Hospital

HOSPITAL METROPOLITANO DR PILA

Ponce, PR · CCN 400003 · Rates published

265 distinct procedures filed

26 distinct payers

7,637 rate rows

2025-04-10 last MRF observed · ⚠ 14 mo old

Data quality

7,634 of 7,637 rate rows are consumer-grade (100.0%)

3 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	2
exceeds 10× this hospital's gross charge — excluded from medians	1

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://hpt.inmediata.com/?handler=DF&d=80B96606-DE16-4B1E-AB6C-444DEDAC5FAEv
Found on page	https://hpt.inmediata.com/index?h=80B96606-DE16-4B1E-AB6C-444DEDAC5FAE
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	57d99ebce1edaba6… · 1,052,422 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
93452 CPT	Exam Of Left Heart With Catheter Insertion	11	$239.84	$2,350.00	$1,967.00	nat. median $5,130 outlier · 0.4×
99204 CPT	Outpatient Clinic Visit New Patient Level 4	2	$552.00	$600.00	$576.00	nat. median $216 outlier · 2.7×
99205 CPT	Outpatient Clinic Visit New Patient Level 5	2	$552.00	$600.00	$576.00	nat. median $269 outlier · 2.1×
73723 CPT	MRI Of Leg Joint With And Without Contrast	21	$124.11	$1,300.00	$323.68	nat. median $1,263 outlier · 0.3×
78452 CPT	Multiple Spect Scans Of Heart Muscle	18	$65.35	$710.00	$300.00	nat. median $1,765 outlier · 0.2×
77049 CPT	MRI Of Both Breasts With And Without Contrast	15	$144.45	$750.00	$295.04	nat. median $958 outlier · 0.3×
73722 CPT	MRI Of Leg Joint With Contrast	21	$100.22	$700.00	$292.54	nat. median $1,302 outlier · 0.2×
72197 CPT	MRI Of Pelvis With And Without Contrast	22	$133.21	$1,300.00	$287.50	nat. median $1,064 outlier · 0.3×
74183 CPT	MRI Of Abdomen With And Without Contrast	22	$133.39	$1,300.00	$287.50	nat. median $1,101 outlier · 0.3×
74182 CPT	MRI Of Abdomen With Contrast	22	$118.50	$700.00	$277.25	nat. median $990 outlier · 0.3×
72157 CPT	MRI Of Middle Spinal Canal With And Without Contrast	22	$102.13	$1,300.00	$264.91	nat. median $1,093 outlier · 0.2×
72156 CPT	MRI Of Upper Spinal Canal With And Without Contrast	22	$101.96	$1,300.00	$263.83	nat. median $1,092 outlier · 0.2×
72158 CPT	MRI Of Lower Spinal Canal With And Without Contrast	22	$101.78	$1,300.00	$263.10	nat. median $1,080 outlier · 0.2×
70553 CPT	MRI Of Brain With And Without Contrast	21	$101.52	$1,300.00	$261.29	nat. median $1,122 outlier · 0.2×
72196 CPT	MRI Of Pelvis With Contrast	22	$107.99	$700.00	$250.72	nat. median $953 outlier · 0.3×
73719 CPT	MRI Of Leg Not Including Joint With Contrast	21	$105.78	$700.00	$249.78	nat. median $973 outlier · 0.3×
70544 CPT	MRI Of Blood Vessels Of Head Without Contrast	17	$86.49	$650.00	$246.86	nat. median $816 outlier · 0.3×
72142 CPT	MRI Of Upper Spinal Canal With Contrast	22	$86.66	$700.00	$242.87	nat. median $958 outlier · 0.3×
70552 CPT	MRI Of Brain With Contrast	21	$85.39	$700.00	$238.93	nat. median $959 outlier · 0.2×
72149 CPT	MRI Of Lower Spinal Canal With Contrast	22	$85.69	$700.00	$238.52	nat. median $970 outlier · 0.2×
73718 CPT	MRI Of Leg Not Including Joint Without Contrast	21	$88.85	$650.00	$234.30	nat. median $916 outlier · 0.3×
72195 CPT	MRI Of Pelvis Without Contrast	22	$90.67	$650.00	$233.82	nat. median $787 outlier · 0.3×
99203 CPT	Outpatient Clinic Visit New Patient Level 3	4	$225.00	$600.00	$225.00	nat. median $160 1.4× median
73218 CPT	MRI Of Arm Without Contrast	24	$75.99	$650.00	$217.82	nat. median $896 outlier · 0.2×
73221 CPT	MRI Of Arm Without Contrast	24	$75.99	$650.00	$217.82	nat. median $879 outlier · 0.2×
74181 CPT	MRI Of Abdomen Without Contrast	22	$87.66	$650.00	$214.60	nat. median $820 outlier · 0.3×
74178 CPT	Cat Scan Of Abdomen And Pelvis With And Without Contrast	17	$94.49	$450.00	$213.30	nat. median $977 outlier · 0.2×
73721 CPT	MRI Of Leg Joint Without Contrast	23	$63.22	$650.00	$209.01	nat. median $899 outlier · 0.2×
74177 CPT	Cat Scan Of Abdomen And Pelvis With Contrast	17	$83.47	$450.00	$206.88	nat. median $928 outlier · 0.2×
70551 CPT	MRI Of Brain Without Contrast	21	$62.26	$650.00	$183.64	nat. median $772 outlier · 0.2×
78582 CPT	Nuclear Medicine Study Of Lung Ventilation And Blood Circulation Through Lungs	16	$71.25	$300.86	$168.79	nat. median $856 outlier · 0.2×
