Price Transparency Hospital negotiated rates

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

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Hospital

DOCTORS CENTER HOSPITAL CAROLINA LLC

Carolina, PR · CCN 400132 · Rates published

1,814 distinct procedures filed
7 distinct payers
16,827 rate rows
2025-10-20 last MRF observed
Data quality

7,516 of 16,827 rate rows are consumer-grade (44.7%)

9,311 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 9,121
exceeds 10× this hospital's gross charge — excluded from medians 190
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/OEUQ-1699383060274/machine-readable/660782101_doctors-center-hospital---san-fernando-de-carolina_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/dchpr-carolina
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint 152ad1ecd7b3cf65… · 295,357 bytes · first seen 2026-05-19

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
A9604
HCPCS 		Quadramet (sm-153) 1 $17,260.00 $17,260.00 $17,260.00 nat. median
$11,413
1.5× median
33228
CPT 		Ins Pacing Elec Cardiac Venous 1 $9,897.00 $9,897.00 $9,897.00 nat. median
$11,435
0.9× median
33208
CPT 		Insrt Heart Pm Atrial & Vent 1 $9,897.00 $9,897.00 $9,897.00 nat. median
$11,773
0.8× median
33207
CPT 		Insert Heart Pm Ventricular 1 $9,897.00 $9,897.00 $9,897.00 nat. median
$11,490
0.9× median
23585
CPT 		Mesalamine 400mg Cap 1 $6,631.00 $6,631.00 $6,631.00 nat. median
$7,145
0.9× median
23405
CPT 		Chlorhexidine Gluconate 4% (30 Ml Ud) 1 $6,631.00 $6,631.00 $6,631.00 nat. median
$6,437
1.0× median
28103
CPT 		Nitroglycerin 2% Oint 30gm 1 $6,631.00 $6,631.00 $6,631.00 nat. median
$6,849
1.0× median
43266
CPT 		Gastro W Transendo Stent Placm 1 $5,282.00 $5,282.00 $5,282.00 nat. median
$5,940
0.9× median
43274
CPT 		Ercp Ins Nasobiliar/pancrea 1 $5,282.00 $5,282.00 $5,282.00 nat. median
$5,992
0.9× median
93653
CPT 		Icar Ablt Arrhyt Foc Supravent 3 $5,000.00 $22,012.00 $5,000.00 nat. median
$26,156
outlier · 0.2×
47382
CPT 		Perc,rfa,liver Tumor US Gu Md 3 $450.00 $5,348.00 $4,800.00 nat. median
$6,451
0.7× median
J1162
HCPCS 		Digoxin Immune Fab 40mg Vial 1 $4,777.00 $4,777.00 $4,777.00 nat. median
$7,316
0.7× median
A9600
HCPCS 		Metastron 1 $4,157.00 $4,157.00 $4,157.00 nat. median
$4,907
0.8× median
93620
CPT 		Compre Electrophysiolog Arrhyt 4 $1,350.00 $6,922.00 $4,000.00 nat. median
$8,805
outlier · 0.5×
37220
CPT 		Pta, Illiac Artery Md 5 $1,200.00 $5,297.00 $3,950.00 nat. median
$7,180
0.6× median
37182
CPT 		Tips 4 $3,500.00 $4,000.00 $3,550.00 nat. median
$7,502
outlier · 0.5×
37183
CPT 		Tips Revision 4 $3,500.00 $4,000.00 $3,550.00 nat. median
$7,031
0.5× median
19499
CPT 		Mibb Device 1 $3,533.00 $3,533.00 $3,533.00 nat. median
$3,721
0.9× median
81211
CPT 		Brca1&2 Seq & Com Dup/del 2 $3,340.00 $3,340.00 $3,340.00 nat. median
$1,691
2.0× median
43276
CPT 		Ercp Stent Exchange W/dilate 2 $989.00 $5,282.00 $3,135.50 nat. median
$6,019
0.5× median
29901
CPT 		Cetaphil Gentle Cleanser 473 Ml Bottle 1 $3,000.00 $3,000.00 $3,000.00 nat. median
$3,765
0.8× median
28315
CPT 		Insulin Isophane (Humulin) 100 Unit/ml Unit 1 $3,000.00 $3,000.00 $3,000.00 nat. median
$3,355
0.9× median
22511
CPT 		Vertebroplasty(lumbosacral) 1 $3,000.00 $3,000.00 $3,000.00 nat. median
$4,208
0.7× median
22510
CPT 		Vertebroplasty(cervicothiracic 1 $3,000.00 $3,000.00 $3,000.00 nat. median
$4,220
0.7× median
75870
CPT 		Vein X-ray Skull 1 $2,954.00 $2,954.00 $2,954.00 nat. median
$2,610
1.1× median
93505
CPT 		Endomycardial Biopsy 1 $2,954.00 $2,954.00 $2,954.00 nat. median
$3,652
0.8× median
36251
CPT 		Renal Selec,uni,angiogram Incl 1 $2,954.00 $2,954.00 $2,954.00 nat. median
$3,999
0.7× median
49429
CPT 		Removal Peritoneal Venous Shun 1 $2,954.00 $2,954.00 $2,954.00 nat. median
$3,416
0.9× median
75889
CPT 		Vein X-ray Liver W/hemodynam 1 $2,954.00 $2,954.00 $2,954.00 nat. median
$3,148
0.9× median
58345
CPT 		Fallopian Dilatation 1 $2,898.00 $2,898.00 $2,898.00 nat. median
$3,409
0.9× median
23031
CPT 		(Ophtalmic) Min Oil/white Petrol Oint 3.5gm 1 $2,634.00 $2,634.00 $2,634.00 nat. median
$2,911
0.9× median
37197
CPT 		Transcatheter F.b. Retrieval 2 $2,000.00 $2,954.00 $2,477.00 nat. median
$4,061
0.6× median
50433
CPT 		Plcmt Nephroureteral Cath Perc 2 $1,200.00 $3,231.00 $2,215.50 nat. median
$3,812
0.6× median
36473
CPT 		Endovenous Mechanochemical 1st 2 $1,200.00 $2,954.00 $2,077.00 nat. median
$3,470
0.6× median
37188
