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

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Hospital

HARDEMAN COUNTY MEMORIAL HOSPITAL

Quanah, TX · CCN 451352 · Rates published

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You selected 93306 (CPT)

US ECHOCARDIOGRAM

This hospital’s price: $771 across 10 payers · range $432-$1,350

Source: https://app.box.com/shared/static/vacoko9urddxnl11q2tevj301zi1pe7u.csv · observed 2026-07-31

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.

1,145 distinct procedures filed
10 distinct payers
29,016 rate rows
2026-07-31 last MRF observed
Data quality

25,974 of 29,016 rate rows are consumer-grade (89.5%)

3,042 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 3,042
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://app.box.com/shared/static/vacoko9urddxnl11q2tevj301zi1pe7u.csv
Found on page https://hcmhosp.net/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-01
Content fingerprint cebca6599505a23e… · 2,177,742 bytes · first seen 2026-05-17

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
J0840
HCPCS 		Antivenim Crofab 1636 10 $4,365.27 $6,715.80 $5,305.48 nat. median
$3,452
1.5× median
28285
CPT 		Hammertoe/correction 10 $2,871.20 $4,417.23 $3,489.61 nat. median
$3,607
1.0× median
36561
CPT 		Vital-port W/attach Cath 10 $2,667.35 $4,103.62 $3,241.86 nat. median
$3,751
0.9× median
J0897
HCPCS 		Prolia 60mg 10 $2,636.77 $4,056.57 $3,204.69 nat. median
$1,982
1.6× median
11644
CPT 		Exc Malignant 3.1 To 4.0 10 $2,299.91 $3,538.32 $2,795.27 nat. median
$1,687
1.7× median
11404
CPT 		Ex Be Hand 3.1-4.0 Cm 10 $2,299.91 $3,538.32 $2,795.27 nat. median
$1,620
1.7× median
11423
CPT 		Ex Lesion 2.1/3.0 10 $2,299.91 $3,538.32 $2,795.27 nat. median
$1,605
1.7× median
15240
CPT 		Skin Graft 10 $2,110.19 $3,246.45 $2,564.70 nat. median
$2,233
1.1× median
J1439
HCPCS 		Ferric Carboxymaltose(injectafer)750mg 10 $2,032.86 $3,127.47 $2,470.70 nat. median
$14
outlier · 183.0×
59409
CPT 		ER Vaginal Delivery Only 10 $1,967.55 $3,027.00 $2,391.33 nat. median
$3,148
0.8× median
81408
CPT 		Marfan Syndrome: Fbn1 10 $1,914.25 $2,945.00 $2,326.55 nat. median
$938
outlier · 2.5×
11042
CPT 		Debride Skin/tissue 10 $1,755.00 $2,700.00 $2,133.00 nat. median
$523
outlier · 4.1×
77059
CPT 		MRI Breast Bilateral Wwo 10 $1,690.00 $2,600.00 $2,054.00 nat. median
$1,630
1.3× median
19120
CPT 		Removal Of 1 Or More Breast Growth, Open Procedure 10 $1,686.05 $2,593.92 $2,049.20 nat. median
$3,667
0.6× median
J1745
HCPCS 		Infliximab (remicade) Vial 100mg 10 $1,597.31 $2,457.40 $1,941.35 nat. median
$405
outlier · 4.8×
32556
CPT 		Pleural Drainage, Percutan W/cath Insrt 10 $1,593.37 $2,451.34 $1,936.56 nat. median
$1,999
1.0× median
3086428
LOCAL 		Brcassure Comprehensive Test 10 $1,592.50 $2,450.00 $1,935.50 nat. median
$1,936
1.0× median
2110834
LOCAL 		Chest Tube Insertion Thoracostomy 10 $1,479.27 $2,275.80 $1,797.88 nat. median
$1,798
1.0× median
95811
CPT 		Cpap Titration 10 $1,430.00 $2,200.00 $1,738.00 nat. median
$1,894
0.9× median
49520
CPT 		Ing Hernia Repair 10 $1,400.65 $2,154.85 $1,702.33 nat. median
