|
10005
|
HCPCS
|
Fine Needle Aspiration Biopsy Using Ultrasound Guidance, First Growth
|
31
|
31
|
$1,207.80
|
$1,207.80
|
$480.34
|
$2,590.54
|
$1,026.63
|
2026-06-08
|
|
10081
|
HCPCS
|
Complicated Drainage Of Cyst Of Tailbone
|
31
|
31
|
$2,068.05
|
$2,068.05
|
$822.46
|
$4,069.56
|
$1,757.84
|
2026-06-08
|
|
11042
|
HCPCS
|
Removal Of Skin And Tissue, 20.0 Sq Cm Or Less
|
31
|
31
|
$1,043.00
|
$1,043.00
|
$414.80
|
$1,448.24
|
$886.55
|
2026-06-08
|
|
11400
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less
|
31
|
31
|
$1,208.85
|
$1,208.85
|
$480.76
|
$1,595.08
|
$1,027.52
|
2026-06-08
|
|
11401
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm
|
31
|
31
|
$1,208.85
|
$1,208.85
|
$480.76
|
$1,595.08
|
$1,027.52
|
2026-06-08
|
|
12037
|
HCPCS
|
Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha…
|
31
|
31
|
$1,568.90
|
$1,568.90
|
$623.95
|
$1,537.52
|
$1,333.57
|
2026-06-08
|
|
12047
|
HCPCS
|
Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, More Than 30.0 C…
|
31
|
31
|
$1,568.90
|
$1,568.90
|
$623.95
|
$1,537.52
|
$1,333.57
|
2026-06-08
|
|
12056
|
HCPCS
|
Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.1-…
|
31
|
31
|
$1,076.15
|
$1,076.15
|
$427.98
|
$1,448.24
|
$914.73
|
2026-06-08
|
|
12057
|
HCPCS
|
Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More …
|
31
|
31
|
$1,568.90
|
$1,568.90
|
$623.95
|
$1,537.52
|
$1,333.57
|
2026-06-08
|
|
19083
|
HCPCS
|
Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth
|
31
|
31
|
$4,597.45
|
$4,597.45
|
$1,828.41
|
$5,046.77
|
$3,907.83
|
2026-06-08
|
|
19084
|
HCPCS
|
Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, Each Additio…
|
31
|
31
|
$2,160.85
|
$2,160.85
|
$859.37
|
$5,046.77
|
$1,836.72
|
2026-06-08
|
|
19281
|
HCPCS
|
Placement Of Locating Device In Breast Using Imaging Guidance, First Growth
|
31
|
31
|
$1,073.05
|
$1,073.05
|
$426.75
|
$5,046.77
|
$912.09
|
2026-06-08
|
|
23665
|
HCPCS
|
Closed Treatment Of Dislocated Shoulder And Broken Upper Arm Bone At Shoulder Jo…
|
31
|
31
|
$1,760.45
|
$1,760.45
|
$700.13
|
$1,744.91
|
$1,496.38
|
2026-06-08
|
|
25505
|
HCPCS
|
Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati…
|
31
|
31
|
$1,848.40
|
$1,848.40
|
$735.11
|
$1,811.43
|
$1,571.14
|
2026-06-08
|
|
25520
|
HCPCS
|
Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side And Dislocated …
|
31
|
31
|
$1,650.65
|
$1,650.65
|
$656.46
|
$1,744.91
|
$1,403.05
|
2026-06-08
|
|
25605
|
HCPCS
|
Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit…
|
81
|
31
|
$1,635.05
|
$1,635.05
|
$406.45
|
$2,403.45
|
$1,005.53
|
2026-06-08
|
|
27768
|
HCPCS
|
Closed Treatment Of Back Portion Of Shin Bone At Ankle With Manipulation
|
56
|
31
|
$4,873.20
|
$4,873.20
|
$182.66
|
$4,775.74
|
$1,744.91
|
2026-06-08
|
|
27810
|
HCPCS
|
Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation
|
56
|
31
|
$4,873.20
|
$4,873.20
|
$693.21
|
$4,775.74
|
$1,744.91
|
2026-06-08
|
|
32551
|
HCPCS
|
Removal Of Fluid From Between Lung And Chest Cavity
|
56
|
31
|
$1,957.60
|
$1,957.60
|
$778.54
|
$3,836.75
|
$1,722.69
|
2026-06-08
|
|
32554
|
HCPCS
|
Aspiration Of Fluid From Chest Cavity
|
31
|
31
|
$2,592.90
|
$2,592.90
|
$1,031.20
|
$3,779.42
|
$2,203.97
|
2026-06-08
|
|
32555
|
HCPCS
|
Aspiration Of Fluid From Chest Cavity Using Imaging Guidance
|
31
|
31
|
$1,469.00
|
$1,469.00
|
$584.22
|
$3,779.42
|
$1,248.65
|
2026-06-08
|
|
32556
|
HCPCS
|
Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube
|
56
|
31
|
$3,915.05
|
$3,915.05
|
$778.54
|
$3,836.75
|
$1,722.69
|
2026-06-08
|
|
36430
|
HCPCS
|
Transfusion Of Blood Or Blood Products
|
156
|
31
|
$1,711.35
|
$1,711.35
|
$459.50
|
$2,768.16
|
$1,168.76
|
2026-06-08
|
|
36556
|
HCPCS
|
Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older)
|
93
|
31
|
$3,474.20
|
$3,474.20
|
$39.46
|
$4,162.46
|
$1,467.15
|
2026-06-08
|
|
36569
|
HCPCS
|
Insertion Of Tube For Infusion (5 Years Or Older)
|
31
|
31
|
$3,341.65
|
$3,341.65
|
$1,328.97
|
$4,162.46
|
$2,840.40
|
2026-06-08
|
|
36573
|
HCPCS
|
Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, …
|
31
|
31
|
$3,341.65
|
$3,341.65
|
$1,328.97
|
$4,162.46
|
$2,840.40
|
2026-06-08
|
|
38505
|
HCPCS
|
Needle Biopsy Or Removal Of Surface Lymph Nodes
|
31
|
31
|
$2,459.35
|
$2,459.35
|
$978.08
|
$4,587.99
|
$2,090.45
|
2026-06-08
|
|
41252
|
HCPCS
|
Repair Of Lacerated Tongue Or Floor Of Mouth, More Than 2.6 Cm
|
31
|
31
|
$2,051.00
|
$2,051.00
|
$642.66
|
$2,009.98
|
$1,599.78
|
2026-06-08
|
|
43247
|
HCPCS
|
Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using …
|
31
|
31
|
$2,452.50
|
$2,452.50
|
$975.36
|
$3,658.73
|
$2,084.63
|
2026-06-08
|
|
46050
|
HCPCS
|
Drainage Of Superficial Rectal Abscess Surrounding Anus
|
31
|
31
|
$2,506.70
|
$2,506.70
|
$996.91
|
$5,455.96
|
$2,130.70
|
2026-06-08
|
|
46608
|
HCPCS
|
Removal Of Foreign Body In Anus Using An Endoscope
|
31
|
31
|
$2,295.35
|
$2,295.35
|
$912.86
|
$3,738.56
|
$1,951.05
|
2026-06-08
|
|
49082
|
HCPCS
|
Drainage Of Fluid From Abdominal Cavity
|
31
|
31
|
$2,059.10
|
$2,059.10
|
$818.90
|
$2,737.10
|
$1,750.24
|
2026-06-08
|
|
49083
|
HCPCS
|
Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance
|
31
|
31
|
$2,720.85
|
$2,720.85
|
$1,082.08
|
$2,737.10
|
$2,312.72
|
2026-06-08
|
|
58301
|
HCPCS
|
Removal Of IUD
|
31
|
31
|
$1,496.55
|
$1,496.55
|
$595.18
|
$1,466.62
|
$1,167.31
|
2026-06-08
|
|
59409
|
HCPCS
|
Vaginal Delivery
|
31
|
31
|
$4,425.50
|
$4,425.50
|
$1,760.02
|
$8,170.45
|
$3,761.68
|
2026-06-08
|
|
6020010000
|
CDM
|
Room & Board - Private (one Bed) - Medical/surgical/gyn
