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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

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 · 2026-10-22
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
$470
outlier · 138.2×
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
$6,656
outlier · 6.3×
J9272
HCPCS 		Dostarlimab-gxly 500 Mg/10 Ml 5 $8,526.00 $50,764.02 $38,256.18 nat. median
$786
outlier · 48.7×
J9144
HCPCS 		Daratumumab Hyaluronida 1800Mg 5 $382.98 $43,730.18 $32,955.43 nat. median
$211
outlier · 155.9×
806
MS_DRG 		Ms-DRG 806 1 $30,543.91 $30,543.91 $30,543.91 nat. median
$7,626
outlier · 4.0×
J3380
HCPCS 		Vedolizumab 300 Mg Vial 5 $72.63 $37,975.12 $28,618.36 nat. median
$162
outlier · 176.6×
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 5 $0.41 $30,637.29 $23,088.52 nat. median
$3,820
outlier · 6.0×
6942
APR_DRG 		Apr-DRG 6942 1 $19,975.72 $19,975.72 $19,975.72 nat. median
$7,098
outlier · 2.8×
J2353
HCPCS 		Octreotide (Depot) 30 Mg Syr 5 $17.33 $26,505.70 $19,974.92 nat. median
$5,573
outlier · 3.6×
J0717
HCPCS 		Certolizumab Pegol 400 Mg Kit 5 $3.42 $25,109.77 $18,922.93 nat. median
$1,598
outlier · 11.8×
7204
APR_DRG 		Apr-DRG 7204 1 $17,330.81 $17,330.81 $17,330.81 nat. median
$20,481
0.8× median
5603
APR_DRG 		Apr-DRG 5603 1 $17,035.33 $17,035.33 $17,035.33 nat. median
$5,223
outlier · 3.3×
J9312
HCPCS 		Rituximab 500 Mg/50 Ml Vial 5 $322.14 $20,650.52 $15,562.40 nat. median
$1,071
outlier · 14.5×
Q5127
HCPCS 		Pegfilgrastim-fpgk 6 Mg/0.6 Ml 5 $5,793.75 $17,380.53 $13,098.11 nat. median
$399
outlier · 32.8×
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
$6,035
1.9× median
1393
APR_DRG 		Apr-DRG 1393 1 $11,336.59 $11,336.59 $11,336.59 nat. median
$8,012
1.4× median
J0870
HCPCS 		Imetelstat 47 Mg Vial 5 $18.24 $43,240.66 $10,962.73 nat. median
$3,859
outlier · 2.8×
5601
APR_DRG 		Apr-DRG 5601 1 $8,731.42 $8,731.42 $8,731.42 nat. median
$3,341
outlier · 2.6×
15275
CPT 		Skin Substitute Graft 25 Sq Cm 5 $7,174.05 $10,705.89 $8,619.90 nat. median
$1,713
outlier · 5.0×
81352
CPT 		Tp53 Somatic Mutation, Prog 5 $7,046.65 $10,515.77 $8,466.82 nat. median
$428
outlier · 19.8×
78815
CPT 		PET CT Skull To Mid Thigh Init 5 $1,440.20 $10,527.41 $7,933.55 nat. median
$2,820
outlier · 2.8×
J0897
HCPCS 		Denosumab 60 Mg/ml Syringe 5 $9.69 $12,945.91 $7,287.68 nat. median
$1,972
outlier · 3.7×
15271
CPT 		Skin Substitute Graft 25 Sq Cm 5 $98.98 $10,705.89 $7,256.83 nat. median
$1,725
outlier · 4.2×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 5 $1,112.40 $8,657.25 $6,524.18 nat. median
$1,982
outlier · 3.3×
J1602
HCPCS 		Golimumab 50 Mg/4 Ml Vial 5 $43.11 $8,562.27 $6,452.60 nat. median
$273
outlier · 23.7×
J9308
HCPCS 		Ramucirumab 100 Mg/10 Ml Vial 5 $86.40 $32,212.62 $6,391.01 nat. median
$1,489
outlier · 4.3×
83884
CPT 		Neurofilament Light Chain 5 $5,224.70 $7,796.86 $6,277.68 nat. median
$225
outlier · 27.9×
74174
CPT 		CTA Abd&Pelv Wwo Dye 5 $4,995.25 $7,454.45 $6,244.07 nat. median
$988
outlier · 6.3×
690
MS_DRG 		Ms-DRG 690 1 $5,981.14 $5,981.14 $5,981.14 nat. median
$8,376
0.7× median
884
MS_DRG 		Ms-DRG 884 1 $5,891.20 $5,891.20 $5,891.20 nat. median
$14,244
outlier · 0.4×
194
MS_DRG 		Ms-DRG 194 1 $5,890.00 $5,890.00 $5,890.00 nat. median
$8,516
0.7× median
536
MS_DRG 		Ms-DRG 536 1 $5,890.00 $5,890.00 $5,890.00 nat. median
$8,433
0.7× median
72158
CPT 		MRI Lumbar Spine Wwo Dye 5 $340.97 $7,346.78 $5,847.13 nat. median
$1,093
outlier · 5.3×
641
MS_DRG 		Ms-DRG 641 1 $5,757.70 $5,757.70 $5,757.70 nat. median
$8,109
0.7× median
Q5122
