Price Transparencybeta Hospital negotiated rates

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

W J MANGOLD MEMORIAL HOSPITAL

Lockney, TX · CCN 451337 · Rates published

3,215 distinct procedures filed
9 distinct payers
60,087 rate rows
2026-05-17 last MRF observed
Data quality

51,918 of 60,087 rate rows are consumer-grade (86.4%)

8,169 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
placeholder amount (≤ $0.02) — excluded from medians 4,119
template filing: same amount across many unrelated codes — excluded 4,050
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 viaDiscovered by HANK
Last fetch not_modified · 2026-05-19
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
6001789
OTHER 		Alteplase (activase) 100mg IV Powder 9 $8,316.00 $15,708.00 $13,009.92 nat. median
$13,010
1.0× median
2000020
OTHER 		Birth Ctr W/epidural >6 9 $500.00 $6,256.85 $5,182.72 nat. median
$38
outlier · 136.4×
2000019
OTHER 		Birth Ctr W/epidural 4-6 9 $500.00 $5,406.85 $4,478.72 nat. median
$310
outlier · 14.5×
6020519
OTHER 		Tenecteplase (tnkase) 50mg Kit 9 $2,831.40 $5,348.20 $4,430.08 nat. median
$4,430
1.0× median
1300201
OTHER 		Picc Insertion Ultrasound Guided 9 $2,461.50 $4,649.50 $4,169.33 nat. median
$2,714
1.5× median
2000018
OTHER 		Birth Ctr With Epidural 2-4 9 $500.00 $4,896.85 $4,056.32 nat. median
$509
outlier · 8.0×
2000017
OTHER 		Birth Ctr With Epidural 0-2 9 $500.00 $4,386.85 $3,633.92 nat. median
$66
outlier · 55.1×
3000715
OTHER 		Vectra Da Score 9 $2,086.49 $3,932.10 $3,256.96 nat. median
$49
outlier · 66.8×
2500100
OTHER 		ER-osteotomy Phalanx Fing 9 $500.00 $3,550.45 $3,183.97 nat. median
$85
outlier · 37.3×
2000016
OTHER 		Remote 30 Day ECG Tech Su 9 $140.00 $3,383.00 $3,033.62 nat. median
$142
outlier · 21.4×
2500064
OTHER 		ER-i&d Epidiymis Testis S 9 $500.00 $3,229.15 $2,895.66 nat. median
$2,896
1.0× median
2500115
OTHER 		ER-repair Cornea Nonperfo 9 $500.00 $3,162.24 $2,876.80 nat. median
$107
outlier · 27.0×
2500001
OTHER 		ER Critical Care 30-74 Mi 9 $487.83 $7,561.60 $2,868.32 nat. median
$2,288
1.3× median
7600002
OTHER 		Polysomnography W/cpap 9 $800.00 $3,318.40 $2,748.80 nat. median
$213
outlier · 12.9×
7600001
OTHER 		Polysomnography 9 $800.00 $3,318.40 $2,748.80 nat. median
$265
outlier · 10.4×
2500069
OTHER 		ER-i&d Perirectal Abscess 9 $500.00 $3,055.75 $2,740.44 nat. median
$18
outlier · 155.7×
2500056
OTHER 		ER-filleted Finger/toe Fl 9 $500.00 $2,941.00 $2,637.34 nat. median
$115
outlier · 23.0×
2500055
OTHER 		ER-fb Thigh/knee Deep Rmv 9 $500.00 $2,754.00 $2,469.40 nat. median
$40
outlier · 62.1×
2500143
OTHER 		ER-repair Surgical Wound 9 $500.00 $2,941.00 $2,435.84 nat. median
$254
outlier · 9.6×
2000001
OTHER 		Birthing Center 9 $500.00 $2,686.85 $2,409.69 nat. median
$144
outlier · 16.7×
1300204
OTHER 		Picc Removal 9 $1,397.25 $2,639.25 $2,366.61 nat. median
$2,367
1.0× median
2500228
OTHER 		ER-vaginal Delivery 9 $500.00 $2,814.35 $2,331.52 nat. median
$42
outlier · 55.1×
2500332
OTHER 		Closed Trmt Post Hip Arthroplasty Disloc 9 $500.00 $2,792.25 $2,312.96 nat. median
$274
outlier · 8.5×
2500333
OTHER 		Closed Trmt Radial Head Or Neck Fx W/man 9 $500.00 $2,792.25 $2,312.96 nat. median
$52
outlier · 44.2×
1300097
OTHER 		Laryngoscopy Direct 9 $1,280.70 $2,419.10 $2,169.33 nat. median
$2,169
1.0× median
2500067
OTHER 		ER-i&d Penis Deep 9 $500.00 $2,403.80 $2,155.54 nat. median
$2,156
1.0× median
2500066
OTHER 		ER-i&d Neck Soft Tissue A 9 $500.00 $2,403.80 $2,155.54 nat. median
$81
outlier · 26.6×
2500248
OTHER 		Laryngoscopy Direct 9 $500.00 $2,419.10 $2,003.84 nat. median
$1,134
1.8× median
1300119
OTHER 		Endovenous Laser 1st Vei 9 $1,181.25 $2,231.25 $2,001.01 nat. median
$2,001
1.0× median
2500118
OTHER 		ER-repair Ext Tendon Without 9 $500.00 $2,216.80 $1,987.92 nat. median
$10
outlier · 190.4×
2500117
OTHER 		ER-repair Ext Tendon Hand 9 $500.00 $2,216.80 $1,987.92 nat. median
$54
outlier · 37.1×
2500116
OTHER 		ER-repair Ext Tendon Fing 9 $500.00 $2,216.80 $1,987.92 nat. median
$1,253
1.6× median
6001733
OTHER 		Denosumab Inj (prolia) 60mg/1ml Syrn 9 $1,218.60 $2,301.80 $1,906.56 nat. median
$1,907
1.0× median
2500053
OTHER 		ER-fb Subq Tissue Complic 9 $500.00 $2,074.00 $1,859.64 nat. median
$66
outlier · 28.1×
2500267
OTHER 		Treat Shoulder Dislocatio 9 $500.00 $2,210.00 $1,830.40 nat. median
$46
outlier · 39.4×
1000012
OTHER 		Or-operating Room 6.0 Hou 9 $250.00 $2,040.00 $1,829.28 nat. median
$1,342
1.4× median
6050085
OTHER 		Hyaluronate Sod (monovisc) Inj 88mg/4ml 9 $1,154.70 $2,181.10 $1,806.72 nat. median
