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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

HOSPITAL EPISCOPAL SAN LUCAS METRO

San Juan, PR · CCN 400139 · Rates published

970 distinct procedures filed
17 distinct payers
14,242 rate rows
2026-07-18 last MRF observed
Data quality

14,194 of 14,242 rate rows are consumer-grade (99.7%)

48 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
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 48
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalsanlucastorage.blob.core.windows.net/images/price-transparency/66-1014091-San-Lucas-Metro-Inc-standardcharges.csv
Found on page https://sanlucaspr.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-10-03
Content fingerprint 950fe51eb3cb989d… · 548,630 bytes · first seen 2026-05-15

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
81795
CPT 		Toxoplasma Gondi/pcr Fluid 1 $1,700.00 $1,700.00 $1,700.00 —
81229
CPT 		Snp Microarray-ped (reveal) 13 $231.20 $1,160.00 $1,160.00 nat. median
$1,230
0.9× median
0360
RC 		Ambulatory Surgery 13 $350.00 $1,750.00 $900.00 nat. median
$1,707
0.5× median
0200
RC 		Intensive Care (icu) 15 $622.00 $980.00 $826.00 nat. median
$3,863
outlier · 0.2×
81507
CPT 		Harmony Prenatal Test 12 $100.00 $795.00 $795.00 nat. median
$795
1.0× median
43263
CPT 		Ercp Sphincter Pressure Measure 16 $501.64 $1,812.99 $789.50 nat. median
$2,290
outlier · 0.3×
43262
CPT 		Ercp Sphincterotom/papillotomy 16 $501.64 $3,648.96 $789.50 nat. median
$3,956
outlier · 0.2×
43264
CPT 		Ercp Removal Duct Calculi/debr 16 $501.64 $3,648.96 $789.50 nat. median
$3,917
outlier · 0.2×
43278
CPT 		Ercp Lesion Ablate W/dilate 16 $501.64 $3,648.96 $789.50 nat. median
$4,026
outlier · 0.2×
43261
CPT 		Ercp W/biopsy 16 $501.64 $3,648.96 $789.50 nat. median
$3,989
outlier · 0.2×
43274
CPT 		Ercp Duct Sent Placement 16 $501.64 $5,430.19 $789.50 nat. median
$5,953
outlier · 0.1×
43265
CPT 		Ercp Destruct Calculi Any Meth 16 $501.64 $5,430.19 $789.50 nat. median
$5,855
outlier · 0.1×
43276
CPT 		Ercp Stent Exchange W/dilate 16 $501.64 $1,813.99 $789.50 nat. median
$5,970
outlier · 0.1×
43275
CPT 		Ercp Remove Frgn Body/ste Duct 16 $501.64 $5,430.19 $789.50 nat. median
$2,456
outlier · 0.3×
43277
CPT 		Ercp Ea Duct/ampulla Dilate 16 $501.64 $5,430.19 $789.50 nat. median
$4,066
outlier · 0.2×
43260
CPT 		Ercp Diagnostic Proc Only 16 $501.64 $3,648.96 $787.50 nat. median
$3,884
outlier · 0.2×
0214
RC 		Telemetry 15 $20.14 $950.00 $745.00 nat. median
$2,859
outlier · 0.3×
36514
CPT 		Therapeutic Plasmapheresis 13 $30.00 $1,639.28 $700.00 nat. median
$1,993
outlier · 0.4×
0120
RC 		Semi-pvt Room & Board Med/Surg 15 $658.00 $890.00 $700.00 nat. median
$856
0.8× median
36512
CPT 		Therapeutic Apheresis For Rbc 11 $30.00 $1,639.28 $700.00 nat. median
$1,950
outlier · 0.4×
36516
CPT 		Apheresis Adsorp/reinfuse 11 $30.00 $4,685.17 $700.00 nat. median
$4,796
outlier · 0.1×
36511
CPT 		Therapeutic Apheresis For Wbc 11 $30.00 $1,639.28 $700.00 nat. median
$1,951
outlier · 0.4×
0160
RC 		Isolation Room & Board Med/Sur 15 $330.00 $925.00 $670.50 nat. median
$852
0.8× median
81406
CPT 		X-linked Agammaglobulinemia 14 $282.88 $1,260.00 $610.36 nat. median
$426
1.4× median
87903
CPT 		HIV-penotype 14 $488.66 $853.00 $591.43 nat. median
$518
1.1× median
81220
CPT 		Cystic Fibrosis Profile 97 Mut 15 $115.60 $1,004.30 $556.60 nat. median
$557
1.0× median
36513
CPT 		Therapeutic Apheresis Platelet 11 $30.00 $700.00 $551.00 nat. median
$571
1.0× median
87633
CPT 		Rsv / Pcr 11 $416.78 $575.00 $460.08 nat. median
$438
1.1× median
77778
CPT 		Interstitial Rad.source Applic 8 $387.09 $534.12 $459.85 nat. median
