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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

DELTA MEMORIAL HOSPITAL

Dumas, AR · CCN 041326 · Rates published

1,727 distinct procedures filed
5 distinct payers
38,138 rate rows
2026-03-31 last MRF observed
Data quality

37,810 of 38,138 rate rows are consumer-grade (99.1%)

328 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
placeholder amount (≤ $0.02) — excluded from medians 256
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 42
per-diem day rate — not a per-procedure price 28
exceeds 10× this hospital's gross charge — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.deltamem.org/docs/710276839_DELTA-MEMORIAL-HOSPITAL_STANDARDCHARGES.csv
Found on page https://www.deltamem.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-21
Content fingerprint a8128820ffa0d08b… · 9,736,954 bytes · first seen 2026-05-09

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
J0840
HCPCS 		Crotalidae Polyvalent Imm Fab (ovine) In 4 $5,867.86 $15,800.64 $10,894.12 nat. median
$3,496
outlier · 3.1×
J3101
HCPCS 		Tenecteplase (tnkase) Inj [50 Mg] 5 $41.06 $19,413.25 $7,356.60 nat. median
$498
outlier · 14.8×
59510
HCPCS 		Clnc Cesarean Delivery 4 $2,305.24 $6,207.44 $5,231.89 nat. median
$3,349
1.6× median
59400
HCPCS 		Clnc OB Care (vaginal Delivery) 4 $2,087.14 $5,620.11 $4,736.87 nat. median
$2,933
1.6× median
23800
HCPCS 		Arthrodesis Glenohum Jnt 4 $953.11 $15,709.75 $4,699.06 nat. median
$6,865
0.7× median
43632
HCPCS 		Pf Removal Of Stomach Partial 4 $1,884.55 $5,500.81 $4,596.74 nat. median
$4,034
1.1× median
43633
HCPCS 		Pf Gastrectomy With Roux-en-y 4 $1,784.43 $5,197.15 $4,343.97 nat. median
$3,996
1.1× median
44150
HCPCS 		Pf Colectomy, Total Abdominal 4 $1,743.56 $5,041.56 $4,217.06 nat. median
$3,739
1.1× median
J0881
HCPCS 		Aranesp (darbepoetin Alfa) Inj 500mcg/ml 5 $4.59 $10,309.64 $3,906.81 nat. median
$899
outlier · 4.3×
J7300
HCPCS 		Paragard (intrauterine) 313.4 Mg IUD 5 $1,207.34 $10,224.85 $3,874.68 nat. median
$1,804
outlier · 2.1×
36516
HCPCS 		Bb Absorption Lifeshare 5 $250.00 $9,880.00 $3,744.00 nat. median
$4,796
0.8× median
44204
HCPCS 		Pf Lap Partial Colectomy 4 $1,430.37 $4,140.28 $3,462.80 nat. median
$4,854
0.7× median
43840
HCPCS 		Pf Repair Of Stomach Lesion 4 $1,275.92 $3,648.66 $3,055.47 nat. median
$4,173
0.7× median
44140
HCPCS 		Pf Colectomy Partial 4 $201.16 $3,627.17 $3,034.70 nat. median
$3,357
0.9× median
43820
HCPCS 		Pf Gastrojejunostomy Without Vagotomy 4 $1,261.32 $3,624.77 $3,033.91 nat. median
$3,095
1.0× median
39561
HCPCS 		Pf Resect Diaphragm Complex 4 $1,218.16 $3,338.58 $2,808.47 nat. median
$2,682
1.0× median
44120
HCPCS 		Pf Resection Small Bowel Singe Resection 4 $1,141.75 $3,306.46 $2,765.28 nat. median
$3,688
0.7× median
J1437
HCPCS 		Monoferric (ferric Derisomaltose) 10ml 5 $22.97 $6,700.35 $2,539.08 nat. median
$41
outlier · 61.8×
44005
HCPCS 		Pf Lysis Of Adhesions Intestine ASSISTAN,assistant Surgeon 4 $163.93 $2,957.44 $2,474.23 nat. median
$2,553
1.0× median
59612
HCPCS 		Pf Vaginal Birth After C-section 5 $363.00 $6,715.17 $2,428.11 nat. median
$3,307
0.7× median
C1751
HCPCS 		Zdnu - Groshong 8 F Single-lumen Cv Cath 4 $1,193.55 $3,213.92 $2,215.91 nat. median
$335
outlier · 6.6×
47600
HCPCS 		Pf Cholecystectomy 4 $1,012.25 $2,735.60 $2,196.40 nat. median
$3,682
0.6× median
59409
HCPCS 		Pf Vaginal Delivery 5 $363.00 $6,715.17 $2,178.68 nat. median
$3,106
0.7× median
15734
HCPCS 		Pf Muscle-skin Graft Trunk 5 $297.00 $4,055.29 $2,176.14 nat. median
$3,867
0.6× median
81162
HCPCS 		Bcra Panel Plus (seq And Dup) 5 $1,609.54 $5,467.97 $2,072.07 nat. median
$1,880
1.1× median
35207
HCPCS 		Rpr Blood Ves Dir Ha/fing 5 $363.00 $7,075.06 $2,058.72 nat. median
$3,594
0.6× median
58740
HCPCS 		Pf Lysis Of Adhesions 4 $837.99 $2,420.02 $2,024.51 nat. median
$2,653
0.8× median
44620
HCPCS 		Pf Closure Of Enterostomy L/s Intestine 4 $813.63 $2,327.60 $1,949.11 nat. median
$2,811
0.7× median
59514
HCPCS 		Pf Cesarean Section 4 $818.12 $2,301.18 $1,930.41 nat. median
$2,304
0.8× median
J0875
HCPCS 		Dalbavancin (dalvance) 500mg Inj 5 $14.58 $5,060.65 $1,917.72 nat. median
$49
outlier · 38.8×
47100
HCPCS 		Pf Biopsy Of Liver 4 $814.30 $2,272.53 $1,907.97 nat. median
$2,751
0.7× median
19307
HCPCS 		Pf Left Modified Radical MASTECTOMY,Left Mastectomy 5 $363.00 $3,376.35 $1,869.67 nat. median
$6,381
outlier · 0.3×
26952
HCPCS 		Amp Finger With Flap 5 $363.00 $7,069.57 $1,860.00 nat. median
$3,254
0.6× median
43327
HCPCS 		Pf Esoph Fundoplasty Laparotomy 4 $790.19 $2,208.09 $1,853.62 nat. median
$3,015
0.6× median
49900
HCPCS 		Pf Repair Of Abdominal Wall 4 $799.61 $2,194.73 $1,845.95 nat. median
$1,950
0.9× median
15830
HCPCS 		Pf Exc Excess Skin (panniculectomy) 5 $297.00 $3,318.84 $1,807.92 nat. median
$6,400
outlier · 0.3×
11005
HCPCS 		Pf Debride Abdominal Wall 4 $699.63 $2,117.35 $1,762.92 nat. median