$1,807
1.0× median
2500265
OTHER 		Skin Tissue Rearrangement 9 $500.00 $2,140.30 $1,772.80 nat. median
$274
outlier · 6.5×
6001168
OTHER 		Hyaluronate Sodium One(synvisc One) 48mg 9 $1,109.25 $2,095.25 $1,735.68 nat. median
$1,736
1.0× median
2500330
OTHER 		Treat Ankle Dislocation 9 $500.00 $2,074.00 $1,717.76 nat. median
$274
outlier · 6.3×
1000011
OTHER 		Or-operating Room 5.5 Hou 9 $250.00 $1,901.45 $1,705.12 nat. median
$1,685
1.0× median
2600064
OTHER 		Rpr Surgical Wound 9 $969.80 $2,014.50 $1,668.48 nat. median
$75
outlier · 22.3×
2500178
OTHER 		ER-trt Elbow Clsd Disloca 9 $500.00 $2,004.30 $1,660.16 nat. median
$19
outlier · 87.3×
2500194
OTHER 		ER-trt Ip Joint Dislocate 9 $500.00 $2,004.30 $1,660.16 nat. median
$105
outlier · 15.8×
1000013
OTHER 		Neonate Crit Care Initial 9 $12.80 $2,530.00 $1,619.20 nat. median
$814
2.0× median
1500012
OTHER 		Anesthesia Service 6.0 Ho 9 $753.60 $1,764.60 $1,582.34 nat. median
$1,661
1.0× median
1000010
OTHER 		Or-operating Room 5.0 Hou 9 $250.00 $1,754.40 $1,573.36 nat. median
$1,727
0.9× median
2600065
OTHER 		Skin Tissue Rearrangement 9 $913.63 $1,897.20 $1,571.84 nat. median
$270
outlier · 5.8×
4400298
OTHER 		US Tte W/doppler Complete 9 $300.00 $1,884.45 $1,560.96 nat. median
$569
outlier · 2.7×
4400041
OTHER 		US Echocardiography Transtho 9 $300.00 $1,881.90 $1,559.04 nat. median
$585
outlier · 2.7×

Other procedures at this hospital

Browse this hospital's 3,215 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
6001789 OTHER Alteplase (activase) 100mg IV Powder 16 9 $20,328.00 $20,328.00 $8,316.00 $15,708.00 $13,009.92 2026-05-17
2000020 OTHER Birth Ctr W/epidural >6 16 9 $8,098.00 $8,098.00 $500.00 $6,256.85 $5,182.72 2026-05-17
2000019 OTHER Birth Ctr W/epidural 4-6 16 9 $6,998.00 $6,998.00 $500.00 $5,406.85 $4,478.72 2026-05-17
6020519 OTHER Tenecteplase (tnkase) 50mg Kit 16 9 $6,922.00 $6,922.00 $2,831.40 $5,348.20 $4,430.08 2026-05-17
1300201 OTHER Picc Insertion Ultrasound Guided 16 9 $6,619.00 $6,619.00 $2,461.50 $4,649.50 $4,169.33 2026-05-17
2000018 OTHER Birth Ctr With Epidural 2-4 16 9 $6,338.00 $6,338.00 $500.00 $4,896.85 $4,056.32 2026-05-17
2000017 OTHER Birth Ctr With Epidural 0-2 16 9 $5,678.00 $5,678.00 $500.00 $4,386.85 $3,633.92 2026-05-17
3000715 OTHER Vectra Da Score 16 9 $5,089.00 $5,089.00 $2,086.49 $3,932.10 $3,256.96 2026-05-17
2500100 OTHER ER-osteotomy Phalanx Fing 16 9 $5,055.00 $5,055.00 $500.00 $3,550.45 $3,183.97 2026-05-17
2000016 OTHER Remote 30 Day ECG Tech Su 16 9 $4,816.00 $4,816.00 $140.00 $3,383.00 $3,033.62 2026-05-17
2500064 OTHER ER-i&d Epidiymis Testis S 16 9 $4,597.00 $4,597.00 $500.00 $3,229.15 $2,895.66 2026-05-17
2500115 OTHER ER-repair Cornea Nonperfo 16 9 $4,941.00 $4,941.00 $500.00 $3,162.24 $2,876.80 2026-05-17
2500001 OTHER ER Critical Care 30-74 Mi 16 9 $11,815.00 $11,815.00 $487.83 $7,561.60 $2,868.32 2026-05-17
7600001 OTHER Polysomnography 16 9 $4,295.00 $4,295.00 $800.00 $3,318.40 $2,748.80 2026-05-17
7600002 OTHER Polysomnography W/cpap 16 9 $4,295.00 $4,295.00 $800.00 $3,318.40 $2,748.80 2026-05-17
2500069 OTHER ER-i&d Perirectal Abscess 16 9 $4,351.00 $4,351.00 $500.00 $3,055.75 $2,740.44 2026-05-17
2500056 OTHER ER-filleted Finger/toe Fl 16 9 $4,187.00 $4,187.00 $500.00 $2,941.00 $2,637.34 2026-05-17
2500055 OTHER ER-fb Thigh/knee Deep Rmv 16 9 $3,920.00 $3,920.00 $500.00 $2,754.00 $2,469.40 2026-05-17
2500143 OTHER ER-repair Surgical Wound 16 9 $3,806.00 $3,806.00 $500.00 $2,941.00 $2,435.84 2026-05-17
2000001 OTHER Birthing Center 16 9 $3,826.00 $3,826.00 $500.00 $2,686.85 $2,409.69 2026-05-17
1300204 OTHER Picc Removal 16 9 $3,757.00 $3,757.00 $1,397.25 $2,639.25 $2,366.61 2026-05-17
2500228 OTHER ER-vaginal Delivery 16 9 $3,643.00 $3,643.00 $500.00 $2,814.35 $2,331.52 2026-05-17
2500332 OTHER Closed Trmt Post Hip Arthroplasty Disloc 16 9 $3,614.00 $3,614.00 $500.00 $2,792.25 $2,312.96 2026-05-17
2500333 OTHER Closed Trmt Radial Head Or Neck Fx W/man 16 9 $3,614.00 $3,614.00 $500.00 $2,792.25 $2,312.96 2026-05-17
1300097 OTHER Laryngoscopy Direct 16 9 $3,444.00 $3,444.00 $1,280.70 $2,419.10 $2,169.33 2026-05-17
2500066 OTHER ER-i&d Neck Soft Tissue A 16 9 $3,422.00 $3,422.00 $500.00 $2,403.80 $2,155.54 2026-05-17
2500067 OTHER ER-i&d Penis Deep 16 9 $3,422.00 $3,422.00 $500.00 $2,403.80 $2,155.54 2026-05-17
2500248 OTHER Laryngoscopy Direct 16 9 $3,131.00 $3,131.00 $500.00 $2,419.10 $2,003.84 2026-05-17
1300119 OTHER Endovenous Laser 1st Vei 16 9 $3,177.00 $3,177.00 $1,181.25 $2,231.25 $2,001.01 2026-05-17
