Compare real prices at Adventist Health Tulare in Tulare, CA. Taven tracks 415 procedures at this hospital using data from their publicly filed transparency report. Last updated March 2026.
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415
Procedures Tracked
with pricing data
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4.5x
Markup Ratio
Avg = 3.0x
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Grade C
Data Quality
Moderate data coverage
✓
CMS v3.0 Compliant
This hospital's pricing data meets the latest CMS v3.0 requirements, including actual allowed amounts from insurer remittance data.
Attested by: PATRICK MATIANOrg NPI: 1679223663
🔒 De-identification Notice: All pricing data shown on this page is derived from publicly available hospital machine-readable files and insurer transparency data as mandated by federal law. No individual patient data, protected health information (PHI), or personally identifiable information is collected, stored, or displayed. Aggregate statistics (such as allowed amount medians and percentiles) are calculated from de-identified claim payment data reported by hospitals per CMS requirements.
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Procedure Prices at Adventist Health Tulare
415 procedures with pricing data. Prices reflect negotiated rates across insurance payers compared to the Tulare, CA metro average. Includes actual allowed amounts from insurer remittance data (CMS v3.0).
Last updated: March 26, 2026
| Procedure | Cash Price | Avg Negotiated | Median Allowed | Range (10th–90th) | Tulare Avg | vs. Avg | Payers |
|---|---|---|---|---|---|---|---|
| Debridement - Subcutaneous Tissue CPT 11042 Wound debridement — removal of dead, damaged, or infected tissue from a wound to promote healing. |
— | $1,549 | $86 | $46–$6,640 | $1,549 | avg | 1 |
| Skin Biopsy (Tangential, Single Lesion) CPT 11102 Skin biopsy, tangential — removal of a thin layer of skin tissue for microscopic examination to diagnose skin conditions or suspicious lesions. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Skin Biopsy (Punch, Single Lesion) CPT 11104 Skin punch biopsy — removal of a small, full-thickness circular sample of skin for laboratory analysis to diagnose skin conditions. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Skin Graft Preparation CPT 15002 Skin Graft Preparation — CPT code 15002 covers skin graft preparation performed in a clinical or hospital setting. |
— | $5,389 | $5,139 | $5,139–$6,640 | $5,389 | avg | 6 |
| Split-Thickness Skin Graft CPT 15100 Split-Thickness Skin Graft — CPT code 15100 covers split-thickness skin graft performed in a clinical or hospital setting. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Skin Substitute Graft (≤25 sq cm) CPT 15271 Skin Substitute Graft (≤25 sq cm) — CPT code 15271 covers skin substitute graft (≤25 sq cm) performed in a clinical or hospital setting. |
— | $4,070 | $5,139 | $84–$6,640 | $4,070 | avg | 6 |
| Skin Substitute Graft (≤100 sq cm) CPT 15275 Skin Substitute Graft (≤100 sq cm) — CPT code 15275 covers skin substitute graft (≤100 sq cm) performed in a clinical or hospital setting. |
— | $3,974 | $5,139 | $152–$6,640 | $3,974 | avg | 7 |
| Destruction of Premalignant Lesion (First) CPT 17000 Destruction of precancerous skin lesion — removal of a precancerous growth (actinic keratosis) using freezing, chemicals, or other methods. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Wart Removal (Up to 14 Lesions) CPT 17110 Destruction of benign skin lesions, up to 14 — removal of warts, skin tags, or other non-cancerous growths. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Breast Excision CPT 19120 Surgical removal of a breast lump or abnormal tissue. This procedure removes a specific area of concern while preserving as much healthy breast tissue as possible. |
— | $3,952 | $5,139 | $378–$6,640 | $3,952 | avg | 6 |
| Partial Mastectomy (Lumpectomy) CPT 19301 Surgical removal of a breast tumor along with a small margin of surrounding tissue. Also called a lumpectomy, this breast-conserving surgery removes the cancer while keeping most of the breast intact. |
— | $4,963 | $6,136 | $593–$6,640 | $4,963 | avg | 2 |
| Simple Mastectomy CPT 19303 Complete surgical removal of one breast. This procedure removes all breast tissue to treat or prevent breast cancer. |
— | $4,966 | $5,139 | $917–$6,640 | $4,966 | avg | 6 |
| Joint Injection (small joint) CPT 20600 Small joint injection — injection of medication into a small joint like a finger or toe to reduce pain and inflammation. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Joint Injection (medium joint) CPT 20605 Medium joint injection — injection of medication into a medium-sized joint like the elbow, wrist, or ankle to reduce pain and inflammation. |
— | $3,676 | $5,139 | $49–$6,640 | $3,676 | avg | 6 |
| Joint Injection (Major Joint) CPT 20610 Large joint injection — injection of medication (such as cortisone) into a large joint like the knee, shoulder, or hip to reduce pain and inflammation. |
— | $2,812 | $2,475 | $49–$6,640 | $2,812 | avg | 2 |
| Joint Injection with Ultrasound (Major Joint) CPT 20611 Ultrasound — joint injection with ultrasound (major joint). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $2,807 | $2,096 | $63–$6,640 | $2,807 | avg | 2 |
| Le Fort I Osteotomy CPT 21141 Le Fort I Osteotomy — CPT code 21141 covers le fort i osteotomy performed in a clinical or hospital setting. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Lumbar Spinal Fusion (Posterior) CPT 22612 Lumbar spinal fusion (lower back) — surgery to permanently join two vertebrae in the lower spine to treat conditions like degenerative disc disease or spondylolisthesis. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Lumbar Spinal Fusion (Posterior Interbody) CPT 22630 Posterior lumbar interbody fusion (PLIF) — spinal fusion through the back where a damaged disc is removed and replaced with a bone graft or cage to stabilize the spine. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Rotator Cuff Repair CPT 23412 Rotator Cuff Repair — CPT code 23412 covers rotator cuff repair performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Shoulder Replacement (Arthroplasty) CPT 23472 Shoulder Replacement (Arthroplasty) — CPT code 23472 covers shoulder replacement (arthroplasty) performed in a clinical or hospital setting. |
— | $4,663 | $5,139 | $1,461–$6,640 | $4,663 | avg | 6 |
| Trigger Finger Release CPT 26055 Trigger finger release — a procedure to free a finger tendon that has become stuck, causing the finger to catch or lock when bending. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Open Fracture Treatment - Metacarpal CPT 26615 Open Fracture Treatment - Metacarpal — CPT code 26615 covers open fracture treatment - metacarpal performed in a clinical or hospital setting. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Total Hip Replacement CPT 27130 Total hip replacement surgery where the damaged hip joint is replaced with an artificial implant to relieve pain and improve mobility. |
— | $4,881 | $6,136 | $49–$6,640 | $4,881 | avg | 2 |
| Open Treatment Hip Fracture CPT 27236 Surgical repair of a broken hip using metal pins, screws, or plates to hold the bone fragments together while they heal. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Total Knee Replacement - Unicompartmental CPT 27446 Partial knee replacement surgery that replaces only the damaged compartment of the knee joint with an artificial implant, preserving healthy bone and tissue. |
— | $4,641 | $5,139 | $1,081–$6,305 | $4,641 | avg | 7 |
| Total Knee Replacement CPT 27447 Full knee replacement surgery where the damaged knee joint is replaced with artificial metal and plastic components to relieve pain and restore function. |
— | $4,657 | $5,264 | $49–$6,640 | $4,657 | avg | 2 |
| Knee Realignment Osteotomy CPT 27477 Surgical reshaping of the leg bones around the knee to redistribute weight and relieve pain, typically used for patients with arthritis affecting one side of the knee. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Closed Treatment Tibial Fracture CPT 27750 Treatment of a broken shinbone (tibia) without surgery, using a cast or brace to hold the bone in place while it heals. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Hammertoe Correction CPT 28285 Surgical correction of a hammertoe — a toe that has become bent or curled. The procedure straightens the toe by removing bone or releasing tight tendons. |
— | $4,024 | $5,139 | $321–$5,957 | $4,024 | avg | 7 |
| Bunionectomy with Metatarsal Osteotomy CPT 28296 Surgical correction of a bunion (hallux valgus) that includes cutting and realigning the metatarsal bone to straighten the big toe and relieve pain. |
$39,287 | $11,634 | — | — | $11,634 | avg | 3 |
| Shoulder Arthroscopy - Debridement CPT 29823 Minimally invasive shoulder surgery using a small camera (arthroscope) to clean out damaged tissue, bone spurs, or loose fragments from the shoulder joint. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Arthroscopic Rotator Cuff Repair CPT 29827 Arthroscopic repair of a torn rotator cuff — the group of tendons that stabilize the shoulder. The surgeon reattaches the torn tendon to the bone using small anchors. |
— | $3,745 | $5,139 | $49–$6,640 | $3,745 | avg | 2 |
| Knee Arthroscopy Medial & Lateral CPT 29880 Arthroscopic knee surgery to treat torn meniscus cartilage on both the inner and outer sides of the knee. Uses a small camera and tools to trim or repair the damaged cartilage. |
$6,470 | $9,544 | — | — | $9,544 | avg | 3 |
| Knee Arthroscopy (Meniscus Surgery) CPT 29881 Arthroscopic knee surgery to treat a torn meniscus on one side of the knee. The surgeon trims or repairs the damaged cartilage through small incisions. |
$7,347 | $10,087 | — | — | $10,087 | avg | 3 |
| Septoplasty (Deviated Septum Repair) CPT 30520 Septoplasty (Deviated Septum Repair) — CPT code 30520 covers septoplasty (deviated septum repair) performed in a clinical or hospital setting. |