$3,788
outlier · 0.4×
11606
CPT 		Exc Lesion 4.0cm Leg 10 $715.00 $3,538.32 $1,699.95 nat. median
$1,802
0.9× median
71552
CPT 		MRI Chest W/o-with 10 $1,332.50 $2,050.00 $1,619.50 nat. median
$1,103
1.5× median
95810
CPT 		Sleep Study 10 $1,300.00 $2,000.00 $1,580.00 nat. median
$1,827
0.9× median
77065
CPT 		Mammography Of One Breast 10 $1,300.00 $2,000.00 $1,580.00 nat. median
$188
outlier · 8.4×
32400
CPT 		Or- Needle Biopsy Ch 10 $1,270.10 $1,954.00 $1,543.66 nat. median
$1,689
0.9× median
45380
CPT 		Biopsy Of Large Bowel Using An Endoscope 10 $1,254.50 $1,930.00 $1,524.70 nat. median
$1,565
1.0× median
45378
CPT 		Diagnostic Examination Of Large Bowel Using An Endoscope 10 $1,254.50 $1,930.00 $1,524.70 nat. median
$1,339
1.1× median
28119
CPT 		Excision Cal Spur 10 $957.07 $2,418.15 $1,522.11 nat. median
$3,462
outlier · 0.4×
45388
CPT 		Colonoscopy Lesion Remov 10 $1,249.95 $1,923.00 $1,519.17 nat. median
$1,879
0.8× median
72157
CPT 		MRI Spinal/thoracic W/o-w 10 $1,235.00 $1,900.00 $1,501.00 nat. median
$1,114
1.3× median
70553
CPT 		MRI Scan Of Brain Before And After Contrast 10 $1,235.00 $1,900.00 $1,501.00 nat. median
$1,136
1.3× median
71551
CPT 		MRI Chest With 10 $1,235.00 $1,900.00 $1,501.00 nat. median
$1,156
1.3× median
78601
CPT 		US Brain Scan W/vas Flow 10 $1,196.65 $1,841.00 $1,454.39 nat. median
$502
outlier · 2.9×
26735
CPT 		Open Tx Fracture/finger 10 $1,188.85 $1,829.00 $1,444.91 nat. median
$3,745
outlier · 0.4×
72159
CPT 		Mr Angio Spinal W/o-w 10 $1,170.00 $1,800.00 $1,422.00 nat. median
$1,092
1.3× median
73225
CPT 		Mr Angio Upp Extre W/o-w 10 $1,170.00 $1,800.00 $1,422.00 nat. median
$1,211
1.2× median
72158
CPT 		MRI Spinal/lumbar W/o-w 10 $1,170.00 $1,800.00 $1,422.00 nat. median
$1,097
1.3× median
73720
CPT 		MRI Low Extremity W/o-w 10 $1,170.00 $1,800.00 $1,422.00 nat. median
$1,135
1.3× median
26665
CPT 		Open Tx Carpometacarpal 10 $1,152.45 $1,773.00 $1,400.67 nat. median
$3,765
outlier · 0.4×
43246
CPT 		Directed Placement Endo 10 $1,149.53 $1,768.50 $1,397.12 nat. median
$2,129
0.7× median
72156
CPT 		MRI Spinal/cervical W/o-w 10 $1,105.00 $1,700.00 $1,343.00 nat. median
$1,110
1.2× median
71555
CPT 		Mr Angio Chest W/o-with 10 $1,105.00 $1,700.00 $1,343.00 nat. median
$1,151
1.2× median
11603
CPT 		Exc Lesions 2.1-3.0cm 10 $1,078.19 $1,658.76 $1,310.42 nat. median
$793
1.7× median
11642
CPT 		Exc Prob Ca 10 $1,078.19 $1,658.76 $1,310.42 nat. median
$777
1.7× median
70549
CPT 		Mr Angio Neck W/o-with 10 $1,040.00 $1,600.00 $1,264.00 nat. median
$1,063
1.2× median
73220
CPT 		MRI Upper Extremity W/o-w 10 $1,040.00 $1,600.00 $1,264.00 nat. median
$1,136
1.1× median
72197
CPT 		MRI Pelvis W/o-with 10 $1,040.00 $1,600.00 $1,264.00 nat. median
$1,074
1.2× median
73222
CPT 		MRI Joint Upr Extrem With Contrast 10 $1,040.00 $1,600.00 $1,264.00 nat. median
$1,282
1.0× median
72147
CPT 		MRI Spinal/thoracic With 10 $1,040.00 $1,600.00 $1,264.00 nat. median
$972
1.3× median
72198
CPT 		Mr Angio Pelvis W/o-with 10 $1,040.00 $1,600.00 $1,264.00 nat. median
$1,136
1.1× median

