median
P9055
HCPCS 		Platelets, Leukocytes Reduced 7 $521.67 $609.50 $609.50 nat. median
$490
1.2× median
P9036
HCPCS 		Plaqueta Pheresis Irradiadas 1 $598.00 $598.00 $598.00 nat. median
$758
0.8× median
P9023
HCPCS 		Leukocyte Poor Blood Each Unit 7 $100.00 $632.50 $563.00 nat. median
$67
outlier · 8.4×
A9557
HCPCS 		Neurolite Hasta 25 Mci 1 Dose 10 $246.00 $1,100.00 $550.00 nat. median
$1,421
outlier · 0.4×
G0378
HCPCS 		Uso E/r Observation 1 $528.00 $528.00 $528.00 nat. median
$105
outlier · 5.0×
60601604
LOCAL 		Fibrin Sealant Component Kit 10 Ml 13 $518.40 $518.40 $518.40 —
A9552
HCPCS 		Flurodeoxyglucose F-18 8 $500.00 $560.00 $515.00 nat. median
$627
0.8× median
51045
CPT 		Mc Custotomy W/insert Ureteral 1 $510.10 $510.10 $510.10 nat. median
$2,235
outlier · 0.2×
59325
CPT 		Cerclage Cervix Abdominal59325 2 $251.81 $750.00 $500.90 nat. median
$2,550
outlier · 0.2×
A9504
HCPCS 		Acutect Mat., Up To 20 MCi 5 $500.00 $595.00 $500.00 nat. median
$867
0.6× median
10005
CPT 		Fine Needle Aspiration Biopsy 6 $450.00 $500.00 $500.00 nat. median
$880
0.6× median
P9034
HCPCS 		Platelets Pheresis, Each Unit 7 $425.00 $498.33 $483.00 nat. median
$439
1.1× median
36558
CPT 		Insertion Of Tunn Cath 3 $272.93 $1,200.00 $475.00 nat. median
$3,467
outlier · 0.1×
55700
CPT 		Transrectal Prostate Biopsy 5 $450.00 $500.00 $475.00 nat. median
$1,997
outlier · 0.2×
74185
CPT 		MRA Abdominal W Or Without Cont 8 $221.33 $650.00 $445.90 nat. median
$853
0.5× median
60601226
LOCAL 		Calfactant 35 Mg/ml 3vial 13 $436.37 $436.37 $436.37 —
77012
CPT 		CT Guidance Needle Repla 8 $122.50 $500.00 $432.30 nat. median
$679
0.6× median
99282
CPT 		Emergency Chest Pain 2 $330.00 $528.00 $429.00 nat. median
$224
1.9× median
81220
CPT 		Cystic Fibrosis Profile 7 $32.00 $1,004.30 $409.10 nat. median
$557
0.7× median
10061
CPT 		I+d,abcess Complex 4 $100.00 $700.00 $407.68 nat. median
$464
0.9× median

Other procedures at this hospital

Browse this hospital's 949 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
             
10005 CPT Fine Needle Aspiration Biopsy 7 6 $525.00 — $450.00 $500.00 $500.00 2026-08-05
10061 CPT I+d,abcess Complex 4 4 $130.00 — $100.00 $700.00 $407.68 2026-08-05
10180 CPT Proc Incision Y Drenaje 2 2 $500.00 — $70.00 $184.92 $127.46 2026-08-05
11043 CPT Debrd Musc Or Facia 20sq 2 2 $205.00 — $160.94 $320.00 $240.47 2026-08-05
11044 CPT Debr Bone First 20sq 2 2 $540.00 — $238.63 $380.00 $309.31 2026-08-05
11750 CPT Excis Of Nail,part/comp 2 2 $335.00 — $100.00 $104.91 $102.45 2026-08-05
15000 CPT Biograft Recip Site Pre 1 1 $650.00 — $250.00 $250.00 $250.00 2026-08-05
15002 CPT Urg Prep 100sq Cm Orless 2 2 $308.00 — $225.00 $235.15 $230.07 2026-08-05
15004 CPT Surg Preparation 100sq 2 2 $330.00 — $220.00 $278.36 $249.18 2026-08-05
15005 CPT Urg Prep Ea 100sq Cmless 2 2 $153.00 — $94.65 $100.00 $97.33 2026-08-05
15050 CPT Skin Graft 2 2 $650.00 — $200.00 $459.49 $329.75 2026-08-05
15261 CPT Add Skin Graft 1 1 $325.00 — $144.80 $144.80 $144.80 2026-08-05
15330 CPT App Graft Jacket Ea Add 1 1 $308.00 — $225.00 $225.00 $225.00 2026-08-05
19081 CPT Breast Biopsy 6 5 $500.00 — $164.10 $450.00 $323.50 2026-08-05
19082 CPT Stereostatic Adicional 6 4 $800.00 — $38.33 $484.00 $162.00 2026-08-05
19318 CPT Mamoplastia Post Bariatrica 7 7 $1,725.00 — $850.00 $2,200.00 $1,260.00 2026-08-05
26010 CPT Cirugia Menor 2 2 $81.00 — $140.00 $142.18 $141.09 2026-08-05
31237 CPT Nasal Endo. Bx Debridment 7 7 $449.00 — $135.00 $263.49 $189.00 2026-08-05
