Hospital

COCHRAN MEMORIAL HOSPITAL

Morton, TX · CCN 451366 · Rates published

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You selected 93350 (HCPCS)

US STRESS ECHOCARDIOGRAPHY

This hospital’s price: $597 across 11 payers · range $388-$597

Source: https://cochranmemorial.com/pricing/751255846_cochran-memorial-hospital_standardcharges.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.

980 distinct procedures filed

11 distinct payers

19,557 rate rows

2026-07-19 last MRF observed

Data quality

19,120 of 19,557 rate rows are consumer-grade (97.8%)

437 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
placeholder amount (≤ $0.02) — excluded from medians	334
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	98
exceeds 10× this hospital's gross charge — excluded from medians	3
per-diem day rate — not a per-procedure price	2

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

Source MRF file	https://www.cochranmemorial.com/pricing/751255846_cochran-memorial-hospital_standardcharges.csv
Found on page	https://www.cochranmemorial.com/pricing.html
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-03
Content fingerprint	57f7fe99683c2b04… · 7,827,423 bytes · first seen 2026-05-15

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
J3101 HCPCS	Tenecteplase Inj [50 Mg]	10	$6,397.81	$9,842.78	$9,744.35	nat. median $3,787 outlier · 2.6×
59409 HCPCS	Vaginal Delivery	11	$1,048.45	$1,613.00	$1,613.00	nat. median $3,148 0.5× median
36011 HCPCS	Selective Cath Placement	9	$151.05	$1,598.00	$1,598.00	nat. median $1,251 1.3× median
J0714 HCPCS	Ceftazidime & Avibactam Inj [2.5 Gm]	10	$711.10	$1,094.00	$1,083.06	nat. median $385 outlier · 2.8×
J0561 HCPCS	Penicillin G Benz Inj [1.2 Mmu/2 Ml]	10	$705.90	$1,086.00	$1,075.14	nat. median $245 outlier · 4.4×
99291 HCPCS	Critical Care	11	$183.89	$1,800.00	$990.00	nat. median $1,530 0.6× median
51045 HCPCS	Cystotomy With Insertion	9	$500.83	$980.00	$980.00	nat. median $2,205 outlier · 0.4×
90651 HCPCS	Vac - Hpv 9-valent Recomb Inj [0.5 Ml]	11	$595.40	$916.00	$916.00	nat. median $407 outlier · 2.3×
90677 HCPCS	Vac - Pneumococcal 20-val Conj [0.5 Ml]	11	$495.95	$763.00	$763.00	nat. median $403 1.9× median
J1610 HCPCS	Glucagon Emerg Kit [1 Mg]	10	$481.67	$741.03	$733.62	nat. median $363 outlier · 2.0×
27560 HCPCS	Kneecap Dislocation Lt	11	$465.40	$716.00	$716.00	nat. median $476 1.5× median
17106 HCPCS	Destruct Lesions < 10 Cm	9	$262.32	$674.00	$674.00	nat. median $523 1.3× median
90670 HCPCS	Vac - Pneumococcal 13-val Conj [0.5 Ml]	11	$257.99	$667.50	$654.15	nat. median $299 outlier · 2.2×
12034 HCPCS	Profee Rpr Interm S/a/t/e 7.6 Cm-12.5 Cm	9	$197.44	$651.00	$651.00	nat. median $582 1.1× median
93225 HCPCS	Holter Monitor	11	$417.30	$642.00	$642.00	nat. median $239 outlier · 2.7×
13121 HCPCS	Lac Rpr Cmplx S/a/l 2.6-7.5 Cm	11	$184.04	$833.00	$628.91	nat. median $780 0.8× median
93350 HCPCS	US Stress Echocardiography	11	$387.89	$596.75	$596.75	nat. median $805 0.7× median
11012 HCPCS	Debridement Skin/muscle	9	$398.17	$577.80	$577.80	nat. median $2,794 outlier · 0.2×
12042 HCPCS	Lac Rpr Interm N/h/f/xtrnl Gent 2.6-7.5	9	$184.75	$565.00	$565.00	nat. median $541 1.0× median
26700 HCPCS	Clsd Tx Metacarpophalangeal Dis, Single	11	$370.50	$570.00	$558.60	nat. median $403 1.4× median
93312 HCPCS	US Transesophg Echo	11	$358.05	$550.85	$550.85	nat. median $943 0.6× median
10121 HCPCS	Removal Forgnbody/complex	9	$188.08	$538.00	$538.00	nat. median $1,664 outlier · 0.3×
A4690 HCPCS	Quick Trach Adult/pedia	11	$337.02	$518.49	$518.49	nat. median $328 1.6× median
84433 HCPCS	S/o Thiopurine Methyltransferase (tpmt)	11	$30.37	$585.00	$503.10	nat. median $45 outlier · 11.2×
90733 HCPCS	Vac - Meningococcal Acwy [0.5 Ml]	11	$325.00	$719.00	$500.00	nat. median $178 outlier · 2.8×
26725 HCPCS	Fx /dislo W Manip Finger Or Toe	11	$199.41	$660.00	$498.30	nat. median $428 1.2× median
J0695 HCPCS	Zerbaxa Inj [1.5 G]	11	$320.45	$493.00	$493.00	nat. median $71 outlier · 6.9×
31525 HCPCS	Laryngoscope Excl Nb	9	$151.44	$489.00	$489.00	nat. median $1,955 outlier · 0.3×
23650 HCPCS	Treat Shold Disloc	11	$107.50	$620.00	$468.10	nat. median $476 1.0× median
20610 HCPCS	Arthrocentesis Major Jt	11	$43.76	$600.00	$453.00	nat. median $395 1.1× median
A7041 HCPCS	Chestdrain Tubes	11	$292.82	$450.50	$450.50	nat. median $128 outlier · 3.5×
90750 HCPCS	Vac - Zoster Recomb Adj [0.5 Ml]	10	$285.68	$439.50	$435.11	nat. median $233 1.9× median
88241 HCPCS	S/o Chromosonal Studies	11	$16.56	$494.35	$425.14	nat. median $13 outlier · 32.0×
93880 HCPCS	US Duplex Scan/extracranial	11	$289.25	$513.60	$409.40	nat. median $531 0.8× median
93975 HCPCS	US Comp Dplx Organ Inflow	11	$268.37	$459.05	$404.62	nat. median $564 0.7× median
32551 HCPCS	Chest Tube Kit	11	$157.62	$623.25	$400.00	nat. median $1,573 outlier · 0.3×
11423 HCPCS	Exc Lesion 2.1-3.0cm	9	$157.01	$394.00	$394.00	nat. median $1,605 outlier · 0.2×
93930 HCPCS	US V/s Venous Upper Extremity Bilateral	11	$296.27	$455.80	$391.99	nat. median $482 0.8× median
J0885 HCPCS	Epoetin Alfa Inj [10000 Unit/ml]	10	$257.08	$395.50	$391.54	nat. median $203 1.9× median
11403 HCPCS	Removal Of Lesion 2.1-3.0	9	$148.04	$377.00	$377.00	nat. median $774 outlier · 0.5×
11983 HCPCS	Removal/insert Drug Implant	9	$98.00	$374.08	$374.08	nat. median $454 0.8× median
90707 HCPCS	Vac - Mmr Inj [0.5 Ml) Clinic	11	$242.12	$372.50	$372.50	nat. median $145 outlier · 2.6×
90716 HCPCS	Vac - Varicella Live [0.5 Ml]	11	$241.48	$371.50	$371.50	nat. median $249 1.5× median
11442 HCPCS	Exc Lesion,1-2.0cm	9	$144.04	$368.00	$368.00	nat. median $766 outlier · 0.5×
16030 HCPCS	Dress / Thickness Burn More Than 10%	11	$238.55	$367.00	$367.00	nat. median $482 0.8× median
36680 HCPCS	Needle Ez-io 45mm 15 G	11	$47.12	$563.00	$363.00	nat. median $430 0.8× median
29445 HCPCS	App Rigit Tot Cont Leg Cast,bilateral Procedure	9	$149.71	$360.70	$360.70	nat. median $389 0.9× median
0110 RC		2	$306.70	$405.79	$356.25	nat. median $961 outlier · 0.4×
12005 HCPCS	Lac Simp Rrp S/n/a/g/trk 12.6-20.0 Cm	11	$99.04	$360.00	$352.80	nat. median $507 0.7× median
10080 HCPCS	I&d Of Pilonidal Cyst Simple	9	$114.47	$350.00	$350.00	nat. median $693 0.5× median

