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

SANFORD CLEAR LAKE MEDICAL CENTER

Clear Lake, SD · CCN 431307 · Rates published

1,425 distinct procedures filed
17 distinct payers
160,618 rate rows
2026-03-04 last MRF observed
Data quality

160,152 of 160,618 rate rows are consumer-grade (99.7%)

466 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
percent-of-charges filed in the dollar field — excluded from medians 394
per-diem day rate — not a per-procedure price 56
exceeds 10× this hospital's gross charge — excluded from medians 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8373/460388596_sanford-clear-lake-medical-center_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/SanfordClearLakeMedicalCenter/8373
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint 3d53d14fd970c3cb… · 48,063,320 bytes · first seen 2026-05-06

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
J3357
HCPCS 		Ustekinumab Soln Prefilled Syringe 90 Mg/ml 17 $23,091.08 $41,856.53 $33,306.53 nat. median
$20,264
1.6× median
J1930
HCPCS 		Lanreotide Acetate Extended Release Inj 120 Mg/0.5ml 17 $8,212.66 $14,886.84 $11,845.92 nat. median
$261
outlier · 45.3×
J3101
HCPCS 		Tenecteplase For IV Soln Kit 50 Mg 17 $5,546.07 $14,374.51 $8,829.94 nat. median
$498
outlier · 17.7×
J2506
HCPCS 		Pegfilgrastim Soln Prefilled Syringe 6 Mg/0.6ml 17 $31.73 $9,221.56 $7,337.88 nat. median
$916
outlier · 8.0×
J0517
HCPCS 		Benralizumab Subcutaneous Soln Prefilled Syringe 30 Mg/ml 17 $170.48 $9,099.39 $7,240.66 nat. median
$404
outlier · 17.9×
J2353
HCPCS 		Octreotide Acetate For IM Inj Kit 30 Mg 17 $4,517.46 $8,188.66 $6,515.97 nat. median
$1,956
outlier · 3.3×
36561
CPT 		Surg 36561 Ins Tun Cva Wport 17 $4,433.86 $8,037.13 $6,395.39 nat. median
$3,304
1.9× median
Q5127
HCPCS 		Pegfilgrastim-fpgk Soln Prefilled Syringe 6 Mg/0.6ml 17 $311.44 $7,690.46 $6,119.53 nat. median
$318
outlier · 19.2×
Q5123
HCPCS 		Rituximab-arrx IV Soln 500 Mg/50ml (10 Mg/ml) 17 $3,577.76 $6,485.31 $5,160.56 nat. median
$244
outlier · 21.2×
Q5111
HCPCS 		Pegfilgrastim-cbqv Soln Prefilled Syringe 6 Mg/0.6ml 17 $146.06 $6,415.42 $5,104.94 nat. median
$665
outlier · 7.7×
J0225
HCPCS 		Inj, Vutrisiran, 1 Mg 1 $5,018.93 $5,018.93 $5,018.93 nat. median
$6,067
0.8× median
74178
CPT 		CT Abd Pelvis Wo Then W Cont 17 $1,215.50 $6,172.68 $4,911.79 nat. median
$539
outlier · 9.1×
C1713
HCPCS 		Plate Lk Stry Rect Sz2 17 $850.55 $38,163.10 $4,719.88 nat. median
$1,045
outlier · 4.5×
J2182
HCPCS 		Mepolizumab For Inj 100 Mg 17 $31.01 $5,638.99 $4,487.11 nat. median
$80
outlier · 56.3×
78452
CPT 		Nm Myocardial Spect Mult Stdy 17 $3,043.63 $5,517.10 $4,390.12 nat. median
$1,464
outlier · 3.0×
95811
CPT 		Sleep Study Splt Nght 95811 17 $3,032.86 $5,497.57 $4,374.59 nat. median
$1,412
outlier · 3.1×
72156
CPT 		MRI C Spine Wo Then W Cont 17 $1,215.50 $5,490.13 $4,368.66 nat. median
$625
outlier · 7.0×
74177
CPT 		CT Abd Pelvis W Contrast 17 $1,215.50 $5,466.88 $4,350.16 nat. median
$501
outlier · 8.7×
70543
CPT 		MRI Face Neck Orb Wo Then W Cont 17 $1,215.50 $5,412.95 $4,307.25 nat. median
$605
outlier · 7.1×
70553
CPT 		MRI Brain Wo Then W Cont 17 $1,215.50 $5,249.29 $4,177.02 nat. median
$616
outlier · 6.8×
J1162
HCPCS 		Digoxin Immune Fab For Inj 40 Mg 17 $2,846.32 $5,159.44 $4,105.52 nat. median
$6,265
0.7× median
72158
CPT 		MRI L Spine Wo Then W Cont 17 $1,215.50 $5,149.79 $4,097.85 nat. median
$616
outlier · 6.7×
72157
CPT 		MRI T Spine Wo Then W Cont 17 $1,215.50 $5,142.35 $4,091.93 nat. median
$624
outlier · 6.6×
95810
CPT 		Psg 4+ Parameters 17 $2,796.36 $5,068.88 $4,033.47 nat. median
$1,446
outlier · 2.8×
74183
CPT 		MRI Abdomen Wo Then W Cont 17 $1,215.50 $4,894.99 $3,895.09 nat. median
$611
outlier · 6.4×
71552
CPT 		MRI Chest Wo Then W Cont 17 $1,215.50 $4,865.24 $3,871.42 nat. median
$691
outlier · 5.6×
11606
CPT 		Surg 11606 Exc Malig Lesn Incl Margins Trunk Arms Legs Exc Diam > 4.0 Cm 17 $2,673.76 $4,846.64 $3,856.62 nat. median
$1,743
outlier · 2.2×
73223
CPT 		MRI Upper Ext Jt Wo Then W Cont 17 $1,215.50 $4,770.39 $3,795.95 nat. median
$757
outlier · 5.0×
74176
CPT 		CT Abd Pelvis Wo Contrast 17 $1,156.10 $4,727.61 $3,761.91 nat. median
$333
outlier · 11.3×
73723
CPT 		MRI Lower Ext Jt Wo Then W Cont 17 $1,215.50 $4,713.66 $3,750.80 nat. median
$756
outlier · 5.0×
72197
CPT 		MRI Pelvis Wo Then W Cont 17 $1,215.50 $4,698.78 $3,738.97 nat. median
$606
outlier · 6.2×
72196
CPT 		MRI Pelvis W Contrast 17 $1,215.50 $4,662.52 $3,710.11 nat. median
$562
outlier · 6.6×
73720
CPT 		MRI Lower Ext Wo Then W Cont 17 $1,215.50 $4,563.95 $3,631.68 nat. median
$754
outlier · 4.8×
70549
CPT 		MRA Neck Wo Then W Cont 17 $1,215.50 $4,472.82 $3,559.16 nat. median
$606
outlier · 5.9×
J2507
HCPCS 		Pegloticase Injection 1 $3,547.84 $3,547.84 $3,547.84 nat. median
$4,390
0.8× median
70546
CPT 		MRA Head Wo Then W Cont 17 $1,215.50 $4,455.15 $3,545.10 nat. median
$625
outlier · 5.7×
73220