$754
0.6× median
87483
CPT 		Meningitis Encephalitis Spinal 7 $375.00 $514.55 $416.78 nat. median
$448
0.9× median
0193
RC 		Skill Nursing Room Level 3 7 $352.00 $800.00 $400.00 nat. median
$854
outlier · 0.5×
0194
RC 		Skill Nursing Room Level 4 6 $352.00 $1,100.00 $400.00 nat. median
$853
outlier · 0.5×
0191
RC 		Skill Nursing Room Level I 8 $340.00 $600.00 $400.00 nat. median
$852
outlier · 0.5×
0192
RC 		Skill Nursing Room Level 2 7 $352.00 $700.00 $400.00 nat. median
$853
outlier · 0.5×
78452
CPT 		Myocard Perf Rest Spect Mult 14 $225.00 $1,005.01 $361.68 nat. median
$1,464
outlier · 0.2×
36450
CPT 		Exchange Trans.blood Newborn 6 $178.06 $437.18 $353.59 nat. median
$542
0.7× median
78830
CPT 		Brain Spect 11 $173.56 $1,005.01 $350.44 nat. median
$1,337
outlier · 0.3×
78803
CPT 		Liver Imaging (spect) 14 $125.00 $1,005.01 $296.06 nat. median
$900
outlier · 0.3×
81225
CPT 		Clopidogrel Cyp2c19 Genotyping 10 $183.68 $291.36 $291.36 nat. median
$303
1.0× median
81404
CPT 		Spink-1 14 $110.00 $1,260.00 $287.07 nat. median
$322
0.9× median
87912
CPT 		Hepatitis B (hbv) Genotype 11 $257.45 $355.00 $284.12 nat. median
$265
1.1× median
77290
CPT 		Set Radiation Therapy Field 11 $4.94 $458.21 $281.82 nat. median
$422
0.7× median
78071
CPT 		Parathyroid Planar W/spect 14 $71.50 $319.35 $264.11 nat. median
$449
0.6× median
78227
CPT 		Hepatobili System Image W/drug 16 $95.00 $431.00 $259.19 nat. median
$675
outlier · 0.4×
87902
CPT 		Hcv Genotype 16 $30.00 $382.87 $257.45 nat. median
$309
0.8× median
87901
CPT 		HIV-genotype (pcr) 16 $30.00 $450.00 $257.45 nat. median
$309
0.8× median
C1751
HCPCS 		Catheter, Infunsion, Inserted Peripherally, Centrally Or Midline 4 $250.00 $250.00 $250.00 nat. median
$335
0.7× median
C1788
HCPCS 		Port, Indwelling (Implantable 5 $250.00 $280.00 $250.00 nat. median
$739
outlier · 0.3×
78451
CPT 		Myocard Perf Rest Spect Single 14 $110.00 $1,005.01 $248.09 nat. median
$1,355
outlier · 0.2×
74178
CPT 		CT Abd & Pel 1+ Section/regns 17 $137.50 $274.93 $236.50 nat. median
$539
outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 970 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
81795 CPT Toxoplasma Gondi/pcr Fluid 1 1 — — $1,700.00 $1,700.00 $1,700.00 2026-07-18
81229 CPT Snp Microarray-ped (reveal) 13 13 — — $231.20 $1,160.00 $1,160.00 2026-07-18
0360 RC Ambulatory Surgery 46 13 — — $350.00 $1,750.00 $900.00 2026-07-18
0200 RC Intensive Care (icu) 15 15 $1,200.00 — $622.00 $980.00 $826.00 2026-07-18
81507 CPT Harmony Prenatal Test 12 12 — — $100.00 $795.00 $795.00 2026-07-18
43261 CPT Ercp W/biopsy 16 16 $668.00 — $501.64 $3,648.96 $789.50 2026-07-18
43265 CPT Ercp Destruct Calculi Any Meth 16 16 $1,330.00 — $501.64 $5,430.19 $789.50 2026-07-18
43276 CPT Ercp Stent Exchange W/dilate 16 16 $2,155.00 — $501.64 $1,813.99 $789.50 2026-07-18
43275 CPT Ercp Remove Frgn Body/ste Duct 16 16 $1,330.00 — $501.64 $5,430.19 $789.50 2026-07-18
43278 CPT Ercp Lesion Ablate W/dilate 16 16 $1,330.00 — $501.64 $3,648.96 $789.50 2026-07-18
43262 CPT Ercp Sphincterotom/papillotomy 16 16 $1,330.00 — $501.64 $3,648.96 $789.50 2026-07-18
43264 CPT Ercp Removal Duct Calculi/debr 16 16 $1,330.00 — $501.64 $3,648.96 $789.50 2026-07-18
43277 CPT Ercp Ea Duct/ampulla Dilate 16 16 $1,330.00 — $501.64 $5,430.19 $789.50 2026-07-18
43263 CPT Ercp Sphincter Pressure Measure 16 16 $1,330.00 — $501.64 $1,812.99 $789.50 2026-07-18
43274 CPT Ercp Duct Sent Placement 16 16 $2,155.00 — $501.64 $5,430.19 $789.50 2026-07-18
43260 CPT Ercp Diagnostic Proc Only 16 16 $668.00 — $501.64 $3,648.96 $787.50 2026-07-18
0214 RC Telemetry 15 15 $1,100.00 — $20.14 $950.00 $745.00 2026-07-18
