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

1,017 distinct procedures filed
5 distinct payers
15,626 rate rows
2026-07-15 last MRF observed
Data quality

15,586 of 15,626 rate rows are consumer-grade (99.7%)

40 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
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 8
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 Latest re-check couldn't be parsed — showing last good data · 2026-09-21
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
HCPCS 		Ocrelizumab 300 Mg/10 Ml 5 $6.09 $86,126.02 $64,905.28 nat. median
$133
outlier · 488.2×
7203
APR_DRG 		Apr-DRG 7203 1 $46,209.81 $46,209.81 $46,209.81 nat. median
$10,768
outlier · 4.3×
5402
APR_DRG 		Apr-DRG 5402 1 $42,065.18 $42,065.18 $42,065.18 nat. median
$6,801
outlier · 6.2×
J9272
HCPCS 		Dostarlimab-gxly 500 Mg/10 Ml 5 $8,526.00 $50,764.02 $38,256.18 nat. median
$567
outlier · 67.5×
J9144
HCPCS 		Daratumumab Hyaluronida 1800Mg 5 $382.98 $43,730.18 $32,955.43 nat. median
$114
outlier · 287.8×
806
MS_DRG 		Ms-DRG 806 1 $30,543.91 $30,543.91 $30,543.91 nat. median
$5,473
outlier · 5.6×
J3380
HCPCS 		Vedolizumab 300 Mg Vial 5 $72.63 $37,975.12 $28,618.36 nat. median
$59
outlier · 486.7×
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 5 $0.41 $30,637.29 $23,088.52 nat. median
$498
outlier · 46.4×
6942
APR_DRG 		Apr-DRG 6942 1 $19,975.72 $19,975.72 $19,975.72 nat. median
$6,778
outlier · 2.9×
J2353
HCPCS 		Octreotide (Depot) 30 Mg Syr 5 $17.33 $26,505.70 $19,974.92 nat. median
$1,956
outlier · 10.2×
J0717
HCPCS 		Certolizumab Pegol 400 Mg Kit 5 $3.42 $25,109.77 $18,922.93 nat. median
$29
outlier · 652.1×
7204
APR_DRG 		Apr-DRG 7204 1 $17,330.81 $17,330.81 $17,330.81 nat. median
$19,607
0.9× median
5603
APR_DRG 		Apr-DRG 5603 1 $17,035.33 $17,035.33 $17,035.33 nat. median
$5,286
outlier · 3.2×
J9312
HCPCS 		Rituximab 500 Mg/50 Ml Vial 5 $322.14 $20,650.52 $15,562.40 nat. median
$739
outlier · 21.1×
Q5127
HCPCS 		Pegfilgrastim-fpgk 6 Mg/0.6 Ml 5 $5,793.75 $17,380.53 $13,098.11 nat. median
$318
outlier · 41.2×
5602
APR_DRG 		Apr-DRG 5602 1 $12,939.93 $12,939.93 $12,939.93 nat. median
$3,747
outlier · 3.5×
36482
CPT 		Endoven Ther Chem Adhes 1St 5 $10,240.10 $15,281.38 $11,632.15 nat. median
$6,090
1.9× median
1393
APR_DRG 		Apr-DRG 1393 1 $11,336.59 $11,336.59 $11,336.59 nat. median
$7,916
1.4× median
J0870
HCPCS 		Imetelstat 47 Mg Vial 5 $18.24 $43,240.66 $10,962.73 nat. median
$103
outlier · 106.8×
5601
APR_DRG 		Apr-DRG 5601 1 $8,731.42 $8,731.42 $8,731.42 nat. median
$3,228
outlier · 2.7×
15275
CPT 		Skin Substitute Graft 25 Sq Cm 5 $7,174.05 $10,705.89 $8,619.90 nat. median
$1,689
outlier · 5.1×
81352
CPT 		Tp53 Somatic Mutation, Prog 5 $7,046.65 $10,515.77 $8,466.82 nat. median
$349
outlier · 24.2×
78815
CPT 		PET CT Skull To Mid Thigh Init 5 $1,440.20 $10,527.41 $7,933.55 nat. median
$1,679
outlier · 4.7×
J0897
HCPCS 		Denosumab 60 Mg/ml Syringe 5 $9.69 $12,945.91 $7,287.68 nat. median
$86
outlier · 84.7×
15271
CPT 		Skin Substitute Graft 25 Sq Cm 5 $98.98 $10,705.89 $7,256.83 nat. median
$1,584
outlier · 4.6×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 5 $1,112.40 $8,657.25 $6,524.18 nat. median
$665
outlier · 9.8×
J1602
HCPCS 		Golimumab 50 Mg/4 Ml Vial 5 $43.11 $8,562.27 $6,452.60 nat. median
$55
outlier · 118.2×
J9308
HCPCS 		Ramucirumab 100 Mg/10 Ml Vial 5 $86.40 $32,212.62 $6,391.01 nat. median
$300
outlier · 21.3×
83884
CPT 		Neurofilament Light Chain 5 $5,224.70 $7,796.86 $6,277.68 nat. median
$120
outlier · 52.2×
74174
CPT 		CTA Abd&Pelv Wwo Dye 5 $4,995.25 $7,454.45 $6,244.07 nat. median
$549
outlier · 11.4×
690
MS_DRG 		Ms-DRG 690 1 $5,981.14 $5,981.14 $5,981.14 nat. median
$6,107
1.0× median
884
MS_DRG 		Ms-DRG 884 1 $5,891.20 $5,891.20 $5,891.20 nat. median
$7,732
0.8× median
194
MS_DRG 		Ms-DRG 194 1 $5,890.00 $5,890.00 $5,890.00 nat. median
$6,156
1.0× median
536
MS_DRG 		Ms-DRG 536 1 $5,890.00 $5,890.00 $5,890.00 nat. median
$6,111
1.0× median
72158
CPT 		MRI Lumbar Spine Wwo Dye 5 $340.97 $7,346.78 $5,847.13 nat. median
$616
outlier · 9.5×
641
MS_DRG 		Ms-DRG 641 1 $5,757.70 $5,757.70 $5,757.70 nat. median
$5,850
1.0× median
Q5122
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Syr 5 $3,939.75 $7,578.91 $5,618.37 nat. median
