Hospital

PARKVIEW HOSPITAL

Wheeler, TX · CCN 451334 · Rates published

972 distinct procedures filed

6 distinct payers

10,349 rate rows

2024-12-30 last MRF observed · ⚠ 18 mo old

Data quality

10,303 of 10,349 rate rows are consumer-grade (99.6%)

46 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	35
placeholder amount (≤ $0.02) — excluded from medians	8
per-diem day rate — not a per-procedure price	2
exceeds 10× this hospital's gross charge — excluded from medians	1

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 18 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://parkviewhosp.org/?jet_download=d48f22d9d6ba7496a1db56eb76af9388cb225ae6
Found on page	https://parkviewhosp.org/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	73aaeb5af4cb4b6d… · 5,545,586 bytes · first seen 2026-05-08

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
J2997 HCPCS	Alteplase Kit 100 Mg	5	$89.64	$16,526.69	$3,419.32	nat. median $545 outlier · 6.3×
J3101 HCPCS	Tenecteplase Kit 50 Mg	5	$154.57	$14,720.93	$3,045.71	nat. median $5,957 0.5× median
J0840 HCPCS	Crotalidae Polyval Immune Fab 2 Vial Kit	6	$677.90	$3,276.52	$1,852.15	nat. median $3,427 0.5× median
71275 HCPCS	CTA Chest W/wo	6	$227.23	$2,784.00	$1,111.50	nat. median $736 1.5× median
59410 HCPCS	Vag Delivery Only Ppc	6	$318.60	$1,790.46	$929.25	nat. median $2,458 outlier · 0.4×
32556 HCPCS	Pleural Drainage	6	$261.18	$1,262.37	$723.71	nat. median $1,954 outlier · 0.4×
26765 HCPCS	Open Trt Dist Phal Frac	6	$174.60	$5,328.75	$712.95	nat. median $3,497 outlier · 0.2×
25520 HCPCS	Closed Trmt Of Radial Frac & Dislocation	6	$252.00	$1,218.00	$648.54	nat. median $1,720 outlier · 0.4×
17108 HCPCS	Destruct Skin Lesions Over 50.0 Sq Cm	6	$225.00	$1,087.50	$630.14	nat. median $1,923 outlier · 0.3×
74176 HCPCS	CT Renal Stone	6	$176.32	$1,696.50	$606.50	nat. median $685 0.9× median
70487 HCPCS	CT Facial Bones Wo	6	$146.27	$1,174.50	$587.62	nat. median $596 1.0× median
71250 HCPCS	CT Chest Wo	6	$128.00	$1,348.50	$561.10	nat. median $473 1.2× median
J1559 HCPCS	Hizentra 10GM/50ml Subcutaneous Infusion	5	$12.97	$2,542.14	$525.96	nat. median $27 outlier · 19.5×
11471 HCPCS	Removal Sweat Gland Lesion Complex	6	$177.30	$856.95	$516.34	nat. median $2,998 outlier · 0.2×
11463 HCPCS	Removal Sweat Gland Lesion Inguinal Comp	6	$170.64	$824.76	$499.44	nat. median $3,028 outlier · 0.2×
31603 HCPCS	Tracheostomy- Emergency Procedure	6	$234.00	$1,131.00	$493.02	nat. median $1,716 outlier · 0.3×
11451 HCPCS	Removal Sweat Gland Lesion Axil Complex	6	$168.30	$813.45	$492.93	nat. median $3,041 outlier · 0.2×
12056 HCPCS	Lyr Cls Face 20.1 30.0 Cm	6	$118.62	$826.50	$484.36	nat. median $635 0.8× median
12057 HCPCS	Lyr Cls Face Grt 30.0 Cm	6	$118.62	$913.50	$484.36	nat. median $661 0.7× median
G0390 HCPCS	Trauma Response Team	6	$162.00	$783.00	$472.50	nat. median $3,172 outlier · 0.1×
72126 HCPCS	CT C-spine W	6	$162.15	$1,174.50	$464.22	nat. median $755 0.6× median
72132 HCPCS	CT L-spine W	6	$162.46	$1,174.50	$464.22	nat. median $760 0.6× median
74177 HCPCS	CT Abdomen/pelvis W	6	$275.58	$2,175.00	$464.22	nat. median $928 0.5× median
74178 HCPCS	CT Abdomen/ Pelvis W/wo	6	$326.63	$2,784.00	$464.22	nat. median $979 outlier · 0.5×
12047 HCPCS	Lyr Cls Nck Hnd Ft Genit > 30.0 Cm	6	$132.12	$1,121.43	$463.67	nat. median $1,847 outlier · 0.3×
25565 HCPCS	Treat Radius/ulna Frac W/munipulation	6	$135.00	$652.50	$450.69	nat. median $1,679 outlier · 0.3×
17107 HCPCS	Destruct Skin Lesions 10.0 To 50.0 Sq Cm	6	$151.20	$730.80	$432.63	nat. median $797 0.5× median
12046 HCPCS	Lyr Cls Nck Hnd Ft Genit 20.1 30.0 Cm	6	$109.44	$794.31	$424.10	nat. median $842 0.5× median
12055 HCPCS	Lyr Cls Face 12.6 20.0 Cm	6	$106.56	$783.00	$424.10	nat. median $652 0.7× median
11470 HCPCS	Removal Sweat Gland Lesion Simple Interm	6	$142.74	$689.91	$422.86	nat. median $2,903 outlier · 0.1×
27550 HCPCS	Cltx Knee Disloc	6	$115.38	$789.96	$417.80	nat. median $531 0.8× median
13152 HCPCS	Rep Comp Lid Ns Ear 2.6 7.5 Cm	6	$123.12	$1,121.43	$415.96	nat. median $918 outlier · 0.5×
J1439 HCPCS	Ferric Carboxymaltose 50mg/mL 15ml Vial	5	$1.08	$1,973.91	$408.39	nat. median $63 outlier · 6.5×
12037 HCPCS	Lyr Cls Sclp Trnk Axl Extr > 30.0 Cm	6	$115.92	$1,121.43	$406.97	nat. median $1,995 outlier · 0.2×
11450 HCPCS	Removal Sweat Gland Lesion Axil Simple I	6	$131.94	$637.71	$395.24	nat. median $2,876 outlier · 0.1×
13132 HCPCS	Rep Comp Fore Chk 2.67.5 Cm	6	$110.88	$1,121.43	$394.91	nat. median $877 outlier · 0.5×
11462 HCPCS	Removal Sweat Gland Lesion Inguinal Simp	6	$128.88	$622.92	$385.04	nat. median $2,939 outlier · 0.1×
11446 HCPCS	Exc Face-mm B9 Marg > 4 Cm	6	$136.44	$659.46	$381.50	nat. median $2,849 outlier · 0.1×
70498 HCPCS	CTA Neck W	6	$227.23	$1,783.50	$376.75	nat. median $722 0.5× median
70496 HCPCS	CTA Head & Neck W	6	$227.23	$2,175.00	$372.82	nat. median $729 0.5× median
12036 HCPCS	Lyr Cls Sclp Trnk Axl Extr 20.1 30.0 Cm	6	$97.92	$1,121.43	$364.59	nat. median $883 outlier · 0.4×
26641 HCPCS	Cltx Carpometa Disloc W Manip	6	$115.38	$577.68	$361.22	nat. median $404 0.9× median
93925 HCPCS	US Lower Extremity Arterial Bilateral	6	$223.67	$565.50	$356.92	nat. median $545 0.7× median
13121 HCPCS	Rep Comp Scalp 2.67.5 Cm	6	$94.32	$1,121.43	$356.73	nat. median $814 outlier · 0.4×
13151 HCPCS	Rep Comp Lid Ns Ear 1.1 2.5 Cm	6	$101.52	$1,121.43	$354.49	nat. median $859 outlier · 0.4×
87902 HCPCS	Hcv Genotyping Non-reflex	6	$170.77	$586.38	$352.71	nat. median $412 0.9× median
12045 HCPCS	Lyr Cls Nck Hnd Ft Genit 12.6 20.0 Cm	6	$95.76	$671.64	$342.42	nat. median $833 outlier · 0.4×
17106 HCPCS	Destruct Skin Lesions Less Than 10 Sq Cm	6	$119.70	$578.55	$338.10	nat. median $523 0.6× median
26725 HCPCS	Cltx Phal Fx W Man	6	$105.48	$557.67	$336.16	nat. median $442 0.8× median
26700 HCPCS	Cltx Metcrpl Disloc	6	$105.12	$557.67	$334.60	nat. median $410 0.8× median

