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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 →

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Hospital

TAMARACK HEALTH ASHLAND MEDICAL CENTER

Ashland, WI · CCN 521359 · Rates published

Your selected procedure

You selected 93306 (CPT)

Tte W/Doppler, Complete

This hospital’s price: $1,508 across 17 payers · range $639-$3,320

Source: https://machine-readable-files.com/tamarack-health-ashland-medical-center/237013497_Memorial-Medical-Center-Inc_standardcharges.csv · observed 2026-01-26

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.

875 distinct procedures filed
30 distinct payers
6,456 rate rows
2026-01-26 last MRF observed
Data quality

5,979 of 6,456 rate rows are consumer-grade (92.6%)

477 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
professional (physician) fee — not the facility price 451
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 15
placeholder amount (≤ $0.02) — excluded from medians 6
exceeds 10× this hospital's gross charge — excluded from medians 4
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://machine-readable-files.com/tamarack-health-ashland-medical-center/237013497_Memorial-Medical-Center-Inc_standardcharges.csv
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-21
Content fingerprint 326df8b876488925… · 5,692,035 bytes · first seen 2026-05-13

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
78815
CPT 		Pet/CT Skull-mid Thigh Tc 11 $2,021.57 $7,313.42 $6,954.00 nat. median
$2,822
outlier · 2.5×
J1561
HCPCS 		Immune Globulin (human) 2.5 Gm/25ml Solution 25 Ml Vial 1 $5,757.82 $5,757.82 $5,757.82 nat. median
$1,094
outlier · 5.3×
74174
CPT 		CT Angio Abd&Pelv W/O&with Contrast 7 $2,561.84 $5,896.97 $5,623.40 nat. median
$998
outlier · 5.6×
78803
CPT 		Tumor Imag, Spect Single Area, Incl Vasc Flow & Blood Pool Imag (Tc) 1 $5,314.57 $5,314.57 $5,314.57 nat. median
$1,394
outlier · 3.8×
74178
CPT 		CT Abd&Pelv 1+ Section/Regns 15 $471.67 $5,432.06 $5,180.06 nat. median
$1,027
outlier · 5.0×
70552
CPT 		MRI Brain W Contrast Tc 1 $4,948.82 $4,948.82 $4,948.82 nat. median
$965
outlier · 5.1×
72197
CPT 		Mri, Pelvis, Without Then With 11 $601.06 $4,729.68 $4,493.20 nat. median
$1,074
outlier · 4.2×
74175
CPT 		CT Angio Abdom Without & With Contrast 1 $4,431.30 $4,431.30 $4,431.30 nat. median
$718
outlier · 6.2×
72158
CPT 		MRI L Spine W&wo Contrast 9 $601.06 $4,453.05 $4,230.40 nat. median
$1,097
outlier · 3.9×
73220
CPT 		MRI Upper W/o+w Tc 2 $4,113.63 $4,149.69 $4,131.66 nat. median
$1,136
outlier · 3.6×
73222
CPT 		MRI,Upr Ext, Joint,W/Cont 5 $601.06 $4,132.15 $4,008.19 nat. median
$1,282
outlier · 3.1×
70543
CPT 		MRI Orb-fac-nec W/O+W/Con 6 $601.06 $4,008.19 $3,908.49 nat. median
$1,087
outlier · 3.6×
73706
CPT 		CT Angio Lwr Extr W/O&with Contrast 1 $3,591.89 $3,591.89 $3,591.89 nat. median
$752
outlier · 4.8×
43244
CPT 		Upper Gi Endoscopy,Ligat Varix 1 $3,494.28 $3,494.28 $3,494.28 nat. median
$2,255
1.5× median
70549
CPT 		Mra, Neck W/O+with Contrast 2 $2,173.82 $4,640.73 $3,407.27 nat. median
$1,063
outlier · 3.2×
78227
CPT 		Hepatobil Syst Image W/Drug 1 $3,358.45 $3,358.45 $3,358.45 nat. median
$940
outlier · 3.6×
73718
CPT 		MRI,Lwrext,No Jnt,No Cont 4 $1,432.95 $3,383.57 $3,348.69 nat. median
$870
outlier · 3.8×
74176
CPT 		CT Abd & Pelvis Without Contrast 17 $448.89 $3,392.02 $3,253.57 nat. median
$694
outlier · 4.7×
73218
CPT 		MRI,Up Ext,No Jnt,No Cont 3 $356.28 $3,285.02 $3,217.29 nat. median
$866
outlier · 3.7×
52287
CPT 		Cystourethroscopy, With Injection(S) For Chemodenervation Of The Bladder 7 $2,653.76 $6,204.37 $2,935.08 nat. median
$2,264
1.3× median
78264
CPT 		Gastric Emptying Study 1 $2,927.25 $2,927.25 $2,927.25 nat. median
$716
outlier · 4.1×
70496
CPT 		CT Angiography, Head 16 $548.46 $3,075.97 $2,902.92 nat. median
$752
outlier · 3.9×
73720
CPT 		MRI Lower W/o+w Tc 4 $592.89 $4,008.19 $2,825.01 nat. median
$1,135
outlier · 2.5×
73723
CPT 		MRI,Lwrext,Jnt W/O+W/Cont 2 $1,789.82 $3,670.62 $2,730.22 nat. median
$1,199
outlier · 2.3×
74183
CPT 		Mri, Abdomen W/o+ W/Contr 4 $1,428.33 $3,206.84 $2,717.14 nat. median
$1,105
outlier · 2.5×
78012
CPT 		Thyroid Uptake Measurement 1 $2,700.04 $2,700.04 $2,700.04 nat. median
$444
outlier · 6.1×
70482
CPT 		CT Orbit/Ear/Fossa Without & With Contrast 3 $1,313.06 $2,862.16 $2,649.88 nat. median
$663
outlier · 4.0×
J7298
HCPCS 		Levonorgestrel 20 Mcg/day IUD 1 Each Box 9 $670.81 $2,693.02 $2,609.72 nat. median
$1,693
1.5× median
72131
CPT 		CT Lumbar Spine Without Contrast 10 $157.59 $2,705.49 $2,597.27 nat. median
$460
outlier · 5.6×
78816
CPT 		Pet/CT Whole Body Tc 4 $2,052.36 $6,280.34 $2,581.27 nat. median
$2,793
0.9× median
74181
CPT 		MRI Abdomen Without Tc 4 $356.28 $3,578.65 $2,580.39 nat. median
$820
outlier · 3.1×
43239
CPT 		Upper Gi Endoscopy,Biopsy 20 $1,147.44 $4,201.56 $2,565.09 nat. median
$1,379
1.9× median
75635
CPT 		CT Angio Abdominal Arteries 3 $581.20 $5,896.97 $2,510.83 nat. median
$727
outlier · 3.5×
43249
CPT 		Up Gi Endoscopy,Ball Dil,30mm 2 $1,496.45 $3,375.72 $2,436.09 nat. median
$2,124
1.1× median
74177
CPT 		CT Abdomen&Pelvis W/Contrast 23 $448.89 $5,238.26 $2,403.12 nat. median
$976
outlier · 2.5×
70544
CPT 		Mra, Head W/Out Contrast 6 $726.04 $3,337.77 $2,400.09 nat. median
$829
outlier · 2.9×
45381
CPT 		Colonoscope, Submucous Inj 1 $2,374.05 $2,374.05 $2,374.05 nat. median
$1,566
1.5× median
45385
CPT 		Colonoscopy,Remv Lesn,Snare 17 $1,052.45 $2,447.55 $2,372.63 nat. median
$1,663
1.4× median
J7300
HCPCS 		Copper IUD 1 Each Box 1 $2,337.00 $2,337.00 $2,337.00 nat. median
$1,616
1.4× median
71270
CPT 		Diagnostic CT Thorax W&wo Contrast 2 $1,401.13 $3,205.69 $2,303.41 nat. median
$684
outlier · 3.4×
77012
CPT 		CT Scan For Needle Biopsy 1 $2,290.23 $2,290.23 $2,290.23 nat. median
$987
outlier · 2.3×
74170
CPT 		CT Abdomen Without & With Contrast 4 $471.67 $3,279.25 $2,283.30 nat. median
$714
outlier · 3.2×
78306
CPT 		Bone Scan, Whole Body 4 $1,300.51 $3,081.21 $2,215.61 nat. median
$760
outlier · 2.9×
72157
CPT 		MRI T Spine W&wo Contrast 5 $601.06 $4,230.40 $2,159.73 nat. median
$1,114
1.9× median
J9202
HCPCS 		Goserelin 3.6 Mg Implant 1 Each Syringe 2 $2,115.65 $2,115.65 $2,115.65 nat. median
$1,833
1.2× median
70553
CPT 		MRI Brain W & Wo Contrast 17 $584.00 $4,598.51 $2,111.98 nat. median
$1,136
1.9× median
74150
CPT 		CT Abdomen Without Contrast 2 $1,279.61 $2,916.31 $2,097.96 nat. median
$448
outlier · 4.7×
43235
CPT 		Upper Gi Endoscopy,Diagnosis 6 $1,852.48 $2,630.52 $2,065.24 nat. median
$1,316
1.6× median
72156
CPT 		MRI C Spine W&wo Contrast 5 $601.06 $4,319.46 $2,059.54 nat. median
$1,110
1.9× median
74160
CPT 		CT Abdomen With Contrast 2 $1,253.45 $2,852.33 $2,052.89 nat. median
$655
outlier · 3.1×