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Syr 5 $3,939.75 $7,578.91 $5,618.37 nat. median
$561
outlier · 10.0×
73723
CPT 		MRI Joint Le Wwo Dye Lt 5 $657.06 $7,408.86 $5,583.38 nat. median
$1,192
outlier · 4.7×
74177
CPT 		CT Abd & Pelv W Contrast 5 $227.52 $6,975.27 $5,551.45 nat. median
$974
outlier · 5.7×
73720
CPT 		MRI Le Wwo Dye Lt 5 $233.96 $7,597.04 $5,404.08 nat. median
$1,129
outlier · 4.8×
74176
CPT 		CT Abd & Pelvis Wo Contrast 5 $95.04 $6,742.47 $5,366.17 nat. median
$694
outlier · 7.7×
72157
CPT 		MRI Chest Spine Wwo Dye 5 $535.35 $7,101.37 $5,351.65 nat. median
$1,105
outlier · 4.8×
74178
CPT 		CT Abd & Pelv Wwo Contrast 5 $479.88 $7,258.00 $5,305.60 nat. median
$1,024
outlier · 5.2×
73220
CPT 		MRI Ue Wwo Dye Lt 5 $319.79 $7,001.46 $5,276.36 nat. median
$1,130
outlier · 4.7×
J9264
HCPCS 		Paclitaxel Protein-bd 100mg Vl 5 $17.39 $6,821.54 $5,140.77 nat. median
$766
outlier · 6.7×
J1569
HCPCS 		Immune Glob Gammagard 5gr/50ml 5 $21.77 $13,556.00 $4,825.76 nat. median
$1,070
outlier · 4.5×
78452
CPT 		Myocard Perf Spect Rest Stress 5 $3,920.15 $5,922.27 $4,764.49 nat. median
$1,816
outlier · 2.6×
J0129
HCPCS 		Abatacept 250 Mg Vial 5 $588.00 $6,259.03 $4,716.85 nat. median
$902
outlier · 5.2×
72148
CPT 		MRI Lumbar Spine Wo Dye 5 $315.18 $5,488.26 $4,597.12 nat. median
$805
outlier · 5.7×
70553
CPT 		MRI Brain Wwo Contrast 5 $729.77 $5,850.07 $4,510.53 nat. median
$1,133
outlier · 4.0×

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
             
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
49082 CPT Abdominal Paracentesis 14 5 $1,440.00 $1,396.80 $86.65 $1,396.80 $946.80 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
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
82088 CPT Aldosterone 11 5 $584.00 $566.48 $379.60 $566.48 $450.85 2026-07-15
J2997 HCPCS Alteplase 2 Mg Vial 8 5 $879.00 $852.77 $37.08 $852.77 $642.65 2026-07-15
93922 CPT Ankle Arm Screen 10 5 $603.00 $584.91 $151.04 $584.91 $440.79 2026-07-15
1393 APR_DRG Apr-DRG 1393 2 1 — — $11,336.59 $11,336.59 $11,336.59 2026-07-15
5402 APR_DRG Apr-DRG 5402 2 1 — — $42,065.18 $42,065.18 $42,065.18 2026-07-15
5601 APR_DRG Apr-DRG 5601 2 1 — — $8,731.42 $8,731.42 $8,731.42 2026-07-15
5602 APR_DRG Apr-DRG 5602 2 1 — — $12,939.93 $12,939.93 $12,939.93 2026-07-15
5603 APR_DRG Apr-DRG 5603 2 1 — — $17,035.33 $17,035.33 $17,035.33 2026-07-15
6401 APR_DRG Apr-DRG 6401 2 1 — — $3,797.02 $3,797.02 $3,797.02 2026-07-15
6942 APR_DRG Apr-DRG 6942 2 1 — — $19,975.72 $19,975.72 $19,975.72 2026-07-15
7203 APR_DRG Apr-DRG 7203 2 1 — — $46,209.81 $46,209.81 $46,209.81 2026-07-15
7204 APR_DRG Apr-DRG 7204 2 1 — — $17,330.81 $17,330.81 $17,330.81 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
93926 CPT Arterial Duplex Le Lt 16 5 $969.00 $939.93 $629.85 $939.93 $756.79 2026-07-15
20605 CPT Asp/Inj Intermediate Joint 8 5 $826.00 $801.22 $536.90 $801.22 $645.11 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
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
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
360 CDM Biopsy Prostate 56 5 $973.00 $943.81 $456.95 $1,533.57 $787.02 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
36430 CPT Blood Administration 11 5 $824.00 $799.28 $535.60 $799.28 $650.96 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
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
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
84681 CPT C Peptide 8 5 $574.00 $556.78 $373.10 $556.78 $448.29 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
92960 CPT Cardioversion Electric Ext 14 5 $1,087.00 $1,054.39 $115.39 $1,054.39 $714.70 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
