Hospital

DRISCOLL CHILDREN'S HOSPITAL RIO GRANDE VALLEY

Edinburg, TX · CCN 453321 · Rates published

Your selected procedure

You selected 93306 (CPT)

Hchg 2d Echo With Spectral and Color Flow Doppler; Complete

This hospital’s price: $583 across 2 payers · range $166-$1,000

Source: https://driscollchildrens.org/wp-content/uploads/742577746-1124796081_Driscoll-Childrens-Hospital_standardcharges.csv · observed 2025-10-06

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.

4,817 distinct procedures filed

241 distinct payers

137,997 rate rows

2025-10-06 last MRF observed · ⚠ 12 mo old

Data quality

136,280 of 137,997 rate rows are consumer-grade (98.8%)

1,717 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
exceeds 10× this hospital's gross charge — excluded from medians	1,118
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	408
per-diem day rate — not a per-procedure price	174
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	9
placeholder amount (≤ $0.02) — excluded from medians	8

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://driscollchildrens.org/wp-content/uploads/742577746-1124796081_Driscoll-Childrens-Hospital_standardcharges.csv
Found on page	https://driscollchildrens.org/patients/resources/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-21
Content fingerprint	e8a68fc1d46b0ff8… · 38,173,057 bytes · first seen 2026-05-05

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
PX-3100812 CDM	Organ Cadaver Donor	3	$165.82	$75,000.00	$75,000.00	nat. median $143,655 0.5× median
PX-3100811 CDM	Organ Living Donor	3	$165.82	$75,000.00	$75,000.00	nat. median $127,034 0.6× median
J9118 HCPCS	Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution	5	$165.82	$27,326.25	$27,326.25	nat. median $200 outlier · 136.7×
J1951 HCPCS	Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe	5	$165.82	$24,985.80	$24,985.80	nat. median $173 outlier · 144.0×
J9229 HCPCS	Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln	5	$165.82	$22,319.64	$22,319.64	nat. median $6,176 outlier · 3.6×
J9210 HCPCS	Emapalumab-lzsg 5 Mg/ml Intravenous Solution	5	$165.82	$39,372.00	$19,686.00	nat. median $743 outlier · 26.5×
J1290 HCPCS	Ecallantide 10 Mg/ml (1 Ml) Subcutaneous Solution	5	$165.82	$15,921.60	$15,921.60	nat. median $853 outlier · 18.7×
81416 CPT	Exome Sequence Analysis, Family Member	5	$165.82	$12,987.60	$12,987.60	nat. median $12,000 1.1× median
J9042 HCPCS	Brentuximab Vedotin 50 Mg Intravenous Solution	5	$165.82	$11,098.00	$11,098.00	nat. median $951 outlier · 11.7×
J9203 HCPCS	Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln	5	$165.82	$9,787.05	$9,787.05	nat. median $687 outlier · 14.2×
36252 CPT	Hchg Angio Renal Bil W/wo Flsh	5	$165.82	$7,166.00	$7,166.00	nat. median $4,292 1.7× median
36226 CPT	Hchg Angio,Vetebral Cerv /Intracranial	5	$165.82	$7,166.00	$7,166.00	nat. median $6,827 1.0× median
36246 CPT	Scp 2nd Art Abd,Pel, L/e	5	$165.82	$7,166.00	$7,166.00	nat. median $1,758 outlier · 4.1×
36251 CPT	Hchg Angio Renal Uni W/wo Flsh	5	$165.82	$7,166.00	$7,166.00	nat. median $3,999 1.8× median
36223 CPT	Angio Carotid Cervical Un	5	$165.82	$7,166.00	$7,166.00	nat. median $6,323 1.1× median
36227 CPT	Hchg Angio Carotid Extrn Uni	5	$165.82	$7,166.00	$7,166.00	nat. median $2,969 outlier · 2.4×
36253 CPT	Hchg Scp Rnl Art 2nd Ordr Uni	5	$165.82	$7,166.00	$7,166.00	nat. median $5,876 1.2× median
36014 CPT	Scp Lt Or Rt Pul Art	5	$165.82	$7,166.00	$7,166.00	nat. median $1,292 outlier · 5.5×
33895 CPT	Hchg Evas St Rpr Thrc/Aa X Crsg	8	$165.82	$7,166.00	$7,166.00	nat. median $4,160 1.7× median
36015 CPT	Scp Seg Or Subseg Pul Art	5	$165.82	$7,166.00	$7,166.00	nat. median $1,245 outlier · 5.8×
36005 CPT	Hchg Inject Contrast Ext Veno	5	$165.82	$7,166.00	$7,166.00	nat. median $712 outlier · 10.1×
36013 CPT	Hchg Introd Cthtr Rt Ht Or Mpa	5	$165.82	$7,166.00	$7,166.00	nat. median $992 outlier · 7.2×
36217 CPT	Scp 3rd> Thor Or Brach Ar	5	$165.82	$7,166.00	$7,166.00	nat. median $1,719 outlier · 4.2×
36221 CPT	Angio Arch	5	$165.82	$7,166.00	$7,166.00	nat. median $3,999 1.8× median
36224 CPT	Hchg Angio, Carotid, Cerebral, Bil	5	$165.82	$7,166.00	$7,166.00	nat. median $7,122 1.0× median
36225 CPT	Hchg Angio,Sbclvn/Inno Vrtbrl	5	$165.82	$7,166.00	$7,166.00	nat. median $4,404 1.6× median
36228 CPT	Hchg Angio Ea Add Intrcrnl/Vert	5	$165.82	$7,166.00	$7,166.00	nat. median $2,822 outlier · 2.5×
36245 CPT	Scp 1st Art Abd,Pel,L/E	5	$165.82	$7,166.00	$7,166.00	nat. median $1,737 outlier · 4.1×
36247 CPT	Scp 3rd Art Abd,Pel,L/E	5	$165.82	$7,166.00	$7,166.00	nat. median $2,033 outlier · 3.5×
36248 CPT	Scp Add 2/3 > Abd Pel L/e	5	$165.82	$7,166.00	$7,166.00	nat. median $750 outlier · 9.6×
36200 CPT	Scp Aorta	5	$165.82	$7,166.00	$7,166.00	nat. median $1,370 outlier · 5.2×
36254 CPT	Hchg Scp Rnl Art 2nd Ordr Bil	5	$165.82	$7,166.00	$7,166.00	nat. median $4,207 1.7× median
33240 CPT	Hchg Insrtn Aicd Only W Ex Sng Lead	5	$165.82	$7,166.00	$7,166.00	nat. median $22,117 outlier · 0.3×
33208 CPT	Hchg Insrt/Rpl Pm Atrial&Vent	5	$165.82	$7,166.00	$7,166.00	nat. median $11,875 0.6× median
33207 CPT	Hchg Insrt/Rpl Pm Vntrclr	5	$165.82	$7,166.00	$7,166.00	nat. median $11,511 0.6× median
33212 CPT	Insrt/Rplc Pm Only-single	5	$165.82	$7,166.00	$7,166.00	nat. median $8,868 0.8× median
10160 CPT	Hchg Puncture Aspir Of Abcess, Hematoma, Bulla, Cyst	5	$165.82	$7,166.00	$7,166.00	nat. median $440 outlier · 16.3×
33222 CPT	Rev/Reloc Skin Pocket	5	$165.82	$7,166.00	$7,166.00	nat. median $2,641 outlier · 2.7×
33621 CPT	Hchg Insrt Cth Stn Plc Hyb I	8	$165.82	$7,166.00	$7,166.00	nat. median $3,086 outlier · 2.3×
33620 CPT	Hchg Rt&Lt Pa Band Hybrd I	8	$165.82	$7,166.00	$7,166.00	nat. median $3,696 1.9× median
33894 CPT	Hchg Evasc St Rpr Thrc/Aa Acrs Br	8	$165.82	$7,166.00	$7,166.00	nat. median $4,533 1.6× median
33745 CPT	Stent Intra-cardiac, Initial	8	$165.82	$7,166.00	$7,166.00	nat. median $5,020 1.4× median
33897 CPT	Perq Trluml Angp Nt/Recr Coa	8	$165.82	$7,166.00	$7,166.00	nat. median $4,690 1.5× median
36000 CPT	Hchg Intr Ndl Orintrcth Vn	5	$165.82	$7,166.00	$7,166.00	nat. median $168 outlier · 42.7×
36010 CPT	Intro Cath Svc Or Ivc	5	$165.82	$7,166.00	$7,166.00	nat. median $1,235 outlier · 5.8×
36012 CPT	Scp 2nd Ordr Vein Or Hghr	5	$165.82	$7,166.00	$7,166.00	nat. median $1,450 outlier · 4.9×
36215 CPT	Scp 1st Thor Or Brach Art	5	$165.82	$7,166.00	$7,166.00	nat. median $1,366 outlier · 5.2×
36216 CPT	Scp 2nd Thor Or Brach Art	5	$165.82	$7,166.00	$7,166.00	nat. median $1,456 outlier · 4.9×
36218 CPT	Scp Add 2 Or 3 Ord Art Th	5	$165.82	$7,166.00	$7,166.00	nat. median $811 outlier · 8.8×
36420 CPT	Cutdown < 1 Year Old	5	$165.82	$7,166.00	$7,166.00	nat. median $151 outlier · 47.5×

