Price Transparencybeta Hospital negotiated rates

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

Export CSV
Hospital

EVERGREENHEALTH MONROE

Monroe, WA · CCN 500084 · Rates published

Your selected procedure

You selected 93306 (CPT)

HC Tte W/Doppler Complete - Tte Complete

This hospital’s price: $588 across 46 payers · range $204-$2,122

Source: https://stmlevergreenncus001.blob.core.windows.net/public/916018764_SNOHOMISH-COUNTY-PUBLIC-HOSPITAL-DISTRICT-NO1_standardcharges.csv · observed 2026-01-05

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

1,520 distinct procedures filed
61 distinct payers
198,014 rate rows
2026-01-05 last MRF observed
Data quality

195,505 of 198,014 rate rows are consumer-grade (98.7%)

2,509 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,015
placeholder amount (≤ $0.02) — excluded from medians 281
per-diem day rate — not a per-procedure price 113
exceeds 10× this hospital's gross charge — excluded from medians 51
percent-of-charges filed in the dollar field — excluded from medians 49
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stmlevergreenncus001.blob.core.windows.net/public/916018764_SNOHOMISH-COUNTY-PUBLIC-HOSPITAL-DISTRICT-NO1_standardcharges.csv
Found on page https://www.evergreenhealth.com/patients-visitors/after-your-visit/billing-financial/get-a-cost-estimate/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint 78dc0a35340bcd61… · 93,391,263 bytes · first seen 2026-05-09

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 50 Mg IV Kit 61 $153.11 $48,808.00 $48,808.00 nat. median
$498
outlier · 98.0×
J2353
HCPCS 		Octreotide Acetate 20 Mg IM Kit 61 $210.56 $28,261.00 $28,261.00 nat. median
$1,956
outlier · 14.4×
J1162
HCPCS 		Digoxin Immune Fab 40 Mg IV Solr 61 $4,134.21 $27,477.00 $27,477.00 nat. median
$6,265
outlier · 4.4×
J2182
HCPCS 		Mepolizumab 100 Mg/ml Sc Sosy 61 $30.48 $23,494.00 $23,494.00 nat. median
$80
outlier · 294.9×
J7165
HCPCS 		Prothrombin Complex Human-lans 1000 Units IV Solr 61 $3.25 $19,287.00 $19,287.00 nat. median
$5
outlier · 4165.7×
J9305
HCPCS 		Pemetrexed Disodium 500 Mg IV Solr 61 $3.97 $20,455.00 $16,670.83 nat. median
$101
outlier · 165.5×
43240
CPT 		Hc Egd Transoral Transmural Drainage Pseudocyst - Endo US (Upper) 61 $598.74 $14,756.00 $14,461.75 nat. median
$5,324
outlier · 2.7×
Q4187
HCPCS 		Hc Epicord 1 Sq Cm 61 $7,559.37 $11,999.00 $11,999.00 nat. median
$477
outlier · 25.2×
J0897
HCPCS 		Denosumab 60 Mg/ml Sc Sosy 61 $25.19 $11,487.00 $11,487.00 nat. median
$86
outlier · 133.6×
30117
CPT 		Hc Removal Of Intranasal Lesion 61 $651.73 $14,960.00 $9,625.00 nat. median
$3,203
outlier · 3.0×
J7190
HCPCS 		Antihemophilic Factor 1000 Units IV Solr 61 $1.11 $9,189.00 $9,189.00 nat. median
$2
outlier · 5890.4×
J1950
HCPCS 		Leuprolide Acetate 3.75 Mg IM Kit 61 $1,389.17 $22,303.29 $9,156.00 nat. median
$3,343
outlier · 2.7×
13101
CPT 		Hc Ed Repair Complex Trunk; 2.6 To 7.5 Cm 61 $387.06 $9,840.00 $9,136.44 nat. median
$871
outlier · 10.5×
41112
CPT 		Hc Excision Of Tongue Lesion 61 $388.10 $8,862.50 $8,302.49 nat. median
$3,041
outlier · 2.7×
41110
CPT 		Hc Excision Of Tongue Lesion 61 $205.76 $8,862.50 $8,302.49 nat. median
$3,124
outlier · 2.7×
J2315
HCPCS 		Naltrexone 380 Mg IM Susr 61 $3.97 $8,135.00 $8,135.00 nat. median
$5
outlier · 1643.4×
42330
CPT 		Hc Removal Of Salivary Stone 61 $262.66 $8,521.00 $8,106.06 nat. median
$3,183
outlier · 2.5×
J9217
HCPCS 		Leuprolide Acetate 7.5 Mg IM Kit 61 $149.27 $10,895.00 $7,553.50 nat. median
$2,144
outlier · 3.5×
54700
CPT 		Hc Ed Incis/Drain Scrotum/Testis,Epididym 61 $336.85 $8,064.00 $7,487.43 nat. median
$2,148
outlier · 3.5×
64469
CPT 		Hc Thrc Fascial Pln Blk Bil Infs 61 $123.01 $7,149.00 $7,149.00 nat. median
$460
outlier · 15.5×
64489
CPT 		Hc Tap Block Bi By Infusion 61 $115.62 $7,149.00 $7,149.00 nat. median
$682
outlier · 10.5×
64468
CPT 		Hc Thrc Fascial Pln Blk Bil Inj 61 $113.06 $7,149.00 $7,149.00 nat. median
$601
outlier · 11.9×
36558
CPT 		Hc Insert Tunneled Cv Cath 61 $397.81 $8,053.19 $6,669.00 nat. median
$3,467
1.9× median
72156
CPT 		Hc Mri, Cerv Spine Combo - MRI Cervical Spine W Wo Contrast 61 $348.96 $6,355.00 $6,355.00 nat. median
$625
outlier · 10.2×
72158
CPT 		Hc Mri, Lumbar Spine Combo - MRI Lumbar Spine W Wo Contrast 61 $347.87 $6,341.00 $6,341.00 nat. median
$616
outlier · 10.3×
74183
CPT 		Hc Mri, Abdomen, Combo - MRI Abdomen Renal W Wo Contrast 61 $357.13 $6,303.00 $6,303.00 nat. median
$611
outlier · 10.3×
74178
CPT 		Hc CT Abd & Pelv 1/> Regns - CT Abdomen Pelvis W Wo Contrast 61 $357.13 $6,292.00 $6,292.00 nat. median
$539
outlier · 11.7×
46320
CPT 		Hc Ed Excision Thrombosed Hemorrhoid, External 61 $178.93 $6,775.00 $6,290.59 nat. median
$1,320
outlier · 4.8×
2060000002
LOCAL 		Hc Progressive Care Room, Isolation, Daily 61 $6,255.00 $6,255.00 $6,255.00 —
72197
CPT 		Hc Mri, Pelvis, Combo - MRI Pelvis W Wo Contrast 61 $357.13 $6,235.00 $6,235.00 nat. median
$606
outlier · 10.3×
64624
CPT 		Hc Destruction Neurolytic Agt Gnclr Nrv W/Img 61 $230.27 $6,825.00 $6,172.00 nat. median
$2,098
outlier · 2.9×
J0630
HCPCS 		Calcitonin (salmon) 200 Unit/ml Ij Soln 61 $1,101.74 $6,129.00 $6,129.00 nat. median
$1,663
outlier · 3.7×
73223
CPT 		Hc MRI Joint Upr Extr W/O&with Contrast - Mr Upr Extrem W/wo IV Contrast 61 $357.13 $6,094.00 $6,094.00 nat. median
$757
outlier · 8.0×
59409
CPT 		Hc Ed Obstetrical Care,Vag Deliv Only 61 $1,219.36 $7,488.49 $5,932.00 nat. median
$3,106
1.9× median
2060000001
LOCAL 		Hc Progressive Care Room, Daily 61 $5,817.00 $5,817.00 $5,817.00 —
81479
CPT 		Hc Neotype Solid Tumor (Neogenomics) 61 $3,534.30 $5,610.00 $5,610.00 nat. median
$706
outlier · 7.9×
72157
CPT 		Hc Mri, Dorsal Spine Combo - MRI Thoracic Spine W Wo Contrast 61 $350.03 $5,600.00 $5,600.00 nat. median
$624
outlier · 9.0×
73723
CPT 		Hc Mri, Joint Of Leg. Combo - Mr W And Wo IV Contrast 61 $357.13 $5,414.00 $5,414.00 nat. median
$756
outlier · 7.2×
73222
CPT 		Hc MRI Joint Upr Extrem With Contrast - Mr Upr Extrem W IV Contrast 61 $385.01 $5,341.00 $5,341.00 nat. median
$1,026
outlier · 5.2×
49405
CPT 		Hc Image-guide Fluid Collxn Drainage Cath Visc Perq 61 $296.14 $5,922.00 $5,329.80 nat. median
$2,114
outlier · 2.5×
74177
CPT 		Hc CT Abd & Pelv W/Contrast - CT Abdomen Pelvis W Contrast 61 $355.54 $5,328.00 $5,328.00 nat. median
$501
outlier · 10.6×
74174
CPT 		Hc CT Angio Abd&Pelv W/O&with Contrast - CT Angiogram Abdomen Pelvis W Contrast 61 $357.13 $5,292.00 $5,292.00 nat. median
$549
outlier · 9.6×
71552
CPT 		Hc Mri, Chest, Combo - MRI Chest W Wo Contrast 61 $357.13 $5,281.00 $5,281.00 nat. median
$691
outlier · 7.6×
27252
CPT 		Hc Ed Closed Rx Trauma Hip Disloc,Anesth 61 $1,179.81 $5,659.00 $5,254.38 nat. median
$1,950
outlier · 2.7×
72149
CPT 		Hc Mri, Lumbar Spine Contrast - MRI Lumbar Spine W Contrast 61 $306.43 $5,244.00 $5,244.00 nat. median
$549
outlier · 9.5×
64488
CPT 		Hc Tap Block Bilateral Injection 61 $92.90 $5,180.00 $5,180.00 nat. median
$1,051
outlier · 4.9×
70553
CPT 		Hc MRI Brain Combo - MRI Brain W Wo Contrast 61 $347.87 $5,074.00 $5,074.00 nat. median
$616
outlier · 8.2×
72142
CPT 		Hc Mri, Cerv Spine Contrast - MRI Cervical Spine W Contrast 61 $313.97 $5,004.00 $5,004.00 nat. median
$541
outlier · 9.2×
73722
CPT 		Hc Mri, Joint Of Leg W/Contrast - Lower Extremity W/Contrast 61 $387.71 $4,889.00 $4,889.00 nat. median
$1,003
outlier · 4.9×
74170
CPT 		Hc CT Abdomen Without & With Contrast - CT Abdomen W Wo Contrast 61 $178.02 $4,857.00 $4,857.00 nat. median
$366
outlier · 13.3×