Other procedures at this hospital

Browse this hospital's 1,145 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
             
J0840 HCPCS Antivenim Crofab 1636 18 10 $6,715.80 $6,715.80 $4,365.27 $6,715.80 $5,305.48 2026-07-31
28285 CPT Hammertoe/correction 18 10 $4,417.23 $4,417.23 $2,871.20 $4,417.23 $3,489.61 2026-07-31
36561 CPT Vital-port W/attach Cath 18 10 $4,103.62 $4,103.62 $2,667.35 $4,103.62 $3,241.86 2026-07-31
J0897 HCPCS Prolia 60mg 18 10 $4,056.57 $4,056.57 $2,636.77 $4,056.57 $3,204.69 2026-07-31
11423 CPT Ex Lesion 2.1/3.0 18 10 $3,538.32 $3,538.32 $2,299.91 $3,538.32 $2,795.27 2026-07-31
11644 CPT Exc Malignant 3.1 To 4.0 18 10 $3,538.32 $3,538.32 $2,299.91 $3,538.32 $2,795.27 2026-07-31
11404 CPT Ex Be Hand 3.1-4.0 Cm 18 10 $3,538.32 $3,538.32 $2,299.91 $3,538.32 $2,795.27 2026-07-31
15240 CPT Skin Graft 18 10 $3,246.45 $3,246.45 $2,110.19 $3,246.45 $2,564.70 2026-07-31
J1439 HCPCS Ferric Carboxymaltose(injectafer)750mg 18 10 $3,127.47 $3,127.47 $2,032.86 $3,127.47 $2,470.70 2026-07-31
59409 CPT ER Vaginal Delivery Only 18 10 $3,027.00 $3,027.00 $1,967.55 $3,027.00 $2,391.33 2026-07-31
81408 CPT Marfan Syndrome: Fbn1 18 10 $2,945.00 $2,945.00 $1,914.25 $2,945.00 $2,326.55 2026-07-31
11042 CPT Debride Skin/tissue 18 10 $2,700.00 $2,700.00 $1,755.00 $2,700.00 $2,133.00 2026-07-31
77059 CPT MRI Breast Bilateral Wwo 18 10 $2,600.00 $2,600.00 $1,690.00 $2,600.00 $2,054.00 2026-07-31
19120 CPT Removal Of 1 Or More Breast Growth, Open Procedure 18 10 $2,593.92 $2,593.92 $1,686.05 $2,593.92 $2,049.20 2026-07-31
J1745 HCPCS Infliximab (remicade) Vial 100mg 18 10 $2,457.40 $2,457.40 $1,597.31 $2,457.40 $1,941.35 2026-07-31
32556 CPT Pleural Drainage, Percutan W/cath Insrt 18 10 $2,451.34 $2,451.34 $1,593.37 $2,451.34 $1,936.56 2026-07-31
3086428 LOCAL Brcassure Comprehensive Test 18 10 $2,450.00 $2,450.00 $1,592.50 $2,450.00 $1,935.50 2026-07-31
2110834 LOCAL Chest Tube Insertion Thoracostomy 18 10 $2,275.80 $2,275.80 $1,479.27 $2,275.80 $1,797.88 2026-07-31
95811 CPT Cpap Titration 18 10 $2,200.00 $2,200.00 $1,430.00 $2,200.00 $1,738.00 2026-07-31
49520 CPT Ing Hernia Repair 18 10 $2,154.85 $2,154.85 $1,400.65 $2,154.85 $1,702.33 2026-07-31
11606 CPT Exc Lesion 4.0cm Leg 36 10 $2,319.16 $2,319.16 $715.00 $3,538.32 $1,699.95 2026-07-31
71552 CPT MRI Chest W/o-with 18 10 $2,050.00 $2,050.00 $1,332.50 $2,050.00 $1,619.50 2026-07-31
95810 CPT Sleep Study 18 10 $2,000.00 $2,000.00 $1,300.00 $2,000.00 $1,580.00 2026-07-31
77065 CPT Mammography Of One Breast 18 10 $2,000.00 $2,000.00 $1,300.00 $2,000.00 $1,580.00 2026-07-31
32400 CPT Or- Needle Biopsy Ch 18 10 $1,954.00 $1,954.00 $1,270.10 $1,954.00 $1,543.66 2026-07-31
45380 CPT Biopsy Of Large Bowel Using An Endoscope 18 10 $1,930.00 $1,930.00 $1,254.50 $1,930.00 $1,524.70 2026-07-31
45378 CPT Diagnostic Examination Of Large Bowel Using An Endoscope 18 10 $1,930.00 $1,930.00 $1,254.50 $1,930.00 $1,524.70 2026-07-31
28119 CPT Excision Cal Spur 36 10 $1,945.28 $1,945.28 $957.07 $2,418.15 $1,522.11 2026-07-31
45388 CPT Colonoscopy Lesion Remov 18 10 $1,923.00 $1,923.00 $1,249.95 $1,923.00 $1,519.17 2026-07-31
72157 CPT MRI Spinal/thoracic W/o-w 18 10 $1,900.00 $1,900.00 $1,235.00 $1,900.00 $1,501.00 2026-07-31
71551 CPT MRI Chest With 18 10 $1,900.00 $1,900.00 $1,235.00 $1,900.00 $1,501.00 2026-07-31
70553 CPT MRI Scan Of Brain Before And After Contrast 18 10 $1,900.00 $1,900.00 $1,235.00 $1,900.00 $1,501.00 2026-07-31
78601 CPT US Brain Scan W/vas Flow 18 10 $1,841.00 $1,841.00 $1,196.65 $1,841.00 $1,454.39 2026-07-31
26735 CPT Open Tx Fracture/finger 18 10 $1,829.00 $1,829.00 $1,188.85 $1,829.00 $1,444.91 2026-07-31
73225 CPT Mr Angio Upp Extre W/o-w 18 10 $1,800.00 $1,800.00 $1,170.00 $1,800.00 $1,422.00 2026-07-31
72158 CPT MRI Spinal/lumbar W/o-w 18 10 $1,800.00 $1,800.00 $1,170.00 $1,800.00 $1,422.00 2026-07-31
73720 CPT MRI Low Extremity W/o-w 18 10 $1,800.00 $1,800.00 $1,170.00 $1,800.00 $1,422.00 2026-07-31
72159 CPT Mr Angio Spinal W/o-w 18 10 $1,800.00 $1,800.00 $1,170.00 $1,800.00 $1,422.00 2026-07-31
26665 CPT Open Tx Carpometacarpal 18 10 $1,773.00 $1,773.00 $1,152.45 $1,773.00 $1,400.67 2026-07-31
43246 CPT Directed Placement Endo 18 10 $1,768.50 $1,768.50 $1,149.53 $1,768.50 $1,397.12 2026-07-31
72156 CPT MRI Spinal/cervical W/o-w 18 10 $1,700.00 $1,700.00 $1,105.00 $1,700.00 $1,343.00 2026-07-31
71555 CPT Mr Angio Chest W/o-with 18 10 $1,700.00 $1,700.00 $1,105.00 $1,700.00 $1,343.00 2026-07-31
11642 CPT Exc Prob Ca 18 10 $1,658.76 $1,658.76 $1,078.19 $1,658.76 $1,310.42 2026-07-31
11603 CPT Exc Lesions 2.1-3.0cm 18 10 $1,658.76 $1,658.76 $1,078.19 $1,658.76 $1,310.42 2026-07-31
76390 CPT MRI Spectroscopy 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
