Hospital

HASKELL MEMORIAL HOSPITAL

Haskell, TX · CCN 451341 · Rates published

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You selected 93306 (CPT)

US ECHO RT W/ IMAGE DOC/M-MODE/COLOR FLO

This hospital’s price: $315 across 5 payers · range $156-$1,313

Source: https://app.box.com/shared/static/8snmebm9qbv4ut7o1a4qqmf7j82pcv84.csv · observed 2026-07-19

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

501 distinct procedures filed

5 distinct payers

6,177 rate rows

2026-07-19 last MRF observed

Data quality

6,159 of 6,177 rate rows are consumer-grade (99.7%)

18 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
per-diem day rate — not a per-procedure price	10
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	8

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

Source MRF file	https://app.box.com/shared/static/h5vvmc8j91ulgf2cucf9hog07r5uyn6y.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=1c1ee65c-1ada-473e-bde2-3aa7100683ac&hospital-id=5
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-08-01
Content fingerprint	066a9ba9e63f21b4… · 240,252 bytes · first seen 2026-05-18

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
44055 CPT	44055 Correction Of Malrotation By Lysis Of Duodenal Bands And/or Reduction Of M…	5	$424.64	$1,769.33	$1,503.93	nat. median $3,019 outlier · 0.5×
44025 CPT	44025 Colotomy, For Exploration, Biopsy(s), Or Foreign Body Removal	5	$409.46	$1,706.07	$1,450.16	nat. median $2,595 0.6× median
E0600 HCPCS	Suction Machine	5	$407.77	$1,699.04	$1,444.18	nat. median $69 outlier · 21.1×
44020 CPT	44020 Enterotomy, Small Intestine, Other Than Duodenum; For Exploration/biopsy/f…	5	$404.00	$1,683.35	$1,430.85	nat. median $2,576 0.6× median
44050 CPT	44050 Reduction Of Volvulus, Intussusception, Internal Hernia, By Laparotomy	5	$390.25	$1,626.04	$1,382.13	nat. median $2,544 0.5× median
44021 CPT	44021 Enterotomy, Small Intestine, Other Than Duodenum; For Decompression	5	$387.13	$1,613.06	$1,371.10	nat. median $2,380 0.6× median
99291 CPT	ER Crit Ill Pt	5	$442.68	$1,844.50	$1,333.37	nat. median $1,530 0.9× median
59409 CPT	ER Vaginal Delivery	5	$261.64	$1,090.15	$950.00	nat. median $3,148 outlier · 0.3×
74185 CPT	MRA-angio-abdomen W/o&with Contrast	5	$317.00	$1,607.11	$713.25	nat. median $1,253 0.6× median
12035 CPT	Repair, Intermediate, Wounds Of Scalp, Axillae, Tr	5	$203.21	$971.70	$663.17	nat. median $643 1.0× median
92506 CPT	St Int Evl/spch,lang,voice,c	5	$156.26	$651.08	$553.42	nat. median $229 outlier · 2.4×
1886378 LOCAL	Autoimmune Hepatitis Diagnostic Panel	5	$155.46	$647.74	$550.58	nat. median $551 1.0× median
G0379 HCPCS	Observation Direct From Clinic	5	$145.22	$605.10	$527.37	nat. median $568 0.9× median
99220 CPT	Initial Obsv Care Hi Sev	5	$175.97	$592.66	$503.76	nat. median $217 outlier · 2.3×
12020 CPT	Treatment Of Superficial Wound Dehiscence; Simple	5	$158.86	$816.53	$496.41	nat. median $780 0.6× median
75635 CPT	CT Angio Abdomen With Runoff	5	$227.23	$1,764.49	$481.22	nat. median $727 0.7× median
99285 CPT	ER Life Threat	5	$118.70	$1,113.95	$478.94	nat. median $1,187 outlier · 0.4×
72197 CPT	MRI Pelvis With And Without Contrast	5	$428.66	$1,571.77	$478.57	nat. median $1,074 outlier · 0.4×
70553 CPT	MRI-brain-wo&w Contrast	5	$428.66	$1,571.77	$478.57	nat. median $1,136 outlier · 0.4×
74178 CPT	CT Abdomen & Pelvis Without & With Contrast	5	$390.13	$1,740.22	$474.60	nat. median $1,027 outlier · 0.5×
74174 CPT	CT Angio Abdomen With Contrast	5	$414.17	$1,740.22	$474.60	nat. median $998 outlier · 0.5×
74177 CPT	CT Abdomen & Pelvis With Contrast	5	$390.13	$1,568.43	$464.22	nat. median $976 outlier · 0.5×
73201 CPT	CT Upper Extr With Contrast	5	$249.00	$985.03	$464.22	nat. median $805 0.6× median
44015 CPT	44015 Tube Or Needle Catheter Jejunostomy For Enteral Alimentation, Intraoperati…	5	$126.15	$525.61	$446.77	nat. median $1,126 outlier · 0.4×
90375 CPT	90375 Rabies, Immune Globulin, Human, For Intramuscular And/or Subcutaneous Use	5	$125.37	$522.36	$444.01	nat. median $1,052 outlier · 0.4×
43762 CPT	Replacement Of Gastrostomy Tube, Percutaneous, Inc	5	$153.27	$638.63	$439.70	nat. median $445 1.0× median
23650 CPT	Treat Shoulder Dislocation Without Anesth	5	$140.94	$642.41	$423.17	nat. median $476 0.9× median
70492 CPT	CT Neck Soft Tissue Without & With Contrast	5	$227.23	$1,470.41	$401.02	nat. median $650 0.6× median
70470 CPT	CT Head/brain Without & With Contrast	5	$227.23	$1,470.41	$401.02	nat. median $629 0.6× median
74170 CPT	CT Abdomen Without & With Contrast	5	$227.23	$1,470.41	$401.02	nat. median $714 0.6× median
73202 CPT	CT Upper Extremity Without & With Contrast	5	$227.23	$1,470.41	$401.02	nat. median $714 0.6× median
71275 CPT	CTA Chest Pe With Contrast	5	$227.23	$1,470.41	$401.02	nat. median $759 0.5× median
72194 CPT	CT Pelvis Without & With Contrast	5	$227.23	$1,470.41	$401.02	nat. median $672 0.6× median
71270 CPT	CT Scan Of Chest Without & With Contrast	5	$227.23	$1,470.41	$401.02	nat. median $684 0.6× median
70488 CPT	CT Face Without & With Contrast	5	$227.23	$1,427.58	$389.34	nat. median $639 0.6× median
12011 CPT	12011 Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And…	5	$46.26	$552.00	$387.93	nat. median $298 1.3× median
10121 CPT	10121 Incision And Removal Of Foreign Body, Subcutaneous Tissues; Complicated	5	$106.94	$445.58	$378.74	nat. median $1,664 outlier · 0.2×
13131 CPT	Rpr Complex Forehead	5	$188.31	$784.63	$378.16	nat. median $607 0.6× median
99223 CPT	Initial Ip Care High Sev	5	$141.19	$571.51	$372.87	nat. median $250 1.5× median
92950 CPT	Cardiopulmonary Resuscitation	5	$151.00	$976.59	$359.48	nat. median $581 0.6× median
28190 CPT	28190 Removal Of Foreign Body, Foot; Subcutaneous	5	$100.45	$418.54	$355.76	nat. median $867 outlier · 0.4×
87902 CPT	Hepatitis C Genotype	5	$118.88	$965.52	$349.61	nat. median $386 0.9× median
72146 CPT	MRI-thoracic Without Contr	5	$294.24	$1,240.09	$338.21	nat. median $800 outlier · 0.4×
27840 CPT	Closed Treatment Of Ankle Dislocation	5	$123.94	$516.42	$329.57	nat. median $508 0.6× median
G0297 HCPCS	G0297 Low Dose CT Scan (ldct) For Lung Cancer Screening	5	$92.40	$385.01	$327.26	nat. median $234 1.4× median
99284 CPT	ER High Severity	5	$95.47	$753.81	$326.34	nat. median $754 outlier · 0.4×
99235 CPT	Observation Or Inpatient Hospital Care, For The Ev	5	$114.75	$478.14	$322.10	nat. median $265 1.2× median
74176 CPT	CT Abdomen & Pelvis Without Contrast	5	$241.79	$1,176.32	$320.82	nat. median $694 outlier · 0.5×
93306 CPT	US Echo Rt With Image Doc/m-mode/color Flo	5	$156.29	$1,313.48	$315.24	nat. median $993 outlier · 0.3×
73721 CPT	MRI-l Extr Without Contrast	5	$294.24	$1,146.82	$312.77	nat. median $856 outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 501 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

