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

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Hospital

FISHER COUNTY HOSPITAL DISTRICT

Rotan, TX · CCN 451313 · Rates published

2,564 distinct procedures filed
5 distinct payers
22,436 rate rows
2026-04-28 last MRF observed
Data quality

22,425 of 22,436 rate rows are consumer-grade (100.0%)

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

Excluded — reasonRows
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 11
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/WAD5510496738/machine-readable/751433495_fisher-county-hospital_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/fisher-county
Discovered viaDiscovered by HANK
Last fetch success · 2026-11-03
Content fingerprint fda1186990f8ecf1… · 8,549,670 bytes · first seen 2026-11-03

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
2500563
CDM 		Tenecteplase(tnk Ase) 50mg Kit IV 5 $6,425.00 $11,272.00 $9,581.00 nat. median
$31
outlier · 306.7×
J2505
HCPCS 		#Neulasta 6mg Sq 5 $4,446.00 $7,800.00 $6,630.00 nat. median
$6,056
1.1× median
J1437
HCPCS 		Monoferric (Derisomaltose) 1000mg/10ml 5 $2,772.00 $5,260.00 $4,453.00 nat. median
$46
outlier · 97.9×
59409
CPT 		Vaginal Delivery 5 $2,290.00 $4,018.00 $3,415.00 nat. median
$3,147
1.1× median
94427
CPT 		Immune Globulin Infu(human) IV 20g 200ml 5 $2,144.00 $3,762.00 $3,198.00 nat. median
$2,183
1.5× median
2502492
CDM 		Denosumab (Prolia) Inj 60mg/ml 5 $1,586.00 $2,782.00 $2,365.00 nat. median
$11
outlier · 215.0×
81229
CPT 		Chromosome Microarray Snp(510002) 5 $1,436.00 $2,520.00 $2,142.00 nat. median
$1,329
1.6× median
10180
CPT 		I&d Complx Postop Wound Infec 5 $1,381.00 $2,422.00 $2,059.00 nat. median
$2,867
0.7× median
70488
CPT 		CT Facial Bones W&w/ocontrast 5 $39.00 $2,340.00 $1,955.00 nat. median
$635
outlier · 3.1×
27502
CPT 		Trt Femoral Shaft Clsd Fx W/mn 5 $1,216.00 $2,133.00 $1,813.00 nat. median
$1,993
0.9× median
51706
CPT 		Ferric Carboxymaltose(injectafer)750mg 5 $1,153.00 $2,022.00 $1,719.00 nat. median
$1,980
0.9× median
27532
CPT 		Clsd Trt Tibial Plateau 5 $538.00 $4,338.00 $1,690.00 nat. median
$3,310
0.5× median
74334
CPT 		Lupron Depot 22.5mg Kt-3 5 $1,113.00 $1,953.00 $1,660.00 nat. median
$6,533
outlier · 0.3×
28200
CPT 		Repair Foot Tendon 5 $304.00 $4,338.00 $1,601.00 nat. median
$3,411
outlier · 0.5×
36556
CPT 		Central Venous Catheter Insert Nontunnel 5 $76.00 $4,555.00 $1,450.50 nat. median
$2,477
0.6× median
A0433
HCPCS 		Als Level 2 5 $969.00 $1,700.00 $1,445.00 nat. median
$1,097
1.3× median
97607
CPT 		Neg Prs Wnd Thr Ndme <=50 Sqcm 5 $969.00 $1,700.00 $1,445.00 nat. median
$437
outlier · 3.3×
97608
CPT 		Neg Prs Wnd Thr Ndme >50 Sqcm 5 $969.00 $1,700.00 $1,445.00 nat. median
$464
outlier · 3.1×
74178
CPT 		CT Abd & Pelvis Wo/w Contrast 5 $91.00 $4,388.00 $1,423.00 nat. median
$1,023
1.4× median
70480
CPT 		CT Iac Without Contrast 5 $40.00 $1,650.00 $1,403.00 nat. median
$474
outlier · 3.0×
70487
CPT 		CT Facial Bones W/contrast 5 $51.00 $1,673.00 $1,384.00 nat. median
$604
outlier · 2.3×
J1162
HCPCS 		Digifab Per Vial IV 5 $903.00 $1,584.00 $1,346.00 nat. median
$7,098
outlier · 0.2×
J9217
HCPCS 		Lupron Depot 7.5mg In 5 $895.00 $1,570.00 $1,335.00 nat. median
$1,581
0.8× median
28103
CPT 		Antivenom Snakebite (Crofab) 10 5 $5.00 $4,606.00 $1,317.00 nat. median
$6,823
outlier · 0.2×
A0427
HCPCS 		Als Emergency Level 1 5 $863.00 $1,514.00 $1,287.00 nat. median
$820
1.6× median
74177
CPT 		CT Scan Of Abdomen And Pelvis With Contrast 5 $82.00 $3,888.00 $1,264.50 nat. median
$970
1.3× median
70498
CPT 		CTA Carotids/neck 5 $79.00 $3,800.00 $1,246.00 nat. median
$735
1.7× median
11624
CPT 		Excision Mal Lesion 3. 5 $819.00 $1,436.00 $1,221.00 nat. median
$1,687
0.7× median
73706
CPT 		CTA Lower Extremity 5 $85.00 $3,600.00 $1,202.50 nat. median
$749
1.6× median
70486
CPT 		CT Facial Bones Without Contrast 5 $39.00 $1,453.00 $1,202.00 nat. median
$473
outlier · 2.5×
A0426
HCPCS 		Als Nonemergency Level 1 5 $795.00 $1,394.00 $1,185.00 nat. median
$528
outlier · 2.2×
74176
CPT 		CT Abd & Pelvis Without Contrast 5 $79.00 $3,488.00 $1,144.00 nat. median
$691
1.7× median
93245
CPT 		Holter Monitor Recording 7-14days Cmp 5 $766.00 $1,344.00 $1,142.00 nat. median
$291
outlier · 3.9×
93241
CPT 		Holter Monitor Recording>48hrs-7days Cmp 5 $738.00 $1,294.00 $1,100.00 nat. median