Other procedures at this hospital

Browse this hospital's 1,520 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3101 HCPCS Tenecteplase 50 Mg IV Kit 130 61 $48,808.00 $48,808.00 $153.11 $48,808.00 $48,808.00 2026-01-05
J2353 HCPCS Octreotide Acetate 20 Mg IM Kit 130 61 $28,261.00 $28,261.00 $210.56 $28,261.00 $28,261.00 2026-01-05
J1162 HCPCS Digoxin Immune Fab 40 Mg IV Solr 130 61 $27,477.00 $27,477.00 $4,134.21 $27,477.00 $27,477.00 2026-01-05
J2182 HCPCS Mepolizumab 100 Mg/ml Sc Sosy 130 61 $23,494.00 $23,494.00 $30.48 $23,494.00 $23,494.00 2026-01-05
J7165 HCPCS Prothrombin Complex Human-lans 1000 Units IV Solr 130 61 $19,287.00 $19,287.00 $3.25 $19,287.00 $19,287.00 2026-01-05
J9305 HCPCS Pemetrexed Disodium 500 Mg IV Solr 172 61 $20,455.00 $20,455.00 $3.97 $20,455.00 $16,670.83 2026-01-05
43240 CPT Hc Egd Transoral Transmural Drainage Pseudocyst - Endo US (Upper) 130 61 $14,756.00 $14,756.00 $598.74 $14,756.00 $14,461.75 2026-01-05
Q4187 HCPCS Hc Epicord 1 Sq Cm 102 61 $11,999.00 $11,999.00 $7,559.37 $11,999.00 $11,999.00 2026-01-05
J0897 HCPCS Denosumab 60 Mg/ml Sc Sosy 130 61 $11,487.00 $11,487.00 $25.19 $11,487.00 $11,487.00 2026-01-05
30117 CPT Hc Removal Of Intranasal Lesion 130 61 $9,625.00 $9,625.00 $651.73 $14,960.00 $9,625.00 2026-01-05
J7190 HCPCS Antihemophilic Factor 1000 Units IV Solr 130 61 $9,189.00 $9,189.00 $1.11 $9,189.00 $9,189.00 2026-01-05
J1950 HCPCS Leuprolide Acetate 3.75 Mg IM Kit 174 61 $9,156.00 $9,156.00 $1,389.17 $22,303.29 $9,156.00 2026-01-05
13101 CPT Hc Ed Repair Complex Trunk; 2.6 To 7.5 Cm 130 61 $9,840.00 $9,840.00 $387.06 $9,840.00 $9,136.44 2026-01-05
41110 CPT Hc Excision Of Tongue Lesion 130 61 $9,204.00 $9,204.00 $205.76 $8,862.50 $8,302.49 2026-01-05
41112 CPT Hc Excision Of Tongue Lesion 130 61 $8,521.00 $8,521.00 $388.10 $8,862.50 $8,302.49 2026-01-05
J2315 HCPCS Naltrexone 380 Mg IM Susr 130 61 $8,135.00 $8,135.00 $3.97 $8,135.00 $8,135.00 2026-01-05
42330 CPT Hc Removal Of Salivary Stone 130 61 $8,521.00 $8,521.00 $262.66 $8,521.00 $8,106.06 2026-01-05
J9217 HCPCS Leuprolide Acetate 7.5 Mg IM Kit 175 61 $10,895.00 $10,895.00 $149.27 $10,895.00 $7,553.50 2026-01-05
54700 CPT Hc Ed Incis/Drain Scrotum/Testis,Epididym 130 61 $8,064.00 $8,064.00 $336.85 $8,064.00 $7,487.43 2026-01-05
64468 CPT Hc Thrc Fascial Pln Blk Bil Inj 103 61 $7,149.00 $7,149.00 $113.06 $7,149.00 $7,149.00 2026-01-05
64489 CPT Hc Tap Block Bi By Infusion 103 61 $7,149.00 $7,149.00 $115.62 $7,149.00 $7,149.00 2026-01-05
64469 CPT Hc Thrc Fascial Pln Blk Bil Infs 103 61 $7,149.00 $7,149.00 $123.01 $7,149.00 $7,149.00 2026-01-05
36558 CPT Hc Insert Tunneled Cv Cath 130 61 $6,669.00 $6,669.00 $397.81 $8,053.19 $6,669.00 2026-01-05
72156 CPT Hc Mri, Cerv Spine Combo - MRI Cervical Spine W Wo Contrast 114 61 $6,355.00 $6,355.00 $348.96 $6,355.00 $6,355.00 2026-01-05
72158 CPT Hc Mri, Lumbar Spine Combo - MRI Lumbar Spine W Wo Contrast 129 61 $6,341.00 $6,341.00 $347.87 $6,341.00 $6,341.00 2026-01-05
74183 CPT Hc Mri, Abdomen, Combo - MRI Abdomen Renal W Wo Contrast 129 61 $6,303.00 $6,303.00 $357.13 $6,303.00 $6,303.00 2026-01-05
74178 CPT Hc CT Abd & Pelv 1/> Regns - CT Abdomen Pelvis W Wo Contrast 129 61 $6,292.00 $6,292.00 $357.13 $6,292.00 $6,292.00 2026-01-05
46320 CPT Hc Ed Excision Thrombosed Hemorrhoid, External 130 61 $6,775.00 $6,775.00 $178.93 $6,775.00 $6,290.59 2026-01-05
2060000002 LOCAL Hc Progressive Care Room, Isolation, Daily 65 61 $6,255.00 $6,255.00 $6,255.00 $6,255.00 $6,255.00 2026-01-05
72197 CPT Hc Mri, Pelvis, Combo - MRI Pelvis W Wo Contrast 129 61 $6,235.00 $6,235.00 $357.13 $6,235.00 $6,235.00 2026-01-05
64624 CPT Hc Destruction Neurolytic Agt Gnclr Nrv W/Img 130 61 $6,825.00 $6,825.00 $230.27 $6,825.00 $6,172.00 2026-01-05
J0630 HCPCS Calcitonin (salmon) 200 Unit/ml Ij Soln 130 61 $6,129.00 $6,129.00 $1,101.74 $6,129.00 $6,129.00 2026-01-05
73223 CPT Hc MRI Joint Upr Extr W/O&with Contrast - Mr Upr Extrem W/wo IV Contrast 129 61 $6,094.00 $6,094.00 $357.13 $6,094.00 $6,094.00 2026-01-05
59409 CPT Hc Ed Obstetrical Care,Vag Deliv Only 130 61 $5,932.00 $5,932.00 $1,219.36 $7,488.49 $5,932.00 2026-01-05
2060000001 LOCAL Hc Progressive Care Room, Daily 65 61 $5,817.00 $5,817.00 $5,817.00 $5,817.00 $5,817.00 2026-01-05
81479 CPT Hc Neotype Solid Tumor (Neogenomics) 130 61 $5,610.00 $5,610.00 $3,534.30 $5,610.00 $5,610.00 2026-01-05
72157 CPT Hc Mri, Dorsal Spine Combo - MRI Thoracic Spine W Wo Contrast 129 61 $5,600.00 $5,600.00 $350.03 $5,600.00 $5,600.00 2026-01-05
73723 CPT Hc Mri, Joint Of Leg. Combo - Mr W And Wo IV Contrast 129 61 $5,414.00 $5,414.00 $357.13 $5,414.00 $5,414.00 2026-01-05
73222 CPT Hc MRI Joint Upr Extrem With Contrast - Mr Upr Extrem W IV Contrast 141 61 $5,341.00 $5,341.00 $385.01 $5,341.00 $5,341.00 2026-01-05
49405 CPT Hc Image-guide Fluid Collxn Drainage Cath Visc Perq 130 61 $5,922.00 $5,922.00 $296.14 $5,922.00 $5,329.80 2026-01-05
74177 CPT Hc CT Abd & Pelv W/Contrast - CT Abdomen Pelvis W Contrast 129 61 $5,328.00 $5,328.00 $355.54 $5,328.00 $5,328.00 2026-01-05
74174 CPT Hc CT Angio Abd&Pelv W/O&with Contrast - CT Angiogram Abdomen Pelvis W Contrast 129 61 $5,292.00 $5,292.00 $357.13 $5,292.00 $5,292.00 2026-01-05
71552 CPT Hc Mri, Chest, Combo - MRI Chest W Wo Contrast 129 61 $5,281.00 $5,281.00 $357.13 $5,281.00 $5,281.00 2026-01-05
