Hospital

FERRY COUNTY MEMORIAL HOSPITAL

Republic, WA · CCN 501322 · Rates published

4,274 distinct procedures filed

23 distinct payers

56,737 rate rows

2026-05-18 last MRF observed

Data quality

56,647 of 56,737 rate rows are consumer-grade (99.8%)

90 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
percent-of-charges filed in the dollar field — excluded from medians	75
exceeds 10× this hospital's gross charge — excluded from medians	15

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

Source MRF file	https://fcphd.org/Price%20Transparency.csv
Found on page	https://www.fcphd.org/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-19
Content fingerprint	50efac77a3f51f73… · 852,831 bytes · first seen 2026-05-18

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
4172834 OTHER	Tenecteplase 50mg Inj	8	$17,200.00	$40,105.80	$27,499.80	nat. median $27,500 1.0× median
4173231 OTHER	Vedolizumab-entyvio	8	$16,678.40	$18,763.20	$18,763.20	nat. median $18,763 1.0× median
4172667 OTHER	Pegfilgrastim 6mg/0.6ml Inj	8	$12,785.20	$14,383.35	$14,383.35	nat. median $14,383 1.0× median
4230410 OTHER	Suture/repair Testi Injr	8	$5,757.60	$6,477.30	$6,477.30	nat. median $6,477 1.0× median
4350409 OTHER	Excision Pilonidal Cyst Simple	8	$5,744.11	$6,462.13	$6,462.13	nat. median $6,462 1.0× median
74174 CPT	CTA Abd/pel W&without Contrast	15	$4,200.56	$7,275.97	$6,450.86	nat. median $959 outlier · 6.7×
4350424 OTHER	Suture/repair Testi Injy	8	$5,510.53	$6,199.34	$6,199.34	nat. median $6,199 1.0× median
4130104 OTHER	CTA Abd/pel W&without Contrast	8	$5,505.23	$6,193.39	$6,193.39	nat. median $6,193 1.0× median
74178 CPT	CT Abd/pelvis W/wo Contrast	15	$3,976.56	$6,887.97	$6,106.86	nat. median $979 outlier · 6.2×
70553 CPT	MRI Brain W/wo Contrast	15	$3,867.36	$6,698.82	$5,939.16	nat. median $1,122 outlier · 5.3×
72158 CPT	MRI L-spine W/wo Contrast	15	$3,852.80	$6,673.60	$5,916.80	nat. median $1,081 outlier · 5.5×
4130100 OTHER	CT Abd/pelvis W/wo Contrast	8	$5,211.72	$5,863.19	$5,863.19	nat. median $5,863 1.0× median
4120009 OTHER	MRI Brain W/wo Contrast	8	$5,068.08	$5,701.59	$5,701.59	nat. median $1,699 outlier · 3.4×
4120018 OTHER	MRI L-spine W/wo Contrast	8	$5,048.98	$5,680.11	$5,680.11	nat. median $718 outlier · 7.9×
4230720 OTHER	I&d Ischiorect/perirect Abs	8	$4,639.28	$5,219.19	$5,219.19	nat. median $5,219 1.0× median
G0390 CPT	Trauma Resp Tm W/critcare	15	$3,301.76	$5,719.12	$5,070.56	nat. median $3,172 1.6× median
40810 CPT	Ex Les Muc/sub Vest Mth Wo Rpr	15	$205.52	$5,744.34	$5,033.70	nat. median $3,051 1.6× median
4237602 OTHER	Ex Les Muc/sub Vest Mth Wo Rpr	8	$4,345.92	$4,889.16	$4,889.16	nat. median $4,889 1.0× median
4230004 OTHER	Trauma Resp Tm W/critcare	8	$4,327.02	$4,867.89	$4,867.89	nat. median $4,868 1.0× median
4357604 OTHER	Exc Les Muc/sub Vst Mth Wo Rpr	8	$4,325.80	$4,866.53	$4,866.53	nat. median $700 outlier · 6.9×
4230707 OTHER	Tx Incomplete Ab Any Tri Surg	8	$4,311.36	$4,850.28	$4,850.28	nat. median $4,850 1.0× median
4350422 OTHER	Tx Incomplete Ab Any Tri	8	$4,291.40	$4,827.83	$4,827.83	nat. median $4,828 1.0× median
4240770 OTHER	Pf Vaginal Delivery Only	8	$4,164.69	$4,685.27	$4,685.27	nat. median $4,685 1.0× median
74177 CPT	CT Abd/pelvis With Contrast	15	$3,029.60	$5,247.70	$4,652.60	nat. median $928 outlier · 5.0×
74183 CPT	MRI Abd W/wo Contrast	15	$3,016.16	$5,224.42	$4,631.96	nat. median $1,102 outlier · 4.2×
72157 CPT	MRI T-spine W/wo Contrast	15	$2,998.80	$5,194.35	$4,605.30	nat. median $1,094 outlier · 4.2×
4350126 OTHER	Pf Vaginal Delivery Only	8	$3,985.97	$4,484.21	$4,484.21	nat. median $4,484 1.0× median
4130099 OTHER	CT Abd/pelvis With Contrast	8	$3,970.47	$4,466.78	$4,466.78	nat. median $4,467 1.0× median
4120033 OTHER	MRI Abd W/wo Contrast	8	$3,952.90	$4,447.02	$4,447.02	nat. median $1,634 outlier · 2.7×
72156 CPT	MRI C-spine W/wo Contrast	15	$2,892.96	$5,011.02	$4,442.76	nat. median $1,092 outlier · 4.1×
70546 CPT	MRA Head W/wo Contrast	15	$2,881.20	$4,990.65	$4,424.70	nat. median $1,043 outlier · 4.2×
4120017 OTHER	MRI T-spine W/wo Contrast	8	$3,929.86	$4,421.10	$4,421.10	nat. median $545 outlier · 8.1×
73720 CPT	MRI Lo Ext W/wo Jnt W/wo	15	$2,848.72	$4,934.39	$4,374.82	nat. median $1,190 outlier · 3.7×
4230709 OTHER	Repr Tendn/musl Flx F/arm/wrst	8	$3,880.88	$4,365.99	$4,365.99	nat. median $4,366 1.0× median
72197 CPT	MRI Pelvis W/wo Contrast	15	$2,836.96	$4,914.02	$4,356.76	nat. median $1,065 outlier · 4.1×
71552 CPT	MRI Chest W/wo Contrast	15	$2,821.28	$4,886.86	$4,332.68	nat. median $1,093 outlier · 4.0×
70549 CPT	MRA Neck W/wo Contrast	15	$2,787.12	$4,827.69	$4,280.22	nat. median $1,051 outlier · 4.1×
4120016 OTHER	MRI C-spine W/wo Contrast	8	$3,791.48	$4,265.42	$4,265.42	nat. median $66 outlier · 65.1×
4120005 OTHER	MRA Head W/wo Contrast	8	$3,775.58	$4,247.53	$4,247.53	nat. median $1,073 outlier · 4.0×
72142 CPT	MRI C Spine Wc	15	$2,749.04	$4,761.73	$4,221.74	nat. median $959 outlier · 4.4×
4120028 OTHER	MRI Lo Ext W/wo Jnt W/wo	8	$3,733.49	$4,200.17	$4,200.17	nat. median $225 outlier · 18.7×
11770 CPT	Excision Pilonidal Cyst Simple	15	$1,005.20	$7,513.92	$4,197.05	nat. median $2,862 1.5× median
4120020 OTHER	MRI Pelvis W/wo Contrast	8	$3,717.44	$4,182.12	$4,182.12	nat. median $80 outlier · 52.0×
4120011 OTHER	MRI Chest W/wo Contrast	8	$3,697.30	$4,159.46	$4,159.46	nat. median $161 outlier · 25.8×
43247 CPT	Egd With Fb Removal	15	$2,706.48	$4,688.01	$4,156.38	nat. median $1,481 outlier · 2.8×
4120007 OTHER	MRA Neck W/wo Contrast	8	$3,652.47	$4,109.03	$4,109.03	nat. median $510 outlier · 8.1×
4350750 OTHER	Debrid Bn Mscl/fascia<20 Sq Cm	8	$3,633.30	$4,087.46	$4,087.46	nat. median $4,087 1.0× median
4120082 OTHER	MRI C Spine Wc	8	$3,602.49	$4,052.80	$4,052.80	nat. median $8 outlier · 532.6×
64999 CPT	Nervous Sys Oth Surg/proc	15	$2,515.52	$4,357.24	$4,046.26	nat. median $702 outlier · 5.8×
71275 CPT	CTA Chest	15	$2,617.44	$4,533.78	$4,019.64	nat. median $736 outlier · 5.5×