36516 CPT Apheresis Adsorp/reinfuse 11 11 — — $30.00 $4,685.17 $700.00 2026-07-18
36512 CPT Therapeutic Apheresis For Rbc 11 11 — — $30.00 $1,639.28 $700.00 2026-07-18
0120 RC Semi-pvt Room & Board Med/Surg 15 15 $1,000.00 — $658.00 $890.00 $700.00 2026-07-18
36514 CPT Therapeutic Plasmapheresis 13 13 — — $30.00 $1,639.28 $700.00 2026-07-18
36511 CPT Therapeutic Apheresis For Wbc 11 11 — — $30.00 $1,639.28 $700.00 2026-07-18
0160 RC Isolation Room & Board Med/Sur 28 15 $1,100.00 — $330.00 $925.00 $670.50 2026-07-18
81406 CPT X-linked Agammaglobulinemia 14 14 — — $282.88 $1,260.00 $610.36 2026-07-18
87903 CPT HIV-penotype 14 14 — — $488.66 $853.00 $591.43 2026-07-18
81220 CPT Cystic Fibrosis Profile 97 Mut 15 15 — — $115.60 $1,004.30 $556.60 2026-07-18
36513 CPT Therapeutic Apheresis Platelet 11 11 — — $30.00 $700.00 $551.00 2026-07-18
87633 CPT Rsv / Pcr 11 11 — — $416.78 $575.00 $460.08 2026-07-18
77778 CPT Interstitial Rad.source Applic 8 8 — — $387.09 $534.12 $459.85 2026-07-18
87483 CPT Meningitis Encephalitis Spinal 7 7 — — $375.00 $514.55 $416.78 2026-07-18
0194 RC Skill Nursing Room Level 4 6 6 $1,200.00 — $352.00 $1,100.00 $400.00 2026-07-18
0192 RC Skill Nursing Room Level 2 7 7 $750.00 — $352.00 $700.00 $400.00 2026-07-18
0193 RC Skill Nursing Room Level 3 7 7 $850.00 — $352.00 $800.00 $400.00 2026-07-18
0191 RC Skill Nursing Room Level I 8 8 $700.00 — $340.00 $600.00 $400.00 2026-07-18
78452 CPT Myocard Perf Rest Spect Mult 14 14 — — $225.00 $1,005.01 $361.68 2026-07-18
36450 CPT Exchange Trans.blood Newborn 6 6 — — $178.06 $437.18 $353.59 2026-07-18
78830 CPT Brain Spect 11 11 — — $173.56 $1,005.01 $350.44 2026-07-18
78803 CPT Liver Imaging (spect) 14 14 — — $125.00 $1,005.01 $296.06 2026-07-18
81225 CPT Clopidogrel Cyp2c19 Genotyping 10 10 — — $183.68 $291.36 $291.36 2026-07-18
81404 CPT Spink-1 14 14 — — $110.00 $1,260.00 $287.07 2026-07-18
87912 CPT Hepatitis B (hbv) Genotype 11 11 — — $257.45 $355.00 $284.12 2026-07-18
77290 CPT Set Radiation Therapy Field 11 11 — — $4.94 $458.21 $281.82 2026-07-18
78071 CPT Parathyroid Planar W/spect 14 14 — — $71.50 $319.35 $264.11 2026-07-18
78227 CPT Hepatobili System Image W/drug 16 16 — — $95.00 $431.00 $259.19 2026-07-18
87902 CPT Hcv Genotype 16 16 — — $30.00 $382.87 $257.45 2026-07-18
87901 CPT HIV-genotype (pcr) 16 16 — — $30.00 $450.00 $257.45 2026-07-18
C1788 HCPCS Port, Indwelling (Implantable 5 5 $555.00 — $250.00 $280.00 $250.00 2026-07-18
C1751 HCPCS Catheter, Infunsion, Inserted Peripherally, Centrally Or Midline 4 4 $135.00 — $250.00 $250.00 $250.00 2026-07-18
78451 CPT Myocard Perf Rest Spect Single 14 14 — — $110.00 $1,005.01 $248.09 2026-07-18
74178 CPT CT Abd & Pel 1+ Section/regns 17 17 — — $137.50 $274.93 $236.50 2026-07-18
81350 CPT Ugt 1 A 1 Irinotecan Toxicity 13 13 — — $54.70 $876.75 $234.00 2026-07-18
74174 CPT CT Angio Abd & Pelv Without &with Contrast 16 16 — — $134.50 $297.19 $225.00 2026-07-18
74177 CPT CT Abd & Pelvis With Contrast 17 17 — — $137.50 $274.93 $225.00 2026-07-18
75574 CPT CT Angio Cardiac W 3d Image 16 16 — — $100.00 $414.96 $220.86 2026-07-18
81342 CPT Tcell Gene Rearrang Pcr Bone M 14 14 — — $197.14 $603.75 $211.94 2026-07-18
V2630 HCPCS Intraocular Lens 12 12 $334.00 — $5.00 $250.00 $200.00 2026-07-18
78804 CPT Gallium Scan Whole Body 16 16 — — $92.50 $1,005.01 $191.56 2026-07-18
75635 CPT CT Angio Abdominal Arteries 16 16 — — $89.25 $284.50 $188.89 2026-07-18
74176 CPT CT Abd & Pelvis Without Contrast 17 17 — — $89.50 $225.00 $180.00 2026-07-18
78802 CPT Tumor Imaging Whole Body 16 16 — — $76.00 $1,005.01 $178.93 2026-07-18
78709 CPT Renal Flow 17 17 — — $121.00 $414.38 $178.50 2026-07-18