44055	CPT	44055 Correction Of Malrotation By Lysis Of Duodenal Bands And/or Reduction Of M…	10	5	$1,769.33	$1,769.33	$424.64	$1,769.33	$1,503.93	2026-07-19
44025	CPT	44025 Colotomy, For Exploration, Biopsy(s), Or Foreign Body Removal	10	5	$1,706.07	$1,706.07	$409.46	$1,706.07	$1,450.16	2026-07-19
E0600	HCPCS	Suction Machine	10	5	$1,699.04	$1,699.04	$407.77	$1,699.04	$1,444.18	2026-07-19
44020	CPT	44020 Enterotomy, Small Intestine, Other Than Duodenum; For Exploration/biopsy/f…	10	5	$1,683.35	$1,683.35	$404.00	$1,683.35	$1,430.85	2026-07-19
44050	CPT	44050 Reduction Of Volvulus, Intussusception, Internal Hernia, By Laparotomy	10	5	$1,626.04	$1,626.04	$390.25	$1,626.04	$1,382.13	2026-07-19
44021	CPT	44021 Enterotomy, Small Intestine, Other Than Duodenum; For Decompression	10	5	$1,613.06	$1,613.06	$387.13	$1,613.06	$1,371.10	2026-07-19
99291	CPT	ER Crit Ill Pt	10	5	$1,844.50	$1,844.50	$442.68	$1,844.50	$1,333.37	2026-07-19
59409	CPT	ER Vaginal Delivery	10	5	$1,090.15	$1,090.15	$261.64	$1,090.15	$950.00	2026-07-19
74185	CPT	MRA-angio-abdomen W/o&with Contrast	10	5	$1,607.11	$1,607.11	$317.00	$1,607.11	$713.25	2026-07-19
12035	CPT	Repair, Intermediate, Wounds Of Scalp, Axillae, Tr	10	5	$1,104.21	$1,104.21	$203.21	$971.70	$663.17	2026-07-19
92506	CPT	St Int Evl/spch,lang,voice,c	10	5	$651.08	$651.08	$156.26	$651.08	$553.42	2026-07-19
1886378	LOCAL	Autoimmune Hepatitis Diagnostic Panel	10	5	$647.74	$647.74	$155.46	$647.74	$550.58	2026-07-19
G0379	HCPCS	Observation Direct From Clinic	10	5	$605.10	$605.10	$145.22	$605.10	$527.37	2026-07-19
99220	CPT	Initial Obsv Care Hi Sev	10	5	$592.66	$592.66	$175.97	$592.66	$503.76	2026-07-19
12020	CPT	Treatment Of Superficial Wound Dehiscence; Simple	20	5	$700.27	$700.27	$158.86	$816.53	$496.41	2026-07-19
75635	CPT	CT Angio Abdomen With Runoff	10	5	$2,005.10	$2,005.10	$227.23	$1,764.49	$481.22	2026-07-19
99285	CPT	ER Life Threat	20	5	$838.71	$838.71	$118.70	$1,113.95	$478.94	2026-07-19
72197	CPT	MRI Pelvis With And Without Contrast	10	5	$1,786.10	$1,786.10	$428.66	$1,571.77	$478.57	2026-07-19
70553	CPT	MRI-brain-wo&w Contrast	10	5	$1,786.10	$1,786.10	$428.66	$1,571.77	$478.57	2026-07-19
74178	CPT	CT Abdomen & Pelvis Without & With Contrast	10	5	$1,977.52	$1,977.52	$390.13	$1,740.22	$474.60	2026-07-19
74174	CPT	CT Angio Abdomen With Contrast	10	5	$1,977.52	$1,977.52	$414.17	$1,740.22	$474.60	2026-07-19
74177	CPT	CT Abdomen & Pelvis With Contrast	10	5	$1,782.31	$1,782.31	$390.13	$1,568.43	$464.22	2026-07-19
73201	CPT	CT Upper Extr With Contrast	10	5	$1,119.35	$1,119.35	$249.00	$985.03	$464.22	2026-07-19
44015	CPT	44015 Tube Or Needle Catheter Jejunostomy For Enteral Alimentation, Intraoperati…	10	5	$525.61	$525.61	$126.15	$525.61	$446.77	2026-07-19
90375	CPT	90375 Rabies, Immune Globulin, Human, For Intramuscular And/or Subcutaneous Use	10	5	$522.36	$522.36	$125.37	$522.36	$444.01	2026-07-19
43762	CPT	Replacement Of Gastrostomy Tube, Percutaneous, Inc	10	5	$638.63	$638.63	$153.27	$638.63	$439.70	2026-07-19
23650	CPT	Treat Shoulder Dislocation Without Anesth	16	5	$587.25	$587.25	$140.94	$642.41	$423.17	2026-07-19
73202	CPT	CT Upper Extremity Without & With Contrast	10	5	$1,670.92	$1,670.92	$227.23	$1,470.41	$401.02	2026-07-19
74170	CPT	CT Abdomen Without & With Contrast	10	5	$1,670.92	$1,670.92	$227.23	$1,470.41	$401.02	2026-07-19
72194	CPT	CT Pelvis Without & With Contrast	10	5	$1,670.92	$1,670.92	$227.23	$1,470.41	$401.02	2026-07-19
71275	CPT	CTA Chest Pe With Contrast	10	5	$1,670.92	$1,670.92	$227.23	$1,470.41	$401.02	2026-07-19
71270	CPT	CT Scan Of Chest Without & With Contrast	10	5	$1,670.92	$1,670.92	$227.23	$1,470.41	$401.02	2026-07-19
70492	CPT	CT Neck Soft Tissue Without & With Contrast	10	5	$1,670.92	$1,670.92	$227.23	$1,470.41	$401.02	2026-07-19
70470	CPT	CT Head/brain Without & With Contrast	10	5	$1,670.92	$1,670.92	$227.23	$1,470.41	$401.02	2026-07-19
70488	CPT	CT Face Without & With Contrast	10	5	$1,622.25	$1,622.25	$227.23	$1,427.58	$389.34	2026-07-19
12011	CPT	12011 Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And…	30	5	$456.39	$456.39	$46.26	$552.00	$387.93	2026-07-19
10121	CPT	10121 Incision And Removal Of Foreign Body, Subcutaneous Tissues; Complicated	10	5	$445.58	$445.58	$106.94	$445.58	$378.74	2026-07-19
13131	CPT	Rpr Complex Forehead	10	5	$784.63	$784.63	$188.31	$784.63	$378.16	2026-07-19
99223	CPT	Initial Ip Care High Sev	10	5	$649.44	$649.44	$141.19	$571.51	$372.87	2026-07-19
92950	CPT	Cardiopulmonary Resuscitation	20	5	$777.34	$777.34	$151.00	$976.59	$359.48	2026-07-19
