Hospital

PINCKNEYVILLE COMMUNITY HOSPITAL

Pinckneyville, IL · CCN 141307 · Rates published

3,178 distinct procedures filed

24 distinct payers

158,580 rate rows

2026-07-30 last MRF observed

Data quality

155,678 of 158,580 rate rows are consumer-grade (98.2%)

2,902 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
per-diem day rate — not a per-procedure price	1,746
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	568
exceeds 10× this hospital's gross charge — excluded from medians	452
percent-of-charges filed in the dollar field — excluded from medians	128
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	8

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

Source MRF file	https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbPCAHPINCKNEYVILLEIL&type=CDMWithoutLabel&fileType=CSV
Found on page	https://apps.para-hcfs.com/PTT/FinalLinks/PinckneyvilleCommunity.aspx
Discovered via	Discovered by HANK
Last fetch	success · 2026-11-10
Content fingerprint	4b15fa3a656b527b… · 29,855,731 bytes · first seen 2026-07-17

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
J2350 HCPCS	Injection, Ocrelizumab, 1 Mg	20	$19,760.22	$117,204.87	$43,926.43	nat. median $714 outlier · 61.6×
J9309 HCPCS	Injection, Polatuzumab Vedotin-piiq, 1 Mg	20	$15,314.34	$38,571.80	$34,043.35	nat. median $4,472 outlier · 7.6×
J9043 HCPCS	Injection, Cabazitaxel, 1 Mg	20	$16,214.26	$39,440.10	$27,874.15	nat. median $742 outlier · 37.6×
J9228 HCPCS	Injection, Ipilimumab, 1 Mg	20	$8,363.85	$64,890.00	$26,677.00	nat. median $9,020 outlier · 3.0×
J9301 HCPCS	Injection, Obinutuzumab, 10 Mg	20	$13,262.22	$32,259.46	$25,001.89	nat. median $299 outlier · 83.7×
J0870 HCPCS	Injection, Imetelstat, 1 Mg	16	$11,305.92	$27,500.90	$24,521.63	nat. median $3,750 outlier · 6.5×
J9119 HCPCS	Injection, Cemiplimab-rwlc, 1 Mg	20	$11,467.58	$27,894.11	$24,196.21	nat. median $93 outlier · 260.1×
J1930 HCPCS	Injection, Lanreotide, 1 Mg	20	$10,619.37	$25,830.90	$23,606.58	nat. median $5,001 outlier · 4.7×
J3590 HCPCS	Unclassified Biologics	16	$10,147.25	$24,682.50	$22,008.57	nat. median $792 outlier · 27.8×
J9144 HCPCS	Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj	20	$10,127.27	$24,710.40	$20,627.28	nat. median $231 outlier · 89.4×
J3380 HCPCS	Injection, Vedolizumab, Intravenous, 1 Mg	20	$9,081.28	$24,196.21	$20,187.44	nat. median $204 outlier · 99.1×
J9306 HCPCS	Injection, Pertuzumab, 1 Mg	20	$7,044.82	$19,434.26	$15,660.44	nat. median $91 outlier · 172.1×
58670 HCPCS	Destruction Of Fallopian Tubes Using An Endoscope	20	$6,232.65	$23,122.23	$13,855.01	nat. median $5,683 outlier · 2.4×
830500860_1 CDM	Epifix 5Cm X 6Cm	16	$6,322.19	$15,378.30	$13,712.32	nat. median $13,712 1.0× median
49320 HCPCS	Diagnostic Exam Of Abdomen Using An Endoscope	20	$6,166.42	$19,950.47	$13,707.78	nat. median $5,669 outlier · 2.4×
J0517 HCPCS	Injection, Benralizumab, 1 Mg	20	$6,123.50	$19,434.26	$13,612.38	nat. median $969 outlier · 14.0×
49565 HCPCS	Repair Recurrent Incisional Or Ventral Hernia; Reducible	16	$6,211.56	$15,109.20	$13,472.37	nat. median $3,127 outlier · 4.3×
J0896 HCPCS	Injection, Luspatercept-aamt, 0.25 Mg	20	$4,481.62	$38,571.80	$13,433.68	nat. median $4,571 outlier · 2.9×
58661 HCPCS	Removal Of Ovaries And/or Tubes Using An Endoscope	20	$6,016.20	$23,122.23	$13,373.85	nat. median $6,009 outlier · 2.2×
J9271 HCPCS	Injection, Pembrolizumab, 1 Mg	20	$5,966.62	$38,571.80	$13,263.64	nat. median $323 outlier · 41.1×
58563 HCPCS	Exam Of Uterus With Destruction Of Lining Of Uterus Using An Endoscope	20	$6,449.84	$15,688.80	$12,685.46	nat. median $5,222 outlier · 2.4×
J2506 HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	20	$7,129.53	$17,342.10	$11,823.43	nat. median $1,662 outlier · 7.1×
42831 HCPCS	Primary Removal Of Adenoids (12 Years Or Older)	20	$6,435.04	$15,652.80	$11,677.65	nat. median $3,445 outlier · 3.4×
830502955_1 CDM	Pod Mtp Right Ortholoc	16	$5,243.18	$12,753.68	$11,372.03	nat. median $11,372 1.0× median
42835 HCPCS	Secondary Removal Of Adenoids (younger Than 12 Years)	20	$5,757.20	$14,004.00	$11,018.12	nat. median $3,445 outlier · 3.2×
42836 HCPCS	Secondary Removal Of Adenoids (12 Years Or Older)	20	$5,757.20	$14,004.00	$11,018.12	nat. median $3,470 outlier · 3.2×
42825 HCPCS	Removal Of Tonsils (younger Than 12 Years)	20	$5,348.72	$13,010.40	$10,833.05	nat. median $5,580 1.9× median
42820 HCPCS	Removal Of Tonsils And Adenoid Glands (younger Than 12 Years)	20	$5,015.35	$12,199.50	$10,833.05	nat. median $5,506 2.0× median
J2783 HCPCS	Injection, Rasburicase, 0.5 Mg	20	$5,794.57	$14,094.90	$10,524.55	nat. median $1,582 outlier · 6.7×
830502639_1 CDM	Pod Right Ortholoc	16	$4,787.43	$11,645.10	$10,383.55	nat. median $10,384 1.0× median
42826 HCPCS	Removal Of Tonsils (12 Years Or Older)	20	$4,657.93	$11,330.10	$10,354.45	nat. median $3,387 outlier · 3.1×
81455 HCPCS	Genomic Sequence Analysis Panel Of DNA Or Combined DNA And RNA Of 51 Or More Gen…	20	$4,667.92	$11,354.40	$10,312.13	nat. median $2,920 outlier · 3.5×
28022 HCPCS	Incision Of Midfoot Joint For Exploration, Fluid Drainage, Or Removal Of Foreign…	20	$4,452.95	$11,664.79	$9,898.79	nat. median $3,261 outlier · 3.0×
42830 HCPCS	Primary Removal Of Adenoids (younger Than 12 Years)	20	$4,444.44	$10,833.05	$9,879.87	nat. median $3,381 outlier · 2.9×
Q5111 HCPCS	Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg	20	$4,639.80	$11,286.00	$9,773.18	nat. median $2,014 outlier · 4.9×
Q5120 HCPCS	Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg	20	$4,363.04	$10,612.80	$9,698.92	nat. median $374 outlier · 25.9×
J3101 HCPCS	Injection, Tenecteplase, 1 Mg	20	$4,229.10	$24,196.21	$9,401.17	nat. median $4,042 outlier · 2.3×
58558 HCPCS	Biopsy Of Lining Of Uterus And/or Removal Of Polyp Using An Endoscope	20	$4,159.54	$12,685.46	$9,246.55	nat. median $3,308 outlier · 2.8×
42821 HCPCS	Removal Of Tonsils And Adenoid Glands (12 Years Or Older)	20	$4,054.09	$10,833.05	$9,012.14	nat. median $3,398 outlier · 2.7×
28825 HCPCS	Amputation Of Toe At Toe Joint	20	$3,855.03	$11,664.79	$8,569.63	nat. median $3,337 outlier · 2.6×
28289 HCPCS	Correction Of Rigid Deformity Of First Joint Of Big Toe	20	$3,855.03	$29,742.86	$8,569.63	nat. median $3,521 outlier · 2.4×
49507 HCPCS	Repair Of Trapped Groin Hernia (5 Years Or Older)	20	$405.43	$20,410.20	$8,390.86	nat. median $3,886 outlier · 2.2×
J1306 HCPCS	Injection, Inclisiran, 1 Mg	20	$3,658.19	$9,773.18	$8,132.06	nat. median $51 outlier · 159.2×
7080000058_1 CDM	Anes, Mon Sed 218-232mins	16	$3,733.30	$9,081.00	$8,097.22	nat. median $8,097 1.0× median
28750 HCPCS	Fusion Of Big Toe At Joint With Foot	20	$59.45	$29,742.86	$8,095.23	nat. median $7,026 1.2× median
J0840 HCPCS	Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram	20	$3,555.33	$38,571.80	$7,903.41	nat. median $3,454 outlier · 2.3×
49618 HCPCS	Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length	20	$791.02	$23,548.69	$7,801.08	nat. median $4,596 1.7× median
49616 HCPCS	Repair Of Recurrent Entrapped Hernia Of Abdomen, 3-10 Cm In Length	20	$844.92	$23,548.69	$7,796.64	nat. median $4,674 1.7× median
49596 HCPCS	Initial Repair Of Entrapped Hernia Of Abdomen, More Than 10 Cm In Length	20	$1,010.66	$23,548.69	$7,796.64	nat. median $3,792 outlier · 2.1×
49614 HCPCS	Repair Of Recurrent Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length	20	$564.16	$23,548.69	$7,796.64	nat. median $5,994 1.3× median