Other procedures at this hospital

Browse this hospital's 875 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
             
78815 CPT Pet/CT Skull-mid Thigh Tc 11 11 $7,765.79 $7,377.50 $2,021.57 $7,313.42 $6,954.00 2026-01-26
J1561 HCPCS Immune Globulin (human) 2.5 Gm/25ml Solution 25 Ml Vial 1 1 $892.45 $847.83 $5,757.82 $5,757.82 $5,757.82 2026-01-26
74174 CPT CT Angio Abd&Pelv W/O&with Contrast 7 7 $6,261.73 $5,948.64 $2,561.84 $5,896.97 $5,623.40 2026-01-26
78803 CPT Tumor Imag, Spect Single Area, Incl Vasc Flow & Blood Pool Imag (Tc) 1 1 $5,643.30 $5,361.14 $5,314.57 $5,314.57 $5,314.57 2026-01-26
74178 CPT CT Abd&Pelv 1+ Section/Regns 15 15 $5,768.06 $5,479.66 $471.67 $5,432.06 $5,180.06 2026-01-26
70552 CPT MRI Brain W Contrast Tc 1 1 $5,365.56 $5,097.28 $4,948.82 $4,948.82 $4,948.82 2026-01-26
72197 CPT Mri, Pelvis, Without Then With 11 11 $4,871.57 $4,627.99 $601.06 $4,729.68 $4,493.20 2026-01-26
74175 CPT CT Angio Abdom Without & With Contrast 1 1 $4,705.40 $4,470.13 $4,431.30 $4,431.30 $4,431.30 2026-01-26
72158 CPT MRI L Spine W&wo Contrast 9 9 $4,586.64 $4,357.31 $601.06 $4,453.05 $4,230.40 2026-01-26
73220 CPT MRI Upper W/o+w Tc 2 2 $4,499.13 $4,274.17 $4,113.63 $4,149.69 $4,131.66 2026-01-26
73222 CPT MRI,Upr Ext, Joint,W/Cont 5 5 $4,256.11 $4,043.30 $601.06 $4,132.15 $4,008.19 2026-01-26
70543 CPT MRI Orb-fac-nec W/O+W/Con 6 6 $4,256.11 $4,043.30 $601.06 $4,008.19 $3,908.49 2026-01-26
73706 CPT CT Angio Lwr Extr W/O&with Contrast 1 1 $3,814.06 $3,623.36 $3,591.89 $3,591.89 $3,591.89 2026-01-26
43244 CPT Upper Gi Endoscopy,Ligat Varix 1 1 $3,821.73 $3,630.64 $3,494.28 $3,494.28 $3,494.28 2026-01-26
70549 CPT Mra, Neck W/O+with Contrast 2 2 $5,031.53 $4,779.95 $2,173.82 $4,640.73 $3,407.27 2026-01-26
78227 CPT Hepatobil Syst Image W/Drug 1 1 $3,566.18 $3,387.87 $3,358.45 $3,358.45 $3,358.45 2026-01-26
73718 CPT MRI,Lwrext,No Jnt,No Cont 4 4 $3,592.87 $3,413.23 $1,432.95 $3,383.57 $3,348.69 2026-01-26
74176 CPT CT Abd & Pelvis Without Contrast 17 17 $3,565.08 $3,386.83 $448.89 $3,392.02 $3,253.57 2026-01-26
73218 CPT MRI,Up Ext,No Jnt,No Cont 3 3 $3,592.87 $3,413.23 $356.28 $3,285.02 $3,217.29 2026-01-26
52287 CPT Cystourethroscopy, With Injection(S) For Chemodenervation Of The Bladder 7 7 $692.79 $658.15 $2,653.76 $6,204.37 $2,935.08 2026-01-26
78264 CPT Gastric Emptying Study 1 1 $3,076.60 $2,922.77 $2,927.25 $2,927.25 $2,927.25 2026-01-26
70496 CPT CT Angiography, Head 16 16 $3,266.23 $3,102.92 $548.46 $3,075.97 $2,902.92 2026-01-26
73720 CPT MRI Lower W/o+w Tc 4 4 $4,256.11 $4,043.30 $592.89 $4,008.19 $2,825.01 2026-01-26
73723 CPT MRI,Lwrext,Jnt W/O+W/Cont 2 2 $4,142.72 $3,935.58 $1,789.82 $3,670.62 $2,730.22 2026-01-26
74183 CPT Mri, Abdomen W/o+ W/Contr 4 4 $3,405.20 $3,234.94 $1,428.33 $3,206.84 $2,717.14 2026-01-26
78012 CPT Thyroid Uptake Measurement 1 1 $2,983.83 $2,834.64 $2,700.04 $2,700.04 $2,700.04 2026-01-26
70482 CPT CT Orbit/Ear/Fossa Without & With Contrast 3 3 $3,039.20 $2,887.24 $1,313.06 $2,862.16 $2,649.88 2026-01-26
J7298 HCPCS Levonorgestrel 20 Mcg/day IUD 1 Each Box 9 9 $2,915.12 $2,769.36 $670.81 $2,693.02 $2,609.72 2026-01-26
72131 CPT CT Lumbar Spine Without Contrast 10 10 $2,786.65 $2,647.32 $157.59 $2,705.49 $2,597.27 2026-01-26
78816 CPT Pet/CT Whole Body Tc 4 4 $6,668.82 $6,335.38 $2,052.36 $6,280.34 $2,581.27 2026-01-26
74181 CPT MRI Abdomen Without Tc 4 4 $3,880.01 $3,686.01 $356.28 $3,578.65 $2,580.39 2026-01-26
43239 CPT Upper Gi Endoscopy,Biopsy 20 20 $2,793.23 $2,653.57 $1,147.44 $4,201.56 $2,565.09 2026-01-26
75635 CPT CT Angio Abdominal Arteries 3 3 $6,261.73 $5,948.64 $581.20 $5,896.97 $2,510.83 2026-01-26
43249 CPT Up Gi Endoscopy,Ball Dil,30mm 2 2 $3,584.52 $3,405.29 $1,496.45 $3,375.72 $2,436.09 2026-01-26
74177 CPT CT Abdomen&Pelvis W/Contrast 23 23 $5,562.27 $5,284.16 $448.89 $5,238.26 $2,403.12 2026-01-26
70544 CPT Mra, Head W/Out Contrast 6 6 $3,544.22 $3,367.01 $726.04 $3,337.77 $2,400.09 2026-01-26
45381 CPT Colonoscope, Submucous Inj 1 1 $2,520.89 $2,394.85 $2,374.05 $2,374.05 $2,374.05 2026-01-26
45385 CPT Colonoscopy,Remv Lesn,Snare 17 17 $2,572.43 $2,443.81 $1,052.45 $2,447.55 $2,372.63 2026-01-26
J7300 HCPCS Copper IUD 1 Each Box 1 1 $2,733.60 $2,596.92 $2,337.00 $2,337.00 $2,337.00 2026-01-26
71270 CPT Diagnostic CT Thorax W&wo Contrast 2 2 $3,403.97 $3,233.77 $1,401.13 $3,205.69 $2,303.41 2026-01-26
