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

MOUNTAINS COMMUNITY HOSPITAL

Lake Arrowhead, CA · CCN 051312 · Rates published

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You selected 27447 (HCPCS)

TOTAL KNEE ARTHROPLASTY

This hospital’s price: $7,269 across 2 payers · range $1,489-$13,048

Source: https://mountains.pt.panaceainc.com/MRFDownload/mountains/mountainscommunityhospital · observed 2026-01-14

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

15,877 distinct procedures filed
10 distinct payers
130,870 rate rows
2026-01-14 last MRF observed
Data quality

89,018 of 130,870 rate rows are consumer-grade (68.0%)

41,852 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 24,349
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 17,161
percent-of-charges filed in the dollar field — excluded from medians 204
template filing: same amount across many unrelated codes — excluded 50
placeholder amount (≤ $0.02) — excluded from medians 48
exceeds 10× this hospital's gross charge — excluded from medians 24
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mountains.pt.panaceainc.com/MRFDownload/mountains/mountainscommunityhospital
Found on page https://www.mchcares.com/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-14
Content fingerprint a5e1e797294208f1… · 53,330,144 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
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 2 $2,167,500.00 $3,325,455.00 $2,746,477.50 nat. median
$2,460,273
1.1× median
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $727,687.80 $727,687.80 $727,687.80 nat. median
$30,221
outlier · 24.1×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $95,794.46 $727,687.83 $492,900.00 nat. median
$631,793
0.8× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $466,069.91 $466,069.91 $466,069.91 nat. median
$691,418
0.7× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $91,451.00 $656,483.97 $460,226.55 nat. median
$610,161
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $89,445.40 $642,086.69 $436,497.66 nat. median
$624,417
0.7× median
Q2040
HCPCS 		Tisagenlecleucel Car-pos T 1 $432,480.00 $432,480.00 $432,480.00 nat. median
$10,345
outlier · 41.8×
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $89,750.48 $583,715.16 $428,210.00 nat. median
$577,541
0.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $89,853.63 $583,715.15 $428,210.00 nat. median
$588,565
0.7× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 3 $61,774.82 $86,971.43 $65,476.58 nat. median
$63,643
1.0× median
0424T
OTHER 		Insj/rplc Nstim Apnea Compl 1 $55,000.50 $55,000.50 $55,000.50 nat. median
$22,425
outlier · 2.5×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $48,512.55 $66,147.00 $53,634.83 nat. median
$65,655
0.8× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $46,453.35 $81,770.23 $52,733.49 nat. median
$75,807
0.7× median
J9226
HCPCS 		Supprelin La Implant 3 $22,821.75 $43,930.19 $39,095.93 nat. median
$55,200
0.7× median
0408T
OTHER 		Insj/rplc Cardiac Modulj Sys 1 $32,076.33 $32,076.33 $32,076.33 nat. median
$31,277
1.0× median
0571T
OTHER 		Insj/rplcmt Icds Ss Eltrd 1 $32,076.33 $32,076.33 $32,076.33 nat. median
$32,779
1.0× median
0266T
OTHER 		Implt/rpl Crtd Sns Dev Total 1 $29,358.48 $29,358.48 $29,358.48 nat. median
$39,896
0.7× median
0431T
OTHER 		Rmvl/rplc Nstim Apnea Pls Gn 1 $29,358.48 $29,358.48 $29,358.48 nat. median
$22,408
1.3× median
0268T
OTHER 		Implt/rpl Crtd Sns Dev Gen 1 $29,358.48 $29,358.48 $29,358.48 nat. median
$28,090
1.0× median
0427T
OTHER 		Insj/rplc Nstim Apnea Pls Gn 1 $29,358.48 $29,358.48 $29,358.48 nat. median
$22,408
1.3× median
C9760
HCPCS 		Non-blind Interatrial Shunt 1 $27,500.50 $27,500.50 $27,500.50 nat. median
$27,848
1.0× median
0515T
OTHER 		Insj Wcs Lv Compl Sys 1 $22,818.32 $22,818.32 $22,818.32 nat. median
$23,321
1.0× median
0409T
OTHER 		Insj/rplc Car Modulj Pls Gn 1 $22,818.32 $22,818.32 $22,818.32 nat. median
$22,847
1.0× median
0614T
OTHER 		Rmvl&rplcmt Ss Impl Dfb Pg 1 $22,818.32 $22,818.32 $22,818.32 nat. median
$23,467
1.0× median
0520T
OTHER 		Rmv&rplcmt Pg Wcs Lv Battery 1 $22,818.32 $22,818.32 $22,818.32 nat. median
$13,712
1.7× median
0414T
