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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

LANDMANN-JUNGMAN MEMORIAL HOSPITAL - CAH

Scotland, SD · CCN 431317 · Rates published

594 distinct procedures filed
6 distinct payers
8,293 rate rows
2026-10-09 last MRF observed
Data quality

8,275 of 8,293 rate rows are consumer-grade (99.8%)

18 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
exceeds 10× this hospital's gross charge — excluded from medians 12
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 4
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/d99637b9-e0f3-44c9-8ed7-babbb31f95f8/466015787_landmann-jungman-hospital_standardcharges.csv
Found on page https://www.avera.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-10
Content fingerprint 48c6b7311f7b3441… · 2,103,604 bytes · first seen 2026-10-10

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
1313
APR_DRG 		Apr-DRG 1313 1 $22,783.42 $22,783.42 $22,783.42 nat. median
$19,006
1.2× median
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 5 $0.41 $19,265.18 $15,652.96 nat. median
$3,824
outlier · 4.1×
6631
APR_DRG 		Apr-DRG 6631 1 $14,284.81 $14,284.81 $14,284.81 nat. median
$4,311
outlier · 3.3×
74177
CPT 		CT Abd & Pelv W Contrast 6 $227.52 $4,601.56 $4,371.48 nat. median
$972
outlier · 4.5×
72158
CPT 		MRI Lumbar Spine Wwo Dye 5 $340.97 $4,976.27 $4,244.76 nat. median
$1,090
outlier · 3.9×
73721
CPT 		MRI Joint Le Wo Dye Rt 6 $315.18 $4,267.25 $3,846.93 nat. median
$852
outlier · 4.5×
72148
CPT 		MRI Lumbar Spine Wo Dye 6 $315.18 $4,267.25 $3,846.93 nat. median
$804
outlier · 4.8×
72141
CPT 		MRI Neck Spine Wo Dye 5 $233.96 $4,267.25 $3,846.93 nat. median
$778
outlier · 4.9×
J0897
HCPCS 		Denosumab 60 Mg/ml Syringe 5 $9.69 $4,598.30 $3,736.12 nat. median
$1,973
1.9× median
73221
CPT 		MRI Joint Ue Wo Dye Rt 5 $408.12 $4,267.25 $3,639.96 nat. median
$842
outlier · 4.3×
70553
CPT 		MRI Brain Wwo Contrast 5 $729.77 $4,267.25 $3,639.96 nat. median
$1,132
outlier · 3.2×
72197
CPT 		MRI Pelvis Wwo Dye 5 $618.17 $4,288.46 $3,484.38 nat. median
$1,063
outlier · 3.3×
72146
CPT 		MRI Chest Spine Wo Dye 5 $390.63 $4,267.25 $3,467.14 nat. median
$794
outlier · 4.4×
74183
CPT 		MRI Abdomen Wwo Dye 5 $619.08 $3,493.59 $3,149.47 nat. median
$1,099
outlier · 2.9×
72157
CPT 		MRI Chest Spine Wwo Dye 5 $535.35 $3,728.92 $3,029.75 nat. median
$1,103
outlier · 2.7×
72156
CPT 		MRI Neck Spine Wwo Dye 5 $340.05 $3,496.62 $2,841.01 nat. median
$1,103
outlier · 2.6×
74176
CPT 		CT Abd & Pelvis Wo Contrast 6 $95.04 $3,129.99 $2,821.68 nat. median
$694
outlier · 4.1×
87154
CPT 		Culture Id By Amp Prb 6 Or 6+ 5 $2,029.90 $3,122.92 $2,815.31 nat. median
$289
outlier · 9.7×
74170
CPT 		CT Abdomen Wwo Dye 5 $58.22 $2,845.17 $2,564.92 nat. median
$710
outlier · 3.6×
93306
CPT 		Tte W Doppler Complete 5 $1,849.36 $2,845.17 $2,564.92 nat. median
$993
outlier · 2.6×
71260
CPT 		CT Thorax W Contrast 6 $80.31 $2,643.17 $2,537.44 nat. median
$648
outlier · 3.9×
J1439
HCPCS 		Ferric Carboxymalt 750mg/15ml 5 $11.91 $3,097.42 $2,516.65 nat. median
$14
outlier · 174.8×
73723
CPT 		MRI Joint Le Wwo Dye Lt 5 $657.06 $3,311.79 $2,505.60 nat. median
$1,191
outlier · 2.1×
72125
CPT 		CT Cervical Spine Wo Contrast 5 $172.58 $2,778.51 $2,504.82 nat. median
$472
outlier · 5.3×
72131
CPT 		CT Lumbar Spine Wo Contrast 5 $234.87 $2,845.17 $2,426.93 nat. median
$457
outlier · 5.3×
C8929
HCPCS 		Echo M Mode 2d W Contrast 5 $1,849.36 $2,845.17 $2,337.30 nat. median
$1,358
1.7× median
70470
CPT 		CT Head/Brain Wwo Contrast 5 $241.32 $2,845.17 $2,311.70 nat. median
$619
outlier · 3.7×
73718
CPT 		MRI Le Wo Dye Lt 5 $56.39 $2,740.13 $2,226.36 nat. median
$866
outlier · 2.6×
70450
CPT 		CT Head/Brain Wo Contrast 6 $1,480.41 $2,277.55 $2,209.22 nat. median
$450
outlier · 4.9×
70491
CPT 		CT Soft Tissue Neck W Cont 5 $357.53 $2,498.74 $2,030.23 nat. median
$627
outlier · 3.2×
11420
CPT 		Exc Ben Lesion <0.5 Neck Ext 5 $1,579.73 $2,430.36 $1,996.54 nat. median
$1,523
1.3× median
70486
CPT 		CT Maxillofacial Wo Contrast 5 $187.95 $2,189.68 $1,974.00 nat. median
$477
outlier · 4.1×
74178