77012 CPT CT Scan For Needle Biopsy 1 1 $2,431.89 $2,310.30 $2,290.23 $2,290.23 $2,290.23 2026-01-26
74170 CPT CT Abdomen Without & With Contrast 4 4 $3,482.09 $3,307.99 $471.67 $3,279.25 $2,283.30 2026-01-26
78306 CPT Bone Scan, Whole Body 4 4 $3,271.80 $3,108.21 $1,300.51 $3,081.21 $2,215.61 2026-01-26
72157 CPT MRI T Spine W&wo Contrast 5 5 $4,586.64 $4,357.31 $601.06 $4,230.40 $2,159.73 2026-01-26
J9202 HCPCS Goserelin 3.6 Mg Implant 1 Each Syringe 2 2 $1,452.00 $1,379.40 $2,115.65 $2,115.65 $2,115.65 2026-01-26
70553 CPT MRI Brain W & Wo Contrast 17 17 $4,882.95 $4,638.80 $584.00 $4,598.51 $2,111.98 2026-01-26
74150 CPT CT Abdomen Without Contrast 2 2 $3,065.10 $2,911.85 $1,279.61 $2,916.31 $2,097.96 2026-01-26
43235 CPT Upper Gi Endoscopy,Diagnosis 6 6 $2,793.23 $2,653.57 $1,852.48 $2,630.52 $2,065.24 2026-01-26
72156 CPT MRI C Spine W&wo Contrast 5 5 $4,586.64 $4,357.31 $601.06 $4,319.46 $2,059.54 2026-01-26
74160 CPT CT Abdomen With Contrast 2 2 $3,092.52 $2,937.89 $1,253.45 $2,852.33 $2,052.89 2026-01-26
70487 CPT CT Maxillofacial With Contrast 1 1 $2,215.63 $2,104.85 $2,043.55 $2,043.55 $2,043.55 2026-01-26
45378 CPT Colonoscopy,Flex,Diagnostic 15 15 $2,194.16 $2,084.45 $916.01 $2,066.35 $2,002.44 2026-01-26
72146 CPT MRI T Spine Wo Contrast 9 9 $4,233.89 $4,022.20 $356.28 $3,987.25 $1,993.63 2026-01-26
72148 CPT MRI L Spine Wo Contrast 16 16 $4,586.64 $4,357.31 $352.50 $4,319.46 $1,981.60 2026-01-26
45380 CPT Colonoscopy,Biopsy 19 19 $2,194.16 $2,084.45 $877.75 $3,274.33 $1,970.48 2026-01-26
94070 CPT Methacholine Challenge 3 3 $1,218.70 $1,157.77 $76.18 $2,032.88 $1,932.98 2026-01-26
78452 CPT Ht Muscle Image Spect, Mult 17 17 $4,456.76 $4,233.92 $1,317.94 $4,197.15 $1,925.50 2026-01-26
71250 CPT Diagnostic CT Thorax Without Contrast 16 16 $2,119.59 $2,013.61 $157.59 $2,016.69 $1,908.01 2026-01-26
70480 CPT CT Orbit/Ear/Fosa Without Contrast 3 3 $1,942.37 $1,845.25 $1,791.51 $1,829.23 $1,829.23 2026-01-26
71275 CPT CT Angiography, Chest 20 20 $4,100.17 $3,895.16 $300.35 $3,901.14 $1,771.44 2026-01-26
45390 CPT Colonoscopy Flx W/Endoscopic Mucosal Resection 1 1 $1,877.04 $1,783.19 $1,731.25 $1,731.25 $1,731.25 2026-01-26
12400040 CDM Room Rate Behavioral Health 9 9 $1,868.36 $1,774.94 $33.50 $1,813.94 $1,708.28 2026-01-26
72195 CPT MRI,Pelvis W/Out Contrast 4 4 $3,880.01 $3,686.01 $1,619.81 $3,578.65 $1,669.28 2026-01-26
72141 CPT MRI C-spine Wo Contrast 13 13 $3,880.01 $3,686.01 $356.28 $3,653.99 $1,664.25 2026-01-26
70551 CPT MRI Brain Wo Contrast Tc 12 12 $3,836.03 $3,644.23 $356.28 $3,612.58 $1,633.18 2026-01-26
73221 CPT MRI Up Extremity Joint Without Tc 16 16 $3,627.61 $3,446.23 $356.28 $3,451.51 $1,569.19 2026-01-26
93306 CPT Tte W/Doppler, Complete 17 17 $3,489.78 $3,315.29 $639.45 $3,320.38 $1,507.72 2026-01-26
12200000 CDM Room Rate Birthplace 10 10 $1,585.69 $1,506.41 $1,424.04 $3,079.00 $1,490.40 2026-01-26
J1670 HCPCS Tetanus Immune Globulin 250 Unit/ml Solution Prefilled Syringe 1 Ml Syringe 1 1 $1,558.00 $1,480.10 $1,480.10 $1,480.10 $1,480.10 2026-01-26
12600000 CDM Room Rate Detox 3 3 $1,682.21 $1,598.10 $1,404.56 $1,633.21 $1,469.89 2026-01-26
43247 CPT Upper Gi Endoscopy,Remov F.b. 3 3 $1,622.71 $1,541.57 $1,453.08 $1,528.19 $1,457.29 2026-01-26
70498 CPT CT Angiography, Neck 15 15 $3,266.23 $3,102.92 $548.46 $3,012.55 $1,447.01 2026-01-26
73721 CPT MRI Low Ext Jnt WO/Cont Tc 20 20 $3,335.73 $3,168.94 $352.50 $3,141.42 $1,441.17 2026-01-26
73701 CPT CT Lower Extremity With Contrast 1 1 $3,045.13 $2,892.87 $1,433.88 $1,433.88 $1,433.88 2026-01-26
72125 CPT CT Neck Spine Without Contrast 19 19 $3,196.76 $3,036.92 $157.59 $3,010.54 $1,381.12 2026-01-26
93880 CPT Cv Carotid Imaging-bilat 8 8 $3,161.61 $3,003.53 $248.62 $2,977.43 $1,346.04 2026-01-26
32555 CPT Aspirate Pleura With Imaging 3 3 $1,466.33 $1,393.01 $612.16 $1,380.91 $1,338.20 2026-01-26
74246 CPT X-ray Exam, Uppr Gi Tract, Incl Scout & Delay; Double Contrast 2 2 $1,434.24 $1,362.53 $1,322.85 $1,322.85 $1,322.85 2026-01-26
73700 CPT CT Lower Extremity Without Contrast 12 12 $1,942.37 $1,845.25 $156.57 $1,829.23 $1,289.75 2026-01-26
12500000 CDM Room Rate Hospice 11 11 $1,375.41 $1,306.64 $1,219.29 $1,325.32 $1,285.56 2026-01-26
12000000 CDM Room Rate General 11 11 $1,365.08 $1,296.83 $1,219.29 $1,325.32 $1,285.56 2026-01-26