Other procedures at this hospital

Browse this hospital's 4,274 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

4172834	OTHER	Tenecteplase 50mg Inj	16	8	$33,031.00	—	$17,200.00	$40,105.80	$27,499.80	2026-05-18
4173231	OTHER	Vedolizumab-entyvio	8	8	$20,848.00	—	$16,678.40	$18,763.20	$18,763.20	2026-05-18
4172667	OTHER	Pegfilgrastim 6mg/0.6ml Inj	8	8	$15,981.50	—	$12,785.20	$14,383.35	$14,383.35	2026-05-18
4230410	OTHER	Suture/repair Testi Injr	8	8	$7,197.00	—	$5,757.60	$6,477.30	$6,477.30	2026-05-18
4350409	OTHER	Excision Pilonidal Cyst Simple	8	8	$7,180.14	—	$5,744.11	$6,462.13	$6,462.13	2026-05-18
74174	CPT	CTA Abd/pel W&without Contrast	15	15	$7,501.00	$6,375.85	$4,200.56	$7,275.97	$6,450.86	2025-07-01
4350424	OTHER	Suture/repair Testi Injy	8	8	$6,888.16	—	$5,510.53	$6,199.34	$6,199.34	2026-05-18
4130104	OTHER	CTA Abd/pel W&without Contrast	8	8	$6,881.54	—	$5,505.23	$6,193.39	$6,193.39	2026-05-18
74178	CPT	CT Abd/pelvis W/wo Contrast	15	15	$7,101.00	$6,035.85	$3,976.56	$6,887.97	$6,106.86	2025-07-01
70553	CPT	MRI Brain W/wo Contrast	15	15	$6,906.00	$5,870.10	$3,867.36	$6,698.82	$5,939.16	2025-07-01
72158	CPT	MRI L-spine W/wo Contrast	15	15	$6,880.00	$5,848.00	$3,852.80	$6,673.60	$5,916.80	2025-07-01
4130100	OTHER	CT Abd/pelvis W/wo Contrast	8	8	$6,514.65	—	$5,211.72	$5,863.19	$5,863.19	2026-05-18
4120009	OTHER	MRI Brain W/wo Contrast	8	8	$6,335.10	—	$5,068.08	$5,701.59	$5,701.59	2026-05-18
4120018	OTHER	MRI L-spine W/wo Contrast	8	8	$6,311.23	—	$5,048.98	$5,680.11	$5,680.11	2026-05-18
4230720	OTHER	I&d Ischiorect/perirect Abs	8	8	$5,799.10	—	$4,639.28	$5,219.19	$5,219.19	2026-05-18
G0390	CPT	Trauma Resp Tm W/critcare	15	15	$5,896.00	$5,011.60	$3,301.76	$5,719.12	$5,070.56	2025-07-01
40810	CPT	Ex Les Muc/sub Vest Mth Wo Rpr	45	15	$5,894.00	$5,009.90	$205.52	$5,744.34	$5,033.70	2025-07-01
4237602	OTHER	Ex Les Muc/sub Vest Mth Wo Rpr	8	8	$5,432.40	—	$4,345.92	$4,889.16	$4,889.16	2026-05-18
4230004	OTHER	Trauma Resp Tm W/critcare	8	8	$5,408.77	—	$4,327.02	$4,867.89	$4,867.89	2026-05-18
4357604	OTHER	Exc Les Muc/sub Vst Mth Wo Rpr	8	8	$5,407.25	—	$4,325.80	$4,866.53	$4,866.53	2026-05-18
4230707	OTHER	Tx Incomplete Ab Any Tri Surg	8	8	$5,389.20	—	$4,311.36	$4,850.28	$4,850.28	2026-05-18
4350422	OTHER	Tx Incomplete Ab Any Tri	8	8	$5,364.25	—	$4,291.40	$4,827.83	$4,827.83	2026-05-18
4240770	OTHER	Pf Vaginal Delivery Only	8	8	$5,205.86	—	$4,164.69	$4,685.27	$4,685.27	2026-05-18
74177	CPT	CT Abd/pelvis With Contrast	15	15	$5,410.00	$4,598.50	$3,029.60	$5,247.70	$4,652.60	2025-07-01
74183	CPT	MRI Abd W/wo Contrast	15	15	$5,386.00	$4,578.10	$3,016.16	$5,224.42	$4,631.96	2025-07-01
72157	CPT	MRI T-spine W/wo Contrast	15	15	$5,355.00	$4,551.75	$2,998.80	$5,194.35	$4,605.30	2025-07-01
4350126	OTHER	Pf Vaginal Delivery Only	8	8	$4,982.46	—	$3,985.97	$4,484.21	$4,484.21	2026-05-18
4130099	OTHER	CT Abd/pelvis With Contrast	8	8	$4,963.09	—	$3,970.47	$4,466.78	$4,466.78	2026-05-18
4120033	OTHER	MRI Abd W/wo Contrast	8	8	$4,941.13	—	$3,952.90	$4,447.02	$4,447.02	2026-05-18
72156	CPT	MRI C-spine W/wo Contrast	15	15	$5,166.00	$4,391.10	$2,892.96	$5,011.02	$4,442.76	2025-07-01
70546	CPT	MRA Head W/wo Contrast	15	15	$5,145.00	$4,373.25	$2,881.20	$4,990.65	$4,424.70	2025-07-01
4120017	OTHER	MRI T-spine W/wo Contrast	8	8	$4,912.33	—	$3,929.86	$4,421.10	$4,421.10	2026-05-18
73720	CPT	MRI Lo Ext W/wo Jnt W/wo	15	15	$5,087.00	$4,323.95	$2,848.72	$4,934.39	$4,374.82	2025-07-01
4230709	OTHER	Repr Tendn/musl Flx F/arm/wrst	8	8	$4,851.10	—	$3,880.88	$4,365.99	$4,365.99	2026-05-18
72197	CPT	MRI Pelvis W/wo Contrast	15	15	$5,066.00	$4,306.10	$2,836.96	$4,914.02	$4,356.76	2025-07-01
71552	CPT	MRI Chest W/wo Contrast	15	15	$5,038.00	$4,282.30	$2,821.28	$4,886.86	$4,332.68	2025-07-01
70549	CPT	MRA Neck W/wo Contrast	15	15	$4,977.00	$4,230.45	$2,787.12	$4,827.69	$4,280.22	2025-07-01
4120016	OTHER	MRI C-spine W/wo Contrast	8	8	$4,739.35	—	$3,791.48	$4,265.42	$4,265.42	2026-05-18
4120005	OTHER	MRA Head W/wo Contrast	8	8	$4,719.48	—	$3,775.58	$4,247.53	$4,247.53	2026-05-18
72142	CPT	MRI C Spine Wc	15	15	$4,909.00	$4,172.65	$2,749.04	$4,761.73	$4,221.74	2025-07-01
4120028	OTHER	MRI Lo Ext W/wo Jnt W/wo	8	8	$4,666.86	—	$3,733.49	$4,200.17	$4,200.17	2026-05-18
11770	CPT	Excision Pilonidal Cyst Simple	30	15	$4,811.00	$4,089.35	$1,005.20	$7,513.92	$4,197.05	2025-07-01
