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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

MILBANK AREA HOSPITAL/AVERA HEALTH

Milbank, SD · CCN 431326 · Rates published

1,004 distinct procedures filed
6 distinct payers
17,365 rate rows
2026-07-15 last MRF observed
Data quality

17,310 of 17,365 rate rows are consumer-grade (99.7%)

55 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
placeholder amount (≤ $0.02) — excluded from medians 20
exceeds 10× this hospital's gross charge — excluded from medians 14
percent-of-charges filed in the dollar field — excluded from medians 9
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 8
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/78e84abe-92bd-4ee6-846a-d026f88e1b6e/460224743_avera-milbank-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 655bd0c32bbf698c… · 4,267,090 bytes · first seen 2026-06-08

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
J2350
HCPCS 		Ocrelizumab 300 Mg/10 Ml 6 $6.09 $84,421.47 $49,764.24 nat. median
$470
outlier · 106.0×
682
MS_DRG 		Ms-DRG 682 1 $28,132.08 $28,132.08 $28,132.08 nat. median
$14,434
1.9× median
J9144
HCPCS 		Daratumumab Hyaluronida 1800Mg 6 $107.92 $42,921.73 $27,334.36 nat. median
$211
outlier · 129.3×
J2329
HCPCS 		Ublituximab-xiiy 150 Mg/6 Ml 6 $6.87 $44,817.44 $26,418.70 nat. median
$177
outlier · 149.2×
J9119
HCPCS 		Cemiplimab-rwlc 350 Mg/7 Ml Vl 6 $59.24 $44,308.18 $26,118.51 nat. median
$91
outlier · 286.9×
788
MS_DRG 		Ms-DRG 788 1 $25,223.90 $25,223.90 $25,223.90 nat. median
$9,599
outlier · 2.6×
5402
APR_DRG 		Apr-DRG 5402 1 $23,717.77 $23,717.77 $23,717.77 nat. median
$6,656
outlier · 3.6×
J9316
HCPCS 		Pertuzu-trastuzu 10 Ml Vial 6 $88.41 $38,095.18 $22,456.11 nat. median
$384
outlier · 58.5×
J3380
HCPCS 		Vedolizumab 300 Mg Vial 6 $43.34 $37,731.04 $22,241.45 nat. median
$162
outlier · 137.3×
81162
CPT 		Brca 1&2 Full Gene Seq Del/Dup 6 $10,730.29 $27,111.10 $22,031.34 nat. median
$1,825
outlier · 12.1×
197
MS_DRG 		Ms-DRG 197 1 $17,988.88 $17,988.88 $17,988.88 nat. median
$10,135
1.8× median
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 6 $0.41 $30,005.60 $17,687.51 nat. median
$3,820
outlier · 4.6×
J0896
HCPCS 		Luspatercept-aamt 25 Mg Vial 6 $1.20 $50,844.94 $16,071.85 nat. median
$4,583
outlier · 3.5×
5401
APR_DRG 		Apr-DRG 5401 1 $14,169.53 $14,169.53 $14,169.53 nat. median
$5,394
outlier · 2.6×
292
MS_DRG 		Ms-DRG 292 2 $6,367.02 $13,525.18 $13,525.18 nat. median
$8,952
1.5× median
64
MS_DRG 		Ms-DRG 64 1 $13,525.18 $13,525.18 $13,525.18 nat. median
$19,252
0.7× median
J0717
HCPCS 		Certolizumab Pegol 400 Mg Kit 6 $3.42 $21,079.74 $12,425.95 nat. median
$1,598
outlier · 7.8×
66
MS_DRG 		Ms-DRG 66 1 $12,075.76 $12,075.76 $12,075.76 nat. median
$7,559
1.6× median
74
MS_DRG 		Ms-DRG 74 1 $12,075.76 $12,075.76 $12,075.76 nat. median
$10,485
1.2× median
J2356
HCPCS 		Tezepelumab-ekko 210 Mg/1.9 Ml 6 $12.98 $16,588.30 $9,778.37 nat. median
$81
outlier · 120.3×
689
MS_DRG 		Ms-DRG 689 1 $9,027.96 $9,027.96 $9,027.96 nat. median
$11,514
0.8× median
78815
CPT 		PET CT Skull To Mid Thigh Init 6 $1,440.20 $10,568.75 $7,909.88 nat. median
$2,820
outlier · 2.8×
J2182
HCPCS 		Mepolizumab 100 Mg Vial 6 $6.38 $12,758.71 $7,520.92 nat. median
$2,791
outlier · 2.7×
690
MS_DRG 		Ms-DRG 690 1 $7,203.20 $7,203.20 $7,203.20 nat. median
$8,376
0.9× median
J9205
HCPCS 		Irinotecan Lipos 43mg/10ml Vl 6 $134.86 $12,214.63 $7,200.20 nat. median
$202
outlier · 35.6×
J2357
HCPCS 		Omalizumab 300 Mg/2Ml Syringe 6 $9.26 $11,983.91 $7,064.20 nat. median
$1,245
outlier · 5.7×
Q5107
HCPCS 		Bevacizumab-awwb 400Mg/16Ml Vi 6 $57.46 $11,568.78 $6,819.49 nat. median
$563
outlier · 12.1×
J3111
HCPCS 		Romosozumab-aqqg 210 Mg/2.34Ml 6 $1.56 $10,938.47 $6,447.94 nat. median
$681
outlier · 9.5×
5601
APR_DRG 		Apr-DRG 5601 1 $6,407.97 $6,407.97 $6,407.97 nat. median
$3,341
1.9× median
J0897
HCPCS 		Denosumab 60 Mg/ml Syringe 6 $9.69 $13,047.40 $6,258.09 nat. median
$1,972
outlier · 3.2×
5602
APR_DRG 		Apr-DRG 5602 1 $6,163.08 $6,163.08 $6,163.08 nat. median
$3,747
1.6× median
81352
CPT 		Tp53 Somatic Mutation, Prog 6 $3,144.11 $7,943.90 $6,008.09 nat. median
$428
outlier · 14.0×
1392
APR_DRG 		Apr-DRG 1392 1 $5,956.16 $5,956.16 $5,956.16 nat. median
$5,416
1.1× median
J9303
HCPCS 		Panitumumab 100 Mg/5 Ml Vial 6 $348.00 $40,605.80 $5,901.45 nat. median
