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

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Hospital

BRISTOL BAY DBA KANAKANAK HOSPITAL

Dillingham, AK · CCN 021309 · Rates published

Your selected procedure

You selected 93350 (HCPCS)

Ultrasound of heart during rest, exercise and/or drug-induced stress with report

This hospital’s price: $316 across 2 payers · range $92-$1,030

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbKHDILLINGHAMAK&type=CDMWithoutLabel&fileType=CSV · observed 2026-05-20

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.

2,631 distinct procedures filed
6 distinct payers
6,111 rate rows
2026-05-20 last MRF observed
Data quality

6,091 of 6,111 rate rows are consumer-grade (99.7%)

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

Excluded — reasonRows
percent-of-charges filed in the dollar field — excluded from medians 9
per-diem day rate — not a per-procedure price 7
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbKHDILLINGHAMAK&type=CDMWithoutLabel&fileType=CSV
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-17
Content fingerprint 50dd8597a41b4789… · 3,940,214 bytes · first seen 2026-07-17

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
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 1 $9,328.00 $24,266.16 $16,797.08 nat. median
$3,787
outlier · 4.4×
A0430
HCPCS 		Ambulance Service, Conventional Air Services, Transport, One Way (fixed Wing) 1 $9,696.00 $9,696.00 $9,696.00 nat. median
$5,472
1.8× median
59400
HCPCS 		Vaginal Delivery With Care Before And After Delivery 2 $2,715.06 $6,145.60 $4,430.33 nat. median
$3,129
1.4× median
37617
HCPCS 		Tying Of Major Artery Of The Abdomen 2 $1,525.55 $6,405.60 $3,965.57 nat. median
$4,756
0.8× median
1355802_1
CDM 		Pericardiocentesis; Initial 1 $3,960.00 $3,960.00 $3,960.00 nat. median
$2,778
1.4× median
65105
HCPCS 		Removal Of Eyeball With Insertion Of Implant Attached To Muscles 2 $1,029.90 $4,030.40 $3,840.00 nat. median
$4,017
1.0× median
49402
HCPCS 		Removal Of Foreign Body In Abdominal Cavity 2 $994.23 $4,086.40 $3,840.00 nat. median
$3,635
1.1× median
62000
HCPCS 		Elevation Of Simple Depressed Broken Skull Bone 2 $1,207.53 $4,977.60 $3,840.00 nat. median
$3,703
1.0× median
67110
HCPCS 		Repair Of Detached Retina By Injection Of Air Or Gas 2 $875.22 $3,840.00 $3,804.80 nat. median
$2,473
1.5× median
26415
HCPCS 		Removal Of Tendon From Top Of Hand Or Finger With Rod Insertion 2 $977.90 $3,840.00 $3,786.40 nat. median
$3,494
1.1× median
67316
HCPCS 		Realignment Of Multiple Vertical Eye Muscles 2 $767.07 $3,840.00 $3,742.40 nat. median
$2,748
1.4× median
59409
HCPCS 		Vaginal Delivery 2 $908.48 $4,224.00 $3,727.20 nat. median
$3,148
1.2× median
66850
HCPCS 		Aspiration Of Lens Material By Fragmenting And Aspiration 2 $849.00 $3,840.00 $3,705.60 nat. median
$3,294
1.1× median
66985
HCPCS 		Insertion Of Prosthetic Lens 2 $829.29 $3,840.00 $3,597.60 nat. median
$2,867
1.3× median
J2315
HCPCS 		Injection, Naltrexone, Depot Form, 1 Mg 1 $3,344.00 $3,660.48 $3,502.24 nat. median
$10
outlier · 338.1×
66983
HCPCS 		Removal Of Cataract And Capsule With Insertion Of Prosthetic Lens 1 $3,470.40 $3,470.40 $3,470.40 nat. median
$2,883
1.2× median
64784
HCPCS 		Removal Of Growth Of Peripheral Nerve 2 $831.44 $3,840.00 $3,442.40 nat. median
$2,284
1.5× median
67312
HCPCS 		Realignment Of Eye By Repair Of 2 Horizontal Muscles 2 $716.42 $3,840.00 $3,328.80 nat. median
$4,068
0.8× median
66830
HCPCS 		Removal Of Recurring Cataract In Lens Capsule With Sectioning Of Cornea And Scle… 2 $764.17 $3,840.00 $3,316.00 nat. median
$2,571
1.3× median
26350
HCPCS 		Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm… 2 $854.32 $5,068.80 $3,307.20 nat. median
$3,386
1.0× median
15110
HCPCS 		Outer Layer Self Skin Graft Of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body Area… 2 $832.86 $3,840.00 $3,261.60 nat. median
$2,188
1.5× median
15115
HCPCS 		Outer Layer Self Skin Graft Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around E… 2 $820.33 $3,840.00 $3,236.80 nat. median
$2,167
1.5× median
69440
HCPCS 		Exploration Of Middle Ear 2 $755.04 $3,840.00 $3,216.80 nat. median
$3,508
0.9× median
67314
HCPCS 		Realignment Of Vertical Eye Muscle 2 $492.80 $3,840.00 $3,143.20 nat. median
$2,761
1.1× median
11012
HCPCS 		Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A… 2 $460.64 $3,840.00 $3,127.20 nat. median
$2,794
1.1× median
67966
HCPCS 		Removal Of Over 1/4 Of Eyelid Margin And Repair Of Eyelid 2 $705.45 $3,840.00 $3,077.60 nat. median
$2,621
1.2× median
68335
HCPCS 		Release Of Scar Tissue From Eyelids With Graft 2 $697.79 $3,840.00 $3,031.20 nat. median
$3,960
0.8× median
65091
HCPCS 		Removal Of Eye Contents 2 $799.00 $3,840.00 $3,028.00 nat. median
$3,960
0.8× median
65093
HCPCS 		Removal Of Eye Contents With Insertion Of Implant 2 $792.78 $3,840.00 $2,996.80 nat. median
$4,025
0.7× median
29850
HCPCS 		Treatment Of Broken Knee Joint Using An Endoscope 2 $719.86 $3,840.00 $2,950.40 nat. median
$2,108
1.4× median
65875
HCPCS 		Removal Of Scar Tissue In Eye (posterior Synechiae) 2 $684.00 $3,840.00 $2,948.80 nat. median
$2,693
1.1× median
68700
HCPCS 		Plastic Repair Of Tear Duct 2 $650.74 $3,840.00 $2,825.60 nat. median
$2,646
1.1× median
67904
HCPCS 		Repair Of Tendon Of Upper Eyelid 2 $642.78 $3,840.00 $2,796.00 nat. median
$2,895
1.0× median
67311
HCPCS 		Realignment Of Horizontal Eye Muscle 2 $492.80 $3,840.00 $2,791.20 nat. median
$2,707
1.0× median
65870
HCPCS 		Removal Of Scar Tissue In Eye (anterior Synechiae) 2 $641.36 $3,840.00 $2,761.60 nat. median
$2,649
1.0× median
90378
HCPCS 		Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 1 $2,354.40 $3,161.60 $2,758.00 nat. median
$2,117
1.3× median
27810
HCPCS 		Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 2 $549.77 $4,224.00 $2,729.20 nat. median
$1,641
1.7× median
67901
HCPCS 		Repair Of Upper Eyelid Muscle To Correct Drooping Or Paralysis Using External Ma… 2 $631.88 $3,840.00 $2,721.60 nat. median
$2,707
1.0× median
50590
HCPCS 		Shock Wave Crushing Of Kidney Stones 2 $672.27 $3,840.00 $2,707.20 nat. median
$4,382
0.6× median
24535
HCPCS 		Closed Treatment Of Upper Arm Bone Broken At Elbow With Manipulation 2 $676.97 $5,068.80 $2,688.80 nat. median
$1,679
1.6× median
23655
HCPCS 		Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 2 $495.98 $4,224.00 $2,644.40 nat. median
$1,762
1.5× median
46262
HCPCS 		Removal Of Multiple Hemorrhoid Groups With Removal Of Abnormal Drainage Tract Fr… 2 $702.72 $3,840.00 $2,634.40 nat. median
$3,080
0.9× median
15823
HCPCS 		Removal Of Excessive Skin And Fat Of Upper Eyelid 2 $599.47 $3,840.00 $2,552.00 nat. median
$2,551
1.0× median
31525
HCPCS 		Diagnostic Exam Of Voice Box Using An Endoscope 2 $177.23 $4,224.00 $2,510.80 nat. median
$1,955
1.3× median
17108
HCPCS 		Destruction Of Birthmark, More Than 50.0 Sq Cm 2 $573.51 $3,840.00 $2,503.20 nat. median
$1,950
1.3× median
46261
HCPCS 		Removal Of Multiple Hemorrhoid Groups And Chronic Tear In Anus 2 $634.14 $3,840.00 $2,481.60 nat. median
$3,105
0.8× median
RBSTAND_1
CDM 		Room & Board - Semi-private (two Beds) - General Classification 1 $2,464.00 $2,464.00 $2,464.00 nat. median
$2,464
1.0× median
24505
HCPCS 		Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 2 $560.40 $3,840.00 $2,433.60 nat. median
$1,628
1.5× median
66680
HCPCS 		Repair Of Iris And Lens 2 $642.76 $3,840.00 $2,420.80 nat. median
$2,669
0.9× median
95044
HCPCS 		Test For Allergy Using Skin Patch 1 $2,409.60 $2,409.60 $2,409.60 nat. median
$272
outlier · 8.8×

