Hospital

ASPIRE HOSPITAL

Conroe, TX · CCN 670093 · Rates published

3,451 distinct procedures filed

5 distinct payers

22,709 rate rows

2026-04-27 last MRF observed

Data quality

22,631 of 22,709 rate rows are consumer-grade (99.7%)

78 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
per-diem day rate — not a per-procedure price	78

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

Source MRF file	https://secure.claraprice.net/price-transparency/TDCQ-1707436189518/machine-readable/262835957_aspire-behavioral-health_standardcharges.json
Found on page	https://secure.claraprice.net/price-transparency/aspire-behavioral-health
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint	148950012e5f69a9… · 126,604 bytes · first seen 2026-05-19

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
37229 CPT	Tib/per Init W/ather	5	$32,834.00	$82,078.00	$45,147.00	nat. median $16,929 outlier · 2.7×
37227 CPT	Fem/pop Tlstent/athe	5	$32,834.00	$82,078.00	$45,147.00	nat. median $18,025 outlier · 2.5×
37231 CPT	Tib/per Rev St/ather	5	$32,834.00	$82,078.00	$45,147.00	nat. median $18,087 outlier · 2.5×
37230 CPT	Tib/per Reva W/stent	5	$32,834.00	$82,078.00	$45,147.00	nat. median $16,861 outlier · 2.7×
37225 CPT	Fem/pop Rev W/arthre	5	$22,589.00	$56,467.00	$31,060.00	nat. median $16,320 1.9× median
J7311 HCPCS	Fluocinolone Acet In	5	$20,677.00	$51,688.00	$28,431.00	nat. median $490 outlier · 58.0×
37228 CPT	Tib/pr Ini Rev W/tla	5	$20,412.00	$51,026.00	$28,067.00	nat. median $10,888 outlier · 2.6×
37226 CPT	Fem/pop Rev W/tlstn	5	$20,412.00	$51,026.00	$28,067.00	nat. median $12,661 outlier · 2.2×
C2616 HCPCS	Brachytx Source Yttr	5	$11,940.00	$29,846.00	$16,417.00	nat. median $28,140 0.6× median
37221 CPT	Iliac Revasc With Sten	5	$7,823.00	$19,555.00	$10,756.00	nat. median $11,953 0.9× median
64561 CPT	Percut Imp Neuro Bil	5	$7,781.00	$19,450.00	$10,699.00	nat. median $6,687 1.6× median
37224 CPT	Fem/pop Rev Uni Tla	5	$6,871.00	$17,176.00	$9,448.00	nat. median $7,244 1.3× median
37220 CPT	Iliac Revasc Uni 1st	5	$5,776.00	$14,440.00	$7,943.00	nat. median $7,180 1.1× median
36566 CPT	Insert Tunnel Cvc W	5	$4,949.00	$12,371.00	$6,805.00	nat. median $5,685 1.2× median
19298 CPT	Hdr Cath Plac Breast	5	$4,515.00	$11,287.00	$6,208.00	nat. median $6,728 0.9× median
77372 CPT	Srs Linear Based	5	$4,439.00	$11,097.00	$6,104.00	nat. median $9,059 0.7× median
J7310 HCPCS	Ganciclovir 4.5mg Oc	5	$4,409.00	$11,021.00	$6,062.00	nat. median $19,165 outlier · 0.3×
J9219 HCPCS	Leuprolide Acet Imp	5	$4,022.00	$10,055.00	$5,531.00	nat. median $7,601 0.7× median
37223 CPT	Iliac Rev Adon W/tls	5	$3,832.00	$9,580.00	$5,270.00	nat. median $7,921 0.7× median
50590 CPT	Lithotripsy Bilatera	5	$3,777.00	$9,442.00	$5,194.00	nat. median $4,400 1.2× median
4004799 CDM	Stent Bronchial Dyna	5	$3,244.00	$8,110.00	$4,461.00	nat. median $134 outlier · 33.3×
J9300 HCPCS	Gemtuzumab Ozogamici	5	$2,700.00	$6,749.00	$3,713.00	nat. median $3,193 1.2× median
A9521 HCPCS	Tc-99m Ceretec Inj P	5	$2,678.00	$6,694.00	$3,682.00	nat. median $1,818 outlier · 2.0×
44370 CPT	Endo Sml Bwl W/trans	5	$2,595.00	$6,486.00	$3,568.00	nat. median $5,958 0.6× median
J2505 HCPCS	Pegfilgrastim 6mg In	5	$2,423.00	$6,057.00	$3,332.00	nat. median $6,803 outlier · 0.5×
77373 CPT	Sbrt Delivery	5	$2,375.00	$5,936.00	$3,265.00	nat. median $3,712 0.9× median
3175078 CDM	Samarium-153 Inj Per	5	$2,293.00	$5,732.00	$3,153.00	nat. median $3,153 1.0× median
4406540 CDM	Tenecteplase 50mg In	5	$2,161.00	$5,401.00	$2,971.00	nat. median $2,971 1.0× median
78816 CPT	PET CT Tumor Whole B	5	$2,099.00	$5,247.00	$2,886.00	nat. median $2,707 1.1× median
J9268 HCPCS	Pentostatin 10mg 1 E	5	$2,083.00	$5,206.00	$2,864.00	nat. median $3,813 0.8× median
77301 CPT	Imrt Course	5	$2,068.00	$5,168.00	$2,843.00	nat. median $2,773 1.0× median
J0350 HCPCS	Anistreplase 30u 1 E	5	$2,044.00	$5,110.00	$2,811.00	nat. median $4,366 0.6× median
73723 CPT	MRI Le Joint Wwo Bil	5	$1,178.00	$5,099.00	$2,805.00	nat. median $1,264 outlier · 2.2×
77295 CPT	Simulation 3d	5	$2,020.00	$5,049.00	$2,778.00	nat. median $1,863 1.5× median
43219 CPT	Esophagos W/stent In	5	$1,983.00	$4,957.00	$2,726.00	nat. median $2,225 1.2× median
J9600 HCPCS	Porfimer Sodium 75mg	5	$1,976.00	$4,940.00	$2,717.00	nat. median $31,627 outlier · 0.1×
4005009 CDM	Stent Duo 22mmx27mmx	5	$1,942.00	$4,855.00	$2,670.00	nat. median $41 outlier · 65.1×
C1876 HCPCS	Stent Non Coated Cov	5	$1,942.00	$4,855.00	$2,670.00	nat. median $2,443 1.1× median
4005007 CDM	Stent Colon 25mmx30m	5	$1,942.00	$4,855.00	$2,670.00	nat. median $46 outlier · 58.0×
73720 CPT	MRI Le Wwo Con Bilat	5	$1,045.00	$4,925.00	$2,613.00	nat. median $1,190 outlier · 2.2×
78815 CPT	PET CT Tumor Skulmid	5	$1,886.00	$4,716.00	$2,594.00	nat. median $2,793 0.9× median
A9507 HCPCS	In-111 Capromab Pend	5	$1,861.00	$4,653.00	$2,559.00	nat. median $4,715 0.5× median
31600 CPT	Tracheostomy	5	$1,856.00	$4,639.00	$2,551.00	nat. median $3,393 0.8× median
73721 CPT	MRI Scan Of Leg Joint	5	$998.00	$5,235.00	$2,494.00	nat. median $899 outlier · 2.8×
55875 CPT	Transperineal Needle	5	$1,775.00	$4,437.00	$2,440.00	nat. median $5,627 outlier · 0.4×
4004040 CDM	Bronch Dilat W/stent	5	$1,758.00	$4,394.00	$2,417.00	nat. median $4 outlier · 604.2×
4004035 CDM	Bronchoscopy Dilate	5	$1,758.00	$4,394.00	$2,417.00	nat. median $2,417 1.0× median
C1874 HCPCS	Stent Coated Covered	5	$1,750.00	$4,374.00	$2,406.00	nat. median $4,694 0.5× median
45100 CPT	Biopsy Anorectal Wal	5	$1,735.00	$4,337.00	$2,385.00	nat. median $2,765 0.9× median
43242 CPT	Egd W/us Fna	5	$1,728.00	$4,320.00	$2,376.00	nat. median $2,363 1.0× median