70496 CPT	Cat Scan Of Blood Vessels In Head With Contrast	14	$68.75	$247.50	$165.00	nat. median $729 outlier · 0.2×
71275 CPT	Cat Scan Of Blood Vessels In Chest With Contrast	12	$73.13	$247.50	$165.00	nat. median $735 outlier · 0.2×
72148 CPT	MRI Of Lower Spinal Canal Without Contrast	22	$60.35	$650.00	$162.50	nat. median $770 outlier · 0.2×
72146 CPT	MRI Of Middle Spinal Canal Without Contrast	22	$60.62	$650.00	$162.50	nat. median $772 outlier · 0.2×
72141 CPT	MRI Of Upper Spinal Canal Without Contrast	22	$60.62	$650.00	$162.50	nat. median $765 outlier · 0.2×
70492 CPT	Cat Scan Of Soft Tissue Of The Neck With And Without Contrast	24	$68.75	$325.00	$160.00	nat. median $633 outlier · 0.3×
74170 CPT	Cat Scan Of Abdomen With And Without Contrast	23	$69.92	$650.00	$159.09	nat. median $702 outlier · 0.2×
72193 CPT	Cat Scan Of Pelvis With Contrast	23	$60.07	$325.00	$156.19	nat. median $629 outlier · 0.2×
74160 CPT	Cat Scan Of Abdomen With Contrast	23	$61.62	$325.00	$156.19	nat. median $645 outlier · 0.2×
71270 CPT	Cat Scan Of Chest With And Without Contrast	23	$73.02	$650.00	$152.77	nat. median $661 outlier · 0.2×
73701 CPT	Cat Scan Of Leg With Contrast	23	$60.07	$325.00	$150.00	nat. median $710 outlier · 0.2×
78803 CPT	Spect Scan To Locate Tumor Or Infection	20	$47.71	$327.51	$150.00	nat. median $1,373 outlier · 0.1×
71260 CPT	Cat Scan Of Chest With Contrast	24	$61.16	$325.00	$137.39	nat. median $646 outlier · 0.2×
70491 CPT	Cat Scan Of Soft Tissue Of The Neck With Contrast	24	$63.21	$325.00	$137.02	nat. median $617 outlier · 0.2×
70470 CPT	Cat Scan Of Head Or Brain With And Without Contrast	24	$51.99	$650.00	$130.86	nat. median $618 outlier · 0.2×
78226 CPT	Nuclear Medicine Study Of Liver And Bile Ducts	17	$80.05	$260.91	$128.07	nat. median $743 outlier · 0.2×
78227 CPT	Nuclear Medicine Study Of Liver And Bile Ducts	17	$80.05	$260.91	$128.07	nat. median $940 outlier · 0.1×
73200 CPT	Cat Scan Of Arm Without Contrast	23	$43.71	$300.00	$127.54	nat. median $548 outlier · 0.2×
78708 CPT	Complete Nuclear Medicine Study Of Kidney With Drug Administration	19	$48.67	$215.21	$124.39	nat. median $722 outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 265 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

93452	CPT	Exam Of Left Heart With Catheter Insertion	18	11	$2,500.00	$2,500.00	$239.84	$2,350.00	$1,967.00	2025-04-10
99205	CPT	Outpatient Clinic Visit New Patient Level 5	2	2	$164.08	$164.08	$552.00	$600.00	$576.00	2025-04-10
99204	CPT	Outpatient Clinic Visit New Patient Level 4	2	2	$111.11	$111.11	$552.00	$600.00	$576.00	2025-04-10
73723	CPT	MRI Of Leg Joint With And Without Contrast	28	21	$800.00	$800.00	$124.11	$1,300.00	$323.68	2025-04-10
78452	CPT	Multiple Spect Scans Of Heart Muscle	25	18	$400.00	$400.00	$65.35	$710.00	$300.00	2025-04-10
77049	CPT	MRI Of Both Breasts With And Without Contrast	22	15	$975.00	$975.00	$144.45	$750.00	$295.04	2025-04-10
73722	CPT	MRI Of Leg Joint With Contrast	28	21	$700.00	$700.00	$100.22	$700.00	$292.54	2025-04-10
72197	CPT	MRI Of Pelvis With And Without Contrast	29	22	$800.00	$800.00	$133.21	$1,300.00	$287.50	2025-04-10
74183	CPT	MRI Of Abdomen With And Without Contrast	29	22	$800.00	$800.00	$133.39	$1,300.00	$287.50	2025-04-10
74182	CPT	MRI Of Abdomen With Contrast	29	22	$700.00	$700.00	$118.50	$700.00	$277.25	2025-04-10
72157	CPT	MRI Of Middle Spinal Canal With And Without Contrast	29	22	$800.00	$800.00	$102.13	$1,300.00	$264.91	2025-04-10
72156	CPT	MRI Of Upper Spinal Canal With And Without Contrast	29	22	$800.00	$800.00	$101.96	$1,300.00	$263.83	2025-04-10
72158	CPT	MRI Of Lower Spinal Canal With And Without Contrast	29	22	$800.00	$800.00	$101.78	$1,300.00	$263.10	2025-04-10
70553	CPT	MRI Of Brain With And Without Contrast	28	21	$800.00	$800.00	$101.52	$1,300.00	$261.29	2025-04-10
72196	CPT	MRI Of Pelvis With Contrast	29	22	$700.00	$700.00	$107.99	$700.00	$250.72	2025-04-10
73719	CPT	MRI Of Leg Not Including Joint With Contrast	28	21	$700.00	$700.00	$105.78	$700.00	$249.78	2025-04-10
70544	CPT	MRI Of Blood Vessels Of Head Without Contrast	22	17	$650.00	$650.00	$86.49	$650.00	$246.86	2025-04-10
72142	CPT	MRI Of Upper Spinal Canal With Contrast	29	22	$700.00	$700.00	$86.66	$700.00	$242.87	2025-04-10
70552	CPT	MRI Of Brain With Contrast	28	21	$700.00	$700.00	$85.39	$700.00	$238.93	2025-04-10
