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

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Hospital

Everest Rehabilitation Hospital Longview

Longview, TX · CCN 673073 · Rates published

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You selected 93306 (CPT)

US 2D ECHO DOPPLER/COLOR FLOW

This hospital’s price: $988 across 8 payers

Source: https://www.longviewrehabhospital.com/docs/irflongviewrehabilitationhospitallibraries/mar2026/921253139_longview-rehabilitation-hospital_standardcharges.csv.zip · observed 2026-03-16

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.

13,405 distinct procedures filed
10 distinct payers
148,884 rate rows
2026-03-16 last MRF observed
Data quality

108,279 of 148,884 rate rows are consumer-grade (72.7%)

40,605 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
per-diem day rate — not a per-procedure price 40,605
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.longviewrehabhospital.com/docs/irflongviewrehabilitationhospitallibraries/mar2026/921253139_longview-rehabilitation-hospital_standardcharges.csv.zip
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-10-22
Content fingerprint 96228d344c61d2f4… · 1,702,292 bytes · first seen 2026-05-13

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
74080530
CDM 		Occ/emb Non Hemorr Art 8 $56,399.93 $56,399.93 $56,399.93 nat. median
$55,326
1.0× median
74080529
CDM 		Occ/emb Non Hemorr Venous 8 $56,399.93 $56,399.93 $56,399.93 nat. median
$55,326
1.0× median
74080532
CDM 		Occ/emb Hemorrhag/lymph 8 $56,399.93 $56,399.93 $56,399.93 nat. median
$55,326
1.0× median
74080531
CDM 		Occ/emb Tumor/organ Infar 8 $56,399.93 $56,399.93 $56,399.93 nat. median
$55,326
1.0× median
74080268
CDM 		Insert Tips 8 $48,288.18 $48,288.18 $48,288.18 nat. median
$47,368
1.0× median
74080483
CDM 		Revise Tips 8 $47,034.04 $47,034.04 $47,034.04 nat. median
$46,138
1.0× median
76085035
CDM 		Sm153 Lexidron To 150mci 8 $41,825.76 $41,825.76 $41,825.76 nat. median
$41,029
1.0× median
74080527
CDM 		Stnt Plc Transc Vein Ini 8 $39,032.60 $39,032.60 $39,032.60 nat. median
$38,289
1.0× median
74080525
CDM 		Stnt Plc Transcth Art Ini 8 $38,869.80 $38,869.80 $38,869.80 nat. median
$38,129
1.0× median
76085037
CDM 		Strontium Sr-89 Thera/mci 8 $38,865.52 $38,865.52 $38,865.52 nat. median
$38,125
1.0× median
74080549
CDM 		Verteb Augm Ea Add W Imag 8 $38,769.13 $38,769.13 $38,769.13 nat. median
$38,031
1.0× median
74080547
CDM 		Verteb Augm Thorac W Imag 8 $38,769.13 $38,769.13 $38,769.13 nat. median
$38,031
1.0× median
74080548
CDM 		Verteb Augm Lumbar W Imag 8 $38,769.13 $38,769.13 $38,769.13 nat. median
$38,031
1.0× median
36224
CPT 		Place Cath Int Carotid Art Bi 8 $35,853.69 $35,853.69 $35,853.69 nat. median
$7,122
outlier · 5.0×
92218460
CDM 		Gamunex-c 1 Gm/10 Ml Sol 8 $29,397.06 $29,397.06 $29,397.06 nat. median
$27,997
1.1× median
36226
CPT 		Place Cath Vertebral Art Bi 8 $29,036.88 $29,036.88 $29,036.88 nat. median
$6,845
outlier · 4.2×
36901
CPT 		Intro Dial Graft 8 $28,319.15 $28,319.15 $28,319.15 nat. median
$1,838
outlier · 15.4×
92220143
CDM 		Interferon Beta-1a30mcg/0.5ml 8 $26,703.08 $26,703.08 $26,703.08 nat. median
$25,432
1.1× median
74080477
CDM 		Revas Tib Peron Ather Add 8 $26,002.81 $26,002.81 $26,002.81 nat. median
$25,508
1.0× median
74080479
CDM 		Revas Tib Peron Stent Ini 8 $26,002.81 $26,002.81 $26,002.81 nat. median
$25,508
1.0× median
74080478
CDM 		Revas Tib Peron Ather Ini 8 $26,002.81 $26,002.81 $26,002.81 nat. median
$25,508
1.0× median
74080481
CDM 		Revas Tib Pr Stnt Ath Ini 8 $26,002.81 $26,002.81 $26,002.81 nat. median
$25,508
1.0× median
74080468
CDM 		Revas Fem Pop Atherectomy 8 $25,905.35 $25,905.35 $25,905.35 nat. median
$25,412
1.0× median
74080469
CDM 		Revas Fem Pop Stent Ather 8 $25,905.35 $25,905.35 $25,905.35 nat. median
$25,412
1.0× median
74080471
CDM 		Revas Femoral Poplt Stent 8 $25,905.35 $25,905.35 $25,905.35 nat. median
$25,412
1.0× median
77020083
CDM 		Liver Tumor Ablat Rf Perc 8 $25,297.02 $25,297.02 $25,297.02 nat. median
$24,815
1.0× median
92218223
CDM 		Soliris 10mg/ml Inj 8 $24,656.94 $24,656.94 $24,656.94 nat. median
$23,483
1.1× median
76085057
CDM 		In111 Satumomab Dx To 6mc 8 $24,275.29 $24,275.29 $24,275.29 nat. median
$23,813
1.0× median
74080660
CDM 		Plc Stnt Bile Duct New Ea 8 $24,053.59 $24,053.59 $24,053.59 nat. median
$23,595
1.0× median
74080661
CDM 		Pl St Bile Duct Cth Nw Ea 8 $24,053.59 $24,053.59 $24,053.59 nat. median
$23,595
1.0× median
74080580
CDM 		Plc Stent Bile Duct Ex Ea 8 $24,053.59 $24,053.59 $24,053.59 nat. median
$23,595
1.0× median
74080582
CDM 		Pl St Bile Duct Cth Nw Ea 8 $24,053.59 $24,053.59 $24,053.59 nat. median
$23,595
1.0× median
74080581