77334 CPT Ck Complex Treatment Device 13 13 $875.27 $831.51 $130.73 $1,342.94 $1,276.94 2026-01-26
G0390 HCPCS Trauma Activation - Pre Hospital Notification 3 3 $2,977.68 $2,828.80 $1,218.25 $2,717.50 $1,243.11 2026-01-26
72128 CPT CT Chest Spine Without Contrast 8 8 $2,786.65 $2,647.32 $157.59 $2,705.49 $1,238.95 2026-01-26
92960 CPT Cardioversion, Elective;Extern 1 1 $1,304.14 $1,238.93 $1,228.18 $1,228.18 $1,228.18 2026-01-26
71260 CPT Diagnostic CT Thorax With Contrast 18 18 $2,707.38 $2,572.01 $448.89 $2,586.46 $1,169.69 2026-01-26
76376 CPT 3d Rendering Of Tomographic Modality Without Postprocessing, Tc 3 3 $1,294.53 $1,229.80 $559.29 $1,193.99 $1,162.57 2026-01-26
76706 CPT Aaa US Screen Tc 2 2 $1,696.56 $1,611.73 $726.40 $1,597.74 $1,162.07 2026-01-26
99285 CPT Facility Emergency Level V Visit 25 25 $1,285.67 $1,221.39 $182.62 $1,248.22 $1,151.27 2026-01-26
C8929 HCPCS Tte W/Doppler, Complete 8 8 $2,634.09 $2,502.39 $639.45 $2,480.65 $1,138.03 2026-01-26
70491 CPT CT Soft Tissue Neck With Contrast 16 16 $2,215.63 $2,104.85 $448.89 $2,108.08 $1,130.06 2026-01-26
15271 CPT Skin Sub Graft Trnk/Arm/Leg 1 1 $2,626.91 $2,495.56 $1,124.73 $1,124.73 $1,124.73 2026-01-26
94002 CPT Vent Mgmt Inpat Init Day 2 2 $1,732.70 $1,646.07 $688.24 $1,551.57 $1,119.90 2026-01-26
17000000 CDM Room Rate Nursery 8 8 $1,199.59 $1,139.61 $1,077.30 $1,149.96 $1,118.07 2026-01-26
70490 CPT CT Soft Tissue Neck Without Contrast 4 4 $1,942.37 $1,845.25 $814.74 $1,791.51 $1,080.07 2026-01-26
67145 CPT Prophylaxis Retina Detach,Photocoag 1 1 $1,535.95 $1,459.15 $1,029.81 $1,029.81 $1,029.81 2026-01-26
93975 CPT Abd Duplex Abd-full 1 1 $1,115.30 $1,059.54 $1,017.86 $1,017.86 $1,017.86 2026-01-26
72193 CPT CT Pelvis With Contrast 4 4 $2,387.83 $2,268.44 $464.59 $2,115.71 $1,000.14 2026-01-26
J0178 HCPCS Aflibercept 2 Mg/0.05ml Solution 0.05 Ml Vial 12 12 $4,661.60 $4,428.52 $930.87 $2,134.00 $976.58 2026-01-26
93976 CPT Abd Duplex Abd-follow Up(T) 4 4 $1,446.75 $1,374.41 $248.62 $1,334.38 $974.56 2026-01-26
72114 CPT Xray Lumbosacral Min 6 Vws Incl Bend 1 1 $1,055.48 $1,002.71 $973.50 $973.50 $973.50 2026-01-26
76882 CPT US Ext Non-vasc Img Lmtd 7 7 $1,051.31 $998.74 $157.96 $990.07 $969.66 2026-01-26
70450 CPT CT Head/Brain Without Contrast 23 23 $2,238.95 $2,127.00 $448.89 $2,108.53 $967.31 2026-01-26
72192 CPT CT Pelvis Without Contrast 7 7 $2,287.64 $2,173.26 $154.22 $1,994.60 $955.03 2026-01-26
90675 CPT Rabies Vaccine, Pcec Recon Susp 1 Each Vial 3 3 $611.42 $580.85 $420.15 $963.60 $918.90 2026-01-26
G0121 HCPCS Colonoscopy,Screen Prev 5 5 $2,194.15 $2,084.44 $871.53 $939.44 $916.00 2026-01-26
73201 CPT CT Upper Extremity With Contrast 1 1 $2,159.49 $2,051.52 $901.54 $901.54 $901.54 2026-01-26
74221 CPT Dbl Contrast X-ray, Esophagus - Radiology 5 5 $958.94 $910.99 $400.33 $912.39 $884.46 2026-01-26
76641 CPT Ultrasound Breast Complete 3 3 $924.29 $878.08 $378.15 $870.45 $870.45 2026-01-26
74300 CPT X-ray Bile Ducts/Pancreas 1 1 $923.78 $877.59 $852.03 $852.03 $852.03 2026-01-26
73200 CPT CT Upper Extremity Without Contrast 11 11 $1,942.37 $1,845.25 $156.57 $1,829.23 $839.18 2026-01-26
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6ml Solution Prefilled Syringe 0.6 Ml Syringe 4 4 $10,020.00 $9,519.00 $440.65 $835.00 $822.48 2026-01-26
A9608 HCPCS Flotufolastat F 18 296-5846 Mbq/ml Solution 1 Each Vial 3 3 $12,157.92 $11,550.02 $382.86 $873.00 $814.58 2026-01-26
V2787 HCPCS 27600000-cnw0t3 Clarion Toric Lens-mmc 2 2 $833.35 $791.68 $791.68 $833.35 $812.51 2026-01-26
74230 CPT Contrast Xray Swallowing Funct Int, Cine/Vid; Inclscout & Delay (Tc) 6 6 $1,233.88 $1,172.19 $494.76 $1,173.98 $809.91 2026-01-26
93925 CPT Art Lower Extremity-bilat 6 6 $875.24 $831.48 $359.54 $824.26 $807.88 2026-01-26
90791 CPT Psychiatric Diag Eval Phd 6 6 $882.51 $838.38 $203.95 $831.11 $806.89 2026-01-26
90375 CPT Rabies Immune Globulin 300 Unit/ml Solution 1 Ml Vial 1 1 $1,633.20 $1,551.54 $792.10 $792.10 $792.10 2026-01-26
70486 CPT CT Maxillofacialw/O Dye 15 15 $1,810.48 $1,719.96 $157.59 $1,705.02 $783.93 2026-01-26
J9217 HCPCS Leuprolide 45 Mg Kit 1 Each Box 10 10 $25,451.64 $24,179.06 $466.19 $2,453.00 $767.63 2026-01-26
93308 CPT Echo Heart Xthoracic,Limited 1 1 $1,722.54 $1,636.41 $745.44 $745.44 $745.44 2026-01-26
