Hospital

WEISER MEMORIAL HOSPITAL

Weiser, ID · CCN 131307 · Rates published

Your selected procedure

You selected 93458 (CPT)

L HRT ARTERY/VENTRICLE ANGIO

This hospital’s price: $528 across 2 payers

Source: https://mrfs.hyvehealthcare.com/WeiserValley/826001139_weiser-valley-hospital-district_standardcharges.csv · observed 2026-08-18

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.

19,410 distinct procedures filed

16 distinct payers

365,336 rate rows

2026-08-18 last MRF observed

Data quality

252,066 of 365,336 rate rows are consumer-grade (69.0%)

113,270 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	99,393
per-diem day rate — not a per-procedure price	9,923
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	3,878
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	54
placeholder amount (≤ $0.02) — excluded from medians	22

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

Source MRF file	https://mrfs.hyvehealthcare.com/WeiserValley/826001139_weiser-valley-hospital-district_standardcharges.csv
Found on page	https://weisermemorialhospital.org/price-transparency
Discovered via	CMS hospital list
Last fetch	success · 2026-09-25
Content fingerprint	8c0e40d6d9ac8e6b… · 79,217,950 bytes · first seen 2026-09-25

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
Q2057 HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	1	$847,682.00	$847,682.00	$847,682.00	nat. median $813,967 1.0× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	13	$341,071.17	$623,184.43	$341,071.17	nat. median $621,313 0.5× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	13	$332,444.96	$646,414.53	$332,444.96	nat. median $599,737 0.6× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	13	$318,572.39	$613,889.90	$318,572.39	nat. median $574,037 0.6× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	13	$311,441.04	$618,421.37	$311,441.04	nat. median $579,571 0.5× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	13	$295,178.84	$585,411.47	$295,178.84	nat. median $562,501 0.5× median
Q2053 HCPCS	Brexucabtagene Car Pos T	13	$294,295.06	$538,395.22	$294,295.06	nat. median $513,770 0.6× median
Q0480 HCPCS	Dme Pos	13	$60,299.95	$60,299.95	$60,299.95	nat. median $108,243 0.6× median
A9543 HCPCS	Y90 Ibritumomab, Rx	13	$44,585.30	$44,585.30	$44,585.30	nat. median $65,477 0.7× median
J9029 HCPCS	Instill Adstiladrin, Tx Dose	13	$38,231.43	$70,702.27	$38,231.43	nat. median $66,211 0.6× median
Q2043 HCPCS	Sipuleucel-t Auto Cd54+	13	$33,488.51	$59,844.52	$33,488.51	nat. median $63,499 0.5× median
E0194 HCPCS	Dme Pos	13	$27,417.99	$27,417.99	$27,417.99	nat. median $4,113 outlier · 6.7×
J9226 HCPCS	Supprelin La Implant	13	$27,292.87	$47,503.87	$27,292.87	nat. median $57,036 outlier · 0.5×
K0606 HCPCS	Dme Pos	13	$21,216.74	$21,216.74	$21,216.74	nat. median $3,608 outlier · 5.9×
J9266 HCPCS	Pegaspargase Injection	13	$16,323.53	$31,266.46	$16,323.53	nat. median $31,084 0.5× median
L8614 HCPCS	Dme Pos	13	$13,596.18	$13,596.18	$13,596.18	nat. median $22,495 0.6× median
Q0483 HCPCS	Dme Pos	13	$13,321.52	$13,321.52	$13,321.52	nat. median $22,635 0.6× median
Q0489 HCPCS	Dme Pos	13	$11,549.03	$11,549.03	$11,549.03	nat. median $19,623 0.6× median
A9604 HCPCS	Sm 153 Lexidronam	13	$11,193.18	$11,193.18	$11,193.18	nat. median $11,059 1.0× median
J3245 HCPCS	Tildrakizumab (ILumya) Pfs 100mg	13	$80.31	$18,659.17	$10,852.78	nat. median $217 outlier · 50.0×
Q0481 HCPCS	Dme Pos	13	$10,324.18	$10,324.18	$10,324.18	nat. median $16,720 0.6× median
C2616 HCPCS	Brachytx, Non-str,yttrium-90	13	$10,306.21	$10,306.21	$10,306.21	nat. median $22,121 outlier · 0.5×
J7310 HCPCS	Ganciclovir Long Act Implant	13	$10,226.88	$10,226.88	$10,226.88	nat. median $13,629 0.8× median
E0766 HCPCS	Dme Pos	13	$9,686.26	$9,686.26	$9,686.26	nat. median $16,158 0.6× median
C9606 HCPCS	Perc D-e Cor Revasc W Ami S	13	$9,660.29	$9,660.29	$9,660.29	nat. median $17,051 0.6× median
C9602 HCPCS	Perc D-e Cor Stent Ather S	13	$9,660.29	$9,660.29	$9,660.29	nat. median $19,918 outlier · 0.5×
C9607 HCPCS	Perc D-e Cor Revasc Chro Sin	13	$9,660.29	$9,660.29	$9,660.29	nat. median $19,925 outlier · 0.5×
81416 CPT	Exome Sequence Analysis	13	$7,236.00	$13,800.00	$9,618.00	nat. median $12,000 0.8× median
L8687 HCPCS	Implt Nrostm Pls Gen Dua Rec	13	$9,429.99	$9,429.99	$9,429.99	nat. median $15,408 0.6× median
E0764 HCPCS	Dme Pos	13	$9,323.71	$9,323.71	$9,323.71	nat. median $1,585 outlier · 5.9×
E0483 HCPCS	Dme Pos	13	$8,957.02	$8,957.02	$8,957.02	nat. median $1,515 outlier · 5.9×
E2402 HCPCS	Dme Pos	13	$8,875.56	$8,875.56	$8,875.56	nat. median $850 outlier · 10.4×
K0864 HCPCS	Dme Pos	13	$8,688.02	$8,688.02	$8,688.02	nat. median $2,216 outlier · 3.9×
Q0479 HCPCS	Dme Pos	13	$8,506.83	$8,506.83	$8,506.83	nat. median $14,835 0.6× median
315U OTHER	Onc Cutan Sq Cll Ca Mrna 40	12	$8,500.00	$9,775.00	$8,500.00	nat. median $8,500 1.0× median
211U OTHER	Onc Pan-tum Dna&rna Gnrj Seq	12	$8,455.00	$9,723.25	$8,455.00	nat. median $8,455 1.0× median
E0636 HCPCS	Dme Pos	13	$8,404.79	$8,404.79	$8,404.79	nat. median $1,239 outlier · 6.8×
E0467 HCPCS	Dme Pos	13	$8,304.64	$8,304.64	$8,304.64	nat. median $1,542 outlier · 5.4×
Q0224 HCPCS	Injection, Pemivibart, For The Pre-exposure Prophylaxis Only, For Certain Adults…	1	$7,962.90	$7,962.90	$7,962.90	nat. median $6,668 1.2× median
81552 CPT	Onc Uveal Mlnma Mrna 15 Gene	12	$7,776.00	$8,942.40	$7,776.00	nat. median $7,932 1.0× median
426U OTHER	Genome Ultra-rapid Seq Alys	12	$7,582.20	$8,719.53	$7,582.20	nat. median $7,582 1.0× median
94U OTHER	Genome Rapid Sequence Alys	12	$7,582.20	$8,719.53	$7,582.20	nat. median $7,582 1.0× median
K0863 HCPCS	Dme Pos	13	$7,300.88	$7,300.88	$7,300.88	nat. median $1,862 outlier · 3.9×
K0860 HCPCS	Dme Pos	13	$7,300.88	$7,300.88	$7,300.88	nat. median $1,862 outlier · 3.9×
L8685 HCPCS	Implt Nrostm Pls Gen Sng Rec	13	$7,246.04	$7,246.04	$7,246.04	nat. median $7,246 1.0× median
81529 CPT	Onc Cutan Mlnma Mrna 31 Gene	12	$7,193.00	$8,271.95	$7,193.00	nat. median $7,337 1.0× median
J3380 HCPCS	Vedolizumab (Entyvio) 300 Mg Vial	13	$13.07	$12,117.38	$7,047.86	nat. median $59 outlier · 119.9×
E1036 HCPCS	Dme Pos	13	$7,012.29	$7,012.29	$7,012.29	nat. median $1,056 outlier · 6.6×
K0854 HCPCS	Dme Pos	13	$6,999.10	$6,999.10	$6,999.10	nat. median $1,785 outlier · 3.9×
L5991 HCPCS	Dme Pos	13	$6,949.31	$6,949.31	$6,949.31	nat. median $11,755 0.6× median