31238 CPT Nasal Endo. Epistaxis Control 7 7 $497.00 — $230.00 $345.00 $258.16 2026-08-05
31500 CPT Intubation,endotraqueal 4 3 $125.00 — $60.00 $146.00 $125.00 2026-08-05
31525 CPT Direct Laryngoscopy 9 8 $457.00 — $100.00 $259.61 $152.00 2026-08-05
31575 CPT Laryngoscophy Fiberoptic 9 8 $100.00 — $40.00 $150.00 $100.00 2026-08-05
32555 CPT Thoracentesis Aspirat W/guide 1 1 $630.00 — $700.00 $700.00 $700.00 2026-08-05
36511 CPT Leukocytapheresis Wbc Reducido 2 2 $1,500.00 — $1,200.00 $1,412.00 $1,306.00 2026-08-05
36513 CPT Plaquetaferesis 6 5 $1,000.00 — $1,000.00 $1,200.00 $1,200.00 2026-08-05
36514 CPT Plasmaferresis 7 6 $1,455.00 — $1,200.00 $1,455.00 $1,220.00 2026-08-05
36558 CPT Insertion Of Tunn Cath 3 3 $1,200.00 — $272.93 $1,200.00 $475.00 2026-08-05
41100 CPT Biopsy Tongue 7 6 $125.00 — $45.00 $193.62 $119.00 2026-08-05
42800 CPT Biopsy Oropharynx 6 6 $190.00 — $42.00 $164.40 $99.00 2026-08-05
43260 CPT Ercp Endo Ret Chola Pancrea 6 6 $3,000.00 — $700.00 $3,700.00 $3,000.00 2026-08-05
49083 CPT Sono Abd Paracent Guided 3 3 $700.00 — $661.00 $1,400.00 $700.00 2026-08-05
50590 CPT Litotripcia 7 6 $5,600.00 — $2,100.00 $4,680.00 $4,000.00 2026-08-05
51045 CPT Mc Custotomy W/insert Ureteral 1 1 $720.00 — $510.10 $510.10 $510.10 2026-08-05
52342 CPT Extraction Ballon 1 1 $241.00 — $322.89 $322.89 $322.89 2026-08-05
55700 CPT Transrectal Prostate Biopsy 6 5 $500.00 — $450.00 $500.00 $475.00 2026-08-05
55873 CPT Mc Cryosurgical Ablation 1 1 $1,200.00 — $2,800.00 $2,800.00 $2,800.00 2026-08-05
59001 CPT Amniotic Fluid Reduction 59001 1 1 $500.00 — $186.34 $186.34 $186.34 2026-08-05
59012 CPT Cordocentesis Pubs 59012 1 1 $500.00 — $748.00 $748.00 $748.00 2026-08-05
59015 CPT Chorionic Villussampling 59015 1 1 $500.00 — $137.06 $137.06 $137.06 2026-08-05
59030 CPT Fetal Scalp Bloodsamplin 59030 1 1 $500.00 — $117.22 $117.22 $117.22 2026-08-05
59070 CPT Transabdominal Aminiofusi59070 2 2 $500.00 — $310.00 $322.30 $316.15 2026-08-05
59320 CPT Cerclage Of Cervix Vagina59320 2 2 $500.00 — $187.00 $200.00 $193.50 2026-08-05
59325 CPT Cerclage Cervix Abdominal59325 2 2 $500.00 — $251.81 $750.00 $500.90 2026-08-05
59866 CPT Multifetal Reductio/guide59866 2 2 $500.00 — $181.00 $225.10 $203.05 2026-08-05
60300142 LOCAL Estrogens, Conjugated 25 Mg Vial 14 13 $350.95 — $350.95 $350.95 $350.95 2026-08-05
60384625 LOCAL Penicillin G Benzathine La 1.2 Mmu/2 Ml 12 11 $176.92 — $176.92 $176.92 $176.92 2026-08-05
60520004 LOCAL Rho(d) Mmune Globulin 14 13 $123.19 — $123.19 $123.19 $123.19 2026-08-05
60600039 LOCAL Calfactant 35 Mg/ml 6vial 14 13 $643.70 — $643.70 $643.70 $643.70 2026-08-05
60600800 LOCAL Calcitonin,salmon,synthetic 400 Unit/2ml 14 13 $621.62 — $621.62 $621.62 $621.62 2026-08-05
60600891 LOCAL Tenecteplase 50 Mg/kit 14 13 $7,947.12 — $7,947.12 $7,947.12 $7,947.12 2026-08-05
60601122 LOCAL Dornase Alfa 1mg/ml Ampul.neb 14 13 $114.54 — $114.54 $114.54 $114.54 2026-08-05
60601218 LOCAL Digoxin Immune Fab 40 Mg Vial 14 13 $4,764.10 — $4,764.10 $4,764.10 $4,764.10 2026-08-05
60601226 LOCAL Calfactant 35 Mg/ml 3vial 14 13 $436.37 — $436.37 $436.37 $436.37 2026-08-05
60601327 LOCAL Ceftazidime/avibactam 2.5 Gm Vial 14 13 $401.17 — $401.17 $401.17 $401.17 2026-08-05
60601357 LOCAL Ceftolozane/tazobactam 1.5 Gm Vial 14 13 $167.00 — $167.00 $167.00 $167.00 2026-08-05
60601430 LOCAL Hepatitis B Immune Globulin (human) 14 13 $196.09 — $196.09 $196.09 $196.09 2026-08-05
60601444 LOCAL Sugammadex Sodium 200 Mg/2 Ml Vial 14 13 $131.49 — $131.49 $131.49 $131.49 2026-08-05
