Hospital

MILBANK AREA HOSPITAL/AVERA HEALTH

Milbank, SD · CCN 431326 · Rates published

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You selected 59400 (CPT)

Obstetrical Care

This hospital’s price: $4,850 across 6 payers · range $3,711-$5,182

Source: https://www.avera.org/app/files/public/78e84abe-92bd-4ee6-846a-d026f88e1b6e/460224743_avera-milbank-hospital_standardcharges.csv · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

1,004 distinct procedures filed

6 distinct payers

17,365 rate rows

2026-07-15 last MRF observed

Data quality

17,316 of 17,365 rate rows are consumer-grade (99.7%)

49 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 — reason	Rows
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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	4
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	2

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 via	Discovered by HANK (automated)
Last fetch	success · 2026-08-01
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 $331 outlier · 150.4×
682 MS_DRG	Ms-DRG 682	1	$28,132.08	$28,132.08	$28,132.08	nat. median $15,088 1.9× median
J9144 HCPCS	Daratumumab Hyaluronida 1800Mg	6	$107.92	$42,921.73	$27,334.36	nat. median $202 outlier · 135.3×
J2329 HCPCS	Ublituximab-xiiy 150 Mg/6 Ml	6	$6.87	$44,817.44	$26,418.70	nat. median $168 outlier · 156.9×
J9119 HCPCS	Cemiplimab-rwlc 350 Mg/7 Ml Vl	6	$59.24	$44,308.18	$26,118.51	nat. median $89 outlier · 295.1×
788 MS_DRG	Ms-DRG 788	1	$25,223.90	$25,223.90	$25,223.90	nat. median $10,065 outlier · 2.5×
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 $360 outlier · 62.4×
J3380 HCPCS	Vedolizumab 300 Mg Vial	6	$43.34	$37,731.04	$22,241.45	nat. median $150 outlier · 148.5×
81162 CPT	Brca 1&2 Full Gene Seq Del/Dup	6	$10,730.29	$27,111.10	$22,031.34	nat. median $1,840 outlier · 12.0×
197 MS_DRG	Ms-DRG 197	1	$17,988.88	$17,988.88	$17,988.88	nat. median $10,618 1.7× median
J3101 HCPCS	Tenecteplase 50 Mg/10 Ml Syrng	6	$0.41	$30,005.60	$17,687.51	nat. median $3,475 outlier · 5.1×
J0896 HCPCS	Luspatercept-aamt 25 Mg Vial	6	$1.20	$50,844.94	$16,071.85	nat. median $4,503 outlier · 3.6×
5401 APR_DRG	Apr-DRG 5401	1	$14,169.53	$14,169.53	$14,169.53	nat. median $5,430 outlier · 2.6×
292 MS_DRG	Ms-DRG 292	2	$6,367.02	$13,525.18	$13,525.18	nat. median $9,526 1.4× median
64 MS_DRG	Ms-DRG 64	1	$13,525.18	$13,525.18	$13,525.18	nat. median $20,032 0.7× median
J0717 HCPCS	Certolizumab Pegol 400 Mg Kit	6	$3.42	$21,079.74	$12,425.95	nat. median $1,187 outlier · 10.5×
66 MS_DRG	Ms-DRG 66	1	$12,075.76	$12,075.76	$12,075.76	nat. median $8,021 1.5× median
74 MS_DRG	Ms-DRG 74	1	$12,075.76	$12,075.76	$12,075.76	nat. median $11,005 1.1× median
J2356 HCPCS	Tezepelumab-ekko 210 Mg/1.9 Ml	6	$12.98	$16,588.30	$9,778.37	nat. median $75 outlier · 130.1×
689 MS_DRG	Ms-DRG 689	1	$9,027.96	$9,027.96	$9,027.96	nat. median $12,008 0.8× median
78815 CPT	PET CT Skull To Mid Thigh Init	6	$1,440.20	$10,568.75	$7,909.88	nat. median $2,791 outlier · 2.8×
J2182 HCPCS	Mepolizumab 100 Mg Vial	6	$6.38	$12,758.71	$7,520.92	nat. median $2,559 outlier · 2.9×
690 MS_DRG	Ms-DRG 690	1	$7,203.20	$7,203.20	$7,203.20	nat. median $8,869 0.8× median
