Hospital

BARTLETT REGIONAL HOSPITAL

Juneau, AK · CCN 020008 · Rates published

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You selected 70551 (HCPCS)

MRI scan of brain without contrast

This hospital’s price: $3,638 across 8 payers · range $3,526-$3,712

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbBRHJUNEAUAK&type=CDMWithoutLabel&fileType=CSV · observed 2026-09-26

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

4,175 distinct procedures filed

8 distinct payers

59,312 rate rows

2026-09-26 last MRF observed

Data quality

56,178 of 59,312 rate rows are consumer-grade (94.7%)

3,134 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	3,118
percent-of-charges filed in the dollar field — excluded from medians	16

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

Source MRF file	https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbBRHJUNEAUAK&type=CDMWithoutLabel&fileType=CSV
Found on page	https://apps.para-hcfs.com/PTT/FinalLinks/Bartlett.aspx
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-12
Content fingerprint	7683c36cc81e84a5… · 31,202,102 bytes · first seen 2026-09-27

Top 50 most expensive offerings

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

Code	Description	Payers	Min $	Max $	Avg median	vs national
J0225 HCPCS	Injection, Vutrisiran, 1 Mg	8	$170,160.02	$179,115.81	$175,533.49	nat. median $6,067 outlier · 28.9×
J9043 HCPCS	Injection, Cabazitaxel, 1 Mg	8	$65,963.25	$69,435.00	$68,046.30	nat. median $509 outlier · 133.7×
J2351 HCPCS	Injection, Ocrelizumab, 1 Mg And Hyaluronidase-ocsq	8	$65,885.94	$69,353.62	$67,966.55	nat. median $56 outlier · 1208.7×
J9347 HCPCS	Injection, Tremelimumab-actl, 1 Mg	8	$59,076.76	$62,186.06	$60,942.34	nat. median $355 outlier · 171.8×
J1747 HCPCS	Injection, Spesolimab-sbzo, 1 Mg	8	$45,589.51	$47,988.96	$47,029.18	nat. median $76 outlier · 622.2×
J9229 HCPCS	Injection, Inotuzumab Ozogamicin, 0.1 Mg	8	$32,744.03	$34,467.40	$33,778.05	nat. median $4,856 outlier · 7.0×
C1820 HCPCS	Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging…	8	$23,103.05	$42,042.00	$32,129.45	nat. median $21,100 1.5× median
J9281 HCPCS	Mitomycin Pyelocalyceal Instillation, 1 Mg	8	$30,545.59	$32,153.25	$31,510.19	nat. median $403 outlier · 78.2×
J0896 HCPCS	Injection, Luspatercept-aamt, 0.25 Mg	8	$29,162.19	$30,697.04	$30,083.10	nat. median $228 outlier · 132.2×
C1767 HCPCS	Generator, Neurostimulator (implantable), Non-rechargeable	8	$21,002.84	$62,379.25	$29,771.12	nat. median $25,172 1.2× median
J2502 HCPCS	Injection, Pasireotide Long Acting, 1 Mg	8	$27,256.25	$28,690.79	$28,116.97	nat. median $648 outlier · 43.4×
J9228 HCPCS	Injection, Ipilimumab, 1 Mg	8	$10,307.34	$43,131.50	$25,912.38	nat. median $6,073 outlier · 4.3×
J2350 HCPCS	Injection, Ocrelizumab, 1 Mg	8	$23,241.04	$24,464.25	$23,974.97	nat. median $133 outlier · 180.3×
J1303 HCPCS	Injection, Ravulizumab-cwvz, 10 Mg	8	$9,210.49	$35,311.25	$21,620.47	nat. median $504 outlier · 42.9×
J9298 HCPCS	Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg	8	$20,387.50	$21,460.53	$21,031.32	nat. median $446 outlier · 47.1×
J3241 HCPCS	Injection, Teprotumumab-trbw, 10 Mg	8	$19,538.41	$20,566.75	$20,155.42	nat. median $709 outlier · 28.4×
J9119 HCPCS	Injection, Cemiplimab-rwlc, 1 Mg	8	$18,477.75	$19,450.26	$19,061.25	nat. median $53 outlier · 357.9×
J9277 HCPCS	Injection, Pembrolizumab, 1 Mg And Berahyaluronidase Alfa-pmph	8	$17,572.39	$18,497.25	$18,127.31	nat. median $40 outlier · 454.1×
J3101 HCPCS	Injection, Tenecteplase, 1 Mg	8	$14,062.29	$21,904.76	$17,805.97	nat. median $498 outlier · 35.8×
J9024 HCPCS	Injection, Atezolizumab, 5 Mg And Hyaluronidase-tqjs	8	$16,118.61	$16,966.96	$16,627.62	nat. median $47 outlier · 357.2×
J9309 HCPCS	Injection, Polatuzumab Vedotin-piiq, 1 Mg	8	$5,001.22	$28,022.51	$15,942.91	nat. median $399 outlier · 40.0×
J1950 HCPCS	Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg	8	$15,223.77	$16,025.02	$15,704.52	nat. median $3,343 outlier · 4.7×
J2327 HCPCS	Injection, Risankizumab-rzaa, Intravenous, 1 Mg	8	$14,526.56	$15,291.12	$14,985.30	nat. median $48 outlier · 312.4×
63602498 CDM	Operating Room Services - General Classification	8	$14,101.80	$14,844.00	$14,547.12	nat. median $14,547 1.0× median
J0222 HCPCS	Injection, Patisiran, 0.1 Mg	8	$14,028.41	$14,766.75	$14,471.42	nat. median $122 outlier · 118.8×
J2997 HCPCS	Injection, Alteplase Recombinant, 1 Mg	8	$712.02	$27,915.85	$13,692.52	nat. median $428 outlier · 32.0×
J9316 HCPCS	Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg	8	$10,445.88	$16,449.51	$13,311.35	nat. median $221 outlier · 60.3×
J1932 HCPCS	Injection, Lanreotide, (cipla), 1 Mg	8	$12,756.83	$13,428.24	$13,159.68	nat. median $76 outlier · 172.1×
36002663 CDM	Operating Room Services - General Classification	8	$12,613.39	$13,277.25	$13,011.71	nat. median $13,012 1.0× median
27803333 CDM	Senegy Foefemral Sz 15	8	$11,967.15	$12,597.00	$12,345.06	nat. median $12,345 1.0× median
27803348 CDM	Femoral Componet Sz 12	8	$11,967.15	$12,597.00	$12,345.06	nat. median $12,345 1.0× median
J9223 HCPCS	Injection, Lurbinectedin, 0.1 Mg	8	$11,413.54	$12,014.25	$11,773.97	nat. median $452 outlier · 26.1×
J9144 HCPCS	Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj	8	$11,395.80	$11,995.58	$11,755.67	nat. median $114 outlier · 102.7×
C1815 HCPCS	Prosthesis, Urinary Sphincter (implantable)	8	$5,388.40	$12,396.25	$11,702.43	nat. median $8,336 1.4× median
J2356 HCPCS	Injection, Tezepelumab-ekko, 1 Mg	8	$11,291.90	$11,886.21	$11,648.49	nat. median $43 outlier · 269.0×
J9289 HCPCS	Injection, Nivolumab, 2 Mg And Hyaluronidase-nvhy	8	$11,181.74	$11,770.25	$11,534.85	nat. median $35 outlier · 325.8×
J9022 HCPCS	Injection, Atezolizumab, 10 Mg	8	$9,530.96	$13,609.88	$11,480.99	nat. median $1,229 outlier · 9.3×
37191 HCPCS	Insertion Of Vena Cava Filter With Review By Radiologist	8	$10,830.00	$11,400.00	$11,172.00	nat. median $5,831 1.9× median
J9301 HCPCS	Injection, Obinutuzumab, 10 Mg	8	$9,871.97	$10,391.55	$10,183.72	nat. median $170 outlier · 60.0×
J9042 HCPCS	Injection, Brentuximab Vedotin, 1 Mg	8	$9,820.39	$10,337.25	$10,130.51	nat. median $555 outlier · 18.2×
J7169 HCPCS	Injection, Coagulation Factor Xa (recombinant), Inactivated-zhzo (andexxa), 10 M…	8	$9,718.50	$10,230.00	$10,025.40	nat. median $260 outlier · 38.6×
J2353 HCPCS	Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg	8	$5,459.16	$14,909.44	$9,955.22	nat. median $1,956 outlier · 5.1×
36002555 CDM	Operating Room Services - General Classification	8	$9,634.66	$10,141.75	$9,938.92	nat. median $9,939 1.0× median
J0565 HCPCS	Injection, Bezlotoxumab, 10 Mg	8	$9,530.40	$10,032.00	$9,831.36	nat. median $121 outlier · 81.5×
J9311 HCPCS	Injection, Rituximab 10 Mg And Hyaluronidase	8	$9,456.42	$9,954.13	$9,755.05	nat. median $79 outlier · 123.7×
J1162 HCPCS	Injection, Digoxin Immune Fab (ovine), Per Vial	8	$9,099.63	$9,578.56	$9,386.99	nat. median $6,265 1.5× median
L8604 HCPCS	Injectable Bulking Agent, Dextranomer/hyaluronic Acid Copolymer Implant, Urinary…	8	$8,983.67	$9,456.49	$9,267.36	nat. median $5,499 1.7× median
J9380 HCPCS	Injection, Teclistamab-cqyv, 0.5 Mg	8	$3,334.49	$15,760.58	$9,241.27	nat. median $65 outlier · 141.8×
J1299 HCPCS	Injection, Eculizumab, 2 Mg	8	$8,792.96	$9,255.75	$9,070.64	nat. median $75 outlier · 120.4×
59160 HCPCS	Scraping Of Lining Of Uterus After Delivery	8	$8,052.20	$8,476.00	$8,306.48	nat. median $3,185 outlier · 2.6×

