Price Transparencybeta 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

AVERA MISSOURI RIVER HEALTH CENTER

Gettysburg, SD · CCN 431302 · Rates published

723 distinct procedures filed
5 distinct payers
9,794 rate rows
2026-07-15 last MRF observed
Data quality

9,770 of 9,794 rate rows are consumer-grade (99.8%)

24 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
exceeds 10× this hospital's gross charge — excluded from medians 12
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/5380b4cd-f869-4c7e-87f7-01531b5e668d/460234354_avera-missouri-river-center_standardcharges.csv
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint 1907b8ad41357e10… · 2,779,893 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
J3245
HCPCS 		Tildrakizumab-asmn 100Mg/Ml Sy 5 $5.04 $56,787.72 $46,140.03 nat. median
$256
outlier · 180.0×
J2327
HCPCS 		Risankizumab-rzaa 600 Mg/10 Ml 5 $68.09 $45,688.70 $37,122.07 nat. median
$1,767
outlier · 21.0×
J3380
HCPCS 		Vedolizumab 300 Mg Vial 5 $72.63 $41,229.60 $33,499.05 nat. median
$155
outlier · 216.7×
4652
APR_DRG 		Apr-DRG 4652 1 $21,284.59 $21,284.59 $21,284.59 nat. median
$5,288
outlier · 4.0×
177
MS_DRG 		Ms-DRG 177 1 $15,919.96 $15,919.96 $15,919.96 nat. median
$15,405
1.0× median
391
MS_DRG 		Ms-DRG 391 1 $15,306.82 $15,306.82 $15,306.82 nat. median
$12,544
1.2× median
689
MS_DRG 		Ms-DRG 689 1 $14,044.45 $14,044.45 $14,044.45 nat. median
$11,515
1.2× median
64
MS_DRG 		Ms-DRG 64 1 $13,776.36 $13,776.36 $13,776.36 nat. median
$19,268
0.7× median
191
MS_DRG 		Ms-DRG 191 1 $13,655.90 $13,655.90 $13,655.90 nat. median
$8,851
1.5× median
872
MS_DRG 		Ms-DRG 872 1 $13,022.54 $13,022.54 $13,022.54 nat. median
$10,410
1.3× median
81352
CPT 		Tp53 Somatic Mutation, Prog 5 $7,183.15 $11,051.00 $9,426.50 nat. median
$429
outlier · 22.0×
392
MS_DRG 		Ms-DRG 392 1 $9,198.70 $9,198.70 $9,198.70 nat. median
$8,186
1.1× median
603
MS_DRG 		Ms-DRG 603 1 $9,197.50 $9,197.50 $9,197.50 nat. median
$8,991
1.0× median
193
MS_DRG 		Ms-DRG 193 1 $9,197.50 $9,197.50 $9,197.50 nat. median
$12,877
0.7× median
194
MS_DRG 		Ms-DRG 194 2 $9,197.50 $19,638.50 $9,197.50 nat. median
$8,522
1.1× median
536
MS_DRG 		Ms-DRG 536 1 $9,197.50 $9,197.50 $9,197.50 nat. median
$8,438
1.1× median
195
MS_DRG 		Ms-DRG 195 1 $9,197.50 $9,197.50 $9,197.50 nat. median
$6,821
1.3× median
1391
APR_DRG 		Apr-DRG 1391 1 $8,240.73 $8,240.73 $8,240.73 nat. median
$4,076
outlier · 2.0×
74178
CPT 		CT Abd & Pelv Wwo Contrast 5 $479.88 $8,718.00 $7,859.27 nat. median
$1,027
outlier · 7.6×
74174
CPT 		CTA Abd&Pelv Wwo Dye 5 $5,465.85 $8,409.00 $7,580.72 nat. median
$998
outlier · 7.6×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 5 $1,112.40 $8,925.00 $7,251.57 nat. median
$1,984
outlier · 3.7×
74177
CPT 		CT Abd & Pelv W Contrast 5 $227.52 $7,832.00 $7,060.55 nat. median
$976
outlier · 7.2×
74176
CPT 		CT Abd & Pelvis Wo Contrast 5 $95.04 $7,297.00 $6,578.24 nat. median
$694
outlier · 9.5×
153
MS_DRG 		Ms-DRG 153 1 $6,142.84 $6,142.84 $6,142.84 nat. median
$7,683
0.8× median
73720
CPT 		MRI Le Wwo Dye Lt 5 $233.96 $7,130.00 $5,793.12 nat. median
$1,135
outlier · 5.1×
J0129
HCPCS 		Abatacept 250 Mg Vial 5 $588.00 $6,454.87 $5,244.58 nat. median
$902
outlier · 5.8×
70496
CPT 		CT Angiography Head W Cont 5 $246.84 $5,193.00 $4,933.35 nat. median
$752
outlier · 6.6×
74183
CPT 		MRI Abdomen Wwo Dye 5 $619.08 $5,805.00 $4,716.57 nat. median
$1,105
outlier · 4.3×
J0585
HCPCS 		Botulinum Tx Type A 200 Un Vl 5 $59.81 $5,559.00 $4,525.02 nat. median
$198
outlier · 22.8×
71275
CPT 		CTA Chest Wwo Contrast 5 $3,003.00 $4,620.00 $4,389.00 nat. median
$759
outlier · 5.8×
74175
CPT 		CTA Abdom Wwo Dye 5 $82.17 $5,313.00 $4,316.82 nat. median
$718
outlier · 6.0×
70553
CPT 		MRI Brain Wwo Contrast 5 $729.77 $4,515.00 $4,289.25 nat. median
$1,136
outlier · 3.8×
73222
CPT 		MRI Joint Ue W Dye Lt 5 $530.75 $5,053.00 $4,105.57 nat. median
$1,282
outlier · 3.2×
73721
CPT 		MRI Joint Le Wo Dye Lt 5 $315.18 $4,300.00 $4,085.00 nat. median
$856
outlier · 4.8×
72158
CPT 		MRI Lumbar Spine Wwo Dye 5 $340.97 $4,300.00 $3,876.45 nat. median
$1,097
outlier · 3.5×