$25,040 | $9,879 | — | — | $9,879 | avg | 3 |
| Nasal Endoscopy (diagnostic) CPT 31231 Nasal Endoscopy (diagnostic) — CPT code 31231 covers nasal endoscopy (diagnostic) performed in a clinical or hospital setting. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Nasal Endoscopy - Surgical Debridement CPT 31237 Nasal Endoscopy - Surgical Debridement — CPT code 31237 covers nasal endoscopy - surgical debridement performed in a clinical or hospital setting. |
— | $5,389 | $5,139 | $5,139–$6,640 | $5,389 | avg | 6 |
| Ethmoidectomy - Partial CPT 31254 Ethmoidectomy - Partial — CPT code 31254 covers ethmoidectomy - partial performed in a clinical or hospital setting. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Sinus Surgery - Ethmoidectomy CPT 31255 Sinus Surgery - Ethmoidectomy — CPT code 31255 covers sinus surgery - ethmoidectomy performed in a clinical or hospital setting. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Sinus Surgery - Frontal CPT 31276 Sinus Surgery - Frontal — CPT code 31276 covers sinus surgery - frontal performed in a clinical or hospital setting. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| TAVR - Transcatheter Aortic Valve Replacement CPT 33361 Replacement of a diseased aortic heart valve without open-heart surgery. A new valve is delivered through a catheter (thin tube) inserted through the leg artery. |
— | $5,389 | $5,139 | $5,139–$6,640 | $5,389 | avg | 6 |
| Mitral Valve Repair CPT 33430 Open-heart surgery to repair a damaged mitral valve — the valve between the upper and lower left chambers of the heart — restoring normal blood flow. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Coronary Artery Bypass (CABG) - Single CPT 33533 Coronary artery bypass surgery (CABG) using a single graft. A healthy blood vessel from another part of the body is used to reroute blood around a blocked heart artery. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Venipuncture (blood draw) CPT 36415 A routine blood draw where a needle is inserted into a vein (usually in the arm) to collect blood for laboratory testing. |
$16 | $4 | — | — | $4 | avg | 3 |
| Central Venous Catheter CPT 36556 Insertion of a central venous catheter (a thin, flexible tube) into a large vein to deliver medications, fluids, or nutrition directly into the bloodstream. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Central Venous Access Device CPT 36571 Central Venous Access Device — CPT code 36571 covers central venous access device performed in a clinical or hospital setting. |
— | $5,353 | $5,139 | $5,139–$6,640 | $5,353 | avg | 7 |
| Central Venous Access - Jugular CPT 36573 Insertion of a central venous catheter into the jugular vein (in the neck) for direct access to the central bloodstream for medications or monitoring. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Arterial Line Placement CPT 36620 Placement of a thin tube (catheter) into an artery, usually in the wrist, to continuously monitor blood pressure during surgery or critical care. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Tonsillectomy & Adenoidectomy (Under 12) CPT 42820 Surgical removal of the tonsils and adenoids. This procedure treats chronic infections, breathing problems, or sleep apnea caused by enlarged tonsils and adenoids. |
$5,539 | $8,264 | — | — | $8,264 | avg | 3 |
| Tonsillectomy (Age 12+) CPT 42826 Surgical removal of the tonsils for patients age 12 and older. This procedure treats chronic tonsillitis, recurrent infections, or breathing problems caused by enlarged tonsils. |
— | $3,271 | $3,198 | $49–$6,640 | $3,271 | avg | 1 |
| Upper Endoscopy (EGD) Diagnostic CPT 43235 Upper endoscopy (EGD) — a flexible tube with a camera is passed through the mouth to visually examine the esophagus, stomach, and upper intestine. |
$3,286 | $4,467 | — | — | $4,467 | avg | 3 |
| Upper Endoscopy (EGD) with Biopsy CPT 43239 Upper endoscopy with biopsy — a flexible tube with a camera is passed through the mouth to examine the esophagus, stomach, and upper intestine, and tissue samples are taken for analysis. |
$13,923 | $5,275 | — | — | $5,275 | avg | 3 |
| Upper Endoscopy with Dilation CPT 43249 Upper endoscopy with dilation — a flexible scope is used to stretch a narrowed area of the esophagus or stomach to improve swallowing. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Upper GI Endoscopy with Polypectomy CPT 43251 Upper GI Endoscopy with Polypectomy — CPT code 43251 covers upper gi endoscopy with polypectomy performed in a clinical or hospital setting. |
— | $4,388 | $5,139 | $221–$6,640 | $4,388 | avg | 7 |
| Upper GI Endoscopy with Band Ligation CPT 43270 Upper GI Endoscopy with Band Ligation — CPT code 43270 covers upper gi endoscopy with band ligation performed in a clinical or hospital setting. |
— | $5,389 | $5,139 | $5,139–$6,640 | $5,389 | avg | 6 |
| Laparoscopic Hiatal Hernia Repair CPT 43282 Laparoscopic Hiatal Hernia Repair — CPT code 43282 covers laparoscopic hiatal hernia repair performed in a clinical or hospital setting. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Gastric Bypass (Laparoscopic Roux-en-Y) CPT 43644 Gastric Bypass (Laparoscopic Roux-en-Y) — CPT code 43644 covers gastric bypass (laparoscopic roux-en-y) performed in a clinical or hospital setting. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Gastric Sleeve (Laparoscopic Sleeve Gastrectomy) CPT 43775 Gastric Sleeve (Laparoscopic Sleeve Gastrectomy) — CPT code 43775 covers gastric sleeve (laparoscopic sleeve gastrectomy) performed in a clinical or hospital setting. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Gastric Bypass - Open CPT 43846 Gastric Bypass - Open — CPT code 43846 covers gastric bypass - open performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Gastric Bypass with Small Intestine CPT 43847 Gastric Bypass with Small Intestine — CPT code 43847 covers gastric bypass with small intestine performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Small Bowel Resection CPT 44120 Small bowel resection �� surgical removal of a portion of the small intestine to treat disease, obstruction, or injury. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Laparoscopic Small Bowel Enterostomy CPT 44180 Laparoscopic Small Bowel Enterostomy — CPT code 44180 covers laparoscopic small bowel enterostomy performed in a clinical or hospital setting. |
— | $5,353 | $5,139 | $5,139–$6,640 | $5,353 | avg | 7 |
| Laparoscopic Appendectomy CPT 44970 Laparoscopic appendectomy — minimally invasive surgical removal of the appendix, typically performed for appendicitis. |
— | $4,876 | $5,139 | $574–$6,640 | $4,876 | avg | 6 |
| Colonoscopy (diagnostic) CPT 45378 Diagnostic colonoscopy — a flexible tube with a camera is inserted through the rectum to examine the entire large intestine for polyps, cancer, or other abnormalities. |
$12,734 | $4,899 | — | — | $4,899 | avg | 3 |
| Colonoscopy with Biopsy CPT 45380 Colonoscopy with biopsy — examination of the large intestine with a camera, during which tissue samples are taken from suspicious areas for laboratory analysis. |
$13,127 | $5,024 | — | — | $5,024 | avg | 3 |
| Colonoscopy with Polyp Removal CPT 45385 Colonoscopy with polyp removal — examination of the large intestine during which precancerous growths (polyps) are found and removed to prevent colon cancer. |
— | $3,137 | $2,843 | $49–$6,640 | $3,137 | avg | 2 |
| Gallbladder Removal (Laparoscopic) CPT 47562 Minimally invasive removal of the gallbladder (laparoscopic cholecystectomy). Small incisions and a camera are used to remove the gallbladder, typically for gallstones or inflammation. |
$25,152 | $10,432 | — | — | $10,432 | avg | 3 |
| Gallbladder Removal with Cholangiography CPT 47563 Laparoscopic gallbladder removal with X-ray imaging of the bile ducts (cholangiography) to check for gallstones in the ducts during surgery. |
$39,663 | $12,547 | — | — | $12,547 | avg | 3 |
| Cholecystectomy - Open CPT 47600 Open cholecystectomy — surgical removal of the gallbladder through a larger incision in the abdomen. |
— | $5,353 | $5,139 | $5,139–$6,640 | $5,353 | avg | 7 |
| Inguinal Hernia Repair CPT 49505 Inguinal hernia repair — surgical repair of a hernia in the groin area where tissue pushes through a weak spot in the abdominal muscles. |
$31,378 | $10,978 | — | — | $10,978 | avg | 3 |
| Inguinal Hernia Repair (Incarcerated) CPT 49507 Inguinal Hernia Repair (Incarcerated) — CPT code 49507 covers inguinal hernia repair (incarcerated) performed in a clinical or hospital setting. |
— | $5,353 | $5,139 | $5,139–$6,640 | $5,353 | avg | 7 |
| Laparoscopic Inguinal Hernia Repair CPT 49650 Laparoscopic inguinal hernia repair — minimally invasive repair of a groin hernia using small incisions and a camera. |
— | $4,306 | $6,131 | $49–$6,640 | $4,306 | avg | 1 |
| Lithotripsy (Kidney Stone Treatment) CPT 50590 Lithotripsy — shock waves are used to break kidney stones into small pieces that can pass naturally through the urinary tract. |
$28,992 | $10,461 | — | — | $10,461 | avg | 3 |
| Bladder Aspiration/Drainage CPT 51102 Bladder Aspiration/Drainage — CPT code 51102 covers bladder aspiration/drainage performed in a clinical or hospital setting. |
— | $3,345 | $3,287 | $167–$6,640 | $3,345 | avg | 1 |
| Cystoscopy (Bladder Exam) CPT 52000 Cystoscopy — a thin scope with a camera is inserted through the urethra to examine the inside of the bladder and urinary tract. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| TURP (Prostate Resection) CPT 52601 Transurethral resection of the prostate (TURP) — surgical removal of prostate tissue through the urethra to treat enlarged prostate and improve urinary flow. |
— | $3,817 | $5,139 | $49–$6,640 | $3,817 | avg | 2 |
| Prostate Biopsy CPT 55700 Prostate Biopsy — CPT code 55700 covers prostate biopsy performed in a clinical or hospital setting. |
$1,588 | $2,663 | — | — | $2,663 | avg | 3 |
| Robotic Prostatectomy CPT 55866 Robotic Prostatectomy — CPT code 55866 covers robotic prostatectomy performed in a clinical or hospital setting. |
