Hospital

MEMORIAL HOSPITAL SWEETWATER COUNTY

Rock Springs, WY · CCN 531318 · Rates published

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You selected 93306 (CPT)

US Echo 2D Complete EO

This hospital’s price: $2,741 across 14 payers · range $2,741-$2,885

Source: https://www.sweetwatermemorial.com/media/92917b8e49e04f19abfbd431ec5696c8/83-6000295_memorial_hospital_of_sweetwater_county_standardcharges-1.csv · observed 2026-05-17

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.

2,549 distinct procedures filed

14 distinct payers

45,788 rate rows

2026-05-17 last MRF observed

Data quality

45,467 of 45,788 rate rows are consumer-grade (99.3%)

321 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
template filing: same amount across many unrelated codes — excluded	260
placeholder amount (≤ $0.02) — excluded from medians	42
percent-of-charges filed in the dollar field — excluded from medians	16
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	3

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

Source MRF file	https://www.sweetwatermemorial.com/media/92917b8e49e04f19abfbd431ec5696c8/83-6000295_memorial_hospital_of_sweetwater_county_standardcharges-1.csv
Found on page	https://www.sweetwatermemorial.com/patients-visitors/patient-financial-services/
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-10-01
Content fingerprint	cd2102a8b0075d04… · 5,097,927 bytes · first seen 2026-05-17

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
77372 CPT	Stereotactic Delivery 1fx	14	$32,152.75	$33,845.00	$32,152.75	nat. median $9,194 outlier · 3.5×
36566 CPT	Insertion Of Tunneled Centrally Inserted Central Venous Access Device, Requiring…	14	$15,606.60	$16,428.00	$15,606.60	nat. median $5,757 outlier · 2.7×
77373 CPT	Sbrt Linear Accelerator Based	14	$14,893.15	$15,677.00	$14,893.15	nat. median $3,775 outlier · 3.9×
27447 CPT	Arthroplasty, Knee, Condyle And Plateau; Medial And Lateral Compartments	14	$12,334.80	$12,984.00	$12,334.80	nat. median $12,734 1.0× median
27132 CPT	Conversion Of Previous Hip Surgery To Total Hip Arthroplasty	14	$11,333.50	$11,930.00	$11,333.50	nat. median $9,823 1.2× median
29888 CPT	Arthroscopically Aided Anterior Cruciate Ligament Repair/augmentation Or Reconst…	14	$11,069.40	$11,652.00	$11,069.40	nat. median $7,341 1.5× median
27130 CPT	Arthroplasty, Acetabular And Proximal Femoral Prosthetic Replacement	14	$10,549.75	$11,105.00	$10,549.75	nat. median $13,098 0.8× median
55874 CPT	Transperineal Placement Of Biodegradable Material, Peri-prostatic, Single Or Mul…	14	$10,288.50	$10,830.00	$10,288.50	nat. median $5,653 1.8× median
27138 CPT	Revision Of Total Hip Arthroplasty; Femoral Component Only, With Or Without Allo…	14	$10,075.70	$10,606.00	$10,075.70	nat. median $9,872 1.0× median
76498 CPT	MRI Whole Body	14	$9,716.60	$10,228.00	$9,716.60	nat. median $447 outlier · 21.7×
27236 CPT	Open Treatment Of Femoral Fracture, Proximal End, Neck, Internal Fixation	14	$8,766.60	$9,228.00	$8,766.60	nat. median $4,844 1.8× median
59510 CPT	Routine Obstetric Care Including Antepartum Care, Cesarean Delivery, And Postpar…	14	$8,764.70	$9,226.00	$8,764.70	nat. median $3,648 outlier · 2.4×
27125 CPT	Hemiarthroplasty, Hip, Partial (eg, Femoral Stem Prosthesis, Bipolar Arthroplast…	14	$8,501.55	$8,949.00	$8,501.55	nat. median $6,455 1.3× median
78816 CPT	PET CT Whole Body	14	$8,489.20	$8,936.00	$8,489.20	nat. median $2,788 outlier · 3.0×
27245 CPT	Treatment Of Intertrochanteric Or Subtrochanteric Femoral Fracture; W Intramedul…	14	$8,310.60	$8,748.00	$8,310.60	nat. median $4,542 1.8× median
50395 CPT	Xr Nephro Dil Urtrs Inj	14	$8,200.40	$8,632.00	$8,200.40	nat. median $2,355 outlier · 3.5×
47399 CPT	Unlisted Procedure, Liver	14	$7,919.20	$8,336.00	$7,919.20	nat. median $1,428 outlier · 5.5×
69706 CPT	Nps Surg Dilat Eust Tube Bilateral	14	$7,907.80	$8,324.00	$7,907.80	nat. median $5,968 1.3× median
78815 CPT	PET CT Skull Base To Midthigh	14	$7,753.90	$8,162.00	$7,753.90	nat. median $2,820 outlier · 2.8×
77301 CPT	Imrt Isodose Planning	14	$20.20	$11,719.00	$7,654.02	nat. median $2,796 outlier · 2.7×
44146 CPT	Colectomy, Partial; With Coloproctostomy (low Pelvic Anastomosis), With Colostom…	14	$7,590.50	$7,990.00	$7,590.50	nat. median $3,462 outlier · 2.2×
69705 CPT	Nps Surg Dilat Eust Tube Unilateral	14	$7,527.80	$7,924.00	$7,527.80	nat. median $5,959 1.3× median
59610 CPT	Routine Obstetric Care Including Antepartum Care, Vaginal Delivery And Postpartu…	14	$7,419.50	$7,810.00	$7,419.50	nat. median $3,322 outlier · 2.2×
78814 CPT	PET Imaging Limited Area	14	$7,350.15	$7,737.00	$7,350.15	nat. median $2,378 outlier · 3.1×
59400 CPT	Routine Obstetric Care Including Antepartum Care, Vaginal Delivery, Postpartum C…	14	$7,137.35	$7,513.00	$7,137.35	nat. median $3,137 outlier · 2.3×
29827 CPT	Arthroscopy, Shoulder, Surgical; With Rotator Cuff Repair	14	$7,077.50	$7,450.00	$7,077.50	nat. median $7,184 1.0× median
52284 CPT	Cystourethroscopy W/mechanical Dilation And Urethral Therapeutic Drug (stricture…	14	$7,039.50	$7,410.00	$7,039.50	nat. median $5,405 1.3× median
78452 CPT	Nm Myocardial Spect Drug Stress Multi	14	$7,038.55	$7,409.00	$7,038.55	nat. median $1,816 outlier · 3.9×
49418 CPT	Insertion Of Tunneled Intraperitoneal Catheter	14	$2,823.40	$11,467.00	$6,932.82	nat. median $4,231 1.6× median
49618 CPT	Repair Of Anterior Abdominal Hernia, Any Approach	14	$1,092.70	$7,272.00	$6,908.40	nat. median $4,620 1.5× median
27828 CPT	Open Tx Of Fx Of Articular Distal Tibia, With Internal Fixation, When Performed; T…	14	$6,833.35	$7,193.00	$6,833.35	nat. median $10,568 0.6× median
27235 CPT	Percutaneous Skeletal Fixation Of Femoral Fracture, Proximal End, Neck	14	$6,817.20	$7,176.00	$6,817.20	nat. median $6,942 1.0× median
27428 CPT	Ligamentous Reconstruction (augmentation), Knee; Intra-articular (open)	14	$6,801.05	$7,159.00	$6,801.05	nat. median $11,589 0.6× median
77295 CPT	Formal Planning	14	$150.20	$11,924.00	$6,745.40	nat. median $1,940 outlier · 3.5×
58563 CPT	Hysteroscopy, Surgical; With Endometrial Ablation	14	$6,561.65	$6,907.00	$6,561.65	nat. median $5,216 1.3× median
29880 CPT	Arthroscopy, Knee, Surgical; With Meniscectomy (medial And Lateral) Including Ch…	14	$6,460.95	$6,801.00	$6,460.95	nat. median $3,840 1.7× median
25609 CPT	Open Tx Distal Radial Intra-articular Fx Or Epiphyseal Separation; With Int Fix 3+…	14	$6,431.50	$6,770.00	$6,431.50	nat. median $7,232 0.9× median
74178 CPT	CT Abdomen And Pelvis With + Without Contrast	14	$6,204.45	$6,734.00	$6,397.30	nat. median $1,024 outlier · 6.2×
29882 CPT	Arthroscopy, Knee, Surgical; With Meniscus Repair (medial Or Lateral)	14	$6,266.20	$6,596.00	$6,266.20	nat. median $3,843 1.6× median
77049 CPT	MRI Breast With + Without Contrast Bilateral	14	$6,216.80	$6,544.00	$6,216.80	nat. median $967 outlier · 6.4×
46320 CPT	Excision Ext Thrombosed Hemorrhoid	14	$6,153.15	$6,477.00	$6,153.15	nat. median $1,318 outlier · 4.7×
27506 CPT	Open Treatment Of Femoral Shaft Fracture, With Insertion Of Intramedullary Impla…	14	$6,082.85	$6,403.00	$6,082.85	nat. median $4,902 1.2× median
75825 CPT	Xr Venogram Cava Inferior	14	$6,035.35	$6,353.00	$6,035.35	nat. median $3,187 1.9× median
95810 CPT	Polysomnography Charge.	14	$5,985.95	$6,301.00	$5,985.95	nat. median $1,825 outlier · 3.3×
19081 CPT	Mg Breast Biopsy With Stereo Guide Left	14	$5,970.75	$6,285.00	$5,970.75	nat. median $2,185 outlier · 2.7×
44144 CPT	Colectomy, Partial; With Resection, With Colostomy Or Ileostomy And Creation Of…	14	$5,968.85	$6,283.00	$5,968.85	nat. median $2,969 outlier · 2.0×
27507 CPT	Open Treatment Of Femoral Shaft Fracture With Plate/screws, With Or Without Cerc…	14	$5,740.85	$6,043.00	$5,740.85	nat. median $4,629 1.2× median
49596 CPT	Repair Of Anterior Abdominal Hernia, Any Approach	14	$901.96	$6,002.00	$5,701.90	nat. median $3,803 1.5× median
26952 CPT	Amp F/th 1/2 Jt/phalanx W/neurect Local Flap	14	$5,694.30	$5,994.00	$5,694.30	nat. median $3,363 1.7× median
77386 CPT	Imrt Tx Delivery Not Brst/pros	14	$188.45	$5,922.00	$5,625.90	nat. median $1,600 outlier · 3.5×