72149	CPT	MRI Of Lower Spinal Canal With Contrast	29	22	$700.00	$700.00	$85.69	$700.00	$238.52	2025-04-10
73718	CPT	MRI Of Leg Not Including Joint Without Contrast	28	21	$650.00	$650.00	$88.85	$650.00	$234.30	2025-04-10
72195	CPT	MRI Of Pelvis Without Contrast	29	22	$650.00	$650.00	$90.67	$650.00	$233.82	2025-04-10
99203	CPT	Outpatient Clinic Visit New Patient Level 3	5	4	$87.29	$87.29	$225.00	$600.00	$225.00	2025-04-10
73218	CPT	MRI Of Arm Without Contrast	31	24	$650.00	$650.00	$75.99	$650.00	$217.82	2025-04-10
73221	CPT	MRI Of Arm Without Contrast	31	24	$650.00	$650.00	$75.99	$650.00	$217.82	2025-04-10
74181	CPT	MRI Of Abdomen Without Contrast	29	22	$650.00	$650.00	$87.66	$650.00	$214.60	2025-04-10
74178	CPT	Cat Scan Of Abdomen And Pelvis With And Without Contrast	24	17	$350.00	$350.00	$94.49	$450.00	$213.30	2025-04-10
73721	CPT	MRI Of Leg Joint Without Contrast	30	23	$650.00	$650.00	$63.22	$650.00	$209.01	2025-04-10
74177	CPT	Cat Scan Of Abdomen And Pelvis With Contrast	24	17	$350.00	$350.00	$83.47	$450.00	$206.88	2025-04-10
70551	CPT	MRI Of Brain Without Contrast	28	21	$650.00	$650.00	$62.26	$650.00	$183.64	2025-04-10
78582	CPT	Nuclear Medicine Study Of Lung Ventilation And Blood Circulation Through Lungs	22	16	$300.00	$300.00	$71.25	$300.86	$168.79	2025-04-10
71275	CPT	Cat Scan Of Blood Vessels In Chest With Contrast	19	12	$350.00	$350.00	$73.13	$247.50	$165.00	2025-04-10
70496	CPT	Cat Scan Of Blood Vessels In Head With Contrast	19	14	$300.00	$300.00	$68.75	$247.50	$165.00	2025-04-10
72141	CPT	MRI Of Upper Spinal Canal Without Contrast	29	22	$650.00	$650.00	$60.62	$650.00	$162.50	2025-04-10
72148	CPT	MRI Of Lower Spinal Canal Without Contrast	29	22	$650.00	$650.00	$60.35	$650.00	$162.50	2025-04-10
72146	CPT	MRI Of Middle Spinal Canal Without Contrast	29	22	$650.00	$650.00	$60.62	$650.00	$162.50	2025-04-10
70492	CPT	Cat Scan Of Soft Tissue Of The Neck With And Without Contrast	31	24	$350.00	$350.00	$68.75	$325.00	$160.00	2025-04-10
74170	CPT	Cat Scan Of Abdomen With And Without Contrast	30	23	$350.00	$350.00	$69.92	$650.00	$159.09	2025-04-10
74160	CPT	Cat Scan Of Abdomen With Contrast	30	23	$350.00	$350.00	$61.62	$325.00	$156.19	2025-04-10
72193	CPT	Cat Scan Of Pelvis With Contrast	30	23	$350.00	$350.00	$60.07	$325.00	$156.19	2025-04-10
71270	CPT	Cat Scan Of Chest With And Without Contrast	30	23	$350.00	$350.00	$73.02	$650.00	$152.77	2025-04-10
78803	CPT	Spect Scan To Locate Tumor Or Infection	27	20	$492.00	$492.00	$47.71	$327.51	$150.00	2025-04-10
73701	CPT	Cat Scan Of Leg With Contrast	30	23	$350.00	$350.00	$60.07	$325.00	$150.00	2025-04-10
71260	CPT	Cat Scan Of Chest With Contrast	31	24	$350.00	$350.00	$61.16	$325.00	$137.39	2025-04-10
70491	CPT	Cat Scan Of Soft Tissue Of The Neck With Contrast	31	24	$350.00	$350.00	$63.21	$325.00	$137.02	2025-04-10
70470	CPT	Cat Scan Of Head Or Brain With And Without Contrast	31	24	$350.00	$350.00	$51.99	$650.00	$130.86	2025-04-10
78226	CPT	Nuclear Medicine Study Of Liver And Bile Ducts	24	17	$260.00	$260.00	$80.05	$260.91	$128.07	2025-04-10
78227	CPT	Nuclear Medicine Study Of Liver And Bile Ducts	24	17	$260.00	$260.00	$80.05	$260.91	$128.07	2025-04-10
73200	CPT	Cat Scan Of Arm Without Contrast	30	23	$300.00	$300.00	$43.71	$300.00	$127.54	2025-04-10
78708	CPT	Complete Nuclear Medicine Study Of Kidney With Drug Administration	26	19	$200.00	$200.00	$48.67	$215.21	$124.39	2025-04-10
72125	CPT	Cat Scan Of Neck Spine Without Contrast	30	23	$300.00	$300.00	$44.86	$300.00	$122.82	2025-04-10
73700	CPT	Cat Scan Of Leg Without Contrast	30	23	$300.00	$300.00	$43.71	$300.00	$122.34	2025-04-10
72131	CPT	Cat Scan Of Lower Spine Without Contrast	30	23	$300.00	$300.00	$43.71	$300.00	$122.34	2025-04-10
78472	CPT	Single Nuclear Medicine Study To Evaluate Blood Ejection From The Heart During S…	28	21	$405.00	$405.00	$43.68	$250.00	$121.88	2025-04-10
71250	CPT	Cat Scan Of Chest Without Contrast	31	24	$300.00	$300.00	$44.05	$300.00	$120.00	2025-04-10
70480	CPT	Cat Scan Of Eye, Ear, Or Sella Turcica Without Contrast	31	24	$300.00	$300.00	$48.23	$300.00	$119.62	2025-04-10
74176	CPT	Cat Scan Of Abdomen And Pelvis Without Contrast	24	17	$300.00	$300.00	$55.69	$400.00	$116.00	2025-04-10