CPT 		MRI Upper Ext Wo Then W Cont 17 $1,215.50 $4,441.20 $3,534.00 nat. median
$737
outlier · 4.8×
70542
CPT 		MRI Face Neck Orb W Contrast 17 $1,215.50 $4,416.10 $3,514.03 nat. median
$476
outlier · 7.4×
73719
CPT 		MRI Lower Ext W Contrast 17 $1,215.50 $4,245.92 $3,378.61 nat. median
$575
outlier · 5.9×
73222
CPT 		MRI Up Ext Jt Wcont 17 $1,222.10 $4,181.76 $3,327.55 nat. median
$1,026
outlier · 3.2×
73219
CPT 		MRI Upper Ext W Contrast 17 $1,215.50 $4,141.77 $3,295.74 nat. median
$622
outlier · 5.3×
J1561
HCPCS 		Immune Globulin (Human) IV Or Subcutaneous Soln 20 Gm/200ml 17 $49.73 $4,128.20 $3,284.93 nat. median
$994
outlier · 3.3×
78451
CPT 		Nm Myocardial Spect Sngl Stdy 17 $2,249.51 $4,077.61 $3,244.68 nat. median
$1,355
outlier · 2.4×
J3358
HCPCS 		Ustekinumab IV Soln 130 Mg/26ml (5 Mg/ml) (For IV Infusion) 17 $2,201.28 $3,990.20 $3,175.12 nat. median
$38
outlier · 83.7×
72147
CPT 		MRI T Spine W Contrast 17 $1,215.50 $3,968.81 $3,158.11 nat. median
$576
outlier · 5.5×
74182
CPT 		MRI Abdomen W Contrast 17 $1,215.50 $3,920.46 $3,119.63 nat. median
$580
outlier · 5.4×
72146
CPT 		MRI T Spine Wo Contrast 17 $1,156.10 $3,919.53 $3,118.89 nat. median
$421
outlier · 7.4×
73722
CPT 		MRI Lower Ext Jt W Contrast 17 $1,222.10 $3,916.74 $3,116.67 nat. median
$1,003
outlier · 3.1×
72142
CPT 		MRI C Spine W Contrast 17 $1,215.50 $3,916.74 $3,116.67 nat. median
$541
outlier · 5.8×
72149
CPT 		MRI L Spine W Contrast 17 $1,215.50 $3,908.37 $3,110.01 nat. median
$549
outlier · 5.7×

Other procedures at this hospital

Browse this hospital's 1,425 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
             
J3357 HCPCS Ustekinumab Soln Prefilled Syringe 90 Mg/ml 76 17 $45,011.86 $36,009.49 $23,091.08 $41,856.53 $33,306.53 2026-03-04
J1930 HCPCS Lanreotide Acetate Extended Release Inj 120 Mg/0.5ml 76 17 $16,009.08 $12,807.27 $8,212.66 $14,886.84 $11,845.92 2026-03-04
J3101 HCPCS Tenecteplase For IV Soln Kit 50 Mg 132 17 $10,811.06 $8,648.85 $5,546.07 $14,374.51 $8,829.94 2026-03-04
J2506 HCPCS Pegfilgrastim Soln Prefilled Syringe 6 Mg/0.6ml 80 17 $9,916.72 $7,933.38 $31.73 $9,221.56 $7,337.88 2026-03-04
J0517 HCPCS Benralizumab Subcutaneous Soln Prefilled Syringe 30 Mg/ml 80 17 $9,785.34 $7,828.28 $170.48 $9,099.39 $7,240.66 2026-03-04
J2353 HCPCS Octreotide Acetate For IM Inj Kit 30 Mg 76 17 $8,805.96 $7,044.77 $4,517.46 $8,188.66 $6,515.97 2026-03-04
36561 CPT Surg 36561 Ins Tun Cva Wport 76 17 $8,643.00 $6,914.40 20% off $4,433.86 $8,037.13 $6,395.39 2026-03-04
Q5127 HCPCS Pegfilgrastim-fpgk Soln Prefilled Syringe 6 Mg/0.6ml 80 17 $8,270.20 $6,616.16 20% off $311.44 $7,690.46 $6,119.53 2026-03-04
Q5123 HCPCS Rituximab-arrx IV Soln 500 Mg/50ml (10 Mg/ml) 76 17 $6,974.20 $5,579.36 20% off $3,577.76 $6,485.31 $5,160.56 2026-03-04
Q5111 HCPCS Pegfilgrastim-cbqv Soln Prefilled Syringe 6 Mg/0.6ml 80 17 $6,899.04 $5,519.24 $146.06 $6,415.42 $5,104.94 2026-03-04
J0225 HCPCS Inj, Vutrisiran, 1 Mg 4 1 — — $5,018.93 $5,018.93 $5,018.93 2026-03-04
74178 CPT CT Abd Pelvis Wo Then W Cont 78 17 $6,638.00 $5,310.40 20% off $1,215.50 $6,172.68 $4,911.79 2026-03-04
C1713 HCPCS Plate Lk Stry Rect Sz2 244 17 $5,523.00 $4,418.40 20% off $850.55 $38,163.10 $4,719.88 2026-03-04
J2182 HCPCS Mepolizumab For Inj 100 Mg 80 17 $6,064.08 $4,851.27 $31.01 $5,638.99 $4,487.11 2026-03-04
78452 CPT Nm Myocardial Spect Mult Stdy 78 17 $5,933.00 $4,746.40 20% off $3,043.63 $5,517.10 $4,390.12 2026-03-04
95811 CPT Sleep Study Splt Nght 95811 76 17 $5,912.00 $4,729.60 $3,032.86 $5,497.57 $4,374.59 2026-03-04
72156 CPT MRI C Spine Wo Then W Cont 76 17 $5,904.00 $4,723.20 20% off $1,215.50 $5,490.13 $4,368.66 2026-03-04
74177 CPT CT Abd Pelvis W Contrast 78 17 $5,879.00 $4,703.20 20% off $1,215.50 $5,466.88 $4,350.16 2026-03-04
70543 CPT MRI Face Neck Orb Wo Then W Cont 76 17 $5,821.00 $4,656.80 $1,215.50 $5,412.95 $4,307.25 2026-03-04
70553 CPT MRI Brain Wo Then W Cont 76 17 $5,645.00 $4,516.00 20% off $1,215.50 $5,249.29 $4,177.02 2026-03-04
J1162 HCPCS Digoxin Immune Fab For Inj 40 Mg 76 17 $5,548.38 $4,438.71 $2,846.32 $5,159.44 $4,105.52 2026-03-04
72158 CPT MRI L Spine Wo Then W Cont 76 17 $5,538.00 $4,430.40 20% off $1,215.50 $5,149.79 $4,097.85 2026-03-04
72157 CPT MRI T Spine Wo Then W Cont 76 17 $5,530.00 $4,424.00 20% off $1,215.50 $5,142.35 $4,091.93 2026-03-04
95810 CPT Psg 4+ Parameters 78 17 $5,451.00 $4,360.80 $2,796.36 $5,068.88 $4,033.47 2026-03-04
74183 CPT MRI Abdomen Wo Then W Cont 78 17 $5,264.00 $4,211.20 20% off $1,215.50 $4,894.99 $3,895.09 2026-03-04
71552 CPT MRI Chest Wo Then W Cont 76 17 $5,232.00 $4,185.60 $1,215.50 $4,865.24 $3,871.42 2026-03-04
11606 CPT Surg 11606 Exc Malig Lesn Incl Margins Trunk Arms Legs Exc Diam > 4.0 Cm 76 17 $5,212.00 $4,169.60 $2,673.76 $4,846.64 $3,856.62 2026-03-04
73223 CPT MRI Upper Ext Jt Wo Then W Cont 76 17 $5,130.00 $4,104.00 20% off $1,215.50 $4,770.39 $3,795.95 2026-03-04