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
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
17250 CPT Chemical Cauterization Tissue 8 5 $571.00 $553.87 $371.15 $553.87 $445.95 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
74230 CPT Cine/Vid X-ray Throat/Esoph 10 5 $913.00 $885.61 $593.45 $885.61 $681.29 2026-07-15
723 CDM Circumcision Neonate <=28 Days 8 5 $713.00 $691.61 $463.45 $691.61 $556.86 2026-07-15
87497 CPT Cmv Quant By Pcr 8 5 $556.00 $539.32 $361.40 $539.32 $434.24 2026-07-15
96125 CPT Cognitive Performance Test St 8 5 $670.00 $649.90 $435.50 $649.90 $523.27 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
45380 CPT Colonoscopy W Biopsy(s) 6 5 $1,643.00 $1,593.71 $239.30 $558.91 $427.84 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
761 CDM Colposcopy 64 5 $1,295.50 $1,256.63 $327.60 $4,276.73 $987.70 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
75635 CPT CTA Abdominal Arteries 8 5 $4,579.00 $4,441.63 $592.68 $4,441.63 $3,347.25 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
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
52235 CPT Cystoscopy And Treatment 6 5 $2,832.00 $2,747.04 $340.43 $800.13 $613.33 2026-07-15
52234 CPT Cystoscopy And Treatment 6 5 $760.00 $737.20 $290.30 $681.60 $523.33 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
J9144 HCPCS Daratumumab Hyaluronida 1800Mg 8 5 $45,082.00 $43,730.18 $382.98 $43,730.18 $32,955.43 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
11046 CPT Debride Muscle Addl 20 Cm 16 5 $664.00 $644.08 $64.35 $1,870.72 $449.86 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
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
11045 CPT Debride Skin Subq Addl 20 Cm 16 5 $664.00 $644.08 $30.52 $935.36 $449.86 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
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
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
77080 CPT Dexa Scan 13 5 $617.00 $598.49 $88.61 $903.00 $526.30 2026-07-15
82626 CPT Dhea 10 5 $633.00 $614.01 $411.45 $614.01 $467.08 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
450 CDM Dissolve Clot Heart Vessel 8 5 $617.00 $598.49 $401.05 $598.49 $481.88 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
93321 CPT Doppler Echo Exam Heart 8 5 $671.00 $650.87 $436.15 $650.87 $524.05 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
74221 CPT Double Contrast Esophagus 10 5 $1,036.00 $1,004.92 $620.03 $1,004.92 $757.32 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
93226 CPT ECG Monit/Report Up To 48 Hour 11 5 $656.00 $636.32 $426.40 $695.52 $518.24 2026-07-15
93325 CPT Echo Color Doppler 8 5 $957.00 $928.29 $622.05 $928.29 $747.41 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
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
43246 CPT Egd Place Gastrostomy Tube 6 5 $2,124.00 $2,060.28 $236.48 $553.53 $422.25 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
99283 CPT Emergency Room Visit Level 3 19 5 $955.00 $926.35 $74.82 $926.35 $658.95 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
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
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
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
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
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
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
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
93971 CPT Extremity Study Lt 21 5 $1,348.00 $1,307.56 $876.20 $1,307.56 $1,040.66 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