27252 CPT Hc Ed Closed Rx Trauma Hip Disloc,Anesth 130 61 $5,659.00 $5,659.00 $1,179.81 $5,659.00 $5,254.38 2026-01-05
72149 CPT Hc Mri, Lumbar Spine Contrast - MRI Lumbar Spine W Contrast 129 61 $5,244.00 $5,244.00 $306.43 $5,244.00 $5,244.00 2026-01-05
64488 CPT Hc Tap Block Bilateral Injection 102 61 $5,180.00 $5,180.00 $92.90 $5,180.00 $5,180.00 2026-01-05
70553 CPT Hc MRI Brain Combo - MRI Brain W Wo Contrast 129 61 $5,074.00 $5,074.00 $347.87 $5,074.00 $5,074.00 2026-01-05
72142 CPT Hc Mri, Cerv Spine Contrast - MRI Cervical Spine W Contrast 129 61 $5,004.00 $5,004.00 $313.97 $5,004.00 $5,004.00 2026-01-05
73722 CPT Hc Mri, Joint Of Leg W/Contrast - Lower Extremity W/Contrast 129 61 $4,889.00 $4,889.00 $387.71 $4,889.00 $4,889.00 2026-01-05
74170 CPT Hc CT Abdomen Without & With Contrast - CT Abdomen W Wo Contrast 129 61 $4,857.00 $4,857.00 $178.02 $4,857.00 $4,857.00 2026-01-05
69801 CPT Hc Incise Inner Ear 130 61 $4,843.00 $4,843.00 $194.77 $16,980.00 $4,843.00 2026-01-05
2000000002 LOCAL Hc ICU Room, Isolation, Daily 65 61 $4,798.00 $4,798.00 $4,798.00 $4,798.00 $4,798.00 2026-01-05
73720 CPT Hc MRI Lwr Extremity W/O&with Contrast - Mr W And Wo IV Cont 129 61 $4,787.00 $4,787.00 $357.13 $4,787.00 $4,787.00 2026-01-05
64487 CPT Hc Tap Block Uni By Infusion 103 61 $4,766.00 $4,766.00 $91.84 $4,766.00 $4,766.00 2026-01-05
64473 CPT Hc Lwr Extr Fscl Pln Blk Uni Inj 103 61 $4,766.00 $4,766.00 $90.85 $4,766.00 $4,766.00 2026-01-05
64474 CPT Hc Lwr Extr Fscl Pln Blk Uni Infs 103 61 $4,766.00 $4,766.00 $113.06 $4,766.00 $4,766.00 2026-01-05
64467 CPT Hc Thrc Fascial Pln Blk Uni Infs 103 61 $4,766.00 $4,766.00 $117.25 $4,766.00 $4,766.00 2026-01-05
64466 CPT Hc Thrc Fascial Pln Blk Uni Inj 103 61 $4,766.00 $4,766.00 $101.63 $4,766.00 $4,766.00 2026-01-05
27266 CPT Hc Ed Cls Tx Pst Hip Art Dis Req Anes 130 61 $5,085.00 $5,085.00 $929.30 $5,085.00 $4,721.43 2026-01-05
25635 CPT Hc Ed Closed Rx Carpal Fx,Maipulatn 130 61 $5,054.00 $5,054.00 $697.54 $5,054.00 $4,692.64 2026-01-05
23931 CPT Hc I&d Upr A/e Bursa 130 61 $5,017.00 $5,017.00 $258.46 $5,017.00 $4,658.28 2026-01-05
72127 CPT Hc CT Scan Cerv Sp Combo - CT Cervical Spine W Wo Contrast 129 61 $4,645.00 $4,645.00 $178.02 $4,645.00 $4,645.00 2026-01-05
64633 CPT Hc Destroy C/Th/Facet Jnt 130 61 $4,585.00 $4,585.00 $301.22 $5,519.00 $4,585.00 2026-01-05
31576 CPT Hc Laryngoscopy With Biopsy 130 61 $4,807.00 $4,807.00 $187.65 $4,807.00 $4,564.23 2026-01-05
21320 CPT Hc Clsd Tx Nsl Fx W/Mnpj&Stablj 130 61 $4,559.00 $4,559.00 $148.40 $4,859.14 $4,559.00 2026-01-05
72147 CPT Hc Mri, Dorsal Spine Contrast - MRI Thoracic Spine W Contrast 129 61 $4,500.00 $4,500.00 $310.74 $4,500.00 $4,500.00 2026-01-05
15275 CPT Hc Skin Sub Graft Face/Nk/Hf/G 25 Sq Cm/< 130 61 $4,473.00 $4,473.00 $145.38 $4,665.60 $4,473.00 2026-01-05
G0390 HCPCS Hc Trauma Respons W/Hosp Criti - Level Three 142 61 $4,465.00 $4,465.00 $1,304.47 $4,465.00 $4,465.00 2026-01-05
J3300 HCPCS Triamcinolone Acetonide 40 Mg/ml Io Susp 129 61 $4,440.00 $4,440.00 $3.72 $4,440.00 $4,440.00 2026-01-05
31525 CPT Hc Ed Laryngoscopy,Direct,Diagnostic 130 61 $4,550.00 $4,550.00 $249.62 $4,550.00 $4,435.73 2026-01-05
72193 CPT Hc CT Scan Of Pelvis Contrast - CT Pelvis W Contrast 114 61 $4,418.00 $4,418.00 $178.02 $4,418.00 $4,418.00 2026-01-05
11044 CPT Hc Debridement, Skin, Sub-q Tissue,Muscle,Bone,=<20 Sq Cm 130 61 $4,719.00 $4,719.00 $347.39 $4,719.00 $4,386.40 2026-01-05
2000000001 LOCAL Hc ICU Room Daily 65 61 $4,356.00 $4,356.00 $4,356.00 $4,356.00 $4,356.00 2026-01-05
C8933 HCPCS Hc MRA Cervical Spine W/wo Contrast 129 61 $4,353.00 $4,353.00 $357.13 $4,353.00 $4,353.00 2026-01-05
64635 CPT Hc Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral 130 61 $4,347.00 $4,347.00 $301.34 $5,519.00 $4,347.00 2026-01-05
31237 CPT Hc Nsl/Sins Ndsc Surg Bx Polypc 130 61 $4,492.00 $4,492.00 $250.75 $4,492.00 $4,306.78 2026-01-05
31238 CPT Hc Nsl/Sins Ndsc Srg Nsl Hemrrg 130 61 $4,492.00 $4,492.00 $261.28 $4,492.00 $4,306.78 2026-01-05
70543 CPT Hc Mri, Face, Neck, Combo - Mr Orbit Face Neck W And Wo IV Contrast 129 61 $4,283.00 $4,283.00 $357.13 $4,283.00 $4,283.00 2026-01-05
42405 CPT Hc Biopsy Of Salivary Gland 130 61 $4,504.00 $4,504.00 $359.14 $4,504.00 $4,257.50 2026-01-05
70546 CPT Hc Mr Angio, Head, Combo - Mr Head Angio W And Wo IV Contrast 129 61 $4,223.00 $4,223.00 $357.13 $4,223.00 $4,223.00 2026-01-05
25520 CPT Hc Ed Closed Rx Radial Shaft Fx W/Dislocation 130 61 $4,547.00 $4,547.00 $888.56 $4,547.00 $4,221.89 2026-01-05
6840000001 LOCAL Hc Trauma Response Without Critical Care - Level Four 103 61 $4,181.00 $4,181.00 $2,634.03 $4,181.00 $4,181.00 2026-01-05
90375 HCPCS Rabies Immune Globulin 300 Unit/ml Ij Soln 174 61 $4,174.00 $4,174.00 $285.65 $16,978.08 $4,174.00 2026-01-05
70552 CPT Hc MRI Brain Contrast - MRI Brain W Contrast 129 61 $4,165.00 $4,165.00 $308.05 $4,165.00 $4,165.00 2026-01-05
36573 CPT Hc Ven Picc Line Placement 130 61 $4,164.00 $4,164.00 $127.42 $4,759.63 $4,164.00 2026-01-05
15271 CPT Hc Skin Sub Graft Trnk/Arm/Leg Area/100sq Cm /<1st 25 130 61 $4,158.00 $4,158.00 $130.50 $4,665.60 $4,158.00 2026-01-05
11422 CPT Hc Ed Exc Skin Benig 1.1-2 Cm Remaindr Body 130 61 $4,180.00 $4,180.00 $217.92 $4,180.00 $4,116.90 2026-01-05