Other procedures at this hospital

Browse this hospital's 980 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

J3101	HCPCS	Tenecteplase Inj [50 Mg]	10	10	$9,842.78	$9,842.78	$6,397.81	$9,842.78	$9,744.35	2026-07-19
59409	HCPCS	Vaginal Delivery	11	11	$1,613.00	$1,613.00	$1,048.45	$1,613.00	$1,613.00	2026-07-19
36011	HCPCS	Selective Cath Placement	9	9	$1,598.00	$1,598.00	$151.05	$1,598.00	$1,598.00	2026-07-19
J0714	HCPCS	Ceftazidime & Avibactam Inj [2.5 Gm]	10	10	$1,094.00	$1,094.00	$711.10	$1,094.00	$1,083.06	2026-07-19
J0561	HCPCS	Penicillin G Benz Inj [1.2 Mmu/2 Ml]	10	10	$1,086.00	$1,086.00	$705.90	$1,086.00	$1,075.14	2026-07-19
99291	HCPCS	Critical Care	20	11	$1,800.00	$1,800.00	$183.89	$1,800.00	$990.00	2026-07-19
51045	HCPCS	Cystotomy With Insertion	9	9	$980.00	$980.00	$500.83	$980.00	$980.00	2026-07-19
90651	HCPCS	Vac - Hpv 9-valent Recomb Inj [0.5 Ml]	11	11	$916.00	$916.00	$595.40	$916.00	$916.00	2026-07-19
90677	HCPCS	Vac - Pneumococcal 20-val Conj [0.5 Ml]	11	11	$763.00	$763.00	$495.95	$763.00	$763.00	2026-07-19
J1610	HCPCS	Glucagon Emerg Kit [1 Mg]	10	10	$741.03	$741.03	$481.67	$741.03	$733.62	2026-07-19
27560	HCPCS	Kneecap Dislocation Lt	11	11	$716.00	$716.00	$465.40	$716.00	$716.00	2026-07-19
17106	HCPCS	Destruct Lesions < 10 Cm	9	9	$674.00	$674.00	$262.32	$674.00	$674.00	2026-07-19
90670	HCPCS	Vac - Pneumococcal 13-val Conj [0.5 Ml]	11	11	$667.50	$667.50	$257.99	$667.50	$654.15	2026-07-19
12034	HCPCS	Profee Rpr Interm S/a/t/e 7.6 Cm-12.5 Cm	9	9	$651.00	$651.00	$197.44	$651.00	$651.00	2026-07-19
93225	HCPCS	Holter Monitor	11	11	$642.00	$642.00	$417.30	$642.00	$642.00	2026-07-19
13121	HCPCS	Lac Rpr Cmplx S/a/l 2.6-7.5 Cm	20	11	$833.00	$833.00	$184.04	$833.00	$628.91	2026-07-19
93350	HCPCS	US Stress Echocardiography	11	11	$596.75	$596.75	$387.89	$596.75	$596.75	2026-07-19
11012	HCPCS	Debridement Skin/muscle	9	9	$577.80	$577.80	$398.17	$577.80	$577.80	2026-07-19
12042	HCPCS	Lac Rpr Interm N/h/f/xtrnl Gent 2.6-7.5	9	9	$565.00	$565.00	$184.75	$565.00	$565.00	2026-07-19
26700	HCPCS	Clsd Tx Metacarpophalangeal Dis, Single	13	11	$570.00	$570.00	$370.50	$570.00	$558.60	2026-07-19
93312	HCPCS	US Transesophg Echo	11	11	$550.85	$550.85	$358.05	$550.85	$550.85	2026-07-19
10121	HCPCS	Removal Forgnbody/complex	9	9	$538.00	$538.00	$188.08	$538.00	$538.00	2026-07-19
A4690	HCPCS	Quick Trach Adult/pedia	11	11	$518.49	$518.49	$337.02	$518.49	$518.49	2026-07-19
84433	HCPCS	S/o Thiopurine Methyltransferase (tpmt)	11	11	$585.00	$585.00	$30.37	$585.00	$503.10	2026-07-19
90733	HCPCS	Vac - Meningococcal Acwy [0.5 Ml]	22	11	$609.50	$609.50	$325.00	$719.00	$500.00	2026-07-19
26725	HCPCS	Fx /dislo W Manip Finger Or Toe	20	11	$660.00	$660.00	$199.41	$660.00	$498.30	2026-07-19
J0695	HCPCS	Zerbaxa Inj [1.5 G]	11	11	$493.00	$493.00	$320.45	$493.00	$493.00	2026-07-19
31525	HCPCS	Laryngoscope Excl Nb	9	9	$489.00	$489.00	$151.44	$489.00	$489.00	2026-07-19
23650	HCPCS	Treat Shold Disloc	20	11	$620.00	$620.00	$107.50	$620.00	$468.10	2026-07-19
20610	HCPCS	Arthrocentesis Major Jt	20	11	$600.00	$600.00	$43.76	$600.00	$453.00	2026-07-19
A7041	HCPCS	Chestdrain Tubes	11	11	$450.50	$450.50	$292.82	$450.50	$450.50	2026-07-19
90750	HCPCS	Vac - Zoster Recomb Adj [0.5 Ml]	10	10	$439.50	$439.50	$285.68	$439.50	$435.11	2026-07-19
88241	HCPCS	S/o Chromosonal Studies	11	11	$494.35	$494.35	$16.56	$494.35	$425.14	2026-07-19
93880	HCPCS	US Duplex Scan/extracranial	22	11	$479.30	$390.30	$289.25	$513.60	$409.40	2026-07-19
93975	HCPCS	US Comp Dplx Organ Inflow	18	11	$459.05	$459.05	$268.37	$459.05	$404.62	2026-07-19
32551	HCPCS	Chest Tube Kit	20	11	$400.00	$400.00	$157.62	$623.25	$400.00	2026-07-19
11423	HCPCS	Exc Lesion 2.1-3.0cm	9	9	$394.00	$394.00	$157.01	$394.00	$394.00	2026-07-19
93930	HCPCS	US V/s Venous Upper Extremity Bilateral	11	11	$455.80	$455.80	$296.27	$455.80	$391.99	2026-07-19
J0885	HCPCS	Epoetin Alfa Inj [10000 Unit/ml]	10	10	$395.50	$395.50	$257.08	$395.50	$391.54	2026-07-19
11403	HCPCS	Removal Of Lesion 2.1-3.0	9	9	$377.00	$377.00	$148.04	$377.00	$377.00	2026-07-19
