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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

COMMUNITY MEMORIAL HOSPITAL

Redfield, SD · CCN 431316 · Rates published

707 distinct procedures filed
5 distinct payers
7,866 rate rows
2026-07-18 last MRF observed
Data quality

7,824 of 7,866 rate rows are consumer-grade (99.5%)

42 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 42
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.redfieldcmh.org/wp-content/uploads/2025/03/466000400_redfield-community-memorial_standardcharges.csv
Found on page https://www.redfieldcmh.org/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-11-10
Content fingerprint 920133fa66fb32f2… · 585,814 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 $23,705.47 $33,154.51 $31,496.78 nat. median
$256
outlier · 123.0×
J0717
HCPCS 		Certolizumab Pegol 400 Mg Kit 5 $9,592.81 $13,416.52 $12,745.69 nat. median
$1,753
outlier · 7.3×
J0491
HCPCS 		Anifrolumab-fnia 300Mg/2Ml Via 5 $8,904.54 $12,453.90 $11,831.21 nat. median
$73
outlier · 161.9×
J1306
HCPCS 		Inclisiran 284mg/1.5ml Syringe 5 $5,983.78 $8,368.92 $7,950.47 nat. median
$51
outlier · 155.7×
Q5120
HCPCS 		Pegfilgrastim-bmez 6 Mg/0.6 Ml 5 $5,667.20 $7,926.15 $7,529.84 nat. median
$374
outlier · 20.1×
70553
CPT 		MRI Brain Wwo Contrast 5 $4,937.08 $6,905.00 $6,559.75 nat. median
$1,122
outlier · 5.8×
J3111
HCPCS 		Romosozumab-aqqg 210 Mg/2.34Ml 5 $4,152.37 $5,807.51 $5,517.13 nat. median
$734
outlier · 7.5×
70543
CPT 		MRI Orbit Face Neck Wwo Cont 5 $4,150.58 $5,805.00 $5,514.75 nat. median
$1,080
outlier · 5.1×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 5 $4,029.46 $5,635.61 $5,353.83 nat. median
$2,014
outlier · 2.7×
73720
CPT 		MRI Le Wwo Dye Lt 5 $3,915.34 $5,476.00 $5,202.20 nat. median
$1,123
outlier · 4.6×
74177
CPT 		CT Abd & Pelv W Contrast 5 $3,893.18 $5,445.00 $5,172.75 nat. median
$970
outlier · 5.3×
72156
CPT 		MRI Neck Spine Wwo Dye 5 $3,880.31 $5,427.00 $5,155.65 nat. median
$1,096
outlier · 4.7×
72158
CPT 		MRI Lumbar Spine Wwo Dye 5 $3,880.31 $5,427.00 $5,155.65 nat. median
$1,083
outlier · 4.8×
95811
CPT 		Polysomnogram W CPap 5 $3,686.54 $5,156.00 $4,898.20 nat. median
$1,887
outlier · 2.6×
73723
CPT 		MRI Joint Le Wwo Dye Rt 5 $3,664.38 $5,125.00 $4,868.75 nat. median
$1,191
outlier · 4.1×
72197
CPT 		MRI Pelvis Wwo Dye 5 $3,605.75 $5,043.00 $4,790.85 nat. median
$1,058
outlier · 4.5×
73221
CPT 		MRI Joint Ue Wo Dye Lt 5 $3,605.75 $5,043.00 $4,790.85 nat. median
$844
outlier · 5.7×
73218
CPT 		MRI Ue Wo Dye Rt 5 $3,605.75 $5,043.00 $4,790.85 nat. median
$864
outlier · 5.5×
74178
CPT 		CT Abd & Pelv Wwo Contrast 5 $3,552.12 $4,968.00 $4,719.60 nat. median
$1,023
outlier · 4.6×
73718
CPT 		MRI Le Wo Dye Lt 5 $3,411.27 $4,771.00 $4,532.45 nat. median
$866
outlier · 5.2×
J0897
HCPCS 		Denosumab 120 Mg/1.7 Ml Vial 5 $2,780.18 $7,138.75 $4,496.29 nat. median
$1,990
outlier · 2.3×
72149
CPT 		MRI Lumbar Spine W Dye 5 $3,383.38 $4,732.00 $4,495.40 nat. median
$974
outlier · 4.6×
74176
CPT 		CT Abd & Pelvis Wo Contrast 5 $3,313.31 $4,634.00 $4,402.30 nat. median
$691
outlier · 6.4×
74174
CPT 		CTA Abd&Pelv Wwo Dye 5 $3,293.29 $4,606.00 $4,375.70 nat. median
$980
outlier · 4.5×
74183
CPT 		MRI Abdomen Wwo Dye 5 $3,289.00 $4,600.00 $4,370.00 nat. median
$1,096
outlier · 4.0×
74182
CPT 		MRI Abdomen W Dye 5 $3,289.00 $4,600.00 $4,370.00 nat. median
$964
outlier · 4.5×
95810
CPT 		Polysomnogram 5 $3,281.14 $4,589.00 $4,359.55 nat. median
$1,814
outlier · 2.4×
72141
CPT 		MRI Neck Spine Wo Dye 5 $3,266.12 $4,568.00 $4,339.60 nat. median
$778
outlier · 5.6×
72148
CPT 		MRI Lumbar Spine Wo Dye 5 $3,266.12 $4,568.00 $4,339.60 nat. median
$803
outlier · 5.4×
72146
CPT 		MRI Chest Spine Wo Dye 5 $3,172.46 $4,437.00 $4,215.15 nat. median
$794
outlier · 5.3×
71260
CPT 		CT Thorax W Contrast 5 $3,118.83 $4,362.00 $4,143.90 nat. median
$647
outlier · 6.4×
73721
CPT 		MRI Joint Le Wo Dye Lt 5 $3,071.64 $4,296.00 $4,081.20 nat. median
$854
outlier · 4.8×
75635
CPT 		CTA Abdominal Arteries 5 $3,043.04 $4,256.00 $4,043.20 nat. median
$725
outlier · 5.6×
73706
CPT 		CTA Le Wwo Dye Rt 5 $3,043.04 $4,256.00 $4,043.20 nat. median
$749
outlier · 5.4×
74175
