Hospital

HOSPITAL METROPOLITANO DR SUSONI

Arecibo, PR · CCN 400117 · Rates published

245 distinct procedures filed

26 distinct payers

5,239 rate rows

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

Data quality

5,239 of 5,239 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old.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=EED40A19-47C4-44EA-AD28-AA3698D28525
Found on page	https://hpt.inmediata.com/index?h=EED40A19-47C4-44EA-AD28-AA3698D28525
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	60dc23649b284ee4… · 713,769 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
71552 CPT	MRI Of Chest With And Without Contrast	20	$226.53	$1,300.00	$372.40	nat. median $1,093 outlier · 0.3×
70554 CPT	Mapping Of Functional Brain Activity Using MRI	11	$169.31	$650.00	$341.12	nat. median $479 0.7× median
70546 CPT	MRI Of Blood Vessels Of Head With And Without Contrast	9	$176.86	$650.00	$341.12	nat. median $1,043 outlier · 0.3×
71551 CPT	MRI Of Chest With Contrast	20	$180.90	$675.00	$325.00	nat. median $1,144 outlier · 0.3×
70543 CPT	MRI Of Face Or Neck With And Without Contrast	20	$180.33	$1,300.00	$325.00	nat. median $1,077 outlier · 0.3×
72198 CPT	MRI Of Blood Vessels Of Pelvis	11	$160.74	$650.00	$325.00	nat. median $1,148 outlier · 0.3×
72197 CPT	MRI Of Pelvis With And Without Contrast	20	$197.07	$1,300.00	$325.00	nat. median $1,064 outlier · 0.3×
70553 CPT	MRI Of Brain With And Without Contrast	20	$188.27	$1,300.00	$325.00	nat. median $1,122 outlier · 0.3×
70547 CPT	MRI Of Blood Vessels Of Neck Without Contrast	12	$139.89	$650.00	$325.00	nat. median $751 outlier · 0.4×
72157 CPT	MRI Of Middle Spinal Canal With And Without Contrast	20	$164.91	$1,300.00	$312.50	nat. median $1,093 outlier · 0.3×
72156 CPT	MRI Of Upper Spinal Canal With And Without Contrast	20	$172.17	$1,300.00	$312.50	nat. median $1,092 outlier · 0.3×
70545 CPT	MRI Of Blood Vessels Of Head With Contrast	14	$153.64	$650.00	$312.50	nat. median $903 outlier · 0.3×
70548 CPT	MRI Of Blood Vessels Of Neck With Contrast	14	$164.35	$650.00	$312.50	nat. median $917 outlier · 0.3×
72158 CPT	MRI Of Lower Spinal Canal With And Without Contrast	20	$186.44	$1,300.00	$312.50	nat. median $1,080 outlier · 0.3×
70336 CPT	MRI Of Jaw Joint	20	$126.22	$650.00	$312.50	nat. median $755 outlier · 0.4×
71550 CPT	MRI Of Chest Without Contrast	20	$140.46	$650.00	$300.75	nat. median $809 outlier · 0.4×
72149 CPT	MRI Of Lower Spinal Canal With Contrast	20	$158.90	$727.50	$300.75	nat. median $970 outlier · 0.3×
70542 CPT	MRI Of Face Or Neck With Contrast	20	$160.62	$650.00	$300.75	nat. median $905 outlier · 0.3×
72195 CPT	MRI Of Pelvis Without Contrast	20	$139.26	$650.00	$300.75	nat. median $787 outlier · 0.4×
72142 CPT	MRI Of Upper Spinal Canal With Contrast	20	$153.60	$727.50	$300.75	nat. median $958 outlier · 0.3×
70540 CPT	MRI Of Face Or Neck Without Contrast	20	$139.07	$650.00	$300.75	nat. median $784 outlier · 0.4×
72196 CPT	MRI Of Pelvis With Contrast	20	$162.09	$650.00	$300.75	nat. median $953 outlier · 0.3×
72147 CPT	MRI Of Middle Spinal Canal With Contrast	20	$141.75	$727.50	$300.75	nat. median $963 outlier · 0.3×
70552 CPT	MRI Of Brain With Contrast	20	$158.61	$725.00	$295.48	nat. median $959 outlier · 0.3×
72148 CPT	MRI Of Lower Spinal Canal Without Contrast	20	$119.38	$650.00	$292.50	nat. median $770 outlier · 0.4×
72146 CPT	MRI Of Middle Spinal Canal Without Contrast	20	$120.60	$650.00	$287.50	nat. median $772 outlier · 0.4×
73721 CPT	MRI Of Leg Joint Without Contrast	20	$104.98	$650.00	$287.50	nat. median $899 outlier · 0.3×
72141 CPT	MRI Of Upper Spinal Canal Without Contrast	20	$120.48	$650.00	$287.50	nat. median $765 outlier · 0.4×
71275 CPT	Cat Scan Of Blood Vessels In Chest With Contrast	9	$140.99	$330.00	$230.22	nat. median $735 outlier · 0.3×
74177 CPT	Cat Scan Of Abdomen And Pelvis With Contrast	16	$143.52	$467.50	$225.00	nat. median $928 outlier · 0.2×
70496 CPT	Cat Scan Of Blood Vessels In Head With Contrast	1	$210.25	$210.25	$210.25	nat. median $729 outlier · 0.3×