Other procedures at this hospital

Browse this hospital's 972 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

J2997	HCPCS	Alteplase Kit 100 Mg	5	5	$18,996.20	$16,146.77	$89.64	$16,526.69	$3,419.32	2024-12-30
J3101	HCPCS	Tenecteplase Kit 50 Mg	5	5	$16,920.61	$14,382.52	$154.57	$14,720.93	$3,045.71	2024-12-30
J0840	HCPCS	Crotalidae Polyval Immune Fab 2 Vial Kit	6	6	$3,766.12	$3,201.20	$677.90	$3,276.52	$1,852.15	2024-12-30
71275	HCPCS	CTA Chest W/wo	8	6	$3,200.00	$2,720.00	$227.23	$2,784.00	$1,111.50	2024-12-30
59410	HCPCS	Vag Delivery Only Ppc	13	6	$2,058.00	$1,749.30	$318.60	$1,790.46	$929.25	2024-12-30
32556	HCPCS	Pleural Drainage	6	6	$1,451.00	$1,233.35	$261.18	$1,262.37	$723.71	2024-12-30
26765	HCPCS	Open Trt Dist Phal Frac	13	6	$970.00	$824.50	$174.60	$5,328.75	$712.95	2024-12-30
25520	HCPCS	Closed Trmt Of Radial Frac & Dislocation	6	6	$1,400.00	$1,190.00	$252.00	$1,218.00	$648.54	2024-12-30
17108	HCPCS	Destruct Skin Lesions Over 50.0 Sq Cm	6	6	$1,250.00	$1,062.50	$225.00	$1,087.50	$630.14	2024-12-30
74176	HCPCS	CT Renal Stone	8	6	$1,250.00	$1,062.50	$176.32	$1,696.50	$606.50	2024-12-30
70487	HCPCS	CT Facial Bones Wo	8	6	$1,250.00	$1,062.50	$146.27	$1,174.50	$587.62	2024-12-30
71250	HCPCS	CT Chest Wo	8	6	$1,550.00	$1,317.50	$128.00	$1,348.50	$561.10	2024-12-30
J1559	HCPCS	Hizentra 10GM/50ml Subcutaneous Infusion	5	5	$2,922.00	$2,483.70	$12.97	$2,542.14	$525.96	2024-12-30
11471	HCPCS	Removal Sweat Gland Lesion Complex	6	6	$985.00	$837.25	$177.30	$856.95	$516.34	2024-12-30
11463	HCPCS	Removal Sweat Gland Lesion Inguinal Comp	6	6	$948.00	$805.80	$170.64	$824.76	$499.44	2024-12-30
31603	HCPCS	Tracheostomy- Emergency Procedure	6	6	$1,300.00	$1,105.00	$234.00	$1,131.00	$493.02	2024-12-30
11451	HCPCS	Removal Sweat Gland Lesion Axil Complex	6	6	$935.00	$794.75	$168.30	$813.45	$492.93	2024-12-30
12057	HCPCS	Lyr Cls Face Grt 30.0 Cm	17	6	$744.00	$632.40	$118.62	$913.50	$484.36	2024-12-30
12056	HCPCS	Lyr Cls Face 20.1 30.0 Cm	17	6	$684.00	$581.40	$118.62	$826.50	$484.36	2024-12-30
G0390	HCPCS	Trauma Response Team	6	6	$900.00	$765.00	$162.00	$783.00	$472.50	2024-12-30
72132	HCPCS	CT L-spine W	6	6	$1,350.00	$1,147.50	$162.46	$1,174.50	$464.22	2024-12-30
72126	HCPCS	CT C-spine W	6	6	$1,350.00	$1,147.50	$162.15	$1,174.50	$464.22	2024-12-30
74177	HCPCS	CT Abdomen/pelvis W	6	6	$2,500.00	$2,125.00	$275.58	$2,175.00	$464.22	2024-12-30
74178	HCPCS	CT Abdomen/ Pelvis W/wo	6	6	$3,200.00	$2,720.00	$326.63	$2,784.00	$464.22	2024-12-30
12047	HCPCS	Lyr Cls Nck Hnd Ft Genit > 30.0 Cm	17	6	$1,057.00	$898.45	$132.12	$1,121.43	$463.67	2024-12-30
25565	HCPCS	Treat Radius/ulna Frac W/munipulation	6	6	$750.00	$637.50	$135.00	$652.50	$450.69	2024-12-30
17107	HCPCS	Destruct Skin Lesions 10.0 To 50.0 Sq Cm	6	6	$840.00	$714.00	$151.20	$730.80	$432.63	2024-12-30
12055	HCPCS	Lyr Cls Face 12.6 20.0 Cm	17	6	$659.00	$560.15	$106.56	$783.00	$424.10	2024-12-30
12046	HCPCS	Lyr Cls Nck Hnd Ft Genit 20.1 30.0 Cm	17	6	$659.00	$560.15	$109.44	$794.31	$424.10	2024-12-30
11470	HCPCS	Removal Sweat Gland Lesion Simple Interm	6	6	$793.00	$674.05	$142.74	$689.91	$422.86	2024-12-30
27550	HCPCS	Cltx Knee Disloc	13	6	$908.00	$771.80	$115.38	$789.96	$417.80	2024-12-30
13152	HCPCS	Rep Comp Lid Ns Ear 2.6 7.5 Cm	13	6	$684.00	$581.40	$123.12	$1,121.43	$415.96	2024-12-30
J1439	HCPCS	Ferric Carboxymaltose 50mg/mL 15ml Vial	5	5	$2,268.86	$1,928.53	$1.08	$1,973.91	$408.39	2024-12-30
12037	HCPCS	Lyr Cls Sclp Trnk Axl Extr > 30.0 Cm	17	6	$930.00	$790.50	$115.92	$1,121.43	$406.97	2024-12-30
11450	HCPCS	Removal Sweat Gland Lesion Axil Simple I	6	6	$733.00	$623.05	$131.94	$637.71	$395.24	2024-12-30
13132	HCPCS	Rep Comp Fore Chk 2.67.5 Cm	13	6	$616.00	$523.60	$110.88	$1,121.43	$394.91	2024-12-30
11462	HCPCS	Removal Sweat Gland Lesion Inguinal Simp	6	6	$716.00	$608.60	$128.88	$622.92	$385.04	2024-12-30
11446	HCPCS	Exc Face-mm B9 Marg > 4 Cm	6	6	$758.00	$644.30	$136.44	$659.46	$381.50	2024-12-30
70498	HCPCS	CTA Neck W	6	6	$2,050.00	$1,742.50	$227.23	$1,783.50	$376.75	2024-12-30
70496	HCPCS	CTA Head & Neck W	6	6	$2,500.00	$2,125.00	$227.23	$2,175.00	$372.82	2024-12-30
