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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

WARNER HOSPITAL AND HEALTH SERVICES

Clinton, IL · CCN 141303 · Rates published

2,997 distinct procedures filed
31 distinct payers
218,723 rate rows
2026-10-21 last MRF observed
Data quality

216,825 of 218,723 rate rows are consumer-grade (99.1%)

1,898 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 996
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 792
exceeds 10× this hospital's gross charge — excluded from medians 60
percent-of-charges filed in the dollar field — excluded from medians 50
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT//FinalLinks/Reports.aspx?dbName=dbDrJohnWarnerIL&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Warner_V3.aspx
Discovered viaCMS hospital list
Last fetch not_modified · 2026-11-06
Content fingerprint 56041dc15311fe39… · 41,503,623 bytes · first seen 2026-10-22

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
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 31 $14,611.60 $36,005.45 $28,657.40 nat. median
$3,824
outlier · 7.5×
619
MS_DRG 		O.r. Procedures For Obesity With Mcc 1 $18,000.00 $18,000.00 $18,000.00 nat. median
$26,741
0.7× median
620
MS_DRG 		O.r. Procedures For Obesity With Cc 1 $18,000.00 $18,000.00 $18,000.00 nat. median
$16,356
1.1× median
621
MS_DRG 		O.r. Procedures For Obesity Without Cc/mcc 1 $18,000.00 $18,000.00 $18,000.00 nat. median
$15,355
1.2× median
J1306
HCPCS 		Injection, Inclisiran, 1 Mg 25 $6,155.60 $15,168.44 $13,156.30 nat. median
$45
outlier · 295.2×
J3032
HCPCS 		Injection, Eptinezumab-jjmr, 1 Mg 31 $3,668.81 $9,279.96 $7,386.09 nat. median
$75
outlier · 98.2×
J0897
HCPCS 		Injection, Denosumab, 1 Mg 31 $3,319.44 $8,179.67 $6,510.35 nat. median
$1,973
outlier · 3.3×
6250001596
CDM 		Reflux Management System 25 $2,908.78 $7,167.72 $6,216.90 nat. median
$6,217
1.0× median
6250001166
CDM 		Lap Band Aps - Allergan 25 $2,654.65 $6,541.50 $5,673.75 nat. median
$5,674
1.0× median
6250001165
CDM 		Lap Band Apl - Allergan 25 $2,654.65 $6,541.50 $5,673.75 nat. median
$5,674
1.0× median
72198
HCPCS 		MRI Scan Of Blood Vessels Of Pelvis 31 $1,865.33 $7,096.87 $5,648.53 nat. median
$1,128
outlier · 5.0×
74185
HCPCS 		MRI Scan Of Blood Vessels Of Abdomen 31 $1,865.33 $7,096.87 $5,648.53 nat. median
$1,240
outlier · 4.6×
71555
HCPCS 		MRI Scan Of Blood Vessels Of Chest 31 $1,865.33 $7,096.87 $5,648.53 nat. median
$1,143
outlier · 4.9×
73725
HCPCS 		MRI Scan Of Blood Vessels Of Leg 31 $1,865.33 $7,096.87 $5,648.53 nat. median
$1,245
outlier · 4.5×
73225
HCPCS 		MRI Scan Of Blood Vessels Of Arm 31 $1,865.33 $6,983.87 $5,558.59 nat. median
$1,206
outlier · 4.6×
Q5158
HCPCS 		Injection, Denosumab-bnht (bomyntra/conexxence), Biosimilar, 1 Mg 25 $2,421.02 $5,965.80 $5,174.42 nat. median
$2,560
outlier · 2.0×
81229
HCPCS 		Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi… 31 $2,321.99 $7,167.36 $4,962.77 nat. median
$1,323
outlier · 3.8×
72157
HCPCS 		MRI Scan Of Middle Spinal Canal Before And After Contrast 31 $1,544.41 $6,124.85 $4,874.88 nat. median
$1,103
outlier · 4.4×
J1602
HCPCS 		Injection, Golimumab, 1 Mg, For Intravenous Use 31 $2,312.78 $5,699.09 $4,783.60 nat. median
$273
outlier · 17.5×
72156
HCPCS 		MRI Scan Of Upper Spinal Canal Before And After Contrast 31 $1,544.41 $6,003.92 $4,778.63 nat. median
$1,103
outlier · 4.3×
72158
HCPCS 		MRI Scan Of Lower Spinal Canal Before And After Contrast 31 $1,544.41 $5,756.03 $4,581.33 nat. median
$1,090
outlier · 4.2×
73720
HCPCS 		MRI Scan Of Leg Before And After Contrast 31 $1,544.41 $7,906.35 $4,571.68 nat. median
$1,125
outlier · 4.1×
81408
HCPCS 		Molecular Pathology Procedure Level 9 Genetic Analysis 31 $2,119.26 $7,167.36 $4,529.48 nat. median
$943
outlier · 4.8×
70553
HCPCS 		MRI Scan Of Brain Before And After Contrast 31 $1,544.41 $5,578.36 $4,516.14 nat. median
$1,132
outlier · 4.0×
73223
HCPCS 		MRI Scan Of Arm Joint Before And After Contrast 31 $1,544.41 $5,945.51 $4,516.14 nat. median
$1,158
outlier · 3.9×
74178
HCPCS 		CT Scan Of Abdomen And Pelvis Before And After Contrast 31 $1,153.20 $5,597.96 $4,455.52 nat. median
$1,024
outlier · 4.4×
J7168
HCPCS 		Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 31 $2,077.25 $6,792.77 $4,439.68 nat. median
$21
outlier · 209.2×
70543
HCPCS 		MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 31 $1,544.41 $5,500.01 $4,220.21 nat. median
$1,083
outlier · 3.9×
72127
HCPCS 		CT Scan Of Upper Spine Before And After Contrast 31 $1,153.20 $5,267.60 $4,192.58 nat. median
$607
outlier · 6.9×
72197
HCPCS 		MRI Scan Of Pelvis Before And After Contrast 31 $1,544.41 $5,206.84 $4,144.22 nat. median
$1,063
outlier · 3.9×
73723
HCPCS 		MRI Scan Of Leg Joint Before And After Contrast 31 $1,544.41 $5,206.84 $4,144.22 nat. median
$1,191
outlier · 3.5×
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 31 $1,409.01 $5,205.91 $4,143.48 nat. median
$988
outlier · 4.2×
75635
HCPCS 		CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 31 $1,409.01 $5,205.91 $4,143.48 nat. median
$719
outlier · 5.8×
74183
HCPCS 		MRI Scan Of Abdomen Before And After Contrast 31 $1,544.41 $5,141.37 $4,138.14 nat. median
$1,099
outlier · 3.8×
70546
HCPCS 		MRI Scan Of Blood Vessels Of Head Before And After Contrast 31 $1,865.33 $8,514.19 $4,106.61 nat. median
$1,068
outlier · 3.8×
70549
HCPCS 		MRI Scan Of Blood Vessels Of Neck Before And After Contrast 31 $1,865.33 $5,727.56 $4,058.50 nat. median
$1,054
