Hospital

MC CAMEY HOSPITAL

Mccamey, TX · CCN 451309 · Rates published

3,139 distinct procedures filed

14 distinct payers

63,830 rate rows

2026-03-24 last MRF observed

Data quality

63,830 of 63,830 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

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

Source MRF file	https://secure.claraprice.net/price-transparency/IWPW-1774366795883/machine-readable/751246166_mccamey-county-hospital-district_standardcharges.json
Found on page	https://secure.claraprice.net/price-transparency/mccamey-county-hospital-district-tx
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-08-01
Content fingerprint	5548cbc826eda1fe… · 154,979 bytes · first seen 2026-05-19

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
37862 CPT	Danazol 200 Mg Cap	14	$4,353.00	$7,255.00	$6,384.50	nat. median $8 outlier · 798.1×
74178 CPT	CT Abd/pelvis Wo/w C	14	$2,520.00	$4,200.00	$3,696.00	nat. median $1,024 outlier · 3.6×
81162 CPT	Brca1 & Brca2,compre	14	$2,340.00	$3,900.00	$3,432.00	nat. median $1,840 1.9× median
70470 CPT	CT Brain Wo/w Contra	14	$2,257.00	$3,881.00	$3,362.00	nat. median $634 outlier · 5.3×
4900018 CDM	Mattress/ Air Pressu	14	$2,222.00	$3,703.00	$3,259.00	nat. median $3,259 1.0× median
74177 CPT	CT Scan Of Abdomen And Pelvis With Contrast	14	$2,160.00	$3,600.00	$3,168.00	nat. median $968 outlier · 3.3×
27240 CPT	Cl Trmt Thigh Fx/man	14	$1,909.00	$3,182.00	$2,800.50	nat. median $2,194 1.3× median
71270 CPT	CT Chest Wo/w Contra	14	$1,901.00	$3,168.00	$2,787.50	nat. median $681 outlier · 4.1×
72194 CPT	CT Pelvis Wo/w Contr	14	$1,892.00	$3,153.00	$2,775.00	nat. median $675 outlier · 4.1×
74176 CPT	CT Abd/pelvis W/ou C	14	$1,800.00	$3,000.00	$2,640.00	nat. median $697 outlier · 3.8×
86711 CPT	Stratify Jcv Antibod	14	$1,657.00	$2,762.00	$2,430.50	nat. median $29 outlier · 82.7×
73200 CPT	CT Forearm Lt W/out	14	$1,069.00	$2,871.00	$2,417.50	nat. median $533 outlier · 4.5×
70491 CPT	CT Neck Sft Tis W/co	14	$1,485.00	$3,267.00	$2,378.50	nat. median $635 outlier · 3.7×
25152 CPT	Crixivan 400 Mg	14	$7.00	$7,675.00	$2,308.50	nat. median $11 outlier · 209.9×
72127 CPT	CT Neck Spine Wo & W	14	$1,560.00	$2,600.00	$2,288.00	nat. median $616 outlier · 3.7×
70471 CPT	CTA Head And Neck	14	$1,544.00	$2,574.00	$2,265.50	nat. median $715 outlier · 3.2×
72126 CPT	CT Spine Cerv W/cont	14	$1,500.00	$2,500.00	$2,200.00	nat. median $760 outlier · 2.9×
25605 CPT	Trtm Fract Rad/ulna	14	$1,479.00	$2,465.00	$2,169.50	nat. median $1,654 1.3× median
72125 CPT	CT Spine Cerv W/out	14	$1,470.00	$2,450.00	$2,156.00	nat. median $483 outlier · 4.5×
86353 CPT	M/a Ind Lymphc Panel	14	$1,447.00	$2,411.00	$2,121.50	nat. median $131 outlier · 16.2×
72130 CPT	CT Chst Spine Wo & W	14	$1,440.00	$2,400.00	$2,112.00	nat. median $606 outlier · 3.5×
4402158 CDM	Elimite 5% Cream	14	$1,440.00	$2,400.00	$2,112.00	nat. median $23 outlier · 91.5×
72129 CPT	CT Thoracic Spne W/c	14	$1,380.00	$2,300.00	$2,024.00	nat. median $590 outlier · 3.4×
73201 CPT	CT Forearm Lt W/cont	14	$1,188.00	$2,900.00	$2,008.00	nat. median $812 outlier · 2.5×
72132 CPT	CT Lumbar Spne W/con	14	$1,366.00	$2,277.00	$2,003.50	nat. median $780 outlier · 2.6×
72128 CPT	CT Thoracic Spne Without	14	$1,366.00	$2,277.00	$2,003.50	nat. median $463 outlier · 4.3×
72192 CPT	CT Pelvis W/out Cont	14	$1,307.00	$2,178.00	$1,916.50	nat. median $467 outlier · 4.1×
70487 CPT	CT Facial Bones W/co	14	$1,188.00	$2,500.00	$1,871.00	nat. median $615 outlier · 3.0×
74170 CPT	CT Abdomen Wo/w Cont	14	$1,260.00	$2,100.00	$1,848.00	nat. median $720 outlier · 2.6×
72131 CPT	CT Lumbar Spne W/out	14	$1,247.00	$2,079.00	$1,829.50	nat. median $457 outlier · 4.0×
73701 CPT	CT Ankle Lt W/contra	14	$1,188.00	$2,231.00	$1,783.50	nat. median $693 outlier · 2.6×
4400103 CDM	Augmentin 125mg/75cc	14	$1,202.00	$2,004.00	$1,763.50	nat. median $23 outlier · 75.5×
87633 CPT	Rp Panel	14	$1,200.00	$2,000.00	$1,760.00	nat. median $539 outlier · 3.3×
17224 CPT	Critical Care 30-74	14	$1,194.00	$1,990.00	$1,751.00	nat. median $855 outlier · 2.0×
70481 CPT	CT Mastoid W/contras	14	$1,188.00	$1,980.00	$1,742.50	nat. median $638 outlier · 2.7×
75572 CPT	CT Heart W/contrast	14	$1,188.00	$1,980.00	$1,742.50	nat. median $490 outlier · 3.6×
72193 CPT	CT Scan Of Pelvis With Contrast	14	$1,188.00	$1,980.00	$1,742.50	nat. median $637 outlier · 2.7×
70460 CPT	CT Brain W/contrast	14	$1,188.00	$1,980.00	$1,742.50	nat. median $586 outlier · 3.0×
74160 CPT	CT Abdomen W/contras	14	$1,188.00	$1,980.00	$1,742.50	nat. median $655 outlier · 2.7×
85056 CPT	Cyanokit 1000mcg	14	$1,176.00	$1,960.00	$1,725.00	nat. median $36 outlier · 47.9×
J0840 HCPCS	Crofab IV	14	$1,168.00	$1,947.00	$1,713.00	nat. median $3,427 outlier · 0.5×
70486 CPT	CT Facial Bones W/ou	14	$1,069.00	$2,450.00	$1,693.00	nat. median $480 outlier · 3.5×
93306 CPT	US Echo Tte Complete	14	$1,106.00	$1,844.00	$1,623.00	nat. median $994 1.6× median
70480 CPT	CT Mastoid W/out Con	14	$1,069.00	$1,782.00	$1,568.50	nat. median $484 outlier · 3.2×
74150 CPT	CT Abdomen W/out Con	14	$1,069.00	$1,782.00	$1,568.50	nat. median $448 outlier · 3.5×
75571 CPT	CT Heart W/out Contr	14	$1,069.00	$1,782.00	$1,568.50	nat. median $121 outlier · 13.0×
71260 CPT	CT Chest W/contrast	14	$1,020.00	$1,980.00	$1,557.00	nat. median $650 outlier · 2.4×
70450 CPT	CT Scan	14	$1,020.00	$1,964.00	$1,550.50	nat. median $456 outlier · 3.4×
70490 CPT	CT Neck Sft Tis Without	14	$1,010.00	$1,782.00	$1,515.00	nat. median $455 outlier · 3.3×
59409 CPT	Vaginal Delivery	14	$1,016.00	$1,693.00	$1,490.00	nat. median $3,157 outlier · 0.5×

