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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

BOWDLE HOSPITAL - CAH

Bowdle, SD · CCN 431318 · Rates published

596 distinct procedures filed
6 distinct payers
7,875 rate rows
2026-07-19 last MRF observed
Data quality

7,857 of 7,875 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 10
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://bowdlehc.com/wp-content/uploads/bowdle-healthcare-center_standardcharges.csv
Found on page https://bowdlehc.com/
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-10-25
Content fingerprint 7df62f64abb0c926… · 2,191,699 bytes · first seen 2026-05-14

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
J2327
HCPCS 		Risankizumab-rzaa 600 Mg/10 Ml 5 $68.09 $20,284.42 $16,481.09 nat. median
$2,076
outlier · 7.9×
J3380
HCPCS 		Vedolizumab 300 Mg Vial 5 $72.63 $17,955.94 $14,589.20 nat. median
$162
outlier · 90.0×
177
MS_DRG 		Ms-DRG 177 1 $14,264.32 $14,264.32 $14,264.32 nat. median
$15,388
0.9× median
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 5 $0.41 $14,016.04 $11,388.03 nat. median
$3,820
outlier · 3.0×
544
MS_DRG 		Ms-DRG 544 1 $10,705.72 $10,705.72 $10,705.72 nat. median
$8,141
1.3× median
J0717
HCPCS 		Certolizumab Pegol 400 Mg Kit 5 $3.42 $11,483.38 $9,330.24 nat. median
$1,598
outlier · 5.8×
74177
CPT 		CT Abd & Pelv W Contrast 5 $227.52 $6,997.54 $6,308.28 nat. median
$974
outlier · 6.5×
74174
CPT 		CTA Abd&Pelv Wwo Dye 5 $4,058.64 $6,244.06 $5,629.02 nat. median
$988
outlier · 5.7×
74176
CPT 		CT Abd & Pelvis Wo Contrast 5 $95.04 $5,832.37 $5,257.88 nat. median
$694
outlier · 7.6×
74178
CPT 		CT Abd & Pelv Wwo Contrast 5 $479.88 $6,413.32 $5,210.82 nat. median
$1,024
outlier · 5.1×
70553
CPT 		MRI Brain Wwo Contrast 5 $729.77 $5,243.78 $4,260.57 nat. median
$1,133
outlier · 3.8×
J3111
HCPCS 		Romosozumab-aqqg 210 Mg/2.34Ml 5 $1.56 $5,092.30 $4,137.49 nat. median
$681
outlier · 6.1×
Q5122
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Syr 5 $2,528.99 $3,939.75 $3,696.21 nat. median
$561
outlier · 6.6×
72141
CPT 		MRI Neck Spine Wo Dye 5 $233.96 $4,512.14 $3,666.11 nat. median
$781
outlier · 4.7×
70498
CPT 		CT Angiography Neck W Cont 5 $278.39 $4,232.59 $3,610.40 nat. median
$739
outlier · 4.9×
812
MS_DRG 		Ms-DRG 812 1 $3,592.12 $3,592.12 $3,592.12 nat. median
$9,307
outlier · 0.4×
J1569
HCPCS 		Immune Glob Gamagar 20gr/200ml 5 $21.77 $4,315.56 $3,506.39 nat. median
$1,070
outlier · 3.3×
71275
CPT 		CTA Chest Wwo Contrast 5 $812.45 $4,062.24 $3,465.09 nat. median
$754
outlier · 4.6×
70551
CPT 		MRI Brain Wo Contrast 5 $447.03 $4,217.30 $3,426.56 nat. median
$784
outlier · 4.4×
72148
CPT 		MRI Lumbar Spine Wo Dye 5 $315.18 $4,090.63 $3,323.64 nat. median
$805
outlier · 4.1×
J0897
HCPCS 		Denosumab 60 Mg/ml Syringe 5 $9.69 $6,039.29 $3,253.57 nat. median
$1,972
1.7× median
71260
CPT 		CT Thorax W Contrast 5 $80.31 $3,586.13 $3,232.89 nat. median
$648
outlier · 5.0×
120
CDM 		Room Medical Unit Semi Private 5 $2,317.25 $3,565.00 $3,213.85 nat. median
$1,499
outlier · 2.1×
689
CDM 		Trauma Team Evaluation Level 5 5 $2,541.79 $3,910.45 $3,212.44 nat. median
$1,169
outlier · 2.7×
G0390
HCPCS 		Trauma Team Level 5 5 $2,541.79 $3,910.45 $3,212.44 nat. median
$3,197
1.0× median
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 5 $1,112.40 $3,945.00 $3,205.32 nat. median
$1,982
1.6× median
70491
CPT 		CT Soft Tissue Neck W Cont 5 $357.53 $3,518.42 $3,171.86 nat. median
$627
outlier · 5.1×
70496
CPT 		CT Angiography Head W Cont 5 $246.84 $3,666.94 $3,127.90 nat. median
$747
outlier · 4.2×
73721
CPT 		MRI Joint Le Wo Dye Lt 5 $315.18 $3,666.94 $2,979.39 nat. median
$856
outlier · 3.5×
70492
CPT 		CT Soft Tissue Neck Wwo Cont 5 $422.85 $3,666.94 $2,979.39 nat. median
$647
outlier · 4.6×
73700
CPT 		CT Le Wo Dye Lt 5 $76.65 $3,597.05 $2,922.60 nat. median
$500
outlier · 5.8×
73221
CPT 		MRI Joint Ue Wo Dye Lt 5 $408.12 $3,385.20 $2,750.47 nat. median
$844
outlier · 3.3×
73200
CPT 		CT Ue Wo Dye Rt 5 $70.19 $3,385.20 $2,750.47 nat. median
$521
outlier · 5.3×
J0881
