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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

CHINESE HOSPITAL

San Francisco, CA · CCN 050407 · Rates published

1,793 distinct procedures filed
25 distinct payers
57,867 rate rows
2026-05-27 last MRF observed
Data quality

57,735 of 57,867 rate rows are consumer-grade (99.8%)

132 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
per-diem day rate — not a per-procedure price 76
exceeds 10× this hospital's gross charge — excluded from medians 43
percent-of-charges filed in the dollar field — excluded from medians 13
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbCHSANFRANCISCOCA&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/ChineseCounty_V4.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-17
Content fingerprint 577ac63710faa3a6… · 39,325,747 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
55873
HCPCS 		Destruction Of Prostate Using Imaging Guidance 24 $6,500.00 $83,124.00 $40,407.50 nat. median
$9,651
outlier · 4.2×
C1764
HCPCS 		Event Recorder, Cardiac (implantable) 18 $3,399.00 $29,957.40 $16,643.00 nat. median
$7,735
outlier · 2.2×
C1786
HCPCS 		Pacemaker, Single Chamber, Rate-responsive (implantable) 18 $3,399.00 $25,212.60 $14,007.00 nat. median
$7,842
1.8× median
C1785
HCPCS 		Pacemaker, Dual Chamber, Rate-responsive (implantable) 18 $3,399.00 $31,255.20 $13,756.47 nat. median
$6,717
outlier · 2.0×
C1762
HCPCS 		Connective Tissue, Human (includes Fascia Lata) 18 $2,164.68 $43,054.20 $10,816.99 nat. median
$2,930
outlier · 3.7×
C1874
HCPCS 		Stent, Coated/covered, With Delivery System 18 $260.90 $20,095.20 $10,047.60 nat. median
$4,814
outlier · 2.1×
L8697
HCPCS 		Femoral Component Size 5 Right Medical 19 $3,399.00 $17,199.00 $9,555.00 nat. median
$9,555
1.0× median
C1761
HCPCS 		Catheter, Transluminal Intravascular Lithotripsy, Coronary 18 $3,399.00 $16,842.60 $9,357.00 nat. median
$7,682
1.2× median
V2785
HCPCS 		Processing, Preserving And Transporting Corneal Tissue 18 $3,399.00 $16,018.20 $8,899.00 nat. median
$5,113
1.7× median
32405
HCPCS 		Biopsy, Lung Or Mediastinum, Percutaneous Needle 18 $2,356.00 $14,828.40 $8,238.00 nat. median
$1,539
outlier · 5.4×
43274
HCPCS 		Insertion Of Stent Into Pancreatic Or Bile Duct Using A Flexible Endoscope 24 $414.74 $48,463.20 $7,781.76 nat. median
$6,019
1.3× median
43276
HCPCS 		Replacement Of Stent In Pancreatic Or Bile Duct Using A Flexible Endoscope 24 $431.50 $48,463.20 $7,781.76 nat. median
$6,059
1.3× median
81443
HCPCS 		Genomic Sequence Analysis Panel For Severe Inherited Conditions With Sequencing… 23 $260.90 $13,482.00 $7,490.00 nat. median
$2,449
outlier · 3.1×
78205
HCPCS 		Liver Imaging (spect) 18 $260.90 $13,253.40 $7,363.00 nat. median
$907
outlier · 8.1×
78806
HCPCS 		Radiopharmaceutical Localization Of Inflammatory Process; Whole Body 18 $260.90 $13,253.40 $7,363.00 nat. median
$1,156
outlier · 6.4×
78607
HCPCS 		Brain Imaging, Tomographic (spect) 18 $260.90 $13,253.40 $7,363.00 nat. median
$1,064
outlier · 6.9×
78805
HCPCS 		Radiopharmaceutical Localization Of Inflammatory Process; Limited Area 18 $260.90 $13,253.40 $7,363.00 nat. median
$890
outlier · 8.3×
75559
HCPCS 		MRI Scan Of Heart Without Contrast With Stress Imaging 24 $260.90 $14,067.00 $6,838.12 nat. median
$672
outlier · 10.2×
NONE
OTHER 		Clarifix 19 $3,307.22 $12,223.80 $6,791.00 nat. median
$13
outlier · 535.1×
C1783
HCPCS 		Ocular Implant, Aqueous Drainage Assist Device 18 $2,700.24 $11,907.00 $6,615.00 nat. median
$2,321
outlier · 2.9×
C1876
HCPCS 		Stent, Non-coated/non-covered, With Delivery System 18 $1,949.16 $17,116.20 $6,112.00 nat. median
$2,542
outlier · 2.4×
70336
HCPCS 		MRI Scan Of Jaw Joint 24 $260.90 $12,502.80 $6,077.75 nat. median
$756
outlier · 8.0×
C1776
HCPCS 		Joint Device (implantable) 18 $189.40 $75,384.00 $5,670.05 nat. median
$3,390
1.7× median
43264
HCPCS 		Removal Of Stone Or Debris From Bile Or Pancreatic Duct Using A Flexible Endosco… 24 $383.84 $30,448.80 $5,601.61 nat. median
$4,047
1.4× median
43261
HCPCS 		Biopsy Of Gallbladder, Pancreatic, Liver, And Bile Ducts Using A Flexible Endosc… 24 $341.03 $30,448.80 $5,601.61 nat. median
$4,067
1.4× median
43260
HCPCS 		Diagnostic Exam Of Gallbladder And Pancreatic, Liver, And Bile Ducts Using An En… 24 $443.24 $30,448.80 $5,601.61 nat. median
$4,000
1.4× median
43262
HCPCS 		Incision Of Pancreatic Outlet Using A Flexible Endoscope 24 $370.44 $30,448.80 $5,601.61 nat. median
$4,025
1.4× median
759025_1
CDM 		Operating Room Services - General Classification 6 $3,399.00 $12,410.00 $5,522.86 nat. median
$5,523
1.0× median
77084
HCPCS 		MRI Scan Of Bone Marrow 24 $260.90 $10,940.40 $5,318.25 nat. median
$443
outlier · 12.0×
76376
HCPCS 		3d Radiographic Procedure 24 $33.03 $10,940.40 $5,318.25 nat. median
$329
outlier · 16.2×
75563
HCPCS 		MRI Scan Of Heart Before And After Contrast With Stress Imaging 24 $260.90 $10,940.40 $5,318.25 nat. median
$999
outlier · 5.3×
47532
HCPCS 		Injection Of Bile Duct For X-ray Through New Skin Access Using Imaging Guidance… 24 $749.07 $31,770.00 $5,201.95 nat. median
$3,811
1.4× median
47531
HCPCS 		Injection Of Bile Duct For X-ray Through Already Existing Skin Access Using Imag… 24 $341.03 $31,770.00 $5,176.07 nat. median
$3,320
1.6× median
C1771
HCPCS 		Repair Device, Urinary, Incontinence, With Sling Graft 18 $696.39 $11,039.40 $5,143.77 nat. median
$2,432
outlier · 2.1×
C1052
HCPCS 		Hemostatic Agent, Gastrointestinal, Topical 18 $1,665.05 $16,273.80 $5,072.00 nat. median