Other procedures at this hospital

Browse this hospital's 3,139 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

37862	CPT	Danazol 200 Mg Cap	18	14	$7,255.00	$7,255.00	$4,353.00	$7,255.00	$6,384.50	2026-03-24
74178	CPT	CT Abd/pelvis Wo/w C	18	14	$4,200.00	$4,200.00	$2,520.00	$4,200.00	$3,696.00	2026-03-24
81162	CPT	Brca1 & Brca2,compre	18	14	$3,900.00	$3,900.00	$2,340.00	$3,900.00	$3,432.00	2026-03-24
70470	CPT	CT Brain Wo/w Contra	36	14	$3,821.50	$3,821.50	$2,257.00	$3,881.00	$3,362.00	2026-03-24
4900018	CDM	Mattress/ Air Pressu	18	14	$3,703.00	$3,703.00	$2,222.00	$3,703.00	$3,259.00	2026-03-24
74177	CPT	CT Scan Of Abdomen And Pelvis With Contrast	18	14	$3,600.00	$3,600.00	$2,160.00	$3,600.00	$3,168.00	2026-03-24
27240	CPT	Cl Trmt Thigh Fx/man	18	14	$3,182.00	$3,182.00	$1,909.00	$3,182.00	$2,800.50	2026-03-24
71270	CPT	CT Chest Wo/w Contra	18	14	$3,168.00	$3,168.00	$1,901.00	$3,168.00	$2,787.50	2026-03-24
72194	CPT	CT Pelvis Wo/w Contr	18	14	$3,153.00	$3,153.00	$1,892.00	$3,153.00	$2,775.00	2026-03-24
74176	CPT	CT Abd/pelvis W/ou C	18	14	$3,000.00	$3,000.00	$1,800.00	$3,000.00	$2,640.00	2026-03-24
86711	CPT	Stratify Jcv Antibod	18	14	$2,762.00	$2,762.00	$1,657.00	$2,762.00	$2,430.50	2026-03-24
73200	CPT	CT Forearm Lt W/out	72	14	$2,844.00	$2,844.00	$1,069.00	$2,871.00	$2,417.50	2026-03-24
70491	CPT	CT Neck Sft Tis W/co	36	14	$2,871.00	$2,871.00	$1,485.00	$3,267.00	$2,378.50	2026-03-24
25152	CPT	Crixivan 400 Mg	36	14	$3,843.50	$3,843.50	$7.00	$7,675.00	$2,308.50	2026-03-24
72127	CPT	CT Neck Spine Wo & W	18	14	$2,600.00	$2,600.00	$1,560.00	$2,600.00	$2,288.00	2026-03-24
70471	CPT	CTA Head And Neck	18	14	$2,574.00	$2,574.00	$1,544.00	$2,574.00	$2,265.50	2026-03-24
72126	CPT	CT Spine Cerv W/cont	18	14	$2,500.00	$2,500.00	$1,500.00	$2,500.00	$2,200.00	2026-03-24
25605	CPT	Trtm Fract Rad/ulna	18	14	$2,465.00	$2,465.00	$1,479.00	$2,465.00	$2,169.50	2026-03-24
72125	CPT	CT Spine Cerv W/out	18	14	$2,450.00	$2,450.00	$1,470.00	$2,450.00	$2,156.00	2026-03-24
86353	CPT	M/a Ind Lymphc Panel	18	14	$2,411.00	$2,411.00	$1,447.00	$2,411.00	$2,121.50	2026-03-24
4402158	CDM	Elimite 5% Cream	18	14	$2,400.00	$2,400.00	$1,440.00	$2,400.00	$2,112.00	2026-03-24
72130	CPT	CT Chst Spine Wo & W	18	14	$2,400.00	$2,400.00	$1,440.00	$2,400.00	$2,112.00	2026-03-24
72129	CPT	CT Thoracic Spne W/c	18	14	$2,300.00	$2,300.00	$1,380.00	$2,300.00	$2,024.00	2026-03-24
73201	CPT	CT Forearm Lt W/cont	72	14	$2,551.00	$2,551.00	$1,188.00	$2,900.00	$2,008.00	2026-03-24
72132	CPT	CT Lumbar Spne W/con	18	14	$2,277.00	$2,277.00	$1,366.00	$2,277.00	$2,003.50	2026-03-24
72128	CPT	CT Thoracic Spne Without	18	14	$2,277.00	$2,277.00	$1,366.00	$2,277.00	$2,003.50	2026-03-24
72192	CPT	CT Pelvis W/out Cont	18	14	$2,178.00	$2,178.00	$1,307.00	$2,178.00	$1,916.50	2026-03-24
70487	CPT	CT Facial Bones W/co	36	14	$2,240.00	$2,240.00	$1,188.00	$2,500.00	$1,871.00	2026-03-24
74170	CPT	CT Abdomen Wo/w Cont	18	14	$2,100.00	$2,100.00	$1,260.00	$2,100.00	$1,848.00	2026-03-24
72131	CPT	CT Lumbar Spne W/out	18	14	$2,079.00	$2,079.00	$1,247.00	$2,079.00	$1,829.50	2026-03-24
73701	CPT	CT Ankle Lt W/contra	36	14	$2,105.50	$2,105.50	$1,188.00	$2,231.00	$1,783.50	2026-03-24
4400103	CDM	Augmentin 125mg/75cc	18	14	$2,004.00	$2,004.00	$1,202.00	$2,004.00	$1,763.50	2026-03-24
87633	CPT	Rp Panel	18	14	$2,000.00	$2,000.00	$1,200.00	$2,000.00	$1,760.00	2026-03-24
17224	CPT	Critical Care 30-74	18	14	$1,990.00	$1,990.00	$1,194.00	$1,990.00	$1,751.00	2026-03-24
75572	CPT	CT Heart W/contrast	18	14	$1,980.00	$1,980.00	$1,188.00	$1,980.00	$1,742.50	2026-03-24
72193	CPT	CT Scan Of Pelvis With Contrast	18	14	$1,980.00	$1,980.00	$1,188.00	$1,980.00	$1,742.50	2026-03-24
70481	CPT	CT Mastoid W/contras	18	14	$1,980.00	$1,980.00	$1,188.00	$1,980.00	$1,742.50	2026-03-24
70460	CPT	CT Brain W/contrast	18	14	$1,980.00	$1,980.00	$1,188.00	$1,980.00	$1,742.50	2026-03-24
74160	CPT	CT Abdomen W/contras	18	14	$1,980.00	$1,980.00	$1,188.00	$1,980.00	$1,742.50	2026-03-24
