Hospital

COGDELL MEMORIAL HOSPITAL

Snyder, TX · CCN 451384 · Rates published

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You selected 45378 (CPT)

Diagnostic exam of large bowel using an endoscope

This hospital’s price: $1,060 across 7 payers · range $132-$3,450

Source: https://secure.claraprice.net/price-transparency/ODBG-1762447756988/machine-readable/752403687_cogdell-memorial-hospital_standardcharges.json · observed 2026-01-21

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.

3,276 distinct procedures filed

7 distinct payers

46,195 rate rows

2026-01-21 last MRF observed

Data quality

46,174 of 46,195 rate rows are consumer-grade (100.0%)

21 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
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	21

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

Source MRF file	https://secure.claraprice.net/price-transparency/ODBG-1762447756988/machine-readable/752403687_cogdell-memorial-hospital_standardcharges.json
Found on page	https://cogdellhospital.com/cms-hpt.txt
Discovered via	CMS hospital list
Last fetch	success · 2026-09-25
Content fingerprint	0dd09b4acd8bb606… · 18,137,283 bytes · first seen 2026-09-25

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
4121800 CDM	Ocrelizumab 300 Mg/10 Ml Sol [Cogd]	7	$23,184.00	$42,584.00	$30,755.00	nat. median $30,755 1.0× median
22566924 CDM	Arthroscopic Ulnohumeral Arthroplasty	7	$18,666.00	$34,284.00	$24,760.00	nat. median $24,760 1.0× median
1184551 CDM	Cholecystectomy Open	7	$14,210.00	$26,100.00	$18,850.00	nat. median $18,850 1.0× median
4121743 CDM	Vedolizumab 300 Mg Rec [Cogd]	7	$10,192.00	$18,720.00	$13,520.00	nat. median $13,520 1.0× median
10555 CDM	Graft Fresh Froz R Fem Head	7	$9,923.00	$18,225.00	$13,163.00	nat. median $13,163 1.0× median
4180484 CDM	Tenecteplase 50 Mg Rec Inj [Cogd]	7	$9,205.00	$16,907.00	$12,211.00	nat. median $12,211 1.0× median
26841 CPT	Arthroplasty Thumb Basilar	7	$7,426.00	$13,640.00	$9,851.00	nat. median $6,890 1.4× median
27700 CPT	Arthroscopy Ankle	7	$7,426.00	$13,640.00	$9,851.00	nat. median $7,011 1.4× median
4180469 CDM	Efgartigimod Alfa 400 Mg/20 Ml Sol [Cogd]	7	$7,280.00	$13,371.00	$9,657.00	nat. median $9,657 1.0× median
4121731 CDM	Leuprolide 22.5 Mg/3 Months Kit[cogd]	7	$7,211.00	$13,245.00	$9,566.00	nat. median $67 outlier · 142.8×
10517 CDM	Infuse Bone Graft 7510400	7	$7,193.00	$13,211.00	$9,541.00	nat. median $7,193 1.3× median
885953 CDM	Arthroscopy Shoulder With Rotator Cuff Repair	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
2095630 CDM	Rotator Cuff Repair Open	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
10289425 CDM	Brostrom Procedure	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
1059682 CDM	Open Reduction Internal Fixation Ankle	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
5663061 CDM	Biceps Tenodesis	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
22566921 CDM	Capitate Shortening Osteotomy	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
22566942 CDM	Open Reduction Internal Fixation Lower Extremity	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
1959655 CDM	Open Reduction Internal Fixation Radius	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
24345480 CDM	Rotator Cuff Repair	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
11574311 CDM	Open Reduction Internal Fixation Radius Distal	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
22566941 CDM	Osteochondral Autograft Trasnfer System	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
1184811 CDM	Arthroscopy Shoulder Bankart	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
1184796 CDM	Open Reduction Internal Fixation Patella	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
22566925 CDM	Arthroscopic Osteochondritis Dissecans Patella / Lateral Femoral Condylectomy Wi…	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
1059684 CDM	Open Reduction Internal Fixation Elbow	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
1059694 CDM	Open Reduction Internal Fixation Clavicle	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
22566948 CDM	Superior Labral Tear From Anterior To Posterior Repair	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
24134294 CDM	Tenodesis	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
22566920 CDM	Third Degree Acromioclavicular Separation With Allograft	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
1184708 CDM	Reconstruction Cruciate Ligament Knee	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
11574314 CDM	Open Reduction Internal Fixation Scaphoid	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
22566943 CDM	Open Reduction Internal Fixation Upper Extremity	7	$6,628.00	$12,174.00	$8,793.00	nat. median $8,793 1.0× median
1184661 CDM	Mastectomy Radical	7	$6,517.00	$11,970.00	$8,645.00	nat. median $8,645 1.0× median
2425538 CDM	Mastectomy Bilateral	7	$6,517.00	$11,970.00	$8,645.00	nat. median $8,645 1.0× median
27447 CPT	27447 Total Knee Arthroplasty	7	$1,127.00	$25,640.00	$8,494.50	nat. median $12,374 0.7× median
4180519 CDM	Immune Globulin 30 Gram Solution 300 Ml Vial [Cogd]	7	$5,980.00	$10,985.00	$7,933.00	nat. median $236 outlier · 33.6×
17832 CDM	Tintrae3030 Surgimesh X B	7	$5,807.00	$10,665.00	$7,703.00	nat. median $180 outlier · 42.8×
995651 CDM	Mastectomy Radical Modified	7	$5,659.00	$10,394.00	$7,507.00	nat. median $7,507 1.0× median
22167095 CDM	Partial Mastectomy	7	$5,610.00	$10,304.00	$7,442.00	nat. median $7,442 1.0× median
22300525 CDM	Lymphadenectomy	7	$5,610.00	$10,304.00	$7,442.00	nat. median $7,442 1.0× median
4129945 CDM	Rituximab 10 Mg/ml Sol[cogd]	7	$5,524.00	$10,147.00	$7,328.00	nat. median $7,328 1.0× median
59510 CPT	Obstetric Care, Planned Cesarean Delivery	7	$3,124.00	$16,230.00	$7,287.00	nat. median $3,349 outlier · 2.2×
55700 CPT	Biopsy Of Prostate Gland	7	$5,371.00	$9,866.00	$7,125.00	nat. median $1,997 outlier · 3.6×
885905 CDM	Cholecystectomy Laparoscopic	7	$5,331.00	$9,791.00	$7,071.00	nat. median $7,071 1.0× median
995560 CDM	Cholecystectomy Laparoscopic With Cholangiogram	7	$5,331.00	$9,791.00	$7,071.00	nat. median $7,071 1.0× median
995674 CDM	Thyroidectomy	7	$5,331.00	$9,791.00	$7,071.00	nat. median $7,071 1.0× median
885892 CDM	Appendectomy Laparoscopic	7	$5,331.00	$9,791.00	$7,071.00	nat. median $7,071 1.0× median
11040 CDM	Patellar Tendon Hemi	7	$5,292.00	$9,720.00	$7,020.00	nat. median $109 outlier · 64.6×
66991 CPT	Cataract Removal W/insertion Of Intraocular Lens; W/insertion Of Anterior Aqueou…	7	$4,363.00	$12,807.00	$7,007.50	nat. median $5,656 1.2× median