Other procedures at this hospital

Browse this hospital's 2,631 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3101 HCPCS Injection, Tenecteplase, 1 Mg 2 1 $20,996.35 $16,797.08 $9,328.00 $24,266.16 $16,797.08 2026-05-20
A0430 HCPCS Ambulance Service, Conventional Air Services, Transport, One Way (fixed Wing) 1 1 $12,120.00 $9,696.00 20% off $9,696.00 $9,696.00 $9,696.00 2026-05-20
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 2 2 $7,682.00 $6,145.60 $2,715.06 $6,145.60 $4,430.33 2026-05-20
37617 HCPCS Tying Of Major Artery Of The Abdomen 2 2 $8,007.00 $6,405.60 $1,525.55 $6,405.60 $3,965.57 2026-05-20
1355802_1 CDM Pericardiocentesis; Initial 1 1 $4,950.00 $3,960.00 20% off $3,960.00 $3,960.00 $3,960.00 2026-05-20
62000 HCPCS Elevation Of Simple Depressed Broken Skull Bone 3 2 $6,222.00 $4,977.60 $1,207.53 $4,977.60 $3,840.00 2026-05-20
49402 HCPCS Removal Of Foreign Body In Abdominal Cavity 3 2 $5,108.00 $4,086.40 20% off $994.23 $4,086.40 $3,840.00 2026-05-20
65105 HCPCS Removal Of Eyeball With Insertion Of Implant Attached To Muscles 3 2 $5,038.00 $4,030.40 20% off $1,029.90 $4,030.40 $3,840.00 2026-05-20
67110 HCPCS Repair Of Detached Retina By Injection Of Air Or Gas 3 2 $4,756.00 $3,804.80 $875.22 $3,840.00 $3,804.80 2026-05-20
26415 HCPCS Removal Of Tendon From Top Of Hand Or Finger With Rod Insertion 3 2 $4,733.00 $3,786.40 20% off $977.90 $3,840.00 $3,786.40 2026-05-20
67316 HCPCS Realignment Of Multiple Vertical Eye Muscles 3 2 $4,678.00 $3,742.40 20% off $767.07 $3,840.00 $3,742.40 2026-05-20
59409 HCPCS Vaginal Delivery 4 2 $4,659.00 $3,727.20 20% off $908.48 $4,224.00 $3,727.20 2026-05-20
66850 HCPCS Aspiration Of Lens Material By Fragmenting And Aspiration 3 2 $4,632.00 $3,705.60 20% off $849.00 $3,840.00 $3,705.60 2026-05-20
66985 HCPCS Insertion Of Prosthetic Lens 3 2 $4,497.00 $3,597.60 20% off $829.29 $3,840.00 $3,597.60 2026-05-20
J2315 HCPCS Injection, Naltrexone, Depot Form, 1 Mg 2 1 $4,377.80 $3,502.24 20% off $3,344.00 $3,660.48 $3,502.24 2026-05-20
66983 HCPCS Removal Of Cataract And Capsule With Insertion Of Prosthetic Lens 1 1 $4,338.00 $3,470.40 20% off $3,470.40 $3,470.40 $3,470.40 2026-05-20
64784 HCPCS Removal Of Growth Of Peripheral Nerve 3 2 $4,303.00 $3,442.40 20% off $831.44 $3,840.00 $3,442.40 2026-05-20
67312 HCPCS Realignment Of Eye By Repair Of 2 Horizontal Muscles 3 2 $4,161.00 $3,328.80 $716.42 $3,840.00 $3,328.80 2026-05-20
66830 HCPCS Removal Of Recurring Cataract In Lens Capsule With Sectioning Of Cornea And Scle… 3 2 $4,145.00 $3,316.00 20% off $764.17 $3,840.00 $3,316.00 2026-05-20
26350 HCPCS Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm… 3 2 $4,134.00 $3,307.20 20% off $854.32 $5,068.80 $3,307.20 2026-05-20
15110 HCPCS Outer Layer Self Skin Graft Of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body Area… 3 2 $4,077.00 $3,261.60 20% off $832.86 $3,840.00 $3,261.60 2026-05-20
15115 HCPCS Outer Layer Self Skin Graft Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around E… 3 2 $4,046.00 $3,236.80 $820.33 $3,840.00 $3,236.80 2026-05-20
69440 HCPCS Exploration Of Middle Ear 3 2 $4,021.00 $3,216.80 $755.04 $3,840.00 $3,216.80 2026-05-20
67314 HCPCS Realignment Of Vertical Eye Muscle 3 2 $3,929.00 $3,143.20 20% off $492.80 $3,840.00 $3,143.20 2026-05-20
11012 HCPCS Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A… 3 2 $3,909.00 $3,127.20 20% off $460.64 $3,840.00 $3,127.20 2026-05-20
67966 HCPCS Removal Of Over 1/4 Of Eyelid Margin And Repair Of Eyelid 3 2 $3,847.00 $3,077.60 20% off $705.45 $3,840.00 $3,077.60 2026-05-20
68335 HCPCS Release Of Scar Tissue From Eyelids With Graft 3 2 $3,789.00 $3,031.20 20% off $697.79 $3,840.00 $3,031.20 2026-05-20
65091 HCPCS Removal Of Eye Contents 3 2 $3,785.00 $3,028.00 20% off $799.00 $3,840.00 $3,028.00 2026-05-20
65093 HCPCS Removal Of Eye Contents With Insertion Of Implant 3 2 $3,746.00 $2,996.80 $792.78 $3,840.00 $2,996.80 2026-05-20
29850 HCPCS Treatment Of Broken Knee Joint Using An Endoscope 3 2 $3,688.00 $2,950.40 20% off $719.86 $3,840.00 $2,950.40 2026-05-20
65875 HCPCS Removal Of Scar Tissue In Eye (posterior Synechiae) 3 2 $3,686.00 $2,948.80 $684.00 $3,840.00 $2,948.80 2026-05-20
68700 HCPCS Plastic Repair Of Tear Duct 3 2 $3,532.00 $2,825.60 20% off $650.74 $3,840.00 $2,825.60 2026-05-20
67904 HCPCS Repair Of Tendon Of Upper Eyelid 3 2 $3,495.00 $2,796.00 20% off $642.78 $3,840.00 $2,796.00 2026-05-20
67311 HCPCS Realignment Of Horizontal Eye Muscle 3 2 $3,489.00 $2,791.20 20% off $492.80 $3,840.00 $2,791.20 2026-05-20
65870 HCPCS Removal Of Scar Tissue In Eye (anterior Synechiae) 3 2 $3,452.00 $2,761.60 20% off $641.36 $3,840.00 $2,761.60 2026-05-20
90378 HCPCS Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 2 1 $3,447.50 $2,758.00 20% off $2,354.40 $3,161.60 $2,758.00 2026-05-20
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 4 2 $3,411.50 $2,729.20 20% off $549.77 $4,224.00 $2,729.20 2026-05-20
67901 HCPCS Repair Of Upper Eyelid Muscle To Correct Drooping Or Paralysis Using External Ma… 3 2 $3,402.00 $2,721.60 20% off $631.88 $3,840.00 $2,721.60 2026-05-20
50590 HCPCS Shock Wave Crushing Of Kidney Stones 3 2 $3,384.00 $2,707.20 20% off $672.27 $3,840.00 $2,707.20 2026-05-20
24535 HCPCS Closed Treatment Of Upper Arm Bone Broken At Elbow With Manipulation 5 2 $3,361.00 $2,688.80 $676.97 $5,068.80 $2,688.80 2026-05-20
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 4 2 $3,305.50 $2,644.40 20% off $495.98 $4,224.00 $2,644.40 2026-05-20
46262 HCPCS Removal Of Multiple Hemorrhoid Groups With Removal Of Abnormal Drainage Tract Fr… 3 2 $3,293.00 $2,634.40 20% off $702.72 $3,840.00 $2,634.40 2026-05-20
15823 HCPCS Removal Of Excessive Skin And Fat Of Upper Eyelid 3 2 $3,190.00 $2,552.00 20% off $599.47 $3,840.00 $2,552.00 2026-05-20
