Hospital

MEMORIAL HOSPITAL, THE

Craig, CO · CCN 061314 · Rates published

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You selected 93306 (CPT)

HC TTE COMP W/DPLR & COLOR W/CONTRAST

This hospital’s price: $2,703 across 20 payers · range $1,175-$3,018

Source: https://memorialregionalhealth.com/wp-content/uploads/840399209_The-Memorial-Hospital_StandardCharges_04.26.csv · observed 2026-05-09

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.

1,457 distinct procedures filed

20 distinct payers

70,095 rate rows

2026-05-09 last MRF observed

Data quality

50,623 of 70,095 rate rows are consumer-grade (72.2%)

19,472 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 — reason	Rows
per-diem day rate — not a per-procedure price	19,440
placeholder amount (≤ $0.02) — excluded from medians	32

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://memorialregionalhealth.com/wp-content/uploads/840399209_The-Memorial-Hospital_StandardCharges_04.26.csv
Found on page	https://memorialregionalhealth.com/price-transparency/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-21
Content fingerprint	3cc8929164760743… · 32,396,794 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J0224 HCPCS	Lumasiran 94.5 Mg/0.5 Ml Subcutaneous Solution	20	$148,749.11	$381,923.38	$341,720.92	nat. median $362 outlier · 944.1×
A9607 HCPCS	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	20	$145,341.93	$373,175.23	$333,893.63	nat. median $432 outlier · 772.1×
Q9982 HCPCS	Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution	20	$84,297.84	$649,321.20	$234,666.96	nat. median $3,080 outlier · 76.2×
A9606 HCPCS	Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln	20	$88,779.68	$227,947.82	$203,953.31	nat. median $266 outlier · 766.7×
J2350 HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	20	$28,343.65	$72,774.23	$65,113.78	nat. median $470 outlier · 138.6×
J3101 HCPCS	Tenecteplase 50 Mg Intravenous Solution	20	$18,809.40	$48,294.41	$43,210.79	nat. median $3,820 outlier · 11.3×
J9228 HCPCS	Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution	20	$12,628.09	$129,693.60	$41,467.86	nat. median $9,003 outlier · 4.6×
J1950 HCPCS	Leuprolide 11.25 Mg (pediatric 3 Month) Intramuscular Syringe Kit	20	$16,158.64	$41,488.40	$37,121.20	nat. median $3,902 outlier · 9.5×
A9588 HCPCS	Fluciclovine F18 10 Mci (370 Mbq) Intravenous Solution	20	$15,786.69	$40,533.38	$36,266.71	nat. median $757 outlier · 47.9×
A9596 HCPCS	Kit For Preparation Of Ga-68-gozetotide 25 Mcg Intravenous Solution	20	$15,710.05	$40,336.62	$36,090.66	nat. median $1,434 outlier · 25.2×
J9022 HCPCS	Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution	20	$15,620.19	$40,105.90	$35,884.23	nat. median $6,785 outlier · 5.3×
A9595 HCPCS	Piflufolastat F 18 296 Mbq To 370 Mbq (8 Mci To 10 Mci) IV Syringe	20	$15,128.91	$42,818.14	$34,778.09	nat. median $909 outlier · 38.2×
J2783 HCPCS	Rasburicase 7.5 Mg Intravenous Solution	20	$13,560.70	$34,818.00	$31,152.95	nat. median $1,587 outlier · 19.6×
J3380 HCPCS	Vedolizumab 300 Mg Intravenous Solution	20	$13,083.07	$33,591.67	$30,055.70	nat. median $162 outlier · 185.5×
J2323 HCPCS	Natalizumab 300 Mg/15 Ml Intravenous Solution	20	$12,392.84	$31,819.44	$28,470.03	nat. median $197 outlier · 144.3×
A9592 HCPCS	Copper Cu-64 Dotatate 148 Mbq/4 Ml (4 Mci/4 Ml) Intravenous Solution	20	$12,293.44	$31,564.23	$28,241.68	nat. median $1,712 outlier · 16.5×
A9572 HCPCS	Indium 111-pentetreotide 3 Mci/ml-10 Mcg Intravenous Kit	20	$12,261.50	$31,482.24	$28,168.32	nat. median $4,685 outlier · 6.0×
J1162 HCPCS	Digoxin Immune Fab 40 Mg Intravenous Solution	20	$11,724.23	$30,102.75	$26,934.04	nat. median $7,141 outlier · 3.8×
A9571 HCPCS	Indium In-111 Oxyquinoline 1 Mci/ml (37 Mbq/ml) Platelet (uw 174240)	20	$11,419.32	$29,319.89	$26,233.58	nat. median $6,122 outlier · 4.3×
A9570 HCPCS	Indium In-111 Oxyquinoline 1 Mci/ml (37 Mbq/ml)(1 Ml) Intravenous Soln	20	$11,419.32	$29,319.89	$26,233.58	nat. median $2,783 outlier · 9.4×
A9557 HCPCS	Kit For Preparation Of Tc-99m-bicisate 0.9 Mg Intravenous Solution	20	$11,365.97	$29,182.90	$26,111.01	nat. median $1,596 outlier · 16.4×
J9308 HCPCS	Ramucirumab 10 Mg/ml Intravenous Solution	20	$10,780.28	$27,679.11	$24,765.52	nat. median $1,489 outlier · 16.6×
J2353 HCPCS	Octreotide,microspheres ER 30 Mg Intramuscular Susp, Extended Release	20	$10,030.00	$25,752.69	$23,041.89	nat. median $5,573 outlier · 4.1×
J1300 HCPCS	Eculizumab 300 Mg/30 Ml Intravenous Solution	20	$9,847.11	$25,283.11	$22,621.73	nat. median $680 outlier · 33.3×
J2506 HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe	20	$9,688.60	$24,876.13	$22,257.59	nat. median $1,646 outlier · 13.5×
A9587 HCPCS	Kit For The Preparation Of Ga-68-dotatate 40 Mcg Intravenous Soln	20	$9,579.30	$24,595.50	$22,006.50	nat. median $117 outlier · 188.7×
A9586 HCPCS	Florbetapir F-18 10 Mci (370 Mbq) Intravenous Solution	20	$9,123.97	$23,426.40	$20,960.46	nat. median $3,946 outlier · 5.3×
J9217 HCPCS	Leuprolide 22.5 Mg (3 Month) Intramuscular Syringe Kit	20	$8,816.46	$45,274.44	$20,280.24	nat. median $1,575 outlier · 12.9×
J0717 HCPCS	Certolizumab Pegol 400 Mg (200 Mg X 2 Vials) Subcutaneous Kit	20	$8,633.69	$22,167.59	$19,834.16	nat. median $1,598 outlier · 12.4×
J9271 HCPCS	Pembrolizumab 25 Mg/ml Intravenous Solution	20	$8,389.64	$21,540.96	$19,273.49	nat. median $276 outlier · 69.9×
J0630 HCPCS	Calcitonin (salmon) 200 Unit/ml Injection Solution	20	$7,984.66	$20,501.16	$18,343.14	nat. median $1,894 outlier · 9.7×
A9502 HCPCS	Kit For The Preparation Of Tc-99m-tetrofosmin 1.38 Mg IV Solution	20	$7,779.99	$19,975.65	$17,872.95	nat. median $236 outlier · 75.7×
J0896 HCPCS	Luspatercept-aamt 25 Mg Subcutaneous Solution	20	$5,736.33	$44,185.16	$15,968.69	nat. median $4,583 outlier · 3.5×
J0480 HCPCS	Basiliximab 20 Mg Intravenous Solution	20	$6,485.56	$16,652.11	$14,899.26	nat. median $6,695 outlier · 2.2×
Q5122 HCPCS	Pegfilgrastim-apgf 6 Mg/0.6 Ml Subcutaneous Syringe	20	$6,157.54	$15,809.91	$14,145.71	nat. median $561 outlier · 25.2×
J9354 HCPCS	Ado-trastuzumab Emtansine 160 Mg Intravenous Solution	20	$5,649.03	$23,206.78	$12,994.30	nat. median $4,219 outlier · 3.1×
J2182 HCPCS	Mepolizumab 100 Mg Subcutaneous Solution	20	$5,074.25	$13,881.48	$11,664.60	nat. median $2,791 outlier · 4.2×
A9521 HCPCS	Kit For Preparation Of Tc-99m-exametazime 0.5 Mg Intravenous Solution	20	$4,881.51	$12,533.61	$11,214.28	nat. median $1,809 outlier · 6.2×
J0840 HCPCS	Crotalidae Polyval Immune Fab Solution For Injection	20	$4,827.70	$12,395.45	$11,090.66	nat. median $3,445 outlier · 3.2×
J9035 HCPCS	Bevacizumab 25 Mg/ml Intravenous Solution	20	$4,812.25	$12,355.77	$11,055.16	nat. median $722 outlier · 15.3×
91110 CPT	Hc Capsule Endoscopy Esoph Through Ileum	20	$4,670.30	$11,991.32	$10,729.07	nat. median $1,315 outlier · 8.2×
J1459 HCPCS	Immune Glob,gamm(igg) 10 %-pro-iga 0 To 50 Mcg/ml Intravenous Solution	20	$2,655.99	$27,277.74	$10,623.96	nat. median $1,388 outlier · 7.7×
J9299 HCPCS	Nivolumab 240 Mg/24 Ml Intravenous Solution	20	$1,846.29	$28,442.84	$10,603.66	nat. median $2,889 outlier · 3.7×
J9047 HCPCS	Carfilzomib 60 Mg Intravenous Solution	20	$4,497.40	$11,547.38	$10,331.87	nat. median $1,607 outlier · 6.4×
J9033 HCPCS	Bendamustine 100 Mg Intravenous Powder For Solution	20	$4,486.23	$11,518.70	$10,306.21	nat. median $333 outlier · 31.0×
A9548 HCPCS	Pentetate Indium Disodium In-111 1.5 Mci/1.5 Ml Intrathecal Solution	20	$3,958.08	$10,162.64	$9,092.89	nat. median $1,511 outlier · 6.0×
J1451 HCPCS	Fomepizole 1 Gram/ml Intravenous Solution	20	$3,823.95	$9,818.25	$8,784.75	nat. median $1,035 outlier · 8.5×
A9509 HCPCS	Sodium Iodine-123 (200 Microci)(whole Body Scan) Capsule (uw 175208)	20	$3,823.42	$9,816.89	$8,783.53	nat. median $467 outlier · 18.8×
J1427 HCPCS	Viltolarsen 50 Mg/ml Intravenous Solution	20	$3,594.51	$9,229.15	$8,257.66	nat. median $94 outlier · 87.8×
J1439 HCPCS	Ferric Carboxymaltose 50 Mg Iron/ml Intravenous Solution	20	$3,538.57	$9,085.52	$8,129.15	nat. median $14 outlier · 573.5×

