Price Transparencybeta Hospital negotiated rates

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

UCI HEALTH - PLACENTIA LINDA

Placentia, CA · CCN 050589 · Rates published

3,675 distinct procedures filed
45 distinct payers
229,680 rate rows
2026-04-01 last MRF observed
Data quality

164,733 of 229,680 rate rows are consumer-grade (71.7%)

64,947 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 64,058
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 889
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ucihealth.org/pricetransparency/952226406_uci-health-placentia-linda_standardcharges.json
Found on page https://www.ucihealth.org/patients-and-visitors/financial-resources/price-transparency
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-21
Content fingerprint 7ecbf23f9e57f105… · 66,837,118 bytes · first seen 2026-05-08

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
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 10 $108,243.35 $281,432.71 $146,128.52 nat. median
$111,503
1.3× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 10 $68,801.71 $178,884.45 $92,882.31 nat. median
$70,178
1.3× median
L7181
HCPCS 		Electronic Elbo Simultaneous 10 $48,155.50 $125,204.30 $65,009.93 nat. median
$50,516
1.3× median
L7180
HCPCS 		Electronic Elbow Sequential 10 $44,356.85 $115,327.81 $59,881.74 nat. median
$46,980
1.3× median
L8701
HCPCS 		Pow Ue Rom Dev Ewh Uprt Cust 10 $34,970.13 $90,922.34 $47,209.68 nat. median
$35,670
1.3× median
L6700
HCPCS 		Ue Add Ext Power Myoel 10 $29,510.19 $76,726.49 $39,838.76 nat. median
$30,378
1.3× median
L5856
HCPCS 		Elec Knee-shin Swing/stance 10 $28,851.23 $75,013.20 $38,949.16 nat. median
$30,017
1.3× median
L6880
HCPCS 		Elec Hand Ind Art Digits 10 $28,715.00 $74,659.00 $38,765.25 nat. median
$30,019
1.3× median
L6975
HCPCS 		Interscap-thor Myoelectronic 10 $22,747.26 $59,142.88 $30,708.80 nat. median
$22,826
1.3× median
Q0483
HCPCS 		Monitor Elec Vad, Rep 10 $22,533.92 $58,588.19 $30,420.79 nat. median
$23,335
1.3× median
L5858
HCPCS 		Stance Phase Only 10 $22,336.47 $58,074.82 $30,154.24 nat. median
$23,237
1.3× median
L5973
HCPCS 		Ank-foot Sys Dors-plant Flex 10 $21,127.66 $54,931.92 $28,522.35 nat. median
$21,726
1.3× median
Q0489
HCPCS 		Pwr Pck Base Combo Vad, Rep 10 $19,535.67 $50,792.74 $26,373.15 nat. median
$20,275
1.3× median
L6970
HCPCS 		Interscapular-thor Switch CT 10 $19,237.24 $50,016.82 $25,970.28 nat. median
$20,980
1.2× median
L6965
HCPCS 		Shldr Disartic Myoelectronic 10 $18,164.17 $47,226.84 $24,521.63 nat. median
$19,981
1.2× median
Q0481
HCPCS 		Microprcsr Cu Elec Vad, Rep 10 $17,463.78 $45,405.83 $23,576.10 nat. median
$15,219
1.5× median
L5859
HCPCS 		Knee-shin Pro Flex/ext Cont 10 $17,437.90 $45,338.54 $23,541.17 nat. median
$18,321
1.3× median
L6960
HCPCS 		Shldr Disartic Switch Contro 10 $15,644.23 $40,675.00 $21,119.71 nat. median
$16,650
1.3× median
L6955
HCPCS 		Above Elbow Myoelectronic CT 10 $14,621.82 $38,016.73 $19,739.46 nat. median
$15,745
1.3× median
Q0479
HCPCS 		Power Module Combo Vad, Rep 10 $14,386.80 $37,405.68 $19,422.18 nat. median
$15,271
1.3× median
L6945
HCPCS 		Elbow Disart Myoelectronic C 10 $12,496.15 $32,489.99 $16,869.81 nat. median
$13,912
1.2× median
L6950
HCPCS 		Above Elbow Switch Control 10 $12,208.90 $31,743.14 $16,482.01 nat. median
$12,858
1.3× median
81416
HCPCS 		Exome Sequence Analysis 10 $12,000.00 $31,200.00 $16,200.00 nat. median
$12,000
1.4× median
L5991
HCPCS 		Low Pros Ext Osseo Connector 10 $11,755.04 $30,563.10 $15,869.31 nat. median
$12,042
1.3× median
L7191
HCPCS 		Elbow Child Myoelectronic CT 10 $11,315.81 $29,421.11 $15,276.34 nat. median
$13,827
1.1× median
L7186
HCPCS 		Electron Elbow Child Switch 10 $10,829.14 $28,155.76 $14,619.33 nat. median
$13,302
1.1× median
L6940
HCPCS 		Elbow Disarticulation Switch 10 $10,752.69 $27,956.99 $14,516.13 nat. median
$12,193
1.2× median
L6925
HCPCS 		Wrist Disart Myoelectronic C 10 $10,417.12 $27,084.51 $14,063.11 nat. median
$10,846
1.3× median
L8619
HCPCS 		Coch Imp Ext Proc/contr Rplc 10 $10,367.03 $26,954.28 $13,995.49 nat. median
$13,189
1.1× median
L5857
HCPCS 		Elec Knee-shin Swing Only 10 $10,237.55 $26,617.63 $13,820.69 nat. median