73718
CPT 		MRI Le Wo Dye Lt 5 $56.39 $4,515.00 $3,876.45 nat. median
$870
outlier · 4.5×
72156
CPT 		MRI Neck Spine Wwo Dye 5 $340.05 $4,515.00 $3,876.45 nat. median
$1,110
outlier · 3.5×
72157
CPT 		MRI Chest Spine Wwo Dye 5 $535.35 $4,515.00 $3,876.45 nat. median
$1,114
outlier · 3.5×
J1439
HCPCS 		Ferric Carboxymalt 750mg/15ml 5 $11.91 $4,487.80 $3,828.09 nat. median
$14
outlier · 283.6×
J9202
HCPCS 		Goserelin 3.6 Mg Implant 5 $77.09 $4,663.34 $3,788.97 nat. median
$1,833
outlier · 2.1×
72148
CPT 		MRI Lumbar Spine Wo Dye 5 $315.18 $4,300.00 $3,706.90 nat. median
$807
outlier · 4.6×
72141
CPT 		MRI Neck Spine Wo Dye 5 $233.96 $4,300.00 $3,706.90 nat. median
$785
outlier · 4.7×
70492
CPT 		CT Soft Tissue Neck Wwo Cont 5 $422.85 $4,318.00 $3,683.25 nat. median
$650
outlier · 5.7×
70498
CPT 		CT Angiography Neck W Cont 5 $278.39 $4,945.00 $3,672.70 nat. median
$744
outlier · 4.9×
73221
CPT 		MRI Joint Ue Wo Dye Rt 5 $408.12 $4,515.00 $3,667.90 nat. median
$844
outlier · 4.3×
72131
CPT 		CT Lumbar Spine Wo Contrast 5 $234.87 $3,969.00 $3,578.06 nat. median
$460
outlier · 7.8×
72132
CPT 		CT Lumbar Spine W Contrast 5 $313.35 $4,338.00 $3,524.62 nat. median
$769
outlier · 4.6×
72146
CPT 		MRI Chest Spine Wo Dye 5 $390.63 $4,300.00 $3,517.65 nat. median
$800
outlier · 4.4×
73218
CPT 		MRI Ue Wo Dye Lt 5 $79.40 $4,300.00 $3,493.75 nat. median
$866
outlier · 4.0×
70543
CPT 		MRI Orbit Face Neck Wwo Cont 5 $335.45 $4,300.00 $3,493.75 nat. median
$1,087
outlier · 3.2×

Other procedures at this hospital

Browse this hospital's 723 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
             
J3245 HCPCS Tildrakizumab-asmn 100Mg/Ml Sy 8 5 $56,787.00 $55,084.09 $5.04 $56,787.72 $46,140.03 2026-07-15
J2327 HCPCS Risankizumab-rzaa 600 Mg/10 Ml 8 5 $45,688.00 $44,318.04 $68.09 $45,688.70 $37,122.07 2026-07-15
J3380 HCPCS Vedolizumab 300 Mg Vial 8 5 $41,229.00 $39,992.71 $72.63 $41,229.60 $33,499.05 2026-07-15
4652 APR_DRG Apr-DRG 4652 2 1 — — $21,284.59 $21,284.59 $21,284.59 2026-07-15
177 MS_DRG Ms-DRG 177 2 1 — — $15,919.96 $15,919.96 $15,919.96 2026-07-15
391 MS_DRG Ms-DRG 391 2 1 — — $15,306.82 $15,306.82 $15,306.82 2026-07-15
689 MS_DRG Ms-DRG 689 2 1 — — $14,044.45 $14,044.45 $14,044.45 2026-07-15
64 MS_DRG Ms-DRG 64 1 1 — — $13,776.36 $13,776.36 $13,776.36 2026-07-15
191 MS_DRG Ms-DRG 191 2 1 — — $13,655.90 $13,655.90 $13,655.90 2026-07-15
872 MS_DRG Ms-DRG 872 1 1 — — $13,022.54 $13,022.54 $13,022.54 2026-07-15
81352 CPT Tp53 Somatic Mutation, Prog 7 5 $11,051.00 $10,719.47 $7,183.15 $11,051.00 $9,426.50 2026-07-15
392 MS_DRG Ms-DRG 392 2 1 — — $9,198.70 $9,198.70 $9,198.70 2026-07-15
193 MS_DRG Ms-DRG 193 2 1 — — $9,197.50 $9,197.50 $9,197.50 2026-07-15
195 MS_DRG Ms-DRG 195 2 1 — — $9,197.50 $9,197.50 $9,197.50 2026-07-15
603 MS_DRG Ms-DRG 603 2 1 — — $9,197.50 $9,197.50 $9,197.50 2026-07-15
536 MS_DRG Ms-DRG 536 2 1 — — $9,197.50 $9,197.50 $9,197.50 2026-07-15
194 MS_DRG Ms-DRG 194 3 2 — — $9,197.50 $19,638.50 $9,197.50 2026-07-15
1391 APR_DRG Apr-DRG 1391 2 1 — — $8,240.73 $8,240.73 $8,240.73 2026-07-15
74178 CPT CT Abd & Pelv Wwo Contrast 10 5 $8,718.00 $8,456.46 $479.88 $8,718.00 $7,859.27 2026-07-15
74174 CPT CTA Abd&Pelv Wwo Dye 6 5 $8,409.00 $8,156.73 $5,465.85 $8,409.00 $7,580.72 2026-07-15
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 8 5 $8,925.00 $8,657.25 $1,112.40 $8,925.00 $7,251.57 2026-07-15
74177 CPT CT Abd & Pelv W Contrast 12 5 $7,832.00 $7,597.04 $227.52 $7,832.00 $7,060.55 2026-07-15
74176 CPT CT Abd & Pelvis Wo Contrast 12 5 $7,297.00 $7,078.09 $95.04 $7,297.00 $6,578.24 2026-07-15
153 MS_DRG Ms-DRG 153 2 1 — — $6,142.84 $6,142.84 $6,142.84 2026-07-15
73720 CPT MRI Le Wwo Dye Lt 8 5 $7,130.00 $6,916.10 $233.96 $7,130.00 $5,793.12 2026-07-15
J0129 HCPCS Abatacept 250 Mg Vial 8 5 $6,454.00 $6,261.22 $588.00 $6,454.87 $5,244.58 2026-07-15
70496 CPT CT Angiography Head W Cont 11 5 $5,193.00 $5,037.21 $246.84 $5,193.00 $4,933.35 2026-07-15
74183 CPT MRI Abdomen Wwo Dye 10 5 $5,805.00 $5,630.85 $619.08 $5,805.00 $4,716.57 2026-07-15
J0585 HCPCS Botulinum Tx Type A 200 Un Vl 10 5 $5,559.00 $5,392.23 $59.81 $5,559.00 $4,525.02 2026-07-15
