healthcosts.net

UPMC Wellsboro

32-36 Central Ave, Wellsboro, PA · UPMC · · NPI 1427501766

Source: hospital's published price file ↗ · Published Mar 6, 2026 · Ingested Aug 13, 2026

Published prices by procedure

Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.

Procedure Cash price Gross charge Negotiated range Payers
#a/b/c/c/h pnl-candida albicans ab CPT 86628 $140.00 $193.00 $11.87 – $157.50 16
#acylcarnitineprfl CPT 82017 $268.80 $371.00 $13.17 – $302.40 14
#aptt mix-1:1 incubated CPT 87532 $252.00 $420.00 $27.39 – $378.00 14
#bac vag cand-c. albicans naa CPT 87481 $220.80 $305.00 $34.68 – $248.40 16
#cbg+cort-cbg CPT 84449 $246.00 $410.00 $17.79 – $369.00 16
#celiac hla-dq8 CPT 81383 $1,607.40 $2,679.00 $107.86 – $2,411.10 16
#cf-97variants CPT 81220 $3,108.00 $5,180.00 $62.64 – $671.48 16
#cmvcul-virus inoculation shell CPT 87254 $10.00 $14.00 $2.25 – $19.33 16
#coxa-coxsackie a serotype a16 CPT 86658 $112.80 $155.00 $10.18 – $126.90 14
#creutz-prot.,western blot CPT 84182 $176.80 $244.00 $24.55 – $198.90 16
#flow interp 9 - 15 markers CPT 88188 $348.00 $480.00 $67.31 – $390.60 16
#pnh-flow cytometry interp CPT 88187 $793.60 $1,094.00 $53.98 – $892.80 16
#resp virpnl dfa-adenovirus CPT 87260 $196.80 $271.00 $11.26 – $221.40 14
(both sides) smear without diff wbc count CPT 85008 $147.20 $203.00 $3.40 – $165.60 16
11-desoxycortisol - sendout CPT 82634 $597.60 $823.00 $17.50 – $672.30 16
17-hydroxypregnenolone CPT 84143 $372.00 $512.00 $22.55 – $418.50 16
17-ketosteroids CPT 83586 $415.20 $572.00 $12.65 – $283.50 16
24 hr ambulatory b/p monitor CPT 93786 $460.80 $635.00 $90.66 – $518.40 13
2d tee w or without fol w/con,in HCPCS C8925 $1,026.40 $1,414.00 $230.94 – $1,154.70 13
2d tte w or without fol w/con,co HCPCS C8923 $1,026.40 $1,414.00 $230.94 – $1,154.70 13
3d ech img cgen car anomal CPT 93319 $1,716.80 $2,366.00 $21.73 – $1,931.40 16
3d recon without postprocess indpndt CPT 76376 $843.20 $1,162.00 $11.65 – $948.60 14
5' nucleotidase - sendout CPT 83915 $294.40 $405.00 $11.02 – $331.20 16
88334 ap bill cytologic exam each additional site CPT 88334 $110.40 $152.00 $12.52 – $124.20 16
99381 initial comp preventive med less than 1 year new CPT 99381 $134.40 $224.00 $25.60 – $137.70 13
99382 initial comp preventive med 1 to 4 years new CPT 99382 $143.40 $239.00 $25.60 – $159.30 13
99383 initial comp preventive med 5 to 11 years new CPT 99383 $151.20 $252.00 $25.60 – $132.30 13
99391 periodic comp preventive med less than 1 year est CPT 99391 $122.40 $204.00 $22.50 – $112.50 13
99392 periodic comp preventive med 1 to 4 years est CPT 99392 $134.40 $224.00 $25.60 – $134.10 13
99393 periodic comp preventive med 5 to 11 years est CPT 99393 $134.40 $224.00 $22.50 – $112.50 13
99394 periodic comp preventive med 12 to 17 years est CPT 99394 $151.20 $252.00 $23.40 – $117.00 13
99397 periodic comp preventive med 65+ years est CPT 99397 $178.80 $298.00 $25.60 – $268.20 13
Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 $4,845.00 $8,075.00 $44.11 – $290.70 15
Abciximab injection HCPCS J0130 $6,244.80 $10,408.00 $1,873.44 – $9,367.20 13
Abd paracentesis/w/o image guide 49082 CPT 49082 $1,175.20 $1,619.00 $59.98 – $1,322.10 16
Abdominal CT scan (with and without contrast) CPT 74170 $4,204.00 $5,794.00 $142.72 – $4,729.50 16
Abdominal CT scan (with contrast) CPT 74160 $3,352.80 $4,621.00 $115.20 – $3,771.90 16
Abdominal CT scan (without contrast) CPT 74150 $2,630.40 $3,625.00 $99.20 – $2,959.20 16
Abdominal MRI (with and without contrast) CPT 74183 $4,850.40 $6,684.00 $604.49 – $5,456.70 16
Abdominal MRI (with contrast) CPT 74182 $3,689.60 $5,085.00 $399.62 – $4,150.80 16
Abdominal MRI (without contrast) CPT 74181 $3,040.00 $4,190.00 $344.32 – $3,420.00 16
Abdominal Ultrasound (complete) CPT 76700 $1,108.80 $1,528.00 $73.60 – $1,247.40 16
Abdominal Ultrasound (limited) CPT 76705 $835.20 $1,151.00 $48.00 – $939.60 16
Abdominal paracentesis w/image guidance CPT 49083 $1,689.00 $2,815.00 $92.76 – $1,322.10 16
Ablation cryo thigh/knee CPT 27599 $507.20 $699.00 $114.12 – $570.60 13
Ablation of upper extremity nerves rf CPT 64999 $998.40 $1,376.00 $212.29 – $1,123.20 13
Abobotulinumtoxina HCPCS J0586 $4,582.80 $7,638.00 $8.75 – $68.40 15
Abscess drain retroperitoneal surg code CPT 49406 $5,596.80 $9,281.00 $190.99 – $6,296.40 16
Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 $168.60 $281.00 $0.06 – $1.80 14
Acetazolamide 500 mg solution for injection HCPCS J1120 $256.80 $321.00 $19.84 – $288.90 14
Acetone qualitative CPT 82009 $72.40 $99.00 $4.47 – $81.45 16
Acetylcholine receptor modulating antibody CPT 86043 $388.20 $647.00 $9.64 – $412.20 15
Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 $1,044.60 $1,741.00 $0.39 – $26.10 14
Acetylcysteine non-comp unit HCPCS J7608 $92.80 $116.00 $0.67 – $11.47 15
Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 $121.80 $203.00 $36.54 – $182.70 13
Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 $141.00 $235.00 $42.30 – $211.50 13
Acromp/acromionectomy prtl CPT 23130 not published not published $993.28 – $1,394.74 2
Acute hepatitis panel CPT 80074 $921.60 $1,271.00 $47.07 – $1,036.80 16
Acute venous thrombus image CPT 78456 $580.00 $799.00 $130.50 – $652.50 16
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 $74.40 $124.00 $0.04 – $0.90 14
Adenosine 3 mg/250 ml bag for osm HCPCS J0153 $382.20 $637.00 $0.56 – $5.40 14
Adenovirus ag ia CPT 87301 $196.00 $270.00 $9.36 – $220.50 14
Adenovirus antibody,serum - quest CPT 86603 $111.20 $153.00 $12.72 – $125.10 16
Adh-sendout CPT 84588 $375.20 $517.00 $33.54 – $422.10 16
Adj gastric band via subq port CPT 43999 $4,264.00 $5,877.00 $644.56 – $4,797.00 13
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 $1,130.40 $1,884.00 $0.18 – $4.63 14
Administration chemotherapy IV infusion each additional hour CPT 96415 $269.60 $372.00 $31.11 – $303.30 16
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 $269.60 $372.00 $60.66 – $303.30 16
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 $977.60 $1,347.00 $137.28 – $1,099.80 16
Administration chemotherapy IV push single/initial substance/drug CPT 96409 $615.20 $847.00 $101.42 – $692.10 16
Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 $269.60 $372.00 $34.94 – $303.30 16
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 $223.20 $372.00 $44.82 – $224.10 16
Administration immunization 1 vaccine CPT 90471 $16.00 $21.00 $3.60 – $18.00 13
Administration immunization each additional component CPT 90461 $58.80 $81.00 $7.94 – $66.15 14
Administration immunization each additional vaccine CPT 90472 $16.00 $21.00 $3.60 – $18.00 13
Administration immunization first component each vaccine CPT 90460 $283.20 $391.00 $17.73 – $318.60 14
Administration immunization intranasal/oral route 1 vaccine CPT 90473 $18.40 $24.00 $4.14 – $52.68 13
Administration immunization intranasal/oral route each additional vaccine CPT 90474 $18.40 $24.00 $4.14 – $20.70 13
Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 $25.20 $42.00 $7.56 – $37.80 13
Administration vaccine hepatitis b HCPCS G0010 $16.00 $21.00 $3.60 – $33.09 13
Administration vaccine influenza virus HCPCS G0008 $16.00 $20.00 $3.60 – $18.00 15
Administration vaccine pneumococcal HCPCS G0009 $16.00 $20.00 $3.60 – $18.00 15
Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 $25.20 $42.00 $7.56 – $37.80 13
Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 $139.20 $232.00 $41.76 – $208.80 15
Aep hearing status deter i&r CPT 92651 $154.40 $213.00 $34.74 – $173.70 16
Aep neurodiagnostic i&r CPT 92653 $295.20 $406.00 $66.42 – $332.10 16
Aep thrshld est mlt freq i&r CPT 92652 $295.20 $406.00 $66.42 – $332.10 16
Agalsidase beta 35 mg intravenous solution HCPCS J0180 $27,295.80 $45,493.00 $230.15 – $1,169.10 15
Albumin (human), 25%, 50ml HCPCS P9047 $304.00 $380.00 $53.08 – $342.00 13
Albumin (human), 5%, 250 ml HCPCS P9045 $682.40 $853.00 $53.08 – $359.10 14
Albumin (microalbumin) 24 hour urine quantitative CPT 82043 $422.40 $582.00 $5.71 – $475.20 16
Albumin body fluid quantitative each specimen CPT 82042 $76.60 $106.00 $6.08 – $41.40 14
Albumin serum plasma or whole blood CPT 82040 $80.80 $111.00 $3.65 – $90.90 16
Albuterol ipratrop non-comp HCPCS J7620 $13.80 $17.25 $0.09 – $1.80 15
Albuterol non-comp con HCPCS J7611 $5.00 $6.25 $0.17 – $5.62 15
Albuterol non-comp unit HCPCS J7613 $10.00 $12.50 $0.06 – $1.80 15
Aldesleukin injection HCPCS J9015 $6,538.20 $10,897.00 $1,961.46 – $9,807.30 14
Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 $8,173.80 $13,623.00 $82.08 – $2,429.89 15
Alkaline phosphatase CPT 84075 $158.40 $218.00 $5.12 – $154.80 16
Allergen alpha lactalbumin ige CPT 86008 $31.80 $43.00 $7.16 – $35.77 16
Allergen egg white ige CPT 86003 $216.80 $271.00 $4.82 – $24.07 16
Allergy injection; single 95115 CPT 95115 $10.20 $17.00 $1.26 – $28.62 14
Allergy injections; 2 or more 95117 CPT 95117 $6.80 $9.00 $1.53 – $42.87 14
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 $2,929.80 $4,883.00 $604.62 – $3,023.10 13
Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 $5,792.80 $7,983.00 $1,303.38 – $6,516.90 13
Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 $4,781.60 $6,590.00 $121.29 – $5,379.30 14
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 $29.80 $37.25 $5.46 – $31.50 15
Alpha-fetoprotein afp-l3 frac & total CPT 82107 $177.60 $245.00 $39.96 – $199.80 16
Alpha-fetoprotein amniotic CPT 82106 $160.20 $267.00 $16.80 – $240.30 16
Alpha-fetoprotein tumor marker CPT 82105 $168.00 $232.00 $16.57 – $189.00 16
Alprostadil for injection HCPCS J0270 $550.20 $917.00 $0.18 – $0.90 13
Alt/sgpt CPT 84460 $161.60 $223.00 $5.24 – $53.77 16
Alteplase 100 mg infusion from pyxis vial HCPCS J2997 $40,758.00 $67,930.00 $94.45 – $531.90 16
Aluminum - quest CPT 82108 $386.40 $532.00 $25.18 – $434.70 16
Alys cplx sp/pn npgt w/prgrm CPT 95972 $1,680.80 $2,316.00 $71.24 – $1,890.90 16
Ambl bp mntr w/sw a/r CPT 93788 $207.20 $286.00 $46.62 – $233.10 13
Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 $26.80 $33.50 $0.63 – $4.50 15
Amino acids quant 2-5 CPT 82136 $266.40 $368.00 $19.38 – $299.70 16
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 $8.00 $10.00 $1.71 – $9.00 14
Aminolevulinic acid delta CPT 82135 $216.00 $298.00 $12.00 – $243.00 16
Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 $70.20 $87.75 $4.86 – $24.30 14
Amiodarone 50 mg/ml intravenous solution HCPCS J0282 $224.40 $374.00 $0.43 – $2.70 14
Ammonia CPT 82140 $152.00 $210.00 $5.00 – $71.10 16
Amniotic fluid scan CPT 82143 $245.60 $338.00 $5.00 – $276.30 16
Amp metatarsal w/toe single 28810 CPT 28810 not published not published $252.45 – $993.28 8
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 $176.40 $294.00 $30.78 – $153.90 14
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 $1,050.00 $1,750.00 $21.48 – $315.00 15
Ampicillin 1 gram solution for injection HCPCS J0290 $77.40 $129.00 $0.55 – $28.80 14
Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 $67.20 $112.00 $1.39 – $24.30 14
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 $280.20 $467.00 $84.06 – $420.30 13
Amputation toe interphalangeal joint CPT 28825 $3,304.80 $4,555.00 $535.81 – $3,717.90 14
Amputation toe metatarsophalangeal joint CPT 28820 not published not published $596.93 – $934.40 2
Amylase CPT 82150 $136.80 $189.00 $5.00 – $153.90 16
An cholangiogram percutaneous compl CPT 47531 $840.00 $1,158.00 $85.71 – $993.28 16
An fluoro guide for cvp CPT 77001 $1,542.40 $2,125.00 $59.21 – $1,735.20 16
Ana ds-dna CPT 86226 $216.00 $298.00 $11.96 – $243.00 16
Anal pressure record CPT 91122 $2,128.00 $2,933.00 $52.48 – $2,394.00 16
Analysis gene f2 20210g>a variant CPT 81240 $2,361.60 $3,936.00 $53.70 – $279.00 16
Analysis gene f5 leiden variant CPT 81241 $1,764.00 $2,205.00 $66.70 – $1,044.00 16
Anaplsma phgcytophlm amp prb CPT 87468 $290.40 $484.00 $28.07 – $435.60 16
Anca screen with reflex to titer -quest CPT 86021 $188.80 $260.00 $5.00 – $136.80 16
Angiotensin ii CPT 82163 $334.40 $461.00 $14.50 – $376.20 16
Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 $99,634.80 $166,058.00 $0.16 – $0.90 14
Anidulafungin injection HCPCS J0348 $417.00 $695.00 $0.52 – $12.60 14
Ankle X-ray CPT 73610 $372.00 $512.00 $23.97 – $418.50 14
Annual Physical, Established Patient (age 18-39) CPT 99395 $156.60 $261.00 $25.60 – $132.30 13
Annual Physical, Established Patient (age 40-64) CPT 99396 $170.40 $284.00 $25.60 – $255.60 13
Annual Physical, New Patient (age 18-39) CPT 99385 $171.60 $286.00 $25.60 – $156.60 13
Annual Physical, New Patient (age 40-64) CPT 99386 $208.80 $348.00 $25.60 – $313.20 13
Ant/post colporrhap/enterocele rpr 57265 CPT 57265 not published not published $993.28 – $1,697.92 2
Anti mog serum - sendout CPT 86362 $115.80 $193.00 $9.64 – $173.70 16
Antibody bacterium, not elsewhere specified CPT 86609 $44.20 $61.00 $9.95 – $49.73 14
Antibody elution rbc reference CPT 86860 $82.40 $113.00 $8.45 – $92.70 16
Antibody htlv-i CPT 86687 $96.00 $132.00 $8.98 – $108.00 16
Antibody id rbc panel CPT 86870 $248.80 $343.00 $8.45 – $279.90 16
Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 $720.80 $993.00 $5.00 – $683.10 16
Antibody influenza virus CPT 86710 $111.20 $153.00 $10.59 – $118.80 14
Antibody lymphocytic choriomeningitis CPT 86727 $111.20 $153.00 $12.72 – $125.10 16
Antibody screen rbc CPT 86850 $136.80 $189.00 $8.45 – $45.00 16
Antibody tetanus CPT 86774 $402.40 $554.00 $11.56 – $257.40 14
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 $11.40 $14.25 $1.49 – $12.60 15
Antihemophilic viii/vwf comp HCPCS J7186 $10.20 $17.00 $1.25 – $15.30 15
Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 $188.80 $260.00 $9.64 – $140.40 16
Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 $188.80 $260.00 $9.64 – $212.40 16
Antinuclear antibodies CPT 86038 $206.40 $285.00 $11.95 – $79.42 16
Antinuclear antibodies titer CPT 86039 $110.40 $152.00 $11.03 – $117.90 16
Antiphosphatidylserine antibody CPT 86148 $476.80 $657.00 $12.54 – $536.40 14
Antistreptolysin o screen CPT 86063 $68.40 $94.00 $5.70 – $76.95 16
Antistreptolysin o titer CPT 86060 $141.60 $195.00 $7.00 – $159.30 16
Antithrombin iii activity CPT 85300 $190.40 $263.00 $9.40 – $97.20 16
Aortic dysfunction/dilation CPT 81410 $8,320.00 $10,400.00 $393.52 – $9,360.00 14
Apc gene dup/delet variants CPT 81203 $1,848.00 $2,547.00 $197.66 – $2,079.00 16
Apc gene full sequence CPT 81201 $1,848.00 $2,547.00 $415.80 – $2,079.00 16
Apheresis plasma CPT 36514 $1,532.00 $2,112.00 $82.50 – $1,723.50 16
Apl(pml-rara) quant - sendout CPT 81315 $503.20 $693.00 $113.22 – $566.10 16
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 $315.20 $435.00 $12.24 – $61.20 14
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 $2,148.00 $2,960.00 $111.24 – $993.28 14
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 $1,830.40 $2,522.00 $27.90 – $139.50 14
App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 $315.20 $435.00 $8.46 – $42.30 14
App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 $6,088.00 $8,391.00 $98.64 – $993.28 14
App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 $2,156.00 $2,972.00 $22.50 – $112.50 14
Appendix Removal (Laparoscopic) CPT 44970 not published not published $993.28 – $1,067.82 2
Appl mltpln uni ext fixj sys CPT 20692 not published not published $982.07 – $993.28 2
Appl modality 1/> areas paraffin bath 97018 CPT 97018 $92.80 $128.00 $6.60 – $104.40 16
Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 $92.80 $128.00 $14.54 – $104.40 16
Appl unipln uni ext fixj sys CPT 20690 not published not published $698.78 – $993.28 2
Application finger splntstatic 29130 CPT 29130 $569.60 $785.00 $82.27 – $640.80 14
Application long leg splint 29505 CPT 29505 $569.60 $785.00 $40.70 – $640.80 16
Application lower leg splint 29515 CPT 29515 $471.00 $785.00 $9.63 – $114.43 16
Application of cylinder cast 29365 CPT 29365 $801.60 $1,336.00 $66.00 – $1,202.40 16
Application of forearm cast 29075 CPT 29075 $998.40 $1,376.00 $32.40 – $993.28 16
Application of long leg cast 29345 CPT 29345 $176.40 $294.00 $19.80 – $993.28 14
Application of paste boot 29580 CPT 29580 $569.60 $785.00 $14.58 – $113.80 14
Application short leg cast 29405 CPT 29405 $103.20 $172.00 $17.05 – $993.28 16
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 $170.40 $284.00 $15.53 – $993.28 14
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 $1,502.40 $2,071.00 $40.68 – $993.28 14
Apply forearm splintdynamic 29126 CPT 29126 $569.60 $785.00 $28.60 – $640.80 16
Apply of finger splint 29131 CPT 29131 $664.80 $917.00 $30.48 – $747.90 16
Apply short leg castambul type 29425 CPT 29425 $100.00 $163.00 $22.50 – $993.28 16
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 $4.20 $7.00 $1.26 – $6.30 15
Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 $166.40 $229.00 $10.56 – $96.30 16
Aquaporin-4 antibody cba each CPT 86052 $160.00 $221.00 $9.64 – $180.00 16
Aquatic exercise - group charge CPT 97150 $112.80 $155.00 $9.06 – $57.60 14
Argatroban nonesrd use 1mg HCPCS J0883 $3,121.80 $5,203.00 $0.80 – $46.80 15
Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 $2,751.00 $4,585.00 $8.15 – $413.10 15
Arterial blood draw/perc 36620 CPT 36620 $1,421.60 $1,959.00 $52.34 – $1,599.30 16
Artery x-rays arm/leg 75710-26 CPT 75710 $3,092.00 $4,261.00 $28.80 – $3,478.50 16
Artery x-rays arms/legs 75716-26 CPT 75716 $2,958.40 $4,077.00 $28.80 – $3,328.20 16
Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah) CPT 29826 not published not published $695.68 – $2,139.16 2
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 $1,115.20 $1,537.00 $21.42 – $993.28 16
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 $1,473.60 $2,456.00 $12.69 – $993.28 16
Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 $1,140.80 $1,572.00 $46.59 – $1,283.40 16
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 $825.60 $1,376.00 $11.84 – $1,400.32 16
Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 $1,444.80 $1,991.00 $54.80 – $1,625.40 16
Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 $825.60 $1,376.00 $9.18 – $993.28 16
Arthrp ntrcrp/crp/mtcr ntrps CPT 25447 not published not published $484.00 – $1,929.94 8
Aspir/inj thyroid cyst 60300 CPT 60300 $1,175.20 $1,865.00 $40.49 – $1,322.10 16
Aspirate bladder/sprapubic cath 51102 CPT 51102 $4,760.80 $6,561.00 $169.77 – $5,355.90 16
Aspirate pleura without imaging 32554 CPT 32554 $1,076.40 $1,794.00 $152.82 – $993.28 14
Aspirate/inj ganglion cyst 20612 CPT 20612 $228.00 $380.00 $6.57 – $993.28 16
Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 $1,175.20 $1,619.00 $65.76 – $1,322.10 16
Assay dir meas fr estradiol CPT 82681 $124.80 $172.00 $21.81 – $140.40 14
Assay neurflmnt light chain CPT 83884 $1,585.20 $2,642.00 $81.90 – $409.50 12
Assay of fluoride CPT 82735 $275.20 $379.00 $8.00 – $309.60 16
Assay of glutathione CPT 82978 $93.60 $129.00 $6.75 – $105.30 16
Assay of lrh hormone CPT 83727 $299.20 $413.00 $16.98 – $336.60 16
Assay of procainamide w/metab CPT 80192 $340.00 $468.00 $16.55 – $382.50 16
Assay of prostaglandin CPT 84150 $964.00 $1,328.00 $11.00 – $249.30 16
Assay of sialic acid CPT 84275 $188.40 $314.00 $13.29 – $282.60 16
Assay of somatostatin CPT 84307 $284.00 $392.00 $18.07 – $319.50 16
Assay of thiocyanate CPT 84430 $273.60 $377.00 $4.80 – $307.80 16
Assay of urine sulfate CPT 84392 $63.20 $87.00 $4.29 – $71.10 14
Assess aphasia/interp/rpt/per hr 96105 CPT 96105 $587.20 $810.00 $38.40 – $660.60 16
Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 $47.60 $65.00 $4.22 – $53.55 16
Ast/sgot CPT 84450 $47.80 $66.00 $5.12 – $53.77 16
Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 $40,521.60 $67,536.00 $91.34 – $506.70 15
Atropine 0.1 mg/ml injection syringe HCPCS J0461 $63.60 $106.00 $0.10 – $0.90 14
Augment injectable kit 3.0cc HCPCS C1734 $9,247.20 $12,744.00 $2,080.62 – $10,403.10 13
Autologous blood op salvage CPT 86891 $268.80 $371.00 $60.48 – $606.30 13
Autologous blood process CPT 86890 $821.60 $1,132.00 $122.78 – $924.30 13
Avelumab 20 mg/ml intravenous solution HCPCS J9023 $172.80 $288.00 $51.84 – $259.20 15
Avul nail plate addl CPT 11732 $31.20 $52.00 $5.04 – $58.03 16
Avulsion nail plate partial/complete simple single nail plate CPT 11730 $471.00 $785.00 $12.69 – $993.28 16
Azacitidine injection HCPCS J9025 $2,860.20 $4,767.00 $0.57 – $42.30 14
Azathioprine 50 mg tablet HCPCS J7500 $14.40 $18.00 $0.06 – $16.20 14
Azithromycin 500 mg intravenous solution HCPCS J0456 $186.40 $233.00 $2.04 – $209.70 15
Aztreonam 1 gram solution for injection HCPCS J0457 $16.80 $21.00 $2.53 – $18.90 14
B cells total count CPT 86355 $136.00 $188.00 $30.60 – $153.00 16
Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 $4,377.00 $7,295.00 $163.98 – $819.90 15
Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 $337.80 $563.00 $49.95 – $506.70 14
Baclofen eval charges CPT 97750 $157.60 $217.00 $18.43 – $140.40 16
Bacterial meningitis antigen CPT 86403 $121.60 $168.00 $11.40 – $136.80 16
Bacterial vaginosis pcr CPT 87801 $406.40 $560.00 $38.80 – $457.20 16
Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 $27.40 $37.00 $3.97 – $30.82 14
Barrier skin flextend 2.25in floating flang new image HCPCS A4409 $4.80 $6.00 $0.63 – $12.04 14
Barrier skn ft cx ff red 2.25 ctf new image w/tape HCPCS A4407 $10.00 $14.00 $2.25 – $17.00 14
Bartholin gland cyst/marsupializat 56440 CPT 56440 $5,744.80 $7,917.00 $96.84 – $957.44 16
Bartonella dna pcr-sendout CPT 87471 $812.00 $1,119.00 $34.68 – $913.50 16
Bausch health Ultrasound surg HCPCS V2788 $800.00 $1,000.00 $179.10 – $895.50 13
Belatacept 250 mg intravenous solution HCPCS J0485 $4,381.80 $7,303.00 $3.89 – $26.10 15
Belimumab 120 mg intravenous solution HCPCS J0490 $7,881.60 $13,136.00 $56.07 – $296.10 15
Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 $114.00 $190.00 $13.49 – $171.00 15
Benign lesion paring 2-4 CPT 11056 $40.20 $67.00 $7.25 – $993.28 16
Benign lesion paring 4+ CPT 11057 $52.80 $88.00 $10.53 – $993.28 16
Benztropine 1 mg/ml injection solution HCPCS J0515 $277.80 $463.00 $15.32 – $209.70 14
Beta 2 glycoprotein 1 antibody iga CPT 86146 $74.60 $103.00 $16.79 – $83.92 16
Beta-2 microglobulin CPT 82232 $324.80 $438.00 $15.99 – $357.30 16
Beta-amyloid 1-40 CPT 82233 $1,404.00 $2,340.00 $421.20 – $2,106.00 12
Beta-amyloid 1-42 CPT 82234 $1,404.00 $2,340.00 $421.20 – $2,106.00 12
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 $287.40 $479.00 $2.88 – $14.40 14
Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 $14,404.80 $24,008.00 $73.20 – $540.90 15
Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 $6,055.20 $10,092.00 $27.86 – $480.60 14
Bilateral n blobk inj pudendal 64430 CPT 64430 $4,291.20 $5,914.00 $38.50 – $993.28 16
Bilateral n block inj occipital 64405 CPT 64405 $687.20 $947.00 $38.50 – $993.28 16
Bilateral n block inj trigeminal 64400 CPT 64400 $998.40 $1,376.00 $14.30 – $1,123.20 16
Bilirubin direct CPT 82248 $100.00 $138.00 $4.96 – $112.50 16
Bilirubin total CPT 82247 $161.60 $202.00 $4.96 – $102.60 16
Biopsy abdominal mass CPT 49180 $1,352.80 $1,865.00 $89.07 – $1,521.90 16
Biopsy bone trocar/needle superficial CPT 20220 $1,352.80 $1,865.00 $69.30 – $1,521.90 16
Biopsy cervixsingle/multiple 57500 CPT 57500 $7,461.60 $10,283.00 $39.24 – $997.12 16
Biopsy lower leg soft tissue 27610 CPT 27610 not published not published $378.95 – $1,471.64 8
Biopsy muscle percutaneous needle CPT 20206 $1,352.80 $1,865.00 $30.96 – $993.28 16
Biopsy needle liver percutaneous CPT 47000 $1,285.60 $1,771.00 $98.61 – $1,446.30 16
Biopsy needle lymph node superficial CPT 38505 $1,352.80 $1,865.00 $74.17 – $1,322.10 16
Biopsy of lip 40490 CPT 40490 $1,065.60 $1,469.00 $40.15 – $1,198.80 16
Biopsy of prostate CPT 55700 $1,818.40 $2,506.00 $70.38 – $993.28 16
Biopsy of salivary gland 42400 CPT 42400 $1,175.20 $1,619.00 $38.50 – $1,322.10 16
Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 $1,352.80 $1,865.00 $150.82 – $1,521.90 16
Biopsy skin incisional single lesion CPT 11106 $640.80 $883.00 $32.40 – $993.28 16
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 $3,164.80 $3,956.00 $69.65 – $993.28 16
Biopsy/removal lymph nodes CPT 38525 not published not published $171.60 – $993.28 8
Biopsy/soft tissue/neck or thorax 21550 CPT 21550 $2,204.00 $3,038.00 $37.95 – $2,479.50 16
Bivalirudin HCPCS J0583 $5,267.40 $8,779.00 $0.17 – $31.50 14
Bladder irrigate/lavage/instill 51700 CPT 51700 $998.40 $1,376.00 $16.02 – $90.45 16
Bleomycin 15 unit solution for injection HCPCS J9040 $306.40 $383.00 $21.52 – $344.70 15
Bln 1.2 mono emrg 15x1.2 HCPCS C1725 $5,457.60 $9,096.00 $69.66 – $348.30 12
Bln 30frx10mmx12cm renal nephromax HCPCS C1726 $5,793.60 $7,984.00 $39.06 – $195.30 13
Bln dil 900ml preperitnl HCPCS C1727 $2,731.20 $3,764.00 $102.24 – $511.20 12
Bln inpact admiral 4x150x130cm HCPCS C2623 $4,375.20 $6,029.00 $984.42 – $4,922.10 13
Bln press regulation 71-80cm HCPCS C1815 $10,689.60 $14,732.00 $964.98 – $4,824.90 13
Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 $52.80 $72.00 $4.54 – $25.26 14
Block plantar digital nerve CPT 64455 $61.80 $103.00 $7.25 – $75.03 14
Block tap inj(s) w/wo img bi CPT 64488 $792.80 $1,093.00 $81.63 – $891.90 14
Blood Clotting (PT/INR) Test CPT 85610 $93.60 $129.00 $3.73 – $18.68 16
Blood Clotting (PTT) Test CPT 85730 $511.20 $705.00 $5.94 – $144.00 16
Blood Count (CBC) Test CPT 85025 $115.20 $159.00 $6.00 – $129.60 16
Blood Count (CBC) Test (without differential) CPT 85027 $97.60 $134.00 $6.39 – $109.80 16
Blood Culture Test CPT 87040 $483.20 $666.00 $10.20 – $543.60 16
Blood draw capillary 36416 CPT 36416 $33.80 $46.00 $7.61 – $38.02 12
Blood gases o2 saturation direct measurement CPT 82805 $147.20 $203.00 $33.12 – $165.60 16
Blood gases ph venous CPT 82800 $137.60 $190.00 $10.87 – $154.80 16
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 $279.20 $384.00 $2.80 – $40.50 16
Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 $27.20 $35.00 $3.63 – $30.60 16
Blood occult feces colorectal neoplasm screening qualitative CPT 82270 $27.20 $35.00 $3.47 – $30.60 16
Blood occult peroxidase activity qualitative gastric CPT 82271 $61.40 $84.00 $3.63 – $69.08 16
Blood smear interpretation CPT 85060 $108.00 $149.00 $18.79 – $121.50 14
Blood smear microscopic w manual differential wbc count CPT 85007 $60.20 $83.00 $3.75 – $67.72 16
Blood split unit HCPCS P9011 $247.80 $413.00 $69.44 – $371.70 14
Blood typing abo CPT 86900 $10.00 $14.00 $2.25 – $11.25 16
Blood typing ag donor ea ag CPT 86902 $78.60 $108.00 $2.82 – $88.42 16
Blood typing rbc ag non abo/rh ea CPT 86905 $98.40 $135.00 $3.28 – $110.70 16
Blood typing rh (d) CPT 86901 $49.20 $67.00 $2.96 – $55.35 16
Blood typing rh phenotype complete reference CPT 86906 $146.40 $202.00 $7.66 – $164.70 16
Blood volume CPT 78122 $1,552.80 $2,140.00 $87.04 – $1,746.90 16
Bone Density Scan (DEXA) CPT 77080 $320.00 $420.00 $66.12 – $360.00 16
Bone biopsy open superficial CPT 20240 $5,752.80 $7,929.00 $104.50 – $1,077.76 16
Bone imaging multiple areas CPT 78305 $1,412.80 $1,947.00 $64.00 – $1,589.40 16
Bone marrow biopsyneedle/trocar 38221 CPT 38221 $1,042.40 $1,436.00 $65.16 – $414.76 16
Bone marrow imaging body CPT 78104 $2,800.00 $3,859.00 $70.40 – $3,150.00 16
Bone marrow interpretation CPT 85097 $304.00 $419.00 $19.20 – $342.00 16
Bone marrow;aspiration only 38220 CPT 38220 $917.60 $1,264.00 $32.22 – $387.00 16
Bone survey-lead poisoning CPT 77074 $844.00 $1,163.00 $38.68 – $949.50 16
Bone void filler nanoss 10cc HCPCS C9362 $4,825.60 $6,651.00 $1,085.76 – $5,428.80 13
Bone/joint imaging ltd area CPT 78300 $1,036.80 $1,429.00 $53.12 – $1,166.40 16
Boot j walker l HCPCS L4386 $1,714.40 $2,363.00 $159.46 – $1,928.70 15
Boot walker genesis full shell 3-strap s HCPCS L4360 $974.40 $1,343.00 $219.24 – $1,096.20 15
Borrelia antibody CPT 86619 $176.40 $294.00 $10.44 – $264.60 14
Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 $85.60 $118.00 $16.83 – $96.30 16
Borrelia miyamotoi amp prb CPT 87478 $351.20 $484.00 $28.07 – $395.10 16
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 $7,423.80 $12,373.00 $2.79 – $318.60 14
Bowel imaging CPT 78290 $1,751.20 $2,413.00 $57.60 – $1,970.10 16
Br punct aspir ea add, l CPT 19001 $1,022.40 $1,619.00 $22.43 – $1,150.20 16
Bra surgical elizabeth pink sm HCPCS L8000 $180.00 $248.00 $16.56 – $82.80 15
Brace ank air stirrup univ HCPCS L4350 $328.80 $454.00 $73.98 – $369.90 15
Brace ankle stablizing lg HCPCS L1902 $346.40 $478.00 $77.94 – $389.70 15
Brace knee extender plus 22-30in HCPCS L1832 $424.80 $586.00 $95.58 – $1,223.04 15
Brace oths wrist hnd fngr without HCPCS L3807 $436.00 $601.00 $46.26 – $231.30 14
Brace wrist classic lft sm HCPCS L3908 $160.00 $221.00 $25.38 – $126.90 15
Braf gene CPT 81210 $1,656.00 $2,070.00 $83.88 – $419.40 16
Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 $4,627.20 $6,377.00 $605.85 – $5,205.60 16
Brain MRA (blood vessel MRI, with contrast) CPT 70545 $3,878.40 $5,345.00 $342.28 – $4,363.20 16
Brain MRA (blood vessel MRI, without contrast) CPT 70544 $2,861.60 $3,944.00 $342.28 – $3,219.30 16
Brain MRI (with and without contrast) CPT 70553 $4,600.00 $6,340.00 $344.32 – $5,175.00 16
Brain MRI (with contrast) CPT 70552 $3,520.00 $4,851.00 $344.32 – $3,960.00 16
Brain MRI (without contrast) CPT 70551 $2,900.80 $3,997.00 $344.32 – $3,263.40 16
Brain flow imaging only CPT 78610 $1,882.40 $2,595.00 $43.52 – $2,117.70 16
Brain image 4+ views CPT 78605 $1,228.00 $1,693.00 $69.12 – $1,381.50 16
Brain image w/flow 4 + views CPT 78606 $2,265.60 $3,123.00 $75.52 – $2,548.80 16
Brca1&2 gen ful dup/del alys CPT 81164 $3,464.00 $4,330.00 $467.38 – $3,897.00 16
Brcassure comprehensive panel-sendout CPT 81162 $2,560.00 $3,200.00 $576.00 – $2,880.00 16
Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 $4,629.60 $6,380.00 $152.78 – $5,208.30 16
Breast punct aspir cyst, bil CPT 19000 $1,119.00 $1,865.00 $23.40 – $122.32 16
Breath tst attain/anal c-14 CPT 78267 $716.80 $988.00 $8.64 – $806.40 14
Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 $31,641.60 $52,736.00 $189.72 – $948.60 15
Bronch ebus samplng 1/2 node CPT 31652 $4,214.40 $5,808.00 $208.90 – $4,741.20 16
Bronch ebus samplng 3/> node CPT 31653 $4,214.40 $5,808.00 $230.59 – $4,741.20 16
Bronch w/debrdmt subgltc & uppr trach CPT 31899 $2,664.80 $3,673.00 $139.57 – $2,997.90 13
Bronchial challenge CPT 94070 $920.80 $1,269.00 $14.59 – $1,035.90 16
Bronchoscopy w/biopsy(s) 31625 CPT 31625 $3,540.00 $4,878.00 $173.59 – $3,982.50 16
Bronchoscopy w/fb removal 31635 CPT 31635 $3,540.00 $4,878.00 $193.76 – $3,982.50 16
Bronchoscopy/lung bx each 31628 CPT 31628 $4,214.40 $5,808.00 $193.38 – $4,741.20 16
Bronchoscopy/needle bx each 31629 CPT 31629 $4,214.40 $5,808.00 $206.13 – $4,741.20 16
Budesonide non-comp unit HCPCS J7626 $463.20 $579.00 $0.76 – $521.10 15
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 $8.20 $10.25 $0.37 – $4.05 15
Bundled special stain group 1 microorganisms CPT 88312 $195.20 $269.00 $43.92 – $219.60 16
Bundled special stain group 2 CPT 88313 $287.20 $396.00 $35.64 – $178.20 16
Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 $0.40 $0.50 $0.01 – $0.05 14
Buprenorph X-ray 100 mg or less HCPCS Q9991 $5,427.00 $9,045.00 $1,628.10 – $8,140.50 14
Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet HCPCS J0572 $27.00 $45.00 $3.02 – $15.07 14
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 $64.40 $80.50 $8.60 – $72.45 14
Buprenorphine X-ray over 100 mg HCPCS Q9992 $7,236.00 $9,045.00 $1,628.10 – $8,140.50 14
Buprenorphine hydrochloride HCPCS J0592 $14.20 $17.75 $3.19 – $15.97 14