Other procedures at this hospital

Browse this hospital's 2,549 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

77372	CPT	Stereotactic Delivery 1fx	14	14	$33,845.00	$33,845.00	$32,152.75	$33,845.00	$32,152.75	2026-05-17
36566	CPT	Insertion Of Tunneled Centrally Inserted Central Venous Access Device, Requiring…	14	14	$16,428.00	$16,428.00	$15,606.60	$16,428.00	$15,606.60	2026-05-17
77373	CPT	Sbrt Linear Accelerator Based	14	14	$15,677.00	$15,677.00	$14,893.15	$15,677.00	$14,893.15	2026-05-17
27447	CPT	Arthroplasty, Knee, Condyle And Plateau; Medial And Lateral Compartments	14	14	$12,984.00	$12,984.00	$12,334.80	$12,984.00	$12,334.80	2026-05-17
27132	CPT	Conversion Of Previous Hip Surgery To Total Hip Arthroplasty	14	14	$11,930.00	$11,930.00	$11,333.50	$11,930.00	$11,333.50	2026-05-17
29888	CPT	Arthroscopically Aided Anterior Cruciate Ligament Repair/augmentation Or Reconst…	14	14	$11,652.00	$11,652.00	$11,069.40	$11,652.00	$11,069.40	2026-05-17
27130	CPT	Arthroplasty, Acetabular And Proximal Femoral Prosthetic Replacement	14	14	$11,105.00	$11,105.00	$10,549.75	$11,105.00	$10,549.75	2026-05-17
55874	CPT	Transperineal Placement Of Biodegradable Material, Peri-prostatic, Single Or Mul…	14	14	$10,830.00	$10,830.00	$10,288.50	$10,830.00	$10,288.50	2026-05-17
27138	CPT	Revision Of Total Hip Arthroplasty; Femoral Component Only, With Or Without Allo…	14	14	$10,606.00	$10,606.00	$10,075.70	$10,606.00	$10,075.70	2026-05-17
76498	CPT	MRI Whole Body	14	14	$10,228.00	$10,228.00	$9,716.60	$10,228.00	$9,716.60	2026-05-17
27236	CPT	Open Treatment Of Femoral Fracture, Proximal End, Neck, Internal Fixation	14	14	$9,228.00	$9,228.00	$8,766.60	$9,228.00	$8,766.60	2026-05-17
59510	CPT	Routine Obstetric Care Including Antepartum Care, Cesarean Delivery, And Postpar…	14	14	$9,226.00	$9,226.00	$8,764.70	$9,226.00	$8,764.70	2026-05-17
27125	CPT	Hemiarthroplasty, Hip, Partial (eg, Femoral Stem Prosthesis, Bipolar Arthroplast…	14	14	$8,949.00	$8,949.00	$8,501.55	$8,949.00	$8,501.55	2026-05-17
78816	CPT	PET CT Whole Body	14	14	$8,936.00	$8,936.00	$8,489.20	$8,936.00	$8,489.20	2026-05-17
27245	CPT	Treatment Of Intertrochanteric Or Subtrochanteric Femoral Fracture; W Intramedul…	14	14	$8,748.00	$8,748.00	$8,310.60	$8,748.00	$8,310.60	2026-05-17
50395	CPT	Xr Nephro Dil Urtrs Inj	14	14	$8,632.00	$8,632.00	$8,200.40	$8,632.00	$8,200.40	2026-05-17
47399	CPT	Unlisted Procedure, Liver	14	14	$8,336.00	$8,336.00	$7,919.20	$8,336.00	$7,919.20	2026-05-17
69706	CPT	Nps Surg Dilat Eust Tube Bilateral	14	14	$8,324.00	$8,324.00	$7,907.80	$8,324.00	$7,907.80	2026-05-17
78815	CPT	PET CT Skull Base To Midthigh	14	14	$8,162.00	$8,162.00	$7,753.90	$8,162.00	$7,753.90	2026-05-17
77301	CPT	Imrt Isodose Planning	28	14	$7,947.00	$7,947.00	$20.20	$11,719.00	$7,654.02	2026-05-17
44146	CPT	Colectomy, Partial; With Coloproctostomy (low Pelvic Anastomosis), With Colostom…	14	14	$7,990.00	$7,990.00	$7,590.50	$7,990.00	$7,590.50	2026-05-17
69705	CPT	Nps Surg Dilat Eust Tube Unilateral	14	14	$7,924.00	$7,924.00	$7,527.80	$7,924.00	$7,527.80	2026-05-17
59610	CPT	Routine Obstetric Care Including Antepartum Care, Vaginal Delivery And Postpartu…	14	14	$7,810.00	$7,810.00	$7,419.50	$7,810.00	$7,419.50	2026-05-17
78814	CPT	PET Imaging Limited Area	14	14	$7,737.00	$7,737.00	$7,350.15	$7,737.00	$7,350.15	2026-05-17
59400	CPT	Routine Obstetric Care Including Antepartum Care, Vaginal Delivery, Postpartum C…	14	14	$7,513.00	$7,513.00	$7,137.35	$7,513.00	$7,137.35	2026-05-17
29827	CPT	Arthroscopy, Shoulder, Surgical; With Rotator Cuff Repair	14	14	$7,450.00	$7,450.00	$7,077.50	$7,450.00	$7,077.50	2026-05-17
52284	CPT	Cystourethroscopy W/mechanical Dilation And Urethral Therapeutic Drug (stricture…	14	14	$7,410.00	$7,410.00	$7,039.50	$7,410.00	$7,039.50	2026-05-17
78452	CPT	Nm Myocardial Spect Drug Stress Multi	14	14	$7,409.00	$7,409.00	$7,038.55	$7,409.00	$7,038.55	2026-05-17
49418	CPT	Insertion Of Tunneled Intraperitoneal Catheter	28	14	$7,219.50	$7,219.50	$2,823.40	$11,467.00	$6,932.82	2026-05-17
49618	CPT	Repair Of Anterior Abdominal Hernia, Any Approach	14	14	$7,272.00	$7,272.00	$1,092.70	$7,272.00	$6,908.40	2026-05-17
27828	CPT	Open Tx Of Fx Of Articular Distal Tibia, With Internal Fixation, When Performed; T…	14	14	$7,193.00	$7,193.00	$6,833.35	$7,193.00	$6,833.35	2026-05-17
27235	CPT	Percutaneous Skeletal Fixation Of Femoral Fracture, Proximal End, Neck	14	14	$7,176.00	$7,176.00	$6,817.20	$7,176.00	$6,817.20	2026-05-17
27428	CPT	Ligamentous Reconstruction (augmentation), Knee; Intra-articular (open)	14	14	$7,159.00	$7,159.00	$6,801.05	$7,159.00	$6,801.05	2026-05-17
77295	CPT	Formal Planning	28	14	$7,043.50	$7,043.50	$150.20	$11,924.00	$6,745.40	2026-05-17
58563	CPT	Hysteroscopy, Surgical; With Endometrial Ablation	14	14	$6,907.00	$6,907.00	$6,561.65	$6,907.00	$6,561.65	2026-05-17
29880	CPT	Arthroscopy, Knee, Surgical; With Meniscectomy (medial And Lateral) Including Ch…	14	14	$6,801.00	$6,801.00	$6,460.95	$6,801.00	$6,460.95	2026-05-17
25609	CPT	Open Tx Distal Radial Intra-articular Fx Or Epiphyseal Separation; With Int Fix 3+…	14	14	$6,770.00	$6,770.00	$6,431.50	$6,770.00	$6,431.50	2026-05-17
74178	CPT	CT Abdomen And Pelvis With + Without Contrast	28	14	$6,632.50	$6,632.50	$6,204.45	$6,734.00	$6,397.30	2026-05-17
29882	CPT	Arthroscopy, Knee, Surgical; With Meniscus Repair (medial Or Lateral)	14	14	$6,596.00	$6,596.00	$6,266.20	$6,596.00	$6,266.20	2026-05-17
77049	CPT	MRI Breast With + Without Contrast Bilateral	14	14	$6,544.00	$6,544.00	$6,216.80	$6,544.00	$6,216.80	2026-05-17