CPT 		CT Abd & Pelv Wwo Contrast 5 $479.88 $2,284.62 $1,948.78 nat. median
$1,024
1.9× median
72128
CPT 		CT Thoracic Spine Wo Contrast 5 $107.93 $2,134.13 $1,923.91 nat. median
$458
outlier · 4.2×
71250
CPT 		CT Thorax Wo Contrast 5 $71.13 $2,240.18 $1,910.87 nat. median
$464
outlier · 4.1×
70498
CPT 		CT Angiography Neck W Cont 5 $278.39 $2,118.98 $1,910.26 nat. median
$736
outlier · 2.6×
72193
CPT 		CT Pelvis W Dye 5 $593.33 $2,315.93 $1,881.70 nat. median
$637
outlier · 3.0×
71275
CPT 		CTA Chest Wwo Contrast 5 $1,272.95 $1,958.39 $1,880.06 nat. median
$753
outlier · 2.5×
86366
CPT 		Musk Antibody Ref 5 $18.40 $2,283.61 $1,875.99 nat. median
$41
outlier · 45.5×
70460
CPT 		CT Head/Brain W Contrast 5 $61.91 $2,159.38 $1,754.49 nat. median
$575
outlier · 3.1×
72192
CPT 		CT Pelvis Wo Dye 5 $597.02 $2,085.65 $1,694.59 nat. median
$458
outlier · 3.7×
G0390
HCPCS 		Trauma Team Level 5 5 $1,290.09 $1,984.76 $1,630.48 nat. median
$3,212
0.5× median
73700
CPT 		CT Le Wo Dye Lt 5 $76.65 $1,993.74 $1,619.91 nat. median
$498
outlier · 3.3×
689
CDM 		Trauma Team Evaluation Level 5 5 $1,257.85 $1,935.16 $1,589.74 nat. median
$1,169
1.4× median
76700
CPT 		Ultrasound Abdomen Complete 5 $1,110.14 $1,707.91 $1,539.68 nat. median
$310
outlier · 5.0×
27810
CPT 		Fx Bimalleolar Ankle W Man Lt 5 $882.31 $2,297.00 $1,510.28 nat. median
$1,643
0.9× median
70496
CPT 		CT Angiography Head W Cont 5 $246.84 $1,664.48 $1,500.53 nat. median
$746
outlier · 2.0×
93880
CPT 		Extracranial Bilat Study 5 $1,110.14 $1,707.91 $1,456.85 nat. median
$530
outlier · 2.7×
93970
CPT 		Venous Duplex 5 $1,045.15 $1,607.92 $1,320.91 nat. median
$564
outlier · 2.3×
76705
CPT 		Ultrasound Abdomen Limited 5 $741.19 $1,140.29 $1,083.28 nat. median
$277
outlier · 3.9×

Other procedures at this hospital

Browse this hospital's 594 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
             
Q9967 HCPCS Iopamidol-370 100 Ml Vial 13 6 $800.00 $776.00 $253.80 $800.00 $760.00 2026-10-09
Q9957 HCPCS Perflutren Lip Micro 2.2mg/2ml 8 5 $305.00 $296.09 $47.75 $305.25 $248.01 2026-10-09
Q9956 HCPCS Perflutren Protein-a Microdota 8 5 $255.00 $248.08 $77.76 $255.75 $207.80 2026-10-09
P9047 HCPCS Albumin Human 25% 25gr/100ml 6 5 $249.00 $242.34 $162.40 $249.84 $225.23 2026-10-09
P9016 HCPCS Red Blood Cells Lekoreduced 10 5 $696.00 $675.99 $452.99 $1,393.80 $628.26 2026-10-09
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Syrng 8 5 $19,265.00 $18,687.22 $0.41 $19,265.18 $15,652.96 2026-10-09
J2003 HCPCS Lidocaine 1% 20 Ml Vial 19 5 $239.00 $232.76 $39.36 $365.96 $155.97 2026-10-09
J1815 HCPCS Insulin Aspart 100Unit/ML 10ml 20 5 $181.00 $175.66 $57.86 $391.85 $160.41 2026-10-09
J1439 HCPCS Ferric Carboxymalt 750mg/15ml 8 5 $3,097.00 $3,004.50 $11.91 $3,097.42 $2,516.65 2026-10-09
J0897 HCPCS Denosumab 60 Mg/ml Syringe 8 5 $4,598.00 $4,460.35 $9.69 $4,598.30 $3,736.12 2026-10-09
J0500 HCPCS Dicyclomine 20 Mg/2 Ml Ampule 8 5 $267.00 $259.20 $8.88 $267.22 $217.12 2026-10-09
J0136 HCPCS Acetamin IV (b Braun) 1,000 Mg 10 5 $324.00 $314.61 $16.88 $324.34 $263.52 2026-10-09
J0134 HCPCS Acetaminoph IV(Fresenius Kabi) 12 6 $204.00 $198.36 $21.48 $317.78 $184.35 2026-10-09
J0131 HCPCS Acetaminophen 1000mg/100ml Via 8 5 $246.00 $239.41 $145.73 $246.81 $200.53 2026-10-09
G0404 HCPCS EKG Welcome To Medicare 8 5 $196.00 $191.04 $128.02 $196.95 $161.80 2026-10-09
G0402 HCPCS Welcome To Medicare Visit 8 5 $193.00 $187.51 $125.65 $193.31 $158.80 2026-10-09
G0399 HCPCS Sleep Study Type Iii Portable 12 6 $369.00 $358.57 $240.28 $369.66 $354.88 2026-10-09
G0390 HCPCS Trauma Team Level 5 8 5 $1,984.00 $1,925.22 $1,290.09 $1,984.76 $1,630.48 2026-10-09
G0379 HCPCS Observation Assess Direct Adm 8 5 $919.00 $892.06 $597.77 $919.65 $755.49 2026-10-09
G0378 HCPCS Observation 1st Hour 21 5 $527.00 $511.40 $40.05 $1,266.54 $342.69 2026-10-09
G0260 HCPCS Injection Si Joint Anes Lt 8 5 $1,038.00 $1,007.62 $675.21 $1,038.78 $853.36 2026-10-09
G0103 HCPCS Psa Screen 12 5 $200.00 $194.96 $130.64 $200.99 $181.19 2026-10-09
C8929 HCPCS Echo M Mode 2d W Contrast 8 5 $2,845.00 $2,759.81 $1,849.36 $2,845.17 $2,337.30 2026-10-09