CPT 		Venous Mech Tromb Repeat Sub D 2 $1,200.00 $2,954.00 $2,077.00 nat. median
$4,098
0.5× median
37765
CPT 		Stab Phlebectomy Var Vei 10-20 2 $1,200.00 $2,954.00 $2,077.00 nat. median
$3,574
0.6× median
49422
CPT 		Rem Tunneled Peritoneal Cathet 2 $1,200.00 $2,954.00 $2,077.00 nat. median
$3,437
0.6× median
37766
CPT 		Stab Phlebectomy Var Vein 21 + 2 $1,200.00 $2,954.00 $2,077.00 nat. median
$3,908
0.5× median
93458
CPT 		L Hrt Artery/ventricle Angio 6 $1,680.00 $3,020.00 $2,035.00 nat. median
$6,395
outlier · 0.3×
93453
CPT 		Comb Rt & Lf Heart Cath & Ventri 6 $1,680.00 $3,020.00 $2,035.00 nat. median
$5,744
outlier · 0.4×
93451
CPT 		Right Heart Catherization 6 $1,680.00 $3,020.00 $2,035.00 nat. median
$4,834
outlier · 0.4×
93452
CPT 		Insertion Of Catheter Into Left Heart For Diagnosis 6 $1,680.00 $3,020.00 $2,035.00 nat. median
$5,130
outlier · 0.4×
93454
CPT 		Cath Placement In Coronary Art 6 $1,680.00 $3,020.00 $2,035.00 nat. median
$5,709
outlier · 0.4×
J3240
HCPCS 		Thyrogen(alpha-1 Antitrypsin 2 1 $2,021.00 $2,021.00 $2,021.00 nat. median
$2,976
0.7× median
36478
CPT 		Endovenous Ablat Laser 1st Vei 3 $1,200.00 $2,954.00 $2,000.00 nat. median
$4,061
outlier · 0.5×
93533
CPT 		Comb Rt Heart Cath Trans Lt He 5 $1,680.00 $2,205.00 $2,000.00 nat. median
$3,967
0.5× median
37213
CPT 		Continued Trombolytic Inf Suse 3 $1,200.00 $2,954.00 $2,000.00 nat. median
$3,730
0.5× median
37212
CPT 		Venous Infusion For Thrombolys 3 $1,200.00 $2,954.00 $2,000.00 nat. median
$3,439
0.6× median
37214
CPT 		Trombolytic Infusion Final Day 3 $1,200.00 $2,954.00 $2,000.00 nat. median
$3,725
0.5× median
93532
CPT 		Comb Rt Heart Cath Trans Lt Tr 5 $1,680.00 $2,205.00 $2,000.00 nat. median
$3,641
0.5× median

Other procedures at this hospital

Browse this hospital's 1,814 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
10030 CPT Drainage By Catheter Soft Tiss 5 5 $150.00 $150.00 $630.00 $665.00 $650.00 2025-10-20
10035 CPT Wire Localization Soft Tissue 1 1 $300.00 $300.00 $652.00 $652.00 $652.00 2025-10-20
11620 CPT Chlorhex Gluc 0.12% (mouth-wash) Ml 1 1 $9.00 $9.00 $1,503.00 $1,503.00 $1,503.00 2025-10-20
19081 CPT Bx 1st Lesion Stereotac Guidan 1 1 $500.00 $500.00 $1,503.00 $1,503.00 $1,503.00 2025-10-20
19083 CPT Bx 1st Lesion Ultrasound Guid 1 1 $500.00 $500.00 $1,503.00 $1,503.00 $1,503.00 2025-10-20
19085 CPT Bx 1st Lesion Magnetic Resonan 1 1 $500.00 $500.00 $1,503.00 $1,503.00 $1,503.00 2025-10-20
19499 CPT Mibb Device 1 1 $500.00 $500.00 $3,533.00 $3,533.00 $3,533.00 2025-10-20
22505 CPT Baby Saline 0.65% Nasal Drp 30ml 1 1 $1.00 $1.00 $1,490.00 $1,490.00 $1,490.00 2025-10-20
22510 CPT Vertebroplasty(cervicothiracic 1 1 $300.00 $300.00 $3,000.00 $3,000.00 $3,000.00 2025-10-20
22511 CPT Vertebroplasty(lumbosacral) 1 1 $300.00 $300.00 $3,000.00 $3,000.00 $3,000.00 2025-10-20
23031 CPT (Ophtalmic) Min Oil/white Petrol Oint 3.5gm 1 1 $1.00 $1.00 $2,634.00 $2,634.00 $2,634.00 2025-10-20
23405 CPT Chlorhexidine Gluconate 4% (30 Ml Ud) 1 1 $1.00 $1.00 $6,631.00 $6,631.00 $6,631.00 2025-10-20
23585 CPT Mesalamine 400mg Cap 1 1 $3.00 $3.00 $6,631.00 $6,631.00 $6,631.00 2025-10-20
26160 CPT Excision Of Lesion Of Tendon 1 1 $150.00 $150.00 $1,490.00 $1,490.00 $1,490.00 2025-10-20
28103 CPT Nitroglycerin 2% Oint 30gm 1 1 $1.00 $1.00 $6,631.00 $6,631.00 $6,631.00 2025-10-20
28315 CPT Insulin Isophane (Humulin) 100 Unit/ml Unit 1 1 $8.00 $8.00 $3,000.00 $3,000.00 $3,000.00 2025-10-20
29901 CPT Cetaphil Gentle Cleanser 473 Ml Bottle 1 1 $7.00 $7.00 $3,000.00 $3,000.00 $3,000.00 2025-10-20
29902 CPT Emollient Lotion 1 Applic/ml Bottle 1 1 $1.00 $1.00 $1,490.00 $1,490.00 $1,490.00 2025-10-20
32551 CPT Tube Thoracostomy Drainage Sys 5 5 $300.00 $300.00 $21.00 $1,484.00 $735.00 2025-10-20
32556 CPT Pleural Drainage Perc Without Imag 1 1 $350.00 $350.00 $1,764.00 $1,764.00 $1,764.00 2025-10-20
32557 CPT Pleural Drainage Perc W Imagen 3 3 $350.00 $350.00 $630.00 $1,484.00 $665.00 2025-10-20
33016 CPT Pericardiocentesis 3 3 $300.00 $300.00 $630.00 $1,484.00 $665.00 2025-10-20
33207 CPT Insert Heart Pm Ventricular 1 1 $2,000.00 $2,000.00 $9,897.00 $9,897.00 $9,897.00 2025-10-20
33208 CPT Insrt Heart Pm Atrial & Vent 1 1 $2,000.00 $2,000.00 $9,897.00 $9,897.00 $9,897.00 2025-10-20
33228 CPT Ins Pacing Elec Cardiac Venous 1 1 $2,000.00 $2,000.00 $9,897.00 $9,897.00 $9,897.00 2025-10-20
35226 CPT Repair Blood Vessel Lesion 1 1 $400.00 $400.00 $652.00 $652.00 $652.00 2025-10-20
