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

AVERA ST BENEDICT HEALTH CENTER - CAH

Parkston, SD · CCN 431330 · Rates published

1,018 distinct procedures filed
5 distinct payers
15,620 rate rows
2026-05-09 last MRF observed
Data quality

15,588 of 15,620 rate rows are consumer-grade (99.8%)

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

Excluded — reasonRows
exceeds 10× this hospital's gross charge — excluded from medians 12
placeholder amount (≤ $0.02) — excluded from medians 10
percent-of-charges filed in the dollar field — excluded from medians 8
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/39440a2e-2d60-4ac7-bf8d-2664d68da7ae/460226738_avera-st-benedicts-hospital_standardcharges.csv
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-17
Content fingerprint 7bb86080e4c431cf… · 4,305,267 bytes · first seen 2026-05-09

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
OTHER 		Ocrelizumab 300 Mg/10 Ml 5 $6.09 $86,126.02 $64,905.28 nat. median
$65
outlier · 1000.5×
7203
OTHER 		Apr-DRG 7203 1 $46,209.81 $46,209.81 $46,209.81 nat. median
$9,378
outlier · 4.9×
5402
OTHER 		Apr-DRG 5402 1 $42,065.18 $42,065.18 $42,065.18 nat. median
$6,101
outlier · 6.9×
J9272
OTHER 		Dostarlimab-gxly 500 Mg/10 Ml 5 $8,526.00 $50,764.02 $38,256.18 nat. median
$251
outlier · 152.3×
J9144
OTHER 		Daratumumab Hyaluronida 1800Mg 5 $382.98 $43,730.18 $32,955.43 nat. median
$58
outlier · 564.8×
806
OTHER 		Ms-DRG 806 1 $30,543.91 $30,543.91 $30,543.91 nat. median
$6,102
outlier · 5.0×
J3380
OTHER 		Vedolizumab 300 Mg Vial 5 $72.63 $37,975.12 $28,618.36 nat. median
$24
outlier · 1212.6×
J3101
OTHER 		Tenecteplase 50 Mg/10 Ml Syrng 5 $0.41 $30,637.29 $23,088.52 nat. median
$195
outlier · 118.4×
6942
OTHER 		Apr-DRG 6942 1 $19,975.72 $19,975.72 $19,975.72 nat. median
$6,901
outlier · 2.9×
J2353
OTHER 		Octreotide (Depot) 30 Mg Syr 5 $17.33 $26,505.70 $19,974.92 nat. median
$221
outlier · 90.2×
J0717
OTHER 		Certolizumab Pegol 400 Mg Kit 5 $3.42 $25,109.77 $18,922.93 nat. median
$5
outlier · 3739.7×
7204
OTHER 		Apr-DRG 7204 1 $17,330.81 $17,330.81 $17,330.81 nat. median
$18,741
0.9× median
5603
OTHER 		Apr-DRG 5603 1 $17,035.33 $17,035.33 $17,035.33 nat. median
$4,889
outlier · 3.5×
J9312
OTHER 		Rituximab 500 Mg/50 Ml Vial 5 $322.14 $20,650.52 $15,562.40 nat. median
$84
outlier · 186.2×
Q5127
OTHER 		Pegfilgrastim-fpgk 6 Mg/0.6 Ml 5 $5,793.75 $17,380.53 $13,098.11 nat. median
$298
outlier · 43.9×
5602
OTHER 		Apr-DRG 5602 1 $12,939.93 $12,939.93 $12,939.93 nat. median
$3,572
outlier · 3.6×
36482
OTHER 		Endoven Ther Chem Adhes 1St 5 $10,240.10 $15,281.38 $11,632.15 nat. median
$5,123
outlier · 2.3×
1393
OTHER 		Apr-DRG 1393 1 $11,336.59 $11,336.59 $11,336.59 nat. median
$7,897
1.4× median
J0870
OTHER 		Imetelstat 47 Mg Vial 5 $18.24 $43,240.66 $10,962.73 nat. median
$58
outlier · 188.0×
5601
OTHER 		Apr-DRG 5601 1 $8,731.42 $8,731.42 $8,731.42 nat. median
$2,577
outlier · 3.4×
15275
OTHER 		Skin Substitute Graft 25 Sq Cm 5 $7,174.05 $10,705.89 $8,619.90 nat. median
$1,281
outlier · 6.7×
81352
OTHER 		Tp53 Somatic Mutation, Prog 5 $7,046.65 $10,515.77 $8,466.82 nat. median
$346
outlier · 24.5×
78815
OTHER 		PET CT Skull To Mid Thigh Init 5 $1,440.20 $10,527.41 $7,933.55 nat. median
$1,700
outlier · 4.7×
J0897
OTHER 		Denosumab 60 Mg/ml Syringe 5 $9.69 $12,945.91 $7,287.68 nat. median
$32
outlier · 229.1×
15271
OTHER 		Skin Substitute Graft 25 Sq Cm 5 $98.98 $10,705.89 $7,256.83 nat. median
$1,419
outlier · 5.1×
Q5111
OTHER 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 5 $1,112.40 $8,657.25 $6,524.18 nat. median
$164
outlier · 39.9×
J1602
OTHER 		Golimumab 50 Mg/4 Ml Vial 5 $43.11 $8,562.27 $6,452.60 nat. median
$14
outlier · 466.2×
J9308
OTHER 		Ramucirumab 100 Mg/10 Ml Vial 5 $86.40 $32,212.62 $6,391.01 nat. median
$79
outlier · 81.3×
83884
OTHER 		Neurofilament Light Chain 5 $5,224.70 $7,796.86 $6,277.68 nat. median
$120
outlier · 52.4×
690
OTHER 		Ms-DRG 690 1 $5,981.14 $5,981.14 $5,981.14 nat. median
$8,286
0.7× median
884
OTHER 		Ms-DRG 884 1 $5,891.20 $5,891.20 $5,891.20 nat. median
$12,103
outlier · 0.5×
194
OTHER 		Ms-DRG 194 1 $5,890.00 $5,890.00 $5,890.00 nat. median
$8,630
0.7× median
536
OTHER 		Ms-DRG 536 1 $5,890.00 $5,890.00 $5,890.00 nat. median
$8,350
0.7× median
72158
OTHER 		MRI Lumbar Spine Wwo Dye 5 $340.97 $7,346.78 $5,847.13 nat. median
$576