Other procedures at this hospital

Browse this hospital's 4,175 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J0225	HCPCS	Injection, Vutrisiran, 1 Mg	8	8	$179,115.81	$152,248.44	$170,160.02	$179,115.81	$175,533.49	2026-09-26
J9043	HCPCS	Injection, Cabazitaxel, 1 Mg	8	8	$69,435.00	$59,019.75	$65,963.25	$69,435.00	$68,046.30	2026-09-26
J2351	HCPCS	Injection, Ocrelizumab, 1 Mg And Hyaluronidase-ocsq	8	8	$69,353.62	$58,950.58	$65,885.94	$69,353.62	$67,966.55	2026-09-26
J9347	HCPCS	Injection, Tremelimumab-actl, 1 Mg	8	8	$62,186.06	$52,858.15	$59,076.76	$62,186.06	$60,942.34	2026-09-26
J1747	HCPCS	Injection, Spesolimab-sbzo, 1 Mg	8	8	$47,988.96	$40,790.62	$45,589.51	$47,988.96	$47,029.18	2026-09-26
J9229	HCPCS	Injection, Inotuzumab Ozogamicin, 0.1 Mg	8	8	$34,467.40	$29,297.29	$32,744.03	$34,467.40	$33,778.05	2026-09-26
C1820	HCPCS	Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging…	16	8	$33,180.50	$28,203.42	$23,103.05	$42,042.00	$32,129.45	2026-09-26
J9281	HCPCS	Mitomycin Pyelocalyceal Instillation, 1 Mg	8	8	$32,153.25	$27,330.26	$30,545.59	$32,153.25	$31,510.19	2026-09-26
J0896	HCPCS	Injection, Luspatercept-aamt, 0.25 Mg	8	8	$30,697.04	$26,092.48	$29,162.19	$30,697.04	$30,083.10	2026-09-26
C1767	HCPCS	Generator, Neurostimulator (implantable), Non-rechargeable	32	8	$30,719.62	$26,111.68	$21,002.84	$62,379.25	$29,771.12	2026-09-26
J2502	HCPCS	Injection, Pasireotide Long Acting, 1 Mg	8	8	$28,690.79	$24,387.17	$27,256.25	$28,690.79	$28,116.97	2026-09-26
J9228	HCPCS	Injection, Ipilimumab, 1 Mg	16	8	$26,990.67	$22,942.07	$10,307.34	$43,131.50	$25,912.38	2026-09-26
J2350	HCPCS	Injection, Ocrelizumab, 1 Mg	8	8	$24,464.25	$20,794.61	$23,241.04	$24,464.25	$23,974.97	2026-09-26
J1303	HCPCS	Injection, Ravulizumab-cwvz, 10 Mg	16	8	$22,503.25	$19,127.76	$9,210.49	$35,311.25	$21,620.47	2026-09-26
J9298	HCPCS	Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg	8	8	$21,460.53	$18,241.45	$20,387.50	$21,460.53	$21,031.32	2026-09-26
J3241	HCPCS	Injection, Teprotumumab-trbw, 10 Mg	8	8	$20,566.75	$17,481.74	$19,538.41	$20,566.75	$20,155.42	2026-09-26
J9119	HCPCS	Injection, Cemiplimab-rwlc, 1 Mg	8	8	$19,450.26	$16,532.72	$18,477.75	$19,450.26	$19,061.25	2026-09-26
J9277	HCPCS	Injection, Pembrolizumab, 1 Mg And Berahyaluronidase Alfa-pmph	8	8	$18,497.25	$15,722.66	$17,572.39	$18,497.25	$18,127.31	2026-09-26
J3101	HCPCS	Injection, Tenecteplase, 1 Mg	16	8	$18,353.58	$15,600.55	$14,062.29	$21,904.76	$17,805.97	2026-09-26
J9024	HCPCS	Injection, Atezolizumab, 5 Mg And Hyaluronidase-tqjs	8	8	$16,966.96	$14,421.92	$16,118.61	$16,966.96	$16,627.62	2026-09-26
J9309	HCPCS	Injection, Polatuzumab Vedotin-piiq, 1 Mg	16	8	$16,643.47	$14,146.95	$5,001.22	$28,022.51	$15,942.91	2026-09-26
J1950	HCPCS	Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg	8	8	$16,025.02	$13,621.27	$15,223.77	$16,025.02	$15,704.52	2026-09-26
J2327	HCPCS	Injection, Risankizumab-rzaa, Intravenous, 1 Mg	8	8	$15,291.12	$12,997.45	$14,526.56	$15,291.12	$14,985.30	2026-09-26
63602498	CDM	Operating Room Services - General Classification	8	8	$14,844.00	$12,617.40	$14,101.80	$14,844.00	$14,547.12	2026-09-26
J0222	HCPCS	Injection, Patisiran, 0.1 Mg	8	8	$14,766.75	$12,551.74	$14,028.41	$14,766.75	$14,471.42	2026-09-26
J2997	HCPCS	Injection, Alteplase Recombinant, 1 Mg	24	8	$13,971.96	$11,876.17	$712.02	$27,915.85	$13,692.52	2026-09-26
J9316	HCPCS	Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg	16	8	$13,722.58	$11,664.19	$10,445.88	$16,449.51	$13,311.35	2026-09-26
J1932	HCPCS	Injection, Lanreotide, (cipla), 1 Mg	8	8	$13,428.24	$11,414.00	$12,756.83	$13,428.24	$13,159.68	2026-09-26
36002663	CDM	Operating Room Services - General Classification	8	8	$13,277.25	$11,285.66	$12,613.39	$13,277.25	$13,011.71	2026-09-26
27803348	CDM	Femoral Componet Sz 12	8	8	$12,597.00	$10,707.45	$11,967.15	$12,597.00	$12,345.06	2026-09-26
27803333	CDM	Senegy Foefemral Sz 15	8	8	$12,597.00	$10,707.45	$11,967.15	$12,597.00	$12,345.06	2026-09-26
J9223	HCPCS	Injection, Lurbinectedin, 0.1 Mg	8	8	$12,014.25	$10,212.11	$11,413.54	$12,014.25	$11,773.97	2026-09-26
J9144	HCPCS	Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj	8	8	$11,995.58	$10,196.24	$11,395.80	$11,995.58	$11,755.67	2026-09-26
C1815	HCPCS	Prosthesis, Urinary Sphincter (implantable)	24	8	$11,941.25	$10,150.06	$5,388.40	$12,396.25	$11,702.43	2026-09-26
J2356	HCPCS	Injection, Tezepelumab-ekko, 1 Mg	8	8	$11,886.21	$10,103.28	$11,291.90	$11,886.21	$11,648.49	2026-09-26
J9289	HCPCS	Injection, Nivolumab, 2 Mg And Hyaluronidase-nvhy	8	8	$11,770.25	$10,004.71	$11,181.74	$11,770.25	$11,534.85	2026-09-26
J9022	HCPCS	Injection, Atezolizumab, 10 Mg	16	8	$11,821.24	$10,048.05	$9,530.96	$13,609.88	$11,480.99	2026-09-26
37191	HCPCS	Insertion Of Vena Cava Filter With Review By Radiologist	8	8	$11,400.00	$9,690.00	$10,830.00	$11,400.00	$11,172.00	2026-09-26
J9301	HCPCS	Injection, Obinutuzumab, 10 Mg	8	8	$10,391.55	$8,832.82	$9,871.97	$10,391.55	$10,183.72	2026-09-26
J9042	HCPCS	Injection, Brentuximab Vedotin, 1 Mg	8	8	$10,337.25	$8,786.66	$9,820.39	$10,337.25	$10,130.51	2026-09-26
J7169	HCPCS	Injection, Coagulation Factor Xa (recombinant), Inactivated-zhzo (andexxa), 10 M…	8	8	$10,230.00	$8,695.50	$9,718.50	$10,230.00	$10,025.40	2026-09-26