74176 CPT CT Abd Pelvis Wo Contrast 80 17 $5,084.00 $4,067.20 20% off $1,156.10 $4,727.61 $3,761.91 2026-03-04
73723 CPT MRI Lower Ext Jt Wo Then W Cont 76 17 $5,069.00 $4,055.20 20% off $1,215.50 $4,713.66 $3,750.80 2026-03-04
72197 CPT MRI Pelvis Wo Then W Cont 76 17 $5,053.00 $4,042.40 20% off $1,215.50 $4,698.78 $3,738.97 2026-03-04
72196 CPT MRI Pelvis W Contrast 76 17 $5,014.00 $4,011.20 20% off $1,215.50 $4,662.52 $3,710.11 2026-03-04
73720 CPT MRI Lower Ext Wo Then W Cont 76 17 $4,908.00 $3,926.40 20% off $1,215.50 $4,563.95 $3,631.68 2026-03-04
70549 CPT MRA Neck Wo Then W Cont 76 17 $4,810.00 $3,848.00 20% off $1,215.50 $4,472.82 $3,559.16 2026-03-04
J2507 HCPCS Pegloticase Injection 4 1 — — $3,547.84 $3,547.84 $3,547.84 2026-03-04
70546 CPT MRA Head Wo Then W Cont 76 17 $4,791.00 $3,832.80 $1,215.50 $4,455.15 $3,545.10 2026-03-04
73220 CPT MRI Upper Ext Wo Then W Cont 76 17 $4,776.00 $3,820.80 $1,215.50 $4,441.20 $3,534.00 2026-03-04
70542 CPT MRI Face Neck Orb W Contrast 76 17 $4,749.00 $3,799.20 20% off $1,215.50 $4,416.10 $3,514.03 2026-03-04
73719 CPT MRI Lower Ext W Contrast 76 17 $4,566.00 $3,652.80 $1,215.50 $4,245.92 $3,378.61 2026-03-04
73222 CPT MRI Up Ext Jt Wcont 76 17 $4,497.00 $3,597.60 20% off $1,222.10 $4,181.76 $3,327.55 2026-03-04
73219 CPT MRI Upper Ext W Contrast 76 17 $4,454.00 $3,563.20 20% off $1,215.50 $4,141.77 $3,295.74 2026-03-04
J1561 HCPCS Immune Globulin (Human) IV Or Subcutaneous Soln 20 Gm/200ml 80 17 $4,439.40 $3,551.52 $49.73 $4,128.20 $3,284.93 2026-03-04
78451 CPT Nm Myocardial Spect Sngl Stdy 76 17 $4,385.00 $3,508.00 20% off $2,249.51 $4,077.61 $3,244.68 2026-03-04
J3358 HCPCS Ustekinumab IV Soln 130 Mg/26ml (5 Mg/ml) (For IV Infusion) 76 17 $4,291.00 $3,432.80 $2,201.28 $3,990.20 $3,175.12 2026-03-04
72147 CPT MRI T Spine W Contrast 76 17 $4,268.00 $3,414.40 20% off $1,215.50 $3,968.81 $3,158.11 2026-03-04
74182 CPT MRI Abdomen W Contrast 76 17 $4,216.00 $3,372.80 $1,215.50 $3,920.46 $3,119.63 2026-03-04
72146 CPT MRI T Spine Wo Contrast 76 17 $4,215.00 $3,372.00 20% off $1,156.10 $3,919.53 $3,118.89 2026-03-04
72142 CPT MRI C Spine W Contrast 76 17 $4,212.00 $3,369.60 20% off $1,215.50 $3,916.74 $3,116.67 2026-03-04
73722 CPT MRI Lower Ext Jt W Contrast 76 17 $4,212.00 $3,369.60 20% off $1,222.10 $3,916.74 $3,116.67 2026-03-04
72149 CPT MRI L Spine W Contrast 76 17 $4,203.00 $3,362.40 20% off $1,215.50 $3,908.37 $3,110.01 2026-03-04
Q5120 HCPCS Pegfilgrastim-bmez Soln Prefilled Syringe 6 Mg/0.6ml 80 17 $4,132.04 $3,305.64 $327.13 $3,842.38 $3,057.50 2026-03-04
71551 CPT MRI Chest W Contrast 76 17 $4,110.00 $3,288.00 20% off $1,222.10 $3,821.89 $3,041.20 2026-03-04
71270 CPT CT Thorax Diagnostic Wo Then W Contrast 76 17 $4,108.00 $3,286.40 20% off $893.20 $3,820.03 $3,039.72 2026-03-04
95805 CPT Multiple Sleep Latency 95805 76 17 $4,108.00 $3,286.40 20% off $2,107.40 $3,820.03 $3,039.72 2026-03-04
72141 CPT MRI C Spine Wo Contrast 78 17 $4,032.00 $3,225.60 20% off $1,156.10 $3,749.36 $2,983.48 2026-03-04
J0897 HCPCS Denosumab Inj Soln Prefilled Syringe 60 Mg/ml 188 17 $3,449.28 $2,759.43 $1,257.12 $5,122.45 $2,981.90 2026-03-04
J1437 HCPCS Ferric Derisomaltose (One Dose) IV Sol 1000 Mg/10ml (Fe Eq) 76 17 $3,950.86 $3,160.69 $2,026.79 $3,673.90 $2,923.43 2026-03-04
72148 CPT MRI L Spine Wo Contrast 80 17 $3,911.00 $3,128.80 $1,156.10 $3,636.84 $2,893.95 2026-03-04
70540 CPT MRI Face Neck Orb Wo Contrast 76 17 $3,904.00 $3,123.20 20% off $1,156.10 $3,630.33 $2,888.76 2026-03-04
0360 RC Central Line Insertion 300 17 $4,037.00 $3,229.60 20% off $667.41 $4,948.93 $2,867.85 2026-03-04
70551 CPT MRI Brain Wo Contrast 76 17 $3,867.00 $3,093.60 20% off $1,156.10 $3,595.92 $2,861.39 2026-03-04
70545 CPT MRA Head W Contrast 76 17 $3,839.00 $3,071.20 20% off $1,215.50 $3,569.89 $2,840.67 2026-03-04
72195 CPT MRI Pelvis Wo Contrast 76 17 $3,830.00 $3,064.00 20% off $1,156.10 $3,561.52 $2,834.01 2026-03-04
70492 CPT CT Sft Tisue Neck Wwo Then W 76 17 $3,827.00 $3,061.60 20% off $893.20 $3,558.73 $2,831.79 2026-03-04
73721 CPT MRI Lower Ext Jt Wo Contrast 78 17 $3,817.00 $3,053.60 20% off $1,156.10 $3,549.43 $2,824.39 2026-03-04
74170 CPT CT Abdomen Wo Then W Cont 76 17 $3,816.00 $3,052.80 $893.20 $3,548.50 $2,823.65 2026-03-04
99291 CPT Ed 99291 Critical Care E&m 30-74 Min 78 17 $3,796.00 $3,036.80 $1,947.35 $3,529.90 $2,808.85 2026-03-04
73718 CPT MRI Lower Ext Wo Contrast 76 17 $3,744.00 $2,995.20 20% off $1,156.10 $3,481.55 $2,770.38 2026-03-04
74181 CPT MRI Abdomen Wo Contrast 76 17 $3,743.00 $2,994.40 20% off $1,156.10 $3,480.62 $2,769.64 2026-03-04
71275 CPT CTA Chest Wcont +wo If Perf 78 17 $3,738.00 $2,990.40 20% off $893.20 $3,475.97 $2,765.93 2026-03-04
73221 CPT MRI Upper Ext Jt Wo Contrast 76 17 $3,724.00 $2,979.20 20% off $1,156.10 $3,462.95 $2,755.57 2026-03-04
45378 CPT Diagnostic Colonoscopy 4 1 — — $2,742.30 $2,742.30 $2,742.30 2026-03-04
70548 CPT MRA Neck W Contrast 76 17 $3,701.00 $2,960.80 $1,215.50 $3,441.56 $2,738.55 2026-03-04