31525 HCPCS Diagnostic Exam Of Voice Box Using An Endoscope 4 2 $3,138.50 $2,510.80 $177.23 $4,224.00 $2,510.80 2026-05-20
17108 HCPCS Destruction Of Birthmark, More Than 50.0 Sq Cm 3 2 $3,129.00 $2,503.20 20% off $573.51 $3,840.00 $2,503.20 2026-05-20
46261 HCPCS Removal Of Multiple Hemorrhoid Groups And Chronic Tear In Anus 3 2 $3,102.00 $2,481.60 20% off $634.14 $3,840.00 $2,481.60 2026-05-20
RBSTAND_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $3,080.00 $2,464.00 20% off $2,464.00 $2,464.00 $2,464.00 2026-05-20
24505 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 3 2 $3,042.00 $2,433.60 20% off $560.40 $3,840.00 $2,433.60 2026-05-20
66680 HCPCS Repair Of Iris And Lens 3 2 $3,026.00 $2,420.80 $642.76 $3,840.00 $2,420.80 2026-05-20
95044 HCPCS Test For Allergy Using Skin Patch 1 1 $3,012.00 $2,409.60 20% off $2,409.60 $2,409.60 $2,409.60 2026-05-20
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 1 1 $3,011.00 $2,408.80 $2,408.80 $2,408.80 $2,408.80 2026-05-20
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 3 2 $3,001.00 $2,400.80 $603.16 $3,840.00 $2,400.80 2026-05-20
15820 HCPCS Repair Of Lower Eyelid Defect 3 2 $2,993.00 $2,394.40 20% off $560.40 $3,840.00 $2,394.40 2026-05-20
32160 HCPCS Massage Of Heart Muscle Through Chest 2 2 $4,731.00 $3,784.80 $954.74 $3,784.80 $2,369.77 2026-05-20
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 3 2 $2,952.00 $2,361.60 20% off $598.99 $3,840.00 $2,361.60 2026-05-20
46260 HCPCS Removal Of Multiple Hemorrhoid Groups 3 2 $2,837.00 $2,269.60 20% off $583.12 $3,840.00 $2,269.60 2026-05-20
46258 HCPCS Removal Of Single External And Internal Hemorrhoid Group With Removal Of Abnorma… 3 2 $2,790.00 $2,232.00 20% off $574.37 $3,840.00 $2,232.00 2026-05-20
55700 HCPCS Biopsy Of Prostate Gland 2 1 $2,787.50 $2,230.00 20% off $620.00 $3,840.00 $2,230.00 2026-05-20
67005 HCPCS Partial Removal Of Eye Fluid Between Lens And Retina 3 2 $2,763.00 $2,210.40 $516.05 $3,840.00 $2,210.40 2026-05-20
RBISO_1 CDM Room & Board - Other - Sterile Environment 1 1 $2,750.00 $2,200.00 20% off $2,200.00 $2,200.00 $2,200.00 2026-05-20
930209_1 CDM Monitoring For Localization Of Cerebral Seizures Focus By Cable/radio, 16+ Chann… 1 1 $2,738.37 $2,190.70 $2,190.70 $2,190.70 $2,190.70 2026-05-20
65275 HCPCS Repair Of Lacerated Cornea 3 2 $2,705.00 $2,164.00 20% off $494.88 $3,840.00 $2,164.00 2026-05-20
23665 HCPCS Closed Treatment Of Dislocated Shoulder And Broken Upper Arm Bone At Shoulder Jo… 3 2 $2,693.00 $2,154.40 $492.38 $3,840.00 $2,154.40 2026-05-20
67917 HCPCS Extensive Repair Of Turning-outward Eyelid Defect 3 2 $2,676.00 $2,140.80 $493.35 $3,840.00 $2,140.80 2026-05-20
67924 HCPCS Extensive Repair Of Turning-inward Eyelid Defect 3 2 $2,676.00 $2,140.80 $493.53 $3,840.00 $2,140.80 2026-05-20
RBNURS3_1 CDM Nursery - Newborn - Level Iii 1 1 $2,669.00 $2,135.20 20% off $2,135.20 $2,135.20 $2,135.20 2026-05-20
RBINTRM_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $2,669.00 $2,135.20 20% off $2,135.20 $2,135.20 $2,135.20 2026-05-20
67961 HCPCS Removal Of Up To 1/4 Of Eyelid Margin And Repair Of Eyelid 3 2 $2,660.00 $2,128.00 20% off $490.73 $3,840.00 $2,128.00 2026-05-20
26951 HCPCS Amputation Of Finger Or Thumb With Direct Closure 3 2 $2,626.00 $2,100.80 $810.37 $3,840.00 $2,100.80 2026-05-20
27768 HCPCS Closed Treatment Of Back Portion Of Shin Bone At Ankle With Manipulation 3 2 $2,606.00 $2,084.80 $525.40 $3,840.00 $2,084.80 2026-05-20
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 5 2 $2,565.00 $2,052.00 20% off $566.43 $5,068.80 $2,052.00 2026-05-20
65400 HCPCS Removal Of Growth Of Cornea 3 2 $3,526.00 $2,820.80 $653.32 $2,820.80 $2,040.00 2026-05-20
67923 HCPCS Repair Of Turning-inward Eyelid Defect 3 2 $2,520.00 $2,016.00 20% off $465.41 $3,840.00 $2,016.00 2026-05-20
46257 HCPCS Removal Of Single External And Internal Hemorrhoid Group And Chronic Tear In Anu… 3 2 $2,518.00 $2,014.40 $510.62 $3,840.00 $2,014.40 2026-05-20
27238 HCPCS Closed Treatment Of Broken Below Neck Of Thigh Bone 3 2 $2,501.00 $2,000.80 20% off $548.07 $3,840.00 $2,000.80 2026-05-20
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 3 2 $2,499.00 $1,999.20 20% off $650.12 $3,840.00 $1,999.20 2026-05-20
67908 HCPCS Removal Of Tissue, Muscle, And Membrane To Correct Eyelid Drooping Or Paralysis 3 2 $2,491.00 $1,992.80 20% off $467.38 $3,840.00 $1,992.80 2026-05-20
99468 HCPCS Initial Inpatient Hospital Critical Care Of Newborn Per Day (28 Days Or Younger) 2 2 $3,621.00 $2,896.80 $1,077.82 $2,896.80 $1,987.31 2026-05-20
44379 HCPCS Insertion Of Small Bowel Stent Below Lower Small Bowel Using An Endoscope 3 2 $2,466.00 $1,972.80 20% off $472.46 $5,736.00 $1,972.80 2026-05-20
24357 HCPCS Incision Of Elbow Tendon 3 2 $2,460.00 $1,968.00 20% off $475.79 $3,840.00 $1,968.00 2026-05-20
41018 HCPCS Drainage Of Abscess, Cyst, Or Blood Accumulation Under Lower Teeth From Outside … 3 2 $2,440.00 $1,952.00 20% off $460.88 $3,840.00 $1,952.00 2026-05-20
68130 HCPCS Removal Of Growth Of Eyelid Lining And Sclera 3 2 $2,413.00 $1,930.40 $446.32 $3,840.00 $1,930.40 2026-05-20
20100 HCPCS Exploration Of Wound Of Neck 3 2 $3,616.00 $2,892.80 $690.17 $2,892.80 $1,921.60 2026-05-20
11646 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More… 3 2 $2,343.00 $1,874.40 $426.97 $3,840.00 $1,874.40 2026-05-20
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 3 2 $2,342.00 $1,873.60 20% off $70.27 $1,873.60 $1,873.60 2026-05-20
46270 HCPCS Repair Of Abnormal Anal Drainage Tract 3 2 $2,339.00 $1,871.20 20% off $487.43 $3,840.00 $1,871.20 2026-05-20
27781 HCPCS Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone With Ma… 3 2 $2,337.00 $1,869.60 20% off $483.46 $3,840.00 $1,869.60 2026-05-20