11983	HCPCS	Removal/insert Drug Implant	9	9	$374.08	$374.08	$98.00	$374.08	$374.08	2026-07-19
90707	HCPCS	Vac - Mmr Inj [0.5 Ml) Clinic	11	11	$372.50	$372.50	$242.12	$372.50	$372.50	2026-07-19
90716	HCPCS	Vac - Varicella Live [0.5 Ml]	11	11	$371.50	$371.50	$241.48	$371.50	$371.50	2026-07-19
11442	HCPCS	Exc Lesion,1-2.0cm	9	9	$368.00	$368.00	$144.04	$368.00	$368.00	2026-07-19
16030	HCPCS	Dress / Thickness Burn More Than 10%	11	11	$367.00	$367.00	$238.55	$367.00	$367.00	2026-07-19
36680	HCPCS	Needle Ez-io 45mm 15 G	33	11	$363.00	$363.00	$47.12	$563.00	$363.00	2026-07-19
29445	HCPCS	App Rigit Tot Cont Leg Cast,bilateral Procedure	9	9	$360.70	$360.70	$149.71	$360.70	$360.70	2026-07-19
0110	RC	—	2	2	$471.85	$471.85	$306.70	$405.79	$356.25	2026-07-19
12005	HCPCS	Lac Simp Rrp S/n/a/g/trk 12.6-20.0 Cm	13	11	$360.00	$360.00	$99.04	$360.00	$352.80	2026-07-19
10080	HCPCS	I&d Of Pilonidal Cyst Simple	9	9	$350.00	$350.00	$114.47	$350.00	$350.00	2026-07-19
90732	HCPCS	Vac - Pneumococcal 20 [0.5 Ml] State	11	11	$349.00	$349.00	$226.85	$349.00	$349.00	2026-07-19
11422	HCPCS	Exc Lesion 1.1-2.0 Cm	9	9	$346.00	$346.00	$135.68	$346.00	$346.00	2026-07-19
99285	HCPCS	Emergency Room/level V	20	11	$345.00	$345.00	$189.75	$525.00	$338.10	2026-07-19
26160	HCPCS	Removal Of Ganglion Cyst	9	9	$333.85	$333.85	$287.11	$335.62	$333.85	2026-07-19
83993	HCPCS	Calprotectin, Fecal	11	11	$385.00	$385.00	$26.90	$385.00	$331.10	2026-07-19
11441	HCPCS	Exc Les,face.6cm To 1.0cm	9	9	$329.00	$329.00	$131.13	$329.00	$329.00	2026-07-19
76817	HCPCS	US OB Trans Vag	11	11	$380.00	$380.00	$131.99	$380.00	$326.80	2026-07-19
J1055	HCPCS	Medroxyprogesterone Inj [150 Mg/ml]	11	11	$324.00	$324.00	$210.60	$324.00	$324.00	2026-07-19
99205	HCPCS	New Patient - Comp	9	9	$323.00	$323.00	$277.78	$323.00	$323.00	2026-07-19
87799	HCPCS	S/0 Polymavirus Bk Quantitation	11	11	$375.14	$375.14	$58.69	$375.14	$322.62	2026-07-19
B4034	HCPCS	Dobbhoff Feeding Tube	11	11	$322.45	$322.45	$209.59	$322.45	$322.45	2026-07-19
41250	HCPCS	Profee Rpr M/t 2.5 Cm < 2/3 Tong	9	9	$321.00	$321.00	$181.20	$321.00	$321.00	2026-07-19
92960	HCPCS	Cardiover Elect Electri	11	11	$314.00	$314.00	$204.10	$314.00	$314.00	2026-07-19
93306	HCPCS	US Echo 2d W/color Flow	22	11	$393.50	$393.50	$193.70	$489.00	$307.93	2026-07-19
11421	HCPCS	Exc Les Nk,hd,ft.0.6-1.0	9	9	$307.00	$307.00	$108.19	$307.00	$307.00	2026-07-19
93978	HCPCS	US Duplex Scan Of Aorta Inferior Vena	11	11	$312.15	$312.15	$202.90	$312.15	$304.57	2026-07-19
93970	HCPCS	US Bilateral Dplx Sc Venous	29	11	$472.50	$472.50	$155.90	$513.60	$304.57	2026-07-19
76700	HCPCS	US Comp Abdm Realtime B-scan	11	11	$350.00	$350.00	$131.99	$350.00	$301.00	2026-07-19
11750	HCPCS	Nail Removal Complex	20	11	$350.00	$350.00	$103.46	$350.00	$301.00	2026-07-19
10120	HCPCS	Removal Foreign Body	13	11	$300.00	$300.00	$111.36	$300.00	$294.00	2026-07-19
11401	HCPCS	Exc Lesion, 0.6cm-1.0cm	9	9	$293.00	$293.00	$103.22	$293.00	$293.00	2026-07-19
16025	HCPCS	Dress / Thick Burn 5-10 %	11	11	$290.00	$290.00	$188.50	$290.00	$290.00	2026-07-19
G0378	HCPCS	Observation/per Day	11	11	$288.90	$288.90	$187.78	$288.90	$288.90	2026-07-19
76770	HCPCS	US Aorta Abdominal Echo	32	11	$301.75	$301.75	$131.99	$337.70	$287.11	2026-07-19
99215	HCPCS	Telemed Established Comprehensive	11	11	$285.00	$285.00	$185.25	$285.00	$285.00	2026-07-19
93979	HCPCS	US Lts F/y Dplx Vasc	11	11	$330.50	$330.50	$133.99	$330.50	$284.23	2026-07-19
76830	HCPCS	US Pelvic Trans Vag	11	11	$330.00	$330.00	$131.99	$330.00	$283.80	2026-07-19
17004	HCPCS	Destruction Facial Lesions 15 >	9	9	$282.00	$282.00	$90.93	$282.00	$282.00	2026-07-19
G0389	HCPCS	US Abdomen (limited)	11	11	$280.00	$280.00	$182.00	$280.00	$280.00	2026-07-19
93925	HCPCS	US Art Unilat Lower Ext	23	11	$428.85	$428.85	$155.90	$428.85	$278.75	2026-07-19
93926	HCPCS	US Art Unilat Ext	11	11	$321.00	$321.00	$133.99	$321.00	$276.06	2026-07-19
93886	HCPCS	US Comp Transcranial Doppler	11	11	$275.40	$275.40	$179.01	$275.40	$275.40	2026-07-19
83013	HCPCS	H-pylori-breath	11	11	$320.00	$320.00	$92.28	$320.00	$275.20	2026-07-19