$487
outlier · 11.5×
73723
CPT 		MRI Joint Le Wwo Dye Lt 5 $657.06 $7,408.86 $5,583.38 nat. median
$756
outlier · 7.4×
74177
CPT 		CT Abd & Pelv W Contrast 5 $227.52 $6,975.27 $5,551.45 nat. median
$501
outlier · 11.1×
73720
CPT 		MRI Le Wwo Dye Lt 5 $233.96 $7,597.04 $5,404.08 nat. median
$754
outlier · 7.2×
74176
CPT 		CT Abd & Pelvis Wo Contrast 5 $95.04 $6,742.47 $5,366.17 nat. median
$333
outlier · 16.1×
72157
CPT 		MRI Chest Spine Wwo Dye 5 $535.35 $7,101.37 $5,351.65 nat. median
$624
outlier · 8.6×
74178
CPT 		CT Abd & Pelv Wwo Contrast 5 $479.88 $7,258.00 $5,305.60 nat. median
$539
outlier · 9.9×
73220
CPT 		MRI Ue Wwo Dye Lt 5 $319.79 $7,001.46 $5,276.36 nat. median
$737
outlier · 7.2×
J9264
HCPCS 		Paclitaxel Protein-bd 100mg Vl 5 $17.39 $6,821.54 $5,140.77 nat. median
$34
outlier · 151.7×
J1569
HCPCS 		Immune Glob Gammagard 5gr/50ml 5 $21.77 $13,556.00 $4,825.76 nat. median
$946
outlier · 5.1×
78452
CPT 		Myocard Perf Spect Rest Stress 5 $3,920.15 $5,922.27 $4,764.49 nat. median
$1,464
outlier · 3.3×
J0129
HCPCS 		Abatacept 250 Mg Vial 5 $588.00 $6,259.03 $4,716.85 nat. median
$122
outlier · 38.6×
72148
CPT 		MRI Lumbar Spine Wo Dye 5 $315.18 $5,488.26 $4,597.12 nat. median
$408
outlier · 11.3×
70553
CPT 		MRI Brain Wwo Contrast 5 $729.77 $5,850.07 $4,510.53 nat. median
$616
outlier · 7.3×

Other procedures at this hospital

Browse this hospital's 1,017 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml 8 5 $88,789.00 $86,126.02 $6.09 $86,126.02 $64,905.28 2026-07-15
7203 APR_DRG Apr-DRG 7203 2 1 — — $46,209.81 $46,209.81 $46,209.81 2026-07-15
5402 APR_DRG Apr-DRG 5402 2 1 — — $42,065.18 $42,065.18 $42,065.18 2026-07-15
J9272 HCPCS Dostarlimab-gxly 500 Mg/10 Ml 8 5 $52,334.00 $50,764.02 $8,526.00 $50,764.02 $38,256.18 2026-07-15
J9144 HCPCS Daratumumab Hyaluronida 1800Mg 8 5 $45,082.00 $43,730.18 $382.98 $43,730.18 $32,955.43 2026-07-15
806 MS_DRG Ms-DRG 806 1 1 — — $30,543.91 $30,543.91 $30,543.91 2026-07-15
J3380 HCPCS Vedolizumab 300 Mg Vial 8 5 $39,149.00 $37,975.12 $72.63 $37,975.12 $28,618.36 2026-07-15
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Syrng 8 5 $31,584.00 $30,637.29 $0.41 $30,637.29 $23,088.52 2026-07-15
6942 APR_DRG Apr-DRG 6942 2 1 — — $19,975.72 $19,975.72 $19,975.72 2026-07-15
J2353 HCPCS Octreotide (Depot) 30 Mg Syr 8 5 $27,325.00 $26,505.70 $17.33 $26,505.70 $19,974.92 2026-07-15
J0717 HCPCS Certolizumab Pegol 400 Mg Kit 8 5 $25,886.00 $25,109.77 $3.42 $25,109.77 $18,922.93 2026-07-15
7204 APR_DRG Apr-DRG 7204 2 1 — — $17,330.81 $17,330.81 $17,330.81 2026-07-15
5603 APR_DRG Apr-DRG 5603 2 1 — — $17,035.33 $17,035.33 $17,035.33 2026-07-15
J9312 HCPCS Rituximab 500 Mg/50 Ml Vial 8 5 $21,289.00 $20,650.52 $322.14 $20,650.52 $15,562.40 2026-07-15
Q5127 HCPCS Pegfilgrastim-fpgk 6 Mg/0.6 Ml 8 5 $17,918.00 $17,380.53 $5,793.75 $17,380.53 $13,098.11 2026-07-15
5602 APR_DRG Apr-DRG 5602 2 1 — — $12,939.93 $12,939.93 $12,939.93 2026-07-15
36482 CPT Endoven Ther Chem Adhes 1St 10 5 $15,754.00 $15,281.38 $10,240.10 $15,281.38 $11,632.15 2026-07-15
1393 APR_DRG Apr-DRG 1393 2 1 — — $11,336.59 $11,336.59 $11,336.59 2026-07-15
J0870 HCPCS Imetelstat 47 Mg Vial 14 5 $11,419.00 $11,076.92 $18.24 $43,240.66 $10,962.73 2026-07-15
5601 APR_DRG Apr-DRG 5601 2 1 — — $8,731.42 $8,731.42 $8,731.42 2026-07-15
15275 CPT Skin Substitute Graft 25 Sq Cm 8 5 $11,037.00 $10,705.89 $7,174.05 $10,705.89 $8,619.90 2026-07-15
81352 CPT Tp53 Somatic Mutation, Prog 8 5 $10,841.00 $10,515.77 $7,046.65 $10,515.77 $8,466.82 2026-07-15
78815 CPT PET CT Skull To Mid Thigh Init 8 5 $10,853.00 $10,527.41 $1,440.20 $10,527.41 $7,933.55 2026-07-15
J0897 HCPCS Denosumab 60 Mg/ml Syringe 14 5 $7,591.00 $7,363.59 $9.69 $12,945.91 $7,287.68 2026-07-15
15271 CPT Skin Substitute Graft 25 Sq Cm 14 5 $11,037.00 $10,705.89 $98.98 $10,705.89 $7,256.83 2026-07-15
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 8 5 $8,925.00 $8,657.25 $1,112.40 $8,657.25 $6,524.18 2026-07-15
J1602 HCPCS Golimumab 50 Mg/4 Ml Vial 8 5 $8,827.00 $8,562.27 $43.11 $8,562.27 $6,452.60 2026-07-15
J9308 HCPCS Ramucirumab 100 Mg/10 Ml Vial 14 5 $6,657.00 $6,457.58 $86.40 $32,212.62 $6,391.01 2026-07-15
83884 CPT Neurofilament Light Chain 8 5 $8,038.00 $7,796.86 $5,224.70 $7,796.86 $6,277.68 2026-07-15