CDM 		Plc Stnt Bile Duct New Ea 8 $24,053.59 $24,053.59 $24,053.59 nat. median
$23,595
1.0× median
74080659
CDM 		Plc Stent Bile Duct Ex Ea 8 $24,053.59 $24,053.59 $24,053.59 nat. median
$23,595
1.0× median
74080421
CDM 		Nephrostolithotm/pyel<2cm 8 $23,284.61 $23,284.61 $23,284.61 nat. median
$22,841
1.0× median
76085056
CDM 		In-111 Pentetr Dx To 6mci 8 $23,220.35 $23,220.35 $23,220.35 nat. median
$22,778
1.0× median
36907
CPT 		Pta Central Dial Seg Add On 8 $22,581.68 $22,581.68 $22,581.68 nat. median
$3,788
outlier · 6.0×
92214439
CDM 		Pegfilgrastim 6mg/0.6ml Sol 8 $22,453.20 $22,453.20 $22,453.20 nat. median
$21,384
1.1× median
76085053
CDM 		In-111 Capromab To 10mci 8 $22,383.90 $22,383.90 $22,383.90 nat. median
$21,958
1.0× median
74080376
CDM 		Extrm Vein Ablat Rf 1st 8 $21,462.84 $21,462.84 $21,462.84 nat. median
$21,054
1.0× median
74080507
CDM 		Translum Ather Abd Aorta 8 $21,362.17 $21,362.17 $21,362.17 nat. median
$20,955
1.0× median
74080509
CDM 		Translum Atherec Brach Ea 8 $21,362.17 $21,362.17 $21,362.17 nat. median
$20,955
1.0× median
74080510
CDM 		Translum Atherec Iliac Ea 8 $21,362.17 $21,362.17 $21,362.17 nat. median
$20,955
1.0× median
74080511
CDM 		Translum Athr Visceral Ea 8 $21,362.17 $21,362.17 $21,362.17 nat. median
$20,955
1.0× median
74080508
CDM 		Translum Ather Renal Art 8 $21,362.17 $21,362.17 $21,362.17 nat. median
$20,955
1.0× median
92218770
CDM 		Immune Globulin 40 Gm Sol 8 $19,958.40 $19,958.40 $19,958.40 nat. median
$19,008
1.1× median
92220181
CDM 		Immune Globul10% 100mg/ml Vial 8 $19,584.18 $19,584.18 $19,584.18 nat. median
$18,652
1.1× median
92218149
CDM 		Simulect 20mg Inj 8 $19,468.95 $19,468.95 $19,468.95 nat. median
$18,542
1.0× median
74080386
CDM 		Hemodialys Upp Extr Dril 8 $19,450.43 $19,450.43 $19,450.43 nat. median
$19,080
1.0× median
74080528
CDM 		Stnt Plc Transc Vein Add 8 $18,736.07 $18,736.07 $18,736.07 nat. median
$18,379
1.0× median

Other procedures at this hospital

Browse this hospital's 13,405 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
74080530 CDM Occ/emb Non Hemorr Art 8 8 $56,399.93 $56,399.93 $56,399.93 $56,399.93 $56,399.93 2026-03-16
74080531 CDM Occ/emb Tumor/organ Infar 8 8 $56,399.93 $56,399.93 $56,399.93 $56,399.93 $56,399.93 2026-03-16
74080529 CDM Occ/emb Non Hemorr Venous 8 8 $56,399.93 $56,399.93 $56,399.93 $56,399.93 $56,399.93 2026-03-16
74080532 CDM Occ/emb Hemorrhag/lymph 8 8 $56,399.93 $56,399.93 $56,399.93 $56,399.93 $56,399.93 2026-03-16
74080268 CDM Insert Tips 8 8 $48,288.18 $48,288.18 $48,288.18 $48,288.18 $48,288.18 2026-03-16
74080483 CDM Revise Tips 8 8 $47,034.04 $47,034.04 $47,034.04 $47,034.04 $47,034.04 2026-03-16
76085035 CDM Sm153 Lexidron To 150mci 8 8 $41,825.76 $41,825.76 $41,825.76 $41,825.76 $41,825.76 2026-03-16
74080527 CDM Stnt Plc Transc Vein Ini 8 8 $39,032.60 $39,032.60 $39,032.60 $39,032.60 $39,032.60 2026-03-16
74080525 CDM Stnt Plc Transcth Art Ini 8 8 $38,869.80 $38,869.80 $38,869.80 $38,869.80 $38,869.80 2026-03-16
76085037 CDM Strontium Sr-89 Thera/mci 8 8 $38,865.52 $38,865.52 $38,865.52 $38,865.52 $38,865.52 2026-03-16
74080548 CDM Verteb Augm Lumbar W Imag 8 8 $38,769.13 $38,769.13 $38,769.13 $38,769.13 $38,769.13 2026-03-16
74080547 CDM Verteb Augm Thorac W Imag 8 8 $38,769.13 $38,769.13 $38,769.13 $38,769.13 $38,769.13 2026-03-16
74080549 CDM Verteb Augm Ea Add W Imag 8 8 $38,769.13 $38,769.13 $38,769.13 $38,769.13 $38,769.13 2026-03-16
36224 CPT Place Cath Int Carotid Art Bi 8 8 $35,853.69 $35,853.69 $35,853.69 $35,853.69 $35,853.69 2026-03-16
92218460 CDM Gamunex-c 1 Gm/10 Ml Sol 8 8 $29,397.06 $29,397.06 $29,397.06 $29,397.06 $29,397.06 2026-03-16
36226 CPT Place Cath Vertebral Art Bi 8 8 $29,036.88 $29,036.88 $29,036.88 $29,036.88 $29,036.88 2026-03-16
36901 CPT Intro Dial Graft 8 8 $28,319.15 $28,319.15 $28,319.15 $28,319.15 $28,319.15 2026-03-16
92220143 CDM Interferon Beta-1a30mcg/0.5ml 8 8 $26,703.08 $26,703.08 $26,703.08 $26,703.08 $26,703.08 2026-03-16
74080478 CDM Revas Tib Peron Ather Ini 8 8 $26,002.81 $26,002.81 $26,002.81 $26,002.81 $26,002.81 2026-03-16
74080481 CDM Revas Tib Pr Stnt Ath Ini 8 8 $26,002.81 $26,002.81 $26,002.81 $26,002.81 $26,002.81 2026-03-16
74080479 CDM Revas Tib Peron Stent Ini 8 8 $26,002.81 $26,002.81 $26,002.81 $26,002.81 $26,002.81 2026-03-16
74080477 CDM Revas Tib Peron Ather Add 8 8 $26,002.81 $26,002.81 $26,002.81 $26,002.81 $26,002.81 2026-03-16
74080471 CDM Revas Femoral Poplt Stent 8 8 $25,905.35 $25,905.35 $25,905.35 $25,905.35 $25,905.35 2026-03-16
74080469 CDM Revas Fem Pop Stent Ather 8 8 $25,905.35 $25,905.35 $25,905.35 $25,905.35 $25,905.35 2026-03-16
74080468 CDM Revas Fem Pop Atherectomy 8 8 $25,905.35 $25,905.35 $25,905.35 $25,905.35 $25,905.35 2026-03-16