Other procedures at this hospital

Browse this hospital's 19,410 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

Q2057	HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	1	1	—	—	$847,682.00	$847,682.00	$847,682.00	2026-08-18
Q2042	HCPCS	Tisagenlecleucel Car-pos T	18	13	—	—	$341,071.17	$623,184.43	$341,071.17	2026-08-18
Q2056	HCPCS	Ciltacabtagene Car-pos T	18	13	—	—	$332,444.96	$646,414.53	$332,444.96	2026-08-18
Q2055	HCPCS	Idecabtagene Vicleucel Car	18	13	—	—	$318,572.39	$613,889.90	$318,572.39	2026-08-18
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	18	13	—	—	$311,441.04	$618,421.37	$311,441.04	2026-08-18
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	18	13	—	—	$295,178.84	$585,411.47	$295,178.84	2026-08-18
Q2053	HCPCS	Brexucabtagene Car Pos T	18	13	—	—	$294,295.06	$538,395.22	$294,295.06	2026-08-18
Q0480	HCPCS	Dme Pos	18	13	—	—	$60,299.95	$60,299.95	$60,299.95	2026-08-18
A9543	HCPCS	Y90 Ibritumomab, Rx	18	13	—	—	$44,585.30	$44,585.30	$44,585.30	2026-08-18
J9029	HCPCS	Instill Adstiladrin, Tx Dose	18	13	—	—	$38,231.43	$70,702.27	$38,231.43	2026-08-18
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	18	13	—	—	$33,488.51	$59,844.52	$33,488.51	2026-08-18
E0194	HCPCS	Dme Pos	18	13	—	—	$27,417.99	$27,417.99	$27,417.99	2026-08-18
J9226	HCPCS	Supprelin La Implant	18	13	—	—	$27,292.87	$47,503.87	$27,292.87	2026-08-18
K0606	HCPCS	Dme Pos	18	13	—	—	$21,216.74	$21,216.74	$21,216.74	2026-08-18
J9266	HCPCS	Pegaspargase Injection	18	13	—	—	$16,323.53	$31,266.46	$16,323.53	2026-08-18
L8614	HCPCS	Dme Pos	18	13	—	—	$13,596.18	$13,596.18	$13,596.18	2026-08-18
Q0483	HCPCS	Dme Pos	18	13	—	—	$13,321.52	$13,321.52	$13,321.52	2026-08-18
Q0489	HCPCS	Dme Pos	18	13	—	—	$11,549.03	$11,549.03	$11,549.03	2026-08-18
A9604	HCPCS	Sm 153 Lexidronam	18	13	—	—	$11,193.18	$11,193.18	$11,193.18	2026-08-18
J3245	HCPCS	Tildrakizumab (ILumya) Pfs 100mg	18	13	$19,039.97	$14,279.98 25% off	$80.31	$18,659.17	$10,852.78	2026-08-18
Q0481	HCPCS	Dme Pos	18	13	—	—	$10,324.18	$10,324.18	$10,324.18	2026-08-18
C2616	HCPCS	Brachytx, Non-str,yttrium-90	18	13	—	—	$10,306.21	$10,306.21	$10,306.21	2026-08-18
J7310	HCPCS	Ganciclovir Long Act Implant	18	13	—	—	$10,226.88	$10,226.88	$10,226.88	2026-08-18
E0766	HCPCS	Dme Pos	18	13	—	—	$9,686.26	$9,686.26	$9,686.26	2026-08-18
C9607	HCPCS	Perc D-e Cor Revasc Chro Sin	18	13	—	—	$9,660.29	$9,660.29	$9,660.29	2026-08-18
C9602	HCPCS	Perc D-e Cor Stent Ather S	18	13	—	—	$9,660.29	$9,660.29	$9,660.29	2026-08-18
C9606	HCPCS	Perc D-e Cor Revasc W Ami S	18	13	—	—	$9,660.29	$9,660.29	$9,660.29	2026-08-18
81416	CPT	Exome Sequence Analysis	18	13	—	—	$7,236.00	$13,800.00	$9,618.00	2026-08-18
L8687	HCPCS	Implt Nrostm Pls Gen Dua Rec	18	13	—	—	$9,429.99	$9,429.99	$9,429.99	2026-08-18
E0764	HCPCS	Dme Pos	18	13	—	—	$9,323.71	$9,323.71	$9,323.71	2026-08-18
E0483	HCPCS	Dme Pos	18	13	—	—	$8,957.02	$8,957.02	$8,957.02	2026-08-18
E2402	HCPCS	Dme Pos	18	13	—	—	$8,875.56	$8,875.56	$8,875.56	2026-08-18
K0864	HCPCS	Dme Pos	18	13	—	—	$8,688.02	$8,688.02	$8,688.02	2026-08-18
Q0479	HCPCS	Dme Pos	18	13	—	—	$8,506.83	$8,506.83	$8,506.83	2026-08-18
315U	OTHER	Onc Cutan Sq Cll Ca Mrna 40	15	12	—	—	$8,500.00	$9,775.00	$8,500.00	2026-08-18
211U	OTHER	Onc Pan-tum Dna&rna Gnrj Seq	15	12	—	—	$8,455.00	$9,723.25	$8,455.00	2026-08-18
E0636	HCPCS	Dme Pos	18	13	—	—	$8,404.79	$8,404.79	$8,404.79	2026-08-18
E0467	HCPCS	Dme Pos	18	13	—	—	$8,304.64	$8,304.64	$8,304.64	2026-08-18
Q0224	HCPCS	Injection, Pemivibart, For The Pre-exposure Prophylaxis Only, For Certain Adults…	1	1	—	—	$7,962.90	$7,962.90	$7,962.90	2026-08-18
81552	CPT	Onc Uveal Mlnma Mrna 15 Gene	15	12	—	—	$7,776.00	$8,942.40	$7,776.00	2026-08-18
94U	OTHER	Genome Rapid Sequence Alys	15	12	—	—	$7,582.20	$8,719.53	$7,582.20	2026-08-18