|
12
|
12
|
$1,470.00
|
$1,470.00
|
$1,146.60
|
$1,440.60
|
$1,271.55
|
2026-06-08
|
|
6020010005
|
CDM
|
Room & Board - Private (one Bed) - Medical/surgical/gyn
|
12
|
12
|
$2,892.00
|
$2,892.00
|
$2,255.76
|
$2,834.16
|
$2,501.58
|
2026-06-08
|
|
6020010010
|
CDM
|
Room & Board - Semi-private (two Beds) - Medical/surgical/gyn
|
12
|
12
|
$1,390.00
|
$1,390.00
|
$1,084.20
|
$1,362.20
|
$1,202.35
|
2026-06-08
|
|
6020010015
|
CDM
|
Room & Board - Semi-private (two Beds) - Medical/surgical/gyn
|
12
|
12
|
$2,733.00
|
$2,733.00
|
$2,131.74
|
$2,678.34
|
$2,364.05
|
2026-06-08
|
|
6020010020
|
CDM
|
Intensive Care Unit - Intermediate ICU
|
12
|
12
|
$1,927.00
|
$1,927.00
|
$1,503.06
|
$1,888.46
|
$1,666.86
|
2026-06-08
|
|
6020010025
|
CDM
|
Intensive Care Unit - Intermediate ICU
|
12
|
12
|
$1,834.00
|
$1,834.00
|
$1,430.52
|
$1,797.32
|
$1,586.41
|
2026-06-08
|
|
619
|
MS_DRG
|
O.r. Procedures For Obesity With Mcc
|
1
|
1
|
$16,349.97
|
$16,349.97
|
$18,000.00
|
$18,000.00
|
$18,000.00
|
2026-06-08
|
|
620
|
MS_DRG
|
O.r. Procedures For Obesity With Cc
|
1
|
1
|
$27,740.57
|
$27,740.57
|
$18,000.00
|
$18,000.00
|
$18,000.00
|
2026-06-08
|
|
621
|
MS_DRG
|
O.r. Procedures For Obesity Without Cc/mcc
|
1
|
1
|
$21,915.33
|
$21,915.33
|
$18,000.00
|
$18,000.00
|
$18,000.00
|
2026-06-08
|
|
6210010000
|
CDM
|
Operating Room Services - General Classification
|
25
|
25
|
$2,194.00
|
$2,194.00
|
$872.55
|
$2,150.12
|
$1,864.90
|
2026-06-08
|
|
6210010010
|
CDM
|
Operating Room Services - General Classification
|
25
|
25
|
$4,014.00
|
$4,014.00
|
$1,596.37
|
$3,933.72
|
$3,411.90
|
2026-06-08
|
|
6210010015
|
CDM
|
Operating Room Services - General Classification
|
25
|
25
|
$1,051.00
|
$1,051.00
|
$417.98
|
$1,029.98
|
$893.35
|
2026-06-08
|
|
6210010020
|
CDM
|
Operating Room Services - General Classification
|
25
|
25
|
$4,158.00
|
$4,158.00
|
$1,653.64
|
$4,074.84
|
$3,534.30
|
2026-06-08
|
|
6210010025
|
CDM
|
Operating Room Services - General Classification
|
25
|
25
|
$1,250.00
|
$1,250.00
|
$497.13
|
$1,225.00
|
$1,062.50
|
2026-06-08
|
|
6210020000
|
CDM
|
Recovery Room - General Classification
|
25
|
25
|
$1,106.00
|
$1,106.00
|
$439.86
|
$1,083.88
|
$940.10
|
2026-06-08
|
|
6210020005
|
CDM
|
Recovery Room - General Classification
|
25
|
25
|
$1,382.00
|
$1,382.00
|
$549.62
|
$1,354.36
|
$1,174.70
|
2026-06-08
|
|
6210020010
|
CDM
|
Recovery Room - General Classification
|
25
|
25
|
$1,726.00
|
$1,726.00
|
$686.43
|
$1,691.48
|
$1,467.10
|
2026-06-08
|
|
6210020015
|
CDM
|
Recovery Room - General Classification
|
25
|
25
|
$2,155.00
|
$2,155.00
|
$857.04
|
$2,111.90
|
$1,831.75
|
2026-06-08
|
|
6210020020
|
CDM
|
Recovery Room - General Classification
|
25
|
25
|
$2,695.00
|
$2,695.00
|
$1,071.80
|
$2,641.10
|
$2,290.75
|
2026-06-08
|
|
6210020025
|
CDM
|
Recovery Room - General Classification
|
25
|
25
|
$3,369.00
|
$3,369.00
|
$1,339.85
|
$3,301.62
|
$2,863.65
|
2026-06-08
|
|
6210020030
|
CDM
|
Recovery Room - General Classification
|
25
|
25
|
$4,209.00
|
$4,209.00
|
$1,673.92
|
$4,124.82
|
$3,577.65
|
2026-06-08
|
|
62270
|
HCPCS
|
Removal Of Cerebrospinal Fluid With Lower Back Spinal Tap For Diagnostic Test
|
31
|
31
|
$1,888.40
|
$1,888.40
|
$751.02
|
$2,898.11
|
$1,605.14
|
2026-06-08
|
|
6230001244
|
CDM
|
Insert Chest Tube Open Rt
|
25
|
25
|
$1,957.60
|
$1,957.60
|
$778.54
|
$1,918.45
|
$1,663.96
|
2026-06-08
|
|
62326
|
HCPCS
|
Insertion Of Tube And Injection Of Substance Into Lower Spine Canal
|
37
|
30
|
$1,388.00
|
$1,388.00
|
$80.83
|
$1,884.80
|
$1,082.64
|
2026-06-08
|
|
6250000184
|
CDM
|
Cath Groshong Dl 9.5
|
25
|
25
|
$1,171.70
|
$1,171.70
|
$465.99
|
$1,148.27
|
$995.95
|
2026-06-08
|
|
6250000232
|
CDM
|
Catheter, Stretta
|
25
|
25
|
$2,062.00
|
$2,062.00
|
$820.06
|
$2,020.76
|
$1,752.70
|
2026-06-08
|
|
6250000337
|
CDM
|
Film Sepra
|
25
|
25
|
$2,495.00
|
$2,495.00
|
$992.26
|
$2,445.10
|
$2,120.75
|
2026-06-08
|
|
6250000392
|
CDM
|
Kit Access Low Pro (Lb)
|
25
|
25
|
$1,190.00
|
$1,190.00
|
$473.26
|
$1,166.20
|
$1,011.50
|
2026-06-08
|
|
6250000393
|
CDM
|
Kit Access Port (Lb)
|
25
|
25
|
$1,650.00
|
$1,650.00
|
$656.21
|
$1,617.00
|
$1,402.50
|
2026-06-08
|
|
6250000394
|
CDM
|
Kit Acl Disp
|
25
|
25
|
$1,153.30
|
$1,153.30
|
$458.67
|
$1,130.23
|
$980.31
|
2026-06-08
|
|
6250000543
|
CDM
|
Pack Ob/Gyn Lap
|
25
|
25
|
$1,253.52
|
$1,253.52
|
$498.52
|
$1,228.45
|
$1,065.49
|
2026-06-08
|
|
6250000659
|
CDM
|
Probe Tac-c Ii
|
25
|
25
|
$1,149.55
|
$1,149.55
|
$457.18
|
$1,126.56
|
$977.12
|
2026-06-08
|
|
6250000660
|
CDM
|
Probe Tac-s
|
25
|
25
|
$1,149.55
|
$1,149.55
|
$457.18
|
$1,126.56
|
$977.12
|
2026-06-08
|
|
6250000682
|
CDM
|
Reload Ta90 4.8grn
|
25
|
25
|
$1,542.58
|
$1,542.58
|
$613.48
|
$1,511.73
|
$1,311.19
|
2026-06-08
|
|
6250000691
|
CDM
|
Retractor Endopath 12mm
|
25
|
25
|
$1,130.27
|
$1,130.27
|
$449.51
|
$1,107.66
|
$960.73
|
2026-06-08
|
|
6250000875
|
CDM
|
Shear Endo Harmonic 5mm
|
25
|
25
|
$1,052.93
|
$1,052.93
|
$418.75
|
$1,031.87
|
$894.99
|
2026-06-08
|
|
6250000952
|
CDM
|
Stapler Proximate 25mm
|
25
|
25
|
$1,225.00
|
$1,225.00
|
$487.18
|
$1,200.50
|
$1,041.25
|
2026-06-08
|
|
6250000960
|
CDM
|
Stapler Stat Tack Hernia
|
25
|
25
|
$1,094.90
|
$1,094.90
|
$435.44
|
$1,073.00
|
$930.67
|
2026-06-08
|
|
6250000962
|
CDM
|
Stapler Stealth Cir 25mm
|
25
|
25
|
$1,058.01
|
$1,058.01
|
$420.77
|
$1,036.85
|
$899.31
|
2026-06-08
|
|
6250001165
|
CDM
|
Lap Band Apl - Allergan
|
25
|
25
|
$6,675.00
|
$6,675.00
|
$2,654.65
|
$6,541.50
|
$5,673.75
|
2026-06-08
|
|
6250001166
|
CDM
|