Other procedures at this hospital

Browse this hospital's 3,451 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

19101	CPT	Bx Breast Open Incis	6	5	$1,697.00	$309.00 82% off	$679.00	$1,697.00	$933.00	2026-04-27
19125	CPT	Excision Breast Lesi	6	5	$3,043.00	$647.00 79% off	$1,217.00	$3,043.00	$1,674.00	2026-04-27
19126	CPT	Excision Addl Breast	6	5	$3,120.00	$207.00 93% off	$1,248.00	$3,120.00	$1,716.00	2026-04-27
19298	CPT	Hdr Cath Plac Breast	6	5	$11,288.00	$382.00 97% off	$4,515.00	$11,287.00	$6,208.00	2026-04-27
21550	CPT	Biopsy Soft Tissue N	6	5	$2,304.00	$206.00 91% off	$922.00	$2,304.00	$1,267.00	2026-04-27
31600	CPT	Tracheostomy	6	5	$4,639.00	$393.00 92% off	$1,856.00	$4,639.00	$2,551.00	2026-04-27
31641	CPT	Bronch With Abla Laser	6	5	$3,053.00	$325.00 89% off	$1,221.00	$3,053.00	$1,679.00	2026-04-27
3170214	CDM	Cardiac Scan Spect R	6	5	$1,926.00	$1,926.00	$770.00	$1,926.00	$1,059.00	2026-04-27
3175066	CDM	In-111 Pentetreotide	6	5	$2,239.00	$2,239.00	$896.00	$2,239.00	$1,231.00	2026-04-27
3175078	CDM	Samarium-153 Inj Per	6	5	$5,733.00	$5,733.00	$2,293.00	$5,732.00	$3,153.00	2026-04-27
3175092	CDM	Tc-99m Cea Scan Per	6	5	$2,293.00	$2,293.00	$917.00	$2,293.00	$1,261.00	2026-04-27
3175102	CDM	Tc-99m Wbc Per Dose	6	5	$2,665.00	$2,665.00	$1,066.00	$2,665.00	$1,466.00	2026-04-27
3180366	CDM	Liver Biopsy Access	6	5	$1,779.00	$1,779.00	$712.00	$1,779.00	$978.00	2026-04-27
36560	CPT	Insert Tunnel Cvc W	6	5	$3,557.00	$521.00 85% off	$1,423.00	$3,557.00	$1,956.00	2026-04-27
36561	CPT	Ins Tunnel Cv Cath W	6	5	$3,567.00	$432.00 88% off	$1,427.00	$3,567.00	$1,962.00	2026-04-27
36565	CPT	Insert Tunnel Cvc W	6	5	$3,644.00	$450.00 88% off	$1,458.00	$3,644.00	$2,004.00	2026-04-27
36566	CPT	Insert Tunnel Cvc W	6	5	$12,372.00	$480.00 96% off	$4,949.00	$12,371.00	$6,805.00	2026-04-27
36568	CPT	Insert Picc Without Port	6	5	$1,634.00	$122.00 93% off	$654.00	$1,634.00	$899.00	2026-04-27
36570	CPT	Insert Picc W/port U	6	5	$1,634.00	$456.00 72% off	$654.00	$1,634.00	$899.00	2026-04-27
36571	CPT	Insert Picc With Port	6	5	$1,623.00	$422.00 74% off	$649.00	$1,623.00	$893.00	2026-04-27
36580	CPT	Replace Non-tunneled	6	5	$1,634.00	$83.00 95% off	$654.00	$1,634.00	$899.00	2026-04-27
36581	CPT	Replace Tunnel Cvc W	6	5	$1,681.00	$237.00 86% off	$672.00	$1,681.00	$925.00	2026-04-27
36584	CPT	Replace Picc Without Por	6	5	$1,620.00	$74.00 95% off	$648.00	$1,620.00	$891.00	2026-04-27
37220	CPT	Iliac Revasc Uni 1st	6	5	$14,441.00	$14,441.00	$5,776.00	$14,440.00	$7,943.00	2026-04-27
37221	CPT	Iliac Revasc With Sten	6	5	$19,557.00	$19,557.00	$7,823.00	$19,555.00	$10,756.00	2026-04-27
37222	CPT	Iliac Revasc Addon	6	5	$3,736.00	$3,736.00	$1,494.00	$3,736.00	$2,055.00	2026-04-27
37223	CPT	Iliac Rev Adon W/tls	6	5	$9,581.00	$9,581.00	$3,832.00	$9,580.00	$5,270.00	2026-04-27
37224	CPT	Fem/pop Rev Uni Tla	6	5	$17,178.00	$17,178.00	$6,871.00	$17,176.00	$9,448.00	2026-04-27
37225	CPT	Fem/pop Rev W/arthre	6	5	$56,473.00	$56,473.00	$22,589.00	$56,467.00	$31,060.00	2026-04-27
37226	CPT	Fem/pop Rev W/tlstn	6	5	$51,031.00	$51,031.00	$20,412.00	$51,026.00	$28,067.00	2026-04-27
37227	CPT	Fem/pop Tlstent/athe	6	5	$82,086.00	$82,086.00	$32,834.00	$82,078.00	$45,147.00	2026-04-27
37228	CPT	Tib/pr Ini Rev W/tla	6	5	$51,031.00	$51,031.00	$20,412.00	$51,026.00	$28,067.00	2026-04-27
37229	CPT	Tib/per Init W/ather	6	5	$82,086.00	$82,086.00	$32,834.00	$82,078.00	$45,147.00	2026-04-27
37230	CPT	Tib/per Reva W/stent	6	5	$82,086.00	$82,086.00	$32,834.00	$82,078.00	$45,147.00	2026-04-27
37231	CPT	Tib/per Rev St/ather	6	5	$82,086.00	$82,086.00	$32,834.00	$82,078.00	$45,147.00	2026-04-27
4000113	CDM	Or Acuty C 1st 1/2hr	6	5	$1,755.00	$1,755.00	$702.00	$1,755.00	$965.00	2026-04-27
4000114	CDM	Or Acuty D 1st 1/2hr	6	5	$2,265.00	$2,265.00	$906.00	$2,265.00	$1,246.00	2026-04-27
4000115	CDM	Or Acuty E 1st 1/2hr	6	5	$2,590.00	$2,590.00	$1,036.00	$2,590.00	$1,425.00	2026-04-27
4000116	CDM	Or Acuty F 1st 1/2hr	6	5	$3,301.00	$3,301.00	$1,320.00	$3,301.00	$1,816.00	2026-04-27
4004035	CDM	Bronchoscopy Dilate	6	5	$4,394.00	$4,394.00	$1,758.00	$4,394.00	$2,417.00	2026-04-27
4004040	CDM	Bronch Dilat W/stent	6	5	$4,394.00	$4,394.00	$1,758.00	$4,394.00	$2,417.00	2026-04-27
4004045	CDM	Bronch W/fb Removal	6	5	$1,957.00	$1,957.00	$783.00	$1,957.00	$1,076.00	2026-04-27