73220 CPT MRI Upper Extremity W/o-w 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
70543 CPT MRI Orbit Face/neck Without W 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
72198 CPT Mr Angio Pelvis W/o-with 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
71550 CPT MRI Chest Without 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
72147 CPT MRI Spinal/thoracic With 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
70542 CPT MRI Orbit Face/neck With 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
73223 CPT MRI Upp Extrem/joint Wo/w 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
70552 CPT MRI Brain With 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
72197 CPT MRI Pelvis W/o-with 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
73222 CPT MRI Joint Upr Extrem With Contrast 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
70549 CPT Mr Angio Neck W/o-with 18 10 $1,600.00 $1,600.00 $1,040.00 $1,600.00 $1,264.00 2026-07-31
32554 CPT Thoracentesis Needle/cath Pleura Without Ima 18 10 $1,583.00 $1,583.00 $1,028.95 $1,583.00 $1,250.57 2026-07-31
72196 CPT MRI Pelvis With 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
73719 CPT MRI Low Extremity With 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
73219 CPT MRI Upper Extremity With 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
74182 CPT MRI Abdomen With 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
73725 CPT Mr Angio Lwr Extrem W/o-w 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
74183 CPT MRI Abdomen W/o-w 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
72142 CPT MRI Spinal/cervical With 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
70545 CPT Mr Angio Head With 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
72149 CPT MRI Spinal/lumbar With 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
70548 CPT Mr Angio Neck With 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
73723 CPT MRI Joint Lwr Extr Wwo Dye 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
70540 CPT MRI Orbit Face/neck Without 18 10 $1,500.00 $1,500.00 $975.00 $1,500.00 $1,185.00 2026-07-31
99291 CPT ER Critical Care 18 10 $1,486.00 $1,486.00 $965.90 $1,486.00 $1,173.94 2026-07-31
75635 CPT CTA Abdomen W/bilateral Run Off 18 10 $1,478.00 $1,478.00 $960.70 $1,478.00 $1,167.62 2026-07-31
28108 CPT Removal Of Toe Lesions 18 10 $1,472.41 $1,472.41 $957.07 $1,472.41 $1,163.20 2026-07-31
43235 CPT Diagnostic Examination Of Esophagus, Stomach, And/or Upper Small Bowel Using An … 36 10 $1,441.83 $1,441.83 $724.75 $1,768.65 $1,132.31 2026-07-31
P9034 HCPCS Bb Platelet Pheresis Obi 18 10 $1,414.80 $1,414.80 $919.62 $1,414.80 $1,117.69 2026-07-31
74185 CPT Mr Angio Abd W/o-w 18 10 $1,400.00 $1,400.00 $910.00 $1,400.00 $1,106.00 2026-07-31
73722 CPT MRI Lwr Extrem/joint With 18 10 $1,400.00 $1,400.00 $910.00 $1,400.00 $1,106.00 2026-07-31
95805 CPT Mslt/multiple Test 18 10 $1,400.00 $1,400.00 $910.00 $1,400.00 $1,106.00 2026-07-31
58120 CPT D & C 18 10 $1,351.17 $1,351.17 $878.26 $1,351.17 $1,067.42 2026-07-31
45331 CPT Sidmoidoscopy W/biopsy 18 10 $1,340.00 $1,340.00 $871.00 $1,340.00 $1,058.60 2026-07-31
45330 CPT Sigmoidoscopy/fiberopiic 18 10 $1,340.00 $1,340.00 $871.00 $1,340.00 $1,058.60 2026-07-31
11421 CPT Exc Lesion Head 36 10 $1,329.38 $1,329.38 $650.00 $1,658.76 $1,039.10 2026-07-31
73218 CPT MRI Upper Extremity Without 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
73221 CPT MRI Joint Upr Extrem Without Contrast 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
72146 CPT MRI Spinal/thoracic Without 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
70551 CPT MRI Brain Without 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
72148 CPT MRI Scan Of Lower Spinal Canal 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
74181 CPT MRI Abdomen Without 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
73721 CPT MRI Scan Of Leg Joint 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
73718 CPT MRI Low Extremity Without 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
72195 CPT MRI Pelvis Without 18 10 $1,300.00 $1,300.00 $845.00 $1,300.00 $1,027.00 2026-07-31
73206 CPT CTA Upper Extremity 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
70488 CPT CT Facial Bones W/wo 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
73706 CPT CTA Bilateral Lower Extremity 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
70470 CPT CT Head W/wo Contrast 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
71270 CPT CT Chest W/wo 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
72127 CPT CT Cervical Spine W/wo 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
