Hospital

HOSPITAL PEREA

Mayaguez, PR · CCN 400123 · Rates published

264 distinct procedures filed

21 distinct payers

6,563 rate rows

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

Data quality

6,560 of 6,563 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	3

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old.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=824CCE7B-104A-4E56-86AE-8F03861803BD
Found on page	https://hpt.inmediata.com/index?h=824CCE7B-104A-4E56-86AE-8F03861803BD
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	656279b105fbcad3… · 907,298 bytes · first seen 2026-05-05

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
74183 CPT	MRI Of Abdomen With And Without Contrast	19	$112.83	$1,300.00	$302.72	nat. median $1,101 outlier · 0.3×
77061 CPT	Digital Imaging Of Breasts To Produce 3d Images	1	$300.75	$300.75	$300.75	nat. median $97 outlier · 3.1×
77062 CPT	Digital Imaging Of Breasts To Produce 3d Images	1	$300.75	$300.75	$300.75	nat. median $113 outlier · 2.7×
74182 CPT	MRI Of Abdomen With Contrast	19	$89.04	$650.00	$294.12	nat. median $990 outlier · 0.3×
70543 CPT	MRI Of Face Or Neck With And Without Contrast	18	$109.59	$1,300.00	$292.49	nat. median $1,077 outlier · 0.3×
77049 CPT	MRI Of Both Breasts With And Without Contrast	13	$117.65	$750.00	$288.47	nat. median $958 outlier · 0.3×
72197 CPT	MRI Of Pelvis With And Without Contrast	18	$112.83	$1,300.00	$287.50	nat. median $1,064 outlier · 0.3×
73221 CPT	MRI Of Arm Without Contrast	19	$69.76	$650.00	$282.81	nat. median $879 outlier · 0.3×
73218 CPT	MRI Of Arm Without Contrast	19	$69.76	$650.00	$282.81	nat. median $896 outlier · 0.3×
72157 CPT	MRI Of Middle Spinal Canal With And Without Contrast	20	$102.14	$1,300.00	$273.32	nat. median $1,093 outlier · 0.3×
72156 CPT	MRI Of Upper Spinal Canal With And Without Contrast	20	$101.96	$1,300.00	$272.60	nat. median $1,092 outlier · 0.2×
72158 CPT	MRI Of Lower Spinal Canal With And Without Contrast	20	$101.79	$1,300.00	$271.51	nat. median $1,080 outlier · 0.3×
72196 CPT	MRI Of Pelvis With Contrast	20	$89.04	$650.00	$271.31	nat. median $953 outlier · 0.3×
70553 CPT	MRI Of Brain With And Without Contrast	20	$101.52	$1,300.00	$271.25	nat. median $1,122 outlier · 0.2×
70542 CPT	MRI Of Face Or Neck With Contrast	19	$83.28	$650.00	$268.26	nat. median $905 outlier · 0.3×
72149 CPT	MRI Of Lower Spinal Canal With Contrast	20	$85.69	$775.00	$265.63	nat. median $970 outlier · 0.3×
78452 CPT	Multiple Spect Scans Of Heart Muscle	16	$105.30	$600.00	$260.56	nat. median $1,765 outlier · 0.1×
72148 CPT	MRI Of Lower Spinal Canal Without Contrast	20	$60.36	$650.00	$260.00	nat. median $770 outlier · 0.3×
70551 CPT	MRI Of Brain Without Contrast	20	$62.26	$650.00	$260.00	nat. median $772 outlier · 0.3×
73718 CPT	MRI Of Leg Not Including Joint Without Contrast	19	$69.58	$650.00	$257.52	nat. median $916 outlier · 0.3×
43239 CPT	Exam Of Esophagus, Stomach, And Upper Small Intestine With Biopsy Using Endoscop…	2	$200.00	$314.81	$257.40	nat. median $1,377 outlier · 0.2×
72142 CPT	MRI Of Upper Spinal Canal With Contrast	20	$86.66	$775.00	$250.58	nat. median $958 outlier · 0.3×
70552 CPT	MRI Of Brain With Contrast	20	$85.39	$5,752.00	$250.28	nat. median $959 outlier · 0.3×
74181 CPT	MRI Of Abdomen Without Contrast	20	$74.99	$650.00	$250.08	nat. median $820 outlier · 0.3×
72195 CPT	MRI Of Pelvis Without Contrast	18	$74.99	$650.00	$243.75	nat. median $787 outlier · 0.3×
73721 CPT	MRI Of Leg Joint Without Contrast	20	$63.23	$650.00	$243.75	nat. median $899 outlier · 0.3×
72146 CPT	MRI Of Middle Spinal Canal Without Contrast	20	$60.62	$650.00	$243.75	nat. median $772 outlier · 0.3×
72141 CPT	MRI Of Upper Spinal Canal Without Contrast	20	$60.62	$650.00	$243.75	nat. median $765 outlier · 0.3×
70544 CPT	MRI Of Blood Vessels Of Head Without Contrast	14	$61.64	$700.00	$234.17	nat. median $816 outlier · 0.3×
78227 CPT	Nuclear Medicine Study Of Liver And Bile Ducts	12	$45.78	$431.00	$214.69	nat. median $940 outlier · 0.2×
78803 CPT	Spect Scan To Locate Tumor Or Infection	15	$52.98	$350.00	$188.52	nat. median $1,373 outlier · 0.1×
74178 CPT	Cat Scan Of Abdomen And Pelvis With And Without Contrast	12	$94.49	$450.00	$187.93	nat. median $977 outlier · 0.2×