35471 CPT Pta Renal Or Visceral Artery 4 4 $1,000.00 $1,000.00 $74.00 $855.00 $700.00 2025-10-20
35472 CPT Pta Aorta 3 3 $750.00 $750.00 $80.00 $880.00 $720.00 2025-10-20
36002 CPT Injection Procedures Percutane 2 2 $300.00 $300.00 $582.00 $1,200.00 $891.00 2025-10-20
36012 CPT Place Cath 2nd Adrenal, Petr 3 3 $169.00 $169.00 $171.00 $1,219.00 $1,080.00 2025-10-20
36251 CPT Renal Selec,uni,angiogram Incl 1 1 $300.00 $300.00 $2,954.00 $2,954.00 $2,954.00 2025-10-20
36252 CPT Renal Selec,bil,angiogram Incl 4 4 $300.00 $300.00 $1,080.00 $2,954.00 $1,700.00 2025-10-20
36253 CPT Renal Superlective Unilateral 1 1 $300.00 $300.00 $1,080.00 $1,080.00 $1,080.00 2025-10-20
36254 CPT Renal Superlective Bilateral 5 5 $300.00 $300.00 $1,080.00 $2,954.00 $1,200.00 2025-10-20
36299 CPT Juglar Vein 2 2 $300.00 $300.00 $1,080.00 $1,140.00 $1,110.00 2025-10-20
36468 CPT Inj Sclerosant Spider Vein 2 2 $300.00 $300.00 $370.00 $1,200.00 $785.00 2025-10-20
36470 CPT Inj Sclerosant Sol Single Vein 2 2 $300.00 $300.00 $370.00 $1,200.00 $785.00 2025-10-20
36471 CPT Inj Sclerosant Sol Multip Vein 2 2 $300.00 $300.00 $370.00 $1,200.00 $785.00 2025-10-20
36473 CPT Endovenous Mechanochemical 1st 2 2 $300.00 $300.00 $1,200.00 $2,954.00 $2,077.00 2025-10-20
36474 CPT Endovenous Mechanochemical Add 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36475 CPT Endovenous Ablat Ther 1st Vein 3 3 $300.00 $300.00 $1,200.00 $2,954.00 $2,000.00 2025-10-20
36476 CPT Endovenous Ablat The Subs Vein 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
36478 CPT Endovenous Ablat Laser 1st Vei 3 3 $300.00 $300.00 $1,200.00 $2,954.00 $2,000.00 2025-10-20
36479 CPT Endovenous Ablat Laser Sub Vei 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
36514 CPT Uso Terapeutic Plasmaferesis 3 3 $2,000.00 $2,000.00 $1,400.00 $1,422.00 $1,400.00 2025-10-20
36555 CPT Ins/central Venous Access Devi 3 3 $250.00 $250.00 $1,200.00 $1,245.00 $1,226.00 2025-10-20
36556 CPT Non Tunneled(5+ Older) 2 2 $125.00 $125.00 $1,200.00 $1,222.00 $1,211.00 2025-10-20
36557 CPT Tunneled<5 No Port, No Pump Md 3 3 $296.00 $296.00 $120.00 $1,256.00 $1,200.00 2025-10-20
36558 CPT Tunneled(5+older)noport, Pump 4 4 $253.00 $253.00 $1,200.00 $1,790.00 $1,477.50 2025-10-20
36560 CPT Tunneled Cath.w/port(child<5) 2 2 $150.00 $150.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36561 CPT Tunneled Port 5+older Md 5 5 $325.00 $325.00 $1,140.00 $2,954.00 $1,380.00 2025-10-20
36563 CPT Tunneled Cath W/pump 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36565 CPT 2 Tunneled Cath 2 Access 3 3 $300.00 $300.00 $1,200.00 $2,954.00 $1,200.00 2025-10-20
36566 CPT 2 Tunneled Cath 2access Sites 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36568 CPT Non-tunneled Picc(child<5) 3 3 $200.00 $200.00 $1,200.00 $1,484.00 $1,200.00 2025-10-20
36569 CPT Non Tunneled Picc(5+older) 5 5 $200.00 $200.00 $1,140.00 $1,484.00 $1,225.00 2025-10-20
36570 CPT Peripherally Inserted Central 2 2 $250.00 $250.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36571 CPT Ins/tunneled Cetral Ven Cat Md 3 3 $295.00 $295.00 $125.00 $1,321.00 $1,200.00 2025-10-20
36575 CPT Repair Of Tunneled 3 3 $300.00 $300.00 $582.00 $1,200.00 $1,200.00 2025-10-20
36578 CPT Replace Cath Central Venous Ac 3 3 $400.00 $400.00 $1,200.00 $2,954.00 $1,200.00 2025-10-20
36580 CPT Venous Access Non Tunneled 5 5 $188.00 $188.00 $1,140.00 $1,484.00 $1,221.00 2025-10-20
36581 CPT Tunneled,no Port, No Pump 4 4 $188.00 $188.00 $1,140.00 $1,370.00 $1,225.00 2025-10-20
36582 CPT Tunneled Port 2 2 $279.00 $279.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36589 CPT Removal Tunneled No Port, No P 3 3 $150.00 $150.00 $582.00 $1,213.00 $1,200.00 2025-10-20
36590 CPT Removal Tunneled Central Venou 3 3 $150.00 $150.00 $1,200.00 $1,484.00 $1,200.00 2025-10-20
36595 CPT Cva Maintenance Fibria Strippi 3 3 $300.00 $300.00 $1,200.00 $2,954.00 $1,200.00 2025-10-20
36596 CPT Cva Maintenance Through Lumen 1 1 $300.00 $300.00 $1,484.00 $1,484.00 $1,484.00 2025-10-20
36870 CPT Clot Removal Any Method 3 3 $150.00 $150.00 $138.00 $1,200.00 $1,140.00 2025-10-20
36901 CPT Intro Cath Dialysis Circuit 3 3 $300.00 $300.00 $1,200.00 $1,484.00 $1,200.00 2025-10-20
36902 CPT Cath Dialysis Circuit W/angiop 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36903 CPT Cath Dialysis Cir W/angio Sten 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36904 CPT Mech Thrombectomy Or Thromboly 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36905 CPT Thrombectomy/thromboly W/angio 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36906 CPT Thrombect/thrombol W/ang & Ste 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