HCPCS 		Darbepoetin Alfa 500mcg/ml Syr 5 $2,069.93 $3,184.50 $2,692.92 nat. median
$752
outlier · 3.6×
71270
CPT 		CT Thorax Wwo Contrast 5 $82.17 $3,175.54 $2,580.13 nat. median
$672
outlier · 3.8×
95811
CPT 		Polysomnogram W CPap 5 $2,022.22 $3,111.11 $2,555.78 nat. median
$1,894
1.3× median
70490
CPT 		CT Soft Tissue Neck Wo Cont 5 $277.47 $3,098.00 $2,517.12 nat. median
$450
outlier · 5.6×
72125
CPT 		CT Cervical Spine Wo Contrast 5 $172.58 $2,610.97 $2,353.79 nat. median
$472
outlier · 5.0×
70486
CPT 		CT Maxillofacial Wo Contrast 5 $187.95 $2,610.97 $2,353.79 nat. median
$478
outlier · 4.9×
71250
CPT 		CT Thorax Wo Contrast 5 $71.13 $2,541.08 $2,290.78 nat. median
$465
outlier · 4.9×
74170
CPT 		CT Abdomen Wwo Dye 5 $58.22 $2,450.45 $2,209.08 nat. median
$710
outlier · 3.1×
70450
CPT 		CT Head/Brain Wo Contrast 5 $1,506.19 $2,317.22 $2,201.36 nat. median
$450
outlier · 4.9×
95810
CPT 		Polysomnogram 5 $1,719.85 $2,645.92 $2,173.62 nat. median
$1,825
1.2× median
72131
CPT 		CT Lumbar Spine Wo Contrast 5 $234.87 $2,610.97 $2,121.41 nat. median
$457
outlier · 4.6×
J1459
HCPCS 		Immune Glob Privige 10gr/100ml 5 $0.29 $2,114.80 $1,718.28 nat. median
$1,388
1.2× median
28490
CPT 		Fx Great Toe 5 $1,254.66 $1,930.24 $1,585.69 nat. median
$334
outlier · 4.7×
93306
CPT 		Tte W Doppler Complete 5 $1,100.90 $1,693.69 $1,526.87 nat. median
$991
1.5× median
76700
CPT 		Ultrasound Abdomen Complete 5 $1,088.83 $1,675.13 $1,376.12 nat. median
$311
outlier · 4.4×
93975
CPT 		Vascular Study 5 $964.62 $1,484.03 $1,219.13 nat. median
$563
outlier · 2.2×
Q9967
HCPCS 		Iopamidol-370 100 Ml Vial 5 $253.80 $1,500.00 $1,218.75 nat. median
$64
outlier · 18.9×

Other procedures at this hospital

Browse this hospital's 596 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
             
J2327 HCPCS Risankizumab-rzaa 600 Mg/10 Ml 8 5 $20,284.00 $20,284.42 $68.09 $20,284.42 $16,481.09 2026-07-19
J3380 HCPCS Vedolizumab 300 Mg Vial 8 5 $17,955.00 $17,955.94 $72.63 $17,955.94 $14,589.20 2026-07-19
177 MS_DRG Ms-DRG 177 2 1 — — $14,264.32 $14,264.32 $14,264.32 2026-07-19
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Syrng 8 5 $14,016.00 $14,016.04 $0.41 $14,016.04 $11,388.03 2026-07-19
544 MS_DRG Ms-DRG 544 2 1 — — $10,705.72 $10,705.72 $10,705.72 2026-07-19
J0717 HCPCS Certolizumab Pegol 400 Mg Kit 8 5 $11,483.00 $11,483.38 $3.42 $11,483.38 $9,330.24 2026-07-19
74177 CPT CT Abd & Pelv W Contrast 10 5 $6,997.00 $6,997.54 $227.52 $6,997.54 $6,308.28 2026-07-19
74174 CPT CTA Abd&Pelv Wwo Dye 6 5 $6,244.00 $6,244.06 $4,058.64 $6,244.06 $5,629.02 2026-07-19
74176 CPT CT Abd & Pelvis Wo Contrast 10 5 $5,832.00 $5,832.37 $95.04 $5,832.37 $5,257.88 2026-07-19
74178 CPT CT Abd & Pelv Wwo Contrast 8 5 $6,413.00 $6,413.32 $479.88 $6,413.32 $5,210.82 2026-07-19
70553 CPT MRI Brain Wwo Contrast 8 5 $5,243.00 $5,243.78 $729.77 $5,243.78 $4,260.57 2026-07-19
J3111 HCPCS Romosozumab-aqqg 210 Mg/2.34Ml 8 5 $5,092.00 $5,092.30 $1.56 $5,092.30 $4,137.49 2026-07-19
Q5122 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Syr 8 5 $3,890.00 $3,890.75 $2,528.99 $3,939.75 $3,696.21 2026-07-19
72141 CPT MRI Neck Spine Wo Dye 8 5 $4,512.00 $4,512.14 $233.96 $4,512.14 $3,666.11 2026-07-19
70498 CPT CT Angiography Neck W Cont 9 5 $4,232.00 $4,232.59 $278.39 $4,232.59 $3,610.40 2026-07-19
812 MS_DRG Ms-DRG 812 2 1 — — $3,592.12 $3,592.12 $3,592.12 2026-07-19
J1569 HCPCS Immune Glob Gamagar 20gr/200ml 8 5 $4,315.00 $4,315.56 $21.77 $4,315.56 $3,506.39 2026-07-19
71275 CPT CTA Chest Wwo Contrast 9 5 $4,062.00 $4,062.24 $812.45 $4,062.24 $3,465.09 2026-07-19
70551 CPT MRI Brain Wo Contrast 8 5 $4,217.00 $4,217.30 $447.03 $4,217.30 $3,426.56 2026-07-19
72148 CPT MRI Lumbar Spine Wo Dye 8 5 $4,090.00 $4,090.63 $315.18 $4,090.63 $3,323.64 2026-07-19
J0897 HCPCS Denosumab 60 Mg/ml Syringe 14 5 $3,337.00 $3,337.00 $9.69 $6,039.29 $3,253.57 2026-07-19
71260 CPT CT Thorax W Contrast 10 5 $3,586.00 $3,586.13 $80.31 $3,586.13 $3,232.89 2026-07-19
120 CDM Room Medical Unit Semi Private 6 5 $3,565.00 $3,565.00 $2,317.25 $3,565.00 $3,213.85 2026-07-19
689 CDM Trauma Team Evaluation Level 5 8 5 $3,910.00 $3,910.45 $2,541.79 $3,910.45 $3,212.44 2026-07-19