$3,247
1.6× median
28292
HCPCS 		Correction Of Bunion 24 $423.48 $28,279.80 $4,753.88 nat. median
$3,590
1.3× median
2860606_1
CDM 		Operating Room Services - General Classification 6 $3,399.00 $8,996.40 $4,703.19 nat. median
$2,577
1.8× median
75557
HCPCS 		MRI Scan Of Heart Without Contrast 24 $260.90 $9,376.20 $4,557.88 nat. median
$538
outlier · 8.5×
50658255_1
CDM 		Infuse Kit Components Spine Medium Kit 6 $3,399.00 $7,823.40 $4,439.06 nat. median
$4,439
1.0× median
50773919_1
CDM 		NeuroSURE(SM): Epilepsy Gene Lc 6 $260.90 $7,379.70 $4,300.73 nat. median
$4,301
1.0× median
43251
HCPCS 		Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi… 16 $2,774.10 $15,991.20 $4,297.47 nat. median
$2,129
outlier · 2.0×
2860607_1
CDM 		Operating Room Services - General Classification 6 $3,399.00 $7,281.10 $4,269.99 nat. median
$2,461
1.7× median
G0121
HCPCS 		Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For… 24 $1,344.41 $8,031.60 $4,238.90 nat. median
$1,283
outlier · 3.3×
G0105
HCPCS 		Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 24 $1,344.41 $8,031.60 $4,238.90 nat. median
$1,300
outlier · 3.3×
L8699
HCPCS 		Prosthetic Implant, Not Otherwise Specified 19 $509.89 $111,391.20 $3,988.60 nat. median
$2,008
2.0× median
50351672_1
CDM 		Infuse Kit Components Spine Small Kit 6 $3,054.97 $6,361.40 $3,983.26 nat. median
$3,983
1.0× median
990678_1
CDM 		Intensive Care Unit - Surgical 6 $2,748.37 $4,947.07 $3,517.91 nat. median
$3,380
1.0× median
V2788
HCPCS 		Presbyopia Correcting Function Of Intraocular Lens 18 $1,316.04 $6,427.80 $3,467.00 nat. median
$898
outlier · 3.9×
78320
HCPCS 		Bone And/or Joint Imaging; Tomographic (spect) 18 $260.90 $6,087.60 $3,382.00 nat. median
$788
outlier · 4.3×
990675_5
CDM 		Room & Board - Semi-private (two Beds) - General Classification 6 $2,599.21 $4,678.59 $3,326.99 nat. median
$3,327
1.0× median

Other procedures at this hospital

Browse this hospital's 1,793 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
             
55873 HCPCS Destruction Of Prostate Using Imaging Guidance 24 24 $46,180.00 $46,180.00 $6,500.00 $83,124.00 $40,407.50 2026-05-27
C1764 HCPCS Event Recorder, Cardiac (implantable) 18 18 $16,643.00 $16,643.00 $3,399.00 $29,957.40 $16,643.00 2026-05-27
C1786 HCPCS Pacemaker, Single Chamber, Rate-responsive (implantable) 18 18 $14,007.00 $14,007.00 $3,399.00 $25,212.60 $14,007.00 2026-05-27
C1785 HCPCS Pacemaker, Dual Chamber, Rate-responsive (implantable) 64 18 $16,078.00 $16,078.00 $3,399.00 $31,255.20 $13,756.47 2026-05-27
C1762 HCPCS Connective Tissue, Human (includes Fascia Lata) 84 18 $13,965.00 $13,965.00 $2,164.68 $43,054.20 $10,816.99 2026-05-27
C1874 HCPCS Stent, Coated/covered, With Delivery System 35 18 $8,738.00 $8,738.00 $260.90 $20,095.20 $10,047.60 2026-05-27
L8697 HCPCS Femoral Component Size 5 Right Medical 19 19 $9,555.00 $9,555.00 $3,399.00 $17,199.00 $9,555.00 2026-05-27
C1761 HCPCS Catheter, Transluminal Intravascular Lithotripsy, Coronary 18 18 $9,357.00 $9,357.00 $3,399.00 $16,842.60 $9,357.00 2026-05-27
V2785 HCPCS Processing, Preserving And Transporting Corneal Tissue 18 18 $8,899.00 $8,899.00 $3,399.00 $16,018.20 $8,899.00 2026-05-27
32405 HCPCS Biopsy, Lung Or Mediastinum, Percutaneous Needle 18 18 $8,238.00 $8,238.00 $2,356.00 $14,828.40 $8,238.00 2026-05-27
43276 HCPCS Replacement Of Stent In Pancreatic Or Bile Duct Using A Flexible Endoscope 24 24 $26,924.00 $26,924.00 $431.50 $48,463.20 $7,781.76 2026-05-27
43274 HCPCS Insertion Of Stent Into Pancreatic Or Bile Duct Using A Flexible Endoscope 24 24 $26,924.00 $26,924.00 $414.74 $48,463.20 $7,781.76 2026-05-27
81443 HCPCS Genomic Sequence Analysis Panel For Severe Inherited Conditions With Sequencing … 23 23 $7,490.00 $7,490.00 $260.90 $13,482.00 $7,490.00 2026-05-27
78205 HCPCS Liver Imaging (spect) 18 18 $7,363.00 $7,363.00 $260.90 $13,253.40 $7,363.00 2026-05-27
78806 HCPCS Radiopharmaceutical Localization Of Inflammatory Process; Whole Body 18 18 $7,363.00 $7,363.00 $260.90 $13,253.40 $7,363.00 2026-05-27
78805 HCPCS Radiopharmaceutical Localization Of Inflammatory Process; Limited Area 18 18 $7,363.00 $7,363.00 $260.90 $13,253.40 $7,363.00 2026-05-27
78607 HCPCS Brain Imaging, Tomographic (spect) 18 18 $7,363.00 $7,363.00 $260.90 $13,253.40 $7,363.00 2026-05-27
75559 HCPCS MRI Scan Of Heart Without Contrast With Stress Imaging 24 24 $7,815.00 $7,815.00 $260.90 $14,067.00 $6,838.12 2026-05-27
NONE OTHER Clarifix 19 19 $6,791.00 $6,791.00 $3,307.22 $12,223.80 $6,791.00 2026-05-27
C1783 HCPCS Ocular Implant, Aqueous Drainage Assist Device 18 18 $6,615.00 $6,615.00 $2,700.24 $11,907.00 $6,615.00 2026-05-27
C1876 HCPCS Stent, Non-coated/non-covered, With Delivery System 36 18 $7,142.00 $7,142.00 $1,949.16 $17,116.20 $6,112.00 2026-05-27
70336 HCPCS MRI Scan Of Jaw Joint 24 24 $6,946.00 $6,946.00 $260.90 $12,502.80 $6,077.75 2026-05-27
C1776 HCPCS Joint Device (implantable) 1,558 18 $5,817.00 $5,817.00 $189.40 $75,384.00 $5,670.05 2026-05-27
43264 HCPCS Removal Of Stone Or Debris From Bile Or Pancreatic Duct Using A Flexible Endosco… 24 24 $16,916.00 $16,916.00 $383.84 $30,448.80 $5,601.61 2026-05-27
43262 HCPCS Incision Of Pancreatic Outlet Using A Flexible Endoscope 24 24 $16,916.00 $16,916.00 $370.44 $30,448.80 $5,601.61 2026-05-27
43260 HCPCS Diagnostic Exam Of Gallbladder And Pancreatic, Liver, And Bile Ducts Using An En… 24 24 $16,916.00 $16,916.00 $443.24 $30,448.80 $5,601.61 2026-05-27
