Price Transparencybeta Hospital negotiated rates

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

ST MICHAEL'S HOSPITAL - CAH

Tyndall, SD · CCN 431327 · Rates published

716 distinct procedures filed
5 distinct payers
10,444 rate rows
2026-07-15 last MRF observed
Data quality

10,391 of 10,444 rate rows are consumer-grade (99.5%)

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

Excluded — reasonRows
percent-of-charges filed in the dollar field — excluded from medians 25
exceeds 10× this hospital's gross charge — excluded from medians 18
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 8
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/3de91237-7976-4ad2-bc47-6a294697805e/460225414_st-michaels-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 401644ad5d5e6dc6… · 2,789,374 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
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 5 $0.41 $35,748.75 $29,045.86 nat. median
$3,824
outlier · 7.6×
2471
APR_DRG 		Apr-DRG 2471 1 $20,178.02 $20,178.02 $20,178.02 nat. median
$4,098
outlier · 4.9×
J2356
HCPCS 		Tezepelumab-ekko 210 Mg/1.9 Ml 5 $12.98 $21,999.62 $17,874.69 nat. median
$81
outlier · 220.1×
192
MS_DRG 		Ms-DRG 192 1 $17,482.42 $17,482.42 $17,482.42 nat. median
$7,109
outlier · 2.5×
189
MS_DRG 		Ms-DRG 189 1 $17,159.02 $17,159.02 $17,159.02 nat. median
$12,270
1.4× median
690
MS_DRG 		Ms-DRG 690 1 $16,595.52 $16,595.52 $16,595.52 nat. median
$8,373
2.0× median
202
MS_DRG 		Ms-DRG 202 1 $13,282.24 $13,282.24 $13,282.24 nat. median
$9,788
1.4× median
293
MS_DRG 		Ms-DRG 293 1 $13,282.24 $13,282.24 $13,282.24 nat. median
$6,357
outlier · 2.1×
177
MS_DRG 		Ms-DRG 177 1 $13,282.24 $13,282.24 $13,282.24 nat. median
$15,375
0.9× median
J2426
HCPCS 		Paliperidone Palm 234mg/1.5ml 5 $793.38 $16,170.78 $13,138.76 nat. median
$2,499
outlier · 5.3×
J3111
HCPCS 		Romosozumab-aqqg 210 Mg/2.34Ml 5 $1.56 $13,136.69 $10,673.56 nat. median
$675
outlier · 15.8×
J0401
HCPCS 		Aripiprazole 400 Mg Vial 5 $0.77 $12,916.91 $10,494.99 nat. median
$1,945
outlier · 5.4×
291
MS_DRG 		Ms-DRG 291 1 $10,308.82 $10,308.82 $10,308.82 nat. median
$12,759
0.8× median
379
MS_DRG 		Ms-DRG 379 1 $9,969.84 $9,969.84 $9,969.84 nat. median
$6,966
1.4× median
J0897
HCPCS 		Denosumab 60 Mg/ml Syringe 5 $9.69 $8,970.15 $7,789.59 nat. median
$1,973
outlier · 3.9×
949
MS_DRG 		Ms-DRG 949 1 $6,883.72 $6,883.72 $6,883.72 nat. median
$11,791
0.6× median
Q5122
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Syr 5 $3,939.75 $8,402.80 $6,827.27 nat. median
$561
outlier · 12.2×
78452
CPT 		Myocard Perf Spect Rest Stress 5 $3,792.75 $5,835.00 $4,977.26 nat. median
$1,815
outlier · 2.7×
J2357
HCPCS 		Omalizumab 150 Mg Vial 5 $9.26 $11,021.60 $4,967.99 nat. median
$1,245
outlier · 4.0×
74178
CPT 		CT Abd & Pelv Wwo Contrast 5 $479.88 $5,697.00 $4,628.81 nat. median
$1,024
outlier · 4.5×
74176
CPT 		CT Abd & Pelvis Wo Contrast 5 $95.04 $4,497.00 $4,272.15 nat. median
$694
outlier · 6.2×
J0349
HCPCS 		Rezafungin 200 Mg Vial 5 $3.78 $5,208.75 $4,232.11 nat. median
$18
outlier · 232.2×
72195
CPT 		MRI Pelvis Wo Dye 5 $2,874.95 $4,423.00 $4,227.43 nat. median
$804
outlier · 5.3×
74177
CPT 		CT Abd & Pelv W Contrast 5 $227.52 $4,946.00 $4,218.94 nat. median
$972
outlier · 4.3×
73721
CPT 		MRI Joint Le Wo Dye Rt 5 $315.18 $4,423.00 $4,201.85 nat. median
$852
outlier · 4.9×
73221
CPT 		MRI Joint Ue Wo Dye Lt 5 $408.12 $4,423.00 $3,987.34 nat. median
$842
outlier · 4.7×
70544
CPT 		MRA Head Wo Contrast 5 $408.12 $4,423.00 $3,987.34 nat. median
$824
outlier · 4.8×
73718
CPT 		MRI Le Wo Dye Rt 5 $56.39 $4,423.00 $3,987.34 nat. median
$866
outlier · 4.6×
70553
CPT 		MRI Brain Wwo Contrast 5 $729.77 $4,423.00 $3,987.34 nat. median
$1,132
outlier · 3.5×
72141
CPT 		MRI Neck Spine Wo Dye 5 $233.96 $4,423.00 $3,987.34 nat. median
$778
outlier · 5.1×
72157
CPT 		MRI Chest Spine Wwo Dye 5 $535.35 $4,423.00 $3,987.34 nat. median
$1,103
outlier · 3.6×
72148
CPT 		MRI Lumbar Spine Wo Dye 5 $315.18 $4,423.00 $3,772.82 nat. median
$804
outlier · 4.7×
70551
CPT 		MRI Brain Wo Contrast 5 $447.03 $4,423.00 $3,772.82 nat. median
$782
outlier · 4.8×
74174
CPT 		CTA Abd&Pelv Wwo Dye 5 $2,631.85 $4,049.00 $3,650.18 nat. median