74174 CPT	Cat Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	5	$143.53	$301.92	$175.53	nat. median $958 outlier · 0.2×
78278 CPT	Nuclear Medicine Study Of Blood Or Protein Loss In The Digestive Tract	18	$50.11	$420.00	$171.81	nat. median $695 outlier · 0.2×
78018 CPT	Whole Body Nuclear Medicine Study To Determine Spread Of Thyroid Cancer	18	$42.17	$495.00	$170.63	nat. median $782 outlier · 0.2×
78315 CPT	Nuclear Medicine Study Of Bones And/or Joints With Delayed Images In 3 Phases	19	$51.19	$495.00	$169.06	nat. median $801 outlier · 0.2×
74177 CPT	Cat Scan Of Abdomen And Pelvis With Contrast	13	$83.47	$450.00	$167.44	nat. median $928 outlier · 0.2×
70492 CPT	Cat Scan Of Soft Tissue Of The Neck With And Without Contrast	20	$73.99	$325.00	$159.47	nat. median $633 outlier · 0.3×
71270 CPT	Cat Scan Of Chest With And Without Contrast	20	$70.92	$650.00	$158.60	nat. median $661 outlier · 0.2×
78195 CPT	Nuclear Medicine Study Of Lymph Nodes	17	$60.19	$350.00	$157.31	nat. median $832 outlier · 0.2×
78802 CPT	Nuclear Medicine Study To Locate Tumor Or Infection With Whole Body Imaging Comp…	18	$42.54	$375.00	$153.17	nat. median $1,341 outlier · 0.1×
78264 CPT	Nuclear Medicine Study Of Stomach Emptying	18	$39.65	$450.00	$149.85	nat. median $708 outlier · 0.2×
74160 CPT	Cat Scan Of Abdomen With Contrast	20	$61.63	$300.00	$146.88	nat. median $645 outlier · 0.2×
71275 CPT	Cat Scan Of Blood Vessels In Chest With Contrast	12	$14.00	$300.00	$146.71	nat. median $735 outlier · 0.2×
73706 CPT	Cat Scan Of Blood Vessels Of Leg With Contrast	12	$60.62	$400.00	$145.91	nat. median $760 outlier · 0.2×
72193 CPT	Cat Scan Of Pelvis With Contrast	20	$59.84	$300.00	$145.30	nat. median $629 outlier · 0.2×
78306 CPT	Nuclear Medicine Study Of Bones And/or Joints In Whole Body	19	$67.71	$495.00	$143.84	nat. median $737 outlier · 0.2×
70491 CPT	Cat Scan Of Soft Tissue Of The Neck With Contrast	20	$63.23	$300.00	$142.50	nat. median $617 outlier · 0.2×
70487 CPT	Cat Scan Of Facial Bones With Contrast	20	$45.70	$300.00	$142.50	nat. median $596 outlier · 0.2×
72194 CPT	Cat Scan Of Pelvis With And Without Contrast	20	$62.73	$650.00	$142.50	nat. median $657 outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 264 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

70552	CPT	MRI Of Brain With Contrast	27	20	$750.00	$750.00	$85.39	$5,752.00	$250.28	2025-04-10
74183	CPT	MRI Of Abdomen With And Without Contrast	26	19	$1,200.00	$1,200.00	$112.83	$1,300.00	$302.72	2025-04-10
70543	CPT	MRI Of Face Or Neck With And Without Contrast	24	18	$770.00	$770.00	$109.59	$1,300.00	$292.49	2025-04-10
72197	CPT	MRI Of Pelvis With And Without Contrast	24	18	$1,200.00	$1,200.00	$112.83	$1,300.00	$287.50	2025-04-10
72157	CPT	MRI Of Middle Spinal Canal With And Without Contrast	27	20	$1,200.00	$1,200.00	$102.14	$1,300.00	$273.32	2025-04-10
72156	CPT	MRI Of Upper Spinal Canal With And Without Contrast	27	20	$1,200.00	$1,200.00	$101.96	$1,300.00	$272.60	2025-04-10
72158	CPT	MRI Of Lower Spinal Canal With And Without Contrast	27	20	$1,200.00	$1,200.00	$101.79	$1,300.00	$271.51	2025-04-10
70553	CPT	MRI Of Brain With And Without Contrast	27	20	$1,200.00	$1,200.00	$101.52	$1,300.00	$271.25	2025-04-10
72149	CPT	MRI Of Lower Spinal Canal With Contrast	27	20	$750.00	$750.00	$85.69	$775.00	$265.63	2025-04-10
72142	CPT	MRI Of Upper Spinal Canal With Contrast	27	20	$750.00	$750.00	$86.66	$775.00	$250.58	2025-04-10
77049	CPT	MRI Of Both Breasts With And Without Contrast	19	13	$825.00	$825.00	$117.65	$750.00	$288.47	2025-04-10
70544	CPT	MRI Of Blood Vessels Of Head Without Contrast	21	14	$700.00	$700.00	$61.64	$700.00	$234.17	2025-04-10
78472	CPT	Single Nuclear Medicine Study To Evaluate Blood Ejection From The Heart During S…	24	17	$140.00	$140.00	$49.39	$690.00	$125.00	2025-04-10
74182	CPT	MRI Of Abdomen With Contrast	26	19	$750.00	$750.00	$89.04	$650.00	$294.12	2025-04-10
73218	CPT	MRI Of Arm Without Contrast	26	19	$650.00	$650.00	$69.76	$650.00	$282.81	2025-04-10
73221	CPT	MRI Of Arm Without Contrast	26	19	$650.00	$650.00	$69.76	$650.00	$282.81	2025-04-10
72196	CPT	MRI Of Pelvis With Contrast	27	20	$750.00	$750.00	$89.04	$650.00	$271.31	2025-04-10
70542	CPT	MRI Of Face Or Neck With Contrast	25	19	$907.50	$907.50	$83.28	$650.00	$268.26	2025-04-10