$280
outlier · 3.9×
73202
CPT 		CT Upper Ext W Without Contrast Lt 5 $734.00 $1,287.00 $1,094.00 nat. median
$714
1.5× median
73702
CPT 		CT Lower Ext W & Without Contrast Lt 5 $734.00 $1,287.00 $1,094.00 nat. median
$710
1.5× median
J2430
HCPCS 		Aredia 30mg IV 5 $457.00 $2,402.00 $1,085.00 nat. median
$74
outlier · 14.6×
93224
CPT 		Holter Monitor Recording Up To 48hrs Cmp 5 $724.00 $1,271.00 $1,080.00 nat. median
$189
outlier · 5.7×
75635
CPT 		CTA Abdominal Aorta Bil Low Ext 5 $108.00 $3,000.00 $1,076.50 nat. median
$725
1.5× median
73206
CPT 		CTA Upper Extremity 5 $81.00 $3,100.00 $1,051.00 nat. median
$694
1.5× median
74175
CPT 		CTA Abdomen 5 $82.00 $3,100.00 $1,039.50 nat. median
$714
1.5× median
J7307
HCPCS 		Etonogestrel Implant(nexplanon) 5 $656.00 $1,150.00 $978.00 nat. median
$1,613
0.6× median
27818
CPT 		Clsd Trt Fx Ankle W/mnp 5 $460.00 $2,133.00 $975.50 nat. median
$1,666
0.6× median
72191
CPT 		CTA Pelvis 5 $81.00 $2,800.00 $965.50 nat. median
$630
1.5× median
86366
CPT 		Muscle Specific Kinase Antibod (504600) 5 $646.00 $1,134.00 $964.00 nat. median
$42
outlier · 23.2×
74170
CPT 		CT Abdomen W Without Contrast 5 $63.00 $2,828.00 $926.50 nat. median
$710
1.3× median
73201
CPT 		CT Upper Ext W/contrast Lt 5 $612.00 $1,073.00 $912.00 nat. median
$804
1.1× median
73200
CPT 		CT Upper Ext Without Contrast Lt 5 $612.00 $1,073.00 $912.00 nat. median
$521
1.8× median
73700
CPT 		CT Lower Ext Without Contrast Lt 5 $612.00 $1,073.00 $912.00 nat. median
$499
1.8× median
73701
CPT 		CT Lower Ext W/contrast Lt 5 $612.00 $1,073.00 $912.00 nat. median
$673
1.4× median

Other procedures at this hospital

Browse this hospital's 2,564 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
J2505 HCPCS #Neulasta 6mg Sq 6 5 $7,800.00 $6,630.00 $4,446.00 $7,800.00 $6,630.00 2026-04-28
J1440 HCPCS #Neupogen 300mcg/1ml S 6 5 $456.00 $388.00 $260.00 $456.00 $388.00 2026-04-28
49082 CPT Abdominal Paracentesis 18 5 $321.00 $273.00 $69.00 $1,239.00 $275.00 2026-04-28
J0287 HCPCS Abelcet 50 Mg IV 12 5 $455.50 $387.00 $173.00 $607.00 $325.00 2026-04-28
57408 CPT Acetylcy (Acetadote) 30ml 200mg/ml 12 5 $360.00 $306.00 $154.00 $449.00 $263.50 2026-04-28
J2997 HCPCS Activase Per 10 Mg Inj 6 5 $787.00 $669.00 $449.00 $787.00 $669.00 2026-04-28
18709 CPT Acyclovir (Zovirax) 5% 5gmtop 6 5 $475.00 $404.00 $271.00 $475.00 $404.00 2026-04-28
M0222 HCPCS Admin/monitor Bebtilovimab IV Inj 6 5 $525.00 $446.00 $299.00 $525.00 $446.00 2026-04-28
A0427 HCPCS Als Emergency Level 1 6 5 $1,514.00 $1,287.00 $863.00 $1,514.00 $1,287.00 2026-04-28
A0433 HCPCS Als Level 2 6 5 $1,700.00 $1,445.00 $969.00 $1,700.00 $1,445.00 2026-04-28
A0426 HCPCS Als Nonemergency Level 1 6 5 $1,394.00 $1,185.00 $795.00 $1,394.00 $1,185.00 2026-04-28
2500214 CDM Amoxtrpot (Augmentin) Susp 125mg/5ml 6 5 $601.00 $511.00 $343.00 $601.00 $511.00 2026-04-28
86148 CPT Anti Phosphatidylserine (117985) 12 5 $443.00 $376.50 $252.00 $444.00 $377.00 2026-04-28
86362 CPT Anti-myelin Oligodendrocyte Gly (505310) 6 5 $851.00 $723.00 $485.00 $851.00 $723.00 2026-04-28
28103 CPT Antivenom Snakebite (Crofab) 10 12 5 $2,307.50 $1,961.50 $5.00 $4,606.00 $1,317.00 2026-04-28
J0881 HCPCS Aranesp 1mcg Iv/subq 30 5 $790.00 $672.00 $4.00 $2,058.00 $672.00 2026-04-28
J2430 HCPCS Aredia 30mg IV 12 5 $1,601.50 $1,361.50 $457.00 $2,402.00 $1,085.00 2026-04-28
2503901 CDM Ascorbic Acid (Ascor) Inj 500mg/ml 6 5 $331.00 $281.00 $189.00 $331.00 $281.00 2026-04-28
0002M CPT Ash Fibrosure (550180) 6 5 $611.00 $519.00 $348.00 $611.00 $519.00 2026-04-28
86146 CPT B2-glycoprote 1 Anti Iga Igg Igm(163915) 18 5 $306.00 $260.00 $129.00 $643.00 $260.00 2026-04-28
P9034 HCPCS Bb Platelets Apheresed 6 5 $720.00 $612.00 $410.00 $720.00 $612.00 2026-04-28
81206 CPT Bcr-abl1 (480481) 6 5 $677.00 $575.00 $386.00 $677.00 $575.00 2026-04-28
2500467 CDM Bicillin La 1.2 Units Inj 6 5 $440.00 $374.00 $251.00 $440.00 $374.00 2026-04-28
87799 CPT Bk Quant Pcr (138962) 6 5 $501.00 $426.00 $286.00 $501.00 $426.00 2026-04-28
A0429 HCPCS Bls Emergency 6 5 $902.00 $767.00 $514.00 $902.00 $767.00 2026-04-28
A0428 HCPCS Bls Nonemergency 6 5 $842.00 $716.00 $480.00 $842.00 $716.00 2026-04-28
18609 CPT Budesonide (Pulmicort180mcg) Mdi 12 5 $323.50 $275.00 $158.00 $370.00 $265.00 2026-04-28
2501463 CDM Calcimar (Miacalcin) 1ml Inj 200u 6 5 $665.00 $565.00 $379.00 $665.00 $565.00 2026-04-28
