Hospital

W J MANGOLD MEMORIAL HOSPITAL

Lockney, TX · CCN 451337 · Rates published

1,936 distinct procedures filed

9 distinct payers

44,546 rate rows

2026-07-31 last MRF observed

Data quality

43,560 of 44,546 rate rows are consumer-grade (97.8%)

986 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
placeholder amount (≤ $0.02) — excluded from medians	528
template filing: same amount across many unrelated codes — excluded	458

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

Source MRF file	https://app.box.com/shared/static/sycn0hdu7ilho1epc5n5f9pp5ol9i4vq.csv
Found on page	https://us.flow-prod.boomi.com/f2a4d421-8a52-4b09-8a4c-8476aae2d651/play/ptt?flow-id=a91f6d2f-a3ad-4257-9185-99463fe7c6a3&flow-version-id=691a537c-ea37-41a1-96ba-24e7272b0047&hospital-id=37
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-01
Content fingerprint	7843985cc9b370f6… · 2,816,410 bytes · first seen 2026-05-16

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
2000020 LOCAL	Birth Ctr W/epidural >6	9	$500.00	$6,256.85	$5,182.72	nat. median $5,183 1.0× median
2000019 LOCAL	Birth Ctr W/epidural 4-6	9	$500.00	$5,406.85	$4,478.72	nat. median $4,479 1.0× median
J2997 HCPCS	Alteplase (activase) 100mg IV Powder	9	$144.90	$15,708.00	$4,294.85	nat. median $488 outlier · 8.8×
36569 CPT	Picc Insertion Ultrasound Guided	9	$2,461.50	$4,649.50	$4,169.33	nat. median $1,713 outlier · 2.4×
2000018 LOCAL	Birth Ctr With Epidural 2-4	9	$500.00	$4,896.85	$4,056.32	nat. median $4,056 1.0× median
J7298 HCPCS	IUD Mirena	9	$2,250.00	$4,250.00	$3,692.80	nat. median $1,720 outlier · 2.1×
2000017 LOCAL	Birth Ctr With Epidural 0-2	9	$500.00	$4,386.85	$3,633.92	nat. median $3,634 1.0× median
81490 CPT	Vectra Da Score	9	$2,086.49	$3,932.10	$3,256.96	nat. median $883 outlier · 3.7×
J7300 HCPCS	IUD Paragard 51285-204-02	9	$1,820.25	$3,438.25	$3,134.88	nat. median $1,618 1.9× median
93229 CPT	Remote 30 Day ECG Tech Su	9	$140.00	$3,383.00	$3,033.62	nat. median $607 outlier · 5.0×
95811 CPT	Polysomnography W/cpap	9	$800.00	$3,318.40	$2,748.80	nat. median $1,923 1.4× median
95810 CPT	Polysomnography	9	$800.00	$3,318.40	$2,748.80	nat. median $1,777 1.5× median
2000001 LOCAL	Birthing Center	9	$500.00	$2,686.85	$2,409.69	nat. median $2,410 1.0× median
36590 CPT	Picc Removal	9	$1,397.25	$2,639.25	$2,366.61	nat. median $1,777 1.3× median
59409 CPT	ER-vaginal Delivery	9	$500.00	$2,814.35	$2,331.52	nat. median $3,157 0.7× median
36478 CPT	Endovenous Laser 1st Vei	9	$1,181.25	$2,231.25	$2,001.01	nat. median $4,102 outlier · 0.5×
J0897 HCPCS	Denosumab Inj (prolia) 60mg/1ml Syrn	9	$1,218.60	$2,301.80	$1,906.56	nat. median $1,965 1.0× median
1000012 LOCAL	Or-operating Room 6.0 Hou	9	$250.00	$2,040.00	$1,829.28	nat. median $1,191 1.5× median
J7327 HCPCS	Hyaluronate Sod (monovisc) Inj 88mg/4ml	9	$1,154.70	$2,181.10	$1,806.72	nat. median $873 outlier · 2.1×
13160 CPT	ER-repair Surgical Wound	9	$500.00	$2,941.00	$1,722.99	nat. median $2,671 0.6× median
1000011 LOCAL	Or-operating Room 5.5 Hou	9	$250.00	$1,901.45	$1,705.12	nat. median $1,110 1.5× median
26567 CPT	ER-osteotomy Phalanx Fing	9	$500.00	$3,550.45	$1,695.38	nat. median $3,625 outlier · 0.5×
J7307 HCPCS	Nexplanon Implant	9	$978.75	$1,848.75	$1,685.62	nat. median $1,658 1.0× median
14350 CPT	ER-filleted Finger/toe Fl	9	$500.00	$2,941.00	$1,644.00	nat. median $2,226 0.7× median
14040 CPT	Skin Tissue Rearrangement	9	$500.00	$2,140.30	$1,622.92	nat. median $2,167 0.7× median
99468 CPT	Neonate Crit Care Initial	9	$12.80	$2,530.00	$1,619.20	nat. median $1,270 1.3× median
1500012 LOCAL	Anesthesia Service 6.0 Ho	9	$753.60	$1,764.60	$1,582.34	nat. median $14 outlier · 113.0×
1000010 LOCAL	Or-operating Room 5.0 Hou	9	$250.00	$1,754.40	$1,573.36	nat. median $1,024 1.5× median
93306 CPT	US Tte W/doppler Complete	9	$300.00	$1,884.45	$1,560.96	nat. median $994 1.6× median
93307 CPT	US Echocardiography Transtho	9	$300.00	$1,881.90	$1,559.04	nat. median $522 outlier · 3.0×
J0129 HCPCS	Orencia 250mg Ivpb	9	$952.20	$1,798.60	$1,557.12	nat. median $842 1.8× median
37766 CPT	Phleb Veins Extrem 20+	9	$876.60	$1,655.80	$1,484.74	nat. median $3,725 outlier · 0.4×
1500011 LOCAL	Anesthesia Service 5.5 Ho	9	$701.70	$1,642.20	$1,472.98	nat. median $14 outlier · 105.2×
27372 CPT	ER-fb Thigh/knee Deep Rmv	9	$500.00	$2,754.00	$1,460.25	nat. median $3,050 outlier · 0.5×
1000009 LOCAL	Or-operating Room 4.5 Hou	9	$250.00	$1,615.85	$1,449.20	nat. median $943 1.5× median