36907 CPT Angioplasty Central Dialysis S 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37182 CPT Tips 4 4 $400.00 $400.00 $3,500.00 $4,000.00 $3,550.00 2025-10-20
37183 CPT Tips Revision 4 4 $400.00 $400.00 $3,500.00 $4,000.00 $3,550.00 2025-10-20
37184 CPT Primary Arterial Tromb Initial 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37185 CPT Primary Arterial Tromb 2nd Sub 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37186 CPT Secondary Mech Thromb Suction 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37187 CPT Venous Mech Tromb-day 1 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37188 CPT Venous Mech Tromb Repeat Sub D 2 2 $300.00 $300.00 $1,200.00 $2,954.00 $2,077.00 2025-10-20
37191 CPT Ins Endovas Vena Cava Filtr Ap 1 1 $400.00 $400.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37192 CPT Inc Filter Respositioning 3 3 $400.00 $400.00 $1,200.00 $2,954.00 $1,200.00 2025-10-20
37193 CPT Ivc Filter Retriveral (Removal 3 3 $400.00 $400.00 $1,200.00 $2,954.00 $1,200.00 2025-10-20
37195 CPT Thrombolysis Cerebral,intraven 2 2 $400.00 $400.00 $314.00 $1,200.00 $757.00 2025-10-20
37197 CPT Transcatheter F.b. Retrieval 2 2 $400.00 $400.00 $2,000.00 $2,954.00 $2,477.00 2025-10-20
37211 CPT Arterial Thrombolytic Infusion 2 2 $400.00 $400.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37212 CPT Venous Infusion For Thrombolys 3 3 $400.00 $400.00 $1,200.00 $2,954.00 $2,000.00 2025-10-20
37213 CPT Continued Trombolytic Inf Suse 3 3 $400.00 $400.00 $1,200.00 $2,954.00 $2,000.00 2025-10-20
37214 CPT Trombolytic Infusion Final Day 3 3 $400.00 $400.00 $1,200.00 $2,954.00 $2,000.00 2025-10-20
37215 CPT Transcath Stnt Cca W/dis Embo 2 2 $400.00 $400.00 $96.00 $1,200.00 $648.00 2025-10-20
37216 CPT Intravasc Stent Without Dis Emboli 1 1 $400.00 $400.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37220 CPT Pta, Illiac Artery Md 5 5 $700.00 $700.00 $1,200.00 $5,297.00 $3,950.00 2025-10-20
37221 CPT Stent Placement W/pta Pef Uni 2 2 $250.00 $250.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37222 CPT Pta Each Add'i Ipsilateral Ili 2 2 $250.00 $250.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37223 CPT Stent Placement W/pta Within 2 2 $250.00 $250.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37224 CPT Revas Endovas Perc Fem Pol W T 2 2 $250.00 $250.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37226 CPT Stent Placement W/pta Perf Uni 2 2 $250.00 $250.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37228 CPT Transluminal Angioplasty 3 3 $250.00 $250.00 $1,200.00 $1,800.00 $1,568.00 2025-10-20
37230 CPT Tib/peroneal Vasc W Trans Sten 1 1 $250.00 $250.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37232 CPT Revascularization, Endovascul 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37234 CPT Transluminal Stent 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37236 CPT Intrav Stent Open/perc Ini Art 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37237 CPT Intrav Stent Open/perc Add Art 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37238 CPT Intrav Stent Open/perc Ini Vei 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37239 CPT Intrav Stent Open/perc Add Vei 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37241 CPT Venous Embolization Hemorrhage 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37242 CPT Arterial Embolization Hemorrha 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37243 CPT Tumor Organ Ischemia/inf Embol 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37244 CPT Arterial/venous Hemorrhage Emb 2 2 $300.00 $300.00 $1,200.00 $2,000.00 $1,600.00 2025-10-20
37246 CPT Pta Initial Artery 3 3 $300.00 $300.00 $1,100.00 $1,200.00 $1,200.00 2025-10-20
37247 CPT Pta Each Add Artery 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37248 CPT Pta Initial Vein 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37249 CPT Pta Each Add Vein 2 2 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
37252 CPT Intravasc US Initial Noncorona 3 3 $300.00 $300.00 $1,080.00 $2,000.00 $1,140.00 2025-10-20
37253 CPT Intravasc US Add Noncoronary V 3 3 $300.00 $300.00 $1,080.00 $2,000.00 $1,140.00 2025-10-20