J2353	HCPCS	Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg	16	8	$10,327.96	$8,778.76	$5,459.16	$14,909.44	$9,955.22	2026-09-26
36002555	CDM	Operating Room Services - General Classification	8	8	$10,141.75	$8,620.49	$9,634.66	$10,141.75	$9,938.92	2026-09-26
J0565	HCPCS	Injection, Bezlotoxumab, 10 Mg	8	8	$10,032.00	$8,527.20	$9,530.40	$10,032.00	$9,831.36	2026-09-26
J9311	HCPCS	Injection, Rituximab 10 Mg And Hyaluronidase	8	8	$9,954.13	$8,461.01	$9,456.42	$9,954.13	$9,755.05	2026-09-26
J1162	HCPCS	Injection, Digoxin Immune Fab (ovine), Per Vial	8	8	$9,578.56	$8,141.78	$9,099.63	$9,578.56	$9,386.99	2026-09-26
L8604	HCPCS	Injectable Bulking Agent, Dextranomer/hyaluronic Acid Copolymer Implant, Urinary…	8	8	$9,456.49	$8,038.02	$8,983.67	$9,456.49	$9,267.36	2026-09-26
J9380	HCPCS	Injection, Teclistamab-cqyv, 0.5 Mg	16	8	$9,635.28	$8,189.99	$3,334.49	$15,760.58	$9,241.27	2026-09-26
J1299	HCPCS	Injection, Eculizumab, 2 Mg	8	8	$9,255.75	$7,867.39	$8,792.96	$9,255.75	$9,070.64	2026-09-26
59160	HCPCS	Scraping Of Lining Of Uterus After Delivery	8	8	$8,476.00	$7,204.60	$8,052.20	$8,476.00	$8,306.48	2026-09-26
J9306	HCPCS	Injection, Pertuzumab, 1 Mg	8	8	$8,247.73	$7,010.57	$7,835.34	$8,247.73	$8,082.78	2026-09-26
J2506	HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	8	8	$8,111.74	$6,894.98	$7,706.15	$8,111.74	$7,949.51	2026-09-26
272000812	CDM	Lap Band System W/access Port	8	8	$8,038.25	$6,832.51	$7,636.34	$8,038.25	$7,877.49	2026-09-26
95783	HCPCS	Sleep Study In Sleep Lab With Continuous Airway Pressure (younger Than 6 Years)	8	8	$7,750.75	$6,588.14	$7,363.21	$7,750.75	$7,595.74	2026-09-26
95782	HCPCS	Sleep Study In Sleep Lab (younger Than 6 Years)	8	8	$7,750.75	$6,588.14	$7,363.21	$7,750.75	$7,595.74	2026-09-26
38500	HCPCS	Biopsy Or Removal Of Lymph Nodes	8	8	$7,635.00	$6,489.75	$7,253.25	$7,635.00	$7,482.30	2026-09-26
Q4108	HCPCS	Integra Matrix, Per Square Centimeter	8	8	$7,556.25	$6,422.81	$7,178.44	$7,556.25	$7,405.13	2026-09-26
90375	HCPCS	Rabies Immune Globulin For Injection	8	8	$7,485.43	$6,362.62	$7,111.16	$7,485.43	$7,335.72	2026-09-26
95811	HCPCS	Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older)	8	8	$7,154.50	$6,081.33	$6,796.78	$7,154.50	$7,011.41	2026-09-26
J0177	HCPCS	Injection, Aflibercept Hd, 1 Mg	8	8	$6,930.00	$5,890.50	$6,583.50	$6,930.00	$6,791.40	2026-09-26
27803364	CDM	Femoral Stem	8	8	$6,916.00	$5,878.60	$6,570.20	$6,916.00	$6,777.68	2026-09-26
17501012	CDM	Nursery - Newborn - Level IV	8	8	$6,790.50	$5,771.93	$6,654.69	$6,790.50	$6,654.69	2026-09-26
J3380	HCPCS	Injection, Vedolizumab, Intravenous, 1 Mg	8	8	$6,759.00	$5,745.15	$6,421.05	$6,759.00	$6,623.82	2026-09-26
J9303	HCPCS	Injection, Panitumumab, 10 Mg	16	8	$6,846.66	$5,819.66	$3,079.79	$10,451.43	$6,585.37	2026-09-26
20001364	CDM	Intensive Care Unit - General Classification	8	8	$6,693.00	$5,689.05	$6,559.14	$6,693.00	$6,559.14	2026-09-26
J9271	HCPCS	Injection, Pembrolizumab, 1 Mg	8	8	$6,660.36	$5,661.31	$6,327.34	$6,660.36	$6,527.15	2026-09-26
50432	HCPCS	Placement Of Tube Of Kidney Using Imaging Guidance With Review By Radiologist	8	8	$6,648.00	$5,650.80	$6,315.60	$6,648.00	$6,515.04	2026-09-26
95810	HCPCS	Sleep Study In Sleep Lab (6 Years Or Older)	8	8	$6,558.25	$5,574.51	$6,230.34	$6,558.25	$6,427.09	2026-09-26
G0390	HCPCS	Trauma Response Team Associated With Hospital Critical Care Service	16	8	$6,501.50	$5,526.27	$2,971.36	$9,875.25	$6,254.62	2026-09-26
J2777	HCPCS	Injection, Faricimab-svoa, 0.1 Mg	8	8	$6,378.00	$5,421.30	$6,059.10	$6,378.00	$6,250.44	2026-09-26
J2781	HCPCS	Injection, Pegcetacoplan, Intravitreal, 1 Mg	8	8	$6,378.00	$5,421.30	$6,059.10	$6,378.00	$6,250.44	2026-09-26
20001365	CDM	Intensive Care Unit - General Classification	8	8	$6,374.25	$5,418.11	$6,246.77	$6,374.25	$6,246.77	2026-09-26
Q4125	HCPCS	Arthroflex, Per Square Centimeter	56	8	$6,362.50	$5,408.13	$3,641.35	$8,060.50	$6,235.25	2026-09-26
J9330	HCPCS	Injection, Temsirolimus, 1 Mg	8	8	$6,340.25	$5,389.21	$6,023.24	$6,340.25	$6,213.45	2026-09-26
36561	HCPCS	Insertion Of Central Venous Tube With Port (5 Years Or Older)	8	8	$6,321.75	$5,373.49	$6,005.66	$6,321.75	$6,195.32	2026-09-26
J1569	HCPCS	Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),…	16	8	$6,287.99	$5,344.80	$4,846.28	$7,474.63	$6,101.12	2026-09-26
27803361	CDM	Tissue Implant	8	8	$6,196.00	$5,266.60	$5,886.20	$6,196.00	$6,072.08	2026-09-26
J1572	HCPCS	Injection, Immune Globulin, (flebogamma/flebogamma Dif), Intravenous, Non-lyophi…	8	8	$6,179.05	$5,252.19	$5,870.10	$6,179.05	$6,055.47	2026-09-26
C1813	HCPCS	Prosthesis, Penile, Inflatable	24	8	$6,002.50	$5,102.13	$2,256.25	$24,106.25	$5,882.45	2026-09-26
20001370	CDM	Intensive Care Unit - Intermediate ICU	8	8	$5,992.50	$5,093.63	$5,872.65	$5,992.50	$5,872.65	2026-09-26
Q5122	HCPCS	Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg	8	8	$5,976.75	$5,080.24	$5,677.91	$5,976.75	$5,857.22	2026-09-26
74178	HCPCS	CT Scan Of Abdomen And Pelvis Before And After Contrast	8	8	$5,952.25	$5,059.41	$5,654.64	$5,952.25	$5,833.21	2026-09-26
J9356	HCPCS	Injection, Trastuzumab, 10 Mg And Hyaluronidase-oysk	8	8	$5,933.30	$5,043.31	$5,636.64	$5,933.30	$5,814.63	2026-09-26
20401411	CDM	Room & Board - Semi-private (two Beds) - Psychiatric	8	8	$5,808.00	$4,936.80	$5,691.84	$5,808.00	$5,691.84	2026-09-26