426U	OTHER	Genome Ultra-rapid Seq Alys	15	12	—	—	$7,582.20	$8,719.53	$7,582.20	2026-08-18
K0860	HCPCS	Dme Pos	18	13	—	—	$7,300.88	$7,300.88	$7,300.88	2026-08-18
K0863	HCPCS	Dme Pos	18	13	—	—	$7,300.88	$7,300.88	$7,300.88	2026-08-18
L8685	HCPCS	Implt Nrostm Pls Gen Sng Rec	18	13	—	—	$7,246.04	$7,246.04	$7,246.04	2026-08-18
81529	CPT	Onc Cutan Mlnma Mrna 31 Gene	15	12	—	—	$7,193.00	$8,271.95	$7,193.00	2026-08-18
J3380	HCPCS	Vedolizumab (Entyvio) 300 Mg Vial	18	13	$12,364.68	$9,273.51 25% off	$13.07	$12,117.38	$7,047.86	2026-08-18
E1036	HCPCS	Dme Pos	18	13	—	—	$7,012.29	$7,012.29	$7,012.29	2026-08-18
K0854	HCPCS	Dme Pos	18	13	—	—	$6,999.10	$6,999.10	$6,999.10	2026-08-18
L5991	HCPCS	Dme Pos	18	13	—	—	$6,949.31	$6,949.31	$6,949.31	2026-08-18
C1776	HCPCS	Joint Device (implantable)	8	7	—	—	$1,113.64	$12,027.00	$6,935.14	2026-08-18
E0465	HCPCS	Dme Pos	18	13	—	—	$6,896.75	$6,896.75	$6,896.75	2026-08-18
E0466	HCPCS	Dme Pos	18	13	—	—	$6,896.75	$6,896.75	$6,896.75	2026-08-18
267U	OTHER	Rare Do Id Opt Gen Mapg&seq	15	12	—	—	$6,739.33	$7,750.23	$6,739.33	2026-08-18
E0786	HCPCS	Dme Pos	18	13	—	—	$6,728.11	$6,728.11	$6,728.11	2026-08-18
E0783	HCPCS	Dme Pos	18	13	—	—	$6,679.89	$6,679.89	$6,679.89	2026-08-18
K0855	HCPCS	Dme Pos	18	13	—	—	$6,611.65	$6,611.65	$6,611.65	2026-08-18
27278	CPT	Arthrd Si Jt Prq Wo Tfxj Dev	18	13	—	—	$6,470.58	$6,470.58	$6,470.58	2026-08-18
C9604	HCPCS	Perc D-e Cor Revasc T Cabg S	18	13	—	—	$6,337.80	$6,337.80	$6,337.80	2026-08-18
E1008	HCPCS	Dme Pos	18	13	—	—	$6,179.91	$6,179.91	$6,179.91	2026-08-18
L8679	HCPCS	Dme Pos	18	13	—	—	$6,158.54	$6,158.54	$6,158.54	2026-08-18
E1007	HCPCS	Dme Pos	18	13	—	—	$6,104.29	$6,104.29	$6,104.29	2026-08-18
E0193	HCPCS	Dme Pos	18	13	—	—	$6,064.37	$6,064.37	$6,064.37	2026-08-18
L8688	HCPCS	Implt Nrostm Pls Gen Dua Non	18	13	—	—	$6,017.09	$6,017.09	$6,017.09	2026-08-18
J3101	HCPCS	Tenecteplase 50 Mg	18	13	$10,424.40	$7,818.30 25% off	$97.95	$10,215.91	$5,941.90	2026-08-18
L8619	HCPCS	Dme Pos	18	13	—	—	$5,836.75	$5,836.75	$5,836.75	2026-08-18
37231	CPT	Tib/per Revasc Stent & Ather	18	13	—	—	$5,803.83	$5,803.83	$5,803.83	2026-08-18
K0840	HCPCS	Dme Pos	18	13	—	—	$5,749.00	$5,749.00	$5,749.00	2026-08-18
E2510	HCPCS	Dme Pos	18	13	—	—	$5,702.30	$5,702.30	$5,702.30	2026-08-18
37227	CPT	Fem/popl Revasc Stnt & Ather	18	13	—	—	$5,524.03	$5,524.03	$5,524.03	2026-08-18
265U	OTHER	Rar Do Whl Gn&mtcdrl DNA Als	15	12	—	—	$5,475.80	$6,297.17	$5,475.80	2026-08-18
212U	OTHER	Rare Ds Gen DNA Alys Proband	15	12	—	—	$5,475.20	$6,296.48	$5,475.20	2026-08-18
295U	OTHER	Onc Brst Dux Carc 7 Proteins	15	12	—	—	$5,435.00	$6,250.25	$5,435.00	2026-08-18
81554	CPT	Pulm Ds Ipf Mrna 190 Gen Alg	15	12	—	—	$5,409.60	$6,221.04	$5,409.60	2026-08-18
K0853	HCPCS	Dme Pos	18	13	—	—	$5,283.20	$5,283.20	$5,283.20	2026-08-18
335U	OTHER	Rare Ds Whl Gen Seq Feta	15	12	—	—	$5,224.60	$6,008.29	$5,224.60	2026-08-18
214U	OTHER	Rare Ds Xom DNA Alys Proband	15	12	—	—	$5,224.60	$6,008.29	$5,224.60	2026-08-18
K0852	HCPCS	Dme Pos	18	13	—	—	$5,142.99	$5,142.99	$5,142.99	2026-08-18
L5987	HCPCS	Dme Pos	18	13	—	—	$5,111.16	$5,111.16	$5,111.16	2026-08-18
K0862	HCPCS	Dme Pos	18	13	—	—	$5,110.38	$5,110.38	$5,110.38	2026-08-18
K0858	HCPCS	Dme Pos	18	13	—	—	$5,110.38	$5,110.38	$5,110.38	2026-08-18
532U	OTHER	Rare Diseases (constitutional Disease/hereditary Disorders), Rapid Whole Genome …	15	12	—	—	$5,031.20	$5,785.88	$5,031.20	2026-08-18
81425	CPT	Genome Sequence Analysis	15	12	—	—	$5,031.20	$5,785.88	$5,031.20	2026-08-18
567U	OTHER	Rare Diseases (constitutional/heritable Disorders), Whole-genome Sequence Analys…	15	12	—	—	$5,031.20	$5,785.88	$5,031.20	2026-08-18
242U	OTHER	Trgt Gen Seq Alys Pnl 55-74	15	12	—	—	$5,000.00	$5,750.00	$5,000.00	2026-08-18