Other procedures at this hospital

Browse this hospital's 3,276 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

4121800	CDM	Ocrelizumab 300 Mg/10 Ml Sol [Cogd]	11	7	$47,315.00	$47,315.00	$23,184.00	$42,584.00	$30,755.00	2026-01-21
22566924	CDM	Arthroscopic Ulnohumeral Arthroplasty	11	7	$38,093.00	$38,093.00	$18,666.00	$34,284.00	$24,760.00	2026-01-21
1184551	CDM	Cholecystectomy Open	11	7	$29,000.00	$29,000.00	$14,210.00	$26,100.00	$18,850.00	2026-01-21
4121743	CDM	Vedolizumab 300 Mg Rec [Cogd]	11	7	$20,800.00	$20,800.00	$10,192.00	$18,720.00	$13,520.00	2026-01-21
10555	CDM	Graft Fresh Froz R Fem Head	11	7	$20,250.00	$20,250.00	$9,923.00	$18,225.00	$13,163.00	2026-01-21
4180484	CDM	Tenecteplase 50 Mg Rec Inj [Cogd]	11	7	$18,786.00	$18,786.00	$9,205.00	$16,907.00	$12,211.00	2026-01-21
26841	CPT	Arthroplasty Thumb Basilar	11	7	$15,156.00	$15,156.00	$7,426.00	$13,640.00	$9,851.00	2026-01-21
27700	CPT	Arthroscopy Ankle	11	7	$15,156.00	$15,156.00	$7,426.00	$13,640.00	$9,851.00	2026-01-21
4180469	CDM	Efgartigimod Alfa 400 Mg/20 Ml Sol [Cogd]	11	7	$14,857.00	$14,857.00	$7,280.00	$13,371.00	$9,657.00	2026-01-21
4121731	CDM	Leuprolide 22.5 Mg/3 Months Kit[cogd]	11	7	$14,717.00	$14,717.00	$7,211.00	$13,245.00	$9,566.00	2026-01-21
10517	CDM	Infuse Bone Graft 7510400	11	7	$14,679.00	$14,679.00	$7,193.00	$13,211.00	$9,541.00	2026-01-21
5663061	CDM	Biceps Tenodesis	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
22566921	CDM	Capitate Shortening Osteotomy	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
1059682	CDM	Open Reduction Internal Fixation Ankle	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
22566925	CDM	Arthroscopic Osteochondritis Dissecans Patella / Lateral Femoral Condylectomy Wi…	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
22566920	CDM	Third Degree Acromioclavicular Separation With Allograft	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
22566943	CDM	Open Reduction Internal Fixation Upper Extremity	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
22566948	CDM	Superior Labral Tear From Anterior To Posterior Repair	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
885953	CDM	Arthroscopy Shoulder With Rotator Cuff Repair	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
1184708	CDM	Reconstruction Cruciate Ligament Knee	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
1059684	CDM	Open Reduction Internal Fixation Elbow	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
22566942	CDM	Open Reduction Internal Fixation Lower Extremity	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
10289425	CDM	Brostrom Procedure	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
24345480	CDM	Rotator Cuff Repair	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
1184811	CDM	Arthroscopy Shoulder Bankart	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
11574311	CDM	Open Reduction Internal Fixation Radius Distal	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
1184796	CDM	Open Reduction Internal Fixation Patella	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
1959655	CDM	Open Reduction Internal Fixation Radius	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
2095630	CDM	Rotator Cuff Repair Open	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
22566941	CDM	Osteochondral Autograft Trasnfer System	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
1059694	CDM	Open Reduction Internal Fixation Clavicle	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
24134294	CDM	Tenodesis	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
11574314	CDM	Open Reduction Internal Fixation Scaphoid	11	7	$13,527.00	$13,527.00	$6,628.00	$12,174.00	$8,793.00	2026-01-21
2425538	CDM	Mastectomy Bilateral	11	7	$13,300.00	$13,300.00	$6,517.00	$11,970.00	$8,645.00	2026-01-21
1184661	CDM	Mastectomy Radical	11	7	$13,300.00	$13,300.00	$6,517.00	$11,970.00	$8,645.00	2026-01-21
27447	CPT	27447 Total Knee Arthroplasty	22	7	$15,927.50	$15,927.50	$1,127.00	$25,640.00	$8,494.50	2026-01-21
4180519	CDM	Immune Globulin 30 Gram Solution 300 Ml Vial [Cogd]	11	7	$12,205.00	$12,205.00	$5,980.00	$10,985.00	$7,933.00	2026-01-21
17832	CDM	Tintrae3030 Surgimesh X B	11	7	$11,850.00	$11,850.00	$5,807.00	$10,665.00	$7,703.00	2026-01-21
995651	CDM	Mastectomy Radical Modified	11	7	$11,549.00	$11,549.00	$5,659.00	$10,394.00	$7,507.00	2026-01-21
22167095	CDM	Partial Mastectomy	11	7	$11,449.00	$11,449.00	$5,610.00	$10,304.00	$7,442.00	2026-01-21
22300525	CDM	Lymphadenectomy	11	7	$11,449.00	$11,449.00	$5,610.00	$10,304.00	$7,442.00	2026-01-21
4129945	CDM	Rituximab 10 Mg/ml Sol[cogd]	11	7	$11,274.00	$11,274.00	$5,524.00	$10,147.00	$7,328.00	2026-01-21