4004050	CDM	Bronch W/cath Intr	6	5	$1,957.00	$1,957.00	$783.00	$1,957.00	$1,076.00	2026-04-27
4004051	CDM	Bronch With Stent Init	6	5	$3,054.00	$3,054.00	$1,222.00	$3,054.00	$1,680.00	2026-04-27
4004053	CDM	Bronch Endo Us(ebus)	6	5	$4,029.00	$4,029.00	$1,612.00	$4,029.00	$2,216.00	2026-04-27
4004260	CDM	Endo-lum Gastric Pli	6	5	$2,479.00	$2,479.00	$992.00	$2,479.00	$1,363.00	2026-04-27
4004625	CDM	Biopsy Prostate Any	6	5	$1,694.00	$1,694.00	$678.00	$1,694.00	$932.00	2026-04-27
4004693	CDM	Destruction Of Hemor	6	5	$1,854.00	$1,854.00	$742.00	$1,854.00	$1,020.00	2026-04-27
4004695	CDM	Destruction Of Hemor	6	5	$1,933.00	$1,933.00	$773.00	$1,933.00	$1,063.00	2026-04-27
4004697	CDM	Destr Hemorroid Int	6	5	$3,490.00	$3,490.00	$1,396.00	$3,490.00	$1,920.00	2026-04-27
4004799	CDM	Stent Bronchial Dyna	6	5	$8,111.00	$8,111.00	$3,244.00	$8,110.00	$4,461.00	2026-04-27
4004801	CDM	Stent Biliary Group	6	5	$3,337.00	$3,337.00	$1,335.00	$3,337.00	$1,835.00	2026-04-27
4004802	CDM	Stent Esophageal Gro	6	5	$3,453.00	$3,453.00	$1,381.00	$3,453.00	$1,899.00	2026-04-27
4005007	CDM	Stent Colon 25mmx30m	6	5	$4,855.00	$4,855.00	$1,942.00	$4,855.00	$2,670.00	2026-04-27
4005009	CDM	Stent Duo 22mmx27mmx	6	5	$4,855.00	$4,855.00	$1,942.00	$4,855.00	$2,670.00	2026-04-27
4005535	CDM	Stent Esoph Group 49	6	5	$4,032.00	$4,032.00	$1,613.00	$4,032.00	$2,218.00	2026-04-27
4110690	CDM	Ppump Dual On-q400ml	6	5	$1,751.00	$1,751.00	$700.00	$1,751.00	$963.00	2026-04-27
4200604	CDM	Insert Intraperiton	6	5	$3,042.00	$3,042.00	$1,217.00	$3,042.00	$1,673.00	2026-04-27
4206002	CDM	Starburst Semi Flex	6	5	$3,510.00	$3,510.00	$1,404.00	$3,510.00	$1,931.00	2026-04-27
4206003	CDM	Starburst Xlie 4-7cm	6	5	$3,990.00	$3,990.00	$1,596.00	$3,990.00	$2,195.00	2026-04-27
4230150	CDM	MRA Upper Extrem W O	6	5	$2,360.00	$2,360.00	$944.00	$2,360.00	$1,298.00	2026-04-27
4252204	CDM	High Int Brachyth 1-	6	5	$2,649.00	$2,649.00	$1,060.00	$2,649.00	$1,457.00	2026-04-27
4252239	CDM	Hdr Brach D 1-4 Sour	6	5	$2,649.00	$2,649.00	$1,060.00	$2,649.00	$1,457.00	2026-04-27
4252328	CDM	Hdr Brach 5-8 Source	6	5	$2,649.00	$2,649.00	$1,060.00	$2,649.00	$1,457.00	2026-04-27
4252780	CDM	Hdr Brach Dist 5-8	6	5	$2,649.00	$2,649.00	$1,060.00	$2,649.00	$1,457.00	2026-04-27
4253019	CDM	Rem Aft Hi Int Brach	6	5	$2,638.00	$2,638.00	$1,055.00	$2,638.00	$1,451.00	2026-04-27
4253021	CDM	Hdr Brach Dist 9-12	6	5	$2,638.00	$2,638.00	$1,055.00	$2,638.00	$1,451.00	2026-04-27
4253200	CDM	Remaft Hi Int Brach>	6	5	$3,603.00	$3,603.00	$1,441.00	$3,603.00	$1,982.00	2026-04-27
4253202	CDM	Hdr Brach Dist>12 Sr	6	5	$3,603.00	$3,603.00	$1,441.00	$3,603.00	$1,982.00	2026-04-27
43215	CPT	Esophagos W/fb Rem	6	5	$1,612.00	$184.00 89% off	$645.00	$1,612.00	$887.00	2026-04-27
43219	CPT	Esophagos W/stent In	6	5	$4,957.00	$4,957.00	$1,983.00	$4,957.00	$2,726.00	2026-04-27
43236	CPT	Egd W/dir Submuc Inj	6	5	$1,696.00	$178.00 90% off	$678.00	$1,696.00	$933.00	2026-04-27
43239	CPT	Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope	6	5	$1,697.00	$178.00 90% off	$679.00	$1,697.00	$933.00	2026-04-27
43240	CPT	Egd W/drainage Of Ps	6	5	$3,575.00	$494.00 86% off	$1,430.00	$3,575.00	$1,966.00	2026-04-27
43241	CPT	Egd W/tube/cath/ J T	6	5	$2,349.00	$183.00 92% off	$940.00	$2,349.00	$1,292.00	2026-04-27
43242	CPT	Egd W/us Fna	6	5	$4,320.00	$332.00 92% off	$1,728.00	$4,320.00	$2,376.00	2026-04-27
43243	CPT	Egd W/inj Sclerosis	6	5	$2,349.00	$302.00 87% off	$940.00	$2,349.00	$1,292.00	2026-04-27
43244	CPT	Egd W/band Ligation	6	5	$3,104.00	$311.00 90% off	$1,242.00	$3,104.00	$1,707.00	2026-04-27
43245	CPT	Egd With Dilation Of G	6	5	$2,084.00	$226.00 89% off	$834.00	$2,084.00	$1,146.00	2026-04-27
43246	CPT	Egd W/perc Tube Plac	6	5	$1,812.00	$257.00 86% off	$725.00	$1,812.00	$997.00	2026-04-27
43247	CPT	Egd W/removal Fb	6	5	$3,011.00	$227.00 92% off	$1,204.00	$3,011.00	$1,656.00	2026-04-27
43248	CPT	Egd With Dil Of Esoph	6	5	$2,349.00	$214.00 91% off	$940.00	$2,349.00	$1,292.00	2026-04-27
43249	CPT	Egd W/ball Dilat Eso	6	5	$1,840.00	$197.00 89% off	$736.00	$1,840.00	$1,012.00	2026-04-27
43250	CPT	Egd W/hot Biopsy Rem	6	5	$2,349.00	$220.00 91% off	$940.00	$2,349.00	$1,292.00	2026-04-27
43251	CPT	Egd W/snare Techniqu	6	5	$2,349.00	$250.00 89% off	$940.00	$2,349.00	$1,292.00	2026-04-27