Other procedures at this hospital

Browse this hospital's 3,178 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

28825	HCPCS	Amputation Of Toe At Toe Joint	40	20	$10,419.00	$10,419.00	$3,855.03	$11,664.79	$8,569.63	2026-06-08
7080000049_1	CDM	Anes, Mon Sed 113-127mins	32	16	$5,731.00	$5,731.00	$2,120.47	$5,157.90	$4,599.13	2026-06-08
7080000050_1	CDM	Anes, Mon Sed 128-142mins	32	16	$6,354.00	$6,354.00	$2,350.98	$5,718.60	$5,099.09	2026-06-08
7080000051_1	CDM	Anes, Mon Sed 143-157 Mins	32	16	$6,977.00	$6,977.00	$2,581.49	$6,279.30	$5,599.05	2026-06-08
7080000052_1	CDM	Anes, Mon Sed 158-172mins	32	16	$7,599.00	$7,599.00	$2,811.63	$6,839.10	$6,098.20	2026-06-08
7080000053_1	CDM	Anes, Mon Sed 173-187mins	32	16	$8,222.00	$8,222.00	$3,042.14	$7,399.80	$6,598.16	2026-06-08
7080000054_1	CDM	Anes, Mon Sed 188-202mins	32	16	$8,845.00	$8,845.00	$3,272.65	$7,960.50	$7,098.11	2026-06-08
7080000055_1	CDM	Anes, Mon Sed 203-217mins	32	16	$9,467.00	$9,467.00	$3,502.79	$8,520.30	$7,597.27	2026-06-08
7080000058_1	CDM	Anes, Mon Sed 218-232mins	32	16	$10,090.00	$10,090.00	$3,733.30	$9,081.00	$8,097.22	2026-06-08
7080000057_1	CDM	Anes, Mon Sed 23-37 Mins	32	16	$1,995.00	$1,995.00	$738.15	$1,795.50	$1,600.99	2026-06-08
7080000036_1	CDM	Anes, Mon Sed 38-52 Mins	32	16	$2,618.00	$2,618.00	$968.66	$2,356.20	$2,100.95	2026-06-08
7080000037_1	CDM	Anes, Mon Sed 53-67 Mins	32	16	$3,241.00	$3,241.00	$1,199.17	$2,916.90	$2,600.90	2026-06-08
7080000031_1	CDM	Anes, Mon Sed 68-82 Mins	32	16	$3,863.00	$3,863.00	$1,429.31	$3,476.70	$3,100.06	2026-06-08
7080000034_1	CDM	Anes, Mon Sed 83-97 Mins	32	16	$4,486.00	$4,486.00	$1,659.82	$4,037.40	$3,600.02	2026-06-08
7080000043_1	CDM	Anes, Mon Sed 98-112mins	32	16	$5,109.00	$5,109.00	$1,890.33	$4,598.10	$4,099.98	2026-06-08
15275	HCPCS	Application Of Skin Substitute Graft To Wound Of Face, Scalp, Eyelids, Mouth, Ne…	110	20	$3,471.00	$3,471.00	$86.36	$10,597.87	$2,235.17	2026-06-08
20611	HCPCS	Aspiration And/or Injection Of Fluid Large Joint Using Ultrasound Guidance	40	20	$5,400.75	$5,400.75	$1,998.28	$4,860.68	$3,196.39	2026-06-08
43249	HCPCS	Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…	78	20	$6,249.00	$6,249.00	$138.49	$5,624.10	$2,312.13	2026-06-08
43233	HCPCS	Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…	76	20	$6,249.00	$6,249.00	$192.74	$5,624.10	$2,312.13	2026-06-08
52204	HCPCS	Biopsy Of Bladder Using An Endoscope	78	20	$6,828.50	$6,828.50	$130.61	$8,498.52	$2,526.55	2026-06-08
43239	HCPCS	Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop…	78	20	$4,025.00	$4,025.00	$125.46	$5,264.05	$1,489.25	2026-06-08
45380	HCPCS	Biopsy Of Large Bowel Using A Flexible Endoscope	78	20	$4,410.00	$4,410.00	$39.09	$5,378.89	$1,631.70	2026-06-08
58558	HCPCS	Biopsy Of Lining Of Uterus And/or Removal Of Polyp Using An Endoscope	40	20	$11,242.00	$11,242.00	$4,159.54	$12,685.46	$9,246.55	2026-06-08
27040	HCPCS	Biopsy Of Surface Tissue Of Pelvis And Hip	78	20	$5,671.00	$5,671.00	$184.43	$9,767.30	$2,098.27	2026-06-08
38510	HCPCS	Biopsy Or Removal Of Deep Lymph Nodes Of Neck	78	20	$12,635.00	$12,635.00	$188.20	$17,345.49	$4,674.95	2026-06-08
38525	HCPCS	Biopsy Or Removal Of Deep Lymph Nodes Of Underarm	76	20	$10,129.00	$10,129.00	$446.25	$17,345.49	$3,747.73	2026-06-08
38531	HCPCS	Biopsy Or Removal Of Lymph Nodes Of Groin	76	20	$12,033.00	$12,033.00	$449.39	$17,345.49	$4,452.21	2026-06-08
85060	HCPCS	Blood Smear Interpretation By Physician With Written Report	40	20	$5,228.75	$5,228.75	$26.26	$4,705.88	$2,928.10	2026-06-08
85097	HCPCS	Bone Marrow, Smear Interpretation	40	20	$2,240.00	$2,240.00	$828.80	$2,902.48	$1,842.40	2026-06-08
35556	HCPCS	Bypass Of Diseased Or Blocked Upper To Lower Leg Artery With Vein	36	18	$3,959.00	$3,959.00	$1,275.13	$3,563.10	$1,500.85	2026-06-08
335	OTHER	Chemo Adm Infusion Ea Addtl Hr	1	1	$195.25	$195.25	$1,834.53	$1,834.53	$1,834.53	2026-07-30
66982	HCPCS	Complex Removal Of Cataract With Insertion Of Prosthetic Lens	40	20	$7,017.00	$7,017.00	$2,596.29	$9,315.76	$5,771.48	2026-06-08
45382	HCPCS	Control Of Bleeding Of Upper Large Bowel Using A Flexible Endoscope	78	20	$4,410.00	$4,410.00	$231.11	$5,378.89	$1,631.70	2026-06-08
28299	HCPCS	Correction Of Bunion With 2 Areas Of Realignment	110	20	$9,005.00	$9,005.00	$282.65	$29,742.86	$7,384.10	2026-06-08
28295	HCPCS	Correction Of Bunion With Alignment Correction Of Midfoot Bone Toward Ankle	78	20	$13,129.00	$13,129.00	$189.48	$29,742.86	$4,857.73	2026-06-08
28289	HCPCS	Correction Of Rigid Deformity Of First Joint Of Big Toe	40	20	$10,419.00	$10,419.00	$3,855.03	$29,742.86	$8,569.63	2026-06-08
28285	HCPCS	Correction Of Toe Joint Deformity	78	20	$10,940.00	$10,940.00	$247.44	$11,664.79	$4,047.80	2026-06-08
52353	HCPCS	Crushing Of Stone Of Ureter Using An Endoscope	76	20	$20,334.50	$20,334.50	$268.16	$18,301.05	$7,523.77	2026-06-08
52356	HCPCS	Crushing Of Stone Of Ureter With Insertion Of Stent Using An Endoscope	76	20	$20,334.50	$20,334.50	$378.12	$22,129.78	$7,523.77	2026-06-08
52317	HCPCS	Crushing, Fragmenting, And Removal Of Bladder Stones, Less Than 2.5 Cm	78	20	$13,796.00	$13,796.00	$258.24	$12,416.40	$5,104.52	2026-06-08
52318	HCPCS	Crushing, Fragmenting, And Removal Of Bladder Stones, More Than 2.5 Cm	76	20	$13,796.00	$13,796.00	$142.42	$12,416.40	$5,104.52	2026-06-08
74178	HCPCS	CT Scan Of Abdomen And Pelvis Before And After Contrast	78	20	$5,296.00	$5,296.00	$54.27	$4,766.40	$1,659.18	2026-06-08