CPT 		CTA Abdom Wwo Dye 5 $3,043.04 $4,256.00 $4,043.20 nat. median
$714
outlier · 5.7×
71275
CPT 		CTA Chest Wwo Contrast 5 $3,043.04 $4,256.00 $4,043.20 nat. median
$753
outlier · 5.4×
72195
CPT 		MRI Pelvis Wo Dye 5 $3,020.88 $4,225.00 $4,013.75 nat. median
$802
outlier · 5.0×
70551
CPT 		MRI Brain Wo Contrast 5 $2,962.96 $4,144.00 $3,936.80 nat. median
$779
outlier · 5.1×
74170
CPT 		CT Abdomen Wwo Dye 5 $2,817.10 $3,940.00 $3,743.00 nat. median
$710
outlier · 5.3×
70492
CPT 		CT Soft Tissue Neck Wwo Cont 5 $2,631.92 $3,681.00 $3,496.95 nat. median
$646
outlier · 5.4×
70470
CPT 		CT Head/Brain Wwo Contrast 5 $2,584.73 $3,615.00 $3,434.25 nat. median
$618
outlier · 5.6×
70491
CPT 		CT Soft Tissue Neck W Cont 5 $2,584.73 $3,615.00 $3,434.25 nat. median
$626
outlier · 5.5×
J0129
HCPCS 		Abatacept 250 Mg Vial 5 $2,503.39 $3,501.25 $3,326.19 nat. median
$935
outlier · 3.6×
73200
CPT 		CT Ue Wo Dye Lt 5 $2,485.34 $3,476.00 $3,302.20 nat. median
$521
outlier · 6.3×
73701
CPT 		CT Le W Dye Lt 5 $2,436.72 $3,408.00 $3,237.60 nat. median
$673
outlier · 4.8×
73700
CPT 		CT Le Wo Dye Lt 5 $2,385.24 $3,336.00 $3,169.20 nat. median
$499
outlier · 6.3×
J3262
HCPCS 		Tocilizumab 200 Mg/10 Ml Vial 5 $881.52 $6,657.64 $3,112.93 nat. median
$1,424
outlier · 2.2×
71250
CPT 		CT Thorax Wo Contrast 5 $2,269.41 $3,174.00 $3,015.30 nat. median
$463
outlier · 6.5×
120
CDM 		Room Medical Unit Semi Private 5 $1,949.81 $2,727.00 $2,590.65 nat. median
$1,554
1.7× median
70496
CPT 		CT Angiography Head W Cont 5 $1,949.09 $2,726.00 $2,589.70 nat. median
$741
outlier · 3.5×

Other procedures at this hospital

Browse this hospital's 707 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
             
76706 CPT Aaa Screening Medicare 7 5 $1,112.00 $945.20 $795.08 $1,112.00 $1,056.40 2026-07-18
J0129 HCPCS Abatacept 250 Mg Vial 7 5 $3,501.25 $2,976.06 $2,503.39 $3,501.25 $3,326.19 2026-07-18
82024 CPT Acth Adrenocorticotropic Hor 7 5 $308.00 $261.80 $220.22 $308.00 $292.60 2026-07-18
80074 CPT Acute Hepatitis Panel 7 5 $320.00 $272.00 $228.80 $320.00 $304.00 2026-07-18
P9047 HCPCS Albumin Human 25% 25gr/100ml 7 5 $271.41 $230.70 $194.06 $271.41 $257.84 2026-07-18
82088 CPT Aldosterone 7 5 $238.00 $202.30 $170.17 $238.00 $226.10 2026-07-18
A0433 HCPCS Amb Als 2 Hosp/Hosp 7 5 $1,400.00 $1,190.00 $1,001.00 $1,400.00 $1,330.00 2026-07-18
A0427 HCPCS Amb Als Emergent Home/Hosp 21 5 $956.00 $812.60 $650.65 $956.00 $882.70 2026-07-18
A0429 HCPCS Amb Bls Emergent Home/Hosp 21 5 $844.00 $717.40 $603.46 $844.00 $801.80 2026-07-18
A0428 HCPCS Amb Bls Nonemergent Hosp/Home 14 5 $779.00 $662.15 $556.99 $779.00 $740.05 2026-07-18
J0283 HCPCS Amiodarone/D5W 150mg/100ml Bag 14 5 $212.70 $180.80 $142.66 $225.88 $196.53 2026-07-18
811 OTHER Anesth Lower Intestinal 7 5 $527.50 $448.38 $377.16 $527.50 $501.13 2026-07-18
812 OTHER Anesth Screening Colonoscopy 7 5 $606.67 $515.67 $433.77 $606.67 $576.34 2026-07-18
813 OTHER Anesth Upper And Lower Gi 7 5 $850.00 $722.50 $607.75 $850.00 $807.50 2026-07-18
731 OTHER Anesth Upper Gi 7 5 $590.00 $501.50 $421.85 $590.00 $560.50 2026-07-18
J0491 HCPCS Anifrolumab-fnia 300Mg/2Ml Via 7 5 $12,453.90 $10,585.82 $8,904.54 $12,453.90 $11,831.21 2026-07-18
93922 CPT Ankle Arm Screen 7 5 $639.00 $543.15 $456.89 $639.00 $607.05 2026-07-18
85520 CPT Apixaban 7 5 $272.00 $231.20 $194.48 $272.00 $258.40 2026-07-18
29581 CPT Appl Multi Layer Ven Wnd Compr 7 5 $602.00 $511.70 $430.43 $602.00 $571.90 2026-07-18
450 CDM Application Splint Or Cast 70 5 $269.50 $229.07 $78.65 $708.00 $223.62 2026-07-18
93925 CPT Arterial Duplex Le Bi 7 5 $1,541.00 $1,309.85 $1,101.82 $1,541.00 $1,463.95 2026-07-18
93926 CPT Arterial Duplex Le Lt 14 5 $847.00 $719.95 $605.61 $847.00 $804.65 2026-07-18
20611 CPT Asp/Inj Large Joint US Lt 30 5 $158.00 $134.30 $130.90 $576.00 $237.12 2026-07-18
87305 CPT Aspergillus Galact Antigen 7 5 $228.00 $193.80 $163.02 $228.00 $216.60 2026-07-18
92524 CPT Behavral Qualit Analys Voice 7 5 $207.00 $175.95 $148.01 $207.00 $196.65 2026-07-18
87799 CPT Bk Virus Quant Pcr, Serum 7 5 $264.00 $224.40 $188.76 $264.00 $250.80 2026-07-18
87449 CPT Blastomyces Ag Qnt 14 5 $287.00 $243.95 $205.21 $287.00 $272.65 2026-07-18