71275 CPT CTA Chest Wwo Contrast 9 5 $4,620.00 $4,481.40 $3,003.00 $4,620.00 $4,389.00 2026-07-15
74175 CPT CTA Abdom Wwo Dye 8 5 $5,313.00 $5,153.61 $82.17 $5,313.00 $4,316.82 2026-07-15
70553 CPT MRI Brain Wwo Contrast 11 5 $4,515.00 $4,379.55 $729.77 $4,515.00 $4,289.25 2026-07-15
73222 CPT MRI Joint Ue W Dye Lt 8 5 $5,053.00 $4,901.41 $530.75 $5,053.00 $4,105.57 2026-07-15
73721 CPT MRI Joint Le Wo Dye Lt 21 5 $4,300.00 $4,171.00 $315.18 $4,300.00 $4,085.00 2026-07-15
72156 CPT MRI Neck Spine Wwo Dye 10 5 $4,300.00 $4,171.00 $340.05 $4,515.00 $3,876.45 2026-07-15
73718 CPT MRI Le Wo Dye Lt 20 5 $4,300.00 $4,171.00 $56.39 $4,515.00 $3,876.45 2026-07-15
72157 CPT MRI Chest Spine Wwo Dye 10 5 $4,300.00 $4,171.00 $535.35 $4,515.00 $3,876.45 2026-07-15
72158 CPT MRI Lumbar Spine Wwo Dye 10 5 $4,300.00 $4,171.00 $340.97 $4,300.00 $3,876.45 2026-07-15
J1439 HCPCS Ferric Carboxymalt 750mg/15ml 9 5 $4,487.00 $4,353.17 $11.91 $4,487.80 $3,828.09 2026-07-15
J9202 HCPCS Goserelin 3.6 Mg Implant 8 5 $4,663.00 $4,523.44 $77.09 $4,663.34 $3,788.97 2026-07-15
72141 CPT MRI Neck Spine Wo Dye 11 5 $3,902.00 $3,784.94 $233.96 $4,300.00 $3,706.90 2026-07-15
72148 CPT MRI Lumbar Spine Wo Dye 11 5 $3,902.00 $3,784.94 $315.18 $4,300.00 $3,706.90 2026-07-15
70492 CPT CT Soft Tissue Neck Wwo Cont 9 5 $4,318.00 $4,188.46 $422.85 $4,318.00 $3,683.25 2026-07-15
70498 CPT CT Angiography Neck W Cont 11 5 $3,866.00 $3,750.02 $278.39 $4,945.00 $3,672.70 2026-07-15
73221 CPT MRI Joint Ue Wo Dye Rt 21 5 $4,300.00 $4,171.00 $408.12 $4,515.00 $3,667.90 2026-07-15
72131 CPT CT Lumbar Spine Wo Contrast 10 5 $3,969.00 $3,849.93 $234.87 $3,969.00 $3,578.06 2026-07-15
72132 CPT CT Lumbar Spine W Contrast 8 5 $4,338.00 $4,207.86 $313.35 $4,338.00 $3,524.62 2026-07-15
72146 CPT MRI Chest Spine Wo Dye 10 5 $3,902.00 $3,784.94 $390.63 $4,300.00 $3,517.65 2026-07-15
70543 CPT MRI Orbit Face Neck Wwo Cont 8 5 $4,300.00 $4,171.00 $335.45 $4,300.00 $3,493.75 2026-07-15
73218 CPT MRI Ue Wo Dye Lt 8 5 $4,300.00 $4,171.00 $79.40 $4,300.00 $3,493.75 2026-07-15
71260 CPT CT Thorax W Contrast 11 5 $3,617.00 $3,508.49 $80.31 $4,217.00 $3,436.15 2026-07-15
74170 CPT CT Abdomen Wwo Dye 8 5 $4,113.00 $3,989.61 $58.22 $4,113.00 $3,341.81 2026-07-15
70491 CPT CT Soft Tissue Neck W Cont 10 5 $3,673.00 $3,562.81 $357.53 $4,112.00 $3,311.21 2026-07-15
70551 CPT MRI Brain Wo Contrast 11 5 $3,832.00 $3,717.04 $447.03 $4,300.00 $3,268.70 2026-07-15
70544 CPT MRA Head Wo Contrast 8 5 $3,890.00 $3,773.30 $408.12 $3,890.00 $3,160.62 2026-07-15
190 MS_DRG Ms-DRG 190 2 1 — — $3,088.18 $3,088.18 $3,088.18 2026-07-15
690 MS_DRG Ms-DRG 690 2 1 — — $3,088.18 $3,088.18 $3,088.18 2026-07-15
446 MS_DRG Ms-DRG 446 2 1 — — $3,088.18 $3,088.18 $3,088.18 2026-07-15
72125 CPT CT Cervical Spine Wo Contrast 12 5 $3,391.00 $3,289.27 $172.58 $3,391.00 $3,056.98 2026-07-15
72128 CPT CT Thoracic Spine Wo Contrast 11 5 $3,105.00 $3,011.85 $107.93 $3,105.00 $2,949.75 2026-07-15
70487 CPT CT Maxillofacial W Contrast 8 5 $3,597.00 $3,489.09 $268.29 $3,597.00 $2,922.56 2026-07-15
111 CDM Room Medical Unit Priv 6 5 $3,164.00 $3,069.08 $2,056.60 $3,164.00 $2,852.35 2026-07-15
70482 CPT CT Orbit Wwo Contrast 10 5 $3,351.00 $3,250.47 $261.57 $3,351.00 $2,825.20 2026-07-15
73701 CPT CT Le W Dye Lt 16 5 $3,433.00 $3,330.01 $268.01 $3,433.00 $2,789.32 2026-07-15
70486 CPT CT Maxillofacial Wo Contrast 10 5 $3,086.00 $2,993.42 $187.95 $3,086.00 $2,782.03 2026-07-15
70470 CPT CT Head/Brain Wwo Contrast 8 5 $3,417.00 $3,314.49 $241.32 $3,417.00 $2,776.31 2026-07-15
70490 CPT CT Soft Tissue Neck Wo Cont 10 5 $3,028.00 $2,937.16 $277.47 $3,028.00 $2,729.74 2026-07-15
72193 CPT CT Pelvis W Dye 8 5 $3,105.00 $3,011.85 $593.33 $3,105.00 $2,522.82 2026-07-15
72192 CPT CT Pelvis Wo Dye 10 5 $2,741.00 $2,658.77 $597.02 $3,681.00 $2,471.01 2026-07-15
70450 CPT CT Head/Brain Wo Contrast 11 5 $2,591.00 $2,513.27 $1,684.15 $3,254.00 $2,461.45 2026-07-15
71250 CPT CT Thorax Wo Contrast 11 5 $2,805.00 $2,720.85 $71.13 $2,805.00 $2,392.67 2026-07-15
P9037 HCPCS Platelet Pheresis Leuk Red Irr 7 5 $2,746.00 $2,663.62 $1,784.90 $2,746.00 $2,342.34 2026-07-15