$988
outlier · 3.7×
73223
CPT 		MRI Joint Ue Wwo Dye Lt 5 $597.27 $4,423.00 $3,593.69 nat. median
$1,158
outlier · 3.1×
74183
CPT 		MRI Abdomen Wwo Dye 5 $619.08 $4,423.00 $3,593.69 nat. median
$1,099
outlier · 3.3×
72156
CPT 		MRI Neck Spine Wwo Dye 5 $340.05 $4,423.00 $3,593.69 nat. median
$1,103
outlier · 3.3×
73723
CPT 		MRI Joint Le Wwo Dye Rt 5 $657.06 $4,423.00 $3,593.69 nat. median
$1,191
outlier · 3.0×
72146
CPT 		MRI Chest Spine Wo Dye 5 $390.63 $4,423.00 $3,593.69 nat. median
$794
outlier · 4.5×
72158
CPT 		MRI Lumbar Spine Wwo Dye 5 $340.97 $4,423.00 $3,593.69 nat. median
$1,090
outlier · 3.3×
563
MS_DRG 		Ms-DRG 563 1 $3,458.62 $3,458.62 $3,458.62 nat. median
$9,140
outlier · 0.4×
71275
CPT 		CTA Chest Wwo Contrast 5 $2,182.70 $3,358.00 $3,209.55 nat. median
$753
outlier · 4.3×
J0129
HCPCS 		Abatacept 250 Mg Vial 5 $588.00 $3,632.67 $2,951.55 nat. median
$903
outlier · 3.3×
73202
CPT 		CT Ue Wwo Dye Lt 5 $286.41 $3,449.00 $2,802.32 nat. median
$710
outlier · 3.9×
J7325
HCPCS 		Hylan Polymer A&b 48mg/6ml Syr 5 $1,735.19 $3,380.60 $2,746.74 nat. median
$143
outlier · 19.2×
120
CDM 		Room Medical Unit Semi Private 5 $1,948.70 $2,998.00 $2,702.69 nat. median
$1,499
1.8× median
73701
CPT 		CT Le W Dye Lt 5 $268.01 $3,298.00 $2,679.62 nat. median
$668
outlier · 4.0×
70498
CPT 		CT Angiography Neck W Cont 5 $278.39 $2,998.00 $2,557.29 nat. median
$736
outlier · 3.5×
73200
CPT 		CT Ue Wo Dye Lt 5 $70.19 $3,127.00 $2,540.68 nat. median
$518
outlier · 4.9×
74170
CPT 		CT Abdomen Wwo Dye 5 $58.22 $2,800.00 $2,524.20 nat. median
$710
outlier · 3.6×

Other procedures at this hospital

Browse this hospital's 716 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
             
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Syrng 8 5 $35,748.00 $34,676.29 $0.41 $35,748.75 $29,045.86 2026-07-15
2471 APR_DRG Apr-DRG 2471 2 1 — — $20,178.02 $20,178.02 $20,178.02 2026-07-15
J2356 HCPCS Tezepelumab-ekko 210 Mg/1.9 Ml 8 5 $21,999.00 $21,339.63 $12.98 $21,999.62 $17,874.69 2026-07-15
192 MS_DRG Ms-DRG 192 2 1 — — $17,482.42 $17,482.42 $17,482.42 2026-07-15
189 MS_DRG Ms-DRG 189 2 1 — — $17,159.02 $17,159.02 $17,159.02 2026-07-15
690 MS_DRG Ms-DRG 690 2 1 — — $16,595.52 $16,595.52 $16,595.52 2026-07-15
202 MS_DRG Ms-DRG 202 2 1 — — $13,282.24 $13,282.24 $13,282.24 2026-07-15
293 MS_DRG Ms-DRG 293 2 1 — — $13,282.24 $13,282.24 $13,282.24 2026-07-15
177 MS_DRG Ms-DRG 177 2 1 — — $13,282.24 $13,282.24 $13,282.24 2026-07-15
J2426 HCPCS Paliperidone Palm 234mg/1.5ml 8 5 $16,170.00 $15,685.66 $793.38 $16,170.78 $13,138.76 2026-07-15
J3111 HCPCS Romosozumab-aqqg 210 Mg/2.34Ml 8 5 $13,136.00 $12,742.59 $1.56 $13,136.69 $10,673.56 2026-07-15
J0401 HCPCS Aripiprazole 400 Mg Vial 8 5 $12,916.00 $12,529.40 $0.77 $12,916.91 $10,494.99 2026-07-15
291 MS_DRG Ms-DRG 291 2 1 — — $10,308.82 $10,308.82 $10,308.82 2026-07-15
379 MS_DRG Ms-DRG 379 2 1 — — $9,969.84 $9,969.84 $9,969.84 2026-07-15
J0897 HCPCS Denosumab 60 Mg/ml Syringe 10 5 $8,640.00 $8,381.47 $9.69 $8,970.15 $7,789.59 2026-07-15
949 MS_DRG Ms-DRG 949 2 1 — — $6,883.72 $6,883.72 $6,883.72 2026-07-15
Q5122 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Syr 8 5 $8,402.00 $8,150.72 $3,939.75 $8,402.80 $6,827.27 2026-07-15
78452 CPT Myocard Perf Spect Rest Stress 11 5 $5,835.00 $5,659.95 $3,792.75 $5,835.00 $4,977.26 2026-07-15
J2357 HCPCS Omalizumab 150 Mg Vial 10 5 $5,510.00 $5,345.48 $9.26 $11,021.60 $4,967.99 2026-07-15
74178 CPT CT Abd & Pelv Wwo Contrast 8 5 $5,697.00 $5,526.09 $479.88 $5,697.00 $4,628.81 2026-07-15
74176 CPT CT Abd & Pelvis Wo Contrast 11 5 $4,497.00 $4,362.09 $95.04 $4,497.00 $4,272.15 2026-07-15
J0349 HCPCS Rezafungin 200 Mg Vial 8 5 $5,208.00 $5,052.49 $3.78 $5,208.75 $4,232.11 2026-07-15
72195 CPT MRI Pelvis Wo Dye 8 5 $4,423.00 $4,290.31 $2,874.95 $4,423.00 $4,227.43 2026-07-15
74177 CPT CT Abd & Pelv W Contrast 11 5 $4,946.00 $4,797.62 $227.52 $4,946.00 $4,218.94 2026-07-15
73721 CPT MRI Joint Le Wo Dye Rt 21 5 $4,423.00 $4,290.31 $315.18 $4,423.00 $4,201.85 2026-07-15
73221 CPT MRI Joint Ue Wo Dye Lt 20 5 $4,423.00 $4,290.31 $408.12 $4,423.00 $3,987.34 2026-07-15
70544 CPT MRA Head Wo Contrast 10 5 $4,423.00 $4,290.31 $408.12 $4,423.00 $3,987.34 2026-07-15
