Price Transparencybeta Hospital negotiated rates

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

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Hospital

ALTUS HOUSTON HOSPITAL, LP

Houston, TX · CCN 670135 · Rates published

3,193 distinct procedures filed
3 distinct payers
22,909 rate rows
2026-05-28 last MRF observed
Data quality

20,019 of 22,909 rate rows are consumer-grade (87.4%)

2,890 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
template filing: same amount across many unrelated codes — excluded 2,880
exceeds 10× this hospital's gross charge — excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/ZWAM-1739310256610/machine-readable/474624853_west-chase-houston-hospital_standardcharges.json
Found on page https://wchh.care/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 0fae947cfac39a7f… · 221,827 bytes · first seen 2026-05-15

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
CP17428471194763655
CDM 		Spinal Fusion Except Cervical Without Mcc 1 $98,535.00 $98,535.00 $98,535.00 nat. median
$98,535
1.0× median
CP17428471194766026
CDM 		Cervical Spinal Fusion Without Cc Or Mcc 1 $91,972.00 $91,972.00 $91,972.00 nat. median
$91,972
1.0× median
CP17428471194764672
CDM 		Cardiac Valve Or Cardiothoracic Procedure With Cardiac Catheterization With Mcc 1 $79,558.00 $79,558.00 $79,558.00 nat. median
$79,558
1.0× median
CP17428471194763579
CDM 		Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 1 $78,554.00 $78,554.00 $78,554.00 nat. median
$78,554
1.0× median
C1820
HCPCS 		B.s Precision Montage MRI 16contact Impl 1 $3,200.00 $109,720.00 $70,600.00 nat. median
$22,013
outlier · 3.2×
2203406
CDM 		Or Level 7 1st 30min 1 $65,341.00 $65,341.00 $65,341.00 nat. median
$65,341
1.0× median
2203404
CDM 		Or Level 5 1st 30min 1 $49,502.00 $49,502.00 $49,502.00 nat. median
$139
outlier · 355.1×
C1767
HCPCS 		Medtronic Interstim Ii 1 $46,720.00 $46,720.00 $46,720.00 nat. median
$22,481
outlier · 2.1×
75743
CPT 		Angiography Pulm Bil Slct Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,174
outlier · 13.7×
75731
CPT 		Angiography Adrenal Uni Slct Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$2,933
outlier · 14.8×
75840
CPT 		Veno Adrenal Uni Selective 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$2,978
outlier · 14.6×
75733
CPT 		Angiography Adrenal Bil Slct Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,156
outlier · 13.8×
75658
CPT 		Angiography Brach Retrograde Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$637
outlier · 68.3×
75885
CPT 		Percutaneous Transhepatic Portography 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,065
outlier · 14.2×
75600
CPT 		Aorto Thor Without Serialography Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,062
outlier · 14.2×
75741
CPT 		Angiography Pulm Uni Slct Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,082
outlier · 14.1×
75842
CPT 		Venography Adrenal Bilateral 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,852
outlier · 11.3×
75810
CPT 		Splenoportography Rad Sup&int 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,146
outlier · 13.8×
75833
CPT 		Veno Renal Bil Selective 1 $43,527.00 $43,527.00 $43,527.00 nat. median
$3,179
outlier · 13.7×
75978
CPT 		Transluminal Balloon Angioplasty Venous 1 $42,520.00 $42,520.00 $42,520.00 nat. median
$867
outlier · 49.0×
C1772
HCPCS 		Medtronic Handset Kit 1 $5,044.00 $49,796.00 $40,400.00 nat. median
$8,330
outlier · 4.8×
75891
CPT 		Hepatic Venography Wedged 1 $35,416.00 $35,416.00 $35,416.00 nat. median
$3,038
outlier · 11.7×
75831
CPT 		Venography Renal Unilateral 1 $33,358.00 $33,358.00 $33,358.00 nat. median
$3,076
outlier · 10.8×
77372
CPT 		Srs Linear Based 1 $32,032.00 $32,032.00 $32,032.00 nat. median
$9,059
outlier · 3.5×
C1813
HCPCS 		Ams 700 Cx, Ms Pump Iz 12 Cm X 12 Mm 1 $3,384.00 $57,032.00 $31,845.00 nat. median
$10,611
outlier · 3.0×
75889
CPT 		Hepatic Venography Wedged 1 $29,532.00 $29,532.00 $29,532.00 nat. median
$3,148
outlier · 9.4×
75630
CPT 		Aorto Abd+bil Iliofemoral Serialography 1 $29,532.00 $29,532.00 $29,532.00 nat. median
$3,277
outlier · 9.0×
77371
CPT 		Srs Multisource 1 $28,834.00 $28,834.00 $28,834.00 nat. median
$9,046
outlier · 3.2×
48550
CPT 		Donor Pancreatectomy Inc Cold Preserv 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$4,148
outlier · 6.8×
63082
CPT 		Vertebral Corpectomy Vertebral Body Res 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$2,379
outlier · 11.9×
63277
CPT 		Bx/exc Xdrl Spine Lesn Lmbr 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$5,531
outlier · 5.1×
63081
CPT 		Remove Vert Body Dcmprn Crvl 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$5,373
outlier · 5.3×
63101