OTHER 		Rmvl & Rpl Car Modulj Pls Gn 1 $22,818.32 $22,818.32 $22,818.32 nat. median
$22,805
1.0× median
0809T
OTHER 		Arthrd Si Jt Prq Tfx&implt 1 $21,897.63 $21,897.63 $21,897.63 nat. median
$4,711
outlier · 4.6×
0775T
OTHER 		Arthrd Si Jt Prq Iartic Impl 1 $21,897.63 $21,897.63 $21,897.63 nat. median
$7,542
outlier · 2.9×
24363
HCPCS 		Replace Elbow Joint 1 $21,897.63 $21,897.63 $21,897.63 nat. median
$16,069
1.4× median
64580
HCPCS 		Opn Impltj Nea Neuromuscular 1 $21,515.36 $21,515.36 $21,515.36 nat. median
$17,983
1.2× median
38240
HCPCS 		Transplt Allo Hct/donor 2 $104.24 $42,233.40 $21,168.82 nat. median
$13,835
1.5× median
J9266
HCPCS 		Pegaspargase Injection 4 $1,959.42 $25,762.46 $20,747.42 nat. median
$32,688
0.6× median
54401
HCPCS 		Insert Self-contd Prosthesis 1 $19,281.71 $19,281.71 $19,281.71 nat. median
$18,598
1.0× median
54405
HCPCS 		Insert Multi-comp Penis Pros 1 $19,281.71 $19,281.71 $19,281.71 nat. median
$18,432
1.0× median
0308T
OTHER 		Insj Ocular Telescope Prosth 1 $18,089.98 $18,089.98 $18,089.98 nat. median
$16,542
1.1× median
0616T
OTHER 		Insertion Of Iris Prosthesis 1 $18,089.98 $18,089.98 $18,089.98 nat. median
$3,955
outlier · 4.6×
0617T
OTHER 		Insj Iris Prosth W/rmvl&insj 1 $18,089.98 $18,089.98 $18,089.98 nat. median
$5,420
outlier · 3.3×
0618T
OTHER 		Insj Iris Prosth Sec Io Lens 1 $18,089.98 $18,089.98 $18,089.98 nat. median
$5,373
outlier · 3.4×
C2616
HCPCS 		Brachytx, Non-str,yttrium-90 1 $17,609.76 $17,609.76 $17,609.76 nat. median
$26,606
0.7× median
C9758
HCPCS 		Blind Interatrial Shunt Ide 1 $17,500.50 $17,500.50 $17,500.50 nat. median
$17,921
1.0× median
C9782
HCPCS 		Blind Myocar Trpl Bon Marrow 1 $17,500.50 $17,500.50 $17,500.50 nat. median
$18,376
1.0× median
69930
HCPCS 		Implant Cochlear Device 2 $1,127.32 $33,337.03 $17,232.17 nat. median
$29,361
0.6× median
36836
HCPCS 		Prq Av Fstl Crtj Uxtr 1 Acs 1 $17,177.60 $17,177.60 $17,177.60 nat. median
$17,497
1.0× median
C9602
HCPCS 		Perc D-e Cor Stent Ather S 1 $17,177.60 $17,177.60 $17,177.60 nat. median
$20,000
0.9× median
C9766
HCPCS 		Revasc Intra Lithotrip-ather 1 $17,177.60 $17,177.60 $17,177.60 nat. median
$19,257
0.9× median
C9607
HCPCS 		Perc D-e Cor Revasc Chro Sin 1 $17,177.60 $17,177.60 $17,177.60 nat. median
$19,903
0.9× median
C9767
HCPCS 		Revasc Lithotrip-stent-ather 1 $17,177.60 $17,177.60 $17,177.60 nat. median
$20,627
0.8× median
C9773
HCPCS 		Revasc Lithotr-stent Tib/per 1 $17,177.60 $17,177.60 $17,177.60 nat. median
$19,347
0.9× median
0238T
OTHER 		Trluml Perip Athrc Iliac Art 1 $17,177.60 $17,177.60 $17,177.60 nat. median
$17,120
1.0× median
C9765
HCPCS 		Revasc Intra Lithotrip-stent 1 $17,177.60 $17,177.60 $17,177.60 nat. median
$19,024
0.9× median

Other procedures at this hospital

Browse this hospital's 15,877 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
             
J3399 HCPCS Inj Onase Abepar-xioi Treat 2 2 — — $2,167,500.00 $3,325,455.00 $2,746,477.50 2026-01-14
C9098 HCPCS Ciltacabtagene Car Pos T 1 1 — — $727,687.80 $727,687.80 $727,687.80 2026-01-14
Q2056 HCPCS Ciltacabtagene Car-pos T 3 3 — — $95,794.46 $727,687.83 $492,900.00 2026-01-14
Q2042 HCPCS Tisagenlecleucel Car-pos T 1 1 — — $466,069.91 $466,069.91 $466,069.91 2026-01-14
Q2055 HCPCS Idecabtagene Vicleucel Car 3 3 — — $91,451.00 $656,483.97 $460,226.55 2026-01-14
Q2054 HCPCS Lisocabtagene Mara Car Pos T 4 4 — — $89,445.40 $642,086.69 $436,497.66 2026-01-14
Q2040 HCPCS Tisagenlecleucel Car-pos T 1 1 — — $432,480.00 $432,480.00 $432,480.00 2026-01-14
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 4 4 — — $89,853.63 $583,715.15 $428,210.00 2026-01-14
Q2053 HCPCS Brexucabtagene Car Pos T 4 4 — — $89,750.48 $583,715.16 $428,210.00 2026-01-14
A9543 HCPCS Y90 Ibritumomab, Rx 3 3 — — $61,774.82 $86,971.43 $65,476.58 2026-01-14
0424T OTHER Insj/rplc Nstim Apnea Compl 1 1 — — $55,000.50 $55,000.50 $55,000.50 2026-01-14
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 5 4 — — $48,512.55 $66,147.00 $53,634.83 2026-01-14
J7330 HCPCS Cultured Chondrocytes Implnt 3 2 — — $46,453.35 $81,770.23 $52,733.49 2026-01-14
J9226 HCPCS Supprelin La Implant 4 3 — — $22,821.75 $43,930.19 $39,095.93 2026-01-14
0408T OTHER Insj/rplc Cardiac Modulj Sys 1 1 — — $32,076.33 $32,076.33 $32,076.33 2026-01-14