Other procedures at this hospital

Browse this hospital's 4,817 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

PX-3100812	CDM	Organ Cadaver Donor	13	3	$239,426.00	$47,885.20 80% off	$165.82	$75,000.00	$75,000.00	2025-10-06
PX-3100811	CDM	Organ Living Donor	13	3	$211,723.04	$42,344.61 80% off	$165.82	$75,000.00	$75,000.00	2025-10-06
J9118	HCPCS	Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution	10	5	$184,379.50	$36,875.90 80% off	$165.82	$27,326.25	$27,326.25	2025-10-06
J1951	HCPCS	Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe	10	5	$159,581.50	$31,916.30 80% off	$165.82	$24,985.80	$24,985.80	2025-10-06
J9229	HCPCS	Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln	10	5	$139,071.25	$27,814.25 80% off	$165.82	$22,319.64	$22,319.64	2025-10-06
J9210	HCPCS	Emapalumab-lzsg 5 Mg/ml Intravenous Solution	26	5	$105,589.00	$21,117.80 80% off	$165.82	$39,372.00	$19,686.00	2025-10-06
J1290	HCPCS	Ecallantide 10 Mg/ml (1 Ml) Subcutaneous Solution	10	5	$58,266.50	$11,653.30 80% off	$165.82	$15,921.60	$15,921.60	2025-10-06
81416	CPT	Exome Sequence Analysis, Family Member	10	5	$4,044.55	$808.91 80% off	$165.82	$12,987.60	$12,987.60	2025-10-06
J9042	HCPCS	Brentuximab Vedotin 50 Mg Intravenous Solution	10	5	$34,290.00	$6,858.00 80% off	$165.82	$11,098.00	$11,098.00	2025-10-06
J9203	HCPCS	Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln	10	5	$71,145.50	$14,229.10 80% off	$165.82	$9,787.05	$9,787.05	2025-10-06
61626	CPT	Hchg Emboliz Hd Nck Extracran	21	5	$8,157.60	$1,631.52 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37218	CPT	Hchg Stent Placement, Common Carotid Or Brachiocephalic	29	8	$11,963.60	$2,392.72 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33620	CPT	Hchg Rt&Lt Pa Band Hybrd I	29	8	$9,026.60	$1,805.32 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36252	CPT	Hchg Angio Renal Bil W/wo Flsh	21	5	$5,051.20	$1,010.24 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33212	CPT	Insrt/Rplc Pm Only-single	21	5	$24,915.00	$4,983.00 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36223	CPT	Angio Carotid Cervical Un	21	5	$5,709.00	$1,141.80 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36215	CPT	Scp 1st Thor Or Brach Art	21	5	$1,758.90	$351.78 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37237	CPT	Stent Each Additional	21	5	$3,602.50	$720.50 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93654	CPT	Hchg Ep Eval W Ablation Vt	21	5	$23,382.70	$4,676.54 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93655	CPT	Hchg Intrcrd Abl; Add On Proc	21	5	$9,199.30	$1,839.86 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36012	CPT	Scp 2nd Ordr Vein Or Hghr	21	5	$1,645.60	$329.12 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
92960	CPT	Cardioversion	21	5	$2,075.70	$415.14 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36217	CPT	Scp 3rd> Thor Or Brach Ar	21	5	$1,952.50	$390.50 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37188	CPT	Hchg Thrmbctmy Perc Venous Rpt S D	29	8	$5,976.30	$1,195.26 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93594	CPT	Hchg Rt Ht Cong Abl Nc	21	5	$8,793.40	$1,758.68 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33017	CPT	Hchg Pericardial Drainage >6 Yrs Non-congenital	29	8	$7,283.10	$1,456.62 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33745	CPT	Stent Intra-cardiac, Initial	29	8	$13,360.60	$2,672.12 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33894	CPT	Hchg Evasc St Rpr Thrc/Aa Acrs Br	29	8	$12,260.60	$2,452.12 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37213	CPT	Transcatheter Arterial Or Venous Infusion For Thrombolysis, Subsequent	21	5	$3,566.20	$713.24 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93598	CPT	Cardiac Output Thermodilution	21	5	$1,336.50	$267.30 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36227	CPT	Hchg Angio Carotid Extrn Uni	21	5	$2,776.40	$555.28 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33208	CPT	Hchg Insrt/Rpl Pm Atrial&Vent	21	5	$33,448.80	$6,689.76 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36254	CPT	Hchg Scp Rnl Art 2nd Ordr Bil	21	5	$18,469.00	$3,693.80 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37211	CPT	Thrombolytic Arterial Infusion Catheter Insertion	21	5	$6,476.80	$1,295.36 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33621	CPT	Hchg Insrt Cth Stn Plc Hyb I	29	8	$9,026.60	$1,805.32 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36245	CPT	Scp 1st Art Abd,Pel,L/E	21	5	$1,501.50	$300.30 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37185	CPT	Hchg Thrmbctmy Perc Art Ea Add Ves	21	5	$2,992.00	$598.40 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37238	CPT	Hchg Trncth Pl Stn Opn Int Vs	21	5	$6,095.10	$1,219.02 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93503	CPT	Arterial Line Monitoring	21	5	$2,220.90	$444.18 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93464	CPT	Hchg Exerc W/Hemodynamic Meas	21	5	$11,487.30	$2,297.46 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93596	CPT	Rt & Lt Ht Cong Nl Nc	21	5	$6,800.20	$1,360.04 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93653	CPT	Hchg Ep Eval W Ablation Svt	21	5	$55,020.90	$11,004.18 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93799	CPT	Hchg Stenting A Fontan Fenestration	21	5	$18,960.70	$3,792.14 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93580	CPT	Asd Occl Proc W Device	21	5	$21,774.50	$4,354.90 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93460	CPT	Hchg Rt&Lt Hrt Cor/Lv	21	5	$23,879.90	$4,775.98 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36556	CPT	Cv Line => 5 Years Old	21	5	$2,664.20	$532.84 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