77020083 CDM Liver Tumor Ablat Rf Perc 8 8 $25,297.02 $25,297.02 $25,297.02 $25,297.02 $25,297.02 2026-03-16
92218223 CDM Soliris 10mg/ml Inj 8 8 $24,656.94 $24,656.94 $24,656.94 $24,656.94 $24,656.94 2026-03-16
76085057 CDM In111 Satumomab Dx To 6mc 8 8 $24,275.29 $24,275.29 $24,275.29 $24,275.29 $24,275.29 2026-03-16
74080660 CDM Plc Stnt Bile Duct New Ea 8 8 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080661 CDM Pl St Bile Duct Cth Nw Ea 8 8 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080659 CDM Plc Stent Bile Duct Ex Ea 8 8 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080581 CDM Plc Stnt Bile Duct New Ea 8 8 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080580 CDM Plc Stent Bile Duct Ex Ea 8 8 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080582 CDM Pl St Bile Duct Cth Nw Ea 8 8 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080421 CDM Nephrostolithotm/pyel<2cm 8 8 $23,284.61 $23,284.61 $23,284.61 $23,284.61 $23,284.61 2026-03-16
76085056 CDM In-111 Pentetr Dx To 6mci 8 8 $23,220.35 $23,220.35 $23,220.35 $23,220.35 $23,220.35 2026-03-16
36907 CPT Pta Central Dial Seg Add On 8 8 $22,581.68 $22,581.68 $22,581.68 $22,581.68 $22,581.68 2026-03-16
92214439 CDM Pegfilgrastim 6mg/0.6ml Sol 8 8 $22,453.20 $22,453.20 $22,453.20 $22,453.20 $22,453.20 2026-03-16
76085053 CDM In-111 Capromab To 10mci 8 8 $22,383.90 $22,383.90 $22,383.90 $22,383.90 $22,383.90 2026-03-16
74080376 CDM Extrm Vein Ablat Rf 1st 8 8 $21,462.84 $21,462.84 $21,462.84 $21,462.84 $21,462.84 2026-03-16
74080511 CDM Translum Athr Visceral Ea 8 8 $21,362.17 $21,362.17 $21,362.17 $21,362.17 $21,362.17 2026-03-16
74080510 CDM Translum Atherec Iliac Ea 8 8 $21,362.17 $21,362.17 $21,362.17 $21,362.17 $21,362.17 2026-03-16
74080509 CDM Translum Atherec Brach Ea 8 8 $21,362.17 $21,362.17 $21,362.17 $21,362.17 $21,362.17 2026-03-16
74080507 CDM Translum Ather Abd Aorta 8 8 $21,362.17 $21,362.17 $21,362.17 $21,362.17 $21,362.17 2026-03-16
74080508 CDM Translum Ather Renal Art 8 8 $21,362.17 $21,362.17 $21,362.17 $21,362.17 $21,362.17 2026-03-16
92218770 CDM Immune Globulin 40 Gm Sol 8 8 $19,958.40 $19,958.40 $19,958.40 $19,958.40 $19,958.40 2026-03-16
92220181 CDM Immune Globul10% 100mg/ml Vial 8 8 $19,584.18 $19,584.18 $19,584.18 $19,584.18 $19,584.18 2026-03-16
92218149 CDM Simulect 20mg Inj 8 8 $19,468.95 $19,468.95 $19,468.95 $19,468.95 $19,468.95 2026-03-16
74080386 CDM Hemodialys Upp Extr Dril 8 8 $19,450.43 $19,450.43 $19,450.43 $19,450.43 $19,450.43 2026-03-16
74080528 CDM Stnt Plc Transc Vein Add 8 8 $18,736.07 $18,736.07 $18,736.07 $18,736.07 $18,736.07 2026-03-16
74080526 CDM Stnt Plc Transcth Art Add 8 8 $18,411.56 $18,411.56 $18,411.56 $18,411.56 $18,411.56 2026-03-16
92217181 CDM Octreotide Acet 30mg Inj 8 8 $17,651.12 $17,651.12 $17,651.12 $17,651.12 $17,651.12 2026-03-16
92215273 CDM Ethacrynate Na 50mg Inj 8 8 $17,390.30 $17,390.30 $17,390.30 $17,390.30 $17,390.30 2026-03-16
92213161 CDM Alteplase Recomb 50mg Inj 8 8 $16,632.69 $16,632.69 $16,632.69 $16,632.69 $16,632.69 2026-03-16
74080537 CDM Cth Plc Renal Art Sel Rt 8 8 $16,486.97 $16,486.97 $16,486.97 $16,486.97 $16,486.97 2026-03-16
74080536 CDM Cth Plc Renal Suprsel Lt 8 8 $16,486.97 $16,486.97 $16,486.97 $16,486.97 $16,486.97 2026-03-16
74080535 CDM Cth Plc Renal Suprsel Rt 8 8 $16,486.97 $16,486.97 $16,486.97 $16,486.97 $16,486.97 2026-03-16
74080538 CDM Cth Plc Renal Art Sel Lt 8 8 $16,486.97 $16,486.97 $16,486.97 $16,486.97 $16,486.97 2026-03-16
74080272 CDM Endovas Repr Visc Aorta 2 8 8 $16,361.67 $16,361.67 $16,361.67 $16,361.67 $16,361.67 2026-03-16
74080271 CDM Endovas Repr Visc Aorta 1 8 8 $16,361.67 $16,361.67 $16,361.67 $16,361.67 $16,361.67 2026-03-16
74080274 CDM Endovas Repr Visc Aorta 4 8 8 $16,361.67 $16,361.67 $16,361.67 $16,361.67 $16,361.67 2026-03-16
74080273 CDM Endovas Repr Visc Aorta 3 8 8 $16,361.67 $16,361.67 $16,361.67 $16,361.67 $16,361.67 2026-03-16
92218595 CDM Pertuzumab 30 Mg/ml Sol 8 8 $16,344.22 $16,344.22 $16,344.22 $16,344.22 $16,344.22 2026-03-16
92220159 CDM Fidaxomicin 40 Mg/ml Sus 8 8 $16,111.12 $16,111.12 $16,111.12 $16,111.12 $16,111.12 2026-03-16
74080546 CDM Vertebropl Inj Add W Imag 8 8 $15,953.62 $15,953.62 $15,953.62 $15,953.62 $15,953.62 2026-03-16
74080545 CDM Vertebropl Inj L/s W Imag 8 8 $15,953.62 $15,953.62 $15,953.62 $15,953.62 $15,953.62 2026-03-16
74080544 CDM Vertebropl Inj C/t W Imag 8 8 $15,953.62 $15,953.62 $15,953.62 $15,953.62 $15,953.62 2026-03-16
92218511 CDM Gamunex-c 1 Gm/10 Ml Inj 8 8 $15,953.46 $15,953.46 $15,953.46 $15,953.46 $15,953.46 2026-03-16
76085045 CDM Arcitumomab Dx To 45mci 8 8 $15,817.60 $15,817.60 $15,817.60 $15,817.60 $15,817.60 2026-03-16
74080422 CDM Nephrostolithotm/pyel>2cm 8 8 $15,806.89 $15,806.89 $15,806.89 $15,806.89 $15,806.89 2026-03-16