72148	CPT	MRI Of Lower Spinal Canal Without Contrast	27	20	$650.00	$650.00	$60.36	$650.00	$260.00	2025-04-10
70551	CPT	MRI Of Brain Without Contrast	27	20	$650.00	$650.00	$62.26	$650.00	$260.00	2025-04-10
73718	CPT	MRI Of Leg Not Including Joint Without Contrast	26	19	$650.00	$650.00	$69.58	$650.00	$257.52	2025-04-10
74181	CPT	MRI Of Abdomen Without Contrast	27	20	$650.00	$650.00	$74.99	$650.00	$250.08	2025-04-10
72141	CPT	MRI Of Upper Spinal Canal Without Contrast	27	20	$650.00	$650.00	$60.62	$650.00	$243.75	2025-04-10
72146	CPT	MRI Of Middle Spinal Canal Without Contrast	27	20	$650.00	$650.00	$60.62	$650.00	$243.75	2025-04-10
72195	CPT	MRI Of Pelvis Without Contrast	25	18	$650.00	$650.00	$74.99	$650.00	$243.75	2025-04-10
73721	CPT	MRI Of Leg Joint Without Contrast	27	20	$650.00	$650.00	$63.23	$650.00	$243.75	2025-04-10
71270	CPT	Cat Scan Of Chest With And Without Contrast	27	20	$500.00	$500.00	$70.92	$650.00	$158.60	2025-04-10
74170	CPT	Cat Scan Of Abdomen With And Without Contrast	27	20	$525.00	$525.00	$69.92	$650.00	$142.50	2025-04-10
72194	CPT	Cat Scan Of Pelvis With And Without Contrast	27	20	$500.00	$500.00	$62.73	$650.00	$142.50	2025-04-10
70470	CPT	Cat Scan Of Head Or Brain With And Without Contrast	27	20	$425.00	$425.00	$52.00	$650.00	$140.00	2025-04-10
78452	CPT	Multiple Spect Scans Of Heart Muscle	22	16	$872.85	$872.85	$105.30	$600.00	$260.56	2025-04-10
78580	CPT	Nuclear Medicine Study Of Blood Circulation Through Lungs	24	18	$135.00	$135.00	$37.49	$550.00	$111.94	2025-04-10
78018	CPT	Whole Body Nuclear Medicine Study To Determine Spread Of Thyroid Cancer	25	18	$594.00	$594.00	$42.17	$495.00	$170.63	2025-04-10
78315	CPT	Nuclear Medicine Study Of Bones And/or Joints With Delayed Images In 3 Phases	26	19	$225.00	$225.00	$51.19	$495.00	$169.06	2025-04-10
78306	CPT	Nuclear Medicine Study Of Bones And/or Joints In Whole Body	26	19	$126.00	$126.00	$67.71	$495.00	$143.84	2025-04-10
74178	CPT	Cat Scan Of Abdomen And Pelvis With And Without Contrast	19	12	$500.00	$500.00	$94.49	$450.00	$187.93	2025-04-10
74177	CPT	Cat Scan Of Abdomen And Pelvis With Contrast	20	13	$465.00	$465.00	$83.47	$450.00	$167.44	2025-04-10
78264	CPT	Nuclear Medicine Study Of Stomach Emptying	25	18	$280.94	$280.94	$39.65	$450.00	$149.85	2025-04-10
74176	CPT	Cat Scan Of Abdomen And Pelvis Without Contrast	22	15	$375.00	$375.00	$55.70	$450.00	$129.69	2025-04-10
78227	CPT	Nuclear Medicine Study Of Liver And Bile Ducts	19	12	$140.00	$140.00	$45.78	$431.00	$214.69	2025-04-10
78278	CPT	Nuclear Medicine Study Of Blood Or Protein Loss In The Digestive Tract	25	18	$135.00	$135.00	$50.11	$420.00	$171.81	2025-04-10
85305	CPT	Lab Test - Measurement Of Total Protein S Blood Clotting Inhibitor Level	26	19	$131.00	$131.00	$10.03	$420.00	$16.52	2025-04-10
78014	CPT	Nuclear Medicine Study Of Thyroid With Measurement Of Iodine Uptake	19	13	$189.00	$189.00	$25.23	$413.00	$135.12	2025-04-10
73706	CPT	Cat Scan Of Blood Vessels Of Leg With Contrast	18	12	$621.95	$621.95	$60.62	$400.00	$145.91	2025-04-10
70496	CPT	Cat Scan Of Blood Vessels In Head With Contrast	18	12	$652.08	$652.08	$79.01	$400.00	$138.07	2025-04-10
70498	CPT	Cat Scan Of Blood Vessels In Neck With Contrast	17	12	$550.00	$550.00	$78.74	$400.00	$137.50	2025-04-10
78802	CPT	Nuclear Medicine Study To Locate Tumor Or Infection With Whole Body Imaging Comp…	25	18	$280.00	$280.00	$42.54	$375.00	$153.17	2025-04-10
78803	CPT	Spect Scan To Locate Tumor Or Infection	22	15	$1,020.00	$1,020.00	$52.98	$350.00	$188.52	2025-04-10
78195	CPT	Nuclear Medicine Study Of Lymph Nodes	24	17	$175.00	$175.00	$60.19	$350.00	$157.31	2025-04-10
78708	CPT	Complete Nuclear Medicine Study Of Kidney With Drug Administration	23	16	$150.00	$150.00	$48.67	$350.00	$138.00	2025-04-10
70492	CPT	Cat Scan Of Soft Tissue Of The Neck With And Without Contrast	27	20	$425.00	$425.00	$73.99	$325.00	$159.47	2025-04-10
70450	CPT	Cat Scan Of Head Or Brain Without Contrast	27	20	$315.00	$315.00	$31.73	$325.00	$123.75	2025-04-10
43239	CPT	Exam Of Esophagus, Stomach, And Upper Small Intestine With Biopsy Using Endoscop…	2	2	$175.00	$175.00	$200.00	$314.81	$257.40	2025-04-10