71550 CPT MRI Chest Wo Contrast 76 17 $3,683.00 $2,946.40 20% off $1,156.10 $3,424.82 $2,725.24 2026-03-04
70498 CPT CT Angio Neck W Con+wo If Perf 78 17 $3,683.00 $2,946.40 20% off $893.20 $3,424.82 $2,725.24 2026-03-04
70496 CPT CTA Head W Cont Wo If Perf 78 17 $3,683.00 $2,946.40 20% off $893.20 $3,424.82 $2,725.24 2026-03-04
J3590 HCPCS Idarucizumab IV Soln 2.5 Gm/50ml 76 17 $3,676.50 $2,941.20 20% off $1,886.04 $3,418.78 $2,720.43 2026-03-04
70488 CPT CT Maxillofacial Wo W Cont 76 17 $3,662.00 $2,929.60 20% off $893.20 $3,405.29 $2,709.70 2026-03-04
73725 CPT MRA Lower Ext W Contrast 76 17 $3,633.00 $2,906.40 20% off $1,156.10 $3,378.33 $2,688.24 2026-03-04
27825 CPT Ed 27825 Clsd Tx Art Fx Tib Wmanip 76 17 $3,574.00 $2,859.20 20% off $1,833.46 $3,323.46 $2,644.58 2026-03-04
70336 CPT MRI Temporomandibular Joint 76 17 $3,572.00 $2,857.60 20% off $1,156.10 $3,321.60 $2,643.10 2026-03-04
70544 CPT MRA Head Wo Contrast 76 17 $3,562.00 $2,849.60 20% off $1,156.10 $3,312.30 $2,635.70 2026-03-04
73218 CPT MRI Up Ext Wo Cont 76 17 $3,537.00 $2,829.60 20% off $1,156.10 $3,289.06 $2,617.20 2026-03-04
70482 CPT CT Orbit Sella Fossa Ear Wo Then W Contrast 76 17 $3,519.00 $2,815.20 20% off $893.20 $3,272.32 $2,603.89 2026-03-04
43248 CPT Egd Insert Gd Wire 76 17 $3,445.00 $2,756.00 20% off $1,767.29 $3,203.51 $2,549.13 2026-03-04
72194 CPT CT Pelvis Wo Then W Cont 76 17 $3,427.00 $2,741.60 20% off $893.20 $3,186.77 $2,535.81 2026-03-04
73702 CPT CT Ext Lower Wo Then W Cont 76 17 $3,409.00 $2,727.20 20% off $893.20 $3,170.03 $2,522.49 2026-03-04
74185 CPT MRA Abdomen W Contrast 76 17 $3,371.00 $2,696.80 $1,156.10 $3,134.69 $2,494.37 2026-03-04
71260 CPT CT Thorax Diagnostic With Contrast 78 17 $3,333.00 $2,666.40 20% off $893.20 $3,099.36 $2,466.26 2026-03-04
74160 CPT CT Abdomen W Contrast 76 17 $3,333.00 $2,666.40 20% off $893.20 $3,099.36 $2,466.26 2026-03-04
36569 CPT Surg 36569 Insertion Picc Without Img Gdn 5 Yr/> 76 17 $3,301.00 $2,640.80 $1,693.41 $3,069.60 $2,442.57 2026-03-04
72133 CPT CT Lumbar Spine Wo Then Wcon 76 17 $3,281.00 $2,624.80 $893.20 $3,051.00 $2,427.78 2026-03-04
70547 CPT MRA Neck Wo Contrast 76 17 $3,278.00 $2,622.40 20% off $1,156.10 $3,048.21 $2,425.55 2026-03-04
70470 CPT CT Head Wo Then W Contrast 78 17 $3,273.00 $2,618.40 20% off $893.20 $3,043.56 $2,421.86 2026-03-04
43239 CPT Ed 43239 Upper Gi Bx 78 17 $3,222.00 $2,577.60 20% off $1,652.89 $2,996.14 $2,384.12 2026-03-04
45385 CPT Colonoscopy W/lesion Removal 4 1 — — $2,382.60 $2,382.60 $2,382.60 2026-03-04
45384 CPT Colonoscopy W/lesion Removal 4 1 — — $2,382.60 $2,382.60 $2,382.60 2026-03-04
45380 CPT Colonoscopy And Biopsy 4 1 — — $2,382.60 $2,382.60 $2,382.60 2026-03-04
J0202 HCPCS Injection, Alemtuzumab 4 1 — — $2,381.81 $2,381.81 $2,381.81 2026-03-04
11423 CPT Surg 11423 Exc Bngn Lsn S/n/h/f/g 2.1-3.0cm 76 17 $3,200.00 $2,560.00 20% off $1,641.60 $2,975.68 $2,367.84 2026-03-04
72131 CPT CT Lumbar Spine Wo Cont 76 17 $3,174.00 $2,539.20 20% off $705.10 $2,951.50 $2,348.60 2026-03-04
72128 CPT CT Thoracic Spine Wo Cont 76 17 $3,174.00 $2,539.20 20% off $705.10 $2,951.50 $2,348.60 2026-03-04
93306 CPT Echo (2d) Complete W Doppler & Color 80 17 $3,130.00 $2,504.00 20% off $1,605.69 $2,910.59 $2,316.05 2026-03-04
0340 RC Ambulance - Nuc Med 76 17 $3,123.00 $2,498.40 20% off $1,602.10 $2,904.08 $2,310.86 2026-03-04
72125 CPT CT Cervical Spine Wo Contrast 76 17 $3,091.00 $2,472.80 $705.10 $2,874.32 $2,287.18 2026-03-04
G0105 HCPCS Colorectal Scrn; Hi Risk Ind 4 1 — — $2,285.80 $2,285.80 $2,285.80 2026-03-04
G0121 HCPCS Colon Ca Scrn Not Hi Rsk Ind 4 1 — — $2,285.80 $2,285.80 $2,285.80 2026-03-04
11422 CPT Surg 11422 Exc Bngn Lsn S/n/h/f/g 1.1-2.0cm 76 17 $3,080.00 $2,464.00 20% off $1,580.04 $2,864.09 $2,279.05 2026-03-04
70460 CPT CT Head W Contrast 76 17 $3,072.00 $2,457.60 20% off $893.20 $2,856.65 $2,273.12 2026-03-04
43235 CPT Egd Diagnostic Brush Wash 4 1 — — $2,270.40 $2,270.40 $2,270.40 2026-03-04
J3032 HCPCS Eptinezumab-jjmr IV Soln 100 Mg/ml 80 17 $3,065.00 $2,452.00 20% off $19.05 $2,850.14 $2,267.95 2026-03-04
J1602 HCPCS Golimumab IV Soln 50 Mg/4ml 80 17 $3,057.72 $2,446.18 $11.33 $2,843.37 $2,262.56 2026-03-04
70491 CPT CT Soft Tissue Neck W Contrast 78 17 $3,012.00 $2,409.60 20% off $893.20 $2,800.86 $2,228.73 2026-03-04
70481 CPT CT Orbit Sella Fossa Ear W Contrast 76 17 $3,012.00 $2,409.60 20% off $893.20 $2,800.86 $2,228.73 2026-03-04
0689 RC Trauma Activation Full 76 17 $2,984.00 $2,387.20 20% off $1,530.79 $2,774.82 $2,208.01 2026-03-04
G0390 HCPCS Trauma Activation Full W Ccare 76 17 $2,984.00 $2,387.20 20% off $1,530.79 $2,774.82 $2,208.01 2026-03-04
11443 CPT Surg 11443 Exc Benign Skin Lesn Incl Margins Face Exc Diam 2.1-3.0 Cm 76 17 $2,980.00 $2,384.00 20% off $1,528.74 $2,771.10 $2,205.05 2026-03-04
72193 CPT CT Pelvis W Contrast 76 17 $2,973.00 $2,378.40 $893.20 $2,764.59 $2,199.87 2026-03-04
