Hospital

HOSPITAL METROPOLITANO DE LA MONTANA

Bda Nueva, PR · CCN 400130 · Rates published

243 distinct procedures filed

22 distinct payers

13,140 rate rows

2025-03-27 last MRF observed · ⚠ 16 mo old

Data quality

13,138 of 13,140 rate rows are consumer-grade (100.0%)

2 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

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 16 months old.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=5B3139A8-A1D2-47D0-AE06-40D37F471EF7
Found on page	https://hpt.inmediata.com/index?h=5B3139A8-A1D2-47D0-AE06-40D37F471EF7
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	4e51298db9e453f8… · 905,155 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
74178 CPT	Cat Scan Of Abdomen And Pelvis With And Without Contrast	13	$98.21	$450.00	$178.54	nat. median $979 outlier · 0.2×
74177 CPT	Cat Scan Of Abdomen And Pelvis With Contrast	13	$87.06	$450.00	$172.09	nat. median $928 outlier · 0.2×
72133 CPT	Cat Scan Of Lower Spine With And Without Contrast	22	$73.85	$650.00	$162.50	nat. median $616 outlier · 0.3×
70482 CPT	Cat Scan Of Eye, Ear, Or Sella Turcica With And Without Contrast	22	$79.27	$650.00	$162.50	nat. median $650 outlier · 0.2×
71270 CPT	Cat Scan Of Chest With And Without Contrast	22	$75.60	$650.00	$162.50	nat. median $661 outlier · 0.2×
70492 CPT	Cat Scan Of Soft Tissue Of The Neck With And Without Contrast	21	$79.98	$650.00	$162.50	nat. median $634 outlier · 0.3×
70481 CPT	Cat Scan Of Eye, Ear, Or Sella Turcica With Contrast	22	$71.44	$300.00	$162.50	nat. median $630 outlier · 0.3×
74160 CPT	Cat Scan Of Abdomen With Contrast	22	$64.11	$300.00	$162.50	nat. median $646 outlier · 0.3×
72126 CPT	Cat Scan Of Neck Spine With Contrast	22	$63.37	$300.00	$162.50	nat. median $755 outlier · 0.2×
72127 CPT	Cat Scan Of Neck Spine With And Without Contrast	22	$74.06	$650.00	$162.50	nat. median $595 outlier · 0.3×
74170 CPT	Cat Scan Of Abdomen With And Without Contrast	22	$72.66	$650.00	$162.50	nat. median $703 outlier · 0.2×
72194 CPT	Cat Scan Of Pelvis With And Without Contrast	22	$71.23	$650.00	$162.50	nat. median $658 outlier · 0.2×
72129 CPT	Cat Scan Of Mid Spine With Contrast	22	$63.45	$300.00	$148.75	nat. median $584 outlier · 0.3×
72132 CPT	Cat Scan Of Lower Spine With Contrast	22	$63.28	$300.00	$148.75	nat. median $760 outlier · 0.2×
71260 CPT	Cat Scan Of Chest With Contrast	22	$63.61	$300.00	$148.75	nat. median $646 outlier · 0.2×
73201 CPT	Cat Scan Of Arm With Contrast	22	$61.43	$300.00	$148.62	nat. median $827 outlier · 0.2×
72193 CPT	Cat Scan Of Pelvis With Contrast	22	$62.23	$300.00	$147.35	nat. median $629 outlier · 0.2×
70470 CPT	Cat Scan Of Head Or Brain With And Without Contrast	22	$54.36	$650.00	$144.36	nat. median $618 outlier · 0.2×
70491 CPT	Cat Scan Of Soft Tissue Of The Neck With Contrast	22	$65.84	$300.00	$143.39	nat. median $617 outlier · 0.2×
70487 CPT	Cat Scan Of Facial Bones With Contrast	21	$47.85	$300.00	$143.12	nat. median $596 outlier · 0.2×
70460 CPT	Cat Scan Of Head Or Brain With Contrast	22	$46.17	$300.00	$137.50	nat. median $582 outlier · 0.2×
70486 CPT	Cat Scan Of Facial Bones Without Contrast	21	$39.42	$300.00	$128.70	nat. median $463 outlier · 0.3×
72128 CPT	Cat Scan Of Mid Spine Without Contrast	22	$45.66	$300.00	$127.50	nat. median $449 outlier · 0.3×
73200 CPT	Cat Scan Of Arm Without Contrast	22	$45.66	$300.00	$127.50	nat. median $548 outlier · 0.2×
72125 CPT	Cat Scan Of Neck Spine Without Contrast	22	$45.71	$300.00	$127.50	nat. median $469 outlier · 0.3×
70490 CPT	Cat Scan Of Soft Tissue Of The Neck Without Contrast	22	$50.72	$300.00	$127.50	nat. median $442 outlier · 0.3×
73700 CPT	Cat Scan Of Leg Without Contrast	22	$45.66	$300.00	$127.50	nat. median $555 outlier · 0.2×
72131 CPT	Cat Scan Of Lower Spine Without Contrast	22	$45.66	$300.00	$127.50	nat. median $449 outlier · 0.3×
