332 shoppable procedures with published pricing. Cash pay ranges from $1 to $26,226.
North Carolina Specialty Hospital publishes pricing for 332 procedures in Charlotte, sourced from federally mandated Hospital Price Transparency files updated monthly. Cash-pay prices range from $1 to $26,226 across 332 published procedures.
North Carolina Specialty Hospital's cash pay prices range from $1 (Flowcytometry/tc Add-on) to $26,226 (Lifecell Strattice Tissue 16x2).
| Category | Range | |||
|---|---|---|---|---|
| Flowcytometry/tc Add-on | other | $1 | $1 to $1 | Low |
| Hemoglobin A1C | lab | $9 | $9 to $9 | Low |
| Urinalysis | lab | $11 | $11 to $11 | Low |
| Hematocrit | other | $12 | $12 to $12 | Low |
| Rbc Sed Rate Nonautomated | other | $14 | $14 to $14 | Low |
| Assay of Urea Nitrogen | other | $16 | $16 to $16 | Low |
| Glucose Blood Test | lab | $16 | $16 to $16 | Low |
| Prothrombin Time | lab | $16 | $16 to $16 | Low |
| Rbc Sed Rate Automated | other | $16 | $16 to $16 | Low |
| Active Wound Care >20 Cm | other | $17 | $17 to $17 | Low |
| Assay of Protein Urine | other | $17 | $17 to $17 | Low |
| Assay of Urine Sodium | other | $17 | $17 to $17 | Low |
| ABO Blood Type | lab | $18 | $18 to $18 | Low |
| Assay of Blood Chloride | other | $18 | $18 to $18 | Low |
| Assay of Serum Potassium | other | $18 | $18 to $18 | Low |
| Blood Typing Serologic Rh | other | $18 | $18 to $18 | Low |
| Automated Reticulocyte Count | other | $19 | $19 to $19 | Low |
| Assay Blood Carbon Dioxide | other | $20 | $20 to $20 | Low |
| Assay of Creatinine | other | $21 | $21 to $21 | Low |
| Venipuncture | lab | $21 | $21 to $21 | Low |
| Assay of Protein Serum | other | $22 | $22 to $22 | Low |
| Antibody Screen | lab | $23 | $23 to $23 | Low |
| Smear Gram Stain | other | $24 | $24 to $24 | Low |
| Assay of Blood/uric Acid | other | $27 | $27 to $27 | Low |
| Automated Platelet Count | other | $27 | $27 to $27 | Low |
| Blood,occult By Peroxidase Act | other | $27 | $27 to $27 | Low |
| Assay of Phosphorus | other | $28 | $28 to $28 | Low |
| Decalcification of Tissue | other | $28 | $28 to $28 | Low |
| Urine Pregnancy Test | other | $28 | $28 to $28 | Low |
| Assay of Serum Sodium | other | $29 | $29 to $29 | Low |
| Assay of Serum Albumin | other | $30 | $30 to $30 | Low |
| Bilirubin Direct | other | $30 | $30 to $30 | Low |
| Bilirubin Total | other | $30 | $30 to $30 | Low |
| Smear Fluorescent/acid Stai | other | $30 | $30 to $30 | Low |
| Aspartate Aminotransferase | other | $31 | $31 to $31 | Low |
| Assay Alkaline Phosphatase | other | $31 | $31 to $31 | Low |
| Assay of Urine Creatinine | other | $31 | $31 to $31 | Low |
| C-reactive Protein | other | $31 | $31 to $31 | Low |
| Fibrinogen | other | $31 | $31 to $31 | Low |
| Alanine Amino | other | $32 | $32 to $32 | Low |
| Cortisol, Serum | other | $32 | $32 to $32 | Low |
| Rbc Pretreatment with Enzymes | other | $32 | $32 to $32 | Low |
| Rheumatoid Factor Quant | other | $32 | $32 to $32 | Low |
| Assay of Triglycerides | other | $33 | $33 to $33 | Low |
| Coombs Test Direct | other | $33 | $33 to $33 | Low |