28190	CPT	28190 Removal Of Foreign Body, Foot; Subcutaneous	10	5	$418.54	$418.54	$100.45	$418.54	$355.76	2026-07-19
87902	CPT	Hepatitis C Genotype	16	5	$1,097.18	$1,097.18	$118.88	$965.52	$349.61	2026-07-19
72146	CPT	MRI-thoracic Without Contr	10	5	$1,409.19	$1,409.19	$294.24	$1,240.09	$338.21	2026-07-19
27840	CPT	Closed Treatment Of Ankle Dislocation	10	5	$516.42	$516.42	$123.94	$516.42	$329.57	2026-07-19
G0297	HCPCS	G0297 Low Dose CT Scan (ldct) For Lung Cancer Screening	10	5	$385.01	$385.01	$92.40	$385.01	$327.26	2026-07-19
99284	CPT	ER High Severity	20	5	$568.87	$568.87	$95.47	$753.81	$326.34	2026-07-19
99235	CPT	Observation Or Inpatient Hospital Care, For The Ev	10	5	$478.14	$478.14	$114.75	$478.14	$322.10	2026-07-19
74176	CPT	CT Abdomen & Pelvis Without Contrast	10	5	$1,336.73	$1,336.73	$241.79	$1,176.32	$320.82	2026-07-19
93306	CPT	US Echo Rt With Image Doc/m-mode/color Flo	10	5	$1,313.48	$1,313.48	$156.29	$1,313.48	$315.24	2026-07-19
72141	CPT	MRI-cerv-without Contrast	10	5	$1,303.21	$1,303.21	$294.24	$1,146.82	$312.77	2026-07-19
73221	CPT	MRI-joint-u Extr Without	10	5	$1,303.21	$1,303.21	$294.24	$1,146.82	$312.77	2026-07-19
72148	CPT	MRI-lumbar-wo Contrast	10	5	$1,303.21	$1,303.21	$294.24	$1,146.82	$312.77	2026-07-19
72195	CPT	MRI-pelvis Without Contra	10	5	$1,303.21	$1,303.21	$294.24	$1,146.82	$312.77	2026-07-19
70551	CPT	MRI-brain-without Contrast	10	5	$1,303.21	$1,303.21	$294.24	$1,146.82	$312.77	2026-07-19
73721	CPT	MRI-l Extr Without Contrast	10	5	$1,303.21	$1,303.21	$294.24	$1,146.82	$312.77	2026-07-19
74181	CPT	MRI-abdomen Without Contrast	10	5	$1,303.21	$1,303.21	$294.24	$1,146.82	$312.77	2026-07-19
81381	CPT	Hla B5701	10	5	$519.12	$519.12	$124.59	$456.83	$305.58	2026-07-19
70544	CPT	MRA-head Without Contrast	10	5	$1,265.36	$1,265.36	$294.24	$1,113.52	$303.69	2026-07-19
12032	CPT	Lay Clo Sclp/ax/tr 2.6cm-7.5cm	20	5	$711.36	$711.36	$109.95	$784.63	$302.50	2026-07-19
9763	OTHER	Pt High Compl Intial Evaluation	10	5	$355.81	$355.81	$85.39	$355.81	$302.44	2026-07-19
31500	CPT	Intubation Endotracheal ER Procedure	24	5	$506.89	$506.89	$71.64	$599.15	$298.49	2026-07-19
93925	CPT	US Lower Ext Artery Bilateral	10	5	$601.31	$601.31	$144.31	$529.15	$294.24	2026-07-19
93880	CPT	US Carotid Doppler	10	5	$508.85	$508.85	$122.12	$447.79	$294.24	2026-07-19
93975	CPT	US Renal Artery Doppler	10	5	$508.85	$508.85	$122.12	$456.78	$294.24	2026-07-19
10061	CPT	10061 Incision And Drainage Of Abscess; Complicated Or Multiple	10	5	$343.92	$343.92	$82.54	$343.92	$292.33	2026-07-19
93970	CPT	US Venous Doppler Bilateral	10	5	$508.85	$508.85	$122.12	$447.79	$290.16	2026-07-19
11981	CPT	11981 Insertion, Non-biodegradable Drug Delivery Implant	10	5	$334.18	$334.18	$80.20	$334.18	$284.05	2026-07-19
70498	CPT	CTA Neck (carotid) With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$280.30	2026-07-19
70496	CPT	CTA Head/brain With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$280.30	2026-07-19
87635	CPT	Infectious Agent Detection By Nucleic Acid	20	5	$306.61	$306.61	$70.08	$321.21	$273.03	2026-07-19
70490	CPT	CT Neck Soft Tis Without Contrast	10	5	$1,670.92	$1,670.92	$126.47	$1,470.41	$268.75	2026-07-19
70460	CPT	CT Head/brain With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$268.64	2026-07-19
73701	CPT	CT Lower Extr With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$268.64	2026-07-19
70487	CPT	CT Maxillofacial With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$268.64	2026-07-19
70491	CPT	CT Neck Soft Tissue With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$268.64	2026-07-19
71260	CPT	CT Chest With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$268.64	2026-07-19
74160	CPT	CT Abdomen With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$268.64	2026-07-19
72193	CPT	CT Pelvis With Contrast	10	5	$1,119.35	$1,119.35	$227.23	$985.03	$268.64	2026-07-19
99226	CPT	Subsequent Observation Care, Per Day, For The Eval	10	5	$314.72	$314.72	$99.96	$314.72	$267.51	2026-07-19
99218	CPT	Initial Obsv Care Low Sev	10	5	$314.18	$314.18	$94.91	$314.18	$267.05	2026-07-19
96365	CPT	IV Inf Tx/prophlx/dx	16	5	$474.48	$474.48	$65.23	$474.48	$261.52	2026-07-19
92523	CPT	Valuation Of Speech Sound Production (eg, Articul	10	5	$293.09	$293.09	$70.34	$293.09	$255.57	2026-07-19
97162	CPT	Pt Mod Compl Intial Evaluation	10	5	$298.49	$298.49	$71.64	$298.49	$253.72	2026-07-19
99222	CPT	Initial Ip Care Mod Sev	10	5	$441.79	$441.79	$111.70	$388.78	$253.43	2026-07-19