60601447 LOCAL Clevidipine Butyrate 50 Mg/100 Ml Vial 14 13 $172.73 — $172.73 $172.73 $172.73 2026-08-05
60601454 LOCAL Filgrastim 480 Biosimilar Mcg/1.6 Ml Vial 14 13 $241.65 — $241.65 $241.65 $241.65 2026-08-05
60601455 LOCAL Filgrastim Biosimilar 300 Mcg/ml Vial 14 13 $151.03 — $151.03 $151.03 $151.03 2026-08-05
60601567 LOCAL Remdesivir 100mg Vial 14 13 $650.72 — $650.72 $650.72 $650.72 2026-08-05
60601604 LOCAL Fibrin Sealant Component Kit 10 Ml 14 13 $518.40 — $518.40 $518.40 $518.40 2026-08-05
60601605 LOCAL Fibrin Sealant Component Kit 4 Ml 14 13 $225.60 — $225.60 $225.60 $225.60 2026-08-05
60601610 LOCAL Imipenem/ Cilastin/ Relebactam 1.25 Mg 14 13 $305.34 — $305.34 $305.34 $305.34 2026-08-05
60906831 LOCAL Alteplase 50mg Vial 15 14 $4,214.50 — $4,214.50 $4,214.50 $4,214.50 2026-08-05
64566 CPT Posterior Tibial Nerve Stimula 7 7 $200.00 — $31.67 $250.00 $151.61 2026-08-05
69100 CPT Biopsy Of External Ear 4 4 $30.00 — $47.00 $152.31 $115.16 2026-08-05
69105 CPT Biopsia Ext Canal Auditivo 5 5 $140.00 — $51.00 $152.31 $108.68 2026-08-05
69205 CPT Remove Frgn Body Ear W/anes 7 7 $75.00 — $30.00 $150.00 $97.68 2026-08-05
70010 CPT Myelograph 1 Leve 8 7 $100.00 — $46.07 $180.00 $99.25 2026-08-05
70336 CPT Temporomandibular Joints MRI 11 10 $284.00 — $163.67 $700.00 $325.00 2026-08-05
70450 CPT CT Head Or Brain Without Contrast 15 14 $175.00 — $51.60 $275.00 $137.50 2026-08-05
70460 CPT CT Head & Brain W Contrast 13 12 $225.00 — $74.06 $285.00 $137.50 2026-08-05
70470 CPT CT Head O Brain W /wo Contrast 12 11 $325.00 — $90.22 $322.00 $137.50 2026-08-05
70480 CPT CT Orbit W/out Contrast 13 12 $175.00 — $79.11 $245.00 $134.06 2026-08-05
70481 CPT CT Orbit With Contrast 13 12 $225.00 — $120.67 $300.00 $150.00 2026-08-05
70482 CPT CT Orbit W / Wo Contrast 12 11 $325.00 — $134.07 $350.00 $162.13 2026-08-05
70486 CPT CT Maxilo Facial Without Contrast 13 12 $225.00 — $68.51 $280.00 $134.07 2026-08-05
70487 CPT CT Maxillo Facial W Contrast 13 12 $225.00 — $78.86 $325.00 $137.50 2026-08-05
70488 CPT CT Maxillofacial W/wo Contrast 12 11 $325.00 — $99.81 $330.00 $140.70 2026-08-05
70490 CPT CT Neck Without Contrast 13 12 $175.00 — $74.35 $250.00 $134.07 2026-08-05
70491 CPT CT Neck W Contrast 13 12 $225.00 — $95.91 $300.00 $137.50 2026-08-05
70492 CPT CT Neck W / Wo Contrast 12 11 $325.00 — $117.24 $300.00 $141.34 2026-08-05
70496 CPT CTA Head W And Without Follw Cont 9 8 $325.00 — $134.07 $350.00 $182.00 2026-08-05
70498 CPT CTA Neck W And Without Follw Cont 9 8 $325.00 — $134.07 $350.00 $182.00 2026-08-05
70540 CPT MRI Orbit Face Or Nec Without Cont 13 12 $354.00 — $146.16 $700.00 $316.88 2026-08-05
70542 CPT Orbit Face With Contrast Mat 10 9 $382.00 — $172.55 $720.00 $316.88 2026-08-05
70543 CPT Orbit Face W&/wo/fow Cont MRI 10 9 $507.00 — $213.15 $650.00 $316.88 2026-08-05
70544 CPT MRA Head, Without C 9 8 $354.00 — $150.98 $650.00 $316.88 2026-08-05
70545 CPT MRA Head With Contrast 9 8 $382.00 — $162.43 $720.00 $316.88 2026-08-05
70546 CPT MRA Head Without Follow Co 9 8 $507.00 — $246.29 $650.00 $325.00 2026-08-05
70547 CPT MRA Neck Without Cont 10 9 $354.00 — $151.30 $650.00 $316.88 2026-08-05
70548 CPT MRA Neck With Contrast 9 8 $382.00 — $166.76 $720.00 $316.88 2026-08-05
70549 CPT MRA Neck Without/follo 9 8 $507.00 — $247.22 $650.00 $325.00 2026-08-05
70551 CPT MRI Brain Without Contrast Mat 12 11 $354.00 — $110.16 $700.00 $325.00 2026-08-05
70552 CPT MRI Brain With Contrast Mat 12 11 $382.00 — $162.52 $700.00 $325.00 2026-08-05