74150 CPT	Cat Scan Of Abdomen Without Contrast	22	$43.51	$300.00	$127.50	nat. median $439 outlier · 0.3×
71250 CPT	Cat Scan Of Chest Without Contrast	22	$48.44	$300.00	$127.50	nat. median $473 outlier · 0.3×
70450 CPT	Cat Scan Of Head Or Brain Without Contrast	22	$33.37	$275.00	$126.21	nat. median $454 outlier · 0.3×
72192 CPT	Cat Scan Of Pelvis Without Contrast	22	$41.97	$300.00	$120.00	nat. median $455 outlier · 0.3×
70480 CPT	Cat Scan Of Eye, Ear, Or Sella Turcica Without Contrast	22	$50.59	$300.00	$119.62	nat. median $473 outlier · 0.3×
74176 CPT	Cat Scan Of Abdomen And Pelvis Without Contrast	14	$59.03	$450.00	$116.00	nat. median $685 outlier · 0.2×
84260 CPT	Lab Test - Serotonin Hormone Level	21	$43.28	$140.00	$111.00	nat. median $59 1.9× median
82088 CPT	Lab Test - Aldosterone Hormone Level	22	$56.94	$146.00	$95.20	nat. median $78 1.2× median
85245 CPT	Lab Test - Measurement Of Blood Clotting Factor Von Willebrand	20	$32.06	$130.00	$86.00	nat. median $47 1.8× median
84207 CPT	Lab Test - Vitamin B-6 Level	21	$39.25	$150.00	$82.50	nat. median $54 1.5× median
76510 CPT	A-scan And B-scan Ultrasound Of Eyes	20	$22.00	$278.00	$77.98	nat. median $152 0.5× median
83970 CPT	Lab Test - Parathyroid Hormone Level	20	$50.96	$130.00	$76.50	nat. median $102 0.8× median
85303 CPT	Lab Test - Measurement Of Protein C Blood Clotting Inhibitor Activity	19	$17.50	$130.00	$69.25	nat. median $37 1.9× median
83498 CPT	Lab Test - Hydroxyprogestone 17-d Level	21	$28.60	$100.00	$66.62	nat. median $48 1.4× median
86360 CPT	Lab Test - Measurement Of Cd4 And Cd8 White Blood T Cells With Ratio	20	$39.00	$123.00	$65.65	nat. median $76 0.9× median
82306 CPT	Lab Test - Vitamin D-3 Level	21	$28.23	$145.00	$63.38	nat. median $68 0.9× median
76700 CPT	Complete Ultrasound Of Abdomen	22	$35.12	$125.00	$63.11	nat. median $310 outlier · 0.2×
76830 CPT	Ultrasound Of Non-pregnant Uterus	21	$34.17	$90.26	$62.03	nat. median $249 outlier · 0.2×
87592 CPT	Lab Test - Measurement Of Gonorrhea Bacteria DNA Level	19	$29.93	$79.05	$59.85	nat. median $46 1.3× median
76805 CPT	External Ultrasound Of Pregnant Uterus In 2nd Or 3rd Trimester	22	$30.00	$87.00	$59.35	nat. median $257 outlier · 0.2×
76872 CPT	Ultrasound Of Pelvic Cavity Via Rectum	22	$27.09	$100.00	$57.50	nat. median $222 outlier · 0.3×
76770 CPT	Complete Ultrasound Of Kidneys, Aorta, And Lymph Nodes	22	$30.00	$129.00	$56.00	nat. median $304 outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 243 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

74178	CPT	Cat Scan Of Abdomen And Pelvis With And Without Contrast	40	13	$325.00	$325.00	$98.21	$450.00	$178.54	2025-03-27
74177	CPT	Cat Scan Of Abdomen And Pelvis With Contrast	40	13	$162.50	$162.50	$87.06	$450.00	$172.09	2025-03-27
71270	CPT	Cat Scan Of Chest With And Without Contrast	58	22	$325.00	$325.00	$75.60	$650.00	$162.50	2025-03-27
72194	CPT	Cat Scan Of Pelvis With And Without Contrast	58	22	$325.00	$325.00	$71.23	$650.00	$162.50	2025-03-27
72133	CPT	Cat Scan Of Lower Spine With And Without Contrast	58	22	$325.00	$325.00	$73.85	$650.00	$162.50	2025-03-27
72127	CPT	Cat Scan Of Neck Spine With And Without Contrast	58	22	$325.00	$325.00	$74.06	$650.00	$162.50	2025-03-27
70481	CPT	Cat Scan Of Eye, Ear, Or Sella Turcica With Contrast	58	22	$162.50	$162.50	$71.44	$300.00	$162.50	2025-03-27
70482	CPT	Cat Scan Of Eye, Ear, Or Sella Turcica With And Without Contrast	58	22	$325.00	$325.00	$79.27	$650.00	$162.50	2025-03-27
70492	CPT	Cat Scan Of Soft Tissue Of The Neck With And Without Contrast	56	21	$325.00	$325.00	$79.98	$650.00	$162.50	2025-03-27
72126	CPT	Cat Scan Of Neck Spine With Contrast	58	22	$162.50	$162.50	$63.37	$300.00	$162.50	2025-03-27
74160	CPT	Cat Scan Of Abdomen With Contrast	58	22	$162.50	$162.50	$64.11	$300.00	$162.50	2025-03-27
74170	CPT	Cat Scan Of Abdomen With And Without Contrast	58	22	$325.00	$325.00	$72.66	$650.00	$162.50	2025-03-27