— | $4,023 | $5,139 | $776–$6,640 | $4,023 | avg | 7 |
| Colposcopy with Biopsy (Cervical) CPT 57454 Colposcopy with Biopsy (Cervical) — CPT code 57454 covers colposcopy with biopsy (cervical) performed in a clinical or hospital setting. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Endometrial Biopsy CPT 58100 Endometrial Biopsy — CPT code 58100 covers endometrial biopsy performed in a clinical or hospital setting. |
— | $5,353 | $5,139 | $5,139–$6,640 | $5,353 | avg | 7 |
| Total Hysterectomy - Abdominal CPT 58150 Total Hysterectomy - Abdominal — CPT code 58150 covers total hysterectomy - abdominal performed in a clinical or hospital setting. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| IUD Insertion CPT 58300 IUD Insertion — CPT code 58300 covers iud insertion performed in a clinical or hospital setting. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| IUD Removal CPT 58301 IUD Removal — CPT code 58301 covers iud removal performed in a clinical or hospital setting. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Laparoscopic Hysterectomy (250g or Less) CPT 58571 Total laparoscopic hysterectomy including removal of the cervix — minimally invasive complete removal of the uterus and cervix. |
— | $4,935 | $5,139 | $1,117–$6,640 | $4,935 | avg | 2 |
| Laparoscopic Ovarian Cyst/Adnexal Removal CPT 58661 Laparoscopic removal of the uterus (hysterectomy) — minimally invasive surgery using small incisions and a camera to remove the uterus. |
$6,567 | $10,137 | — | — | $10,137 | avg | 3 |
| Fetal Non-Stress Test CPT 59025 Fetal non-stress test — monitoring the baby's heart rate in response to its own movements to assess fetal wellbeing. |
— | $2,903 | $5,139 | $20–$5,139 | $2,903 | avg | 6 |
| Vaginal Delivery (routine, global) CPT 59400 Routine obstetric care including prenatal visits, vaginal delivery, and postpartum care — comprehensive maternity care package. |
— | $6,119 | $6,119 | $5,139–$7,099 | $6,119 | avg | 5 |
| Vaginal Delivery Only CPT 59409 Vaginal Delivery Only — CPT code 59409 covers vaginal delivery only performed in a clinical or hospital setting. |
— | $6,946 | $7,099 | $6,640–$7,099 | $6,946 | avg | 3 |
| C-Section Delivery (global) CPT 59510 Routine obstetric care including prenatal visits, cesarean delivery, and postpartum care — comprehensive maternity care package with C-section. |
— | $6,119 | $6,119 | $5,139–$7,099 | $6,119 | avg | 6 |
| VBAC Delivery CPT 59610 VBAC Delivery — CPT code 59610 covers vbac delivery performed in a clinical or hospital setting. |
— | $6,119 | $6,119 | $5,139–$7,099 | $6,119 | avg | 2 |
| Lumbar Epidural Injection CPT 62322 Lumbar or sacral epidural injection — injection of medication into the epidural space of the lower spine for pain relief. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Lumbar Epidural - Fluoroscopic CPT 62323 Lumbar or sacral epidural injection with imaging guidance — a precisely targeted spinal injection using X-ray or fluoroscopy for accurate placement. |
— | $5,389 | $5,139 | $5,139–$6,640 | $5,389 | avg | 6 |
| Lumbar Laminotomy CPT 63030 Lumbar laminotomy — surgical removal of a small portion of the vertebral bone (lamina) in the lower back to relieve pressure on spinal nerves, typically for a herniated disc. |
— | $5,353 | $5,139 | $5,139–$6,640 | $5,353 | avg | 7 |
| Lumbar Laminectomy (Single Level) CPT 63047 Lumbar laminectomy — surgical removal of the bony arch (lamina) of a vertebra in the lower back to create more space for the spinal cord and nerves. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Transforaminal Epidural Injection CPT 64483 Lumbar epidural steroid injection — injection of anti-inflammatory medication into the space around spinal nerves in the lower back to relieve pain. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Facet Joint Injection - Lumbar CPT 64493 Lumbar facet joint injection — injection of medication into the small joints of the lower spine to diagnose and treat back pain. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Facet Joint Destruction - Lumbar CPT 64635 Facet Joint Destruction - Lumbar — CPT code 64635 covers facet joint destruction - lumbar performed in a clinical or hospital setting. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Carpal Tunnel Release CPT 64721 Carpal tunnel release — surgery to relieve pressure on the median nerve in the wrist, treating numbness, tingling, and weakness in the hand. |
— | $3,189 | $2,778 | $49–$6,640 | $3,189 | avg | 2 |
| Glaucoma Laser Surgery CPT 65855 Glaucoma Laser Surgery — CPT code 65855 covers glaucoma laser surgery performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Glaucoma Filter Surgery CPT 66170 Glaucoma Filter Surgery — CPT code 66170 covers glaucoma filter surgery performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| YAG Laser Capsulotomy CPT 66821 YAG Laser Capsulotomy — CPT code 66821 covers yag laser capsulotomy performed in a clinical or hospital setting. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Complex Cataract Surgery CPT 66982 CT scan — complex cataract surgery. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $5,389 | $5,139 | $5,139–$6,640 | $5,389 | avg | 6 |
| Cataract Surgery CPT 66984 Cataract surgery with lens implant — removal of the clouded natural lens of the eye and replacement with a clear artificial lens to restore vision. |
— | $5,639 | $5,139 | $5,139–$6,640 | $5,639 | avg | 2 |
| Strabismus Surgery CPT 67311 Strabismus Surgery — CPT code 67311 covers strabismus surgery performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Eyelid Repair - Blepharoplasty CPT 67904 Eyelid Repair - Blepharoplasty — CPT code 67904 covers eyelid repair - blepharoplasty performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Eyelid Repair - Lower Lid CPT 67917 Eyelid Repair - Lower Lid — CPT code 67917 covers eyelid repair - lower lid performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Tear Duct Probing CPT 68810 CT scan — tear duct probing. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $6,640 | $6,640 | $6,640–$6,640 | $6,640 | avg | 1 |
| Ear Wax Removal CPT 69210 Ear Wax Removal — CPT code 69210 covers ear wax removal performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Ear Tube Placement (Tympanostomy) CPT 69436 Ear Tube Placement (Tympanostomy) — CPT code 69436 covers ear tube placement (tympanostomy) performed in a clinical or hospital setting. |
— | $5,389 | $5,139 | $5,139–$6,640 | $5,389 | avg | 6 |
| CT Head without Contrast CPT 70450 CT scan — ct head without contrast. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $816 | $451 | $42–$2,303 | $816 | avg | 1 |
| CT Head with Contrast CPT 70460 CT scan — ct head with contrast. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $2,303 | $2,303 | $2,303–$2,303 | $2,303 | avg | 1 |
| Brain MRI without Contrast CPT 70551 MRI of the brain without contrast — detailed magnetic resonance imaging of the brain to evaluate for abnormalities without using contrast dye. |
— | $2,478 | $2,478 | $2,478–$2,478 | $2,478 | avg | 1 |
| MRI Brain with/without Contrast CPT 70553 MRI of the brain with and without contrast dye — detailed imaging of the brain using magnetic fields and radio waves to diagnose tumors, stroke, or other conditions. |
$979 | $2,491 | — | — | $2,491 | avg | 3 |
| Chest X-Ray (single view) CPT 71045 X-ray imaging — chest x-ray (single view). A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $141 | $21 | $9–$347 | $141 | avg | 1 |
| Chest X-Ray (2 views) CPT 71046 Chest X-ray, two views — standard imaging of the lungs and chest from front and side to evaluate for pneumonia, heart problems, or other chest conditions. |
— | $209 | $112 | $11–$452 | $209 | avg | 1 |
| CT Chest without Contrast CPT 71250 CT scan of the chest without contrast — detailed cross-sectional imaging of the lungs, heart, and chest structures without contrast dye. |
— | $1,042 | $254 | $49–$2,303 | $1,042 | avg | 1 |
| CT Chest with Contrast CPT 71260 CT scan of the chest with contrast — detailed cross-sectional imaging of the chest after injecting contrast dye to better visualize blood vessels and tissues. |
$3,985 | $1,981 | — | — | $1,981 | avg | 3 |
| Lumbar Spine X-Ray CPT 72100 X-ray imaging — lumbar spine x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $126 | $42 | $11–$498 | $126 | avg | 1 |
| MRI Cervical Spine without Contrast CPT 72141 MRI of the cervical spine (neck) without contrast — detailed imaging of the neck spine to evaluate for herniated discs, spinal cord problems, or nerve issues. |
— | $1,014 | $486 | $49–$2,478 | $1,014 | avg | 1 |
| MRI Lumbar Spine without Contrast CPT 72148 MRI of the lumbar spine (lower back) without contrast — detailed imaging of the lower spine to evaluate for herniated discs, spinal stenosis, or nerve compression. |
— | $1,024 | $486 | $49–$2,478 | $1,024 | avg | 1 |
| Shoulder X-Ray CPT 73030 X-ray imaging — shoulder x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $244 | $49 | $10–$899 | $244 | avg | 1 |
| Hand X-Ray CPT 73130 X-ray imaging — hand x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $29 | $29 | $8–$49 | $29 | -1% | 1 |
| MRI Shoulder without Contrast CPT 73221 MRI of any joint of the upper extremity without contrast — detailed imaging of a shoulder, elbow, wrist, or hand joint. |
— | $1,003 | $486 | $49–$2,478 | $1,003 | avg | 1 |
| Knee X-Ray CPT 73560 X-ray imaging — knee x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $28 | $27 | $9–$49 | $28 | avg | 1 |
| Ankle X-Ray CPT 73610 X-ray imaging — ankle x-ray. A quick imaging test using small amounts of radiation to create pictures of bones and internal structures. |
— | $173 | $49 | $8–$410 | $173 | avg | 1 |
| MRI Knee without Contrast CPT 73721 MRI of any joint of the lower extremity without contrast — detailed imaging of a hip, knee, ankle, or foot joint using magnetic resonance. |
— | $1,187 | $570 | $49–$2,478 | $1,187 | avg | 1 |