J0129 HCPCS Abatacept For IV Soln 250 Mg 80 17 $2,926.84 $2,341.48 $44.25 $2,721.67 $2,165.72 2026-03-04
11403 CPT Surg 11403 Exc Benign Lesion Margin Xcpt Skin Tag T/a/l 2.1-3.0 Cm 76 17 $2,904.00 $2,323.20 20% off $1,489.75 $2,700.43 $2,148.82 2026-03-04
78315 CPT Nm Bone And Or Jnt Img 3 Phase Stdy 76 17 $2,835.00 $2,268.00 20% off $1,454.36 $2,636.27 $2,097.76 2026-03-04
0750 RC Colon Polyp Bx 356 17 $2,786.00 $2,228.80 $1,191.19 $3,125.39 $2,081.05 2026-03-04
78708 CPT Nm Kidney Img Morph W Vasc Flow Func Sngl W Rx 76 17 $2,795.00 $2,236.00 20% off $1,433.84 $2,599.07 $2,068.16 2026-03-04
70487 CPT CT Maxillofacial W Cont 76 17 $2,785.00 $2,228.00 20% off $893.20 $2,589.77 $2,060.76 2026-03-04
93303 CPT Echo Congenitl Comp 76 17 $2,779.00 $2,223.20 20% off $1,425.63 $2,584.19 $2,056.32 2026-03-04
74150 CPT CT Abdomen Wo Contrast 76 17 $2,768.00 $2,214.40 $705.10 $2,573.96 $2,048.18 2026-03-04
73700 CPT CT Ext Lower Wo Cont 76 17 $2,744.00 $2,195.20 20% off $705.10 $2,551.65 $2,030.42 2026-03-04
81503 CPT Cdmr Ova-1 81503.900 76 17 $2,736.00 $2,188.80 $1,403.57 $2,544.21 $2,024.51 2026-03-04
71250 CPT CT Thorax Diagnostic Wo Contrast 80 17 $2,736.00 $2,188.80 $705.10 $2,544.21 $2,024.51 2026-03-04
95913 CPT Nrv Conduction Test 13 > Studies 76 17 $2,729.00 $2,183.20 20% off $1,399.98 $2,537.70 $2,019.33 2026-03-04
93350 CPT Echo 2d With Stress 76 17 $2,699.00 $2,159.20 20% off $1,384.59 $2,509.80 $1,997.12 2026-03-04
70480 CPT CT Orbit Sella Fossa Ear Wo Contrast 78 17 $2,693.00 $2,154.40 $705.10 $2,504.22 $1,992.68 2026-03-04
70490 CPT CT Soft Tissue Neck Wo Con 76 17 $2,671.00 $2,136.80 $705.10 $2,483.76 $1,976.40 2026-03-04
70486 CPT CT Maxillofacial Wo Cont 76 17 $2,660.00 $2,128.00 20% off $705.10 $2,473.53 $1,968.27 2026-03-04
95912 CPT Nrv Conduction Test 11-12 Studies 76 17 $2,649.00 $2,119.20 20% off $1,358.94 $2,463.31 $1,960.13 2026-03-04
11642 CPT Surg 11642 Exc Malig Lesn Incl Margins Face Exc Diam 1.1-2.0 Cm 76 17 $2,600.00 $2,080.00 20% off $1,333.80 $2,417.74 $1,923.87 2026-03-04
70450 CPT CT Head Wo Contrast 78 17 $2,599.00 $2,079.20 20% off $940.50 $2,416.81 $1,923.13 2026-03-04
43249 CPT Esoph Egd Dilation <30 Mm 4 1 — — $1,916.20 $1,916.20 $1,916.20 2026-03-04
78306 CPT Nm Bone And Or Jnt Img Whole Body 76 17 $2,586.00 $2,068.80 $1,326.62 $2,404.72 $1,913.51 2026-03-04
J2802 HCPCS Romiplostim For Inj 125 Mcg 76 17 $2,565.72 $2,052.58 $1,316.21 $2,385.86 $1,898.51 2026-03-04
73200 CPT CT Ext Upper Wo Cont 76 17 $2,528.00 $2,022.40 $705.10 $2,350.79 $1,870.60 2026-03-04
11421 CPT Surg 11421 Exc Bngn Lsn Scalp Neck Hands Feet Genital 0.6-1.0cm 76 17 $2,518.00 $2,014.40 $1,291.73 $2,341.49 $1,863.19 2026-03-04
96440 CPT Chmotx Admn Plrl Cav Thrcnts 4 1 — — $1,822.40 $1,822.40 $1,822.40 2026-03-04
78582 CPT Nm Pulm Ventilation And Perfusion Img 76 17 $2,449.00 $1,959.20 20% off $1,256.34 $2,277.33 $1,812.14 2026-03-04
78278 CPT Nm Acute Gastrointestinal Blood Loss Img 76 17 $2,444.00 $1,955.20 20% off $1,253.77 $2,272.68 $1,808.44 2026-03-04
11402 CPT Surg 11402 Exc Bengn Skn Lesn Inc Margn No Skn Tag Trnk Arm Leg Dia 1.1-2.0 76 17 $2,430.00 $1,944.00 20% off $1,246.59 $2,259.66 $1,798.08 2026-03-04
72192 CPT CT Pelvis Wo Contrast 76 17 $2,430.00 $1,944.00 20% off $705.10 $2,259.66 $1,798.08 2026-03-04
78226 CPT Nm Hepatobiliary Img Incl Gallbladder 76 17 $2,410.00 $1,928.00 20% off $1,236.33 $2,241.06 $1,783.28 2026-03-04
49083 CPT Surg 49083 Abd Paracentesis W Imaging 76 17 $2,366.00 $1,892.80 20% off $1,213.76 $2,200.14 $1,750.72 2026-03-04
73701 CPT CT Ext Lower W Cont 76 17 $2,333.00 $1,866.40 $893.20 $2,169.46 $1,726.31 2026-03-04
13121 CPT Ed 13121 Rpr Cmplx Wnd 2.6-7.5 Cm 76 17 $2,308.00 $1,846.40 $1,184.00 $2,146.21 $1,707.81 2026-03-04
78264 CPT Nm Gastric Emptying Img Study 76 17 $2,302.00 $1,841.60 20% off $1,180.93 $2,140.63 $1,703.37 2026-03-04
11641 CPT Surg 11641 Exc Malig Lesn Incl Margins Face Exc Diam 0.6-1.0 Cm 76 17 $2,302.00 $1,841.60 20% off $1,180.93 $2,140.63 $1,703.37 2026-03-04
92960 CPT Cardioversion 76 17 $2,275.00 $1,820.00 20% off $1,167.08 $2,115.52 $1,683.38 2026-03-04
32555 CPT Surg 32555 Thoracentesis W Imaging 78 17 $2,255.00 $1,804.00 20% off $1,156.82 $2,096.92 $1,668.59 2026-03-04
95911 CPT Nrv Conduction Test 9-10 Studies 76 17 $2,230.00 $1,784.00 20% off $1,143.99 $2,073.68 $1,650.09 2026-03-04
J2426 HCPCS Paliperidone Palmitate ER Susp Pref Syr 156 Mg/ml 76 17 $2,186.30 $1,749.04 20% off $1,121.57 $2,033.04 $1,617.76 2026-03-04
78227 CPT Nm Hepatobiliary Img Incl Gallbladder W Pharm Intv 76 17 $2,114.00 $1,691.20 20% off $1,084.48 $1,965.81 $1,564.26 2026-03-04
27818 CPT Ed 27818 Clsd Tx Trimal Wmanip 76 17 $2,113.00 $1,690.40 $1,083.97 $1,964.88 $1,563.52 2026-03-04
25605 CPT Ed 25605 Clsd Tx Distal Radial Wmanip 76 17 $2,105.00 $1,684.00 20% off $1,079.87 $1,957.44 $1,557.60 2026-03-04
93307 CPT Echo 2d Wo Dop Col Comp 76 17 $2,016.00 $1,612.80 20% off $1,034.21 $1,874.68 $1,491.74 2026-03-04