2500118 OTHER ER-repair Ext Tendon Without 16 9 $3,156.00 $3,156.00 $500.00 $2,216.80 $1,987.92 2026-05-17
2500116 OTHER ER-repair Ext Tendon Fing 16 9 $3,156.00 $3,156.00 $500.00 $2,216.80 $1,987.92 2026-05-17
2500117 OTHER ER-repair Ext Tendon Hand 16 9 $3,156.00 $3,156.00 $500.00 $2,216.80 $1,987.92 2026-05-17
6001733 OTHER Denosumab Inj (prolia) 60mg/1ml Syrn 16 9 $2,979.00 $2,979.00 $1,218.60 $2,301.80 $1,906.56 2026-05-17
2500053 OTHER ER-fb Subq Tissue Complic 16 9 $2,952.00 $2,952.00 $500.00 $2,074.00 $1,859.64 2026-05-17
2500267 OTHER Treat Shoulder Dislocatio 16 9 $2,860.00 $2,860.00 $500.00 $2,210.00 $1,830.40 2026-05-17
1000012 OTHER Or-operating Room 6.0 Hou 16 9 $2,904.00 $2,904.00 $250.00 $2,040.00 $1,829.28 2026-05-17
6050085 OTHER Hyaluronate Sod (monovisc) Inj 88mg/4ml 16 9 $2,823.00 $2,823.00 $1,154.70 $2,181.10 $1,806.72 2026-05-17
2500265 OTHER Skin Tissue Rearrangement 16 9 $2,770.00 $2,770.00 $500.00 $2,140.30 $1,772.80 2026-05-17
6001168 OTHER Hyaluronate Sodium One(synvisc One) 48mg 16 9 $2,712.00 $2,712.00 $1,109.25 $2,095.25 $1,735.68 2026-05-17
2500330 OTHER Treat Ankle Dislocation 16 9 $2,684.00 $2,684.00 $500.00 $2,074.00 $1,717.76 2026-05-17
1000011 OTHER Or-operating Room 5.5 Hou 16 9 $2,707.00 $2,707.00 $250.00 $1,901.45 $1,705.12 2026-05-17
2600064 OTHER Rpr Surgical Wound 16 9 $2,607.00 $2,607.00 $969.80 $2,014.50 $1,668.48 2026-05-17
2500194 OTHER ER-trt Ip Joint Dislocate 16 9 $2,594.00 $2,594.00 $500.00 $2,004.30 $1,660.16 2026-05-17
2500178 OTHER ER-trt Elbow Clsd Disloca 16 9 $2,594.00 $2,594.00 $500.00 $2,004.30 $1,660.16 2026-05-17
1000013 OTHER Neonate Crit Care Initial 16 9 $2,530.00 $2,530.00 $12.80 $2,530.00 $1,619.20 2026-05-17
1500012 OTHER Anesthesia Service 6.0 Ho 16 9 $2,512.00 $2,512.00 $753.60 $1,764.60 $1,582.34 2026-05-17
1000010 OTHER Or-operating Room 5.0 Hou 16 9 $2,498.00 $2,498.00 $250.00 $1,754.40 $1,573.36 2026-05-17
2600065 OTHER Skin Tissue Rearrangement 16 9 $2,456.00 $2,456.00 $913.63 $1,897.20 $1,571.84 2026-05-17
4400298 OTHER US Tte W/doppler Complete 16 9 $2,439.00 $2,439.00 $300.00 $1,884.45 $1,560.96 2026-05-17
4400041 OTHER US Echocardiography Transtho 16 9 $2,436.00 $2,436.00 $300.00 $1,881.90 $1,559.04 2026-05-17
6052619 OTHER Orencia 250mg Ivpb 16 9 $2,433.00 $2,433.00 $952.20 $1,798.60 $1,557.12 2026-05-17
1000037 OTHER Spinal Puncture Lumbar Diagnostic 16 9 $3,625.00 $3,625.00 $173.00 $2,545.75 $1,486.25 2026-05-17
1300117 OTHER Phleb Veins Extrem 20+ 16 9 $2,357.00 $2,357.00 $876.60 $1,655.80 $1,484.74 2026-05-17
1500011 OTHER Anesthesia Service 5.5 Ho 16 9 $2,339.00 $2,339.00 $701.70 $1,642.20 $1,472.98 2026-05-17
6001791 OTHER Tocilizumab (actemra) 200mg 16 9 $2,283.00 $2,283.00 $933.75 $1,763.75 $1,461.12 2026-05-17
1000009 OTHER Or-operating Room 4.5 Hou 16 9 $2,301.00 $2,301.00 $250.00 $1,615.85 $1,449.20 2026-05-17
2600120 OTHER Rpr Osteotomy Phalanx Fing 16 9 $2,261.00 $2,261.00 $841.09 $1,746.75 $1,447.04 2026-05-17
2600066 OTHER Filleted Finger/toe Fl 16 9 $2,261.00 $2,261.00 $841.09 $1,746.75 $1,447.04 2026-05-17
2500322 OTHER Intmd Rpr S/a/t/ext 20.1- 16 9 $2,250.00 $2,250.00 $500.00 $1,738.25 $1,440.00 2026-05-17
2500065 OTHER ER-i&d Hematoma 16 9 $2,180.00 $2,180.00 $500.00 $1,530.85 $1,372.97 2026-05-17
2500057 OTHER ER-finger Abscess Drain 16 9 $2,180.00 $2,180.00 $500.00 $1,530.85 $1,372.97 2026-05-17
6000996 OTHER Zoledronic Acid (reclast) 5mg 16 9 $2,145.00 $2,145.00 $877.50 $1,657.50 $1,372.80 2026-05-17
1500010 OTHER Anesthesia Service 5.0 Ho 16 9 $2,166.00 $2,166.00 $649.80 $1,521.50 $1,364.37 2026-05-17
1000008 OTHER Or-operating Room 4.0 Hou 16 9 $2,103.00 $2,103.00 $250.00 $1,477.30 $1,324.71 2026-05-17
2600143 OTHER Trt Knee Dislocation 16 9 $2,050.00 $2,050.00 $762.60 $1,583.55 $1,312.00 2026-05-17
1500009 OTHER Anesthesia Service 4.5 Ho 16 9 $1,992.00 $1,992.00 $597.60 $1,399.10 $1,254.69 2026-05-17
1300148 OTHER Exc H-f-nk-sp Mlg+marg 2. 16 9 $1,992.00 $1,992.00 $740.70 $1,399.10 $1,254.69 2026-05-17
1300118 OTHER Exc Tr-ext B9+marg 3.1-4 16 9 $1,992.00 $1,992.00 $740.70 $1,399.10 $1,254.69 2026-05-17
2600139 OTHER Rmv Fb Thigh/knee Deep 16 9 $1,947.00 $1,947.00 $724.28 $1,504.50 $1,246.08 2026-05-17
4200010 OTHER CT Lower Extremity With And Without Contrast 16 9 $3,038.00 $3,038.00 $227.23 $2,346.85 $1,245.58 2026-05-17
4000162 OTHER X-ray Exam Knee 4 Or More 16 9 $3,038.00 $3,038.00 $134.67 $2,346.85 $1,245.58 2026-05-17
4000160 OTHER X-ray Exam Knee 4 Or More 16 9 $3,038.00 $3,038.00 $134.67 $2,209.54 $1,245.58 2026-05-17