73718 CPT MRI Le Wo Dye Rt 10 5 $4,423.00 $4,290.31 $56.39 $4,423.00 $3,987.34 2026-07-15
70553 CPT MRI Brain Wwo Contrast 10 5 $4,423.00 $4,290.31 $729.77 $4,423.00 $3,987.34 2026-07-15
72141 CPT MRI Neck Spine Wo Dye 10 5 $4,423.00 $4,290.31 $233.96 $4,423.00 $3,987.34 2026-07-15
72157 CPT MRI Chest Spine Wwo Dye 10 5 $4,423.00 $4,290.31 $535.35 $4,423.00 $3,987.34 2026-07-15
72148 CPT MRI Lumbar Spine Wo Dye 9 5 $4,423.00 $4,290.31 $315.18 $4,423.00 $3,772.82 2026-07-15
70551 CPT MRI Brain Wo Contrast 11 5 $4,423.00 $4,290.31 $447.03 $4,423.00 $3,772.82 2026-07-15
74174 CPT CTA Abd&Pelv Wwo Dye 6 5 $4,049.00 $3,927.53 $2,631.85 $4,049.00 $3,650.18 2026-07-15
73223 CPT MRI Joint Ue Wwo Dye Lt 8 5 $4,423.00 $4,290.31 $597.27 $4,423.00 $3,593.69 2026-07-15
74183 CPT MRI Abdomen Wwo Dye 8 5 $4,423.00 $4,290.31 $619.08 $4,423.00 $3,593.69 2026-07-15
72156 CPT MRI Neck Spine Wwo Dye 8 5 $4,423.00 $4,290.31 $340.05 $4,423.00 $3,593.69 2026-07-15
73723 CPT MRI Joint Le Wwo Dye Rt 8 5 $4,423.00 $4,290.31 $657.06 $4,423.00 $3,593.69 2026-07-15
72146 CPT MRI Chest Spine Wo Dye 8 5 $4,423.00 $4,290.31 $390.63 $4,423.00 $3,593.69 2026-07-15
72158 CPT MRI Lumbar Spine Wwo Dye 8 5 $4,423.00 $4,290.31 $340.97 $4,423.00 $3,593.69 2026-07-15
563 MS_DRG Ms-DRG 563 2 1 — — $3,458.62 $3,458.62 $3,458.62 2026-07-15
71275 CPT CTA Chest Wwo Contrast 8 5 $3,358.00 $3,257.26 $2,182.70 $3,358.00 $3,209.55 2026-07-15
J0129 HCPCS Abatacept 250 Mg Vial 8 5 $3,632.00 $3,523.69 $588.00 $3,632.67 $2,951.55 2026-07-15
73202 CPT CT Ue Wwo Dye Lt 8 5 $3,449.00 $3,345.53 $286.41 $3,449.00 $2,802.32 2026-07-15
J7325 HCPCS Hylan Polymer A&b 48mg/6ml Syr 8 5 $3,380.00 $3,279.18 $1,735.19 $3,380.60 $2,746.74 2026-07-15
120 CDM Room Medical Unit Semi Private 6 5 $2,998.00 $2,908.06 $1,948.70 $2,998.00 $2,702.69 2026-07-15
73701 CPT CT Le W Dye Lt 16 5 $3,298.00 $3,199.06 $268.01 $3,298.00 $2,679.62 2026-07-15
70498 CPT CT Angiography Neck W Cont 11 5 $2,998.00 $2,908.06 $278.39 $2,998.00 $2,557.29 2026-07-15
73200 CPT CT Ue Wo Dye Lt 16 5 $3,127.00 $3,033.19 $70.19 $3,127.00 $2,540.68 2026-07-15
74170 CPT CT Abdomen Wwo Dye 10 5 $2,800.00 $2,716.00 $58.22 $2,800.00 $2,524.20 2026-07-15
72131 CPT CT Lumbar Spine Wo Contrast 11 5 $2,856.00 $2,770.32 $234.87 $2,856.00 $2,436.17 2026-07-15
71260 CPT CT Thorax W Contrast 11 5 $2,851.00 $2,765.47 $80.31 $2,851.00 $2,431.90 2026-07-15
70492 CPT CT Soft Tissue Neck Wwo Cont 8 5 $2,851.00 $2,765.47 $422.85 $2,851.00 $2,316.43 2026-07-15
Q5103 HCPCS Infliximab-dyyb 100 Mg Vial 8 5 $2,406.00 $2,334.35 $1,564.26 $3,013.05 $2,310.28 2026-07-15
72128 CPT CT Thoracic Spine Wo Contrast 10 5 $2,550.00 $2,473.50 $107.93 $2,550.00 $2,298.82 2026-07-15
72125 CPT CT Cervical Spine Wo Contrast 12 5 $2,550.00 $2,473.50 $172.58 $2,550.00 $2,298.82 2026-07-15
99291 CPT Critical Care 1st 30-74 Min 15 5 $3,443.00 $3,339.71 $329.00 $3,443.00 $2,289.59 2026-07-15
70487 CPT CT Maxillofacial W Contrast 8 5 $2,744.00 $2,661.68 $268.29 $2,744.00 $2,229.50 2026-07-15
70470 CPT CT Head/Brain Wwo Contrast 9 5 $2,550.00 $2,473.50 $241.32 $2,550.00 $2,175.15 2026-07-15
73700 CPT CT Le Wo Dye Lt 18 5 $2,550.00 $2,473.50 $76.65 $2,550.00 $2,175.15 2026-07-15
J1439 HCPCS Ferric Carboxymalt 750mg/15ml 8 5 $2,626.00 $2,548.07 $11.91 $2,626.88 $2,134.34 2026-07-15
71250 CPT CT Thorax Wo Contrast 11 5 $2,400.00 $2,328.00 $71.13 $2,400.00 $2,047.20 2026-07-15
70491 CPT CT Soft Tissue Neck W Cont 10 5 $2,400.00 $2,328.00 $357.53 $2,400.00 $2,047.20 2026-07-15
74150 CPT CT Abdomen Wo Dye 10 5 $2,250.00 $2,182.50 $791.13 $2,250.00 $2,028.38 2026-07-15
70490 CPT CT Soft Tissue Neck Wo Cont 10 5 $2,250.00 $2,182.50 $277.47 $2,250.00 $2,028.38 2026-07-15
70450 CPT CT Head/Brain Wo Contrast 10 5 $1,951.00 $1,892.47 $1,268.15 $1,951.00 $1,864.72 2026-07-15
72193 CPT CT Pelvis W Dye 8 5 $2,250.00 $2,182.50 $593.33 $2,250.00 $1,828.12 2026-07-15
70496 CPT CT Angiography Head W Cont 10 5 $1,982.00 $1,922.54 $246.84 $1,982.00 $1,786.78 2026-07-15
70486 CPT CT Maxillofacial Wo Contrast 10 5 $1,951.00 $1,892.47 $187.95 $1,951.00 $1,758.83 2026-07-15
Q5101 HCPCS Filgrastim-sndz 480 Mcg/0.8ml 8 5 $1,769.00 $1,716.22 $1,150.05 $2,902.40 $1,698.53 2026-07-15