74174 CPT CTA Abd&Pelv Wwo Dye 6 5 $7,685.00 $7,454.45 $4,995.25 $7,454.45 $6,244.07 2026-07-15
690 MS_DRG Ms-DRG 690 2 1 — — $5,981.14 $5,981.14 $5,981.14 2026-07-15
884 MS_DRG Ms-DRG 884 2 1 — — $5,891.20 $5,891.20 $5,891.20 2026-07-15
536 MS_DRG Ms-DRG 536 2 1 — — $5,890.00 $5,890.00 $5,890.00 2026-07-15
194 MS_DRG Ms-DRG 194 2 1 — — $5,890.00 $5,890.00 $5,890.00 2026-07-15
72158 CPT MRI Lumbar Spine Wwo Dye 9 5 $7,574.00 $7,346.78 $340.97 $7,346.78 $5,847.13 2026-07-15
641 MS_DRG Ms-DRG 641 2 1 — — $5,757.70 $5,757.70 $5,757.70 2026-07-15
Q5122 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Syr 10 5 $7,813.00 $7,578.91 $3,939.75 $7,578.91 $5,618.37 2026-07-15
73723 CPT MRI Joint Le Wwo Dye Lt 8 5 $7,638.00 $7,408.86 $657.06 $7,408.86 $5,583.38 2026-07-15
74177 CPT CT Abd & Pelv W Contrast 13 5 $7,191.00 $6,975.27 $227.52 $6,975.27 $5,551.45 2026-07-15
73720 CPT MRI Le Wwo Dye Lt 18 5 $7,832.00 $7,597.04 $233.96 $7,597.04 $5,404.08 2026-07-15
74176 CPT CT Abd & Pelvis Wo Contrast 13 5 $6,951.00 $6,742.47 $95.04 $6,742.47 $5,366.17 2026-07-15
72157 CPT MRI Chest Spine Wwo Dye 8 5 $7,321.00 $7,101.37 $535.35 $7,101.37 $5,351.65 2026-07-15
74178 CPT CT Abd & Pelv Wwo Contrast 10 5 $7,258.00 $7,040.26 $479.88 $7,258.00 $5,305.60 2026-07-15
73220 CPT MRI Ue Wwo Dye Lt 8 5 $7,218.00 $7,001.46 $319.79 $7,001.46 $5,276.36 2026-07-15
J9264 HCPCS Paclitaxel Protein-bd 100mg Vl 8 5 $7,032.00 $6,821.54 $17.39 $6,821.54 $5,140.77 2026-07-15
J1569 HCPCS Immune Glob Gammagard 5gr/50ml 26 5 $5,026.00 $4,876.03 $21.77 $13,556.00 $4,825.76 2026-07-15
78452 CPT Myocard Perf Spect Rest Stress 11 5 $6,031.00 $5,850.07 $3,920.15 $5,922.27 $4,764.49 2026-07-15
J0129 HCPCS Abatacept 250 Mg Vial 8 5 $6,452.00 $6,259.03 $588.00 $6,259.03 $4,716.85 2026-07-15
72148 CPT MRI Lumbar Spine Wo Dye 12 5 $5,658.00 $5,488.26 $315.18 $5,488.26 $4,597.12 2026-07-15
70553 CPT MRI Brain Wwo Contrast 19 5 $5,743.00 $5,570.71 $729.77 $5,850.07 $4,510.53 2026-07-15
72156 CPT MRI Neck Spine Wwo Dye 8 5 $6,152.00 $5,967.44 $340.05 $5,967.44 $4,497.11 2026-07-15
70543 CPT MRI Orbit Face Neck Wwo Cont 8 5 $5,842.00 $5,666.74 $335.45 $5,666.74 $4,270.50 2026-07-15
74183 CPT MRI Abdomen Wwo Dye 10 5 $5,947.00 $5,768.59 $619.08 $5,768.59 $4,161.09 2026-07-15
72146 CPT MRI Chest Spine Wo Dye 10 5 $5,614.00 $5,445.58 $390.63 $5,445.58 $4,103.84 2026-07-15
71275 CPT CTA Chest Wwo Contrast 10 5 $5,012.00 $4,861.64 $3,257.80 $4,861.64 $4,072.25 2026-07-15
73221 CPT MRI Joint Ue Wo Dye Lt 22 5 $5,614.00 $5,445.58 $408.12 $5,445.58 $3,914.85 2026-07-15
73718 CPT MRI Le Wo Dye Lt 20 5 $5,658.00 $5,488.26 $56.39 $5,488.26 $3,904.02 2026-07-15
73721 CPT MRI Joint Le Wo Dye Rt 22 5 $5,658.00 $5,488.26 $315.18 $5,488.26 $3,904.02 2026-07-15
72141 CPT MRI Neck Spine Wo Dye 10 5 $5,658.00 $5,488.26 $233.96 $5,488.26 $3,904.02 2026-07-15
177 MS_DRG Ms-DRG 177 2 1 — — $3,849.64 $3,849.64 $3,849.64 2026-07-15
159 MS_DRG Ms-DRG 159 2 1 — — $3,848.76 $3,848.76 $3,848.76 2026-07-15
74175 CPT CTA Abdom Wwo Dye 11 5 $4,973.00 $4,823.81 $82.17 $4,823.81 $3,839.16 2026-07-15
72195 CPT MRI Pelvis Wo Dye 6 5 $4,692.00 $4,551.24 $3,049.80 $4,551.24 $3,812.25 2026-07-15
6401 APR_DRG Apr-DRG 6401 2 1 — — $3,797.02 $3,797.02 $3,797.02 2026-07-15
Q5115 HCPCS Rituximab-abbs 100Mg/10Ml Via 14 5 $2,474.00 $2,400.09 $1,608.31 $11,086.65 $3,708.00 2026-07-15
73701 CPT CT Le W Dye Rt 17 5 $4,616.00 $4,477.52 $268.01 $4,477.52 $3,563.55 2026-07-15
70498 CPT CT Angiography Neck W Cont 12 5 $4,737.00 $4,594.89 $278.39 $4,594.89 $3,497.55 2026-07-15
72128 CPT CT Thoracic Spine Wo Contrast 8 5 $4,758.00 $4,615.26 $107.93 $4,615.26 $3,478.10 2026-07-15
70496 CPT CT Angiography Head W Cont 12 5 $4,607.00 $4,468.79 $246.84 $4,468.79 $3,401.49 2026-07-15
71260 CPT CT Thorax W Contrast 12 5 $4,652.00 $4,512.44 $80.31 $4,512.44 $3,400.61 2026-07-15
J1561 HCPCS Immune Glob 10% 40 Gm/400 Ml 28 5 $7,165.00 $6,950.21 $3.60 $13,609.40 $3,364.94 2026-07-15
75635 CPT CTA Abdominal Arteries 8 5 $4,579.00 $4,441.63 $592.68 $4,441.63 $3,347.25 2026-07-15
73201 CPT CT Ue W Dye Lt 16 5 $4,548.00 $4,411.56 $90.44 $4,411.56 $3,324.59 2026-07-15
72131 CPT CT Lumbar Spine Wo Contrast 10 5 $4,758.00 $4,615.26 $234.87 $4,615.26 $3,317.98 2026-07-15
789 MS_DRG Ms-DRG 789 2 1 — — $3,161.41 $3,161.41 $3,161.41 2026-07-15