G0390 HCPCS Trauma Team Level 5 8 5 $3,910.00 $3,910.45 $2,541.79 $3,910.45 $3,212.44 2026-07-19
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 8 5 $3,945.00 $3,945.00 $1,112.40 $3,945.00 $3,205.32 2026-07-19
70491 CPT CT Soft Tissue Neck W Cont 10 5 $3,518.00 $3,518.42 $357.53 $3,518.42 $3,171.86 2026-07-19
70496 CPT CT Angiography Head W Cont 9 5 $3,666.00 $3,666.94 $246.84 $3,666.94 $3,127.90 2026-07-19
70492 CPT CT Soft Tissue Neck Wwo Cont 8 5 $3,666.00 $3,666.94 $422.85 $3,666.94 $2,979.39 2026-07-19
73721 CPT MRI Joint Le Wo Dye Lt 16 5 $3,666.00 $3,666.94 $315.18 $3,666.94 $2,979.39 2026-07-19
73700 CPT CT Le Wo Dye Lt 8 5 $3,597.00 $3,597.05 $76.65 $3,597.05 $2,922.60 2026-07-19
73200 CPT CT Ue Wo Dye Rt 8 5 $3,385.00 $3,385.20 $70.19 $3,385.20 $2,750.47 2026-07-19
73221 CPT MRI Joint Ue Wo Dye Lt 8 5 $3,385.00 $3,385.20 $408.12 $3,385.20 $2,750.47 2026-07-19
J0881 HCPCS Darbepoetin Alfa 500mcg/ml Syr 8 5 $3,184.00 $3,184.50 $2,069.93 $3,184.50 $2,692.92 2026-07-19
71270 CPT CT Thorax Wwo Contrast 8 5 $3,175.00 $3,175.54 $82.17 $3,175.54 $2,580.13 2026-07-19
95811 CPT Polysomnogram W CPap 8 5 $3,111.00 $3,111.11 $2,022.22 $3,111.11 $2,555.78 2026-07-19
70490 CPT CT Soft Tissue Neck Wo Cont 8 5 $3,098.00 $3,098.00 $277.47 $3,098.00 $2,517.12 2026-07-19
70486 CPT CT Maxillofacial Wo Contrast 10 5 $2,610.00 $2,610.97 $187.95 $2,610.97 $2,353.79 2026-07-19
72125 CPT CT Cervical Spine Wo Contrast 10 5 $2,610.00 $2,610.97 $172.58 $2,610.97 $2,353.79 2026-07-19
71250 CPT CT Thorax Wo Contrast 10 5 $2,541.00 $2,541.08 $71.13 $2,541.08 $2,290.78 2026-07-19
74170 CPT CT Abdomen Wwo Dye 10 5 $2,450.00 $2,450.45 $58.22 $2,450.45 $2,209.08 2026-07-19
70450 CPT CT Head/Brain Wo Contrast 9 5 $2,317.00 $2,317.22 $1,506.19 $2,317.22 $2,201.36 2026-07-19
95810 CPT Polysomnogram 8 5 $2,645.00 $2,645.92 $1,719.85 $2,645.92 $2,173.62 2026-07-19
72131 CPT CT Lumbar Spine Wo Contrast 8 5 $2,610.00 $2,610.97 $234.87 $2,610.97 $2,121.41 2026-07-19
J1459 HCPCS Immune Glob Privige 10gr/100ml 8 5 $2,114.00 $2,114.80 $0.29 $2,114.80 $1,718.28 2026-07-19
28490 CPT Fx Great Toe 8 5 $1,930.00 $1,930.24 $1,254.66 $1,930.24 $1,585.69 2026-07-19
93306 CPT Tte W Doppler Complete 10 5 $1,693.00 $1,693.69 $1,100.90 $1,693.69 $1,526.87 2026-07-19
76700 CPT Ultrasound Abdomen Complete 8 5 $1,675.00 $1,675.13 $1,088.83 $1,675.13 $1,376.12 2026-07-19
93975 CPT Vascular Study 8 5 $1,484.00 $1,484.03 $964.62 $1,484.03 $1,219.13 2026-07-19
Q9967 HCPCS Iopamidol-370 100 Ml Vial 10 5 $1,500.00 $1,500.00 $253.80 $1,500.00 $1,218.75 2026-07-19
93970 CPT Venous Duplex 11 6 $1,262.00 $1,262.35 $820.53 $1,262.35 $1,199.23 2026-07-19
99291 CPT Critical Care 1st 30-74 Min 14 5 $1,765.00 $1,765.76 $329.00 $1,765.76 $1,160.99 2026-07-19
72052 CPT X-ray Spine Cervical 6 Views 8 5 $1,416.00 $1,416.48 $818.73 $1,416.48 $1,150.89 2026-07-19
76770 CPT Ultrasound Abdo Back Wall Comp 11 6 $1,202.00 $1,202.29 $781.49 $1,202.29 $1,142.18 2026-07-19
87497 CPT Cmv Quant By Pcr 10 5 $1,263.00 $1,263.44 $821.24 $1,263.44 $1,138.99 2026-07-19
76705 CPT Ultrasound Abdomen Limited 19 5 $1,133.00 $1,133.50 $736.77 $1,303.12 $1,076.83 2026-07-19
76830 CPT Ultrasound Transvaginal 8 5 $1,306.00 $1,306.03 $848.92 $1,306.03 $1,072.90 2026-07-19
90377 CPT Rabies Imm Glo 300U/2Ml Kedrab 8 5 $1,295.00 $1,295.00 $21.92 $1,295.00 $1,052.19 2026-07-19
76856 CPT Ultrasound Pelvic Complete 8 5 $1,247.00 $1,247.06 $810.59 $1,247.06 $1,024.46 2026-07-19
0202U CPT Respir Path 22 Targets Biofire 8 5 $1,243.00 $1,243.79 $808.46 $1,243.79 $1,021.77 2026-07-19
J0248 HCPCS Remdesivir 100 Mg Vial 8 5 $1,247.00 $1,247.98 $70.71 $1,247.98 $1,013.99 2026-07-19
93880 CPT Extracranial Bilat Study 10 5 $1,214.00 $1,214.30 $242.86 $1,214.30 $997.55 2026-07-19
87799 CPT Ebv By Pcr Quant 10 5 $1,093.00 $1,093.09 $710.51 $1,093.09 $985.42 2026-07-19
99285 CPT Emergency Room Visit Level 5 16 5 $1,351.00 $1,351.90 $267.73 $1,351.90 $971.34 2026-07-19
93308 CPT Echo Limited 8 5 $1,162.00 $1,162.98 $755.94 $1,162.98 $955.38 2026-07-19