326U	OTHER	Trgt Gen Seq Alys Pnl 83+	15	12	—	—	$5,000.00	$5,750.00	$5,000.00	2026-08-18
L5270	HCPCS	Dme Pos	18	13	—	—	$4,963.06	$4,963.06	$4,963.06	2026-08-18
108U	OTHER	Gi Barrett Esoph 9 Prtn Bmrk	15	12	—	—	$4,950.00	$5,692.50	$4,950.00	2026-08-18
L8627	HCPCS	Dme Pos	18	13	—	—	$4,923.66	$4,923.66	$4,923.66	2026-08-18
E1035	HCPCS	Dme Pos	18	13	—	—	$4,913.85	$4,913.85	$4,913.85	2026-08-18
L5280	HCPCS	Dme Pos	18	13	—	—	$4,913.43	$4,913.43	$4,913.43	2026-08-18
K0828	HCPCS	Dme Pos	18	13	—	—	$4,896.96	$4,896.96	$4,896.96	2026-08-18
K0859	HCPCS	Dme Pos	18	13	—	—	$4,873.77	$4,873.77	$4,873.77	2026-08-18
36837	CPT	Prq Av Fstl Crt Uxtr Sep Acs	18	13	—	—	$4,804.56	$4,804.56	$4,804.56	2026-08-18
36U	OTHER	Xome Tum & Nml Spec Seq Alys	15	12	—	—	$4,780.00	$5,497.00	$4,780.00	2026-08-18
E0304	HCPCS	Dme Pos	18	13	—	—	$4,737.17	$4,737.17	$4,737.17	2026-08-18
E1006	HCPCS	Dme Pos	18	13	—	—	$4,687.72	$4,687.72	$4,687.72	2026-08-18
L5341	HCPCS	Dme Pos	18	13	—	—	$4,638.77	$4,638.77	$4,638.77	2026-08-18
L5250	HCPCS	Dme Pos	18	13	—	—	$4,632.43	$4,632.43	$4,632.43	2026-08-18
L8609	HCPCS	Dme Pos	18	13	—	—	$4,629.23	$4,629.23	$4,629.23	2026-08-18
L8686	HCPCS	Implt Nrostm Pls Gen Sng Non	18	13	—	—	$4,623.56	$4,623.56	$4,623.56	2026-08-18
K0829	HCPCS	Dme Pos	18	13	—	—	$4,606.60	$4,606.60	$4,606.60	2026-08-18
473U	OTHER	Oncology (solid Tumor), Next-generation Sequencing (ngs) Of DNA From Formalin-fi…	15	12	—	—	$4,500.00	$5,175.00	$4,500.00	2026-08-18
K0850	HCPCS	Dme Pos	18	13	—	—	$4,451.10	$4,451.10	$4,451.10	2026-08-18
L5331	HCPCS	Dme Pos	18	13	—	—	$4,444.44	$4,444.44	$4,444.44	2026-08-18
37230	CPT	Tib/per Revasc W/stent	18	13	—	—	$4,420.02	$4,420.02	$4,420.02	2026-08-18
37229	CPT	Tib/per Revasc W/ather	18	13	—	—	$4,419.55	$4,419.55	$4,419.55	2026-08-18
L8682	HCPCS	Dme Pos	18	13	—	—	$4,400.18	$4,400.18	$4,400.18	2026-08-18
37225	CPT	Fem/popl Revas W/ather	18	13	—	—	$4,325.43	$4,325.43	$4,325.43	2026-08-18
K0011	HCPCS	Dme Pos	18	13	—	—	$4,315.97	$4,315.97	$4,315.97	2026-08-18
37243	CPT	Vasc Embolize/occlude Organ	18	13	—	—	$4,303.46	$4,303.46	$4,303.46	2026-08-18
K0851	HCPCS	Dme Pos	18	13	—	—	$4,279.81	$4,279.81	$4,279.81	2026-08-18
K0826	HCPCS	Dme Pos	18	13	—	—	$4,203.75	$4,203.75	$4,203.75	2026-08-18
K0857	HCPCS	Dme Pos	18	13	—	—	$4,201.50	$4,201.50	$4,201.50	2026-08-18
300U	OTHER	Onc Pan Tum Whl Gen Seq&opt	15	12	—	—	$4,183.13	$4,810.60	$4,183.13	2026-08-18
J3316	HCPCS	Inj., Triptorelin Xr 3.75 Mg	1	1	—	—	$4,141.48	$4,141.48	$4,141.48	2026-08-18
K0861	HCPCS	Dme Pos	18	13	—	—	$4,125.53	$4,125.53	$4,125.53	2026-08-18
K0856	HCPCS	Dme Pos	18	13	—	—	$4,118.89	$4,118.89	$4,118.89	2026-08-18
L5600	HCPCS	Dme Pos	18	13	—	—	$4,118.01	$4,118.01	$4,118.01	2026-08-18
E0986	HCPCS	Dme Pos	18	13	—	—	$4,098.29	$4,098.29	$4,098.29	2026-08-18
425U	OTHER	Genom Rpd Seq Alys Ea Cmprtr	15	12	—	—	$4,094.39	$4,708.55	$4,094.39	2026-08-18
36836	CPT	Prq Av Fstl Crtj Uxtr 1 Acs	18	13	—	—	$4,045.82	$4,045.82	$4,045.82	2026-08-18
C9740	HCPCS	Cysto Impl 4 Or More	18	13	—	—	$4,008.19	$4,008.19	$4,008.19	2026-08-18
37226	CPT	Fem/popl Revasc W/stent	18	13	—	—	$4,001.70	$4,001.70	$4,001.70	2026-08-18
44136	CPT	Intestine Transplant Live	18	13	—	—	$4,001.00	$4,001.00	$4,001.00	2026-08-18
E0472	HCPCS	Dme Pos	18	13	—	—	$3,959.72	$3,959.72	$3,959.72	2026-08-18
74174	CPT	CTA Abd/pelvis	18	13	$6,857.00	$5,142.75 25% off	$207.38	$6,719.86	$3,908.49	2026-08-18
L5615	HCPCS	Dme Pos	18	13	—	—	$3,904.07	$3,904.07	$3,904.07	2026-08-18
A9572	HCPCS	Indium In-111 Pentetreotide	18	13	—	—	$3,901.80	$3,901.80	$3,901.80	2026-08-18
560U	OTHER	Oncology (minimal Residual Disease [mrd]), Genomic Sequence Analysis, Cell-free …	15	12	—	—	$3,878.45	$4,460.22	$3,878.45	2026-08-18
306U	OTHER	Onc Mrd Nxt-gnrj Alys 1st	15	12	—	—	$3,878.45	$4,460.22	$3,878.45	2026-08-18