74177	HCPCS	CT Scan Of Abdomen And Pelvis With Contrast	110	20	$5,160.00	$5,160.00	$84.07	$4,766.40	$1,947.38	2026-06-08
74176	HCPCS	CT Scan Of Abdomen And Pelvis Without Contrast	78	20	$4,893.00	$4,893.00	$79.78	$4,403.70	$1,659.18	2026-06-08
75635	HCPCS	CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast	110	20	$3,492.00	$3,492.00	$78.45	$3,765.60	$1,548.08	2026-06-08
74174	HCPCS	CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	78	20	$5,439.00	$5,439.00	$101.16	$4,895.10	$2,012.43	2026-06-08
74175	HCPCS	CT Scan Of Blood Vessels Of Abdomen With Contrast	78	20	$5,175.00	$5,175.00	$83.46	$4,657.50	$1,914.75	2026-06-08
71275	HCPCS	CT Scan Of Blood Vessels Of Chest With Contrast	78	20	$4,450.00	$4,450.00	$83.77	$4,005.00	$1,646.50	2026-06-08
70498	HCPCS	CT Scan Of Blood Vessels Of Neck With Contrast	78	20	$4,885.00	$4,885.00	$29.48	$4,396.50	$1,807.45	2026-06-08
70482	HCPCS	CT Scan Of Cranial Cavity Before And After Contrast	110	20	$3,358.00	$3,358.00	$58.18	$3,657.60	$1,503.68	2026-06-08
73702	HCPCS	CT Scan Of Leg Before And After Contrast	158	20	$3,294.00	$3,294.00	$55.90	$5,389.20	$1,659.18	2026-06-08
73701	HCPCS	CT Scan Of Leg With Contrast Material	158	20	$3,160.00	$3,160.00	$53.60	$5,169.60	$1,659.18	2026-06-08
103995_1	CDM	Cyanokit 5gm Vial 250ml	32	16	$2,159.00	$2,159.00	$798.83	$1,943.10	$1,732.60	2026-06-08
58670	HCPCS	Destruction Of Fallopian Tubes Using An Endoscope	40	20	$16,845.00	$16,845.00	$6,232.65	$23,122.23	$13,855.01	2026-06-08
46930	HCPCS	Destruction Of Internal Hemorrhoids Using Heat	78	20	$4,029.00	$4,029.00	$147.87	$7,849.82	$1,520.54	2026-06-08
58353	HCPCS	Destruction Of Lining Of Uterus	40	20	$8,277.00	$8,277.00	$3,062.49	$12,685.46	$6,807.84	2026-06-08
52214	HCPCS	Destruction Of Tissue Of Bladder, Urethra, Or Surrounding Glands Using An Endosc…	78	20	$13,796.00	$13,796.00	$158.00	$12,416.40	$5,104.52	2026-06-08
360	OTHER	Diagnostic Brush/wash Colonoscopy	2	1	$2,922.25	$2,922.25	$1,909.12	$2,935.57	$2,422.35	2026-07-30
49320	HCPCS	Diagnostic Exam Of Abdomen Using An Endoscope	40	20	$16,666.00	$16,666.00	$6,166.42	$19,950.47	$13,707.78	2026-06-08
45990	HCPCS	Diagnostic Exam Of Anus And Rectum Under Anesthesia	76	20	$8,994.00	$8,994.00	$103.59	$8,094.60	$3,327.78	2026-06-08
52351	HCPCS	Diagnostic Exam Of Bladder, Urethra, And Ureter Or Kidney Using An Endoscope	76	20	$13,796.00	$13,796.00	$67.80	$12,416.40	$5,104.52	2026-06-08
10140	HCPCS	Drainage Of Blood Or Fluid Accumulation	110	20	$3,481.00	$3,481.00	$25.49	$5,855.13	$2,039.44	2026-06-08
21501	HCPCS	Drainage Of Deep Abscess Or Blood Accumulation In Soft Tissue Of Neck Or Chest	78	20	$10,445.00	$10,445.00	$328.45	$12,637.64	$3,864.65	2026-06-08
830500855_1	CDM	Epifix 18 Mm Disk	32	16	$2,057.00	$2,057.00	$761.09	$1,851.30	$1,650.74	2026-06-08
830500856_1	CDM	Epifix 2Cm X 2Cm	32	16	$2,957.00	$2,957.00	$1,094.09	$2,661.30	$2,372.99	2026-06-08
830500857_1	CDM	Epifix 2Cm X 3Cm	32	16	$3,434.00	$3,434.00	$1,270.58	$3,090.60	$2,755.78	2026-06-08
830500858_1	CDM	Epifix 2Cm X 4Cm	32	16	$3,857.00	$3,857.00	$1,427.09	$3,471.30	$3,095.24	2026-06-08
830500859_1	CDM	Epifix 4Cm X 4Cm	32	16	$8,987.00	$8,987.00	$3,325.19	$8,088.30	$7,212.07	2026-06-08
830500860_1	CDM	Epifix 5Cm X 6Cm	32	16	$17,087.00	$17,087.00	$6,322.19	$15,378.30	$13,712.32	2026-06-08
6230000023_1	CDM	ER Procedure Lv4	32	16	$1,924.00	$1,924.00	$711.88	$1,731.60	$1,544.01	2026-06-08
58563	HCPCS	Exam Of Uterus With Destruction Of Lining Of Uterus Using An Endoscope	40	20	$17,432.00	$17,432.00	$6,449.84	$15,688.80	$12,685.46	2026-06-08
52287	HCPCS	Exam With Injections Of Chemical For Destruction Of Bladder Using An Endoscope	78	20	$8,194.00	$8,194.00	$154.41	$8,498.52	$3,031.78	2026-06-08
46924	HCPCS	Extensive Destruction Of Growth Of Anus	78	20	$9,599.00	$9,599.00	$174.35	$8,639.10	$3,551.63	2026-06-08
11771	HCPCS	Extensive Removal Of Cyst Of Tailbone	78	20	$9,495.00	$9,495.00	$69.70	$9,757.11	$3,513.15	2026-06-08
88184	HCPCS	Flow Cytometry Technique For DNA Or Cell Analysis, First Marker	40	20	$5,228.75	$5,228.75	$806.66	$4,705.88	$2,928.10	2026-06-08
94003	HCPCS	Follow-up Inpatient Or Observation Ventilation Assistance And Management	40	20	$2,047.00	$2,047.00	$757.39	$5,771.64	$1,683.66	2026-06-08
28750	HCPCS	Fusion Of Big Toe At Joint With Foot	78	20	$21,879.00	$21,879.00	$59.45	$29,742.86	$8,095.23	2026-06-08
81445	HCPCS	Genomic Sequence Analysis Panel Of DNA Or Combined DNA And RNA Of 5-50 Genes Ass…	72	20	$1,831.00	$1,831.00	$677.47	$2,297.70	$1,510.58	2026-06-08
81455	HCPCS	Genomic Sequence Analysis Panel Of DNA Or Combined DNA And RNA Of 51 Or More Gen…	40	20	$12,616.00	$12,616.00	$4,667.92	$11,354.40	$10,312.13	2026-06-08
110085_1	CDM	HyperRabImmunoglobulin10MLVial	32	16	$9,519.78	$9,519.78	$3,522.32	$8,567.80	$7,639.62	2026-06-08
49568	HCPCS	Implantation Of Mesh Or Other Prosthesis For Open Incisional Or Ventral Hernia R…	32	16	$9,261.00	$9,261.00	$3,426.57	$8,334.90	$7,431.95	2026-06-08
51040	HCPCS	Incision Of Bladder With Drainage	76	20	$8,194.00	$8,194.00	$274.03	$8,498.52	$3,031.78	2026-06-08
28270	HCPCS	Incision Of Joint Capsule Of Foot And Toe	78	20	$12,035.00	$12,035.00	$315.15	$11,664.79	$4,452.95	2026-06-08
28022	HCPCS	Incision Of Midfoot Joint For Exploration, Fluid Drainage, Or Removal Of Foreign…	40	20	$12,035.00	$12,035.00	$4,452.95	$11,664.79	$9,898.79	2026-06-08
28308	HCPCS	Incision Or Partial Removal Of Foot Bone (other Than Big Toe) To Straighten Toe	78	20	$12,035.00	$12,035.00	$369.69	$11,664.79	$4,452.95	2026-06-08