A9585 HCPCS Gadobutrol Inj 10 Mm/10 Ml Vl 19 5 $400.00 $388.00 $2.69 $400.00 $300.00 2026-10-09
99397 CPT Preventive Exam 65 Year Est 9 5 $190.00 $185.16 $124.08 $190.89 $162.83 2026-10-09
99292 CPT Critical Care Ea Addl 30 Min 16 5 $380.00 $369.35 $164.83 $380.77 $273.58 2026-10-09
99291 CPT Critical Care 1st 30-74 Min 16 5 $1,280.00 $1,242.26 $329.00 $1,280.68 $920.17 2026-10-09
99285 CPT Emergency Room Visit Level 5 15 5 $927.00 $899.36 $267.73 $927.18 $616.57 2026-10-09
99284 CPT Emergency Room Visit Level 4 19 6 $639.00 $620.15 $184.86 $639.33 $505.07 2026-10-09
99283 CPT Emergency Room Visit Level 3 18 5 $412.00 $399.72 $108.68 $412.08 $321.84 2026-10-09
99282 CPT Emergency Room Visit Level 2 11 6 $236.00 $229.25 $153.62 $236.34 $212.70 2026-10-09
99239 CPT IP/Obs Discharge >30 Min 6 5 $115.00 $111.69 $179.47 $243.58 $204.89 2026-10-09
99233 CPT Inpatient/Obs Subsequent High 6 5 $111.00 $107.77 $184.54 $250.08 $204.29 2026-10-09
99223 CPT IP/Obs Initial High Comp 6 5 $215.00 $208.68 $270.04 $389.40 $334.66 2026-10-09
99222 CPT Inpatient Initial/Obs Mod Comp 6 5 $145.00 $141.08 $202.33 $274.01 $246.06 2026-10-09
99221 CPT Inpatient/Obs Initial Low Comp 6 5 $108.00 $104.83 $127.26 $194.22 $157.56 2026-10-09
99212 CPT Est Patient Level 2 Sf Comp 9 5 $193.00 $187.51 $125.65 $193.31 $164.89 2026-10-09
99211 CPT Care/Removal Urinary Catheter 36 5 $191.50 $186.33 $117.00 $200.99 $160.81 2026-10-09
99202 CPT New Patient Level 2 Sf Comp 8 5 $193.00 $187.51 $125.65 $193.31 $158.80 2026-10-09
97597 CPT Debride Wound 1st 20 Cm 8 5 $431.00 $418.33 $280.33 $431.27 $354.28 2026-10-09
97166 CPT Ot Eval Mod Complexity 8 5 $260.00 $252.76 $169.38 $260.58 $214.06 2026-10-09
97165 CPT Ot Eval Low Complexity 10 5 $239.00 $232.19 $155.59 $239.37 $215.79 2026-10-09
97164 CPT Re Evaluation Pt 10 5 $186.00 $181.24 $121.45 $186.85 $159.38 2026-10-09
97163 CPT Pt Eval High Complexity 8 5 $274.00 $266.48 $178.57 $274.72 $225.69 2026-10-09
97162 CPT Pt Eval Mod Complexity 13 6 $267.00 $259.62 $173.97 $267.65 $254.27 2026-10-09
97161 CPT Pt Eval Low Complexity 12 6 $247.00 $240.03 $160.84 $247.45 $237.56 2026-10-09
96523 CPT Implanted Vad Flush 8 5 $210.00 $203.78 $136.55 $210.08 $172.58 2026-10-09
96376 CPT IV Injection Ea Addl Same Drug 19 5 $173.00 $168.51 $112.92 $216.14 $168.51 2026-10-09
96374 CPT IV Push Injection Initial 23 5 $316.00 $306.56 $202.86 $316.04 $269.58 2026-10-09
96365 CPT Inf Therapy Med Initial 24 6 $430.00 $417.35 $200.89 $430.26 $309.06 2026-10-09
96360 CPT Inf Therapy Hyd Initial 22 6 $500.00 $485.93 $200.89 $500.96 $309.06 2026-10-09
96125 CPT Cognitive Performance Test St 8 5 $417.00 $404.62 $271.13 $417.13 $342.67 2026-10-09
94664 CPT Inhalation Treat Chronic Init 8 5 $305.00 $295.94 $198.31 $305.09 $250.63 2026-10-09
94660 CPT CPap/BiPap First Day 19 5 $305.00 $295.94 $198.31 $586.81 $305.09 2026-10-09
94640 CPT Inhalation Treat Acute Initial 41 6 $308.00 $298.81 $198.31 $616.10 $262.77 2026-10-09
94060 CPT Pft Pre & Post Screen Spirome 8 5 $607.00 $588.80 $394.56 $607.01 $498.66 2026-10-09
93975 CPT Vascular Study 8 5 $1,168.00 $1,133.51 $759.57 $1,168.57 $959.98 2026-10-09
93971 CPT Extremity Study Lt 16 5 $932.00 $904.26 $605.95 $932.23 $765.83 2026-10-09
93970 CPT Venous Duplex 8 5 $1,607.00 $1,559.68 $1,045.15 $1,607.92 $1,320.91 2026-10-09
93931 CPT Arterial Duplex Ue Lt 8 5 $583.00 $566.27 $379.46 $583.78 $479.57 2026-10-09
93926 CPT Arterial Duplex Le Lt 16 5 $832.00 $807.27 $540.96 $832.24 $683.68 2026-10-09
93922 CPT Ankle Arm Screen 8 5 $480.00 $466.34 $312.49 $480.76 $394.94 2026-10-09
93880 CPT Extracranial Bilat Study 11 5 $1,707.00 $1,656.67 $1,110.14 $1,707.91 $1,456.85 2026-10-09
93798 CPT Cardiac Rehab Ii Monitored 11 5 $358.00 $347.79 $233.06 $358.55 $305.84 2026-10-09
93356 CPT Myocardial Strain Image Speckl 8 5 $535.00 $519.24 $347.94 $535.30 $439.75 2026-10-09
93306 CPT Tte W Doppler Complete 10 5 $2,845.00 $2,759.81 $1,849.36 $2,845.17 $2,564.92 2026-10-09
93246 CPT Ext ECG >7 Days Hook Up 11 5 $212.00 $205.74 $137.87 $212.10 $180.92 2026-10-09
93242 CPT Ext ECG 48 Hrs -7days Hook Up 8 5 $212.00 $205.74 $137.87 $212.10 $174.24 2026-10-09