74174	CPT	Cat Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	8	5	$350.00	$350.00	$143.53	$301.92	$175.53	2025-04-10
77062	CPT	Digital Imaging Of Breasts To Produce 3d Images	1	1	$80.00	$80.00	$300.75	$300.75	$300.75	2025-04-10
77061	CPT	Digital Imaging Of Breasts To Produce 3d Images	1	1	$80.00	$80.00	$300.75	$300.75	$300.75	2025-04-10
74160	CPT	Cat Scan Of Abdomen With Contrast	27	20	$465.00	$465.00	$61.63	$300.00	$146.88	2025-04-10
71275	CPT	Cat Scan Of Blood Vessels In Chest With Contrast	19	12	$467.62	$467.62	$14.00	$300.00	$146.71	2025-04-10
72193	CPT	Cat Scan Of Pelvis With Contrast	27	20	$465.00	$465.00	$59.84	$300.00	$145.30	2025-04-10
70491	CPT	Cat Scan Of Soft Tissue Of The Neck With Contrast	27	20	$375.00	$375.00	$63.23	$300.00	$142.50	2025-04-10
70487	CPT	Cat Scan Of Facial Bones With Contrast	27	20	$375.00	$375.00	$45.70	$300.00	$142.50	2025-04-10
71260	CPT	Cat Scan Of Chest With Contrast	27	20	$465.00	$465.00	$61.16	$300.00	$142.50	2025-04-10
74175	CPT	Cat Scan Of Blood Vessels Of Abdomen With Contrast	17	11	$465.00	$465.00	$58.01	$300.00	$140.16	2025-04-10
73200	CPT	Cat Scan Of Arm Without Contrast	27	20	$330.00	$330.00	$43.71	$300.00	$137.50	2025-04-10
73700	CPT	Cat Scan Of Leg Without Contrast	27	20	$330.00	$330.00	$43.71	$300.00	$137.50	2025-04-10
70490	CPT	Cat Scan Of Soft Tissue Of The Neck Without Contrast	27	20	$315.00	$315.00	$48.23	$300.00	$135.18	2025-04-10
74150	CPT	Cat Scan Of Abdomen Without Contrast	27	20	$375.00	$375.00	$41.19	$300.00	$135.00	2025-04-10
71250	CPT	Cat Scan Of Chest Without Contrast	27	20	$390.00	$390.00	$44.05	$300.00	$135.00	2025-04-10
72128	CPT	Cat Scan Of Mid Spine Without Contrast	27	20	$390.00	$390.00	$42.72	$300.00	$135.00	2025-04-10
72192	CPT	Cat Scan Of Pelvis Without Contrast	27	20	$390.00	$390.00	$39.99	$300.00	$135.00	2025-04-10
70486	CPT	Cat Scan Of Facial Bones Without Contrast	27	20	$315.00	$315.00	$37.65	$300.00	$133.11	2025-04-10
72125	CPT	Cat Scan Of Neck Spine Without Contrast	27	20	$390.00	$390.00	$44.86	$300.00	$131.28	2025-04-10
72131	CPT	Cat Scan Of Lower Spine Without Contrast	27	20	$390.00	$390.00	$43.71	$300.00	$130.95	2025-04-10
70460	CPT	Cat Scan Of Head Or Brain With Contrast	27	20	$375.00	$375.00	$44.02	$300.00	$129.94	2025-04-10
70480	CPT	Cat Scan Of Eye, Ear, Or Sella Turcica Without Contrast	27	20	$315.00	$315.00	$48.23	$300.00	$123.75	2025-04-10
78070	CPT	Nuclear Medicine Study Of Parathyroid Gland	25	18	$374.22	$374.22	$30.23	$278.76	$105.81	2025-04-10
78013	CPT	Nuclear Medicine Scan Of Thyroid	19	13	$119.00	$119.00	$17.68	$238.00	$93.50	2025-04-10
85240	CPT	Lab Test - Measurement Of Blood Clotting Factor Viii Deficiency	26	19	$232.00	$232.00	$12.53	$200.00	$34.56	2025-04-10
82652	CPT	Lab Test - Vitamin D Level	26	19	$196.00	$196.00	$33.27	$195.00	$74.28	2025-04-10
80197	CPT	Lab Test - Tacrolimus Level	24	18	$190.00	$190.00	$11.87	$190.00	$25.89	2025-04-10
85246	CPT	Lab Test - Measurement Of Blood Clotting Factor Von Willebrand Antigen	26	19	$177.00	$177.00	$12.53	$177.00	$32.16	2025-04-10
80055	CPT	Lab Test - Panel For Pregnant Patients Without HIV Testing	26	19	$75.00	$75.00	$41.31	$175.00	$55.14	2025-04-10
84402	CPT	Lab Test - Free Testosterone Level	27	20	$70.00	$70.00	$22.02	$170.00	$38.00	2025-04-10
84207	CPT	Lab Test - Vitamin B-6 Level	26	19	$168.00	$168.00	$24.28	$150.00	$63.00	2025-04-10
82088	CPT	Lab Test - Aldosterone Hormone Level	28	21	$75.00	$75.00	$38.86	$146.00	$66.76	2025-04-10
84154	CPT	Lab Test - Free Prostate Specific Antigen Level	26	19	$160.00	$160.00	$15.90	$145.00	$28.17	2025-04-10
84432	CPT	Lab Test - Thyroglobulin Hormone Level	26	19	$82.00	$82.00	$18.45	$140.00	$23.50	2025-04-10
85245	CPT	Lab Test - Measurement Of Blood Clotting Factor Von Willebrand	26	19	$337.50	$337.50	$19.82	$135.00	$42.50	2025-04-10
83970	CPT	Lab Test - Parathyroid Hormone Level	27	20	$154.00	$154.00	$35.67	$130.00	$64.25	2025-04-10
82306	CPT	Lab Test - Vitamin D-3 Level	26	19	$282.00	$282.00	$25.59	$130.00	$59.35	2025-04-10
77066	CPT	Diagnostic Mammogram Of Both Breasts	21	15	$135.42	$135.42	$35.00	$123.61	$60.49	2025-04-10
84481	CPT	Lab Test - Free T3 Thyroid Hormone Level	26	19	$70.00	$70.00	$14.64	$115.00	$25.00	2025-04-10
86361	CPT	Lab Test - Measurement Of Cd4 White Blood T Cells	25	18	$77.00	$77.00	$23.14	$108.00	$38.96	2025-04-10