99195	CPT	Therapeutic Phlebotomy	21	5	$2,341.90	$468.38 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36246	CPT	Scp 2nd Art Abd,Pel, L/e	21	5	$1,402.50	$280.50 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93453	CPT	Hchg Rt&Lt Hrt Cath W/Ventric	21	5	$23,452.00	$4,690.40 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37239	CPT	Hchg Stent Ea Add Vein	21	5	$3,049.20	$609.84 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93451	CPT	Hchg Right Heart Cath	20	4	$14,691.60	$2,938.32 80% off	$1,000.00	$7,166.00	$7,166.00	2025-10-06
93505	CPT	Biopsy Endomyocardial	21	5	$3,417.70	$683.54 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36620	CPT	Aterial Cannula/Monitor	21	5	$2,184.60	$436.92 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33018	CPT	Hchg Pericardial Drainage <= 5yrs/Congenital Cardiac All Ages	29	8	$8,938.60	$1,787.72 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36216	CPT	Scp 2nd Thor Or Brach Art	21	5	$1,644.50	$328.90 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36013	CPT	Hchg Introd Cthtr Rt Ht Or Mpa	21	5	$3,105.30	$621.06 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36015	CPT	Scp Seg Or Subseg Pul Art	21	5	$1,952.50	$390.50 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36225	CPT	Hchg Angio,Sbclvn/Inno Vrtbrl	21	5	$5,709.00	$1,141.80 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36555	CPT	Cv Line < 5 Years Old	21	5	$2,664.20	$532.84 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37197	CPT	Hchg Trans Cath Retrv W Image	21	5	$3,842.30	$768.46 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37246	CPT	Hchg Angplsty Prphrl Artry S&i	21	5	$3,061.30	$612.26 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
92987	CPT	Mitral Valvuloplasty	21	5	$14,106.40	$2,821.28 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36224	CPT	Hchg Angio, Carotid, Cerebral, Bil	21	5	$6,191.90	$1,238.38 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37249	CPT	Venous Angioplasty Ea Add	21	5	$10,177.20	$2,035.44 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37186	CPT	Hchg Thrmbctmy Perc Secondary Art	21	5	$5,976.30	$1,195.26 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36420	CPT	Cutdown < 1 Year Old	21	5	$764.50	$152.90 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37187	CPT	Hchg Thrmbctmy Perc Venous	29	8	$6,274.40	$1,254.88 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
49185	CPT	Hchg Sclerotherapy Of A Fluid Collection	21	5	$5,487.90	$1,097.58 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37236	CPT	Stent-initial	21	5	$6,847.50	$1,369.50 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37248	CPT	Venous Angioplasty	21	5	$10,919.70	$2,183.94 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36247	CPT	Scp 3rd Art Abd,Pel,L/E	21	5	$1,749.00	$349.80 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
32557	CPT	Plu Drn W Ind Cath W Image	21	5	$2,572.90	$514.58 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
92950	CPT	Hchg Cpr	21	5	$833.80	$166.76 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37247	CPT	Artery Angioplasty, Ea Additional Artery	21	5	$6,563.70	$1,312.74 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
10160	CPT	Hchg Puncture Aspir Of Abcess, Hematoma, Bulla, Cyst	21	5	$1,971.20	$394.24 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36228	CPT	Hchg Angio Ea Add Intrcrnl/Vert	21	5	$5,709.00	$1,141.80 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93452	CPT	Hchg Lt Hrt Cath W/Ventric	20	4	$14,285.70	$2,857.14 80% off	$1,000.00	$7,166.00	$7,166.00	2025-10-06
36248	CPT	Scp Add 2/3 > Abd Pel L/e	21	5	$1,860.10	$372.02 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93456	CPT	Hchg Rt Hrt Cor Art Angio	21	5	$15,550.70	$3,110.14 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93455	CPT	Hchg Cor Art/Grft Angio S&i	21	5	$15,088.70	$3,017.74 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93459	CPT	Hchg Lt Hrt Cor/Lv/Grft Angio	21	5	$19,593.20	$3,918.64 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93462	CPT	Hchg Lt Hrt Cath Trnsptl Punc	21	5	$2,472.80	$494.56 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93581	CPT	Vsd Closure W/Implant	21	5	$21,140.90	$4,228.18 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93595	CPT	Lt Ht Cong Nl Or Abn Nc	21	5	$11,347.60	$2,269.52 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93609	CPT	Map Tachy Intra V/a	21	5	$16,949.90	$3,389.98 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93623	CPT	Ep W Stim/Pacing IV Drug	21	5	$13,982.10	$2,796.42 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36218	CPT	Scp Add 2 Or 3 Ord Art Th	21	5	$1,952.50	$390.50 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93458	CPT	Hchg Lt Hrt Cor/Lv Angio	20	4	$14,715.80	$2,943.16 80% off	$1,000.00	$7,166.00	$7,166.00	2025-10-06