| CT Abdomen/Pelvis without Contrast CPT 74176 CT scan of the abdomen and pelvis without contrast followed by with contrast — complete imaging study of the abdomen and pelvis. |
— | $610 | $221 | $83–$2,303 | $610 | avg | 1 |
| CT Abdomen/Pelvis with Contrast CPT 74177 CT scan of the abdomen and pelvis with contrast — comprehensive cross-sectional imaging of the abdominal and pelvic organs after contrast injection. |
— | $1,417 | $454 | $87–$4,332 | $1,417 | avg | 1 |
| Breast Ultrasound CPT 76642 Ultrasound — breast ultrasound. This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $190 | $194 | $35–$335 | $190 | avg | 1 |
| Abdominal Ultrasound CPT 76700 Abdominal ultrasound — uses sound waves to create images of organs in the abdomen including the liver, gallbladder, kidneys, and pancreas. |
— | $228 | $139 | $40–$477 | $228 | avg | 1 |
| OB Ultrasound (first trimester) CPT 76801 Ultrasound — ob ultrasound (first trimester). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $277 | $134 | $49–$584 | $277 | avg | 1 |
| OB Ultrasound (complete) CPT 76805 Ultrasound — ob ultrasound (complete). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $234 | $125 | $49–$536 | $234 | avg | 1 |
| Transvaginal Ultrasound CPT 76830 Transvaginal ultrasound — an ultrasound probe is placed internally to obtain detailed images of the uterus, ovaries, and pelvic structures. |
— | $214 | $96 | $34–$760 | $214 | avg | 1 |
| Pelvic Ultrasound CPT 76856 Pelvic ultrasound — uses sound waves to examine the uterus, ovaries, bladder, and other pelvic organs. |
— | $171 | $95 | $34–$549 | $171 | avg | 1 |
| 3D Mammography (Tomosynthesis) CPT 77063 3D Mammography (Tomosynthesis) — CPT code 77063 covers 3d mammography (tomosynthesis) performed in a clinical or hospital setting. |
— | $61 | $68 | $27–$86 | $61 | avg | 1 |
| Diagnostic Mammogram (unilateral) CPT 77065 Screening mammogram of one breast — X-ray imaging of one breast to check for early signs of breast cancer. |
— | $184 | $215 | $39–$313 | $184 | avg | 1 |
| Diagnostic Mammogram (bilateral) CPT 77066 Screening mammogram of both breasts — routine X-ray imaging of both breasts to detect early breast cancer in women without symptoms. |
— | $217 | $178 | $49–$428 | $217 | avg | 1 |
| Screening Mammogram (bilateral) CPT 77067 Screening mammogram of both breasts including computer-aided detection — enhanced breast X-ray with software assistance for improved cancer detection. |
— | $190 | $228 | $37–$302 | $190 | avg | 1 |
| Nuclear Stress Test (SPECT MPI) CPT 78452 Myocardial perfusion imaging (stress test with nuclear imaging) — evaluates blood flow to the heart muscle during rest and stress to detect blocked arteries. |
— | $1,066 | $496 | $77–$2,310 | $1,066 | avg | 1 |
| BMP (Basic Metabolic Panel) CPT 80048 Basic metabolic panel — a blood test measuring 8 substances (glucose, calcium, sodium, potassium, CO2, chloride, BUN, creatinine) to assess kidney function, blood sugar, and electrolyte balance. |
— | $128 | $128 | $12–$244 | $128 | avg | 1 |
| CMP (Comprehensive Metabolic Panel) CPT 80053 Comprehensive metabolic panel — a blood test measuring 14 substances to evaluate kidney and liver function, blood sugar, electrolytes, and protein levels. |
— | $350 | $269 | $15–$653 | $350 | avg | 1 |
| Lipid Panel CPT 80061 Lipid panel — a blood test measuring cholesterol levels including total cholesterol, HDL ("good"), LDL ("bad"), and triglycerides to assess heart disease risk. |
— | $800 | $201 | $19–$2,777 | $800 | avg | 1 |
| Urinalysis (automated) CPT 81003 Urinalysis (automated) — CPT code 81003 covers urinalysis (automated) performed in a clinical or hospital setting. |
— | $463 | $68 | $3–$1,246 | $463 | avg | 1 |
| Glucose (blood sugar) CPT 82947 Blood glucose test — measures the level of sugar in your blood, used to screen for and monitor diabetes. |
— | $11 | $11 | $6–$16 | $11 | -2% | 1 |
| Hemoglobin A1C CPT 83036 Hemoglobin A1c test — a blood test that shows your average blood sugar level over the past 2-3 months, used to diagnose and monitor diabetes. |
— | $75 | $101 | $14–$111 | $75 | avg | 1 |
| PSA (Prostate) CPT 84153 PSA (Prostate) — CPT code 84153 covers psa (prostate) performed in a clinical or hospital setting. |
— | $111 | $111 | $26–$195 | $111 | avg | 1 |
| CBC (Complete Blood Count) CPT 85025 Complete blood count (CBC) with differential — a common blood test that measures red blood cells, white blood cells, platelets, and hemoglobin to evaluate overall health. |
— | $87 | $118 | $11–$130 | $87 | -1% | 1 |
| PT/INR (Prothrombin Time) CPT 85610 PT/INR (Prothrombin Time) — CPT code 85610 covers pt/inr (prothrombin time) performed in a clinical or hospital setting. |
— | $55 | $54 | $0–$112 | $55 | avg | 1 |
| Blood Type (ABO) CPT 86900 Blood Type (ABO) — CPT code 86900 covers blood type (abo) performed in a clinical or hospital setting. |
— | $99 | $140 | $4–$154 | $99 | avg | 1 |
| COVID-19 Test (PCR) CPT 87635 COVID-19 Test (PCR) — CPT code 87635 covers covid-19 test (pcr) performed in a clinical or hospital setting. |
— | $54 | $51 | $41–$64 | $54 | avg | 1 |
| Tdap Vaccine CPT 90715 Tdap Vaccine — CPT code 90715 covers tdap vaccine performed in a clinical or hospital setting. |
— | $57 | $62 | $48–$62 | $57 | avg | 2 |
| Psychiatric Diagnostic Evaluation CPT 90791 Psychiatric Diagnostic Evaluation — CPT code 90791 covers psychiatric diagnostic evaluation performed in a clinical or hospital setting. |
— | $228 | $183 | $149–$398 | $228 | avg | 1 |
| Psychotherapy (16-37 min) CPT 90832 Psychotherapy (16-37 min) — CPT code 90832 covers psychotherapy (16-37 min) performed in a clinical or hospital setting. |
— | $378 | $580 | $68–$627 | $378 | avg | 1 |
| Psychotherapy (38-52 min) CPT 90834 Psychotherapy (38-52 min) — CPT code 90834 covers psychotherapy (38-52 min) performed in a clinical or hospital setting. |
— | $394 | $580 | $99–$627 | $394 | avg | 1 |
| Psychotherapy (53+ min) CPT 90837 Psychotherapy (53+ min) — CPT code 90837 covers psychotherapy (53+ min) performed in a clinical or hospital setting. |
— | $411 | $580 | $133–$627 | $411 | avg | 1 |
| Group Psychotherapy CPT 90853 Group Psychotherapy — CPT code 90853 covers group psychotherapy performed in a clinical or hospital setting. |
— | $357 | $555 | $37–$627 | $357 | avg | 1 |
| Coronary Stent Placement CPT 92928 Coronary Stent Placement — CPT code 92928 covers coronary stent placement performed in a clinical or hospital setting. |
— | $4,371 | $6,221 | $45–$6,640 | $4,371 | avg | 2 |
| Echocardiogram Complete CPT 93306 Echocardiogram Complete — CPT code 93306 covers echocardiogram complete performed in a clinical or hospital setting. |
— | $303 | $224 | $73–$689 | $303 | avg | 1 |
| Left Heart Catheterization CPT 93458 Left Heart Catheterization — CPT code 93458 covers left heart catheterization performed in a clinical or hospital setting. |
— | $3,983 | $6,136 | $327–$6,640 | $3,983 | avg | 1 |
| Carotid Ultrasound CPT 93880 Ultrasound — carotid ultrasound. This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $274 | $293 | $32–$432 | $274 | avg | 1 |
| Venous Duplex Scan (legs) CPT 93971 Venous Duplex Scan (legs) — CPT code 93971 covers venous duplex scan (legs) performed in a clinical or hospital setting. |
— | $169 | $122 | $24–$409 | $169 | avg | 1 |
| Therapeutic Injection (IM/SubQ) CPT 96372 Therapeutic injection — injection of medication into a muscle or under the skin for treatment purposes. |
— | $542 | $169 | $26–$3,223 | $542 | avg | 2 |
| IV Push (single drug) CPT 96374 IV push medication — rapid injection of medication directly into a vein or existing IV line. |
— | $196 | $232 | $62–$259 | $196 | avg | 2 |
| Chemotherapy Infusion (first hour) CPT 96413 Chemotherapy IV infusion, first hour — administration of cancer-fighting medication through an IV line for the initial hour. |
— | $504 | $599 | $169–$650 | $504 | avg | 1 |
| PT - Therapeutic Exercise CPT 97110 Therapeutic exercises — a physical therapy session focused on exercises to improve strength, flexibility, endurance, or range of motion. |
— | $42 | $26 | $14–$85 | $42 | -1% | 1 |
| PT - Manual Therapy CPT 97140 Manual therapy — hands-on treatment by a physical therapist including joint mobilization, soft tissue massage, and manual stretching. |
— | $45 | $43 | $16–$79 | $45 | avg | 1 |
| PT Evaluation - Low Complexity CPT 97161 Physical therapy evaluation, low complexity — initial assessment by a physical therapist for a straightforward condition. |
— | $133 | $133 | $73–$193 | $133 | avg | 1 |
| PT Evaluation - High Complexity CPT 97163 Physical therapy evaluation, high complexity — comprehensive initial assessment by a physical therapist for a complex condition. |
— | $199 | $199 | $73–$325 | $199 | avg | 1 |
| PT - Therapeutic Activities CPT 97530 Therapeutic activities — functional movement training to improve your ability to perform daily activities. |
— | $479 | $62 | $17–$1,776 | $479 | avg | 1 |
| ER Visit - Minor Problem CPT 99281 Emergency department visit for a minor, self-limited problem requiring minimal evaluation. |
— | $987 | $705 | $79–$2,853 | $987 | avg | 1 |
| ER Visit - Low Complexity CPT 99282 Emergency department visit for a low to moderate severity problem requiring a brief evaluation. |
— | $635 | $612 | $58–$1,300 | $635 | avg | 6 |
| ER Visit - Moderate Complexity CPT 99283 Emergency department visit for a moderate severity problem requiring an expanded evaluation. |
— | $1,491 | $1,508 | $79–$3,004 | $1,491 | avg | 1 |
| ER Visit - High Complexity CPT 99284 Emergency department visit for a high severity problem requiring urgent evaluation, but not an immediate threat to life. |
— | $1,973 | $2,815 | $112–$3,004 | $1,973 | avg | 1 |
| ER Visit - Immediate Threat to Life CPT 99285 Emergency department visit for a severe, potentially life-threatening problem requiring immediate and comprehensive evaluation. |
— | $923 | $174 | $58–$2,931 | $923 | avg | 6 |