94002	HCPCS	Initial Hospital Inpatient Or Observation Ventilation Assistance And Management	40	20	$2,204.00	$2,204.00	$815.48	$5,771.64	$1,812.79	2026-06-08
49594	HCPCS	Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length	66	20	$19,156.00	$19,156.00	$736.04	$23,548.69	$7,087.72	2026-06-08
49592	HCPCS	Initial Repair Of Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length	66	20	$19,156.00	$19,156.00	$469.74	$23,548.69	$7,087.72	2026-06-08
49596	HCPCS	Initial Repair Of Entrapped Hernia Of Abdomen, More Than 10 Cm In Length	66	20	$21,072.00	$21,072.00	$1,010.66	$23,548.69	$7,796.64	2026-06-08
49593	HCPCS	Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length	66	20	$13,018.00	$13,018.00	$565.11	$23,548.69	$4,816.66	2026-06-08
49591	HCPCS	Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length	66	20	$13,018.00	$13,018.00	$337.41	$23,548.69	$4,816.66	2026-06-08
49595	HCPCS	Initial Repair Of Sliding Hernia Of Abdomen, More Than 10 Cm In Length	66	20	$13,018.00	$13,018.00	$354.70	$23,548.69	$4,816.66	2026-06-08
45381	HCPCS	Injection Beneath Lining Of Large Bowel Using A Flexible Endoscope	78	20	$4,410.00	$4,410.00	$181.44	$5,378.89	$1,631.70	2026-06-08
47531	HCPCS	Injection Of Bile Duct For X-ray Through Already Existing Skin Access Using Imag…	78	20	$11,825.00	$11,825.00	$63.15	$10,642.50	$4,375.25	2026-06-08
J0129	HCPCS	Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…	40	20	$4,058.00	$4,058.00	$1,501.46	$9,773.18	$3,337.70	2026-06-08
J0490	HCPCS	Injection, Belimumab, 10 Mg	72	20	$4,946.00	$4,946.00	$575.35	$6,882.46	$1,830.02	2026-06-08
J9034	HCPCS	Injection, Bendamustine Hcl (bendeka), 1 Mg	40	20	$7,437.00	$7,437.00	$2,751.69	$9,773.18	$6,116.93	2026-06-08
J9033	HCPCS	Injection, Bendamustine Hydrochloride, 1 Mg	72	20	$8,201.00	$8,201.00	$786.62	$9,773.18	$3,034.37	2026-06-08
J0517	HCPCS	Injection, Benralizumab, 1 Mg	40	20	$16,550.00	$16,550.00	$6,123.50	$19,434.26	$13,612.38	2026-06-08
J9035	HCPCS	Injection, Bevacizumab, 10 Mg	72	20	$2,491.00	$2,491.00	$921.67	$9,773.18	$3,575.68	2026-06-08
J9041	HCPCS	Injection, Bortezomib, 0.1 Mg	40	20	$4,909.00	$4,909.00	$1,599.21	$4,418.10	$2,749.04	2026-06-08
J9043	HCPCS	Injection, Cabazitaxel, 1 Mg	40	20	$43,822.33	$43,822.33	$16,214.26	$39,440.10	$27,874.15	2026-06-08
J0630	HCPCS	Injection, Calcitonin Salmon, Up To 400 Units	72	20	$9,408.00	$9,408.00	$2,959.65	$8,467.20	$6,599.22	2026-06-08
J9047	HCPCS	Injection, Carfilzomib, 1 Mg	104	20	$5,320.80	$5,320.80	$657.16	$9,640.42	$3,963.28	2026-06-08
J9119	HCPCS	Injection, Cemiplimab-rwlc, 1 Mg	40	20	$30,993.45	$30,993.45	$11,467.58	$27,894.11	$24,196.21	2026-06-08
J0840	HCPCS	Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram	40	20	$9,609.00	$9,609.00	$3,555.33	$38,571.80	$7,903.41	2026-06-08
J0875	HCPCS	Injection, Dalbavancin, 5 Mg	40	20	$4,900.00	$4,900.00	$1,813.00	$19,434.26	$4,030.25	2026-06-08
J9145	HCPCS	Injection, Daratumumab, 10 Mg	64	16	$4,066.00	$4,066.00	$619.75	$5,811.30	$1,948.30	2026-06-08
J9144	HCPCS	Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj	72	20	$27,456.00	$27,456.00	$10,127.27	$24,710.40	$20,627.28	2026-06-08
J0881	HCPCS	Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use)	184	20	$4,659.00	$4,659.00	$349.21	$10,462.50	$2,479.94	2026-06-08
J9155	HCPCS	Injection, Degarelix, 1 Mg	72	20	$3,801.00	$3,801.00	$851.74	$3,420.90	$1,847.36	2026-06-08
J0897	HCPCS	Injection, Denosumab, 1 Mg	80	20	$6,678.00	$6,678.00	$1,741.96	$7,783.20	$4,119.50	2026-06-08
Q2050	HCPCS	Injection, Doxorubicin Hydrochloride, Liposomal, Not Otherwise Specified, 10 Mg	72	20	$8,185.00	$8,185.00	$1,137.75	$7,366.50	$3,021.24	2026-06-08
J9173	HCPCS	Injection, Durvalumab, 10 Mg	72	20	$2,779.00	$2,779.00	$1,028.23	$10,134.00	$4,166.20	2026-06-08
J3032	HCPCS	Injection, Eptinezumab-jjmr, 1 Mg	40	20	$4,767.83	$4,767.83	$1,764.10	$5,278.55	$3,921.54	2026-06-08
J9179	HCPCS	Injection, Eribulin Mesylate, 0.1 Mg	80	20	$4,181.75	$4,181.75	$1,523.85	$6,882.46	$3,397.76	2026-06-08
J9358	HCPCS	Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg	40	20	$7,418.00	$7,418.00	$2,744.66	$9,773.18	$6,101.31	2026-06-08
J1439	HCPCS	Injection, Ferric Carboxymaltose, 1 Mg	40	20	$3,864.00	$3,864.00	$1,429.68	$3,477.60	$2,631.01	2026-06-08
Q0138	HCPCS	Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd …	40	20	$2,732.00	$2,732.00	$1,010.84	$2,458.80	$1,529.92	2026-06-08
J0870	HCPCS	Injection, Imetelstat, 1 Mg	32	16	$30,556.55	$30,556.55	$11,305.92	$27,500.90	$24,521.63	2026-06-08
J1569	HCPCS	Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),…	208	20	$3,648.00	$3,648.00	$166.50	$13,091.40	$2,132.38	2026-06-08
J1561	HCPCS	Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)…	200	20	$4,118.00	$4,118.00	$157.62	$14,781.60	$1,763.62	2026-06-08
J1306	HCPCS	Injection, Inclisiran, 1 Mg	40	20	$9,887.00	$9,887.00	$3,658.19	$9,773.18	$8,132.06	2026-06-08
J1745	HCPCS	Injection, Infliximab, Excludes Biosimilar, 10 Mg	40	20	$3,519.00	$3,519.00	$1,302.03	$5,278.55	$2,894.38	2026-06-08
Q5104	HCPCS	Injection, Infliximab-abda, Biosimilar, (renflexis), 10 Mg	40	20	$2,276.00	$2,276.00	$842.12	$5,278.55	$1,872.01	2026-06-08
Q5103	HCPCS	Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg	40	20	$2,854.00	$2,854.00	$1,055.98	$5,278.55	$2,347.41	2026-06-08
J9228	HCPCS	Injection, Ipilimumab, 1 Mg	72	20	$22,605.00	$22,605.00	$8,363.85	$64,890.00	$26,677.00	2026-06-08
J1930	HCPCS	Injection, Lanreotide, 1 Mg	40	20	$28,701.00	$28,701.00	$10,619.37	$25,830.90	$23,606.58	2026-06-08