74080499 CDM Thrombect Av Grft Nondial 8 8 $15,786.54 $15,786.54 $15,786.54 $15,786.54 $15,786.54 2026-03-16
76085006 CDM Nm Iobenguan I-131/0.5mci 8 8 $15,686.94 $15,686.94 $15,686.94 $15,686.94 $15,686.94 2026-03-16
92217475 CDM Leuprolide Acet 22.5mg Kit Pi3 8 8 $15,124.76 $15,124.76 $15,124.76 $15,124.76 $15,124.76 2026-03-16
92218596 CDM Trastuzumab 440 Mg Sol 8 8 $14,905.55 $14,905.55 $14,905.55 $14,905.55 $14,905.55 2026-03-16
76085069 CDM In-111 Wbc Dx Per Dose 8 8 $14,664.13 $14,664.13 $14,664.13 $14,664.13 $14,664.13 2026-03-16
92215810 CDM Darbepoetin A 500mcg/1ml Inj 8 8 $14,628.60 $14,628.60 $14,628.60 $14,628.60 $14,628.60 2026-03-16
74080430 CDM Peritl Cth Drn/dialy Perm 8 8 $14,519.55 $14,519.55 $14,519.55 $14,519.55 $14,519.55 2026-03-16
74080392 CDM Ins Intraperit Cath Perm 8 8 $14,379.25 $14,379.25 $14,379.25 $14,379.25 $14,379.25 2026-03-16
74080442 CDM Pta Brachiocep Ea Ves 8 8 $14,352.47 $14,352.47 $14,352.47 $14,352.47 $14,352.47 2026-03-16
74080517 CDM Ven Mech Thrombect Ea Add 8 8 $13,795.55 $13,795.55 $13,795.55 $13,795.55 $13,795.55 2026-03-16
75020094 CDM Cholecystostomy Perc 8 8 $13,759.14 $13,759.14 $13,759.14 $13,759.14 $13,759.14 2026-03-16
74080542 CDM Extrm Ven Ablat Laser Add 8 8 $13,707.73 $13,707.73 $13,707.73 $13,707.73 $13,707.73 2026-03-16
74080524 CDM Venous Mech Thrombectomy 8 8 $13,524.59 $13,524.59 $13,524.59 $13,524.59 $13,524.59 2026-03-16
74080285 CDM Art Mech Thrombectmy Prim 8 8 $13,524.59 $13,524.59 $13,524.59 $13,524.59 $13,524.59 2026-03-16
74080414 CDM Lig/strp Short Saph Vein 8 8 $13,345.73 $13,345.73 $13,345.73 $13,345.73 $13,345.73 2026-03-16
74080413 CDM Lig/div/exc Var Vein 1leg 8 8 $13,345.73 $13,345.73 $13,345.73 $13,345.73 $13,345.73 2026-03-16
92217507 CDM Certolizumab Pegol 200mg/ml In 8 8 $13,268.37 $13,268.37 $13,268.37 $13,268.37 $13,268.37 2026-03-16
74080572 CDM Plc Uret Stnt Nw W Cth Bi 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
77020103 CDM Plc Uret Stnt Nw W Cth Bi 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
74080571 CDM Plc Ureter Stnt New W Cth 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
77020101 CDM Plc Ureter Stnt Nw Acc Bi 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
74080570 CDM Plc Ureter Stnt Nw Acc Bi 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
74080568 CDM Plc Ureter Stnt Pre Ex Bi 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
77020100 CDM Plc Ureter Stnt Nw Access 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
77020099 CDM Plc Ureter Stnt Pre Ex Bi 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
74080569 CDM Plc Ureter Stnt Nw Access 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
74080567 CDM Plc Ureter Stnt Pre Exist 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
77020102 CDM Plc Ureter Stnt New W Cth 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
77020098 CDM Plc Ureter Stnt Pre Exist 8 8 $13,103.69 $13,103.69 $13,103.69 $13,103.69 $13,103.69 2026-03-16
92217953 CDM Romiplostim 500mcg Inj 8 8 $13,004.40 $13,004.40 $13,004.40 $13,004.40 $13,004.40 2026-03-16
74080653 CDM Cholang Nw Acces Inj Imag 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080574 CDM Cholang Nw Acces Inj Imag 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080576 CDM Plc Bili Drn Cth Int-ext 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080578 CDM Exch Bili Drn Cath W Imag 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080577 CDM Conv Bili Drn Cth Int-ext 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080657 CDM Exch Bili Drn Cath W Imag 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080656 CDM Conv Bili Drn Cth Int-ext 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080655 CDM Plc Bili Drn Cth Int-ext 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080662 CDM Plc Access Bili Tree Sb 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080575 CDM Plc Bili Drn Cth Ext Imag 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080654 CDM Plc Bili Drn Cth Ext Imag 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080583 CDM Plc Access Bili Tree Sb 8 8 $12,715.98 $12,715.98 $12,715.98 $12,715.98 $12,715.98 2026-03-16
74080377 CDM Extrm Ven Ablat Rf Ea Add 8 8 $12,668.86 $12,668.86 $12,668.86 $12,668.86 $12,668.86 2026-03-16
92217176 CDM Octreotide Acet 20mg Pdr 8 8 $12,517.25 $12,517.25 $12,517.25 $12,517.25 $12,517.25 2026-03-16
92220164 CDM Aripipr Laur 1064mg/3.9ml Susp 8 8 $12,516.37 $12,516.37 $12,516.37 $12,516.37 $12,516.37 2026-03-16
76085076 CDM I-123 Ioflupne To5mci/dse 8 8 $12,086.24 $12,086.24 $12,086.24 $12,086.24 $12,086.24 2026-03-16
74080498 CDM Thrombect Av Fistl W/grft 8 8 $12,045.54 $12,045.54 $12,045.54 $12,045.54 $12,045.54 2026-03-16