11602 CPT Surg 11602 Exc Malig Lesn Incl Margins Trnk Arms Legs Exc Diam 1.1 To 2.0 C 76 17 $2,005.00 $1,604.00 20% off $1,028.57 $1,864.45 $1,483.60 2026-03-04
11441 CPT Surg 11441 Exc Benign Skin Lesn Incl Margins Face Exc Diam 0.6-1.0 Cm 76 17 $2,000.00 $1,600.00 20% off $1,026.00 $1,859.80 $1,479.90 2026-03-04
J7168 HCPCS Prothrombin Complex Conc Human For Inj Kit 500 Unit 76 17 $1,966.00 $1,572.80 20% off $1,008.56 $1,828.18 $1,454.74 2026-03-04
11440 CPT Surg 11440 Exc Benign Skin Lesn Incl Margins Face Exc Diam 0.5 Cm < 76 17 $1,961.00 $1,568.80 20% off $1,005.99 $1,823.53 $1,451.04 2026-03-04
13132 CPT Ed 13132 Rpr Cpx Wd Or Lsn 2.6-7.5cm 76 17 $1,898.00 $1,518.40 $973.67 $1,764.95 $1,404.42 2026-03-04
J3424 HCPCS Hydroxocobalamin (Antidote) For IV Soln 5 Gm 76 17 $1,873.08 $1,498.47 $960.89 $1,741.78 $1,385.98 2026-03-04
78014 CPT Nm Thyroid Img W Sngl Mult Uptake 76 17 $1,849.00 $1,479.20 20% off $948.54 $1,719.39 $1,368.17 2026-03-04
40652 CPT Ed 40652 Rpr Lip Full Thk Up To Hlf 76 17 $1,834.00 $1,467.20 20% off $940.84 $1,705.44 $1,357.07 2026-03-04
93880 CPT Dup Carotid Bilat 78 17 $1,800.00 $1,440.00 20% off $923.40 $1,673.82 $1,331.91 2026-03-04
J9035 HCPCS Bevacizumab IV Soln 100 Mg/4ml (For Infusion) 132 17 $1,472.19 $1,177.76 $755.23 $3,950.22 $1,324.97 2026-03-04
78580 CPT Nm Pulm Perfusion Img 76 17 $1,789.00 $1,431.20 20% off $917.76 $1,663.59 $1,323.77 2026-03-04
99285 CPT Ed 99285 Emer Case Level V 80 17 $1,785.00 $1,428.00 20% off $915.71 $1,659.87 $1,320.81 2026-03-04
93975 CPT Duplex Abd Pelvis Retroperitoneal Cmpl 78 17 $1,692.00 $1,353.60 20% off $868.00 $1,573.39 $1,251.99 2026-03-04
93970 CPT Duplex Venous Ext Cmpl Bilat 78 17 $1,658.00 $1,326.40 $850.55 $1,541.77 $1,226.84 2026-03-04
75563 CPT Card MRI W/stress Img & Dye 4 1 — — $1,222.10 $1,222.10 $1,222.10 2026-03-04
93930 CPT Duplex Art Upper Ext Cmpl Bilat 76 17 $1,645.00 $1,316.00 20% off $843.89 $1,529.69 $1,217.22 2026-03-04
73201 CPT CT Upper Extremity With Contrast 4 1 — — $1,215.50 $1,215.50 $1,215.50 2026-03-04
C8908 HCPCS MRI Without Fol W/cont, Breast, 4 1 — — $1,215.50 $1,215.50 $1,215.50 2026-03-04
72132 CPT CT Lumbar Spine With Contrast 4 1 — — $1,215.50 $1,215.50 $1,215.50 2026-03-04
72126 CPT CT Neck Spine With Contrast 4 1 — — $1,215.50 $1,215.50 $1,215.50 2026-03-04
75561 CPT Cardiac MRI For Morph With Contrast 4 1 — — $1,215.50 $1,215.50 $1,215.50 2026-03-04
70552 CPT MRI Brain Stem With Contrast 4 1 — — $1,215.50 $1,215.50 $1,215.50 2026-03-04
74174 CPT CTA Abd&plvs W/contrast 4 1 — — $1,215.50 $1,215.50 $1,215.50 2026-03-04
95812 CPT EEG 41-60 Minutes 76 17 $1,631.00 $1,304.80 20% off $836.70 $1,516.67 $1,206.86 2026-03-04
J1439 HCPCS Ferric Carboxymaltose IV Soln 750 Mg/15ml (Fe Equivalent) 76 17 $1,614.15 $1,291.32 20% off $828.06 $1,501.00 $1,194.39 2026-03-04
93925 CPT Duplex Art Lower Ext Cmpl Bilat 78 17 $1,601.00 $1,280.80 20% off $821.31 $1,488.77 $1,184.66 2026-03-04
87903 CPT Phenotype DNA Tiss Culture HIV First 1-10 Drugs 87903.900 76 17 $1,578.00 $1,262.40 $809.51 $1,467.38 $1,167.64 2026-03-04
11042 CPT Ed 11042 Debr Skn Subq Tiss 20 Cm < 76 17 $1,572.00 $1,257.60 20% off $806.44 $1,461.80 $1,163.20 2026-03-04
73225 CPT Mr Angio Upr Extr W/O&with Contrast 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
77084 CPT MRI Bone Marrow Blood Supply 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
72198 CPT Mr Angio Pelvis Without & With Contrast 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
77046 CPT MRI Breast C- Unilateral 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
72159 CPT Mr Angio Spine W/O&with Contrast 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
75557 CPT Cardiac MRI For Morph 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
77047 CPT MRI Breast C- Bilateral 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
71555 CPT MRI Angio Chest W Or Without Contrast 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
74712 CPT MRI Fetal Sngl/1st Gestation 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
70555 CPT Fmri Brain By Phys/psych 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
70554 CPT Fmri Brain By Tech 4 1 — — $1,156.10 $1,156.10 $1,156.10 2026-03-04
95819 CPT EEG Awake & Asleep 76 17 $1,540.00 $1,232.00 20% off $790.02 $1,432.05 $1,139.53 2026-03-04
87507 CPT Cdmr Infectious Agent Nucleic Acid Gi 12-25 Targets 87507 76 17 $1,534.00 $1,227.20 20% off $786.94 $1,426.47 $1,135.09 2026-03-04
74415 CPT Ivp W Infus & Tomo 76 17 $1,479.00 $1,183.20 $758.73 $1,375.32 $1,094.38 2026-03-04
93017 CPT Cardiac Stress Test Tracing 78 17 $1,474.00 $1,179.20 $756.16 $1,370.67 $1,090.68 2026-03-04
95816 CPT EEG Awake Drowsy 76 17 $1,464.00 $1,171.20 $751.03 $1,361.37 $1,083.29 2026-03-04
11401 CPT Surg 11401 Exc Bengn Skn Lesn Inc Margn No Skn Tag Trnk Arm Leg Dia 0.6-1.0 76 17 $1,460.00 $1,168.00 20% off $748.98 $1,357.65 $1,080.33 2026-03-04