$1,789
outlier · 3.3×
78452
CPT 		Myocard Perf Spect Rest Stress 6 $2,891.82 $7,306.45 $5,417.00 nat. median
$1,816
outlier · 3.0×
95810
CPT 		Polysomnogram 6 $2,596.66 $6,906.00 $5,393.59 nat. median
$1,825
outlier · 3.0×
78451
CPT 		Myocard Perf Spect Rest Or Str 6 $2,608.31 $6,590.15 $5,355.36 nat. median
$1,546
outlier · 3.5×
J9034
HCPCS 		Bendamustine 100 Mg/4 Ml Vial 6 $28.26 $8,284.66 $5,276.02 nat. median
$90
outlier · 58.9×
Q5108
HCPCS 		Pegfilgrastim-jmdb 6 Mg/0.6 Ml 6 $250.60 $7,625.51 $5,217.45 nat. median
$1,244
outlier · 4.2×
95811
CPT 		Polysomnogram W CPap 6 $307.42 $6,862.00 $5,177.51 nat. median
$1,894
outlier · 2.7×
6401
APR_DRG 		Apr-DRG 6401 1 $5,096.88 $5,096.88 $5,096.88 nat. median
$1,109
outlier · 4.6×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 6 $271.10 $8,478.75 $4,998.00 nat. median
$1,982
outlier · 2.5×
J1602
HCPCS 		Golimumab 50 Mg/4 Ml Vial 6 $21.08 $8,399.98 $4,951.56 nat. median
$273
outlier · 18.2×
59400
CPT 		Obstetrical Care 6 $3,710.90 $5,181.79 $4,850.13 nat. median
$3,137
1.5× median
Q5122
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Syr 6 $234.02 $8,113.98 $4,782.98 nat. median
$561
outlier · 8.5×
394
MS_DRG 		Ms-DRG 394 1 $4,530.74 $4,530.74 $4,530.74 nat. median
$9,683
outlier · 0.5×
G0390
HCPCS 		Trauma Team Level 5 6 $2,181.93 $5,512.85 $4,479.92 nat. median
$3,197
1.4× median
689
CDM 		Trauma Team Evaluation Level 5 6 $2,181.93 $5,512.85 $4,479.92 nat. median
$1,169
outlier · 3.8×
74174
CPT 		CTA Abd&Pelv Wwo Dye 6 $1,834.00 $7,214.30 $4,411.52 nat. median
$988
outlier · 4.5×
J9264
HCPCS 		Paclitaxel Protein-bd 100mg Vl 6 $17.39 $6,728.39 $3,966.21 nat. median
$766
outlier · 5.2×

Other procedures at this hospital

Browse this hospital's 1,004 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
             
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml 11 6 $88,864.00 $86,198.77 $6.09 $84,421.47 $49,764.24 2026-07-15
682 MS_DRG Ms-DRG 682 2 1 — — $28,132.08 $28,132.08 $28,132.08 2026-07-15
J9144 HCPCS Daratumumab Hyaluronida 1800Mg 12 6 $45,180.00 $43,825.35 $107.92 $42,921.73 $27,334.36 2026-07-15
J2329 HCPCS Ublituximab-xiiy 150 Mg/6 Ml 11 6 $47,176.00 $45,760.96 $6.87 $44,817.44 $26,418.70 2026-07-15
J9119 HCPCS Cemiplimab-rwlc 350 Mg/7 Ml Vl 11 6 $46,640.00 $45,240.98 $59.24 $44,308.18 $26,118.51 2026-07-15
788 MS_DRG Ms-DRG 788 1 1 — — $25,223.90 $25,223.90 $25,223.90 2026-07-15
5402 APR_DRG Apr-DRG 5402 2 1 — — $23,717.77 $23,717.77 $23,717.77 2026-07-15
J9316 HCPCS Pertuzu-trastuzu 10 Ml Vial 11 6 $40,100.00 $38,897.18 $88.41 $38,095.18 $22,456.11 2026-07-15
J3380 HCPCS Vedolizumab 300 Mg Vial 13 6 $39,716.00 $38,525.37 $43.34 $37,731.04 $22,241.45 2026-07-15
81162 CPT Brca 1&2 Full Gene Seq Del/Dup 9 6 $28,538.00 $27,681.86 $10,730.29 $27,111.10 $22,031.34 2026-07-15
197 MS_DRG Ms-DRG 197 2 1 — — $17,988.88 $17,988.88 $17,988.88 2026-07-15
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Syrng 13 6 $31,584.00 $30,637.29 $0.41 $30,005.60 $17,687.51 2026-07-15
J0896 HCPCS Luspatercept-aamt 25 Mg Vial 18 6 $17,827.00 $17,293.05 $1.20 $50,844.94 $16,071.85 2026-07-15
5401 APR_DRG Apr-DRG 5401 2 1 — — $14,169.53 $14,169.53 $14,169.53 2026-07-15
64 MS_DRG Ms-DRG 64 2 1 — — $13,525.18 $13,525.18 $13,525.18 2026-07-15
292 MS_DRG Ms-DRG 292 3 2 — — $6,367.02 $13,525.18 $13,525.18 2026-07-15
J0717 HCPCS Certolizumab Pegol 400 Mg Kit 11 6 $22,189.00 $21,523.52 $3.42 $21,079.74 $12,425.95 2026-07-15
74 MS_DRG Ms-DRG 74 2 1 — — $12,075.76 $12,075.76 $12,075.76 2026-07-15
66 MS_DRG Ms-DRG 66 2 1 — — $12,075.76 $12,075.76 $12,075.76 2026-07-15
J2356 HCPCS Tezepelumab-ekko 210 Mg/1.9 Ml 11 6 $17,461.00 $16,937.53 $12.98 $16,588.30 $9,778.37 2026-07-15
689 MS_DRG Ms-DRG 689 2 1 — — $9,027.96 $9,027.96 $9,027.96 2026-07-15
78815 CPT PET CT Skull To Mid Thigh Init 20 6 $11,125.00 $10,791.25 $1,440.20 $10,568.75 $7,909.88 2026-07-15
J2182 HCPCS Mepolizumab 100 Mg Vial 11 6 $13,430.00 $13,027.31 $6.38 $12,758.71 $7,520.92 2026-07-15
690 MS_DRG Ms-DRG 690 2 1 — — $7,203.20 $7,203.20 $7,203.20 2026-07-15
J9205 HCPCS Irinotecan Lipos 43mg/10ml Vl 11 6 $12,857.00 $12,471.77 $134.86 $12,214.63 $7,200.20 2026-07-15
J2357 HCPCS Omalizumab 300 Mg/2Ml Syringe 11 6 $12,614.00 $12,236.20 $9.26 $11,983.91 $7,064.20 2026-07-15