44378 HCPCS Control Of Bleeding Of Small Bowel Using An Endoscope 3 2 $2,318.00 $1,854.40 $443.12 $3,840.00 $1,854.40 2026-05-20
26645 HCPCS Closed Treatment Of Broken Thumb At Wrist With Manipulation 3 2 $2,316.00 $1,852.80 20% off $465.72 $3,840.00 $1,852.80 2026-05-20
42720 HCPCS Drainage Of Abscess Of Throat From Inside Mouth 3 2 $2,316.00 $1,852.80 20% off $429.45 $3,840.00 $1,852.80 2026-05-20
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 4 2 $2,292.50 $1,834.00 20% off $103.42 $2,640.00 $1,834.00 2026-05-20
46947 HCPCS Stapling Of Internal Hemorrhoid 3 2 $2,281.00 $1,824.80 20% off $462.05 $3,840.00 $1,824.80 2026-05-20
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 3 2 $2,258.00 $1,806.40 $579.10 $3,840.00 $1,806.40 2026-05-20
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 3 2 $2,748.00 $2,198.40 $361.90 $2,198.40 $1,804.00 2026-05-20
54830 HCPCS Removal Of Growth Of Sperm Duct 3 2 $2,217.00 $1,773.60 20% off $442.06 $3,840.00 $1,773.60 2026-05-20
65420 HCPCS Removal Or Relocation Of Corneal Conjunctiva 3 2 $2,211.00 $1,768.80 20% off $412.17 $3,840.00 $1,768.80 2026-05-20
63688 HCPCS Removal Or Revision Of Spinal Neurostimulator Generator Or Receiver 3 2 $2,207.00 $1,765.60 20% off $368.89 $3,840.00 $1,765.60 2026-05-20
99471 HCPCS Initial Inpatient Hospital Critical Care Of Infant Or Young Child Per Day (29 Da… 2 2 $3,234.00 $2,587.20 20% off $933.38 $2,587.20 $1,760.29 2026-05-20
52344 HCPCS Repair Of Stricture Of Ureter Using An Endoscope 3 2 $2,199.00 $1,759.20 20% off $430.30 $3,840.00 $1,759.20 2026-05-20
57210 HCPCS Suture Of Injury Of Vagina And/or Skin 3 2 $2,187.00 $1,749.60 20% off $441.72 $3,840.00 $1,749.60 2026-05-20
67880 HCPCS Creation Of Permanent Eyelid Margin Scarring 3 2 $2,154.00 $1,723.20 20% off $399.14 $3,840.00 $1,723.20 2026-05-20
20103 HCPCS Exploration Of Wound Of Arm Or Leg 4 2 $2,357.50 $1,886.00 20% off $395.24 $1,968.00 $1,722.00 2026-05-20
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 3 2 $2,152.00 $1,721.60 20% off $326.45 $1,804.00 $1,721.60 2026-05-20
59820 HCPCS Treatment Of Miscarriage During First Trimester 3 2 $2,148.00 $1,718.40 $417.04 $3,840.00 $1,718.40 2026-05-20
27538 HCPCS Closed Treatment Of Broken Top Of Shin Bone At Knee 3 2 $2,111.00 $1,688.80 20% off $533.73 $3,840.00 $1,688.80 2026-05-20
52352 HCPCS Removal Or Manipulation Of Stone In Ureter Or Kidney Using An Endoscope 3 2 $2,110.00 $1,688.00 20% off $412.90 $3,840.00 $1,688.00 2026-05-20
46255 HCPCS Removal Of Single External And Internal Hemorrhoid Group 3 2 $2,109.00 $1,687.20 20% off $428.20 $3,840.00 $1,687.20 2026-05-20
19120 HCPCS Removal Of Growth And Tissue Of Breast, Duct, Or Nipple 3 2 $2,092.00 $1,673.60 20% off $493.27 $3,840.00 $1,673.60 2026-05-20
26320 HCPCS Removal Of Implant From Finger Or Hand 3 2 $2,053.00 $1,642.40 $404.36 $3,840.00 $1,642.40 2026-05-20
67031 HCPCS Release Of Scar Tissue Between Lens And Retina Using A Laser 3 2 $2,086.00 $1,668.80 20% off $382.82 $1,668.80 $1,640.00 2026-05-20
15781 HCPCS Dermabrasion Of Skin Of Part Of Face 3 2 $2,536.00 $2,028.80 20% off $453.45 $2,028.80 $1,640.00 2026-05-20
11011 HCPCS Removal Of Foreign Material From Skin, Tissue, And Muscle At Open Broken And/or … 3 2 $2,213.00 $1,770.40 $335.81 $1,770.40 $1,640.00 2026-05-20
67145 HCPCS Photocoagulation Treatment To Prevent Detachment Of Retina 3 2 $2,909.00 $2,327.20 20% off $233.44 $2,327.20 $1,640.00 2026-05-20
17107 HCPCS Destruction Of Birthmark, 10.0-50.0 Sq Cm 3 2 $2,092.00 $1,673.60 20% off $388.48 $1,673.60 $1,640.00 2026-05-20
67210 HCPCS Destruction Of Growth Of Retina Using A Laser 3 2 $2,923.00 $2,338.40 $537.70 $2,338.40 $1,640.00 2026-05-20
66762 HCPCS Creation Of Opening Of Iris For Eye Fluid Drainage Using A Laser 3 2 $2,487.00 $1,989.60 20% off $460.00 $1,989.60 $1,640.00 2026-05-20
50222021160_1{2} CDM 45802-0700-01 - Tacrolimus Topical 0.1% Oin 1 1 $2,026.10 $1,620.88 $1,620.88 $1,620.88 $1,620.88 2026-05-20
50222021160_1 CDM 50222-0211-60 - Tacrolimus Topical 0.1% Oin 1 1 $2,026.10 $1,620.88 $1,620.88 $1,620.88 $1,620.88 2026-05-20
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 3 2 $2,015.00 $1,612.00 20% off $569.77 $4,224.00 $1,612.00 2026-05-20
65600 HCPCS Multiple Punctures Of Cornea 3 2 $2,004.00 $1,603.20 20% off $373.34 $3,840.00 $1,603.20 2026-05-20
45390 HCPCS Removal Of Large Bowel Tissue Using A Flexible Endoscope 3 2 $2,003.00 $1,602.40 $383.54 $2,812.80 $1,602.40 2026-05-20
59426 HCPCS Predelivery Care, 7 Or More Visits 2 2 $2,875.00 $2,300.00 20% off $902.53 $2,300.00 $1,601.26 2026-05-20
42340 HCPCS Complicated Removal Of Saliva Gland Stone 3 2 $2,001.00 $1,600.80 20% off $384.54 $3,840.00 $1,600.80 2026-05-20
40812 HCPCS Removal Of Growth Of Mouth With Simple Repair 3 2 $2,000.00 $1,600.00 20% off $207.87 $3,840.00 $1,600.00 2026-05-20
J2794 HCPCS Injection, Risperidone (risperdal Consta), 0.5 Mg 4 1 $1,972.55 $1,578.04 20% off $880.00 $3,542.44 $1,578.04 2026-05-20
26742 HCPCS Closed Treatment Of Broken Finger Or Hand At Base Of Finger With Manipulation 3 2 $1,969.00 $1,575.20 20% off $405.62 $3,840.00 $1,575.20 2026-05-20
24075 HCPCS Removal Of Growth Under Skin Of Upper Arm Or Elbow, Less Than 3.0 Cm 3 2 $1,950.00 $1,560.00 20% off $386.05 $3,840.00 $1,560.00 2026-05-20
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 3 2 $1,940.00 $1,552.00 20% off $380.15 $5,068.80 $1,552.00 2026-05-20
54150 HCPCS Removal Of Foreskin Using Clamp Or Device 4 2 $1,930.50 $1,544.40 $112.40 $4,224.00 $1,544.40 2026-05-20
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 4 2 $1,930.50 $1,544.40 $185.81 $2,640.00 $1,544.40 2026-05-20
