Hospital

MID COAST MEDICAL CENTER-TRINITY

Trinity, TX · CCN 670331 · Rates published

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You selected 93306 (CPT)

US ECHOCARDIOGRAM 2D DOPPLER COLOR

This hospital’s price: $2,151 across 1 payer

Source: https://app.box.com/shared/static/i4fov2292agvi1btraj9co4h4uodvlig.csv · observed 2025-03-01

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.

2,638 distinct procedures filed

1 distinct payers

3,771 rate rows

2025-03-01 last MRF observed · ⚠ 19 mo old

Data quality

3,770 of 3,771 rate rows are consumer-grade (100.0%)

1 row is 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
placeholder amount (≤ $0.02) — excluded from medians	1

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 19 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://app.box.com/shared/static/i4fov2292agvi1btraj9co4h4uodvlig.csv
Found on page	https://midcoasthealthsystem.org/cms-hpt.txt
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-10-01
Content fingerprint	125cd8942b51fde8… · 460,090 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
3500446 LOCAL	Idarucizumab 2.5gm/50ml Vial (praxbind)	1	$17,640.00	$17,640.00	$17,640.00	nat. median $17,640 1.0× median
J3101 HCPCS	Tenecteplase 50mg Vial	1	$13,552.25	$13,552.25	$13,552.25	nat. median $3,787 outlier · 3.6×
J2997 HCPCS	Alteplase 100mg/100 Ml Inj (activase)	1	$371.00	$21,531.00	$10,951.00	nat. median $500 outlier · 21.9×
J2760 HCPCS	Phentolamine 5mg/2ml Vial (regitine)	1	$10,710.00	$10,710.00	$10,710.00	nat. median $720 outlier · 14.9×
33210 CPT	Insertion Transvenous Pac	1	$644.00	$19,093.00	$9,868.50	nat. median $8,289 1.2× median
J1162 HCPCS	Digoxin Immune Fab 40mg Vial (digifab)	1	$8,520.25	$8,520.25	$8,520.25	nat. median $7,165 1.2× median
59812 CPT	Treatment Incomplete Abortion	1	$7,700.00	$7,700.00	$7,700.00	nat. median $3,249 outlier · 2.4×
3507401 LOCAL	Orbactiv 1200mg (nf)	1	$7,527.26	$7,527.26	$7,527.26	nat. median $143 outlier · 52.8×
21337 CPT	Closed Tx Nasal Fx	1	$7,150.00	$7,150.00	$7,150.00	nat. median $3,235 outlier · 2.2×
J0840 HCPCS	Crofab	1	$6,590.25	$6,590.25	$6,590.25	nat. median $3,452 1.9× median
J0630 HCPCS	Calcitonin 400unit/2ml Inj (miacalcin)	1	$5,754.50	$5,754.50	$5,754.50	nat. median $1,896 outlier · 3.0×
3507016 LOCAL	Golimumab 50mg/4ml	1	$4,807.19	$4,807.19	$4,807.19	nat. median $1,923 outlier · 2.5×
3507731 LOCAL	Actemra 400mg/20ml Vial	1	$4,756.48	$4,756.48	$4,756.48	nat. median $4,233 1.1× median
75710 CPT	Xr Angiography Extremity Unilateral	1	$4,730.00	$4,730.00	$4,730.00	nat. median $3,197 1.5× median
27266 CPT	Closed Trmt Post Hip Dislocation	1	$4,452.00	$4,452.00	$4,452.00	nat. median $2,037 outlier · 2.2×
Q0247 HCPCS	Sotrovimab 500mg/8ml	1	$4,410.00	$4,410.00	$4,410.00	nat. median $2,394 1.8× median
59409 CPT	Pf-vaginal Delivery Only	1	$2,717.00	$6,089.00	$4,403.00	nat. median $3,148 1.4× median
69005 CPT	Drainage Ext Ear, Complicated	1	$4,311.00	$4,311.00	$4,311.00	nat. median $1,770 outlier · 2.4×
78451 CPT	Nm Myocard Perf Image-single	1	$4,059.00	$4,059.00	$4,059.00	nat. median $1,550 outlier · 2.6×
95811 CPT	Sleep Study (cpap)	1	$3,990.00	$3,990.00	$3,990.00	nat. median $1,894 outlier · 2.1×
G0399 HCPCS	Sleep Study At Home	1	$3,805.00	$3,805.00	$3,805.00	nat. median $342 outlier · 11.1×
95810 CPT	Sleep Study	1	$3,805.00	$3,805.00	$3,805.00	nat. median $1,827 outlier · 2.1×
95800 CPT	Sleep Study Unattended	1	$3,805.00	$3,805.00	$3,805.00	nat. median $346 outlier · 11.0×
J1569 HCPCS	Crofab	1	$945.00	$6,590.25	$3,767.62	nat. median $1,074 outlier · 3.5×
J0897 HCPCS	Denosumab 60mg/1ml Inj (prolia)	1	$3,722.44	$3,722.44	$3,722.44	nat. median $1,982 1.9× median
49407 CPT	Peritoneal Procedures	1	$3,472.00	$3,472.00	$3,472.00	nat. median $2,059 1.7× median
42300 CPT	Drainage Salivary Gland	1	$3,425.00	$3,425.00	$3,425.00	nat. median $1,651 outlier · 2.1×
78806 CPT	Nm Indium 111 White Bld Cell	1	$3,389.00	$3,389.00	$3,389.00	nat. median $1,156 outlier · 2.9×
78452 CPT	Nm Cardiac Muga Scan	1	$1,155.00	$5,198.00	$3,176.50	nat. median $1,822 1.7× median
J7325 HCPCS	Synvisc-one 48mg/6ml Inj	1	$3,134.75	$3,134.75	$3,134.75	nat. median $145 outlier · 21.6×
38300 CPT	Drainage Lymph Node Lesio	1	$3,108.00	$3,108.00	$3,108.00	nat. median $2,760 1.1× median
G0390 HCPCS	Trauma Response Level	1	$3,000.00	$3,000.00	$3,000.00	nat. median $3,197 0.9× median
26011 CPT	Drainage Finger Abscess Complicated	1	$2,970.00	$2,970.00	$2,970.00	nat. median $1,701 1.7× median
13132 CPT	Pf-repair Complex Chin 2.	1	$1,462.00	$4,385.00	$2,923.50	nat. median $856 outlier · 3.4×
23931 CPT	I&d Upper Arm & Elbow Bu	1	$1,455.00	$4,366.00	$2,910.50	nat. median $1,756 1.7× median
93312 CPT	US Tee	1	$2,750.00	$2,750.00	$2,750.00	nat. median $943 outlier · 2.9×
15240 CPT	Full Thickness Graft 20	1	$1,211.00	$4,106.00	$2,658.50	nat. median $2,233 1.2× median
28208 CPT	Pf-repair Extensor Tendon	1	$223.00	$5,086.00	$2,654.50	nat. median $3,348 0.8× median
P9052 HCPCS	Bb Platelets	1	$2,580.00	$2,580.00	$2,580.00	nat. median $1,142 outlier · 2.3×
14301 CPT	Pf-adjacent Tissue Transf	1	$2,548.00	$2,548.00	$2,548.00	nat. median $3,781 0.7× median
J0129 HCPCS	Abatacept 250mg Vial (orencia)	1	$2,487.50	$2,487.50	$2,487.50	nat. median $902 outlier · 2.8×
36556 CPT	Central Line Insertion 5	1	$426.00	$3,322.00	$2,461.00	nat. median $2,483 1.0× median
43999 CPT	Unlisted Procedure Stomac	1	$2,460.00	$2,460.00	$2,460.00	nat. median $1,583 1.6× median
25660 CPT	Clsd Treat Carpal Disloca	1	$1,227.00	$3,676.00	$2,451.50	nat. median $476 outlier · 5.2×
27792 CPT	Fx Care Distal Fibula W/w	1	$806.00	$4,023.00	$2,414.50	nat. median $6,924 outlier · 0.3×
11400 CPT	Exc Lesion 0.5 Or Less	1	$2,401.00	$2,401.00	$2,401.00	nat. median $711 outlier · 3.4×
26418 CPT	Pf-repair Extensor Tendon	1	$273.00	$4,400.00	$2,336.50	nat. median $2,008 1.2× median
46999 CPT	Unlisted Proc Anus	1	$2,310.00	$2,310.00	$2,310.00	nat. median $1,262 1.8× median
36569 CPT	Insertion Picc Cath	1	$2,257.00	$2,257.00	$2,257.00	nat. median $1,726 1.3× median
70015 CPT	Cisternography S&i	1	$2,247.00	$2,247.00	$2,247.00	nat. median $778 outlier · 2.9×