27266 CPT	Closed Trmt Post Hip Arthroplasty Disloc	9	$500.00	$2,792.25	$1,425.60	nat. median $2,048 0.7× median
65275 CPT	ER-repair Cornea Nonperfo	9	$500.00	$3,162.24	$1,420.65	nat. median $3,945 outlier · 0.4×
J3489 HCPCS	Zoledronic Acid (reclast) 5mg	9	$877.50	$1,657.50	$1,372.80	nat. median $129 outlier · 10.6×
1500010 LOCAL	Anesthesia Service 5.0 Ho	9	$649.80	$1,521.50	$1,364.37	nat. median $13 outlier · 105.0×
46040 CPT	ER-i&d Perirectal Abscess	9	$500.00	$3,055.75	$1,331.55	nat. median $1,717 0.8× median
1000008 LOCAL	Or-operating Room 4.0 Hou	9	$250.00	$1,477.30	$1,324.71	nat. median $862 1.5× median
26418 CPT	ER-repair Ext Tendon Fing	9	$500.00	$2,216.80	$1,303.98	nat. median $2,019 0.6× median
26410 CPT	ER-repair Ext Tendon Hand	9	$500.00	$2,216.80	$1,293.96	nat. median $1,988 0.7× median
26433 CPT	ER-repair Ext Tendon Without	9	$500.00	$2,216.80	$1,284.00	nat. median $3,320 outlier · 0.4×
31515 CPT	Laryngoscopy Direct	9	$249.24	$2,419.10	$1,283.71	nat. median $546 outlier · 2.3×
11623 CPT	Exc H-f-nk-sp Mlg+marg 2.	9	$740.70	$1,399.10	$1,254.69	nat. median $1,579 0.8× median
11404 CPT	Exc Tr-ext B9+marg 3.1-4	9	$740.70	$1,399.10	$1,254.69	nat. median $1,618 0.8× median
1500009 LOCAL	Anesthesia Service 4.5 Ho	9	$597.60	$1,399.10	$1,254.69	nat. median $10 outlier · 125.5×
73564 CPT	X-ray Exam Knee 4 Or More	9	$111.93	$2,346.85	$1,245.58	nat. median $188 outlier · 6.6×
37765 CPT	Phleb Veins Extrem 10-20	9	$734.85	$1,388.05	$1,245.01	nat. median $3,546 outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 1,936 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

2000020	LOCAL	Birth Ctr W/epidural >6	16	9	$8,098.00	$8,098.00	$500.00	$6,256.85	$5,182.72	2026-07-31
2000019	LOCAL	Birth Ctr W/epidural 4-6	16	9	$6,998.00	$6,998.00	$500.00	$5,406.85	$4,478.72	2026-07-31
J2997	HCPCS	Alteplase (activase) 100mg IV Powder	32	9	$10,341.50	$10,341.50	$144.90	$15,708.00	$4,294.85	2026-07-31
36569	CPT	Picc Insertion Ultrasound Guided	16	9	$6,619.00	$6,619.00	$2,461.50	$4,649.50	$4,169.33	2026-07-31
2000018	LOCAL	Birth Ctr With Epidural 2-4	16	9	$6,338.00	$6,338.00	$500.00	$4,896.85	$4,056.32	2026-07-31
J7298	HCPCS	IUD Mirena	16	9	$5,770.00	$5,770.00	$2,250.00	$4,250.00	$3,692.80	2026-07-31
2000017	LOCAL	Birth Ctr With Epidural 0-2	16	9	$5,678.00	$5,678.00	$500.00	$4,386.85	$3,633.92	2026-07-31
81490	CPT	Vectra Da Score	16	9	$5,089.00	$5,089.00	$2,086.49	$3,932.10	$3,256.96	2026-07-31
J7300	HCPCS	IUD Paragard 51285-204-02	16	9	$5,228.00	$5,228.00	$1,820.25	$3,438.25	$3,134.88	2026-07-31
93229	CPT	Remote 30 Day ECG Tech Su	16	9	$4,816.00	$4,816.00	$140.00	$3,383.00	$3,033.62	2026-07-31
95811	CPT	Polysomnography W/cpap	16	9	$4,295.00	$4,295.00	$800.00	$3,318.40	$2,748.80	2026-07-31
95810	CPT	Polysomnography	16	9	$4,295.00	$4,295.00	$800.00	$3,318.40	$2,748.80	2026-07-31
2000001	LOCAL	Birthing Center	16	9	$3,826.00	$3,826.00	$500.00	$2,686.85	$2,409.69	2026-07-31
36590	CPT	Picc Removal	16	9	$3,757.00	$3,757.00	$1,397.25	$2,639.25	$2,366.61	2026-07-31
59409	CPT	ER-vaginal Delivery	16	9	$3,643.00	$3,643.00	$500.00	$2,814.35	$2,331.52	2026-07-31
36478	CPT	Endovenous Laser 1st Vei	16	9	$3,177.00	$3,177.00	$1,181.25	$2,231.25	$2,001.01	2026-07-31
J0897	HCPCS	Denosumab Inj (prolia) 60mg/1ml Syrn	16	9	$2,979.00	$2,979.00	$1,218.60	$2,301.80	$1,906.56	2026-07-31
1000012	LOCAL	Or-operating Room 6.0 Hou	16	9	$2,904.00	$2,904.00	$250.00	$2,040.00	$1,829.28	2026-07-31
J7327	HCPCS	Hyaluronate Sod (monovisc) Inj 88mg/4ml	16	9	$2,823.00	$2,823.00	$1,154.70	$2,181.10	$1,806.72	2026-07-31
13160	CPT	ER-repair Surgical Wound	32	9	$3,206.50	$3,206.50	$500.00	$2,941.00	$1,722.99	2026-07-31
1000011	LOCAL	Or-operating Room 5.5 Hou	16	9	$2,707.00	$2,707.00	$250.00	$1,901.45	$1,705.12	2026-07-31
26567	CPT	ER-osteotomy Phalanx Fing	32	9	$3,658.00	$3,658.00	$500.00	$3,550.45	$1,695.38	2026-07-31
J7307	HCPCS	Nexplanon Implant	16	9	$2,833.00	$2,833.00	$978.75	$1,848.75	$1,685.62	2026-07-31
14350	CPT	ER-filleted Finger/toe Fl	32	9	$3,224.00	$3,224.00	$500.00	$2,941.00	$1,644.00	2026-07-31
14040	CPT	Skin Tissue Rearrangement	32	9	$2,613.00	$2,613.00	$500.00	$2,140.30	$1,622.92	2026-07-31
99468	CPT	Neonate Crit Care Initial	16	9	$2,530.00	$2,530.00	$12.80	$2,530.00	$1,619.20	2026-07-31
1500012	LOCAL	Anesthesia Service 6.0 Ho	16	9	$2,512.00	$2,512.00	$753.60	$1,764.60	$1,582.34	2026-07-31