81162 CPT Hc Chg Brca1 Brca2 Gene Alys Full Seq Full Dup/Del Alys 130 61 $4,081.00 $4,081.00 $1,824.88 $6,387.08 $4,081.00 2026-01-05
99291 CPT Hc Critical Care, E/m 30-74 Minutes 143 61 $5,572.00 $5,572.00 $329.25 $5,572.00 $4,076.63 2026-01-05
72126 CPT Hc CT Scan Cerv Spine Contrast - CT Cervical Spine W Contrast 129 61 $4,058.00 $4,058.00 $183.84 $4,058.00 $4,058.00 2026-01-05
26236 CPT Hc Ed Partial Removal Finger Bone 130 61 $4,180.00 $4,180.00 $715.98 $4,180.00 $4,029.00 2026-01-05
73706 CPT Hc CT Angio Lwr Extr W/O&with Contrast - CT Lower Ext Lt Angio W And Wo IV Cont 129 61 $4,000.00 $4,000.00 $178.02 $4,000.00 $4,000.00 2026-01-05
J1670 HCPCS Tetanus Immune Globulin 250 Unit/ml IM Sosy 130 61 $3,982.00 $3,982.00 $486.89 $3,982.00 $3,982.00 2026-01-05
74160 CPT Hc CT Abdomen With Contrast - CT Abdomen W Contrast 114 61 $3,980.00 $3,980.00 $178.02 $3,980.00 $3,980.00 2026-01-05
73220 CPT Hc MRI Upper Extremity Combo - Mr Upr Extrem W/wo IV Contrast 129 61 $3,967.00 $3,967.00 $357.13 $3,967.00 $3,967.00 2026-01-05
72146 CPT Hc Mri, Dorsal Spine - MRI Thoracic Spine Wo Contrast 114 61 $3,900.00 $3,900.00 $199.98 $3,900.00 $3,900.00 2026-01-05
45388 CPT Hc Colonoscopy With Ablation 130 61 $3,897.00 $3,897.00 $414.00 $4,011.00 $3,897.00 2026-01-05
45385 CPT Hc Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq - Colonoscopy 130 61 $3,897.00 $3,897.00 $389.55 $4,011.00 $3,897.00 2026-01-05
45380 CPT Hc Colonoscopy W/Biopsy Single/Multiple - Colonoscopy 130 61 $3,897.00 $3,897.00 $308.94 $4,011.00 $3,897.00 2026-01-05
45381 CPT Hc Colsc Flx With Directed Submucosal Njx Any Sbst - Colonoscopy 130 61 $3,897.00 $3,897.00 $308.94 $4,011.00 $3,897.00 2026-01-05
45384 CPT Hc Colsc Flx W/Removal Lesion By Hot Bx Forceps - Colonoscopy 130 61 $3,897.00 $3,897.00 $349.71 $4,011.00 $3,897.00 2026-01-05
72133 CPT Hc CT Scan Lumbar Sp Combo - CT Lumbar Spine W Wo Contrast 129 61 $3,812.00 $3,812.00 $178.02 $3,812.00 $3,812.00 2026-01-05
40812 CPT Hc Excise/Repair Mouth Lesion 130 61 $4,036.00 $4,036.00 $289.46 $4,036.00 $3,802.00 2026-01-05
73702 CPT Hc CT Scan Of Leg Combo - CT Lower Extremity Left W And Wo IV Contrast 129 61 $3,800.00 $3,800.00 $178.02 $3,800.00 $3,800.00 2026-01-05
64480 CPT Hc Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,Ea Add Level 102 61 $3,796.00 $3,796.00 $95.52 $3,796.00 $3,796.00 2026-01-05
74181 CPT Hc Mri, Abdomen (mri) - MRI Abdomen Wo Contrast 129 61 $3,781.00 $3,781.00 $209.66 $3,781.00 $3,781.00 2026-01-05
74176 CPT Hc CT Abd & Pelvis Without Contrast - CT Abdomen Pelvis Wo Contrast 129 61 $3,747.00 $3,747.00 $168.77 $3,747.00 $3,747.00 2026-01-05
72195 CPT Hc Mri, Pelvis, Without Contrast - MRI Pelvis Wo Contrast 114 61 $3,742.00 $3,742.00 $233.47 $3,742.00 $3,742.00 2026-01-05
74175 CPT Hc CT Angio Abdom Without & With Contrast - CT Angiogram Abdomen W Contrast 129 61 $3,717.00 $3,717.00 $178.02 $3,717.00 $3,717.00 2026-01-05
43249 CPT Hc Egd Balloon Dilation Esophagus <30 Mm Diam - Egd 130 61 $3,715.00 $3,715.00 $236.18 $4,643.17 $3,715.00 2026-01-05
73221 CPT Hc Mri, Joint Upper Extrem - Mr Upr Extrem Wo IV Contrast 129 61 $3,685.00 $3,685.00 $230.54 $3,685.00 $3,685.00 2026-01-05
71270 CPT Hc Cat Scan Of Chest Combo - CT Chest W Wo Contrast 129 61 $3,678.00 $3,678.00 $178.02 $3,678.00 $3,678.00 2026-01-05
99285 CPT Hc Ed Emergency Department Level 5 Visit High Severity&Threat Func 130 61 $3,902.00 $3,902.00 $268.86 $3,902.00 $3,623.01 2026-01-05
45338 CPT Hc Sigmoidoscopy,Remv Lesn,Snare - Endoscopy Sigmoid 130 61 $3,674.00 $3,674.00 $185.87 $3,674.00 $3,621.00 2026-01-05
J0248 HCPCS Remdesivir 100 Mg IV Solr 130 61 $3,612.00 $3,612.00 $6.06 $3,612.00 $3,612.00 2026-01-05
72148 CPT Hc Mri, Lumbar Spine - MRI Lumbar Spine Wo Contrast 129 61 $3,582.00 $3,582.00 $200.53 $3,582.00 $3,582.00 2026-01-05
70549 CPT Hc Mr Angio, Neck, Combo - Mr Neck Angio W And Wo IV Contrast 129 61 $3,575.00 $3,575.00 $357.13 $3,575.00 $3,575.00 2026-01-05
72194 CPT Hc CT Scan Of Pelvis Combo - CT Pelvis W Wo Contrast 129 61 $3,528.00 $3,528.00 $178.02 $3,528.00 $3,528.00 2026-01-05
1200000004 LOCAL Hc Room & Bed, Telemetry, Isolation, Daily 65 61 $3,516.00 $3,516.00 $3,516.00 $3,516.00 $3,516.00 2026-01-05
70488 CPT Hc CT Scans Face/Jaw Combo - CT Sinus Facial Bones W Wo Contrast 141 61 $3,516.00 $3,516.00 $178.02 $3,516.00 $3,516.00 2026-01-05
70470 CPT Hc CT Scan Head Combo - CT Head W Wo Contrast 129 61 $3,482.00 $3,482.00 $178.02 $3,482.00 $3,482.00 2026-01-05
70492 CPT Hc CT Neck Tissue Combo - CT Soft Tissue Neck W Wo Contrast 129 61 $3,474.00 $3,474.00 $178.02 $3,474.00 $3,474.00 2026-01-05
72130 CPT Hc CT Scan Dorsal Sp Combo - CT Thoracic Spine W Wo Contrast 129 61 $3,432.00 $3,432.00 $178.02 $3,432.00 $3,432.00 2026-01-05
64490 CPT Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level 130 61 $3,419.00 $3,419.00 $164.90 $3,568.00 $3,419.00 2026-01-05
64479 CPT Hc Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level 130 61 $3,419.00 $3,419.00 $204.51 $3,568.00 $3,419.00 2026-01-05
62321 CPT Hc Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn 130 61 $3,419.00 $3,419.00 $167.23 $3,568.00 $3,419.00 2026-01-05
72132 CPT Hc CT Scan Lumbar Sp Contrast - CT Lumbar Spine W Contrast 129 61 $3,410.00 $3,410.00 $184.91 $3,410.00 $3,410.00 2026-01-05
45378 CPT Hc Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy 130 61 $3,407.00 $3,407.00 $284.11 $4,011.00 $3,407.00 2026-01-05