43255	CPT	Egd W/cntrl Bleeding	6	5	$1,832.00	$256.00 86% off	$733.00	$1,832.00	$1,008.00	2026-04-27
43256	CPT	Egd W/stent Placemen	6	5	$3,575.00	$3,575.00	$1,430.00	$3,575.00	$1,966.00	2026-04-27
43258	CPT	Egd Ablation Other	6	5	$2,349.00	$2,349.00	$940.00	$2,349.00	$1,292.00	2026-04-27
43259	CPT	Egd W/ultrasound Exm	6	5	$3,757.00	$287.00 92% off	$1,503.00	$3,757.00	$2,066.00	2026-04-27
43261	CPT	Ercp W/biopsy	6	5	$2,211.00	$427.00 81% off	$884.00	$2,211.00	$1,216.00	2026-04-27
43262	CPT	Ercp W/sphincterotom	6	5	$2,676.00	$450.00 83% off	$1,070.00	$2,676.00	$1,472.00	2026-04-27
43263	CPT	Ercp W/sphincter Odd	6	5	$2,676.00	$451.00 83% off	$1,070.00	$2,676.00	$1,472.00	2026-04-27
43264	CPT	Ercp W/stone Removal	6	5	$2,676.00	$459.00 83% off	$1,070.00	$2,676.00	$1,472.00	2026-04-27
43265	CPT	Ercp W/lithotripsy	6	5	$2,676.00	$545.00 80% off	$1,070.00	$2,676.00	$1,472.00	2026-04-27
43267	CPT	Ercp W/insert Nasobi	6	5	$3,030.00	$3,030.00	$1,212.00	$3,030.00	$1,667.00	2026-04-27
43268	CPT	Ercp W/stent Insert	6	5	$2,676.00	$2,676.00	$1,070.00	$2,676.00	$1,472.00	2026-04-27
43269	CPT	Ercp W/stent Rem/chg	6	5	$2,676.00	$2,676.00	$1,070.00	$2,676.00	$1,472.00	2026-04-27
43271	CPT	Ercp W/baln Dilation	6	5	$2,676.00	$2,676.00	$1,070.00	$2,676.00	$1,472.00	2026-04-27
43272	CPT	Ercp W/ablation Othr	6	5	$2,676.00	$2,676.00	$1,070.00	$2,676.00	$1,472.00	2026-04-27
43499	CPT	Unlisted Procedure E	6	5	$1,782.00	$1,782.00	$713.00	$1,782.00	$980.00	2026-04-27
4406057	CDM	Abciximab 2mg/ml	6	5	$1,685.00	$1,685.00	$674.00	$1,685.00	$927.00	2026-04-27
4406262	CDM	Drotrecogin 20mg Inj	6	5	$2,949.00	$2,949.00	$1,180.00	$2,949.00	$1,622.00	2026-04-27
4406466	CDM	Palivizumab 50mg Via	6	5	$1,880.00	$1,880.00	$752.00	$1,880.00	$1,034.00	2026-04-27
4406507	CDM	Ribavirin 6g 1 Ea	6	5	$4,125.00	$4,125.00	$1,650.00	$4,125.00	$2,269.00	2026-04-27
4406540	CDM	Tenecteplase 50mg In	6	5	$5,402.00	$5,402.00	$2,161.00	$5,401.00	$2,971.00	2026-04-27
4406561	CDM	Topotecan Hcl 4mg 1e	6	5	$2,159.00	$2,159.00	$864.00	$2,159.00	$1,187.00	2026-04-27
44370	CPT	Endo Sml Bwl W/trans	6	5	$6,487.00	$340.00 95% off	$2,595.00	$6,486.00	$3,568.00	2026-04-27
44372	CPT	Small Bowel Endo With	6	5	$1,651.00	$306.00 81% off	$660.00	$1,651.00	$908.00	2026-04-27
44373	CPT	Small Bowel Endo G T	6	5	$1,651.00	$246.00 85% off	$660.00	$1,651.00	$908.00	2026-04-27
44376	CPT	Small Bowel Endoscop	6	5	$1,726.00	$359.00 79% off	$690.00	$1,726.00	$949.00	2026-04-27
44377	CPT	Small Bowel Endo Inc	6	5	$1,726.00	$377.00 78% off	$690.00	$1,726.00	$949.00	2026-04-27
44378	CPT	Small Bow Endo Inc I	6	5	$1,726.00	$484.00 72% off	$690.00	$1,726.00	$949.00	2026-04-27
45100	CPT	Biopsy Anorectal Wal	6	5	$4,337.00	$432.00 90% off	$1,735.00	$4,337.00	$2,385.00	2026-04-27
45341	CPT	Flex Sigmoidoscopy W	6	5	$1,889.00	$161.00 91% off	$756.00	$1,889.00	$1,039.00	2026-04-27
45342	CPT	Flex Sigmoidoscopy W	6	5	$2,172.00	$219.00 90% off	$869.00	$2,172.00	$1,195.00	2026-04-27
45345	CPT	Flex Sigmoid W/stent	6	5	$2,600.00	$2,600.00	$1,040.00	$2,600.00	$1,430.00	2026-04-27
45378	CPT	Diagnostic Exam Of Large Bowel Using An Endoscope	12	5	$1,600.00	$238.00 85% off	$630.00	$1,626.00	$894.00	2026-04-27
45379	CPT	Colonoscopy W/rem Fo	6	5	$2,515.00	$303.00 88% off	$1,006.00	$2,515.00	$1,383.00	2026-04-27
45380	CPT	Biopsy Exam Of Large Bowel Using An Endoscope	6	5	$1,996.00	$257.00 87% off	$798.00	$1,996.00	$1,098.00	2026-04-27
45381	CPT	Colon With Directed Su	6	5	$2,079.00	$257.00 88% off	$832.00	$2,079.00	$1,143.00	2026-04-27
45382	CPT	Colonoscopy W/contro	6	5	$2,079.00	$328.00 84% off	$832.00	$2,079.00	$1,143.00	2026-04-27
45383	CPT	Colonoscopy W/ablati	6	5	$2,079.00	$2,079.00	$832.00	$2,079.00	$1,143.00	2026-04-27
45384	CPT	Colonoscopy W/hot Bi	6	5	$2,079.00	$293.00 86% off	$832.00	$2,079.00	$1,143.00	2026-04-27
45385	CPT	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope	6	5	$2,079.00	$323.00 84% off	$832.00	$2,079.00	$1,143.00	2026-04-27
45386	CPT	Colon With Dilation By	6	5	$2,079.00	$271.00 87% off	$832.00	$2,079.00	$1,143.00	2026-04-27
45387	CPT	Colonos W Transendo	6	5	$3,461.00	$3,461.00	$1,384.00	$3,461.00	$1,904.00	2026-04-27
47382	CPT	Ablation Liver Tumor	6	5	$3,902.00	$929.00 76% off	$1,561.00	$3,902.00	$2,146.00	2026-04-27
49423	CPT	Exchange Prev Place	6	5	$1,732.00	$88.00 95% off	$693.00	$1,732.00	$953.00	2026-04-27