63661 HCPCS Insertion Of Spinal Neurostimulator Electrode Array Using Fluoroscopic Guidance 3 2 $1,917.00 $1,533.60 20% off $384.14 $3,840.00 $1,533.60 2026-05-20
67914 HCPCS Suture Repair Of Turning-outward Upper Or Lower Eyelid Defect 3 2 $1,911.00 $1,528.80 20% off $357.88 $3,840.00 $1,528.80 2026-05-20
11606 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 3 2 $1,901.00 $1,520.80 20% off $349.74 $3,840.00 $1,520.80 2026-05-20
69110 HCPCS Partial Removal Of External Ear With Simple Repair 3 2 $1,895.00 $1,516.00 20% off $361.54 $3,840.00 $1,516.00 2026-05-20
930209_2 CDM Monitoring For Localization Of Cerebral Seizures Focus By Cable/radio, 16+ Chann… 1 1 $1,880.00 $1,504.00 20% off $1,504.00 $1,504.00 $1,504.00 2026-05-20
46250 HCPCS Removal Of Multiple External Hemorrhoids 3 2 $1,878.00 $1,502.40 $385.09 $3,840.00 $1,502.40 2026-05-20
25075 HCPCS Removal Of Growth Under Skin Of Forearm Or Wrist, Less Than 3.0 Cm 3 2 $1,870.00 $1,496.00 20% off $368.73 $3,840.00 $1,496.00 2026-05-20
J0132 HCPCS Injection, Acetylcysteine, 100 Mg 1 1 $1,859.58 $1,487.66 20% off $1,487.66 $1,487.66 $1,487.66 2026-05-20
26040 HCPCS Release Of Tissue Of Palm 3 2 $1,843.00 $1,474.40 $367.00 $3,840.00 $1,474.40 2026-05-20
26055 HCPCS Incision Of Tendon Covering Of Finger 3 2 $1,833.00 $1,466.40 $340.34 $1,951.20 $1,466.40 2026-05-20
32601 HCPCS Diagnostic Exam Of Lungs, Heart Sac, Chest Cavity, Or Lung Lining Using An Endos… 3 2 $1,830.00 $1,464.00 20% off $362.37 $5,800.00 $1,464.00 2026-05-20
66821 HCPCS Removal Of Recurring Cataract In Lens Capsule Using A Laser 3 2 $1,820.00 $1,456.00 20% off $337.20 $1,640.00 $1,456.00 2026-05-20
57023 HCPCS Incision And Drainage Of Vaginal Blood Accumulation 3 2 $1,816.00 $1,452.80 20% off $359.74 $3,840.00 $1,452.80 2026-05-20
67921 HCPCS Suture Repair Of Turning-inward Eyelid Defect 3 2 $1,814.00 $1,451.20 20% off $339.18 $3,840.00 $1,451.20 2026-05-20
44377 HCPCS Biopsy Of Small Bowel Using An Endoscope 3 2 $1,804.00 $1,443.20 20% off $344.40 $3,840.00 $1,443.20 2026-05-20
52351 HCPCS Diagnostic Exam Of Bladder, Urethra, And Ureter Or Kidney Using An Endoscope 3 2 $1,800.00 $1,440.00 20% off $353.18 $3,840.00 $1,440.00 2026-05-20
40650 HCPCS Repair Of Lip And Border 3 2 $1,795.00 $1,436.00 20% off $411.97 $1,921.60 $1,436.00 2026-05-20
45100 HCPCS Biopsy Of Anal And/or Rectal Wall Through Anus 3 2 $1,777.00 $1,421.60 20% off $365.78 $3,840.00 $1,421.60 2026-05-20
SWING_1 CDM Room & Board - Semi-private (two Beds) - Other 1 1 $1,760.00 $1,408.00 20% off $1,408.00 $1,408.00 $1,408.00 2026-05-20
11626 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 3 2 $1,744.00 $1,395.20 20% off $322.89 $3,840.00 $1,395.20 2026-05-20
11010 HCPCS Removal Of Foreign Material From Skin And Tissue At Open Broken And/or Dislocate… 3 2 $1,733.00 $1,386.40 $312.27 $1,640.00 $1,386.40 2026-05-20
21337 HCPCS Closed Treatment Of Broken Bone Separating Nose Airways 3 2 $1,732.00 $1,385.60 20% off $339.74 $3,840.00 $1,385.60 2026-05-20
13151 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 1.1-2.5 Cm 3 2 $1,717.00 $1,373.60 20% off $301.17 $1,640.00 $1,373.60 2026-05-20
52235 HCPCS Destruction And/or Removal Of Growth Of Bladder And Urethra Using An Endoscope, … 3 2 $1,716.00 $1,372.80 20% off $336.39 $3,840.00 $1,372.80 2026-05-20
44376 HCPCS Diagnostic Exam Of Small Bowel (including Lower Small Intestine) Using An Endosc… 3 2 $1,712.00 $1,369.60 20% off $328.32 $3,840.00 $1,369.60 2026-05-20
52001 HCPCS Irrigation And Removal Of Multiple Blood Clots From Bladder And Urethra Using An… 3 2 $1,709.00 $1,367.20 20% off $334.61 $3,840.00 $1,367.20 2026-05-20
41115 HCPCS Removal Of Tissue Connecting Tongue And Floor Of Mouth 3 2 $1,695.00 $1,356.00 20% off $163.07 $3,024.00 $1,356.00 2026-05-20
11644 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3.1-… 3 2 $1,689.00 $1,351.20 20% off $306.74 $3,840.00 $1,351.20 2026-05-20
81420 HCPCS Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque… 1 1 $1,670.00 $1,336.00 20% off $1,336.00 $1,336.00 $1,336.00 2026-05-20
17286 HCPCS Destruction Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, … 3 2 $1,652.00 $1,321.60 20% off $294.64 $1,640.00 $1,321.60 2026-05-20
41113 HCPCS Removal Of Growth Of Back 1/3 Of Tongue With Suturing 3 2 $1,641.00 $1,312.80 20% off $300.00 $3,840.00 $1,312.80 2026-05-20
52315 HCPCS Complicated Removal Of Foreign Body, Stone, Or Stent In Urethra Or Bladder Using… 3 2 $1,633.00 $1,306.40 $320.41 $3,840.00 $1,306.40 2026-05-20
27502 HCPCS Closed Treatment Of Broken Thigh Bone At Midportion With Manipulation 3 2 $1,624.00 $1,299.20 20% off $919.16 $2,048.80 $1,299.20 2026-05-20
L1840 HCPCS Knee Orthosis, Derotation, Medial-lateral, Anterior Cruciate Ligament, Custom Fa… 1 1 $1,612.00 $1,289.60 20% off $1,289.60 $1,289.60 $1,289.60 2026-05-20
55250 HCPCS Removal Of Sperm Duct 3 2 $1,605.00 $1,284.00 20% off $272.88 $3,840.00 $1,284.00 2026-05-20
62355 HCPCS Removal Of Implanted Tube In Spinal Canal 3 2 $1,590.00 $1,272.00 20% off $334.67 $3,840.00 $1,272.00 2026-05-20
87901 HCPCS Analysis Test By Nucleic Acid For HIV-1 Virus 1 1 $1,581.00 $1,264.80 20% off $1,264.80 $1,264.80 $1,264.80 2026-05-20
52276 HCPCS Incision Of Urethra Using An Endoscope 3 2 $1,574.00 $1,259.20 20% off $308.76 $3,840.00 $1,259.20 2026-05-20
52330 HCPCS Manipulation Of Stone In Ureter Using An Endoscope 3 2 $1,569.00 $1,255.20 20% off $306.71 $3,840.00 $1,255.20 2026-05-20
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 3 2 $1,566.00 $1,252.80 20% off $278.55 $1,804.00 $1,252.80 2026-05-20
28455 HCPCS Treatment Of Broken Foot Bone At Ankle With Manipulation 3 2 $1,524.00 $1,219.20 20% off $276.94 $3,840.00 $1,219.20 2026-05-20
31641 HCPCS Destruction Of Growth Or Narrowing Of Lung Airway Using An Endoscope 3 2 $1,520.00 $1,216.00 20% off $301.68 $3,840.00 $1,216.00 2026-05-20