85056	CPT	Cyanokit 1000mcg	18	14	$1,960.00	$1,960.00	$1,176.00	$1,960.00	$1,725.00	2026-03-24
J0840	HCPCS	Crofab IV	18	14	$1,947.00	$1,947.00	$1,168.00	$1,947.00	$1,713.00	2026-03-24
70486	CPT	CT Facial Bones W/ou	54	14	$1,881.00	$1,881.00	$1,069.00	$2,450.00	$1,693.00	2026-03-24
93306	CPT	US Echo Tte Complete	18	14	$1,844.00	$1,844.00	$1,106.00	$1,844.00	$1,623.00	2026-03-24
75571	CPT	CT Heart W/out Contr	18	14	$1,782.00	$1,782.00	$1,069.00	$1,782.00	$1,568.50	2026-03-24
74150	CPT	CT Abdomen W/out Con	18	14	$1,782.00	$1,782.00	$1,069.00	$1,782.00	$1,568.50	2026-03-24
70480	CPT	CT Mastoid W/out Con	18	14	$1,782.00	$1,782.00	$1,069.00	$1,782.00	$1,568.50	2026-03-24
71260	CPT	CT Chest W/contrast	36	14	$1,840.00	$1,840.00	$1,020.00	$1,980.00	$1,557.00	2026-03-24
70450	CPT	CT Scan	36	14	$1,832.00	$1,832.00	$1,020.00	$1,964.00	$1,550.50	2026-03-24
70490	CPT	CT Neck Sft Tis Without	36	14	$1,732.50	$1,732.50	$1,010.00	$1,782.00	$1,515.00	2026-03-24
59409	CPT	Vaginal Delivery	18	14	$1,693.00	$1,693.00	$1,016.00	$1,693.00	$1,490.00	2026-03-24
24505	CPT	Humerus Trmt W/mani	18	14	$1,664.00	$1,664.00	$998.00	$1,664.00	$1,464.50	2026-03-24
93970	CPT	US Venous Extrem;bil	18	14	$1,655.00	$1,655.00	$993.00	$1,655.00	$1,456.50	2026-03-24
73700	CPT	CT Ankle Lt W/out Co	72	14	$1,615.50	$1,615.50	$891.00	$1,750.00	$1,393.00	2026-03-24
27810	CPT	Cl Trmt Ankle Fx/man	18	14	$1,544.00	$1,544.00	$926.00	$1,544.00	$1,359.00	2026-03-24
71250	CPT	CT Chest W/out Contr	36	14	$1,591.00	$1,591.00	$840.00	$1,782.00	$1,323.00	2026-03-24
87507	CPT	Gi Panel	18	14	$1,500.00	$1,500.00	$900.00	$1,500.00	$1,320.00	2026-03-24
93925	CPT	US Arteri Lo Extr;bi	18	14	$1,453.00	$1,453.00	$872.00	$1,453.00	$1,279.00	2026-03-24
60573	CPT	Effexor 150 Mg Caps	36	14	$2,094.00	$2,094.00	$11.00	$4,170.00	$1,260.00	2026-03-24
87902	CPT	Hepatitis C Virl RNA	18	14	$1,418.00	$1,418.00	$851.00	$1,418.00	$1,247.50	2026-03-24
93117	CPT	Remdesivir Inj 100mg	18	14	$1,400.00	$1,400.00	$840.00	$1,400.00	$1,232.00	2026-03-24
J2430	HCPCS	Pamidronate 90mg Inj	18	14	$1,375.00	$1,375.00	$825.00	$1,375.00	$1,210.50	2026-03-24
4402080	CDM	Tarceva 150 Mg Tabs	18	14	$1,352.00	$1,352.00	$811.00	$1,352.00	$1,190.00	2026-03-24
93930	CPT	US Arteri Up Extr;bi	18	14	$1,310.00	$1,310.00	$786.00	$1,310.00	$1,153.00	2026-03-24
70498	CPT	CT Angiography Neck	18	14	$1,287.00	$1,287.00	$772.00	$1,287.00	$1,132.50	2026-03-24
70496	CPT	CT Angiography Head	18	14	$1,287.00	$1,287.00	$772.00	$1,287.00	$1,132.50	2026-03-24
93976	CPT	US Arteria Dup;limit	18	14	$1,281.00	$1,281.00	$769.00	$1,281.00	$1,127.50	2026-03-24
90416	CPT	Dislocated Finger	36	14	$1,653.50	$1,653.50	$362.00	$2,703.00	$1,113.00	2026-03-24
4402388	CDM	Benlysta 120mg	18	14	$1,225.00	$1,225.00	$735.00	$1,225.00	$1,078.50	2026-03-24
93931	CPT	US Arter Up Ext Lt;u	18	14	$1,222.00	$1,222.00	$733.00	$1,222.00	$1,075.50	2026-03-24
93975	CPT	US Arter/ven;complet	18	14	$1,205.00	$1,205.00	$723.00	$1,205.00	$1,060.50	2026-03-24
93433	CPT	Clsd Trmt Radius Fx	18	14	$1,205.00	$1,205.00	$723.00	$1,205.00	$1,060.50	2026-03-24
4600152	CDM	ER Level 4	18	14	$1,200.00	$1,200.00	$720.00	$1,200.00	$1,056.00	2026-03-24
65074	CPT	Critical Care 165-19	18	14	$1,174.00	$1,174.00	$704.00	$1,174.00	$1,033.50	2026-03-24
4600181	CDM	Critical Care 135-16	18	14	$1,174.00	$1,174.00	$704.00	$1,174.00	$1,033.50	2026-03-24
44085	CPT	ER High Severity	18	14	$1,167.00	$1,167.00	$700.00	$1,167.00	$1,027.00	2026-03-24
81402	CPT	21 Hydroxyl Def Proc	18	14	$1,131.00	$1,131.00	$679.00	$1,131.00	$995.50	2026-03-24
87910	CPT	Cytomegalovirus Geno	18	14	$1,124.00	$1,124.00	$674.00	$1,124.00	$989.50	2026-03-24
40652	CPT	Repair Lip Half Vert	18	14	$1,108.00	$1,108.00	$665.00	$1,108.00	$975.00	2026-03-24
81220	CPT	Cystic Fibrosis Scrn	18	14	$1,093.00	$1,093.00	$656.00	$1,093.00	$962.00	2026-03-24
3100249	CDM	Priv Rm W/telemetry	18	14	$1,082.00	$1,082.00	$649.00	$1,082.00	$952.50	2026-03-24
