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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

AVERA FLANDREAU HOSPITAL - CAH

Flandreau, SD · CCN 431310 · Rates published

671 distinct procedures filed
6 distinct payers
12,005 rate rows
2026-07-19 last MRF observed
Data quality

11,952 of 12,005 rate rows are consumer-grade (99.6%)

53 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 16
placeholder amount (≤ $0.02) — excluded from medians 12
percent-of-charges filed in the dollar field — excluded from medians 11
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 8
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/1e3c55a9-2dbc-464c-87ba-19e0db01977a/460224743_avera-flandreau-hospital_standardcharges.csv
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-11-07
Content fingerprint 07a843fe1cfb120e… · 2,724,991 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
2471
APR_DRG 		Apr-DRG 2471 1 $18,603.36 $18,603.36 $18,603.36 nat. median
$4,098
outlier · 4.5×
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 6 $0.41 $30,005.60 $15,459.20 nat. median
$4,042
outlier · 3.8×
552
MS_DRG 		Ms-DRG 552 1 $12,978.34 $12,978.34 $12,978.34 nat. median
$9,816
1.3× median
J0717
HCPCS 		Certolizumab Pegol 400 Mg Kit 6 $3.42 $24,592.04 $12,670.08 nat. median
$1,753
outlier · 7.2×
65
MS_DRG 		Ms-DRG 65 1 $10,441.12 $10,441.12 $10,441.12 nat. median
$10,441
1.0× median
309
MS_DRG 		Ms-DRG 309 1 $9,967.78 $9,967.78 $9,967.78 nat. median
$7,892
1.3× median
194
MS_DRG 		Ms-DRG 194 1 $8,663.40 $8,663.40 $8,663.40 nat. median
$8,489
1.0× median
195
MS_DRG 		Ms-DRG 195 1 $6,656.36 $6,656.36 $6,656.36 nat. median
$6,810
1.0× median
871
MS_DRG 		Ms-DRG 871 1 $6,655.48 $6,655.48 $6,655.48 nat. median
$18,592
outlier · 0.4×
74174
CPT 		CTA Abd&Pelv Wwo Dye 6 $1,834.00 $8,964.20 $6,510.84 nat. median
$980
outlier · 6.6×
74178
CPT 		CT Abd & Pelv Wwo Contrast 6 $479.88 $8,964.20 $6,133.40 nat. median
$1,023
outlier · 6.0×
J3262
HCPCS 		Tocilizumab 400 Mg/20 Ml Vial 6 $2.72 $11,424.88 $5,886.22 nat. median
$1,424
outlier · 4.1×
74177
CPT 		CT Abd & Pelv W Contrast 6 $227.52 $7,733.95 $5,617.29 nat. median
$970
outlier · 5.8×
Q5115
HCPCS 		Rituximab-abbs 500Mg/50Ml Vial 6 $63.66 $10,715.55 $5,520.76 nat. median
$862
outlier · 6.4×
74176
CPT 		CT Abd & Pelvis Wo Contrast 6 $95.04 $6,507.50 $4,726.50 nat. median
$691
outlier · 6.8×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 6 $271.10 $8,478.75 $4,368.34 nat. median
$2,014
outlier · 2.2×
J1602
HCPCS 		Golimumab 50 Mg/4 Ml Vial 6 $21.08 $8,399.98 $4,327.76 nat. median
$324
outlier · 13.3×
Q5135
HCPCS 		Tocilizumab-aazg 400 Mg/20 Ml 6 $6.17 $7,989.23 $4,116.14 nat. median
$1,013
outlier · 4.1×
J3032
HCPCS 		Eptinezumab-jjmr 100Mg/Ml Vial 6 $38.64 $7,699.55 $3,966.89 nat. median
$84
outlier · 47.5×
78452
CPT 		Myocard Perf Spect Rest Stress 6 $1,103.05 $5,417.00 $3,922.97 nat. median
$1,797
outlier · 2.2×
750
CDM 		Colonoscopy 6 $952.19 $9,471.50 $3,913.97 nat. median
$3,784
1.0× median
J9202
HCPCS 		Goserelin 10.8 Mg Implant 6 $77.09 $11,629.14 $3,839.97 nat. median
$1,861
outlier · 2.1×
J0897
HCPCS 		Denosumab 60 Mg/ml Syringe 6 $9.69 $7,238.36 $3,729.28 nat. median
$1,990
1.9× median
78451
CPT 		Myocard Perf Spect Rest Or Str 6 $1,103.05 $4,783.00 $3,671.82 nat. median
$1,542
outlier · 2.4×
70553
CPT 		MRI Brain Wwo Contrast 6 $729.77 $5,052.10 $3,526.07 nat. median
$1,122
outlier · 3.1×
379
MS_DRG 		Ms-DRG 379 1 $3,344.94 $3,344.94 $3,344.94 nat. median
$6,960
outlier · 0.5×
70498
CPT 		CT Angiography Neck W Cont 6 $278.39 $4,487.80 $3,259.56 nat. median
$735
outlier · 4.4×
70496
CPT 		CT Angiography Head W Cont 6 $246.84 $4,487.80 $3,259.56 nat. median
$741
outlier · 4.4×
71260
CPT 		CT Thorax W Contrast 6 $80.31 $4,658.80 $3,187.60 nat. median
$647
outlier · 4.9×
C8929
HCPCS 		Echo M Mode 2d W Contrast 6 $819.77 $3,546.35 $2,724.89 nat. median
$1,358
outlier · 2.0×
87154
CPT 		Culture Id By Amp Prb 6 Or 6+ 6 $801.76 $3,468.45 $2,668.88 nat. median
$289
outlier · 9.2×
72148
CPT 		MRI Lumbar Spine Wo Dye 6 $315.18 $3,895.95 $2,665.65 nat. median
$803
outlier · 3.3×
70549
CPT 		MRA Neck Wwo Contrast 6 $666.92 $5,052.10 $2,645.35 nat. median
$1,042
