Hospital

AVERA DELLS AREA HOSPITAL - CAH

Dell Rapids, SD · CCN 431331 · Rates published

861 distinct procedures filed

6 distinct payers

16,127 rate rows

2026-05-09 last MRF observed

Data quality

16,088 of 16,127 rate rows are consumer-grade (99.8%)

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

Excluded — reason	Rows
exceeds 10× this hospital's gross charge — excluded from medians	14
placeholder amount (≤ $0.02) — excluded from medians	14
percent-of-charges filed in the dollar field — excluded from medians	9
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	2

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.avera.org/app/files/public/2e1bd421-a31b-49d2-aa47-b2e43dfccccc/460224743_avera-dell-rapids-hospital_standardcharges.csv
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-05-17
Content fingerprint	bdfd3bdb62c99bc0… · 3,549,042 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
J3380 OTHER	Vedolizumab 300 Mg Vial	6	$43.34	$39,563.32	$28,560.56	nat. median $24 outlier · 1210.2×
J3101 OTHER	Tenecteplase 50 Mg/10 Ml Syrng	6	$0.41	$30,005.60	$23,050.62	nat. median $195 outlier · 118.2×
J0717 OTHER	Certolizumab Pegol 400 Mg Kit	6	$3.42	$24,592.04	$17,752.86	nat. median $5 outlier · 3508.5×
291 OTHER	Ms-DRG 291	1	$17,423.62	$17,423.62	$17,423.62	nat. median $13,078 1.3× median
871 OTHER	Ms-DRG 871	1	$14,150.42	$14,150.42	$14,150.42	nat. median $16,181 0.9× median
603 OTHER	Ms-DRG 603	1	$11,327.04	$11,327.04	$11,327.04	nat. median $9,288 1.2× median
74177 OTHER	CT Abd & Pelv W Contrast	6	$227.52	$7,733.95	$6,357.46	nat. median $458 outlier · 13.9×
95811 OTHER	Polysomnogram W CPap	6	$2,143.56	$7,298.85	$6,146.40	nat. median $996 outlier · 6.2×
Q5111 OTHER	Pegfilgrastim-cbqv 6 Mg/0.6 Ml	6	$271.10	$8,478.75	$6,120.76	nat. median $164 outlier · 37.4×
J3032 OTHER	Eptinezumab-jjmr 100Mg/Ml Vial	6	$38.64	$8,042.75	$5,806.02	nat. median $21 outlier · 272.2×
95810 OTHER	Polysomnogram	6	$2,055.39	$6,998.65	$5,753.62	nat. median $979 outlier · 5.9×
698 OTHER	Ms-DRG 698	1	$5,680.28	$5,680.28	$5,680.28	nat. median $16,061 outlier · 0.4×
74178 OTHER	CT Abd & Pelv Wwo Contrast	6	$479.88	$7,164.90	$5,632.36	nat. median $495 outlier · 11.4×
J0129 OTHER	Abatacept 250 Mg Vial	6	$87.60	$6,143.46	$4,434.93	nat. median $49 outlier · 90.0×
750 OTHER	Colonoscopy	6	$1,280.33	$8,797.00	$4,222.01	nat. median $2,494 1.7× median
70553 OTHER	MRI Brain Wwo Contrast	6	$729.77	$5,616.40	$4,192.80	nat. median $596 outlier · 7.0×
74176 OTHER	CT Abd & Pelvis Wo Contrast	6	$95.04	$5,052.10	$4,179.95	nat. median $302 outlier · 13.8×
73720 OTHER	MRI Le Wwo Dye Lt	6	$233.96	$5,546.10	$4,003.70	nat. median $553 outlier · 7.2×
72157 OTHER	MRI Chest Spine Wwo Dye	6	$535.35	$5,546.10	$4,003.70	nat. median $630 outlier · 6.4×
72158 OTHER	MRI Lumbar Spine Wwo Dye	6	$340.97	$5,546.10	$4,003.70	nat. median $576 outlier · 6.9×
73221 OTHER	MRI Joint Ue Wo Dye Rt	6	$408.12	$4,728.15	$3,842.24	nat. median $396 outlier · 9.7×
72148 OTHER	MRI Lumbar Spine Wo Dye	6	$315.18	$4,728.15	$3,716.82	nat. median $383 outlier · 9.7×
73721 OTHER	MRI Joint Le Wo Dye Lt	6	$315.18	$4,728.15	$3,716.82	nat. median $442 outlier · 8.4×
70551 OTHER	MRI Brain Wo Contrast	6	$447.03	$4,116.35	$3,345.08	nat. median $394 outlier · 8.5×
74183 OTHER	MRI Abdomen Wwo Dye	6	$619.08	$4,473.55	$3,229.43	nat. median $634 outlier · 5.1×
70543 OTHER	MRI Orbit Face Neck Wwo Cont	6	$335.45	$4,376.65	$3,159.48	nat. median $604 outlier · 5.2×
73220 OTHER	MRI Ue Wwo Dye Lt	6	$319.79	$4,326.30	$3,123.14	nat. median $560 outlier · 5.6×
72146 OTHER	MRI Chest Spine Wo Dye	6	$390.63	$4,116.35	$2,971.57	nat. median $372 outlier · 8.0×
72141 OTHER	MRI Neck Spine Wo Dye	6	$233.96	$3,816.15	$2,955.34	nat. median $372 outlier · 7.9×
71271 OTHER	Ldct For Lung Cancer Screen	6	$101.48	$3,467.50	$2,920.00	nat. median $135 outlier · 21.7×
74170 OTHER	CT Abdomen Wwo Dye	6	$58.22	$3,588.15	$2,915.84	nat. median $308 outlier · 9.5×
87154 OTHER	Culture Id By Amp Prb 6 Or 6+	6	$1,018.63	$3,477.00	$2,902.55	nat. median $227 outlier · 12.8×
73718 OTHER	MRI Le Wo Dye Rt	6	$56.39	$3,664.15	$2,783.21	nat. median $401 outlier · 6.9×
74181 OTHER	MRI Abdomen Wo Dye	6	$544.29	$3,721.15	$2,686.28	nat. median $394 outlier · 6.8×