| Critical Care - First Hour CPT 99291 Critical care, first 30-74 minutes — intensive medical care for a critically ill or injured patient whose condition requires constant attention from the physician. |
— | $1,539 | $1,519 | $49–$3,004 | $1,539 | avg | 1 |
| Critical Care - Additional 30 Min CPT 99292 Critical care, each additional 30 minutes — continued intensive care beyond the first 74 minutes for a critically ill patient. |
— | $91 | $107 | $49–$117 | $91 | avg | 1 |
| Ceftriaxone Injection 250mg CPT J0696 HCPCS Level II code J0696 — Ceftriaxone Injection 250mg. Healthcare Common Procedure Coding System code for ceftriaxone injection 250mg. |
— | $42 | $62 | $4–$62 | $42 | +1% | 2 |
| Triamcinolone Injection CPT J3301 HCPCS Level II code J3301 — Triamcinolone Injection. Healthcare Common Procedure Coding System code for triamcinolone injection. |
— | $32 | $32 | $1–$62 | $32 | -1% | 2 |
| Dexamethasone Injection CPT J1100 HCPCS Level II code J1100 — Dexamethasone Injection. Healthcare Common Procedure Coding System code for dexamethasone injection. |
— | $39 | $26 | $22–$62 | $39 | avg | 2 |
| Debridement of Skin (infected) CPT 11000 Debridement of extensively eczematous or infected skin |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Skin Tag Removal (up to 15) CPT 11200 Removal of skin tags, multiple fibrocutaneous tags |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Skin Lesion Shave (0.6-1.0 cm) CPT 11301 Shave removal of epidermal or dermal lesion, trunk/extremities |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Skin Lesion Shave - Scalp/Neck (0.5 cm) CPT 11305 Shave removal of epidermal or dermal lesion, scalp/neck/hands/feet |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Excision of Benign Skin Lesion (0.5 cm or less) CPT 11400 Excision of benign lesion, trunk/arms/legs |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Excision of Benign Skin Lesion (1.1-2.0 cm) CPT 11402 Excision of benign lesion, trunk/arms/legs, 1.1-2.0 cm |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Excision Benign Lesion - Face (0.5 cm) CPT 11440 Excision of benign lesion, face/ears/eyelids/nose/lips |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Excision Malignant Lesion (0.5 cm or less) CPT 11600 Excision of malignant lesion, trunk/arms/legs |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Excision Malignant Lesion (0.6-1.0 cm) CPT 11601 Excision of malignant lesion, trunk/arms/legs, 0.6-1.0 cm |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Permanent Nail Removal CPT 11750 Excision of nail and nail matrix, permanent removal |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Destruction of Premalignant Lesions (2-14) CPT 17003 Destruction of premalignant lesions, second through 14th lesion |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Destruction Malignant Lesion (trunk) CPT 17260 Destruction of malignant lesion, trunk, any method |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Mohs Surgery (first stage) CPT 17311 Mohs micrographic surgery, first stage, up to 5 tissue blocks |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Laser Treatment for Skin (small) CPT 96920 Laser treatment for inflammatory skin disease, less than 250 sq cm |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Tendon Sheath Injection CPT 20550 Injection of tendon sheath, ligament, or trigger point |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Hardware Removal (deep) CPT 20680 Removal of implant, deep (plate, screw, rod) |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Shoulder Injection with Imaging CPT 23350 Injection for shoulder arthrography |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Tennis Elbow Repair CPT 24341 Repair of lateral collateral ligament, elbow |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Closed Treatment Distal Radius Fracture CPT 25600 Closed treatment of distal radial fracture without manipulation |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Intertrochanteric Fracture Treatment CPT 27245 Treatment of intertrochanteric femoral fracture with plate/screws |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Open Treatment Ankle Fracture (bimalleolar) CPT 27792 Open treatment of distal fibula fracture, bimalleolar |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Amputation - Toe CPT 28820 Amputation of toe at metatarsophalangeal joint |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Endoscopic Carpal Tunnel Release CPT 29848 Endoscopy of wrist, carpal tunnel release |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Shoulder Arthroscopy - Acromioplasty CPT 29826 Arthroscopy, shoulder, surgical, decompression of subacromial space |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Knee Arthroscopy with Meniscus Repair CPT 29882 Arthroscopy, knee, surgical, meniscus repair |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| ACL Reconstruction (Knee Ligament Repair) CPT 29888 Arthroscopically aided anterior cruciate ligament repair/augmentation |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Esophagoscopy (diagnostic) CPT 43191 Esophagoscopy, flexible, diagnostic |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| EGD with Stent Placement CPT 43210 Esophagogastroduodenoscopy with stent placement |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| EGD with Gastrostomy Tube CPT 43246 Upper GI endoscopy with gastrostomy tube placement |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| EGD with Foreign Body Removal CPT 43247 Upper GI endoscopy with removal of foreign body |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Sigmoidoscopy (diagnostic) CPT 45330 Sigmoidoscopy, flexible, diagnostic |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Sigmoidoscopy with Biopsy CPT 45331 Sigmoidoscopy, flexible, with biopsy |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Colonoscopy with Lesion Removal (hot biopsy) CPT 45384 Colonoscopy with removal of tumor by hot biopsy forceps |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Colonoscopy with Ablation CPT 45388 Colonoscopy with ablation of tumor or polyp |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Colonoscopy with Foreign Body Removal CPT 45390 Colonoscopy with removal of foreign body |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Colonoscopy with Endoscopic Ultrasound CPT 45391 Colonoscopy with endoscopic ultrasound examination |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laceration Repair - Simple (2.5 cm or less) CPT 12001 Simple repair of superficial wounds, scalp/neck/extremities |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laceration Repair - Simple (7.6-12.5 cm) CPT 12004 Simple repair of superficial wounds, 7.6-12.5 cm |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laceration Repair - Face (2.5 cm or less) CPT 12011 Simple repair of superficial wounds of face, 2.5 cm or less |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laceration Repair - Face (2.6-5.0 cm) CPT 12013 Simple repair of superficial wounds of face, 2.6-5.0 cm |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laceration Repair - Intermediate (2.5 cm or less) CPT 12031 Repair, intermediate, wounds of scalp/trunk/extremities |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laceration Repair - Intermediate (2.6-7.5 cm) CPT 12032 Repair, intermediate, wounds of scalp/trunk/extremities |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Burn Dressing (small) CPT 16020 Dressings and/or debridement of partial-thickness burns, small |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Burn Dressing (medium) CPT 16025 Dressings and/or debridement of partial-thickness burns, medium |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Closed Treatment Radial Head Fracture CPT 24640 Closed treatment of radial head subluxation (nursemaid elbow) |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Short Arm Splint CPT 29125 Application of short arm splint, forearm to hand |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Finger Splint CPT 29130 Application of finger splint |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Long Leg Splint CPT 29505 Application of long leg splint, thigh to ankle |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Short Leg Splint CPT 29515 Application of short leg splint, calf to foot |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Nasal Foreign Body Removal CPT 30300 Removal of foreign body from intranasal, office type |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Anterior Nasal Packing (nosebleed) CPT 30901 Control nasal hemorrhage, anterior, simple |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Endotracheal Intubation CPT 31500 Intubation, endotracheal, emergency procedure |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Chest Tube Insertion CPT 32551 Tube thoracostomy, insertion of chest tube |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| IV Line Placement (peripheral) CPT 36000 Introduction of needle or intracatheter, vein |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| IV Infusion (hydration, first hour) CPT 96360 Intravenous infusion, hydration, initial 31-60 minutes |
— | $259 | $259 | $259–$259 | $259 | avg | 1 |
| IV Infusion (hydration, additional hour) CPT 96361 Intravenous infusion, hydration, each additional hour |
— | $259 | $259 | $259–$259 | $259 | avg | 1 |
| IV Infusion (therapeutic, first hour) CPT 96365 Intravenous infusion for therapy/prophylaxis, initial up to 1 hour |
— | $259 | $259 | $259–$259 | $259 | avg | 1 |
| IV Infusion (therapeutic, additional hour) CPT 96366 Intravenous infusion for therapy, each additional hour |
— | $259 | $259 | $259–$259 | $259 | avg | 1 |
| IV Infusion (additional sequential) CPT 96367 Intravenous infusion, additional sequential infusion, up to 1 hour |
— | $259 | $259 | $259–$259 | $259 | avg | 1 |
| IV Push (each additional) CPT 96375 Therapeutic, prophylactic, or diagnostic injection; each additional sequential IV push |
— | $259 | $259 | $259–$259 | $259 | avg | 1 |