129 CDM Room Swing Bed Skilled 6 5 $1,013.00 $1,013.00 $658.45 $1,013.00 $913.22 2026-07-19
J7325 HCPCS Hylan Polymer A&b 48mg/6ml Syr 8 5 $945.00 $945.00 $614.25 $1,735.19 $897.75 2026-07-19
93976 CPT Vascular Study 8 5 $1,054.00 $1,054.87 $685.67 $1,054.87 $866.58 2026-07-19
93971 CPT Extremity Study Lt 16 5 $1,039.00 $1,039.58 $675.73 $1,039.58 $854.01 2026-07-19
93925 CPT Arterial Duplex Le Bi 8 5 $1,039.00 $1,039.58 $675.73 $1,039.58 $854.01 2026-07-19
72040 CPT X-ray Spine Cervical 2-3 Views 10 5 $891.00 $891.07 $551.93 $891.07 $803.30 2026-07-19
76775 CPT Ultrasound Aorta 8 5 $976.00 $976.25 $634.56 $976.25 $801.99 2026-07-19
93926 CPT Arterial Duplex Le Lt 8 5 $967.00 $967.51 $628.88 $967.51 $794.81 2026-07-19
76536 CPT Ultrasound Head And Neck 10 5 $957.00 $957.68 $191.54 $957.68 $786.74 2026-07-19
Q5104 HCPCS Infliximab-abda 100 Mg Vial 8 5 $782.00 $782.17 $508.41 $5,119.19 $743.06 2026-07-19
A0429 HCPCS Amb Bls Emergent Home/Hosp 32 5 $874.00 $874.69 $568.55 $910.73 $732.80 2026-07-19
24075 CPT Excise Tumor Arm <3cm Lt 6 5 $345.00 $345.00 $667.44 $901.40 $724.31 2026-07-19
26160 CPT Excision Cyst Hand/Finger 6 5 $502.00 $502.32 $655.34 $873.26 $713.68 2026-07-19
72072 CPT X-ray Spine Thoracic 3 Views 8 5 $751.00 $751.30 $488.35 $751.30 $697.55 2026-07-19
72070 CPT X-ray Spine Thoracic 2 Views 8 5 $722.00 $722.90 $469.88 $1,015.91 $686.76 2026-07-19
76870 CPT Ultrasound Scrotum 8 5 $790.00 $790.61 $513.90 $790.61 $649.49 2026-07-19
93922 CPT Ankle Arm Screen 8 5 $785.00 $785.15 $510.35 $785.15 $645.00 2026-07-19
99284 CPT Emergency Room Visit Level 4 17 5 $936.00 $936.94 $110.65 $936.94 $623.07 2026-07-19
J7323 HCPCS Hyaluronate (Euflexxa)20MG/2ML 8 5 $645.00 $645.64 $419.67 $1,787.24 $613.36 2026-07-19
81256 CPT Hemochromat Mutation 8 5 $744.00 $744.74 $484.08 $744.74 $611.80 2026-07-19
36430 CPT Blood Administration 10 5 $733.00 $733.82 $146.76 $733.82 $602.84 2026-07-19
77067 CPT Mammo Screen Implant Bi 30 6 $654.00 $654.11 $388.97 $763.31 $578.89 2026-07-19
72100 CPT X-ray Lumbosacral 2-3 Views 10 5 $704.00 $704.34 $90.44 $704.34 $572.27 2026-07-19
92523 CPT Speech Sound Lang Comprehen 8 5 $692.00 $692.33 $450.01 $692.33 $568.75 2026-07-19
77080 CPT Dexa Scan 10 5 $622.00 $622.44 $88.61 $622.44 $561.13 2026-07-19
72020 CPT X-ray Spine Single View 8 5 $666.00 $666.12 $244.37 $666.12 $541.22 2026-07-19
99283 CPT Emergency Room Visit Level 3 17 6 $690.00 $690.14 $108.68 $690.14 $532.79 2026-07-19
28470 CPT Fx Metatarsal 8 5 $647.00 $647.92 $421.15 $647.92 $532.27 2026-07-19
70140 CPT X-ray Facial Bones < 3 Views 10 5 $574.00 $574.39 $66.51 $574.39 $517.81 2026-07-19
86480 CPT Tbint Quantiferon 10 5 $573.00 $573.30 $372.64 $573.30 $516.83 2026-07-19
76882 CPT Ultrasound Axilla Rt 24 5 $536.00 $536.17 $348.51 $1,536.44 $509.36 2026-07-19
71111 CPT X-ray Ribs Bilateral 4 Views 8 5 $626.00 $626.81 $63.74 $626.81 $509.28 2026-07-19
90675 CPT Rabies Vax Pcec/Pf 2.5Unit Vl 8 5 $614.00 $614.42 $125.24 $614.42 $499.22 2026-07-19
72220 CPT Sacrum Or Coccyx Min 2 View 16 5 $629.50 $630.08 $335.02 $744.74 $486.87 2026-07-19
P9016 HCPCS Red Blood Cells Lekoreduced 10 5 $587.00 $587.50 $235.00 $587.50 $482.63 2026-07-19
74019 CPT X-ray Abdomen 11 5 $505.00 $505.60 $328.64 $660.48 $480.32 2026-07-19
73080 CPT X-ray Elbow Rt 18 5 $549.00 $549.28 $38.91 $549.28 $468.54 2026-07-19
71101 CPT X-ray Ribs Uni W Chest Rt 18 5 $488.00 $488.12 $317.28 $3,427.98 $463.71 2026-07-19
73590 CPT X-ray Lower Leg Lt 16 5 $552.00 $552.55 $73.88 $573.30 $448.11 2026-07-19
71046 CPT X-ray Chest 2v PA/Lateral 11 5 $470.00 $470.65 $305.92 $783.14 $447.12 2026-07-19
73090 CPT X-ray Forearm 2 Views Lt 16 5 $536.00 $536.17 $282.72 $536.17 $435.63 2026-07-19
99282 CPT Emergency Room Visit Level 2 10 5 $482.00 $482.66 $313.73 $482.66 $435.12 2026-07-19
73060 CPT X-ray Humerus Lt 16 5 $525.00 $525.25 $67.44 $525.25 $426.76 2026-07-19
84207 CPT Vitamin B6 10 5 $470.00 $470.65 $305.92 $470.65 $424.29 2026-07-19
90677 CPT Pneumo 20 Valent Vacc 0.5 Ml 11 6 $444.00 $444.60 $288.99 $444.60 $422.37 2026-07-19
71100 CPT X-ray Ribs 2 Views Rt 18 5 $440.00 $440.08 $88.02 $3,616.49 $418.08 2026-07-19