50200	CPT	Bx Renal Perc Needle	6	5	$2,249.00	$160.00 93% off	$900.00	$2,249.00	$1,237.00	2026-04-27
50590	CPT	Lithotripsy Bilatera	6	5	$9,443.00	$751.00 92% off	$3,777.00	$9,442.00	$5,194.00	2026-04-27
53899	CPT	Renal Cyst Ablation	6	5	$2,057.00	$2,057.00	$823.00	$2,057.00	$1,131.00	2026-04-27
55700	CPT	Biopsy Of Prostate Gland	6	5	$1,694.00	$1,694.00	$678.00	$1,694.00	$932.00	2026-04-27
55875	CPT	Transperineal Needle	6	5	$4,437.00	$993.00 78% off	$1,775.00	$4,437.00	$2,440.00	2026-04-27
58823	CPT	Drain Pelv Abcess Tr	6	5	$1,645.00	$1,645.00	$658.00	$1,645.00	$905.00	2026-04-27
60699	CPT	Adrenal Tumor Ablati	6	5	$2,296.00	$2,296.00	$918.00	$2,296.00	$1,263.00	2026-04-27
64561	CPT	Percut Imp Neuro Bil	6	5	$19,452.00	$391.00 98% off	$7,781.00	$19,450.00	$10,699.00	2026-04-27
70336	CPT	MRI Tmj	6	5	$1,821.00	$400.00 78% off	$728.00	$1,821.00	$1,002.00	2026-04-27
70450	CPT	CT Scan	6	5	$1,757.00	$250.00 86% off	$703.00	$1,757.00	$966.00	2026-04-27
70460	CPT	CT Head Or Brain W/c	6	5	$1,651.00	$300.00 82% off	$660.00	$1,651.00	$908.00	2026-04-27
70470	CPT	CT Head Or Brain Wwo	6	5	$1,912.00	$350.00 82% off	$765.00	$1,912.00	$1,052.00	2026-04-27
70481	CPT	CT Iac With Con	6	5	$2,011.00	$300.00 85% off	$804.00	$2,011.00	$1,106.00	2026-04-27
70482	CPT	CT Iac W/o-w Con	6	5	$2,800.00	$350.00 88% off	$1,120.00	$2,800.00	$1,540.00	2026-04-27
70486	CPT	CT Maxillofacial Without	12	5	$1,967.00	$250.00 87% off	$770.00	$2,009.00	$1,105.00	2026-04-27
70487	CPT	CT Maxillofacial With	6	5	$2,068.00	$300.00 85% off	$827.00	$2,068.00	$1,137.00	2026-04-27
70488	CPT	CT Maxillofac W/&without	6	5	$2,469.00	$350.00 86% off	$988.00	$2,469.00	$1,358.00	2026-04-27
70491	CPT	CT Neck St With Cont	6	5	$1,879.00	$300.00 84% off	$752.00	$1,879.00	$1,033.00	2026-04-27
70492	CPT	CT Neck St With & Without	6	5	$2,143.00	$350.00 84% off	$857.00	$2,143.00	$1,179.00	2026-04-27
70540	CPT	MRI Orbit/face/neck	6	5	$1,874.00	$400.00 79% off	$750.00	$1,874.00	$1,031.00	2026-04-27
70542	CPT	MRI Orbit/face/neck	6	5	$2,811.00	$500.00 82% off	$1,124.00	$2,811.00	$1,546.00	2026-04-27
70543	CPT	MRI Orbit/face/neck	6	5	$2,343.00	$500.00 79% off	$937.00	$2,343.00	$1,289.00	2026-04-27
70544	CPT	MRA Head Without Con	6	5	$1,888.00	$400.00 79% off	$755.00	$1,888.00	$1,038.00	2026-04-27
70545	CPT	MRA Head W/con	6	5	$2,094.00	$500.00 76% off	$838.00	$2,094.00	$1,152.00	2026-04-27
70546	CPT	MRA Head W/o-w Con	6	5	$3,146.00	$500.00 84% off	$1,258.00	$3,146.00	$1,730.00	2026-04-27
70547	CPT	MRA Neck Without Con	6	5	$1,807.00	$400.00 78% off	$723.00	$1,807.00	$994.00	2026-04-27
70548	CPT	MRA Neck W/con	6	5	$2,631.00	$500.00 81% off	$1,052.00	$2,631.00	$1,447.00	2026-04-27
70549	CPT	MRA Neck W/o-w Con	6	5	$2,637.00	$500.00 81% off	$1,055.00	$2,637.00	$1,450.00	2026-04-27
70551	CPT	MRI Brain Without Con	6	5	$1,823.00	$400.00 78% off	$729.00	$1,823.00	$1,003.00	2026-04-27
70552	CPT	MRI Brain W/con	6	5	$2,127.00	$500.00 76% off	$851.00	$2,127.00	$1,170.00	2026-04-27
70553	CPT	MRI Scan	6	5	$3,354.00	$500.00 85% off	$1,342.00	$3,354.00	$1,845.00	2026-04-27
71260	CPT	CT Chest W/con	6	5	$2,276.00	$300.00 87% off	$910.00	$2,276.00	$1,252.00	2026-04-27
71270	CPT	CT Chest W/& Without Con	6	5	$2,585.00	$350.00 86% off	$1,034.00	$2,585.00	$1,422.00	2026-04-27
71275	CPT	CT Angio Chest W/o-w	6	5	$1,774.00	$350.00 80% off	$710.00	$1,774.00	$976.00	2026-04-27
71550	CPT	MRI Chest Without Con	6	5	$2,449.00	$400.00 84% off	$980.00	$2,449.00	$1,347.00	2026-04-27
71551	CPT	MRI Chest W/con	6	5	$2,425.00	$500.00 79% off	$970.00	$2,425.00	$1,334.00	2026-04-27
71552	CPT	MRI Chest W/o-w Con	6	5	$3,059.00	$500.00 84% off	$1,224.00	$3,059.00	$1,682.00	2026-04-27
72126	CPT	CT Cervical Spine With	6	5	$2,191.00	$300.00 86% off	$876.00	$2,191.00	$1,205.00	2026-04-27
72127	CPT	CT Spine Cerv W/o-w	6	5	$2,849.00	$350.00 88% off	$1,140.00	$2,849.00	$1,567.00	2026-04-27
72128	CPT	CT Spine Thor Without Co	6	5	$1,598.00	$250.00 84% off	$639.00	$1,598.00	$879.00	2026-04-27
72129	CPT	CT Spine Thor With Con	6	5	$2,226.00	$300.00 87% off	$890.00	$2,226.00	$1,224.00	2026-04-27
72130	CPT	CT Spine Thor W/o-w	6	5	$3,093.00	$350.00 89% off	$1,237.00	$3,093.00	$1,701.00	2026-04-27
72131	CPT	CT Spine Lumb Without	6	5	$1,752.00	$250.00 86% off	$701.00	$1,752.00	$964.00	2026-04-27