93923	HCPCS	US Com Scan /lower Ext	33	11	$320.00	$320.00	$197.14	$395.45	$275.20	2026-07-19
76856	HCPCS	US Pelv Realtime B Scan	18	11	$279.90	$279.90	$137.30	$321.00	$274.30	2026-07-19
93976	HCPCS	US Ltd F/y Fplx Org	11	11	$312.15	$312.15	$133.99	$312.15	$268.45	2026-07-19
93971	HCPCS	US Unilateral Venous Scan	11	11	$312.15	$312.15	$133.99	$312.15	$268.45	2026-07-19
76705	HCPCS	US Gallbaldder Ultrasound	32	11	$295.30	$295.30	$131.99	$321.00	$265.01	2026-07-19
43754	HCPCS	Gastric Intubation ER Single	11	11	$260.00	$260.00	$169.00	$260.00	$260.00	2026-07-19
13122	HCPCS	Profee Rpr Cmplx S/a/l/ Ea Addit 5cm <	9	9	$259.94	$259.94	$74.84	$259.94	$259.94	2026-07-19
11982	HCPCS	Remove Drug Implant Device	9	9	$259.20	$259.20	$69.64	$259.20	$259.20	2026-07-19
17111	HCPCS	Destruction Lesion 15 >	9	9	$257.00	$257.00	$80.63	$257.00	$257.00	2026-07-19
26770	HCPCS	Clsd Tx, Interphalangeal Joint,1 W/manip	28	11	$256.80	$256.80	$189.20	$333.71	$256.80	2026-07-19
46320	HCPCS	Incision Ext Hemorrhoid	9	9	$256.05	$256.05	$118.34	$256.05	$256.05	2026-07-19
76536	HCPCS	US Thyroid Ultrasound	18	11	$280.35	$280.35	$131.99	$280.35	$254.80	2026-07-19
93882	HCPCS	US Ltd F/u Dplx Cranial	11	11	$293.80	$293.80	$133.99	$293.80	$252.67	2026-07-19
99222	HCPCS	Profee Initial Ip Care	9	9	$247.80	$247.80	$129.62	$247.80	$247.80	2026-07-19
29365	HCPCS	App Cyl Cast Thigh-ankle	9	9	$246.25	$246.25	$89.69	$246.25	$246.25	2026-07-19
11400	HCPCS	Removal/skin Lesion1st	9	9	$245.00	$245.00	$83.31	$245.00	$245.00	2026-07-19
76775	HCPCS	US Ltd F/y Reftoperi Realt	11	11	$280.00	$280.00	$131.99	$280.00	$240.80	2026-07-19
11420	HCPCS	Exc Lesion 0.5 Cm Or<	9	9	$240.00	$240.00	$83.17	$240.00	$240.00	2026-07-19
93308	HCPCS	US Echocardiogram F/u Or Ltd	11	11	$238.70	$238.70	$155.16	$238.70	$238.70	2026-07-19
30300	HCPCS	Removal Foreign Body; Nose	20	11	$315.00	$315.00	$81.70	$315.00	$237.82	2026-07-19
74400	HCPCS	Xr Pyelogram, IV (ivp)	11	11	$274.00	$274.00	$178.10	$274.00	$235.64	2026-07-19
76870	HCPCS	US Testicle Ultrasound	11	11	$273.50	$273.50	$131.99	$273.50	$235.21	2026-07-19
90698	HCPCS	Vac - Dtap-ipv-hib [0.5 Ml]	11	11	$235.00	$235.00	$152.75	$235.00	$235.00	2026-07-19
11981	HCPCS	Insertion Drug Dlvr Implant	9	9	$234.78	$234.78	$60.35	$234.78	$234.78	2026-07-19
12031	HCPCS	Laceration Scalp	9	9	$231.87	$231.87	$145.88	$231.87	$231.87	2026-07-19
80050	HCPCS	General Health Panel	11	11	$231.15	$231.15	$150.25	$231.15	$231.15	2026-07-19
99284	HCPCS	Emergency Room/level IV	20	11	$234.00	$234.00	$128.70	$420.00	$229.32	2026-07-19
10060	HCPCS	Skin Absess Simple	13	11	$233.00	$233.00	$109.59	$233.00	$228.34	2026-07-19
77073	HCPCS	Xr Long Bones, Series,left	11	11	$261.30	$261.30	$131.99	$261.30	$224.72	2026-07-19
99223	HCPCS	Adm/hospital,high Complex	9	9	$224.70	$224.70	$173.42	$224.70	$224.70	2026-07-19
76881	HCPCS	US Extremity	11	11	$260.00	$260.00	$137.30	$260.00	$223.60	2026-07-19
31500	HCPCS	Endotracheal Intubation	20	11	$284.00	$284.00	$146.97	$284.00	$222.12	2026-07-19
90746	HCPCS	Vac - Hep B Rec Inj - Adult	11	11	$220.00	$220.00	$143.00	$220.00	$220.00	2026-07-19
17110	HCPCS	Destruction Lesion 1-14	9	9	$217.00	$217.00	$67.99	$217.00	$217.00	2026-07-19
86337	HCPCS	Diabetes Autoimmune Profile	11	11	$250.00	$250.00	$29.33	$250.00	$215.00	2026-07-19
99292	HCPCS	Critical Care, Each Additional 30 Minute	20	11	$330.00	$330.00	$111.09	$330.00	$213.83	2026-07-19
29126	HCPCS	App Short Arm Splint D	11	11	$212.20	$212.20	$137.93	$212.20	$212.20	2026-07-19
90744	HCPCS	Vac - Hep B [1 Ml] - Pedi	11	11	$212.00	$212.00	$137.80	$212.00	$212.00	2026-07-19
99214	HCPCS	Established Expanded Detailed	11	11	$211.00	$211.00	$137.15	$211.00	$211.00	2026-07-19
99204	HCPCS	New Pat/ Expanded Detailed	9	9	$211.00	$211.00	$181.46	$211.00	$211.00	2026-07-19
99221	HCPCS	Observation Pro-fee	9	9	$210.60	$210.60	$82.47	$210.60	$210.60	2026-07-19
87507	HCPCS	S/o Gastrointestinal Panel (stool Pcr)	11	11	$209.69	$209.69	$136.30	$209.69	$209.69	2026-07-19