93225	CPT	Holter Monitor Hooku	18	14	$1,076.00	$1,076.00	$646.00	$1,076.00	$946.50	2026-03-24
4600069	CDM	I&d Finger Abscess C	18	14	$1,073.00	$1,073.00	$644.00	$1,073.00	$944.50	2026-03-24
40650	CPT	Repair Lip Vermillio	18	14	$1,063.00	$1,063.00	$638.00	$1,063.00	$935.50	2026-03-24
76801	CPT	US Ob<14 Wks;1 Fetus	18	14	$1,011.00	$1,011.00	$607.00	$1,011.00	$889.50	2026-03-24
12037	CPT	Repair Interm Over 3	18	14	$1,010.00	$1,010.00	$606.00	$1,010.00	$889.00	2026-03-24
44010	CPT	Repair Interm Over 3	18	14	$1,010.00	$1,010.00	$606.00	$1,010.00	$889.00	2026-03-24
26725	CPT	Cl Trt Phalan Fx W/m	18	14	$1,003.00	$1,003.00	$602.00	$1,003.00	$883.00	2026-03-24
40018	CPT	ER Level 3	18	14	$1,000.00	$1,000.00	$600.00	$1,000.00	$880.00	2026-03-24
55500	CPT	Currettage Postpartu	18	14	$1,000.00	$1,000.00	$600.00	$1,000.00	$880.00	2026-03-24
4600492	CDM	Cl Trmt Humerus Fx	18	14	$997.00	$997.00	$598.00	$997.00	$877.00	2026-03-24
23655	CPT	Shoulder Discloc W/a	18	14	$981.00	$981.00	$589.00	$981.00	$863.50	2026-03-24
59122	CPT	Cv Cath Insertion	18	14	$967.00	$967.00	$580.00	$967.00	$851.00	2026-03-24
J7307	HCPCS	Nexplanon Implant	18	14	$964.00	$964.00	$578.00	$964.00	$848.50	2026-03-24
76817	CPT	US Transvaginal Obst	18	14	$964.00	$964.00	$578.00	$964.00	$848.50	2026-03-24
76881	CPT	US Extr Nonvasc;comp	18	14	$963.00	$963.00	$578.00	$963.00	$847.50	2026-03-24
4402018	CDM	Benzaclin Gel	18	14	$960.00	$960.00	$576.00	$960.00	$845.00	2026-03-24
25500	CPT	Trtmt Radial Fractur	18	14	$958.00	$958.00	$575.00	$958.00	$843.00	2026-03-24
69313	CPT	Removal Fb Foot Comp	18	14	$948.00	$948.00	$569.00	$948.00	$834.00	2026-03-24
81335	CPT	Tpmt Gene Com Varian	18	14	$945.00	$945.00	$567.00	$945.00	$832.00	2026-03-24
93926	CPT	US Arter Lo Ext Lt;u	36	14	$1,016.50	$1,016.50	$502.00	$1,196.00	$829.00	2026-03-24
3250266	CDM	Swb Priv Rm W/teleme	18	14	$936.00	$936.00	$562.00	$936.00	$823.50	2026-03-24
93880	CPT	US Carotid Dup;bilat	18	14	$916.00	$916.00	$550.00	$916.00	$806.00	2026-03-24
76856	CPT	US Pelv Non Ob;compl	18	14	$910.00	$910.00	$546.00	$910.00	$801.00	2026-03-24
4600132	CDM	Inc & Drain Pilo Cys	18	14	$878.00	$878.00	$527.00	$878.00	$772.50	2026-03-24
55505	CPT	Pneumococcal 13	18	14	$864.00	$864.00	$518.00	$864.00	$760.50	2026-03-24
4400942	CDM	Isuprel 0.2mg/ml Inh	18	14	$859.00	$859.00	$515.00	$859.00	$756.00	2026-03-24
3950003	CDM	Private Room-hosp	18	14	$850.00	$850.00	$510.00	$850.00	$748.00	2026-03-24
4600174	CDM	Cpr Resusitation	18	14	$841.00	$841.00	$505.00	$841.00	$740.00	2026-03-24
4400107	CDM	Ceclor 250 Mg Susp	18	14	$840.00	$840.00	$504.00	$840.00	$739.00	2026-03-24
4400394	CDM	Ceclor Susp. 125mg/5	18	14	$840.00	$840.00	$504.00	$840.00	$739.00	2026-03-24
29445	CPT	Apply Rigid Leg Cast	18	14	$839.00	$839.00	$503.00	$839.00	$738.50	2026-03-24
69306	CPT	Removal Fb Foot Deep	18	14	$836.00	$836.00	$502.00	$836.00	$735.50	2026-03-24
4600430	CDM	Picc 5yr+ Without Imagin	18	14	$826.00	$826.00	$496.00	$826.00	$726.50	2026-03-24
4401031	CDM	Byetta 5mcg1.2ml Pen	18	14	$822.00	$822.00	$493.00	$822.00	$723.50	2026-03-24
4600306	CDM	Fngr Dislocat W/anet	18	14	$817.00	$817.00	$490.00	$817.00	$719.00	2026-03-24
49082	CPT	Peritonecenteses, Ab	18	14	$811.00	$811.00	$487.00	$811.00	$713.50	2026-03-24
45020	CPT	Repair Simple Over 3	18	14	$808.00	$808.00	$485.00	$808.00	$711.00	2026-03-24
76830	CPT	Ultrasound Pelvis Through Vagina	18	14	$803.00	$803.00	$482.00	$803.00	$707.00	2026-03-24
76705	CPT	US Abdominal;limited	54	14	$829.00	$829.00	$449.00	$856.00	$705.00	2026-03-24
40950	CPT	Car/metcrp Fx W/mani	18	14	$801.00	$801.00	$481.00	$801.00	$705.00	2026-03-24
12002	CPT	Repair Simple 2.6 -	18	14	$800.00	$800.00	$480.00	$800.00	$704.00	2026-03-24
4402303	CDM	Valproic Acid	18	14	$794.00	$794.00	$476.00	$794.00	$699.00	2026-03-24
18572	CPT	Removal Fb Foot	18	14	$792.00	$792.00	$475.00	$792.00	$697.00	2026-03-24