G0390 HCPCS Trauma Team Level 5 8 5 $2,051.00 $1,989.47 $1,333.15 $2,051.00 $1,684.89 2026-07-15
71271 CPT Ldct For Lung Cancer Screen 9 5 $1,951.00 $1,892.47 $101.48 $1,951.00 $1,664.20 2026-07-15
24576 CPT Fx Humeral Condylar Wo Man Rt 8 5 $1,988.00 $1,928.36 $1,292.20 $1,988.00 $1,633.14 2026-07-15
360 CDM Or Level 2 16 5 $2,342.50 $2,272.22 $387.40 $4,089.00 $1,626.92 2026-07-15
70480 CPT CT Orbit Wo Contrast 8 5 $1,951.00 $1,892.47 $192.56 $1,951.00 $1,585.18 2026-07-15
72192 CPT CT Pelvis Wo Dye 8 5 $1,951.00 $1,892.47 $597.02 $1,951.00 $1,585.18 2026-07-15
36569 CPT Insert Picc Line >5 Without Guide 8 5 $1,901.00 $1,843.97 $1,235.65 $1,901.00 $1,561.67 2026-07-15
J0248 HCPCS Remdesivir 100 Mg Vial 8 5 $1,798.00 $1,744.74 $70.71 $1,798.70 $1,461.44 2026-07-15
J0894 HCPCS Decitabine 50 Mg Vial 10 5 $1,750.00 $1,697.50 $4.46 $1,750.00 $1,428.88 2026-07-15
24565 CPT Humerus Fx W Manipulation Rt 14 5 $2,087.00 $2,024.39 $1,025.31 $2,087.00 $1,372.20 2026-07-15
93925 CPT Arterial Duplex Le Bi 10 5 $1,516.00 $1,470.52 $985.40 $1,516.00 $1,366.68 2026-07-15
25605 CPT Fx Distal Radius W Man Rt 20 5 $1,823.00 $1,768.31 $1,052.28 $2,246.00 $1,330.05 2026-07-15
93970 CPT Venous Duplex 8 5 $1,561.00 $1,514.17 $1,014.65 $1,561.00 $1,282.36 2026-07-15
93306 CPT Tte W Doppler Complete 11 5 $1,334.00 $1,293.98 $867.10 $1,334.00 $1,267.30 2026-07-15
99285 CPT Emergency Room Visit Level 5 17 5 $1,854.00 $1,798.38 $267.73 $1,854.00 $1,232.91 2026-07-15
25600 CPT Fx Distal Radius Rt 18 5 $1,437.00 $1,393.89 $934.05 $1,437.00 $1,225.76 2026-07-15
93880 CPT Extracranial Bilat Study 11 5 $1,351.00 $1,310.47 $878.15 $1,351.00 $1,152.40 2026-07-15
23600 CPT Fx Prox Humeral Wo Man Rt 19 5 $1,344.00 $1,303.68 $873.60 $1,344.00 $1,146.43 2026-07-15
27750 CPT Treatment Tibia Fracture Lt 8 5 $1,370.00 $1,328.90 $890.50 $1,370.00 $1,125.45 2026-07-15
C8929 HCPCS Echo M Mode 2d W Contrast 8 5 $1,334.00 $1,293.98 $867.10 $1,334.00 $1,095.88 2026-07-15
27824 CPT Fx Distal Tibia Rt 8 5 $1,296.00 $1,257.12 $842.40 $1,296.00 $1,064.66 2026-07-15
23620 CPT Closed Tx Gr Tuberosity Fx Rt 10 5 $1,162.00 $1,127.14 $755.30 $1,162.00 $1,047.55 2026-07-15
27786 CPT Fx Distal Fibula Lt 8 5 $1,269.00 $1,230.93 $824.85 $1,269.00 $1,042.49 2026-07-15
27780 CPT Treatment Fibula Fracture Lt 8 5 $1,260.00 $1,222.20 $819.00 $1,260.00 $1,035.09 2026-07-15
26600 CPT Fx Metacarpal 8 5 $1,222.00 $1,185.34 $794.30 $1,222.00 $1,003.88 2026-07-15
24600 CPT Dislocation Elbow Wo Anes Rt 14 5 $1,510.00 $1,464.70 $710.78 $1,510.00 $992.83 2026-07-15
93017 CPT Cardiovascular Stress Test 11 5 $1,128.00 $1,094.16 $733.20 $1,128.00 $962.18 2026-07-15
99284 CPT Emergency Room Visit Level 4 18 5 $1,330.00 $1,290.10 $184.86 $1,330.00 $955.61 2026-07-15
26700 CPT Dislocation Mcp W Man Wo Anes 14 5 $1,385.00 $1,343.45 $656.61 $1,385.00 $910.63 2026-07-15
93922 CPT Ankle Arm Screen 8 5 $1,088.00 $1,055.36 $707.20 $1,088.00 $893.79 2026-07-15
23650 CPT Dislocation Shoulder Wo AnesLT 29 5 $1,324.00 $1,284.28 $629.84 $1,324.00 $880.46 2026-07-15
129 CDM Room Swing Bed Skilled 6 5 $938.00 $909.86 $609.70 $938.00 $845.61 2026-07-15
Q5110 HCPCS Filgrastim-aafi 480 Mcg/0.8 Ml 8 5 $866.00 $840.80 $563.42 $927.00 $832.13 2026-07-15
689 CDM Trauma Team Evaluation Level 5 8 5 $980.00 $950.60 $637.00 $980.00 $805.07 2026-07-15
92950 CPT Heart/Lung Resuscitation Cpr 17 5 $1,030.00 $999.10 $275.08 $1,030.00 $795.16 2026-07-15
76700 CPT Ultrasound Abdomen Complete 10 5 $873.00 $846.81 $567.45 $873.00 $787.01 2026-07-15
93971 CPT Extremity Study Lt 18 5 $902.00 $874.94 $586.30 $902.00 $769.41 2026-07-15
82373 CPT Carbohydrate Deficient Trnsfe 8 5 $902.00 $874.94 $586.30 $902.00 $741.00 2026-07-15
96413 CPT Chemotherapy Inf Initial 8 5 $888.00 $861.36 $577.20 $888.00 $729.49 2026-07-15
76770 CPT Ultrasound Abdo Back Wall Comp 10 5 $807.00 $782.79 $524.55 $807.00 $727.51 2026-07-15
28470 CPT Fx Metatarsal 8 5 $868.00 $841.96 $564.20 $868.00 $713.06 2026-07-15
81219 CPT Calr Mutation 8 5 $859.00 $833.23 $558.35 $859.00 $705.67 2026-07-15
P9047 HCPCS Albumin Human 25% 25gr/100ml 8 5 $730.00 $708.10 $474.50 $3,118.50 $700.80 2026-07-15