outlier · 2.5×
72156
CPT 		MRI Neck Spine Wwo Dye 6 $340.05 $5,052.10 $2,645.35 nat. median
$1,096
outlier · 2.4×
74183
CPT 		MRI Abdomen Wwo Dye 6 $619.08 $5,052.10 $2,645.35 nat. median
$1,096
outlier · 2.4×
72158
CPT 		MRI Lumbar Spine Wwo Dye 6 $340.97 $5,052.10 $2,645.35 nat. median
$1,083
outlier · 2.4×
72157
CPT 		MRI Chest Spine Wwo Dye 6 $535.35 $4,917.20 $2,599.20 nat. median
$1,099
outlier · 2.4×
71275
CPT 		CTA Chest Wwo Contrast 6 $811.42 $3,510.25 $2,549.55 nat. median
$753
outlier · 3.4×
71271
CPT 		Ldct For Lung Cancer Screen 6 $101.48 $3,467.50 $2,518.50 nat. median
$214
outlier · 11.8×
70450
CPT 		CT Head/Brain Wo Contrast 6 $524.00 $3,258.50 $2,366.70 nat. median
$446
outlier · 5.3×
70551
CPT 		MRI Brain Wo Contrast 6 $447.03 $3,457.05 $2,365.35 nat. median
$779
outlier · 3.0×
73721
CPT 		MRI Joint Le Wo Dye Lt 6 $315.18 $3,457.05 $2,365.35 nat. median
$854
outlier · 2.8×
689
CDM 		Trauma Team Evaluation Level 5 6 $706.67 $3,057.10 $2,352.36 nat. median
$1,169
outlier · 2.0×
72125
CPT 		CT Cervical Spine Wo Contrast 6 $172.58 $3,258.50 $2,342.78 nat. median
$471
outlier · 5.0×
70487
CPT 		CT Maxillofacial W Contrast 6 $268.29 $4,514.40 $2,325.87 nat. median
$604
outlier · 3.9×
72129
CPT 		CT Thoracic Spine W Contrast 6 $128.15 $4,514.40 $2,325.87 nat. median
$576
outlier · 4.0×
70486
CPT 		CT Maxillofacial Wo Contrast 6 $187.95 $3,258.50 $2,318.86 nat. median
$473
outlier · 4.9×
71250
CPT 		CT Thorax Wo Contrast 6 $71.13 $3,258.50 $2,318.86 nat. median
$463
outlier · 5.0×
74170
CPT 		CT Abdomen Wwo Dye 6 $58.22 $4,487.80 $2,312.16 nat. median
$710
outlier · 3.3×
70490
CPT 		CT Soft Tissue Neck Wo Cont 6 $277.47 $3,258.50 $2,298.10 nat. median
$448
outlier · 5.1×

Other procedures at this hospital

Browse this hospital's 671 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
             
93978 CPT Abdomen Vascular Complete 11 6 $1,300.00 $1,261.00 $285.48 $1,235.00 $1,003.60 2026-07-19
82024 CPT Acth Adrenocorticotropic Hor 10 6 $622.00 $603.34 $136.59 $590.90 $454.68 2026-07-19
80074 CPT Acute Hepatitis Panel 12 6 $785.00 $761.45 $172.39 $745.75 $541.65 2026-07-19
87149 CPT Afb Id By Na Probe 10 6 $397.00 $385.09 $87.18 $377.15 $290.21 2026-07-19
82105 CPT Afp Tm 12 6 $357.00 $346.29 $78.40 $339.15 $246.33 2026-07-19
P9047 HCPCS Albumin Human 25% 25gr/100ml 12 6 $618.00 $600.27 $106.16 $3,118.50 $452.37 2026-07-19
P9045 HCPCS Albumin Human 5% 12.5 Gr/250ml 12 6 $495.00 $481.10 $106.16 $3,123.57 $362.56 2026-07-19
82077 CPT Alcohol/Ethanol Auto Analyzer 16 6 $385.00 $373.45 $84.55 $365.75 $281.44 2026-07-19
82088 CPT Aldosterone 10 6 $504.00 $488.88 $110.68 $478.80 $368.42 2026-07-19
82104 CPT Alpha 1 Antitrypsin Pheno 10 6 $318.00 $308.46 $69.83 $302.10 $232.46 2026-07-19
A0426 HCPCS Amb Als Nonemerg Hosp/Hosp 10 6 $1,266.00 $1,228.02 $278.01 $1,202.70 $925.44 2026-07-19
G0480 HCPCS Amitriptyline/Nortriptyline 20 6 $832.00 $807.04 $88.28 $1,198.90 $381.90 2026-07-19
86036 CPT Anca 10 6 $517.00 $501.49 $113.53 $491.15 $377.93 2026-07-19
93922 CPT Ankle Arm Screen 13 6 $488.00 $473.36 $91.20 $463.60 $336.72 2026-07-19
2471 APR_DRG Apr-DRG 2471 2 1 — — $18,603.36 $18,603.36 $18,603.36 2026-07-19
93925 CPT Arterial Duplex Le Bi 13 6 $1,204.00 $1,167.88 $229.20 $1,143.80 $830.76 2026-07-19
93926 CPT Arterial Duplex Le Lt 10 6 $985.00 $955.45 $216.31 $935.75 $720.03 2026-07-19
82232 CPT Beta 2 Microglobulin 10 6 $355.00 $344.35 $77.96 $337.25 $259.50 2026-07-19
87799 CPT Bk Virus Quant Pcr, Serum 20 6 $572.00 $554.84 $123.85 $551.00 $417.81 2026-07-19
87449 CPT Blastomyces Ag Qnt 20 6 $678.50 $658.14 $81.25 $937.65 $338.06 2026-07-19
36430 CPT Blood Administration 13 6 $515.00 $499.55 $103.00 $489.25 $355.35 2026-07-19
82803 CPT Blood Gas Wo Oximetry 12 6 $329.00 $319.13 $72.25 $312.55 $240.50 2026-07-19
87798 CPT Bord Parapertussis Amp Arup 20 6 $491.50 $476.75 $104.53 $481.65 $358.65 2026-07-19
J0666 HCPCS Bupivac Liposome 1.3% Pf 20 Ml 12 6 $1,774.00 $1,721.40 $2.18 $1,713.62 $1,297.26 2026-07-19
84681 CPT C Peptide 10 6 $351.00 $340.47 $77.08 $333.45 $256.58 2026-07-19
86300 CPT Ca 27-29 10 6 $498.00 $483.06 $109.36 $473.10 $364.04 2026-07-19
J0613 HCPCS Calcium Gluc/NS (Wgcc) 1,000Mg 12 6 $340.00 $330.60 $0.22 $323.78 $235.17 2026-07-19