Lap Band Aps - Allergan
|
25
|
25
|
$6,675.00
|
$6,675.00
|
$2,654.65
|
$6,541.50
|
$5,673.75
|
2026-06-08
|
|
6250001300
|
CDM
|
Tunneler Ivs
|
25
|
25
|
$1,365.00
|
$1,365.00
|
$542.86
|
$1,337.70
|
$1,160.25
|
2026-06-08
|
|
6250001388
|
CDM
|
Lap Band - Realize
|
25
|
25
|
$4,650.60
|
$4,650.60
|
$1,849.54
|
$4,557.59
|
$3,953.01
|
2026-06-08
|
|
6250001405
|
CDM
|
Port Kit Realize
|
25
|
25
|
$1,472.92
|
$1,472.92
|
$585.78
|
$1,443.46
|
$1,251.98
|
2026-06-08
|
|
6250001409
|
CDM
|
Echelon Flex 60
|
25
|
25
|
$1,080.48
|
$1,080.48
|
$429.71
|
$1,058.87
|
$918.41
|
2026-06-08
|
|
6250001539
|
CDM
|
Power Port Implant Port 6fr
|
25
|
25
|
$1,279.26
|
$1,279.26
|
$508.76
|
$1,253.67
|
$1,087.37
|
2026-06-08
|
|
6250001596
|
CDM
|
Reflux Management System
|
25
|
25
|
$7,314.00
|
$7,314.00
|
$2,908.78
|
$7,167.72
|
$6,216.90
|
2026-06-08
|
|
6250001612
|
CDM
|
Sealent Patch Evarrest
|
25
|
25
|
$1,550.00
|
$1,550.00
|
$616.44
|
$1,519.00
|
$1,317.50
|
2026-06-08
|
|
6250001613
|
CDM
|
Shears Harmonic Ace+7
|
25
|
25
|
$1,243.19
|
$1,243.19
|
$494.42
|
$1,218.33
|
$1,056.71
|
2026-06-08
|
|
6250001649
|
CDM
|
Esophyx Z+
|
25
|
25
|
$3,775.00
|
$3,775.00
|
$1,501.32
|
$3,699.50
|
$3,208.75
|
2026-06-08
|
|
6250001650
|
CDM
|
Serosafuse Fast Cart 7.5 Mm
|
25
|
25
|
$1,062.50
|
$1,062.50
|
$422.56
|
$1,041.25
|
$903.13
|
2026-06-08
|
|
6250001692
|
CDM
|
Harmonic Hd 10001 Shears
|
25
|
25
|
$1,608.38
|
$1,608.38
|
$639.65
|
$1,576.21
|
$1,367.12
|
2026-06-08
|
|
6250001720
|
CDM
|
Maryland Fushion 44 Cm Voy
|
25
|
25
|
$1,062.50
|
$1,062.50
|
$422.56
|
$1,041.25
|
$903.13
|
2026-06-08
|
|
6250001724
|
CDM
|
Enseal X1 Curved
|
25
|
25
|
$1,225.56
|
$1,225.56
|
$487.41
|
$1,201.05
|
$1,041.73
|
2026-06-08
|
|
6250001738
|
CDM
|
Stapler Titan
|
25
|
25
|
$3,150.00
|
$3,150.00
|
$1,252.76
|
$3,087.00
|
$2,677.50
|
2026-06-08
|
|
6250001745
|
CDM
|
Powerseal 5mm 44cm Jaw Sealer
|
25
|
25
|
$1,062.50
|
$1,062.50
|
$422.56
|
$1,041.25
|
$903.13
|
2026-06-08
|
|
6250001773
|
CDM
|
11 Cm Ventralight Mesh
|
25
|
25
|
$1,354.40
|
$1,354.40
|
$538.64
|
$1,327.31
|
$1,151.24
|
2026-06-08
|
|
6250001775
|
CDM
|
Ventralight St Mesh
|
25
|
25
|
$1,175.75
|
$1,175.75
|
$467.60
|
$1,152.24
|
$999.39
|
2026-06-08
|
|
6250001779
|
CDM
|
Ventralight 15 Cm Circle
|
25
|
25
|
$1,237.80
|
$1,237.80
|
$492.27
|
$1,213.04
|
$1,052.13
|
2026-06-08
|
|
6250001780
|
CDM
|
Ventralight 15 X 20 Cm Oval
|
25
|
25
|
$1,683.40
|
$1,683.40
|
$669.49
|
$1,649.73
|
$1,430.89
|
2026-06-08
|
|
6250001781
|
CDM
|
Ventralight 20 X 25 Cm Oval
|
25
|
25
|
$2,641.60
|
$2,641.60
|
$1,050.56
|
$2,588.77
|
$2,245.36
|
2026-06-08
|
|
6250001782
|
CDM
|
Ventralight 25 X 30 Cm Oval
|
25
|
25
|
$3,450.20
|
$3,450.20
|
$1,372.14
|
$3,381.20
|
$2,932.67
|
2026-06-08
|
|
6250001784
|
CDM
|
23cm Powerseal Sealer
|
25
|
25
|
$1,129.00
|
$1,129.00
|
$449.00
|
$1,106.42
|
$959.65
|
2026-06-08
|
|
6250006013
|
CDM
|
Absorbtack 5mm Fix Dev
|
25
|
25
|
$1,744.34
|
$1,744.34
|
$693.72
|
$1,709.45
|
$1,482.69
|
2026-06-08
|
|
64450
|
HCPCS
|
Injection Of Anesthetic Agent And/or Steroid Into Other Nerve Or Branch
|
31
|
31
|
$1,248.80
|
$1,248.80
|
$496.65
|
$1,513.35
|
$1,061.48
|
2026-06-08
|
|
70336
|
HCPCS
|
MRI Scan Of Jaw Joint
|
31
|
31
|
$2,851.70
|
$2,851.70
|
$915.36
|
$2,794.67
|
$2,224.33
|
2026-06-08
|
|
70450
|
HCPCS
|
CT Scan Head Or Brain Without Contrast
|
31
|
31
|
$2,656.65
|
$2,656.65
|
$1,056.55
|
$2,603.52
|
$2,072.19
|
2026-06-08
|
|
70460
|
HCPCS
|
CT Scan Head Or Brain With Contrast
|
31
|
31
|
$2,697.25
|
$2,697.25
|
$1,072.70
|
$2,643.31
|
$2,103.86
|
2026-06-08
|
|
70470
|
HCPCS
|
CT Scan Of Head Or Brain Before And After Contrast
|
31
|
31
|
$3,678.45
|
$3,678.45
|
$1,153.20
|
$3,604.88
|
$2,869.19
|
2026-06-08
|
|
70480
|
HCPCS
|
CT Scan Of Cranial Cavity Without Contrast
|
56
|
31
|
$2,950.65
|
$2,950.65
|
$404.83
|
$2,891.64
|
$1,672.04
|
2026-06-08
|
|
70481
|
HCPCS
|
CT Scan Of Cranial Cavity With Contrast
|
31
|
31
|
$3,419.70
|
$3,419.70
|
$1,153.20
|
$3,351.31
|
$2,667.37
|
2026-06-08
|
|
70482
|
HCPCS
|
CT Scan Of Cranial Cavity Before And After Contrast
|
31
|
31
|
$3,749.65
|
$3,749.65
|
$1,153.20
|
$3,674.66
|
$2,924.73
|
2026-06-08
|
|
70486
|
HCPCS
|
CT Scan Of Face Without Contrast
|
56
|
31
|
$2,820.40
|
$2,820.40
|
$404.83
|
$2,763.99
|
$2,268.95
|
2026-06-08
|
|
70487
|
HCPCS
|
CT Scan Of Face With Contrast
|
56
|
31
|
$3,199.60
|
$3,199.60
|
$1,153.20
|
$3,492.97
|
$2,719.66
|
2026-06-08
|
|
70488
|
HCPCS
|
CT Scan Of Face Before And After Contrast
|
31
|
31
|
$3,515.65
|
$3,515.65
|
$1,153.20
|
$3,445.34
|
$2,742.21
|
2026-06-08
|
|
70490
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck Without Contrast
|
31
|
31
|
$2,861.00
|
$2,861.00
|
$404.83
|
$2,803.78
|
$2,231.58
|
2026-06-08
|
|
70491
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck With Contrast
|
31
|
31
|
$2,884.60
|
$2,884.60
|
$1,147.21
|
$2,826.91
|
$2,249.99
|
2026-06-08
|
|
70492
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck Before And After Contrast
|
31
|
31
|
$3,474.20
|
$3,474.20
|
$1,153.20
|
$3,404.72
|
$2,709.88
|
2026-06-08
|
|
70496
|
HCPCS
|
CT Scan Of Blood Vessels Of Head With Contrast
|
31
|
31
|
$3,955.00
|
$3,955.00
|
$1,409.01
|
$3,875.90
|
$3,084.90
|
2026-06-08
|
|
70498
|
HCPCS
|
CT Scan Of Blood Vessels Of Neck With Contrast
|
31
|
31
|
$4,011.05
|
$4,011.05
|
$1,409.01
|
$3,930.83
|
$3,128.62
|
2026-06-08
|
|
70540
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast
|
81
|
31
|
$3,587.45
|
$3,587.45
|
$915.36
|
$3,684.46
|
$3,007.72
|
2026-06-08
|
|
70542