Butorphanol tartrate 1 mg HCPCS J0595 $133.20 $222.00 $6.43 – $135.90 14
Bx bone trocar/ndl deep CPT 20225 $1,352.80 $1,865.00 $107.80 – $1,521.90 16
Bx breast 1st lesion strtctc CPT 19081 $4,474.40 $6,167.00 $163.13 – $5,033.70 16
Bx breast add lesion Ultrasound imag CPT 19084 $2,315.20 $3,191.00 $72.73 – $2,604.60 16
Bx breast add lesion strtctc CPT 19082 $2,515.20 $3,466.00 $77.42 – $2,829.60 16
Bx breast perq without image 19100 CPT 19100 $4,291.20 $5,914.00 $37.98 – $1,112.32 16
Bx of cervix w/scope leep 57460 CPT 57460 not published not published $164.78 – $993.28 8
Bx pancreas pq ndl CPT 48102 $1,175.20 $1,619.00 $264.42 – $1,322.10 14
Bx pleura pq ndl CPT 32400 $1,175.20 $1,619.00 $89.14 – $1,322.10 16
Bx skin incisnl ea sep/add l les CPT 11107 $320.80 $442.00 $17.10 – $85.50 16
Bx skin punch ea sep/ addl les CPT 11105 $180.00 $248.00 $24.25 – $154.80 16
Bx skin tangential ea sep/ addl les CPT 11103 $180.00 $248.00 $20.52 – $136.80 16
Bx soft tiss pelvis/hip deep 27041 CPT 27041 $1,352.80 $1,865.00 $37.95 – $1,521.90 16
Bx thyroid/percutan core needle 60100 CPT 60100 $1,352.80 $1,865.00 $42.30 – $936.96 16
Bx vag mucos smpl (sep proc) CPT 57100 $849.60 $1,171.00 $35.46 – $776.96 16
Bx vulva or perineum/1 lesion 56605 CPT 56605 $4,291.20 $5,914.00 $31.86 – $993.28 16
Bx vulva or perineum/ea add lesion 56606 CPT 56606 $557.60 $769.00 $15.84 – $79.20 16
Bx/curett of cervix w/scope 57454 CPT 57454 $1,015.20 $1,399.00 $70.74 – $993.28 16
Bx/exc lymph node/open/deep cervic 38510 CPT 38510 not published not published $149.60 – $951.04 8
Bx/exc lymph node/open/superfic 38500 CPT 38500 not published not published $448.22 – $839.68 2
Bypass temp external fem-fem CPT 37799 $1,781.60 $2,455.00 $400.86 – $2,004.30 13
C-1 esterase, berinert HCPCS J0597 $156.00 $195.00 $35.10 – $175.50 15
C-peptide CPT 84681 $421.60 $581.00 $20.57 – $257.40 16
C-reactive protein CPT 86140 $288.00 $397.00 $3.00 – $324.00 16
C-reactive protein high sensitivity CPT 86141 $571.20 $952.00 $10.53 – $615.60 16
C-reactive protein, quantitative CPT 86406 $533.60 $735.00 $10.51 – $600.30 16
C1 esterase inhibitor func - sendout CPT 86161 $143.20 $197.00 $11.86 – $161.10 16
CT 3d report other modality w/workstation CPT 76377 $843.20 $1,162.00 $30.43 – $948.60 14
CT Angiogram of Abdomen and Pelvis CPT 74174 $8,850.40 $12,197.00 $427.14 – $9,956.70 16
CT Angiogram of the Chest (for blood clot) CPT 71275 $4,092.00 $5,640.00 $277.50 – $4,603.50 16
CT Angiogram of the Head CPT 70496 $4,948.80 $6,820.00 $256.26 – $5,567.40 16
CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 $6,921.60 $9,539.00 $326.02 – $7,786.80 16
CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 $5,385.60 $7,422.00 $246.69 – $6,058.80 16
CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 $4,015.20 $5,534.00 $129.37 – $4,517.10 16
CT angio hrt w/3d image CPT 75574 $2,580.00 $3,555.00 $265.05 – $2,902.50 16
CT angio pelvis CPT 72191 $3,016.00 $4,157.00 $268.54 – $3,393.00 16
CT guidance for needle placement CPT 77012 $3,512.00 $4,841.00 $130.88 – $3,951.00 16
CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 $3,532.80 $4,869.00 $12.80 – $3,974.40 16
CT heart w/evaluation of calcium without contrast CPT 75571 $200.00 $250.00 $37.80 – $189.00 16
CT hrt w/3d image CPT 75572 $4,092.00 $5,640.00 $216.36 – $4,603.50 16
CT limited or localized follow-up study CPT 76380 $654.40 $902.00 $67.84 – $736.20 14
CT lower extremity w/contrast (both sides) CPT 73701 $3,240.80 $4,467.00 $105.60 – $3,645.90 14
CT lower extremity without contrast (both sides) CPT 73700 $2,852.80 $3,931.00 $101.17 – $3,209.40 14
CT lwr extremity w/o&w/dye CPT 73702 $3,409.60 $4,699.00 $118.40 – $3,835.80 14
CT neck soft tissue w/contrast CPT 70491 $3,036.80 $4,185.00 $105.60 – $3,416.40 16
CT neck soft tissue without & w/contrast CPT 70492 $3,804.00 $5,243.00 $118.40 – $4,279.50 16
CT neck soft tissue without contrast CPT 70490 $2,492.80 $3,436.00 $101.12 – $2,804.40 16
CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 $2,600.80 $3,585.00 $165.12 – $2,925.90 16
CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 $1,962.40 $2,705.00 $145.92 – $2,207.70 16
CT orbit/sella/fossa w/wo contrast CPT 70482 $3,280.80 $4,521.00 $194.56 – $3,690.90 16
CT t-spine w /wo contrast CPT 72130 $3,146.40 $4,337.00 $174.08 – $3,539.70 16
CT thoracic spine w/contrast CPT 72129 $3,090.40 $4,259.00 $112.00 – $3,476.70 16
CT thoracic spine without contrast CPT 72128 $2,508.00 $3,457.00 $115.97 – $2,821.50 16
CT thorax low dose for lung screening without contrast CPT 71271 $306.40 $422.00 $68.94 – $344.70 16
CT upper extremity w/contrast (both sides) CPT 73201 $2,852.80 $3,931.00 $105.60 – $3,209.40 14
CT upper extremity without contrast (both sides) CPT 73200 $2,350.40 $3,239.00 $101.17 – $2,644.20 14
CT uppr extremity w/o&w/dye CPT 73202 $4,323.20 $5,958.00 $118.40 – $4,863.60 14
Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 $808.20 $1,347.00 $227.28 – $1,212.30 15
Caffeine citrate 20 mg/ml inj for po HCPCS J0706 $111.00 $185.00 $2.70 – $13.50 13
Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 $20,030.40 $25,038.00 $484.97 – $22,534.20 14
Calcium 24 hour urine CPT 82340 $95.20 $131.00 $5.96 – $71.10 16
Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 $0.80 $1.00 $0.04 – $0.90 14
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 $0.80 $1.00 $0.09 – $0.90 14
Calcium ionized CPT 82330 $129.60 $179.00 $8.85 – $145.80 16
Calcium total CPT 82310 $47.80 $66.00 $5.10 – $53.77 16
Calprotectin fecal CPT 83993 $351.20 $484.00 $19.40 – $395.10 16
Campylobacter antibody CPT 86625 $92.80 $128.00 $12.97 – $104.40 16
Candida dna CPT 87480 $267.20 $369.00 $19.82 – $300.60 16
Cannula ercp contour 5-4-3 tip HCPCS C1889 $168.60 $281.00 $4.14 – $20.70 13
Cap nerve 2x15mm HCPCS C1763 $2,275.20 $3,135.00 $58.86 – $294.30 13
Cap trach decann 15mm HCPCS C1750 $1,127.20 $1,553.00 $83.16 – $415.80 13
Carbamazepine free CPT 80157 $284.00 $392.00 $10.99 – $181.80 16
Carbamazepine free -sendout CPT 80161 $238.40 $329.00 $14.55 – $268.20 14
Carbamazepine total therapeutic drug level CPT 80156 $238.40 $329.00 $14.40 – $268.20 16
Carbohydrate urine - sendout CPT 84377 $30.60 $42.00 $5.44 – $34.42 16
Carbon dioxide CPT 82374 $47.80 $66.00 $4.82 – $53.77 16
Carboplatin 10 mg/ml desensitization HCPCS J9045 $500.40 $834.00 $2.47 – $47.70 14
Carboxyhemoglobin quantitative CPT 82375 $274.40 $378.00 $5.60 – $308.70 16
Carcinoembryonic ag (cea) CPT 82378 $496.80 $685.00 $17.00 – $453.60 16
Cardiac MRI w/stress img CPT 75559 $3,213.60 $4,429.00 $321.97 – $3,615.30 16
Cardiac perf planar mult/ef/wm CPT 78454 $3,152.00 $4,344.00 $272.88 – $3,546.00 16
Cardiac perf planar sgl/ef/wm CPT 78453 $3,868.00 $5,331.00 $218.19 – $4,351.50 16
Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 $4,562.40 $6,287.00 $243.44 – $5,132.70 16
Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 $218.40 $301.00 $49.14 – $245.70 14
Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 $213.60 $294.00 $41.38 – $240.30 14
Cardiac shunt imaging CPT 78428 $2,004.80 $2,763.00 $96.00 – $2,255.40 16
Cardiolipin antibody iga CPT 86147 $485.60 $669.00 $24.30 – $121.50 16
Cardioversion elective electrical conversion arrhythmia external CPT 92960 $1,505.60 $2,075.00 $95.70 – $1,693.80 16
Caregiver training strategies&tq 1st 30 minutes CPT 97550 $103.20 $172.00 $30.96 – $154.80 13
Carfilzomib 10 mg intravenous solution HCPCS J9047 $10,440.00 $17,400.00 $52.20 – $261.00 15
Carmustine 100 mg intravenous powder for solution HCPCS J9050 $21,846.60 $36,411.00 $238.46 – $32,769.90 15
Carotene CPT 82380 $252.80 $349.00 $9.12 – $284.40 16
Carotid Artery Ultrasound (Duplex) CPT 93880 $1,733.60 $2,389.00 $152.76 – $1,950.30 16
Carpal Tunnel Release Surgery CPT 64721 not published not published $330.00 – $921.15 8
Caspofungin acetate HCPCS J0637 $1,752.00 $2,920.00 $3.54 – $189.00 14
Cataract Surgery CPT 66984 not published not published $662.78 – $2,930.19 8
Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 $454.40 $626.00 $102.24 – $511.20 13
Cath ablt clsfast 7fx100cmx HCPCS C1888 $3,656.80 $5,040.00 $822.78 – $4,113.90 12
Cath ablt rx lasr 2.0mm turbo HCPCS C1885 $42.80 $59.00 $9.63 – $48.15 12
Cath acuity innr ic130 6f 63cm HCPCS C1887 $157.60 $217.00 $9.63 – $48.15 12
Cath adherent clot 10mm 6f 10 HCPCS C1757 $276.00 $380.00 $25.02 – $125.10 12
Cath bi-dir df smarttouch HCPCS C1732 $1,433.60 $1,976.00 $322.56 – $1,612.80 12
Cath council tip 16fr 5cc HCPCS A4344 $57.60 $79.00 $1.71 – $31.77 15
Cath cv dl inj 7fx16cm HCPCS C1751 $1,068.80 $1,473.00 $4.28 – $59.47 13
Cath entrl fd nutri 5fr 40cm HCPCS B4082 $8.40 $14.00 $2.52 – $18.85 13
Cath groshong MRI 8fr plstc port HCPCS C1788 $2,151.20 $2,964.00 $122.40 – $612.00 13
Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 $78.60 $108.00 $17.68 – $88.42 12
Cath infuse micro 150cm rapidtransit HCPCS A4351 $114.00 $190.00 $0.36 – $4.02 14
Cath malecot 28fr 4-wing ltx HCPCS C1729 $812.80 $1,120.00 $3.51 – $79.99 13
Cath pezzer 34fr drain bardex propor head mushrm ltx HCPCS A4340 $103.20 $142.00 $5.49 – $48.31 14
Cath uret open tp 6fx70cm HCPCS C1758 $348.80 $481.00 $6.88 – $34.42 12
Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 $460.00 $634.00 $57.20 – $993.28 16
Catheterization collection of specimen single patient all places of service HCPCS P9612 $42.60 $71.00 $6.69 – $36.00 14
Cathj umbilical vein dx/ther nb CPT 36510 $1,015.20 $1,399.00 $46.75 – $1,142.10 16
Cauterization chemical granulation tissue CPT 17250 $494.40 $681.00 $19.26 – $96.30 16
Cdna analysis for variants CPT 81403 $2,276.80 $2,846.00 $96.12 – $480.60 14
Cebpa gene full sequence CPT 81218 $2,643.20 $3,642.00 $239.08 – $2,973.60 16
Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 $42.00 $70.00 $0.72 – $3.60 15
Cefepime 1 gram solution for injection HCPCS J0692 $186.60 $311.00 $1.22 – $69.30 15
Cefotaxime sodium injection HCPCS J0698 $10.20 $17.00 $3.06 – $15.30 13
Cefoxitin 1 gram intravenous solution HCPCS J0694 $105.00 $175.00 $4.78 – $78.30 14
Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 $814.20 $1,357.00 $1.62 – $8.10 15
Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 $41.40 $69.00 $1.57 – $14.40 15
Ceftazidime and avibactam HCPCS J0714 $1,516.80 $2,528.00 $104.73 – $569.70 15
Ceftriaxone 1 gram solution for injection HCPCS J0696 $75.00 $125.00 $0.36 – $1.80 15
Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 $30.60 $51.00 $1.85 – $13.50 14
Cell count body fluid CPT 89050 $224.80 $310.00 $4.50 – $252.90 16
Cell count w differential body fluid CPT 89051 $191.20 $264.00 $5.54 – $108.00 16
Cell cryopreserve/storage CPT 88240 $161.60 $223.00 $10.20 – $181.80 14
Cell function assay w/stim CPT 86352 $1,087.20 $1,498.00 $77.84 – $1,223.10 16
Cell marker study CPT 88182 $166.40 $229.00 $8.79 – $187.20 16
Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 $42,145.80 $70,243.00 $29.29 – $180.00 15
Cerebrospinal fld flw imag CPT 78645 $700.00 $965.00 $140.80 – $787.50 16
Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 $34.60 $43.25 $3.91 – $5,821.73 16
Cervical or vaginal cancer screening g0101 HCPCS G0101 $48.00 $80.00 $6.88 – $59.23 13
Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 $2,809.20 $4,682.00 $78.37 – $420.30 15
Cftr gene intron poly t CPT 81224 $288.00 $360.00 $64.80 – $324.00 14
Change cystostomy tube simple CPT 51705 $998.40 $1,376.00 $27.72 – $138.60 16
Change of windpipe airway 31502 CPT 31502 $571.20 $788.00 $117.61 – $642.60 14
Chemo adm cns w/lmbr punct CPT 96450 $841.60 $1,160.00 $84.33 – $946.80 16
Chemo extend IV infus w/pump HCPCS G0498 $841.60 $1,160.00 $189.36 – $946.80 13
Chemotherapy injection 96542 CPT 96542 $841.60 $1,160.00 $41.17 – $946.80 16
Chemotx admn pertl cav impl CPT 96446 $637.60 $879.00 $18.81 – $717.30 16
Chest 2 vws w oblique CPT 71048 $603.20 $832.00 $24.87 – $678.60 16
Chest CT scan (with and without contrast) CPT 71270 $3,812.80 $5,254.00 $132.48 – $4,289.40 16
Chest CT scan (with contrast) CPT 71260 $3,222.40 $4,440.00 $112.00 – $3,625.20 16
Chest CT scan (without contrast) CPT 71250 $2,714.40 $3,741.00 $106.37 – $3,053.70 16
Chest X-ray CPT 71046 $701.60 $967.00 $19.01 – $789.30 16
Chest X-ray (single view) CPT 71045 $212.00 $292.00 $10.38 – $238.50 16
Chest apical lordotic proj CPT 71047 $603.20 $832.00 $24.19 – $678.60 16
Chg radiologic exam esophagus double contrast CPT 74221 $862.40 $1,189.00 $71.69 – $970.20 16
Chlamydia culture CPT 87110 $883.20 $1,217.00 $19.38 – $993.60 16
Chlamydia type CPT 87140 $63.20 $87.00 $3.00 – $71.10 16
Chlnggrphy intraop addl s&i CPT 74301 $288.80 $398.00 $64.98 – $324.90 13
Chloride CPT 82435 $47.80 $66.00 $4.55 – $53.77 16
Chloride 24 hour urine CPT 82436 $80.80 $111.00 $5.68 – $90.90 16
Chloroprocaine hcl injection HCPCS J2401 $1.20 $1.50 $0.04 – $0.90 14
Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 $1,236.80 $1,546.00 $1.98 – $39.45 14
Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 $215.40 $359.00 $25.27 – $199.80 14
Chlorpromazine 100 mg tablet HCPCS Q0161 $0.80 $1.00 $0.18 – $0.90 13
Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 $1,188.80 $1,638.00 $112.07 – $1,337.40 13
Cholecystostomy complete w/supervision & interpretation CPT 47490 $4,756.80 $6,555.00 $241.92 – $5,351.40 14
Cholesterol CPT 82465 $47.80 $66.00 $4.30 – $53.77 16
Cholesterol (Lipid) Test CPT 80061 $276.00 $380.00 $13.24 – $296.10 16
Cholesterol body fluid CPT 84999 $622.40 $858.00 $64.62 – $323.10 12
Cholinesterase CPT 82480 $103.20 $172.00 $6.00 – $154.80 16
Chromatography CPT 83021 $22.40 $31.00 $5.04 – $30.11 16
Chromo high res and frag x - sendout CPT 81243 $770.40 $1,148.00 $45.63 – $836.10 16
Chromogenic substrate assay CPT 85130 $158.40 $264.00 $9.28 – $237.60 14
Chromosome analysis 15-20 cell count CPT 88262 $1,241.60 $1,712.00 $124.02 – $1,383.30 16
Chromosome analysis 45 CPT 88263 $1,109.60 $1,529.00 $148.54 – $1,248.30 16
Chromosome study additional CPT 88289 $1,276.00 $1,759.00 $34.03 – $1,435.50 16
Chronic urticaria - sendout CPT 86343 $160.00 $221.00 $9.73 – $180.00 14
Chylomicron screen, bf - sendout CPT 82664 $404.80 $558.00 $48.03 – $455.40 14
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 $9.00 $15.00 $1.26 – $6.30 14
Circum 28 days or older CPT 54161 not published not published $140.80 – $787.20 8
Circumcision (newborn) CPT 54150 $630.60 $1,051.00 $86.90 – $706.50 15
Cisplatin 1 mg/ml desensitization HCPCS J9060 $83.40 $139.00 $2.29 – $24.30 14
Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 $2,014.80 $3,358.00 $10.68 – $302.40 15
Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 $2,100.00 $2,894.00 $472.50 – $2,362.50 12
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 $45.80 $57.25 $0.70 – $9.90 15
Clip ligating vesolock lg HCPCS C1760 $736.00 $1,014.00 $165.60 – $828.00 12
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 $453.60 $756.00 $18.17 – $135.90 14
Clos txnose fx without stablz 21315 CPT 21315 $998.40 $1,376.00 $131.45 – $1,123.20 16
Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 $998.40 $1,376.00 $34.65 – $1,123.20 16
Closed treatment of femoral fracture proximal end neck; wi CPT 27232 $3,630.40 $5,003.00 $439.68 – $4,084.20 14
Closed tx humerus fx w/manip 24505 CPT 24505 $998.40 $1,376.00 $179.30 – $1,123.20 16
Closed tx humerus fx with manip 23605 CPT 23605 $3,791.20 $5,225.00 $203.50 – $4,265.10 16
Closed tx humerus fx without manip 23600 CPT 23600 $998.40 $1,376.00 $128.15 – $993.28 16
Closed tx metatarsophalangeal jnt disl without anes CPT 28630 $998.40 $1,376.00 $59.95 – $1,123.20 16
Closed tx/acetabululm without manip 27220 CPT 27220 $561.60 $774.00 $126.36 – $1,172.75 16
Closed tx/talus fracture without manip 28430 CPT 28430 $998.40 $1,376.00 $122.10 – $1,123.20 16
Clot factor viii reltd antgn CPT 85244 $348.00 $480.00 $20.18 – $391.50 16
Clot factor xii hageman CPT 85280 $197.60 $272.00 $13.00 – $222.30 16
Clozapine, 25 mg HCPCS S0136 $8.40 $10.50 $0.27 – $5.85 14
Clsd tx bimalleol ank fx without manip 27808 CPT 27808 $998.40 $1,376.00 $224.64 – $1,123.20 14
Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 $998.40 $1,376.00 $53.35 – $1,123.20 16
Clsd tx clavicle dislocation without manip 23540 CPT 23540 $647.20 $891.00 $69.30 – $728.10 16
Clsd tx dist fib fx w/manip 27788 CPT 27788 $868.80 $1,197.00 $174.90 – $993.28 16
Clsd tx elbow dislocation child 24640 CPT 24640 $998.40 $1,376.00 $58.30 – $1,123.20 16
Clsd tx fracture of radius 25500 CPT 25500 $998.40 $1,376.00 $86.35 – $1,123.20 16
Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 $998.40 $1,482.00 $182.60 – $1,272.32 16
Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 $998.40 $1,376.00 $125.95 – $993.28 16
Clsd tx fx radius/ulna w/manip 25565 CPT 25565 $995.20 $1,371.00 $220.55 – $1,119.60 16
Clsd tx fx radius/ulna without manip 25560 CPT 25560 $998.40 $1,376.00 $125.95 – $993.28 16
Clsd tx hip disloc without anes 27265 CPT 27265 $868.80 $1,197.00 $195.48 – $1,080.46 16
Clsd tx humeral fract without manip 24530 CPT 24530 $998.40 $1,376.00 $135.85 – $993.28 16
Clsd tx humerus fract without manip 24500 CPT 24500 $998.40 $1,376.00 $123.20 – $1,123.20 16
Clsd tx iphal jnt disl w/manip req anes CPT 26775 $4,051.20 $5,583.00 $437.41 – $4,557.60 14
Clsd tx mandibular fx without manip 21450 CPT 21450 $1,163.20 $1,603.00 $148.50 – $1,308.60 16
Clsd tx metatarsal fracture w/manip 28475 CPT 28475 $647.20 $891.00 $129.80 – $993.28 16
Clsd tx patella disloc without anes 27560 CPT 27560 $998.40 $1,376.00 $112.20 – $1,123.20 16
Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 $950.40 $1,309.00 $213.84 – $1,069.20 16
Clsd tx radius fracture w/manip 24655 CPT 24655 $4,070.40 $5,609.00 $130.35 – $4,579.20 16
Clsd tx shoulder dislc/fx 23665 CPT 23665 $3,791.20 $5,225.00 $172.70 – $4,265.10 16
Clsd tx temporomandibular dislocat 21480 CPT 21480 $998.40 $1,376.00 $31.88 – $1,123.20 16
Clsd tx toe dislocation without anes28660 CPT 28660 $742.40 $1,023.00 $53.35 – $835.20 16
Clsd tx trimall ankle fx w/manip 27818 CPT 27818 $868.80 $1,197.00 $195.48 – $1,243.08 16
Clsd tx trimall ankle fx without manip 27816 CPT 27816 $998.40 $1,376.00 $224.64 – $1,123.20 14
Clsd tx wrist carpal fx without manip 25630 CPT 25630 $998.40 $1,376.00 $146.70 – $993.28 14
Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 $998.40 $1,376.00 $134.20 – $993.28 16
Clsd tx wrist ulnar styloid fx 25650 CPT 25650 $882.40 $1,216.00 $160.60 – $993.28 16
Clsd tx/clavicular fx without manip 23500 CPT 23500 $998.40 $1,376.00 $77.55 – $993.28 16
Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 $998.40 $1,376.00 $52.80 – $479.70 16
Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 $766.40 $1,056.00 $172.44 – $993.28 14
Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 $3,540.00 $4,878.00 $434.50 – $3,982.50 16
Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 $825.60 $1,376.00 $19.08 – $190.44 16
Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 $825.60 $1,376.00 $23.58 – $993.28 16
Clsd tx/grt hum tube fx without manip 23620 CPT 23620 $882.40 $1,216.00 $133.20 – $993.28 16
Clsd tx/metacar/interphal artic fx 26740 CPT 26740 $882.40 $1,216.00 $42.90 – $993.28 16
Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 $998.40 $1,376.00 $76.45 – $993.28 16
Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 $998.40 $1,376.00 $116.60 – $1,123.20 16
Clsd tx/metatarsal fx without manip 28470 CPT 28470 $825.60 $1,376.00 $30.42 – $993.28 16
Clsd tx/patellar fx without manip 27520 CPT 27520 $998.40 $1,376.00 $144.10 – $771.30 16
Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 $998.40 $1,376.00 $61.60 – $993.28 16
Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 $998.40 $1,376.00 $113.30 – $993.28 16
Clsd tx/scapular fx without manip 23570 CPT 23570 $998.40 $1,376.00 $80.30 – $618.30 16
Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 $3,791.20 $5,225.00 $152.90 – $4,265.10 16
Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 $998.40 $1,376.00 $118.80 – $993.28 16
Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 $998.40 $1,376.00 $108.90 – $1,123.20 16
Clsd/ulnar fx/prox end without manip 24670 CPT 24670 $998.40 $1,376.00 $110.00 – $993.28 16
Cltx gr hmrl tbrs fx w/mnpj CPT 23625 $882.40 $1,216.00 $172.70 – $993.28 16
Cltx hum epcndylr fx wo mnpj CPT 24560 $998.40 $1,376.00 $122.10 – $1,123.20 16
Cltx humrl cndylr fx wo mnpj CPT 24576 $998.40 $1,376.00 $122.10 – $1,123.20 16
Cltx lunate dislc w/mnpj CPT 25690 $998.40 $1,376.00 $224.64 – $1,123.20 16
Cltx mndblr fx w/mnpj CPT 21451 $4,051.20 $5,583.00 $439.45 – $4,557.60 16
Cltx scap fx w/mnpj +-tractj CPT 23575 $2,933.60 $4,043.00 $123.20 – $3,300.30 16
Cmv pcr-sendout CPT 87496 $1,040.80 $1,434.00 $34.68 – $900.00 16
Co-treatment - group 15 mins, st CPT 92508 $110.40 $152.00 $12.80 – $124.20 14
Co2 monitor per day CPT 94681 $1,197.60 $1,651.00 $28.80 – $1,347.30 16
Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 $32,266.20 $53,777.00 $1.80 – $9.00 15
Coagulation time activated teg CPT 85347 $31.00 $42.00 $4.23 – $34.88 16
Coagulation time otr method CPT 85348 $40.20 $55.00 $4.44 – $45.23 16
Cold agglutinin titer CPT 86157 $120.80 $167.00 $7.96 – $135.90 16
Colistimethate sodium inj HCPCS J0770 $129.00 $215.00 $13.06 – $193.50 14
Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 $75.60 $104.00 $2.88 – $48.29 15
Collar cerv ascend 172 reg HCPCS L0172 $163.20 $225.00 $36.72 – $241.85 15
Collar cerv patriot adlt HCPCS L0150 $141.60 $195.00 $31.86 – $207.45 14
Collection blood specimen from completely implantable venous access device CPT 36591 $196.00 $270.00 $31.08 – $220.50 14
Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 $196.00 $270.00 $38.42 – $220.50 14
Collection of venous blood by venipuncture CPT 36415 $34.00 $47.00 $6.69 – $38.02 14
Colonoscopy & polypectomy 44392 CPT 44392 $3,933.60 $5,421.00 $212.64 – $4,425.30 16
Colonoscopy (diagnostic) CPT 45378 $2,000.00 $2,625.00 $198.55 – $2,250.00 16
Colonoscopy (with biopsy) CPT 45380 $3,933.60 $5,421.00 $108.90 – $841.35 16
Colonoscopy (with polyp removal) CPT 45385 $3,933.60 $5,421.00 $294.89 – $4,425.30 16
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 $3,933.60 $5,421.00 $261.22 – $4,425.30 16
Colonoscopy for bleeding 44391 CPT 44391 $3,933.60 $5,421.00 $241.94 – $4,425.30 16
Colonoscopy for foreign body CPT 44390 $3,933.60 $5,421.00 $213.15 – $4,425.30 16
Colonoscopy stoma w/snare 44394 CPT 44394 $3,933.60 $5,421.00 $885.06 – $4,425.30 14
Colonoscopy submucous njx CPT 45381 $3,933.60 $5,421.00 $234.53 – $4,425.30 16
Colonoscopy thru stoma spx CPT 44388 $3,816.80 $5,261.00 $160.08 – $4,293.90 16
Colonoscopy w/ablation CPT 45388 $3,933.60 $5,421.00 $885.06 – $4,425.30 13
Colonoscopy w/balloon dilat CPT 45386 $3,933.60 $5,421.00 $255.45 – $4,425.30 16
Colonoscopy w/band ligation CPT 45398 $3,933.60 $5,421.00 $885.06 – $4,425.30 13
Colonoscopy w/control bleed CPT 45382 $3,933.60 $5,421.00 $279.40 – $4,425.30 16
Colonoscopy w/decompression CPT 44408 $3,816.80 $5,261.00 $858.78 – $4,293.90 13
Colonoscopy w/endoscope Ultrasound CPT 45391 $3,933.60 $5,421.00 $241.22 – $4,425.30 16
Colonoscopy w/endoscopic fnb CPT 45392 $3,933.60 $5,421.00 $305.16 – $4,425.30 16
Colonoscopy w/fb removal CPT 45379 $2,431.20 $3,351.00 $260.75 – $2,735.10 16
Colonoscopy w/injection CPT 44404 $3,933.60 $5,421.00 $885.06 – $4,425.30 13
Colonoscopy w/resection CPT 45390 $3,933.60 $5,421.00 $885.06 – $4,425.30 13
Colonoscopy w/stent plcmt CPT 44402 $7,896.80 $10,883.00 $993.28 – $8,883.90 13
Colonoscopy with ablation CPT 44401 $3,933.60 $5,421.00 $885.06 – $4,425.30 13
Colonoscopy with biopsy CPT 44389 $3,933.60 $5,421.00 $177.36 – $4,425.30 16
Colonoscopy/w endoscopic stent 45389 CPT 45389 $7,896.80 $10,883.00 $993.28 – $8,883.90 13
Colposcopy vulva 56820 CPT 56820 $1,577.60 $2,175.00 $45.36 – $993.28 16
Colposcopy vulva w/biopsy 56821 CPT 56821 $2,133.60 $2,940.00 $61.02 – $993.28 16
Colposcopy w/biopsy of cervix 57455 CPT 57455 $2,084.80 $2,873.00 $57.96 – $993.28 16
Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 $434.40 $599.00 $43.45 – $747.52 16
Comp cystometrogram/void presssure 51728 CPT 51728 $2,793.60 $3,850.00 $157.86 – $789.30 16
Comp cystometrogram/void/uret pres 51729 CPT 51729 $2,826.40 $3,896.00 $169.20 – $846.00 16
Compatibility test each unit antiglobulin technique CPT 86922 $524.00 $722.00 $21.00 – $589.50 16
Compatibility test each unit electronic CPT 86923 $100.00 $138.00 $21.00 – $112.50 15
Compatibility test each unit immediate spin technique CPT 86920 $266.40 $368.00 $21.00 – $299.70 16
Complement antigen each component c3 CPT 86160 $332.00 $458.00 $11.86 – $115.20 16
Complement fixation each CPT 86171 $120.80 $167.00 $7.00 – $135.90 16
Complex cystometrogram 51726 CPT 51726 $4,291.20 $5,914.00 $46.75 – $993.28 16
Complex repair trunk 1.1-2.5cm 13120 CPT 13120 $998.40 $1,376.00 $66.00 – $1,123.20 16
Complex repair trunk 2.6-7.5cm 13101 CPT 13101 $2,627.20 $3,620.00 $491.80 – $2,955.60 14
Complex uroflowmetry (electronic) 51741 CPT 51741 $1,703.20 $2,347.00 $8.46 – $153.87 16
Complx repair enel 1.1-2.5 cm 13151 CPT 13151 $2,627.20 $3,620.00 $194.70 – $2,955.60 16
Complx repair enel 2.6-7.5 cm 13152 CPT 13152 $2,627.20 $3,620.00 $591.12 – $2,955.60 14
Complx repair enel addl 5cm/< 13153 CPT 13153 $798.40 $1,100.00 $151.64 – $898.20 14
Complx repair fccmnaxghf 13131 CPT 13131 $2,627.20 $3,620.00 $78.10 – $2,955.60 16
Complx repair fccmnaxghf 13132 CPT 13132 $2,627.20 $3,620.00 $591.12 – $2,955.60 14
Complx repair sal addl 5 cm/> 13122 CPT 13122 $998.40 $1,376.00 $93.25 – $1,123.20 14
Concentration infection agents any type CPT 87015 $92.80 $128.00 $6.60 – $104.40 16
Condylomata destruction 56420 CPT 56420 $712.80 $983.00 $50.76 – $864.00 16
Conization/cerv/loop electrode exc 57522 CPT 57522 not published not published $239.75 – $993.28 8
Conjugated estrogens 25 mg solution for injection HCPCS J1410 $1,375.20 $2,292.00 $171.54 – $857.70 15
Consult comp w/report rfrd material CPT 88325 $212.80 $293.00 $47.88 – $239.40 14
Consultation pathology during surgery CPT 88329 $192.00 $265.00 $29.77 – $216.00 16
Consultation pathology during surgery cytological exam initial site CPT 88333 $213.60 $294.00 $20.49 – $240.30 16
Consultation pathology during surgery frozen section each additional block CPT 88332 $256.00 $353.00 $9.97 – $288.00 16
Consultation pathology during surgery frozen section first tissue block CPT 88331 $333.60 $460.00 $9.60 – $375.30 16
Consultation/report referred material w/preparation of slides CPT 88323 $891.20 $1,229.00 $13.26 – $1,002.60 16
Consultation/report referred slides prepared elsewhere CPT 88321 $222.40 $307.00 $48.00 – $250.20 14
Contrast baths charges CPT 97034 $124.80 $172.00 $16.61 – $140.40 14
Contrast x-ray gallbladder CPT 74290 $870.40 $1,199.00 $28.80 – $979.20 16
Contrast x-ray of ankle CPT 73615 $868.80 $1,197.00 $35.20 – $977.40 14
Contrast x-ray of elbow CPT 73085 $868.80 $1,197.00 $35.20 – $977.40 14
Contrast x-ray of hip CPT 73525 $868.80 $1,197.00 $60.80 – $977.40 14
Contrast x-ray of knee joint CPT 73580 $868.80 $1,197.00 $21.12 – $977.40 14
Contrast x-ray of wrist CPT 73115 $868.80 $1,197.00 $35.20 – $977.40 14
Control nosebleed pack+caut 30905 CPT 30905 $569.60 $785.00 $87.45 – $993.28 16
Control of nosebleed ant comp 30903 CPT 30903 $569.60 $785.00 $44.55 – $640.80 16
Control of nosebleedantersmpl 30901 CPT 30901 $569.60 $785.00 $29.70 – $993.28 16
Conv gtube to jtube CPT 44373 $4,128.80 $5,690.00 $196.35 – $4,644.90 16
Coombs direct CPT 86880 $84.80 $117.00 $5.32 – $95.40 16
Coombs indirect titer reference CPT 86886 $370.40 $510.00 $5.12 – $416.70 16
Copper intrauterine device HCPCS J7300 $2,606.40 $3,258.00 $564.30 – $2,821.50 14
Cor hlx vlgs dstl mtar osteo CPT 28296 not published not published $1,388.80 – $1,662.99 2
Cor hlx vlgs prx phlx osteot CPT 28298 not published not published $1,544.15 – $1,756.16 2
Core ndl bx lng/med perq CPT 32408 $3,521.60 $4,853.00 $133.56 – $3,961.80 16
Cornea pre-cut midwest eye cornea pre-cut midwest eye HCPCS V2785 $1,451.20 $2,000.00 $326.52 – $1,632.60 13
Coronary thrombolysis/iv infusion 92977 CPT 92977 $577.60 $796.00 $113.51 – $649.80 14
Correct bunion/keller/mcbride/mayo 28292 CPT 28292 not published not published $329.45 – $1,582.08 8
Cortisol total am CPT 82533 $1,184.80 $1,633.00 $12.00 – $170.10 16
Cosyntropin 0.25 mg solution for injection HCPCS J0834 $594.40 $743.00 $25.37 – $668.70 14
Counseling smoke cess interm >10mins CPT 99407 $64.00 $84.00 $14.40 – $72.00 16
Cover eye w/membrane CPT 65778 $17,461.60 $24,064.00 $993.28 – $19,644.30 14
Coveredge 32 lead kit 40cm 48 HCPCS C1897 $3,664.00 $5,049.00 $824.40 – $4,122.00 13
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 $1,360.00 $1,700.00 $306.00 – $1,530.00 14
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose HCPCS M0250 $1,360.00 $1,700.00 $306.00 – $1,530.00 14
Covid-19 administration immunization im inj 1st/only component CPT 90480 $25.20 $42.00 $7.56 – $37.80 12
Cr-51 sodium chromate HCPCS A9553 $504.80 $696.00 $113.58 – $567.90 12
Crbrospnl fld flw imag cistern CPT 78630 $3,645.60 $5,024.00 $104.32 – $4,101.30 16
Create eardrum opening CPT 69436 $8,618.40 $11,878.00 $108.35 – $9,695.70 16
Creatine kinase CPT 82550 $153.60 $212.00 $6.44 – $51.52 16
Creatine kinase isoenzymes CPT 82552 $45.80 $63.00 $10.30 – $51.52 16
Creatine kinase mb CPT 82553 $176.80 $244.00 $10.08 – $198.90 16
Creatinine CPT 82565 $47.80 $66.00 $5.07 – $53.77 16
Creatinine 24 hour urine CPT 82570 $128.80 $177.00 $5.12 – $71.10 16
Creatinine clearance urine CPT 82575 $176.80 $244.00 $9.35 – $198.90 16
Critical care 30-74 minutes CPT 99291 $2,172.00 $2,994.00 $74.34 – $371.70 16
Critical care each additional 30 minutes CPT 99292 $609.60 $840.00 $12.06 – $168.81 16
Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 $272.40 $454.00 $81.72 – $408.60 15
Crotalidae poly immune fab HCPCS J0840 $14,450.40 $24,084.00 $1,828.71 – $21,675.60 15
Cryocautery of cervix 57511 CPT 57511 $723.20 $996.00 $56.65 – $1,004.80 16
Cryofibrinogen qualitative - sendout CPT 82585 $65.40 $90.00 $5.00 – $73.58 16
Cryoprecipitate each unit HCPCS P9012 $284.00 $392.00 $58.09 – $319.50 14
Cryptosporidium antigen CPT 87272 $196.80 $271.00 $9.36 – $221.40 14
Crystal identification light microscopy CPT 89060 $112.80 $155.00 $7.24 – $126.90 16
Csf leakage imaging CPT 78650 $4,322.40 $5,957.00 $69.12 – $4,862.70 16
Cta abdomen without & /or w/contrast CPT 74175 $4,521.60 $6,232.00 $268.54 – $5,086.80 16
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 $5,761.60 $7,940.00 $292.30 – $6,481.80 16
Cta lower extremity without & w/contrast (both sides) CPT 73706 $3,747.20 $5,164.00 $241.37 – $4,215.60 14
Cta neck without &/or w/contrast CPT 70498 $3,143.20 $4,331.00 $256.26 – $3,536.10 16
Cta upper extremity w &/or without contrast left CPT 73206 $4,521.60 $6,232.00 $241.37 – $5,086.80 14
Culture aerobic additional method definitive id each CPT 87077 $205.60 $284.00 $7.10 – $92.70 16
Culture afb any source CPT 87116 $92.80 $128.00 $7.50 – $99.00 16
Culture anaerobic additional method definitive id each CPT 87076 $154.40 $213.00 $7.99 – $173.70 16
Culture anaerobic except blood CPT 87075 $177.60 $245.00 $9.36 – $199.80 16
Culture bact stool aero addl path ea CPT 87046 $104.00 $144.00 $2.61 – $117.00 16
Culture body fluid CPT 87070 $280.80 $387.00 $6.90 – $315.90 16
Culture fungi definitive id mold CPT 87107 $166.40 $229.00 $10.20 – $187.20 16
Culture fungi definitive id yeast CPT 87106 $90.40 $125.00 $9.70 – $101.70 16
Culture fungi other (except blood) CPT 87102 $207.20 $286.00 $8.31 – $101.70 16