74160 CPT CT Abdomen W Dye 8 5 $2,879.00 $2,792.63 $706.77 $2,879.00 $2,339.19 2026-07-15
J0248 HCPCS Remdesivir 100 Mg Vial 8 5 $2,847.00 $2,762.23 $70.71 $2,847.66 $2,313.72 2026-07-15
70480 CPT CT Orbit Wo Contrast 9 5 $2,695.00 $2,614.15 $192.56 $2,695.00 $2,298.84 2026-07-15
120 CDM Room Medical Unit Semi Private 6 5 $2,461.00 $2,387.17 $1,599.65 $2,461.00 $2,218.59 2026-07-15
73700 CPT CT Le Wo Dye Lt 20 5 $2,571.00 $2,493.87 $76.65 $4,296.00 $2,193.06 2026-07-15
Q5121 HCPCS Infliximab-axxq 100 Mg Vial 8 5 $2,179.00 $2,114.48 $1,416.92 $4,302.83 $2,070.89 2026-07-15
99291 CPT Critical Care 1st 30-74 Min 15 5 $3,113.00 $3,019.61 $228.45 $3,113.00 $2,023.45 2026-07-15
73201 CPT CT Ue W Dye Lt 8 5 $2,450.00 $2,376.50 $90.44 $2,450.00 $1,990.62 2026-07-15
73200 CPT CT Ue Wo Dye Lt 18 5 $2,226.00 $2,159.22 $70.19 $2,750.00 $1,898.78 2026-07-15
86341 CPT Islet Cell Antibody Ica 512 25 5 $1,994.00 $1,934.18 $122.85 $2,414.00 $1,700.88 2026-07-15
Q5104 HCPCS Infliximab-abda 100 Mg Vial 8 5 $1,763.00 $1,710.20 $1,146.01 $5,119.19 $1,674.94 2026-07-15
99285 CPT Emergency Room Visit Level 5 17 5 $2,087.00 $2,024.39 $184.62 $2,087.00 $1,611.16 2026-07-15
G0480 HCPCS Clonidine, Serum 23 5 $2,019.00 $1,958.43 $189.80 $2,357.00 $1,595.01 2026-07-15
80230 CPT Infliximab Qn w/Reflex To Ab,S 7 5 $1,773.00 $1,719.81 $1,152.45 $1,773.00 $1,512.37 2026-07-15
87471 CPT Bartonella DNA Amp Probe 8 5 $1,649.00 $1,599.53 $1,071.85 $1,649.00 $1,486.57 2026-07-15
88377 CPT Morph Ana Ea Man Multpx Hema 7 5 $1,652.00 $1,602.44 $1,073.80 $1,652.00 $1,409.16 2026-07-15
76942 CPT US Guide For Needle Placement 10 5 $1,445.00 $1,401.65 $939.25 $1,445.00 $1,372.75 2026-07-15
25605 CPT Fx Distal Radius W Man Lt 15 5 $1,643.00 $1,593.71 $396.00 $1,643.00 $1,268.40 2026-07-15
87118 CPT Mycobacterial Id, Each 7 5 $1,479.00 $1,434.63 $961.35 $1,479.00 $1,261.59 2026-07-15
689 CDM Trauma Team Evaluation Level 5 7 5 $1,409.00 $1,366.73 $915.85 $1,409.00 $1,201.88 2026-07-15
129 CDM Room Swing Bed Skilled 6 5 $1,332.00 $1,292.04 $865.80 $1,332.00 $1,200.80 2026-07-15
73523 CPT X-ray Hips 5 Views Bi 10 5 $1,301.00 $1,261.97 $690.20 $1,301.00 $1,172.85 2026-07-15
G0390 HCPCS Trauma Team Level 5 7 5 $1,362.00 $1,321.14 $885.30 $1,362.00 $1,161.79 2026-07-15
82397 CPT Infliximab Ab, S 7 5 $1,360.00 $1,319.20 $884.00 $1,360.00 $1,160.08 2026-07-15
87529 CPT Hsv DNA Amp Probe 7 5 $1,290.00 $1,251.30 $838.50 $1,290.00 $1,100.37 2026-07-15
92950 CPT Heart/Lung Resuscitation Cpr 9 5 $1,158.00 $1,123.26 $752.70 $1,216.00 $1,100.10 2026-07-15
20670 CPT Remove Implant Superficial 13 5 $1,688.00 $1,637.36 $174.84 $1,688.00 $1,097.20 2026-07-15
77002 CPT Needle Localization By X-ray 11 5 $1,116.00 $1,082.52 $83.48 $1,116.00 $1,060.20 2026-07-15
761 CDM Pain Clinic Level 1 21 5 $1,107.00 $1,073.79 $712.40 $1,610.00 $1,046.50 2026-07-15
87507 CPT Gi Pathogens Panel Ref 7 5 $1,195.00 $1,159.15 $776.75 $1,195.00 $1,019.34 2026-07-15
90678 CPT Rsv Vaccine Bivalent 8 5 $1,249.00 $1,212.31 $41.69 $1,249.80 $1,015.46 2026-07-15
99284 CPT Emergency Room Visit Level 4 18 5 $1,284.00 $1,245.48 $127.14 $1,284.00 $1,002.81 2026-07-15
Q0138 HCPCS Ferumoxy 510mg/17ml (non-esrd) 9 5 $1,145.00 $1,111.35 $7.28 $1,145.72 $977.30 2026-07-15
Q0139 HCPCS Ferumoxytol 510 Mg/17 Ml Vial 8 5 $1,145.00 $1,111.35 $7.28 $1,145.72 $930.90 2026-07-15
72120 CPT X-ray Ls Spine Bending 2-3 V 9 5 $1,070.00 $1,037.90 $152.07 $1,070.00 $912.71 2026-07-15
72072 CPT X-ray Spine Thoracic 3 Views 11 5 $955.00 $926.35 $620.75 $955.00 $907.25 2026-07-15
P9040 HCPCS Rbc Packed Leuko-reduc Irrad 7 5 $1,056.00 $1,024.32 $686.40 $1,056.00 $900.77 2026-07-15
94660 CPT CPap/BiPap First Day 7 5 $1,045.00 $1,013.65 $679.25 $1,045.00 $891.39 2026-07-15
96413 CPT Chemotherapy Inf Initial 9 5 $914.00 $886.58 $594.10 $914.00 $868.30 2026-07-15
73522 CPT X-ray Hips 3-4 Views Bi 8 5 $940.00 $911.80 $611.00 $940.00 $797.87 2026-07-15
77067 CPT Mammo Screen Implant Bi 17 5 $824.00 $799.28 $535.60 $826.00 $782.80 2026-07-15
0202U CPT Respir Path 22 Targets Biofire 7 5 $870.00 $843.90 $565.50 $870.00 $742.11 2026-07-15