$10,749
1.3× median
L6935
HCPCS 		Below Elbow Myoelectronic CT 10 $9,866.92 $25,653.99 $13,320.34 nat. median
$11,147
1.2× median
L7190
HCPCS 		Elbow Adolescent Myoelectron 10 $9,600.27 $24,960.70 $12,960.36 nat. median
$10,857
1.2× median
L6920
HCPCS 		Wrist Disarticul Switch Ctrl 10 $9,127.55 $23,731.63 $12,322.19 nat. median
$9,420
1.3× median
L8627
HCPCS 		Cid Ext Speech Process Repl 10 $8,805.87 $22,895.26 $11,887.92 nat. median
$8,785
1.4× median
L5615
HCPCS 		Ak 4 Bar Link Hydl Swg/stanc 10 $8,770.77 $22,804.00 $11,840.54 nat. median
$7,274
1.6× median
L5987
HCPCS 		Shank Ft W Vert Load Pylon 10 $8,645.73 $22,478.90 $11,671.74 nat. median
$8,991
1.3× median
0315U
CPT 		10 $8,500.00 $22,100.00 $11,475.00 nat. median
$8,670
1.3× median
L6930
HCPCS 		Below Elbow Switch Control 10 $8,495.44 $22,088.14 $11,468.84 nat. median
$9,632
1.2× median
L5250
HCPCS 		Hip Canad Sing Axi Cons Fric 10 $8,469.42 $22,020.49 $11,433.72 nat. median
$7,091
1.6× median
0211U
CPT 		Next-generation DNA And RNA Sequencing In Tissue Specimen, Interpretative Report… 10 $8,455.00 $21,983.00 $11,414.25 nat. median
$8,455
1.4× median
L5270
HCPCS 		Tilt Table Locking Hip Sing 10 $8,395.23 $21,827.60 $11,333.56 nat. median
$7,136
1.6× median
L5280
HCPCS 		Hemipelvect Canad Sing Axis 10 $8,311.28 $21,609.33 $11,220.23 nat. median
$7,340
1.5× median
L5341
HCPCS 		Hemipelvectomy Canadian Sach 10 $8,249.73 $21,449.30 $11,137.14 nat. median
$7,400
1.5× median
L5827
HCPCS 		Endo Knee Shin Single Axis 10 $7,924.88 $20,604.69 $10,698.59 nat. median
$7,370
1.5× median
81552
HCPCS 		Onc Uveal Mlnma Mrna 15 Gene 10 $7,776.00 $20,217.60 $10,497.60 nat. median
$8,087
1.3× median
0582U
CPT 		10 $7,582.20 $19,713.72 $10,235.97 nat. median
$5,335
1.9× median
0426U
CPT 		10 $7,582.20 $19,713.72 $10,235.97 nat. median
$7,810
1.3× median
0094U
CPT 		Rapid Sequence Analysis Of Genome For Unexplained Heritable Disorder 10 $7,582.20 $19,713.72 $10,235.97 nat. median
$7,734
1.3× median
L7185
HCPCS 		Electron Elbow Adolescent Sw 10 $7,329.25 $19,056.05 $9,894.49 nat. median
$9,262
1.1× median
L5600
HCPCS 		Hip Disart Sach Laminat Mold 10 $7,258.09 $18,871.03 $9,798.42 nat. median
$5,933
1.7× median

Other procedures at this hospital

Browse this hospital's 3,675 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
             
Q0480 HCPCS Driver Pneumatic Vad, Rep 12 10 — — $108,243.35 $281,432.71 $146,128.52 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 12 10 — — $68,801.71 $178,884.45 $92,882.31 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 12 10 — — $48,155.50 $125,204.30 $65,009.93 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 12 10 — — $44,356.85 $115,327.81 $59,881.74 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 12 10 — — $34,970.13 $90,922.34 $47,209.68 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 12 10 — — $29,510.19 $76,726.49 $39,838.76 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 12 10 — — $28,851.23 $75,013.20 $38,949.16 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 12 10 — — $28,715.00 $74,659.00 $38,765.25 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 12 10 — — $22,747.26 $59,142.88 $30,708.80 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 12 10 — — $22,533.92 $58,588.19 $30,420.79 2026-04-01
L5858 HCPCS Stance Phase Only 12 10 — — $22,336.47 $58,074.82 $30,154.24 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 12 10 — — $21,127.66 $54,931.92 $28,522.35 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 12 10 — — $19,535.67 $50,792.74 $26,373.15 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 12 10 — — $19,237.24 $50,016.82 $25,970.28 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 12 10 — — $18,164.17 $47,226.84 $24,521.63 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 12 10 — — $17,463.78 $45,405.83 $23,576.10 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 12 10 — — $17,437.90 $45,338.54 $23,541.17 2026-04-01
L6960 HCPCS Shldr Disartic Switch Contro 12 10 — — $15,644.23 $40,675.00 $21,119.71 2026-04-01
L6955 HCPCS Above Elbow Myoelectronic CT 12 10 — — $14,621.82 $38,016.73 $19,739.46 2026-04-01