| Deb Bone Add-on | other | $33 | $33 to $33 | Low |
| Deb Subq Tissue Add-on | other | $34 | $34 to $34 | Low |
| Antibody Id/eash Sel Reagent C | other | $35 | $35 to $35 | Low |
| Gait Training Therapy | other | $35 | $35 to $35 | Low |
| Microalbumin, Urine | other | $35 | $35 to $35 | Low |
| Physical Therapy Session | therapy | $35 | $35 to $35 | Low |
| Self Care Mngment Training | other | $35 | $35 to $35 | Low |
| Therapeutic Activities | therapy | $35 | $35 to $35 | Low |
| Lactate (ld) (ldh) Enzyme | other | $36 | $36 to $36 | Low |
| Partial Thromboplastin Time | lab | $36 | $36 to $36 | Low |
| Assay of Iron | other | $37 | $37 to $37 | Low |
| Assay of Amylase | other | $39 | $39 to $39 | Low |
| Assay of Ck | other | $39 | $39 to $39 | Low |
| Assay of Thyroid | other | $39 | $39 to $39 | Low |
| Ccp Antibodies | other | $39 | $39 to $39 | Low |
| Assay of Magnesium | other | $40 | $40 to $40 | Low |
| Assay of Lipase | other | $41 | $41 to $41 | Low |
| Assay of Total Thyroxine | other | $41 | $41 to $41 | Low |
| Electrolyte Panel | lab | $42 | $42 to $42 | Low |
| Exam Synovial Fluid Crystals | other | $43 | $43 to $43 | Low |
| Microbe Susceptible Disk | other | $43 | $43 to $43 | Low |
| Drug Test Prsmv Dir Opt Obs | other | $44 | $44 to $44 | Low |
| Istat Chem 8-clia Waived | other | $44 | $44 to $44 | Low |
| Compatibility Test Spin | other | $46 | $46 to $46 | Low |
| Fungal Culture Hair,skin,nails | lab | $46 | $46 to $46 | Low |
| Complete Blood Count (CBC) | lab | $47 | $47 to $47 | Low |
| Rbc Pretreatment | other | $47 | $47 to $47 | Low |
| Ag Detect Nos Ia Mult | other | $48 | $48 to $48 | Low |
| Bld Typing Serologic Rh Phnt | other | $48 | $48 to $48 | Low |
| Blood Typing Rbc Antigens | other | $48 | $48 to $48 | Low |
| Clostridium Ag Ia | other | $48 | $48 to $48 | Low |
| Hepatic Function Panel | lab | $49 | $49 to $49 | Low |
| Iron Binding Test | other | $49 | $49 to $49 | Low |
| Drug Screen Quantalcohols | other | $50 | $50 to $50 | Low |
| EKG (Electrocardiogram) | cardiac | $50 | $50 to $50 | Low |
| Urine Bacteria Culture | lab | $50 | $50 to $50 | Low |
| Basic Metabolic Panel (BMP) | lab | $51 | $51 to $51 | Low |
| Fungus Isolation Culture | lab | $52 | $52 to $52 | Low |
| Bacterial Culture | lab | $53 | $53 to $53 | Low |
| Assay of Free Thyroxine | other | $54 | $54 to $54 | Low |
| Influenza Rapid Test | lab | $54 | $54 to $54 | Low |
| Antibody; HIV 1&2 Single Assay | other | $55 | $55 to $55 | Low |
| Assay of Calcium | other | $55 | $55 to $55 | Low |
| Compatibility Test Antiglob | other | $57 | $57 to $57 | Low |
| Rbc Pretreatment Serum | other | $57 | $57 to $57 | Low |
| Assay of Troponin Quant | other | $59 | $59 to $59 | Low |
| Cultr Bacteria Except Blood | other | $59 | $59 to $59 | Low |
| Hepatitis B Surface Ag Ia | other | $62 | $62 to $62 | Low |
| Assay Triiodothyronine | other | $63 | $63 to $63 | Low |
| Cholesterol Management | cardiac | $63 | $63 to $63 | Low |
| Comprehensive Metabolic Panel | lab | $63 | $63 to $63 | Low |
| Assay of Lactic Acid | other | $64 | $64 to $64 | Low |