72081 CPT X-ray Spine Scoliosis 1 View 8 5 $511.00 $511.06 $112.53 $511.06 $415.24 2026-07-19
73610 CPT X-ray Ankle 3 Views Lt 20 5 $458.00 $458.64 $99.63 $458.64 $413.47 2026-07-19
J0561 HCPCS Pen G Benzathine 1200000Un/2ML 8 5 $507.00 $507.78 $260.76 $507.78 $412.57 2026-07-19
70030 CPT X-ray Eye Fb Detection 8 5 $433.00 $433.52 $281.79 $433.52 $411.84 2026-07-19
86682 CPT Helminth Antibody Nos 8 5 $501.00 $501.28 $325.83 $501.28 $411.80 2026-07-19
87536 CPT HIV 1 Na Quan 8 5 $500.00 $500.14 $325.09 $500.14 $410.87 2026-07-19
82951 CPT Glucose Tol 1st 3 Specimens 8 5 $496.00 $496.86 $322.96 $496.86 $408.17 2026-07-19
32551 CPT Insertion Chest Tube Rt 14 5 $580.00 $580.32 $297.55 $580.32 $406.43 2026-07-19
83921 CPT Methylmalonic Acid 8 5 $494.00 $494.68 $321.54 $494.68 $406.38 2026-07-19
73110 CPT X-ray Wrist 3 Views Lt 20 5 $446.00 $446.63 $58.22 $446.63 $402.64 2026-07-19
73130 CPT X-ray Hand Lt 20 5 $446.00 $446.63 $59.16 $446.63 $402.64 2026-07-19
90679 CPT RSVPreF3 Antigen Comp 120 Mcg 8 5 $493.00 $493.00 $125.24 $493.00 $400.56 2026-07-19
88184 CPT Flow Cytometry First Mark 8 5 $480.00 $480.48 $312.31 $480.48 $394.72 2026-07-19
99236 CPT Admit/Discharge Same Day High 6 5 $549.00 $549.28 $322.41 $436.48 $391.90 2026-07-19
73552 CPT X-ray Femur 2 Views Lt 16 5 $479.00 $479.39 $130.01 $479.39 $389.50 2026-07-19
85379 CPT D-dimer Quant 11 5 $456.00 $456.46 $296.70 $456.46 $389.36 2026-07-19
87636 CPT Influ & CoV2 Pcr Ceph 8 5 $472.00 $472.84 $307.35 $472.84 $388.44 2026-07-19
73030 CPT X-ray Shoulder Lt 20 5 $446.00 $446.63 $89.33 $446.63 $380.98 2026-07-19
71045 CPT X-ray Chest 1 View 12 5 $393.00 $393.12 $255.53 $593.33 $373.46 2026-07-19
80197 CPT Tacrolimus 10 5 $412.00 $412.78 $268.31 $412.78 $372.12 2026-07-19
88305 CPT Surg Path L4 10 5 $412.00 $412.78 $268.31 $412.78 $372.12 2026-07-19
82024 CPT Acth Adrenocorticotropic Hor 8 5 $452.00 $452.09 $293.86 $452.09 $371.39 2026-07-19
74018 CPT X-ray Abdomen 11 5 $388.00 $388.75 $252.69 $523.40 $369.31 2026-07-19
82379 CPT Carnitine Total And Free 8 5 $446.00 $446.63 $290.31 $446.63 $366.91 2026-07-19
73010 CPT X-ray Shoulder Blade Rt 8 5 $446.00 $446.63 $174.17 $446.63 $362.89 2026-07-19
73630 CPT X-ray Foot 3 Views Lt 18 5 $424.00 $424.79 $65.60 $424.79 $362.35 2026-07-19
97606 CPT Neg Pressure Wound Dme >50 Cm 8 5 $436.00 $436.80 $283.92 $436.80 $358.83 2026-07-19
72170 CPT X-ray Pelvis 1-2 Views 10 5 $393.00 $393.12 $255.53 $393.12 $357.67 2026-07-19
73000 CPT X-ray Collar Bone Lt 16 5 $440.00 $440.08 $187.04 $440.08 $357.56 2026-07-19
87493 CPT C Diff By Pcr 10 5 $388.00 $388.75 $252.69 $388.75 $350.46 2026-07-19
11423 CPT Exc Ben Lesion 2.1-3.0 Neck 6 5 $303.00 $303.68 $322.18 $431.79 $345.16 2026-07-19
73070 CPT X-ray Elbow Lt 16 5 $424.00 $424.79 $41.69 $424.79 $345.14 2026-07-19
99223 CPT IP/Obs Initial High Comp 6 5 $488.00 $488.12 $270.04 $389.40 $334.66 2026-07-19
80074 CPT Acute Hepatitis Panel 8 5 $405.00 $405.13 $263.33 $405.13 $332.81 2026-07-19
87635 CPT Sars-cov-2 Amp Probe 10 5 $369.00 $369.10 $239.91 $369.10 $332.75 2026-07-19
73523 CPT X-ray Hips 5 Views Bi 8 5 $349.00 $349.44 $227.14 $690.20 $331.97 2026-07-19
82088 CPT Aldosterone 8 5 $404.00 $404.04 $262.63 $404.04 $331.92 2026-07-19
51700 CPT Irrigation Bladder Simple 8 5 $404.00 $404.04 $262.63 $404.04 $331.92 2026-07-19
12031 CPT Repair Lac Intermed <2.5 Cm 6 5 $644.00 $644.28 $307.22 $423.98 $328.60 2026-07-19
73560 CPT X-ray Knee 1-2 Views Lt 20 5 $354.00 $354.90 $84.00 $354.90 $319.95 2026-07-19
73100 CPT X-ray Wrist 2 Views Lt 16 5 $393.00 $393.12 $66.51 $393.12 $319.41 2026-07-19
97167 CPT Ot Eval High Complexity 8 5 $388.00 $388.75 $252.69 $388.75 $319.36 2026-07-19
82542 CPT Pth Like Protein 8 5 $386.00 $386.57 $251.27 $386.57 $317.56 2026-07-19
73502 CPT X-ray Hip Uni 2-3 Views Rt 21 5 $331.00 $331.97 $215.78 $860.42 $315.37 2026-07-19
93798 CPT Cardiac Rehab Ii Monitored 10 5 $346.00 $346.16 $225.00 $346.16 $312.06 2026-07-19
85613 CPT Drvvt 8 5 $373.00 $373.46 $242.75 $373.46 $306.79 2026-07-19
11441 CPT Exc Ben Lesion 0.6-1.0 Face 6 5 $405.00 $405.13 $272.97 $364.78 $291.58 2026-07-19