30905	CPT	Cont Nasal Hemmorage Post	20	5	$303.63	$303.63	$64.50	$313.00	$252.62	2026-07-19
99309	CPT	S/b Pt Unstbl/dev Sig Com	10	5	$287.68	$287.68	$88.11	$287.68	$244.53	2026-07-19
G0438	HCPCS	G0438 Annual Wellness Visit; Includes A Personalized Prevention Plan Of Service,…	10	5	$279.57	$279.57	$67.10	$279.57	$237.63	2026-07-19
10140	CPT	10140 Incision And Drainage Of Hematoma, Seroma Or Fluid Collection	10	5	$278.49	$278.49	$66.84	$278.49	$236.72	2026-07-19
71250	CPT	CT Chest/thorax Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
73700	CPT	CT Lower Extr Without Contras	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
74150	CPT	CT Abd Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
73200	CPT	CT Upper Extr Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
70450	CPT	CT Head/brain Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
70480	CPT	CT Orbit Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
70486	CPT	CT Maxillofacial Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
72192	CPT	CT Pelvis Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
72131	CPT	CT Lumbar Spine Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
72128	CPT	CT Thoracic Spine Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
72125	CPT	CT Cervical Spine Without Contrast	10	5	$980.38	$980.38	$126.47	$862.73	$235.29	2026-07-19
99234	CPT	Observation Or Inpatient Hospital Care, For The Evaluation And Management Of A P…	10	5	$398.53	$398.53	$121.65	$350.71	$232.84	2026-07-19
92526	CPT	Reatment Of Swallowing Dysfunction And/or Oral Fu	20	5	$257.89	$257.89	$58.12	$273.62	$232.58	2026-07-19
G0402	HCPCS	G0402 Initial Preventive Physical (welcome To Medicare)	10	5	$272.54	$272.54	$65.41	$272.54	$231.66	2026-07-19
12041	CPT	Repair Intermediate Suture ER 2.5 Cm Or Less	20	5	$311.48	$311.48	$58.40	$334.06	$228.74	2026-07-19
99292	CPT	Critical Care Fac Ea Ad/30 Min	10	5	$395.83	$395.83	$95.00	$395.83	$224.05	2026-07-19
11750	CPT	11750 Excision Of Nail And Nail Matrix, Partial Or Complete (eg, Ingrown Or Defo…	10	5	$257.40	$257.40	$61.78	$257.40	$218.79	2026-07-19
10120	CPT	10120 Incision And Removal Of Foreign Body, Subcutaneous Tissues; Simple	35	5	$341.75	$341.75	$59.57	$721.90	$218.42	2026-07-19
97003	CPT	Ot Eval	10	5	$254.82	$254.82	$61.16	$254.82	$216.60	2026-07-19
99282	CPT	ER Low Mod	10	5	$297.95	$297.95	$71.51	$297.95	$211.91	2026-07-19
11106	CPT	11106 Incisional Biopsy Of Skin; Single Lesion	10	5	$248.75	$248.75	$59.70	$248.75	$211.44	2026-07-19
12015	CPT	Simple Rpr To Head Area 7.6cm - 12.5cm	10	5	$865.74	$865.74	$83.73	$865.74	$207.78	2026-07-19
97161	CPT	Pt Low Compl Intial Evaluation	10	5	$242.80	$242.80	$58.27	$242.80	$206.38	2026-07-19
26770	CPT	Treat Finger Dislocation Without Anesth	10	5	$438.01	$438.01	$105.12	$438.01	$205.52	2026-07-19
P9016	HCPCS	Leukocytepoor Blood, Processing And Storage	10	5	$239.68	$239.68	$57.52	$239.68	$203.73	2026-07-19
P9010	HCPCS	Blood (whole), For Transfusion, Per Unit	10	5	$239.68	$239.68	$57.52	$239.68	$203.73	2026-07-19
11976	CPT	11976 Removal, Implantable Contraceptive Capsules	10	5	$238.47	$238.47	$57.23	$238.47	$202.70	2026-07-19
90791	CPT	90791 Psychiatric Diagnostic Evaluation	10	5	$237.93	$237.93	$57.10	$237.93	$202.24	2026-07-19
36430	CPT	Blood Administration	10	5	$826.27	$826.27	$24.63	$826.27	$198.30	2026-07-19
99315	CPT	S/b Day Of Discharge Mgmt	10	5	$231.44	$231.44	$70.49	$231.44	$196.72	2026-07-19
12016	CPT	ER Simple Wound Repair Scalp Neck Extrem 12.6-20.0cm	20	5	$252.53	$252.53	$49.58	$262.67	$194.18	2026-07-19
11440	CPT	11440excision, Other Benign Lesion Including Margins, Except Skin Tag (unless Li…	10	5	$228.20	$228.20	$54.77	$228.20	$193.97	2026-07-19
99233	CPT	Pt Unstbl/devlp Sig/compl	10	5	$333.10	$333.10	$71.89	$293.13	$191.55	2026-07-19
42000	CPT	Fac Fee I&d Abscess Palate Uvula	10	5	$218.46	$218.46	$52.43	$218.46	$190.17	2026-07-19
99221	CPT	Initial Ip Care Low Sev	10	5	$326.61	$326.61	$70.42	$287.42	$187.34	2026-07-19
99225	CPT	Obsv Subseq Care/day 25 Min	10	5	$219.54	$219.54	$52.69	$219.54	$186.61	2026-07-19
99217	CPT	Initial Obsv Care D/c Day	10	5	$219.00	$219.00	$69.82	$219.00	$186.15	2026-07-19
99238	CPT	Day Of D/c Mgmt-30 Min+	15	5	$231.44	$231.44	$64.14	$203.67	$185.40	2026-07-19
99305	CPT	99305 Prof Fee Initial Nursing Facility Care, Moderate	25	5	$214.14	$214.14	$71.25	$367.96	$182.02	2026-07-19
12002	CPT	12002 Simple Repair Of Wounds; Scalp, Neck, Axillae, Genitalia, Trunk, Extremet…	30	5	$287.14	$287.14	$45.59	$512.09	$180.63	2026-07-19