Q0479 HCPCS Power Module Combo Vad, Rep 12 10 — — $14,386.80 $37,405.68 $19,422.18 2026-04-01
L6945 HCPCS Elbow Disart Myoelectronic C 12 10 — — $12,496.15 $32,489.99 $16,869.81 2026-04-01
L6950 HCPCS Above Elbow Switch Control 12 10 — — $12,208.90 $31,743.14 $16,482.01 2026-04-01
81416 HCPCS Exome Sequence Analysis 12 10 — — $12,000.00 $31,200.00 $16,200.00 2026-04-01
L5991 HCPCS Low Pros Ext Osseo Connector 12 10 — — $11,755.04 $30,563.10 $15,869.31 2026-04-01
L7191 HCPCS Elbow Child Myoelectronic CT 12 10 — — $11,315.81 $29,421.11 $15,276.34 2026-04-01
L7186 HCPCS Electron Elbow Child Switch 12 10 — — $10,829.14 $28,155.76 $14,619.33 2026-04-01
L6940 HCPCS Elbow Disarticulation Switch 12 10 — — $10,752.69 $27,956.99 $14,516.13 2026-04-01
L6925 HCPCS Wrist Disart Myoelectronic C 12 10 — — $10,417.12 $27,084.51 $14,063.11 2026-04-01
L8619 HCPCS Coch Imp Ext Proc/contr Rplc 12 10 — — $10,367.03 $26,954.28 $13,995.49 2026-04-01
L5857 HCPCS Elec Knee-shin Swing Only 12 10 — — $10,237.55 $26,617.63 $13,820.69 2026-04-01
L6935 HCPCS Below Elbow Myoelectronic CT 12 10 — — $9,866.92 $25,653.99 $13,320.34 2026-04-01
L7190 HCPCS Elbow Adolescent Myoelectron 12 10 — — $9,600.27 $24,960.70 $12,960.36 2026-04-01
L6920 HCPCS Wrist Disarticul Switch Ctrl 12 10 — — $9,127.55 $23,731.63 $12,322.19 2026-04-01
L8627 HCPCS Cid Ext Speech Process Repl 12 10 — — $8,805.87 $22,895.26 $11,887.92 2026-04-01
L5615 HCPCS Ak 4 Bar Link Hydl Swg/stanc 12 10 — — $8,770.77 $22,804.00 $11,840.54 2026-04-01
L5987 HCPCS Shank Ft W Vert Load Pylon 12 10 — — $8,645.73 $22,478.90 $11,671.74 2026-04-01
0315U CPT — 12 10 — — $8,500.00 $22,100.00 $11,475.00 2026-04-01
L6930 HCPCS Below Elbow Switch Control 12 10 — — $8,495.44 $22,088.14 $11,468.84 2026-04-01
L5250 HCPCS Hip Canad Sing Axi Cons Fric 12 10 — — $8,469.42 $22,020.49 $11,433.72 2026-04-01
0211U CPT Next-generation DNA And RNA Sequencing In Tissue Specimen, Interpretative Report… 12 10 — — $8,455.00 $21,983.00 $11,414.25 2026-04-01
L5270 HCPCS Tilt Table Locking Hip Sing 12 10 — — $8,395.23 $21,827.60 $11,333.56 2026-04-01
L5280 HCPCS Hemipelvect Canad Sing Axis 12 10 — — $8,311.28 $21,609.33 $11,220.23 2026-04-01
L5341 HCPCS Hemipelvectomy Canadian Sach 12 10 — — $8,249.73 $21,449.30 $11,137.14 2026-04-01
L5827 HCPCS Endo Knee Shin Single Axis 12 10 — — $7,924.88 $20,604.69 $10,698.59 2026-04-01
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 12 10 — — $7,776.00 $20,217.60 $10,497.60 2026-04-01
0582U CPT — 12 10 — — $7,582.20 $19,713.72 $10,235.97 2026-04-01
0426U CPT — 12 10 — — $7,582.20 $19,713.72 $10,235.97 2026-04-01
0094U CPT Rapid Sequence Analysis Of Genome For Unexplained Heritable Disorder 12 10 — — $7,582.20 $19,713.72 $10,235.97 2026-04-01
L7185 HCPCS Electron Elbow Adolescent Sw 12 10 — — $7,329.25 $19,056.05 $9,894.49 2026-04-01
L5600 HCPCS Hip Disart Sach Laminat Mold 12 10 — — $7,258.09 $18,871.03 $9,798.42 2026-04-01
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 12 10 — — $7,193.00 $18,701.80 $9,710.55 2026-04-01
L7170 HCPCS Electronic Elbow Hosmer Swit 12 10 — — $7,178.38 $18,663.79 $9,690.81 2026-04-01
L6570 HCPCS Scap Thorac Prosth Tiss Shap 12 10 — — $7,144.50 $18,575.70 $9,645.07 2026-04-01
L5331 HCPCS Hip Disart Canadian Sach Ft 12 10 — — $7,129.62 $18,537.01 $9,624.99 2026-04-01
L5702 HCPCS Replace Socket Hip 12 10 — — $7,091.90 $18,438.94 $9,574.06 2026-04-01
L7008 HCPCS Pediatric Electric Hand 12 10 — — $7,082.01 $18,413.23 $9,560.71 2026-04-01
0267U CPT — 12 10 — — $6,739.33 $17,522.26 $9,098.10 2026-04-01
L8683 HCPCS Radiofq Trsmtr For Implt Neu 12 10 — — $6,622.33 $17,218.06 $8,940.15 2026-04-01
L5595 HCPCS Hip Disartic Sach Thermopls 12 10 — — $6,572.57 $17,088.68 $8,872.97 2026-04-01
L6350 HCPCS Thoracic Intern Lock Elbow 12 10 — — $6,345.51 $16,498.33 $8,566.44 2026-04-01
L5961 HCPCS Endo Poly Hip, Pneu/hyd/rot 12 10 — — $6,280.50 $16,329.30 $8,478.67 2026-04-01
L5160 HCPCS Mold Socket Bent Knee Shin S 12 10 — — $6,234.83 $16,210.56 $8,417.02 2026-04-01
L6550 HCPCS Shldr Disar Prosth Tiss Shap 12 10 — — $6,224.47 $16,183.62 $8,403.03 2026-04-01
L5230 HCPCS Fem Focal Defic Constant Fri 12 10 — — $6,209.65 $16,145.09 $8,383.02 2026-04-01