outlier · 10.1×
641
OTHER 		Ms-DRG 641 1 $5,757.70 $5,757.70 $5,757.70 nat. median
$8,198
0.7× median
Q5122
OTHER 		Pegfilgrastim 6 Mg/0.6 Ml Syr 5 $3,939.75 $7,578.91 $5,618.37 nat. median
$146
outlier · 38.4×
74174
OTHER 		CTA Abd&Pelv Wwo Dye 5 $71.13 $7,454.45 $5,617.73 nat. median
$502
outlier · 11.2×
73723
OTHER 		MRI Joint Le Wwo Dye Lt 5 $657.06 $7,408.86 $5,583.38 nat. median
$583
outlier · 9.6×
74177
OTHER 		CT Abd & Pelv W Contrast 5 $227.52 $6,975.27 $5,551.45 nat. median
$458
outlier · 12.1×
73720
OTHER 		MRI Le Wwo Dye Lt 5 $233.96 $7,597.04 $5,404.08 nat. median
$553
outlier · 9.8×
74176
OTHER 		CT Abd & Pelvis Wo Contrast 5 $95.04 $6,742.47 $5,366.17 nat. median
$302
outlier · 17.8×
72157
OTHER 		MRI Chest Spine Wwo Dye 5 $535.35 $7,101.37 $5,351.65 nat. median
$630
outlier · 8.5×
74178
OTHER 		CT Abd & Pelv Wwo Contrast 5 $479.88 $7,258.00 $5,305.60 nat. median
$495
outlier · 10.7×
73220
OTHER 		MRI Ue Wwo Dye Lt 5 $319.79 $7,001.46 $5,276.36 nat. median
$560
outlier · 9.4×
J9264
OTHER 		Paclitaxel Protein-bd 100mg Vl 5 $17.39 $6,821.54 $5,140.77 nat. median
$14
outlier · 375.2×
J1569
OTHER 		Immune Glob Gammagard 5gr/50ml 5 $21.77 $13,556.00 $4,825.76 nat. median
$52
outlier · 92.6×
78452
OTHER 		Myocard Perf Spect Rest Stress 5 $3,920.15 $5,922.27 $4,764.49 nat. median
$1,353
outlier · 3.5×
J0129
OTHER 		Abatacept 250 Mg Vial 5 $588.00 $6,259.03 $4,716.85 nat. median
$49
outlier · 95.8×
72148
OTHER 		MRI Lumbar Spine Wo Dye 5 $315.18 $5,488.26 $4,597.12 nat. median
$383
outlier · 12.0×
70553
OTHER 		MRI Brain Wwo Contrast 5 $729.77 $5,850.07 $4,510.53 nat. median
$596
outlier · 7.6×

Other procedures at this hospital

Browse this hospital's 1,018 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 OTHER Ocrelizumab 300 Mg/10 Ml 8 5 $88,789.00 $86,126.02 $6.09 $86,126.02 $64,905.28 2026-05-09
7203 OTHER Apr-DRG 7203 2 1 — — $46,209.81 $46,209.81 $46,209.81 2026-05-09
5402 OTHER Apr-DRG 5402 2 1 — — $42,065.18 $42,065.18 $42,065.18 2026-05-09
J9272 OTHER Dostarlimab-gxly 500 Mg/10 Ml 8 5 $52,334.00 $50,764.02 $8,526.00 $50,764.02 $38,256.18 2026-05-09
J9144 OTHER Daratumumab Hyaluronida 1800Mg 8 5 $45,082.00 $43,730.18 $382.98 $43,730.18 $32,955.43 2026-05-09
806 OTHER Ms-DRG 806 1 1 — — $30,543.91 $30,543.91 $30,543.91 2026-05-09
J3380 OTHER Vedolizumab 300 Mg Vial 8 5 $39,149.00 $37,975.12 $72.63 $37,975.12 $28,618.36 2026-05-09
J3101 OTHER Tenecteplase 50 Mg/10 Ml Syrng 8 5 $31,584.00 $30,637.29 $0.41 $30,637.29 $23,088.52 2026-05-09
6942 OTHER Apr-DRG 6942 2 1 — — $19,975.72 $19,975.72 $19,975.72 2026-05-09
J2353 OTHER Octreotide (Depot) 30 Mg Syr 8 5 $27,325.00 $26,505.70 $17.33 $26,505.70 $19,974.92 2026-05-09
J0717 OTHER Certolizumab Pegol 400 Mg Kit 8 5 $25,886.00 $25,109.77 $3.42 $25,109.77 $18,922.93 2026-05-09
7204 OTHER Apr-DRG 7204 2 1 — — $17,330.81 $17,330.81 $17,330.81 2026-05-09
5603 OTHER Apr-DRG 5603 2 1 — — $17,035.33 $17,035.33 $17,035.33 2026-05-09
J9312 OTHER Rituximab 500 Mg/50 Ml Vial 8 5 $21,289.00 $20,650.52 $322.14 $20,650.52 $15,562.40 2026-05-09
Q5127 OTHER Pegfilgrastim-fpgk 6 Mg/0.6 Ml 8 5 $17,918.00 $17,380.53 $5,793.75 $17,380.53 $13,098.11 2026-05-09
5602 OTHER Apr-DRG 5602 2 1 — — $12,939.93 $12,939.93 $12,939.93 2026-05-09
36482 OTHER Endoven Ther Chem Adhes 1St 10 5 $15,754.00 $15,281.38 $10,240.10 $15,281.38 $11,632.15 2026-05-09
1393 OTHER Apr-DRG 1393 2 1 — — $11,336.59 $11,336.59 $11,336.59 2026-05-09
J0870 OTHER Imetelstat 47 Mg Vial 14 5 $11,419.00 $11,076.92 $18.24 $43,240.66 $10,962.73 2026-05-09
5601 OTHER Apr-DRG 5601 2 1 — — $8,731.42 $8,731.42 $8,731.42 2026-05-09
15275 OTHER Skin Substitute Graft 25 Sq Cm 8 5 $11,037.00 $10,705.89 $7,174.05 $10,705.89 $8,619.90 2026-05-09
81352 OTHER Tp53 Somatic Mutation, Prog 8 5 $10,841.00 $10,515.77 $7,046.65 $10,515.77 $8,466.82 2026-05-09
78815 OTHER PET CT Skull To Mid Thigh Init 8 5 $10,853.00 $10,527.41 $1,440.20 $10,527.41 $7,933.55 2026-05-09
J0897 OTHER Denosumab 60 Mg/ml Syringe 14 5 $7,591.00 $7,363.59 $9.69 $12,945.91 $7,287.68 2026-05-09
15271 OTHER Skin Substitute Graft 25 Sq Cm 14 5 $11,037.00 $10,705.89 $98.98 $10,705.89 $7,256.83 2026-05-09
Q5111 OTHER Pegfilgrastim-cbqv 6 Mg/0.6 Ml 8 5 $8,925.00 $8,657.25 $1,112.40 $8,657.25 $6,524.18 2026-05-09
J1602 OTHER Golimumab 50 Mg/4 Ml Vial 8 5 $8,827.00 $8,562.27 $43.11 $8,562.27 $6,452.60 2026-05-09