Other procedures at this hospital

Browse this hospital's 2,638 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

3500446	LOCAL	Idarucizumab 2.5gm/50ml Vial (praxbind)	1	1	$17,640.00	$17,640.00	$17,640.00	$17,640.00	$17,640.00	2025-03-01
J3101	HCPCS	Tenecteplase 50mg Vial	1	1	$13,552.25	$13,552.25	$13,552.25	$13,552.25	$13,552.25	2025-03-01
J2997	HCPCS	Alteplase 100mg/100 Ml Inj (activase)	2	1	$10,951.00	$10,951.00	$371.00	$21,531.00	$10,951.00	2025-03-01
J2760	HCPCS	Phentolamine 5mg/2ml Vial (regitine)	1	1	$10,710.00	$10,710.00	$10,710.00	$10,710.00	$10,710.00	2025-03-01
33210	CPT	Insertion Transvenous Pac	2	1	$9,868.50	$9,868.50	$644.00	$19,093.00	$9,868.50	2025-03-01
J1162	HCPCS	Digoxin Immune Fab 40mg Vial (digifab)	1	1	$8,520.25	$8,520.25	$8,520.25	$8,520.25	$8,520.25	2025-03-01
59812	CPT	Treatment Incomplete Abortion	1	1	$7,700.00	$7,700.00	$7,700.00	$7,700.00	$7,700.00	2025-03-01
3507401	LOCAL	Orbactiv 1200mg (nf)	1	1	$7,527.26	$7,527.26	$7,527.26	$7,527.26	$7,527.26	2025-03-01
21337	CPT	Closed Tx Nasal Fx	1	1	$7,150.00	$7,150.00	$7,150.00	$7,150.00	$7,150.00	2025-03-01
J0840	HCPCS	Crofab	1	1	$6,590.25	$6,590.25	$6,590.25	$6,590.25	$6,590.25	2025-03-01
J0630	HCPCS	Calcitonin 400unit/2ml Inj (miacalcin)	1	1	$5,754.50	$5,754.50	$5,754.50	$5,754.50	$5,754.50	2025-03-01
3507016	LOCAL	Golimumab 50mg/4ml	1	1	$4,807.19	$4,807.19	$4,807.19	$4,807.19	$4,807.19	2025-03-01
3507731	LOCAL	Actemra 400mg/20ml Vial	1	1	$4,756.48	$4,756.48	$4,756.48	$4,756.48	$4,756.48	2025-03-01
75710	CPT	Xr Angiography Extremity Unilateral	1	1	$4,730.00	$4,730.00	$4,730.00	$4,730.00	$4,730.00	2025-03-01
27266	CPT	Closed Trmt Post Hip Dislocation	1	1	$4,452.00	$4,452.00	$4,452.00	$4,452.00	$4,452.00	2025-03-01
Q0247	HCPCS	Sotrovimab 500mg/8ml	1	1	$4,410.00	$4,410.00	$4,410.00	$4,410.00	$4,410.00	2025-03-01
59409	CPT	Pf-vaginal Delivery Only	2	1	$4,403.00	$4,403.00	$2,717.00	$6,089.00	$4,403.00	2025-03-01
69005	CPT	Drainage Ext Ear, Complicated	1	1	$4,311.00	$4,311.00	$4,311.00	$4,311.00	$4,311.00	2025-03-01
78451	CPT	Nm Myocard Perf Image-single	1	1	$4,059.00	$4,059.00	$4,059.00	$4,059.00	$4,059.00	2025-03-01
95811	CPT	Sleep Study (cpap)	1	1	$3,990.00	$3,990.00	$3,990.00	$3,990.00	$3,990.00	2025-03-01
95800	CPT	Sleep Study Unattended	1	1	$3,805.00	$3,805.00	$3,805.00	$3,805.00	$3,805.00	2025-03-01
G0399	HCPCS	Sleep Study At Home	1	1	$3,805.00	$3,805.00	$3,805.00	$3,805.00	$3,805.00	2025-03-01
95810	CPT	Sleep Study	1	1	$3,805.00	$3,805.00	$3,805.00	$3,805.00	$3,805.00	2025-03-01
J1569	HCPCS	Crofab	2	1	$3,767.62	$3,767.62	$945.00	$6,590.25	$3,767.62	2025-03-01
J0897	HCPCS	Denosumab 60mg/1ml Inj (prolia)	1	1	$3,722.44	$3,722.44	$3,722.44	$3,722.44	$3,722.44	2025-03-01
49407	CPT	Peritoneal Procedures	1	1	$3,472.00	$3,472.00	$3,472.00	$3,472.00	$3,472.00	2025-03-01
42300	CPT	Drainage Salivary Gland	1	1	$3,425.00	$3,425.00	$3,425.00	$3,425.00	$3,425.00	2025-03-01
78806	CPT	Nm Indium 111 White Bld Cell	1	1	$3,389.00	$3,389.00	$3,389.00	$3,389.00	$3,389.00	2025-03-01
78452	CPT	Nm Cardiac Muga Scan	2	1	$3,176.50	$3,176.50	$1,155.00	$5,198.00	$3,176.50	2025-03-01
J7325	HCPCS	Synvisc-one 48mg/6ml Inj	1	1	$3,134.75	$3,134.75	$3,134.75	$3,134.75	$3,134.75	2025-03-01
38300	CPT	Drainage Lymph Node Lesio	1	1	$3,108.00	$3,108.00	$3,108.00	$3,108.00	$3,108.00	2025-03-01
G0390	HCPCS	Trauma Response Level	1	1	$3,000.00	$3,000.00	$3,000.00	$3,000.00	$3,000.00	2025-03-01
26011	CPT	Drainage Finger Abscess Complicated	1	1	$2,970.00	$2,970.00	$2,970.00	$2,970.00	$2,970.00	2025-03-01
13132	CPT	Pf-repair Complex Chin 2.	2	1	$2,923.50	$2,923.50	$1,462.00	$4,385.00	$2,923.50	2025-03-01
23931	CPT	I&d Upper Arm & Elbow Bu	2	1	$2,910.50	$2,910.50	$1,455.00	$4,366.00	$2,910.50	2025-03-01
93312	CPT	US Tee	1	1	$2,750.00	$2,750.00	$2,750.00	$2,750.00	$2,750.00	2025-03-01
15240	CPT	Full Thickness Graft 20	2	1	$2,658.50	$2,658.50	$1,211.00	$4,106.00	$2,658.50	2025-03-01
28208	CPT	Pf-repair Extensor Tendon	2	1	$2,654.50	$2,654.50	$223.00	$5,086.00	$2,654.50	2025-03-01
P9052	HCPCS	Bb Platelets	1	1	$2,580.00	$2,580.00	$2,580.00	$2,580.00	$2,580.00	2025-03-01