73206 CPT CT Angio Upr Extrm Without & With Contrast 16 16 — — $90.00 $243.96 $177.06 2026-07-18
72191 CPT CT Angiograph Pelv Without & With Contrast 16 16 — — $90.00 $220.76 $175.00 2026-07-18
74175 CPT CT Angio Abdomen Without & With Contrast 16 16 — — $90.50 $221.85 $175.00 2026-07-18
73706 CPT CT Angio Lwr Extr Without & With Contrast 16 16 — — $92.00 $254.47 $175.00 2026-07-18
71275 CPT CT Angiography/chest W/cm 16 16 — — $90.50 $213.87 $174.11 2026-07-18
88248 CPT Chromosome Analysis 50-100 8 8 — — $173.17 $388.00 $173.17 2026-07-18
88249 CPT Chromosome Analysis 100 8 8 — — $173.17 $225.00 $173.17 2026-07-18
88245 CPT Chromosome Analysis 20-25 8 8 — — $173.17 $213.80 $173.17 2026-07-18
70496 CPT CT Angiography Head W/cm 16 16 — — $91.00 $210.25 $172.67 2026-07-18
70498 CPT CT Angiography Neck W/cm 16 16 — — $91.00 $209.52 $172.34 2026-07-18
78707 CPT Renal Scan 17 17 — — $109.50 $414.38 $170.00 2026-07-18
78075 CPT I-131 Mibg 16 16 — — $100.00 $1,005.01 $169.56 2026-07-18
9928 RC — 60 15 $350.00 — $132.30 $240.00 $168.00 2026-07-18
74262 CPT CT Colonography With Contrast 12 12 — — $23.00 $299.54 $167.48 2026-07-18
75600 CPT Aortography Thor Without Serialogr 15 15 — — $23.00 $2,423.07 $167.31 2026-07-18
93975 CPT Duplex Art Mesenteric Complete 16 16 — — $75.00 $233.08 $162.62 2026-07-18
0459 RC Emergency Room (Traumatic) 14 14 $350.00 — $132.30 $240.00 $162.50 2026-07-18
73202 CPT CT Upp Extr Without Cont.mat.fol/c 17 17 — — $110.00 $221.85 $162.50 2026-07-18
88182 CPT Cell Cycle Flow Cytometry 6 6 — — $55.00 $193.00 $161.98 2026-07-18
74170 CPT CT Abdomen Wo/cm F Cm 17 17 — — $84.00 $196.84 $157.50 2026-07-18
72194 CPT CT Pelvis Wo/cm F By Cm 17 17 — — $81.00 $203.73 $157.50 2026-07-18
73201 CPT CT Upper Ext W/cont. 17 17 — — $97.50 $274.93 $157.24 2026-07-18
70482 CPT CT Sc Orbit/ear/fossa WO&with Contrast 16 16 — — $130.00 $233.45 $155.89 2026-07-18
78278 CPT Acute Gi Blood Loss Imaging 16 16 — — $87.50 $320.44 $154.28 2026-07-18
75831 CPT Venograms 16 16 — — $6.00 $2,423.07 $153.71 2026-07-18
78014 CPT Thyroid Img W/blood Flow W/upt 16 16 — — $80.00 $309.34 $152.14 2026-07-18
88235 CPT Amniotic Fluid 12 12 — — $75.00 $568.49 $150.30 2026-07-18
74261 CPT CT Colonography Diagnostic 12 12 — — $81.86 $257.95 $150.00 2026-07-18
72132 CPT CT Lumbar Spine W/cm 17 17 — — $89.25 $274.93 $150.00 2026-07-18
73702 CPT CT Lower Extremity Wo/cm F Cm 17 17 — — $74.38 $218.59 $150.00 2026-07-18
74160 CPT CT Abdomen W/contrast Material 17 17 — — $89.25 $180.28 $150.00 2026-07-18
72193 CPT CT Pelvis W/contrast Material 17 17 — — $89.25 $180.28 $150.00 2026-07-18
77470 CPT Radioelement Application 8 8 — — $32.87 $445.33 $149.91 2026-07-18
72130 CPT CT Thoraci Spine Wo/cm F By Cm 17 17 — — $70.50 $213.15 $149.21 2026-07-18
72133 CPT CT Lumbar S. Wo/cm F Cm 17 17 — — $100.00 $210.62 $147.75 2026-07-18
72127 CPT CT Cerv.spine Wo/cm-fcm 17 17 — — $70.00 $211.70 $147.41 2026-07-18
71270 CPT CT Thorax Wo/cm F By Cm 17 17 — — $89.25 $175.00 $147.41 2026-07-18
86849 CPT Interferon (quantiferon) 1 1 — — $145.00 $145.00 $145.00 2026-07-18
70492 CPT CT Sft Tiss Neck W/ocont.mat&f 17 17 — — $78.00 $175.00 $144.93 2026-07-18
81207 CPT Bcr-abl1 Transcript 15 15 — — $99.00 $504.00 $144.84 2026-07-18
78264 CPT Gastric Emptying Scan 16 16 — — $82.50 $317.18 $144.81 2026-07-18
88264 CPT Chromosome Analysis 20-25 8 8 — — $144.61 $382.00 $144.61 2026-07-18
88237 CPT Chromosome Analysis(kariotype) 12 12 — — $30.00 $428.00 $143.75 2026-07-18
78472 CPT Gated Spect 16 16 — — $112.50 $309.34 $141.31 2026-07-18
88233 CPT Chromosome Analysis Tissue Bio 8 8 — — $140.73 $190.00 $140.73 2026-07-18
78262 CPT Gastroesophageal Ref 16 16 — — $95.00 $309.34 $140.64 2026-07-18