Q5107 HCPCS Bevacizumab-awwb 400Mg/16Ml Vi 11 6 $12,177.00 $11,812.33 $57.46 $11,568.78 $6,819.49 2026-07-15
J3111 HCPCS Romosozumab-aqqg 210 Mg/2.34Ml 11 6 $11,514.00 $11,168.75 $1.56 $10,938.47 $6,447.94 2026-07-15
5601 APR_DRG Apr-DRG 5601 2 1 — — $6,407.97 $6,407.97 $6,407.97 2026-07-15
J0897 HCPCS Denosumab 60 Mg/ml Syringe 18 6 $7,702.00 $7,471.20 $9.69 $13,047.40 $6,258.09 2026-07-15
5602 APR_DRG Apr-DRG 5602 2 1 — — $6,163.08 $6,163.08 $6,163.08 2026-07-15
81352 CPT Tp53 Somatic Mutation, Prog 10 6 $8,362.00 $8,111.14 $3,144.11 $7,943.90 $6,008.09 2026-07-15
1392 APR_DRG Apr-DRG 1392 2 1 — — $5,956.16 $5,956.16 $5,956.16 2026-07-15
J9303 HCPCS Panitumumab 100 Mg/5 Ml Vial 13 6 $7,644.00 $7,415.03 $348.00 $40,605.80 $5,901.45 2026-07-15
78452 CPT Myocard Perf Spect Rest Stress 15 6 $7,691.00 $7,460.27 $2,891.82 $7,306.45 $5,417.00 2026-07-15
95810 CPT Polysomnogram 12 6 $6,906.00 $6,698.82 $2,596.66 $6,906.00 $5,393.59 2026-07-15
78451 CPT Myocard Perf Spect Rest Or Str 9 6 $6,937.00 $6,728.89 $2,608.31 $6,590.15 $5,355.36 2026-07-15
J9034 HCPCS Bendamustine 100 Mg/4 Ml Vial 12 6 $8,720.00 $8,459.07 $28.26 $8,284.66 $5,276.02 2026-07-15
Q5108 HCPCS Pegfilgrastim-jmdb 6 Mg/0.6 Ml 13 6 $8,026.00 $7,786.04 $250.60 $7,625.51 $5,217.45 2026-07-15
95811 CPT Polysomnogram W CPap 14 6 $7,206.00 $6,989.82 $307.42 $6,862.00 $5,177.51 2026-07-15
6401 APR_DRG Apr-DRG 6401 2 1 — — $5,096.88 $5,096.88 $5,096.88 2026-07-15
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 11 6 $8,925.00 $8,657.25 $271.10 $8,478.75 $4,998.00 2026-07-15
J1602 HCPCS Golimumab 50 Mg/4 Ml Vial 11 6 $8,842.00 $8,576.82 $21.08 $8,399.98 $4,951.56 2026-07-15
59400 CPT Obstetrical Care 8 6 $3,765.00 $3,652.05 $3,710.90 $5,181.79 $4,850.13 2026-07-15
Q5122 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Syr 11 6 $8,541.00 $8,284.80 $234.02 $8,113.98 $4,782.98 2026-07-15
394 MS_DRG Ms-DRG 394 1 1 — — $4,530.74 $4,530.74 $4,530.74 2026-07-15
689 CDM Trauma Team Evaluation Level 5 9 6 $5,803.00 $5,628.91 $2,181.93 $5,512.85 $4,479.92 2026-07-15
G0390 HCPCS Trauma Team Level 5 9 6 $5,803.00 $5,628.91 $2,181.93 $5,512.85 $4,479.92 2026-07-15
74174 CPT CTA Abd&Pelv Wwo Dye 11 6 $7,594.00 $7,366.18 $1,834.00 $7,214.30 $4,411.52 2026-07-15
J9264 HCPCS Paclitaxel Protein-bd 100mg Vl 11 6 $7,082.00 $6,870.04 $17.39 $6,728.39 $3,966.21 2026-07-15
J9312 HCPCS Rituximab 100 Mg/10 Ml Vial 18 6 $4,257.00 $4,130.10 $161.14 $20,224.74 $3,838.44 2026-07-15
70553 CPT MRI Brain Wwo Contrast 28 6 $5,153.00 $4,998.41 $729.77 $5,139.50 $3,747.31 2026-07-15
Q5115 HCPCS Rituximab-abbs 100Mg/10Ml Via 23 6 $2,258.00 $2,190.77 $63.66 $13,761.03 $3,708.00 2026-07-15
J0129 HCPCS Abatacept 250 Mg Vial 11 6 $6,470.00 $6,276.26 $87.60 $6,146.85 $3,623.41 2026-07-15
72157 CPT MRI Chest Spine Wwo Dye 21 6 $5,196.00 $5,040.12 $535.35 $5,182.25 $3,377.40 2026-07-15
72158 CPT MRI Lumbar Spine Wwo Dye 14 6 $5,557.00 $5,390.29 $340.97 $5,292.00 $3,361.99 2026-07-15
J3262 HCPCS Tocilizumab 200 Mg/10 Ml Vial 25 6 $5,901.00 $5,724.15 $2.72 $11,424.88 $3,304.67 2026-07-15
74177 CPT CT Abd & Pelv W Contrast 16 6 $5,306.00 $5,146.82 $227.52 $5,040.70 $3,265.61 2026-07-15
74178 CPT CT Abd & Pelv Wwo Contrast 15 6 $5,609.00 $5,440.73 $479.88 $5,328.55 $3,258.01 2026-07-15
70543 CPT MRI Orbit Face Neck Wwo Cont 12 6 $5,069.00 $4,916.93 $335.45 $4,815.55 $3,066.74 2026-07-15
74176 CPT CT Abd & Pelvis Wo Contrast 16 6 $4,946.00 $4,797.62 $95.04 $4,698.70 $3,044.00 2026-07-15
73723 CPT MRI Joint Le Wwo Dye Lt 13 6 $5,196.00 $5,040.12 $657.06 $4,936.20 $2,909.76 2026-07-15
73720 CPT MRI Le Wwo Dye Lt 22 6 $5,196.00 $5,040.12 $233.96 $4,936.20 $2,909.76 2026-07-15
73223 CPT MRI Joint Ue Wwo Dye Rt 14 6 $5,196.00 $5,040.12 $597.27 $4,936.20 $2,909.76 2026-07-15
72197 CPT MRI Pelvis Wwo Dye 12 6 $4,798.00 $4,654.06 $618.17 $4,558.10 $2,902.79 2026-07-15
72156 CPT MRI Neck Spine Wwo Dye 21 6 $5,181.00 $5,025.57 $340.05 $4,921.95 $2,901.36 2026-07-15
J9202 HCPCS Goserelin 3.6 Mg Implant 12 6 $4,767.00 $4,624.66 $77.09 $4,529.31 $2,884.45 2026-07-15
P9035 HCPCS Platelet Pheresis Leuko Reduc 9 6 $3,677.00 $3,566.69 $1,382.55 $3,493.15 $2,838.64 2026-07-15
J1439 HCPCS Ferric Carboxymalt 750mg/15ml 12 6 $4,594.00 $4,456.29 $2.22 $4,364.40 $2,779.43 2026-07-15
J1569 HCPCS Immune Glob Gammagard 5gr/50ml 25 6 $4,888.00 $4,741.94 $21.77 $9,313.57 $2,737.62 2026-07-15
