Hospital

AVERA DE SMET MEMORIAL HOSPITAL - CAH

De Smet, SD · CCN 431332 · Rates published

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You selected 93306 (CPT)

TTE W Doppler Complete

This hospital’s price: $2,807 across 5 payers · range $2,363-$3,527

Source: https://www.avera.org/app/files/public/2e34ab5e-829e-46eb-9b0e-c49857a0ce65/460224604_avera-desmet-hospital_standardcharges.csv · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

730 distinct procedures filed

5 distinct payers

9,866 rate rows

2026-07-15 last MRF observed

Data quality

9,844 of 9,866 rate rows are consumer-grade (99.8%)

22 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
percent-of-charges filed in the dollar field — excluded from medians	8
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	6
exceeds 10× this hospital's gross charge — excluded from medians	6
placeholder amount (≤ $0.02) — excluded from medians	2

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

Source MRF file	https://www.avera.org/app/files/public/2e34ab5e-829e-46eb-9b0e-c49857a0ce65/460224604_avera-desmet-hospital_standardcharges.csv
Discovered via	Discovered by HANK (automated)
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint	865cf5d9c6972436… · 2,632,241 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 HCPCS	Vedolizumab 300 Mg Vial	5	$72.63	$37,975.12	$29,401.36	nat. median $162 outlier · 181.5×
J3101 HCPCS	Tenecteplase 50 Mg/10 Ml Syrng	5	$0.41	$30,637.29	$23,056.93	nat. median $3,820 outlier · 6.0×
641 MS_DRG	Ms-DRG 641	1	$20,604.70	$20,604.70	$20,604.70	nat. median $8,109 outlier · 2.5×
J0717 HCPCS	Certolizumab Pegol 400 Mg Kit	5	$3.42	$25,109.77	$19,440.65	nat. median $1,598 outlier · 12.2×
J2506 HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Syr	5	$64.98	$19,871.51	$15,385.06	nat. median $1,646 outlier · 9.3×
536 MS_DRG	Ms-DRG 536	1	$13,747.64	$13,747.64	$13,747.64	nat. median $8,433 1.6× median
J3111 HCPCS	Romosozumab-aqqg 210 Mg/2.34Ml	5	$1.56	$11,171.48	$8,649.26	nat. median $681 outlier · 12.7×
J1569 HCPCS	Immune Glob Gamagar 20gr/200ml	5	$21.77	$9,509.65	$7,362.62	nat. median $1,070 outlier · 6.9×
192 MS_DRG	Ms-DRG 192	1	$6,890.58	$6,890.58	$6,890.58	nat. median $7,110 1.0× median
194 MS_DRG	Ms-DRG 194	1	$6,890.58	$6,890.58	$6,890.58	nat. median $8,516 0.8× median
310 MS_DRG	Ms-DRG 310	1	$6,383.92	$6,383.92	$6,383.92	nat. median $6,284 1.0× median
J3032 HCPCS	Eptinezumab-jjmr 100Mg/Ml Vial	5	$90.03	$7,920.30	$6,132.11	nat. median $76 outlier · 81.1×
J0897 HCPCS	Denosumab 60 Mg/ml Syringe	5	$9.69	$7,349.92	$5,690.51	nat. median $1,972 outlier · 2.9×
74174 CPT	CTA Abd&Pelv Wwo Dye	5	$4,425.20	$6,603.76	$5,531.50	nat. median $988 outlier · 5.6×
74178 CPT	CT Abd & Pelv Wwo Contrast	5	$479.88	$7,075.18	$5,324.62	nat. median $1,024 outlier · 5.2×
78452 CPT	Myocard Perf Spect Rest Stress	5	$1,200.00	$5,850.07	$4,710.21	nat. median $1,816 outlier · 2.6×
74177 CPT	CT Abd & Pelv W Contrast	5	$227.52	$6,002.36	$4,686.84	nat. median $974 outlier · 4.8×
74176 CPT	CT Abd & Pelvis Wo Contrast	5	$95.04	$6,002.36	$4,596.54	nat. median $694 outlier · 6.6×
71275 CPT	CTA Chest Wwo Contrast	5	$2,741.05	$4,090.49	$3,255.52	nat. median $754 outlier · 4.3×
72132 CPT	CT Lumbar Spine W Contrast	5	$313.35	$4,176.82	$3,233.81	nat. median $766 outlier · 4.2×
74170 CPT	CT Abdomen Wwo Dye	5	$58.22	$4,252.00	$3,193.25	nat. median $710 outlier · 4.5×
J1439 HCPCS	Ferric Carboxymalt 750mg/15ml	5	$11.91	$4,223.00	$3,178.14	nat. median $14 outlier · 224.2×
689 CDM	Trauma Team Evaluation Level 5	5	$2,614.30	$3,901.34	$3,141.18	nat. median $1,169 outlier · 2.7×
70498 CPT	CT Angiography Neck W Cont	5	$278.39	$3,996.40	$3,094.12	nat. median $739 outlier · 4.2×
70496 CPT	CT Angiography Head W Cont	5	$246.84	$3,940.14	$3,050.56	nat. median $747 outlier · 4.1×
111 CDM	Room Medical Unit Priv	5	$2,397.20	$3,577.36	$2,996.50	nat. median $434 outlier · 6.9×
G0390 HCPCS	Trauma Team Level 5	5	$2,490.15	$3,716.07	$2,992.01	nat. median $3,197 0.9× median
71270 CPT	CT Thorax Wwo Contrast	5	$82.17	$3,827.62	$2,963.44	nat. median $672 outlier · 4.4×
72131 CPT	CT Lumbar Spine Wo Contrast	5	$234.87	$3,870.30	$2,912.70	nat. median $457 outlier · 6.4×
74160 CPT	CT Abdomen W Dye	5	$706.77	$3,717.04	$2,877.83	nat. median $652 outlier · 4.4×
93351 CPT	Stress Tte Complete	5	$2,371.85	$3,539.53	$2,849.87	nat. median $816 outlier · 3.5×
C8929 HCPCS	Echo M Mode 2d W Contrast	5	$2,363.40	$3,636.00	$2,839.72	nat. median $1,354 outlier · 2.1×
70470 CPT	CT Head/Brain Wwo Contrast	5	$241.32	$3,638.47	$2,817.00	nat. median $622 outlier · 4.5×
93306 CPT	Tte W Doppler Complete	5	$2,363.40	$3,526.92	$2,806.99	nat. median $991 outlier · 2.8×
74175 CPT	CTA Abdom Wwo Dye	5	$82.17	$3,588.03	$2,777.95	nat. median $714 outlier · 3.9×
72126 CPT	CT Cervical Spine W Contrast	5	$214.92	$3,573.48	$2,766.69	nat. median $756 outlier · 3.7×
72129 CPT	CT Thoracic Spine W Contrast	5	$128.15	$3,549.23	$2,747.91	nat. median $584 outlier · 4.7×
99291 CPT	Critical Care 1st 30-74 Min	5	$329.00	$3,992.52	$2,706.27	nat. median $1,530 1.8× median
71260 CPT	CT Thorax W Contrast	5	$80.31	$3,521.10	$2,649.90	nat. median $648 outlier · 4.1×
72128 CPT	CT Thoracic Spine Wo Contrast	5	$107.93	$3,411.49	$2,641.26	nat. median $458 outlier · 5.8×
72125 CPT	CT Cervical Spine Wo Contrast	5	$172.58	$3,411.49	$2,567.41	nat. median $472 outlier · 5.4×
74150 CPT	CT Abdomen Wo Dye	5	$791.13	$3,243.68	$2,511.35	nat. median $448 outlier · 5.6×
71250 CPT	CT Thorax Wo Contrast	5	$71.13	$3,232.04	$2,502.33	nat. median $465 outlier · 5.4×
70450 CPT	CT Head/Brain Wo Contrast	5	$2,029.95	$3,029.31	$2,410.96	nat. median $450 outlier · 5.4×
70491 CPT	CT Soft Tissue Neck W Cont	5	$357.53	$2,989.54	$2,249.86	nat. median $627 outlier · 3.6×
72193 CPT	CT Pelvis W Dye	5	$593.33	$2,708.24	$2,155.42	nat. median $637 outlier · 3.4×
J0248 HCPCS	Remdesivir 100 Mg Vial	5	$70.71	$2,762.23	$2,138.59	nat. median $510 outlier · 4.2×
72192 CPT	CT Pelvis Wo Dye	5	$597.02	$2,601.54	$2,014.18	nat. median $459 outlier · 4.4×
70490 CPT	CT Soft Tissue Neck Wo Cont	5	$277.47	$2,673.32	$2,011.88	nat. median $450 outlier · 4.5×
Q5121 HCPCS	Infliximab-axxq 100 Mg Vial	5	$1,412.42	$8,501.52	$1,958.91	nat. median $206 outlier · 9.5×