77067	CPT	Screening Mammogram	21	15	$135.42	$135.42	$14.92	$102.22	$49.41	2025-04-10
76830	CPT	Ultrasound Of Non-pregnant Uterus	27	20	$135.00	$135.00	$32.87	$100.00	$54.38	2025-04-10
76770	CPT	Complete Ultrasound Of Kidneys, Aorta, And Lymph Nodes	27	20	$130.00	$130.00	$30.00	$100.00	$54.16	2025-04-10
76872	CPT	Ultrasound Of Pelvic Cavity Via Rectum	26	19	$100.00	$100.00	$25.90	$100.00	$53.78	2025-04-10
76801	CPT	External Ultrasound Of Pregnant Uterus In 1st Trimester	24	18	$100.00	$100.00	$19.50	$100.00	$50.59	2025-04-10
76700	CPT	Complete Ultrasound Of Abdomen	27	20	$130.00	$130.00	$33.40	$100.00	$50.00	2025-04-10
83498	CPT	Lab Test - Hydroxyprogestone 17-d Level	26	19	$154.00	$154.00	$23.48	$100.00	$49.23	2025-04-10
76817	CPT	Vaginal Ultrasound Of Pregnant Uterus In 1st Trimester	25	18	$100.00	$100.00	$19.50	$100.00	$48.12	2025-04-10
76506	CPT	Ultrasound Of Brain	27	20	$75.00	$75.00	$24.38	$100.00	$45.00	2025-04-10
84403	CPT	Lab Test - Total Testosterone Level	27	20	$45.00	$45.00	$22.31	$100.00	$36.98	2025-04-10
84425	CPT	Lab Test - Vitamin B-1 Level	26	19	$140.00	$140.00	$18.35	$100.00	$32.00	2025-04-10
77065	CPT	Diagnostic Mammogram Of One Breast	21	15	$105.00	$105.00	$25.00	$96.79	$43.25	2025-04-10
84030	CPT	Lab Test - Pku Test	26	20	$126.00	$126.00	$4.75	$95.06	$10.07	2025-04-10
76805	CPT	External Ultrasound Of Pregnant Uterus In 2nd Or 3rd Trimester	27	20	$138.00	$138.00	$30.00	$94.97	$50.18	2025-04-10
76536	CPT	Ultrasound Of Soft Tissue Of Head And Neck	26	19	$135.00	$135.00	$24.38	$91.35	$43.53	2025-04-10
77080	CPT	Measurement Of Bone Density Using Dual-energy X-rays Of Hips, Pelvis, And/or Spi…	22	16	$150.00	$150.00	$10.46	$90.00	$33.29	2025-04-10
76870	CPT	Ultrasound Of Scrotum	27	20	$100.00	$100.00	$18.99	$82.00	$42.00	2025-04-10
87635	CPT	Lab Test - Identification Of Covid-19 Virus DNA Using Amplified Probe Technique	8	7	$120.00	$120.00	$36.67	$80.00	$51.33	2025-04-10
76856	CPT	Complete Ultrasound Of Female Pelvis Unrelated To Pregnancy	27	20	$100.00	$100.00	$23.95	$78.30	$47.50	2025-04-10
76641	CPT	Ultrasound Of Breast	22	15	$135.00	$135.00	$25.35	$76.50	$41.64	2025-04-10
76642	CPT	Ultrasound Of Breast	22	15	$135.00	$135.00	$25.35	$76.50	$41.64	2025-04-10
82670	CPT	Lab Test - Estradiol Hormone Level	26	19	$42.00	$42.00	$24.14	$76.00	$44.75	2025-04-10
82672	CPT	Lab Test - Estrogen Hormone Level	27	20	$71.00	$71.00	$18.75	$75.00	$30.72	2025-04-10
84144	CPT	Lab Test - Progesterone Hormone Level	26	19	$32.00	$32.00	$18.03	$70.00	$29.70	2025-04-10
83001	CPT	Lab Test - Fsh Hormone Level	27	20	$35.00	$35.00	$16.06	$70.00	$27.72	2025-04-10
80061	CPT	Lab Test - Cholesterol Panel	27	20	$96.00	$96.00	$12.77	$70.00	$22.79	2025-04-10
80069	CPT	Lab Test - Kidney Function Panel	27	20	$40.00	$40.00	$7.50	$70.00	$12.30	2025-04-10
80186	CPT	Lab Test - Free Phenytoin Level	25	19	$91.00	$91.00	$7.75	$65.00	$19.23	2025-04-10
82530	CPT	Lab Test - Cortisol Hormone Level	27	20	$84.00	$84.00	$14.26	$62.50	$26.69	2025-04-10
82533	CPT	Lab Test - Cortisol Hormone Level	27	20	$84.00	$84.00	$14.26	$62.50	$26.69	2025-04-10
84146	CPT	Lab Test - Prolactin Hormone Level	27	20	$55.00	$55.00	$18.48	$62.25	$30.00	2025-04-10
82164	CPT	Lab Test - Angiotensin Converting Enzyme Level	27	20	$105.00	$105.00	$12.62	$62.00	$30.48	2025-04-10
86769	CPT	Lab Test - Identification Of Covid-19 Antibody	10	6	$40.00	$40.00	$12.67	$62.00	$25.00	2025-04-10
77075	CPT	X-ray For Complete Bone Evaluation	15	11	$134.00	$134.00	$23.53	$61.62	$37.50	2025-04-10
84702	CPT	Lab Test - Pregnancy Hormone Level	27	20	$45.00	$45.00	$14.36	$60.00	$23.20	2025-04-10
84153	CPT	Lab Test - Total Prostate Specific Antigen Level	26	20	$40.00	$40.00	$21.12	$58.00	$28.59	2025-04-10
80053	CPT	Lab Test - Comprehensive Metabolic Panel	27	20	$45.00	$45.00	$9.13	$55.00	$19.20	2025-04-10
82330	CPT	Lab Test - Ionized Calcium Level	27	20	$70.00	$70.00	$9.00	$52.00	$22.51	2025-04-10
71046	CPT	X-ray Of Chest, 2 Views	20	14	$67.10	$67.10	$7.60	$50.33	$15.78	2025-04-10
84166	CPT	Lab Test - Protein Level In Body Fluid Other Than Blood	22	16	$45.00	$45.00	$15.41	$50.00	$25.09	2025-04-10
84443	CPT	Lab Test - Thyroid Stimulating Hormone Level	27	20	$45.00	$45.00	$14.53	$50.00	$25.00	2025-04-10