CPT 		Remove Vert Body Dcmprn Thrc 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$4,386
outlier · 6.5×
63090
CPT 		Remove Vert Body Dcmprn Lmbr 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$4,253
outlier · 6.7×
63087
CPT 		Remov Vertbr Dcmprn Thrclmbr 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$4,386
outlier · 6.5×
63088
CPT 		Vertebr Corpectomy Vertebral Body Resect 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$2,738
outlier · 10.3×
63103
CPT 		Vertebral Corpectomy Vertebral Body Rese 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$2,856
outlier · 9.9×
22523
CPT 		Perq Vertebral Augmentation Th 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$7,261
outlier · 3.9×
63050
CPT 		Cervical Laminoplsty 2/> Seg 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$4,071
outlier · 7.0×
0163T
CPT 		Total Disc Arthroplasty Anterior Approac 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$7,759
outlier · 3.6×
49566
CPT 		Rerepair Ventrl Hern Block 1 $7,090.00 $49,502.00 $28,296.00 nat. median
$4,352
outlier · 6.5×
C1889
HCPCS 		Bard Ventralight Mesh 6 X 8 1 $11,786.00 $26,800.00 $26,000.00 nat. median
$2,392
outlier · 10.9×
75726
CPT 		Angio Visc Selective Or Supra Selective 1 $25,810.00 $25,810.00 $25,810.00 nat. median
$5,021
outlier · 5.1×
75605
CPT 		Aorto/ Serialography Thor Rad Sup&int 1 $25,352.00 $25,352.00 $25,352.00 nat. median
$4,988
outlier · 5.1×
C1815
HCPCS 		Ams 800 Contol Pump 1 $5,022.00 $25,020.00 $24,102.00 nat. median
$7,760
outlier · 3.1×
C1776
HCPCS 		Biomet Partial Femur Cemented Size 4 1 $5,040.00 $57,080.00 $24,000.00 nat. median
$3,432
outlier · 7.0×
75705
CPT 		Angiography Spinal Slct Rad Sup&int 1 $23,153.00 $23,153.00 $23,153.00 nat. median
$5,052
outlier · 4.6×
78815
CPT 		PET CT Skull Base To Mid Thigh 1 $21,866.00 $21,866.00 $21,866.00 nat. median
$2,793
outlier · 7.8×
78816
CPT 		PET CT Full Body Skull To Feet 1 $21,866.00 $21,866.00 $21,866.00 nat. median
$2,707
outlier · 8.1×
CP17428471194764652
CDM 		Uterine And Adnexa Procedures For Non-malignancy Without Cc Or Mcc 1 $21,337.00 $21,337.00 $21,337.00 nat. median
$21,337
1.0× median

Other procedures at this hospital

Browse this hospital's 3,193 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
             
CP17428471194763655 CDM Spinal Fusion Except Cervical Without Mcc 3 1 $123,169.00 $123,169.00 $98,535.00 $98,535.00 $98,535.00 2026-05-28
CP17428471194766026 CDM Cervical Spinal Fusion Without Cc Or Mcc 3 1 $114,965.00 $114,965.00 $91,972.00 $91,972.00 $91,972.00 2026-05-28
CP17428471194764672 CDM Cardiac Valve Or Cardiothoracic Procedure With Cardiac Catheterization With Mcc 3 1 $99,448.00 $99,448.00 $79,558.00 $79,558.00 $79,558.00 2026-05-28
CP17428471194763579 CDM Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 3 1 $98,193.00 $98,193.00 $78,554.00 $78,554.00 $78,554.00 2026-05-28
C1820 HCPCS B.s Precision Montage MRI 16contact Impl 36 1 $88,250.00 $88,250.00 $3,200.00 $109,720.00 $70,600.00 2026-05-28
2203406 CDM Or Level 7 1st 30min 3 1 $81,676.00 $81,676.00 $65,341.00 $65,341.00 $65,341.00 2026-05-28
2203404 CDM Or Level 5 1st 30min 3 1 $61,878.00 $61,878.00 $49,502.00 $49,502.00 $49,502.00 2026-05-28
C1767 HCPCS Medtronic Interstim Ii 3 1 $58,400.00 $58,400.00 $46,720.00 $46,720.00 $46,720.00 2026-05-28
75840 CPT Veno Adrenal Uni Selective 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75733 CPT Angiography Adrenal Bil Slct Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75741 CPT Angiography Pulm Uni Slct Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75658 CPT Angiography Brach Retrograde Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75842 CPT Venography Adrenal Bilateral 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75600 CPT Aorto Thor Without Serialography Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75885 CPT Percutaneous Transhepatic Portography 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75833 CPT Veno Renal Bil Selective 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75731 CPT Angiography Adrenal Uni Slct Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75810 CPT Splenoportography Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75743 CPT Angiography Pulm Bil Slct Rad Sup&int 3 1 $54,409.00 $54,409.00 $43,527.00 $43,527.00 $43,527.00 2026-05-28
75978 CPT Transluminal Balloon Angioplasty Venous 3 1 $53,150.00 $53,150.00 $42,520.00 $42,520.00 $42,520.00 2026-05-28
C1772 HCPCS Medtronic Handset Kit 9 1 $50,500.00 $50,500.00 $5,044.00 $49,796.00 $40,400.00 2026-05-28
75891 CPT Hepatic Venography Wedged 3 1 $44,270.00 $44,270.00 $35,416.00 $35,416.00 $35,416.00 2026-05-28
75831 CPT Venography Renal Unilateral 3 1 $41,698.00 $41,698.00 $33,358.00 $33,358.00 $33,358.00 2026-05-28