Other procedures at this hospital

Browse this hospital's 730 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	HCPCS	Vedolizumab 300 Mg Vial	8	5	$39,149.00	$37,975.12	$72.63	$37,975.12	$29,401.36	2026-07-15
J3101	HCPCS	Tenecteplase 50 Mg/10 Ml Syrng	10	5	$31,584.00	$30,637.29	$0.41	$30,637.29	$23,056.93	2026-07-15
641	MS_DRG	Ms-DRG 641	2	1	—	—	$20,604.70	$20,604.70	$20,604.70	2026-07-15
J0717	HCPCS	Certolizumab Pegol 400 Mg Kit	8	5	$25,886.00	$25,109.77	$3.42	$25,109.77	$19,440.65	2026-07-15
J2506	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Syr	8	5	$20,486.00	$19,871.51	$64.98	$19,871.51	$15,385.06	2026-07-15
536	MS_DRG	Ms-DRG 536	2	1	—	—	$13,747.64	$13,747.64	$13,747.64	2026-07-15
J3111	HCPCS	Romosozumab-aqqg 210 Mg/2.34Ml	8	5	$11,516.00	$11,171.48	$1.56	$11,171.48	$8,649.26	2026-07-15
J1569	HCPCS	Immune Glob Gamagar 20gr/200ml	8	5	$9,803.00	$9,509.65	$21.77	$9,509.65	$7,362.62	2026-07-15
194	MS_DRG	Ms-DRG 194	2	1	—	—	$6,890.58	$6,890.58	$6,890.58	2026-07-15
192	MS_DRG	Ms-DRG 192	2	1	—	—	$6,890.58	$6,890.58	$6,890.58	2026-07-15
310	MS_DRG	Ms-DRG 310	2	1	—	—	$6,383.92	$6,383.92	$6,383.92	2026-07-15
J3032	HCPCS	Eptinezumab-jjmr 100Mg/Ml Vial	8	5	$8,165.00	$7,920.30	$90.03	$7,920.30	$6,132.11	2026-07-15
J0897	HCPCS	Denosumab 60 Mg/ml Syringe	8	5	$7,577.00	$7,349.92	$9.69	$7,349.92	$5,690.51	2026-07-15
74174	CPT	CTA Abd&Pelv Wwo Dye	6	5	$6,808.00	$6,603.76	$4,425.20	$6,603.76	$5,531.50	2026-07-15
74178	CPT	CT Abd & Pelv Wwo Contrast	10	5	$7,294.00	$7,075.18	$479.88	$7,075.18	$5,324.62	2026-07-15
78452	CPT	Myocard Perf Spect Rest Stress	12	5	$6,031.00	$5,850.07	$1,200.00	$5,850.07	$4,710.21	2026-07-15
74177	CPT	CT Abd & Pelv W Contrast	12	5	$6,188.00	$6,002.36	$227.52	$6,002.36	$4,686.84	2026-07-15
74176	CPT	CT Abd & Pelvis Wo Contrast	11	5	$6,188.00	$6,002.36	$95.04	$6,002.36	$4,596.54	2026-07-15
71275	CPT	CTA Chest Wwo Contrast	9	5	$4,217.00	$4,090.49	$2,741.05	$4,090.49	$3,255.52	2026-07-15
72132	CPT	CT Lumbar Spine W Contrast	8	5	$4,306.00	$4,176.82	$313.35	$4,176.82	$3,233.81	2026-07-15
74170	CPT	CT Abdomen Wwo Dye	10	5	$4,252.00	$4,124.44	$58.22	$4,252.00	$3,193.25	2026-07-15
J1439	HCPCS	Ferric Carboxymalt 750mg/15ml	10	5	$4,353.00	$4,223.00	$11.91	$4,223.00	$3,178.14	2026-07-15
689	CDM	Trauma Team Evaluation Level 5	8	5	$4,022.00	$3,901.34	$2,614.30	$3,901.34	$3,141.18	2026-07-15
70498	CPT	CT Angiography Neck W Cont	10	5	$4,120.00	$3,996.40	$278.39	$3,996.40	$3,094.12	2026-07-15
70496	CPT	CT Angiography Head W Cont	10	5	$4,062.00	$3,940.14	$246.84	$3,940.14	$3,050.56	2026-07-15
111	CDM	Room Medical Unit Priv	6	5	$3,688.00	$3,577.36	$2,397.20	$3,577.36	$2,996.50	2026-07-15
G0390	HCPCS	Trauma Team Level 5	8	5	$3,831.00	$3,716.07	$2,490.15	$3,716.07	$2,992.01	2026-07-15
71270	CPT	CT Thorax Wwo Contrast	8	5	$3,946.00	$3,827.62	$82.17	$3,827.62	$2,963.44	2026-07-15
72131	CPT	CT Lumbar Spine Wo Contrast	10	5	$3,990.00	$3,870.30	$234.87	$3,870.30	$2,912.70	2026-07-15
74160	CPT	CT Abdomen W Dye	8	5	$3,832.00	$3,717.04	$706.77	$3,717.04	$2,877.83	2026-07-15
93351	CPT	Stress Tte Complete	10	5	$3,649.00	$3,539.53	$2,371.85	$3,539.53	$2,849.87	2026-07-15
C8929	HCPCS	Echo M Mode 2d W Contrast	10	5	$3,636.00	$3,526.92	$2,363.40	$3,636.00	$2,839.72	2026-07-15
70470	CPT	CT Head/Brain Wwo Contrast	8	5	$3,751.00	$3,638.47	$241.32	$3,638.47	$2,817.00	2026-07-15
93306	CPT	Tte W Doppler Complete	11	5	$3,636.00	$3,526.92	$2,363.40	$3,526.92	$2,806.99	2026-07-15
74175	CPT	CTA Abdom Wwo Dye	8	5	$3,699.00	$3,588.03	$82.17	$3,588.03	$2,777.95	2026-07-15
72126	CPT	CT Cervical Spine W Contrast	8	5	$3,684.00	$3,573.48	$214.92	$3,573.48	$2,766.69	2026-07-15
72129	CPT	CT Thoracic Spine W Contrast	8	5	$3,659.00	$3,549.23	$128.15	$3,549.23	$2,747.91	2026-07-15
99291	CPT	Critical Care 1st 30-74 Min	14	5	$4,116.00	$3,992.52	$329.00	$3,992.52	$2,706.27	2026-07-15
71260	CPT	CT Thorax W Contrast	11	5	$3,630.00	$3,521.10	$80.31	$3,521.10	$2,649.90	2026-07-15