Other procedures at this hospital

Browse this hospital's 1,457 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J0224	HCPCS	Lumasiran 94.5 Mg/0.5 Ml Subcutaneous Solution	23	20	$402,024.61	$402,024.61	$148,749.11	$381,923.38	$341,720.92	2026-05-09
A9607	HCPCS	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	23	20	$392,816.03	$392,816.03	$145,341.93	$373,175.23	$333,893.63	2026-05-09
Q9982	HCPCS	Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution	46	20	$455,664.00	$455,664.00	$84,297.84	$649,321.20	$234,666.96	2026-05-09
A9606	HCPCS	Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln	23	20	$239,945.07	$239,945.07	$88,779.68	$227,947.82	$203,953.31	2026-05-09
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	24	20	$76,604.45	$76,604.45	$28,343.65	$72,774.23	$65,113.78	2026-05-09
J3101	HCPCS	Tenecteplase 50 Mg Intravenous Solution	23	20	$50,836.22	$50,836.22	$18,809.40	$48,294.41	$43,210.79	2026-05-09
J9228	HCPCS	Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution	46	20	$85,324.78	$85,324.78	$12,628.09	$129,693.60	$41,467.86	2026-05-09
J1950	HCPCS	Leuprolide 11.25 Mg (pediatric 3 Month) Intramuscular Syringe Kit	23	20	$43,672.00	$43,672.00	$16,158.64	$41,488.40	$37,121.20	2026-05-09
A9588	HCPCS	Fluciclovine F18 10 Mci (370 Mbq) Intravenous Solution	23	20	$42,666.72	$42,666.72	$15,786.69	$40,533.38	$36,266.71	2026-05-09
A9596	HCPCS	Kit For Preparation Of Ga-68-gozetotide 25 Mcg Intravenous Solution	23	20	$42,459.60	$42,459.60	$15,710.05	$40,336.62	$36,090.66	2026-05-09
J9022	HCPCS	Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution	23	20	$42,216.74	$42,216.74	$15,620.19	$40,105.90	$35,884.23	2026-05-09
A9595	HCPCS	Piflufolastat F 18 296 Mbq To 370 Mbq (8 Mci To 10 Mci) IV Syringe	46	20	$42,980.34	$42,980.34	$15,128.91	$42,818.14	$34,778.09	2026-05-09
J2783	HCPCS	Rasburicase 7.5 Mg Intravenous Solution	23	20	$36,650.53	$36,650.53	$13,560.70	$34,818.00	$31,152.95	2026-05-09
J3380	HCPCS	Vedolizumab 300 Mg Intravenous Solution	23	20	$35,359.65	$35,359.65	$13,083.07	$33,591.67	$30,055.70	2026-05-09
J2323	HCPCS	Natalizumab 300 Mg/15 Ml Intravenous Solution	23	20	$33,494.15	$33,494.15	$12,392.84	$31,819.44	$28,470.03	2026-05-09
A9592	HCPCS	Copper Cu-64 Dotatate 148 Mbq/4 Ml (4 Mci/4 Ml) Intravenous Solution	23	20	$33,225.50	$33,225.50	$12,293.44	$31,564.23	$28,241.68	2026-05-09
A9572	HCPCS	Indium 111-pentetreotide 3 Mci/ml-10 Mcg Intravenous Kit	23	20	$33,139.20	$33,139.20	$12,261.50	$31,482.24	$28,168.32	2026-05-09
J1162	HCPCS	Digoxin Immune Fab 40 Mg Intravenous Solution	23	20	$31,687.11	$31,687.11	$11,724.23	$30,102.75	$26,934.04	2026-05-09
A9570	HCPCS	Indium In-111 Oxyquinoline 1 Mci/ml (37 Mbq/ml)(1 Ml) Intravenous Soln	23	20	$30,863.04	$30,863.04	$11,419.32	$29,319.89	$26,233.58	2026-05-09
A9571	HCPCS	Indium In-111 Oxyquinoline 1 Mci/ml (37 Mbq/ml) Platelet (uw 174240)	23	20	$30,863.04	$30,863.04	$11,419.32	$29,319.89	$26,233.58	2026-05-09
A9557	HCPCS	Kit For Preparation Of Tc-99m-bicisate 0.9 Mg Intravenous Solution	23	20	$30,718.84	$30,718.84	$11,365.97	$29,182.90	$26,111.01	2026-05-09
J9308	HCPCS	Ramucirumab 10 Mg/ml Intravenous Solution	23	20	$29,135.90	$29,135.90	$10,780.28	$27,679.11	$24,765.52	2026-05-09
J2353	HCPCS	Octreotide,microspheres ER 30 Mg Intramuscular Susp, Extended Release	23	20	$27,108.10	$27,108.10	$10,030.00	$25,752.69	$23,041.89	2026-05-09
J1300	HCPCS	Eculizumab 300 Mg/30 Ml Intravenous Solution	23	20	$26,613.80	$26,613.80	$9,847.11	$25,283.11	$22,621.73	2026-05-09
J2506	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe	23	20	$26,185.40	$26,185.40	$9,688.60	$24,876.13	$22,257.59	2026-05-09
A9587	HCPCS	Kit For The Preparation Of Ga-68-dotatate 40 Mcg Intravenous Soln	23	20	$25,890.00	$25,890.00	$9,579.30	$24,595.50	$22,006.50	2026-05-09
A9586	HCPCS	Florbetapir F-18 10 Mci (370 Mbq) Intravenous Solution	23	20	$24,659.37	$24,659.37	$9,123.97	$23,426.40	$20,960.46	2026-05-09
J9217	HCPCS	Leuprolide 22.5 Mg (3 Month) Intramuscular Syringe Kit	69	20	$31,771.09	$31,771.09	$8,816.46	$45,274.44	$20,280.24	2026-05-09
J0717	HCPCS	Certolizumab Pegol 400 Mg (200 Mg X 2 Vials) Subcutaneous Kit	23	20	$23,334.30	$23,334.30	$8,633.69	$22,167.59	$19,834.16	2026-05-09
J9271	HCPCS	Pembrolizumab 25 Mg/ml Intravenous Solution	23	20	$22,674.69	$22,674.69	$8,389.64	$21,540.96	$19,273.49	2026-05-09
J0630	HCPCS	Calcitonin (salmon) 200 Unit/ml Injection Solution	23	20	$21,580.17	$21,580.17	$7,984.66	$20,501.16	$18,343.14	2026-05-09
A9502	HCPCS	Kit For The Preparation Of Tc-99m-tetrofosmin 1.38 Mg IV Solution	23	20	$21,027.00	$21,027.00	$7,779.99	$19,975.65	$17,872.95	2026-05-09
J0896	HCPCS	Luspatercept-aamt 25 Mg Subcutaneous Solution	46	20	$31,007.15	$31,007.15	$5,736.33	$44,185.16	$15,968.69	2026-05-09
J0480	HCPCS	Basiliximab 20 Mg Intravenous Solution	23	20	$17,528.54	$17,528.54	$6,485.56	$16,652.11	$14,899.26	2026-05-09
Q5122	HCPCS	Pegfilgrastim-apgf 6 Mg/0.6 Ml Subcutaneous Syringe	23	20	$16,642.01	$16,642.01	$6,157.54	$15,809.91	$14,145.71	2026-05-09
J9354	HCPCS	Ado-trastuzumab Emtansine 160 Mg Intravenous Solution	46	20	$19,847.92	$19,847.92	$5,649.03	$23,206.78	$12,994.30	2026-05-09
J2182	HCPCS	Mepolizumab 100 Mg Subcutaneous Solution	46	20	$14,163.14	$14,163.14	$5,074.25	$13,881.48	$11,664.60	2026-05-09
A9521	HCPCS	Kit For Preparation Of Tc-99m-exametazime 0.5 Mg Intravenous Solution	23	20	$13,193.27	$13,193.27	$4,881.51	$12,533.61	$11,214.28	2026-05-09