1300116 OTHER Phleb Veins Extrem 10-20 16 9 $1,977.00 $1,977.00 $734.85 $1,388.05 $1,245.01 2026-05-17
2600118 OTHER Rpr Ext Tendon Finger 16 9 $1,928.00 $1,928.00 $717.22 $1,489.20 $1,233.92 2026-05-17
1300189 OTHER Remove Tendon Sheath Lesi 16 9 $1,948.00 $1,948.00 $724.50 $1,368.50 $1,227.11 2026-05-17
2600138 OTHER Trt Hip Post Hip Arthroplasty Disloc 16 9 $1,901.00 $1,901.00 $707.17 $1,468.80 $1,216.64 2026-05-17
2600241 OTHER Rpr Cornea Nonperfo 16 9 $1,895.00 $1,895.00 $704.94 $1,463.70 $1,212.80 2026-05-17
2600117 OTHER Rpr Ext Tendon Hand 16 9 $1,875.00 $1,875.00 $697.50 $1,448.40 $1,200.00 2026-05-17
2600072 OTHER Explore Wound Extremity 16 9 $1,875.00 $1,875.00 $697.50 $1,448.40 $1,200.00 2026-05-17
1000007 OTHER Or-operating Room 3.5 Hou 16 9 $1,900.00 $1,900.00 $250.00 $1,334.50 $1,196.75 2026-05-17
2600054 OTHER Rpr Int 20.1-30.0 16 9 $1,852.00 $1,852.00 $688.94 $1,430.55 $1,185.28 2026-05-17
7000735 OTHER IUD Mirena 32 9 $2,932.00 $2,932.00 $37.60 $4,250.00 $1,161.12 2026-05-17
2600091 OTHER Trt Dislocation/fracture 16 9 $1,796.00 $1,796.00 $668.11 $1,387.20 $1,149.44 2026-05-17
1500008 OTHER Anesthesia Service 4.0 Ho 16 9 $1,819.00 $1,819.00 $545.70 $1,277.55 $1,145.70 2026-05-17
2600212 OTHER I&d Perirectal Abscess 16 9 $1,776.00 $1,776.00 $660.67 $1,371.90 $1,136.64 2026-05-17
2600119 OTHER Rpr Ext Tendon Without 16 9 $1,766.00 $1,766.00 $656.95 $1,364.25 $1,130.24 2026-05-17
2600110 OTHER Trt Colles Clsd Fx W/m 16 9 $1,759.00 $1,759.00 $654.35 $1,359.15 $1,125.76 2026-05-17
2600158 OTHER Rmvl Fb Foot Subq 16 9 $1,746.00 $1,746.00 $649.51 $1,348.95 $1,117.44 2026-05-17
2600147 OTHER Trt Tib Shft Clsd Fx W 16 9 $1,743.00 $1,743.00 $648.40 $1,346.40 $1,115.52 2026-05-17
2600140 OTHER Trt Femoral Clsd Fx With 16 9 $1,707.00 $1,707.00 $635.00 $1,318.35 $1,092.48 2026-05-17
2600108 OTHER Trt Rad/ Ulnar Shft Clsd 16 9 $1,680.00 $1,680.00 $624.96 $1,297.95 $1,075.20 2026-05-17
1000006 OTHER Or-operating Room 3.0 Hou 16 9 $1,697.00 $1,697.00 $250.00 $1,191.70 $1,068.79 2026-05-17
2600006 OTHER ER Critical Care 30-74 Min 16 9 $1,650.00 $1,650.00 $613.80 $1,275.00 $1,056.00 2026-05-17
11988 OTHER Ambulance 16 9 $1,650.00 $1,650.00 $676.50 $1,275.00 $1,056.00 2026-05-17
2600105 OTHER Trt Radial Shft Clsd 16 9 $1,637.00 $1,637.00 $608.96 $1,264.80 $1,047.68 2026-05-17
2600062 OTHER Rpr Cmplx 2.6-7.5 16 9 $1,637.00 $1,637.00 $608.96 $1,264.80 $1,047.68 2026-05-17
2600132 OTHER Trt Finger Fx Ea 16 9 $1,634.00 $1,634.00 $607.85 $1,262.25 $1,045.76 2026-05-17
2600094 OTHER Trt Humeral Shft Fx 16 9 $1,621.00 $1,621.00 $603.01 $1,252.05 $1,037.44 2026-05-17
1500007 OTHER Anesthesia Service 3.5 Ho 16 9 $1,645.00 $1,645.00 $493.50 $1,155.15 $1,036.03 2026-05-17
2600156 OTHER Trt Ankle Dislocation 16 9 $1,608.00 $1,608.00 $598.18 $1,241.85 $1,029.12 2026-05-17
4000297 OTHER Xr Hepatobiliary System Imag 16 9 $1,605.00 $1,605.00 $175.00 $1,240.15 $1,027.20 2026-05-17
2600145 OTHER Trt Knee Cap Dislocation 16 9 $1,584.00 $1,584.00 $589.25 $1,224.00 $1,013.76 2026-05-17
2600053 OTHER Rpr Int 12.6-20.0 16 9 $1,578.00 $1,578.00 $587.02 $1,218.90 $1,009.92 2026-05-17
2600136 OTHER Trt Femoral Neck Clsd 16 9 $1,571.00 $1,571.00 $584.41 $1,213.80 $1,005.44 2026-05-17
1300193 OTHER Remove Foreign Body 16 9 $1,592.00 $1,592.00 $591.75 $1,117.75 $1,002.57 2026-05-17
2500314 OTHER Repair Lip 16 9 $1,557.00 $1,557.00 $500.00 $1,202.75 $996.48 2026-05-17
2600060 OTHER Rpr Cmplx 2.6-7.5 16 9 $1,548.00 $1,548.00 $575.86 $1,195.95 $990.72 2026-05-17
2600099 OTHER Trt Elbow Clsd Dislocation 16 9 $1,542.00 $1,542.00 $573.62 $1,190.85 $986.88 2026-05-17
2600087 OTHER Trt Humeral Clsd Fx With 16 9 $1,522.00 $1,522.00 $566.18 $1,175.55 $974.08 2026-05-17
2600081 OTHER I&d Neck Soft Tissue 16 9 $1,518.00 $1,518.00 $564.70 $1,173.00 $971.52 2026-05-17
2600204 OTHER Rpr Lip 16 9 $1,502.00 $1,502.00 $558.74 $1,160.25 $961.28 2026-05-17
2500102 OTHER Abd Paracentesis 16 9 $1,512.00 $1,512.00 $500.00 $1,062.50 $952.59 2026-05-17
2500033 OTHER ER-control Throat Bleed 16 9 $1,503.00 $1,503.00 $500.00 $1,055.70 $946.71 2026-05-17
1000005 OTHER Or-operating Room 2.5 Hou 16 9 $1,499.00 $1,499.00 $250.00 $1,053.15 $944.31 2026-05-17
2500329 OTHER Repair Int N-hf/genit 12.6-20 16 9 $1,463.00 $1,463.00 $500.00 $1,130.50 $936.32 2026-05-17
1500006 OTHER Anesthesia Service 3.0 Ho 16 9 $1,472.00 $1,472.00 $441.60 $1,033.60 $927.04 2026-05-17
2600114 OTHER Trt Wrist Dislocation 16 9 $1,439.00 $1,439.00 $535.31 $1,111.80 $920.96 2026-05-17