70553 CPT MRI Brain W&without Follow Contra 10 9 $507.00 — $185.23 $720.00 $320.94 2026-08-05
71250 CPT CT Chest Or Torax Without Contrast 14 13 $175.00 — $74.86 $275.00 $137.50 2026-08-05
71260 CPT CT Chest Or Torax W Contrast 12 11 $225.00 — $96.17 $350.00 $246.00 2026-08-05
71270 CPT CT Torax W/wo Follow Contrast 13 12 $325.00 — $119.01 $300.00 $150.00 2026-08-05
71275 CPT CTA Chest W Or Without No Coronary 11 10 $225.00 — $146.25 $350.00 $178.50 2026-08-05
71550 CPT Chest Without Contrast Mat MRI 12 11 $354.00 — $163.67 $700.00 $325.00 2026-08-05
71551 CPT Chest With Contrast MRI 10 9 $382.00 — $262.73 $720.00 $325.00 2026-08-05
71552 CPT Chest Without/followed Con MRI 10 9 $507.00 — $316.88 $775.00 $333.29 2026-08-05
71555 CPT MRA Chest Without Cont No Coronary 9 8 $382.00 — $217.29 $650.00 $316.88 2026-08-05
72125 CPT CT Cervical Spine Without Contrast 13 12 $175.00 — $79.11 $275.00 $134.07 2026-08-05
72126 CPT CT Cervical Spine W Contrast 13 12 $225.00 — $105.81 $310.00 $150.00 2026-08-05
72127 CPT CT Cervicalspine W/wo Contrast 12 11 $325.00 — $129.95 $380.00 $149.09 2026-08-05
72128 CPT CT Thoracic Spine Without Contrast 13 12 $175.00 — $78.90 $275.00 $137.50 2026-08-05
72129 CPT CT Thoracic Spine W Contrast 13 12 $225.00 — $107.06 $310.00 $150.00 2026-08-05
72130 CPT CT Thoracic Spine Without Contrast 12 11 $325.00 — $125.00 $380.00 $148.49 2026-08-05
72131 CPT CT Lumbar Spine Without Contrast 13 12 $325.00 — $78.59 $380.00 $137.50 2026-08-05
72132 CPT CT Lumbar Spine W Contrast 13 12 $225.00 — $106.43 $310.00 $150.00 2026-08-05
72133 CPT CT Lumbar Spine W/wo Contrast 12 11 $175.00 — $130.26 $300.00 $150.00 2026-08-05
72141 CPT Cervical Spinal Without C MRI 12 11 $354.00 — $105.36 $700.00 $320.94 2026-08-05
72142 CPT Cervical Spinal With Cont MRI 12 11 $382.00 — $165.80 $720.00 $325.00 2026-08-05
72146 CPT Thoracic Spine Without Con MRI 11 10 $354.00 — $105.36 $650.00 $325.00 2026-08-05
72147 CPT Thoracic Spine With Contra MRI 12 11 $382.00 — $163.78 $720.00 $325.00 2026-08-05
72148 CPT Lumbar Spine Without Contr MRI 12 11 $354.00 — $104.61 $700.00 $325.00 2026-08-05
72149 CPT Lumbar Spine With Contrast MRI 12 11 $382.00 — $163.02 $720.00 $325.00 2026-08-05
72156 CPT Cervical Spinwithout/follo MRI 11 10 $507.00 — $186.50 $750.00 $325.00 2026-08-05
72157 CPT Thoracicspine Without/foll MRI 11 10 $507.00 — $187.00 $750.00 $325.00 2026-08-05
72158 CPT Lumbar Spine Without/follo MRI 11 10 $507.00 — $185.99 $750.00 $325.00 2026-08-05
72159 CPT MRA Spinal With Or W/out Cont 8 7 $382.00 — $178.39 $650.00 $285.68 2026-08-05
72191 CPT CTA Pelvis With Or Without Cont 9 8 $225.00 — $121.88 $350.00 $170.17 2026-08-05
72192 CPT CT Pelvico Without Contrast 13 12 $175.00 — $64.22 $250.00 $125.00 2026-08-05
72193 CPT CT Pelvis W Contrast 14 13 $225.00 — $118.49 $250.00 $156.25 2026-08-05
72194 CPT CT Pelvis W / Wo Contrast 12 11 $325.00 — $121.88 $360.00 $153.75 2026-08-05
72195 CPT Pelvis Without Contrast MRI 11 10 $354.00 — $150.99 $650.00 $325.00 2026-08-05
72196 CPT Pelvis With Contrast MRI 12 11 $382.00 — $177.59 $700.00 $320.94 2026-08-05
72197 CPT Pelvis Without/follow Cont MRI 10 9 $507.00 — $220.61 $650.00 $324.54 2026-08-05
72198 CPT MRA Pelvis With Or Without Cont 9 8 $382.00 — $219.82 $650.00 $316.88 2026-08-05
73200 CPT CT Upper Extremi Without Contrast 13 12 $175.00 — $79.11 $250.00 $137.50 2026-08-05
73201 CPT CT Upper Extremity W Contrast 11 10 $225.00 — $116.22 $350.00 $275.00 2026-08-05