77372 CPT Srs Linear Based 3 1 $40,040.00 $40,040.00 $32,032.00 $32,032.00 $32,032.00 2026-05-28
C1813 HCPCS Ams 700 Cx, Ms Pump Iz 12 Cm X 12 Mm 24 1 $39,806.50 $39,806.50 $3,384.00 $57,032.00 $31,845.00 2026-05-28
75889 CPT Hepatic Venography Wedged 3 1 $36,915.00 $36,915.00 $29,532.00 $29,532.00 $29,532.00 2026-05-28
75630 CPT Aorto Abd+bil Iliofemoral Serialography 3 1 $36,915.00 $36,915.00 $29,532.00 $29,532.00 $29,532.00 2026-05-28
77371 CPT Srs Multisource 3 1 $36,043.00 $36,043.00 $28,834.00 $28,834.00 $28,834.00 2026-05-28
63088 CPT Vertebr Corpectomy Vertebral Body Resect 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
63087 CPT Remov Vertbr Dcmprn Thrclmbr 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
63082 CPT Vertebral Corpectomy Vertebral Body Res 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
63101 CPT Remove Vert Body Dcmprn Thrc 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
63090 CPT Remove Vert Body Dcmprn Lmbr 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
48550 CPT Donor Pancreatectomy Inc Cold Preserv 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
63050 CPT Cervical Laminoplsty 2/> Seg 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
22523 CPT Perq Vertebral Augmentation Th 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
63103 CPT Vertebral Corpectomy Vertebral Body Rese 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
63081 CPT Remove Vert Body Dcmprn Crvl 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
0163T CPT Total Disc Arthroplasty Anterior Approac 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
63277 CPT Bx/exc Xdrl Spine Lesn Lmbr 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
49566 CPT Rerepair Ventrl Hern Block 6 1 $35,370.00 $35,370.00 $7,090.00 $49,502.00 $28,296.00 2026-05-28
C1889 HCPCS Bard Ventralight Mesh 6 X 8 9 1 $32,500.00 $32,500.00 $11,786.00 $26,800.00 $26,000.00 2026-05-28
75726 CPT Angio Visc Selective Or Supra Selective 3 1 $32,262.00 $32,262.00 $25,810.00 $25,810.00 $25,810.00 2026-05-28
75605 CPT Aorto/ Serialography Thor Rad Sup&int 3 1 $31,690.00 $31,690.00 $25,352.00 $25,352.00 $25,352.00 2026-05-28
C1815 HCPCS Ams 800 Contol Pump 9 1 $30,128.00 $30,128.00 $5,022.00 $25,020.00 $24,102.00 2026-05-28
C1776 HCPCS Biomet Partial Femur Cemented Size 4 39 1 $30,000.00 $30,000.00 $5,040.00 $57,080.00 $24,000.00 2026-05-28
75705 CPT Angiography Spinal Slct Rad Sup&int 3 1 $28,941.00 $28,941.00 $23,153.00 $23,153.00 $23,153.00 2026-05-28
78815 CPT PET CT Skull Base To Mid Thigh 3 1 $27,332.00 $27,332.00 $21,866.00 $21,866.00 $21,866.00 2026-05-28
78816 CPT PET CT Full Body Skull To Feet 3 1 $27,332.00 $27,332.00 $21,866.00 $21,866.00 $21,866.00 2026-05-28
CP17428471194764652 CDM Uterine And Adnexa Procedures For Non-malignancy Without Cc Or Mcc 3 1 $26,671.00 $26,671.00 $21,337.00 $21,337.00 $21,337.00 2026-05-28
74480 CPT Intro Ureteral Cath Or Stent Into Ureter 3 1 $26,073.00 $26,073.00 $20,858.00 $20,858.00 $20,858.00 2026-05-28
74485 CPT Dilation Nephrostomy Ureters Or Urethra 3 1 $26,073.00 $26,073.00 $20,858.00 $20,858.00 $20,858.00 2026-05-28
74475 CPT Intro Cath Into Renal Pelvis For Drainag 3 1 $26,073.00 $26,073.00 $20,858.00 $20,858.00 $20,858.00 2026-05-28
21600 CPT Excision Rib Partial 6 2 $49,351.00 $49,351.00 $1,058.00 $39,481.00 $20,269.50 2026-05-28
49594 CPT Repair Of Anterior Abdominal Hernia(s) 6 2 $46,908.00 $46,908.00 $1,508.00 $37,526.00 $19,517.00 2026-05-28
77373 CPT Sbrt Delivery 3 1 $24,376.00 $24,376.00 $19,501.00 $19,501.00 $19,501.00 2026-05-28
75563 CPT Card MRI W/stress Img & Dye 3 1 $24,236.00 $24,236.00 $19,389.00 $19,389.00 $19,389.00 2026-05-28
75710 CPT Angiography Ext Uni Rad Sup&int 3 1 $23,495.00 $23,495.00 $18,796.00 $18,796.00 $18,796.00 2026-05-28
75893 CPT Venous Sampling Throu Cath W/wo Angio 3 1 $23,005.00 $23,005.00 $18,404.00 $18,404.00 $18,404.00 2026-05-28
C1778 HCPCS 3660 Ploclaim 5 Elite 51 1 $21,000.00 $21,000.00 $400.00 $84,000.00 $16,800.00 2026-05-28
Q4125 HCPCS Lifenet Decellularized Dermis 2.5 X3.5mm 3 1 $19,735.00 $19,735.00 $15,788.00 $15,788.00 $15,788.00 2026-05-28
75716 CPT Angiography Ext Bil Rad Sup&int 3 1 $19,648.00 $19,648.00 $15,718.00 $15,718.00 $15,718.00 2026-05-28
2802657 CDM Artisan 50cm 2x8 Surgical Lead Kit 3 1 $19,000.00 $19,000.00 $15,200.00 $15,200.00 $15,200.00 2026-05-28
L8680 HCPCS Abbott Octrode External Pulse Generator 9 1 $19,000.00 $19,000.00 $8,800.00 $31,860.00 $15,200.00 2026-05-28
2203394 CDM Or 2 1st 30 Min 3 1 $18,846.00 $18,846.00 $15,077.00 $15,077.00 $15,077.00 2026-05-28
75825 CPT Venography Caval Infer W/serialography 3 1 $18,770.00 $18,770.00 $15,016.00 $15,016.00 $15,016.00 2026-05-28