26750 CPT Fx Distal Finger/Thumb Wo Man 8 5 $843.00 $817.71 $547.95 $843.00 $692.53 2026-07-15
76705 CPT Ultrasound Abdomen Limited 19 5 $831.00 $806.07 $471.90 $831.00 $689.70 2026-07-15
76536 CPT Ultrasound Head And Neck 11 5 $725.00 $703.25 $471.25 $725.00 $688.75 2026-07-15
96365 CPT Inf Therapy Med Initial 12 5 $763.00 $740.11 $495.95 $763.00 $687.85 2026-07-15
26720 CPT Fx Finger/Thumb Wo Man 8 5 $837.00 $811.89 $544.05 $837.00 $687.60 2026-07-15
A9585 HCPCS Gadobutrol Inj 10 Mm/10 Ml Vl 11 5 $800.00 $776.00 $2.69 $800.00 $682.40 2026-07-15
J2997 HCPCS Alteplase 2 Mg Vial 8 5 $828.00 $803.48 $37.08 $828.33 $673.02 2026-07-15
76856 CPT Ultrasound Pelvic Complete 8 5 $810.00 $785.70 $526.50 $810.00 $665.41 2026-07-15
99283 CPT Emergency Room Visit Level 3 18 5 $850.00 $824.50 $108.68 $850.00 $663.85 2026-07-15
36430 CPT Blood Administration 19 5 $729.00 $707.13 $473.85 $769.00 $655.96 2026-07-15
76870 CPT Ultrasound Scrotum 10 5 $722.00 $700.34 $469.30 $722.00 $650.88 2026-07-15
Q9963 HCPCS Diatrizoate Meglum/Sod 120ml 8 5 $800.00 $776.00 $37.07 $800.00 $650.00 2026-07-15
24670 CPT Fx Ulna Proximal Wo Man Lt 16 5 $817.00 $792.49 $321.10 $1,140.00 $617.50 2026-07-15
12052 CPT Repair Lac Interm 2.6-5.0 Cm 16 5 $852.00 $826.44 $403.24 $852.00 $612.16 2026-07-15
28430 CPT Clsd Txt Talus Fx Wo Man Lt 8 5 $739.00 $716.83 $480.35 $739.00 $607.09 2026-07-15
76857 CPT Ultrasound Pelvic Limited 8 5 $726.00 $704.22 $471.90 $726.00 $596.41 2026-07-15
76775 CPT Ultrasound Limited 8 5 $726.00 $704.22 $471.90 $726.00 $596.41 2026-07-15
31500 CPT Insert Emergency Airway 15 5 $869.00 $842.93 $273.72 $869.00 $577.88 2026-07-15
12034 CPT Repair Lac Interm 7.6-12.5 Cm 14 5 $878.00 $851.66 $413.34 $878.00 $577.45 2026-07-15
0202U CPT Respir Path 22 Targets Biofire 8 5 $701.00 $679.97 $455.65 $701.00 $575.87 2026-07-15
Q9956 HCPCS Perflutren Protein-a Microdota 8 5 $708.00 $687.25 $77.76 $708.50 $575.65 2026-07-15
10061 CPT I&d Abscess Comp/Multiple 16 5 $786.00 $762.42 $373.43 $786.00 $564.74 2026-07-15
Q9957 HCPCS Perflutren Lip Micro 2.2mg/2ml 8 5 $695.00 $674.15 $47.75 $695.00 $564.69 2026-07-15
12042 CPT Repair Lac Interm 2.6-7.5 Cm 14 5 $833.00 $808.01 $396.46 $833.00 $552.04 2026-07-15
J0881 HCPCS Darbepoe Alfa 25mcg/0.42ml Syr 8 5 $567.00 $550.43 $368.84 $2,669.46 $544.75 2026-07-15
92523 CPT Speech Sound Lang Comprehen 8 5 $654.00 $634.38 $425.10 $654.00 $537.26 2026-07-15
12032 CPT Repair Lac Interm 2.6-7.5 Cm 14 5 $811.00 $786.67 $387.06 $811.00 $536.90 2026-07-15
A9500 HCPCS Radiophar Tc99M Sestamibi Dose 11 5 $629.00 $610.13 $408.85 $1,258.00 $536.54 2026-07-15
97166 CPT Ot Eval Mod Complexity 10 5 $588.00 $570.36 $382.20 $588.00 $530.08 2026-07-15
74022 CPT X-ray Series Abdomen 8 5 $535.00 $518.95 $347.75 $661.43 $513.60 2026-07-15
81338 CPT Mpl Mutation 8 5 $624.00 $605.28 $405.60 $624.00 $512.62 2026-07-15
81270 CPT Jak2 Mutation 8 5 $624.00 $605.28 $405.60 $624.00 $512.62 2026-07-15
C8924 HCPCS Tte 2d W Contrast Limited 8 5 $619.00 $600.43 $402.35 $619.00 $508.51 2026-07-15
11043 CPT Debride Muscle/Fascia 20 Cm 14 5 $768.00 $744.96 $302.96 $768.00 $504.96 2026-07-15
99282 CPT Emergency Room Visit Level 2 11 5 $590.00 $572.30 $383.50 $590.00 $503.27 2026-07-15
93923 CPT Ue/le Artery 3 Levels 8 5 $605.00 $586.85 $393.25 $605.00 $497.01 2026-07-15
97165 CPT Ot Eval Low Complexity 10 5 $551.00 $534.47 $358.15 $551.00 $496.73 2026-07-15
93308 CPT Echo Limited 10 5 $600.00 $582.00 $390.00 $600.00 $495.40 2026-07-15
76830 CPT Ultrasound Transvaginal 10 5 $537.00 $520.89 $349.05 $537.00 $484.11 2026-07-15
80197 CPT Tacrolimus 10 5 $526.00 $510.22 $341.90 $526.00 $474.19 2026-07-15
761 CDM Injection Joint/TP Bilateral 24 5 $574.00 $556.78 $157.30 $1,033.00 $471.54 2026-07-15
96125 CPT Cognitive Performance Test St 8 5 $573.00 $555.81 $372.45 $573.00 $470.72 2026-07-15
73523 CPT X-ray Hips 5 Views Bi 8 5 $471.00 $456.87 $306.15 $690.20 $452.16 2026-07-15
93926 CPT Arterial Duplex Le Lt 16 5 $544.00 $527.68 $353.60 $544.00 $446.89 2026-07-15
12007 CPT Repair Lac Simple >30.0 Cm 16 5 $618.00 $599.46 $275.51 $618.00 $444.04 2026-07-15
J3489 HCPCS Zoledron Ac/Man/H2O 5mg/100ml 8 5 $539.00 $523.41 $17.25 $539.60 $438.42 2026-07-15