C8929 HCPCS Echo M Mode 2d W Contrast 11 6 $3,486.00 $3,381.42 $1,310.74 $3,486.00 $2,691.19 2026-07-15
74183 CPT MRI Abdomen Wwo Dye 13 6 $4,799.00 $4,655.03 $619.08 $4,559.05 $2,687.44 2026-07-15
72195 CPT MRI Pelvis Wo Dye 9 6 $3,849.00 $3,733.53 $1,169.00 $3,656.55 $2,501.85 2026-07-15
72146 CPT MRI Chest Spine Wo Dye 12 6 $4,057.00 $3,935.29 $390.63 $3,854.15 $2,454.49 2026-07-15
C1889 HCPCS Device Ut Nvsr V5 US 11 6 $3,665.00 $3,555.06 $1,378.04 $3,481.76 $2,437.23 2026-07-15
93306 CPT Tte W Doppler Complete 16 6 $3,326.00 $3,226.22 $1,250.58 $3,159.70 $2,389.73 2026-07-15
Q5135 HCPCS Tocilizumab-aazg 200 Mg/10 Ml 11 6 $4,208.00 $4,081.97 $6.17 $3,997.81 $2,356.60 2026-07-15
73706 CPT CTA Le Wwo Dye Rt 23 6 $4,194.00 $4,068.18 $71.13 $3,984.30 $2,348.64 2026-07-15
J9217 HCPCS Leuprolide Acetate 45 Mg Syr 32 6 $3,675.00 $3,564.75 $1.47 $4,067.26 $2,334.68 2026-07-15
120 CDM Room Medical Unit Semi Private 7 6 $3,022.00 $2,931.34 $1,136.27 $2,870.90 $2,332.98 2026-07-15
A9552 HCPCS Radiophar Fdg 11 6 $2,999.00 $2,909.03 $1,127.62 $2,849.05 $2,315.23 2026-07-15
72148 CPT MRI Lumbar Spine Wo Dye 14 6 $4,101.00 $3,977.97 $315.18 $3,895.95 $2,296.56 2026-07-15
93970 CPT Venous Duplex 13 6 $3,451.00 $3,347.47 $1,297.58 $3,278.45 $2,294.91 2026-07-15
72141 CPT MRI Neck Spine Wo Dye 14 6 $4,017.00 $3,896.49 $233.96 $3,816.15 $2,249.52 2026-07-15
70492 CPT CT Soft Tissue Neck Wwo Cont 11 6 $3,921.00 $3,803.37 $422.85 $3,724.95 $2,195.76 2026-07-15
74181 CPT MRI Abdomen Wo Dye 13 6 $3,917.00 $3,799.49 $544.29 $3,721.15 $2,193.52 2026-07-15
112 CDM Room Womens Ctr 7 6 $2,809.00 $2,724.73 $1,056.18 $2,668.55 $2,168.55 2026-07-15
73221 CPT MRI Joint Ue Wo Dye Rt 29 6 $3,849.00 $3,733.53 $408.12 $3,656.55 $2,155.44 2026-07-15
70549 CPT MRA Neck Wwo Contrast 11 6 $3,849.00 $3,733.53 $666.92 $3,656.55 $2,155.44 2026-07-15
70544 CPT MRA Head Wo Contrast 13 6 $3,849.00 $3,733.53 $408.12 $3,656.55 $2,155.44 2026-07-15
73718 CPT MRI Le Wo Dye Lt 26 6 $3,849.00 $3,733.53 $56.39 $3,656.55 $2,155.44 2026-07-15
70551 CPT MRI Brain Wo Contrast 14 6 $3,849.00 $3,733.53 $447.03 $3,656.55 $2,155.44 2026-07-15
73721 CPT MRI Joint Le Wo Dye Lt 29 6 $3,849.00 $3,733.53 $315.18 $3,656.55 $2,155.44 2026-07-15
70498 CPT CT Angiography Neck W Cont 15 6 $3,792.00 $3,678.24 $278.39 $3,602.40 $2,123.52 2026-07-15
70496 CPT CT Angiography Head W Cont 15 6 $3,792.00 $3,678.24 $246.84 $3,602.40 $2,123.52 2026-07-15
Q5119 HCPCS Rituximab-pvvr 100Mg/10Ml Vial 18 6 $2,311.00 $2,242.03 $47.18 $10,703.22 $2,083.70 2026-07-15
70540 CPT MRI Orbit Face Neck Wo Cont 11 6 $3,665.00 $3,555.05 $350.15 $3,481.75 $2,052.40 2026-07-15
71275 CPT CTA Chest Wwo Contrast 12 6 $3,279.00 $3,180.63 $876.00 $3,115.05 $2,017.88 2026-07-15
78315 CPT Bone Scan 3 Phase 11 6 $2,598.00 $2,520.06 $976.85 $2,474.00 $2,005.66 2026-07-15
70491 CPT CT Soft Tissue Neck W Cont 15 6 $3,565.00 $3,458.05 $357.53 $3,386.75 $1,996.40 2026-07-15
78227 CPT Hida With Ef w/Pharm 13 6 $3,001.00 $2,910.97 $1,128.38 $2,850.95 $1,995.66 2026-07-15
78226 CPT Hepatobiliary Scan Without Ef 9 6 $2,534.00 $2,457.98 $952.78 $2,407.30 $1,956.25 2026-07-15
87507 CPT Gi Path Panel 12-25 9 6 $2,487.00 $2,412.39 $935.11 $2,362.65 $1,919.96 2026-07-15
75635 CPT CTA Abdominal Arteries 12 6 $3,289.00 $3,190.33 $592.68 $3,124.55 $1,841.84 2026-07-15
72132 CPT CT Lumbar Spine W Contrast 11 6 $2,627.00 $2,548.19 $313.35 $2,495.65 $1,834.00 2026-07-15
73201 CPT CT Ue W Dye Rt 11 6 $2,560.00 $2,483.20 $90.44 $2,432.00 $1,834.00 2026-07-15
J0630 HCPCS Calcitonin Salmon 400Unit/2ML 11 6 $2,368.00 $2,297.67 $0.18 $2,284.82 $1,828.66 2026-07-15
70490 CPT CT Soft Tissue Neck Wo Cont 11 6 $3,241.00 $3,143.77 $277.47 $3,078.95 $1,814.96 2026-07-15
70488 CPT CT Maxillofac Wwo Contrast 11 6 $3,231.00 $3,134.07 $319.79 $3,069.45 $1,809.36 2026-07-15
J9145 HCPCS Daratumumab 100 Mg/5 Ml Vial 11 6 $3,219.00 $3,122.99 $5.30 $3,058.60 $1,802.96 2026-07-15
72193 CPT CT Pelvis W Dye 13 6 $3,210.00 $3,113.70 $593.33 $3,049.50 $1,797.60 2026-07-15
59514 CPT Cesarean Delivery Only 8 6 $825.00 $800.25 $1,386.60 $1,930.28 $1,782.45 2026-07-15
70450 CPT CT Head/Brain Wo Contrast 14 6 $2,445.00 $2,371.65 $524.00 $2,322.75 $1,738.39 2026-07-15
Q5118 HCPCS Bevacizumab/BVZR 100Mg/4Ml 11 6 $2,249.00 $2,182.30 $46.00 $2,510.63 $1,736.84 2026-07-15
93303 CPT Echo Congenital Abn Complete 9 6 $2,214.00 $2,147.58 $832.46 $2,103.30 $1,709.21 2026-07-15