70498 CPT	Cat Scan Of Blood Vessels In Neck With Contrast	7	$123.00	$330.00	$206.37	nat. median $722 outlier · 0.3×
72191 CPT	Cat Scan Of Blood Vessels Of Pelvis With Contrast	7	$146.91	$330.00	$203.22	nat. median $602 outlier · 0.3×
70482 CPT	Cat Scan Of Eye, Ear, Or Sella Turcica With And Without Contrast	20	$126.09	$650.00	$197.31	nat. median $648 outlier · 0.3×
70481 CPT	Cat Scan Of Eye, Ear, Or Sella Turcica With Contrast	20	$112.04	$325.00	$175.63	nat. median $630 outlier · 0.3×
72130 CPT	Cat Scan Of Mid Spine With And Without Contrast	20	$122.78	$650.00	$175.40	nat. median $592 outlier · 0.3×
70488 CPT	Cat Scan Of Facial Bones With And Without Contrast	20	$115.64	$650.00	$175.00	nat. median $634 outlier · 0.3×
72133 CPT	Cat Scan Of Lower Spine With And Without Contrast	20	$110.28	$650.00	$175.00	nat. median $615 outlier · 0.3×
72127 CPT	Cat Scan Of Neck Spine With And Without Contrast	20	$110.26	$650.00	$175.00	nat. median $595 outlier · 0.3×
71270 CPT	Cat Scan Of Chest With And Without Contrast	20	$112.19	$650.00	$173.78	nat. median $661 outlier · 0.3×
72194 CPT	Cat Scan Of Pelvis With And Without Contrast	20	$107.21	$650.00	$173.44	nat. median $657 outlier · 0.3×
70492 CPT	Cat Scan Of Soft Tissue Of The Neck With And Without Contrast	20	$115.72	$325.00	$172.63	nat. median $633 outlier · 0.3×
72129 CPT	Cat Scan Of Mid Spine With Contrast	20	$104.90	$325.00	$170.56	nat. median $584 outlier · 0.3×
45380 CPT	Exam Of Entire Large Intestine With Biopsy Using Colonoscope	6	$125.00	$569.40	$166.00	nat. median $1,566 outlier · 0.1×
43235 CPT	Diagnostic Exam Of Esophagus, Stomach And Small Bowel Using Endoscope Inserted T…	6	$88.00	$454.04	$166.00	nat. median $1,340 outlier · 0.1×
72193 CPT	Cat Scan Of Pelvis With Contrast	20	$99.70	$325.00	$162.50	nat. median $629 outlier · 0.3×
72132 CPT	Cat Scan Of Lower Spine With Contrast	20	$91.48	$325.00	$162.50	nat. median $760 outlier · 0.2×
72126 CPT	Cat Scan Of Neck Spine With Contrast	20	$104.37	$325.00	$162.50	nat. median $753 outlier · 0.2×
70487 CPT	Cat Scan Of Facial Bones With Contrast	20	$93.53	$325.00	$157.50	nat. median $596 outlier · 0.3×
71260 CPT	Cat Scan Of Chest With Contrast	20	$93.38	$325.00	$157.24	nat. median $646 outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 245 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

87635	CPT	Lab Test - Identification Of Covid-19 Virus DNA Using Amplified Probe Technique	29	26	$175.00	$175.00	$51.33	$76.33	$51.33	2025-04-10
85048	CPT	Lab Test - Automated Leukocyte White Blood Cell Count	24	21	$10.00	$10.00	$2.00	$22.43	$3.62	2025-04-10
71552	CPT	MRI Of Chest With And Without Contrast	23	20	$552.00	$552.00	$226.53	$1,300.00	$372.40	2025-04-10
70543	CPT	MRI Of Face Or Neck With And Without Contrast	23	20	$552.00	$552.00	$180.33	$1,300.00	$325.00	2025-04-10
71551	CPT	MRI Of Chest With Contrast	23	20	$552.00	$552.00	$180.90	$675.00	$325.00	2025-04-10
72197	CPT	MRI Of Pelvis With And Without Contrast	23	20	$552.00	$552.00	$197.07	$1,300.00	$325.00	2025-04-10
70553	CPT	MRI Of Brain With And Without Contrast	23	20	$552.00	$552.00	$188.27	$1,300.00	$325.00	2025-04-10
72157	CPT	MRI Of Middle Spinal Canal With And Without Contrast	23	20	$552.00	$552.00	$164.91	$1,300.00	$312.50	2025-04-10
72158	CPT	MRI Of Lower Spinal Canal With And Without Contrast	23	20	$552.00	$552.00	$186.44	$1,300.00	$312.50	2025-04-10
70336	CPT	MRI Of Jaw Joint	23	20	$552.00	$552.00	$126.22	$650.00	$312.50	2025-04-10
72156	CPT	MRI Of Upper Spinal Canal With And Without Contrast	23	20	$552.00	$552.00	$172.17	$1,300.00	$312.50	2025-04-10
72196	CPT	MRI Of Pelvis With Contrast	23	20	$552.00	$552.00	$162.09	$650.00	$300.75	2025-04-10
72147	CPT	MRI Of Middle Spinal Canal With Contrast	23	20	$552.00	$552.00	$141.75	$727.50	$300.75	2025-04-10
71550	CPT	MRI Of Chest Without Contrast	23	20	$552.00	$552.00	$140.46	$650.00	$300.75	2025-04-10
70540	CPT	MRI Of Face Or Neck Without Contrast	23	20	$552.00	$552.00	$139.07	$650.00	$300.75	2025-04-10