97605 CPT Neg Pressure Wound Dme <50 Cm 10 5 $323.00 $323.23 $210.10 $323.23 $291.39 2026-07-19
93005 CPT EKG Tracing 13 6 $305.00 $305.76 $198.74 $305.76 $290.47 2026-07-19
80069 CPT Renal Function Panel 10 5 $321.00 $321.05 $208.68 $321.05 $289.43 2026-07-19
99292 CPT Critical Care Ea Addl 30 Min 14 5 $440.00 $440.08 $164.83 $440.08 $289.35 2026-07-19
82627 CPT Dheas 10 5 $319.00 $319.96 $207.97 $319.96 $288.44 2026-07-19
73620 CPT X-ray Foot 2 Views Lt 16 5 $354.00 $354.90 $212.82 $354.90 $288.36 2026-07-19
90750 CPT Varicella Zoster Adjuvant Vax 10 5 $319.00 $319.02 $207.36 $319.02 $287.60 2026-07-19
82330 CPT Ionized Calcium 8 5 $349.00 $349.44 $227.14 $349.44 $287.06 2026-07-19
73600 CPT X-ray Ankle 2 Views Rt 18 5 $336.00 $336.34 $86.75 $336.34 $286.90 2026-07-19
96365 CPT Inf Therapy Med Initial 21 5 $283.00 $283.92 $184.55 $397.49 $283.92 2026-07-19
86812 CPT Hla B27 8 5 $340.00 $340.70 $221.46 $340.70 $279.88 2026-07-19
83880 CPT B Type Natriuretic Peptide 10 5 $307.00 $307.94 $200.16 $307.94 $277.61 2026-07-19
G0480 HCPCS Clobazam 8 5 $335.00 $335.24 $217.91 $335.24 $275.40 2026-07-19
92610 CPT Swallow Eval Non Radiol 8 5 $333.00 $333.06 $216.49 $333.06 $273.61 2026-07-19
P9612 HCPCS Cath For Collecting Specimen 8 5 $330.00 $330.72 $214.97 $330.72 $271.69 2026-07-19
97162 CPT Pt Eval Mod Complexity 10 5 $326.00 $326.51 $65.30 $326.51 $268.23 2026-07-19
97166 CPT Ot Eval Mod Complexity 8 5 $326.00 $326.51 $212.23 $326.51 $268.23 2026-07-19
97161 CPT Pt Eval Low Complexity 12 6 $277.00 $277.37 $180.29 $277.37 $263.50 2026-07-19
92522 CPT Eval St Speech Production 8 5 $318.00 $318.86 $207.26 $318.86 $261.94 2026-07-19
83970 CPT Pth 10 5 $290.00 $290.47 $188.81 $290.47 $261.86 2026-07-19
J1815 HCPCS Insulin Glar 100Unit/ML 10ml 28 5 $278.50 $279.13 $168.26 $391.85 $258.88 2026-07-19
J1610 HCPCS Glucagon 1 Mg/ml Vial 8 5 $317.00 $317.68 $98.91 $317.68 $258.12 2026-07-19
96360 CPT Inf Therapy Hyd Initial 10 5 $283.00 $283.92 $184.55 $283.92 $255.95 2026-07-19
92507 CPT Speech Therapy Trmt 8 5 $307.00 $307.94 $200.16 $307.94 $252.97 2026-07-19
86778 CPT Toxoplasma IgM 8 5 $307.00 $307.94 $200.16 $307.94 $252.97 2026-07-19
11402 CPT Exc Ben Lesion 1.1-2.0 Trunk 6 5 $324.00 $324.32 $236.15 $318.30 $252.56 2026-07-19
83520 CPT Thyrotropin Recept Aby 37 5 $386.00 $386.57 $135.57 $516.52 $251.27 2026-07-19
81418 CPT Pharmacogenomic Geno 8 5 $305.00 $305.76 $198.74 $305.76 $251.18 2026-07-19
73140 CPT X-ray Finger(s) Lt 20 5 $293.00 $293.75 $58.75 $293.75 $250.57 2026-07-19
82306 CPT 25 Hydvit D2 And D3 19 5 $293.00 $293.75 $180.29 $293.75 $250.57 2026-07-19
97165 CPT Ot Eval Low Complexity 10 5 $277.00 $277.37 $180.29 $277.37 $250.05 2026-07-19
82803 CPT Blood Gas Wo Oximetry 8 5 $303.00 $303.68 $197.39 $303.68 $249.48 2026-07-19
99222 CPT Inpatient Initial/Obs Mod Comp 6 5 $331.00 $331.97 $202.33 $274.01 $246.06 2026-07-19
84270 CPT Sex Hormone Binding Globulin 10 5 $271.00 $271.91 $176.74 $271.91 $245.12 2026-07-19
82952 CPT Glucose Tol Addl Spec #1 8 5 $297.00 $297.02 $193.06 $297.02 $244.00 2026-07-19
96374 CPT IV Push Injection Initial 11 5 $283.00 $283.92 $184.55 $283.92 $242.18 2026-07-19
80151 CPT Amiodarone 8 5 $293.00 $293.75 $190.94 $293.75 $241.31 2026-07-19
73660 CPT X-ray Toe(s) 2 Views Rt 8 5 $293.00 $293.75 $66.51 $293.75 $238.68 2026-07-19
11421 CPT Exc Ben Lesion 0.6-1.0 Neck 6 5 $476.00 $476.11 $223.11 $304.78 $238.34 2026-07-19
99212 CPT Est Patient Level 2 Wound Care 8 5 $289.00 $289.12 $187.93 $289.12 $237.51 2026-07-19
84402 CPT Testosterone Fre Female/Child 10 5 $262.00 $262.08 $170.35 $262.08 $236.26 2026-07-19
11440 CPT Exc Ben Lesion <0.5 Face Ears 6 5 $297.00 $297.02 $221.35 $290.05 $236.12 2026-07-19
80048 CPT Basic Metabolic Panel 13 6 $245.00 $245.70 $159.71 $245.70 $233.42 2026-07-19
11401 CPT Exc Ben Lesion 0.6-1.0 Trunk 6 5 $376.00 $376.74 $216.16 $289.52 $231.18 2026-07-19
73562 CPT X-ray Knee 3 Views Rt 18 5 $282.00 $282.83 $56.57 $282.83 $229.80 2026-07-19
83835 CPT Metanephrines Urine 8 5 $278.00 $278.46 $181.00 $278.46 $228.75 2026-07-19