J0896	HCPCS	Injection, Luspatercept-aamt, 0.25 Mg	72	20	$36,307.25	$36,307.25	$4,481.62	$38,571.80	$13,433.68	2026-06-08
J9299	HCPCS	Injection, Nivolumab, 1 Mg	136	20	$9,093.00	$9,093.00	$1,368.26	$24,196.21	$7,501.73	2026-06-08
J9301	HCPCS	Injection, Obinutuzumab, 10 Mg	40	20	$35,843.84	$35,843.84	$13,262.22	$32,259.46	$25,001.89	2026-06-08
J2350	HCPCS	Injection, Ocrelizumab, 1 Mg	40	20	$53,406.00	$53,406.00	$19,760.22	$117,204.87	$43,926.43	2026-06-08
J2353	HCPCS	Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg	104	20	$13,066.00	$13,066.00	$1,790.43	$24,196.21	$7,308.45	2026-06-08
J2357	HCPCS	Injection, Omalizumab, 5 Mg	40	20	$4,169.88	$4,169.88	$1,542.86	$6,882.46	$3,429.73	2026-06-08
J9264	HCPCS	Injection, Paclitaxel Protein-bound Particles, 1 Mg	40	20	$4,840.18	$4,840.18	$1,790.87	$6,882.46	$3,981.05	2026-06-08
J9303	HCPCS	Injection, Panitumumab, 10 Mg	104	20	$5,190.00	$5,190.00	$1,634.29	$19,434.26	$4,268.77	2026-06-08
J2506	HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	40	20	$19,269.00	$19,269.00	$7,129.53	$17,342.10	$11,823.43	2026-06-08
Q5120	HCPCS	Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg	40	20	$11,792.00	$11,792.00	$4,363.04	$10,612.80	$9,698.92	2026-06-08
Q5111	HCPCS	Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg	40	20	$12,540.00	$12,540.00	$4,639.80	$11,286.00	$9,773.18	2026-06-08
J9271	HCPCS	Injection, Pembrolizumab, 1 Mg	40	20	$16,126.00	$16,126.00	$5,966.62	$38,571.80	$13,263.64	2026-06-08
J9305	HCPCS	Injection, Pemetrexed, Not Otherwise Specified, 10 Mg	40	20	$2,122.00	$2,122.00	$785.14	$6,882.46	$1,745.35	2026-06-08
J9306	HCPCS	Injection, Pertuzumab, 1 Mg	40	20	$19,040.05	$19,040.05	$7,044.82	$19,434.26	$15,660.44	2026-06-08
J9309	HCPCS	Injection, Polatuzumab Vedotin-piiq, 1 Mg	40	20	$41,390.10	$41,390.10	$15,314.34	$38,571.80	$34,043.35	2026-06-08
J2783	HCPCS	Injection, Rasburicase, 0.5 Mg	40	20	$15,661.00	$15,661.00	$5,794.57	$14,094.90	$10,524.55	2026-06-08
J9312	HCPCS	Injection, Rituximab, 10 Mg	72	20	$2,919.00	$2,919.00	$1,080.03	$19,434.26	$5,251.41	2026-06-08
Q5115	HCPCS	Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg	72	20	$12,783.25	$12,783.25	$975.56	$11,504.93	$4,729.80	2026-06-08
J3111	HCPCS	Injection, Romosozumab-aqqg, 1 Mg	40	20	$6,713.00	$6,713.00	$2,483.81	$6,041.70	$5,278.55	2026-06-08
J9317	HCPCS	Injection, Sacituzumab Govitecan-hziy, 2.5 Mg	40	20	$7,311.58	$7,311.58	$2,705.28	$6,580.42	$5,152.49	2026-06-08
J3101	HCPCS	Injection, Tenecteplase, 1 Mg	40	20	$11,430.00	$11,430.00	$4,229.10	$24,196.21	$9,401.17	2026-06-08
J9355	HCPCS	Injection, Trastuzumab, Excludes Biosimilar, 10 Mg	40	20	$4,775.25	$4,775.25	$1,766.84	$9,773.18	$3,927.64	2026-06-08
J3380	HCPCS	Injection, Vedolizumab, Intravenous, 1 Mg	40	20	$24,544.00	$24,544.00	$9,081.28	$24,196.21	$20,187.44	2026-06-08
36561	HCPCS	Insertion Of Central Venous Tube With Port (5 Years Or Older)	78	20	$9,266.00	$9,266.00	$31.36	$11,565.62	$3,428.42	2026-06-08
36563	HCPCS	Insertion Of Central Venous Tube With Pump	78	20	$17,555.00	$17,555.00	$122.34	$15,799.50	$6,495.35	2026-06-08
52332	HCPCS	Insertion Of Stent In Ureter Using An Endoscope	78	20	$13,796.00	$13,796.00	$143.28	$12,416.40	$5,104.52	2026-06-08
43246	HCPCS	Insertion Of Stomach Tube Using A Flexible Endoscope	76	20	$6,096.00	$6,096.00	$184.43	$5,486.40	$2,255.52	2026-06-08
36569	HCPCS	Insertion Of Tube For Infusion (5 Years Or Older)	72	20	$2,643.00	$2,643.00	$977.91	$5,988.79	$2,180.48	2026-06-08
J9217	HCPCS	Leuprolide Acetate (for Depot Suspension), 7.5 Mg	104	20	$17,525.00	$17,525.00	$1,739.53	$15,782.40	$6,488.32	2026-06-08
J9218	HCPCS	Leuprolide Acetate, Per 1 Mg	32	16	$5,435.28	$5,435.28	$2,011.05	$4,891.75	$4,361.81	2026-06-08
7010000631_1	CDM	Mds Fish Panel	32	16	$2,770.00	$2,770.00	$1,024.90	$2,493.00	$2,222.93	2026-06-08
830501410_1	CDM	Mesh 6 Inch Bard	32	16	$2,232.00	$2,232.00	$825.84	$2,008.80	$1,791.18	2026-06-08
830501411_1	CDM	Mesh 6x8 Inch Bard	32	16	$2,595.00	$2,595.00	$960.15	$2,335.50	$2,082.49	2026-06-08
830501412_1	CDM	Mesh 7x9 Inch Bard	32	16	$3,615.00	$3,615.00	$1,337.55	$3,253.50	$2,901.04	2026-06-08
830501413_1	CDM	Mesh 8 Inch Bard	32	16	$3,720.00	$3,720.00	$1,376.40	$3,348.00	$2,985.30	2026-06-08
830501414_1	CDM	Mesh 8x10 Inch Bard	32	16	$4,380.00	$4,380.00	$1,620.60	$3,942.00	$3,514.95	2026-06-08
88377	HCPCS	Microscopic Genetic Analysis Of Tissue, Manual, Each Additional Multiplex Stain …	40	20	$2,761.00	$2,761.00	$718.07	$2,484.90	$1,546.16	2026-06-08
81479	HCPCS	Molecular Pathology Procedure	40	20	$7,843.16	$7,843.16	$206.17	$7,058.84	$4,392.17	2026-06-08
81405	HCPCS	Molecular Pathology Procedure Level 6 Genetic Analysis	40	20	$7,843.16	$7,843.16	$729.05	$7,058.84	$4,392.17	2026-06-08
73220	HCPCS	MRI Scan Of Arm Before And After Contrast	118	20	$4,511.00	$4,511.00	$43.00	$4,059.90	$1,804.40	2026-06-08
73223	HCPCS	MRI Scan Of Arm Joint Before And After Contrast	118	20	$4,175.00	$4,175.00	$37.04	$3,757.50	$1,670.00	2026-06-08
73222	HCPCS	MRI Scan Of Arm Joint With Contrast	158	20	$2,659.00	$2,659.00	$74.94	$2,393.10	$1,914.48	2026-06-08
74185	HCPCS	MRI Scan Of Blood Vessels Of Abdomen	78	20	$4,329.00	$4,329.00	$82.83	$3,896.10	$1,601.73	2026-06-08
73225	HCPCS	MRI Scan Of Blood Vessels Of Arm	78	20	$4,347.00	$4,347.00	$22.09	$3,912.30	$1,608.39	2026-06-08
71555	HCPCS	MRI Scan Of Blood Vessels Of Chest	78	20	$4,761.00	$4,761.00	$82.39	$4,284.90	$1,761.57	2026-06-08