46320	CPT	Excision Ext Thrombosed Hemorrhoid	14	14	$6,477.00	$6,477.00	$6,153.15	$6,477.00	$6,153.15	2026-05-17
27506	CPT	Open Treatment Of Femoral Shaft Fracture, With Insertion Of Intramedullary Impla…	14	14	$6,403.00	$6,403.00	$6,082.85	$6,403.00	$6,082.85	2026-05-17
75825	CPT	Xr Venogram Cava Inferior	14	14	$6,353.00	$6,353.00	$6,035.35	$6,353.00	$6,035.35	2026-05-17
95810	CPT	Polysomnography Charge.	14	14	$6,301.00	$6,301.00	$5,985.95	$6,301.00	$5,985.95	2026-05-17
19081	CPT	Mg Breast Biopsy With Stereo Guide Left	14	14	$6,285.00	$6,285.00	$5,970.75	$6,285.00	$5,970.75	2026-05-17
44144	CPT	Colectomy, Partial; With Resection, With Colostomy Or Ileostomy And Creation Of …	14	14	$6,283.00	$6,283.00	$5,968.85	$6,283.00	$5,968.85	2026-05-17
27507	CPT	Open Treatment Of Femoral Shaft Fracture With Plate/screws, With Or Without Cerc…	14	14	$6,043.00	$6,043.00	$5,740.85	$6,043.00	$5,740.85	2026-05-17
49596	CPT	Repair Of Anterior Abdominal Hernia, Any Approach	14	14	$6,002.00	$6,002.00	$901.96	$6,002.00	$5,701.90	2026-05-17
26952	CPT	Amp F/th 1/2 Jt/phalanx W/neurect Local Flap	14	14	$5,994.00	$5,994.00	$5,694.30	$5,994.00	$5,694.30	2026-05-17
77386	CPT	Imrt Tx Delivery Not Brst/pros	14	14	$5,922.00	$5,922.00	$188.45	$5,922.00	$5,625.90	2026-05-17
44143	CPT	Colectomy, Partial; With End Colostomy And Closure Of Distal Segment (Hartmann T…	14	14	$5,914.00	$5,914.00	$5,618.30	$5,914.00	$5,618.30	2026-05-17
27720	CPT	Repair Of Nonunion Or Malunion, Tibia; Without Graft, (eg, Compression Technique…	14	14	$5,848.00	$5,848.00	$5,555.60	$5,848.00	$5,555.60	2026-05-17
29823	CPT	Arthroscopy, Shoulder, Surgical; Debridement, Extensive	14	14	$5,845.00	$5,845.00	$5,552.75	$5,845.00	$5,552.75	2026-05-17
27257	CPT	0 Hip Dis Spon With Man W/ans Bth TechFee	14	14	$5,843.00	$5,843.00	$5,550.85	$5,843.00	$5,550.85	2026-05-17
49406	CPT	CT Drain Per/Retr Fld w/Cath Perc	14	14	$5,811.00	$5,811.00	$5,520.45	$5,811.00	$5,520.45	2026-05-17
27487	CPT	Revision Of Total Knee Arthroplasty, With Or Without Allograft; Femoral And Enti…	14	14	$5,810.00	$5,810.00	$5,519.50	$5,810.00	$5,519.50	2026-05-17
44120	CPT	Enterectomy, Resection Of Small Intestine; Single Resection And Anastomosis	14	14	$5,671.00	$5,671.00	$5,387.45	$5,671.00	$5,387.45	2026-05-17
44140	CPT	Colectomy, Partial; With Anastomosis	14	14	$5,664.00	$5,664.00	$5,380.80	$5,664.00	$5,380.80	2026-05-17
27134	CPT	Revision Of Total Hip Arthroplasty; Both Components, With Or Without Autograft O…	14	14	$5,656.00	$5,656.00	$5,373.20	$5,656.00	$5,373.20	2026-05-17
74174	CPT	CT Angio Abdomen And Pelvis	28	14	$5,646.00	$5,646.00	$5,363.70	$5,646.00	$5,363.70	2026-05-17
29822	CPT	Arthroscopy, Shoulder, Surgical; Debridement, Limited	14	14	$5,640.00	$5,640.00	$5,358.00	$5,640.00	$5,358.00	2026-05-17
36558	CPT	Central Line Insertion	28	14	$5,439.50	$5,439.50	$2,691.35	$8,046.00	$5,238.35	2026-05-17
70549	CPT	MRA Neck With + Without Contrast	28	14	$5,353.50	$5,353.50	$4,933.35	$5,514.00	$5,215.65	2026-05-17
38724	CPT	Cervical Lymphadenectomy (modified Radical Neck Dissection)	14	14	$5,469.00	$5,469.00	$5,195.55	$5,469.00	$5,195.55	2026-05-17
44150	CPT	Colectomy, Total, Abdominal, Without Proctectomy; With Ileostomy Or Ileoproctost…	14	14	$5,461.00	$5,461.00	$5,187.95	$5,461.00	$5,187.95	2026-05-17
74177	CPT	CT Abd And Pelvis W Contrast	28	14	$5,336.50	$5,336.50	$4,973.25	$5,438.00	$5,166.10	2026-05-17
24515	CPT	Open Treatment Of Humeral Shaft Fracture With Plate/screws, With Or Without Cerc…	14	14	$5,401.00	$5,401.00	$5,130.95	$5,401.00	$5,130.95	2026-05-17
70553	CPT	MRI Brain With + Without Contrast	14	14	$5,393.00	$5,393.00	$5,123.35	$5,393.00	$5,123.35	2026-05-17
72158	CPT	MRI Spine Lumbar With + Without Contrast	14	14	$5,393.00	$5,393.00	$5,123.35	$5,393.00	$5,123.35	2026-05-17
71552	CPT	MRI Chest With + Without Contrast	14	14	$5,393.00	$5,393.00	$5,123.35	$5,393.00	$5,123.35	2026-05-17
73720	CPT	MRI Femur With + Without Contrast Lt	14	14	$5,393.00	$5,393.00	$5,123.35	$5,393.00	$5,123.35	2026-05-17
74183	CPT	MRI Abdomen With + Without Contrast	14	14	$5,393.00	$5,393.00	$5,123.35	$5,393.00	$5,123.35	2026-05-17
72156	CPT	MRI Spine Cervical With + Without Contrast	14	14	$5,393.00	$5,393.00	$5,123.35	$5,393.00	$5,123.35	2026-05-17
70543	CPT	MRI Face Neck Orbit With + Without Contrast	14	14	$5,393.00	$5,393.00	$5,123.35	$5,393.00	$5,123.35	2026-05-17
72197	CPT	MRI Pelvis With + Without Contrast	14	14	$5,393.00	$5,393.00	$5,123.35	$5,393.00	$5,123.35	2026-05-17
50432	CPT	CT Perc Neph Tube Placement	28	14	$5,246.00	$5,246.00	$4,695.85	$5,549.00	$5,107.27	2026-05-17
70546	CPT	MRA Brain/Head With + Without Contrast	28	14	$5,232.50	$5,232.50	$4,818.40	$5,393.00	$5,097.68	2026-05-17
43659	CPT	Unlisted Laparoscopy Procedure, Stomach	14	14	$5,363.00	$5,363.00	$5,094.85	$5,363.00	$5,094.85	2026-05-17
43840	CPT	Gastrorrhaphy, Suture Of Perforated Duodenal Or Gastric Ulcer, Wound, Or Injury	14	14	$5,363.00	$5,363.00	$5,094.85	$5,363.00	$5,094.85	2026-05-17
29826	CPT	Arthroscopy, Shoulder, Surgical; Decompress Subacromial Space With Part Acromiopla…	14	14	$5,263.00	$5,263.00	$4,999.85	$5,263.00	$4,999.85	2026-05-17
29881	CPT	Arthroscopy, Knee, Surgical; With Meniscectomy (medial Or Lateral) Including Cho…	14	14	$5,263.00	$5,263.00	$4,999.85	$5,263.00	$4,999.85	2026-05-17
29875	CPT	Arthroscopy, Knee, Surgical; Synovectomy, Limited (eg, Plica Or Shelf Resection)	14	14	$5,263.00	$5,263.00	$4,999.85	$5,263.00	$4,999.85	2026-05-17