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast
|
81
|
31
|
$3,827.80
|
$3,827.80
|
$1,452.58
|
$4,126.34
|
$3,104.58
|
2026-06-08
|
|
70543
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast
|
81
|
31
|
$5,313.10
|
$5,313.10
|
$1,544.41
|
$5,500.01
|
$4,220.21
|
2026-06-08
|
|
70544
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head Without Contrast
|
81
|
31
|
$4,868.40
|
$4,868.40
|
$1,838.05
|
$5,000.06
|
$3,928.45
|
2026-06-08
|
|
70545
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head With Contrast
|
81
|
31
|
$5,612.25
|
$5,612.25
|
$1,731.76
|
$7,425.51
|
$3,701.28
|
2026-06-08
|
|
70546
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head Before And After Contrast
|
81
|
31
|
$6,122.50
|
$6,122.50
|
$1,865.33
|
$8,514.19
|
$4,106.61
|
2026-06-08
|
|
70547
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck Without Contrast
|
56
|
31
|
$5,102.10
|
$5,102.10
|
$1,428.76
|
$5,000.06
|
$3,053.67
|
2026-06-08
|
|
70548
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck With Contrast
|
56
|
31
|
$5,612.25
|
$5,612.25
|
$1,480.02
|
$5,500.01
|
$3,163.23
|
2026-06-08
|
|
70549
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck Before And After Contrast
|
56
|
31
|
$5,844.45
|
$5,844.45
|
$1,865.33
|
$5,727.56
|
$4,058.50
|
2026-06-08
|
|
70551
|
HCPCS
|
MRI Scan Of Brain Without Contrast
|
56
|
31
|
$3,827.80
|
$3,827.80
|
$915.36
|
$3,751.24
|
$3,046.89
|
2026-06-08
|
|
70552
|
HCPCS
|
MRI Scan Of Brain With Contrast
|
56
|
31
|
$3,919.95
|
$3,919.95
|
$1,487.56
|
$3,841.55
|
$3,120.24
|
2026-06-08
|
|
70553
|
HCPCS
|
MRI Scan Of Brain Before And After Contrast
|
81
|
31
|
$5,431.45
|
$5,431.45
|
$1,544.41
|
$5,578.36
|
$4,516.14
|
2026-06-08
|
|
7070004111
|
CDM
|
Sodium Chloride 0.9% Vial
|
25
|
25
|
$2,025.00
|
$2,025.00
|
$805.34
|
$1,984.50
|
$1,721.25
|
2026-06-08
|
|
7070010177
|
CDM
|
Indigo Carmine 0.8% Inj
|
25
|
25
|
$1,321.20
|
$1,321.20
|
$525.44
|
$1,294.78
|
$1,123.02
|
2026-06-08
|
|
71260
|
HCPCS
|
CT Scan Of Chest With Contrast
|
31
|
31
|
$3,101.05
|
$3,101.05
|
$1,153.20
|
$3,039.03
|
$2,418.82
|
2026-06-08
|
|
71270
|
HCPCS
|
CT Scan Of Chest Before And After Contrast
|
31
|
31
|
$3,427.40
|
$3,427.40
|
$1,153.20
|
$3,358.85
|
$2,673.37
|
2026-06-08
|
|
71275
|
HCPCS
|
CT Scan Of Blood Vessels Of Chest With Contrast
|
31
|
31
|
$4,389.35
|
$4,389.35
|
$1,409.01
|
$4,301.56
|
$3,423.69
|
2026-06-08
|
|
71550
|
HCPCS
|
MRI Scan Of Chest Without Contrast
|
31
|
31
|
$3,576.95
|
$3,576.95
|
$915.36
|
$3,505.41
|
$2,790.02
|
2026-06-08
|
|
71551
|
HCPCS
|
MRI Scan Of Chest With Contrast
|
31
|
31
|
$3,827.80
|
$3,827.80
|
$1,522.32
|
$3,751.24
|
$2,985.68
|
2026-06-08
|
|
71552
|
HCPCS
|
MRI Scan Of Chest Before And After Contrast
|
31
|
31
|
$5,102.10
|
$5,102.10
|
$1,544.41
|
$5,000.06
|
$3,979.64
|
2026-06-08
|
|
71555
|
HCPCS
|
MRI Scan Of Blood Vessels Of Chest
|
31
|
31
|
$7,241.70
|
$7,241.70
|
$1,865.33
|
$7,096.87
|
$5,648.53
|
2026-06-08
|
|
72125
|
HCPCS
|
CT Scan Of Upper Spine Without Contrast
|
31
|
31
|
$3,101.05
|
$3,101.05
|
$404.83
|
$3,039.03
|
$2,418.82
|
2026-06-08
|
|
72126
|
HCPCS
|
CT Scan Of Upper Spine With Contrast
|
31
|
31
|
$4,886.90
|
$4,886.90
|
$1,153.20
|
$4,789.16
|
$3,811.78
|
2026-06-08
|
|
72127
|
HCPCS
|
CT Scan Of Upper Spine Before And After Contrast
|
31
|
31
|
$5,375.10
|
$5,375.10
|
$1,153.20
|
$5,267.60
|
$4,192.58
|
2026-06-08
|
|
72128
|
HCPCS
|
CT Scan Of Middle Spine Without Contrast
|
31
|
31
|
$2,842.75
|
$2,842.75
|
$404.83
|
$2,785.90
|
$2,217.35
|
2026-06-08
|
|
72129
|
HCPCS
|
CT Scan Of Middle Spine With Contrast
|
31
|
31
|
$4,406.30
|
$4,406.30
|
$1,153.20
|
$4,318.17
|
$3,436.91
|
2026-06-08
|
|
72130
|
HCPCS
|
CT Scan Of Middle Spine Before And After Contrast
|
31
|
31
|
$4,847.60
|
$4,847.60
|
$1,153.20
|
$4,750.65
|
$3,781.13
|
2026-06-08
|
|
72131
|
HCPCS
|
CT Scan Of Lower Spine Without Contrast
|
31
|
31
|
$3,264.10
|
$3,264.10
|
$404.83
|
$3,198.82
|
$2,546.00
|
2026-06-08
|
|
72132
|
HCPCS
|
CT Scan Of Lower Spine With Contrast
|
31
|
31
|
$3,753.80
|
$3,753.80
|
$1,153.20
|
$3,678.72
|
$2,927.96
|
2026-06-08
|
|
72133
|
HCPCS
|
CT Scan Of Lower Spine Before And After Contrast
|
31
|
31
|
$4,080.20
|
$4,080.20
|
$1,153.20
|
$3,998.60
|
$3,182.56
|
2026-06-08
|
|
72141
|
HCPCS
|
MRI Scan Of Upper Spinal Canal Without Contrast
|
31
|
31
|
$3,827.80
|
$3,827.80
|
$915.36
|
$3,751.24
|
$2,985.68
|
2026-06-08
|
|
72142
|
HCPCS
|
MRI Scan Of Upper Spinal Canal With Contrast
|
31
|
31
|
$4,010.45
|
$4,010.45
|
$1,544.41
|
$3,930.24
|
$3,128.15
|
2026-06-08
|
|
72146
|
HCPCS
|
MRI Scan Of Middle Spinal Canal Without Contrast
|
31
|
31
|
$4,080.20
|
$4,080.20
|
$915.36
|
$3,998.60
|
$3,182.56
|
2026-06-08
|
|
72147
|
HCPCS
|
MRI Scan Of Middle Spinal Canal With Contrast
|
31
|
31
|
$4,243.40
|
$4,243.40
|
$1,544.41
|
$4,158.53
|
$3,309.85
|
2026-06-08
|
|
72148
|
HCPCS
|
MRI Scan Of Lower Spinal Canal Without Contrast
|
31
|
31
|
$4,433.60
|
$4,433.60
|
$915.36
|
$4,344.93
|
$3,458.21
|
2026-06-08
|
|
72149
|
HCPCS
|
MRI Scan Of Lower Spinal Canal With Contrast
|
31
|
31
|
$4,829.30
|
$4,829.30
|
$1,544.41
|
$4,732.71
|
$3,766.85
|
2026-06-08
|
|
72156
|
HCPCS
|
MRI Scan Of Upper Spinal Canal Before And After Contrast
|
31
|
31
|
$6,126.45
|
$6,126.45
|
$1,544.41
|
$6,003.92
|
$4,778.63
|
2026-06-08
|
|
72157
|
HCPCS
|
MRI Scan Of Middle Spinal Canal Before And After Contrast
|
31
|
31
|
$6,249.85
|
$6,249.85
|
$1,544.41
|
$6,124.85
|
$4,874.88
|
2026-06-08
|
|
72158
|
HCPCS
|
MRI Scan Of Lower Spinal Canal Before And After Contrast