J1439 HCPCS Ferric Carboxymalt 750mg/15ml 10 5 $4,258.00 $4,130.39 $11.91 $4,248.33 $3,112.70 2026-07-15
70551 CPT MRI Brain Wo Contrast 12 5 $3,785.00 $3,671.45 $447.03 $3,705.99 $3,075.32 2026-07-15
70450 CPT CT Head/Brain Wo Contrast 11 5 $3,519.00 $3,413.43 $2,287.35 $3,413.43 $3,001.71 2026-07-15
70470 CPT CT Head/Brain Wwo Contrast 8 5 $4,022.00 $3,901.34 $241.32 $3,901.34 $2,940.08 2026-07-15
72192 CPT CT Pelvis Wo Dye 9 5 $3,808.00 $3,693.76 $597.02 $3,693.76 $2,939.78 2026-07-15
71250 CPT CT Thorax Wo Contrast 11 5 $4,229.00 $4,102.13 $71.13 $4,102.13 $2,918.01 2026-07-15
73200 CPT CT Ue Wo Dye Lt 8 5 $3,980.00 $3,860.60 $70.19 $3,860.60 $2,909.38 2026-07-15
72125 CPT CT Cervical Spine Wo Contrast 12 5 $3,519.00 $3,413.43 $172.58 $3,413.43 $2,859.19 2026-07-15
73700 CPT CT Le Wo Dye Lt 20 5 $4,115.00 $3,991.55 $76.65 $3,991.55 $2,839.35 2026-07-15
72193 CPT CT Pelvis W Dye 10 5 $4,080.00 $3,957.60 $593.33 $3,957.60 $2,815.20 2026-07-15
78451 CPT Myocard Perf Spect Rest Or Str 8 5 $3,552.00 $3,445.44 $2,308.80 $3,445.44 $2,774.11 2026-07-15
112 CDM Room Womens Ctr 6 5 $3,340.00 $3,239.80 $2,171.00 $3,239.80 $2,713.75 2026-07-15
111 CDM Room Medical Unit Priv 6 5 $3,340.00 $3,239.80 $2,171.00 $3,239.80 $2,713.75 2026-07-15
74170 CPT CT Abdomen Wwo Dye 10 5 $3,920.00 $3,802.40 $58.22 $3,802.40 $2,704.80 2026-07-15
C8929 HCPCS Echo M Mode 2d W Contrast 10 5 $3,689.00 $3,578.33 $702.60 $3,578.33 $2,696.66 2026-07-15
J9217 HCPCS Leuprolide Acetate 22.5 Mg Syr 20 5 $3,724.00 $3,612.37 $1.47 $4,152.89 $2,676.24 2026-07-15
93306 CPT Tte W Doppler Complete 11 5 $3,425.00 $3,322.25 $2,117.61 $3,322.25 $2,644.10 2026-07-15
G0390 HCPCS Trauma Team Level 5 8 5 $3,135.00 $3,040.95 $2,037.75 $3,040.95 $2,448.43 2026-07-15
689 CDM Trauma Team Evaluation Level 5 8 5 $3,135.00 $3,040.95 $2,037.75 $3,040.95 $2,448.43 2026-07-15
C1888 HCPCS Cath Interven 6Fr 100cm 8cm 16 5 $3,129.50 $3,036.02 $1,816.64 $3,361.05 $2,387.42 2026-07-15
70491 CPT CT Soft Tissue Neck W Cont 11 5 $3,042.00 $2,950.74 $357.53 $2,950.74 $2,348.42 2026-07-15
70481 CPT CT Orbit W Contrast 8 5 $3,170.00 $3,074.90 $80.31 $3,074.90 $2,317.27 2026-07-15
74160 CPT CT Abdomen W Dye 10 5 $3,249.00 $3,151.53 $706.77 $3,151.53 $2,291.14 2026-07-15
78227 CPT Hida With Ef w/Pharm 10 5 $2,763.00 $2,680.11 $1,795.95 $2,680.11 $2,157.90 2026-07-15
70487 CPT CT Maxillofacial W Contrast 10 5 $2,875.00 $2,788.75 $268.29 $2,788.75 $2,101.62 2026-07-15
90375 CPT Rabies Imm Glob (Human) 300u/m 8 5 $2,848.00 $2,763.49 $146.90 $2,763.49 $2,082.59 2026-07-15
74240 CPT X-ray Upper Gi Delay Without Air 8 5 $2,821.00 $2,736.37 $87.98 $2,736.37 $2,062.15 2026-07-15
70486 CPT CT Maxillofacial Wo Contrast 11 5 $2,651.00 $2,571.47 $187.95 $2,571.47 $2,046.57 2026-07-15
99291 CPT Critical Care 1st 30-74 Min 17 5 $3,068.00 $2,975.96 $196.93 $2,975.96 $2,040.22 2026-07-15
170 CDM Baby Assessment And Monitor 2 12 5 $2,616.00 $2,537.52 $1,153.10 $3,354.26 $1,984.24 2026-07-15
J0248 HCPCS Remdesivir 100 Mg Vial 10 5 $2,840.00 $2,755.48 $70.71 $2,755.48 $1,960.08 2026-07-15
74150 CPT CT Abdomen Wo Dye 8 5 $2,577.00 $2,499.69 $791.13 $2,499.69 $1,883.79 2026-07-15
78306 CPT Bone Scan Whole Body 10 5 $2,534.00 $2,457.98 $1,647.10 $2,457.98 $1,852.36 2026-07-15
87507 CPT Gi Pathogens Panel Ref 8 5 $2,368.00 $2,296.96 $1,539.20 $2,296.96 $1,849.41 2026-07-15
70480 CPT CT Orbit Wo Contrast 8 5 $2,525.00 $2,449.25 $192.56 $2,449.25 $1,845.78 2026-07-15
70490 CPT CT Soft Tissue Neck Wo Cont 8 5 $2,462.00 $2,388.14 $277.47 $2,388.14 $1,799.72 2026-07-15
87154 CPT 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 2026-07-15
78803 CPT Bone Scan Spect 8 5 $2,285.00 $2,216.45 $1,485.25 $2,216.45 $1,784.59 2026-07-15
129 CDM Room Swing Bed Skilled 6 5 $2,186.00 $2,120.42 $1,420.90 $2,120.42 $1,776.12 2026-07-15
272 CDM System Clsr Venaseal Glu 8 5 $2,250.00 $2,182.50 $1,462.50 $2,182.50 $1,757.25 2026-07-15
11043 CPT Debride Muscle/Fascia 20 Cm 16 5 $2,529.00 $2,453.13 $182.22 $2,453.13 $1,713.40 2026-07-15
P9032 HCPCS Platelet Concentr Irradiate 8 5 $2,177.00 $2,111.69 $1,415.05 $2,111.69 $1,700.24 2026-07-15
P9040 HCPCS Rbc Packed Leuko-reduc Irrad 8 5 $2,081.00 $2,018.57 $1,352.65 $2,018.57 $1,625.26 2026-07-15