L6300 HCPCS Shlder Disart Int Lock Elbow 12 10 — — $6,081.45 $15,811.77 $8,209.95 2026-04-01
L5150 HCPCS Mold Sckt Ext Knee Shin Sach 12 10 — — $5,732.23 $14,903.80 $7,738.51 2026-04-01
L6026 HCPCS Part Hand Myo Exclu Term Dev 12 10 — — $5,673.74 $14,751.72 $7,659.55 2026-04-01
L5105 HCPCS Plast Socket Jts/thgh Lacer 12 10 — — $5,670.63 $14,743.64 $7,655.35 2026-04-01
L5701 HCPCS Replace Socket Above Knee 12 10 — — $5,550.13 $14,430.34 $7,492.67 2026-04-01
0265U CPT — 12 10 — — $5,475.80 $14,237.08 $7,392.33 2026-04-01
0212U CPT Whole Genome And Mitochondrial DNA Sequence Analysis For Rare Disease, Including… 12 10 — — $5,475.20 $14,235.52 $7,391.52 2026-04-01
Q0482 HCPCS Microprcsr Cu Combo Vad, Rep 12 10 — — $5,469.98 $14,221.95 $7,384.48 2026-04-01
L6205 HCPCS Elbow Molded With Expand Inter 12 10 — — $5,435.97 $14,133.52 $7,338.56 2026-04-01
0295U CPT — 12 10 — — $5,435.00 $14,131.00 $7,337.25 2026-04-01
81554 HCPCS Pulm Ds Ipf Mrna 190 Gen Alg 12 10 — — $5,409.60 $14,064.96 $7,302.96 2026-04-01
L5321 HCPCS Ak Open End Sach 12 10 — — $5,364.98 $13,948.95 $7,242.72 2026-04-01
L8044 HCPCS Hemi-facial Prosthesis 12 10 — — $5,287.15 $13,746.59 $7,137.65 2026-04-01
0214U CPT Whole Exome And Mitochondrial DNA Sequence Analysis For Rare Disease, Including … 12 10 — — $5,224.60 $13,583.96 $7,053.21 2026-04-01
0335U CPT — 12 10 — — $5,224.60 $13,583.96 $7,053.21 2026-04-01
L6885 HCPCS Replc Sockt Shldr Dis/interc 12 10 — — $5,199.26 $13,518.08 $7,019.01 2026-04-01
L6360 HCPCS Thoracic Passive Restor Comp 12 10 — — $5,199.26 $13,518.08 $7,019.01 2026-04-01
L5980 HCPCS Flex Foot System 12 10 — — $5,166.71 $13,433.45 $6,975.06 2026-04-01
L5782 HCPCS Hd Low Limb Pros Vacuum Pump 12 10 — — $5,069.52 $13,180.75 $6,843.85 2026-04-01
81425 HCPCS Genome Sequence Analysis 12 10 — — $5,031.20 $13,081.12 $6,792.12 2026-04-01
0532U CPT — 12 10 — — $5,031.20 $13,081.12 $6,792.12 2026-04-01
0567U CPT — 12 10 — — $5,031.20 $13,081.12 $6,792.12 2026-04-01
Q0495 HCPCS Charger Elec/combo Vad, Rep 12 10 — — $5,020.16 $13,052.42 $6,777.22 2026-04-01
0326U CPT — 12 10 — — $5,000.00 $13,000.00 $6,750.00 2026-04-01
0242U CPT — 12 10 — — $5,000.00 $13,000.00 $6,750.00 2026-04-01
L6310 HCPCS Shoulder Passive Restor Comp 12 10 — — $4,953.47 $12,879.02 $6,687.18 2026-04-01
0108U CPT Whole Slide Digital Imaging Of Esophageal Cells In Formalin-fixed Paraffin-embed… 12 10 — — $4,950.00 $12,870.00 $6,682.50 2026-04-01
L5840 HCPCS Multi-axial Knee/shin System 12 10 — — $4,941.29 $12,847.35 $6,670.74 2026-04-01
L7259 HCPCS Electronic Wrist Rotator Any 12 10 — — $4,939.22 $12,841.97 $6,667.94 2026-04-01
L2005 HCPCS Kafo Sng/dbl Mechanical Act 12 10 — — $4,915.21 $12,779.55 $6,635.53 2026-04-01
L6881 HCPCS Term Dev Auto Grasp Feature 12 10 — — $4,913.43 $12,774.92 $6,633.13 2026-04-01
L5200 HCPCS Kne Sing Axis Fric Shin Sach 12 10 — — $4,913.09 $12,774.03 $6,632.67 2026-04-01
L5312 HCPCS Knee Disart, Sach Ft, Endo 12 10 — — $4,823.95 $12,542.27 $6,512.33 2026-04-01
L5781 HCPCS Lower Limb Pros Vacuum Pump 12 10 — — $4,808.77 $12,502.80 $6,491.84 2026-04-01
L0830 HCPCS Halo Cerv Into Milwaukee Typ 12 10 — — $4,804.53 $12,491.78 $6,486.11 2026-04-01
0036U CPT Exome Gene Sequence Analysis In Paired Formalin-fixed Paraffin Embedded Tumor Ti… 12 10 — — $4,780.00 $12,428.00 $6,453.00 2026-04-01
81415 HCPCS Exome Sequence Analysis 12 10 — — $4,780.00 $12,428.00 $6,453.00 2026-04-01
L8043 HCPCS Upper Facial Prosthesis 12 10 — — $4,775.50 $12,416.30 $6,446.93 2026-04-01
L6450 HCPCS Elb Disart Prosth Tiss Shap 12 10 — — $4,616.98 $12,004.15 $6,232.92 2026-04-01
L6624 HCPCS Flex/ext/rotation Wrist Unit 12 10 — — $4,526.27 $11,768.30 $6,110.47 2026-04-01
L5060 HCPCS Symes Met Fr Leath Socket Ar 12 10 — — $4,508.51 $11,722.13 $6,086.49 2026-04-01
L5220 HCPCS No Knee Joint With Artic Ali 12 10 — — $4,502.37 $11,706.16 $6,078.20 2026-04-01
0473U CPT — 12 10 — — $4,500.00 $11,700.00 $6,075.00 2026-04-01
L5828 HCPCS Endo Knee-shin Fluid Swg/sta 12 10 — — $4,478.35 $11,643.71 $6,045.77 2026-04-01
L5700 HCPCS Replace Socket Below Knee 12 10 — — $4,470.21 $11,622.55 $6,034.78 2026-04-01
L5814 HCPCS Endo Knee-shin Hydral Swg Ph 12 10 — — $4,463.49 $11,605.07 $6,025.71 2026-04-01