59510	CPT	Obstetric Care, Planned Cesarean Delivery	22	7	$12,204.50	$12,204.50	$3,124.00	$16,230.00	$7,287.00	2026-01-21
55700	CPT	Biopsy Of Prostate Gland	11	7	$10,962.00	$10,962.00	$5,371.00	$9,866.00	$7,125.00	2026-01-21
885892	CDM	Appendectomy Laparoscopic	11	7	$10,879.00	$10,879.00	$5,331.00	$9,791.00	$7,071.00	2026-01-21
995674	CDM	Thyroidectomy	11	7	$10,879.00	$10,879.00	$5,331.00	$9,791.00	$7,071.00	2026-01-21
995560	CDM	Cholecystectomy Laparoscopic With Cholangiogram	11	7	$10,879.00	$10,879.00	$5,331.00	$9,791.00	$7,071.00	2026-01-21
885905	CDM	Cholecystectomy Laparoscopic	11	7	$10,879.00	$10,879.00	$5,331.00	$9,791.00	$7,071.00	2026-01-21
11040	CDM	Patellar Tendon Hemi	11	7	$10,800.00	$10,800.00	$5,292.00	$9,720.00	$7,020.00	2026-01-21
66991	CPT	Cataract Removal W/insertion Of Intraocular Lens; W/insertion Of Anterior Aqueou…	22	7	$11,567.00	$11,567.00	$4,363.00	$12,807.00	$7,007.50	2026-01-21
995673	CDM	Thyroid Lobectomy	11	7	$10,773.00	$10,773.00	$5,279.00	$9,696.00	$7,002.00	2026-01-21
885956	CDM	Tonsillectomy And Adenoidectomy	11	7	$10,702.00	$10,702.00	$5,244.00	$9,632.00	$6,956.00	2026-01-21
Q4107	HCPCS	Graft Jacket 4x8 Regular	11	7	$10,470.00	$10,470.00	$5,130.00	$9,423.00	$6,806.00	2026-01-21
4190587	CDM	Rituximab Abbs 10 Mg/ml Sol [Cogd]	11	7	$10,147.00	$10,147.00	$4,972.00	$9,132.00	$6,596.00	2026-01-21
885913	CDM	Endometrial Ablation	11	7	$9,868.00	$9,868.00	$4,835.00	$8,881.00	$6,414.00	2026-01-21
995645	CDM	Laparotomy Exploratory	11	7	$9,826.00	$9,826.00	$4,815.00	$8,843.00	$6,387.00	2026-01-21
29826	CPT	Shaving Of Shoulder Bone Using Endoscope	22	7	$12,401.50	$12,401.50	$237.00	$21,888.00	$6,176.00	2026-01-21
27134	CPT	27134 Rev Total Hip Arthroplast	22	7	$10,415.50	$10,415.50	$1,650.00	$14,482.00	$6,075.50	2026-01-21
27487	CPT	27487 Revision Knee Arthroplast Clinic Charge	22	7	$10,222.00	$10,222.00	$1,531.00	$14,482.00	$5,901.50	2026-01-21
15273	CPT	15273 App Skn Subgrft T/a/l Area/100sq Cm 1st 100sq Cm	11	7	$8,973.00	$8,973.00	$4,397.00	$8,076.00	$5,832.00	2026-01-21
17356	CDM	Istent Inject	11	7	$8,550.00	$8,550.00	$4,190.00	$7,695.00	$5,558.00	2026-01-21
CDM	CDM	Istent Infinite	11	7	$8,550.00	$8,550.00	$4,190.00	$7,695.00	$5,558.00	2026-01-21
17307	CDM	Max Force Graft	11	7	$8,433.00	$8,433.00	$4,132.00	$7,590.00	$5,481.00	2026-01-21
4190569	CDM	Inclisiran 284 Mg/1.5 Ml IV Sol [Cogd]	11	7	$8,197.00	$8,197.00	$4,017.00	$7,377.00	$5,328.00	2026-01-21
10335	CDM	Plexur M 10cc	11	7	$8,187.00	$8,187.00	$4,012.00	$7,368.00	$5,322.00	2026-01-21
4180524	CDM	Denosumab 120 Mg/1.7 Ml Sol [Cogd]	11	7	$7,885.00	$7,885.00	$3,864.00	$7,097.00	$5,125.00	2026-01-21
4190571	CDM	Methotrexate 25 Mg/ml Pf Sol [Cogd]	11	7	$7,819.00	$7,819.00	$3,831.00	$7,037.00	$5,082.00	2026-01-21
27130	CPT	27130 Total Hip Arthroplasty	22	7	$8,931.00	$8,931.00	$1,129.00	$13,045.00	$5,066.50	2026-01-21
4120663	CDM	Antivenin (Crotalidae) Polyvalent Inj Sol [Cogd]	11	7	$7,675.00	$7,675.00	$3,761.00	$6,908.00	$4,989.00	2026-01-21
L8612	HCPCS	Xen Gel Stent	11	7	$7,656.00	$7,656.00	$3,751.00	$6,890.00	$4,976.00	2026-01-21
995603	CDM	Hernia Repair Ventral Laparoscopic	11	7	$7,416.00	$7,416.00	$3,634.00	$6,674.00	$4,820.00	2026-01-21
869411	CDM	Appendectomy	11	7	$7,416.00	$7,416.00	$3,634.00	$6,674.00	$4,820.00	2026-01-21
885928	CDM	Hernia Repair Inguinal	11	7	$7,416.00	$7,416.00	$3,634.00	$6,674.00	$4,820.00	2026-01-21
885932	CDM	Hernia Repair Ventral	11	7	$7,416.00	$7,416.00	$3,634.00	$6,674.00	$4,820.00	2026-01-21
C1776	HCPCS	Swanson Carpal Schphoid	11	7	$7,089.00	$7,089.00	$3,474.00	$6,380.00	$4,608.00	2026-01-21
26850	CPT	26850 Arthrodesis Mcp Clinic Charge	22	7	$8,510.50	$8,510.50	$680.00	$13,640.00	$4,552.50	2026-01-21
59610	CPT	Obstetric Care, Planned Vaginal Delivery (post Delivery By Cesarean Section)	22	7	$8,129.00	$8,129.00	$1,303.00	$12,238.00	$4,528.50	2026-01-21
22310787	CDM	Cystoscopy Rpg Stent	11	7	$6,587.00	$6,587.00	$3,228.00	$5,928.00	$4,282.00	2026-01-21
20357974	CDM	Cystoscopy With Biopsy Prostate	11	7	$6,587.00	$6,587.00	$3,228.00	$5,928.00	$4,282.00	2026-01-21
66984	CPT	Removal Of Cataract With Insertion Of Lens	22	7	$7,381.50	$7,381.50	$3,100.00	$7,593.00	$4,154.50	2026-01-21
C1783	HCPCS	Hydrus Glaucoma Stent	11	7	$6,360.00	$6,360.00	$3,116.00	$5,724.00	$4,134.00	2026-01-21
24345482	CDM	Distal Clavicle Excision	11	7	$6,349.00	$6,349.00	$3,111.00	$5,714.00	$4,127.00	2026-01-21
24345498	CDM	Medial Meniscus Repair	11	7	$6,349.00	$6,349.00	$3,111.00	$5,714.00	$4,127.00	2026-01-21
1184943	CDM	Toespercutaneous Pinning	11	7	$6,347.00	$6,347.00	$3,110.00	$5,712.00	$4,126.00	2026-01-21
47562	CPT	Removal Of Gallbladder Using An Endoscope	22	7	$7,569.00	$7,569.00	$956.00	$11,867.00	$4,109.00	2026-01-21