82570	CPT	Lab Test - Creatinine Level In Sample Other Than Blood	27	20	$15.00	$15.00	$4.47	$50.00	$6.71	2025-04-10
84157	CPT	Lab Test - Total Protein Level In Body Fluid Other Than Blood Or Urine	25	18	$18.00	$18.00	$3.17	$50.00	$5.84	2025-04-10
82746	CPT	Lab Test - Folic Acid Level	27	20	$35.00	$35.00	$9.75	$46.13	$20.00	2025-04-10
82607	CPT	Lab Test - Vitamin B-12 Level	27	20	$35.00	$35.00	$13.03	$45.50	$21.06	2025-04-10
87426	CPT	Lab Test - Identification Of Covid-19 Virus Using Multiple-step Immunoassay Meth…	11	6	$50.00	$50.00	$29.38	$45.23	$45.23	2025-04-10
84480	CPT	Lab Test - Total T3 Thyroid Hormone Level	26	19	$30.00	$30.00	$12.26	$45.00	$22.00	2025-04-10
80185	CPT	Lab Test - Total Phenytoin Level	27	20	$40.00	$40.00	$11.45	$45.00	$19.00	2025-04-10
83615	CPT	Lab Test - Ldh Enzyme Level	28	21	$98.00	$98.00	$7.17	$42.50	$12.35	2025-04-10
83625	CPT	Lab Test - Ldh Enzyme Level	28	21	$98.00	$98.00	$7.17	$42.50	$12.35	2025-04-10
72110	CPT	X-ray Of Lower Back, Minimum Of 4 Views	27	20	$70.00	$70.00	$13.10	$42.00	$23.09	2025-04-10
80162	CPT	Lab Test - Total Digoxin Level	27	20	$40.00	$40.00	$11.47	$40.80	$23.00	2025-04-10
82728	CPT	Lab Test - Ferritin Level	27	20	$35.00	$35.00	$11.78	$40.30	$18.57	2025-04-10
83002	CPT	Lab Test - Lh Hormone Level	27	20	$35.00	$35.00	$16.00	$40.00	$25.22	2025-04-10
80048	CPT	Lab Test - Basic Metabolic Panel With Total Calcium	27	20	$30.00	$30.00	$7.31	$40.00	$11.98	2025-04-10
72052	CPT	X-ray Of Neck, 6 Or More Views	27	20	$65.00	$65.00	$14.56	$39.00	$25.00	2025-04-10
85384	CPT	Lab Test - Measurement Of Blood Clot Activity	27	20	$20.00	$20.00	$7.34	$38.00	$11.87	2025-04-10
84439	CPT	Lab Test - Free Thyroxine Level	26	19	$25.00	$25.00	$7.79	$37.75	$12.84	2025-04-10
72100	CPT	X-ray Of Lower Back, 2-3 Views	27	20	$50.00	$50.00	$9.37	$37.18	$16.00	2025-04-10
80076	CPT	Lab Test - Liver Function Panel	27	20	$32.00	$32.00	$7.06	$35.00	$12.59	2025-04-10
85732	CPT	Lab Test - Thromboplastin Time With Plasma Substitution	13	10	$462.50	$462.50	$5.59	$35.00	$7.98	2025-04-10
74021	CPT	X-ray Of Abdomen, 3 Or More Views	16	13	$55.00	$55.00	$6.30	$32.00	$20.26	2025-04-10
70260	CPT	X-ray Of Skull Bones, 4 Or More Views	27	20	$81.00	$81.00	$12.42	$31.33	$20.00	2025-04-10
71111	CPT	X-ray Of Ribs On Both Sides And Chest, 4 Or More Views	27	20	$55.00	$55.00	$12.25	$31.17	$20.00	2025-04-10
73502	CPT	X-ray Of Single Hip, 2-3 Views	19	13	$45.00	$45.00	$9.80	$30.81	$16.14	2025-04-10
84165	CPT	Lab Test - Protein Level In Blood	27	20	$25.00	$25.00	$12.98	$30.75	$15.01	2025-04-10
72050	CPT	X-ray Of Neck, 4 Or 5 Views	27	20	$55.00	$55.00	$11.90	$30.08	$19.00	2025-04-10
93000	CPT	12-lead EKG With Physician Interpretation	3	3	$50.00	$50.00	$30.00	$30.00	$30.00	2025-04-10
83036	CPT	Lab Test - Hemoglobin A1c Level	27	20	$23.00	$23.00	$9.25	$30.00	$14.93	2025-04-10
83721	CPT	Lab Test - Ldl Cholesterol Level	26	19	$20.00	$20.00	$8.25	$30.00	$14.66	2025-04-10
84703	CPT	Lab Test - Pregnancy Hormone Identification	27	20	$30.00	$30.00	$6.50	$30.00	$12.82	2025-04-10
82575	CPT	Lab Test - Calculation Of Creatinine Clearance	27	20	$25.00	$25.00	$8.17	$30.00	$12.20	2025-04-10
84156	CPT	Lab Test - Total Protein Level In Urine	24	17	$15.00	$15.00	$3.17	$30.00	$5.73	2025-04-10
73564	CPT	X-ray Of Knee, 4 Or More Views	27	20	$46.00	$46.00	$6.30	$29.00	$17.50	2025-04-10
74018	CPT	X-ray Of Abdomen, 1 View	20	14	$30.00	$30.00	$4.90	$28.00	$12.71	2025-04-10
72190	CPT	X-ray Of Pelvis, 3 Or More Views	27	20	$45.00	$45.00	$8.40	$27.55	$16.68	2025-04-10
73565	CPT	X-ray Of Both Knees With Standing Views	27	20	$46.00	$46.00	$7.35	$27.55	$15.00	2025-04-10
87045	CPT	Lab Test - Stool Culture For Bacteria	28	21	$45.00	$45.00	$8.16	$27.50	$13.09	2025-04-10
87046	CPT	Lab Test - Stool Culture For Bacteria	28	21	$45.00	$45.00	$8.16	$27.50	$13.09	2025-04-10
73521	CPT	X-ray Of Both Hips, 2 Views	20	13	$45.00	$45.00	$10.52	$26.82	$20.00	2025-04-10
73110	CPT	X-ray Of Wrist, 3 Or More Views	27	20	$45.00	$45.00	$8.40	$26.82	$16.00	2025-04-10
73562	CPT	X-ray Of Knee, 3 Views	27	20	$40.00	$40.00	$8.75	$26.82	$15.00	2025-04-10
71110	CPT	X-ray Of Ribs On Both Sides, 3 Or More Views	27	20	$44.00	$44.00	$10.18	$26.67	$17.50	2025-04-10
70220	CPT	X-ray Of Paranasal Sinuses, 3 Or More Views	27	20	$75.00	$75.00	$10.10	$26.67	$17.50	2025-04-10