92960 CPT Cardioversion Electric Ext 6 5 $504.00 $428.00 $287.00 $504.00 $428.00 2026-04-28
29425 CPT Cast Walking Short Leg Apply 6 5 $369.00 $314.00 $210.00 $369.00 $314.00 2026-04-28
36556 CPT Central Venous Catheter Insert Nontunnel 12 5 $2,430.00 $2,065.50 $76.00 $4,555.00 $1,450.50 2026-04-28
51705 CPT Change Of Bladder Tube Smpl 6 5 $408.00 $347.00 $233.00 $408.00 $347.00 2026-04-28
71022 CPT Chest W/oblique Projections 6 5 $330.00 $281.00 $188.00 $330.00 $281.00 2026-04-28
81229 CPT Chromosome Microarray Snp(510002) 6 5 $2,520.00 $2,142.00 $1,436.00 $2,520.00 $2,142.00 2026-04-28
65853 CPT Ciproflox (Cipro Hc) Otic Susp 10ml 6 5 $413.00 $351.00 $235.00 $413.00 $351.00 2026-04-28
25605 CPT Clsd Trt Distal Radial Fx 12 5 $610.50 $519.00 $243.00 $848.00 $478.00 2026-04-28
25600 CPT Clsd Trt Distal Radial Fx 12 5 $415.50 $353.50 $180.00 $525.00 $321.50 2026-04-28
24600 CPT Clsd Trt Elbow Dislocation 12 5 $426.00 $362.00 $180.00 $620.00 $351.00 2026-04-28
26750 CPT Clsd Trt Finger 12 5 $295.50 $251.50 $180.00 $320.00 $268.00 2026-04-28
27818 CPT Clsd Trt Fx Ankle W/mnp 12 5 $1,425.00 $1,211.00 $460.00 $2,133.00 $975.50 2026-04-28
26755 CPT Clsd Trt Fx Finger W/mnp 12 5 $393.50 $334.50 $180.00 $472.00 $301.50 2026-04-28
24576 CPT Clsd Trt Hemeral Condylar Fx 6 5 $315.00 $268.00 $180.00 $315.00 $268.00 2026-04-28
23600 CPT Clsd Trt Humerus Fracture 6 5 $315.00 $268.00 $180.00 $315.00 $268.00 2026-04-28
26770 CPT Clsd Trt Interphalangeal Dsloc 12 5 $368.00 $313.00 $180.00 $474.00 $305.50 2026-04-28
26725 CPT Clsd Trt Phalangeal Sh 12 5 $410.00 $348.50 $180.00 $505.00 $312.50 2026-04-28
26720 CPT Clsd Trt Phalangeal Shaft 6 5 $315.00 $268.00 $180.00 $315.00 $268.00 2026-04-28
23650 CPT Clsd Trt Should W/mnp 18 5 $315.00 $268.00 $145.00 $566.00 $268.00 2026-04-28
26605 CPT Clsd Trt Sngl Metacarpal Fracture W/mani 12 5 $456.00 $387.50 $265.00 $480.00 $395.00 2026-04-28
27532 CPT Clsd Trt Tibial Plateau 12 5 $2,622.50 $2,229.00 $538.00 $4,338.00 $1,690.00 2026-04-28
13101 CPT Cmplx Rpr Trunk 2.6-7.5cm 12 5 $695.50 $591.50 $205.00 $802.00 $545.00 2026-04-28
74280 CPT Colon A/c W Without Glucagon 12 5 $480.00 $408.00 $57.00 $743.00 $320.50 2026-04-28
74270 CPT Colon Be W Without Kub 12 5 $373.00 $317.00 $47.00 $568.00 $251.00 2026-04-28
92950 CPT Cpr 12 5 $431.50 $366.50 $168.00 $479.00 $338.00 2026-04-28
31605 CPT Cricothyriod Membrane 12 5 $400.50 $340.00 $185.00 $477.00 $310.00 2026-04-28
99291 CPT Critical Care First 30-74 Min 12 5 $777.00 $660.50 $196.00 $1,205.00 $518.00 2026-04-28
74176 CPT CT Abd & Pelvis Without Contrast 12 5 $1,894.00 $1,610.00 $79.00 $3,488.00 $1,144.00 2026-04-28
74178 CPT CT Abd & Pelvis Wo/w Contrast 12 5 $2,366.50 $2,011.50 $91.00 $4,388.00 $1,423.00 2026-04-28
74170 CPT CT Abdomen W Without Contrast 12 5 $1,534.50 $1,304.50 $63.00 $2,828.00 $926.50 2026-04-28
74160 CPT CT Abdomen W/contrast 12 5 $1,289.00 $1,095.50 $57.00 $2,358.00 $782.00 2026-04-28
74150 CPT CT Abdomen Without Contrast 12 5 $1,127.00 $958.00 $54.00 $2,049.00 $686.50 2026-04-28
72127 CPT CT C-spine W & Without Contrast 12 5 $1,206.50 $1,025.50 $57.00 $2,194.00 $735.00 2026-04-28
72126 CPT CT C-spine W/contrast 12 5 $1,027.50 $873.50 $55.00 $1,845.00 $631.00 2026-04-28
72125 CPT CT C-spine Without Contrast 12 5 $880.50 $748.50 $46.00 $1,589.00 $539.00 2026-04-28
71270 CPT CT Chest W Without Contrast 12 5 $1,343.00 $1,141.50 $56.00 $2,471.00 $811.50 2026-04-28
71260 CPT CT Chest W/contrast 12 5 $1,050.00 $892.50 $53.00 $1,899.00 $641.50 2026-04-28
71250 CPT CT Chest Without Contrast 12 5 $995.50 $846.50 $49.00 $1,790.00 $610.50 2026-04-28
70488 CPT CT Facial Bones W&w/ocontrast 18 5 $2,300.00 $1,955.00 $39.00 $2,340.00 $1,955.00 2026-04-28
70487 CPT CT Facial Bones W/contrast 18 5 $1,628.00 $1,384.00 $51.00 $1,673.00 $1,384.00 2026-04-28
70486 CPT CT Facial Bones Without Contrast 18 5 $1,414.00 $1,202.00 $39.00 $1,453.00 $1,202.00 2026-04-28
70470 CPT CT Head Brain W Without Contrast 12 5 $962.00 $817.50 $57.00 $1,704.00 $595.50 2026-04-28
70460 CPT CT Head Brain W/contrast 12 5 $808.00 $687.00 $51.00 $1,421.00 $502.50 2026-04-28
70482 CPT CT Iac W&without Contrast 12 5 $1,182.50 $1,005.00 $45.00 $2,312.00 $704.50 2026-04-28
70481 CPT CT Iac W/contrast 12 5 $737.50 $627.00 $38.00 $1,430.00 $448.50 2026-04-28
70480 CPT CT Iac Without Contrast 9 5 $1,650.00 $1,403.00 $40.00 $1,650.00 $1,403.00 2026-04-28