| Blood Culture | lab | $64 | $64 to $64 | Low |
| Assay of Vitamin B | other | $65 | $65 to $65 | Low |
| Mycobacteria Culture | lab | $67 | $67 to $67 | Low |
| Antinuclear Antibodies | imaging | $68 | $68 to $68 | Low |
| Free Assay | other | $68 | $68 to $68 | Low |
| Clot Factor Viii Vw Ristoctn | other | $69 | $69 to $69 | Low |
| Creatine Mb Fraction | other | $69 | $69 to $69 | Low |
| Sars Antigen Fia | other | $69 | $69 to $69 | Low |
| Gross Exam Only By Pathologist | other | $72 | $72 to $72 | Low |
| Lipid Panel | lab | $76 | $76 to $76 | Low |
| Assay of Ferritin | other | $77 | $77 to $77 | Low |
| Culture Screen Only | lab | $77 | $77 to $77 | Low |
| Rubeola Antibody | other | $77 | $77 to $77 | Low |
| Assay of Digoxin | other | $80 | $80 to $80 | Low |
| Assay of Vancomycin | other | $81 | $81 to $81 | Low |
| Lyme Disease Antibody | other | $82 | $82 to $82 | Low |
| Assay of Folic Acid Serum | other | $83 | $83 to $83 | Low |
| Flu Vaccine Administration | preventive | $84 | $84 to $84 | Low |
| Vitamin B | other | $85 | $85 to $85 | Low |
| Hepatitis C Ab Test | other | $86 | $86 to $86 | Low |
| Carcinoembryonic Antigen | other | $87 | $87 to $87 | Low |
| Assay of Prealbumin | other | $88 | $88 to $88 | Low |
| Feces Culture Aerobic Bact | lab | $89 | $89 to $89 | Low |
| Alfuria 60 Mcg/0.5 Ml Flu Vacc | other | $96 | $96 to $96 | Low |
| Thyroid Panel (TSH) | lab | $101 | $101 to $101 | Low |
| IV Infusion, Ea Add Hr | surgery | $107 | $107 to $107 | Low |
| Prostate Cancer Screening | other | $110 | $110 to $110 | Low |
| PSA (Prostate-Specific Antigen) | lab | $110 | $110 to $110 | Low |
| Surgical Pathology | lab | $112 | $112 to $112 | Low |
| Blood Gases Any Combination | other | $116 | $116 to $116 | Low |
| Apligraf | other | $118 | $118 to $118 | Low |
| Tx/pro/dx Inj Same Drug Add On | other | $118 | $118 to $118 | Low |
| Cold Agglutinin Screen | other | $120 | $120 to $120 | Low |
| IV Push Inj Each New Drug | other | $122 | $122 to $122 | Low |
| Hydrate IV Infusion Add-on | surgery | $125 | $125 to $125 | Low |
| Therapeutic Injection | preventive | $126 | $126 to $126 | Low |
| Phytonadione Inj 1 Mg/0.5 Ml C | other | $150 | $150 to $150 | Low |
| Cryoprecipitate, Each Unit | other | $151 | $151 to $151 | Low |
| 2019-ncovid Any Technq-non-cdc | other | $154 | $154 to $154 | Low |
| Hc 2019 Novel Coronavirus Naa | other | $154 | $154 to $154 | Low |
| Fdp,fibrinogen Degradation Pro | other | $162 | $162 to $162 | Low |
| Irrig Drug Delivery Device | obstetric | $162 | $162 to $162 | Low |
| Meas Post-voiding Residl Urine | other | $162 | $162 to $162 | Low |
| Special Stains Group 1 | other | $169 | $169 to $169 | Low |
| Pt Re-eval Est Plan Care | other | $177 | $177 to $177 | Low |
| Tx/proph/dg Addl Seq IV Inf | other | $178 | $178 to $178 | Low |
| Vitamin D Level | lab | $178 | $178 to $178 | Low |
| Special Stains Group 2 | other | $184 | $184 to $184 | Low |
| Td Vacc No Presv 7 Yrs+ IM | other | $184 | $184 to $184 | Low |
| Tb Test Cell Immun Measure | other | $186 | $186 to $186 | Low |