93226 CPT ECG Monit/Report Up To 48 Hour 8 5 $628.00 $609.37 $408.34 $628.22 $516.08 2026-10-09
93225 CPT Holter Monitor Hook Up <48 Hrs 8 5 $548.00 $531.98 $356.48 $548.43 $450.53 2026-10-09
93005 CPT EKG Tracing 13 6 $196.00 $191.04 $128.02 $196.95 $187.10 2026-10-09
92612 CPT Eval Endo Swallow Function 8 5 $979.00 $950.31 $636.80 $979.70 $804.82 2026-10-09
92610 CPT Swallow Eval Non Radiol 8 5 $701.00 $680.89 $456.27 $701.95 $576.65 2026-10-09
92526 CPT Dysphagia Treatment 8 5 $354.00 $343.87 $230.43 $354.51 $291.23 2026-10-09
90739 CPT HepB Adult 2 Dose IM 8 5 $302.00 $292.94 $146.96 $302.00 $245.38 2026-10-09
90677 CPT Pneumo Conjugate Vaccine 20 Va 11 5 $364.00 $353.67 $237.00 $380.34 $353.67 2026-10-09
87799 CPT Bk Virus Quant Pcr, Serum 21 5 $1,033.00 $1,002.23 $206.80 $1,033.23 $318.15 2026-10-09
87641 CPT Mrsa By Pcr 8 5 $336.00 $326.24 $218.61 $336.33 $276.29 2026-10-09
87637 CPT Influ/RSV/CoV2 Pcr Ceph 11 5 $466.00 $452.62 $303.30 $466.62 $398.03 2026-10-09
87636 CPT Influ & CoV2 Pcr Ceph 10 5 $466.00 $452.62 $303.30 $466.62 $420.66 2026-10-09
87591 CPT N Gonorrhoeae DNA Amp Probe 11 5 $225.00 $218.47 $146.40 $225.23 $213.97 2026-10-09
87536 CPT HIV 1 Na Quan 8 5 $565.00 $548.63 $367.64 $565.60 $464.64 2026-10-09
87502 CPT Influenza A&b By Pcr 11 5 $278.00 $270.40 $181.19 $278.76 $237.78 2026-10-09
87497 CPT Cmv Quant By Pcr 10 5 $520.00 $504.55 $338.10 $520.15 $468.91 2026-10-09
87493 CPT C Diff By Pcr 11 5 $162.00 $157.73 $105.70 $162.61 $154.48 2026-10-09
87491 CPT Chlamydia DNA Amp Probe 11 5 $225.00 $218.47 $146.40 $225.23 $213.97 2026-10-09
87449 CPT Beta D Glucan 24 5 $258.00 $250.80 $28.89 $258.56 $185.78 2026-10-09
87385 CPT Histoplasma Antigen 16 5 $273.00 $265.13 $115.05 $369.66 $208.64 2026-10-09
87338 CPT H Pylori Antigen Stool 10 5 $184.00 $179.29 $120.14 $184.83 $166.62 2026-10-09
87329 CPT Giardia Antigen 10 5 $176.00 $171.45 $114.89 $176.75 $159.34 2026-10-09
87305 CPT Aspergillus Galact Antigen 8 5 $710.00 $688.73 $461.52 $710.03 $583.29 2026-10-09
87252 CPT Culture Viral 8 5 $242.00 $235.13 $157.56 $242.40 $199.13 2026-10-09
87154 CPT Culture Id By Amp Prb 6 Or 6+ 10 5 $3,122.00 $3,029.23 $2,029.90 $3,122.92 $2,815.31 2026-10-09
87116 CPT Culture Afb 10 5 $228.00 $221.41 $148.37 $228.26 $205.78 2026-10-09
87107 CPT Fungal Id Ea Organism Mold 8 5 $239.00 $232.19 $155.59 $239.37 $196.64 2026-10-09
86920 CPT Crossmatch Immed Spin 10 5 $239.00 $232.19 $155.59 $478.74 $215.79 2026-10-09
86671 CPT Saccharomyces Antibody 8 5 $194.00 $188.18 $126.10 $194.00 $159.37 2026-10-09
86665 CPT Epstein Barr Capsid IgM 8 5 $185.00 $180.26 $120.80 $185.84 $152.67 2026-10-09
86635 CPT Coccidioides Antibody 8 5 $232.00 $225.33 $151.00 $232.30 $190.84 2026-10-09
86618 CPT Lyme Disease Antibody 8 5 $224.00 $217.49 $145.74 $224.22 $184.19 2026-10-09
86480 CPT Tbint Quantiferon 11 5 $378.00 $367.39 $246.19 $378.75 $359.81 2026-10-09
86366 CPT Musk Antibody Ref 10 5 $2,283.00 $2,215.10 $18.40 $2,283.61 $1,875.99 2026-10-09
86364 CPT Tissue Transglutaminase 8 5 $242.00 $235.13 $157.56 $242.40 $199.13 2026-10-09
86334 CPT Immunofix Electroph Serum 8 5 $239.00 $232.19 $155.59 $239.37 $196.64 2026-10-09
86255 CPT Striational Antibody 10 5 $293.00 $284.21 $12.05 $293.00 $240.70 2026-10-09
86235 CPT Ssb Ena Antibody 8 5 $253.00 $245.90 $164.78 $253.51 $208.25 2026-10-09
86225 CPT DNA Double Strand Antibody 8 5 $253.00 $245.90 $164.78 $253.51 $208.25 2026-10-09
86160 CPT C4 Complement 8 5 $228.00 $221.41 $148.37 $228.26 $187.52 2026-10-09
86041 CPT Acetylcholine Binding Aby 10 5 $283.00 $274.51 $18.40 $283.00 $232.49 2026-10-09
86039 CPT Ana By Ifa Titer 10 5 $176.00 $171.45 $114.89 $176.75 $159.34 2026-10-09
85240 CPT Factor 8 8 5 $292.00 $284.11 $190.38 $292.90 $240.62 2026-10-09
84484 CPT Troponin Quant 13 6 $181.00 $176.35 $118.17 $181.80 $172.71 2026-10-09
84481 CPT T3 Free 10 5 $222.00 $215.53 $144.43 $222.20 $200.31 2026-10-09
84445 CPT Tsi 8 5 $263.00 $255.70 $171.35 $263.61 $216.56 2026-10-09
84425 CPT Vitamin B1 8 5 $548.00 $531.98 $356.48 $548.43 $450.53 2026-10-09
84403 CPT Testosterone Total Ref 31 5 $186.00 $181.24 $107.01 $196.95 $159.38 2026-10-09