77002 CPT Fluoroscopy Guid Needle Plcmt Tc 4 4 $784.99 $745.74 $724.02 $762.13 $739.27 2026-01-26
76497 CPT CT Whole Body Scan 1 1 $813.20 $772.54 $730.30 $730.30 $730.30 2026-01-26
76999 CPT Sono Examination Proc Unlisted 1 1 $789.40 $749.93 $728.09 $728.09 $728.09 2026-01-26
93971 CPT Venous Duplex Scan Uni 15 15 $1,599.96 $1,519.96 $641.55 $1,522.29 $691.24 2026-01-26
90651 CPT Hpv, Gardasil 9, 2 Or 3 Dose, IM 2 2 $731.80 $695.21 $689.18 $689.18 $689.18 2026-01-26
72120 CPT Xray Ls Spine Bend Tc 1 1 $751.93 $714.33 $687.51 $687.51 $687.51 2026-01-26
54150 CPT Circumcision,Clamp,Newborn 2 2 $769.41 $730.94 $670.85 $703.49 $687.17 2026-01-26
73564 CPT Xray Knee 4 Or More Vws 17 17 $743.72 $706.53 $296.01 $710.51 $678.74 2026-01-26
C1776 HCPCS 27800000-0112710 Bard Mesh Pre Shaped W-mmc 16 16 $191.09 $181.54 $183.29 $1,700.74 $667.27 2026-01-26
11643 CPT Exc Skn Malg 2.1-3cm Fce,Fcial 1 1 $568.92 $540.47 $664.27 $664.27 $664.27 2026-01-26
78707 CPT Renogram Flow + Function 1 1 $718.94 $682.99 $663.10 $663.10 $663.10 2026-01-26
45391 CPT Colonoscopy Flex Prox To Splenic Flexure W Endoscopic Ultrasound Exam 1 1 $714.82 $679.08 $659.28 $659.28 $659.28 2026-01-26
72082 CPT X-ray Exam Entire Spine 2-3 Vws 3 3 $711.53 $675.95 $81.77 $670.09 $656.27 2026-01-26
76642 CPT Ultrasound Breast Limited 9 9 $706.13 $670.82 $160.37 $665.00 $651.28 2026-01-26
76700 CPT US Abdomen Tc 6 6 $715.06 $679.31 $299.93 $673.41 $649.91 2026-01-26
76870 CPT US Scrotum & Contents Tc 4 4 $957.68 $909.80 $161.39 $901.90 $648.95 2026-01-26
82731 CPT Assay Of Fetal Fibronectin 4 4 $705.11 $669.85 $66.55 $664.03 $646.92 2026-01-26
99284 CPT Facility Emergency Level IV Visit 25 25 $854.79 $812.05 $253.44 $815.49 $639.41 2026-01-26
93923 CPT Art Lower Extremity+Upper 1 1 $658.30 $625.39 $608.10 $608.10 $608.10 2026-01-26
72080 CPT Xray Thoracolumbar 2 Vws 1 1 $641.72 $609.63 $604.34 $604.34 $604.34 2026-01-26
72070 CPT Xray Thoracic Spine 2 Vws 4 4 $667.12 $633.76 $84.25 $628.26 $603.68 2026-01-26
72072 CPT Xray Thoracic Spine 3 Vws 4 4 $674.09 $640.39 $82.90 $634.83 $603.63 2026-01-26
76830 CPT US Transvaginal Tc 5 5 $652.49 $619.87 $584.29 $614.49 $601.82 2026-01-26
76805 CPT US,Preg. Uterus,Fetal/Mat.Eval.,>1st Trim.(>/= 14 Wks 0 Dys),Transabd;Single/Fir… 5 5 $641.01 $608.96 $144.84 $603.67 $591.22 2026-01-26
76801 CPT OB US < 14 Wks, Single Fetus - Radiology, Tech 11 11 $641.01 $608.96 $147.05 $603.67 $591.22 2026-01-26
P9035 HCPCS Leukoreduced Platelets 1 1 $1,374.02 $1,305.32 $586.96 $586.96 $586.96 2026-01-26
93017 CPT Cardiac Stress Tst,Tracing Only 18 18 $900.02 $855.02 $251.32 $856.33 $586.78 2026-01-26
90677 CPT Pneumococcal 20-val Conj Vacc 0.5 Ml Suspension Prefilled Syringe 0.5 Ml Syringe 1 1 $679.40 $645.43 $585.25 $585.25 $585.25 2026-01-26
94727 CPT Pulm Function Test By Gas 1 1 $650.20 $617.69 $582.23 $582.23 $582.23 2026-01-26
74270 CPT X-ray Exam, Colon, Incl Scout & Delay; Single Contrast (Tc) 1 1 $1,357.17 $1,289.31 $579.76 $579.76 $579.76 2026-01-26
J2506 HCPCS Pegfilgrastim 6 Mg/0.6ml Solution Prefilled Syringe 0.6 Ml Syringe 3 3 $7,385.66 $7,016.38 $266.33 $574.08 $562.22 2026-01-26
88365 CPT In Situ Hybridization (Eg, Fish), Each Probe, Tech 1 1 $596.30 $566.49 $561.57 $561.57 $561.57 2026-01-26
G0379 HCPCS Direct Admit Hospital Observ 6 6 $647.21 $614.85 $262.33 $609.51 $556.73 2026-01-26
76886 CPT Echo Exam, Infant Hip Lim 2 2 $1,032.69 $981.06 $157.96 $944.21 $551.09 2026-01-26
J9042 HCPCS Brentuximab 50 Mg Recon Soln 1 Each Vial 1 1 $30,421.92 $28,900.82 $546.71 $546.71 $546.71 2026-01-26
71111 CPT Xray Ribs Bilat 3 Vws With Pa Chest 1 1 $1,300.85 $1,235.81 $545.65 $545.65 $545.65 2026-01-26
70220 CPT Xray Sinuses Minimum 3 Vws 9 9 $590.72 $561.18 $241.68 $562.04 $544.83 2026-01-26
76819 CPT Fetal Profile Without Stress 10 10 $606.54 $576.21 $74.34 $571.20 $541.06 2026-01-26
88184 CPT Flow Cytometry, Cell Surface, Cytoplasmic, Nuclear Marker, Tech. Comp.; 1st 1 1 $104.25 $99.04 $539.23 $539.23 $539.23 2026-01-26
72110 CPT Xray Lumbosacral Minimum 4 Vws 2 2 $1,055.48 $1,002.71 $84.25 $994.00 $539.12 2026-01-26
95819 CPT Eeg,Awake/Asleep, W/Stimulat 2 2 $785.48 $746.21 $327.92 $739.72 $533.82 2026-01-26
72100 CPT Xray Lumbosacral 2 Or 3 Vws 12 12 $590.72 $561.18 $81.77 $556.31 $528.97 2026-01-26
76856 CPT US Pelvic Tc Complete 13 13 $570.76 $542.22 $227.64 $543.06 $521.86 2026-01-26