74175 CPT CTA Abdomen 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
74170 CPT CT Abdomen W/wo Contrast 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
70498 CPT CTA Neck 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
74174 CPT CTA Abdomen / Pelvis 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
72133 CPT CT Lumbar Spine W/wo 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
73202 CPT CT Upper Extremity W/wo 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
73702 CPT CT Lower Extremity W/wo 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
71275 CPT CT Angiography Chest 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
72130 CPT CT Thoracic Spine W/wo 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
70492 CPT CT Soft Tissue Neck W/wo 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
72194 CPT CT Pelvis W/wo Contrast 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
70496 CPT CTA Head 18 10 $1,278.00 $1,278.00 $830.70 $1,278.00 $1,009.62 2026-07-31
74178 CPT CT Abd & Pelvis W/wo Contrast 36 10 $1,191.64 $1,191.64 $718.44 $1,278.00 $958.50 2026-07-31
70336 CPT MRI Tmj 18 10 $1,200.00 $1,200.00 $780.00 $1,200.00 $948.00 2026-07-31
70544 CPT Mr Angio Head Without 18 10 $1,200.00 $1,200.00 $780.00 $1,200.00 $948.00 2026-07-31
72141 CPT MRI Spinal/cervical Without 18 10 $1,200.00 $1,200.00 $780.00 $1,200.00 $948.00 2026-07-31
70547 CPT Mr Angio Neck Without 18 10 $1,200.00 $1,200.00 $780.00 $1,200.00 $948.00 2026-07-31
70546 CPT Mr Angio Head W/o-with 18 10 $1,200.00 $1,200.00 $780.00 $1,200.00 $948.00 2026-07-31
11623 CPT Exc Lesion Hand W/graft 18 10 $1,200.00 $1,200.00 $780.00 $1,200.00 $948.00 2026-07-31
10121 CPT Incision/removaal Complic 18 10 $1,179.44 $1,179.44 $766.64 $1,179.44 $931.76 2026-07-31
93307 CPT US Echocardiogram 2d 18 10 $1,179.00 $1,179.00 $766.35 $1,179.00 $931.41 2026-07-31
70491 CPT CT Soft Tissue Neck With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
72129 CPT CT Thoracic Spine With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
72126 CPT CT Cervical Spine With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
72193 CPT CT Scan, Pelvis, With Contrast 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
73201 CPT CT Upper Extremity With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
71260 CPT CT Chest With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
73701 CPT CT Lower Extremity With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
72132 CPT CT Lumbar Spine With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
74160 CPT CT Abdomen With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
70460 CPT CT Head With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
70487 CPT CT Facial Bones With 18 10 $1,168.00 $1,168.00 $759.20 $1,168.00 $922.72 2026-07-31
32551 CPT Chest Tube Insertion 18 10 $1,156.00 $1,156.00 $751.40 $1,156.00 $913.24 2026-07-31
36680 CPT Insert Needle Bone Cavity 18 10 $1,132.71 $1,132.71 $736.26 $1,132.71 $894.84 2026-07-31
27603 CPT Drain Lower Leg Lesion 18 10 $1,124.49 $1,124.49 $730.92 $1,124.49 $888.35 2026-07-31
33010 CPT Pericardiocentesis Initl 18 10 $1,123.00 $1,123.00 $729.95 $1,123.00 $887.17 2026-07-31
92960 CPT Cardio Version External 18 10 $1,120.00 $1,120.00 $728.00 $1,120.00 $884.80 2026-07-31
J1442 HCPCS Filgrastim (neupogen) 480mcg 18 10 $1,116.00 $1,116.00 $725.40 $1,116.00 $881.64 2026-07-31
43239 CPT Biopsy Of The Esophagus, Stomach, And/or Upper Small Bowel Using An Endoscope 18 10 $1,115.00 $1,115.00 $724.75 $1,115.00 $880.85 2026-07-31
23655 CPT Clos Disclos Should W/ane 18 10 $1,106.00 $1,106.00 $718.90 $1,106.00 $873.74 2026-07-31
27829 CPT Operating Room 90 Min 18 10 $1,100.00 $1,100.00 $715.00 $1,100.00 $869.00 2026-07-31
27818 CPT Closed Tx Ankle Fx/manipu 18 10 $1,069.00 $1,069.00 $694.85 $1,069.00 $844.51 2026-07-31
25565 CPT Closed Tx Of Radial W/mal 18 10 $1,068.00 $1,068.00 $694.20 $1,068.00 $843.72 2026-07-31
11765 CPT Excision Of Nail Fold Toe 18 10 $1,059.00 $1,059.00 $688.35 $1,059.00 $836.61 2026-07-31
13132 CPT Repair Cmpx Forehead 18 10 $1,048.67 $1,048.67 $681.64 $1,048.67 $828.45 2026-07-31
12020 CPT Closer Of Split Wound 18 10 $1,042.00 $1,042.00 $677.30 $1,042.00 $823.18 2026-07-31
23665 CPT Clsd Tx Shoulder Diloc W/fracture 18 10 $1,041.81 $1,041.81 $677.18 $1,041.81 $823.03 2026-07-31
36556 CPT Insert Non-tunnel Cv Cath 36 10 $1,046.87 $1,046.87 $505.70 $1,315.73 $816.61 2026-07-31
11442 CPT Exe Lesion 1.1 To 2.0cm 18 10 $1,000.00 $1,000.00 $650.00 $1,000.00 $790.00 2026-07-31
11441 CPT Exc Lesion Face 18 10 $1,000.00 $1,000.00 $650.00 $1,000.00 $790.00 2026-07-31
11402 CPT Exc Lesion 1.1 To 2.0cm 18 10 $1,000.00 $1,000.00 $650.00 $1,000.00 $790.00 2026-07-31