11760 CPT Ed 11760 Rpr Of Nail Bed 76 17 $1,438.00 $1,150.40 $737.69 $1,337.20 $1,064.05 2026-03-04
Q5115 HCPCS Rituximab-abbs IV Soln 100 Mg/10ml (10 Mg/ml) 132 17 $1,178.10 $942.48 $604.37 $3,798.17 $1,060.29 2026-03-04
77075 CPT Rad Exam Osseous Survey Compl 76 17 $1,410.00 $1,128.00 20% off $723.33 $1,311.16 $1,043.33 2026-03-04
93978 CPT Duplex Aorta Ivc Iliac Or Graft Cmpl 78 17 $1,407.00 $1,125.60 20% off $721.79 $1,308.37 $1,041.11 2026-03-04
12020 CPT Ed 12020 Wnd Tx Dehiscence Superfcl 76 17 $1,400.00 $1,120.00 20% off $718.20 $1,301.86 $1,035.93 2026-03-04
76700 CPT US Abd Complete 76 17 $1,387.00 $1,109.60 20% off $711.53 $1,289.77 $1,026.31 2026-03-04
J2358 HCPCS Olanzapine Pamoate For Extended Rel IM Susp 210 Mg (Base Eq) 132 17 $1,254.36 $1,003.49 $643.49 $1,636.44 $1,024.50 2026-03-04
99284 CPT Ed 99284 Emer Case Level IV 78 17 $1,379.00 $1,103.20 $707.43 $1,282.33 $1,020.39 2026-03-04
0202U CPT Cdmr Nfct Ds 22 Trgt Sars-cov-2 0202u 76 17 $1,375.00 $1,100.00 20% off $705.38 $1,278.61 $1,017.43 2026-03-04
74400 CPT Rad Urography IV W Wo Kub W Wo Tomo 76 17 $1,369.00 $1,095.20 $702.30 $1,273.03 $1,012.99 2026-03-04
92950 CPT Ed 92950 Cardiopulmon Resuscitation 76 17 $1,363.00 $1,090.40 $699.22 $1,267.45 $1,008.55 2026-03-04
93308 CPT Echo 2-d Limited 76 17 $1,343.00 $1,074.40 $688.96 $1,248.86 $993.75 2026-03-04
M0243 HCPCS Carve Outs 4 1 — — $991.10 $991.10 $991.10 2026-03-04
94070 CPT Bronchospasm Provocation Eval 76 17 $1,339.00 $1,071.20 $686.91 $1,245.14 $990.79 2026-03-04
J0881 HCPCS Darbepoetin Alfa Soln Prefilled Syringe 100 Mcg/0.5ml 132 17 $1,606.86 $1,285.49 $560.66 $1,494.22 $983.61 2026-03-04
71271 CPT CT Thorax Lw Dose Lung Ca Scr No Contrast 78 17 $1,323.00 $1,058.40 $678.70 $1,230.26 $978.96 2026-03-04
0350 RC Ambulance Ip - CT 76 17 $1,301.00 $1,040.80 20% off $667.41 $1,209.80 $962.67 2026-03-04
0610 RC Ambulance Ip - MRI 76 17 $1,301.00 $1,040.80 20% off $667.41 $1,209.80 $962.67 2026-03-04
95909 CPT Nrv Conduction Tst 5-6 Studies 76 17 $1,287.00 $1,029.60 20% off $660.23 $1,196.78 $952.32 2026-03-04
36430 CPT Transfusion Blood 76 17 $1,277.00 $1,021.60 20% off $655.10 $1,187.48 $944.91 2026-03-04
93923 CPT Cmpl Bilat Physiologic Studies Ext Art 3+ Lvls 76 17 $1,246.00 $996.80 20% off $639.20 $1,158.66 $921.98 2026-03-04
0440 RC Ambulance Ip Speech Language 76 17 $1,240.00 $992.00 20% off $636.12 $1,153.08 $917.54 2026-03-04
93976 CPT Duplex Abd Pelvis Retroperitoneal Ltd 76 17 $1,230.00 $984.00 20% off $630.99 $1,143.78 $910.14 2026-03-04
93924 CPT Cmpl Bilat Phys Studies Lower Ext Art Pre Post Exer 76 17 $1,212.00 $969.60 20% off $621.76 $1,127.04 $896.82 2026-03-04
73706 CPT CT Angio Lwr Extr W/O&with Contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
77049 CPT MRI Breast C-+ W/cad Bi 4 1 — — $893.20 $893.20 $893.20 2026-03-04
73206 CPT CT Angio Upr Extrm W/O&with Contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
73202 CPT CT Uppr Extremity W/O&with Contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
72191 CPT CT Angiograph Pelv W/O&with Contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
72130 CPT CT Chest Spine Without & With Contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
72129 CPT CT Chest Spine With Contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
72127 CPT CT Neck Spine Without & With Contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
77048 CPT MRI Breast C-+ W/cad Uni 4 1 — — $893.20 $893.20 $893.20 2026-03-04
75574 CPT CT Angio Hrt W/3d Image 4 1 — — $893.20 $893.20 $893.20 2026-03-04
75573 CPT CT Hrt C+ Strux Cgen Hrt Ds 4 1 — — $893.20 $893.20 $893.20 2026-03-04
75572 CPT CT Hrt W/3d Image 4 1 — — $893.20 $893.20 $893.20 2026-03-04
74262 CPT CT Colonography Dx With Contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
74175 CPT CTA Abdomen W/contrast 4 1 — — $893.20 $893.20 $893.20 2026-03-04
93926 CPT Duplex Art Lower Ext Unilat Ltd 76 17 $1,198.00 $958.40 20% off $614.57 $1,114.02 $886.46 2026-03-04
76805 CPT US Pg Utr 2-3tri Sgl 1st 76 17 $1,197.00 $957.60 20% off $614.06 $1,113.09 $885.72 2026-03-04
93931 CPT Duplex Art Upper Ext Unilat Ltd 76 17 $1,194.00 $955.20 $612.52 $1,110.30 $883.50 2026-03-04
J1745 HCPCS Infliximab For IV Inj 100 Mg 132 17 $1,000.78 $800.63 $32.81 $2,187.31 $874.98 2026-03-04
12032 CPT Ed 12032 Lyr Clsr Of Wnd 2.6-7.5cm 76 17 $1,180.00 $944.00 20% off $605.34 $1,097.28 $873.14 2026-03-04
12034 CPT Ed 12034 Lyr Clsr Of Wnd 7.6-12.5cm 76 17 $1,172.00 $937.60 20% off $601.24 $1,089.84 $867.22 2026-03-04
A9540 HCPCS Tc99m Maa Per Study Dose Up To 10 Mci 76 17 $1,171.00 $936.80 20% off $600.72 $1,088.91 $866.48 2026-03-04
76856 CPT US Pelvic Complete 76 17 $1,152.00 $921.60 20% off $590.98 $1,071.24 $852.42 2026-03-04
76770 CPT US Retroperitoneum 78 17 $1,152.00 $921.60 20% off $590.98 $1,071.24 $852.42 2026-03-04
12031 CPT Ed 12031 Lyr Clsr Of Wnd 2.5cm Or < 76 17 $1,130.00 $904.00 20% off $579.69 $1,050.79 $836.14 2026-03-04