| Vaccine Administration | preventive | $191 | $191 to $191 | Low |
| Foot X-Ray | imaging | $194 | $194 to $194 | Low |
| Forearm X-Ray | imaging | $194 | $194 to $194 | Low |
| Humerus X-Ray | imaging | $194 | $194 to $194 | Low |
| Wrist X-Ray | imaging | $194 | $194 to $194 | Low |
| X-ray Exam of Ankle | imaging | $194 | $194 to $194 | Low |
| X-ray Exam of Clavicle Left | imaging | $194 | $194 to $194 | Low |
| X-ray Exam of Femur 1 | imaging | $194 | $194 to $194 | Low |
| X-ray Exam of Femur 2/> | imaging | $194 | $194 to $194 | Low |
| X-ray Exam of Finger | imaging | $194 | $194 to $194 | Low |
| X-ray Exam of Lower Leg | imaging | $194 | $194 to $194 | Low |
| X-ray Exam of Toe | imaging | $194 | $194 to $194 | Low |
| X-Ray of the Hand | imaging | $194 | $194 to $194 | Low |
| X-Ray of the Knee | imaging | $194 | $194 to $194 | Low |
| Stress Test | cardiac | $198 | $198 to $198 | Low |
| Hip X-Ray | imaging | $200 | $200 to $200 | Low |
| Knee X-Ray | imaging | $200 | $200 to $200 | Low |
| Shoulder X-Ray | imaging | $200 | $200 to $200 | Low |
| X-ray Exam Hip Uni 1 View | imaging | $200 | $200 to $200 | Low |
| X-ray Exam of Elbow | imaging | $200 | $200 to $200 | Low |
| X-ray Exam of Shoulder | imaging | $200 | $200 to $200 | Low |
| Chest X-Ray 1 View | imaging | $204 | $204 to $204 | Low |
| X-Ray of the Chest | imaging | $204 | $204 to $204 | Low |
| X-ray Exam Abdomen 1 View | imaging | $206 | $206 to $206 | Low |
| X-ray Exam Neck Spine 2-3 Vw | imaging | $206 | $206 to $206 | Low |
| Immunihistology-additional Sli | other | $211 | $211 to $211 | Low |
| Hla B27 | other | $223 | $223 to $223 | Low |
| Fresh Frozen Plasma | other | $224 | $224 to $224 | Low |
| X-ray Ac Joints Bi W/wo Weight | imaging | $235 | $235 to $235 | Low |
| Fibrin Degradation Quant | other | $238 | $238 to $238 | Low |
| Assay of Parathormone | other | $248 | $248 to $248 | Low |
| Physical Therapy | therapy | $254 | $254 to $254 | Low |
| Ahmed Valve | other | $255 | $255 to $255 | Low |
| Blood Gases W/o2 Saturation | other | $255 | $255 to $255 | Low |
| Occupational Therapy | therapy | $262 | $262 to $262 | Low |
| Physical Therapy Evaluation | therapy | $262 | $262 to $262 | Low |
| Blood Platelet Aggregation | other | $264 | $264 to $264 | Low |
| Graft Applic<100cm,add-on 25cm | other | $268 | $268 to $268 | Low |
| Gastrografin 66-10 Sol 120 Ml | other | $283 | $283 to $283 | Low |
| Application of Paste Boot | other | $296 | $296 to $296 | Low |
| Apply Multlay Comprs Lwr Leg | other | $305 | $305 to $305 | Low |
| Allopatch Human Dermis 5x5 Cm | other | $311 | $311 to $311 | Low |
| Assay of Natriuretic Peptide | other | $312 | $312 to $312 | Low |
| X-ray Exam Entire Spi 2/3 Vw | imaging | $320 | $320 to $320 | Low |
| Puraply Am 1 SQ Cm | other | $323 | $323 to $323 | Low |
| Dress/debrid P-thick Burn S | other | $334 | $334 to $334 | Low |
| Neg Press Wound Tx <=50 Cm | other | $334 | $334 to $334 | Low |
| Thyroid Ultrasound | imaging | $334 | $334 to $334 | Low |
| Insert Temp Bladder Cath | other | $342 | $342 to $342 | Low |
| Active Wound Care/20 Cm OR < | other | $345 | $345 to $345 | Low |