4120020	OTHER	MRI Pelvis W/wo Contrast	8	8	$4,646.80	—	$3,717.44	$4,182.12	$4,182.12	2026-05-18
4120011	OTHER	MRI Chest W/wo Contrast	8	8	$4,621.62	—	$3,697.30	$4,159.46	$4,159.46	2026-05-18
43247	CPT	Egd With Fb Removal	15	15	$4,833.00	$4,108.05	$2,706.48	$4,688.01	$4,156.38	2025-07-01
4120007	OTHER	MRA Neck W/wo Contrast	8	8	$4,565.59	—	$3,652.47	$4,109.03	$4,109.03	2026-05-18
4350750	OTHER	Debrid Bn Mscl/fascia<20 Sq Cm	8	8	$4,541.62	—	$3,633.30	$4,087.46	$4,087.46	2026-05-18
4120082	OTHER	MRI C Spine Wc	8	8	$4,503.11	—	$3,602.49	$4,052.80	$4,052.80	2026-05-18
64999	CPT	Nervous Sys Oth Surg/proc	30	15	$4,481.50	$3,809.27	$2,515.52	$4,357.24	$4,046.26	2025-07-01
71275	CPT	CTA Chest	15	15	$4,674.00	$3,972.90	$2,617.44	$4,533.78	$4,019.64	2025-07-01
4350140	OTHER	Egd With Fb Removal	8	8	$4,433.30	—	$3,546.64	$3,989.97	$3,989.97	2026-05-18
72127	CPT	CT Cervical W/wo Contrast	15	15	$4,603.00	$3,912.55	$2,577.68	$4,464.91	$3,958.58	2025-07-01
4230706	OTHER	Episiotomy/vag Repr Non Attend	8	8	$4,391.04	—	$3,512.83	$3,951.94	$3,951.94	2026-05-18
4350227	OTHER	I&d Hema/seroma Fluid Coll	8	8	$4,388.97	—	$3,511.18	$3,950.07	$3,950.07	2026-05-18
73223	CPT	MRI Up Ext W/jnt W/wo	15	15	$4,568.00	$3,882.80	$2,558.08	$4,430.96	$3,928.48	2025-07-01
59409	CPT	Pf Vaginal Delivery Only	60	15	$4,855.00	$4,126.75	$1,313.20	$5,504.75	$3,915.28	2025-07-01
4130092	OTHER	CTA Chest	8	8	$4,287.85	—	$3,430.28	$3,859.07	$3,859.07	2026-05-18
4237613	OTHER	Pf Critical Care Initl 30-74 M	8	8	$4,286.92	—	$3,429.54	$3,858.23	$3,858.23	2026-05-18
70543	CPT	MRI Orb/face/neck W/wo	15	15	$4,466.00	$3,796.10	$2,500.96	$4,332.02	$3,840.76	2025-07-01
15940	CPT	Exc Ischial Press Ulcr W/sutre	15	15	$4,224.00	$3,590.40	$3,590.40	$4,055.04	$3,822.72	2025-07-01
70552	CPT	MRI-brain With Contrast	15	15	$4,427.00	$3,762.95	$2,479.12	$4,294.19	$3,807.22	2025-07-01
4130018	OTHER	CT Cervical W/wo Contrast	8	8	$4,222.24	—	$3,377.79	$3,800.02	$3,800.02	2026-05-18
4120025	OTHER	MRI Up Ext W/jnt W/wo	8	8	$4,190.27	—	$3,352.22	$3,771.24	$3,771.24	2026-05-18
73723	CPT	MRI Lo Ext W/jnt W/wo	15	15	$4,362.00	$3,707.70	$2,442.72	$4,231.14	$3,751.32	2025-07-01
24101	CPT	Pf Arthrotomy Elbw W/exp	15	15	$4,360.00	$3,706.00	$2,441.60	$4,229.20	$3,749.60	2025-07-01
4230714	OTHER	Nervous Sys Surg Oth/proc	8	8	$4,120.37	—	$3,296.30	$3,708.33	$3,708.33	2026-05-18
74175	CPT	CTA Abdomen	15	15	$4,307.00	$3,660.95	$2,411.92	$4,177.79	$3,704.02	2025-07-01
4359907	OTHER	Nervous Sys Oth Surg/proc	8	8	$4,101.30	—	$3,281.04	$3,691.17	$3,691.17	2026-05-18
4120003	OTHER	MRI Orb/face/neck W/wo	8	8	$4,096.61	—	$3,277.29	$3,686.95	$3,686.95	2026-05-18
73220	CPT	MRI Up Ext Without Jnt W/wo	15	15	$4,287.00	$3,643.95	$2,400.72	$4,158.39	$3,686.82	2025-07-01
4237592	OTHER	Skin Sc Tissue Mf/muscle/bone	8	8	$4,095.04	—	$3,276.03	$3,685.54	$3,685.54	2026-05-18
11047	CPT	Debride Bone Ea Add 20 Sq Cm	15	15	$4,045.00	$3,438.25	$3,438.25	$3,883.20	$3,660.72	2025-07-01
4120081	OTHER	MRI-brain With Contrast	8	8	$4,060.95	—	$3,248.76	$3,654.86	$3,654.86	2026-05-18
72148	CPT	MRI L-spine Without Contrast	15	15	$4,248.00	$3,610.80	$2,378.88	$4,120.56	$3,653.28	2025-07-01
24000	CPT	Pf Arthro Elbw Exp/drain/ro Fb	15	15	$4,231.00	$3,596.35	$2,369.36	$4,104.07	$3,638.66	2025-07-01
75635	CPT	CTA Abd Aor/bi Iliofem Lo	15	15	$4,226.00	$3,592.10	$2,366.56	$4,099.22	$3,634.36	2025-07-01
74176	CPT	CT Abd/pelvis Wo Contrast	15	15	$4,202.00	$3,571.70	$2,353.12	$4,075.94	$3,613.72	2025-07-01
4120030	OTHER	MRI Lo Ext W/jnt W/wo	8	8	$4,001.78	—	$3,201.42	$3,601.60	$3,601.60	2026-05-18
4350080	OTHER	Pf Arthrotomy Elbw W/exp	8	8	$3,999.22	—	$3,199.38	$3,599.30	$3,599.30	2026-05-18
70498	CPT	CTA Cartoid	15	15	$4,176.00	$3,549.60	$2,338.56	$4,050.72	$3,591.36	2025-07-01
99291	CPT	Crit Care Each Add'l 30min	45	15	$4,202.00	$3,571.70	$646.80	$4,532.81	$3,571.70	2025-07-01
4130097	OTHER	CTA Abdomen	8	8	$3,951.26	—	$3,161.01	$3,556.13	$3,556.13	2026-05-18
4120023	OTHER	MRI Up Ext Without Jnt W/wo	8	8	$3,932.85	—	$3,146.28	$3,539.57	$3,539.57	2026-05-18
4237584	OTHER	Closed Tx Mtpj Dislc W/anes	8	8	$3,931.69	—	$3,145.35	$3,538.52	$3,538.52	2026-05-18
4237603	OTHER	Vag Deliv W/wo Episiotomy/fore	8	8	$3,925.58	—	$3,140.46	$3,533.02	$3,533.02	2026-05-18