72129	CPT	Cat Scan Of Mid Spine With Contrast	58	22	$162.50	$162.50	$63.45	$300.00	$148.75	2025-03-27
72132	CPT	Cat Scan Of Lower Spine With Contrast	58	22	$162.50	$162.50	$63.28	$300.00	$148.75	2025-03-27
71260	CPT	Cat Scan Of Chest With Contrast	58	22	$162.50	$162.50	$63.61	$300.00	$148.75	2025-03-27
73201	CPT	Cat Scan Of Arm With Contrast	58	22	$162.50	$162.50	$61.43	$300.00	$148.62	2025-03-27
72193	CPT	Cat Scan Of Pelvis With Contrast	58	22	$162.50	$162.50	$62.23	$300.00	$147.35	2025-03-27
70470	CPT	Cat Scan Of Head Or Brain With And Without Contrast	58	22	$325.00	$325.00	$54.36	$650.00	$144.36	2025-03-27
70491	CPT	Cat Scan Of Soft Tissue Of The Neck With Contrast	58	22	$162.50	$162.50	$65.84	$300.00	$143.39	2025-03-27
70487	CPT	Cat Scan Of Facial Bones With Contrast	56	21	$162.50	$162.50	$47.85	$300.00	$143.12	2025-03-27
70460	CPT	Cat Scan Of Head Or Brain With Contrast	58	22	$162.50	$162.50	$46.17	$300.00	$137.50	2025-03-27
70486	CPT	Cat Scan Of Facial Bones Without Contrast	56	21	$162.50	$162.50	$39.42	$300.00	$128.70	2025-03-27
72128	CPT	Cat Scan Of Mid Spine Without Contrast	58	22	$162.50	$162.50	$45.66	$300.00	$127.50	2025-03-27
71250	CPT	Cat Scan Of Chest Without Contrast	58	22	$162.50	$162.50	$48.44	$300.00	$127.50	2025-03-27
70490	CPT	Cat Scan Of Soft Tissue Of The Neck Without Contrast	58	22	$162.50	$162.50	$50.72	$300.00	$127.50	2025-03-27
72125	CPT	Cat Scan Of Neck Spine Without Contrast	58	22	$162.50	$162.50	$45.71	$300.00	$127.50	2025-03-27
73700	CPT	Cat Scan Of Leg Without Contrast	58	22	$162.50	$162.50	$45.66	$300.00	$127.50	2025-03-27
73200	CPT	Cat Scan Of Arm Without Contrast	58	22	$162.50	$162.50	$45.66	$300.00	$127.50	2025-03-27
74150	CPT	Cat Scan Of Abdomen Without Contrast	58	22	$162.50	$162.50	$43.51	$300.00	$127.50	2025-03-27
72131	CPT	Cat Scan Of Lower Spine Without Contrast	58	22	$162.50	$162.50	$45.66	$300.00	$127.50	2025-03-27
70450	CPT	Cat Scan Of Head Or Brain Without Contrast	58	22	$162.50	$162.50	$33.37	$275.00	$126.21	2025-03-27
72192	CPT	Cat Scan Of Pelvis Without Contrast	58	22	$162.50	$162.50	$41.97	$300.00	$120.00	2025-03-27
70480	CPT	Cat Scan Of Eye, Ear, Or Sella Turcica Without Contrast	58	22	$162.50	$162.50	$50.59	$300.00	$119.62	2025-03-27
74176	CPT	Cat Scan Of Abdomen And Pelvis Without Contrast	42	14	$162.50	$162.50	$59.03	$450.00	$116.00	2025-03-27
84260	CPT	Lab Test - Serotonin Hormone Level	56	21	$145.00	$145.00	$43.28	$140.00	$111.00	2025-03-27
82088	CPT	Lab Test - Aldosterone Hormone Level	58	22	$130.00	$130.00	$56.94	$146.00	$95.20	2025-03-27
85245	CPT	Lab Test - Measurement Of Blood Clotting Factor Von Willebrand	54	20	$135.00	$135.00	$32.06	$130.00	$86.00	2025-03-27
84207	CPT	Lab Test - Vitamin B-6 Level	56	21	$120.00	$120.00	$39.25	$150.00	$82.50	2025-03-27
76510	CPT	A-scan And B-scan Ultrasound Of Eyes	52	20	$100.00	—	$22.00	$278.00	$77.98	2025-03-27
83970	CPT	Lab Test - Parathyroid Hormone Level	54	20	$130.00	$130.00	$50.96	$130.00	$76.50	2025-03-27
85303	CPT	Lab Test - Measurement Of Protein C Blood Clotting Inhibitor Activity	52	19	$190.00	$190.00	$17.50	$130.00	$69.25	2025-03-27
83498	CPT	Lab Test - Hydroxyprogestone 17-d Level	56	21	$100.00	$100.00	$28.60	$100.00	$66.62	2025-03-27
86360	CPT	Lab Test - Measurement Of Cd4 And Cd8 White Blood T Cells With Ratio	54	20	$90.00	$90.00	$39.00	$123.00	$65.65	2025-03-27
82306	CPT	Lab Test - Vitamin D-3 Level	56	21	$130.00	$130.00	$28.23	$145.00	$63.38	2025-03-27
76700	CPT	Complete Ultrasound Of Abdomen	58	22	$50.00	$50.00	$35.12	$125.00	$63.11	2025-03-27
76830	CPT	Ultrasound Of Non-pregnant Uterus	56	21	$50.00	$50.00	$34.17	$90.26	$62.03	2025-03-27
87592	CPT	Lab Test - Measurement Of Gonorrhea Bacteria DNA Level	52	19	$70.00	$70.00	$29.93	$79.05	$59.85	2025-03-27
76805	CPT	External Ultrasound Of Pregnant Uterus In 2nd Or 3rd Trimester	58	22	$50.00	$50.00	$30.00	$87.00	$59.35	2025-03-27
76872	CPT	Ultrasound Of Pelvic Cavity Via Rectum	58	22	$50.00	$50.00	$27.09	$100.00	$57.50	2025-03-27