26010	CPT	I&d Finger Abscess S	18	14	$784.00	$784.00	$470.00	$784.00	$690.00	2026-03-24
4600041	CDM	Repair Interim 12.6-	18	14	$783.00	$783.00	$470.00	$783.00	$689.00	2026-03-24
23505	CPT	Clavical Fx W/manip	18	14	$777.00	$777.00	$466.00	$777.00	$683.50	2026-03-24
33804	CPT	Trtmt Ulna Fracture	18	14	$777.00	$777.00	$466.00	$777.00	$683.50	2026-03-24
76700	CPT	Ultrasound Of Abdomen	18	14	$777.00	$777.00	$466.00	$777.00	$683.50	2026-03-24
4600464	CDM	Cl Trmt Humer Fx Without	18	14	$770.00	$770.00	$462.00	$770.00	$677.50	2026-03-24
4600116	CDM	Repair Lip Over	18	14	$769.00	$769.00	$461.00	$769.00	$676.50	2026-03-24
4402196	CDM	Gardasil (Hpv) Inj	18	14	$768.00	$768.00	$461.00	$768.00	$675.50	2026-03-24
4402434	CDM	Gardasil (Hpv) Inj	18	14	$768.00	$768.00	$461.00	$768.00	$675.50	2026-03-24
4600071	CDM	Metacarpal W/manip	18	14	$766.00	$766.00	$460.00	$766.00	$674.00	2026-03-24
27750	CPT	Tr Tibia Fx Without Mani	18	14	$766.00	$766.00	$460.00	$766.00	$674.00	2026-03-24
23650	CPT	Shoulder Dislocation	18	14	$766.00	$766.00	$460.00	$766.00	$674.00	2026-03-24
76770	CPT	US Aorta;complete	36	14	$792.00	$792.00	$437.00	$856.00	$670.00	2026-03-24
4600051	CDM	Repair Complex 2.6-7	18	14	$758.00	$758.00	$455.00	$758.00	$667.00	2026-03-24
13121	CPT	Repair Complex 2.6-7	18	14	$758.00	$758.00	$455.00	$758.00	$667.00	2026-03-24
49491	CPT	Repair Complex 2.6-7	18	14	$758.00	$758.00	$455.00	$758.00	$667.00	2026-03-24
13101	CPT	Rpr Complx Trnk 2.6-	18	14	$758.00	$758.00	$455.00	$758.00	$667.00	2026-03-24
P9016	HCPCS	Red Blood Cells	18	14	$755.00	$755.00	$453.00	$755.00	$664.50	2026-03-24
99236	CPT	Obs E/m Same Day 85	18	14	$755.00	$755.00	$453.00	$755.00	$664.50	2026-03-24
76604	CPT	US Bck Up Sft/chst;l	18	14	$749.00	$749.00	$449.00	$749.00	$659.00	2026-03-24
G0410	HCPCS	Psytx,group Iop	18	14	$737.00	$737.00	$442.00	$737.00	$648.50	2026-03-24
90853	CPT	Group Psychotherapy	18	14	$737.00	$737.00	$442.00	$737.00	$648.50	2026-03-24
90837	CPT	Psychotherapy, 60 Min	18	14	$737.00	$737.00	$442.00	$737.00	$648.50	2026-03-24
C7903	HCPCS	Psytx,remote Grp Iop	18	14	$737.00	$737.00	$442.00	$737.00	$648.50	2026-03-24
88235	CPT	Culture Setup Blood	18	14	$732.00	$732.00	$439.00	$732.00	$644.50	2026-03-24
12054	CPT	Repair Interim 7.6-1	18	14	$732.00	$732.00	$439.00	$732.00	$644.50	2026-03-24
10061	CPT	Inc & Drain-complica	18	14	$725.00	$725.00	$435.00	$725.00	$638.50	2026-03-24
33800	CPT	4600057	180	14	$746.00	$746.00	$26.00	$1,651.00	$638.00	2026-03-24
70220	CPT	Xray Sinuses Complet	18	14	$721.00	$721.00	$433.00	$721.00	$634.50	2026-03-24
4402563	CDM	Rabies Vaccine 1ml	18	14	$709.00	$709.00	$425.00	$709.00	$624.00	2026-03-24
76805	CPT	Abdomial Ultrasound Of Pregnant Uterus	18	14	$708.00	$708.00	$425.00	$708.00	$623.00	2026-03-24
4600043	CDM	Repair Complex 1.1-2	18	14	$707.00	$707.00	$424.00	$707.00	$622.00	2026-03-24
4600047	CDM	Repair Complex 1.1-2	18	14	$707.00	$707.00	$424.00	$707.00	$622.00	2026-03-24
31500	CPT	Intubation,endotrach	18	14	$707.00	$707.00	$424.00	$707.00	$622.00	2026-03-24
13151	CPT	Repair Complex 1.1-2	18	14	$707.00	$707.00	$424.00	$707.00	$622.00	2026-03-24
13120	CPT	Rpr Cmplx 1.1-2.5	18	14	$707.00	$707.00	$424.00	$707.00	$622.00	2026-03-24
4530000	CDM	Intubation	18	14	$707.00	$707.00	$424.00	$707.00	$622.00	2026-03-24
65235	CPT	Remove Foreign Body	18	14	$690.00	$690.00	$414.00	$690.00	$607.00	2026-03-24
90847	CPT	Family Psychotherapy, Including Patient, 50 Min	18	14	$687.00	$687.00	$412.00	$687.00	$604.50	2026-03-24
99223	CPT	Obs Init/day High 75	18	14	$687.00	$687.00	$412.00	$687.00	$604.50	2026-03-24
76819	CPT	Feta Bio Pro Without Nst	18	14	$684.00	$684.00	$410.00	$684.00	$602.00	2026-03-24
12053	CPT	Repair Interim 5.1 -	18	14	$682.00	$682.00	$409.00	$682.00	$600.50	2026-03-24
86480	CPT	TB Gold	18	14	$681.00	$681.00	$409.00	$681.00	$599.50	2026-03-24
87799	CPT	Parvovirus Big DNA	18	14	$674.00	$674.00	$404.00	$674.00	$593.50	2026-03-24