74080448 CDM Rem Pericath Mater Cv Dev 8 8 $11,989.85 $11,989.85 $11,989.85 $11,989.85 $11,989.85 2026-03-16
74080447 CDM Rem Intralum Materl Cvdev 8 8 $11,989.85 $11,989.85 $11,989.85 $11,989.85 $11,989.85 2026-03-16
74080412 CDM Lig/strip Saph W Exc Ulcr 8 8 $11,761.72 $11,761.72 $11,761.72 $11,761.72 $11,761.72 2026-03-16
92219404 CDM Immune Glob 10% 100 Mg/ml Sol 8 8 $11,655.00 $11,655.00 $11,655.00 $11,655.00 $11,655.00 2026-03-16
92217325 CDM Teriparatide 600mcg/2.4ml Sol 8 8 $11,332.06 $11,332.06 $11,332.06 $11,332.06 $11,332.06 2026-03-16
74080543 CDM Rpr Intest Fistula W Plug 8 8 $11,264.78 $11,264.78 $11,264.78 $11,264.78 $11,264.78 2026-03-16
74080431 CDM Peritl Cth W Sq Resr Perm 8 8 $11,244.43 $11,244.43 $11,244.43 $11,244.43 $11,244.43 2026-03-16
92214015 CDM Digoxin Immune Fab Ov 40mg Inj 8 8 $11,231.45 $11,231.45 $11,231.45 $11,231.45 $11,231.45 2026-03-16
75020102 CDM Bx Leg/ankl Sft Tiss Deep 8 8 $11,230.51 $11,230.51 $11,230.51 $11,230.51 $11,230.51 2026-03-16
77020104 CDM Bx Leg/ankl Sft Tiss Deep 8 8 $11,230.51 $11,230.51 $11,230.51 $11,230.51 $11,230.51 2026-03-16
21925 CPT Bx Back/flnk Sft Tis Deep 8 8 $11,128.76 $11,128.76 $11,128.76 $11,128.76 $11,128.76 2026-03-16
74250057 CDM Mr Low Extrem Jnt Wo&w Lt 8 8 $11,096.63 $11,096.63 $11,096.63 $11,096.63 $11,096.63 2026-03-16
74250034 CDM Mr Low Extrem Jnt Wo&w Rt 8 8 $11,096.63 $11,096.63 $11,096.63 $11,096.63 $11,096.63 2026-03-16
74080435 CDM Place Aorta Aortic Tube 8 8 $10,943.48 $10,943.48 $10,943.48 $10,943.48 $10,943.48 2026-03-16
74080475 CDM Revas Ipsil Ili Stent Add 8 8 $10,802.11 $10,802.11 $10,802.11 $10,802.11 $10,802.11 2026-03-16
74080473 CDM Revas Iliac Trns Ang Ini 8 8 $10,802.11 $10,802.11 $10,802.11 $10,802.11 $10,802.11 2026-03-16
74080482 CDM Revas Tibial Pern Ang Ini 8 8 $10,802.11 $10,802.11 $10,802.11 $10,802.11 $10,802.11 2026-03-16
74080480 CDM Revas Tib Pr Stnt Ath Add 8 8 $10,802.11 $10,802.11 $10,802.11 $10,802.11 $10,802.11 2026-03-16
74080474 CDM Revas Ipsil Ili Angio Add 8 8 $10,802.11 $10,802.11 $10,802.11 $10,802.11 $10,802.11 2026-03-16
74080476 CDM Revas Tib Peron Angio Add 8 8 $10,802.11 $10,802.11 $10,802.11 $10,802.11 $10,802.11 2026-03-16
74080472 CDM Revas Iliac Stent Ini Ves 8 8 $10,802.11 $10,802.11 $10,802.11 $10,802.11 $10,802.11 2026-03-16
74080470 CDM Revas Fem Pop Trans Angio 8 8 $10,774.26 $10,774.26 $10,774.26 $10,774.26 $10,774.26 2026-03-16
92211086 CDM Leuprolide Acet 30mg Kit Pi4 8 8 $10,764.87 $10,764.87 $10,764.87 $10,764.87 $10,764.87 2026-03-16
92216376 CDM Albumin Human 25% Ivs 8 8 $10,585.13 $10,585.13 $10,585.13 $10,585.13 $10,585.13 2026-03-16
72133 CPT CT Lumbar Spine W/wo Contrast 8 8 $10,514.01 $10,514.01 $10,514.01 $10,514.01 $10,514.01 2026-03-16
74080369 CDM Enterostomy/cecostmy Tube 8 8 $10,421.90 $10,421.90 $10,421.90 $10,421.90 $10,421.90 2026-03-16
92220165 CDM Aripipr Laur 882mg/3.2ml Susp 8 8 $10,375.41 $10,375.41 $10,375.41 $10,375.41 $10,375.41 2026-03-16
74080446 CDM Rem Fb Shoulder Deep 8 8 $10,339.43 $10,339.43 $10,339.43 $10,339.43 $10,339.43 2026-03-16
92217060 CDM Immune Globulin 10% Ivs 8 8 $9,979.20 $9,979.20 $9,979.20 $9,979.20 $9,979.20 2026-03-16
74080449 CDM Rem Perm Peritoneal Cath 8 8 $9,852.13 $9,852.13 $9,852.13 $9,852.13 $9,852.13 2026-03-16
74250030 CDM Mr Low Extrem Jnt W Rt 8 8 $9,783.59 $9,783.59 $9,783.59 $9,783.59 $9,783.59 2026-03-16
74250056 CDM Mr Low Extrem Jnt W Lt 8 8 $9,783.59 $9,783.59 $9,783.59 $9,783.59 $9,783.59 2026-03-16
74080624 CDM Cth Plc Eca Sel Addon 8 8 $9,712.90 $9,712.90 $9,712.90 $9,712.90 $9,712.90 2026-03-16
74080339 CDM Cth Plc Eca Sel Addon 8 8 $9,658.28 $9,658.28 $9,658.28 $9,658.28 $9,658.28 2026-03-16
74080350 CDM Cth Plc Vert Sel 8 8 $9,658.28 $9,658.28 $9,658.28 $9,658.28 $9,658.28 2026-03-16
74080351 CDM Cth Plc Vert Sel Bilat 8 8 $9,658.28 $9,658.28 $9,658.28 $9,658.28 $9,658.28 2026-03-16
74080341 CDM Cth Plc Ica Sel Bilat 8 8 $9,658.28 $9,658.28 $9,658.28 $9,658.28 $9,658.28 2026-03-16
74080340 CDM Cth Plc Ica Sel 8 8 $9,658.28 $9,658.28 $9,658.28 $9,658.28 $9,658.28 2026-03-16
74080343 CDM Cth Plc Renal Suprsel Bil 8 8 $9,603.66 $9,603.66 $9,603.66 $9,603.66 $9,603.66 2026-03-16
74080342 CDM Cth Plc Renal Art Sel Bil 8 8 $9,603.66 $9,603.66 $9,603.66 $9,603.66 $9,603.66 2026-03-16
92220174 CDM Risperidone 120 Mg Kit 8 8 $9,501.79 $9,501.79 $9,501.79 $9,501.79 $9,501.79 2026-03-16
74080298 CDM Av Fistul Lig/band Access 8 8 $9,408.74 $9,408.74 $9,408.74 $9,408.74 $9,408.74 2026-03-16
74080540 CDM Extrm Ven Ablat Laser 1st 8 8 $9,322.24 $9,322.24 $9,322.24 $9,322.24 $9,322.24 2026-03-16
77020052 CDM Bx Groin Mass 8 8 $9,279.14 $9,279.14 $9,279.14 $9,279.14 $9,279.14 2026-03-16
74080590 CDM Occlusion/embol Ureteral 8 8 $9,267.36 $9,267.36 $9,267.36 $9,267.36 $9,267.36 2026-03-16