29877	CPT	Arthroscopy, Knee, Surgical; Debridement/shaving Of Articular Cartilage (chondro…	14	14	$5,263.00	$5,263.00	$4,999.85	$5,263.00	$4,999.85	2026-05-17
73220	CPT	MRI Forearm With + Without Contrast Lt	28	14	$5,211.00	$5,211.00	$4,933.35	$5,229.00	$4,967.55	2026-05-17
73223	CPT	MRI Elbow With + Without Contrast Left	14	14	$5,193.00	$5,193.00	$4,933.35	$5,193.00	$4,933.35	2026-05-17
73723	CPT	MRI Ankle With + Without Contrast Left	42	14	$5,193.00	$5,193.00	$4,628.40	$5,393.00	$4,933.35	2026-05-17
25447	CPT	Arthroplasty, Interposition, Intercarpal Or Carpometacarpal Joints	14	14	$5,129.00	$5,129.00	$4,872.55	$5,129.00	$4,872.55	2026-05-17
32160	CPT	Open Chest Heart Massage Tech Fee	14	14	$5,121.00	$5,121.00	$4,864.95	$5,121.00	$4,864.95	2026-05-17
44206	CPT	Laparoscopy, Surgical; Colectomy, Partial With End	14	14	$5,119.00	$5,119.00	$381.83	$5,119.00	$4,863.05	2026-05-17
27536	CPT	Open Treatment Of Tibia Fracture, Proximal, Bicondylar, With Or Without Internal…	14	14	$5,095.00	$5,095.00	$4,840.25	$5,095.00	$4,840.25	2026-05-17
77047	CPT	MRI Breast Without Contrast Bilateral	14	14	$5,072.00	$5,072.00	$4,818.40	$5,072.00	$4,818.40	2026-05-17
29876	CPT	Arthroscopy, Knee, Surgical; Synovectomy, Major, 2 Or More Compartments	14	14	$5,064.00	$5,064.00	$4,810.80	$5,064.00	$4,810.80	2026-05-17
44205	CPT	Laparoscopy, Surgical; Colectomy, Partial, With Removal Of Terminal Ileum With I…	14	14	$5,057.00	$5,057.00	$4,804.15	$5,057.00	$4,804.15	2026-05-17
49616	CPT	Repair Of Anterior Abdominal Hernia, Any Approach	14	14	$5,036.00	$5,036.00	$756.86	$5,036.00	$4,784.20	2026-05-17
19085	CPT	MRI Breast Biopsy With MRI Guide Left	14	14	$4,997.00	$4,997.00	$4,747.15	$4,997.00	$4,747.15	2026-05-17
74176	CPT	CT Abdomen And Pelvis Without Contrast	14	14	$4,989.00	$4,989.00	$4,739.55	$4,989.00	$4,739.55	2026-05-17
44640	CPT	Closure Of Intestinal Cutaneous Fistula	14	14	$4,972.00	$4,972.00	$4,723.40	$4,972.00	$4,723.40	2026-05-17
27822	CPT	Open Treatment Of Trimalleolar Ankle Fracture; Without Fixation Of Posterior Lip	14	14	$4,956.00	$4,956.00	$4,708.20	$4,956.00	$4,708.20	2026-05-17
J2353	HCPCS	Octreotide Acetate Injectable Suspension 20mg Inj	14	14	$4,939.00	$4,939.00	$4,692.05	$4,939.00	$4,692.05	2026-05-17
58558	CPT	Hysteroscopy, Surgical; With Biopsy Of Endometrium And/or Polypectomy, With Or W/o…	14	14	$4,917.00	$4,917.00	$4,671.15	$4,917.00	$4,671.15	2026-05-17
70548	CPT	MRA Neck With Contrast	28	14	$4,773.50	$4,773.50	$4,382.35	$4,934.00	$4,650.15	2026-05-17
44950	CPT	Appendectomy	14	14	$4,888.00	$4,888.00	$4,643.60	$4,888.00	$4,643.60	2026-05-17
77048	CPT	MRI Breast With + Without Contrast Left	14	14	$4,872.00	$4,872.00	$4,628.40	$4,872.00	$4,628.40	2026-05-17
78451	CPT	Nm Myocardial Spect Drug Stress Single	14	14	$4,842.00	$4,842.00	$4,599.90	$4,842.00	$4,599.90	2026-05-17
19083	CPT	US Breast Biopsy With US Guide Left	28	14	$4,720.00	$4,720.00	$4,352.90	$4,858.00	$4,598.55	2026-05-17
50389	CPT	Removal Of Nephrostomy Tube, Requiring Fluoroscopic Guidance	14	14	$4,829.00	$4,829.00	$4,587.55	$4,829.00	$4,587.55	2026-05-17
51102	CPT	Aspiration Of Bladder	14	14	$4,824.00	$4,824.00	$4,582.80	$4,824.00	$4,582.80	2026-05-17
27880	CPT	Amputation Lower Leg	14	14	$4,807.00	$4,807.00	$4,566.65	$4,807.00	$4,566.65	2026-05-17
52441	CPT	Urolift, With Insertion Of Permanent Adjustable Transprostatic Implant; Single I…	14	14	$4,807.00	$4,807.00	$4,566.65	$4,807.00	$4,566.65	2026-05-17
73222	CPT	MRI Elbow With Contrast Left	28	14	$4,683.00	$4,683.00	$4,210.40	$4,934.00	$4,559.65	2026-05-17
24342	CPT	Reinsertion Of Ruptured Biceps Or Triceps Tendon, Distal, With Or Without Tendon…	14	14	$4,786.00	$4,786.00	$4,546.70	$4,786.00	$4,546.70	2026-05-17
35221	CPT	Repair Blood Vessel, Direct; Intra-abdominal ProFee	14	14	$4,775.00	$4,775.00	$4,536.25	$4,775.00	$4,536.25	2026-05-17
55700	CPT	Biopsy Of Prostate	42	14	$4,759.00	$4,759.00	$835.05	$5,047.00	$4,521.05	2026-05-17
72149	CPT	MRI Spine Lumbar With Contrast	14	14	$4,753.00	$4,753.00	$4,515.35	$4,753.00	$4,515.35	2026-05-17
72157	CPT	MRI Spine Thoracic With + Without Contrast	14	14	$4,753.00	$4,753.00	$4,515.35	$4,753.00	$4,515.35	2026-05-17
44160	CPT	Colectomy, Partial, With Removal Of Terminal Ileum With Ileocolostomy	14	14	$4,741.00	$4,741.00	$4,503.95	$4,741.00	$4,503.95	2026-05-17
73722	CPT	MRI Ankle With Contrast Left	28	14	$4,592.50	$4,592.50	$4,210.40	$4,753.00	$4,473.68	2026-05-17
77385	CPT	Imrt Tx Delivery	14	14	$4,688.00	$4,688.00	$4,453.60	$4,688.00	$4,453.60	2026-05-17
44626	CPT	Closure Of Enterostomy, Large Or Small Intestine; With Resection And Colorectal …	14	14	$4,665.00	$4,665.00	$4,431.75	$4,665.00	$4,431.75	2026-05-17
49617	CPT	Repair Of Anterior Abdominal Hernia, Any Approac	14	14	$4,631.00	$4,631.00	$780.34	$4,631.00	$4,399.45	2026-05-17
25607	CPT	Open Tx Distal Radial Extra-articular Fx Or Epiphyseal Separation, With Internal…	14	14	$4,614.00	$4,614.00	$4,383.30	$4,614.00	$4,383.30	2026-05-17
27252	CPT	Cltx Hip Dislocation Traumatic Req Anesthesi	14	14	$4,582.00	$4,582.00	$4,352.90	$4,582.00	$4,352.90	2026-05-17
77293	CPT	P Respiratory Motion Mgmt	28	14	$4,526.00	$4,526.00	$45.40	$8,561.00	$4,311.98	2026-05-17
74185	CPT	MRA Abdomen With + Without Contrast	14	14	$4,534.00	$4,534.00	$4,307.30	$4,534.00	$4,307.30	2026-05-17
71555	CPT	MRA Chest With + Without Contrast	14	14	$4,534.00	$4,534.00	$4,307.30	$4,534.00	$4,307.30	2026-05-17
47563	CPT	Lap, Cholecystectomy With Cholangiography	14	14	$4,523.00	$4,523.00	$4,296.85	$4,523.00	$4,296.85	2026-05-17