88262 CPT Chromosome Analysis 15-20 12 12 — — $125.00 $428.00 $138.03 2026-07-18
78630 CPT Cysternography 17 17 — — $96.25 $414.38 $137.50 2026-07-18
70481 CPT CT Scan Orbit/ear/fossa With Contrast 17 17 — — $89.25 $211.34 $137.50 2026-07-18
72129 CPT CT Thoracic Spine W/cm 17 17 — — $89.25 $175.00 $137.50 2026-07-18
72126 CPT CT Cervical Spine W/cm 17 17 — — $89.25 $274.93 $137.50 2026-07-18
73701 CPT CT Lower Extremity W/cm 17 17 — — $67.54 $175.00 $137.50 2026-07-18
71260 CPT CT Thorax W/cm 17 17 — — $89.25 $175.00 $137.05 2026-07-18
70460 CPT CT Head/brain W/cm 17 17 — — $88.10 $175.00 $137.05 2026-07-18
70491 CPT CT Soft Tissue N/w/cm 17 17 — — $89.25 $175.00 $137.05 2026-07-18
70488 CPT CT Maxil.w/ocont.mat.fl/cnt.ma 17 17 — — $65.00 $175.00 $137.05 2026-07-18
70470 CPT CT Head/brain Wo/cm Fcm 17 17 — — $61.50 $175.00 $137.05 2026-07-18
70487 CPT CT Maxillofacial W/cont. Mat 17 17 — — $89.25 $175.00 $137.05 2026-07-18
81401 CPT Acondropasie Mutation Fg/fr3 13 13 — — $102.18 $1,470.00 $137.00 2026-07-18
79101 CPT Metastron Tech.comp. 15 15 — — $44.17 $225.00 $135.00 2026-07-18
0750 RC Colonoscopy 14 14 $540.00 — $100.00 $400.00 $135.00 2026-07-18
75572 CPT CT Heart With 3d Image 16 16 — — $50.00 $274.93 $134.93 2026-07-18
78579 CPT Lung Scan Vent (aerosol / Gas) 16 16 — — $44.03 $309.34 $133.99 2026-07-18
78801 CPT Radiopharma. Loc Tumor/multipl 16 16 — — $75.00 $309.34 $132.94 2026-07-18
88230 CPT Prader Willi Syndrome-chrom 15 12 12 — — $116.49 $413.49 $130.16 2026-07-18
78315 CPT Bone By 3 Phase 17 17 — — $100.00 $316.45 $130.00 2026-07-18
73200 CPT CT Upper Ext Without Con 17 17 — — $81.86 $207.48 $130.00 2026-07-18
77012 CPT CT Scan Biopsy/aspiration 14 14 — — $55.79 $350.00 $129.50 2026-07-18
73700 CPT CT Lower Extremity Wo/cm 17 17 — — $81.82 $150.00 $127.97 2026-07-18
71250 CPT CT Scan Biopsy/needle 17 17 — — $81.82 $150.00 $126.00 2026-07-18
72128 CPT CT Thoracic Spine Wo/cm 17 17 — — $81.82 $150.00 $126.00 2026-07-18
78195 CPT Lymphatic & Lymph Nodes Imagin 17 17 — — $52.50 $414.38 $125.00 2026-07-18
78215 CPT Liver & Spleen Scan 16 16 — — $62.50 $309.34 $124.19 2026-07-18
79005 CPT Therapy Hyperthyroid 15 15 — — $42.04 $232.50 $121.50 2026-07-18
93886 CPT Doppler Transcranial Complete 16 16 — — $62.50 $235.08 $121.36 2026-07-18
72192 CPT CT Pelvis Wo/cont Mater 17 17 — — $75.75 $150.00 $120.00 2026-07-18
74150 CPT CT Abdomen Wo/contrast Materia 17 17 — — $74.53 $150.00 $120.00 2026-07-18
78800 CPT Gallium Scan 16 16 — — $60.00 $309.34 $119.46 2026-07-18
78070 CPT Parathyroid Scan 16 16 — — $50.00 $309.34 $118.53 2026-07-18
70490 CPT CT Soft Tissue N Wo/cm 17 17 — — $81.82 $150.00 $115.50 2026-07-18
70486 CPT CT Maxillofacial Without Cont.mat. 17 17 — — $79.82 $150.00 $115.50 2026-07-18
72125 CPT CT Cervical Spine Wo/cm 17 17 — — $81.82 $150.00 $115.50 2026-07-18
72131 CPT CT Lumbar Spine Wo/cm 17 17 — — $81.82 $150.00 $115.50 2026-07-18
70480 CPT CT Scan Orbit/ear/fossa Wo/dye 17 17 — — $53.55 $150.00 $115.50 2026-07-18
70450 CPT CT Head/brain Wo/cm 17 17 — — $60.75 $150.00 $115.50 2026-07-18
74270 CPT Colon Barium Enema 11 11 — — $40.00 $137.05 $108.78 2026-07-18
93925 CPT Duplex Art/lower Ext-bilateral 17 17 — — $34.18 $229.09 $108.00 2026-07-18
78013 CPT Thyroid Imaging W/blood Flow 16 16 — — $57.50 $309.34 $103.53 2026-07-18
78290 CPT Meckels Divert Exam 17 17 — — $36.75 $317.54 $100.00 2026-07-18
87536 CPT HIV RNA By Pcr 16 16 — — $75.00 $190.00 $99.44 2026-07-18
99195 CPT Phlebotomy Therapeutic 7 7 — — $16.25 $104.73 $98.27 2026-07-18
93880 CPT Duplex Carotid Complete Bilat 17 17 — — $35.28 $186.09 $96.00 2026-07-18