2600102 OTHER Trt Clsd Radial Head Or Neck Fx W/man 16 9 $1,433.00 $1,433.00 $533.08 $1,106.70 $917.12 2026-05-17
7000487 OTHER Dressing Tegaderm 6x8 1628 32 9 $2,619.50 $2,619.50 $4.40 $3,438.25 $914.38 2026-05-17
2600116 OTHER Finger Abscess Drain 16 9 $1,410.00 $1,410.00 $524.52 $1,088.85 $902.40 2026-05-17
2500104 OTHER ER-pudendal Nerve Block I 16 9 $1,431.00 $1,431.00 $500.00 $1,004.70 $901.17 2026-05-17
2600150 OTHER Trt Fibula Fx Clsd W/m 16 9 $1,406.00 $1,406.00 $523.03 $1,086.30 $899.84 2026-05-17
1300109 OTHER Treat Thigh Fx Growth Pla 16 9 $1,426.00 $1,426.00 $530.10 $1,001.30 $898.07 2026-05-17
4000319 OTHER Duplex Scan Bilateral Study 16 9 $1,399.00 $1,399.00 $573.59 $1,080.35 $895.36 2026-05-17
4400305 OTHER US Duplex Scan Complete Bilateral Study 16 9 $1,399.00 $1,399.00 $350.00 $1,080.35 $895.36 2026-05-17
2600044 OTHER Rpr Int S/a/t/ext 20.1 16 9 $1,396.00 $1,396.00 $519.31 $1,078.65 $893.44 2026-05-17
2600090 OTHER Trt Shldr Clds Dislocation 16 9 $1,393.00 $1,393.00 $518.20 $1,076.10 $891.52 2026-05-17
2600058 OTHER Rpr Cmplx 2.6-7.5 16 9 $1,393.00 $1,393.00 $518.20 $1,076.10 $891.52 2026-05-17
2600152 OTHER Trt Dist Fib Clsd Fx W 16 9 $1,383.00 $1,383.00 $514.48 $1,068.45 $885.12 2026-05-17
2600061 OTHER Rpr Cmplx 1.1-2.5 16 9 $1,383.00 $1,383.00 $514.48 $1,068.45 $885.12 2026-05-17
3000485 OTHER Hepatitis C Genotype Dna/rna 16 9 $2,142.00 $2,142.00 $154.87 $1,654.95 $878.22 2026-05-17
2600209 OTHER Control Throat Bleed 16 9 $1,360.00 $1,360.00 $505.92 $1,050.60 $870.40 2026-05-17
2500325 OTHER Treat Finger Fracture Eac 16 9 $1,348.00 $1,348.00 $500.00 $1,041.25 $862.72 2026-05-17
2600210 OTHER Control Nose/ Throat Bleed 16 9 $1,337.00 $1,337.00 $497.36 $1,032.75 $855.68 2026-05-17
5 OTHER Private Cardiac Equipment 16 9 $1,332.00 $1,332.00 $532.80 $968.36 $852.48 2026-05-17
1300185 OTHER Removal Of Sperm Duct(s) 16 9 $1,350.00 $1,350.00 $501.75 $947.75 $850.12 2026-05-17
13 OTHER Private Swingbed Card Eq 16 9 $1,320.00 $1,320.00 $528.00 $959.64 $844.80 2026-05-17
2500327 OTHER Treat Knee Dislocation 16 9 $1,320.00 $1,320.00 $500.00 $1,020.00 $844.80 2026-05-17
1300098 OTHER Appendectomy 16 9 $1,340.00 $1,340.00 $498.15 $940.95 $843.92 2026-05-17
2600048 OTHER Rpr Int N-hf/genit 12.6-20 16 9 $1,317.00 $1,317.00 $489.92 $1,017.45 $842.88 2026-05-17
2600137 OTHER Trt Hip Dislocation 16 9 $1,317.00 $1,317.00 $489.92 $1,017.45 $842.88 2026-05-17
2600089 OTHER Trt Shldr Dislocation 16 9 $1,317.00 $1,317.00 $489.92 $1,017.45 $842.88 2026-05-17
6000665 OTHER Private Tet Immuneglob(hypertet)250usyrn 16 9 $1,316.00 $1,316.00 $538.20 $1,016.60 $842.24 2026-05-17
4200057 OTHER CTA Ext Lower With Lt 16 9 $2,050.00 $2,050.00 $227.23 $1,583.55 $840.50 2026-05-17
4200054 OTHER CT Angio Upper Extrm W/wo 16 9 $2,050.00 $2,050.00 $227.23 $1,583.55 $840.50 2026-05-17
4200050 OTHER CT Angiography Neck 16 9 $2,050.00 $2,050.00 $227.23 $1,583.55 $840.50 2026-05-17
4200060 OTHER CTA Ext Lower W Contrast 16 9 $2,050.00 $2,050.00 $227.23 $1,583.55 $840.50 2026-05-17
4200055 OTHER CTA Ext Lower With Rt 16 9 $2,050.00 $2,050.00 $227.23 $1,583.55 $840.50 2026-05-17
4200056 OTHER CT Angio Abdominal Arteri 16 9 $2,050.00 $2,050.00 $227.23 $1,583.55 $840.50 2026-05-17
4200052 OTHER CT Angiography Chest 16 9 $2,050.00 $2,050.00 $227.23 $1,583.55 $840.50 2026-05-17
4200053 OTHER CT Angiograph Pelv W/wo 16 9 $2,050.00 $2,050.00 $227.23 $1,583.55 $840.50 2026-05-17
2500048 OTHER ER-fb Foot Subq Remove 16 9 $1,333.00 $1,333.00 $500.00 $935.85 $839.43 2026-05-17
2600056 OTHER Wound Repair (moderate) 16 9 $1,301.00 $1,301.00 $483.97 $1,004.70 $832.64 2026-05-17
4200023 OTHER CT Orbit Sella Fossa W/wo 16 9 $2,023.00 $2,023.00 $227.23 $1,563.15 $829.43 2026-05-17
4200012 OTHER CT Lower Extremity With And Without Contrast 16 9 $2,023.00 $2,023.00 $227.23 $1,471.33 $829.43 2026-05-17
4200041 OTHER CT Chest Spine With And Without Contrast 16 9 $2,023.00 $2,023.00 $227.23 $1,563.15 $829.43 2026-05-17
4200026 OTHER CT Scan Of Pelvis Without And With Contrast 16 9 $2,023.00 $2,023.00 $227.23 $1,563.15 $829.43 2026-05-17
4200037 OTHER CT Neck Spine With And Without Contrast 16 9 $2,023.00 $2,023.00 $227.23 $1,563.15 $829.43 2026-05-17
4200044 OTHER CT Scan Of The Chest With And Without Dye 16 9 $2,023.00 $2,023.00 $227.23 $1,563.15 $829.43 2026-05-17
4200011 OTHER CT Lower Extremity With And Without Contrast 16 9 $2,023.00 $2,023.00 $227.23 $1,471.33 $829.43 2026-05-17
4200035 OTHER CT - St Neck W&wo Contr 16 9 $2,023.00 $2,023.00 $227.23 $1,563.15 $829.43 2026-05-17