71260 CPT Hc Cat Scan Of Chest Contrast - CT Chest Pulmonary Embolism W IV Cont 129 61 $3,326.00 $3,326.00 $178.02 $3,326.00 $3,326.00 2026-01-05
11421 CPT Hc Exc Skin Benig 0.6-1 Cm Remaindr Body 130 61 $3,300.00 $3,300.00 $173.68 $4,011.00 $3,300.00 2026-01-05
70498 CPT Hc CT Angio,Neck Combo - CT Neck Angio W And Wo IV Contrast 129 61 $3,285.00 $3,285.00 $178.02 $3,285.00 $3,285.00 2026-01-05
70496 CPT Hc CT Angio,Head Combo - CT Head Angio W And Wo IV Contrast 129 61 $3,285.00 $3,285.00 $178.02 $3,285.00 $3,285.00 2026-01-05
75635 CPT Hc CT Angio Abdominal Arteries - CT Angio Aorta & Bilat Iliofemoral Run 129 61 $3,277.00 $3,277.00 $178.02 $3,277.00 $3,277.00 2026-01-05
71275 CPT Hc CT Angio, Chest, Combo, Incl Image - CT Chest Angio W And Wo IV Cont 129 61 $3,265.00 $3,265.00 $178.02 $3,265.00 $3,265.00 2026-01-05
11043 CPT Hc Debridement, Skin, Sub-q Tissue,Muscle,=<20 Sq Cm 130 61 $3,250.00 $3,250.00 $238.91 $4,011.00 $3,250.00 2026-01-05
70491 CPT Hc CT Neck Tissue Contrast - CT Soft Tissue Neck W Contrast 129 61 $3,248.00 $3,248.00 $178.02 $3,248.00 $3,248.00 2026-01-05
43247 CPT Hc Egd Flexible Foreign Body Removal 130 61 $3,245.00 $3,245.00 $271.28 $4,011.00 $3,245.00 2026-01-05
45330 CPT Hc Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa If Pfrmd - Endoscopy Sigmoid 130 61 $3,241.00 $3,241.00 $89.01 $3,568.00 $3,241.00 2026-01-05
1200000002 LOCAL Hc Room & Bed, Telemetry, Daily 65 61 $3,216.00 $3,216.00 $3,216.00 $3,216.00 $3,216.00 2026-01-05
73701 CPT Hc CT Scan Of Leg Contrast - CT Lower Extremity W IV Contrast 129 61 $3,200.00 $3,200.00 $178.02 $3,200.00 $3,200.00 2026-01-05
G0105 HCPCS Hc Colorectal Scrn; Hi Risk Ind 130 61 $3,171.00 $3,171.00 $284.11 $4,011.00 $3,171.00 2026-01-05
71550 CPT Hc Mri, Chest - MRI Chest Wo Contrast 129 61 $3,162.00 $3,162.00 $233.47 $3,162.00 $3,162.00 2026-01-05
G0121 HCPCS Hc Colon Ca Scrn Not Hi Rsk Ind 130 61 $3,146.00 $3,146.00 $284.53 $4,011.00 $3,146.00 2026-01-05
73721 CPT Hc MRI Jnt Of Lwr Extre Without Contrast - Mr Lower Ext Joint Wo IV Cont 129 61 $3,117.00 $3,117.00 $230.00 $3,117.00 $3,117.00 2026-01-05
45390 CPT Hc Colonoscopy Flx W/Endoscopic Mucosal Resection - Colonoscopy 130 61 $3,117.00 $3,117.00 $508.46 $5,668.36 $3,117.00 2026-01-05
64417 CPT Hc Inject Nerv Blck,Axillary Nerv 130 61 $3,111.00 $3,111.00 $100.05 $3,568.00 $3,111.00 2026-01-05
46040 CPT Hc Ed I&d Perirectal Abscess 130 61 $3,284.00 $3,284.00 $679.66 $3,284.00 $3,105.74 2026-01-05
72129 CPT Hc CT Scan Dorsal Sp Contrast - CT Thoracic Spine W Contrast 129 61 $3,100.00 $3,100.00 $178.02 $3,100.00 $3,100.00 2026-01-05
70482 CPT Hc CT Scan Skull Combo - CT Auditory Canals / Posterior Fossa W Wo Cont 129 61 $3,080.00 $3,080.00 $178.02 $3,080.00 $3,080.00 2026-01-05
C8911 HCPCS Hc Mr MRA Chest With Or Without 129 61 $3,079.00 $3,079.00 $357.13 $3,079.00 $3,079.00 2026-01-05
10140 CPT Hc Ed Incision & Drainage Hematoma 130 61 $3,069.00 $3,069.00 $188.50 $3,933.03 $3,069.00 2026-01-05
28190 CPT Hc Ed Remv Foot Foreign Body,Subcutaneous 130 61 $3,288.00 $3,288.00 $210.50 $3,288.00 $3,052.91 2026-01-05
70551 CPT Hc MRI Brain - MRI Brain Wo Contrast 129 61 $3,044.00 $3,044.00 $209.66 $3,044.00 $3,044.00 2026-01-05
73719 CPT Hc Mri, Lower Extrem W/Contrast - Mr Foot W IV Contrast 129 61 $3,030.00 $3,030.00 $306.98 $3,030.00 $3,030.00 2026-01-05
44388 CPT Hc Colonoscopy Stoma Dx Induding Collj Spec Spx - Colonoscopy 130 61 $3,010.00 $3,010.00 $240.48 $3,568.00 $3,010.00 2026-01-05
J2760 HCPCS Phentolamine Mesylate 5 Mg Ij Solr 130 61 $3,007.00 $3,007.00 $412.36 $3,007.00 $3,007.00 2026-01-05
73201 CPT Hc CT Scan Of Arm Contrast - CT Shoulder Arthrogram Lt W Fl Guided Inj 129 61 $3,005.00 $3,005.00 $239.28 $3,005.00 $3,005.00 2026-01-05
24655 CPT Hc Ed Closed Rx Radial Head/Neck Fx,Manip 130 61 $3,000.00 $3,000.00 $665.47 $3,794.51 $3,000.00 2026-01-05
43235 CPT Hc Esophagogastroduodenoscopy Transoral Diagnostic 130 61 $2,999.00 $2,999.00 $189.58 $3,568.00 $2,999.00 2026-01-05
23605 CPT Hc Ed Closed Rx Prox Humerus Fx,Manip 130 61 $2,951.00 $2,951.00 $697.28 $3,770.01 $2,951.00 2026-01-05
21315 CPT Hc Ed Closed Rx Nose Fracture, Without Stabilization 130 61 $2,947.00 $2,947.00 $93.82 $3,693.82 $2,947.00 2026-01-05
73202 CPT Hc CT Scan Of Arm Combo - CT Upper Extremity Right W And Wo IV Contrast 129 61 $2,947.00 $2,947.00 $178.02 $2,947.00 $2,947.00 2026-01-05
25605 CPT Hc Ed Closed Rx Dist Rad/Ulna Fx,Manipul 130 61 $2,923.00 $2,923.00 $831.17 $3,756.01 $2,923.00 2026-01-05
43239 CPT Hc Egd Transoral Biopsy Single/Multiple - Egd 130 61 $2,916.00 $2,916.00 $213.04 $4,011.00 $2,916.00 2026-01-05
73718 CPT Hc Mri, Lower Extrem - Mr Wo IV Contrast 129 61 $2,894.00 $2,894.00 $233.47 $2,894.00 $2,894.00 2026-01-05
26951 CPT Hc Ed Amputation Finger/Thumb 130 61 $2,890.00 $2,890.00 $1,126.77 $6,206.16 $2,890.00 2026-01-05
70548 CPT Hc Mr Angio, Neck W/Contrast - Mr Neck Angio W IV Contrast 129 61 $2,849.00 $2,849.00 $289.74 $2,849.00 $2,849.00 2026-01-05
J0883 HCPCS Argatroban 250 Mg/2.5ml IV Soln 130 61 $2,836.00 $2,836.00 $0.89 $2,836.00 $2,836.00 2026-01-05
45331 CPT Hc Sigmoidoscopy,Biopsy - Endoscopy Sigmoid 130 61 $2,816.00 $2,816.00 $112.90 $3,568.00 $2,816.00 2026-01-05