75736 CPT Angio Pelvic Slct/supraslct Rad Sup&int 3 1 $18,426.00 $18,426.00 $14,741.00 $14,741.00 $14,741.00 2026-05-28
77525 CPT Proton Treatment Delivery Complex 3 1 $18,150.00 $18,150.00 $14,520.00 $14,520.00 $14,520.00 2026-05-28
75872 CPT Venography Epidural 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-05-28
75756 CPT Angiography Int Mammary Rad Sup&int 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-05-28
75827 CPT Venography Caval Sup With Serialography 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-05-28
75887 CPT Percutaneous Transhepatic Portography 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-05-28
75746 CPT Angio Pulm Nonslct Cath/ven Inj Rad 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-05-28
75860 CPT Venography Venous Sinus 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-05-28
75880 CPT Venography Orbital 3 1 $17,585.00 $17,585.00 $14,068.00 $14,068.00 $14,068.00 2026-05-28
75803 CPT Lymphangiography Extremity Only Bil Rad 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-05-28
75807 CPT Lymphangiography Pelvic/abd Bilat Rad 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-05-28
74320 CPT Cholangiography Perc Transhepatic Rad 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-05-28
75822 CPT Venography Extremity B/l 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-05-28
75805 CPT Lymphangiography Pel/abd Unilateral Rad 3 1 $17,281.00 $17,281.00 $13,825.00 $13,825.00 $13,825.00 2026-05-28
77523 CPT Proton Treatment Delivery Intermediate 3 1 $17,089.00 $17,089.00 $13,671.00 $13,671.00 $13,671.00 2026-05-28
Q4107 HCPCS Graft Jacket 12 1 $16,282.50 $16,282.50 $6,059.00 $16,780.00 $13,026.00 2026-05-28
78609 CPT Brain Imag Positron Emission Tomography 3 1 $16,013.00 $16,013.00 $12,810.00 $12,810.00 $12,810.00 2026-05-28
78814 CPT PET CT Limited Study 3 1 $15,819.00 $15,819.00 $12,655.00 $12,655.00 $12,655.00 2026-05-28
78608 CPT Brain Imaging (Pet) 3 1 $15,671.00 $15,671.00 $12,537.00 $12,537.00 $12,537.00 2026-05-28
Q4138 HCPCS Med Usa Biod Dryflex 3 1 $15,500.00 $15,500.00 $12,400.00 $12,400.00 $12,400.00 2026-05-28
93452 CPT Insertion Of Catheter Into Left Heart For Diagnosis 6 2 $28,105.00 $28,105.00 $2,196.00 $22,484.00 $12,340.00 2026-05-28
78813 CPT PET Image Full Body 3 1 $15,305.00 $15,305.00 $12,244.00 $12,244.00 $12,244.00 2026-05-28
77424 CPT Io Rad Tx Delivery By Xr 3 1 $14,591.00 $14,591.00 $11,673.00 $11,673.00 $11,673.00 2026-05-28
2203407 CDM Or Level 7 Each Add 15 3 1 $13,823.00 $13,823.00 $11,058.00 $11,058.00 $11,058.00 2026-05-28
78492 CPT Myocrd Img PET Mlt Rst&strs 3 1 $13,726.00 $13,726.00 $10,981.00 $10,981.00 $10,981.00 2026-05-28
75966 CPT Transluminal Balloon Angioplasty Renal 3 1 $13,449.00 $13,449.00 $10,759.00 $10,759.00 $10,759.00 2026-05-28
L8642 HCPCS Arthrosurface Hemi Implant 15mm 2.5mmx4. 3 1 $13,180.00 $13,180.00 $10,544.00 $10,544.00 $10,544.00 2026-05-28
78812 CPT PET Image Skull-thigh 3 1 $13,113.00 $13,113.00 $10,490.00 $10,490.00 $10,490.00 2026-05-28
77522 CPT Proton Trmt Simple W/comp 3 1 $13,064.00 $13,064.00 $10,451.00 $10,451.00 $10,451.00 2026-05-28
72240 CPT Myelography Cervical Rad Sup&int 3 1 $13,053.00 $13,053.00 $10,442.00 $10,442.00 $10,442.00 2026-05-28
70015 CPT Cistern Positive Contrast Rad Sup&int 3 1 $13,053.00 $13,053.00 $10,442.00 $10,442.00 $10,442.00 2026-05-28
70010 CPT Myelography Posterior Fossa Rad Sup&int 3 1 $13,053.00 $13,053.00 $10,442.00 $10,442.00 $10,442.00 2026-05-28
72270 CPT Myelography Two Or More Regions 3 1 $13,053.00 $13,053.00 $10,442.00 $10,442.00 $10,442.00 2026-05-28
78491 CPT Myocrd Img PET 1std Rst/strs 3 1 $12,581.00 $12,581.00 $10,065.00 $10,065.00 $10,065.00 2026-05-28
74178 CPT CT Abdomen Pelvis Wwo 3 1 $12,555.00 $12,555.00 $10,044.00 $10,044.00 $10,044.00 2026-05-28
C1765 HCPCS Sky Biologics Active Wound Barrier 3 1 $12,475.00 $12,475.00 $9,980.00 $9,980.00 $9,980.00 2026-05-28
45391 CPT Ultrasound Examination Of Lower Large Bowel Using An Endoscope 6 2 $23,345.00 $23,345.00 $1,058.00 $18,676.00 $9,867.00 2026-05-28
72158 CPT MRI Lumbar Spine Wwo 3 1 $12,204.00 $12,204.00 $9,763.00 $9,763.00 $9,763.00 2026-05-28
87492 CPT Inf Agent Det Chlamydia Trachomatis 3 1 $12,149.00 $12,149.00 $9,719.00 $9,719.00 $9,719.00 2026-05-28
87507 CPT Inf Agent Det By DNA Or RNA Gi Pathogen 3 1 $12,149.00 $12,149.00 $9,719.00 $9,719.00 $9,719.00 2026-05-28
75894 CPT Transcath Ther Embolization Any Method 3 1 $12,123.00 $12,123.00 $9,698.00 $9,698.00 $9,698.00 2026-05-28
78811 CPT PET Image Ltd Area 3 1 $12,000.00 $12,000.00 $9,600.00 $9,600.00 $9,600.00 2026-05-28
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 3 1 $11,827.00 $11,827.00 $9,462.00 $9,462.00 $9,462.00 2026-05-28