72132 CPT CT L-spine W/contrast 12 5 $1,027.50 $873.50 $55.00 $1,845.00 $631.00 2026-04-28
72133 CPT CT L-spine Without And W Contrast 12 5 $1,098.50 $933.50 $57.00 $1,978.00 $673.00 2026-04-28
72131 CPT CT L-spine Without Contrast 12 5 $880.50 $748.50 $46.00 $1,589.00 $539.00 2026-04-28
73702 CPT CT Lower Ext W & Without Contrast Lt 6 5 $1,287.00 $1,094.00 $734.00 $1,287.00 $1,094.00 2026-04-28
73701 CPT CT Lower Ext W/contrast Lt 6 5 $1,073.00 $912.00 $612.00 $1,073.00 $912.00 2026-04-28
73700 CPT CT Lower Ext Without Contrast Lt 6 5 $1,073.00 $912.00 $612.00 $1,073.00 $912.00 2026-04-28
72194 CPT CT Pelvis W Without Contrast 12 5 $1,022.50 $869.50 $55.00 $1,836.00 $628.00 2026-04-28
72192 CPT CT Pelvis Without Contrast 12 5 $813.50 $691.50 $49.00 $1,439.00 $504.00 2026-04-28
70450 CPT CT Scan 12 5 $690.50 $587.00 $39.00 $1,235.00 $425.00 2026-04-28
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 12 5 $2,100.50 $1,785.50 $82.00 $3,888.00 $1,264.50 2026-04-28
72193 CPT CT Scan Of Pelvis With Contrast 11 5 $1,530.00 $1,301.00 $84.00 $1,530.00 $872.00 2026-04-28
70492 CPT CT Soft Tissue Neck W Without Contrast 12 5 $1,142.00 $970.50 $73.00 $2,006.00 $710.50 2026-04-28
70491 CPT CT Soft Tissue Neck W/contrast 12 5 $955.50 $812.00 $62.00 $1,673.00 $596.00 2026-04-28
70490 CPT CT Soft Tissue Neck Without Contrast 12 5 $837.00 $711.50 $58.00 $1,453.00 $524.50 2026-04-28
72129 CPT CT T-spine W/contrast 12 5 $1,028.00 $873.50 $55.00 $1,845.00 $631.50 2026-04-28
72128 CPT CT T-spine Without Contrast 12 5 $880.50 $748.50 $46.00 $1,589.00 $539.00 2026-04-28
72130 CPT CT T-spine Wo/w Contrast 12 5 $1,207.00 $1,026.00 $57.00 $2,194.00 $735.50 2026-04-28
73202 CPT CT Upper Ext W Without Contrast Lt 6 5 $1,287.00 $1,094.00 $734.00 $1,287.00 $1,094.00 2026-04-28
73201 CPT CT Upper Ext W/contrast Lt 6 5 $1,073.00 $912.00 $612.00 $1,073.00 $912.00 2026-04-28
73200 CPT CT Upper Ext Without Contrast Lt 6 5 $1,073.00 $912.00 $612.00 $1,073.00 $912.00 2026-04-28
74174 CPT CTA Abdomen & Pelvis 12 5 $1,383.50 $1,176.00 $99.00 $2,390.00 $869.50 2026-04-28
74175 CPT CTA Abdomen 12 5 $1,706.00 $1,450.00 $82.00 $3,100.00 $1,039.50 2026-04-28
75635 CPT CTA Abdominal Aorta Bil Low Ext 12 5 $1,721.50 $1,463.50 $108.00 $3,000.00 $1,076.50 2026-04-28
70498 CPT CTA Carotids/neck 12 5 $2,063.00 $1,753.50 $79.00 $3,800.00 $1,246.00 2026-04-28
71275 CPT CTA Chest (Noncoronary) 12 5 $1,108.50 $942.00 $82.00 $1,904.00 $699.00 2026-04-28
70496 CPT CTA Head 12 5 $1,413.00 $1,201.00 $79.00 $2,500.00 $875.50 2026-04-28
73706 CPT CTA Lower Extremity 12 5 $1,976.50 $1,680.00 $85.00 $3,600.00 $1,202.50 2026-04-28
72191 CPT CTA Pelvis 12 5 $1,567.50 $1,332.50 $81.00 $2,800.00 $965.50 2026-04-28
73206 CPT CTA Upper Extremity 12 5 $1,717.50 $1,460.00 $81.00 $3,100.00 $1,051.00 2026-04-28
87497 CPT Cytomegalovirus (Cmv) Quant (139149) 6 5 $441.00 $375.00 $251.00 $441.00 $375.00 2026-04-28
11044 CPT Debride Tissue/muscle/ 6 5 $300.00 $255.00 $171.00 $300.00 $255.00 2026-04-28
97602 CPT Debridement Non Selective 6 5 $300.00 $255.00 $171.00 $300.00 $255.00 2026-04-28
11042 CPT Debridement Skin &Sbct 6 5 $320.00 $272.00 $182.00 $320.00 $272.00 2026-04-28
2502492 CDM Denosumab (Prolia) Inj 60mg/ml 6 5 $2,782.00 $2,365.00 $1,586.00 $2,782.00 $2,365.00 2026-04-28
16803 CPT Desonide(desowen) 0.05% Lotion 6 5 $356.00 $303.00 $203.00 $356.00 $303.00 2026-04-28
2502203 CDM Desoximetasone(topicort)0.05% Gel 6 5 $337.00 $286.00 $192.00 $337.00 $286.00 2026-04-28
J1162 HCPCS Digifab Per Vial IV 6 5 $1,584.00 $1,346.00 $903.00 $1,584.00 $1,346.00 2026-04-28
92975 CPT Dissolve Clot Heart Vessel 6 5 $400.00 $340.00 $228.00 $400.00 $340.00 2026-04-28
27301 CPT Drain Thigh/knee Lesion 6 5 $750.00 $638.00 $427.00 $750.00 $638.00 2026-04-28
10080 CPT Drainage Of Pilonidal Cyst 12 5 $456.50 $388.00 $102.00 $635.00 $320.00 2026-04-28
76880 CPT Echo Extr Non Vascular 6 5 $343.00 $292.00 $196.00 $343.00 $292.00 2026-04-28
99284 CPT Emergency Room L-4 12 5 $360.00 $306.00 $116.00 $517.00 $249.00 2026-04-28
99285 CPT Emergency Room L-5 12 5 $527.00 $448.00 $169.00 $776.00 $360.00 2026-04-28
81517 CPT Enhanced Liver Fibrosis (550659) 6 5 $476.00 $405.00 $271.00 $476.00 $405.00 2026-04-28
2501679 CDM Epogen 10,000 1ml Iv/ 6 5 $307.00 $261.00 $175.00 $307.00 $261.00 2026-04-28
2501689 CDM Epogen 20,000 Mu 1ml Sq 6 5 $378.00 $321.00 $215.00 $378.00 $321.00 2026-04-28