| IV Push (each additional, same drug) CPT 96376 Therapeutic injection, IV push, each additional sequential IV push of same substance |
— | $259 | $259 | $259–$259 | $259 | avg | 5 |
| Hepatitis A Vaccine (adult) CPT 90632 Hepatitis A vaccine, adult dosage |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Hepatitis A & B Vaccine (combo) CPT 90636 Hepatitis A and hepatitis B vaccine, adult dosage |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Hib Vaccine CPT 90647 Haemophilus influenzae type b vaccine |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| HPV Vaccine (9-valent) CPT 90651 Human papillomavirus vaccine, 9-valent, 3 dose schedule |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Pneumococcal Vaccine (PCV13) CPT 90670 Pneumococcal conjugate vaccine, 13 valent |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Rotavirus Vaccine CPT 90681 Rotavirus vaccine, human, attenuated |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Flu Vaccine (quadrivalent) CPT 90686 Influenza virus vaccine, quadrivalent, preservative free |
— | $62 | $62 | $62–$62 | $62 | -1% | 5 |
| DTaP-IPV Vaccine CPT 90696 Diphtheria, tetanus, acellular pertussis and polio vaccine |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| MMR Vaccine CPT 90707 Measles, mumps, rubella vaccine |
— | $62 | $62 | $62–$62 | $62 | -1% | 6 |
| Polio Vaccine (IPV) CPT 90713 Poliovirus vaccine, inactivated |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Td Vaccine (adult) CPT 90714 Tetanus and diphtheria toxoids, adult, preservative free |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Varicella (Chickenpox) Vaccine CPT 90716 Varicella virus vaccine, live |
— | $62 | $62 | $62–$62 | $62 | -1% | 5 |
| Pneumococcal Vaccine (PPSV23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Shingles Vaccine (Zoster) CPT 90736 Zoster (shingles) vaccine, live |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Hepatitis B Vaccine (adult) CPT 90746 Hepatitis B vaccine, adult dosage |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Breast Biopsy (stereotactic) CPT 19081 Biopsy, breast, with placement of breast localization device, stereotactic guidance |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Breast Biopsy (ultrasound-guided) CPT 19083 Biopsy, breast, with placement of breast localization device, ultrasound guidance |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Breast Biopsy (MRI-guided) CPT 19084 Biopsy, breast, with placement of breast localization device, MRI guidance |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Breast Augmentation (Implant) CPT 19325 Mammaplasty, augmentative |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Breast Implant Removal CPT 19328 Removal of intact mammary implant |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Breast Reconstruction (immediate) CPT 19340 Immediate insertion of breast prosthesis following mastopexy or mastectomy |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Vulvectomy (partial) CPT 56620 Vulvectomy, simple, partial |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Colposcopy (diagnostic) CPT 57420 Colposcopy of entire vagina, with cervix if present |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Colposcopy with Biopsy (cervix) CPT 57452 Colposcopy of cervix including upper adjacent vagina |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| LEEP Procedure (cervix) CPT 57460 Colposcopy with loop electrode excision procedure of cervix |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Cervical Conization CPT 57520 Conization of cervix, with or without fulguration |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Dilation and Curettage (D&C) CPT 58120 Dilation and curettage, diagnostic and/or therapeutic |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Vaginal Hysterectomy CPT 58260 Vaginal hysterectomy, for uterus 250g or less |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Vaginal Hysterectomy with Tube/Ovary Removal CPT 58262 Vaginal hysterectomy with removal of tube(s) and/or ovary(s) |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Vaginal Hysterectomy (>250g) CPT 58291 Vaginal hysterectomy, for uterus greater than 250g |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Hysterosalpingography (HSG) CPT 58340 Catheterization and introduction of saline for sonohysterography |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Hysteroscopy (diagnostic) CPT 58555 Hysteroscopy, diagnostic, separate procedure |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Hysteroscopy with Biopsy/Polypectomy CPT 58558 Hysteroscopy, surgical, with sampling of endometrium |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Hysteroscopy with Ablation CPT 58563 Hysteroscopy, surgical, with endometrial ablation |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Tubal Ligation CPT 58600 Ligation or transection of fallopian tube(s), abdominal or vaginal approach |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Laparoscopy with Lysis of Adhesions CPT 58660 Laparoscopy, lysis of adhesions |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laparoscopic Endometriosis Excision CPT 58662 Laparoscopy with fulguration or excision of lesions of ovary/peritoneum |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Amniocentesis CPT 59000 Amniocentesis, diagnostic |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Chorionic Villus Sampling CPT 59015 Chorionic villus sampling, any method |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Delivery of Placenta CPT 59414 Delivery of placenta (separate procedure) |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Incomplete Abortion Treatment CPT 59812 Treatment of incomplete abortion, any trimester, surgical |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Missed Abortion Treatment (first trimester) CPT 59820 Treatment of missed abortion, completed surgically, first trimester |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Incision and Drainage of Abscess (simple) CPT 10060 Incision and drainage of abscess, simple or single |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Incision and Drainage of Abscess (complex) CPT 10061 Incision and drainage of abscess, complicated or multiple |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Foreign Body Removal (skin, simple) CPT 10120 Incision and removal of foreign body, subcutaneous tissues, simple |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Foreign Body Removal (skin, complex) CPT 10121 Incision and removal of foreign body, subcutaneous tissues, complicated |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Incision and Drainage of Hematoma CPT 10140 Incision and drainage of hematoma, seroma, or fluid collection |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Aspiration of Abscess/Cyst CPT 10160 Puncture aspiration of abscess, hematoma, bulla, or cyst |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Debridement - Muscle/Fascia CPT 11043 Debridement, muscle and/or fascia, first 20 sq cm |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Breast Biopsy (needle, percutaneous) CPT 19100 Biopsy of breast, percutaneous, needle core |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Knee Cartilage Removal (arthrotomy) CPT 27332 Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Pacemaker Insertion CPT 33208 Insertion of new or replacement of permanent pacemaker |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| ICD (Defibrillator) Insertion CPT 33249 Insertion or replacement of permanent implantable defibrillator system |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Bone Marrow Aspiration CPT 38220 Diagnostic bone marrow aspiration(s) |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Bone Marrow Biopsy CPT 38221 Diagnostic bone marrow biopsy(ies) |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Lymph Node Biopsy/Excision (superficial) CPT 38500 Biopsy or excision of lymph node(s), superficial |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Lymph Node Biopsy/Excision (deep) CPT 38510 Biopsy or excision of lymph node(s), deep cervical |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Lip Biopsy CPT 40490 Biopsy of lip, vermilion |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Tongue Biopsy (anterior 2/3) CPT 41100 Biopsy of tongue, anterior two-thirds |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Salivary Stone Removal (Sialolithotomy) CPT 42330 Sialolithotomy, submandibular or sublingual, intraoral |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Drainage of Peritonsillar Abscess CPT 42700 Incision and drainage, abscess, peritonsillar |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Nasogastric Tube Placement CPT 43760 Change of gastrostomy tube, percutaneous, without imaging |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Lysis of Abdominal Adhesions (open) CPT 44005 Enterolysis, freeing of intestinal adhesion |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Partial Colectomy CPT 44140 Colectomy, partial, with anastomosis |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laparoscopic Partial Colectomy CPT 44204 Laparoscopic partial colectomy with anastomosis |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Appendectomy (open) CPT 44950 Appendectomy |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Liver Biopsy (needle) CPT 47000 Biopsy of liver, needle, percutaneous |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Exploratory Laparotomy CPT 49000 Exploratory laparotomy, exploratory celiotomy |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Diagnostic Laparoscopy CPT 49320 Laparoscopy, abdomen, diagnostic |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Incisional Hernia Repair CPT 49560 Repair initial incisional or ventral hernia, reducible |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Incisional Hernia Repair (incarcerated) CPT 49561 Repair initial incisional or ventral hernia, incarcerated or