83993 CPT Calprotectin 11 6 $1,446.00 $1,402.62 $317.54 $1,373.70 $997.74 2026-07-19
93798 CPT Cardiac Rehab Ii Monitored 16 6 $323.00 $313.31 $70.93 $504.00 $252.26 2026-07-19
93017 CPT Cardiovascular Stress Test 12 6 $1,414.00 $1,371.58 $310.51 $1,346.00 $1,033.63 2026-07-19
51701 CPT Cath Insert Straight Non-indwe 20 6 $337.50 $327.38 $71.81 $330.60 $246.28 2026-07-19
J0717 HCPCS Certolizumab Pegol 400 Mg Kit 12 6 $25,886.00 $25,109.77 $3.42 $24,592.04 $12,670.08 2026-07-19
96415 CPT Chemotherapy Inf Ea Addl Hr 12 6 $669.00 $648.93 $146.91 $635.55 $461.61 2026-07-19
96413 CPT Chemotherapy Inf Initial 12 6 $823.00 $798.31 $180.73 $781.85 $567.87 2026-07-19
87497 CPT Cmv Quant By Pcr 10 6 $1,598.00 $1,550.06 $350.92 $1,518.10 $1,168.14 2026-07-19
750 CDM Colonoscopy 30 6 $5,375.00 $5,213.75 $952.19 $9,471.50 $3,913.97 2026-07-19
45378 CPT Colonoscopy Diagnostic 8 6 $868.00 $841.96 $362.29 $514.44 $388.75 2026-07-19
45388 CPT Colonoscopy W Ablation 8 6 $1,018.00 $987.46 $528.09 $752.92 $566.81 2026-07-19
45380 CPT Colonoscopy W Biopsy(s) 8 6 $1,036.00 $1,004.92 $393.92 $558.91 $422.80 2026-07-19
45385 CPT Colonoscopy W Lesion Removal 8 6 $1,163.00 $1,128.11 $497.75 $709.52 $532.76 2026-07-19
30905 CPT Control Posterior Hemorrhage 18 6 $477.00 $462.69 $104.75 $453.15 $264.50 2026-07-19
94660 CPT CPap/BiPap First Day 22 6 $680.00 $659.60 $115.07 $794.20 $430.47 2026-07-19
99291 CPT Critical Care 1st 30-74 Min 18 6 $2,159.00 $2,094.23 $329.00 $2,051.05 $592.11 2026-07-19
82523 CPT Cross Linked C Teleop 10 6 $430.00 $417.10 $94.43 $408.50 $314.33 2026-07-19
74177 CPT CT Abd & Pelv W Contrast 17 6 $8,141.00 $7,896.77 $227.52 $7,733.95 $5,617.29 2026-07-19
74178 CPT CT Abd & Pelv Wwo Contrast 13 6 $9,436.00 $9,152.92 $479.88 $8,964.20 $6,133.40 2026-07-19
74176 CPT CT Abd & Pelvis Wo Contrast 16 6 $6,850.00 $6,644.50 $95.04 $6,507.50 $4,726.50 2026-07-19
74160 CPT CT Abdomen W Dye 12 6 $4,077.00 $3,954.69 $706.77 $3,873.15 $1,995.49 2026-07-19
74150 CPT CT Abdomen Wo Dye 12 6 $3,430.00 $3,327.10 $524.00 $3,258.50 $1,678.82 2026-07-19
74170 CPT CT Abdomen Wwo Dye 12 6 $4,724.00 $4,582.28 $58.22 $4,487.80 $2,312.16 2026-07-19
70496 CPT CT Angiography Head W Cont 15 6 $4,724.00 $4,582.28 $246.84 $4,487.80 $3,259.56 2026-07-19
70498 CPT CT Angiography Neck W Cont 15 6 $4,724.00 $4,582.28 $278.39 $4,487.80 $3,259.56 2026-07-19
72125 CPT CT Cervical Spine Wo Contrast 16 6 $3,430.00 $3,327.10 $172.58 $3,258.50 $2,342.78 2026-07-19
70450 CPT CT Head/Brain Wo Contrast 15 6 $3,430.00 $3,327.10 $524.00 $3,258.50 $2,366.70 2026-07-19
73701 CPT CT Le W Dye Lt 24 6 $4,076.00 $3,953.72 $268.01 $3,872.20 $1,995.00 2026-07-19
73700 CPT CT Le Wo Dye Lt 24 6 $3,430.00 $3,327.10 $76.65 $3,258.50 $1,678.82 2026-07-19
72131 CPT CT Lumbar Spine Wo Contrast 12 6 $3,430.00 $3,327.10 $234.87 $3,258.50 $1,678.82 2026-07-19
70487 CPT CT Maxillofacial W Contrast 12 6 $4,752.00 $4,609.44 $268.29 $4,514.40 $2,325.87 2026-07-19
70486 CPT CT Maxillofacial Wo Contrast 15 6 $3,430.00 $3,327.10 $187.95 $3,258.50 $2,318.86 2026-07-19
70480 CPT CT Orbit Wo Contrast 12 6 $3,430.00 $3,327.10 $192.56 $3,258.50 $1,678.82 2026-07-19
72192 CPT CT Pelvis Wo Dye 12 6 $3,430.00 $3,327.10 $524.00 $3,258.50 $1,678.82 2026-07-19
70491 CPT CT Soft Tissue Neck W Cont 12 6 $4,076.00 $3,953.72 $357.53 $3,872.20 $1,995.00 2026-07-19
70490 CPT CT Soft Tissue Neck Wo Cont 14 6 $3,430.00 $3,327.10 $277.47 $3,258.50 $2,298.10 2026-07-19
72129 CPT CT Thoracic Spine W Contrast 12 6 $4,752.00 $4,609.44 $128.15 $4,514.40 $2,325.87 2026-07-19
72128 CPT CT Thoracic Spine Wo Contrast 13 6 $3,430.00 $3,327.10 $107.93 $3,258.50 $2,229.50 2026-07-19
71260 CPT CT Thorax W Contrast 13 6 $4,904.00 $4,756.88 $80.31 $4,658.80 $3,187.60 2026-07-19
71250 CPT CT Thorax Wo Contrast 15 6 $3,430.00 $3,327.10 $71.13 $3,258.50 $2,318.86 2026-07-19
73200 CPT CT Ue Wo Dye Rt 12 6 $3,430.00 $3,327.10 $70.19 $3,258.50 $1,678.82 2026-07-19
74174 CPT CTA Abd&Pelv Wwo Dye 11 6 $9,436.00 $9,152.92 $1,834.00 $8,964.20 $6,510.84 2026-07-19
71275 CPT CTA Chest Wwo Contrast 12 6 $3,695.00 $3,584.15 $811.42 $3,510.25 $2,549.55 2026-07-19