92217838 CDM Immune Globulin 100mg/ml Inj 8 8 $9,147.92 $9,147.92 $9,147.92 $9,147.92 $9,147.92 2026-03-16
92218081 CDM Invega Sustenna 234mg Inj 8 8 $9,014.67 $9,014.67 $9,014.67 $9,014.67 $9,014.67 2026-03-16
74080585 CDM Plc Nephrou Cth Ima Nw Bi 8 8 $8,798.27 $8,798.27 $8,798.27 $8,798.27 $8,798.27 2026-03-16
74080584 CDM Plc Nephrour Cth Imag New 8 8 $8,798.27 $8,798.27 $8,798.27 $8,798.27 $8,798.27 2026-03-16
77020092 CDM Plc Nephrour Cth Imag New 8 8 $8,798.27 $8,798.27 $8,798.27 $8,798.27 $8,798.27 2026-03-16
77020091 CDM Plc Nephrostom Cth W Imag 8 8 $8,798.27 $8,798.27 $8,798.27 $8,798.27 $8,798.27 2026-03-16
77020093 CDM Plc Nephrou Cth Ima Nw Bi 8 8 $8,798.27 $8,798.27 $8,798.27 $8,798.27 $8,798.27 2026-03-16
74080563 CDM Plc Nephrostom Cth W Imag 8 8 $8,798.27 $8,798.27 $8,798.27 $8,798.27 $8,798.27 2026-03-16
92215574 CDM Darbepoetin A 300mcg/0.6ml Inj 8 8 $8,777.16 $8,777.16 $8,777.16 $8,777.16 $8,777.16 2026-03-16
75705 CPT Angio Spinal Selective 8 8 $8,416.99 $8,416.99 $8,416.99 $8,416.99 $8,416.99 2026-03-16
72142 CPT MRI Cervical W/contrast 8 8 $8,413.36 $8,413.36 $8,413.36 $8,413.36 $8,413.36 2026-03-16
92214994 CDM Adalimumab 40mg/0.8ml Kit 8 8 $8,393.93 $8,393.93 $8,393.93 $8,393.93 $8,393.93 2026-03-16
74080313 CDM Bx Up Arm Soft Tiss Super 8 8 $8,385.93 $8,385.93 $8,385.93 $8,385.93 $8,385.93 2026-03-16
74080415 CDM Ligation Vena Cava Infer 8 8 $8,339.88 $8,339.88 $8,339.88 $8,339.88 $8,339.88 2026-03-16
92213619 CDM Leuprolide Acet 22.5mg Kit Pi3 8 8 $8,215.96 $8,215.96 $8,215.96 $8,215.96 $8,215.96 2026-03-16
74080052 CDM Ir Portogram Wo Hemodynam 8 8 $8,151.38 $8,151.38 $8,151.38 $8,151.38 $8,151.38 2026-03-16
76085047 CDM Depreotide Dx Up To 35mci 8 8 $8,083.91 $8,083.91 $8,083.91 $8,083.91 $8,083.91 2026-03-16
75020079 CDM Pelvis/hip Abs Drain Deep 8 8 $8,037.86 $8,037.86 $8,037.86 $8,037.86 $8,037.86 2026-03-16
74080557 CDM Carotid Stnt Transc Anteg 8 8 $7,991.05 $7,991.05 $7,991.05 $7,991.05 $7,991.05 2026-03-16
A9547 HCPCS In-111 Oxyquinoline Per.5mci 8 8 $7,966.35 $7,966.35 $7,966.35 $7,966.35 $7,966.35 2026-03-16
74080534 CDM Image Cath Fluid Perito 8 8 $7,802.24 $7,802.24 $7,802.24 $7,802.24 $7,802.24 2026-03-16
74080533 CDM Image Cath Fluid Visceral 8 8 $7,802.24 $7,802.24 $7,802.24 $7,802.24 $7,802.24 2026-03-16
75020092 CDM Image Cath Fluid Visceral 8 8 $7,802.24 $7,802.24 $7,802.24 $7,802.24 $7,802.24 2026-03-16
75020093 CDM Image Cath Fluid Perito 8 8 $7,802.24 $7,802.24 $7,802.24 $7,802.24 $7,802.24 2026-03-16
77020082 CDM Image Cath Fluid Perito 8 8 $7,802.24 $7,802.24 $7,802.24 $7,802.24 $7,802.24 2026-03-16
77020081 CDM Image Cath Fluid Visceral 8 8 $7,802.24 $7,802.24 $7,802.24 $7,802.24 $7,802.24 2026-03-16
74080367 CDM Endovas Rpr Aaa Mod Bi 1 8 8 $7,777.60 $7,777.60 $7,777.60 $7,777.60 $7,777.60 2026-03-16
92217954 CDM Immune Globulin 1gm/10/ml Inj 8 8 $7,748.24 $7,748.24 $7,748.24 $7,748.24 $7,748.24 2026-03-16
74080300 CDM Biliary Endo Dx Perc 8 8 $7,664.08 $7,664.08 $7,664.08 $7,664.08 $7,664.08 2026-03-16
74080299 CDM Biliary Endo Bx Perc 8 8 $7,664.08 $7,664.08 $7,664.08 $7,664.08 $7,664.08 2026-03-16
92211207 CDM Calcitonin 200u/ml Inj 8 8 $7,657.93 $7,657.93 $7,657.93 $7,657.93 $7,657.93 2026-03-16
76085013 CDM Nm Myocar Plnr Wall Mult 8 8 $7,499.14 $7,499.14 $7,499.14 $7,499.14 $7,499.14 2026-03-16
78452 CPT Myocard Perf Multi Spect 8 8 $7,499.14 $7,499.14 $7,499.14 $7,499.14 $7,499.14 2026-03-16
74080444 CDM Pta Venous 8 8 $7,400.61 $7,400.61 $7,400.61 $7,400.61 $7,400.61 2026-03-16
72127 CPT CT Cervical Spine W&without Cont 8 8 $7,319.72 $7,319.72 $7,319.72 $7,319.72 $7,319.72 2026-03-16
74080513 CDM Rem&rep Nephroure Cth Ext 8 8 $7,296.72 $7,296.72 $7,296.72 $7,296.72 $7,296.72 2026-03-16
78804 CPT Nm Tumor Loc Whole Body 2+days 8 8 $7,258.17 $7,258.17 $7,258.17 $7,258.17 $7,258.17 2026-03-16
74080014 CDM Ir Aortogrm Abd W Iliofem 8 8 $7,222.82 $7,222.82 $7,222.82 $7,222.82 $7,222.82 2026-03-16
75726 CPT Angio Visceral Select 8 8 $7,169.27 $7,169.27 $7,169.27 $7,169.27 $7,169.27 2026-03-16
74020114 CDM Hc Ir Replace Tnl Cv Cath 8 8 $7,164.15 $7,164.15 $7,164.15 $7,164.15 $7,164.15 2026-03-16
92220175 CDM Risperidone 90 Mg Kit 8 8 $7,126.31 $7,126.31 $7,126.31 $7,126.31 $7,126.31 2026-03-16
74080303 CDM Bladder Asp W Ins Suprap 8 8 $7,028.97 $7,028.97 $7,028.97 $7,028.97 $7,028.97 2026-03-16
74182 CPT MRI Abdomen W/contrast 8 8 $6,874.75 $6,874.75 $6,874.75 $6,874.75 $6,874.75 2026-03-16
92215649 CDM Goserelin Acet 10.8mg Inj 8 8 $6,860.70 $6,860.70 $6,860.70 $6,860.70 $6,860.70 2026-03-16
75630 CPT Aortogram Abd&bil Femoral Ext 8 8 $6,815.84 $6,815.84 $6,815.84 $6,815.84 $6,815.84 2026-03-16
92215043 CDM Darbepoetin A 300mcg/ml Inj 8 8 $6,788.12 $6,788.12 $6,788.12 $6,788.12 $6,788.12 2026-03-16