11420	CPT	11420 Excision, Benign Lesion Including Margins, Except Skin Tag (unless Listed …	10	5	$207.11	$207.11	$49.71	$207.11	$176.04	2026-07-19
80074	CPT	Hepatitis Panel	10	5	$225.49	$225.49	$54.12	$225.49	$175.47	2026-07-19
11104	CPT	11104 Punch Biopsy Of Skin (including Simple Closure, When Performed); Single Le…	10	5	$204.94	$204.94	$49.19	$204.94	$174.20	2026-07-19
11400	CPT	11400 Excision, Benign Lesion Including Margins, Except Skin Tag (unless Listed …	10	5	$204.94	$204.94	$49.19	$204.94	$174.20	2026-07-19
99283	CPT	ER Moderate	20	5	$335.26	$335.26	$65.25	$468.83	$171.45	2026-07-19
12005	CPT	Laceration 12.6 Cm -20 Cm	20	5	$377.44	$377.44	$79.43	$405.02	$171.12	2026-07-19
10060	CPT	10060 Incision And Drainage Of Abscess; Simple Or Single	30	5	$307.15	$307.15	$47.63	$432.06	$168.69	2026-07-19
74400	CPT	Xr Ivp	10	5	$700.27	$700.27	$85.96	$616.24	$168.06	2026-07-19
L4361	HCPCS	L4361 Walking Boot, Pneumatic And/or Vacuum, With Or Without Joints, With Or Without Interfa…	10	5	$194.13	$194.13	$46.59	$194.13	$165.01	2026-07-19
11982	CPT	11982 Removal, Non-biodegradable Drug Delivery Implant	10	5	$192.51	$192.51	$46.20	$192.51	$163.63	2026-07-19
90732	CPT	90732pneumococcal Polysaccharide Vaccine, 23-valent (ppsv23), Adult Or Immunosup…	10	5	$190.88	$190.88	$45.81	$190.88	$162.25	2026-07-19
20605	CPT	20605 Arthrocentesis, Aspiration And/or Injection, Intermediate Joint Or Bursa (…	10	5	$190.34	$190.34	$45.68	$190.34	$161.79	2026-07-19
G0439	HCPCS	G0439 Annual Wellness Visit, Includes A Personalized Prevention Plan Of Service,…	10	5	$189.26	$189.26	$45.42	$189.26	$160.87	2026-07-19
87801	CPT	Alere I Rsv Test	10	5	$295.03	$295.03	$70.20	$259.63	$160.80	2026-07-19
97166	CPT	Ot Evaluation Moderate Complexity	10	5	$298.49	$298.49	$71.64	$298.49	$158.04	2026-07-19
97165	CPT	Ot Evaluation Low Complexity	10	5	$243.34	$243.34	$58.40	$243.34	$158.04	2026-07-19
17110	CPT	17110 Destruction (eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery,…	10	5	$182.23	$182.23	$43.74	$182.23	$154.90	2026-07-19
20600	CPT	20600 Arthrocentesis, Aspiration And/or Injection, Small Joint Or Bursa (eg, Fin…	10	5	$181.69	$181.69	$43.61	$181.69	$154.44	2026-07-19
11730	CPT	11730 Avulsion Of Nail Plate, Partial Or Complete, Simple; Single	10	5	$181.15	$181.15	$43.48	$181.15	$153.98	2026-07-19
30901	CPT	Contr Nasal Hemorrage Ant	20	5	$223.33	$223.33	$38.51	$257.94	$153.81	2026-07-19
92507	CPT	Treatment Of Speech, Language, Voice, Communicatio	10	5	$221.83	$221.83	$53.24	$221.83	$152.90	2026-07-19
81291	CPT	Mthfr (5,10-methylenetetrahydrofolate Reductase)	10	5	$275.78	$275.78	$65.34	$242.69	$150.30	2026-07-19
G0181	HCPCS	G0181 Home Health - Monthly Oversight	10	5	$176.28	$176.28	$42.31	$176.28	$149.84	2026-07-19
84484	CPT	Troponin-i	10	5	$272.43	$272.43	$12.47	$239.74	$148.47	2026-07-19
93922	CPT	US Abi	10	5	$401.24	$401.24	$73.05	$401.24	$146.10	2026-07-19
87502	CPT	Alere I Influenza A & B Test	10	5	$223.65	$223.65	$53.68	$196.81	$142.95	2026-07-19
92610	CPT	Evaluation Of Oral And Pharyngeal Swallowing Funct	10	5	$256.86	$256.86	$61.65	$256.86	$139.98	2026-07-19
12014	CPT	Rpr Face/ear/nose/mouth 5.1cm-7.5cm	20	5	$278.22	$278.22	$46.26	$274.16	$139.87	2026-07-19
11102	CPT	11102 Tangential Biopsy Of Skin (shave,curette); Single Lesion	10	5	$163.31	$163.31	$39.19	$163.31	$138.81	2026-07-19
U0002	HCPCS	2019-ncov Coronavirus, Sars-cov-2/2019-ncov (covid	10	5	$330.94	$330.94	$51.31	$330.94	$138.54	2026-07-19
83880	CPT	Bnp	10	5	$252.21	$252.21	$39.26	$221.94	$137.45	2026-07-19
76882	CPT	US Lower Extr Non Vascular	12	4	$356.89	$356.89	$84.36	$318.82	$137.30	2026-07-19
87153	CPT	Bacterial Dna/rna Id	10	5	$432.60	$432.60	$103.82	$400.00	$136.37	2026-07-19
93971	CPT	US Venous Doppler Unilateral Or Ltd	10	5	$401.24	$401.24	$86.98	$353.09	$134.67	2026-07-19
99281	CPT	ER Visit Eval & Manage	16	5	$297.95	$297.95	$41.53	$297.95	$134.57	2026-07-19
76870	CPT	US Genitalia Scrotum &conten	10	5	$334.18	$334.18	$80.20	$294.08	$134.57	2026-07-19
76700	CPT	US Abdomen Total	10	5	$334.18	$334.18	$80.20	$294.08	$134.57	2026-07-19
76705	CPT	US Abdomen Ltd Single Organ	10	5	$334.18	$334.18	$80.20	$294.08	$134.57	2026-07-19
76770	CPT	US Retroperitoneal Rt W/doc	10	5	$334.18	$334.18	$80.20	$294.08	$134.57	2026-07-19
76856	CPT	US Pelvis Non-OB	10	5	$334.18	$334.18	$80.20	$294.08	$134.57	2026-07-19
97597	CPT	97597 Debridement (eg, High Pressure Waterjet With/without Suction, Sharp Select…	10	5	$157.90	$157.90	$37.90	$157.90	$134.22	2026-07-19
99232	CPT	Pt Resp Inadq/thpy/dev Co	10	5	$232.52	$232.52	$53.46	$204.62	$133.58	2026-07-19