43037 CPT Estradiol (Estrace) Cream 0.1mg 6 5 $380.00 $323.00 $217.00 $380.00 $323.00 2026-04-28
J7307 HCPCS Etonogestrel Implant(nexplanon) 6 5 $1,150.00 $978.00 $656.00 $1,150.00 $978.00 2026-04-28
11443 CPT Ex Ben Les Fce Ear El 12 5 $895.50 $761.00 $202.00 $1,437.00 $586.50 2026-04-28
11442 CPT Ex Ben Les Fce Ear El 1.1-2.0cm 6 5 $288.00 $245.00 $164.00 $288.00 $245.00 2026-04-28
11422 CPT Ex Ben Les Sclp Nck H 1.1-2.0cm 12 5 $814.50 $692.00 $109.00 $1,437.00 $505.50 2026-04-28
11423 CPT Ex Ben Les Sclp Nck H 2.1-3.0cm 6 5 $340.00 $289.00 $194.00 $340.00 $289.00 2026-04-28
11424 CPT Ex Ben Les Sclp Nck H 3.1-4.0cm 6 5 $340.00 $289.00 $194.00 $340.00 $289.00 2026-04-28
11400 CPT Ex Ben Les Trnk Arm L 0.5cm Or < 12 5 $543.00 $461.50 $76.00 $952.00 $338.50 2026-04-28
11403 CPT Ex Ben Les Trnk Arm L 2.1-3.0cm 6 5 $283.00 $241.00 $161.00 $283.00 $241.00 2026-04-28
11404 CPT Ex Ben Les Trnk Arm L 3.14.0 Cm 6 5 $300.00 $255.00 $171.00 $300.00 $255.00 2026-04-28
11406 CPT Ex Ben Les Trnk Arm L >4.0 Cm 6 5 $497.00 $422.00 $283.00 $497.00 $422.00 2026-04-28
11623 CPT Ex Malig Les 2. Hand/feet 6 5 $299.00 $254.00 $170.00 $299.00 $254.00 2026-04-28
11642 CPT Ex Malig Les Fce Ear Eli 1.1-2cm 6 5 $562.00 $478.00 $320.00 $562.00 $478.00 2026-04-28
11620 CPT Ex Malig Les Sclp Nck 12 5 $853.00 $725.00 $153.00 $1,437.00 $544.00 2026-04-28
11604 CPT Ex Malig Les Trnk Arm 12 5 $580.00 $493.00 $299.00 $635.00 $502.00 2026-04-28
11603 CPT Ex Malig Les Trnk Arm 12 5 $540.00 $459.00 $254.00 $635.00 $425.50 2026-04-28
11602 CPT Ex Malig Les Trnk Arm 1.1-2.0cm 6 5 $340.00 $289.00 $194.00 $340.00 $289.00 2026-04-28
11606 CPT Ex Malig Les Trnk Arm Over 4.0 Cm 6 5 $507.00 $431.00 $289.00 $507.00 $431.00 2026-04-28
11750 CPT Ex Nail/nail Matrix 18 5 $349.00 $297.00 $92.00 $529.00 $297.00 2026-04-28
11765 CPT Ex Wedge Of Skin Nail 12 5 $364.50 $310.00 $114.00 $529.00 $251.00 2026-04-28
26111 CPT Exc Hand Les Sc 1.5cm > 6 5 $661.00 $562.00 $377.00 $661.00 $562.00 2026-04-28
27043 CPT Exc Hip Pelvis Lesion 3cm> 6 5 $759.00 $645.00 $433.00 $759.00 $645.00 2026-04-28
11624 CPT Excision Mal Lesion 3. 6 5 $1,436.00 $1,221.00 $819.00 $1,436.00 $1,221.00 2026-04-28
94770 CPT Exhaled Carbon Dioxide Test 6 5 $464.00 $394.00 $264.00 $464.00 $394.00 2026-04-28
20103 CPT Explore Wound Extremity 6 5 $953.00 $810.00 $543.00 $953.00 $810.00 2026-04-28
81240 CPT Factor Ii DNA Analysis(511162) 6 5 $360.00 $306.00 $205.00 $360.00 $306.00 2026-04-28
81241 CPT Factor V Leiden Dna(081547) 12 5 $323.50 $275.00 $181.00 $330.00 $281.00 2026-04-28
28190 CPT Fb Rmve Foot Subq 12 5 $601.00 $511.00 $143.00 $952.00 $396.50 2026-04-28
51706 CPT Ferric Carboxymaltose(injectafer)750mg 6 5 $2,022.00 $1,719.00 $1,153.00 $2,022.00 $1,719.00 2026-04-28
2501978 CDM Filgrastin (Neupogen) 480mcg 6 5 $766.00 $651.00 $437.00 $766.00 $651.00 2026-04-28
J3110 HCPCS Forteo Pen 10mcg Sq 12 5 $466.00 $396.00 $7.00 $920.00 $268.00 2026-04-28
83521 CPT Free K+l Lt Chains, Qn Urine(121228) 6 5 $295.00 $251.00 $168.00 $295.00 $251.00 2026-04-28
2500643 CDM Futicas Prop (Advair Disk) 500/50mcg 6 5 $702.00 $597.00 $400.00 $702.00 $597.00 2026-04-28
64121 CPT Gardasil-9 Sdv 0.5ml IM 6 5 $295.00 $251.00 $168.00 $295.00 $251.00 2026-04-28
87507 CPT Gastro Profile Stool Pcr(183480) 6 5 $780.00 $663.00 $445.00 $780.00 $663.00 2026-04-28
80050 CPT General Health Panel 6 5 $335.00 $285.00 $191.00 $335.00 $285.00 2026-04-28
54858 CPT Glucagon Iv,sq,im 1mg 6 5 $404.00 $343.00 $230.00 $404.00 $343.00 2026-04-28
59702 CPT Glucagon 1mg 6 5 $464.00 $394.00 $264.00 $464.00 $394.00 2026-04-28
87517 CPT Hbv Quantitation (551630) 12 5 $462.50 $393.00 $171.00 $625.00 $328.00 2026-04-28
86804 CPT Hcv Antibody Immunoblot Assay 6 5 $464.00 $394.00 $264.00 $464.00 $394.00 2026-04-28
87902 CPT Hcv Nssa Drug Resistance Assay(550325) 12 5 $610.50 $519.00 $305.00 $686.00 $511.50 2026-04-28
87522 CPT Hcv Quantitative RNA W/genotyping(550090 12 5 $477.50 $405.50 $264.00 $491.00 $417.00 2026-04-28
81256 CPT Hemochromatosis DNA (511345) 6 5 $480.00 $408.00 $274.00 $480.00 $408.00 2026-04-28
87516 CPT Hep B Virus DNA (551610) 6 5 $286.00 $243.00 $163.00 $286.00 $243.00 2026-04-28
87521 CPT Hepatitis C Virus RNA (551300) 6 5 $417.00 $354.00 $238.00 $417.00 $354.00 2026-04-28
81293 CPT Hereditary Nonpolyposis Colon C (511635) 6 5 $500.00 $425.00 $285.00 $500.00 $425.00 2026-04-28