74175 OTHER	CTA Abdom Wwo Dye	6	$82.17	$3,417.15	$2,686.24	nat. median $336 outlier · 8.0×
93306 OTHER	Tte W Doppler Complete	6	$927.95	$3,159.70	$2,597.61	nat. median $609 outlier · 4.3×
70470 OTHER	CT Head/Brain Wwo Contrast	6	$241.32	$3,588.15	$2,590.27	nat. median $276 outlier · 9.4×
81479 OTHER	Btk Inhibitor Panel	6	$924.61	$3,148.30	$2,588.23	nat. median $277 outlier · 9.3×
689 OTHER	Trauma Team Evaluation Level 5	6	$897.82	$3,511.54	$2,558.31	nat. median $11,307 outlier · 0.2×
71260 OTHER	CT Thorax W Contrast	6	$80.31	$3,044.75	$2,519.13	nat. median $260 outlier · 9.7×
71275 OTHER	CTA Chest Wwo Contrast	6	$65.60	$3,291.75	$2,500.34	nat. median $311 outlier · 8.0×
C8929 OTHER	Echo M Mode 2d W Contrast	6	$801.85	$2,730.30	$2,284.83	nat. median $961 outlier · 2.4×
G0390 OTHER	Trauma Team Level 5	6	$812.17	$2,765.45	$2,273.49	nat. median $1,527 1.5× median
70544 OTHER	MRA Head Wo Contrast	6	$408.12	$3,138.80	$2,265.89	nat. median $401 outlier · 5.6×
70491 OTHER	CT Soft Tissue Neck W Cont	6	$357.53	$2,679.00	$2,177.04	nat. median $282 outlier · 7.7×
70486 OTHER	CT Maxillofacial Wo Contrast	6	$187.95	$2,581.15	$2,135.56	nat. median $178 outlier · 12.0×
72132 OTHER	CT Lumbar Spine W Contrast	6	$313.35	$2,831.95	$2,115.31	nat. median $437 outlier · 4.8×
70487 OTHER	CT Maxillofacial W Contrast	6	$268.29	$2,925.05	$2,111.58	nat. median $272 outlier · 7.8×
73201 OTHER	CT Ue W Dye Rt	6	$90.44	$2,910.80	$2,101.29	nat. median $454 outlier · 4.6×
73701 OTHER	CT Le W Dye Lt	6	$268.01	$2,889.90	$2,086.20	nat. median $290 outlier · 7.2×

Other procedures at this hospital

Browse this hospital's 861 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J3380	OTHER	Vedolizumab 300 Mg Vial	12	6	$41,645.00	$40,396.23	$43.34	$39,563.32	$28,560.56	2026-05-09
J3101	OTHER	Tenecteplase 50 Mg/10 Ml Syrng	14	6	$31,584.00	$30,637.29	$0.41	$30,005.60	$23,050.62	2026-05-09
J0717	OTHER	Certolizumab Pegol 400 Mg Kit	12	6	$25,886.00	$25,109.77	$3.42	$24,592.04	$17,752.86	2026-05-09
291	OTHER	Ms-DRG 291	1	1	—	—	$17,423.62	$17,423.62	$17,423.62	2026-05-09
871	OTHER	Ms-DRG 871	1	1	—	—	$14,150.42	$14,150.42	$14,150.42	2026-05-09
603	OTHER	Ms-DRG 603	1	1	—	—	$11,327.04	$11,327.04	$11,327.04	2026-05-09
74177	OTHER	CT Abd & Pelv W Contrast	17	6	$8,141.00	$7,896.77	$227.52	$7,733.95	$6,357.46	2026-05-09
95811	OTHER	Polysomnogram W CPap	15	6	$7,683.00	$7,452.51	$2,143.56	$7,298.85	$6,146.40	2026-05-09
Q5111	OTHER	Pegfilgrastim-cbqv 6 Mg/0.6 Ml	12	6	$8,925.00	$8,657.25	$271.10	$8,478.75	$6,120.76	2026-05-09
J3032	OTHER	Eptinezumab-jjmr 100Mg/Ml Vial	12	6	$8,466.00	$8,212.07	$38.64	$8,042.75	$5,806.02	2026-05-09
95810	OTHER	Polysomnogram	12	6	$7,367.00	$7,145.99	$2,055.39	$6,998.65	$5,753.62	2026-05-09
698	OTHER	Ms-DRG 698	2	1	—	—	$5,680.28	$5,680.28	$5,680.28	2026-05-09
74178	OTHER	CT Abd & Pelv Wwo Contrast	14	6	$7,542.00	$7,315.74	$479.88	$7,164.90	$5,632.36	2026-05-09
J0129	OTHER	Abatacept 250 Mg Vial	12	6	$6,466.00	$6,272.80	$87.60	$6,143.46	$4,434.93	2026-05-09
750	OTHER	Colonoscopy	60	6	$5,501.00	$5,335.97	$1,280.33	$8,797.00	$4,222.01	2026-05-09
70553	OTHER	MRI Brain Wwo Contrast	25	6	$5,241.00	$5,083.77	$729.77	$5,616.40	$4,192.80	2026-05-09
74176	OTHER	CT Abd & Pelvis Wo Contrast	18	6	$5,318.00	$5,158.46	$95.04	$5,052.10	$4,179.95	2026-05-09
72158	OTHER	MRI Lumbar Spine Wwo Dye	12	6	$5,838.00	$5,662.86	$340.97	$5,546.10	$4,003.70	2026-05-09
73720	OTHER	MRI Le Wwo Dye Lt	12	6	$5,838.00	$5,662.86	$233.96	$5,546.10	$4,003.70	2026-05-09
72157	OTHER	MRI Chest Spine Wwo Dye	12	6	$5,838.00	$5,662.86	$535.35	$5,546.10	$4,003.70	2026-05-09
73221	OTHER	MRI Joint Ue Wo Dye Rt	15	6	$4,977.00	$4,827.69	$408.12	$4,728.15	$3,842.24	2026-05-09
72148	OTHER	MRI Lumbar Spine Wo Dye	14	6	$4,977.00	$4,827.69	$315.18	$4,728.15	$3,716.82	2026-05-09
73721	OTHER	MRI Joint Le Wo Dye Lt	28	6	$4,977.00	$4,827.69	$315.18	$4,728.15	$3,716.82	2026-05-09
70551	OTHER	MRI Brain Wo Contrast	15	6	$4,333.00	$4,203.01	$447.03	$4,116.35	$3,345.08	2026-05-09
74183	OTHER	MRI Abdomen Wwo Dye	12	6	$4,709.00	$4,567.73	$619.08	$4,473.55	$3,229.43	2026-05-09
70543	OTHER	MRI Orbit Face Neck Wwo Cont	12	6	$4,607.00	$4,468.79	$335.45	$4,376.65	$3,159.48	2026-05-09
73220	OTHER	MRI Ue Wwo Dye Lt	12	6	$4,554.00	$4,417.38	$319.79	$4,326.30	$3,123.14	2026-05-09