0202U CPT Hc Pcr, Respiratory Pathogens 130 61 $3,021.00 $3,021.00 $416.78 $3,021.00 $2,805.00 2026-01-05
70540 CPT Hc Mri, Face, Neck - MRI Neck Soft Tissue Only Wo Contrast 129 61 $2,797.00 $2,797.00 $233.47 $2,797.00 $2,797.00 2026-01-05
70460 CPT Hc CT Scan Head Contrast - CT Head W Contrast 129 61 $2,770.00 $2,770.00 $157.46 $2,770.00 $2,770.00 2026-01-05
70544 CPT Hc Mr Angio, Head - Mr Head Angio Wo IV Contrast 129 61 $2,750.00 $2,750.00 $233.47 $2,750.00 $2,750.00 2026-01-05
72131 CPT Hc CT Scan,Lumbar Spine,without Contrast - CT Lumbar Spine Wo Contrast 114 61 $2,750.00 $2,750.00 $104.75 $2,750.00 $2,750.00 2026-01-05
64520 CPT Hc Inject Nerv Blck,Paravert Sympath 130 61 $2,748.00 $2,748.00 $133.36 $3,568.00 $2,748.00 2026-01-05
76881 CPT Hc US Compl Joint R-t W/Img - US Extremity Complete 130 61 $2,746.00 $2,746.00 $17.10 $2,746.00 $2,746.00 2026-01-05
73219 CPT MRI Upper Extremity Oth Than Jt W/Contr Matrl 129 61 $2,728.00 $2,728.00 $357.13 $2,728.00 $2,728.00 2026-01-05
74150 CPT Hc CT Abdomen Without Contrast - CT Abdomen Wo Contrast 129 61 $2,710.00 $2,710.00 $104.75 $2,710.00 $2,710.00 2026-01-05
73218 CPT Hc Mri, Upper Extremity Without Contrast - Mr Hand Wo IV Contrast 129 61 $2,691.00 $2,691.00 $233.47 $2,691.00 $2,691.00 2026-01-05
62322 CPT Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac Without Img Gdn 130 61 $2,683.00 $2,683.00 $121.34 $3,568.00 $2,683.00 2026-01-05
70487 CPT Hc CT Scan, Face/Jaw Contrast - CT Sinus Facial Bones W Contrast 129 61 $2,679.00 $2,679.00 $163.38 $2,679.00 $2,679.00 2026-01-05
90675 HCPCS Rabies Vaccine, Pcec IM Susr 130 61 $2,669.00 $2,669.00 $296.99 $2,669.00 $2,669.00 2026-01-05
64421 CPT Hc Inject Nerv Blck,Intercost,Multpl 130 61 $2,655.00 $2,655.00 $37.95 $3,568.00 $2,655.00 2026-01-05
64418 CPT Hc Inject Nerv Blck,Suprascap N. 130 61 $2,645.00 $2,645.00 $85.87 $3,568.00 $2,645.00 2026-01-05
72141 CPT Hc Mri, Cerv Spine - MRI Cervical Spine Wo Contrast 141 61 $3,658.00 $3,658.00 $199.44 $3,658.00 $2,610.45 2026-01-05
1200000003 LOCAL Hc Room & Bed, Isolation, Daily 65 61 $2,578.00 $2,578.00 $2,578.00 $2,578.00 $2,578.00 2026-01-05
64445 CPT Hc Inj,Anes Agent,Sciatic Nerve,Single 130 61 $2,570.00 $2,570.00 $111.92 $3,568.00 $2,570.00 2026-01-05
64449 CPT Hc Inj Aa&/Strd Lmbr Plex Infs 130 61 $2,568.00 $2,568.00 $100.83 $3,568.00 $2,568.00 2026-01-05
64416 CPT Hc Inj Aa&/Strd Brch Pl Infs Img 130 61 $2,568.00 $2,568.00 $118.75 $3,568.00 $2,568.00 2026-01-05
27096 CPT Hc Injection,Sacroiliac Joint 130 61 $2,567.00 $2,567.00 $658.90 $3,568.00 $2,567.00 2026-01-05
64495 CPT Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, Add Level 102 61 $2,504.00 $2,504.00 $79.66 $3,568.00 $2,504.00 2026-01-05
72128 CPT Hc CT Scan,Thoracic Spine,without Contrast - CT Thoracic Spine Wo Contrast 129 61 $2,500.00 $2,500.00 $104.75 $2,500.00 $2,500.00 2026-01-05
64454 CPT Hc Inj Aa&/Strd Gncl Nerves W/Img 130 61 $2,483.00 $2,483.00 $128.51 $3,568.00 $2,483.00 2026-01-05
62327 CPT Hc Inj Interlaminar Lmbr/Sac 130 61 $2,477.00 $2,477.00 $166.00 $3,568.00 $2,477.00 2026-01-05
J0561 HCPCS Penicillin G Benzathine 1200000 Unit/2ml IM Susy 130 61 $2,461.00 $2,461.00 $22.00 $2,461.00 $2,461.00 2026-01-05
J0666 HCPCS Bupivacaine Liposome 1.3 % Ij Susp 144 61 $2,457.00 $2,457.00 $1,178.73 $2,457.00 $2,457.00 2026-01-05
70490 CPT Hc CT Scan,Soft Tissue Neck,without Contrast - CT Soft Tissue Neck Wo Cont 114 61 $2,427.00 $2,427.00 $104.75 $2,427.00 $2,427.00 2026-01-05
64510 CPT Hc Inject Nerv Blck,Stellate Ganglion 130 61 $2,423.00 $2,423.00 $119.70 $3,568.00 $2,423.00 2026-01-05
27781 CPT Hc Ed Prox Fibula/Shft Fx W/Manj 130 61 $2,416.00 $2,416.00 $661.58 $3,502.51 $2,416.00 2026-01-05
32551 CPT Hc Ed Tube Thoracostomy Includes Water Seal 130 61 $2,402.00 $2,402.00 $236.43 $3,580.82 $2,402.00 2026-01-05
73700 CPT Hc CT Scan,Lower Extremity,without Contrast - CT Ankle Left Wo IV Contrast 129 61 $2,400.00 $2,400.00 $104.75 $2,400.00 $2,400.00 2026-01-05
87507 CPT Hc, Iadna-dna/rna Probe Tq 12-25 - Gastrointestinal Panel 130 61 $2,579.00 $2,579.00 $416.78 $2,579.00 $2,394.60 2026-01-05
64446 CPT Hc Inj Aa&/Strd Sc Nrv Infs Img 130 61 $2,477.00 $2,477.00 $116.16 $2,477.00 $2,390.37 2026-01-05
32557 CPT Hc Perq Drainage Pleura Insert Cath W/Imaging 130 61 $2,388.00 $2,388.00 $226.86 $4,011.00 $2,388.00 2026-01-05
81277 CPT Hc Cytogenomic Microarray Zb7bs (Um) 130 61 $2,366.00 $2,366.00 $1,160.00 $4,060.00 $2,366.00 2026-01-05
49084 CPT Hc Ed Peritoneal Lavage W/wo Imaging Guidance 130 61 $2,418.00 $2,418.00 $164.02 $2,418.00 $2,324.82 2026-01-05
26011 CPT Hc Ed Drain Finger Abscess,Complicated 130 61 $2,319.00 $2,319.00 $296.75 $3,558.03 $2,319.00 2026-01-05
J1410 HCPCS Estrogens Conjugated 25 Mg Ij Solr 130 61 $2,315.00 $2,315.00 $334.70 $2,315.00 $2,315.00 2026-01-05
49082 CPT Hc Ed Abdom Paracentesis Dx/Ther Without Imaging Guidance 130 61 $2,371.00 $2,371.00 $113.01 $2,371.00 $2,301.32 2026-01-05
93306 CPT Hc Tte W/Doppler Complete - Tte Complete 130 61 $2,476.00 $2,476.00 $203.63 $2,476.00 $2,298.97 2026-01-05
H0011 HCPCS Hc Rc Semi-private Room, Detoxification, Daily 65 61 $2,297.00 $2,297.00 $2,297.00 $2,297.00 $2,297.00 2026-01-05
27510 CPT Hc Ed Closed Rx Femur,Distal+Manip 130 61 $2,291.00 $2,291.00 $1,080.74 $3,440.01 $2,291.00 2026-01-05
70481 CPT Hc CT Scan Skull Contrast - CT Auditory Canals/Posterior Fossa W IV Cnt 129 61 $2,283.00 $2,283.00 $178.02 $2,283.00 $2,283.00 2026-01-05