12036	HCPCS	Lyr Cls Sclp Trnk Axl Extr 20.1 30.0 Cm	17	6	$812.00	$690.20	$97.92	$1,121.43	$364.59	2024-12-30
26641	HCPCS	Cltx Carpometa Disloc W Manip	13	6	$664.00	$564.40	$115.38	$577.68	$361.22	2024-12-30
93925	HCPCS	US Lower Extremity Arterial Bilateral	6	6	$650.00	$552.50	$223.67	$565.50	$356.92	2024-12-30
13121	HCPCS	Rep Comp Scalp 2.67.5 Cm	13	6	$524.00	$445.40	$94.32	$1,121.43	$356.73	2024-12-30
13151	HCPCS	Rep Comp Lid Ns Ear 1.1 2.5 Cm	13	6	$564.00	$479.40	$101.52	$1,121.43	$354.49	2024-12-30
87902	HCPCS	Hcv Genotyping Non-reflex	6	6	$674.00	$572.90	$170.77	$586.38	$352.71	2024-12-30
12045	HCPCS	Lyr Cls Nck Hnd Ft Genit 12.6 20.0 Cm	17	6	$659.00	$560.15	$95.76	$671.64	$342.42	2024-12-30
17106	HCPCS	Destruct Skin Lesions Less Than 10 Sq Cm	6	6	$665.00	$565.25	$119.70	$578.55	$338.10	2024-12-30
26725	HCPCS	Cltx Phal Fx W Man	13	6	$586.00	$498.10	$105.48	$557.67	$336.16	2024-12-30
26700	HCPCS	Cltx Metcrpl Disloc	13	6	$584.00	$496.40	$105.12	$557.67	$334.60	2024-12-30
13101	HCPCS	Rep Comp Trunk 2.6 To 7.5 Cm	13	6	$494.00	$419.90	$88.92	$1,121.43	$334.00	2024-12-30
22315	HCPCS	Closed Tx Vert Fx W/manj	6	6	$507.00	$430.95	$91.26	$496.86	$333.35	2024-12-30
23650	HCPCS	Cltx Shoulder Disloc	13	6	$556.00	$472.60	$100.08	$557.67	$327.29	2024-12-30
12035	HCPCS	Lyr Cls Sclp Trnk Axl Extr 12.6 20.0 Cm	17	6	$733.00	$623.05	$84.60	$1,121.43	$326.98	2024-12-30
11426	HCPCS	Exc H-f-nk-sp B9 Marg > 4 Cm	6	6	$647.00	$549.95	$116.46	$562.89	$325.83	2024-12-30
13131	HCPCS	Rep Comp Fore Chk 1.12.5 Cm	13	6	$490.00	$416.50	$88.20	$573.33	$325.30	2024-12-30
12054	HCPCS	Lyr Cls Face 7.6 12.5 Cm	17	6	$659.00	$560.15	$80.28	$604.65	$324.46	2024-12-30
27560	HCPCS	Cltx Patellar Disloc	13	6	$642.00	$545.70	$91.26	$558.54	$322.77	2024-12-30
99291	HCPCS	Critcl Care 1st 30 74 Min	13	6	$440.00	$374.00	$79.20	$1,713.90	$321.44	2024-12-30
12044	HCPCS	Lyr Cls Nck Hnd Ft Genit 7.6 12.5 Cm	17	6	$659.00	$560.15	$75.96	$775.17	$319.69	2024-12-30
93970	HCPCS	US Venous Doppler Bilat	6	6	$650.00	$552.50	$174.17	$565.50	$318.48	2024-12-30
31605	HCPCS	Tracheostomy Cricothyroid Memb	13	6	$366.00	$311.10	$65.88	$1,686.93	$318.42	2024-12-30
93880	HCPCS	US Carotid Bilateral	6	6	$550.00	$467.50	$177.12	$478.50	$313.22	2024-12-30
11406	HCPCS	Exc Tr-ext B9 Marg > 4.0 Cm	6	6	$607.00	$515.95	$109.26	$528.09	$310.81	2024-12-30
12053	HCPCS	Lyr Cls Face 5.1 7.5 Cm	17	6	$659.00	$560.15	$76.68	$578.55	$305.93	2024-12-30
74170	HCPCS	CT Abdomen W/wo	6	6	$2,500.00	$2,125.00	$227.23	$2,175.00	$304.34	2024-12-30
93306	HCPCS	US Echocardiography	6	6	$750.00	$637.50	$135.00	$652.50	$302.96	2024-12-30
36590	HCPCS	Removal Cvad W/subcutaneos Port Or Pump	6	6	$744.00	$632.40	$133.92	$647.28	$300.33	2024-12-30
22310	HCPCS	Cltxmnt Vert Body Frac	13	6	$552.00	$469.20	$99.36	$557.67	$299.70	2024-12-30
25605	HCPCS	Treat Fracture Radius/ulna Profee	14	6	$350.00	$297.50	$63.00	$573.21	$299.25	2024-12-30
13120	HCPCS	Rep Comp Scalp 1.12.5 Cm	13	6	$462.00	$392.70	$83.16	$573.33	$298.64	2024-12-30
26600	HCPCS	Cltx Metcrpl Fx Singl Wo Man	13	6	$532.00	$452.20	$95.76	$557.67	$296.42	2024-12-30
13100	HCPCS	Rep Comp Trunk 1.1 To 2.5 Cm	13	6	$404.00	$343.40	$72.72	$1,121.43	$286.29	2024-12-30
12020	HCPCS	Closure Of Split Wound Simple	6	6	$540.00	$459.00	$97.20	$469.80	$283.25	2024-12-30
12034	HCPCS	Lyr Cls Sclp Trnk Axl Extr 7.6 12.5 Cm	17	6	$601.00	$510.85	$72.72	$573.33	$280.67	2024-12-30
11444	HCPCS	Exc Face-mm B9 Marg 3.1-4 Cm	6	6	$545.00	$463.25	$98.10	$474.15	$277.48	2024-12-30
72194	HCPCS	CT-pelvis W/wo Contrast	6	6	$1,950.00	$1,657.50	$227.23	$1,696.50	$273.69	2024-12-30
11762	HCPCS	Recnstrctn Nail Bed W Graft	13	6	$366.00	$311.10	$65.88	$3,671.40	$272.13	2024-12-30
71270	HCPCS	CT Chest W/wo	6	6	$2,500.00	$2,125.00	$188.41	$2,175.00	$268.34	2024-12-30
26770	HCPCS	Cltx Inter Jnt Wo Ane	13	6	$492.00	$418.20	$88.56	$441.09	$266.18	2024-12-30
10121	HCPCS	Incis Remov Fb Subq Comp	17	6	$450.00	$382.50	$65.16	$3,499.14	$266.07	2024-12-30
70492	HCPCS	CT Neck St W/wo	6	6	$1,950.00	$1,657.50	$212.49	$1,696.50	$265.26	2024-12-30