72128	CPT	CT Thoracic Spine Wo Contrast	8	5	$3,517.00	$3,411.49	$107.93	$3,411.49	$2,641.26	2026-07-15
72125	CPT	CT Cervical Spine Wo Contrast	11	5	$3,517.00	$3,411.49	$172.58	$3,411.49	$2,567.41	2026-07-15
74150	CPT	CT Abdomen Wo Dye	8	5	$3,344.00	$3,243.68	$791.13	$3,243.68	$2,511.35	2026-07-15
71250	CPT	CT Thorax Wo Contrast	10	5	$3,332.00	$3,232.04	$71.13	$3,232.04	$2,502.33	2026-07-15
70450	CPT	CT Head/Brain Wo Contrast	9	5	$3,123.00	$3,029.31	$2,029.95	$3,029.31	$2,410.96	2026-07-15
70491	CPT	CT Soft Tissue Neck W Cont	10	5	$3,082.00	$2,989.54	$357.53	$2,989.54	$2,249.86	2026-07-15
72193	CPT	CT Pelvis W Dye	9	5	$2,792.00	$2,708.24	$593.33	$2,708.24	$2,155.42	2026-07-15
J0248	HCPCS	Remdesivir 100 Mg Vial	8	5	$2,847.00	$2,762.23	$70.71	$2,762.23	$2,138.59	2026-07-15
72192	CPT	CT Pelvis Wo Dye	8	5	$2,682.00	$2,601.54	$597.02	$2,601.54	$2,014.18	2026-07-15
70490	CPT	CT Soft Tissue Neck Wo Cont	10	5	$2,756.00	$2,673.32	$277.47	$2,673.32	$2,011.88	2026-07-15
Q5121	HCPCS	Infliximab-axxq 100 Mg Vial	10	5	$2,172.00	$2,107.76	$1,412.42	$8,501.52	$1,958.91	2026-07-15
93925	CPT	Arterial Duplex Le Bi	10	5	$2,472.00	$2,397.84	$1,606.80	$2,397.84	$1,930.63	2026-07-15
73700	CPT	CT Le Wo Dye Lt	16	5	$2,512.00	$2,436.64	$76.65	$2,436.64	$1,886.51	2026-07-15
73200	CPT	CT Ue Wo Dye Lt	16	5	$2,506.00	$2,430.82	$70.19	$2,430.82	$1,882.01	2026-07-15
76700	CPT	Ultrasound Abdomen Complete	10	5	$2,413.00	$2,340.61	$1,568.45	$2,340.61	$1,812.16	2026-07-15
99285	CPT	Emergency Room Visit Level 5	17	5	$2,679.00	$2,598.63	$267.73	$2,598.63	$1,781.54	2026-07-15
76770	CPT	Ultrasound Abdo Back Wall Comp	10	5	$2,306.00	$2,236.82	$1,498.90	$2,236.82	$1,731.81	2026-07-15
93975	CPT	Vascular Study	10	5	$2,281.00	$2,212.57	$1,482.65	$2,212.57	$1,713.03	2026-07-15
93880	CPT	Extracranial Bilat Study	11	5	$2,115.00	$2,051.55	$1,374.75	$2,051.55	$1,670.85	2026-07-15
11043	CPT	Debride Muscle/Fascia 20 Cm	14	5	$2,529.00	$2,453.13	$302.96	$2,453.13	$1,662.82	2026-07-15
93017	CPT	Cardiovascular Stress Test	12	5	$2,091.00	$2,028.27	$1,359.15	$2,028.27	$1,633.07	2026-07-15
93970	CPT	Venous Duplex	10	5	$2,160.00	$2,095.20	$1,404.00	$2,095.20	$1,622.16	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
129	CDM	Room Swing Bed Skilled	6	5	$1,846.00	$1,790.62	$1,199.90	$1,790.62	$1,499.88	2026-07-15
P9035	HCPCS	Platelet Pheresis Leuko Reduc	8	5	$1,913.00	$1,855.61	$1,243.45	$1,855.61	$1,494.05	2026-07-15
93226	CPT	ECG Monit/Report Up To 48 Hour	8	5	$1,859.00	$1,803.23	$1,208.35	$1,803.23	$1,451.88	2026-07-15
76856	CPT	Ultrasound Pelvic Complete	8	5	$1,775.00	$1,721.75	$1,153.75	$1,721.75	$1,386.28	2026-07-15
70486	CPT	CT Maxillofacial Wo Contrast	10	5	$1,894.00	$1,837.18	$187.95	$1,837.18	$1,382.62	2026-07-15
80230	CPT	Infliximab Qn w/Reflex To Ab,S	10	5	$1,773.00	$1,719.81	$1,152.45	$1,719.81	$1,375.85	2026-07-15
99284	CPT	Emergency Room Visit Level 4	19	5	$1,877.00	$1,820.69	$184.86	$1,820.69	$1,370.21	2026-07-15
76775	CPT	Ultrasound Aorta	8	5	$1,729.00	$1,677.13	$1,123.85	$1,677.13	$1,350.35	2026-07-15
93930	CPT	Duplex Arterial Ue Complete	8	5	$1,603.00	$1,554.91	$1,041.95	$1,554.91	$1,251.94	2026-07-15
81381	CPT	Hla B*57:01	8	5	$1,590.00	$1,542.30	$1,033.50	$1,542.30	$1,241.79	2026-07-15
94660	CPT	CPap/BiPap First Day	16	5	$1,582.00	$1,534.54	$753.35	$1,944.85	$1,213.74	2026-07-15
93971	CPT	Extremity Study Rt	18	5	$1,537.00	$1,490.89	$999.05	$1,537.00	$1,200.39	2026-07-15
11404	CPT	Exc Ben Lesion 3.1-4.0 Trunk	14	5	$1,788.00	$1,734.36	$334.03	$1,734.36	$1,175.61	2026-07-15
71101	CPT	X-ray Ribs Uni W Chest Lt	18	5	$1,326.00	$1,286.22	$861.90	$3,427.98	$1,131.08	2026-07-15
90675	CPT	Rabies Vacc Hmn Post-ex Nonim	8	5	$1,475.00	$1,431.29	$125.24	$1,431.29	$1,108.14	2026-07-15
93926	CPT	Arterial Duplex Le Rt	10	5	$1,452.00	$1,408.44	$276.40	$1,408.44	$1,090.45	2026-07-15
11042	CPT	Debride Skin Subq 20 Cm	17	5	$1,614.00	$1,565.58	$120.87	$1,565.58	$1,073.31	2026-07-15
J0881	HCPCS	Darbepoet Alfa 40mcg/0.4ml Syr	26	5	$997.00	$967.74	$416.07	$4,588.63	$1,057.62	2026-07-15