22284730	CDM	Claviculectomy	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
1184848	CDM	Epicondylar Release	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
1253546	CDM	Pinning Percutaneous Foot	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22566922	CDM	Arthroscopic Chondroplasty	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
885912	CDM	Arthroscopy Elbow	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22486970	CDM	Distal Clavicle Resection	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
23472	CPT	23472 Arthroplasty Glenohum Jt	33	7	$6,317.00	$6,317.00	$1,264.00	$16,698.00	$4,106.00	2026-01-21
22566937	CDM	Medial Retinacular Plication	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22961297	CDM	Percutaneous Pinning Finger	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22566935	CDM	Lateral Meniscus Resection	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
6028977	CDM	Triangular Fibrocartilage Complex Repair	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22566934	CDM	Diagnostic Arthroscopy	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22019693	CDM	Arthroplasty Metatarsophalangeal Joint	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
885921	CDM	Open Reduction Internal Fixation Finger	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
24345499	CDM	Lateral Meniscus Repair	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
9803398	CDM	Arthroscopy Wrist	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22566936	CDM	Medial Meniscus Resection	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22490549	CDM	Styloidectomy Radial	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
885916	CDM	Extensor Tendon Repair	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
1253517	CDM	Repair Tendon Upper Extremity	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
22409345	CDM	Meniscus Repair	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
885934	CDM	Arthroscopy Knee	11	7	$6,317.00	$6,317.00	$3,095.00	$5,685.00	$4,106.00	2026-01-21
10170	CDM	Endo Dis Tro Rnd	11	7	$6,198.00	$6,198.00	$3,037.00	$5,578.00	$4,029.00	2026-01-21
27506	CPT	27506 Optx Fem Shft Fx W/insj Imed Implt W/wo Screw	22	7	$6,799.50	$6,799.50	$1,187.00	$9,339.00	$3,992.50	2026-01-21
Q4125	HCPCS	Aflex200 Dermis 2.0mm	22	7	$6,982.50	$6,982.50	$2,933.00	$7,182.00	$3,929.50	2026-01-21
27245	CPT	27245 Trochanteric Fx With Nail Clinic Charge	22	7	$6,707.50	$6,707.50	$1,086.00	$9,339.00	$3,909.50	2026-01-21
59400	CPT	Obstetric Care, Planned Vaginal Delivery	44	7	$5,961.50	$5,961.50	$1,018.00	$12,238.00	$3,736.00	2026-01-21
49999	CPT	49999 Abdomen Surg Procdr Ed Charge	11	7	$5,719.00	$5,719.00	$2,802.00	$5,147.00	$3,717.00	2026-01-21
8197589	CDM	Myringotomy With Ear Tube Placement	11	7	$5,631.00	$5,631.00	$2,759.00	$5,068.00	$3,660.00	2026-01-21
42826	CPT	Tonsillectomy	11	7	$5,631.00	$5,631.00	$2,759.00	$5,068.00	$3,660.00	2026-01-21
18559368	CDM	Anal Fistulectomy	11	7	$5,615.00	$5,615.00	$2,751.00	$5,054.00	$3,650.00	2026-01-21
885927	CDM	Hernia Repair Incisional	18	7	$7,416.00	$7,416.00	$1,603.00	$6,674.00	$3,634.00	2026-01-21
22501021	CDM	Implant Removal	11	7	$5,567.00	$5,567.00	$2,728.00	$5,010.00	$3,619.00	2026-01-21
22566946	CDM	Removal Internal Fixation Humeral Head	11	7	$5,567.00	$5,567.00	$2,728.00	$5,010.00	$3,619.00	2026-01-21
1102651	CDM	Excision Cyst Pilonidal	11	7	$5,567.00	$5,567.00	$2,728.00	$5,010.00	$3,619.00	2026-01-21
1184604	CDM	Hardware Removal Lower Extremity	11	7	$5,567.00	$5,567.00	$2,728.00	$5,010.00	$3,619.00	2026-01-21
1184605	CDM	Hardware Removal Upper Extremity	11	7	$5,567.00	$5,567.00	$2,728.00	$5,010.00	$3,619.00	2026-01-21
1184745	CDM	Hardware Removal Clavicle	11	7	$5,567.00	$5,567.00	$2,728.00	$5,010.00	$3,619.00	2026-01-21
17259	CDM	Bio4 Bone Matrix 2.5cc	11	7	$5,564.00	$5,564.00	$2,726.00	$5,008.00	$3,617.00	2026-01-21
17861	CDM	Tintrac15 Surgimesh X B	11	7	$5,550.00	$5,550.00	$2,720.00	$4,995.00	$3,608.00	2026-01-21
885910	CDM	Dilation And Curettage	11	7	$5,403.00	$5,403.00	$2,647.00	$4,863.00	$3,512.00	2026-01-21
885888	CDM	Tubal Ligation Laparoscopic	11	7	$5,403.00	$5,403.00	$2,647.00	$4,863.00	$3,512.00	2026-01-21
25545	CPT	25545 Orif Ulnar Shaft Fx W/without	22	7	$6,292.00	$6,292.00	$575.00	$9,789.00	$3,433.00	2026-01-21
42830	CPT	Adenoidectomy	11	7	$5,278.00	$5,278.00	$2,586.00	$4,750.00	$3,431.00	2026-01-21
10550	CDM	Graft Jacket 2x4	11	7	$5,012.00	$5,012.00	$2,456.00	$4,511.00	$3,258.00	2026-01-21
4190578	CDM	Pegfilgrastim Jmdb 6 Mg/0.6 Ml Sol [Cogd]	11	7	$5,010.00	$5,010.00	$2,455.00	$4,509.00	$3,257.00	2026-01-21
49505	CPT	Repair Of Groin Hernia Patient Age 5 Years Or Older	22	7	$5,971.50	$5,971.50	$755.00	$9,362.00	$3,242.00	2026-01-21