12052	HCPCS	Lyr Cls Face 2.6 5.0 Cm	17	6	$568.00	$482.80	$71.64	$573.33	$264.67	2024-12-30
11044	HCPCS	Debrid Skin Sub-q Muscle Bone	6	6	$441.00	$374.85	$79.38	$383.67	$263.44	2024-12-30
90671	HCPCS	Cln- Pneumococcal 15 Conjugate 0.5ml	6	6	$524.61	$445.92	$94.43	$456.41	$261.96	2024-12-30
12042	HCPCS	Lyr Cls Nck Hnd Ft Genit 2.6 7.5 Cm	17	6	$558.00	$474.30	$70.20	$573.33	$260.18	2024-12-30
99285	HCPCS	Ed Visit 5 High Sever Sig	14	6	$344.00	$292.40	$61.92	$1,174.50	$254.25	2024-12-30
12032	HCPCS	Lyr Cls Sclp Trnk Axl Extr 2.6 7.5 Cm	17	6	$584.00	$496.40	$68.04	$573.33	$253.45	2024-12-30
32551	HCPCS	Professional Chest Tube Insertion	13	6	$340.00	$289.00	$61.20	$1,276.29	$249.90	2024-12-30
74160	HCPCS	CT Abdomen W	6	6	$1,950.00	$1,657.50	$223.59	$1,696.50	$249.05	2024-12-30
10180	HCPCS	Complex Drainage Wound	6	6	$474.00	$402.90	$85.32	$412.38	$248.47	2024-12-30
24600	HCPCS	Closed Trmt Elbow Disloc; Without Anes	6	6	$375.00	$318.75	$67.50	$367.50	$246.56	2024-12-30
20615	HCPCS	Treatment Of Bone Cyst	6	6	$470.00	$399.50	$84.60	$408.90	$243.63	2024-12-30
71260	HCPCS	CT Chest W	6	6	$1,950.00	$1,657.50	$160.50	$1,696.50	$239.76	2024-12-30
72129	HCPCS	CT T-spine W	6	6	$1,350.00	$1,147.50	$163.39	$1,174.50	$239.75	2024-12-30
70470	HCPCS	CT Head W/wo	6	6	$1,950.00	$1,657.50	$166.86	$1,696.50	$239.38	2024-12-30
70491	HCPCS	CT Neck St W	6	6	$1,350.00	$1,147.50	$177.23	$1,174.50	$239.33	2024-12-30
12051	HCPCS	Lyr Cls Face < 2.5 Cm	17	6	$497.00	$422.45	$60.12	$573.33	$238.57	2024-12-30
M0240	HCPCS	Admin For Regenerons	6	6	$450.50	$382.93	$81.09	$391.94	$236.51	2024-12-30
99236	HCPCS	Obsrv/inpt Hosp Care E&m High Sever	9	6	$642.00	$545.70	$115.56	$558.54	$235.24	2024-12-30
23540	HCPCS	Clsd Tx Acromioclviculr Dislo Wo Man	13	6	$440.00	$374.00	$79.20	$557.67	$234.96	2024-12-30
72193	HCPCS	CT Pelvis W	6	6	$1,350.00	$1,147.50	$219.38	$1,174.50	$233.03	2024-12-30
11422	HCPCS	Trim Skin Lesion	10	6	$1,200.00	$1,020.00	$60.84	$1,044.00	$232.22	2024-12-30
11424	HCPCS	Exc H-f-nk-sp B9 Marg 3.1-4	6	6	$452.00	$384.20	$81.36	$393.24	$231.48	2024-12-30
23570	HCPCS	Cltx Scapular Frac	13	6	$460.00	$391.00	$82.80	$441.09	$231.26	2024-12-30
26740	HCPCS	Cltx Art Fx Wo Man	13	6	$412.00	$350.20	$74.16	$557.67	$229.85	2024-12-30
81517	HCPCS	Enhanced Liver Fibrosis	6	6	$542.00	$460.70	$97.56	$471.54	$228.61	2024-12-30
70460	HCPCS	CT Head W	6	6	$1,350.00	$1,147.50	$142.58	$1,174.50	$227.23	2024-12-30
12041	HCPCS	Lyr Cls Nck Hnd Ft Genit < 2.5 Cm	17	6	$457.00	$388.45	$54.72	$573.33	$222.57	2024-12-30
11443	HCPCS	Exc Face-mm B9 Marg 2.1-3 Cm	6	6	$433.00	$368.05	$77.94	$376.71	$221.75	2024-12-30
12031	HCPCS	Lyr Cls Sclp Trnk Axl Extr < 2.5 Cm	17	6	$457.00	$388.45	$53.64	$573.33	$221.73	2024-12-30
11404	HCPCS	Exc Tr-ext B9 Marg 3.1-4 Cm	6	6	$420.00	$357.00	$75.60	$365.40	$216.44	2024-12-30
99255	HCPCS	Inpt Consult High Severity	9	6	$924.00	$785.40	$166.32	$803.88	$212.44	2024-12-30
28470	HCPCS	Cltx Met Fx Without Man	13	6	$396.00	$336.60	$71.28	$557.67	$212.24	2024-12-30
J0248	HCPCS	Remdesivir 100mg Vial	5	5	$1,170.00	$994.50	$6.22	$1,017.90	$210.60	2024-12-30
25560	HCPCS	Treat Radius/ulna Fract Without Munipulation	6	6	$325.00	$276.25	$58.50	$285.92	$205.55	2024-12-30
11750	HCPCS	Exc Nail Matrix Permanent	17	6	$400.00	$340.00	$61.20	$987.45	$204.30	2024-12-30
70480	HCPCS	CT Orbit Wo IV Contrast	6	6	$1,250.00	$1,062.50	$134.67	$1,087.50	$204.19	2024-12-30
90750	HCPCS	Cln-zoster Vaccine Recombinant	6	6	$452.94	$385.00	$81.53	$394.06	$203.69	2024-12-30
92960	HCPCS	Cardioversion External	19	6	$275.00	$233.75	$43.56	$1,226.70	$202.12	2024-12-30
92950	HCPCS	Heart/lung Resuscitation Cpr	15	6	$200.00	$170.00	$36.00	$275.00	$199.88	2024-12-30
11423	HCPCS	Exc H-f-nk-sp B9+marg 2.1-3	6	6	$389.00	$330.65	$70.02	$338.43	$199.48	2024-12-30
73200	HCPCS	CT Elbow Left,left	18	6	$1,250.00	$1,062.50	$134.67	$1,131.00	$199.07	2024-12-30
36556	HCPCS	Insert Non Tunnel Cv Cath 5+	13	6	$244.00	$207.40	$43.92	$2,200.23	$198.81	2024-12-30
26720	HCPCS	Cltx Phal Fx Wo Man	13	6	$354.00	$300.90	$63.72	$441.09	$198.78	2024-12-30