12052	HCPCS	Lac Rpr Interm F/e/e/n/l/m 2.6-5.0 Cm	13	11	$210.00	$210.00	$136.50	$210.00	$205.80	2026-07-19
12014	HCPCS	Lac Simp Rpr F/e/e/n/l/m 5.1 To 7.5 Cm	20	11	$272.13	$272.13	$79.48	$272.13	$205.45	2026-07-19
10061	HCPCS	I&d Complicate	16	9	$205.45	$205.45	$176.69	$405.00	$205.45	2026-07-19
11102	HCPCS	Shave Biopsy	9	9	$205.00	$205.00	$33.28	$205.00	$205.00	2026-07-19
11104	HCPCS	Skin Biopsy-first	9	9	$205.00	$205.00	$42.13	$205.00	$205.00	2026-07-19
82653	HCPCS	S/o Pancreatic Elastase	11	11	$237.29	$237.29	$31.47	$237.29	$204.07	2026-07-19
11730	HCPCS	Nail Removal Partial/complete ER	31	11	$208.00	$208.00	$53.97	$399.00	$203.84	2026-07-19
76645	HCPCS	US Breast Ultrasound	22	11	$202.85	$202.85	$131.85	$202.85	$202.85	2026-07-19
J0712	HCPCS	Ceftaroline Fosamil [600 Mg]	10	10	$204.50	$204.50	$132.92	$204.50	$202.45	2026-07-19
12004	HCPCS	Lac Simp Rpr S/n/a/g/trk 7.6/12.5 Cm	20	11	$268.00	$268.00	$79.27	$268.00	$202.34	2026-07-19
24600	HCPCS	Tx Of Clsd Elbow Disloc	9	9	$200.00	$200.00	$172.00	$436.52	$200.00	2026-07-19
11402	HCPCS	Removal Skin Les 1.1-2cm	9	9	$200.00	$200.00	$112.07	$200.00	$200.00	2026-07-19
29065	HCPCS	App Should-hand Cast	9	9	$196.70	$196.70	$70.28	$196.70	$196.70	2026-07-19
29085	HCPCS	App Hand&lower Forearmj	9	9	$188.00	$188.00	$69.23	$188.00	$188.00	2026-07-19
84591	HCPCS	S/o Vit B3	11	11	$217.00	$217.00	$23.37	$217.00	$186.62	2026-07-19
0301	RC	—	11	11	$183.00	$183.00	$118.95	$183.00	$183.00	2026-07-19
74420	HCPCS	Xr Petro Pyelogram	11	11	$182.65	$182.65	$118.72	$182.65	$182.65	2026-07-19
87522	HCPCS	S/o Hepatitis C Quant	11	11	$210.00	$210.00	$58.69	$210.00	$180.60	2026-07-19
86361	HCPCS	Helper-t Lymphocyle Marker Cd4	11	11	$209.00	$209.00	$36.69	$209.00	$179.74	2026-07-19
29075	HCPCS	Cast Elbow To Finger Short Arm	9	9	$178.50	$178.50	$64.07	$178.50	$178.50	2026-07-19
30901	HCPCS	Con Nasal Hemor, Simpl	20	11	$235.00	$235.00	$54.95	$235.00	$177.43	2026-07-19
S5520	HCPCS	Pic Line/central Line	11	11	$176.25	$176.25	$114.56	$176.25	$176.25	2026-07-19
0258	RC	—	11	11	$175.50	$175.50	$114.08	$175.50	$175.50	2026-07-19
12013	HCPCS	Lac Simp Rpp F/e/e/n/l/m 2.6-5.0 Cm	13	11	$179.00	$179.00	$61.48	$179.00	$175.42	2026-07-19
76641	HCPCS	US U/s Breast Bilateral	11	11	$202.85	$202.85	$131.85	$202.85	$174.45	2026-07-19
86747	HCPCS	Parvovirus	11	11	$200.00	$200.00	$20.59	$200.00	$172.00	2026-07-19
81252	HCPCS	S/o Connexin 26	11	11	$200.00	$200.00	$130.00	$200.00	$172.00	2026-07-19
80047	HCPCS	Epoc,clia Wave	11	11	$200.00	$200.00	$18.81	$200.00	$172.00	2026-07-19
99195	HCPCS	Therapeutic Phlebotomy	11	11	$170.00	$170.00	$110.50	$170.00	$170.00	2026-07-19
87517	HCPCS	S/o Hep B Virus Quant	25	11	$250.00	$250.00	$58.69	$260.00	$169.00	2026-07-19
85613	HCPCS	Lupus Anticoagulant With Reflex	18	11	$169.75	$169.75	$13.12	$394.70	$168.06	2026-07-19
56420	HCPCS	Drainage Of Gland Abscess	9	9	$168.00	$168.00	$109.45	$168.00	$168.00	2026-07-19
0300	RC	—	11	11	$167.75	$167.75	$109.04	$167.75	$167.75	2026-07-19
87636	HCPCS	Flu A, B And Covid,CLIA Wave	11	11	$167.05	$167.05	$108.58	$167.05	$167.05	2026-07-19
93922	HCPCS	Bilateral Nonivasive Extrem Arterial Stu	11	11	$165.55	$165.55	$107.61	$165.55	$165.55	2026-07-19
82777	HCPCS	S/o Gallectin 3	11	11	$165.00	$165.00	$107.25	$165.00	$165.00	2026-07-19
93307	HCPCS	US Echo 2d W/wo	11	11	$163.00	$163.00	$105.95	$163.00	$163.00	2026-07-19
93325	HCPCS	US Color Flow Vel Map	11	11	$163.00	$163.00	$105.95	$163.00	$163.00	2026-07-19
93320	HCPCS	US Doppler Echo	11	11	$163.00	$163.00	$105.95	$163.00	$163.00	2026-07-19
93931	HCPCS	US Ltd F/u Upper Ext	18	11	$227.70	$227.70	$107.61	$227.70	$162.24	2026-07-19
16020	HCPCS	Dress/debrid P-thick Burn 5%	20	11	$161.00	$161.00	$59.35	$235.00	$161.00	2026-07-19
G0168	HCPCS	Dermabond Adhesive	11	11	$158.74	$158.74	$103.18	$158.74	$158.74	2026-07-19
77072	HCPCS	Xr Bone Age Study	11	11	$184.00	$184.00	$119.60	$184.00	$158.24	2026-07-19
76857	HCPCS	US Ltd F/ Pelvic Realt	11	11	$183.60	$183.60	$119.34	$183.60	$157.90	2026-07-19
76999	HCPCS	US Soft Tissue	11	11	$181.50	$181.50	$109.09	$181.50	$156.09	2026-07-19