70487	CPT	Cat Scan Of Facial Bones With Contrast	31	24	$350.00	$350.00	$45.70	$325.00	$113.82	2025-04-10
78802	CPT	Nuclear Medicine Study To Locate Tumor Or Infection With Whole Body Imaging Comp…	29	22	$283.00	$283.00	$38.14	$301.23	$112.50	2025-04-10
70450	CPT	Cat Scan Of Head Or Brain Without Contrast	31	24	$300.00	$300.00	$31.72	$300.00	$110.60	2025-04-10
74150	CPT	Cat Scan Of Abdomen Without Contrast	30	23	$300.00	$300.00	$41.18	$300.00	$109.56	2025-04-10
70460	CPT	Cat Scan Of Head Or Brain With Contrast	31	24	$350.00	$350.00	$44.01	$325.00	$108.75	2025-04-10
72192	CPT	Cat Scan Of Pelvis Without Contrast	30	23	$300.00	$300.00	$39.98	$300.00	$108.53	2025-04-10
70490	CPT	Cat Scan Of Soft Tissue Of The Neck Without Contrast	31	24	$300.00	$300.00	$48.23	$300.00	$106.21	2025-04-10
78195	CPT	Nuclear Medicine Study Of Lymph Nodes	28	21	$200.00	$200.00	$43.75	$317.90	$100.52	2025-04-10
78315	CPT	Nuclear Medicine Study Of Bones And/or Joints With Delayed Images In 3 Phases	29	22	$345.00	$345.00	$45.70	$316.45	$100.45	2025-04-10
78278	CPT	Nuclear Medicine Study Of Blood Or Protein Loss In The Digestive Tract	29	22	$250.00	$250.00	$44.38	$320.44	$100.00	2025-04-10
70486	CPT	Cat Scan Of Facial Bones Without Contrast	31	24	$300.00	$300.00	$37.65	$300.00	$98.60	2025-04-10
78264	CPT	Nuclear Medicine Study Of Stomach Emptying	29	22	$290.00	$290.00	$35.99	$317.18	$95.00	2025-04-10
78306	CPT	Nuclear Medicine Study Of Bones And/or Joints In Whole Body	30	23	$246.00	$246.00	$38.63	$278.76	$87.50	2025-04-10
79005	CPT	Administration Of Therapeutic Radioactive Drug By Mouth	23	17	$250.00	$250.00	$38.13	$465.00	$85.49	2025-04-10
77066	CPT	Diagnostic Mammogram Of Both Breasts	22	15	$100.00	$100.00	$36.64	$123.61	$78.75	2025-04-10
78070	CPT	Nuclear Medicine Study Of Parathyroid Gland	29	22	$260.00	$260.00	$30.23	$278.76	$70.00	2025-04-10
80055	CPT	Lab Test - Panel For Pregnant Patients Without HIV Testing	29	23	$75.00	$75.00	$45.00	$175.00	$65.00	2025-04-10
82306	CPT	Lab Test - Vitamin D-3 Level	31	24	$25.00	$25.00	$28.23	$150.00	$65.00	2025-04-10
77065	CPT	Diagnostic Mammogram Of One Breast	21	14	$100.00	$100.00	$25.00	$96.79	$63.18	2025-04-10
82088	CPT	Lab Test - Aldosterone Hormone Level	31	24	$61.50	$61.50	$38.86	$146.00	$62.00	2025-04-10
87635	CPT	Lab Test - Identification Of Covid-19 Virus DNA Using Amplified Probe Technique	20	13	$84.63	$84.63	$51.00	$84.63	$59.00	2025-04-10
77067	CPT	Screening Mammogram	21	14	$100.00	$100.00	$14.64	$102.22	$58.50	2025-04-10
83970	CPT	Lab Test - Parathyroid Hormone Level	29	22	$154.00	$154.00	$39.36	$130.00	$57.67	2025-04-10
82652	CPT	Lab Test - Vitamin D Level	29	22	$412.00	$412.00	$36.71	$195.00	$55.14	2025-04-10
76830	CPT	Ultrasound Of Non-pregnant Uterus	31	24	$100.00	$100.00	$25.00	$125.00	$50.00	2025-04-10
76872	CPT	Ultrasound Of Pelvic Cavity Via Rectum	30	23	$100.00	$100.00	$25.00	$125.00	$50.00	2025-04-10
76801	CPT	External Ultrasound Of Pregnant Uterus In 1st Trimester	25	18	$45.00	$45.00	$19.50	$100.00	$49.17	2025-04-10
76700	CPT	Complete Ultrasound Of Abdomen	31	24	$100.00	$100.00	$25.00	$100.00	$49.00	2025-04-10
76770	CPT	Complete Ultrasound Of Kidneys, Aorta, And Lymph Nodes	31	24	$100.00	$100.00	$22.75	$100.00	$47.50	2025-04-10
76817	CPT	Vaginal Ultrasound Of Pregnant Uterus In 1st Trimester	29	22	$45.00	$45.00	$19.50	$125.00	$47.50	2025-04-10
84207	CPT	Lab Test - Vitamin B-6 Level	30	23	$75.00	$75.00	$26.79	$150.00	$47.01	2025-04-10
76641	CPT	Ultrasound Of Breast	24	17	$100.00	$100.00	$15.00	$100.00	$46.09	2025-04-10
76705	CPT	Limited Or Follow-up Ultrasound Of Abdomen	26	19	$45.00	$45.00	$21.00	$68.00	$45.48	2025-04-10
76805	CPT	External Ultrasound Of Pregnant Uterus In 2nd Or 3rd Trimester	31	24	$100.00	$100.00	$17.50	$106.00	$45.23	2025-04-10
87426	CPT	Lab Test - Identification Of Covid-19 Virus Using Multiple-step Immunoassay Meth…	19	12	$70.00	$70.00	$30.00	$70.00	$45.23	2025-04-10
76856	CPT	Complete Ultrasound Of Female Pelvis Unrelated To Pregnancy	31	24	$100.00	$100.00	$18.75	$78.30	$45.00	2025-04-10
76536	CPT	Ultrasound Of Soft Tissue Of Head And Neck	31	24	$96.00	$96.00	$15.00	$91.35	$44.54	2025-04-10
82670	CPT	Lab Test - Estradiol Hormone Level	30	23	$18.00	$18.00	$26.64	$116.16	$44.00	2025-04-10