82670	CPT	Lab Test - Estradiol Hormone Level	56	21	$70.00	$70.00	$39.04	$76.00	$56.00	2025-03-27
76770	CPT	Complete Ultrasound Of Kidneys, Aorta, And Lymph Nodes	58	22	$50.00	$50.00	$30.00	$129.00	$56.00	2025-03-27
84402	CPT	Lab Test - Free Testosterone Level	56	21	$100.00	$100.00	$35.57	$170.00	$55.38	2025-03-27
76801	CPT	External Ultrasound Of Pregnant Uterus In 1st Trimester	48	17	$50.00	$50.00	$25.00	$100.00	$55.06	2025-03-27
84425	CPT	Lab Test - Vitamin B-1 Level	56	21	$100.00	$100.00	$28.00	$90.00	$54.77	2025-03-27
86359	CPT	Lab Test - Measurement Of T White Blood Cells	54	20	$120.00	$120.00	$26.35	$120.00	$52.70	2025-03-27
87635	CPT	Lab Test - Identification Of Covid-19 Virus DNA Using Amplified Probe Technique	2	1	$150.00	$150.00	$51.33	$51.33	$51.33	2025-03-27
76817	CPT	Vaginal Ultrasound Of Pregnant Uterus In 1st Trimester	54	20	$50.00	$50.00	$23.16	$100.00	$50.00	2025-03-27
76536	CPT	Ultrasound Of Soft Tissue Of Head And Neck	58	22	$50.00	$50.00	$22.31	$91.35	$49.65	2025-03-27
87591	CPT	Lab Test - Identification Of Gonorrhea Bacteria DNA Using Amplified Probe	52	19	$50.00	$50.00	$18.00	$66.30	$49.04	2025-03-27
76856	CPT	Complete Ultrasound Of Female Pelvis Unrelated To Pregnancy	58	22	$50.00	$50.00	$31.05	$78.30	$49.00	2025-03-27
76506	CPT	Ultrasound Of Brain	56	21	$50.00	$50.00	$28.72	$100.00	$48.59	2025-03-27
76705	CPT	Limited Or Follow-up Ultrasound Of Abdomen	52	19	$37.50	$37.50	$22.00	$100.00	$47.50	2025-03-27
84481	CPT	Lab Test - Free T3 Thyroid Hormone Level	56	21	$80.00	$80.00	$13.00	$115.00	$47.28	2025-03-27
76775	CPT	Limited Ultrasound Of Kidneys, Aorta, And Lymph Nodes	52	19	$37.50	$37.50	$17.57	$91.67	$46.25	2025-03-27
85305	CPT	Lab Test - Measurement Of Total Protein S Blood Clotting Inhibitor Level	54	20	$420.00	$420.00	$14.25	$126.24	$45.00	2025-03-27
87426	CPT	Lab Test - Identification Of Covid-19 Virus Using Multiple-step Immunoassay Meth…	8	3	$101.00	$101.00	$31.66	$45.23	$43.68	2025-03-27
86632	CPT	Lab Test - Identification Of Chlamydia Bacteria IgM Antibody	54	20	$80.00	$80.00	$17.74	$70.00	$42.50	2025-03-27
82679	CPT	Lab Test - Estrone Hormone Level	56	21	$75.00	$75.00	$34.88	$112.74	$41.47	2025-03-27
76870	CPT	Ultrasound Of Scrotum	58	22	$50.00	$50.00	$20.17	$86.67	$41.00	2025-03-27
86361	CPT	Lab Test - Measurement Of Cd4 White Blood T Cells	52	19	$45.00	$45.00	$36.21	$63.75	$39.00	2025-03-27
82672	CPT	Lab Test - Estrogen Hormone Level	58	22	$75.00	$75.00	$23.00	$70.00	$39.00	2025-03-27
82677	CPT	Lab Test - Estriol Hormone Level	56	21	$75.00	$75.00	$20.00	$65.00	$38.66	2025-03-27
86631	CPT	Lab Test - Identification Of Chlamydia Bacteria Antibody	54	20	$80.00	$80.00	$16.52	$62.00	$38.00	2025-03-27
82180	CPT	Lab Test - Vitamin C Level	56	21	$100.00	$100.00	$13.00	$100.00	$37.25	2025-03-27
84403	CPT	Lab Test - Total Testosterone Level	58	22	$70.00	$70.00	$30.00	$100.00	$36.70	2025-03-27
87811	CPT	Lab Test - Identification Of Covid-19 Antigen Using Immunoassay Technique	4	1	$95.00	$95.00	$31.00	$41.38	$36.19	2025-03-27
76641	CPT	Ultrasound Of Breast	18	6	$50.00	$50.00	$30.00	$61.67	$35.68	2025-03-27
82330	CPT	Lab Test - Ionized Calcium Level	58	22	$50.00	$50.00	$9.00	$52.00	$35.00	2025-03-27
84144	CPT	Lab Test - Progesterone Hormone Level	56	21	$70.00	$70.00	$25.00	$65.00	$35.00	2025-03-27
85246	CPT	Lab Test - Measurement Of Blood Clotting Factor Von Willebrand Antigen	52	19	$150.00	$150.00	$29.53	$150.00	$32.06	2025-03-27
77075	CPT	X-ray For Complete Bone Evaluation	10	5	$69.12	$69.12	$30.72	$30.72	$30.72	2025-03-27
84153	CPT	Lab Test - Total Prostate Specific Antigen Level	56	21	$45.00	$45.00	$17.54	$58.00	$30.18	2025-03-27
84146	CPT	Lab Test - Prolactin Hormone Level	58	22	$40.00	$40.00	$23.00	$42.50	$30.00	2025-03-27
86701	CPT	Lab Test - Identification Of HIV-1 Antibodies	54	20	$30.00	$30.00	$9.69	$50.00	$29.25	2025-03-27