87631 CPT Influ And Rsv Amp Probe 10 5 $486.00 $471.42 $315.90 $486.00 $438.13 2026-07-15
92526 CPT Dysphagia Treatment 8 5 $531.00 $515.07 $345.15 $531.00 $436.22 2026-07-15
72050 CPT X-ray Spine Cervical 4-5 Views 10 5 $440.00 $426.80 $286.00 $746.06 $433.40 2026-07-15
73522 CPT X-ray Hips 3-4 Views Bi 8 5 $451.00 $437.47 $293.15 $793.91 $432.96 2026-07-15
P9040 HCPCS Rbc Packed Leuko-reduc Irrad 10 5 $463.00 $449.11 $300.95 $890.00 $417.39 2026-07-15
77067 CPT Mammography Screening Digital 27 5 $489.00 $474.33 $317.85 $514.00 $417.12 2026-07-15
28510 CPT Fx Phalanges 8 5 $504.00 $488.88 $327.60 $504.00 $414.04 2026-07-15
82024 CPT Acth Adrenocorticotropic Hor 8 5 $496.00 $481.12 $322.40 $496.00 $407.46 2026-07-15
83880 CPT B Type Natriuretic Peptide 11 5 $476.00 $461.72 $309.40 $476.00 $406.03 2026-07-15
72110 CPT X-ray Lumbosacral 4 Views 8 5 $493.00 $478.21 $67.44 $493.00 $400.56 2026-07-15
Q9967 HCPCS Iopamidol-370 100 Ml Vial 21 5 $817.00 $793.30 $253.80 $817.84 $400.00 2026-07-15
86304 CPT Ca 125 8 5 $482.00 $467.54 $313.30 $482.00 $395.96 2026-07-15
85379 CPT D-dimer Quant 12 5 $428.00 $415.16 $278.20 $428.00 $385.84 2026-07-15
71111 CPT X-ray Ribs Bilateral 4 Views 8 5 $462.00 $448.14 $63.74 $462.00 $375.38 2026-07-15
76706 CPT Aaa Screening Medicare 8 5 $454.00 $440.38 $295.10 $454.00 $372.96 2026-07-15
51705 CPT Suprapubic Cath Change 8 5 $454.00 $440.38 $295.10 $454.00 $372.96 2026-07-15
72120 CPT X-ray Ls Spine Bending 2-3 V 8 5 $451.00 $437.47 $152.07 $451.00 $366.44 2026-07-15
30300 CPT Remove Foreign Body Nose 14 5 $552.00 $535.44 $247.43 $552.00 $362.94 2026-07-15
83970 CPT Pth 11 5 $424.00 $411.28 $275.60 $424.00 $361.67 2026-07-15
96374 CPT IV Push Injection Initial 12 5 $401.00 $388.97 $260.65 $401.00 $361.50 2026-07-15
72072 CPT X-ray Spine Thoracic 3 Views 11 5 $370.00 $358.90 $240.50 $697.55 $358.90 2026-07-15
86256 CPT Pla2R Titer 8 5 $436.00 $422.92 $283.40 $436.00 $358.18 2026-07-15
97163 CPT Pt Eval High Complexity 8 5 $435.00 $421.95 $282.75 $435.00 $357.36 2026-07-15
83921 CPT Methylmalonic Acid 10 5 $391.00 $379.27 $254.15 $391.00 $352.49 2026-07-15
J2305 HCPCS Nitroglycer/D5W 50mg/250ml Bot 10 5 $389.00 $378.15 $3.20 $443.66 $351.45 2026-07-15
J3475 HCPCS Magnesium Sulf/H2O 2gr/50ml Bg 11 5 $365.00 $354.53 $9.65 $365.85 $347.22 2026-07-15
56405 CPT I & D Vulva/Perineum 14 5 $528.00 $512.16 $255.90 $528.00 $347.16 2026-07-15
115 CDM Room Hospice Respite Care 6 5 $385.00 $373.45 $250.25 $385.00 $347.08 2026-07-15
72070 CPT X-ray Spine Thoracic 2 Views 8 5 $359.00 $348.23 $233.35 $1,015.91 $344.64 2026-07-15
J3375 HCPCS Vancomycin 1500mg/300ml-rmtemp 24 5 $420.00 $407.56 $265.49 $430.25 $344.15 2026-07-15
87154 CPT Culture Id By Amp Prb 6 Or 6+ 8 5 $417.00 $404.49 $271.05 $417.00 $342.56 2026-07-15
96360 CPT Inf Therapy Hyd Initial 11 5 $401.00 $388.97 $260.65 $401.00 $342.05 2026-07-15
84425 CPT Vitamin B1 8 5 $413.00 $400.61 $268.45 $413.00 $339.28 2026-07-15
92610 CPT Swallow Eval Non Radiol 8 5 $412.00 $399.64 $267.80 $412.00 $338.46 2026-07-15
93798 CPT Cardiac Rehab Ii Monitored 8 5 $410.00 $397.70 $266.50 $410.00 $336.81 2026-07-15
99223 CPT IP/Obs Initial High Comp 6 5 $737.00 $714.89 $270.04 $389.40 $334.66 2026-07-15
72100 CPT X-ray Lumbosacral 2-3 Views 11 5 $392.00 $380.24 $90.44 $392.00 $334.38 2026-07-15
51703 CPT Cath Insert Compl Indwelling 8 5 $407.00 $394.79 $264.55 $407.00 $334.35 2026-07-15
99195 CPT Phlebotomy Therapeutic 8 5 $406.00 $393.82 $263.90 $406.00 $333.53 2026-07-15
51702 CPT Cath Insert Simple Indwelling 18 5 $420.00 $407.40 $224.90 $494.00 $332.16 2026-07-15
97162 CPT Pt Eval Mod Complexity 11 5 $385.00 $373.45 $250.25 $385.00 $328.41 2026-07-15
J1265 HCPCS Dopamine/D5W 400 Mg/250 Ml Bag 8 5 $403.00 $391.04 $121.32 $403.13 $327.55 2026-07-15
J0736 HCPCS Clindamycin/D5W 900mg/50ml Bag 9 5 $375.00 $364.48 $2.19 $375.75 $320.51 2026-07-15
99215 CPT Est Patient Level 5 14 5 $487.00 $472.39 $215.01 $487.00 $320.21 2026-07-15
J0134 HCPCS Acetaminoph IV(Fresenius Kabi) 9 5 $375.00 $363.98 $21.48 $375.24 $320.08 2026-07-15
87040 CPT Culture Blood 10 5 $355.00 $344.35 $230.75 $355.00 $320.03 2026-07-15
74019 CPT X-ray Abdomen 12 5 $331.00 $321.07 $215.15 $660.48 $319.53 2026-07-15