82397	CPT	Infliximab Ab, S	10	5	$1,360.00	$1,319.20	$884.00	$1,319.20	$1,055.36	2026-07-15
72110	CPT	X-ray Lumbosacral 4 Views	8	5	$1,405.00	$1,362.85	$67.44	$1,362.85	$1,055.16	2026-07-15
76705	CPT	Ultrasound Abdomen Limited	11	5	$1,344.00	$1,303.68	$844.74	$1,303.68	$1,037.57	2026-07-15
96413	CPT	Chemotherapy Inf Initial	10	5	$1,337.00	$1,296.89	$869.05	$1,296.89	$1,012.55	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
93976	CPT	Vascular Study	8	5	$1,286.00	$1,247.42	$835.90	$1,247.42	$1,004.37	2026-07-15
93246	CPT	Ext ECG >7 Days Hook Up	11	5	$1,286.00	$1,247.42	$835.90	$1,247.42	$1,003.08	2026-07-15
93242	CPT	Ext ECG 48 Hrs -7days Hook Up	10	5	$1,266.00	$1,228.02	$822.90	$1,228.02	$981.79	2026-07-15
11106	CPT	Incisional Biopsy 1st Lesion	14	5	$1,409.00	$1,366.73	$111.84	$1,366.73	$926.42	2026-07-15
72050	CPT	X-ray Spine Cervical 4-5 Views	8	5	$1,193.00	$1,157.21	$746.06	$1,157.21	$895.94	2026-07-15
Q0138	HCPCS	Ferumoxy 510mg/17ml (non-esrd)	8	5	$1,145.00	$1,111.35	$7.28	$1,111.35	$860.44	2026-07-15
73523	CPT	X-ray Hips 5 Views Bi	8	5	$1,136.00	$1,101.92	$690.20	$1,101.92	$853.13	2026-07-15
90651	CPT	9vHPV 3 Dose	8	5	$1,114.00	$1,080.58	$189.30	$1,080.58	$836.62	2026-07-15
84445	CPT	Tsi	8	5	$1,061.00	$1,029.17	$689.65	$1,029.17	$828.64	2026-07-15
71110	CPT	X-ray Ribs Bilateral 3 Views	10	5	$1,088.00	$1,055.36	$47.21	$1,055.36	$814.32	2026-07-15
80197	CPT	Tacrolimus	8	5	$1,042.00	$1,010.74	$677.30	$1,010.74	$813.80	2026-07-15
71100	CPT	X-ray Ribs 2 Views Lt	18	5	$891.00	$864.27	$579.15	$3,616.49	$803.24	2026-07-15
90684	CPT	Pneumo Conjugate Vaccine 21 Va	10	5	$1,050.00	$1,018.79	$474.00	$1,050.30	$788.78	2026-07-15
73522	CPT	X-ray Hips 3-4 Views Bi	8	5	$910.00	$882.70	$591.50	$882.70	$785.07	2026-07-15
90677	CPT	Pneumo 20 Valent Vacc 0.5 Ml	17	5	$965.00	$936.39	$380.34	$1,050.20	$767.23	2026-07-15
76536	CPT	Ultrasound Head And Neck	12	5	$971.00	$941.87	$631.15	$941.87	$758.35	2026-07-15
72100	CPT	X-ray Lumbosacral 2-3 Views	10	5	$1,032.00	$1,001.04	$90.44	$1,001.04	$753.36	2026-07-15
64450	CPT	Inject Anes Agent Oth Nerve Lt	14	5	$1,124.00	$1,090.28	$83.15	$1,090.28	$739.03	2026-07-15
J1610	HCPCS	Glucagon 1 Mg/ml Vial	14	5	$763.00	$740.62	$98.91	$1,287.61	$732.99	2026-07-15
80074	CPT	Acute Hepatitis Panel	10	5	$930.00	$902.10	$604.50	$1,044.63	$726.33	2026-07-15
99283	CPT	Emergency Room Visit Level 3	18	5	$1,039.00	$1,007.83	$108.68	$1,007.83	$724.70	2026-07-15
Q9967	HCPCS	Iopamidol-370 100 Ml Vial	12	5	$964.00	$935.08	$253.80	$935.08	$723.97	2026-07-15
110	CDM	Room Custodial Care	6	5	$879.00	$852.63	$571.35	$852.63	$714.19	2026-07-15
80050	CPT	General Health Panel	12	5	$869.00	$842.93	$564.85	$842.93	$713.88	2026-07-15
92950	CPT	Heart/Lung Resuscitation Cpr	14	5	$1,042.00	$1,010.74	$275.08	$1,010.74	$685.12	2026-07-15
73564	CPT	X-ray Knee 4 Lt	17	5	$870.00	$843.90	$129.06	$843.90	$671.64	2026-07-15
72072	CPT	X-ray Spine Thoracic 3 Views	10	5	$816.00	$791.52	$530.40	$791.52	$663.00	2026-07-15
76870	CPT	Ultrasound Scrotum	8	5	$846.00	$820.62	$549.90	$820.62	$660.73	2026-07-15
76604	CPT	Ultrasound Chest	8	5	$841.00	$815.77	$546.65	$815.77	$656.82	2026-07-15
80306	CPT	Drug Screen Urine Inst Ass Obv	8	5	$825.00	$800.25	$536.25	$800.25	$644.33	2026-07-15
31500	CPT	Insert Emergency Airway	14	5	$971.00	$941.87	$273.72	$941.87	$638.43	2026-07-15
76830	CPT	Ultrasound Transvaginal	8	5	$807.00	$782.79	$524.55	$782.79	$630.26	2026-07-15
71046	CPT	X-ray Chest 2v PA/Lateral	13	5	$738.00	$715.86	$479.70	$783.14	$629.51	2026-07-15
76882	CPT	US Extremity Nonvasc Limit Rt	18	5	$806.00	$781.82	$523.90	$806.00	$629.49	2026-07-15
P9040	HCPCS	Rbc Packed Leuko-reduc Irrad	8	5	$803.00	$778.91	$521.95	$778.91	$627.14	2026-07-15
93325	CPT	Echo Color Doppler	8	5	$802.00	$777.94	$521.30	$777.94	$626.36	2026-07-15
72040	CPT	X-ray Spine Cervical 2-3 Views	12	5	$811.00	$786.67	$154.40	$786.67	$592.03	2026-07-15