83001	CPT	Lab Test - Fsh Hormone Level	58	22	$70.00	$70.00	$25.00	$60.00	$28.28	2025-03-27
84702	CPT	Lab Test - Pregnancy Hormone Level	56	21	$50.00	$50.00	$21.00	$60.00	$28.00	2025-03-27
84154	CPT	Lab Test - Free Prostate Specific Antigen Level	54	20	$30.00	$30.00	$12.85	$145.00	$27.85	2025-03-27
89300	CPT	Analysis Of Sperm In Cervical Mucous To Assess Fertility	54	20	$35.00	—	$5.00	$35.00	$27.50	2025-03-27
72114	CPT	X-ray Of Lower Back, Minimum Of 6 Views	58	22	$25.00	$25.00	$16.00	$57.00	$27.47	2025-03-27
80164	CPT	Lab Test - Total Valproic Acid Level	56	21	$50.00	$50.00	$18.93	$50.00	$26.90	2025-03-27
83002	CPT	Lab Test - Lh Hormone Level	58	22	$40.00	$40.00	$24.38	$40.00	$25.88	2025-03-27
84152	CPT	Lab Test - Direct Measurement Of Prostate Specific Antigen Level	54	20	$100.00	$100.00	$12.85	$100.00	$25.70	2025-03-27
72052	CPT	X-ray Of Neck, 6 Or More Views	58	22	$20.00	$20.00	$14.76	$52.50	$25.00	2025-03-27
84443	CPT	Lab Test - Thyroid Stimulating Hormone Level	58	22	$40.00	$40.00	$16.02	$50.00	$25.00	2025-03-27
84166	CPT	Lab Test - Protein Level In Body Fluid Other Than Blood	48	18	$50.00	$50.00	$12.46	$50.00	$24.92	2025-03-27
86696	CPT	Lab Test - Identification Of Herpes Simplex Virus Type 2 Antibody	52	19	$50.00	$50.00	$18.00	$50.00	$24.89	2025-03-27
84432	CPT	Lab Test - Thyroglobulin Hormone Level	54	20	$60.00	$60.00	$22.00	$82.00	$24.38	2025-03-27
85306	CPT	Lab Test - Measurement Of Free Protein S Blood Clotting Inhibitor Level	52	19	$125.00	$125.00	$10.71	$125.00	$24.38	2025-03-27
80061	CPT	Lab Test - Cholesterol Panel	58	22	$70.00	$70.00	$12.77	$60.00	$24.00	2025-03-27
84480	CPT	Lab Test - Total T3 Thyroid Hormone Level	56	21	$45.00	$45.00	$18.00	$45.00	$24.00	2025-03-27
86702	CPT	Lab Test - Identification Of HIV-2 Antibodies	54	20	$30.00	$30.00	$8.39	$99.00	$23.39	2025-03-27
72110	CPT	X-ray Of Lower Back, Minimum Of 4 Views	58	22	$20.00	$20.00	$12.77	$46.00	$21.88	2025-03-27
70130	CPT	X-ray Of Mastoid Processes Of Skull, 4 Or More Views	58	22	$15.00	$15.00	$14.88	$40.00	$21.83	2025-03-27
71048	CPT	X-ray Of Chest, 4 Or More Views	36	12	$22.50	$22.50	$11.49	$26.10	$21.34	2025-03-27
80156	CPT	Lab Test - Total Carbamazepine Level	56	21	$40.00	—	$20.00	$40.00	$20.98	2025-03-27
82746	CPT	Lab Test - Folic Acid Level	58	22	$40.00	$40.00	$9.75	$40.00	$20.54	2025-03-27
82607	CPT	Lab Test - Vitamin B-12 Level	58	22	$40.00	$40.00	$18.00	$45.00	$20.53	2025-03-27
71110	CPT	X-ray Of Ribs On Both Sides, 3 Or More Views	58	22	$25.00	$25.00	$11.10	$40.00	$20.43	2025-03-27
71111	CPT	X-ray Of Ribs On Both Sides And Chest, 4 Or More Views	56	21	$20.00	$20.00	$13.46	$43.00	$20.00	2025-03-27
70260	CPT	X-ray Of Skull Bones, 4 Or More Views	58	22	$17.50	$17.50	$12.03	$43.00	$20.00	2025-03-27
87045	CPT	Lab Test - Stool Culture For Bacteria	58	22	$30.00	$30.00	$10.00	$28.00	$20.00	2025-03-27
74021	CPT	X-ray Of Abdomen, 3 Or More Views	36	12	$25.00	$25.00	$17.68	$25.73	$19.89	2025-03-27
71047	CPT	X-ray Of Chest, 3 Views	36	12	$17.50	$17.50	$9.58	$25.37	$19.89	2025-03-27
72050	CPT	X-ray Of Neck, 4 Or 5 Views	58	22	$17.50	$17.50	$12.04	$45.00	$19.49	2025-03-27
82728	CPT	Lab Test - Ferritin Level	56	21	$40.00	$40.00	$17.00	$40.00	$19.03	2025-03-27
84439	CPT	Lab Test - Free Thyroxine Level	56	21	$30.00	$30.00	$10.00	$30.00	$19.00	2025-03-27
70330	CPT	X-ray Of Both Sides Of Jaw Joint	58	22	$15.00	$15.00	$8.00	$40.00	$19.00	2025-03-27
70150	CPT	X-ray Of Face Bones, 3 Or More Views	58	22	$15.00	$15.00	$11.65	$37.00	$18.67	2025-03-27
80185	CPT	Lab Test - Total Phenytoin Level	56	21	$40.00	$40.00	$14.63	$45.00	$18.52	2025-03-27
86695	CPT	Lab Test - Identification Of Herpes Simplex Virus Type 1 Antibody	54	20	$50.00	$50.00	$4.07	$68.00	$18.43	2025-03-27
72074	CPT	X-ray Of Mid Back, 4 Or More Views	58	22	$17.50	$17.50	$11.36	$39.00	$18.00	2025-03-27
70200	CPT	X-ray Of Both Eyes, 4 Or More Views	58	22	$15.00	$15.00	$11.90	$37.00	$17.91	2025-03-27