49595	CPT	Repair Of Anterior Abdominal Hernia, Any Approac	14	14	$4,520.00	$4,520.00	$679.22	$4,520.00	$4,294.00	2026-05-17
44300	CPT	Placement, Enterostomy Or Cecostomy, Tube Open (eg, For Feeding Or Decompression…	14	14	$4,500.00	$4,500.00	$4,275.00	$4,500.00	$4,275.00	2026-05-17
47350	CPT	, Management Of Liver Hemorrhage	14	14	$4,499.00	$4,499.00	$4,274.05	$4,499.00	$4,274.05	2026-05-17
59515	CPT	Cesarean Delivery Only; Including Postpartum Care	14	14	$4,488.00	$4,488.00	$4,263.60	$4,488.00	$4,263.60	2026-05-17
70552	CPT	MRI Brain With Contrast	14	14	$4,473.00	$4,473.00	$4,249.35	$4,473.00	$4,249.35	2026-05-17
58291	CPT	Vaginal Hysterectomy, For Uterus Greater Than 250 G; With Removal Of Tube(s) And…	14	14	$4,452.00	$4,452.00	$4,229.40	$4,452.00	$4,229.40	2026-05-17
25606	CPT	Percutaneous Skeletal Fixation Of Distal Radial Fracture Or Epiphyseal Separatio…	14	14	$4,446.00	$4,446.00	$4,223.70	$4,446.00	$4,223.70	2026-05-17
44204	CPT	Laparo Partial Colectomy	14	14	$4,441.00	$4,441.00	$4,218.95	$4,441.00	$4,218.95	2026-05-17
35840	CPT	Exploration For Postoperative Hemorrhage, Thrombosis Or Infection; Abdomen	14	14	$4,435.00	$4,435.00	$4,213.25	$4,435.00	$4,213.25	2026-05-17
43281	CPT	Lap Paraesophag Hern Repair	14	14	$4,429.00	$4,429.00	$4,207.55	$4,429.00	$4,207.55	2026-05-17
49594	CPT	Repair Of Anterior Abdominal Hernia, Any Approach	14	14	$4,376.00	$4,376.00	$657.52	$4,376.00	$4,157.20	2026-05-17
19305	CPT	Mastectomy, Radical, Including Pectoral Muscles, Axillary Lymph Nodes	14	14	$4,360.00	$4,360.00	$4,142.00	$4,360.00	$4,142.00	2026-05-17
27385	CPT	Suture Of Quadriceps Or Hamstring Muscle Rupture; Primary	14	14	$4,343.00	$4,343.00	$4,125.85	$4,343.00	$4,125.85	2026-05-17
27486	CPT	Revision Of Total Knee Arthroplasty, With Or Without Allograft; 1 Component	14	14	$4,340.00	$4,340.00	$4,123.00	$4,340.00	$4,123.00	2026-05-17
64721	CPT	Neuroplasty And/or Transposition; Median Nerve At Carpal Tunnel	14	14	$4,307.00	$4,307.00	$4,091.65	$4,307.00	$4,091.65	2026-05-17
72147	CPT	MRI Spine Thoracic With Contrast	14	14	$4,306.00	$4,306.00	$4,090.70	$4,306.00	$4,090.70	2026-05-17
27814	CPT	Open Treatment Of Bimalleolar Ankle Fracture, Includes Internal Fixation, When P…	14	14	$4,273.00	$4,273.00	$4,059.35	$4,273.00	$4,059.35	2026-05-17
43631	CPT	Gastrectomy, Partial, Distal; With Gastroduodenostomy	14	14	$4,271.00	$4,271.00	$4,057.45	$4,271.00	$4,057.45	2026-05-17
47564	CPT	Cholecystectomy With Exploration Of Bile Duct	14	14	$4,258.00	$4,258.00	$4,045.10	$4,258.00	$4,045.10	2026-05-17
26951	CPT	Amputation, Finger Or Thumb, Primary Or Seco	28	14	$4,187.00	$4,187.00	$535.51	$5,939.00	$4,038.53	2026-05-17
70545	CPT	MRA Brain/Head With Contrast	28	14	$4,145.50	$4,145.50	$3,785.75	$4,306.00	$4,037.85	2026-05-17
74182	CPT	MRI Abdomen With Contrast	14	14	$4,242.00	$4,242.00	$4,029.90	$4,242.00	$4,029.90	2026-05-17
72142	CPT	MRI Spine Cervical With Contrast	14	14	$4,240.00	$4,240.00	$4,028.00	$4,240.00	$4,028.00	2026-05-17
27381	CPT	Suture Of Infrapatellar Tendon; Secondary Reconstruction, Including Fascial Or T…	14	14	$4,224.00	$4,224.00	$4,012.80	$4,224.00	$4,012.80	2026-05-17
58571	CPT	Laparoscopy, Surgical, With Total Hysterectomy, For Uterus 250 G Or Less; With Remvl…	14	14	$4,198.00	$4,198.00	$3,988.10	$4,198.00	$3,988.10	2026-05-17
73221	CPT	MRI Elbow Without Contrast Left	14	14	$4,152.00	$4,152.00	$3,944.40	$4,152.00	$3,944.40	2026-05-17
72148	CPT	MRI Spine Lumbar Without Contrast	14	14	$4,152.00	$4,152.00	$3,944.40	$4,152.00	$3,944.40	2026-05-17
73721	CPT	MRI Ankle Without Contrast Left	14	14	$4,152.00	$4,152.00	$3,944.40	$4,152.00	$3,944.40	2026-05-17
27310	CPT	Arthrotomy Knee With Exploration, Drainage, Or Removal Of Foreign Body	14	14	$4,145.00	$4,145.00	$3,937.75	$4,145.00	$3,937.75	2026-05-17
60252	CPT	Thyroidectomy, Total Or Subtotal For Malignancy; With Limited Neck Dissection Pr…	14	14	$4,137.00	$4,137.00	$3,930.15	$4,137.00	$3,930.15	2026-05-17
49002	CPT	Reopening Of Recent Laparotomy	14	14	$4,135.00	$4,135.00	$3,928.25	$4,135.00	$3,928.25	2026-05-17
27758	CPT	Open Treatment Of Tibial Shaft Fracture, Wit	28	14	$4,035.50	$4,035.50	$816.56	$4,134.00	$3,927.30	2026-05-17
23615	CPT	Open Tx Proximal Humeral Fx, Incl Int Fixation, Includes Repair Of Tuberosity	14	14	$4,103.00	$4,103.00	$3,897.85	$4,103.00	$3,897.85	2026-05-17
58353	CPT	Endometrial Ablation, Thermal, Without Hysteroscopic Guidance	14	14	$4,063.00	$4,063.00	$3,859.85	$4,063.00	$3,859.85	2026-05-17
59614	CPT	Vaginal Delivery Only, Vbac (with Or Without Episiotomy And/or Forceps); Including P…	14	14	$4,063.00	$4,063.00	$3,859.85	$4,063.00	$3,859.85	2026-05-17
44602	CPT	Suture- Small Intestine	14	14	$4,056.00	$4,056.00	$3,853.20	$4,056.00	$3,853.20	2026-05-17
72159	CPT	MRA Spine With + Without Contrast	14	14	$4,047.00	$4,047.00	$3,844.65	$4,047.00	$3,844.65	2026-05-17
73225	CPT	MRA Upper Extremity With + Without Cnt Left	14	14	$4,047.00	$4,047.00	$3,844.65	$4,047.00	$3,844.65	2026-05-17
72198	CPT	MRA Pelvis With + Without Contrast	14	14	$4,047.00	$4,047.00	$3,844.65	$4,047.00	$3,844.65	2026-05-17
38720	CPT	Cervical Lymphadenectomy (complete)	14	14	$4,022.00	$4,022.00	$3,820.90	$4,022.00	$3,820.90	2026-05-17
47605	CPT	Cholecystectomy; With Cholangiography	14	14	$4,005.00	$4,005.00	$3,804.75	$4,005.00	$3,804.75	2026-05-17
73219	CPT	MRI Forearm With Contrast Left	28	14	$3,901.50	$3,901.50	$3,478.90	$4,141.00	$3,797.97	2026-05-17
73218	CPT	MRI Forearm Without Contrast Lt	14	14	$3,985.00	$3,985.00	$3,785.75	$3,985.00	$3,785.75	2026-05-17