70470 CPT CT Head/Brain Wwo Contrast 14 6 $3,045.00 $2,953.65 $241.32 $2,892.75 $1,705.20 2026-07-15
272 CDM Cement Bn Smpx P Radopq Strl 18 6 $4,215.00 $4,088.55 $67.68 $7,837.50 $1,636.50 2026-07-15
J0248 HCPCS Remdesivir 100 Mg Vial 11 6 $2,897.00 $2,810.98 $12.70 $2,753.02 $1,622.84 2026-07-15
750 CDM Colonoscopy 36 6 $2,213.00 $2,146.61 $526.40 $4,333.90 $1,604.96 2026-07-15
74170 CPT CT Abdomen Wwo Dye 13 6 $2,860.00 $2,774.20 $58.22 $2,717.00 $1,601.60 2026-07-15
71271 CPT Ldct For Lung Cancer Screen 15 6 $2,445.00 $2,371.65 $101.48 $2,322.75 $1,589.25 2026-07-15
59409 CPT Obstetrical Care 8 6 $755.00 $732.35 $1,222.50 $1,701.85 $1,588.15 2026-07-15
70487 CPT CT Maxillofacial W Contrast 13 6 $2,835.00 $2,749.95 $268.29 $2,693.25 $1,587.60 2026-07-15
72129 CPT CT Thoracic Spine W Contrast 11 6 $2,828.00 $2,743.16 $128.15 $2,686.60 $1,583.68 2026-07-15
71270 CPT CT Thorax Wwo Contrast 13 6 $2,809.00 $2,724.73 $82.17 $2,675.00 $1,573.04 2026-07-15
72133 CPT CT Lumbar Spine Wwo Contrast 13 6 $2,809.00 $2,724.73 $385.11 $2,668.55 $1,573.04 2026-07-15
72192 CPT CT Pelvis Wo Dye 11 6 $2,809.00 $2,724.73 $524.00 $2,668.55 $1,573.04 2026-07-15
C1776 HCPCS Shell Actb 52mm Pncl Sect Srs 91 6 $2,250.00 $2,182.50 $338.40 $5,250.00 $1,560.00 2026-07-15
74150 CPT CT Abdomen Wo Dye 12 6 $2,508.00 $2,432.76 $524.00 $2,382.60 $1,517.34 2026-07-15
74160 CPT CT Abdomen W Dye 13 6 $2,684.00 $2,603.48 $706.77 $2,549.80 $1,503.04 2026-07-15
73702 CPT CT Le Wwo Dye Rt 11 6 $2,675.00 $2,594.75 $57.30 $2,541.25 $1,498.00 2026-07-15
170 CDM Baby Assessment And Monitoring 7 6 $1,939.00 $1,880.83 $729.06 $1,842.05 $1,496.91 2026-07-15
71260 CPT CT Thorax W Contrast 15 6 $2,627.00 $2,548.19 $80.31 $2,495.65 $1,471.12 2026-07-15
70481 CPT CT Orbit W Contrast 13 6 $2,627.00 $2,548.19 $80.31 $2,495.65 $1,471.12 2026-07-15
J0666 HCPCS Bupivac Liposome 1.3% Pf 20 Ml 12 6 $1,783.00 $1,730.43 $2.18 $1,713.62 $1,449.46 2026-07-15
93880 CPT Extracranial Bilat Study 12 6 $2,187.00 $2,121.39 $822.31 $2,077.65 $1,437.95 2026-07-15
73701 CPT CT Le W Dye Rt 11 6 $2,560.00 $2,483.20 $268.01 $2,432.00 $1,433.60 2026-07-15
C1781 HCPCS Mesh Sheet Flat Bard 3X6In 45 6 $1,743.00 $1,691.38 $141.68 $2,900.16 $1,424.47 2026-07-15
72125 CPT CT Cervical Spine Wo Contrast 15 6 $2,445.00 $2,371.65 $172.58 $2,322.75 $1,420.08 2026-07-15
J1097 HCPCS Omidria 1-03 Vial 4 Ml 12 6 $2,298.00 $2,229.16 $6.03 $2,183.20 $1,390.36 2026-07-15
80299 CPT Ustekinumab 9 6 $1,791.00 $1,737.27 $673.42 $1,701.45 $1,382.65 2026-07-15
360 CDM Cataract 81 6 $1,848.00 $1,792.56 $340.66 $7,984.75 $1,378.45 2026-07-15
72131 CPT CT Lumbar Spine Wo Contrast 14 6 $2,445.00 $2,371.65 $234.87 $2,322.75 $1,369.20 2026-07-15
72128 CPT CT Thoracic Spine Wo Contrast 14 6 $2,445.00 $2,371.65 $107.93 $2,322.75 $1,369.20 2026-07-15
71250 CPT CT Thorax Wo Contrast 15 6 $2,445.00 $2,371.65 $71.13 $2,322.75 $1,369.20 2026-07-15
70486 CPT CT Maxillofacial Wo Contrast 15 6 $2,445.00 $2,371.65 $187.95 $2,322.75 $1,369.20 2026-07-15
73700 CPT CT Le Wo Dye Lt 25 6 $2,445.00 $2,371.65 $76.65 $2,322.75 $1,369.20 2026-07-15
70480 CPT CT Orbit Wo Contrast 14 6 $2,445.00 $2,371.65 $192.56 $2,322.75 $1,369.20 2026-07-15
73200 CPT CT Ue Wo Dye Lt 11 6 $2,445.00 $2,371.65 $70.19 $2,322.75 $1,369.20 2026-07-15
Q5104 HCPCS Infliximab-abda 100 Mg Vial 11 6 $1,770.00 $1,717.47 $52.52 $5,119.19 $1,366.90 2026-07-15
91110 CPT Gastro Imaging W/Interp & Rprt 9 6 $1,716.00 $1,664.52 $645.22 $1,630.20 $1,324.75 2026-07-15
81517 CPT Enhanced Liver Fibrosis 9 6 $1,701.00 $1,649.97 $639.58 $1,615.95 $1,313.17 2026-07-15
C1782 HCPCS Blade Myosure Lt Hysterscopic 9 6 $1,643.00 $1,593.72 $617.77 $1,560.86 $1,268.40 2026-07-15
76811 CPT OB US Detailed Single Fetus 13 6 $1,900.00 $1,843.00 $714.40 $1,805.00 $1,263.50 2026-07-15
J0881 HCPCS Darbepoe Alfa 300mcg/0.6ml Syr 18 6 $4,437.00 $4,304.10 $5.94 $4,215.36 $1,251.09 2026-07-15
36573 CPT Insert Picc >5 Yrs W Img Gde 9 6 $1,609.00 $1,560.73 $604.98 $1,528.55 $1,242.15 2026-07-15
78306 CPT Bone Scan Whole Body 9 6 $1,554.00 $1,507.38 $584.30 $1,476.30 $1,199.69 2026-07-15
J1745 HCPCS Infliximab (Gen) 100 Mg Vial 13 6 $2,105.00 $2,042.45 $1.46 $10,256.56 $1,179.15 2026-07-15
25605 CPT Fx Distal Radius W Man Lt 26 6 $1,643.00 $1,593.71 $617.77 $1,560.85 $1,154.42 2026-07-15