|
31
|
31
|
$5,873.50
|
$5,873.50
|
$1,544.41
|
$5,756.03
|
$4,581.33
|
2026-06-08
|
|
72159
|
HCPCS
|
MRI Scan Of Blood Vessels Of Spinal Canal
|
31
|
31
|
$2,546.65
|
$2,546.65
|
$1,012.80
|
$2,495.72
|
$1,986.39
|
2026-06-08
|
|
72191
|
HCPCS
|
CT Scan Of Blood Vessels Of Pelvis With Contrast
|
31
|
31
|
$2,546.65
|
$2,546.65
|
$1,012.80
|
$2,495.72
|
$1,986.39
|
2026-06-08
|
|
72192
|
HCPCS
|
CT Scan Of Pelvis Without Contrast
|
56
|
31
|
$2,546.65
|
$2,546.65
|
$404.83
|
$2,495.72
|
$2,059.88
|
2026-06-08
|
|
72193
|
HCPCS
|
CT Scan Of Pelvis With Contrast
|
31
|
31
|
$2,805.55
|
$2,805.55
|
$1,115.77
|
$2,749.44
|
$2,188.33
|
2026-06-08
|
|
72194
|
HCPCS
|
CT Scan Of Pelvis Before And After Contrast
|
31
|
31
|
$3,246.60
|
$3,246.60
|
$1,153.20
|
$3,181.67
|
$2,532.35
|
2026-06-08
|
|
72195
|
HCPCS
|
MRI Scan Of Pelvis Without Contrast
|
56
|
31
|
$3,678.45
|
$3,678.45
|
$915.36
|
$3,604.88
|
$2,955.82
|
2026-06-08
|
|
72196
|
HCPCS
|
MRI Scan Of Pelvis With Contrast
|
31
|
31
|
$3,827.80
|
$3,827.80
|
$1,522.32
|
$3,751.24
|
$2,985.68
|
2026-06-08
|
|
72197
|
HCPCS
|
MRI Scan Of Pelvis Before And After Contrast
|
31
|
31
|
$5,313.10
|
$5,313.10
|
$1,544.41
|
$5,206.84
|
$4,144.22
|
2026-06-08
|
|
72198
|
HCPCS
|
MRI Scan Of Blood Vessels Of Pelvis
|
31
|
31
|
$7,241.70
|
$7,241.70
|
$1,865.33
|
$7,096.87
|
$5,648.53
|
2026-06-08
|
|
73200
|
HCPCS
|
CT Scan Of Arm Without Contrast
|
56
|
31
|
$2,824.10
|
$2,824.10
|
$404.83
|
$2,767.62
|
$2,291.82
|
2026-06-08
|
|
73201
|
HCPCS
|
CT Scan Of Arm With Contrast
|
31
|
31
|
$3,229.55
|
$3,229.55
|
$1,153.20
|
$3,164.96
|
$2,519.05
|
2026-06-08
|
|
73202
|
HCPCS
|
CT Scan Of Arm Before And After Contrast
|
31
|
31
|
$3,713.85
|
$3,713.85
|
$1,153.20
|
$3,639.57
|
$2,896.80
|
2026-06-08
|
|
73218
|
HCPCS
|
MRI Scan Of Arm Without Contrast
|
56
|
31
|
$3,576.95
|
$3,576.95
|
$915.36
|
$3,505.41
|
$2,879.94
|
2026-06-08
|
|
73219
|
HCPCS
|
MRI Scan Of Arm With Contrast
|
106
|
31
|
$3,827.80
|
$3,827.80
|
$1,388.75
|
$6,039.01
|
$3,067.58
|
2026-06-08
|
|
73220
|
HCPCS
|
MRI Scan Of Arm Before And After Contrast
|
56
|
31
|
$5,102.10
|
$5,102.10
|
$1,544.41
|
$5,000.06
|
$3,997.69
|
2026-06-08
|
|
73221
|
HCPCS
|
MRI Scan Of Arm Joint Without Contrast
|
81
|
31
|
$4,080.20
|
$4,080.20
|
$915.36
|
$4,331.36
|
$3,187.59
|
2026-06-08
|
|
73222
|
HCPCS
|
MRI Scan Of Arm Joint With Contrast
|
106
|
31
|
$4,659.25
|
$4,659.25
|
$1,544.41
|
$5,390.49
|
$3,797.63
|
2026-06-08
|
|
73223
|
HCPCS
|
MRI Scan Of Arm Joint Before And After Contrast
|
81
|
31
|
$5,578.80
|
$5,578.80
|
$1,544.41
|
$5,945.51
|
$4,516.14
|
2026-06-08
|
|
73225
|
HCPCS
|
MRI Scan Of Blood Vessels Of Arm
|
31
|
31
|
$7,126.40
|
$7,126.40
|
$1,865.33
|
$6,983.87
|
$5,558.59
|
2026-06-08
|
|
73564
|
HCPCS
|
X-ray Of Knee, 4 Or More Views
|
56
|
31
|
$1,124.20
|
$1,124.20
|
$213.04
|
$1,652.38
|
$955.57
|
2026-06-08
|
|
73700
|
HCPCS
|
CT Scan Of Leg Without Contrast
|
56
|
31
|
$2,423.75
|
$2,423.75
|
$404.83
|
$2,744.44
|
$2,060.19
|
2026-06-08
|
|
73701
|
HCPCS
|
CT Scan Of Leg With Contrast Material
|
31
|
31
|
$3,229.55
|
$3,229.55
|
$1,153.20
|
$3,164.96
|
$2,519.05
|
2026-06-08
|
|
73702
|
HCPCS
|
CT Scan Of Leg Before And After Contrast
|
31
|
31
|
$3,713.90
|
$3,713.90
|
$1,153.20
|
$3,639.62
|
$2,896.84
|
2026-06-08
|
|
73718
|
HCPCS
|
MRI Scan Of Leg Without Contrast
|
81
|
31
|
$3,753.80
|
$3,753.80
|
$915.36
|
$4,347.48
|
$3,164.55
|
2026-06-08
|
|
73719
|
HCPCS
|
MRI Scan Of Leg With Contrast
|
81
|
31
|
$4,210.55
|
$4,210.55
|
$1,522.32
|
$4,782.25
|
$3,253.63
|
2026-06-08
|
|
73720
|
HCPCS
|
MRI Scan Of Leg Before And After Contrast
|
131
|
31
|
$5,636.65
|
$5,636.65
|
$1,544.41
|
$7,906.35
|
$4,571.68
|
2026-06-08
|
|
73721
|
HCPCS
|
MRI Scan Of Leg Joint Without Contrast
|
56
|
31
|
$3,833.80
|
$3,833.80
|
$915.36
|
$3,998.60
|
$3,220.64
|
2026-06-08
|
|
73722
|
HCPCS
|
MRI Scan Of Leg Joint With Contrast
|
56
|
31
|
$4,402.00
|
$4,402.00
|
$1,544.41
|
$4,398.49
|
$3,622.13
|
2026-06-08
|
|
73723
|
HCPCS
|
MRI Scan Of Leg Joint Before And After Contrast
|
31
|
31
|
$5,313.10
|
$5,313.10
|
$1,544.41
|
$5,206.84
|
$4,144.22
|
2026-06-08
|
|
73725
|
HCPCS
|
MRI Scan Of Blood Vessels Of Leg
|
31
|
31
|
$7,241.70
|
$7,241.70
|
$1,865.33
|
$7,096.87
|
$5,648.53
|
2026-06-08
|
|
74150
|
HCPCS
|
CT Scan Of Abdomen Without Contrast
|
31
|
31
|
$2,677.65
|
$2,677.65
|
$404.83
|
$2,624.10
|
$2,088.57
|
2026-06-08
|
|
74160
|
HCPCS
|
CT Scan Of Abdomen With Contrast
|
31
|
31
|
$3,170.45
|
$3,170.45
|
$1,153.20
|
$3,107.04
|
$2,472.95
|
2026-06-08
|
|
74170
|
HCPCS
|
CT Scan Of Abdomen Before And After Contrast
|
31
|
31
|
$3,646.95
|
$3,646.95
|
$1,153.20
|
$3,574.01
|
$2,844.62
|
2026-06-08
|
|
74174
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast
|
31
|
31
|
$5,312.15
|
$5,312.15
|
$1,409.01
|
$5,205.91
|
$4,143.48
|
2026-06-08
|
|
74175
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen With Contrast
|
31
|
31
|
$4,528.30
|
$4,528.30
|
$1,409.01
|
$4,437.73
|
$3,532.07
|
2026-06-08
|
|
74176
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Without Contrast
|
33
|
31
|
$4,732.95
|
$4,732.95
|
$1,153.20
|
$4,638.29
|
$3,691.70
|
2026-06-08
|
|
74177
|
HCPCS
|
CT Scan Of Abdomen And Pelvis With Contrast
|
31
|
31
|
$5,059.40
|
$5,059.40
|
$1,153.20
|
$4,958.21
|
$3,946.33
|
2026-06-08
|
|
74178
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Before And After Contrast
|
31
|
31
|
$5,712.20
|
$5,712.20
|
$1,153.20
|
$5,597.96
|
$4,455.52
|
2026-06-08
|
|
74181
|
HCPCS
|
MRI Scan Of Abdomen Without Contrast