36430 CPT Blood Administration 14 5 $1,118.00 $950.30 $735.74 $1,207.00 $1,027.47 2026-07-18
36592 CPT Blood Draw Cent/Periph Cath 7 5 $234.00 $198.90 $167.31 $234.00 $222.30 2026-07-18
82803 CPT Blood Gas Wo Oximetry 7 5 $258.00 $219.30 $184.47 $258.00 $245.10 2026-07-18
87493 CPT C Diff By Pcr 7 5 $225.00 $191.25 $160.88 $225.00 $213.75 2026-07-18
86301 CPT Ca 19-9 7 5 $232.00 $197.20 $165.88 $232.00 $220.40 2026-07-18
93798 CPT Cardiac Rehab Ii Monitored 7 5 $257.00 $218.45 $183.76 $257.00 $244.15 2026-07-18
82379 CPT Carnitine Total And Free 7 5 $205.00 $174.25 $146.58 $205.00 $194.75 2026-07-18
51703 CPT Cath Insert Comp Indwelling 14 5 $266.50 $226.53 $143.00 $333.00 $219.05 2026-07-18
J0717 HCPCS Certolizumab Pegol 400 Mg Kit 7 5 $13,416.52 $11,404.04 $9,592.81 $13,416.52 $12,745.69 2026-07-18
43762 CPT Change Gastrostomy Tube 7 5 $259.00 $309.40 $309.40 $593.79 $526.11 2026-07-18
761 CDM Change/Reposition Feeding Tube 21 5 $298.00 $253.30 $206.64 $2,211.00 $289.00 2026-07-18
17250 CPT Chemical Cauterization Tissue 14 5 $439.00 $373.15 $133.50 $738.00 $368.34 2026-07-18
96415 CPT Chemotherapy Inf Ea Addl Hr 7 5 $202.00 $171.70 $144.43 $202.00 $191.90 2026-07-18
96413 CPT Chemotherapy Inf Initial 7 5 $810.00 $688.50 $579.15 $810.00 $769.50 2026-07-18
0353U CPT Chlmyd & Gonorr Amp Prb 7 5 $216.00 $183.60 $154.44 $216.00 $205.20 2026-07-18
88262 CPT Chromosome Analysis 15-20 Cell 7 5 $342.00 $290.70 $244.53 $342.00 $324.90 2026-07-18
96125 CPT Cognitive Performance Test Ot 7 5 $223.00 $189.55 $159.45 $223.00 $211.85 2026-07-18
45378 CPT Colonoscopy Diagnostic 7 5 $542.00 $460.70 $677.85 $827.94 $766.99 2026-07-18
45380 CPT Colonoscopy W Biopsy(s) 7 5 $694.00 $589.90 $881.53 $1,066.10 $987.23 2026-07-18
30903 CPT Control Anterior Hemorrhage Lt 7 5 $177.00 $331.50 $329.25 $582.71 $563.30 2026-07-18
30901 CPT Control Anterior Hemorrhage Lt 14 5 $150.00 $212.50 $201.00 $361.70 $307.48 2026-07-18
94660 CPT CPap/BiPap First Day 7 5 $1,032.00 $877.20 $737.88 $1,032.00 $980.40 2026-07-18
99291 CPT Critical Care 1st 30-74 Min 14 5 $1,111.00 $944.35 $383.10 $1,790.00 $894.17 2026-07-18
99292 CPT Critical Care Ea Addl 30 Min 7 5 $199.00 $169.15 $166.72 $225.75 $206.43 2026-07-18
86922 CPT Crossmatch Ahg 7 5 $225.00 $191.25 $160.88 $225.00 $213.75 2026-07-18
74177 CPT CT Abd & Pelv W Contrast 7 5 $5,445.00 $4,628.25 $3,893.18 $5,445.00 $5,172.75 2026-07-18
74178 CPT CT Abd & Pelv Wwo Contrast 7 5 $4,968.00 $4,222.80 $3,552.12 $4,968.00 $4,719.60 2026-07-18
74176 CPT CT Abd & Pelvis Wo Contrast 7 5 $4,634.00 $3,938.90 $3,313.31 $4,634.00 $4,402.30 2026-07-18
74160 CPT CT Abdomen W Dye 7 5 $2,700.00 $2,295.00 $1,930.50 $2,700.00 $2,565.00 2026-07-18
74150 CPT CT Abdomen Wo Dye 7 5 $2,005.50 $1,969.45 $1,656.66 $2,317.00 $2,201.15 2026-07-18
74170 CPT CT Abdomen Wwo Dye 7 5 $2,356.20 $3,349.00 $2,817.10 $3,940.00 $3,743.00 2026-07-18
70496 CPT CT Angiography Head W Cont 7 5 $1,408.00 $2,317.10 $1,949.09 $2,726.00 $2,589.70 2026-07-18
70498 CPT CT Angiography Neck W Cont 7 5 $4,069.80 $2,317.10 43% off $1,949.09 $2,726.00 $2,589.70 2026-07-18
72125 CPT CT Cervical Spine Wo Contrast 7 5 $2,442.00 $2,071.45 $1,742.46 $2,437.00 $2,315.15 2026-07-18
70450 CPT CT Head/Brain Wo Contrast 7 5 $2,502.00 $2,126.70 $1,788.93 $2,502.00 $2,376.90 2026-07-18
70470 CPT CT Head/Brain Wwo Contrast 7 5 $3,615.00 $3,072.75 $2,584.73 $3,615.00 $3,434.25 2026-07-18
73701 CPT CT Le W Dye Lt 14 5 $3,408.00 $2,896.80 $2,436.72 $3,408.00 $3,237.60 2026-07-18
73700 CPT CT Le Wo Dye Lt 14 5 $1,267.00 $2,835.60 $2,385.24 $3,336.00 $3,169.20 2026-07-18
72132 CPT CT Lumbar Spine W Contrast 7 5 $2,490.00 $2,116.50 $1,780.35 $2,490.00 $2,365.50 2026-07-18
72131 CPT CT Lumbar Spine Wo Contrast 7 5 $2,502.00 $2,126.70 $1,788.93 $2,502.00 $2,376.90 2026-07-18
70488 CPT CT Maxillofac Wwo Contrast 7 5 $2,502.00 $2,126.70 $1,788.93 $2,502.00 $2,376.90 2026-07-18
70487 CPT CT Maxillofacial W Contrast 7 5 $2,284.00 $1,941.40 $1,633.06 $2,284.00 $2,169.80 2026-07-18
70486 CPT CT Maxillofacial Wo Contrast 7 5 $1,969.00 $1,673.65 $1,407.84 $1,969.00 $1,870.55 2026-07-18
70480 CPT CT Orbit Wo Contrast 7 5 $2,327.00 $1,977.95 $1,663.81 $2,327.00 $2,210.65 2026-07-18