99205	HCPCS	Office Visit New Pt Level 5	6	6	$250.00	$212.50	$45.00	$217.50	$197.00	2024-12-30
76770	HCPCS	US Abdominal Aorta	8	6	$450.00	$382.50	$101.50	$391.50	$195.96	2024-12-30
12007	HCPCS	Rep Smp Scpnckaxgntrnkxtrm Over 30.	17	6	$425.00	$361.25	$53.28	$381.06	$194.79	2024-12-30
90670	HCPCS	Cln-pneumococcal 13-valent 0.5ml	11	6	$265.00	$225.25	$44.64	$252.83	$194.78	2024-12-30
11980	HCPCS	Biote Male Pellet Insertion	10	6	$725.00	$616.25	$63.00	$630.75	$193.88	2024-12-30
73700	HCPCS	CT Ankle Bilateral,bilateral	18	6	$1,250.00	$1,062.50	$124.47	$1,131.00	$193.03	2024-12-30
31515	HCPCS	Laryngoscopy Direct Aspiration	13	6	$220.00	$187.00	$39.60	$3,285.99	$191.40	2024-12-30
11403	HCPCS	Exc Tr-ext B9 Marg 2.1-3 Cm	6	6	$370.00	$314.50	$66.60	$321.90	$190.90	2024-12-30
36555	HCPCS	Insert Central Line< 5 Years	13	6	$236.00	$200.60	$42.48	$2,200.23	$189.39	2024-12-30
99235	HCPCS	Obsrv/inpt Hosp Care E&m Mod Sever	9	6	$498.00	$423.30	$89.64	$433.26	$189.27	2024-12-30
T1015	HCPCS	Clinic Vst/encounter All-inclusive,team	15	6	$190.00	$161.50	$128.62	$248.00	$188.31	2024-12-30
10080	HCPCS	I & D Pilon Cyst Simp	14	6	$202.00	$171.70	$36.36	$421.95	$186.85	2024-12-30
11442	HCPCS	Exc Face-mm B9 Marg 1.1-2 Cm	6	6	$362.00	$307.70	$65.16	$314.94	$186.59	2024-12-30
26750	HCPCS	Cltx Fx Fingr Thumb Without Man	13	6	$354.00	$300.90	$63.72	$441.09	$185.92	2024-12-30
12016	HCPCS	Rep Smp Face 12.6 To 20.0 Cm	17	6	$396.00	$336.60	$47.52	$381.06	$184.12	2024-12-30
30905	HCPCS	Control Nasal Hemorr Post Init	14	6	$198.00	$168.30	$35.64	$338.43	$183.15	2024-12-30
93971	HCPCS	US Venous Doppler Left,left	12	6	$550.00	$467.50	$110.85	$478.50	$179.85	2024-12-30
M0239	HCPCS	IV Infusion Bamlanivimab & Monitoring	6	6	$340.00	$289.00	$61.20	$295.80	$178.50	2024-12-30
M0243	HCPCS	IV Infusion Casirivimab/imde Monitoring	6	6	$340.00	$289.00	$61.20	$295.80	$178.50	2024-12-30
99284	HCPCS	Ed Visit 4 High Sever	14	6	$234.00	$198.90	$42.12	$998.00	$177.19	2024-12-30
70490	HCPCS	CT Neck St Wo	6	6	$1,250.00	$1,062.50	$134.67	$1,087.50	$176.72	2024-12-30
99254	HCPCS	Inpt Consult Moderatehigh Severity	9	6	$966.00	$821.10	$136.03	$840.42	$175.75	2024-12-30
70486	HCPCS	CT Sinus Wo	6	6	$1,250.00	$1,062.50	$122.97	$1,087.50	$173.80	2024-12-30
12006	HCPCS	Rep Smp Scpnckaxgntrnkxtrm 20.1cm3	17	6	$369.00	$313.65	$42.84	$573.33	$173.17	2024-12-30
99306	HCPCS	Initial Nursing Facility Care	9	6	$324.00	$275.40	$58.32	$281.88	$172.72	2024-12-30
72125	HCPCS	CT C-spine Wo	6	6	$1,250.00	$1,062.50	$125.09	$1,087.50	$169.60	2024-12-30
30300	HCPCS	Remove Fb Intranasal	13	6	$242.00	$205.70	$43.56	$343.65	$169.47	2024-12-30
72128	HCPCS	CT T-spine Wo	6	6	$1,250.00	$1,062.50	$124.77	$1,087.50	$169.46	2024-12-30
72131	HCPCS	CT L-spine Wo	6	6	$1,250.00	$1,062.50	$124.16	$1,087.50	$169.19	2024-12-30
74150	HCPCS	CT Abdomen Wo	6	6	$1,550.00	$1,317.50	$131.58	$1,348.50	$167.71	2024-12-30
11441	HCPCS	Exc Face-mm B9 Marg 0.6-1 Cm	6	6	$323.00	$274.55	$58.14	$281.01	$167.20	2024-12-30
28495	HCPCS	Cltx Fx Great Toe W Man	13	6	$296.00	$251.60	$53.28	$557.67	$167.18	2024-12-30
12021	HCPCS	Closure Of Split Wound With Packing	6	6	$315.00	$267.75	$56.70	$274.05	$166.79	2024-12-30
72192	HCPCS	CT Pelvis Wo	6	6	$1,250.00	$1,062.50	$128.02	$1,087.50	$166.00	2024-12-30
12018	HCPCS	Rep Smp Face >30 Cm	17	6	$352.00	$299.20	$62.28	$381.06	$165.88	2024-12-30
11402	HCPCS	Exc Tr-ext B9 Marg 1.1-2 Cm	6	6	$320.00	$272.00	$57.60	$278.40	$165.26	2024-12-30
99223	HCPCS	Observ High Cmpl Ea Hr	13	6	$546.00	$464.10	$98.28	$516.78	$164.64	2024-12-30
36430	HCPCS	Blood Infusion 1- 4 Hours (prbc)	13	5	$891.00	$757.35	$32.83	$852.60	$160.38	2024-12-30
28515	HCPCS	Cltx Fx Phalanx W Man	13	6	$280.00	$238.00	$50.40	$557.67	$159.96	2024-12-30
76536	HCPCS	US Thyroid Complete	8	6	$350.00	$297.50	$96.23	$304.50	$159.21	2024-12-30
69000	HCPCS	I & D Abscess Ear Simple	13	6	$232.00	$197.20	$41.76	$421.95	$158.02	2024-12-30
11760	HCPCS	Repair Of Nail Bed	13	6	$256.00	$217.60	$46.08	$573.33	$158.02	2024-12-30
30906	HCPCS	Control Nasal Hemorr Post Subs	21	6	$260.00	$221.00	$28.44	$351.99	$158.00	2024-12-30