| Chem Caut of Granltj Tissue | other | $345 | $345 to $345 | Low |
| Hbo Therapy Per 30 Min Session | other | $364 | $364 to $364 | Low |
| Breast Ultrasound Complete | imaging | $365 | $365 to $365 | Low |
| CT Lower Extremity | imaging | $365 | $365 to $365 | Low |
| Hip Bilateral 2 V | other | $365 | $365 to $365 | Low |
| Lower Extremity Study | other | $365 | $365 to $365 | Low |
| Thoracic Spine X-Ray | imaging | $365 | $365 to $365 | Low |
| Ultrasound Breast Limited | imaging | $365 | $365 to $365 | Low |
| Us Compl Joint R-t W/img | other | $365 | $365 to $365 | Low |
| Us Exam Abdo Back Wall Lim | other | $365 | $365 to $365 | Low |
| Us Exam Scrotum | other | $365 | $365 to $365 | Low |
| Us Extremity Non Vascular Lt | other | $365 | $365 to $365 | Low |
| X-ray Exam of Jaw 4/> Views | imaging | $365 | $365 to $365 | Low |
| Abdominal Ultrasound | imaging | $368 | $368 to $368 | Low |
| CT Chest without Contrast | imaging | $368 | $368 to $368 | Low |
| Ultrasound of the Abdomen | imaging | $368 | $368 to $368 | Low |
| Pelvic Ultrasound Complete | imaging | $372 | $372 to $372 | Low |
| X-ray Exam Abdomen 3+ Views | imaging | $372 | $372 to $372 | Low |
| Er-o.v.-established Level 3 | other | $374 | $374 to $374 | Low |
| CT Upper Ext Left W/o Contrast | other | $376 | $376 to $376 | Low |
| Extremity Study | other | $376 | $376 to $376 | Low |
| Lumbar Spine X-Ray | imaging | $376 | $376 to $376 | Low |
| Retroperitoneal Ultrasound | imaging | $376 | $376 to $376 | Low |
| X-ray Exam Abdomen 2 Views | imaging | $376 | $376 to $376 | Low |
| X-ray Exam of Pelvis | imaging | $376 | $376 to $376 | Low |
| CT Orbit/ear/fossa W/o Dye | other | $381 | $381 to $381 | Low |
| CT Abdomen without Contrast | imaging | $393 | $393 to $393 | Low |
| CT Contrast Low Osmolar 200-299ml | imaging | $397 | $397 to $397 | Low |
| Graft Jacket | other | $399 | $399 to $399 | Low |
| Drainage of Skin Abscess | other | $404 | $404 to $404 | Low |
| Cortisone Shot (Joint Injection) | surgery | $416 | $416 to $416 | Low |
| Path Consult Intraop Frozen Se | other | $425 | $425 to $425 | Low |
| Nervous System Surgery | surgery | $432 | $432 to $432 | Low |
| Anti-xa | other | $454 | $454 to $454 | Low |
| Pretreatment of Rbc By Density | other | $465 | $465 to $465 | Low |
| Albumin (human) 5% Glass Bottl | other | $472 | $472 to $472 | Low |
| Punch Bx Skin Single Lesion | other | $515 | $515 to $515 | Low |
| Airway Inhalation Treatment | other | $542 | $542 to $542 | Low |
| Pos Airway Pressure CPAP | other | $542 | $542 to $542 | Low |
| Epifix 1 SQ Cm | other | $549 | $549 to $549 | Low |
| IOL Akreos Lens B&l | other | $551 | $551 to $551 | Low |
| Neg Press Wnd Tx <=50 SQ Cm | other | $558 | $558 to $558 | Low |
| CT Pelvis W/o Dye | other | $562 | $562 to $562 | Low |
| CT Soft Tissue Neck W/o Dye | other | $562 | $562 to $562 | Low |
| CT Sinus without Contrast | imaging | $563 | $563 to $563 | Low |
| IV Infusion, 1st Hr | surgery | $568 | $568 to $568 | Low |
| Hydration IV Infusion Init | surgery | $573 | $573 to $573 | Low |