43261 HCPCS Biopsy Of Gallbladder, Pancreatic, Liver, And Bile Ducts Using A Flexible Endosc… 24 24 $16,916.00 $16,916.00 $341.03 $30,448.80 $5,601.61 2026-05-27
759025_1 CDM Operating Room Services - General Classification 6 6 $14,600.00 $14,600.00 $3,399.00 $12,410.00 $5,522.86 2026-05-27
76376 HCPCS 3d Radiographic Procedure 24 24 $6,078.00 $6,078.00 $33.03 $10,940.40 $5,318.25 2026-05-27
77084 HCPCS MRI Scan Of Bone Marrow 24 24 $6,078.00 $6,078.00 $260.90 $10,940.40 $5,318.25 2026-05-27
75563 HCPCS MRI Scan Of Heart Before And After Contrast With Stress Imaging 24 24 $6,078.00 $6,078.00 $260.90 $10,940.40 $5,318.25 2026-05-27
47532 HCPCS Injection Of Bile Duct For X-ray Through New Skin Access Using Imaging Guidance … 24 24 $17,650.00 $17,650.00 $749.07 $31,770.00 $5,201.95 2026-05-27
47531 HCPCS Injection Of Bile Duct For X-ray Through Already Existing Skin Access Using Imag… 24 24 $17,650.00 $17,650.00 $341.03 $31,770.00 $5,176.07 2026-05-27
C1771 HCPCS Repair Device, Urinary, Incontinence, With Sling Graft 72 18 $5,690.00 $5,690.00 $696.39 $11,039.40 $5,143.77 2026-05-27
C1052 HCPCS Hemostatic Agent, Gastrointestinal, Topical 54 18 $5,072.00 $5,072.00 $1,665.05 $16,273.80 $5,072.00 2026-05-27
28292 HCPCS Correction Of Bunion 24 24 $15,711.00 $15,711.00 $423.48 $28,279.80 $4,753.88 2026-05-27
2860606_1 CDM Operating Room Services - General Classification 6 6 $10,584.00 $10,584.00 $3,399.00 $8,996.40 $4,703.19 2026-05-27
75557 HCPCS MRI Scan Of Heart Without Contrast 24 24 $5,209.00 $5,209.00 $260.90 $9,376.20 $4,557.88 2026-05-27
50658255_1 CDM Infuse Kit Components Spine Medium Kit 6 6 $9,204.00 $9,204.00 $3,399.00 $7,823.40 $4,439.06 2026-05-27
50773919_1 CDM NeuroSURE(SM): Epilepsy Gene Lc 6 6 $8,682.00 $8,682.00 $260.90 $7,379.70 $4,300.73 2026-05-27
43251 HCPCS Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi… 16 16 $8,884.00 $8,884.00 $2,774.10 $15,991.20 $4,297.47 2026-05-27
2860607_1 CDM Operating Room Services - General Classification 6 6 $8,566.00 $8,566.00 $3,399.00 $7,281.10 $4,269.99 2026-05-27
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 24 24 $4,462.00 $4,462.00 $1,344.41 $8,031.60 $4,238.90 2026-05-27
G0105 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 24 24 $4,462.00 $4,462.00 $1,344.41 $8,031.60 $4,238.90 2026-05-27
L8699 HCPCS Prosthetic Implant, Not Otherwise Specified 151 19 $3,437.00 $3,437.00 $509.89 $111,391.20 $3,988.60 2026-05-27
50351672_1 CDM Infuse Kit Components Spine Small Kit 6 6 $7,484.00 $7,484.00 $3,054.97 $6,361.40 $3,983.26 2026-05-27
990678_1 CDM Intensive Care Unit - Surgical 6 6 $10,466.00 $10,466.00 $2,748.37 $4,947.07 $3,517.91 2026-05-27
V2788 HCPCS Presbyopia Correcting Function Of Intraocular Lens 54 18 $3,467.00 $3,467.00 $1,316.04 $6,427.80 $3,467.00 2026-05-27
78320 HCPCS Bone And/or Joint Imaging; Tomographic (spect) 18 18 $3,382.00 $3,382.00 $260.90 $6,087.60 $3,382.00 2026-05-27
990674_5 CDM Intensive Care Unit - General Classification 6 6 $9,898.00 $9,898.00 $2,599.21 $4,678.59 $3,326.99 2026-05-27
990675_5 CDM Room & Board - Semi-private (two Beds) - General Classification 6 6 $9,898.00 $9,898.00 $2,599.21 $4,678.59 $3,326.99 2026-05-27
50411180_1 CDM Infuse Kit Components Spine Xsmall Kit 6 6 $6,158.00 $6,158.00 $2,513.70 $5,234.30 $3,325.32 2026-05-27
2860605_1 CDM Operating Room Services - General Classification 6 6 $6,062.00 $6,062.00 $2,474.51 $5,152.70 $3,273.48 2026-05-27
50701687_1 CDM Xen45 Gel Stent 6 6 $5,933.00 $5,933.00 $2,421.85 $5,043.05 $3,203.82 2026-05-27
C1782 HCPCS Morcellator 54 18 $3,100.00 $3,100.00 $1,140.92 $5,857.20 $3,100.00 2026-05-27
78710 HCPCS Kidney Imaging Morphology; Tomographic (spect) 18 18 $3,071.00 $3,071.00 $260.90 $5,527.80 $3,071.00 2026-05-27
78803 HCPCS Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day … 24 24 $3,486.00 $3,486.00 $260.90 $6,274.80 $3,050.25 2026-05-27
50432 HCPCS Placement Of Tube Of Kidney Using Imaging Guidance With Review By Radiologist 24 24 $10,419.00 $10,419.00 $773.64 $18,754.20 $3,037.11 2026-05-27
54001 HCPCS Incision Of Foreskin 24 24 $6,343.00 $6,343.00 $135.52 $11,417.40 $3,035.50 2026-05-27
50435 HCPCS Replacement Of Kidney Drainage Tube Using Imaging Guidance With Review By Radiol… 24 24 $10,419.00 $10,419.00 $434.47 $18,754.20 $3,022.00 2026-05-27
15240 HCPCS Full Thickness Skin Graft To Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Gen… 24 24 $6,073.00 $6,073.00 $483.82 $10,931.40 $2,997.74 2026-05-27
15760 HCPCS Graft With Closure Of Wound 24 24 $6,073.00 $6,073.00 $605.06 $10,931.40 $2,997.74 2026-05-27
52499137_1 CDM Strand Plus 6 6 $5,546.00 $5,546.00 $2,263.88 $4,714.10 $2,994.84 2026-05-27
C1889 HCPCS Implantable/insertable Device, Not Otherwise Classified 36 18 $6,664.50 $6,664.50 $573.52 $21,463.20 $2,964.00 2026-05-27
990677_1 CDM Coronary Care Unit - Intermediate Ccu 6 6 $8,722.00 $8,722.00 $2,290.40 $4,122.72 $2,931.71 2026-05-27
990675_6 CDM Room & Board - Semi-private (two Beds) - General Classification 6 6 $8,722.00 $8,722.00 $2,290.40 $4,122.72 $2,931.71 2026-05-27
990674_6 CDM Intensive Care Unit - Other Intensive Care 6 6 $8,722.00 $8,722.00 $2,290.40 $4,122.72 $2,931.71 2026-05-27
43246 HCPCS Insertion Of Stomach Tube Using A Flexible Endoscope 24 24 $8,884.00 $8,884.00 $242.00 $15,991.20 $2,926.68 2026-05-27
44378 HCPCS Control Of Bleeding Of Small Bowel Using An Endoscope 24 24 $9,104.00 $9,104.00 $348.10 $16,387.20 $2,926.68 2026-05-27