72195	CPT	MRI Of Pelvis Without Contrast	23	20	$552.00	$552.00	$139.26	$650.00	$300.75	2025-04-10
72149	CPT	MRI Of Lower Spinal Canal With Contrast	23	20	$552.00	$552.00	$158.90	$727.50	$300.75	2025-04-10
72142	CPT	MRI Of Upper Spinal Canal With Contrast	23	20	$552.00	$552.00	$153.60	$727.50	$300.75	2025-04-10
70542	CPT	MRI Of Face Or Neck With Contrast	23	20	$552.00	$552.00	$160.62	$650.00	$300.75	2025-04-10
70552	CPT	MRI Of Brain With Contrast	23	20	$552.00	$552.00	$158.61	$725.00	$295.48	2025-04-10
72148	CPT	MRI Of Lower Spinal Canal Without Contrast	23	20	$552.00	$552.00	$119.38	$650.00	$292.50	2025-04-10
72141	CPT	MRI Of Upper Spinal Canal Without Contrast	23	20	$552.00	$552.00	$120.48	$650.00	$287.50	2025-04-10
73721	CPT	MRI Of Leg Joint Without Contrast	23	20	$552.00	$552.00	$104.98	$650.00	$287.50	2025-04-10
72146	CPT	MRI Of Middle Spinal Canal Without Contrast	23	20	$552.00	$552.00	$120.60	$650.00	$287.50	2025-04-10
70482	CPT	Cat Scan Of Eye, Ear, Or Sella Turcica With And Without Contrast	23	20	$194.00	$194.00	$126.09	$650.00	$197.31	2025-04-10
70481	CPT	Cat Scan Of Eye, Ear, Or Sella Turcica With Contrast	23	20	$194.00	$194.00	$112.04	$325.00	$175.63	2025-04-10
72130	CPT	Cat Scan Of Mid Spine With And Without Contrast	23	20	$194.00	$194.00	$122.78	$650.00	$175.40	2025-04-10
72127	CPT	Cat Scan Of Neck Spine With And Without Contrast	23	20	$194.00	$194.00	$110.26	$650.00	$175.00	2025-04-10
70488	CPT	Cat Scan Of Facial Bones With And Without Contrast	23	20	$194.00	$194.00	$115.64	$650.00	$175.00	2025-04-10
72133	CPT	Cat Scan Of Lower Spine With And Without Contrast	23	20	$194.00	$194.00	$110.28	$650.00	$175.00	2025-04-10
71270	CPT	Cat Scan Of Chest With And Without Contrast	23	20	$194.00	$194.00	$112.19	$650.00	$173.78	2025-04-10
72194	CPT	Cat Scan Of Pelvis With And Without Contrast	23	20	$194.00	$194.00	$107.21	$650.00	$173.44	2025-04-10
70492	CPT	Cat Scan Of Soft Tissue Of The Neck With And Without Contrast	23	20	$194.00	$194.00	$115.72	$325.00	$172.63	2025-04-10
72129	CPT	Cat Scan Of Mid Spine With Contrast	23	20	$194.00	$194.00	$104.90	$325.00	$170.56	2025-04-10
72126	CPT	Cat Scan Of Neck Spine With Contrast	23	20	$194.00	$194.00	$104.37	$325.00	$162.50	2025-04-10
72193	CPT	Cat Scan Of Pelvis With Contrast	23	20	$194.00	$194.00	$99.70	$325.00	$162.50	2025-04-10
72132	CPT	Cat Scan Of Lower Spine With Contrast	23	20	$194.00	$194.00	$91.48	$325.00	$162.50	2025-04-10
70487	CPT	Cat Scan Of Facial Bones With Contrast	23	20	$194.00	$194.00	$93.53	$325.00	$157.50	2025-04-10
71260	CPT	Cat Scan Of Chest With Contrast	23	20	$194.00	$194.00	$93.38	$325.00	$157.24	2025-04-10
70491	CPT	Cat Scan Of Soft Tissue Of The Neck With Contrast	23	20	$194.00	$194.00	$98.55	$325.00	$154.24	2025-04-10
70470	CPT	Cat Scan Of Head Or Brain With And Without Contrast	23	20	$194.00	$194.00	$86.85	$650.00	$150.00	2025-04-10
70460	CPT	Cat Scan Of Head Or Brain With Contrast	23	20	$194.00	$194.00	$79.24	$325.00	$150.00	2025-04-10
72192	CPT	Cat Scan Of Pelvis Without Contrast	23	20	$194.00	$194.00	$67.73	$300.00	$150.00	2025-04-10
72128	CPT	Cat Scan Of Mid Spine Without Contrast	23	20	$194.00	$194.00	$74.40	$300.00	$150.00	2025-04-10
70490	CPT	Cat Scan Of Soft Tissue Of The Neck Without Contrast	23	20	$194.00	$194.00	$82.79	$300.00	$138.95	2025-04-10
70486	CPT	Cat Scan Of Facial Bones Without Contrast	23	20	$194.00	$194.00	$75.49	$300.00	$138.75	2025-04-10
71250	CPT	Cat Scan Of Chest Without Contrast	23	20	$194.00	$194.00	$72.95	$300.00	$138.75	2025-04-10
70480	CPT	Cat Scan Of Eye, Ear, Or Sella Turcica Without Contrast	23	20	$194.00	$194.00	$86.74	$300.00	$138.75	2025-04-10
70450	CPT	Cat Scan Of Head Or Brain Without Contrast	23	20	$194.00	$194.00	$58.42	$300.00	$137.50	2025-04-10
72125	CPT	Cat Scan Of Neck Spine Without Contrast	23	20	$194.00	$194.00	$74.73	$300.00	$137.50	2025-04-10
72131	CPT	Cat Scan Of Lower Spine Without Contrast	23	20	$194.00	$194.00	$72.68	$300.00	$137.50	2025-04-10