0571T OTHER Insj/rplcmt Icds Ss Eltrd 1 1 — — $32,076.33 $32,076.33 $32,076.33 2026-01-14
0427T OTHER Insj/rplc Nstim Apnea Pls Gn 1 1 — — $29,358.48 $29,358.48 $29,358.48 2026-01-14
0266T OTHER Implt/rpl Crtd Sns Dev Total 1 1 — — $29,358.48 $29,358.48 $29,358.48 2026-01-14
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 1 1 — — $29,358.48 $29,358.48 $29,358.48 2026-01-14
0268T OTHER Implt/rpl Crtd Sns Dev Gen 1 1 — — $29,358.48 $29,358.48 $29,358.48 2026-01-14
C9760 HCPCS Non-blind Interatrial Shunt 1 1 — — $27,500.50 $27,500.50 $27,500.50 2026-01-14
0409T OTHER Insj/rplc Car Modulj Pls Gn 1 1 — — $22,818.32 $22,818.32 $22,818.32 2026-01-14
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 1 1 — — $22,818.32 $22,818.32 $22,818.32 2026-01-14
0520T OTHER Rmv&rplcmt Pg Wcs Lv Battery 1 1 — — $22,818.32 $22,818.32 $22,818.32 2026-01-14
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 1 1 — — $22,818.32 $22,818.32 $22,818.32 2026-01-14
0515T OTHER Insj Wcs Lv Compl Sys 1 1 — — $22,818.32 $22,818.32 $22,818.32 2026-01-14
0809T OTHER Arthrd Si Jt Prq Tfx&implt 1 1 — — $21,897.63 $21,897.63 $21,897.63 2026-01-14
0775T OTHER Arthrd Si Jt Prq Iartic Impl 1 1 — — $21,897.63 $21,897.63 $21,897.63 2026-01-14
24363 HCPCS Replace Elbow Joint 1 1 — — $21,897.63 $21,897.63 $21,897.63 2026-01-14
64580 HCPCS Opn Impltj Nea Neuromuscular 1 1 — — $21,515.36 $21,515.36 $21,515.36 2026-01-14
38240 HCPCS Transplt Allo Hct/donor 2 2 — — $104.24 $42,233.40 $21,168.82 2026-01-14
J9266 HCPCS Pegaspargase Injection 5 4 — — $1,959.42 $25,762.46 $20,747.42 2026-01-14
54405 HCPCS Insert Multi-comp Penis Pros 1 1 — — $19,281.71 $19,281.71 $19,281.71 2026-01-14
54401 HCPCS Insert Self-contd Prosthesis 1 1 — — $19,281.71 $19,281.71 $19,281.71 2026-01-14
0617T OTHER Insj Iris Prosth W/rmvl&insj 1 1 — — $18,089.98 $18,089.98 $18,089.98 2026-01-14
0308T OTHER Insj Ocular Telescope Prosth 1 1 — — $18,089.98 $18,089.98 $18,089.98 2026-01-14
0618T OTHER Insj Iris Prosth Sec Io Lens 1 1 — — $18,089.98 $18,089.98 $18,089.98 2026-01-14
0616T OTHER Insertion Of Iris Prosthesis 1 1 — — $18,089.98 $18,089.98 $18,089.98 2026-01-14
C2616 HCPCS Brachytx, Non-str,yttrium-90 1 1 — — $17,609.76 $17,609.76 $17,609.76 2026-01-14
C9782 HCPCS Blind Myocar Trpl Bon Marrow 1 1 — — $17,500.50 $17,500.50 $17,500.50 2026-01-14
C9758 HCPCS Blind Interatrial Shunt Ide 1 1 — — $17,500.50 $17,500.50 $17,500.50 2026-01-14
69930 HCPCS Implant Cochlear Device 2 2 — — $1,127.32 $33,337.03 $17,232.17 2026-01-14
C9773 HCPCS Revasc Lithotr-stent Tib/per 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
C9774 HCPCS Revasc Lithotr-ather Tib/per 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
0793T OTHER Prq Tcat Thrm Ablt Nrv P-art 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
C9765 HCPCS Revasc Intra Lithotrip-stent 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
0803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
0797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
36836 HCPCS Prq Av Fstl Crtj Uxtr 1 Acs 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
0238T OTHER Trluml Perip Athrc Iliac Art 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
C9766 HCPCS Revasc Intra Lithotrip-ather 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
C9767 HCPCS Revasc Lithotrip-stent-ather 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
0632T OTHER Perq Tcat US Abltj Nrv P-art 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
C9602 HCPCS Perc D-e Cor Stent Ather S 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
36837 HCPCS Prq Av Fstl Crt Uxtr Sep Acs 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
0645T OTHER Tcat Impltj C Sins Rdctj Dev 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
C9775 HCPCS Revasc Lith-sten-ath Tib/per 1 1 — — $17,177.60 $17,177.60 $17,177.60 2026-01-14
33249 HCPCS Insj/rplcmt Defib W/lead(s) 2 2 — — $895.01 $32,076.33 $16,485.67 2026-01-14
L7180 HCPCS Electronic Elbow Sequential 1 1 — — $16,310.00 $16,310.00 $16,310.00 2026-01-14
33270 HCPCS Ins/rep Subq Defibrillator 2 2 — — $508.93 $32,076.33 $16,292.63 2026-01-14
A9604 HCPCS Sm 153 Lexidronam 3 3 — — $8,804.57 $17,259.85 $16,287.34 2026-01-14