4200030 OTHER 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 2026-05-17
4200032 OTHER 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 2026-05-17
4200049 OTHER 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 2026-05-17
4200003 OTHER CT Scan Of Abdomen Without And With Contrast 16 9 $2,023.00 $2,023.00 $227.23 $1,563.15 $829.43 2026-05-17
2500209 OTHER ER-trt Radial Shft Clsd F 16 9 $1,285.00 $1,285.00 $500.00 $992.80 $822.40 2026-05-17
1000004 OTHER Or-operating Room 2.0 Hou 16 9 $1,304.00 $1,304.00 $250.00 $915.45 $821.15 2026-05-17
7000631 OTHER Quick Trach Kit Child 2.0 120900020 16 9 $1,282.00 $1,282.00 $512.80 $990.25 $820.48 2026-05-17
1500005 OTHER Anesthesia Service 2.5 Ho 16 9 $1,299.00 $1,299.00 $389.70 $912.05 $818.06 2026-05-17
2500035 OTHER ER-critical Care 30-74 Mi 16 9 $1,815.00 $1,815.00 $487.83 $1,161.60 $813.75 2026-05-17
2600059 OTHER Rpr Cmplx 1.1-2.5 16 9 $1,264.00 $1,264.00 $470.21 $976.65 $808.96 2026-05-17
2600134 OTHER Trt Ip Joint Dislocation 16 9 $1,251.00 $1,251.00 $465.37 $966.45 $800.64 2026-05-17
2600043 OTHER Rpr Int 12-6-20.0 16 9 $1,248.00 $1,248.00 $464.26 $963.90 $798.72 2026-05-17
2600123 OTHER Trt Thumb Clsd Dislocation 16 9 $1,245.00 $1,245.00 $463.14 $961.35 $796.80 2026-05-17
2500309 OTHER Treat Kneecap Dislocation 16 9 $1,238.00 $1,238.00 $500.00 $956.25 $792.32 2026-05-17
2600095 OTHER Trt Humeral Clsd Fx 16 9 $1,235.00 $1,235.00 $459.42 $953.70 $790.40 2026-05-17
3 OTHER Private Isolation Room 16 9 $1,232.00 $1,232.00 $492.80 $895.66 $788.48 2026-05-17
9 OTHER Semi-private Cardiac Equi 16 9 $1,232.00 $1,232.00 $492.80 $895.66 $788.48 2026-05-17
4 OTHER Private Equipment Room 16 9 $1,232.00 $1,232.00 $492.80 $895.66 $788.48 2026-05-17
2 OTHER Private Cardiac Monitor 16 9 $1,232.00 $1,232.00 $492.80 $895.66 $788.48 2026-05-17
2500034 OTHER ER-cpr 16 9 $1,251.00 $1,251.00 $479.93 $878.05 $787.69 2026-05-17
2600155 OTHER Trt Ankle Clsd Dislocation 16 9 $1,228.00 $1,228.00 $456.82 $948.60 $785.92 2026-05-17
7000630 OTHER Quick Trach Kit Adult 4.0 120900040 16 9 $1,227.00 $1,227.00 $490.80 $947.75 $785.28 2026-05-17
2600052 OTHER Rpr Int 7.6-12.5 16 9 $1,218.00 $1,218.00 $453.10 $940.95 $779.52 2026-05-17
2600144 OTHER Trt Patellar Clsd Dislocation 16 9 $1,215.00 $1,215.00 $451.98 $938.40 $777.60 2026-05-17
2600129 OTHER Trt Articular Clsd Fx 16 9 $1,212.00 $1,212.00 $450.86 $935.85 $775.68 2026-05-17
2600098 OTHER Trt Elbow Clsd Dislocation 16 9 $1,205.00 $1,205.00 $448.26 $930.75 $771.20 2026-05-17
2600047 OTHER Rpr Int 7.5-12.5 16 9 $1,205.00 $1,205.00 $448.26 $930.75 $771.20 2026-05-17
6020173 OTHER Erythromycin Ethyl Susp 200mg/5ml 16 9 $1,186.00 $1,186.00 $485.10 $916.30 $759.04 2026-05-17
3000372 OTHER Tissue Exam By Pathologis 16 9 $1,168.00 $1,168.00 $478.88 $901.85 $747.52 2026-05-17
4200024 OTHER CT Scan, Pelvis, With Contrast 16 9 $1,814.00 $1,814.00 $227.23 $1,401.65 $743.74 2026-05-17
4200001 OTHER CT Scan Of Abdomen With Contrast 16 9 $1,814.00 $1,814.00 $227.23 $1,401.65 $743.74 2026-05-17
4200048 OTHER CT Scan Of Abdomen And Pelvis With Contrast 16 9 $1,814.00 $1,814.00 $464.22 $1,401.65 $743.74 2026-05-17
4200046 OTHER CT Scan Of The Head Or Brain With Dye 16 9 $1,814.00 $1,814.00 $227.23 $1,401.65 $743.74 2026-05-17
4200028 OTHER CT Scan Of The Face Or Jaw With Dye 16 9 $1,814.00 $1,814.00 $227.23 $1,401.65 $743.74 2026-05-17
4200038 OTHER CT Scan Of Lumbar Lower Spine With Contrast 16 9 $1,814.00 $1,814.00 $464.22 $1,401.65 $743.74 2026-05-17
4200033 OTHER CT Of Neck Soft Tissue With Dye 16 9 $1,814.00 $1,814.00 $227.23 $1,401.65 $743.74 2026-05-17
4200042 OTHER CT Scan Of The Chest With Dye 16 9 $1,814.00 $1,814.00 $227.23 $1,401.65 $743.74 2026-05-17
2600093 OTHER Trt Humeral Shft Clsd 16 9 $1,162.00 $1,162.00 $432.26 $897.60 $743.68 2026-05-17
2600057 OTHER Rpr Cmplx 1.1-2.5 16 9 $1,155.00 $1,155.00 $429.66 $892.50 $739.20 2026-05-17
2600051 OTHER Rpr Int 5.1-7.5 16 9 $1,155.00 $1,155.00 $429.66 $892.50 $739.20 2026-05-17
2600097 OTHER Trt Humeral Condylar 16 9 $1,122.00 $1,122.00 $417.38 $867.00 $718.08 2026-05-17
2600146 OTHER Trt Tib Shft Clsd Fx W 16 9 $1,122.00 $1,122.00 $417.38 $867.00 $718.08 2026-05-17
7 OTHER Semi-private Cardiac Mon 16 9 $1,122.00 $1,122.00 $448.80 $815.69 $718.08 2026-05-17
1 OTHER Private Room 16 9 $1,122.00 $1,122.00 $448.80 $815.69 $718.08 2026-05-17
8 OTHER Semi-private Equipment 16 9 $1,122.00 $1,122.00 $448.80 $815.69 $718.08 2026-05-17
3000482 OTHER Tumor Immunohistochem/man 16 9 $1,120.00 $1,120.00 $459.20 $865.30 $716.80 2026-05-17