72192 CPT CT Pelvis Wo Dye 7 5 $2,512.00 $2,135.20 $1,796.08 $2,512.00 $2,386.40 2026-07-18
70491 CPT CT Soft Tissue Neck W Cont 7 5 $3,615.00 $3,072.75 $2,584.73 $3,615.00 $3,434.25 2026-07-18
70490 CPT CT Soft Tissue Neck Wo Cont 7 5 $2,502.00 $2,126.70 $1,788.93 $2,502.00 $2,376.90 2026-07-18
70492 CPT CT Soft Tissue Neck Wwo Cont 7 5 $3,681.00 $3,128.85 $2,631.92 $3,681.00 $3,496.95 2026-07-18
72128 CPT CT Thoracic Spine Wo Contrast 7 5 $2,502.00 $2,126.70 $1,788.93 $2,502.00 $2,376.90 2026-07-18
71260 CPT CT Thorax W Contrast 7 5 $2,738.00 $3,707.70 $3,118.83 $4,362.00 $4,143.90 2026-07-18
71250 CPT CT Thorax Wo Contrast 7 5 $1,449.00 $2,697.90 $2,269.41 $3,174.00 $3,015.30 2026-07-18
73200 CPT CT Ue Wo Dye Lt 14 5 $3,476.00 $2,954.60 $2,485.34 $3,476.00 $3,302.20 2026-07-18
74174 CPT CTA Abd&Pelv Wwo Dye 7 5 $4,400.00 $3,915.10 $3,293.29 $4,606.00 $4,375.70 2026-07-18
74175 CPT CTA Abdom Wwo Dye 7 5 $3,696.00 $3,617.60 $3,043.04 $4,256.00 $4,043.20 2026-07-18
75635 CPT CTA Abdominal Arteries 7 5 $3,518.64 $3,617.60 $3,043.04 $4,256.00 $4,043.20 2026-07-18
71275 CPT CTA Chest Wwo Contrast 7 5 $3,906.00 $3,617.60 $3,043.04 $4,256.00 $4,043.20 2026-07-18
73706 CPT CTA Le Wwo Dye Rt 7 5 $929.00 $3,617.60 $3,043.04 $4,256.00 $4,043.20 2026-07-18
J0881 HCPCS Darbepoet Alfa 60mcg/0.3ml Syr 7 5 $524.95 $446.21 $375.34 $524.95 $498.70 2026-07-18
11043 CPT Debride Muscle/Fascia 20 Cm 7 5 $368.00 $312.80 $450.83 $593.84 $514.64 2026-07-18
11042 CPT Debride Skin Subq 20 Cm 14 5 $1,740.50 $1,479.42 $166.50 $3,273.00 $1,323.57 2026-07-18
11045 CPT Debride Skin Subq Addl 20 Cm 14 5 $430.00 $365.50 $72.25 $775.00 $330.21 2026-07-18
97597 CPT Debride Wound 1st 20 Cm 14 5 $336.50 $286.02 $96.75 $510.00 $285.69 2026-07-18
97602 CPT Debride Wound Non-selective 14 5 $304.50 $258.82 $54.40 $545.00 $253.00 2026-07-18
J0897 HCPCS Denosumab 120 Mg/1.7 Ml Vial 14 5 $5,513.56 $4,686.52 $2,780.18 $7,138.75 $4,496.29 2026-07-18
94762 CPT Desaturation And Hr Study 7 5 $451.00 $383.35 $322.47 $451.00 $428.45 2026-07-18
77080 CPT Dexa Scan 7 5 $642.00 $545.70 $459.03 $642.00 $609.90 2026-07-18
16020 CPT Dress/Debride Small Burn 14 5 $184.50 $238.85 $162.75 $425.00 $259.68 2026-07-18
G0481 HCPCS Drug Test Def 8-14 Classes 7 5 $374.00 $317.90 $267.41 $374.00 $355.30 2026-07-18
92526 CPT Dysphagia Treatment 7 5 $247.00 $209.95 $176.61 $247.00 $234.65 2026-07-18
93226 CPT ECG Monit/Report Up To 48 Hour 7 5 $723.00 $614.55 $516.95 $723.00 $686.85 2026-07-18
43239 CPT Egd Biopsy Single/Multiple 7 5 $605.00 $514.25 $661.50 $906.96 $864.11 2026-07-18
43235 CPT Egd Diagnostic Brush Wash 7 5 $462.00 $392.70 $582.00 $676.70 $657.64 2026-07-18
93005 CPT EKG Tracing 7 5 $192.00 $163.20 $137.28 $192.00 $182.40 2026-07-18
99281 CPT Emergency Room Visit Level 1 7 5 $402.00 $341.70 $287.43 $402.00 $381.90 2026-07-18
99282 CPT Emergency Room Visit Level 2 14 5 $254.00 $215.90 $54.75 $444.00 $194.95 2026-07-18
99283 CPT Emergency Room Visit Level 3 14 5 $336.50 $286.02 $96.99 $564.00 $263.13 2026-07-18
99284 CPT Emergency Room Visit Level 4 14 5 $510.00 $433.50 $164.81 $834.00 $401.65 2026-07-18
99285 CPT Emergency Room Visit Level 5 14 5 $632.00 $537.20 $239.33 $995.00 $507.15 2026-07-18
82668 CPT Erythropoietin 7 5 $202.00 $171.70 $144.43 $202.00 $191.90 2026-07-18
99212 CPT Est Patient Level 2 Sf Comp 14 5 $245.00 $208.25 $76.50 $399.00 $192.75 2026-07-18
99213 CPT Est Patient Level 3 Low Comp 14 5 $290.00 $246.50 $104.25 $434.00 $234.53 2026-07-18
99214 CPT Est Patient Level 4 Mod Comp 14 5 $343.50 $291.98 $163.50 $482.00 $284.88 2026-07-18
82671 CPT Estrogen Fractionated 7 5 $261.00 $221.85 $186.62 $261.00 $247.95 2026-07-18
93880 CPT Extracranial Bilat Study 7 5 $1,441.00 $1,224.85 $1,030.32 $1,441.00 $1,368.95 2026-07-18
93971 CPT Extremity Study Lt 14 5 $985.00 $837.25 $704.28 $985.00 $935.75 2026-07-18
85220 CPT Factor 5 Activity 7 5 $607.00 $515.95 $434.01 $607.00 $576.65 2026-07-18
85250 CPT Factor 9 Activity 7 5 $247.00 $209.95 $176.61 $247.00 $234.65 2026-07-18
81241 CPT Factor V Leiden Mutation 7 5 $325.00 $276.25 $232.38 $325.00 $308.75 2026-07-18
85246 CPT Factor Viii Rel Agn 7 5 $200.00 $170.00 $143.00 $200.00 $190.00 2026-07-18