64493 CPT Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 1st Level 130 61 $2,278.00 $2,278.00 $142.38 $3,568.00 $2,278.00 2026-01-05
46050 CPT Hc Ed I&d Perianal Abscess,Superficial 130 61 $2,308.00 $2,308.00 $161.79 $2,308.00 $2,277.29 2026-01-05
64425 CPT Hc Inject Nerv Blck,Ilioingu/Iliohyp 130 61 $2,269.00 $2,269.00 $84.80 $3,568.00 $2,269.00 2026-01-05
70547 CPT Hc Mr Angio, Neck - Mr Neck Angio Wo IV Contrast 129 61 $2,265.00 $2,265.00 $233.47 $2,265.00 $2,265.00 2026-01-05
72192 CPT Hc CT Scan,Pelvis,without Contrast - CT Pelvis Wo Contrast 129 61 $2,243.00 $2,243.00 $104.75 $2,243.00 $2,243.00 2026-01-05
64494 CPT Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 2nd Level 102 61 $2,232.00 $2,232.00 $78.88 $3,568.00 $2,232.00 2026-01-05
24620 CPT Hc Ed Closed Rx Monteggia Fx/Disloc Elbow 130 61 $2,224.00 $2,224.00 $952.48 $3,406.51 $2,224.00 2026-01-05
25565 CPT Hc Ed Closed Rx Rad/Ulna Shaft Fx,Manip 130 61 $2,200.00 $2,200.00 $755.04 $3,394.51 $2,200.00 2026-01-05
81445 CPT Hc Ngs Lung 152 61 $2,181.00 $2,181.00 $597.91 $2,335.33 $2,181.00 2026-01-05
42400 CPT Hc Biopsy Salivary Gland,Needle 130 61 $2,172.00 $2,172.00 $83.39 $3,568.00 $2,172.00 2026-01-05
10121 CPT Hc Remove Foreign Body Complic 130 61 $2,168.00 $2,168.00 $289.26 $2,798.82 $2,168.00 2026-01-05
99284 CPT Hc Ed Emergency Department Level 4 Visit High/Urgent Severity 130 61 $2,324.00 $2,324.00 $185.54 $2,324.00 $2,157.84 2026-01-05
70480 CPT Hc CT Scan,Orbit/Sella/Post Fossa/Ear,without - CT Auditory Canals Wo Cont 129 61 $2,151.00 $2,151.00 $104.75 $2,151.00 $2,151.00 2026-01-05
32555 CPT Hc Ed Thoracentesis Needle/Cath Pleura W/Imaging 134 61 $2,147.00 $2,147.00 $166.32 $3,568.00 $2,147.00 2026-01-05
92960 CPT Hc Ed Cardioversion, Elective; External 130 61 $2,147.00 $2,147.00 $167.39 $2,147.00 $2,147.00 2026-01-05
G0260 HCPCS Hc Inj For Sacroiliac Jt Anesth W/wo Arth 130 61 $2,146.00 $2,146.00 $658.90 $3,568.00 $2,146.00 2026-01-05
36569 CPT Hc Insert Picc Without Sub-q Port 142 61 $2,213.00 $2,213.00 $144.45 $4,759.63 $2,132.50 2026-01-05
1200000001 LOCAL Hc Room & Bed, Daily 65 61 $2,127.00 $2,127.00 $2,127.00 $2,127.00 $2,127.00 2026-01-05
36556 CPT Hc Ed Insert Non-tunnel Cv Cath 130 61 $2,110.00 $2,110.00 $128.34 $9,529.73 $2,110.00 2026-01-05
11042 CPT Hc Debridement, Skin, Sub-q Tissue,=<20 Sq Cm 134 61 $2,090.00 $2,090.00 $94.64 $4,011.00 $2,090.00 2026-01-05
20606 CPT Hc Ed Arthrocentesis Aspir&/Inj Interm Jt/Burs W/us 130 61 $2,220.00 $2,220.00 $80.66 $2,220.00 $2,061.27 2026-01-05
11047 CPT Hc Debridement, Skin, Sub-q Tissue,Muscle,Bone,Each Add 20 Sq Cm 102 61 $2,060.00 $2,060.00 $148.19 $3,568.00 $2,060.00 2026-01-05
24675 CPT Hc Ed Closed Tx Ulnar Fracture Prox End W Manipulation 130 61 $2,059.00 $2,059.00 $682.00 $3,324.01 $2,059.00 2026-01-05
72125 CPT Hc CT Scan,Cervical Spine,without Contrast - CT Cervical Spine Wo Contrast 114 61 $2,059.00 $2,059.00 $104.75 $2,059.00 $2,059.00 2026-01-05
J1442 HCPCS Filgrastim 300 Mcg/0.5ml Ij Sosy 172 61 $2,051.00 $2,051.00 $0.99 $2,657.72 $2,051.00 2026-01-05
64447 CPT Hc Inj,Anes Agent,Femoral Nerve,Single 143 61 $2,645.00 $2,645.00 $98.38 $2,645.00 $2,033.75 2026-01-05
J3489 HCPCS Zoledronic Acid 5 Mg/100ml IV Soln 102 61 $2,032.00 $2,032.00 $1,280.16 $2,032.00 $2,032.00 2026-01-05
11402 CPT Hc Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg 130 61 $2,031.00 $2,031.00 $184.24 $3,568.00 $2,031.00 2026-01-05
70486 CPT Hc CT Scan,Maxillofacial Without Contrast - CT Sinus Facial Bones Wo Cont 129 61 $2,012.00 $2,012.00 $104.75 $2,012.00 $2,012.00 2026-01-05
71250 CPT Hc CT Scan,Thorax,without Contrast - CT Chest Wo Contrast 129 61 $1,973.00 $1,973.00 $104.75 $1,973.00 $1,973.00 2026-01-05
62323 CPT Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn 130 61 $1,960.00 $1,960.00 $154.70 $3,568.00 $1,960.00 2026-01-05
73200 CPT Hc CT Scan Upper Extremity W/wo Dye - CT W/wo IV Contrast 129 61 $1,951.00 $1,951.00 $104.75 $1,951.00 $1,951.00 2026-01-05
70450 CPT Hc CT Scan,Head/Brain,without Contrast Matl - CT Head Wo Contrast 129 61 $1,936.00 $1,936.00 $104.75 $1,936.00 $1,936.00 2026-01-05
J0881 HCPCS Darbepoetin Alfa 40 Mcg/0.4ml Ij Sosy 195 61 $1,904.00 $1,904.00 $2.90 $14,220.00 $1,904.00 2026-01-05
20950 CPT Hc Ed Monitoring Interstitial Fluid 130 61 $2,047.00 $2,047.00 $139.81 $2,047.00 $1,900.70 2026-01-05
49083 CPT Hc Ed Abdom Paracentesis Dx/Ther W Imaging Guidance 135 61 $1,890.00 $1,890.00 $163.68 $4,011.00 $1,890.00 2026-01-05
27810 CPT Hc Ed Closed Tx Bimalleolar Ankle Fracture W Manip 130 61 $1,868.00 $1,868.00 $696.88 $3,228.51 $1,868.00 2026-01-05
27752 CPT Hc Ed Closed Rx Tibia Shaft Fx,Manipulatn 130 61 $1,866.00 $1,866.00 $791.84 $3,227.51 $1,866.00 2026-01-05
2500000004 OTHER Pneumococcal 21-val Conj Vacc 0.5 Ml IM Sosy 154 61 $1,857.00 $1,857.00 $54.81 $1,857.00 $1,857.00 2026-01-05
93303 CPT Hc Echo Transthoracic - Congenital Tte Complete 130 61 $1,851.00 $1,851.00 $249.92 $1,851.00 $1,851.00 2026-01-05
L3905 HCPCS Hc Who W/Nontorsion Jnt(S) Cf 130 61 $1,812.00 $1,812.00 $1,010.24 $3,714.87 $1,812.00 2026-01-05
12036 CPT Hc Ed Layr Clos Wnd Trunk,Arm,Leg 20.1-30 Cm 130 61 $1,925.00 $1,925.00 $441.89 $1,925.00 $1,787.37 2026-01-05