12004	CPT	Laceration 7.6 Cm -12.5 C	20	5	$288.76	$288.76	$46.26	$315.80	$128.19	2026-07-19
73030	CPT	Xr Shoulder Complete Min/2vi Lt	20	5	$149.79	$149.79	$35.95	$149.79	$127.32	2026-07-19
73060	CPT	Xr Humerus 2 Views Lt	20	5	$149.79	$149.79	$35.95	$149.79	$127.32	2026-07-19
73560	CPT	Xr Knee Ap & Lateral Lt	20	5	$149.79	$149.79	$35.95	$149.79	$127.32	2026-07-19
G0480	HCPCS	Confirmatory Benzo Urine Drug Test	18	5	$265.24	$265.24	$52.75	$466.82	$127.32	2026-07-19
99304	CPT	99304 Initial Nursing Facility Care, Low	25	5	$149.25	$149.25	$71.25	$297.41	$126.86	2026-07-19
51700	CPT	Irrigation Of Bladder	10	5	$525.61	$525.61	$35.63	$525.61	$126.15	2026-07-19
12001	CPT	12001 Simple Repair Of Superficial Wounds Of Scalp, Neck, Axillae, External Geni…	30	5	$162.77	$162.77	$35.43	$287.68	$125.48	2026-07-19
11200	CPT	11200 Removal Of Skin Tags, Multiple Fibrocutaneous Tags, Any Area; Up To And In…	10	5	$144.92	$144.92	$34.78	$144.92	$123.18	2026-07-19
24640	CPT	Closed Tx Of Rad Head Sublx In Child W/m	10	5	$241.17	$241.17	$57.88	$241.17	$122.97	2026-07-19
93270	CPT	Heart Monitor	16	5	$225.49	$225.49	$8.83	$225.49	$120.50	2026-07-19
99307	CPT	99307 Prof Fee Subsequent Nursing Facility Care, Straightforward	25	5	$141.14	$141.14	$42.53	$259.56	$119.97	2026-07-19
74019	CPT	Xr Abdomen Flat/upright	10	5	$222.79	$222.79	$53.47	$196.06	$118.74	2026-07-19
87521	CPT	Hepatitis C RNA By Pcr	10	5	$793.82	$793.82	$35.09	$698.56	$117.28	2026-07-19
J0500	HCPCS	J0500 Injection, Dicyclomine Hcl, Up To 20 Mg	10	5	$137.35	$137.35	$32.96	$137.35	$116.75	2026-07-19
16020	CPT	Debridement; Skin Partial	26	5	$221.71	$221.71	$39.04	$340.51	$115.83	2026-07-19
12013	CPT	Rpr Face/ear/nose/mouth 2.6cm-5.0cm	20	5	$256.31	$256.31	$46.26	$287.68	$114.57	2026-07-19
97164	CPT	Pt Reassessment/reeval	10	5	$134.11	$134.11	$32.19	$134.11	$113.99	2026-07-19
26600	CPT	Closed Tx Of Metcarpal Fx Singw/o Anesth	10	5	$344.46	$344.46	$59.76	$344.46	$113.54	2026-07-19
87426	CPT	Sars Cov Antigen	10	5	$132.65	$132.65	$31.84	$132.65	$112.75	2026-07-19
29105	CPT	29105 Application Of Long Arm Splint (shoulder To Hand)	26	5	$135.19	$135.19	$31.80	$306.74	$112.61	2026-07-19
69200	CPT	69200 Removal Foreign Body From External Auditory Canal; Without General Anesthe…	30	5	$170.88	$170.88	$29.52	$170.88	$112.61	2026-07-19
64400	CPT	Inj Anesthetic Agent; Trig Nerve Any Div	10	5	$206.57	$206.57	$49.58	$206.57	$111.51	2026-07-19
96374	CPT	In Inject Initial	16	5	$134.65	$134.65	$30.47	$134.65	$109.20	2026-07-19
96360	CPT	IV Infusion Hydr Int 1 Hr	10	5	$250.37	$250.37	$54.02	$250.37	$108.04	2026-07-19
51701	CPT	Insr Temp Blad Cath	10	5	$200.62	$200.62	$21.05	$176.55	$107.59	2026-07-19
87536	CPT	Hiv1 By RNA Quantificatio	10	5	$402.86	$402.86	$85.10	$354.52	$106.39	2026-07-19
87798	CPT	Mycoplasma Genitlium DNA Qualitative Pcr	13	5	$836.27	$836.27	$35.09	$735.92	$105.31	2026-07-19
30300	CPT	Remove Fb Intranasal Ofc Pro	10	5	$157.36	$157.36	$37.77	$157.36	$103.13	2026-07-19
36680	CPT	Insert Needle Bone Cavity	10	5	$361.22	$361.22	$53.44	$361.22	$101.54	2026-07-19
73521	CPT	Xr Hip Bilateral Min 2 View Each	10	5	$236.85	$236.85	$56.84	$208.43	$100.69	2026-07-19
73522	CPT	Xr Hip Bilateral W/pelvis 3-4 View	10	5	$334.18	$334.18	$80.20	$294.08	$100.69	2026-07-19
87880	CPT	Rapid Strep Poc	10	5	$116.80	$116.80	$28.03	$116.80	$99.28	2026-07-19
87400	CPT	Influenza A/b Poc	10	5	$116.80	$116.80	$28.03	$116.80	$99.28	2026-07-19
88346	CPT	Celiac Serology	10	5	$197.91	$197.91	$36.53	$197.91	$98.63	2026-07-19
29515	CPT	29515 Application Of Short Leg Splint (calf To Foot)	20	5	$220.35	$220.35	$27.64	$325.53	$97.90	2026-07-19
87338	CPT	Helicobacter Pylori Stool	10	5	$178.90	$178.90	$14.38	$157.43	$97.50	2026-07-19
99308	CPT	99308 Subsequent Nursing Facility Care, Low	25	5	$114.10	$114.10	$66.64	$259.56	$96.99	2026-07-19
90746	CPT	90746 Hepatitis B Vaccine (hepb), Adult Dosage, 3 Dose Schedule, For Intramuscul…	10	5	$111.94	$111.94	$26.87	$111.94	$95.15	2026-07-19
97530	CPT	O/t Ther Activ/ea 15 Min	20	5	$110.31	$110.31	$26.47	$110.31	$93.76	2026-07-19
97112	CPT	O/t Neuromuscular Re-educatn	20	5	$109.23	$109.23	$26.22	$109.23	$92.85	2026-07-19
97535	CPT	O/t Self/hm Mgmt Ea/15 Mn/p/t	10	5	$109.23	$109.23	$26.22	$109.23	$92.85	2026-07-19
76805	CPT	US Pregnancy Uterus	10	5	$334.18	$334.18	$80.20	$294.08	$92.76	2026-07-19
72072	CPT	Xr Thoracic Spine Ap/obl 3 View	10	5	$236.85	$236.85	$56.84	$208.43	$90.89	2026-07-19
70150	CPT	Xr Facial Bones Complete	10	5	$236.85	$236.85	$56.84	$208.43	$90.89	2026-07-19