15115	CPT	15115 Epidermal Agrft F/s/n/h/f/g/m/d Gt 1st 100 Cm/<	11	7	$4,829.00	$4,829.00	$2,366.00	$4,346.00	$3,139.00	2026-01-21
15110	CPT	15110 Epidermal Autograft, Trunk, Arms, Legs; First 100 Sq Cm Or Less	11	7	$4,829.00	$4,829.00	$2,366.00	$4,346.00	$3,139.00	2026-01-21
32550	CPT	32550 Ins Tunld Pleur Cath Ed Charge	11	7	$4,765.00	$4,765.00	$2,335.00	$4,289.00	$3,097.00	2026-01-21
22566947	CDM	Removal Lens Material	11	7	$4,726.00	$4,726.00	$2,316.00	$4,253.00	$3,072.00	2026-01-21
29881	CPT	Removal Of One Knee Cartilage Using An Endoscope	22	7	$5,618.00	$5,618.00	$730.00	$8,772.00	$3,058.00	2026-01-21
22365102	CDM	Subacromial Decompression	11	7	$4,590.00	$4,590.00	$2,249.00	$4,131.00	$2,984.00	2026-01-21
CP17677490514536046	CDM	Prevena 20cm Peel & Place Dressing	11	7	$4,514.00	$4,514.00	$2,212.00	$4,063.00	$2,934.00	2026-01-21
15274	CPT	15274 App Skn Sub Grft T/a/l Area>=100scm Adl 100sqcm	11	7	$4,487.00	$4,487.00	$2,199.00	$4,038.00	$2,917.00	2026-01-21
22566926	CDM	Bilateral Tubal Ligation	11	7	$4,420.00	$4,420.00	$2,166.00	$3,978.00	$2,873.00	2026-01-21
23107739	CDM	Tubal Ligation	11	7	$4,420.00	$4,420.00	$2,166.00	$3,978.00	$2,873.00	2026-01-21
10680	CDM	Plexur M	11	7	$4,404.00	$4,404.00	$2,158.00	$3,964.00	$2,863.00	2026-01-21
4121746	CDM	Denosumab 60 Mg/ml Sol[cogd]	11	7	$4,287.00	$4,287.00	$2,101.00	$3,858.00	$2,787.00	2026-01-21
81162	CPT	Brcassure Comprehensive Test (Ref)	11	7	$4,278.00	$4,278.00	$2,096.00	$5,134.00	$2,781.00	2026-01-21
4121822	CDM	Dalbavancin 500 Mg Rec [Cogd]	11	7	$4,270.00	$4,270.00	$2,092.00	$3,843.00	$2,776.00	2026-01-21
23203619	CDM	Cystoscopy With Retrograde Pyelogram	11	7	$4,261.00	$4,261.00	$2,088.00	$3,835.00	$2,770.00	2026-01-21
995682	CDM	Vasectomy	11	7	$4,261.00	$4,261.00	$2,088.00	$3,835.00	$2,770.00	2026-01-21
24345609	CDM	Stent Removal With Retrograde Pyelogram	11	7	$4,261.00	$4,261.00	$2,088.00	$3,835.00	$2,770.00	2026-01-21
1184676	CDM	55700 Biopsy Prostate	11	7	$4,261.00	$4,261.00	$2,088.00	$3,835.00	$2,770.00	2026-01-21
995557	CDM	Cesarean Section	11	7	$4,181.00	$4,181.00	$2,049.00	$3,763.00	$2,718.00	2026-01-21
52281	CPT	Cystoscopy Urethral Dilation	11	7	$4,070.00	$4,070.00	$1,994.00	$3,663.00	$2,646.00	2026-01-21
1184546	CDM	Carpal Tunnel Release	11	7	$4,050.00	$4,050.00	$1,985.00	$3,645.00	$2,633.00	2026-01-21
3108291	CDM	Nerve Decompression	11	7	$4,050.00	$4,050.00	$1,985.00	$3,645.00	$2,633.00	2026-01-21
81223	CPT	Pancreatitis: 3-gene Panel (Ref)	11	7	$4,000.00	$4,000.00	$1,960.00	$4,800.00	$2,600.00	2026-01-21
11462	CPT	Excision Of Skin And Subcutaneous Tissue For Hidradenitis, Inguinal; With Simple O…	11	7	$3,991.00	$3,991.00	$1,956.00	$3,592.00	$2,594.00	2026-01-21
11450	CPT	Excision Of Skin And Subcutaneous Tissue For Hidradenitis, Axillary,w Simple Or …	11	7	$3,991.00	$3,991.00	$1,956.00	$3,592.00	$2,594.00	2026-01-21
11471	CPT	11471 Excision, Skin/subq Tissue Hidradenitis, Perianal, Perineal, Umbilical; Co…	11	7	$3,991.00	$3,991.00	$1,956.00	$3,592.00	$2,594.00	2026-01-21
11451	CPT	Excision Of Skin And Subcutaneous Tissue For Hidradenitis, Axillary; With Comple…	11	7	$3,991.00	$3,991.00	$1,956.00	$3,592.00	$2,594.00	2026-01-21
59514	CPT	Cesarean Section With Tubal Ligation	22	7	$3,975.00	$3,975.00	$801.00	$4,863.00	$2,469.50	2026-01-21
38100	CPT	38100 Prof Splenectomy Total	22	7	$3,939.00	$3,939.00	$1,044.00	$4,500.00	$2,450.00	2026-01-21
17860	CDM	Surgimesh X B Tintrac10	11	7	$3,750.00	$3,750.00	$1,838.00	$3,375.00	$2,438.00	2026-01-21
17081	CDM	Stry Dmb Gel 5cc	11	7	$3,696.00	$3,696.00	$1,811.00	$3,326.00	$2,402.00	2026-01-21
1184898	CDM	Cubital Tunnel Release	11	7	$3,602.00	$3,602.00	$1,765.00	$3,242.00	$2,341.00	2026-01-21
4190593	CDM	Eptinezumab Jjmr 100 Mg/ml Sol [Cogd]	11	7	$3,588.00	$3,588.00	$1,758.00	$3,229.00	$2,332.00	2026-01-21
4121717	CDM	Ferric Carboxymaltose 50mg/ml 15ml Inj.[cogd]	11	7	$3,574.00	$3,574.00	$1,751.00	$3,217.00	$2,323.00	2026-01-21
27650	CPT	27650 Rpr Prim Rupt Achil Tend	22	7	$3,989.50	$3,989.50	$605.00	$5,714.00	$2,289.00	2026-01-21
17084	CDM	Stryker Dmb Putty 5cc	11	7	$3,511.00	$3,511.00	$1,720.00	$3,160.00	$2,282.00	2026-01-21
71551	CPT	MRI Chest With Contrast	11	7	$3,494.00	$3,494.00	$1,712.00	$3,145.00	$2,271.00	2026-01-21
72157	CPT	MRI Spine Thoracic With + Without Contrast	11	7	$3,271.00	$3,271.00	$1,603.00	$2,944.00	$2,126.00	2026-01-21
22172181	CDM	Closed Reduction With Cast Application	11	7	$3,240.00	$3,240.00	$1,588.00	$2,916.00	$2,106.00	2026-01-21
62322	CPT	Injection(s) Of Therapeutic Substance	11	7	$3,212.00	$3,212.00	$1,574.00	$2,891.00	$2,088.00	2026-01-21
72156	CPT	MRI Spine Cervical With + Without Contrast	11	7	$3,177.00	$3,177.00	$1,557.00	$2,859.00	$2,065.00	2026-01-21