93971 CPT Extremity Study Lt 26 6 $1,708.00 $1,656.76 $73.02 $1,622.60 $1,135.82 2026-07-15
P9016 HCPCS Red Blood Cells Lekoreduced 11 6 $1,449.00 $1,405.53 $544.82 $1,622.88 $1,118.63 2026-07-15
C8924 HCPCS Tte 2d W Contrast Limited 9 6 $1,410.00 $1,367.70 $530.16 $1,339.50 $1,088.52 2026-07-15
93975 CPT Vascular Study 12 6 $1,637.00 $1,587.89 $615.51 $1,555.15 $1,076.33 2026-07-15
99291 CPT Critical Care 1st 30-74 Min 19 6 $2,855.00 $2,769.35 $196.93 $2,712.25 $1,073.48 2026-07-15
Q9967 HCPCS Iopamidol-370 100 Ml Vial 27 6 $1,580.00 $1,532.60 $0.28 $1,501.00 $1,027.00 2026-07-15
82653 CPT Pancreatic Elastase 9 6 $1,300.00 $1,261.00 $488.80 $1,235.00 $1,003.60 2026-07-15
710 CDM Recovery Phase 1 Per 15 Min 27 6 $1,533.00 $1,487.01 $143.26 $1,601.70 $996.45 2026-07-15
76700 CPT Ultrasound Abdomen Complete 11 6 $1,283.00 $1,244.51 $482.41 $1,221.00 $990.48 2026-07-15
81511 CPT Maternal Ser Scrn 4 Anal 9 6 $1,208.00 $1,171.76 $454.21 $1,147.60 $932.58 2026-07-15
93308 CPT Echo Limited 11 6 $1,206.00 $1,169.82 $453.46 $1,533.00 $931.03 2026-07-15
129 CDM Room Swing Bed Skilled 7 6 $1,195.00 $1,159.15 $449.32 $1,135.25 $922.54 2026-07-15
99215 CPT OB Outpatient Visit B 10 6 $1,147.00 $1,112.59 $431.27 $1,089.65 $895.81 2026-07-15
80280 CPT Vedolizumab 9 6 $1,115.00 $1,081.55 $419.24 $1,059.25 $860.78 2026-07-15
76770 CPT Ultrasound Abdo Back Wall Comp 14 6 $1,096.00 $1,063.12 $412.10 $1,041.20 $855.98 2026-07-15
93926 CPT Arterial Duplex Le Lt 18 6 $1,106.00 $1,072.82 $415.86 $1,050.70 $853.83 2026-07-15
0202U CPT Respir Path 22 Targets Biofire 9 6 $1,084.00 $1,051.48 $407.58 $1,029.80 $836.85 2026-07-15
86361 CPT Cd4 Absolute Count 11 6 $1,233.00 $1,196.01 $463.61 $1,171.35 $819.95 2026-07-15
93978 CPT Abdomen Vascular Complete 9 6 $1,059.00 $1,027.23 $398.18 $1,006.05 $817.55 2026-07-15
84433 CPT Thiopurine Methyltransfer Rbc 9 6 $1,044.00 $1,012.68 $392.54 $991.80 $805.97 2026-07-15
76775 CPT Ultrasound Aorta 11 6 $1,042.00 $1,010.74 $391.79 $992.00 $804.42 2026-07-15
76705 CPT Ultrasound Abdomen Limited 16 6 $1,094.00 $1,061.18 $48.74 $1,039.30 $786.04 2026-07-15
87529 CPT Hsv DNA Amp Probe 10 6 $1,006.00 $975.82 $378.26 $955.70 $785.68 2026-07-15
93925 CPT Arterial Duplex Le Bi 13 6 $1,174.00 $1,138.78 $441.42 $1,115.30 $780.71 2026-07-15
90675 CPT Rabies Vax Pcec/Pf 2.5Unit Vl 11 6 $1,347.00 $1,307.03 $125.24 $1,280.08 $754.57 2026-07-15
76000 CPT Fluoroscope Examination 9 6 $982.00 $952.54 $369.23 $932.90 $753.11 2026-07-15
99285 CPT Emergency Room Visit Level 5 23 6 $2,002.00 $1,941.94 $164.45 $1,901.90 $752.75 2026-07-15
76856 CPT Ultrasound Pelvic Complete 14 6 $899.00 $872.03 $338.02 $856.00 $738.53 2026-07-15
76942 CPT US Guide For Needle Placement 10 6 $945.00 $916.65 $355.32 $897.75 $738.04 2026-07-15
92960 CPT Cardioversion Electric Ext 9 6 $948.00 $919.56 $356.45 $900.60 $731.86 2026-07-15
32554 CPT Thoracentesis Wo Guide 9 6 $938.00 $909.86 $352.69 $891.10 $724.14 2026-07-15
93017 CPT Cardiovascular Stress Test 13 6 $918.00 $890.46 $345.17 $1,057.00 $708.70 2026-07-15
96409 CPT Chemotherapy IV Push 14 6 $980.00 $950.60 $368.48 $931.00 $704.13 2026-07-15
76882 CPT US Extremity Nonvasc Limit Lt 23 6 $1,022.00 $991.34 $384.27 $970.90 $679.63 2026-07-15
94002 CPT Vent Assist & Mgmt First Day 9 6 $879.00 $852.63 $330.50 $835.05 $678.59 2026-07-15
76604 CPT Ultrasound Chest 9 6 $875.00 $848.75 $329.00 $831.25 $675.50 2026-07-15
76801 CPT OB US < 14 Wks Single Fetus 12 6 $1,021.00 $990.37 $383.90 $969.95 $671.31 2026-07-15
74019 CPT X-ray Abdomen 13 6 $1,042.00 $1,010.74 $208.40 $989.90 $660.48 2026-07-15
115 CDM Room Hospice Respite Care 7 6 $854.00 $828.38 $321.10 $811.30 $659.29 2026-07-15
99284 CPT Emergency Room Visit Level 4 24 6 $1,396.00 $1,354.12 $86.46 $1,326.20 $653.33 2026-07-15
Q0139 HCPCS Ferumoxytol 510 Mg/17 Ml Vial 11 6 $1,145.00 $1,111.35 $0.76 $1,088.43 $641.60 2026-07-15
77080 CPT Dexa Scan 14 6 $1,037.00 $1,005.89 $88.61 $987.00 $638.06 2026-07-15
Q0138 HCPCS Ferumoxy 510mg/17ml (non-esrd) 13 6 $1,139.00 $1,105.02 $0.76 $1,082.24 $637.95 2026-07-15
93976 CPT Vascular Study 12 6 $968.00 $938.96 $363.97 $919.60 $636.46 2026-07-15
J0561 HCPCS Pen G Benzathine 1200000Un/2ML 13 6 $1,116.00 $1,082.77 $53.64 $1,361.83 $625.11 2026-07-15
82726 CPT Adrenoleukodystro Nbs 9 6 $806.00 $781.82 $303.06 $765.70 $622.23 2026-07-15