$1,999
0.9× median
59426
HCPCS 		Rhc Antepartum Care Only 4 $764.87 $2,059.61 $1,735.93 nat. median
$1,292
1.3× median
J0897
HCPCS 		Prolia (denosumab) Inj. 60mg/ml 5 $14.43 $4,528.18 $1,715.94 nat. median
$86
outlier · 20.0×
58720
HCPCS 		Pf Removal Tube/ovary 4 $707.61 $2,118.51 $1,712.82 nat. median
$2,980
0.6× median
15839
HCPCS 		Pf Exc Excess Skin Other Area 4 $689.65 $2,080.08 $1,680.47 nat. median
$2,968
0.6× median
49062
HCPCS 		Pf Drainage Of Extraperitoneal Lymphocel 4 $117.14 $1,995.26 $1,679.47 nat. median
$2,550
0.7× median
15274
HCPCS 		Pf Wc Skn Sub Grft Trk/arm/lg Child + On 4 $39.77 $8,694.81 $1,669.05 nat. median
$549
outlier · 3.0×
27087
HCPCS 		Removal Foreign Body Pelvis/hip Deep 5 $250.00 $7,069.57 $1,664.82 nat. median
$3,466
outlier · 0.5×
J0885
HCPCS 		Procrit Inj [40,000 Unt/ml] 5 $11.70 $6,522.70 $1,631.15 nat. median
$148
outlier · 11.1×
C8911
HCPCS 		MRA Chest W And Without Contrast (m-care & Adv) 4 $832.64 $2,242.07 $1,545.85 nat. median
$828
1.9× median
19303
HCPCS 		Pf Simple Mastectomy Right Breast 5 $320.00 $2,704.23 $1,512.12 nat. median
$6,248
outlier · 0.2×
44180
HCPCS 		Pf Lysis Of Adhesions 5 $363.00 $2,614.02 $1,488.51 nat. median
$6,040
outlier · 0.2×
60240
HCPCS 		Pf Removal Of Thyroid 5 $320.00 $2,590.47 $1,455.23 nat. median
$6,016
outlier · 0.2×
J7298
HCPCS 		Mirena (levonorgestrel) 52 Mg Iu System 5 $1,287.51 $3,807.60 $1,442.88 nat. median
$1,565
0.9× median

Other procedures at this hospital

Browse this hospital's 1,727 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
J0840 HCPCS Crotalidae Polyvalent Imm Fab (ovine) In 12 4 $16,632.25 $13,305.80 20% off $5,867.86 $15,800.64 $10,894.12 2026-03-31
J3101 HCPCS Tenecteplase (tnkase) Inj [50 Mg] 14 5 $20,435.00 $16,348.00 20% off $41.06 $19,413.25 $7,356.60 2026-03-31
59510 HCPCS Clnc Cesarean Delivery 12 4 $6,534.15 $5,227.32 20% off $2,305.24 $6,207.44 $5,231.89 2026-03-31
59400 HCPCS Clnc OB Care (vaginal Delivery) 12 4 $5,915.91 $4,732.73 $2,087.14 $5,620.11 $4,736.87 2026-03-31
23800 HCPCS Arthrodesis Glenohum Jnt 24 4 $10,050.29 $8,040.23 20% off $953.11 $15,709.75 $4,699.06 2026-03-31
43632 HCPCS Pf Removal Of Stomach Partial 12 4 $5,790.33 $4,632.26 20% off $1,884.55 $5,500.81 $4,596.74 2026-03-31
43633 HCPCS Pf Gastrectomy With Roux-en-y 12 4 $5,470.68 $4,376.54 20% off $1,784.43 $5,197.15 $4,343.97 2026-03-31
44150 HCPCS Pf Colectomy, Total Abdominal 12 4 $5,306.91 $4,245.53 $1,743.56 $5,041.56 $4,217.06 2026-03-31
J0881 HCPCS Aranesp (darbepoetin Alfa) Inj 500mcg/ml 14 5 $10,852.25 $8,681.80 20% off $4.59 $10,309.64 $3,906.81 2026-03-31
J7300 HCPCS Paragard (intrauterine) 313.4 Mg IUD 14 5 $10,763.00 $8,610.40 20% off $1,207.34 $10,224.85 $3,874.68 2026-03-31
36516 HCPCS Bb Absorption Lifeshare 14 5 $10,400.00 $8,320.00 20% off $250.00 $9,880.00 $3,744.00 2026-03-31
44204 HCPCS Pf Lap Partial Colectomy 12 4 $4,358.19 $3,486.55 20% off $1,430.37 $4,140.28 $3,462.80 2026-03-31
43840 HCPCS Pf Repair Of Stomach Lesion 12 4 $3,840.69 $3,072.55 20% off $1,275.92 $3,648.66 $3,055.47 2026-03-31
44140 HCPCS Pf Colectomy Partial 24 4 $3,818.07 $3,054.46 $201.16 $3,627.17 $3,034.70 2026-03-31
43820 HCPCS Pf Gastrojejunostomy Without Vagotomy 12 4 $3,815.55 $3,052.44 20% off $1,261.32 $3,624.77 $3,033.91 2026-03-31
39561 HCPCS Pf Resect Diaphragm Complex 12 4 $3,514.29 $2,811.43 20% off $1,218.16 $3,338.58 $2,808.47 2026-03-31
44120 HCPCS Pf Resection Small Bowel Singe Resection 12 4 $3,480.48 $2,784.38 20% off $1,141.75 $3,306.46 $2,765.28 2026-03-31
J1437 HCPCS Monoferric (ferric Derisomaltose) 10ml 14 5 $7,053.00 $5,642.40 20% off $22.97 $6,700.35 $2,539.08 2026-03-31
44005 HCPCS Pf Lysis Of Adhesions Intestine ASSISTAN,assistant Surgeon 24 4 $3,113.10 $2,490.48 20% off $163.93 $2,957.44 $2,474.23 2026-03-31
59612 HCPCS Pf Vaginal Birth After C-section 26 5 $2,428.11 $1,942.49 $363.00 $6,715.17 $2,428.11 2026-03-31
C1751 HCPCS Zdnu - Groshong 8 F Single-lumen Cv Cath 12 4 $3,383.07 $2,706.46 $1,193.55 $3,213.92 $2,215.91 2026-03-31
47600 HCPCS Pf Cholecystectomy 12 4 $2,879.58 $2,303.66 20% off $1,012.25 $2,735.60 $2,196.40 2026-03-31
59409 HCPCS Pf Vaginal Delivery 34 5 $2,293.35 $1,834.68 $363.00 $6,715.17 $2,178.68 2026-03-31
15734 HCPCS Pf Muscle-skin Graft Trunk 14 5 $4,268.73 $3,414.98 20% off $297.00 $4,055.29 $2,176.14 2026-03-31
81162 HCPCS Bcra Panel Plus (seq And Dup) 22 5 $5,755.76 $4,604.61 $1,609.54 $5,467.97 $2,072.07 2026-03-31
35207 HCPCS Rpr Blood Ves Dir Ha/fing 26 5 $7,447.43 $5,957.94 20% off $363.00 $7,075.06 $2,058.72 2026-03-31
58740 HCPCS Pf Lysis Of Adhesions 12 4 $2,547.39 $2,037.91 20% off $837.99 $2,420.02 $2,024.51 2026-03-31
44620 HCPCS Pf Closure Of Enterostomy L/s Intestine 12 4 $2,450.10 $1,960.08 20% off $813.63 $2,327.60 $1,949.11 2026-03-31
59514 HCPCS Pf Cesarean Section 12 4 $2,422.29 $1,937.83 20% off $818.12 $2,301.18 $1,930.41 2026-03-31