37765 CPT Stab Phlebectomy Var Vei 10-20 2 2 $300.00 $300.00 $1,200.00 $2,954.00 $2,077.00 2025-10-20
37766 CPT Stab Phlebectomy Var Vein 21 + 2 2 $300.00 $300.00 $1,200.00 $2,954.00 $2,077.00 2025-10-20
38220 CPT Dx Bone Marrow Aspirations 1 1 $300.00 $300.00 $1,503.00 $1,503.00 $1,503.00 2025-10-20
38221 CPT Dx Bone Marrow Biopsies 2 2 $300.00 $300.00 $500.00 $1,503.00 $1,001.50 2025-10-20
43255 CPT Esophagogastroduodenoscopy Ble 1 1 $300.00 $300.00 $1,764.00 $1,764.00 $1,764.00 2025-10-20
43260 CPT Ercp 6 6 $3,200.00 $3,200.00 $1,100.00 $3,549.00 $1,268.00 2025-10-20
43261 CPT Ercp W Biopsy, Sing/mult 5 5 $3,200.00 $3,200.00 $989.00 $3,549.00 $1,200.00 2025-10-20
43262 CPT Ercp Spincerotomy/papillotomy 5 5 $3,200.00 $3,200.00 $1,100.00 $3,549.00 $1,680.00 2025-10-20
43263 CPT Ercp W P/measure Of Sphincter 5 5 $3,200.00 $3,200.00 $989.00 $1,764.00 $1,200.00 2025-10-20
43264 CPT Ercp Calculus/calc Removal 5 5 $3,200.00 $3,200.00 $1,100.00 $3,549.00 $1,689.00 2025-10-20
43265 CPT Ercp Calculus/calc Destruct 5 5 $3,200.00 $3,200.00 $1,100.00 $5,282.00 $1,689.00 2025-10-20
43266 CPT Gastro W Transendo Stent Placm 1 1 $1,300.00 $1,300.00 $5,282.00 $5,282.00 $5,282.00 2025-10-20
43274 CPT Ercp Ins Nasobiliar/pancrea 1 1 $3,200.00 $3,200.00 $5,282.00 $5,282.00 $5,282.00 2025-10-20
43275 CPT Ercp Remove Forgn Body Duct 1 1 $3,200.00 $3,200.00 $1,764.00 $1,764.00 $1,764.00 2025-10-20
43276 CPT Ercp Stent Exchange W/dilate 2 2 $3,200.00 $3,200.00 $989.00 $5,282.00 $3,135.50 2025-10-20
43453 CPT Esophaus Dilation 2 2 $300.00 $300.00 $180.00 $1,764.00 $972.00 2025-10-20
44300 CPT Enterostomy- External 5 5 $300.00 $300.00 $630.00 $790.00 $665.00 2025-10-20
44320 CPT Colostomy Or Skin Level Cecost 4 4 $300.00 $300.00 $630.00 $1,180.00 $675.00 2025-10-20
44500 CPT Introd Long Gastroinstest Tube 1 1 $300.00 $300.00 $840.00 $840.00 $840.00 2025-10-20
45330 CPT Sigmoidoscopy Flexible Diag 1 1 $500.00 $500.00 $847.00 $847.00 $847.00 2025-10-20
45382 CPT Colonoscopy W/control Bleed 1 1 $700.00 $700.00 $1,094.00 $1,094.00 $1,094.00 2025-10-20
45385 CPT Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope 1 1 $700.00 $700.00 $1,094.00 $1,094.00 $1,094.00 2025-10-20
47010 CPT Hepatotomy Abcess/cyst Drainag 3 3 $250.00 $250.00 $630.00 $1,266.00 $1,230.00 2025-10-20
47382 CPT Perc,rfa,liver Tumor US Gu Md 3 3 $738.00 $738.00 $450.00 $5,348.00 $4,800.00 2025-10-20
47399 CPT Liver Ablation 1 1 $300.00 $300.00 $652.00 $652.00 $652.00 2025-10-20
47490 CPT Perc. Cholecystostomy 5 5 $300.00 $300.00 $630.00 $970.00 $700.00 2025-10-20
47500 CPT Inyec Proc. Percu, Tranhepati 4 4 $300.00 $300.00 $1,140.00 $1,297.00 $1,200.00 2025-10-20
47505 CPT Injec, Cholangio Existing Cath 1 1 $300.00 $300.00 $1,265.00 $1,265.00 $1,265.00 2025-10-20
47510 CPT Intro Percu. Transhepa Cath Bi 2 2 $300.00 $300.00 $1,200.00 $1,479.00 $1,339.50 2025-10-20
47511 CPT Intro Percu Biliary Drainage 2 2 $300.00 $300.00 $1,200.00 $1,542.00 $1,371.00 2025-10-20
47525 CPT Change Of Biliary Drainage Ca 1 1 $300.00 $300.00 $1,380.00 $1,380.00 $1,380.00 2025-10-20
47530 CPT Revise/reinsert Transhepa Tub 1 1 $300.00 $300.00 $1,389.00 $1,389.00 $1,389.00 2025-10-20
47533 CPT Perc Placement Biliary Drainag 2 2 $300.00 $300.00 $1,080.00 $1,200.00 $1,140.00 2025-10-20
47535 CPT Convent Ext Biliary Drai Int-e 2 2 $300.00 $300.00 $1,080.00 $1,200.00 $1,140.00 2025-10-20
47536 CPT Exchange Biliary Drainage Cath 2 2 $300.00 $300.00 $1,080.00 $1,200.00 $1,140.00 2025-10-20
47537 CPT Removal Biliary Drainage Cath 3 3 $300.00 $300.00 $840.00 $1,200.00 $1,080.00 2025-10-20
47539 CPT Plcmt Bile Duct Stent New Without 2 2 $300.00 $300.00 $1,080.00 $1,200.00 $1,140.00 2025-10-20
47540 CPT Plcmt Bile Duct Stent New W Dr 2 2 $300.00 $300.00 $1,080.00 $1,200.00 $1,140.00 2025-10-20
47541 CPT Plcmt Access Biliary Perc New 3 3 $300.00 $300.00 $1,080.00 $1,200.00 $1,140.00 2025-10-20
47801 CPT Placement Choledochael Stent 2 2 $300.00 $300.00 $450.00 $1,200.00 $825.00 2025-10-20
49020 CPT Abscess Drainage Of Peritoneal 4 4 $300.00 $300.00 $630.00 $1,075.00 $675.00 2025-10-20
49021 CPT Abscess Drainage,peritoneal 3 3 $325.00 $325.00 $700.00 $914.00 $878.00 2025-10-20
49083 CPT Abd Paracentesis W/imaging 1 1 $500.00 $500.00 $840.00 $840.00 $840.00 2025-10-20
49185 CPT Sclerotheraphy Fluid Collectio 2 2 $300.00 $300.00 $450.00 $1,503.00 $976.50 2025-10-20
49400 CPT Peritoneogram Air&or Contr 3 3 $300.00 $300.00 $36.00 $1,200.00 $1,200.00 2025-10-20