Q5110 HCPCS Filgrastim-aafi 480 Mcg/0.8 Ml 8 5 $780.00 $756.91 $507.21 $927.00 $741.30 2026-07-15
73502 CPT X-ray Hip Uni 2-3 Views Rt 36 5 $345.00 $334.65 $224.25 $1,131.00 $735.15 2026-07-15
71101 CPT X-ray Ribs Uni W Chest Lt 20 5 $756.00 $733.32 $491.40 $3,427.98 $718.60 2026-07-15
J2997 HCPCS Alteplase 2 Mg Vial 8 5 $879.00 $852.77 $37.08 $879.14 $714.31 2026-07-15
87556 CPT Mtb DNA Probe (arup) 7 5 $805.00 $780.85 $523.25 $805.00 $686.67 2026-07-15
J1611 HCPCS Glucagon (Fresenius Kabi) Vial 8 5 $794.00 $770.88 $81.80 $794.72 $645.71 2026-07-15
J1610 HCPCS Glucagon 1 Mg/ml Vial 8 5 $794.00 $770.88 $98.91 $794.72 $645.71 2026-07-15
12041 CPT Repair Lac Interm <2.5 Cm 15 5 $826.00 $801.22 $173.83 $826.00 $637.67 2026-07-15
P9016 HCPCS Red Blood Cells Lekoreduced 9 5 $662.00 $642.14 $430.30 $1,324.00 $628.90 2026-07-15
72220 CPT Sacrum Or Coccyx Min 2 View 16 5 $774.00 $750.78 $447.69 $774.00 $628.88 2026-07-15
73552 CPT X-ray Femur 2 Views Lt 16 5 $758.00 $735.26 $130.01 $758.00 $615.88 2026-07-15
99283 CPT Emergency Room Visit Level 3 18 5 $787.00 $763.39 $74.82 $787.00 $614.64 2026-07-15
72040 CPT X-ray Spine Cervical 2-3 Views 12 5 $666.00 $646.02 $432.90 $666.00 $600.40 2026-07-15
A9585 HCPCS Gadobutrol Inj 10 Mm/10 Ml Vl 19 5 $800.00 $776.00 $2.69 $800.00 $600.00 2026-07-15
23600 CPT Fx Prox Humeral Wo Man Lt 14 5 $698.00 $677.06 $453.70 $698.00 $595.39 2026-07-15
J0695 HCPCS Ceftolozane/Tazobac 1.5gr Vial 8 5 $730.00 $708.99 $7.71 $730.92 $593.87 2026-07-15
12044 CPT Repair Lac Interm 7.6-12.5 Cm 13 5 $826.00 $801.22 $253.91 $826.00 $593.10 2026-07-15
80299 CPT Dexamethasone 14 5 $867.50 $841.48 $100.10 $1,581.00 $590.83 2026-07-15
P9047 HCPCS Albumin Human 25% 25gr/100ml 8 5 $618.00 $600.27 $402.24 $3,118.50 $587.89 2026-07-15
77080 CPT Dexa Scan 11 5 $609.00 $590.73 $88.61 $609.00 $578.55 2026-07-15
12014 CPT Repair Lac Simple 5.1-7.5 Cm 7 5 $666.00 $646.02 $432.90 $666.00 $568.10 2026-07-15
12052 CPT Repair Lac Interm 2.6-5.0 Cm 13 5 $826.00 $801.22 $238.97 $826.00 $559.61 2026-07-15
11402 CPT Exc Ben Lesion 1.1-2.0 Trunk 15 5 $724.00 $702.28 $138.88 $724.00 $558.93 2026-07-15
74019 CPT X-ray Abdomen 12 5 $582.00 $564.54 $378.30 $660.48 $552.90 2026-07-15
12042 CPT Repair Lac Interm 2.6-7.5 Cm 13 5 $826.00 $801.22 $235.09 $826.00 $550.12 2026-07-15
84445 CPT Tsi 9 5 $569.00 $551.93 $369.85 $662.00 $540.55 2026-07-15
12011 CPT Repair Lac Simple <2.5 Cm 15 5 $700.00 $679.00 $64.07 $700.00 $540.40 2026-07-15
73080 CPT X-ray Elbow Lt 20 5 $598.00 $580.06 $38.91 $598.00 $539.10 2026-07-15
83993 CPT Calprotectin 9 5 $566.00 $549.02 $367.90 $566.00 $537.70 2026-07-15
87637 CPT Influ/RSV/CoV2 Pcr Ceph 10 5 $582.00 $564.54 $378.30 $582.00 $524.67 2026-07-15
G0379 HCPCS Observation Assess Direct Adm 9 5 $609.00 $590.73 $174.00 $609.00 $519.48 2026-07-15
70260 CPT X-ray Skull 4 Views 10 5 $571.00 $553.87 $72.96 $571.00 $514.75 2026-07-15
73090 CPT X-ray Forearm 2 Views Lt 16 5 $626.00 $607.22 $282.72 $626.00 $508.62 2026-07-15
85220 CPT Factor 5 Activity 7 5 $594.00 $576.18 $386.10 $594.00 $506.68 2026-07-15
73130 CPT X-ray Hand Lt 22 5 $532.00 $516.04 $59.16 $532.00 $505.40 2026-07-15
72070 CPT X-ray Spine Thoracic 2 Views 12 5 $525.00 $509.25 $341.25 $1,015.91 $498.75 2026-07-15
11106 CPT Incisional Biopsy 1st Lesion 15 5 $756.00 $733.32 $69.02 $756.00 $491.40 2026-07-15
72100 CPT X-ray Lumbosacral 2-3 Views 12 5 $544.00 $527.68 $90.44 $544.00 $490.41 2026-07-15
99195 CPT Phlebotomy Therapeutic 9 5 $516.00 $500.52 $335.40 $516.00 $490.20 2026-07-15
73060 CPT X-ray Humerus Rt 18 5 $573.00 $555.81 $67.44 $573.00 $488.77 2026-07-15
87636 CPT Influ & CoV2 Pcr Ceph 9 5 $511.00 $495.67 $332.15 $511.00 $485.45 2026-07-15
12004 CPT Repair Lac Simple 7.6-12.5 Cm 14 5 $666.00 $646.02 $84.56 $666.00 $473.52 2026-07-15
81515 CPT Vpp 9 5 $497.00 $482.09 $323.05 $497.00 $472.15 2026-07-15
11441 CPT Exc Ben Lesion 0.6-1.0 Face 13 5 $724.00 $702.28 $158.62 $724.00 $470.60 2026-07-15
12018 CPT Repair Lac Simple >30.0 Cm 13 5 $700.00 $679.00 $197.72 $700.00 $466.70 2026-07-15
93246 CPT Ext ECG >7 Days Hook Up 9 5 $491.00 $476.27 $319.15 $491.00 $466.45 2026-07-15