72146	OTHER	MRI Chest Spine Wo Dye	12	6	$4,333.00	$4,203.01	$390.63	$4,116.35	$2,971.57	2026-05-09
72141	OTHER	MRI Neck Spine Wo Dye	14	6	$4,017.00	$3,896.49	$233.96	$3,816.15	$2,955.34	2026-05-09
71271	OTHER	Ldct For Lung Cancer Screen	15	6	$3,650.00	$3,540.50	$101.48	$3,467.50	$2,920.00	2026-05-09
74170	OTHER	CT Abdomen Wwo Dye	15	6	$3,777.00	$3,663.69	$58.22	$3,588.15	$2,915.84	2026-05-09
87154	OTHER	Culture Id By Amp Prb 6 Or 6+	12	6	$3,651.00	$3,541.47	$1,018.63	$3,477.00	$2,902.55	2026-05-09
73718	OTHER	MRI Le Wo Dye Rt	26	6	$3,857.00	$3,741.29	$56.39	$3,664.15	$2,783.21	2026-05-09
74181	OTHER	MRI Abdomen Wo Dye	12	6	$3,917.00	$3,799.49	$544.29	$3,721.15	$2,686.28	2026-05-09
74175	OTHER	CTA Abdom Wwo Dye	14	6	$3,597.00	$3,489.09	$82.17	$3,417.15	$2,686.24	2026-05-09
93306	OTHER	Tte W Doppler Complete	16	6	$3,326.00	$3,226.22	$927.95	$3,159.70	$2,597.61	2026-05-09
70470	OTHER	CT Head/Brain Wwo Contrast	12	6	$3,777.00	$3,663.69	$241.32	$3,588.15	$2,590.27	2026-05-09
81479	OTHER	Btk Inhibitor Panel	10	6	$3,314.00	$3,214.58	$924.61	$3,148.30	$2,588.23	2026-05-09
689	OTHER	Trauma Team Evaluation Level 5	12	6	$3,218.00	$3,121.46	$897.82	$3,511.54	$2,558.31	2026-05-09
71260	OTHER	CT Thorax W Contrast	16	6	$3,205.00	$3,108.85	$80.31	$3,044.75	$2,519.13	2026-05-09
71275	OTHER	CTA Chest Wwo Contrast	15	6	$3,465.00	$3,361.05	$65.60	$3,291.75	$2,500.34	2026-05-09
C8929	OTHER	Echo M Mode 2d W Contrast	14	6	$2,874.00	$2,787.78	$801.85	$2,730.30	$2,284.83	2026-05-09
G0390	OTHER	Trauma Team Level 5	10	6	$2,911.00	$2,823.67	$812.17	$2,765.45	$2,273.49	2026-05-09
70544	OTHER	MRA Head Wo Contrast	12	6	$3,304.00	$3,204.88	$408.12	$3,138.80	$2,265.89	2026-05-09
70491	OTHER	CT Soft Tissue Neck W Cont	15	6	$2,820.00	$2,735.40	$357.53	$2,679.00	$2,177.04	2026-05-09
70486	OTHER	CT Maxillofacial Wo Contrast	16	6	$2,717.00	$2,635.49	$187.95	$2,581.15	$2,135.56	2026-05-09
72132	OTHER	CT Lumbar Spine W Contrast	14	6	$2,981.00	$2,891.57	$313.35	$2,831.95	$2,115.31	2026-05-09
70487	OTHER	CT Maxillofacial W Contrast	12	6	$3,079.00	$2,986.63	$268.29	$2,925.05	$2,111.58	2026-05-09
73201	OTHER	CT Ue W Dye Rt	12	6	$3,064.00	$2,972.08	$90.44	$2,910.80	$2,101.29	2026-05-09
73701	OTHER	CT Le W Dye Lt	24	6	$3,042.00	$2,950.74	$268.01	$2,889.90	$2,086.20	2026-05-09
70450	OTHER	CT Head/Brain Wo Contrast	16	6	$2,663.00	$2,583.11	$24.20	$2,529.85	$2,067.68	2026-05-09
72125	OTHER	CT Cervical Spine Wo Contrast	15	6	$2,663.00	$2,583.11	$172.58	$2,529.85	$2,055.84	2026-05-09
71250	OTHER	CT Thorax Wo Contrast	15	6	$2,663.00	$2,583.11	$71.13	$2,529.85	$2,055.84	2026-05-09
73700	OTHER	CT Le Wo Dye Lt	28	6	$2,739.00	$2,656.83	$76.65	$2,663.00	$2,045.49	2026-05-09
73200	OTHER	CT Ue Wo Dye Rt	26	6	$2,816.00	$2,731.52	$70.19	$2,675.20	$2,032.03	2026-05-09
72131	OTHER	CT Lumbar Spine Wo Contrast	14	6	$2,663.00	$2,583.11	$234.87	$2,529.85	$1,988.73	2026-05-09
72128	OTHER	CT Thoracic Spine Wo Contrast	14	6	$2,663.00	$2,583.11	$107.93	$2,529.85	$1,988.73	2026-05-09
J0248	OTHER	Remdesivir 100 Mg Vial	12	6	$2,847.00	$2,762.23	$12.70	$2,705.28	$1,952.92	2026-05-09
74150	OTHER	CT Abdomen Wo Dye	12	6	$2,663.00	$2,583.11	$524.00	$2,529.85	$1,826.28	2026-05-09
72195	OTHER	MRI Pelvis Wo Dye	12	6	$2,521.00	$2,445.37	$53.64	$2,394.95	$1,728.90	2026-05-09
120	OTHER	Room Medical Unit Semi Private	8	6	$2,160.00	$2,095.20	$602.64	$2,052.00	$1,697.76	2026-05-09
93226	OTHER	ECG Monit/Report Up To 48 Hour	13	6	$2,064.00	$2,002.08	$575.86	$1,960.80	$1,630.56	2026-05-09
74300	OTHER	X-ray Bile Ducts/Pancreas	12	6	$2,085.00	$2,022.45	$581.72	$1,980.75	$1,618.66	2026-05-09
70490	OTHER	CT Soft Tissue Neck Wo Cont	12	6	$2,340.00	$2,269.80	$277.47	$2,223.00	$1,604.77	2026-05-09
93970	OTHER	Venous Duplex	14	6	$2,018.00	$1,957.46	$563.02	$1,917.10	$1,576.06	2026-05-09
93975	OTHER	Vascular Study	10	6	$1,999.00	$1,939.03	$557.72	$1,899.05	$1,561.22	2026-05-09
99291	OTHER	Critical Care 1st 30-74 Min	19	6	$2,378.00	$2,306.66	$329.00	$2,259.10	$1,545.70	2026-05-09
360	OTHER	Or Level 2	40	6	$2,678.50	$2,598.15	$421.01	$7,296.95	$1,529.50	2026-05-09
J1745	OTHER	Infliximab (Gen) 100 Mg Vial	12	6	$2,118.00	$2,054.75	$1.46	$2,012.39	$1,452.73	2026-05-09
Q9967	OTHER	Iopamidol-370 100 Ml Vial	17	6	$1,790.00	$1,736.30	$0.28	$1,700.50	$1,432.00	2026-05-09