1000010	LOCAL	Or-operating Room 5.0 Hou	16	9	$2,498.00	$2,498.00	$250.00	$1,754.40	$1,573.36	2026-07-31
93306	CPT	US Tte W/doppler Complete	16	9	$2,439.00	$2,439.00	$300.00	$1,884.45	$1,560.96	2026-07-31
93307	CPT	US Echocardiography Transtho	16	9	$2,436.00	$2,436.00	$300.00	$1,881.90	$1,559.04	2026-07-31
J0129	HCPCS	Orencia 250mg Ivpb	16	9	$2,433.00	$2,433.00	$952.20	$1,798.60	$1,557.12	2026-07-31
37766	CPT	Phleb Veins Extrem 20+	16	9	$2,357.00	$2,357.00	$876.60	$1,655.80	$1,484.74	2026-07-31
1500011	LOCAL	Anesthesia Service 5.5 Ho	16	9	$2,339.00	$2,339.00	$701.70	$1,642.20	$1,472.98	2026-07-31
27372	CPT	ER-fb Thigh/knee Deep Rmv	32	9	$2,933.50	$2,933.50	$500.00	$2,754.00	$1,460.25	2026-07-31
1000009	LOCAL	Or-operating Room 4.5 Hou	16	9	$2,301.00	$2,301.00	$250.00	$1,615.85	$1,449.20	2026-07-31
27266	CPT	Closed Trmt Post Hip Arthroplasty Disloc	32	9	$2,757.50	$2,757.50	$500.00	$2,792.25	$1,425.60	2026-07-31
65275	CPT	ER-repair Cornea Nonperfo	32	9	$3,418.00	$3,418.00	$500.00	$3,162.24	$1,420.65	2026-07-31
J3489	HCPCS	Zoledronic Acid (reclast) 5mg	16	9	$2,145.00	$2,145.00	$877.50	$1,657.50	$1,372.80	2026-07-31
1500010	LOCAL	Anesthesia Service 5.0 Ho	16	9	$2,166.00	$2,166.00	$649.80	$1,521.50	$1,364.37	2026-07-31
46040	CPT	ER-i&d Perirectal Abscess	32	9	$3,063.50	$3,063.50	$500.00	$3,055.75	$1,331.55	2026-07-31
1000008	LOCAL	Or-operating Room 4.0 Hou	16	9	$2,103.00	$2,103.00	$250.00	$1,477.30	$1,324.71	2026-07-31
26418	CPT	ER-repair Ext Tendon Fing	32	9	$2,542.00	$2,542.00	$500.00	$2,216.80	$1,303.98	2026-07-31
26410	CPT	ER-repair Ext Tendon Hand	32	9	$2,515.50	$2,515.50	$500.00	$2,216.80	$1,293.96	2026-07-31
26433	CPT	ER-repair Ext Tendon Without	32	9	$2,461.00	$2,461.00	$500.00	$2,216.80	$1,284.00	2026-07-31
31515	CPT	Laryngoscopy Direct	41	9	$3,131.00	$3,131.00	$249.24	$2,419.10	$1,283.71	2026-07-31
1500009	LOCAL	Anesthesia Service 4.5 Ho	16	9	$1,992.00	$1,992.00	$597.60	$1,399.10	$1,254.69	2026-07-31
11623	CPT	Exc H-f-nk-sp Mlg+marg 2.	16	9	$1,992.00	$1,992.00	$740.70	$1,399.10	$1,254.69	2026-07-31
11404	CPT	Exc Tr-ext B9+marg 3.1-4	16	9	$1,992.00	$1,992.00	$740.70	$1,399.10	$1,254.69	2026-07-31
73564	CPT	X-ray Exam Knee 4 Or More	57	9	$3,038.00	$3,038.00	$111.93	$2,346.85	$1,245.58	2026-07-31
37765	CPT	Phleb Veins Extrem 10-20	16	9	$1,977.00	$1,977.00	$734.85	$1,388.05	$1,245.01	2026-07-31
26160	CPT	Remove Tendon Sheath Lesi	16	9	$1,948.00	$1,948.00	$724.50	$1,368.50	$1,227.11	2026-07-31
1000007	LOCAL	Or-operating Room 3.5 Hou	16	9	$1,900.00	$1,900.00	$250.00	$1,334.50	$1,196.75	2026-07-31
1500008	LOCAL	Anesthesia Service 4.0 Ho	16	9	$1,819.00	$1,819.00	$545.70	$1,277.55	$1,145.70	2026-07-31
21501	CPT	ER-i&d Neck Soft Tissue A	32	9	$2,470.00	$2,470.00	$500.00	$2,403.80	$1,138.50	2026-07-31
27842	CPT	Treat Ankle Dislocation	32	9	$2,146.00	$2,146.00	$500.00	$2,074.00	$1,100.44	2026-07-31
24655	CPT	Closed Trmt Radial Head Or Neck Fx W/man	32	9	$2,523.50	$2,523.50	$500.00	$2,792.25	$1,074.15	2026-07-31
1000006	LOCAL	Or-operating Room 3.0 Hou	16	9	$1,697.00	$1,697.00	$250.00	$1,191.70	$1,068.79	2026-07-31
24605	CPT	ER-trt Elbow Clsd Disloca	32	9	$2,068.00	$2,068.00	$500.00	$2,004.30	$1,063.54	2026-07-31
11988	LOCAL	Ambulance	16	9	$1,650.00	$1,650.00	$676.50	$1,275.00	$1,056.00	2026-07-31
1500007	LOCAL	Anesthesia Service 3.5 Ho	16	9	$1,645.00	$1,645.00	$493.50	$1,155.15	$1,036.03	2026-07-31
78226	CPT	Xr Hepatobiliary System Imag	16	9	$1,605.00	$1,605.00	$175.00	$1,240.15	$1,027.20	2026-07-31
23655	CPT	Treat Shoulder Dislocatio	32	9	$2,088.50	$2,088.50	$489.92	$2,210.00	$987.53	2026-07-31
10121	CPT	ER-fb Subq Tissue Complic	48	9	$1,592.00	$1,592.00	$328.10	$2,074.00	$986.25	2026-07-31
40650	CPT	Repair Lip	32	9	$1,529.50	$1,529.50	$500.00	$1,202.75	$978.88	2026-07-31
12036	CPT	Intmd Rpr S/a/t/ext 20.1-	32	9	$1,823.00	$1,823.00	$500.00	$1,738.25	$950.93	2026-07-31
1000005	LOCAL	Or-operating Room 2.5 Hou	16	9	$1,499.00	$1,499.00	$250.00	$1,053.15	$944.31	2026-07-31
26775	CPT	ER-trt Ip Joint Dislocate	32	9	$1,922.50	$1,922.50	$465.37	$2,004.30	$938.03	2026-07-31
26011	CPT	ER-finger Abscess Drain	32	9	$1,795.00	$1,795.00	$500.00	$1,530.85	$931.58	2026-07-31
1500006	LOCAL	Anesthesia Service 3.0 Ho	16	9	$1,472.00	$1,472.00	$441.60	$1,033.60	$927.04	2026-07-31
J7325	HCPCS	Hyaluronate Sodium (synvisc) 16mg	32	9	$1,808.50	$1,808.50	$369.90	$2,095.25	$903.98	2026-07-31
42961	CPT	Control Throat Bleed	32	9	$1,431.50	$1,431.50	$500.00	$1,055.70	$898.70	2026-07-31