93882 CPT Duplex Extracranial Carotid Unilat 76 17 $1,128.00 $902.40 20% off $578.66 $1,048.93 $834.66 2026-03-04
95910 CPT Nrv Conduction Test 7-8 Studies 76 17 $1,124.00 $899.20 $576.61 $1,045.21 $831.71 2026-03-04
93971 CPT Duplex Venous Ext Ltd Unilat 78 17 $1,122.00 $897.60 20% off $575.59 $1,043.35 $830.23 2026-03-04
88309 CPT Surgical Path Level Vi 88309 76 17 $1,118.00 $894.40 20% off $573.53 $1,039.63 $827.26 2026-03-04
J1451 HCPCS Fomepizole Inj 1 Gm/ml (For IV Infusion) 76 17 $1,107.00 $885.60 20% off $567.89 $1,029.40 $819.12 2026-03-04
20610 CPT Surg 20610 Inj Major Joint Bursa Wo US Guid 78 17 $1,104.00 $883.20 $566.35 $1,026.61 $816.90 2026-03-04
J0248 HCPCS Remdesivir For IV Soln 100 Mg 76 17 $1,100.00 $880.00 20% off $564.30 $1,022.89 $813.95 2026-03-04
93979 CPT Duplex Aorta Ivc Iliac Or Graft Unilat Ltd 76 17 $1,079.00 $863.20 $553.53 $1,003.36 $798.40 2026-03-04
12044 CPT Ed 12044 Lyr Clsr Wd 7.6-12.5cm Nhf 76 17 $1,075.00 $860.00 20% off $551.48 $999.64 $795.45 2026-03-04
99292 CPT Ed 99292 Crit Care Ea Addl 30 Mins 76 17 $1,043.00 $834.40 20% off $535.06 $969.89 $771.77 2026-03-04
76830 CPT US Transvaginal 78 17 $1,043.00 $834.40 20% off $535.06 $969.89 $771.77 2026-03-04
96413 CPT Chemo Infusion 1st Hr 82 17 $1,036.00 $828.80 20% off $313.60 $963.38 $766.59 2026-03-04
99283 CPT Ed 99283 Emer Case Level Iii 78 17 $1,034.00 $827.20 $530.44 $961.52 $765.11 2026-03-04
0110 RC Routine Room & Board 228 13 $1,003.50 $802.80 20% off $202.40 $2,203.86 $765.00 2026-03-04
76870 CPT US Scrotum 76 17 $1,031.00 $824.80 20% off $528.90 $958.73 $762.89 2026-03-04
90375 CPT Rabies Immune Globulin (Human) Inj 300 Unit/ML 76 17 $1,022.10 $817.68 20% off $524.34 $950.45 $756.30 2026-03-04
76817 CPT US Pg Utr Transvag 76 17 $1,016.00 $812.80 20% off $521.21 $944.78 $751.79 2026-03-04
95908 CPT Nrv Conduction Tst 3-4 Studies 76 17 $1,016.00 $812.80 20% off $521.21 $944.78 $751.79 2026-03-04
10120 CPT Ed 10120 Inc&remv Fb Smpl 76 17 $1,013.00 $810.40 20% off $519.67 $941.99 $749.57 2026-03-04
76536 CPT US Soft Tissue Head Neck 78 17 $1,009.00 $807.20 $517.62 $938.27 $746.61 2026-03-04
72052 CPT Rad Exam Spine Cerv 6 + Vws 76 17 $995.00 $796.00 20% off $510.44 $925.25 $736.25 2026-03-04
24640 CPT Ed 24640 Clsd Tx Radial Head Elb W Manip 76 17 $972.00 $777.60 20% off $498.64 $903.86 $719.23 2026-03-04
64450 CPT Ed 64450 Inj Nerve Block Oth Prphrl 132 17 $799.00 $639.20 $409.89 $1,406.94 $719.10 2026-03-04
72084 CPT Rad Exam Spine Entire Thor Lumb 6 + Vws 76 17 $961.00 $768.80 20% off $492.99 $893.63 $711.09 2026-03-04
76705 CPT US Abd Limited 78 17 $956.00 $764.80 20% off $490.43 $888.98 $707.39 2026-03-04
74261 CPT CT Colonography Dx 4 1 — — $705.10 $705.10 $705.10 2026-03-04
93320 CPT Doppler Spectral Display Comp 76 17 $951.00 $760.80 20% off $487.86 $884.33 $703.69 2026-03-04
M0224 HCPCS Pemivibart Infusion 76 17 $950.00 $760.00 20% off $487.35 $883.41 $702.96 2026-03-04
0370 RC General Anes Component 132 17 $1,258.00 $1,006.40 20% off $358.07 $1,169.81 $699.45 2026-03-04
A9562 HCPCS Tc99m Mertiatide Per Study Dose Up To 15 Mci 76 17 $945.00 $756.00 20% off $484.79 $878.76 $699.25 2026-03-04
12052 CPT Ed 12052 Lyr Clsr Of Wnd 2.6-5.0cm 76 17 $934.00 $747.20 $479.14 $868.53 $691.12 2026-03-04
93226 CPT Holter Monitor Scan Up To 48hr 76 17 $926.00 $740.80 20% off $475.04 $861.09 $685.20 2026-03-04
76818 CPT US Fetal Bpp W Nst Ea Addl M59 76 17 $916.00 $732.80 20% off $469.91 $851.79 $677.79 2026-03-04
74230 CPT Rad Swallowing Func W Cinerad Or Videorad 76 17 $910.00 $728.00 20% off $466.83 $846.21 $673.36 2026-03-04
J2760 HCPCS Phentolamine Mesylate For Inj 5 Mg 76 17 $903.18 $722.55 $463.33 $839.87 $668.31 2026-03-04
76775 CPT US Retroperitoneum Ltd 76 17 $900.00 $720.00 20% off $461.70 $836.91 $665.96 2026-03-04
76857 CPT US Pelvic Limited 76 17 $890.00 $712.00 20% off $456.57 $827.61 $658.55 2026-03-04
Q5104 HCPCS Infliximab-abda For IV Inj 100 Mg 136 17 $884.26 $707.41 $27.68 $822.27 $654.30 2026-03-04
Q0138 HCPCS Ferumoxytol Inj 510 Mg/17ml (30 Mg/ml) (Elemental Fe) 76 17 $878.76 $703.01 $450.80 $817.16 $650.24 2026-03-04
23650 CPT Ed 23650 Clsd Tx Shoulder Disloc W Manip Wo Anes 76 17 $871.00 $696.80 20% off $446.82 $809.94 $644.50 2026-03-04
12041 CPT Ed 12041 Lyr Clsr Wnd 2.5cm Or <nhf 76 17 $843.00 $674.40 20% off $432.46 $783.91 $623.78 2026-03-04
72083 CPT Rad Exam Spine Entire Thor Lumb 4 Or 5 Vws 76 17 $842.00 $673.60 20% off $431.95 $782.98 $623.04 2026-03-04
71111 CPT Rad Exam Ribs Bilat W Chest Min 4 Vws 76 17 $840.00 $672.00 20% off $430.92 $781.12 $621.56 2026-03-04
24600 CPT Ed 24600 Clsd Tx Elbow Disloc Without Anes 76 17 $839.00 $671.20 $430.41 $780.19 $620.82 2026-03-04
93325 CPT Color Flow Vel Map 76 17 $836.00 $668.80 20% off $428.87 $777.40 $618.60 2026-03-04
10160 CPT Surg 10160 Puncture Aspiration Abscess Hematoma Bulla/cyst 76 17 $818.00 $654.40 20% off $419.63 $760.66 $605.28 2026-03-04
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