4400589	CDM	Glucagon Per 1 Mg	18	14	$674.00	$674.00	$404.00	$674.00	$593.50	2026-03-24
76870	CPT	US Testicular Scrota	18	14	$669.00	$669.00	$401.00	$669.00	$588.50	2026-03-24
27760	CPT	Med Mallel Without Manip	18	14	$660.00	$660.00	$396.00	$660.00	$581.00	2026-03-24
4600035	CDM	Repair Interim 20.1-	18	14	$657.00	$657.00	$394.00	$657.00	$578.00	2026-03-24
12006	CPT	Repair Simple 20.1 -	18	14	$657.00	$657.00	$394.00	$657.00	$578.00	2026-03-24
12036	CPT	Repair Interim 20.1-	18	14	$657.00	$657.00	$394.00	$657.00	$578.00	2026-03-24
12017	CPT	Repair Simple 20.1-3	18	14	$657.00	$657.00	$394.00	$657.00	$578.00	2026-03-24
4400234	CDM	Atrovent Inhaler	18	14	$647.00	$647.00	$388.00	$647.00	$569.00	2026-03-24
90846	CPT	Family Psychotherapy, Not Including Patient, 50 Min	18	14	$646.00	$646.00	$388.00	$646.00	$568.50	2026-03-24
40604	CPT	Metatarsall Without Mani	36	14	$778.50	$778.50	$302.00	$1,054.00	$567.50	2026-03-24
49083	CPT	Abd Paracente W/imag	18	14	$638.00	$638.00	$383.00	$638.00	$561.50	2026-03-24
57472	CPT	Gastrostomy T Replce	18	14	$632.00	$632.00	$379.00	$632.00	$556.50	2026-03-24
4600038	CDM	Repair Interim 2.6 -	18	14	$631.00	$631.00	$379.00	$631.00	$555.50	2026-03-24
76536	CPT	US Parathyr Non Nucl	36	14	$650.00	$650.00	$369.00	$685.00	$554.00	2026-03-24
87536	CPT	HIV-1 Quantification	18	14	$629.00	$629.00	$377.00	$629.00	$553.50	2026-03-24
32551	CPT	Tube Thoracostomy	18	14	$627.00	$627.00	$376.00	$627.00	$551.50	2026-03-24
3950004	CDM	Swing Bed Private Rm	18	14	$620.00	$620.00	$372.00	$620.00	$545.50	2026-03-24
C7901	HCPCS	Psytx,re Indiv 30-60	18	14	$616.00	$616.00	$370.00	$616.00	$542.00	2026-03-24
10030	CPT	I&d Abscess	18	14	$615.00	$615.00	$369.00	$615.00	$541.50	2026-03-24
4400412	CDM	Azmacort Inhaler	18	14	$614.00	$614.00	$368.00	$614.00	$540.50	2026-03-24
90834	CPT	Psychotherapy, 45 Min	18	14	$611.00	$611.00	$367.00	$611.00	$537.50	2026-03-24
12005	CPT	Rpr Simpl 12.6-20cm	18	14	$606.00	$606.00	$364.00	$606.00	$533.00	2026-03-24
4600028	CDM	Repair Interim 12.6-	18	14	$606.00	$606.00	$364.00	$606.00	$533.00	2026-03-24
4600072	CDM	Car/metcp Dislc W/ma	18	14	$606.00	$606.00	$364.00	$606.00	$533.00	2026-03-24
95135	CPT	Repair Simple 12.6-2	18	14	$606.00	$606.00	$364.00	$606.00	$533.00	2026-03-24
24600	CPT	Elbow Disloca Without An	18	14	$606.00	$606.00	$364.00	$606.00	$533.00	2026-03-24
40974	CPT	Bennett Fx W/manip	18	14	$606.00	$606.00	$364.00	$606.00	$533.00	2026-03-24
4600180	CDM	Critical Care 105-13	18	14	$606.00	$606.00	$364.00	$606.00	$533.00	2026-03-24
12035	CPT	Interm. Repair 12.6-	18	14	$606.00	$606.00	$364.00	$606.00	$533.00	2026-03-24
26770	CPT	Disl Phalang W Mani	18	14	$604.00	$604.00	$362.00	$604.00	$531.50	2026-03-24
56420	CPT	I&d Bartholi Gla	18	14	$604.00	$604.00	$362.00	$604.00	$531.50	2026-03-24
87522	CPT	Hep C Viral Load	36	14	$623.50	$623.50	$352.00	$661.00	$528.00	2026-03-24
80074	CPT	Hepatitis Panel	18	14	$594.00	$594.00	$356.00	$594.00	$523.00	2026-03-24
76882	CPT	US Extr Nonvasc;limi	18	14	$589.00	$589.00	$353.00	$589.00	$518.50	2026-03-24
99235	CPT	Obs E/m Same Day/70	18	14	$587.00	$587.00	$352.00	$587.00	$516.50	2026-03-24
4600158	CDM	Lumbar Puncture	18	14	$585.00	$585.00	$351.00	$585.00	$515.00	2026-03-24
26700	CPT	J/cphalang W/manip	18	14	$583.00	$583.00	$350.00	$583.00	$513.00	2026-03-24
88305	CPT	Surg Pathology-level	18	14	$574.00	$574.00	$344.00	$574.00	$505.50	2026-03-24
51705	CPT	Change Cystostomy Tu	18	14	$570.00	$570.00	$342.00	$570.00	$501.50	2026-03-24
72110	CPT	X-ray Of Lower Back	18	14	$567.00	$567.00	$340.00	$567.00	$499.00	2026-03-24
93971	CPT	US Venous Extr Lt;un	18	14	$563.00	$563.00	$338.00	$563.00	$495.50	2026-03-24
40937	CPT	Inc/rem Fb Complicat	36	14	$689.50	$689.50	$242.00	$975.00	$494.50	2026-03-24
12015	CPT	Repair Simple 7.6cm-	18	14	$556.00	$556.00	$334.00	$556.00	$489.00	2026-03-24
4600127	CDM	Interm. Repair 7.6-1	18	14	$556.00	$556.00	$334.00	$556.00	$489.00	2026-03-24
12044	CPT	Rpr Interm 7.6-12.5	18	14	$556.00	$556.00	$334.00	$556.00	$489.00	2026-03-24