72193	OTHER	CT Pelvis W Dye	12	6	$2,083.00	$2,020.51	$581.16	$1,978.85	$1,428.52	2026-05-09
J0666	OTHER	Bupivac Liposome 1.3% Pf 20 Ml	12	6	$1,756.00	$1,703.33	$2.18	$1,713.62	$1,380.22	2026-05-09
93880	OTHER	Extracranial Bilat Study	13	6	$1,717.00	$1,665.49	$479.04	$1,635.00	$1,356.43	2026-05-09
88262	OTHER	Chromosome Analysis 15-20 Cell	10	6	$1,732.00	$1,680.04	$483.23	$1,645.40	$1,352.69	2026-05-09
88230	OTHER	Tissue Culture Non Neoplastic	10	6	$1,732.00	$1,680.04	$483.23	$1,645.40	$1,352.69	2026-05-09
P9016	OTHER	Red Blood Cells Lekoreduced	13	6	$1,644.00	$1,594.68	$458.68	$1,561.80	$1,283.30	2026-05-09
76881	OTHER	US Extremity Nonvasc Comp Lt	23	6	$1,610.00	$1,561.70	$363.86	$1,533.00	$1,271.90	2026-05-09
93971	OTHER	Extremity Study Rt	21	6	$1,603.00	$1,554.91	$447.24	$1,522.85	$1,266.37	2026-05-09
25605	OTHER	Fx Distal Radius W Man Lt	38	6	$1,808.00	$1,753.76	$82.60	$1,717.60	$1,226.56	2026-05-09
81270	OTHER	Jak2 Mutation	10	6	$1,565.00	$1,518.05	$436.64	$1,486.75	$1,222.26	2026-05-09
72192	OTHER	CT Pelvis Wo Dye	12	6	$1,731.00	$1,679.07	$482.95	$1,644.45	$1,187.12	2026-05-09
76700	OTHER	Ultrasound Abdomen Complete	12	6	$1,500.00	$1,455.00	$418.50	$1,425.00	$1,177.98	2026-05-09
11043	OTHER	Debride Muscle/Fascia 20 Cm	18	6	$2,529.00	$2,453.13	$302.96	$2,402.55	$1,174.72	2026-05-09
90675	OTHER	Rabies Vax Pcec/Pf 2.5Unit Vl	14	6	$1,347.00	$1,307.03	$125.24	$1,280.08	$1,006.28	2026-05-09
81279	OTHER	Jak2 Exon 12 Mutation	10	6	$1,234.00	$1,196.98	$344.29	$1,172.30	$963.75	2026-05-09
76705	OTHER	Ultrasound Abdomen Limited	16	6	$1,206.00	$1,169.82	$336.47	$1,145.70	$958.77	2026-05-09
A0428	OTHER	Amb Bls Non Emerg Hosp/Hosp	10	6	$1,205.00	$1,168.85	$336.20	$1,144.75	$941.11	2026-05-09
80145	OTHER	Adalimumab	10	6	$1,188.00	$1,152.36	$331.45	$1,128.60	$927.83	2026-05-09
93925	OTHER	Arterial Duplex Le Bi	13	6	$1,174.00	$1,138.78	$327.55	$1,115.30	$927.46	2026-05-09
99285	OTHER	Emergency Room Visit Level 5	23	6	$1,381.00	$1,339.57	$267.73	$1,311.95	$918.37	2026-05-09
710	OTHER	Recovery Phase 1 Per 15 Min	30	6	$1,225.00	$1,188.25	$84.82	$1,396.50	$914.83	2026-05-09
80280	OTHER	Vedolizumab	10	6	$1,171.00	$1,135.87	$326.71	$1,112.45	$914.55	2026-05-09
32556	OTHER	Insert Cath Pleura Wo Image Lt	18	6	$1,961.00	$1,902.17	$240.06	$1,862.95	$910.88	2026-05-09
90677	OTHER	Pneumo Conjugate Vaccine 20 Va	15	6	$1,130.00	$1,096.29	$315.33	$1,076.30	$872.51	2026-05-09
87529	OTHER	Hsv DNA Amp Probe	10	6	$1,063.00	$1,031.11	$296.58	$1,009.85	$830.20	2026-05-09
90684	OTHER	Pneumo Conjugate Vaccine 21 Va	16	6	$1,050.00	$1,018.79	$293.03	$1,050.30	$825.54	2026-05-09
76882	OTHER	US Extremity Nonvasc Limit Lt	21	6	$1,023.00	$992.31	$285.42	$971.85	$808.17	2026-05-09
76770	OTHER	Ultrasound Abdo Back Wall Comp	13	6	$1,023.00	$992.31	$285.42	$971.85	$808.17	2026-05-09
76536	OTHER	Ultrasound Head And Neck	14	6	$1,023.00	$992.31	$285.42	$971.85	$803.42	2026-05-09
76870	OTHER	Ultrasound Scrotum	12	6	$1,023.00	$992.31	$285.42	$971.85	$803.42	2026-05-09
71111	OTHER	X-ray Ribs Bilateral 4 Views	10	6	$1,064.00	$1,032.08	$63.74	$1,010.80	$794.60	2026-05-09
76856	OTHER	Ultrasound Pelvic Complete	11	6	$1,023.00	$992.31	$285.42	$971.85	$789.76	2026-05-09
Q0138	OTHER	Ferumoxy 510mg/17ml (non-esrd)	12	6	$1,145.00	$1,111.35	$0.76	$1,088.43	$785.74	2026-05-09
129	OTHER	Room Swing Bed Skilled	8	6	$996.00	$966.12	$277.88	$946.20	$782.86	2026-05-09
72110	OTHER	X-ray Lumbosacral 4 Views	10	6	$1,022.00	$991.34	$67.44	$970.90	$763.23	2026-05-09
93976	OTHER	Vascular Study	12	6	$968.00	$938.96	$270.07	$919.60	$756.01	2026-05-09
76775	OTHER	Ultrasound Aorta	12	6	$958.00	$929.26	$267.28	$910.10	$748.20	2026-05-09
83993	OTHER	Calprotectin	10	6	$940.00	$911.80	$262.26	$893.00	$734.14	2026-05-09
73523	OTHER	X-ray Hips 5 Views Bi	12	6	$983.00	$953.51	$274.26	$933.85	$734.11	2026-05-09
90651	OTHER	9vHPV 3 Dose	12	6	$1,067.00	$1,034.99	$189.30	$1,013.65	$731.75	2026-05-09
31500	OTHER	Insert Emergency Airway	20	6	$1,110.00	$1,076.70	$273.72	$1,054.50	$729.83	2026-05-09
93926	OTHER	Arterial Duplex Le Rt	10	6	$932.00	$904.04	$260.03	$885.40	$727.89	2026-05-09
17250	OTHER	Chemical Cauterization Tissue	10	6	$878.00	$851.66	$244.96	$834.10	$685.72	2026-05-09
0202U	OTHER	Respir Path 22 Targets Biofire	10	6	$870.00	$843.90	$242.73	$826.50	$679.47	2026-05-09