27516	CPT	Treat Thigh Fx Growth Pla	16	9	$1,426.00	$1,426.00	$530.10	$1,001.30	$898.07	2026-07-31
93925	CPT	US Duplex Scan Complete Bilateral Study	17	9	$1,399.00	$1,399.00	$350.00	$1,080.35	$895.36	2026-07-31
26765	CPT	Treat Finger Fracture Eac	32	9	$1,491.00	$1,491.00	$500.00	$1,262.25	$890.74	2026-07-31
27552	CPT	Treat Knee Dislocation	32	9	$1,685.00	$1,685.00	$500.00	$1,583.55	$882.55	2026-07-31
87902	CPT	Hepatitis C Genotype Dna/rna	16	9	$2,142.00	$2,142.00	$154.87	$1,654.95	$878.22	2026-07-31
J3262	HCPCS	Tocilizumab (actemra) 200mg	32	9	$1,667.00	$1,667.00	$429.75	$1,763.75	$872.75	2026-07-31
12045	CPT	Repair Int N-hf/genit 12.6-20	32	9	$1,390.00	$1,390.00	$489.92	$1,130.50	$870.32	2026-07-31
99291	CPT	ER Critical Care 30-74 Mi	48	9	$1,815.00	$1,815.00	$487.83	$7,561.60	$866.25	2026-07-31
73702	CPT	CT Lower Extremity With And Without Contrast	48	9	$2,023.00	$2,023.00	$227.23	$2,346.85	$853.71	2026-07-31
28193	CPT	ER-fb Foot Subq Remove	32	9	$1,539.50	$1,539.50	$500.00	$1,348.95	$853.12	2026-07-31
5	LOCAL	Private Cardiac Equipment	16	9	$1,332.00	$1,332.00	$532.80	$968.36	$852.48	2026-07-31
55250	CPT	Removal Of Sperm Duct(s)	16	9	$1,350.00	$1,350.00	$501.75	$947.75	$850.12	2026-07-31
25505	CPT	ER-trt Radial Shft Clsd F	32	9	$1,461.00	$1,461.00	$500.00	$1,264.80	$849.20	2026-07-31
13	LOCAL	Private Swingbed Card Eq	16	9	$1,320.00	$1,320.00	$528.00	$959.64	$844.80	2026-07-31
44950	CPT	Appendectomy	16	9	$1,340.00	$1,340.00	$498.15	$940.95	$843.92	2026-07-31
J1670	HCPCS	Private Tet Immuneglob(hypertet)250usyrn	16	9	$1,316.00	$1,316.00	$538.20	$1,016.60	$842.24	2026-07-31
75635	CPT	CT Angio Abdominal Arteri	16	9	$2,050.00	$2,050.00	$227.23	$1,583.55	$840.50	2026-07-31
70498	CPT	CT Angiography Neck	16	9	$2,050.00	$2,050.00	$227.23	$1,583.55	$840.50	2026-07-31
71275	CPT	CT Angiography Chest	16	9	$2,050.00	$2,050.00	$227.23	$1,583.55	$840.50	2026-07-31
73706	CPT	CTA Ext Lower W Contrast	48	9	$2,050.00	$2,050.00	$227.23	$1,583.55	$840.50	2026-07-31
72191	CPT	CT Angiograph Pelv W/wo	16	9	$2,050.00	$2,050.00	$227.23	$1,583.55	$840.50	2026-07-31
73206	CPT	CT Angio Upper Extrm W/wo	16	9	$2,050.00	$2,050.00	$227.23	$1,583.55	$840.50	2026-07-31
72127	CPT	CT Neck Spine With And Without Contrast	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
72130	CPT	CT Chest Spine With And Without Contrast	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
70482	CPT	CT Orbit Sella Fossa W/wo	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
70492	CPT	CT - St Neck W&wo Contr	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
74178	CPT	CT Scan Of The Pelvis Or Abdomen With And Without Dye	16	9	$2,023.00	$2,023.00	$464.22	$1,563.15	$829.43	2026-07-31
70470	CPT	CT Scan Of The Head Or Brain With And Without Dye	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
72194	CPT	CT Scan Of Pelvis Without And With Contrast	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
70488	CPT	CT Scan Of The Face Or Jaw With And Without Dye	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
71270	CPT	CT Scan Of The Chest With And Without Dye	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
74170	CPT	CT Scan Of Abdomen Without And With Contrast	16	9	$2,023.00	$2,023.00	$227.23	$1,563.15	$829.43	2026-07-31
1000004	LOCAL	Or-operating Room 2.0 Hou	16	9	$1,304.00	$1,304.00	$250.00	$915.45	$821.15	2026-07-31
7000631	LOCAL	Quick Trach Kit Child 2.0 120900020	16	9	$1,282.00	$1,282.00	$512.80	$990.25	$820.48	2026-07-31
1500005	LOCAL	Anesthesia Service 2.5 Ho	16	9	$1,299.00	$1,299.00	$389.70	$912.05	$818.06	2026-07-31
27562	CPT	Treat Kneecap Dislocation	32	9	$1,411.00	$1,411.00	$500.00	$1,224.00	$818.04	2026-07-31
4	LOCAL	Private Equipment Room	16	9	$1,232.00	$1,232.00	$492.80	$895.66	$788.48	2026-07-31
3	LOCAL	Private Isolation Room	16	9	$1,232.00	$1,232.00	$492.80	$895.66	$788.48	2026-07-31
2	LOCAL	Private Cardiac Monitor	16	9	$1,232.00	$1,232.00	$492.80	$895.66	$788.48	2026-07-31
9	LOCAL	Semi-private Cardiac Equi	16	9	$1,232.00	$1,232.00	$492.80	$895.66	$788.48	2026-07-31
7000630	LOCAL	Quick Trach Kit Adult 4.0 120900040	16	9	$1,227.00	$1,227.00	$490.80	$947.75	$785.28	2026-07-31
54015	CPT	ER-i&d Penis Deep	32	9	$2,218.00	$2,218.00	$377.21	$2,403.80	$759.83	2026-07-31
88307	CPT	Tissue Exam By Pathologis	16	9	$1,168.00	$1,168.00	$478.88	$901.85	$747.52	2026-07-31
70460	CPT	CT Scan Of The Head Or Brain With Dye	16	9	$1,814.00	$1,814.00	$227.23	$1,401.65	$743.74	2026-07-31