99152	HCPCS	Mod Sed Initial 15 Min > 5 Yrs Age	11	11	$150.00	$150.00	$97.50	$150.00	$150.00	2026-07-19
12051	HCPCS	Lac Rpr Interm F/e/e/n/l/m 2.5 Cm	12	11	$150.00	$150.00	$97.50	$163.54	$150.00	2026-07-19
92250	HCPCS	Fundus Photography With Interp And Repor	11	11	$150.00	$150.00	$97.50	$150.00	$150.00	2026-07-19
42100	HCPCS	Biopsy Of Palate/Uvula	9	9	$148.50	$148.50	$110.84	$148.50	$148.50	2026-07-19
84445	HCPCS	S/o Tsi	18	11	$151.50	$151.50	$69.68	$172.80	$148.47	2026-07-19
85303	HCPCS	Protein C, Functional	11	11	$169.75	$169.75	$18.96	$169.75	$145.98	2026-07-19
85306	HCPCS	Protein S, Functional	11	11	$169.75	$169.75	$20.99	$169.75	$145.98	2026-07-19
81291	HCPCS	Mthfr Thermolabile Variant, DNA Analysis	11	11	$169.75	$169.75	$89.52	$169.75	$145.98	2026-07-19
81241	HCPCS	Factor V Leiden Mutation Analysis	11	11	$169.75	$169.75	$100.51	$169.75	$145.98	2026-07-19
86000	HCPCS	S/o Febrile Agglutination	11	11	$166.90	$166.90	$9.56	$166.90	$143.53	2026-07-19
90633	HCPCS	Vac - Hep A [0.5 Ml]	22	11	$188.75	$188.75	$75.08	$262.00	$142.90	2026-07-19
94060	HCPCS	Pre/post Bronchodialator	11	11	$142.70	$142.70	$92.76	$142.70	$142.70	2026-07-19
87902	HCPCS	S/o Hcv-RNA Genotype	22	11	$183.70	$183.70	$86.06	$235.00	$142.57	2026-07-19
29515	HCPCS	App Of Short Leg Splint	11	11	$142.00	$142.00	$92.30	$142.00	$142.00	2026-07-19
96365	HCPCS	IV Inf Tx/prop/dx's	12	11	$140.00	$140.00	$91.00	$140.00	$138.60	2026-07-19
E0116	HCPCS	Crutches	11	11	$138.57	$138.57	$90.07	$138.57	$138.57	2026-07-19
82810	HCPCS	Arterial Blood Gases	11	11	$160.50	$160.50	$13.38	$160.50	$138.03	2026-07-19
12041	HCPCS	Lac Rpr Interm N/h/f/xtrnl Gent 2.5 Cm <	20	11	$136.95	$136.95	$89.02	$464.00	$136.95	2026-07-19
16000	HCPCS	Dress / 1st Degree Burn / Localonly	11	11	$136.00	$136.00	$88.40	$136.00	$136.00	2026-07-19
12001	HCPCS	Lac Simp Rpr S/n/a/g/trk 2.5.cm <	20	11	$178.00	$178.00	$48.41	$178.00	$134.39	2026-07-19
12032	HCPCS	Profee Rpr Interm S/a/t/e 2.6 - 7.5 Cm	9	9	$134.20	$134.20	$115.41	$180.75	$134.20	2026-07-19
93888	HCPCS	US Ltd F/u	11	11	$137.70	$137.70	$89.50	$137.70	$133.99	2026-07-19
L4386	HCPCS	Pro Step Walker Boot	11	11	$133.51	$133.51	$86.78	$133.51	$133.51	2026-07-19
86162	HCPCS	S/o Complement Ch100	11	11	$154.40	$154.40	$27.84	$154.40	$132.78	2026-07-19
83498	HCPCS	S/o 17-oh-progesterone	11	11	$154.10	$154.10	$37.22	$154.10	$132.53	2026-07-19
70260	HCPCS	Xr Skull Complete Series	27	11	$164.55	$164.55	$14.44	$181.05	$131.99	2026-07-19
72082	HCPCS	Scoliosis Series 2v,professional Component	9	9	$279.00	$279.00	$16.61	$279.00	$131.99	2026-07-19
70150	HCPCS	Xr Facial Bones Complete,lt,left	40	11	$205.45	$205.45	$13.68	$205.45	$131.99	2026-07-19
70130	HCPCS	Xr Mastoid Series	11	11	$142.40	$142.40	$92.56	$142.40	$131.99	2026-07-19
82373	HCPCS	S/o Carbohydrate Deficient	11	11	$151.50	$151.50	$24.75	$151.50	$130.29	2026-07-19
80235	HCPCS	Lacosamide	11	11	$150.00	$150.00	$37.14	$150.00	$129.00	2026-07-19
86615	HCPCS	S/o B Pertussis Ab	11	11	$150.00	$150.00	$18.07	$150.00	$129.00	2026-07-19
12053	HCPCS	Prof Rpr Interm F/e/e/n/l/muc 5.1-7.5 Cm	9	9	$128.40	$128.40	$110.42	$205.31	$128.40	2026-07-19
99386	HCPCS	Compre Preventive Med	11	11	$128.40	$128.40	$83.46	$128.40	$128.40	2026-07-19
96369	HCPCS	IV Sub Q Inf Initial Up To 1hr W/pump	22	11	$185.36	$185.36	$25.02	$332.22	$127.22	2026-07-19
70120	HCPCS	Xr Mastoid 2 Views	11	11	$127.10	$127.10	$82.62	$127.10	$127.10	2026-07-19
93000	HCPCS	Ekg/interp/report	11	11	$126.30	$126.30	$82.10	$126.30	$126.30	2026-07-19
55000	HCPCS	Punct Aspirat Hydrocele	9	9	$126.10	$126.10	$84.88	$126.10	$126.10	2026-07-19
29505	HCPCS	App/long Leg Splint	20	11	$167.00	$167.00	$59.65	$167.00	$126.09	2026-07-19
86757	HCPCS	Rickettsia Typhi Antibodies, IgG	11	11	$146.61	$146.61	$26.51	$146.61	$126.08	2026-07-19
86235	HCPCS	S/0 Anti Smith Antibodies	25	11	$152.00	$152.00	$24.56	$193.25	$125.61	2026-07-19
12015	HCPCS	Lac Simp Rpr F/e/e/n/l/m 7.6/12.5 Cm	20	11	$150.00	$150.00	$97.50	$150.00	$125.50	2026-07-19
29105	HCPCS	Appl/long Arm Splint(shoulder To Hand)	13	11	$128.00	$128.00	$41.57	$128.00	$125.44	2026-07-19