72100	OTHER	X-ray Lumbosacral 2-3 Views	15	6	$824.00	$799.28	$90.44	$782.80	$659.20	2026-05-09
L3702	OTHER	Orthosis Long Arm Wrist Hand	10	6	$841.00	$815.87	$234.67	$799.05	$656.90	2026-05-09
94660	OTHER	CPap/BiPap First Day	10	6	$836.00	$810.92	$233.24	$794.20	$652.91	2026-05-09
93922	OTHER	Ankle Arm Screen	13	6	$823.00	$798.31	$229.62	$783.00	$650.17	2026-05-09
77080	OTHER	Dexa Scan	24	6	$948.00	$919.56	$16.12	$902.00	$650.14	2026-05-09
C1781	OTHER	Mesh Srg 3Dmax 6x4 Lt	49	6	$972.00	$943.42	$92.92	$1,146.30	$646.78	2026-05-09
73503	OTHER	X-ray Hip Uni W Pelvis 4 V Lt	10	6	$837.00	$811.89	$233.52	$795.15	$625.07	2026-05-09
99284	OTHER	Emergency Room Visit Level 4	25	6	$933.00	$905.01	$177.60	$886.35	$620.45	2026-05-09
C1726	OTHER	Dil Pebax 180Cm Od15-18	11	6	$781.00	$758.00	$218.02	$742.37	$603.27	2026-05-09
11106	OTHER	Incisional Biopsy 1st Lesion	10	6	$756.00	$733.32	$210.92	$718.20	$590.43	2026-05-09
A9585	OTHER	Gadobutrol Inj 10 Mm/10 Ml Vl	25	6	$900.00	$873.00	$0.56	$855.00	$585.00	2026-05-09
73564	OTHER	X-ray Knee 4 Lt	29	6	$724.00	$702.28	$129.06	$689.00	$579.20	2026-05-09
80050	OTHER	General Health Panel	16	6	$719.00	$697.43	$200.60	$733.00	$571.61	2026-05-09
92950	OTHER	Heart/Lung Resuscitation Cpr	18	6	$1,070.00	$1,037.90	$275.08	$1,016.50	$569.40	2026-05-09
73030	OTHER	X-ray Shoulder Rt	27	6	$728.00	$706.16	$203.11	$728.00	$568.26	2026-05-09
37195	OTHER	Thrombolytic Therapy Stroke	10	6	$722.00	$700.34	$201.44	$685.90	$563.88	2026-05-09
90710	OTHER	Mmrv Subq	12	6	$718.00	$697.04	$98.13	$682.67	$560.59	2026-05-09
72072	OTHER	X-ray Spine Thoracic 3 Views	11	6	$693.00	$672.21	$193.35	$697.55	$554.40	2026-05-09
74019	OTHER	X-ray Abdomen	15	6	$691.00	$670.27	$192.79	$660.48	$552.80	2026-05-09
27786	OTHER	Fx Distal Fibula Lt	20	6	$611.00	$592.67	$170.47	$799.18	$550.82	2026-05-09
29581	OTHER	Appl Multi Layer Ven Wnd Compr	10	6	$704.00	$682.88	$196.42	$668.80	$549.83	2026-05-09
71046	OTHER	X-ray Chest 2v PA/Lateral	17	6	$685.00	$664.45	$191.12	$783.14	$548.00	2026-05-09
73630	OTHER	X-ray Foot 3 Views Rt	27	6	$669.00	$648.93	$65.60	$635.55	$535.20	2026-05-09
73610	OTHER	X-ray Ankle 3 Views Lt	27	6	$669.00	$648.93	$99.63	$635.55	$535.20	2026-05-09
45385	OTHER	Colonoscopy W Lesion Removal	8	6	$703.00	$681.91	$497.75	$709.52	$532.76	2026-05-09
93246	OTHER	Ext ECG >7 Days Hook Up	15	6	$658.00	$638.26	$183.58	$625.10	$526.40	2026-05-09
J1611	OTHER	Glucagon (Fresenius Kabi) Vial	12	6	$763.00	$740.62	$81.80	$725.35	$523.62	2026-05-09
J1610	OTHER	Glucagon 1 Mg/ml Vial	12	6	$763.00	$740.62	$98.91	$725.35	$523.62	2026-05-09
76604	OTHER	Ultrasound Chest	10	6	$665.00	$645.05	$185.54	$631.75	$519.37	2026-05-09
90620	OTHER	MenB 2 Dose IM	12	6	$752.00	$729.73	$209.89	$714.69	$515.93	2026-05-09
87517	OTHER	Hep B Na Quan	10	6	$657.00	$637.29	$183.30	$624.15	$513.12	2026-05-09
24500	OTHER	Fx Humeral Shaft Wo Man Lt	20	6	$655.00	$635.35	$182.75	$622.25	$511.56	2026-05-09
90670	OTHER	Pneumococcal (pcv13)	12	6	$646.00	$626.91	$33.53	$613.99	$507.46	2026-05-09
72050	OTHER	X-ray Spine Cervical 4-5 Views	13	6	$623.00	$604.31	$173.82	$746.06	$498.40	2026-05-09
71045	OTHER	X-ray Chest 1 View	16	6	$623.00	$604.31	$118.60	$593.33	$498.40	2026-05-09
73130	OTHER	X-ray Hand Lt	27	6	$645.00	$625.65	$59.16	$614.00	$497.94	2026-05-09
73110	OTHER	X-ray Wrist 3 Views Lt	25	6	$645.00	$625.65	$58.22	$612.75	$497.94	2026-05-09
25560	OTHER	Fx Radius & Ulnar Shaft Rt	10	6	$635.00	$615.95	$177.17	$603.25	$495.94	2026-05-09
73502	OTHER	X-ray Hip Uni 2-3 Views Lt	50	6	$519.00	$503.43	$144.80	$860.42	$493.05	2026-05-09
83520	OTHER	Adalimumab Ab, S	60	6	$677.00	$656.69	$31.53	$999.40	$488.52	2026-05-09
12034	OTHER	Repair Lac Interm 7.6-12.5 Cm	20	6	$742.00	$719.74	$207.02	$704.90	$487.87	2026-05-09
77067	OTHER	Mammography Screening Digital	42	6	$607.00	$588.79	$169.35	$757.00	$485.60	2026-05-09
70160	OTHER	X-ray Facial Bones 3 Views	10	6	$645.00	$625.65	$86.75	$612.75	$481.69	2026-05-09
761	OTHER	Chest Tube Insertion	10	6	$613.00	$594.61	$171.03	$582.35	$478.75	2026-05-09
74221	OTHER	Double Contrast Esophagus	10	6	$579.00	$561.63	$161.54	$620.03	$478.54	2026-05-09
12051	OTHER	Repair Lac Interm <2.5 Cm	18	6	$742.00	$719.74	$207.02	$704.90	$477.26	2026-05-09
G0379	OTHER	Observation Assess Direct Adm	10	6	$609.00	$590.73	$169.91	$578.55	$475.63	2026-05-09