72132	CPT	CT Scan Of Lumbar Lower Spine With Contrast	16	9	$1,814.00	$1,814.00	$464.22	$1,401.65	$743.74	2026-07-31
71260	CPT	CT Scan Of The Chest With Dye	16	9	$1,814.00	$1,814.00	$227.23	$1,401.65	$743.74	2026-07-31
74160	CPT	CT Scan Of Abdomen With Contrast	16	9	$1,814.00	$1,814.00	$227.23	$1,401.65	$743.74	2026-07-31
72193	CPT	CT Scan, Pelvis, With Contrast	16	9	$1,814.00	$1,814.00	$227.23	$1,401.65	$743.74	2026-07-31
70487	CPT	CT Scan Of The Face Or Jaw With Dye	16	9	$1,814.00	$1,814.00	$227.23	$1,401.65	$743.74	2026-07-31
70491	CPT	CT Of Neck Soft Tissue With Dye	16	9	$1,814.00	$1,814.00	$227.23	$1,401.65	$743.74	2026-07-31
74177	CPT	CT Scan Of Abdomen And Pelvis With Contrast	16	9	$1,814.00	$1,814.00	$464.22	$1,401.65	$743.74	2026-07-31
23665	CPT	ER-trt Closed Shoulder Di	32	9	$1,246.50	$1,246.50	$451.00	$1,076.10	$727.00	2026-07-31
23675	CPT	Treat Dislocation/fractur	32	9	$1,379.50	$1,379.50	$394.83	$1,387.20	$718.18	2026-07-31
7	LOCAL	Semi-private Cardiac Mon	16	9	$1,122.00	$1,122.00	$448.80	$815.69	$718.08	2026-07-31
1	LOCAL	Private Room	16	9	$1,122.00	$1,122.00	$448.80	$815.69	$718.08	2026-07-31
8	LOCAL	Semi-private Equipment	16	9	$1,122.00	$1,122.00	$448.80	$815.69	$718.08	2026-07-31
88360	CPT	Tumor Immunohistochem/man	16	9	$1,120.00	$1,120.00	$459.20	$865.30	$716.80	2026-07-31
J1110	HCPCS	Dihydroergota (migranal) Nasal 4mg/1ml	16	9	$1,114.00	$1,114.00	$455.40	$860.20	$712.96	2026-07-31
20103	CPT	Explore Wound Extremity	32	9	$1,405.00	$1,405.00	$383.35	$1,448.40	$710.00	2026-07-31
1500004	LOCAL	Anesthesia Service 2.0 Ho	16	9	$1,125.00	$1,125.00	$337.50	$790.50	$708.75	2026-07-31
17	LOCAL	Semi-private Sb Card Equi	16	9	$1,100.00	$1,100.00	$440.00	$799.70	$704.00	2026-07-31
94002	CPT	Mechanical Ventilation	16	9	$1,100.00	$1,100.00	$75.00	$850.00	$704.00	2026-07-31
58600	CPT	Div Of Fallopian Tubes	16	9	$1,100.00	$1,100.00	$451.00	$850.00	$704.00	2026-07-31
92950	CPT	Cpr	32	9	$1,150.50	$1,150.50	$390.60	$878.05	$693.75	2026-07-31
1000003	LOCAL	Or-operating Room 1.5 Hou	16	9	$1,100.00	$1,100.00	$250.00	$772.65	$692.88	2026-07-31
11642	CPT	Exc F/e/e/n/l Mal+mrg 1.1	16	9	$1,096.00	$1,096.00	$407.25	$769.25	$690.10	2026-07-31
99285	CPT	ER Level 5 Comprehensive	48	9	$1,452.00	$1,452.00	$397.70	$929.28	$684.80	2026-07-31
13101	CPT	Wound Repair (moderate)	32	9	$1,166.00	$1,166.00	$395.37	$1,004.70	$681.49	2026-07-31
92960	CPT	ER-cardioversion External	16	9	$1,081.00	$1,081.00	$414.89	$759.05	$680.80	2026-07-31
81335	CPT	Thiopurine Methyltransferase(tpmt)geno	16	9	$1,060.00	$1,060.00	$434.60	$818.55	$678.40	2026-07-31
13152	CPT	ER-repair Cmplx 2.6-7.5cm	32	9	$1,334.00	$1,334.00	$395.37	$1,264.80	$671.17	2026-07-31
13100	CPT	ER-repair Cmplx 1.1-2.5cm	32	9	$1,068.50	$1,068.50	$395.37	$854.25	$659.84	2026-07-31
13151	CPT	ER-repair Cmplx 1.1-2.5cm	32	9	$1,207.00	$1,207.00	$395.37	$1,068.45	$659.84	2026-07-31
6052604	LOCAL	Remdesivir Inj 100mg Vial	16	9	$1,001.00	$1,001.00	$400.40	$773.50	$640.64	2026-07-31
88348	CPT	Electron Microscopy	16	9	$990.00	$990.00	$405.90	$765.00	$633.60	2026-07-31
17106	CPT	Destruction Of Skin Lesio	16	9	$990.00	$990.00	$368.10	$695.30	$623.55	2026-07-31
13132	CPT	ER-repair Cmplx 2.6-7.5cm	32	9	$1,234.00	$1,234.00	$353.10	$1,195.95	$621.34	2026-07-31
47000	CPT	CT Needle Biopsy Of Liver	16	9	$1,507.00	$1,507.00	$405.00	$1,164.50	$617.87	2026-07-31
1500003	LOCAL	Anesthesia Service 1.5 Ho	16	9	$952.00	$952.00	$285.60	$668.10	$599.39	2026-07-31
P9021	HCPCS	Red Blood Cells Each Unit	32	9	$935.00	$935.00	$99.00	$722.50	$598.40	2026-07-31
81511	CPT	Alpha Fetoprotein Tetra Profile	16	9	$932.00	$932.00	$382.12	$719.95	$596.48	2026-07-31
93970	CPT	US Venous Doppler Study	32	9	$927.00	$927.00	$350.00	$715.70	$593.28	2026-07-31
93880	CPT	US Carotoid Doppler Studies	32	9	$927.00	$927.00	$350.00	$715.70	$593.28	2026-07-31
93975	CPT	Duplex Ultrasound Scan Of Blood Flow, Complete, Abdomen	16	9	$927.00	$927.00	$350.00	$715.70	$593.28	2026-07-31
11	LOCAL	Private Swingbed Equipment	16	9	$920.00	$920.00	$368.00	$668.84	$588.80	2026-07-31
12	LOCAL	Private Swingbed Card Mon	16	9	$920.00	$920.00	$368.00	$668.84	$588.80	2026-07-31
13131	CPT	ER-repair Cmplx 1.1-2.5cm	32	9	$1,092.00	$1,092.00	$353.10	$976.65	$588.80	2026-07-31
13121	CPT	ER-repair Cmplx 2.6-7.5cm	32	9	$1,156.50	$1,156.50	$353.10	$1,076.10	$588.80	2026-07-31
6	LOCAL	Semi-private Room	16	9	$902.00	$902.00	$360.80	$655.75	$577.28	2026-07-31