1300203 OTHER Infusion (first Hour) 16 9 $1,137.00 $1,137.00 $99.00 $799.00 $716.34 2026-05-17
2600124 OTHER Trt Cmc Clsd Dislocation 16 9 $1,116.00 $1,116.00 $415.15 $861.90 $714.24 2026-05-17
2600084 OTHER Trt Clavicle Dislocation 16 9 $1,116.00 $1,116.00 $415.15 $861.90 $714.24 2026-05-17
6000948 OTHER Dihydroergota (migranal) Nasal 4mg/1ml 16 9 $1,114.00 $1,114.00 $455.40 $860.20 $712.96 2026-05-17
1500004 OTHER Anesthesia Service 2.0 Ho 16 9 $1,125.00 $1,125.00 $337.50 $790.50 $708.75 2026-05-17
2600055 OTHER Rpr Cmplx 1.1-2.5 16 9 $1,106.00 $1,106.00 $411.43 $854.25 $707.84 2026-05-17
2600127 OTHER Trt Finger/thumb Clsd 16 9 $1,103.00 $1,103.00 $410.32 $851.70 $705.92 2026-05-17
2600005 OTHER ER Level 5 Comprehensive 16 9 $1,100.00 $1,100.00 $409.20 $850.00 $704.00 2026-05-17
2500247 OTHER Div Of Fallopian Tubes 16 9 $1,100.00 $1,100.00 $451.00 $850.00 $704.00 2026-05-17
17 OTHER Semi-private Sb Card Equi 16 9 $1,100.00 $1,100.00 $440.00 $799.70 $704.00 2026-05-17
2500169 OTHER ER-trt Closed Shoulder Di 16 9 $1,100.00 $1,100.00 $451.00 $850.00 $704.00 2026-05-17
2600196 OTHER Control Nose Bleed Pos 16 9 $1,093.00 $1,093.00 $406.60 $844.05 $699.52 2026-05-17
2600154 OTHER Trt Dist Tib Clsd Fx W 16 9 $1,088.00 $1,088.00 $404.74 $840.65 $696.32 2026-05-17
2600148 OTHER Trt Ankle Fx Without Mnp 16 9 $1,083.00 $1,083.00 $402.88 $836.40 $693.12 2026-05-17
2600153 OTHER Trt Bimalleolar Ankle 16 9 $1,083.00 $1,083.00 $402.88 $836.40 $693.12 2026-05-17
1000003 OTHER Or-operating Room 1.5 Hou 16 9 $1,100.00 $1,100.00 $250.00 $772.65 $692.88 2026-05-17
2600125 OTHER Trt Knuckle Disclocation 16 9 $1,080.00 $1,080.00 $401.76 $833.85 $691.20 2026-05-17
1300191 OTHER Exc F/e/e/n/l Mal+mrg 1.1 16 9 $1,096.00 $1,096.00 $407.25 $769.25 $690.10 2026-05-17
2600109 OTHER Trt Colles Clsd Fx Without 16 9 $1,076.00 $1,076.00 $400.27 $831.30 $688.64 2026-05-17
2600086 OTHER Trt Humeral Clsd Fx With 16 9 $1,070.00 $1,070.00 $398.04 $826.20 $684.80 2026-05-17
2600096 OTHER Trt Humeral Epicondyla 16 9 $1,066.00 $1,066.00 $396.55 $823.65 $682.24 2026-05-17
2500016 OTHER ER-cardioversion External 16 9 $1,081.00 $1,081.00 $414.89 $759.05 $680.80 2026-05-17
3000672 OTHER Thiopurine Methyltransferase(tpmt)geno 16 9 $1,060.00 $1,060.00 $434.60 $818.55 $678.40 2026-05-17
2600113 OTHER Trt Ulnar Stylo 16 9 $1,060.00 $1,060.00 $394.32 $818.55 $678.40 2026-05-17
2600122 OTHER Trt Metacarpal Fx 16 9 $1,056.00 $1,056.00 $392.83 $816.00 $675.84 2026-05-17
6001790 OTHER Tocilizumab (actemra) 80mg 16 9 $1,051.00 $1,051.00 $429.75 $811.75 $672.64 2026-05-17
2600249 OTHER Cpr 16 9 $1,050.00 $1,050.00 $390.60 $810.90 $672.00 2026-05-17
2600042 OTHER Rpr Layered Scp/ax/tru 16 9 $1,050.00 $1,050.00 $390.60 $810.90 $672.00 2026-05-17
2600141 OTHER Trt Patellar Clsd Fx W 16 9 $1,047.00 $1,047.00 $389.48 $808.35 $670.08 2026-05-17
2600088 OTHER Trt Shldr Clsd Dislocation 16 9 $1,040.00 $1,040.00 $386.88 $803.25 $665.60 2026-05-17
1300113 OTHER Thoracentesis W/tube Inse 16 9 $1,056.00 $1,056.00 $392.40 $741.20 $664.92 2026-05-17
2500006 OTHER ER Level 5 W/25 Modifier 16 9 $1,452.00 $1,452.00 $397.70 $929.28 $663.40 2026-05-17
2500097 OTHER ER-level 5 Comprehensive 16 9 $1,452.00 $1,452.00 $397.70 $929.28 $663.40 2026-05-17
2600131 OTHER Trt Finger Fx Ea 16 9 $1,033.00 $1,033.00 $384.28 $798.15 $661.12 2026-05-17
2500112 OTHER Wound Repair (moderate) 16 9 $1,031.00 $1,031.00 $395.37 $749.85 $659.84 2026-05-17
2600151 OTHER Trt Dist Fib Clsd Fx W 16 9 $1,020.00 $1,020.00 $379.44 $787.95 $652.80 2026-05-17
2500114 OTHER ER-repair Cmplx 2.6-7.5cm 16 9 $1,031.00 $1,031.00 $395.37 $723.35 $649.05 2026-05-17
2500110 OTHER ER-repair Cmplx 1.1-2.5cm 16 9 $1,031.00 $1,031.00 $395.37 $723.35 $649.05 2026-05-17
2500108 OTHER ER-repair Cmplx 1.1-2.5cm 16 9 $1,031.00 $1,031.00 $395.37 $723.35 $649.05 2026-05-17
2600219 OTHER I&d Penis Deep 16 9 $1,014.00 $1,014.00 $377.21 $782.85 $648.96 2026-05-17
6020130 OTHER Cyanide Antidote Kit 16 9 $1,012.00 $1,012.00 $414.00 $782.00 $647.68 2026-05-17
6052604 OTHER Remdesivir Inj 100mg Vial 16 9 $1,001.00 $1,001.00 $400.40 $773.50 $640.64 2026-05-17
2600149 OTHER Trt Prox Fib Clsd Fx W 16 9 $997.00 $997.00 $370.88 $770.10 $638.08 2026-05-17
2600112 OTHER Trt Carpal Clsd Fx Without 16 9 $994.00 $994.00 $369.77 $767.55 $636.16 2026-05-17
2600111 OTHER Trt Navilcular Clsd Fx 16 9 $990.00 $990.00 $368.28 $765.00 $633.60 2026-05-17
3000432 OTHER Electron Microscopy 16 9 $990.00 $990.00 $405.90 $765.00 $633.60 2026-05-17