86256 CPT dsDNA IgG 14 5 $633.50 $614.50 $160.55 $1,020.00 $455.00 2026-07-15
12015 CPT Repair Lac Simple 7.6-12.5 Cm 13 5 $700.00 $679.00 $108.66 $700.00 $455.00 2026-07-15
12013 CPT Repair Lac Simple 2.6-5.0 Cm 13 5 $700.00 $679.00 $66.94 $700.00 $455.00 2026-07-15
12002 CPT Repair Lac Simple 2.6-7.5 Cm 15 5 $700.00 $679.00 $67.93 $700.00 $455.00 2026-07-15
85379 CPT D-dimer Quant 11 5 $478.00 $463.66 $310.70 $478.00 $454.10 2026-07-15
71100 CPT X-ray Ribs 2 Views Lt 18 5 $476.00 $461.72 $74.00 $3,616.49 $452.20 2026-07-15
86860 CPT Antibody Elution Rbc Ea 7 5 $523.00 $507.31 $339.95 $523.00 $446.12 2026-07-15
73030 CPT X-ray Shoulder Lt 22 5 $469.00 $454.93 $237.65 $469.00 $445.55 2026-07-15
82653 CPT Pancreatic Elastase 7 5 $521.00 $505.37 $338.65 $521.00 $444.41 2026-07-15
88305 CPT Surg Path L4 9 5 $516.00 $500.52 $103.20 $516.00 $440.15 2026-07-15
87631 CPT Influ And Rsv Amp Probe 9 5 $461.00 $447.17 $299.65 $486.00 $437.95 2026-07-15
80053 CPT Comprehensive Metabolic Panel 12 5 $456.00 $442.32 $296.40 $456.00 $433.20 2026-07-15
71046 CPT X-ray Chest 2v PA/Lateral 13 5 $452.00 $438.44 $293.80 $783.14 $429.40 2026-07-15
36430 CPT Blood Administration 9 5 $451.00 $437.47 $293.15 $748.00 $428.45 2026-07-15
73564 CPT X-ray Knee 4 Rt 8 5 $525.00 $509.25 $129.06 $525.00 $426.56 2026-07-15
74018 CPT X-ray Abdomen 10 5 $448.00 $434.56 $291.20 $523.40 $425.80 2026-07-15
26720 CPT Fx Finger/Thumb Wo Man 7 5 $491.00 $476.27 $319.15 $491.00 $418.82 2026-07-15
73590 CPT X-ray Lower Leg Rt 19 5 $487.00 $472.39 $73.88 $596.00 $415.41 2026-07-15
96365 CPT Inf Therapy Med Initial 21 5 $500.00 $485.00 $279.50 $500.00 $408.50 2026-07-15
80069 CPT Renal Function Panel 10 5 $427.00 $414.19 $277.55 $427.00 $405.65 2026-07-15
97161 CPT Pt Eval Low Complexity 11 5 $426.00 $413.22 $276.90 $426.00 $404.70 2026-07-15
97162 CPT Pt Eval Mod Complexity 11 5 $426.00 $413.22 $276.90 $426.00 $404.70 2026-07-15
82951 CPT Glucose Tol 1st 3 Specimens 9 5 $426.00 $413.22 $276.90 $426.00 $404.70 2026-07-15
10120 CPT I&r Foreign Body Simple 15 5 $517.00 $501.49 $126.55 $517.00 $399.12 2026-07-15
73610 CPT X-ray Ankle 3 Views Lt 24 5 $467.00 $452.99 $99.63 $467.00 $398.35 2026-07-15
86255 CPT Pla2R Elisa 7 5 $467.00 $452.99 $303.55 $467.00 $398.35 2026-07-15
10061 CPT I&d Abscess Comp/Multiple 15 5 $457.00 $443.29 $173.85 $506.04 $395.79 2026-07-15
72050 CPT X-ray Spine Cervical 4-5 Views 10 5 $405.00 $392.85 $263.25 $746.06 $394.88 2026-07-15
73565 CPT X-ray Knees Bi 8 5 $486.00 $471.42 $267.09 $486.00 $394.88 2026-07-15
99282 CPT Emergency Room Visit Level 2 15 5 $511.00 $495.67 $44.27 $511.00 $394.49 2026-07-15
70030 CPT X-ray Eye Fb Detection 6 5 $429.00 $416.13 $278.85 $429.00 $386.75 2026-07-15
80076 CPT Hepatic Function Panel 10 5 $404.00 $391.88 $262.60 $404.00 $383.80 2026-07-15
71045 CPT X-ray Chest 1 View 13 5 $403.00 $390.91 $261.95 $593.33 $382.85 2026-07-15
80179 CPT Salicylate 10 5 $403.00 $390.91 $261.95 $403.00 $382.85 2026-07-15
80143 CPT Acetaminophen 10 5 $403.00 $390.91 $261.95 $403.00 $382.85 2026-07-15
90677 CPT Pneumo Conjugate Vaccine 20 Va 10 5 $405.00 $393.04 $263.38 $405.20 $382.64 2026-07-15
82610 CPT Cystatin C 7 5 $446.00 $432.62 $289.90 $446.00 $380.44 2026-07-15
73110 CPT X-ray Wrist 3 Views Lt 20 5 $410.00 $397.70 $58.22 $410.00 $369.62 2026-07-15
36593 CPT Declot/Thrombo Impl Vad 7 5 $432.00 $419.04 $280.80 $432.00 $368.50 2026-07-15
73562 CPT X-ray Knee 3 Views Lt 21 5 $385.00 $373.45 $109.76 $385.00 $365.75 2026-07-15
97165 CPT Ot Eval Low Complexity 8 5 $426.00 $413.22 $276.90 $426.00 $363.38 2026-07-15
97166 CPT Ot Eval Mod Complexity 7 5 $426.00 $413.22 $276.90 $426.00 $363.38 2026-07-15
80306 CPT Drug Screen Urine Inst Ass Obv 9 5 $382.00 $370.54 $248.30 $382.00 $362.90 2026-07-15
73630 CPT X-ray Foot 3 Views Rt 23 5 $421.00 $408.37 $65.60 $421.00 $359.11 2026-07-15
84482 CPT Reverse T3 9 5 $378.00 $366.66 $245.70 $378.00 $359.10 2026-07-15
96360 CPT Inf Therapy Hyd Initial 23 5 $482.00 $467.54 $232.05 $482.00 $357.00 2026-07-15
27808 CPT Fx Bimalleolar Ankle Lt 8 5 $396.00 $384.12 $257.40 $396.00 $357.00 2026-07-15