78459 CPT Myocrd Img PET Single Study 3 1 $11,594.00 $11,594.00 $9,275.00 $9,275.00 $9,275.00 2026-05-28
0275T CPT Perq Lamot/lam Lumbar 3 1 $11,519.00 $11,519.00 $9,215.00 $9,215.00 $9,215.00 2026-05-28
2203399 CDM Or 6 Each Add 15 Min 3 1 $11,519.00 $11,519.00 $9,215.00 $9,215.00 $9,215.00 2026-05-28
22585 CPT Arthrodesis Anterior Interbody Tech 1st 3 1 $11,519.00 $11,519.00 $9,215.00 $9,215.00 $9,215.00 2026-05-28
63051 CPT C-laminoplasty W/graft/plate 3 1 $11,519.00 $11,519.00 $9,215.00 $9,215.00 $9,215.00 2026-05-28
75820 CPT Veno Extremity Unilateral 3 1 $11,282.00 $11,282.00 $9,026.00 $9,026.00 $9,026.00 2026-05-28
44322 CPT Colostomy With Biopsies 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
31299 CPT Procedure Accessory Sinuses 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
44204 CPT Laparo Partial Colectomy 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
38525 CPT Biop/exc Lymph Nodes Open Deep Axil Nd 12 2 $19,921.50 $19,921.50 $1,058.00 $16,798.00 $8,801.50 2026-05-28
19361 CPT Breast Reconstr W/lat Flap 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
20926 CPT Tiss Grafts Oth Eg Paratenon Fat Dermis 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
47122 CPT Extensive Removal Of Liver 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
19305 CPT Mast Radical 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
19260 CPT Exc Chest Wall Tumor Including Ribs 1st 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
20100 CPT Explore Wound Neck 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
19120 CPT Removal Of One Or More Breast Growth, Open Procedure 12 2 $21,594.00 $21,594.00 $1,232.00 $19,474.00 $8,801.50 2026-05-28
45562 CPT Exploration/repair Of Rectum 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
20974 CPT Electrical Bone Stimulation 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
45385 CPT Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope 12 2 $21,095.50 $21,095.50 $1,058.00 $18,676.00 $8,801.50 2026-05-28
C9728 HCPCS Place Device/marker Non Pro 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
11310 CPT Shave Skin Lesion 0.5 Cm/< 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
44960 CPT Appendectomy 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
69105 CPT Biopsy External Auditory Canal 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
43239 CPT Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 12 2 $18,888.00 $18,888.00 $1,058.00 $15,144.00 $8,801.50 2026-05-28
45380 CPT Biopsy Exam Of Large Bowel Using An Endoscope 12 2 $21,095.50 $21,095.50 $1,058.00 $18,676.00 $8,801.50 2026-05-28
15420 CPT Xenograft Skin Dermal/temp Wound Close 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
42971 CPT Control Nose/throat Bleeding 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
49020 CPT Drainage Abdom Abscess Open 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
45378 CPT Diagnostic Exam Of Large Bowel Using An Endoscope 12 2 $18,849.00 $18,849.00 $1,058.00 $15,082.00 $8,801.50 2026-05-28
49203 CPT Exc Abd Tum 5 Cm Or Less 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
44604 CPT Suture Large Intestine 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
63707 CPT Repair Spinal Fluid Leakage 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
51585 CPT Removal Of Bladder & Nodes 6 1 $11,002.00 $11,002.00 $2,526.00 $15,077.00 $8,801.50 2026-05-28
74176 CPT CT Abdomen Pelvis Wo 3 1 $10,697.00 $10,697.00 $8,558.00 $8,558.00 $8,558.00 2026-05-28
S2083 HCPCS Lap-band Ap With Rapidport Ez 6 2 $19,975.00 $19,975.00 $924.00 $15,980.00 $8,452.00 2026-05-28
C9362 HCPCS Fortis Dbm Strips 10cc (Per 5cc) 9 1 $10,500.00 $10,500.00 $7,650.00 $16,800.00 $8,400.00 2026-05-28
71552 CPT MRI Chest Wwo 3 1 $10,383.00 $10,383.00 $8,306.00 $8,306.00 $8,306.00 2026-05-28
74174 CPT CTA Abdomen Pelvis Wwo 3 1 $10,369.00 $10,369.00 $8,295.00 $8,295.00 $8,295.00 2026-05-28
77520 CPT Proton Trmt Simple Without Comp 3 1 $10,345.00 $10,345.00 $8,276.00 $8,276.00 $8,276.00 2026-05-28
70546 CPT Mr Angiograph Head W/wo Dye 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
74183 CPT MRI Abdomen Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
72197 CPT MRI Pelvis Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
70543 CPT MRI Orbit/face/neck Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
73720 CPT MRI Low Ext Nonjoint Wwo Lt 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
73220 CPT MRI Up Ext Nonjoint Wwo Lt 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
73723 CPT MRI Low Ext Joint Wwo Lt 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
75561 CPT Cardiac MRI For Morph With Contrast 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