73202 CPT CT Upper Extrem W/wo Contrast 13 12 $325.00 — $121.88 $350.00 $155.30 2026-08-05
73206 CPT CTA Upper W O Without Non Cont Ima 8 7 $225.00 — $121.88 $350.00 $170.47 2026-08-05
73218 CPT Upper Ext Without Joint Without Contra 9 8 $354.00 — $163.92 $650.00 $325.00 2026-08-05
73219 CPT Upper Ext Without Joint With Cont 10 9 $382.00 — $228.15 $750.00 $327.62 2026-08-05
73220 CPT Upper Ext W/ojoint Without Followw 11 10 $507.00 — $276.86 $750.00 $386.75 2026-08-05
73221 CPT Bilatleft W/joint Without Contrast 15 10 $354.00 — $118.34 $1,250.00 $325.00 2026-08-05
73222 CPT Bilatleft W/joint With Contras 14 9 $382.00 — $209.47 $750.00 $355.70 2026-08-05
73223 CPT Bilatleft W/joint Without Follow C 10 9 $507.00 — $254.90 $775.00 $373.64 2026-08-05
73225 CPT MRA Upper Extremity W Or Without C 7 6 $382.00 — $254.47 $650.00 $316.88 2026-08-05
73700 CPT CT Lower Extremit Without Contrast 13 12 $175.00 — $78.90 $250.00 $137.50 2026-08-05
73701 CPT CT Lower Extremity W Contrast 13 12 $225.00 — $106.43 $275.00 $150.00 2026-08-05
73702 CPT CT Lower Extremi W/wo Contrast 13 12 $325.00 — $121.88 $300.00 $151.05 2026-08-05
73718 CPT Lower Ext Without Joint Without Cont 9 8 $506.00 — $163.67 $650.00 $325.00 2026-08-05
73719 CPT MRI Low Ext Without Joint With Con 9 8 $382.00 — $178.13 $650.00 $316.88 2026-08-05
73720 CPT Lowerext W/ojoint Without Followit 11 10 $507.00 — $228.38 $700.00 $326.25 2026-08-05
73721 CPT Lowerext W/joint Without Cont MRI 11 10 $354.00 — $118.59 $700.00 $325.00 2026-08-05
73722 CPT Lowerext W/joint With Cont Mr 10 9 $382.00 — $211.99 $720.00 $325.00 2026-08-05
73723 CPT Lower Ext Without W/and Follow Con 10 9 $507.00 — $256.16 $650.00 $379.34 2026-08-05
73725 CPT MRA Lower Extremity W Or Without C 9 8 $382.00 — $172.80 $650.00 $319.00 2026-08-05
74150 CPT CT Abdomen W Contrast 14 13 $225.00 — $117.73 $350.00 $155.91 2026-08-05
74170 CPT CT Abdominal W / Wo Contrast 11 10 $325.00 — $135.65 $325.00 $252.00 2026-08-05
74174 CPT CTA Abd+pelvis With Contrast 8 7 $225.00 — $178.13 $450.00 $258.27 2026-08-05
74175 CPT CTA Abd W And Follow Cont 10 9 $225.00 — $146.25 $360.00 $174.33 2026-08-05
74176 CPT CT Abd+pelv Without Cont 11 10 $325.00 — $79.36 $400.00 $207.19 2026-08-05
74177 CPT CT Abd+pelv With Cont 11 10 $386.00 — $137.50 $315.68 $207.19 2026-08-05
74178 CPT CT Abd+pelv W/and Without Cont 11 10 $486.00 — $89.50 $254.47 $200.00 2026-08-05
74181 CPT MRI 9 8 $650.00 — $150.22 $650.00 $386.75 2026-08-05
74182 CPT MRI Abdomen W Contrast 9 8 $650.00 — $212.65 $720.00 $325.00 2026-08-05
74183 CPT MRI Abdomen W/and Fallowcontra 11 10 $650.00 — $227.61 $750.00 $325.16 2026-08-05
74185 CPT MRA Abdominal W Or Without Cont 9 8 $382.00 — $221.33 $650.00 $445.90 2026-08-05
74261 CPT CT Virtual Colonograph Without 10 9 $315.00 — $65.63 $270.64 $128.56 2026-08-05
76088 CPT Mamogram Ductogram 2 2 $66.00 — $54.98 $140.00 $97.49 2026-08-05
76811 CPT Obsono Complet Det Singlefetus 10 9 $70.00 — $61.66 $193.00 $106.54 2026-08-05
76812 CPT Obson Complete Detail Add Fetu 9 8 $70.00 — $40.00 $149.58 $100.00 2026-08-05
76825 CPT Ecocardiograph Fetal-card W/2d 9 9 $150.00 — $75.00 $200.82 $140.57 2026-08-05
76941 CPT US Guidance For Intra Uterine Transfusion 4 3 $40.00 — $47.50 $106.00 $97.50 2026-08-05
76981 CPT Sono Elastography 3 3 $200.00 — $71.77 $200.00 $153.64 2026-08-05
77012 CPT CT Guidance Needle Repla 8 8 $700.00 — $122.50 $500.00 $432.30 2026-08-05
78013 CPT Thyroid Imaging 9 8 $90.00 — $58.67 $408.00 $140.46 2026-08-05