49405 CPT Image Guided Collect Drain Cat 5 5 $300.00 $300.00 $665.00 $1,503.00 $700.00 2025-10-20
49406 CPT Image Gui Cath Peri/ret Perc 4 4 $300.00 $300.00 $630.00 $1,503.00 $840.50 2025-10-20
49411 CPT Place Ins Mark Perq Abd/pel Re 1 1 $338.00 $338.00 $1,284.00 $1,284.00 $1,284.00 2025-10-20
49418 CPT Ins Periton Tunneled Cath W/im 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
49422 CPT Rem Tunneled Peritoneal Cathet 2 2 $300.00 $300.00 $1,200.00 $2,954.00 $2,077.00 2025-10-20
49423 CPT Change Abscess Drain(injection 3 3 $300.00 $300.00 $80.00 $1,764.00 $1,200.00 2025-10-20
49424 CPT Contrast Inj Abscess Cyst 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
49429 CPT Removal Peritoneal Venous Shun 1 1 $300.00 $300.00 $2,954.00 $2,954.00 $2,954.00 2025-10-20
49442 CPT Ins Cecostomy Other Clonic Tub 1 1 $600.00 $600.00 $1,094.00 $1,094.00 $1,094.00 2025-10-20
49446 CPT Conversion G-tube To G-j Tube 1 1 $600.00 $600.00 $1,764.00 $1,764.00 $1,764.00 2025-10-20
49450 CPT Replac Gastro/cecos Tube W/flu 1 1 $600.00 $600.00 $840.00 $840.00 $840.00 2025-10-20
49451 CPT Replac Distodged J-tube 1 1 $600.00 $600.00 $840.00 $840.00 $840.00 2025-10-20
49452 CPT Replacem Gj-tube Percutaneous 1 1 $600.00 $600.00 $840.00 $840.00 $840.00 2025-10-20
49460 CPT Mechanical Removal Obstructed 1 1 $600.00 $600.00 $840.00 $840.00 $840.00 2025-10-20
50020 CPT Abscess Drian, Renal 5 5 $300.00 $300.00 $630.00 $1,888.00 $1,150.00 2025-10-20
50382 CPT Remov/replace Uret Stent Percu 1 1 $400.00 $400.00 $1,888.00 $1,888.00 $1,888.00 2025-10-20
50384 CPT Removal Ureteral Stent Percuta 2 2 $400.00 $400.00 $1,200.00 $1,888.00 $1,544.00 2025-10-20
50385 CPT Remov/replace Uret Stent Trans 1 1 $400.00 $400.00 $1,888.00 $1,888.00 $1,888.00 2025-10-20
50386 CPT Removal Ureteral Stent Transur 1 1 $400.00 $400.00 $1,888.00 $1,888.00 $1,888.00 2025-10-20
50387 CPT Removal/replace Ext Nephrouret 1 1 $400.00 $400.00 $1,888.00 $1,888.00 $1,888.00 2025-10-20
50389 CPT Removal Nephrostomy Tube Fluor 2 2 $400.00 $400.00 $633.00 $1,200.00 $916.50 2025-10-20
50430 CPT Inj Antegrade Nepho/ureter New 3 3 $400.00 $400.00 $633.00 $1,140.00 $1,080.00 2025-10-20
50431 CPT Inj Antegrade Nepho/ureter Exi 3 3 $400.00 $400.00 $633.00 $1,140.00 $1,080.00 2025-10-20
50433 CPT Plcmt Nephroureteral Cath Perc 2 2 $400.00 $400.00 $1,200.00 $3,231.00 $2,215.50 2025-10-20
50434 CPT Convert Nephrostomy Catheter 2 2 $400.00 $400.00 $1,200.00 $1,888.00 $1,544.00 2025-10-20
50435 CPT Exchange Nephrostomy Cath Perc 2 2 $400.00 $400.00 $1,200.00 $1,888.00 $1,544.00 2025-10-20
50436 CPT Dilat Nephrostomy Tract/pye 3 3 $300.00 $300.00 $210.00 $1,230.00 $1,200.00 2025-10-20
50693 CPT Plcmt Ureteral Stent Exist Rep 2 2 $300.00 $300.00 $700.00 $1,200.00 $950.00 2025-10-20
50694 CPT Plcmt Ure Stent New Acc Without Se 3 3 $300.00 $300.00 $1,200.00 $1,700.00 $1,700.00 2025-10-20
50695 CPT Plcmt Ure Stent New Acc W Sep 1 1 $300.00 $300.00 $1,200.00 $1,200.00 $1,200.00 2025-10-20
51101 CPT Aspiration Bladder By Intracat 1 1 $300.00 $300.00 $969.00 $969.00 $969.00 2025-10-20
51102 CPT Aspiration Bladder W Ins Supra 1 1 $300.00 $300.00 $1,888.00 $1,888.00 $1,888.00 2025-10-20
57010 CPT Abscess Drain, Pelvic 6 6 $300.00 $300.00 $630.00 $2,898.00 $697.50 2025-10-20
58345 CPT Fallopian Dilatation 1 1 $300.00 $300.00 $2,898.00 $2,898.00 $2,898.00 2025-10-20
62280 CPT Neurolytic Inj/inf Subarachnoi 1 1 $400.00 $400.00 $845.00 $845.00 $845.00 2025-10-20
62282 CPT Neurolytic Inj/inf Single Epid 1 1 $400.00 $400.00 $845.00 $845.00 $845.00 2025-10-20
62302 CPT Cervical Myelogram,via Lumbar 1 1 $300.00 $300.00 $742.00 $742.00 $742.00 2025-10-20
62303 CPT Thoracic Myelogram,via Lumbar 1 1 $300.00 $300.00 $742.00 $742.00 $742.00 2025-10-20
62305 CPT Myelogram,two Or More Regions 1 1 $300.00 $300.00 $742.00 $742.00 $742.00 2025-10-20
62322 CPT Injection(s) Of Therapeutic Substance 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
62324 CPT Inj Indewelling Cath,cervw/o I 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
62325 CPT Inj Indewelling Cath,cerv W/i 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
62326 CPT Inj Indewelling Cath,lumbw/oim 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
62327 CPT Inj.indewelling Cath,lumbw/im 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
64421 CPT Intercostal Nerves Block Multi 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
64479 CPT Nerve Root Blk/trans C/t W/img 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