Q0138 HCPCS Ferumoxy 510mg/17ml (non-esrd) 7 5 $1,280.73 $1,088.62 $915.72 $1,280.73 $1,216.69 2026-07-18
Q5101 HCPCS Filgrastim-sndz 300 Mcg/0.5 Ml 14 5 $544.60 $462.90 $323.76 $636.38 $453.91 2026-07-18
J1611 HCPCS Glucagon (Fresenius Kabi) Kit 7 5 $420.85 $357.72 $300.91 $420.85 $399.81 2026-07-18
J1610 HCPCS Glucagon 1 Mg/ml Vial 7 5 $447.01 $379.96 $319.61 $447.01 $424.66 2026-07-18
87338 CPT H Pylori Antigen Stool 7 5 $217.00 $184.45 $155.16 $217.00 $206.15 2026-07-18
92950 CPT Heart/Lung Resuscitation Cpr 7 5 $1,027.00 $872.95 $734.31 $1,027.00 $975.65 2026-07-18
87522 CPT Hep C RNA Pcr Quant 7 5 $475.00 $403.75 $339.63 $475.00 $451.25 2026-07-18
90371 CPT Hepatitis B Ig 5 Ml Vial 7 5 $1,214.18 $1,032.05 $868.14 $1,214.18 $1,153.47 2026-07-18
73502 CPT Hip Unilat W Pelvis 2 View Lt 28 5 $591.50 $502.77 $399.69 $624.00 $550.62 2026-07-18
87385 CPT Histoplasma Antigen 7 5 $336.00 $285.60 $240.24 $336.00 $319.20 2026-07-18
87389 CPT HIV1Ag/HIV12Ab Sng Result 7 5 $203.00 $172.55 $145.15 $203.00 $192.85 2026-07-18
86812 CPT Hla B27 7 5 $234.00 $198.90 $167.31 $234.00 $222.30 2026-07-18
93225 CPT Holter Monitor Hook Up <48 Hrs 7 5 $465.00 $395.25 $332.48 $465.00 $441.75 2026-07-18
J7325 HCPCS Hylan Polymer A&b 48mg/6ml Syr 7 5 $1,205.00 $1,024.25 $861.58 $1,205.00 $1,144.75 2026-07-18
10120 CPT I&r Foreign Body Simple 7 5 $117.00 $208.25 $264.00 $402.80 $341.30 2026-07-18
0077U CPT Ig Paraprotein Qual 7 5 $309.00 $262.65 $220.94 $309.00 $293.55 2026-07-18
88342 CPT Immunohisto Stain Init Pr Spec 7 5 $235.00 $199.75 $168.03 $235.00 $223.25 2026-07-18
J1306 HCPCS Inclisiran 284mg/1.5ml Syringe 7 5 $8,368.92 $7,113.58 $5,983.78 $8,368.92 $7,950.47 2026-07-18
96360 CPT Inf Therapy Hyd Initial 7 5 $452.00 $384.20 $323.18 $452.00 $429.40 2026-07-18
96365 CPT Inf Therapy Med Initial 7 5 $498.00 $423.30 $356.07 $498.00 $473.10 2026-07-18
96367 CPT Inf Therapy Med Sequential 7 5 $209.00 $177.65 $149.44 $209.00 $198.55 2026-07-18
Q5121 HCPCS Infliximab-axxq 100 Mg Vial 7 5 $1,205.80 $1,024.93 $862.15 $1,205.80 $1,145.51 2026-07-18
Q5103 HCPCS Infliximab-dyyb 100 Mg Vial 7 5 $1,303.30 $1,107.81 $931.86 $1,303.30 $1,238.14 2026-07-18
94664 CPT Inhalation Treat Chronic Init 7 5 $248.00 $210.80 $177.32 $248.00 $235.60 2026-07-18
99222 CPT Inpatient Initial/Obs Mod Comp 7 5 $204.00 $173.40 $183.82 $241.79 $223.70 2026-07-18
99233 CPT Inpatient/Obs Subsequent High 7 5 $186.00 $158.10 $140.13 $206.43 $185.09 2026-07-18
31500 CPT Insert Emergency Airway 14 5 $480.50 $408.42 $228.75 $748.00 $450.59 2026-07-18
36680 CPT Insertion Needle Intraosseous 7 5 $447.00 $379.95 $319.61 $447.00 $424.65 2026-07-18
99239 CPT IP/Obs Discharge >30 Min 7 5 $180.00 $153.00 $144.85 $199.19 $191.70 2026-07-18
99223 CPT IP/Obs Initial High Comp 7 5 $272.00 $231.20 $271.47 $358.83 $300.59 2026-07-18
51700 CPT Irrigation Bladder 7 5 $300.00 $255.00 $214.50 $300.00 $285.00 2026-07-18
96374 CPT IV Push Injection Initial 7 5 $299.00 $254.15 $213.79 $299.00 $284.05 2026-07-18
81270 CPT Jak2 Mutation 7 5 $444.00 $377.40 $317.46 $444.00 $421.80 2026-07-18
71271 CPT Ldct For Lung Cancer Screen 7 5 $289.00 $245.65 $206.64 $289.00 $274.55 2026-07-18
J9217 HCPCS Leuprolide Acetate 45 Mg Syr 7 5 $2,533.04 $2,153.08 $1,811.12 $2,533.04 $2,406.39 2026-07-18
80177 CPT Levetiracetam 7 5 $226.00 $192.10 $161.59 $226.00 $214.70 2026-07-18
87476 CPT Lyme Disease DNA Amp Probe 7 5 $192.00 $163.20 $137.28 $192.00 $182.40 2026-07-18
77067 CPT Mammography Screening Digital 7 5 $440.00 $374.00 $314.60 $440.00 $418.00 2026-07-18
83921 CPT Methylmalonic Acid 7 5 $289.00 $245.65 $206.64 $289.00 $274.55 2026-07-18
74182 CPT MRI Abdomen W Dye 7 5 $4,600.00 $3,910.00 $3,289.00 $4,600.00 $4,370.00 2026-07-18
74183 CPT MRI Abdomen Wwo Dye 7 5 $4,600.00 $3,910.00 $3,289.00 $4,600.00 $4,370.00 2026-07-18
70551 CPT MRI Brain Wo Contrast 7 5 $4,144.00 $3,522.40 $2,962.96 $4,144.00 $3,936.80 2026-07-18
70553 CPT MRI Brain Wwo Contrast 7 5 $5,632.00 $5,869.25 $4,937.08 $6,905.00 $6,559.75 2026-07-18
72146 CPT MRI Chest Spine Wo Dye 7 5 $4,437.00 $3,771.45 $3,172.46 $4,437.00 $4,215.15 2026-07-18
73721 CPT MRI Joint Le Wo Dye Lt 14 5 $4,296.00 $3,651.60 $3,071.64 $4,296.00 $4,081.20 2026-07-18