J0875 HCPCS Dalbavancin (dalvance) 500mg Inj 14 5 $5,327.00 $4,261.60 $14.58 $5,060.65 $1,917.72 2026-03-31
47100 HCPCS Pf Biopsy Of Liver 12 4 $2,392.14 $1,913.71 20% off $814.30 $2,272.53 $1,907.97 2026-03-31
19307 HCPCS Pf Left Modified Radical MASTECTOMY,Left Mastectomy 14 5 $3,376.35 $2,701.08 20% off $363.00 $3,376.35 $1,869.67 2026-03-31
26952 HCPCS Amp Finger With Flap 26 5 $7,441.65 $5,953.32 20% off $363.00 $7,069.57 $1,860.00 2026-03-31
43327 HCPCS Pf Esoph Fundoplasty Laparotomy 12 4 $2,324.31 $1,859.45 $790.19 $2,208.09 $1,853.62 2026-03-31
49900 HCPCS Pf Repair Of Abdominal Wall 12 4 $2,310.24 $1,848.19 20% off $799.61 $2,194.73 $1,845.95 2026-03-31
15830 HCPCS Pf Exc Excess Skin (panniculectomy) 14 5 $3,318.84 $2,655.07 20% off $297.00 $3,318.84 $1,807.92 2026-03-31
11005 HCPCS Pf Debride Abdominal Wall 12 4 $2,228.79 $1,783.03 20% off $699.63 $2,117.35 $1,762.92 2026-03-31
59426 HCPCS Rhc Antepartum Care Only 12 4 $2,168.01 $1,734.41 $764.87 $2,059.61 $1,735.93 2026-03-31
J0897 HCPCS Prolia (denosumab) Inj. 60mg/ml 14 5 $4,766.50 $3,813.20 20% off $14.43 $4,528.18 $1,715.94 2026-03-31
58720 HCPCS Pf Removal Tube/ovary 12 4 $2,118.51 $1,694.81 $707.61 $2,118.51 $1,712.82 2026-03-31
15839 HCPCS Pf Exc Excess Skin Other Area 12 4 $2,080.08 $1,664.06 20% off $689.65 $2,080.08 $1,680.47 2026-03-31
49062 HCPCS Pf Drainage Of Extraperitoneal Lymphocel 24 4 $2,100.27 $1,680.22 $117.14 $1,995.26 $1,679.47 2026-03-31
15274 HCPCS Pf Wc Skn Sub Grft Trk/arm/lg Child + On 24 4 $4,633.65 $3,706.92 $39.77 $8,694.81 $1,669.05 2026-03-31
27087 HCPCS Removal Foreign Body Pelvis/hip Deep 26 5 $7,441.65 $5,953.32 20% off $250.00 $7,069.57 $1,664.82 2026-03-31
J0885 HCPCS Procrit Inj [40,000 Unt/ml] 38 5 $3,423.00 $2,738.40 20% off $11.70 $6,522.70 $1,631.15 2026-03-31
C8911 HCPCS MRA Chest W And Without Contrast (m-care & Adv) 12 4 $2,360.07 $1,888.06 $832.64 $2,242.07 $1,545.85 2026-03-31
19303 HCPCS Pf Simple Mastectomy Right Breast 14 5 $2,704.23 $2,163.38 20% off $320.00 $2,704.23 $1,512.12 2026-03-31
44180 HCPCS Pf Lysis Of Adhesions 14 5 $2,614.02 $2,091.22 $363.00 $2,614.02 $1,488.51 2026-03-31
60240 HCPCS Pf Removal Of Thyroid 14 5 $2,590.47 $2,072.38 $320.00 $2,590.47 $1,455.23 2026-03-31
J7307 HCPCS Nexplanon (etonogetrol Implant) 68mg 14 5 $4,008.00 $3,206.40 20% off $1,287.51 $3,807.60 $1,442.88 2026-03-31
J7298 HCPCS Mirena (levonorgestrel) 52 Mg Iu System 14 5 $4,008.00 $3,206.40 20% off $1,287.51 $3,807.60 $1,442.88 2026-03-31
23930 HCPCS Rhc I&d Up Arm/elbow Dp Abscs 14 5 $2,732.64 $2,186.11 20% off $250.00 $2,627.26 $1,438.63 2026-03-31
44050 HCPCS Pf Reduce Of Bowel Obstruction 14 5 $2,656.41 $2,125.13 $320.00 $2,523.59 $1,421.80 2026-03-31
59620 HCPCS Pf C-section Following Attempted Vbac 14 5 $2,422.29 $1,937.83 20% off $363.00 $2,301.18 $1,332.09 2026-03-31
25605 HCPCS Clsd Tx Dist Rad Fx W/man 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,291.07 2026-03-31
24565 HCPCS Clsd Tx Humeral W Man 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,286.89 2026-03-31
23333 HCPCS Removal Foreign Body Of Shoulder Deep 26 5 $6,458.12 $5,166.50 $250.00 $6,135.21 $1,286.55 2026-03-31
27825 HCPCS Cl Tx Fx Distal Tibia W/wo Anest W Manip 26 5 $3,586.30 $2,869.04 20% off $297.00 $3,406.98 $1,282.90 2026-03-31
26410 HCPCS Rpr Extensor Tendon Hand Each Tendon 22 5 $3,586.30 $2,869.04 20% off $297.00 $3,406.98 $1,277.90 2026-03-31
27502 HCPCS Tx Femoral Shaft Fx With Manip 22 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
25565 HCPCS Cl Tx Radial&ulnar Shaft Fx W Manip 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
24605 HCPCS Closed Reduction Of Elbow 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
27252 HCPCS Cl Tx Hip Disloc Traumatic W Anesthesia 22 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
27752 HCPCS Cl Tx Tibial Shaft W Manipulation 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
27552 HCPCS Cl Tx Knee Dislocation W Anesthesia 22 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
27842 HCPCS Closed Reduction Ankle With 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
26418 HCPCS Rpr Extensor Tendon Finger Each Tendon 22 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
27503 HCPCS Cl Tx Supra/transcon Femoral Fx W Manip 22 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
27510 HCPCS Cl Tx Femoral Fx D/m/l W Manip 22 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
27266 HCPCS Cl Tx Post Hip Arthroplasty Dis Wo Anes 22 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
24535 HCPCS Cl Tx Supra/transcon Humeral Fx W Manip 22 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,277.90 2026-03-31
25505 HCPCS Cl Tx Radial Shaft Fx W Manip 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,266.12 2026-03-31
0360 RC — 98 5 $2,000.00 $1,600.00 20% off $176.40 $6,650.00 $1,260.00 2026-03-31