P9031 HCPCS Platelets Leukocyte Reduced 8 5 $2,081.00 $2,018.57 $1,352.65 $2,018.57 $1,625.26 2026-07-15
Q5106 HCPCS Epoetin Alfa-epbx 40,000 Sdv 8 5 $1,799.00 $1,745.32 $1,169.55 $2,703.75 $1,622.07 2026-07-15
19083 CPT Biopsy Breast 1st Lesion Lt 8 5 $2,066.00 $2,004.02 $1,342.90 $2,004.02 $1,613.55 2026-07-15
76700 CPT Ultrasound Abdomen Complete 10 5 $2,182.00 $2,116.54 $1,418.30 $2,116.54 $1,611.11 2026-07-15
P9037 HCPCS Platelet Pheresis Leuk Red Irr 10 5 $2,186.00 $2,120.42 $437.20 $2,120.42 $1,597.96 2026-07-15
Q5104 HCPCS Infliximab-abda 100 Mg Vial 8 5 $1,758.00 $1,705.35 $1,142.76 $5,119.19 $1,584.92 2026-07-15
J1745 HCPCS Infliximab (Gen) 100 Mg Vial 10 5 $2,108.00 $2,044.77 $1.46 $9,359.54 $1,540.95 2026-07-15
P9035 HCPCS Platelet Pheresis Leuko Reduc 10 5 $2,081.00 $2,018.57 $437.20 $2,018.57 $1,521.21 2026-07-15
94762 CPT Desaturation And Hr Study 8 5 $1,938.00 $1,879.86 $1,259.70 $1,879.86 $1,513.58 2026-07-15
A9552 HCPCS Radiophar Fdg 8 5 $1,931.00 $1,873.07 $1,255.15 $1,873.07 $1,508.11 2026-07-15
93970 CPT Venous Duplex 12 5 $1,893.00 $1,836.21 $1,230.45 $1,836.21 $1,478.43 2026-07-15
J9155 HCPCS Degarelix 80 Mg Vial 14 5 $1,612.00 $1,564.32 $135.29 $2,132.19 $1,472.74 2026-07-15
99285 CPT Emergency Room Visit Level 5 18 5 $2,150.00 $2,085.50 $184.62 $2,085.50 $1,456.62 2026-07-15
J0666 HCPCS Bupivac Liposome 1.3% Pf 20 Ml 10 5 $1,783.00 $1,730.43 $1,159.57 $1,730.43 $1,449.46 2026-07-15
76705 CPT Ultrasound Abdomen Limited 12 5 $1,779.00 $1,725.63 $1,156.35 $1,725.63 $1,389.40 2026-07-15
93923 CPT Ue/le Artery 3 Levels 9 5 $1,737.00 $1,684.89 $1,129.05 $1,684.89 $1,372.23 2026-07-15
93880 CPT Extracranial Bilat Study 11 5 $1,720.00 $1,668.40 $1,118.00 $1,668.40 $1,327.84 2026-07-15
93882 CPT Carotid Duplex Rt 8 5 $1,662.00 $1,612.14 $1,080.30 $1,612.14 $1,298.02 2026-07-15
93017 CPT Cardiovascular Stress Test 11 5 $1,652.00 $1,602.44 $1,073.80 $1,602.44 $1,275.34 2026-07-15
93925 CPT Arterial Duplex Le Bi 10 5 $1,719.00 $1,667.43 $325.60 $1,667.43 $1,256.59 2026-07-15
86366 CPT Musk Antibody Ref 8 5 $1,603.00 $1,554.91 $1,041.95 $1,554.91 $1,251.94 2026-07-15
76805 CPT OB US >14 Wk Tvta Single Fetus 11 5 $1,605.00 $1,556.85 $1,043.25 $1,556.85 $1,239.06 2026-07-15
25605 CPT Fx Distal Radius W Man Rt 20 5 $1,327.00 $1,287.19 $616.32 $1,593.71 $1,178.78 2026-07-15
71101 CPT X-ray Ribs Uni W Chest Lt 20 5 $1,378.00 $1,336.66 $895.70 $3,427.98 $1,175.43 2026-07-15
76770 CPT Ultrasound Abdo Back Wall Comp 10 5 $1,499.00 $1,454.03 $974.35 $1,591.14 $1,170.72 2026-07-15
70030 CPT X-ray Eye Fb Detection 11 5 $1,368.00 $1,326.96 $642.32 $5,074.70 $1,166.90 2026-07-15
96413 CPT Chemotherapy Inf Initial 10 5 $1,452.00 $1,408.44 $943.80 $1,541.46 $1,134.01 2026-07-15
74300 CPT X-ray Bile Ducts/Pancreas 8 5 $1,528.00 $1,482.16 $965.04 $1,482.16 $1,116.97 2026-07-15
11042 CPT Debride Skin Subq 20 Cm 17 5 $1,614.00 $1,565.58 $71.89 $1,565.58 $1,113.66 2026-07-15
76642 CPT Ultrasound Breast Limited Rt 31 5 $1,284.00 $1,245.48 $834.60 $1,867.25 $1,095.25 2026-07-15
90675 CPT Rabies Vacc Hmn Post-ex Nonim 8 5 $1,475.00 $1,431.29 $125.24 $1,431.29 $1,078.63 2026-07-15
76641 CPT Ultrasound Breast Complete Lt 10 5 $1,467.00 $1,422.99 $885.96 $1,422.99 $1,072.38 2026-07-15
32551 CPT Insertion Chest Tube Lt 14 5 $1,609.00 $1,560.73 $181.56 $1,560.73 $1,057.91 2026-07-15
77001 CPT Fluoroguide For Vein Device 8 5 $1,439.00 $1,395.83 $99.63 $1,395.83 $1,051.91 2026-07-15
93971 CPT Extremity Study Lt 21 5 $1,348.00 $1,307.56 $876.20 $1,307.56 $1,040.66 2026-07-15
99284 CPT Emergency Room Visit Level 4 19 5 $1,498.00 $1,453.06 $127.14 $1,453.06 $1,033.62 2026-07-15
0202U CPT Respir Path 22 Targets Biofire 8 5 $1,296.00 $1,257.12 $842.40 $1,257.12 $1,012.17 2026-07-15
76882 CPT US Extremity Nonvasc Limit Lt 16 5 $1,269.00 $1,230.93 $824.85 $1,230.93 $991.09 2026-07-15
761 CDM Colposcopy 64 5 $1,295.50 $1,256.63 $327.60 $4,276.73 $987.70 2026-07-15
J7325 HCPCS Hylan G-f 20 16 Mg/2 Ml Syr 8 5 $1,091.00 $1,058.71 $709.44 $1,735.19 $983.95 2026-07-15
76942 CPT US Guide For Needle Placement 8 5 $1,257.00 $1,219.29 $817.05 $1,219.29 $981.71 2026-07-15
93308 CPT Echo Limited 8 5 $1,220.00 $1,183.40 $793.00 $1,183.40 $952.82 2026-07-15
49082 CPT Abdominal Paracentesis 14 5 $1,440.00 $1,396.80 $86.65 $1,396.80 $946.80 2026-07-15
