Price Transparencybeta Hospital negotiated rates

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

SARAH D CULBERTSON MEMORIAL HOSPITAL

Rushville, IL · CCN 141333 · Rates published

9,814 distinct procedures filed
25 distinct payers
72,448 rate rows
2026-05-28 last MRF observed
Data quality

71,792 of 72,448 rate rows are consumer-grade (99.1%)

656 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
template filing: same amount across many unrelated codes — excluded 480
percent-of-charges filed in the dollar field — excluded from medians 91
exceeds 10× this hospital's gross charge — excluded from medians 47
per-diem day rate — not a per-procedure price 32
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://cmhospital.com/media-library/documents/Resources/FULL_CHARGE_MASTER.xlsx
Found on page https://cmhospital.com/patients-and-visitors/billing/pricing
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-17
Content fingerprint 8e9d1bc86b9b4cbb… · 2,094,575 bytes · first seen 2026-05-04

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
J3357
HCPCS 		Ustekinumab, For Subcutaneous Injection, 1 Mg 12 $23,075.95 $77,959.98 $65,192.04 nat. median
$12,959
outlier · 5.0×
12201374
OTHER 		Atezolizumab (tecentriq) 1200 Mg Sdv 5 $16,360.15 $27,682.15 $24,913.94 nat. median
$24,914
1.0× median
12202655
OTHER 		Leuprolide (lupron) Inj 22.5 Mg 5 $15,954.05 $26,995.00 $24,295.50 nat. median
$24,296
1.0× median
12207050
OTHER 		Cabazitaxel (jevtana) 60 Mg Sdv 5 $15,417.12 $26,086.50 $23,477.85 nat. median
$23,478
1.0× median
J9228
HCPCS 		Injection, Ipilimumab, 1 Mg 12 $3,035.59 $60,303.12 $23,075.95 nat. median
$8,184
outlier · 2.8×
J9298
HCPCS 		Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg 12 $10,311.64 $70,118.93 $22,718.43 nat. median
$550
outlier · 41.3×
J1628
HCPCS 		Injection, Guselkumab, 1 Mg 12 $8,925.60 $25,793.21 $19,664.73 nat. median
$196
outlier · 100.1×
12207086
OTHER 		Obinutuzumab (gazyva) Sdv 1000 Mg / 40ml 5 $11,848.25 $20,047.80 $18,043.02 nat. median
$18,043
1.0× median
12207047
OTHER 		Nivolumab (opdivo) 240 Mg Sdv 5 $11,726.24 $19,841.35 $17,857.22 nat. median
$17,857
1.0× median
J2327
HCPCS 		Injection, Risankizumab-rzaa, Intravenous, 1 Mg 12 $7,251.16 $61,791.06 $16,863.17 nat. median
$961
outlier · 17.5×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 12 $7,626.23 $21,692.10 $16,801.97 nat. median
$3,475
outlier · 4.8×
3005910
OTHER 		Tnkase Inj 50 Mg Sdv 5 $10,766.96 $18,218.20 $16,396.38 nat. median
$16,396
1.0× median
12201369
OTHER 		Ramucirumab (cyramza) 500 Mg / 50 Ml Sdv 5 $10,605.35 $17,944.75 $16,150.28 nat. median
$16,150
1.0× median
12207039
OTHER 		Pembrolizumab (keytruda) 100 Mg Sdv 5 $10,558.72 $17,865.85 $16,079.27 nat. median
$16,079
1.0× median
12207048
OTHER 		Somatuline(lanreotide)sd Syr 120mg/0.5ml 5 $10,349.59 $17,512.00 $15,760.80 nat. median
$15,761
1.0× median
J9217
HCPCS 		Leuprolide Acetate (for Depot Suspension), 7.5 Mg 12 $1,040.69 $17,170.38 $14,358.30 nat. median
$1,518
outlier · 9.5×
12207038
OTHER 		Gammagard (immglob) 30 Gm Sdv 5 $9,113.37 $15,420.25 $13,878.23 nat. median
$13,878
1.0× median
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 12 $6,020.00 $14,475.61 $13,263.17 nat. median