97606	CPT	Neg Pressure Wound Dme >50 Cm	8	5	$758.00	$735.26	$492.70	$735.26	$592.00	2026-07-15
88305	CPT	Surg Path L4	10	5	$749.00	$726.53	$486.85	$749.00	$584.97	2026-07-15
72082	CPT	X-ray Spine 2-3 View	8	5	$769.00	$745.93	$130.92	$745.93	$577.52	2026-07-15
Q9957	HCPCS	Perflutren Lip Micro 2.2mg/2ml	8	5	$764.00	$741.32	$47.75	$741.32	$573.95	2026-07-15
90620	CPT	MenB 2 Dose IM	8	5	$759.00	$736.23	$254.82	$736.23	$570.01	2026-07-15
96360	CPT	Inf Therapy Hyd Initial	12	5	$724.00	$702.28	$470.60	$702.28	$565.44	2026-07-15
96365	CPT	Inf Therapy Med Initial	12	5	$724.00	$702.28	$470.60	$702.28	$565.44	2026-07-15
72070	CPT	X-ray Spine Thoracic 2 Views	10	5	$695.00	$674.15	$251.70	$1,015.91	$564.69	2026-07-15
73502	CPT	X-ray Hip Uni 2-3 Views Rt	33	5	$422.00	$409.34	$274.30	$860.42	$561.60	2026-07-15
93922	CPT	Ankle Arm Screen	10	5	$714.00	$692.58	$464.10	$692.58	$557.63	2026-07-15
74019	CPT	X-ray Abdomen	10	5	$672.00	$651.84	$436.80	$660.48	$546.00	2026-07-15
11402	CPT	Exc Ben Lesion 1.1-2.0 Trunk	14	5	$814.00	$789.58	$236.15	$789.58	$535.20	2026-07-15
99204	CPT	New Patient Level 4 Wound Care	14	5	$814.00	$789.58	$207.60	$789.58	$535.20	2026-07-15
Q9956	HCPCS	Perflutren Protein-a Microdota	10	5	$731.00	$709.31	$77.76	$709.31	$533.81	2026-07-15
40650	CPT	Repr Lip Fll Thckns Vermiln On	14	5	$552.00	$535.44	$358.80	$844.82	$529.92	2026-07-15
93225	CPT	Holter Monitor Hook Up <48 Hrs	8	5	$678.00	$657.66	$440.70	$657.66	$529.52	2026-07-15
29581	CPT	Appl Multi Layer Ven Wnd Compr	11	5	$670.00	$649.90	$435.50	$704.00	$529.30	2026-07-15
99282	CPT	Emergency Room Visit Level 2	12	5	$677.00	$656.69	$440.05	$656.69	$528.74	2026-07-15
73552	CPT	X-ray Femur 2 Views Lt	20	5	$705.00	$683.85	$130.01	$683.85	$514.65	2026-07-15
73080	CPT	X-ray Elbow Rt	17	5	$665.00	$645.05	$38.91	$645.05	$513.38	2026-07-15
92524	CPT	Behavral Qualit Analys Voice	8	5	$655.00	$635.35	$425.75	$635.35	$511.56	2026-07-15
86870	CPT	Rbc Antibody Identif Panel	8	5	$649.00	$629.53	$421.85	$629.53	$506.87	2026-07-15
70250	CPT	X-ray Skull < 4 Views	10	5	$686.00	$665.42	$94.25	$665.42	$500.78	2026-07-15
11760	CPT	Repair Nailbed	14	5	$756.00	$733.32	$221.56	$733.32	$497.07	2026-07-15
83880	CPT	Pro-b Type Natriuretic Peptide	21	5	$472.00	$457.84	$306.80	$739.14	$495.30	2026-07-15
73130	CPT	X-ray Hand Lt	20	5	$672.00	$651.84	$59.16	$651.84	$490.56	2026-07-15
70030	CPT	X-ray Eye Fb Detection	8	5	$542.00	$525.74	$352.30	$5,074.70	$488.62	2026-07-15
87799	CPT	Ebv By Pcr Quant	8	5	$620.00	$601.40	$403.00	$601.40	$484.22	2026-07-15
87906	CPT	HIV 1 Sequence Integras Resist	8	5	$601.00	$582.97	$390.65	$582.97	$469.38	2026-07-15
85335	CPT	Factor 8 Inhibitor	8	5	$599.00	$581.03	$389.35	$581.03	$467.82	2026-07-15
73630	CPT	X-ray Foot 3 Views Lt	20	5	$634.00	$614.98	$65.60	$614.98	$466.58	2026-07-15
P9016	HCPCS	Red Blood Cells Lekoreduced	10	5	$617.00	$598.49	$401.05	$598.49	$463.37	2026-07-15
82610	CPT	Cystatin C	8	5	$590.00	$572.30	$383.50	$572.30	$460.79	2026-07-15
12053	CPT	Repair Lac Interm 5.1-7.5 Cm	14	5	$576.00	$558.72	$374.40	$600.32	$459.31	2026-07-15
73110	CPT	X-ray Wrist 3 Views Lt	20	5	$629.00	$610.13	$58.22	$610.13	$459.17	2026-07-15
73060	CPT	X-ray Humerus Rt	8	5	$605.00	$586.85	$67.44	$586.85	$454.36	2026-07-15
73030	CPT	X-ray Shoulder Lt	20	5	$617.00	$598.49	$237.65	$598.49	$450.41	2026-07-15
81206	CPT	Bcr/abl1 Major Mutation	8	5	$576.00	$558.72	$374.40	$558.72	$449.86	2026-07-15
87637	CPT	Influ/RSV/CoV2 Pcr Ceph	10	5	$598.00	$580.06	$373.03	$580.06	$449.10	2026-07-15
73562	CPT	X-ray Knee 3 Views Lt	20	5	$608.00	$589.76	$109.76	$589.76	$447.73	2026-07-15
72220	CPT	X-ray Sacrum Tailbone	10	5	$605.00	$586.85	$393.25	$586.85	$447.69	2026-07-15
77067	CPT	Mammography Screening Digital	12	5	$569.00	$551.93	$369.85	$551.93	$444.39	2026-07-15
28400	CPT	Fx Calcaneus Lt	8	5	$566.00	$549.02	$367.90	$549.02	$442.04	2026-07-15
11045	CPT	Debride Skin Subq Addl 20 Cm	17	5	$664.00	$644.08	$48.41	$644.08	$441.56	2026-07-15