71048	CPT	X-ray Of Chest, 4 Or More Views	10	8	$70.00	$70.00	$14.94	$26.25	$22.83	2025-04-10
73610	CPT	X-ray Of Ankle, 3 Or More Views	27	20	$40.00	$40.00	$8.22	$26.00	$15.77	2025-04-10
73630	CPT	X-ray Of Foot, 3 Or More Views	27	20	$45.00	$45.00	$7.69	$26.00	$15.73	2025-04-10
73080	CPT	X-ray Of Elbow, 3 Or More Views	27	20	$40.00	$40.00	$8.22	$26.00	$15.26	2025-04-10
71045	CPT	X-ray Of Chest, 1 View	22	15	$30.00	$30.00	$4.90	$26.00	$10.68	2025-04-10
97110	CPT	Individual Physical Therapy Exercises	17	12	$35.00	$35.00	$10.73	$25.91	$20.00	2025-04-10
73140	CPT	X-ray Of Fingers	27	20	$30.00	$30.00	$4.90	$25.73	$11.53	2025-04-10
72072	CPT	X-ray Of Mid Back, 3 Views	25	18	$45.00	$45.00	$9.28	$25.50	$16.00	2025-04-10
71101	CPT	X-ray Of Ribs One On Side And Chest, 3 Or More Views	27	20	$44.00	$44.00	$9.86	$25.01	$16.09	2025-04-10
82274	CPT	Lab Test - Identification Of Hidden Blood In Stool Using Immunoassay	18	12	$26.00	$26.00	$10.00	$25.00	$22.30	2025-04-10
73650	CPT	X-ray Of Heel	27	20	$40.00	$40.00	$7.21	$25.00	$13.00	2025-04-10
80051	CPT	Lab Test - Electrolyte Panel	27	20	$30.00	$30.00	$6.06	$25.00	$10.00	2025-04-10
82247	CPT	Lab Test - Total Bilirubin Level	26	19	$15.00	$15.00	$4.33	$25.00	$7.08	2025-04-10
70250	CPT	X-ray Of Skull Bones, 1-3 Views	27	20	$55.00	$55.00	$7.35	$24.28	$14.00	2025-04-10
72070	CPT	X-ray Of Mid Back, 2 Views	27	20	$40.00	$40.00	$7.35	$24.00	$13.00	2025-04-10
73552	CPT	X-ray Of Upper Leg, 2 Or More Views	21	14	$40.00	$40.00	$7.35	$23.92	$12.69	2025-04-10
73130	CPT	X-ray Of Hand, 3 Or More Views	27	20	$46.00	$46.00	$8.13	$23.56	$15.00	2025-04-10
72170	CPT	X-ray Of Pelvis, 1-2 Views	27	20	$30.00	$30.00	$5.25	$23.56	$11.50	2025-04-10
73100	CPT	X-ray Of Wrist, 2 Views	27	20	$40.00	$40.00	$7.35	$23.19	$12.24	2025-04-10
73560	CPT	X-ray Of Knee, 1 Or 2 Views	27	20	$35.00	$35.00	$7.35	$23.19	$12.15	2025-04-10
82310	CPT	Lab Test - Total Calcium Level In Blood	27	20	$15.00	$15.00	$4.46	$23.10	$7.03	2025-04-10
73030	CPT	X-ray Of Shoulder, 2 Or More Views	27	20	$40.00	$40.00	$7.72	$23.00	$13.49	2025-04-10
72080	CPT	X-ray Of Mid/Lower Back Junction	27	20	$75.00	$75.00	$7.70	$22.83	$13.50	2025-04-10
73501	CPT	X-ray Of Single Hip, 1 View	20	14	$30.00	$30.00	$4.90	$22.82	$11.38	2025-04-10
71100	CPT	X-ray Of Ribs On One Side, 2 Views	27	20	$40.00	$40.00	$8.84	$22.50	$14.98	2025-04-10
82951	CPT	Lab Test - Glucose Level Following Sugar Intake	26	19	$15.00	$15.00	$6.97	$22.50	$10.70	2025-04-10
82950	CPT	Lab Test - Glucose Level Following Sugar Intake	26	19	$15.00	$15.00	$6.97	$22.50	$10.70	2025-04-10
72040	CPT	X-ray Of Neck, 2 Or 3 Views	26	19	$40.00	$40.00	$7.35	$22.47	$13.36	2025-04-10
74019	CPT	X-ray Of Abdomen, 2 Views	11	6	$45.00	$45.00	$9.22	$22.11	$16.99	2025-04-10
73590	CPT	X-ray Of Lower Leg	27	20	$40.00	$40.00	$7.35	$22.00	$12.00	2025-04-10
73600	CPT	X-ray Of Ankle, 2 Views	27	20	$70.00	$70.00	$7.35	$21.74	$12.50	2025-04-10
70210	CPT	X-ray Of Paranasal Sinuses, 1-2 Views	27	20	$35.00	$35.00	$7.35	$21.38	$12.49	2025-04-10
73060	CPT	X-ray Of Upper Arm	27	20	$35.00	$35.00	$7.35	$21.02	$12.00	2025-04-10
73120	CPT	X-ray Of Hand, 2 Views	27	20	$35.00	$35.00	$6.94	$21.00	$12.00	2025-04-10
70140	CPT	X-ray Of Face Bones, 1-2 Views	27	20	$35.00	$35.00	$7.35	$20.67	$12.15	2025-04-10
70360	CPT	X-ray Of Soft Tissue Of The Neck	27	20	$30.00	$30.00	$4.90	$20.29	$10.13	2025-04-10
84436	CPT	Lab Test - Total Thyroxine Level	27	20	$15.00	$15.00	$5.94	$20.00	$9.87	2025-04-10
83735	CPT	Lab Test - Magnesium Level	27	20	$41.00	$41.00	$5.79	$20.00	$9.80	2025-04-10
72220	CPT	X-ray Of Tailbone	27	20	$45.00	$45.00	$6.30	$19.93	$12.00	2025-04-10
73000	CPT	X-ray Of Collarbone	27	20	$30.00	$30.00	$4.20	$19.93	$11.00	2025-04-10
73070	CPT	X-ray Of Elbow , 2 Views	27	20	$35.00	$35.00	$7.17	$19.57	$12.00	2025-04-10
82270	CPT	Lab Test - Identification Of Hidden Blood In Stool Sample Using Chemical Reagent…	26	19	$8.00	$8.00	$3.00	$19.20	$4.60	2025-04-10
73090	CPT	X-ray Of Lower Arm	27	20	$35.00	$35.00	$6.85	$19.00	$12.00	2025-04-10
84478	CPT	Lab Test - Triglycerides Level	27	20	$15.00	$15.00	$4.96	$18.97	$13.00	2025-04-10
73620	CPT	X-ray Of Foot, 2 Views	27	20	$80.00	$80.00	$6.95	$18.84	$12.00	2025-04-10