42335 HCPCS Complicated Removal Of Saliva Gland Stone From Inside Mouth 3 2 $1,518.00 $1,214.40 $295.05 $3,840.00 $1,214.40 2026-05-20
38500 HCPCS Biopsy Or Removal Of Lymph Nodes 3 2 $1,514.00 $1,211.20 20% off $299.76 $3,840.00 $1,211.20 2026-05-20
90375 HCPCS Rabies Immune Globulin For Injection 2 1 $1,502.21 $1,201.77 $358.40 $2,045.14 $1,201.77 2026-05-20
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 3 2 $1,492.00 $1,193.60 20% off $307.73 $3,840.00 $1,193.60 2026-05-20
31640 HCPCS Removal Of Growth Of Lung Airways Using An Endoscope 3 2 $1,485.00 $1,188.00 20% off $294.62 $3,840.00 $1,188.00 2026-05-20
S9485 HCPCS Crisis Intervention Mental Health Services, Per Diem 1 1 $1,485.00 $1,188.00 20% off $1,188.00 $1,188.00 $1,188.00 2026-05-20
31638 HCPCS Revision Of Previously Inserted Lung Airway Stent Using An Endoscope 3 2 $1,483.00 $1,186.40 $294.27 $6,528.00 $1,186.40 2026-05-20
L1845 HCPCS Knee Orthosis, Double Upright, Thigh And Calf, With Adjustable Flexion And Exten… 1 1 $1,480.00 $1,184.00 20% off $1,184.00 $1,184.00 $1,184.00 2026-05-20
52275 HCPCS Incision Of Urethra In Male Using An Endoscope 3 2 $1,479.00 $1,183.20 $289.79 $3,840.00 $1,183.20 2026-05-20
99475 HCPCS Initial Inpatient Hospital Critical Care Of Infant Or Young Child Per Day (2-5 Y… 2 2 $2,134.00 $1,707.20 20% off $656.55 $1,707.20 $1,181.88 2026-05-20
65860 HCPCS Laser Removal Of Scar Tissue Of Eye 3 2 $1,477.00 $1,181.60 20% off $268.90 $1,640.00 $1,181.60 2026-05-20
L1932 HCPCS Ankle Foot Orthosis, Rigid Anterior Tibial Section, Total Carbon Fiber Or Equal … 1 1 $1,476.00 $1,180.80 20% off $1,180.80 $1,180.80 $1,180.80 2026-05-20
52234 HCPCS Destruction And/or Removal Of Growth Of Bladder And Urethra Using An Endoscope, … 3 2 $1,465.00 $1,172.00 20% off $286.46 $3,840.00 $1,172.00 2026-05-20
69145 HCPCS Removal Of Growth In Soft Tissue Of Ear Canal 3 2 $1,448.00 $1,158.40 $284.08 $3,840.00 $1,158.40 2026-05-20
11624 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4.0 … 3 2 $1,423.00 $1,138.40 $259.33 $3,840.00 $1,138.40 2026-05-20
23931 HCPCS Drainage Of Fluid Filled Sac In Elbow Joint 3 2 $1,422.00 $1,137.60 20% off $188.97 $3,840.00 $1,137.60 2026-05-20
45398 HCPCS Banding Of Hemorrhoids Using A Flexible Endoscope (colonoscope) 3 2 $1,416.00 $1,132.80 20% off $272.31 $2,400.00 $1,132.80 2026-05-20
12020 HCPCS Simple Closure Of Surface Wound Reopening 4 2 $1,408.00 $1,126.40 $220.70 $1,804.00 $1,126.40 2026-05-20
67930 HCPCS Suture Of Recent Wound Of Eyelid 3 2 $1,403.00 $1,122.40 $255.58 $3,840.00 $1,122.40 2026-05-20
40819 HCPCS Removal Of Tissue At Dental Edge And Cheek 3 2 $1,397.00 $1,117.60 20% off $231.94 $3,840.00 $1,117.60 2026-05-20
58558 HCPCS Biopsy Of Lining Of Uterus And/or Removal Of Polyp Using An Endoscope 3 2 $1,394.00 $1,115.20 $264.47 $3,840.00 $1,115.20 2026-05-20
66761 HCPCS Creation Of Eye Fluid Drainage Tracts In Iris Using A Laser, Per Session 3 2 $1,380.00 $1,104.00 20% off $254.00 $1,640.00 $1,104.00 2026-05-20
32554 HCPCS Aspiration Of Fluid From Chest Cavity 3 2 $1,371.00 $1,096.80 20% off $106.42 $1,640.00 $1,096.80 2026-05-20
2651554_1 CDM Monitoring Of Localization Of Cerebral Seizure By Cable/radio 16+ Channel Teleme… 1 1 $1,365.81 $1,092.65 $1,092.65 $1,092.65 $1,092.65 2026-05-20
2651552_1 CDM Monitoring For Localization Of Cerebral Seizure Focus By Comp Port 16+ Channel E… 1 1 $1,365.81 $1,092.65 $1,092.65 $1,092.65 $1,092.65 2026-05-20
11643 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.1-… 3 2 $1,362.00 $1,089.60 20% off $246.96 $3,840.00 $1,089.60 2026-05-20
M0244 HCPCS Intravenous Infusion Or Subcutaneous Injection, Casirivimab And Imdevimab Includ… 2 1 $1,361.50 $1,089.20 $990.40 $1,188.00 $1,089.20 2026-05-20
M0241 HCPCS Intravenous Infusion Or Subcutaneous Injection, Casirivimab And Imdevimab Includ… 2 1 $1,361.50 $1,089.20 $990.40 $1,188.00 $1,089.20 2026-05-20
31631 HCPCS Placement Of Stent Into Windpipe Using An Endoscope 3 2 $1,354.00 $1,083.20 $266.23 $6,528.00 $1,083.20 2026-05-20
11044 HCPCS Removal Of Bone, 20.0 Sq Cm Or Less 3 2 $1,354.00 $1,083.20 $261.27 $3,840.00 $1,083.20 2026-05-20
40831 HCPCS Repair Of Lacerated Mouth, More Than 2.5 Cm 3 2 $1,347.00 $1,077.60 20% off $236.59 $1,640.00 $1,077.60 2026-05-20
99291 HCPCS Critical Care, First 30-74 Minutes 4 2 $1,342.50 $1,074.00 20% off $269.49 $1,344.00 $1,074.00 2026-05-20
42405 HCPCS Biopsy Of Saliva Gland 3 2 $1,337.00 $1,069.60 20% off $254.68 $3,840.00 $1,069.60 2026-05-20
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 3 2 $1,323.00 $1,058.40 $281.45 $1,976.00 $1,058.40 2026-05-20
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 3 2 $1,322.00 $1,057.60 20% off $225.83 $3,840.00 $1,057.60 2026-05-20
RBOB_1 CDM Room/bed: OB/Triage 1 1 $1,320.00 $1,056.00 20% off $1,056.00 $1,056.00 $1,056.00 2026-05-20
RBNURS2_1 CDM Nursery - Newborn - Level Ii 1 1 $1,320.00 $1,056.00 20% off $1,056.00 $1,056.00 $1,056.00 2026-05-20
69610 HCPCS Repair Of Eardrum 3 2 $1,319.00 $1,055.20 $318.43 $3,840.00 $1,055.20 2026-05-20
42409 HCPCS Creation Of Tract To Drain Cyst Of Saliva Gland 3 2 $1,319.00 $1,055.20 $258.16 $3,840.00 $1,055.20 2026-05-20
31636 HCPCS Placement Of Stent In Lung Airway Using An Endoscope, First Stent 3 2 $1,307.00 $1,045.60 20% off $261.42 $6,528.00 $1,045.60 2026-05-20
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 3 2 $1,305.00 $1,044.00 20% off $226.36 $3,840.00 $1,044.00 2026-05-20
68815 HCPCS Probing Of Nasal Tear Duct With Insertion Of Tube Or Stent 3 2 $1,298.00 $1,038.40 $240.21 $3,840.00 $1,038.40 2026-05-20
41116 HCPCS Removal Of Growth Of Floor Of Mouth 3 2 $1,298.00 $1,038.40 $244.06 $3,840.00 $1,038.40 2026-05-20