20553	HCPCS	Trigger Point 3/>muscle	9	9	$125.00	$125.00	$44.84	$125.00	$125.00	2026-07-19
80061	HCPCS	Lipid Profile	22	11	$145.10	$145.10	$18.35	$145.10	$124.79	2026-07-19
J3430	HCPCS	Phytonadione Inj [10 Mg/ml]	11	11	$124.00	$124.00	$80.60	$124.00	$124.00	2026-07-19
A4562	HCPCS	Pessaries #5	22	11	$128.80	$128.80	$80.60	$133.59	$124.00	2026-07-19
92950	HCPCS	Heart/lung Resuscitation	42	11	$123.65	$123.65	$72.05	$598.00	$123.65	2026-07-19
L8603	HCPCS	Pressary Kit	11	11	$123.50	$123.50	$80.28	$123.50	$123.50	2026-07-19
80180	HCPCS	S/o Cellcept	11	11	$143.25	$143.25	$24.73	$143.25	$123.20	2026-07-19
12002	HCPCS	Lac Simp Rrp S/n/a/g/trk 2.6-7.5 Cm	14	11	$122.00	$122.00	$63.16	$122.00	$120.78	2026-07-19
99283	HCPCS	Emergency Room/level Iii	20	11	$123.00	$123.00	$67.65	$315.00	$120.54	2026-07-19
87798	HCPCS	Bacterial Vaginosis, Naa	19	11	$122.82	$122.82	$48.07	$150.00	$120.36	2026-07-19
82491	HCPCS	S/o Levetiracetam	22	11	$127.50	$127.50	$76.70	$137.00	$118.00	2026-07-19
L3003	HCPCS	Ankle Brace Gel	11	11	$116.85	$116.85	$75.95	$116.85	$116.85	2026-07-19
11000	HCPCS	Debridement Of Infected Skin	9	9	$115.55	$115.55	$27.13	$115.55	$115.55	2026-07-19
93875	HCPCS	US Ex/cranial Phys Studies	11	11	$115.55	$115.55	$75.11	$115.55	$115.55	2026-07-19
97602	HCPCS	Nsw Debridem Without A/sessio	11	11	$115.49	$115.49	$75.07	$115.49	$115.49	2026-07-19
65220	HCPCS	Removal Fgn Body Eye	27	11	$117.00	$117.00	$41.54	$195.00	$114.66	2026-07-19
30903	HCPCS	Celox	53	11	$115.00	$115.00	$6.50	$300.00	$114.50	2026-07-19
87389	HCPCS	HIV-p24 Anti W/refex,clia Wave	11	11	$133.00	$133.00	$32.99	$133.00	$114.38	2026-07-19
86790	HCPCS	S/o Hantavirus	18	11	$174.91	$174.91	$17.65	$174.91	$112.70	2026-07-19
82951	HCPCS	Glucose Tolerance 3 Hr,clia Wave	39	11	$134.80	$134.80	$17.63	$147.25	$112.15	2026-07-19
A4556	HCPCS	Electrodes Lf Pac / Combos	44	11	$116.12	$116.12	$51.19	$124.00	$112.05	2026-07-19
L1810	HCPCS	Hinged Knee Sm Patella	44	11	$117.92	$117.92	$6.96	$124.37	$111.60	2026-07-19
89051	HCPCS	S/o Cell Count,synovial Fluid W/crystal	11	11	$129.00	$129.00	$7.67	$129.00	$110.94	2026-07-19
92977	HCPCS	Dissolve Clot/ IV Infus	11	11	$109.54	$109.54	$71.20	$109.54	$109.54	2026-07-19
70030	HCPCS	Xr Eye/foreign Body, Lt,left	22	11	$126.40	$126.40	$82.16	$126.40	$109.09	2026-07-19
20552	HCPCS	Trigger Point 1-2 Muscles	16	9	$231.87	$231.87	$39.34	$231.87	$109.00	2026-07-19
84022	HCPCS	S/o Perphenazine	11	11	$107.70	$107.70	$70.00	$107.70	$107.70	2026-07-19
86800	HCPCS	S/o Anti Thyroglobulin Ab	11	11	$124.85	$124.85	$21.80	$124.85	$107.37	2026-07-19
73030	HCPCS	Xr Shoulder (2v), Rt,right	54	11	$109.15	$109.15	$9.98	$160.50	$107.14	2026-07-19
B4087	HCPCS	Esophageal Combitube 37fr	33	11	$107.00	$107.00	$2.95	$176.40	$107.00	2026-07-19
73590	HCPCS	Xr Leg 2 Views Lt,left	40	11	$160.50	$160.50	$8.51	$160.50	$106.70	2026-07-19
71101	HCPCS	Xr Ribs Posteroant/chest 3 Views Lt,left	40	11	$141.25	$141.25	$14.04	$141.25	$106.65	2026-07-19
11440	HCPCS	Rem Les Face 0.5cm/less	17	9	$365.00	$365.00	$23.09	$365.00	$106.44	2026-07-19
20550	HCPCS	Trigger Point Tendon / Ligament	9	9	$105.00	$105.00	$36.97	$105.00	$105.00	2026-07-19
51702	HCPCS	Insert Temp Indwelling Foley Catheter	20	11	$126.00	$126.00	$25.11	$126.00	$104.18	2026-07-19
87493	HCPCS	C-diff Pcr	11	11	$121.07	$121.07	$51.06	$121.07	$104.12	2026-07-19
84135	HCPCS	S/o Pregnanediol-urine	11	11	$120.05	$120.05	$29.14	$120.05	$103.24	2026-07-19
83858	HCPCS	S/o Methsuxamine	11	11	$103.00	$103.00	$66.95	$103.00	$103.00	2026-07-19
70210	HCPCS	Xr Sinuses 3 Views	22	11	$105.93	$105.93	$66.76	$109.15	$102.70	2026-07-19
84145	HCPCS	S/o Procalcitonin	11	11	$119.00	$119.00	$37.29	$119.00	$102.34	2026-07-19
73000	HCPCS	Xr Clavicle 1 View, Lt,left	62	11	$102.10	$102.10	$8.86	$128.55	$102.10	2026-07-19
83880	HCPCS	S/o B-natiuretic Peptide,clia Wave	18	11	$102.70	$102.70	$53.79	$165.00	$101.68	2026-07-19
73130	HCPCS	Xr Hand 3 Views Lt,left	40	11	$145.00	$145.00	$9.60	$145.00	$101.67	2026-07-19