78018 CPT Thyroid Whole Body Scan 14 13 $310.00 — $70.00 $700.00 $177.50 2026-08-05
78070 CPT Parathyroid Scan 15 14 $122.00 — $30.23 $286.00 $122.00 2026-08-05
78071 CPT Parathyroid Spect 3 3 $444.00 — $143.00 $260.00 $240.41 2026-08-05
78075 CPT Acth 27 14 $160.00 — $38.62 $442.60 $105.00 2026-08-05
78104 CPT Bone Marrow 10 9 $250.00 — $92.50 $370.00 $185.00 2026-08-05
78135 CPT Rbc Labeled 13 12 $200.00 — $46.07 $400.00 $200.00 2026-08-05
78205 CPT Liver Imaging Spect 13 12 $245.00 — $60.00 $500.00 $189.58 2026-08-05
78215 CPT Liver And Spleen 14 13 $142.00 — $74.59 $340.00 $141.00 2026-08-05
78223 CPT Hida Scan 14 13 $155.00 — $60.00 $431.00 $200.20 2026-08-05
78262 CPT Gastroesophageal Reflux 14 13 $120.00 — $80.00 $380.00 $120.00 2026-08-05
78264 CPT Gastric Emptying 14 13 $133.00 — $60.94 $330.00 $133.00 2026-08-05
78278 CPT G I Bleeding 14 13 $98.00 — $72.50 $380.00 $100.25 2026-08-05
78290 CPT Meckels Diverticulum 14 13 $100.00 — $52.50 $370.00 $96.25 2026-08-05
78306 CPT Bone Scan 14 13 $155.00 — $70.00 $350.00 $147.50 2026-08-05
78315 CPT Bone Three Phase 14 13 $180.00 — $87.75 $400.00 $136.75 2026-08-05
78320 CPT Bone Scan Spect 14 13 $330.00 — $85.00 $660.00 $210.00 2026-08-05
78451 CPT Stress Cardiolite 14 13 $499.00 — $87.50 $1,420.00 $311.04 2026-08-05
78452 CPT Stress Thallium & Persantine 12 11 $499.00 — $175.00 $1,420.00 $338.54 2026-08-05
78453 CPT Thallium Spect At Rest 11 10 $50.00 — $50.00 $418.32 $160.00 2026-08-05
78469 CPT Pyrophosphate Spect 13 12 $243.00 — $60.00 $486.00 $149.74 2026-08-05
78472 CPT Muga Scan 14 13 $200.00 — $109.69 $400.00 $184.28 2026-08-05
78579 CPT Lung Ventilation 14 13 $142.00 — $44.03 $284.00 $135.99 2026-08-05
78580 CPT Lung Perfusion 14 13 $95.00 — $60.00 $216.04 $110.00 2026-08-05
78607 CPT Brain Spect 14 13 $230.00 — $60.00 $460.00 $205.00 2026-08-05
78630 CPT Cysternography 14 13 $205.00 — $105.00 $410.00 $205.00 2026-08-05
78647 CPT Cysternography Spect 13 12 $240.00 — $92.50 $480.00 $240.00 2026-08-05
78707 CPT Renal Scan W Dmsa-mag3 W Pharm 16 13 $180.00 — $109.50 $360.00 $170.00 2026-08-05
78760 CPT Testicular Scan 1 1 $120.00 — $240.00 $240.00 $240.00 2026-08-05
78802 CPT Gallium Scan Whole Body 14 13 $250.00 — $87.50 $380.00 $118.75 2026-08-05
78803 CPT Gallium Spect (tumor) 14 13 $250.00 — $109.69 $500.00 $222.50 2026-08-05
78804 CPT Gallium Scan Area 14 13 $800.00 — $61.43 $486.08 $130.75 2026-08-05
78805 CPT Scintimammography 13 12 $149.00 — $61.43 $298.00 $107.85 2026-08-05
78807 CPT Gallium Scan Whole B Inflamato 6 5 $250.00 — $150.00 $311.01 $247.19 2026-08-05
78811 CPT PET Chest,head,neck(limited) 8 7 $1,450.00 — $600.00 $900.00 $746.88 2026-08-05
78812 CPT PET Chest,head,neck (skull) 8 7 $1,450.00 — $600.00 $900.00 $746.88 2026-08-05
78813 CPT PET Chest,head,neck (whole) 6 5 $1,450.00 — $600.00 $950.00 $756.84 2026-08-05
78814 CPT PET W Concurrently (limited) 8 7 $1,450.00 — $600.00 $950.00 $755.92 2026-08-05
78815 CPT PET W Concurrently (skull) 9 7 $2,500.00 — $635.00 $945.00 $800.00 2026-08-05
78816 CPT PET W Concurrency (whole) 7 6 $2,500.00 — $635.00 $950.00 $900.00 2026-08-05
79005 CPT Therapy Carcinoma Metastasis 21 13 $480.00 — $38.13 $960.00 $207.00 2026-08-05
81220 CPT Cystic Fibrosis Profile 7 7 $456.00 — $32.00 $1,004.30 $409.10 2026-08-05
82731 CPT Fetal Fibronectin 11 10 $180.00 — $64.41 $225.00 $98.00 2026-08-05
84260 CPT Serotonin Blood 11 10 $110.00 — $30.98 $140.00 $112.00 2026-08-05
84588 CPT Arginine Vasopres (avp,antidi) 11 10 $140.00 — $33.94 $165.00 $100.00 2026-08-05