83498	CPT	Lab Test - Hydroxyprogestone 17-d Level	30	23	$60.00	$60.00	$25.91	$100.00	$43.95	2025-04-10
86769	CPT	Lab Test - Identification Of Covid-19 Antibody	17	10	$50.00	$50.00	$10.00	$62.00	$42.13	2025-04-10
74400	CPT	X-ray Of Urinary Tract With Intravenous Injection Of Contrast	26	20	$169.00	$169.00	$19.50	$120.34	$41.81	2025-04-10
76870	CPT	Ultrasound Of Scrotum	31	24	$100.00	$100.00	$18.98	$74.75	$41.00	2025-04-10
74240	CPT	X-ray Of Esophagus, Stomach And Upper Small Intestine With Single Contrast Agen…	32	25	$130.00	$130.00	$19.12	$92.08	$41.00	2025-04-10
84402	CPT	Lab Test - Free Testosterone Level	31	24	$88.00	$88.00	$25.47	$170.00	$38.00	2025-04-10
86361	CPT	Lab Test - Measurement Of Cd4 White Blood T Cells	29	22	$165.00	$165.00	$25.53	$108.00	$37.58	2025-04-10
77075	CPT	X-ray For Complete Bone Evaluation	17	13	$134.00	$134.00	$17.37	$76.39	$36.39	2025-04-10
84403	CPT	Lab Test - Total Testosterone Level	32	25	$53.00	$53.00	$24.62	$100.00	$36.17	2025-04-10
85245	CPT	Lab Test - Measurement Of Blood Clotting Factor Von Willebrand	30	23	$233.50	$233.50	$12.53	$130.00	$35.42	2025-04-10
77080	CPT	Measurement Of Bone Density Using Dual-energy X-rays Of Hips, Pelvis, And/or Spi…	27	20	$130.00	$130.00	$18.26	$103.00	$34.57	2025-04-10
82677	CPT	Lab Test - Estriol Hormone Level	30	23	$37.50	$37.50	$23.06	$65.00	$33.89	2025-04-10
74220	CPT	X-ray Of Esophagus With Single Contrast Agent	32	25	$105.00	$105.00	$14.35	$75.34	$31.00	2025-04-10
82672	CPT	Lab Test - Estrogen Hormone Level	31	24	$45.00	$45.00	$20.69	$70.00	$30.34	2025-04-10
84425	CPT	Lab Test - Vitamin B-1 Level	30	23	$75.00	$75.00	$20.24	$90.00	$30.11	2025-04-10
84144	CPT	Lab Test - Progesterone Hormone Level	31	24	$53.00	$53.00	$19.89	$65.00	$29.28	2025-04-10
72082	CPT	X-ray Of Entire Back For Scoliosis Evaluation, 2-3 Views	16	12	$46.00	$46.00	$10.22	$57.55	$29.00	2025-04-10
84146	CPT	Lab Test - Prolactin Hormone Level	32	25	$55.00	$55.00	$18.48	$62.25	$29.00	2025-04-10
83001	CPT	Lab Test - Fsh Hormone Level	32	25	$45.00	$45.00	$17.71	$60.00	$26.36	2025-04-10
84153	CPT	Lab Test - Total Prostate Specific Antigen Level	31	24	$187.50	$187.50	$17.54	$58.00	$25.92	2025-04-10
84154	CPT	Lab Test - Free Prostate Specific Antigen Level	29	22	$105.00	$105.00	$17.54	$145.00	$25.72	2025-04-10
84152	CPT	Lab Test - Direct Measurement Of Prostate Specific Antigen Level	27	22	$123.75	$123.75	$17.54	$100.00	$25.70	2025-04-10
82530	CPT	Lab Test - Cortisol Hormone Level	32	25	$180.00	$180.00	$15.74	$52.50	$25.10	2025-04-10
82533	CPT	Lab Test - Cortisol Hormone Level	32	25	$180.00	$180.00	$15.74	$52.50	$25.10	2025-04-10
84481	CPT	Lab Test - Free T3 Thyroid Hormone Level	31	24	$62.00	$62.00	$16.15	$115.00	$25.00	2025-04-10
80061	CPT	Lab Test - Cholesterol Panel	32	25	$96.00	$96.00	$12.77	$60.00	$25.00	2025-04-10
83002	CPT	Lab Test - Lh Hormone Level	32	25	$40.00	$40.00	$17.65	$40.00	$25.00	2025-04-10
84166	CPT	Lab Test - Protein Level In Body Fluid Other Than Blood	26	20	$280.50	$280.50	$17.00	$50.00	$24.92	2025-04-10
84443	CPT	Lab Test - Thyroid Stimulating Hormone Level	32	25	$13.00	$13.00	$13.00	$50.00	$24.53	2025-04-10
85240	CPT	Lab Test - Measurement Of Blood Clotting Factor Viii Deficiency	31	24	$148.50	$148.50	$12.53	$125.00	$24.39	2025-04-10
72110	CPT	X-ray Of Lower Back, Minimum Of 4 Views	32	25	$81.00	$81.00	$11.50	$50.60	$24.00	2025-04-10
82164	CPT	Lab Test - Angiotensin Converting Enzyme Level	30	23	$60.00	$60.00	$13.92	$62.00	$23.45	2025-04-10
84432	CPT	Lab Test - Thyroglobulin Hormone Level	29	22	$37.50	$37.50	$15.31	$157.50	$22.50	2025-04-10
86328	CPT	Lab Test - Identification Of Covid-19 Antibody Using Test Strip	11	9	$42.00	$42.00	$19.00	$35.00	$22.00	2025-04-10
82274	CPT	Lab Test - Identification Of Hidden Blood In Stool Using Immunoassay	20	14	$27.00	$27.00	$10.00	$25.00	$21.86	2025-04-10
84702	CPT	Lab Test - Pregnancy Hormone Level	32	25	$45.00	$45.00	$14.36	$60.00	$21.17	2025-04-10
70260	CPT	X-ray Of Skull Bones, 4 Or More Views	32	25	$81.00	$81.00	$11.75	$52.00	$21.00	2025-04-10
97110	CPT	Individual Physical Therapy Exercises	18	16	$35.00	$35.00	$10.73	$30.00	$20.80	2025-04-10
80162	CPT	Lab Test - Total Digoxin Level	31	24	$35.00	$35.00	$12.66	$40.80	$20.70	2025-04-10