1000002	LOCAL	Or-operating Room 1.0 Hou	16	9	$889.00	$889.00	$250.00	$624.75	$560.11	2026-07-31
12020	CPT	ER-trt Wound Dehiscence S	32	9	$895.00	$895.00	$342.76	$736.95	$552.52	2026-07-31
74245	CPT	Xr Upper Gi Series W/small B	16	9	$860.00	$860.00	$85.00	$663.85	$550.40	2026-07-31
J0885	HCPCS	Epoetin Alfa (procrit) 20000u/1ml Vial	16	9	$657.00	$657.00	$269.37	$657.00	$538.74	2026-07-31
77012	CPT	CT Scan For Needle Biopsy	16	9	$835.00	$835.00	$342.35	$645.15	$534.40	2026-07-31
25650	CPT	Cl Trmt Ulnar Stylo	41	9	$915.00	$915.00	$340.20	$818.55	$532.48	2026-07-31
54700	CPT	ER-i&d Epidiymis Testis S	32	9	$2,652.00	$2,652.00	$263.00	$3,229.15	$529.65	2026-07-31
12034	CPT	Rpr Layered Scp/ax/tru	32	9	$924.00	$924.00	$327.18	$810.90	$527.24	2026-07-31
16	LOCAL	Semi-private Sb Card Monit	16	9	$810.00	$810.00	$324.00	$588.87	$518.40	2026-07-31
15	LOCAL	Semi-private Sb Equipment	16	9	$810.00	$810.00	$324.00	$588.87	$518.40	2026-07-31
26700	CPT	Treat Knuckle Dislocation	32	9	$918.50	$918.50	$310.37	$833.85	$508.00	2026-07-31
49082	CPT	Abd Paracentesis	32	9	$1,086.00	$1,086.00	$245.52	$1,062.50	$505.00	2026-07-31
11983	CPT	Remove/insert Drug Implan	16	9	$799.00	$799.00	$297.00	$561.00	$503.18	2026-07-31
J7323	HCPCS	Euflexxa 20mg/2ml Syrn	16	9	$786.00	$786.00	$321.30	$606.90	$503.04	2026-07-31
86922	CPT	Crossmatch Antiglobulin (ahg)	16	9	$785.00	$785.00	$321.85	$589.05	$502.40	2026-07-31
1500002	LOCAL	Anesthesia Service 1.0 Ho	16	9	$778.00	$778.00	$233.40	$545.70	$489.71	2026-07-31
86920	CPT	Initial Spin Crossmatch	16	9	$763.00	$763.00	$312.83	$589.05	$488.32	2026-07-31
70450	CPT	CT Scan, Head Or Brain, Without Contrast	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
72125	CPT	CT Neck Spine Without Contrast	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
72128	CPT	CT Chest Spine Without Contrast	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
74150	CPT	CT Scan Of Abdomen Without Contrast	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
70490	CPT	CT Soft Tissue Neck Without Contrast	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
72131	CPT	CT Scan Of Lumbar Lower Spine Without Contrast	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
70480	CPT	CT Orbit Sella Fossa Without	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
74176	CPT	CT Scan Of The Pelvis And Abdomen Without Dye	16	9	$1,173.00	$1,173.00	$294.24	$906.10	$488.10	2026-07-31
70486	CPT	CT Scan Of The Face Or Jaw Without Dye	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
72192	CPT	CT Scan Of Pelvis Without Contrast	16	9	$1,173.00	$1,173.00	$134.67	$906.10	$488.10	2026-07-31
46050	CPT	ER-i&d Perianal Abscess	32	9	$853.50	$853.50	$264.12	$699.55	$483.75	2026-07-31
7000516	LOCAL	Ez-io Needle 15mm 9018-vc-005	16	9	$754.00	$754.00	$301.60	$582.25	$482.56	2026-07-31
7000517	LOCAL	Ez-io Needle 25mm 9001-vc-005 5ea/bxmin	16	9	$754.00	$754.00	$301.60	$582.25	$482.56	2026-07-31
7000518	LOCAL	Ez-io Needle 45mm 9079-vc-005	16	9	$754.00	$754.00	$301.60	$582.25	$482.56	2026-07-31
70496	CPT	CT Angiography Head	16	9	$1,007.00	$1,007.00	$227.23	$1,007.00	$481.44	2026-07-31
24200	CPT	ER-fb Arm/elbow Subq Rmve	32	9	$752.50	$752.50	$261.52	$562.70	$479.25	2026-07-31
12056	CPT	ER-repair Int 20.1-30.0cm	32	9	$1,059.50	$1,059.50	$109.47	$1,430.55	$477.97	2026-07-31
25605	CPT	ER-trt Colles Clsd Fx W/m	32	9	$1,030.00	$1,030.00	$123.41	$1,359.15	$477.68	2026-07-31
27752	CPT	ER-trt Tib Shft Clsd Fx W	32	9	$1,022.00	$1,022.00	$123.41	$1,346.40	$474.70	2026-07-31
20520	CPT	ER-fb Muscle/tendon Smpl	32	9	$744.50	$744.50	$255.56	$562.70	$468.00	2026-07-31
27508	CPT	ER-trt Femoral Clsd Fx With	32	9	$1,004.00	$1,004.00	$123.41	$1,318.35	$468.00	2026-07-31
25565	CPT	ER-trt Rad/ulnar Shft Cls	32	9	$990.50	$990.50	$123.41	$1,297.95	$462.98	2026-07-31
10140	CPT	ER-i&d Hematoma	32	9	$1,366.00	$1,366.00	$205.34	$1,530.85	$462.93	2026-07-31
32554	CPT	ER-thoracentesis	48	9	$723.00	$723.00	$264.45	$741.20	$462.72	2026-07-31
7000717	LOCAL	Thora_para +cath Tray New Tpt1000sp	16	9	$715.00	$715.00	$286.00	$552.50	$457.60	2026-07-31
1600007	LOCAL	Recovery Room 4.0 Hours	16	9	$726.00	$726.00	$278.76	$510.00	$457.32	2026-07-31
33010	CPT	ER-pericardiocentesis	16	9	$710.00	$710.00	$272.26	$500.00	$454.40	2026-07-31
24505	CPT	ER-trt Humeral Shft Fx With	32	9	$961.00	$961.00	$123.41	$1,252.05	$452.00	2026-07-31
28190	CPT	Removal Of Fb Foot	32	9	$767.50	$767.50	$270.86	$640.05	$451.84	2026-07-31