Culture fungi skin/hair/nail CPT 87101 $85.60 $118.00 $7.62 – $96.30 16
Culture mycobacteria definitive id each isolate CPT 87118 $154.20 $257.00 $14.44 – $231.30 16
Culture mycoplasma any source CPT 87109 $350.40 $483.00 $15.21 – $394.20 16
Culture screening strep group a CPT 87081 $337.60 $465.00 $5.20 – $101.70 16
Culture typing immunologic CPT 87147 $17.40 $24.00 $3.00 – $19.57 16
Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 $65.40 $90.00 $14.71 – $73.58 16
Culture urine each isolate CPT 87088 $92.80 $128.00 $8.00 – $104.40 16
Curette/treat cornea CPT 65435 $2,283.20 $3,147.00 $61.55 – $2,568.60 16
Cutter lead HCPCS C1773 $619.20 $1,032.00 $11.56 – $57.83 12
Cv stress test i&r only 93018 CPT 93018 $42.60 $71.00 $12.78 – $142.85 14
Cv stress test/supervision only 93016 CPT 93016 $42.60 $71.00 $12.78 – $72.53 14
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 $54.00 $67.50 $1.00 – $8.10 15
Cyclic citrullinated peptide antibody CPT 86200 $304.00 $419.00 $12.80 – $327.60 16
Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 $13.20 $22.00 $0.48 – $19.80 15
Cyclophosphamide 25 mg capsule HCPCS J8530 $43.20 $72.00 $1.10 – $64.80 14
Cyclosporine 2 hour CPT 80158 $542.40 $748.00 $17.09 – $610.20 16
Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 $29.00 $36.25 $6.48 – $72.58 14
Cyclosporine modified 25 mg capsule HCPCS J7515 $8.80 $11.00 $0.34 – $9.90 15
Cyclosporine oral 100 mg HCPCS J7502 $34.00 $46.00 $1.72 – $37.80 15
Cyp2c19 gene com variants CPT 81225 $1,004.00 $1,255.00 $225.90 – $1,129.50 14
Cyp2d6 gene com variants CPT 81226 $240.00 $400.00 $72.00 – $445.64 14
Cystatin c CPT 82610 $332.80 $459.00 $15.20 – $374.40 16
Cystic fibrosis cftr CPT 81223 $4,001.60 $5,002.00 $399.20 – $4,248.90 16
Cysto/uretero w/lithotripsy CPT 52356 not published not published $585.08 – $993.28 2
Cystogram >= 3 views supervision & interpretation CPT 74430 $961.60 $1,325.00 $27.52 – $1,081.80 16
Cystometrogram w/up 51727 CPT 51727 $2,776.80 $3,827.00 $156.24 – $781.20 16
Cystoscopy & ureter catheter CPT 52005 $2,835.20 $3,907.00 $127.60 – $3,189.60 16
Cystoscopy (Bladder Scope) CPT 52000 $1,557.60 $2,146.00 $43.20 – $744.96 16
Cystoscopy and radiotracer CPT 52250 not published not published $214.50 – $993.28 8
Cystoscopy and treatment CPT 52224 not published not published $168.85 – $697.60 8
Cystoscopy and treatment CPT 52234 not published not published $237.60 – $984.85 8
Cystoscopy and treatment CPT 52235 not published not published $297.01 – $1,533.30 8
Cystoscopy and treatment CPT 52310 $5,744.80 $7,917.00 $81.72 – $830.72 16
Cystoscopy chemodenervation CPT 52287 $1,976.00 $2,724.00 $90.00 – $993.28 16
Cystouretero & or pyeloscope CPT 52351 not published not published $667.07 – $993.28 2
Cystouretero w/biopsy CPT 52354 not published not published $836.61 – $993.28 2
Cystouretero w/lithotripsy CPT 52353 not published not published $954.79 – $993.28 2
Cystouretero w/stone remove CPT 52352 not published not published $824.16 – $993.28 2
Cystourethroscop/calib/dilat stric 52281 CPT 52281 not published not published $118.25 – $678.40 8
Cystourethroscopy w/biopsy(s) 52204 CPT 52204 not published not published $135.85 – $893.44 8
Cytarabine 20 mg/ml injection solution HCPCS J9100 $70.80 $118.00 $0.83 – $20.70 14
Cyto/molecular report CPT 88291 $326.40 $449.00 $12.37 – $71.10 14
Cytogenetics 25-99 CPT 88274 $412.00 $568.00 $33.09 – $215.10 14
Cytomegalovirus (cmv) antibody igg CPT 86644 $176.80 $244.00 $14.22 – $121.50 16
Cytomegalovirus (cmv) antibody igm CPT 86645 $176.80 $244.00 $16.65 – $198.90 16
Cytopath c/v auto in fluid CPT 88174 $334.40 $461.00 $23.88 – $376.20 16
Cytopath fl nongyn filter CPT 88106 $169.60 $234.00 $3.20 – $190.80 16
Cytopath smear oth prep screen & interp CPT 88161 $120.80 $167.00 $11.26 – $135.90 16
Cytopath smear other source CPT 88160 $66.40 $91.00 $3.20 – $74.70 16
Cytopathology cellular enhancement technique non-gyn CPT 88112 $172.00 $237.00 $38.70 – $218.54 16
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 $104.00 $137.00 $21.96 – $109.80 16
Cytopathology cervical/vaginal thin layer manual screening CPT 88142 $81.60 $107.00 $16.00 – $91.80 16
Cytopathology concentration technique smears & interpretation CPT 88108 $62.20 $85.00 $5.12 – $77.31 16
Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 $280.80 $387.00 $8.32 – $315.90 16
Cytopathology fna adequacy evaluation first episode each site CPT 88172 $85.60 $118.00 $19.26 – $122.78 14
Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 $450.40 $621.00 $39.16 – $506.70 14
D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 not published not published $538.76 – $929.28 2
Dacarbazine 100 mg intravenous solution HCPCS J9130 $76.80 $128.00 $3.45 – $57.60 14
Dactinomycin 0.5 mg intravenous solution HCPCS J9120 $2,879.40 $4,799.00 $328.34 – $4,319.10 15
Dalbavancin 500 mg intravenous solution HCPCS J0875 $7,113.00 $11,855.00 $15.61 – $106.20 15
Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 $2,063.40 $3,439.00 $0.03 – $24.27 15
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 $104.40 $174.00 $31.32 – $156.60 15
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 $17,923.80 $29,873.00 $2.93 – $53.10 15
Darbepoetin alfa, esrd use HCPCS J0882 $2,151.00 $3,585.00 $2.93 – $53.10 15
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 $483.00 $805.00 $144.90 – $724.50 15
Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 $622.20 $1,037.00 $21.70 – $465.30 15
Dch glucoscan CPT 82948 $14.40 $20.00 $2.00 – $16.20 16
Dch pulmonary stress test CPT 94621 $188.80 $260.00 $42.48 – $212.40 16
Dch validity tests CPT 81002 $62.20 $85.00 $2.65 – $13.28 16
Deamidated gliadin antibody iga CPT 86258 $80.40 $134.00 $9.41 – $120.60 14
Debr musc/fascia 20sq cm/< 11043 CPT 11043 $728.40 $1,214.00 $23.40 – $775.68 16
Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 $1,592.00 $2,195.00 $32.23 – $1,791.00 16
Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 $1,778.40 $2,451.00 $400.14 – $2,000.70 14
Debride nail1-5 11720 CPT 11720 $471.00 $785.00 $4.59 – $59.26 16
Debride nail6 or more 11721 CPT 11721 $206.40 $344.00 $5.89 – $99.88 16
Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 $728.40 $1,214.00 $3.96 – $46.42 14
Debridement (>20 cm) charge pt CPT 97598 $312.80 $432.00 $3.51 – $94.55 16
Debridement bone <= 20 sq cm CPT 11044 $2,103.20 $2,898.00 $36.30 – $775.68 16
Debridement subcutaneous tissue <= 20 sq cm CPT 11042 $825.60 $1,376.00 $10.98 – $775.68 16
Debridement/bone/20 sq cm or less 11046 CPT 11046 not published not published $38.95 – $80.89 2
Debridement/bone/ea add 20 sq cm 11047 CPT 11047 not published not published $67.84 – $133.38 2
Decalcification CPT 88311 $469.60 $647.00 $7.92 – $528.30 16
Decitabine 50 mg intravenous solution HCPCS J0894 $5,326.20 $8,877.00 $1.22 – $159.30 14
Declotting thrombolytic agent implanted vas access device 36 CPT 36593 $790.40 $1,089.00 $27.57 – $889.20 16
Decompression of tibia nerve CPT 28035 not published not published $321.20 – $1,251.46 8
Deferoxamine 500 mg solution for injection HCPCS J0895 $43.20 $72.00 $9.01 – $64.80 14
Degarelix 120 mg subcutaneous solution HCPCS J9155 $2,262.60 $3,771.00 $4.45 – $42.30 15
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 $78.60 $108.00 $13.00 – $88.42 16
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 $10,269.00 $17,115.00 $25.92 – $1,809.19 16
Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 $712.80 $983.00 $25.85 – $801.90 15
Dermagraft HCPCS Q4106 $2,778.40 $3,829.00 $42.18 – $3,125.70 14
Desmopressin 4 mcg/ml injection solution HCPCS J2597 $2,755.80 $4,593.00 $1.98 – $9.90 15
Desoxycorticosterone CPT 82633 $481.60 $664.00 $30.62 – $541.80 16
Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 $1,489.60 $2,053.00 $47.34 – $308.87 16
Dest mal lesion tal <0.5 17260 CPT 17260 $1,172.00 $1,615.00 $37.44 – $262.74 16
Destroy premlg lesns;1st lesn 17000 CPT 17000 $847.20 $1,412.00 $7.65 – $1,181.44 16
Destruct ben lesion 15/> 17111 CPT 17111 $147.00 $245.00 $18.54 – $993.28 16
Destruction 2-14 lesions 17003 CPT 17003 $118.20 $197.00 $1.08 – $22.58 16
Destruction benign lesions < 14 lesions CPT 17110 $847.20 $1,412.00 $13.81 – $825.60 16
Developmental screen/score/document 96110 CPT 96110 $20.40 $28.00 $4.59 – $22.95 15
Device ablt adv novasure HCPCS C1886 $7,153.60 $9,858.00 $796.50 – $3,982.50 12
Device intraute mirena HCPCS J7298 $4,133.60 $5,167.00 $930.06 – $4,650.30 14
Device sut capio slim opn HCPCS C2631 $1,632.80 $2,250.00 $367.38 – $1,836.90 12
Device tiss remov myosure reach HCPCS C1782 $3,273.60 $4,512.00 $470.70 – $2,353.50 12
Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 $161.60 $212.00 $22.63 – $181.80 16
Dexametha opth insert 0.1 mg HCPCS J1096 $1,432.80 $2,388.00 $102.94 – $537.30 15
Dexamethasone 4 mg tablet HCPCS J8540 $5.40 $9.00 $0.02 – $0.90 15
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 $6.60 $11.00 $0.09 – $0.90 15
Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 $1,196.40 $1,994.00 $63.06 – $898.20 15
Dextran 40 infusion HCPCS J7100 $645.60 $807.00 $145.26 – $726.30 13
Dextrose 5 % IV bolus HCPCS J7070 $26.80 $33.50 $3.11 – $29.70 14
Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 $32.40 $40.50 $1.41 – $15.30 14
Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 $29.00 $36.25 $6.48 – $32.40 13
Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 $60.40 $75.50 $0.90 – $4.50 14
Dhea-s (dehydroepiand sulfate) CPT 82627 $222.40 $307.00 $21.00 – $250.20 16
Diabetes (HbA1c) Test CPT 83036 $200.00 $276.00 $7.00 – $225.00 16
Diag laparo separate proc 49320 CPT 49320 not published not published $701.79 – $993.28 2
Diagnostic Mammogram (both breasts) CPT 77066 $584.00 $805.00 $116.26 – $657.00 15
Diagnostic Mammogram (one breast) CPT 77065 $383.20 $528.00 $86.22 – $431.10 15
Diagnostic anoscopy spx 46600 CPT 46600 $3,052.80 $4,207.00 $21.60 – $108.00 16
Diagnostic laryngoscopy 31505 CPT 31505 $338.40 $466.00 $76.14 – $380.70 14
Dialysis one evaluation CPT 90945 $1,536.00 $2,117.00 $44.80 – $1,728.00 14
Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 $79.20 $132.00 $0.08 – $0.90 13
Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 $127.20 $212.00 $7.35 – $95.40 14
Dicyclomine injection HCPCS J0500 $494.40 $618.00 $11.36 – $556.20 14
Diffusing capacity CPT 94729 $498.40 $687.00 $42.39 – $560.70 16
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 $34.00 $42.50 $7.56 – $37.80 14
Digoxin immune fab 40 mg intravenous solution HCPCS J1162 $16,441.80 $27,403.00 $2,284.56 – $11,422.80 15
Digoxin total therapeutic drug level CPT 80162 $152.00 $210.00 $11.00 – $171.00 16
Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 $924.80 $1,156.00 $60.00 – $1,040.40 14
Dilate esophagus 1/mult pass CPT 43450 $4,264.00 $5,877.00 $64.90 – $4,797.00 16
Dilation of cervical canal 57800 CPT 57800 $4,291.20 $5,914.00 $25.38 – $1,045.76 16
Dilation of rectal stricture 45910 CPT 45910 $3,933.60 $5,421.00 $48.40 – $4,425.30 16
Dilator fascial 10fx20cm HCPCS C2627 $1,022.40 $1,409.00 $11.56 – $57.83 12
Dimenhydrinate injection HCPCS J1240 $13.20 $16.50 $2.97 – $14.85 14
Dimethyl sulfoxide 50% 50 ml HCPCS J1212 $3,160.80 $5,268.00 $748.85 – $4,741.20 15
Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 $16.80 $21.00 $0.76 – $18.90 15
Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 $25.80 $43.00 $7.38 – $36.90 16
Disability dlco CPT 94727 $282.40 $390.00 $28.08 – $317.70 16
Disaccharidases CPT 82657 $107.20 $148.00 $17.31 – $120.60 14
Discography cerv/thor spine CPT 72285 $2,404.00 $3,313.00 $46.08 – $2,704.50 16
Dna antibody native/double stranded CPT 86225 $301.60 $416.00 $13.58 – $339.30 16
Dna gardnerella CPT 87510 $267.20 $369.00 $16.04 – $300.60 16
Dna trichomonas CPT 87660 $279.20 $384.00 $19.82 – $314.10 16
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 $162.00 $270.00 $5.22 – $26.10 14
Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 $7,030.80 $11,718.00 $0.63 – $65.70 14
Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 $89.40 $149.00 $0.18 – $0.90 14
Doppler echo complete CPT 93320 $1,160.00 $1,599.00 $52.98 – $1,305.00 16
Doppler upper/lower extremity arteries complete bilateral CPT 93923 $1,308.00 $1,803.00 $89.66 – $1,471.50 16
Doppler upper/lower extremity arteries limited bilateral CPT 93922 $919.20 $1,266.00 $47.50 – $1,034.10 16
Doripenem 50 mg/ml inj 10 ml HCPCS J1267 $8.40 $14.00 $2.52 – $12.60 13
Dornase alfa non-comp unit HCPCS J7639 $236.00 $295.00 $51.57 – $265.50 15
Dornhoffer fixed part w/window HCPCS L8614 $44,163.20 $60,862.00 $9,936.72 – $49,683.60 13
Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 $162.60 $271.00 $3.02 – $48.60 14
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 $4,487.40 $7,479.00 $108.47 – $3,366.90 14
Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 $1.20 $1.50 $0.11 – $0.90 14
Dpyd gene common variants CPT 81232 $2,358.60 $3,931.00 $136.49 – $3,537.90 14
Drain blood from under nail 11740 CPT 11740 $298.40 $412.00 $26.40 – $993.28 16
Drain cath image guided visceral pq CPT 49405 $5,596.80 $7,713.00 $190.71 – $6,296.40 16
Drain cerebro spinal fluid 62272 CPT 62272 $1,524.80 $2,101.00 $40.70 – $1,715.40 16
Drain finger abscess;simple 26010 CPT 26010 $712.80 $983.00 $29.15 – $993.28 16
Drain thigh/knee lesion 27301 CPT 27301 $6,528.00 $8,996.00 $97.35 – $7,344.00 16
Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 $1,741.60 $2,400.00 $29.15 – $1,959.30 16
Drainage ext aud canal abscess 69020 CPT 69020 $1,741.60 $2,400.00 $38.50 – $1,959.30 16
Drainage external ear complex 69005 CPT 69005 $8,618.40 $11,878.00 $151.23 – $9,695.70 16
Drainage external ear simple 69000 CPT 69000 $712.80 $983.00 $47.30 – $993.28 16
Drainage of arm bursa 23931 CPT 23931 $4,036.80 $5,563.00 $43.45 – $993.28 16
Drainage of kidney lesion CPT 50390 $1,352.80 $1,865.00 $100.70 – $1,521.90 16
Drainage of rectal abscess CPT 45005 $5,976.80 $8,237.00 $103.40 – $6,723.90 16
Drainage of rectal abscess 45020 CPT 45020 $6,501.60 $8,960.00 $165.55 – $7,314.30 16
Dress/debrid prtl-thick burn l 16030 CPT 16030 $998.40 $1,376.00 $126.59 – $1,123.20 16
Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 $998.40 $1,376.00 $110.61 – $1,123.20 16
Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 $712.80 $983.00 $22.00 – $801.90 16
Drng of eyelid abscess 67700 CPT 67700 $8,618.40 $11,878.00 $165.27 – $9,695.70 14
Drng of finger abscess comp 26011 CPT 26011 $2,267.20 $3,125.00 $88.00 – $2,550.60 16
Drng of scrotum abscess 55100 CPT 55100 $3,497.60 $4,821.00 $38.50 – $3,934.80 16
Droperidol 2.5 mg/ml injection solution HCPCS J1790 $39.60 $49.50 $7.63 – $44.10 14
Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 $2,151.20 $2,964.00 $233.64 – $1,168.20 12
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 $660.00 $909.00 $11.88 – $742.50 13
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 $841.60 $1,160.00 $2.49 – $946.80 13
Drug assay vedolizumab CPT 80280 $431.40 $719.00 $30.12 – $647.10 14
Drug asy hydroxychloroquine CPT 80220 $196.20 $327.00 $14.55 – $294.30 14
Drug test def 1-7 classes HCPCS G0480 $480.80 $663.00 $25.38 – $126.90 15
Drug test def 8-14 classes HCPCS G0481 $316.80 $528.00 $95.04 – $475.20 15
Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 $383.20 $479.00 $14.22 – $96.29 16
Drvvt confirm - quest CPT 85597 $211.20 $291.00 $17.78 – $230.40 16
Ductogram sgl duct CPT 77053 $1,043.20 $1,437.00 $49.89 – $1,173.60 16
Dup scan/hemodialysis access 93990 CPT 93990 $1,062.40 $1,464.00 $101.74 – $1,195.20 16
Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 $1,179.20 $1,625.00 $152.76 – $1,326.60 16
Duplex scan bilateral study 93985 CPT 93985 $1,728.80 $2,382.00 $222.68 – $1,944.90 16
Duplex scan unilateral study 93986 CPT 93986 $864.00 $1,191.00 $126.76 – $972.00 16
Duragen 1x1 5ea/bx HCPCS C9354 $514.40 $709.00 $115.74 – $578.70 13
Durvalumab 50 mg/ml intravenous solution HCPCS J9173 $324.60 $541.00 $85.12 – $486.90 15
Dx bronchoscope/lavage 31624 CPT 31624 $3,540.00 $4,878.00 $148.66 – $3,982.50 16
Dx bronchoscope/wash 31622 CPT 31622 $3,540.00 $4,878.00 $147.25 – $3,159.90 16
Dxa bone density axl vrt fx CPT 77085 $813.60 $1,121.00 $73.47 – $915.30 14
E equine encephalitis igg CPT 86652 $111.20 $153.00 $13.03 – $125.10 16
ER Visit (level 1, minor) CPT 99281 $352.80 $588.00 $14.40 – $72.00 14
ER Visit (level 2) CPT 99282 $492.00 $678.00 $29.52 – $147.60 15
ER Visit (level 3) CPT 99283 $900.00 $1,240.00 $36.72 – $183.60 15
ER Visit (level 4) CPT 99284 $1,504.00 $2,073.00 $64.08 – $320.40 15
ER Visit (level 5, high severity) CPT 99285 $1,557.60 $2,146.00 $62.46 – $312.30 15
Ear irrigation 69209 CPT 69209 $117.00 $195.00 $1.80 – $993.28 14
Ecg 12 lead tracing only CPT 93005 $271.80 $453.00 $9.81 – $54.51 16
Ecg < 30 days transmission & analysis CPT 93271 $312.80 $432.00 $70.38 – $351.90 16
Ecg external < 48 hours recording CPT 93225 $551.40 $919.00 $20.07 – $145.80 16
Ecg external < 48 hours scanning analysis w/report CPT 93226 $671.40 $1,119.00 $16.65 – $192.86 16
Ecg external > 48 hours up to 7 days recording CPT 93242 $91.20 $126.00 $10.01 – $102.60 16
Ecg external >7 days up to 15 days recording CPT 93246 $75.00 $125.00 $9.61 – $112.50 16
Echo exam uterus 76831- CPT 76831 $840.80 $1,159.00 $182.34 – $945.90 14
Echo guidance radiotherapy CPT 76965 $2,659.20 $3,665.00 $21.43 – $2,991.60 14
Echo guide for amniocentesis CPT 76946 $603.20 $832.00 $23.81 – $678.60 16
Echo guide for artery repair CPT 76936 $1,220.80 $1,682.00 $112.96 – $1,373.40 16
Echo stress CPT 93350 $1,056.00 $1,455.00 $59.52 – $1,109.70 16
Echo tee probe placement image acquisition interpretation & report CPT 93312 $1,040.80 $1,434.00 $170.15 – $1,170.90 16
Echo transesophageal CPT 93314 $472.80 $652.00 $106.38 – $531.90 16
Echo transesophageal intraop CPT 93318 $2,591.20 $3,571.00 $392.84 – $2,915.10 13
Echo transthoracic CPT 93303 $1,094.40 $1,508.00 $121.60 – $1,231.20 16
Echo transthoracic CPT 93304 $647.20 $891.00 $27.52 – $728.10 16
Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 $1,026.40 $1,414.00 $121.60 – $1,122.30 16
Echocardiogram (Heart Ultrasound) CPT 93306 $2,739.20 $3,775.00 $125.62 – $3,081.60 16
Echocardiography doppler color flow mapping CPT 93325 $580.80 $800.00 $20.44 – $653.40 16
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 $2,739.20 $3,775.00 $578.38 – $3,081.60 13
Echocardiography transthoracic 2d followup/limited CPT 93308 $483.20 $666.00 $27.52 – $543.60 16
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 $440.00 $607.00 $99.00 – $495.00 13
Echocardiograpy doppler follow up/limited study CPT 93321 $922.40 $1,272.00 $26.30 – $1,037.70 16
Echograp trans r pros study CPT 76873 $474.40 $654.00 $83.46 – $533.70 14
Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 $268.80 $336.00 $44.82 – $302.40 15
Eeg monitor/record/awake/drowsy 95816 CPT 95816 $1,439.20 $1,983.00 $17.28 – $1,619.10 16
Eeg recording awake and asleep CPT 95819 $1,439.20 $1,983.00 $17.28 – $1,619.10 16
Eeg/cerebral death evaluation only 95824 -26 CPT 95824 $1,439.20 $1,983.00 $323.82 – $1,619.10 13
Eeg/record in coma or sleep only 95822 CPT 95822 $1,439.20 $1,983.00 $24.32 – $1,619.10 16
Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 $79.20 $99.00 $17.82 – $89.10 15
Egd Ultrasound exam duodenum/jejunum CPT 43259 $4,128.80 $5,690.00 $928.98 – $4,644.90 13
Egd Ultrasound fine needle bx/aspir CPT 43238 $4,128.80 $5,690.00 $232.08 – $4,644.90 16
Egd Ultrasound fine needle bx/aspir CPT 43242 $4,128.80 $5,690.00 $277.43 – $4,644.90 16
Egd Ultrasound transmural injxn/mark CPT 43253 $4,128.80 $5,690.00 $385.47 – $4,644.90 14
Egd balloon dil esoph30 mm/> CPT 43233 $4,128.80 $5,690.00 $332.32 – $4,644.90 14
Egd control bleeding any CPT 43255 $4,128.80 $5,690.00 $255.75 – $4,644.90 16
Egd dilate stricture CPT 43245 $4,128.80 $5,690.00 $180.20 – $4,644.90 16
Egd endo mucosal resection CPT 43254 $4,128.80 $5,690.00 $400.54 – $4,644.90 14
Egd endoscopic stent place CPT 43266 $7,896.80 $10,883.00 $331.59 – $8,883.90 14
Egd guide wire insertion CPT 43248 $4,264.00 $5,877.00 $637.56 – $4,797.00 14
Egd injection varices CPT 43243 $4,128.80 $5,690.00 $928.98 – $4,644.90 14
Egd lesion ablation CPT 43270 $4,128.80 $5,690.00 $928.98 – $4,644.90 14
Egd remove foreign body CPT 43247 $4,264.00 $5,877.00 $191.43 – $4,797.00 16
Egd remove lesion snare CPT 43251 $4,128.80 $5,690.00 $208.28 – $4,644.90 16
Egd varices ligation CPT 43244 $4,128.80 $5,690.00 $678.33 – $4,644.90 14
Egd w/thrml txmnt gerd CPT 43257 $7,896.80 $10,883.00 $541.08 – $8,883.90 14
Egd/insert intraluminal tube/cath 43241 CPT 43241 $4,128.80 $5,690.00 $148.54 – $4,644.90 16
Egd/remov tum/polyp/hot bx forcep 43250 CPT 43250 $4,128.80 $5,690.00 $928.98 – $4,644.90 14
Egfr gene com variants CPT 81235 $1,008.00 $1,260.00 $31.50 – $397.12 16
Ehrlicha chaffeensis amp prb CPT 87484 $351.20 $484.00 $28.07 – $395.10 16
Electrical stimulation/unattended 97014 CPT 97014 $27.00 $45.00 $2.16 – $40.74 14
Electrolyte panel CPT 80051 $158.40 $218.00 $6.92 – $178.20 16
Elotuzumab 300 mg intravenous solution HCPCS J9176 $28.80 $48.00 $7.88 – $43.20 15
Emb w/colposcopy 58110 CPT 58110 $706.40 $973.00 $21.60 – $108.00 16
Emb without cervical dilation 58100 CPT 58100 $2,633.60 $3,630.00 $37.26 – $934.40 16
Encephalitis, california igg/igm CPT 86651 $111.20 $153.00 $13.03 – $125.10 16
Encephalitis, st louis igg/igm CPT 86653 $111.20 $153.00 $13.03 – $125.10 16
Encephalitis, western equine igg/igm CPT 86654 $111.20 $153.00 $13.03 – $125.10 16
Endo cath bile duct s&i CPT 74328 $1,471.20 $2,028.00 $331.02 – $1,655.10 13
Endo cath panc duct s&i CPT 74329 $1,471.20 $2,028.00 $331.02 – $1,655.10 13
Endo cholangiopancreatograph CPT 43261 $7,896.80 $10,883.00 $993.28 – $8,883.90 14
Endo cholangiopancreatograph CPT 43262 $7,896.80 $10,883.00 $184.32 – $8,883.90 14
Endocerv curettage w/scope 57456 CPT 57456 $232.00 $320.00 $52.20 – $993.28 16
Endocervical curettage 57505 CPT 57505 $1,478.40 $2,037.00 $24.20 – $993.28 16
Endoscopic Ultrasound exam esoph CPT 43237 $4,128.80 $5,690.00 $186.92 – $4,644.90 16
Endoscopic injection/implant CPT 51715 $12,844.00 $17,701.00 $106.92 – $993.28 16
Endoscopic pancreatoscopy CPT 43273 $7,896.80 $10,883.00 $96.90 – $8,883.90 14
Endoscopy bowel pouch/biop CPT 44386 $3,816.80 $5,261.00 $121.29 – $4,293.90 16
Endoscopy of bowel pouch 44385 CPT 44385 $3,816.80 $5,261.00 $103.09 – $4,293.90 16
Endoscopy swallow (fees) vid CPT 92612 $196.00 $270.00 $44.10 – $316.31 16
Endoscpy nsl/sns w/cntrl nsl hmrrgh CPT 31238 $2,765.60 $3,812.00 $453.07 – $3,111.30 14
Enfortumab vedotin-ejfv 20 mg intravenous solution HCPCS J9177 $64.20 $107.00 $19.26 – $96.30 15
Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 $69.60 $116.00 $0.59 – $8.74 15
Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 $441.60 $552.00 $0.23 – $14.24 15
Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 $213.00 $355.00 $2.11 – $12.60 14
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 $4,764.60 $7,941.00 $8.54 – $180.00 16
Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 $229.80 $383.00 $6.48 – $32.40 15
Epstein barr early antigen antibody CPT 86663 $271.20 $374.00 $12.97 – $305.10 16
Epstein barr nuclear antigen antibody CPT 86664 $353.60 $487.00 $15.11 – $397.80 16
Epstein barr viral capsid antigen antibody igm CPT 86665 $353.60 $487.00 $17.93 – $100.80 16
Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 $2,520.60 $4,201.00 $50.40 – $252.00 13
Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 $46.40 $58.00 $10.44 – $52.20 15
Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 $7,896.80 $10,883.00 $686.48 – $8,883.90 14
Ercp biliary & pancreas CPT 74330 $1,294.40 $1,784.00 $291.24 – $1,456.20 13
Ercp ea duct/ampulla dilate CPT 43277 $7,896.80 $10,883.00 $569.35 – $8,883.90 14
Ercp lesion ablate w/dilate 43278 CPT 43278 $7,896.80 $10,883.00 $647.45 – $8,883.90 14
Ercp lithotripsy calculi CPT 43265 $7,896.80 $10,883.00 $993.28 – $8,883.90 14
Ercp remove duct calculi 43264 CPT 43264 $7,896.80 $10,883.00 $993.28 – $8,883.90 14
Ercp remove forgn body duct 43275 CPT 43275 $7,896.80 $10,883.00 $565.94 – $8,883.90 14
Ercp stent exchange w/dilate CPT 43276 $7,896.80 $10,883.00 $714.16 – $8,883.90 14
Ercp w/specimen collection CPT 43260 $7,896.80 $10,883.00 $524.80 – $8,883.90 14
Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 $509.40 $849.00 $89.34 – $764.10 15
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 $595.80 $993.00 $9.86 – $445.50 15
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 $460.00 $575.00 $64.62 – $517.50 14
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 $11.80 $14.75 $0.22 – $12.60 14
Esoph egd dilation <30 mm CPT 43249 $4,128.80 $5,690.00 $621.62 – $4,644.90 14
Esoph endoscopy dilation CPT 43226 $4,128.80 $5,690.00 $135.28 – $4,644.90 16
Esoph imped function test CPT 91037 $6,467.20 $8,912.00 $93.94 – $7,275.60 16
Esophageal dilat s&i CPT 74360 $672.80 $927.00 $105.43 – $756.90 16
Esophagosc flex trnsn biopsy CPT 43198 $4,264.00 $5,877.00 $279.43 – $4,797.00 14
Esophagoscop mucosal resect CPT 43211 $4,128.80 $5,690.00 $347.79 – $4,644.90 14
Esophagoscop stent placement CPT 43212 $7,896.80 $10,883.00 $275.30 – $8,883.90 14
Esophagoscop ultrasound exam CPT 43231 $4,128.80 $5,690.00 $180.76 – $4,644.90 16
Esophagoscopy balloon <30mm CPT 43220 $4,128.80 $5,690.00 $122.47 – $4,644.90 16
Esophagoscopy control bleed CPT 43227 $4,128.80 $5,690.00 $202.32 – $4,644.90 16
Esophagoscopy flex biopsy CPT 43202 $4,128.80 $5,690.00 $111.63 – $4,644.90 16
Esophagoscopy flex dx brush CPT 43197 $4,264.00 $5,877.00 $249.74 – $4,797.00 14
Esophagoscopy flex remove fb CPT 43215 $4,128.80 $5,690.00 $577.28 – $4,644.90 14
Esophagoscopy lesion ablate CPT 43229 $7,896.80 $10,883.00 $973.38 – $8,883.90 14
Esophagoscopy snare les remv CPT 43217 $4,128.80 $5,690.00 $164.50 – $4,644.90 16
Esophagoscopy w/us needle bx CPT 43232 $4,128.80 $5,690.00 $535.78 – $4,644.90 14
Esophagoscopy/flex/diagnostic 43200 CPT 43200 $4,264.00 $5,877.00 $102.82 – $4,797.00 16
Esophagus endoscopy/ligation CPT 43205 $4,128.80 $5,690.00 $559.77 – $4,644.90 14
Esophagus motility study CPT 91010 $2,426.40 $3,344.00 $21.12 – $2,729.70 16
Established Patient Office Visit (level 1) CPT 99211 $199.80 $333.00 $4.68 – $32.39 16
Established Patient Office Visit (level 2) CPT 99212 $250.80 $418.00 $11.84 – $59.17 16
Established Patient Office Visit (level 3) CPT 99213 $250.80 $418.00 $13.14 – $82.05 16
Established Patient Office Visit (level 4) CPT 99214 $327.00 $545.00 $14.22 – $122.27 16
Established Patient Office Visit (level 5) CPT 99215 $421.20 $702.00 $19.08 – $187.68 16
Estradiol total CPT 82670 $451.20 $622.00 $21.50 – $242.10 16
Estrogens total-sendout CPT 82672 $375.20 $517.00 $13.92 – $422.10 16
Ethanolamine oleate 100 mg HCPCS J1430 $1,605.00 $2,675.00 $481.50 – $2,407.50 15
Ethylene glycol -sendout CPT 82693 $245.60 $338.00 $11.64 – $276.30 14
Etonogestrel implant system HCPCS J7307 $5,044.00 $6,305.00 $1,019.14 – $5,674.50 14
Etoposide 20 mg/ml intravenous solution HCPCS J9181 $52.20 $87.00 $0.94 – $8.10 14
Etoposide 50 mg cap HCPCS J8560 $285.60 $476.00 $77.46 – $428.40 14
Euflexxa inj per dose HCPCS J7323 $752.40 $1,254.00 $112.45 – $1,128.60 15
Eval/fit voice prosthesis iii, st CPT 92607 $375.20 $517.00 $84.42 – $422.10 14
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 $270.40 $373.00 $60.84 – $304.20 14
Evaluation of speech fluency 92521 CPT 92521 $552.80 $762.00 $113.04 – $621.90 14
Evaluation psychiatric diagnostic CPT 90791 $182.40 $251.00 $33.60 – $209.34 14
Event monitor CPT 93270 $558.40 $770.00 $16.17 – $628.20 16
Evok oa screening qual CPT 92558 $140.80 $194.00 $6.62 – $158.40 13
Evoked potentials auditory screening automated analysis CPT 92650 $154.40 $213.00 $24.36 – $173.70 15
Exam of vagina w/scope 57420 CPT 57420 $162.60 $271.00 $22.14 – $993.28 16
Exam plvc w/anes othr thn lcl CPT 57410 not published not published $43.45 – $128.00 8
Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 $490.80 $818.00 $53.82 – $993.28 16
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 $490.80 $818.00 $46.75 – $867.84 16
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 not published not published $39.60 – $884.48 8
Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 not published not published $133.10 – $1,082.88 8
Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 $346.40 $478.00 $51.15 – $737.28 16
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 $636.00 $877.00 $71.50 – $750.08 16
Exc benign tal 0.5 < cm 11400 CPT 11400 $1,741.60 $2,400.00 $41.25 – $993.28 16
Exc feenl mal+mrg 0.6-1 11641 CPT 11641 $1,534.40 $2,115.00 $82.80 – $993.28 16
Exc leg/ankle tum subfasc<5cm 27619 CPT 27619 not published not published $132.00 – $1,158.97 8
Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 $2,371.20 $3,268.00 $86.58 – $993.28 16
Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 not published not published $94.05 – $993.28 8
Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 not published not published $138.05 – $993.28 8
Exc malig feenl 1.1-2 11642 CPT 11642 not published not published $148.50 – $993.28 8
Exc malig feenl 3.1-4.0 11644 CPT 11644 not published not published $243.10 – $993.28 8
Exc malig feenl <0.5cm 11640 CPT 11640 $1,534.40 $2,115.00 $66.42 – $993.28 16
Exc malig feenl >4cm 11646 CPT 11646 not published not published $281.60 – $993.28 8
Exc malig tal 0.6-1.0cm 11601 CPT 11601 $1,534.40 $2,115.00 $78.84 – $993.28 16
Exc malig tal <0.5cm 11600 CPT 11600 not published not published $88.00 – $993.28 8
Exc prtl bn phlnx toe CPT 28124 not published not published $798.54 – $993.28 2
Exc shoulder tum deep < 5 cm CPT 23076 not published not published $129.25 – $1,071.36 8
Exc skn hdrdnt ax smpl/ntrm CPT 11450 not published not published $201.56 – $993.28 8
Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 not published not published $207.90 – $993.28 8
Exc snhfg mal+mrg >4 cm 11626 CPT 11626 not published not published $264.00 – $993.28 8
Exc subq tum/sft tis/pel/hip 3cm/> 27043 CPT 27043 not published not published $691.01 – $993.28 2
Exc tendon sheath or cap lesion 26160 CPT 26160 not published not published $559.88 – $992.00 2
Exc thigh/knee les sc<3cm 27327 CPT 27327 not published not published $129.25 – $1,071.36 8
Exc thrombosed hemorrhoid 46320 CPT 46320 $8,618.40 $11,878.00 $44.00 – $993.28 16
Exc tmr sft tiss shldr subq <3cm CPT 23075 not published not published $59.40 – $872.96 8
Exc vagina lesion 57135 CPT 57135 not published not published $157.30 – $993.28 8
Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 $8,618.40 $11,878.00 $166.62 – $9,695.70 16
Exchange drainage catheter CPT 49423 $1,175.20 $1,619.00 $64.68 – $1,322.10 16
Excis partial tal calc CPT 28120 not published not published $243.65 – $1,294.08 8
Excise/repair mouth lesion CPT 40812 not published not published $72.05 – $674.56 8
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 not published not published $72.05 – $674.56 8
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 not published not published $41.25 – $948.48 8
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 $346.40 $478.00 $59.40 – $872.96 16
Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 not published not published $129.25 – $1,071.36 8
Excision of anal lesion(s) CPT 46922 not published not published $119.17 – $993.28 8
Excision olecranon bursa CPT 24105 not published not published $206.25 – $979.20 8
Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 $3,588.80 $4,946.00 $651.42 – $3,257.10 13
Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 $4,135.20 $5,698.00 $723.42 – $3,617.10 13
Explore penetrating wnd/extremity 20103 CPT 20103 $4,051.20 $5,583.00 $767.96 – $4,557.60 14
Explore/treat wrist joint CPT 25101 $6,511.20 $8,973.00 $306.35 – $7,325.10 16
Ext ecg>48hr<7d scan a/r CPT 93243 $341.60 $470.00 $76.86 – $384.30 16
Ext ecg>7d<15d scan a/r CPT 93247 $229.80 $383.00 $68.94 – $344.70 16
External chromosome analysis 20-25 cells CPT 88264 $1,140.00 $1,571.00 $96.48 – $482.40 16
External newborn metabolic screening panel HCPCS S3620 $301.60 $377.00 $24.32 – $339.30 13
External pretreatment of serum for use in antibody identification by dilution CPT 86976 $146.40 $202.00 $19.49 – $164.70 13
External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 $428.80 $591.00 $96.48 – $482.40 16
Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 $212.00 $292.00 $17.72 – $109.80 16
Eye implant band 40 HCPCS C1784 $3,584.00 $4,939.00 $806.40 – $4,032.00 13
Facial bones <3 CPT 70140 $388.00 $534.00 $23.18 – $436.50 16
Factor ix CPT 85250 $321.60 $536.00 $5.00 – $111.60 16
Factor viii CPT 85240 $289.60 $399.00 $13.00 – $325.80 16
Factor viii recomb novoeight HCPCS J7182 $3.40 $4.25 $0.77 – $3.83 15
Factor viii recombinant nos HCPCS J7192 $4.20 $7.00 $1.26 – $6.30 15
Fallopian tube recnl CPT 58345 $972.80 $1,341.00 $218.88 – $2,207.67 14
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 $52.80 $88.00 $15.84 – $79.20 15
Family therapy with patient 50 min 90847 CPT 90847 $128.00 $176.00 $16.64 – $222.70 14
Family therapy without pt 50min 90846 CPT 90846 $128.00 $176.00 $16.64 – $196.32 14
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 $0.40 $0.50 $0.01 – $0.45 14
Fat/lipids feces qualitative CPT 82705 $241.60 $333.00 $5.04 – $271.80 16
Fatty acids nonesterified CPT 82725 $185.60 $256.00 $13.18 – $208.80 16
Felbamate (felbatol(r)) - sendout CPT 80167 $226.20 $377.00 $14.55 – $339.30 14
Feno poc CPT 95012 $273.60 $377.00 $26.52 – $307.80 14
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 $218.40 $364.00 $0.18 – $1.10 14
Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 $5,580.60 $9,301.00 $1.11 – $10.80 15
Ferritin CPT 82728 $256.80 $372.00 $5.04 – $25.20 16
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 $3,963.60 $6,606.00 $0.32 – $10.80 14
Fetal biophys profile w/nst 76818 CPT 76818 $1,152.00 $1,588.00 $74.36 – $1,296.00 16
Fetal fibronectin CPT 82731 $1,029.60 $1,419.00 $20.00 – $1,158.30 16
Fetal hemoglobin (kleihauer betke) CPT 85460 $431.20 $594.00 $7.64 – $485.10 16
Fetal non stress test CPT 59025 $451.20 $622.00 $6.04 – $507.60 16
Fibrin degradation d dimer quantitative CPT 85379 $179.20 $247.00 $10.06 – $201.60 16
Fibrin degradation products CPT 85362 $111.20 $153.00 $6.81 – $125.10 16
Fibrinogen activity CPT 85384 $160.80 $222.00 $9.61 – $180.90 16
Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 $61.80 $103.00 $3.00 – $92.70 16
Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 $80.80 $111.00 $5.00 – $90.90 16
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 $2,461.20 $4,102.00 $1.00 – $5.62 15
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 $582.00 $970.00 $0.18 – $0.90 14
Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 $2,032.80 $3,388.00 $0.46 – $533.48 15
Finasteride, 5 mg HCPCS S0138 $20.60 $25.75 $0.07 – $23.18 14
Fine needle asp without image guide 10021 CPT 10021 $722.40 $1,204.00 $21.42 – $993.28 16
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 $1,320.00 $1,820.00 $84.41 – $1,485.00 16
Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 $877.60 $1,210.00 $26.64 – $133.20 16
Fixation of knee joint CPT 27570 not published not published $109.45 – $889.60 8
Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 not published not published $957.59 – $993.28 2
Fl exam g/colon tube w contrast CPT 49465 $2,151.20 $2,964.00 $26.11 – $2,420.10 16
Flecainide (tambocor)-sendout CPT 80181 $228.80 $315.00 $14.55 – $257.40 14
Flexible Sigmoidoscopy CPT 45330 $797.60 $1,047.00 $58.47 – $897.30 16
Flow cytometry interp 16 or more CPT 88189 $452.80 $624.00 $88.68 – $509.40 16
Flow cytometry marker each additional CPT 88185 $334.40 $461.00 $18.26 – $353.70 16
Flow cytometry one marker technical component CPT 88184 $1,882.40 $2,595.00 $37.14 – $358.20 16
Floxuridine injection HCPCS J9200 $555.60 $926.00 $166.68 – $4,128.02 15
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 $42.00 $70.00 $2.26 – $15.36 15
Fludarabine 50 mg intravenous solution HCPCS J9185 $1,258.80 $2,098.00 $68.20 – $1,888.20 15
Fluidotherapy charges pt CPT 97022 $143.20 $197.00 $15.32 – $104.40 16
Fluorescent antibody titer dna CPT 86256 $244.80 $337.00 $9.11 – $275.40 16
Fluoroguide for spine inject 77003-26 CPT 77003 $1,542.40 $2,125.00 $36.08 – $1,735.20 16
Fluoroguide needle placement CPT 77002 $1,542.40 $2,125.00 $45.66 – $1,735.20 16
Fluoroscopy up to 1 hour CPT 76000 $647.20 $891.00 $14.72 – $728.10 16
Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 $318.60 $531.00 $1.99 – $20.70 14
Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 $718.20 $1,197.00 $7.30 – $126.90 15
Fna bx w/ct gdn 1st les CPT 10009 $1,175.20 $1,619.00 $102.33 – $1,322.10 16
Fna bx w/ct gdn ea addl CPT 10010 $877.60 $1,210.00 $74.79 – $987.30 16
Fna bx w/mr gdn 1st les CPT 10011 $710.40 $979.00 $147.66 – $799.20 15
Folic acid CPT 82746 $158.40 $218.00 $12.00 – $178.20 16
Folic acid 5 mg/ml injection solution HCPCS J1808 $0.80 $1.00 $0.05 – $0.23 14
Fomepizole 1 gram/ml intravenous solution HCPCS J1451 $5,244.60 $8,741.00 $6.28 – $78.30 14
Fondaparinux sodium HCPCS J1652 $595.80 $993.00 $0.72 – $45.00 15
Foot X-ray CPT 73630 $364.80 $608.00 $5.04 – $68.14 14
Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 $1,549.20 $2,582.00 $0.10 – $15.30 14
Foscarnet sodium injection HCPCS J1455 $1,974.60 $3,291.00 $16.08 – $592.20 15
Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 $366.60 $611.00 $10.98 – $54.90 13
Fracture assessment via dxa CPT 77086 $679.20 $936.00 $46.45 – $764.10 14
Fragmenting of kidney stone CPT 50590 not published not published $274.45 – $1,861.10 8
Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 $294.40 $405.00 $33.00 – $331.20 15
Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 $366.40 $505.00 $33.00 – $412.20 16
Fresh frozen plasma thawing ea un CPT 86927 $86.40 $119.00 $19.44 – $122.78 13
Fructosamine glycated protein CPT 82985 $280.80 $468.00 $16.44 – $284.40 16
Furosemide 10 mg/ml injection solution HCPCS J1938 $0.40 $0.50 $0.02 – $0.45 15
Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 $26.40 $44.00 $1.62 – $8.10 13
Fusion of big toe joint CPT 28750 not published not published $306.35 – $1,347.84 8
G-esoph reflx tst w/electrod CPT 91035 $5,380.80 $7,415.00 $365.89 – $6,053.40 16
G-tube reposition CPT 43761 $2,128.00 $2,933.00 $103.87 – $2,394.00 16
G0180 home health certification HCPCS G0180 $93.60 $156.00 $28.08 – $140.40 13
Ga-67 gallium 0.1 mci HCPCS A9556 $52.00 $71.00 $11.70 – $58.50 12
Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 $2.40 $4.00 $0.28 – $3.60 13
Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 $14.40 $24.00 $1.48 – $9.90 13
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 $65.40 $109.00 $0.11 – $0.90 13
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 $22.20 $37.00 $6.66 – $33.30 13
Galac-1-phosphate uridyltran - sendout CPT 82775 $41.40 $57.00 $2.00 – $46.58 16
Galectin-3 CPT 82777 $94.40 $130.00 $14.24 – $106.20 16
Gallbladder Removal (Laparoscopic) CPT 47562 not published not published $993.28 – $1,414.39 2
Gamma globulin 1 cc inj HCPCS J1460 $381.00 $635.00 $49.03 – $284.40 15
Gamma glutamyltransferase CPT 82977 $134.40 $185.00 $7.12 – $151.20 16
Gammaglobulin iga CPT 82784 $340.00 $468.00 $9.19 – $62.10 16
Gammaglobulin ige CPT 82785 $274.40 $378.00 $16.27 – $308.70 16
Gamunex-c/gammaked HCPCS J1561 $20,308.80 $33,848.00 $48.96 – $380.70 15
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 $735.20 $919.00 $39.54 – $827.10 14
Gardner vag dna quant CPT 87512 $351.20 $484.00 $32.60 – $395.10 14
Gastroesophageal reflux study CPT 78262 $1,960.80 $2,703.00 $41.60 – $2,205.90 16
Gastroesophageal reflux test CPT 91034 $2,960.00 $4,079.00 $168.17 – $3,330.00 16
Gated heart multiple CPT 78473 $2,779.20 $3,830.00 $290.56 – $3,126.60 16
Gel-syn injection 0.1 mg HCPCS J7328 $8.40 $14.00 $0.70 – $12.60 14
Gemcitabine 1 gram intravenous solution HCPCS J9201 $365.40 $609.00 $3.13 – $26.55 15
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 $37,978.20 $63,297.00 $236.62 – $1,266.30 15
Generator barostim neo2 2014 HCPCS C1767 $29,759.20 $41,012.00 $330.84 – $1,654.20 13
Genetic tstg severe inh cond CPT 81443 $13,264.80 $22,108.00 $1,122.30 – $5,611.50 14
Genome sequence analysis CPT 81425 $4,188.00 $6,980.00 $1,256.40 – $6,282.00 14
Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 $49.60 $62.00 $1.08 – $5.40 15
Gentamicin peak therapeutic drug level CPT 80170 $424.80 $586.00 $12.00 – $477.90 16
Ghs IV inf sq injection, on-body injector CPT 96377 $177.60 $245.00 $19.79 – $199.80 15
Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 $1,360.00 $1,700.00 $306.00 – $1,530.00 16
Ghs IV infusion casirivimab/imdevimab HCPCS M0243 $1,360.00 $1,700.00 $306.00 – $1,530.00 16
Ghs IV infusion sotrovimab HCPCS M0247 $1,360.00 $1,700.00 $306.00 – $1,530.00 16
Ghs IV thrombolytics - cerebral CPT 37195 $620.80 $856.00 $139.68 – $698.40 14
Ghs abscess perianal iandd CPT 46050 $1,829.60 $2,521.00 $51.66 – $931.84 16
Ghs alcohol, methyl (methanol)-medtox CPT 84600 $133.60 $184.00 $13.36 – $150.30 14
Ghs antibodies (torch) igm CPT 86694 $551.20 $759.00 $14.22 – $620.10 16
Ghs aspiration bladder - needle CPT 51100 $688.20 $1,147.00 $32.98 – $1,032.30 16
Ghs bladder cath - complex-foley CPT 51703 $492.00 $678.00 $82.07 – $993.28 16
Ghs change cysto/gastrost CPT 43762 $2,128.00 $2,933.00 $34.21 – $2,394.00 16
Ghs chemo >8 hrs CPT 96416 $841.60 $1,160.00 $148.68 – $946.80 16
Ghs chemo IV push, ea addtl CPT 96411 $540.00 $744.00 $58.18 – $607.50 16
Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 $65.40 $90.00 $14.71 – $73.58 16
Ghs cl tx metacarpophal disloc without anes CPT 26700 $998.40 $1,376.00 $42.90 – $1,123.20 16
Ghs closd tx interphalang jt disloc w/ma CPT 26770 $998.40 $1,376.00 $40.15 – $1,123.20 16
Ghs closed reduction ankle dislocation CPT 27840 $998.40 $1,376.00 $98.45 – $1,123.20 16
Ghs closed tx bimalleolar fracture w/manip CPT 27810 $868.80 $1,197.00 $195.48 – $1,114.22 14
Ghs closed tx radiocarpal disloc w manip CPT 25660 $998.40 $1,376.00 $114.40 – $1,123.20 16
Ghs closed tx tibial fracture w/manip CPT 27752 $868.80 $1,197.00 $195.48 – $996.67 16
Ghs clsd red med malleolus fx w manip CPT 27762 $3,540.00 $4,878.00 $782.84 – $3,982.50 14
Ghs clsd red med malleolus fx without manip CPT 27760 $998.40 $1,376.00 $158.94 – $993.28 14
Ghs clsd tx frac distal tibia w/manipulation CPT 27825 $3,419.20 $4,712.00 $769.32 – $3,846.60 14
Ghs community re-entry 15 minutes CPT 97537 $85.60 $118.00 $19.26 – $96.30 13
Ghs conjunctiva foreign body-embed bil CPT 65210 $494.40 $681.00 $111.24 – $993.28 14
Ghs conjunctiva foreign body-superf bil CPT 65205 $494.40 $681.00 $111.02 – $993.28 14
Ghs corneal fb with slit lamp bilat CPT 65222 $494.40 $681.00 $28.60 – $810.24 16
Ghs corneal fb without slit lamp bilat CPT 65220 $494.40 $681.00 $29.15 – $988.16 16
Ghs diphtheria toxoid ab igg CPT 86648 $368.00 $507.00 $15.03 – $257.40 16
Ghs dislocation elbow closed treatment CPT 24600 $998.40 $1,376.00 $112.75 – $1,123.20 16
Ghs ed peritoneal lavage w guidance if performed CPT 49084 $5,277.60 $8,796.00 $85.38 – $7,916.40 16
Ghs ed rmvl or bivalving cast CPT 29700 $471.00 $785.00 $11.34 – $187.33 13
Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 $1,644.80 $2,267.00 $101.39 – $1,850.40 16
Ghs excision ingrown nail CPT 11765 $589.80 $983.00 $21.42 – $148.03 16
Ghs eyelid foreign body-embedded - bil CPT 67938 $868.80 $1,197.00 $174.00 – $994.56 14
Ghs fb removal - incisional CPT 10121 $7,126.80 $11,878.00 $39.24 – $921.60 16
Ghs fb removal - non-incisional CPT 20520 $3,784.80 $5,216.00 $68.75 – $957.44 16
Ghs fb removal foot - deep - left CPT 28192 $7,126.80 $11,878.00 $46.44 – $921.60 16
Ghs fish cytogen CPT 88271 $428.80 $591.00 $16.73 – $91.80 14
Ghs fish hybrid in situ 100-300 CPT 88275 $428.80 $591.00 $39.97 – $482.40 14
Ghs flow volume loop CPT 94375 $198.40 $273.00 $23.09 – $223.20 16
Ghs gastric intub aspiration lavage CPT 43753 $1,759.80 $2,933.00 $18.16 – $993.28 16
Ghs hcv amplificaiton CPT 87521 $482.40 $665.00 $34.68 – $542.70 16
Ghs histoplasma antigen CPT 87385 $815.20 $1,124.00 $10.34 – $917.10 14
Ghs hla-dr/dq, multiple antigens CPT 86817 $746.40 $1,029.00 $88.98 – $839.70 16
Ghs i and d abscess/hematoma scrotum CPT 54700 $8,618.40 $11,878.00 $42.35 – $9,695.70 16
Ghs i and d perirectal abscess 46040 CPT 46040 $2,627.20 $3,620.00 $119.35 – $2,955.60 16
Ghs i and d pilonidal cyst complex CPT 10081 $4,051.20 $5,583.00 $123.75 – $4,557.60 16
Ghs i and d pilonidal cyst simple CPT 10080 $712.80 $983.00 $39.60 – $993.28 16
Ghs incision thrombosed ext hemorrhoid CPT 46083 $998.40 $1,376.00 $45.10 – $993.28 16
Ghs inf midline insertion CPT 36140 $395.20 $545.00 $88.92 – $993.28 16
Ghs inhibitor screen CPT 85335 $417.60 $575.00 $7.55 – $469.80 16
Ghs init tx 1st degree burn CPT 16000 $569.60 $785.00 $19.80 – $640.80 16
Ghs inj tendon origin/insertion CPT 20551 $616.20 $1,027.00 $11.34 – $116.19 16
Ghs insertion of needle - bone CPT 36680 $569.60 $785.00 $54.45 – $640.80 16
Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 $998.40 $1,376.00 $101.20 – $1,123.20 16
Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 $4,494.00 $7,490.00 $101.20 – $6,741.00 16
Ghs intermed repair over 30 cm - 12037 CPT 12037 $8,088.00 $11,147.00 $101.20 – $9,099.00 16
Ghs intro needle/intracath vein - 36000 CPT 36000 $143.20 $197.00 $8.89 – $993.28 16
Ghs irrigate corpora cavernosa for priapism CPT 54220 $2,619.00 $4,365.00 $377.20 – $3,928.50 14
Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 $569.60 $785.00 $34.65 – $640.80 16
Ghs layer closure 2.5 cm or less - 12031 CPT 12031 $998.40 $1,376.00 $26.95 – $1,123.20 16
Ghs layer closure 2.5 cm or less - 12041 CPT 12041 $998.40 $1,376.00 $26.95 – $1,123.20 16
Ghs layer closure 2.5cm or less - 12051 CPT 12051 $998.40 $1,376.00 $34.65 – $1,123.20 16
Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 $998.40 $1,376.00 $52.25 – $1,123.20 16
Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 $998.40 $1,376.00 $39.05 – $993.28 16
Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 $998.40 $1,376.00 $52.25 – $1,123.20 16
Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 $998.40 $1,376.00 $51.15 – $1,123.20 16
Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 $998.40 $1,376.00 $53.35 – $1,123.20 16
Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 $998.40 $1,376.00 $67.65 – $1,123.20 16
Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 $1,372.00 $1,891.00 $101.20 – $1,543.50 16
Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 $998.40 $1,376.00 $101.20 – $1,123.20 16
Ghs leukocyte alkaline phos (mayo) CPT 85540 $352.80 $486.00 $8.00 – $396.90 16
Ghs mbp CPT 83873 $252.80 $349.00 $15.00 – $284.40 16
Ghs moderate sedation < 5 yr, 30 min CPT 99151 $177.60 $245.00 $20.92 – $199.80 16
Ghs moderate sedation ea addtl 15 min CPT 99153 $177.60 $245.00 $9.16 – $199.80 16
Ghs myocardial strain img spckl track CPT 93356 $958.40 $1,321.00 $9.00 – $1,078.20 14
Ghs nailbed repair/nail removal CPT 11760 $998.40 $1,376.00 $25.30 – $1,123.20 16
Ghs nerve blk intercostal, ea addtl level CPT 64421 $1,886.40 $2,600.00 $47.85 – $2,122.20 16
Ghs nerve block axillary nerve CPT 64417 $2,764.00 $3,809.00 $23.10 – $3,109.50 16
Ghs nerve block brachial plexus CPT 64415 $2,764.00 $3,809.00 $38.50 – $3,109.50 16
Ghs nerve block sciatic nerve CPT 64445 $2,902.40 $3,999.00 $25.85 – $3,265.20 16
Ghs ng placement w fluoro guidance CPT 43752 $712.80 $983.00 $160.38 – $801.90 13
Ghs o2 saturation CPT 82810 $128.80 $177.00 $9.66 – $73.58 16
Ghs o2 uptake rest & exercise CPT 94680 $799.20 $1,101.00 $19.20 – $899.10 16
Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 $47.80 $66.00 $10.76 – $53.77 14
Ghs ot prosthetic training/15 min CPT 97761 $157.60 $217.00 $33.08 – $177.30 14
Ghs ot sensory integrative tech/15min CPT 97533 $157.60 $217.00 $35.46 – $177.30 14
Ghs pacing - transcutaneous CPT 92953 $1,735.20 $2,391.00 $124.43 – $1,952.10 14
Ghs peritonsillar abscess i andd CPT 42700 $998.40 $1,376.00 $68.20 – $1,123.20 16
Ghs phenylketonurid CPT 84030 $123.20 $170.00 $5.44 – $138.60 16
Ghs plngl fx pm cl CPT 26725 $998.40 $1,376.00 $84.70 – $1,123.20 16
Ghs plt ct-manual CPT 85032 $84.80 $117.00 $3.00 – $95.40 16
Ghs polysom <6 yrs 4/> parameters CPT 95782 $4,187.20 $5,771.00 $848.34 – $4,710.60 16
Ghs ppd (tb intradermal) CPT 86580 $26.20 $36.00 $5.50 – $29.48 16
Ghs prostatic acid phosphatase (mayo) CPT 84066 $287.20 $396.00 $9.55 – $323.10 16
Ghs protoporphyrins fract CPT 84202 $168.80 $233.00 $14.19 – $189.90 16
Ghs removal intranasal foreign body CPT 30300 $298.40 $412.00 $24.75 – $993.28 16
Ghs removal pharyngeal foreign body CPT 42809 $852.00 $1,174.00 $71.50 – $993.28 16
Ghs reticulocyte count CPT 85044 $42.80 $59.00 $4.00 – $48.15 16
Ghs rsv eia (respir synctial vrs) CPT 87420 $345.60 $477.00 $10.87 – $388.80 14
Ghs sedimentation rate CPT 85651 $73.60 $101.00 $3.00 – $82.80 16
Ghs semen analysis fert CPT 89320 $236.00 $326.00 $9.61 – $265.50 14
Ghs sensitivity (per antimicro) CPT 87184 $135.20 $186.00 $7.39 – $152.10 16
Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 $712.80 $983.00 $101.20 – $993.28 16
Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 $712.80 $983.00 $101.20 – $993.28 16
Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 $945.60 $1,303.00 $101.20 – $1,063.80 16
Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 $712.80 $983.00 $52.25 – $993.28 16
Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 $712.80 $983.00 $53.35 – $944.64 16
Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 $712.80 $983.00 $67.65 – $801.90 16
Ghs simple repair over 30 cm - 12007 CPT 12007 $712.80 $983.00 $101.20 – $993.28 16
Ghs sleep study unattended CPT 95800 $752.80 $1,037.00 $117.80 – $846.90 16
Ghs sp train/fitting sp device - kx CPT 92609 $216.80 $299.00 $46.44 – $232.20 14
Ghs speech-gen aug dev eval iii, st CPT 92608 $188.80 $260.00 $38.37 – $212.40 14
Ghs sphenopalatine ganglion block CPT 64505 $687.20 $947.00 $59.95 – $773.10 16
Ghs st - re-eval for alt comm CPT 92597 $301.60 $416.00 $56.63 – $339.30 14
Ghs strapping shoulder - 29240 CPT 29240 $569.60 $785.00 $21.45 – $640.80 16
Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 $558.40 $770.00 $93.80 – $628.20 16
Ghs superficial wnd dehis w packing12021 CPT 12021 $945.60 $1,303.00 $73.08 – $993.28 16
Ghs superficial wnd dehiscence simp12020 CPT 12020 $2,181.60 $3,636.00 $26.82 – $993.28 16
Ghs tx distal phalangeal fx with manipulation CPT 26755 $998.40 $1,376.00 $80.30 – $1,123.20 16
Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 $604.00 $833.00 $135.90 – $993.28 16
Ghs vaginal delivery only CPT 59409 $1,224.80 $1,688.00 $275.58 – $1,691.16 14
Gi inhouse confirmation CPT 87045 $104.00 $144.00 $6.90 – $117.00 16
Glassia injection HCPCS J0257 $34.80 $58.00 $5.64 – $52.20 15
Glucagon 1 mg solution for injection HCPCS J1610 $1,053.60 $1,317.00 $182.45 – $1,185.30 15
Glucagon plasma - sendout CPT 82943 $244.80 $337.00 $14.12 – $275.40 16
Glucose 1 hr post dose CPT 82950 $45.00 $62.00 $4.70 – $50.62 16
Glucose blood by monitoring device cleared by fda for home use CPT 82962 $37.80 $52.00 $2.00 – $40.50 16
Glucose blood quantitative CPT 82947 $63.20 $87.00 $3.89 – $70.88 16
Glucose body fluid CPT 82945 $63.20 $87.00 $3.89 – $71.10 16
Glucose tolerance test (gtt) 3 specimens CPT 82951 $241.60 $333.00 $12.50 – $271.80 16
Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 $52.00 $71.00 $3.27 – $58.50 16
Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 $35.40 $44.25 $0.46 – $39.60 15
Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 $104.80 $131.00 $11.04 – $117.90 15
Gonadotropin follicle stimulating hormone (fsh) CPT 83001 $340.00 $468.00 $17.50 – $382.50 16
Gonadotropin luteinizing hormone (lh) CPT 83002 $309.60 $468.00 $17.00 – $348.30 16
Goserelin 10.8 mg subcutaneous implant HCPCS J9202 $4,524.00 $7,540.00 $452.34 – $2,261.70 15
Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 $3,426.40 $4,722.00 $30.23 – $3,854.70 14
Graft axiofill 1000mg HCPCS J3590 $8,212.20 $13,687.00 $994.50 – $4,972.50 13
Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 $15,834.40 $21,822.00 $1,839.06 – $9,195.30 13
Graft nerve adv 3-4x70mm HCPCS C1762 $25,992.80 $35,822.00 $183.42 – $917.10 13
Graft patch felt ptfe 2x2 HCPCS C1768 $5,246.40 $7,230.00 $17.41 – $87.08 13
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 $3,241.60 $4,468.00 $101.03 – $1,340.10 13
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 $7,673.60 $10,820.00 $52.75 – $2,504.70 13
Graft xenmtrx sft rect 15x20cm HCPCS C1781 $4,445.60 $6,127.00 $15.16 – $75.83 13
Graft xenmtrx sft rect 19x28cm HCPCS C2625 $2,112.60 $3,521.00 $44.46 – $222.30 13
Granisetron hcl injection HCPCS J1626 $27.00 $45.00 $0.19 – $3.60 14
Great toe with reduction 28495 CPT 28495 $998.40 $1,376.00 $83.05 – $1,123.20 16
Guide endoanchr sg-64 aaa 62cm HCPCS L8670 $9,038.40 $12,456.00 $30.42 – $152.10 13
Guide wire threaded 1.4x150mm HCPCS C1769 $1,221.60 $1,683.00 $3.02 – $15.07 13
Guide worley csg 9fx50cm std HCPCS C1892 $228.00 $314.00 $28.98 – $144.90 12
Guided cath fluid drainage 10030 CPT 10030 $2,640.80 $3,639.00 $137.81 – $2,970.90 16
Gw stiffened micro access kit HCPCS C1894 $1,028.80 $1,418.00 $1.62 – $244.34 13
H pylori (c-13) breath CPT 83013 $458.40 $632.00 $60.10 – $515.70 16
Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 $160.00 $200.00 $4.40 – $180.00 15
Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 $9.00 $11.25 $0.77 – $7.20 15
Hand X-ray CPT 73130 $356.80 $491.00 $14.72 – $401.40 14
Hand-held pefr meter a4614 HCPCS A4614 $30.40 $42.00 $6.84 – $48.63 14
Haptoglobin quantitative CPT 83010 $188.00 $259.00 $12.00 – $181.80 16
Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 $1,539.20 $2,121.00 $50.42 – $1,731.60 16
Hc i-131 sodium iodide cap dx per mci HCPCS A9528 $230.40 $317.00 $51.84 – $259.20 12
Hc nm fusion spect CT unlisted CPT 78999 $452.80 $624.00 $101.88 – $509.40 13
Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 $2,367.20 $3,262.00 $227.12 – $2,663.10 15
Hcg qualitative CPT 84703 $124.00 $171.00 $7.43 – $139.50 16
Hcg quantitative CPT 84702 $364.80 $503.00 $14.88 – $165.60 16
Head CT scan (with and without contrast) CPT 70470 $3,270.40 $4,507.00 $128.00 – $3,679.20 16
Head CT scan (with contrast) CPT 70460 $2,868.00 $3,952.00 $102.40 – $3,226.50 16
Head CT scan (without contrast) CPT 70450 $1,938.40 $2,671.00 $99.20 – $2,180.70 16
Heart image spect CPT 78494 $1,996.80 $2,752.00 $218.56 – $2,246.40 16
Heart infarct image CPT 78466 $1,323.20 $1,824.00 $71.68 – $1,488.60 16
Hematocrit CPT 85014 $95.20 $131.00 $2.35 – $24.07 16
Hematopoietic nuclear tx CPT 79403 $746.40 $1,029.00 $113.09 – $839.70 16
Hemodialysis one evaluation CPT 90935 $2,340.80 $3,226.00 $211.20 – $1,541.70 14
Hemoglobin CPT 85018 $45.60 $76.00 $2.35 – $24.07 16
Hemoglobin f (fetal) chemical CPT 83030 $289.60 $399.00 $5.00 – $325.80 16
Hemoglobin fetal qualitative CPT 83033 $276.00 $399.00 $6.53 – $108.00 16
Hemoglobin methemoglobin quantitative CPT 83050 $274.40 $378.00 $3.00 – $308.70 16
Hemoglobin plasma CPT 83051 $74.00 $102.00 $3.50 – $83.25 16
Hemoglobin urine CPT 83069 $63.20 $87.00 $3.08 – $71.10 14
Hemophilus influenza antibdy CPT 86684 $168.00 $232.00 $15.65 – $189.00 16
Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 $5,744.80 $7,917.00 $50.60 – $993.28 16
Heparin assay CPT 85520 $405.60 $559.00 $6.53 – $410.40 16
Heparin bolus from bag HCPCS J1644 $46.20 $77.00 $0.18 – $0.90 14
Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 $4.40 $5.50 $0.02 – $1.80 15
Hepatitis a antibody igm CPT 86709 $203.20 $280.00 $11.13 – $228.60 16
Hepatitis b core antibody igm CPT 86705 $203.20 $280.00 $11.64 – $228.60 16
Hepatitis b core antibody total CPT 86704 $551.20 $759.00 $11.91 – $620.10 16
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 $1,109.60 $1,387.00 $11.00 – $401.40 16
Hepatitis b surface antibody CPT 86706 $166.40 $229.00 $10.62 – $187.20 16
Hepatitis c antibody CPT 86803 $338.40 $466.00 $14.10 – $380.70 16
Hepatobiliary system imaging CPT 78226 $1,944.00 $2,680.00 $266.27 – $2,187.00 16
Hereditary colon ca dsordrs CPT 81435 $3,202.80 $5,338.00 $338.04 – $1,690.20 16
Hernia Repair (Inguinal) CPT 49505 not published not published $349.25 – $1,059.55 8
Herpes simplex 2 ag if CPT 87273 $173.60 $239.00 $11.84 – $195.30 16
Herpes simplex type 1 antibody igg CPT 86695 $328.00 $453.00 $13.03 – $369.00 16
Herpes simplex type 2 antibody igg CPT 86696 $111.20 $153.00 $19.13 – $125.10 16
Herpes simplex virus isolation CPT 87255 $540.80 $746.00 $33.46 – $608.40 16
Heterophile antibodies screening CPT 86308 $68.40 $94.00 $5.12 – $76.95 16
Hexa gene CPT 81255 $1,396.80 $1,746.00 $50.85 – $1,571.40 16
Hip X-ray CPT 73502 $790.40 $1,089.00 $28.62 – $889.20 14
Histamine CPT 83088 $424.80 $586.00 $13.00 – $477.90 16
Hla i low res one antigen equiv ea CPT 81374 $956.80 $1,319.00 $73.46 – $929.70 16
Hla i typing high res 1 allele grp ea CPT 81381 $1,363.20 $1,704.00 $103.22 – $639.90 16
Hla ii typing ag equiv lr CPT 81375 $912.00 $1,520.00 $218.16 – $1,368.00 16
Hla typing a b or c CPT 86813 $967.20 $1,332.00 $57.32 – $1,088.10 16
Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 $9.00 $15.00 $0.18 – $0.90 13
Home sleep test/type 4 porta HCPCS G0400 $2,075.20 $2,860.00 $218.68 – $2,334.60 13
Homocysteine CPT 83090 $364.80 $503.00 $17.71 – $410.40 16
Homogenization tissue CPT 87176 $116.00 $160.00 $5.80 – $130.50 16
Homovanillic acid (hva) CPT 83150 $128.00 $176.00 $7.50 – $144.00 16
Hpv types 16 & 18 only CPT 87625 $228.00 $314.00 $38.21 – $243.90 16
Hrdtry cardmypy gene panel CPT 81439 $9,300.80 $11,626.00 $456.69 – $10,463.40 14
Hrdtry perph neurphy panel CPT 81448 $7,200.00 $12,000.00 $456.69 – $10,800.00 14
Htt gene detc abnor alleles CPT 81271 $1,394.40 $1,743.00 $106.97 – $1,568.70 14
Human epididymis protein 4 (he4) CPT 86305 $200.80 $277.00 $20.57 – $225.90 16
Hyaluronidase 150 unit/ml injection solution HCPCS J3470 $259.20 $432.00 $32.22 – $388.80 14
Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 $2.80 $3.50 $0.36 – $53.36 15
Hydralazine 20 mg/ml injection solution HCPCS J0360 $92.80 $116.00 $5.60 – $81.00 14
Hydration IV infusion each additional hour CPT 96361 $389.60 $537.00 $9.90 – $438.30 16
Hydration IV infusion initial 31minutes - 1 hour CPT 96360 $1,143.00 $1,905.00 $34.79 – $894.60 16
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 $583.20 $972.00 $14.58 – $72.90 15
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 $8.00 $10.00 $0.01 – $3.24 15
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 $630.40 $788.00 $0.18 – $0.90 13
Hydrxycorticsterds 17- (17-ohcs) CPT 83491 $204.00 $281.00 $7.00 – $229.50 16
Hymovis injection 1 mg HCPCS J7322 $70.20 $117.00 $17.62 – $105.30 15
Hysterosalpingography s&i CPT 74740 $1,642.40 $2,264.00 $33.92 – $1,847.70 14
Hysteroscopy ablation CPT 58563 not published not published $347.49 – $993.28 8
Hysteroscopy biopsy CPT 58558 not published not published $577.87 – $993.28 2
Hysteroscopy dx sep proc CPT 58555 not published not published $191.70 – $993.28 8
Hysteroscopy lysis CPT 58559 not published not published $740.01 – $993.28 2
Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 $157.80 $263.00 $11.00 – $225.00 16
I & d vag hematoma non-ob 57023 CPT 57023 not published not published $320.61 – $993.28 2
I&d frarm&/wrst deep absc/hematoma CPT 25028 $7,427.20 $10,235.00 $97.35 – $8,355.60 16
I&d lacrimal sac CPT 68420 $7,494.40 $10,328.00 $301.31 – $8,431.20 14
I-123 iobenguane diag HCPCS A9582 $9,129.60 $12,582.00 $2,054.16 – $10,270.80 12
I-123 ioflupane diag HCPCS A9584 $6,765.60 $9,324.00 $1,522.26 – $7,611.30 12
I-123 sod iodide diag per 100 uci HCPCS A9516 $124.80 $172.00 $28.08 – $140.40 12
I131 iodide cap, rx HCPCS A9517 $128.80 $177.00 $28.98 – $144.90 12
I131 iodide sol, rx HCPCS A9530 $95.20 $131.00 $21.42 – $107.10 12
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 $285.60 $476.00 $21.16 – $167.40 16
IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 $344.80 $476.00 $12.57 – $387.90 16
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 $344.80 $476.00 $13.52 – $387.90 16
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 $1,143.00 $1,905.00 $43.23 – $853.20 16
Iadna legionella pneumophila amplified probe tq CPT 87541 $351.20 $484.00 $27.39 – $395.10 14
Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 $2,792.80 $3,491.00 $172.31 – $3,141.90 14
Idarubicin hcl injection HCPCS J9211 $555.60 $926.00 $36.67 – $833.40 14
Ifosfamide 1 gram intravenous solution HCPCS J9208 $268.20 $447.00 $25.20 – $402.30 14
Igh gene rearrange amp meth CPT 81261 $961.60 $1,202.00 $195.68 – $1,081.80 16
Igh@ var region somatic mutation analy CPT 81263 $2,004.60 $3,341.00 $291.08 – $1,530.90 16
Igk rearrangeabn clonal pop CPT 81264 $961.60 $1,202.00 $162.57 – $1,081.80 16
Ihc/icc per specimen each additional single antibody stain CPT 88341 $355.20 $489.00 $43.56 – $399.60 16
Ihc/icc per specimen each multiplex antibody stain CPT 88344 $329.60 $455.00 $73.15 – $370.80 16
Ihc/icc per specimen initial single antibody stain CPT 88342 $673.60 $928.00 $51.38 – $757.80 16
Immobilizer shldr cntor adlt HCPCS L3670 $43.00 $59.00 $2.65 – $229.76 15
Immobilizer shldr dlx str 24-36in med HCPCS L1830 $239.20 $330.00 $8.78 – $160.53 15
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 $623.20 $779.00 $41.76 – $208.80 15
Immunoassay tumor antigen quantitative ca 125 CPT 86304 $210.40 $290.00 $20.57 – $236.70 16
Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 $211.20 $291.00 $20.57 – $237.60 16
Immunoassay tumor qual CPT 86294 $190.20 $317.00 $19.97 – $285.30 14
Immunodiff gel qual ea antigen/ab CPT 86331 $280.80 $387.00 $8.00 – $315.90 16
Immunodiffusion nes CPT 86329 $148.80 $205.00 $13.89 – $167.40 16
Immunofixation electrophoresis serum CPT 86334 $265.60 $366.00 $22.08 – $298.80 16
Immunofluorescence per specimen each additional single antibody stain CPT 88350 $102.40 $141.00 $15.40 – $115.20 16
Immunofluorescence per specimen initial single antibody stain CPT 88346 $102.40 $141.00 $19.58 – $115.20 16
Implant cartilage 10mm synthetic HCPCS L8699 $8,470.40 $11,673.00 $36.72 – $183.60 13
Implant neuroelectrodes CPT 64561 $19,225.60 $26,496.00 $162.36 – $1,500.72 14
Implant ureth bulk agent HCPCS L8606 $1,323.20 $1,824.00 $280.98 – $1,404.90 13
Imported lipodox inj HCPCS Q2049 $11,220.60 $18,701.00 $528.86 – $3,366.90 14
In situ hybridization per specimen initial single probe stain CPT 88365 $619.20 $854.00 $14.77 – $696.60 16
In-111 ibritumomab tiux dx HCPCS A9542 $14,710.40 $20,272.00 $3,309.84 – $16,549.20 12
In-111 pentetate dtpa / 0.5 mci HCPCS A9548 $658.40 $907.00 $148.14 – $740.70 12
In-111 pentetreotide HCPCS A9572 $4,204.80 $5,795.00 $946.08 – $4,730.40 12
In-111 satumomab pend HCPCS A4642 $1,095.20 $1,509.00 $246.42 – $1,232.10 12
Incision & drainage hematoma/seroma/fluid collection CPT 10140 $3,349.80 $5,583.00 $23.40 – $792.32 16