36440 CPT Hc Push Transfusion Blood Age 2 130 61 $1,779.00 $1,779.00 $76.10 $3,568.00 $1,779.00 2026-01-05
11441 CPT Hc Exc Skin Benig 0.6-1 Cm Face,Facial 130 61 $1,771.00 $1,771.00 $212.62 $4,011.00 $1,771.00 2026-01-05
13152 CPT Hc Ed Recmpl Wnd Lid,Nos,Ear 2.5-7.5 Cm 130 61 $1,905.00 $1,905.00 $522.90 $1,905.00 $1,768.80 2026-01-05
13121 CPT Hc Ed Recmpl Wnd Scalp,Extr 2.6-7.5 Cm 130 61 $1,905.00 $1,905.00 $404.30 $1,905.00 $1,768.80 2026-01-05
64483 CPT Hc Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Level 130 61 $1,762.00 $1,762.00 $174.03 $3,568.00 $1,762.00 2026-01-05
27825 CPT Hc Ed Closed Rx Weight Bear Dist Tib,Manip 130 61 $1,760.00 $1,760.00 $797.26 $3,174.51 $1,760.00 2026-01-05
13153 CPT Hc Ed Repair Complex Eyelids Nose 103 61 $1,757.00 $1,757.00 $211.95 $1,757.00 $1,757.00 2026-01-05
32554 CPT Hc Ed Thoracentesis Needle/Cath Pleura Without Imaging 130 61 $1,887.00 $1,887.00 $134.80 $1,887.00 $1,752.08 2026-01-05
27818 CPT Hc Ed Closed Rx Trimalleolar Fx,Manip 130 61 $1,745.00 $1,745.00 $715.73 $3,167.01 $1,745.00 2026-01-05
73206 CPT Hc CT Angio,Upper Extrem,Combo - CT Upper Ext Angio W And Wo IV Cont 129 61 $1,739.00 $1,739.00 $178.02 $1,739.00 $1,739.00 2026-01-05
93975 CPT Hc Vasc Duplex Abd/Pel Vasc Study,Complete 130 61 $1,836.00 $1,836.00 $233.47 $1,836.00 $1,704.72 2026-01-05
1290000001 LOCAL Hc Rc Rehab Room Daily 65 61 $1,637.00 $1,637.00 $1,637.00 $1,637.00 $1,637.00 2026-01-05
0042T CPT Hc CT Perfusion Brain 102 61 $1,617.00 $1,617.00 $1,018.71 $1,617.00 $1,617.00 2026-01-05
23650 CPT Hc Ed Closed Rx Shldr Dislocation 130 61 $1,738.00 $1,738.00 $224.69 $1,738.00 $1,613.74 2026-01-05
13151 CPT Hc Recmpl Wnd Lid,Nos,Ear 1.1-2.5 Cm 143 61 $1,761.00 $1,761.00 $435.28 $14,960.00 $1,570.51 2026-01-05
73525 CPT Hc Arthrogram Of Hip - Xr Hip Arthrogram 130 61 $1,567.00 $1,567.00 $156.51 $1,567.00 $1,567.00 2026-01-05
93978 CPT Hc Vasc Duplex Large Vessel(S),Complete 130 61 $1,564.00 $1,564.00 $227.86 $1,564.00 $1,564.00 2026-01-05
93925 CPT Hc Duplex Lo Extrem Art Bilat - Lower Extremity Arterial Duplex 130 61 $1,678.00 $1,678.00 $233.47 $1,678.00 $1,558.03 2026-01-05
J1610 HCPCS Glucagon Hcl (diagnostic) 1 Mg Ij Solr 142 61 $1,555.00 $1,555.00 $166.77 $1,555.00 $1,555.00 2026-01-05
93970 CPT Hc Duplex Extrem Venous,Bilat - Cv US Doppler Venous Legs Bilateral 143 61 $2,069.00 $2,069.00 $233.47 $2,069.00 $1,539.34 2026-01-05
J1447 HCPCS Tbo-filgrastim 300 Mcg/0.5ml Sc Sosy 172 61 $1,538.00 $1,538.00 $0.41 $2,001.64 $1,538.00 2026-01-05
27788 CPT Hc Ed Closed Rx Dist Fibula Fx,Manip 130 61 $1,650.00 $1,650.00 $224.69 $1,650.00 $1,532.03 2026-01-05
26755 CPT Hc Ed Close Rx Dist Fingr Fx,Manipulatn 130 61 $1,650.00 $1,650.00 $224.69 $1,650.00 $1,532.03 2026-01-05
26725 CPT Hc Ed Close Rx Prox/Mid Fing Shft Fx,Manip 130 61 $1,650.00 $1,650.00 $224.69 $1,650.00 $1,532.03 2026-01-05
26605 CPT Hc Ed Closed Rx Metacarpal Fx,Manip 130 61 $1,650.00 $1,650.00 $224.69 $1,650.00 $1,532.03 2026-01-05
99465 CPT Hc Rt Delivery/Birthing Room Resuscitation 130 61 $1,532.00 $1,532.00 $218.06 $1,881.46 $1,532.00 2026-01-05
12016 CPT Hc Resuperf Wnd Face 12.6-20 Cm 130 61 $1,649.00 $1,649.00 $193.74 $1,649.00 $1,531.10 2026-01-05
J9185 HCPCS Fludarabine Phosphate 50 Mg/2ml IV Soln 130 61 $1,514.00 $1,514.00 $190.90 $1,514.00 $1,514.00 2026-01-05
64415 CPT Hc Inj,Anes Agent,Brachial Plexus,Single 130 61 $1,514.00 $1,514.00 $107.79 $3,568.00 $1,514.00 2026-01-05
92950 CPT Hc Ed Heart/Lung Resuscitation (Cpr) 130 61 $1,500.00 $1,500.00 $280.53 $1,500.00 $1,500.00 2026-01-05
11440 CPT Hc Exc Skin Benig <0.5 Cm Face,Facial 130 61 $1,496.00 $1,496.00 $172.21 $4,011.00 $1,496.00 2026-01-05
73580 CPT Hc Arthrogram Of Knee Joint - Xr Knee Arthrogram 130 61 $1,461.00 $1,461.00 $124.75 $1,461.00 $1,461.00 2026-01-05
41100 CPT Hc Biopsy Of Tongue 130 61 $1,457.00 $1,457.00 $170.83 $3,568.00 $1,457.00 2026-01-05
69433 CPT Hc Create Eardrum Opening 127 61 $1,457.00 $1,457.00 $211.54 $1,875.00 $1,457.00 2026-01-05
13132 CPT Hc Ed Recmpl Wnd Head,Fac,Hand 2.6-7.5 Cm 130 61 $1,455.00 $1,455.00 $472.74 $1,570.51 $1,455.00 2026-01-05
20610 CPT Hc Ed Arthrocentesis Aspir&/Inj Major Jt/Bursa Without US 134 61 $1,430.00 $1,430.00 $70.26 $3,568.00 $1,430.00 2026-01-05
93880 CPT Hc Vasc Duplex Scan Extracranial,Bilat 130 61 $1,525.00 $1,525.00 $233.47 $1,525.00 $1,415.97 2026-01-05
12035 CPT Hc Ed Layr Clos Wnd Trunk,Arm,Leg 12.6-20 Cm 130 61 $1,514.00 $1,514.00 $379.22 $1,514.00 $1,405.75 2026-01-05
81420 CPT Hc Chg Fetal Chromosomal Aneuploidy Genomic Seq Analys 130 61 $1,401.00 $1,401.00 $759.05 $2,656.68 $1,401.00 2026-01-05
12054 CPT Hc Ed Layr Clos Wnd Face,Facial 7.6-12.5 Cm 130 61 $1,505.00 $1,505.00 $344.62 $1,505.00 $1,397.39 2026-01-05
28515 CPT Hc Ed Closed Rx Toe Fx,Manipulatn 130 61 $1,500.00 $1,500.00 $224.69 $1,500.00 $1,392.75 2026-01-05
28495 CPT Hc Ed Closed Rx Big Toe Fx,Manip 130 61 $1,500.00 $1,500.00 $224.69 $1,500.00 $1,392.75 2026-01-05
93976 CPT Hc Vascular Study - US Abdomen Doppler Limited 130 61 $1,372.00 $1,372.00 $104.75 $1,372.00 $1,372.00 2026-01-05
12044 CPT Hc Ed Layr Clos Wnd Rest Body 7.6-12.5 Cm 130 61 $1,372.00 $1,372.00 $337.98 $1,570.51 $1,372.00 2026-01-05
25600 CPT Hc Ed Closed Rx Dist Rad/Ulna Fx 130 61 $1,472.00 $1,472.00 $224.69 $1,472.00 $1,366.75 2026-01-05
See an error in this hospital's data? Submit a correction