L6200 HCPCS Elbow Mold Outsid Lock Hinge 12 10 — — $4,453.13 $11,578.14 $6,011.73 2026-04-01
L8035 HCPCS Custom Breast Prosthesis 12 10 — — $4,403.12 $11,448.11 $5,944.21 2026-04-01
L3904 HCPCS Whfo Electric Custom Fitted 12 10 — — $4,390.61 $11,415.59 $5,927.32 2026-04-01
L6250 HCPCS Elbow Inter Loc Elbow Forarm 12 10 — — $4,383.37 $11,396.76 $5,917.55 2026-04-01
Q0484 HCPCS Monitor Elec Or Comb Vad Rep 12 10 — — $4,376.02 $11,377.65 $5,907.62 2026-04-01
L5968 HCPCS Multiaxial Ankle W Dorsiflex 12 10 — — $4,367.41 $11,355.27 $5,896.00 2026-04-01
L7009 HCPCS Adult Electric Hook 12 10 — — $4,298.30 $11,175.58 $5,802.71 2026-04-01
L8042 HCPCS Orbital Prosthesis 12 10 — — $4,263.82 $11,085.93 $5,756.16 2026-04-01
L6130 HCPCS Elbow Stump Activated Lock H 12 10 — — $4,225.63 $10,986.64 $5,704.60 2026-04-01
L7007 HCPCS Adult Electric Hand 12 10 — — $4,212.72 $10,953.07 $5,687.17 2026-04-01
L6500 HCPCS Above Elbow Prosth Tiss Shap 12 10 — — $4,197.24 $10,912.82 $5,666.27 2026-04-01
0300U CPT — 12 10 — — $4,183.13 $10,876.14 $5,647.23 2026-04-01
0425U CPT — 12 10 — — $4,094.39 $10,645.41 $5,527.43 2026-04-01
L5930 HCPCS High Activity Knee Frame 12 10 — — $4,045.31 $10,517.81 $5,461.17 2026-04-01
L5981 HCPCS Flex-walk Sys Low Ext Prosth 12 10 — — $4,010.20 $10,426.52 $5,413.77 2026-04-01
L5613 HCPCS Ak 4 Bar Ling W/hydraul Swig 12 10 — — $4,000.34 $10,400.88 $5,400.45 2026-04-01
L6055 HCPCS Wrst Mold Sock W/exp Interfa 12 10 — — $3,964.06 $10,306.56 $5,351.49 2026-04-01
L6588 HCPCS Shdr Fair Lead Cable Molded 12 10 — — $3,958.76 $10,292.78 $5,344.32 2026-04-01
L0810 HCPCS Halo Cervical Into Jckt Vest 12 10 — — $3,952.09 $10,275.43 $5,335.32 2026-04-01
L5590 HCPCS Prep Ak Ischial Laminated 12 10 — — $3,924.01 $10,202.43 $5,297.41 2026-04-01
L6648 HCPCS Ext Pwrd Shlder Lock/unlock 12 10 — — $3,909.46 $10,164.60 $5,277.77 2026-04-01
L5728 HCPCS Knee-shin Fluid Swg & Stance 12 10 — — $3,884.12 $10,098.71 $5,243.56 2026-04-01
0560U CPT — 12 10 — — $3,878.45 $10,083.97 $5,235.91 2026-04-01
0306U CPT — 12 10 — — $3,878.45 $10,083.97 $5,235.91 2026-04-01
0497U CPT — 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
81518 HCPCS Onc Brst Mrna 11 Genes 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
81541 HCPCS Onc Prostate Mrna 46 Genes 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
0288U CPT — 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
81522 HCPCS Onc Breast Mrna 12 Genes 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
81542 HCPCS Onc Prostate Mrna 22 Cnt Gen 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
81523 HCPCS Onc Brst Mrna 70 Cnt 31 Gene 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
0578U CPT — 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
0047U CPT Prostate Cancer Mrna Gene Expression Profiling Using Real Time Reverse Transcrip… 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
81519 HCPCS Oncology Breast Mrna 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
0045U CPT Breast Ductal Carcinoma In Situ, Mrna Gene Expression Profiling Using Real Time … 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
81521 HCPCS Onc Breast Mrna 70 Genes 12 10 — — $3,873.00 $10,069.80 $5,228.55 2026-04-01
L1005 HCPCS Tension Based Scoliosis Orth 12 10 — — $3,839.20 $9,981.92 $5,182.92 2026-04-01
L5580 HCPCS Prep Ak Ischial Thermo Mold 12 10 — — $3,829.74 $9,957.32 $5,170.15 2026-04-01
L5841 HCPCS Addition Endoskletl Knee-shi 12 10 — — $3,818.92 $9,929.19 $5,155.54 2026-04-01
L8041 HCPCS Midfacial Prosthesis 12 10 — — $3,794.81 $9,866.51 $5,122.99 2026-04-01
L6715 HCPCS Term Device, Multi Art Digit 12 10 — — $3,794.37 $9,865.36 $5,122.40 2026-04-01
0583U CPT — 12 10 — — $3,791.10 $9,856.86 $5,117.99 2026-04-01
L6646 HCPCS Multipo Locking Shoulder Jnt 12 10 — — $3,790.61 $9,855.59 $5,117.32 2026-04-01
L6400 HCPCS Below Elbow Prosth Tiss Shap 12 10 — — $3,787.65 $9,847.89 $5,113.33 2026-04-01
L6120 HCPCS Elbow Mold Doub Splt Soc Ste 12 10 — — $3,782.53 $9,834.58 $5,106.41 2026-04-01
L5826 HCPCS Miniature Knee Joint 12 10 — — $3,753.23 $9,758.40 $5,066.86 2026-04-01
81540 HCPCS Oncology Tum Unknown Origin 12 10 — — $3,750.00 $9,750.00 $5,062.50 2026-04-01