outlier · 3.8×
73220
HCPCS 		MRI Scan Of Arm Before And After Contrast 31 $1,544.41 $5,000.06 $3,997.69 nat. median
$1,128
outlier · 3.5×
78709
HCPCS 		Nuclear Medicine Studies Of Kidney, Blood Flow, And Function 31 $1,394.02 $5,015.44 $3,991.88 nat. median
$739
outlier · 5.4×
C8914
HCPCS 		Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Lower… 31 $1,865.33 $5,000.06 $3,979.64 nat. median
$1,177
outlier · 3.4×
C8920
HCPCS 		Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Pelvi… 31 $1,865.33 $5,000.06 $3,979.64 nat. median
$1,018
outlier · 3.9×
C8902
HCPCS 		Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom… 31 $1,865.33 $5,000.06 $3,979.64 nat. median
$1,044
outlier · 3.8×
71552
HCPCS 		MRI Scan Of Chest Before And After Contrast 31 $1,544.41 $5,000.06 $3,979.64 nat. median
$1,097
outlier · 3.6×
C8911
HCPCS 		Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest… 31 $1,865.33 $5,000.06 $3,979.64 nat. median
$1,023
outlier · 3.9×
C8933
HCPCS 		Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Spina… 31 $1,865.33 $5,000.06 $3,979.64 nat. median
$738
outlier · 5.4×
J1439
HCPCS 		Injection, Ferric Carboxymaltose, 1 Mg 31 $1,723.66 $4,998.32 $3,978.25 nat. median
$14
outlier · 276.3×
C8936
HCPCS 		Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Upper… 31 $1,865.33 $4,997.56 $3,977.65 nat. median
$928
outlier · 4.3×
6250001388
CDM 		Lap Band - Realize 25 $1,849.54 $4,557.59 $3,953.01 nat. median
$3,953
1.0× median
74177
HCPCS 		CT Scan Of Abdomen And Pelvis With Contrast 31 $1,153.20 $4,958.21 $3,946.33 nat. median
$972
outlier · 4.1×
70544
HCPCS 		MRI Scan Of Blood Vessels Of Head Without Contrast 31 $1,838.05 $5,000.06 $3,928.45 nat. median
$824
outlier · 4.8×
19083
HCPCS 		Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 31 $1,828.41 $5,046.77 $3,907.83 nat. median
$2,144
1.8× median

Other procedures at this hospital

Browse this hospital's 2,997 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
Q5158 HCPCS Injection, Denosumab-bnht (bomyntra/conexxence), Biosimilar, 1 Mg 50 25 $6,087.55 $6,087.55 $2,421.02 $5,965.80 $5,174.42 2026-10-21
P9036 HCPCS Platelets, Pheresis, Irradiated, Each Unit 62 31 $1,866.65 $1,866.65 $742.37 $1,829.32 $1,455.99 2026-10-21
P9034 HCPCS Platelets, Pheresis, Each Unit 62 31 $1,308.60 $1,308.60 $520.43 $1,282.43 $1,047.77 2026-10-21
M0247 HCPCS Intravenous Infusion, Sotrovimab, Includes Infusion And Post Administration Moni… 62 31 $1,059.50 $1,059.50 $421.36 $1,117.51 $900.58 2026-10-21
M0245 HCPCS Intravenous Infusion, Bamlanivimab And Etesevimab, Includes Infusion And Post Ad… 62 31 $1,059.50 $1,059.50 $421.36 $1,117.51 $900.58 2026-10-21
M0243 HCPCS Intravenous Infusion Or Subcutaneous Injection, Casirivimab And Imdevimab Includ… 62 31 $1,059.50 $1,059.50 $421.36 $1,117.51 $900.58 2026-10-21
M0222 HCPCS Intravenous Injection, Bebtelovimab, Includes Injection And Post Administration … 50 25 $1,059.50 $1,059.50 $421.36 $1,038.31 $900.58 2026-10-21
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 62 31 $5,223.15 $5,223.15 $2,077.25 $6,792.77 $4,439.68 2026-10-21
J3101 HCPCS Injection, Tenecteplase, 1 Mg 62 31 $36,740.25 $36,740.25 $14,611.60 $36,005.45 $28,657.40 2026-10-21
J3032 HCPCS Injection, Eptinezumab-jjmr, 1 Mg 62 31 $9,469.35 $9,469.35 $3,668.81 $9,279.96 $7,386.09 2026-10-21
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 62 31 $5,815.40 $5,815.40 $2,312.78 $5,699.09 $4,783.60 2026-10-21
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 62 31 $5,100.33 $5,100.33 $1,723.66 $4,998.32 $3,978.25 2026-10-21
J1306 HCPCS Injection, Inclisiran, 1 Mg 50 25 $15,478.00 $15,478.00 $6,155.60 $15,168.44 $13,156.30 2026-10-21
J0897 HCPCS Injection, Denosumab, 1 Mg 62 31 $8,346.60 $8,346.60 $3,319.44 $8,179.67 $6,510.35 2026-10-21
J0561 HCPCS Injection, Penicillin G Benzathine, 100,000 Units 62 31 $1,806.65 $1,806.65 $367.78 $1,770.52 $1,409.19 2026-10-21
C8936 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Upper… 62 31 $5,099.55 $5,099.55 $1,865.33 $4,997.56 $3,977.65 2026-10-21
C8933 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Spina… 62 31 $5,102.10 $5,102.10 $1,865.33 $5,000.06 $3,979.64 2026-10-21
C8920 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Pelvi… 62 31 $5,102.10 $5,102.10 $1,865.33 $5,000.06 $3,979.64 2026-10-21
C8914 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Lower… 62 31 $5,102.10 $5,102.10 $1,865.33 $5,000.06 $3,979.64 2026-10-21
C8911 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest… 62 31 $5,102.10 $5,102.10 $1,865.33 $5,000.06 $3,979.64 2026-10-21
C8902 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom… 62 31 $5,102.10 $5,102.10 $1,865.33 $5,000.06 $3,979.64 2026-10-21
C1788 HCPCS Port, Indwelling (implantable) 100 25 $1,502.82 $1,502.82 $508.76 $1,691.85 $1,087.37 2026-10-21
C1781 HCPCS Mesh (implantable) 2,100 25 $1,210.00 $1,210.00 $44.38 $11,686.50 $902.92 2026-10-21
A9570 HCPCS Indium In-111 Labeled Autologous White Blood Cells, Diagnostic, Per Study Dose 50 25 $4,462.65 $4,462.65 $1,774.80 $4,373.40 $3,793.25 2026-10-21
A9569 HCPCS Technetium Tc-99m Exametazime Labeled Autologous White Blood Cells, Diagnostic, … 50 25 $4,412.60 $4,412.60 $1,754.89 $4,324.35 $3,750.71 2026-10-21
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 50 25 $1,792.00 $1,792.00 $712.68 $1,756.16 $1,523.20 2026-10-21
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 50 25 $1,161.00 $1,161.00 $461.73 $1,137.78 $986.85 2026-10-21