87536 CPT HIV 1 RNA Real Time Pcr (550420) 12 5 $645.00 $548.00 $280.00 $799.00 $473.00 2026-04-28
93226 CPT Holter Mon Scan Analysis W/report 6 5 $727.00 $618.00 $414.00 $727.00 $618.00 2026-04-28
93247 CPT Holter Mon Scan/report 7-14days 6 5 $800.00 $680.00 $456.00 $800.00 $680.00 2026-04-28
93243 CPT Holter Mon Scan/report>48hr-7days 6 5 $750.00 $638.00 $427.00 $750.00 $638.00 2026-04-28
93246 CPT Holter Monitor Recording 7-14days 6 5 $484.00 $411.00 $276.00 $484.00 $411.00 2026-04-28
93245 CPT Holter Monitor Recording 7-14days Cmp 6 5 $1,344.00 $1,142.00 $766.00 $1,344.00 $1,142.00 2026-04-28
93225 CPT Holter Monitor Recording Up To 48hrs 6 5 $484.00 $411.00 $276.00 $484.00 $411.00 2026-04-28
93224 CPT Holter Monitor Recording Up To 48hrs Cmp 6 5 $1,271.00 $1,080.00 $724.00 $1,271.00 $1,080.00 2026-04-28
93242 CPT Holter Monitor Recording>48hrs-7days 6 5 $484.00 $411.00 $276.00 $484.00 $411.00 2026-04-28
93241 CPT Holter Monitor Recording>48hrs-7days Cmp 6 5 $1,294.00 $1,100.00 $738.00 $1,294.00 $1,100.00 2026-04-28
90651 CPT Hpv (Gardisil 9) Vac: 0.5 Ml 6 5 $456.00 $388.00 $260.00 $456.00 $388.00 2026-04-28
J7321 HCPCS Hyalgan 20mg/2ml Syrin 6 5 $395.00 $336.00 $225.00 $395.00 $336.00 2026-04-28
J1730 HCPCS Hyperstat 300mg/20ml I 6 5 $342.00 $291.00 $195.00 $342.00 $291.00 2026-04-28
2500455 CDM Hypertet Inj 250units 6 5 $408.00 $347.00 $233.00 $408.00 $347.00 2026-04-28
10061 CPT I&d Abscess Complctd O 18 5 $351.00 $298.00 $143.00 $535.00 $298.00 2026-04-28
10180 CPT I&d Complx Postop Wound Infec 6 5 $2,422.00 $2,059.00 $1,381.00 $2,422.00 $2,059.00 2026-04-28
10140 CPT I&d Hematoma Sermona 12 5 $785.50 $667.50 $76.00 $1,437.00 $476.50 2026-04-28
46050 CPT I&d Of Anal Abscess 12 5 $784.50 $667.00 $100.00 $1,215.00 $523.50 2026-04-28
46040 CPT I&d Of Rectal Abcess 12 5 $1,205.00 $1,024.50 $420.00 $1,588.00 $863.50 2026-04-28
94427 CPT Immune Globulin Infu(human) IV 20g 200ml 6 5 $3,762.00 $3,198.00 $2,144.00 $3,762.00 $3,198.00 2026-04-28
46083 CPT Incise External Hemorrhoid 12 5 $360.50 $306.50 $104.00 $408.00 $289.50 2026-04-28
2502064 CDM Infliximab (Remicade) 100mg/20ml Inj 6 5 $1,023.00 $870.00 $583.00 $1,023.00 $870.00 2026-04-28
80230 CPT Infliximab And Anti Infliximab(503870) 6 5 $309.00 $263.00 $176.00 $309.00 $263.00 2026-04-28
64450 CPT Inj Anes Agent Other Peripheral 24 5 $529.00 $449.50 $38.00 $972.00 $327.50 2026-04-28
32556 CPT Insert Cath Pleura Without Image 12 5 $1,333.50 $1,133.50 $110.00 $2,487.00 $799.00 2026-04-28
11981 CPT Insertion Drug Delivery Inplant 6 5 $369.00 $314.00 $210.00 $369.00 $314.00 2026-04-28
36569 CPT Insj Picc 5+yr Without Imaging 12 5 $1,144.50 $973.00 $84.00 $2,154.00 $681.50 2026-04-28
16964 CPT Insulin Detemir(levemir Flx Tch) Pen 3ml 6 5 $291.00 $247.00 $166.00 $291.00 $247.00 2026-04-28
88250 CPT Insulin Glulisin(apidra Solostar)pen 3ml 6 5 $283.00 $241.00 $161.00 $283.00 $241.00 2026-04-28
16925 CPT Insuln Degludec(tresiba)3ml/200ut/ml Pen 6 5 $293.00 $249.00 $167.00 $293.00 $249.00 2026-04-28
31500 CPT Intubation 12 5 $311.00 $264.50 $130.00 $362.00 $240.50 2026-04-28
59700 CPT Iprat Brom (Atrovent) Hfa Mdi 18 5 $310.00 $264.00 $125.00 $639.00 $264.00 2026-04-28
54004 CPT Ipratro Bromide(atrovent Nasal) .06% Spy 6 5 $288.00 $245.00 $164.00 $288.00 $245.00 2026-04-28
M0245 HCPCS IV Infusion Adm Bam And Etesevimab 6 5 $465.00 $395.00 $265.00 $465.00 $395.00 2026-04-28
M0239 HCPCS IV Infusion Adm Bamlanivimab 6 5 $465.00 $395.00 $265.00 $465.00 $395.00 2026-04-28
M0243 HCPCS IV Or Inj Adm Regen-cov 6 5 $675.00 $574.00 $385.00 $675.00 $574.00 2026-04-28
81270 CPT Jak2 V617f Qual (489230) 6 5 $420.00 $357.00 $239.00 $420.00 $357.00 2026-04-28
31515 CPT Laryngoscopy Direct With 12 5 $369.00 $314.00 $99.00 $576.00 $245.00 2026-04-28
2501635 CDM Latanoprost (Xalatan) .005% Opth Sol 6 5 $286.00 $243.00 $163.00 $286.00 $243.00 2026-04-28
12051 CPT Layer Closure Wound Fa 2.5cm Or Les 18 5 $420.00 $357.00 $137.00 $529.00 $329.50 2026-04-28
16940 CPT Liraglutide(victoza) 18mg/3ml Pen 6 5 $387.00 $329.00 $221.00 $387.00 $329.00 2026-04-28
74334 CPT Lupron Depot 22.5mg Kt-3 6 5 $1,953.00 $1,660.00 $1,113.00 $1,953.00 $1,660.00 2026-04-28
J9217 HCPCS Lupron Depot 7.5mg In 6 5 $1,570.00 $1,335.00 $895.00 $1,570.00 $1,335.00 2026-04-28
82657 CPT Lysosomal Acid Lipase Deficiency(402300) 12 5 $390.00 $331.50 $208.00 $415.00 $343.00 2026-04-28