70546	HCPCS	MRI Scan Of Blood Vessels Of Head Before And After Contrast	78	20	$5,576.00	$5,576.00	$28.70	$5,018.40	$2,063.12	2026-06-08
73725	HCPCS	MRI Scan Of Blood Vessels Of Leg	118	20	$4,347.00	$4,347.00	$79.68	$3,912.30	$1,738.80	2026-06-08
70547	HCPCS	MRI Scan Of Blood Vessels Of Neck Without Contrast	40	20	$3,625.50	$3,625.50	$1,341.44	$3,262.95	$2,683.76	2026-06-08
72198	HCPCS	MRI Scan Of Blood Vessels Of Pelvis	78	20	$4,761.00	$4,761.00	$40.80	$4,284.90	$1,761.57	2026-06-08
70543	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast	78	20	$4,960.00	$4,960.00	$28.39	$4,464.00	$1,835.20	2026-06-08
71552	HCPCS	MRI Scan Of Chest Before And After Contrast	78	20	$5,163.00	$5,163.00	$89.06	$4,646.70	$1,910.31	2026-06-08
73723	HCPCS	MRI Scan Of Leg Joint Before And After Contrast	118	20	$4,175.00	$4,175.00	$70.72	$3,757.50	$1,670.00	2026-06-08
72158	HCPCS	MRI Scan Of Lower Spinal Canal Before And After Contrast	78	20	$4,421.00	$4,421.00	$42.04	$3,978.90	$1,635.77	2026-06-08
72149	HCPCS	MRI Scan Of Lower Spinal Canal With Contrast	110	20	$3,897.00	$3,897.00	$82.03	$4,854.60	$1,995.78	2026-06-08
72157	HCPCS	MRI Scan Of Middle Spinal Canal Before And After Contrast	78	20	$4,271.00	$4,271.00	$72.03	$3,843.90	$1,580.27	2026-06-08
72147	HCPCS	MRI Scan Of Middle Spinal Canal With Contrast	78	20	$4,137.00	$4,137.00	$70.00	$3,723.30	$1,530.69	2026-06-08
72156	HCPCS	MRI Scan Of Upper Spinal Canal Before And After Contrast	78	20	$4,392.00	$4,392.00	$85.66	$3,952.80	$1,625.04	2026-06-08
830501463_1	CDM	Myosure Lite Tissue Remvl Dev	32	16	$2,085.00	$2,085.00	$771.45	$1,876.50	$1,673.22	2026-06-08
830501464_1	CDM	Myosure Reach Tissue Remvl Dev	32	16	$3,465.00	$3,465.00	$1,282.05	$3,118.50	$2,780.66	2026-06-08
60100	HCPCS	Needle Biopsy Of Thyroid Through Skin	40	20	$1,938.00	$1,938.00	$717.06	$3,727.17	$1,594.01	2026-06-08
830501543_1	CDM	Novasure	32	16	$2,905.00	$2,905.00	$1,074.85	$2,614.50	$2,331.26	2026-06-08
78452	HCPCS	Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect	40	20	$7,195.00	$7,195.00	$2,662.15	$6,475.50	$4,992.15	2026-06-08
78451	HCPCS	Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect	40	20	$3,115.00	$3,115.00	$1,152.55	$4,803.89	$2,562.09	2026-06-08
78472	HCPCS	Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit…	40	20	$4,392.00	$4,392.00	$1,625.04	$3,952.80	$2,583.95	2026-06-08
78708	HCPCS	Nuclear Medicine Study Of Kidney, Blood, Flow, And Function With Drug Administra…	78	20	$4,623.00	$4,623.00	$54.13	$4,160.70	$1,710.51	2026-06-08
78579	HCPCS	Nuclear Medicine Study Of Lung Ventilation	78	20	$4,673.00	$4,673.00	$22.48	$4,803.89	$1,729.01	2026-06-08
78582	HCPCS	Nuclear Medicine Study Of Lung Ventilation And Circulation	78	20	$4,472.00	$4,472.00	$48.54	$4,803.89	$1,654.64	2026-06-08
78800	HCPCS	Nuclear Medicine Study, 1 Area	78	20	$11,392.00	$11,392.00	$30.22	$10,252.80	$4,215.04	2026-06-08
78830	HCPCS	Nuclear Medicine Study, Spect Imaging With Concurrent CT Scan, 1 Area Or Single …	78	20	$5,222.00	$5,222.00	$7.98	$4,803.89	$1,932.14	2026-06-08
78802	HCPCS	Nuclear Medicine Study, Whole Body	78	20	$13,808.00	$13,808.00	$35.76	$12,427.20	$4,803.89	2026-06-08
19301	HCPCS	Partial Removal Of Breast	76	20	$10,129.00	$10,129.00	$460.18	$17,755.49	$3,747.73	2026-06-08
7015000012_1	CDM	Plasmapheresis	32	16	$2,686.00	$2,686.00	$993.82	$2,417.40	$2,155.52	2026-06-08
P9055	HCPCS	Platelets, Leukocytes Reduced, Cmv-negative, Apheresis/pheresis, Each Unit	40	20	$1,820.00	$1,820.00	$673.40	$1,638.00	$1,496.95	2026-06-08
P9034	HCPCS	Platelets, Pheresis, Each Unit	40	20	$1,809.00	$1,809.00	$669.33	$1,628.10	$1,487.91	2026-06-08
P9053	HCPCS	Platelets, Pheresis, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit	40	20	$2,076.00	$2,076.00	$768.12	$1,868.40	$1,507.49	2026-06-08
P9037	HCPCS	Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit	40	20	$2,091.00	$2,091.00	$773.67	$1,881.90	$1,507.49	2026-06-08
P9073	HCPCS	Platelets, Pheresis, Pathogen-reduced, Each Unit	40	20	$2,036.00	$2,036.00	$753.32	$1,832.40	$1,507.49	2026-06-08
830502591_1	CDM	Pod Ez Clip Fixation Device	32	16	$4,221.00	$4,221.00	$1,561.77	$3,798.90	$3,387.35	2026-06-08
830502956_1	CDM	Pod Lag Ortholoc 3.5x26	32	16	$1,912.00	$1,912.00	$707.44	$1,720.80	$1,534.38	2026-06-08
830502983_1	CDM	Pod Lag Ortholoc 3.5x32	32	16	$2,078.00	$2,078.00	$768.86	$1,870.20	$1,667.60	2026-06-08
830502595_1	CDM	Pod Left Ortholoc	32	16	$7,515.50	$7,515.50	$2,780.74	$6,763.95	$6,031.19	2026-06-08
830502955_1	CDM	Pod Mtp Right Ortholoc	32	16	$14,170.75	$14,170.75	$5,243.18	$12,753.68	$11,372.03	2026-06-08
830502957_1	CDM	Pod Ortholoc Plating System	32	16	$4,258.75	$4,258.75	$1,575.74	$3,832.88	$3,417.65	2026-06-08
830502602_1	CDM	Pod Pro-dense 5cc	32	16	$9,549.00	$9,549.00	$3,533.13	$8,594.10	$7,663.08	2026-06-08
830502958_1	CDM	Pod Reamer 18mm	32	16	$2,130.75	$2,130.75	$788.38	$1,917.68	$1,709.93	2026-06-08
830502959_1	CDM	Pod Reamer 20mm	32	16	$2,130.75	$2,130.75	$788.38	$1,917.68	$1,709.93	2026-06-08
830502639_1	CDM	Pod Right Ortholoc	32	16	$12,939.00	$12,939.00	$4,787.43	$11,645.10	$10,383.55	2026-06-08
830502890_1	CDM	Pod Smart Toe 2- 15mm Angled	32	16	$3,693.00	$3,693.00	$1,366.41	$3,323.70	$2,963.64	2026-06-08
830502891_1	CDM	Pod Smart Toe Dip 13mm	32	16	$3,693.00	$3,693.00	$1,366.41	$3,323.70	$2,963.64	2026-06-08
830503002_1	CDM	Pod Stravix Pl Umb Tissue	32	16	$2,730.00	$2,730.00	$1,010.10	$2,457.00	$2,190.82	2026-06-08