74250 CPT Gastrografin Challenge 8 5 $1,295.00 $1,256.15 $206.36 $1,256.15 $946.64 2026-07-15
76536 CPT Ultrasound Head And Neck 11 5 $1,226.00 $1,189.22 $796.90 $1,189.22 $946.47 2026-07-15
74246 CPT Contrast X-ray Upper Gi W Air 8 5 $1,294.00 $1,255.18 $178.77 $1,255.18 $945.91 2026-07-15
74420 CPT Contrast X-ray Urinary Tract 10 5 $1,260.00 $1,222.20 $262.10 $1,673.00 $921.06 2026-07-15
96360 CPT Inf Therapy Hyd Initial 23 5 $909.00 $881.73 $590.85 $1,279.43 $877.13 2026-07-15
76775 CPT Ultrasound Aorta 10 5 $1,121.00 $1,087.37 $728.65 $1,208.00 $875.50 2026-07-15
76819 CPT Fetal Biophys Profil Wo Nst 11 5 $1,129.00 $1,095.13 $733.85 $1,095.13 $871.59 2026-07-15
J0561 HCPCS Pen G Benzathine 1200000Un/2ML 8 5 $1,191.00 $1,155.52 $260.76 $1,155.52 $870.81 2026-07-15
96365 CPT Inf Therapy Med Initial 25 5 $893.00 $866.21 $580.45 $1,279.43 $866.21 2026-07-15
80074 CPT Acute Hepatitis Panel 8 5 $1,075.00 $1,042.75 $698.75 $1,042.75 $839.58 2026-07-15
88377 CPT Morph Ana Ea Man Multpx Hema 8 5 $1,074.00 $1,041.78 $698.10 $1,041.78 $838.80 2026-07-15
93976 CPT Vascular Study 9 5 $1,050.00 $1,018.50 $682.50 $1,018.50 $829.50 2026-07-15
76816 CPT OB US Follow-up Per Fetus 10 5 $1,129.00 $1,095.13 $733.85 $1,095.13 $825.30 2026-07-15
Q0138 HCPCS Ferumoxy 510mg/17ml (non-esrd) 10 5 $1,145.00 $1,111.35 $7.28 $1,111.35 $819.19 2026-07-15
77002 CPT Needle Localization By X-ray 8 5 $1,117.00 $1,083.49 $83.48 $1,083.49 $816.53 2026-07-15
76856 CPT Ultrasound Pelvic Complete 8 5 $1,044.00 $1,012.68 $678.60 $1,012.68 $815.37 2026-07-15
76830 CPT Ultrasound Transvaginal 10 5 $1,044.00 $1,012.68 $678.60 $1,108.14 $815.37 2026-07-15
84445 CPT Tsi 8 5 $1,010.00 $979.70 $656.50 $979.70 $788.81 2026-07-15
360 CDM Biopsy Prostate 56 5 $973.00 $943.81 $456.95 $1,533.57 $787.02 2026-07-15
76870 CPT Ultrasound Scrotum 8 5 $974.00 $944.78 $633.10 $944.78 $760.69 2026-07-15
74221 CPT Double Contrast Esophagus 10 5 $1,036.00 $1,004.92 $620.03 $1,004.92 $757.32 2026-07-15
93926 CPT Arterial Duplex Le Lt 16 5 $969.00 $939.93 $629.85 $939.93 $756.79 2026-07-15
93325 CPT Echo Color Doppler 8 5 $957.00 $928.29 $622.05 $928.29 $747.41 2026-07-15
72050 CPT X-ray Spine Cervical 4-5 Views 8 5 $899.00 $872.03 $584.35 $872.03 $746.06 2026-07-15
P9016 HCPCS Red Blood Cells Lekoreduced 11 5 $962.00 $933.14 $625.30 $933.14 $742.66 2026-07-15
74220 CPT Contrast X-ray Esophagus 8 5 $1,014.00 $983.58 $357.53 $983.58 $741.23 2026-07-15
Q9967 HCPCS Iopamidol-370 100 Ml Vial 23 5 $1,500.00 $1,455.00 $253.80 $1,455.00 $727.50 2026-07-15
92950 CPT Heart/Lung Resuscitation Cpr 16 5 $1,063.00 $1,031.11 $192.77 $1,031.11 $720.18 2026-07-15
92960 CPT Cardioversion Electric Ext 14 5 $1,087.00 $1,054.39 $115.39 $1,054.39 $714.70 2026-07-15
C1788 HCPCS Port Impl Pp Clrvu 8f 1 Lmn 8 5 $907.00 $880.27 $589.88 $880.28 $708.76 2026-07-15
Q5110 HCPCS Filgrastim-aafi 480 Mcg/0.8 Ml 8 5 $780.00 $756.91 $507.21 $927.00 $703.45 2026-07-15
72072 CPT X-ray Spine Thoracic 3 Views 11 5 $902.00 $874.94 $586.30 $874.94 $697.55 2026-07-15
76817 CPT Transvaginal US Obstetrical 11 5 $898.00 $871.06 $583.70 $871.06 $693.26 2026-07-15
73523 CPT X-ray Hips 5 Views Bi 8 5 $831.00 $806.07 $540.15 $806.07 $690.20 2026-07-15
74230 CPT Cine/Vid X-ray Throat/Esoph 10 5 $913.00 $885.61 $593.45 $885.61 $681.29 2026-07-15
76872 CPT Ultrasound Transrectal 10 5 $930.00 $902.10 $604.50 $902.10 $679.83 2026-07-15
73522 CPT X-ray Hips 3-4 Views Bi 8 5 $754.00 $731.38 $490.10 $793.91 $679.73 2026-07-15
11606 CPT Exc Mal Lesion >4.0 Trunk Limb 6 5 $1,077.00 $1,044.69 $374.28 $874.16 $672.99 2026-07-15
64400 CPT Inj Trigeminal N Block Rt 14 5 $1,023.00 $992.31 $57.77 $992.31 $672.62 2026-07-15
71100 CPT X-ray Ribs 2 Views Rt 19 5 $785.00 $761.45 $510.25 $3,616.49 $669.61 2026-07-15
99283 CPT Emergency Room Visit Level 3 19 5 $955.00 $926.35 $74.82 $926.35 $658.95 2026-07-15
76604 CPT Ultrasound Chest 10 5 $841.00 $815.77 $546.65 $885.96 $656.82 2026-07-15
36430 CPT Blood Administration 11 5 $824.00 $799.28 $535.60 $799.28 $650.96 2026-07-15
G0416 HCPCS Prostate Sat Biopsy 8 5 $831.00 $806.07 $540.15 $806.07 $649.01 2026-07-15
20605 CPT Asp/Inj Intermediate Joint 8 5 $826.00 $801.22 $536.90 $801.22 $645.11 2026-07-15