82607	CPT	Lab Test - Vitamin B-12 Level	32	25	$45.00	$45.00	$14.38	$45.50	$20.67	2025-04-10
84480	CPT	Lab Test - Total T3 Thyroid Hormone Level	31	24	$35.00	$35.00	$13.51	$45.00	$20.31	2025-04-10
71111	CPT	X-ray Of Ribs On Both Sides And Chest, 4 Or More Views	31	24	$48.50	$48.50	$12.25	$51.00	$20.00	2025-04-10
72050	CPT	X-ray Of Neck, 4 Or 5 Views	32	25	$81.00	$81.00	$11.25	$45.10	$20.00	2025-04-10
80198	CPT	Lab Test - Theophylline Level	31	24	$40.00	$40.00	$13.49	$42.00	$20.00	2025-04-10
82746	CPT	Lab Test - Folic Acid Level	32	25	$40.00	$40.00	$9.00	$46.13	$20.00	2025-04-10
71047	CPT	X-ray Of Chest, 3 Views	22	15	$51.00	$51.00	$8.45	$40.00	$19.95	2025-04-10
70200	CPT	X-ray Of Both Eyes, 4 Or More Views	32	25	$49.00	$49.00	$10.25	$45.10	$19.47	2025-04-10
74021	CPT	X-ray Of Abdomen, 3 Or More Views	22	15	$50.00	$50.00	$10.12	$41.50	$19.40	2025-04-10
70150	CPT	X-ray Of Face Bones, 3 Or More Views	32	25	$48.00	$48.00	$10.00	$44.00	$19.29	2025-04-10
82330	CPT	Lab Test - Ionized Calcium Level	31	24	$45.00	$45.00	$9.00	$52.00	$19.09	2025-04-10
71110	CPT	X-ray Of Ribs On Both Sides, 3 Or More Views	32	25	$44.00	$44.00	$10.00	$44.00	$18.75	2025-04-10
70220	CPT	X-ray Of Paranasal Sinuses, 3 Or More Views	32	25	$47.00	$47.00	$10.00	$44.00	$18.71	2025-04-10
80185	CPT	Lab Test - Total Phenytoin Level	31	24	$35.00	$35.00	$12.64	$45.00	$18.54	2025-04-10
82728	CPT	Lab Test - Ferritin Level	31	24	$27.00	$27.00	$13.00	$40.30	$18.49	2025-04-10
73521	CPT	X-ray Of Both Hips, 2 Views	19	15	$46.00	$46.00	$8.73	$31.74	$18.00	2025-04-10
73564	CPT	X-ray Of Knee, 4 Or More Views	32	25	$46.00	$46.00	$6.30	$38.50	$17.60	2025-04-10
71101	CPT	X-ray Of Ribs One On Side And Chest, 3 Or More Views	31	24	$44.00	$44.00	$9.86	$38.50	$17.50	2025-04-10
80053	CPT	Lab Test - Comprehensive Metabolic Panel	32	25	$45.00	$45.00	$10.07	$55.00	$17.38	2025-04-10
72100	CPT	X-ray Of Lower Back, 2-3 Views	32	25	$46.00	$46.00	$8.50	$37.40	$17.00	2025-04-10
73630	CPT	X-ray Of Foot, 3 Or More Views	32	25	$46.00	$46.00	$7.00	$32.00	$16.99	2025-04-10
72072	CPT	X-ray Of Mid Back, 3 Views	28	21	$45.00	$45.00	$7.35	$37.40	$16.95	2025-04-10
85302	CPT	Lab Test - Measurement Of Protein C Blood Clotting Inhibitor Antigen	29	22	$30.00	$30.00	$11.46	$77.00	$16.87	2025-04-10
72190	CPT	X-ray Of Pelvis, 3 Or More Views	32	25	$46.00	$46.00	$6.40	$32.00	$16.45	2025-04-10
85305	CPT	Lab Test - Measurement Of Total Protein S Blood Clotting Inhibitor Level	29	22	$30.00	$30.00	$11.06	$126.24	$16.22	2025-04-10
74019	CPT	X-ray Of Abdomen, 2 Views	22	15	$50.00	$50.00	$9.21	$30.00	$16.04	2025-04-10
71046	CPT	X-ray Of Chest, 2 Views	23	16	$46.00	$46.00	$7.60	$46.00	$16.00	2025-04-10
73080	CPT	X-ray Of Elbow, 3 Or More Views	32	25	$46.00	$46.00	$7.00	$32.00	$16.00	2025-04-10
73110	CPT	X-ray Of Wrist, 3 Or More Views	32	25	$46.00	$46.00	$7.00	$33.83	$16.00	2025-04-10
70250	CPT	X-ray Of Skull Bones, 1-3 Views	32	25	$46.00	$46.00	$7.35	$37.40	$16.00	2025-04-10
73610	CPT	X-ray Of Ankle, 3 Or More Views	32	25	$46.00	$46.00	$7.00	$32.00	$16.00	2025-04-10
71100	CPT	X-ray Of Ribs On One Side, 2 Views	32	25	$46.00	$46.00	$7.75	$34.10	$15.61	2025-04-10
73502	CPT	X-ray Of Single Hip, 2-3 Views	19	14	$46.00	$46.00	$9.43	$37.67	$15.00	2025-04-10
73565	CPT	X-ray Of Both Knees With Standing Views	32	25	$46.00	$46.00	$6.00	$48.00	$15.00	2025-04-10
83036	CPT	Lab Test - Hemoglobin A1c Level	31	24	$23.00	$23.00	$9.25	$30.00	$14.93	2025-04-10
72070	CPT	X-ray Of Mid Back, 2 Views	32	25	$46.00	$46.00	$7.35	$36.30	$14.80	2025-04-10
73562	CPT	X-ray Of Knee, 3 Views	32	25	$46.00	$46.00	$7.00	$33.13	$14.80	2025-04-10
73130	CPT	X-ray Of Hand, 3 Or More Views	32	25	$46.00	$46.00	$7.00	$32.00	$14.62	2025-04-10
73030	CPT	X-ray Of Shoulder, 2 Or More Views	32	25	$46.00	$46.00	$7.25	$32.00	$14.50	2025-04-10
73552	CPT	X-ray Of Upper Leg, 2 Or More Views	19	14	$46.00	$46.00	$7.60	$27.55	$14.50	2025-04-10
84165	CPT	Lab Test - Protein Level In Blood	32	25	$30.00	$30.00	$10.24	$30.75	$14.49	2025-04-10
73551	CPT	X-ray Of Upper Leg, 1 View	14	12	$46.00	$46.00	$6.52	$21.97	$14.32	2025-04-10
87045	CPT	Lab Test - Stool Culture For Bacteria	32	25	$25.00	$25.00	$9.00	$28.00	$14.25	2025-04-10
72220	CPT	X-ray Of Tailbone	32	25	$46.00	$46.00	$6.30	$32.00	$14.14	2025-04-10