87902 CPT Genotype DNA Hepatitis C 3 3 $317.60 $301.72 $266.02 $1,155.09 $506.82 2026-01-26
74019 CPT X-ray Exam Abdomen 2 Views 7 7 $535.11 $508.35 $223.39 $503.94 $493.54 2026-01-26
84445 CPT Thyrstim Immun Glob (Tsi) - Ref 1 1 $639.71 $607.72 $493.16 $493.16 $493.16 2026-01-26
73552 CPT X-ray Exam Femur Min 2 Vws 8 8 $539.35 $512.38 $216.27 $507.93 $492.69 2026-01-26
73523 CPT X-ray Exam Hip,Bilat W/Pelvis Min 5 Vws 1 1 $516.98 $491.13 $486.86 $486.86 $486.86 2026-01-26
30903 CPT Ctrl Nosebleed,Anter,Complex 1 1 $519.26 $493.30 $481.44 $481.44 $481.44 2026-01-26
93979 CPT Abd Duplex Scan-aorta 1 1 $519.44 $493.47 $479.09 $479.09 $479.09 2026-01-26
73502 CPT X-ray Exam Hip,Unilat W/Pelvis 2-3 Vws 18 18 $539.35 $512.38 $81.77 $513.40 $474.07 2026-01-26
72040 CPT Xray Cervical Spine 2 Or 3 Vws 11 11 $527.86 $501.47 $80.54 $497.12 $474.05 2026-01-26
70470 CPT CT Head/Brain Without & With Contrast 2 2 $2,786.65 $2,647.32 $471.67 $471.67 $471.67 2026-01-26
76536 CPT US Head/Neck Tc 8 8 $524.82 $498.58 $161.39 $494.25 $470.82 2026-01-26
65855 CPT Laser Surgery Of Eye 1 1 $1,127.50 $1,071.13 $470.70 $470.70 $470.70 2026-01-26
76705 CPT US Abdomen Limited Tc 16 16 $510.75 $485.21 $160.37 $481.00 $466.12 2026-01-26
76816 CPT US Pregnancy Tc Follow-up 10 10 $510.75 $485.21 $144.84 $480.99 $462.84 2026-01-26
73522 CPT X-ray Exam Hip,Bilat W/Pelvis 3-4 Vws 5 5 $503.87 $478.68 $217.69 $474.52 $460.69 2026-01-26
76815 CPT US Pregnancy Tc Limited 7 7 $510.75 $485.21 $144.84 $480.99 $458.68 2026-01-26
73110 CPT Xray Wrist Minimum 3 Vws 16 16 $505.36 $480.09 $82.90 $480.83 $450.15 2026-01-26
73590 CPT Xray Tibia & Fibula 2 Vws 10 10 $487.71 $463.32 $199.54 $464.03 $447.88 2026-01-26
73080 CPT Xray Elbow 3+Vws Tc 13 13 $493.41 $468.74 $196.79 $469.46 $437.18 2026-01-26
96365 CPT IV Infusion Therapy, 1 Hour 24 24 $695.22 $660.46 $277.27 $661.47 $434.97 2026-01-26
96413 CPT Chemotherapy, IV Infusion, 1 Hour 19 19 $970.44 $921.92 $314.59 $746.46 $434.97 2026-01-26
96360 CPT First Hour IV Hydration <1 Hour 21 21 $514.26 $488.55 $206.21 $484.74 $434.97 2026-01-26
90837 CPT Ind Psychotherapy 60 Masters 2 2 $472.07 $448.47 $203.95 $662.33 $433.14 2026-01-26
87507 CPT Infection Agent Detect Dna/Rna Probe Tq 12-25 11 11 $3,595.17 $3,415.41 $353.88 $822.24 $430.66 2026-01-26
88344 CPT Immunohisto Antibody Slide Ea Multiplex 2 2 $688.00 $653.60 $266.87 $590.50 $428.69 2026-01-26
73060 CPT Xray Humerus Minimum 2 Vws 6 6 $465.61 $442.33 $190.49 $438.49 $427.58 2026-01-26
51728 CPT Cystometrogram W/vp 1 1 $979.53 $930.55 $423.19 $423.19 $423.19 2026-01-26
11044 CPT Debride Tissue/Muscle/Bone 1 1 $768.22 $729.81 $411.79 $411.79 $411.79 2026-01-26
83970 CPT Lab Pth Immunoch Part 1 3 3 $276.04 $262.24 $42.01 $433.24 $407.61 2026-01-26
73000 CPT Xray Clavicle Complete 8 8 $441.98 $419.88 $181.57 $416.24 $405.88 2026-01-26
73610 CPT Xray Ankle Minimum 3 Vws 13 13 $451.71 $429.12 $80.54 $425.39 $404.49 2026-01-26
73501 CPT X-ray Exam Hip,Unilat W/Pelvis 1vw 10 10 $597.09 $567.24 $249.27 $562.31 $404.35 2026-01-26
64468 CPT Bilateral Thoracic Fascial Plane Block By Injections 1 1 $435.69 $413.91 $401.85 $401.85 $401.85 2026-01-26
86789 CPT West Nile Ab, Igg - Ref 1 1 $246.10 $233.80 $401.06 $401.06 $401.06 2026-01-26
J9228 HCPCS Ipilimumab 50 Mg/10ml Solution 10 Ml Vial 2 2 $21,731.38 $20,644.81 $396.87 $405.22 $401.05 2026-01-26
J1610 HCPCS Glucagon Rdna (diagnostic) 1 Mg Recon Soln 1 Each Vial 3 3 $411.84 $391.25 $391.26 $399.49 $399.49 2026-01-26
90847 CPT Conjoint/Family Psychothrpy Phd 1 1 $526.83 $500.49 $396.93 $396.93 $396.93 2026-01-26
73020 CPT Xray Shoulder 1 Vw 12 12 $430.38 $408.86 $176.08 $409.48 $395.23 2026-01-26
94660 CPT Pos Airway Pressure, Cpap 4 4 $419.68 $398.70 $383.72 $469.93 $393.20 2026-01-26
13131 CPT Repr Cmpl Wnd Head,Fac,Hand 1.1-2.5 1 1 $445.99 $423.69 $390.49 $390.49 $390.49 2026-01-26
71101 CPT Xray Ribs Unilat 2 Vws With Pa Chest 10 10 $424.36 $403.14 $172.00 $403.76 $389.70 2026-01-26
73560 CPT Xray Knee 1 Or 2 Vws 11 11 $444.75 $422.51 $178.33 $418.85 $387.78 2026-01-26
73070 CPT Xray Elbow 2 Vws 3 3 $410.01 $389.51 $357.49 $386.13 $386.13 2026-01-26
93922 CPT Extremity Study - Vascular Diagnostics 1 1 $420.26 $399.25 $383.21 $383.21 $383.21 2026-01-26
92612 CPT Endoscopy Swallow Tst (Fees) 3 3 $876.47 $832.65 $365.90 $801.38 $382.05 2026-01-26