J9308 OTHER Ramucirumab 100 Mg/10 Ml Vial 14 5 $6,657.00 $6,457.58 $86.40 $32,212.62 $6,391.01 2026-05-09
83884 OTHER Neurofilament Light Chain 8 5 $8,038.00 $7,796.86 $5,224.70 $7,796.86 $6,277.68 2026-05-09
690 OTHER Ms-DRG 690 2 1 — — $5,981.14 $5,981.14 $5,981.14 2026-05-09
884 OTHER Ms-DRG 884 2 1 — — $5,891.20 $5,891.20 $5,891.20 2026-05-09
194 OTHER Ms-DRG 194 2 1 — — $5,890.00 $5,890.00 $5,890.00 2026-05-09
536 OTHER Ms-DRG 536 2 1 — — $5,890.00 $5,890.00 $5,890.00 2026-05-09
72158 OTHER MRI Lumbar Spine Wwo Dye 9 5 $7,574.00 $7,346.78 $340.97 $7,346.78 $5,847.13 2026-05-09
641 OTHER Ms-DRG 641 2 1 — — $5,757.70 $5,757.70 $5,757.70 2026-05-09
Q5122 OTHER Pegfilgrastim 6 Mg/0.6 Ml Syr 10 5 $7,813.00 $7,578.91 $3,939.75 $7,578.91 $5,618.37 2026-05-09
74174 OTHER CTA Abd&Pelv Wwo Dye 8 5 $7,685.00 $7,454.45 $71.13 $7,454.45 $5,617.73 2026-05-09
73723 OTHER MRI Joint Le Wwo Dye Lt 8 5 $7,638.00 $7,408.86 $657.06 $7,408.86 $5,583.38 2026-05-09
74177 OTHER CT Abd & Pelv W Contrast 13 5 $7,191.00 $6,975.27 $227.52 $6,975.27 $5,551.45 2026-05-09
73720 OTHER MRI Le Wwo Dye Lt 18 5 $7,832.00 $7,597.04 $233.96 $7,597.04 $5,404.08 2026-05-09
74176 OTHER CT Abd & Pelvis Wo Contrast 13 5 $6,951.00 $6,742.47 $95.04 $6,742.47 $5,366.17 2026-05-09
72157 OTHER MRI Chest Spine Wwo Dye 8 5 $7,321.00 $7,101.37 $535.35 $7,101.37 $5,351.65 2026-05-09
74178 OTHER CT Abd & Pelv Wwo Contrast 10 5 $7,258.00 $7,040.26 $479.88 $7,258.00 $5,305.60 2026-05-09
73220 OTHER MRI Ue Wwo Dye Lt 8 5 $7,218.00 $7,001.46 $319.79 $7,001.46 $5,276.36 2026-05-09
J9264 OTHER Paclitaxel Protein-bd 100mg Vl 8 5 $7,032.00 $6,821.54 $17.39 $6,821.54 $5,140.77 2026-05-09
J1569 OTHER Immune Glob Gammagard 5gr/50ml 26 5 $5,026.00 $4,876.03 $21.77 $13,556.00 $4,825.76 2026-05-09
78452 OTHER Myocard Perf Spect Rest Stress 11 5 $6,031.00 $5,850.07 $3,920.15 $5,922.27 $4,764.49 2026-05-09
J0129 OTHER Abatacept 250 Mg Vial 8 5 $6,452.00 $6,259.03 $588.00 $6,259.03 $4,716.85 2026-05-09
72148 OTHER MRI Lumbar Spine Wo Dye 12 5 $5,658.00 $5,488.26 $315.18 $5,488.26 $4,597.12 2026-05-09
70553 OTHER MRI Brain Wwo Contrast 19 5 $5,743.00 $5,570.71 $729.77 $5,850.07 $4,510.53 2026-05-09
72156 OTHER MRI Neck Spine Wwo Dye 8 5 $6,152.00 $5,967.44 $340.05 $5,967.44 $4,497.11 2026-05-09
70543 OTHER MRI Orbit Face Neck Wwo Cont 8 5 $5,842.00 $5,666.74 $335.45 $5,666.74 $4,270.50 2026-05-09
74183 OTHER MRI Abdomen Wwo Dye 10 5 $5,947.00 $5,768.59 $619.08 $5,768.59 $4,161.09 2026-05-09
72146 OTHER MRI Chest Spine Wo Dye 10 5 $5,614.00 $5,445.58 $390.63 $5,445.58 $4,103.84 2026-05-09
73221 OTHER MRI Joint Ue Wo Dye Lt 22 5 $5,614.00 $5,445.58 $408.12 $5,445.58 $3,914.85 2026-05-09
72141 OTHER MRI Neck Spine Wo Dye 10 5 $5,658.00 $5,488.26 $233.96 $5,488.26 $3,904.02 2026-05-09
73721 OTHER MRI Joint Le Wo Dye Rt 22 5 $5,658.00 $5,488.26 $315.18 $5,488.26 $3,904.02 2026-05-09
73718 OTHER MRI Le Wo Dye Lt 20 5 $5,658.00 $5,488.26 $56.39 $5,488.26 $3,904.02 2026-05-09
177 OTHER Ms-DRG 177 2 1 — — $3,849.64 $3,849.64 $3,849.64 2026-05-09
159 OTHER Ms-DRG 159 2 1 — — $3,848.76 $3,848.76 $3,848.76 2026-05-09
74175 OTHER CTA Abdom Wwo Dye 11 5 $4,973.00 $4,823.81 $82.17 $4,823.81 $3,839.16 2026-05-09
6401 OTHER Apr-DRG 6401 2 1 — — $3,797.02 $3,797.02 $3,797.02 2026-05-09
Q5115 OTHER Rituximab-abbs 100Mg/10Ml Via 14 5 $2,474.00 $2,400.09 $1,608.31 $11,086.65 $3,708.00 2026-05-09
71275 OTHER CTA Chest Wwo Contrast 12 5 $5,012.00 $4,861.64 $65.60 $4,861.64 $3,700.64 2026-05-09
73701 OTHER CT Le W Dye Rt 17 5 $4,616.00 $4,477.52 $268.01 $4,477.52 $3,563.55 2026-05-09
70498 OTHER CT Angiography Neck W Cont 12 5 $4,737.00 $4,594.89 $278.39 $4,594.89 $3,497.55 2026-05-09
72128 OTHER CT Thoracic Spine Wo Contrast 8 5 $4,758.00 $4,615.26 $107.93 $4,615.26 $3,478.10 2026-05-09
72195 OTHER MRI Pelvis Wo Dye 8 5 $4,692.00 $4,551.24 $53.64 $4,551.24 $3,429.85 2026-05-09
70496 OTHER CT Angiography Head W Cont 12 5 $4,607.00 $4,468.79 $246.84 $4,468.79 $3,401.49 2026-05-09
71260 OTHER CT Thorax W Contrast 12 5 $4,652.00 $4,512.44 $80.31 $4,512.44 $3,400.61 2026-05-09
J1561 OTHER Immune Glob 10% 40 Gm/400 Ml 28 5 $7,165.00 $6,950.21 $3.60 $13,609.40 $3,364.94 2026-05-09
75635 OTHER CTA Abdominal Arteries 8 5 $4,579.00 $4,441.63 $592.68 $4,441.63 $3,347.25 2026-05-09
73201 OTHER CT Ue W Dye Lt 16 5 $4,548.00 $4,411.56 $90.44 $4,411.56 $3,324.59 2026-05-09