76857	OTHER	Ultrasound Pelvic Limited	10	6	$604.00	$585.88	$168.52	$573.80	$471.73	2026-05-09
93979	OTHER	Duplex Aorta Limited	10	6	$590.00	$572.30	$164.61	$560.50	$460.79	2026-05-09
87536	OTHER	HIV 1 Na Quan	10	6	$585.00	$567.45	$163.22	$555.75	$456.88	2026-05-09
93225	OTHER	Holter Monitor Hook Up <48 Hrs	13	6	$572.00	$554.84	$159.59	$543.40	$451.88	2026-05-09
72190	OTHER	X-ray Pelvis 3 Views	10	6	$545.00	$528.65	$152.06	$522.48	$450.44	2026-05-09
26770	OTHER	Dislocation Finger Wo Anes	18	6	$471.00	$456.87	$131.41	$710.47	$447.45	2026-05-09
71101	OTHER	X-ray Ribs Uni W Chest Rt	23	6	$559.00	$542.23	$155.96	$3,427.98	$447.20	2026-05-09
25600	OTHER	Fx Distal Radius Rt	22	6	$572.00	$554.84	$159.59	$543.40	$446.73	2026-05-09
Q9957	OTHER	Perflutren Lip Micro 2.2mg/2ml	14	6	$598.00	$580.54	$47.75	$568.58	$445.34	2026-05-09
94060	OTHER	Pft Pre & Post Screen Spirome	13	6	$552.00	$535.44	$154.01	$524.40	$441.60	2026-05-09
11045	OTHER	Debride Skin Subq Addl 20 Cm	21	6	$664.00	$644.08	$48.41	$3,718.40	$441.56	2026-05-09
J2404	OTHER	Nicardipine/Ns 40 Mg/200ml Bag	12	6	$560.00	$543.26	$0.16	$1,828.74	$440.21	2026-05-09
73590	OTHER	X-ray Lower Leg Lt	24	6	$559.00	$542.23	$73.88	$531.05	$439.38	2026-05-09
23600	OTHER	Fx Prox Humeral Wo Man Rt	22	6	$561.00	$544.17	$156.52	$532.95	$438.14	2026-05-09
71100	OTHER	X-ray Ribs 2 Views Rt	21	6	$510.00	$494.70	$142.29	$3,616.49	$435.03	2026-05-09
Q9956	OTHER	Perflutren Protein-a Microdota	13	6	$599.00	$581.83	$77.76	$569.83	$432.83	2026-05-09
11760	OTHER	Repair Nailbed	18	6	$831.00	$806.07	$221.56	$789.45	$429.59	2026-05-09
71110	OTHER	X-ray Ribs Bilateral 3 Views	10	6	$571.00	$553.87	$47.21	$542.45	$426.42	2026-05-09
28190	OTHER	Remove Foreign Body Foot Lt	36	6	$724.00	$702.28	$202.00	$687.80	$423.12	2026-05-09
45380	OTHER	Colonoscopy W Biopsy(s)	8	6	$592.00	$574.24	$393.92	$558.91	$422.80	2026-05-09
73080	OTHER	X-ray Elbow Rt	21	6	$546.00	$529.62	$38.91	$518.70	$421.51	2026-05-09
73140	OTHER	X-ray Finger(s) Lt	26	6	$545.00	$528.65	$64.68	$517.75	$420.74	2026-05-09
26600	OTHER	Fx Metacarpal	28	6	$479.00	$464.63	$133.64	$783.80	$418.97	2026-05-09
83013	OTHER	H Pylori Breath	10	6	$528.00	$512.16	$147.31	$501.60	$412.37	2026-05-09
82803	OTHER	Arterial Blood Gas Analysis	10	6	$525.00	$509.25	$146.48	$498.75	$410.02	2026-05-09
36430	OTHER	Blood Administration	13	6	$519.00	$503.43	$144.80	$810.16	$410.01	2026-05-09
87637	OTHER	Influ/RSV/CoV2 Pcr Ceph	14	6	$524.00	$508.28	$146.20	$497.80	$409.25	2026-05-09
99283	OTHER	Emergency Room Visit Level 3	22	6	$622.00	$603.34	$108.68	$590.90	$408.97	2026-05-09
80307	OTHER	Drug Screen Multichan Urine	11	6	$517.00	$501.49	$144.24	$491.15	$408.43	2026-05-09
73120	OTHER	X-ray Hand Lt	20	6	$546.00	$529.62	$152.33	$518.70	$407.75	2026-05-09
72220	OTHER	X-ray Sacrum Tailbone	12	6	$508.00	$492.76	$141.73	$482.60	$406.40	2026-05-09
80074	OTHER	Acute Hepatitis Panel	12	6	$511.00	$495.67	$142.57	$485.45	$406.25	2026-05-09
88312	OTHER	Special Stain Gms	10	6	$520.00	$504.40	$145.08	$494.00	$406.12	2026-05-09
73552	OTHER	X-ray Femur 2 Views Rt	25	6	$524.00	$508.28	$99.80	$499.00	$404.53	2026-05-09
90750	OTHER	Zoster (hzv) IM	12	6	$543.00	$527.10	$151.61	$516.23	$403.70	2026-05-09
10080	OTHER	I&d Pilonidal Cyst Simple	18	6	$796.00	$772.12	$213.05	$756.20	$401.68	2026-05-09
87305	OTHER	Aspergillus Galact Antigen	10	6	$514.00	$498.58	$143.41	$488.30	$401.44	2026-05-09
74018	OTHER	X-ray Abdomen	13	6	$499.00	$484.03	$139.22	$523.40	$399.20	2026-05-09
11402	OTHER	Exc Ben Lesion 1.1-2.0 Trunk	18	6	$724.00	$702.28	$202.00	$687.80	$394.45	2026-05-09
73000	OTHER	X-ray Collar Bone Lt	23	6	$508.00	$492.76	$141.73	$482.60	$392.18	2026-05-09
23500	OTHER	Fx Clavicle Lt	12	6	$502.00	$486.94	$140.06	$476.90	$392.06	2026-05-09
P9045	OTHER	Albumin Human 5% 12.5 Gr/250ml	12	6	$495.00	$481.10	$106.16	$3,123.57	$389.84	2026-05-09
45378	OTHER	Colonoscopy Diagnostic	8	6	$456.00	$442.32	$362.29	$514.44	$388.75	2026-05-09
90697	OTHER	Dtap-ipv-hib-hepb IM	12	6	$565.00	$548.63	$32.97	$537.32	$387.89	2026-05-09
20520	OTHER	Remove Fb Muscle Simple	10	6	$495.00	$480.15	$138.11	$470.25	$386.60	2026-05-09
16020	OTHER	Dress/Debride Small Burn	20	6	$586.00	$568.42	$111.84	$702.40	$385.29	2026-05-09
90648	OTHER	Hib Prp-t 4 Dose	12	6	$560.00	$543.59	$27.10	$532.38	$384.32	2026-05-09