87637 CPT Influ/RSV/CoV2 Pcr Ceph 8 5 $388.00 $376.36 $252.20 $388.00 $318.74 2026-07-15
J0131 HCPCS Acetaminophen 1000mg/100ml Via 11 5 $373.00 $362.40 $145.73 $373.61 $318.69 2026-07-15
84145 CPT Procalcitonin 10 5 $353.00 $342.41 $229.45 $353.00 $318.23 2026-07-15
73503 CPT X-ray Hip Uni W Pelvis 4 V Lt 16 5 $327.00 $317.19 $212.55 $392.75 $313.92 2026-07-15
82088 CPT Aldosterone 8 5 $380.00 $368.60 $247.00 $380.00 $312.17 2026-07-15
80285 CPT Voriconazole 8 5 $378.00 $366.66 $245.70 $378.00 $310.52 2026-07-15
J9025 HCPCS Azacitidine 100 Mg Vial 10 5 $340.00 $330.01 $0.53 $419.04 $306.71 2026-07-15
15271 CPT Skin Substitute Graft 25 Sq Cm 16 5 $422.00 $409.34 $166.07 $422.00 $303.20 2026-07-15
J3480 HCPCS Sod Chl 0.9%Kcl 20Meq 1000ml 44 5 $367.00 $356.02 $9.57 $734.10 $302.57 2026-07-15
99235 CPT Admit/Discharge Same Day Mod 6 5 $708.00 $686.76 $247.05 $334.65 $302.36 2026-07-15
97161 CPT Pt Eval Low Complexity 12 5 $334.00 $323.98 $217.10 $334.00 $301.10 2026-07-15
30905 CPT Control Posterior Hemorrhage 14 5 $454.00 $440.38 $206.18 $454.00 $298.50 2026-07-15
110 CDM Room Custodial Care 6 5 $330.00 $320.10 $214.50 $330.00 $297.50 2026-07-15
76882 CPT US Extremity Nonvasc Limit Rt 8 5 $362.00 $351.14 $235.30 $362.00 $297.38 2026-07-15
43239 CPT Egd Biopsy Single/Multiple 6 5 $843.00 $817.71 $272.42 $385.31 $296.67 2026-07-15
10120 CPT I&r Foreign Body Simple 14 5 $451.00 $437.47 $215.90 $451.00 $296.53 2026-07-15
10060 CPT I&d Abscess Simple/Single 14 5 $451.00 $437.47 $219.53 $451.00 $296.53 2026-07-15
92507 CPT Speech Therapy Trmt 8 5 $360.00 $349.20 $234.00 $360.00 $295.74 2026-07-15
72202 CPT X-ray Si Joints 3 Views 9 5 $311.00 $301.67 $202.15 $542.46 $295.45 2026-07-15
87636 CPT Influ & CoV2 Pcr Ceph 8 5 $358.00 $347.26 $232.70 $358.00 $294.10 2026-07-15
J1956 HCPCS Levofloxac/D5W 500mg/100ml Bag 8 5 $359.00 $348.96 $2.07 $359.75 $292.30 2026-07-15
P9016 HCPCS Red Blood Cells Lekoreduced 10 5 $324.00 $314.28 $210.60 $324.00 $292.09 2026-07-15
J0456 HCPCS Azithromycin 500 Mg Vial 8 5 $304.00 $294.90 $197.61 $304.03 $291.86 2026-07-15
J0692 HCPCS Cefepime 1000 Mg Vial 17 5 $306.00 $296.90 $8.09 $311.85 $290.78 2026-07-15
85305 CPT Protein S Total 8 5 $353.00 $342.41 $229.45 $353.00 $289.99 2026-07-15
85302 CPT Protein C Antigen 8 5 $353.00 $342.41 $229.45 $353.00 $289.99 2026-07-15
J1836 HCPCS Metronidazole/Ns 500mg/100ml 8 5 $356.00 $345.66 $0.32 $356.35 $289.54 2026-07-15
82668 CPT Erythropoietin 8 5 $350.00 $339.50 $227.50 $350.00 $287.52 2026-07-15
84146 CPT Prolactin 10 5 $314.00 $304.58 $204.10 $314.00 $283.07 2026-07-15
72220 CPT X-ray Sacrum Tailbone 8 5 $294.00 $285.18 $191.10 $447.69 $282.24 2026-07-15
80074 CPT Acute Hepatitis Panel 10 5 $312.00 $302.64 $202.80 $614.00 $281.27 2026-07-15
84436 CPT T4 Total 9 5 $329.00 $319.13 $213.85 $329.00 $280.64 2026-07-15
72040 CPT X-ray Spine Cervical 2-3 Views 9 5 $294.00 $285.18 $191.10 $551.93 $279.30 2026-07-15
71101 CPT X-ray Ribs Uni W Chest Lt 15 5 $294.00 $285.18 $191.10 $294.00 $279.30 2026-07-15
J0690 HCPCS Cefazolin 1000 Mg Vial 16 5 $301.00 $292.56 $0.06 $310.49 $275.69 2026-07-15
71046 CPT X-ray Chest 2v PA/Lateral 11 5 $286.00 $277.42 $185.90 $783.14 $275.00 2026-07-15
80177 CPT Levetiracetam 9 5 $322.00 $312.34 $209.30 $322.00 $274.67 2026-07-15
Q4186 HCPCS Soft Tissue Graft Epifix 24 5 $334.00 $323.98 $159.25 $475.00 $274.38 2026-07-15
71100 CPT X-ray Ribs 2 Views Rt 14 5 $288.00 $279.36 $187.20 $288.00 $273.60 2026-07-15
J1335 HCPCS Ertapenem 1000 Mg Vial 8 5 $336.00 $326.46 $27.20 $336.56 $273.45 2026-07-15
82384 CPT Catecholamines Fract 8 5 $330.00 $320.10 $214.50 $330.00 $271.10 2026-07-15
94660 CPT CPap/BiPap First Day 8 5 $330.00 $320.10 $214.50 $330.00 $271.10 2026-07-15
84402 CPT Testosterone Fre Female/Child 19 5 $271.00 $262.87 $176.15 $381.00 $271.00 2026-07-15
84166 CPT Protein Electrophoresis Urine 10 5 $298.00 $289.06 $193.70 $298.00 $268.64 2026-07-15
J1271 HCPCS Doxycycline 100 Mg Vial 8 5 $325.00 $316.18 $211.87 $325.96 $267.77 2026-07-15
J1920 HCPCS Labetalol 5 Mg/ml 20 Ml Vial 12 5 $313.00 $304.14 $8.37 $313.55 $267.46 2026-07-15
83002 CPT Lh 10 5 $292.00 $283.24 $189.80 $292.00 $263.24 2026-07-15