73706 CPT CTA Le Wwo Dye Lt 24 6 $4,284.00 $4,155.48 $71.13 $4,069.80 $2,096.80 2026-07-19
87154 CPT Culture Id By Amp Prb 6 Or 6+ 10 6 $3,651.00 $3,541.47 $801.76 $3,468.45 $2,668.88 2026-07-19
87045 CPT Culture Stool 11 6 $499.00 $484.03 $109.58 $474.05 $344.31 2026-07-19
82610 CPT Cystatin C 10 6 $721.00 $699.37 $158.33 $684.95 $527.05 2026-07-19
85379 CPT D-dimer Quant 14 6 $348.00 $337.56 $76.42 $330.60 $240.12 2026-07-19
J0881 HCPCS Darbepoet Alfa 40mcg/0.4ml Syr 28 6 $997.00 $967.74 $5.94 $2,669.46 $679.35 2026-07-19
J0897 HCPCS Denosumab 60 Mg/ml Syringe 12 6 $7,619.00 $7,390.75 $9.69 $7,238.36 $3,729.28 2026-07-19
77080 CPT Dexa Scan 14 6 $903.00 $875.91 $88.61 $857.85 $623.07 2026-07-19
82626 CPT Dhea 11 6 $407.00 $394.79 $89.38 $386.65 $314.20 2026-07-19
82627 CPT Dheas 11 6 $403.00 $390.91 $88.50 $382.85 $278.07 2026-07-19
26770 CPT Dislocation Finger Wo Anes 18 6 $348.00 $337.56 $76.42 $710.47 $330.60 2026-07-19
23650 CPT Dislocation Shoulder Wo Anes 8 6 $691.00 $670.27 $629.84 $802.00 $674.64 2026-07-19
80306 CPT Drug Screen Urine Inst Ass Obv 16 6 $331.00 $321.07 $72.69 $314.45 $241.96 2026-07-19
93226 CPT ECG Monit/Report Up To 48 Hour 14 6 $1,704.00 $1,652.88 $374.20 $1,618.80 $1,245.62 2026-07-19
C8929 HCPCS Echo M Mode 2d W Contrast 14 6 $3,733.00 $3,621.01 $819.77 $3,546.35 $2,724.89 2026-07-19
43239 CPT Egd Biopsy Single/Multiple 8 6 $765.00 $742.05 $272.42 $385.31 $290.85 2026-07-19
43251 CPT Egd Remove Lesion Snare 8 6 $479.00 $464.63 $384.52 $546.39 $411.45 2026-07-19
93005 CPT EKG Tracing 17 6 $413.00 $400.61 $90.69 $392.35 $284.97 2026-07-19
99282 CPT Emergency Room Visit Level 2 14 6 $520.00 $504.40 $114.19 $494.00 $358.80 2026-07-19
99283 CPT Emergency Room Visit Level 3 23 6 $671.00 $650.87 $108.68 $637.45 $307.02 2026-07-19
99284 CPT Emergency Room Visit Level 4 24 6 $1,055.00 $1,023.35 $184.86 $1,002.25 $516.37 2026-07-19
99285 CPT Emergency Room Visit Level 5 23 6 $1,514.00 $1,468.58 $267.73 $1,438.30 $497.95 2026-07-19
J3032 HCPCS Eptinezumab-jjmr 100Mg/Ml Vial 12 6 $8,104.00 $7,861.65 $38.64 $7,699.55 $3,966.89 2026-07-19
82670 CPT Estradiol Total 12 6 $293.00 $284.21 $64.34 $278.35 $228.83 2026-07-19
80169 CPT Everolimus 10 6 $864.00 $838.08 $189.73 $820.80 $631.59 2026-07-19
93242 CPT Ext ECG 48 Hrs -7days Hook Up 11 6 $691.00 $670.27 $151.74 $656.45 $476.79 2026-07-19
93246 CPT Ext ECG >7 Days Hook Up 14 6 $691.00 $670.27 $151.74 $656.45 $476.79 2026-07-19
93880 CPT Extracranial Bilat Study 12 6 $1,733.00 $1,681.01 $380.57 $1,650.00 $1,266.83 2026-07-19
93971 CPT Extremity Study Lt 22 6 $985.00 $955.45 $216.31 $935.75 $720.03 2026-07-19
Q0138 HCPCS Ferumoxy 510mg/17ml (non-esrd) 12 6 $1,145.00 $1,111.35 $0.76 $1,088.43 $560.77 2026-07-19
Q5110 HCPCS Filgrastim-aafi 480 Mcg/0.8 Ml 12 6 $780.00 $756.91 $0.58 $927.00 $570.41 2026-07-19
27786 CPT Fx Distal Fibula Lt 10 6 $346.00 $335.62 $75.98 $328.70 $252.93 2026-07-19
26750 CPT Fx Distal Finger/Thumb Wo Man 10 6 $364.00 $353.08 $79.93 $345.80 $266.08 2026-07-19
25600 CPT Fx Distal Radius Lt 22 6 $364.00 $353.08 $79.93 $345.80 $251.16 2026-07-19
25605 CPT Fx Distal Radius W Man Rt 30 6 $1,643.00 $1,593.71 $245.66 $1,560.85 $1,133.67 2026-07-19
26720 CPT Fx Finger/Thumb Wo Man 10 6 $491.00 $476.27 $107.82 $466.45 $358.92 2026-07-19
24500 CPT Fx Humeral Shaft Wo Man Lt 10 6 $329.00 $319.13 $72.25 $312.55 $240.50 2026-07-19
26600 CPT Fx Metacarpal 10 6 $329.00 $319.13 $72.25 $312.55 $240.50 2026-07-19
23600 CPT Fx Prox Humeral Wo Man Lt 20 6 $346.00 $335.62 $75.98 $328.70 $252.93 2026-07-19
24650 CPT Fx Radial Head/Neck Wo Man Lt 10 6 $364.00 $353.08 $79.93 $345.80 $266.08 2026-07-19
24530 CPT Fx Supra/Transcondylar Hum Lt 10 6 $346.00 $335.62 $75.98 $328.70 $252.93 2026-07-19
A9585 HCPCS Gadobutrol Inj 10 Mm/10 Ml Vl 32 6 $675.00 $654.75 $0.56 $855.00 $259.01 2026-07-19
74250 CPT Gastrografin Challenge 10 6 $607.00 $588.79 $133.30 $576.65 $406.69 2026-07-19
83516 CPT Glom Base Membrane Aby 30 6 $351.00 $340.47 $66.98 $450.30 $265.57 2026-07-19
J1610 HCPCS Glucagon 1 Mg/ml Vial 13 6 $794.00 $770.88 $98.91 $754.98 $516.57 2026-07-19
J1602 HCPCS Golimumab 50 Mg/4 Ml Vial 12 6 $8,842.00 $8,576.82 $21.08 $8,399.98 $4,327.76 2026-07-19