87636	OTHER	Influ & CoV2 Pcr Ceph	13	6	$486.00	$471.42	$135.59	$461.70	$383.94	2026-05-09
73090	OTHER	X-ray Forearm 2 Views Rt	25	6	$497.00	$482.09	$138.66	$472.15	$383.68	2026-05-09
81515	OTHER	Vpp	11	6	$497.00	$482.09	$138.66	$472.15	$383.68	2026-05-09
73562	OTHER	X-ray Knee 3 Views Rt	27	6	$496.00	$481.12	$109.76	$471.20	$382.91	2026-05-09
73501	OTHER	X-ray Hip Uni 1 View Lt	10	6	$460.00	$446.20	$128.34	$711.09	$380.19	2026-05-09
88184	OTHER	Flow Cytometry First Mark	10	6	$482.00	$467.54	$134.48	$457.90	$376.44	2026-05-09
86355	OTHER	B Cells Total Ss5	10	6	$479.00	$464.63	$133.64	$455.05	$374.10	2026-05-09
76706	OTHER	Aaa Screening Medicare	10	6	$477.00	$462.69	$133.08	$453.15	$372.53	2026-05-09
90739	OTHER	HepB Adult 2 Dose IM	12	6	$541.00	$524.77	$146.96	$513.95	$371.02	2026-05-09
88342	OTHER	Immunohisto Stain Init Pr Spec	10	6	$473.00	$458.81	$131.97	$449.35	$369.42	2026-05-09
25500	OTHER	Fx Radius Rt	10	6	$470.00	$455.90	$131.13	$446.50	$367.07	2026-05-09
76830	OTHER	Ultrasound Transvaginal	13	6	$475.00	$460.75	$132.53	$451.25	$366.70	2026-05-09
99282	OTHER	Emergency Room Visit Level 2	14	6	$461.00	$447.17	$128.62	$437.95	$366.50	2026-05-09
82610	OTHER	Cystatin C	10	6	$469.00	$454.93	$130.85	$445.55	$366.29	2026-05-09
96413	OTHER	Chemotherapy Inf Initial	10	6	$469.00	$454.93	$130.85	$445.55	$366.29	2026-05-09
64450	OTHER	Inject Anes Agent Oth Nerve Rt	18	6	$788.00	$764.36	$83.15	$748.60	$366.02	2026-05-09
96365	OTHER	Inf Therapy Med Initial	29	6	$549.00	$532.53	$118.58	$521.55	$365.08	2026-05-09
72070	OTHER	X-ray Spine Thoracic 2 Views	12	6	$456.00	$442.32	$127.22	$1,015.91	$364.80	2026-05-09
73560	OTHER	X-ray Knee 1-2 Views Lt	25	6	$472.00	$457.84	$84.00	$448.40	$364.38	2026-05-09
10061	OTHER	I&d Abscess Comp/Multiple	28	6	$416.00	$403.52	$116.06	$506.04	$363.31	2026-05-09
70030	OTHER	X-ray Eye Fb Detection	8	6	$462.00	$448.14	$128.90	$438.90	$363.13	2026-05-09
73060	OTHER	X-ray Humerus Lt	22	6	$497.00	$482.09	$67.44	$472.15	$358.64	2026-05-09
G0121	OTHER	Screen Colonoscopy Not Hi Risk	8	6	$482.00	$467.54	$171.02	$514.81	$358.38	2026-05-09
G0105	OTHER	Screening Colonoscopy Hi Risk	8	6	$482.00	$467.54	$170.90	$514.08	$357.97	2026-05-09
36680	OTHER	Insert Needle Bone Cavity	10	6	$457.00	$443.29	$127.50	$434.15	$356.91	2026-05-09
92610	OTHER	Swallow Eval Non Radiol	12	6	$454.00	$440.38	$126.67	$431.30	$354.58	2026-05-09
92523	OTHER	Speech Sound Lang Comp Or Expr	24	6	$451.00	$437.47	$106.58	$494.00	$354.35	2026-05-09
88341	OTHER	Immunohisto Stain Add Per Spc	10	6	$450.00	$436.50	$125.55	$427.50	$351.45	2026-05-09
73660	OTHER	X-ray Toe(s) 2 Views Lt	23	6	$446.00	$432.62	$66.51	$424.00	$344.31	2026-05-09
24650	OTHER	Fx Radial Head/Neck Wo Man Rt	11	6	$434.00	$420.98	$121.09	$412.30	$342.86	2026-05-09
94762	OTHER	Desaturation And Hr Study	11	6	$444.00	$430.68	$123.88	$421.80	$342.77	2026-05-09
83519	OTHER	Igf Binding Protein 1	10	6	$436.00	$422.92	$121.64	$414.20	$340.51	2026-05-09
96360	OTHER	Inf Therapy Hyd Initial	14	6	$425.00	$412.25	$118.58	$403.75	$340.00	2026-05-09
72170	OTHER	X-ray Pelvis 1-2 Views	14	6	$424.00	$411.28	$80.60	$402.80	$339.20	2026-05-09
28510	OTHER	Fx Phalanges	10	6	$434.00	$420.98	$121.09	$412.30	$338.96	2026-05-09
28490	OTHER	Fx Great Toe	10	6	$434.00	$420.98	$121.09	$412.30	$338.96	2026-05-09
28470	OTHER	Fx Metatarsal	10	6	$434.00	$420.98	$121.09	$412.30	$338.96	2026-05-09
26720	OTHER	Fx Finger/Thumb Wo Man	10	6	$434.00	$420.98	$121.09	$412.30	$338.96	2026-05-09
51700	OTHER	Irrigate Bladder	10	6	$433.00	$420.01	$120.81	$411.35	$338.17	2026-05-09
93242	OTHER	Ext ECG 48 Hrs -7days Hook Up	11	6	$428.00	$415.16	$119.41	$406.60	$338.12	2026-05-09
83970	OTHER	Pth	14	6	$424.00	$411.28	$118.30	$403.00	$337.08	2026-05-09
85220	OTHER	Factor 5 Activity	10	6	$428.00	$415.16	$119.41	$406.60	$334.27	2026-05-09
11042	OTHER	Debride Skin Subq 20 Cm	33	6	$416.00	$403.52	$116.06	$1,533.30	$332.80	2026-05-09
73010	OTHER	X-ray Shoulder Blade Rt	10	6	$433.00	$420.01	$120.81	$411.35	$323.37	2026-05-09
72040	OTHER	X-ray Spine Cervical 2-3 Views	13	6	$403.00	$390.91	$112.44	$551.93	$322.40	2026-05-09
86256	OTHER	Antibody Titer (Arup)	30	6	$431.00	$418.07	$36.83	$733.40	$321.87	2026-05-09