85300 CPT Antithrombin Activity 8 5 $320.00 $310.40 $208.00 $320.00 $262.88 2026-07-15
J2543 HCPCS Piperacillin/Tazob 2.25gr Vial 20 5 $304.00 $295.76 $56.25 $307.32 $261.12 2026-07-15
83993 CPT Calprotectin 11 5 $303.00 $293.91 $196.95 $303.00 $258.46 2026-07-15
J2354 HCPCS Octreotide Acet 500 Mcg/Ml Amp 8 5 $316.00 $306.96 $37.83 $316.45 $257.12 2026-07-15
96401 CPT Injection Chemo Sq/IM Nonhorm 10 5 $284.00 $275.48 $184.60 $284.00 $256.02 2026-07-15
80175 CPT Lamotrigine 10 5 $282.00 $273.54 $183.30 $282.00 $254.22 2026-07-15
73502 CPT X-ray Hip Uni 2-3 Views Lt 20 5 $263.00 $255.11 $170.95 $860.42 $254.06 2026-07-15
87581 CPT Mycoplasma Pneum Pcr 8 5 $308.00 $298.76 $200.20 $308.00 $253.02 2026-07-15
J0295 HCPCS Ampicillin/Sulbactam 3 Gr Vial 8 5 $308.00 $298.86 $107.16 $308.10 $250.33 2026-07-15
J3379 HCPCS Valproate Sod 500 Mg/5 Ml Vial 8 5 $304.00 $295.45 $197.98 $304.59 $250.22 2026-07-15
G0103 HCPCS Psa Screen 12 5 $277.00 $268.69 $180.05 $277.00 $249.71 2026-07-15
83001 CPT Fsh 11 5 $292.00 $283.24 $189.80 $292.00 $249.08 2026-07-15
J0737 HCPCS Clindamycin/D5W 600 Mg Baxter 14 5 $259.00 $251.59 $2.46 $376.77 $249.00 2026-07-15
73564 CPT X-ray Knee 4 Rt 18 5 $290.00 $281.30 $129.06 $290.00 $247.37 2026-07-15
24640 CPT Dislocation Nursemaid Elbow Lt 16 5 $344.00 $333.68 $162.62 $344.00 $247.16 2026-07-15
99222 CPT Inpatient Initial/Obs Mod Comp 6 5 $564.00 $547.08 $202.33 $274.01 $246.06 2026-07-15
J2185 HCPCS Meropenem 1 Gm Vial 8 5 $300.00 $291.87 $31.58 $300.90 $244.48 2026-07-15
11042 CPT Debride Skin Subq 20 Cm 27 5 $366.00 $355.02 $120.87 $366.00 $243.39 2026-07-15
84144 CPT Progesterone 10 5 $271.00 $262.87 $176.15 $271.00 $242.16 2026-07-15
73090 CPT X-ray Forearm 2 Views Lt 17 5 $249.00 $241.53 $161.85 $282.72 $241.53 2026-07-15
99214 CPT Est Patient Level 4 14 5 $366.00 $355.02 $151.00 $366.00 $240.64 2026-07-15
99204 CPT New Patient Level 4 Mod Comp 6 5 $346.00 $335.62 $207.60 $281.18 $240.41 2026-07-15
80162 CPT Digoxin 8 5 $292.00 $283.24 $189.80 $292.00 $239.88 2026-07-15
G0472 HCPCS Hcv Antibody Screen 8 5 $292.00 $283.24 $189.80 $292.00 $239.88 2026-07-15
30903 CPT Control Anterior Hemorrhage Lt 32 5 $332.00 $322.04 $149.60 $756.00 $238.54 2026-07-15
73552 CPT X-ray Femur 2 Views Rt 18 5 $278.00 $269.66 $130.01 $278.00 $237.13 2026-07-15
97164 CPT Re Evaluation Pt 10 5 $263.00 $255.11 $170.95 $263.00 $237.09 2026-07-15
73610 CPT X-ray Ankle 3 Views Lt 20 5 $263.00 $255.11 $99.63 $263.00 $237.09 2026-07-15
70110 CPT X-ray Mandible 4 Views 6 5 $261.00 $253.17 $169.65 $261.00 $235.29 2026-07-15
72170 CPT X-ray Pelvis 1-2 Views 11 5 $241.00 $233.77 $156.65 $341.88 $233.77 2026-07-15
86920 CPT Crossmatch Immed Spin 10 5 $258.00 $250.26 $167.70 $258.00 $232.58 2026-07-15
J3291 HCPCS Tranexamic Ac 1000 Mg/100 Ml 8 5 $282.00 $274.33 $183.83 $282.81 $232.33 2026-07-15
73080 CPT X-ray Elbow Lt 17 5 $272.00 $263.84 $38.91 $272.00 $232.02 2026-07-15
73562 CPT X-ray Knee 3 Views Rt 23 5 $270.00 $261.90 $109.76 $270.00 $230.31 2026-07-15
87338 CPT H Pylori Antigen Stool 11 5 $269.00 $260.93 $174.85 $269.00 $229.46 2026-07-15
86334 CPT Immunofix Electroph Serum 9 5 $268.00 $259.96 $174.20 $268.00 $228.60 2026-07-15
73030 CPT X-ray Shoulder Lt 21 5 $235.00 $227.95 $152.75 $237.65 $227.95 2026-07-15
74018 CPT X-ray Abdomen 12 5 $235.00 $227.95 $152.75 $523.40 $227.95 2026-07-15
88342 CPT Immunohisto Stain Init Pr Spec 8 5 $277.00 $268.69 $180.05 $277.00 $227.56 2026-07-15
12004 CPT Repair Lac Simple 7.6-12.5 Cm 16 5 $313.00 $303.61 $140.14 $313.00 $224.89 2026-07-15
82077 CPT Alcohol/Ethanol Auto Analyzer 12 5 $249.00 $241.53 $161.85 $249.00 $224.48 2026-07-15
86255 CPT Pla2R Elisa 8 5 $271.00 $262.87 $176.15 $271.00 $222.62 2026-07-15
80202 CPT Vancomycin 10 5 $244.00 $236.68 $158.60 $244.00 $219.97 2026-07-15
J3430 HCPCS Phytonadione 10 Mg/ml Ampule 8 5 $228.00 $221.67 $148.54 $233.82 $219.38 2026-07-15
99213 CPT Est Patient Level 3 22 5 $243.00 $235.71 $98.49 $674.00 $219.06 2026-07-15
77080 CPT Dexa Scan 17 5 $336.00 $325.92 $16.12 $336.00 $218.40 2026-07-15
J3410 HCPCS Hydroxyzine Hcl 50 Mg/ml Vial 8 5 $266.00 $258.92 $11.27 $266.93 $216.88 2026-07-15
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