72131 OTHER CT Lumbar Spine Wo Contrast 10 5 $4,758.00 $4,615.26 $234.87 $4,615.26 $3,317.98 2026-05-09
789 OTHER Ms-DRG 789 2 1 — — $3,161.41 $3,161.41 $3,161.41 2026-05-09
J1439 OTHER Ferric Carboxymalt 750mg/15ml 10 5 $4,258.00 $4,130.39 $11.91 $4,248.33 $3,112.70 2026-05-09
70551 OTHER MRI Brain Wo Contrast 12 5 $3,785.00 $3,671.45 $447.03 $3,705.99 $3,075.32 2026-05-09
70470 OTHER CT Head/Brain Wwo Contrast 8 5 $4,022.00 $3,901.34 $241.32 $3,901.34 $2,940.08 2026-05-09
72192 OTHER CT Pelvis Wo Dye 9 5 $3,808.00 $3,693.76 $597.02 $3,693.76 $2,939.78 2026-05-09
71250 OTHER CT Thorax Wo Contrast 11 5 $4,229.00 $4,102.13 $71.13 $4,102.13 $2,918.01 2026-05-09
73200 OTHER CT Ue Wo Dye Lt 8 5 $3,980.00 $3,860.60 $70.19 $3,860.60 $2,909.38 2026-05-09
72125 OTHER CT Cervical Spine Wo Contrast 12 5 $3,519.00 $3,413.43 $172.58 $3,413.43 $2,859.19 2026-05-09
73700 OTHER CT Le Wo Dye Lt 20 5 $4,115.00 $3,991.55 $76.65 $3,991.55 $2,839.35 2026-05-09
72193 OTHER CT Pelvis W Dye 10 5 $4,080.00 $3,957.60 $593.33 $3,957.60 $2,815.20 2026-05-09
78451 OTHER Myocard Perf Spect Rest Or Str 8 5 $3,552.00 $3,445.44 $2,308.80 $3,445.44 $2,774.11 2026-05-09
70450 OTHER CT Head/Brain Wo Contrast 13 5 $3,519.00 $3,413.43 $24.20 $3,413.43 $2,716.67 2026-05-09
112 OTHER Room Womens Ctr 6 5 $3,340.00 $3,239.80 $2,171.00 $3,239.80 $2,713.75 2026-05-09
111 OTHER Room Medical Unit Priv 6 5 $3,340.00 $3,239.80 $2,171.00 $3,239.80 $2,713.75 2026-05-09
74170 OTHER CT Abdomen Wwo Dye 10 5 $3,920.00 $3,802.40 $58.22 $3,802.40 $2,704.80 2026-05-09
C8929 OTHER Echo M Mode 2d W Contrast 10 5 $3,689.00 $3,578.33 $702.60 $3,578.33 $2,696.66 2026-05-09
J9217 OTHER Leuprolide Acetate 22.5 Mg Syr 20 5 $3,724.00 $3,612.37 $1.47 $4,152.89 $2,676.24 2026-05-09
93306 OTHER Tte W Doppler Complete 11 5 $3,425.00 $3,322.25 $2,117.61 $3,322.25 $2,644.10 2026-05-09
G0390 OTHER Trauma Team Level 5 8 5 $3,135.00 $3,040.95 $2,037.75 $3,040.95 $2,448.43 2026-05-09
689 OTHER Trauma Team Evaluation Level 5 8 5 $3,135.00 $3,040.95 $2,037.75 $3,040.95 $2,448.43 2026-05-09
C1888 OTHER Cath Interven 6Fr 100cm 8cm 16 5 $3,129.50 $3,036.02 $1,816.64 $3,361.05 $2,387.42 2026-05-09
70491 OTHER CT Soft Tissue Neck W Cont 11 5 $3,042.00 $2,950.74 $357.53 $2,950.74 $2,348.42 2026-05-09
70481 OTHER CT Orbit W Contrast 8 5 $3,170.00 $3,074.90 $80.31 $3,074.90 $2,317.27 2026-05-09
74160 OTHER CT Abdomen W Dye 10 5 $3,249.00 $3,151.53 $706.77 $3,151.53 $2,291.14 2026-05-09
78227 OTHER Hida With Ef w/Pharm 10 5 $2,763.00 $2,680.11 $1,795.95 $2,680.11 $2,157.90 2026-05-09
70487 OTHER CT Maxillofacial W Contrast 10 5 $2,875.00 $2,788.75 $268.29 $2,788.75 $2,101.62 2026-05-09
90375 OTHER Rabies Imm Glob (Human) 300u/m 8 5 $2,848.00 $2,763.49 $146.90 $2,763.49 $2,082.59 2026-05-09
74240 OTHER X-ray Upper Gi Delay Without Air 8 5 $2,821.00 $2,736.37 $87.98 $2,736.37 $2,062.15 2026-05-09
70486 OTHER CT Maxillofacial Wo Contrast 11 5 $2,651.00 $2,571.47 $187.95 $2,571.47 $2,046.57 2026-05-09
99291 OTHER Critical Care 1st 30-74 Min 17 5 $3,068.00 $2,975.96 $196.93 $2,975.96 $2,040.22 2026-05-09
170 OTHER Baby Assessment And Monitor 2 12 5 $2,616.00 $2,537.52 $1,153.10 $3,354.26 $1,984.24 2026-05-09
J0248 OTHER Remdesivir 100 Mg Vial 10 5 $2,840.00 $2,755.48 $70.71 $2,755.48 $1,960.08 2026-05-09
74150 OTHER CT Abdomen Wo Dye 8 5 $2,577.00 $2,499.69 $791.13 $2,499.69 $1,883.79 2026-05-09
78306 OTHER Bone Scan Whole Body 10 5 $2,534.00 $2,457.98 $1,647.10 $2,457.98 $1,852.36 2026-05-09
87507 OTHER Gi Pathogens Panel Ref 8 5 $2,368.00 $2,296.96 $1,539.20 $2,296.96 $1,849.41 2026-05-09
70480 OTHER CT Orbit Wo Contrast 8 5 $2,525.00 $2,449.25 $192.56 $2,449.25 $1,845.78 2026-05-09
70490 OTHER CT Soft Tissue Neck Wo Cont 8 5 $2,462.00 $2,388.14 $277.47 $2,388.14 $1,799.72 2026-05-09
87154 OTHER Culture Id By Amp Prb 6 Or 6+ 11 5 $2,261.00 $2,193.17 $1,469.65 $3,477.00 $1,786.19 2026-05-09
78803 OTHER Bone Scan Spect 8 5 $2,285.00 $2,216.45 $1,485.25 $2,216.45 $1,784.59 2026-05-09
129 OTHER Room Swing Bed Skilled 6 5 $2,186.00 $2,120.42 $1,420.90 $2,120.42 $1,776.12 2026-05-09
272 OTHER System Clsr Venaseal Glu 8 5 $2,250.00 $2,182.50 $1,462.50 $2,182.50 $1,757.25 2026-05-09
11043 OTHER Debride Muscle/Fascia 20 Cm 16 5 $2,529.00 $2,453.13 $182.22 $2,453.13 $1,713.40 2026-05-09
P9032 OTHER Platelet Concentr Irradiate 8 5 $2,177.00 $2,111.69 $1,415.05 $2,111.69 $1,700.24 2026-05-09