10180	CPT	10180 Incision And Drainage, Complex, Post-op Wound Infection	22	7	$4,007.50	$4,007.50	$170.00	$6,773.00	$2,064.00	2026-01-21
4190589	CDM	Romosozumab 105 Mg/1.17 Ml Sol [Cogd]	11	7	$3,155.00	$3,155.00	$1,546.00	$2,840.00	$2,051.00	2026-01-21
11846209	CDM	Tenolysis	11	7	$3,154.00	$3,154.00	$1,545.00	$2,839.00	$2,050.00	2026-01-21
885958	CDM	Ulnar Collateral Ligament Repair	11	7	$3,154.00	$3,154.00	$1,545.00	$2,839.00	$2,050.00	2026-01-21
22172174	CDM	Ulnar Nerve Decompression	11	7	$3,154.00	$3,154.00	$1,545.00	$2,839.00	$2,050.00	2026-01-21
14033381	CDM	Repair Boutinniere Deformity	11	7	$3,154.00	$3,154.00	$1,545.00	$2,839.00	$2,050.00	2026-01-21
885900	CDM	Carpal Tunnel Release Endoscopic	11	7	$3,154.00	$3,154.00	$1,545.00	$2,839.00	$2,050.00	2026-01-21
9830230	CDM	Dequervain's Release	11	7	$3,154.00	$3,154.00	$1,545.00	$2,839.00	$2,050.00	2026-01-21
10214	CDM	Groshong 7fr Single Lumen	11	7	$3,105.00	$3,105.00	$1,521.00	$2,795.00	$2,018.00	2026-01-21
72158	CPT	MRI Spine Lumbar With + Without Contrast	11	7	$3,100.00	$3,100.00	$1,519.00	$2,790.00	$2,015.00	2026-01-21
12037	CPT	12037 Int Rep Wnd Hd Nk Sc Ed Charge	11	7	$3,089.00	$3,089.00	$1,514.00	$2,780.00	$2,008.00	2026-01-21
10334	CDM	Str Vitoss Ba	11	7	$3,075.00	$3,075.00	$1,507.00	$2,768.00	$1,999.00	2026-01-21
23966980	CDM	Open Reduction Internal Fixation Hip	11	7	$3,060.00	$3,060.00	$1,499.00	$2,754.00	$1,989.00	2026-01-21
C5273	HCPCS	C5273 App Skn Subgrft T/a/l Area/100sq Cm 1st 100sq Cm	11	7	$2,967.00	$2,967.00	$1,454.00	$2,670.00	$1,929.00	2026-01-21
17342	CDM	Abs-1010-bc 1cc Biocartilage	11	7	$2,940.00	$2,940.00	$1,441.00	$2,646.00	$1,911.00	2026-01-21
73720	CPT	MRI Femur With + Without Contrast Left	11	7	$2,839.00	$2,839.00	$1,391.00	$2,555.00	$1,845.00	2026-01-21
78452	CPT	Nm Myocardial Perf Multi Rest/stress	11	7	$2,824.00	$2,824.00	$1,384.00	$2,542.00	$1,836.00	2026-01-21
70543	CPT	MRI Face Neck Orbit With + Without Contrast	11	7	$2,812.00	$2,812.00	$1,378.00	$2,531.00	$1,828.00	2026-01-21
4180496	CDM	Levonorgestrel 52 Mg Dev [Cogd]	11	7	$2,776.00	$2,776.00	$1,360.00	$2,498.00	$1,804.00	2026-01-21
4121609	CDM	Etonogestrel 68 Mg Imp[cogd]	11	7	$2,775.00	$2,775.00	$1,360.00	$2,498.00	$1,804.00	2026-01-21
72197	CPT	MRI Pelvis With + Without Contrast	11	7	$2,732.00	$2,732.00	$1,339.00	$2,459.00	$1,776.00	2026-01-21
72142	CPT	MRI Spine Cervical With Contrast	11	7	$2,726.00	$2,726.00	$1,336.00	$2,453.00	$1,772.00	2026-01-21
73719	CPT	MRI Femur With Contrast Left	11	7	$2,712.00	$2,712.00	$1,329.00	$2,441.00	$1,763.00	2026-01-21
73223	CPT	MRI Elbow With + Without Contrast Left	11	7	$2,673.00	$2,673.00	$1,310.00	$2,406.00	$1,737.00	2026-01-21
70549	CPT	MRA Neck With + Without Contrast	11	7	$2,658.00	$2,658.00	$1,302.00	$2,392.00	$1,728.00	2026-01-21
70546	CPT	Mrv Brain With + Without Contrast	11	7	$2,658.00	$2,658.00	$1,302.00	$2,392.00	$1,728.00	2026-01-21
72147	CPT	MRI Spine Thoracic With Contrast	11	7	$2,643.00	$2,643.00	$1,295.00	$2,379.00	$1,718.00	2026-01-21
74178	CPT	Cogd CT Chest/abd/pelvis W + Without Contrast	22	7	$2,666.50	$2,666.50	$1,281.00	$2,447.00	$1,699.00	2026-01-21
72149	CPT	MRI Spine Lumbar With Contrast	11	7	$2,609.00	$2,609.00	$1,278.00	$2,348.00	$1,696.00	2026-01-21
15116	CPT	15116 Epidermal Agrft F/s/n/h/f/g/m/d Gt Ea 100 Cm	11	7	$2,609.00	$2,609.00	$1,278.00	$2,348.00	$1,696.00	2026-01-21
15111	CPT	15111 Epidrm Agrft T/a/l Ea 100 Cm/ea 1% Bdy Inft/chld	11	7	$2,609.00	$2,609.00	$1,278.00	$2,348.00	$1,696.00	2026-01-21
99291	CPT	99291- Ed Critical Care-1st Hour	22	7	$2,768.50	$2,768.50	$196.00	$3,073.00	$1,681.50	2026-01-21
10215	CDM	Endo Dis Tro Oval	11	7	$2,579.00	$2,579.00	$1,264.00	$2,321.00	$1,676.00	2026-01-21
74183	CPT	MRI Abdomen With + Without Contrast	11	7	$2,572.00	$2,572.00	$1,260.00	$2,315.00	$1,672.00	2026-01-21
74181	CPT	MRI Abdomen Mrcp Without Cont	11	7	$2,493.00	$2,493.00	$1,222.00	$2,244.00	$1,620.00	2026-01-21
73222	CPT	MRI Elbow With Contrast Left	11	7	$2,423.00	$2,423.00	$1,187.00	$2,181.00	$1,575.00	2026-01-21
74182	CPT	MRI Abdomen With Contrast	11	7	$2,415.00	$2,415.00	$1,183.00	$2,174.00	$1,570.00	2026-01-21
72146	CPT	MRI Spine Thoracic Without Contrast	11	7	$2,403.00	$2,403.00	$1,177.00	$2,163.00	$1,562.00	2026-01-21
4190585	CDM	Calcitonin 200 Intl Units/ml Inj [Cogd]	11	7	$2,400.00	$2,400.00	$1,176.00	$2,160.00	$1,560.00	2026-01-21
10249	CDM	Stimublast 5cc Putty	11	7	$2,400.00	$2,400.00	$1,176.00	$2,160.00	$1,560.00	2026-01-21
10524	CDM	Stimublast Gel 5cc	11	7	$2,400.00	$2,400.00	$1,176.00	$2,160.00	$1,560.00	2026-01-21
10602	CDM	Evicel 5ml Kit	11	7	$2,386.00	$2,386.00	$1,169.00	$2,147.00	$1,551.00	2026-01-21
17247	CDM	Vistaseal Fibrin Sealant (Human) 10ml	11	7	$2,386.00	$2,386.00	$1,169.00	$2,147.00	$1,551.00	2026-01-21