73060	CPT	X-ray Of Upper Arm	32	25	$46.00	$46.00	$7.25	$31.90	$14.03	2025-04-10
70100	CPT	X-ray Of Jaw, 1-3 Views	31	24	$46.00	$46.00	$7.35	$31.04	$14.00	2025-04-10
73501	CPT	X-ray Of Single Hip, 1 View	20	14	$46.00	$46.00	$7.00	$24.41	$14.00	2025-04-10
70140	CPT	X-ray Of Face Bones, 1-2 Views	32	25	$46.00	$46.00	$6.75	$34.10	$13.74	2025-04-10
73560	CPT	X-ray Of Knee, 1 Or 2 Views	32	25	$46.00	$46.00	$6.75	$30.00	$13.60	2025-04-10
72040	CPT	X-ray Of Neck, 2 Or 3 Views	29	22	$46.00	$46.00	$7.35	$35.20	$13.50	2025-04-10
73590	CPT	X-ray Of Lower Leg	32	25	$46.00	$46.00	$6.75	$55.00	$13.50	2025-04-10
73090	CPT	X-ray Of Lower Arm	32	25	$46.00	$46.00	$6.75	$30.00	$13.45	2025-04-10
83721	CPT	Lab Test - Ldl Cholesterol Level	30	23	$35.00	$35.00	$9.10	$30.00	$13.37	2025-04-10
85613	CPT	Lab Test - Measurement Of Blood Clotting Factor X Using Diluted Russell Viper Ve…	28	22	$45.00	$45.00	$5.55	$75.00	$13.29	2025-04-10
73600	CPT	X-ray Of Ankle, 2 Views	32	25	$46.00	$46.00	$6.50	$29.00	$13.12	2025-04-10
77072	CPT	X-ray For Measurement Of Bone Age	21	15	$81.00	$81.00	$5.82	$28.00	$13.00	2025-04-10
73070	CPT	X-ray Of Elbow , 2 Views	32	25	$46.00	$46.00	$6.50	$28.60	$13.00	2025-04-10
73100	CPT	X-ray Of Wrist, 2 Views	32	25	$46.00	$46.00	$6.50	$29.00	$13.00	2025-04-10
73120	CPT	X-ray Of Hand, 2 Views	32	25	$46.00	$46.00	$6.50	$29.00	$13.00	2025-04-10
73650	CPT	X-ray Of Heel	32	25	$46.00	$46.00	$6.25	$27.50	$13.00	2025-04-10
72170	CPT	X-ray Of Pelvis, 1-2 Views	32	25	$46.00	$46.00	$5.25	$30.00	$12.84	2025-04-10
74018	CPT	X-ray Of Abdomen, 1 View	22	15	$46.00	$46.00	$6.40	$25.00	$12.80	2025-04-10
84439	CPT	Lab Test - Free Thyroxine Level	31	24	$111.00	$111.00	$8.59	$37.75	$12.66	2025-04-10
73620	CPT	X-ray Of Foot, 2 Views	32	25	$46.00	$46.00	$6.50	$29.00	$12.54	2025-04-10
70160	CPT	X-ray Of Nose Bones	32	25	$46.00	$46.00	$6.75	$31.04	$12.50	2025-04-10
70210	CPT	X-ray Of Paranasal Sinuses, 1-2 Views	32	25	$46.00	$46.00	$7.35	$33.00	$12.50	2025-04-10
80069	CPT	Lab Test - Kidney Function Panel	31	24	$30.00	$30.00	$8.28	$70.00	$12.13	2025-04-10
85384	CPT	Lab Test - Measurement Of Blood Clot Activity	31	24	$15.00	$15.00	$8.00	$38.49	$11.87	2025-04-10
80048	CPT	Lab Test - Basic Metabolic Panel With Total Calcium	31	24	$21.00	$21.00	$8.00	$40.00	$11.56	2025-04-10
84478	CPT	Lab Test - Triglycerides Level	32	25	$18.00	$18.00	$5.48	$15.00	$11.12	2025-04-10
84703	CPT	Lab Test - Pregnancy Hormone Identification	31	24	$30.00	$30.00	$7.17	$25.00	$11.00	2025-04-10
73660	CPT	X-ray Of Toes	32	25	$46.00	$46.00	$4.90	$24.20	$11.00	2025-04-10
73140	CPT	X-ray Of Fingers	32	25	$46.00	$46.00	$4.90	$32.08	$11.00	2025-04-10
82575	CPT	Lab Test - Calculation Of Creatinine Clearance	32	25	$25.00	$25.00	$7.00	$23.13	$11.00	2025-04-10
71045	CPT	X-ray Of Chest, 1 View	23	16	$46.00	$46.00	$6.13	$46.00	$10.87	2025-04-10
73000	CPT	X-ray Of Collarbone	32	25	$46.00	$46.00	$4.20	$30.00	$10.85	2025-04-10
70360	CPT	X-ray Of Soft Tissue Of The Neck	32	25	$46.00	$46.00	$4.90	$26.40	$10.11	2025-04-10
73020	CPT	X-ray Of Shoulder, 1 View	32	25	$46.00	$46.00	$4.90	$27.50	$10.00	2025-04-10
84436	CPT	Lab Test - Total Thyroxine Level	31	24	$29.00	$29.00	$6.54	$20.00	$9.68	2025-04-10
82150	CPT	Lab Test - Amylase Enzyme Level	32	25	$35.00	$35.00	$6.18	$14.00	$9.63	2025-04-10
84479	CPT	Lab Test - Thyroid Hormone Uptake Analysis	32	25	$29.00	$29.00	$6.16	$15.00	$9.50	2025-04-10
83735	CPT	Lab Test - Magnesium Level	32	25	$41.00	$41.00	$6.38	$15.00	$9.38	2025-04-10
85025	CPT	Lab Test - Complete Blood Cell Count With White Blood Cell Percentage	31	24	$42.00	$42.00	$7.41	$11.14	$9.00	2025-04-10
85027	CPT	Lab Test - Complete Blood Cell Count Without White Blood Cell Percentage	27	22	$15.00	$15.00	$5.85	$15.00	$8.58	2025-04-10
85730	CPT	Lab Test - Thromboplastin Time	32	25	$12.00	$12.00	$5.73	$14.00	$8.52	2025-04-10
83690	CPT	Lab Test - Lipase Enzyme Level	32	25	$94.00	$94.00	$6.00	$15.00	$8.50	2025-04-10
83615	CPT	Lab Test - Ldh Enzyme Level	32	25	$18.00	$18.00	$5.75	$10.60	$8.00	2025-04-10
83540	CPT	Lab Test - Iron Level	32	25	$17.00	$17.00	$6.17	$14.00	$8.00	2025-04-10
82340	CPT	Lab Test - Calcium Level In Urine	32	25	$15.00	$15.00	$5.75	$15.00	$7.46	2025-04-10
84460	CPT	Lab Test - Sgpt Enzyme Level	32	25	$12.00	$12.00	$5.05	$11.03	$7.40	2025-04-10