73560	CPT	X-ray Knee 1-2 Views Lt	19	5	$571.00	$553.87	$84.00	$553.87	$440.81	2026-07-15
86341	CPT	Glutmic Acid Decarbox Aby	8	5	$564.00	$547.08	$366.60	$547.08	$440.49	2026-07-15
12034	CPT	Repair Lac Interm 7.6-12.5 Cm	14	5	$548.00	$531.56	$356.20	$571.03	$437.23	2026-07-15
97598	CPT	Debride Wound Addl 20 Cm	14	5	$664.00	$644.08	$22.81	$644.08	$436.58	2026-07-15
92523	CPT	Speech Sound Lang Comprehen	10	5	$556.00	$539.32	$361.40	$623.00	$434.24	2026-07-15
80175	CPT	Lamotrigine	8	5	$556.00	$539.32	$361.40	$539.32	$434.24	2026-07-15
93321	CPT	Doppler Echo Exam Heart	8	5	$556.00	$539.32	$361.40	$539.32	$434.24	2026-07-15
71045	CPT	X-ray Chest 1 View	13	5	$508.00	$492.76	$330.20	$593.33	$433.32	2026-07-15
88184	CPT	Flow Cytometry First Mark	8	5	$554.00	$537.38	$360.10	$537.38	$432.68	2026-07-15
93308	CPT	Echo Limited	8	5	$551.00	$534.47	$358.15	$534.47	$430.33	2026-07-15
12052	CPT	Repair Lac Interm 2.6-5.0 Cm	14	5	$548.00	$531.56	$356.20	$559.61	$429.86	2026-07-15
85303	CPT	Protein C Activity	8	5	$548.00	$531.56	$356.20	$531.56	$427.99	2026-07-15
73610	CPT	X-ray Ankle 3 Views Lt	20	5	$580.00	$562.60	$99.63	$562.60	$423.40	2026-07-15
12032	CPT	Repair Lac Interm 2.6-7.5 Cm	16	5	$548.00	$531.56	$356.20	$534.49	$418.79	2026-07-15
26720	CPT	Fx Finger/Thumb Wo Man	14	5	$463.00	$449.11	$300.95	$517.16	$418.20	2026-07-15
80299	CPT	Dexamethasone	10	5	$555.00	$538.35	$108.40	$538.35	$416.80	2026-07-15
73590	CPT	X-ray Lower Leg Lt	20	5	$564.00	$547.08	$73.88	$547.08	$411.72	2026-07-15
99281	CPT	Emergency Room Visit Level 1	19	5	$423.00	$410.31	$84.60	$651.84	$410.31	2026-07-15
85379	CPT	D-dimer Quant	12	5	$499.00	$484.03	$324.35	$484.03	$409.93	2026-07-15
81207	CPT	Bcr/abl1 Minor Mutation	8	5	$522.00	$506.34	$339.30	$506.34	$407.68	2026-07-15
A9500	HCPCS	Radiophar Tc99M Sestamibi Dose	12	5	$521.00	$505.37	$219.20	$505.37	$406.90	2026-07-15
12031	CPT	Repair Lac Intermed <2.5 Cm	16	5	$548.00	$531.56	$307.22	$531.56	$400.04	2026-07-15
87636	CPT	Influ & CoV2 Pcr Ceph	8	5	$511.00	$495.67	$332.15	$495.67	$399.09	2026-07-15
10120	CPT	I&r Foreign Body Simple	16	5	$606.00	$587.82	$215.90	$587.82	$398.44	2026-07-15
80179	CPT	Salicylate	8	5	$507.00	$491.79	$329.55	$491.79	$395.96	2026-07-15
81241	CPT	Factor V Leiden Mutation	8	5	$504.00	$488.88	$327.60	$488.88	$393.62	2026-07-15
99236	CPT	Admit/Discharge Same Day High	6	5	$677.00	$656.69	$322.41	$436.48	$391.90	2026-07-15
12051	CPT	Repair Lac Interm <2.5 Cm	14	5	$548.00	$531.56	$341.90	$531.56	$391.68	2026-07-15
88342	CPT	Immunohisto Stain Init Pr Spec	8	5	$501.00	$485.97	$325.65	$485.97	$391.28	2026-07-15
73000	CPT	X-ray Collar Bone Lt	16	5	$519.00	$503.43	$187.04	$503.43	$389.77	2026-07-15
80053	CPT	Comprehensive Metabolic Panel	13	5	$455.00	$441.35	$295.75	$441.35	$388.12	2026-07-15
80061	CPT	Lipid Panel	12	5	$445.00	$431.65	$289.25	$431.65	$379.59	2026-07-15
82653	CPT	Pancreatic Elastase	8	5	$486.00	$471.42	$315.90	$471.42	$379.56	2026-07-15
73070	CPT	X-ray Elbow Lt	18	5	$519.00	$503.43	$41.69	$503.43	$378.87	2026-07-15
96125	CPT	Cognitive Performance Test St	8	5	$484.00	$469.48	$314.60	$469.48	$378.00	2026-07-15
72170	CPT	X-ray Pelvis 1-2 Views	10	5	$517.00	$501.49	$336.05	$501.49	$377.41	2026-07-15
86361	CPT	Cd4 Absolute Count	9	5	$477.00	$462.69	$310.05	$462.69	$376.83	2026-07-15
87338	CPT	H Pylori Antigen Stool	8	5	$480.00	$465.60	$312.00	$465.60	$374.88	2026-07-15
90734	CPT	Mcv4 Or MenACWY IM	8	5	$499.00	$484.03	$57.95	$484.03	$374.75	2026-07-15
83519	CPT	Igf Binding Protein 1	8	5	$476.00	$461.72	$309.40	$461.72	$371.75	2026-07-15
92507	CPT	Speech Therapy Trmt	8	5	$471.00	$456.87	$306.15	$456.87	$367.85	2026-07-15
92522	CPT	Eval St Speech Production	8	5	$463.00	$449.11	$300.95	$449.11	$361.61	2026-07-15
74018	CPT	X-ray Abdomen	11	5	$422.00	$409.34	$274.30	$523.40	$359.97	2026-07-15
80143	CPT	Acetaminophen	8	5	$460.00	$446.20	$299.00	$446.20	$359.26	2026-07-15
92610	CPT	Swallow Eval Non Radiol	8	5	$459.00	$445.23	$298.35	$445.23	$358.48	2026-07-15