93620	CPT	Ep Ra Rv&His W Induc Arry	21	5	$14,808.20	$2,961.64 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93454	CPT	Hchg Coronary Art Angio S&i	21	5	$11,278.30	$2,255.66 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36221	CPT	Angio Arch	21	5	$2,569.60	$513.92 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93457	CPT	Hchg Rt Hrt Cor/Grft Angio	21	5	$20,424.80	$4,084.96 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93593	CPT	Rt Ht Cong Nl Nc	21	5	$6,800.20	$1,360.04 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93597	CPT	Rt & Lt Ht Cong Abl Nc	21	5	$25,362.70	$5,072.54 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36251	CPT	Hchg Angio Renal Uni W/wo Flsh	21	5	$4,656.30	$931.26 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93657	CPT	Hchg Add Ablt L R Atrm Afib	21	5	$8,769.20	$1,753.84 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93461	CPT	Hchg Rt&Lt Hrt Cor/Lv/Grft	21	5	$28,756.20	$5,751.24 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
92997	CPT	Pulmonary Angioplasty	21	5	$10,921.90	$2,184.38 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33897	CPT	Perq Trluml Angp Nt/Recr Coa	29	8	$7,984.90	$1,596.98 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93656	CPT	Hchg Ep W Afib Abl Vt P.v.i.	20	4	$23,387.10	$4,677.42 80% off	$1,000.00	$7,166.00	$7,166.00	2025-10-06
36200	CPT	Scp Aorta	21	5	$2,329.80	$465.96 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
93613	CPT	3-d Mapping Tachycardia	21	5	$12,226.50	$2,445.30 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33240	CPT	Hchg Insrtn Aicd Only W Ex Sng Lead	21	5	$59,898.30	$11,979.66 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33207	CPT	Hchg Insrt/Rpl Pm Vntrclr	21	5	$24,915.00	$4,983.00 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33016	CPT	Periocardiocentesis	21	5	$7,283.10	$1,456.62 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33222	CPT	Rev/Reloc Skin Pocket	21	5	$17,602.20	$3,520.44 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37212	CPT	Transcatheter Venous Infusion Thrombolysis, Initial, Any Method	21	5	$5,112.80	$1,022.56 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
37184	CPT	Hchg Thrmbctmy Perc Art Intl Ves	21	5	$5,976.30	$1,195.26 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36253	CPT	Hchg Scp Rnl Art 2nd Ordr Uni	21	5	$17,130.30	$3,426.06 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33206	CPT	Hchg Insrt/Rpl Pm Atrial	21	5	$26,942.30	$5,388.46 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36226	CPT	Hchg Angio,Vetebral Cerv /Intracranial	21	5	$5,709.00	$1,141.80 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
33895	CPT	Hchg Evas St Rpr Thrc/Aa X Crsg	29	8	$9,754.80	$1,950.96 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36014	CPT	Scp Lt Or Rt Pul Art	21	5	$1,952.50	$390.50 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36000	CPT	Hchg Intr Ndl Orintrcth Vn	21	5	$3,770.80	$754.16 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36005	CPT	Hchg Inject Contrast Ext Veno	21	5	$3,049.20	$609.84 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
36010	CPT	Intro Cath Svc Or Ivc	21	5	$1,758.90	$351.78 80% off	$165.82	$7,166.00	$7,166.00	2025-10-06
J9301	HCPCS	Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution	10	5	$59,915.00	$11,983.00 80% off	$165.82	$7,055.00	$7,055.00	2025-10-06
J3380	HCPCS	Vedolizumab 300 Mg Intravenous Solution	10	5	$65,313.50	$13,062.70 80% off	$165.82	$6,804.00	$6,804.00	2025-10-06
J1303	HCPCS	Ravulizumab-cwvz 100 Mg/ml Intravenous Solution	18	5	$182,506.50	$36,501.30 80% off	$165.82	$24,406.80	$6,656.40	2025-10-06
J9266	HCPCS	Pegaspargase 750 Unit/ml Injection Solution	107	32	$170,276.25	$34,055.25 80% off	$165.82	$25,762.46	$6,233.87	2025-10-06
J9271	HCPCS	Pembrolizumab 25 Mg/ml Intravenous Solution	10	5	$32,717.75	$6,543.55 80% off	$165.82	$5,481.00	$5,481.00	2025-10-06
81425	CPT	Genome Sequence Analysis	10	5	$25,137.85	$5,027.57 80% off	$165.82	$5,445.27	$5,445.27	2025-10-06
81415	CPT	Whole Genome Sequencing	10	5	$16,204.65	$3,240.93 80% off	$165.82	$5,173.39	$5,173.39	2025-10-06
J9039	HCPCS	Blinatumomab 35 Mcg Intravenous Kit	10	5	$56,612.50	$11,322.50 80% off	$165.82	$5,063.80	$5,063.80	2025-10-06
J9021	HCPCS	Asparaginase Erwinia Chrysanthemi-rywn 10 Mg/0.5 Ml IM Solution	10	5	$30,877.75	$6,175.55 80% off	$165.82	$4,953.00	$4,953.00	2025-10-06
J1950	HCPCS	Leuprolide 30 Mg (pediatric 3 Month) Intramuscular Syringe Kit	34	5	$37,527.00	$7,505.40 80% off	$165.82	$12,348.16	$4,630.56	2025-10-06
J2997	HCPCS	Alteplase 2 Mg Intra-catheter Solution	26	5	$30,704.50	$6,140.90 80% off	$165.82	$8,915.00	$4,457.50	2025-10-06
81440	CPT	Mitochondrial Gene	10	5	$1,652.55	$330.51 80% off	$165.82	$3,597.57	$3,597.57	2025-10-06
J9352	HCPCS	Trabectedin 1 Mg Intravenous Solution	10	5	$21,453.75	$4,290.75 80% off	$165.82	$3,372.80	$3,372.80	2025-10-06
A0431	HCPCS	Amb Rotary Wing Base Rate	91	26	$29,348.00	$5,869.60 80% off	$165.82	$4,084.85	$3,363.35	2025-10-06
J0597	HCPCS	C1 Esterase Inhibitor 500 Unit (10 Ml) Intravenous Kit	10	5	$13,237.50	$2,647.50 80% off	$165.82	$3,222.50	$3,222.50	2025-10-06
81456	CPT	Hchg Tgsap So/Hl 51/< RNA Alys	10	5	$13,767.80	$2,753.56 80% off	$165.82	$3,159.88	$3,159.88	2025-10-06
J7504	HCPCS	Lymphocyte,anti-thymo Immune Globulin 50 Mg/ml Intravenous Solution	10	5	$35,318.00	$7,063.60 80% off	$165.82	$2,989.44	$2,989.44	2025-10-06