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 2 2 — — $325.13 $32,076.33 $16,200.73 2026-01-14
33231 HCPCS Insrt Pulse Gen W/mult Leads 2 2 — — $324.53 $32,076.33 $16,200.43 2026-01-14
0094U OTHER Genome Rapid Sequence Alys 2 2 — — $7,582.20 $23,735.55 $15,658.88 2026-01-14
L5856 HCPCS Elec Knee-shin Swing/stance 1 1 — — $15,119.69 $15,119.69 $15,119.69 2026-01-14
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 2 2 — — $740.13 $29,358.48 $15,049.30 2026-01-14
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 2 2 — — $549.90 $29,358.48 $14,954.19 2026-01-14
61886 HCPCS Implant Neurostim Arrays 2 2 — — $378.63 $29,358.48 $14,868.55 2026-01-14
63685 HCPCS Ins/rplc Spi Npg/rcvr Pocket 2 2 — — $378.26 $29,358.48 $14,868.37 2026-01-14
A9572 HCPCS Indium In-111 Pentetreotide 1 1 — — $14,096.10 $14,096.10 $14,096.10 2026-01-14
0267U OTHER Rare Do Id Opt Gen Mapg&seq 2 2 — — $6,739.33 $21,096.99 $13,918.16 2026-01-14
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 2 2 — — $275.87 $27,305.17 $13,790.52 2026-01-14
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 3 3 — — $7,193.00 $18,701.80 $13,199.39 2026-01-14
0627T OTHER Perq Njx Algc Fluor Lmbr 1st 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
C9757 HCPCS Spine Device Implant Surgery 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
24362 HCPCS Reconstruct Elbow Joint 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
C9734 HCPCS U/s Trtmt, Not Leiomyomata 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
0629T OTHER Perq Njx Algc CT Lmbr 1st 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
69714 HCPCS Impl Oi Implt Skull Perq Esp 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
69729 HCPCS Impl Oi Implt Sk Tc Esp>=100 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
69730 HCPCS Rplc Oi Implt Sk Tc Esp>=100 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
69716 HCPCS Impl Oi Implt Sk Tc Esp<100 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
23472 HCPCS Reconstruct Shoulder Joint 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
C9781 HCPCS Arthro/shoul Surg; W/spacer 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
27446 HCPCS Revision Of Knee Joint 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
69719 HCPCS Rplcm Oi Implt Sk Tc Esp<100 1 1 — — $13,048.08 $13,048.08 $13,048.08 2026-01-14
J9600 HCPCS Porfimer Sodium Injection 4 3 — — $2,602.22 $22,490.02 $12,782.63 2026-01-14
0686T OTHER Histotripsy Mal Hepatcel Tis 1 1 — — $12,500.50 $12,500.50 $12,500.50 2026-01-14
L5973 HCPCS Ank-foot Sys Dors-plant Flex 1 1 — — $12,453.00 $12,453.00 $12,453.00 2026-01-14
93656 HCPCS Compre Ep Eval Abltj Atr Fib 2 2 — — $880.47 $23,481.29 $12,180.88 2026-01-14
93654 HCPCS Compre Ep Eval Tx Vt 2 2 — — $880.22 $23,481.29 $12,180.75 2026-01-14
J7310 HCPCS Ganciclovir Long Act Implant 2 2 — — $7,245.14 $16,960.00 $12,102.57 2026-01-14
93653 HCPCS Compre Ep Eval Tx Svt 2 2 — — $659.46 $23,481.29 $12,070.38 2026-01-14
K0863 HCPCS Pwc Gp3 Vhd Mult Pow Opt S/b 1 1 — — $12,064.92 $12,064.92 $12,064.92 2026-01-14
K0860 HCPCS Pwc Gp3 Vhd Sing Pow Opt S/b 1 1 — — $12,064.92 $12,064.92 $12,064.92 2026-01-14
53451 HCPCS Tprnl Balo Cntnc Dev Bi 1 1 — — $12,028.07 $12,028.07 $12,028.07 2026-01-14
K0864 HCPCS Pwc Gp3 Xhd Mult Pow Opt S/b 1 1 — — $11,964.50 $11,964.50 $11,964.50 2026-01-14
0398T OTHER Mrgfus Strtctc Les Abltj 1 1 — — $11,952.59 $11,952.59 $11,952.59 2026-01-14
0425T OTHER Insj/rplc Nstim Apnea Sen Ld 1 1 — — $11,952.59 $11,952.59 $11,952.59 2026-01-14
0426T OTHER Insj/rplc Nstim Apnea Stm Ld 1 1 — — $11,952.59 $11,952.59 $11,952.59 2026-01-14
43647 HCPCS Lap Impl Electrode Antrum 1 1 — — $11,952.59 $11,952.59 $11,952.59 2026-01-14
0036U OTHER Xome Tum & Nml Spec Seq Alys 4 3 — — $4,780.00 $14,730.16 $11,806.60 2026-01-14
36906 HCPCS Thrmbc/nfs Dialysis Circuit 2 2 — — $6,259.85 $17,177.60 $11,718.72 2026-01-14
22633 HCPCS Arthrd Cmbn 1ntrspc Lumbar 2 2 — — $1,514.84 $21,897.63 $11,706.24 2026-01-14
L5858 HCPCS Stance Phase Only 1 1 — — $11,705.58 $11,705.58 $11,705.58 2026-01-14
24371 HCPCS Revise Reconst Elbow Joint 2 2 — — $1,478.78 $21,897.63 $11,688.21 2026-01-14
0211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 2 2 — — $8,455.00 $14,854.96 $11,654.98 2026-01-14