14301	CPT	Pf-adjacent Tissue Transf	1	1	$2,548.00	$2,548.00	$2,548.00	$2,548.00	$2,548.00	2025-03-01
J0129	HCPCS	Abatacept 250mg Vial (orencia)	1	1	$2,487.50	$2,487.50	$2,487.50	$2,487.50	$2,487.50	2025-03-01
36556	CPT	Central Line Insertion 5	3	1	$2,461.00	$2,461.00	$426.00	$3,322.00	$2,461.00	2025-03-01
43999	CPT	Unlisted Procedure Stomac	1	1	$2,460.00	$2,460.00	$2,460.00	$2,460.00	$2,460.00	2025-03-01
25660	CPT	Clsd Treat Carpal Disloca	2	1	$2,451.50	$2,451.50	$1,227.00	$3,676.00	$2,451.50	2025-03-01
27792	CPT	Fx Care Distal Fibula W/w	2	1	$2,414.50	$2,414.50	$806.00	$4,023.00	$2,414.50	2025-03-01
11400	CPT	Exc Lesion 0.5 Or Less	1	1	$2,401.00	$2,401.00	$2,401.00	$2,401.00	$2,401.00	2025-03-01
26418	CPT	Pf-repair Extensor Tendon	2	1	$2,336.50	$2,336.50	$273.00	$4,400.00	$2,336.50	2025-03-01
46999	CPT	Unlisted Proc Anus	1	1	$2,310.00	$2,310.00	$2,310.00	$2,310.00	$2,310.00	2025-03-01
36569	CPT	Insertion Picc Cath	1	1	$2,257.00	$2,257.00	$2,257.00	$2,257.00	$2,257.00	2025-03-01
70015	CPT	Cisternography S&i	1	1	$2,247.00	$2,247.00	$2,247.00	$2,247.00	$2,247.00	2025-03-01
72194	CPT	CT Pelvis Wwo	1	1	$2,200.00	$2,200.00	$2,200.00	$2,200.00	$2,200.00	2025-03-01
46050	CPT	Incision Of Anal Abscess	1	1	$2,193.00	$2,193.00	$2,193.00	$2,193.00	$2,193.00	2025-03-01
99285	CPT	Emergency Room Lev 5	3	1	$2,193.00	$2,193.00	$576.00	$2,193.00	$2,193.00	2025-03-01
99291	CPT	Critical Care 30-74 Min	3	1	$2,167.00	$2,167.00	$880.00	$2,926.00	$2,167.00	2025-03-01
93306	CPT	US Echocardiogram 2d Doppler Color	1	1	$2,151.00	$2,151.00	$2,151.00	$2,151.00	$2,151.00	2025-03-01
73206	CPT	CTA Upper Extremity	1	1	$2,145.00	$2,145.00	$2,145.00	$2,145.00	$2,145.00	2025-03-01
81455	CPT	Next Generation Sequencing Panel	1	1	$2,138.00	$2,138.00	$2,138.00	$2,138.00	$2,138.00	2025-03-01
36430	CPT	Bb Blood Administration 6-8	2	1	$2,123.00	$2,123.00	$924.00	$3,322.00	$2,123.00	2025-03-01
J3489	HCPCS	Zoledronic Acid 5mg/100ml Vial (reclast)	1	1	$2,109.50	$2,109.50	$2,109.50	$2,109.50	$2,109.50	2025-03-01
6510259	LOCAL	Derma Gel Wound Dressing	1	1	$2,104.76	$2,104.76	$2,104.76	$2,104.76	$2,104.76	2025-03-01
12037	CPT	Rpr Scalp Trunk Over 30.0	1	1	$2,100.00	$2,100.00	$2,100.00	$2,100.00	$2,100.00	2025-03-01
70553	CPT	MRI Brain Wwo	1	1	$2,090.00	$2,090.00	$2,090.00	$2,090.00	$2,090.00	2025-03-01
70543	CPT	MRI Orbit Face Neck Wwo	1	1	$2,090.00	$2,090.00	$2,090.00	$2,090.00	$2,090.00	2025-03-01
36590	CPT	Removal Tunneled Central Venous Access	1	1	$2,090.00	$2,090.00	$2,090.00	$2,090.00	$2,090.00	2025-03-01
23505	CPT	Trmt Clavicular Fx W/mani	1	1	$2,090.00	$2,090.00	$2,090.00	$2,090.00	$2,090.00	2025-03-01
20822	CPT	Pf-replantation Digit Amp	2	1	$2,081.50	$2,081.50	$1,675.00	$2,488.00	$2,081.50	2025-03-01
72157	CPT	MRI T Spine Wwo	1	1	$1,980.00	$1,980.00	$1,980.00	$1,980.00	$1,980.00	2025-03-01
72156	CPT	MRI C Spine Wwo	1	1	$1,980.00	$1,980.00	$1,980.00	$1,980.00	$1,980.00	2025-03-01
72148	CPT	MRI Spine Lumbar Wo	1	1	$1,980.00	$1,980.00	$1,980.00	$1,980.00	$1,980.00	2025-03-01
74183	CPT	MRI Abdomen Wwo	1	1	$1,980.00	$1,980.00	$1,980.00	$1,980.00	$1,980.00	2025-03-01
72158	CPT	MRI Spine Lumbar Wwo	1	1	$1,980.00	$1,980.00	$1,980.00	$1,980.00	$1,980.00	2025-03-01
J1561	HCPCS	Immune Globulin 10gm Vial (gamunex-c)	2	1	$1,968.75	$1,968.75	$1,312.50	$2,625.00	$1,968.75	2025-03-01
40800	CPT	Drainage Abscess Mouth Simple	1	1	$1,891.00	$1,891.00	$1,891.00	$1,891.00	$1,891.00	2025-03-01
74178	CPT	CT Abdomen Pelvis Wwo	1	1	$1,870.00	$1,870.00	$1,870.00	$1,870.00	$1,870.00	2025-03-01
10081	CPT	I&d Cyst Complicated	1	1	$1,870.00	$1,870.00	$1,870.00	$1,870.00	$1,870.00	2025-03-01
70470	CPT	CT Head Wwo	1	1	$1,870.00	$1,870.00	$1,870.00	$1,870.00	$1,870.00	2025-03-01
74177	CPT	CT Abdomen Pelvis W	1	1	$1,870.00	$1,870.00	$1,870.00	$1,870.00	$1,870.00	2025-03-01
81404	CPT	Apo E4	1	1	$1,812.00	$1,812.00	$1,812.00	$1,812.00	$1,812.00	2025-03-01
74170	CPT	CT Abdomen Wwo	1	1	$1,760.00	$1,760.00	$1,760.00	$1,760.00	$1,760.00	2025-03-01
2100065	LOCAL	Episiotomy Repair	1	1	$1,728.00	$1,728.00	$1,728.00	$1,728.00	$1,728.00	2025-03-01
90375	CPT	Rabies Immune Globulin	1	1	$1,691.87	$1,691.87	$1,691.87	$1,691.87	$1,691.87	2025-03-01