43255 HCPCS Control Of Bleeding Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flex… 24 24 $8,884.00 $8,884.00 $412.81 $15,991.20 $2,926.68 2026-05-27
43249 HCPCS Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl… 24 24 $9,768.00 $9,768.00 $319.89 $17,582.40 $2,926.68 2026-05-27
43275 HCPCS Removal Of Stent From Pancreatic Or Bile Duct Using A Flexible Endoscope 24 24 $16,916.00 $16,916.00 $342.14 $30,448.80 $2,926.68 2026-05-27
43244 HCPCS Tying Of Dilated Veins Of Stomach And/or Esophagus Using A Flexible Endoscope 24 24 $8,884.00 $8,884.00 $214.82 $15,991.20 $2,926.68 2026-05-27
43227 HCPCS Control Of Bleeding In Esophagus Using A Flexible Endoscope 24 24 $9,104.00 $9,104.00 $172.37 $16,387.20 $2,926.68 2026-05-27
44366 HCPCS Control Of Bleeding Of First Or Second Part Of Small Bowel Using An Endoscope 24 24 $9,104.00 $9,104.00 $234.92 $16,387.20 $2,926.68 2026-05-27
L0486 HCPCS Tlso, Triplanar Control, Two Piece Rigid Plastic Shell With Interface Liner, Mul… 25 25 $7,431.00 $7,431.00 $1,942.31 $13,375.80 $2,786.51 2026-05-27
43215 HCPCS Removal Of Foreign Bodies In Esophagus Using A Flexible Endoscope 24 24 $8,884.00 $8,884.00 $223.38 $15,991.20 $2,774.10 2026-05-27
C1768 HCPCS Graft, Vascular 72 18 $2,808.50 $2,808.50 $944.57 $6,006.60 $2,763.22 2026-05-27
31625 HCPCS Biopsy Of Lung Airway Using An Endoscope 24 24 $8,200.00 $8,200.00 $201.41 $14,760.00 $2,714.66 2026-05-27
0018U OTHER MicroRNA Gene Analysis Of Thyroid Nodule Tissue 41 24 $4,741.00 $4,741.00 $260.90 $8,533.80 $2,707.11 2026-05-27
74330 HCPCS Review By Radiologist Of Image From Tube Placement Into Bile And Pancreatic Duct… 18 18 $2,704.00 $2,704.00 $260.90 $4,867.20 $2,704.00 2026-05-27
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 31 24 $7,363.00 $7,363.00 $260.90 $13,253.40 $2,622.09 2026-05-27
51163935_1 CDM Omni Suregical System 6 6 $4,845.00 $4,845.00 $1,977.73 $4,118.25 $2,616.30 2026-05-27
2860604_1 CDM Operating Room Services - General Classification 6 6 $4,839.00 $4,839.00 $1,975.28 $4,113.15 $2,613.06 2026-05-27
C1747 HCPCS Endoscope, Single-use (i.e. Disposable), Urinary Tract, Imaging/illumination Dev… 18 18 $2,609.00 $2,609.00 $1,064.99 $4,696.20 $2,609.00 2026-05-27
31622 HCPCS Diagnostic Exam Of Lung Airway Using An Endoscope 24 24 $8,200.00 $8,200.00 $164.93 $14,760.00 $2,586.01 2026-05-27
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 24 24 $8,238.00 $8,238.00 $613.92 $14,828.40 $2,518.98 2026-05-27
49590105_1 CDM Operating Room Services - General Classification 6 6 $4,631.00 $4,631.00 $1,890.37 $3,936.35 $2,500.74 2026-05-27
990674_1 CDM Room & Board - Private (one Bed) - General Classification 6 6 $7,424.00 $7,424.00 $1,949.54 $3,509.18 $2,495.41 2026-05-27
52483385_1 CDM Multiaxial Cross Connector 6 6 $4,594.00 $4,594.00 $1,875.27 $3,904.90 $2,480.76 2026-05-27
27825 HCPCS Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint With Manipula… 24 24 $4,951.00 $4,951.00 $473.68 $8,911.80 $2,452.47 2026-05-27
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 24 24 $4,951.00 $4,951.00 $271.41 $8,911.80 $2,452.47 2026-05-27
26418 HCPCS Repair Of Tendon On Top Side Of Finger 24 24 $4,951.00 $4,951.00 $420.28 $8,911.80 $2,452.47 2026-05-27
26410 HCPCS Repair Of Tendon On Top Of Hand 24 24 $4,951.00 $4,951.00 $428.28 $8,911.80 $2,452.47 2026-05-27
V2790 HCPCS Amniotic Membrane For Surgical Reconstruction, Per Procedure 36 18 $2,531.00 $2,531.00 $991.11 $4,741.20 $2,428.00 2026-05-27
50200 HCPCS Needle Biopsy Of Kidney 24 24 $8,238.00 $8,238.00 $70.74 $14,828.40 $2,396.53 2026-05-27
38505 HCPCS Needle Biopsy Or Removal Of Surface Lymph Nodes 24 24 $8,238.00 $8,238.00 $70.74 $14,828.40 $2,396.53 2026-05-27
32400 HCPCS Needle Biopsy Of Lining Of Lung 24 24 $8,238.00 $8,238.00 $134.03 $14,828.40 $2,396.53 2026-05-27
49180 HCPCS Needle Biopsy Of Growth Of Abdominal Cavity 24 24 $8,238.00 $8,238.00 $249.81 $14,828.40 $2,396.53 2026-05-27
47000 HCPCS Needle Biopsy Of Liver Through Skin 24 24 $8,238.00 $8,238.00 $168.28 $14,828.40 $2,396.53 2026-05-27
27040 HCPCS Biopsy Of Surface Tissue Of Pelvis And Hip 24 24 $5,714.00 $5,714.00 $136.63 $10,285.20 $2,396.53 2026-05-27
48102 HCPCS Needle Biopsy Of Pancreas 24 24 $8,238.00 $8,238.00 $378.63 $14,828.40 $2,396.53 2026-05-27
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 24 24 $5,002.00 $5,002.00 $71.56 $9,003.60 $2,396.53 2026-05-27
19281 HCPCS Placement Of Locating Device In Breast Using Imaging Guidance, First Growth 24 24 $3,470.00 $3,470.00 $215.93 $6,264.00 $2,387.66 2026-05-27
38221 HCPCS Biopsy Of Bone Marrow 24 24 $8,238.00 $8,238.00 $195.83 $14,828.40 $2,387.66 2026-05-27
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 31 24 $6,310.00 $6,310.00 $224.12 $12,677.40 $2,356.00 2026-05-27
32557 HCPCS Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube Using Imag… 24 24 $5,158.00 $5,158.00 $101.27 $9,284.40 $2,351.93 2026-05-27
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 24 24 $4,951.00 $4,951.00 $146.69 $8,911.80 $2,351.93 2026-05-27
24655 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation 24 24 $4,951.00 $4,951.00 $331.63 $8,911.80 $2,351.93 2026-05-27
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 24 24 $5,574.00 $5,574.00 $363.34 $10,033.20 $2,327.23 2026-05-27
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 24 24 $5,574.00 $5,574.00 $57.52 $10,033.20 $2,327.23 2026-05-27
81408 HCPCS Molecular Pathology Procedure Level 9 Genetic Analysis 34 23 $2,467.00 $2,467.00 $260.90 $4,440.60 $2,309.65 2026-05-27