24505 HCPCS Cl Tx Humeral Shaft Fx W Manipulation 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,240.95 2026-03-31
58940 HCPCS Pf Removal Of Ovary/ovaries 12 4 $1,527.18 $1,221.74 20% off $519.82 $1,527.18 $1,237.16 2026-03-31
26236 HCPCS Partial Removal Finger Bone 24 4 $2,395.82 $1,916.65 20% off $423.48 $3,406.98 $1,235.30 2026-03-31
27768 HCPCS Cl Tx Post Malleolus Fx Wo Manipulation 26 5 $3,586.30 $2,869.04 20% off $297.00 $3,406.98 $1,223.58 2026-03-31
27818 HCPCS Cl Tx Trimal Ank Fx W/man 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,208.19 2026-03-31
46230 HCPCS Pf Exc Multiple Papilla/tags Anus 34 5 $1,264.49 $1,011.59 20% off $168.35 $6,102.50 $1,201.27 2026-03-31
21933 HCPCS Pf Exc Tmr Sft Tis Back Subfas >5cm 14 5 $2,081.53 $1,665.22 20% off $320.00 $2,081.53 $1,200.77 2026-03-31
27762 HCPCS Cl Tx Med Malleolus Fx W Manipulation 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,200.51 2026-03-31
13160 HCPCS Pf Late Closure Of Wound 14 5 $2,263.74 $1,810.99 20% off $250.00 $2,150.55 $1,200.28 2026-03-31
58662 HCPCS Pf Lap Exc Lesion 14 5 $2,032.41 $1,625.93 $363.00 $2,032.41 $1,197.70 2026-03-31
J0585 HCPCS Onabotulinumtoxin-a (botox) 200u Inj 26 5 $13,314.00 $10,651.20 $6.12 $12,648.30 $1,188.69 2026-03-31
60220 HCPCS Pf Total Thyroid Lobectomy Unilateral 14 5 $2,004.36 $1,603.49 $363.00 $2,004.36 $1,183.68 2026-03-31
49000 HCPCS Pf Exploratory Laparotomy 14 5 $2,169.27 $1,735.42 $297.00 $2,060.81 $1,178.90 2026-03-31
27810 HCPCS Cl Tx Fx Ankle W Manipulation 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,173.99 2026-03-31
23605 HCPCS Closed Tx Prox Humerus Fx W Manipulation 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,171.95 2026-03-31
58700 HCPCS Pf Salpingectomy 12 4 $2,190.72 $1,752.58 $741.96 $2,081.18 $1,158.08 2026-03-31
26675 HCPCS Cls Tx Hand Dislocation 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,157.85 2026-03-31
24675 HCPCS Cl Tx Ulnar Fx Proximal End W Manip 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,147.14 2026-03-31
J7297 HCPCS Liletta (levonrgestrol-release Iu) 52mg 14 5 $3,172.00 $2,537.60 20% off $987.63 $3,013.40 $1,141.92 2026-03-31
90380 HCPCS Vac-beyfortus 50mg/0.5ml Inj (private) 12 4 $1,728.00 $1,382.40 $609.64 $1,641.60 $1,131.84 2026-03-31
23655 HCPCS Clsd Tx Should W/man W/an 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,115.28 2026-03-31
24655 HCPCS Cl Tx Radial Head/neck Fx W Manipulation 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,110.09 2026-03-31
27781 HCPCS Cl Tx Proximal Fibula/shaft Fx W Manipul 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,106.16 2026-03-31
49594 HCPCS Pf Aa Hernia 3-10 Cm Inc/str 14 5 $1,824.93 $1,459.94 20% off $363.00 $1,824.93 $1,093.96 2026-03-31
J1439 HCPCS Injectafer (ferric Carboxymal) 750mg Inj 14 5 $3,025.13 $2,420.10 20% off $1.06 $2,873.87 $1,089.05 2026-03-31
26705 HCPCS Clsd Tx Fng Sng W Anes 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $1,087.29 2026-03-31
19301 HCPCS Pf Mastectomy, Partial (lumpectomy) 14 5 $1,841.79 $1,473.43 20% off $320.00 $1,841.79 $1,080.89 2026-03-31
49553 HCPCS Pf Rpr Femoral Hernia Init Incarc/strang 14 5 $1,788.30 $1,430.64 $363.00 $1,788.30 $1,075.65 2026-03-31
49520 HCPCS Pf Rerepair Ing Hernia Reduceable 14 5 $1,777.02 $1,421.62 $363.00 $1,777.02 $1,070.01 2026-03-31
47562 HCPCS Pf Lap Cholecystectomy 14 5 $1,776.06 $1,420.85 $363.00 $1,776.06 $1,069.53 2026-03-31
81229 HCPCS Chromosomal M Array Copy No&snp 14 5 $2,900.00 $2,320.00 20% off $625.50 $2,755.00 $1,044.00 2026-03-31
14001 HCPCS Pf Tis Transfer Trunk 10.1-30 Sqcm 14 5 $1,806.24 $1,444.99 20% off $320.00 $1,755.26 $1,037.63 2026-03-31
J1745 HCPCS Remicade (infliximad) Inj 100mg 14 5 $2,862.00 $2,289.60 20% off $65.70 $2,718.90 $1,030.32 2026-03-31
44950 HCPCS Pf Appendectomy 14 5 $1,730.67 $1,384.54 $320.00 $1,730.67 $1,025.34 2026-03-31
15220 HCPCS Pf Skin Full Graft Scalp/arm/leg 14 5 $1,708.56 $1,366.85 $320.00 $1,708.56 $1,014.28 2026-03-31
28193 HCPCS Rem Fb Foot Complicated 26 5 $3,748.13 $2,998.50 20% off $297.00 $3,560.72 $1,013.82 2026-03-31
14040 HCPCS Pf Adjacent Tissue Transfer/rearrange 14 5 $1,784.42 $1,427.54 $250.00 $1,755.26 $1,002.63 2026-03-31
24201 HCPCS Rem Foreign Body Upper Arm/elbow Deep 26 5 $6,458.13 $5,166.50 20% off $250.00 $6,135.22 $996.33 2026-03-31
44970 HCPCS Pf Lap Appendectomy 14 5 $1,623.30 $1,298.64 $363.00 $1,623.30 $993.15 2026-03-31
49525 HCPCS Pf Rpr Inguinal Sliding Hernia, Any Age 14 5 $1,622.34 $1,297.87 20% off $363.00 $1,622.34 $992.67 2026-03-31
27257 HCPCS Tx Spontaneous Hip Disloc W Manip W Anes 26 5 $3,586.30 $2,869.04 20% off $250.00 $3,406.98 $979.05 2026-03-31
49507 HCPCS Pf Rpr Init Ing Incarc Hernia 5yr> 14 5 $1,585.05 $1,268.04 20% off $363.00 $1,585.05 $974.02 2026-03-31
33016 HCPCS Pericardiocentesis 24 4 $2,172.88 $1,738.30 20% off $207.52 $3,533.65 $969.21 2026-03-31