96413 HCPCS Administration Of Chemotherapy Into Vein, 1 Hour Or Less 62 31 $1,059.50 $1,059.50 $421.36 $1,117.51 $900.58 2026-10-21
95806 HCPCS Sleep Study Including Heart Rate, Breathing, Airflow, And Effort 62 31 $1,333.55 $1,333.55 $530.35 $1,306.88 $1,040.17 2026-10-21
94660 HCPCS Therapy Procedure Using A Positive Pressure Ventilator 112 31 $1,670.75 $1,670.75 $464.04 $1,637.34 $991.78 2026-10-21
94003 HCPCS Follow-up Inpatient Or Observation Ventilation Assistance And Management 62 31 $2,188.35 $2,188.35 $870.31 $4,011.53 $1,860.10 2026-10-21
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 62 31 $3,417.65 $3,417.65 $1,359.20 $4,011.53 $2,905.00 2026-10-21
93978 HCPCS Complete Ultrasound Of Aorta, Vena Cava, Groin Vessels Or Bypass Grafts 62 31 $1,407.50 $1,407.50 $559.76 $1,379.35 $1,097.85 2026-10-21
93975 HCPCS Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 112 31 $1,347.75 $1,347.75 $536.00 $1,903.11 $1,145.59 2026-10-21
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 62 31 $1,365.25 $1,365.25 $542.96 $1,337.95 $1,064.90 2026-10-21
93931 HCPCS Ultrasound Of One Arm Arteries Or Artery Grafts 62 31 $1,129.15 $1,129.15 $414.64 $1,106.57 $880.74 2026-10-21
93930 HCPCS Ultrasound Of Arm Arteries Or Artery Grafts 62 31 $1,693.60 $1,693.60 $414.64 $1,659.73 $1,321.01 2026-10-21
93926 HCPCS Ultrasound Of One Leg Arteries Or Artery Grafts 62 31 $1,209.30 $1,209.30 $414.64 $1,185.11 $943.25 2026-10-21
93925 HCPCS Ultrasound Of Leg Arteries Or Artery Grafts 62 31 $1,813.85 $1,813.85 $638.85 $1,777.57 $1,414.80 2026-10-21
93924 HCPCS Ultrasound Of Leg Arteries At Rest And After Exercise 62 31 $1,454.75 $1,454.75 $414.64 $1,425.66 $1,134.71 2026-10-21
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 62 31 $1,643.40 $1,643.40 $638.85 $1,610.53 $1,281.85 2026-10-21
93308 HCPCS Ultrasound Of Heart, Follow-up 112 31 $1,237.60 $1,237.60 $492.19 $1,819.52 $1,089.09 2026-10-21
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 112 31 $2,636.80 $2,636.80 $1,048.66 $3,904.57 $2,241.28 2026-10-21
93225 HCPCS Electrocardiogram (ecg) 2-day Continuous 62 31 $1,353.70 $1,353.70 $234.29 $1,326.63 $1,055.89 2026-10-21
93017 HCPCS Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg) 62 31 $1,145.00 $1,145.00 $455.37 $1,122.10 $893.10 2026-10-21
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 62 31 $1,737.25 $1,737.25 $690.90 $2,666.27 $1,476.66 2026-10-21
90376 HCPCS Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle, Heat-t… 62 31 $2,025.00 $2,025.00 $805.34 $4,783.60 $1,721.25 2026-10-21
82139 HCPCS Amino Acid Level, 6 Or More Amino Acids, Quantitative, Each Specimen 112 31 $1,395.35 $1,395.35 $36.78 $1,367.44 $1,075.80 2026-10-21
81408 HCPCS Molecular Pathology Procedure Level 9 Genetic Analysis 62 31 $5,328.80 $5,328.80 $2,119.26 $7,167.36 $4,529.48 2026-10-21
81404 HCPCS Molecular Pathology Procedure Level 5 Genetic Analysis 62 31 $2,317.55 $2,317.55 $506.72 $2,271.20 $1,807.69 2026-10-21
81275 HCPCS Gene Analysis (v-ki-ras2 Kirsten Rat Sarcoma Viral Oncogene) Variants In Codons … 62 31 $1,308.90 $1,308.90 $506.72 $1,282.72 $1,020.94 2026-10-21
81263 HCPCS Gene Rearrangement Analysis (immunoglobulin Heavy Chain Locus), Variable Region … 62 31 $2,025.40 $2,025.40 $506.72 $1,984.89 $1,579.81 2026-10-21
81229 HCPCS Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi… 62 31 $5,838.55 $5,838.55 $2,321.99 $7,167.36 $4,962.77 2026-10-21
81223 HCPCS Gene Analysis (cystic Fibrosis Transmembrane Conductance Regular) Full Gene Sequ… 62 31 $2,317.55 $2,317.55 $921.69 $2,271.20 $1,807.69 2026-10-21
81220 HCPCS Gene Analysis (cystic Fibrosis Transmembrane Conductance Regular) Common Variant… 162 31 $2,036.95 $2,036.95 $149.10 $2,937.21 $1,210.40 2026-10-21
79101 HCPCS Radioactive Drug Therapy Through A Vein 62 31 $1,696.20 $1,696.20 $674.58 $1,662.28 $1,323.04 2026-10-21
78830 HCPCS Nuclear Medicine Study, Spect Imaging With Concurrent CT Scan, 1 Area Or Single … 62 31 $1,347.10 $1,347.10 $535.74 $3,338.90 $1,145.04 2026-10-21
78803 HCPCS Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day … 162 31 $1,692.55 $1,692.55 $546.24 $3,338.90 $1,404.82 2026-10-21
78802 HCPCS Nuclear Medicine Study, Whole Body 62 31 $3,480.50 $3,480.50 $1,384.19 $3,410.89 $2,958.43 2026-10-21
78800 HCPCS Nuclear Medicine Study, 1 Area 62 31 $3,077.35 $3,077.35 $1,223.86 $3,338.90 $2,615.75 2026-10-21
78799 HCPCS Other Nuclear Medicine Study Of Urogenital System 62 31 $1,684.15 $1,684.15 $669.79 $1,650.47 $1,394.02 2026-10-21
78761 HCPCS Nuclear Medicine Study Of Testicle And Blood Flow 62 31 $1,247.70 $1,247.70 $496.21 $1,394.02 $1,060.55 2026-10-21
78740 HCPCS Nuclear Medicine Study To Assess Urine Flow 62 31 $1,645.40 $1,645.40 $654.38 $1,612.49 $1,394.02 2026-10-21
78709 HCPCS Nuclear Medicine Studies Of Kidney, Blood Flow, And Function 62 31 $5,117.80 $5,117.80 $1,394.02 $5,015.44 $3,991.88 2026-10-21
78708 HCPCS Nuclear Medicine Study Of Kidney, Blood, Flow, And Function With Drug Administra… 162 31 $2,336.45 $2,336.45 $673.39 $2,538.45 $1,439.22 2026-10-21
78707 HCPCS Nuclear Medicine Study Of Kidney, Blood Flow, And Function 62 31 $2,437.15 $2,437.15 $969.25 $2,388.41 $1,900.98 2026-10-21
78700 HCPCS Nuclear Medicine Study Of Kidney 62 31 $1,666.35 $1,666.35 $662.71 $1,633.02 $1,394.02 2026-10-21
78606 HCPCS Nuclear Medicine Study Of Brain And Blood Flow, 4 Static Views Or More 62 31 $2,354.70 $2,354.70 $936.46 $2,307.61 $1,836.67 2026-10-21
78605 HCPCS Nuclear Medicine Study Of Brain, 4 Static Views Or More 62 31 $1,776.40 $1,776.40 $706.47 $1,740.87 $1,394.02 2026-10-21