L8683	HCPCS	Dme Pos	18	13	—	—	$3,873.16	$3,873.16	$3,873.16	2026-08-18
497U	OTHER	Oncology (prostate), Mrna Gene-expression Profiling By Real-time Rt-pcr Of 6 Gen…	15	12	—	—	$3,873.00	$4,453.95	$3,873.00	2026-08-18
288U	OTHER	Onc Lung Mrna Quan Pcr 11&3	15	12	—	—	$3,873.00	$4,453.95	$3,873.00	2026-08-18
47U	OTHER	Onc Prst8 Mrna 17 Gene Alg	15	12	—	—	$3,873.00	$4,453.95	$3,873.00	2026-08-18
81542	CPT	Onc Prostate Mrna 22 Cnt Gen	15	12	—	—	$3,873.00	$4,453.95	$3,873.00	2026-08-18
81521	CPT	Onc Breast Mrna 70 Genes	15	12	—	—	$3,873.00	$4,453.95	$3,873.00	2026-08-18
81518	CPT	Onc Brst Mrna 11 Genes	15	12	—	—	$3,873.00	$4,453.95	$3,873.00	2026-08-18
45U	OTHER	Onc Brst Dux Carc Is 12 Gene	15	12	—	—	$3,873.00	$4,453.95	$3,873.00	2026-08-18
81541	CPT	Onc Prostate Mrna 46 Genes	15	12	—	—	$3,873.00	$4,453.95	$3,873.00	2026-08-18
E0652	HCPCS	Dme Pos	18	13	—	—	$3,850.91	$3,850.91	$3,850.91	2026-08-18
L5702	HCPCS	Dme Pos	18	13	—	—	$3,845.39	$3,845.39	$3,845.39	2026-08-18
K0848	HCPCS	Dme Pos	18	13	—	—	$3,837.37	$3,837.37	$3,837.37	2026-08-18
L6570	HCPCS	Dme Pos	18	13	—	—	$3,836.28	$3,836.28	$3,836.28	2026-08-18
81415	CPT	Exome Sequence Analysis	18	13	—	—	$2,882.34	$5,497.00	$3,831.17	2026-08-18
E1005	HCPCS	Dme Pos	18	13	—	—	$3,827.06	$3,827.06	$3,827.06	2026-08-18
E1841	HCPCS	Dme Pos	18	13	—	—	$3,816.45	$3,816.45	$3,816.45	2026-08-18
A0431	HCPCS	Rotary Wing Air Transport	18	13	—	—	$3,798.18	$3,798.18	$3,798.18	2026-08-18
L6350	HCPCS	Dme Pos	18	13	—	—	$3,779.82	$3,779.82	$3,779.82	2026-08-18
K0839	HCPCS	Dme Pos	18	13	—	—	$3,774.70	$3,774.70	$3,774.70	2026-08-18
E0694	HCPCS	Dme Pos	18	13	—	—	$3,730.07	$3,730.07	$3,730.07	2026-08-18
44135	CPT	Intestine Transplnt Cadaver	18	13	—	—	$3,702.94	$3,702.94	$3,702.94	2026-08-18
K0849	HCPCS	Dme Pos	18	13	—	—	$3,689.36	$3,689.36	$3,689.36	2026-08-18
19U	OTHER	Onc RNA Tiss Predict Alg	15	12	—	—	$3,675.00	$4,226.25	$3,675.00	2026-08-18
258U	OTHER	Ai Psor Mrna 50-100 Gen Alg	15	12	—	—	$3,675.00	$4,226.25	$3,675.00	2026-08-18
J0600	HCPCS	Edetate Calcium Disodium Inj	18	13	—	—	$3,668.71	$6,830.64	$3,668.71	2026-08-18
C1818	HCPCS	Integrated Keratoprosthesis	18	13	—	—	$3,662.80	$3,662.80	$3,662.80	2026-08-18
485U	OTHER	Oncology (solid Tumor), Cell-free DNA And RNA By Next-generation Sequencing, Int…	15	12	—	—	$3,649.48	$4,196.90	$3,649.48	2026-08-18
E0482	HCPCS	Dme Pos	18	13	—	—	$3,623.07	$3,623.07	$3,623.07	2026-08-18
K0827	HCPCS	Dme Pos	18	13	—	—	$3,619.61	$3,619.61	$3,619.61	2026-08-18
E0782	HCPCS	Dme Pos	18	13	—	—	$3,617.25	$3,617.25	$3,617.25	2026-08-18
L5160	HCPCS	Dme Pos	18	13	—	—	$3,600.28	$3,600.28	$3,600.28	2026-08-18
287U	OTHER	Onc Thyr Dna&mrna 112 Genes	15	12	—	—	$3,600.00	$4,140.00	$3,600.00	2026-08-18
81546	CPT	Onc Thyr Mrna 10,196 Gen Alg	15	12	—	—	$3,600.00	$4,140.00	$3,600.00	2026-08-18
313U	OTHER	Onc Pncrs Dna&mrna Seq 74	15	12	—	—	$3,600.00	$4,140.00	$3,600.00	2026-08-18
391U	OTHER	Onc Sld Tum Dna&rna 437 Gen	15	12	—	—	$3,600.00	$4,140.00	$3,600.00	2026-08-18
362U	OTHER	Onc Pap Thyr Ca RNA 82&10	15	12	—	—	$3,600.00	$4,140.00	$3,600.00	2026-08-18
26U	OTHER	Onc Thyr Dna&mrna 112 Genes	15	12	—	—	$3,600.00	$4,140.00	$3,600.00	2026-08-18
E2328	HCPCS	Dme Pos	18	13	—	—	$3,598.28	$3,598.28	$3,598.28	2026-08-18
C9600	HCPCS	Perc Drug-el Cor Stent Sing	18	13	—	—	$3,590.69	$3,590.69	$3,590.69	2026-08-18
340U	OTHER	Onc Pan Ca Alys Mrd Plasma	15	12	—	—	$3,590.00	$4,128.50	$3,590.00	2026-08-18
K0010	HCPCS	Dme Pos	18	13	—	—	$3,589.00	$3,589.00	$3,589.00	2026-08-18
L5230	HCPCS	Dme Pos	18	13	—	—	$3,559.86	$3,559.86	$3,559.86	2026-08-18
59510	CPT	Total Obc-section	33	13	$6,228.02	$4,671.02 25% off	$1,399.03	$6,103.45	$3,549.97	2026-08-18
37242	CPT	Vasc Embolize/occlude Artery	18	13	—	—	$3,545.01	$3,545.01	$3,545.01	2026-08-18