L5301 HCPCS Bk Mold Socket Sach Ft Endo 12 10 — — $3,731.84 $9,702.78 $5,037.99 2026-04-01
L6882 HCPCS Microprocessor Control Uplmb 12 10 — — $3,727.07 $9,690.38 $5,031.55 2026-04-01
L5979 HCPCS Multi-axial Ankle/ft Prosth 12 10 — — $3,690.19 $9,594.49 $4,981.76 2026-04-01
0258U CPT — 12 10 — — $3,675.00 $9,555.00 $4,961.25 2026-04-01
0019U CPT Cancer RNA Gene Expression Profiling By Whole Transcriptome Sequencing In Fresh … 12 10 — — $3,675.00 $9,555.00 $4,961.25 2026-04-01
0485U CPT — 12 10 — — $3,649.48 $9,488.65 $4,926.80 2026-04-01
L6884 HCPCS Replc Sockt Above Elbow Disa 12 10 — — $3,644.20 $9,474.92 $4,919.67 2026-04-01
L5210 HCPCS No Knee/ankle Joints With Ft B 12 10 — — $3,624.97 $9,424.92 $4,893.71 2026-04-01
0287U CPT — 12 10 — — $3,600.00 $9,360.00 $4,860.00 2026-04-01
81546 HCPCS Onc Thyr Mrna 10,196 Gen Alg 12 10 — — $3,600.00 $9,360.00 $4,860.00 2026-04-01
0362U CPT — 12 10 — — $3,600.00 $9,360.00 $4,860.00 2026-04-01
0026U CPT DNA And Mrna Next-generation Sequencing Of 112 Genes With Interrogation For Sequ… 12 10 — — $3,600.00 $9,360.00 $4,860.00 2026-04-01
0313U CPT — 12 10 — — $3,600.00 $9,360.00 $4,860.00 2026-04-01
0391U CPT — 12 10 — — $3,600.00 $9,360.00 $4,860.00 2026-04-01
0340U CPT — 12 10 — — $3,590.00 $9,334.00 $4,846.50 2026-04-01
0080U CPT Mass Spectrometric Analysis Of Galectin-3-binding Protein And Scavenger Receptor… 12 10 — — $3,520.00 $9,152.00 $4,752.00 2026-04-01
0037U CPT Acute Myelogenous Leukemia Targeted DNA Sequencing Analysis Of 324 Genes With In… 12 10 — — $3,500.00 $9,100.00 $4,725.00 2026-04-01
0244U CPT — 12 10 — — $3,500.00 $9,100.00 $4,725.00 2026-04-01
0239U CPT — 12 10 — — $3,500.00 $9,100.00 $4,725.00 2026-04-01
0388U CPT — 12 10 — — $3,500.00 $9,100.00 $4,725.00 2026-04-01
0334U CPT — 12 10 — — $3,500.00 $9,100.00 $4,725.00 2026-04-01
0016M OTHER Onc Bladder Mrna 209 Gen Alg 12 10 — — $3,489.63 $9,073.04 $4,711.00 2026-04-01
L6590 HCPCS Shdr Fair Lead Cable Direct 12 10 — — $3,478.09 $9,043.03 $4,695.42 2026-04-01
L7040 HCPCS Prehensile Actuator 12 10 — — $3,451.37 $8,973.56 $4,659.35 2026-04-01
0329U CPT — 12 10 — — $3,437.98 $8,938.75 $4,641.27 2026-04-01
L6693 HCPCS Lockingelbow Forearm Cntrbal 12 10 — — $3,412.03 $8,871.28 $4,606.24 2026-04-01
L8046 HCPCS Partial Facial Prosthesis 12 10 — — $3,411.08 $8,868.81 $4,604.96 2026-04-01
L5585 HCPCS Prep Ak Ischial Open End 12 10 — — $3,391.68 $8,818.37 $4,578.77 2026-04-01
L6110 HCPCS Elbow Mold Sock Suspension T 12 10 — — $3,331.21 $8,661.15 $4,497.13 2026-04-01
81440 HCPCS Mitochondrial Gene 12 10 — — $3,324.00 $8,642.40 $4,487.40 2026-04-01
L8045 HCPCS Auricular Prosthesis 12 10 — — $3,323.07 $8,639.98 $4,486.15 2026-04-01
L6370 HCPCS Thoracic Passive Restor Cap 12 10 — — $3,315.39 $8,620.01 $4,475.78 2026-04-01
L5100 HCPCS Molded Socket Shin Sach Foot 12 10 — — $3,291.35 $8,557.51 $4,443.32 2026-04-01
0379U CPT — 12 10 — — $3,288.51 $8,550.13 $4,439.49 2026-04-01
0539U CPT — 12 10 — — $3,288.51 $8,550.13 $4,439.49 2026-04-01
81464 HCPCS So Gsap Cll Fr Mcrstl Ins 12 10 — — $3,288.51 $8,550.13 $4,439.49 2026-04-01
L5050 HCPCS Ank Symes Mold Sckt Sach Ft 12 10 — — $3,259.73 $8,475.30 $4,400.64 2026-04-01
0055U CPT Assay Of Cell-free Dna, Polymerase Chain Reaction (pcr) Of 96 DNA Target Sequenc… 12 10 — — $3,240.00 $8,424.00 $4,374.00 2026-04-01
0576U CPT — 12 10 — — $3,240.00 $8,424.00 $4,374.00 2026-04-01
81595 HCPCS Cardiology Hrt Trnspl Mrna 12 10 — — $3,240.00 $8,424.00 $4,374.00 2026-04-01
81558 HCPCS Trnspl Rej Kdn Mrna Qpcr 139 12 10 — — $3,240.00 $8,424.00 $4,374.00 2026-04-01
L5020 HCPCS Tibial Tubercle Hgt With Toe F 12 10 — — $3,234.86 $8,410.64 $4,367.07 2026-04-01
0266U CPT — 12 10 — — $3,200.00 $8,320.00 $4,320.00 2026-04-01
0262U CPT — 12 10 — — $3,200.00 $8,320.00 $4,320.00 2026-04-01
L0710 HCPCS Ctlso A-p-l Control With Inter 12 10 — — $3,199.93 $8,319.82 $4,319.90 2026-04-01
0153U CPT Mrna Gene Expression Profiling Of Breast Cancer By Real-time Polymerase Chain Re… 12 10 — — $3,159.42 $8,214.49 $4,265.22 2026-04-01
0253U CPT — 12 10 — — $3,159.42 $8,214.49 $4,265.22 2026-04-01
0088U CPT Microarray Gene Expression Profiling Of 1494 Genes In Allograft Kidney Transplan… 12 10 — — $3,159.42 $8,214.49 $4,265.22 2026-04-01