84402 CPT Testosterone Fre Female/Child 21 5 $247.00 $240.03 $154.93 $247.45 $211.07 2026-10-09
84270 CPT Sex Hormone Binding Globulin 8 5 $217.00 $210.64 $141.15 $217.15 $178.39 2026-10-09
84244 CPT Renin 8 5 $311.00 $301.75 $202.20 $311.08 $255.55 2026-10-09
84154 CPT Psa Free 10 5 $226.00 $219.45 $147.06 $226.24 $203.95 2026-10-09
84153 CPT Psa Total 12 6 $200.00 $194.96 $130.64 $200.99 $181.19 2026-10-09
84146 CPT Prolactin 8 5 $238.00 $231.21 $154.93 $238.36 $195.81 2026-10-09
84145 CPT Procalcitonin 10 5 $304.00 $294.89 $197.61 $304.01 $274.06 2026-10-09
84144 CPT Progesterone 10 5 $238.00 $231.21 $154.93 $238.36 $214.88 2026-10-09
83993 CPT Calprotectin 9 5 $835.00 $810.21 $542.93 $835.27 $712.49 2026-10-09
83970 CPT Pth 11 6 $384.00 $373.27 $250.13 $384.81 $365.57 2026-10-09
83880 CPT B Type Natriuretic Peptide 11 5 $271.00 $263.54 $176.60 $271.69 $231.75 2026-10-09
83010 CPT Haptoglobin Quant 10 5 $176.00 $171.45 $114.89 $176.75 $159.34 2026-10-09
83002 CPT Lh 10 5 $225.00 $218.47 $146.40 $225.23 $203.05 2026-10-09
83001 CPT Fsh 8 5 $230.00 $223.37 $149.68 $230.28 $189.18 2026-10-09
82803 CPT Blood Gas Wo Oximetry 10 5 $269.00 $261.58 $175.29 $269.67 $243.11 2026-10-09
82746 CPT Folic Acid Blood 11 5 $185.00 $180.26 $120.80 $185.84 $176.55 2026-10-09
82728 CPT Ferritin 12 6 $167.00 $162.63 $108.98 $167.66 $160.95 2026-10-09
82671 CPT Estrogen Fractionated 10 5 $521.00 $505.53 $338.75 $521.16 $469.83 2026-10-09
82670 CPT Estradiol Total 8 5 $211.00 $204.76 $137.21 $211.09 $173.41 2026-10-09
82607 CPT B12 13 6 $217.00 $210.64 $141.15 $217.15 $206.29 2026-10-09
82533 CPT Cortisol Total 8 5 $252.00 $244.93 $164.12 $252.50 $207.43 2026-10-09
82306 CPT 25 Hydvit D2 And D3 24 6 $138.00 $134.22 $89.94 $396.93 $260.98 2026-10-09
82166 CPT Mullerian Inhib Hormone 8 5 $244.00 $237.09 $158.87 $244.42 $200.79 2026-10-09
82105 CPT Afp Tm 8 5 $203.00 $196.92 $131.96 $203.01 $166.77 2026-10-09
82088 CPT Aldosterone 8 5 $228.00 $221.41 $148.37 $228.26 $187.52 2026-10-09
81418 CPT Pharmacogenomic Geno 8 5 $245.00 $238.07 $159.53 $245.43 $201.62 2026-10-09
81241 CPT Factor V Leiden Mutation 8 5 $197.00 $192.02 $128.67 $197.96 $162.62 2026-10-09
80306 CPT Drug Screen Urine Inst Ass Obv 12 6 $227.00 $220.43 $147.71 $227.25 $204.87 2026-10-09
80197 CPT Tacrolimus 9 5 $309.00 $299.79 $200.89 $309.06 $263.63 2026-10-09
80177 CPT Levetiracetam 9 5 $358.00 $347.79 $233.06 $358.55 $305.84 2026-10-09
80159 CPT Clozapine 8 5 $199.00 $193.98 $129.99 $199.98 $164.28 2026-10-09
80143 CPT Acetaminophen 8 5 $199.00 $193.98 $129.99 $199.98 $164.28 2026-10-09
80074 CPT Acute Hepatitis Panel 11 5 $432.00 $419.31 $280.98 $432.28 $410.67 2026-10-09
80061 CPT Lipid Panel 13 6 $192.00 $187.12 $125.39 $192.91 $183.26 2026-10-09
80053 CPT Comprehensive Metabolic Panel 14 6 $308.00 $298.81 $200.23 $308.05 $292.65 2026-10-09
80051 CPT Electrolyte Panel 8 5 $207.00 $200.84 $134.58 $207.05 $170.09 2026-10-09
80050 CPT General Health Panel 13 6 $926.00 $898.38 $590.85 $926.17 $790.02 2026-10-09
80048 CPT Basic Metabolic Panel 14 6 $192.00 $187.12 $125.39 $192.91 $183.26 2026-10-09
77080 CPT Dexa Scan 11 5 $518.00 $502.59 $88.61 $518.13 $441.96 2026-10-09
77067 CPT Mammography Screening Digital 13 6 $565.00 $548.63 $367.64 $565.60 $537.32 2026-10-09
76882 CPT US Extremity Nonvasc Limit Rt 18 5 $239.00 $232.19 $155.59 $239.37 $204.18 2026-10-09
76870 CPT Ultrasound Scrotum 10 5 $534.00 $518.26 $347.29 $534.29 $481.66 2026-10-09
76857 CPT Ultrasound Bladder Limited 8 5 $509.00 $493.77 $330.88 $509.04 $418.17 2026-10-09
76856 CPT Ultrasound Pelvic Complete 8 5 $887.00 $861.16 $577.06 $887.79 $729.32 2026-10-09
76830 CPT Ultrasound Transvaginal 10 5 $1,140.00 $1,106.08 $741.19 $1,140.29 $1,027.97 2026-10-09
76817 CPT Transvaginal US Obstetrical 8 5 $445.00 $432.05 $289.52 $445.41 $365.90 2026-10-09
76805 CPT OB US >14 Wk Tvta Single Fetus 10 5 $550.00 $533.94 $357.79 $550.45 $496.23 2026-10-09
76801 CPT OB US < 14 Wks Single Fetus 10 5 $518.00 $502.59 $336.78 $518.13 $467.09 2026-10-09
76775 CPT Ultrasound Aorta 19 5 $835.00 $810.21 $342.04 $835.27 $526.21 2026-10-09
76770 CPT Ultrasound Abdo Back Wall Comp 8 5 $1,047.00 $1,015.95 $680.79 $1,047.37 $860.41 2026-10-09