11643 CPT Exc Mal Lesion 2.1-3.0cm 18 10 $1,000.00 $1,000.00 $650.00 $1,000.00 $790.00 2026-07-31
93306 CPT US Echocardiogram 36 10 $1,007.00 $1,007.00 $431.60 $1,350.00 $770.75 2026-07-31
27810 CPT Clsed Tx W/manipulation 18 10 $969.00 $969.00 $629.85 $969.00 $765.51 2026-07-31
75574 CPT CT Angiography 18 10 $959.00 $959.00 $623.35 $959.00 $757.61 2026-07-31
11440 CPT Exc Face Mm 0.5<cm 18 10 $928.00 $928.00 $603.20 $928.00 $733.12 2026-07-31
72125 CPT CT Cervical Spine Wo 18 10 $913.00 $913.00 $593.45 $913.00 $721.27 2026-07-31
2613150 LOCAL Repair Cmplx Eye 1.0 Less 18 10 $898.00 $898.00 $583.70 $898.00 $709.42 2026-07-31
13152 CPT Repair Cmplx Eye 2.6-7.5 18 10 $898.00 $898.00 $583.70 $898.00 $709.42 2026-07-31
13151 CPT Repair Cmplx Eye 1.1-2.5 18 10 $898.00 $898.00 $583.70 $898.00 $709.42 2026-07-31
11602 CPT Exc Of Mal Lesion 1.1-2.0 18 10 $882.18 $882.18 $573.42 $882.18 $696.92 2026-07-31
11401 CPT Exc Lesion 0.6-1cm 18 10 $882.18 $882.18 $573.42 $882.18 $696.92 2026-07-31
70490 CPT CT Soft Tissue Neck Wo 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
70486 CPT CT Sinuses Without Contrast 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
70450 CPT CT Scan, Head Or Brain, Without Contrast 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
74150 CPT CT Abdomen Wo Contrast 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
73700 CPT CT Lower Extremity Wo 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
74176 CPT CT Abd & Pelvis Without Contrast 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
72131 CPT CT Lumbar Wo Contrast 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
72128 CPT CT Thoracic Spine Wo 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
72192 CPT CT Pelvis Wo 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
71250 CPT CT Chest Without Contrast 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
73200 CPT CT Upper Extremity Wo 18 10 $875.00 $875.00 $568.75 $875.00 $691.25 2026-07-31
78201 CPT US Liver Scan 18 10 $872.34 $872.34 $567.02 $872.34 $689.15 2026-07-31
P9022 HCPCS Bb Red Cells Washed Obi 18 10 $861.00 $861.00 $559.65 $861.00 $680.19 2026-07-31
49999 CPT Unlisted Procedure/ Abd/peritoneum &omen 18 10 $826.50 $826.50 $537.23 $826.50 $652.94 2026-07-31
36571 CPT Insert Picvad Cath 18 10 $778.00 $778.00 $505.70 $778.00 $614.62 2026-07-31
28208 CPT Repair Foot Tendon/ea Tendon 18 10 $770.91 $770.91 $501.09 $770.91 $609.02 2026-07-31
78185 CPT US Spleen Scan 18 10 $768.00 $768.00 $499.20 $768.00 $606.72 2026-07-31
26070 CPT Drainage/removal Of Foriegn Body Carpome 18 10 $753.00 $753.00 $489.45 $753.00 $594.87 2026-07-31
19020 CPT Incision/drainage/ Mastonomy With Explorat 18 10 $750.51 $750.51 $487.83 $750.51 $592.90 2026-07-31
78306 CPT US Bone Scan-whole Body 18 10 $741.00 $741.00 $481.65 $741.00 $585.39 2026-07-31
97606 CPT Neg Press Wnd Therapy >50 Sqcm 18 10 $733.80 $733.80 $476.97 $733.80 $579.70 2026-07-31
78290 CPT US Meckels Diverticula 18 10 $731.00 $731.00 $475.15 $731.00 $577.49 2026-07-31
78579 CPT US Pulmonary Vent Imaging 18 10 $731.00 $731.00 $475.15 $731.00 $577.49 2026-07-31
28190 CPT Removal Foreign Body/foot 18 10 $708.00 $708.00 $460.20 $708.00 $559.32 2026-07-31
93930 CPT US Upper Extremity Bilateral Arterial 18 10 $700.56 $700.56 $455.36 $700.56 $553.44 2026-07-31
93975 CPT US Renal Arteries 18 10 $700.56 $700.56 $455.36 $700.56 $553.44 2026-07-31
93970 CPT US Doppler Venous System 36 10 $697.78 $697.78 $451.75 $700.56 $551.25 2026-07-31
36430 CPT Bb W-bld Process Fee Obi 36 10 $702.00 $702.00 $444.60 $720.00 $543.06 2026-07-31
12036 CPT Simp Repair 20.1cm-30.0cm 18 10 $683.00 $683.00 $443.95 $683.00 $539.57 2026-07-31
12032 CPT Repair Inter Lay 2.6-7.5 18 10 $683.00 $683.00 $443.95 $683.00 $539.57 2026-07-31
12053 CPT Repair Inter Lay 5.1-7.5 18 10 $683.00 $683.00 $443.95 $683.00 $539.57 2026-07-31
93925 CPT US Lower Extremity Bilateral Arterial 18 10 $680.00 $680.00 $442.00 $680.00 $537.20 2026-07-31
12042 CPT Rpr Intermed N/h/f/xtrnl Gent 2.6-7.5 18 10 $677.00 $677.00 $440.05 $677.00 $534.83 2026-07-31
12046 CPT Repair Inter N/h/f Ext Gen 20.1-30.0 18 10 $675.00 $675.00 $438.75 $675.00 $533.25 2026-07-31
1660020 LOCAL Operating Room 120 Min 18 10 $672.00 $672.00 $436.80 $672.00 $530.88 2026-07-31
51720 CPT Treatment/bladder Lession 18 10 $669.00 $669.00 $434.85 $669.00 $528.51 2026-07-31
P9019 HCPCS Bb Platelet Concentr Obi 18 10 $648.20 $648.20 $421.33 $648.20 $512.08 2026-07-31
5440055 LOCAL 181-210 Min Anes Time 18 10 $642.00 $642.00 $417.30 $642.00 $507.18 2026-07-31
16030 CPT Dress/debrid P-thick Burn L 18 10 $641.54 $641.54 $417.00 $641.54 $506.82 2026-07-31