strangulated |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Laparoscopic Ventral Hernia Repair CPT 49652 Laparoscopy, repair of ventral hernia |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laparoscopic Incisional Hernia Repair CPT 49653 Laparoscopy, repair of incisional hernia |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Kidney Biopsy (needle) CPT 50200 Renal biopsy, percutaneous, by trocar or needle |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Kidney Stone Removal (percutaneous) CPT 50080 Percutaneous nephrostolithotomy or pyelostolithotomy |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Cystoscopy with Ureteral Catheter CPT 52005 Cystourethroscopy, with ureteral catheterization |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Cystoscopy with Stent Removal CPT 52310 Cystourethroscopy, with removal of foreign body or ureteral stent |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Cystoscopy with Stent Insertion CPT 52332 Cystourethroscopy, with insertion of indwelling ureteral stent |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Cystoscopy with Lithotripsy CPT 52353 Cystourethroscopy, with lithotripsy |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Hydrocelectomy (excision) CPT 55040 Excision of hydrocele, unilateral |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Vasectomy CPT 55250 Vasectomy, unilateral or bilateral |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| I&D of Bartholin Gland Abscess CPT 56405 Incision and drainage of vulva or perineal abscess |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Lumbar Puncture (spinal tap) CPT 62270 Lumbar puncture (spinal tap), diagnostic |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Cervical Epidural Injection CPT 62320 Injection, including indwelling catheter placement, cervical or thoracic |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Cervical Epidural with Imaging CPT 62321 Injection, cervical or thoracic with imaging guidance |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Trigeminal Nerve Block CPT 64400 Injection, anesthetic agent; trigeminal nerve |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Greater Occipital Nerve Block CPT 64405 Injection, anesthetic agent; greater occipital nerve |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Brachial Plexus Block CPT 64415 Injection, anesthetic agent; brachial plexus, single |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Femoral Nerve Block CPT 64447 Injection, anesthetic agent; femoral nerve, single |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Peripheral Nerve Block CPT 64450 Injection, anesthetic agent; other peripheral nerve or branch |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Cervical Transforaminal Epidural CPT 64479 Injection, anesthetic agent and/or steroid, transforaminal epidural, cervical or thoracic |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Transforaminal Epidural (additional level) CPT 64484 Injection, transforaminal epidural, lumbar or sacral, each additional level |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Facet Joint Injection - Cervical (first level) CPT 64490 Injection, diagnostic or therapeutic agent, paravertebral facet joint, cervical or thoracic, first level |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Facet Joint Injection - Cervical (second level) CPT 64491 Injection, paravertebral facet joint, cervical or thoracic, second level |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Facet Joint Injection - Lumbar (second level) CPT 64494 Injection, paravertebral facet joint, lumbar or sacral, second level |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Intercostal Nerve Destruction CPT 64625 Destruction by neurolytic agent, intercostal nerve |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Facet Joint Destruction - Cervical (first level) CPT 64633 Destruction by neurolytic agent, paravertebral facet joint nerve, cervical or thoracic, single level |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Facet Joint Destruction - Cervical (additional level) CPT 64634 Destruction by neurolytic agent, paravertebral facet joint nerve, cervical or thoracic, each additional level |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Facet Joint Destruction - Lumbar (additional level) CPT 64636 Destruction by neurolytic agent, paravertebral facet joint nerve, lumbar or sacral, each additional level |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Pacemaker Insertion (ventricular) CPT 33207 Insertion of new or replacement of permanent pacemaker, ventricular |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Leadless Pacemaker Insertion CPT 33274 Transcatheter insertion or replacement of permanent leadless pacemaker |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Coronary Angioplasty (single vessel) CPT 92920 Percutaneous transluminal coronary angioplasty, single vessel |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Right Heart Catheterization CPT 93451 Right heart catheterization |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Coronary Angiography CPT 93454 Catheter placement in coronary artery for coronary angiography |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Botulinum Toxin A (Botox) Injection CPT J0585 Injection, onabotulinumtoxinA, 1 unit |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Testosterone Injection CPT J1071 Injection, testosterone cypionate, 1 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Heparin Injection (per 10 units) CPT J1642 Injection, heparin sodium, per 10 units |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Ketorolac (Toradol) Injection CPT J1885 Injection, ketorolac tromethamine, per 15 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 6 |
| Meperidine (Demerol) Injection CPT J2175 Injection, meperidine hydrochloride, per 100 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Midazolam Injection CPT J2250 Injection, midazolam hydrochloride, per 1 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 5 |
| Morphine Injection CPT J2270 Injection, morphine sulfate, up to 10 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Ondansetron (Zofran) Injection CPT J2405 Injection, ondansetron hydrochloride, per 1 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 6 |
| Promethazine (Phenergan) Injection CPT J2550 Injection, promethazine HCl, up to 50 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Propofol Injection CPT J2704 Injection, propofol, 10 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Ropivacaine Injection CPT J2795 Injection, ropivacaine hydrochloride, 1 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 6 |
| Fentanyl Injection CPT J3010 Injection, fentanyl citrate, 0.1 mg |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Normal Saline (1000 ml) CPT J7120 Ringers lactate infusion, up to 1000 cc |
— | $62 | $62 | $62–$62 | $62 | -1% | 6 |
| Normal Saline Infusion (250 cc) CPT J7050 Infusion, normal saline solution, 250 cc |
— | $62 | $62 | $62–$62 | $62 | -1% | 1 |
| Bronchoscopy with Lavage CPT 31624 Bronchoscopy with bronchial alveolar lavage |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Bronchoscopy with Biopsy CPT 31625 Bronchoscopy with bronchial or endobronchial biopsy |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Intravitreal Injection CPT 67028 Intravitreal injection of a pharmacologic agent |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Corneal Transplant (lamellar) CPT 65710 Keratoplasty (corneal transplant), lamellar |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Coronary Bypass without MCC CPT 236 CABG surgery without major complications |
— | $64,955 | $64,955 | $64,758–$65,152 | $64,955 | avg | 1 |
| Coronary Bypass with MCC CPT 235 CABG surgery with major complications |
— | $64,955 | $64,955 | $64,758–$65,152 | $64,955 | avg | 1 |
| Cardiac Valve Procedures with CC CPT 216 Heart valve repair or replacement with complications |
— | $64,955 | $64,955 | $64,758–$65,152 | $64,955 | avg | 1 |
| Rhinoplasty - Nose Job (Primary, Tip/Cartilage) CPT 30400 Rhinoplasty - Nose Job (Primary, Tip/Cartilage) — CPT code 30400 covers rhinoplasty - nose job (primary, tip/cartilage) performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Rhinoplasty - Nose Job (Primary, Complete) CPT 30410 Rhinoplasty - Nose Job (Primary, Complete) — CPT code 30410 covers rhinoplasty - nose job (primary, complete) performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Septorhinoplasty (Nose Job with Septal Repair) CPT 30420 Septorhinoplasty (Nose Job with Septal Repair) — CPT code 30420 covers septorhinoplasty (nose job with septal repair) performed in a clinical or hospital setting. |
— | $5,890 | $5,890 | $5,139–$6,640 | $5,890 | avg | 2 |