76705 CPT Ultrasound Abdomen Limited 11 5 $1,140.00 $1,106.08 $741.19 $1,140.29 $1,083.28 2026-10-09
76700 CPT Ultrasound Abdomen Complete 10 5 $1,707.00 $1,656.67 $1,110.14 $1,707.91 $1,539.68 2026-10-09
76536 CPT Ultrasound Head And Neck 11 5 $877.00 $851.36 $570.50 $877.69 $748.67 2026-10-09
74183 CPT MRI Abdomen Wwo Dye 10 5 $3,493.00 $3,388.78 $619.08 $3,493.59 $3,149.47 2026-10-09
74178 CPT CT Abd & Pelv Wwo Contrast 11 5 $2,284.00 $2,216.08 $479.88 $2,284.62 $1,948.78 2026-10-09
74177 CPT CT Abd & Pelv W Contrast 13 6 $4,601.00 $4,463.51 $227.52 $4,601.56 $4,371.48 2026-10-09
74176 CPT CT Abd & Pelvis Wo Contrast 12 6 $3,129.00 $3,036.09 $95.04 $3,129.99 $2,821.68 2026-10-09
74170 CPT CT Abdomen Wwo Dye 10 5 $2,845.00 $2,759.81 $58.22 $2,845.17 $2,564.92 2026-10-09
74022 CPT X-ray Series Abdomen 8 5 $464.00 $450.66 $301.99 $661.43 $446.01 2026-10-09
74019 CPT X-ray Abdomen 11 5 $516.00 $500.63 $335.47 $660.48 $500.63 2026-10-09
74018 CPT X-ray Abdomen 10 5 $378.00 $367.39 $246.19 $523.40 $373.07 2026-10-09
73723 CPT MRI Joint Le Wwo Dye Lt 16 5 $3,094.00 $3,001.81 $657.06 $3,311.79 $2,505.60 2026-10-09
73721 CPT MRI Joint Le Wo Dye Rt 20 6 $4,267.00 $4,139.23 $315.18 $4,267.25 $3,846.93 2026-10-09
73718 CPT MRI Le Wo Dye Lt 16 5 $2,740.00 $2,657.93 $56.39 $2,740.13 $2,226.36 2026-10-09
73700 CPT CT Le Wo Dye Lt 16 5 $1,993.00 $1,933.93 $76.65 $1,993.74 $1,619.91 2026-10-09
73660 CPT X-ray Toe(s) 2 Views Rt 19 5 $217.00 $210.64 $66.51 $217.15 $185.23 2026-10-09
73650 CPT X-ray Heel 2 Views Lt 8 5 $229.00 $222.39 $64.68 $229.27 $186.28 2026-10-09
73630 CPT X-ray Foot 3 Views Rt 23 6 $441.00 $428.13 $65.60 $441.37 $419.30 2026-10-09
73620 CPT X-ray Foot 2 Views Rt 8 5 $228.00 $221.41 $148.37 $228.26 $212.82 2026-10-09
73610 CPT X-ray Ankle 3 Views Lt 21 5 $427.00 $414.41 $99.63 $427.23 $405.87 2026-10-09
73600 CPT X-ray Ankle 2 Views Lt 20 5 $228.00 $221.41 $86.75 $228.26 $205.78 2026-10-09
73590 CPT X-ray Lower Leg Lt 20 5 $414.00 $401.68 $73.88 $414.10 $373.31 2026-10-09
73564 CPT X-ray Knee 4 Lt 16 5 $410.00 $397.76 $129.06 $410.06 $333.17 2026-10-09
73562 CPT X-ray Knee 3 Views Lt 23 6 $341.00 $331.14 $109.76 $341.38 $291.20 2026-10-09
73560 CPT X-ray Knee 1-2 Views Rt 21 6 $413.00 $400.70 $84.00 $413.09 $392.44 2026-10-09
73552 CPT X-ray Femur 2 Views Lt 16 5 $354.00 $343.87 $130.01 $354.51 $288.04 2026-10-09
73502 CPT X-ray Hip Uni 2-3 Views Rt 19 5 $367.00 $356.61 $238.97 $860.42 $356.61 2026-10-09
73501 CPT X-ray Hip Uni 1 View Lt 8 5 $362.00 $351.71 $235.68 $711.09 $348.08 2026-10-09
73221 CPT MRI Joint Ue Wo Dye Rt 19 5 $4,267.00 $4,139.23 $408.12 $4,267.25 $3,639.96 2026-10-09
73140 CPT X-ray Finger(s) Lt 22 5 $356.00 $345.83 $64.68 $356.53 $321.41 2026-10-09
73130 CPT X-ray Hand Lt 22 5 $399.00 $387.96 $59.16 $399.96 $360.56 2026-10-09
73120 CPT X-ray Hand Rt 8 5 $266.00 $258.64 $173.32 $266.64 $216.64 2026-10-09
73110 CPT X-ray Wrist 3 Views Rt 19 5 $377.00 $366.41 $58.22 $377.74 $322.21 2026-10-09
73100 CPT X-ray Wrist 2 Views Lt 8 5 $354.00 $343.87 $66.51 $354.51 $288.04 2026-10-09
73090 CPT X-ray Forearm 2 Views Lt 17 5 $438.00 $425.19 $282.72 $438.34 $373.90 2026-10-09
73080 CPT X-ray Elbow Lt 19 5 $409.00 $396.78 $38.91 $409.05 $348.92 2026-10-09
73060 CPT X-ray Humerus Lt 9 5 $386.00 $375.23 $67.44 $386.83 $329.97 2026-10-09
73030 CPT X-ray Shoulder Rt 19 5 $480.00 $466.34 $237.65 $480.76 $410.09 2026-10-09
73020 CPT X-ray Shoulder Lt 8 5 $217.00 $210.64 $141.15 $217.15 $187.95 2026-10-09
72220 CPT X-ray Sacrum Tailbone 18 5 $307.00 $297.83 $199.58 $447.69 $297.83 2026-10-09
72197 CPT MRI Pelvis Wwo Dye 8 5 $4,288.00 $4,159.81 $618.17 $4,288.46 $3,484.38 2026-10-09
72193 CPT CT Pelvis W Dye 8 5 $2,315.00 $2,246.45 $593.33 $2,315.93 $1,881.70 2026-10-09
72192 CPT CT Pelvis Wo Dye 8 5 $2,085.00 $2,023.08 $597.02 $2,085.65 $1,694.59 2026-10-09
72170 CPT X-ray Pelvis 1-2 Views 9 5 $330.00 $320.36 $214.68 $341.88 $320.36 2026-10-09
72158 CPT MRI Lumbar Spine Wwo Dye 9 5 $4,976.00 $4,826.98 $340.97 $4,976.27 $4,244.76 2026-10-09
72157 CPT MRI Chest Spine Wwo Dye 8 5 $3,728.00 $3,617.05 $535.35 $3,728.92 $3,029.75 2026-10-09