72132	CPT	CT Lumbar Spine With C	6	5	$2,440.00	$300.00 88% off	$976.00	$2,440.00	$1,342.00	2026-04-27
72133	CPT	CT Spine Lumb W/o-w	6	5	$3,400.00	$350.00 90% off	$1,360.00	$3,400.00	$1,870.00	2026-04-27
72141	CPT	MRI Spine Cerv Without	6	5	$2,232.00	$400.00 82% off	$893.00	$2,232.00	$1,228.00	2026-04-27
72142	CPT	MRI Spine Cerv With	6	5	$2,565.00	$500.00 81% off	$1,026.00	$2,565.00	$1,411.00	2026-04-27
72146	CPT	MRI Spine Thora Without	6	5	$2,013.00	$400.00 80% off	$805.00	$2,013.00	$1,107.00	2026-04-27
72147	CPT	MRI Spine Thora With	6	5	$2,049.00	$500.00 76% off	$820.00	$2,049.00	$1,127.00	2026-04-27
72148	CPT	MRI Scan Of Lower Spinal Canal	6	5	$2,682.00	$400.00 85% off	$1,073.00	$2,682.00	$1,475.00	2026-04-27
72149	CPT	MRI Spine Lumb With	6	5	$2,627.00	$500.00 81% off	$1,051.00	$2,627.00	$1,445.00	2026-04-27
72156	CPT	MRI Spine Cerv W/wo	6	5	$3,101.00	$500.00 84% off	$1,240.00	$3,101.00	$1,706.00	2026-04-27
72157	CPT	MRI Spine Thora W/wo	6	5	$2,679.00	$500.00 81% off	$1,072.00	$2,679.00	$1,473.00	2026-04-27
72158	CPT	MRI Spine Lumb W/wo	6	5	$2,962.00	$500.00 83% off	$1,185.00	$2,962.00	$1,629.00	2026-04-27
72159	CPT	MRA Spine Canal W Or	6	5	$2,409.00	$500.00 79% off	$964.00	$2,409.00	$1,325.00	2026-04-27
72191	CPT	CT Angio Pelvis W/o-	6	5	$1,650.00	$350.00 79% off	$660.00	$1,650.00	$908.00	2026-04-27
72192	CPT	CT Pelvis Without Con	6	5	$1,831.00	$250.00 86% off	$732.00	$1,831.00	$1,007.00	2026-04-27
72193	CPT	CT Scan Of Pelvis With Contrast	6	5	$2,059.00	$300.00 85% off	$824.00	$2,059.00	$1,132.00	2026-04-27
72194	CPT	CT Pelvis W/o-w Con	6	5	$2,081.00	$350.00 83% off	$832.00	$2,081.00	$1,145.00	2026-04-27
72195	CPT	MRI Pelvis Without Con	6	5	$2,018.00	$400.00 80% off	$807.00	$2,018.00	$1,110.00	2026-04-27
72196	CPT	MRI Pelvis W/con	6	5	$2,432.00	$500.00 79% off	$973.00	$2,432.00	$1,338.00	2026-04-27
72197	CPT	MRI Pelvis W/o-w Con	6	5	$2,479.00	$500.00 80% off	$992.00	$2,479.00	$1,363.00	2026-04-27
73200	CPT	CT Up Ext Without Bilat	12	5	$1,878.00	$250.00 87% off	$567.00	$2,339.00	$1,286.00	2026-04-27
73201	CPT	CT Up Ext W/con Bila	12	5	$2,624.50	$300.00 89% off	$792.00	$3,268.00	$1,797.00	2026-04-27
73202	CPT	CT Up Ext W/o-w Bila	12	5	$3,028.50	$350.00 88% off	$914.00	$3,771.00	$2,074.00	2026-04-27
73206	CPT	CT Angio Ue With Co Bi	12	5	$3,282.00	$350.00 89% off	$502.00	$5,307.00	$1,689.50	2026-04-27
73218	CPT	MRI Ue Without Con Bilat	12	5	$3,215.50	$400.00 88% off	$971.00	$4,004.00	$2,202.00	2026-04-27
73219	CPT	MRI Upper Extr With Co	12	5	$3,229.50	$500.00 85% off	$1,232.00	$3,380.00	$1,859.00	2026-04-27
73220	CPT	MRI Ue Wwo Unilat	12	5	$3,174.50	$500.00 84% off	$958.00	$3,953.00	$2,174.00	2026-04-27
73221	CPT	MRI Ue Joint Without Uni	12	5	$2,983.50	$400.00 87% off	$901.00	$3,715.00	$2,043.00	2026-04-27
73222	CPT	MRI Ue Joint With Uni	12	5	$2,281.50	$500.00 78% off	$870.00	$2,388.00	$1,313.00	2026-04-27
73223	CPT	MRI Ue Joint Wwo Uni	12	5	$3,435.50	$500.00 85% off	$1,037.00	$4,278.00	$2,353.00	2026-04-27
73225	CPT	MRA Upper Extr W-without	12	5	$2,255.00	$500.00 78% off	$860.00	$2,360.00	$1,298.00	2026-04-27
73700	CPT	CT Bilat Le Without	12	5	$1,287.00	$250.00 81% off	$388.00	$1,603.00	$882.00	2026-04-27
73701	CPT	CT Le W/con Bilat	12	5	$1,965.00	$300.00 85% off	$593.00	$2,447.00	$1,346.00	2026-04-27
73702	CPT	CT Le W/& Without Con Bi	12	5	$2,275.00	$350.00 85% off	$687.00	$2,833.00	$1,558.00	2026-04-27
73706	CPT	CT Angio Extr Lower	12	5	$3,166.50	$350.00 89% off	$604.00	$4,823.00	$1,719.50	2026-04-27
73718	CPT	MRI Le Non Jt No Con	12	5	$3,416.00	$400.00 88% off	$834.00	$4,747.00	$2,085.00	2026-04-27
73719	CPT	MRI Le W/con Bilat	12	5	$2,105.00	$500.00 76% off	$804.00	$2,201.00	$1,211.00	2026-04-27
73720	CPT	MRI Le Wwo Con Bilat	12	5	$3,769.00	$500.00 87% off	$1,045.00	$4,925.00	$2,613.00	2026-04-27
73721	CPT	MRI Scan Of Leg Joint	12	5	$3,865.00	$400.00 90% off	$998.00	$5,235.00	$2,494.00	2026-04-27
73722	CPT	MRI Le Joint With Bila	12	5	$2,559.00	$500.00 80% off	$962.00	$2,714.00	$1,493.00	2026-04-27
73723	CPT	MRI Le Joint Wwo Bil	12	5	$4,022.00	$500.00 88% off	$1,178.00	$5,099.00	$2,805.00	2026-04-27
74150	CPT	CT Abdomen Without Con	6	5	$1,900.00	$250.00 87% off	$760.00	$1,900.00	$1,045.00	2026-04-27
74160	CPT	CT Abdomen With Con	6	5	$2,574.00	$300.00 88% off	$1,030.00	$2,574.00	$1,416.00	2026-04-27