76085011 CDM Nm Lymph System 8 8 $6,702.32 $6,702.32 $6,702.32 $6,702.32 $6,702.32 2026-03-16
74080357 CDM Dilate Bile Duct W Stent 8 8 $6,689.47 $6,689.47 $6,689.47 $6,689.47 $6,689.47 2026-03-16
74080500 CDM Thromboly Cerebr IV Infus 8 8 $6,689.47 $6,689.47 $6,689.47 $6,689.47 $6,689.47 2026-03-16
74080374 CDM Eval Cv Dvce W Fluoro Inj 8 8 $6,650.91 $6,650.91 $6,650.91 $6,650.91 $6,650.91 2026-03-16
74080626 CDM Eval Cv Dvce W Fluoro Inj 8 8 $6,650.91 $6,650.91 $6,650.91 $6,650.91 $6,650.91 2026-03-16
74250033 CDM Mr Low Extrem Jnt Wo Rt 8 8 $6,566.30 $6,566.30 $6,566.30 $6,566.30 $6,566.30 2026-03-16
74250032 CDM Mr Low Extrem Jnt Wo Lt 8 8 $6,566.30 $6,566.30 $6,566.30 $6,566.30 $6,566.30 2026-03-16
74250031 CDM Mr Low Extrem Jnt Wo Bil 8 8 $6,566.30 $6,566.30 $6,566.30 $6,566.30 $6,566.30 2026-03-16
92217241 CDM Romiplostim 250mcg Inj 8 8 $6,502.20 $6,502.20 $6,502.20 $6,502.20 $6,502.20 2026-03-16
74170 CPT CT Abdomen W/wo Contrast 8 8 $6,495.36 $6,495.36 $6,495.36 $6,495.36 $6,495.36 2026-03-16
70546 CPT MRA Head W/wo Contrast 8 8 $6,479.55 $6,479.55 $6,479.55 $6,479.55 $6,479.55 2026-03-16
74250052 CDM Mr Upp Extrem Jnt Wo&w Lt 8 8 $6,407.79 $6,407.79 $6,407.79 $6,407.79 $6,407.79 2026-03-16
74250045 CDM Mr Upp Extrem Jnt Wo&w Rt 8 8 $6,407.79 $6,407.79 $6,407.79 $6,407.79 $6,407.79 2026-03-16
92216796 CDM Immune Globulin 5% Inj 8 8 $6,404.11 $6,404.11 $6,404.11 $6,404.11 $6,404.11 2026-03-16
92218483 CDM Flebogamma 5 Gm/100 Ml Inj 8 8 $6,341.33 $6,341.33 $6,341.33 $6,341.33 $6,341.33 2026-03-16
92216576 CDM Multivatamin Inj 8 8 $6,233.22 $6,233.22 $6,233.22 $6,233.22 $6,233.22 2026-03-16
76085014 CDM Nm Myocar Plnr Wall Sngl 8 8 $6,224.65 $6,224.65 $6,224.65 $6,224.65 $6,224.65 2026-03-16
78451 CPT Myocard Perf Sgl Spect 8 8 $6,224.65 $6,224.65 $6,224.65 $6,224.65 $6,224.65 2026-03-16
74080334 CDM Cth Plc Abd/pel/ 3rd Init 8 8 $6,188.24 $6,188.24 $6,188.24 $6,188.24 $6,188.24 2026-03-16
92218343 CDM Velcade 3.5 Mg Vial 8 8 $6,093.36 $6,093.36 $6,093.36 $6,093.36 $6,093.36 2026-03-16
72149 CPT MRI Lumbar Sp W/contrast 8 8 $6,029.44 $6,029.44 $6,029.44 $6,029.44 $6,029.44 2026-03-16
72130 CPT CT Thoracic Spine W/wo Cont 8 8 $6,022.96 $6,022.96 $6,022.96 $6,022.96 $6,022.96 2026-03-16
74178 CPT CT Abd & Pelvis W/wo Contrast 8 8 $6,017.14 $6,017.14 $6,017.14 $6,017.14 $6,017.14 2026-03-16
92217549 CDM Paliperidone Palmitate 156mg S 8 8 $6,009.95 $6,009.95 $6,009.95 $6,009.95 $6,009.95 2026-03-16
74080010 CDM Ir Venogram Extremity Bil 8 8 $5,984.75 $5,984.75 $5,984.75 $5,984.75 $5,984.75 2026-03-16
72147 CPT MRI Thoracic W Contrast 8 8 $5,970.76 $5,970.76 $5,970.76 $5,970.76 $5,970.76 2026-03-16
73520050 CDM Tongue Base Vol Reduction 8 8 $5,965.47 $5,965.47 $5,965.47 $5,965.47 $5,965.47 2026-03-16
76085068 CDM Exametazime Wbc Dx/dose 8 8 $5,955.83 $5,955.83 $5,955.83 $5,955.83 $5,955.83 2026-03-16
74080013 CDM Ir Angio Extremity Bil 8 8 $5,947.26 $5,947.26 $5,947.26 $5,947.26 $5,947.26 2026-03-16
75716 CPT Angio Extremity Bilateral 8 8 $5,947.26 $5,947.26 $5,947.26 $5,947.26 $5,947.26 2026-03-16
77020002 CDM Xr Angio Extremity Bil 8 8 $5,947.26 $5,947.26 $5,947.26 $5,947.26 $5,947.26 2026-03-16
72129 CPT CT Thoracic Spine W/contrast 8 8 $5,941.49 $5,941.49 $5,941.49 $5,941.49 $5,941.49 2026-03-16
74080337 CDM Cth Plc Car/inom Art Sel 8 8 $5,926.91 $5,926.91 $5,926.91 $5,926.91 $5,926.91 2026-03-16
74080330 CDM Cth Pl Car/inm Art Sel Bi 8 8 $5,926.91 $5,926.91 $5,926.91 $5,926.91 $5,926.91 2026-03-16
74080331 CDM Cth Pl Car/inm Sel Ica Bi 8 8 $5,926.91 $5,926.91 $5,926.91 $5,926.91 $5,926.91 2026-03-16
74080345 CDM Cth Plc Thor Aor Nsel 8 8 $5,926.91 $5,926.91 $5,926.91 $5,926.91 $5,926.91 2026-03-16
74080506 CDM Transcth Ret Ivas Fb Perc 8 8 $5,926.91 $5,926.91 $5,926.91 $5,926.91 $5,926.91 2026-03-16
74080344 CDM Cth Plc Subc/inom Art Sel 8 8 $5,926.91 $5,926.91 $5,926.91 $5,926.91 $5,926.91 2026-03-16
74080338 CDM Cth Plc Car/inom Sel Ica 8 8 $5,926.91 $5,926.91 $5,926.91 $5,926.91 $5,926.91 2026-03-16
74080332 CDM Cth Pl Sub/inm Art Sel Bi 8 8 $5,926.91 $5,926.91 $5,926.91 $5,926.91 $5,926.91 2026-03-16
74080437 CDM Plc Interstit Perc Thorax 8 8 $5,898.00 $5,898.00 $5,898.00 $5,898.00 $5,898.00 2026-03-16
92215333 CDM Darbepoetin A 200mcg/ml Inj 8 8 $5,851.44 $5,851.44 $5,851.44 $5,851.44 $5,851.44 2026-03-16
92219401 CDM Immune Glob 10% 100 Mg/ml Sol 8 8 $5,828.76 $5,828.76 $5,828.76 $5,828.76 $5,828.76 2026-03-16
74080039 CDM Ir Aortogram Abd W Serial 8 8 $5,825.17 $5,825.17 $5,825.17 $5,825.17 $5,825.17 2026-03-16
74080137 CDM Xr Aortogram Abd W Serial 8 8 $5,825.17 $5,825.17 $5,825.17 $5,825.17 $5,825.17 2026-03-16
92218010 CDM Melphalan Hydrochl 50mg Inj 8 8 $5,813.64 $5,813.64 $5,813.64 $5,813.64 $5,813.64 2026-03-16