76700	CPT	Complete Ultrasound Of Abdomen	23	20	$47.00	$47.00	$37.50	$125.00	$67.21	2025-04-10
76805	CPT	External Ultrasound Of Pregnant Uterus In 2nd Or 3rd Trimester	23	20	$47.00	$47.00	$35.00	$125.00	$65.16	2025-04-10
76830	CPT	Ultrasound Of Non-pregnant Uterus	23	20	$65.00	$65.00	$29.96	$125.00	$50.00	2025-04-10
84402	CPT	Lab Test - Free Testosterone Level	23	20	$380.00	$380.00	$35.57	$170.00	$40.00	2025-04-10
84403	CPT	Lab Test - Total Testosterone Level	23	20	$119.00	$119.00	$30.00	$75.50	$37.00	2025-04-10
70390	CPT	X-ray Of Salivary Gland With Contrast Injection	23	20	$98.00	$98.00	$10.50	$100.00	$35.00	2025-04-10
82672	CPT	Lab Test - Estrogen Hormone Level	23	20	$71.00	$71.00	$23.00	$70.00	$31.07	2025-04-10
84146	CPT	Lab Test - Prolactin Hormone Level	23	20	$50.00	$50.00	$27.08	$62.25	$30.00	2025-04-10
84153	CPT	Lab Test - Total Prostate Specific Antigen Level	23	20	$35.00	$35.00	$22.00	$58.00	$30.00	2025-04-10
83001	CPT	Lab Test - Fsh Hormone Level	23	20	$83.00	$83.00	$25.31	$60.00	$29.00	2025-04-10
72052	CPT	X-ray Of Neck, 6 Or More Views	23	20	$157.00	$157.00	$16.80	$55.00	$26.72	2025-04-10
83002	CPT	Lab Test - Lh Hormone Level	23	20	$74.00	$74.00	$25.00	$40.00	$26.53	2025-04-10
72114	CPT	X-ray Of Lower Back, Minimum Of 6 Views	23	20	$81.00	$81.00	$16.00	$64.00	$26.23	2025-04-10
84443	CPT	Lab Test - Thyroid Stimulating Hormone Level	23	20	$83.00	$83.00	$20.75	$41.63	$25.00	2025-04-10
85306	CPT	Lab Test - Measurement Of Free Protein S Blood Clotting Inhibitor Level	23	20	$253.00	$253.00	$14.01	$125.00	$25.00	2025-04-10
80164	CPT	Lab Test - Total Valproic Acid Level	23	20	$86.00	$86.00	$18.93	$50.00	$25.00	2025-04-10
80061	CPT	Lab Test - Cholesterol Panel	23	20	$187.00	$187.00	$18.72	$60.00	$25.00	2025-04-10
82533	CPT	Lab Test - Cortisol Hormone Level	23	20	$83.00	$83.00	$22.78	$45.00	$25.00	2025-04-10
84702	CPT	Lab Test - Pregnancy Hormone Level	23	20	$75.00	$75.00	$21.00	$54.75	$23.89	2025-04-10
72074	CPT	X-ray Of Mid Back, 4 Or More Views	23	20	$50.00	$50.00	$15.00	$39.00	$23.61	2025-04-10
72110	CPT	X-ray Of Lower Back, Minimum Of 4 Views	23	20	$134.00	$134.00	$14.35	$48.00	$23.38	2025-04-10
80162	CPT	Lab Test - Total Digoxin Level	23	20	$40.00	$40.00	$18.55	$40.80	$23.00	2025-04-10
70330	CPT	X-ray Of Both Sides Of Jaw Joint	23	20	$134.00	$134.00	$8.00	$40.00	$22.84	2025-04-10
71111	CPT	X-ray Of Ribs On Both Sides And Chest, 4 Or More Views	23	20	$55.00	$55.00	$12.25	$46.00	$22.08	2025-04-10
72050	CPT	X-ray Of Neck, 4 Or 5 Views	23	20	$134.00	$134.00	$11.90	$41.00	$21.51	2025-04-10
82607	CPT	Lab Test - Vitamin B-12 Level	23	20	$66.00	$66.00	$18.61	$45.50	$21.49	2025-04-10
70260	CPT	X-ray Of Skull Bones, 4 Or More Views	23	20	$123.00	$123.00	$13.30	$47.00	$21.05	2025-04-10
80156	CPT	Lab Test - Total Carbamazepine Level	23	20	$60.00	$60.00	$16.80	$42.75	$21.00	2025-04-10
84630	CPT	Lab Test - Zinc Level	23	20	$53.00	$53.00	$5.00	$60.00	$21.00	2025-04-10
70200	CPT	X-ray Of Both Eyes, 4 Or More Views	23	20	$112.00	$112.00	$11.90	$41.00	$20.60	2025-04-10
80184	CPT	Lab Test - Phenobarbital Level	23	20	$80.00	$80.00	$16.01	$40.00	$20.00	2025-04-10
82330	CPT	Lab Test - Ionized Calcium Level	23	20	$140.00	$140.00	$10.02	$52.00	$19.51	2025-04-10
70150	CPT	X-ray Of Face Bones, 3 Or More Views	23	20	$107.00	$107.00	$11.90	$40.00	$19.03	2025-04-10
71110	CPT	X-ray Of Ribs On Both Sides, 3 Or More Views	23	20	$101.00	$101.00	$11.90	$40.00	$19.01	2025-04-10
80185	CPT	Lab Test - Total Phenytoin Level	23	20	$74.00	$74.00	$15.00	$40.00	$18.99	2025-04-10
72120	CPT	X-ray Of Lower Back, 2-3 Bending Views	23	20	$145.00	$145.00	$9.80	$36.00	$18.57	2025-04-10
83625	CPT	Lab Test - Ldh Enzyme Level	23	20	$44.00	$44.00	$12.53	$45.00	$18.41	2025-04-10
70110	CPT	X-ray Of Jaw, 4 Or More Views	23	20	$134.00	$134.00	$10.50	$40.00	$18.41	2025-04-10
70220	CPT	X-ray Of Paranasal Sinuses, 3 Or More Views	23	20	$123.00	$123.00	$11.90	$40.00	$18.29	2025-04-10
72190	CPT	X-ray Of Pelvis, 3 Or More Views	23	20	$89.00	$89.00	$8.40	$34.00	$18.24	2025-04-10