87502 CPT Influenza A&b Rt-pcr 11 11 — — $93.83 $131.70 $95.80 2026-07-18
78466 CPT Myocardial Pyp Infarct Scan 17 17 — — $35.00 $309.34 $95.00 2026-07-18
93970 CPT Duplex Ext Venous-bilat Compl 17 17 — — $31.97 $186.09 $94.20 2026-07-18
78306 CPT Bone Scan Whole Body 17 17 — — $70.00 $309.34 $92.50 2026-07-18
88189 CPT Flow Cytometry/read 16 Or < 5 5 — — $83.36 $100.00 $91.92 2026-07-18
81270 CPT Jak2 V617f Mutation 15 15 — — $75.00 $435.10 $91.66 2026-07-18
93930 CPT Duplex Art/upp/ext-bilat Compl 17 17 — — $28.67 $186.09 $88.20 2026-07-18
93890 CPT Doppler Transcr Vasoreactivity 7 7 — — $26.46 $233.81 $86.50 2026-07-18
93980 CPT Doppler Penile Complete 16 16 — — $56.67 $193.49 $85.93 2026-07-18
78185 CPT Spleen Scan-mult Vie 17 17 — — $29.40 $309.34 $85.00 2026-07-18
93978 CPT Duplex Aorta Complete 17 17 — — $31.97 $186.09 $85.00 2026-07-18
72270 CPT Myelogram Compl 3 Ar 17 17 — — $6.00 $608.22 $84.36 2026-07-18
78445 CPT Bone Flow 17 17 — — $29.75 $309.34 $82.50 2026-07-18
93882 CPT Duplex Carotid Unilat/limited 16 16 — — $40.00 $108.75 $81.91 2026-07-18
76805 CPT OB US >/= 14 Wks Single Fetus 15 15 — — $37.50 $138.26 $81.86 2026-07-18
93976 CPT Duplex Renal Art Uni/limited 14 14 — — $55.00 $115.27 $81.86 2026-07-18
78600 CPT Brain Scan 17 17 — — $39.20 $309.34 $80.00 2026-07-18
86890 CPT Autologous Transfusion 8 8 — — $25.00 $253.47 $80.00 2026-07-18
82731 CPT Fibronectina Fetal 13 13 — — $61.41 $175.00 $79.52 2026-07-18
86932 CPT Frozen Blood Freeze & Thawing 2 2 — — $73.95 $85.00 $79.47 2026-07-18
72255 CPT Myelogran Thoracic 16 16 — — $29.00 $608.22 $78.87 2026-07-18
78580 CPT Lung Scan-perfusion 17 17 — — $36.75 $309.34 $77.50 2026-07-18
76981 CPT Elastography US (parenchyma) 9 9 — — $47.40 $106.07 $77.26 2026-07-18
74415 CPT Nephrotomogram 16 16 — — $20.00 $137.05 $76.25 2026-07-18
93990 CPT Duplex Arterio-venous Fistula 14 14 — — $7.72 $115.27 $76.03 2026-07-18
76380 CPT CT Limited Follow Up 16 16 — — $50.72 $137.50 $75.50 2026-07-18
88184 CPT Leukemial/lymphoma Panel 5 5 — — $50.00 $75.23 $75.23 2026-07-18
78761 CPT Testicular Imaging W/vasc Flow 17 17 — — $40.25 $309.34 $75.00 2026-07-18
78740 CPT Nuclear Cystogram 17 17 — — $63.00 $309.34 $75.00 2026-07-18
78201 CPT Liver Scan-mult View 17 17 — — $31.85 $414.38 $75.00 2026-07-18
81241 CPT Factor V Leiden Mutation 13 13 — — $41.79 $187.00 $73.37 2026-07-18
76830 CPT Transvaginal US Non-obstetric 16 16 — — $34.30 $122.33 $72.18 2026-07-18
72240 CPT Myelograms Cervical 17 17 — — $29.00 $608.22 $72.18 2026-07-18
72265 CPT Myelogram Lumbar 17 17 — — $33.00 $608.22 $71.50 2026-07-18
93888 CPT Doppler Transcranial Limited 16 16 — — $37.50 $115.27 $70.93 2026-07-18
76856 CPT Pelvic Sonogram 15 15 — — $35.00 $107.76 $70.67 2026-07-18
88188 CPT Flow Cytometry 9 To 15 Markers 5 5 — — $61.67 $80.00 $70.21 2026-07-18
87801 CPT Hiv/hcv Nat Testing 12 12 — — $49.00 $100.00 $70.20 2026-07-18
78300 CPT Bone Scan Spect 17 17 — — $36.75 $309.34 $70.00 2026-07-18
80074 CPT Hepatitis Prifile 7 16 16 — — $47.63 $90.00 $70.00 2026-07-18
81256 CPT Hereditary Hemochromatosis 15 15 — — $65.36 $317.36 $70.00 2026-07-18
93923 CPT Doppler Art Upper/low Ext Comp 17 17 — — $25.36 $120.45 $70.00 2026-07-18
86480 CPT Igra (for Tb) 11 11 — — $61.98 $99.50 $68.36 2026-07-18
93979 CPT Duplex Aorta Unilat/limited 16 16 — — $19.85 $99.69 $68.17 2026-07-18
86931 CPT Thawing Cryos 2 2 — — $60.90 $75.00 $67.95 2026-07-18
76499 CPT Bronchography Unilat 3 3 — — $32.50 $67.78 $67.78 2026-07-18
78012 CPT Thyroid Uptake Measurement 16 16 — — $29.00 $309.34 $67.75 2026-07-18
80346 CPT Benzodiazepine Level 8 8 — — $14.15 $78.21 $67.50 2026-07-18
74250 CPT Small Bowel Series 17 17 — — $19.25 $200.00 $66.05 2026-07-18