85300	CPT	Lab Test - Measurement Of Antithrombin Iii Blood Clotting Inhibitor Activity	56	21	$80.00	$80.00	$12.92	$74.00	$17.77	2025-03-27
71101	CPT	X-ray Of Ribs One On Side And Chest, 3 Or More Views	58	22	$15.00	$15.00	$10.33	$35.00	$17.70	2025-03-27
72120	CPT	X-ray Of Lower Back, 2-3 Bending Views	58	22	$20.00	$20.00	$11.16	$41.00	$17.58	2025-03-27
70220	CPT	X-ray Of Paranasal Sinuses, 3 Or More Views	58	22	$15.00	$15.00	$10.10	$40.00	$17.50	2025-03-27
80053	CPT	Lab Test - Comprehensive Metabolic Panel	56	21	$25.00	$25.00	$10.09	$55.00	$17.25	2025-03-27
73564	CPT	X-ray Of Knee, 4 Or More Views	58	22	$20.00	$20.00	$10.89	$40.00	$17.15	2025-03-27
74019	CPT	X-ray Of Abdomen, 2 Views	36	12	$20.00	$20.00	$15.23	$22.11	$17.00	2025-03-27
70110	CPT	X-ray Of Jaw, 4 Or More Views	58	22	$15.00	$15.00	$10.69	$37.00	$17.00	2025-03-27
73521	CPT	X-ray Of Both Hips, 2 Views	30	11	$20.00	$20.00	$10.89	$26.82	$16.93	2025-03-27
73552	CPT	X-ray Of Upper Leg, 2 Or More Views	22	9	$12.50	$12.50	$11.55	$23.92	$16.82	2025-03-27
86703	CPT	Lab Test - Identification Of HIV-1 And HIV-2 Antibodies	54	20	$390.00	$390.00	$15.27	$390.00	$16.77	2025-03-27
72190	CPT	X-ray Of Pelvis, 3 Or More Views	58	22	$20.00	$20.00	$11.22	$34.00	$16.50	2025-03-27
72202	CPT	X-ray Of Sacroiliac Joints, 3 Or More Views	58	22	$15.00	$15.00	$9.50	$31.00	$16.00	2025-03-27
72100	CPT	X-ray Of Lower Back, 2-3 Views	58	22	$15.00	$15.00	$9.83	$28.00	$15.77	2025-03-27
73565	CPT	X-ray Of Both Knees With Standing Views	56	21	$20.00	$20.00	$9.74	$40.00	$15.73	2025-03-27
73110	CPT	X-ray Of Wrist, 3 Or More Views	58	22	$15.00	$15.00	$9.66	$28.00	$15.72	2025-03-27
83718	CPT	Lab Test - Hdl Cholesterol Level	58	22	$30.00	$30.00	$10.12	$24.00	$15.60	2025-03-27
71046	CPT	X-ray Of Chest, 2 Views	36	12	$12.50	$12.50	$7.73	$19.93	$15.55	2025-03-27
73610	CPT	X-ray Of Ankle, 3 Or More Views	58	22	$15.00	$15.00	$8.59	$28.00	$15.50	2025-03-27
73630	CPT	X-ray Of Foot, 3 Or More Views	58	22	$15.00	$15.00	$8.02	$28.00	$15.50	2025-03-27
73562	CPT	X-ray Of Knee, 3 Views	58	22	$15.00	$15.00	$9.82	$30.00	$15.42	2025-03-27
70250	CPT	X-ray Of Skull Bones, 1-3 Views	58	22	$15.00	$15.00	$9.37	$30.00	$15.32	2025-03-27
73130	CPT	X-ray Of Hand, 3 Or More Views	58	22	$15.00	$15.00	$8.51	$30.00	$15.30	2025-03-27
87850	CPT	Lab Test - Identification Of Gonorrhea Bacteria DNA Using Direct Observation	52	19	$30.00	$30.00	$7.61	$40.00	$15.22	2025-03-27
71100	CPT	X-ray Of Ribs On One Side, 2 Views	58	22	$12.50	$12.50	$9.30	$31.00	$15.17	2025-03-27
84165	CPT	Lab Test - Protein Level In Blood	58	22	$30.00	$30.00	$13.00	$30.00	$15.01	2025-03-27
83036	CPT	Lab Test - Hemoglobin A1c Level	56	21	$30.00	$30.00	$9.00	$30.00	$15.00	2025-03-27
85378	CPT	Lab Test - Qualitative D-dimer Test	54	20	$60.00	$60.00	$9.97	$60.00	$15.00	2025-03-27
72072	CPT	X-ray Of Mid Back, 3 Views	56	21	$15.00	$15.00	$9.96	$34.00	$15.00	2025-03-27
73050	CPT	X-ray Of Shoulder Joint Without Contrast	58	22	$15.00	$15.00	$8.05	$33.00	$15.00	2025-03-27
73502	CPT	X-ray Of Single Hip, 2-3 Views	34	11	$15.00	$15.00	$9.27	$30.81	$15.00	2025-03-27
83625	CPT	Lab Test - Ldh Enzyme Level	58	22	$70.00	$70.00	$11.50	$27.50	$14.99	2025-03-27
83615	CPT	Lab Test - Ldh Enzyme Level	58	22	$70.00	$70.00	$11.50	$27.50	$14.99	2025-03-27
84703	CPT	Lab Test - Pregnancy Hormone Identification	56	21	$30.00	$30.00	$9.29	$25.00	$14.82	2025-03-27
72080	CPT	X-ray Of Mid/Lower Back Junction	58	22	$12.50	$12.50	$8.74	$34.00	$14.50	2025-03-27
73030	CPT	X-ray Of Shoulder, 2 Or More Views	58	22	$12.50	$12.50	$8.14	$26.00	$14.50	2025-03-27
85379	CPT	Lab Test - Quantitative D-dimer Test	52	19	$15.00	$15.00	$7.11	$17.00	$14.22	2025-03-27
72070	CPT	X-ray Of Mid Back, 2 Views	58	22	$12.50	$12.50	$9.19	$33.00	$14.10	2025-03-27
74018	CPT	X-ray Of Abdomen, 1 View	36	12	$12.50	$12.50	$12.40	$18.48	$13.92	2025-03-27
73080	CPT	X-ray Of Elbow, 3 Or More Views	58	22	$15.00	$15.00	$8.59	$28.00	$13.88	2025-03-27