70336	CPT	MRI Tmj	14	14	$3,985.00	$3,985.00	$3,785.75	$3,985.00	$3,785.75	2026-05-17
A9548	HCPCS	Nm Indium Iii	14	14	$3,979.00	$3,979.00	$3,780.05	$3,979.00	$3,780.05	2026-05-17
62323	CPT	CT Injection Lmbr/Scrl Epidural	14	14	$3,978.00	$3,978.00	$3,779.10	$3,978.00	$3,779.10	2026-05-17
27244	CPT	Treatment Of Intertrochanteric Or Subtrochan	14	14	$3,954.00	$3,954.00	$1,134.63	$3,954.00	$3,756.30	2026-05-17
24160	CPT	Removal Of Prosthesis, Includes Debridement And Synovectomy When Performed; Hume…	14	14	$3,949.00	$3,949.00	$3,751.55	$3,949.00	$3,751.55	2026-05-17
24000	CPT	Arthrotomy, Elbow, Including Exploration, Drainage, Or Removal Of Foreign Body	14	14	$3,932.00	$3,932.00	$3,735.40	$3,932.00	$3,735.40	2026-05-17
36555	CPT	Central Line Plcmt <5 Yrs TechFee	14	14	$3,916.00	$3,916.00	$3,720.20	$3,916.00	$3,720.20	2026-05-17
44125	CPT	Enterectomy, Resection Of Small Intestine; With Enterostomy	14	14	$3,867.00	$3,867.00	$3,673.65	$3,867.00	$3,673.65	2026-05-17
44320	CPT	Colostomy Or Skin Level Cecostomy;	14	14	$3,858.00	$3,858.00	$3,665.10	$3,858.00	$3,665.10	2026-05-17
36569	CPT	Central/PICC Line Placement	84	14	$3,768.00	$3,768.00	$335.35	$3,879.00	$3,650.85	2026-05-17
59410	CPT	Vaginal Delivery Only; Including Postpartum Care	14	14	$3,837.00	$3,837.00	$3,645.15	$3,837.00	$3,645.15	2026-05-17
72146	CPT	MRI Spine Thoracic Without Contrast	14	14	$3,822.00	$3,822.00	$3,630.90	$3,822.00	$3,630.90	2026-05-17
19307	CPT	Mastectomy, Modified Radical, Including Axillary L	28	14	$3,818.00	$3,818.00	$273.09	$3,819.00	$3,627.10	2026-05-17
47600	CPT	Cholecystectomy;	14	14	$3,806.00	$3,806.00	$3,615.70	$3,806.00	$3,615.70	2026-05-17
64718	CPT	Neuroplasty And/or Transposition; Ulnar Nerve At Elbow	14	14	$3,798.00	$3,798.00	$3,608.10	$3,798.00	$3,608.10	2026-05-17
27827	CPT	Optx Fx Distal Tibia Only TechFee	14	14	$3,798.00	$3,798.00	$3,608.10	$3,798.00	$3,608.10	2026-05-17
58267	CPT	Vaginal Hysterectomy, For Uterus 250 G Or Less; With Colpo-urethrocystopexy	14	14	$3,795.00	$3,795.00	$3,605.25	$3,795.00	$3,605.25	2026-05-17
36561	CPT	Insertion Of Tunneled Centrally Inserted Central Venous Access Device, W/sub Por…	14	14	$3,793.00	$3,793.00	$3,603.35	$3,793.00	$3,603.35	2026-05-17
24343	CPT	Repr Elbow Lat Ligmnt W/tiss	14	14	$3,769.00	$3,769.00	$3,580.55	$3,769.00	$3,580.55	2026-05-17
23550	CPT	Open Treatment Of Acromioclavicular Dislocation, Acute Or Chronic;	14	14	$3,765.00	$3,765.00	$3,576.75	$3,765.00	$3,576.75	2026-05-17
29824	CPT	Arthroscopy, Shoulder, Surgical; Distal Claviculectomy Including Distal Articula…	14	14	$3,762.00	$3,762.00	$3,573.90	$3,762.00	$3,573.90	2026-05-17
27380	CPT	Suture Of Infrapatellar Tendon; Primary	14	14	$3,762.00	$3,762.00	$3,573.90	$3,762.00	$3,573.90	2026-05-17
27650	CPT	Repair, Primary, Open Or Percutaneous, Ruptured Achilles Tendon;	14	14	$3,762.00	$3,762.00	$3,573.90	$3,762.00	$3,573.90	2026-05-17
29874	CPT	Arthroscopy, Knee, Surgical; For Removal Of Loose Body Or Foreign Body	14	14	$3,762.00	$3,762.00	$3,573.90	$3,762.00	$3,573.90	2026-05-17
49615	CPT	Repair Of Anterior Abdominal Hernia, Any Approac	14	14	$3,752.00	$3,752.00	$563.87	$3,752.00	$3,564.40	2026-05-17
58559	CPT	Hysteroscopy, Surgical; With Lysis Of Intrauterine Adhesions (any Method)	14	14	$3,747.00	$3,747.00	$3,559.65	$3,747.00	$3,559.65	2026-05-17
60271	CPT	Thyroidectomy, Including Substernal Thyroid; Cervical Approach	14	14	$3,740.00	$3,740.00	$3,553.00	$3,740.00	$3,553.00	2026-05-17
77046	CPT	MRI Breast Unilateral L	28	14	$3,725.00	$3,725.00	$3,538.75	$3,725.00	$3,538.75	2026-05-17
15738	CPT	Muscle-skin Graft- Leg	14	14	$3,712.00	$3,712.00	$3,526.40	$3,712.00	$3,526.40	2026-05-17
20692	CPT	Application Of A Multiplane (pins Or Wires More Than 1 Plane), Unilateral, Exter…	14	14	$3,681.00	$3,681.00	$3,496.95	$3,681.00	$3,496.95	2026-05-17
72141	CPT	MRI Spine Cervical Without Contrast	14	14	$3,678.00	$3,678.00	$3,494.10	$3,678.00	$3,494.10	2026-05-17
73718	CPT	MRI Femur Without Contrast Lt	14	14	$3,678.00	$3,678.00	$3,494.10	$3,678.00	$3,494.10	2026-05-17
27266	CPT	Closed Treatment Of Post Hip Arthroplasty Dislocation; Requiring General Anesthe…	28	14	$3,625.50	$3,625.50	$1,840.15	$5,314.00	$3,492.65	2026-05-17
44970	CPT	Laparoscopy, Surgical, Appendectomy	14	14	$3,676.00	$3,676.00	$3,492.20	$3,676.00	$3,492.20	2026-05-17
44979	CPT	Laparoscope Proc- App	14	14	$3,676.00	$3,676.00	$3,492.20	$3,676.00	$3,492.20	2026-05-17
70542	CPT	MRI Face Neck Orbit With Contrast	14	14	$3,662.00	$3,662.00	$3,478.90	$3,662.00	$3,478.90	2026-05-17
73719	CPT	MRI Femur With Contrast Left	14	14	$3,662.00	$3,662.00	$3,478.90	$3,662.00	$3,478.90	2026-05-17
71551	CPT	MRI Chest With Contrast	14	14	$3,662.00	$3,662.00	$3,478.90	$3,662.00	$3,478.90	2026-05-17
72196	CPT	MRI Pelvis With Contrast	14	14	$3,662.00	$3,662.00	$3,478.90	$3,662.00	$3,478.90	2026-05-17
58140	CPT	Myomectomy Abdom Method	14	14	$3,652.00	$3,652.00	$3,469.40	$3,652.00	$3,469.40	2026-05-17
19303	CPT	Mastectomy, Simple, Complete	14	14	$3,649.00	$3,649.00	$3,466.55	$3,649.00	$3,466.55	2026-05-17
44620	CPT	Closure Of Enterostomy, Large Or Small Intestine	14	14	$3,616.00	$3,616.00	$3,435.20	$3,616.00	$3,435.20	2026-05-17
95811	CPT	Attended Psg With Cpap Profee	28	14	$3,606.50	$3,606.50	$325.85	$6,870.00	$3,434.75	2026-05-17
27513	CPT	Open Treatment Of Femoral Supracondylar Or Transcondylar Fracture With Intercond…	14	14	$3,615.00	$3,615.00	$3,434.25	$3,615.00	$3,434.25	2026-05-17