11010	HCPCS	Debrid With Open Fx/and/or Dosloc	6	6	$238.00	$202.30	$42.84	$233.24	$156.49	2024-12-30
11011	HCPCS	Debrid Openfx/skin Sub-q Muscle	6	6	$238.00	$202.30	$42.84	$233.24	$156.49	2024-12-30
99215	HCPCS	Office Visit Est Pt. Level 5	6	6	$220.00	$187.00	$39.60	$191.40	$155.78	2024-12-30
17004	HCPCS	Destroy Lesions 15 Or More	6	6	$290.00	$246.50	$52.20	$252.30	$155.01	2024-12-30
99204	HCPCS	Office Visit New Pt. Level 4	6	6	$205.00	$174.25	$36.90	$178.35	$155.00	2024-12-30
11421	HCPCS	Exc H-f-nk-sp B9 Marg 0.6-1	6	6	$301.00	$255.85	$54.18	$261.87	$154.59	2024-12-30
76775	HCPCS	US Abdominal Wall Soft Tissue	8	6	$235.00	$199.75	$56.20	$304.50	$153.69	2024-12-30
16030	HCPCS	Drss Dbrid Burn Prtl Thckns Lg	18	6	$260.00	$221.00	$16.20	$738.63	$152.82	2024-12-30
27840	HCPCS	Closed Treat Ankle Dislo Without Anthes	6	6	$230.00	$195.50	$41.40	$225.40	$151.23	2024-12-30
11401	HCPCS	Exc Tr-ext B9 Marg 0.6-1 Cm	6	6	$287.00	$243.95	$51.66	$249.69	$149.06	2024-12-30
10120	HCPCS	Incis Remov Fb Subq Simp	17	6	$265.00	$225.25	$36.36	$738.63	$148.47	2024-12-30
12005	HCPCS	Rep Smp Scpnckaxgntrnkxtrm 12.6cm2	17	6	$312.00	$265.20	$35.28	$381.06	$148.19	2024-12-30
90734	HCPCS	Cln-meningococcal Intramuscular Kit	14	6	$290.00	$246.50	$50.40	$335.82	$148.02	2024-12-30
12017	HCPCS	Rep Smp Face 20.1 To 30.0 Cm	17	6	$310.00	$263.50	$55.08	$381.06	$147.26	2024-12-30
70450	HCPCS	CT Head Wo	6	6	$1,250.00	$1,062.50	$102.01	$1,087.50	$147.14	2024-12-30
87798	HCPCS	B Pertussis/ B Parapertussis Pcr	8	6	$334.00	$283.90	$23.23	$425.43	$146.78	2024-12-30
30903	HCPCS	Control Nasal Hemorr Ant Comp	14	6	$158.00	$134.30	$28.44	$338.43	$146.15	2024-12-30
0551	RC	—	6	6	$277.90	$236.22	$50.02	$241.77	$145.90	2024-12-30
99234	HCPCS	Obsrv/inpt Hosp Care E&m Low Sever	9	6	$396.00	$336.60	$71.28	$344.52	$144.37	2024-12-30
90710	HCPCS	Cln-mmrii	6	6	$217.91	$185.22	$39.22	$217.91	$144.36	2024-12-30
12015	HCPCS	Rep Smp Face 7.6 To 12.5 Cm	17	6	$313.00	$266.05	$35.28	$381.06	$143.98	2024-12-30
11012	HCPCS	Debrid Open Fx/skin Sub-q Musc Bone	6	6	$216.00	$183.60	$38.88	$211.68	$142.02	2024-12-30
81256	HCPCS	Hereditary Hemachromatosis DNA	6	6	$480.00	$408.00	$64.05	$417.60	$140.77	2024-12-30
56405	HCPCS	I & D Vulva Perineal Abs	13	6	$212.00	$180.20	$38.16	$589.86	$139.45	2024-12-30
11765	HCPCS	Wedge Excise Skin Nail Fold	13	6	$184.00	$156.40	$33.12	$381.06	$138.93	2024-12-30
99310	HCPCS	Subsqt Nursing Facility Care Per Day	9	6	$264.00	$224.40	$47.52	$229.68	$138.55	2024-12-30
11106	HCPCS	Incal Bx Skn Single Les	6	6	$250.00	$212.50	$45.00	$217.50	$138.49	2024-12-30
25500	HCPCS	Closed Trmt Radial Frac Without Munipulation	6	6	$210.00	$178.50	$37.80	$205.80	$138.07	2024-12-30
28490	HCPCS	Cltx Fx Great Toe Wo Man	13	6	$244.00	$207.40	$43.92	$441.09	$137.68	2024-12-30
76881	HCPCS	US Soft Tissue Extremity	6	6	$350.00	$297.50	$51.22	$304.50	$137.30	2024-12-30
76882	HCPCS	US Thigh Unilateral	6	6	$350.00	$297.50	$24.90	$304.50	$137.30	2024-12-30
76856	HCPCS	US Pelvis Complete	6	6	$350.00	$297.50	$98.64	$304.50	$137.30	2024-12-30
11440	HCPCS	Exc Face-mm B9 Marg 0.5 < Cm	6	6	$258.00	$219.30	$46.44	$224.46	$135.39	2024-12-30
72050	HCPCS	Xr Cervical Spine Complete View	6	6	$310.00	$263.50	$43.26	$269.70	$134.67	2024-12-30
71110	HCPCS	Xr Ribs Bilateral	6	6	$285.00	$242.25	$33.39	$247.95	$134.67	2024-12-30
71048	HCPCS	Xr Chest 4 Views	6	6	$285.00	$242.25	$32.64	$247.95	$134.67	2024-12-30
70260	HCPCS	Xr Skull 4+ Views	6	6	$235.00	$199.75	$38.68	$204.45	$134.67	2024-12-30
70250	HCPCS	Xr Skull 1-3 Views	6	6	$185.00	$157.25	$30.35	$160.95	$134.67	2024-12-30
70200	HCPCS	Xr Orbits	6	6	$185.00	$157.25	$36.13	$160.95	$134.67	2024-12-30
70150	HCPCS	Xr Facial Bones Complete	6	6	$235.00	$199.75	$35.01	$204.45	$134.67	2024-12-30
70130	HCPCS	Xr Mastoid Complete	6	6	$185.00	$157.25	$45.76	$160.95	$134.67	2024-12-30
70110	HCPCS	Xr Mandible	18	6	$185.00	$157.25	$32.27	$160.95	$134.67	2024-12-30
74019	HCPCS	Xr Abdomen 2 Views	6	6	$235.00	$199.75	$25.97	$204.45	$134.67	2024-12-30
76830	HCPCS	US Transvaginal	6	6	$350.00	$297.50	$101.89	$304.50	$134.67	2024-12-30
76705	HCPCS	US Abdomen Limited	6	6	$350.00	$297.50	$81.51	$304.50	$134.67	2024-12-30