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 62 31 $2,322.85 $2,322.85 $923.80 $3,338.90 $1,974.42 2026-10-21
78580 HCPCS Nuclear Medicine Study Of Lung Circulation 62 31 $1,819.75 $1,819.75 $723.71 $3,338.90 $1,546.79 2026-10-21
78579 HCPCS Nuclear Medicine Study Of Lung Ventilation 62 31 $1,819.75 $1,819.75 $723.71 $3,338.90 $1,546.79 2026-10-21
78473 HCPCS Nuclear Medicine Studies Of Heart Pumping Function By Labeling Red Blood Cells W… 62 31 $3,372.50 $3,372.50 $1,341.24 $3,305.05 $2,630.55 2026-10-21
78472 HCPCS Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit… 112 31 $2,575.00 $2,575.00 $1,024.08 $2,849.01 $2,188.75 2026-10-21
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 172 31 $1,692.55 $1,692.55 $67.04 $3,338.90 $1,238.74 2026-10-21
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 62 31 $2,575.00 $2,575.00 $1,024.08 $2,523.50 $2,008.50 2026-10-21
78306 HCPCS Nuclear Medicine Study Of Bone And/or Joint Whole Body 62 31 $2,149.50 $2,149.50 $854.86 $2,106.51 $1,676.61 2026-10-21
78305 HCPCS Nuclear Medicine Study Of Bone And/or Joint Multiple Areas 62 31 $1,660.05 $1,660.05 $660.20 $1,626.85 $1,394.02 2026-10-21
78300 HCPCS Nuclear Medicine Study Of Bone And/or Joint Limited Area 112 31 $1,635.05 $1,635.05 $490.15 $1,602.35 $1,084.56 2026-10-21
78290 HCPCS Nuclear Medicine Study Of Intestine 62 31 $1,459.40 $1,459.40 $580.40 $1,430.21 $1,240.49 2026-10-21
78278 HCPCS Nuclear Medicine Study To Assess Blood Loss 112 31 $1,026.15 $1,026.15 $408.10 $3,338.90 $1,109.71 2026-10-21
78264 HCPCS Nuclear Medicine Study Of Stomach To Assess Emptying 62 31 $3,474.20 $3,474.20 $1,381.69 $3,404.72 $2,709.88 2026-10-21
78261 HCPCS Nuclear Medicine Study Of Stomach Lining 62 31 $1,684.15 $1,684.15 $669.79 $1,650.47 $1,394.02 2026-10-21
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 112 31 $1,958.65 $1,958.65 $778.96 $2,687.26 $1,664.85 2026-10-21
78226 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System 112 31 $1,958.65 $1,958.65 $778.96 $2,084.41 $1,661.93 2026-10-21
78215 HCPCS Nuclear Medicine Study Of Liver And Spleen 62 31 $1,632.25 $1,632.25 $649.15 $3,338.90 $1,387.41 2026-10-21
78185 HCPCS Nuclear Medicine Study Of Spleen 62 31 $1,209.85 $1,209.85 $481.16 $1,394.02 $1,028.37 2026-10-21
78071 HCPCS Nuclear Medicine Study Of Parathyroid With Spect 62 31 $2,134.55 $2,134.55 $848.91 $2,091.86 $1,664.95 2026-10-21
78070 HCPCS Nuclear Medicine Study Of Parathyroid 62 31 $2,865.25 $2,865.25 $1,139.51 $3,338.90 $2,435.46 2026-10-21
78014 HCPCS Nuclear Medicine Study Of Thyroid And Thyroid Function 62 31 $1,788.45 $1,788.45 $711.27 $1,752.68 $1,394.99 2026-10-21
78013 HCPCS Nuclear Medicine Study Of Thyroid 62 31 $1,420.85 $1,420.85 $565.07 $1,394.02 $1,207.72 2026-10-21
77075 HCPCS Complete X-ray Of Body Bones 112 31 $1,465.45 $1,465.45 $448.96 $1,436.14 $1,178.92 2026-10-21
77047 HCPCS MRI Scan Of Both Breasts Without Contrast 62 31 $3,827.80 $3,827.80 $915.36 $3,751.24 $2,985.68 2026-10-21
77046 HCPCS MRI Scan Of 1 Breast Without Contrast 62 31 $3,576.95 $3,576.95 $915.36 $3,505.41 $2,790.02 2026-10-21
77012 HCPCS Review By Radiologist Of CT Guidance For Needle Placement 62 31 $2,945.35 $2,945.35 $312.48 $2,886.44 $2,297.37 2026-10-21
76870 HCPCS Ultrasound Scan Of Scrotum 112 31 $1,209.45 $1,209.45 $414.64 $1,185.26 $962.71 2026-10-21
76776 HCPCS Ultrasound Scan Of Transplanted Kidney 62 31 $1,264.95 $1,264.95 $414.64 $1,239.65 $986.66 2026-10-21
76770 HCPCS Complete Ultrasound Scan Behind Abdominal Cavity 112 31 $1,172.10 $1,172.10 $444.79 $1,148.66 $932.97 2026-10-21
76706 HCPCS Ultrasound Scan Of Abdominal Aorta 62 31 $1,172.10 $1,172.10 $414.64 $1,148.66 $914.24 2026-10-21
76700 HCPCS Complete Ultrasound Scan Of Abdomen 62 31 $1,226.35 $1,226.35 $487.72 $1,201.82 $956.55 2026-10-21
76642 HCPCS Limited Ultrasound Scan Of 1 Breast 162 31 $1,244.25 $1,244.25 $413.91 $1,529.88 $884.64 2026-10-21
76641 HCPCS Complete Ultrasound Scan Of 1 Breast 62 31 $1,866.40 $1,866.40 $414.64 $1,829.07 $1,455.79 2026-10-21
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 62 31 $5,312.15 $5,312.15 $1,409.01 $5,205.91 $4,143.48 2026-10-21
75574 HCPCS CT Scan Of Blood Vessels And Grafts Of Heart With Contrast 62 31 $4,079.65 $4,079.65 $1,409.01 $3,998.06 $3,182.13 2026-10-21
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 62 31 $7,241.70 $7,241.70 $1,865.33 $7,096.87 $5,648.53 2026-10-21
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 162 31 $5,102.10 $5,102.10 $1,544.41 $5,141.37 $4,138.14 2026-10-21
74182 HCPCS MRI Scan Of Abdomen With Contrast 112 31 $3,827.80 $3,827.80 $1,452.58 $3,751.24 $3,046.89 2026-10-21
74181 HCPCS MRI Scan Of Abdomen Without Contrast 112 31 $3,678.45 $3,678.45 $915.36 $3,604.88 $2,928.01 2026-10-21
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 62 31 $5,712.20 $5,712.20 $1,153.20 $5,597.96 $4,455.52 2026-10-21
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 62 31 $5,059.40 $5,059.40 $1,153.20 $4,958.21 $3,946.33 2026-10-21
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 66 31 $4,732.95 $4,732.95 $1,153.20 $4,638.29 $3,691.70 2026-10-21
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 62 31 $4,528.30 $4,528.30 $1,409.01 $4,437.73 $3,532.07 2026-10-21
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 62 31 $5,312.15 $5,312.15 $1,409.01 $5,205.91 $4,143.48 2026-10-21