P9040 OTHER Rbc Packed Leuko-reduc Irrad 8 5 $2,081.00 $2,018.57 $1,352.65 $2,018.57 $1,625.26 2026-05-09
P9031 OTHER Platelets Leukocyte Reduced 8 5 $2,081.00 $2,018.57 $1,352.65 $2,018.57 $1,625.26 2026-05-09
Q5106 OTHER Epoetin Alfa-epbx 40,000 Sdv 8 5 $1,799.00 $1,745.32 $1,169.55 $2,703.75 $1,622.07 2026-05-09
19083 OTHER Biopsy Breast 1st Lesion Lt 8 5 $2,066.00 $2,004.02 $1,342.90 $2,004.02 $1,613.55 2026-05-09
76700 OTHER Ultrasound Abdomen Complete 10 5 $2,182.00 $2,116.54 $1,418.30 $2,116.54 $1,611.11 2026-05-09
P9037 OTHER Platelet Pheresis Leuk Red Irr 10 5 $2,186.00 $2,120.42 $437.20 $2,120.42 $1,597.96 2026-05-09
Q5104 OTHER Infliximab-abda 100 Mg Vial 8 5 $1,758.00 $1,705.35 $1,142.76 $5,119.19 $1,584.92 2026-05-09
J1745 OTHER Infliximab (Gen) 100 Mg Vial 10 5 $2,108.00 $2,044.77 $1.46 $9,359.54 $1,540.95 2026-05-09
P9035 OTHER Platelet Pheresis Leuko Reduc 10 5 $2,081.00 $2,018.57 $437.20 $2,018.57 $1,521.21 2026-05-09
94762 OTHER Desaturation And Hr Study 8 5 $1,938.00 $1,879.86 $1,259.70 $1,879.86 $1,513.58 2026-05-09
A9552 OTHER Radiophar Fdg 8 5 $1,931.00 $1,873.07 $1,255.15 $1,873.07 $1,508.11 2026-05-09
93970 OTHER Venous Duplex 12 5 $1,893.00 $1,836.21 $1,230.45 $1,836.21 $1,478.43 2026-05-09
J9155 OTHER Degarelix 80 Mg Vial 14 5 $1,612.00 $1,564.32 $135.29 $2,132.19 $1,472.74 2026-05-09
99285 OTHER Emergency Room Visit Level 5 18 5 $2,150.00 $2,085.50 $184.62 $2,085.50 $1,456.62 2026-05-09
J0666 OTHER Bupivac Liposome 1.3% Pf 20 Ml 10 5 $1,783.00 $1,730.43 $1,159.57 $1,730.43 $1,449.46 2026-05-09
76705 OTHER Ultrasound Abdomen Limited 12 5 $1,779.00 $1,725.63 $1,156.35 $1,725.63 $1,389.40 2026-05-09
93923 OTHER Ue/le Artery 3 Levels 9 5 $1,737.00 $1,684.89 $1,129.05 $1,684.89 $1,372.23 2026-05-09
93880 OTHER Extracranial Bilat Study 11 5 $1,720.00 $1,668.40 $1,118.00 $1,668.40 $1,327.84 2026-05-09
93882 OTHER Carotid Duplex Rt 8 5 $1,662.00 $1,612.14 $1,080.30 $1,612.14 $1,298.02 2026-05-09
93017 OTHER Cardiovascular Stress Test 11 5 $1,652.00 $1,602.44 $1,073.80 $1,602.44 $1,275.34 2026-05-09
93925 OTHER Arterial Duplex Le Bi 10 5 $1,719.00 $1,667.43 $325.60 $1,667.43 $1,256.59 2026-05-09
86366 OTHER Musk Antibody Ref 8 5 $1,603.00 $1,554.91 $1,041.95 $1,554.91 $1,251.94 2026-05-09
76805 OTHER OB US >14 Wk Tvta Single Fetus 11 5 $1,605.00 $1,556.85 $1,043.25 $1,556.85 $1,239.06 2026-05-09
25605 OTHER Fx Distal Radius W Man Rt 20 5 $1,327.00 $1,287.19 $616.32 $1,593.71 $1,178.78 2026-05-09
71101 OTHER X-ray Ribs Uni W Chest Lt 20 5 $1,378.00 $1,336.66 $895.70 $3,427.98 $1,175.43 2026-05-09
76770 OTHER Ultrasound Abdo Back Wall Comp 10 5 $1,499.00 $1,454.03 $974.35 $1,591.14 $1,170.72 2026-05-09
70030 OTHER X-ray Eye Fb Detection 11 5 $1,368.00 $1,326.96 $642.32 $5,074.70 $1,166.90 2026-05-09
96413 OTHER Chemotherapy Inf Initial 10 5 $1,452.00 $1,408.44 $943.80 $1,541.46 $1,134.01 2026-05-09
74300 OTHER X-ray Bile Ducts/Pancreas 8 5 $1,528.00 $1,482.16 $965.04 $1,482.16 $1,116.97 2026-05-09
11042 OTHER Debride Skin Subq 20 Cm 17 5 $1,614.00 $1,565.58 $71.89 $1,565.58 $1,113.66 2026-05-09
76642 OTHER Ultrasound Breast Limited Rt 31 5 $1,284.00 $1,245.48 $834.60 $1,867.25 $1,095.25 2026-05-09
90675 OTHER Rabies Vacc Hmn Post-ex Nonim 8 5 $1,475.00 $1,431.29 $125.24 $1,431.29 $1,078.63 2026-05-09
76641 OTHER Ultrasound Breast Complete Lt 10 5 $1,467.00 $1,422.99 $885.96 $1,422.99 $1,072.38 2026-05-09
32551 OTHER Insertion Chest Tube Lt 14 5 $1,609.00 $1,560.73 $181.56 $1,560.73 $1,057.91 2026-05-09
77001 OTHER Fluoroguide For Vein Device 8 5 $1,439.00 $1,395.83 $99.63 $1,395.83 $1,051.91 2026-05-09
93971 OTHER Extremity Study Lt 21 5 $1,348.00 $1,307.56 $876.20 $1,307.56 $1,040.66 2026-05-09
99284 OTHER Emergency Room Visit Level 4 19 5 $1,498.00 $1,453.06 $127.14 $1,453.06 $1,033.62 2026-05-09
0202U OTHER Respir Path 22 Targets Biofire 8 5 $1,296.00 $1,257.12 $842.40 $1,257.12 $1,012.17 2026-05-09
76882 OTHER US Extremity Nonvasc Limit Lt 16 5 $1,269.00 $1,230.93 $824.85 $1,230.93 $991.09 2026-05-09
761 OTHER Colposcopy 64 5 $1,295.50 $1,256.63 $327.60 $4,276.73 $987.70 2026-05-09
J7325 OTHER Hylan G-f 20 16 Mg/2 Ml Syr 8 5 $1,091.00 $1,058.71 $709.44 $1,735.19 $983.95 2026-05-09
76942 OTHER US Guide For Needle Placement 8 5 $1,257.00 $1,219.29 $817.05 $1,219.29 $981.71 2026-05-09
93308 OTHER Echo Limited 8 5 $1,220.00 $1,183.40 $793.00 $1,183.40 $952.82 2026-05-09