75820 HCPCS Review By Radiologist Of 1 Arm Or Leg Vein Of 1 Arm Or Leg Image 24 24 $5,306.00 $5,306.00 $87.67 $9,550.80 $2,275.71 2026-05-27
990675_1 CDM Room & Board - Semi-private (two Beds) - General Classification 6 6 $6,730.00 $6,730.00 $1,767.30 $3,181.14 $2,262.15 2026-05-27
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 40 23 $8,451.00 $8,451.00 $260.90 $15,211.80 $2,189.00 2026-05-27
36430 HCPCS Transfusion Of Blood Or Blood Products 24 24 $2,293.00 $2,293.00 $637.79 $4,127.40 $2,178.35 2026-05-27
2860603_1 CDM Operating Room Services - General Classification 6 6 $3,786.00 $3,786.00 $1,545.45 $3,218.10 $2,044.44 2026-05-27
V2787 HCPCS Astigmatism Correcting Function Of Intraocular Lens 90 18 $2,078.00 $2,078.00 $703.74 $3,927.60 $2,020.90 2026-05-27
74245 HCPCS Radiologic Examination, Gastrointestinal Tract, Upper; With Small Intestine, Inc… 18 18 $1,961.00 $1,961.00 $260.90 $3,529.80 $1,961.00 2026-05-27
73219 HCPCS MRI Scan Of Arm With Contrast 37 24 $12,155.00 $12,155.00 $260.90 $21,879.00 $1,956.40 2026-05-27
C1765 HCPCS Adhesion Barrier 18 18 $1,955.00 $1,955.00 $798.03 $3,519.00 $1,955.00 2026-05-27
74360 HCPCS Review By Radiologist Of Image To Guide Opening Of Digestive Tract 18 18 $1,947.00 $1,947.00 $260.90 $3,504.60 $1,947.00 2026-05-27
C1788 HCPCS Port, Indwelling (implantable) 18 18 $1,927.00 $1,927.00 $786.60 $3,468.60 $1,927.00 2026-05-27
L0464 HCPCS Tlso, Triplanar Control, Modular Segmented Spinal System, Four Rigid Plastic She… 25 25 $4,590.00 $4,590.00 $1,340.27 $8,262.00 $1,922.81 2026-05-27
78454 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress With Single 2d … 24 24 $7,363.00 $7,363.00 $241.42 $13,253.40 $1,880.99 2026-05-27
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 24 24 $7,363.00 $7,363.00 $260.90 $13,253.40 $1,880.99 2026-05-27
78075 HCPCS Nuclear Medicine Study Of Adrenal Glands 24 24 $7,363.00 $7,363.00 $260.90 $13,253.40 $1,880.99 2026-05-27
78110 HCPCS Nuclear Medicine Study Of Plasma Volume, 1 Sampling 24 24 $7,363.00 $7,363.00 $49.64 $13,253.40 $1,871.63 2026-05-27
78453 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress With Single 2d Im… 24 24 $7,363.00 $7,363.00 $253.32 $13,253.40 $1,871.63 2026-05-27
49555230_1 CDM Operating Room Services - General Classification 6 6 $3,408.00 $3,408.00 $1,391.15 $2,896.80 $1,840.32 2026-05-27
90381 HCPCS Respiratory Syncytial Virus Antibody, 1.0 Ml Dosage For Injection Into Muscle 18 18 $1,829.00 $1,829.00 $746.60 $3,292.20 $1,829.00 2026-05-27
45386 HCPCS Balloon Dilation Of Large Bowel Using A Flexible Endoscope 24 24 $7,695.00 $7,695.00 $797.47 $13,851.00 $1,825.10 2026-05-27
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 24 24 $6,310.00 $6,310.00 $400.22 $11,358.00 $1,825.10 2026-05-27
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 24 24 $6,310.00 $6,310.00 $374.91 $11,358.00 $1,825.10 2026-05-27
45382 HCPCS Control Of Bleeding Of Upper Large Bowel Using A Flexible Endoscope 24 24 $7,695.00 $7,695.00 $415.49 $13,851.00 $1,825.10 2026-05-27
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 24 24 $7,695.00 $7,695.00 $330.23 $13,851.00 $1,825.10 2026-05-27
45338 HCPCS Removal Of Polyps Or Growths Of Lower Large Bowel Using A Flexible Endoscope Wit… 24 24 $7,695.00 $7,695.00 $143.34 $13,851.00 $1,825.10 2026-05-27
45334 HCPCS Control Of Bleeding Of Lower Large Bowel Using A Flexible Endoscope 24 24 $7,695.00 $7,695.00 $123.23 $13,851.00 $1,825.10 2026-05-27
45332 HCPCS Removal Of Foreign Bodies In Lower Portion Of Large Bowel Using A Flexible Endos… 24 24 $7,695.00 $7,695.00 $93.82 $13,851.00 $1,825.10 2026-05-27
44391 HCPCS Control Of Bleeding Of Large Bowel Using An Endoscope Inserted Through Surgicall… 24 24 $5,689.00 $5,689.00 $231.57 $10,240.20 $1,825.10 2026-05-27
45340 HCPCS Balloon Dilation Of Lower Large Bowel Using A Flexible Endoscope 24 24 $7,695.00 $7,695.00 $355.63 $13,851.00 $1,825.10 2026-05-27
73701 HCPCS CT Scan Of Leg With Contrast Material 38 24 $5,075.00 $5,075.00 $253.57 $9,135.00 $1,811.71 2026-05-27
49756120_1 CDM Inflatable Bone Tamp 6 6 $3,342.00 $3,342.00 $1,364.20 $2,840.70 $1,804.68 2026-05-27
49764861_1 CDM Acrysof Iq Restor 11.5 6 6 $3,239.00 $3,239.00 $1,322.16 $2,753.15 $1,749.06 2026-05-27
49804973_1 CDM Acrysof Iq Restor Multifocal Iol 20.0 6 6 $3,239.00 $3,239.00 $1,322.16 $2,753.15 $1,749.06 2026-05-27
49764860_1 CDM Acrysof Iq Restor 11.0 6 6 $3,239.00 $3,239.00 $1,322.16 $2,753.15 $1,749.06 2026-05-27
L0650 HCPCS Lumbar-sacral Orthosis, Sagittal-coronal Control, With Rigid Anterior And Poster… 25 25 $4,224.00 $4,224.00 $395.76 $7,603.20 $1,725.06 2026-05-27
L0456 HCPCS Tlso, Flexible, Provides Trunk Support, Thoracic Region, Rigid Posterior Panel A… 35 25 $3,070.00 $3,070.00 $896.80 $6,298.20 $1,704.01 2026-05-27
52499149_1 CDM Xtab Cannulated Fenestrated Polyaxial Screw 7.5mm X 40mm 6 6 $3,150.00 $3,150.00 $1,285.83 $2,677.50 $1,701.00 2026-05-27
99291 HCPCS Critical Care, First 30-74 Minutes 33 24 $4,471.00 $4,471.00 $174.42 $8,047.80 $1,672.99 2026-05-27
73722 HCPCS MRI Scan Of Leg Joint With Contrast 31 24 $10,419.00 $10,419.00 $260.90 $18,754.20 $1,587.69 2026-05-27
L0637 HCPCS Lumbar-sacral Orthosis, Sagittal-coronal Control, With Rigid Anterior And Poster… 25 25 $4,224.00 $4,224.00 $1,090.88 $7,603.20 $1,565.04 2026-05-27
50392432_1 CDM Propel Mini Mometasone Furoate Implant 16mm 6 6 $2,880.00 $2,880.00 $1,175.62 $2,448.00 $1,555.20 2026-05-27