Incision of burn scab initi CPT 16035 $998.40 $1,376.00 $224.64 – $1,123.20 14
Incision of metatarsal CPT 28306 $712.80 $1,188.00 $59.76 – $1,454.08 16
Incision of metatarsal CPT 28308 $669.00 $1,115.00 $55.62 – $1,326.08 14
Incision tendon sheath CPT 26055 not published not published $220.00 – $823.04 8
Incisn of toe tndn CPT 28010 $366.00 $610.00 $58.68 – $993.28 16
Infect ag drug suscept pheno predict CPT 87900 $1,682.40 $2,318.00 $128.83 – $1,802.70 16
Infect ag eia influenza a or b ea CPT 87400 $171.20 $236.00 $6.09 – $192.60 16
Infect ag genotype na cytomegalovirus CPT 87910 $1,795.20 $2,474.00 $254.45 – $2,019.60 16
Infect ag genotype na dna hepatitis b CPT 87912 $445.60 $614.00 $100.26 – $501.30 16
Infect ag genotype na hiv-1 other region CPT 87906 $1,682.40 $2,318.00 $127.22 – $1,802.70 16
Infect ag genotype na hiv-1 revr trn/prt CPT 87901 $1,682.40 $2,318.00 $254.45 – $1,802.70 16
Infect ag ia optc obs influenza CPT 87804 $458.40 $632.00 $3.73 – $18.68 16
Infect ag if nos ea CPT 87299 $256.00 $353.00 $12.57 – $288.00 14
Infect ag na herpes simplex quant CPT 87530 $532.80 $734.00 $33.45 – $599.40 14
Infect ag na hpv high-risk types CPT 87624 $392.80 $542.00 $34.68 – $333.00 16
Infect ag na influenza r/amp 1st 2 types CPT 87502 $1,388.00 $1,913.00 $94.68 – $1,561.50 16
Infect ag na resp virus 12-25 targets CPT 87633 $754.40 $1,040.00 $169.74 – $848.70 16
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 $124.80 $172.00 $9.36 – $140.40 14
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 $597.60 $823.00 $10.79 – $672.30 14
Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 $241.60 $333.00 $11.84 – $162.00 16
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 $201.60 $278.00 $11.23 – $226.80 14
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 $875.20 $1,206.00 $10.21 – $984.60 16
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 $82.40 $113.00 $10.21 – $92.70 16
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 $273.60 $377.00 $23.80 – $268.20 16
Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 $636.80 $878.00 $9.36 – $284.40 14
Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 $174.40 $240.00 $9.36 – $196.20 14
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 $140.00 $193.00 $11.84 – $157.50 16
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 $336.00 $560.00 $74.61 – $504.00 13
Infectious agent nucleic acid amplified probe CPT 87798 $1,081.60 $1,491.00 $14.71 – $73.58 16
Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 $333.60 $460.00 $23.19 – $375.30 16
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 $346.40 $478.00 $36.84 – $389.70 16
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 $704.80 $971.00 $158.58 – $792.90 14
Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 $307.20 $423.00 $27.39 – $345.60 14
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 $453.60 $756.00 $34.68 – $680.40 16
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 $307.20 $423.00 $32.54 – $345.60 14
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 $460.80 $635.00 $23.19 – $375.30 16
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 $100.00 $125.00 $22.50 – $112.50 16
Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 $460.80 $635.00 $34.68 – $494.10 16
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 $529.60 $730.00 $119.16 – $595.80 14
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 $104.00 $144.00 $23.40 – $126.79 14
Infectious agent nucleic acid quantification bk virus CPT 87799 $1,043.20 $1,437.00 $33.45 – $704.70 14
Infectious agent nucleic acid quantification hepatitis b CPT 87517 $620.80 $856.00 $39.65 – $698.40 16
Infectious agent nucleic acid quantification hepatitis c CPT 87522 $941.60 $1,298.00 $39.65 – $1,059.30 16
Infectious agent nucleic acid quantification hiv-1 CPT 87536 $1,288.80 $1,777.00 $84.10 – $1,380.60 16
Infliximab 100 mg intravenous solution HCPCS J1745 $5,408.40 $9,014.00 $31.09 – $1,135.97 16
Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 $135.20 $169.00 $20.41 – $152.10 14
Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 $4,383.60 $7,306.00 $19.99 – $315.90 14
Influenza dna amp prob addl CPT 87503 $337.60 $465.00 $23.38 – $379.80 16
Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 $40.00 $52.00 $9.00 – $45.00 15
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 $501.60 $691.00 $34.32 – $564.30 16
Initiation & management bipap/cpap initial day CPT 94660 $208.00 $287.00 $43.85 – $234.00 14
Inj anifrolumab-fnia 1mg HCPCS J0491 $10,166.40 $16,944.00 $10.08 – $50.40 15
Inj aval alfa-nqpt 4mg HCPCS J0219 $5,052.80 $6,316.00 $80.91 – $5,684.40 15
Inj calcitriol per 0.1 mcg HCPCS J0636 $27.60 $46.00 $0.90 – $4.50 13
Inj ceftolozane tazobactam HCPCS J0695 $487.80 $813.00 $7.20 – $36.00 15
Inj cntr knee arthro incl ct/mri CPT 27369 $1,172.00 $1,615.00 $42.56 – $1,318.50 14
Inj dx for sinogram CPT 20501 $2,348.80 $3,237.00 $38.50 – $2,642.40 16
Inj epidural sgl lumb-sacral without img CPT 62322 $1,524.80 $2,101.00 $78.27 – $1,715.40 16
Inj for ext venography CPT 36005 $1,056.80 $1,456.00 $48.02 – $1,188.90 16
Inj givosiran 0.5 mg HCPCS J0223 $237.60 $396.00 $71.28 – $356.40 15
Inj imip 4 cilas 4 releb 2mg HCPCS J0742 $652.80 $1,088.00 $1.62 – $8.10 15
Inj levocarnitine per 1 gm HCPCS J1955 $205.60 $257.00 $23.61 – $231.30 14
Inj mepivacaine hcl/10 ml HCPCS J0670 $31.80 $53.00 $1.80 – $9.00 14
Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 $558.40 $806.00 $125.64 – $628.20 15
Inj multihance HCPCS A9577 $612.60 $1,021.00 $1.74 – $45.90 13
Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 $1,264.80 $2,108.00 $30.32 – $1,897.20 14
Inj proc ankle arthr CPT 27648 $1,172.00 $1,615.00 $27.50 – $1,318.50 16
Inj proc elbow arthro CPT 24220 $1,172.00 $1,615.00 $44.80 – $1,318.50 14
Inj proc for lymphang CPT 38790 $574.40 $792.00 $80.92 – $993.28 16
Inj proc myelogram lumbar CPT 62284 $1,323.20 $1,824.00 $87.49 – $1,488.60 16
Inj proc sialogram CPT 42550 $1,172.00 $1,615.00 $37.95 – $1,318.50 16
Inj prohance multipack HCPCS A9576 $46.20 $77.00 $1.42 – $69.30 13
Inj retro urethrocysto CPT 51610 $4,464.00 $6,152.00 $37.95 – $5,022.00 16
Inj tedizolid phosphate HCPCS J3090 $1,282.20 $2,137.00 $1.80 – $9.00 15
Inj testosterone cypionate HCPCS J1071 $40.80 $68.00 $0.03 – $14.14 15
Inj, abilify maintena, 1 mg HCPCS J0401 $7,107.60 $11,846.00 $5.22 – $2,777.90 16
Inj, bezlotoxumab, 10 mg HCPCS J0565 $17,599.20 $29,332.00 $39.83 – $264.60 15
Inj, bupivacaine liposome HCPCS J0666 $7.60 $9.50 $1.47 – $8.10 15
Inj, cefiderocol, 10 mg HCPCS J0699 $5.80 $7.25 $1.30 – $6.53 15
Inj, clevidipine butyrate HCPCS C9248 $839.40 $1,399.00 $10.08 – $50.40 13
Inj, tyenne, 1 mg HCPCS Q5135 $12.60 $15.75 $2.83 – $14.18 14
Inj. fe derisomaltose 10 mg HCPCS J1437 $141.60 $177.00 $22.02 – $159.30 15
Inj. herceptin hylecta, 10mg HCPCS J9356 $37.20 $62.00 $11.16 – $61.44 15
Inj. pemetrexed, 10 mg HCPCS J9304 $152.40 $254.00 $45.72 – $228.60 15
Inj. teprotumumab-trbw 10 mg HCPCS J3241 $36,300.60 $60,501.00 $217.80 – $1,089.00 15
Inj., benralizumab, 1 mg HCPCS J0517 $568.00 $710.00 $127.80 – $639.00 15
Inj., emapalumab-lzsg, 1 mg HCPCS J9210 $1,790.40 $2,984.00 $384.85 – $2,685.60 15
Inj., lumoxiti, 0.01 mg HCPCS J9313 $52.80 $88.00 $15.84 – $79.20 14
Inj., meropenem, vaborbactam HCPCS J2186 $991.20 $1,652.00 $2.18 – $14.40 14
Inj., tildrakizumab, 1 mg HCPCS J3245 $424.00 $530.00 $95.40 – $477.00 15
Injection arthrography hip without anesthesia (both sides) CPT 27093 $1,172.00 $1,615.00 $61.44 – $1,318.50 14
Injection carpal tunnel therapeutic (both sides) CPT 20526 $355.20 $489.00 $30.60 – $153.00 16
Injection epidural blood patch or clot CPT 62273 $1,470.60 $2,451.00 $52.80 – $993.28 16
Injection for arthrography wrist (both sides) CPT 25246 $1,172.00 $1,615.00 $44.80 – $1,318.50 14
Injection for bladder x-ray CPT 51600 $3,513.60 $4,843.00 $35.20 – $3,952.80 16
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 $1,172.00 $1,615.00 $133.29 – $1,318.50 14
Injection into brain canal CPT 61055 $1,323.20 $1,824.00 $116.05 – $1,488.60 16
Injection radioactive tracer sentinel node (both sides) CPT 38792 $614.40 $846.00 $138.24 – $691.20 13
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 $1,501.60 $2,070.00 $337.86 – $1,689.30 13
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 $200.00 $276.00 $34.12 – $225.00 16
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 $177.60 $245.00 $14.31 – $199.80 16
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 $168.80 $245.00 $37.98 – $189.90 12
Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 $147.00 $245.00 $10.98 – $54.90 16
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 $1,054.40 $1,453.00 $67.10 – $1,186.20 16
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 $1,778.40 $2,451.00 $14.45 – $149.53 16
Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 $616.20 $1,027.00 $12.91 – $97.72 16
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 $998.40 $1,376.00 $20.16 – $116.19 16
Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 $791.20 $1,090.00 $23.04 – $116.19 16
Injection, belinostat, 10mg HCPCS J9032 $95.40 $159.00 $28.62 – $143.10 15
Injection, cangrelor HCPCS C9460 $41,627.40 $69,379.00 $19.98 – $124.20 14
Injection, daratumumab 10 mg HCPCS J9145 $9,445.80 $15,743.00 $70.74 – $353.70 15
Injection, fulvestrant HCPCS J9395 $4,423.20 $7,372.00 $6.73 – $663.30 15
Injection, inclisiran, 1 mg HCPCS J1306 $39.20 $49.00 $8.82 – $44.10 15
Injection, isavuconazonium HCPCS J1833 $1,378.20 $2,297.00 $1.01 – $5.40 14
Injection, renflexis HCPCS Q5104 $1,624.80 $2,708.00 $27.00 – $167.40 14
Injection,onabotulinumtoxina HCPCS J0585 $2,783.40 $4,639.00 $6.50 – $41.40 15
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 $3.00 $5.00 $0.90 – $2,698.05 15
Ins mark abd/pel for right perq CPT 49411 $4,976.80 $6,859.00 $173.93 – $5,598.90 16
Ins picad w subq port 5yr> CPT 36571 $2,063.20 $2,843.00 $464.22 – $2,755.22 14
Ins tun cv cath wo subq prt/pm CPT 36558 $5,788.20 $9,647.00 $745.38 – $3,726.90 14
Ins tun cvad 2 cath w/subq port(s) CPT 36566 $5,640.60 $9,401.00 $993.28 – $8,460.90 14
Insert cath pleura with image CPT 32557 $2,467.20 $3,400.00 $555.12 – $2,775.60 14
Insert cath pleura without image CPT 32556 $1,020.00 $1,406.00 $229.50 – $1,147.50 14
Insert drug delivery implant CPT 11981 $1,437.00 $2,395.00 $44.64 – $993.28 16
Insert intrauterine device iud CPT 58300 $733.60 $1,011.00 $18.98 – $144.00 15
Insert pessary/other device CPT 57160 $907.20 $1,251.00 $16.66 – $124.20 16
Insertion catheter bladder non indwelling CPT 51701 $298.40 $412.00 $9.00 – $107.25 16
Insertion catheter bladder temporary simple CPT 51702 $1,009.80 $1,683.00 $13.50 – $167.61 16
Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 $3,349.80 $5,583.00 $124.53 – $3,726.90 16
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 $3,204.80 $4,416.00 $96.13 – $2,480.40 16
Insertion picc without port or pump with imaging guidance=>5y CPT 36573 $1,532.00 $2,112.00 $76.74 – $1,723.50 16
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 $4,508.00 $6,213.00 $600.12 – $3,000.60 14
Insitu hybridization manual CPT 88368 $412.80 $688.00 $81.10 – $619.20 16
Inst fibrinolysis agent ini day CPT 32561 $1,327.20 $1,829.00 $73.84 – $1,493.10 14
Insulin total CPT 83525 $200.00 $276.00 $11.00 – $225.00 16
Int hrhc lig 1 hroid without img CPT 46945 $4,520.00 $6,230.00 $50.60 – $993.28 16
Interferon alfa-2b inj HCPCS J9214 $1,111.20 $1,852.00 $33.30 – $166.50 13
Intraoral i+d tongue/floor lingual 41000 CPT 41000 $1,291.20 $1,780.00 $42.35 – $1,452.60 16
Intrapul surf admin endo tube CPT 94610 $73.60 $101.00 $16.56 – $94.01 14
Intrinsic factor antibody CPT 86340 $246.40 $339.00 $14.90 – $277.20 16
Intro long gi tube CPT 44500 $3,526.20 $5,877.00 $21.64 – $761.40 16
Intro long gi tube w/mult fluo CPT 74340 $464.80 $641.00 $104.58 – $522.90 13
Intubation endotracheal emergency procedure CPT 31500 $868.80 $1,197.00 $79.20 – $993.28 16
Iodine i-123 sod iodide mil HCPCS A9509 $1,979.20 $2,728.00 $445.32 – $2,226.60 12
Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 $41.40 $69.00 $0.18 – $0.90 13
Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 $78.60 $131.00 $0.15 – $0.90 13
Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 $33,224.40 $55,374.00 $183.48 – $997.20 15
Ipratropium bromide non-comp HCPCS J7644 $7.20 $12.00 $0.10 – $4.95 15
Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 $1,091.20 $1,364.00 $1.75 – $42.30 14
Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 $210.60 $351.00 $63.18 – $315.90 15
Iron CPT 83540 $58.20 $80.00 $6.39 – $65.25 16
Iron binding capacity CPT 83550 $121.60 $168.00 $5.00 – $136.80 16
Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 $555.60 $926.00 $0.23 – $12.21 15
Irradiation of blood product each unit reference CPT 86945 $98.40 $164.00 $26.52 – $146.70 13
Irrigation implantable venous access device for drug delivery systems CPT 96523 $201.60 $278.00 $21.43 – $193.50 16
Irrigation vagina and/or appl medicament tx disease CPT 57150 $891.20 $1,229.00 $13.86 – $106.61 16
Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 $149.40 $249.00 $44.82 – $224.10 15
Ivp w/wo kub w/wo tomography CPT 74400 $1,552.00 $2,139.00 $35.20 – $1,746.00 16
Ixabepilone 15 mg intravenous solution HCPCS J9207 $16,246.20 $27,077.00 $108.36 – $541.80 15
Jak2 targeted sequence analysis CPT 81279 $1,223.20 $1,529.00 $148.16 – $1,376.10 16
Jejunstmy tube plcmt CPT 44372 $4,128.80 $5,690.00 $228.25 – $4,644.90 16
John cunningham antibody CPT 86711 $3,827.20 $5,274.00 $15.83 – $4,305.60 16
Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 $211.20 $291.00 $5.00 – $237.60 16
Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 $24.60 $30.75 $0.18 – $0.90 16
Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 $886.40 $1,221.00 $62.72 – $997.20 16
Kidney function study CPT 78725 $1,426.40 $1,966.00 $82.62 – $1,604.70 16
Kidney imag w/bld flow multi CPT 78709 $1,404.00 $1,935.00 $237.62 – $1,579.50 16
Kidney imaging morphology CPT 78700 $2,058.40 $2,837.00 $53.12 – $2,315.70 16
Kidney img w/bldflw sgl without rx CPT 78707 $1,877.60 $2,587.00 $88.32 – $2,112.30 16
Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 $489.60 $675.00 $2.70 – $13.50 12
Kit gene analys d816 variant CPT 81273 $1,144.80 $1,431.00 $99.90 – $1,287.90 16
Kit lead specify 5-6-5 HCPCS C1778 $13,784.80 $18,998.00 $165.60 – $828.00 13
Knee Arthroscopy (Cartilage Repair) CPT 29877 not published not published $1,192.96 – $1,879.99 2
Knee Arthroscopy (Meniscus Repair) CPT 29881 not published not published $597.85 – $1,862.21 8
Knee MRI (with and without contrast) CPT 73723 $4,850.40 $6,684.00 $604.71 – $5,456.70 14
Knee MRI (with contrast) CPT 73722 $3,689.60 $5,085.00 $393.92 – $4,150.80 14
Knee MRI (without contrast) CPT 73721 $3,040.00 $4,190.00 $344.32 – $3,420.00 14
Knee X-ray CPT 73564 $576.80 $795.00 $28.70 – $648.90 14
Knee arthroscopy/surgery CPT 29875 not published not published $1,192.96 – $1,736.90 2
Knee arthroscopy/surgery CPT 29876 not published not published $1,192.96 – $2,017.35 2
Knee arthroscopy/surgery CPT 29880 not published not published $993.28 – $2,034.51 2
Knee arthroscopy/surgery CPT 29882 not published not published $597.85 – $1,887.87 8
Knee arthroscopy/surgery CPT 29883 not published not published $993.28 – $2,412.60 2
Knee arthroscopy/surgery CPT 29888 not published not published $993.28 – $3,124.04 2
Kyleena, 19.5 mg HCPCS J7296 $2,489.60 $3,112.00 $449.46 – $2,247.30 14
L/s ratio fetal lung CPT 83661 $489.60 $675.00 $21.73 – $550.80 16
Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 $327.00 $545.00 $0.36 – $1.80 13
Lactate dehydrogenase (ldh) CPT 83615 $52.00 $71.00 $5.98 – $58.50 16
Lactated ringers intravenous solution HCPCS J7120 $32.40 $40.50 $0.00 – $5.40 15
Lactic acid CPT 83605 $147.20 $203.00 $8.00 – $165.60 16
Lactoferrin fecal qualitative CPT 83630 $424.80 $586.00 $12.31 – $477.90 16
Lactoferrin fecal quant CPT 83631 $212.00 $292.00 $19.40 – $238.50 16
Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 $33,573.60 $55,956.00 $34.05 – $418.50 15
Lap ing hernia repair init CPT 49650 not published not published $818.32 – $994.55 2
Laparo cholecystectomy/graph CPT 47563 not published not published $993.28 – $1,521.52 2
Laparo proc abdm/per/oment 49329 CPT 49329 not published not published $4,069.64 – $4,069.64 1
Laparoscopy aspiration CPT 49322 not published not published $777.81 – $993.28 2
Laparoscopy excise lesions CPT 58662 not published not published $993.28 – $1,370.62 2
Laparoscopy lysis CPT 58660 not published not published $993.28 – $1,343.38 2
Laparoscopy remove adnexa CPT 58661 not published not published $993.28 – $1,365.27 2
Laparoscopy tubal block 58671 CPT 58671 not published not published $783.85 – $993.28 2
Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 $5,113.60 $7,048.00 $129.80 – $5,752.80 16
Lead capillary CPT 83655 $404.80 $558.00 $10.00 – $56.70 16
Lead ingevity 45cm pfret MRI HCPCS C1898 $1,635.20 $2,253.00 $55.26 – $276.30 13
Leg Vein Ultrasound (DVT study, both legs) CPT 93970 $1,449.60 $1,998.00 $146.18 – $1,630.80 16
Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 $360.00 $505.00 $81.00 – $405.00 13
Lens iol ant bicnvx 24.0 multi HCPCS V2632 $606.40 $836.00 $76.50 – $382.50 13
Lens iol ant chamb 10.5 HCPCS V2630 $350.40 $483.00 $78.84 – $394.20 13
Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 $87.60 $146.00 $3.22 – $18.00 14
Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 $1,045.80 $1,743.00 $313.74 – $1,730.32 15
Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 $6,275.40 $10,459.00 $176.45 – $6,206.00 16
Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 $276.00 $460.00 $0.04 – $0.90 14
Levetiracetam therapeutic drug level CPT 80177 $400.00 $551.00 $13.09 – $450.00 16
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 $37.00 $46.25 $2.54 – $13.50 14
Liberta rc ipg HCPCS C1820 $7,270.40 $10,019.00 $1,635.84 – $8,179.20 13
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 $0.16 $0.20 $0.00 – $0.09 14
Ligate/transect fallopian tubes 58600 CPT 58600 not published not published $942.08 – $1,013.57 2
Ligation/biopsy of temporal artery 37609 CPT 37609 not published not published $136.40 – $541.22 8
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 $370.20 $617.00 $3.57 – $184.50 14
Lip surgery procedure CPT 40799 $121.80 $203.00 $36.54 – $182.70 13
Lipase CPT 83690 $168.80 $233.00 $5.00 – $189.90 16
Lipoprotein blood quant CPT 83704 $476.80 $657.00 $26.70 – $511.20 14
Lipoprotein direct measurement hdl CPT 83718 $76.60 $106.00 $7.00 – $86.17 16
Lipoprotein direct measurement ldl CPT 83721 $199.20 $274.00 $10.37 – $224.10 16
Lithium therapeutic drug level CPT 80178 $100.00 $138.00 $6.54 – $112.50 16
Liver Function Test CPT 80076 $280.80 $387.00 $8.08 – $315.90 16
Liver elastography 91200 CPT 91200 $581.60 $801.00 $24.22 – $654.30 16
Liver imag w/vasclr flow CPT 78202 $1,826.40 $2,517.00 $64.00 – $2,054.70 16
Liver/spleen imag static only CPT 78215 $1,582.40 $2,181.00 $59.52 – $1,780.20 16
Liver/spleen imag w/vasclr flow CPT 78216 $1,882.40 $2,595.00 $78.72 – $2,117.70 16
Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 not published not published $358.05 – $932.62 8
Loop ostmy bridg ster HCPCS A4421 $78.60 $108.00 $1.54 – $88.42 13
Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 $31.20 $52.00 $0.18 – $1.38 15
Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 $4,323.20 $5,958.00 $174.08 – $4,863.60 16
Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 $3,090.40 $4,259.00 $120.32 – $3,476.70 16
Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 $2,480.80 $3,419.00 $112.77 – $2,790.90 16
Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 $4,850.40 $6,684.00 $344.32 – $5,456.70 16
Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 $3,689.60 $5,085.00 $344.32 – $4,150.80 16
Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 $3,040.00 $4,190.00 $239.62 – $3,420.00 16
Lower Back (Lumbar Spine) X-ray CPT 72100 $504.00 $695.00 $28.80 – $567.00 16
Lumbar diskogram s&i CPT 72295 $2,380.80 $3,281.00 $46.08 – $2,678.40 16
Lung Function Test (Spirometry) CPT 94010 $276.00 $380.00 $11.52 – $152.10 16
Lung function test (mbc/mvv) CPT 94200 $109.60 $151.00 $6.91 – $123.30 16
Lung perfusion imaging CPT 78580 $580.00 $799.00 $60.80 – $652.50 16
Lurbinectedin 4 mg intravenous solution HCPCS J9223 $380.40 $634.00 $114.12 – $570.60 15
Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 $83.40 $139.00 $25.02 – $125.10 15
Lymphatics/lymph node imaging CPT 78195 $1,417.60 $1,954.00 $166.40 – $1,594.80 16
Lymphocyte transformation mitogen CPT 86353 $761.60 $1,050.00 $48.45 – $856.80 16
M.avium-intra dna amp prob CPT 87561 $570.40 $786.00 $27.39 – $641.70 14
M/phmtrc alys ishquant/semiq CPT 88377 $488.80 $674.00 $109.98 – $549.90 16
MRA abdomen post contrast CPT 74185 $3,306.40 $4,133.00 $435.20 – $2,250.00 16
MRA ext low(run-off)pst cntrst CPT 73725 $4,049.60 $5,062.00 $435.20 – $4,555.80 14
MRA pelvis CPT 72198 $1,811.20 $2,264.00 $407.52 – $2,037.60 15
MRA pelvis w IV cont HCPCS C8918 $1,497.60 $2,496.00 $287.67 – $2,246.40 13
MRA upper extremity post contrast-bil CPT 73225 $2,369.60 $3,266.00 $435.20 – $2,665.80 13
MRA w/cont, abd HCPCS C8900 $1,653.60 $2,756.00 $287.67 – $2,480.40 13
MRA without fol w/cont, abd HCPCS C8902 $2,734.20 $4,557.00 $287.67 – $4,101.30 13
MRA without fol w/cont, lwr ext HCPCS C8914 $3,348.60 $5,581.00 $287.67 – $5,022.90 13
MRI cardiac morph & func wo IV cont CPT 75557 $3,040.00 $4,190.00 $322.19 – $3,420.00 16
MRI cardiac morph & func wwo IV cont CPT 75561 $3,689.60 $5,085.00 $492.35 – $4,150.80 16
MRI chest w IV cont CPT 71551 $3,689.60 $5,085.00 $399.62 – $4,150.80 16
MRI chest without & w/contrast CPT 71552 $4,820.80 $6,643.00 $605.30 – $5,423.40 16
MRI chest without contrast CPT 71550 $3,040.00 $4,190.00 $344.32 – $3,420.00 16
MRI loex nonjt w IV cont CPT 73719 $3,689.60 $5,085.00 $393.92 – $4,150.80 14
MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 $4,850.40 $6,684.00 $344.32 – $5,456.70 14
MRI lower extremity other than joint without contrast (both sides) CPT 73718 $3,040.00 $4,190.00 $328.78 – $3,420.00 14
MRI orbit fac&nck w IV cont CPT 70542 $3,520.00 $4,851.00 $393.92 – $3,960.00 16
MRI orbit/face/neck without & w/contrast CPT 70543 $4,600.00 $6,340.00 $605.15 – $5,175.00 16
MRI orbit/face/neck without contrast CPT 70540 $2,900.80 $3,997.00 $344.32 – $3,263.40 16
MRI tmj CPT 70336 $3,040.00 $4,190.00 $338.62 – $3,420.00 16
MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 $4,850.40 $6,684.00 $344.32 – $5,456.70 14
MRI upper extremity other than joint without contrast (both sides) CPT 73218 $3,040.00 $4,190.00 $328.78 – $3,420.00 14
MRI upper extremity w/dye CPT 73219 $3,689.60 $5,085.00 $393.92 – $4,150.80 14
Macroscopic exam arthropod CPT 87168 $90.40 $125.00 $3.33 – $101.70 14
Macroscopic exam parasite CPT 87169 $62.20 $85.00 $3.37 – $69.97 14
Magnesium CPT 83735 $151.20 $208.00 $6.62 – $70.88 16
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 $74.40 $124.00 $0.18 – $0.90 14
Mammosite ced HCPCS C1728 $13,311.20 $18,345.00 $2,995.02 – $14,975.10 12
Manipulate finger w/anesth CPT 26340 not published not published $174.04 – $993.28 8
Manipulation chest wall demonstration/evaluation subsequent CPT 94668 $233.60 $322.00 $30.14 – $262.80 14
Manipulation chest wall initial demonstration/evaluation CPT 94667 $287.20 $396.00 $49.73 – $323.10 14
Mannitol 12.5 gm/50 ml inj HCPCS J2150 $88.80 $148.00 $3.06 – $15.30 13
Marker biop eviva buckle ss HCPCS A4648 $404.80 $558.00 $91.08 – $455.40 13
Mastectomy partial CPT 19301 not published not published $552.76 – $993.28 2
Mastoids complete CPT 70130 $580.00 $799.00 $35.20 – $652.50 14
Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 $383.20 $528.00 $14.29 – $431.10 16
Mayo aathr protein s free CPT 85306 $443.20 $611.00 $15.14 – $203.40 16
Mayo activated protein c resistance assay CPT 85307 $306.40 $422.00 $15.14 – $344.70 16
Mayo adalimumab (humira) therapeutic drug level CPT 80145 $248.80 $343.00 $30.12 – $279.90 14
Mayo alkaline phosphatase isoenzyme CPT 84080 $158.40 $218.00 $11.55 – $178.20 14
Mayo alpha 1 antitrypsin CPT 82103 $238.40 $329.00 $13.29 – $268.20 16
Mayo analysis gene calr common variants exon 9 CPT 81219 $864.00 $1,080.00 $94.96 – $972.00 14
Mayo analysis gene jak2 p.val617phe variant CPT 81270 $1,680.00 $2,100.00 $90.59 – $1,016.10 16
Mayo analysis gene smn1 dosage/deletion CPT 81329 $2,514.40 $3,143.00 $109.60 – $1,033.20 16
Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 $11,640.60 $19,401.00 $905.73 – $17,460.90 14
Mayo androstenedione CPT 82157 $186.40 $257.00 $25.00 – $209.70 16
Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 $168.00 $232.00 $14.43 – $189.00 16
Mayo antithrombin iii antigen CPT 85301 $704.80 $971.00 $10.69 – $792.90 16
Mayo aspergillus fumigatus antibody CPT 86606 $280.80 $387.00 $14.88 – $162.00 16
Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 $351.20 $484.00 $28.07 – $395.10 16
Mayo bart bartonella henselae antibody igg CPT 86611 $20.40 $28.00 $4.59 – $22.95 16
Mayo blastomyces antibody immunodiffusion CPT 86612 $212.00 $292.00 $12.75 – $238.50 16
Mayo bordetella pertussis antibody igg CPT 86615 $121.60 $168.00 $13.03 – $136.80 16
Mayo brcmg brucella antibody igm CPT 86622 $144.00 $198.00 $8.82 – $162.00 16
Mayo c1 esterase inhibitor CPT 83883 $158.40 $218.00 $10.62 – $178.20 14
Mayo carnitine total and free quantitative each specimen plasma CPT 82379 $400.80 $552.00 $13.17 – $450.90 14
Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 $351.00 $585.00 $26.46 – $526.50 16
Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 $463.20 $579.00 $104.22 – $521.10 16
Mayo ceruloplasmin CPT 82390 $118.40 $163.00 $10.00 – $133.20 16
Mayo chemiluminescent parathyroid related peptide CPT 82397 $356.80 $491.00 $11.02 – $215.10 14
Mayo chikv chikungunya antibodies igg CPT 86790 $436.00 $601.00 $10.06 – $490.50 14
Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 $47.00 $64.00 $9.88 – $52.88 16
Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 $47.00 $64.00 $10.57 – $52.88 16
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 $1,327.20 $1,829.00 $115.13 – $1,422.00 16
Mayo chromium CPT 82495 $280.80 $387.00 $6.00 – $315.90 16
Mayo coccidioides antibody CPT 86635 $278.40 $383.00 $11.33 – $313.20 16
Mayo cocou cortisone urine CPT 82542 $369.60 $509.00 $19.27 – $255.60 16
Mayo cortisol free CPT 82530 $329.60 $412.00 $16.51 – $226.80 16
Mayo covid-19 antibody nucleocapsid total CPT 86769 $164.00 $205.00 $11.16 – $184.50 16
Mayo coxiella brunetii (q fever) igg antibody CPT 86638 $206.40 $285.00 $11.98 – $232.20 16
Mayo deoxyribonuclease antibody titer CPT 86215 $124.00 $171.00 $13.09 – $139.50 16
Mayo dhea (dehydroepiandrosterone) CPT 82626 $580.00 $799.00 $21.00 – $652.50 16
Mayo dihydrotestosterone CPT 82642 $364.80 $503.00 $22.86 – $162.00 14
Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid CPT 83518 $171.20 $236.00 $7.53 – $192.60 14
Mayo efpo chloride stool CPT 82438 $324.00 $446.00 $3.00 – $364.50 16
Mayo estriol CPT 82677 $147.20 $203.00 $17.50 – $165.60 16
Mayo estrone CPT 82679 $215.20 $296.00 $13.00 – $242.10 16
Mayo ethosuximide therapeutic drug level CPT 80168 $385.60 $531.00 $13.00 – $433.80 16
Mayo everolimus therapeutic drug level CPT 80169 $434.40 $599.00 $13.56 – $488.70 16
Mayo factor ii CPT 85210 $65.80 $90.00 $4.00 – $74.03 16
Mayo factor v CPT 85220 $408.80 $564.00 $5.00 – $459.90 16
Mayo factor vii CPT 85230 $224.00 $309.00 $5.00 – $252.00 16
Mayo factor viii vw factor antigen CPT 85246 $289.60 $399.00 $22.67 – $325.80 16
Mayo factor viii vw factor multimetric analysis CPT 85247 $289.60 $399.00 $22.67 – $325.80 16
Mayo factor viii vw factor ristocetin cofactor CPT 85245 $289.60 $399.00 $22.67 – $325.80 16
Mayo factor x CPT 85260 $431.20 $594.00 $12.00 – $485.10 16
Mayo factor xi CPT 85270 $196.80 $271.00 $12.00 – $221.40 16
Mayo fat/lipids feces quantitative CPT 82710 $239.20 $330.00 $4.02 – $269.10 16
Mayo fbl culture fungi blood CPT 87103 $471.60 $786.00 $12.46 – $707.40 16
Mayo ffspg allergen clam igg CPT 86001 $183.20 $252.00 $5.78 – $178.20 16
Mayo fibrinogen antigen CPT 85385 $144.80 $200.00 $9.91 – $162.90 16
Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 $522.40 $720.00 $14.47 – $587.70 16
Mayo gamma-globin full gene sequencing CPT 81479 $9,836.80 $12,296.00 $39.78 – $198.90 12
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 $432.80 $596.00 $27.39 – $486.90 14
Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 $609.60 $840.00 $27.39 – $685.80 14
Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 $248.80 $343.00 $13.62 – $279.90 16
Mayo hla typing a/b/c single antigen CPT 86812 $355.20 $494.00 $12.00 – $399.60 16
Mayo hvdip HIV 1 antibody CPT 86701 $180.80 $249.00 $8.79 – $193.50 16
Mayo hvdip HIV 2 antibody CPT 86702 $180.80 $249.00 $13.36 – $193.50 16
Mayo hydroxyprogesterone 17-d CPT 83498 $564.00 $777.00 $20.50 – $634.50 16
Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 $1,267.20 $1,746.00 $13.48 – $302.40 14
Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 $594.40 $819.00 $9.95 – $49.73 16
Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 $238.40 $329.00 $20.57 – $222.30 16
Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 $440.00 $607.00 $20.57 – $495.00 16
Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 $227.20 $313.00 $12.54 – $255.60 14
Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 $516.80 $712.00 $11.84 – $554.40 16
Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 $693.60 $1,156.00 $34.68 – $1,040.40 16
Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 $65.40 $90.00 $14.71 – $73.58 14
Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 $290.40 $484.00 $34.10 – $435.60 13
Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 $611.20 $842.00 $42.34 – $687.60 16
Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 $669.00 $1,115.00 $57.75 – $1,003.50 16
Mayo infliximab therapeutic drug level CPT 80230 $236.80 $327.00 $30.12 – $266.40 14
Mayo inhab inhibin a CPT 86336 $154.40 $213.00 $12.17 – $173.70 14
Mayo insft insulin free CPT 83527 $148.80 $205.00 $12.80 – $167.40 16
Mayo insulin antibodies CPT 86337 $238.40 $329.00 $11.00 – $268.20 16
Mayo iodine CPT 83789 $244.80 $337.00 $18.83 – $275.40 14
Mayo lacosamide therapeutic drug level CPT 80235 $248.80 $343.00 $21.17 – $279.90 14
Mayo lamotrigine therapeutic drug level CPT 80175 $400.00 $551.00 $13.09 – $158.40 16
Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 $37.80 $52.00 $8.51 – $42.52 16
Mayo legionella antibody CPT 86713 $472.80 $652.00 $15.12 – $320.40 16
Mayo lipoprotein electrophoresis CPT 83700 $315.20 $435.00 $11.13 – $354.60 16
Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 $282.40 $390.00 $10.76 – $53.77 16
Mayo manganese CPT 83785 $100.80 $139.00 $20.81 – $113.40 14
Mayo metanephrines plasma CPT 83835 $496.80 $685.00 $13.00 – $431.10 16
Mayo mgle voltage-gated calcium channel antibody each CPT 86596 $284.00 $392.00 $11.91 – $319.50 16
Mayo microsomal antibody liver-kidney CPT 86376 $390.40 $538.00 $7.91 – $180.00 16
Mayo mitotane (lysodren) therapeutic drug level CPT 80299 $530.40 $663.00 $15.30 – $271.80 16
Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 $1,528.80 $1,911.00 $106.97 – $1,044.90 14
Mayo muscle-specific kinase (musk) antibody CPT 86366 $235.20 $392.00 $18.18 – $352.80 13
Mayo mycophenolic acid therapeutic drug level CPT 80180 $244.80 $337.00 $17.84 – $275.40 16