49082 OTHER Abdominal Paracentesis 14 5 $1,440.00 $1,396.80 $86.65 $1,396.80 $946.80 2026-05-09
74250 OTHER Gastrografin Challenge 8 5 $1,295.00 $1,256.15 $206.36 $1,256.15 $946.64 2026-05-09
76536 OTHER Ultrasound Head And Neck 11 5 $1,226.00 $1,189.22 $796.90 $1,189.22 $946.47 2026-05-09
74246 OTHER Contrast X-ray Upper Gi W Air 8 5 $1,294.00 $1,255.18 $178.77 $1,255.18 $945.91 2026-05-09
74420 OTHER Contrast X-ray Urinary Tract 10 5 $1,260.00 $1,222.20 $262.10 $1,673.00 $921.06 2026-05-09
96360 OTHER Inf Therapy Hyd Initial 23 5 $909.00 $881.73 $590.85 $1,279.43 $877.13 2026-05-09
76775 OTHER Ultrasound Aorta 10 5 $1,121.00 $1,087.37 $728.65 $1,208.00 $875.50 2026-05-09
76819 OTHER Fetal Biophys Profil Wo Nst 11 5 $1,129.00 $1,095.13 $733.85 $1,095.13 $871.59 2026-05-09
J0561 OTHER Pen G Benzathine 1200000Un/2ML 8 5 $1,191.00 $1,155.52 $260.76 $1,155.52 $870.81 2026-05-09
96365 OTHER Inf Therapy Med Initial 25 5 $893.00 $866.21 $580.45 $1,279.43 $866.21 2026-05-09
80074 OTHER Acute Hepatitis Panel 8 5 $1,075.00 $1,042.75 $698.75 $1,042.75 $839.58 2026-05-09
88377 OTHER Morph Ana Ea Man Multpx Hema 8 5 $1,074.00 $1,041.78 $698.10 $1,041.78 $838.80 2026-05-09
93976 OTHER Vascular Study 9 5 $1,050.00 $1,018.50 $682.50 $1,018.50 $829.50 2026-05-09
76816 OTHER OB US Follow-up Per Fetus 10 5 $1,129.00 $1,095.13 $733.85 $1,095.13 $825.30 2026-05-09
Q0138 OTHER Ferumoxy 510mg/17ml (non-esrd) 10 5 $1,145.00 $1,111.35 $7.28 $1,111.35 $819.19 2026-05-09
77002 OTHER Needle Localization By X-ray 8 5 $1,117.00 $1,083.49 $83.48 $1,083.49 $816.53 2026-05-09
76856 OTHER Ultrasound Pelvic Complete 8 5 $1,044.00 $1,012.68 $678.60 $1,012.68 $815.37 2026-05-09
76830 OTHER Ultrasound Transvaginal 10 5 $1,044.00 $1,012.68 $678.60 $1,108.14 $815.37 2026-05-09
84445 OTHER Tsi 8 5 $1,010.00 $979.70 $656.50 $979.70 $788.81 2026-05-09
360 OTHER Biopsy Prostate 56 5 $973.00 $943.81 $456.95 $1,533.57 $787.02 2026-05-09
76870 OTHER Ultrasound Scrotum 8 5 $974.00 $944.78 $633.10 $944.78 $760.69 2026-05-09
74221 OTHER Double Contrast Esophagus 10 5 $1,036.00 $1,004.92 $620.03 $1,004.92 $757.32 2026-05-09
93926 OTHER Arterial Duplex Le Lt 16 5 $969.00 $939.93 $629.85 $939.93 $756.79 2026-05-09
93325 OTHER Echo Color Doppler 8 5 $957.00 $928.29 $622.05 $928.29 $747.41 2026-05-09
72050 OTHER X-ray Spine Cervical 4-5 Views 8 5 $899.00 $872.03 $584.35 $872.03 $746.06 2026-05-09
P9016 OTHER Red Blood Cells Lekoreduced 11 5 $962.00 $933.14 $625.30 $933.14 $742.66 2026-05-09
74220 OTHER Contrast X-ray Esophagus 8 5 $1,014.00 $983.58 $357.53 $983.58 $741.23 2026-05-09
Q9967 OTHER Iopamidol-370 100 Ml Vial 23 5 $1,500.00 $1,455.00 $253.80 $1,455.00 $727.50 2026-05-09
92950 OTHER Heart/Lung Resuscitation Cpr 16 5 $1,063.00 $1,031.11 $192.77 $1,031.11 $720.18 2026-05-09
92960 OTHER Cardioversion Electric Ext 14 5 $1,087.00 $1,054.39 $115.39 $1,054.39 $714.70 2026-05-09
C1788 OTHER Port Impl Pp Clrvu 8f 1 Lmn 8 5 $907.00 $880.27 $589.88 $880.28 $708.76 2026-05-09
Q5110 OTHER Filgrastim-aafi 480 Mcg/0.8 Ml 8 5 $780.00 $756.91 $507.21 $927.00 $703.45 2026-05-09
72072 OTHER X-ray Spine Thoracic 3 Views 11 5 $902.00 $874.94 $586.30 $874.94 $697.55 2026-05-09
76817 OTHER Transvaginal US Obstetrical 11 5 $898.00 $871.06 $583.70 $871.06 $693.26 2026-05-09
73523 OTHER X-ray Hips 5 Views Bi 8 5 $831.00 $806.07 $540.15 $806.07 $690.20 2026-05-09
74230 OTHER Cine/Vid X-ray Throat/Esoph 10 5 $913.00 $885.61 $593.45 $885.61 $681.29 2026-05-09
76872 OTHER Ultrasound Transrectal 10 5 $930.00 $902.10 $604.50 $902.10 $679.83 2026-05-09
73522 OTHER X-ray Hips 3-4 Views Bi 8 5 $754.00 $731.38 $490.10 $793.91 $679.73 2026-05-09
11606 OTHER Exc Mal Lesion >4.0 Trunk Limb 6 5 $1,077.00 $1,044.69 $374.28 $874.16 $672.99 2026-05-09
64400 OTHER Inj Trigeminal N Block Rt 14 5 $1,023.00 $992.31 $57.77 $992.31 $672.62 2026-05-09
71100 OTHER X-ray Ribs 2 Views Rt 19 5 $785.00 $761.45 $510.25 $3,616.49 $669.61 2026-05-09
99283 OTHER Emergency Room Visit Level 3 19 5 $955.00 $926.35 $74.82 $926.35 $658.95 2026-05-09
76604 OTHER Ultrasound Chest 10 5 $841.00 $815.77 $546.65 $885.96 $656.82 2026-05-09
36430 OTHER Blood Administration 11 5 $824.00 $799.28 $535.60 $799.28 $650.96 2026-05-09
G0416 OTHER Prostate Sat Biopsy 8 5 $831.00 $806.07 $540.15 $806.07 $649.01 2026-05-09
20605 OTHER Asp/Inj Intermediate Joint 8 5 $826.00 $801.22 $536.90 $801.22 $645.11 2026-05-09