74170	CPT	CT Abd Without And W Con	6	5	$2,790.00	$350.00 87% off	$1,116.00	$2,790.00	$1,535.00	2026-04-27
74174	CPT	CTA Abd/pel	6	5	$3,027.00	$350.00 88% off	$1,211.00	$3,027.00	$1,665.00	2026-04-27
74175	CPT	CT Angio Abdomen	6	5	$1,997.00	$350.00 82% off	$799.00	$1,997.00	$1,098.00	2026-04-27
74176	CPT	Abd & Pel Wo Contras	12	5	$1,844.00	$250.00 86% off	$630.00	$2,112.00	$1,162.00	2026-04-27
74177	CPT	CT Scan Of Abdomen And Pelvis With Contrast	11	5	$2,010.00	$300.00 85% off	$804.00	$2,010.00	$1,106.00	2026-04-27
74178	CPT	Abd Pel W Wo Urogram	12	5	$2,845.50	$250.00 91% off	$1,092.00	$2,961.00	$1,629.00	2026-04-27
74181	CPT	MRI Abdomen Without Cont	6	5	$2,479.00	$400.00 84% off	$992.00	$2,479.00	$1,363.00	2026-04-27
74182	CPT	MRI Abdomen W/con	6	5	$2,816.00	$500.00 82% off	$1,126.00	$2,816.00	$1,549.00	2026-04-27
74183	CPT	MRI Abdomen W/o-w Co	6	5	$3,240.00	$500.00 85% off	$1,296.00	$3,240.00	$1,782.00	2026-04-27
74185	CPT	MRA Abdomen With Contr	18	5	$2,221.00	$500.00 77% off	$741.00	$2,278.00	$1,237.50	2026-04-27
75635	CPT	CT Angio Aorta With	6	5	$1,801.00	$250.00 86% off	$720.00	$1,801.00	$991.00	2026-04-27
75716	CPT	Angio Extremity Bila	6	5	$1,801.00	$232.00 87% off	$720.00	$1,801.00	$991.00	2026-04-27
76390	CPT	MRI Spectroscopy	6	5	$1,680.00	$1,680.00	$672.00	$1,680.00	$924.00	2026-04-27
77031	CPT	Breast Loc Guide Bx/	6	5	$1,803.00	$1,803.00	$721.00	$1,803.00	$992.00	2026-04-27
77295	CPT	Simulation 3d	6	5	$5,050.00	$280.00 94% off	$2,020.00	$5,049.00	$2,778.00	2026-04-27
77301	CPT	Imrt Course	6	5	$5,169.00	$1,554.00 70% off	$2,068.00	$5,168.00	$2,843.00	2026-04-27
77370	CPT	Spl Physics Consult	6	5	$2,580.00	$159.00 94% off	$1,032.00	$2,580.00	$1,419.00	2026-04-27
77372	CPT	Srs Linear Based	6	5	$11,098.00	$1,036.00 91% off	$4,439.00	$11,097.00	$6,104.00	2026-04-27
77373	CPT	Sbrt Delivery	6	5	$5,937.00	$1,082.00 82% off	$2,375.00	$5,936.00	$3,265.00	2026-04-27
77385	CPT	Imrt Simple	6	5	$2,089.00	$2,089.00	$836.00	$2,089.00	$1,149.00	2026-04-27
77386	CPT	Complex Imrt	6	5	$2,089.00	$2,089.00	$836.00	$2,089.00	$1,149.00	2026-04-27
77432	CPT	Sterotactic Radiatio	6	5	$2,647.00	$612.00 77% off	$1,059.00	$2,647.00	$1,456.00	2026-04-27
77435	CPT	Sbrt Management	6	5	$3,991.00	$711.00 82% off	$1,596.00	$3,991.00	$2,195.00	2026-04-27
77470	CPT	Spl Treatment Proc	6	5	$2,580.00	$156.00 94% off	$1,032.00	$2,580.00	$1,419.00	2026-04-27
77762	CPT	Intracav Rad Src Int	6	5	$1,642.00	$797.00 51% off	$657.00	$1,642.00	$903.00	2026-04-27
77763	CPT	Intracav Rad Src Com	6	5	$1,642.00	$1,132.00 31% off	$657.00	$1,642.00	$903.00	2026-04-27
77778	CPT	Interst Radtx Cmplx	6	5	$2,905.00	$1,330.00 54% off	$1,162.00	$2,905.00	$1,598.00	2026-04-27
77799	CPT	Intravasc Brachy	6	5	$2,452.00	$2,452.00	$981.00	$2,452.00	$1,349.00	2026-04-27
78315	CPT	Bone Scan 3 Phase	6	5	$1,740.00	$429.00 75% off	$696.00	$1,740.00	$957.00	2026-04-27
78320	CPT	Bone Scan Tomo Spect	6	5	$1,740.00	$1,740.00	$696.00	$1,740.00	$957.00	2026-04-27
78459	CPT	PET Myocard Metabol	6	5	$1,957.00	$1,957.00	$783.00	$1,957.00	$1,076.00	2026-04-27
78473	CPT	Cardiac Scan Gated M	6	5	$1,984.00	$378.00 81% off	$794.00	$1,984.00	$1,091.00	2026-04-27
78608	CPT	PET Brain Imet Eval	6	5	$3,035.00	$3,035.00	$1,214.00	$3,035.00	$1,669.00	2026-04-27
78609	CPT	PET Brain Perfuse Ev	6	5	$3,035.00	$3,035.00	$1,214.00	$3,035.00	$1,669.00	2026-04-27
78804	CPT	Tumor Local Whole Bo	6	5	$2,565.00	$791.00 69% off	$1,026.00	$2,565.00	$1,411.00	2026-04-27
78811	CPT	PET Tumor Limit Area	6	5	$3,142.00	$3,142.00	$1,257.00	$3,142.00	$1,728.00	2026-04-27
78812	CPT	PET Tumor Skull-midt	6	5	$3,667.00	$3,667.00	$1,467.00	$3,667.00	$2,017.00	2026-04-27
78813	CPT	PET Tumor Whole Body	6	5	$4,191.00	$4,191.00	$1,676.00	$4,191.00	$2,305.00	2026-04-27
78814	CPT	PET CT Tumor Ltd Are	6	5	$4,222.00	$4,222.00	$1,689.00	$4,222.00	$2,322.00	2026-04-27
78815	CPT	PET CT Tumor Skulmid	6	5	$4,716.00	$4,716.00	$1,886.00	$4,716.00	$2,594.00	2026-04-27
78816	CPT	PET CT Tumor Whole B	6	5	$5,248.00	$5,248.00	$2,099.00	$5,247.00	$2,886.00	2026-04-27
79403	CPT	Hematopoietic Nuclea	6	5	$1,783.00	$225.00 87% off	$713.00	$1,783.00	$981.00	2026-04-27
90376	CPT	Bayrab 150u/ml(gn) 2	12	5	$1,661.50	$1,661.50	$305.00	$2,560.00	$893.50	2026-04-27
91020	CPT	Gastric Motility Stu	6	5	$2,816.00	$437.00 84% off	$1,126.00	$2,816.00	$1,549.00	2026-04-27