72202	CPT	X-ray Of Sacroiliac Joints, 3 Or More Views	23	20	$112.00	$112.00	$7.00	$32.00	$17.85	2025-04-10
72080	CPT	X-ray Of Mid/Lower Back Junction	23	20	$89.00	$89.00	$7.70	$34.00	$17.39	2025-04-10
73110	CPT	X-ray Of Wrist, 3 Or More Views	23	20	$78.00	$78.00	$8.40	$32.00	$17.32	2025-04-10
80053	CPT	Lab Test - Comprehensive Metabolic Panel	23	20	$41.00	$41.00	$13.04	$55.00	$17.25	2025-04-10
71101	CPT	X-ray Of Ribs One On Side And Chest, 3 Or More Views	23	20	$44.00	$44.00	$14.00	$35.00	$17.16	2025-04-10
72072	CPT	X-ray Of Mid Back, 3 Views	23	20	$45.00	$45.00	$10.50	$34.00	$17.00	2025-04-10
72100	CPT	X-ray Of Lower Back, 2-3 Views	23	20	$123.00	$123.00	$9.80	$29.00	$17.00	2025-04-10
70250	CPT	X-ray Of Skull Bones, 1-3 Views	23	20	$112.00	$112.00	$7.35	$34.00	$16.83	2025-04-10
70120	CPT	X-ray Of Mastoid Processes Of Skull, 1-3 Views	23	20	$78.00	$78.00	$7.35	$31.00	$16.50	2025-04-10
71130	CPT	X-ray Of Shoulder Joint Without Contrast	23	20	$89.00	$89.00	$9.80	$32.00	$16.48	2025-04-10
73080	CPT	X-ray Of Elbow, 3 Or More Views	23	20	$101.00	$101.00	$8.40	$32.00	$16.00	2025-04-10
73130	CPT	X-ray Of Hand, 3 Or More Views	23	20	$46.00	$46.00	$8.75	$32.00	$15.50	2025-04-10
84165	CPT	Lab Test - Protein Level In Blood	23	20	$30.00	$30.00	$11.86	$30.75	$15.38	2025-04-10
70328	CPT	X-ray Of One Side Of Jaw Joint	23	20	$78.00	$78.00	$5.95	$27.00	$15.32	2025-04-10
73010	CPT	X-ray Of Shoulder Blade	23	20	$78.00	$78.00	$7.35	$24.00	$15.32	2025-04-10
71100	CPT	X-ray Of Ribs On One Side, 2 Views	23	20	$89.00	$89.00	$9.80	$31.00	$15.09	2025-04-10
84703	CPT	Lab Test - Pregnancy Hormone Identification	23	20	$50.00	$50.00	$10.24	$25.00	$15.00	2025-04-10
83718	CPT	Lab Test - Hdl Cholesterol Level	23	20	$47.00	$47.00	$11.44	$24.00	$15.00	2025-04-10
72070	CPT	X-ray Of Mid Back, 2 Views	23	20	$89.00	$89.00	$7.35	$33.00	$14.78	2025-04-10
72040	CPT	X-ray Of Neck, 2 Or 3 Views	23	20	$78.00	$78.00	$7.35	$32.00	$14.65	2025-04-10
70030	CPT	X-ray Of Eye To Detect Foreign Body	23	20	$78.00	$78.00	$8.40	$32.00	$14.62	2025-04-10
73100	CPT	X-ray Of Wrist, 2 Views	23	20	$67.00	$67.00	$7.35	$26.00	$14.57	2025-04-10
73030	CPT	X-ray Of Shoulder, 2 Or More Views	23	20	$101.00	$101.00	$8.40	$29.00	$14.50	2025-04-10
73060	CPT	X-ray Of Upper Arm	23	20	$78.00	$78.00	$7.35	$29.00	$14.39	2025-04-10
73092	CPT	X-ray Of Baby's Arm	23	20	$46.00	$46.00	$10.43	$26.00	$14.23	2025-04-10
73140	CPT	X-ray Of Fingers	23	20	$67.00	$67.00	$4.90	$27.21	$14.00	2025-04-10
73000	CPT	X-ray Of Collarbone	23	20	$67.00	$67.00	$4.20	$27.00	$14.00	2025-04-10
70210	CPT	X-ray Of Paranasal Sinuses, 1-2 Views	23	20	$112.00	$112.00	$7.35	$30.00	$13.87	2025-04-10
82180	CPT	Lab Test - Vitamin C Level	23	20	$66.00	$66.00	$13.00	$100.00	$13.81	2025-04-10
70140	CPT	X-ray Of Face Bones, 1-2 Views	23	20	$89.00	$89.00	$7.35	$31.00	$13.77	2025-04-10
73120	CPT	X-ray Of Hand, 2 Views	23	20	$67.00	$67.00	$7.35	$26.00	$13.69	2025-04-10
71120	CPT	X-ray Of Breastbone	23	20	$89.00	$89.00	$7.35	$27.00	$13.62	2025-04-10
80076	CPT	Lab Test - Liver Function Panel	23	20	$267.00	$267.00	$9.15	$35.00	$13.60	2025-04-10
70160	CPT	X-ray Of Nose Bones	23	20	$76.00	$76.00	$7.35	$27.00	$13.50	2025-04-10
73090	CPT	X-ray Of Lower Arm	23	20	$67.00	$67.00	$7.35	$27.00	$13.50	2025-04-10
72170	CPT	X-ray Of Pelvis, 1-2 Views	23	20	$67.00	$67.00	$5.25	$27.00	$13.50	2025-04-10
82575	CPT	Lab Test - Calculation Of Creatinine Clearance	23	20	$66.00	$66.00	$8.00	$23.13	$13.20	2025-04-10
73070	CPT	X-ray Of Elbow , 2 Views	23	20	$67.00	$67.00	$7.35	$26.00	$13.00	2025-04-10
72220	CPT	X-ray Of Tailbone	23	20	$89.00	$89.00	$6.30	$25.50	$12.99	2025-04-10
70360	CPT	X-ray Of Soft Tissue Of The Neck	23	20	$60.00	$60.00	$4.90	$24.00	$12.75	2025-04-10
80069	CPT	Lab Test - Kidney Function Panel	23	20	$21.00	$21.00	$11.48	$53.00	$12.21	2025-04-10
72020	CPT	X-ray Of Back, Single View	23	20	$46.00	$46.00	$8.00	$24.00	$11.16	2025-04-10
73020	CPT	X-ray Of Shoulder, 1 View	23	20	$56.00	$56.00	$4.90	$25.00	$10.03	2025-04-10