| Revision Rhinoplasty - Intermediate (Nose Job Revision) CPT 30435 Revision Rhinoplasty - Intermediate (Nose Job Revision) — CPT code 30435 covers revision rhinoplasty - intermediate (nose job revision) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Revision Rhinoplasty - Major (Nose Job Revision) CPT 30450 Revision Rhinoplasty - Major (Nose Job Revision) — CPT code 30450 covers revision rhinoplasty - major (nose job revision) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Tummy Tuck (Abdominoplasty) CPT 15830 Tummy Tuck (Abdominoplasty) — CPT code 15830 covers tummy tuck (abdominoplasty) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Body Contouring - Thigh Lift CPT 15832 Body Contouring - Thigh Lift — CPT code 15832 covers body contouring - thigh lift performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Body Contouring - Hip Lift CPT 15834 Body Contouring - Hip Lift — CPT code 15834 covers body contouring - hip lift performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Body Contouring - Buttock Lift CPT 15835 Body Contouring - Buttock Lift — CPT code 15835 covers body contouring - buttock lift performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Body Contouring - Forearm/Hand CPT 15837 Body Contouring - Forearm/Hand — CPT code 15837 covers body contouring - forearm/hand performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Submental Fat Removal (Double Chin) CPT 15838 Submental Fat Removal (Double Chin) — CPT code 15838 covers submental fat removal (double chin) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Body Contouring - Other Area CPT 15839 Body Contouring - Other Area — CPT code 15839 covers body contouring - other area performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Lower Eyelid Surgery (Blepharoplasty) CPT 15820 Lower Eyelid Surgery (Blepharoplasty) — CPT code 15820 covers lower eyelid surgery (blepharoplasty) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Lower Eyelid Surgery - Fat Pad Removal (Blepharoplasty) CPT 15821 Lower Eyelid Surgery - Fat Pad Removal (Blepharoplasty) — CPT code 15821 covers lower eyelid surgery - fat pad removal (blepharoplasty) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Upper Eyelid Surgery - Excess Skin (Blepharoplasty) CPT 15823 Upper Eyelid Surgery - Excess Skin (Blepharoplasty) — CPT code 15823 covers upper eyelid surgery - excess skin (blepharoplasty) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Liposuction - Trunk/Abdomen CPT 15877 Liposuction - Trunk/Abdomen — CPT code 15877 covers liposuction - trunk/abdomen performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Liposuction - Upper Extremity (Arms) CPT 15878 Liposuction - Upper Extremity (Arms) — CPT code 15878 covers liposuction - upper extremity (arms) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Liposuction - Lower Extremity (Legs) CPT 15879 Liposuction - Lower Extremity (Legs) — CPT code 15879 covers liposuction - lower extremity (legs) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Neck Lift (with Platysmal Tightening) CPT 15825 Neck Lift (with Platysmal Tightening) — CPT code 15825 covers neck lift (with platysmal tightening) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Frown Line Correction (Glabellar) CPT 15826 Frown Line Correction (Glabellar) — CPT code 15826 covers frown line correction (glabellar) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Facelift - Cheek, Chin & Neck (Rhytidectomy) CPT 15828 Facelift - Cheek, Chin & Neck (Rhytidectomy) — CPT code 15828 covers facelift - cheek, chin & neck (rhytidectomy) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Facelift - SMAS Flap (Deep Plane Rhytidectomy) CPT 15829 Facelift - SMAS Flap (Deep Plane Rhytidectomy) — CPT code 15829 covers facelift - smas flap (deep plane rhytidectomy) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Hair Transplant (1-15 Grafts) CPT 15775 Hair Transplant (1-15 Grafts) — CPT code 15775 covers hair transplant (1-15 grafts) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Hair Transplant (16+ Grafts) CPT 15776 Hair Transplant (16+ Grafts) — CPT code 15776 covers hair transplant (16+ grafts) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| LASIK Eye Surgery CPT 65760 LASIK Eye Surgery — CPT code 65760 covers lasik eye surgery performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Epikeratoplasty (Corneal Surgery) CPT 65767 Epikeratoplasty (Corneal Surgery) — CPT code 65767 covers epikeratoplasty (corneal surgery) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Radial Keratotomy (RK Eye Surgery) CPT 65771 Radial Keratotomy (RK Eye Surgery) — CPT code 65771 covers radial keratotomy (rk eye surgery) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Brow Lift (Brow Ptosis Repair) CPT 67900 Brow Lift (Brow Ptosis Repair) — CPT code 67900 covers brow lift (brow ptosis repair) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Ear Pinning (Otoplasty) CPT 69300 Ear Pinning (Otoplasty) — CPT code 69300 covers ear pinning (otoplasty) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Chin Implant (Genioplasty) CPT 21120 Chin Implant (Genioplasty) — CPT code 21120 covers chin implant (genioplasty) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Chin Reshaping - Sliding Osteotomy CPT 21121 Chin Reshaping - Sliding Osteotomy — CPT code 21121 covers chin reshaping - sliding osteotomy performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Chin Reshaping - Multiple Osteotomies CPT 21122 Chin Reshaping - Multiple Osteotomies — CPT code 21122 covers chin reshaping - multiple osteotomies performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Chin Reshaping with Bone Graft CPT 21123 Chin Reshaping with Bone Graft — CPT code 21123 covers chin reshaping with bone graft performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Lap-Band Surgery (Laparoscopic Gastric Band) CPT 43770 Lap-Band Surgery (Laparoscopic Gastric Band) — CPT code 43770 covers lap-band surgery (laparoscopic gastric band) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Vasectomy Reversal (Vasovasostomy) CPT 55400 Vasectomy Reversal (Vasovasostomy) — CPT code 55400 covers vasectomy reversal (vasovasostomy) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Male Breast Reduction (Gynecomastia Surgery) CPT 19300 Male Breast Reduction (Gynecomastia Surgery) — CPT code 19300 covers male breast reduction (gynecomastia surgery) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laser Skin Resurfacing (Single Lesion) CPT 15786 Laser Skin Resurfacing (Single Lesion) — CPT code 15786 covers laser skin resurfacing (single lesion) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Laser Skin Resurfacing (Additional Lesions) CPT 15787 Laser Skin Resurfacing (Additional Lesions) — CPT code 15787 covers laser skin resurfacing (additional lesions) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Circumcision (Newborn) CPT 54150 Circumcision (Newborn) — CPT code 54150 covers circumcision (newborn) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Circumcision (Surgical, Older Child/Adult) CPT 54160 Circumcision (Surgical, Older Child/Adult) — CPT code 54160 covers circumcision (surgical, older child/adult) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Complex Bunionectomy CPT 28299 Complex Bunionectomy — CPT code 28299 covers complex bunionectomy performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| ACDF - Cervical Disc Fusion (Single Level) CPT 22551 Cervical spinal fusion (neck) — surgery to permanently join two or more vertebrae in the neck using bone grafts and hardware, typically to treat herniated discs or spinal instability. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| ACDF - Cervical Disc Fusion (Each Additional Level) CPT 22552 ACDF - Cervical Disc Fusion (Each Additional Level) — CPT code 22552 covers acdf - cervical disc fusion (each additional level) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Lumbar Laminectomy (Each Additional Level) CPT 63048 Lumbar Laminectomy (Each Additional Level) — CPT code 63048 covers lumbar laminectomy (each additional level) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 6 |
| Tonsillectomy (Under Age 12) CPT 42825 Tonsillectomy (Under Age 12) — CPT code 42825 covers tonsillectomy (under age 12) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 5 |
| Tonsillectomy & Adenoidectomy (Age 12+) CPT 42821 Tonsillectomy & Adenoidectomy (Age 12+) — CPT code 42821 covers tonsillectomy & adenoidectomy (age 12+) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Sinus Surgery - Maxillary Antrostomy CPT 31267 Sinus Surgery - Maxillary Antrostomy — CPT code 31267 covers sinus surgery - maxillary antrostomy performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Excision of Benign Skin Lesion (2.1-3.0 cm) CPT 11403 Excision of Benign Skin Lesion (2.1-3.0 cm) — CPT code 11403 covers excision of benign skin lesion (2.1-3.0 cm) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
| Excision of Benign Skin Lesion (Over 4.0 cm) CPT 11406 Excision of Benign Skin Lesion (Over 4.0 cm) — CPT code 11406 covers excision of benign skin lesion (over 4.0 cm) performed in a clinical or hospital setting. |
— | $5,139 | $5,139 | $5,139–$5,139 | $5,139 | avg | 1 |
Prices are typical ranges based on Adventist Health Tulare's published transparency data, including actual allowed amounts calculated from insurer remittance (ERA) data per CMS v3.0 requirements. Your actual cost depends on your specific plan, deductible status, and clinical details.
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Insurance Plans with Negotiated Rates
Taven has payer-specific negotiated rate data from 3 insurers at Adventist Health Tulare. The "Avg Negotiated" rate in the table above represents the average across all payers. Individual payer rates may be higher or lower.
Aetna (CVS Health)
Cigna Healthcare
UnitedHealthcare (UHC)
Negotiated rates vary by insurance plan. The prices shown are aggregated from this hospital's publicly filed machine-readable file. Your actual rate depends on your specific insurance plan and network tier. Use our price comparison tool to see payer-specific breakdowns.
Financial Assistance at Adventist Health Tulare
As a nonprofit hospital, Adventist Health Tulare is required under IRS Section 501(r) to offer a financial assistance program (also called "charity care").
Patients at or below 300% of the Federal Poverty Level generally qualify for reduced or free care. You can apply as soon as care is received — through the hospital's financial counseling office, online portal, or billing department.
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Under the No Surprises Act and hospital price transparency rules, you have the right to receive a Good Faith Estimate before scheduled care, protection from surprise out-of-network bills in emergencies, and access to the hospital's published pricing data.
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▸ Technical Details
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Health System
AdventHealth
Medicare Provider #
050784
Emergency Services
Yes
Metro Area
Tulare, CA
Procedures Tracked
415
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