74177	CPT	CT Scan Of Abdomen And Pelvis With Contrast	22	7	$2,422.50	$2,422.50	$1,164.00	$2,223.00	$1,544.00	2026-01-21
73220	CPT	MRI Forearm With + Without Contrast Left	11	7	$2,361.00	$2,361.00	$1,157.00	$2,125.00	$1,535.00	2026-01-21
73725	CPT	MRA Lower Ext Without Contrast	11	7	$2,361.00	$2,361.00	$1,157.00	$2,125.00	$1,535.00	2026-01-21
73718	CPT	MRI Femur Without Contrast Left	11	7	$2,361.00	$2,361.00	$1,157.00	$2,125.00	$1,535.00	2026-01-21
70540	CPT	MRI Face Neck Orbit Without Contrast	11	7	$2,334.00	$2,334.00	$1,144.00	$2,101.00	$1,517.00	2026-01-21
73221	CPT	MRI Elbow Without Contrast Left	11	7	$2,302.00	$2,302.00	$1,128.00	$2,072.00	$1,496.00	2026-01-21
72148	CPT	MRI Scan Of Lower Spinal Canal	11	7	$2,283.00	$2,283.00	$1,119.00	$2,055.00	$1,484.00	2026-01-21
49406	CPT	49406 Image-guided Fluid Collection Drainage By Catheter;	11	7	$2,281.00	$2,281.00	$1,118.00	$2,053.00	$1,483.00	2026-01-21
995685	CDM	Esophagogastroduodenoscopy And Colonoscopy	11	7	$2,274.00	$2,274.00	$1,114.00	$2,047.00	$1,478.00	2026-01-21
22283297	CDM	Sphincterectomy	11	7	$2,274.00	$2,274.00	$1,114.00	$2,047.00	$1,478.00	2026-01-21
1251755	CDM	Colonoscopy With Biopsy	11	7	$2,274.00	$2,274.00	$1,114.00	$2,047.00	$1,478.00	2026-01-21
885907	CDM	Colonoscopy	11	7	$2,274.00	$2,274.00	$1,114.00	$2,047.00	$1,478.00	2026-01-21
1296770	CDM	Colonoscopy With Polypectomy	11	7	$2,274.00	$2,274.00	$1,114.00	$2,047.00	$1,478.00	2026-01-21
72195	CPT	MRI Pelvis Without Contrast	11	7	$2,254.00	$2,254.00	$1,104.00	$2,029.00	$1,465.00	2026-01-21
10156	CDM	Pl 10 Hole Cl10ll	11	7	$2,235.00	$2,235.00	$1,095.00	$2,012.00	$1,453.00	2026-01-21
49203	CPT	49203 Excision Or Destruction, Cysts Or Tumors, 5 Cm Or Less In Diameter	18	7	$2,963.00	$2,963.00	$751.00	$2,667.00	$1,452.00	2026-01-21
46040	CPT	46040 Incsn Rectal Abcess Ed Charge	22	7	$2,429.00	$2,429.00	$420.00	$3,273.00	$1,440.50	2026-01-21
72141	CPT	MRI Spine Cervical Without Contrast	11	7	$2,203.00	$2,203.00	$1,079.00	$1,983.00	$1,432.00	2026-01-21
10705	CDM	Lap Chole Kit	11	7	$2,199.00	$2,199.00	$1,078.00	$1,979.00	$1,429.00	2026-01-21
70544	CPT	MRA Head Without Contrast	11	7	$2,179.00	$2,179.00	$1,068.00	$1,961.00	$1,416.00	2026-01-21
70547	CPT	MRA Neck Without Contrast	11	7	$2,179.00	$2,179.00	$1,068.00	$1,961.00	$1,416.00	2026-01-21
27266	CPT	27266 Trmt Disloc Post Hip	22	7	$2,237.50	$2,237.50	$540.00	$2,733.00	$1,391.00	2026-01-21
45385	CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope	22	7	$2,519.00	$2,519.00	$361.00	$3,871.00	$1,385.00	2026-01-21
69205	CPT	69205 Rem Fb Extaud Gen An Ed Charge	11	7	$2,130.00	$2,130.00	$1,044.00	$1,917.00	$1,385.00	2026-01-21
10636	CDM	Protack Stapler 5mm	11	7	$2,127.00	$2,127.00	$1,042.00	$1,914.00	$1,383.00	2026-01-21
75635	CPT	CT Angio Abd Aorta + Iliofemoral Le Runo	11	7	$2,080.00	$2,080.00	$1,019.00	$1,872.00	$1,352.00	2026-01-21
24516	CPT	24516 Tx Humeral Shaft Fx,w Implant, W Or Without Cerclage Or Screws	11	7	$2,079.00	$2,079.00	$1,019.00	$1,871.00	$1,351.00	2026-01-21
74176	CPT	Cogd CT Chest/abd/pel Without Contrast	22	7	$2,108.50	$2,108.50	$1,013.00	$1,935.00	$1,344.00	2026-01-21
801	CDM	Ez-io Needle Set Adult	11	7	$2,049.00	$2,049.00	$1,004.00	$1,844.00	$1,332.00	2026-01-21
802	CDM	Ez-io Needle Set Pediatric	11	7	$2,049.00	$2,049.00	$1,004.00	$1,844.00	$1,332.00	2026-01-21
4180518	CDM	Immune Globulin 5 Gram Solution 50 Ml Vial [Cogd]	11	7	$2,034.00	$2,034.00	$997.00	$1,831.00	$1,322.00	2026-01-21
17357	CDM	Stry Prolayer 5 X 5cm Mesh	11	7	$2,018.00	$2,018.00	$989.00	$1,816.00	$1,312.00	2026-01-21
73219	CPT	MRI Forearm With Contrast Left	11	7	$2,010.00	$2,010.00	$985.00	$1,809.00	$1,307.00	2026-01-21
10133	CDM	Endo Absorbatack 5mm	11	7	$1,994.00	$1,994.00	$977.00	$1,795.00	$1,296.00	2026-01-21
CP17677490514532026	CDM	Prevena Plus Incision Management	11	7	$1,989.00	$1,989.00	$975.00	$1,790.00	$1,293.00	2026-01-21
11470	CPT	11470 Excision Of Skin And Subcutaneous Tissue For Hidradenitis, Perianal, Perin…	22	7	$2,339.00	$2,339.00	$272.00	$3,592.00	$1,287.00	2026-01-21
93306	CPT	US Echocardiogram Complete	11	7	$1,976.00	$1,976.00	$968.00	$1,778.00	$1,284.00	2026-01-21
45380	CPT	Biopsy Exam Of Large Bowel Using An Endoscope	22	7	$2,366.00	$2,366.00	$286.00	$3,733.00	$1,279.50	2026-01-21
28192	CPT	28192 Rem Deep Fb Of Foot Ed Charge	22	7	$2,122.00	$2,122.00	$286.00	$2,786.00	$1,275.00	2026-01-21
47600	CPT	47600 Cholecystectomy	15	7	$2,564.00	$2,564.00	$981.00	$2,308.00	$1,269.00	2026-01-21
10554	CDM	Flexigraft Fiber 5cc	11	7	$1,950.00	$1,950.00	$956.00	$1,755.00	$1,268.00	2026-01-21
4120203	CDM	Tetanus Immune Globulin 250 Units IM Sol 1 Ea Vfc [Cogd]	11	7	$1,948.00	$1,948.00	$955.00	$1,753.00	$1,266.00	2026-01-21