48393074_1 CDM Operating Room Services - General Classification 6 6 $2,847.00 $2,847.00 $1,162.15 $2,419.95 $1,537.38 2026-05-27
90389 HCPCS Tetanus Immune Globulin For Injection Into Muscle 18 18 $1,525.00 $1,525.00 $622.51 $2,745.00 $1,525.00 2026-05-27
50179502_8 CDM Rev - Ihs-moa Clinic Visit 6 6 $2,778.00 $2,778.00 $1,133.98 $2,361.30 $1,500.12 2026-05-27
49738199_1 CDM Curved Needle Kit 6 6 $2,776.00 $2,776.00 $1,133.16 $2,359.60 $1,499.04 2026-05-27
74300 HCPCS Review By Radiologist Of Bile And/or Pancreatic Duct Image During Surgery 18 18 $1,492.00 $1,492.00 $229.04 $2,685.60 $1,492.00 2026-05-27
C1898 HCPCS Lead, Pacemaker, Other Than Transvenous Vdd Single Pass 72 18 $1,447.00 $1,447.00 $557.19 $4,658.40 $1,491.38 2026-05-27
758757_1 CDM Operating Room Services - General Classification 6 6 $2,723.70 $2,723.70 $1,111.81 $2,315.15 $1,470.80 2026-05-27
92310 HCPCS Contact Lens Services Both Eyes 36 18 $1,444.00 $1,444.00 $493.11 $3,024.00 $1,456.92 2026-05-27
C1726 HCPCS Catheter, Balloon Dilatation, Non-vascular 195 18 $1,365.00 $1,365.00 $274.31 $47,817.00 $1,449.00 2026-05-27
C1781 HCPCS Mesh (implantable) 180 18 $1,439.00 $1,439.00 $424.53 $4,579.20 $1,432.81 2026-05-27
46050 HCPCS Drainage Of Superficial Rectal Abscess Surrounding Anus 24 24 $2,872.00 $2,872.00 $79.67 $5,169.60 $1,418.35 2026-05-27
45900 HCPCS Manual Replacement Of Prolapsed Rectum Under Anesthesia 24 24 $2,872.00 $2,872.00 $45.79 $5,169.60 $1,418.35 2026-05-27
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 24 24 $5,215.00 $5,215.00 $295.23 $9,387.00 $1,418.35 2026-05-27
45337 HCPCS Decompression Of Twisted Or Abnormally Dilated Lower Large Bowel Using A Flexibl… 24 24 $7,695.00 $7,695.00 $124.72 $13,851.00 $1,418.35 2026-05-27
45333 HCPCS Removal Of Polyps Or Growths Of Lower Large Bowel Using A Flexible Endoscope Wit… 24 24 $7,695.00 $7,695.00 $106.11 $13,851.00 $1,418.35 2026-05-27
45331 HCPCS Biopsy Of Lower Large Bowel Using A Flexible Endoscope 24 24 $7,695.00 $7,695.00 $72.23 $13,851.00 $1,418.35 2026-05-27
45330 HCPCS Diagnostic Exam Of Lower Portion Of Large Bowel Using A Flexible Endoscope 24 24 $7,695.00 $7,695.00 $54.73 $13,851.00 $1,418.35 2026-05-27
L0457 HCPCS Tlso, Flexible, Provides Trunk Support, Thoracic Region, Rigid Posterior Panel A… 25 25 $3,495.00 $3,495.00 $331.31 $6,291.00 $1,418.11 2026-05-27
73222 HCPCS MRI Scan Of Arm Joint With Contrast 30 24 $12,155.00 $12,155.00 $260.90 $21,879.00 $1,417.15 2026-05-27
49309230_1 CDM Acrysof Iq Restor Multifocal Iol 16.0 6 6 $2,591.00 $2,591.00 $1,057.65 $2,202.35 $1,399.14 2026-05-27
0245U OTHER Gene Analysis Of 10 Genes And 37 RNA Fusions And Expression Of 4 Mrna Markers, N… 24 24 $2,508.00 $2,508.00 $260.90 $4,514.40 $1,392.68 2026-05-27
C1713 HCPCS Anchor/screw For Opposing Bone-to-bone Or Soft Tissue-to-bone (implantable) 3,632 18 $1,366.00 $1,366.00 $48.58 $29,883.60 $1,390.00 2026-05-27
49083 HCPCS Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance 24 24 $4,561.00 $4,561.00 $89.85 $8,209.80 $1,383.32 2026-05-27
43247 HCPCS Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using … 24 24 $7,043.00 $7,043.00 $366.35 $12,677.40 $1,383.32 2026-05-27
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 24 24 $7,043.00 $7,043.00 $234.18 $12,677.40 $1,383.32 2026-05-27
50179501_8 CDM Rev - Ihs-moa Clinic Visit 6 6 $2,547.00 $2,547.00 $1,039.69 $2,164.95 $1,375.38 2026-05-27
49082 HCPCS Drainage Of Fluid From Abdominal Cavity 24 24 $4,561.00 $4,561.00 $58.57 $8,209.80 $1,317.76 2026-05-27
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 30 24 $12,155.00 $12,155.00 $260.90 $21,879.00 $1,315.49 2026-05-27
76942 HCPCS Ultrasonic Guidance For Needle Placement 50 24 $3,417.00 $3,417.00 $76.77 $12,490.20 $1,312.74 2026-05-27
10790828_1 CDM Operating Room Services - Minor Surgery 6 6 $2,431.00 $2,431.00 $992.33 $2,066.35 $1,312.74 2026-05-27
51562948_1 CDM Leave Of Absence - General Classification 6 6 $3,859.00 $3,859.00 $1,013.37 $1,824.07 $1,297.12 2026-05-27
51562952_1 CDM Leave Of Absence - Nursing Home (for Hospitalization) 6 6 $3,859.00 $3,859.00 $1,013.37 $1,824.07 $1,297.12 2026-05-27
51562955_1 CDM All Inclusive Rate - All-inclusive Room And Board 6 6 $3,859.00 $3,859.00 $1,013.37 $1,824.07 $1,297.12 2026-05-27
51562945_1 CDM Leave Of Absence - Nursing Home (for Hospitalization) 6 6 $3,859.00 $3,859.00 $1,013.37 $1,824.07 $1,297.12 2026-05-27
74247 HCPCS Radiological Examination, Gastrointestinal Tract, Upper, Air Contrast, With Spec… 18 18 $1,276.00 $1,276.00 $260.90 $2,296.80 $1,276.00 2026-05-27
49877329_1 CDM Acrysof Iq Toric Astigmatism I.ol. 22.0 6 6 $2,328.00 $2,328.00 $950.29 $1,978.80 $1,257.12 2026-05-27
49877328_1 CDM Acrysof Iq Toric Astigmatism I.ol. 21.5 6 6 $2,328.00 $2,328.00 $950.29 $1,978.80 $1,257.12 2026-05-27
49804969_1 CDM Acrysof Iq Toric Astigmatism Iol 29.5 6 6 $2,328.00 $2,328.00 $950.29 $1,978.80 $1,257.12 2026-05-27
73719 HCPCS MRI Scan Of Leg With Contrast 31 24 $10,419.00 $10,419.00 $260.90 $18,754.20 $1,234.93 2026-05-27
50695732_1 CDM Spyglass Spybite Max Forceps 6 6 $2,241.00 $2,241.00 $914.78 $1,904.85 $1,210.14 2026-05-27
50695733_1 CDM Spyglass Retrieval Basket 6 6 $2,218.00 $2,218.00 $905.39 $1,885.30 $1,197.72 2026-05-27
88309 HCPCS Pathology Examination Of Tissue Using A Microscope, High Complexity 24 24 $3,343.00 $3,343.00 $260.90 $6,017.40 $1,164.75 2026-05-27
88333 HCPCS Pathology Cytologic Examination Of Specimen During Surgery, Initial Site 24 24 $3,343.00 $3,343.00 $180.95 $6,017.40 $1,164.75 2026-05-27