| CT Cervical Spine without Contrast | imaging | $579 | $579 to $579 | Low |
| CT Head | imaging | $579 | $579 to $579 | Low |
| CT Scan of the Head | imaging | $579 | $579 to $579 | Low |
| CT Lumbar Spine without Contrast | imaging | $580 | $580 to $580 | Low |
| Apply Rigid Leg Cast | other | $609 | $609 to $609 | Low |
| Ther/proph/diag Inj IV Push | other | $628 | $628 to $628 | Low |
| Anjeso (meloxicam) Inj 30 Mg | other | $652 | $652 to $652 | Low |
| Rbc Leukocytes Reduced | other | $659 | $659 to $659 | Low |
| Deb Musc/fascia 20 SQ Cm/< | other | $675 | $675 to $675 | Low |
| Deb Subq Tissue 20 SQ Cm/< | other | $675 | $675 to $675 | Low |
| Hosp Obs Direct Referral | other | $685 | $685 to $685 | Low |
| Tumor Immunohistochem/comput | other | $687 | $687 to $687 | Low |
| Immunohisto Antb 1st Stain | other | $708 | $708 to $708 | Low |
| Flowcytometry/ Tc 1 Marker | other | $709 | $709 to $709 | Low |
| Rbc Antibody Identification | other | $709 | $709 to $709 | Low |
| Carotid Duplex Ultrasound | imaging | $740 | $740 to $740 | Low |
| Upper Extremity Study | other | $740 | $740 to $740 | Low |
| Drain/inj Joint/bursa W/us | other | $795 | $795 to $795 | Low |
| Graft Applic <100cm, 1st 25 Cm | other | $810 | $810 to $810 | Low |
| Graft Applic <100cm, 1st 25cm | other | $810 | $810 to $810 | Low |
| CT Lower Ext Left W/wo Contras | other | $859 | $859 to $859 | Low |
| CT Upper Ext Left W/contrast | other | $859 | $859 to $859 | Low |
| CT Upper Ext Left W/wo Contras | other | $859 | $859 to $859 | Low |
| Platelet Pheres Leuko-storage& | other | $859 | $859 to $859 | Low |
| N Block, Other Peripheral | other | $866 | $866 to $866 | Low |
| CT Lower Ext Left W/contrast | other | $884 | $884 to $884 | Low |
| Argatroban Non-esrd 1mg | other | $906 | $906 to $906 | Low |
| Intravitreal Injection | surgery | $912 | $912 to $912 | Low |
| CT Lumbar Spine W/dye | other | $962 | $962 to $962 | Low |
| CT Abdomen with Contrast | imaging | $963 | $963 to $963 | Low |
| CT Pelvis W/dye | other | $963 | $963 to $963 | Low |
| CT Neck with Contrast | imaging | $992 | $992 to $992 | Low |
| CT Scan of the Chest | imaging | $992 | $992 to $992 | Low |
| CT Abdomen and Pelvis without Contrast | imaging | $1,021 | $1,021 to $1,021 | Low |
| Tissue Exam By Pathologist | other | $1,039 | $1,039 to $1,039 | Low |
| Inj Paravert F Jnt L/s 2 Lev | other | $1,041 | $1,041 to $1,041 | Low |
| Inj Paravert F Jnt L/s 3 Lev | other | $1,041 | $1,041 to $1,041 | Low |
| Inj Paravert F Jnt C/t 2 Lev | other | $1,061 | $1,061 to $1,061 | Low |
| CT Abdomen with and without Contrast | imaging | $1,067 | $1,067 to $1,067 | Low |
| CT Angio Abdom W/o & W/dye | other | $1,099 | $1,099 to $1,099 | Low |
| CT Angiography Head | imaging | $1,099 | $1,099 to $1,099 | Low |
| CT Angiography Neck | imaging | $1,099 | $1,099 to $1,099 | Low |
| Digital Nerve Block | other | $1,110 | $1,110 to $1,110 | Low |
| CT Angiography Chest | imaging | $1,132 | $1,132 to $1,132 | Low |
| Destr L/s Facet Jnt Addtl | other | $1,160 | $1,160 to $1,160 | Low |
| Destr Paravertebrl N Add-on | other | $1,160 | $1,160 to $1,160 | Low |