11044 HCPCS Debride Bone 20 Sq Cm/< 28 5 $3,748.88 $2,999.10 20% off $207.60 $3,561.44 $969.21 2026-03-31
10140 HCPCS Pf Drainage Of Hematoma/seroma 32 5 $2,732.64 $2,186.11 20% off $114.25 $3,561.44 $968.90 2026-03-31
72285 HCPCS Pf Pain Mgmt Diskogra Cerv Thor Super In 24 5 $350.22 $280.18 $5.00 $4,269.11 $967.82 2026-03-31
46040 HCPCS Pf I&d Of Perirectal Abscess 26 5 $1,173.57 $938.86 $250.00 $2,571.92 $964.68 2026-03-31
11772 HCPCS Pf Removal Pilonidal Cyst Compl 14 5 $1,604.58 $1,283.66 20% off $320.00 $1,604.58 $962.29 2026-03-31
19304 HCPCS Pf Right Mastectomy SUBCUTANEOUS,Right Mastectomy 14 5 $1,636.59 $1,309.27 20% off $363.00 $1,554.76 $958.88 2026-03-31
14020 HCPCS Pf Tissue Transfer S/a/l 10 Sq Cm/< 14 5 $1,596.09 $1,276.87 20% off $320.00 $1,596.09 $958.04 2026-03-31
12047 HCPCS Rep Int N/h/f/g>30 Cm 26 5 $4,314.65 $3,451.72 20% off $297.00 $4,098.92 $942.96 2026-03-31
72295 HCPCS Pf Pain Mgmt Diskography Lumbar Super In 24 5 $299.34 $239.47 20% off $5.00 $4,269.11 $942.38 2026-03-31
36590 HCPCS Pf Rem Of Central Venous Access Device 28 5 $2,131.59 $1,705.26 20% off $176.34 $3,533.65 $927.91 2026-03-31
72197 HCPCS MRI Pelvis General W & Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $925.16 2026-03-31
73723 HCPCS MRI Any Joint Lower Ext W&without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $925.16 2026-03-31
73223 HCPCS MRI Any Joint Upp Ext W&without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $925.16 2026-03-31
74183 HCPCS MRI Abdomen W & Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $925.16 2026-03-31
71552 HCPCS MRI Chest W And Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $925.16 2026-03-31
70543 HCPCS MRI Orbits W And Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $925.16 2026-03-31
22900 HCPCS Pf Exc Abdl Tum Deep<5 Cm 14 5 $1,587.00 $1,269.60 20% off $250.00 $1,587.00 $918.50 2026-03-31
86366 HCPCS Musk Ab 14 5 $2,598.75 $2,079.00 20% off $18.40 $2,468.81 $916.84 2026-03-31
23505 HCPCS Closed Tx Clavicular Fx W Manipulation 26 5 $3,586.30 $2,869.04 20% off $297.00 $3,406.98 $916.83 2026-03-31
70546 HCPCS MRA Head W And Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $916.00 2026-03-31
72156 HCPCS MRI Spinal Canal Cerv W And Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $916.00 2026-03-31
72158 HCPCS MRI Spinal Canal Lumbar W&without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $916.00 2026-03-31
73720 HCPCS MRI Lower Extremity Nonjnt W&wo Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $916.00 2026-03-31
72157 HCPCS MRI Spinal Canal Thoracic W&without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $916.00 2026-03-31
70549 HCPCS MRA Neck W And Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $916.00 2026-03-31
73722 HCPCS MRI Lower Extremity W Contrast 14 5 $2,596.35 $2,077.08 20% off $514.92 $2,466.53 $916.00 2026-03-31
73220 HCPCS MRI Upper Extremity W And Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $916.00 2026-03-31
70553 HCPCS MRI Brain W And Without Contrast 14 5 $2,596.35 $2,077.08 20% off $366.59 $2,466.53 $916.00 2026-03-31
C1788 HCPCS Mediport Tray - Cardinal 12 4 $1,376.46 $1,101.17 $485.62 $1,307.64 $901.59 2026-03-31
70552 HCPCS MRI Brain With Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
72142 HCPCS MRI Cervical Spine W Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
74182 HCPCS MRI Abdomen With Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
71551 HCPCS MRI Chest With Contrast 14 5 $2,529.48 $2,023.58 20% off $516.42 $2,403.01 $892.40 2026-03-31
72147 HCPCS MRI Thoracic Spine W Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
70548 HCPCS MRA Neck With Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
73219 HCPCS MRI Upper Ext Non Joint W Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
72149 HCPCS MRI Spinal Canal Lumbar With Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
70542 HCPCS MRI Neck/orbit/face With Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
72196 HCPCS MRI Pelvis With Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
70545 HCPCS MRA Head With Contrast 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
73222 HCPCS MRI Upper Ext Joint W&without Contrast 14 5 $2,529.48 $2,023.58 20% off $514.92 $2,403.01 $892.40 2026-03-31
73719 HCPCS MRI Lower Extrem Other Than Joint W Cont 14 5 $2,529.48 $2,023.58 20% off $366.59 $2,403.01 $892.40 2026-03-31
49505 HCPCS Pf Repair Init Ing Hernia 5yr> 14 5 $1,408.98 $1,127.18 20% off $363.00 $1,408.98 $885.99 2026-03-31
31603 HCPCS Tracheostomy Emergency 26 5 $3,470.35 $2,776.28 $286.74 $3,296.83 $883.00 2026-03-31
12037 HCPCS Rep Int Sc/tr/ext>30cm 26 5 $5,534.76 $4,427.81 $250.00 $5,258.02 $882.27 2026-03-31
15278 HCPCS Pf Wc Skn Sub Grft Fac/nk/h/f/g Chld+ On 24 4 $2,359.53 $1,887.62 20% off $49.82 $4,344.43 $876.03 2026-03-31
81420 HCPCS Qnatal (non Invasive Prenatal Screening) 14 5 $1,897.63 $1,518.10 20% off $669.49 $1,802.75 $865.32 2026-03-31