55100	CPT	Drainage Abscess Scrotum	2	1	$1,690.50	$1,690.50	$851.00	$2,530.00	$1,690.50	2025-03-01
78226	CPT	Nm Hida Imaging Without Flow	1	1	$1,663.00	$1,663.00	$1,663.00	$1,663.00	$1,663.00	2025-03-01
78227	CPT	Nm Hida Imaging W/flow	1	1	$1,663.00	$1,663.00	$1,663.00	$1,663.00	$1,663.00	2025-03-01
27752	CPT	Fx Care Tibial Shaft W/ma	2	1	$1,650.50	$1,650.50	$1,559.00	$1,742.00	$1,650.50	2025-03-01
72141	CPT	MRI C Spine Wo	1	1	$1,650.00	$1,650.00	$1,650.00	$1,650.00	$1,650.00	2025-03-01
73221	CPT	MRI Up Ext Joint Wo Left	3	1	$1,650.00	$1,650.00	$1,650.00	$1,650.00	$1,650.00	2025-03-01
70488	CPT	CT Face Sinus Wwo	1	1	$1,650.00	$1,650.00	$1,650.00	$1,650.00	$1,650.00	2025-03-01
70491	CPT	CT Neck Soft Tissue W	1	1	$1,650.00	$1,650.00	$1,650.00	$1,650.00	$1,650.00	2025-03-01
73702	CPT	CT Low Ext Wwo Bilat	3	1	$1,650.00	$1,650.00	$1,018.00	$2,145.00	$1,650.00	2025-03-01
70460	CPT	CT Head W	1	1	$1,650.00	$1,650.00	$1,650.00	$1,650.00	$1,650.00	2025-03-01
72146	CPT	MRI T Spine Wo	1	1	$1,650.00	$1,650.00	$1,650.00	$1,650.00	$1,650.00	2025-03-01
5360211	LOCAL	Cytogenetics-chromosome A	1	1	$1,639.00	$1,639.00	$1,639.00	$1,639.00	$1,639.00	2025-03-01
73223	CPT	MRI Up Ext Joint Wwo Left	2	1	$1,628.00	$1,628.00	$1,628.00	$1,628.00	$1,628.00	2025-03-01
70549	CPT	MRA Neck Wwo	1	1	$1,628.00	$1,628.00	$1,628.00	$1,628.00	$1,628.00	2025-03-01
73225	CPT	MRA Up Extrem Wo/w-bil	3	1	$1,628.00	$1,628.00	$1,628.00	$3,366.00	$1,628.00	2025-03-01
74185	CPT	MRA Abdomen Wwo	1	1	$1,628.00	$1,628.00	$1,628.00	$1,628.00	$1,628.00	2025-03-01
70545	CPT	MRA Head W	1	1	$1,628.00	$1,628.00	$1,628.00	$1,628.00	$1,628.00	2025-03-01
70546	CPT	MRA Head Wwo	1	1	$1,628.00	$1,628.00	$1,628.00	$1,628.00	$1,628.00	2025-03-01
72198	CPT	MRA Pelvis Wwo	1	1	$1,628.00	$1,628.00	$1,628.00	$1,628.00	$1,628.00	2025-03-01
74182	CPT	MRI Abdomen W	1	1	$1,628.00	$1,628.00	$1,628.00	$1,628.00	$1,628.00	2025-03-01
73723	CPT	MRI Low Ext Joint Wwo Left	3	1	$1,628.00	$1,628.00	$1,628.00	$3,366.00	$1,628.00	2025-03-01
73725	CPT	MRA Low Extremity W/wo Bi	6	1	$1,628.00	$1,628.00	$1,100.00	$3,366.00	$1,628.00	2025-03-01
73720	CPT	MRI Low Ext Nonjoint Wwo Left	2	1	$1,628.00	$1,628.00	$1,628.00	$1,628.00	$1,628.00	2025-03-01
49020	CPT	Drainage Of Abscess	1	1	$1,614.00	$1,614.00	$1,614.00	$1,614.00	$1,614.00	2025-03-01
19285	CPT	US Breast Localization 1st	1	1	$1,605.00	$1,605.00	$1,605.00	$1,605.00	$1,605.00	2025-03-01
27762	CPT	Fx Care Medial Malleolus	2	1	$1,559.50	$1,559.50	$1,377.00	$1,742.00	$1,559.50	2025-03-01
1000001	LOCAL	Step Down Private Room	1	1	$1,550.00	$1,550.00	$1,550.00	$1,550.00	$1,550.00	2025-03-01
72197	CPT	MRI Pelvis Wwo	1	1	$1,540.00	$1,540.00	$1,540.00	$1,540.00	$1,540.00	2025-03-01
73218	CPT	MRI Up Ext Nonjoint Wo Left	3	1	$1,540.00	$1,540.00	$1,540.00	$2,310.00	$1,540.00	2025-03-01
73220	CPT	MRI Up Ext Nonjoint Wwo	1	1	$1,540.00	$1,540.00	$1,540.00	$1,540.00	$1,540.00	2025-03-01
G0257	HCPCS	Unscheduled Outpt Dialysi	1	1	$1,529.00	$1,529.00	$1,529.00	$1,529.00	$1,529.00	2025-03-01
90935	CPT	Hemodialysis W/phy Evalua	1	1	$1,522.00	$1,522.00	$1,522.00	$1,522.00	$1,522.00	2025-03-01
70010	CPT	Myelography S&i	1	1	$1,507.00	$1,507.00	$1,507.00	$1,507.00	$1,507.00	2025-03-01
78582	CPT	Nm Lung Perf W/vent	1	1	$1,502.00	$1,502.00	$1,502.00	$1,502.00	$1,502.00	2025-03-01
24605	CPT	Pf-reduce Dislocated Elbo	2	1	$1,500.50	$1,500.50	$1,301.00	$1,700.00	$1,500.50	2025-03-01
81226	CPT	Cytochrome P450-2d6	1	1	$1,498.00	$1,498.00	$1,498.00	$1,498.00	$1,498.00	2025-03-01
99284	CPT	Emergency Room Lev 4	3	1	$1,486.00	$1,486.00	$377.00	$1,486.00	$1,486.00	2025-03-01
73580	CPT	Xr Arthrogram Knee Supervision	2	1	$1,485.00	$1,485.00	$990.00	$1,980.00	$1,485.00	2025-03-01
46040	CPT	I&d Perirectal Abscess	2	1	$1,478.50	$1,478.50	$1,227.00	$1,730.00	$1,478.50	2025-03-01
78306	CPT	Nm Bone Imaging Whole Body	1	1	$1,448.00	$1,448.00	$1,448.00	$1,448.00	$1,448.00	2025-03-01
70492	CPT	CT Neck Soft Tissue Wwo	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
72193	CPT	CT Pelvis W	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