0087U CPT Mrna Gene Expression Profiling By Microarray Of 1283 Genes In Heart Transplant B… 12 10 — — $3,159.42 $8,214.49 $4,265.22 2026-04-01
L5570 HCPCS Prep Ak Ischial Direct Form 12 10 — — $3,155.30 $8,203.78 $4,259.65 2026-04-01
L7406 HCPCS Add To Upp Extr User Adj Mec 12 10 — — $3,150.07 $8,190.18 $4,252.60 2026-04-01
L5783 HCPCS Add Low Ext Mec Limb Vol Sys 12 10 — — $3,150.07 $8,190.18 $4,252.60 2026-04-01
L8040 HCPCS Nasal Prosthesis 12 10 — — $3,148.18 $8,185.27 $4,250.04 2026-04-01
81525 HCPCS Oncology Colon Mrna 12 10 — — $3,116.00 $8,101.60 $4,206.60 2026-04-01
L0820 HCPCS Halo Cervical Into Body Jack 12 10 — — $3,115.46 $8,100.20 $4,205.87 2026-04-01
L1000 HCPCS Ctlso Milwauke Initial Model 12 10 — — $3,110.63 $8,087.64 $4,199.35 2026-04-01
L0700 HCPCS Ctlso A-p-l Control Molded 12 10 — — $3,097.57 $8,053.68 $4,181.72 2026-04-01
L5830 HCPCS Endo Knee-shin Pneum/swg Pha 12 10 — — $3,097.40 $8,053.24 $4,181.49 2026-04-01
L6050 HCPCS Wrst MLd Sck Flx Hng Tri Pad 12 10 — — $3,090.96 $8,036.50 $4,172.80 2026-04-01
0511U CPT — 12 10 — — $3,033.86 $7,888.04 $4,095.71 2026-04-01
0248U CPT — 12 10 — — $3,033.86 $7,888.04 $4,095.71 2026-04-01
0435U CPT — 12 10 — — $3,033.86 $7,888.04 $4,095.71 2026-04-01
0525U CPT — 12 10 — — $3,033.86 $7,888.04 $4,095.71 2026-04-01
0172U CPT Somatic Mutation Analysis Of Brca1, DNA Repair Associated (brca1) And Brca2 (brc… 12 10 — — $3,030.00 $7,878.00 $4,090.50 2026-04-01
L6638 HCPCS Elec Lock On Manual Pw Elbow 12 10 — — $3,005.49 $7,814.27 $4,057.41 2026-04-01
0018U CPT Thyroid Cancer Microrna Profiling By Reverse Transcription Polymerase Chain Reac… 12 10 — — $3,002.09 $7,805.43 $4,052.82 2026-04-01
L5610 HCPCS Above Knee Hydracadence 12 10 — — $2,999.99 $7,799.97 $4,049.99 2026-04-01
0538U CPT — 12 10 — — $2,989.55 $7,772.83 $4,035.90 2026-04-01
81459 HCPCS So Neo Gsap Dna/dna&rna 12 10 — — $2,989.55 $7,772.83 $4,035.90 2026-04-01
0543U CPT — 12 10 — — $2,989.55 $7,772.83 $4,035.90 2026-04-01
L5540 HCPCS Prep Bk Ptb Laminated Socket 12 10 — — $2,952.49 $7,676.47 $3,985.86 2026-04-01
L5703 HCPCS Symes Ankle Without (sach) Foot 12 10 — — $2,946.99 $7,662.17 $3,978.44 2026-04-01
0409U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
81455 HCPCS Targeted Genomic Seq Analys 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
81456 HCPCS Tgsap So/hl 51/< RNA Alys 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0592U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0250U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0530U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0585U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0487U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0048U CPT Solid Organ Neoplasia-targeted DNA Sequencing Of Protein-coding Exons Of 468 Can… 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0571U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0444U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0298U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0297U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0586U CPT — 12 10 — — $2,919.60 $7,590.96 $3,941.46 2026-04-01
0050U CPT Acute Myelogenous Leukemia Targeted DNA Sequencing Analysis Of 194 Genes With In… 12 10 — — $2,916.60 $7,583.16 $3,937.41 2026-04-01
L5560 HCPCS Prep Ak Ischial Plast Molded 12 10 — — $2,878.04 $7,482.90 $3,885.36 2026-04-01
81538 HCPCS Oncology Lung 12 10 — — $2,871.00 $7,464.60 $3,875.85 2026-04-01
0417U CPT — 12 10 — — $2,842.53 $7,390.58 $3,837.41 2026-04-01
L5505 HCPCS Init Ak Ischal Plstr Direct 12 10 — — $2,839.14 $7,381.76 $3,832.84 2026-04-01
L6721 HCPCS Hook/hand, Hvy Dty, Vol Open 12 10 — — $2,826.66 $7,349.32 $3,815.99 2026-04-01
L5530 HCPCS Prep Bk Ptb Thermopls Molded 12 10 — — $2,819.42 $7,330.49 $3,806.22 2026-04-01
L1681 HCPCS Ho Bilateral Hip Abduction 12 10 — — $2,795.26 $7,267.68 $3,773.61 2026-04-01
L6320 HCPCS Shoulder Passive Restor Cap 12 10 — — $2,789.54 $7,252.80 $3,765.88 2026-04-01
L5535 HCPCS Prep Bk Ptb Open End Socket 12 10 — — $2,768.11 $7,197.09 $3,736.95 2026-04-01
0118U CPT Quantification Of Transplant Donor-derived Cell-free DNA Using Whole Genome Next… 12 10 — — $2,753.25 $7,158.45 $3,716.89 2026-04-01