J9202 HCPCS Goserelin 10.8 Mg Implant 20 6 $12,241.00 $11,873.96 $77.09 $11,629.14 $3,839.97 2026-07-19
87338 CPT H Pylori Antigen Stool 11 6 $523.00 $507.31 $114.85 $496.85 $360.87 2026-07-19
83010 CPT Haptoglobin Quant 10 6 $496.00 $481.12 $108.92 $471.20 $362.58 2026-07-19
92950 CPT Heart/Lung Resuscitation Cpr 19 6 $494.00 $479.18 $108.48 $469.30 $360.12 2026-07-19
87522 CPT Hep C RNA Pcr Quant 10 6 $1,026.00 $995.22 $225.31 $974.70 $750.01 2026-07-19
85520 CPT Heparin Xa 12 6 $331.00 $321.07 $72.69 $314.45 $228.39 2026-07-19
78227 CPT Hida With Ef w/Pharm 10 6 $3,090.00 $2,997.30 $678.56 $2,935.50 $2,258.79 2026-07-19
87385 CPT Histoplasma Antigen 10 6 $763.00 $740.11 $167.55 $724.85 $557.75 2026-07-19
93225 CPT Holter Monitor Hook Up <48 Hrs 14 6 $327.00 $317.19 $71.81 $310.65 $239.03 2026-07-19
56405 CPT I & D Vulva/Perineum 18 6 $371.00 $359.87 $81.47 $352.45 $273.12 2026-07-19
10061 CPT I&d Abscess Comp/Multiple 11 6 $1,614.00 $1,565.58 $354.43 $1,533.30 $1,246.01 2026-07-19
10060 CPT I&d Abscess Simple/Single 18 6 $318.00 $308.46 $69.83 $302.10 $233.39 2026-07-19
86335 CPT Immunofix Electroph Fluid 10 6 $388.00 $376.36 $85.20 $368.60 $283.63 2026-07-19
88341 CPT Immunohisto Stain Add Per Spc 10 6 $473.00 $458.81 $103.87 $449.35 $345.76 2026-07-19
88342 CPT Immunohisto Stain Init Pr Spec 10 6 $473.00 $458.81 $103.87 $449.35 $345.76 2026-07-19
96361 CPT Inf Therapy Hyd Ea Addl Hour 29 6 $327.00 $317.19 $71.81 $330.60 $240.12 2026-07-19
96360 CPT Inf Therapy Hyd Initial 29 6 $405.00 $392.85 $88.94 $409.45 $297.39 2026-07-19
96366 CPT Inf Therapy Med Ea Addl Hr 29 6 $345.00 $334.65 $75.76 $330.60 $240.12 2026-07-19
96365 CPT Inf Therapy Med Initial 31 6 $546.00 $529.62 $94.65 $518.70 $367.64 2026-07-19
82397 CPT Infliximab Ab, S 10 6 $1,428.00 $1,385.16 $313.59 $1,356.60 $1,043.87 2026-07-19
80230 CPT Infliximab Qn w/Reflex To Ab,S 10 6 $1,862.00 $1,806.14 $408.90 $1,768.90 $1,361.12 2026-07-19
Q5104 HCPCS Infliximab-abda 100 Mg Vial 12 6 $1,783.00 $1,729.60 $52.52 $5,119.19 $1,303.44 2026-07-19
Q5121 HCPCS Infliximab-axxq 100 Mg Vial 14 6 $2,199.00 $2,133.88 $39.66 $4,685.74 $1,608.12 2026-07-19
87636 CPT Influ & CoV2 Pcr Ceph 10 6 $486.00 $471.42 $106.73 $461.70 $355.26 2026-07-19
87637 CPT Influ/RSV/CoV2 Pcr Ceph 13 6 $524.00 $508.28 $115.07 $497.80 $361.56 2026-07-19
94664 CPT Inhalation Treat Chronic Init 10 6 $625.00 $606.25 $137.25 $593.75 $456.88 2026-07-19
96402 CPT Injection Chemo Sq/IM Hormonal 10 6 $560.00 $543.20 $122.98 $532.00 $409.36 2026-07-19
99222 CPT Inpatient Initial/Obs Mod Comp 8 6 $279.00 $270.63 $202.33 $274.01 $239.01 2026-07-19
Q9967 HCPCS Iopamidol-370 100 Ml Vial 27 6 $1,800.00 $1,746.00 $0.28 $1,710.00 $767.70 2026-07-19
99223 CPT IP/Obs Initial High Comp 8 6 $350.00 $339.50 $270.04 $389.40 $318.47 2026-07-19
51700 CPT Irrigation Bladder Simple 23 6 $371.00 $359.87 $81.47 $432.25 $295.75 2026-07-19
80189 CPT Itraconazole 10 6 $407.00 $394.79 $89.38 $386.65 $297.51 2026-07-19
83520 CPT Lambda Light Chain 33 6 $592.00 $574.24 $59.07 $940.50 $393.68 2026-07-19
71271 CPT Ldct For Lung Cancer Screen 14 6 $3,650.00 $3,540.50 $101.48 $3,467.50 $2,518.50 2026-07-19
J2020 HCPCS Linezolid 600 Mg/300 Ml Bag 12 6 $333.00 $323.04 $5.96 $968.84 $243.44 2026-07-19
77067 CPT Mammo Screen Implant Bi 28 6 $593.00 $575.21 $130.22 $757.00 $463.13 2026-07-19
C1781 HCPCS Mesh Srg 13x9cm Lt 40 6 $760.50 $738.15 $88.94 $1,146.30 $384.75 2026-07-19
83835 CPT Metanephrines Urine 11 6 $305.00 $295.85 $66.98 $289.75 $235.46 2026-07-19
86376 CPT Microsome Liver/Kidney Aby 22 6 $333.00 $323.01 $61.71 $365.75 $244.97 2026-07-19
70544 CPT MRA Head Wo Contrast 12 6 $3,639.00 $3,529.83 $408.12 $3,457.05 $1,781.11 2026-07-19
70549 CPT MRA Neck Wwo Contrast 12 6 $5,318.00 $5,158.46 $666.92 $5,052.10 $2,645.35 2026-07-19
74183 CPT MRI Abdomen Wwo Dye 14 6 $5,318.00 $5,158.46 $619.08 $5,052.10 $2,645.35 2026-07-19
70551 CPT MRI Brain Wo Contrast 13 6 $3,639.00 $3,529.83 $447.03 $3,457.05 $2,365.35 2026-07-19
70553 CPT MRI Brain Wwo Contrast 14 6 $5,318.00 $5,158.46 $729.77 $5,052.10 $3,526.07 2026-07-19
72146 CPT MRI Chest Spine Wo Dye 12 6 $4,057.00 $3,935.29 $390.63 $3,854.15 $1,985.70 2026-07-19