80U	OTHER	Onc Lng 5 Clin Rsk Factr Alg	15	12	—	—	$3,520.00	$4,048.00	$3,520.00	2026-08-18
E1004	HCPCS	Dme Pos	18	13	—	—	$3,518.14	$3,518.14	$3,518.14	2026-08-18
A9582	HCPCS	Iodine I-123 Iobenguane	18	13	—	—	$3,511.62	$3,511.62	$3,511.62	2026-08-18
L5961	HCPCS	Dme Pos	18	13	—	—	$3,511.22	$3,511.22	$3,511.22	2026-08-18
239U	OTHER	Trgt Gen Seq Alys Pnl 311+	15	12	—	—	$3,500.00	$4,025.00	$3,500.00	2026-08-18
334U	OTHER	Onc Sld Orgn Tgsa DNA 84/+	15	12	—	—	$3,500.00	$4,025.00	$3,500.00	2026-08-18
388U	OTHER	Onc Nonsm Cll Lng Ca 37 Gen	15	12	—	—	$3,500.00	$4,025.00	$3,500.00	2026-08-18
37U	OTHER	Trgt Gen Seq DNA 324 Genes	15	12	—	—	$3,500.00	$4,025.00	$3,500.00	2026-08-18
244U	OTHER	Onc Solid Orgn DNA 257 Genes	15	12	—	—	$3,500.00	$4,025.00	$3,500.00	2026-08-18
16M	OTHER	Onc Bladder Mrna 219 Gen Alg	15	12	—	—	$3,489.63	$4,013.07	$3,489.63	2026-08-18
L6550	HCPCS	Dme Pos	18	13	—	—	$3,441.50	$3,441.50	$3,441.50	2026-08-18
329U	OTHER	Onc Neo Xome&trns Seq Alys	15	12	—	—	$3,437.98	$3,953.68	$3,437.98	2026-08-18
A9515	HCPCS	Choline C-11	18	13	—	—	$3,437.10	$3,437.10	$3,437.10	2026-08-18
E0471	HCPCS	Dme Pos	18	13	—	—	$3,419.73	$3,419.73	$3,419.73	2026-08-18
E0784	HCPCS	Dme Pos	18	13	—	—	$3,396.10	$3,396.10	$3,396.10	2026-08-18
L8690	HCPCS	Dme Pos	18	13	—	—	$3,379.98	$3,379.98	$3,379.98	2026-08-18
L6300	HCPCS	Dme Pos	18	13	—	—	$3,363.02	$3,363.02	$3,363.02	2026-08-18
E0277	HCPCS	Dme Pos	18	13	—	—	$3,326.33	$3,326.33	$3,326.33	2026-08-18
E0747	HCPCS	Dme Pos	18	13	—	—	$3,299.32	$3,299.32	$3,299.32	2026-08-18
37244	CPT	Vasc Embolize/occlude Bleed	18	13	—	—	$3,293.08	$3,293.08	$3,293.08	2026-08-18
539U	OTHER	Oncology (solid Tumor), Cell-free Circulating Tumor DNA (ctDNA), 152 Genes, Next…	15	12	—	—	$3,288.51	$3,781.79	$3,288.51	2026-08-18
379U	OTHER	Tgsap Sl Or Neo Dna523&rna55	15	12	—	—	$3,288.51	$3,781.79	$3,288.51	2026-08-18
E0748	HCPCS	Dme Pos	18	13	—	—	$3,277.95	$3,277.95	$3,277.95	2026-08-18
L5595	HCPCS	Dme Pos	18	13	—	—	$3,267.13	$3,267.13	$3,267.13	2026-08-18
A0430	HCPCS	Fixed Wing Air Transport	18	13	—	—	$3,266.83	$3,266.83	$3,266.83	2026-08-18
67966	CPT	Excision And Repair Of Eyelid 1/4 Lid Ma	18	13	$5,731.00	$4,298.25 25% off	$418.14	$5,616.38	$3,266.67	2026-08-18
47143	CPT	Prep Donor Liver Whole	18	13	—	—	$3,259.47	$3,259.47	$3,259.47	2026-08-18
81558	CPT	Transplantation Medicine (allograft Rejection, Kidney), Mrna, Gene Expression Pr…	15	12	—	—	$3,240.00	$3,726.00	$3,240.00	2026-08-18
55U	OTHER	Card Hrt Trnspl 96 DNA Seq	15	12	—	—	$3,240.00	$3,726.00	$3,240.00	2026-08-18
27487	CPT	Revise Total Knee	33	13	$5,674.57	$4,255.93 25% off	$939.18	$5,561.07	$3,234.50	2026-08-18
Q0482	HCPCS	Dme Pos	18	13	—	—	$3,233.73	$3,233.73	$3,233.73	2026-08-18
E1840	HCPCS	Dme Pos	18	13	—	—	$3,224.42	$3,224.42	$3,224.42	2026-08-18
L6205	HCPCS	Dme Pos	18	13	—	—	$3,211.97	$3,211.97	$3,211.97	2026-08-18
L5701	HCPCS	Dme Pos	18	13	—	—	$3,211.42	$3,211.42	$3,211.42	2026-08-18
266U	OTHER	Unxpl Cnst Hrtbl Do Gn Xprsn	15	12	—	—	$3,200.00	$3,680.00	$3,200.00	2026-08-18
262U	OTHER	Onc Sld Tum Rt-pcr 7 Gen	15	12	—	—	$3,200.00	$3,680.00	$3,200.00	2026-08-18
59400	CPT	OB Care Wdeliv 59400	18	13	$5,609.52	$4,207.14 25% off	$1,268.36	$5,497.32	$3,197.42	2026-08-18
E1003	HCPCS	Dme Pos	18	13	—	—	$3,186.86	$3,186.86	$3,186.86	2026-08-18
L5312	HCPCS	Dme Pos	18	13	—	—	$3,183.03	$3,183.03	$3,183.03	2026-08-18
88U	OTHER	Trnsplj Kdn Algrft Rej 1494	15	12	—	—	$3,159.42	$3,633.33	$3,159.42	2026-08-18
87U	OTHER	Crd Hrt Trnspl Mrna 1283 Gen	15	12	—	—	$3,159.42	$3,633.33	$3,159.42	2026-08-18
253U	OTHER	Rprdtve Med RNA Gen Prfl 238	15	12	—	—	$3,159.42	$3,633.33	$3,159.42	2026-08-18
153U	OTHER	Onc Breast Mrna 101 Genes	15	12	—	—	$3,159.42	$3,633.33	$3,159.42	2026-08-18
L5321	HCPCS	Dme Pos	18	13	—	—	$3,132.35	$3,132.35	$3,132.35	2026-08-18