|
56
|
31
|
$3,678.45
|
$3,678.45
|
$915.36
|
$3,604.88
|
$2,928.01
|
2026-06-08
|
|
74182
|
HCPCS
|
MRI Scan Of Abdomen With Contrast
|
56
|
31
|
$3,827.80
|
$3,827.80
|
$1,452.58
|
$3,751.24
|
$3,046.89
|
2026-06-08
|
|
74183
|
HCPCS
|
MRI Scan Of Abdomen Before And After Contrast
|
81
|
31
|
$5,102.10
|
$5,102.10
|
$1,544.41
|
$5,141.37
|
$4,138.14
|
2026-06-08
|
|
74185
|
HCPCS
|
MRI Scan Of Blood Vessels Of Abdomen
|
31
|
31
|
$7,241.70
|
$7,241.70
|
$1,865.33
|
$7,096.87
|
$5,648.53
|
2026-06-08
|
|
75574
|
HCPCS
|
CT Scan Of Blood Vessels And Grafts Of Heart With Contrast
|
31
|
31
|
$4,079.65
|
$4,079.65
|
$1,409.01
|
$3,998.06
|
$3,182.13
|
2026-06-08
|
|
75635
|
HCPCS
|
CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast
|
31
|
31
|
$5,312.15
|
$5,312.15
|
$1,409.01
|
$5,205.91
|
$4,143.48
|
2026-06-08
|
|
76641
|
HCPCS
|
Complete Ultrasound Scan Of 1 Breast
|
31
|
31
|
$1,866.40
|
$1,866.40
|
$414.64
|
$1,829.07
|
$1,455.79
|
2026-06-08
|
|
76642
|
HCPCS
|
Limited Ultrasound Scan Of 1 Breast
|
81
|
31
|
$1,244.25
|
$1,244.25
|
$413.91
|
$1,529.88
|
$884.64
|
2026-06-08
|
|
76700
|
HCPCS
|
Complete Ultrasound Scan Of Abdomen
|
31
|
31
|
$1,226.35
|
$1,226.35
|
$487.72
|
$1,201.82
|
$956.55
|
2026-06-08
|
|
76706
|
HCPCS
|
Ultrasound Scan Of Abdominal Aorta
|
31
|
31
|
$1,172.10
|
$1,172.10
|
$414.64
|
$1,148.66
|
$914.24
|
2026-06-08
|
|
76770
|
HCPCS
|
Complete Ultrasound Scan Behind Abdominal Cavity
|
56
|
31
|
$1,172.10
|
$1,172.10
|
$444.79
|
$1,148.66
|
$932.97
|
2026-06-08
|
|
76776
|
HCPCS
|
Ultrasound Scan Of Transplanted Kidney
|
31
|
31
|
$1,264.95
|
$1,264.95
|
$414.64
|
$1,239.65
|
$986.66
|
2026-06-08
|
|
76870
|
HCPCS
|
Ultrasound Scan Of Scrotum
|
56
|
31
|
$1,209.45
|
$1,209.45
|
$414.64
|
$1,185.26
|
$962.71
|
2026-06-08
|
|
77012
|
HCPCS
|
Review By Radiologist Of CT Guidance For Needle Placement
|
31
|
31
|
$2,945.35
|
$2,945.35
|
$312.48
|
$2,886.44
|
$2,297.37
|
2026-06-08
|
|
77046
|
HCPCS
|
MRI Scan Of 1 Breast Without Contrast
|
31
|
31
|
$3,576.95
|
$3,576.95
|
$915.36
|
$3,505.41
|
$2,790.02
|
2026-06-08
|
|
77047
|
HCPCS
|
MRI Scan Of Both Breasts Without Contrast
|
31
|
31
|
$3,827.80
|
$3,827.80
|
$915.36
|
$3,751.24
|
$2,985.68
|
2026-06-08
|
|
77075
|
HCPCS
|
Complete X-ray Of Body Bones
|
56
|
31
|
$1,465.45
|
$1,465.45
|
$448.96
|
$1,436.14
|
$1,178.92
|
2026-06-08
|
|
78013
|
HCPCS
|
Nuclear Medicine Study Of Thyroid
|
31
|
31
|
$1,420.85
|
$1,420.85
|
$565.07
|
$1,394.02
|
$1,207.72
|
2026-06-08
|
|
78014
|
HCPCS
|
Nuclear Medicine Study Of Thyroid And Thyroid Function
|
31
|
31
|
$1,788.45
|
$1,788.45
|
$711.27
|
$1,752.68
|
$1,394.99
|
2026-06-08
|
|
78070
|
HCPCS
|
Nuclear Medicine Study Of Parathyroid
|
31
|
31
|
$2,865.25
|
$2,865.25
|
$1,139.51
|
$3,338.90
|
$2,435.46
|
2026-06-08
|
|
78071
|
HCPCS
|
Nuclear Medicine Study Of Parathyroid With Spect
|
31
|
31
|
$2,134.55
|
$2,134.55
|
$848.91
|
$2,091.86
|
$1,664.95
|
2026-06-08
|
|
78185
|
HCPCS
|
Nuclear Medicine Study Of Spleen
|
31
|
31
|
$1,209.85
|
$1,209.85
|
$481.16
|
$1,394.02
|
$1,028.37
|
2026-06-08
|
|
78215
|
HCPCS
|
Nuclear Medicine Study Of Liver And Spleen
|
31
|
31
|
$1,632.25
|
$1,632.25
|
$649.15
|
$3,338.90
|
$1,387.41
|
2026-06-08
|
|
78226
|
HCPCS
|
Nuclear Medicine Study Of Liver And Bile Duct System
|
56
|
31
|
$1,958.65
|
$1,958.65
|
$778.96
|
$2,084.41
|
$1,661.93
|
2026-06-08
|
|
78227
|
HCPCS
|
Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs
|
56
|
31
|
$1,958.65
|
$1,958.65
|
$778.96
|
$2,687.26
|
$1,664.85
|
2026-06-08
|
|
78261
|
HCPCS
|
Nuclear Medicine Study Of Stomach Lining
|
31
|
31
|
$1,684.15
|
$1,684.15
|
$669.79
|
$1,650.47
|
$1,394.02
|
2026-06-08
|
|
78264
|
HCPCS
|
Nuclear Medicine Study Of Stomach To Assess Emptying
|
31
|
31
|
$3,474.20
|
$3,474.20
|
$1,381.69
|
$3,404.72
|
$2,709.88
|
2026-06-08
|
|
78278
|
HCPCS
|
Nuclear Medicine Study To Assess Blood Loss
|
56
|
31
|
$1,026.15
|
$1,026.15
|
$408.10
|
$3,338.90
|
$1,109.71
|
2026-06-08
|
|
78290
|
HCPCS
|
Nuclear Medicine Study Of Intestine
|
31
|
31
|
$1,459.40
|
$1,459.40
|
$580.40
|
$1,430.21
|
$1,240.49
|
2026-06-08
|
|
78300
|
HCPCS
|
Nuclear Medicine Study Of Bone And/or Joint Limited Area
|
56
|
31
|
$1,635.05
|
$1,635.05
|
$490.15
|
$1,602.35
|
$1,084.56
|
2026-06-08
|
|
78305
|
HCPCS
|
Nuclear Medicine Study Of Bone And/or Joint Multiple Areas
|
31
|
31
|
$1,660.05
|
$1,660.05
|
$660.20
|
$1,626.85
|
$1,394.02
|
2026-06-08
|
|
78306
|
HCPCS
|
Nuclear Medicine Study Of Bone And/or Joint Whole Body
|
31
|
31
|
$2,149.50
|
$2,149.50
|
$854.86
|
$2,106.51
|
$1,676.61
|
2026-06-08
|
|
78315
|
HCPCS
|
Nuclear Medicine Study Of Bone Taken At Different Times
|
31
|
31
|
$2,575.00
|
$2,575.00
|
$1,024.08
|
$2,523.50
|
$2,008.50
|
2026-06-08
|
|
78452
|
HCPCS
|
Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect
|
86
|
31
|
$1,692.55
|
$1,692.55
|
$67.04
|
$3,338.90
|
$1,228.11
|
2026-06-08
|
|
78472
|
HCPCS
|
Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit…
|
56
|
31
|
$2,575.00
|
$2,575.00
|
$1,024.08
|
$2,849.01
|
$2,188.75
|
2026-06-08
|
|
78473
|
HCPCS
|
Nuclear Medicine Studies Of Heart Pumping Function By Labeling Red Blood Cells W…
|
31
|
31
|
$3,372.50
|
$3,372.50
|
$1,341.24
|
$3,305.05
|
$2,630.55
|
2026-06-08
|
|
78579
|
HCPCS
|
Nuclear Medicine Study Of Lung Ventilation
|
31
|
31
|
$1,819.75
|
$1,819.75
|
$723.71
|
$3,338.90
|
$1,546.79
|
2026-06-08
|
|
78580
|
HCPCS
|
Nuclear Medicine Study Of Lung Circulation
|
31
|
31
|
$1,819.75
|
$1,819.75
|
$723.71
|
$3,338.90
|
$1,546.79
|
2026-06-08