85260 CPT Factor X 11 10 $94.00 — $17.90 $125.00 $95.00 2026-08-05
86701 CPT HIV-1 Rna,quant Pcr 10 9 $280.00 — $93.00 $190.00 $135.78 2026-08-05
86870 CPT Antigenos (por Unidad) 10 9 $50.00 — $45.00 $161.00 $109.25 2026-08-05
86890 CPT Autologous Blood Or Component 9 8 $253.00 — $40.00 $253.00 $241.45 2026-08-05
86965 CPT Pooling Of Platelets Or Other 6 5 $661.25 — $28.00 $661.25 $661.25 2026-08-05
86999 CPT After Hour Panel-fee For Weeke 4 4 $115.00 — $86.00 $115.00 $100.50 2026-08-05
87522 CPT Hcv Viral RNA Quant Pcr 10 9 $209.00 — $40.00 $195.00 $95.85 2026-08-05
87902 CPT Hcv Viral RNA Genotype 10 9 $392.00 — $30.00 $382.87 $282.73 2026-08-05
88262 CPT Chromosom (sangre)kariogr 8 8 $1,203.20 — $125.49 $1,204.00 $306.69 2026-08-05
88269 CPT Chrom Amnfl Kario 3 3 $424.00 — $173.66 $234.00 $205.34 2026-08-05
90651 CPT Gardasil 9 5 5 $295.00 — $215.90 $268.77 $231.00 2026-08-05
90736 CPT Vac Zoster(shingles)subcut Inj 4 4 $280.00 — $186.00 $236.55 $226.45 2026-08-05
92950 CPT Cpr 10 10 $102.00 — $75.00 $341.84 $121.00 2026-08-05
93306 CPT Echo W/spectral Dopp/col.flow 17 16 $320.00 — $72.72 $400.00 $198.90 2026-08-05
93307 CPT Echo/doppler 15 14 $250.00 — $33.35 $250.00 $100.05 2026-08-05
93312 CPT Tee (echo Transesophagea) 16 15 $230.00 — $32.37 $460.00 $132.91 2026-08-05
93350 CPT Stress Echo Transtho Dobutamin 17 10 $200.00 — $93.01 $300.00 $140.28 2026-08-05
93880 CPT Duplex Carotid Study 15 14 $125.00 — $50.00 $140.00 $119.26 2026-08-05
93886 CPT Transcraneal 13 12 $141.00 — $75.00 $196.17 $107.64 2026-08-05
93925 CPT Duplex Arterial Lower Study 15 14 $125.00 — $55.00 $229.09 $108.00 2026-08-05
93930 CPT Duplex Arterial Upper Study 15 14 $125.00 — $55.00 $250.00 $110.00 2026-08-05
93970 CPT Duplex Scan Etr.vein Up/le 16 15 $125.00 — $29.25 $167.83 $113.87 2026-08-05
93971 CPT Duplex Venous Unilat Upper/low 15 14 $125.00 — $36.00 $230.00 $96.00 2026-08-05
93975 CPT Color Dopler 10 9 $100.00 — $70.00 $233.08 $133.00 2026-08-05
94002 CPT Ventilador *day* 12 11 $130.00 — $66.30 $200.00 $97.30 2026-08-05
99070 CPT Aguja Stereostactic Prove 11g 2 2 $520.00 — $254.00 $285.00 $269.50 2026-08-05
99201 CPT E+m New Patient (brief) 7 6 $62.00 — $45.49 $552.00 $400.00 2026-08-05
99202 CPT E+m New Patient (limite) 8 7 $78.00 — $76.50 $552.00 $400.00 2026-08-05
99203 CPT E+m New Pat(intermdiate) 9 8 $102.00 — $25.00 $552.00 $400.00 2026-08-05
99204 CPT E+m New Pat(extended) 9 8 $128.00 — $25.00 $552.00 $236.00 2026-08-05
99205 CPT E+m New Patient(complex) 8 7 $182.00 — $210.87 $552.00 $330.00 2026-08-05
99211 CPT E+m Establish Pt(brief) 10 9 $62.00 — $22.05 $320.00 $225.00 2026-08-05
99212 CPT E+m Establ Pt(limited) 8 7 $78.00 — $44.77 $316.00 $225.00 2026-08-05
99213 CPT E+m Established P Interm 8 7 $80.00 — $74.32 $316.00 $204.00 2026-08-05
99214 CPT E+m Establ Pt(extended) 8 7 $101.00 — $109.66 $316.00 $204.00 2026-08-05
99215 CPT E+m Establ Pt(complex) 9 8 $128.00 — $1.00 $316.00 $225.00 2026-08-05
99250 CPT Ret Cam 3 3 $140.00 — $55.00 $300.00 $280.00 2026-08-05
99281 CPT Nst ER Observation 3 Horas 12 11 $165.00 — $30.00 $279.00 $193.50 2026-08-05
99282 CPT Emergency Chest Pain 2 2 $300.00 — $330.00 $528.00 $429.00 2026-08-05
99284 CPT Uso S/e Urgente/moderado 3 2 $275.00 — $190.00 $199.00 $197.00 2026-08-05
99285 CPT ER Urgente/complejo 3 2 $300.00 — $190.00 $199.00 $197.00 2026-08-05
99291 CPT Uso ER Critical Care 1 5 5 $300.00 — $150.00 $190.00 $185.00 2026-08-05
99292 CPT Uso ER Critical Care 2 4 4 $50.00 — $75.00 $188.00 $137.47 2026-08-05