47490	HCPCS	Insertion Of Tube Into Gallbladder Using Imaging Guidance With Review By Radiolo…	8	8	$5,806.25	$4,935.31	$5,515.94	$5,806.25	$5,690.13	2026-09-26
74177	HCPCS	CT Scan Of Abdomen And Pelvis With Contrast	8	8	$5,790.50	$4,921.93	$5,500.98	$5,790.50	$5,674.69	2026-09-26
Q5111	HCPCS	Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg	16	8	$5,829.88	$4,955.40	$5,042.60	$6,351.75	$5,671.08	2026-09-26
20001369	CDM	Intensive Care Unit - Intermediate ICU	8	8	$5,674.00	$4,822.90	$5,560.52	$5,674.00	$5,560.52	2026-09-26
73722	HCPCS	MRI Scan Of Leg Joint With Contrast	16	8	$5,734.12	$4,874.01	$3,631.85	$7,645.25	$5,542.99	2026-09-26
J9352	HCPCS	Injection, Trabectedin, 0.1 Mg	8	8	$5,645.57	$4,798.73	$5,363.29	$5,645.57	$5,532.66	2026-09-26
73721	HCPCS	MRI Scan Of Leg Joint Without Contrast	16	8	$5,716.75	$4,859.24	$3,621.16	$7,621.75	$5,526.20	2026-09-26
12001008	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$5,619.50	$4,776.58	$5,507.11	$5,619.50	$5,507.11	2026-09-26
32557	HCPCS	Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube Using Imag…	8	8	$5,560.25	$4,726.21	$5,282.24	$5,560.25	$5,449.05	2026-09-26
J0178	HCPCS	Injection, Aflibercept, 1 Mg	8	8	$5,550.00	$4,717.50	$5,272.50	$5,550.00	$5,439.00	2026-09-26
27803362	CDM	Acetabular Modular	8	8	$5,548.00	$4,715.80	$5,270.60	$5,548.00	$5,437.04	2026-09-26
2780022042	CDM	Tibialis Tend. Ant. Mm#22042	8	8	$5,519.25	$4,691.36	$5,243.29	$5,519.25	$5,408.87	2026-09-26
36558	HCPCS	Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older)	8	8	$5,457.50	$4,638.88	$5,184.63	$5,457.50	$5,348.35	2026-09-26
2720004840	CDM	Arthrex Knee Scorpion	8	8	$5,450.90	$4,633.27	$5,178.36	$5,450.90	$5,341.88	2026-09-26
74183	HCPCS	MRI Scan Of Abdomen Before And After Contrast	8	8	$5,416.75	$4,604.24	$5,145.91	$5,416.75	$5,308.42	2026-09-26
20240	HCPCS	Biopsy Of Surface Bone	8	8	$5,410.25	$4,598.71	$5,139.74	$5,410.25	$5,302.05	2026-09-26
J3240	HCPCS	Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial	8	8	$5,406.19	$4,595.26	$5,135.88	$5,406.19	$5,298.07	2026-09-26
12001007	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$5,404.00	$4,593.40	$5,295.92	$5,404.00	$5,295.92	2026-09-26
36003005	CDM	Operating Room Services - General Classification	8	8	$5,389.00	$4,580.65	$5,119.55	$5,389.00	$5,281.22	2026-09-26
72157	HCPCS	MRI Scan Of Middle Spinal Canal Before And After Contrast	16	8	$5,352.25	$4,549.41	$5,084.64	$5,352.25	$5,245.21	2026-09-26
J9206	HCPCS	Injection, Irinotecan, 20 Mg	8	8	$5,350.88	$4,548.25	$5,083.34	$5,350.88	$5,243.86	2026-09-26
2780000376	CDM	Anterior Tibialis Graft Non-IM	8	8	$5,323.25	$4,524.76	$5,057.09	$5,323.25	$5,216.79	2026-09-26
2780000826	CDM	Anterior Tibialis Graft Import	8	8	$5,323.25	$4,524.76	$5,057.09	$5,323.25	$5,216.79	2026-09-26
2780003156	CDM	Tibialis Tend Anterior W/spec	8	8	$5,306.75	$4,510.74	$5,041.41	$5,306.75	$5,200.62	2026-09-26
27803354	CDM	Plate Sky Level 1 14mmxti	8	8	$5,291.00	$4,497.35	$5,026.45	$5,291.00	$5,185.18	2026-09-26
J9308	HCPCS	Injection, Ramucirumab, 5 Mg	16	8	$5,385.19	$4,577.41	$2,240.47	$8,412.00	$5,174.90	2026-09-26
72156	HCPCS	MRI Scan Of Upper Spinal Canal Before And After Contrast	16	8	$5,269.50	$4,479.08	$5,006.03	$5,269.50	$5,164.11	2026-09-26
72197	HCPCS	MRI Scan Of Pelvis Before And After Contrast	8	8	$5,263.25	$4,473.76	$5,000.09	$5,263.25	$5,157.99	2026-09-26
71552	HCPCS	MRI Scan Of Chest Before And After Contrast	8	8	$5,259.50	$4,470.58	$4,996.53	$5,259.50	$5,154.31	2026-09-26
74176	HCPCS	CT Scan Of Abdomen And Pelvis Without Contrast	16	8	$5,238.25	$4,452.51	$4,976.34	$5,238.25	$5,133.49	2026-09-26
70543	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast	8	8	$5,229.50	$4,445.08	$4,968.03	$5,229.50	$5,124.91	2026-09-26
70553	HCPCS	MRI Scan Of Brain Before And After Contrast	8	8	$5,220.50	$4,437.43	$4,959.48	$5,220.50	$5,116.09	2026-09-26
J0897	HCPCS	Injection, Denosumab, 1 Mg	16	8	$5,261.18	$4,472.01	$4,124.50	$6,180.79	$5,106.66	2026-09-26
70471	HCPCS	Computed Tomographic Angiography (cta), Head And Neck, With Contrast Material(s)…	8	8	$5,190.50	$4,411.93	$4,930.98	$5,190.50	$5,086.69	2026-09-26
72198	HCPCS	MRI Scan Of Blood Vessels Of Pelvis	8	8	$5,170.75	$4,395.14	$4,912.21	$5,170.75	$5,067.34	2026-09-26
71555	HCPCS	MRI Scan Of Blood Vessels Of Chest	8	8	$5,170.75	$4,395.14	$4,912.21	$5,170.75	$5,067.34	2026-09-26
72195	HCPCS	MRI Scan Of Pelvis Without Contrast	16	8	$5,237.00	$4,451.45	$3,316.93	$6,982.50	$5,062.44	2026-09-26
20401009	CDM	Room & Board - Semi-private (two Beds) - Psychiatric	8	8	$5,055.25	$4,296.96	$4,954.15	$5,055.25	$4,954.15	2026-09-26
Q9992	HCPCS	Injection, Buprenorphine Extended-release (sublocade), Greater Than 100 Mg	8	8	$5,043.55	$4,287.02	$4,791.37	$5,043.55	$4,942.68	2026-09-26
2720000697	CDM	Small Frag Instur Case 690.347	8	8	$5,042.50	$4,286.13	$4,790.38	$5,042.50	$4,941.65	2026-09-26
J0180	HCPCS	Injection, Agalsidase Beta, 1 Mg	16	8	$5,108.55	$4,342.27	$1,862.33	$8,256.75	$4,902.13	2026-09-26
Q5120	HCPCS	Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg	8	8	$4,996.16	$4,246.74	$4,746.35	$4,996.16	$4,896.24	2026-09-26
59412	HCPCS	Turning Of Fetus Through External Manipulation	8	8	$4,984.25	$4,236.61	$4,735.04	$4,984.25	$4,884.57	2026-09-26