J0840	HCPCS	Crotalidae Polyval Immune Fab Solution For Injection	23	20	$13,047.84	$13,047.84	$4,827.70	$12,395.45	$11,090.66	2026-05-09
J9035	HCPCS	Bevacizumab 25 Mg/ml Intravenous Solution	23	20	$13,006.07	$13,006.07	$4,812.25	$12,355.77	$11,055.16	2026-05-09
91110	CPT	Hc Capsule Endoscopy Esoph Through Ileum	23	20	$12,622.44	$8,204.58 35% off	$4,670.30	$11,991.32	$10,729.07	2026-05-09
J1459	HCPCS	Immune Glob,gamm(igg) 10 %-pro-iga 0 To 50 Mcg/ml Intravenous Solution	69	20	$14,356.71	$14,356.71	$2,655.99	$27,277.74	$10,623.96	2026-05-09
J9299	HCPCS	Nivolumab 240 Mg/24 Ml Intravenous Solution	69	20	$12,474.89	$12,474.89	$1,846.29	$28,442.84	$10,603.66	2026-05-09
J9047	HCPCS	Carfilzomib 60 Mg Intravenous Solution	23	20	$12,155.14	$12,155.14	$4,497.40	$11,547.38	$10,331.87	2026-05-09
J9033	HCPCS	Bendamustine 100 Mg Intravenous Powder For Solution	23	20	$12,124.95	$12,124.95	$4,486.23	$11,518.70	$10,306.21	2026-05-09
A9548	HCPCS	Pentetate Indium Disodium In-111 1.5 Mci/1.5 Ml Intrathecal Solution	23	20	$10,697.52	$10,697.52	$3,958.08	$10,162.64	$9,092.89	2026-05-09
J1451	HCPCS	Fomepizole 1 Gram/ml Intravenous Solution	23	20	$10,335.00	$10,335.00	$3,823.95	$9,818.25	$8,784.75	2026-05-09
A9509	HCPCS	Sodium Iodine-123 (200 Microci)(whole Body Scan) Capsule (uw 175208)	23	20	$10,333.57	$10,333.57	$3,823.42	$9,816.89	$8,783.53	2026-05-09
J1427	HCPCS	Viltolarsen 50 Mg/ml Intravenous Solution	23	20	$9,714.90	$9,714.90	$3,594.51	$9,229.15	$8,257.66	2026-05-09
J1439	HCPCS	Ferric Carboxymaltose 50 Mg Iron/ml Intravenous Solution	23	20	$9,563.70	$9,563.70	$3,538.57	$9,085.52	$8,129.15	2026-05-09
Q0222	HCPCS	Bebtelovimab 175 Mg/2 Ml (87.5 Mg/ml) Intravenous Solution (unapp)	23	20	$8,568.00	$8,568.00	$3,170.16	$8,139.60	$7,282.80	2026-05-09
A9584	HCPCS	Ioflupane I 123 5 Mci/2.5 Ml (185 Mbq/2.5 Ml) Intravenous Solution	23	20	$8,519.54	$8,519.54	$3,152.23	$8,093.56	$7,241.61	2026-05-09
J1602	HCPCS	Golimumab 12.5 Mg/ml Intravenous Solution	23	20	$8,156.71	$8,156.71	$3,017.98	$7,748.87	$6,933.20	2026-05-09
J3240	HCPCS	Thyrotropin Alfa 0.9 Mg Intramuscular Solution	23	20	$7,870.39	$7,870.39	$2,912.04	$7,476.87	$6,689.83	2026-05-09
J3358	HCPCS	Ustekinumab 130 Mg/26 Ml Intravenous Solution	23	20	$7,866.69	$7,866.69	$2,910.68	$7,473.36	$6,686.69	2026-05-09
J0894	HCPCS	Decitabine 50 Mg Intravenous Solution	23	20	$7,329.93	$7,329.93	$2,712.07	$6,963.43	$6,230.44	2026-05-09
A9582	HCPCS	Iobenguane Sulfate I-123 10 Mci/5 Ml (370 Mbq/5 Ml) Intravenous Soln	23	20	$6,793.58	$6,793.58	$2,513.62	$6,453.90	$5,774.54	2026-05-09
J0897	HCPCS	Denosumab 60 Mg/ml Subcutaneous Syringe	46	20	$9,410.08	$9,410.08	$2,452.41	$11,582.42	$5,641.20	2026-05-09
A9552	HCPCS	Fluorodeoxyglucose F-18 20 Mci To 300 Mci/ml Intravenous Solution	23	20	$6,619.21	$6,619.21	$2,449.11	$6,288.25	$5,626.33	2026-05-09
J9259	HCPCS	Paclitaxel Protein-bound 100 Mg Intravenous Suspension	23	20	$6,555.87	$6,555.87	$2,425.67	$6,228.08	$5,572.49	2026-05-09
J9041	HCPCS	Bortezomib 3.5 Mg Injection Powder For Solution	23	20	$6,540.24	$6,540.24	$2,419.89	$6,213.23	$5,559.20	2026-05-09
J9264	HCPCS	Paclitaxel Protein-bound 100 Mg Intravenous Suspension	23	20	$6,446.65	$6,446.65	$2,385.26	$6,124.32	$5,479.65	2026-05-09
J9312	HCPCS	Rituximab 10 Mg/ml Concentrate,intravenous	46	20	$11,499.73	$11,499.73	$1,418.30	$18,207.90	$5,366.55	2026-05-09
90376	CPT	Rabies Immune Globulin (pf) 150 Unit/ml Intramuscular Solution	23	20	$6,236.35	$6,236.35	$2,307.45	$5,924.53	$5,300.90	2026-05-09
J7327	HCPCS	Hyaluronate Sodium, Stabilized 88 Mg/4 Ml Intra-articular Syringe	23	20	$6,120.00	$6,120.00	$2,264.40	$5,814.00	$5,202.00	2026-05-09
59412	CPT	Hc Ext Cephalic Version W/wo Toco	23	20	$6,072.92	$3,947.39 35% off	$2,246.98	$5,769.27	$5,161.98	2026-05-09
J1569	HCPCS	Immune Glob,gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection Solution	115	20	$6,916.42	$6,916.42	$255.91	$19,711.79	$5,118.15	2026-05-09
J9120	HCPCS	Dactinomycin 0.5 Mg Intravenous Solution	23	20	$5,948.93	$5,948.93	$2,201.10	$5,651.48	$5,056.59	2026-05-09
Q5115	HCPCS	Rituximab-abbs 10 Mg/ml Intravenous Solution	46	20	$10,755.40	$10,755.40	$1,326.50	$17,029.38	$5,019.18	2026-05-09
10180	CPT	Hc I&d,complex,postop Wound Inf	23	20	$5,637.25	$3,664.21 35% off	$2,085.78	$5,355.39	$4,791.66	2026-05-09
J9305	HCPCS	Pemetrexed Disodium 100 Mg Intravenous Powder For Solution	46	20	$9,897.26	$9,897.26	$1,220.66	$15,670.67	$4,618.73	2026-05-09
47000	CPT	Hc Biopsy Liver Needle	23	20	$5,387.48	$3,501.86 35% off	$1,993.37	$5,118.11	$4,579.36	2026-05-09
J7296	HCPCS	Levonorgestrel 17.5 Mcg/24 Hr (up To 5 Yrs) 19.5mg Intrauterine Device	23	20	$5,255.11	$5,255.11	$1,944.39	$4,992.35	$4,466.84	2026-05-09
J7298	HCPCS	Levonorgestrel 21 Mcg/24 Hr (up To 8 Years) 52 Mg Intrauterine Device	23	20	$5,255.11	$5,255.11	$1,944.39	$4,992.35	$4,466.84	2026-05-09
95811	CPT	Hc Sleep Apnea Study W/cpap Titr	26	20	$5,181.75	$3,368.13 35% off	$1,917.25	$4,922.66	$4,407.34	2026-05-09
J7300	HCPCS	Copper 380 Square Mm Intrauterine Device	23	20	$5,175.45	$5,175.45	$1,914.92	$4,916.68	$4,399.13	2026-05-09
A9516	HCPCS	Sodium Iodide-123 3.7 Mbq (100 Microci) Capsule	46	20	$7,750.18	$7,750.18	$1,911.71	$9,816.89	$4,397.45	2026-05-09
95810	CPT	Hc Baseline Sleep Study	26	20	$5,160.56	$3,354.36 35% off	$1,909.41	$4,902.53	$4,389.31	2026-05-09
78452	CPT	Hc Heart Muscle Spect Mult	25	20	$5,088.04	$3,307.22 35% off	$1,882.57	$4,833.64	$4,324.83	2026-05-09