10	LOCAL	Private Swingbed Room	16	9	$700.00	$700.00	$280.00	$508.90	$448.00	2026-07-31
27230	CPT	ER-trt Femoral Neck Clsd	32	9	$936.00	$936.00	$123.41	$1,213.80	$442.70	2026-07-31
99284	CPT	ER Level 4 Extended	48	9	$968.00	$968.00	$256.46	$619.52	$441.60	2026-07-31
93926	CPT	Duplex Scan Unilateral Lower Extremity	17	9	$685.00	$685.00	$280.85	$685.00	$438.40	2026-07-31
74400	CPT	Xr Pyelogram IV	16	9	$1,067.00	$1,067.00	$85.00	$824.50	$437.47	2026-07-31
1000001	LOCAL	Or-operating Room 0.5 Hou	16	9	$694.00	$694.00	$250.00	$487.05	$436.96	2026-07-31
88262	CPT	Chromosome Analysis Bloo	16	9	$1,062.00	$1,062.00	$74.98	$820.25	$435.42	2026-07-31
23605	CPT	ER-trt Humeral Clsd Fx With	32	9	$911.50	$911.50	$123.41	$1,175.55	$433.59	2026-07-31
12055	CPT	ER-repair Int 12.6-20.0cm	32	9	$922.50	$922.50	$109.47	$1,218.90	$427.01	2026-07-31
11402	CPT	Exc Tr-ext B9+marg 1.1-2	16	9	$672.00	$672.00	$249.75	$471.75	$423.16	2026-07-31
25675	CPT	Treat Wrist Dislocation	32	9	$873.00	$873.00	$125.87	$1,111.80	$421.15	2026-07-31
93922	CPT	Limited Physiologic Studies Upper Or Low	17	9	$648.00	$648.00	$265.68	$648.00	$414.72	2026-07-31
11424	CPT	Exc H-f-nk-sp B9+marg 3.1	16	9	$658.00	$658.00	$244.35	$461.55	$414.19	2026-07-31
26605	CPT	Cl Txmt Metacarpal Fx	41	9	$645.00	$645.00	$239.40	$816.00	$412.80	2026-07-31
7000711	LOCAL	Surgicel Absorb 4x8 2300001952	16	9	$644.00	$644.00	$257.60	$497.25	$412.16	2026-07-31
27781	CPT	ER-trt Fibula Clsd Fx W/m	32	9	$853.50	$853.50	$123.41	$1,086.30	$412.01	2026-07-31
27265	CPT	Treat Hip Dislocation	32	9	$822.50	$822.50	$134.48	$1,017.45	$408.96	2026-07-31
36592	CPT	Collection Blood From Picc	16	9	$648.00	$648.00	$240.75	$454.75	$407.99	2026-07-31
11421	CPT	Exc H-f-nk-sp B9+marg 0.6	16	9	$648.00	$648.00	$240.75	$454.75	$407.99	2026-07-31
27788	CPT	ER-trt Dist Fib Clsd Fx W	32	9	$842.00	$842.00	$123.41	$1,068.45	$407.74	2026-07-31
1500001	LOCAL	Anesthesia Service 0.5 Ho	16	9	$641.00	$641.00	$192.30	$450.50	$403.87	2026-07-31
41800	CPT	Drainage Gum Lesion	32	9	$767.00	$767.00	$240.26	$731.85	$399.53	2026-07-31
92609	CPT	St Modify Voice Prostheti	16	9	$618.00	$618.00	$90.00	$476.85	$395.52	2026-07-31
26600	CPT	ER-trt Mc Clsd Fx Without Mnp	48	9	$700.00	$700.00	$123.41	$744.60	$395.24	2026-07-31
1600006	LOCAL	Recovery Room 3.0 Hours	16	9	$625.00	$625.00	$239.73	$438.60	$393.50	2026-07-31
26742	CPT	ER-clsd Treatment Of Arti	32	9	$771.50	$771.50	$126.84	$935.85	$390.93	2026-07-31
7000613	LOCAL	Paracentesis Safety Trat 8888568006	16	9	$605.00	$605.00	$242.00	$467.50	$387.20	2026-07-31
26641	CPT	ER-trt Thumb Clsd Disloca	32	9	$773.00	$773.00	$123.41	$961.35	$382.07	2026-07-31
12021	CPT	Closure Of Splint Wound	32	9	$616.00	$616.00	$207.58	$520.20	$380.25	2026-07-31
24530	CPT	ER-trt Humeral Clsd Fx With	32	9	$768.00	$768.00	$123.41	$953.70	$380.21	2026-07-31
12035	CPT	ER-int 12.6 - 20.0cm	32	9	$771.00	$771.00	$112.43	$963.90	$379.13	2026-07-31
27840	CPT	ER-trt Ankle Clsd Disloca	32	9	$764.50	$764.50	$123.41	$948.60	$378.91	2026-07-31
12052	CPT	ER-repair Int 2.6-5.0cm	48	9	$611.00	$611.00	$109.47	$762.45	$378.00	2026-07-31
14	LOCAL	Semi-private Swingbed Rm	16	9	$590.00	$590.00	$236.00	$428.93	$377.60	2026-07-31
27560	CPT	ER-trt Patellar Clsd Disl	32	9	$758.00	$758.00	$123.41	$938.40	$376.49	2026-07-31
12041	CPT	Intmd Rpr N-hf/genit 2.5c	32	9	$684.50	$684.50	$225.50	$632.40	$375.00	2026-07-31
67700	CPT	Drain Eyelid Abscess	32	9	$718.50	$718.50	$219.76	$696.15	$374.82	2026-07-31
24600	CPT	ER-trt Elbow Clsd Disloca	32	9	$753.00	$753.00	$123.41	$930.75	$374.63	2026-07-31
71250	CPT	CT Scan Of The Chest Without Dye	16	9	$616.00	$616.00	$134.67	$616.00	$373.91	2026-07-31
23545	CPT	Treat Clavicle Dislocatio	32	9	$722.00	$722.00	$134.48	$861.90	$371.57	2026-07-31
74270	CPT	Contrast X-ray Exam Of Colon	16	9	$896.00	$896.00	$85.00	$691.90	$367.36	2026-07-31
24500	CPT	ER-trt Humeral Shft Clsd	32	9	$731.50	$731.50	$123.41	$897.60	$366.63	2026-07-31
54150	CPT	Circumcision W/regionl Bl	16	9	$581.00	$581.00	$216.00	$408.00	$365.92	2026-07-31
42970	CPT	Control Nose/ Throat Bleed	32	9	$785.50	$785.50	$89.67	$1,032.75	$365.68	2026-07-31
C1773	HCPCS	Retrieval Net Roth Steris 711050	16	9	$605.00	$605.00	$211.50	$399.50	$364.25	2026-07-31
97598	CPT	Pt Active Wound Care > 20 Cm	16	9	$568.00	$568.00	$90.00	$438.60	$363.52	2026-07-31
64430	CPT	ER-pudendal Nerve Block I	32	9	$862.50	$862.50	$109.37	$1,004.70	$363.48	2026-07-31