Q9991	HCPCS	Injection, Buprenorphine Extended-release (sublocade), Less Than Or Equal To 100…	8	8	$4,979.25	$4,232.36	$4,730.29	$4,979.25	$4,879.67	2026-09-26
27803366	CDM	Modular Neck Taper	8	8	$4,978.50	$4,231.73	$4,729.58	$4,978.50	$4,878.93	2026-09-26
20001368	CDM	Intensive Care Unit - General Classification	8	8	$4,973.75	$4,227.69	$4,874.28	$4,973.75	$4,874.28	2026-09-26
95805	HCPCS	Sleep Study, Multiple Trials	8	8	$4,948.50	$4,206.23	$4,701.08	$4,948.50	$4,849.53	2026-09-26
12001159	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$4,925.75	$4,186.89	$4,827.24	$4,925.75	$4,827.24	2026-09-26
12001417	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$4,925.75	$4,186.89	$4,827.24	$4,925.75	$4,827.24	2026-09-26
12001151	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$4,925.75	$4,186.89	$4,827.24	$4,925.75	$4,827.24	2026-09-26
J1561	HCPCS	Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)…	32	8	$4,991.18	$4,242.50	$2,005.12	$16,193.67	$4,825.03	2026-09-26
2780000850	CDM	Mesh Wittman Patch	8	8	$4,897.50	$4,162.88	$4,652.63	$4,897.50	$4,799.55	2026-09-26
J0875	HCPCS	Injection, Dalbavancin, 5 Mg	8	8	$4,867.33	$4,137.23	$4,623.96	$4,867.33	$4,769.98	2026-09-26
27211463	CDM	Torque Limit Attachmnt 511.773	8	8	$4,862.50	$4,133.13	$4,619.38	$4,862.50	$4,765.25	2026-09-26
20225	HCPCS	Deep Biopsy Of Bone Using Needle Or Trocar	8	8	$4,852.25	$4,124.41	$4,609.64	$4,852.25	$4,755.21	2026-09-26
74174	HCPCS	CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	8	8	$4,845.75	$4,118.89	$4,603.46	$4,845.75	$4,748.84	2026-09-26
2720006200	CDM	75mm Pin Clamp Large Blue	8	8	$4,826.75	$4,102.74	$4,585.41	$4,826.75	$4,730.22	2026-09-26
J9227	HCPCS	Injection, Isatuximab-irfc, 10 Mg	8	8	$4,818.54	$4,095.76	$4,577.61	$4,818.54	$4,722.17	2026-09-26
70546	HCPCS	MRI Scan Of Blood Vessels Of Head Before And After Contrast	8	8	$4,818.00	$4,095.30	$4,577.10	$4,818.00	$4,721.64	2026-09-26
12001534	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$4,801.50	$4,081.28	$4,705.47	$4,801.50	$4,705.47	2026-09-26
72158	HCPCS	MRI Scan Of Lower Spinal Canal Before And After Contrast	16	8	$4,766.50	$4,051.53	$4,528.18	$4,766.50	$4,671.17	2026-09-26
J2426	HCPCS	Injection, Paliperidone Palmitate Extended Release (invega Sustenna), 1 Mg	32	8	$4,791.42	$4,072.70	$3,022.92	$9,490.16	$4,654.62	2026-09-26
C1052	HCPCS	Hemostatic Agent, Gastrointestinal, Topical	8	8	$4,732.00	$4,022.20	$4,495.40	$4,732.00	$4,637.36	2026-09-26
73723	HCPCS	MRI Scan Of Leg Joint Before And After Contrast	16	8	$4,731.75	$4,021.99	$4,495.16	$4,731.75	$4,637.12	2026-09-26
78803	HCPCS	Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day …	8	8	$4,722.00	$4,013.70	$4,485.90	$4,722.00	$4,627.56	2026-09-26
27803363	CDM	Acetabular Lnr 32mm 6305-50-32	8	8	$4,699.25	$3,994.36	$4,464.29	$4,699.25	$4,605.27	2026-09-26
36003033	CDM	Operating Room Services - General Classification	8	8	$4,696.50	$3,992.03	$4,461.68	$4,696.50	$4,602.57	2026-09-26
70549	HCPCS	MRI Scan Of Blood Vessels Of Neck Before And After Contrast	8	8	$4,681.25	$3,979.06	$4,447.19	$4,681.25	$4,587.63	2026-09-26
2720000699	CDM	Torque Limiting Attach 511.773	8	8	$4,675.00	$3,973.75	$4,441.25	$4,675.00	$4,581.50	2026-09-26
73223	HCPCS	MRI Scan Of Arm Joint Before And After Contrast	16	8	$4,659.25	$3,960.36	$4,426.29	$4,659.25	$4,566.07	2026-09-26
C1778	HCPCS	Lead, Neurostimulator (implantable)	16	8	$4,749.62	$4,037.18	$835.05	$8,620.25	$4,534.12	2026-09-26
33017	HCPCS	Drainage Of Heart Sac Using Tube And Imaging Guidance (6 Years Or Older)	8	8	$4,618.50	$3,925.73	$4,387.58	$4,618.50	$4,526.13	2026-09-26
J9033	HCPCS	Injection, Bendamustine Hydrochloride, 1 Mg	8	8	$4,617.91	$3,925.22	$4,387.01	$4,617.91	$4,525.55	2026-09-26
27803357	CDM	Tibial Sz 5 5980-47-01	8	8	$4,569.25	$3,883.86	$4,340.79	$4,569.25	$4,477.87	2026-09-26
73720	HCPCS	MRI Scan Of Leg Before And After Contrast	24	8	$4,554.25	$3,871.11	$4,326.54	$9,108.50	$4,474.56	2026-09-26
J9177	HCPCS	Injection, Enfortumab Vedotin-ejfv, 0.25 Mg	16	8	$4,608.44	$3,917.18	$3,667.71	$5,356.13	$4,474.53	2026-09-26
62305	HCPCS	X-ray Of Multiple Regions Of Spinal Canal With Review By Radiologist	8	8	$4,561.50	$3,877.28	$4,333.43	$4,561.50	$4,470.27	2026-09-26
J9312	HCPCS	Injection, Rituximab, 10 Mg	16	8	$4,644.91	$3,948.17	$2,046.46	$7,135.65	$4,466.52	2026-09-26
72142	HCPCS	MRI Scan Of Upper Spinal Canal With Contrast	8	8	$4,533.50	$3,853.48	$4,306.83	$4,533.50	$4,442.83	2026-09-26
27811353	CDM	Breast Implant 133fx15	8	8	$4,516.75	$3,839.24	$4,290.91	$4,516.75	$4,426.42	2026-09-26
27803345	CDM	Breast Implant 133fx13	8	8	$4,516.75	$3,839.24	$4,290.91	$4,516.75	$4,426.42	2026-09-26
J7312	HCPCS	Injection, Dexamethasone, Intravitreal Implant, 0.1 Mg	8	8	$4,509.57	$3,833.13	$4,284.09	$4,509.57	$4,419.38	2026-09-26
J3032	HCPCS	Injection, Eptinezumab-jjmr, 1 Mg	8	8	$4,485.00	$3,812.25	$4,260.75	$4,485.00	$4,395.30	2026-09-26
73220	HCPCS	MRI Scan Of Arm Before And After Contrast	24	8	$4,461.75	$3,792.49	$4,238.66	$8,923.25	$4,383.67	2026-09-26
75574	HCPCS	CT Scan Of Blood Vessels And Grafts Of Heart With Contrast	8	8	$4,463.50	$3,793.98	$4,240.33	$4,463.50	$4,374.23	2026-09-26
J2182	HCPCS	Injection, Mepolizumab, 1 Mg	8	8	$4,463.49	$3,793.97	$4,240.32	$4,463.49	$4,374.22	2026-09-26