81229	CPT	Cytogen M Array Copy No&Snp	10	5	$5,000.20	$1,000.04 80% off	$165.82	$2,980.80	$2,980.80	2025-10-06
81426	CPT	Genome Sequence Analysis-each Comparator Genome	10	5	$13,541.25	$2,708.25 80% off	$165.82	$2,932.98	$2,932.98	2025-10-06
A0430	HCPCS	Amb Fixed Wing Base Rate	91	26	$25,167.00	$5,033.40 80% off	$165.82	$3,513.39	$2,892.84	2025-10-06
81443	CPT	Hchg Genetic Tstg Severe Inh Cond	10	5	$9,479.45	$1,895.89 80% off	$165.82	$2,650.07	$2,650.07	2025-10-06
81419	CPT	Epilepsy Gen Seq Alys Panel	10	5	$6,813.75	$1,362.75 80% off	$165.82	$2,650.07	$2,650.07	2025-10-06
81455	CPT	Targeted Genomic Seq Analysis 51+	112	34	$26,524.75	$5,304.95 80% off	$165.82	$3,159.88	$2,452.46	2025-10-06
J7189	HCPCS	Coagulation Factor Viia Recomb 1 Mg (1,000 Mcg) Intravenous Solution	18	5	$23,857.00	$4,771.40 80% off	$165.82	$4,680.00	$2,340.00	2025-10-06
81442	CPT	Noonan Spectrum Disord.	10	5	$6,367.55	$1,273.51 80% off	$165.82	$2,320.02	$2,320.02	2025-10-06
0152U	CPT	Nfct Ds DNA Untrgt Ngnrj Seq	10	5	$9,085.00	$1,817.00 80% off	$165.82	$2,301.19	$2,301.19	2025-10-06
J0840	HCPCS	Crotalidae Polyval Immune Fab Solution For Injection	10	5	$15,487.75	$3,097.55 80% off	$165.82	$2,056.35	$2,056.35	2025-10-06
J3240	HCPCS	Thyrotropin Alfa 0.9 Mg Intramuscular Solution	10	5	$6,957.25	$1,391.45 80% off	$165.82	$2,001.49	$2,001.49	2025-10-06
81430	CPT	Hearing Loss Sequence Analys	10	5	$1,713.50	$342.70 80% off	$165.82	$1,758.74	$1,758.74	2025-10-06
J0178	HCPCS	Aflibercept 2 Mg/0.05 Ml Intravitreal Solution For Injection	10	5	$13,553.75	$2,710.75 80% off	$165.82	$1,751.34	$1,751.34	2025-10-06
90375	HCPCS	Rabies Immune Globulin (pf) 300 Unit/ml Intramuscular Solution	26	5	$18,177.50	$3,635.50 80% off	$165.82	$2,846.80	$1,708.08	2025-10-06
81408	CPT	Mopath Procedure Level 9	112	34	$4,884.05	$976.81 80% off	$165.82	$2,164.60	$1,680.00	2025-10-06
J9036	HCPCS	Bendamustine 25 Mg/ml Intravenous Solution	10	5	$13,607.25	$2,721.45 80% off	$165.82	$1,672.00	$1,672.00	2025-10-06
J3358	HCPCS	Ustekinumab 130 Mg/26 Ml Intravenous Solution	10	5	$17,996.00	$3,599.20 80% off	$165.82	$1,636.70	$1,636.70	2025-10-06
81162	CPT	Brca1&2 Gen Full Seq Dup/Del	112	34	$15,487.05	$3,097.41 80% off	$165.82	$1,975.07	$1,532.90	2025-10-06
J1322	HCPCS	Elosulfase Alfa 5 Mg/5 Ml (1 Mg/ml) Intravenous Solution	10	5	$8,763.25	$1,752.65 80% off	$165.82	$1,400.65	$1,400.65	2025-10-06
81460	CPT	Whole Mitochondrial Sequencing	10	5	$9,845.15	$1,969.03 80% off	$165.82	$1,392.92	$1,392.92	2025-10-06
J2860	HCPCS	Siltuximab 100 Mg Intravenous Solution	18	5	$9,253.50	$1,850.70 80% off	$165.82	$5,568.80	$1,392.20	2025-10-06
33477	CPT	Hchg Prosth Pul Valve Endovas	10	5	$20,589.80	$4,117.96 80% off	$165.82	$1,276.89	$1,276.89	2025-10-06
81277	CPT	Hchg Cytogenomic Neo Microra Alys	10	5	$4,491.90	$898.38 80% off	$165.82	$1,255.47	$1,255.47	2025-10-06
J9264	HCPCS	Paclitaxel Protein-bound 100 Mg Intravenous Suspension	10	5	$6,575.75	$1,315.15 80% off	$165.82	$1,206.00	$1,206.00	2025-10-06
J3262	HCPCS	Tocilizumab 80 Mg/4 Ml (20 Mg/ml) Intravenous Solution	26	5	$9,266.25	$1,853.25 80% off	$165.82	$2,364.00	$1,182.00	2025-10-06
81411	CPT	Hchg Aortic Dysfunction/Dilation	112	34	$3,122.25	$624.45 80% off	$165.82	$1,461.31	$1,134.16	2025-10-06
61624	CPT	Emboliz Intracaran/Spinal	9	4	$8,644.90	$1,728.98 80% off	$1,000.00	$1,107.13	$1,107.13	2025-10-06
J0180	HCPCS	Agalsidase Beta 35 Mg Intravenous Solution	18	5	$49,704.50	$9,940.90 80% off	$165.82	$7,538.30	$1,076.90	2025-10-06
J1931	HCPCS	Laronidase 2.9 Mg/5 Ml Intravenous Solution	10	5	$9,452.75	$1,890.55 80% off	$165.82	$1,074.16	$1,074.16	2025-10-06
J2506	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe	10	5	$24,527.75	$4,905.55 80% off	$165.82	$1,028.52	$1,028.52	2025-10-06
J0841	HCPCS	Antivenin Crotalidae (equine) Solution For Injection	10	5	$7,676.00	$1,535.20 80% off	$165.82	$1,019.46	$1,019.46	2025-10-06
81465	CPT	Whole Mitochondrial Deletions	10	5	$8,665.25	$1,733.05 80% off	$165.82	$1,013.03	$1,013.03	2025-10-06
J9330	HCPCS	Temsirolimus 30 Mg/3 Ml (10 Mg/ml) (first Dilution) Intravenous Soln	10	5	$15,297.75	$3,059.55 80% off	$165.82	$1,009.20	$1,009.20	2025-10-06
19318	CPT	Hchg Breast Reduction	1	1	$16,508.80	$3,301.76 80% off	$1,000.00	$1,000.00	$1,000.00	2025-10-06
95810	CPT	Psc Age 6-20 4+ Param	1	1	$9,590.90	$1,918.18 80% off	$1,000.00	$1,000.00	$1,000.00	2025-10-06
33249	CPT	Insrt/Remv Acid	1	1	$85,085.00	$17,017.00 80% off	$1,000.00	$1,000.00	$1,000.00	2025-10-06
J0485	HCPCS	Belatacept 250 Mg Intravenous Solution	10	5	$7,390.75	$1,478.15 80% off	$165.82	$1,000.00	$945.00	2025-10-06
J1568	HCPCS	Immune Glob,gamm(igg)10 %-malt-iga Over 50 Mcg/ml Intravenous Solution	18	5	$16,492.00	$3,298.40 80% off	$165.82	$1,764.80	$941.20	2025-10-06
J7195	HCPCS	Coagulation Factor Ix (recomb) 2,000 Unit Intravenous Solution	18	5	$8.50	$1.70 80% off	$165.82	$3,520.00	$940.00	2025-10-06
J7511	HCPCS	Anti-thymocyte Globulin (rabbit) 25 Mg Intravenous Solution	10	5	$5,041.50	$1,008.30 80% off	$165.82	$1,000.00	$920.53	2025-10-06
81185	CPT	Cacna1a Gene Full Gene Seq	10	5	$3,358.00	$671.60 80% off	$165.82	$1,000.00	$915.92	2025-10-06
78832	CPT	Nuclear Medicine Study, Spect Imaging With Concurrent CT Scan, At Leas	103	30	$6,330.24	$1,266.05 80% off	$908.50	$1,000.00	$908.50	2025-10-06
J9312	HCPCS	Rituximab 10 Mg/ml Concentrate,intravenous	18	5	$6,103.50	$1,220.70 80% off	$165.82	$4,052.00	$905.20	2025-10-06