90371	CPT	Hepatitis B Immune Globulin > 1,560 Unit/5 Ml Intramuscular Solution	23	20	$5,035.29	$5,035.29	$1,863.06	$4,783.53	$4,280.00	2026-05-09
J1745	HCPCS	Infliximab 100 Mg Intravenous Solution	23	20	$4,764.71	$4,764.71	$1,762.94	$4,526.47	$4,050.00	2026-05-09
15271	CPT	Hc Skin Sub Graft Trnk/arm/leg Up To 100cm (high)	23	20	$4,757.29	$3,092.23 35% off	$1,760.20	$4,519.43	$4,043.70	2026-05-09
15275	CPT	Hc Skin Sub Graft Face/nk/hf/g Up To 100cm (high)	23	20	$4,757.29	$3,092.23 35% off	$1,760.20	$4,519.43	$4,043.70	2026-05-09
38505	CPT	Hc Nedl Bx Lymph Node Unilateral	23	20	$4,744.34	$3,083.82 35% off	$1,755.41	$4,507.12	$4,032.69	2026-05-09
59414	CPT	Hc Delivery-placenta Only	23	20	$4,740.48	$3,081.31 35% off	$1,753.98	$4,503.46	$4,029.41	2026-05-09
91035	CPT	Hc Bravo Reflux W Mucosal Ph	23	20	$4,733.22	$3,076.59 35% off	$1,751.29	$4,496.56	$4,023.24	2026-05-09
Q0138	HCPCS	Ferumoxytol 510 Mg/17 Ml (30 Mg/ml) Intravenous Solution	46	20	$4,799.06	$4,799.06	$1,749.41	$4,626.48	$4,021.52	2026-05-09
J3262	HCPCS	Tocilizumab 200 Mg/10 Ml (20 Mg/ml) Intravenous Solution	69	20	$5,417.88	$5,417.88	$801.84	$10,293.96	$4,009.23	2026-05-09
90375	CPT	Rabies Immune Globulin (pf) 300 Unit/ml Intramuscular Solution	23	20	$4,688.65	$4,688.65	$1,734.80	$4,454.22	$3,985.35	2026-05-09
J1212	HCPCS	Dimethyl Sulfoxide 50 % Intravesical Solution	23	20	$4,560.50	$4,560.50	$1,687.39	$4,332.47	$3,876.42	2026-05-09
A9562	HCPCS	Kit For Prep Tc-99m-mertiatide (betiatide) 1 Mg Intravenous Solution	23	20	$4,530.75	$4,530.75	$1,676.38	$4,304.21	$3,851.14	2026-05-09
J1670	HCPCS	Tetanus Immune Globulin (pf) 250 Unit/ml Intramuscular Syringe	23	20	$4,472.79	$4,472.79	$1,654.93	$4,249.15	$3,801.87	2026-05-09
74178	CPT	Hc CT Abd & Pelvis W/wo Contrast	24	20	$4,469.67	$2,905.28 35% off	$1,653.78	$4,246.19	$3,799.22	2026-05-09
32408	CPT	Hc Core Needle Bx Lung/mediastinum Perq W/img	23	20	$4,443.82	$2,888.48 35% off	$1,644.21	$4,221.63	$3,777.25	2026-05-09
78802	CPT	Hc Nm Rp Loclzj Tum Whbdy 1 D Img	23	20	$4,417.68	$2,871.49 35% off	$1,634.54	$4,196.80	$3,755.03	2026-05-09
J7318	HCPCS	Hyaluronate Sodium, Stabilized 60 Mg/3 Ml Intra-articular Syringe	23	20	$4,386.00	$4,386.00	$1,622.82	$4,166.70	$3,728.10	2026-05-09
78582	CPT	Hc Pulmonary Vent/perfusion Imaging	24	20	$4,329.52	$2,814.18 35% off	$1,601.92	$4,113.05	$3,680.09	2026-05-09
73720	CPT	Hc MRI Lower Extrem Unilateral W/wo Contrast	24	20	$4,248.59	$2,761.58 35% off	$1,571.98	$4,036.16	$3,611.30	2026-05-09
78451	CPT	Hc Heart Muscle Spect Single	23	20	$4,247.93	$2,761.15 35% off	$1,571.73	$4,035.53	$3,610.74	2026-05-09
72157	CPT	Hc MRI Thoracic Spine W/wo Contrast	24	20	$4,120.57	$2,678.37 35% off	$1,524.61	$3,914.54	$3,502.48	2026-05-09
74177	CPT	Hc CT Abdomen & Pelvis W/contrast	28	20	$4,097.29	$2,663.23 35% off	$1,516.00	$3,892.43	$3,484.95	2026-05-09
J2597	HCPCS	Desmopressin 4 Mcg/ml Injection Solution	48	20	$4,094.04	$4,094.04	$1,292.74	$3,895.88	$3,479.93	2026-05-09
A9520	HCPCS	Kit For The Prep Of Tc-99m-tilmanocept 250 Mcg Solution For Injection	23	20	$4,056.10	$4,056.10	$1,500.76	$3,853.29	$3,447.69	2026-05-09
J7297	HCPCS	Levonorgestrel 20.4 Mcg/24 Hr (up To 8 Yrs) 52 Mg Intrauterine Device	23	20	$4,031.13	$4,031.13	$1,491.52	$3,829.57	$3,426.46	2026-05-09
Q5103	HCPCS	Infliximab-dyyb 100 Mg Intravenous Solution	23	20	$4,012.23	$4,012.23	$1,484.53	$3,811.62	$3,410.40	2026-05-09
36569	CPT	Hc Peripherally Inserted Central Catheter > 5yrs	23	20	$3,964.99	$2,577.24 35% off	$1,467.05	$3,766.74	$3,370.24	2026-05-09
J1568	HCPCS	Immune Glob,gamm(igg) 5 %-malt-iga Over 50 Mcg/ml Intravenous Solution	23	20	$3,962.91	$3,962.91	$1,466.28	$3,764.76	$3,368.47	2026-05-09
J9145	HCPCS	Daratumumab 20 Mg/ml Intravenous Solution	46	20	$6,823.80	$6,823.80	$1,009.92	$10,372.18	$3,316.36	2026-05-09
19083	CPT	Hc Bx Breast 1st Lesion US Guide	26	20	$3,714.98	$2,414.73 35% off	$1,374.54	$3,529.24	$3,159.78	2026-05-09
A9541	HCPCS	Kit For Preparation Of Tc 99m-sodium Thiosulfate 2 Mg Solution	23	20	$3,667.75	$3,667.75	$98.17	$3,484.36	$3,117.59	2026-05-09
73723	CPT	Hc MRI Lower Joint Unilateral W/wo Contrast	23	20	$3,646.19	$2,370.02 35% off	$1,349.09	$3,463.88	$3,099.26	2026-05-09
73223	CPT	Hc MRI Upper Joint Unilateral W/wo Contrast	23	20	$3,646.19	$2,370.02 35% off	$1,349.09	$3,463.88	$3,099.26	2026-05-09
74176	CPT	Hc CT Abd & Pelvis Without Contrast	26	20	$3,628.66	$2,358.62 35% off	$34.56	$3,447.23	$3,086.36	2026-05-09
36556	CPT	Hc Central Venous Cath Insert >5yrs	23	20	$3,615.80	$2,350.27 35% off	$1,337.85	$3,435.01	$3,073.43	2026-05-09
99291	CPT	Hc ER Critical Care	24	20	$3,583.13	$2,329.03 35% off	$1,325.76	$3,403.97	$3,045.66	2026-05-09
90381	CPT	Nirsevimab-alip 100 Mg/ml Intramuscular Syringe	23	20	$3,410.55	$3,410.55	$1,261.90	$3,240.02	$2,898.97	2026-05-09
90380	CPT	Nirsevimab-alip 50 Mg/0.5 Ml Intramuscular Syringe	23	20	$3,410.55	$3,410.55	$1,261.90	$3,240.02	$2,898.97	2026-05-09
J2760	HCPCS	Phentolamine 5 Mg Injection Solution	23	20	$3,375.90	$3,375.90	$1,249.08	$3,207.11	$2,869.52	2026-05-09
95805	CPT	Hc Mlt Sleep Latency Or Maint Of Wakefulness Tstg	23	20	$3,267.94	$2,124.16 35% off	$1,209.14	$3,104.54	$2,777.75	2026-05-09
93452	CPT	Hc Lt Heart Cath W/vgram	23	20	$3,263.40	$2,121.21 35% off	$1,207.46	$3,100.23	$2,773.89	2026-05-09
77049	CPT	Hc MRI Breast W & Wo, Bilateral, Incl Cad	24	20	$3,234.59	$2,102.48 35% off	$1,196.80	$3,072.86	$2,749.40	2026-05-09