73223 CPT MRI Up Ext Joint Wwo Lt 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
72156 CPT MRI Cervical Spine Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
70559 CPT MRI Open Intracranial Proc W/wo Dye 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
72157 CPT MRI Thoracic Spine Wwo 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
70553 CPT MRI Scan 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
70549 CPT Mr Angiograph Neck W/wo Dye 3 1 $10,265.00 $10,265.00 $8,212.00 $8,212.00 $8,212.00 2026-05-28
C1763 HCPCS Aesculap Arradius 2.5x3.5x14 57 1 $10,250.00 $10,250.00 $1,828.00 $29,000.00 $8,200.00 2026-05-28
93610 CPT Intraatrial Pacing 4 2 $10,013.00 $10,013.00 $275.00 $8,010.00 $8,010.00 2026-05-28
45398 CPT Colonoscopy Flexible W/band Ligations 6 2 $18,564.00 $18,564.00 $1,058.00 $14,851.00 $7,954.50 2026-05-28
36475 CPT Endovenous Rf 1st Vein 6 2 $18,140.00 $18,140.00 $1,232.00 $14,512.00 $7,872.00 2026-05-28
77778 CPT Apply Interstit Radiat Compl 3 1 $9,657.00 $9,657.00 $7,726.00 $7,726.00 $7,726.00 2026-05-28
77022 CPT Magnetic Resonance Guidance 3 1 $9,652.00 $9,652.00 $7,722.00 $7,722.00 $7,722.00 2026-05-28
36902 CPT Introduction Of Needle(s) And/or Cathete 6 2 $16,338.00 $16,338.00 $2,196.00 $13,070.00 $7,633.00 2026-05-28
Q4139 HCPCS Hybrid Amniotic Membrane Tissue 1.25ml 12 1 $9,369.00 $9,369.00 $4,000.00 $17,000.00 $7,495.00 2026-05-28
77048 CPT MRI Breast With Cad Wwo Unilat 3 1 $9,328.00 $9,328.00 $7,462.00 $7,462.00 $7,462.00 2026-05-28
C8905 HCPCS MRI Without Fol W/cont Brst Unilat 3 1 $9,328.00 $9,328.00 $7,462.00 $7,462.00 $7,462.00 2026-05-28
43235 CPT Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 12 2 $17,119.50 $17,119.50 $924.00 $15,077.00 $7,420.00 2026-05-28
70545 CPT Mr Angiography Head With Contrast 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
72196 CPT MRI Pelvis W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
74182 CPT MRI Abdomen W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
70542 CPT MRI Orbit/face/neck W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
70548 CPT Mr Angiography Neck With Contrast 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
71551 CPT MRI Chest W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
73722 CPT MRI Low Ext Joint W Lt 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
72147 CPT MRI Thoracic Spine W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
72149 CPT MRI Lumbar Spine W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
73222 CPT MRI Up Ext Joint W Lt 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
73219 CPT MRI Up Ext Nonjoint W Lt 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
70558 CPT MRI Open Intracranial Proc With Contrast 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
72142 CPT MRI Cervical Spine W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
70552 CPT MRI Brain W 3 1 $9,075.00 $9,075.00 $7,260.00 $7,260.00 $7,260.00 2026-05-28
76825 CPT Echo Exam Of Fetal Heart 3 1 $8,983.00 $8,983.00 $7,186.00 $7,186.00 $7,186.00 2026-05-28
S2068 HCPCS Breast Diep Or Siea Flap 1st 3 1 $8,959.00 $8,959.00 $7,167.00 $7,167.00 $7,167.00 2026-05-28
62287 CPT Percutaneous Diskectomy 1st 9 2 $61,878.00 $61,878.00 $1,665.00 $49,502.00 $7,090.00 2026-05-28
63661 CPT Remove Spine Eltrd Perq Aray 1st 9 2 $61,878.00 $61,878.00 $924.00 $49,502.00 $7,090.00 2026-05-28
64722 CPT Decompression Unspecified Nerves Specify 9 2 $61,878.00 $61,878.00 $924.00 $49,502.00 $7,090.00 2026-05-28
27702 CPT Arthroplasty Ankle W/implant 1st 30 9 2 $61,878.00 $61,878.00 $1,868.00 $49,502.00 $7,090.00 2026-05-28
64555 CPT Implant Neuroelectrodes 1st 9 2 $61,878.00 $61,878.00 $924.00 $49,502.00 $7,090.00 2026-05-28
62355 CPT Remove Spinal Canal Catheter 1st 9 2 $61,878.00 $61,878.00 $1,058.00 $49,502.00 $7,090.00 2026-05-28
27487 CPT Revise/replace Knee Joint 1st 9 2 $61,878.00 $61,878.00 $1,868.00 $49,502.00 $7,090.00 2026-05-28
49320 CPT Diag Laparo Separate Proc 1st 9 2 $61,878.00 $61,878.00 $1,232.00 $49,502.00 $7,090.00 2026-05-28
27446 CPT Revision Of Knee Joint 1st 9 2 $61,878.00 $61,878.00 $1,665.00 $49,502.00 $7,090.00 2026-05-28
27447 CPT Total Knee Arthroplasty 1st 9 2 $61,878.00 $61,878.00 $1,868.00 $49,502.00 $7,090.00 2026-05-28
23473 CPT Revis Reconst Shoulder Joint 1st 9 2 $61,878.00 $61,878.00 $1,665.00 $49,502.00 $7,090.00 2026-05-28
27125 CPT Partial Hip Replacement 1st 9 2 $61,878.00 $61,878.00 $1,868.00 $49,502.00 $7,090.00 2026-05-28
27132 CPT Total Hip Arthroplasty 1st 9 2 $61,878.00 $61,878.00 $1,868.00 $49,502.00 $7,090.00 2026-05-28
24342 CPT Repair Of Ruptured Tendon 1st 9 2 $61,878.00 $61,878.00 $1,232.00 $49,502.00 $7,090.00 2026-05-28