86580	CPT	Lab Test - Skin Test For Tuberculosis Infection	25	19	$5.50	$5.50	$5.83	$18.00	$14.26	2025-04-10
85008	CPT	Lab Test - Examination Of White Blood Cells Using Microscope	27	20	$12.00	$12.00	$2.97	$17.00	$4.87	2025-04-10
73020	CPT	X-ray Of Shoulder, 1 View	27	20	$30.00	$30.00	$4.90	$16.67	$9.50	2025-04-10
84479	CPT	Lab Test - Thyroid Hormone Uptake Analysis	27	20	$15.00	$15.00	$5.59	$15.00	$10.00	2025-04-10
82150	CPT	Lab Test - Amylase Enzyme Level	27	20	$18.00	$18.00	$6.83	$15.00	$9.93	2025-04-10
83690	CPT	Lab Test - Lipase Enzyme Level	27	20	$18.00	$18.00	$5.96	$15.00	$9.13	2025-04-10
85730	CPT	Lab Test - Thromboplastin Time	27	20	$10.00	$10.00	$5.00	$15.00	$9.00	2025-04-10
85025	CPT	Lab Test - Complete Blood Cell Count With White Blood Cell Percentage	27	20	$15.00	$15.00	$6.63	$15.00	$9.00	2025-04-10
83540	CPT	Lab Test - Iron Level	27	20	$20.00	$20.00	$5.59	$15.00	$8.00	2025-04-10
82340	CPT	Lab Test - Calcium Level In Urine	27	20	$18.00	$18.00	$5.25	$15.00	$7.77	2025-04-10
85610	CPT	Lab Test - Measurement Of Prothrombin Time	27	20	$10.00	$10.00	$3.40	$15.00	$7.28	2025-04-10
84075	CPT	Lab Test - Total Alkaline Phosphatase Level	27	20	$15.00	$15.00	$4.47	$15.00	$7.00	2025-04-10
82565	CPT	Lab Test - Creatinine Level In Blood Sample	27	20	$15.00	$15.00	$4.43	$15.00	$7.00	2025-04-10
84100	CPT	Lab Test - Phosphate Level	27	20	$15.00	$15.00	$4.10	$15.00	$6.46	2025-04-10
82945	CPT	Lab Test - Glucose Level In Body Fluid Other Than Blood	25	18	$15.00	$15.00	$3.40	$15.00	$5.48	2025-04-10
86901	CPT	Lab Test - Blood Typing For Group And Rh Status	27	20	$15.00	$15.00	$2.99	$13.33	$7.00	2025-04-10
86900	CPT	Lab Test - Blood Typing For Group And Rh Status	27	20	$15.00	$15.00	$2.99	$13.33	$7.00	2025-04-10
84540	CPT	Lab Test - Urea Nitrogen Level In Urine	27	20	$15.00	$15.00	$3.90	$12.10	$5.76	2025-04-10
82248	CPT	Lab Test - Direct Bilirubin Level	26	19	$18.00	$18.00	$4.33	$12.00	$8.00	2025-04-10
85002	CPT	Lab Test - Bleeding Time	27	20	$15.00	$15.00	$2.00	$12.00	$4.79	2025-04-10
81000	CPT	Lab Test - Manual Analysis Of Urine By Dipstick With Microscope Evaluation	21	14	$12.00	$12.00	$2.81	$12.00	$4.54	2025-04-10
85044	CPT	Lab Test - Manual Red Blood Cell Count	27	20	$10.00	$10.00	$3.00	$11.25	$5.32	2025-04-10
84460	CPT	Lab Test - Sgpt Enzyme Level	27	20	$15.00	$15.00	$4.58	$11.03	$7.40	2025-04-10
84133	CPT	Lab Test - Potassium Level	27	20	$18.00	$18.00	$3.85	$10.43	$7.20	2025-04-10
84132	CPT	Lab Test - Potassium Level	27	20	$18.00	$18.00	$3.85	$10.43	$7.20	2025-04-10
84450	CPT	Lab Test - Sgot Enzyme Level	27	20	$15.00	$15.00	$4.47	$10.18	$7.33	2025-04-10
84295	CPT	Lab Test - Sodium Level In Blood Or Plasma Sample	27	20	$15.00	$15.00	$4.16	$10.00	$6.89	2025-04-10
84300	CPT	Lab Test - Sodium Level In Urine Sample	27	20	$18.00	$18.00	$4.20	$10.00	$6.79	2025-04-10
85660	CPT	Lab Test - Screening For Sickle Cell Anemia	27	20	$15.00	$15.00	$3.00	$10.00	$6.65	2025-04-10
82465	CPT	Lab Test - Total Cholesterol Level	27	20	$15.00	$15.00	$3.76	$10.00	$6.40	2025-04-10
84550	CPT	Lab Test - Uric Acid Level	27	20	$15.00	$15.00	$3.91	$10.00	$6.24	2025-04-10
82947	CPT	Lab Test - Glucose Level In Blood	27	20	$15.00	$15.00	$4.51	$10.00	$5.87	2025-04-10
84520	CPT	Lab Test - Urea Nitrogen Level In Blood	27	20	$13.00	$13.00	$3.42	$10.00	$5.65	2025-04-10
84155	CPT	Lab Test - Total Protein Level In Blood	27	20	$15.00	$15.00	$3.17	$10.00	$5.63	2025-04-10
85049	CPT	Lab Test - Platelet Count	25	18	$10.00	$10.00	$3.00	$10.00	$5.53	2025-04-10
81001	CPT	Lab Test - Machine Analysis Of Urine By Dipstick With Microscope Evaluation	27	20	$12.00	$12.00	$3.00	$10.00	$5.36	2025-04-10
85651	CPT	Lab Test - Sedimentation Rate	27	20	$10.00	$10.00	$3.07	$10.00	$5.02	2025-04-10
85048	CPT	Lab Test - Automated Leukocyte White Blood Cell Count	28	21	$10.00	$10.00	$2.00	$10.00	$3.43	2025-04-10
85014	CPT	Lab Test - Red Blood Cell Volume	27	20	$5.00	$5.00	$2.05	$10.00	$3.31	2025-04-10
82948	CPT	Lab Test - Glucose Level In Blood Using Strip	26	20	$5.00	$5.00	$1.78	$6.55	$4.44	2025-04-10
85018	CPT	Lab Test - Hemoglobin Blood Count	27	20	$7.70	$7.70	$1.78	$6.48	$3.00	2025-04-10
81003	CPT	Lab Test - Machine Analysis Of Urine By Dipstick	13	11	$5.00	$5.00	$1.94	$5.00	$2.77	2025-04-10

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