78472	CPT	Hc Cardiac Blood Pool Imaging W Ef	23	20	$3,210.09	$2,086.55 35% off	$1,187.73	$3,049.59	$2,728.58	2026-05-09
93306	CPT	Hc Tte Comp W/dplr & Color W/contrast	27	20	$3,176.39	$2,064.65 35% off	$1,175.26	$3,017.57	$2,703.43	2026-05-09
72159	CPT	Hc MRA Spine Wo Contrast	46	20	$3,446.88	$2,240.47 35% off	$1,143.22	$3,613.76	$2,628.02	2026-05-09
74174	CPT	Hc CTA Abdomen And Pelvis	25	20	$3,088.00	$2,007.20 35% off	$1,142.56	$2,933.60	$2,624.80	2026-05-09
78709	CPT	Hc Kidney Imag Mult W/wo Pharm W Flow	23	20	$3,005.19	$1,953.37 35% off	$1,111.92	$2,854.93	$2,554.41	2026-05-09
J9075	HCPCS	Cyclophosphamide 1 Gram Intravenous Powder For Solution	46	20	$4,482.90	$4,482.90	$1,105.78	$5,678.34	$2,543.60	2026-05-09
72197	CPT	Hc MRI Pelvis W/wo Contrast	25	20	$2,943.83	$1,913.48 35% off	$1,089.22	$2,796.64	$2,502.26	2026-05-09
62305	CPT	Hc Myelogram Mult Sites Incl Lumb Injection	23	20	$2,941.31	$1,911.85 35% off	$1,088.28	$2,794.24	$2,500.11	2026-05-09
78018	CPT	Hc Nm Thyroid Whole Body	23	20	$2,901.01	$1,885.65 35% off	$1,073.37	$2,755.96	$2,465.86	2026-05-09
78708	CPT	Hc Kidney Imaging W/pharm Single W Flow	23	20	$2,900.68	$1,885.44 35% off	$1,073.25	$2,755.65	$2,465.58	2026-05-09
90713	CPT	Poliovirus Vaccine 40 Unit-8 Unit-32 Unit/0.5 Ml Injection Suspension	23	20	$2,886.09	$2,886.09	$1,067.85	$2,741.79	$2,453.18	2026-05-09
J2357	HCPCS	Omalizumab 150 Mg Subcutaneous Solution	115	20	$5,330.81	$5,330.81	$986.19	$10,736.22	$2,452.16	2026-05-09
93350	CPT	Hc Stress Tte Only Without Contrast	23	20	$2,868.92	$1,864.79 35% off	$1,061.50	$2,725.47	$2,438.58	2026-05-09
A9558	HCPCS	Xenon-133 In Carbon Dioxide 370 Mbq (10 Mci) Gas For Inhalation	46	20	$3,694.12	$3,694.12	$1,042.77	$4,341.44	$2,398.66	2026-05-09
70498	CPT	Hc CTA Neck W/wo Contrast	27	20	$2,801.49	$1,820.96 35% off	$1,036.55	$2,661.42	$2,381.27	2026-05-09
J1561	HCPCS	Immune Glob G 20 Gram/200 Ml(10%)-gly-iga Ave 46 Mcg/ml Injection Soln	46	20	$5,983.04	$5,983.04	$210.83	$10,826.45	$2,378.97	2026-05-09
73222	CPT	Hc MRI Upper Joint Unilateral W/contrast	25	20	$2,743.97	$1,783.58 35% off	$1,015.27	$2,606.78	$2,332.37	2026-05-09
75574	CPT	Hc CTA Coronary Arteries W/contrast	24	20	$2,736.63	$1,778.80 35% off	$1,012.55	$2,736.63	$2,327.64	2026-05-09
71270	CPT	Hc CT Thorax Dx W/wo Contrast	23	20	$2,671.36	$1,736.38 35% off	$988.40	$2,537.79	$2,270.66	2026-05-09
77048	CPT	Hc MRI Breast W & Wo, Unilateral, Incl Cad	23	20	$2,637.00	$1,714.05 35% off	$975.69	$2,505.15	$2,241.45	2026-05-09
32555	CPT	Hc Thoracentesis/aspiration With Imaging Unilateral	23	20	$2,628.41	$1,708.46 35% off	$972.51	$2,496.99	$2,234.15	2026-05-09
72156	CPT	Hc MRI Cervical Spine W/wo Contrast	25	20	$2,626.82	$1,707.43 35% off	$971.92	$2,495.48	$2,232.80	2026-05-09
75635	CPT	Hc CTA Abd Ileo/femoral Runoff W/wo Contrast	23	20	$2,624.83	$1,706.13 35% off	$971.19	$2,493.59	$2,231.11	2026-05-09
75580	CPT	Hc Software Anlys Cor Ffr Derived From CTA Incld I&r	24	20	$2,616.60	$1,700.79 35% off	$968.14	$2,485.77	$2,224.11	2026-05-09
90675	CPT	Rabies Vaccine, Purified Chicken Embryo Cell (pf) 2.5 Unit IM Susp	46	20	$2,731.72	$2,731.72	$966.29	$2,709.25	$2,221.28	2026-05-09
72158	CPT	Hc MRI Lumbar Spine W/wo Contrast	25	20	$2,612.26	$1,697.96 35% off	$966.54	$2,481.65	$2,220.42	2026-05-09
73725	CPT	Hc MRA Lower Extrem Unilateral Without Contrast	46	20	$2,846.83	$1,850.43 35% off	$965.25	$2,930.64	$2,218.89	2026-05-09
49083	CPT	Hc Paracentesis With Imaging	24	20	$2,600.20	$1,690.12 35% off	$962.07	$2,611.04	$2,210.17	2026-05-09
Q9968	HCPCS	Isosulfan Blue 1 % Subcutaneous Solution	46	20	$4,551.95	$4,551.95	$663.92	$6,944.06	$2,204.59	2026-05-09
J0585	HCPCS	Onabotulinumtoxina 100 Unit Solution For Injection	23	20	$2,586.72	$2,586.72	$957.09	$2,457.38	$2,198.71	2026-05-09
J9280	HCPCS	Mitomycin 20 Mg Intravenous Solution	46	20	$3,867.72	$3,867.72	$954.04	$4,899.11	$2,194.54	2026-05-09
99285	CPT	Hc Emergency Room-level 5	26	20	$2,569.32	$1,670.05 35% off	$823.84	$2,440.85	$2,185.33	2026-05-09
70543	CPT	Hc MRI Neck/orbit/face W/wo Contrast	25	20	$2,568.69	$1,669.64 35% off	$950.42	$2,440.26	$2,183.39	2026-05-09
87507	CPT	Hc Iadna-dna/rna Probe Tq 12-25; Qual	26	20	$2,557.13	$1,662.13 35% off	$946.14	$2,429.27	$2,174.96	2026-05-09
62304	CPT	Hc Myelogram Lumbosacral Incl Lumbar Injection	23	20	$2,549.26	$1,657.01 35% off	$943.23	$2,421.80	$2,166.87	2026-05-09
62303	CPT	Hc Myelogram Thoracic Include Lumbar Injection	23	20	$2,549.26	$1,657.01 35% off	$943.23	$2,421.80	$2,166.87	2026-05-09
62302	CPT	Hc Myelogram Cervical Includ Lumbar Injection	23	20	$2,549.26	$1,657.01 35% off	$943.23	$2,421.80	$2,166.87	2026-05-09
G0390	HCPCS	Hc Full Trauma Activation	47	20	$3,790.40	$2,463.76 35% off	$938.99	$3,600.88	$2,159.93	2026-05-09
71275	CPT	Hc CTA Pulmonary W/wo Contrast	27	20	$2,533.32	$1,646.65 35% off	$937.33	$2,406.65	$2,156.11	2026-05-09
J7315	HCPCS	Mitomycin 0.2 Mg Ophthalmic Kit	23	20	$2,473.51	$2,473.51	$915.20	$2,349.83	$2,102.48	2026-05-09
J1095	HCPCS	Dexamethasone (pf) 9 % Intraocular Suspension	23	20	$2,427.60	$2,427.60	$898.21	$2,306.22	$2,063.46	2026-05-09
73719	CPT	Hc MRI Lower Extrem Unilateral W/contrast	23	20	$2,402.62	$1,561.70 35% off	$888.97	$2,282.49	$2,042.23	2026-05-09
78264	CPT	Hc Nm Gastric Emptying Imaging	24	20	$2,388.02	$1,552.21 35% off	$883.57	$2,268.62	$2,029.82	2026-05-09