13120	CPT	ER-repair Cmplx 1.1-2.5cm	32	9	$724.50	$724.50	$112.43	$892.50	$361.83	2026-07-31
12054	CPT	ER-repair Int 7.6-12.5cm	32	9	$742.50	$742.50	$109.47	$940.95	$360.05	2026-07-31
11406	CPT	Exc Lesion Trunk/arms	16	9	$572.00	$572.00	$212.40	$401.20	$360.04	2026-07-31
24576	CPT	ER-trt Humeral Condylar C	32	9	$711.50	$711.50	$123.41	$867.00	$359.19	2026-07-31
27750	CPT	ER-trt Tib Shft Clsd Fx W	32	9	$711.50	$711.50	$123.41	$867.00	$359.19	2026-07-31
26670	CPT	ER-trt Cmc Clsd Dislocate	32	9	$708.50	$708.50	$123.41	$861.90	$358.07	2026-07-31
12044	CPT	ER-repair Int 7.5-12.5cm	32	9	$736.00	$736.00	$109.47	$930.75	$357.63	2026-07-31
12042	CPT	Intmd Wnd Repair N-hf/gen	48	9	$550.00	$550.00	$196.65	$752.25	$357.16	2026-07-31
26725	CPT	ER-trt Finger/thumb Clsd	32	9	$702.00	$702.00	$123.41	$851.70	$355.66	2026-07-31
41250	CPT	Repair Tongue Laceration	32	9	$653.50	$653.50	$164.82	$698.70	$353.86	2026-07-31
32551	CPT	ER-tube Thoracostomy	32	9	$582.00	$582.00	$193.07	$500.00	$353.25	2026-07-31
27824	CPT	ER-trt Dist Tib Clsd Fx W	32	9	$694.50	$694.50	$123.41	$840.65	$352.87	2026-07-31
74280	CPT	Xr Colon W/double Air Contra	16	9	$860.00	$860.00	$85.00	$663.85	$352.60	2026-07-31
64402	CPT	N Block Inj Facial	16	9	$550.00	$550.00	$225.50	$500.00	$352.00	2026-07-31
27808	CPT	ER-trt Bimalleolar Ankle	32	9	$692.00	$692.00	$123.41	$836.40	$351.94	2026-07-31
27760	CPT	ER-trt Ankle Without Mnp Fx	32	9	$692.00	$692.00	$123.41	$836.40	$351.94	2026-07-31
12032	CPT	ER-repair Int 2.6-7.5cm	64	9	$579.50	$579.50	$109.47	$754.80	$350.72	2026-07-31
25600	CPT	ER-trt Colles Clsd Fx Without	32	9	$688.50	$688.50	$123.41	$831.30	$350.63	2026-07-31
23600	CPT	ER-trt Humeral Clsd Fx With	32	9	$685.50	$685.50	$123.41	$826.20	$349.52	2026-07-31
24560	CPT	ER-trt Humeral Epicondyla	32	9	$683.50	$683.50	$123.41	$823.65	$348.77	2026-07-31
12053	CPT	ER-repair Int 5.1-7.5cm	32	9	$711.00	$711.00	$109.47	$892.50	$348.33	2026-07-31
11750	CPT	ER-ex Nail/nail Matrix	48	9	$549.00	$549.00	$189.35	$562.70	$346.50	2026-07-31
26755	CPT	Treat Finger Fracture Ea	32	9	$670.00	$670.00	$125.87	$798.15	$345.64	2026-07-31
11601	CPT	Exc Tr-ext Mlg+marg 0.6-1	16	9	$549.00	$549.00	$203.85	$385.05	$345.56	2026-07-31
27520	CPT	ER-trt Patellar Clsd Fx W	32	9	$674.00	$674.00	$123.41	$808.35	$345.24	2026-07-31
11400	CPT	Exc Tr-ext B9+marg 0.5 <	16	9	$548.00	$548.00	$203.85	$385.05	$345.24	2026-07-31
23650	CPT	ER-trt Shldr Clsd Disloca	32	9	$670.50	$670.50	$123.41	$803.25	$343.94	2026-07-31
86870	CPT	Antibody Identification	16	9	$1,375.00	$1,375.00	$64.11	$880.00	$340.52	2026-07-31
27786	CPT	ER-trt Dist Fib Clsd Fx W	32	9	$660.50	$660.50	$123.41	$787.95	$340.22	2026-07-31
57454	CPT	Colposcopy W/bx	16	9	$583.00	$583.00	$197.10	$373.12	$339.45	2026-07-31
7000422	LOCAL	Central Line Triple Kit Ak-45703acdc	16	9	$528.00	$528.00	$211.20	$408.00	$337.92	2026-07-31
90651	CPT	Private Hpv-9 (gardasil 9) Vial	16	9	$526.00	$526.00	$215.10	$406.30	$336.64	2026-07-31
27780	CPT	ER-trt Prox Fib Clsd Fx W	32	9	$649.00	$649.00	$123.41	$770.10	$335.94	2026-07-31
25630	CPT	ER-trt Carpal Clsd Fx Without	32	9	$647.50	$647.50	$123.41	$767.55	$335.38	2026-07-31
25622	CPT	ER-trt Navilcular Clsd Fx	32	9	$645.50	$645.50	$123.41	$765.00	$334.64	2026-07-31
1600005	LOCAL	Recovery Room 2.5 Hours	16	9	$531.00	$531.00	$203.96	$373.15	$334.54	2026-07-31
27530	CPT	ER-trt Tibial Clsd Fx Without	32	9	$642.50	$642.50	$123.41	$759.90	$333.52	2026-07-31
24670	CPT	ER-trt Ulnar Clsd Fx Without	32	9	$624.50	$624.50	$123.41	$731.85	$326.83	2026-07-31
26010	CPT	ER-finger Abscess Drain	32	9	$631.00	$631.00	$109.18	$754.80	$324.22	2026-07-31
94644	CPT	Cont Aerosol Inh 1st Hr	16	9	$506.00	$506.00	$75.00	$391.00	$323.84	2026-07-31
94645	CPT	Cont Aerosol Inh Addt Hrs	16	9	$506.00	$506.00	$75.00	$391.00	$323.84	2026-07-31
12051	CPT	ER-repair Int 2.5cm Or <*	48	9	$516.00	$516.00	$109.47	$680.85	$323.80	2026-07-31
25560	CPT	ER-trt Rad/ulnar Shft Cls	32	9	$612.50	$612.50	$123.41	$714.00	$322.37	2026-07-31
26770	CPT	ER-trt Finger Clsd Disloc	32	9	$608.00	$608.00	$123.41	$706.35	$320.69	2026-07-31
30905	CPT	Control Nose Bleed Pos	32	9	$663.50	$663.50	$89.67	$844.05	$320.30	2026-07-31
62270	CPT	ER-spinal Tap Dx	64	9	$625.50	$625.50	$165.23	$2,545.75	$319.14	2026-07-31
25500	CPT	ER-trt Radial Shft Clsd F	32	9	$603.00	$603.00	$123.41	$698.70	$318.83	2026-07-31

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