23472 CPT Reconstruct Shoulder Joint 1st 9 2 $61,878.00 $61,878.00 $1,665.00 $49,502.00 $7,090.00 2026-05-28
22515 CPT Perq Vertebral Augmentation Ea Add Th 1s 9 2 $61,878.00 $61,878.00 $924.00 $49,502.00 $7,090.00 2026-05-28
23420 CPT Repair Of Shoulder 1st 9 2 $61,878.00 $61,878.00 $2,196.00 $49,502.00 $7,090.00 2026-05-28
62350 CPT Implant Spinal Canal Cath 1st 9 2 $61,878.00 $61,878.00 $1,058.00 $49,502.00 $7,090.00 2026-05-28
2203405 CDM Or Level 5 Each Add 15 Min 3 1 $8,862.00 $8,862.00 $7,090.00 $7,090.00 $7,090.00 2026-05-28
54400 CPT Insert Self-contd Prosthesis 1st 9 2 $61,878.00 $61,878.00 $1,232.00 $49,502.00 $7,090.00 2026-05-28
74470 CPT Xr Renal Cyst Study 3 1 $8,855.00 $8,855.00 $7,084.00 $7,084.00 $7,084.00 2026-05-28
36832 CPT Revision, Open, Arteriovenous Fistula; W 6 2 $15,708.00 $15,708.00 $1,508.00 $12,566.00 $7,037.00 2026-05-28
72141 CPT MRI Cervical Spine Wo 3 1 $8,786.00 $8,786.00 $7,029.00 $7,029.00 $7,029.00 2026-05-28
72146 CPT MRI Thoracic Spine Wo 3 1 $8,695.00 $8,695.00 $6,956.00 $6,956.00 $6,956.00 2026-05-28
75896 CPT Transcatheter Therapy Infusion 3 1 $8,680.00 $8,680.00 $6,944.00 $6,944.00 $6,944.00 2026-05-28
87633 CPT Inf Agent Det By DNA Or RNA Resp Virus 3 1 $8,576.00 $8,576.00 $6,861.00 $6,861.00 $6,861.00 2026-05-28
C1762 HCPCS Alliance Bonebank Allograft 120 1 $8,437.50 $8,437.50 $600.00 $40,000.00 $6,750.00 2026-05-28
72148 CPT MRI Scan Of Lower Spinal Canal 3 1 $8,385.00 $8,385.00 $6,708.00 $6,708.00 $6,708.00 2026-05-28
Q4100 HCPCS Human Allograft Tissue Per Cc 18 1 $8,297.50 $8,297.50 $2,828.00 $24,000.00 $6,638.00 2026-05-28
78804 CPT Rp Loclzj Tum Whbdy 2+d Img 3 1 $8,235.00 $8,235.00 $6,588.00 $6,588.00 $6,588.00 2026-05-28
15772 CPT Each Add'l 50cc Injectate 1st 9 2 $18,846.00 $18,846.00 $924.00 $15,077.00 $6,526.00 2026-05-28
15771 CPT Grfg Autol Fat Lipo 50 Cc/< 1st 9 2 $18,846.00 $18,846.00 $1,508.00 $15,077.00 $6,526.00 2026-05-28
72195 CPT MRI Pelvis Wo 3 1 $8,080.00 $8,080.00 $6,464.00 $6,464.00 $6,464.00 2026-05-28
72125 CPT CT Cervical Spine Wo 3 1 $8,000.00 $8,000.00 $6,400.00 $6,400.00 $6,400.00 2026-05-28
L8689 HCPCS Nevro Charger Kit 6 1 $7,867.50 $7,867.50 $4,000.00 $8,588.00 $6,294.00 2026-05-28
75970 CPT Transcatheter Biopsy Rad Sup&int 3 1 $7,844.00 $7,844.00 $6,275.00 $6,275.00 $6,275.00 2026-05-28
75625 CPT Aorto/serialography Abd Rad Sup&int 3 1 $7,812.00 $7,812.00 $6,250.00 $6,250.00 $6,250.00 2026-05-28
73225 CPT MRA Up Ext Wwo Lt 3 1 $7,709.00 $7,709.00 $6,167.00 $6,167.00 $6,167.00 2026-05-28
70555 CPT MRI Brain By Phys/psych 3 1 $7,549.00 $7,549.00 $6,039.00 $6,039.00 $6,039.00 2026-05-28
73719 CPT MRI Low Ext Nonjoint W Lt 3 1 $7,490.00 $7,490.00 $5,992.00 $5,992.00 $5,992.00 2026-05-28
73218 CPT MRI Up Ext Nonjoint Wo Lt 3 1 $7,490.00 $7,490.00 $5,992.00 $5,992.00 $5,992.00 2026-05-28
A4264 HCPCS Permanent Birth Control 6 1 $7,375.00 $7,375.00 $5,800.00 $6,000.00 $5,900.00 2026-05-28
72133 CPT CT Lumbar Spine Wwo 3 1 $7,366.00 $7,366.00 $5,893.00 $5,893.00 $5,893.00 2026-05-28
74170 CPT CT Abdomen Wwo 3 1 $7,262.00 $7,262.00 $5,810.00 $5,810.00 $5,810.00 2026-05-28
72285 CPT Discography Cerv Or Thoracic Rad Sup&int 3 1 $7,212.00 $7,212.00 $5,770.00 $5,770.00 $5,770.00 2026-05-28
72295 CPT Discography Lumbar Rad Sup&int 3 1 $7,212.00 $7,212.00 $5,770.00 $5,770.00 $5,770.00 2026-05-28
70332 CPT Temporomandibular Jt Arthro Rad Sup&int 3 1 $7,196.00 $7,196.00 $5,757.00 $5,757.00 $5,757.00 2026-05-28
72265 CPT Myelography Lumbosacral Rad Sup&int 3 1 $7,196.00 $7,196.00 $5,757.00 $5,757.00 $5,757.00 2026-05-28
75870 CPT Venography Sup Sag Sinus 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
74305 CPT Cholangio/ Pancreatography With Cath 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
74190 CPT Peritoneogram 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
76098 CPT Xrination Specimen 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
77054 CPT Mammary Ductogram/galactogram Mult Ducts 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
76102 CPT Xr Complex Motion 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
77053 CPT Mammary Ductogram Or Galactogram 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
70390 CPT Sialography Rad Sup&int 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
70170 CPT Dacryocysto Nasolac Duct Rad Sup&int 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
75801 CPT Lymphangiography Extremity Uni Rad 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
74740 CPT Hysterosalpingography Rad Sup&int 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
76101 CPT Xr Complex Motion 3 1 $7,162.00 $7,162.00 $5,730.00 $5,730.00 $5,730.00 2026-05-28
C1768 HCPCS Checkpoint Guardian 6 1 $7,140.00 $7,140.00 $2,644.00 $8,780.00 $5,712.00 2026-05-28