3200074 CDM Magnevist X-ray 20ml 6 5 $299.00 $254.00 $170.00 $299.00 $254.00 2026-04-28
90710 CPT Measles/mumps/rubella/varicell Vac 6 5 $500.00 $425.00 $285.00 $500.00 $425.00 2026-04-28
J7302 HCPCS Mirena IUD 52 Mg 6 5 $900.00 $765.00 $513.00 $900.00 $765.00 2026-04-28
78163 CPT Mometa Furoa (Nasonex) Nasal Spray 6 5 $321.00 $273.00 $183.00 $321.00 $273.00 2026-04-28
J1437 HCPCS Monoferric (Derisomaltose) 1000mg/10ml 12 5 $5,061.50 $4,302.50 $2,772.00 $5,260.00 $4,453.00 2026-04-28
86366 CPT Muscle Specific Kinase Antibod (504600) 6 5 $1,134.00 $964.00 $646.00 $1,134.00 $964.00 2026-04-28
2500449 CDM Mvi (Infuvite) Inj 6 5 $318.00 $270.00 $181.00 $318.00 $270.00 2026-04-28
2501758 CDM Nanitrite(cyanide) Antidote Kit 6 5 $515.00 $438.00 $294.00 $515.00 $438.00 2026-04-28
97605 CPT Neg Prs Wnd Ther Dme <=50 Sqcm 6 5 $600.00 $510.00 $342.00 $600.00 $510.00 2026-04-28
97606 CPT Neg Prs Wnd Ther Dme > 50 Sqcm 6 5 $600.00 $510.00 $342.00 $600.00 $510.00 2026-04-28
97607 CPT Neg Prs Wnd Thr Ndme <=50 Sqcm 6 5 $1,700.00 $1,445.00 $969.00 $1,700.00 $1,445.00 2026-04-28
97608 CPT Neg Prs Wnd Thr Ndme >50 Sqcm 6 5 $1,700.00 $1,445.00 $969.00 $1,700.00 $1,445.00 2026-04-28
J1442 HCPCS Neupogen 480 Mcg 1.6m 6 5 $483.00 $411.00 $275.00 $483.00 $411.00 2026-04-28
86051 CPT Neuromyelitis Optica, Igg Autoa (004210) 6 5 $802.00 $682.00 $457.00 $802.00 $682.00 2026-04-28
99205 CPT New Patient Office Or Other Outpatient Visit, 60 Min 6 5 $345.00 $293.00 $197.00 $345.00 $293.00 2026-04-28
99306 CPT Nh Initial Care High 11 5 $283.00 $241.00 $161.00 $283.00 $241.00 2026-04-28
18743 CPT Nitropress (Nipride) IV 50mg/2ml 6 5 $310.00 $264.00 $177.00 $310.00 $264.00 2026-04-28
36410 CPT Non Routine Blood Draw- Midline 6 5 $680.00 $578.00 $388.00 $680.00 $578.00 2026-04-28
80055 CPT Obstetric Blood Test Panel 6 5 $402.00 $342.00 $229.00 $402.00 $342.00 2026-04-28
2500678 CDM Olopatadine(patanol) 0.1% Opth Sol 6 5 $308.00 $262.00 $176.00 $308.00 $262.00 2026-04-28
93925 CPT Phys US Arterial Lower Ext Bilat 12 5 $503.50 $428.00 $36.00 $871.00 $316.00 2026-04-28
93930 CPT Phys US Arterial Upper Ext Bilateral 12 5 $504.50 $428.50 $36.00 $871.00 $317.00 2026-04-28
93880 CPT Phys US Carotids Complete 12 5 $531.00 $451.00 $37.00 $924.00 $332.50 2026-04-28
93308 CPT Phys US Echo Limited 12 5 $397.50 $338.00 $24.00 $705.00 $246.00 2026-04-28
93307 CPT Phys US Echocardiogram 2d-without M-mode 12 5 $705.00 $599.50 $42.00 $1,254.00 $435.50 2026-04-28
93306 CPT Phys US Echocardiogram Complete Standard 12 5 $751.00 $638.50 $66.00 $1,254.00 $481.50 2026-04-28
93320 CPT Phys US Echocardiogram Dopple 12 5 $416.00 $353.50 $17.00 $768.00 $251.00 2026-04-28
93970 CPT Phys US Venous Doppler Bilat 12 5 $478.50 $406.50 $32.00 $838.00 $298.50 2026-04-28
2501243 CDM Pilocarpin (Isopto Carpine)optic1% 15ml 6 5 $296.00 $252.00 $169.00 $296.00 $252.00 2026-04-28
51971 CPT Pneumococcal 13valent(prevnar-13)im 0.5m 6 5 $337.00 $286.00 $192.00 $337.00 $286.00 2026-04-28
90670 CPT Pneumococcal 13valent(prevnar-13)im:05ml 6 5 $420.00 $357.00 $239.00 $420.00 $357.00 2026-04-28
52000 CPT Pneumococcal 20valent(prevnar-20)im 0.5m 6 5 $396.00 $337.00 $226.00 $396.00 $337.00 2026-04-28
90677 CPT Pneumococcal 20valent(prevnar-20)im:05ml 6 5 $470.00 $400.00 $268.00 $470.00 $400.00 2026-04-28
90684 CPT Pneumococcal 21valent(capvaxive) IM 0.5m 12 5 $452.50 $385.00 $248.00 $470.00 $398.50 2026-04-28
86317 CPT Pneumococcal Immunity 14 Type(139090) 18 5 $537.00 $456.00 $64.00 $615.00 $456.00 2026-04-28
46074 CPT Premarin Im/iv 25mg 6 5 $519.00 $441.00 $296.00 $519.00 $441.00 2026-04-28
0030T CPT Prothrombin Igg&igm 6 5 $300.00 $255.00 $171.00 $300.00 $255.00 2026-04-28
11982 CPT Removal Drug Delivery Implant 12 5 $392.00 $333.50 $210.00 $415.00 $345.00 2026-04-28
11976 CPT Removal Implant Contraceptive Capsules 6 5 $369.00 $314.00 $210.00 $369.00 $314.00 2026-04-28
28193 CPT Removal Of Foreign Body Foot Complicated 6 5 $520.00 $442.00 $296.00 $520.00 $442.00 2026-04-28
28192 CPT Removal Of Foreign Body Foot Deep 6 5 $460.00 $391.00 $262.00 $460.00 $391.00 2026-04-28
27340 CPT Removal Of Kneecap Bursa 6 5 $746.00 $634.00 $425.00 $746.00 $634.00 2026-04-28
11983 CPT Removal/insertion Drug Delivery Inplant 6 5 $469.00 $399.00 $267.00 $469.00 $399.00 2026-04-28
28200 CPT Repair Foot Tendon 12 5 $2,533.50 $2,153.50 $304.00 $4,338.00 $1,601.00 2026-04-28