78227	CPT	Hc Hepatobiliary W Pharm /ef	24	20	$2,374.34	$1,543.32 35% off	$878.51	$2,255.62	$2,018.19	2026-05-09
P9035	HCPCS	Hc Platelets, Pheresis, Leukocytes Reduced, Each Unit	23	20	$2,366.52	$1,538.23 35% off	$875.61	$2,248.19	$2,011.54	2026-05-09
73220	CPT	Hc MRI Upper Extrem W/wo Contrast Unilateral	23	20	$2,353.66	$1,529.87 35% off	$870.85	$2,235.98	$2,000.61	2026-05-09
76498	CPT	Hc MRI Cad (non Breast)	23	20	$2,353.54	$1,529.80 35% off	$870.81	$2,235.86	$2,000.51	2026-05-09
74183	CPT	Hc MRI Abdomen W/wo Contrast	26	20	$2,350.97	$1,528.13 35% off	$869.86	$2,233.42	$1,999.62	2026-05-09
72193	CPT	Hc CT Pelvis W/contrast	24	20	$2,340.61	$1,521.39 35% off	$866.03	$2,223.58	$1,989.52	2026-05-09
71552	CPT	Hc MRI Chest W/wo Contrast	23	20	$2,322.20	$1,509.42 35% off	$859.21	$2,206.09	$1,973.87	2026-05-09
78278	CPT	Hc Nm Gi Bleed Imaging	23	20	$2,308.31	$1,500.40 35% off	$854.07	$2,192.89	$1,962.06	2026-05-09
70546	CPT	Hc MRA Head W/wo Contrast	23	20	$2,302.01	$1,496.30 35% off	$851.74	$2,186.91	$1,956.71	2026-05-09
88309	CPT	Hc Surg Path Level-vi Gross & Micro	23	20	$2,292.82	$1,490.33 35% off	$848.34	$2,178.18	$1,948.90	2026-05-09
72149	CPT	Hc MRI Lumbar Spine W/contrast	23	20	$2,288.74	$1,487.68 35% off	$846.83	$2,174.30	$1,945.43	2026-05-09
73219	CPT	Hc MRI Upper Extremity W/contrast Unilateral	23	20	$2,288.52	$1,487.53 35% off	$846.75	$2,174.09	$1,945.24	2026-05-09
70549	CPT	Hc MRA Neck W/wo Contrast	23	20	$2,286.06	$1,485.93 35% off	$845.84	$2,171.76	$1,943.15	2026-05-09
85097	CPT	Hc Bone Marrow Aspirate/interp	23	20	$2,277.51	$1,480.38 35% off	$842.68	$2,163.63	$1,935.88	2026-05-09
72194	CPT	Hc CT Pelvis W/wo Contrast	23	20	$2,276.24	$1,479.55 35% off	$842.21	$2,162.43	$1,934.80	2026-05-09
72133	CPT	Hc CT Lumbar Spine W/wo Contrast	23	20	$2,261.51	$1,469.98 35% off	$836.76	$2,148.43	$1,922.28	2026-05-09
72198	CPT	Hc MRA Pelvis Without Contrast	46	20	$2,421.64	$1,574.07 35% off	$817.24	$2,502.81	$1,878.65	2026-05-09
78315	CPT	Hc Nm Bone Imaging 3 Phase	23	20	$2,203.68	$1,432.39 35% off	$815.36	$2,093.50	$1,873.13	2026-05-09
70545	CPT	Hc MRA Head W/contrast	23	20	$2,195.26	$1,426.91 35% off	$812.25	$2,085.50	$1,865.97	2026-05-09
94002	CPT	Hc Ventilator 1st Day	23	20	$2,178.27	$1,415.87 35% off	$805.96	$2,069.36	$1,851.53	2026-05-09
78707	CPT	Hc Kidney Imaging Without Pharm Single W Flow	23	20	$2,170.55	$1,410.85 35% off	$803.10	$2,062.02	$1,844.97	2026-05-09
Q0249	HCPCS	Tocilizumab 80 Mg/4 Ml (20 Mg/ml) Intravenous Solution (uw) Covid Use Only	23	20	$2,167.14	$2,167.14	$801.84	$2,058.78	$1,842.07	2026-05-09
74182	CPT	Hc MRI Abdomen W/contrast	23	20	$2,153.27	$1,399.62 35% off	$796.71	$2,045.61	$1,830.28	2026-05-09
71555	CPT	Hc MRA Chest W/contrast	69	20	$2,203.85	$1,432.50 35% off	$794.54	$2,330.29	$1,827.65	2026-05-09
J0248	HCPCS	Remdesivir 100 Mg Intravenous Powder For Solution	47	20	$2,121.60	$2,121.60	$784.99	$2,215.06	$1,805.69	2026-05-09
78801	CPT	Hc Nm Rp Loclzj Tum 2+area 1+d Img	23	20	$2,114.98	$1,374.73 35% off	$782.54	$2,009.23	$1,797.73	2026-05-09
74185	CPT	Hc MRA Abdomen W/contrast	69	20	$2,282.37	$1,483.54 35% off	$779.55	$2,291.83	$1,793.18	2026-05-09
19084	CPT	Hc Bx Breast Add Lesion US Guide	23	20	$2,108.13	$1,370.28 35% off	$780.01	$2,002.72	$1,791.91	2026-05-09
92960	CPT	Hc Cardioversion Electric External	24	20	$2,105.33	$1,368.46 35% off	$778.97	$2,000.06	$1,789.53	2026-05-09
78306	CPT	Hc Nm Bone Imaging Whole Body	23	20	$2,099.82	$1,364.88 35% off	$776.93	$1,994.83	$1,784.85	2026-05-09
74160	CPT	Hc CT Abdomen W/contrast	24	20	$2,095.85	$1,362.30 35% off	$775.46	$1,991.06	$1,781.47	2026-05-09
60100	CPT	Hc Thyroid Core Needle Biopsy	23	20	$2,089.54	$1,358.20 35% off	$773.13	$1,985.06	$1,776.11	2026-05-09
93271	CPT	Hc Event Monitor	23	20	$2,087.45	$1,356.84 35% off	$772.36	$1,983.08	$1,774.33	2026-05-09
62270	CPT	Hc Lumbar Puncture Diagnostic	23	20	$2,083.67	$1,354.38 35% off	$770.96	$1,979.49	$1,771.12	2026-05-09
72127	CPT	Hc CT Cervicalspine W/wo Contrast	23	20	$2,080.14	$1,352.09 35% off	$769.65	$1,976.13	$1,768.12	2026-05-09
70540	CPT	Hc MRI Neck/orbit/face Without Contrast	23	20	$2,073.77	$1,347.95 35% off	$767.29	$1,970.08	$1,762.70	2026-05-09
J0881	HCPCS	Darbepoetin Alfa 100 Mcg/0.5 Ml In Polysorbate Injection Syringe	69	20	$3,157.92	$3,157.92	$467.37	$4,500.04	$1,752.65	2026-05-09
J9171	HCPCS	Docetaxel 160 Mg/16 Ml (10 Mg/ml) Intravenous Solution	23	20	$2,054.04	$2,054.04	$759.99	$1,951.34	$1,745.93	2026-05-09
92950	CPT	Hc Cpr	23	20	$2,053.96	$1,335.07 35% off	$759.97	$1,951.26	$1,745.87	2026-05-09
J1442	HCPCS	Filgrastim 480 Mcg/1.6 Ml Injection Solution	23	20	$2,045.43	$2,045.43	$756.81	$1,943.16	$1,738.62	2026-05-09
79005	CPT	Hc Nm Radioactive Thyroid Tx-oral Admin	23	20	$2,042.05	$1,327.33 35% off	$755.56	$1,939.95	$1,735.74	2026-05-09
73722	CPT	Hc MRI Lower Joint Unilateral W/contrast	23	20	$2,035.88	$1,323.32 35% off	$753.28	$1,934.09	$1,730.50	2026-05-09
73718	CPT	Hc MRI Lower Extrem Unilateral Without Contrast	23	20	$2,032.63	$1,321.20 35% off	$752.07	$1,931.00	$1,727.74	2026-05-09
90678	CPT	Resp Syncytial Virus Vac, Pref A And B (pf) 120 Mcg/0.5 Ml IM Solution	23	20	$2,032.55	$2,032.55	$752.04	$1,930.92	$1,727.67	2026-05-09
75774	CPT	Hc Angio Selective Vessel Addl	23	20	$2,023.09	$1,315.00 35% off	$748.54	$1,921.94	$1,719.63	2026-05-09
78606	CPT	Hc Brain Imaging With Flow Study	23	20	$2,007.94	$1,305.16 35% off	$742.94	$1,907.54	$1,706.75	2026-05-09