24600 CPT Dislocation Elbow Wo Anes Rt 13 5 $356.00 $345.32 $231.40 $926.91 $356.00 2026-07-15
72170 CPT X-ray Pelvis 1-2 Views 10 5 $389.00 $377.33 $252.85 $389.00 $355.72 2026-07-15
28490 CPT Fx Great Toe 7 5 $416.00 $403.52 $270.40 $416.00 $354.85 2026-07-15
28400 CPT Fx Calcaneus Lt 7 5 $416.00 $403.52 $270.40 $416.00 $354.85 2026-07-15
28470 CPT Fx Metatarsal 7 5 $416.00 $403.52 $270.40 $416.00 $354.85 2026-07-15
27824 CPT Fx Distal Tibia Lt 7 5 $416.00 $403.52 $270.40 $416.00 $354.85 2026-07-15
27530 CPT Treat Knee Fracture Rt 7 5 $416.00 $403.52 $270.40 $416.00 $354.85 2026-07-15
80048 CPT Basic Metabolic Panel 12 5 $369.00 $357.93 $239.85 $369.00 $350.55 2026-07-15
96415 CPT Chemotherapy Inf Ea Addl Hr 9 5 $368.00 $356.96 $239.20 $640.00 $349.60 2026-07-15
88184 CPT Flow Cytometry First Mark 10 5 $367.00 $355.99 $238.55 $367.00 $348.65 2026-07-15
110 CDM Room Custodial Care 6 5 $386.00 $374.42 $250.90 $386.00 $347.98 2026-07-15
12001 CPT Repair Lac Simple <2.5 Cm 30 5 $700.00 $679.00 $51.59 $700.00 $346.00 2026-07-15
115 CDM Room Hospice Respite Care 6 5 $383.00 $371.51 $248.95 $383.00 $345.27 2026-07-15
82378 CPT Cea 9 5 $362.00 $351.14 $235.30 $362.00 $343.90 2026-07-15
G0103 HCPCS Psa Screen 10 5 $362.00 $351.14 $235.30 $362.00 $343.90 2026-07-15
80202 CPT Vancomycin 9 5 $362.00 $351.14 $235.30 $362.00 $343.90 2026-07-15
80074 CPT Acute Hepatitis Panel 9 5 $362.00 $351.14 $235.30 $362.00 $343.90 2026-07-15
84153 CPT Psa Total 9 5 $362.00 $351.14 $235.30 $362.00 $343.90 2026-07-15
83970 CPT Pth 10 5 $362.00 $351.14 $235.30 $362.00 $343.90 2026-07-15
12031 CPT Repair Lac Intermed <2.5 Cm 13 5 $430.00 $417.10 $181.84 $430.00 $339.70 2026-07-15
97167 CPT Ot Eval High Complexity 9 5 $356.00 $345.32 $231.40 $405.00 $338.20 2026-07-15
27786 CPT Fx Distal Fibula Lt 7 5 $396.00 $384.12 $257.40 $396.00 $337.79 2026-07-15
27780 CPT Treatment Fibula Fracture Lt 7 5 $396.00 $384.12 $257.40 $396.00 $337.79 2026-07-15
26750 CPT Fx Distal Finger/Thumb Wo Man 7 5 $396.00 $384.12 $257.40 $396.00 $337.79 2026-07-15
26600 CPT Fx Metacarpal 7 5 $396.00 $384.12 $257.40 $396.00 $337.79 2026-07-15
25622 CPT Fx Carpal Scaphoid Wo Man Rt 7 5 $396.00 $384.12 $257.40 $396.00 $337.79 2026-07-15
25600 CPT Fx Distal Radius Rt 7 5 $396.00 $384.12 $257.40 $396.00 $337.79 2026-07-15
99223 CPT IP/Obs Initial High Comp 6 5 $322.00 $312.34 $209.42 $389.40 $334.66 2026-07-15
88368 CPT Morphometric Ana Ea Hematologi 7 5 $389.00 $377.33 $252.85 $389.00 $331.82 2026-07-15
86043 CPT Acetylcholine Mod Aby 7 5 $388.00 $376.36 $252.20 $388.00 $330.96 2026-07-15
72200 CPT X-ray Si Joints 10 5 $339.00 $328.83 $220.35 $483.57 $330.52 2026-07-15
86480 CPT Tbint Quantiferon 9 5 $385.00 $373.45 $250.25 $385.00 $328.41 2026-07-15
11765 CPT Wedge Exc Nail Fold 15 5 $504.00 $488.88 $96.00 $504.00 $327.60 2026-07-15
83880 CPT B Type Natriuretic Peptide 11 5 $344.00 $333.68 $223.60 $344.00 $326.80 2026-07-15
10160 CPT Punc Asp Abscess Hematoma Cyst 15 5 $420.00 $407.40 $114.68 $420.00 $324.24 2026-07-15
J0613 HCPCS Calcium Gluc/NS (Wgcc) 1,000Mg 7 5 $340.00 $330.60 $221.53 $340.82 $323.78 2026-07-15
84702 CPT Hcg Beta Quan Serum 9 5 $339.00 $328.83 $220.35 $339.00 $322.05 2026-07-15
99205 CPT New Patient Level 5 High Comp 6 5 $215.00 $208.55 $193.98 $382.02 $320.46 2026-07-15
70250 CPT X-ray Skull < 4 Views 10 5 $353.00 $342.41 $94.25 $353.00 $318.23 2026-07-15
87798 CPT Bord Parapertussis Amp Arup 48 5 $409.00 $396.73 $127.40 $914.00 $317.48 2026-07-15
86922 CPT Crossmatch Ahg 9 5 $333.00 $323.01 $216.45 $333.00 $316.35 2026-07-15
73551 CPT X-ray Femur 1 View Rt 8 5 $389.00 $377.33 $101.48 $389.00 $316.06 2026-07-15
71271 CPT Ldct For Lung Cancer Screen 11 5 $330.00 $320.10 $101.48 $330.00 $313.50 2026-07-15
86870 CPT Rbc Antibody Identif Panel 7 5 $367.00 $355.99 $238.55 $367.00 $313.05 2026-07-15
82104 CPT Alpha 1 Antitrypsin Pheno 9 5 $329.00 $319.13 $213.85 $364.00 $312.55 2026-07-15
71120 CPT X-ray Sternum 2 Views 10 5 $346.00 $335.62 $79.40 $346.00 $311.92 2026-07-15
82530 CPT Cortisol Free Urine 7 5 $364.00 $353.08 $236.60 $364.00 $310.49 2026-07-15