80306 CPT Drug Screen Urine Inst Ass Obv 12 5 $825.00 $800.25 $536.25 $800.25 $644.33 2026-07-15
J2997 HCPCS Alteplase 2 Mg Vial 8 5 $879.00 $852.77 $37.08 $852.77 $642.65 2026-07-15
71046 CPT X-ray Chest 2v PA/Lateral 13 5 $741.00 $718.77 $481.65 $783.14 $632.07 2026-07-15
72040 CPT X-ray Spine Cervical 2-3 Views 11 5 $912.00 $884.64 $551.93 $884.64 $629.28 2026-07-15
J0881 HCPCS Darbepoet Alfa 40mcg/0.4ml Syr 20 5 $715.00 $693.66 $327.09 $2,669.46 $629.24 2026-07-15
73564 CPT X-ray Knee 4 Lt 16 5 $846.00 $820.62 $129.06 $820.62 $618.42 2026-07-15
52235 CPT Cystoscopy And Treatment 6 5 $2,832.00 $2,747.04 $340.43 $800.13 $613.33 2026-07-15
C1781 HCPCS Mesh Hernia Umb Spr Sm Crc 1.7 41 5 $2,273.00 $2,205.49 $263.25 $2,934.15 $607.55 2026-07-15
72070 CPT X-ray Spine Thoracic 2 Views 11 5 $706.00 $684.82 $458.90 $1,033.00 $602.22 2026-07-15
76815 CPT OB US Limited Fetus(s) 11 5 $770.00 $746.90 $500.50 $746.90 $594.44 2026-07-15
99465 CPT Neonatal Resuscitation 8 5 $758.00 $735.26 $492.70 $735.26 $592.00 2026-07-15
J1611 HCPCS Glucagon (Fresenius Kabi) Vial 8 5 $794.00 $770.88 $81.80 $770.88 $580.94 2026-07-15
77065 CPT Mammography Dx Digital Lt 19 5 $748.00 $725.56 $486.20 $725.56 $577.46 2026-07-15
11055 CPT Pare 1 Benign Lesion 14 5 $878.00 $851.66 $19.05 $851.66 $577.29 2026-07-15
72110 CPT X-ray Lumbosacral 4 Views 8 5 $788.00 $764.36 $67.44 $764.36 $576.03 2026-07-15
92610 CPT Swallow Eval Non Radiol 11 5 $735.00 $712.95 $477.75 $712.95 $567.42 2026-07-15
37195 CPT Thrombolytic Therapy Stroke 8 5 $722.00 $700.34 $469.30 $700.34 $563.88 2026-07-15
76801 CPT OB US < 14 Wks Single Fetus 10 5 $770.00 $746.90 $500.50 $746.90 $562.87 2026-07-15
77067 CPT Mammo Screen Implant Bi 29 5 $712.00 $690.64 $462.80 $690.64 $562.48 2026-07-15
73502 CPT X-ray Hip Uni 2-3 Views Lt 40 5 $304.00 $294.88 $197.60 $860.42 $560.79 2026-07-15
J1610 HCPCS Glucagon 1 Mg/ml Vial 8 5 $763.00 $740.62 $98.91 $740.62 $558.14 2026-07-15
77066 CPT Mammography Diagnostic Digital 10 5 $763.00 $740.11 $495.95 $740.11 $557.75 2026-07-15
723 CDM Circumcision Neonate <=28 Days 8 5 $713.00 $691.61 $463.45 $691.61 $556.86 2026-07-15
A9585 HCPCS Gadobutrol Inj 10 Mm/10 Ml Vl 19 5 $800.00 $776.00 $2.69 $776.00 $552.00 2026-07-15
73630 CPT X-ray Foot 3 Views Lt 21 5 $799.00 $775.03 $65.60 $775.03 $551.31 2026-07-15
73130 CPT X-ray Hand Rt 21 5 $797.00 $773.09 $59.16 $773.09 $549.93 2026-07-15
97606 CPT Neg Pressure Wound Dme >50 Cm 10 5 $721.00 $699.37 $468.65 $699.37 $545.08 2026-07-15
72190 CPT X-ray Pelvis 3 Views 8 5 $731.00 $709.07 $475.15 $709.07 $543.40 2026-07-15
74019 CPT X-ray Abdomen 12 5 $602.00 $583.94 $391.30 $660.48 $542.70 2026-07-15
99204 CPT New Patient Level 4 Wound Care 17 5 $814.00 $789.58 $124.26 $789.58 $541.31 2026-07-15
45385 CPT Colonoscopy W Lesion Removal 12 5 $1,463.50 $1,419.60 $302.87 $709.52 $540.97 2026-07-15
72082 CPT X-ray Spine 2-3 View 8 5 $723.00 $701.31 $130.92 $701.31 $528.51 2026-07-15
A9500 HCPCS Radiophar Tc99M Sestamibi Dose 11 5 $669.00 $648.93 $434.85 $970.14 $528.51 2026-07-15
92611 CPT Swallow Evaluation Video 10 5 $676.00 $655.72 $439.40 $655.72 $527.95 2026-07-15
62270 CPT Spinal Fluid Tap Diagnostic 14 5 $801.00 $776.97 $72.34 $776.97 $526.65 2026-07-15
77080 CPT Dexa Scan 13 5 $617.00 $598.49 $88.61 $903.00 $526.30 2026-07-15
73030 CPT X-ray Shoulder Rt 23 5 $746.00 $723.62 $237.65 $723.62 $525.40 2026-07-15
93321 CPT Doppler Echo Exam Heart 8 5 $671.00 $650.87 $436.15 $650.87 $524.05 2026-07-15
52234 CPT Cystoscopy And Treatment 6 5 $760.00 $737.20 $290.30 $681.60 $523.33 2026-07-15
96125 CPT Cognitive Performance Test St 8 5 $670.00 $649.90 $435.50 $649.90 $523.27 2026-07-15
73110 CPT X-ray Wrist 3 Views Rt 21 5 $758.00 $735.26 $58.22 $735.26 $523.02 2026-07-15
A9502 HCPCS Radiophar Tc99M Myoview 8 5 $669.00 $648.93 $434.85 $648.93 $522.49 2026-07-15
76857 CPT Ultrasound Pelvic Limited 10 5 $712.00 $690.64 $462.80 $690.64 $520.47 2026-07-15
93226 CPT ECG Monit/Report Up To 48 Hour 11 5 $656.00 $636.32 $426.40 $695.52 $518.24 2026-07-15
73100 CPT X-ray Wrist 2 Views Rt 17 5 $664.00 $644.08 $66.51 $644.08 $512.61 2026-07-15
G0480 HCPCS Phosphatidylethanol (PEth) 26 5 $654.00 $634.38 $193.70 $1,111.48 $510.77 2026-07-15
C1726 HCPCS Dil Pebax 180Cm Od15-18 19 5 $781.00 $758.00 $82.39 $758.00 $507.94 2026-07-15