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
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
Q5110 HCPCS Filgrastim-aafi 480 Mcg/0.8 Ml 8 5 $780.00 $756.91 $507.21 $927.00 $703.45 2026-07-15
88184 CPT Flow Cytometry First Mark 8 5 $554.00 $537.38 $360.10 $537.38 $432.68 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
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
A9585 HCPCS Gadobutrol Inj 10 Mm/10 Ml Vl 19 5 $800.00 $776.00 $2.69 $776.00 $552.00 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
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
J1611 HCPCS Glucagon (Fresenius Kabi) Vial 8 5 $794.00 $770.88 $81.80 $770.88 $580.94 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
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
Q4186 HCPCS Graft Skin Epifix 16 5 $567.50 $550.64 $292.01 $665.52 $440.87 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
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
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
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
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
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
88360 CPT Immunohisto Stain Qnt Man 8 5 $644.00 $624.68 $418.60 $624.68 $502.97 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
96365 CPT Inf Therapy Med Initial 25 5 $893.00 $866.21 $580.45 $1,279.43 $866.21 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
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
87637 CPT Influ/RSV/CoV2 Pcr Ceph 13 5 $598.00 $580.06 $352.59 $580.06 $472.42 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
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
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
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
77067 CPT Mammo Screen Implant Bi 29 5 $712.00 $690.64 $462.80 $690.64 $562.48 2026-07-15
77066 CPT Mammography Diagnostic Digital 10 5 $763.00 $740.11 $495.95 $740.11 $557.75 2026-07-15
77065 CPT Mammography Dx Digital Lt 19 5 $748.00 $725.56 $486.20 $725.56 $577.46 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
159 MS_DRG Ms-DRG 159 2 1 — — $3,848.76 $3,848.76 $3,848.76 2026-07-15
177 MS_DRG Ms-DRG 177 2 1 — — $3,849.64 $3,849.64 $3,849.64 2026-07-15
194 MS_DRG Ms-DRG 194 2 1 — — $5,890.00 $5,890.00 $5,890.00 2026-07-15
536 MS_DRG Ms-DRG 536 2 1 — — $5,890.00 $5,890.00 $5,890.00 2026-07-15
641 MS_DRG Ms-DRG 641 2 1 — — $5,757.70 $5,757.70 $5,757.70 2026-07-15
690 MS_DRG Ms-DRG 690 2 1 — — $5,981.14 $5,981.14 $5,981.14 2026-07-15
789 MS_DRG Ms-DRG 789 2 1 — — $3,161.41 $3,161.41 $3,161.41 2026-07-15
806 MS_DRG Ms-DRG 806 1 1 — — $30,543.91 $30,543.91 $30,543.91 2026-07-15
884 MS_DRG Ms-DRG 884 2 1 — — $5,891.20 $5,891.20 $5,891.20 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
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
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
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
97606 CPT Neg Pressure Wound Dme >50 Cm 10 5 $721.00 $699.37 $468.65 $699.37 $545.08 2026-07-15
99465 CPT Neonatal Resuscitation 8 5 $758.00 $735.26 $492.70 $735.26 $592.00 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
99204 CPT New Patient Level 4 Wound Care 17 5 $814.00 $789.58 $124.26 $789.58 $541.31 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
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
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
76815 CPT OB US Limited Fetus(s) 11 5 $770.00 $746.90 $500.50 $746.90 $594.44 2026-07-15
G0379 HCPCS Observation Assess Direct Adm 8 5 $609.00 $590.73 $395.85 $590.73 $475.63 2026-07-15