90651	CPT	Human Papillomavirus Vaccine,9-valent (pf) 0.5 Ml IM Suspension	23	20	$1,975.95	$1,975.95	$731.10	$1,877.15	$1,679.56	2026-05-09
72148	CPT	Hc MRI Lumbar Spine Without Contrast	27	20	$1,965.21	$1,277.38 35% off	$727.13	$1,866.95	$1,672.59	2026-05-09
74181	CPT	Hc MRI Abdomen Without Contrast	25	20	$1,955.55	$1,271.10 35% off	$723.55	$1,857.77	$1,662.22	2026-05-09
72129	CPT	Hc CT Thoracic Spine W/contrast	23	20	$1,947.96	$1,266.17 35% off	$720.75	$1,850.56	$1,655.77	2026-05-09
70470	CPT	Hc CT Head/brain W/wo Contrast	23	20	$1,947.88	$1,266.12 35% off	$720.72	$1,850.49	$1,655.70	2026-05-09
72141	CPT	Hc MRI Cervical Spine Without Contrast	25	20	$1,935.91	$1,258.34 35% off	$716.29	$1,839.11	$1,645.52	2026-05-09
70488	CPT	Hc CT Maxillofacial W/wo Contrast	23	20	$1,935.11	$1,257.82 35% off	$715.99	$1,838.35	$1,644.84	2026-05-09
J1611	HCPCS	Glucagon Hcl 1 Mg Solution For Injection	23	20	$1,927.83	$1,927.83	$713.30	$1,831.44	$1,638.66	2026-05-09
77047	CPT	Hc MRI Breast W/o; Bilateral	25	20	$1,914.24	$1,244.25 35% off	$708.27	$1,818.53	$1,627.10	2026-05-09
72126	CPT	Hc CT Cervical Spine W/contrast	23	20	$1,899.50	$1,234.67 35% off	$702.81	$1,804.52	$1,614.58	2026-05-09
74170	CPT	Hc CT Abdomen W/wo Contrast	23	20	$1,896.30	$1,232.59 35% off	$701.63	$1,801.49	$1,611.86	2026-05-09
78579	CPT	Hc Pulmonary Ventilation	23	20	$1,895.03	$1,231.76 35% off	$701.16	$1,800.28	$1,610.78	2026-05-09
87633	CPT	Hc Ia Resp Virus 12-25 Targets	26	20	$1,884.07	$1,224.64 35% off	$697.11	$1,789.87	$1,602.49	2026-05-09
19285	CPT	Hc Pl Needle Loc 1st Lesion US Guide	23	20	$1,879.90	$1,221.93 35% off	$695.56	$1,785.91	$1,597.92	2026-05-09
71260	CPT	Hc CT Thorax Dx W/contrast	27	20	$1,872.49	$1,217.11 35% off	$374.50	$1,778.87	$1,591.62	2026-05-09
Q5106	HCPCS	Epoetin Alfa-epbx 40,000 Unit/ml Injection Solution	23	20	$1,870.69	$1,870.69	$692.16	$1,777.16	$1,590.09	2026-05-09
70553	CPT	Hc MRI Brain W/wo Contrast	26	20	$1,859.70	$1,208.80 35% off	$688.09	$1,766.72	$1,581.77	2026-05-09
72128	CPT	Hc CT Thoracic Spine Without Contrast	25	20	$1,854.25	$1,205.26 35% off	$686.07	$1,761.54	$1,578.15	2026-05-09
78580	CPT	Hc Pulmonary Perfusion Particulate	23	20	$1,855.68	$1,206.19 35% off	$686.60	$1,762.90	$1,577.33	2026-05-09
90710	CPT	Measles,mumps,rubel,varicel Liv(pf)10e3-4.3-3-3.99tcid50/0.5 Ml Subcut	23	20	$1,840.65	$1,840.65	$681.04	$1,748.62	$1,564.55	2026-05-09
72125	CPT	Hc CT Cervical Spine Without Contrast	26	20	$1,835.78	$1,193.25 35% off	$367.16	$1,743.99	$1,561.42	2026-05-09
70544	CPT	Hc MRA Head Without Contrast	24	20	$1,832.44	$1,191.08 35% off	$678.00	$1,740.82	$1,557.57	2026-05-09
99284	CPT	Hc Emergency Room-level 4	28	20	$1,820.01	$1,183.00 35% off	$84.77	$1,729.01	$1,548.01	2026-05-09
73221	CPT	Hc MRI Upper Extrem 1 Joint Without Contrast	24	20	$1,815.05	$1,179.78 35% off	$671.57	$1,724.30	$1,542.79	2026-05-09
94003	CPT	Hc Ventilator Subsequent Day	23	20	$1,812.21	$1,177.93 35% off	$670.52	$1,721.60	$1,540.38	2026-05-09
73218	CPT	Hc MRI Upper Extremity Without Contrast	23	20	$1,812.18	$1,177.91 35% off	$670.51	$1,721.57	$1,540.35	2026-05-09
70487	CPT	Hc CT Maxillofacial W/contrast	23	20	$1,789.25	$1,163.01 35% off	$662.02	$1,699.79	$1,520.86	2026-05-09
72191	CPT	Hc CTA Pelvis W/wo Contrast	23	20	$1,784.18	$1,159.71 35% off	$660.15	$1,694.97	$1,516.55	2026-05-09
J0185	HCPCS	Aprepitant 7.2 Mg/ml Intravenous Emulsion	23	20	$1,747.73	$1,747.73	$646.66	$1,660.34	$1,485.57	2026-05-09
70547	CPT	Hc MRA Neck Without Contrast	23	20	$1,736.33	$1,128.61 35% off	$642.44	$1,649.51	$1,475.88	2026-05-09
78800	CPT	Hc Nm Rp Loclzj Tum 1 Area 1 D Img	23	20	$1,714.44	$1,114.38 35% off	$634.34	$1,628.72	$1,457.27	2026-05-09
73706	CPT	Hc CTA Lower Extremity W/wo Contrast Unilateral	23	20	$1,700.92	$1,105.59 35% off	$629.34	$1,615.87	$1,445.78	2026-05-09
78300	CPT	Hc Nm Bone Imaging Limited Area	23	20	$1,700.55	$1,105.35 35% off	$629.20	$1,615.52	$1,445.47	2026-05-09
70481	CPT	Hc CT Orbit/sella/iac W/contrast	25	20	$1,696.97	$1,103.03 35% off	$627.88	$1,612.12	$1,442.42	2026-05-09
72192	CPT	Hc CT Pelvis Without Contrast	23	20	$1,691.90	$1,099.73 35% off	$626.00	$1,607.31	$1,438.12	2026-05-09
38222	CPT	Hc Bone Marrow Diagnostic; Biopsy(ies) & Aspiration(s) Unilateral	23	20	$1,688.46	$1,097.49 35% off	$624.73	$1,604.04	$1,435.19	2026-05-09
36430	CPT	Hc Admin Blood Transfusion Daily	24	20	$1,683.56	$1,094.31 35% off	$622.92	$1,599.38	$1,431.03	2026-05-09
A9560	HCPCS	Kit For Tc 99m-labeled Red Blood Cells Intravenous Solution	23	20	$1,656.96	$1,656.96	$613.08	$1,574.11	$1,408.42	2026-05-09
78215	CPT	Hc Nm Liver/spleen Static Imaging	23	20	$1,656.56	$1,076.76 35% off	$612.93	$1,573.73	$1,408.08	2026-05-09
72195	CPT	Hc MRI Pelvis Without Contrast	23	20	$1,642.06	$1,067.33 35% off	$607.56	$1,559.96	$1,395.75	2026-05-09
L3766	HCPCS	Hc Cus Fit & Adj Ewhfo W/joint(s)	23	20	$1,637.41	$1,064.31 35% off	$605.84	$1,555.54	$1,391.80	2026-05-09
73225	CPT	Hc MRA Upper Extremity Without Contrast Unilateral	46	20	$1,886.64	$1,226.32 35% off	$601.58	$2,040.03	$1,382.90	2026-05-09
71271	CPT	Hc CT Low Dose Lung Ca Screen Without	26	20	$1,617.29	$1,051.23 35% off	$598.40	$1,536.43	$1,375.59	2026-05-09
70336	CPT	Hc MRI Tmj Unilateral	23	20	$1,612.70	$1,048.25 35% off	$596.70	$1,532.07	$1,370.80	2026-05-09
74150	CPT	Hc CT Abdomen Without Contrast	23	20	$1,605.68	$1,043.69 35% off	$594.10	$1,525.40	$1,364.83	2026-05-09