4350209	OTHER	Exc Tumor HAND/FING<1.5cm	8	8	$3,906.39	—	$3,125.11	$3,515.75	$3,515.75	2026-05-18
4120015	OTHER	MRI L-spine Without Contrast	8	8	$3,896.59	—	$3,117.27	$3,506.93	$3,506.93	2026-05-18
4240165	OTHER	Pf Arthro Elbw Exp/drain/ro Fb	8	8	$3,881.56	—	$3,105.25	$3,493.40	$3,493.40	2026-05-18
4130089	OTHER	CTA Abd Aor/bi Iliofem Lo	8	8	$3,876.96	—	$3,101.57	$3,489.26	$3,489.26	2026-05-18
4350213	OTHER	Exc Ischial Press Ulcr W/sutre	8	8	$3,875.05	—	$3,100.04	$3,487.55	$3,487.55	2026-05-18
70496	CPT	CTA Head (cow)	15	15	$4,035.00	$3,429.75	$2,259.60	$3,913.95	$3,470.10	2025-07-01
4230320	OTHER	Crit Care Each Add'l 30min	8	8	$3,854.82	—	$3,083.86	$3,469.34	$3,469.34	2026-05-18
4130101	OTHER	CT Abd/pelvis Wo Contrast	8	8	$3,854.82	—	$3,083.86	$3,469.34	$3,469.34	2026-05-18
72141	CPT	MRI C-spine Without Contrast	15	15	$4,018.00	$3,415.30	$2,250.08	$3,897.46	$3,455.48	2025-07-01
72130	CPT	CT Thoracic With/wo Contrast	15	15	$4,016.00	$3,413.60	$2,248.96	$3,895.52	$3,453.76	2025-07-01
4130094	OTHER	CTA Cartoid	8	8	$3,830.40	—	$3,064.32	$3,447.36	$3,447.36	2026-05-18
70551	CPT	MRI Brain Without Contrast	15	15	$3,971.00	$3,375.35	$2,223.76	$3,851.87	$3,415.06	2025-07-01
26350	CPT	Pf Repair Flex Tendon Wo Graft	15	15	$3,940.00	$3,349.00	$2,206.40	$3,821.80	$3,388.40	2025-07-01
72149	CPT	MRI L Spine W/contrast	15	15	$3,918.00	$3,330.30	$2,194.08	$3,800.46	$3,369.48	2025-07-01
73202	CPT	CT Up Ext W/wo Contrast	15	15	$3,909.00	$3,322.65	$2,189.04	$3,791.73	$3,361.74	2025-07-01
4357606	OTHER	App Epifix Ar/100sqcm 1 25sqcm	8	8	$3,722.02	—	$2,977.62	$3,349.82	$3,349.82	2026-05-18
4350753	OTHER	Debride Bone Ea Add 20 Sq Cm	8	8	$3,710.67	—	$2,968.54	$3,339.60	$3,339.60	2026-05-18
4130096	OTHER	CTA Head (cow)	8	8	$3,701.24	—	$2,960.99	$3,331.12	$3,331.12	2026-05-18
44389	CPT	Colon Stoma W/bx Single Mult	15	15	$3,873.00	$3,292.05	$2,168.88	$3,756.81	$3,330.78	2025-07-01
71270	CPT	CT Chest W/wo Contrast Diag	15	15	$3,866.00	$3,286.10	$2,164.96	$3,750.02	$3,324.76	2025-07-01
4120013	OTHER	MRI C-spine Without Contrast	8	8	$3,685.85	—	$2,948.68	$3,317.27	$3,317.27	2026-05-18
72133	CPT	CT Lumbar With/wo Contrast	15	15	$3,857.00	$3,278.45	$2,159.92	$3,741.29	$3,317.02	2025-07-01
4130021	OTHER	CT Thoracic With/wo Contrast	8	8	$3,684.23	—	$2,947.38	$3,315.81	$3,315.81	2026-05-18
70492	CPT	CT St Neck W/wo Contrast	15	15	$3,844.00	$3,267.40	$2,152.64	$3,728.68	$3,305.84	2025-07-01
73706	CPT	CTA Lower Extremity	15	15	$3,818.00	$3,245.30	$2,138.08	$3,703.46	$3,283.48	2025-07-01
4120008	OTHER	MRI Brain Without Contrast	8	8	$3,642.81	—	$2,914.25	$3,278.53	$3,278.53	2026-05-18
72146	CPT	MRI T-spine Without Contrast	15	15	$3,790.00	$3,221.50	$2,122.40	$3,676.30	$3,259.40	2025-07-01
4350120	OTHER	Colonoscopy Remove Tpl W/snare	8	8	$3,616.06	—	$2,892.85	$3,254.45	$3,254.45	2026-05-18
4350756	OTHER	Mult Nerve Blck Inj Rib Nerve	8	8	$3,615.62	—	$2,892.50	$3,254.06	$3,254.06	2026-05-18
4240189	OTHER	Pf Repair Flex Tendon Wo Graft	8	8	$3,614.31	—	$2,891.45	$3,252.88	$3,252.88	2026-05-18
4120079	OTHER	MRI L Spine W/contrast	8	8	$3,594.49	—	$2,875.59	$3,235.04	$3,235.04	2026-05-18
4350407	OTHER	Colonoscopy Screen High Risk	8	8	$3,593.97	—	$2,875.18	$3,234.57	$3,234.57	2026-05-18
73221	CPT	MRI Up Ext W/jnt Without Cont	15	15	$3,761.00	$3,196.85	$2,106.16	$3,648.17	$3,234.46	2025-07-01
4130030	OTHER	CT Up Ext W/wo Contrast	8	8	$3,585.78	—	$2,868.62	$3,227.20	$3,227.20	2026-05-18
46060	CPT	Pf Incision Of Rec Absces	15	15	$3,749.00	$3,186.65	$2,099.44	$3,636.53	$3,224.14	2025-07-01
4350090	OTHER	Colon W/bx Single/multi	8	8	$3,571.89	—	$2,857.51	$3,214.70	$3,214.70	2026-05-18
4350425	OTHER	Colon Stoma W/bx Single Mult	8	8	$3,553.04	—	$2,842.43	$3,197.74	$3,197.74	2026-05-18
4130015	OTHER	CT Chest W/wo Contrast Diag	8	8	$3,546.15	—	$2,836.92	$3,191.54	$3,191.54	2026-05-18
4130024	OTHER	CT Lumbar With/wo Contrast	8	8	$3,537.63	—	$2,830.10	$3,183.87	$3,183.87	2026-05-18
4130012	OTHER	CT St Neck W/wo Contrast	8	8	$3,526.56	—	$2,821.25	$3,173.90	$3,173.90	2026-05-18
70488	CPT	CT Maxillofacial W/wo Contrast	15	15	$3,670.00	$3,119.50	$2,055.20	$3,559.90	$3,156.20	2025-07-01
4130102	OTHER	CTA Lower Extremity	8	8	$3,502.70	—	$2,802.16	$3,152.43	$3,152.43	2026-05-18
72191	CPT	CTA Pelvis	15	15	$3,665.00	$3,115.25	$2,052.40	$3,555.05	$3,151.90	2025-07-01