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
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
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
11055 CPT Pare 1 Benign Lesion 14 5 $878.00 $851.66 $19.05 $851.66 $577.29 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
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
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
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
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
G0480 HCPCS Phosphatidylethanol (PEth) 26 5 $654.00 $634.38 $193.70 $1,111.48 $510.77 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
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
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
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
C1788 HCPCS Port Impl Pp Clrvu 8f 1 Lmn 8 5 $907.00 $880.27 $589.88 $880.28 $708.76 2026-07-15
G0416 HCPCS Prostate Sat Biopsy 8 5 $831.00 $806.07 $540.15 $806.07 $649.01 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
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
A9552 HCPCS Radiophar Fdg 8 5 $1,931.00 $1,873.07 $1,255.15 $1,873.07 $1,508.11 2026-07-15
A9502 HCPCS Radiophar Tc99M Myoview 8 5 $669.00 $648.93 $434.85 $648.93 $522.49 2026-07-15
A9500 HCPCS Radiophar Tc99M Sestamibi Dose 11 5 $669.00 $648.93 $434.85 $970.14 $528.51 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
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
P9016 HCPCS Red Blood Cells Lekoreduced 11 5 $962.00 $933.14 $625.30 $933.14 $742.66 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
28190 CPT Remove Foreign Body Foot Lt 14 5 $724.00 $702.28 $161.35 $702.28 $476.03 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
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
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
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
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
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
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
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
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
J2805 HCPCS Sincalide 5 Mcg Vial 8 5 $601.00 $583.22 $163.05 $583.22 $439.52 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
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
92523 CPT Speech Sound Lang Comprehen 8 5 $556.00 $539.32 $361.40 $539.32 $434.24 2026-07-15
62270 CPT Spinal Fluid Tap Diagnostic 14 5 $801.00 $776.97 $72.34 $776.97 $526.65 2026-07-15
92610 CPT Swallow Eval Non Radiol 11 5 $735.00 $712.95 $477.75 $712.95 $567.42 2026-07-15
92611 CPT Swallow Evaluation Video 10 5 $676.00 $655.72 $439.40 $655.72 $527.95 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
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
37195 CPT Thrombolytic Therapy Stroke 8 5 $722.00 $700.34 $469.30 $700.34 $563.88 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
76817 CPT Transvaginal US Obstetrical 11 5 $898.00 $871.06 $583.70 $871.06 $693.26 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
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
84445 CPT Tsi 8 5 $1,010.00 $979.70 $656.50 $979.70 $788.81 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
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
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
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
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
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