84403 CPT Testosterone Total Ref 28 5 $250.00 $250.07 $151.19 $334.15 $227.41 2026-07-19
82232 CPT Beta 2 Microglobulin 8 5 $270.00 $270.82 $176.03 $270.82 $222.48 2026-07-19
86638 CPT Q Fever Antibody 8 5 $269.00 $269.72 $175.32 $269.72 $221.57 2026-07-19
84481 CPT T3 Free 10 5 $245.00 $245.70 $159.71 $245.70 $221.50 2026-07-19
86870 CPT Rbc Antibody Identif Panel 8 5 $268.00 $268.63 $174.61 $268.63 $220.68 2026-07-19
29581 CPT Appl Multi Layer Ven Wnd Compr 10 5 $263.00 $263.17 $52.63 $263.17 $216.19 2026-07-19
84484 CPT Troponin Quant 12 5 $239.00 $239.15 $155.45 $239.15 $215.59 2026-07-19
87040 CPT Culture Blood 10 5 $239.00 $239.15 $155.45 $239.15 $215.59 2026-07-19
82384 CPT Catecholamines Fract 8 5 $262.00 $262.08 $170.35 $262.08 $215.30 2026-07-19
51703 CPT Cath Insert Compl Indwelling 8 5 $257.00 $257.71 $167.51 $257.71 $211.71 2026-07-19
87899 CPT Legionella Antigen Urine 37 5 $236.00 $236.96 $48.67 $440.08 $210.51 2026-07-19
87502 CPT Influenza A&b By Pcr 8 5 $255.00 $255.53 $166.09 $255.53 $209.92 2026-07-19
86140 CPT C-reactive Protein 10 5 $232.00 $232.60 $151.19 $232.60 $209.69 2026-07-19
99213 CPT Est Patient Level 3 Wound Care 14 5 $317.00 $317.20 $98.49 $317.20 $208.56 2026-07-19
51798 CPT Bladder Scan 10 5 $230.00 $230.41 $149.77 $230.41 $207.71 2026-07-19
86300 CPT Ca 27-29 8 5 $252.00 $252.25 $163.96 $252.25 $207.22 2026-07-19
86334 CPT Immunofix Electroph Serum 19 5 $241.00 $241.33 $149.06 $241.33 $205.85 2026-07-19
86146 CPT Beta-2-glycoprotein IgG 8 5 $250.00 $250.07 $162.55 $250.07 $205.44 2026-07-19
99239 CPT IP/Obs Discharge >30 Min 6 5 $269.00 $269.72 $179.47 $243.58 $204.89 2026-07-19
99233 CPT Inpatient/Obs Subsequent High 6 5 $277.00 $277.37 $184.54 $250.08 $204.29 2026-07-19
84590 CPT Vitamin A 8 5 $245.00 $245.70 $159.71 $245.70 $201.84 2026-07-19
84244 CPT Renin 8 5 $245.00 $245.70 $159.71 $245.70 $201.84 2026-07-19
73120 CPT X-ray Hand Lt 16 5 $238.00 $238.06 $154.74 $238.06 $201.03 2026-07-19
80053 CPT Comprehensive Metabolic Panel 11 5 $233.00 $233.69 $151.90 $233.69 $199.34 2026-07-19
86618 CPT Lyme Disease Antibody 8 5 $241.00 $241.33 $156.86 $241.33 $198.25 2026-07-19
86777 CPT Toxoplasma IgG 8 5 $238.00 $238.06 $154.74 $238.06 $195.57 2026-07-19
23500 CPT Fx Clavicle Rt 8 5 $237.00 $237.12 $154.13 $237.12 $194.79 2026-07-19
82607 CPT B12 10 5 $215.00 $215.12 $139.83 $215.12 $193.93 2026-07-19
83935 CPT Osmolality Urine 10 5 $215.00 $215.12 $139.83 $215.12 $193.93 2026-07-19
86762 CPT Rubella IgG 8 5 $235.00 $235.87 $153.32 $235.87 $193.77 2026-07-19
84153 CPT Psa Total 10 5 $211.00 $211.85 $137.70 $211.85 $190.99 2026-07-19
88341 CPT Immunohisto Stain Add Per Spc 8 5 $231.00 $231.92 $150.75 $231.92 $190.53 2026-07-19
87070 CPT Culture Bacteria Oth 10 5 $210.00 $210.76 $136.99 $210.76 $190.00 2026-07-19
82085 CPT Aldolase 8 5 $226.00 $226.04 $146.93 $226.04 $185.69 2026-07-19
86920 CPT Crossmatch Immed Spin 10 5 $226.00 $226.04 $45.21 $226.04 $185.69 2026-07-19
84703 CPT Hcg Beta Qual 10 5 $205.00 $205.30 $133.44 $205.30 $185.08 2026-07-19
82150 CPT Amylase Serum 10 5 $203.00 $203.11 $132.02 $203.11 $183.10 2026-07-19
51702 CPT Cath Insert Simple Indwelling 10 5 $200.00 $200.93 $130.60 $200.93 $181.13 2026-07-19
83001 CPT Fsh 10 5 $200.00 $200.93 $130.60 $200.93 $181.13 2026-07-19
88342 CPT Immunohisto Stain Init Pr Spec 8 5 $220.00 $220.48 $143.31 $220.48 $181.12 2026-07-19
11420 CPT Exc Ben Lesion <0.5 Neck Ext 6 5 $375.00 $375.65 $169.24 $229.43 $180.87 2026-07-19
97168 CPT Re Evaluation Ot 8 5 $218.00 $218.40 $141.96 $218.40 $179.42 2026-07-19
82941 CPT Gastrin 8 5 $217.00 $217.31 $141.25 $217.31 $178.52 2026-07-19
82550 CPT Cpk Total 10 5 $197.00 $197.65 $128.47 $197.65 $178.19 2026-07-19
12055 CPT Repair Lac Interm 12.6-20.0 Cm 14 5 $182.00 $182.00 $118.30 $824.66 $177.45 2026-07-19
86664 CPT Lab-epstein Barr Nuclear Antig 8 5 $215.00 $215.12 $139.83 $215.12 $176.72 2026-07-19
86663 CPT Epstein Barr Early Antigen 8 5 $215.00 $215.12 $139.83 $215.12 $176.72 2026-07-19
97129 CPT Cognitive Skills Development 8 5 $215.00 $215.12 $139.83 $215.12 $176.72 2026-07-19
86200 CPT Citrulline Antibody 8 5 $215.00 $215.12 $139.83 $215.12 $176.72 2026-07-19