73090	CPT	X-ray Forearm 2 Views Lt	20	5	$480.00	$465.60	$282.72	$465.60	$350.40	2026-07-15
70100	CPT	X-ray Mandible < 4 Views	8	5	$457.00	$443.29	$102.20	$443.29	$343.21	2026-07-15
85305	CPT	Protein S Total	8	5	$437.00	$423.89	$284.05	$423.89	$341.30	2026-07-15
93798	CPT	Cardiac Rehab Ii Monitored	10	5	$448.00	$434.56	$291.20	$434.56	$339.07	2026-07-15
36430	CPT	Blood Administration	10	5	$451.00	$437.47	$293.15	$437.47	$338.70	2026-07-15
73120	CPT	X-ray Hand Rt	8	5	$451.00	$437.47	$198.99	$437.47	$338.70	2026-07-15
85302	CPT	Protein C Antigen	8	5	$433.00	$420.01	$281.45	$420.01	$338.17	2026-07-15
51700	CPT	Irrigation Bladder Simple	19	5	$345.00	$334.65	$224.25	$519.00	$337.35	2026-07-15
84402	CPT	Testosterone Fre Female/Child	10	5	$448.00	$434.56	$64.30	$434.56	$336.45	2026-07-15
86382	CPT	Rabies Ab Screen	8	5	$430.00	$417.10	$279.50	$417.10	$335.83	2026-07-15
99223	CPT	IP/Obs Initial High Comp	6	5	$620.00	$601.40	$270.04	$389.40	$334.66	2026-07-15
71271	CPT	Ldct For Lung Cancer Screen	12	5	$444.00	$430.68	$101.48	$430.68	$333.44	2026-07-15
86644	CPT	Cmv Antibody IgG	32	5	$423.50	$410.80	$181.35	$575.21	$330.62	2026-07-15
30903	CPT	Control Anterior Hemorrhage Lt	14	5	$496.00	$481.12	$149.60	$481.12	$326.12	2026-07-15
12041	CPT	Repair Lac Interm <2.5 Cm	14	5	$441.00	$427.77	$286.65	$427.77	$325.36	2026-07-15
80048	CPT	Basic Metabolic Panel	11	5	$381.00	$369.57	$247.65	$369.57	$324.99	2026-07-15
51705	CPT	Suprapubic Cath Change	8	5	$414.00	$401.58	$269.10	$401.58	$323.34	2026-07-15
99306	CPT	Nf Initial Visit High	6	5	$475.00	$460.75	$264.20	$387.63	$322.74	2026-07-15
85240	CPT	Factor 8	8	5	$412.00	$399.64	$267.80	$399.64	$321.77	2026-07-15
99205	CPT	New Patient Level 5 High Comp	6	5	$271.00	$262.87	$282.08	$382.02	$320.46	2026-07-15
86140	CPT	C-reactive Protein	12	5	$375.00	$363.75	$243.75	$363.75	$319.88	2026-07-15
88312	CPT	Special Stain Afb	16	5	$409.50	$397.22	$261.95	$403.52	$319.76	2026-07-15
82077	CPT	Alcohol/Ethanol Auto Analyzer	11	5	$414.00	$401.58	$269.10	$401.58	$319.61	2026-07-15
73020	CPT	X-ray Shoulder Lt	16	5	$425.00	$412.25	$187.95	$412.25	$319.18	2026-07-15
80069	CPT	Renal Function Panel	10	5	$425.00	$412.25	$276.25	$412.25	$319.18	2026-07-15
73100	CPT	X-ray Wrist 2 Views Lt	16	5	$425.00	$412.25	$66.51	$412.25	$319.18	2026-07-15
71120	CPT	X-ray Sternum 2 Views	8	5	$424.00	$411.28	$79.40	$411.28	$318.42	2026-07-15
87536	CPT	HIV 1 Na Quan	9	5	$403.00	$390.91	$261.95	$390.91	$318.37	2026-07-15
87517	CPT	Hep B Na Quan	8	5	$407.00	$394.79	$264.55	$394.79	$317.87	2026-07-15
99292	CPT	Critical Care Ea Addl 30 Min	14	5	$479.00	$464.63	$164.83	$464.63	$314.95	2026-07-15
J3489	HCPCS	Zoledron Ac/Man/H2O 5mg/100ml	8	5	$414.00	$402.39	$17.25	$402.39	$311.54	2026-07-15
87329	CPT	Giardia Antigen	11	5	$394.00	$382.18	$256.10	$382.18	$311.26	2026-07-15
73620	CPT	X-ray Foot 2 Views Lt	20	5	$425.00	$412.25	$85.00	$412.25	$310.25	2026-07-15
73600	CPT	X-ray Ankle 2 Views Rt	18	5	$425.00	$412.25	$86.75	$412.25	$310.25	2026-07-15
83993	CPT	Calprotectin	10	5	$413.00	$400.61	$268.45	$400.61	$310.16	2026-07-15
73501	CPT	X-ray Hip Uni 1 View Rt	8	5	$344.00	$333.68	$223.60	$711.09	$310.12	2026-07-15
27786	CPT	Fx Distal Fibula Lt	8	5	$396.00	$384.12	$257.40	$384.12	$309.27	2026-07-15
27530	CPT	Treat Knee Fracture Rt	8	5	$396.00	$384.12	$257.40	$384.12	$309.27	2026-07-15
27520	CPT	Treat Kneecap Fracture Lt	8	5	$396.00	$384.12	$257.40	$384.12	$309.27	2026-07-15
26750	CPT	Fx Distal Finger/Thumb Wo Man	8	5	$396.00	$384.12	$257.40	$384.12	$309.27	2026-07-15
24670	CPT	Fx Ulna Proximal Wo Man Lt	8	5	$396.00	$384.12	$257.40	$384.12	$309.27	2026-07-15
23500	CPT	Fx Clavicle Lt	8	5	$396.00	$384.12	$257.40	$384.12	$309.27	2026-07-15
25600	CPT	Fx Distal Radius Lt	18	5	$396.00	$384.12	$257.40	$384.12	$305.71	2026-07-15
G0480	HCPCS	Nicotine Cotinine	8	5	$391.00	$379.27	$254.15	$379.27	$305.37	2026-07-15
99235	CPT	Admit/Discharge Same Day Mod	6	5	$519.00	$503.43	$247.05	$334.65	$302.36	2026-07-15