73590 CPT X-ray Lower Leg Lt 18 5 $722.00 $700.34 $73.88 $700.34 $503.28 2026-07-15
88360 CPT Immunohisto Stain Qnt Man 8 5 $644.00 $624.68 $418.60 $624.68 $502.97 2026-07-15
73620 CPT X-ray Foot 2 Views Lt 16 5 $664.00 $644.08 $212.82 $644.08 $485.38 2026-07-15
450 CDM Dissolve Clot Heart Vessel 8 5 $617.00 $598.49 $401.05 $598.49 $481.88 2026-07-15
71110 CPT X-ray Ribs Bilateral 3 Views 8 5 $656.00 $636.32 $47.21 $636.32 $479.53 2026-07-15
12045 CPT Repair Lac Interm 12.6-20.0 Cm 14 5 $529.00 $513.13 $319.83 $743.29 $476.89 2026-07-15
73562 CPT X-ray Knee 3 Views Lt 22 5 $690.00 $669.30 $109.76 $669.30 $476.10 2026-07-15
28190 CPT Remove Foreign Body Foot Lt 14 5 $724.00 $702.28 $161.35 $702.28 $476.03 2026-07-15
73080 CPT X-ray Elbow Lt 16 5 $651.00 $631.47 $38.91 $631.47 $475.88 2026-07-15
G0379 HCPCS Observation Assess Direct Adm 8 5 $609.00 $590.73 $395.85 $590.73 $475.63 2026-07-15
73552 CPT X-ray Femur 2 Views Lt 18 5 $615.00 $596.55 $130.01 $596.55 $474.78 2026-07-15
87637 CPT Influ/RSV/CoV2 Pcr Ceph 13 5 $598.00 $580.06 $352.59 $580.06 $472.42 2026-07-15
73565 CPT X-ray Knees Bi 8 5 $639.00 $619.83 $267.09 $619.83 $467.11 2026-07-15
82626 CPT Dhea 10 5 $633.00 $614.01 $411.45 $614.01 $467.08 2026-07-15
72100 CPT X-ray Lumbosacral 2-3 Views 12 5 $566.00 $549.02 $90.44 $600.30 $459.88 2026-07-15
73610 CPT X-ray Ankle 3 Views Rt 21 5 $666.00 $646.02 $99.63 $646.02 $459.54 2026-07-15
73120 CPT X-ray Hand Lt 20 5 $664.00 $644.08 $198.99 $644.08 $458.16 2026-07-15
11604 CPT Exc Mal Lesion 3.1-4.0 Trunk 6 5 $749.00 $726.53 $253.89 $592.26 $458.11 2026-07-15
20610 CPT Asp/Inj Large Joint Bi 28 5 $671.00 $650.87 $53.87 $2,639.37 $454.60 2026-07-15
73090 CPT X-ray Forearm 2 Views Rt 17 5 $585.00 $567.45 $282.72 $567.45 $451.62 2026-07-15
74018 CPT X-ray Abdomen 11 5 $475.00 $460.75 $308.75 $523.40 $451.25 2026-07-15
82088 CPT Aldosterone 11 5 $584.00 $566.48 $379.60 $566.48 $450.85 2026-07-15
11623 CPT Exc Mal Lesion 2.1-3.0 Neck 6 5 $784.00 $760.48 $250.29 $584.42 $450.84 2026-07-15
11046 CPT Debride Muscle Addl 20 Cm 16 5 $664.00 $644.08 $64.35 $1,870.72 $449.86 2026-07-15
11045 CPT Debride Skin Subq Addl 20 Cm 16 5 $664.00 $644.08 $30.52 $935.36 $449.86 2026-07-15
70160 CPT X-ray Facial Bones 3 Views 8 5 $614.00 $595.58 $86.75 $595.58 $448.84 2026-07-15
84681 CPT C Peptide 8 5 $574.00 $556.78 $373.10 $556.78 $448.29 2026-07-15
87799 CPT Bk Virus Quant Pcr, Serum 19 5 $688.00 $667.36 $177.45 $667.36 $447.20 2026-07-15
P9045 HCPCS Albumin Human 5% 12.5 Gr/250ml 8 5 $495.00 $481.10 $322.39 $3,123.57 $447.12 2026-07-15
17250 CPT Chemical Cauterization Tissue 8 5 $571.00 $553.87 $371.15 $553.87 $445.95 2026-07-15
12054 CPT Repair Lac Interm 7.6-12.5 Cm 14 5 $503.00 $487.91 $257.83 $607.18 $445.95 2026-07-15
C8924 HCPCS Tte 2d W Contrast Limited 8 5 $566.00 $549.02 $367.90 $549.02 $442.04 2026-07-15
Q4186 HCPCS Graft Skin Epifix 16 5 $567.50 $550.64 $292.01 $665.52 $440.87 2026-07-15
93922 CPT Ankle Arm Screen 10 5 $603.00 $584.91 $151.04 $584.91 $440.79 2026-07-15
J2805 HCPCS Sincalide 5 Mcg Vial 8 5 $601.00 $583.22 $163.05 $583.22 $439.52 2026-07-15
87497 CPT Cmv Quant By Pcr 8 5 $556.00 $539.32 $361.40 $539.32 $434.24 2026-07-15
92523 CPT Speech Sound Lang Comprehen 8 5 $556.00 $539.32 $361.40 $539.32 $434.24 2026-07-15
88184 CPT Flow Cytometry First Mark 8 5 $554.00 $537.38 $360.10 $537.38 $432.68 2026-07-15
72220 CPT X-ray Sacrum Tailbone 10 5 $537.00 $520.89 $349.05 $520.89 $431.12 2026-07-15
52224 CPT Cystoscopy And Treatment 6 5 $1,977.00 $1,917.69 $240.33 $565.18 $428.47 2026-07-15
73060 CPT X-ray Humerus Lt 20 5 $614.00 $595.58 $67.44 $614.00 $427.91 2026-07-15
45380 CPT Colonoscopy W Biopsy(s) 6 5 $1,643.00 $1,593.71 $239.30 $558.91 $427.84 2026-07-15
45381 CPT Colonoscopy Submucous Inj 6 5 $1,536.00 $1,489.92 $239.30 $558.91 $427.44 2026-07-15
12052 CPT Repair Lac Interm 2.6-5.0 Cm 14 5 $529.00 $513.13 $238.97 $559.61 $426.80 2026-07-15
99282 CPT Emergency Room Visit Level 2 12 5 $542.00 $525.74 $352.30 $525.74 $423.30 2026-07-15
43246 CPT Egd Place Gastrostomy Tube 6 5 $2,124.00 $2,060.28 $236.48 $553.53 $422.25 2026-07-15
J9171 HCPCS Docetaxel 80 Mg/4 Ml Vial 14 5 $3,065.00 $2,973.15 $32.34 $2,973.15 $420.62 2026-07-15
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