| Inj Foramen Epidural Add-on | other | $1,160 | $1,160 to $1,160 | Low |
| Inj Foramen Epidural L/s | other | $1,160 | $1,160 to $1,160 | Low |
| Inj Paravert F Jnt C/t 1 Lev | other | $1,160 | $1,160 to $1,160 | Low |
| Inj Paravert F Jnt L/s 1 Lev | other | $1,160 | $1,160 to $1,160 | Low |
| N Block Stellate Ganglion | other | $1,160 | $1,160 to $1,160 | Low |
| Blood Transfusion Service | surgery | $1,233 | $1,233 to $1,233 | Low |
| CT Abdomen and Pelvis with and without Contrast | imaging | $1,564 | $1,564 to $1,564 | Low |
| Njx Interlaminar Lmbr/sac | other | $1,608 | $1,608 to $1,608 | Low |
| CT Angio Abd&pelv W/o&w/dye | other | $1,610 | $1,610 to $1,610 | Low |
| CT Scan of the Abdomen and Pelvis | imaging | $1,610 | $1,610 to $1,610 | Low |
| Intraop Cyto Path Consult 1 | other | $1,726 | $1,726 to $1,726 | Low |
| Astigmatism-correct Function | other | $1,746 | $1,746 to $1,746 | Low |
| Deb Bone 20 SQ Cm/< | other | $1,825 | $1,825 to $1,825 | Low |
| Inject Epidural Patch | other | $1,843 | $1,843 to $1,843 | Low |
| Glucagon Emergency Kit 1 Mg | emergency | $1,943 | $1,943 to $1,943 | Low |
| Destr Paravertebrl Nerve | other | $1,944 | $1,944 to $1,944 | Low |
| Destr L/s Facet Jnt | other | $1,947 | $1,947 to $1,947 | Low |
| Zynrelef Implant (bupivacaine | surgery | $2,228 | $2,228 to $2,228 | Low |
| Njx Aa&/strd Brach Plexus | other | $2,394 | $2,394 to $2,394 | Low |
| N Block Inj Fem Cont Inf | other | $2,455 | $2,455 to $2,455 | Low |
| Drainage of Hematoma/fluid | other | $2,751 | $2,751 to $2,751 | Low |
| Insert Picc Cath - OR | other | $2,836 | $2,836 to $2,836 | Low |
| Dexametha Opth Insert 0.1 Mg | imaging | $2,867 | $2,867 to $2,867 | Low |
| Hosp Obs Hrs 8 & Above | other | $3,091 | $3,091 to $3,091 | Low |
| Cath, Bal Dil, Non-vascular | other | $3,247 | $3,247 to $3,247 | Low |
| IOL Crystalens OR Trulign | other | $3,312 | $3,312 to $3,312 | Low |
| Neuragen | other | $3,423 | $3,423 to $3,423 | Low |
| Propel Mometasone Furoate Sinu | other | $3,497 | $3,497 to $3,497 | Low |
| IOL Staar Visian Clearlens Exc | other | $4,755 | $4,755 to $4,755 | Low |
| Integra Silicone Pip Implant | surgery | $5,150 | $5,150 to $5,150 | Low |
| Destruction Neurolytic Agt Gen | other | $5,222 | $5,222 to $5,222 | Low |
| Implant Neuroelectrodes | surgery | $5,400 | $5,400 to $5,400 | Low |
| Removal Tunneled Cv Cath | surgery | $8,480 | $8,480 to $8,480 | Low |
| Integra 10x25cm | other | $10,127 | $10,127 to $10,127 | Low |
| Kcentra 1,000 Unit Injection V | other | $11,591 | $11,591 to $11,591 | Low |
| Anchor Tissue to Bone | other | $12,062 | $12,062 to $12,062 | Low |
| Dermacell, Awm, Porous SQ Cm | other | $14,345 | $14,345 to $14,345 | Low |
| ERCP Duct Stent Placement | cardiac | $14,520 | $14,520 to $14,520 | Low |
| Corneal Tissue Processing | other | $15,355 | $15,355 to $15,355 | Low |
| Exactech Total Shoulder | other | $17,020 | $17,020 to $17,020 | Low |
| Drugs Unclassified Injection | other | $18,095 | $18,095 to $18,095 | Low |
| Lifecell Strattice Tissue 16x2 | other | $26,226 | $26,226 to $26,226 | Low |