42831	HCPCS	Primary Removal Of Adenoids (12 Years Or Older)	40	20	$17,392.00	$17,392.00	$6,435.04	$15,652.80	$11,677.65	2026-06-08
42830	HCPCS	Primary Removal Of Adenoids (younger Than 12 Years)	40	20	$12,012.00	$12,012.00	$4,444.44	$10,833.05	$9,879.87	2026-06-08
64721	HCPCS	Release And/or Relocation Of Hand Nerve	78	20	$6,292.00	$6,292.00	$312.53	$7,348.90	$2,328.04	2026-06-08
28240	HCPCS	Release Or Lengthening Of Tendon In Foot	78	20	$10,419.00	$10,419.00	$275.06	$11,664.79	$3,855.03	2026-06-08
28039	HCPCS	Removal (1.5 Centimeters Or Greater) Tissue Growth Beneath The Skin Of Foot Or T…	40	20	$9,042.00	$9,042.00	$3,345.54	$11,664.79	$7,437.05	2026-06-08
44970	HCPCS	Removal Of Appendix Using An Endoscope	76	20	$18,432.00	$18,432.00	$606.30	$20,833.56	$6,819.84	2026-06-08
11626	HCPCS	Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha…	78	20	$5,249.00	$5,249.00	$21.10	$9,757.11	$1,942.13	2026-06-08
66984	HCPCS	Removal Of Cataract With Insertion Of Prosthetic Lens	40	20	$4,427.00	$4,427.00	$1,637.99	$9,315.76	$3,641.21	2026-06-08
20680	HCPCS	Removal Of Deep Implant From Bone	78	20	$9,400.00	$9,400.00	$177.28	$12,635.29	$3,478.00	2026-06-08
46320	HCPCS	Removal Of External Hemorrhoid With Blood Clot	78	20	$4,029.00	$4,029.00	$109.53	$7,849.82	$1,490.73	2026-06-08
25111	HCPCS	Removal Of First Cyst Of Wrist	76	20	$5,602.00	$5,602.00	$295.13	$7,120.77	$2,072.74	2026-06-08
47600	HCPCS	Removal Of Gallbladder	76	20	$7,021.00	$7,021.00	$1,066.43	$29,592.74	$3,693.60	2026-06-08
47562	HCPCS	Removal Of Gallbladder Using An Endoscope	76	20	$16,756.00	$16,756.00	$664.60	$18,740.10	$6,199.72	2026-06-08
47605	HCPCS	Removal Of Gallbladder With X-ray Study Of Bile Ducts	76	20	$11,901.00	$11,901.00	$1,122.67	$29,592.74	$4,403.37	2026-06-08
47563	HCPCS	Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope	76	20	$16,159.00	$16,159.00	$721.16	$18,740.10	$5,978.83	2026-06-08
19125	HCPCS	Removal Of Growth Of Breast Identified By X-ray Marker, First Growth	78	20	$10,129.00	$10,129.00	$460.10	$9,116.10	$3,747.73	2026-06-08
68110	HCPCS	Removal Of Growth Of Eyelid Lining, 1.0 Cm Or Less	40	20	$8,166.00	$8,166.00	$3,021.42	$7,349.40	$5,689.96	2026-06-08
40812	HCPCS	Removal Of Growth Of Mouth With Simple Repair	78	20	$5,102.00	$5,102.00	$166.70	$9,920.56	$1,887.74	2026-06-08
21552	HCPCS	Removal Of Growth Of Soft Tissue Under Skin Of Neck Or Front Of Chest, 3.0 Cm Or…	76	20	$10,018.00	$10,018.00	$442.82	$12,637.64	$3,706.66	2026-06-08
21931	HCPCS	Removal Of Growth Under Skin Of Back Or Lower Sides, 3.0 Cm Or More	76	20	$4,590.00	$4,590.00	$469.66	$9,767.30	$1,698.30	2026-06-08
21012	HCPCS	Removal Of Growth Under Skin Of Face Or Scalp, 2.0 Cm Or More	76	20	$5,457.00	$5,457.00	$328.17	$9,767.30	$2,019.09	2026-06-08
25075	HCPCS	Removal Of Growth Under Skin Of Forearm Or Wrist, Less Than 3.0 Cm	78	20	$4,590.00	$4,590.00	$308.75	$9,273.43	$1,698.30	2026-06-08
27618	HCPCS	Removal Of Growth Under Skin Of Leg Or Ankle, Less Than 3.0 Cm	78	20	$4,590.00	$4,590.00	$253.13	$9,767.30	$1,698.30	2026-06-08
21555	HCPCS	Removal Of Growth Under Skin Of Neck Or Front Of Chest, Less Than 3.0 Cm	78	20	$5,671.00	$5,671.00	$300.73	$12,637.64	$2,098.27	2026-06-08
24075	HCPCS	Removal Of Growth Under Skin Of Upper Arm Or Elbow, Less Than 3.0 Cm	78	20	$4,590.00	$4,590.00	$324.29	$9,767.30	$1,698.30	2026-06-08
46250	HCPCS	Removal Of Multiple External Hemorrhoids	78	20	$9,405.00	$9,405.00	$71.40	$12,278.21	$3,479.85	2026-06-08
46230	HCPCS	Removal Of Multiple External Noncancer Growths Of Anus	78	20	$9,405.00	$9,405.00	$59.37	$8,464.50	$3,479.85	2026-06-08
46260	HCPCS	Removal Of Multiple Hemorrhoid Groups	76	20	$9,405.00	$9,405.00	$88.48	$12,278.21	$3,479.85	2026-06-08
11404	HCPCS	Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm	78	20	$5,512.00	$5,512.00	$99.88	$6,601.03	$2,039.44	2026-06-08
11423	HCPCS	Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3…	78	20	$5,512.00	$5,512.00	$83.34	$6,601.03	$2,039.44	2026-06-08
11424	HCPCS	Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4…	78	20	$5,249.00	$5,249.00	$100.43	$6,601.03	$1,942.13	2026-06-08
11426	HCPCS	Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More …	78	20	$9,042.00	$9,042.00	$113.96	$9,757.11	$3,345.54	2026-06-08
58661	HCPCS	Removal Of Ovaries And/or Tubes Using An Endoscope	40	20	$16,260.00	$16,260.00	$6,016.20	$23,122.23	$13,373.85	2026-06-08
43251	HCPCS	Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…	78	20	$6,249.00	$6,249.00	$176.25	$5,624.10	$2,312.13	2026-06-08
43250	HCPCS	Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…	78	20	$5,726.00	$5,726.00	$156.91	$5,264.05	$2,118.62	2026-06-08
45384	HCPCS	Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec…	78	20	$4,410.00	$4,410.00	$210.49	$5,378.89	$1,631.70	2026-06-08
45385	HCPCS	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S…	78	20	$4,410.00	$4,410.00	$228.04	$5,378.89	$1,631.70	2026-06-08
46255	HCPCS	Removal Of Single External And Internal Hemorrhoid Group	78	20	$9,628.00	$9,628.00	$71.40	$12,278.21	$3,562.36	2026-06-08
55250	HCPCS	Removal Of Sperm Duct	78	20	$8,194.00	$8,194.00	$217.81	$12,915.15	$3,031.78	2026-06-08
42826	HCPCS	Removal Of Tonsils (12 Years Or Older)	40	20	$12,589.00	$12,589.00	$4,657.93	$11,330.10	$10,354.45	2026-06-08
42825	HCPCS	Removal Of Tonsils (younger Than 12 Years)	40	20	$14,456.00	$14,456.00	$5,348.72	$13,010.40	$10,833.05	2026-06-08
42821	HCPCS	Removal Of Tonsils And Adenoid Glands (12 Years Or Older)	40	20	$10,957.00	$10,957.00	$4,054.09	$10,833.05	$9,012.14	2026-06-08