80306 OTHER Drug Screen Urine Inst Ass Obv 12 5 $825.00 $800.25 $536.25 $800.25 $644.33 2026-05-09
J2997 OTHER Alteplase 2 Mg Vial 8 5 $879.00 $852.77 $37.08 $852.77 $642.65 2026-05-09
71046 OTHER X-ray Chest 2v PA/Lateral 13 5 $741.00 $718.77 $481.65 $783.14 $632.07 2026-05-09
72040 OTHER X-ray Spine Cervical 2-3 Views 11 5 $912.00 $884.64 $551.93 $884.64 $629.28 2026-05-09
J0881 OTHER Darbepoet Alfa 40mcg/0.4ml Syr 20 5 $715.00 $693.66 $327.09 $2,669.46 $629.24 2026-05-09
73564 OTHER X-ray Knee 4 Lt 16 5 $846.00 $820.62 $129.06 $820.62 $618.42 2026-05-09
52235 OTHER Cystoscopy And Treatment 6 5 $2,832.00 $2,747.04 $340.43 $800.13 $613.33 2026-05-09
C1781 OTHER Mesh Hernia Umb Spr Sm Crc 1.7 41 5 $2,273.00 $2,205.49 $263.25 $2,934.15 $607.55 2026-05-09
72070 OTHER X-ray Spine Thoracic 2 Views 11 5 $706.00 $684.82 $458.90 $1,033.00 $602.22 2026-05-09
76815 OTHER OB US Limited Fetus(s) 11 5 $770.00 $746.90 $500.50 $746.90 $594.44 2026-05-09
99465 OTHER Neonatal Resuscitation 8 5 $758.00 $735.26 $492.70 $735.26 $592.00 2026-05-09
J1611 OTHER Glucagon (Fresenius Kabi) Vial 8 5 $794.00 $770.88 $81.80 $770.88 $580.94 2026-05-09
77065 OTHER Mammography Dx Digital Lt 19 5 $748.00 $725.56 $486.20 $725.56 $577.46 2026-05-09
11055 OTHER Pare 1 Benign Lesion 14 5 $878.00 $851.66 $19.05 $851.66 $577.29 2026-05-09
72110 OTHER X-ray Lumbosacral 4 Views 8 5 $788.00 $764.36 $67.44 $764.36 $576.03 2026-05-09
92610 OTHER Swallow Eval Non Radiol 11 5 $735.00 $712.95 $477.75 $712.95 $567.42 2026-05-09
37195 OTHER Thrombolytic Therapy Stroke 8 5 $722.00 $700.34 $469.30 $700.34 $563.88 2026-05-09
76801 OTHER OB US < 14 Wks Single Fetus 10 5 $770.00 $746.90 $500.50 $746.90 $562.87 2026-05-09
77067 OTHER Mammo Screen Implant Bi 29 5 $712.00 $690.64 $462.80 $690.64 $562.48 2026-05-09
73502 OTHER X-ray Hip Uni 2-3 Views Lt 40 5 $304.00 $294.88 $197.60 $860.42 $560.79 2026-05-09
J1610 OTHER Glucagon 1 Mg/ml Vial 8 5 $763.00 $740.62 $98.91 $740.62 $558.14 2026-05-09
77066 OTHER Mammography Diagnostic Digital 10 5 $763.00 $740.11 $495.95 $740.11 $557.75 2026-05-09
723 OTHER Circumcision Neonate <=28 Days 8 5 $713.00 $691.61 $463.45 $691.61 $556.86 2026-05-09
A9585 OTHER Gadobutrol Inj 10 Mm/10 Ml Vl 19 5 $800.00 $776.00 $2.69 $776.00 $552.00 2026-05-09
73630 OTHER X-ray Foot 3 Views Lt 21 5 $799.00 $775.03 $65.60 $775.03 $551.31 2026-05-09
73130 OTHER X-ray Hand Rt 21 5 $797.00 $773.09 $59.16 $773.09 $549.93 2026-05-09
97606 OTHER Neg Pressure Wound Dme >50 Cm 10 5 $721.00 $699.37 $468.65 $699.37 $545.08 2026-05-09
72190 OTHER X-ray Pelvis 3 Views 8 5 $731.00 $709.07 $475.15 $709.07 $543.40 2026-05-09
74019 OTHER X-ray Abdomen 12 5 $602.00 $583.94 $391.30 $660.48 $542.70 2026-05-09
99204 OTHER New Patient Level 4 Wound Care 17 5 $814.00 $789.58 $124.26 $789.58 $541.31 2026-05-09
45385 OTHER Colonoscopy W Lesion Removal 12 5 $1,463.50 $1,419.60 $302.87 $709.52 $540.97 2026-05-09
72082 OTHER X-ray Spine 2-3 View 8 5 $723.00 $701.31 $130.92 $701.31 $528.51 2026-05-09
A9500 OTHER Radiophar Tc99M Sestamibi Dose 11 5 $669.00 $648.93 $434.85 $970.14 $528.51 2026-05-09
92611 OTHER Swallow Evaluation Video 10 5 $676.00 $655.72 $439.40 $655.72 $527.95 2026-05-09
62270 OTHER Spinal Fluid Tap Diagnostic 14 5 $801.00 $776.97 $72.34 $776.97 $526.65 2026-05-09
77080 OTHER Dexa Scan 13 5 $617.00 $598.49 $88.61 $903.00 $526.30 2026-05-09
73030 OTHER X-ray Shoulder Rt 23 5 $746.00 $723.62 $237.65 $723.62 $525.40 2026-05-09
93321 OTHER Doppler Echo Exam Heart 8 5 $671.00 $650.87 $436.15 $650.87 $524.05 2026-05-09
52234 OTHER Cystoscopy And Treatment 6 5 $760.00 $737.20 $290.30 $681.60 $523.33 2026-05-09
96125 OTHER Cognitive Performance Test St 8 5 $670.00 $649.90 $435.50 $649.90 $523.27 2026-05-09
73110 OTHER X-ray Wrist 3 Views Rt 21 5 $758.00 $735.26 $58.22 $735.26 $523.02 2026-05-09
A9502 OTHER Radiophar Tc99M Myoview 8 5 $669.00 $648.93 $434.85 $648.93 $522.49 2026-05-09
76857 OTHER Ultrasound Pelvic Limited 10 5 $712.00 $690.64 $462.80 $690.64 $520.47 2026-05-09
93226 OTHER ECG Monit/Report Up To 48 Hour 11 5 $656.00 $636.32 $426.40 $695.52 $518.24 2026-05-09
73100 OTHER X-ray Wrist 2 Views Rt 17 5 $664.00 $644.08 $66.51 $644.08 $512.61 2026-05-09
G0480 OTHER Phosphatidylethanol (PEth) 26 5 $654.00 $634.38 $193.70 $1,111.48 $510.77 2026-05-09
C1726 OTHER Dil Pebax 180Cm Od15-18 19 5 $781.00 $758.00 $82.39 $758.00 $507.94 2026-05-09