72157 CPT MRI Chest Spine Wwo Dye 12 6 $5,176.00 $5,020.72 $535.35 $4,917.20 $2,599.20 2026-07-19
73721 CPT MRI Joint Le Wo Dye Lt 26 6 $3,639.00 $3,529.83 $315.18 $3,457.05 $2,365.35 2026-07-19
73221 CPT MRI Joint Ue Wo Dye Lt 24 6 $3,639.00 $3,529.83 $408.12 $3,457.05 $1,781.11 2026-07-19
73718 CPT MRI Le Wo Dye Lt 12 6 $3,639.00 $3,529.83 $56.39 $3,457.05 $1,781.11 2026-07-19
72148 CPT MRI Lumbar Spine Wo Dye 15 6 $4,101.00 $3,977.97 $315.18 $3,895.95 $2,665.65 2026-07-19
72158 CPT MRI Lumbar Spine Wwo Dye 12 6 $5,318.00 $5,158.46 $340.97 $5,052.10 $2,645.35 2026-07-19
72141 CPT MRI Neck Spine Wo Dye 12 6 $4,017.00 $3,896.49 $233.96 $3,816.15 $1,966.12 2026-07-19
72156 CPT MRI Neck Spine Wwo Dye 12 6 $5,318.00 $5,158.46 $340.05 $5,052.10 $2,645.35 2026-07-19
194 MS_DRG Ms-DRG 194 2 1 — — $8,663.40 $8,663.40 $8,663.40 2026-07-19
195 MS_DRG Ms-DRG 195 2 1 — — $6,656.36 $6,656.36 $6,656.36 2026-07-19
309 MS_DRG Ms-DRG 309 1 1 — — $9,967.78 $9,967.78 $9,967.78 2026-07-19
379 MS_DRG Ms-DRG 379 1 1 — — $3,344.94 $3,344.94 $3,344.94 2026-07-19
552 MS_DRG Ms-DRG 552 2 1 — — $12,978.34 $12,978.34 $12,978.34 2026-07-19
65 MS_DRG Ms-DRG 65 1 1 — — $10,441.12 $10,441.12 $10,441.12 2026-07-19
871 MS_DRG Ms-DRG 871 1 1 — — $6,655.48 $6,655.48 $6,655.48 2026-07-19
86366 CPT Musk Antibody Ref 10 6 $1,326.00 $1,286.22 $291.19 $1,259.70 $969.31 2026-07-19
78451 CPT Myocard Perf Spect Rest Or Str 12 6 $5,023.00 $4,872.31 $1,103.05 $4,783.00 $3,671.82 2026-07-19
78452 CPT Myocard Perf Spect Rest Stress 12 6 $5,023.00 $4,872.31 $1,103.05 $5,417.00 $3,922.97 2026-07-19
93356 CPT Myocardial Strain Image Speckl 11 6 $1,270.00 $1,231.90 $278.89 $1,206.50 $876.30 2026-07-19
80171 CPT Neurontin/Gabapentin 10 6 $369.00 $357.93 $81.03 $350.55 $269.74 2026-07-19
J2404 HCPCS Nicardipine/Ns 40 Mg/200ml Bag 12 6 $560.00 $543.26 $0.16 $1,828.74 $409.40 2026-07-19
G0379 HCPCS Observation Assess Direct Adm 10 6 $609.00 $590.73 $133.74 $578.55 $445.18 2026-07-19
59409 CPT Obstetrical Care 18 6 $3,348.00 $3,247.56 $735.22 $3,180.60 $1,701.85 2026-07-19
360 CDM Or Level 1 60 6 $1,820.00 $1,765.40 $245.73 $2,935.50 $1,294.43 2026-07-19
97165 CPT Ot Eval Low Complexity 14 6 $338.00 $327.86 $74.22 $338.00 $247.08 2026-07-19
97166 CPT Ot Eval Mod Complexity 11 6 $370.00 $358.90 $81.25 $351.50 $255.30 2026-07-19
82653 CPT Pancreatic Elastase 10 6 $1,300.00 $1,261.00 $285.48 $1,235.00 $950.30 2026-07-19
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 12 6 $8,925.00 $8,657.25 $271.10 $8,478.75 $4,368.34 2026-07-19
J0561 HCPCS Pen G Benzathine 1200000Un/2ML 12 6 $1,141.00 $1,107.02 $53.64 $1,084.20 $558.59 2026-07-19
Q9957 HCPCS Perflutren Lip Micro 2.2mg/2ml 12 6 $582.00 $565.41 $47.75 $553.76 $285.30 2026-07-19
Q9956 HCPCS Perflutren Protein-a Microdota 14 6 $643.00 $624.62 $77.76 $611.74 $431.44 2026-07-19
94060 CPT Pft Pre & Post Screen Spirome 10 6 $552.00 $535.44 $121.22 $524.40 $403.51 2026-07-19
83880 CPT Pro-b Type Natriuretic Peptide 27 6 $556.00 $539.32 $122.10 $797.00 $474.27 2026-07-19
84165 CPT Protein Electrophoresis 11 6 $345.00 $334.65 $75.76 $327.75 $266.34 2026-07-19
84166 CPT Protein Electrophoresis Urine 10 6 $345.00 $334.65 $75.76 $327.75 $252.19 2026-07-19
84153 CPT Psa Total 13 6 $293.00 $284.21 $64.34 $279.00 $226.20 2026-07-19
97163 CPT Pt Eval High Complexity 10 6 $328.00 $318.16 $72.03 $311.60 $239.77 2026-07-19
97161 CPT Pt Eval Low Complexity 16 6 $301.00 $291.97 $66.10 $529.00 $235.08 2026-07-19
97162 CPT Pt Eval Mod Complexity 14 6 $347.00 $336.59 $76.20 $329.65 $239.43 2026-07-19
83970 CPT Pth 11 6 $424.00 $411.28 $93.11 $402.80 $292.56 2026-07-19
82542 CPT Pth Like Protein 10 6 $508.00 $492.76 $111.56 $482.60 $371.35 2026-07-19
94625 CPT Pulmonary Rehab Without Monitoring 10 6 $570.00 $552.90 $125.17 $541.50 $416.67 2026-07-19
11104 CPT Punch Biopsy 1st Lesion 10 6 $607.00 $588.79 $133.30 $576.65 $443.72 2026-07-19
90675 CPT Rabies Vax Pcec/Pf 2.5Unit Vl 12 6 $1,347.00 $1,307.03 $125.24 $1,280.08 $765.70 2026-07-19
A9502 HCPCS Radiophar Tc99M Myoview 12 6 $706.00 $684.82 $155.04 $672.00 $516.09 2026-07-19
A9500 HCPCS Radiophar Tc99M Sestamibi Dose 10 6 $666.00 $646.02 $146.25 $632.70 $486.85 2026-07-19