33240 HCPCS Insrt Pulse Gen W/singl Lead 2 2 — — $383.84 $22,818.32 $11,601.08 2026-01-14
81416 HCPCS Exome Sequence Analysis 2 2 — — $11,149.41 $12,000.00 $11,574.70 2026-01-14
K0854 HCPCS Pwc Gp 3 Xhd Seat/back 1 1 — — $11,566.32 $11,566.32 $11,566.32 2026-01-14
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 2 2 — — $313.43 $22,818.32 $11,565.88 2026-01-14
33230 HCPCS Insrt Pulse Gen W/dual Leads 2 2 — — $312.84 $22,818.32 $11,565.58 2026-01-14
22856 HCPCS Tot Disc Arthrp 1ntrspc Crv 2 2 — — $1,231.20 $21,897.63 $11,564.42 2026-01-14
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 2 2 — — $301.74 $22,818.32 $11,560.03 2026-01-14
22612 HCPCS Arthrd Pst Tq 1ntrspc Lumbar 2 2 — — $1,192.48 $21,897.63 $11,545.06 2026-01-14
21243 HCPCS Reconstruction Of Jaw Joint 2 2 — — $1,180.19 $21,897.63 $11,538.91 2026-01-14
23616 HCPCS Optx Prx Hmrl Fx Fix Rpr Rpl 2 2 — — $1,173.49 $21,897.63 $11,535.56 2026-01-14
22630 HCPCS Arthrd Pst Tq 1ntrspc Lum 2 2 — — $1,124.72 $21,897.63 $11,511.17 2026-01-14
25446 HCPCS Arthrp W/prostc Dst Rds&crps 2 2 — — $999.25 $21,897.63 $11,448.44 2026-01-14
27702 HCPCS Reconstruct Ankle Joint 2 2 — — $927.77 $21,897.63 $11,412.70 2026-01-14
K0840 HCPCS Pwc Gp2 Xhd Sing Pow Opt S/b 1 1 — — $11,397.96 $11,397.96 $11,397.96 2026-01-14
24361 HCPCS Reconstruct Elbow Joint 2 2 — — $855.92 $21,897.63 $11,376.78 2026-01-14
22867 HCPCS Insj Stablj Dev W/dcmprn 2 2 — — $839.54 $21,897.63 $11,368.58 2026-01-14
28705 HCPCS Arthrodesis Pantalar 2 2 — — $769.54 $21,897.63 $11,333.58 2026-01-14
47135 HCPCS Transplantation Of Liver 1 1 — — $11,326.00 $11,326.00 $11,326.00 2026-01-14
20696 HCPCS App Mltpln Uni Xtrnl Fix 1st 2 2 — — $739.02 $21,897.63 $11,318.33 2026-01-14
0265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 2 2 — — $5,475.80 $17,141.60 $11,308.70 2026-01-14
0212U OTHER Rare Ds Gen DNA Alys Proband 2 2 — — $5,475.20 $17,139.72 $11,307.46 2026-01-14
27279 HCPCS Arthrd Si Jt Plmt Tartclr Dv 2 2 — — $486.66 $21,897.63 $11,192.15 2026-01-14
63655 HCPCS Implant Neuroelectrodes 2 2 — — $776.62 $21,515.36 $11,145.99 2026-01-14
25442 HCPCS Arthrp W/prostc Dstl Ulna 2 2 — — $385.70 $21,897.63 $11,141.67 2026-01-14
61885 HCPCS Insrt/redo Neurostim 1 Array 2 2 — — $388.31 $21,515.36 $10,951.83 2026-01-14
K0855 HCPCS Pwc Gp 3 Xhd Cap Chair 1 1 — — $10,926.12 $10,926.12 $10,926.12 2026-01-14
64590 HCPCS Ins/rpl Prph Sac/gstr Npg/r 2 2 — — $135.14 $21,515.36 $10,825.25 2026-01-14
0335U OTHER Rare Ds Whl Gen Seq Fetal 2 2 — — $5,224.60 $16,355.23 $10,789.92 2026-01-14
0214U OTHER Rare Ds Xom DNA Alys Proband 2 2 — — $5,224.60 $16,355.23 $10,789.92 2026-01-14
0236T OTHER Trluml Perip Athrc Abd Aorta 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
33901 HCPCS Perq P-art Revsc 1 Nm Nt Bi 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
0234T OTHER Trluml Perip Athrc Renal Art 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
C9600 HCPCS Perc Drug-el Cor Stent Sing 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
C9604 HCPCS Perc D-e Cor Revasc T Cabg S 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
C9772 HCPCS Revasc Lithotrip Tibi/perone 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
0237T OTHER Trluml Perip Athrc Brchiocph 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
C9783 HCPCS Blind Cor Sinus Reducer Impl 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
0505T OTHER Ev Fempop Artl Revsc 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
33900 HCPCS Perq P-art Revsc 1 Nm Nt Uni 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
33903 HCPCS Perq P-art Revsc 1 Abnor Bi 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
C9764 HCPCS Revasc Intravasc Lithotripsy 1 1 — — $10,615.31 $10,615.31 $10,615.31 2026-01-14
0525T OTHER Insj/rplcmt Compl Iims 1 1 — — $10,328.77 $10,328.77 $10,328.77 2026-01-14
0108U OTHER Gi Barrett Esoph 9 Prtn Bmrk 2 2 — — $4,950.00 $15,495.62 $10,222.81 2026-01-14
54411 HCPCS Remov/replc Penis Pros Comp 2 2 — — $789.28 $19,281.71 $10,035.50 2026-01-14
54410 HCPCS Remove/replace Penis Prosth 2 2 — — $721.89 $19,281.71 $10,001.80 2026-01-14
53444 HCPCS Insert Tandem Cuff 2 2 — — $636.26 $19,281.71 $9,958.99 2026-01-14