J9205 HCPCS	Irinotecan Lipos 43mg/10ml Vl	6	$134.86	$12,214.63	$7,200.20	nat. median $193 outlier · 37.4×
J2357 HCPCS	Omalizumab 300 Mg/2Ml Syringe	6	$9.26	$11,983.91	$7,064.20	nat. median $1,217 outlier · 5.8×
Q5107 HCPCS	Bevacizumab-awwb 400Mg/16Ml Vi	6	$57.46	$11,568.78	$6,819.49	nat. median $483 outlier · 14.1×
J3111 HCPCS	Romosozumab-aqqg 210 Mg/2.34Ml	6	$1.56	$10,938.47	$6,447.94	nat. median $657 outlier · 9.8×
5601 APR_DRG	Apr-DRG 5601	1	$6,407.97	$6,407.97	$6,407.97	nat. median $3,444 1.9× median
J0897 HCPCS	Denosumab 60 Mg/ml Syringe	6	$9.69	$13,047.40	$6,258.09	nat. median $1,965 outlier · 3.2×
5602 APR_DRG	Apr-DRG 5602	1	$6,163.08	$6,163.08	$6,163.08	nat. median $3,846 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 $5,553 1.1× median
J9303 HCPCS	Panitumumab 100 Mg/5 Ml Vial	6	$348.00	$40,605.80	$5,901.45	nat. median $1,725 outlier · 3.4×
78452 CPT	Myocard Perf Spect Rest Stress	6	$2,891.82	$7,306.45	$5,417.00	nat. median $1,777 outlier · 3.0×
95810 CPT	Polysomnogram	6	$2,596.66	$6,906.00	$5,393.59	nat. median $1,777 outlier · 3.0×
78451 CPT	Myocard Perf Spect Rest Or Str	6	$2,608.31	$6,590.15	$5,355.36	nat. median $1,548 outlier · 3.5×
J9034 HCPCS	Bendamustine 100 Mg/4 Ml Vial	6	$28.26	$8,284.66	$5,276.02	nat. median $88 outlier · 60.0×
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 $1,923 outlier · 2.7×
6401 APR_DRG	Apr-DRG 6401	1	$5,096.88	$5,096.88	$5,096.88	nat. median $1,135 outlier · 4.5×
Q5111 HCPCS	Pegfilgrastim-cbqv 6 Mg/0.6 Ml	6	$271.10	$8,478.75	$4,998.00	nat. median $1,862 outlier · 2.7×
J1602 HCPCS	Golimumab 50 Mg/4 Ml Vial	6	$21.08	$8,399.98	$4,951.56	nat. median $228 outlier · 21.8×
59400 CPT	Obstetrical Care	6	$3,710.90	$5,181.79	$4,850.13	nat. median $3,099 1.6× median
Q5122 HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Syr	6	$234.02	$8,113.98	$4,782.98	nat. median $559 outlier · 8.6×
394 MS_DRG	Ms-DRG 394	1	$4,530.74	$4,530.74	$4,530.74	nat. median $10,183 outlier · 0.4×
G0390 HCPCS	Trauma Team Level 5	6	$2,181.93	$5,512.85	$4,479.92	nat. median $3,212 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	$71.13	$7,214.30	$4,252.64	nat. median $982 outlier · 4.3×
J9264 HCPCS	Paclitaxel Protein-bd 100mg Vl	6	$17.39	$6,728.39	$3,966.21	nat. median $737 outlier · 5.4×

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.

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	13	6	$7,594.00	$7,366.18	$71.13	$7,214.30	$4,252.64	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
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
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
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
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
72195	CPT	MRI Pelvis Wo Dye	11	6	$3,849.00	$3,733.53	$53.64	$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
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
71275	CPT	CTA Chest Wwo Contrast	14	6	$3,279.00	$3,180.63	$65.60	$3,115.05	$1,870.33	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
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
70450	CPT	CT Head/Brain Wo Contrast	16	6	$2,445.00	$2,371.65	$24.20	$2,322.75	$1,504.66	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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