73206 CPT CTA Up Ext Rt Wwo 3 1 $7,115.00 $7,115.00 $5,692.00 $5,692.00 $5,692.00 2026-05-28
76826 CPT Echo Exam Of Fetal Heart 3 1 $7,099.00 $7,099.00 $5,679.00 $5,679.00 $5,679.00 2026-05-28
70554 CPT MRI Brain By Tech 3 1 $7,091.00 $7,091.00 $5,673.00 $5,673.00 $5,673.00 2026-05-28
74400 CPT Urography Pyelography IV W/wo Kub/tomo 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
74247 CPT Xr Gastrointestinal Tract 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
75635 CPT CTA Abdominal Arteries 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78472 CPT Gated Heart Planar Single 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78305 CPT Bone And/or Joint Imaging Multiple Areas 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78227 CPT Hepatobil Syst Image W/drug 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78278 CPT Acute Gi Blood Loss Imaging 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78195 CPT Lymphatics And Lymph Nodes Imaging 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78290 CPT Meckels Divert Exam 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78226 CPT Hepatobiliary System Imaging 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78300 CPT Bone And/or Joint Imaging Limited Area 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
78070 CPT Parathyroid Imaging 3 1 $7,069.00 $7,069.00 $5,655.00 $5,655.00 $5,655.00 2026-05-28
2802661 CDM J&j 2.7 Lcp Condylar Plate 7hole Shaft 3 1 $7,030.00 $7,030.00 $5,624.00 $5,624.00 $5,624.00 2026-05-28
70498 CPT CTA Neck 3 1 $7,010.00 $7,010.00 $5,608.00 $5,608.00 $5,608.00 2026-05-28
76936 CPT US Guide Compression Rep Pseudoaneurysm 3 1 $7,008.00 $7,008.00 $5,606.00 $5,606.00 $5,606.00 2026-05-28
70496 CPT CTA Head Brain 3 1 $7,000.00 $7,000.00 $5,600.00 $5,600.00 $5,600.00 2026-05-28
66821 CPT Removal Of Recurring Cataract In Lens Capsule Using Laser 6 2 $12,554.00 $12,554.00 $1,058.00 $10,043.00 $5,550.50 2026-05-28
63655 CPT Implant Neuroelectrodes 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22554 CPT Neck Spine Fusion 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22856 CPT Cerv Artific Diskectomy 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22857 CPT Lumbar Artif Diskectomy 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22558 CPT Lumbar Spine Fusion 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22861 CPT Revise Cerv Artific Disc 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22630 CPT Lumbar Spine Fusion 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22855 CPT Removal Anterior Instrumentation 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22610 CPT Thorax Spine Fusion 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22850 CPT Remove Spine Fixation Device 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22849 CPT Reinsertion Spinal Fixation Device 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22600 CPT Neck Spine Fusion 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22556 CPT Thorax Spine Fusion 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
27280 CPT Fusion Of Sacroiliac Joint 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
27130 CPT Total Hip Arthroplasty 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
27134 CPT Revise Hip Joint Replacement 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22633 CPT Lumbar Spine Fusion Combined 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
63056 CPT Decompress Spinal Cord Lmbr 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22802 CPT Post Fusion 7-12 Vert Seg 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22532 CPT Lat Thorax Spine Fusion 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
27138 CPT Revise Hip Joint Replacement 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22612 CPT Lumbar Spine Fusion 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
22551 CPT Neck Spine Fuse&remov Bel C2 1st 6 2 $39,791.00 $39,791.00 $1,868.00 $9,215.00 $5,541.50 2026-05-28
73718 CPT MRI Low Ext Nonjoint Wo Lt 3 1 $6,916.00 $6,916.00 $5,533.00 $5,533.00 $5,533.00 2026-05-28
49653 CPT Lap Vent/abd Hern Proc Comp 3 1 $6,836.00 $6,836.00 $5,469.00 $5,469.00 $5,469.00 2026-05-28
49654 CPT Lap Inc Hernia Repair 3 1 $6,836.00 $6,836.00 $5,469.00 $5,469.00 $5,469.00 2026-05-28
19366 CPT Breast Reconstruction W/other Tech 1st 3 1 $6,836.00 $6,836.00 $5,469.00 $5,469.00 $5,469.00 2026-05-28
29826 CPT Shaving Of Shoulder Bone Using Endoscope 9 2 $28,812.00 $28,812.00 $1,232.00 $23,050.00 $5,469.00 2026-05-28
34718 CPT Endovascular Repair The Iliac Artery 3 1 $6,836.00 $6,836.00 $5,469.00 $5,469.00 $5,469.00 2026-05-28
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