J9035	HCPCS	Bevacizumab 25 Mg/ml Intravenous Solution	18	5	$23,785.00	$4,757.00 80% off	$165.82	$2,943.20	$867.90	2025-10-06
J9055	HCPCS	Cetuximab 100 Mg/50 Ml Intravenous Solution	18	5	$3,869.00	$773.80 80% off	$165.82	$1,441.60	$860.40	2025-10-06
J0490	HCPCS	Belimumab 120 Mg Intravenous Solution	18	5	$3,946.25	$789.25 80% off	$165.82	$2,037.20	$805.58	2025-10-06
0282U	CPT	Rbc DNA Gntyp 12 Bld Grp Gen	10	5	$1,698.55	$339.71 80% off	$165.82	$1,000.00	$779.26	2025-10-06
J1745	HCPCS	Infliximab 100 Mg Intravenous Solution	107	32	$8,899.00	$1,779.80 80% off	$165.82	$1,000.00	$768.90	2025-10-06
81431	CPT	Hearing Loss Dup/Del Analys	10	5	$1,713.50	$342.70 80% off	$165.82	$1,000.00	$735.50	2025-10-06
81175	CPT	Asxl1 Full Gene Sequence	10	5	$2,685.25	$537.05 80% off	$165.82	$1,000.00	$732.18	2025-10-06
J0475	HCPCS	Baclofen 40,000 Mcg/20 Ml (2,000 Mcg/ml) Intrathecal Solution	10	5	$6,266.25	$1,253.25 80% off	$165.82	$1,000.00	$729.96	2025-10-06
J1459	HCPCS	Immune Glob,gamm(igg) 10 %-pro-iga 0 To 50 Mcg/ml Intravenous Solution	18	5	$11,308.75	$2,261.75 80% off	$165.82	$1,000.00	$719.85	2025-10-06
81407	CPT	Mopath Procedure Level 8	112	34	$12,087.65	$2,417.53 80% off	$165.82	$1,000.00	$710.87	2025-10-06
33741	CPT	Transcatheter Atrial Septostomy Balloon	10	5	$23,845.80	$4,769.16 80% off	$165.82	$1,000.00	$709.52	2025-10-06
Q5115	HCPCS	Rituximab-abbs 10 Mg/ml Intravenous Solution	18	5	$5,143.25	$1,028.65 80% off	$165.82	$1,989.50	$698.95	2025-10-06
J1212	HCPCS	Dimethyl Sulfoxide 50 % Intravesical Solution	10	5	$5,795.00	$1,159.00 80% off	$165.82	$1,000.00	$682.52	2025-10-06
80412	CPT	Cortrosyn Stim Test	112	34	$368.00	$73.60 80% off	$165.82	$1,000.00	$673.36	2025-10-06
J1602	HCPCS	Golimumab 12.5 Mg/ml Intravenous Solution	10	5	$17,801.00	$3,560.20 80% off	$165.82	$1,000.00	$664.50	2025-10-06
81201	CPT	Apc Gene Analysis Full	112	34	$2,848.55	$569.71 80% off	$165.82	$1,020.47	$655.20	2025-10-06
81445	CPT	Targeted Genomic Seq Analys	10	5	$6,311.20	$1,262.24 80% off	$165.82	$1,000.00	$647.12	2025-10-06
81325	CPT	Pmp22 Gene Full Sequence	112	34	$2,156.25	$431.25 80% off	$165.82	$1,000.00	$646.45	2025-10-06
J9261	HCPCS	Nelarabine 250 Mg/50 Ml Intravenous Solution	10	5	$6,861.25	$1,372.25 80% off	$165.82	$1,000.00	$644.95	2025-10-06
81450	CPT	Targeted Genomic Seq Analysis 5-50	112	34	$10,276.40	$2,055.28 80% off	$165.82	$1,000.00	$638.01	2025-10-06
Q5119	HCPCS	Rituximab-pvvr 10 Mg/ml Intravenous Solution	18	5	$6,085.75	$1,217.15 80% off	$165.82	$1,375.50	$637.55	2025-10-06
81324	CPT	Pmp22 Gene Dup/Delet	112	34	$2,939.40	$587.88 80% off	$165.82	$1,000.00	$637.02	2025-10-06
J0587	HCPCS	Rimabotulinumtoxinb 5,000 Unit/ml Intramuscular Solution	10	5	$4,665.75	$933.15 80% off	$165.82	$1,000.00	$636.00	2025-10-06
81439	CPT	Hchg Hrdtry Cardmypy Gene Panel	10	5	$2,658.80	$531.76 80% off	$165.82	$1,000.00	$633.04	2025-10-06
81413	CPT	Hchg Car Ion Chnnlpath Inc 10 Gns	10	5	$4,414.85	$882.97 80% off	$165.82	$1,000.00	$633.04	2025-10-06
81414	CPT	Hchg Car Ion Chnnlpath Inc 2 Gns	10	5	$2,883.05	$576.61 80% off	$165.82	$1,000.00	$633.04	2025-10-06
57415	CPT	Removal Impacted Vag Fb Spx W/Anes Oth/Thn Local	10	5	$2,730.00	$546.00 80% off	$165.82	$1,000.00	$606.00	2025-10-06
J9120	HCPCS	Dactinomycin 0.5 Mg Intravenous Solution	10	5	$6,840.50	$1,368.10 80% off	$165.82	$1,000.00	$594.55	2025-10-06
41899	CPT	Hchg Unlisted Procedure, Dentoalveolar Structures	3	3	$14,886.30	$2,977.26 80% off	$165.82	$1,000.00	$585.90	2025-10-06
20670	CPT	Hchg Removal Of Implant; Superficial (Eg, Buried Wire, Pin Or Rod) (Separate Pro…	2	2	$12,236.40	$2,447.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
20612	CPT	Hchg Aspiration &/or Inj Of Ganglion Cyst(S) Any Location	2	2	$1,866.70	$373.34 80% off	$165.82	$1,000.00	$582.91	2025-10-06
12032	CPT	Hchg Repair, Intermediate, Wounds Of Scalp, Axillae, Trunk And/or Extremities (e…	2	2	$2,514.60	$502.92 80% off	$165.82	$1,000.00	$582.91	2025-10-06
20610	CPT	Arthrocentesis, Aspiration And Or Injection Major Joint	2	2	$1,304.80	$260.96 80% off	$165.82	$1,000.00	$582.91	2025-10-06
20605	CPT	Hchg Arthorcentesis, Aspiration &/or Inj, Intermediate Joint/Bursa Without Ultrsound…	2	2	$1,866.70	$373.34 80% off	$165.82	$1,000.00	$582.91	2025-10-06
12031	CPT	Hchg Repair, Intermediate, Wounds Of Scalp, Axillae, Trunk And/or Extremities (e…	2	2	$2,897.40	$579.48 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11305	CPT	Hchg Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Scalp, Neck, Hands, F…	2	2	$421.30	$84.26 80% off	$165.82	$1,000.00	$582.91	2025-10-06
20600	CPT	Hchg Arthrocentesis, Aspiration &/or Injection, Small Joint/Bursa Without Ultrasound…	2	2	$1,866.70	$373.34 80% off	$165.82	$1,000.00	$582.91	2025-10-06
20550	CPT	Hchg Injection(S); Single Tendon/Sheet/Ligament, Aponeurosis/Plantar Fascia	2	2	$1,866.70	$373.34 80% off	$165.82	$1,000.00	$582.91	2025-10-06
12011	CPT	Hchg Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips 2.5 …	2	2	$1,035.10	$207.02 80% off	$165.82	$1,000.00	$582.91	2025-10-06
20520	CPT	Removal Fb Muscle, Simple	2	2	$1,018.08	$203.62 80% off	$165.82	$1,000.00	$582.91	2025-10-06
20501	CPT	Injection Sinus Tract Dx	2	2	$388.64	$77.73 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11971	CPT	Hchg Removal Of Tissue Expander Without Insertion Of Implant	2	2	$13,154.90	$2,630.98 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11302	CPT	Hchg Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Trunk, Arms Or Legs; …	2	2	$525.80	$105.16 80% off	$165.82	$1,000.00	$582.91	2025-10-06