4350137	OTHER	Colon Rm Tpl Hot Bx Forcep	8	8	$3,497.10	—	$2,797.68	$3,147.39	$3,147.39	2026-05-18
70482	CPT	CT Ear W/wo Contrast	15	15	$3,658.00	$3,109.30	$2,048.48	$3,548.26	$3,145.88	2025-07-01
4240850	OTHER	Pf Amput W/local Adv Flaps	8	8	$3,489.16	—	$2,791.33	$3,140.24	$3,140.24	2026-05-18
4120014	OTHER	MRI T-spine Without Contrast	8	8	$3,476.58	—	$2,781.26	$3,128.92	$3,128.92	2026-05-18
4237612	OTHER	Closed Humer Tuber Fx W/man	8	8	$3,471.81	—	$2,777.45	$3,124.63	$3,124.63	2026-05-18
4357001	OTHER	Pf Removal Central Line W Pump	8	8	$3,464.13	—	$2,771.30	$3,117.72	$3,117.72	2026-05-18
73718	CPT	MRI Lo Ex Without Jnt Without	15	15	$3,612.00	$3,070.20	$2,022.72	$3,503.64	$3,106.32	2025-07-01
4120024	OTHER	MRI Up Ext W/jnt Without Cont	8	8	$3,449.60	—	$2,759.68	$3,104.64	$3,104.64	2026-05-18
4350013	OTHER	Pf Incision Of Rec Absces	8	8	$3,439.30	—	$2,751.44	$3,095.37	$3,095.37	2026-05-18
73725	CPT	MRA Low Ext	15	15	$3,585.00	$3,047.25	$2,007.60	$3,477.45	$3,083.10	2025-07-01
70544	CPT	MRA Head Without Contrast	15	15	$3,567.00	$3,031.95	$1,997.52	$3,459.99	$3,067.62	2025-07-01
70470	CPT	CT Head W/wo Contrast	15	15	$3,546.00	$3,014.10	$1,985.76	$3,439.62	$3,049.56	2025-07-01
72126	CPT	CT Cervical With Contrast	15	15	$3,541.00	$3,009.85	$1,982.96	$3,434.77	$3,045.26	2025-07-01
4350088	OTHER	Egd W/biopsy Single/mult	8	8	$3,370.73	—	$2,696.58	$3,033.66	$3,033.66	2026-05-18
4130009	OTHER	CT Maxillofacial W/wo Contrast	8	8	$3,366.94	—	$2,693.55	$3,030.25	$3,030.25	2026-05-18
4130098	OTHER	CTA Pelvis	8	8	$3,362.10	—	$2,689.68	$3,025.89	$3,025.89	2026-05-18
11012	CPT	Pf Skin Sc Tiss Mf/muscle/bone	30	15	$3,807.00	$3,235.95	$1,764.00	$4,330.08	$3,024.00	2025-07-01
4130006	OTHER	CT Ear W/wo Contrast	8	8	$3,355.37	—	$2,684.30	$3,019.83	$3,019.83	2026-05-18
73702	CPT	CT Low Extr W/wo Contrast	15	15	$3,501.00	$2,975.85	$1,960.56	$3,395.97	$3,010.86	2025-07-01
4240067	OTHER	Pf Closed Trimal Ank Fx W/man	8	8	$3,341.37	—	$2,673.10	$3,007.23	$3,007.23	2026-05-18
4120027	OTHER	MRI Lo Ex Without Jnt Without	8	8	$3,313.07	—	$2,650.46	$2,981.76	$2,981.76	2026-05-18
4350089	OTHER	Colon Diag Flex/spec Collect	8	8	$3,293.98	—	$2,635.18	$2,964.58	$2,964.58	2026-05-18
25040	CPT	Pf Arthro W Exp/drain/ro Fb	15	15	$3,442.00	$2,925.70	$1,927.52	$3,338.74	$2,960.12	2025-07-01
4120031	OTHER	MRA Low Ext	8	8	$3,288.38	—	$2,630.70	$2,959.54	$2,959.54	2026-05-18
4350749	OTHER	Debride Mucl Fascia<20 Sq Cm	8	8	$3,278.66	—	$2,622.93	$2,950.79	$2,950.79	2026-05-18
26111	CPT	Exc Tumor HAND/FING<1.5cm	30	15	$3,300.00	$2,805.00	$1,311.52	$4,087.68	$2,945.52	2025-07-01
4120004	OTHER	MRA Head Without Contrast	8	8	$3,272.17	—	$2,617.74	$2,944.95	$2,944.95	2026-05-18
72195	CPT	MRI Pelvis Without Contrast	15	15	$3,413.00	$2,901.05	$1,911.28	$3,310.61	$2,935.18	2025-07-01
4130003	OTHER	CT Head W/wo Contrast	8	8	$3,252.83	—	$2,602.26	$2,927.55	$2,927.55	2026-05-18
4130017	OTHER	CT Cervical With Contrast	8	8	$3,247.87	—	$2,598.30	$2,923.08	$2,923.08	2026-05-18
73218	CPT	MRI Up Ext Wo Jnt Wo Cont	15	15	$3,397.00	$2,887.45	$1,902.32	$3,295.09	$2,921.42	2025-07-01
73721	CPT	MRI Lo Ext W/jnt Without	15	15	$3,368.00	$2,862.80	$1,886.08	$3,266.96	$2,896.48	2025-07-01
4130033	OTHER	CT Low Extr W/wo Contrast	8	8	$3,211.89	—	$2,569.51	$2,890.70	$2,890.70	2026-05-18
71550	CPT	MRI Chest Without Contrast	15	15	$3,359.00	$2,855.15	$1,881.04	$3,258.23	$2,888.74	2025-07-01
71555	CPT	MRA Chest	15	15	$3,354.00	$2,850.90	$1,878.24	$3,253.38	$2,884.44	2025-07-01
72198	CPT	MRA Pelvis	15	15	$3,354.00	$2,850.90	$1,878.24	$3,253.38	$2,884.44	2025-07-01
74185	CPT	MRA Abd	15	15	$3,352.00	$2,849.20	$1,877.12	$3,251.44	$2,882.72	2025-07-01
74181	CPT	MRI Abd Without Contrast	15	15	$3,334.00	$2,833.90	$1,867.04	$3,233.98	$2,867.24	2025-07-01
74170	CPT	CT Abd W/wo Contrast	15	15	$3,332.00	$2,832.20	$1,865.92	$3,232.04	$2,865.52	2025-07-01
4240166	OTHER	Pf Arthro W Exp/drain/ro Fb	8	8	$3,157.28	—	$2,525.82	$2,841.55	$2,841.55	2026-05-18
4350087	OTHER	Egd-diag Flex W/spec Collect	8	8	$3,146.32	—	$2,517.06	$2,831.69	$2,831.69	2026-05-18
4350139	OTHER	Colonoscopy W/control Bleed	8	8	$3,143.30	—	$2,514.64	$2,828.97	$2,828.97	2026-05-18
11642	CPT	Exc Mal Les+marg1.1-2cm	30	15	$3,224.85	$2,741.12	$796.32	$4,826.59	$2,826.44	2025-07-01