76700	HCPCS	US Abdomen Complete	6	6	$450.00	$382.50	$109.02	$391.50	$134.67	2024-12-30
74022	HCPCS	Xr Abdomen Complete W/cxr	6	6	$250.00	$212.50	$39.47	$217.50	$134.67	2024-12-30
76870	HCPCS	US Scrotum	6	6	$350.00	$297.50	$93.62	$304.50	$134.67	2024-12-30
76641	HCPCS	US Breast	6	6	$250.00	$212.50	$84.52	$217.50	$134.67	2024-12-30
73564	HCPCS	Xr Knee Left 4 Or More Views,left	12	6	$235.00	$199.75	$34.40	$204.45	$134.67	2024-12-30
73010	HCPCS	Xr Scapula Left 2 Views,left	12	6	$185.00	$157.25	$22.49	$160.95	$134.67	2024-12-30
72190	HCPCS	Xr Pelvis Complete	6	6	$235.00	$199.75	$34.38	$204.45	$134.67	2024-12-30
72170	HCPCS	Xr Pelvis 1-2 Views	6	6	$185.00	$157.25	$22.33	$160.95	$134.67	2024-12-30
72114	HCPCS	Xr Lumbar Spine Complete + Flex/ext	6	6	$385.00	$327.25	$57.25	$334.95	$134.67	2024-12-30
72110	HCPCS	Xr Lumbar Spine Complete	6	6	$310.00	$263.50	$45.44	$269.70	$134.67	2024-12-30
72100	HCPCS	Xr Lumbar Spine 2-3 Views	6	6	$235.00	$199.75	$33.31	$204.45	$134.67	2024-12-30
72070	HCPCS	Xr Thoracic Spine 2-3v	6	6	$235.00	$199.75	$27.86	$204.45	$134.67	2024-12-30
31500	HCPCS	Professional - Airway- Oral Pharyngeal	17	6	$248.00	$210.80	$39.60	$338.43	$133.78	2024-12-30
73521	HCPCS	Xr Bilat Hips W Pelvis	8	6	$235.00	$199.75	$30.59	$204.45	$132.58	2024-12-30
87502	HCPCS	Rapid Flu A+b	6	6	$185.00	$157.25	$90.22	$160.95	$131.25	2024-12-30
99343	HCPCS	Home V Np Detailed	6	6	$265.00	$225.25	$47.70	$230.55	$130.90	2024-12-30
28630	HCPCS	Cls Trt Jnt Disloc Metatars Wo Anes	13	6	$216.00	$183.60	$38.88	$557.67	$130.51	2024-12-30
0421	RC	—	6	6	$303.78	$258.21	$54.68	$264.29	$129.74	2024-12-30
99233	HCPCS	Subsqt Hosp Day E&m Signif Compl	9	6	$309.00	$262.65	$55.62	$268.83	$129.67	2024-12-30
17111	HCPCS	Destruct Lesion 15 Or More	6	6	$253.00	$215.05	$45.54	$220.11	$129.07	2024-12-30
74290	HCPCS	Xr Contrast X-ray Gallbladder	6	6	$160.00	$136.00	$55.53	$160.00	$128.40	2024-12-30
72052	HCPCS	Xr Cervical Spine Routine	6	6	$165.00	$140.25	$54.78	$143.55	$127.97	2024-12-30
90716	HCPCS	Cln-varicella Ped 0.5ml Sdv	6	6	$202.80	$172.38	$36.50	$176.44	$127.77	2024-12-30
99305	HCPCS	Initial Nursing Facility Care	9	6	$254.00	$215.90	$45.72	$220.98	$126.81	2024-12-30
G0402	HCPCS	Init Prev Pe Ltd Dur 1st 12 Mos Mcr	6	6	$200.00	$170.00	$36.00	$174.00	$126.00	2024-12-30
29345	HCPCS	Cast Long Leg - Adult	6	6	$230.00	$195.50	$41.40	$200.10	$125.24	2024-12-30
10061	HCPCS	I&d Abscess Cpmplex	11	6	$170.00	$144.50	$30.60	$348.00	$124.95	2024-12-30
99239	HCPCS	Hosp Disch Mgmnt > 30 Min	9	6	$315.00	$267.75	$56.70	$274.05	$124.90	2024-12-30
90732	HCPCS	Pneumococcal Vaccine Polyvalent Inj	6	6	$275.50	$234.18	$49.59	$239.68	$124.31	2024-12-30
99222	HCPCS	Initial Observation Care	13	6	$200.00	$170.00	$36.00	$217.50	$124.20	2024-12-30
11400	HCPCS	Exc Tr-ext B9 Marg 0.5 < Cm	6	6	$238.00	$202.30	$42.84	$207.06	$122.91	2024-12-30
99253	HCPCS	Inpt Consult Moderate Severity	9	6	$288.00	$244.80	$51.84	$250.56	$121.87	2024-12-30
56420	HCPCS	I & D Bart Gl& Abscess	13	6	$180.00	$153.00	$32.40	$341.04	$121.64	2024-12-30
11420	HCPCS	Exc H-f-nk-sp B9 Marg 0.5 <	6	6	$235.00	$199.75	$42.30	$204.45	$121.47	2024-12-30
77073	HCPCS	Xr Bone Age	6	6	$150.00	$127.50	$32.03	$134.67	$120.38	2024-12-30
12014	HCPCS	Rep Smp Face 5.1 To 7.5 Cm	17	6	$258.00	$219.30	$28.08	$256.65	$120.13	2024-12-30
10140	HCPCS	Drainage Of Hematoma/fluid	18	6	$315.00	$267.75	$19.80	$691.65	$119.87	2024-12-30
82088	HCPCS	Aldosterone-lcms-serum	10	6	$149.00	$126.65	$27.07	$224.46	$119.57	2024-12-30
28510	HCPCS	Cltx Fx Phalanx Wo Man	13	6	$234.00	$198.90	$42.12	$441.09	$117.96	2024-12-30
G0439	HCPCS	Annual Wellness Vst; Pps Subsqt Vst	6	6	$210.00	$178.50	$37.80	$182.70	$117.09	2024-12-30
99214	HCPCS	Office Visit Est Pt. Level 4	6	6	$175.00	$148.75	$31.50	$152.25	$116.66	2024-12-30
24640	HCPCS	Cltx Radial Head Subl	13	6	$184.00	$156.40	$33.12	$557.67	$115.38	2024-12-30
G0438	HCPCS	Annual Wellnes Vst; Persnl Pps Init	6	6	$180.00	$153.00	$32.40	$157.82	$113.71	2024-12-30
99386	HCPCS	Well 40-64 Years Old; New	6	6	$180.00	$153.00	$32.40	$156.60	$113.40	2024-12-30