64483 CPT Injection(s) Of Anesthetic Into Lower Spine Using Imaging Guidance 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
64490 CPT Facet Inj Cerv/thor 1w/imaging 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
64493 CPT Facet Inj Lumb/sac 1st W/img 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
64510 CPT Stellate Ganglion Block(cervi 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
64530 CPT Celiac Nerve Block 1 1 $300.00 $300.00 $845.00 $845.00 $845.00 2025-10-20
64633 CPT Destr Cerv/thoracic Single Fac 1 1 $300.00 $300.00 $1,789.00 $1,789.00 $1,789.00 2025-10-20
64635 CPT Destr Lumbar/sacral Single Fac 1 1 $300.00 $300.00 $1,789.00 $1,789.00 $1,789.00 2025-10-20
70015 CPT Contrast X-ray Of Brain 1 1 $156.00 $156.00 $742.00 $742.00 $742.00 2025-10-20
70336 CPT Magnetic Image Jaw Joint 7 7 $400.00 $400.00 $227.00 $700.00 $650.00 2025-10-20
70553 CPT MRI Scan 7 7 $425.00 $425.00 $356.00 $750.00 $650.00 2025-10-20
71551 CPT MRI Chest With Contrast 7 7 $425.00 $425.00 $439.00 $742.00 $650.00 2025-10-20
72142 CPT MRI Neck Spine With Contrast 7 7 $425.00 $425.00 $356.00 $730.00 $650.00 2025-10-20
72147 CPT MRI Chest Spine With Contrast 7 7 $425.00 $425.00 $356.00 $730.00 $650.00 2025-10-20
72149 CPT MRI Lumbar Spine With Contrast 7 7 $425.00 $425.00 $356.00 $730.00 $650.00 2025-10-20
72159 CPT Mr Angio Spine W/o&with Contrast 6 6 $425.00 $425.00 $520.00 $730.00 $648.50 2025-10-20
73219 CPT MRI Upper Extremity With Contrast 7 7 $425.00 $425.00 $356.00 $975.00 $650.00 2025-10-20
73222 CPT MRI Joint Upr Extrem With Contrast 7 7 $425.00 $425.00 $543.00 $742.00 $650.00 2025-10-20
74363 CPT X-ray Bile Duct Dilation 1 1 $300.00 $300.00 $1,255.00 $1,255.00 $1,255.00 2025-10-20
74475 CPT X-ray Control Cath Insert 1 1 $300.00 $300.00 $1,263.00 $1,263.00 $1,263.00 2025-10-20
75563 CPT Card MRI W/stress Img & Dye 1 1 $400.00 $400.00 $742.00 $742.00 $742.00 2025-10-20
75605 CPT Contrast Exam Thoracic Aorta 4 4 $345.00 $345.00 $181.00 $1,259.00 $1,199.50 2025-10-20
75630 CPT X-ray Aorta Leg Arteries 5 5 $369.00 $369.00 $201.00 $2,954.00 $1,210.00 2025-10-20
75705 CPT Artery X-rays Spine 3 3 $415.00 $415.00 $177.00 $1,200.00 $1,200.00 2025-10-20
75710 CPT Angiography,extremity Unilater 3 3 $750.00 $750.00 $162.00 $2,954.00 $1,140.00 2025-10-20
75726 CPT Artery X-rays Abdomen 4 4 $344.00 $344.00 $1,200.00 $1,860.00 $1,300.00 2025-10-20
75731 CPT Artery X-rays Adrenal Gland 4 4 $344.00 $344.00 $180.00 $2,954.00 $1,200.00 2025-10-20
75733 CPT Artery X-rays Adrenals 4 4 $357.00 $357.00 $163.00 $2,954.00 $1,200.00 2025-10-20
75736 CPT Artery X-rays Pelvis 4 4 $344.00 $344.00 $160.00 $1,860.00 $1,280.00 2025-10-20
75741 CPT Artery X-rays Lung 4 4 $357.00 $357.00 $1,200.00 $2,954.00 $1,221.00 2025-10-20
75743 CPT Artery X-rays Lungs 5 5 $384.00 $384.00 $169.00 $2,954.00 $1,369.00 2025-10-20
75746 CPT Artery X-rays Lung 4 4 $344.00 $344.00 $160.00 $2,954.00 $1,200.00 2025-10-20
75756 CPT Artery X-rays Chest 4 4 $344.00 $344.00 $140.00 $2,954.00 $1,200.00 2025-10-20
75774 CPT Artery X-ray Each Vessel 3 3 $283.00 $283.00 $146.00 $1,200.00 $1,200.00 2025-10-20
75803 CPT Lymph Vessel X-ray Arms/legs 2 2 $225.00 $225.00 $92.00 $1,484.00 $788.00 2025-10-20
75810 CPT Vein X-ray Spleen/liver 4 4 $425.00 $425.00 $160.00 $2,954.00 $1,200.00 2025-10-20
75825 CPT Vein X-ray Trunk 4 4 $303.00 $303.00 $1,200.00 $2,954.00 $1,300.00 2025-10-20
75827 CPT Vein X-ray Chest 4 4 $303.00 $303.00 $160.00 $1,484.00 $1,280.00 2025-10-20
75831 CPT Vein X-ray Kidney 4 4 $425.00 $425.00 $160.00 $2,954.00 $1,200.00 2025-10-20
75833 CPT Vein X-ray Kidneys 4 4 $450.00 $450.00 $188.00 $2,954.00 $1,200.00 2025-10-20
75840 CPT Vein X-ray Adrenal Gland 4 4 $425.00 $425.00 $212.00 $2,954.00 $1,200.00 2025-10-20
75842 CPT Vein X-ray Adrenal Glands 3 3 $450.00 $450.00 $188.00 $1,200.00 $1,200.00 2025-10-20
75860 CPT Vein X-ray Neck 4 4 $960.00 $960.00 $180.00 $2,954.00 $1,200.00 2025-10-20
75870 CPT Vein X-ray Skull 1 1 $960.00 $960.00 $2,954.00 $2,954.00 $2,954.00 2025-10-20
75872 CPT Vein X-ray Skull Epidural 4 4 $425.00 $425.00 $180.00 $1,200.00 $891.00 2025-10-20
75880 CPT Vein X-ray Eye Socket 4 4 $125.00 $125.00 $28.00 $1,200.00 $891.00 2025-10-20
75885 CPT Vein X-ray Liver W/hemodynam 2 2 $450.00 $450.00 $180.00 $2,954.00 $1,567.00 2025-10-20
75887 CPT Vein X-ray Liver Without Hemodyn 2 2 $450.00 $450.00 $185.00 $2,954.00 $1,569.50 2025-10-20