4120073	OTHER	MRI Pelvis Without Contrast	8	8	$3,131.15	—	$2,504.92	$2,818.04	$2,818.04	2026-05-18
11772	CPT	Pf Excis Pilonidal Cyst Compl	15	15	$3,266.00	$2,776.10	$1,828.96	$3,168.02	$2,808.76	2025-07-01
4120022	OTHER	MRI Up Ext Wo Jnt Wo Cont	8	8	$3,116.09	—	$2,492.87	$2,804.48	$2,804.48	2026-05-18
54670	CPT	Pf Suture/repair Testicu Injry	60	15	$4,366.00	$3,711.10	$655.76	$7,609.65	$2,789.76	2025-07-01
4120029	OTHER	MRI Lo Ext W/jnt Without	8	8	$3,089.37	—	$2,471.50	$2,780.43	$2,780.43	2026-05-18
4120010	OTHER	MRI Chest Without Contrast	8	8	$3,081.08	—	$2,464.86	$2,772.97	$2,772.97	2026-05-18
4120021	OTHER	MRA Pelvis	8	8	$3,076.33	—	$2,461.06	$2,768.70	$2,768.70	2026-05-18
4120012	OTHER	MRA Chest	8	8	$3,076.33	—	$2,461.06	$2,768.70	$2,768.70	2026-05-18
4120034	OTHER	MRA Abd	8	8	$3,074.54	—	$2,459.63	$2,767.09	$2,767.09	2026-05-18
4173315	OTHER	Hyaluronate Sod Inj (Monovisc)	8	8	$3,074.50	—	$2,459.60	$2,767.05	$2,767.05	2026-05-18
4120032	OTHER	MRI Abd Without Contrast	8	8	$3,058.25	—	$2,446.60	$2,752.43	$2,752.43	2026-05-18
70491	CPT	CT St Neck With Contrast	15	15	$3,199.00	$2,719.15	$1,791.44	$3,103.03	$2,751.14	2025-07-01
4130036	OTHER	CT Abd W/wo Contrast	8	8	$3,056.50	—	$2,445.20	$2,750.85	$2,750.85	2026-05-18
4240154	OTHER	Pf Complx Repair Wnd2.6-7.5cm	8	8	$3,053.22	—	$2,442.58	$2,747.90	$2,747.90	2026-05-18
70547	CPT	MRA Neck Without Contrast	15	15	$3,191.00	$2,712.35	$1,786.96	$3,095.27	$2,744.26	2025-07-01
31635	CPT	Pf Bronchoscopy W/fb Remove	15	15	$3,166.00	$2,691.10	$1,772.96	$3,071.02	$2,722.76	2025-07-01
13160	CPT	Pf Sec Close/dehis Wnd Complx	15	15	$3,160.00	$2,686.00	$1,769.60	$3,065.20	$2,717.60	2025-07-01
4350131	OTHER	Egd W/ro Tpl	8	8	$3,012.42	—	$2,409.94	$2,711.18	$2,711.18	2026-05-18
4350212	OTHER	Exc Benign Les +marg3.1-4cm	8	8	$3,002.37	—	$2,401.90	$2,702.13	$2,702.13	2026-05-18
4350075	OTHER	Pf Excis Pilonidal Cyst Compl	8	8	$2,995.86	—	$2,396.69	$2,696.27	$2,696.27	2026-05-18
4050806	CDM	Infovac Wound Care	15	15	$3,133.00	$2,663.05	$1,754.48	$3,039.01	$2,694.38	2025-07-01
4173270	OTHER	Denosumab 120mg	16	8	$3,327.50	—	$44.00	$5,940.00	$2,664.75	2026-05-18
4239563	OTHER	Remve Fb External Audit Canal	8	8	$2,960.00	—	$2,368.00	$2,664.00	$2,664.00	2026-05-18
71260	CPT	CT Chest W/contrast Diag	15	15	$3,093.00	$2,629.05	$1,732.08	$3,000.21	$2,659.98	2025-07-01
72129	CPT	CT Thoracic With Contrast	15	15	$3,090.00	$2,626.50	$1,730.40	$2,997.30	$2,657.40	2025-07-01
11643	CPT	Exc Mal Les+marg2.1-3cm	30	15	$2,991.45	$2,542.73	$994.00	$4,039.58	$2,649.23	2025-07-01
4130011	OTHER	CT St Neck With Contrast	8	8	$2,934.10	—	$2,347.28	$2,640.69	$2,640.69	2026-05-18
4357614	OTHER	Esophago Flextransoral	8	8	$2,932.34	—	$2,345.87	$2,639.11	$2,639.11	2026-05-18
4120006	OTHER	MRA Neck Without Contrast	8	8	$2,926.66	—	$2,341.33	$2,633.99	$2,633.99	2026-05-18
4350188	OTHER	Pf Egd W/control Of Bleed	8	8	$2,906.59	—	$2,325.27	$2,615.93	$2,615.93	2026-05-18
4240018	OTHER	Pf Bronchoscopy W/fb Remove	8	8	$2,904.22	—	$2,323.38	$2,613.80	$2,613.80	2026-05-18
4240155	OTHER	Pf Sec Close/dehis Wnd Complx	8	8	$2,898.90	—	$2,319.12	$2,609.01	$2,609.01	2026-05-18
4240091	OTHER	Pf Skin Sc Tiss Mf/muscle/bone	8	8	$2,889.44	—	$2,311.55	$2,600.50	$2,600.50	2026-05-18
72194	CPT	CT Pelvis W/wo Contrast	15	15	$3,014.00	$2,561.90	$1,687.84	$2,923.58	$2,592.04	2025-07-01
73201	CPT	CT Upper Extremity W/contrast	15	15	$3,007.00	$2,555.95	$1,683.92	$2,916.79	$2,586.02	2025-07-01
70336	CPT	MRI Temporo Joint	15	15	$3,000.00	$2,550.00	$1,680.00	$2,910.00	$2,580.00	2025-07-01
4350176	OTHER	Pf Colon W/submucosal Inj	8	8	$2,857.91	—	$2,286.33	$2,572.12	$2,572.12	2026-05-18
11641	CPT	Exc Mal Les+marg.6-1cm	30	15	$2,932.80	$2,492.88	$623.28	$4,562.50	$2,559.66	2025-07-01
12057	CPT	Pf Inter Repair WND>30cm	15	15	$2,970.00	$2,524.50	$1,663.20	$2,880.90	$2,554.20	2025-07-01
4130014	OTHER	CT Chest W/contrast Diag	8	8	$2,836.91	—	$2,269.53	$2,553.22	$2,553.22	2026-05-18
72132	CPT	CT Lumbar With Contrast	15	15	$2,967.00	$2,521.95	$1,661.52	$2,877.99	$2,551.62	2025-07-01
4130020	OTHER	CT Thoracic With Contrast	8	8	$2,834.02	—	$2,267.22	$2,550.62	$2,550.62	2026-05-18
72193	CPT	CT Pelvis With Contrast	15	15	$2,963.00	$2,518.55	$1,659.28	$2,874.11	$2,548.18	2025-07-01
72125	CPT	CT Cervical Without Contrast	15	15	$2,946.00	$2,504.10	$1,649.76	$2,857.62	$2,533.56	2025-07-01