87493 CPT C Diff By Pcr 11 5 $321.00 $311.37 $208.65 $321.00 $304.95 2026-07-15
82627 CPT Dheas 9 5 $320.00 $310.40 $208.00 $320.00 $304.00 2026-07-15
24650 CPT Fx Radial Head/Neck Wo Man Lt 7 5 $356.00 $345.32 $231.40 $356.00 $303.67 2026-07-15
93242 CPT Ext ECG 48 Hrs -7days Hook Up 9 5 $319.00 $309.43 $207.35 $467.00 $303.05 2026-07-15
73020 CPT X-ray Shoulder Lt 20 5 $336.00 $325.92 $187.95 $336.00 $302.90 2026-07-15
73560 CPT X-ray Knee 1-2 Views Lt 22 5 $318.00 $308.46 $84.00 $318.00 $302.05 2026-07-15
70160 CPT X-ray Facial Bones 3 Views 8 5 $371.00 $359.87 $86.75 $371.00 $301.44 2026-07-15
87497 CPT Cmv Quant By Pcr 8 5 $333.00 $323.01 $216.45 $333.00 $300.20 2026-07-15
93005 CPT EKG Tracing 11 5 $312.00 $302.64 $202.80 $312.00 $296.40 2026-07-15
82166 CPT Mullerian Inhib Hormone 7 5 $346.00 $335.62 $224.90 $346.00 $295.14 2026-07-15
82553 CPT Cpk Mb Fraction 9 5 $310.00 $300.70 $201.50 $327.00 $294.50 2026-07-15
11750 CPT Exc Nail Matrix Part/Complete 15 5 $453.00 $439.41 $96.71 $453.00 $294.45 2026-07-15
11401 CPT Exc Ben Lesion 0.6-1.0 Trunk 13 5 $419.00 $406.43 $126.70 $419.00 $289.52 2026-07-15
82803 CPT Blood Gas Wo Oximetry 10 5 $320.00 $310.40 $208.00 $320.00 $288.48 2026-07-15
G0438 HCPCS Annual Wellness Visit Initial 6 5 $231.00 $224.07 $92.40 $358.02 $286.56 2026-07-15
J3480 HCPCS D5/Ns Kcl 20 Meq 1000 Ml Bag 26 5 $316.00 $306.80 $9.57 $948.87 $283.88 2026-07-15
J1956 HCPCS Levofloxac/D5W 750mg/150ml Bag 10 5 $309.00 $299.90 $2.07 $309.18 $278.73 2026-07-15
P9017 HCPCS Plasma Fresh Frozen 9 5 $292.00 $283.24 $189.80 $584.00 $277.40 2026-07-15
96402 CPT Injection Chemo Sq/IM Hormonal 7 5 $320.00 $310.40 $208.00 $320.00 $272.96 2026-07-15
J0131 HCPCS Acetaminophen 1000mg/100ml Via 11 5 $318.00 $309.32 $145.73 $318.89 $272.01 2026-07-15
73140 CPT X-ray Finger(s) Lt 20 5 $301.00 $291.97 $64.68 $301.00 $271.35 2026-07-15
82077 CPT Alcohol/Ethanol Auto Analyzer 10 5 $285.00 $276.45 $185.25 $285.00 $270.75 2026-07-15
80185 CPT Phenytoin Total 9 5 $285.00 $276.45 $185.25 $285.00 $270.75 2026-07-15
87075 CPT Culture Anaerobe Exept Bld 9 5 $285.00 $276.45 $185.25 $285.00 $270.75 2026-07-15
11042 CPT Debride Skin Subq 20 Cm 15 5 $416.00 $403.52 $59.40 $416.00 $270.40 2026-07-15
11000 CPT Debride Infect Skin Up To 10% 13 5 $416.00 $403.52 $33.36 $416.00 $270.40 2026-07-15
11104 CPT Punch Biopsy 1st Lesion 13 5 $416.00 $403.52 $56.71 $416.00 $270.40 2026-07-15
11102 CPT Tangential Biopsy 1st Lesion 13 5 $416.00 $403.52 $45.38 $416.00 $270.40 2026-07-15
87040 CPT Culture Blood 11 5 $283.00 $274.51 $183.95 $283.00 $268.85 2026-07-15
96374 CPT IV Push Injection Initial 21 5 $361.00 $350.17 $173.55 $361.00 $267.00 2026-07-15
80061 CPT Lipid Panel 11 5 $279.00 $270.63 $181.35 $279.00 $265.00 2026-07-15
86301 CPT Ca 19-9 9 5 $278.00 $269.66 $180.70 $278.00 $264.10 2026-07-15
87385 CPT Histoplasma Antigen 7 5 $308.00 $298.76 $200.20 $308.00 $262.72 2026-07-15
73120 CPT X-ray Hand Rt 8 5 $317.00 $307.49 $198.99 $317.00 $257.56 2026-07-15
70140 CPT X-ray Facial Bones < 3 Views 10 5 $282.00 $273.54 $66.51 $282.00 $254.22 2026-07-15
Q9967 HCPCS Iopamidol-370 100 Ml Vial 21 5 $600.00 $582.00 $58.50 $600.00 $253.80 2026-07-15
73620 CPT X-ray Foot 2 Views Rt 8 5 $312.00 $302.64 $202.80 $312.00 $253.50 2026-07-15
J0744 HCPCS Ciprofloxac/D5 400mg/200ml Bag 8 5 $311.00 $302.57 $5.85 $311.93 $253.44 2026-07-15
80203 CPT Zonisamide 9 5 $264.00 $256.08 $171.60 $292.00 $250.80 2026-07-15
84484 CPT Troponin Quant 11 5 $264.00 $256.08 $171.60 $264.00 $250.80 2026-07-15
97163 CPT Pt Eval High Complexity 9 5 $294.00 $285.18 $81.00 $294.00 $250.78 2026-07-15
64615 CPT Chemodenerv Muscle Migraine 6 5 $159.00 $154.23 $138.83 $321.69 $248.63 2026-07-15
82668 CPT Erythropoietin 7 5 $291.00 $282.27 $189.15 $291.00 $248.22 2026-07-15
J1836 HCPCS Metronidazole/Ns 500mg/100ml 8 5 $304.00 $295.15 $0.32 $304.28 $247.23 2026-07-15
99222 CPT Inpatient Initial/Obs Mod Comp 6 5 $162.00 $157.14 $141.80 $274.01 $246.06 2026-07-15
64483 CPT Inj Foramen Epidural L/s Bi 12 5 $1,266.50 $1,228.51 $134.72 $312.87 $244.09 2026-07-15
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