J9225	HCPCS	Vantas Implant	18	13	—	—	$3,115.27	$3,115.27	$3,115.27	2026-08-18
81519	CPT	Oncology Breast Mrna	18	13	—	—	$2,335.42	$4,453.95	$3,104.21	2026-08-18
81522	CPT	Onc Breast Mrna 12 Genes	18	13	—	—	$2,335.42	$4,453.95	$3,104.21	2026-08-18
81523	CPT	Onc Brst Mrna 70 Cnt 31 Gene	18	13	—	—	$2,335.42	$4,453.95	$3,104.21	2026-08-18
L6885	HCPCS	Dme Pos	18	13	—	—	$3,073.68	$3,073.68	$3,073.68	2026-08-18
L6360	HCPCS	Dme Pos	18	13	—	—	$3,073.68	$3,073.68	$3,073.68	2026-08-18
K0843	HCPCS	Dme Pos	18	13	—	—	$3,062.68	$3,062.68	$3,062.68	2026-08-18
J1162	HCPCS	Digoxin Immune Fab (ovine)	18	13	—	—	$3,057.20	$5,683.69	$3,057.20	2026-08-18
511U	OTHER	Oncology (solid Tumor), Tumor Cell Culture In 3d Microenvironment, 36 Or More Dr…	15	12	—	—	$3,033.86	$3,488.94	$3,033.86	2026-08-18
435U	OTHER	Onc Chemo Rx Cytox Csc 14 Rx	15	12	—	—	$3,033.86	$3,488.94	$3,033.86	2026-08-18
248U	OTHER	Onc Brn Sphrd Cll 12 Rx Pnl	15	12	—	—	$3,033.86	$3,488.94	$3,033.86	2026-08-18
525U	OTHER	Oncology, Spheroid Cell Culture, 11-drug Panel (carboplatin, Docetaxel, Doxorubi…	15	12	—	—	$3,033.86	$3,488.94	$3,033.86	2026-08-18
172U	OTHER	Onc Sld Tum Alys Brca1 Brca2	15	12	—	—	$3,030.00	$3,484.50	$3,030.00	2026-08-18
E2508	HCPCS	Dme Pos	18	13	—	—	$3,013.32	$3,013.32	$3,013.32	2026-08-18
81540	CPT	Oncology Tum Unknown Origin	18	13	—	—	$2,261.25	$4,312.50	$3,005.62	2026-08-18
E0373	HCPCS	Dme Pos	18	13	—	—	$3,003.18	$3,003.18	$3,003.18	2026-08-18
18U	OTHER	Onc Thyr 10 Microrna Seq Alg	15	12	—	—	$3,002.09	$3,452.40	$3,002.09	2026-08-18
47383	CPT	Perq Abltj Lvr Cryoablation	18	13	—	—	$3,001.61	$3,001.61	$3,001.61	2026-08-18
L5782	HCPCS	Dme Pos	18	13	—	—	$2,996.98	$2,996.98	$2,996.98	2026-08-18
39503	CPT	Repair Of Diaphragm Hernia	18	13	—	—	$2,996.70	$2,996.70	$2,996.70	2026-08-18
543U	OTHER	Oncology (solid Tumor), Next-generation Sequencing Of DNA From Formalin-fixed Pa…	15	12	—	—	$2,989.55	$3,437.98	$2,989.55	2026-08-18
538U	OTHER	Oncology (solid Tumor), Next-generation Targeted Sequencing Analysis, Formalin-f…	15	12	—	—	$2,989.55	$3,437.98	$2,989.55	2026-08-18
L8044	HCPCS	Dme Pos	18	13	—	—	$2,983.27	$2,983.27	$2,983.27	2026-08-18
Q0495	HCPCS	Dme Pos	18	13	—	—	$2,967.81	$2,967.81	$2,967.81	2026-08-18
J0225	HCPCS	Inj, Vutrisiran, 1 Mg	18	13	—	—	$2,965.40	$5,510.51	$2,965.40	2026-08-18
L5150	HCPCS	Dme Pos	18	13	—	—	$2,950.97	$2,950.97	$2,950.97	2026-08-18
L5200	HCPCS	Dme Pos	18	13	—	—	$2,948.14	$2,948.14	$2,948.14	2026-08-18
L5980	HCPCS	Dme Pos	18	13	—	—	$2,934.07	$2,934.07	$2,934.07	2026-08-18
L5840	HCPCS	Dme Pos	18	13	—	—	$2,921.17	$2,921.17	$2,921.17	2026-08-18
297U	OTHER	Onc Pan Tum Whl Gen Seq DNA	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
409U	OTHER	Gi Baret Esph DNA Mthyln Aly	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
250U	OTHER	Onc Sld Org Neo DNA 505 Gene	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
298U	OTHER	Onc Pan Tum Whl Trns Seq RNA	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
444U	OTHER	Oncology (solid Organ Neoplasia), Targeted Genomic Sequence Analysis Panel Of 36…	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
571U	OTHER	Oncology (solid Tumor), DNA (80 Genes) And RNA (10 Genes), By Next-generation Se…	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
487U	OTHER	Oncology (solid Tumor), Cell-free Circulating Dna, Targeted Genomic Sequence Ana…	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
48U	OTHER	Onc Sld Org Neo DNA 468 Gene	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
530U	OTHER	Oncology (pan-solid Tumor), ctDNA, Utilizing Plasma, Next-generation Sequencing …	15	12	—	—	$2,919.60	$3,357.54	$2,919.60	2026-08-18
50U	OTHER	Trgt Gen Seq DNA 194 Genes	15	12	—	—	$2,916.60	$3,354.09	$2,916.60	2026-08-18