50200	CPT	CT Biopsy Renal	28	14	$3,604.00	$3,604.00	$3,423.80	$3,604.00	$3,423.80	2026-05-17
32400	CPT	CT Biopsy Pleura	14	14	$3,604.00	$3,604.00	$3,423.80	$3,604.00	$3,423.80	2026-05-17
32408	CPT	CT Biopsy Lung/Mediastinum	14	14	$3,604.00	$3,604.00	$3,423.80	$3,604.00	$3,423.80	2026-05-17
44625	CPT	Closure Of Enterostomy, Lg/small Intestine; With Resection And Anastomosis	14	14	$3,598.00	$3,598.00	$3,418.10	$3,598.00	$3,418.10	2026-05-17
58150	CPT	Total Abdominal Hysterectomy, With Or Without Removal Of Tube(s), With Or Without Remova…	14	14	$3,592.00	$3,592.00	$3,412.40	$3,592.00	$3,412.40	2026-05-17
47000	CPT	CT Biopsy Liver	28	14	$3,502.00	$3,502.00	$3,230.00	$3,604.00	$3,411.90	2026-05-17
28805	CPT	Amputation, Foot; Transmetatarsal	14	14	$3,589.00	$3,589.00	$3,409.55	$3,589.00	$3,409.55	2026-05-17
58180	CPT	Supracervical Abdominal Hysterectomy	14	14	$3,576.00	$3,576.00	$3,397.20	$3,576.00	$3,397.20	2026-05-17
59409	CPT	Vaginal Delivery Only, With Or Without Episiotomy And/or Forceps	14	14	$3,556.00	$3,556.00	$3,378.20	$3,556.00	$3,378.20	2026-05-17
58542	CPT	Lap. Supracervical Hysterectomy 250g Or Less With Tube/ovary Removal	14	14	$3,556.00	$3,556.00	$3,378.20	$3,556.00	$3,378.20	2026-05-17
72195	CPT	MRI Pelvis Without Contrast	14	14	$3,530.00	$3,530.00	$3,353.50	$3,530.00	$3,353.50	2026-05-17
70540	CPT	MRI Face Neck Orbit Without Contrast	14	14	$3,530.00	$3,530.00	$3,353.50	$3,530.00	$3,353.50	2026-05-17
74181	CPT	MRI Abdomen Without Contrast	14	14	$3,530.00	$3,530.00	$3,353.50	$3,530.00	$3,353.50	2026-05-17
71550	CPT	MRI Chest Without Contrast	14	14	$3,530.00	$3,530.00	$3,353.50	$3,530.00	$3,353.50	2026-05-17
74170	CPT	CT Abdomen W/wo	28	14	$3,430.50	$3,430.50	$3,169.20	$3,525.00	$3,342.38	2026-05-17
52442	CPT	Cystourethroscopy, Insertion Permanent Adjustable Transprostatic Implant; Each A…	14	14	$3,505.00	$3,505.00	$3,329.75	$3,505.00	$3,329.75	2026-05-17
25078	CPT	Resect Forearm/wrist Tum=3cm	14	14	$3,486.00	$3,486.00	$3,311.70	$3,486.00	$3,311.70	2026-05-17
27882	CPT	Amputation, Leg, Through Tibia And Fibula; Open, Circular (guillotine)	14	14	$3,481.00	$3,481.00	$3,306.95	$3,481.00	$3,306.95	2026-05-17
58573	CPT	Tlh W/t/o Uterus Over 250 G	14	14	$3,477.00	$3,477.00	$3,303.15	$3,477.00	$3,303.15	2026-05-17
70544	CPT	MRA Brain/Head Without Contrast	14	14	$3,470.00	$3,470.00	$3,296.50	$3,470.00	$3,296.50	2026-05-17
58554	CPT	Laparo-vag Hyst W/t/o- Compl	14	14	$3,455.00	$3,455.00	$3,282.25	$3,455.00	$3,282.25	2026-05-17
72127	CPT	CT Spine Cervical With + Without Contrast	14	14	$3,445.00	$3,445.00	$3,272.75	$3,445.00	$3,272.75	2026-05-17
44310	CPT	Ileostomy Or Jejunostomy, Non-tube	14	14	$3,427.00	$3,427.00	$3,255.65	$3,427.00	$3,255.65	2026-05-17
24359	CPT	Tenotomy, Elbow, Lateral Or Medial; Debridement, Open With Tendon Repair Or Reat…	14	14	$3,419.00	$3,419.00	$3,248.05	$3,419.00	$3,248.05	2026-05-17
27769	CPT	Open Treatment Of Posterior Malleolus Fracture, Includes Internal Fixation, When…	14	14	$3,413.00	$3,413.00	$3,242.35	$3,413.00	$3,242.35	2026-05-17
24587	CPT	Open Treatment Of Periarticular Fracture And	14	14	$3,410.00	$3,410.00	$1,002.73	$3,410.00	$3,239.50	2026-05-17
21014	CPT	Excision Tumor Soft Tissue Face/Scalp Subfascia	14	14	$3,399.00	$3,399.00	$3,229.05	$3,399.00	$3,229.05	2026-05-17
71270	CPT	CT Chest With + Without Contrast	28	14	$3,392.00	$3,392.00	$3,222.40	$3,392.00	$3,222.40	2026-05-17
38100	CPT	Splenectomy; Total (separate Procedure)	14	14	$3,388.00	$3,388.00	$3,218.60	$3,388.00	$3,218.60	2026-05-17
27535	CPT	Open Treatment Of Tibial Fracture, Proximal; Unicondylar, Includes Internal Fixa…	14	14	$3,370.00	$3,370.00	$3,201.50	$3,370.00	$3,201.50	2026-05-17
44187	CPT	Laparoscopy, Surgical; Ileostomy Or Jejuostomy'non-tube	14	14	$3,356.00	$3,356.00	$3,188.20	$3,356.00	$3,188.20	2026-05-17
49614	CPT	Repair Of Anterior Abdominal Hernia, Any Approach	14	14	$3,354.00	$3,354.00	$504.12	$3,354.00	$3,186.30	2026-05-17
25676	CPT	Open Treatment Of Distal Radioulnar Dislocation, Acute Or Chronic	14	14	$3,350.00	$3,350.00	$3,182.50	$3,350.00	$3,182.50	2026-05-17
25652	CPT	Open Treatment Of Ulnar Styloid Fracture	14	14	$3,350.00	$3,350.00	$3,182.50	$3,350.00	$3,182.50	2026-05-17
58570	CPT	Laparoscopy, Surgical, With Total Hysterectomy, For Uterus 250 G Or Less;	14	14	$3,347.00	$3,347.00	$3,179.65	$3,347.00	$3,179.65	2026-05-17
73725	CPT	MRA Lower Extremity Without Contrast Bilat	42	14	$3,342.00	$3,342.00	$3,011.50	$4,534.00	$3,174.90	2026-05-17
38505	CPT	CT Biopsy Lymph Node	14	14	$3,341.00	$3,341.00	$3,173.95	$3,341.00	$3,173.95	2026-05-17
20206	CPT	US Biopsy Muscle	14	14	$3,341.00	$3,341.00	$3,173.95	$3,341.00	$3,173.95	2026-05-17
44960	CPT	Appendectomy; For Ruptured Appendix With Abscess Or Generalized Peritonitis	14	14	$3,338.00	$3,338.00	$3,171.10	$3,338.00	$3,171.10	2026-05-17
70551	CPT	MRI Brain Without Contrast	14	14	$3,331.00	$3,331.00	$3,164.45	$3,331.00	$3,164.45	2026-05-17
23655	CPT	Clsd Tx Shoulder Dislc W/manipulation Req An	28	14	$3,278.50	$3,278.50	$1,227.40	$5,265.00	$3,146.88	2026-05-17
72194	CPT	CT Pelvis With + Without Contrast	14	14	$3,300.00	$3,300.00	$3,135.00	$3,300.00	$3,135.00	2026-05-17
50040	CPT	Nephrostomy, Nephrotomy With Drainage	14	14	$3,282.00	$3,282.00	$3,117.90	$3,282.00	$3,117.90	2026-05-17
25651	CPT	Percutaneous Skeletal Fixation Of Ulnar Styloid Fracture	14	14	$3,270.00	$3,270.00	$3,106.50	$3,270.00	$3,106.50	2026-05-17
49656	CPT	Laparoscopy, Surgical, Repair, Recurrent Incisional Hernia; Reductible	14	14	$3,262.00	$3,262.00	$3,098.90	$3,262.00	$3,098.90	2026-05-17