99385	HCPCS	Well 18-39 Years Old; New	6	6	$200.00	$170.00	$36.00	$174.00	$112.28	2024-12-30
93922	HCPCS	US Ankle Brachial Indices	6	6	$250.00	$212.50	$45.00	$217.50	$111.51	2024-12-30
99226	HCPCS	Subsqnt Observatn Care Sever Complic	9	6	$309.00	$262.65	$55.62	$268.83	$110.53	2024-12-30
72040	HCPCS	Xr Cervical Spine 2-3 Views	6	6	$235.00	$199.75	$31.95	$204.45	$109.47	2024-12-30
72020	HCPCS	Xr Cervical Spine 1 View	6	6	$185.00	$157.25	$19.58	$160.95	$109.47	2024-12-30
71120	HCPCS	Xr Sternum 2 Views	6	6	$165.00	$140.25	$26.20	$143.55	$109.47	2024-12-30
71100	HCPCS	Xr Ribs Left 2-3 Views,left	12	6	$235.00	$199.75	$26.50	$204.45	$109.47	2024-12-30
71046	HCPCS	Xr Chest 2 Views	6	6	$235.00	$199.75	$23.78	$204.45	$109.47	2024-12-30
71045	HCPCS	Xr Chest Portable	6	6	$185.00	$157.25	$15.54	$160.95	$109.47	2024-12-30
70328	HCPCS	Xr Tmj Routine	6	6	$185.00	$157.25	$25.35	$160.95	$109.47	2024-12-30
70220	HCPCS	Xr Sinuses Complete	6	6	$235.00	$199.75	$31.73	$204.45	$109.47	2024-12-30
70210	HCPCS	Xr Sinuses 1-2 Views	6	6	$185.00	$157.25	$25.33	$160.95	$109.47	2024-12-30
70140	HCPCS	Xr Facial Bones 1-2 Views	6	6	$185.00	$157.25	$24.82	$160.95	$109.47	2024-12-30
74018	HCPCS	Xr Abdomen 1 View	6	6	$185.00	$157.25	$21.26	$160.95	$109.47	2024-12-30
73650	HCPCS	Xr Heel Bilateral,bilateral	18	6	$135.00	$114.75	$22.86	$269.70	$109.47	2024-12-30
73630	HCPCS	Xr Foot Bilateral,bilateral	18	6	$185.00	$157.25	$25.88	$269.70	$109.47	2024-12-30
73590	HCPCS	Xr Tibia/fibula Left 2 Views,left	12	6	$155.00	$131.75	$22.61	$134.85	$109.47	2024-12-30
73610	HCPCS	Xr Ankle Bilateral,bilateral	18	6	$185.00	$157.25	$26.42	$269.70	$109.47	2024-12-30
73562	HCPCS	Xr Knee Left 3 Views,left	12	6	$185.00	$157.25	$29.97	$160.95	$109.47	2024-12-30
73565	HCPCS	Xr Knee Bilateral	6	6	$310.00	$263.50	$27.78	$269.70	$109.47	2024-12-30
73552	HCPCS	Xr Femur Bilateral,bilateral	18	6	$185.00	$157.25	$25.08	$269.70	$109.47	2024-12-30
73502	HCPCS	Xr Hip Left 2 Views,left	12	6	$185.00	$157.25	$31.95	$160.95	$109.47	2024-12-30
73130	HCPCS	Xr Hand Bilateral,bilateral	18	6	$165.00	$140.25	$26.15	$187.05	$109.47	2024-12-30
73110	HCPCS	Xr Wrist Bilateral,bilateral	18	6	$165.00	$140.25	$29.69	$204.45	$109.47	2024-12-30
73080	HCPCS	Xr Elbow Bilateral,bilateral	18	6	$165.00	$140.25	$27.78	$204.45	$109.47	2024-12-30
73030	HCPCS	Xr Shoulder Left 2-3 Views,left	12	6	$235.00	$199.75	$25.34	$204.45	$109.47	2024-12-30
73060	HCPCS	Xr Humerus Bilateral,bilateral	18	6	$155.00	$131.75	$23.97	$204.45	$109.47	2024-12-30
73020	HCPCS	Xr Shoulder Left 1 View,left	12	6	$185.00	$157.25	$19.31	$160.95	$109.47	2024-12-30
11200	HCPCS	Removal Of Skin Tags	6	6	$250.00	$212.50	$45.00	$217.50	$109.35	2024-12-30
99203	HCPCS	Office Visit New Pt. Level 3	6	6	$190.00	$161.50	$34.20	$165.30	$108.92	2024-12-30
11042	HCPCS	Debrid Skin Sbq Tissue <= 20 Sq Cm	18	6	$141.00	$119.85	$21.96	$738.63	$108.62	2024-12-30
12004	HCPCS	Rep Smp Scpnckaxgntrnkxtrm 7.6cm12	17	6	$147.00	$124.95	$26.28	$256.65	$108.04	2024-12-30
10160	HCPCS	Punct Aspir Abscess Hema Bulla	17	6	$250.00	$212.50	$33.84	$421.95	$107.78	2024-12-30
29065	HCPCS	Cast Long Arm - Adult	6	6	$230.00	$195.50	$41.40	$200.10	$107.06	2024-12-30
17110	HCPCS	Destruct Lesion 1-14	6	6	$200.00	$170.00	$36.00	$174.00	$105.98	2024-12-30
30901	HCPCS	Control Nasal Hemorr Ant Simp	14	6	$114.00	$96.90	$20.52	$343.65	$105.45	2024-12-30
73000	HCPCS	Xr Clavicle Bilateral	24	6	$150.00	$127.50	$23.41	$160.95	$104.76	2024-12-30
70160	HCPCS	Xr Nasal Bones 1-3 Views	6	6	$135.00	$114.75	$26.96	$117.45	$104.34	2024-12-30
73660	HCPCS	Xr Toes Left 1-3 Views,left	12	6	$135.00	$114.75	$23.90	$117.45	$104.34	2024-12-30
73560	HCPCS	Xr Knee Left 1-2 Views,left	18	6	$135.00	$114.75	$25.05	$117.45	$104.34	2024-12-30
73620	HCPCS	Xr Foot Left 2 Views,left	12	6	$135.00	$114.75	$22.32	$117.45	$104.34	2024-12-30
73090	HCPCS	Xr Forearm Left 2 Views,left	12	6	$135.00	$114.75	$22.86	$117.45	$104.34	2024-12-30
92540	HCPCS	Pt Vestibular Evaluation	6	6	$145.00	$123.25	$26.10	$145.00	$103.95	2024-12-30

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