87637	CPT	Covid, Flu A&b, Rsv	18	14	$550.00	$550.00	$330.00	$550.00	$484.00	2026-03-24
G0176	HCPCS	Act Thera, Iop 45 =>	18	14	$545.00	$545.00	$327.00	$545.00	$480.00	2026-03-24
G0177	HCPCS	Train/educ,iop 45 =>	18	14	$545.00	$545.00	$327.00	$545.00	$480.00	2026-03-24
73521	CPT	X Ray Hips Bilat 2 V	18	14	$541.00	$541.00	$325.00	$541.00	$476.00	2026-03-24
76810	CPT	US Ob>=14 Addl Fetus	18	14	$540.00	$540.00	$324.00	$540.00	$475.00	2026-03-24
4400695	CDM	Regranex Gel. 0.01%1	18	14	$532.00	$532.00	$319.00	$532.00	$468.50	2026-03-24
4600079	CDM	Lat Mallel Without Manip	18	14	$532.00	$532.00	$319.00	$532.00	$468.50	2026-03-24
99222	CPT	Obs Init/day Mod 55	18	14	$530.00	$530.00	$318.00	$530.00	$466.50	2026-03-24
54820	CPT	Beconase Nasal Spray	18	14	$528.00	$528.00	$317.00	$528.00	$464.50	2026-03-24
12011	CPT	Rpr Simp;face 2.5/<	18	14	$525.00	$525.00	$315.00	$525.00	$462.50	2026-03-24
40977	CPT	Simple Repair(facial	18	14	$525.00	$525.00	$315.00	$525.00	$462.50	2026-03-24
4400862	CDM	Kayexalate Powder	18	14	$520.00	$520.00	$312.00	$520.00	$457.50	2026-03-24
81241	CPT	Factor V (Leiden)	18	14	$519.00	$519.00	$311.00	$519.00	$456.50	2026-03-24
45613	CPT	Asp/inject Major Joi	18	14	$519.00	$519.00	$311.00	$519.00	$456.50	2026-03-24
29580	CPT	Strapping; Unna Boot	18	14	$515.00	$515.00	$309.00	$515.00	$453.50	2026-03-24
73080	CPT	X Ray Elbow 3v Bil	36	14	$528.00	$528.00	$293.00	$567.00	$447.00	2026-03-24
4600032	CDM	Repair Interim 2.6 -	18	14	$505.00	$505.00	$303.00	$505.00	$444.50	2026-03-24
4600126	CDM	Intermed. Repair 2.6	18	14	$505.00	$505.00	$303.00	$505.00	$444.50	2026-03-24
4600026	CDM	Repair Interim 2.6 -	18	14	$505.00	$505.00	$303.00	$505.00	$444.50	2026-03-24
76802	CPT	US Ob<14 Addl Fetus	18	14	$505.00	$505.00	$303.00	$505.00	$444.50	2026-03-24
12051	CPT	Repair Complex 2.5 <	18	14	$505.00	$505.00	$303.00	$505.00	$444.50	2026-03-24
73010	CPT	X Ray Scapula 2 V	18	14	$503.00	$503.00	$302.00	$503.00	$443.00	2026-03-24
4400435	CDM	Depo Provera 150mg/5	18	14	$501.00	$501.00	$301.00	$501.00	$441.00	2026-03-24
26720	CPT	Cl Trt Phalan Fx Without	18	14	$500.00	$500.00	$300.00	$500.00	$440.00	2026-03-24
C7900	HCPCS	Psytx,re Indiv 15-29	18	14	$495.00	$495.00	$297.00	$495.00	$436.00	2026-03-24
54009	CPT	Stribild Tab	18	14	$494.00	$494.00	$296.00	$494.00	$435.00	2026-03-24
83519	CPT	Acetycholine Antibod	72	14	$501.00	$501.00	$262.00	$624.00	$432.00	2026-03-24
4402447	CDM	Combivent 20/100	18	14	$484.00	$484.00	$290.00	$484.00	$426.00	2026-03-24
4901090	CDM	Knee Brace Instable	18	14	$480.00	$480.00	$288.00	$480.00	$422.50	2026-03-24
70150	CPT	X-ray Ex Facial Bone	18	14	$479.00	$479.00	$287.00	$479.00	$421.50	2026-03-24
87521	CPT	Hepatitis C Viral Rn	18	14	$474.00	$474.00	$284.00	$474.00	$417.50	2026-03-24
93271	CPT	Telemetry	18	14	$469.00	$469.00	$281.00	$469.00	$412.50	2026-03-24
70200	CPT	X-ray Ex Eye Sockets	18	14	$467.00	$467.00	$280.00	$467.00	$411.00	2026-03-24
76641	CPT	US Breast Lt;complte	18	14	$465.00	$465.00	$279.00	$465.00	$409.50	2026-03-24
80220	CPT	Hydroxychlorquine	18	14	$464.00	$464.00	$278.00	$464.00	$408.50	2026-03-24
99234	CPT	Obs E/m Same Day 45	18	14	$461.00	$461.00	$277.00	$461.00	$405.50	2026-03-24
90832	CPT	Psychotherapy, 30 Min	18	14	$460.00	$460.00	$276.00	$460.00	$405.00	2026-03-24
12013	CPT	Rpair Simple 2.6-5.0	18	14	$459.00	$459.00	$275.00	$459.00	$404.00	2026-03-24
4600037	CDM	Repair Interm 2.5 <	18	14	$455.00	$455.00	$273.00	$455.00	$400.50	2026-03-24
37804	CPT	Intermediate Repair	18	14	$455.00	$455.00	$273.00	$455.00	$400.50	2026-03-24
33805	CPT	Simple Repair 2.6-7.	18	14	$455.00	$455.00	$273.00	$455.00	$400.50	2026-03-24
12041	CPT	Repair Interm <2.5cm	18	14	$455.00	$455.00	$273.00	$455.00	$400.50	2026-03-24
4402064	CDM	Nasonex 50mcg Spray	18	14	$453.00	$453.00	$272.00	$453.00	$399.00	2026-03-24
74022	CPT	X Ray Abdomen Compl	18	14	$452.00	$452.00	$271.00	$452.00	$398.00	2026-03-24