84479	CPT	Lab Test - Thyroid Hormone Uptake Analysis	23	20	$33.00	$33.00	$8.84	$15.00	$10.00	2025-04-10
84436	CPT	Lab Test - Total Thyroxine Level	23	20	$35.00	$35.00	$9.00	$20.00	$9.84	2025-04-10
81025	CPT	Lab Test - Urine Pregnancy Test	23	20	$20.00	$20.00	$7.00	$13.00	$9.06	2025-04-10
83540	CPT	Lab Test - Iron Level	23	20	$33.00	$33.00	$7.00	$14.00	$9.05	2025-04-10
83690	CPT	Lab Test - Lipase Enzyme Level	23	20	$39.00	$39.00	$6.00	$15.00	$8.49	2025-04-10
82340	CPT	Lab Test - Calcium Level In Urine	23	20	$27.00	$27.00	$6.00	$15.00	$8.43	2025-04-10
84460	CPT	Lab Test - Sgpt Enzyme Level	23	20	$25.00	$25.00	$7.00	$11.03	$7.58	2025-04-10
84075	CPT	Lab Test - Total Alkaline Phosphatase Level	23	20	$15.00	$15.00	$6.00	$11.10	$7.41	2025-04-10
84450	CPT	Lab Test - Sgot Enzyme Level	23	20	$25.00	$25.00	$7.00	$10.18	$7.41	2025-04-10
82310	CPT	Lab Test - Total Calcium Level In Blood	23	20	$27.00	$27.00	$6.00	$23.10	$7.39	2025-04-10
84295	CPT	Lab Test - Sodium Level In Blood Or Plasma Sample	23	20	$30.00	$30.00	$6.00	$8.00	$7.05	2025-04-10
84300	CPT	Lab Test - Sodium Level In Urine Sample	23	20	$30.00	$30.00	$6.00	$8.00	$6.96	2025-04-10
82465	CPT	Lab Test - Total Cholesterol Level	23	20	$30.00	$30.00	$5.00	$10.00	$6.24	2025-04-10
85345	CPT	Lab Test - Measurement Of Blood Clot Formation Time Using Lee And White Method	23	20	$33.00	$33.00	$3.00	$7.00	$6.01	2025-04-10
85660	CPT	Lab Test - Screening For Sickle Cell Anemia	23	20	$28.00	$28.00	$3.00	$25.00	$5.85	2025-04-10
84520	CPT	Lab Test - Urea Nitrogen Level In Blood	23	20	$15.00	$15.00	$5.00	$10.00	$5.83	2025-04-10
84155	CPT	Lab Test - Total Protein Level In Blood	23	20	$15.00	$15.00	$4.00	$10.00	$5.63	2025-04-10
82947	CPT	Lab Test - Glucose Level In Blood	23	20	$25.00	$25.00	$5.00	$8.00	$5.62	2025-04-10
85002	CPT	Lab Test - Bleeding Time	23	20	$25.00	$25.00	$2.00	$12.00	$5.00	2025-04-10
85008	CPT	Lab Test - Examination Of White Blood Cells Using Microscope	23	20	$10.00	$10.00	$3.00	$17.00	$4.93	2025-04-10
82270	CPT	Lab Test - Identification Of Hidden Blood In Stool Sample Using Chemical Reagent…	23	20	$25.00	$25.00	$3.00	$24.00	$4.66	2025-04-10
85014	CPT	Lab Test - Red Blood Cell Volume	23	20	$7.00	$7.00	$3.00	$6.55	$3.39	2025-04-10
85018	CPT	Lab Test - Hemoglobin Blood Count	23	20	$25.00	$25.00	$2.00	$6.55	$3.39	2025-04-10
82652	CPT	Lab Test - Vitamin D Level	22	19	$196.00	$196.00	$52.44	$195.00	$74.28	2025-04-10
86360	CPT	Lab Test - Measurement Of Cd4 And Cd8 White Blood T Cells With Ratio	22	19	$333.00	$333.00	$40.00	$130.25	$67.30	2025-04-10
82306	CPT	Lab Test - Vitamin D-3 Level	22	19	$130.00	$130.00	$36.55	$150.00	$65.00	2025-04-10
82024	CPT	Lab Test - Pituitary Hormone Level	22	19	$333.00	$333.00	$52.00	$140.00	$57.77	2025-04-10
84207	CPT	Lab Test - Vitamin B-6 Level	22	19	$248.00	$248.00	$39.25	$150.00	$56.06	2025-04-10
84260	CPT	Lab Test - Serotonin Hormone Level	22	19	$187.00	$187.00	$24.53	$140.00	$49.89	2025-04-10
83498	CPT	Lab Test - Hydroxyprogestone 17-d Level	22	19	$246.00	$246.00	$37.95	$100.00	$49.23	2025-04-10
82670	CPT	Lab Test - Estradiol Hormone Level	22	19	$243.00	$243.00	$38.06	$76.00	$44.75	2025-04-10
85220	CPT	Lab Test - Measurement Of Blood Clotting Factor V	22	19	$161.00	$161.00	$24.66	$210.00	$39.32	2025-04-10
84446	CPT	Lab Test - Vitamin E Level	22	19	$160.00	$160.00	$19.81	$65.00	$39.20	2025-04-10
84590	CPT	Lab Test - Vitamin A Level	22	19	$50.00	$50.00	$16.20	$75.74	$36.27	2025-04-10
84425	CPT	Lab Test - Vitamin B-1 Level	22	19	$140.00	$140.00	$29.67	$90.00	$36.23	2025-04-10
82677	CPT	Lab Test - Estriol Hormone Level	22	19	$253.00	$253.00	$30.00	$65.00	$35.98	2025-04-10
85240	CPT	Lab Test - Measurement Of Blood Clotting Factor Viii Deficiency	22	19	$83.00	$83.00	$12.53	$125.00	$34.40	2025-04-10
85250	CPT	Lab Test - Measurement Of Blood Clotting Factor Ix	22	19	$83.00	$83.00	$26.53	$125.00	$33.00	2025-04-10
84144	CPT	Lab Test - Progesterone Hormone Level	22	19	$116.00	$116.00	$25.00	$65.00	$32.41	2025-04-10
84481	CPT	Lab Test - Free T3 Thyroid Hormone Level	22	19	$333.00	$333.00	$23.07	$115.00	$28.82	2025-04-10