11760 CPT Repair Of Nail Bed 12 5 $553.00 $470.00 $101.00 $802.00 $380.50 2026-04-28
43762 CPT Replace Gtube 6 5 $408.00 $347.00 $233.00 $408.00 $347.00 2026-04-28
13151 CPT Rpr Cmplx E/n/e/l 1.1-2.5cm 12 5 $713.50 $606.50 $228.00 $802.00 $578.00 2026-04-28
13152 CPT Rpr Cmplx E/n/e/l 2.6-7.5cm 12 5 $768.50 $653.50 $272.00 $802.00 $653.50 2026-04-28
13132 CPT Rpr Cmplx F/n/g/h/f 2.6-7.5cm 12 5 $668.00 $567.50 $246.00 $898.00 $475.00 2026-04-28
13121 CPT Rpr Cmplx Scalp Arms Legs 2.6-7.5cm 12 5 $716.50 $609.00 $210.00 $802.00 $583.50 2026-04-28
12052 CPT Rpr Int Fce Ear Elid N 2.6-5.0 12 5 $497.50 $423.00 $168.00 $529.00 $423.00 2026-04-28
12053 CPT Rpr Int Fce Ear Elid N 5.1-7.5cm 12 5 $534.50 $454.50 $182.00 $540.00 $454.50 2026-04-28
12054 CPT Rpr Int Fce Ear Elid N 7.6-12.5cm 12 5 $549.50 $467.50 $192.00 $570.00 $466.00 2026-04-28
12042 CPT Rpr Int Nck Hnd Feet 12 5 $494.00 $420.00 $164.00 $529.00 $420.00 2026-04-28
12041 CPT Rpr Int Nck Hnd Feet* 12 5 $461.00 $392.00 $126.00 $529.00 $363.50 2026-04-28
12036 CPT Rpr Int Sclp Trnk Ext 6 5 $802.00 $682.00 $457.00 $802.00 $682.00 2026-04-28
12035 CPT Rpr Int Sclp Trnk Ext 6 5 $529.00 $450.00 $302.00 $529.00 $450.00 2026-04-28
12031 CPT Rpr Int Sclp Trnk Ext 2.5 Or <Cm 18 5 $427.00 $363.00 $116.00 $529.00 $332.50 2026-04-28
12034 CPT Rpr Int Sclp Trnk Ext 7.6-12.5 Cm 12 5 $511.00 $434.50 $175.00 $529.00 $434.50 2026-04-28
12032 CPT Rpr Int Sclp Trnk Ext* 2.6-7.5cm 12 5 $488.50 $415.50 $160.00 $529.00 $414.50 2026-04-28
12005 CPT Rpr Smple Sclp Nck Trn 12.6-20.0cm 18 5 $314.00 $267.00 $88.00 $529.00 $275.00 2026-04-28
12007 CPT Rpr Smple Sclp Nck Trn Over 30.0 Cm 12 5 $323.00 $274.50 $131.00 $371.00 $242.50 2026-04-28
12006 CPT Rpr Smple Sclp Trnk Ext 6 5 $529.00 $450.00 $302.00 $529.00 $450.00 2026-04-28
2501125 CDM Santyl Collagenase Ointment 6 5 $325.00 $276.00 $185.00 $325.00 $276.00 2026-04-28
94618 CPT Six Minute Walk Test 6 5 $300.00 $255.00 $171.00 $300.00 $255.00 2026-04-28
95806 CPT Sleep Study Unattended 6 5 $350.00 $298.00 $199.00 $350.00 $298.00 2026-04-28
93017 CPT Stress Test 6 5 $727.00 $618.00 $414.00 $727.00 $618.00 2026-04-28
92953 CPT Temp Transcutaneous Pacing 6 5 $504.00 $428.00 $287.00 $504.00 $428.00 2026-04-28
2500563 CDM Tenecteplase(tnk Ase) 50mg Kit IV 6 5 $11,272.00 $9,581.00 $6,425.00 $11,272.00 $9,581.00 2026-04-28
J1670 HCPCS Tetanus Immune Globli Termed 6 5 $510.00 $434.00 $291.00 $510.00 $434.00 2026-04-28
L0469 HCPCS Thoracis Lumbar Immobilizer 6 5 $900.00 $765.00 $513.00 $900.00 $765.00 2026-04-28
78087 CPT Tobramycin (Tobradex) Opth Oint 3.5 6 5 $326.00 $277.00 $186.00 $326.00 $277.00 2026-04-28
81401 CPT Tpmt Genetic Testing (504142) 6 5 $474.00 $403.00 $270.00 $474.00 $403.00 2026-04-28
81404 CPT Trans Amyloidosis Ttr (252810) 6 5 $480.00 $408.00 $274.00 $480.00 $408.00 2026-04-28
36430 CPT Transfusion Blood 6 5 $607.00 $516.00 $346.00 $607.00 $516.00 2026-04-28
23500 CPT Trt Clavicle Clsd Fx Without Mnp 6 5 $315.00 $268.00 $180.00 $315.00 $268.00 2026-04-28
27502 CPT Trt Femoral Shaft Clsd Fx W/mn 6 5 $2,133.00 $1,813.00 $1,216.00 $2,133.00 $1,813.00 2026-04-28
32422 CPT Trt Of Collapsed Lung 6 5 $292.00 $248.00 $166.00 $292.00 $248.00 2026-04-28
26742 CPT Trt Phalangeal Clsd Fx W/manipulati 6 5 $400.00 $340.00 $228.00 $400.00 $340.00 2026-04-28
74247 CPT Ugi A/c W/kub 6 5 $544.00 $462.00 $310.00 $544.00 $462.00 2026-04-28
74249 CPT Ugi A/c W/small Bowel F/thru 6 5 $806.00 $685.00 $459.00 $806.00 $685.00 2026-04-28
74241 CPT Ugi W/kub 6 5 $450.00 $383.00 $257.00 $450.00 $383.00 2026-04-28
74245 CPT Ugi W/small Bowel 6 5 $788.00 $670.00 $449.00 $788.00 $670.00 2026-04-28
59409 CPT Vaginal Delivery 6 5 $4,018.00 $3,415.00 $2,290.00 $4,018.00 $3,415.00 2026-04-28
2502546 CDM Varenicline(chantix Pak) Tab 1mg 6 5 $333.00 $283.00 $190.00 $333.00 $283.00 2026-04-28
2503765 CDM Veklury(remdesivir) 100mg/20ml Sdv 6 5 $624.00 $530.00 $356.00 $624.00 $530.00 2026-04-28
36425 CPT Venipuncture Cutdown Over 1 Yr 6 5 $415.00 $353.00 $237.00 $415.00 $353.00 2026-04-28
94002 CPT Ventilator Mgmt Initial Day 6 5 $295.00 $251.00 $168.00 $295.00 $251.00 2026-04-28
84207 CPT Vitamin B6 (004655) 6 5 $342.00 $291.00 $195.00 $342.00 $291.00 2026-04-28
82652 CPT Vitamin D 1,25 Dihydroxy (081091) 6 5 $337.00 $286.00 $192.00 $337.00 $286.00 2026-04-28
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