|
|
78582
|
HCPCS
|
Nuclear Medicine Study Of Lung Ventilation And Circulation
|
31
|
31
|
$2,322.85
|
$2,322.85
|
$923.80
|
$3,338.90
|
$1,974.42
|
2026-06-08
|
|
78605
|
HCPCS
|
Nuclear Medicine Study Of Brain, 4 Static Views Or More
|
31
|
31
|
$1,776.40
|
$1,776.40
|
$706.47
|
$1,740.87
|
$1,394.02
|
2026-06-08
|
|
78606
|
HCPCS
|
Nuclear Medicine Study Of Brain And Blood Flow, 4 Static Views Or More
|
31
|
31
|
$2,354.70
|
$2,354.70
|
$936.46
|
$2,307.61
|
$1,836.67
|
2026-06-08
|
|
78700
|
HCPCS
|
Nuclear Medicine Study Of Kidney
|
31
|
31
|
$1,666.35
|
$1,666.35
|
$662.71
|
$1,633.02
|
$1,394.02
|
2026-06-08
|
|
78707
|
HCPCS
|
Nuclear Medicine Study Of Kidney, Blood Flow, And Function
|
31
|
31
|
$2,437.15
|
$2,437.15
|
$969.25
|
$2,388.41
|
$1,900.98
|
2026-06-08
|
|
78708
|
HCPCS
|
Nuclear Medicine Study Of Kidney, Blood, Flow, And Function With Drug Administra…
|
81
|
31
|
$2,336.45
|
$2,336.45
|
$673.39
|
$2,538.45
|
$1,439.22
|
2026-06-08
|
|
78709
|
HCPCS
|
Nuclear Medicine Studies Of Kidney, Blood Flow, And Function
|
31
|
31
|
$5,117.80
|
$5,117.80
|
$1,394.02
|
$5,015.44
|
$3,991.88
|
2026-06-08
|
|
78740
|
HCPCS
|
Nuclear Medicine Study To Assess Urine Flow
|
31
|
31
|
$1,645.40
|
$1,645.40
|
$654.38
|
$1,612.49
|
$1,394.02
|
2026-06-08
|
|
78761
|
HCPCS
|
Nuclear Medicine Study Of Testicle And Blood Flow
|
31
|
31
|
$1,247.70
|
$1,247.70
|
$496.21
|
$1,394.02
|
$1,060.55
|
2026-06-08
|
|
78799
|
HCPCS
|
Other Nuclear Medicine Study Of Urogenital System
|
31
|
31
|
$1,684.15
|
$1,684.15
|
$669.79
|
$1,650.47
|
$1,394.02
|
2026-06-08
|
|
78800
|
HCPCS
|
Nuclear Medicine Study, 1 Area
|
31
|
31
|
$3,077.35
|
$3,077.35
|
$1,223.86
|
$3,338.90
|
$2,615.75
|
2026-06-08
|
|
78802
|
HCPCS
|
Nuclear Medicine Study, Whole Body
|
31
|
31
|
$3,480.50
|
$3,480.50
|
$1,384.19
|
$3,410.89
|
$2,958.43
|
2026-06-08
|
|
78803
|
HCPCS
|
Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day …
|
81
|
31
|
$1,692.55
|
$1,692.55
|
$546.24
|
$3,338.90
|
$1,386.97
|
2026-06-08
|
|
78830
|
HCPCS
|
Nuclear Medicine Study, Spect Imaging With Concurrent CT Scan, 1 Area Or Single …
|
31
|
31
|
$1,347.10
|
$1,347.10
|
$535.74
|
$3,338.90
|
$1,145.04
|
2026-06-08
|
|
79101
|
HCPCS
|
Radioactive Drug Therapy Through A Vein
|
31
|
31
|
$1,696.20
|
$1,696.20
|
$674.58
|
$1,662.28
|
$1,323.04
|
2026-06-08
|
|
81220
|
HCPCS
|
Gene Analysis (cystic Fibrosis Transmembrane Conductance Regular) Common Variant…
|
81
|
31
|
$2,036.95
|
$2,036.95
|
$149.10
|
$2,937.21
|
$1,191.97
|
2026-06-08
|
|
81223
|
HCPCS
|
Gene Analysis (cystic Fibrosis Transmembrane Conductance Regular) Full Gene Sequ…
|
31
|
31
|
$2,317.55
|
$2,317.55
|
$921.69
|
$2,271.20
|
$1,807.69
|
2026-06-08
|
|
81229
|
HCPCS
|
Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi…
|
31
|
31
|
$5,838.55
|
$5,838.55
|
$2,321.99
|
$7,167.36
|
$4,962.77
|
2026-06-08
|
|
81263
|
HCPCS
|
Gene Rearrangement Analysis (immunoglobulin Heavy Chain Locus), Variable Region …
|
31
|
31
|
$2,025.40
|
$2,025.40
|
$506.72
|
$1,984.89
|
$1,579.81
|
2026-06-08
|
|
81275
|
HCPCS
|
Gene Analysis (v-ki-ras2 Kirsten Rat Sarcoma Viral Oncogene) Variants In Codons …
|
31
|
31
|
$1,308.90
|
$1,308.90
|
$506.72
|
$1,282.72
|
$1,020.94
|
2026-06-08
|
|
81404
|
HCPCS
|
Molecular Pathology Procedure Level 5 Genetic Analysis
|
31
|
31
|
$2,317.55
|
$2,317.55
|
$506.72
|
$2,271.20
|
$1,807.69
|
2026-06-08
|
|
81408
|
HCPCS
|
Molecular Pathology Procedure Level 9 Genetic Analysis
|
31
|
31
|
$5,328.80
|
$5,328.80
|
$2,119.26
|
$7,167.36
|
$4,529.48
|
2026-06-08
|
|
82139
|
HCPCS
|
Amino Acid Level, 6 Or More Amino Acids, Quantitative, Each Specimen
|
56
|
31
|
$1,395.35
|
$1,395.35
|
$36.78
|
$1,367.44
|
$1,075.80
|
2026-06-08
|
|
90376
|
HCPCS
|
Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle, Heat-t…
|
31
|
31
|
$2,025.00
|
$2,025.00
|
$805.34
|
$4,783.60
|
$1,721.25
|
2026-06-08
|
|
92950
|
HCPCS
|
Manual Attempt To Restore Blood Circulation And Breathing
|
31
|
31
|
$1,737.25
|
$1,737.25
|
$690.90
|
$2,666.27
|
$1,476.66
|
2026-06-08
|
|
93017
|
HCPCS
|
Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg)
|
31
|
31
|
$1,145.00
|
$1,145.00
|
$455.37
|
$1,122.10
|
$893.10
|
2026-06-08
|
|
93225
|
HCPCS
|
Electrocardiogram (ecg) 2-day Continuous
|
31
|
31
|
$1,353.70
|
$1,353.70
|
$234.29
|
$1,326.63
|
$1,055.89
|
2026-06-08
|
|
93306
|
HCPCS
|
Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu…
|
56
|
31
|
$2,636.80
|
$2,636.80
|
$1,048.66
|
$3,904.57
|
$2,241.28
|
2026-06-08
|
|
93308
|
HCPCS
|
Ultrasound Of Heart, Follow-up
|
56
|
31
|
$1,237.60
|
$1,237.60
|
$492.19
|
$1,819.52
|
$1,089.09
|
2026-06-08
|
|
93880
|
HCPCS
|
Ultrasound Of Both Sides Of Head And Neck Blood Flow
|
31
|
31
|
$1,643.40
|
$1,643.40
|
$638.85
|
$1,610.53
|
$1,281.85
|
2026-06-08
|
|
93924
|
HCPCS
|
Ultrasound Of Leg Arteries At Rest And After Exercise
|
31
|
31
|
$1,454.75
|
$1,454.75
|
$414.64
|
$1,425.66
|
$1,134.71
|
2026-06-08
|
|
93925
|
HCPCS
|
Ultrasound Of Leg Arteries Or Artery Grafts
|
31
|
31
|
$1,813.85
|
$1,813.85
|
$638.85
|
$1,777.57
|
$1,414.80
|
2026-06-08
|
|
93926
|
HCPCS
|
Ultrasound Of One Leg Arteries Or Artery Grafts
|
31
|
31
|
$1,209.30
|
$1,209.30
|
$414.64
|
$1,185.11
|
$943.25
|
2026-06-08
|
|
93930
|
HCPCS
|
Ultrasound Of Arm Arteries Or Artery Grafts
|
31
|
31
|
$1,693.60
|
$1,693.60
|
$414.64
|
$1,659.73
|
$1,321.01
|
2026-06-08
|
|
93931
|
HCPCS
|
Ultrasound Of One Arm Arteries Or Artery Grafts
|
31
|
31
|
$1,129.15
|
$1,129.15
|
$414.64
|
$1,106.57
|
$880.74
|
2026-06-08
|
|
93970
|
HCPCS
|
Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers
|
31
|
31
|
$1,365.25
|
$1,365.25
|
$542.96
|
$1,337.95
|
$1,064.90
|
2026-06-08
|
|
93975
|
HCPCS
|
Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow
|
56
|
31
|
$1,347.75
|
$1,347.75
|
$536.00
|
$1,903.11
|
$1,145.59
|
2026-06-08
|
|
93978
|
HCPCS
|
Complete Ultrasound Of Aorta, Vena Cava, Groin Vessels Or Bypass Grafts
|
31
|
31
|
$1,407.50
|
$1,407.50
|
$559.76
|
$1,379.35
|
$1,097.85
|
2026-06-08
|
|
94002
|
HCPCS
|
Initial Hospital Inpatient Or Observation Ventilation Assistance And Management
|
31
|
31
|
$3,417.65
|
$3,417.65
|
$1,359.20
|
$4,011.53
|
$2,905.00
|
2026-06-08
|
|
94003
|
HCPCS
|
Follow-up Inpatient Or Observation Ventilation Assistance And Management
|
31
|
31
|
$2,188.35
|
$2,188.35
|
$870.31
|
$4,011.53
|
$1,860.10
|
2026-06-08
|
|
94660
|
HCPCS
|
Therapy Procedure Using A Positive Pressure Ventilator
|
56
|
31
|
$1,670.75
|
$1,670.75
|
$464.04
|
$1,637.34
|
$991.78
|
2026-06-08
|
|
95806
|
HCPCS
|
Sleep Study Including Heart Rate, Breathing, Airflow, And Effort
|
31
|
31
|
$1,333.55
|
$1,333.55
|
$530.35
|
$1,306.88
|
$1,040.17
|
2026-06-08
|
|
96413
|
HCPCS
|
Administration Of Chemotherapy Into Vein, 1 Hour Or Less
|
31
|
31
|
$1,059.50
|
$1,059.50
|
$421.36
|
$1,117.51
|
$900.58
|
2026-06-08
|
|
99284
|
HCPCS
|
Emergency Department Visit With Moderate Level Of Medical Decision Making
|
25
|
25
|
$1,161.00
|
$1,161.00
|
$461.73
|
$1,137.78
|
$986.85
|
2026-06-08
|
|
99285
|
HCPCS
|
Emergency Department Visit With High Level Of Medical Decision Making
|
25
|
25
|
$1,792.00
|
$1,792.00
|
$712.68
|
$1,756.16
|
$1,523.20
|
2026-06-08
|
|
A9569
|
HCPCS
|
Technetium Tc-99m Exametazime Labeled Autologous White Blood Cells, Diagnostic, …
|
25
|
25
|
$4,412.60
|
$4,412.60
|
$1,754.89
|
$4,324.35
|
$3,750.71
|
2026-06-08
|
|
A9570
|
HCPCS
|
Indium In-111 Labeled Autologous White Blood Cells, Diagnostic, Per Study Dose
|
25
|
25
|
$4,462.65
|
$4,462.65
|
$1,774.80
|
$4,373.40
|
$3,793.25
|
2026-06-08
|
|
C1781
|
HCPCS
|
Mesh (implantable)
|
1,050
|
25
|
$1,210.00
|
$1,210.00
|
$44.38
|
$11,686.50
|
$880.70
|
2026-06-08
|
|
C1788
|
HCPCS
|
Port, Indwelling (implantable)
|
50
|
25
|
$1,502.82
|
$1,502.82
|
$508.76
|
$1,691.85
|
$1,087.37
|
2026-06-08
|
|
C8902
|
HCPCS
|
Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom…
|
31
|
31
|
$5,102.10
|
$5,102.10
|
$1,865.33
|
$5,000.06
|
$3,979.64
|
2026-06-08
|
|
C8911
|
HCPCS
|
Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest…
|
31
|
31
|
$5,102.10
|
$5,102.10
|
$1,865.33
|
$5,000.06
|
$3,979.64
|
2026-06-08
|
|
C8914
|
HCPCS
|
Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Lower…
|
31
|
31
|
$5,102.10
|
$5,102.10
|
$1,865.33
|
$5,000.06
|
$3,979.64
|
2026-06-08
|
|
C8920
|
HCPCS
|
Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Pelvi…
|
31
|
31
|
$5,102.10
|
$5,102.10
|
$1,865.33
|
$5,000.06
|
$3,979.64
|
2026-06-08
|
|
C8933
|
HCPCS
|
Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Spina…
|
31
|
31
|
$5,102.10
|
$5,102.10
|
$1,865.33
|
$5,000.06
|
$3,979.64
|
2026-06-08
|
|
C8936
|
HCPCS
|
Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Upper…
|
31
|
31
|
$5,099.55
|
$5,099.55
|
$1,865.33
|
$4,997.56
|
$3,977.65
|
2026-06-08
|
|
J0561
|
HCPCS
|
Injection, Penicillin G Benzathine, 100,000 Units
|
31
|
31
|
$1,806.65
|
$1,806.65
|
$367.78
|
$1,770.52
|
$1,409.19
|
2026-06-08
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
31
|
31
|
$8,346.60
|
$8,346.60
|
$3,319.44
|
$8,179.67
|
$6,510.35
|
2026-06-08
|
|
J1306
|
HCPCS
|
Injection, Inclisiran, 1 Mg
|
25
|
25
|
$15,478.00
|
$15,478.00
|
$6,155.60
|
$15,168.44
|
$13,156.30
|
2026-06-08
|
|
J1439
|
HCPCS
|
Injection, Ferric Carboxymaltose, 1 Mg
|
31
|
31
|
$5,100.33
|
$5,100.33
|
$1,723.66
|
$4,998.32
|
$3,978.25
|
2026-06-08
|
|
J1602
|
HCPCS
|
Injection, Golimumab, 1 Mg, For Intravenous Use
|
31
|
31
|
$5,815.40
|
$5,815.40
|
$2,312.78
|
$5,699.09
|
$4,783.60
|
2026-06-08
|
|
J3032
|
HCPCS
|
Injection, Eptinezumab-jjmr, 1 Mg
|
31
|
31
|
$9,469.35
|
$9,469.35
|
$3,668.81
|
$9,279.96
|
$7,386.09
|
2026-06-08
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
31
|
31
|
$36,740.25
|
$36,740.25
|
$14,611.60
|
$36,005.45
|
$28,657.40
|
2026-06-08
|
|
J7168
|
HCPCS
|
Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity
|
31
|
31
|
$5,223.15
|
$5,223.15
|
$2,077.25
|
$6,792.77
|
$4,439.68
|
2026-06-08
|
|
M0222
|
HCPCS
|
Intravenous Injection, Bebtelovimab, Includes Injection And Post Administration …
|
25
|
25
|
$1,059.50
|
$1,059.50
|
$421.36
|
$1,038.31
|
$900.58
|
2026-06-08
|
|
M0243
|
HCPCS
|
Intravenous Infusion Or Subcutaneous Injection, Casirivimab And Imdevimab Includ…
|
31
|
31
|
$1,059.50
|
$1,059.50
|
$421.36
|
$1,117.51
|
$900.58
|
2026-06-08
|
|
M0245
|
HCPCS
|
Intravenous Infusion, Bamlanivimab And Etesevimab, Includes Infusion And Post Ad…
|
31
|
31
|
$1,059.50
|
$1,059.50
|
$421.36
|
$1,117.51
|
$900.58
|
2026-06-08
|
|
M0247
|
HCPCS
|
Intravenous Infusion, Sotrovimab, Includes Infusion And Post Administration Moni…
|
31
|
31
|
$1,059.50
|
$1,059.50
|
$421.36
|
$1,117.51
|
$900.58
|
2026-06-08
|
|
P9034
|
HCPCS
|
Platelets, Pheresis, Each Unit
|
31
|
31
|
$1,308.60
|
$1,308.60
|
$520.43
|
$1,282.43
|
$1,047.77
|
2026-06-08
|
|
P9036
|
HCPCS
|
Platelets, Pheresis, Irradiated, Each Unit
|
31
|
31
|
$1,866.65
|
$1,866.65
|
$742.37
|
$1,829.32
|
$1,455.99
|
2026-06-08
|
|
Q5158
|
HCPCS
|
Injection, Denosumab-bnht (bomyntra/conexxence), Biosimilar, 1 Mg
|
25
|
25
|
$6,087.55
|
$6,087.55
|
$2,421.02
|
$5,965.80
|
$5,174.42
|
2026-06-08
|