28192 HCPCS Rem Fb Foot Deep 26 5 $3,748.13 $2,998.50 20% off $250.00 $3,560.72 $855.69 2026-03-31
37722 HCPCS Pf Lig/stripping Long Saphenous Veins 14 5 $1,345.62 $1,076.50 $363.00 $1,345.62 $854.31 2026-03-31
27043 HCPCS Pf Exc Sft Tissue Pelvis/hip >3cm 14 5 $1,321.50 $1,057.20 $363.00 $1,321.50 $842.25 2026-03-31
15276 HCPCS Pf Wc Skn Sub Grft Face/nk/h/f/g Add On 24 4 $2,319.83 $1,855.86 20% off $23.04 $4,344.43 $838.31 2026-03-31
71555 HCPCS MRA Chest W And Without Contrast 14 5 $2,360.07 $1,888.06 $276.90 $2,242.07 $832.64 2026-03-31
27301 HCPCS Pf Drainage Thigh/knee Lesion 14 5 $1,406.19 $1,124.95 20% off $250.00 $1,406.19 $828.10 2026-03-31
15272 HCPCS Pf Wc Skn Sub Grft Trk/arm/lg Add On 24 4 $2,308.98 $1,847.18 20% off $15.28 $4,344.43 $828.01 2026-03-31
46260 HCPCS Pf Hemorrhoidectomy Int/ext 2 Groups 14 5 $1,351.26 $1,081.01 $297.00 $1,351.26 $824.13 2026-03-31
21931 HCPCS Pf Exc Tmr Sft Tis Back 3 Cm Or Greater 14 5 $1,323.69 $1,058.95 20% off $320.00 $1,323.69 $821.85 2026-03-31
C8902 HCPCS MRA Abdomen W And Without Contrast (m-care & Adv) 12 4 $1,254.30 $1,003.44 $442.52 $1,191.58 $821.57 2026-03-31
28635 HCPCS Cl Tx Disloc Mtp Joint W Anes 24 4 $1,977.88 $1,582.30 20% off $126.28 $3,406.98 $817.35 2026-03-31
27619 HCPCS Pf Exc Tumor Sft Tissue Leg <5cm 14 5 $1,318.74 $1,054.99 20% off $297.00 $1,318.74 $807.87 2026-03-31
21552 HCPCS Pf Exc Tumor Neck/anter Thorax 14 5 $1,245.54 $996.43 20% off $320.00 $1,245.54 $782.77 2026-03-31
11771 HCPCS Pf Exc Pilonidal Cyst Extensive 14 5 $1,229.61 $983.69 $320.00 $1,229.61 $774.80 2026-03-31
19125 HCPCS Pf Excision Of Breast Lesion 14 5 $1,288.68 $1,030.94 20% off $250.00 $1,288.68 $769.34 2026-03-31
37765 HCPCS Pf Stab Phlebectomy Varicose Veins 10-20 14 5 $1,278.30 $1,022.64 20% off $248.39 $1,278.30 $763.35 2026-03-31
85097 HCPCS Bone Marrow Smear Interp 12 4 $1,941.28 $1,553.02 20% off $60.76 $1,844.22 $749.57 2026-03-31
A2019 HCPCS Kerecis Marigen Shield Per Sq Cm 8 3 $2,087.70 $1,670.16 $736.54 $1,983.32 $747.74 2026-03-31
23071 HCPCS Pf Exc Lesion Sc 3cm/> 14 5 $1,171.89 $937.51 20% off $320.00 $1,171.89 $745.95 2026-03-31
38510 HCPCS Pf Bx/exc Lymph Node Open Deep Cervical 14 5 $1,191.18 $952.94 20% off $297.00 $1,191.18 $744.09 2026-03-31
27337 HCPCS Pf Exc Thigh/knee Lesion Sc 3cm/> 14 5 $1,168.17 $934.54 $320.00 $1,168.17 $744.09 2026-03-31
36558 HCPCS Insrt Cntrl Vns Cath 34 5 $755.49 $604.39 20% off $240.55 $7,075.06 $741.84 2026-03-31
19120 HCPCS Pf Exc B9 Lesion Of Breast 14 5 $1,161.57 $929.26 $320.00 $1,161.57 $740.78 2026-03-31
38531 HCPCS Pf Open Bx/exc Inguinofem Nodes 14 5 $1,226.67 $981.34 $250.00 $1,226.67 $738.34 2026-03-31
27632 HCPCS Pf Exc Leg/ankle Lesion 3cm/> 14 5 $1,156.02 $924.82 $320.00 $1,156.02 $738.01 2026-03-31
58605 HCPCS Pf Post Partum Tubal 12 4 $926.79 $741.43 20% off $308.19 $880.45 $737.38 2026-03-31
38525 HCPCS Pf Bx/removal Lymph Node 14 5 $1,223.67 $978.94 $250.00 $1,223.67 $736.84 2026-03-31
28810 HCPCS Pf Amputation Metatarsal With Toe Single 14 5 $1,222.92 $978.34 $250.00 $1,222.92 $736.46 2026-03-31
27324 HCPCS Pf Biopsy Thigh Soft Tissue 14 5 $1,125.96 $900.77 $297.00 $1,125.96 $711.48 2026-03-31
49322 HCPCS Pf Laparoscopy Aspiration 14 5 $1,053.54 $842.83 20% off $356.76 $1,053.54 $705.15 2026-03-31
88309 HCPCS Charge Level 6 Surg Pathology Gm & M 14 5 $1,941.28 $1,553.02 20% off $46.00 $1,844.22 $698.86 2026-03-31
58600 HCPCS Pf Tubal Ligation 14 5 $1,033.59 $826.87 20% off $339.10 $1,033.59 $686.35 2026-03-31
99291 HCPCS Critical Care 30-74mn 36 5 $1,919.30 $1,535.44 $51.00 $1,823.34 $677.13 2026-03-31
J1610 HCPCS Glucagon Emerg Kit [1 Mg] 14 5 $1,880.00 $1,504.00 20% off $38.55 $1,786.00 $676.80 2026-03-31
46270 HCPCS Pf Surgical Treatment Anal Fistula 14 5 $1,103.37 $882.70 $250.00 $1,103.37 $676.68 2026-03-31
59820 HCPCS Pf Treatment Of Missed Ab, Surg 1st Trim 14 5 $1,031.46 $825.17 $320.00 $1,031.46 $675.73 2026-03-31
64788 HCPCS Pf Exc Neurofibroma Cutaneous Nerve 14 5 $1,095.63 $876.50 20% off $250.00 $1,095.63 $672.82 2026-03-31
59821 HCPCS Pf Trmt Of Missed Abortion 2nd Trimester 14 5 $1,017.51 $814.01 $320.00 $1,017.51 $668.75 2026-03-31
72133 HCPCS CT L-spine W/wo Contrast 14 5 $1,881.36 $1,505.09 $174.94 $1,787.29 $663.74 2026-03-31
35226 HCPCS Repair Of Blood Vessel Lower Ext 22 5 $1,622.42 $1,297.94 $250.00 $2,097.60 $660.03 2026-03-31
72130 HCPCS CT T-spine W/wo Contrast 14 5 $1,863.00 $1,490.40 $174.94 $1,769.85 $657.27 2026-03-31
72127 HCPCS CT C-spine W/wo Contrast 14 5 $1,859.00 $1,487.20 20% off $174.94 $1,766.05 $655.86 2026-03-31
49321 HCPCS Pf Laparoscopy With Biopsy 14 5 $971.76 $777.41 $330.64 $971.76 $651.20 2026-03-31
21930 HCPCS Pf Exc Tumor Soft Tissue Back <3cm 14 5 $1,024.38 $819.50 20% off $250.00 $1,024.38 $637.19 2026-03-31
71275 HCPCS CTA Chest 14 5 $1,805.31 $1,444.25 $174.94 $1,715.04 $636.91 2026-03-31