4190559	CDM	Lecanemab 500mg/5ml Sdv [Cogd]	11	7	$1,940.00	$1,940.00	$951.00	$1,746.00	$1,261.00	2026-01-21
70553	CPT	MRI Scan	22	7	$2,054.00	$2,054.00	$539.00	$2,708.00	$1,231.50	2026-01-21
36573	CPT	Insertion Of Peripherally Insert Central Venous Catheter, Wo Subcutaneous Port O…	11	7	$1,888.00	$1,888.00	$925.00	$1,699.00	$1,227.00	2026-01-21
73218	CPT	MRI Forearm Without Contrast Left	11	7	$1,883.00	$1,883.00	$923.00	$1,695.00	$1,224.00	2026-01-21
95811	CPT	95811 Polysomnography With Cpap Charge	11	7	$1,875.00	$1,875.00	$919.00	$1,688.00	$1,219.00	2026-01-21
95810	CPT	Sleep Study	11	7	$1,875.00	$1,875.00	$919.00	$1,688.00	$1,219.00	2026-01-21
95805	CPT	95805 Multiple Sleep Latency	11	7	$1,875.00	$1,875.00	$919.00	$1,688.00	$1,219.00	2026-01-21
59409	CPT	Delivery Vac Extrac Charge	33	7	$2,100.00	$2,100.00	$703.00	$2,035.00	$1,218.00	2026-01-21
25605	CPT	25605 Closed Treatment Of Distal Radial Fracture (Eg, Colles Or Smith Type) With …	33	7	$2,400.00	$2,400.00	$530.00	$3,662.00	$1,201.00	2026-01-21
27502	CPT	Cltx Fem Shft Fx W/manj W/wo Skin/skeletal Tracj	11	7	$1,834.00	$1,834.00	$899.00	$1,651.00	$1,192.00	2026-01-21
23655	CPT	23655 Trt Shoulder Disloc Ed Charge	15	7	$2,400.00	$2,400.00	$404.00	$2,160.00	$1,188.00	2026-01-21
72133	CPT	CT Spine Lumbar With + Without Contrast	11	7	$1,824.00	$1,824.00	$894.00	$1,642.00	$1,186.00	2026-01-21
72127	CPT	CT Spine Cervical With + Without Contrast	11	7	$1,824.00	$1,824.00	$894.00	$1,642.00	$1,186.00	2026-01-21
72130	CPT	CT Spine Thoracic With + Without Contrast	11	7	$1,824.00	$1,824.00	$894.00	$1,642.00	$1,186.00	2026-01-21
70496	CPT	CT Angiography Head With Contrast	11	7	$1,820.00	$1,820.00	$892.00	$1,638.00	$1,183.00	2026-01-21
74175	CPT	CT Angiography Abdomen With Contrast	11	7	$1,820.00	$1,820.00	$892.00	$1,638.00	$1,183.00	2026-01-21
73206	CPT	CT Angiography Upper Extremity Left	11	7	$1,820.00	$1,820.00	$892.00	$1,638.00	$1,183.00	2026-01-21
73706	CPT	CT Angiography Lower Extremity Bilat	11	7	$1,820.00	$1,820.00	$892.00	$1,638.00	$1,183.00	2026-01-21
74174	CPT	CT Angiography Abdomen/pelvis	11	7	$1,820.00	$1,820.00	$892.00	$1,638.00	$1,183.00	2026-01-21
995688	CDM	Esophagogastroduodenoscopy Dilatation	11	7	$1,813.00	$1,813.00	$888.00	$1,632.00	$1,178.00	2026-01-21
1251729	CDM	Esophagogastroduodenoscopy With Biopsy	11	7	$1,813.00	$1,813.00	$888.00	$1,632.00	$1,178.00	2026-01-21
23114117	CDM	Esophagogastroduodenoscopy With Dilation	11	7	$1,813.00	$1,813.00	$888.00	$1,632.00	$1,178.00	2026-01-21
885915	CDM	Esophagogastroduodenoscopy	11	7	$1,813.00	$1,813.00	$888.00	$1,632.00	$1,178.00	2026-01-21
99285	CPT	99285- Ed Visit Level 5 High Decision Making Ed Profee	22	7	$1,882.00	$1,882.00	$169.00	$2,158.00	$1,175.00	2026-01-21
10689	CDM	Sut Polysorb 8-0 Se1408 Covid	11	7	$1,807.00	$1,807.00	$885.00	$1,626.00	$1,175.00	2026-01-21
10553	CDM	Flexigraft Strip 15x40x2x	11	7	$1,800.00	$1,800.00	$882.00	$1,620.00	$1,170.00	2026-01-21
4180502	CDM	Remdesivir 100 Mg Rec [Cogd]	11	7	$1,798.00	$1,798.00	$881.00	$1,618.00	$1,169.00	2026-01-21
25505	CPT	25505 Clsd Tx Dis Rad Shft Ed Charge	22	7	$1,828.50	$1,828.50	$473.00	$2,160.00	$1,153.50	2026-01-21
1184914	CDM	Portacath Catheter Removal	11	7	$1,772.00	$1,772.00	$868.00	$1,595.00	$1,152.00	2026-01-21
10060213	CDM	Portacath Insertion And Removal	11	7	$1,772.00	$1,772.00	$868.00	$1,595.00	$1,152.00	2026-01-21
995554	CDM	Central Line Insertion	11	7	$1,772.00	$1,772.00	$868.00	$1,595.00	$1,152.00	2026-01-21
1184804	CDM	Portacath	11	7	$1,772.00	$1,772.00	$868.00	$1,595.00	$1,152.00	2026-01-21
C5275	HCPCS	C5275 Sub Grft F/s/n/h/f/g/m/d <100sq Cm 1st 25 Sq Cm	11	7	$1,771.00	$1,771.00	$868.00	$1,594.00	$1,151.00	2026-01-21
C5271	HCPCS	C5271 App Skn Sub Grft T/a/l Area/100sq Cm /<1st 25	11	7	$1,771.00	$1,771.00	$868.00	$1,594.00	$1,151.00	2026-01-21
C5277	HCPCS	C5277 Sub Grft F/s/n/h/f/g/m/d >= 100scm 1st 100sq Cm	11	7	$1,771.00	$1,771.00	$868.00	$1,594.00	$1,151.00	2026-01-21
25565	CPT	25565 Clsd Tx Rad/uln Fx Ed Charge	22	7	$1,819.50	$1,819.50	$491.00	$2,160.00	$1,145.50	2026-01-21
74160	CPT	CT Abdomen With Contrast	22	7	$1,835.00	$1,835.00	$588.00	$2,223.00	$1,145.00	2026-01-21
70498	CPT	Cogd CT Angiography Head/neck	22	7	$1,785.00	$1,785.00	$858.00	$1,638.00	$1,138.00	2026-01-21
1025687	CDM	Hemorrhoidectomy	11	7	$1,730.00	$1,730.00	$848.00	$1,557.00	$1,125.00	2026-01-21
1184683	CDM	Sigmoidoscopy Flexible	11	7	$1,730.00	$1,730.00	$848.00	$1,557.00	$1,125.00	2026-01-21
24445202	CDM	Ild Dx Profile (Ref)	11	7	$1,725.00	$1,725.00	$845.00	$2,070.00	$1,121.00	2026-01-21
10606	CDM	Halo Cutting Forcep	11	7	$1,725.00	$1,725.00	$845.00	$1,553.00	$1,121.00	2026-01-21

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