84445 CPT Thyroid Stimulating Immunoglob 16 16 — — $35.00 $200.00 $65.89 2026-07-18
81240 CPT Factor Ii DNA (prothrombin) 12 12 — — $38.18 $160.00 $65.69 2026-07-18
83970 CPT Pth-intact 16 16 — — $41.28 $130.00 $65.69 2026-07-18
84238 CPT Acetylcholine Receptor Bind Ab 16 16 — — $36.57 $153.49 $65.44 2026-07-18
81291 CPT Methylenete Trahydrofolate 11 11 — — $48.18 $252.88 $65.34 2026-07-18
77065 CPT Compute Aided Detection Icad 8 8 — — $37.50 $96.79 $65.33 2026-07-18
83951 CPT Oncoprotein Dcp 9 9 — — $64.41 $103.00 $64.41 2026-07-18
76872 CPT Endorectal Sonogram 16 16 — — $35.00 $138.94 $63.69 2026-07-18
82088 CPT Aldosterone - Urine 16 16 — — $40.75 $145.26 $62.80 2026-07-18
73580 CPT Arthogram Knee 17 17 — — $5.25 $274.93 $62.50 2026-07-18
74330 CPT E.r.c.p. 12 12 — — $26.00 $146.59 $62.20 2026-07-18
80307 CPT Oxycodone/oxymorphone 21 16 — — $13.73 $97.00 $62.14 2026-07-18
73525 CPT Arthogram Hip 17 17 — — $5.25 $274.93 $61.30 2026-07-18
73040 CPT Arthogram Shoulder 17 17 — — $5.25 $274.93 $61.08 2026-07-18
86353 CPT Tib Lymphocyte Profile 15 15 — — $42.50 $201.49 $60.53 2026-07-18
74280 CPT Colon Enema With Air 17 17 — — $17.50 $167.74 $60.50 2026-07-18
87517 CPT Hepatitis B DNA Pcr Quant 16 16 — — $42.84 $165.00 $60.00 2026-07-18
36440 CPT Push Transf Blood2yrs Or Under 7 7 — — $50.00 $437.18 $60.00 2026-07-18
80345 CPT Barbiturate Urine 5 5 — — $3.00 $85.00 $60.00 2026-07-18
75809 CPT Shuntogram 16 16 — — $12.50 $97.09 $58.66 2026-07-18
82652 CPT Vit D1/ 25 Dihydroxy(calcitrio 16 16 — — $29.28 $195.00 $58.63 2026-07-18
87522 CPT Hcv RNA By Pcr Qualitative 16 16 — — $40.00 $195.00 $58.29 2026-07-18
76817 CPT Transvaginal US Obstetric 16 16 — — $37.50 $94.55 $57.89 2026-07-18
82024 CPT A C T H 17 17 — — $38.62 $160.00 $57.45 2026-07-18
75571 CPT CT Heart Without Contrast W Cor Calcium 12 12 — — $25.00 $76.59 $56.72 2026-07-18
75820 CPT Venography Extremiti 17 17 — — $13.00 $1,195.90 $56.67 2026-07-18
88187 CPT Flow Cytometry 2 To 8 Markers 5 5 — — $15.00 $65.00 $56.54 2026-07-18
82507 CPT Urine Citric Acid (citrate) 16 16 — — $27.80 $100.49 $56.17 2026-07-18
74740 CPT Hysterosalpinogram 16 16 — — $22.50 $186.09 $55.95 2026-07-18
86860 CPT Antibody Elution-cr 4 4 — — $22.00 $80.50 $55.23 2026-07-18
76506 CPT Neurosonogram 17 17 — — $25.00 $97.90 $55.00 2026-07-18
75989 CPT CT Guidance/drainage 13 13 — — $23.50 $72.50 $55.00 2026-07-18
80190 CPT Napa - Pronestyl 16 16 — — $18.42 $60.00 $55.00 2026-07-18
74240 CPT Upper Gastro Int/ser 15 15 — — $33.00 $137.05 $54.02 2026-07-18
76641 CPT US Breast Complete Unilateral 14 14 — — $27.84 $89.64 $53.65 2026-07-18
80055 CPT Obstetric Panel 16 16 — — $47.81 $80.00 $53.35 2026-07-18
87497 CPT Cmv Quantitative DNA Pcr Urine 15 15 — — $42.84 $163.00 $52.88 2026-07-18
87635 CPT Covid-19 (depto. Salud) 10 10 — — $51.31 $80.00 $51.33 2026-07-18
88275 CPT Cytogenetics 100-300 8 8 — — $50.00 $122.00 $51.19 2026-07-18
76642 CPT US Breast Limited Unilateral 13 13 — — $21.00 $73.54 $51.13 2026-07-18
93922 CPT Transcutaneous Oxygen Tension 16 16 — — $25.00 $99.23 $51.02 2026-07-18
86360 CPT T+b Complete Lymphocyte Profil 16 16 — — $40.00 $123.00 $50.91 2026-07-18
83876 CPT Myeloperoxidase 11 11 — — $20.80 $50.86 $50.86 2026-07-18
84588 CPT Adh 16 16 — — $33.94 $165.00 $50.74 2026-07-18
93931 CPT Duplex Art/upp/ext Unilat/lim 17 17 — — $19.85 $109.11 $50.40 2026-07-18
86077 CPT Blood Bank Physicians Servi/sv 3 3 — — $48.80 $53.20 $50.00 2026-07-18
76770 CPT Renal Sonogram 17 17 — — $28.00 $110.81 $50.00 2026-07-18
76705 CPT Abdominal Sonogram Limited 17 17 — — $17.50 $81.86 $50.00 2026-07-18