64633 HCPCS Pain Mgmt Destrct Neuro Agnt Parvrtebral 26 5 $4,493.80 $3,595.04 20% off $180.49 $4,269.11 $635.91 2026-03-31
11471 HCPCS Pf Exc Hidrad Perianal/perneal/umb Comp 14 5 $973.23 $778.58 20% off $297.00 $973.23 $635.12 2026-03-31
86353 HCPCS Lymphocyte Stimulation 10 4 $1,776.57 $1,421.26 $65.11 $1,687.74 $633.05 2026-03-31
36561 HCPCS Pf Insert Tunneled Cv Cath 14 5 $968.31 $774.65 $297.00 $968.31 $632.65 2026-03-31
21012 HCPCS Pf Exc Tumor Soft Tissue Face/scalp >2cm 14 5 $940.08 $752.06 20% off $320.00 $940.08 $630.04 2026-03-31
74175 HCPCS CTA Abdomen 14 5 $1,783.91 $1,427.13 $174.94 $1,694.71 $629.37 2026-03-31
64635 HCPCS Pain Mgmt Destrct Neuro Agnt Paravrtebra 26 5 $4,493.80 $3,595.04 20% off $180.94 $4,269.11 $627.51 2026-03-31
22902 HCPCS Pf Exc Abd Lesion <3cm 14 5 $920.55 $736.44 $320.00 $920.55 $620.27 2026-03-31
11008 HCPCS Pf Removal Mesh Abdominal Wall 12 4 $783.18 $626.54 20% off $246.41 $744.02 $619.62 2026-03-31
72191 HCPCS CTA Pelvis 14 5 $1,750.78 $1,400.62 20% off $174.94 $1,663.24 $617.67 2026-03-31
20103 HCPCS Pf Explor Wound Extremity 14 5 $977.34 $781.87 20% off $250.00 $977.34 $613.67 2026-03-31
22999 HCPCS Pf Rectus Diastsasis 12 4 $1,335.63 $1,068.50 20% off $210.54 $1,268.85 $607.81 2026-03-31
64555 HCPCS Pf Implant Of Neurostimulator 14 5 $955.11 $764.09 $306.87 $907.35 $607.11 2026-03-31
57720 HCPCS Pf Rpr Cervical Lac In Delivery 14 5 $909.00 $727.20 $303.32 $909.00 $606.16 2026-03-31
28825 HCPCS Pf Partial Amputation Of Toe 14 5 $1,044.39 $835.51 20% off $163.90 $1,044.39 $604.14 2026-03-31
24075 HCPCS Pf Exc Tumor Soft Tissue Upper Arm <3cm 14 5 $896.04 $716.83 20% off $297.00 $896.04 $596.52 2026-03-31
73706 HCPCS CTA Lower Extremity BILATERAL,Bilateral 42 5 $1,685.00 $1,348.00 20% off $174.94 $1,600.75 $594.47 2026-03-31
72194 HCPCS CT Pelvis W Without Contrast 14 5 $1,684.75 $1,347.80 20% off $174.94 $1,600.51 $594.38 2026-03-31
46250 HCPCS Pf Hemorrhoidectomy Ext 2 Or More Column 14 5 $890.67 $712.54 $297.00 $890.67 $593.84 2026-03-31
11000 HCPCS Rhc Debridement Eczematous 14 5 $1,001.25 $801.00 20% off $250.00 $951.19 $590.85 2026-03-31
26115 HCPCS Pf Exc Hand Lesion <1.5cm 14 5 $930.87 $744.70 $250.00 $930.87 $590.43 2026-03-31
36571 HCPCS Pf Insert Picvad Cath 14 5 $882.03 $705.62 20% off $297.02 $882.03 $589.52 2026-03-31
15277 HCPCS Wcc Skn Sub Graft Face/nk/h/f/g Child 26 5 $4,573.08 $3,658.46 20% off $202.62 $4,344.43 $587.43 2026-03-31
72132 HCPCS CT L-spine With Contrast 14 5 $1,654.00 $1,323.20 20% off $261.00 $1,571.30 $583.53 2026-03-31
11463 HCPCS Pf Exc Hidradenitis Inguinal Complex 14 5 $916.56 $733.25 $250.00 $916.56 $583.28 2026-03-31
70492 HCPCS CT Soft Tissue Neck W/wo Con 14 5 $1,653.19 $1,322.55 20% off $142.00 $1,570.53 $583.25 2026-03-31
11451 HCPCS Pf Exc Of Hidradenitis Axillary Complex 14 5 $914.94 $731.95 20% off $250.00 $914.94 $582.47 2026-03-31
11446 HCPCS Pf Exc Face/mm Diameter Over 4.0 Cm 14 5 $909.60 $727.68 20% off $250.00 $909.60 $579.80 2026-03-31
21501 HCPCS Pf I&d Deep Abscess Soft Tissue Neck 14 5 $905.46 $724.37 $250.00 $905.46 $577.73 2026-03-31
70498 HCPCS CTA Neck 14 5 $1,636.27 $1,309.02 $174.94 $1,554.46 $577.28 2026-03-31
56740 HCPCS Pf Exc Bartholins Cyst 14 5 $864.00 $691.20 $287.88 $864.00 $575.94 2026-03-31
73221 HCPCS MRI Any Joint Uppe Extremity Without Contras 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
72146 HCPCS MRI Spinal Canal Thoracic Without Contrast 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
72141 HCPCS MRI Spinal Canal & Cervical Without Contrast 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
73218 HCPCS MRI Upper Ext Non Joint Without Contrast 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
72148 HCPCS MRI Spinal Canal Lumbar Without Contrast 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
70544 HCPCS MRA Head Without Contrast 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
73721 HCPCS MRI Any Joint Low Extremity Without Contrast 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
72195 HCPCS MRI Pelvic Without Contrast 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
73718 HCPCS MRI Lower Extremity Nonjoint Without Contras 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
70551 HCPCS MRI Brain Without Contrast 14 5 $1,629.54 $1,303.63 20% off $223.73 $1,548.06 $574.90 2026-03-31
10080 HCPCS I&d Pilonidal Cyst 40 5 $1,611.43 $1,289.14 20% off $100.93 $1,541.31 $570.45 2026-03-31
72126 HCPCS CT C-spine With Contrast 14 5 $1,608.50 $1,286.80 20% off $261.00 $1,528.08 $567.48 2026-03-31
74170 HCPCS CT Abdomen W & Without Contrast 14 5 $1,596.89 $1,277.51 20% off $174.94 $1,517.05 $563.38 2026-03-31
74176 HCPCS CT Abd/pelvis Without Contrast 14 5 $1,596.00 $1,276.80 20% off $108.30 $1,516.20 $563.07 2026-03-31
72129 HCPCS CT T-spine With Contrast 14 5 $1,577.56 $1,262.05 $174.94 $1,498.68 $556.56 2026-03-31