73723 CPT MRI Joint Le Wwo Dye Rt 7 5 $4,069.80 $4,356.25 $3,664.38 $5,125.00 $4,868.75 2026-07-18
73221 CPT MRI Joint Ue Wo Dye Lt 14 5 $3,255.00 $4,286.55 $3,605.75 $5,043.00 $4,790.85 2026-07-18
73718 CPT MRI Le Wo Dye Lt 14 5 $2,849.00 $4,055.35 $3,411.27 $4,771.00 $4,532.45 2026-07-18
73720 CPT MRI Le Wwo Dye Lt 7 5 $5,476.00 $4,654.60 $3,915.34 $5,476.00 $5,202.20 2026-07-18
72149 CPT MRI Lumbar Spine W Dye 7 5 $4,273.50 $4,022.20 $3,383.38 $4,732.00 $4,495.40 2026-07-18
72148 CPT MRI Lumbar Spine Wo Dye 7 5 $4,292.00 $3,882.80 $3,266.12 $4,568.00 $4,339.60 2026-07-18
72158 CPT MRI Lumbar Spine Wwo Dye 7 5 $5,427.00 $4,612.95 $3,880.31 $5,427.00 $5,155.65 2026-07-18
72141 CPT MRI Neck Spine Wo Dye 7 5 $4,292.00 $3,882.80 $3,266.12 $4,568.00 $4,339.60 2026-07-18
72156 CPT MRI Neck Spine Wwo Dye 7 5 $5,427.00 $4,612.95 $3,880.31 $5,427.00 $5,155.65 2026-07-18
70543 CPT MRI Orbit Face Neck Wwo Cont 7 5 $5,805.00 $4,934.25 $4,150.58 $5,805.00 $5,514.75 2026-07-18
72195 CPT MRI Pelvis Wo Dye 7 5 $4,225.00 $3,591.25 $3,020.88 $4,225.00 $4,013.75 2026-07-18
72197 CPT MRI Pelvis Wwo Dye 7 5 $2,805.00 $4,286.55 $3,605.75 $5,043.00 $4,790.85 2026-07-18
73218 CPT MRI Ue Wo Dye Rt 7 5 $3,255.00 $4,286.55 $3,605.75 $5,043.00 $4,790.85 2026-07-18
87641 CPT Mrsa By Pcr 7 5 $337.00 $286.45 $240.96 $337.00 $320.15 2026-07-18
83874 CPT Myoglobin Urine 7 5 $224.00 $190.40 $160.16 $224.00 $212.80 2026-07-18
97605 CPT Neg Pressure Wound Dme <50 Cm 7 5 $573.00 $487.05 $409.70 $573.00 $544.35 2026-07-18
84591 CPT Niacin Vit B3 7 5 $204.00 $173.40 $145.86 $204.00 $193.80 2026-07-18
87798 CPT Norovirus Pcr 1 Or 2 Each 7 5 $285.00 $242.25 $203.78 $285.00 $270.75 2026-07-18
76801 CPT OB US < 14 Wks Single Fetus 7 5 $1,112.00 $945.20 $795.08 $1,112.00 $1,056.40 2026-07-18
G0378 HCPCS Observation 1st Hour 14 5 $363.00 $308.55 $41.47 $668.00 $267.81 2026-07-18
360 CDM Or Level 2 14 5 $1,469.50 $1,249.08 $421.85 $2,349.00 $1,134.77 2026-07-18
97167 CPT Ot Eval High Complexity 7 5 $273.00 $232.05 $195.20 $273.00 $259.35 2026-07-18
97165 CPT Ot Eval Low Complexity 7 5 $207.00 $175.95 $148.01 $207.00 $196.65 2026-07-18
999 CDM Outreach Rent 7 5 $50.00 $199.44 $167.77 $234.64 $222.91 2026-07-18
87177 CPT Ova And Parasites Smears 7 5 $267.00 $226.95 $190.91 $267.00 $253.65 2026-07-18
Q5120 HCPCS Pegfilgrastim-bmez 6 Mg/0.6 Ml 7 5 $7,926.15 $6,737.23 $5,667.20 $7,926.15 $7,529.84 2026-07-18
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 7 5 $5,635.61 $4,790.27 $4,029.46 $5,635.61 $5,353.83 2026-07-18
94060 CPT Pft Pre & Post Screen Spirome 7 5 $584.00 $322.15 45% off $270.99 $379.00 $360.05 2026-07-18
81418 CPT Pharmacogenomic Geno 7 5 $238.00 $202.30 $170.17 $238.00 $226.10 2026-07-18
95810 CPT Polysomnogram 7 5 $2,772.00 $3,900.65 $3,281.14 $4,589.00 $4,359.55 2026-07-18
95811 CPT Polysomnogram W CPap 7 5 $3,160.00 $4,382.60 $3,686.54 $5,156.00 $4,898.20 2026-07-18
83880 CPT Pro-b Type Natriuretic Peptide 7 5 $253.00 $215.05 $180.90 $253.00 $240.35 2026-07-18
84145 CPT Procalcitonin 7 5 $230.00 $195.50 $164.45 $230.00 $218.50 2026-07-18
84206 CPT Proinsulin 7 5 $197.00 $167.45 $140.86 $197.00 $187.15 2026-07-18
84146 CPT Prolactin 7 5 $340.00 $289.00 $243.10 $340.00 $323.00 2026-07-18
84150 CPT Prostaglandin 7 5 $340.00 $289.00 $243.10 $340.00 $323.00 2026-07-18
85303 CPT Protein C Activity 7 5 $263.00 $223.55 $188.05 $263.00 $249.85 2026-07-18
85306 CPT Protein S Functional 7 5 $225.00 $191.25 $160.88 $225.00 $213.75 2026-07-18
81240 CPT Prothrombin Mutation 7 5 $268.00 $227.80 $191.62 $268.00 $254.60 2026-07-18
97163 CPT Pt Eval High Complexity 7 5 $273.00 $232.05 $195.20 $273.00 $259.35 2026-07-18
97161 CPT Pt Eval Low Complexity 7 5 $207.00 $175.95 $148.01 $207.00 $196.65 2026-07-18
97162 CPT Pt Eval Mod Complexity 7 5 $240.00 $204.00 $171.60 $240.00 $228.00 2026-07-18
83970 CPT Pth 7 5 $215.00 $182.75 $153.73 $215.00 $204.25 2026-07-18
94761 CPT Pulse Oximetry Multiple 7 5 $213.00 $181.05 $152.30 $213.00 $202.35 2026-07-18
90377 CPT Rabies Imm Glo 300U/2Ml Kedrab 7 5 $1,213.33 $1,031.33 $867.53 $1,213.33 $1,152.66 2026-07-18
90675 CPT Rabies Vacc Hmn Post-ex Nonim 14 5 $858.62 $729.83 $588.47 $894.20 $807.82 2026-07-18