J9219	HCPCS	Leuprolide Acetate Implant	18	13	—	—	$2,906.35	$2,906.35	$2,906.35	2026-08-18
37183	CPT	Revision Tips	18	13	—	—	$2,906.03	$2,906.03	$2,906.03	2026-08-18
L2005	HCPCS	Dme Pos	18	13	—	—	$2,905.76	$2,905.76	$2,905.76	2026-08-18
L6881	HCPCS	Dme Pos	18	13	—	—	$2,904.70	$2,904.70	$2,904.70	2026-08-18
55873	CPT	Cryoablate Prostate	18	13	—	—	$2,897.45	$2,897.45	$2,897.45	2026-08-18
K0824	HCPCS	Dme Pos	18	13	—	—	$2,896.65	$2,896.65	$2,896.65	2026-08-18
A9571	HCPCS	Indium In-111 Auto Platelet	18	13	—	—	$2,894.01	$2,894.01	$2,894.01	2026-08-18
A9570	HCPCS	Indium In-111 Auto Wbc	18	13	—	—	$2,894.01	$2,894.01	$2,894.01	2026-08-18
27134	CPT	Revj Tot Hip Arthr Bth W/wo Agrft/alg Pf	18	13	$5,068.35	$3,801.26 25% off	$1,018.19	$4,966.98	$2,888.95	2026-08-18
K0837	HCPCS	Dme Pos	18	13	—	—	$2,886.24	$2,886.24	$2,886.24	2026-08-18
L5105	HCPCS	Dme Pos	18	13	—	—	$2,853.97	$2,853.97	$2,853.97	2026-08-18
22513	CPT	Perq Vertebral Augmentation	18	13	—	—	$2,852.42	$2,852.42	$2,852.42	2026-08-18
C9804	HCPCS	On-q Pump (Ropivacaine 0.2%) 750mL	15	12	$5,000.00	$3,750.00 25% off	$2,764.50	$4,900.00	$2,850.00	2026-08-18
47135	CPT	Transplantation Of Liver	18	13	—	—	$2,843.84	$2,843.84	$2,843.84	2026-08-18
L5781	HCPCS	Dme Pos	18	13	—	—	$2,842.83	$2,842.83	$2,842.83	2026-08-18
417U	OTHER	Crd C Hrt Ds 9 Gen 12 Vrnts	15	12	—	—	$2,842.53	$3,268.91	$2,842.53	2026-08-18
22514	CPT	Perq Vertebral Augmentation	18	13	—	—	$2,838.92	$2,838.92	$2,838.92	2026-08-18
E1002	HCPCS	Dme Pos	18	13	—	—	$2,832.11	$2,832.11	$2,832.11	2026-08-18
J0480	HCPCS	Basiliximab	18	13	—	—	$2,808.52	$5,259.18	$2,808.52	2026-08-18
95811	CPT	Polysomnography W/cpap	18	13	$4,925.97	$3,694.48 25% off	$351.29	$4,827.45	$2,807.80	2026-08-18
L6310	HCPCS	Dme Pos	18	13	—	—	$2,791.60	$2,791.60	$2,791.60	2026-08-18
K0831	HCPCS	Pwc Gp2 Std Seat Elevate Cap	18	13	—	—	$2,753.57	$2,753.57	$2,753.57	2026-08-18
K0830	HCPCS	Pwc Gp2 Std Seat Elevate S/b	18	13	—	—	$2,753.57	$2,753.57	$2,753.57	2026-08-18
E1802	HCPCS	Dme Pos	18	13	—	—	$2,753.42	$2,753.42	$2,753.42	2026-08-18
118U	OTHER	Trnsplj Don-drv Cll-fr DNA	15	12	—	—	$2,753.25	$3,166.24	$2,753.25	2026-08-18
540U	OTHER	Transplantation Medicine, Quantification Of Donor-derived Cell-free DNA Using Ne…	15	12	—	—	$2,753.25	$3,166.24	$2,753.25	2026-08-18
493U	OTHER	Transplantation Medicine, Quantification Of Donor-derived Cell-free DNA (cfDNA) …	15	12	—	—	$2,753.25	$3,166.24	$2,753.25	2026-08-18
36573	CPT	Xr Picc Insertion W Rs & I 5yr/>	18	13	$4,817.40	$3,613.05 25% off	$196.03	$4,721.05	$2,745.91	2026-08-18
K0012	HCPCS	Dme Pos	18	13	—	—	$2,737.44	$2,737.44	$2,737.44	2026-08-18
E0372	HCPCS	Dme Pos	18	13	—	—	$2,730.32	$2,730.32	$2,730.32	2026-08-18
E0760	HCPCS	Dme Pos	18	13	—	—	$2,723.91	$2,723.91	$2,723.91	2026-08-18
81426	CPT	Genome Sequence Analysis	15	12	—	—	$2,709.95	$3,116.44	$2,709.95	2026-08-18
213U	OTHER	Rare Ds Gen DNA Alys Ea Comp	15	12	—	—	$2,709.95	$3,116.44	$2,709.95	2026-08-18
L8043	HCPCS	Dme Pos	18	13	—	—	$2,694.57	$2,694.57	$2,694.57	2026-08-18
36906	CPT	Thrmbc/nfs Dialysis Circuit	18	13	—	—	$2,691.06	$2,691.06	$2,691.06	2026-08-18
27486	CPT	Revise Total Knee 1 Comp Assist 27486	33	13	$3,145.80	$2,359.35 25% off	$754.88	$4,624.32	$2,689.65	2026-08-18
L6624	HCPCS	Dme Pos	18	13	—	—	$2,675.83	$2,675.83	$2,675.83	2026-08-18
K0825	HCPCS	Dme Pos	18	13	—	—	$2,664.42	$2,664.42	$2,664.42	2026-08-18
81440	CPT	Mitochondrial Gene	18	13	—	—	$2,004.37	$3,822.60	$2,664.18	2026-08-18
L5220	HCPCS	Dme Pos	18	13	—	—	$2,661.70	$2,661.70	$2,661.70	2026-08-18
319U	OTHER	Neph RNA Pretrnspl Perph Bld	15	12	—	—	$2,650.00	$3,047.50	$2,650.00	2026-08-18
320U	OTHER	Neph RNA Psttrnspl Perph Bld	15	12	—	—	$2,650.00	$3,047.50	$2,650.00	2026-08-18

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