72156 CPT MRI Neck Spine Wwo Dye 8 5 $3,496.00 $3,391.72 $340.05 $3,496.62 $2,841.01 2026-10-09
72148 CPT MRI Lumbar Spine Wo Dye 10 6 $4,267.00 $4,139.23 $315.18 $4,267.25 $3,846.93 2026-10-09
72146 CPT MRI Chest Spine Wo Dye 8 5 $4,267.00 $4,139.23 $390.63 $4,267.25 $3,467.14 2026-10-09
72141 CPT MRI Neck Spine Wo Dye 10 5 $4,267.00 $4,139.23 $233.96 $4,267.25 $3,846.93 2026-10-09
72131 CPT CT Lumbar Spine Wo Contrast 9 5 $2,845.00 $2,759.81 $234.87 $2,845.17 $2,426.93 2026-10-09
72128 CPT CT Thoracic Spine Wo Contrast 10 5 $2,134.00 $2,070.11 $107.93 $2,134.13 $1,923.91 2026-10-09
72125 CPT CT Cervical Spine Wo Contrast 12 5 $2,778.00 $2,695.15 $172.58 $2,778.51 $2,504.82 2026-10-09
72110 CPT X-ray Lumbosacral 4 Views 8 5 $632.00 $613.29 $67.44 $632.26 $513.71 2026-10-09
72100 CPT X-ray Lumbosacral 2-3 Views 10 5 $348.00 $338.00 $90.44 $348.45 $314.13 2026-10-09
72081 CPT X-ray Spine Scoliosis 1 View 8 5 $298.00 $289.99 $112.53 $298.96 $242.91 2026-10-09
72072 CPT X-ray Spine Thoracic 3 Views 10 5 $593.00 $576.06 $386.02 $697.55 $584.97 2026-10-09
72070 CPT X-ray Spine Thoracic 2 Views 8 5 $330.00 $320.36 $214.68 $1,015.91 $317.06 2026-10-09
72040 CPT X-ray Spine Cervical 2-3 Views 10 6 $512.00 $496.71 $332.85 $551.93 $491.59 2026-10-09
71275 CPT CTA Chest Wwo Contrast 8 5 $1,958.00 $1,899.64 $1,272.95 $1,958.39 $1,880.06 2026-10-09
71260 CPT CT Thorax W Contrast 12 6 $2,643.00 $2,563.87 $80.31 $2,643.17 $2,537.44 2026-10-09
71250 CPT CT Thorax Wo Contrast 11 5 $2,240.00 $2,172.97 $71.13 $2,240.18 $1,910.87 2026-10-09
71110 CPT X-ray Ribs Bilateral 3 Views 9 5 $414.00 $401.68 $47.21 $414.10 $353.23 2026-10-09
71101 CPT X-ray Ribs Uni W Chest Lt 19 6 $499.00 $484.95 $324.97 $3,427.98 $484.95 2026-10-09
71100 CPT X-ray Ribs 2 Views Lt 16 5 $471.00 $457.52 $306.59 $3,616.49 $452.80 2026-10-09
71046 CPT X-ray Chest 2v PA/Lateral 13 6 $378.00 $367.39 $246.19 $783.14 $367.39 2026-10-09
71045 CPT X-ray Chest 1 View 13 6 $299.00 $290.97 $194.98 $593.33 $290.97 2026-10-09
70553 CPT MRI Brain Wwo Contrast 11 5 $4,267.00 $4,139.23 $729.77 $4,267.25 $3,639.96 2026-10-09
70498 CPT CT Angiography Neck W Cont 10 5 $2,118.00 $2,055.41 $278.39 $2,118.98 $1,910.26 2026-10-09
70496 CPT CT Angiography Head W Cont 10 5 $1,664.00 $1,614.55 $246.84 $1,664.48 $1,500.53 2026-10-09
70491 CPT CT Soft Tissue Neck W Cont 8 5 $2,498.00 $2,423.78 $357.53 $2,498.74 $2,030.23 2026-10-09
70486 CPT CT Maxillofacial Wo Contrast 10 5 $2,189.00 $2,123.99 $187.95 $2,189.68 $1,974.00 2026-10-09
70470 CPT CT Head/Brain Wwo Contrast 8 5 $2,845.00 $2,759.81 $241.32 $2,845.17 $2,311.70 2026-10-09
70460 CPT CT Head/Brain W Contrast 8 5 $2,159.00 $2,094.60 $61.91 $2,159.38 $1,754.49 2026-10-09
70450 CPT CT Head/Brain Wo Contrast 11 6 $2,277.00 $2,209.22 $1,480.41 $2,277.55 $2,209.22 2026-10-09
70360 CPT X-ray Neck Soft Tissue 8 5 $269.00 $261.58 $70.19 $269.67 $219.11 2026-10-09
70160 CPT X-ray Facial Bones 3 Views 8 5 $291.00 $283.13 $86.75 $291.89 $237.16 2026-10-09
70110 CPT X-ray Mandible 4 Views 6 5 $354.00 $343.87 $230.43 $354.51 $319.59 2026-10-09
70100 CPT X-ray Mandible < 4 Views 6 5 $354.00 $343.87 $230.43 $354.51 $319.59 2026-10-09
70030 CPT X-ray Eye Fb Detection 6 5 $270.00 $262.56 $175.94 $270.68 $244.02 2026-10-09
689 CDM Trauma Team Evaluation Level 5 8 5 $1,935.00 $1,877.11 $1,257.85 $1,935.16 $1,589.74 2026-10-09
6631 APR_DRG Apr-DRG 6631 2 1 — — $14,284.81 $14,284.81 $14,284.81 2026-10-09
65210 CPT Remove Foreign Body Eye Rt 14 5 $598.00 $580.60 $73.06 $598.56 $393.55 2026-10-09
51703 CPT Cath Insert Compl Indwelling 8 5 $437.00 $424.21 $284.26 $437.33 $359.26 2026-10-09
51702 CPT Cath Insert Simple Indwelling 21 5 $735.00 $713.22 $158.87 $735.28 $244.42 2026-10-09
51701 CPT Cath Insert Straight Non-indwe 16 5 $409.50 $397.76 $120.14 $635.29 $298.88 2026-10-09
36600 CPT Arterial Puncture 8 5 $193.00 $187.55 $125.68 $193.35 $158.84 2026-10-09
36430 CPT Blood Administration 10 5 $655.00 $636.10 $426.25 $2,623.08 $591.17 2026-10-09
30903 CPT Control Anterior Hemorrhage Lt 28 5 $319.00 $309.43 $118.95 $455.00 $174.38 2026-10-09
30901 CPT Control Anterior Hemorrhage Rt 14 5 $380.00 $369.35 $109.69 $380.77 $250.36 2026-10-09