72040	CPT	X-ray Of Neck, 2 Or 3 Views	56	21	$12.50	$12.50	$9.39	$22.47	$13.87	2025-03-27
77072	CPT	X-ray For Measurement Of Bone Age	22	8	$28.00	$28.00	$11.28	$28.00	$13.86	2025-03-27
82951	CPT	Lab Test - Glucose Level Following Sugar Intake	58	22	$75.00	$75.00	$11.00	$20.00	$13.65	2025-03-27
82950	CPT	Lab Test - Glucose Level Following Sugar Intake	58	22	$75.00	$75.00	$11.00	$20.00	$13.65	2025-03-27
84478	CPT	Lab Test - Triglycerides Level	58	22	$15.00	$15.00	$7.09	$15.00	$13.60	2025-03-27
73560	CPT	X-ray Of Knee, 1 Or 2 Views	58	22	$12.50	$12.50	$8.56	$23.19	$13.49	2025-03-27
73600	CPT	X-ray Of Ankle, 2 Views	58	22	$12.50	$12.50	$8.29	$22.60	$13.45	2025-03-27
85613	CPT	Lab Test - Measurement Of Blood Clotting Factor X Using Diluted Russell Viper Ve…	44	20	$75.00	$75.00	$9.00	$75.00	$13.37	2025-03-27
83721	CPT	Lab Test - Ldl Cholesterol Level	54	20	$30.00	$30.00	$6.50	$29.00	$13.33	2025-03-27
80076	CPT	Lab Test - Liver Function Panel	56	21	$20.00	$20.00	$10.09	$35.00	$13.26	2025-03-27
73140	CPT	X-ray Of Fingers	58	22	$12.50	$12.50	$5.95	$25.73	$13.14	2025-03-27
70030	CPT	X-ray Of Eye To Detect Foreign Body	58	22	$12.50	$12.50	$7.76	$28.00	$13.00	2025-03-27
70328	CPT	X-ray Of One Side Of Jaw Joint	58	22	$12.50	$12.50	$7.00	$27.00	$12.86	2025-03-27
71120	CPT	X-ray Of Breastbone	58	22	$12.50	$12.50	$8.39	$32.00	$12.71	2025-03-27
73010	CPT	X-ray Of Shoulder Blade	58	22	$12.50	$12.50	$8.37	$27.00	$12.63	2025-03-27
72170	CPT	X-ray Of Pelvis, 1-2 Views	58	22	$15.00	$15.00	$7.07	$23.56	$12.56	2025-03-27
73100	CPT	X-ray Of Wrist, 2 Views	58	22	$12.50	$12.50	$8.03	$26.00	$12.50	2025-03-27
70210	CPT	X-ray Of Paranasal Sinuses, 1-2 Views	58	22	$12.50	$12.50	$8.24	$27.00	$12.50	2025-03-27
70160	CPT	X-ray Of Nose Bones	58	22	$12.50	$12.50	$8.95	$24.00	$12.49	2025-03-27
70140	CPT	X-ray Of Face Bones, 1-2 Views	58	22	$12.50	$12.50	$8.31	$27.00	$12.44	2025-03-27
73060	CPT	X-ray Of Upper Arm	58	22	$12.50	$12.50	$8.03	$29.00	$12.42	2025-03-27
80069	CPT	Lab Test - Kidney Function Panel	56	21	$30.00	$30.00	$11.90	$70.00	$12.32	2025-03-27
72200	CPT	X-ray Of Sacroiliac Joints, 1-2 Views	56	21	$12.50	$12.50	$6.58	$27.00	$12.32	2025-03-27
73590	CPT	X-ray Of Lower Leg	58	22	$12.50	$12.50	$7.81	$27.00	$12.20	2025-03-27
73090	CPT	X-ray Of Lower Arm	58	22	$12.50	$12.50	$7.23	$24.00	$12.00	2025-03-27
73120	CPT	X-ray Of Hand, 2 Views	58	22	$12.50	$12.50	$7.32	$20.29	$12.00	2025-03-27
73070	CPT	X-ray Of Elbow , 2 Views	58	22	$12.50	$12.50	$7.67	$26.00	$12.00	2025-03-27
72220	CPT	X-ray Of Tailbone	58	22	$15.00	$15.00	$7.89	$29.00	$12.00	2025-03-27
73620	CPT	X-ray Of Foot, 2 Views	58	22	$12.50	$12.50	$7.25	$26.00	$12.00	2025-03-27
73650	CPT	X-ray Of Heel	58	22	$10.00	$10.00	$7.55	$33.00	$12.00	2025-03-27
80048	CPT	Lab Test - Basic Metabolic Panel With Total Calcium	54	20	$25.00	$25.00	$8.06	$40.00	$12.00	2025-03-27
73660	CPT	X-ray Of Toes	58	22	$12.50	$12.50	$5.82	$22.11	$11.87	2025-03-27
85385	CPT	Lab Test - Measurement Of Blood Clot Activity	52	19	$15.00	$15.00	$8.28	$17.00	$11.87	2025-03-27
73000	CPT	X-ray Of Collarbone	58	22	$12.50	$12.50	$6.46	$27.00	$11.50	2025-03-27
70360	CPT	X-ray Of Soft Tissue Of The Neck	58	22	$12.50	$12.50	$6.71	$18.00	$11.05	2025-03-27
82575	CPT	Lab Test - Calculation Of Creatinine Clearance	58	22	$30.00	$30.00	$7.00	$21.25	$11.00	2025-03-27
71045	CPT	X-ray Of Chest, 1 View	36	12	$10.00	$10.00	$6.36	$12.00	$10.49	2025-03-27
80178	CPT	Lab Test - Lithium Level	56	21	$30.00	$30.00	$9.24	$20.00	$10.34	2025-03-27
82150	CPT	Lab Test - Amylase Enzyme Level	56	21	$15.00	$15.00	$8.00	$14.00	$10.03	2025-03-27
80051	CPT	Lab Test - Electrolyte Panel	56	21	$10.00	$10.00	$8.66	$25.00	$10.00	2025-03-27
84479	CPT	Lab Test - Thyroid Hormone Uptake Analysis	58	22	$15.00	$15.00	$6.17	$15.00	$10.00	2025-03-27
72020	CPT	X-ray Of Back, Single View	56	21	$10.00	$10.00	$6.40	$21.00	$10.00	2025-03-27