80050	CPT	General Health Panel	18	14	$451.00	$451.00	$271.00	$451.00	$397.00	2026-03-24
20611	CPT	Asp/inj Maj Joint/us	18	14	$450.00	$450.00	$270.00	$450.00	$396.00	2026-03-24
90454	CPT	Inhalation Treatment	18	14	$449.00	$449.00	$269.00	$449.00	$395.00	2026-03-24
93046	CPT	Mycamine	18	14	$449.00	$449.00	$269.00	$449.00	$395.00	2026-03-24
87535	CPT	HIV-1 Dan By Pcr	18	14	$449.00	$449.00	$269.00	$449.00	$395.00	2026-03-24
87517	CPT	Hep B Viral Load	18	14	$448.00	$448.00	$269.00	$448.00	$394.00	2026-03-24
99282	CPT	ER Level 2	18	14	$447.00	$447.00	$268.00	$447.00	$393.00	2026-03-24
4402120	CDM	Advair Diskus 500/50	18	14	$445.00	$445.00	$267.00	$445.00	$392.00	2026-03-24
4600057	CDM	Asp/inject Interm Jo	18	14	$445.00	$445.00	$267.00	$445.00	$392.00	2026-03-24
J3030	HCPCS	Imitrex 6mg/.5cc In	18	14	$444.00	$444.00	$266.00	$444.00	$391.00	2026-03-24
97162	CPT	Pt Eval;mod Comp 30	18	14	$442.00	$442.00	$265.00	$442.00	$389.00	2026-03-24
87529	CPT	Hsv Type 1 & 2, Pcr	18	14	$440.00	$440.00	$264.00	$440.00	$387.00	2026-03-24
72082	CPT	Xray Spine Entire	18	14	$438.00	$438.00	$263.00	$438.00	$385.50	2026-03-24
85420	CPT	Plasminogen Activity	18	14	$436.00	$436.00	$262.00	$436.00	$383.50	2026-03-24
80307	CPT	Drug Screen Comprehe	18	14	$433.00	$433.00	$260.00	$433.00	$381.00	2026-03-24
73610	CPT	X Ray Ankle 3v Bil	36	14	$461.00	$461.00	$232.00	$536.00	$380.50	2026-03-24
10140	CPT	I&d Hematoma Seroma	18	14	$424.00	$424.00	$254.00	$424.00	$373.50	2026-03-24
70130	CPT	X-ray Ex Of Mastoids	18	14	$422.00	$422.00	$253.00	$422.00	$371.50	2026-03-24
10060	CPT	I&d Abscess Simple	18	14	$421.00	$421.00	$253.00	$421.00	$370.50	2026-03-24
4600129	CDM	Inc & Drainage Simpl	18	14	$421.00	$421.00	$253.00	$421.00	$370.50	2026-03-24
99205	CPT	New Patient Office Or Other Outpatient Visit, 60 Min	18	14	$417.00	$417.00	$250.00	$417.00	$367.00	2026-03-24
82787	CPT	Igg Subclasses Panel	18	14	$417.00	$417.00	$250.00	$417.00	$367.00	2026-03-24
84990	CPT	Metacarpal Without Manip	18	14	$417.00	$417.00	$250.00	$417.00	$367.00	2026-03-24
73564	CPT	X Ray Knee 4v Lt	36	14	$437.50	$437.50	$232.00	$489.00	$364.50	2026-03-24
73650	CPT	X Ray Calcaneus Rt	36	14	$433.50	$433.50	$232.00	$481.00	$364.50	2026-03-24
97163	CPT	Pt Eval;hgh Comp 45	18	14	$413.00	$413.00	$248.00	$413.00	$363.50	2026-03-24
84181	CPT	Western Blot Test	18	14	$413.00	$413.00	$248.00	$413.00	$363.50	2026-03-24
70260	CPT	X-ray Exam Of Skull	18	14	$412.00	$412.00	$247.00	$412.00	$362.50	2026-03-24
72220	CPT	Xray Sacrum & Coccyx	18	14	$412.00	$412.00	$247.00	$412.00	$362.50	2026-03-24
70250	CPT	X-ray Exam Of Skull	18	14	$412.00	$412.00	$247.00	$412.00	$362.50	2026-03-24
71047	CPT	X Ray Chest; 3 Views	18	14	$410.00	$410.00	$246.00	$410.00	$361.00	2026-03-24
76857	CPT	US Pelv Non Ob;limit	18	14	$409.00	$409.00	$245.00	$409.00	$360.00	2026-03-24
4402398	CDM	Qvar 80mcg	18	14	$408.00	$408.00	$245.00	$408.00	$359.00	2026-03-24
73630	CPT	X Ray Foot 3v Bilat	36	14	$436.50	$436.50	$217.00	$512.00	$357.00	2026-03-24
96374	CPT	IV Push Single Init	18	14	$406.00	$406.00	$244.00	$406.00	$357.00	2026-03-24
73030	CPT	X Ray Shoulder Rt	36	14	$445.50	$445.50	$217.00	$530.00	$357.00	2026-03-24
12001	CPT	Laceration <= 2.5 Cm	54	14	$404.00	$404.00	$102.00	$800.00	$355.50	2026-03-24
4600133	CDM	Inc/rem Fb Simple	18	14	$404.00	$404.00	$242.00	$404.00	$355.50	2026-03-24
40947	CPT	Dificid 200 Mg	36	14	$558.00	$558.00	$58.00	$1,020.00	$354.00	2026-03-24
73000	CPT	X Ray Clavicle 2v B	36	14	$447.00	$447.00	$214.00	$537.00	$353.50	2026-03-24
76642	CPT	US Breast Lt;limited	18	14	$401.00	$401.00	$241.00	$401.00	$353.00	2026-03-24
4600062	CDM	Ac Separate Without Mani	18	14	$401.00	$401.00	$241.00	$401.00	$353.00	2026-03-24
71046	CPT	X Ray Chest; 2 Views	18	14	$400.00	$400.00	$240.00	$400.00	$352.00	2026-03-24
87801	CPT	Chlam/gonorr Amp Prb	36	14	$470.00	$470.00	$210.00	$590.00	$352.00	2026-03-24

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