4071002	OTHER	Calr Gene Com Variants	8	8	$2,800.00	—	$2,240.00	$2,520.00	$2,520.00	2026-05-18
4230722	OTHER	Sigmoidoscopy And Biopsy	8	8	$2,792.70	—	$2,234.16	$2,513.43	$2,513.43	2026-05-18
28292	CPT	Bunion Procedure	15	15	$2,770.00	$2,354.50	$2,354.50	$2,659.20	$2,506.85	2025-07-01
4359511	OTHER	Sigmoidoscopy And Biopsy	8	8	$2,779.77	—	$2,223.82	$2,501.79	$2,501.79	2026-05-18
70481	CPT	CT Ear With Contrast	30	15	$2,870.00	$2,439.50	$1,575.84	$2,838.22	$2,501.73	2025-07-01
4230318	OTHER	Ed Facility Level 5	8	8	$2,778.69	—	$2,222.95	$2,500.82	$2,500.82	2026-05-18
4130027	OTHER	CT Pelvis W/wo Contrast	8	8	$2,764.24	—	$2,211.39	$2,487.82	$2,487.82	2026-05-18
4130029	OTHER	CT Upper Extremity W/contrast	8	8	$2,758.30	—	$2,206.64	$2,482.47	$2,482.47	2026-05-18
4230343	OTHER	Exp Penetrate Wnd Extremity	8	8	$2,753.19	—	$2,202.55	$2,477.87	$2,477.87	2026-05-18
4120001	OTHER	MRI Temporo Joint	8	8	$2,752.19	—	$2,201.75	$2,476.97	$2,476.97	2026-05-18
4240060	OTHER	Pf Closed Tibia W/man W/wo Tra	8	8	$2,742.81	—	$2,194.25	$2,468.53	$2,468.53	2026-05-18
4240143	OTHER	Pf Inter Repair WND>30cm	8	8	$2,723.89	—	$2,179.11	$2,451.50	$2,451.50	2026-05-18
4130023	OTHER	CT Lumbar With Contrast	8	8	$2,721.24	—	$2,176.99	$2,449.12	$2,449.12	2026-05-18
4350138	OTHER	Colon W/removal Fb	8	8	$2,718.68	—	$2,174.94	$2,446.81	$2,446.81	2026-05-18
4130026	OTHER	CT Pelvis With Contrast	8	8	$2,717.99	—	$2,174.39	$2,446.19	$2,446.19	2026-05-18
74160	CPT	CT Abd With Contrast	15	15	$2,843.00	$2,416.55	$1,592.08	$2,757.71	$2,444.98	2025-07-01
11771	CPT	Pf Excis Pilonidal Cyst Exten	15	15	$2,830.00	$2,405.50	$1,584.80	$2,745.10	$2,433.80	2025-07-01
4130016	OTHER	CT Cervical Without Contrast	8	8	$2,702.22	—	$2,161.78	$2,432.00	$2,432.00	2026-05-18
31603	CPT	Pf Tracheostomy	15	15	$2,827.00	$2,402.95	$1,583.12	$2,742.19	$2,431.22	2025-07-01
11644	CPT	Exc Mal Les+marg3.1-4cm	30	15	$2,706.10	$2,300.18	$1,205.12	$3,129.79	$2,429.31	2025-07-01
70487	CPT	CT Maxillofacial With Contrast	15	15	$2,824.00	$2,400.40	$1,581.44	$2,739.28	$2,428.64	2025-07-01
4130042	OTHER	CT Orbits W/contrast	8	8	$2,684.29	—	$2,147.43	$2,415.86	$2,415.86	2026-05-18
4240179	OTHER	Pf Closed Rad Ulnar Fx W/man	8	8	$2,669.28	—	$2,135.42	$2,402.35	$2,402.35	2026-05-18
11646	CPT	Pf Exc Mal LES+MARG>4cm	15	15	$2,792.00	$2,373.20	$1,563.52	$2,708.24	$2,401.12	2025-07-01
4240066	OTHER	Pf Closed Bimal Ank Fx W/man	8	8	$2,662.99	—	$2,130.39	$2,396.69	$2,396.69	2026-05-18
4350754	OTHER	Inj Ane 1 Intercostal Nerve	8	8	$2,661.49	—	$2,129.19	$2,395.34	$2,395.34	2026-05-18
25260	CPT	Pf Rp Tend/mucl Flx F/arm/wrst	30	15	$3,585.50	$3,047.68	$1,054.48	$5,129.36	$2,393.89	2025-07-01
43251	CPT	Pf Upper Gastro Endo W/ro	30	15	$2,709.50	$2,303.07	$1,463.28	$2,721.82	$2,385.10	2025-07-01
46040	CPT	I&d Ischiorect/perirect Abs	30	15	$3,789.00	$3,220.65	$703.36	$6,132.34	$2,379.32	2025-07-01
36590	CPT	Pf Removal Central Line W Pump	30	15	$3,141.50	$2,670.27	$2,114.56	$3,662.72	$2,356.58	2025-07-01
4130035	OTHER	CT Abd With Contrast	8	8	$2,607.85	—	$2,086.28	$2,347.07	$2,347.07	2026-05-18
70460	CPT	CT Head With Contrast	15	15	$2,718.00	$2,310.30	$1,522.08	$2,636.46	$2,337.48	2025-07-01
21555	CPT	Pf Excision Tmr SUBCUT<3cm	15	15	$2,718.00	$2,310.30	$1,522.08	$2,636.46	$2,337.48	2025-07-01
4350074	OTHER	Pf Excis Pilonidal Cyst Exten	8	8	$2,596.18	—	$2,076.94	$2,336.56	$2,336.56	2026-05-18
4240017	OTHER	Pf Tracheostomy	8	8	$2,593.40	—	$2,074.72	$2,334.06	$2,334.06	2026-05-18
4130008	OTHER	CT Maxillofacial With Contrast	8	8	$2,589.96	—	$2,071.97	$2,330.96	$2,330.96	2026-05-18
26591	CPT	Pf Repair Intrinsic Muscle Hd	15	15	$2,702.00	$2,296.70	$1,513.12	$2,620.94	$2,323.72	2025-07-01
4130005	OTHER	CT Ear With Contrast	8	8	$2,581.05	—	$2,064.84	$2,322.95	$2,322.95	2026-05-18
73701	CPT	CT Lower Extremity With C	15	15	$2,694.00	$2,289.90	$1,508.64	$2,613.18	$2,316.84	2025-07-01
4350134	OTHER	Upper Gastro Endo W/ro By	8	8	$2,573.71	—	$2,058.97	$2,316.34	$2,316.34	2026-05-18
4230228	OTHER	Insrt Non-tunn Cent Cath >5y	8	8	$2,564.93	—	$2,051.94	$2,308.44	$2,308.44	2026-05-18
4350072	OTHER	Pf Exc Mal LES+MARG>4cm	8	8	$2,561.30	—	$2,049.04	$2,305.17	$2,305.17	2026-05-18
24076	CPT	Pf Excision Tmr ARM/ELBW<5cm	15	15	$2,667.00	$2,266.95	$1,493.52	$2,586.99	$2,293.62	2025-07-01