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 62 31 $3,646.95 $3,646.95 $1,153.20 $3,574.01 $2,844.62 2026-10-21
74160 HCPCS CT Scan Of Abdomen With Contrast 62 31 $3,170.45 $3,170.45 $1,153.20 $3,107.04 $2,472.95 2026-10-21
74150 HCPCS CT Scan Of Abdomen Without Contrast 62 31 $2,677.65 $2,677.65 $404.83 $2,624.10 $2,088.57 2026-10-21
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 62 31 $7,241.70 $7,241.70 $1,865.33 $7,096.87 $5,648.53 2026-10-21
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 62 31 $5,313.10 $5,313.10 $1,544.41 $5,206.84 $4,144.22 2026-10-21
73722 HCPCS MRI Scan Of Leg Joint With Contrast 112 31 $4,402.00 $4,402.00 $1,544.41 $4,398.49 $3,622.13 2026-10-21
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 112 31 $3,833.80 $3,833.80 $915.36 $3,998.60 $3,220.64 2026-10-21
73720 HCPCS MRI Scan Of Leg Before And After Contrast 262 31 $5,636.65 $5,636.65 $1,544.41 $7,906.35 $4,571.68 2026-10-21
73719 HCPCS MRI Scan Of Leg With Contrast 162 31 $4,210.55 $4,210.55 $1,522.32 $4,782.25 $3,253.63 2026-10-21
73718 HCPCS MRI Scan Of Leg Without Contrast 162 31 $3,753.80 $3,753.80 $915.36 $4,347.48 $3,164.55 2026-10-21
73702 HCPCS CT Scan Of Leg Before And After Contrast 62 31 $3,713.90 $3,713.90 $1,153.20 $3,639.62 $2,896.84 2026-10-21
73701 HCPCS CT Scan Of Leg With Contrast Material 62 31 $3,229.55 $3,229.55 $1,153.20 $3,164.96 $2,519.05 2026-10-21
73700 HCPCS CT Scan Of Leg Without Contrast 112 31 $2,423.75 $2,423.75 $404.83 $2,744.44 $2,060.19 2026-10-21
73564 HCPCS X-ray Of Knee, 4 Or More Views 112 31 $1,124.20 $1,124.20 $213.04 $1,652.38 $955.57 2026-10-21
73225 HCPCS MRI Scan Of Blood Vessels Of Arm 62 31 $7,126.40 $7,126.40 $1,865.33 $6,983.87 $5,558.59 2026-10-21
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 162 31 $5,578.80 $5,578.80 $1,544.41 $5,945.51 $4,516.14 2026-10-21
73222 HCPCS MRI Scan Of Arm Joint With Contrast 212 31 $4,659.25 $4,659.25 $1,544.41 $5,390.49 $3,797.63 2026-10-21
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 162 31 $4,080.20 $4,080.20 $915.36 $4,331.36 $3,187.59 2026-10-21
73220 HCPCS MRI Scan Of Arm Before And After Contrast 112 31 $5,102.10 $5,102.10 $1,544.41 $5,000.06 $3,997.69 2026-10-21
73219 HCPCS MRI Scan Of Arm With Contrast 212 31 $3,827.80 $3,827.80 $1,388.75 $6,039.01 $3,067.58 2026-10-21
73218 HCPCS MRI Scan Of Arm Without Contrast 112 31 $3,576.95 $3,576.95 $915.36 $3,505.41 $2,879.94 2026-10-21
73202 HCPCS CT Scan Of Arm Before And After Contrast 62 31 $3,713.85 $3,713.85 $1,153.20 $3,639.57 $2,896.80 2026-10-21
73201 HCPCS CT Scan Of Arm With Contrast 62 31 $3,229.55 $3,229.55 $1,153.20 $3,164.96 $2,519.05 2026-10-21
73200 HCPCS CT Scan Of Arm Without Contrast 112 31 $2,824.10 $2,824.10 $404.83 $2,767.62 $2,291.82 2026-10-21
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 62 31 $7,241.70 $7,241.70 $1,865.33 $7,096.87 $5,648.53 2026-10-21
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 62 31 $5,313.10 $5,313.10 $1,544.41 $5,206.84 $4,144.22 2026-10-21
72196 HCPCS MRI Scan Of Pelvis With Contrast 62 31 $3,827.80 $3,827.80 $1,522.32 $3,751.24 $2,985.68 2026-10-21
72195 HCPCS MRI Scan Of Pelvis Without Contrast 112 31 $3,678.45 $3,678.45 $915.36 $3,604.88 $2,955.82 2026-10-21
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 62 31 $3,246.60 $3,246.60 $1,153.20 $3,181.67 $2,532.35 2026-10-21
72193 HCPCS CT Scan Of Pelvis With Contrast 62 31 $2,805.55 $2,805.55 $1,115.77 $2,749.44 $2,188.33 2026-10-21
72192 HCPCS CT Scan Of Pelvis Without Contrast 112 31 $2,546.65 $2,546.65 $404.83 $2,495.72 $2,059.88 2026-10-21
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 62 31 $2,546.65 $2,546.65 $1,012.80 $2,495.72 $1,986.39 2026-10-21
72159 HCPCS MRI Scan Of Blood Vessels Of Spinal Canal 62 31 $2,546.65 $2,546.65 $1,012.80 $2,495.72 $1,986.39 2026-10-21
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 62 31 $5,873.50 $5,873.50 $1,544.41 $5,756.03 $4,581.33 2026-10-21
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 62 31 $6,249.85 $6,249.85 $1,544.41 $6,124.85 $4,874.88 2026-10-21
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 62 31 $6,126.45 $6,126.45 $1,544.41 $6,003.92 $4,778.63 2026-10-21
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 62 31 $4,829.30 $4,829.30 $1,544.41 $4,732.71 $3,766.85 2026-10-21
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 62 31 $4,433.60 $4,433.60 $915.36 $4,344.93 $3,458.21 2026-10-21
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 62 31 $4,243.40 $4,243.40 $1,544.41 $4,158.53 $3,309.85 2026-10-21
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 62 31 $4,080.20 $4,080.20 $915.36 $3,998.60 $3,182.56 2026-10-21
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 62 31 $4,010.45 $4,010.45 $1,544.41 $3,930.24 $3,128.15 2026-10-21
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 62 31 $3,827.80 $3,827.80 $915.36 $3,751.24 $2,985.68 2026-10-21
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 62 31 $4,080.20 $4,080.20 $1,153.20 $3,998.60 $3,182.56 2026-10-21
72132 HCPCS CT Scan Of Lower Spine With Contrast 62 31 $3,753.80 $3,753.80 $1,153.20 $3,678.72 $2,927.96 2026-10-21
72131 HCPCS CT Scan Of Lower Spine Without Contrast 62 31 $3,264.10 $3,264.10 $404.83 $3,198.82 $2,546.00 2026-10-21
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 62 31 $4,847.60 $4,847.60 $1,153.20 $4,750.65 $3,781.13 2026-10-21
72129 HCPCS CT Scan Of Middle Spine With Contrast 62 31 $4,406.30 $4,406.30 $1,153.20 $4,318.17 $3,436.91 2026-10-21