29581 CPT Appl Multi Layer Ven Wnd Compr 8 5 $416.00 $403.64 $270.48 $416.12 $341.84 2026-10-09
29580 CPT Apply Unna Boot Rt 8 5 $236.00 $229.59 $153.85 $236.69 $194.44 2026-10-09
27810 CPT Fx Bimalleolar Ankle W Man Lt 28 5 $2,297.00 $2,228.09 $882.31 $2,297.00 $1,510.28 2026-10-09
27520 CPT Treat Kneecap Fracture Rt 8 5 $1,178.00 $1,143.34 $766.15 $1,178.70 $968.30 2026-10-09
25600 CPT Fx Distal Radius Rt 10 5 $360.00 $349.20 $234.00 $360.00 $324.54 2026-10-09
23500 CPT Fx Clavicle Rt 10 5 $828.00 $804.03 $538.78 $828.90 $747.25 2026-10-09
20610 CPT Asp/Inj Large Joint Lt 34 5 $433.50 $420.88 $229.78 $442.79 $346.35 2026-10-09
20605 CPT Asp/Inj Intermediate Joint Lt 16 5 $442.00 $429.51 $287.81 $442.79 $363.75 2026-10-09
20552 CPT Inject Trigger Points 1-2 Mus 8 5 $297.00 $289.01 $193.67 $297.95 $244.76 2026-10-09
20550 CPT Inject Single Tendon Sheath Lt 16 5 $297.00 $289.01 $193.67 $297.95 $244.76 2026-10-09
17110 CPT Destroy Benign Lesions 1-14 8 5 $298.00 $289.11 $193.73 $298.05 $244.85 2026-10-09
17000 CPT Destroy Premal Lesion 1st 8 5 $205.00 $198.88 $133.27 $205.03 $168.43 2026-10-09
1313 APR_DRG Apr-DRG 1313 2 1 — — $22,783.42 $22,783.42 $22,783.42 2026-10-09
129 CDM Room Swing Bed Skilled 6 5 $1,016.00 $985.58 $660.44 $1,016.06 $915.98 2026-10-09
12052 CPT Repair Lac Interm 2.6-5.0 Cm 14 5 $826.00 $801.39 $403.24 $826.18 $554.51 2026-10-09
12042 CPT Repair Lac Interm 2.6-7.5 Cm 14 5 $895.00 $868.99 $396.46 $895.87 $589.04 2026-10-09
12031 CPT Repair Lac Intermed <2.5 Cm 14 5 $686.00 $666.20 $307.22 $686.80 $451.57 2026-10-09
12020 CPT Treat Wound Dehiscence Simple 8 5 $898.00 $871.06 $583.70 $898.00 $737.70 2026-10-09
12014 CPT Repair Lac Simple 5.1-7.5 Cm 14 5 $782.00 $759.27 $141.36 $782.75 $514.66 2026-10-09
12013 CPT Repair Lac Simple 2.6-5.0 Cm 14 5 $680.00 $659.60 $109.90 $680.00 $447.10 2026-10-09
12011 CPT Repair Lac Simple <2.5 Cm 17 5 $360.00 $349.75 $107.01 $360.57 $278.36 2026-10-09
12002 CPT Repair Lac Simple 2.6-7.5 Cm 16 5 $378.00 $367.39 $112.84 $378.75 $272.13 2026-10-09
12001 CPT Repair Lac Simple <2.5 Cm 33 5 $323.00 $313.50 $86.23 $323.20 $249.51 2026-10-09
11765 CPT Wedge Exc Nail Fold 8 5 $570.00 $552.90 $370.50 $570.00 $468.25 2026-10-09
11750 CPT Exc Nail Matrix Part/Complete 8 5 $599.00 $581.32 $389.55 $599.30 $492.32 2026-10-09
11740 CPT Evacuate Subungual Hematoma 8 5 $193.00 $187.55 $125.68 $193.35 $158.84 2026-10-09
11730 CPT Avulsion Nail Plate Simp Singl 22 5 $205.00 $198.88 $108.43 $384.00 $184.83 2026-10-09
11721 CPT Debride Nails 6-10 8 5 $206.00 $199.86 $133.93 $206.04 $169.26 2026-10-09
115 CDM Room Hospice Ip 6 5 $278.00 $270.40 $181.19 $278.76 $251.30 2026-10-09
11421 CPT Exc Ben Lesion 0.6-1.0 Neck 10 5 $1,055.00 $1,023.73 $43.03 $1,055.39 $867.00 2026-10-09
11420 CPT Exc Ben Lesion <0.5 Neck Ext 8 5 $2,430.00 $2,357.45 $1,579.73 $2,430.36 $1,996.54 2026-10-09
11306 CPT Shave Lesion 0.6-1.0 Neck Ext 8 5 $298.00 $289.11 $193.73 $298.05 $244.85 2026-10-09
11200 CPT Remove Skin Tags Up To 15 8 5 $205.00 $198.88 $133.27 $205.03 $168.43 2026-10-09
11105 CPT Punch Biopsy Ea Addl Lesion 8 5 $190.00 $185.16 $124.08 $190.89 $156.81 2026-10-09
11104 CPT Punch Biopsy 1st Lesion 8 5 $599.00 $581.32 $389.55 $599.30 $492.32 2026-10-09
11102 CPT Tangential Biopsy 1st Lesion 8 5 $205.00 $198.88 $133.27 $205.03 $168.43 2026-10-09
111 CDM Room Medical Unit Priv 12 5 $1,160.00 $1,125.68 $75.50 $2,204.83 $774.64 2026-10-09
11056 CPT Pare 2-4 Benign Lesions 8 5 $298.00 $289.11 $193.73 $298.05 $244.85 2026-10-09
11055 CPT Pare 1 Benign Lesion 8 5 $205.00 $198.88 $133.27 $205.03 $168.43 2026-10-09
110 CDM Room Custodial Care 6 5 $279.00 $271.38 $181.85 $279.77 $252.21 2026-10-09
10160 CPT Punc Asp Abscess Hematoma Cyst 8 5 $599.00 $581.32 $389.55 $599.30 $492.32 2026-10-09
101 CDM Il Apartment Level 1 12 5 $637.50 $618.38 $373.75 $700.00 $552.00 2026-10-09
10060 CPT I&d Abscess Simple/Single 22 5 $233.00 $226.31 $133.27 $367.64 $234.19 2026-10-09
0202U CPT Respir Path 22 Targets Biofire 8 5 $837.00 $812.17 $544.24 $837.29 $687.84 2026-10-09
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