84154	CPT	Lab Test - Free Prostate Specific Antigen Level	22	19	$160.00	$160.00	$13.17	$145.00	$26.34	2025-04-10
84482	CPT	Lab Test - Reverse T3 Thyroid Hormone Level	22	19	$140.00	$140.00	$5.51	$100.00	$23.51	2025-04-10
85300	CPT	Lab Test - Measurement Of Antithrombin Iii Blood Clotting Inhibitor Activity	22	19	$126.00	$126.00	$12.53	$125.00	$23.38	2025-04-10
84432	CPT	Lab Test - Thyroglobulin Hormone Level	22	19	$82.00	$82.00	$22.00	$175.00	$23.14	2025-04-10
84480	CPT	Lab Test - Total T3 Thyroid Hormone Level	22	19	$60.00	$60.00	$19.31	$45.00	$21.93	2025-04-10
85305	CPT	Lab Test - Measurement Of Total Protein S Blood Clotting Inhibitor Level	22	19	$131.00	$131.00	$14.25	$126.24	$20.46	2025-04-10
82728	CPT	Lab Test - Ferritin Level	22	19	$53.00	$53.00	$17.00	$40.30	$19.27	2025-04-10
85302	CPT	Lab Test - Measurement Of Protein C Blood Clotting Inhibitor Antigen	22	19	$126.00	$126.00	$16.80	$77.00	$17.80	2025-04-10
83036	CPT	Lab Test - Hemoglobin A1c Level	22	19	$50.00	$50.00	$13.56	$30.00	$14.80	2025-04-10
84439	CPT	Lab Test - Free Thyroxine Level	22	19	$57.00	$57.00	$10.00	$37.75	$14.19	2025-04-10
83721	CPT	Lab Test - Ldl Cholesterol Level	22	19	$30.00	$30.00	$13.33	$30.00	$13.66	2025-04-10
80048	CPT	Lab Test - Basic Metabolic Panel With Total Calcium	22	19	$33.00	$33.00	$9.15	$40.00	$12.00	2025-04-10
85025	CPT	Lab Test - Complete Blood Cell Count With White Blood Cell Percentage	22	19	$27.00	$27.00	$8.00	$11.14	$9.88	2025-04-10
85730	CPT	Lab Test - Thromboplastin Time	22	19	$30.00	$30.00	$8.00	$14.00	$8.60	2025-04-10
85670	CPT	Lab Test - Thrombin Clotting Time Test	22	19	$112.00	$112.00	$4.00	$16.88	$8.27	2025-04-10
82248	CPT	Lab Test - Direct Bilirubin Level	22	19	$53.00	$53.00	$7.02	$10.18	$8.00	2025-04-10
85610	CPT	Lab Test - Measurement Of Prothrombin Time	22	19	$20.00	$20.00	$4.85	$12.00	$7.78	2025-04-10
82570	CPT	Lab Test - Creatinine Level In Sample Other Than Blood	22	19	$33.00	$33.00	$5.00	$12.10	$7.23	2025-04-10
82247	CPT	Lab Test - Total Bilirubin Level	22	19	$33.00	$33.00	$5.00	$24.00	$7.19	2025-04-10
86361	CPT	Lab Test - Measurement Of Cd4 White Blood T Cells	21	18	$56.00	$56.00	$36.47	$69.38	$38.35	2025-04-10
85247	CPT	Lab Test - Measurement Of Blood Clotting Factors Viii And Von Willebrand	21	18	$220.00	$220.00	$12.53	$250.00	$32.06	2025-04-10
85246	CPT	Lab Test - Measurement Of Blood Clotting Factor Von Willebrand Antigen	21	18	$199.00	$199.00	$12.53	$150.00	$32.00	2025-04-10
84252	CPT	Lab Test - Vitamin B-2 Level	21	19	$247.00	$247.00	$14.50	$225.00	$28.99	2025-04-10
85293	CPT	Lab Test - Measurement Of Blood Clotting Factor, Fitzgerald Assay	21	18	$250.00	$250.00	$14.00	$140.00	$27.13	2025-04-10
85280	CPT	Lab Test - Measurement Of Blood Clotting Factor Xii	21	18	$195.00	$195.00	$25.27	$100.00	$27.04	2025-04-10
82239	CPT	Lab Test - Bile Acids Level	21	18	$130.00	$130.00	$20.00	$60.00	$23.94	2025-04-10
85303	CPT	Lab Test - Measurement Of Protein C Blood Clotting Inhibitor Activity	21	18	$206.00	$206.00	$17.50	$150.00	$19.81	2025-04-10
80197	CPT	Lab Test - Tacrolimus Level	21	18	$190.00	$190.00	$9.83	$170.00	$19.66	2025-04-10
83719	CPT	Lab Test - Vldl Cholesterol Level	21	18	$96.00	$96.00	$10.00	$25.63	$16.26	2025-04-10
82157	CPT	Lab Test - Androstenedione Hormone Levels	20	17	$300.00	$300.00	$40.90	$125.00	$45.97	2025-04-10
82679	CPT	Lab Test - Estrone Hormone Level	20	17	$270.00	$270.00	$34.88	$112.74	$37.88	2025-04-10
85301	CPT	Lab Test - Measurement Of Antithrombin Iii Blood Clotting Inhibitor Level	20	18	$95.00	$95.00	$7.75	$75.00	$15.49	2025-04-10
85379	CPT	Lab Test - Quantitative D-dimer Test	20	18	$180.00	$180.00	$7.74	$180.00	$14.20	2025-04-10
72200	CPT	X-ray Of Sacroiliac Joints, 1-2 Views	20	19	$67.00	$67.00	$4.20	$27.00	$13.25	2025-04-10
85362	CPT	Lab Test - Measurement Of Blood Clot Dissolving Activity Using Agglutination Sli…	20	17	$56.00	$56.00	$9.62	$40.00	$10.93	2025-04-10
85045	CPT	Lab Test - Immature Red Blood Cell Count	20	18	$17.00	$17.00	$2.87	$10.00	$5.67	2025-04-10