72128 HCPCS CT Scan Of Middle Spine Without Contrast 62 31 $2,842.75 $2,842.75 $404.83 $2,785.90 $2,217.35 2026-10-21
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 62 31 $5,375.10 $5,375.10 $1,153.20 $5,267.60 $4,192.58 2026-10-21
72126 HCPCS CT Scan Of Upper Spine With Contrast 62 31 $4,886.90 $4,886.90 $1,153.20 $4,789.16 $3,811.78 2026-10-21
72125 HCPCS CT Scan Of Upper Spine Without Contrast 62 31 $3,101.05 $3,101.05 $404.83 $3,039.03 $2,418.82 2026-10-21
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 62 31 $7,241.70 $7,241.70 $1,865.33 $7,096.87 $5,648.53 2026-10-21
71552 HCPCS MRI Scan Of Chest Before And After Contrast 62 31 $5,102.10 $5,102.10 $1,544.41 $5,000.06 $3,979.64 2026-10-21
71551 HCPCS MRI Scan Of Chest With Contrast 62 31 $3,827.80 $3,827.80 $1,522.32 $3,751.24 $2,985.68 2026-10-21
71550 HCPCS MRI Scan Of Chest Without Contrast 62 31 $3,576.95 $3,576.95 $915.36 $3,505.41 $2,790.02 2026-10-21
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 62 31 $4,389.35 $4,389.35 $1,409.01 $4,301.56 $3,423.69 2026-10-21
71270 HCPCS CT Scan Of Chest Before And After Contrast 62 31 $3,427.40 $3,427.40 $1,153.20 $3,358.85 $2,673.37 2026-10-21
71260 HCPCS CT Scan Of Chest With Contrast 62 31 $3,101.05 $3,101.05 $1,153.20 $3,039.03 $2,418.82 2026-10-21
7070010177 CDM Indigo Carmine 0.8% Inj 50 25 $1,321.20 $1,321.20 $525.44 $1,294.78 $1,123.02 2026-10-21
7070004111 CDM Sodium Chloride 0.9% Vial 50 25 $2,025.00 $2,025.00 $805.34 $1,984.50 $1,721.25 2026-10-21
70553 HCPCS MRI Scan Of Brain Before And After Contrast 162 31 $5,431.45 $5,431.45 $1,544.41 $5,578.36 $4,516.14 2026-10-21
70552 HCPCS MRI Scan Of Brain With Contrast 112 31 $3,919.95 $3,919.95 $1,487.56 $3,841.55 $3,120.24 2026-10-21
70551 HCPCS MRI Scan Of Brain Without Contrast 112 31 $3,827.80 $3,827.80 $915.36 $3,751.24 $3,046.89 2026-10-21
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 112 31 $5,844.45 $5,844.45 $1,865.33 $5,727.56 $4,058.50 2026-10-21
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 112 31 $5,612.25 $5,612.25 $1,480.02 $5,500.01 $3,163.23 2026-10-21
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 112 31 $5,102.10 $5,102.10 $1,428.76 $5,000.06 $3,053.67 2026-10-21
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 162 31 $6,122.50 $6,122.50 $1,865.33 $8,514.19 $4,106.61 2026-10-21
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 162 31 $5,612.25 $5,612.25 $1,731.76 $7,425.51 $3,701.28 2026-10-21
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 162 31 $4,868.40 $4,868.40 $1,838.05 $5,000.06 $3,928.45 2026-10-21
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 162 31 $5,313.10 $5,313.10 $1,544.41 $5,500.01 $4,220.21 2026-10-21
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 162 31 $3,827.80 $3,827.80 $1,452.58 $4,126.34 $3,104.58 2026-10-21
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 162 31 $3,587.45 $3,587.45 $915.36 $3,684.46 $3,007.72 2026-10-21
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 62 31 $4,011.05 $4,011.05 $1,409.01 $3,930.83 $3,128.62 2026-10-21
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 62 31 $3,955.00 $3,955.00 $1,409.01 $3,875.90 $3,084.90 2026-10-21
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 62 31 $3,474.20 $3,474.20 $1,153.20 $3,404.72 $2,709.88 2026-10-21
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 62 31 $2,884.60 $2,884.60 $1,147.21 $2,826.91 $2,249.99 2026-10-21
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 62 31 $2,861.00 $2,861.00 $404.83 $2,803.78 $2,231.58 2026-10-21
70488 HCPCS CT Scan Of Face Before And After Contrast 62 31 $3,515.65 $3,515.65 $1,153.20 $3,445.34 $2,742.21 2026-10-21
70487 HCPCS CT Scan Of Face With Contrast 112 31 $3,199.60 $3,199.60 $1,153.20 $3,492.97 $2,719.66 2026-10-21
70486 HCPCS CT Scan Of Face Without Contrast 112 31 $2,820.40 $2,820.40 $404.83 $2,763.99 $2,268.95 2026-10-21
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 62 31 $3,749.65 $3,749.65 $1,153.20 $3,674.66 $2,924.73 2026-10-21
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 62 31 $3,419.70 $3,419.70 $1,153.20 $3,351.31 $2,667.37 2026-10-21
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 112 31 $2,950.65 $2,950.65 $404.83 $2,891.64 $1,672.04 2026-10-21
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 62 31 $3,678.45 $3,678.45 $1,153.20 $3,604.88 $2,869.19 2026-10-21
70460 HCPCS CT Scan Head Or Brain With Contrast 62 31 $2,697.25 $2,697.25 $1,072.70 $2,643.31 $2,103.86 2026-10-21
70450 HCPCS CT Scan Head Or Brain Without Contrast 62 31 $2,656.65 $2,656.65 $1,056.55 $2,603.52 $2,072.19 2026-10-21
70336 HCPCS MRI Scan Of Jaw Joint 62 31 $2,851.70 $2,851.70 $915.36 $2,794.67 $2,224.33 2026-10-21
64450 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Other Nerve Or Branch 62 31 $1,248.80 $1,248.80 $496.65 $1,513.35 $1,061.48 2026-10-21
6250006013 CDM Absorbtack 5mm Fix Dev 50 25 $1,744.34 $1,744.34 $693.72 $1,709.45 $1,482.69 2026-10-21
6250001784 CDM 23cm Powerseal Sealer 50 25 $1,129.00 $1,129.00 $449.00 $1,106.42 $959.65 2026-10-21
6250001782 CDM Ventralight 25 X 30 Cm Oval 50 25 $3,450.20 $3,450.20 $1,372.14 $3,381.20 $2,932.67 2026-10-21
6250001781 CDM Ventralight 20 X 25 Cm Oval 50 25 $2,641.60 $2,641.60 $1,050.56 $2,588.77 $2,245.36 2026-10-21
6250001780 CDM Ventralight 15 X 20 Cm Oval 50 25 $1,683.40 $1,683.40 $669.49 $1,649.73 $1,430.89 2026-10-21
6250001779 CDM Ventralight 15 Cm Circle 50 25 $1,237.80 $1,237.80 $492.27 $1,213.04 $1,052.13 2026-10-21