37195 CPT Thrombolytic Therapy Stroke 17 6 $722.00 $700.34 $271.47 $1,550.90 $615.87 2026-07-15
C1726 HCPCS Dil Pebax 180Cm Od18-20 10 6 $781.00 $758.00 $293.82 $742.37 $610.31 2026-07-15
71101 CPT X-ray Ribs Uni W Chest Lt 22 6 $709.00 $687.73 $266.58 $3,427.98 $604.78 2026-07-15
76536 CPT Ultrasound Head And Neck 12 6 $917.00 $889.49 $344.79 $871.15 $602.92 2026-07-15
73523 CPT X-ray Hips 5 Views Bi 11 6 $780.00 $756.60 $293.28 $741.00 $602.16 2026-07-15
76830 CPT Ultrasound Transvaginal 15 6 $770.00 $746.90 $289.52 $731.50 $594.44 2026-07-15
J2785 HCPCS Regadenoson 0.4 Mg/5 Ml Syr 11 6 $1,053.00 $1,021.41 $7.62 $1,000.35 $589.68 2026-07-15
97606 CPT Neg Pressure Wound Dme >50 Cm 9 6 $758.00 $735.26 $285.01 $720.10 $585.18 2026-07-15
12045 CPT Repair Lac Interm 12.6-20.0 Cm 17 6 $742.00 $719.74 $278.99 $743.29 $583.84 2026-07-15
96401 CPT Injection Chemo Sq/IM Nonhorm 11 6 $746.00 $723.62 $280.50 $708.70 $575.91 2026-07-15
96402 CPT Injection Chemo Sq/IM Hormonal 11 6 $746.00 $723.62 $280.50 $708.70 $575.91 2026-07-15
96416 CPT Chemo Prolong Infuse W Pump 10 6 $725.00 $703.25 $272.60 $688.75 $566.23 2026-07-15
76817 CPT Transvaginal US Obstetrical 14 6 $851.00 $825.47 $38.12 $808.45 $559.53 2026-07-15
76506 CPT Echo Head 9 6 $716.00 $694.52 $269.22 $680.20 $552.75 2026-07-15
72110 CPT X-ray Lumbosacral 4 Views 12 6 $987.00 $957.39 $67.44 $937.65 $552.72 2026-07-15
76870 CPT Ultrasound Scrotum 12 6 $840.00 $814.80 $315.84 $798.00 $552.30 2026-07-15
723 CDM Circumcision Neonate <=28 Days 9 6 $713.00 $691.61 $268.09 $677.35 $550.44 2026-07-15
73522 CPT X-ray Hips 3-4 Views Bi 9 6 $644.00 $624.68 $242.14 $793.91 $549.33 2026-07-15
93356 CPT Myocardial Strain Image Speckl 11 6 $826.00 $801.22 $254.00 $784.70 $549.29 2026-07-15
96413 CPT Chemotherapy Inf Initial 13 6 $823.00 $798.31 $309.45 $781.85 $547.29 2026-07-15
93922 CPT Ankle Arm Screen 14 6 $759.00 $736.23 $285.38 $721.05 $545.35 2026-07-15
G0482 HCPCS Drug Screen Multichan Meconium 9 6 $698.00 $677.06 $262.45 $663.10 $538.86 2026-07-15
76818 CPT Fetal Biophys Profile W Nst 11 6 $810.00 $785.70 $304.56 $769.50 $538.65 2026-07-15
82166 CPT Mullerian Inhib Hormone 11 6 $801.00 $776.97 $301.18 $760.95 $532.66 2026-07-15
72120 CPT X-ray Ls Spine Bending 2-3 V 11 6 $816.00 $791.52 $152.07 $777.00 $530.40 2026-07-15
96521 CPT Refill Portable Pump 9 6 $679.00 $658.63 $255.30 $645.05 $524.19 2026-07-15
99465 CPT Neonatal Resuscitation 9 6 $676.00 $655.72 $254.18 $642.20 $521.87 2026-07-15
76819 CPT Fetal Biophys Profil Wo Nst 15 6 $776.00 $752.72 $34.76 $737.20 $516.04 2026-07-15
93321 CPT Doppler Echo Exam Heart 9 6 $662.00 $642.14 $248.91 $628.90 $511.06 2026-07-15
85598 CPT Hexagonal Phospholipid Neu 9 6 $660.00 $640.20 $248.16 $627.00 $509.52 2026-07-15
83519 CPT Pinp 9 6 $660.00 $640.20 $248.16 $627.00 $509.52 2026-07-15
94660 CPT CPap/BiPap First Day 18 6 $718.50 $696.94 $206.42 $843.60 $509.41 2026-07-15
76642 CPT Ultrasound Breast Limited Lt 39 6 $604.00 $585.88 $227.10 $860.70 $507.36 2026-07-15
J2997 HCPCS Alteplase 2 Mg Vial 11 6 $903.00 $876.34 $37.08 $858.27 $505.93 2026-07-15
32555 CPT Aspirate Pleura W Imaging Rt 44 6 $951.00 $922.47 $214.01 $1,216.95 $503.47 2026-07-15
99283 CPT Emergency Room Visit Level 3 23 6 $889.00 $862.33 $108.68 $844.55 $497.84 2026-07-15
A9502 HCPCS Radiophar Tc99M Myoview 9 6 $623.00 $604.31 $234.25 $591.85 $480.96 2026-07-15
87517 CPT Hep B Na Quan 9 6 $622.00 $603.34 $233.87 $590.90 $480.18 2026-07-15
87177 CPT Ova And Parasites Smears 11 6 $622.00 $603.34 $233.87 $622.00 $480.18 2026-07-15
88184 CPT Flow Cytometry First Mark 10 6 $612.00 $593.64 $230.11 $581.40 $477.97 2026-07-15
P9047 HCPCS Albumin Human 25% 25gr/100ml 11 6 $618.00 $600.27 $106.16 $3,118.50 $477.74 2026-07-15
71100 CPT X-ray Ribs 2 Views Rt 20 6 $584.00 $566.48 $219.58 $3,616.49 $474.50 2026-07-15
G0379 HCPCS Observation Assess Direct Adm 9 6 $609.00 $590.73 $228.98 $578.55 $470.15 2026-07-15
93243 CPT Ext ECG 48hr-7 Days Analysis 9 6 $608.00 $589.76 $228.61 $577.60 $469.38 2026-07-15
1996 OTHER Hosp Manage Cont Drug Admin 8 6 $775.00 $751.75 $180.00 $736.25 $468.88 2026-07-15
96411 CPT Chemotherapy IV Push Addl 10 6 $600.00 $582.00 $225.60 $570.00 $468.60 2026-07-15
93225 CPT Holter Monitor Hook Up <48 Hrs 9 6 $606.00 $587.82 $227.86 $575.70 $467.83 2026-07-15