J0881 HCPCS Darbepoetin A 200mcg/0.4ml Inj 8 8 $5,772.19 $5,772.19 $5,772.19 $5,772.19 $5,772.19 2026-03-16
76085017 CDM Nm Pertechnetate Per Mci 8 8 $5,733.06 $5,733.06 $5,733.06 $5,733.06 $5,733.06 2026-03-16
70545 CPT MRA Head With Contrast 8 8 $5,712.71 $5,712.71 $5,712.71 $5,712.71 $5,712.71 2026-03-16
70482 CPT CT Intracranial Struc W/wo Con 8 8 $5,700.93 $5,700.93 $5,700.93 $5,700.93 $5,700.93 2026-03-16
92218310 CDM Actemra 20mg/ml 8 8 $5,673.78 $5,673.78 $5,673.78 $5,673.78 $5,673.78 2026-03-16
76085044 CDM Apcitide Dx To 20mci 8 8 $5,672.02 $5,672.02 $5,672.02 $5,672.02 $5,672.02 2026-03-16
74250040 CDM Mr Upp Extrem Jnt W Lt 8 8 $5,649.53 $5,649.53 $5,649.53 $5,649.53 $5,649.53 2026-03-16
74250041 CDM Mr Upp Extrem Jnt W Rt 8 8 $5,649.53 $5,649.53 $5,649.53 $5,649.53 $5,649.53 2026-03-16
74250039 CDM Mr Upp Extrem Jnt W Bil 8 8 $5,649.53 $5,649.53 $5,649.53 $5,649.53 $5,649.53 2026-03-16
74080246 CDM Xr Pta Peripheral Artery 8 8 $5,647.38 $5,647.38 $5,647.38 $5,647.38 $5,647.38 2026-03-16
74080054 CDM Ir Pta Peripheral Artery 8 8 $5,647.38 $5,647.38 $5,647.38 $5,647.38 $5,647.38 2026-03-16
74080057 CDM Ir Pta Venous 8 8 $5,645.24 $5,645.24 $5,645.24 $5,645.24 $5,645.24 2026-03-16
74080222 CDM Xr Pta Venous 8 8 $5,645.24 $5,645.24 $5,645.24 $5,645.24 $5,645.24 2026-03-16
74080197 CDM Xr Pta Venous 8 8 $5,645.24 $5,645.24 $5,645.24 $5,645.24 $5,645.24 2026-03-16
72195 CPT MRI Pelvis Without Contrast 8 8 $5,629.38 $5,629.38 $5,629.38 $5,629.38 $5,629.38 2026-03-16
92212836 CDM Insulin Hum Regular 500u/ml In 8 8 $5,620.86 $5,620.86 $5,620.86 $5,620.86 $5,620.86 2026-03-16
74177 CPT CT Abd & Pelvis W/contrast 8 8 $5,581.81 $5,581.81 $5,581.81 $5,581.81 $5,581.81 2026-03-16
77020106 CDM Sclero Fluid Collect Perc 8 8 $5,563.85 $5,563.85 $5,563.85 $5,563.85 $5,563.85 2026-03-16
76085007 CDM Nm Kid W Flo/fn Mult Wo&w 8 8 $5,562.77 $5,562.77 $5,562.77 $5,562.77 $5,562.77 2026-03-16
74080283 CDM Art Mech Throm 2ndary Add 8 8 $5,544.57 $5,544.57 $5,544.57 $5,544.57 $5,544.57 2026-03-16
74080284 CDM Art Mech Thromb Prim Add 8 8 $5,544.57 $5,544.57 $5,544.57 $5,544.57 $5,544.57 2026-03-16
92218777 CDM Ahf Viii(recombinant)1000u Inj 8 8 $5,544.00 $5,544.00 $5,544.00 $5,544.00 $5,544.00 2026-03-16
72196 CPT MRI Pelvis With Contrast 8 8 $5,501.73 $5,501.73 $5,501.73 $5,501.73 $5,501.73 2026-03-16
92217874 CDM Interferon Beta-1a Kit 8 8 $5,500.85 $5,500.85 $5,500.85 $5,500.85 $5,500.85 2026-03-16
74183 CPT MRI Abdomen W/wo Contrast 8 8 $5,489.65 $5,489.65 $5,489.65 $5,489.65 $5,489.65 2026-03-16
72126 CPT CT Cervical Spine W/contrast 8 8 $5,485.86 $5,485.86 $5,485.86 $5,485.86 $5,485.86 2026-03-16
74080348 CDM Cth Plc Thor/brac 3rd Sel 8 8 $5,424.62 $5,424.62 $5,424.62 $5,424.62 $5,424.62 2026-03-16
70498 CPT CTA Neck Wo/w Contrast 8 8 $5,372.79 $5,372.79 $5,372.79 $5,372.79 $5,372.79 2026-03-16
74250074 CDM MRI Extr Uppr Jt Wo 8 8 $5,341.88 $5,341.88 $5,341.88 $5,341.88 $5,341.88 2026-03-16
92210095 CDM Immune Globulin 10gm Inj 8 8 $5,327.72 $5,327.72 $5,327.72 $5,327.72 $5,327.72 2026-03-16
75020098 CDM Image Cath Fluid Soft Tis 8 8 $5,285.39 $5,285.39 $5,285.39 $5,285.39 $5,285.39 2026-03-16
74080402 CDM Ins Tunnel Cvad W Port>5 8 8 $5,281.22 $5,281.22 $5,281.22 $5,281.22 $5,281.22 2026-03-16
92215387 CDM Drotrecogin Alfa 20mg Pds 8 8 $5,244.37 $5,244.37 $5,244.37 $5,244.37 $5,244.37 2026-03-16
70481 CPT CT Intracranial Struc W Cont 8 8 $5,214.70 $5,214.70 $5,214.70 $5,214.70 $5,214.70 2026-03-16
74080333 CDM Cth Plc Abd/pel/ 2nd Init 8 8 $5,198.63 $5,198.63 $5,198.63 $5,198.63 $5,198.63 2026-03-16
76499 CPT Unlisted Rad Proc Outside Serv 8 8 $5,135.55 $5,135.55 $5,135.55 $5,135.55 $5,135.55 2026-03-16
92220093 CDM Leuprolide 22.5 Mg Kit 8 8 $5,121.90 $5,121.90 $5,121.90 $5,121.90 $5,121.90 2026-03-16
74080094 CDM Ir Angio Extremity Lt 8 8 $5,115.10 $5,115.10 $5,115.10 $5,115.10 $5,115.10 2026-03-16
74080226 CDM Xr Angio Extremity Lt 8 8 $5,115.10 $5,115.10 $5,115.10 $5,115.10 $5,115.10 2026-03-16
74080227 CDM Xr Angio Extremity Rt 8 8 $5,115.10 $5,115.10 $5,115.10 $5,115.10 $5,115.10 2026-03-16
74080093 CDM Ir Angio Extremity Rt 8 8 $5,115.10 $5,115.10 $5,115.10 $5,115.10 $5,115.10 2026-03-16
74080092 CDM Ir Venogram Extremity Lt 8 8 $5,072.26 $5,072.26 $5,072.26 $5,072.26 $5,072.26 2026-03-16
74080215 CDM Xr Venogram Extremity Lt 8 8 $5,072.26 $5,072.26 $5,072.26 $5,072.26 $5,072.26 2026-03-16
74080216 CDM Xr Venogram Extremity Rt 8 8 $5,072.26 $5,072.26 $5,072.26 $5,072.26 $5,072.26 2026-03-16
74080091 CDM Ir Venogram Extremity Rt 8 8 $5,072.26 $5,072.26 $5,072.26 $5,072.26 $5,072.26 2026-03-16
74080061 CDM Ir Transcath Thrpy Embolz 8 8 $5,049.77 $5,049.77 $5,049.77 $5,049.77 $5,049.77 2026-03-16
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