Mayo myoglobin CPT 83874 $556.80 $768.00 $12.77 – $491.40 16
Mayo nickel CPT 83885 $326.40 $449.00 $11.00 – $367.20 16
Mayo organic acid methylmalonic single quantitative CPT 83921 $732.80 $1,010.00 $18.20 – $824.40 16
Mayo oxalate 24 hour urine CPT 83945 $205.60 $284.00 $13.00 – $71.10 16
Mayo parvs parvovirus b19 antibody igg CPT 86747 $441.60 $609.00 $14.85 – $496.80 16
Mayo paval fluorescent antibody screen agna type 1 CPT 86255 $523.20 $721.00 $11.91 – $113.40 16
Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 $215.20 $296.00 $34.68 – $242.10 16
Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 $232.20 $387.00 $17.78 – $348.30 16
Mayo pntft phenytoin free therapeutic drug level CPT 80186 $93.60 $129.00 $13.00 – $105.30 16
Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 $317.60 $438.00 $2.00 – $208.80 16
Mayo pregnenolone CPT 84140 $422.40 $582.00 $20.43 – $475.20 16
Mayo prmb primidone therapeutic drug level CPT 80188 $129.60 $179.00 $16.40 – $145.80 16
Mayo proinsulin CPT 84206 $526.40 $726.00 $8.00 – $592.20 16
Mayo psaft prostate specific antigen free CPT 84154 $509.60 $702.00 $18.17 – $573.30 16
Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 $700.00 $965.00 $14.36 – $173.70 14
Mayo rbcme osmotic fragility rbc incubated CPT 85557 $99.20 $137.00 $12.00 – $111.60 16
Mayo receptor assay transferrin soluble CPT 84238 $700.00 $965.00 $22.00 – $787.50 16
Mayo renin CPT 84244 $222.40 $307.00 $12.00 – $250.20 16
Mayo repu protein electrophoresis urine CPT 84166 $265.60 $366.00 $17.62 – $298.80 16
Mayo selenium CPT 84255 $182.40 $251.00 $19.93 – $205.20 14
Mayo serotonin CPT 84260 $763.20 $1,052.00 $30.62 – $858.60 16
Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 $103.20 $142.00 $19.13 – $116.10 16
Mayo sirolimus therapeutic drug level CPT 80195 $340.00 $468.00 $13.56 – $382.50 16
Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 $491.40 $819.00 $147.42 – $737.10 12
Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 $176.80 $244.00 $4.00 – $52.88 16
Mayo tau phosphorylated 217 each CPT 84393 $259.80 $433.00 $77.94 – $389.70 12
Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 $413.60 $517.00 $93.06 – $465.30 14
Mayo tgrp testosterone free CPT 84402 $87.20 $120.00 $19.62 – $98.10 16
Mayo tgrp testosterone total CPT 84403 $222.40 $307.00 $25.52 – $250.20 16
Mayo thyroglobulin CPT 84432 $514.40 $709.00 $15.88 – $238.50 16
Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 $118.40 $163.00 $10.06 – $133.20 16
Mayo ticks babesia microti antibody igg CPT 86753 $147.20 $203.00 $9.68 – $165.60 14
Mayo tulab francisella tularensis antibody igg CPT 86668 $178.40 $246.00 $13.99 – $200.70 16
Mayo vasoactive intestinal peptide CPT 84586 $454.40 $626.00 $34.92 – $511.20 16
Mayo vitamin b-2 (riboflavin) CPT 84252 $304.00 $419.00 $8.00 – $342.00 16
Mayo vitamin b3 (niacin) CPT 84591 $282.40 $390.00 $13.32 – $317.70 14
Mayo vitamin k CPT 84597 $388.00 $534.00 $10.71 – $436.50 14
Mayo zonisamide therapeutic drug level CPT 80203 $372.80 $513.00 $13.09 – $419.40 16
Measurement post void urine by ultrasound CPT 51798 $157.60 $217.00 $9.54 – $47.70 16
Mechlorethamine hcl inj HCPCS J9230 $690.00 $1,150.00 $207.00 – $1,035.00 13
Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 $533.40 $889.00 $1.08 – $5.40 13
Megestrol 20 mg tabs 100 each bottle HCPCS S0179 $4.20 $5.25 $0.27 – $1.35 13
Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 $8,335.20 $11,487.00 $204.96 – $9,377.10 13
Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 $28.20 $47.00 $2.16 – $15.69 14
Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 $7,678.20 $12,797.00 $23.04 – $115.20 15
Meropenem 1 gram intravenous solution HCPCS J2185 $55.20 $92.00 $0.42 – $8.10 15
Mesna 100 mg/ml intravenous solution HCPCS J9209 $153.60 $256.00 $1.86 – $45.90 14
Metabolic Blood Panel (Basic) CPT 80048 $225.60 $311.00 $8.36 – $253.80 16
Metabolic Blood Panel (Comprehensive) CPT 80053 $260.80 $359.00 $10.43 – $293.40 16
Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 $463.20 $772.00 $0.90 – $4.50 14
Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 $78.20 $97.75 $4.79 – $87.97 14
Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 $332.00 $415.00 $1.84 – $26.10 15
Methotrexate sodium 2.5 mg tablet HCPCS J8610 $38.60 $48.25 $0.16 – $43.20 15
Methotrexate therapeutic drug level CPT 80204 $438.60 $731.00 $30.12 – $657.90 14
Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 $1,135.20 $1,892.00 $2.70 – $13.50 14
Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 $53.00 $66.25 $11.88 – $59.40 14
Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 $504.60 $841.00 $1.08 – $5.40 13
Methylprednisolone 4 mg tablet HCPCS J7509 $9.00 $11.25 $0.11 – $9.90 14
Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 $1.60 $2.00 $0.12 – $8.20 16
Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 $4.60 $5.75 $0.09 – $6.23 16
Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 $5.40 $6.75 $0.57 – $4.50 15
Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 $1.20 $2.00 $0.12 – $1.80 14
Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 $0.20 $0.25 $0.03 – $0.23 14
Micafungin 100 mg intravenous solution HCPCS J2248 $5.80 $7.25 $0.26 – $6.30 14
Microdissection manual CPT 88381 $1,058.40 $1,764.00 $141.03 – $1,587.60 14
Microwave bronch, 3d, ebus HCPCS C9751 $3,523.20 $4,855.00 $792.72 – $3,963.60 13
Midazolam 1 mg/ml injection solution HCPCS J2250 $97.20 $162.00 $0.15 – $0.90 15
Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 $73.20 $122.00 $1.45 – $17.10 14
Minocycline hydrochloride HCPCS J2265 $5.20 $6.50 $1.17 – $5.85 14
Mitomycin 40 mg intravenous solution HCPCS J9280 $3,278.40 $5,464.00 $20.35 – $241.20 15
Mitomycin instillation HCPCS J9281 $818.40 $1,023.00 $184.14 – $920.70 15
Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 $1,254.00 $2,090.00 $23.88 – $375.30 15
Mlh1 gene CPT 81288 $1,619.20 $2,024.00 $150.17 – $1,260.00 14
Mlh1 gene dup/delete variant CPT 81294 $1,502.40 $1,878.00 $152.54 – $1,690.20 16
Mlh1 gene full seq CPT 81292 $1,502.40 $1,878.00 $338.04 – $1,690.20 16
Mnpj anes sho jt fixj aprats CPT 23700 not published not published $140.80 – $725.76 8
Mopath procedure level 1 CPT 81400 $303.20 $379.00 $49.95 – $341.10 14
Mopath procedure level 3 CPT 81402 $1,211.20 $1,514.00 $117.38 – $835.20 14
Mopath procedure level 5 CPT 81404 $6,400.00 $8,000.00 $214.59 – $2,103.30 14
Mopath procedure level 6 CPT 81405 $2,934.00 $4,890.00 $113.40 – $567.00 14
Mopath procedure level 7 CPT 81406 $8,366.40 $10,458.00 $23.58 – $279.57 14
Mopath procedure level 8 CPT 81407 $2,276.80 $2,846.00 $458.46 – $2,292.30 14
Mopath procedure level 9 CPT 81408 $4,626.40 $5,783.00 $545.76 – $2,728.80 14
Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 $918.00 $1,530.00 $3.60 – $18.00 14
Morphine 4 mg/ml injection (wrapper) HCPCS J2270 $1,561.20 $2,602.00 $0.18 – $2.18 15
Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 $337.60 $422.00 $75.96 – $379.80 16
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 $599.40 $999.00 $79.54 – $899.10 16
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 $1,050.40 $1,448.00 $45.41 – $1,181.70 16
Mpl gene analysis common variants CPT 81338 $1,223.20 $1,529.00 $117.38 – $1,376.10 14
Mr safety determination physician/other qhp CPT 76016 $160.20 $267.00 $48.06 – $240.30 13
Mr safety implant elec prepj CPT 76018 $166.80 $278.00 $50.04 – $250.20 13
Mr sfty implt&/fb asmt stf 1 CPT 76014 $44.40 $74.00 $9.61 – $66.60 13
Mr sfty med physics xm cstmz CPT 76017 $439.80 $733.00 $131.94 – $659.70 13
Msh2 gene dup/delete variant CPT 81297 $1,502.40 $1,878.00 $121.37 – $1,690.20 16
Msh2 gene full seq CPT 81295 $1,502.40 $1,878.00 $121.37 – $1,690.20 16
Msh6 gene dup/delete variant CPT 81300 $1,502.40 $1,878.00 $129.34 – $1,690.20 16
Msh6 gene full seq CPT 81298 $1,502.40 $1,878.00 $230.26 – $1,690.20 16
Mthfr gene analy common variants CPT 81291 $349.60 $437.00 $51.02 – $393.30 14
Mucopolysaccharides CPT 83864 $340.00 $468.00 $18.00 – $382.50 16
Multiple sleep latency test CPT 95805 $5,312.80 $7,322.00 $257.69 – $5,976.90 16
Mumps antibody igg CPT 86735 $344.80 $476.00 $10.19 – $387.90 14
Mycophenolate mofetil 250 mg capsule HCPCS J7517 $120.00 $200.00 $0.16 – $6.30 14
Mycoplasma antibody igm CPT 86738 $703.20 $969.00 $13.08 – $791.10 16
Myd88 gene p.leu265pro vrnt CPT 81305 $358.40 $448.00 $80.64 – $403.20 14
Myelogphy 2/> spine regions CPT 72270 $4,915.20 $6,774.00 $49.92 – $5,529.60 16
Myelography l-s spine CPT 72265 $4,168.00 $5,745.00 $42.24 – $4,689.00 16
Myelography neck spine CPT 72240 $4,204.00 $5,794.00 $47.04 – $4,729.50 16
Myelography thoracic spine CPT 72255 $3,476.80 $4,791.00 $47.04 – $3,911.40 16
Myelography via inj w/s&i 2+ regions CPT 62305 $4,915.20 $6,774.00 $114.50 – $5,529.60 16
Myelography via inj w/s&i cervical CPT 62302 $4,204.00 $5,794.00 $111.12 – $4,729.50 16
Myelography via inj w/s&i lumbosacral CPT 62304 $4,168.00 $5,745.00 $109.28 – $4,689.00 16
Myelography via inj w/s&i thoracic CPT 62303 $3,476.80 $4,791.00 $112.58 – $3,911.40 16
Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 $152.00 $210.00 $9.00 – $171.00 14
Nafcillin 2 gram solution for injection HCPCS J2290 $1.80 $2.25 $0.05 – $2.02 14
Nalbuphine 10 mg/ml injection solution HCPCS J2300 $16.20 $27.00 $3.24 – $16.20 14
Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 $1.20 $2.00 $0.08 – $1.80 14
Naltrexone, depot form HCPCS J2315 $7,275.00 $12,125.00 $4.24 – $1,622.23 16
Nasal endoscopy with removal of nasal foreign body CPT 30999 $135.00 $225.00 $40.50 – $202.50 13
Nasopharyngoscopy w/endoscope CPT 92511 $441.60 $609.00 $99.36 – $496.80 14
Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 $28,621.80 $47,703.00 $24.00 – $144.00 15
Natriuretic peptide CPT 83880 $413.60 $570.00 $37.94 – $364.50 16
Natural killer cells total count CPT 86357 $136.00 $188.00 $30.60 – $153.00 16
Navigational bronchoscopy 31627 CPT 31627 $6,768.80 $9,328.00 $74.09 – $7,614.90 14
Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 $4,323.20 $5,958.00 $174.08 – $4,863.60 16
Neck (Cervical Spine) CT scan (with contrast) CPT 72126 $3,841.60 $5,294.00 $120.32 – $4,321.80 16
Neck (Cervical Spine) CT scan (without contrast) CPT 72125 $2,550.40 $3,514.00 $106.37 – $2,869.20 16
Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 $4,677.60 $6,446.00 $344.32 – $5,262.30 16
Neck (Cervical Spine) MRI (with contrast) CPT 72142 $3,557.60 $4,902.00 $344.32 – $4,002.30 16
Neck (Cervical Spine) MRI (without contrast) CPT 72141 $2,932.00 $4,040.00 $344.32 – $3,298.50 16
Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 $4,627.20 $6,377.00 $605.85 – $5,205.60 16
Neck MRA (blood vessel MRI, with contrast) CPT 70548 $3,878.40 $5,345.00 $342.28 – $4,363.20 16
Neck MRA (blood vessel MRI, without contrast) CPT 70547 $2,861.60 $3,944.00 $342.28 – $3,219.30 16
Neisseria meningitidis CPT 86741 $168.80 $233.00 $10.30 – $189.90 14
Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 $166.80 $278.00 $2.52 – $12.60 13
Nerve teasing preparations CPT 88362 $1,171.20 $1,614.00 $39.42 – $1,317.60 15
Neuroeltrd stim post tibial CPT 64566 $1,827.20 $2,518.00 $64.80 – $324.00 14
New Patient Office Visit (level 2) CPT 99202 $250.80 $418.00 $13.14 – $100.71 16
New Patient Office Visit (level 3) CPT 99203 $327.00 $545.00 $15.30 – $126.65 16
New Patient Office Visit (level 4) CPT 99204 $421.20 $702.00 $21.96 – $193.76 16
New Patient Office Visit (level 5) CPT 99205 $589.80 $983.00 $23.76 – $236.04 16
Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 $3.00 $3.75 $0.07 – $2.70 14
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 $4.00 $5.00 $0.90 – $4.50 14
Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 $12,144.00 $20,240.00 $32.96 – $182.70 15
Njx interlaminar crv/thrc CPT 62324 $3,647.20 $5,026.00 $83.56 – $4,103.10 16
Nm imaging bone/joint 3 phase study CPT 78315 $2,037.60 $2,808.00 $152.32 – $2,292.30 16
Nm imaging bone/joint whole body CPT 78306 $1,783.20 $2,457.00 $78.72 – $2,006.10 16
Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 $1,996.80 $2,752.00 $78.08 – $2,246.40 16
Nm imaging gastric emptying study CPT 78264 $1,826.40 $2,517.00 $126.72 – $2,054.70 16
Nm imaging gastrointestinal acute blood loss CPT 78278 $2,045.60 $2,819.00 $49.92 – $2,301.30 16
Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 $2,366.40 $3,261.00 $364.11 – $2,662.20 16
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 $2,005.60 $2,764.00 $88.32 – $2,256.30 16
Nm imaging pulmonary ventilation/perfusion CPT 78582 $2,680.80 $3,695.00 $254.48 – $3,015.90 16
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 $1,806.40 $2,490.00 $196.58 – $2,032.20 16
Nm radiopharmaceutical therapy oral administration CPT 79005 $1,142.40 $1,574.00 $48.37 – $1,285.20 16
Non-card vasc flow imaging CPT 78445 $504.80 $696.00 $40.32 – $567.90 16
Npm1 gene CPT 81310 $2,643.20 $3,642.00 $197.22 – $2,973.60 16
Nuclear Stress Test (Heart) CPT 78452 $5,087.20 $7,011.00 $356.28 – $5,723.10 16
Nuclear exam of tear flow CPT 78660 $770.40 $1,062.00 $73.60 – $866.70 16
Nuclear rx IV admin CPT 79101 $3,156.80 $4,350.00 $47.65 – $3,551.40 16
Nuclear rx intracav admin CPT 79200 $3,796.80 $5,232.00 $80.55 – $4,271.40 16
Nudt15 gene common variants CPT 81306 $450.00 $750.00 $135.00 – $675.00 14
Nushield 1 square cm HCPCS Q4160 $3,704.80 $5,106.00 $235.08 – $1,175.40 13
Ob Ultrasound nuchal meas 1 gest CPT 76813 $628.80 $866.00 $65.00 – $707.40 16
Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 $898.20 $1,497.00 $79.00 – $450.90 15
Observation direct referral from physician office for admission HCPCS G0379 $141.60 $195.00 $31.86 – $159.30 12
Observation per hour HCPCS G0378 $213.60 $294.00 $48.06 – $240.30 12
Obstetrics panel CPT 80055 $276.00 $380.00 $12.00 – $310.50 16
Obtaining screen pap smear HCPCS Q0091 $64.00 $84.00 $7.92 – $39.60 13
Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 $146.40 $244.00 $43.92 – $219.60 15
Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 $220.80 $368.00 $0.61 – $16.20 15
Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 $28,302.00 $47,170.00 $203.58 – $4,443.72 16
Ofatumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9302 $109.80 $183.00 $32.94 – $164.70 14
Oil silicone ophth 8.5ml silikon 1000 HCPCS C1814 $2,772.80 $3,821.00 $410.58 – $2,052.90 13
Olanzapine 10 mg intramuscular solution HCPCS J2359 $12.80 $16.00 $0.87 – $23.81 15
Onco (ovar) two proteins CPT 81500 $127.20 $212.00 $38.16 – $257.45 14
Ondansetron 4 mg s0119 HCPCS S0119 $136.80 $171.00 $0.16 – $153.90 14
Ondansetron 8 mg disintegrating tablet HCPCS Q0162 $25.20 $42.00 $0.01 – $37.80 13
Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 $27.40 $34.25 $0.09 – $0.90 15
Open bx/exc inguinofem nodes CPT 38531 not published not published $539.07 – $993.28 2
Ophthalmic mitomycin HCPCS J7315 $1,663.20 $2,772.00 $498.96 – $2,494.80 13
Optx ulnar styloid fracture CPT 25652 not published not published $993.28 – $1,051.57 2
Oral aprepitant HCPCS J8501 $1,583.40 $2,639.00 $2.73 – $95.40 15
Oral busulfan HCPCS J8510 $24.60 $41.00 $7.38 – $84.21 14
Oral everolimus HCPCS J7527 $115.20 $192.00 $1.37 – $172.80 14
Organic acids total quant ea spec CPT 83918 $335.20 $462.00 $22.75 – $377.10 16
Oritavancin 400 mg intravenous solution HCPCS J2407 $13,431.00 $22,385.00 $28.68 – $503.10 15
Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 $61.00 $76.25 $11.19 – $68.62 14
Oscillation chest wall mechanical per session CPT 94669 $155.20 $214.00 $33.30 – $166.50 14
Osmolality blood CPT 83930 $134.40 $185.00 $3.00 – $151.20 16
Osmolality urine CPT 83935 $436.80 $602.00 $3.00 – $146.70 16
Ot evaluation high complexity patient/family CPT 97167 $238.40 $329.00 $53.64 – $268.20 14
Ot evaluation low complexity patient/family CPT 97165 $238.40 $329.00 $53.64 – $268.20 14
Ot evaluation moderate complexity patient/family CPT 97166 $238.40 $329.00 $32.42 – $268.20 14
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 $157.60 $217.00 $28.08 – $140.40 14
Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 $157.60 $217.00 $23.13 – $140.40 16
Ot re-evaluation patient/family CPT 97168 $117.60 $162.00 $26.46 – $132.30 16
Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 $157.60 $217.00 $14.30 – $83.92 16
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 $128.80 $177.00 $20.32 – $144.90 16
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 $128.80 $177.00 $20.95 – $144.90 16
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 $157.60 $217.00 $9.22 – $140.40 16
Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 $157.60 $217.00 $18.43 – $140.40 16
Ot training self care/home management direct contact each 15 minutes CPT 97535 $157.60 $217.00 $25.93 – $140.40 14
Oth resp proc, group HCPCS G0239 $473.60 $686.00 $26.52 – $532.80 13
Oxaliplatin 5 mg/ml desensitization HCPCS J9263 $1,965.00 $3,275.00 $0.08 – $14.40 14
Oxytocin 10 unit/ml injection solution HCPCS J2590 $29.00 $36.25 $6.48 – $32.40 13
P-32 chromic phos ther per mci HCPCS A9564 $1,311.20 $1,807.00 $295.02 – $1,475.10 12
P-32 sod phosphate ther per mci HCPCS A9563 $268.80 $371.00 $60.48 – $302.40 12
PSA (Prostate) Test CPT 84153 $239.20 $330.00 $18.17 – $256.50 16
Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 $300.60 $501.00 $0.14 – $0.90 14
Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 $6,166.20 $10,277.00 $10.54 – $92.70 15
Paliperidone 117 mg/0.75 ml inj HCPCS J2426 $9,557.40 $15,929.00 $9.63 – $2,283.23 16
Palivizumab 50 mg/0.5 ml inj CPT 90378 $6,940.20 $11,567.00 $11.00 – $10,410.30 16
Palonosetron hcl HCPCS J2469 $378.60 $631.00 $0.36 – $56.70 14
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 $200.00 $250.00 $9.64 – $225.00 14
Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 $550.80 $918.00 $68.76 – $343.80 15
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 $30.80 $38.50 $6.84 – $34.20 13
Papaverin hcl injection HCPCS J2440 $264.80 $331.00 $59.58 – $297.90 13
Parathormone (pth) intact CPT 83970 $228.00 $314.00 $40.80 – $210.60 16
Parathyrd planar w/spect&ct CPT 78072 $2,701.60 $3,723.00 $330.43 – $3,039.30 15
Parathyroid planar imaging CPT 78070 $2,248.00 $3,099.00 $80.00 – $2,529.00 16
Parathyroid planar img w/tomo spect CPT 78071 $2,248.00 $3,099.00 $285.53 – $2,529.00 16
Paricalcitol HCPCS J2501 $28.20 $47.00 $0.95 – $20.70 14
Paring/cutting benign hyperkeratotic lesion single CPT 11055 $29.20 $48.00 $6.57 – $993.28 16
Partial removal finger bone CPT 26236 $6,609.60 $9,109.00 $302.50 – $7,435.80 16
Partial removal of foot bone CPT 28288 not published not published $271.15 – $993.28 8
Partial removal of thyroid CPT 60220 not published not published $993.28 – $1,804.93 2
Partial removal of toe CPT 28160 not published not published $727.99 – $1,196.80 2
Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 $6,781.60 $9,346.00 $2.54 – $6,358.50 13
Passy muir valve metal trach HCPCS L8501 $350.40 $483.00 $78.84 – $394.20 15
Path clin consltj sf 5-20 CPT 80503 $228.00 $314.00 $27.31 – $256.50 14
Pegaspargase injection HCPCS J9266 $62,371.80 $103,953.00 $18,711.54 – $93,557.70 15
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 $1,069.80 $1,783.00 $89.34 – $1,604.70 15
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 $18,128.40 $30,214.00 $106.33 – $941.40 14
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 $7,964.40 $13,274.00 $99.13 – $1,164.60 14
Pegloticase 8 mg/ml intravenous solution HCPCS J2507 $94,586.40 $157,644.00 $3,547.08 – $17,735.40 15
Pegunigalsidase alfa-iwxj HCPCS J2508 $548.00 $685.00 $123.30 – $616.50 15
Pelvic CT scan (with and without contrast) CPT 72194 $3,064.00 $4,223.00 $131.20 – $3,447.00 16
Pelvic CT scan (with contrast) CPT 72193 $2,300.00 $3,170.00 $110.72 – $2,587.50 16
Pelvic CT scan (without contrast) CPT 72192 $1,588.80 $2,189.00 $86.40 – $1,787.40 16
Pelvic MRI (with and without contrast) CPT 72197 $4,850.40 $6,684.00 $604.49 – $5,456.70 16
Pelvic MRI (with contrast) CPT 72196 $3,689.60 $5,085.00 $260.35 – $4,150.80 16
Pelvic MRI (without contrast) CPT 72195 $3,040.00 $4,190.00 $334.23 – $3,420.00 16
Pelvic Ultrasound (complete) CPT 76856 $885.60 $1,220.00 $59.52 – $996.30 16
Pelvic Ultrasound (limited) CPT 76857 $869.60 $1,198.00 $24.32 – $978.30 16
Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 $21,534.00 $35,890.00 $60.29 – $323.10 15
Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 $15,666.00 $26,110.00 $4.36 – $469.80 15
Peng benzathine/procaine inj HCPCS J0558 $581.40 $969.00 $14.40 – $72.00 15
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 $1,494.00 $2,490.00 $14.40 – $72.00 15
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 $136.80 $228.00 $0.79 – $9.00 14
Penile rear tip xtnd 0.5cm HCPCS C2622 $31,936.00 $44,012.00 $7,185.60 – $35,928.00 13
Penile vascular study CPT 93980 $809.60 $1,116.00 $120.50 – $910.80 16
Pentobarbital sodium inj HCPCS J2515 $115.20 $192.00 $1.80 – $9.00 13
Pentostatin 10 mg intravenous solution HCPCS J9268 $10,218.00 $17,030.00 $2,608.16 – $15,327.00 15
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 $1,066.20 $1,777.00 $40.65 – $799.20 13
Pericardiocentesis wwo imaging CPT 33016 $2,977.60 $4,103.00 $213.32 – $3,349.80 16
Perq dev breast 1st strtctc CPT 19283 $2,168.80 $2,989.00 $91.72 – $2,439.90 16
Perq rplcmt g-tube req revsn gstrst trk CPT 43763 $2,128.00 $2,933.00 $75.02 – $2,394.00 16
Pertuzu, trastuzu, 10 mg HCPCS J9316 $324.60 $541.00 $62.10 – $486.90 15
Pertuzumab 30 mg/ml desensitization HCPCS J9306 $22,539.60 $37,566.00 $16.02 – $80.10 15
Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 $903.20 $1,244.00 $45.31 – $312.30 13
Pfc sigma fem post aug sz3 8mm HCPCS C1776 $22,916.00 $32,297.00 $16.38 – $81.90 13
Ph body fluid CPT 83986 $63.20 $87.00 $2.00 – $53.77 16
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 $128.80 $161.00 $15.30 – $76.50 14
Phenobarbital therapeutic drug level CPT 80184 $198.40 $273.00 $15.12 – $145.80 16
Phentolaine mesylate inj HCPCS J2760 $1,968.60 $3,281.00 $252.90 – $1,264.50 15
Phenylephrine 10 mg/ml injection solution HCPCS J2371 $0.60 $1.00 $0.00 – $0.01 14
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 $15.00 $25.00 $0.45 – $4.50 14
Phenytoin total therapeutic drug level CPT 80185 $137.60 $190.00 $13.00 – $154.80 16
Phlebotomy therapeutic CPT 99195 $233.60 $322.00 $11.00 – $262.80 16
Phosphorus CPT 84100 $85.60 $118.00 $4.69 – $96.30 16
Phosphorus 24 hour urine CPT 84105 $90.40 $125.00 $5.71 – $71.10 16
Phys blood bank serv reactj CPT 86078 $481.60 $664.00 $41.56 – $541.80 16
Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 $220.80 $368.00 $2.73 – $22.50 14
Pinworm exam CPT 87172 $54.60 $75.00 $3.33 – $61.42 14
Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 $114.00 $190.00 $1.07 – $40.50 14
Place po breast cath for rad CPT 19296 $720.80 $993.00 $162.18 – $8,233.65 14
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 $1,380.00 $1,902.00 $90.85 – $1,552.50 16
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 $1,380.00 $1,902.00 $43.26 – $1,552.50 16
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 $1,144.80 $1,578.00 $77.78 – $1,287.90 16
Placement of seton CPT 46020 not published not published $192.18 – $993.28 8
Platelet aggregation each agent teg CPT 85576 $466.40 $643.00 $24.62 – $524.70 16
Platelet automated CPT 85049 $42.80 $59.00 $3.00 – $48.15 16
Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 $4,912.80 $6,770.00 $33.00 – $5,526.90 15
Platelets pheresis leukocytes reduced each unit HCPCS P9035 $3,282.40 $4,523.00 $379.20 – $3,692.70 13
Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 $3,498.40 $4,822.00 $498.30 – $3,935.70 13
Platelets pheresis pathogen-reduced each unit HCPCS P9073 $2,166.40 $2,985.00 $451.21 – $2,437.20 13
Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 $1,144.80 $1,578.00 $37.38 – $1,287.90 16
Plc pq device breast ea addl lesion stereo guide CPT 19284 $1,958.40 $2,699.00 $43.55 – $2,203.20 16
Plethysmography lung volumes/airway resistance CPT 94726 $282.40 $390.00 $38.96 – $317.70 16
Pms2 gene dup/delet variants CPT 81319 $1,502.40 $1,878.00 $177.33 – $1,690.20 16
Pms2 gene full seq analysis CPT 81317 $1,502.40 $1,878.00 $338.04 – $1,690.20 16
Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 $324.80 $447.00 $25.77 – $172.80 16
Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 $36,544.20 $60,907.00 $78.48 – $392.40 15
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 $7,850.40 $10,819.00 $662.62 – $8,831.70 16
Positioner proc acufex leg acs HCPCS E0190 $51.40 $71.00 $11.56 – $57.83 12
Post op service lvrs min 6 HCPCS G0305 $598.40 $824.00 $134.64 – $673.20 13
Potassium 24 hour urine CPT 84133 $63.20 $87.00 $4.67 – $53.77 16
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 $61.80 $103.00 $0.11 – $0.90 14
Potassium serum/plasma/whole blood CPT 84132 $47.80 $66.00 $4.70 – $53.77 16
Pq dr cath chg w cont s&i CPT 75984 $1,628.80 $2,245.00 $12.80 – $1,832.40 16
Pq thr inj ext pse CPT 36002 $884.00 $1,218.00 $113.66 – $994.50 16
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 $7,427.20 $10,235.00 $200.75 – $8,355.60 16
Pr application of long arm splint CPT 29105 $569.60 $785.00 $36.85 – $993.28 16
Pr application splint static short arm CPT 29125 $569.60 $785.00 $28.60 – $640.80 16
Pr assessment emotional/behavioral per instrument brief CPT 96127 $84.80 $117.00 $4.40 – $95.40 16
Pr biopsy skin punch single lesion CPT 11104 $362.40 $500.00 $44.47 – $993.28 16
Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 $1,059.00 $1,765.00 $86.58 – $1,687.62 14
Pr correction hammertoe CPT 28285 $669.00 $1,115.00 $55.80 – $1,212.16 16
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 $40.20 $52.00 $9.04 – $45.23 14
Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 not published not published $158.09 – $993.28 8
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 $589.80 $983.00 $11.61 – $74.04 16
Pr e&m preventive medicine initial comprehensive new patient 12-17 years CPT 99384 $178.80 $298.00 $25.60 – $140.40 13
Pr ecg 12 lead report only CPT 93010 $42.60 $71.00 $9.60 – $63.90 14
Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 $111.60 $186.00 $28.17 – $167.40 16
Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 $4,078.80 $6,798.00 $792.72 – $3,963.60 14
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 $208.20 $347.00 $62.46 – $312.30 13
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 $4,352.80 $5,999.00 $42.66 – $732.16 16
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 not published not published $88.55 – $2,024.96 8
Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 $1,470.60 $2,451.00 $33.12 – $993.28 14
Pr incision & drainage abscess complicated/multiple CPT 10061 $712.80 $983.00 $57.75 – $768.00 16
Pr incision & drainage abscess simple/single CPT 10060 $589.80 $983.00 $13.54 – $792.32 16
Pr incision & drainage abscess vulva/perineal CPT 56405 $998.40 $1,376.00 $58.86 – $993.28 16
Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 $589.80 $983.00 $21.96 – $994.56 16
Pr management transitional care high w/in 7 days of discharge CPT 99496 $278.40 $464.00 $21.96 – $316.41 14
Pr management transitional care moderate w/in 14 days of discharge CPT 99495 $307.20 $423.00 $57.78 – $288.90 14
Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 $177.60 $245.00 $10.89 – $199.80 16
Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 not published not published $993.28 – $1,230.05 2
Pr planning advance care 1st 30 minutes CPT 99497 $95.40 $159.00 $28.62 – $143.10 13
Pr removal drug delivery implant CPT 11982 $2,048.80 $2,823.00 $53.28 – $993.28 16
Pr removal foreign body external auditory canal without anesthesia CPT 69200 $298.40 $412.00 $33.00 – $622.08 16
Pr removal intrauterine device CPT 58301 $712.80 $983.00 $18.98 – $993.28 15
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 $998.40 $1,376.00 $36.30 – $1,123.20 16
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 $712.80 $983.00 $52.25 – $993.28 16
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 $712.80 $983.00 $34.65 – $801.90 16
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 $712.80 $983.00 $26.95 – $801.90 16
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 $712.80 $983.00 $39.05 – $993.28 16
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 not published not published $730.88 – $1,580.10 2
Pr tube thoracostomy w/connection to drainage open CPT 32551 $2,627.20 $3,620.00 $269.64 – $1,521.90 14
Pralidoxime 1 gram solution for injection HCPCS J2730 $399.60 $666.00 $119.88 – $599.40 13
Prealbumin CPT 84134 $137.60 $190.00 $14.42 – $154.80 16
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 $13.80 $23.00 $0.23 – $6.30 14
Prednisone 1 mg tablet HCPCS J7512 $14.80 $18.50 $0.01 – $0.90 15
Pregnancy Ultrasound (complete, after first trimester) CPT 76805 $835.20 $1,151.00 $59.52 – $939.60 16
Pregnancy Ultrasound (first trimester) CPT 76801 $835.20 $1,151.00 $49.14 – $939.60 16
Pregnancy associated plasma protein-a CPT 84163 $191.20 $264.00 $14.88 – $212.40 16
Prep skin to 100cm2 other CPT 15004 $475.20 $792.00 $54.18 – $993.28 14
Prep skin to 100cm2 trk/ext CPT 15002 not published not published $445.52 – $993.28 2
Pressure max expiratory/inspiratory CPT 94799 $187.20 $258.00 $31.86 – $159.30 13
Pretreat rbc absorption reference CPT 86978 $118.40 $163.00 $26.52 – $133.20 13
Pretreat rbc w chem/drugs reference CPT 86970 $295.20 $406.00 $26.52 – $332.10 13
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 $227.20 $313.00 $51.12 – $255.60 13
Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 $533.60 $667.00 $99.72 – $498.60 15
Procalcitonin CPT 84145 $161.60 $223.00 $22.21 – $181.80 16
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 $115.20 $144.00 $1.81 – $100.80 14
Prochlorperazine maleate 5 mg tablet HCPCS Q0164 $3.00 $5.00 $0.90 – $4.50 13
Proctosigmoidoscopy dilate 45303 CPT 45303 $3,933.60 $5,421.00 $31.14 – $4,425.30 16
Proctosigmoidoscopy dx 45300 CPT 45300 $3,816.80 $5,261.00 $26.10 – $993.28 16
Proctosigmoidoscopy w/bx 45305 CPT 45305 $3,933.60 $5,421.00 $58.30 – $4,425.30 16
Progesterone CPT 84144 $324.80 $447.00 $17.00 – $365.40 16
Prolactin CPT 84146 $372.00 $512.00 $19.15 – $418.50 16
Promethazine hcl injection HCPCS J2550 $8.40 $10.50 $1.62 – $9.00 15
Propofol infusion 10 mg/ml HCPCS J2704 $174.00 $290.00 $0.09 – $0.90 14
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 $4.80 $6.00 $1.08 – $5.40 13
Prostate biopsy, any mthd HCPCS G0416 $118.40 $163.00 $26.64 – $253.07 13
Protamine 10 mg/ml intravenous solution HCPCS J2720 $115.20 $192.00 $1.26 – $6.30 14
Protein c activity CPT 85303 $375.20 $517.00 $13.68 – $356.40 16
Protein electrophoretic fractionation & quantitation serum CPT 84165 $207.20 $286.00 $10.62 – $233.10 16
Protein s total CPT 85305 $666.40 $919.00 $11.47 – $203.40 16
Protein total 24 hour urine CPT 84156 $45.00 $62.00 $3.63 – $50.62 16
Protein total body fluid CPT 84157 $100.00 $138.00 $3.96 – $112.50 16
Protein total serum plasma whole blood CPT 84155 $104.00 $144.00 $3.63 – $117.00 16
Prothrombin complex kcentra HCPCS J7168 $13.80 $17.25 $2.14 – $15.30 14
Prothrombin time substitution plasma fractions each CPT 85611 $230.40 $317.00 $3.90 – $259.20 16
Prp i/hern init block >5 yr CPT 49507 not published not published $993.28 – $1,222.76 2
Psychotherapy patient individual therapy 30 minutes CPT 90832 $128.00 $176.00 $28.60 – $144.00 16
Psychotherapy patient individual therapy 45 minutes CPT 90834 $128.00 $176.00 $28.80 – $144.00 16