13133 CPT Repair Cmpx Head Addl 18 10 $637.00 $637.00 $414.05 $637.00 $503.23 2026-07-31
13131 CPT Repair Cmplx Fhea 1.5-2.5 18 10 $637.00 $637.00 $414.05 $637.00 $503.23 2026-07-31
13121 CPT Repair Cmplx 2.6cm-7.5cm 18 10 $637.00 $637.00 $414.05 $637.00 $503.23 2026-07-31
13120 CPT Repair Cmplx Sclp 1.1-2.5 18 10 $637.00 $637.00 $414.05 $637.00 $503.23 2026-07-31
3086742 LOCAL Celiac Disease Hla Dq Assoc. 18 10 $634.00 $634.00 $412.10 $634.00 $500.86 2026-07-31
12044 CPT Rpr Inter N/h/f Ext Gen 7.6-12.5 18 10 $610.00 $610.00 $396.50 $610.00 $481.90 2026-07-31
78580 CPT US Pulmonary Perfusion 18 10 $607.00 $607.00 $394.55 $607.00 $479.53 2026-07-31
P9016 HCPCS Bb Red Cell Pro Fee Reduced Obi 18 10 $603.00 $603.00 $391.95 $603.00 $476.37 2026-07-31
3228109 LOCAL Bb L04 Abid Obi 18 10 $600.10 $600.10 $390.07 $600.10 $474.08 2026-07-31
5440045 LOCAL 151-180 Min Anes Time 18 10 $586.00 $586.00 $380.90 $586.00 $462.94 2026-07-31
93880 CPT US Carotid Scan Bilateral 36 10 $578.28 $578.28 $296.40 $700.56 $456.00 2026-07-31
11057 CPT Trim Skin Lesion >4 18 10 $572.25 $572.25 $371.96 $572.25 $452.08 2026-07-31
11056 CPT Trim Skin Lesion 2 To 4 18 10 $572.25 $572.25 $371.96 $572.25 $452.08 2026-07-31
11055 CPT Trim Skin Lesion 18 10 $572.25 $572.25 $371.96 $572.25 $452.08 2026-07-31
5440035 LOCAL 121-150 Min Anes Time 18 10 $567.00 $567.00 $368.55 $567.00 $447.93 2026-07-31
45915 CPT Removal Fecal Inpaction/ Anesthesia 18 10 $558.45 $558.45 $362.99 $558.45 $441.18 2026-07-31
92523 CPT Sp Eval Speech Sound Product 18 10 $555.00 $555.00 $360.75 $555.00 $438.45 2026-07-31
26725 CPT Treat Finger Fracture-reduction 18 10 $554.00 $554.00 $360.10 $554.00 $437.66 2026-07-31
11640 CPT Exc Malignant 0.5cm/less 18 10 $553.00 $553.00 $359.45 $553.00 $436.87 2026-07-31
64400 CPT Nerve Block Inj Trigeminl 18 10 $549.00 $549.00 $356.85 $549.00 $433.71 2026-07-31
70482 CPT CT Orbits/sella W/wo 18 10 $543.00 $543.00 $352.95 $543.00 $428.97 2026-07-31
70481 CPT CT Orbits/sella With 18 10 $543.00 $543.00 $352.95 $543.00 $428.97 2026-07-31
3228101 LOCAL Bb L30 Blood Component Prep Obi 18 10 $540.80 $540.80 $351.52 $540.80 $427.23 2026-07-31
29445 CPT Ot Lc Rigid Total Contact 36 10 $539.00 $539.00 $49.59 $539.00 $425.81 2026-07-31
29405 CPT Ot App/sh L Cast Bel Kne/toe 36 10 $539.00 $539.00 $37.01 $539.00 $425.81 2026-07-31
29365 CPT Ot Cylinder Cast Thigh/ankle 36 10 $539.00 $539.00 $53.54 $539.00 $425.81 2026-07-31
29345 CPT Appli Long Leg Cast Thigh To Toes 54 10 $539.00 $539.00 $56.99 $539.00 $425.81 2026-07-31
29075 CPT Apply Short Arm Cast 54 10 $539.00 $539.00 $42.43 $549.00 $425.81 2026-07-31
29065 CPT Ot Long Cast Shoulder/hand 36 10 $539.00 $539.00 $43.91 $539.00 $425.81 2026-07-31
11200 CPT Exc Skin Tag/biospy 36 10 $592.00 $592.00 $119.60 $1,000.00 $417.00 2026-07-31
97607 CPT Neg Pressure Wnd Vac Non-dme 18 10 $526.16 $526.16 $342.00 $526.16 $415.67 2026-07-31
26645 CPT Treat Thumb Fracture 18 10 $523.00 $523.00 $339.95 $523.00 $413.17 2026-07-31
90670 CPT Pcv 13 (prevnar) 0.5ml 36 10 $490.97 $490.97 $286.21 $541.62 $406.22 2026-07-31
96116 CPT Ot Neurobehav Status Ex Hr 54 10 $539.00 $539.00 $123.50 $539.00 $404.25 2026-07-31
5440020 LOCAL 91-120 Min Anes Time 18 10 $506.00 $506.00 $328.90 $506.00 $399.74 2026-07-31
43761 CPT Repositioning Of Naso- Gastric Feeding 18 10 $500.01 $500.01 $325.01 $500.01 $395.01 2026-07-31
12051 CPT Repair Cmplx 2.5cm -less 18 10 $491.00 $491.00 $319.15 $491.00 $387.89 2026-07-31
12035 CPT Repair Inter Lay 12.6-20. 18 10 $491.00 $491.00 $319.15 $491.00 $387.89 2026-07-31
12052 CPT Repair Inter 2.6cm/5.0cm 18 10 $491.00 $491.00 $319.15 $491.00 $387.89 2026-07-31
26641 CPT Clsd Treat Thumb With Manipulation 18 10 $486.81 $486.81 $316.43 $486.81 $384.58 2026-07-31
5440015 LOCAL 61-90 Min Anes Times 18 10 $483.00 $483.00 $313.95 $483.00 $381.57 2026-07-31
92950 CPT Cpr 36 10 $482.25 $482.25 $304.20 $496.50 $372.90 2026-07-31
31500 CPT Insert Emergency Airway 36 10 $482.25 $482.25 $304.20 $496.50 $372.90 2026-07-31
70480 CPT CT Orbits 18 10 $468.42 $468.42 $304.47 $468.42 $370.05 2026-07-31
62270 CPT Lumbar Punctur Diagnostic 18 10 $465.00 $465.00 $302.25 $465.00 $367.35 2026-07-31
78226 CPT US Hepatobilliary 18 10 $464.00 $464.00 $301.60 $464.00 $366.56 2026-07-31
24670 CPT Clsd Tx Ulna Fractureproximal End Without 18 10 $462.50 $462.50 $300.63 $462.50 $365.38 2026-07-31
21480 CPT Closed Tx Temporomandibular Dislocation 18 10 $462.50 $462.50 $300.63 $462.50 $365.38 2026-07-31
3085304 LOCAL Protein S Antigen 18 10 $462.00 $462.00 $300.30 $462.00 $364.98 2026-07-31
87631 CPT Resp Virus 3-5 18 10 $427.89 $427.89 $135.38 $427.89 $363.25 2026-07-31
93980 CPT US Ppg/dopp Penile Press 18 10 $456.00 $456.00 $296.40 $456.00 $360.24 2026-07-31