86870 CPT Rbc Antibody Identif Panel 10 6 $671.00 $650.87 $147.35 $637.45 $490.50 2026-07-19
710 CDM Recovery Phase 1 Per 15 Min 30 6 $979.00 $949.63 $53.14 $1,115.30 $643.69 2026-07-19
P9016 HCPCS Red Blood Cells Lekoreduced 13 6 $1,096.00 $1,063.12 $219.20 $1,041.20 $756.24 2026-07-19
J0248 HCPCS Remdesivir 100 Mg Vial 12 6 $2,900.00 $2,813.70 $12.70 $2,755.68 $1,419.76 2026-07-19
30300 CPT Remove Foreign Body Nose 10 6 $320.00 $310.40 $70.27 $304.00 $233.92 2026-07-19
84244 CPT Renin 11 6 $353.00 $342.41 $77.52 $335.35 $272.52 2026-07-19
12035 CPT Repair Lac Interm 12.6-20.0 Cm 18 6 $772.00 $748.84 $169.53 $733.40 $523.68 2026-07-19
12032 CPT Repair Lac Interm 2.6-7.5 Cm 18 6 $480.00 $465.60 $105.41 $534.49 $407.91 2026-07-19
12041 CPT Repair Lac Interm <2.5 Cm 18 6 $504.00 $488.88 $110.68 $478.80 $328.19 2026-07-19
0202U CPT Respir Path 22 Targets Biofire 10 6 $1,084.00 $1,051.48 $238.05 $1,029.80 $792.40 2026-07-19
84482 CPT Reverse T3 10 6 $340.00 $329.80 $74.66 $323.00 $248.54 2026-07-19
Q5115 HCPCS Rituximab-abbs 500Mg/50Ml Vial 12 6 $11,279.00 $10,941.14 $63.66 $10,715.55 $5,520.76 2026-07-19
120 CDM Room Medical Unit Semi Private 8 6 $2,246.00 $2,178.62 $493.22 $2,133.70 $1,641.83 2026-07-19
129 CDM Room Swing Bed Skilled 8 6 $1,037.00 $1,005.89 $227.73 $985.15 $758.04 2026-07-19
99281 CPT Sane Exam 11 6 $706.00 $684.82 $155.04 $670.70 $487.14 2026-07-19
G0121 HCPCS Screen Colonoscopy Not Hi Risk 8 6 $868.00 $841.96 $171.02 $514.81 $358.38 2026-07-19
G0105 HCPCS Screening Colonoscopy Hi Risk 8 6 $868.00 $841.96 $170.90 $514.08 $357.97 2026-07-19
J2805 HCPCS Sincalide 5 Mcg Vial 12 6 $601.00 $583.22 $132.04 $571.20 $309.80 2026-07-19
84305 CPT Somatomedin 10 6 $478.00 $463.66 $104.97 $454.10 $349.42 2026-07-19
88312 CPT Special Stain Pas Fungus 10 6 $317.00 $307.49 $69.61 $301.15 $231.72 2026-07-19
92507 CPT Speech Therapy Trmt 12 6 $307.00 $297.79 $67.42 $596.00 $239.76 2026-07-19
84481 CPT T3 Free 12 6 $340.00 $329.80 $74.66 $323.00 $265.54 2026-07-19
80197 CPT Tacrolimus 10 6 $422.00 $409.34 $92.67 $400.90 $308.48 2026-07-19
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Syrng 14 6 $31,584.00 $30,637.29 $0.41 $30,005.60 $15,459.20 2026-07-19
84402 CPT Testosterone Free 22 6 $346.50 $336.11 $71.81 $347.70 $247.91 2026-07-19
84403 CPT Testosterone Total 29 6 $392.00 $380.24 $55.34 $372.40 $239.40 2026-07-19
84432 CPT Thyroglobulin 10 6 $346.00 $335.62 $75.98 $328.70 $252.93 2026-07-19
J3262 HCPCS Tocilizumab 400 Mg/20 Ml Vial 12 6 $12,026.00 $11,665.40 $2.72 $11,424.88 $5,886.22 2026-07-19
Q5135 HCPCS Tocilizumab-aazg 400 Mg/20 Ml 12 6 $8,409.00 $8,157.43 $6.17 $7,989.23 $4,116.14 2026-07-19
76817 CPT Transvaginal US Obstetrical 11 6 $809.00 $784.73 $177.66 $768.55 $558.21 2026-07-19
689 CDM Trauma Team Evaluation Level 5 10 6 $3,218.00 $3,121.46 $706.67 $3,057.10 $2,352.36 2026-07-19
G0390 HCPCS Trauma Team Level 5 10 6 $3,064.00 $2,972.08 $672.85 $2,910.80 $2,239.78 2026-07-19
27840 CPT Treat Ankle Dislocation 18 6 $331.00 $321.07 $72.69 $1,037.29 $314.45 2026-07-19
27520 CPT Treat Kneecap Fracture Rt 21 6 $364.00 $353.08 $79.93 $345.80 $281.01 2026-07-19
84445 CPT Tsi 12 6 $910.00 $882.70 $199.84 $864.50 $627.90 2026-07-19
93306 CPT Tte W Doppler Complete 15 6 $3,326.00 $3,226.22 $730.39 $3,159.70 $2,294.94 2026-07-19
93923 CPT Ue/le Artery 3 Levels 10 6 $1,548.00 $1,501.56 $339.94 $1,470.60 $1,131.59 2026-07-19
76770 CPT Ultrasound Abdo Back Wall Comp 13 6 $1,610.00 $1,561.70 $353.56 $1,610.00 $1,110.90 2026-07-19
76700 CPT Ultrasound Abdomen Complete 11 6 $1,610.00 $1,561.70 $353.56 $1,529.50 $1,242.92 2026-07-19
76705 CPT Ultrasound Abdomen Limited 15 6 $1,152.00 $1,117.44 $252.98 $1,094.40 $802.47 2026-07-19
76775 CPT Ultrasound Aorta 11 6 $842.00 $816.74 $184.90 $799.90 $580.98 2026-07-19
76536 CPT Ultrasound Head And Neck 13 6 $1,163.00 $1,128.11 $255.39 $1,107.00 $802.47 2026-07-19
76856 CPT Ultrasound Pelvic Complete 10 6 $1,422.00 $1,379.34 $312.27 $1,350.90 $1,039.48 2026-07-19
76870 CPT Ultrasound Scrotum 12 6 $1,163.00 $1,128.11 $255.39 $1,104.85 $850.15 2026-07-19
76830 CPT Ultrasound Transvaginal 14 6 $857.00 $831.29 $188.20 $857.00 $626.47 2026-07-19
76882 CPT US Extremity Nonvasc Limit Lt 10 6 $1,163.00 $1,128.11 $255.39 $1,104.85 $850.15 2026-07-19