27759	CPT	Treatment Of Tibial Shaft Fracture By Intramedullary Implant	14	14	$3,249.00	$3,249.00	$3,086.55	$3,249.00	$3,086.55	2026-05-17
60260	CPT	Thyroidectomy, Removal Of All Remaining Thyroid Tissue Following Previous Remova…	14	14	$3,243.00	$3,243.00	$3,080.85	$3,243.00	$3,080.85	2026-05-17
59514	CPT	Cesarean Delivery Only	14	14	$3,234.00	$3,234.00	$3,072.30	$3,234.00	$3,072.30	2026-05-17
28122	CPT	Partial Excision Of Bone; Tarsal Or Metatarsal Bone, Except Talus Or Calcaneus	14	14	$3,232.00	$3,232.00	$3,070.40	$3,232.00	$3,070.40	2026-05-17
28415	CPT	Open Treatment Of Calcaneal Fracture, Includes Internal Fixation, When Performed…	14	14	$3,230.00	$3,230.00	$3,068.50	$3,230.00	$3,068.50	2026-05-17
27823	CPT	Open Treatment Of Trimalleolar Ankle Fracture; With Fixation Of Posterior Lip	14	14	$3,225.00	$3,225.00	$3,063.75	$3,225.00	$3,063.75	2026-05-17
78832	CPT	Meml Nm CT Tumor Loc Multiple Areas Spect	14	14	$3,222.00	$3,222.00	$3,060.90	$3,222.00	$3,060.90	2026-05-17
19302	CPT	Mastectomy, Partial; With Axillary Lymphadenectomy	14	14	$3,202.00	$3,202.00	$3,041.90	$3,202.00	$3,041.90	2026-05-17
77432	CPT	P Srs Tx Management	14	14	$3,200.00	$3,200.00	$38.80	$3,200.00	$3,040.00	2026-05-17
44188	CPT	Laparoscopy, Surgical, Colostomy Or Skin Level Cecostomy ProFee	14	14	$3,198.00	$3,198.00	$3,038.10	$3,198.00	$3,038.10	2026-05-17
27524	CPT	Open Treatment Of Patellar Fracture, With Internal Fixation And/or Patellectomy	14	14	$3,182.00	$3,182.00	$3,022.90	$3,182.00	$3,022.90	2026-05-17
78072	CPT	Nm Parathyroid Image With Spect/CT Inj/Scn	14	14	$3,181.00	$3,181.00	$3,021.95	$3,181.00	$3,021.95	2026-05-17
78071	CPT	Nm Parathyroid Imaging With Spect Inj/Scan	14	14	$3,181.00	$3,181.00	$3,021.95	$3,181.00	$3,021.95	2026-05-17
24430	CPT	Repair Of Nonunion Or Malunion, Humerus; Without Graft (eg, Compression Techniqu…	14	14	$3,180.00	$3,180.00	$3,021.00	$3,180.00	$3,021.00	2026-05-17
44005	CPT	Enterolysis (freeing Of Intestinal Adhesion) (separate Procedure)	14	14	$3,175.00	$3,175.00	$3,016.25	$3,175.00	$3,016.25	2026-05-17
71275	CPT	CT Angio Chest	14	14	$3,150.00	$3,150.00	$2,992.50	$3,150.00	$2,992.50	2026-05-17
29806	CPT	Arthroscopy, Shoulder, Surgical; Capsulorrhaphy	14	14	$3,131.00	$3,131.00	$2,974.45	$3,131.00	$2,974.45	2026-05-17
43280	CPT	Laparoscopy- Fundoplasty	14	14	$3,121.00	$3,121.00	$2,964.95	$3,121.00	$2,964.95	2026-05-17
29807	CPT	Arthroscopy, Shoulder, Surgical; Repair Of Slap Lesion	14	14	$3,120.00	$3,120.00	$2,964.00	$3,120.00	$2,964.00	2026-05-17
27240	CPT	Closed Treatment Of Intertrochanteric, Peritrochan	25	14	$3,102.00	$3,102.00	$142.62	$3,102.00	$2,944.05	2026-05-17
52317	CPT	Litholapaxy; Simple Or Small (less Than 2.5 Cm)	14	14	$3,093.00	$3,093.00	$2,938.35	$3,093.00	$2,938.35	2026-05-17
59300	CPT	Episiotomy Or Vaginal Repair, By Other Than Attending	14	14	$3,084.00	$3,084.00	$2,929.80	$3,084.00	$2,929.80	2026-05-17
27792	CPT	Open Treatment Of Distal Fibular Fracture, Includes Internal Fixation, When Perf…	14	14	$3,080.00	$3,080.00	$2,926.00	$3,080.00	$2,926.00	2026-05-17
23515	CPT	Open Treatment Of Clavicular Fracture, Includes Internal Fixation, When Performe…	14	14	$3,080.00	$3,080.00	$2,926.00	$3,080.00	$2,926.00	2026-05-17
10121	CPT	Incision & Removal Foreign Body Comp Fac	28	14	$3,047.00	$3,047.00	$181.91	$5,229.00	$2,916.28	2026-05-17
25405	CPT	Repair Of Nonunion Or Malunion, Radius Or Ulna; With Autograft (includes Obtaini…	14	14	$3,069.00	$3,069.00	$2,915.55	$3,069.00	$2,915.55	2026-05-17
62311\|62322	OTHER	Epidural Nsg Care Charge	14	14	$3,069.00	$3,069.00	$2,915.55	$3,069.00	$2,915.55	2026-05-17
62322	CPT	Epidural	14	14	$3,069.00	$3,069.00	$2,915.55	$3,069.00	$2,915.55	2026-05-17
72130	CPT	CT Spine Thoracic With + Without Contrast	14	14	$3,067.00	$3,067.00	$2,913.65	$3,067.00	$2,913.65	2026-05-17
72133	CPT	CT Spine Lumbar With + Without Contrast	14	14	$3,067.00	$3,067.00	$2,913.65	$3,067.00	$2,913.65	2026-05-17
27766	CPT	Open Treatment Of Medial Malleolus Fracture,	14	14	$3,061.00	$3,061.00	$553.48	$3,061.00	$2,907.95	2026-05-17
44180	CPT	Laparoscopy, Surgical, Enterolysis (freeing Of Intestinal Adhesion) (separate Pr…	14	14	$3,057.00	$3,057.00	$2,904.15	$3,057.00	$2,904.15	2026-05-17
49441	CPT	Place Duod/jej Tube Perc	14	14	$3,056.00	$3,056.00	$2,903.20	$3,056.00	$2,903.20	2026-05-17
43215	CPT	Esophagoscopy, Flexible, Transoral; With Removal Of Foreign Body	28	14	$3,012.50	$3,012.50	$1,289.15	$4,668.00	$2,895.80	2026-05-17
60240	CPT	Thyroidectomy, Total Or Complete ProFee	12	12	$3,048.00	$3,048.00	$888.80	$3,048.00	$2,895.60	2026-05-17
59426	CPT	Antepartum Care Only 7 More Visits	14	14	$3,048.00	$3,048.00	$2,895.60	$3,048.00	$2,895.60	2026-05-17
59120	CPT	Surgical Treatment Of Ectopic Pregnancy; Requiring Salpingectomy And/or Oophorec…	14	14	$3,039.00	$3,039.00	$2,887.05	$3,039.00	$2,887.05	2026-05-17
19082	CPT	Meml Mg Stereotactic Bx Add'l	14	14	$3,025.00	$3,025.00	$2,873.75	$3,025.00	$2,873.75	2026-05-17
58545	CPT	Laparoscopy, Surgical, Myomectomy, Excision; 1 To 4 Intramural Myomas With Total…	14	14	$3,007.00	$3,007.00	$2,856.65	$3,007.00	$2,856.65	2026-05-17
13160	CPT	Late Closure Wound	14	14	$3,003.00	$3,003.00	$2,852.85	$3,003.00	$2,852.85	2026-05-17
70547	CPT	MRA Neck Without Contrast	14	14	$3,002.00	$3,002.00	$2,851.90	$3,002.00	$2,851.90	2026-05-17
26992	CPT	Incision, Bone Cortex, Pelvis And/or Hip Joint (eg, Osteomye	14	14	$2,993.00	$2,993.00	$2,843.35	$2,993.00	$2,843.35	2026-05-17

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