71046 CPT X-ray Exam Chest 2 Views 23 23 $423.93 $402.73 $81.77 $411.58 $380.71 2026-01-26
36593 CPT Declot Vascular Access Device 4 4 $583.54 $554.36 $233.99 $522.54 $379.53 2026-01-26
73100 CPT Xray Wrist 2 Vws 5 5 $416.61 $395.78 $178.74 $392.35 $369.14 2026-01-26
73630 CPT Xray Foot Minimum 3 Vws 17 17 $410.01 $389.51 $40.89 $390.11 $367.16 2026-01-26
84702 CPT Hcg, Quantitative - Ref 14 14 $166.12 $157.81 $15.55 $374.54 $366.81 2026-01-26
73130 CPT Xray Hand 3vws Tc 16 16 $403.07 $382.92 $40.89 $383.50 $365.25 2026-01-26
94060 CPT Broncho Response & Spirometry 14 14 $539.35 $512.38 $152.37 $519.37 $363.29 2026-01-26
52310 CPT Fac/Cystscpy Remv Calculus Simple 4 4 $838.21 $796.30 $349.93 $758.75 $362.14 2026-01-26
84588 CPT Vasopressin (Adh) - Ref 1 1 $402.73 $382.59 $361.68 $361.68 $361.68 2026-01-26
P9016 HCPCS Leukoreduced Rbc's 14 14 $620.11 $589.10 $253.70 $583.99 $358.70 2026-01-26
73090 CPT Xray Forearm 2 Vws 8 8 $396.13 $376.32 $147.23 $384.59 $358.46 2026-01-26
70540 CPT MRI Orbit/Face/Neck Tc 1 1 $3,907.57 $3,712.19 $356.28 $356.28 $356.28 2026-01-26
73600 CPT Xray Ankle 2 Vws 1 1 $389.16 $369.70 $355.83 $355.83 $355.83 2026-01-26
87631 CPT Resp Virus 3-5 Targets 3 3 $389.50 $370.03 $140.78 $366.82 $352.46 2026-01-26
72170 CPT Xray Pelvis 1 Or 2 Vws 17 17 $382.21 $363.10 $151.82 $363.66 $348.82 2026-01-26
73030 CPT Xray Shoulder Minimum 2 Vws 18 18 $516.98 $491.13 $82.90 $491.88 $348.32 2026-01-26
77066 CPT Digital Mamm, Diag, Bilat, Tc W/Cad Perf 5 5 $386.74 $367.40 $156.75 $356.71 $347.32 2026-01-26
74018 CPT X-ray Exam Abdomen 1 View 15 15 $389.16 $369.70 $157.74 $370.27 $344.82 2026-01-26
73620 CPT Xray Foot 2 Vws 4 4 $382.21 $363.10 $160.32 $352.53 $341.36 2026-01-26
73650 CPT Xray Calcaneus Minimum 2 Vws 2 2 $361.38 $343.31 $340.32 $340.33 $340.32 2026-01-26
71045 CPT X-ray Exam Chest 1 View 20 20 $375.26 $356.50 $153.53 $357.04 $339.74 2026-01-26
52001 CPT Cystoscopy, Removal Of Clots 1 1 $784.83 $745.59 $339.08 $339.08 $339.08 2026-01-26
72202 CPT Xray Sacroiliac Jnts 3 Or More Vws 2 2 $505.36 $480.09 $210.98 $466.11 $338.55 2026-01-26
90734 CPT Meningococcal Vaccine, Menveo 2 2 $356.10 $338.30 $329.39 $338.30 $333.85 2026-01-26
70160 CPT Xray Nasal Bones Minimum 3 Vws 2 2 $354.42 $336.70 $324.06 $338.42 $331.24 2026-01-26
88185 CPT Flow Cytometry, Cell Surface, Cytoplasmic, Nuclear Marker, Tech. Comp.; Add'l 1 1 $807.08 $766.73 $330.33 $330.33 $330.33 2026-01-26
84145 CPT Procalcitonin 19 19 $361.38 $343.31 $28.13 $343.83 $329.80 2026-01-26
G0498 HCPCS Chemo Admin Portable Pump At Home 1 1 $906.55 $861.22 $325.38 $325.38 $325.38 2026-01-26
77370 CPT Radiation Physics Consult 5 5 $232.75 $221.11 $173.62 $799.28 $324.90 2026-01-26
70360 CPT Xray Neck, Soft Tissue 4 4 $355.40 $337.63 $141.17 $334.70 $323.02 2026-01-26
73140 CPT Xray Finger(S) Tc 7 7 $349.48 $332.01 $146.59 $329.13 $322.34 2026-01-26
67840 CPT Fac/Rem Eyelid Lesn(Not Chalazion) 1 1 $743.68 $706.50 $321.30 $321.30 $321.30 2026-01-26
94618 CPT Pulmonary Stress Test 1 1 $340.23 $323.22 $320.41 $320.41 $320.41 2026-01-26
99283 CPT Facility Emergency Level Iii Visit 23 23 $571.81 $543.22 $233.53 $878.86 $317.76 2026-01-26
71271 CPT Low Dose CT Lung Ca Screen Wo Contrast 15 15 $739.26 $702.30 $157.59 $696.20 $316.52 2026-01-26
70100 CPT Xray Mandible Partial Less Than 4 Vws 1 1 $332.65 $316.02 $313.28 $313.28 $313.28 2026-01-26
G0105 HCPCS Colonoscopy,Flex,Screen 4 4 $739.31 $702.34 $299.65 $316.54 $309.51 2026-01-26
72190 CPT Xray Pelvis Compl 3+ Tc 1 1 $334.72 $317.98 $308.72 $308.72 $308.72 2026-01-26
80179 CPT Salicylate 16 16 $343.89 $326.70 $14.91 $323.86 $307.94 2026-01-26
80143 CPT Acetaminophen 16 16 $343.89 $326.70 $14.91 $327.19 $307.94 2026-01-26
96409 CPT Chemotherapy, IV Push, Single Drug 2 2 $528.53 $502.10 $195.40 $417.16 $306.28 2026-01-26
64454 CPT Injection Aa&/Steroid Genicul Nrv Branch W/Img 4 4 $698.26 $663.35 $294.98 $337.36 $304.27 2026-01-26
76770 CPT US Retroperitoneal Tc 14 14 $704.85 $669.61 $242.93 $663.79 $300.09 2026-01-26
73562 CPT Xray Knee 3 Vws 20 20 $451.71 $429.12 $185.56 $429.78 $299.51 2026-01-26
73660 CPT Xray Toe(S) Tc 5 5 $326.62 $310.29 $289.40 $307.60 $298.64 2026-01-26
41112 CPT Excis Tongue Lesn,Ant 2/3+Clos 1 1 $690.35 $655.83 $298.26 $298.26 $298.26 2026-01-26