J3375 HCPCS Vancomycin 2000 Mg/400 Ml Bag 20 6 $432.00 $419.52 $84.05 $458.13 $317.07 2026-07-19
93975 CPT Vascular Study 10 6 $1,517.00 $1,471.49 $333.13 $1,441.15 $1,108.92 2026-07-19
93976 CPT Vascular Study 11 6 $968.00 $938.96 $212.57 $919.60 $667.92 2026-07-19
93970 CPT Venous Duplex 13 6 $1,626.00 $1,577.22 $357.07 $1,626.00 $1,121.94 2026-07-19
94002 CPT Vent Assist & Mgmt First Day 10 6 $725.00 $703.25 $159.21 $688.75 $529.98 2026-07-19
84425 CPT Vitamin B1 12 6 $334.00 $323.98 $73.35 $317.30 $230.46 2026-07-19
84207 CPT Vitamin B6 10 6 $525.00 $509.25 $115.29 $498.75 $383.77 2026-07-19
82652 CPT Vitamin D 125 Dihydroxy 10 6 $444.00 $430.68 $97.50 $421.80 $324.56 2026-07-19
82306 CPT Vitamin D 25 Oh 15 6 $385.00 $373.45 $84.55 $365.75 $265.65 2026-07-19
80285 CPT Voriconazole 10 6 $809.00 $784.73 $177.66 $768.55 $591.38 2026-07-19
81515 CPT Vpp 10 6 $497.00 $482.09 $109.14 $472.15 $363.31 2026-07-19
74019 CPT X-ray Abdomen 14 6 $592.00 $574.24 $130.00 $660.48 $432.75 2026-07-19
74018 CPT X-ray Abdomen 14 6 $382.00 $370.54 $83.89 $523.40 $279.24 2026-07-19
73610 CPT X-ray Ankle 3 Views Rt 25 6 $420.00 $407.40 $92.23 $399.00 $273.00 2026-07-19
74300 CPT X-ray Bile Ducts/Pancreas 11 6 $755.00 $732.35 $165.80 $965.04 $582.86 2026-07-19
71045 CPT X-ray Chest 1 View 16 6 $518.00 $502.46 $113.75 $593.33 $420.88 2026-07-19
71046 CPT X-ray Chest 2v PA/Lateral 16 6 $596.00 $578.12 $130.88 $783.14 $446.56 2026-07-19
73080 CPT X-ray Elbow Lt 21 6 $420.00 $407.40 $38.91 $399.00 $273.00 2026-07-19
70030 CPT X-ray Eye Fb Detection 8 6 $415.00 $402.55 $91.13 $394.25 $303.37 2026-07-19
70150 CPT X-ray Facial Bones 3 Views 10 6 $442.00 $428.74 $82.17 $419.90 $296.14 2026-07-19
73552 CPT X-ray Femur 2 Views Lt 21 6 $346.00 $335.62 $75.98 $328.70 $238.74 2026-07-19
73620 CPT X-ray Foot 2 Views Rt 22 6 $331.00 $321.07 $72.69 $314.45 $228.39 2026-07-19
73630 CPT X-ray Foot 3 Views Rt 27 6 $420.00 $407.40 $65.60 $399.00 $273.00 2026-07-19
73090 CPT X-ray Forearm 2 Views Lt 20 6 $365.00 $354.05 $80.15 $346.75 $282.25 2026-07-19
73130 CPT X-ray Hand Rt 25 6 $420.00 $407.40 $59.16 $399.00 $273.00 2026-07-19
73502 CPT X-ray Hip Uni 2-3 Views Lt 41 6 $346.00 $335.62 $75.98 $860.42 $328.70 2026-07-19
73522 CPT X-ray Hips 3-4 Views Bi 12 6 $819.00 $794.43 $179.85 $793.91 $598.69 2026-07-19
73523 CPT X-ray Hips 5 Views Bi 11 6 $983.00 $953.51 $215.87 $933.85 $690.20 2026-07-19
73562 CPT X-ray Knee 3 Views Rt 26 6 $369.00 $357.93 $81.03 $350.55 $251.91 2026-07-19
73564 CPT X-ray Knee 4 Lt 27 6 $574.00 $556.78 $126.05 $545.30 $387.66 2026-07-19
72120 CPT X-ray Ls Spine Bending 2-3 V 10 6 $708.00 $686.76 $152.07 $672.60 $474.36 2026-07-19
72100 CPT X-ray Lumbosacral 2-3 Views 14 6 $478.00 $463.66 $90.44 $454.10 $326.44 2026-07-19
70100 CPT X-ray Mandible < 4 Views 8 6 $385.00 $373.45 $84.55 $365.75 $281.44 2026-07-19
72170 CPT X-ray Pelvis 1-2 Views 13 6 $346.00 $335.62 $75.98 $341.88 $267.11 2026-07-19
72190 CPT X-ray Pelvis 3 Views 10 6 $632.00 $613.04 $138.79 $600.40 $505.19 2026-07-19
71100 CPT X-ray Ribs 2 Views Lt 10 6 $385.00 $373.45 $84.55 $3,616.49 $312.82 2026-07-19
71111 CPT X-ray Ribs Bilateral 4 Views 10 6 $1,064.00 $1,032.08 $63.74 $1,010.80 $712.88 2026-07-19
71101 CPT X-ray Ribs Uni W Chest Lt 20 6 $693.00 $672.21 $152.18 $3,427.98 $563.07 2026-07-19
72220 CPT X-ray Sacrum Tailbone 23 6 $492.00 $477.24 $108.04 $468.00 $379.82 2026-07-19
73030 CPT X-ray Shoulder Lt 25 6 $632.00 $613.04 $138.79 $600.40 $426.71 2026-07-19
72040 CPT X-ray Spine Cervical 2-3 Views 13 6 $433.00 $420.01 $95.09 $551.93 $298.77 2026-07-19
72070 CPT X-ray Spine Thoracic 2 Views 13 6 $420.00 $407.40 $92.23 $1,015.91 $324.24 2026-07-19
72072 CPT X-ray Spine Thoracic 3 Views 13 6 $585.00 $567.45 $128.47 $697.55 $403.65 2026-07-19
77071 CPT X-ray Stress View 10 6 $346.00 $335.62 $75.98 $328.70 $231.82 2026-07-19
72080 CPT X-ray Thoracolumbar Junc 2v 10 6 $455.00 $441.35 $79.40 $432.25 $304.85 2026-07-19
73110 CPT X-ray Wrist 3 Views Lt 25 6 $369.00 $357.93 $58.22 $350.55 $254.61 2026-07-19
80203 CPT Zonisamide 10 6 $623.00 $604.31 $136.81 $591.85 $455.41 2026-07-19
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