P9017	OTHER	Plasma Fresh Frozen	10	6	$409.00	$396.73	$114.11	$388.55	$319.43	2026-05-09
82671	OTHER	Estrogen Fractionated	10	6	$409.00	$396.73	$114.11	$388.55	$319.43	2026-05-09
24530	OTHER	Fx Supra/Transcondylar Hum Rt	11	6	$413.00	$400.61	$115.23	$392.35	$318.84	2026-05-09
99223	OTHER	IP/Obs Initial High Comp	8	6	$350.00	$339.50	$270.04	$389.40	$318.47	2026-05-09
82626	OTHER	Dhea	10	6	$407.00	$394.79	$113.55	$386.65	$317.87	2026-05-09
73020	OTHER	X-ray Shoulder Rt	10	6	$424.00	$411.28	$118.30	$402.80	$316.64	2026-05-09
81256	OTHER	Hemochromat Mutation	10	6	$400.00	$388.00	$111.60	$380.00	$312.40	2026-05-09
97163	OTHER	Pt Eval High Complexity	13	6	$395.00	$383.15	$110.21	$375.25	$312.05	2026-05-09
G0399	OTHER	Sleep Study Type Iii Portable	15	6	$395.00	$383.15	$110.21	$375.25	$312.05	2026-05-09
10120	OTHER	I&r Foreign Body Simple	33	6	$416.00	$403.52	$116.06	$443.65	$310.56	2026-05-09
94664	OTHER	Inhalation Treat Chronic Init	23	6	$387.00	$375.39	$107.97	$595.00	$309.60	2026-05-09
97166	OTHER	Ot Eval Mod Complexity	15	6	$385.00	$373.45	$107.42	$365.75	$308.00	2026-05-09
11750	OTHER	Exc Nail Matrix Part/Complete	18	6	$504.00	$488.88	$140.62	$478.80	$306.99	2026-05-09
86341	OTHER	Glutmic Acid Decarbox Aby	20	6	$397.00	$385.09	$89.00	$451.25	$303.05	2026-05-09
G0438	OTHER	Annual Wellness Visit Initial	8	6	$228.00	$221.16	$184.13	$358.02	$302.76	2026-05-09
93005	OTHER	EKG Tracing	17	6	$388.00	$376.36	$73.80	$368.60	$302.58	2026-05-09
30300	OTHER	Remove Foreign Body Nose	18	6	$457.00	$443.29	$127.50	$434.15	$300.48	2026-05-09
12013	OTHER	Repair Lac Simple 2.6-5.0 Cm	45	6	$434.00	$420.98	$97.65	$412.30	$298.55	2026-05-09
65220	OTHER	Remove Foreign Body Eye Rt	37	6	$457.00	$443.29	$81.33	$477.85	$297.05	2026-05-09
30903	OTHER	Control Anterior Hemorrhage Bi	37	6	$457.00	$443.29	$127.50	$651.70	$297.05	2026-05-09
J3375	OTHER	Vancomycin (Swfi/Peg) 1750/350	20	6	$377.00	$366.17	$103.85	$363.62	$294.77	2026-05-09
87252	OTHER	Culture Viral	10	6	$376.00	$364.72	$104.90	$357.20	$293.65	2026-05-09
97598	OTHER	Debride Wound Addl 20 Cm	18	6	$632.00	$613.04	$22.81	$600.40	$293.56	2026-05-09
99281	OTHER	Emergency Room Visit Level 1	22	6	$507.50	$492.28	$86.21	$670.70	$293.55	2026-05-09
99235	OTHER	Admit/Discharge Same Day Mod	8	6	$401.00	$388.97	$247.05	$334.65	$290.75	2026-05-09
12004	OTHER	Repair Lac Simple 7.6-12.5 Cm	21	6	$434.00	$420.98	$121.09	$412.30	$288.61	2026-05-09
80053	OTHER	Comprehensive Metabolic Panel	15	6	$365.00	$354.05	$101.84	$347.00	$288.35	2026-05-09
J3489	OTHER	Zoledron Ac/Man/H2O 5mg/100ml	12	6	$420.00	$407.43	$11.20	$399.03	$288.05	2026-05-09
30905	OTHER	Control Posterior Hemorrhage	18	6	$435.00	$421.95	$121.37	$413.25	$285.63	2026-05-09
88185	OTHER	Flow Cytometry Ea Addit Marker	10	6	$365.00	$354.05	$101.84	$346.75	$285.06	2026-05-09
73650	OTHER	X-ray Heel 2 Views Lt	20	6	$381.00	$369.57	$64.68	$361.95	$284.53	2026-05-09
83921	OTHER	Methylmalonic Acid	12	6	$363.00	$352.11	$101.28	$344.85	$283.50	2026-05-09
24640	OTHER	Dislocation Nursemaid Elbow Lt	37	6	$434.00	$420.98	$121.09	$412.30	$282.10	2026-05-09
12011	OTHER	Repair Lac Simple <2.5 Cm	37	6	$338.00	$327.86	$94.30	$412.30	$282.10	2026-05-09
80197	OTHER	Tacrolimus	10	6	$359.00	$348.23	$100.16	$341.05	$280.38	2026-05-09
97165	OTHER	Ot Eval Low Complexity	14	6	$355.00	$344.35	$99.05	$337.25	$278.81	2026-05-09
84482	OTHER	Reverse T3	10	6	$355.00	$344.35	$99.05	$337.25	$277.25	2026-05-09
97162	OTHER	Pt Eval Mod Complexity	16	6	$347.00	$336.59	$96.81	$329.65	$275.87	2026-05-09
12016	OTHER	Repair Lac Simple 12.6-20.0 Cm	18	6	$413.00	$400.61	$115.23	$392.35	$275.52	2026-05-09
92507	OTHER	Speech Therapy Trmt	13	6	$343.00	$332.71	$95.70	$596.00	$274.40	2026-05-09
96366	OTHER	Inf Therapy Med Ea Addl Hr	14	6	$345.00	$334.65	$96.26	$327.75	$274.27	2026-05-09
11313	OTHER	Shave Lesion >2.0 Face Ears	18	6	$416.00	$403.52	$116.06	$395.20	$271.94	2026-05-09
11102	OTHER	Tangential Biopsy 1st Lesion	21	6	$416.00	$403.52	$47.80	$395.20	$270.40	2026-05-09
88112	OTHER	Cytopath Con Tech Thin Prep	10	6	$344.00	$333.68	$95.98	$326.80	$268.66	2026-05-09
87338	OTHER	H Pylori Antigen Stool	11	6	$340.00	$329.80	$94.86	$323.00	$268.60	2026-05-09
11765	OTHER	Wedge Exc Nail Fold	18	6	$416.00	$403.52	$116.06	$395.20	$265.71	2026-05-09

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