4246558	OTHER	Pf Insrt Tun Cent Cth Wo Prt<5	8	8	$2,541.78	—	$2,033.42	$2,287.60	$2,287.60	2026-05-18
4350094	OTHER	Bunion Procedure	8	8	$2,540.60	—	$2,032.48	$2,286.54	$2,286.54	2026-05-18
4350192	OTHER	Pf Colnscpy Mdcr Scrn Nhr	8	8	$2,527.28	—	$2,021.82	$2,274.55	$2,274.55	2026-05-18
4130002	OTHER	CT Head With Contrast	8	8	$2,493.48	—	$1,994.78	$2,244.13	$2,244.13	2026-05-18
4350185	OTHER	Pf Excision Tmr SUBCUT<3cm	8	8	$2,493.30	—	$1,994.64	$2,243.97	$2,243.97	2026-05-18
11602	CPT	Exc Mal Les+marg1.1-2cm	30	15	$2,575.00	$2,188.75	$514.64	$4,061.76	$2,243.89	2025-07-01
4230725	OTHER	Repair Of Nail Bed	8	8	$2,485.06	—	$1,988.05	$2,236.55	$2,236.55	2026-05-18
4240194	OTHER	Pf Repair Intrinsic Muscle Hd	8	8	$2,478.52	—	$1,982.82	$2,230.67	$2,230.67	2026-05-18
4240159	OTHER	Pf Closed Humeral Fx W/man	8	8	$2,470.83	—	$1,976.66	$2,223.75	$2,223.75	2026-05-18
4130032	OTHER	CT Lower Extremity With C	8	8	$2,470.68	—	$1,976.54	$2,223.61	$2,223.61	2026-05-18
87150	CPT	Cult Nuc Acd Amp Prb Cult/isol	15	15	$2,584.00	$2,196.40	$1,447.04	$2,506.48	$2,222.24	2025-07-01
81503	CPT	Onco Biochemi Assay 5 Prt	15	15	$2,584.00	$2,196.40	$1,447.04	$2,506.48	$2,222.24	2025-07-01
4240150	OTHER	Pf Complx Repair Wnd2.6-7.5cm	8	8	$2,461.45	—	$1,969.16	$2,215.31	$2,215.31	2026-05-18
4240208	OTHER	Pf Placement Of Gastrostomy	8	8	$2,457.38	—	$1,965.90	$2,211.64	$2,211.64	2026-05-18
72128	CPT	CT Thoracic Without Contrast	15	15	$2,571.00	$2,185.35	$1,439.76	$2,493.87	$2,211.06	2025-07-01
4358758	OTHER	Egd W/direc Submuc Inj	8	8	$2,454.16	—	$1,963.33	$2,208.74	$2,208.74	2026-05-18
4350500	OTHER	Colonoscopy W/resection	8	8	$2,449.36	—	$1,959.49	$2,204.42	$2,204.42	2026-05-18
26433	CPT	Pf Repair Exten Tendn Wo Graft	15	15	$2,561.00	$2,176.85	$1,434.16	$2,484.17	$2,202.46	2025-07-01
4350079	OTHER	Pf Excision Tmr ARM/ELBW<5cm	8	8	$2,446.00	—	$1,956.80	$2,201.40	$2,201.40	2026-05-18
4357023	OTHER	US Guided Paracentesis	8	8	$2,432.02	—	$1,945.62	$2,188.82	$2,188.82	2026-05-18
12056	CPT	Pf Inter Repair Wnd20.1-30cm	15	15	$2,538.00	$2,157.30	$1,421.28	$2,461.86	$2,182.68	2025-07-01
27810	CPT	Closed Bimal Ankle Fx W/man	30	15	$2,587.50	$2,199.38	$1,272.32	$2,815.91	$2,181.12	2025-07-01
26116	CPT	Pf Excis Tmr HAND/FING<1.5cm	15	15	$2,535.00	$2,154.75	$1,419.60	$2,458.95	$2,180.10	2025-07-01
43243	CPT	Upper Gi Endoscpy W Inj.	30	15	$3,029.50	$2,575.07	$1,263.92	$3,687.94	$2,178.22	2025-07-01
70540	CPT	MRI Orb/face/neck Without Con	15	15	$2,526.00	$2,147.10	$1,414.56	$2,450.22	$2,172.36	2025-07-01
4350133	OTHER	Pf Upper Gastro Endo W/ro	8	8	$2,396.34	—	$1,917.07	$2,156.71	$2,156.71	2026-05-18
73200	CPT	CT Upper Extremity Without	15	15	$2,502.00	$2,126.70	$1,401.12	$2,426.94	$2,151.72	2025-07-01
4070766	OTHER	Cult Nuc Acd Amp Prb Cult/isol	8	8	$2,370.06	—	$1,896.05	$2,133.05	$2,133.05	2026-05-18
4070750	OTHER	Onco Biochemi Assay 5 Prt	8	8	$2,370.06	—	$1,896.05	$2,133.05	$2,133.05	2026-05-18
11451	CPT	Pf Exc Hidradeni Axi Cmp Rpr	15	15	$2,476.00	$2,104.60	$1,386.56	$2,401.72	$2,129.36	2025-07-01
72131	CPT	CT Lumbar Without Contrast	15	15	$2,468.00	$2,097.80	$1,382.08	$2,393.96	$2,122.48	2025-07-01
4130019	OTHER	CT Thoracic Without Contrast	8	8	$2,357.90	—	$1,886.32	$2,122.11	$2,122.11	2026-05-18
70490	CPT	CT St Neck Without Contrast	15	15	$2,461.00	$2,091.85	$1,378.16	$2,387.17	$2,116.46	2025-07-01
4230705	OTHER	Paracentesis Abdominal W/image	8	8	$2,349.36	—	$1,879.49	$2,114.42	$2,114.42	2026-05-18
4240193	OTHER	Pf Repair Exten Tendn Wo Graft	8	8	$2,349.04	—	$1,879.23	$2,114.14	$2,114.14	2026-05-18
4350194	OTHER	Pf Ampu Interphal Jnt	8	8	$2,329.53	—	$1,863.62	$2,096.58	$2,096.58	2026-05-18
4240142	OTHER	Pf Inter Repair Wnd20.1-30cm	8	8	$2,327.75	—	$1,862.20	$2,094.98	$2,094.98	2026-05-18
26025	CPT	Pf Drain Palmar Bursa Sin	15	15	$2,434.00	$2,068.90	$1,363.04	$2,360.98	$2,093.24	2025-07-01
4350082	OTHER	Pf Excis Tmr HAND/FING<1.5cm	8	8	$2,325.39	—	$1,860.31	$2,092.85	$2,092.85	2026-05-18
27762	CPT	Closed Tx Inside/shin Bone Ank	45	15	$2,323.00	$1,974.55	$1,227.52	$2,688.84	$2,090.70	2025-07-01
4240197	OTHER	Pf Closed Mc Fx W/man Ext Fix	8	8	$2,321.84	—	$1,857.47	$2,089.66	$2,089.66	2026-05-18
11471	CPT	Pf Ro Swgl Les, P/u, Comp	15	15	$2,429.00	$2,064.65	$1,360.24	$2,356.13	$2,088.94	2025-07-01

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