72147	HCPCS	MRI Scan Of Middle Spinal Canal With Contrast	8	8	$4,449.75	$3,782.29	$4,227.26	$4,449.75	$4,360.76	2026-09-26
J0630	HCPCS	Injection, Calcitonin Salmon, Up To 400 Units	8	8	$4,439.50	$3,773.58	$4,217.53	$4,439.50	$4,350.71	2026-09-26
J1459	HCPCS	Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui…	24	8	$4,414.25	$3,752.11	$2,522.11	$7,757.11	$4,325.97	2026-09-26
J9354	HCPCS	Injection, Ado-trastuzumab Emtansine, 1 Mg	8	8	$4,380.03	$3,723.03	$4,161.03	$4,380.03	$4,292.43	2026-09-26
70542	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast	8	8	$4,362.00	$3,707.70	$4,143.90	$4,362.00	$4,274.76	2026-09-26
20001367	CDM	Intensive Care Unit - General Classification	8	8	$4,340.50	$3,689.43	$4,253.69	$4,340.50	$4,253.69	2026-09-26
19081	HCPCS	Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, First…	16	8	$4,335.75	$3,685.39	$4,118.96	$4,335.75	$4,249.04	2026-09-26
J9217	HCPCS	Leuprolide Acetate (for Depot Suspension), 7.5 Mg	64	8	$4,354.91	$3,701.67	$1,430.97	$17,988.04	$4,231.20	2026-09-26
72149	HCPCS	MRI Scan Of Lower Spinal Canal With Contrast	8	8	$4,311.50	$3,664.78	$4,095.93	$4,311.50	$4,225.27	2026-09-26
12001416	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$4,298.75	$3,653.94	$4,212.78	$4,298.75	$4,212.78	2026-09-26
12001150	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$4,298.75	$3,653.94	$4,212.78	$4,298.75	$4,212.78	2026-09-26
12001158	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$4,298.75	$3,653.94	$4,212.78	$4,298.75	$4,212.78	2026-09-26
50435	HCPCS	Replacement Of Kidney Drainage Tube Using Imaging Guidance With Review By Radiol…	8	8	$4,294.00	$3,649.90	$4,079.30	$4,294.00	$4,208.12	2026-09-26
78452	HCPCS	Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect	8	8	$4,280.50	$3,638.43	$4,066.48	$4,280.50	$4,194.89	2026-09-26
2720008188	CDM	Fhl Implant System 7.0mm	8	8	$4,276.50	$3,635.03	$4,062.68	$4,276.50	$4,190.97	2026-09-26
75635	HCPCS	CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast	8	8	$4,260.00	$3,621.00	$4,047.00	$4,260.00	$4,174.80	2026-09-26
12001006	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$4,223.75	$3,590.19	$4,139.28	$4,223.75	$4,139.28	2026-09-26
72196	HCPCS	MRI Scan Of Pelvis With Contrast	8	8	$4,195.50	$3,566.18	$3,985.73	$4,195.50	$4,111.59	2026-09-26
74170	HCPCS	CT Scan Of Abdomen Before And After Contrast	8	8	$4,184.00	$3,556.40	$3,974.80	$4,184.00	$4,100.32	2026-09-26
17501620	CDM	Nursery - Newborn - Level Iii	8	8	$4,174.50	$3,548.33	$4,091.01	$4,174.50	$4,091.01	2026-09-26
Q5117	HCPCS	Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg	16	8	$4,230.18	$3,595.66	$2,525.89	$5,801.53	$4,085.14	2026-09-26
Q5115	HCPCS	Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg	16	8	$4,236.15	$3,600.73	$1,939.34	$6,430.88	$4,075.38	2026-09-26
J9205	HCPCS	Injection, Irinotecan Liposome, 1 Mg	8	8	$4,151.35	$3,528.65	$3,943.78	$4,151.35	$4,068.32	2026-09-26
50200	HCPCS	Needle Biopsy Of Kidney	8	8	$4,131.75	$3,511.99	$3,925.16	$4,131.75	$4,049.12	2026-09-26
74175	HCPCS	CT Scan Of Blood Vessels Of Abdomen With Contrast	8	8	$4,126.25	$3,507.31	$3,919.94	$4,126.25	$4,043.73	2026-09-26
47000	HCPCS	Needle Biopsy Of Liver Through Skin	16	8	$4,134.25	$3,514.11	$3,812.83	$4,255.00	$4,027.88	2026-09-26
73719	HCPCS	MRI Scan Of Leg With Contrast	8	8	$4,104.50	$3,488.83	$3,899.28	$4,104.50	$4,022.41	2026-09-26
72133	HCPCS	CT Scan Of Lower Spine Before And After Contrast	8	8	$4,084.00	$3,471.40	$3,879.80	$4,084.00	$4,002.32	2026-09-26
36580	HCPCS	Replacement Of Nontunneled Central Venous Tube	8	8	$4,073.75	$3,462.69	$3,870.06	$4,073.75	$3,992.28	2026-09-26
27803353	CDM	Implant Bengal Std 7mmx7Deg	8	8	$4,069.00	$3,458.65	$3,865.55	$4,069.00	$3,987.62	2026-09-26
70552	HCPCS	MRI Scan Of Brain With Contrast	8	8	$4,068.50	$3,458.23	$3,865.08	$4,068.50	$3,987.13	2026-09-26
99291	HCPCS	Critical Care, First 30-74 Minutes	8	8	$4,061.00	$3,451.85	$3,857.95	$4,061.00	$3,979.78	2026-09-26
72148	HCPCS	MRI Scan Of Lower Spinal Canal Without Contrast	16	8	$4,052.75	$3,444.84	$3,850.11	$4,052.75	$3,971.70	2026-09-26
17001015	CDM	Nursery - General Classification	8	8	$4,044.25	$3,437.61	$3,963.37	$4,044.25	$3,963.37	2026-09-26
72127	HCPCS	CT Scan Of Upper Spine Before And After Contrast	8	8	$4,040.25	$3,434.21	$3,838.24	$4,040.25	$3,959.45	2026-09-26
19083	HCPCS	Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth	8	8	$4,013.50	$3,411.48	$3,812.83	$4,013.50	$3,933.23	2026-09-26
36003004	CDM	Operating Room Services - General Classification	8	8	$4,004.00	$3,403.40	$3,803.80	$4,004.00	$3,923.92	2026-09-26
C1762	HCPCS	Connective Tissue, Human (includes Fascia Lata)	216	8	$3,972.50	$3,376.63	$2,321.80	$22,941.50	$3,893.05	2026-09-26
12401408	CDM	Room & Board - Semi-private (two Beds) - Psychiatric	8	8	$3,949.75	$3,357.29	$3,870.76	$3,949.75	$3,870.76	2026-09-26
71270	HCPCS	CT Scan Of Chest Before And After Contrast	8	8	$3,946.25	$3,354.31	$3,748.94	$3,946.25	$3,867.33	2026-09-26
73219	HCPCS	MRI Scan Of Arm With Contrast	16	8	$3,941.00	$3,349.85	$3,743.95	$3,941.00	$3,862.18	2026-09-26
J9285	HCPCS	Injection, Olaratumab, 10 Mg	8	8	$3,940.75	$3,349.64	$3,743.71	$3,940.75	$3,861.94	2026-09-26