10030	CPT	Percutaneous Abscess Drainage W Indwelling Catheter	2	2	$3,952.48	$790.50 80% off	$165.82	$1,000.00	$582.91	2025-10-06
20206	CPT	Perc Needle Bx Muscle	2	2	$871.36	$174.27 80% off	$165.82	$1,000.00	$582.91	2025-10-06
19325	CPT	Hchg Breast Augmentation With Implant	2	2	$14,652.00	$2,930.40 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11960	CPT	Hchg Insertion Of Tissue Expander(S) For Other Than Breast, Including Subsequent…	2	2	$17,697.90	$3,539.58 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29520	CPT	Hchg Hchg Strapping Hip Rt	2	2	$377.30	$75.46 80% off	$165.82	$1,000.00	$582.91	2025-10-06
19300	CPT	Hchg Mastectomy For Gynecomastia	2	2	$16,408.70	$3,281.74 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11954	CPT	Hchg Subcutaneous Injection Of Filling Material (Eg, Collagen); Over 10.0 Cc	2	2	$9,265.30	$1,853.06 80% off	$165.82	$1,000.00	$582.91	2025-10-06
10012	CPT	Fine Needle Asp W Mr Ea Additional	2	2	$1,249.92	$249.98 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29450	CPT	Hchg Appl Cast Club Foot W Mold Or Manipul Short/Long Rt	2	2	$567.60	$113.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29445	CPT	Hchg App Cast Rigid Leg Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
19120	CPT	Hchg Excision Of Cyst, Fibroadenoma, Or Other Benign Or Malignant Tumor, Aberran…	2	2	$12,509.20	$2,501.84 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29505	CPT	Hchg Application Long Leg Splint Thigh To Ankle Or Toes	2	2	$330.65	$66.13 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29515	CPT	Hchg Application Short Leg Splint Calf To Foot	2	2	$330.65	$66.13 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29440	CPT	Hchg Add Walker To Previous Applied Cast	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29530	CPT	Hchg Strapping Knee Rt	2	2	$377.30	$75.46 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29540	CPT	Hchg Strapping Ankle Or Foot Rt	2	2	$377.30	$75.46 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29550	CPT	Hchg Strapping Toes Rt	2	2	$457.60	$91.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29700	CPT	Hchg Removal/Bival Gaunlet/Boot/Body Cast Rt	2	2	$515.90	$103.18 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29705	CPT	Hchg Removal/Bival Full Arm, Leg Cast Rt	2	2	$567.60	$113.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29710	CPT	Hchg Removal /Bival Shoulder Or Hip Spica Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29720	CPT	Hchg Repair Spica -body Cast-jacket	2	2	$515.90	$103.18 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29730	CPT	Hchg Window Cast Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29740	CPT	Wedging Of Cast Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29750	CPT	Wedging Clubfoot Cast Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30117	CPT	Hchg Excision Or Destruction (Eg, Laser), Intranasal Lesion; Internal Approach	2	2	$9,572.20	$1,914.44 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30130	CPT	Hchg Excision Inferior Turbinate, Partial Or Complete, Any Method	2	2	$9,593.10	$1,918.62 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30140	CPT	Hchg Submucous Resection Inferior Turbinate, Partial Or Complete, Any Method	2	2	$7,991.50	$1,598.30 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30220	CPT	Hchg Insertion, Nasal Septal Prosthesis (Button)	2	2	$5,948.80	$1,189.76 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30300	CPT	Hchg Removal Of Nasal Foreign Body	2	2	$330.65	$66.13 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30400	CPT	Hchg Rhinoplasty, Primary; Lateral And Alar Cartilages And/or Elevation Of Nasal…	2	2	$11,820.60	$2,364.12 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30420	CPT	Hchg Rhinoplasty, Primary; Including Major Septal Repair	2	2	$20,881.30	$4,176.26 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30430	CPT	Hchg Rhinoplasty, Secondary; Minor Revision (Small Amount Of Nasal Tip Work)	2	2	$12,105.50	$2,421.10 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30465	CPT	Hchg Repair Of Nasal Vestibular Stenosis (Eg, Spreader Grafting, Lateral Nasal W…	2	2	$11,608.30	$2,321.66 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30468	CPT	Hchg Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Im…	2	2	$9,258.70	$1,851.74 80% off	$165.82	$1,000.00	$582.91	2025-10-06
30520	CPT	Hchg Septoplasty Or Submucous Resection, With Or Without Cartilage Scoring, Cont…	2	2	$8,846.20	$1,769.24 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29435	CPT	Hchg App Cast Ptb Short Leg Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
17999	CPT	Hchg Unlisted Procedure, Skin, Mucous Membrane And Subcutaneous Tissue	2	2	$10,035.30	$2,007.06 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11952	CPT	Hchg Subcutaneous Injection Of Filling Material (Eg, Collagen); 5.1 To 10.0 Cc	2	2	$3,281.30	$656.26 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29425	CPT	Hchg Appl Cast Short Leg Walker/Amb Rt	2	2	$624.80	$124.96 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29405	CPT	Hchg Appl Cast Short Leg Knee-toes Rt	2	2	$567.60	$113.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