70547	CPT	MRA Neck Wo	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
72132	CPT	CT L Spine W	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
70544	CPT	MRA Head Wo	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
74181	CPT	MRI Abdomen Wo	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
73701	CPT	CT Low Ext W Bilat	3	1	$1,430.00	$1,430.00	$908.00	$1,925.00	$1,430.00	2025-03-01
73201	CPT	CT Up Ext W Bilat	3	1	$1,430.00	$1,430.00	$1,430.00	$1,925.00	$1,430.00	2025-03-01
72126	CPT	CT Cervical Spine W	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
73721	CPT	MRI Low Ext Joint Wo Left	3	1	$1,430.00	$1,430.00	$1,430.00	$2,310.00	$1,430.00	2025-03-01
72195	CPT	MRI Pelvis Wo	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
73718	CPT	MRI Low Ext Nonjoint Wo Left	3	1	$1,430.00	$1,430.00	$1,430.00	$2,310.00	$1,430.00	2025-03-01
70450	CPT	CT Head Wo	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
70551	CPT	MRI Brain Wo	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
74176	CPT	CT Abdomen Pelvis Wo	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
74160	CPT	CT Abdomen W	1	1	$1,430.00	$1,430.00	$1,430.00	$1,430.00	$1,430.00	2025-03-01
73719	CPT	MRI Low Ext Nonjoint W Left	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
71551	CPT	MRI Chest W	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
72149	CPT	MRI Spine Lumber W	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
71555	CPT	MRA Chest Wwo	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
73222	CPT	MRI Up Ext Joint W Left	2	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
72147	CPT	MRI T Spine W	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
73722	CPT	MRI Low Ext Joint W Bilat	3	1	$1,409.00	$1,409.00	$1,409.00	$2,928.00	$1,409.00	2025-03-01
72142	CPT	MRI C Spine W	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
70552	CPT	MRI Brain W	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
73219	CPT	MRI Up Ext Nonjoint W Left	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
72196	CPT	MRI Pelvis W	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
70548	CPT	MRA Neck W	1	1	$1,409.00	$1,409.00	$1,409.00	$1,409.00	$1,409.00	2025-03-01
45915	CPT	Pf-rem Fecal Impact Fb With	2	1	$1,383.50	$1,383.50	$692.00	$2,075.00	$1,383.50	2025-03-01
36560	CPT	Central Line Insert Under	2	1	$1,366.00	$1,366.00	$160.00	$2,572.00	$1,366.00	2025-03-01
32557	CPT	Incision Pleura W Imaging	1	1	$1,364.00	$1,364.00	$1,364.00	$1,364.00	$1,364.00	2025-03-01
32555	CPT	Thoracentesis W Imaging	1	1	$1,364.00	$1,364.00	$1,364.00	$1,364.00	$1,364.00	2025-03-01
1000008	LOCAL	Isolation Room	1	1	$1,350.00	$1,350.00	$1,350.00	$1,350.00	$1,350.00	2025-03-01
1000004	LOCAL	Telemetry Private Room	1	1	$1,350.00	$1,350.00	$1,350.00	$1,350.00	$1,350.00	2025-03-01
1000005	LOCAL	Telemetry Semi Private Room	1	1	$1,350.00	$1,350.00	$1,350.00	$1,350.00	$1,350.00	2025-03-01
45999	CPT	Rem Fecal Impact	1	1	$1,348.00	$1,348.00	$1,348.00	$1,348.00	$1,348.00	2025-03-01
78709	CPT	Nm Kidney Scan W/flow & Func	1	1	$1,320.00	$1,320.00	$1,320.00	$1,320.00	$1,320.00	2025-03-01
72125	CPT	CT Cervical Spine Wo	1	1	$1,320.00	$1,320.00	$1,320.00	$1,320.00	$1,320.00	2025-03-01
78707	CPT	Nm Kidney Imaging W/function	1	1	$1,320.00	$1,320.00	$1,320.00	$1,320.00	$1,320.00	2025-03-01
70486	CPT	CT Face Sinus Wo	1	1	$1,320.00	$1,320.00	$1,320.00	$1,320.00	$1,320.00	2025-03-01
70487	CPT	CT Face Sinus W	1	1	$1,320.00	$1,320.00	$1,320.00	$1,320.00	$1,320.00	2025-03-01
70490	CPT	CT Neck Soft Tissue Wo	1	1	$1,320.00	$1,320.00	$1,320.00	$1,320.00	$1,320.00	2025-03-01
49999	CPT	Manual Reduction Of Herni	2	1	$1,313.50	$1,313.50	$414.00	$2,213.00	$1,313.50	2025-03-01
20103	CPT	Exp Penetrating Wound Ext	2	1	$1,308.50	$1,308.50	$1,146.00	$1,471.00	$1,308.50	2025-03-01
88348	CPT	Electron Microscopy	1	1	$1,300.00	$1,300.00	$1,300.00	$1,300.00	$1,300.00	2025-03-01
90970	CPT	Esrd Dialysis Patient Ove	1	1	$1,300.00	$1,300.00	$1,300.00	$1,300.00	$1,300.00	2025-03-01
10140	CPT	I & D Hematoma	2	1	$1,293.50	$1,293.50	$377.00	$2,210.00	$1,293.50	2025-03-01
78801	CPT	Nm Scintigram - Multiple Are	1	1	$1,265.00	$1,265.00	$1,265.00	$1,265.00	$1,265.00	2025-03-01