78700	CPT	Hc Nm Kidney Imaging, Morphology	23	20	$1,603.31	$1,042.15 35% off	$593.22	$1,523.14	$1,362.81	2026-05-09
70551	CPT	Hc MRI Brain Without Contrast	25	20	$1,592.89	$1,035.37 35% off	$589.37	$1,513.25	$1,353.96	2026-05-09
73206	CPT	Hc CTA Upper Extremity W/wo Contrast Unilateral	24	20	$1,589.89	$1,033.42 35% off	$588.26	$1,510.40	$1,351.41	2026-05-09
70460	CPT	Hc CT Head/brain W/contrast	23	20	$1,587.08	$1,031.60 35% off	$587.22	$1,507.73	$1,349.02	2026-05-09
78605	CPT	Hc Brain Imaging Min 4 Views	23	20	$1,582.48	$1,028.61 35% off	$585.52	$1,503.36	$1,345.11	2026-05-09
73202	CPT	Hc Uppr Extr W/wo Contrast Unilateral	23	20	$1,576.81	$1,024.92 35% off	$583.42	$1,497.97	$1,340.29	2026-05-09
73721	CPT	Hc MRI Lower Joint Unilateral Without Contrast	24	20	$1,575.03	$1,023.76 35% off	$582.76	$1,496.28	$1,338.78	2026-05-09
Q4187	HCPCS	Hc Epicord Per Sq Cm (high)	23	20	$1,574.09	$1,023.15 35% off	$582.41	$1,495.39	$1,337.98	2026-05-09
L3900	HCPCS	Hc Cus Whfo Flex Hinge W/f Driven	23	20	$1,570.46	$1,020.79 35% off	$581.07	$1,491.94	$1,334.89	2026-05-09
C9290	HCPCS	Bupivacaine Liposome(pf) 1.3 %(13.3 Mg/ml) Suspension For Infiltration	46	20	$1,568.38	$1,568.38	$580.30	$2,461.90	$1,334.85	2026-05-09
78226	CPT	Hc Hepatobiliary Imaging	23	20	$1,566.65	$1,018.32 35% off	$579.66	$1,488.32	$1,331.65	2026-05-09
J0885	HCPCS	Epoetin Alfa 10,000 Unit/ml Injection Solution	46	20	$2,725.95	$2,725.95	$403.44	$4,143.44	$1,324.81	2026-05-09
77046	CPT	Hc MRI Breast W/o; Unilateral	23	20	$1,558.40	$1,012.96 35% off	$576.61	$1,480.48	$1,324.64	2026-05-09
G0416	HCPCS	Hc Prostate Biopsy, Any Method	23	20	$1,557.17	$1,012.16 35% off	$576.15	$1,479.31	$1,323.59	2026-05-09
72146	CPT	Hc MRI Thoracic Spine Without Contrast	26	20	$1,547.91	$1,006.14 35% off	$572.73	$1,470.51	$1,316.58	2026-05-09
71550	CPT	Hc MRI Chest Without Contrast	23	20	$1,544.90	$1,004.18 35% off	$571.61	$1,467.66	$1,313.17	2026-05-09
70491	CPT	Hc CT Neck Soft Tissue W/contrast	27	20	$1,541.72	$1,002.11 35% off	$570.44	$1,464.63	$1,312.16	2026-05-09
73701	CPT	Hc CT Lower Extremity W/contrast Unilateral	23	20	$1,543.28	$1,003.13 35% off	$571.01	$1,466.12	$1,311.79	2026-05-09
J9395	HCPCS	Fulvestrant 250 Mg/5 Ml Intramuscular Syringe	69	20	$1,530.00	$1,530.00	$264.18	$3,757.89	$1,300.50	2026-05-09
73200	CPT	Hc CT Upper Extremity Without Contrast	24	20	$1,526.70	$992.35 35% off	$564.88	$1,450.37	$1,297.70	2026-05-09
73201	CPT	Hc CT Upper Extremity W/contrast	23	20	$1,525.60	$991.64 35% off	$564.47	$1,449.32	$1,296.76	2026-05-09
72131	CPT	Hc CT Lumbar Spine Without Contrast	24	20	$1,523.90	$990.53 35% off	$33.22	$1,447.71	$1,295.32	2026-05-09
J0558	HCPCS	Penicillin G Benzathine And Procaine 1,200,000 Unit/2 Ml IM Syringe	23	20	$1,522.81	$1,522.81	$563.44	$1,446.67	$1,294.39	2026-05-09
87902	CPT	Hc Hep C Genotyping By Sequencin	24	20	$1,452.13	$943.88 35% off	$537.29	$1,455.22	$1,234.31	2026-05-09
87901	CPT	Hc HIV 1 Genotype Analysis Nuc Acid-rl	23	20	$1,452.13	$943.88 35% off	$537.29	$1,379.52	$1,234.31	2026-05-09
71250	CPT	Hc CT Thorax Dx Without Contrast	25	20	$1,451.55	$943.50 35% off	$537.07	$1,378.97	$1,233.82	2026-05-09
90620	CPT	Meningococcal B Vac,4-cmp 50 Mcg-50 Mcg-50 Mcg-25 Mcg/0.5ml IM Syringe	23	20	$1,450.85	$1,450.85	$536.81	$1,378.31	$1,233.22	2026-05-09
70486	CPT	Hc CT Maxillofacial Without Contrast	26	20	$1,446.64	$940.31 35% off	$535.26	$1,374.31	$1,230.44	2026-05-09
70496	CPT	Hc CTA Head W/wo Contrast	27	20	$1,433.11	$931.52 35% off	$530.25	$1,361.45	$1,219.72	2026-05-09
70492	CPT	Hc CT Neck Soft Tiss W/wo Contrast	24	20	$1,433.11	$931.52 35% off	$530.25	$1,361.45	$1,218.14	2026-05-09
73700	CPT	Hc CT Lower Extremity Without Contrast Unilateral	23	20	$1,433.03	$931.46 35% off	$530.22	$1,361.38	$1,218.08	2026-05-09
78014	CPT	Hc Thyroid Imaging W Sngl/mult Measurements	23	20	$1,431.05	$930.18 35% off	$529.49	$1,359.50	$1,216.39	2026-05-09
J2997	HCPCS	Alteplase 2 Mg Intra-catheter Solution	47	20	$1,157.18	$1,157.18	$428.16	$57,603.02	$1,212.03	2026-05-09
78290	CPT	Hc Nm Meckels Bowel Imaging	23	20	$1,419.25	$922.51 35% off	$525.12	$1,348.29	$1,206.36	2026-05-09
L3765	HCPCS	Hc Cus Fit & Adj Ewhfo Rigid Without Jnts	23	20	$1,407.93	$915.15 35% off	$520.93	$1,337.53	$1,196.74	2026-05-09
P9037	HCPCS	Hc Platelets Pheresis Lr Irrad Ea Unit	23	20	$1,406.20	$914.03 35% off	$520.29	$1,335.89	$1,195.27	2026-05-09
P9036	HCPCS	Hc Platelets Pheresis Irrad Ea Unit	23	20	$1,406.20	$914.03 35% off	$520.29	$1,335.89	$1,195.27	2026-05-09
93970	CPT	Hc Doppler Extrem Complete Bilateral	25	20	$1,372.04	$891.82 35% off	$507.65	$1,303.44	$1,166.23	2026-05-09
70450	CPT	Hc CT Head/brain Without Contrast	28	20	$1,361.37	$884.89 35% off	$272.28	$1,293.30	$1,158.66	2026-05-09
95816	CPT	Hc EEG Awake/drowsy	23	20	$1,350.63	$877.90 35% off	$499.73	$1,283.10	$1,148.04	2026-05-09
L0460	HCPCS	Hc Prefab Cus Tlso Post Frame	23	20	$1,345.13	$874.33 35% off	$497.70	$1,277.87	$1,143.36	2026-05-09
93930	CPT	Hc US Doppler Extrem Upper Bilateral	23	20	$1,338.96	$870.32 35% off	$495.42	$1,272.01	$1,138.12	2026-05-09
Q9957	HCPCS	Perflutren Lipid Microspheres 1.1 Mg/ml Intravenous Suspension	46	20	$1,383.81	$1,383.81	$493.22	$1,400.05	$1,134.53	2026-05-09
91037	CPT	Hc Manometry	23	20	$1,324.58	$860.97 35% off	$490.09	$1,258.35	$1,125.89	2026-05-09
74175	CPT	Hc CTA Abdomen W/wo Contrast	24	20	$1,323.00	$859.95 35% off	$489.51	$1,256.85	$1,124.55	2026-05-09

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