17250	CPT	Hchg Chemical Cauterization Of Granulation Tissue (Ie, Proud Flesh)	2	2	$929.50	$185.90 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29365	CPT	Hchg App Cast Long Leg Thigh To Ankle Rt	2	2	$567.60	$113.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29358	CPT	Hchg Appl Cast Long Leg Brace Rt	2	2	$515.90	$103.18 80% off	$165.82	$1,000.00	$582.91	2025-10-06
17111	CPT	Hchg Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, …	2	2	$666.60	$133.32 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11951	CPT	Hchg Subcutaneous Injection Of Filling Material (Eg, Collagen); 1.1 To 5.0 Cc	2	2	$3,854.40	$770.88 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11105	CPT	Hchg Punch Biopsy Of Skin (Including Simple Closure, When Performed)	2	2	$755.70	$151.14 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29355	CPT	Hchg Appl Cast Long Leg Walker /Amb Rt	2	2	$567.60	$113.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29345	CPT	Hchg Appl Cast Long Leg Thight-toes Rt	2	2	$647.90	$129.58 80% off	$165.82	$1,000.00	$582.91	2025-10-06
17110	CPT	Hchg Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, …	2	2	$935.00	$187.00 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29325	CPT	Hchg App Cast Hips	2	2	$515.90	$103.18 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29305	CPT	Hchg Hchg App Cast Hip Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
17108	CPT	Hchg Destruction Of Cutaneous Vascular Proliferative Lesions (Eg, Laser Techniqu…	2	2	$9,598.60	$1,919.72 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11950	CPT	Hchg Subcutaneous Injection Of Filling Material (Eg, Collagen); 1 Cc Or Less	2	2	$4,063.40	$812.68 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29280	CPT	Hchg Strapping Hand Or Finger Rt	2	2	$457.60	$91.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29260	CPT	Hchg Strapping Elbow Or Wrist Rt	2	2	$377.30	$75.46 80% off	$165.82	$1,000.00	$582.91	2025-10-06
17107	CPT	Hchg Destruction Of Cutaneous Vascular Proliferative Lesions (Eg, Laser Techniqu…	2	2	$2,721.40	$544.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29240	CPT	Hchg Strapping Shoulder Rt	2	2	$129.80	$25.96 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29200	CPT	Hchg Strapping Chest	2	2	$438.90	$87.78 80% off	$165.82	$1,000.00	$582.91	2025-10-06
17106	CPT	Hchg Destruction Of Cutaneous Vascular Proliferative Lesions (Eg, Laser Techniqu…	2	2	$1,735.80	$347.16 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11901	CPT	Hchg Injection, Intralesional; More Than 7 Lesions	2	2	$528.00	$105.60 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11104	CPT	Hchg Punch Biopsy Of Skin (Including Simple Closure, When Performed); Single Les…	2	2	$1,604.90	$320.98 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29131	CPT	Hchg Application Finger Splint Dynamic	2	2	$177.10	$35.42 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29130	CPT	Hchg Application Finger Splint Static	2	2	$330.65	$66.13 80% off	$165.82	$1,000.00	$582.91	2025-10-06
16030	CPT	Dress/Debride Prtl Thk Burns >10% Body Surface	2	2	$1,036.20	$207.24 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29126	CPT	Hchg Appl Short Arm Splint Forearm -hand Dynamic Rt	2	2	$515.90	$103.18 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29125	CPT	Hchg Application Short Arm Splint Forearm To Hand	2	2	$330.65	$66.13 80% off	$165.82	$1,000.00	$582.91	2025-10-06
16025	CPT	Dress/Debride Prtl Thk Burns 5%-10% Body Surface	2	2	$1,004.30	$200.86 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11900	CPT	Hchg Injection, Intralesional; Up To And Including 7 Lesions	2	2	$749.10	$149.82 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29105	CPT	Hchg Application Long Arm Splt Shoulder To Hand	2	2	$330.65	$66.13 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29086	CPT	Hchg Appl Cast Finger Second Digit Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
16020	CPT	Dress/Debride Prtl Thk Burns <5% Body Surface	2	2	$1,009.80	$201.96 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29085	CPT	Hchg Appl Cast Hand And Lower Forearm Rt	2	2	$567.60	$113.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29075	CPT	Hchg Appl Cast Elbow To Finger Rt	2	2	$624.80	$124.96 80% off	$165.82	$1,000.00	$582.91	2025-10-06
16000	CPT	Initial Tx 1st Deg Burn Local	2	2	$495.00	$99.00 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11771	CPT	Hchg Excision Of Pilonidal Cyst Or Sinus; Extensive	2	2	$13,201.10	$2,640.22 80% off	$165.82	$1,000.00	$582.91	2025-10-06
11103	CPT	Hchg Tangential Biopsy Of Skin (Eg, Shave, Scoop, Saucerize, Curette); Each Sepa…	2	2	$489.50	$97.90 80% off	$165.82	$1,000.00	$582.91	2025-10-06
10011	CPT	Fine Needle Asp W Mr	2	2	$1,249.92	$249.98 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29065	CPT	Hchg Shoulder To Hand Long Arm Rt	2	2	$567.60	$113.52 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29058	CPT	Hchg Appl Cast Plaster Velpeau Rt	2	2	$466.40	$93.28 80% off	$165.82	$1,000.00	$582.91	2025-10-06
15877	CPT	Hchg Suction Assisted Lipectomy; Trunk	2	2	$15,107.40	$3,021.48 80% off	$165.82	$1,000.00	$582.91	2025-10-06
29055	CPT	Hchg App Cast Shoulder Spica	2	2	$1,113.20	$222.64 80% off	$165.82	$1,000.00	$582.91	2025-10-06

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