74022	CPT	Xr Abd Complete Acute Series 3 View	10	5	$252.53	$252.53	$60.61	$222.23	$90.89	2026-07-19
71101	CPT	Xr Ribs Unilat With Post Chest 3 View	10	5	$195.21	$195.21	$46.85	$171.78	$90.89	2026-07-19
71110	CPT	Xr Ribs Bilat 3 View	10	5	$278.49	$278.49	$66.84	$245.07	$90.89	2026-07-19
72050	CPT	Xr Cervical Spine Min/4 View	10	5	$252.53	$252.53	$60.61	$222.23	$90.89	2026-07-19
72114	CPT	Xr Lumbosacral Min 4 View W/bending	10	5	$252.53	$252.53	$60.61	$222.23	$90.89	2026-07-19
17000	CPT	17000 Destruction Premalignant Lesions; First Lesion	10	5	$106.53	$106.53	$25.57	$106.53	$90.55	2026-07-19
76536	CPT	US Soft Tissue Head & Neck	10	5	$334.18	$334.18	$80.20	$294.08	$90.04	2026-07-19
80050	CPT	General Health Panel	10	5	$223.33	$223.33	$33.30	$223.33	$89.91	2026-07-19
97110	CPT	O/t Ther Ex (ea 15 Min)	20	5	$104.91	$104.91	$25.18	$104.91	$89.17	2026-07-19
86480	CPT	TB Quantiferon Gold	10	5	$370.95	$370.95	$61.98	$326.44	$89.03	2026-07-19
29125	CPT	29125 Application Of Short Arm Splint (forearm To Hand); Static	30	5	$127.08	$127.08	$25.05	$325.53	$88.71	2026-07-19
11740	CPT	Evac Of Subungual Hemtoma	20	5	$619.97	$619.97	$25.94	$1,136.12	$88.25	2026-07-19
76830	CPT	US Echo Transvaginal	10	5	$312.74	$312.74	$75.06	$275.21	$88.00	2026-07-19
20610	CPT	20610 Arthrocentesis, Aspiration And/or Injection, Major Joint Or Bursa; Without…	30	5	$162.77	$162.77	$20.96	$629.43	$87.94	2026-07-19
11055	CPT	11055 Paring Or Cutting Of Benign Hyperkeratotic Lesion (eg, Corn Or Callus); Si…	10	5	$102.20	$102.20	$24.53	$102.20	$86.87	2026-07-19
99219	CPT	Initial Obsv Care Mod Sev	20	5	$225.16	$225.16	$10.38	$407.07	$86.53	2026-07-19
86922	CPT	Blood Crossmatch	10	5	$280.38	$280.38	$31.57	$280.38	$85.24	2026-07-19
99384	CPT	99384 Preventive Evaluation, New Pt; 12-17 Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99383	CPT	99383 Preventive Evaluation, New Pt; 5-11 Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99382	CPT	99382 Preventive Evaluation, New Pt; 1-4 Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99358	CPT	99358 Prolonged Services, Indirect Contact; First Hour	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99355	CPT	99355 Prof Fee Prolonged Services, Direct Contact, Office; Addtl 30 Min	15	5	$162.77	$162.77	$71.25	$259.56	$84.75	2026-07-19
99354	CPT	99354 Prof Fee Prolonged Services, Direct Contact, Office; First Hour	15	5	$214.14	$214.14	$71.25	$259.56	$84.75	2026-07-19
99318	CPT	99318 Annual Nursing Facility Assessment	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99385	CPT	99385 Prof Fee Preventive Evaluation, New Pt; 18-39 Yrs	15	5	$222.79	$222.79	$71.25	$259.56	$84.75	2026-07-19
99386	CPT	99386 Preventive Evaluation, New Pt; 40-64 Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99387	CPT	99387 Preventive Evaluation, New Pt; 65+ Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99392	CPT	99392 Preventive Evaluation, Established Pt; 1-4 Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99306	CPT	99306 Initial Nursing Facility Care, High	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99393	CPT	99393 Preventive Evaluation, Established Pt; 5-11 Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99394	CPT	99394 Preventive Evaluation, Established Pt; 12-17 Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99395	CPT	99395 Preventive Evaluation, Established Pt; 18-39 Yrs	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99396	CPT	99396 Preventive Eval Est Pt. 40-64 Year Age	15	5	$83.82	$83.82	$71.25	$259.56	$84.75	2026-07-19
99397	CPT	99397 Prof Fee Preventive Evaluation, Established Pt; 65+ Yrs	15	5	$222.79	$222.79	$71.25	$259.56	$84.75	2026-07-19
99215	CPT	99215 Office/outpatient Visit - Established Patient, Level 5 (40 Min)	20	5	$161.41	$161.41	$71.25	$259.56	$84.75	2026-07-19
99214	CPT	99214 Office/outpatient Visit - Established Patient, Level 4 (25 Min)	20	5	$130.87	$130.87	$71.25	$259.56	$84.75	2026-07-19
99213	CPT	99213 Office/outpatient Visit - Established Patient, Level 3 (15 Min)	20	5	$103.01	$103.01	$71.25	$259.56	$84.75	2026-07-19
99204	CPT	99204 Office/outpatient Visit - New Patient, Level 4 (45 Min)	20	5	$176.28	$176.28	$71.25	$259.56	$84.75	2026-07-19
99203	CPT	99203 Office/outpatient Visit - New Patient, Level 3 (30 Min)	20	5	$129.78	$129.78	$71.25	$259.56	$84.75	2026-07-19
99202	CPT	99202 Office/outpatient Visit - New Patient, Level 2 (20 Min)	20	5	$103.82	$103.82	$71.25	$259.56	$84.75	2026-07-19
51702	CPT	Cath Urethra; Simple	32	5	$124.14	$124.14	$20.25	$171.96	$84.69	2026-07-19