76818 HCPCS Ultrasound And Monitoring Of Heart Of Fetus 24 24 $1,313.00 $1,313.00 $151.14 $2,363.40 $1,148.88 2026-05-27
71551 HCPCS MRI Scan Of Chest With Contrast 24 24 $6,078.00 $6,078.00 $260.90 $10,940.40 $1,138.95 2026-05-27
50619490_1 CDM Room & Board - Other - Other 6 6 $3,365.00 $3,365.00 $883.65 $1,590.57 $1,131.07 2026-05-27
32408 HCPCS Core Needle Biopsy Of Lung Or Center Cavity Of Chest (mediastinum), Accessed Thr… 40 24 $8,238.00 $8,238.00 $73.67 $14,828.40 $1,124.64 2026-05-27
74340 HCPCS Review By Radiologist Of Placement Of Long Small Bowel Tube 18 18 $1,120.00 $1,120.00 $260.90 $2,016.00 $1,120.00 2026-05-27
76498 HCPCS Other MRI Scan 16 16 $6,946.00 $6,946.00 $125.81 $12,502.80 $1,108.65 2026-05-27
52494161_1 CDM Perla Tl 05.5 X L35 Cortical Bone Screw 6 6 $2,048.00 $2,048.00 $835.99 $1,740.80 $1,105.92 2026-05-27
73718 HCPCS MRI Scan Of Leg Without Contrast 31 24 $10,419.00 $10,419.00 $260.90 $18,754.20 $1,103.18 2026-05-27
78645 HCPCS Nuclear Medicine Study Of Cerebrospinal Fluid Flow To Evaluate Shunt 31 24 $5,026.00 $5,026.00 $214.24 $9,046.80 $1,099.70 2026-05-27
C1601 HCPCS Endoscope, Single-use (i.e. Disposable), Pulmonary, Imaging/illumination Device … 17 17 $1,099.00 $1,099.00 $535.21 $1,978.20 $1,099.00 2026-05-27
L8607 HCPCS Injectable Bulking Agent For Vocal Cord Medialization, 0.1 Ml, Includes Shipping… 35 25 $2,704.00 $2,704.00 $45.87 $4,867.20 $1,084.05 2026-05-27
50390 HCPCS Aspiration And/or Injection Of Cyst Of Kidney 24 24 $5,714.00 $5,714.00 $70.74 $10,285.20 $1,080.03 2026-05-27
11976 HCPCS Removal Of Implantable Contraceptive Capsules 24 24 $3,470.00 $3,470.00 $99.67 $6,246.00 $1,080.03 2026-05-27
11106 HCPCS Incision Biopsy, First Skin Growth 31 24 $1,881.00 $1,881.00 $194.92 $3,385.80 $1,079.13 2026-05-27
52696304_1 CDM 4.3mm Drill Bit Length 413mm 6 6 $1,992.00 $1,992.00 $813.13 $1,693.20 $1,075.68 2026-05-27
90935 HCPCS Hemodialysis Procedure With Physician Evaluation 24 24 $3,664.00 $3,664.00 $81.19 $6,595.20 $1,046.76 2026-05-27
74710 HCPCS Pelvimetry, With Or Without Placental Localization 18 18 $1,046.00 $1,046.00 $159.55 $1,882.80 $1,046.00 2026-05-27
10080 HCPCS Simple Drainage Of Cyst Of Tailbone 24 24 $2,276.00 $2,276.00 $55.10 $4,096.80 $1,028.84 2026-05-27
60100 HCPCS Needle Biopsy Of Thyroid Through Skin 24 24 $3,470.00 $3,470.00 $53.24 $6,246.00 $1,028.84 2026-05-27
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 24 24 $6,946.00 $6,946.00 $260.90 $12,502.80 $1,012.13 2026-05-27
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 31 24 $10,419.00 $10,419.00 $260.90 $18,754.20 $1,008.19 2026-05-27
73720 HCPCS MRI Scan Of Leg Before And After Contrast 31 24 $13,892.00 $13,892.00 $260.90 $25,005.60 $1,008.19 2026-05-27
73220 HCPCS MRI Scan Of Arm Before And After Contrast 31 24 $13,892.00 $13,892.00 $260.90 $25,005.60 $1,008.19 2026-05-27
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 24 24 $6,946.00 $6,946.00 $260.90 $12,502.80 $1,007.92 2026-05-27
51402515_1 CDM Spine Avaflex Curved Needle 6 6 $1,865.00 $1,865.00 $761.29 $1,585.25 $1,007.10 2026-05-27
49971086_1 CDM Acrysof Iq Toric Astigmatism I.o.l. 14.5 6 6 $1,862.00 $1,862.00 $760.07 $1,582.70 $1,005.48 2026-05-27
50695731_1 CDM Autolith Electrohydraulic Lithotrispy Probe 6 6 $1,862.00 $1,862.00 $760.07 $1,582.70 $1,005.48 2026-05-27
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 25 25 $2,773.00 $2,773.00 $511.59 $4,991.40 $1,003.14 2026-05-27
C1751 HCPCS Catheter, Infusion, Inserted Peripherally, Centrally Or Midline (other Than Hemo… 108 18 $1,044.50 $1,044.50 $305.33 $2,361.60 $994.00 2026-05-27
49555206_1 CDM Complex Medical Procedure TechFee 6 6 $1,924.00 $1,924.00 $698.41 $1,635.40 $990.86 2026-05-27
C2625 HCPCS Stent, Non-coronary, Temporary, With Delivery System 126 18 $974.00 $974.00 $290.23 $17,094.60 $988.76 2026-05-27
90651 HCPCS Human Papillomavirus Vaccine Types 6, 11, 16, 18, 31, 33, 45, 52, 58, Nonavalent 18 18 $987.00 $987.00 $402.89 $1,776.60 $987.00 2026-05-27
758755_1 CDM Mac 6 6 $1,814.00 $1,814.00 $740.47 $1,541.90 $979.56 2026-05-27
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 30 24 $13,892.00 $13,892.00 $260.90 $25,005.60 $978.40 2026-05-27
49976051_1 CDM Curved Needle Bone Filler 6 6 $1,803.00 $1,803.00 $735.98 $1,532.55 $973.62 2026-05-27
71552 HCPCS MRI Scan Of Chest Before And After Contrast 24 24 $11,287.00 $11,287.00 $260.90 $20,316.60 $970.41 2026-05-27
49590106_1 CDM Operating Room Services - General Classification 6 6 $1,787.00 $1,787.00 $729.45 $1,518.95 $964.98 2026-05-27
92960 HCPCS External Shock To Heart To Regulate Heart Beat 24 24 $3,153.00 $3,153.00 $175.66 $5,675.40 $960.28 2026-05-27
32555 HCPCS Aspiration Of Fluid From Chest Cavity Using Imaging Guidance 24 24 $3,713.00 $3,713.00 $92.33 $6,683.40 $956.75 2026-05-27
32554 HCPCS Aspiration Of Fluid From Chest Cavity 24 24 $3,713.00 $3,713.00 $74.09 $6,683.40 $956.75 2026-05-27
52696221_1 CDM 5.0 Cannulated Drill Bit Large Qc/300 6 6 $1,770.00 $1,770.00 $722.51 $1,504.50 $955.80 2026-05-27
A4649 HCPCS Surgical Supply; Miscellaneous 54 18 $955.00 $955.00 $294.72 $2,968.20 $955.00 2026-05-27
51319856_1 CDM Coolseal Reveal 6 6 $1,758.00 $1,758.00 $717.62 $1,494.30 $949.32 2026-05-27
90684 HCPCS Pneumococcal Conjugate Vaccine, 21 Valent (pcv21), For Intramuscular Use 18 18 $948.00 $948.00 $386.97 $1,706.40 $948.00 2026-05-27
90679 HCPCS Respiratory Syncytial Virus Vaccine, preF, Recombinant, Subunit, Adjuvanted, For… 18 18 $942.00 $942.00 $384.52 $1,695.60 $942.00 2026-05-27