76700 CPT Abdominal Sonogram Complete 17 17 — — $35.00 $102.31 $50.00 2026-07-18
70390 CPT Sialogram 17 17 — — $6.00 $186.09 $50.00 2026-07-18
82664 CPT Chylomicron Screen/body Fluids 16 16 — — $25.00 $61.50 $50.00 2026-07-18
93971 CPT Duplex Ext Venous-unilat/lim 17 17 — — $17.64 $103.24 $50.00 2026-07-18
88312 CPT Sudan Stain (pleural Fluid) 5 5 — — $30.00 $113.52 $50.00 2026-07-18
84207 CPT Vit B6/ Pyridoxal Phosphate 16 16 — — $28.10 $149.74 $49.89 2026-07-18
93981 CPT Duplex Penile Vessels F/u -lim 17 17 — — $22.00 $81.86 $49.81 2026-07-18
86359 CPT T Cells Total Count 16 16 — — $37.73 $120.00 $49.29 2026-07-18
87798 CPT Ebv Virus Pcr 15 15 — — $35.09 $78.00 $49.00 2026-07-18
74420 CPT Retrograde Pyelogram 16 16 — — $14.55 $274.93 $48.75 2026-07-18
86870 CPT Antibody Panel 8 8 — — $16.32 $108.50 $47.50 2026-07-18
87799 CPT Epstein B. Virus By Pcr 11 11 — — $42.84 $128.00 $47.19 2026-07-18
88313 CPT Iron Stain-b. Marrow 5 5 — — $25.00 $82.68 $47.00 2026-07-18
82157 CPT Androstenedione 16 16 — — $29.28 $122.49 $46.77 2026-07-18
83698 CPT Lipoprotein Assay Pla2 11 11 — — $37.38 $67.00 $46.31 2026-07-18
87521 CPT HIV-viral Load 16 16 — — $25.00 $150.00 $46.16 2026-07-18
87476 CPT Lyme Titer/csf Pcr (b.burdorfe 14 14 — — $35.09 $120.00 $46.16 2026-07-18
80050 CPT General Health Panel 6 6 — — $10.07 $90.00 $46.00 2026-07-18
86328 CPT Covid-19 Rapid Test 11 11 — — $20.95 $62.00 $45.28 2026-07-18
84260 CPT Serotonin Plasma 16 16 — — $30.98 $140.00 $45.03 2026-07-18
87426 CPT Sars-cov-2 Antigen 11 11 — — $35.33 $60.00 $45.00 2026-07-18
76870 CPT Testicular Sonogram 17 17 — — $21.00 $103.02 $45.00 2026-07-18
80299 CPT Klonopin (clorazepam) 27 16 — — $15.11 $100.00 $45.00 2026-07-18
93926 CPT Duplex Art/low Ext-unilat/lim 17 17 — — $17.64 $115.27 $45.00 2026-07-18
83498 CPT Hydroxiprogesterone 16 16 — — $27.17 $100.00 $44.70 2026-07-18
82633 CPT Deoxycorticosterone 16 16 — — $30.98 $102.00 $44.28 2026-07-18
82306 CPT Vitamina D/25 Hydroxy 17 17 — — $29.60 $120.00 $44.04 2026-07-18
74246 CPT Barium Swallow 17 17 — — $23.00 $137.05 $44.00 2026-07-18
83088 CPT Histamine Level (plasma) 15 15 — — $29.53 $150.00 $43.92 2026-07-18
82308 CPT Calcitonina 16 16 — — $26.79 $120.00 $43.91 2026-07-18
87661 CPT Trichomonas Vaginalis Naa 13 13 — — $35.09 $50.19 $43.24 2026-07-18
74400 CPT I.v.p. 17 17 — — $21.00 $137.05 $43.00 2026-07-18
82670 CPT Estradiol 16 16 — — $27.94 $76.00 $42.78 2026-07-18
86769 CPT Sars-cov-2 Total 10 10 — — $35.00 $62.00 $42.13 2026-07-18
77080 CPT Densitometria Osea 18 17 — — $20.00 $81.86 $41.95 2026-07-18
83880 CPT B-type Natriuretic Peptide 17 17 — — $36.13 $90.00 $41.90 2026-07-18
87556 CPT DNA Amp Probe (tb) 11 11 — — $38.70 $78.00 $41.68 2026-07-18
86357 CPT Natural Killer Cell Surf Ag Cd 13 13 — — $37.73 $240.00 $41.57 2026-07-18
84143 CPT 17-oh Preg-nenolone 16 16 — — $22.81 $100.00 $40.97 2026-07-18
86361 CPT Cd3 16 16 — — $26.78 $86.00 $39.91 2026-07-18
82634 CPT 11 Deoxycortisol 16 16 — — $29.28 $141.00 $39.84 2026-07-18
84586 CPT Vaso Active Intestinal Polypep 16 16 — — $24.15 $186.00 $39.47 2026-07-18
86978 CPT Differential Adsor Per Cell-cr 5 5 — — $33.06 $55.00 $39.14 2026-07-18
74455 CPT Uretrocystogram 17 17 — — $14.50 $186.09 $39.00 2026-07-18
82108 CPT Aluminum Serum 16 16 — — $25.48 $68.00 $38.94 2026-07-18
87535 CPT RNA Qualitative 11 11 — — $35.09 $78.00 $38.70 2026-07-18
87581 CPT M.pneumoniae DNA Pcr Csf 11 11 — — $35.09 $78.00 $38.70 2026-07-18
87496 CPT Cmv Pcr Qualitative 11 11 — — $35.09 $78.00 $38.70 2026-07-18
87529 CPT Herpes Simplex 11 11 — — $35.09 $78.00 $38.70 2026-07-18
87641 CPT Mrsa/pcr 11 11 — — $35.09 $70.00 $38.70 2026-07-18
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