0493U CPT — 12 10 — — $2,753.25 $7,158.45 $3,716.89 2026-04-01
0540U CPT — 12 10 — — $2,753.25 $7,158.45 $3,716.89 2026-04-01
L6621 HCPCS Flex/ext Wrist W/wo Friction 12 10 — — $2,748.98 $7,147.35 $3,711.12 2026-04-01
L1710 HCPCS Legg Perthes Orth Newington 12 10 — — $2,738.97 $7,121.32 $3,697.61 2026-04-01
L6584 HCPCS Elbow Fair Lead Cable Molded 12 10 — — $2,735.49 $7,112.27 $3,692.91 2026-04-01
81426 HCPCS Genome Sequence Analysis 12 10 — — $2,709.95 $7,045.87 $3,658.43 2026-04-01
0213U CPT Whole Genome And Mitochondrial DNA Sequence Analysis For Rare Disease, Including… 12 10 — — $2,709.95 $7,045.87 $3,658.43 2026-04-01
0320U CPT — 12 10 — — $2,650.00 $6,890.00 $3,577.50 2026-04-01
0319U CPT — 12 10 — — $2,650.00 $6,890.00 $3,577.50 2026-04-01
L0486 HCPCS Tlso Rigidlined Cust Fab Two 12 10 — — $2,583.85 $6,718.01 $3,488.19 2026-04-01
L6384 HCPCS Postop Dsg Cast Chg Shlder/t 12 10 — — $2,583.31 $6,716.61 $3,487.47 2026-04-01
0215U CPT Whole Exome And Mitochondrial DNA Sequence Analysis For Rare Disease, Including … 12 10 — — $2,574.65 $6,694.09 $3,475.77 2026-04-01
0336U CPT — 12 10 — — $2,574.65 $6,694.09 $3,475.77 2026-04-01
L6100 HCPCS Elb Mold Sock Flex Hinge Pad 12 10 — — $2,572.24 $6,687.82 $3,472.53 2026-04-01
L1300 HCPCS Body Jacket Mold To Patient 12 10 — — $2,559.37 $6,654.36 $3,455.15 2026-04-01
L2037 HCPCS Kafo Plas Sing Free Knee Mol 12 10 — — $2,551.96 $6,635.10 $3,445.14 2026-04-01
L2036 HCPCS Kafo Plas Doub Free Knee Mol 12 10 — — $2,549.08 $6,627.61 $3,441.26 2026-04-01
0261U CPT — 12 10 — — $2,513.25 $6,534.45 $3,392.89 2026-04-01
0017M OTHER Onc Dlbcl Mrna 20 Genes Alg 12 10 — — $2,510.21 $6,526.55 $3,388.78 2026-04-01
0120U CPT B-cell Lymphoma Classification, Mrna Gene Expression Profiling By Fluorescent Pr… 12 10 — — $2,510.21 $6,526.55 $3,388.78 2026-04-01
81520 HCPCS Onc Breast Mrna 58 Genes 12 10 — — $2,510.21 $6,526.55 $3,388.78 2026-04-01
L5824 HCPCS Endo Knee-shin Fluid Swing P 12 10 — — $2,503.27 $6,508.50 $3,379.41 2026-04-01
0092U CPT Immunoassay Of 3 Protein Biomarkers For Lung Cancer In Plasma Using Magnetic Nan… 12 10 — — $2,488.00 $6,468.80 $3,358.80 2026-04-01
L5420 HCPCS Postop Dsg & 1 Cast Chg Ak/d 12 10 — — $2,481.17 $6,451.04 $3,349.58 2026-04-01
L2128 HCPCS Kafo Fem Fx Cast Molded To P 12 10 — — $2,472.79 $6,429.25 $3,338.27 2026-04-01
L6900 HCPCS Hand Restorat Thumb/1 Finger 12 10 — — $2,455.98 $6,385.55 $3,315.57 2026-04-01
0276U CPT — 12 10 — — $2,448.56 $6,366.26 $3,305.55 2026-04-01
81443 HCPCS Genetic Tstg Severe Inh Cond 12 10 — — $2,448.56 $6,366.26 $3,305.55 2026-04-01
81441 HCPCS Ibmfs Seq Alys Pnl 30 Genes 12 10 — — $2,448.56 $6,366.26 $3,305.55 2026-04-01
81412 HCPCS Ashkenazi Jewish Assoc Dis 12 10 — — $2,448.56 $6,366.26 $3,305.55 2026-04-01
81419 HCPCS Epilepsy Gen Seq Alys Panel 12 10 — — $2,448.56 $6,366.26 $3,305.55 2026-04-01
L6722 HCPCS Hook/hand, Hvy Dty, Vol Clos 12 10 — — $2,436.81 $6,335.71 $3,289.69 2026-04-01
L1844 HCPCS Ko W/adj Jt Rot Cntrl Molded 12 10 — — $2,436.24 $6,334.22 $3,288.93 2026-04-01
0492U CPT — 12 10 — — $2,435.00 $6,331.00 $3,287.25 2026-04-01
0490U CPT — 12 10 — — $2,435.00 $6,331.00 $3,287.25 2026-04-01
0491U CPT — 12 10 — — $2,435.00 $6,331.00 $3,287.25 2026-04-01
0338U CPT — 12 10 — — $2,435.00 $6,331.00 $3,287.25 2026-04-01
0337U CPT — 12 10 — — $2,435.00 $6,331.00 $3,287.25 2026-04-01
L5611 HCPCS Ak 4 Bar Link W/fric Swing 12 10 — — $2,426.18 $6,308.07 $3,275.34 2026-04-01
L5726 HCPCS Knee-shin Ext Jnts Fld Swg E 12 10 — — $2,414.52 $6,277.75 $3,259.60 2026-04-01
L6010 HCPCS Part Hand Little/ring 12 10 — — $2,413.59 $6,275.33 $3,258.35 2026-04-01
L1755 HCPCS Legg Perthes Patten Bottom T 12 10 — — $2,413.42 $6,274.89 $3,258.12 2026-04-01
L1310 HCPCS Post-operative Body Jacket 12 10 — — $2,405.14 $6,253.36 $3,246.93 2026-04-01
L2034 HCPCS Kafo Pla Sin Up W/wo K/a Cus 12 10 — — $2,403.16 $6,248.22 $3,244.26 2026-04-01
L5988 HCPCS Vertical Shock Reducing Pylo 12 10 — — $2,400.94 $6,242.44 $3,241.27 2026-04-01
L1200 HCPCS Furnsh Initial Orthosis Only 12 10 — — $2,400.62 $6,241.61 $3,240.84 2026-04-01
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