91065	CPT	Breath Hydrogen Test	6	5	$2,849.00	$91.00 97% off	$1,140.00	$2,849.00	$1,567.00	2026-04-27
95805	CPT	Multiple Sleep Laten	6	5	$2,025.00	$677.00 67% off	$810.00	$2,025.00	$1,114.00	2026-04-27
95810	CPT	Sleep Study	6	5	$3,147.00	$953.00 70% off	$1,259.00	$3,147.00	$1,731.00	2026-04-27
95811	CPT	Split Night Polysomn	6	5	$3,538.00	$1,001.00 72% off	$1,415.00	$3,538.00	$1,946.00	2026-04-27
A4642	HCPCS	In-111 Oncoscint Per	6	5	$1,919.00	$1,919.00	$768.00	$1,919.00	$1,055.00	2026-04-27
A9507	HCPCS	In-111 Capromab Pend	6	5	$4,653.00	$4,653.00	$1,861.00	$4,653.00	$2,559.00	2026-04-27
A9508	HCPCS	I-131 Mibg Inj Per 0	6	5	$2,878.00	$2,878.00	$1,151.00	$2,878.00	$1,583.00	2026-04-27
A9521	HCPCS	Tc-99m Ceretec Inj P	6	5	$6,695.00	$6,695.00	$2,678.00	$6,694.00	$3,682.00	2026-04-27
C1717	HCPCS	Brach Src Hdr Ir-192	6	5	$1,609.00	$1,609.00	$644.00	$1,609.00	$885.00	2026-04-27
C1874	HCPCS	Stent Coated Covered	6	5	$4,374.00	$4,374.00	$1,750.00	$4,374.00	$2,406.00	2026-04-27
C1876	HCPCS	Stent Non Coated Cov	6	5	$4,855.00	$4,855.00	$1,942.00	$4,855.00	$2,670.00	2026-04-27
C2616	HCPCS	Brachytx Source Yttr	6	5	$29,849.00	$29,849.00	$11,940.00	$29,846.00	$16,417.00	2026-04-27
C8903	HCPCS	MRI Breast Unilatera	6	5	$2,233.00	$2,233.00	$893.00	$2,233.00	$1,228.00	2026-04-27
C8904	HCPCS	MRI Breast Unilatera	6	5	$1,717.00	$1,717.00	$687.00	$1,717.00	$944.00	2026-04-27
C8905	HCPCS	MRI Breast Bilateral	12	5	$2,694.00	$2,694.00	$693.00	$3,656.00	$1,732.00	2026-04-27
C8906	HCPCS	MRI Breast Bilateral	6	5	$3,685.00	$3,685.00	$1,474.00	$3,685.00	$2,027.00	2026-04-27
C8907	HCPCS	MRI Breast Bilateral	6	5	$2,493.00	$2,493.00	$997.00	$2,493.00	$1,371.00	2026-04-27
C8909	HCPCS	MRA Chest With Contras	6	5	$2,043.00	$2,043.00	$817.00	$2,043.00	$1,124.00	2026-04-27
C8910	HCPCS	MRA Chest Without Contra	6	5	$1,793.00	$1,793.00	$717.00	$1,793.00	$986.00	2026-04-27
C8911	HCPCS	MRA Chest W/o-w Cont	6	5	$2,498.00	$2,498.00	$999.00	$2,498.00	$1,374.00	2026-04-27
C8912	HCPCS	MRA Le With Contrast	6	5	$2,829.00	$2,829.00	$1,132.00	$2,829.00	$1,556.00	2026-04-27
C8913	HCPCS	MRA Le Without Contrast	6	5	$2,176.00	$2,176.00	$870.00	$2,176.00	$1,197.00	2026-04-27
C8914	HCPCS	MRA Le W/wo Contrast	6	5	$2,327.00	$2,327.00	$931.00	$2,327.00	$1,280.00	2026-04-27
C8920	HCPCS	MRA Pelvis W/ow/	6	5	$1,610.00	$1,610.00	$644.00	$1,610.00	$886.00	2026-04-27
J0130	HCPCS	Abciximab 10mg Inj	12	5	$4,730.00	$4,730.00	$413.00	$8,426.00	$2,202.00	2026-04-27
J0350	HCPCS	Anistreplase 30u 1 E	6	5	$5,111.00	$5,111.00	$2,044.00	$5,110.00	$2,811.00	2026-04-27
J0480	HCPCS	Basiliximab 20mg 1 E	6	5	$2,868.00	$2,868.00	$1,147.00	$2,868.00	$1,577.00	2026-04-27
J0740	HCPCS	Cidofovir 75mg/ml 5	6	5	$2,039.00	$2,039.00	$816.00	$2,039.00	$1,121.00	2026-04-27
J0850	HCPCS	Cytomegaloimm Glob 2	6	5	$3,391.00	$3,391.00	$1,356.00	$3,391.00	$1,865.00	2026-04-27
J1162	HCPCS	Digoxin Imm Fab 40mg	6	5	$2,139.00	$2,139.00	$856.00	$2,139.00	$1,176.00	2026-04-27
J2505	HCPCS	Pegfilgrastim 6mg In	6	5	$6,058.00	$6,058.00	$2,423.00	$6,057.00	$3,332.00	2026-04-27
J2993	HCPCS	Reteplase 18.1mg Inj	6	5	$2,119.00	$2,119.00	$848.00	$2,119.00	$1,165.00	2026-04-27
J3240	HCPCS	Thyrotropin Alpha 0.	6	5	$3,995.00	$3,995.00	$1,598.00	$3,995.00	$2,197.00	2026-04-27
J7310	HCPCS	Ganciclovir 4.5mg Oc	6	5	$11,022.00	$11,022.00	$4,409.00	$11,021.00	$6,062.00	2026-04-27
J7311	HCPCS	Fluocinolone Acet In	6	5	$51,693.00	$51,693.00	$20,677.00	$51,688.00	$28,431.00	2026-04-27
J7505	HCPCS	Muromonab-cd3 1mg/ml	6	5	$2,229.00	$2,229.00	$892.00	$2,229.00	$1,226.00	2026-04-27
J9015	HCPCS	Aldesleukin 22mmu 1e	6	5	$2,070.00	$2,070.00	$828.00	$2,070.00	$1,139.00	2026-04-27
J9160	HCPCS	Denileukin Diftitox	6	5	$2,296.00	$2,296.00	$918.00	$2,296.00	$1,263.00	2026-04-27
J9217	HCPCS	Leuprolide 7.5mg 1e	6	5	$1,665.00	$1,665.00	$666.00	$1,665.00	$916.00	2026-04-27
J9219	HCPCS	Leuprolide Acet Imp	6	5	$10,056.00	$10,056.00	$4,022.00	$10,055.00	$5,531.00	2026-04-27
J9268	HCPCS	Pentostatin 10mg 1 E	6	5	$5,207.00	$5,207.00	$2,083.00	$5,206.00	$2,864.00	2026-04-27
J9300	HCPCS	Gemtuzumab Ozogamici	6	5	$6,750.00	$6,750.00	$2,700.00	$6,749.00	$3,713.00	2026-04-27
J9600	HCPCS	Porfimer Sodium 75mg	6	5	$4,940.00	$4,940.00	$1,976.00	$4,940.00	$2,717.00	2026-04-27

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