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 31 24 $3,478.00 $3,478.00 $253.57 $7,826.40 $940.01 2026-05-27
80050 HCPCS General Health Panel 18 18 $931.00 $931.00 $210.43 $1,675.80 $931.00 2026-05-27
52337757_1 CDM Clareon Totic Iol T3 15.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337758_1 CDM Clareon Totic Iol T4 15.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337759_1 CDM Clareon Totic Iol T3 15.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337729_1 CDM Clareon Totic Iol T4 18.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337737_1 CDM Clareon Totic Iol T4 11.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52353080_1 CDM Clareon Totic Iol T4 21.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52353074_1 CDM Clareon Totic Iol T3 21.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337766_1 CDM Clareon Totic Iol T5 16.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337756_1 CDM Clareon Totic Iol T4 14.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52353076_1 CDM Clareon Totic Iol T4 20.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52356332_1 CDM Clareon Totic Iol T4 23.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52356334_1 CDM Clareon Totic Iol T3 24.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52357857_1 CDM Clareon Totic Iol T5 24.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337717_1 CDM Clareon Totic Iol T4 10.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337720_1 CDM Clareon Totic Iol T5 12.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52356322_1 CDM Clareon Totic Iol T5 22.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337728_1 CDM Clareon Totic Iol T3 17.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52356325_1 CDM Clareon Totic Iol T3 23.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337742_1 CDM Clareon Totic Iol T4 13.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52353079_1 CDM Clareon Totic Iol T4 20.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52356327_1 CDM Clareon Totic Iol T3 23.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337730_1 CDM Clareon Totic Iol T4 18.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337767_1 CDM Clareon Totic Iol T4 17.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337714_1 CDM Clareon Totic Iol T5 12.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337715_1 CDM Clareon Totic Iol T4 13.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337733_1 CDM Clareon Totic Iol T4 10.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52353075_1 CDM Clareon Totic Iol T3 20.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52353078_1 CDM Clareon Totic Iol T3 20.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52356329_1 CDM Clareon Totic Iol T5 22.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52357859_1 CDM Clareon Totic Iol T5 25.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337724_1 CDM Clareon Totic Iol T3 14.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337743_1 CDM Clareon Totic Iol T4 17.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337727_1 CDM Clareon Totic Iol T5 16.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337740_1 CDM Clareon Totic Iol T4 12.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337754_1 CDM Clareon Totic Iol T5 14.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337726_1 CDM Clareon Totic Iol T5 15.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337735_1 CDM Clareon Totic Iol T4 11.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337725_1 CDM Clareon Totic Iol T5 14.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337738_1 CDM Clareon Totic Iol T5 11.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337769_1 CDM Clareon Totic Iol T3 19.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337711_1 CDM Clareon Totic Iol T5 10.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337712_1 CDM Clareon Totic Iol T5 11.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337762_1 CDM Clareon Totic Iol T3 16.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337732_1 CDM Clareon Totic Iol T4 19.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52353077_1 CDM Clareon Totic Iol T5 20.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52356323_1 CDM Clareon Totic Iol T3 22.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52356330_1 CDM Clareon Totic Iol T4 23.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337721_1 CDM Clareon Totic Iol T3 12.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337722_1 CDM Clareon Totic Iol T3 13.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337760_1 CDM Clareon Totic Iol T4 15.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337718_1 CDM Clareon Totic Iol T5 10.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337723_1 CDM Clareon Totic Iol T5 13.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337755_1 CDM Clareon Totic Iol T3 14.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337761_1 CDM Clareon Totic Iol T5 15.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52353073_1 CDM Clareon Totic Iol T5 20.5 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337763_1 CDM Clareon Totic Iol T4 16.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
52337750_1 CDM Clareon Totic Iol T4 19.0 6 6 $1,724.00 $1,724.00 $703.74 $1,465.40 $930.96 2026-05-27
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