Psychotherapy patient individual therapy 60 minutes CPT 90837 $128.00 $176.00 $28.80 – $166.92 16
Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 $124.80 $172.00 $16.20 – $140.40 14
Pt application of modality >=1 area hot/cold packs CPT 97010 $47.00 $64.00 $10.57 – $52.88 14
Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 $124.80 $172.00 $16.97 – $140.40 14
Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 $122.40 $169.00 $13.38 – $137.70 14
Pt application of modality traction mechanical CPT 97012 $124.80 $172.00 $16.76 – $140.40 14
Pt evaluation high complexity patient/family CPT 97163 $238.40 $329.00 $53.64 – $268.20 14
Pt evaluation low complexity patient/family CPT 97161 $238.40 $329.00 $53.64 – $268.20 14
Pt evaluation moderate complexity patient/family CPT 97162 $238.40 $329.00 $32.42 – $268.20 14
Pt re-evaluation patient/family CPT 97164 $117.60 $162.00 $26.46 – $132.30 16
Pt repositioning canalith procedure(s) per day CPT 95992 $269.60 $372.00 $28.31 – $303.30 13
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 $137.60 $190.00 $9.52 – $154.80 13
Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 $157.60 $217.00 $9.22 – $177.30 16
Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 $157.60 $217.00 $18.43 – $177.30 16
Pt wheelchair management each 15 minutes CPT 97542 $200.00 $276.00 $25.14 – $225.00 14
Pulmonary vent imaging CPT 78579 $1,697.60 $2,339.00 $141.75 – $1,909.80 16
Pulse ox continuous overnight monitoring CPT 94762 $365.60 $504.00 $82.26 – $411.30 14
Pulse ox multiple CPT 94761 $469.60 $647.00 $4.25 – $503.10 16
Pulse ox single CPT 94760 $75.80 $104.00 $2.18 – $81.00 16
Puncture arterial withdrawal blood for diagnosis CPT 36600 $105.60 $146.00 $13.00 – $118.80 16
Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 $1,352.80 $1,865.00 $26.40 – $993.28 16
Puncture spinal lumbar diagnostic CPT 62270 $1,470.60 $2,451.00 $46.20 – $1,138.50 16
Pyridoxine hcl 100 mg HCPCS J3415 $70.20 $117.00 $4.14 – $20.70 14
Pyruvate CPT 84210 $328.00 $453.00 $8.00 – $369.00 16
Quant diff pulm perf and vent w/imaging CPT 78598 $3,736.00 $5,149.00 $245.43 – $4,203.00 16
Quant diff pulm perf w/imaging CPT 78597 $1,362.40 $1,877.00 $151.94 – $1,532.70 16
Quest t3 uptake CPT 84479 $357.60 $492.00 $6.39 – $181.80 16
Rabies ig heat-treated human im/subq 90376 CPT 90376 $3,289.80 $5,483.00 $11.00 – $4,934.70 16
Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 $15,010.80 $25,018.00 $11.00 – $961.20 16
Radium ra223 dichl ther/uci HCPCS A9606 $464.80 $641.00 $104.58 – $522.90 12
Radphm lcl tmr plnr bdy sgl day img CPT 78802 $1,645.60 $2,268.00 $89.60 – $1,851.30 16
Radphm lcl tmr plnr bdy two day img CPT 78804 $2,886.40 $3,977.00 $394.09 – $3,247.20 16
Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 $3,347.20 $4,613.00 $609.33 – $3,765.60 16
Radphm lcl tomogr sgl area sgl day CPT 78803 $3,347.20 $4,613.00 $284.40 – $3,765.60 16
Radphm lcl tumor plr sgl day CPT 78800 $930.40 $1,282.00 $70.40 – $1,046.70 16
Radphm quant measure sgl area add-on CPT 78835 $3,347.20 $4,613.00 $80.00 – $3,765.60 16
Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 $5,140.20 $8,567.00 $74.36 – $387.90 15
Rapid Strep Test CPT 87880 $36.00 $49.00 $6.30 – $40.50 16
Rasburicase 1.5 mg intravenous solution HCPCS J2783 $3,833.40 $6,389.00 $377.52 – $1,917.00 15
Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 $14,859.00 $24,765.00 $148.50 – $742.50 15
Rbc count only automated CPT 85041 $21.40 $29.00 $2.98 – $22.95 16
Rbc serum pretx incubj drugs CPT 86975 $229.60 $316.00 $51.66 – $294.81 13
Reconstruct shoulder joint CPT 23472 not published not published $993.28 – $4,297.36 2
Red blood cells each unit HCPCS P9021 $919.20 $1,266.00 $33.00 – $629.10 16
Red blood cells leukocytes reduced each unit HCPCS P9016 $1,242.40 $1,713.00 $147.74 – $1,397.70 14
Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 $1,438.40 $1,982.00 $202.32 – $1,618.20 13
Red cell sequestration CPT 78140 $3,163.20 $4,360.00 $24.32 – $3,558.60 16
Release of foot tendon 28225 CPT 28225 not published not published $116.05 – $993.28 8
Release palm contracture CPT 26123 not published not published $993.28 – $1,802.45 2
Rem/biv cast full arm/leg CPT 29705 $569.60 $785.00 $128.16 – $640.80 13
Remdesivir 100 mg intravenous powder for solution HCPCS J0248 $16.00 $20.00 $3.60 – $18.00 15
Remote 30 day ecg tech supp CPT 93229 $1,580.00 $2,178.00 $113.55 – $1,777.50 13
Removal central venous catheter tunneled without port/pump CPT 36589 $2,627.20 $3,620.00 $73.44 – $993.28 14
Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 $3,725.60 $5,135.00 $101.70 – $993.28 16
Removal cerumen impacted (both sides) CPT 69210 $247.20 $412.00 $7.65 – $993.28 14
Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 $712.80 $983.00 $29.70 – $801.90 15
Removal embedded foreign body vestibule mouth smpl CPT 40804 $2,137.60 $2,946.00 $33.55 – $2,404.80 16
Removal foreign body foot subcutaneous right CPT 28190 $1,778.40 $2,451.00 $33.55 – $2,000.70 16
Removal of adenoids CPT 42830 not published not published $417.01 – $793.60 2
Removal of foot lesion CPT 28080 $644.40 $1,074.00 $54.18 – $997.12 16
Removal of foot lesion CPT 28090 not published not published $169.95 – $1,134.08 8
Removal of heel bone CPT 28118 not published not published $1,064.96 – $1,145.96 2
Removal of heel spur CPT 28119 not published not published $317.90 – $1,064.96 8
Removal of hydrocele CPT 55040 not published not published $952.75 – $1,066.24 2
Removal of implant deep CPT 20680 $744.60 $1,241.00 $90.36 – $921.60 16
Removal of skin tags each add'l 10 CPT 11201 $396.00 $546.00 $8.82 – $44.10 16
Removal of tendon lesion CPT 27630 $639.60 $1,066.00 $77.76 – $1,045.76 16
Removal of toe lesions CPT 28092 $476.40 $794.00 $39.78 – $1,053.44 16
Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 $471.00 $785.00 $9.63 – $993.28 16
Removal sutr and stapl no anes CPT 15854 $39.00 $65.00 $11.70 – $58.50 14
Removal sutr or stapl no anes CPT 15853 $3,927.20 $4,909.00 $8.28 – $41.40 14
Removal w/reinsrt nonbiogrdble CPT 11983 $2,071.20 $2,854.00 $95.40 – $477.00 16
Remove anal fist subq CPT 46270 not published not published $233.75 – $928.00 8
Remove epididymis lesion CPT 54840 not published not published $902.40 – $946.77 2
Remove ext hem groups 2+ CPT 46250 not published not published $142.45 – $948.48 8
Remove foreign body from eye CPT 65235 $4,494.00 $7,490.00 $993.28 – $6,741.00 14
Remove in/ex hem groups 2+ CPT 46260 not published not published $369.60 – $1,348.46 8
Remove pilonidal cyst compl CPT 11772 not published not published $256.30 – $1,100.89 8
Remove pilonidal cyst exten CPT 11771 not published not published $256.30 – $1,072.64 8
Remove tonsils and adenoids CPT 42820 not published not published $635.33 – $888.32 2
Remove tonsils and adenoids CPT 42821 not published not published $764.89 – $896.00 2
Remove wrist tendon lesion CPT 25111 not published not published $632.45 – $1,093.12 2
Renal function panel CPT 80069 $188.80 $260.00 $8.58 – $212.40 16
Reopen fallopian tube CPT 58350 not published not published $163.62 – $3,619.10 2
Repair blood vessel dir lower extr CPT 35226 $1,582.20 $2,637.00 $474.66 – $2,373.30 14
Repair blood vessel direct hand finger CPT 35207 $7,133.40 $11,889.00 $726.32 – $10,700.10 16
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 $2,627.20 $3,620.00 $577.06 – $2,955.60 14
Repair deformity of toe CPT 28313 $624.60 $1,041.00 $52.92 – $993.28 16
Repair dental ellis ii fx CPT 41899 $278.40 $383.00 $62.64 – $313.20 13
Repair of achilles tendon CPT 27654 not published not published $524.70 – $1,970.19 8
Repair of ankle ligament CPT 27695 not published not published $993.28 – $1,679.39 2
Repair of eye wound CPT 65280 $8,442.40 $11,635.00 $566.69 – $9,497.70 16
Repair of foot tendon CPT 28200 not published not published $260.70 – $993.28 8
Repair of shoulder CPT 23420 not published not published $636.90 – $2,666.90 8
Repair of thigh muscle CPT 27385 not published not published $535.15 – $1,604.02 8
Repair rotator cuff acute CPT 23410 not published not published $492.80 – $2,215.83 8
Repair rotator cuff chronic CPT 23412 not published not published $636.90 – $2,539.58 8
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 $5,218.40 $7,191.00 $95.15 – $5,870.70 16
Repair rpr lip full thickness vermilion only CPT 40650 $4,051.20 $5,583.00 $273.82 – $4,557.60 16
Repair shoulder capsule CPT 23455 not published not published $595.10 – $2,867.06 8
Repair tendon extensor foot 1/2 each tendon CPT 28208 not published not published $261.80 – $993.28 8
Repair tendon/muscle forearm/wrist prime sngl ea CPT 25260 $6,096.00 $10,160.00 $399.30 – $9,144.00 16
Repair/graft achilles tendon CPT 27652 not published not published $993.28 – $2,029.06 2
Replace duod/jej tube perc CPT 49451 $2,260.00 $3,114.00 $77.36 – $2,542.50 16
Replace g/c tube perc CPT 49450 $3,755.20 $5,175.00 $35.64 – $1,150.09 16
Reptilase test CPT 85635 $105.60 $146.00 $6.00 – $118.80 16
Rerepair ing hernia reduce CPT 49520 $8,618.40 $11,878.00 $475.20 – $9,695.70 16
Resp virus 6-11 targets CPT 87632 $1,237.80 $2,063.00 $215.52 – $1,856.70 16
Resuscitation cardiopulmonary CPT 92950 $729.60 $1,006.00 $164.16 – $820.80 13
Reticulocyte automated CPT 85045 $91.20 $126.00 $3.95 – $102.60 16
Revise arm/leg nerve CPT 64708 not published not published $993.28 – $1,282.23 2
Revise hip joint replacement CPT 27134 not published not published $1,280.00 – $6,363.81 2
Revise vag graft via vagina CPT 57295 $6,759.20 $9,315.00 $247.14 – $1,235.70 14
Revise/replace knee joint CPT 27486 not published not published $993.28 – $5,048.80 2
Revision of knee joint CPT 27442 not published not published $749.65 – $2,788.99 8
Rheumatoid factor qualitative CPT 86430 $90.40 $125.00 $6.07 – $101.70 16
Rheumatoid factor quantitative CPT 86431 $171.20 $236.00 $5.61 – $127.80 16
Rho d immune globulin inj HCPCS J2790 $728.80 $911.00 $82.58 – $819.90 14
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 $163.20 $204.00 $4.86 – $183.60 14
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 $0.20 $0.25 $0.05 – $0.23 14
Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 $26.40 $33.00 $5.94 – $29.70 15
Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 $4,199.40 $6,999.00 $10.98 – $1,239.37 16
Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 $218.40 $364.00 $36.69 – $327.60 15
Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 $4,351.20 $7,252.00 $75.22 – $652.50 15
Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 $265.80 $443.00 $29.38 – $398.70 14
Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 $199.80 $333.00 $27.84 – $224.10 14
Rmv implant contraceptive capsule 11976 CPT 11976 $2,633.60 $3,630.00 $33.55 – $246.60 15
Rmvl ext fixj sys under anes CPT 20694 not published not published $615.88 – $993.28 2
Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 $1,778.40 $2,451.00 $33.55 – $2,000.70 16
Rmvl ninfct mesh hernia rpr 49623 CPT 49623 not published not published $198.35 – $199.10 2
Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 $197.60 $247.00 $30.78 – $222.30 15
Romiplostim 125 mcg subcutaneous solution HCPCS J2802 $44.60 $55.75 $4.72 – $23.62 15
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 $8,542.20 $14,237.00 $5.76 – $28.80 15
Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 $178.80 $298.00 $0.05 – $0.90 14
Rp loclzj tum 2+area 1+d img CPT 78801 $2,779.20 $3,830.00 $75.52 – $3,126.60 16
Rp loclzj tum spect w/ct 1 CPT 78830 $3,347.20 $4,613.00 $416.61 – $3,765.60 16
Rp loclzj tum spect w/ct 2 CPT 78832 $3,796.80 $5,232.00 $792.37 – $4,271.40 16
Rpl non-tun cvc wo sbq prt/pmp CPT 36580 $2,759.20 $3,802.00 $547.03 – $3,104.10 14
Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 not published not published $751.37 – $993.28 2
Rpr aa hrn 1st 3-10 rdc CPT 49593 not published not published $577.00 – $993.28 2
Rpr aa hrn 1st < 3 cm rdc CPT 49591 not published not published $344.03 – $993.28 2
Rpr aa hrn 1st < 3 ncr/strn CPT 49592 not published not published $478.93 – $993.28 2
Rpr aa hrn 1st > 10 rdc CPT 49595 not published not published $775.87 – $993.28 2
Rpr aa hrn rcr < 3 ncr/strn CPT 49614 not published not published $575.68 – $993.28 2
Rpr fem hernia init blocked CPT 49553 not published not published $993.28 – $1,138.46 2
Rsv assay w/optic CPT 87807 $13.60 $18.00 $3.06 – $18.56 16
Rubella antibody igg CPT 86762 $157.60 $217.00 $14.22 – $165.60 16
Rubeola antibody igg CPT 86765 $265.60 $366.00 $11.80 – $298.80 16
Russell viper venom diluted CPT 85613 $751.20 $1,035.00 $9.47 – $576.90 16
Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 $67.20 $112.00 $19.98 – $99.90 15
Salivary glnd img serial img CPT 78231 $1,960.80 $2,703.00 $44.80 – $2,205.90 16
Sarscov coronavirus ag ia CPT 87426 $46.40 $58.00 $10.44 – $52.69 16
Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 $1,530.40 $2,109.00 $152.76 – $1,721.70 16
Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 $1,262.40 $1,740.00 $100.61 – $1,420.20 16
Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 $1,127.20 $1,553.00 $100.61 – $1,268.10 16
Scan duplex extracranial arteries unilateral/limited study CPT 93882 $1,041.60 $1,435.00 $151.88 – $1,171.80 16
Scan duplex extremity veins unilateral/limited study CPT 93971 $1,002.40 $1,382.00 $100.61 – $1,127.70 16
Scan duplex lower extremity arteries complete bilateral CPT 93925 $2,029.60 $2,797.00 $152.76 – $2,283.30 16
Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 $1,192.80 $1,644.00 $100.61 – $1,341.90 16
Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 $1,127.20 $1,553.00 $100.61 – $1,268.10 16
Scope plantar fasciotomy CPT 29893 not published not published $846.45 – $993.28 2
Scr c/v cyto,thinlayer,rescr HCPCS G0145 $104.00 $137.00 $20.68 – $115.20 13
Screen cerv/vag thin layer HCPCS G0123 $81.60 $107.00 $15.82 – $91.80 13
Screening Colonoscopy (average risk) HCPCS G0121 not published not published $648.87 – $648.87 1
Screening Colonoscopy (high risk) HCPCS G0105 $2,000.00 $2,625.00 $450.00 – $2,250.00 13
Screening Mammogram CPT 77067 $273.60 $377.00 $61.56 – $307.80 15
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 $292.00 $402.00 $18.22 – $328.50 15
Screening hepatitis b non-obstetric high risk HCPCS G0499 $172.00 $237.00 $19.00 – $193.50 15
Screening hepatitis c antibody high risk HCPCS G0472 $251.20 $347.00 $19.00 – $282.60 15
Screening prostate cancer PSA HCPCS G0103 $120.00 $168.00 $15.08 – $135.00 13
Screw cortex 2.0 x 10mm HCPCS C1713 $9,627.20 $13,268.00 $1.44 – $7.20 13
Sedimentation rate erythrocyte automated CPT 85652 $69.60 $95.00 $2.67 – $78.30 16
Semen analysis presence/motility CPT 89321 $143.20 $197.00 $9.41 – $161.10 14
Semen analysis w/count CPT 89310 $213.60 $294.00 $6.72 – $240.30 14
Serpina1 gene CPT 81332 $351.20 $439.00 $43.14 – $376.20 16
Sgmdsc w/band ligation CPT 45350 $3,933.60 $5,421.00 $885.06 – $4,425.30 13
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 $83.40 $139.00 $14.22 – $855.04 16
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 $1,024.80 $1,412.00 $34.74 – $855.04 16
Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 $494.40 $681.00 $21.06 – $855.04 16
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 $494.40 $681.00 $27.72 – $855.04 16
Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 $1,024.80 $1,412.00 $18.72 – $855.04 16
Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 $1,024.80 $1,412.00 $28.08 – $855.04 16
Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 $1,444.00 $1,990.00 $33.30 – $855.04 16
Sho arthrs srg capsulorraphy CPT 29806 not published not published $846.09 – $1,883.80 8
Sho arthrs srg lmtd dbrdmt CPT 29822 not published not published $561.93 – $1,683.77 8
Shoe post-op mens m HCPCS L3260 $75.60 $94.50 $17.01 – $85.05 12
Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 not published not published $993.28 – $1,952.98 2
Shoulder MRI (with and without contrast) CPT 73223 $4,850.40 $6,684.00 $604.71 – $5,456.70 14
Shoulder MRI (with contrast) CPT 73222 $3,689.60 $5,085.00 $393.92 – $4,150.80 14
Shoulder MRI (without contrast) CPT 73221 $3,040.00 $4,190.00 $344.32 – $3,420.00 14
Shoulder X-ray CPT 73030 $372.00 $512.00 $21.12 – $418.50 14
Shunt glaucoma baerveldt 350mm HCPCS C1783 $6,739.20 $9,287.00 $491.94 – $2,459.70 13
Sialography s&i CPT 70390 $1,552.00 $2,139.00 $26.88 – $1,746.00 16
Sickling rbc CPT 85660 $98.40 $135.00 $3.00 – $110.70 16
Sig w/tndsc balloon dilation CPT 45340 $3,933.60 $5,421.00 $109.36 – $4,425.30 16
Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 $3,816.80 $5,261.00 $104.10 – $4,293.90 16
Sigmoidoscopy and biopsy CPT 45331 $3,816.80 $5,261.00 $70.04 – $4,293.90 16
Sigmoidoscopy flex decompression 45337 CPT 45337 $3,933.60 $5,421.00 $135.27 – $4,425.30 16
Sigmoidoscopy for bleeding CPT 45334 $3,933.60 $5,421.00 $123.20 – $4,425.30 16
Sigmoidoscopy w/ablation CPT 45346 $3,933.60 $5,421.00 $885.06 – $4,425.30 13
Sigmoidoscopy w/fb removal 45332 CPT 45332 $3,933.60 $5,421.00 $55.00 – $4,425.30 16
Sigmoidoscopy w/plcmt stent CPT 45347 $7,896.80 $10,883.00 $993.28 – $8,883.90 13
Sigmoidoscopy w/tumr remove CPT 45338 $3,933.60 $5,421.00 $134.15 – $4,425.30 16
Sigmoidoscopy w/ultrasound CPT 45341 $3,933.60 $5,421.00 $147.92 – $4,425.30 16
Sigmoidoscopy w/us guide bx CPT 45342 $3,933.60 $5,421.00 $219.74 – $4,425.30 16
Sigmoidoscopy/submucosal injection 45335 CPT 45335 not published not published $86.52 – $993.28 8
Signal avg ecg w or without ecg 93278 CPT 93278 $536.00 $739.00 $27.56 – $603.00 15
Simple cystometrogram 51725 CPT 51725 $4,291.20 $5,914.00 $46.75 – $993.28 16
Sincalide 5 mcg solution for injection HCPCS J2805 $516.00 $645.00 $116.10 – $580.50 14
Sinus CT scan (with and without contrast) CPT 70488 $3,280.80 $4,521.00 $128.00 – $3,690.90 16
Sinus CT scan (with contrast) CPT 70487 $2,612.80 $3,600.00 $102.40 – $2,939.40 16
Sinus CT scan (without contrast) CPT 70486 $1,924.00 $2,651.00 $99.20 – $2,164.50 16
Sirolimus, oral HCPCS J7520 $180.00 $225.00 $0.87 – $202.50 15
Skin Biopsy CPT 11102 $362.40 $500.00 $35.45 – $993.28 16
Skyla, 13.5 mg HCPCS J7301 $2,325.00 $3,875.00 $697.50 – $3,487.50 14
Sleep Study (Polysomnography) CPT 95810 $6,611.20 $9,111.00 $346.01 – $7,437.60 16
Sleep study attended CPT 95807 $6,004.00 $8,274.00 $360.95 – $6,754.50 16
Sleep study unattended CPT 95806 $653.60 $901.00 $113.55 – $735.30 14
Sling arm deluxe w/pad xs HCPCS A4565 $244.00 $336.00 $7.74 – $38.70 13
Sling suprapubic suburetheral HCPCS C1771 $4,885.60 $6,733.00 $703.98 – $3,519.90 13
Slitting of prepuce CPT 54001 $4,708.80 $6,489.00 $52.80 – $5,297.40 16
Slp eval non-spch gen comm dev CPT 92605 $375.20 $517.00 $67.20 – $422.10 13
Slp pure tone screening CPT 92551 $22.80 $38.00 $2.88 – $14.40 15
Sm-153 lexidron ther HCPCS A9604 $15,008.80 $20,684.00 $3,376.98 – $16,884.90 12
Small bowel endoscopy CPT 44360 $4,128.80 $5,690.00 $149.01 – $4,644.90 16
Small bowel endoscopy CPT 44364 $4,128.80 $5,690.00 $210.00 – $4,644.90 16
Small bowel endoscopy CPT 44366 $4,128.80 $5,690.00 $228.25 – $4,644.90 16
Small bowel endoscopy CPT 44369 $4,128.80 $5,690.00 $228.25 – $4,644.90 16
Small bowel endoscopy CPT 44382 $4,264.00 $5,877.00 $76.74 – $4,797.00 16
Small bowel endoscopy >2nd w/remove 44363 CPT 44363 $4,128.80 $5,690.00 $197.48 – $4,644.90 16
Small bowel endoscopy br/wa CPT 44380 $4,264.00 $5,877.00 $64.44 – $4,797.00 16
Small bowel endoscopy br/wa CPT 44381 $4,128.80 $5,690.00 $928.98 – $4,644.90 13
Small bowel endoscopy/stent 44370 CPT 44370 $7,896.80 $10,883.00 $460.56 – $8,883.90 14
Smear fluorescent and/or acid fast stain CPT 87206 $111.20 $153.00 $3.00 – $101.70 16
Smear gram stain CPT 87205 $111.20 $153.00 $4.22 – $82.80 16
Smear nasal eosinophil CPT 89190 $122.40 $169.00 $5.72 – $137.70 16
Smear special stain inclusion bodies/parasites CPT 87207 $235.20 $324.00 $4.50 – $264.60 16
Smear wet mount CPT 87210 $135.20 $186.00 $5.75 – $96.30 16
Sodium 24 hour urine CPT 84300 $74.20 $102.00 $5.01 – $53.77 16
Sodium chloride 0.9 % IV bolus HCPCS J7040 $22.20 $27.75 $1.26 – $13.50 14
Sodium chloride 0.9 % IV bolus HCPCS J7050 $32.40 $42.00 $0.65 – $13.50 14
Sodium chloride 0.9 % intravenous solution HCPCS J7030 $26.00 $38.00 $0.00 – $20.70 15
Sodium chloride 3 % ivpb HCPCS J7131 $26.40 $44.00 $0.18 – $0.90 13
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 $147.60 $246.00 $2.02 – $44.10 14
Sodium serum/plasma/whole blood CPT 84295 $47.80 $66.00 $4.76 – $53.77 16
Specific gravity body fluid CPT 84315 $52.00 $71.00 $2.56 – $58.50 14
Speech evaluation complex CPT 70371 $1,175.20 $1,619.00 $61.98 – $1,322.10 16
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 $1,644.80 $2,267.00 $80.72 – $1,850.40 16
Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 $636.80 $878.00 $14.59 – $716.40 16
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 $656.00 $904.00 $147.60 – $738.00 14
Splint extn xsm w sof-stretch rolyan HCPCS L3925 $130.40 $180.00 $29.34 – $146.70 15
Splint fing stax assort 1-7in HCPCS Q4049 $24.80 $31.00 $5.58 – $27.90 13
Splint func pos polyflex ii med HCPCS L3999 $169.60 $212.00 $38.16 – $190.80 12
Splint rstrc wrst/cmc right med HCPCS L3923 $148.00 $204.00 $26.61 – $166.50 14
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 not published not published $723.20 – $2,357.48 2
Sr-89 stront chlor ther / mci HCPCS A9600 $2,773.60 $3,822.00 $624.06 – $3,120.30 12
St analysis behavior qualitative voice/resonance CPT 92524 $375.20 $517.00 $84.42 – $422.10 14
St cognitve performance testing healthcare professional each hour CPT 96125 $474.40 $654.00 $77.54 – $533.70 14
St evaluate speech sound production CPT 92522 $375.20 $517.00 $84.42 – $422.10 14
St evaluate speech sound production comprehensive/expressive CPT 92523 $375.20 $517.00 $84.42 – $422.10 14
St evaluation motion fluoroscopic swallow function cine/video CPT 92611 $301.60 $416.00 $46.55 – $339.30 16
St evaluation swallow function CPT 92610 $301.60 $416.00 $42.79 – $339.30 16
St treatment speech individual CPT 92507 $217.60 $300.00 $23.87 – $244.80 16
St treatment swallow dysfunction/oral CPT 92526 $216.80 $299.00 $48.78 – $243.90 14
Stent axios caut enh 15x10mm electrocaut HCPCS C1874 $11,702.40 $16,127.00 $1,446.84 – $7,234.20 13
Stent bili dbl pgtl 10fx5cm HCPCS C2617 $577.60 $796.00 $32.58 – $162.90 13
Stent bili rx wallflx 10x80 uncvr HCPCS C1876 $7,876.80 $10,855.00 $748.44 – $3,742.20 13
Strapping of ankle and/or ft 29540 CPT 29540 $315.60 $526.00 $9.54 – $75.17 16
Strapping of elbow or wrist 29260 CPT 29260 $569.60 $785.00 $34.52 – $640.80 16
Strapping of knee CPT 29530 $295.20 $406.00 $28.05 – $332.10 16
Strapping of toes 29550 CPT 29550 $28.20 $38.00 $6.12 – $61.49 16
Strep a ag ia CPT 87430 $92.80 $128.00 $6.30 – $104.40 16
Strep b dna amp probe CPT 87653 $129.60 $170.00 $29.16 – $145.80 16
Stress test pulmonary CPT 94618 $789.60 $1,088.00 $11.08 – $846.00 16
Stress tte complete CPT 93351 $2,406.40 $3,316.00 $152.59 – $2,707.20 16
Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 $69.60 $116.00 $1.98 – $9.90 13
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 $0.40 $0.50 $0.05 – $0.45 14
Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 $148.00 $185.00 $33.30 – $166.50 14
Support clav 29.6-40.5in med HCPCS L3650 $218.40 $301.00 $49.14 – $245.70 15
Surg dx exam anorectal CPT 45990 not published not published $168.51 – $993.28 2
Surgical pathology level 1 gross examination only CPT 88300 $58.20 $80.00 $1.92 – $65.47 16
Surgical pathology level 2 gross & microscopic examination CPT 88302 $228.80 $315.00 $6.40 – $257.40 16
Surgical pathology level 3 gross & microscopic examination CPT 88304 $256.80 $354.00 $8.32 – $288.90 16
Surgical pathology level 4 gross & microscopic examination CPT 88305 $302.40 $417.00 $11.52 – $340.20 16
Surgical pathology level 5 gross & microscopic examination CPT 88307 $493.60 $680.00 $14.72 – $555.30 16
Surgical pathology level 6 gross & microscopic examination CPT 88309 $748.80 $1,032.00 $22.40 – $842.40 16
Suscept studies macrobroth dilution ea CPT 87188 $104.80 $145.00 $6.00 – $117.90 16
Susceptibility agar dilution per agent CPT 87181 $111.20 $153.00 $4.70 – $125.10 16
Susceptibility enzyme detection per enzyme CPT 87185 $20.40 $28.00 $4.59 – $22.95 16
Susceptibility mic per plate CPT 87186 $224.80 $310.00 $8.00 – $252.90 16
Synvisc or synvisc-one HCPCS J7325 $72.00 $120.00 $7.95 – $108.00 15
Syphilis test non-treponemal antibody quantitative rpr CPT 86593 $92.80 $128.00 $4.34 – $104.40 16
System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 $8,429.60 $11,617.00 $1,896.66 – $9,483.30 13
T cells absolute cd 4 count CPT 86361 $174.40 $240.00 $26.46 – $196.20 16
T cells absolute cd4/cd8 including ratio CPT 86360 $136.00 $188.00 $30.60 – $153.00 16
T cells total count CPT 86359 $136.00 $188.00 $30.60 – $153.00 16
T3 (triiodothyronine) free CPT 84481 $166.40 $229.00 $16.74 – $187.20 16
T3 (triiodothyronine) total CPT 84480 $268.80 $371.00 $8.00 – $302.40 16
T4 (thyroxine) free CPT 84439 $362.40 $500.00 $8.00 – $140.40 16
T4 (thyroxine) total CPT 84436 $100.00 $138.00 $6.79 – $112.50 16
Tacrol envarsus ex rel oral HCPCS J7503 $3.40 $4.25 $0.77 – $3.83 14
Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 $27.60 $34.50 $0.17 – $15.30 15
Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 $1,588.00 $1,985.00 $263.15 – $1,786.50 15
Tacrolimus therapeutic drug level CPT 80197 $333.60 $460.00 $13.56 – $243.00 16
Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 $14.80 $18.50 $3.33 – $16.65 13
Target gsa panel hmtlmph neop CPT 81450 $3,743.20 $4,679.00 $180.00 – $916.29 16
Target gsa panel organ/hmtlmph neop CPT 81455 $5,631.60 $9,386.00 $1,689.48 – $8,447.40 16
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 $797.40 $1,329.00 $54.00 – $270.00 16
Tb test cell mediated immunity antigen response gamma interferon CPT 86480 $252.80 $349.00 $56.88 – $284.40 16
Tc-99m apcitide diag HCPCS A9504 $2,130.40 $2,936.00 $479.34 – $2,396.70 12
Tc-99m arcitumomab HCPCS A9568 $3,364.00 $4,636.00 $756.90 – $3,784.50 12
Tc-99m bicisate HCPCS A9557 $844.00 $1,163.00 $189.90 – $949.50 12
Tc-99m depreotide HCPCS A9536 $252.80 $349.00 $56.88 – $284.40 12
Tc-99m disofenin HCPCS A9510 $72.40 $99.00 $16.29 – $81.45 12
Tc-99m exametazime diag HCPCS A9521 $867.20 $1,195.00 $195.12 – $975.60 12
Tc-99m fanolesomab diag HCPCS A9566 $4,710.40 $6,491.00 $1,059.84 – $5,299.20 12
Tc-99m labeled rbc HCPCS A9560 $177.60 $245.00 $39.96 – $199.80 12
Tc-99m maa HCPCS A9540 $161.60 $223.00 $36.36 – $181.80 12
Tc-99m mebrofenin HCPCS A9537 $353.60 $487.00 $79.56 – $397.80 12
Tc-99m medronate HCPCS A9503 $47.80 $66.00 $10.76 – $53.77 12
Tc-99m mertiatide HCPCS A9562 $857.60 $1,182.00 $192.96 – $964.80 12
Tc-99m non-heu per study dose HCPCS Q9969 $20.00 $32.00 $4.50 – $22.50 12
Tc-99m oxidronate HCPCS A9561 $54.20 $74.00 $12.20 – $60.98 12
Tc-99m pentetate dtpa HCPCS A9539 $67.40 $93.00 $15.16 – $75.83 12
Tc-99m pentetate dtpa aerosol HCPCS A9567 $236.80 $327.00 $53.28 – $266.40 12
Tc-99m pertechnetate per mci HCPCS A9512 $72.40 $99.00 $16.29 – $81.45 12
Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 $152.00 $210.00 $34.20 – $171.00 12
Tc-99m sestamibi p study dose HCPCS A9500 $287.20 $396.00 $64.62 – $323.10 12
Tc-99m succimer (dmsa) HCPCS A9551 $672.80 $927.00 $151.38 – $756.90 12
Tc-99m sulfur colloid HCPCS A9541 $191.20 $264.00 $43.02 – $215.10 12
Tc-99m tetrofosmin p study dose HCPCS A9502 $617.60 $852.00 $138.96 – $694.80 12
Telehealth original site facility fee HCPCS Q3014 $120.00 $158.00 $20.12 – $135.00 13
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 $8,196.60 $13,661.00 $26.71 – $491.40 15
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 $27,148.20 $45,247.00 $162.72 – $813.60 15
Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 not published not published $91.30 – $993.28 8
Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 $111.20 $139.00 $7.39 – $125.10 14
Test stress cardiovascular tracing only CPT 93017 $1,957.60 $2,697.00 $25.92 – $141.67 16
Testicular imaging w/vasc flow CPT 78761 $1,443.20 $1,989.00 $121.60 – $1,623.60 16
Tetanus immune globulin inj HCPCS J1670 $2,306.40 $3,844.00 $293.58 – $1,467.90 15
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 $48.80 $61.00 $10.98 – $54.90 15
Theophylline therapeutic drug level CPT 80198 $198.40 $273.00 $11.00 – $223.20 16
Ther nma rdctj intus/obstrcj CPT 74283 $1,674.40 $2,308.00 $28.80 – $1,883.70 16
Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 $42.60 $53.25 $1.82 – $23.40 15
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 $1,542.40 $2,371.00 $347.04 – $1,735.20 14
Thrombin time CPT 85670 $98.40 $135.00 $5.70 – $110.70 16
Thromboplastin time partial (ptt) substitution fractions each CPT 85732 $128.00 $176.00 $6.39 – $144.00 16
Thyroglobulin antibody CPT 86800 $253.60 $350.00 $15.73 – $271.80 16
Thyroid (TSH) Test CPT 84443 $542.40 $748.00 $16.60 – $249.30 16
Thyroid Ultrasound CPT 76536 $781.60 $1,077.00 $65.25 – $879.30 16
Thyroid imaging CPT 78013 $1,510.40 $2,081.00 $169.87 – $1,699.20 16
Thyroid met imaging CPT 78015 $1,051.20 $1,449.00 $54.40 – $1,182.60 16
Thyroid mets imag whole body CPT 78018 $3,900.80 $5,376.00 $72.32 – $4,388.40 16
Thyroid uptake measurement CPT 78012 $1,076.00 $1,483.00 $67.32 – $1,210.50 16
Thyroxine binding globulin (tbg) CPT 84442 $251.20 $347.00 $10.00 – $282.60 16
Tigecycline injection HCPCS J3243 $724.80 $1,208.00 $0.39 – $21.60 14
Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 $306.00 $510.00 $91.80 – $459.00 15
Tissue culture skin/biopsy CPT 88233 $1,571.20 $2,165.00 $139.08 – $1,767.60 16
Tissue culture tumor CPT 88239 $2,394.40 $3,300.00 $145.80 – $2,693.70 16
Tissue exam koh skin/hair/nails CPT 87220 $85.60 $118.00 $3.90 – $96.30 16
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 $4,244.40 $7,074.00 $567.90 – $2,839.50 13
Tissue transglutaminase iga CPT 86364 $329.60 $455.00 $9.00 – $352.80 14
Tl-201 thallium diag per mci HCPCS A9505 $61.40 $84.00 $13.81 – $69.08 12
Tlh uterus 250 g or less CPT 58570 not published not published $993.28 – $1,327.27 2
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 $1,094.40 $1,824.00 $0.81 – $23.40 15
Tobramycin peak therapeutic drug level CPT 80200 $217.60 $300.00 $15.94 – $244.80 16
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 $9,652.20 $16,087.00 $5.71 – $36.00 15
Tomosynthesis breast diagnostic left HCPCS G0279 $136.80 $171.00 $23.76 – $118.80 15
Tomosynthesis breast screen bilateral CPT 77063 $69.60 $95.00 $15.66 – $78.30 16
Tonsillectomy (age 12+) CPT 42826 not published not published $671.46 – $896.00 2
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 $17.40 $29.00 $2.54 – $26.10 14
Total Hip Replacement CPT 27130 $19,440.80 $26,792.00 $821.34 – $4,895.36 14
Total Knee Replacement CPT 27447 not published not published $993.28 – $5,731.96 2
Toxoplasma antibody igg CPT 86777 $292.00 $402.00 $14.22 – $328.50 16
Toxoplasma antibody igm CPT 86778 $292.00 $402.00 $14.24 – $173.70 16
Tpmt gene com vrnts CPT 81335 $450.00 $750.00 $135.00 – $675.00 14
Trabectedin 1 mg intravenous solution HCPCS J9352 $13,269.60 $22,116.00 $391.07 – $1,990.80 15
Transcutaneous hgb 88738 CPT 88738 $80.80 $111.00 $4.47 – $90.90 16
Transferrin CPT 84466 $130.40 $180.00 $12.62 – $146.70 16
Transfusion blood/blood component(s) CPT 36430 $2,201.60 $3,035.00 $30.62 – $993.28 16
Transplant forearm tendon CPT 25310 not published not published $492.80 – $1,441.20 8
Trastuzumab 150 mg intravenous solution HCPCS J9355 $7,007.40 $11,679.00 $75.03 – $701.10 15
Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 $448.80 $748.00 $47.55 – $673.20 14
Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 $5,910.00 $9,850.00 $27.99 – $211.50 14
Trauma partial team response w/critical care services level 4 HCPCS G0390 $7,799.20 $10,748.00 $899.12 – $8,774.10 13
Treat ankle dislocation CPT 27842 $3,791.20 $5,225.00 $130.35 – $4,265.10 16
Treat clavicle dislocation 23545 CPT 23545 $998.40 $1,376.00 $129.80 – $1,123.20 16
Treat ectopic pregnancy CPT 59151 not published not published $993.28 – $1,480.67 2
Treat elbow dislocation CPT 24605 $3,791.20 $5,225.00 $173.25 – $4,265.10 16
Treat elbow fracture CPT 24620 $3,791.20 $5,225.00 $154.55 – $4,265.10 16
Treat finger fracture each CPT 26742 $3,791.20 $5,225.00 $80.85 – $4,265.10 16
Treat fracture of radius CPT 25505 $998.40 $1,376.00 $159.50 – $1,123.20 16
Treat fracture of ulna CPT 25535 $604.00 $833.00 $135.90 – $993.28 16
Treat hip dislocation CPT 27252 $3,688.80 $5,084.00 $309.65 – $4,149.90 16
Treat hip dislocation CPT 27257 $4,051.20 $5,583.00 $260.70 – $4,557.60 16
Treat humerus fracture CPT 24535 $3,931.20 $5,418.00 $226.60 – $4,422.60 16
Treat humerus fracture CPT 24565 $4,070.40 $5,609.00 $190.85 – $4,579.20 16
Treat knee dislocation CPT 27552 $3,791.20 $5,225.00 $172.70 – $4,265.10 16
Treat knee fracture 27530 CPT 27530 $998.40 $1,376.00 $141.35 – $993.28 16
Treat kneecap dislocation CPT 27562 $2,336.00 $3,219.00 $147.95 – $2,628.00 16
Treat kneecap fracture CPT 27524 not published not published $446.60 – $1,922.66 8
Treat lower leg joint CPT 27829 not published not published $993.28 – $1,247.22 2
Treat metacarpal fracture CPT 26615 not published not published $255.20 – $1,117.44 8
Treat metatarsal fracture CPT 28485 not published not published $168.85 – $1,085.44 8
Treat midfoot fracture each CPT 28455 $7,873.60 $10,851.00 $139.70 – $8,857.80 16
Treat thigh fracture CPT 27238 $4,291.20 $5,914.00 $248.76 – $1,243.80 16
Treat thigh fracture CPT 27246 $647.20 $891.00 $123.20 – $801.25 16
Treat toe fracture CPT 28525 $6,191.20 $8,532.00 $540.62 – $6,965.10 14
Treat ulnar fracture CPT 24675 $4,070.40 $5,609.00 $200.75 – $4,579.20 16
Treat ulnar fracture CPT 24685 not published not published $460.90 – $1,626.93 8
Treat wrist bone fracture CPT 25635 $2,793.60 $3,850.00 $159.50 – $3,142.80 16
Treat wrist dislocation CPT 25675 $998.40 $1,376.00 $114.40 – $1,123.20 16
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) CPT 25608 not published not published $993.28 – $1,105.17 2
Treatment incomplete abortion completed surgically any trimester CPT 59812 $8,618.40 $11,878.00 $199.65 – $9,695.70 16
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 $297.60 $411.00 $28.27 – $334.80 16
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 $282.40 $390.00 $10.78 – $317.70 16
Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 $346.40 $478.00 $2.65 – $149.53 14
Treatment missed abortion completed surgically 1st trimester CPT 59820 $10,578.40 $14,578.00 $192.60 – $963.00 14
Treatment of ankle fracture CPT 27792 not published not published $993.28 – $1,448.70 2
Treatment of ankle fracture CPT 27814 $1,622.40 $2,704.00 $114.30 – $1,933.21 16
Treatment of ankle fracture CPT 27822 not published not published $993.28 – $1,899.65 2
Treatment of ankle fracture 27786 CPT 27786 $825.60 $1,376.00 $70.56 – $993.28 16
Treatment of fibula fracture 27780 CPT 27780 $998.40 $1,376.00 $145.26 – $993.28 14
Treatment of heel fracture 28400 CPT 28400 $998.40 $1,376.00 $118.80 – $596.50 16
Treatment of thigh fracture CPT 27501 $766.40 $1,056.00 $172.44 – $1,213.22 14
Treatment of thigh fracture CPT 27503 $6,511.20 $8,973.00 $993.28 – $7,325.10 14
Treatment of thigh fracture CPT 27508 $998.40 $1,376.00 $224.64 – $1,123.20 16
Treatment of thigh fracture CPT 27510 $3,791.20 $5,225.00 $348.70 – $4,265.10 16
Treatment of tibia fracture CPT 27759 not published not published $993.28 – $2,343.47 2
Treatment of toe fracture 28510 CPT 28510 $825.60 $1,376.00 $18.72 – $993.28 14
Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 $246.00 $410.00 $73.80 – $369.00 15
Treponema pallidum antibody CPT 86780 $176.80 $244.00 $9.95 – $49.73 16
Trg gene rearrangement anal CPT 81342 $636.00 $795.00 $143.10 – $715.50 14
Triamcinolone a inj prs-free HCPCS J3300 $696.00 $1,160.00 $5.22 – $26.10 15
Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 $43.20 $72.00 $0.84 – $9.90 15
Triglycerides CPT 84478 $147.20 $203.00 $5.68 – $165.60 16
Trim nondyst nails CPT 11719 $157.60 $217.00 $28.21 – $177.30 14
Trimethobenzamide hcl inj HCPCS J3250 $162.60 $271.00 $21.24 – $106.20 14
Trmt of fracture (femoral shaft) 27500 CPT 27500 $882.40 $1,216.00 $198.54 – $1,213.22 16
Trnscath tx thromblytc vein ini day CPT 37212 $5,236.20 $8,727.00 $314.51 – $7,854.30 16
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 not published not published $993.28 – $1,534.60 2
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/< CPT 14302 not published not published $230.53 – $341.70 2
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 not published not published $268.40 – $1,730.23 8
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 not published not published $128.70 – $833.44 8
Troponin quantitative CPT 84484 $110.40 $152.00 $9.87 – $109.80 16
Tte w or without fol w/con,stres HCPCS C8928 $1,171.20 $1,614.00 $263.52 – $1,317.60 13
Tte w or without fol w/cont, com HCPCS C8921 $904.80 $1,508.00 $271.44 – $1,357.20 13
Tte w or without fol w/cont, f/u HCPCS C8922 $647.20 $891.00 $145.62 – $728.10 13
Tubal Ligation (Laparoscopic) CPT 58670 not published not published $761.95 – $993.28 2
Tube trach disp innr can 5 xlt HCPCS A7521 $266.40 $368.00 $25.38 – $126.90 14
Tx closed distal humerus fx CPT 24999 $153.60 $212.00 $34.56 – $172.80 13
Tx closed hip disl traumatic without anes CPT 27250 $998.40 $1,376.00 $224.64 – $1,123.20 16
Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 $4,518.40 $6,227.00 $250.25 – $5,083.20 16
Tx closed tib shaft fx without manip CPT 27750 $718.20 $1,197.00 $50.40 – $709.98 16
Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 $7,873.60 $10,851.00 $195.80 – $8,857.80 16
Tx open nsl fx uncomp CPT 21325 $6,492.00 $8,947.00 $198.55 – $7,303.50 16
Tx phalangeal shaft fx open prox/middle ea CPT 26735 $6,348.00 $10,580.00 $246.40 – $9,522.00 16
Tx tarsal bone fx without manip 28450 CPT 28450 $825.60 $1,376.00 $30.42 – $993.28 16
Ultrasound abdomen aorta screening study aaa CPT 76706 $331.20 $457.00 $64.14 – $372.60 16
Ultrasound breast complete CPT 76641 $888.80 $1,225.00 $68.39 – $999.90 14
Ultrasound breast unilateral limited (both sides) CPT 76642 $630.40 $868.00 $52.40 – $709.20 14
Ultrasound chest CPT 76604 $557.60 $769.00 $60.06 – $627.30 16
Ultrasound encephalogram CPT 76506 $738.40 $1,017.00 $60.80 – $830.70 16
Ultrasound exam k transpl w/doppler CPT 76776 $869.60 $1,198.00 $81.27 – $978.30 16
Ultrasound fetal biophysical profile without non-stress testing CPT 76819 $652.80 $900.00 $62.31 – $734.40 16
Ultrasound guidance for vascular access CPT 76937 $484.00 $667.00 $16.15 – $544.50 16
Ultrasound guide intraoperative CPT 76998 $760.00 $1,048.00 $171.00 – $855.00 12
Ultrasound guided needle placement supervision & interpretation CPT 76942 $1,221.60 $1,683.00 $55.30 – $1,374.30 16
Ultrasound hips infant dynamic CPT 76885 $1,209.60 $1,667.00 $107.96 – $1,360.80 16
Ultrasound infant hips ltd without stress CPT 76886 $796.80 $1,098.00 $67.84 – $896.40 14
Ultrasound joint complete left CPT 76881 $1,025.60 $1,413.00 $84.71 – $1,153.80 14
Ultrasound joint/nonvascular extremity limited left CPT 76882 $692.00 $953.00 $10.05 – $778.50 14
Ultrasound ob >=14wks ea addl gest CPT 76810 $373.60 $515.00 $54.54 – $602.06 16
Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 $373.60 $515.00 $28.13 – $420.30 16
Ultrasound pregnant uterus follow up per fetus CPT 76816 $835.20 $1,151.00 $50.92 – $939.60 16
Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 $796.80 $1,098.00 $49.92 – $896.40 16
Ultrasound pregnant uterus transvaginal CPT 76817 $820.80 $1,131.00 $67.88 – $923.40 16
Ultrasound prostate/transrectal CPT 76872 $840.80 $1,159.00 $69.31 – $945.90 16
Ultrasound retroperitoneal limited CPT 76775 $844.00 $1,163.00 $62.72 – $949.50 16
Ultrasound scrotum and contents CPT 76870 $781.60 $1,077.00 $56.32 – $879.30 16
Ultrasound spinal canal and contents CPT 76800 $692.00 $953.00 $65.25 – $778.50 16
Ultrasound transvaginal non obstetric CPT 76830 $820.80 $1,131.00 $59.52 – $923.40 16
Unlisted CT procedure CPT 76497 $917.60 $1,264.00 $67.84 – $1,032.30 13
Unlisted cv px dx nuc med CPT 78499 $2,254.40 $3,107.00 $303.48 – $2,536.20 13
Unlisted gi px dx nuc med CPT 78299 $944.00 $1,301.00 $212.40 – $1,062.00 13
Unlisted laps px uterus CPT 58578 not published not published $4,069.64 – $4,069.64 1
Unlisted misc path test CPT 89240 $112.80 $155.00 $25.38 – $126.90 13
Unlisted muscskel px dx nuc CPT 78399 $660.00 $909.00 $148.50 – $742.50 13
Unlisted procedure microbiology CPT 87999 $151.20 $208.00 $34.02 – $170.10 12
Unlisted procedure rectum CPT 45999 $3,816.80 $5,261.00 $648.87 – $4,293.90 13
Unlisted px casting/strpg CPT 29799 $152.00 $210.00 $34.20 – $171.00 13
Unlisted px hands/fingers CPT 26989 $5,143.20 $7,088.00 $161.64 – $5,786.10 13
Unlisted px mediastinum CPT 39499 $114.40 $158.00 $25.74 – $128.70 12
Unlisted px small intestine CPT 44799 $4,264.00 $5,877.00 $644.56 – $4,797.00 13
Unlisted ultrasound procedure CPT 76999 $146.40 $202.00 $32.94 – $164.70 13
Unlstd hematop ret/endo lymp CPT 78199 $734.40 $1,012.00 $165.24 – $826.20 13
Unsched dialysis esrd pt hos HCPCS G0257 $2,013.60 $2,775.00 $453.06 – $2,265.30 13
Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 $4,850.40 $6,684.00 $344.32 – $5,456.70 16
Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 $3,689.60 $5,085.00 $344.32 – $4,150.80 16
Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 $3,040.00 $4,190.00 $239.62 – $3,420.00 16
Upper Endoscopy (EGD, diagnostic) CPT 43235 $4,264.00 $5,877.00 $137.74 – $4,797.00 16
Upper Endoscopy (EGD, with biopsy) CPT 43239 $4,264.00 $5,877.00 $163.44 – $4,797.00 16
Uppr gi scope w/submuc inj CPT 43236 $4,264.00 $5,877.00 $166.71 – $4,797.00 16
Urea nitrogen CPT 84520 $47.80 $66.00 $3.90 – $53.77 16
Urea nitrogen 24 hour urine CPT 84540 $76.60 $106.00 $4.34 – $85.95 14
Ureteral reflux study CPT 78740 $2,251.20 $3,103.00 $64.00 – $2,532.60 16
Urethrcystgrphy rtrgrde s&i CPT 74450 $776.80 $1,071.00 $28.80 – $873.90 16
Urethrocystography void s&i CPT 74455 $1,539.20 $2,121.00 $35.20 – $1,731.60 16
Uric acid blood CPT 84550 $59.20 $81.00 $4.47 – $66.60 16
Uric acid urine CPT 84560 $99.20 $137.00 $4.50 – $71.10 16
Urinalysis (with microscopy) CPT 81001 $84.80 $117.00 $3.00 – $95.40 16
Urinalysis (without microscopy) CPT 81003 $45.80 $63.00 $2.22 – $51.52 16
Urinalysis qual/semiquant excpt ia CPT 81005 $62.20 $85.00 $2.14 – $69.97 16
Urinary bldr retent nuc study CPT 78730 $1,801.60 $2,483.00 $46.27 – $2,026.80 16
Urine Culture Test CPT 87086 $264.00 $364.00 $7.98 – $297.00 16
Urine pregnancy test CPT 81025 $137.40 $229.00 $4.00 – $22.50 16
Urography, antegrade CPT 74425 $1,369.60 $1,888.00 $28.80 – $1,540.80 16
Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 $76.00 $95.00 $12.99 – $85.50 15
Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 $57.00 $95.00 $17.10 – $149.40 14
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 $209.40 $349.00 $44.00 – $314.10 16
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 $340.00 $425.00 $44.00 – $314.10 16
Vaccine dtap < 7 years im CPT 90700 $33.60 $56.00 $9.72 – $48.60 16
Vaccine dtap-hep b-ipv im CPT 90723 $39.60 $66.00 $11.00 – $59.40 16
Vaccine dtap-ipv 4-6 years im CPT 90696 $31.20 $52.00 $9.36 – $46.80 16
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 $31.20 $52.00 $6.48 – $32.40 16
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 $32.40 $54.00 $9.36 – $46.80 16
Vaccine hepatitis a (hepa) adult im CPT 90632 $108.00 $142.00 $11.00 – $121.50 16
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 $67.80 $113.00 $11.00 – $101.70 16
Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 $86.40 $113.00 $11.00 – $97.20 16
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 $168.80 $211.00 $11.00 – $189.90 16
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 $63.20 $83.00 $11.00 – $71.10 16
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 $195.60 $326.00 $58.68 – $293.40 13
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 $157.80 $263.00 $11.00 – $236.70 16
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 $12.60 $21.00 $3.78 – $18.90 16
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 $12.00 $20.00 $3.60 – $18.00 16
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 $14.40 $24.00 $3.60 – $18.00 16
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 $54.00 $90.00 $11.00 – $81.00 15
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 $24.00 $30.00 $5.40 – $27.00 15
Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 $111.60 $186.00 $11.00 – $123.30 16
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 $86.40 $144.00 $11.00 – $129.60 16
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 $108.80 $143.00 $11.00 – $122.40 16
Vaccine mmr live subcutaneous CPT 90707 $64.80 $85.00 $11.00 – $72.90 16
Vaccine mmrv live subcutaneous CPT 90710 $112.20 $187.00 $11.00 – $168.30 16
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 $75.00 $125.00 $11.00 – $112.50 16
Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 $144.00 $240.00 $11.00 – $216.00 16
Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 $192.00 $240.00 $11.00 – $216.00 16
Vaccine polio (ipv) subcutaneous/im CPT 90713 $40.20 $67.00 $11.00 – $57.60 16
Vaccine rabies im CPT 90675 $800.00 $1,050.00 $11.00 – $900.00 16
Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 $672.00 $882.00 $11.00 – $756.00 16
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 $1,184.80 $1,481.00 $11.00 – $1,327.50 16
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 $885.00 $1,475.00 $11.00 – $1,327.50 16
Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 $63.00 $105.00 $11.00 – $94.50 16
Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 $60.60 $101.00 $11.00 – $90.90 16
Vaccine td preservative free >= 7 years im CPT 90714 $74.40 $97.00 $11.00 – $83.70 16
Vaccine tdap >=7 years im CPT 90715 $42.40 $55.00 $9.54 – $47.70 16
Vaccine typhoid vicps im CPT 90691 $39.00 $65.00 $11.00 – $58.50 16
Vaccine varicella live subcutaneous CPT 90716 $748.80 $936.00 $11.00 – $842.40 16
Vaginal bx CPT 58999 not published not published $139.08 – $139.08 1
Valproic acid total therapeutic drug level CPT 80164 $219.20 $302.00 $13.38 – $246.60 16
Vancomycin 1,000 mg intravenous injection HCPCS J3373 $0.60 $1.00 $0.03 – $0.90 14
Vancomycin hcl injection HCPCS J3370 $74.40 $124.00 $3.06 – $15.30 13
Vancomycin peak therapeutic drug level CPT 80202 $257.60 $355.00 $13.38 – $289.80 16
Varicella zoster antibody igg CPT 86787 $241.60 $333.00 $12.73 – $125.10 16
Vasectomy CPT 55250 $4,608.00 $6,350.00 $120.78 – $993.28 16
Vasopressin 20 unit/ml intravenous solution HCPCS J2598 $42.00 $52.50 $0.93 – $46.80 14
Vedolizumab 300 mg intravenous solution HCPCS J3380 $27,154.80 $45,258.00 $21.31 – $135.90 15
Ven thrombosis images bilat CPT 78458 $2,406.40 $3,316.00 $83.20 – $2,707.20 16
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 $617.60 $852.00 $7.14 – $694.80 14
Venogram ext bil s&i CPT 75822 $4,780.80 $6,589.00 $28.80 – $5,378.40 16
Venogram extremity supervision & interpretation unilateral CPT 75820 $3,993.60 $5,504.00 $28.80 – $4,492.80 16
Venous thrombosis imaging CPT 78457 $1,417.60 $1,954.00 $83.20 – $1,594.80 16
Ventilator each subsequent day CPT 94003 $2,078.40 $2,864.00 $61.16 – $2,338.20 14
Ventilator initial day CPT 94002 $2,098.40 $2,892.00 $84.16 – $2,360.70 14
Version cephalic external CPT 59412 $111.20 $153.00 $25.02 – $2,207.67 13
Vinblastine 1 mg/ml intravenous solution HCPCS J9360 $199.20 $332.00 $5.30 – $29.70 14
Vincristine 1 mg/ml intravenous solution HCPCS J9370 $48.60 $81.00 $7.20 – $36.00 14
Vinorelbine 10 mg/ml intravenous solution (wrapper) HCPCS J9390 $417.00 $695.00 $7.68 – $125.10 14
Vitamin D Test CPT 82306 $274.40 $378.00 $29.26 – $294.30 16
Vitamin b-12 CPT 82607 $161.60 $223.00 $13.00 – $181.80 16
Voiding pressure study/intra-abd 51797 CPT 51797 $666.40 $919.00 $38.50 – $275.40 16
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr HCPCS J3465 $690.60 $1,151.00 $0.77 – $51.30 14
Warde 1003990 aldosterone CPT 82088 $688.80 $949.00 $26.00 – $738.00 16
Warde 1005020 citrate 24 hour urine CPT 82507 $294.40 $405.00 $14.22 – $71.10 14
Warde 1005055 5-hiaa 24 hour urine CPT 83497 $451.20 $622.00 $12.75 – $507.60 16
Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 $504.80 $696.00 $22.00 – $284.40 16
Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 $252.80 $349.00 $12.00 – $284.40 16
Warde 1015200 kappa light chain free CPT 83521 $158.40 $218.00 $9.95 – $49.73 16
Warde 3004000 immunoglobulin subclass 1 CPT 82787 $55.20 $76.00 $7.92 – $62.10 16
Warde 3008005 oligoclonal bands CPT 83916 $287.20 $396.00 $15.00 – $323.10 16
Warde 3016000 west nile virus antibody CPT 86788 $111.20 $153.00 $16.65 – $125.10 16
Warde 3016000 west nile virus antibody igg CPT 86789 $111.20 $153.00 $14.22 – $125.10 16
Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 $121.60 $168.00 $9.56 – $136.80 14
Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 $50.00 $69.00 $7.50 – $56.25 16
Warde 3400652 smear complex special stain ova/parasites CPT 87209 $107.20 $148.00 $17.78 – $120.60 16
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis CPT 81513 $650.40 $897.00 $111.36 – $731.70 14
Warde 3400852 arsenic CPT 82175 $404.80 $506.00 $14.81 – $135.90 14
Warde 3708165 mercury urine CPT 83825 $404.80 $558.00 $12.00 – $135.90 16
Warde acetylcholine receptor blocking antibody CPT 86042 $388.20 $647.00 $14.72 – $412.20 15
Warde actin (smooth muscle) antibody each CPT 86015 $160.00 $221.00 $9.22 – $171.00 16
Warde adenosine deaminase pleural fluid CPT 84311 $105.60 $146.00 $6.32 – $118.80 14
Warde adrenocorticotropic hormone (acth) CPT 82024 $745.60 $1,028.00 $38.17 – $838.80 16
Warde aldolase CPT 82085 $168.00 $232.00 $9.00 – $189.00 16
Warde amino acids 6 or more quantitative each specimen CPT 82139 $872.00 $1,202.00 $16.67 – $981.00 16
Warde amiodarone therapeutic drug level CPT 80151 $212.00 $292.00 $14.55 – $238.50 14
Warde analysis gene hfe common variants CPT 81256 $1,331.20 $1,664.00 $40.32 – $201.60 16
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 $788.00 $985.00 $128.03 – $779.40 14
Warde anti-mullerian hormone CPT 82166 $294.60 $491.00 $38.17 – $441.90 13
Warde apolipoprotein b CPT 82172 $161.60 $223.00 $19.00 – $132.30 16
Warde bile acids CPT 82239 $294.40 $405.00 $15.00 – $331.20 16
Warde cadmium blood CPT 82300 $298.40 $412.00 $19.00 – $335.70 16
Warde calcitonin CPT 82308 $585.60 $807.00 $20.93 – $658.80 16
Warde calculus (stone) infrared CPT 82365 $422.40 $582.00 $10.00 – $475.20 16
Warde clozapine therapeutic drug level CPT 80159 $417.60 $575.00 $19.92 – $469.80 16
Warde cobalt heavy metal quantitative each nes CPT 83018 $374.40 $516.00 $21.70 – $225.90 16
Warde collagen cross links c-telopeptide CPT 82523 $580.00 $799.00 $14.58 – $652.50 14
Warde complement total hemolytic CPT 86162 $199.20 $274.00 $20.00 – $213.30 16
Warde copper CPT 82525 $328.00 $453.00 $12.00 – $369.00 16
Warde cryoglobulin CPT 82595 $91.20 $126.00 $6.39 – $73.58 16
Warde erythropoietin CPT 82668 $216.00 $298.00 $15.00 – $243.00 16
Warde estrogen fractionated CPT 82671 $353.60 $487.00 $22.00 – $397.80 16
Warde fluorescent antibody screen endomysial iga CPT 86231 $100.80 $139.00 $9.67 – $113.40 16
Warde folic acid rbc CPT 82747 $230.40 $317.00 $17.44 – $259.20 16
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 $312.00 $431.00 $8.00 – $351.00 16
Warde gastrin CPT 82941 $252.80 $349.00 $14.00 – $284.40 16
Warde growth hormone (hgh) CPT 83003 $340.00 $468.00 $8.00 – $382.50 16
Warde helminth antibody strongyloides igg CPT 86682 $252.80 $349.00 $10.16 – $205.20 14
Warde hepatitis a antibody CPT 86708 $301.60 $416.00 $12.25 – $339.30 16
Warde hepatitis be antibody CPT 86707 $120.80 $167.00 $11.43 – $135.90 16
Warde immunofixation electrophoresis urine CPT 86335 $279.20 $384.00 $29.01 – $314.10 16
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 $124.80 $172.00 $10.00 – $140.40 16
Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 $1,911.20 $2,633.00 $101.88 – $509.40 14
Warde islet cell antibody zinc transporter 8 CPT 86341 $284.00 $392.00 $23.29 – $127.80 16
Warde lipoprotein (a) CPT 83695 $112.80 $155.00 $14.16 – $126.90 16
Warde lipoprotein-associated phospholipase a2 CPT 83698 $322.40 $444.00 $37.94 – $362.70 16
Warde mitochondrial antibody each CPT 86381 $132.60 $221.00 $19.87 – $102.60 14
Warde oxcarbazepine therapeutic drug level CPT 80183 $241.60 $333.00 $13.09 – $271.80 16
Warde pancreatic elastase fecal quantitative CPT 82653 $552.00 $761.00 $18.38 – $621.00 16
Warde protein c antigen CPT 85302 $230.40 $317.00 $11.87 – $259.20 16
Warde sex hormone binding globulin CPT 84270 $206.40 $285.00 $21.47 – $232.20 16
Warde somatomedin CPT 84305 $617.60 $852.00 $21.01 – $694.80 16
Warde t3 (triiodothyronine) reverse CPT 84482 $887.20 $1,222.00 $15.57 – $998.10 16
Warde thyroid stimulating immunoglobulins CPT 84445 $1,051.20 $1,449.00 $20.00 – $1,182.60 16
Warde topiramate therapeutic drug level CPT 80201 $157.60 $217.00 $11.78 – $177.30 16
Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 $894.40 $1,233.00 $25.77 – $1,006.20 16
Warde viscosity CPT 85810 $250.40 $345.00 $4.00 – $281.70 16
Warde vitamin a CPT 84590 $509.60 $702.00 $11.47 – $573.30 16
Warde vitamin b-1 (thiamine) CPT 84425 $235.20 $324.00 $7.00 – $264.60 16
Warde vitamin b6 (pyridoxine) CPT 84207 $274.40 $378.00 $27.77 – $308.70 16
Warde vitamin c (ascorbic acid) CPT 82180 $374.40 $516.00 $7.00 – $421.20 16
Warde vitamin d (1 25 dihydroxy) CPT 82652 $700.00 $965.00 $38.05 – $787.50 16
Warde vitamin e (alpha-tocopherol) CPT 84446 $451.20 $622.00 $10.00 – $507.60 16
Warde zinc CPT 84630 $312.00 $431.00 $11.26 – $333.90 16
Wbc automated CPT 85048 $42.80 $59.00 $2.51 – $48.15 16
Western blot test CPT 84181 $219.20 $302.00 $16.83 – $246.60 16
Wet mounts/ w preparations HCPCS Q0111 $78.80 $108.00 $2.88 – $14.40 15
Whole blood for transfusion HCPCS P9010 $919.20 $1,266.00 $33.00 – $1,034.10 16
Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 $230.40 $384.00 $3.96 – $31.88 13
Wrist X-ray CPT 73110 $374.40 $516.00 $14.72 – $421.20 14
X-ray abdomen 1 view CPT 74018 $650.40 $897.00 $17.63 – $731.70 16
X-ray abdomen 2 views CPT 74019 $395.20 $545.00 $21.09 – $444.60 16
X-ray abdomen >=3 views CPT 74021 $406.40 $560.00 $24.54 – $457.20 16
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 $609.60 $840.00 $30.72 – $685.80 16
X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 $480.80 $663.00 $24.32 – $540.90 16
X-ray ankle 2 views (both sides) CPT 73600 $697.60 $962.00 $14.72 – $784.80 14
X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 $868.80 $1,197.00 $21.12 – $977.40 14
X-ray bone age studies CPT 77072 $350.40 $483.00 $12.54 – $394.20 16
X-ray bone length studies CPT 77073 $584.00 $805.00 $26.80 – $657.00 16
X-ray bone survey complete CPT 77075 $2,025.60 $2,792.00 $57.88 – $2,278.80 16
X-ray bone survey infant CPT 77076 $843.20 $1,162.00 $35.92 – $948.60 16
X-ray cervical spine 2-3 views CPT 72040 $770.40 $1,062.00 $21.12 – $866.70 16
X-ray cervical spine 4-5 views CPT 72050 $636.00 $877.00 $33.92 – $715.50 16
X-ray cervical spine >= 6 views CPT 72052 $821.60 $1,132.00 $41.60 – $924.30 16
X-ray clavicle complete (both sides) CPT 73000 $312.00 $431.00 $14.72 – $351.00 14
X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 $783.20 $1,079.00 $28.80 – $881.10 16
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 $1,338.40 $1,845.00 $49.92 – $1,505.70 16
X-ray elbow 2 views (both sides) CPT 73070 $659.20 $908.00 $14.72 – $741.60 14
X-ray elbow >= 3 views (both sides) CPT 73080 $452.00 $623.00 $14.72 – $508.50 14
X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 $862.40 $1,189.00 $28.80 – $970.20 16
X-ray exam entire spi 4/5 vw CPT 72083 $868.80 $1,197.00 $47.71 – $977.40 16
X-ray exam entire spi 6/> vw CPT 72084 $1,174.40 $1,618.00 $57.57 – $1,321.20 16
X-ray exam of arm infant CPT 73092 $617.60 $852.00 $14.08 – $694.80 14
X-ray exam of eye sockets CPT 70200 $482.40 $665.00 $26.88 – $542.70 16
X-ray exam of femur 1 CPT 73551 $287.20 $396.00 $18.41 – $323.10 14
X-ray exam of jaw joint CPT 70328 $804.80 $1,109.00 $21.12 – $905.40 16
X-ray exam of jaw joint CPT 70332 $656.00 $904.00 $35.20 – $738.00 16
X-ray exam of mastoids CPT 70120 $480.80 $663.00 $21.12 – $540.90 14
X-ray exam of middle ear CPT 70134 $574.40 $792.00 $28.80 – $646.20 16
X-ray exam of salivary gland CPT 70380 $606.40 $836.00 $26.88 – $682.20 16
X-ray exam of sinuses CPT 70210 $385.60 $531.00 $21.12 – $433.80 16
X-ray exam si joints CPT 72200 $257.60 $355.00 $21.12 – $289.80 16
X-ray exam thorac spine4/>vw CPT 72074 $821.60 $1,132.00 $27.52 – $924.30 16
X-ray eye detection foreign body (both sides) CPT 70030 $652.80 $900.00 $19.16 – $734.40 14
X-ray facial bones complete > 3 views CPT 70150 $536.80 $740.00 $28.80 – $603.90 16
X-ray femur >=2 views (both sides) CPT 73552 $724.80 $999.00 $21.82 – $815.40 14
X-ray finger(s) >= 2 views (both sides) CPT 73140 $356.80 $491.00 $11.52 – $401.40 14
X-ray foot 2 views (both sides) CPT 73620 $759.20 $1,046.00 $12.80 – $854.10 14
X-ray forearm 2 views (both sides) CPT 73090 $660.00 $909.00 $14.72 – $742.50 14
X-ray hand 2 views (both sides) CPT 73120 $682.40 $941.00 $12.80 – $767.70 14
X-ray heel/calcaneus > 2 views (both sides) CPT 73650 $354.40 $488.00 $14.72 – $398.70 14
X-ray hip uni w/wo pelvis min 4 views CPT 73503 $500.80 $690.00 $35.43 – $563.40 14
X-ray hip with pelvis when performed bilateral 2 views CPT 73521 $452.80 $624.00 $26.59 – $509.40 16
X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 $500.80 $690.00 $32.04 – $563.40 16
X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 $951.20 $1,310.00 $38.52 – $1,070.10 16
X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 $751.20 $1,035.00 $19.10 – $845.10 14
X-ray humerus >= 2 views left CPT 73060 $685.60 $945.00 $14.72 – $771.30 14
X-ray joint survey 1 view CPT 77077 $417.60 $575.00 $29.85 – $469.80 16
X-ray knee 1-2 views (both sides) CPT 73560 $736.00 $1,014.00 $21.12 – $828.00 14
X-ray knee 3 views (both sides) CPT 73562 $482.40 $665.00 $21.12 – $542.70 14
X-ray knee ap standing bilateral CPT 73565 $287.20 $396.00 $22.22 – $323.10 16
X-ray l/s-spine bend vw only 2-3 vw CPT 72120 $504.00 $695.00 $26.88 – $567.00 16
X-ray lower extremities infant > 2 views (both sides) CPT 73592 $617.60 $852.00 $21.12 – $694.80 14
X-ray lumbosacral spine >= 4 views CPT 72110 $859.20 $1,184.00 $28.80 – $966.60 16
X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 $1,000.80 $1,380.00 $26.88 – $1,125.90 16
X-ray mandible complete > 4 views CPT 70110 $499.20 $688.00 $21.12 – $561.60 16
X-ray mandible ltd <4 views CPT 70100 $454.40 $626.00 $21.12 – $511.20 16
X-ray nasal bones complete > 3 views CPT 70160 $316.80 $437.00 $14.72 – $356.40 16
X-ray neck soft tissue CPT 70360 $344.80 $476.00 $12.80 – $387.90 16
X-ray nose to rectum for foreign body child CPT 76010 $294.40 $405.00 $11.14 – $331.20 16
X-ray optic foramina CPT 70190 $354.40 $488.00 $26.88 – $398.70 16
X-ray pelvis 1-2 views CPT 72170 $617.60 $852.00 $12.80 – $694.80 16
X-ray pelvis complete > 3 views CPT 72190 $616.00 $849.00 $26.88 – $693.00 16
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 $875.20 $1,206.00 $28.80 – $984.60 16
X-ray ribs 2 views left CPT 71100 $368.80 $508.00 $21.12 – $414.90 16
X-ray ribs 3 views bilateral CPT 71110 $561.60 $774.00 $21.12 – $631.80 16
X-ray ribs w/posterior anterior chest 3 views left CPT 71101 $482.40 $665.00 $21.12 – $542.70 16
X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 $779.20 $1,074.00 $21.12 – $876.60 16
X-ray sacroiliac joints >= 3 views CPT 72202 $480.80 $663.00 $21.12 – $540.90 16
X-ray sacrum/coccyx >= 2 views CPT 72220 $468.80 $646.00 $21.12 – $527.40 16
X-ray scapula complete (both sides) CPT 73010 $368.00 $507.00 $21.12 – $414.00 14
X-ray sella turcica CPT 70240 $598.40 $824.00 $14.72 – $673.20 16
X-ray shoulder 1 view (both sides) CPT 73020 $704.80 $971.00 $18.57 – $792.90 14
X-ray sinus tract/fistula/abscess CPT 76080 $1,411.20 $1,945.00 $21.12 – $1,587.60 16
X-ray sinuses paranasal complete > 3 views CPT 70220 $542.40 $748.00 $28.80 – $610.20 16
X-ray skull < 4 views CPT 70250 $440.00 $607.00 $26.88 – $495.00 16
X-ray skull > 4 views complete CPT 70260 $532.80 $734.00 $35.19 – $599.40 16
X-ray slg plne bdy sect without urogr CPT 76100 $1,143.20 $1,575.00 $35.20 – $1,286.10 16
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 $809.60 $1,116.00 $28.80 – $910.80 16
X-ray small intestine follow-through study CPT 74248 $480.00 $662.00 $46.07 – $540.00 16
X-ray spine single view CPT 72020 $374.40 $516.00 $18.51 – $421.20 16
X-ray sternoclavicular joint(s) > 3 views CPT 71130 $466.40 $643.00 $14.72 – $524.70 16
X-ray sternum > 2 views CPT 71120 $401.60 $553.00 $14.72 – $451.80 16
X-ray surgical specimen CPT 76098 $216.00 $298.00 $13.59 – $243.00 16
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 $1,000.80 $1,380.00 $35.84 – $1,125.90 16
X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 $816.80 $1,126.00 $21.12 – $918.90 16
X-ray thoracic spine 2 views CPT 72070 $776.00 $1,070.00 $25.84 – $873.00 16
X-ray thoracic spine 3 views CPT 72072 $666.40 $919.00 $27.52 – $749.70 16
X-ray thoracolumbar spine >=2 views CPT 72080 $405.60 $559.00 $21.12 – $456.30 16
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 $479.20 $660.00 $24.20 – $539.10 16
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 $868.80 $1,197.00 $43.96 – $977.40 16
X-ray tibia/fibula 2 views (both sides) CPT 73590 $782.40 $1,078.00 $21.12 – $880.20 14
X-ray toe(s) > 2 views (both sides) CPT 73660 $440.80 $608.00 $11.52 – $495.90 14
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 $701.60 $967.00 $51.20 – $789.30 16
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 $701.60 $967.00 $49.92 – $789.30 16
X-ray wrist 2 views (both sides) CPT 73100 $710.40 $979.00 $14.72 – $799.20 14
Xcapsl ctrc rmvl cplx wo ecp CPT 66982 not published not published $1,727.55 – $2,117.12 2
Xcapsl ctrc rmvl insj 1+ CPT 66991 not published not published $696.24 – $993.28 2
Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 not published not published $873.61 – $993.28 2
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 not published not published $195.25 – $1,606.12 8
Xfer tis s/a/l 10 sq cm/< CPT 14020 not published not published $165.00 – $1,034.50 8
Yttrium y-90 ibritumomab ther HCPCS A9543 $114,488.00 $157,779.00 $25,759.80 – $128,799.00 12
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 $135.00 $225.00 $1.51 – $9.90 14
Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 $229.80 $383.00 $6.83 – $172.80 14
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 $74.40 $124.00 $7.88 – $111.60 15
Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 $4,651.80 $7,753.00 $5.06 – $927.90 14
_afb id by dna probe rflx ast CPT 87149 $170.40 $235.00 $19.82 – $191.70 16
_afb org id by sequencing rflx ast-sendout CPT 87153 $1,823.20 $2,513.00 $114.02 – $2,051.10 16

A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.