A4301 HCPCS Mediport Imp Casc 10 9 $420.00 — $232.00 $500.00 $275.00 2026-08-05
A9500 HCPCS Cardiolite - X Dose 13 12 $124.00 — $70.00 $600.00 $121.70 2026-08-05
A9504 HCPCS Acutect Mat., Up To 20 MCi 5 5 $595.00 — $500.00 $595.00 $500.00 2026-08-05
A9521 HCPCS Tec 99 & Ceretec Wbc - X Dose 12 11 $1,547.00 — $200.00 $3,094.00 $1,547.00 2026-08-05
A9552 HCPCS Flurodeoxyglucose F-18 9 8 $550.00 — $500.00 $560.00 $515.00 2026-08-05
A9557 HCPCS Neurolite Hasta 25 Mci 1 Dose 11 10 $550.00 — $246.00 $1,100.00 $550.00 2026-08-05
C1788 HCPCS Power Port Isp 8fr. 9 8 $375.00 — $232.00 $500.00 $300.00 2026-08-05
G0378 HCPCS Uso E/r Observation 1 1 $165.00 — $528.00 $528.00 $528.00 2026-08-05
J0150 HCPCS Adenocard 3 Mg/ml 2 2 $54.00 — $108.00 $112.50 $110.25 2026-08-05
J1327 HCPCS Eptifibatide 0.75 Mg/ml 2 2 $480.18 — $308.27 $308.27 $308.27 2026-08-05
J2785 HCPCS Regadenoson 9 9 $160.00 — $160.00 $320.00 $160.00 2026-08-05
J2997 HCPCS Activase 50 Mg 1 1 $4,125.00 — $1,991.54 $1,991.54 $1,991.54 2026-08-05
J3490 HCPCS Oxido Nitrico 1 Hora 10 9 $125.00 — $84.00 $250.00 $125.00 2026-08-05
J9999 HCPCS Cyclophosphamide 500 Mg Vial 1 1 $12.71 — $125.00 $125.00 $125.00 2026-08-05
L8699 HCPCS Dornhoffer Footplate Shoe 2 2 $400.00 — $350.00 $350.00 $350.00 2026-08-05
P9010 HCPCS W B Sangre Completa 8 7 $260.00 — $201.25 $264.60 $219.00 2026-08-05
P9011 HCPCS Blood Split Unit 8 7 $240.35 — $200.00 $240.35 $233.93 2026-08-05
P9016 HCPCS Leukocyte Poor Blood 8 7 $224.25 — $224.25 $308.70 $264.50 2026-08-05
P9017 HCPCS Plasma Fresco Ab+ 8 7 $140.00 — $57.50 $115.76 $105.00 2026-08-05
P9021 HCPCS Red Blood Cells Each Unit 8 7 $207.00 — $207.00 $264.60 $213.00 2026-08-05
P9022 HCPCS Rbc Lavadas 8 7 $360.00 — $203.73 $287.00 $238.07 2026-08-05
P9023 HCPCS Leukocyte Poor Blood Each Unit 8 7 $632.50 — $100.00 $632.50 $563.00 2026-08-05
P9031 HCPCS Plaquetas Leukocites 8 7 $111.67 — $108.33 $142.00 $126.12 2026-08-05
P9032 HCPCS Platelets Irradiated Each Unit 8 7 $132.25 — $115.50 $132.25 $128.25 2026-08-05
P9033 HCPCS Platelets, Leukocytes Reduced 8 7 $155.25 — $136.67 $155.25 $149.38 2026-08-05
P9034 HCPCS Platelets Pheresis, Each Unit 8 7 $483.00 — $425.00 $498.33 $483.00 2026-08-05
P9035 HCPCS Plaquetaferesis Leucoreducidas 8 7 $900.00 — $481.00 $661.25 $610.62 2026-08-05
P9036 HCPCS Plaqueta Pheresis Irradiadas 1 1 $469.53 — $598.00 $598.00 $598.00 2026-08-05
P9037 HCPCS Plaq/pheresis/leuk Reducidos 8 7 $653.50 — $500.00 $690.00 $665.63 2026-08-05
P9038 HCPCS Red Blood Cell Irradiada 8 7 $250.69 — $213.00 $241.50 $231.82 2026-08-05
P9040 HCPCS Red Blood Cell Leukocytes 8 7 $258.75 — $221.00 $258.75 $250.10 2026-08-05
P9044 HCPCS Plasma, Cryoprecipitate 8 7 $103.50 — $90.00 $103.50 $99.00 2026-08-05
P9051 HCPCS Whole Blood Or Red Blood Cells 8 7 $264.50 — $233.67 $264.50 $264.50 2026-08-05
P9052 HCPCS Platelets Hla-mached Leukocyte 8 7 $759.00 — $531.67 $759.00 $759.00 2026-08-05
P9053 HCPCS Platelets, Pheresis, Leukocyte 8 7 $690.00 — $546.67 $690.00 $690.00 2026-08-05
P9055 HCPCS Platelets, Leukocytes Reduced 8 7 $609.50 — $521.67 $609.50 $609.50 2026-08-05
P9056 HCPCS Whole Blood, Leukocytes 8 7 $270.25 — $235.00 $270.25 $270.25 2026-08-05
P9058 HCPCS Red Blood Cells, Leukocytes 8 7 $281.75 — $245.00 $281.75 $281.75 2026-08-05
P9071 HCPCS Plasma (single Donor) Pathogen 8 7 $115.00 — $85.00 $115.00 $115.00 2026-08-05
P9073 HCPCS Platelet, Pheresis, Pathogen 8 7 $828.00 — $706.67 $828.00 $828.00 2026-08-05
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