53445 HCPCS Insert Uro/ves Nck Sphincter 2 2 — — $634.03 $19,281.71 $9,957.87 2026-01-14
53447 HCPCS Remove/replace Ur Sphincter 2 2 — — $591.21 $19,281.71 $9,936.46 2026-01-14
54416 HCPCS Remv/repl Penis Contain Pros 2 2 — — $563.66 $19,281.71 $9,922.68 2026-01-14
0045U OTHER Onc Brst Dux Carc Is 12 Gene 4 3 — — $3,873.00 $11,935.12 $9,566.31 2026-01-14
0258U OTHER Ai Psor Mrna 50-100 Gen Alg 3 3 — — $3,675.00 $11,504.32 $9,555.00 2026-01-14
33229 HCPCS Remv&replc Pm Gen Mult Leads 2 2 — — $301.48 $18,672.01 $9,486.74 2026-01-14
33221 HCPCS Insert Pulse Gen Mult Leads 2 2 — — $291.26 $18,672.01 $9,481.64 2026-01-14
0080U OTHER Onc Lng 5 Clin Rsk Factr Alg 3 3 — — $3,520.00 $11,019.11 $9,152.00 2026-01-14
93590 HCPCS Perq Transcath Cls Mitral 2 2 — — $1,006.03 $17,177.60 $9,091.81 2026-01-14
0600T OTHER Ablt Ire 1+ O/t Lv/prst8 Prq 1 1 — — $9,087.30 $9,087.30 $9,087.30 2026-01-14
55867 HCPCS Laps Surg Prst8ect Smpl Stot 1 1 — — $9,087.30 $9,087.30 $9,087.30 2026-01-14
0601T OTHER Abltj Ire 1+tumors Open 1 1 — — $9,087.30 $9,087.30 $9,087.30 2026-01-14
C9784 HCPCS Endo Sleeve Gastro W/tube 1 1 — — $9,087.30 $9,087.30 $9,087.30 2026-01-14
C9785 HCPCS Endo Outlet Restrict W/tube 1 1 — — $9,087.30 $9,087.30 $9,087.30 2026-01-14
0047U OTHER Onc Prst8 Mrna 17 Gene Alg 5 4 — — $3,098.40 $11,935.12 $9,062.82 2026-01-14
81541 HCPCS Onc Prostate Mrna 46 Genes 5 4 — — $3,098.40 $14,989.70 $9,062.82 2026-01-14
81521 HCPCS Onc Breast Mrna 70 Genes 5 4 — — $3,098.40 $14,989.70 $9,062.82 2026-01-14
93591 HCPCS Perq Transcath Cls Aortic 2 2 — — $835.12 $17,177.60 $9,006.36 2026-01-14
37231 HCPCS Tib/per Revasc Stent & Ather 2 2 — — $646.18 $17,177.60 $8,911.89 2026-01-14
37227 HCPCS Fem/popl Revasc Stnt & Ather 2 2 — — $632.81 $17,177.60 $8,905.20 2026-01-14
37229 HCPCS Tib/per Revasc W/ather 2 2 — — $613.25 $17,177.60 $8,895.42 2026-01-14
37230 HCPCS Tib/per Revasc W/stent 2 2 — — $594.57 $17,177.60 $8,886.08 2026-01-14
93582 HCPCS Perq Transcath Closure Pda 2 2 — — $565.26 $17,177.60 $8,871.43 2026-01-14
92933 HCPCS Prq Trlml C Athrc St Angiop1 2 2 — — $540.15 $17,177.60 $8,858.87 2026-01-14
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 2 2 — — $417.72 $17,177.60 $8,797.66 2026-01-14
E1008 HCPCS Pwr Seat Combo Pwr Shear 1 1 — — $8,742.05 $8,742.05 $8,742.05 2026-01-14
E1007 HCPCS Pwr Seat Combo W/shear 1 1 — — $8,741.27 $8,741.27 $8,741.27 2026-01-14
K0853 HCPCS Pwc Gp 3 Vhd Cap Chair 1 1 — — $8,730.72 $8,730.72 $8,730.72 2026-01-14
19357 HCPCS Tiss Xpndr Plmt Brst Rcnstj 2 2 — — $708.86 $16,683.77 $8,696.32 2026-01-14
62362 HCPCS Implant Spine Infusion Pump 2 2 — — $262.10 $16,938.46 $8,600.28 2026-01-14
62361 HCPCS Implant Spine Infusion Pump 2 2 — — $200.30 $16,938.46 $8,569.38 2026-01-14
53452 HCPCS Tprnl Balo Cntnc Dev Uni 1 1 — — $8,557.53 $8,557.53 $8,557.53 2026-01-14
C9761 HCPCS Cysto, Litho, Vacuum Kidney 1 1 — — $8,557.53 $8,557.53 $8,557.53 2026-01-14
55873 HCPCS Cryoablate Prostate 1 1 — — $8,557.53 $8,557.53 $8,557.53 2026-01-14
0421T OTHER Waterjet Prostate Abltj Cmpl 1 1 — — $8,557.53 $8,557.53 $8,557.53 2026-01-14
C9740 HCPCS Cysto Impl 4 Or More 1 1 — — $8,557.53 $8,557.53 $8,557.53 2026-01-14
C9769 HCPCS Cysto W/temp Pros Implant 1 1 — — $8,557.53 $8,557.53 $8,557.53 2026-01-14
50576 HCPCS Kidney Endoscopy & Treatment 1 1 — — $8,557.53 $8,557.53 $8,557.53 2026-01-14
62360 HCPCS Insert Spine Infusion Device 2 2 — — $83.40 $16,938.46 $8,510.93 2026-01-14
K0852 HCPCS Pwc Gp 3 Vhd Seat/back 1 1 — — $8,499.12 $8,499.12 $8,499.12 2026-01-14
K0858 HCPCS Pwc Gp3 Hd Sing Pow Opt S/b 1 1 — — $8,445.12 $8,445.12 $8,445.12 2026-01-14
K0862 HCPCS Pwc Gp3 Hd Mult Pow Opt S/b 1 1 — — $8,445.12 $8,445.12 $8,445.12 2026-01-14
0026U OTHER Onc Thyr Dna&mrna 112 Genes 5 4 — — $2,880.00 $12,549.60 $8,424.00 2026-01-14
67027 HCPCS Implant Eye Drug System 2 2 — — $588.23 $16,020.20 $8,304.22 2026-01-14
K0828 HCPCS Pwc Gp 2 Xtra Hd Seat/back 1 1 — — $8,289.84 $8,289.84 $8,289.84 2026-01-14
C9780 HCPCS Insert Cv Cath Inf & Sup App 1 1 — — $8,250.50 $8,250.50 $8,250.50 2026-01-14
0037U OTHER Trgt Gen Seq DNA 324 Genes 5 4 — — $2,800.00 $10,785.68 $8,190.00 2026-01-14
0572T OTHER Insertion Ss Dfb Electrode 1 1 — — $8,162.77 $8,162.77 $8,162.77 2026-01-14