86870 CPT Rbc Antibody Identif Panel 7 5 $263.00 $223.55 $188.05 $263.00 $249.85 2026-07-18
86043 CPT Rbc Folic Acid 7 5 $224.00 $190.40 $160.16 $224.00 $212.80 2026-07-18
710 CDM Recovery Phase 1 Per 15 Min 14 5 $741.00 $629.85 $267.41 $1,108.00 $583.11 2026-07-18
P9016 HCPCS Red Blood Cells Lekoreduced 7 5 $645.00 $548.25 $461.18 $645.00 $612.75 2026-07-18
12035 CPT Repair Lac Interm 12.6-20.0 Cm 7 5 $260.00 $524.45 $524.45 $993.56 $870.80 2026-07-18
12034 CPT Repair Lac Interm 7.6-12.5 Cm 7 5 $225.00 $455.60 $477.75 $815.01 $748.80 2026-07-18
12013 CPT Repair Lac Simple 2.6-5.0 Cm 7 5 $130.00 $156.40 $225.89 $333.75 $261.70 2026-07-18
12002 CPT Repair Lac Simple 2.6-7.5 Cm 14 5 $493.50 $419.48 $217.93 $807.00 $441.50 2026-07-18
12014 CPT Repair Lac Simple 5.1-7.5 Cm 7 5 $135.00 $190.40 $190.40 $346.83 $317.35 2026-07-18
12011 CPT Repair Lac Simple <2.5 Cm 7 5 $110.00 $150.45 $217.93 $304.50 $251.59 2026-07-18
12001 CPT Repair Lac Simple <2.5 Cm 7 5 $109.00 $126.65 $181.13 $288.00 $211.20 2026-07-18
0202U CPT Respir Path 22 Targets Biofire 7 5 $997.00 $847.45 $712.86 $997.00 $947.15 2026-07-18
85245 CPT Ristocetin CoFactor 7 5 $200.00 $170.00 $143.00 $200.00 $190.00 2026-07-18
J3111 HCPCS Romosozumab-aqqg 210 Mg/2.34Ml 7 5 $5,807.51 $4,936.38 $4,152.37 $5,807.51 $5,517.13 2026-07-18
120 CDM Room Medical Unit Semi Private 7 5 $2,727.00 $2,317.95 $1,949.81 $2,727.00 $2,590.65 2026-07-18
110 CDM Room Respite 7 5 $513.00 $436.05 $366.80 $513.00 $487.35 2026-07-18
129 CDM Room Swing Bed Skilled 7 5 $1,892.00 $1,608.20 $1,352.78 $1,892.00 $1,797.40 2026-07-18
G0121 HCPCS Screen Colonoscopy Not Hi Risk 7 5 $542.00 $460.70 $376.13 $827.94 $761.25 2026-07-18
81229 CPT Snp Microarray Prenatal 7 5 $1,504.00 $1,278.40 $1,075.36 $1,504.00 $1,428.80 2026-07-18
84305 CPT Somatomedin 7 5 $238.00 $202.30 $170.17 $238.00 $226.10 2026-07-18
92523 CPT Speech Sound Lang Comp Or Expr 14 5 $384.00 $326.40 $264.55 $398.00 $361.33 2026-07-18
92507 CPT Speech Therapy Trmt 7 5 $310.00 $263.50 $221.65 $310.00 $294.50 2026-07-18
92610 CPT Swallow Eval Non Radiol 7 5 $394.00 $334.90 $281.71 $394.00 $374.30 2026-07-18
80197 CPT Tacrolimus 7 5 $254.00 $215.90 $181.61 $254.00 $241.30 2026-07-18
86481 CPT Tbint Quantiferon 7 5 $267.00 $226.95 $190.91 $267.00 $253.65 2026-07-18
J3245 HCPCS Tildrakizumab-asmn 100Mg/Ml Sy 7 5 $33,154.51 $28,181.33 $23,705.47 $33,154.51 $31,496.78 2026-07-18
88230 CPT Tissue Culture Non Neoplastic 7 5 $553.00 $470.05 $395.40 $553.00 $525.35 2026-07-18
86364 CPT Tissue Transglutaminase 7 5 $202.00 $171.70 $144.43 $202.00 $191.90 2026-07-18
J3262 HCPCS Tocilizumab 200 Mg/10 Ml Vial 21 5 $3,276.77 $2,785.25 $881.52 $6,657.64 $3,112.93 2026-07-18
G0390 HCPCS Trauma Team Level 5 7 5 $1,425.00 $1,211.25 $1,018.88 $1,425.00 $1,353.75 2026-07-18
27840 CPT Treat Ankle Dislocation Rt 7 5 $622.00 $528.70 $528.70 $955.64 $864.11 2026-07-18
84445 CPT Tsi 7 5 $276.00 $234.60 $197.34 $276.00 $262.20 2026-07-18
93306 CPT Tte W Doppler Complete 7 5 $2,590.00 $2,201.50 $1,851.85 $2,590.00 $2,460.50 2026-07-18
76770 CPT Ultrasound Abdo Back Wall Comp 7 5 $931.00 $791.35 $665.67 $931.00 $884.45 2026-07-18
76700 CPT Ultrasound Abdomen Complete 7 5 $1,467.00 $1,246.95 $1,048.91 $1,467.00 $1,393.65 2026-07-18
76705 CPT Ultrasound Abdomen Limited 7 5 $1,194.00 $1,014.90 $853.71 $1,194.00 $1,134.30 2026-07-18
76775 CPT Ultrasound Aorta 7 5 $926.00 $787.10 $662.09 $926.00 $879.70 2026-07-18
76882 CPT Ultrasound Axilla Rt 21 5 $740.00 $629.00 $488.35 $740.00 $676.36 2026-07-18
76857 CPT Ultrasound Bladder Limited 7 5 $752.00 $639.20 $537.68 $752.00 $714.40 2026-07-18
76604 CPT Ultrasound Chest 7 5 $819.00 $696.15 $585.59 $819.00 $778.05 2026-07-18
76536 CPT Ultrasound Head And Neck 7 5 $982.00 $834.70 $702.13 $982.00 $932.90 2026-07-18
76856 CPT Ultrasound Pelvic Complete 7 5 $986.00 $838.10 $704.99 $986.00 $936.70 2026-07-18
76870 CPT Ultrasound Scrotum 7 5 $1,089.00 $925.65 $778.64 $1,089.00 $1,034.55 2026-07-18
76830 CPT Ultrasound Transvaginal 7 5 $1,056.00 $897.60 $755.04 $1,056.00 $1,003.20 2026-07-18
76942 CPT US Guide For Needle Plcmnt Pc 7 5 $742.00 $630.70 $530.53 $742.00 $704.90 2026-07-18
93975 CPT Vascular Study 7 5 $1,989.00 $1,690.65 $1,422.14 $1,989.00 $1,889.55 2026-07-18