2600050 OTHER Rpr Int 2.6-5.0 16 9 $987.00 $987.00 $367.16 $762.45 $631.68 2026-05-17
2600142 OTHER Trt Tibial Clsd Fx Without 16 9 $984.00 $984.00 $366.05 $759.90 $629.76 2026-05-17
2500068 OTHER ER-i&d Perianal Abscess 16 9 $997.00 $997.00 $382.37 $699.55 $627.66 2026-05-17
2600041 OTHER Rpr Int 2.6-7.5 16 9 $977.00 $977.00 $363.44 $754.80 $625.28 2026-05-17
2600115 OTHER Finger Abscess Drain 16 9 $977.00 $977.00 $363.44 $754.80 $625.28 2026-05-17
1300170 OTHER Destruction Of Skin Lesio 16 9 $990.00 $990.00 $368.10 $695.30 $623.55 2026-05-17
2600046 OTHER Rpr Int N-hf/genit 16 9 $974.00 $974.00 $362.33 $752.25 $623.36 2026-05-17
4200059 OTHER CT Needle Biopsy Of Liver 16 9 $1,507.00 $1,507.00 $405.00 $1,164.50 $617.87 2026-05-17
2600121 OTHER Trt Mc Clsd Fx Without Mnp 16 9 $964.00 $964.00 $358.61 $744.60 $616.96 2026-05-17
2500320 OTHER Treat Dislocation/fractur 16 9 $963.00 $963.00 $394.83 $743.75 $616.32 2026-05-17
2600038 OTHER Trt Wound Dihiscence 16 9 $954.00 $954.00 $354.89 $736.95 $610.56 2026-05-17
2600103 OTHER Trt Ulnar Clsd Fx 16 9 $948.00 $948.00 $352.66 $731.85 $606.72 2026-05-17
2600207 OTHER Drainage Gum Lesion 16 9 $948.00 $948.00 $352.66 $731.85 $606.72 2026-05-17
1500003 OTHER Anesthesia Service 1.5 Ho 16 9 $952.00 $952.00 $285.60 $668.10 $599.39 2026-05-17
3020003 OTHER Transfused Prbc Each Unit 16 9 $935.00 $935.00 $99.00 $722.50 $598.40 2026-05-17
2500308 OTHER Explore Wound Extremity 16 9 $935.00 $935.00 $383.35 $722.50 $598.40 2026-05-17
3200003 OTHER Red Blood Cells Each Unit 16 9 $935.00 $935.00 $99.00 $722.50 $598.40 2026-05-17
3000613 OTHER Alpha Fetoprotein Tetra Profile 16 9 $932.00 $932.00 $382.12 $719.95 $596.48 2026-05-17
4400039 OTHER Duplex Ultrasound Scan Of Blood Flow, Complete, Abdomen 16 9 $927.00 $927.00 $350.00 $715.70 $593.28 2026-05-17
4400019 OTHER US Carotoid Doppler Studies 16 9 $927.00 $927.00 $350.00 $715.70 $593.28 2026-05-17
4000057 OTHER Xr Extracranial Arteries Com 16 9 $927.00 $927.00 $350.00 $715.70 $593.28 2026-05-17
4400004 OTHER US Venous Sono Bilateral 16 9 $927.00 $927.00 $350.00 $715.70 $593.28 2026-05-17
4400281 OTHER US Venous Doppler Study 16 9 $927.00 $927.00 $350.00 $715.70 $593.28 2026-05-17
2600107 OTHER Trt Rad/ Ulnar Shft Clsd 16 9 $924.00 $924.00 $343.73 $714.00 $591.36 2026-05-17
12 OTHER Private Swingbed Card Mon 16 9 $920.00 $920.00 $368.00 $668.84 $588.80 2026-05-17
11 OTHER Private Swingbed Equipment 16 9 $920.00 $920.00 $368.00 $668.84 $588.80 2026-05-17
2600133 OTHER Trt Finger Clsd Dislocation 16 9 $915.00 $915.00 $340.38 $706.35 $585.60 2026-05-17
2500113 OTHER ER-repair Cmplx 2.6-7.5cm 16 9 $920.00 $920.00 $353.10 $646.00 $579.40 2026-05-17
2500111 OTHER ER-repair Cmplx 2.6-7.5cm 16 9 $920.00 $920.00 $353.10 $646.00 $579.40 2026-05-17
2500107 OTHER ER-repair Cmplx 1.1-2.5cm 16 9 $920.00 $920.00 $353.10 $646.00 $579.40 2026-05-17
2600206 OTHER Rpr Tongue Laceration 16 9 $905.00 $905.00 $336.66 $698.70 $579.20 2026-05-17
2600104 OTHER Trt Radial Shft Clsd 16 9 $905.00 $905.00 $336.66 $698.70 $579.20 2026-05-17
6000327 OTHER Hyaluronate Sodium (synvisc) 16mg 16 9 $905.00 $905.00 $369.90 $698.70 $579.20 2026-05-17
6 OTHER Semi-private Room 16 9 $902.00 $902.00 $360.80 $655.75 $577.28 2026-05-17
2600243 OTHER Drain Eyelid Abscess 16 9 $901.00 $901.00 $335.17 $696.15 $576.64 2026-05-17
1300092 OTHER Cl Trmt Ulnar Stylo 16 9 $915.00 $915.00 $340.20 $642.60 $576.30 2026-05-17
2600015 OTHER Fb Subq Tissue Complicated 16 9 $882.00 $882.00 $328.10 $680.85 $564.48 2026-05-17
2600049 OTHER Rpr Int 2.5 Cm Or < 16 9 $882.00 $882.00 $328.10 $680.85 $564.48 2026-05-17
6020012 OTHER Acyclovir (zovirax) 5% Oint** 16 9 $880.00 $880.00 $360.00 $680.00 $563.20 2026-05-17
1000002 OTHER Or-operating Room 1.0 Hou 16 9 $889.00 $889.00 $250.00 $624.75 $560.11 2026-05-17
4000275 OTHER Xr Upper Gi Series W/small B 16 9 $860.00 $860.00 $85.00 $663.85 $550.40 2026-05-17
2600106 OTHER Trt Ulnar Shft Clsd 16 9 $852.00 $852.00 $316.94 $657.90 $545.28 2026-05-17
2600101 OTHER Trt Radial Head/nck Cl 16 9 $852.00 $852.00 $316.94 $657.90 $545.28 2026-05-17
2600163 OTHER Trt Mt Clsd Fx With Mnp 16 9 $842.00 $842.00 $313.22 $650.25 $538.88 2026-05-17
6001813 OTHER Epoetin Alfa (procrit) 20000u/1ml Vial 16 9 $657.00 $657.00 $269.37 $657.00 $538.74 2026-05-17
2600244 OTHER Rmv Fb Eyelid Embedded 16 9 $839.00 $839.00 $312.11 $647.70 $536.96 2026-05-17
2500225 OTHER ER-trt Wound Dehiscence S 16 9 $836.00 $836.00 $342.76 $646.00 $535.04 2026-05-17
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