0527T OTHER Insj/rplcmt Iims Implt Mntr 1 1 — — $8,162.77 $8,162.77 $8,162.77 2026-01-14
0517T OTHER Insj Wcs Lv Both Compnt Pg 1 1 — — $8,162.77 $8,162.77 $8,162.77 2026-01-14
0411T OTHER Insj/rplc Car Modulj Vnt Elt 1 1 — — $8,162.77 $8,162.77 $8,162.77 2026-01-14
0410T OTHER Insj/rplc Car Modulj Atr Elt 1 1 — — $8,162.77 $8,162.77 $8,162.77 2026-01-14
0516T OTHER Insj Wcs Lv Eltrd Only 1 1 — — $8,162.77 $8,162.77 $8,162.77 2026-01-14
0526T OTHER Insj/rplcmt Iims Eltrd Only 1 1 — — $8,162.77 $8,162.77 $8,162.77 2026-01-14
0340U OTHER Onc Pan Ca Alys Mrd Plasma 2 2 — — $3,920.00 $12,271.28 $8,095.64 2026-01-14
81425 HCPCS Genome Sequence Analysis 2 2 — — $5,031.20 $11,149.41 $8,090.31 2026-01-14
L6975 HCPCS Interscap-thor Myoelectronic 1 1 — — $8,050.00 $8,050.00 $8,050.00 2026-01-14
81540 HCPCS Oncology Tum Unknown Origin 2 2 — — $3,750.00 $12,260.85 $8,005.43 2026-01-14
81415 HCPCS Exome Sequence Analysis 2 2 — — $4,780.00 $11,149.41 $7,964.70 2026-01-14
36903 HCPCS Intro Cath Dialysis Circuit 2 2 — — $5,174.97 $10,615.31 $7,895.14 2026-01-14
A9515 HCPCS Choline C-11 1 1 — — $7,824.60 $7,824.60 $7,824.60 2026-01-14
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 3 3 — — $7,776.00 $25,424.10 $7,776.00 2026-01-14
E1035 HCPCS Patient Transfer System <300 1 1 — — $7,726.32 $7,726.32 $7,726.32 2026-01-14
77424 HCPCS Io Rad Tx Delivery By X-ray 1 1 — — $7,690.57 $7,690.57 $7,690.57 2026-01-14
K0829 HCPCS Pwc Gp 2 Xtra Hd Cap Chair 1 1 — — $7,612.44 $7,612.44 $7,612.44 2026-01-14
0250U OTHER Onc Sld Org Neo DNA 505 Gene 3 3 — — $2,919.60 $9,139.59 $7,590.96 2026-01-14
0019U OTHER Onc RNA Tiss Predict Alg 2 2 — — $3,675.00 $11,504.32 $7,589.66 2026-01-14
K0826 HCPCS Pwc Gp 2 Vhd Seat/back 1 1 — — $7,523.16 $7,523.16 $7,523.16 2026-01-14
K0839 HCPCS Pwc Gp2 Vhd Sing Pow Opt S/b 1 1 — — $7,523.16 $7,523.16 $7,523.16 2026-01-14
37241 HCPCS Vasc Embolize/occlude Venous 2 2 — — $4,381.60 $10,615.31 $7,498.45 2026-01-14
0242U OTHER Trgt Gen Seq Alys Pnl 55-74 4 4 — — $5,000.00 $13,000.00 $7,450.12 2026-01-14
0313U OTHER Onc Pncrs Dna&mrna Seq 74 2 2 — — $3,600.00 $11,269.54 $7,434.77 2026-01-14
E0304 HCPCS Hosp Bed Xtra Hvy Dty X Wide 1 1 — — $7,398.43 $7,398.43 $7,398.43 2026-01-14
E0783 HCPCS Programmable Infusion Pump 1 1 — — $7,269.63 $7,269.63 $7,269.63 2026-01-14
27447 HCPCS Total Knee Arthroplasty 2 2 — — $1,489.20 $13,048.08 $7,268.64 2026-01-14
27130 HCPCS Total Hip Arthroplasty 2 2 — — $1,489.20 $13,048.08 $7,268.64 2026-01-14
81520 HCPCS Onc Breast Mrna 58 Genes 5 4 — — $2,231.29 $11,994.18 $7,251.71 2026-01-14
81440 HCPCS Mitochondrial Gene 2 2 — — $3,324.00 $11,149.41 $7,236.70 2026-01-14
22551 HCPCS Arthrd Ant Ntrbdy Cervical 2 2 — — $1,422.88 $13,048.08 $7,235.48 2026-01-14
0016M OTHER Onc Bladder Mrna 219 Gen Alg 2 2 — — $3,489.63 $10,924.04 $7,206.84 2026-01-14
23473 HCPCS Revis Reconst Shoulder Joint 2 2 — — $1,356.29 $13,048.08 $7,202.19 2026-01-14
24370 HCPCS Revise Reconst Elbow Joint 2 2 — — $1,285.55 $13,048.08 $7,166.82 2026-01-14
L6970 HCPCS Interscapular-thor Switch CT 1 1 — — $7,070.00 $7,070.00 $7,070.00 2026-01-14
22554 HCPCS Arthrd Ant Ntrbd Min Dsc Crv 2 2 — — $1,083.39 $13,048.08 $7,065.74 2026-01-14
27828 HCPCS Treat Lower Leg Fracture 2 2 — — $965.37 $13,048.08 $7,006.72 2026-01-14
27429 HCPCS Reconstruction Knee 2 2 — — $959.79 $13,048.08 $7,003.94 2026-01-14
28420 HCPCS Optx Calcaneal Fx W/bone Grf 2 2 — — $934.47 $13,048.08 $6,991.28 2026-01-14
23491 HCPCS Reinforce Shoulder Bones 2 2 — — $916.23 $13,048.08 $6,982.16 2026-01-14
27827 HCPCS Treat Lower Leg Fracture 2 2 — — $904.32 $13,048.08 $6,976.20 2026-01-14
27442 HCPCS Revision Of Knee Joint 2 2 — — $893.52 $13,048.08 $6,970.80 2026-01-14
24587 HCPCS Optx Partclr Fx&/dslc Elbw W 2 2 — — $879.74 $13,048.08 $6,963.91 2026-01-14
27428 HCPCS Reconstruction Knee 2 2 — — $851.08 $13,048.08 $6,949.58 2026-01-14
25441 HCPCS Arthrp W/prostc Dstl Rds 2 2 — — $844.38 $13,048.08 $6,946.23 2026-01-14
24435 HCPCS Rpr Non/mal Hum With Agrft 2 2 — — $843.26 $13,048.08 $6,945.67 2026-01-14
23470 HCPCS Reconstruct Shoulder Joint 2 2 — — $843.26 $13,048.08 $6,945.67 2026-01-14
23802 HCPCS Arthrd Glenohumeral Jt W/grf 2 2 — — $843.26 $13,048.08 $6,945.67 2026-01-14