82803 CPT Blood Gases: Ph, Po2 & Pco2 18 18 $447.69 $425.31 $26.94 $425.96 $296.28 2026-01-26
84439 CPT Assay, Free Thyroxine 13 13 $326.36 $310.04 $9.32 $307.34 $293.09 2026-01-26
L1810 HCPCS Knee Brace Roadrunner 4 4 $319.41 $303.44 $128.79 $299.25 $290.53 2026-01-26
87624 CPT Hpv High-risk Types 12 12 $219.42 $208.45 $36.26 $368.41 $287.96 2026-01-26
82670 CPT Estradiol 11 11 $118.98 $113.03 $28.87 $296.31 $287.24 2026-01-26
90834 CPT Ind Psychotherapy 45 Phd 15 11 $579.18 $550.22 $79.46 $409.20 $283.44 2026-01-26
C1713 HCPCS 27800000-1.8mm Qfix Mini Suture Anchor Ref 72290123-mmc 16 16 $528.06 $501.66 $43.99 $1,565.70 $282.74 2026-01-26
82088 CPT Assay Of Aldosterone 1 1 $246.28 $233.97 $280.94 $280.94 $280.94 2026-01-26
94726 CPT Pulm Funct Tst Plethysmograp 17 17 $650.20 $617.69 $76.18 $612.32 $280.91 2026-01-26
11043 CPT Debride Tissue/Muscle 1 1 $701.74 $666.65 $279.88 $279.88 $279.88 2026-01-26
96366 CPT Each Add'l Hour IV Infusion <8 Hour 20 20 $496.69 $471.86 $32.45 $482.22 $277.64 2026-01-26
A4570 HCPCS Cl-splint Ankle Air 2 2 $299.73 $284.74 $276.45 $276.45 $276.45 2026-01-26
76857 CPT US Follicles-limited Tc 5 5 $638.45 $606.53 $160.37 $601.26 $275.83 2026-01-26
A9516 HCPCS Iodine I-123 100 Microcuries 1 1 $295.36 $280.59 $267.27 $267.27 $267.27 2026-01-26
70030 CPT Xray Eye Foreign Body 3 3 $287.30 $272.94 $262.69 $270.56 $264.98 2026-01-26
97162 CPT Physical Therapy Evaluation Mod Complex 14 14 $287.30 $272.94 $116.45 $524.86 $264.98 2026-01-26
90384 CPT Rh Ig, Full-dose, IM 2 2 $394.72 $374.98 $156.99 $371.72 $264.36 2026-01-26
L1820 HCPCS Rom Knee Brace Medium 7 7 $302.96 $287.81 $128.51 $277.01 $263.39 2026-01-26
87469 CPT Detection Of Babesia Microtim By Amplified Nucleic Acid Probe Technique 1 1 $663.06 $629.91 $263.37 $263.37 $263.37 2026-01-26
J9303 HCPCS Panitumumab 100 Mg/5ml Solution 5 Ml Vial 2 2 $4,347.96 $4,130.56 $131.44 $393.40 $262.42 2026-01-26
84402 CPT Testosterone,Free - Ref 9 9 $284.10 $269.90 $26.32 $267.56 $262.04 2026-01-26
82140 CPT Assay Of Ammonia 12 12 $292.15 $277.54 $15.06 $277.97 $261.99 2026-01-26
11982 CPT Remove Drug Implant Device 1 1 $372.62 $353.99 $256.67 $256.67 $256.67 2026-01-26
80076 CPT Hepatic Function Panel 5 5 $272.49 $258.87 $8.44 $256.62 $256.61 2026-01-26
43762 CPT Replace Gastro Tube Perc Without Image;WO Revision 1 1 $844.20 $801.99 $255.87 $255.87 $255.87 2026-01-26
87493 CPT C Diff Amplified Probe 12 12 $380.90 $361.86 $38.51 $362.41 $255.68 2026-01-26
44361 CPT Small Bowel Endoscopy,Biopsy 1 1 $542.81 $515.67 $255.60 $255.60 $255.60 2026-01-26
92610 CPT Evaluate Swallow Fctn Brief 10 10 $378.61 $359.68 $154.90 $367.58 $254.87 2026-01-26
82677 CPT Estriol - Ref 1 1 $266.54 $253.21 $254.18 $254.18 $254.18 2026-01-26
99282 CPT Facility Emergency Level Ii Visit 17 17 $276.18 $262.37 $112.99 $268.14 $251.29 2026-01-26
80061 CPT Lipid Profile 20 20 $374.56 $355.83 $13.84 $356.38 $248.38 2026-01-26
94761 CPT Noninvasv Oxygen Satur,Multiple 4 4 $265.61 $252.33 $108.66 $250.13 $244.98 2026-01-26
J2790 HCPCS Rho Immune Globulin - 300 Mcg 1 1 $394.72 $374.98 $244.73 $244.73 $244.73 2026-01-26
A9500 HCPCS Supply Technicium Sestamibi,per Dose 14 14 $368.19 $349.78 $149.65 $346.75 $244.39 2026-01-26
93970 CPT Ven Duplex Bilateral 4 4 $2,331.62 $2,215.04 $194.69 $248.62 $243.95 2026-01-26
11981 CPT Insert Drug Implant Device 1 1 $318.27 $302.36 $243.77 $243.77 $243.77 2026-01-26
84112 CPT Placental Alpha Micro Ig C/v 9 9 $267.46 $254.09 $90.57 $259.67 $240.19 2026-01-26
41010 CPT Incision Of Tongue Fold 1 1 $246.25 $233.94 $238.16 $238.16 $238.16 2026-01-26
93798 CPT Cardiac Rehab I With Monitor 12 12 $364.43 $346.21 $145.35 $343.21 $237.60 2026-01-26
87491 CPT Chlamydia Trachomatis Dna, Amp Probe 11 11 $263.88 $250.69 $36.26 $256.61 $236.29 2026-01-26
87591 CPT Neisseria Gonorrhoeae Dna, Amp Probe 11 11 $262.69 $249.56 $36.26 $247.39 $235.23 2026-01-26
J9355 HCPCS Trastuzumab 150 Mg Recon Soln 1 Each Vial 1 1 $3,740.20 $3,553.19 $234.39 $234.39 $234.39 2026-01-26
64612 CPT Dest,Nerve,Facial 1 1 $564.68 $536.45 $234.19 $234.19 $234.19 2026-01-26
L3010 HCPCS Foot Insert Removable Long Arch Sppt 2 2 $250.74 $238.20 $229.26 $231.27 $230.26 2026-01-26
89051 CPT Body Fluid Cell Count W Diff 7 7 $248.50 $236.08 $5.79 $229.55 $229.20 2026-01-26
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