82248	CPT	Lab Test - Direct Bilirubin Level	30	23	$25.00	$25.00	$4.78	$12.00	$7.30	2025-04-10
84450	CPT	Lab Test - Sgot Enzyme Level	32	25	$12.00	$12.00	$4.94	$20.00	$7.23	2025-04-10
82565	CPT	Lab Test - Creatinine Level In Blood Sample	32	25	$12.00	$12.00	$4.00	$10.18	$7.07	2025-04-10
82247	CPT	Lab Test - Total Bilirubin Level	30	23	$12.00	$12.00	$4.78	$24.00	$7.04	2025-04-10
84075	CPT	Lab Test - Total Alkaline Phosphatase Level	32	25	$31.00	$31.00	$4.94	$12.00	$7.03	2025-04-10
86901	CPT	Lab Test - Blood Typing For Group And Rh Status	31	24	$10.00	$10.00	$2.99	$16.81	$7.00	2025-04-10
86900	CPT	Lab Test - Blood Typing For Group And Rh Status	31	24	$10.00	$10.00	$2.99	$16.81	$7.00	2025-04-10
82310	CPT	Lab Test - Total Calcium Level In Blood	32	25	$12.00	$12.00	$4.92	$23.10	$7.00	2025-04-10
82950	CPT	Lab Test - Glucose Level Following Sugar Intake	32	25	$15.00	$15.00	$4.53	$10.00	$7.00	2025-04-10
84132	CPT	Lab Test - Potassium Level	32	25	$15.00	$15.00	$4.24	$10.43	$6.94	2025-04-10
84133	CPT	Lab Test - Potassium Level	32	25	$15.00	$15.00	$4.24	$10.43	$6.94	2025-04-10
84295	CPT	Lab Test - Sodium Level In Blood Or Plasma Sample	32	25	$12.00	$12.00	$4.59	$8.00	$6.82	2025-04-10
84300	CPT	Lab Test - Sodium Level In Urine Sample	32	25	$15.00	$15.00	$4.64	$8.00	$6.71	2025-04-10
85610	CPT	Lab Test - Measurement Of Prothrombin Time	31	24	$12.00	$12.00	$3.75	$12.00	$6.56	2025-04-10
84100	CPT	Lab Test - Phosphate Level	32	25	$12.00	$12.00	$4.52	$10.00	$6.54	2025-04-10
84550	CPT	Lab Test - Uric Acid Level	32	25	$15.00	$15.00	$4.42	$10.00	$6.48	2025-04-10
84560	CPT	Lab Test - Uric Acid Level	32	25	$15.00	$15.00	$4.42	$10.00	$6.48	2025-04-10
82570	CPT	Lab Test - Creatinine Level In Sample Other Than Blood	31	24	$45.00	$45.00	$4.00	$12.10	$6.39	2025-04-10
82465	CPT	Lab Test - Total Cholesterol Level	32	25	$12.00	$12.00	$4.14	$10.00	$6.12	2025-04-10
85660	CPT	Lab Test - Screening For Sickle Cell Anemia	32	25	$12.00	$12.00	$3.00	$10.00	$6.00	2025-04-10
85049	CPT	Lab Test - Platelet Count	29	22	$12.00	$12.00	$3.00	$10.00	$6.00	2025-04-10
84520	CPT	Lab Test - Urea Nitrogen Level In Blood	32	25	$12.00	$12.00	$3.76	$10.00	$5.68	2025-04-10
84540	CPT	Lab Test - Urea Nitrogen Level In Urine	32	25	$15.00	$15.00	$3.60	$12.10	$5.61	2025-04-10
85045	CPT	Lab Test - Immature Red Blood Cell Count	27	22	$12.00	$12.00	$3.81	$12.00	$5.59	2025-04-10
82947	CPT	Lab Test - Glucose Level In Blood	32	25	$24.00	$24.00	$3.74	$8.00	$5.54	2025-04-10
84155	CPT	Lab Test - Total Protein Level In Blood	32	25	$16.00	$16.00	$3.50	$10.00	$5.47	2025-04-10
84156	CPT	Lab Test - Total Protein Level In Urine	28	21	$36.00	$36.00	$3.50	$30.00	$5.20	2025-04-10
85044	CPT	Lab Test - Manual Red Blood Cell Count	32	25	$12.00	$12.00	$3.00	$11.25	$5.16	2025-04-10
84525	CPT	Lab Test - Urea Nitrogen Level Using Reagent Strip	28	22	$16.00	$16.00	$2.61	$10.00	$5.16	2025-04-10
84157	CPT	Lab Test - Total Protein Level In Body Fluid Other Than Blood Or Urine	28	21	$18.00	$18.00	$3.50	$50.00	$5.14	2025-04-10
81001	CPT	Lab Test - Machine Analysis Of Urine By Dipstick With Microscope Evaluation	32	25	$8.00	$8.00	$3.00	$8.00	$5.00	2025-04-10
85002	CPT	Lab Test - Bleeding Time	32	25	$10.00	$10.00	$2.00	$12.00	$4.58	2025-04-10
81000	CPT	Lab Test - Manual Analysis Of Urine By Dipstick With Microscope Evaluation	22	15	$16.00	$16.00	$3.02	$8.00	$4.50	2025-04-10
85652	CPT	Lab Test - Sedimentation Rate	32	25	$18.00	$18.00	$2.98	$9.00	$4.49	2025-04-10
85651	CPT	Lab Test - Sedimentation Rate	32	25	$18.00	$18.00	$2.98	$9.00	$4.49	2025-04-10
82948	CPT	Lab Test - Glucose Level In Blood Using Strip	28	23	$12.00	$12.00	$1.74	$6.55	$4.44	2025-04-10
81002	CPT	Lab Test - Manual Analysis Of Urine By Dipstick	20	13	$4.00	$4.00	$2.44	$5.00	$3.48	2025-04-10
85014	CPT	Lab Test - Red Blood Cell Volume	32	25	$4.00	$4.00	$2.26	$6.55	$3.31	2025-04-10
85048	CPT	Lab Test - Automated Leukocyte White Blood Cell Count	32	25	$10.00	$10.00	$2.00	$7.40	$3.22	2025-04-10
85018	CPT	Lab Test - Hemoglobin Blood Count	32	25	$24.00	$24.00	$2.00	$6.55	$3.00	2025-04-10
81003	CPT	Lab Test - Machine Analysis Of Urine By Dipstick	20	13	$5.00	$5.00	$1.87	$7.20	$2.47	2025-04-10

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