K0857 HCPCS Pwc Gp3 Std Sing Pow Opt Cap 1 1 — — $6,943.20 $6,943.20 $6,943.20 2026-01-14
24586 HCPCS Optx Partclr Fx&/dislc Elbow 2 2 — — $835.07 $13,048.08 $6,941.57 2026-01-14
25491 HCPCS Prophylactic Tx Ulna 2 2 — — $829.11 $13,048.08 $6,938.59 2026-01-14
24346 HCPCS Reconstruct Elbow Med Ligmnt 2 2 — — $818.69 $13,048.08 $6,933.39 2026-01-14
81426 HCPCS Genome Sequence Analysis 2 2 — — $2,709.95 $11,149.41 $6,929.68 2026-01-14
0404T OTHER Trnscrv Uterin Fibroid Abltj 1 1 — — $6,925.56 $6,925.56 $6,925.56 2026-01-14
27443 HCPCS Revision Of Knee Joint 2 2 — — $776.99 $13,048.08 $6,912.53 2026-01-14
24498 HCPCS Proph Tx W/wo Mthylmthcrylt 2 2 — — $766.19 $13,048.08 $6,907.14 2026-01-14
27438 HCPCS Revise Kneecap With Implant 2 2 — — $753.16 $13,048.08 $6,900.62 2026-01-14
27441 HCPCS Revision Of Knee Joint 2 2 — — $744.60 $13,048.08 $6,896.34 2026-01-14
27759 HCPCS Treatment Of Tibia Fracture 2 2 — — $722.26 $13,048.08 $6,885.17 2026-01-14
27870 HCPCS Fusion Of Ankle Joint Open 2 2 — — $717.05 $13,048.08 $6,882.57 2026-01-14
24430 HCPCS Rpr Non/mal Humerus Wo Graft 2 2 — — $716.68 $13,048.08 $6,882.38 2026-01-14
27415 HCPCS Osteochondral Knee Allograft 2 2 — — $686.26 $13,048.08 $6,867.17 2026-01-14
29856 HCPCS Tibial Arthroscopy/surgery 2 2 — — $683.54 $13,048.08 $6,865.81 2026-01-14
24802 HCPCS Arthrd Elbow Jt Autog Graft 2 2 — — $674.61 $13,048.08 $6,861.34 2026-01-14
29889 HCPCS Arthrs Aid Pcl Rpr/agmntj 2 2 — — $674.61 $13,048.08 $6,861.34 2026-01-14
25810 HCPCS Arthrd Wrst Iliac/oth Agrft 2 2 — — $673.12 $13,048.08 $6,860.60 2026-01-14
24546 HCPCS Optx Hum Fx W/ntrcndylr Xtn 2 2 — — $661.58 $13,048.08 $6,854.83 2026-01-14
27440 HCPCS Revision Of Knee Joint 2 2 — — $632.54 $13,048.08 $6,840.31 2026-01-14
29907 HCPCS Subtalar Arthro W/fusion 2 2 — — $623.60 $13,048.08 $6,835.84 2026-01-14
E0786 HCPCS Implantable Pump Replacement 1 1 — — $6,835.16 $6,835.16 $6,835.16 2026-01-14
27871 HCPCS Fusion Of Tibiofibular Joint 2 2 — — $621.37 $13,048.08 $6,834.72 2026-01-14
29867 HCPCS Allgrft Implnt Knee W/scope 2 2 — — $600.48 $13,048.08 $6,824.28 2026-01-14
28715 HCPCS Arthrodesis Triple 2 2 — — $597.91 $13,048.08 $6,822.99 2026-01-14
J1675 HCPCS Histrelin Acetate 1 1 — — $6,820.46 $6,820.46 $6,820.46 2026-01-14
28320 HCPCS Repair Of Foot Bones 2 2 — — $591.21 $13,048.08 $6,819.64 2026-01-14
28735 HCPCS Fusion Of Foot Bones 2 2 — — $590.47 $13,048.08 $6,819.28 2026-01-14
24410 HCPCS Mlt Osteot Rlgnm Imed Rd Hum 2 2 — — $590.47 $13,048.08 $6,819.28 2026-01-14
25365 HCPCS Revise Radius & Ulna 2 2 — — $590.47 $13,048.08 $6,819.28 2026-01-14
27709 HCPCS Osteotomy Tibia & Fibula 2 2 — — $590.47 $13,048.08 $6,819.28 2026-01-14
23680 HCPCS Optx Sho Dislc Neck Fx Fixj 2 2 — — $590.47 $13,048.08 $6,819.28 2026-01-14
K0861 HCPCS Pwc Gp3 Std Mult Pow Opt S/b 1 1 — — $6,817.68 $6,817.68 $6,817.68 2026-01-14
25391 HCPCS Lengthen Radius Or Ulna 2 2 — — $581.90 $13,048.08 $6,814.99 2026-01-14
K0856 HCPCS Pwc Gp3 Std Sing Pow Opt S/b 1 1 — — $6,806.76 $6,806.76 $6,806.76 2026-01-14
24516 HCPCS Tx Humrl Shaft Fx Imed Implt 2 2 — — $562.92 $13,048.08 $6,805.50 2026-01-14
27758 HCPCS Treatment Of Tibia Fracture 2 2 — — $548.03 $13,048.08 $6,798.05 2026-01-14
23485 HCPCS Revision Of Collar Bone 2 2 — — $548.03 $13,048.08 $6,798.05 2026-01-14
24365 HCPCS Reconstruct Head Of Radius 2 2 — — $537.60 $13,048.08 $6,792.84 2026-01-14
50242012047 NDC Tenecteplase 12 10 $12,107.25 $4,842.90 60% off $2,090.00 $10,291.16 $6,780.06 2026-01-14
23615 HCPCS Optx Prox Humrl Fx W/int Fix 2 2 — — $505.96 $13,048.08 $6,777.02 2026-01-14
E2510 HCPCS Sgd W Multi Methods Msg/accs 1 1 — — $6,768.25 $6,768.25 $6,768.25 2026-01-14
22869 HCPCS Insj Stablj Dev Without Dcmprn 2 2 — — $468.35 $13,048.08 $6,758.22 2026-01-14
24515 HCPCS Optx Humrl Shft Fx Plate/scr 2 2 — — $463.89 $13,048.08 $6,755.99 2026-01-14
28730 HCPCS Fusion Of Foot Bones 2 2 — — $463.89 $13,048.08 $6,755.99 2026-01-14
24666 HCPCS Optx Radial Head/nck Fx Rplc 2 2 — — $463.89 $13,048.08 $6,755.99 2026-01-14
24366 HCPCS Reconstruct Head Of Radius 2 2 — — $463.89 $13,048.08 $6,755.99 2026-01-14
27356 HCPCS Remove Femur Lesion/graft 2 2 — — $463.89 $13,048.08 $6,755.99 2026-01-14
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