73590 OTHER X-ray Lower Leg Lt 18 5 $722.00 $700.34 $73.88 $700.34 $503.28 2026-05-09
88360 OTHER Immunohisto Stain Qnt Man 8 5 $644.00 $624.68 $418.60 $624.68 $502.97 2026-05-09
73620 OTHER X-ray Foot 2 Views Lt 16 5 $664.00 $644.08 $212.82 $644.08 $485.38 2026-05-09
450 OTHER Dissolve Clot Heart Vessel 8 5 $617.00 $598.49 $401.05 $598.49 $481.88 2026-05-09
71110 OTHER X-ray Ribs Bilateral 3 Views 8 5 $656.00 $636.32 $47.21 $636.32 $479.53 2026-05-09
12045 OTHER Repair Lac Interm 12.6-20.0 Cm 14 5 $529.00 $513.13 $319.83 $743.29 $476.89 2026-05-09
73562 OTHER X-ray Knee 3 Views Lt 22 5 $690.00 $669.30 $109.76 $669.30 $476.10 2026-05-09
28190 OTHER Remove Foreign Body Foot Lt 14 5 $724.00 $702.28 $161.35 $702.28 $476.03 2026-05-09
73080 OTHER X-ray Elbow Lt 16 5 $651.00 $631.47 $38.91 $631.47 $475.88 2026-05-09
G0379 OTHER Observation Assess Direct Adm 8 5 $609.00 $590.73 $395.85 $590.73 $475.63 2026-05-09
73552 OTHER X-ray Femur 2 Views Lt 18 5 $615.00 $596.55 $130.01 $596.55 $474.78 2026-05-09
87637 OTHER Influ/RSV/CoV2 Pcr Ceph 13 5 $598.00 $580.06 $352.59 $580.06 $472.42 2026-05-09
73565 OTHER X-ray Knees Bi 8 5 $639.00 $619.83 $267.09 $619.83 $467.11 2026-05-09
82626 OTHER Dhea 10 5 $633.00 $614.01 $411.45 $614.01 $467.08 2026-05-09
72100 OTHER X-ray Lumbosacral 2-3 Views 12 5 $566.00 $549.02 $90.44 $600.30 $459.88 2026-05-09
73610 OTHER X-ray Ankle 3 Views Rt 21 5 $666.00 $646.02 $99.63 $646.02 $459.54 2026-05-09
73120 OTHER X-ray Hand Lt 20 5 $664.00 $644.08 $198.99 $644.08 $458.16 2026-05-09
11604 OTHER Exc Mal Lesion 3.1-4.0 Trunk 6 5 $749.00 $726.53 $253.89 $592.26 $458.11 2026-05-09
20610 OTHER Asp/Inj Large Joint Bi 28 5 $671.00 $650.87 $53.87 $2,639.37 $454.60 2026-05-09
73090 OTHER X-ray Forearm 2 Views Rt 17 5 $585.00 $567.45 $282.72 $567.45 $451.62 2026-05-09
74018 OTHER X-ray Abdomen 11 5 $475.00 $460.75 $308.75 $523.40 $451.25 2026-05-09
82088 OTHER Aldosterone 11 5 $584.00 $566.48 $379.60 $566.48 $450.85 2026-05-09
11623 OTHER Exc Mal Lesion 2.1-3.0 Neck 6 5 $784.00 $760.48 $250.29 $584.42 $450.84 2026-05-09
11046 OTHER Debride Muscle Addl 20 Cm 16 5 $664.00 $644.08 $64.35 $1,870.72 $449.86 2026-05-09
11045 OTHER Debride Skin Subq Addl 20 Cm 16 5 $664.00 $644.08 $30.52 $935.36 $449.86 2026-05-09
70160 OTHER X-ray Facial Bones 3 Views 8 5 $614.00 $595.58 $86.75 $595.58 $448.84 2026-05-09
84681 OTHER C Peptide 8 5 $574.00 $556.78 $373.10 $556.78 $448.29 2026-05-09
87799 OTHER Bk Virus Quant Pcr, Serum 19 5 $688.00 $667.36 $177.45 $667.36 $447.20 2026-05-09
P9045 OTHER Albumin Human 5% 12.5 Gr/250ml 8 5 $495.00 $481.10 $322.39 $3,123.57 $447.12 2026-05-09
17250 OTHER Chemical Cauterization Tissue 8 5 $571.00 $553.87 $371.15 $553.87 $445.95 2026-05-09
12054 OTHER Repair Lac Interm 7.6-12.5 Cm 14 5 $503.00 $487.91 $257.83 $607.18 $445.95 2026-05-09
C8924 OTHER Tte 2d W Contrast Limited 8 5 $566.00 $549.02 $367.90 $549.02 $442.04 2026-05-09
Q4186 OTHER Graft Skin Epifix 16 5 $567.50 $550.64 $292.01 $665.52 $440.87 2026-05-09
93922 OTHER Ankle Arm Screen 10 5 $603.00 $584.91 $151.04 $584.91 $440.79 2026-05-09
J2805 OTHER Sincalide 5 Mcg Vial 8 5 $601.00 $583.22 $163.05 $583.22 $439.52 2026-05-09
87497 OTHER Cmv Quant By Pcr 8 5 $556.00 $539.32 $361.40 $539.32 $434.24 2026-05-09
92523 OTHER Speech Sound Lang Comprehen 8 5 $556.00 $539.32 $361.40 $539.32 $434.24 2026-05-09
88184 OTHER Flow Cytometry First Mark 8 5 $554.00 $537.38 $360.10 $537.38 $432.68 2026-05-09
72220 OTHER X-ray Sacrum Tailbone 10 5 $537.00 $520.89 $349.05 $520.89 $431.12 2026-05-09
52224 OTHER Cystoscopy And Treatment 6 5 $1,977.00 $1,917.69 $240.33 $565.18 $428.47 2026-05-09
73060 OTHER X-ray Humerus Lt 20 5 $614.00 $595.58 $67.44 $614.00 $427.91 2026-05-09
45380 OTHER Colonoscopy W Biopsy(s) 6 5 $1,643.00 $1,593.71 $239.30 $558.91 $427.84 2026-05-09
45381 OTHER Colonoscopy Submucous Inj 6 5 $1,536.00 $1,489.92 $239.30 $558.91 $427.44 2026-05-09
12052 OTHER Repair Lac Interm 2.6-5.0 Cm 14 5 $529.00 $513.13 $238.97 $559.61 $426.80 2026-05-09
99282 OTHER Emergency Room Visit Level 2 12 5 $542.00 $525.74 $352.30 $525.74 $423.30 2026-05-09
43246 OTHER Egd Place Gastrostomy Tube 6 5 $2,124.00 $2,060.28 $236.48 $553.53 $422.25 2026-05-09
J9171 OTHER Docetaxel 80 Mg/4 Ml Vial 14 5 $3,065.00 $2,973.15 $32.34 $2,973.15 $420.62 2026-05-09
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