P9021 HCPCS Bb Red Bloods Cells Ea Unit Obi 18 10 $447.00 $447.00 $290.55 $447.00 $353.13 2026-07-31
3087083 LOCAL Gc/chlamydia/tric, Naa 18 10 $446.51 $446.51 $290.23 $446.51 $352.74 2026-07-31
J1756 HCPCS Venofer 20mg/ml 18 10 $433.30 $433.30 $281.65 $433.30 $342.31 2026-07-31
5880270 LOCAL Elec Stimulation/unatten 18 10 $430.00 $430.00 $279.50 $430.00 $339.70 2026-07-31
5880265 LOCAL Elec Stimul Manual 18 10 $430.00 $430.00 $279.50 $430.00 $339.70 2026-07-31
5880130 LOCAL Mist Croup Machine 18 10 $430.00 $430.00 $279.50 $430.00 $339.70 2026-07-31
99285 CPT Er/comp High Complexity 36 10 $470.00 $470.00 $113.75 $765.00 $336.12 2026-07-31
10120 CPT Incision/removal Fb Simp 36 10 $434.00 $434.00 $187.85 $579.00 $332.68 2026-07-31
29582 CPT Pt Apply Multlay Cmp Upr Leg 18 10 $415.00 $415.00 $269.75 $415.00 $327.85 2026-07-31
99284 CPT Er/detailed Mod Complexity 36 10 $430.00 $430.00 $178.75 $585.00 $327.62 2026-07-31
51700 CPT Bladder Irrigation 18 10 $409.00 $409.00 $265.85 $409.00 $323.11 2026-07-31
55100 CPT I/d Of Scrotal Wall Abcess 18 10 $408.50 $408.50 $265.53 $408.50 $322.72 2026-07-31
5440010 LOCAL 31-60 Min Anes Times 18 10 $405.00 $405.00 $263.25 $405.00 $319.95 2026-07-31
23540 CPT Clsd Tx Acro Clav Dislocation Without Man 18 10 $402.00 $402.00 $261.30 $402.00 $317.58 2026-07-31
93015 CPT Ecg/ekg W/stress 18 10 $400.00 $400.00 $260.00 $400.00 $316.00 2026-07-31
81256 CPT Hereditary Hemochromatosis ; DNA 18 10 $400.00 $400.00 $260.00 $400.00 $316.00 2026-07-31
78012 CPT US Thyroid Uptake 18 10 $398.00 $398.00 $258.70 $398.00 $314.42 2026-07-31
78013 CPT US Thyroid Scan 18 10 $398.00 $398.00 $258.70 $398.00 $314.42 2026-07-31
16025 CPT Burn Tx Wo/anes Medium 36 10 $364.30 $364.30 $202.80 $416.60 $312.00 2026-07-31
J0878 HCPCS Daptomycin (cubicin) 1 G 36 10 $468.69 $468.69 $1.22 $935.51 $304.98 2026-07-31
J3590 HCPCS Diastat 2.5mg R 18 10 $378.00 $378.00 $245.70 $378.00 $298.62 2026-07-31
99222 CPT Hosp/admit Comp High Complexity 50min 18 10 $375.00 $375.00 $243.75 $375.00 $296.25 2026-07-31
88262 CPT Count 15-20 Cell W/band 18 10 $365.00 $365.00 $237.25 $365.00 $288.35 2026-07-31
25605 CPT Cl Tx Radius/ulna Rx 36 10 $365.50 $365.50 $231.40 $375.00 $282.65 2026-07-31
1660005 LOCAL Operating Room 30 Min 18 10 $357.00 $357.00 $232.05 $357.00 $282.03 2026-07-31
11750 CPT Excision Of Nail 18 10 $350.50 $350.50 $227.83 $350.50 $276.90 2026-07-31
12015 CPT Simple Rpr F/e/e/n/l/m 7.6cm-12.5cm 18 10 $350.00 $350.00 $227.50 $350.00 $276.50 2026-07-31
97597 CPT Ot/pt Debridement Open Wnd 20sq Cm</ 36 10 $350.00 $350.00 $26.16 $350.00 $276.50 2026-07-31
J0570 HCPCS Bicillin La 1 200 000 U 18 10 $348.70 $348.70 $226.66 $348.70 $275.47 2026-07-31
12001 CPT Repair Superficial Wound 36 10 $332.50 $332.50 $178.10 $391.00 $274.00 2026-07-31
3085734 LOCAL Systemic Lupus Profile A 18 10 $344.00 $344.00 $223.60 $344.00 $271.76 2026-07-31
88182 CPT T-cell Subset 18 10 $343.00 $343.00 $222.95 $343.00 $270.97 2026-07-31
43752 CPT Naso 36 10 $344.06 $344.06 $171.60 $424.12 $269.84 2026-07-31
90791 CPT Psychosocial Assessment 18 10 $337.00 $337.00 $219.05 $337.00 $266.23 2026-07-31
27520 CPT Clos Tx Patellar Without Man 18 10 $335.19 $335.19 $217.87 $335.19 $264.80 2026-07-31
27560 CPT Clsd Tx Patellas Wo/anes 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
27265 CPT Closed Tx Hip Dislocation 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
27256 CPT Tx Hip Dislocation 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
26770 CPT Closed Ip Joint Dislocat 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
26750 CPT Closed Tx Of Fx Finger 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
26720 CPT Treat Finger Fracture 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
26700 CPT Clsed Tx Dislocation 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
25560 CPT Closed Tx Radical Wo/mal 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
25500 CPT Closed Tx Radial Shaft 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
24650 CPT Clsd Tx Radial Head/elbow 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
24640 CPT Closed Treatment/head 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
24600 CPT Clsd Tx Elbow Disloc Without 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
23650 CPT Closed Tx Disloc Should 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
23505 CPT Clsd Tx Clav Fx W/manipul 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
23500 CPT Clsd Tx Clav Fx Without Man 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
28470 CPT Clsed Tx Metatarsal Fx 18 10 $335.00 $335.00 $217.75 $335.00 $264.65 2026-07-31
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