93976 CPT Vascular Study 7 5 $1,019.00 $866.15 $728.59 $1,019.00 $968.05 2026-07-18
93970 CPT Venous Duplex 7 5 $1,566.00 $1,331.10 $1,119.69 $1,566.00 $1,487.70 2026-07-18
84207 CPT Vitamin B6 7 5 $217.00 $184.45 $155.16 $217.00 $206.15 2026-07-18
82652 CPT Vitamin D 125 Dihydroxy 7 5 $283.00 $240.55 $202.35 $283.00 $268.85 2026-07-18
74019 CPT X-ray Abdomen 7 5 $523.00 $444.55 $373.95 $523.00 $496.85 2026-07-18
74018 CPT X-ray Abdomen 7 5 $370.00 $314.50 $264.55 $370.00 $351.50 2026-07-18
73050 CPT X-ray Ac Joints 7 5 $240.00 $204.00 $171.60 $240.00 $228.00 2026-07-18
73600 CPT X-ray Ankle 2 Views Lt 14 5 $271.00 $230.35 $193.77 $271.00 $257.45 2026-07-18
73610 CPT X-ray Ankle 3 Views Lt 14 5 $332.00 $282.20 $237.38 $332.00 $315.40 2026-07-18
71045 CPT X-ray Chest 1 View 7 5 $342.00 $290.70 $244.53 $342.00 $324.90 2026-07-18
71046 CPT X-ray Chest 2v PA/Lateral 7 5 $363.00 $308.55 $259.55 $363.00 $344.85 2026-07-18
73000 CPT X-ray Collar Bone Lt 14 5 $271.00 $230.35 $193.77 $271.00 $257.45 2026-07-18
73080 CPT X-ray Elbow Lt 14 5 $332.00 $282.20 $237.38 $332.00 $315.40 2026-07-18
73070 CPT X-ray Elbow Lt 14 5 $273.00 $232.05 $195.20 $273.00 $259.35 2026-07-18
73552 CPT X-ray Femur 2 Views Lt 14 5 $271.00 $230.35 $193.77 $271.00 $257.45 2026-07-18
73620 CPT X-ray Foot 2 Views Lt 14 5 $208.00 $176.80 $148.72 $208.00 $197.60 2026-07-18
73630 CPT X-ray Foot 3 Views Lt 14 5 $332.00 $282.20 $237.38 $332.00 $315.40 2026-07-18
73090 CPT X-ray Forearm 2 Views Lt 14 5 $206.00 $175.10 $147.29 $206.00 $195.70 2026-07-18
73130 CPT X-ray Hand Lt 14 5 $332.00 $282.20 $237.38 $332.00 $315.40 2026-07-18
73522 CPT X-ray Hips 3-4 Views Bi 7 5 $676.00 $574.60 $483.34 $676.00 $642.20 2026-07-18
73523 CPT X-ray Hips 5 Views Bi 7 5 $897.00 $762.45 $641.36 $897.00 $852.15 2026-07-18
73060 CPT X-ray Humerus Lt 14 5 $271.00 $230.35 $193.77 $271.00 $257.45 2026-07-18
73560 CPT X-ray Knee 1-2 Views Lt 14 5 $203.00 $172.55 $145.15 $203.00 $192.85 2026-07-18
73562 CPT X-ray Knee 3 Views Lt 14 5 $398.00 $338.30 $284.57 $398.00 $378.10 2026-07-18
73564 CPT X-ray Knee 4 Lt 14 5 $438.00 $372.30 $313.17 $438.00 $416.10 2026-07-18
73565 CPT X-ray Knees Bi 7 5 $533.00 $453.05 $381.10 $533.00 $506.35 2026-07-18
73590 CPT X-ray Lower Leg Lt 14 5 $271.00 $230.35 $193.77 $271.00 $257.45 2026-07-18
72120 CPT X-ray Ls Spine Bending 2-3 V 7 5 $411.00 $349.35 $293.87 $411.00 $390.45 2026-07-18
72100 CPT X-ray Lumbosacral 2-3 Views 7 5 $259.00 $220.15 $185.19 $259.00 $246.05 2026-07-18
72110 CPT X-ray Lumbosacral 4 Views 7 5 $341.00 $289.85 $243.82 $341.00 $323.95 2026-07-18
70110 CPT X-ray Mandible 4 Views 7 5 $543.00 $461.55 $388.25 $543.00 $515.85 2026-07-18
70360 CPT X-ray Neck Soft Tissue 7 5 $465.00 $395.25 $332.48 $465.00 $441.75 2026-07-18
72170 CPT X-ray Pelvis 1-2 Views 7 5 $542.00 $460.70 $387.53 $542.00 $514.90 2026-07-18
71100 CPT X-ray Ribs 2 Views Lt 14 5 $311.00 $264.35 $222.37 $311.00 $295.45 2026-07-18
71110 CPT X-ray Ribs Bilateral 3 Views 7 5 $251.00 $213.35 $179.47 $251.00 $238.45 2026-07-18
71101 CPT X-ray Ribs Uni W Chest Lt 14 5 $413.00 $351.05 $295.30 $413.00 $392.35 2026-07-18
72220 CPT X-ray Sacrum Tailbone 7 5 $347.00 $294.95 $248.11 $347.00 $329.65 2026-07-18
73010 CPT X-ray Shoulder Blade Lt 7 5 $310.00 $263.50 $221.65 $310.00 $294.50 2026-07-18
73030 CPT X-ray Shoulder Lt 14 5 $302.00 $256.70 $215.93 $302.00 $286.90 2026-07-18
70210 CPT X-ray Sinus < 3 Views 7 5 $477.00 $405.45 $341.06 $477.00 $453.15 2026-07-18
70250 CPT X-ray Skull < 4 Views 7 5 $255.00 $216.75 $182.33 $255.00 $242.25 2026-07-18
72040 CPT X-ray Spine Cervical 2-3 Views 7 5 $271.00 $230.35 $193.77 $271.00 $257.45 2026-07-18
72050 CPT X-ray Spine Cervical 4-5 Views 7 5 $378.00 $321.30 $270.27 $378.00 $359.10 2026-07-18
72070 CPT X-ray Spine Thoracic 2 Views 7 5 $525.00 $446.25 $375.38 $525.00 $498.75 2026-07-18
73100 CPT X-ray Wrist 2 Views Lt 14 5 $228.00 $193.80 $163.02 $228.00 $216.60 2026-07-18
73110 CPT X-ray Wrist 3 Views Lt 14 5 $332.00 $282.20 $237.38 $332.00 $315.40 2026-07-18
80203 CPT Zonisamide 7 5 $289.00 $245.65 $206.64 $289.00 $274.55 2026-07-18
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