73020	CPT	X-ray Of Shoulder, 1 View	58	22	$10.00	$10.00	$6.45	$25.00	$9.70	2025-03-27
83735	CPT	Lab Test - Magnesium Level	58	22	$20.00	$20.00	$9.00	$15.00	$9.36	2025-03-27
85025	CPT	Lab Test - Complete Blood Cell Count With White Blood Cell Percentage	54	20	$15.00	$15.00	$6.63	$11.14	$9.04	2025-03-27
83540	CPT	Lab Test - Iron Level	58	22	$15.00	$15.00	$6.83	$14.00	$9.03	2025-03-27
83690	CPT	Lab Test - Lipase Enzyme Level	58	22	$15.00	$15.00	$6.00	$15.00	$8.51	2025-03-27
84132	CPT	Lab Test - Potassium Level	58	22	$10.00	$10.00	$6.00	$10.00	$8.00	2025-03-27
82248	CPT	Lab Test - Direct Bilirubin Level	54	20	$10.00	$10.00	$7.02	$12.00	$8.00	2025-03-27
86592	CPT	Lab Test - Identification Of Non-treponemal Syphilis Antibodies	58	22	$15.00	$15.00	$4.07	$12.00	$8.00	2025-03-27
85730	CPT	Lab Test - Thromboplastin Time	58	22	$15.00	$15.00	$5.73	$14.00	$8.00	2025-03-27
84450	CPT	Lab Test - Sgot Enzyme Level	58	22	$10.00	$10.00	$6.39	$20.00	$7.80	2025-03-27
84460	CPT	Lab Test - Sgpt Enzyme Level	58	22	$10.00	$10.00	$6.54	$11.05	$7.80	2025-03-27
82340	CPT	Lab Test - Calcium Level In Urine	58	22	$10.00	$10.00	$6.00	$15.00	$7.49	2025-03-27
84075	CPT	Lab Test - Total Alkaline Phosphatase Level	58	22	$15.00	$15.00	$6.00	$10.20	$7.22	2025-03-27
82310	CPT	Lab Test - Total Calcium Level In Blood	58	22	$10.00	$10.00	$6.00	$10.20	$7.07	2025-03-27
82247	CPT	Lab Test - Total Bilirubin Level	54	20	$25.00	$25.00	$5.00	$24.00	$7.02	2025-03-27
82565	CPT	Lab Test - Creatinine Level In Blood Sample	58	22	$15.00	$15.00	$4.00	$10.00	$7.00	2025-03-27
73501	CPT	X-ray Of Single Hip, 1 View	8	4	$12.50	$12.50	$6.92	$12.20	$6.92	2025-03-27
84300	CPT	Lab Test - Sodium Level In Urine Sample	58	22	$10.00	$10.00	$5.00	$8.00	$6.79	2025-03-27
86900	CPT	Lab Test - Blood Typing For Group And Rh Status	56	21	$14.60	$14.60	$4.17	$12.67	$6.67	2025-03-27
86901	CPT	Lab Test - Blood Typing For Group And Rh Status	56	21	$14.60	$14.60	$4.17	$12.67	$6.67	2025-03-27
84100	CPT	Lab Test - Phosphate Level	58	22	$15.00	$15.00	$6.00	$10.00	$6.63	2025-03-27
85610	CPT	Lab Test - Measurement Of Prothrombin Time	58	22	$15.00	$15.00	$3.75	$12.00	$6.50	2025-03-27
84560	CPT	Lab Test - Uric Acid Level	58	22	$10.00	$10.00	$5.00	$10.00	$6.50	2025-03-27
84550	CPT	Lab Test - Uric Acid Level	58	22	$10.00	$10.00	$5.00	$10.00	$6.50	2025-03-27
82540	CPT	Lab Test - Creatine Level	58	22	$20.00	$20.00	$5.27	$45.00	$6.48	2025-03-27
82570	CPT	Lab Test - Creatinine Level In Sample Other Than Blood	56	21	$50.00	$50.00	$4.00	$12.00	$6.39	2025-03-27
82465	CPT	Lab Test - Total Cholesterol Level	58	22	$10.00	$10.00	$5.00	$10.00	$6.38	2025-03-27
87177	CPT	Laboratory Examination Of Stool For Parasites	56	21	$10.00	$10.00	$3.50	$9.10	$6.33	2025-03-27
85049	CPT	Lab Test - Platelet Count	52	19	$10.00	$10.00	$3.00	$10.00	$6.25	2025-03-27
84520	CPT	Lab Test - Urea Nitrogen Level In Blood	58	22	$10.00	$10.00	$3.79	$10.00	$6.00	2025-03-27
82947	CPT	Lab Test - Glucose Level In Blood	58	22	$10.00	$10.00	$4.85	$8.00	$6.00	2025-03-27
84155	CPT	Lab Test - Total Protein Level In Blood	58	22	$10.00	$10.00	$4.00	$10.20	$6.00	2025-03-27
85045	CPT	Lab Test - Immature Red Blood Cell Count	52	19	$10.00	$10.00	$2.80	$10.00	$5.59	2025-03-27
84156	CPT	Lab Test - Total Protein Level In Urine	48	18	$30.00	$30.00	$2.56	$30.00	$5.12	2025-03-27
85652	CPT	Lab Test - Sedimentation Rate	52	19	$10.00	$10.00	$2.58	$10.00	$4.95	2025-03-27
85008	CPT	Lab Test - Examination Of White Blood Cells Using Microscope	56	21	$10.00	$10.00	$3.00	$17.00	$4.90	2025-03-27
82270	CPT	Lab Test - Identification Of Hidden Blood In Stool Sample Using Chemical Reagent…	58	22	$15.00	$15.00	$2.50	$10.00	$4.54	2025-03-27
81001	CPT	Lab Test - Machine Analysis Of Urine By Dipstick With Microscope Evaluation	48	19	$10.00	$10.00	$3.00	$8.00	$4.43	2025-03-27
85018	CPT	Lab Test - Hemoglobin Blood Count	58	22	$5.00	$5.00	$2.00	$6.55	$4.00	2025-03-27

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