J2720	HCPCS	Protamine Inj [10 Mg/ml]	11	11	$100.50	$100.50	$65.32	$100.50	$100.50	2026-07-19
74410	HCPCS	Interp Of Ivp-drip Infus	18	9	$100.00	$100.00	$25.54	$100.00	$100.00	2026-07-19
11057	HCPCS	Paring Or Cutting B9 >4	9	9	$100.00	$100.00	$28.27	$100.00	$100.00	2026-07-19
28470	HCPCS	Clsd Tx Metatar Without Mani	9	9	$100.00	$100.00	$86.00	$226.58	$100.00	2026-07-19
28430	HCPCS	Clsd Tx Talus Fx Without Mani	9	9	$100.00	$100.00	$86.00	$235.35	$100.00	2026-07-19
25675	HCPCS	Clsd Tx Distal Radioular	9	9	$100.00	$100.00	$86.00	$530.54	$100.00	2026-07-19
24640	HCPCS	Clsd Tx Radial Head	9	9	$100.00	$100.00	$78.66	$100.00	$100.00	2026-07-19
25600	HCPCS	Clsd Tx Dist Rad Fx Without M	9	9	$100.00	$100.00	$86.00	$370.05	$100.00	2026-07-19
23540	HCPCS	Clsd Tx Acromioclavicwoma	9	9	$100.00	$100.00	$86.00	$278.28	$100.00	2026-07-19
20605	HCPCS	Drain/inj JOINT/BURSA/without US	20	11	$100.00	$100.00	$35.42	$119.00	$100.00	2026-07-19
80076	HCPCS	Liver Profile Studies	11	11	$115.20	$115.20	$11.19	$115.20	$99.07	2026-07-19
70328	HCPCS	Xr Tempromandibular Open & Closed	20	11	$136.30	$136.30	$9.61	$136.30	$98.84	2026-07-19
70200	HCPCS	Xr Eye, Lt 4 Views,left	40	11	$130.65	$130.65	$14.44	$130.65	$98.64	2026-07-19
99231	HCPCS	Profee Subsequent Ip Care	9	9	$98.45	$98.45	$48.93	$98.45	$98.45	2026-07-19
73552	HCPCS	Xr Femur 2 View, Lt,left	40	11	$134.20	$134.20	$9.61	$134.20	$98.16	2026-07-19
80307	HCPCS	S/o Drug Quant Unspecified	19	11	$250.00	$250.00	$65.00	$250.00	$98.00	2026-07-19
82544	HCPCS	S/o Zonegran-cc	11	11	$98.00	$98.00	$63.70	$98.00	$98.00	2026-07-19
73660	HCPCS	Xr Toe 2nd Lt 2 Views,left	40	11	$133.55	$133.55	$7.02	$133.55	$97.95	2026-07-19
87045	HCPCS	S/o Culture, Stool	11	11	$113.30	$113.30	$12.94	$113.30	$97.44	2026-07-19
99203	HCPCS	New Pat- Expanded Problem	9	9	$97.00	$97.00	$83.42	$97.00	$97.00	2026-07-19
29125	HCPCS	App/short Arm Splint (forearm To Hand)	20	11	$128.00	$128.00	$38.66	$128.00	$96.64	2026-07-19
11740	HCPCS	Evacuation Sub. Hematoma	13	11	$98.00	$98.00	$34.21	$98.00	$96.04	2026-07-19
11765	HCPCS	Wedge Exc/skin Of Nailbed	9	9	$96.00	$96.00	$82.56	$97.51	$96.00	2026-07-19
E0455	HCPCS	Breathing Tmt/sub F/y	22	11	$134.82	$134.82	$29.22	$224.70	$95.50	2026-07-19
73110	HCPCS	Xr Navicular	62	11	$96.00	$96.00	$9.60	$111.60	$95.03	2026-07-19
20600	HCPCS	Arthrocentesis, Sm. Joint	9	9	$95.00	$95.00	$34.66	$95.00	$95.00	2026-07-19
87521	HCPCS	S/o Hep-c, Amplif Na Probe	11	11	$110.00	$110.00	$48.07	$110.00	$94.60	2026-07-19
72100	HCPCS	Xr Spine Lumbar 2 Views	40	11	$122.00	$122.00	$11.82	$128.00	$94.06	2026-07-19
96360	HCPCS	Hydration IV Infusion Initial	22	11	$116.62	$116.62	$59.80	$141.25	$92.00	2026-07-19
99443	HCPCS	Non Face To Face Ems 21-30 Min,, 0	9	9	$90.00	$54.00 40% off	$77.40	$90.00	$90.00	2026-07-19
99348	HCPCS	Home Visit Est Pt	9	9	$90.00	$90.00	$77.40	$90.00	$90.00	2026-07-19
G0402	HCPCS	Ppps Initial Preventive Exam	9	9	$90.00	$90.00	$77.40	$90.00	$90.00	2026-07-19
99213	HCPCS	Established Expanded Problem	11	11	$90.00	$90.00	$58.50	$90.00	$90.00	2026-07-19
94680	HCPCS	Breathing Treatment	11	11	$89.90	$89.90	$58.44	$89.90	$89.90	2026-07-19
70110	HCPCS	Xr Mandible Compl/minimum 4 Views	22	11	$97.78	$97.78	$58.44	$105.65	$89.90	2026-07-19
73551	HCPCS	Xr Femur 1 View, Lt,left	40	11	$117.95	$117.95	$8.86	$117.95	$89.06	2026-07-19
11056	HCPCS	Bunionectomy 2-4 Lesions	9	9	$89.05	$89.05	$21.94	$89.05	$89.05	2026-07-19
96374	HCPCS	Ivp Single/initial Sbst/drug	12	11	$89.00	$89.00	$57.85	$89.00	$89.00	2026-07-19
83721	HCPCS	Ldl Cholesterol,clia Wave	11	11	$103.00	$103.00	$14.39	$103.00	$88.58	2026-07-19
L4350	HCPCS	Aircast Splint Stand/rt	11	11	$88.45	$88.45	$57.49	$88.45	$88.45	2026-07-19
90713	HCPCS	Vac Ipv State	11	11	$88.00	$88.00	$57.20	$88.00	$88.00	2026-07-19
86431	HCPCS	S/o Rheumatoid Factor Quan	11	11	$101.70	$101.70	$7.77	$101.70	$87.46	2026-07-19
74019	HCPCS	Xr Abdomen 2 Views	40	11	$115.55	$115.55	$11.84	$115.55	$87.24	2026-07-19
73502	HCPCS	Xr Hip Joint 2 View Lt,left	40	11	$115.55	$115.55	$11.82	$115.55	$87.24	2026-07-19

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