72130	HCPCS	CT Scan Of Middle Spine Before And After Contrast	8	8	$3,931.00	$3,341.35	$3,734.45	$3,931.00	$3,852.38	2026-09-26
72194	HCPCS	CT Scan Of Pelvis Before And After Contrast	8	8	$3,915.75	$3,328.39	$3,719.96	$3,915.75	$3,837.44	2026-09-26
J0129	HCPCS	Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…	8	8	$3,912.80	$3,325.88	$3,717.16	$3,912.80	$3,834.54	2026-09-26
38222	HCPCS	Biopsy And Aspiration Of Bone Marrow Sample For Diagnosis	16	8	$3,931.75	$3,341.99	$3,643.96	$4,027.75	$3,826.36	2026-09-26
72001700	CDM	Labor Room/delivery - General Classification	8	8	$3,879.00	$3,297.15	$3,685.05	$3,879.00	$3,801.42	2026-09-26
71275	HCPCS	CT Scan Of Blood Vessels Of Chest With Contrast	8	8	$3,865.00	$3,285.25	$3,671.75	$3,865.00	$3,787.70	2026-09-26
2720009864	CDM	Exodus Hip Stem Removal Blades	8	8	$3,850.00	$3,272.50	$3,657.50	$3,850.00	$3,773.00	2026-09-26
27811800	CDM	Art Ins Sz5-6 Lt 25mm 74027269	8	8	$3,827.00	$3,252.95	$3,635.65	$3,827.00	$3,750.46	2026-09-26
70496	HCPCS	CT Scan Of Blood Vessels Of Head With Contrast	8	8	$3,798.00	$3,228.30	$3,608.10	$3,798.00	$3,722.04	2026-09-26
J9317	HCPCS	Injection, Sacituzumab Govitecan-hziy, 2.5 Mg	8	8	$3,797.39	$3,227.78	$3,607.52	$3,797.39	$3,721.44	2026-09-26
27811792	CDM	Plate Lo-pro Mtp Cont Std Rt	8	8	$3,761.25	$3,197.06	$3,573.19	$3,761.25	$3,686.03	2026-09-26
36002332	CDM	Litho Laser Fiber 200Mic Disp	8	8	$3,759.25	$3,195.36	$3,571.29	$3,759.25	$3,684.07	2026-09-26
27803358	CDM	Patella 32x8.5 00-5972-066-32	8	8	$3,759.25	$3,195.36	$3,571.29	$3,759.25	$3,684.07	2026-09-26
J9358	HCPCS	Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg	8	8	$3,753.62	$3,190.58	$3,565.94	$3,753.62	$3,678.55	2026-09-26
73706	HCPCS	CT Scan Of Blood Vessels Of Lower Leg With Contrast	24	8	$3,729.00	$3,169.65	$3,542.55	$7,457.75	$3,663.74	2026-09-26
72146	HCPCS	MRI Scan Of Middle Spinal Canal Without Contrast	16	8	$3,737.25	$3,176.66	$3,550.39	$3,737.25	$3,662.51	2026-09-26
74181	HCPCS	MRI Scan Of Abdomen Without Contrast	8	8	$3,726.75	$3,167.74	$3,540.41	$3,726.75	$3,652.22	2026-09-26
J9173	HCPCS	Injection, Durvalumab, 10 Mg	16	8	$3,786.09	$3,218.18	$1,963.34	$5,505.51	$3,648.45	2026-09-26
74182	HCPCS	MRI Scan Of Abdomen With Contrast	8	8	$3,718.00	$3,160.30	$3,532.10	$3,718.00	$3,643.64	2026-09-26
70498	HCPCS	CT Scan Of Blood Vessels Of Neck With Contrast	8	8	$3,715.75	$3,158.39	$3,529.96	$3,715.75	$3,641.44	2026-09-26
71260	HCPCS	CT Scan Of Chest With Contrast	8	8	$3,712.50	$3,155.63	$3,526.88	$3,712.50	$3,638.25	2026-09-26
70551	HCPCS	MRI Scan Of Brain Without Contrast	16	8	$3,711.75	$3,154.99	$3,526.16	$3,711.75	$3,637.52	2026-09-26
J9202	HCPCS	Goserelin Acetate Implant, Per 3.6 Mg	8	8	$3,705.35	$3,149.55	$3,520.08	$3,705.35	$3,631.24	2026-09-26
70545	HCPCS	MRI Scan Of Blood Vessels Of Head With Contrast	8	8	$3,702.50	$3,147.13	$3,517.38	$3,702.50	$3,628.45	2026-09-26
70540	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast	8	8	$3,681.25	$3,129.06	$3,497.19	$3,681.25	$3,607.63	2026-09-26
74160	HCPCS	CT Scan Of Abdomen With Contrast	8	8	$3,671.25	$3,120.56	$3,487.69	$3,671.25	$3,597.83	2026-09-26
62322	HCPCS	Injection Of Substance Into Lower Spine Canal	8	8	$3,656.50	$3,108.03	$3,473.68	$3,656.50	$3,583.37	2026-09-26
C1776	HCPCS	Joint Device (implantable)	1,840	8	$3,719.12	$3,161.26	$444.60	$28,535.50	$3,582.86	2026-09-26
Q5119	HCPCS	Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg	16	8	$3,698.39	$3,143.64	$1,813.76	$5,487.56	$3,561.20	2026-09-26
72193	HCPCS	CT Scan Of Pelvis With Contrast	8	8	$3,628.75	$3,084.44	$3,447.31	$3,628.75	$3,556.18	2026-09-26
36002626	CDM	Laser Fiber Greenlight	8	8	$3,620.00	$3,077.00	$3,439.00	$3,620.00	$3,547.60	2026-09-26
73222	HCPCS	MRI Scan Of Arm Joint With Contrast	16	8	$3,620.00	$3,077.00	$3,439.00	$3,620.00	$3,547.60	2026-09-26
70492	HCPCS	CT Scan Of Soft Tissue Of Neck Before And After Contrast	8	8	$3,615.75	$3,073.39	$3,434.96	$3,615.75	$3,543.44	2026-09-26
72141	HCPCS	MRI Scan Of Upper Spinal Canal Without Contrast	16	8	$3,609.50	$3,068.08	$3,429.03	$3,609.50	$3,537.31	2026-09-26
73225	HCPCS	MRI Scan Of Blood Vessels Of Arm	16	8	$3,579.75	$3,042.79	$3,400.76	$3,579.75	$3,508.16	2026-09-26
64483	HCPCS	Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I…	8	8	$3,576.00	$3,039.60	$3,397.20	$3,576.00	$3,504.48	2026-09-26
72126	HCPCS	CT Scan Of Upper Spine With Contrast	8	8	$3,565.00	$3,030.25	$3,386.75	$3,565.00	$3,493.70	2026-09-26
27210399	CDM	Stapler Intraluminel 25mm	8	8	$3,550.50	$3,017.93	$3,372.98	$3,550.50	$3,479.49	2026-09-26
70336	HCPCS	MRI Scan Of Jaw Joint	8	8	$3,548.25	$3,016.01	$3,370.84	$3,548.25	$3,477.29	2026-09-26
27802627	CDM	Implant Tendon Passive	8	8	$3,537.75	$3,007.09	$3,360.86	$3,537.75	$3,467.00	2026-09-26
73221	HCPCS	MRI Scan Of Arm Joint Without Contrast	24	8	$3,519.50	$2,991.58	$3,343.53	$7,038.75	$3,457.91	2026-09-26
70488	HCPCS	CT Scan Of Face Before And After Contrast	8	8	$3,523.75	$2,995.19	$3,347.56	$3,523.75	$3,453.28	2026-09-26
74185	HCPCS	MRI Scan Of Blood Vessels Of Abdomen	8	8	$3,517.50	$2,989.88	$3,341.63	$3,517.50	$3,447.15	2026-09-26
72132	HCPCS	CT Scan Of Lower Spine With Contrast	8	8	$3,516.00	$2,988.60	$3,340.20	$3,516.00	$3,445.68	2026-09-26
73718	HCPCS	MRI Scan Of Leg Without Contrast	24	8	$3,496.00	$2,971.60	$3,321.20	$6,991.75	$3,434.82	2026-09-26