75889 CPT Vein X-ray Liver W/hemodynam 1 1 $850.00 $850.00 $2,954.00 $2,954.00 $2,954.00 2025-10-20
75891 CPT Vein X-ray Liver 2 2 $425.00 $425.00 $160.00 $2,954.00 $1,557.00 2025-10-20
75894 CPT X-rays Transcath Therapy 4 4 $625.00 $625.00 $292.00 $2,091.00 $1,291.00 2025-10-20
75964 CPT Repair Artery Blockage Each 2 2 $225.00 $225.00 $100.00 $1,200.00 $650.00 2025-10-20
75966 CPT Repair Arterial Blockage 2 2 $438.00 $438.00 $179.00 $1,200.00 $689.50 2025-10-20
75968 CPT Vascular Biopsy 2 2 $313.00 $313.00 $140.00 $1,200.00 $670.00 2025-10-20
75978 CPT Repair Venous Blockage 3 3 $413.00 $413.00 $250.00 $1,325.00 $1,325.00 2025-10-20
78110 CPT Plasma Volume Single 1 1 $300.00 $300.00 $1,316.00 $1,316.00 $1,316.00 2025-10-20
78111 CPT Plasma Volume Multiple 1 1 $366.00 $366.00 $1,316.00 $1,316.00 $1,316.00 2025-10-20
78453 CPT Ht Muscle Image Planar Sing 1 1 $1,440.00 $1,440.00 $1,316.00 $1,316.00 $1,316.00 2025-10-20
78456 CPT Acute Venous Thrombus Image 1 1 $522.00 $522.00 $1,316.00 $1,316.00 $1,316.00 2025-10-20
78459 CPT Heart Muscle Imaging (Pet) 3 3 $1,000.00 $1,000.00 $275.00 $1,316.00 $969.00 2025-10-20
78491 CPT Heart Image (Pet) Single 1 1 $800.00 $800.00 $1,450.00 $1,450.00 $1,450.00 2025-10-20
78492 CPT Heart Image (Pet) Multiple 1 1 $800.00 $800.00 $1,450.00 $1,450.00 $1,450.00 2025-10-20
78608 CPT Brain Imaging (Pet) 6 6 $800.00 $800.00 $970.00 $1,961.00 $1,750.00 2025-10-20
78650 CPT Csf Leakage Imaging 1 1 $525.00 $525.00 $1,316.00 $1,316.00 $1,316.00 2025-10-20
78811 CPT PET Image Ltd Area 7 7 $750.00 $750.00 $980.00 $1,750.00 $1,400.00 2025-10-20
78812 CPT PET Image Skull-thigh 7 7 $750.00 $750.00 $980.00 $1,750.00 $1,450.00 2025-10-20
78813 CPT PET Image Full Body 7 7 $750.00 $750.00 $1,000.00 $1,961.00 $1,488.00 2025-10-20
78814 CPT PET Image W/ct Lmtd 7 7 $950.00 $950.00 $1,003.00 $2,157.00 $1,607.00 2025-10-20
78815 CPT PET Image W/ct Skull-thigh 7 7 $1,250.00 $1,250.00 $1,013.00 $2,465.00 $1,615.00 2025-10-20
78816 CPT PET Image W/ct Full Body 7 7 $1,350.00 $1,350.00 $1,014.00 $2,692.00 $1,743.00 2025-10-20
78832 CPT Nuclear Localization/abscess 3 3 $263.00 $263.00 $140.00 $1,450.00 $653.00 2025-10-20
80418 CPT Pituitary Evaluation Panel 5 5 $600.00 $600.00 $55.00 $1,375.00 $950.00 2025-10-20
81211 CPT Brca1&2 Seq & Com Dup/del 2 2 $6,534.00 $6,534.00 $3,340.00 $3,340.00 $3,340.00 2025-10-20
81213 CPT Brca1&2 Uncom Dup/del Var 2 2 $1,744.00 $1,744.00 $656.00 $656.00 $656.00 2025-10-20
93451 CPT Right Heart Catherization 6 6 $2,200.00 $2,200.00 $1,680.00 $3,020.00 $2,035.00 2025-10-20
93452 CPT Insertion Of Catheter Into Left Heart For Diagnosis 6 6 $2,200.00 $2,200.00 $1,680.00 $3,020.00 $2,035.00 2025-10-20
93453 CPT Comb Rt & Lf Heart Cath & Ventri 6 6 $2,500.00 $2,500.00 $1,680.00 $3,020.00 $2,035.00 2025-10-20
93454 CPT Cath Placement In Coronary Art 6 6 $2,200.00 $2,200.00 $1,680.00 $3,020.00 $2,035.00 2025-10-20
93458 CPT L Hrt Artery/ventricle Angio 6 6 $2,200.00 $2,200.00 $1,680.00 $3,020.00 $2,035.00 2025-10-20
93460 CPT R&l Heart Cath Ventricle Angio 6 6 $2,500.00 $2,500.00 $1,680.00 $3,020.00 $1,910.50 2025-10-20
93503 CPT Insert Placement Flow Cath Monitoring 1 1 $750.00 $750.00 $1,484.00 $1,484.00 $1,484.00 2025-10-20
93505 CPT Endomycardial Biopsy 1 1 $750.00 $750.00 $2,954.00 $2,954.00 $2,954.00 2025-10-20
93530 CPT Rt Heart Cath Congenital Ca 5 5 $2,200.00 $2,200.00 $1,680.00 $2,205.00 $2,000.00 2025-10-20
93531 CPT Comb Rt Heart Cath Retrogr Lt 5 5 $2,200.00 $2,200.00 $1,680.00 $2,205.00 $2,000.00 2025-10-20
93532 CPT Comb Rt Heart Cath Trans Lt Tr 5 5 $2,200.00 $2,200.00 $1,680.00 $2,205.00 $2,000.00 2025-10-20
93533 CPT Comb Rt Heart Cath Trans Lt He 5 5 $2,200.00 $2,200.00 $1,680.00 $2,205.00 $2,000.00 2025-10-20
93620 CPT Compre Electrophysiolog Arrhyt 4 4 $2,000.00 $2,000.00 $1,350.00 $6,922.00 $4,000.00 2025-10-20
93653 CPT Icar Ablt Arrhyt Foc Supravent 3 3 $7,000.00 $7,000.00 $5,000.00 $22,012.00 $5,000.00 2025-10-20
A9596 HCPCS Gallium 68 Psma 11 (Illuccix) 1 1 $5,000.00 $5,000.00 $992.00 $992.00 $992.00 2025-10-20
A9600 HCPCS Metastron 1 1 $4,200.00 $4,200.00 $4,157.00 $4,157.00 $4,157.00 2025-10-20
A9604 HCPCS Quadramet (sm-153) 1 1 $3,200.00 $3,200.00 $17,260.00 $17,260.00 $17,260.00 2025-10-20
J1162 HCPCS Digoxin Immune Fab 40mg Vial 1 1 $1,434.00 $1,434.00 $4,777.00 $4,777.00 $4,777.00 2025-10-20
J3240 HCPCS Thyrogen(alpha-1 Antitrypsin 2 1 1 $1,750.00 $1,750.00 $2,021.00 $2,021.00 $2,021.00 2025-10-20
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