42820	HCPCS	Removal Of Tonsils And Adenoid Glands (younger Than 12 Years)	40	20	$13,555.00	$13,555.00	$5,015.35	$12,199.50	$10,833.05	2026-06-08
52352	HCPCS	Removal Or Manipulation Of Stone In Ureter Or Kidney Using An Endoscope	76	20	$13,796.00	$13,796.00	$58.60	$12,416.40	$5,104.52	2026-06-08
46270	HCPCS	Repair Of Abnormal Anal Drainage Tract	78	20	$9,405.00	$9,405.00	$125.51	$12,278.21	$3,479.85	2026-06-08
46280	HCPCS	Repair Of Abnormal Drainage Tract Around Anal Sphincter	76	20	$8,994.00	$8,994.00	$483.94	$12,278.21	$3,327.78	2026-06-08
49505	HCPCS	Repair Of Groin Hernia (5 Years Or Older)	152	20	$11,823.00	$11,823.00	$298.55	$20,410.20	$4,374.51	2026-06-08
49520	HCPCS	Repair Of Groin Hernia That Is Not Trapped	76	20	$12,397.00	$12,397.00	$453.22	$19,232.79	$4,586.89	2026-06-08
49650	HCPCS	Repair Of Groin Hernia Using An Endoscope	152	20	$16,756.00	$16,756.00	$440.69	$31,728.60	$6,199.72	2026-06-08
49616	HCPCS	Repair Of Recurrent Entrapped Hernia Of Abdomen, 3-10 Cm In Length	66	20	$21,072.00	$21,072.00	$844.92	$23,548.69	$7,796.64	2026-06-08
49614	HCPCS	Repair Of Recurrent Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length	66	20	$21,072.00	$21,072.00	$564.16	$23,548.69	$7,796.64	2026-06-08
49618	HCPCS	Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length	66	20	$21,084.00	$21,084.00	$791.02	$23,548.69	$7,801.08	2026-06-08
49651	HCPCS	Repair Of Recurrent Groin Hernia Using An Endoscope	152	20	$17,628.00	$17,628.00	$112.40	$31,728.60	$6,522.36	2026-06-08
49615	HCPCS	Repair Of Recurrent Sliding Hernia Of Abdomen, 3-10 Cm In Length	66	20	$14,320.00	$14,320.00	$628.69	$23,548.69	$5,298.40	2026-06-08
49613	HCPCS	Repair Of Recurrent Sliding Hernia Of Abdomen, Less Than 3 Cm In Length	66	20	$14,320.00	$14,320.00	$414.83	$23,548.69	$5,298.40	2026-06-08
49617	HCPCS	Repair Of Recurrent Sliding Hernia Of Abdomen, More Than 10 Cm In Length	66	20	$14,320.00	$14,320.00	$537.16	$23,548.69	$5,298.40	2026-06-08
49507	HCPCS	Repair Of Trapped Groin Hernia (5 Years Or Older)	76	20	$22,678.00	$22,678.00	$405.43	$20,410.20	$8,390.86	2026-06-08
49565	HCPCS	Repair Recurrent Incisional Or Ventral Hernia; Reducible	32	16	$16,788.00	$16,788.00	$6,211.56	$15,109.20	$13,472.37	2026-06-08
49585	HCPCS	Repair Umbilical Hernia, Age 5 Years Or Older; Reducible	54	20	$10,395.00	$10,395.00	$58.00	$9,355.50	$3,846.15	2026-06-08
36582	HCPCS	Replacement Of Tunneled Central Venous Tube With Port	78	20	$10,427.00	$10,427.00	$268.81	$11,565.62	$3,857.99	2026-06-08
36597	HCPCS	Repositioning Of Central Venous Tube Using Fluoroscopic Guidance	78	20	$5,454.00	$5,454.00	$54.26	$4,908.60	$2,017.98	2026-06-08
90380	HCPCS	Respiratory Syncytial Virus Antibody, 0.5 Ml Dosage For Injection Into Muscle	40	20	$1,816.75	$1,816.75	$277.71	$5,278.55	$1,494.28	2026-06-08
90381	HCPCS	Respiratory Syncytial Virus Antibody, 1.0 Ml Dosage For Injection Into Muscle	40	20	$1,816.75	$1,816.75	$277.71	$5,278.55	$1,494.28	2026-06-08
42836	HCPCS	Secondary Removal Of Adenoids (12 Years Or Older)	40	20	$15,560.00	$15,560.00	$5,757.20	$14,004.00	$11,018.12	2026-06-08
42835	HCPCS	Secondary Removal Of Adenoids (younger Than 12 Years)	40	20	$15,560.00	$15,560.00	$5,757.20	$14,004.00	$11,018.12	2026-06-08
52310	HCPCS	Simple Removal Of Foreign Body, Stone, Or Stent In Urethra Or Bladder Using An E…	78	20	$8,194.00	$8,194.00	$138.67	$8,498.52	$3,031.78	2026-06-08
46922	HCPCS	Simple Removal Of Growth Of Anus	78	20	$10,389.00	$10,389.00	$135.81	$9,350.10	$3,843.93	2026-06-08
15273	HCPCS	Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Trunk, Arms, Or Legs, 100.…	78	20	$5,995.00	$5,995.00	$180.11	$10,597.87	$2,218.15	2026-06-08
95810	HCPCS	Sleep Study In Sleep Lab (6 Years Or Older)	78	20	$5,817.00	$5,817.00	$89.78	$5,235.30	$2,152.29	2026-06-08
95811	HCPCS	Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older)	78	20	$7,903.00	$7,903.00	$60.65	$7,112.70	$2,924.11	2026-06-08
95805	HCPCS	Sleep Study, Multiple Trials	40	20	$4,863.00	$4,863.00	$1,799.31	$4,376.70	$3,999.82	2026-06-08
830501002_1	CDM	Smart Toe 2 Implant 15MMAngled	32	16	$5,828.00	$5,828.00	$2,156.36	$5,245.20	$4,676.97	2026-06-08
104027_1	CDM	Sodium Nitroprusside 50 Mg/2ml	32	16	$2,658.00	$2,658.00	$983.46	$2,392.20	$2,133.05	2026-06-08
81420	HCPCS	Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque…	40	20	$2,570.00	$2,570.00	$950.90	$2,902.48	$2,113.82	2026-06-08
86366	HCPCS	Test For Muscle-specific Kinase Antibody	32	16	$2,866.00	$2,866.00	$1,060.42	$2,579.40	$2,299.97	2026-06-08
C8929	HCPCS	Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi…	40	20	$4,146.00	$4,146.00	$1,534.02	$3,731.40	$2,674.32	2026-06-08
C8924	HCPCS	Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi…	40	20	$2,342.00	$2,342.00	$866.54	$2,363.53	$1,926.30	2026-06-08
C8930	HCPCS	Transthoracic Echocardiography, With Contrast, Or Without Contrast Followed By W…	40	20	$4,485.00	$4,485.00	$1,659.45	$4,036.50	$2,796.36	2026-06-08
93350	HCPCS	Ultrasound Of Heart During Rest, Exercise And/or Drug-induced Stress With Report	40	20	$4,217.00	$4,217.00	$1,560.29	$3,795.30	$2,699.89	2026-06-08
J3590	HCPCS	Unclassified Biologics	32	16	$27,425.00	$27,425.00	$10,147.25	$24,682.50	$22,008.57	2026-06-08
830503284_1	CDM	Uretero-renoscope	32	16	$2,925.00	$2,925.00	$1,082.25	$2,632.50	$2,347.32	2026-06-08
402	OTHER	US Abdominal Sono	2	1	$1,421.12	$1,421.12	$570.49	$2,594.71	$1,582.60	2026-07-30

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