2720009911	CDM	Allograft Oats Dispos Kit 20mm	8	8	$3,500.00	$2,975.00	$3,325.00	$3,500.00	$3,430.00	2026-09-26
70548	HCPCS	MRI Scan Of Blood Vessels Of Neck With Contrast	8	8	$3,499.25	$2,974.36	$3,324.29	$3,499.25	$3,429.27	2026-09-26
74713	HCPCS	MRI Scan Of Fetus For Each Additional Pregnancy	8	8	$3,491.50	$2,967.78	$3,316.93	$3,491.50	$3,421.67	2026-09-26
74712	HCPCS	MRI Scan Of Fetus For Single Or First Pregnancy	8	8	$3,491.50	$2,967.78	$3,316.93	$3,491.50	$3,421.67	2026-09-26
12001002	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$3,491.00	$2,967.35	$3,421.18	$3,491.00	$3,421.18	2026-09-26
36002540	CDM	Operating Room Services - General Classification	8	8	$3,490.25	$2,966.71	$3,315.74	$3,490.25	$3,420.45	2026-09-26
70482	HCPCS	CT Scan Of Cranial Cavity Before And After Contrast	8	8	$3,483.75	$2,961.19	$3,309.56	$3,483.75	$3,414.08	2026-09-26
73702	HCPCS	CT Scan Of Leg Before And After Contrast	16	8	$3,481.00	$2,958.85	$3,306.95	$3,481.00	$3,411.38	2026-09-26
36002279	CDM	Uterine Balloon Thermachoice	8	8	$3,465.50	$2,945.68	$3,292.23	$3,465.50	$3,396.19	2026-09-26
73202	HCPCS	CT Scan Of Arm Before And After Contrast	16	8	$3,455.00	$2,936.75	$3,282.25	$3,455.00	$3,385.90	2026-09-26
70470	HCPCS	CT Scan Of Head Or Brain Before And After Contrast	8	8	$3,439.00	$2,923.15	$3,267.05	$3,439.00	$3,370.22	2026-09-26
73218	HCPCS	MRI Scan Of Arm Without Contrast	16	8	$3,422.00	$2,908.70	$3,250.90	$3,422.00	$3,353.56	2026-09-26
36556	HCPCS	Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older)	8	8	$3,401.75	$2,891.49	$3,231.66	$3,401.75	$3,333.72	2026-09-26
73206	HCPCS	CT Scan Of Blood Vessels Of Arm With Contrast	16	8	$3,390.00	$2,881.50	$3,220.50	$3,390.00	$3,322.20	2026-09-26
36003003	CDM	Operating Room Services - General Classification	8	8	$3,388.25	$2,880.01	$3,218.84	$3,388.25	$3,320.49	2026-09-26
36100005	CDM	Operating Room Services - Minor Surgery	8	8	$3,388.25	$2,880.01	$3,218.84	$3,388.25	$3,320.49	2026-09-26
36573	HCPCS	Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, …	8	8	$3,377.00	$2,870.45	$3,208.15	$3,377.00	$3,309.46	2026-09-26
36002546	CDM	Tip Applicator Ext Duraseal	8	8	$3,374.50	$2,868.33	$3,205.78	$3,374.50	$3,307.01	2026-09-26
71551	HCPCS	MRI Scan Of Chest With Contrast	8	8	$3,369.00	$2,863.65	$3,200.55	$3,369.00	$3,301.62	2026-09-26
72129	HCPCS	CT Scan Of Middle Spine With Contrast	8	8	$3,363.25	$2,858.76	$3,195.09	$3,363.25	$3,295.99	2026-09-26
21550	HCPCS	Biopsy Of Soft Tissue Of Neck Or Chest	8	8	$3,352.50	$2,849.63	$3,184.88	$3,352.50	$3,285.45	2026-09-26
C8929	HCPCS	Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi…	16	8	$3,390.62	$2,882.03	$3,158.04	$3,457.00	$3,284.15	2026-09-26
62302	HCPCS	X-ray Of Upper Spinal Canal With Review By Radiologist	8	8	$3,339.00	$2,838.15	$3,172.05	$3,339.00	$3,272.22	2026-09-26
62304	HCPCS	X-ray Of Lower Spinal Canal With Review By Radiologist	8	8	$3,334.00	$2,833.90	$3,167.30	$3,334.00	$3,267.32	2026-09-26
36569	HCPCS	Insertion Of Tube For Infusion (5 Years Or Older)	8	8	$3,309.00	$2,812.65	$3,143.55	$3,309.00	$3,242.82	2026-09-26
70547	HCPCS	MRI Scan Of Blood Vessels Of Neck Without Contrast	8	8	$3,301.75	$2,806.49	$3,136.66	$3,301.75	$3,235.72	2026-09-26
Q0138	HCPCS	Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd …	8	8	$3,274.75	$2,783.54	$3,111.01	$3,274.75	$3,209.26	2026-09-26
71550	HCPCS	MRI Scan Of Chest Without Contrast	8	8	$3,268.50	$2,778.23	$3,105.08	$3,268.50	$3,203.13	2026-09-26
51710	HCPCS	Complicated Change Of Bladder Tube	8	8	$3,268.00	$2,777.80	$3,104.60	$3,268.00	$3,202.64	2026-09-26
76102521	CDM	Specialty Services - Treatment Room	8	8	$3,268.00	$2,777.80	$3,104.60	$3,268.00	$3,202.64	2026-09-26
C1782	HCPCS	Morcellator	24	8	$3,264.50	$2,774.83	$2,061.98	$3,411.75	$3,199.21	2026-09-26
J2802	HCPCS	Injection, Romiplostim, 1 Microgram	16	8	$3,293.06	$2,799.10	$2,402.84	$4,056.81	$3,191.64	2026-09-26
J9299	HCPCS	Injection, Nivolumab, 1 Mg	32	8	$3,290.11	$2,796.59	$1,809.50	$9,528.74	$3,185.84	2026-09-26
12001005	CDM	Room & Board - Semi-private (two Beds) - General Classification	8	8	$3,249.75	$2,762.29	$3,184.76	$3,249.75	$3,184.76	2026-09-26
36584	HCPCS	Replacement Of Peripherally Inserted Central Venous Tube (picc) With Review By R…	8	8	$3,229.75	$2,745.29	$3,068.26	$3,229.75	$3,165.16	2026-09-26
27805572	CDM	Plt 2.4x150mm 20Hole Ti 449.70	8	8	$3,224.50	$2,740.83	$3,063.28	$3,224.50	$3,160.01	2026-09-26
C9399	HCPCS	Unclassified Drugs Or Biologicals	8	8	$3,223.58	$2,740.04	$3,062.40	$3,223.58	$3,159.11	2026-09-26
27811640	CDM	Liner 36mmX64mm 6305-64-36	8	8	$3,223.25	$2,739.76	$3,062.09	$3,223.25	$3,158.79	2026-09-26
27811638	CDM	Liner 36mmX60mm 6305-60-36	8	8	$3,223.25	$2,739.76	$3,062.09	$3,223.25	$3,158.79	2026-09-26
27811637	CDM	Liner 36mmX58mm 6305-58-36	8	8	$3,223.25	$2,739.76	$3,062.09	$3,223.25	$3,158.79	2026-09-26
27811643	CDM	Liner 36mmX70mm 6305-70-36	8	8	$3,223.25	$2,739.76	$3,062.09	$3,223.25	$3,158.79	2026-09-26
27811642	CDM	Liner 36mmX68mm 6305-68-36	8	8	$3,223.25	$2,739.76	$3,062.09	$3,223.25	$3,158.79	2026-09-26
27811641	CDM	Liner 36mmX66mm 6305-66-36	8	8	$3,223.25	$2,739.76	$3,062.09	$3,223.25	$3,158.79	2026-09-26

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