59812 HCPCS Pf Treatment Of Incomplete Abortion 14 5 $835.14 $668.11 20% off $275.89 $835.14 $555.51 2026-03-31
49320 HCPCS Pf Laparoscopy Diagnostic 28 5 $926.25 $741.00 20% off $50.71 $926.25 $555.02 2026-03-31
21555 HCPCS Pf Exc Tumor Soft Tissue Neck <3 Cm 14 5 $856.95 $685.56 20% off $250.00 $856.95 $553.48 2026-03-31
71550 HCPCS MRI Chest Without Contrast 14 5 $1,568.37 $1,254.70 $223.73 $1,489.95 $553.32 2026-03-31
70547 HCPCS MRA Neck Without Contrast 14 5 $1,568.37 $1,254.70 $223.73 $1,489.95 $553.32 2026-03-31
74181 HCPCS MRI Abdomen Without Contrast 14 5 $1,568.37 $1,254.70 $223.73 $1,489.95 $553.32 2026-03-31
70540 HCPCS MRI Neck/orbit/face Without Contrast 14 5 $1,568.37 $1,254.70 $223.73 $1,489.95 $553.32 2026-03-31
70336 HCPCS MRI Tmj Without Contrast 14 5 $1,568.37 $1,254.70 $223.73 $1,489.95 $553.32 2026-03-31
13132 HCPCS Pf Cmplx Rpr 26 5 $873.66 $698.93 $261.30 $2,522.67 $545.64 2026-03-31
73206 HCPCS CTA Upper Extremity LT,Left 28 5 $1,546.00 $1,236.80 20% off $174.94 $1,468.70 $545.43 2026-03-31
44121 HCPCS Pf Removal Small Intestine Each Add 12 4 $685.92 $548.74 $218.66 $651.62 $543.38 2026-03-31
11626 HCPCS Pf Exc Malign S/n/h/f/g Over 4.0 Cm 14 5 $828.24 $662.59 20% off $250.00 $828.24 $539.12 2026-03-31
J0561 HCPCS Penicillin G Benz Inj [2.4 Mmu/4ml] 14 5 $1,496.00 $1,196.80 20% off $5.66 $1,421.20 $538.56 2026-03-31
70470 HCPCS CT Head W/wo Contrast 14 5 $1,499.05 $1,199.24 20% off $174.94 $1,424.10 $528.87 2026-03-31
36581 HCPCS Pf Replace Tunneled Cv Cath 26 5 $527.94 $422.35 20% off $170.56 $7,075.06 $527.94 2026-03-31
92961 HCPCS Cardioversion - Internal 22 5 $1,470.35 $1,176.28 $51.00 $1,396.83 $523.93 2026-03-31
64625 HCPCS Pain Mgmt Rf Ablt Nrv Nrvtg Si Jt 26 5 $2,522.47 $2,017.97 20% off $5.00 $4,269.11 $523.57 2026-03-31
13152 HCPCS Rep Com Fac/ear 2.6-7.5 C 22 5 $1,452.38 $1,161.90 20% off $289.42 $1,379.76 $522.86 2026-03-31
13151 HCPCS Rep Com Fac/ear 1.1-2.5 C 22 5 $1,452.38 $1,161.90 20% off $241.68 $1,379.76 $522.86 2026-03-31
13101 HCPCS Pf Cmplx Rpr Trunk 2.6-7.5 Cm 26 5 $717.21 $573.77 $216.31 $2,220.24 $522.86 2026-03-31
12046 HCPCS Rep Int N/h/f/g 20.1-30 C 22 5 $1,452.38 $1,161.90 20% off $297.00 $1,379.76 $522.86 2026-03-31
12044 HCPCS Rep It N/h/f/g 7.6-12.5 C 26 5 $1,452.38 $1,161.90 20% off $195.44 $1,379.76 $522.86 2026-03-31
11470 HCPCS Pf Exc Hidraden Perianal/perneal/umbilic 14 5 $789.84 $631.87 20% off $250.00 $789.84 $519.92 2026-03-31
13121 HCPCS Rep Comp Sc/a/l 2.6-7.5 C 22 5 $1,452.38 $1,161.90 20% off $223.57 $1,379.76 $517.53 2026-03-31
13120 HCPCS Rep Comp Sc/a/l 1.1-2.5 C 22 5 $1,452.38 $1,161.90 20% off $203.88 $1,379.76 $517.53 2026-03-31
13100 HCPCS Rep Comp Trunk 1.1-2.5 Cm 22 5 $1,452.38 $1,161.90 20% off $176.77 $1,379.76 $517.53 2026-03-31
12045 HCPCS Rep Int N/h/f/g/ 12.6-20 22 5 $1,452.38 $1,161.90 20% off $250.00 $1,379.76 $517.53 2026-03-31
12036 HCPCS Rep Int Sc/t/ex 20.1-30 C 22 5 $1,452.38 $1,161.90 20% off $270.48 $1,379.76 $517.53 2026-03-31
11426 HCPCS Pf Ex B9 Lesion S/n/h/f/g Over 4cm Diam 14 5 $780.74 $624.59 20% off $249.91 $780.74 $515.33 2026-03-31
94002 HCPCS Ventilator Initial Day 12 4 $1,391.80 $1,113.44 $491.03 $1,322.21 $514.75 2026-03-31
94003 HCPCS Ventilator Subsq Day 12 4 $1,391.80 $1,113.44 $491.03 $1,322.21 $514.75 2026-03-31
15273 HCPCS Wcc Skn Sub Graft Trk/arm/lg Child 26 5 $9,152.43 $7,321.94 20% off $176.27 $8,694.81 $509.85 2026-03-31
73202 HCPCS CT Upper Ext W /wo Contrast BILAT,Bilateral 42 5 $1,425.00 $1,140.00 20% off $162.00 $1,353.75 $502.74 2026-03-31
10121 HCPCS I&d With Rem Fb Complica 26 5 $3,748.88 $2,999.10 20% off $175.45 $3,561.44 $501.36 2026-03-31
C1781 HCPCS Mesh - 15x15 - Progrip 156 4 $1,170.15 $936.12 20% off $81.82 $8,510.64 $500.40 2026-03-31
72193 HCPCS CT Pelvis With Contrast 14 5 $1,401.23 $1,120.98 20% off $174.94 $1,331.17 $494.35 2026-03-31
G0379 HCPCS Direct Admit Observation 12 4 $1,370.28 $1,096.22 20% off $483.43 $520.29 $494.15 2026-03-31
45388 HCPCS Pf Colonoscopy W/ablation 14 5 $738.84 $591.07 20% off $248.37 $738.84 $493.61 2026-03-31
99285 HCPCS Em 5 Comprehensive 44 5 $1,370.28 $1,096.22 20% off $51.00 $1,301.77 $493.30 2026-03-31
70488 HCPCS CT Maxillofacial W/wo Contrast 14 5 $1,384.60 $1,107.68 $174.94 $1,315.37 $488.49 2026-03-31
21011 HCPCS Pf Exc Tumor Soft Tissue Of Face/scalp 14 5 $721.14 $576.91 20% off $250.82 $721.14 $485.98 2026-03-31
11450 HCPCS Pf Exc Hidradenitis Axillary 14 5 $712.89 $570.31 20% off $254.03 $712.89 $483.46 2026-03-31
38500 HCPCS Pf Excision/biopsy Of Lymph Node 14 5 $718.50 $574.80 20% off $245.66 $718.50 $482.08 2026-03-31
87507 HCPCS Gi Panel 10 4 $1,338.00 $1,070.40 $472.05 $1,271.10 $481.68 2026-03-31
11043 HCPCS Pf Debridement Muscle/fascia 20cm< 28 5 $948.40 $758.72 20% off $142.38 $1,379.76 $478.41 2026-03-31
72128 HCPCS CT T-spine Wo Contrast 14 5 $1,345.19 $1,076.15 20% off $107.60 $1,277.93 $474.58 2026-03-31
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