99328 HCPCS Domiciliary Or Rest Home Visit For The Evaluation And Management Of A New Patien… 1 1 $1,276.00 $1,020.80 20% off $1,020.80 $1,020.80 $1,020.80 2026-05-20
45386 HCPCS Balloon Dilation Of Large Bowel Using A Flexible Endoscope 3 2 $1,275.00 $1,020.00 20% off $245.47 $2,400.00 $1,020.00 2026-05-20
11604 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 3 2 $1,273.00 $1,018.40 20% off $230.83 $1,640.00 $1,018.40 2026-05-20
V5261 HCPCS Hearing Aid, Digital, Binaural, Bte 1 1 $1,257.14 $1,005.71 20% off $1,005.71 $1,005.71 $1,005.71 2026-05-20
31647 HCPCS Assessment Of Initial Lobe Of Lung For Air Leak And Airway Sizing With Insertion… 3 2 $1,255.00 $1,004.00 20% off $249.39 $6,528.00 $1,004.00 2026-05-20
11623 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3.0 … 3 2 $1,255.00 $1,004.00 20% off $226.74 $3,840.00 $1,004.00 2026-05-20
12057 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More … 3 2 $2,517.00 $2,013.60 20% off $473.58 $2,013.60 $1,003.20 2026-05-20
31605 HCPCS Emergent Incision Of Windpipe For Insertion Of Breathing Tube 3 2 $1,981.00 $1,584.80 20% off $390.15 $1,584.80 $1,003.20 2026-05-20
43754 HCPCS Diagnostic Insertion Of Stomach Tube And Aspiration Of Stomach Contents 1 1 $1,254.00 $1,003.20 $1,003.20 $1,003.20 $1,003.20 2026-05-20
27840 HCPCS Closed Treatment Of Dislocated Ankle 3 2 $2,208.00 $1,766.40 $531.38 $1,766.40 $1,003.20 2026-05-20
32550 HCPCS Insertion Of Indwelling Tube For Drainage Of Lung Fluid 3 2 $1,233.00 $986.40 20% off $239.90 $5,068.80 $986.40 2026-05-20
17284 HCPCS Destruction Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, … 3 2 $1,228.00 $982.40 20% off $215.75 $1,640.00 $982.40 2026-05-20
31661 HCPCS Thermal Repair Of Airways Of Multiple Lobes Of Lung Using An Endoscope 3 2 $1,220.00 $976.00 20% off $244.28 $6,528.00 $976.00 2026-05-20
65855 HCPCS Laser Repair To Improve Eye Fluid Flow 3 2 $1,216.00 $972.80 20% off $221.28 $1,640.00 $972.80 2026-05-20
13100 HCPCS Complicated Repair Of Wound Of Trunk, 1.1-2.5 Cm 3 2 $1,214.00 $971.20 $218.87 $1,640.00 $971.20 2026-05-20
52224 HCPCS Destruction Of Growth Of Bladder And Urethra Using An Endoscope, Less Than 0.5 C… 3 2 $1,212.00 $969.60 20% off $236.09 $3,840.00 $969.60 2026-05-20
J7325 HCPCS Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,… 1 1 $1,195.00 $956.00 20% off $956.00 $956.00 $956.00 2026-05-20
31648 HCPCS Removal Of Bronchial Valves Of Lung Airways Of Lobe Of Lung Using An Endoscope, … 3 2 $1,194.00 $955.20 $238.12 $3,840.00 $955.20 2026-05-20
56515 HCPCS Extensive Destruction Of Growth Of External Female Genitals 3 2 $1,193.00 $954.40 20% off $237.24 $3,840.00 $954.40 2026-05-20
54162 HCPCS Removal Of Scar Tissue After Foreskin Removal 3 2 $1,187.00 $949.60 20% off $236.22 $3,840.00 $949.60 2026-05-20
51715 HCPCS Injection Of Implant Material Beneath Lining Of Bladder And/or Urethra Using An … 3 2 $1,185.00 $948.00 20% off $231.61 $3,840.00 $948.00 2026-05-20
20606 HCPCS Aspiration And/or Injection Of Fluid From Medium Joint Using Ultrasound Guidance 4 2 $1,182.50 $946.00 20% off $59.85 $1,804.00 $946.00 2026-05-20
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 1 1 $1,178.00 $942.40 20% off $942.40 $942.40 $942.40 2026-05-20
31530 HCPCS Removal Of Foreign Body In Voice Box Using An Endoscope 3 2 $1,177.00 $941.60 20% off $223.45 $5,068.80 $941.60 2026-05-20
31626 HCPCS Placement Of Radiation Therapy Markers Into Lung Airways Using An Endoscope 3 2 $1,177.00 $941.60 20% off $237.40 $6,528.00 $941.60 2026-05-20
31630 HCPCS Dilation Of Windpipe Cartilage Or Treatment Of Broken Windpipe Cartilage Using A… 3 2 $1,175.00 $940.00 20% off $234.53 $3,840.00 $940.00 2026-05-20
27040 HCPCS Biopsy Of Surface Tissue Of Pelvis And Hip 3 2 $1,172.00 $937.60 20% off $228.61 $3,840.00 $937.60 2026-05-20
54161 HCPCS Removal Of Foreskin (older Than 28 Days) 3 2 $1,172.00 $937.60 20% off $232.66 $3,840.00 $937.60 2026-05-20
20680 HCPCS Removal Of Deep Implant From Bone 3 2 $1,172.00 $937.60 20% off $486.32 $3,840.00 $937.60 2026-05-20
27257 HCPCS Treatment Of Spontaneous Dislocated Hip Under Anesthesia 3 2 $1,166.00 $932.80 20% off $408.15 $5,068.80 $932.80 2026-05-20
11603 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 3 2 $1,158.00 $926.40 20% off $208.24 $1,640.00 $926.40 2026-05-20
67922 HCPCS Repair Of Turning-inward Eyelid Defect Using Heat 3 2 $1,143.00 $914.40 20% off $217.75 $3,840.00 $914.40 2026-05-20
31634 HCPCS Exam Of Lung Airways With Repair Of Air Leak Using An Endoscope 3 2 $1,137.00 $909.60 20% off $228.41 $6,528.00 $909.60 2026-05-20
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 3 2 $1,132.00 $905.60 20% off $240.75 $1,804.00 $905.60 2026-05-20
13131 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 3 2 $1,566.00 $1,252.80 20% off $262.85 $1,252.80 $903.20 2026-05-20
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 3 2 $1,330.00 $1,064.00 20% off $277.94 $1,064.00 $903.20 2026-05-20
24600 HCPCS Repair Of Dislocated Elbow 3 2 $1,330.00 $1,064.00 20% off $472.67 $1,064.00 $903.20 2026-05-20
23545 HCPCS Closed Treatment Of Dislocated Joint Between Collar Bone And Shoulder With Manip… 3 2 $1,894.00 $1,515.20 20% off $488.18 $1,515.20 $903.20 2026-05-20
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 3 2 $1,129.00 $903.20 $218.69 $1,640.00 $903.20 2026-05-20
99337 HCPCS Domiciliary Or Rest Home Visit For The Evaluation And Management Of An Establish… 1 1 $1,128.00 $902.40 20% off $902.40 $902.40 $902.40 2026-05-20
30802 HCPCS Destruction Of Surface Soft Tissue Of Nasal Passages 3 2 $1,127.00 $901.60 20% off $219.81 $3,840.00 $901.60 2026-05-20
59812 HCPCS Treatment Of Miscarriage 3 2 $1,125.00 $900.00 20% off $337.13 $3,840.00 $900.00 2026-05-20