90732 CPT Pneumococcal 23 Vax 0.5 Ml Syr 8 5 $213.00 $213.30 $67.16 $213.30 $173.31 2026-07-19
P9047 HCPCS Albumin Human 25% 25gr/100ml 6 5 $191.00 $191.70 $124.61 $191.70 $172.82 2026-07-19
84425 CPT Vitamin B1 10 5 $190.00 $190.01 $123.51 $190.01 $171.30 2026-07-19
84480 CPT T3 Total 10 5 $188.00 $188.92 $122.80 $188.92 $170.31 2026-07-19
87804 CPT Influenza A Antigen 19 5 $198.00 $198.74 $123.51 $198.74 $169.53 2026-07-19
Q5110 HCPCS Filgrastim-aafi 300 Mcg/0.5 Ml 8 5 $177.00 $177.94 $115.66 $927.00 $169.04 2026-07-19
27786 CPT Fx Distal Fibula Rt 8 5 $205.00 $205.30 $133.44 $205.30 $168.66 2026-07-19
81025 CPT Hcg Beta Qual Urine 8 5 $205.00 $205.30 $133.44 $205.30 $168.66 2026-07-19
26750 CPT Fx Distal Finger/Thumb Wo Man 8 5 $205.00 $205.30 $133.44 $205.30 $168.66 2026-07-19
26720 CPT Fx Finger/Thumb Wo Man 8 5 $205.00 $205.30 $133.44 $205.30 $168.66 2026-07-19
25600 CPT Fx Distal Radius Lt 8 5 $205.00 $205.30 $133.44 $205.30 $168.66 2026-07-19
83002 CPT Lh 10 5 $186.00 $186.73 $121.37 $186.73 $168.33 2026-07-19
12052 CPT Repair Lac Interm 2.6-5.0 Cm 14 5 $172.00 $172.54 $112.15 $559.61 $168.22 2026-07-19
12041 CPT Repair Lac Interm <2.5 Cm 14 5 $172.00 $172.54 $112.15 $409.19 $168.22 2026-07-19
G0472 HCPCS Hcv Antibody Screen 8 5 $204.00 $204.20 $132.73 $204.20 $167.75 2026-07-19
86147 CPT Cardiolipin Antibody 8 5 $204.00 $204.20 $132.73 $204.20 $167.75 2026-07-19
87641 CPT Mrsa By Pcr 10 5 $182.00 $182.36 $118.53 $182.36 $164.40 2026-07-19
11641 CPT Exc Mal Lesion 0.6-1.0 Face 16 5 $163.00 $163.80 $106.47 $432.43 $163.80 2026-07-19
96366 CPT Inf Therapy Med Ea Addl Hr 12 5 $181.00 $181.27 $117.83 $181.27 $163.42 2026-07-19
83051 CPT Hemoglobin Plasma 8 5 $198.00 $198.74 $129.18 $198.74 $163.26 2026-07-19
82390 CPT Cerulaplasmin 8 5 $198.00 $198.74 $129.18 $198.74 $163.26 2026-07-19
86803 CPT Hcv Antibody 8 5 $198.00 $198.74 $129.18 $198.74 $163.26 2026-07-19
84144 CPT Progesterone 10 5 $180.00 $180.18 $117.12 $180.18 $162.43 2026-07-19
80162 CPT Digoxin 8 5 $197.00 $197.65 $128.47 $197.65 $162.37 2026-07-19
86301 CPT Ca 19-9 8 5 $197.00 $197.65 $128.47 $197.65 $162.37 2026-07-19
84443 CPT Tsh 10 5 $179.00 $179.09 $116.41 $179.09 $161.45 2026-07-19
11602 CPT Exc Mal Lesion 1.1-2.0 Trunk 14 5 $163.00 $163.80 $106.47 $451.89 $159.71 2026-07-19
11642 CPT Exc Mal Lesion 1.1-2.0 Face 14 5 $163.00 $163.80 $106.47 $507.05 $159.71 2026-07-19
80202 CPT Vancomycin 8 5 $194.00 $194.38 $126.35 $194.38 $159.69 2026-07-19
84146 CPT Prolactin 8 5 $194.00 $194.38 $126.35 $194.38 $159.69 2026-07-19
82728 CPT Ferritin 10 5 $176.00 $176.90 $114.98 $176.90 $159.48 2026-07-19
99211 CPT Care/Removal Urinary Catheter 48 5 $208.00 $208.57 $102.21 $228.80 $159.25 2026-07-19
761 CDM Application/Rem Cast Or Splint 24 5 $193.00 $193.44 $66.01 $295.93 $158.91 2026-07-19
99221 CPT Inpatient/Obs Initial Low Comp 6 5 $252.00 $252.25 $127.26 $194.22 $157.56 2026-07-19
86015 CPT Smooth Muscle Antibody 8 5 $191.00 $191.10 $124.22 $191.10 $156.99 2026-07-19
86381 CPT Mitochondrial Antibody 8 5 $191.00 $191.10 $124.22 $191.10 $156.99 2026-07-19
96375 CPT IV Injection Subsequent 11 5 $163.00 $163.80 $106.47 $163.80 $155.61 2026-07-19
87798 CPT Parvovirus Pcr 8 5 $188.00 $188.92 $122.80 $188.92 $155.20 2026-07-19
86765 CPT Rubeola IgG Antibody 8 5 $187.00 $187.85 $122.10 $187.85 $154.32 2026-07-19
82507 CPT Citric Acid Urine 8 5 $187.00 $187.82 $122.08 $187.82 $154.30 2026-07-19
11303 CPT Shave Lesion >2.0 Trunk Limb 6 5 $425.00 $425.88 $142.25 $201.52 $152.57 2026-07-19
83993 CPT Calprotectin 8 5 $184.00 $184.55 $119.96 $184.55 $151.60 2026-07-19
87812 CPT SarsCoV & Influ Ab Ag By Ia 10 5 $167.00 $167.08 $108.60 $167.08 $150.62 2026-07-19
G0103 HCPCS Psa Screen 10 5 $167.00 $167.08 $108.60 $167.08 $150.62 2026-07-19
85025 CPT Cbc W Auto Diff 12 6 $165.00 $165.98 $107.89 $165.98 $149.63 2026-07-19
29065 CPT Apply Long Arm Cast Lt 12 5 $207.00 $207.48 $137.65 $186.84 $149.55 2026-07-19
96367 CPT Inf Therapy Med Sequential 8 5 $181.00 $181.27 $117.83 $181.27 $148.91 2026-07-19
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