6250001775 CDM Ventralight St Mesh 50 25 $1,175.75 $1,175.75 $467.60 $1,152.24 $999.39 2026-10-21
6250001773 CDM 11 Cm Ventralight Mesh 50 25 $1,354.40 $1,354.40 $538.64 $1,327.31 $1,151.24 2026-10-21
6250001745 CDM Powerseal 5mm 44cm Jaw Sealer 50 25 $1,062.50 $1,062.50 $422.56 $1,041.25 $903.13 2026-10-21
6250001738 CDM Stapler Titan 50 25 $3,150.00 $3,150.00 $1,252.76 $3,087.00 $2,677.50 2026-10-21
6250001724 CDM Enseal X1 Curved 50 25 $1,225.56 $1,225.56 $487.41 $1,201.05 $1,041.73 2026-10-21
6250001720 CDM Maryland Fushion 44 Cm Voy 50 25 $1,062.50 $1,062.50 $422.56 $1,041.25 $903.13 2026-10-21
6250001692 CDM Harmonic Hd 10001 Shears 50 25 $1,608.38 $1,608.38 $639.65 $1,576.21 $1,367.12 2026-10-21
6250001650 CDM Serosafuse Fast Cart 7.5 Mm 50 25 $1,062.50 $1,062.50 $422.56 $1,041.25 $903.13 2026-10-21
6250001649 CDM Esophyx Z+ 50 25 $3,775.00 $3,775.00 $1,501.32 $3,699.50 $3,208.75 2026-10-21
6250001613 CDM Shears Harmonic Ace+7 50 25 $1,243.19 $1,243.19 $494.42 $1,218.33 $1,056.71 2026-10-21
6250001612 CDM Sealent Patch Evarrest 50 25 $1,550.00 $1,550.00 $616.44 $1,519.00 $1,317.50 2026-10-21
6250001596 CDM Reflux Management System 50 25 $7,314.00 $7,314.00 $2,908.78 $7,167.72 $6,216.90 2026-10-21
6250001539 CDM Power Port Implant Port 6fr 50 25 $1,279.26 $1,279.26 $508.76 $1,253.67 $1,087.37 2026-10-21
6250001409 CDM Echelon Flex 60 50 25 $1,080.48 $1,080.48 $429.71 $1,058.87 $918.41 2026-10-21
6250001405 CDM Port Kit Realize 50 25 $1,472.92 $1,472.92 $585.78 $1,443.46 $1,251.98 2026-10-21
6250001388 CDM Lap Band - Realize 50 25 $4,650.60 $4,650.60 $1,849.54 $4,557.59 $3,953.01 2026-10-21
6250001300 CDM Tunneler Ivs 50 25 $1,365.00 $1,365.00 $542.86 $1,337.70 $1,160.25 2026-10-21
6250001166 CDM Lap Band Aps - Allergan 50 25 $6,675.00 $6,675.00 $2,654.65 $6,541.50 $5,673.75 2026-10-21
6250001165 CDM Lap Band Apl - Allergan 50 25 $6,675.00 $6,675.00 $2,654.65 $6,541.50 $5,673.75 2026-10-21
6250000962 CDM Stapler Stealth Cir 25mm 50 25 $1,058.01 $1,058.01 $420.77 $1,036.85 $899.31 2026-10-21
6250000960 CDM Stapler Stat Tack Hernia 50 25 $1,094.90 $1,094.90 $435.44 $1,073.00 $930.67 2026-10-21
6250000952 CDM Stapler Proximate 25mm 50 25 $1,225.00 $1,225.00 $487.18 $1,200.50 $1,041.25 2026-10-21
6250000875 CDM Shear Endo Harmonic 5mm 50 25 $1,052.93 $1,052.93 $418.75 $1,031.87 $894.99 2026-10-21
6250000691 CDM Retractor Endopath 12mm 50 25 $1,130.27 $1,130.27 $449.51 $1,107.66 $960.73 2026-10-21
6250000682 CDM Reload Ta90 4.8grn 50 25 $1,542.58 $1,542.58 $613.48 $1,511.73 $1,311.19 2026-10-21
6250000660 CDM Probe Tac-s 50 25 $1,149.55 $1,149.55 $457.18 $1,126.56 $977.12 2026-10-21
6250000659 CDM Probe Tac-c Ii 50 25 $1,149.55 $1,149.55 $457.18 $1,126.56 $977.12 2026-10-21
6250000543 CDM Pack Ob/Gyn Lap 50 25 $1,253.52 $1,253.52 $498.52 $1,228.45 $1,065.49 2026-10-21
6250000394 CDM Kit Acl Disp 50 25 $1,153.30 $1,153.30 $458.67 $1,130.23 $980.31 2026-10-21
6250000393 CDM Kit Access Port (Lb) 50 25 $1,650.00 $1,650.00 $656.21 $1,617.00 $1,402.50 2026-10-21
6250000392 CDM Kit Access Low Pro (Lb) 50 25 $1,190.00 $1,190.00 $473.26 $1,166.20 $1,011.50 2026-10-21
6250000337 CDM Film Sepra 50 25 $2,495.00 $2,495.00 $992.26 $2,445.10 $2,120.75 2026-10-21
6250000232 CDM Catheter, Stretta 50 25 $2,062.00 $2,062.00 $820.06 $2,020.76 $1,752.70 2026-10-21
6250000184 CDM Cath Groshong Dl 9.5 50 25 $1,171.70 $1,171.70 $465.99 $1,148.27 $995.95 2026-10-21
62326 HCPCS Insertion Of Tube And Injection Of Substance Into Lower Spine Canal 74 30 $1,388.00 $1,388.00 $80.83 $1,884.80 $1,082.64 2026-10-21
6230001244 CDM Insert Chest Tube Open Rt 50 25 $1,957.60 $1,957.60 $778.54 $1,918.45 $1,663.96 2026-10-21
62270 HCPCS Removal Of Cerebrospinal Fluid With Lower Back Spinal Tap For Diagnostic Test 62 31 $1,888.40 $1,888.40 $751.02 $2,898.11 $1,605.14 2026-10-21
6210020030 CDM Recovery Room - General Classification 50 25 $4,209.00 $4,209.00 $1,673.92 $4,124.82 $3,577.65 2026-10-21
6210020025 CDM Recovery Room - General Classification 50 25 $3,369.00 $3,369.00 $1,339.85 $3,301.62 $2,863.65 2026-10-21
6210020020 CDM Recovery Room - General Classification 50 25 $2,695.00 $2,695.00 $1,071.80 $2,641.10 $2,290.75 2026-10-21
6210020015 CDM Recovery Room - General Classification 50 25 $2,155.00 $2,155.00 $857.04 $2,111.90 $1,831.75 2026-10-21
6210020010 CDM Recovery Room - General Classification 50 25 $1,726.00 $1,726.00 $686.43 $1,691.48 $1,467.10 2026-10-21
6210020005 CDM Recovery Room - General Classification 50 25 $1,382.00 $1,382.00 $549.62 $1,354.36 $1,174.70 2026-10-21
6210020000 CDM Recovery Room - General Classification 50 25 $1,106.00 $1,106.00 $439.86 $1,083.88 $940.10 2026-10-21
6210010025 CDM Operating Room Services - General Classification 50 25 $1,250.00 $1,250.00 $497.13 $1,225.00 $1,062.50 2026-10-21
6210010020 CDM Operating Room Services - General Classification 50 25 $4,158.00 $4,158.00 $1,653.64 $4,074.84 $3,534.30 2026-10-21
6210010015 CDM Operating Room Services - General Classification 50 25 $1,051.00 $1,051.00 $417.98 $1,029.98 $893.35 2026-10-21
6210010010 CDM Operating Room Services - General Classification 50 25 $4,014.00 $4,014.00 $1,596.37 $3,933.72 $3,411.90 2026-10-21
6210010000 CDM Operating Room Services - General Classification 50 25 $2,194.00 $2,194.00 $872.55 $2,150.12 $1,864.90 2026-10-21
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 2 1 $21,915.33 $21,915.33 $18,000.00 $18,000.00 $18,000.00 2026-10-21
620 MS_DRG O.r. Procedures For Obesity With Cc 2 1 $27,740.57 $27,740.57 $18,000.00 $18,000.00 $18,000.00 2026-10-21