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 1 1 $1,119.00 $895.20 $895.20 $895.20 $895.20 2026-05-20
2651554_2 CDM Monitoring Of Localization Of Cerebral Seizure By Cable/radio 16+ Channel Teleme… 1 1 $1,117.00 $893.60 20% off $893.60 $893.60 $893.60 2026-05-20
23675 HCPCS Closed Treatment Of Dislocated Shoulder And Broken Neck Of Upper Arm Bone With M… 3 2 $1,114.00 $891.20 $610.19 $1,707.20 $891.20 2026-05-20
57135 HCPCS Removal Of Cyst Or Growth Of Vaginal 3 2 $1,112.00 $889.60 20% off $209.60 $3,840.00 $889.60 2026-05-20
95913 HCPCS Nerve Conduction, 13 Or More Studies 3 2 $1,111.00 $888.80 20% off $247.93 $1,092.65 $888.80 2026-05-20
31002 HCPCS Irrigation Of Sphenoid Nasal Sinus 3 2 $1,109.00 $887.20 $202.70 $3,840.00 $887.20 2026-05-20
31629 HCPCS Needle Biopsy Of Windpipe Cartilage, Airway, And/or Lung Using An Endoscope 3 2 $1,107.00 $885.60 20% off $226.28 $3,840.00 $885.60 2026-05-20
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 1 1 $1,100.00 $880.00 20% off $880.00 $880.00 $880.00 2026-05-20
V5257 HCPCS Hearing Aid, Digital, Monaural, Bte 1 1 $1,100.00 $880.00 20% off $880.00 $880.00 $880.00 2026-05-20
90675 HCPCS Rabies Vaccine For Injection Into Muscle 2 1 $1,095.35 $876.28 $377.60 $1,374.96 $876.28 2026-05-20
11642 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1.1-… 3 2 $1,090.00 $872.00 20% off $196.60 $1,640.00 $872.00 2026-05-20
26011 HCPCS Complicated Drainage Of Abscess In Finger 3 2 $1,086.00 $868.80 20% off $218.51 $3,840.00 $868.80 2026-05-20
57461 HCPCS Cone Biopsy Of Cervix And Vagina Using An Endoscope With Loop Electrode 3 2 $1,086.00 $868.80 20% off $210.40 $3,840.00 $868.80 2026-05-20
99327 HCPCS Domiciliary Or Rest Home Visit For The Evaluation And Management Of A New Patien… 1 1 $1,085.00 $868.00 20% off $868.00 $868.00 $868.00 2026-05-20
27788 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation 4 2 $1,667.50 $1,334.00 20% off $489.77 $1,764.80 $862.00 2026-05-20
27560 HCPCS Closed Treatment Of Dislocated Kneecap 4 2 $1,431.00 $1,144.80 $464.91 $1,386.40 $862.00 2026-05-20
46924 HCPCS Extensive Destruction Of Growth Of Anus 3 2 $1,071.00 $856.80 20% off $215.62 $3,840.00 $856.80 2026-05-20
99472 HCPCS Follow-up Inpatient Hospital Critical Care Of Infant Or Young Child Per Day (29 … 2 2 $1,538.00 $1,230.40 $480.71 $1,230.40 $855.56 2026-05-20
43276 HCPCS Replacement Of Stent In Pancreatic Or Bile Duct Using A Flexible Endoscope 3 2 $1,069.00 $855.20 $554.85 $6,034.40 $855.20 2026-05-20
11443 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2… 3 2 $1,063.00 $850.40 20% off $197.65 $3,840.00 $850.40 2026-05-20
56440 HCPCS Creation Of Drainage Tract For Gland Cyst Of Female Genitals 3 2 $1,059.00 $847.20 $207.03 $3,840.00 $847.20 2026-05-20
11424 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 3 2 $1,054.00 $843.20 $204.53 $3,840.00 $843.20 2026-05-20
21315 HCPCS Closed Treatment Of Broken Nose Bone With Manipulation 3 2 $1,054.00 $843.20 $68.18 $3,024.00 $843.20 2026-05-20
52214 HCPCS Destruction Of Tissue Of Bladder, Urethra, Or Surrounding Glands Using An Endosc… 3 2 $1,049.00 $839.20 $204.02 $3,840.00 $839.20 2026-05-20
31643 HCPCS Placement Of Tube For Radiation Delivery In Lung Airway Using An Endoscope 3 2 $1,047.00 $837.60 20% off $206.80 $3,840.00 $837.60 2026-05-20
31635 HCPCS Removal Of Foreign Body In Lung Airways Using An Endoscope 3 2 $1,041.00 $832.80 20% off $210.81 $3,840.00 $832.80 2026-05-20
31628 HCPCS Biopsy Of Lobe Of Lung Using An Endoscope, 1 Lobe 3 2 $1,041.00 $832.80 20% off $213.57 $3,840.00 $832.80 2026-05-20
99469 HCPCS Follow-up Inpatient Hospital Critical Care Of Newborn Per Day (28 Days Or Younge… 2 2 $1,491.00 $1,192.80 20% off $466.41 $1,192.80 $829.61 2026-05-20
96913 HCPCS Therapy Procedure Using Ultraviolet Radiation, 4-8 Hours 1 1 $1,036.00 $828.80 20% off $828.80 $828.80 $828.80 2026-05-20
59425 HCPCS Predelivery Care, 4 To 6 Visits 2 2 $1,437.00 $1,149.60 20% off $492.30 $1,149.60 $820.95 2026-05-20
26755 HCPCS Closed Treatment Of Broken End Of Finger Or Thumb With Manipulation 3 2 $1,048.00 $838.40 20% off $352.82 $838.40 $820.80 2026-05-20
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 3 2 $1,333.00 $1,066.40 $379.81 $1,066.40 $820.80 2026-05-20
26740 HCPCS Closed Treatment Of Broken Finger Or Hand At Base Of Finger 3 2 $1,040.00 $832.00 20% off $263.48 $832.00 $820.80 2026-05-20
26700 HCPCS Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation 3 2 $1,519.00 $1,215.20 20% off $410.96 $1,215.20 $820.80 2026-05-20
26670 HCPCS Closed Treatment Of Dislocated Hand Bone At Wrist Joint With Manipulation 3 2 $1,356.00 $1,084.80 20% off $420.05 $1,084.80 $820.80 2026-05-20
26641 HCPCS Closed Treatment Of Dislocated Thumb At Wrist With Manipulation 3 2 $1,583.00 $1,266.40 $452.87 $1,266.40 $820.80 2026-05-20
26605 HCPCS Closed Treatment Of Broken Hand Bone With Manipulation 3 2 $1,552.00 $1,241.60 20% off $364.63 $1,241.60 $820.80 2026-05-20
26600 HCPCS Closed Treatment Of Broken Hand Bone 3 2 $1,040.00 $832.00 20% off $348.64 $832.00 $820.80 2026-05-20
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 3 2 $1,033.00 $826.40 20% off $237.40 $826.40 $820.80 2026-05-20
25650 HCPCS Closed Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist 3 2 $1,673.00 $1,338.40 $380.55 $1,338.40 $820.80 2026-05-20
25630 HCPCS Closed Treatment Of Other Broken Wrist Bone 3 2 $1,415.00 $1,132.00 20% off $342.38 $1,132.00 $820.80 2026-05-20
25622 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb 3 2 $1,510.00 $1,208.00 20% off $345.42 $1,208.00 $820.80 2026-05-20
25600 HCPCS Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb … 3 2 $1,510.00 $1,208.00 20% off $394.19 $1,208.00 $820.80 2026-05-20
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