76775 CPT Ultrasound Aorta 10 5 $1,121.00 $1,087.37 $728.65 $1,208.00 $875.50 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
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
76604 CPT Ultrasound Chest 10 5 $841.00 $815.77 $546.65 $885.96 $656.82 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
76856 CPT Ultrasound Pelvic Complete 8 5 $1,044.00 $1,012.68 $678.60 $1,012.68 $815.37 2026-07-15
76857 CPT Ultrasound Pelvic Limited 10 5 $712.00 $690.64 $462.80 $690.64 $520.47 2026-07-15
76870 CPT Ultrasound Scrotum 8 5 $974.00 $944.78 $633.10 $944.78 $760.69 2026-07-15
76872 CPT Ultrasound Transrectal 10 5 $930.00 $902.10 $604.50 $902.10 $679.83 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
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
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
93976 CPT Vascular Study 9 5 $1,050.00 $1,018.50 $682.50 $1,018.50 $829.50 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
93970 CPT Venous Duplex 12 5 $1,893.00 $1,836.21 $1,230.45 $1,836.21 $1,478.43 2026-07-15
74019 CPT X-ray Abdomen 12 5 $602.00 $583.94 $391.30 $660.48 $542.70 2026-07-15
74018 CPT X-ray Abdomen 11 5 $475.00 $460.75 $308.75 $523.40 $451.25 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
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
71046 CPT X-ray Chest 2v PA/Lateral 13 5 $741.00 $718.77 $481.65 $783.14 $632.07 2026-07-15
73080 CPT X-ray Elbow Lt 16 5 $651.00 $631.47 $38.91 $631.47 $475.88 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
70160 CPT X-ray Facial Bones 3 Views 8 5 $614.00 $595.58 $86.75 $595.58 $448.84 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
73620 CPT X-ray Foot 2 Views Lt 16 5 $664.00 $644.08 $212.82 $644.08 $485.38 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
73090 CPT X-ray Forearm 2 Views Rt 17 5 $585.00 $567.45 $282.72 $567.45 $451.62 2026-07-15
73120 CPT X-ray Hand Lt 20 5 $664.00 $644.08 $198.99 $644.08 $458.16 2026-07-15
73130 CPT X-ray Hand Rt 21 5 $797.00 $773.09 $59.16 $773.09 $549.93 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
73522 CPT X-ray Hips 3-4 Views Bi 8 5 $754.00 $731.38 $490.10 $793.91 $679.73 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
73060 CPT X-ray Humerus Lt 20 5 $614.00 $595.58 $67.44 $614.00 $427.91 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
73564 CPT X-ray Knee 4 Lt 16 5 $846.00 $820.62 $129.06 $820.62 $618.42 2026-07-15
73565 CPT X-ray Knees Bi 8 5 $639.00 $619.83 $267.09 $619.83 $467.11 2026-07-15
73590 CPT X-ray Lower Leg Lt 18 5 $722.00 $700.34 $73.88 $700.34 $503.28 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
72110 CPT X-ray Lumbosacral 4 Views 8 5 $788.00 $764.36 $67.44 $764.36 $576.03 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
71100 CPT X-ray Ribs 2 Views Rt 19 5 $785.00 $761.45 $510.25 $3,616.49 $669.61 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
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
72220 CPT X-ray Sacrum Tailbone 10 5 $537.00 $520.89 $349.05 $520.89 $431.12 2026-07-15
73030 CPT X-ray Shoulder Rt 23 5 $746.00 $723.62 $237.65 $723.62 $525.40 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
72040 CPT X-ray Spine Cervical 2-3 Views 11 5 $912.00 $884.64 $551.93 $884.64 $629.28 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
72070 CPT X-ray Spine Thoracic 2 Views 11 5 $706.00 $684.82 $458.90 $1,033.00 $602.22 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
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
73100 CPT X-ray Wrist 2 Views Rt 17 5 $664.00 $644.08 $66.51 $644.08 $512.61 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
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