29505	CPT	Appl Long Leg Splint	20	5	$241.98	$241.98	$40.87	$325.53	$84.04	2026-07-19
99497	CPT	99497 Advance Care Planning, First 30 Minutes	20	5	$112.48	$112.48	$20.12	$141.14	$83.82	2026-07-19
94060	CPT	94060 Bronchodilation Responsiveness, Spirometry As In 94010, Pre- And Post-bron…	10	5	$95.71	$95.71	$22.97	$95.71	$81.35	2026-07-19
99212	CPT	99212 Office/outpatient Visit - Established Patient, Level 2 (10 Min)	20	5	$78.95	$78.95	$62.97	$259.56	$79.25	2026-07-19
99205	CPT	99205 Office/outpatient Visit - New Patient, Level 5 (60 Min)	10	5	$83.82	$83.82	$71.25	$259.56	$79.25	2026-07-19
99201	CPT	99201 Office/outpatient Visit - New Patient, Level 1 (10 Min)	10	5	$83.82	$83.82	$71.25	$259.56	$79.25	2026-07-19
20551	CPT	20551 Injection(s); Single Tendon Origin/insertion	10	5	$92.47	$92.47	$22.19	$92.47	$78.60	2026-07-19
G0432	HCPCS	HIV Antibody Screen	10	5	$92.20	$92.20	$22.13	$92.20	$78.37	2026-07-19
76706	CPT	US B-scan Abdominal Aortic Aneurysm Scre	10	5	$324.45	$324.45	$66.86	$285.52	$77.87	2026-07-19
20552	CPT	20552 Injection(s); Single Or Multiple Trigger Point(s), 1 Or 2 Muscle(s)	10	5	$91.39	$91.39	$21.93	$91.39	$77.68	2026-07-19
96375	CPT	IV Additional Seq Push Drug	16	5	$134.65	$134.65	$21.07	$134.65	$76.93	2026-07-19
20550	CPT	20550 Injection(s); Single Tendon Sheath, Or Ligament, Aponeurosis (eg, Plantar …	10	5	$90.31	$90.31	$21.67	$90.31	$76.76	2026-07-19
99359	CPT	99359 Prof Fee Prolonged Services, Indirect Contact; Addtl 30 Min	15	5	$89.76	$89.76	$71.25	$259.56	$76.30	2026-07-19
97116	CPT	Pt Gait Training	10	5	$89.22	$89.22	$21.41	$89.22	$75.84	2026-07-19
G0180	HCPCS	G0180 Home Health Certification For Medicare	10	5	$87.06	$87.06	$20.89	$87.06	$74.00	2026-07-19
97140	CPT	97140 Manual Therapy Techniques (eg, Mobilization/manipulation, Manual Lymphatic…	30	5	$86.52	$86.52	$11.16	$91.93	$73.54	2026-07-19
87516	CPT	Hepatitis B Virus (dna)	10	5	$305.52	$305.52	$35.09	$268.86	$73.32	2026-07-19
99231	CPT	Pt Stable Recorvering	10	5	$127.08	$127.08	$37.20	$111.83	$72.63	2026-07-19
73050	CPT	Radiologic Examination; Acromioclavicular Joints,	10	5	$299.58	$299.58	$57.35	$263.63	$71.90	2026-07-19
84445	CPT	Thyroid Stimulating Immunoglobulins	10	5	$295.38	$295.38	$50.86	$259.93	$70.89	2026-07-19
94640	CPT	Airway Inhalation Treatment	48	5	$120.59	$120.59	$6.88	$143.30	$67.42	2026-07-19
96366	CPT	IV Infus Ther Add Hr	16	5	$120.05	$120.05	$17.67	$120.05	$67.42	2026-07-19
69210	CPT	Ear Irrigation Poc	30	5	$108.15	$108.15	$18.82	$170.88	$66.65	2026-07-19
J3030	HCPCS	J3030 Injection, Sumatriptan Succinate, 6 Mg	10	5	$77.33	$77.33	$18.56	$77.33	$65.73	2026-07-19
71045	CPT	Xr Chest Single View Frontal	10	5	$149.79	$149.79	$35.95	$131.82	$62.11	2026-07-19
71046	CPT	Xr Chest Pa And Lat	10	5	$149.79	$149.79	$35.95	$131.82	$62.11	2026-07-19
71047	CPT	Xr Chest 2v W/apical Lordoti	10	5	$149.79	$149.79	$35.95	$131.82	$62.11	2026-07-19
74018	CPT	Xr Kub Abdomen Single	10	5	$149.79	$149.79	$35.95	$131.82	$62.11	2026-07-19
65205	CPT	Removal Fb Conjunctivia	20	5	$198.45	$198.45	$21.75	$255.23	$61.26	2026-07-19
73501	CPT	Xr Hip Unilateral One View Lt	10	5	$149.79	$149.79	$35.95	$131.82	$60.80	2026-07-19
73552	CPT	Xr Femur Ap & Lat Lt	20	5	$149.79	$149.79	$35.95	$131.82	$60.80	2026-07-19
73502	CPT	Xr Hip Complete Min/2 Views Lt	20	5	$149.79	$149.79	$35.95	$131.82	$60.80	2026-07-19
83789	CPT	Bile Acid Total & Fractionated For Pregn	10	5	$734.34	$734.34	$24.11	$646.22	$60.34	2026-07-19
87651	CPT	Alere I Strep A Test	10	5	$98.74	$98.74	$23.70	$86.89	$59.51	2026-07-19
Q0091	HCPCS	Q0091 Screening Pap Smear; Obtaining, Preparing And Conveyance Of Cervical Or Va…	10	5	$69.76	$69.76	$16.74	$69.76	$59.30	2026-07-19
16000	CPT	Initial Tx Of Burns	10	5	$246.04	$246.04	$24.89	$246.04	$59.05	2026-07-19
29130	CPT	29130 Application Of Finger Splint; Static	20	5	$169.80	$169.80	$15.72	$272.00	$58.47	2026-07-19
72170	CPT	Xr Pelvis 1 Or 2 View	10	5	$149.79	$149.79	$35.95	$134.67	$57.35	2026-07-19
70160	CPT	Xr Nasal Complete	10	5	$153.57	$153.57	$36.86	$135.14	$57.35	2026-07-19
70210	CPT	Xr Sinuses	10	5	$149.79	$149.79	$35.95	$131.82	$57.35	2026-07-19
71100	CPT	Xr Ribs Unilat Min 2 Vi Rt	10	5	$149.79	$149.79	$35.95	$131.82	$57.35	2026-07-19
71120	CPT	Xr Sternum Min 2 Vie	10	5	$153.57	$153.57	$36.86	$135.14	$57.35	2026-07-19
72040	CPT	Xr C-spine 2 Or 3 View	10	5	$149.79	$149.79	$35.95	$131.82	$57.35	2026-07-19
72070	CPT	Xr T-spine 2 View	10	5	$149.79	$149.79	$35.95	$134.67	$57.35	2026-07-19

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