78014	CPT	Nm Thyroid Imaging Quantitat	1	1	$1,261.00	$1,261.00	$1,261.00	$1,261.00	$1,261.00	2025-03-01
1000003	LOCAL	Step Down Semi Private Room	1	1	$1,250.00	$1,250.00	$1,250.00	$1,250.00	$1,250.00	2025-03-01
23655	CPT	Pf-reduction/dis Shoulder	2	1	$1,249.50	$1,249.50	$1,189.00	$1,310.00	$1,249.50	2025-03-01
75820	CPT	Xr Venogram Unilateral	1	1	$1,242.00	$1,242.00	$1,242.00	$1,242.00	$1,242.00	2025-03-01
11010	CPT	Debridement W/fb Removal	2	1	$1,237.50	$1,237.50	$63.00	$2,412.00	$1,237.50	2025-03-01
78216	CPT	Nm Liver/speen W/vascular Fl	1	1	$1,228.00	$1,228.00	$1,228.00	$1,228.00	$1,228.00	2025-03-01
78708	CPT	Nm Kidney Imaging Single Stu	2	1	$1,221.00	$1,221.00	$1,122.00	$1,320.00	$1,221.00	2025-03-01
72131	CPT	CT L Spine Wo	1	1	$1,210.00	$1,210.00	$1,210.00	$1,210.00	$1,210.00	2025-03-01
72192	CPT	CT Pelvis Wo	1	1	$1,210.00	$1,210.00	$1,210.00	$1,210.00	$1,210.00	2025-03-01
73200	CPT	CT Up Ext Wo Left	3	1	$1,210.00	$1,210.00	$1,210.00	$1,430.00	$1,210.00	2025-03-01
71271	CPT	CT Low Dose Lung Ca Screening	1	1	$1,210.00	$1,210.00	$1,210.00	$1,210.00	$1,210.00	2025-03-01
72128	CPT	CT Thoracic Spine Wo	1	1	$1,210.00	$1,210.00	$1,210.00	$1,210.00	$1,210.00	2025-03-01
74150	CPT	CT Abdomen Wo	1	1	$1,210.00	$1,210.00	$1,210.00	$1,210.00	$1,210.00	2025-03-01
73700	CPT	CT Low Ext Wo Bilat	3	1	$1,210.00	$1,210.00	$1,210.00	$1,210.00	$1,210.00	2025-03-01
71270	CPT	CT Chest Wwo	2	1	$1,169.00	$1,169.00	$358.00	$1,980.00	$1,169.00	2025-03-01
70481	CPT	CT Iac W	2	1	$1,169.00	$1,169.00	$908.00	$1,430.00	$1,169.00	2025-03-01
78195	CPT	Nm Scintigraphy Lymphatics/n	1	1	$1,155.00	$1,155.00	$1,155.00	$1,155.00	$1,155.00	2025-03-01
46250	CPT	Excision Of External Hemo	2	1	$1,151.50	$1,151.50	$268.00	$2,035.00	$1,151.50	2025-03-01
1000006	LOCAL	Swing Bed	1	1	$1,150.00	$1,150.00	$1,150.00	$1,150.00	$1,150.00	2025-03-01
1000000	LOCAL	Private Room	1	1	$1,150.00	$1,150.00	$1,150.00	$1,150.00	$1,150.00	2025-03-01
37618	CPT	Arterial Ligation Extremi	1	1	$1,146.00	$1,146.00	$1,146.00	$1,146.00	$1,146.00	2025-03-01
J3486	HCPCS	Ziprasidone 20mg Vial (geodon)	1	1	$1,144.00	$1,144.00	$1,144.00	$1,144.00	$1,144.00	2025-03-01
81270	CPT	Jak2 Gene Mutation	1	1	$1,141.00	$1,141.00	$1,141.00	$1,141.00	$1,141.00	2025-03-01
84999	CPT	Ova 1	2	1	$1,123.50	$1,123.50	$45.00	$2,202.00	$1,123.50	2025-03-01
J0878	HCPCS	Daptomycin 500mg Vial (cubicin)	1	1	$1,122.75	$1,122.75	$1,122.75	$1,122.75	$1,122.75	2025-03-01
87912	CPT	Hbv Genotype	1	1	$1,120.00	$1,120.00	$1,120.00	$1,120.00	$1,120.00	2025-03-01
J1670	HCPCS	Tetanus Immune Glob 250 Unt(hypertet-sd)	1	1	$1,119.75	$1,119.75	$1,119.75	$1,119.75	$1,119.75	2025-03-01
66999	CPT	Pf-unlisted Proc Anterio	2	1	$1,118.50	$1,118.50	$37.00	$2,200.00	$1,118.50	2025-03-01
93308	CPT	US Echocardiogram Ltd-f/u	1	1	$1,114.00	$1,114.00	$1,114.00	$1,114.00	$1,114.00	2025-03-01
71550	CPT	MRI Chest Wo	1	1	$1,100.00	$1,100.00	$1,100.00	$1,100.00	$1,100.00	2025-03-01
70336	CPT	MRI Temporomandibular Joint	1	1	$1,100.00	$1,100.00	$1,100.00	$1,100.00	$1,100.00	2025-03-01
70540	CPT	MRI Orbit Face Neck Wo	1	1	$1,100.00	$1,100.00	$1,100.00	$1,100.00	$1,100.00	2025-03-01
11401	CPT	Exc Lesion 0.6-1.0	1	1	$1,100.00	$1,100.00	$1,100.00	$1,100.00	$1,100.00	2025-03-01
90945	CPT	Dialysis Single Evaluati	1	1	$1,096.00	$1,096.00	$1,096.00	$1,096.00	$1,096.00	2025-03-01
J0248	HCPCS	Remdesivir 100 Mg (veklury) Vial	1	1	$1,092.00	$1,092.00	$1,092.00	$1,092.00	$1,092.00	2025-03-01
37211	CPT	Pf-transcatheter Therapy	1	1	$1,073.00	$1,073.00	$1,073.00	$1,073.00	$1,073.00	2025-03-01
25605	CPT	Fx Care Distal Radius W/m	2	1	$1,071.00	$1,071.00	$365.00	$1,777.00	$1,071.00	2025-03-01
32556	CPT	Incision Pleura Without Imagi	2	1	$1,058.00	$1,058.00	$466.00	$1,650.00	$1,058.00	2025-03-01
3500057	LOCAL	Amoxicillin/clav 125mg/5ml 75ml Susp	1	1	$1,052.25	$1,052.25	$1,052.25	$1,052.25	$1,052.25	2025-03-01
11760	CPT	Pf-repair Of Nail Bed	2	1	$1,042.00	$1,042.00	$413.00	$1,671.00	$1,042.00	2025-03-01
13131	CPT	Repair Face, Hands, Feet	1	1	$1,023.00	$1,023.00	$1,023.00	$1,023.00	$1,023.00	2025-03-01