93320 CPT Cardiac Doppler 9 6 $600.00 $582.00 $225.60 $570.00 $463.20 2026-07-15
23650 CPT Dislocation Shoulder Wo AnesRT 17 6 $475.00 $460.75 $178.60 $802.00 $451.25 2026-07-15
72050 CPT X-ray Spine Cervical 4-5 Views 10 6 $555.00 $538.35 $208.68 $746.06 $450.94 2026-07-15
72072 CPT X-ray Spine Thoracic 3 Views 11 6 $584.00 $566.48 $219.58 $697.55 $450.85 2026-07-15
J1610 HCPCS Glucagon 1 Mg Emergency Kit 11 6 $800.00 $776.52 $98.91 $760.51 $448.30 2026-07-15
12042 CPT Repair Lac Interm 2.6-7.5 Cm 19 6 $742.00 $719.74 $278.99 $704.90 $444.09 2026-07-15
99214 CPT OB Outpatient Visit A 11 6 $574.00 $556.78 $18.16 $545.30 $443.13 2026-07-15
77067 CPT Mammo Screen Implant Bi 38 6 $560.00 $543.20 $210.56 $757.00 $442.40 2026-07-15
72190 CPT X-ray Pelvis 3 Views 9 6 $518.00 $502.46 $194.77 $522.48 $441.85 2026-07-15
A9500 HCPCS Radiophar Tc99M Sestamibi Dose 14 6 $561.00 $544.17 $210.94 $628.32 $438.14 2026-07-15
93246 CPT Ext ECG >7 Days Hook Up 14 6 $608.00 $589.76 $228.61 $577.60 $436.85 2026-07-15
77066 CPT Mammography Diagnostic Digital 14 6 $602.00 $583.94 $226.35 $571.90 $432.53 2026-07-15
87536 CPT HIV 1 Na Quan 11 6 $649.00 $629.53 $244.02 $616.55 $431.58 2026-07-15
23540 CPT Dislocate Acromiocla Wo Man Lt 17 6 $452.00 $438.44 $169.95 $641.59 $429.40 2026-07-15
27550 CPT Treat Knee Dislocation Rt 17 6 $452.00 $438.44 $169.95 $1,335.32 $429.40 2026-07-15
26700 CPT Dislocation Mcp W Man Wo Anes 17 6 $452.00 $438.44 $169.95 $848.68 $429.40 2026-07-15
92507 CPT Speech Therapy Trmt 13 6 $556.00 $539.32 $209.06 $596.00 $429.23 2026-07-15
32551 CPT Insertion Chest Tube Lt 17 6 $815.00 $790.55 $297.55 $774.25 $426.94 2026-07-15
80177 CPT Levetiracetam 12 6 $593.00 $575.21 $222.97 $563.35 $426.08 2026-07-15
26750 CPT Fx Distal Finger/Thumb Wo Man 9 6 $550.00 $533.50 $206.80 $522.50 $424.60 2026-07-15
26720 CPT Fx Finger/Thumb Wo Man 9 6 $550.00 $533.50 $206.80 $522.50 $424.60 2026-07-15
71046 CPT X-ray Chest 2v PA/Lateral 17 6 $493.00 $478.21 $84.40 $783.14 $420.53 2026-07-15
83993 CPT Calprotectin 13 6 $539.00 $522.83 $202.66 $512.05 $416.11 2026-07-15
87798 CPT Ehrlichia/Anaplasma Pcr 56 6 $590.00 $572.30 $80.84 $1,084.90 $410.87 2026-07-15
12041 CPT Repair Lac Interm <2.5 Cm 17 6 $742.00 $719.74 $278.99 $704.90 $409.19 2026-07-15
76805 CPT OB US >14 Wk Tvta Single Fetus 13 6 $609.00 $590.73 $228.98 $578.55 $404.99 2026-07-15
26600 CPT Fx Metacarpal 9 6 $524.00 $508.28 $197.02 $497.80 $404.53 2026-07-15
93242 CPT Ext ECG 48 Hrs -7days Hook Up 13 6 $608.00 $589.76 $228.61 $577.60 $404.32 2026-07-15
80195 CPT Sirolimus 9 6 $521.00 $505.37 $195.90 $494.95 $402.21 2026-07-15
92523 CPT Speech Sound Lang Comprehen 9 6 $520.00 $504.40 $195.52 $494.00 $401.44 2026-07-15
86036 CPT Anca 9 6 $517.00 $501.49 $194.39 $491.15 $399.12 2026-07-15
99195 CPT Phlebotomy Therapeutic 9 6 $516.00 $500.52 $194.02 $490.20 $398.35 2026-07-15
G0498 HCPCS Chemo Extend IV Infus W/Pump 9 6 $511.00 $495.67 $192.14 $485.45 $394.49 2026-07-15
99282 CPT Emergency Room Visit Level 2 13 6 $504.00 $488.88 $189.50 $478.80 $389.09 2026-07-15
84207 CPT Vitamin B6 9 6 $503.00 $487.91 $189.13 $477.85 $388.32 2026-07-15
81291 CPT Mthfr Mutation 9 6 $502.00 $486.94 $188.75 $476.90 $387.54 2026-07-15
86341 CPT Glutmic Acid Decarbox Aby 36 6 $708.00 $686.76 $115.81 $1,420.25 $381.90 2026-07-15
72220 CPT X-ray Sacrum Tailbone 10 6 $468.00 $453.96 $16.62 $447.69 $380.25 2026-07-15
110 CDM Room Custodial Care 7 6 $491.00 $476.27 $184.62 $466.45 $379.05 2026-07-15
82652 CPT Vitamin D 125 Dihydroxy 9 6 $491.00 $476.27 $184.62 $466.45 $379.05 2026-07-15
87305 CPT Aspergillus Galact Antigen 9 6 $490.00 $475.30 $184.24 $465.50 $378.28 2026-07-15
36430 CPT Blood Administration 11 6 $488.00 $473.36 $183.49 $928.00 $376.74 2026-07-15
28190 CPT Remove Foreign Body Foot Lt 17 6 $724.00 $702.28 $270.72 $687.80 $375.65 2026-07-15
83520 CPT Thyrotropin Recept Aby 49 6 $990.00 $960.30 $89.49 $1,577.95 $372.24 2026-07-15
77065 CPT Mammography Dx Digital Rt 25 6 $559.00 $542.23 $210.18 $531.05 $371.74 2026-07-15
88342 CPT Immunohisto Stain Init Pr Spec 10 6 $473.00 $458.81 $177.85 $449.35 $369.42 2026-07-15
72100 CPT X-ray Lumbosacral 2-3 Views 13 6 $630.00 $611.10 $90.44 $598.50 $366.00 2026-07-15
99213 CPT Est Patient Level 3 Wound Care 10 6 $468.00 $453.96 $175.97 $444.60 $365.51 2026-07-15
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