G0438	HCPCS	Annual Wellness Visit Initial	6	5	$230.00	$223.10	$184.13	$358.02	$297.00	2026-07-15
82803	CPT	Blood Gas Wo Oximetry	10	5	$377.00	$365.69	$245.05	$377.00	$294.44	2026-07-15
26600	CPT	Fx Metacarpal	8	5	$377.00	$365.69	$245.05	$365.69	$294.44	2026-07-15
25660	CPT	Dislocate Radiocarpal W Man Lt	8	5	$377.00	$365.69	$245.05	$365.69	$294.44	2026-07-15
25650	CPT	Fx Ulnar Styloid Lt	8	5	$377.00	$365.69	$245.05	$365.69	$294.44	2026-07-15
25530	CPT	Fx Ulnar Shaft Wo Man Rt	8	5	$377.00	$365.69	$245.05	$365.69	$294.44	2026-07-15
24650	CPT	Fx Radial Head/Neck Wo Man Lt	16	5	$377.00	$365.69	$245.05	$365.69	$294.44	2026-07-15
24576	CPT	Fx Humeral Condylar Wo Man Rt	8	5	$377.00	$365.69	$245.05	$365.69	$294.44	2026-07-15
87529	CPT	Hsv DNA Amp Probe	8	5	$377.00	$365.69	$245.05	$365.69	$294.44	2026-07-15
86318	CPT	Infectious Mono Test	10	5	$392.00	$380.24	$254.80	$380.24	$294.39	2026-07-15
73660	CPT	X-ray Toe(s) 2 Views Lt	18	5	$403.00	$390.91	$66.51	$390.91	$294.19	2026-07-15
82670	CPT	Estradiol Total	11	5	$375.00	$363.75	$69.07	$363.75	$289.50	2026-07-15
84481	CPT	T3 Free	10	5	$385.00	$373.45	$85.73	$373.45	$289.13	2026-07-15
97166	CPT	Ot Eval Mod Complexity	10	5	$385.00	$373.45	$250.25	$373.45	$289.13	2026-07-15
97602	CPT	Debride Wound Non-selective	11	5	$364.00	$353.08	$236.60	$353.08	$287.56	2026-07-15
87425	CPT	Rotavirus	9	5	$364.00	$353.08	$236.60	$353.08	$287.56	2026-07-15
87493	CPT	C Diff By Pcr	10	5	$366.00	$355.02	$237.90	$355.02	$285.85	2026-07-15
11300	CPT	Shave Lesion <0.5 Trunk Limbs	14	5	$431.00	$418.07	$67.60	$418.07	$283.38	2026-07-15
84702	CPT	Hcg Beta Quan Serum	10	5	$377.00	$365.69	$51.31	$365.69	$283.12	2026-07-15
90632	CPT	Hepatitis A Vaccine Adult IM	10	5	$314.00	$304.58	$204.10	$345.69	$283.07	2026-07-15
84403	CPT	Testosterone Total Ref	11	5	$365.00	$354.05	$64.30	$354.05	$281.78	2026-07-15
97162	CPT	Pt Eval Mod Complexity	11	5	$358.00	$347.26	$208.05	$347.26	$276.38	2026-07-15
87476	CPT	Lyme Disease DNA Amp Probe	10	5	$368.00	$356.96	$127.80	$356.96	$276.37	2026-07-15
82378	CPT	Cea	8	5	$353.00	$342.41	$229.45	$342.41	$275.69	2026-07-15
51702	CPT	Cath Insert Simple Indwelling	21	5	$392.00	$380.24	$188.50	$380.24	$275.50	2026-07-15
82384	CPT	Catecholamines Fract	10	5	$365.00	$354.05	$63.50	$354.05	$274.12	2026-07-15
12013	CPT	Repair Lac Simple 2.6-5.0 Cm	22	5	$375.00	$363.75	$109.90	$363.75	$273.75	2026-07-15
12011	CPT	Repair Lac Simple <2.5 Cm	17	5	$375.00	$363.75	$107.01	$363.75	$273.75	2026-07-15
11104	CPT	Punch Biopsy 1st Lesion	14	5	$416.00	$403.52	$92.98	$403.52	$273.52	2026-07-15
11102	CPT	Tangential Biopsy 1st Lesion	16	5	$416.00	$403.52	$45.00	$403.52	$273.52	2026-07-15
85306	CPT	Protein S Functional	8	5	$347.00	$336.59	$225.55	$336.59	$271.00	2026-07-15
82166	CPT	Mullerian Inhib Hormone	10	5	$359.00	$348.23	$130.19	$348.23	$269.61	2026-07-15
96367	CPT	Inf Therapy Med Sequential	21	5	$329.00	$319.13	$98.04	$355.02	$267.18	2026-07-15
87807	CPT	Rsv	8	5	$342.00	$331.74	$222.30	$331.74	$267.10	2026-07-15
99310	CPT	Nf Visit High	6	5	$390.00	$378.30	$223.80	$327.84	$266.75	2026-07-15
82746	CPT	Folic Acid Blood	10	5	$355.00	$344.35	$43.86	$344.35	$266.61	2026-07-15
73140	CPT	X-ray Finger(s) Lt	20	5	$365.00	$354.05	$64.68	$354.05	$266.45	2026-07-15
86334	CPT	Immunofix Electroph Serum	10	5	$341.00	$330.77	$221.65	$330.77	$266.32	2026-07-15
86592	CPT	Rpr	8	5	$341.00	$330.77	$221.65	$330.77	$266.32	2026-07-15
87177	CPT	Ova And Parasites Smears	10	5	$338.00	$327.86	$219.70	$327.86	$263.98	2026-07-15
J1956	HCPCS	Levofloxac/D5W 500mg/100ml Bag	17	5	$368.00	$357.83	$2.07	$357.83	$263.73	2026-07-15
86922	CPT	Crossmatch Ahg	11	5	$333.00	$323.01	$216.45	$323.01	$263.07	2026-07-15
J2305	HCPCS	Nitroglycer/D5W 50mg/250ml Bot	8	5	$349.00	$339.28	$3.20	$339.28	$262.68	2026-07-15
12002	CPT	Repair Lac Simple 2.6-7.5 Cm	16	5	$375.00	$363.75	$112.84	$363.75	$261.56	2026-07-15

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