73202	CPT	CT Up Ext Wwo Left	1	1	$1,018.00	$1,018.00	$1,018.00	$1,018.00	$1,018.00	2025-03-01
72130	CPT	CT Thoracic Spine Wwo	1	1	$1,018.00	$1,018.00	$1,018.00	$1,018.00	$1,018.00	2025-03-01
72133	CPT	CT L Spine Wwo	1	1	$1,018.00	$1,018.00	$1,018.00	$1,018.00	$1,018.00	2025-03-01
70482	CPT	CT Orbits W/wo	1	1	$1,018.00	$1,018.00	$1,018.00	$1,018.00	$1,018.00	2025-03-01
3506785	LOCAL	Granix 480mcg/0.8ml Syringe	1	1	$1,007.75	$1,007.75	$1,007.75	$1,007.75	$1,007.75	2025-03-01
12035	CPT	Int Rpr Trunk/ext 12.6-20	2	1	$1,006.00	$1,006.00	$758.00	$1,254.00	$1,006.00	2025-03-01
1000002	LOCAL	Semi Private Room	1	1	$1,000.00	$1,000.00	$1,000.00	$1,000.00	$1,000.00	2025-03-01
J1442	HCPCS	Filgrastim 300mcg/1ml Vial (neupogen)	2	1	$999.50	$999.50	$771.25	$1,227.75	$999.50	2025-03-01
25565	CPT	Fx Care Radius/ulna W/man	2	1	$996.00	$996.00	$518.00	$1,474.00	$996.00	2025-03-01
70480	CPT	CT Orbits Wo	2	1	$990.00	$990.00	$660.00	$1,320.00	$990.00	2025-03-01
78580	CPT	Nm Lung Perf Without Vent	1	1	$990.00	$990.00	$990.00	$990.00	$990.00	2025-03-01
73040	CPT	Xr Arthrogram Shoulder	1	1	$990.00	$990.00	$990.00	$990.00	$990.00	2025-03-01
81401	CPT	Huntington's Disease	2	1	$984.50	$984.50	$554.00	$1,415.00	$984.50	2025-03-01
76098	CPT	Xr Breast Specimen	1	1	$983.00	$983.00	$983.00	$983.00	$983.00	2025-03-01
94003	CPT	Vent Subs Day	1	1	$982.00	$982.00	$982.00	$982.00	$982.00	2025-03-01
94002	CPT	Vent First Day	1	1	$982.00	$982.00	$982.00	$982.00	$982.00	2025-03-01
74249	CPT	Xr Fluoro Ugi W Air W Sbft	1	1	$979.00	$979.00	$979.00	$979.00	$979.00	2025-03-01
P9022	HCPCS	Bb Washed Rbc Unit	1	1	$956.00	$956.00	$956.00	$956.00	$956.00	2025-03-01
45900	CPT	Pf-reduction Of Procident	2	1	$955.00	$955.00	$619.00	$1,291.00	$955.00	2025-03-01
81220	CPT	Cystic Fibrosis Mutation	1	1	$952.00	$952.00	$952.00	$952.00	$952.00	2025-03-01
36593	CPT	Declotting Of Implanted Vascular Access	1	1	$950.00	$950.00	$950.00	$950.00	$950.00	2025-03-01
78015	CPT	Nm Body Thy C I131 Limited A	1	1	$949.00	$949.00	$949.00	$949.00	$949.00	2025-03-01
3500579	LOCAL	Metronidazole 1% Topical Gel	1	1	$948.75	$948.75	$948.75	$948.75	$948.75	2025-03-01
27818	CPT	Open Fx Ankle W/manipulat	2	1	$947.50	$947.50	$518.00	$1,377.00	$947.50	2025-03-01
25690	CPT	Closed Trmt Lunate Disloc	2	1	$940.00	$940.00	$138.00	$1,742.00	$940.00	2025-03-01
93017	CPT	EKG-stress Test	1	1	$936.00	$936.00	$936.00	$936.00	$936.00	2025-03-01
49082	CPT	Abdominal Paracentesis	2	1	$931.50	$931.50	$249.00	$1,614.00	$931.50	2025-03-01
27265	CPT	Closed Trmt Post Hip Disl	2	1	$928.50	$928.50	$625.00	$1,232.00	$928.50	2025-03-01
24600	CPT	Pf-reduction Dislocated E	2	1	$926.00	$926.00	$844.00	$1,008.00	$926.00	2025-03-01
P9040	HCPCS	Bb Packed Rbc - Irradiated L	1	1	$920.00	$920.00	$920.00	$920.00	$920.00	2025-03-01
78264	CPT	Nm Gastric Empty Study	1	1	$915.00	$915.00	$915.00	$915.00	$915.00	2025-03-01
78315	CPT	Nm Bone Scan 3 Phase	1	1	$912.00	$912.00	$912.00	$912.00	$912.00	2025-03-01
72129	CPT	CT Thoracic Spine W	1	1	$908.00	$908.00	$908.00	$908.00	$908.00	2025-03-01
72270	CPT	Xr Myelography 2 Or More W I	1	1	$908.00	$908.00	$908.00	$908.00	$908.00	2025-03-01
3507319	LOCAL	Avycaz 2.5gm (nf)	1	1	$904.20	$904.20	$904.20	$904.20	$904.20	2025-03-01
93225	CPT	Holter Monitor 24 Hours	3	1	$903.00	$903.00	$231.00	$1,218.00	$903.00	2025-03-01
71260	CPT	CT Chest W	2	1	$894.00	$894.00	$358.00	$1,430.00	$894.00	2025-03-01
37609	CPT	Ligation Temporal Artery	2	1	$892.00	$892.00	$273.00	$1,511.00	$892.00	2025-03-01
59414	CPT	Delivery Of Placenta	2	1	$886.00	$886.00	$329.00	$1,443.00	$886.00	2025-03-01
73525	CPT	MRI Shoulder Arthrogram	1	1	$884.00	$884.00	$884.00	$884.00	$884.00	2025-03-01
99283	CPT	Emergency Room Lev 3	3	1	$883.00	$883.00	$256.00	$883.00	$883.00	2025-03-01
74247	CPT	Xr Fluoro Ugi W Air W Kub	1	1	$876.00	$876.00	$876.00	$876.00	$876.00	2025-03-01
72265	CPT	Xr Myelography Lumbosacral W	1	1	$873.00	$873.00	$873.00	$873.00	$873.00	2025-03-01
3500312	LOCAL	Estrogens, Conj 0.625mg/gm Vag Crm	1	1	$870.50	$870.50	$870.50	$870.50	$870.50	2025-03-01
90937	CPT	Hemodialysis Repeat Evalu	1	1	$867.00	$867.00	$867.00	$867.00	$867.00	2025-03-01