74177	CPT	Cat Scan Of Abdomen And Pelvis With Contrast	19	16	$585.00	$585.00	$143.52	$467.50	$225.00	2025-04-10
84152	CPT	Lab Test - Direct Measurement Of Prostate Specific Antigen Level	19	17	$166.00	$166.00	$13.17	$100.00	$26.34	2025-04-10
84597	CPT	Lab Test - Vitamin K Level	19	16	$189.00	$189.00	$17.00	$210.00	$19.63	2025-04-10
80186	CPT	Lab Test - Free Phenytoin Level	19	17	$91.00	$91.00	$16.80	$65.00	$17.00	2025-04-10
85613	CPT	Lab Test - Measurement Of Blood Clotting Factor X Using Diluted Russell Viper Ve…	19	17	$93.00	$93.00	$5.55	$75.00	$12.38	2025-04-10
84156	CPT	Lab Test - Total Protein Level In Urine	19	16	$18.00	$18.00	$2.63	$30.00	$5.25	2025-04-10
81001	CPT	Lab Test - Machine Analysis Of Urine By Dipstick With Microscope Evaluation	19	16	$15.00	$15.00	$4.32	$8.00	$4.54	2025-04-10
80201	CPT	Lab Test - Topiramate Level	18	16	$175.00	$175.00	$8.54	$125.00	$17.07	2025-04-10
70545	CPT	MRI Of Blood Vessels Of Head With Contrast	17	14	$552.00	$552.00	$153.64	$650.00	$312.50	2025-04-10
70548	CPT	MRI Of Blood Vessels Of Neck With Contrast	17	14	$552.00	$552.00	$164.35	$650.00	$312.50	2025-04-10
84166	CPT	Lab Test - Protein Level In Body Fluid Other Than Blood	17	14	$45.00	$45.00	$12.77	$54.00	$25.54	2025-04-10
71045	CPT	X-ray Of Chest, 1 View	17	14	$56.00	$56.00	$4.90	$38.08	$12.14	2025-04-10
82274	CPT	Lab Test - Identification Of Hidden Blood In Stool Using Immunoassay	16	13	$46.00	$46.00	$9.00	$25.00	$22.78	2025-04-10
97110	CPT	Individual Physical Therapy Exercises	16	14	$38.00	$38.00	$12.00	$25.56	$20.78	2025-04-10
70547	CPT	MRI Of Blood Vessels Of Neck Without Contrast	15	12	$552.00	$552.00	$139.89	$650.00	$325.00	2025-04-10
71046	CPT	X-ray Of Chest, 2 Views	15	12	$78.00	$78.00	$7.35	$25.00	$13.93	2025-04-10
70554	CPT	Mapping Of Functional Brain Activity Using MRI	14	11	$552.00	$552.00	$169.31	$650.00	$341.12	2025-04-10
72198	CPT	MRI Of Blood Vessels Of Pelvis	14	11	$552.00	$552.00	$160.74	$650.00	$325.00	2025-04-10
81000	CPT	Lab Test - Manual Analysis Of Urine By Dipstick With Microscope Evaluation	14	13	$8.00	$8.00	$4.02	$7.75	$4.54	2025-04-10
81002	CPT	Lab Test - Manual Analysis Of Urine By Dipstick	14	13	$4.00	$4.00	$3.30	$4.00	$3.66	2025-04-10
43239	CPT	Exam Of Esophagus, Stomach, And Upper Small Intestine With Biopsy Using Endoscop…	13	10	$130.00	$130.00	$88.00	$405.48	$127.00	2025-04-10
77066	CPT	Diagnostic Mammogram Of Both Breasts	13	10	$122.00	$122.00	$37.50	$123.61	$85.20	2025-04-10
77067	CPT	Screening Mammogram	13	10	$110.00	$110.00	$32.50	$102.22	$67.00	2025-04-10
77065	CPT	Diagnostic Mammogram Of One Breast	13	10	$110.00	$110.00	$25.00	$96.79	$66.75	2025-04-10
70546	CPT	MRI Of Blood Vessels Of Head With And Without Contrast	12	9	$552.00	$552.00	$176.86	$650.00	$341.12	2025-04-10
71048	CPT	X-ray Of Chest, 4 Or More Views	12	9	$157.00	$157.00	$20.00	$71.50	$27.21	2025-04-10
71047	CPT	X-ray Of Chest, 3 Views	12	9	$67.00	$67.00	$17.48	$41.50	$25.56	2025-04-10
71275	CPT	Cat Scan Of Blood Vessels In Chest With Contrast	11	9	$194.00	$194.00	$140.99	$330.00	$230.22	2025-04-10
85397	CPT	Lab Test - Evaluation Of Blood Clotting Or Dissolving Function	10	10	$350.00	$350.00	$32.29	$37.00	$32.29	2025-04-10
72191	CPT	Cat Scan Of Blood Vessels Of Pelvis With Contrast	9	7	$194.00	$194.00	$146.91	$330.00	$203.22	2025-04-10
70498	CPT	Cat Scan Of Blood Vessels In Neck With Contrast	8	7	$194.00	$194.00	$123.00	$330.00	$206.37	2025-04-10
43235	CPT	Diagnostic Exam Of Esophagus, Stomach And Small Bowel Using Endoscope Inserted T…	7	6	$120.00	$120.00	$88.00	$454.04	$166.00	2025-04-10
45380	CPT	Exam Of Entire Large Intestine With Biopsy Using Colonoscope	6	6	$410.00	$410.00	$125.00	$569.40	$166.00	2025-04-10
99203	CPT	Outpatient Clinic Visit New Patient Level 3	2	2	$85.00	$85.00	$60.00	$114.10	$87.05	2025-04-10
70496	CPT	Cat Scan Of Blood Vessels In Head With Contrast	1	1	$194.00	$194.00	$210.25	$210.25	$210.25	2025-04-10

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