619 MS_DRG O.r. Procedures For Obesity With Mcc 2 1 $16,349.97 $16,349.97 $18,000.00 $18,000.00 $18,000.00 2026-10-21
6020010025 CDM Intensive Care Unit - Intermediate ICU 24 12 $1,834.00 $1,834.00 $1,430.52 $1,797.32 $1,586.41 2026-10-21
6020010020 CDM Intensive Care Unit - Intermediate ICU 24 12 $1,927.00 $1,927.00 $1,503.06 $1,888.46 $1,666.86 2026-10-21
6020010015 CDM Room & Board - Semi-private (two Beds) - Medical/surgical/gyn 24 12 $2,733.00 $2,733.00 $2,131.74 $2,678.34 $2,364.05 2026-10-21
6020010010 CDM Room & Board - Semi-private (two Beds) - Medical/surgical/gyn 24 12 $1,390.00 $1,390.00 $1,084.20 $1,362.20 $1,202.35 2026-10-21
6020010005 CDM Room & Board - Private (one Bed) - Medical/surgical/gyn 24 12 $2,892.00 $2,892.00 $2,255.76 $2,834.16 $2,501.58 2026-10-21
6020010000 CDM Room & Board - Private (one Bed) - Medical/surgical/gyn 24 12 $1,470.00 $1,470.00 $1,146.60 $1,440.60 $1,271.55 2026-10-21
59409 HCPCS Vaginal Delivery 62 31 $4,425.50 $4,425.50 $1,760.02 $8,170.45 $3,761.68 2026-10-21
58301 HCPCS Removal Of IUD 62 31 $1,496.55 $1,496.55 $595.18 $1,466.62 $1,167.31 2026-10-21
49083 HCPCS Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance 62 31 $2,720.85 $2,720.85 $1,082.08 $2,737.10 $2,312.72 2026-10-21
49082 HCPCS Drainage Of Fluid From Abdominal Cavity 62 31 $2,059.10 $2,059.10 $818.90 $2,737.10 $1,750.24 2026-10-21
46608 HCPCS Removal Of Foreign Body In Anus Using An Endoscope 62 31 $2,295.35 $2,295.35 $912.86 $3,738.56 $1,951.05 2026-10-21
46050 HCPCS Drainage Of Superficial Rectal Abscess Surrounding Anus 62 31 $2,506.70 $2,506.70 $996.91 $5,455.96 $2,130.70 2026-10-21
43247 HCPCS Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using … 62 31 $2,452.50 $2,452.50 $975.36 $3,658.73 $2,084.63 2026-10-21
41252 HCPCS Repair Of Lacerated Tongue Or Floor Of Mouth, More Than 2.6 Cm 62 31 $2,051.00 $2,051.00 $642.66 $2,009.98 $1,599.78 2026-10-21
38505 HCPCS Needle Biopsy Or Removal Of Surface Lymph Nodes 62 31 $2,459.35 $2,459.35 $978.08 $4,587.99 $2,090.45 2026-10-21
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 62 31 $3,341.65 $3,341.65 $1,328.97 $4,162.46 $2,840.40 2026-10-21
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 62 31 $3,341.65 $3,341.65 $1,328.97 $4,162.46 $2,840.40 2026-10-21
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 186 31 $3,474.20 $3,474.20 $39.46 $4,162.46 $1,525.83 2026-10-21
36430 HCPCS Transfusion Of Blood Or Blood Products 312 31 $1,711.35 $1,711.35 $459.50 $2,768.16 $1,206.23 2026-10-21
32556 HCPCS Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube 112 31 $3,915.05 $3,915.05 $778.54 $3,836.75 $1,722.69 2026-10-21
32555 HCPCS Aspiration Of Fluid From Chest Cavity Using Imaging Guidance 62 31 $1,469.00 $1,469.00 $584.22 $3,779.42 $1,248.65 2026-10-21
32554 HCPCS Aspiration Of Fluid From Chest Cavity 62 31 $2,592.90 $2,592.90 $1,031.20 $3,779.42 $2,203.97 2026-10-21
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 112 31 $1,957.60 $1,957.60 $778.54 $3,836.75 $1,722.69 2026-10-21
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 112 31 $4,873.20 $4,873.20 $693.21 $4,775.74 $1,744.91 2026-10-21
27768 HCPCS Closed Treatment Of Back Portion Of Shin Bone At Ankle With Manipulation 112 31 $4,873.20 $4,873.20 $182.66 $4,775.74 $1,744.91 2026-10-21
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 162 31 $1,635.05 $1,635.05 $406.45 $2,403.45 $1,054.58 2026-10-21
25520 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side And Dislocated … 62 31 $1,650.65 $1,650.65 $656.46 $1,744.91 $1,403.05 2026-10-21
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 62 31 $1,848.40 $1,848.40 $735.11 $1,811.43 $1,571.14 2026-10-21
23665 HCPCS Closed Treatment Of Dislocated Shoulder And Broken Upper Arm Bone At Shoulder Jo… 62 31 $1,760.45 $1,760.45 $700.13 $1,744.91 $1,496.38 2026-10-21
19281 HCPCS Placement Of Locating Device In Breast Using Imaging Guidance, First Growth 62 31 $1,073.05 $1,073.05 $426.75 $5,046.77 $912.09 2026-10-21
19084 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, Each Additio… 62 31 $2,160.85 $2,160.85 $859.37 $5,046.77 $1,836.72 2026-10-21
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 62 31 $4,597.45 $4,597.45 $1,828.41 $5,046.77 $3,907.83 2026-10-21
12057 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More … 62 31 $1,568.90 $1,568.90 $623.95 $1,537.52 $1,333.57 2026-10-21
12056 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.1-… 62 31 $1,076.15 $1,076.15 $427.98 $1,448.24 $914.73 2026-10-21
12047 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, More Than 30.0 C… 62 31 $1,568.90 $1,568.90 $623.95 $1,537.52 $1,333.57 2026-10-21
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 62 31 $1,568.90 $1,568.90 $623.95 $1,537.52 $1,333.57 2026-10-21
11401 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 62 31 $1,208.85 $1,208.85 $480.76 $1,595.08 $1,027.52 2026-10-21
11400 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 62 31 $1,208.85 $1,208.85 $480.76 $1,595.08 $1,027.52 2026-10-21
11042 HCPCS Removal Of Skin And Tissue, 20.0 Sq Cm Or Less 62 31 $1,043.00 $1,043.00 $414.80 $1,448.24 $886.55 2026-10-21
10081 HCPCS Complicated Drainage Of Cyst Of Tailbone 62 31 $2,068.05 $2,068.05 $822.46 $4,069.56 $1,757.84 2026-10-21
10005 HCPCS Fine Needle Aspiration Biopsy Using Ultrasound Guidance, First Growth 62 31 $1,207.80 $1,207.80 $480.34 $2,590.54 $1,026.63 2026-10-21
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