88309	CPT	Frozen Sec 2 Spec	3	1	$859.00	$859.00	$487.00	$1,352.00	$859.00	2025-03-01
G0259	HCPCS	Xr Arthrogram Sacroiliac Joints	1	1	$855.00	$855.00	$855.00	$855.00	$855.00	2025-03-01
76700	CPT	US Abdomen Complete	1	1	$851.00	$851.00	$851.00	$851.00	$851.00	2025-03-01
5360520	LOCAL	Myasthenia Gravis Panel #	1	1	$842.00	$842.00	$842.00	$842.00	$842.00	2025-03-01
27550	CPT	Closed Trmt Knee Dislocat	2	1	$837.00	$837.00	$260.00	$1,414.00	$837.00	2025-03-01
74174	CPT	CT CTA Aorta W Contrast	1	1	$835.00	$835.00	$835.00	$835.00	$835.00	2025-03-01
70498	CPT	CTA Neck	1	1	$835.00	$835.00	$835.00	$835.00	$835.00	2025-03-01
71275	CPT	CT CTA Chest W Contrast	1	1	$835.00	$835.00	$835.00	$835.00	$835.00	2025-03-01
24655	CPT	Fx Care Radius W/manipula	2	1	$834.50	$834.50	$461.00	$1,208.00	$834.50	2025-03-01
23665	CPT	Pf-reduce Shoulder Fx/dis	2	1	$834.50	$834.50	$461.00	$1,208.00	$834.50	2025-03-01
62272	CPT	Pf-spinal Puncture For Dr	2	1	$833.50	$833.50	$361.00	$1,306.00	$833.50	2025-03-01
24065	CPT	Pf-trmt Radial Fx Without Man	2	1	$828.50	$828.50	$146.00	$1,511.00	$828.50	2025-03-01
94726	CPT	Total Lung Capacity	1	1	$825.00	$825.00	$825.00	$825.00	$825.00	2025-03-01
78070	CPT	Nm Parathyroid Scan	1	1	$823.00	$823.00	$823.00	$823.00	$823.00	2025-03-01
87902	CPT	Hcv Ns-5a Drug Resistant	1	1	$816.00	$816.00	$816.00	$816.00	$816.00	2025-03-01
78278	CPT	Nm Gi Blood Localizatn	1	1	$814.00	$814.00	$814.00	$814.00	$814.00	2025-03-01
9002050	LOCAL	Anchor Suture	1	1	$814.00	$814.00	$814.00	$814.00	$814.00	2025-03-01
27840	CPT	Pf-reduction Dislocated A	2	1	$805.00	$805.00	$518.00	$1,092.00	$805.00	2025-03-01
92960	CPT	Cardioversion	3	1	$800.00	$800.00	$219.00	$1,093.00	$800.00	2025-03-01
93975	CPT	US Abd/renal/scrotal/pelvic Art	2	1	$798.00	$798.00	$747.00	$849.00	$798.00	2025-03-01
24565	CPT	Fx Care Humerus W/manipul	2	1	$793.50	$793.50	$132.00	$1,455.00	$793.50	2025-03-01
95816	CPT	EEG	1	1	$788.00	$788.00	$788.00	$788.00	$788.00	2025-03-01
40650	CPT	Pf-repair Of Lip Full Th	2	1	$786.50	$786.50	$662.00	$911.00	$786.50	2025-03-01
93701	CPT	Bioimped Thoracic Elect	1	1	$784.00	$784.00	$784.00	$784.00	$784.00	2025-03-01
71250	CPT	CT Chest Wo	2	1	$784.00	$784.00	$358.00	$1,210.00	$784.00	2025-03-01
62270	CPT	Lumbar Puncture	2	1	$784.00	$784.00	$262.00	$1,306.00	$784.00	2025-03-01
27750	CPT	Fx Care Tibial Shaft Without	2	1	$782.50	$782.50	$624.00	$941.00	$782.50	2025-03-01
78800	CPT	Nm Gallium Scan/rad Loclz Tu	1	1	$781.00	$781.00	$781.00	$781.00	$781.00	2025-03-01
31603	CPT	Pf-tracheostomy Emergenc	2	1	$780.00	$780.00	$766.00	$794.00	$780.00	2025-03-01
26725	CPT	Fx Care Finger W/manipula	2	1	$770.00	$770.00	$624.00	$916.00	$770.00	2025-03-01
73615	CPT	Xr Arthrogram Ankle	1	1	$768.00	$768.00	$768.00	$768.00	$768.00	2025-03-01
64400	CPT	Nerve Block Injection	1	1	$762.00	$762.00	$762.00	$762.00	$762.00	2025-03-01
6510312	LOCAL	Multi-lumen Cvc Kit	1	1	$757.82	$757.82	$757.82	$757.82	$757.82	2025-03-01
3500636	LOCAL	Nitroprusside 25mg/ml 2ml Vial	1	1	$756.00	$756.00	$756.00	$756.00	$756.00	2025-03-01
3500102	LOCAL	Betaxolol 0.25% Ophth Drops (betoptic-s)	1	1	$755.50	$755.50	$755.50	$755.50	$755.50	2025-03-01
12036	CPT	Pf-repair Lac Scalp 20.1-	2	1	$750.50	$750.50	$246.00	$1,255.00	$750.50	2025-03-01
27810	CPT	Fx Care Bimalleolar Ankle	2	1	$749.00	$749.00	$377.00	$1,121.00	$749.00	2025-03-01
78999	CPT	Nm Unlisted Misc Procedure	1	1	$746.00	$746.00	$746.00	$746.00	$746.00	2025-03-01
74430	CPT	Xr Cystography 3 Views	1	1	$746.00	$746.00	$746.00	$746.00	$746.00	2025-03-01
26605	CPT	Fx Care Metacarpal W/mani	2	1	$743.00	$743.00	$624.00	$862.00	$743.00	2025-03-01
74740	CPT	Xr Fluoro Hysterosalpingography	1	1	$743.00	$743.00	$743.00	$743.00	$743.00	2025-03-01
J1720	HCPCS	Hydrocortisone Sod Succ 100mg Vial	2	1	$738.25	$738.25	$46.00	$1,430.50	$738.25	2025-03-01
93923	CPT	US Ankle/brachial Index Measurement	1	1	$729.00	$729.00	$729.00	$729.00	$729.00	2025-03-01
85247	CPT	Von Willebrand Panel	1	1	$728.00	$728.00	$728.00	$728.00	$728.00	2025-03-01
29065	CPT	Application Long Arm Cast	1	1	$728.00	$728.00	$728.00	$728.00	$728.00	2025-03-01

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