$150
outlier · 88.6×
3004495
OTHER 		Leuprolide (lupron) Inj 22.5mg 3 Mo Kit 5 $8,617.34 $14,580.95 $13,122.86 nat. median
$13,123
1.0× median
12207079
OTHER 		Pegfilgrastim (neulasta) Onpro 6mg/0.6ml 5 $8,603.42 $14,557.40 $13,101.66 nat. median
$13,102
1.0× median
3006464
OTHER 		Rituximab (rituxan) Sdv 500mg 5 $8,387.94 $14,192.80 $12,773.52 nat. median
$12,774
1.0× median
12209037
OTHER 		Rituximab (rituxan) 500 Mg/50 Ml Sdv 5 $8,387.94 $14,192.80 $12,773.52 nat. median
$12,774
1.0× median
12208002
OTHER 		Durvalumab (imfinzi) Sdv 500 Mg 5 $7,973.65 $13,491.80 $12,142.62 nat. median
$12,143
1.0× median
12202659
OTHER 		Pegfigrastim (neulasta) Inj 6mg 5 $7,415.34 $12,547.10 $11,292.39 nat. median
$11,292
1.0× median
J9301
HCPCS 		Injection, Obinutuzumab, 10 Mg 12 $5,080.63 $14,475.61 $11,193.56 nat. median
$272
outlier · 41.1×
12207054
OTHER 		Pegfilgrastim (fulphila) Inj 6 Mg 5 $7,147.41 $12,093.75 $10,884.38 nat. median
$10,884
1.0× median
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 12 $4,840.01 $11,626.73 $10,663.43 nat. median
$67
outlier · 159.9×
11407225
OTHER 		Lap Cholecystectomy 4 $10,340.67 $11,489.63 $10,340.67 nat. median
$10,341
1.0× median
11407321
OTHER 		Lap Cholecystectomy Turned Open Chole 4 $10,224.90 $11,361.00 $10,224.90 nat. median
$10,225
1.0× median
11407360
OTHER 		Excision Mass/lymph Node Groin 4 $9,953.10 $11,059.00 $9,953.10 nat. median
$9,953
1.0× median
11407125
OTHER 		Lap Ventral Hernia Repair W/mesh System 4 $9,771.30 $10,857.00 $9,771.30 nat. median
$9,771
1.0× median
11407950
OTHER 		Lap Inguinal Hernia Repair-any 4 $9,771.30 $10,857.00 $9,771.30 nat. median
$9,771
1.0× median
12208008
OTHER 		Pemetrexed (alimta) Sdv 500 Mg 5 $6,344.39 $10,735.00 $9,661.50 nat. median
$9,662
1.0× median
11402643
OTHER 		Lap Appi/open 4 $9,560.70 $10,623.00 $9,560.70 nat. median
$9,561
1.0× median
J0881
HCPCS 		Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use) 12 $1,483.65 $11,377.80 $9,514.40 nat. median
$744
outlier · 12.8×
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 12 $4,719.16 $11,321.35 $9,467.19 nat. median
$1,555
outlier · 6.1×
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 12 $4,702.84 $11,282.20 $9,434.45 nat. median
$2,559
outlier · 3.7×
11455660
OTHER 		Laparoscopic Lysis Of Adhesions 4 $9,306.90 $10,341.00 $9,306.90 nat. median
$9,307
1.0× median
11407224
OTHER 		Lap Cholecyst W/cholang 4 $9,305.10 $10,339.00 $9,305.10 nat. median
$9,305
1.0× median
12201371
OTHER 		Gammagard (immglob) 20 Gm Sdv 5 $6,099.24 $10,320.20 $9,288.18 nat. median
$9,288
1.0× median
11407226
OTHER 		Lap Appendectomy 4 $8,848.80 $9,832.00 $8,848.80 nat. median
$8,849
1.0× median
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 12 $3,968.66 $23,075.95 $8,743.68 nat. median
$254
outlier · 34.4×
12207065
OTHER 		Bevacizumab (avastin) 400 Mg Sdv 5 $5,710.98 $9,663.25 $8,696.93 nat. median
$8,697
1.0× median
90375
HCPCS 		Rabies Immune Globulin For Injection 12 $4,108.14 $9,855.52 $8,241.42 nat. median
$1,039
outlier · 7.9×
11407250
OTHER 		Colectomy 4 $8,159.40 $9,066.00 $8,159.40 nat. median
$8,159
1.0× median
11407350
OTHER 		Enterectomy W/anastomosis Single 4 $8,159.40 $9,066.00 $8,159.40 nat. median
$8,159
1.0× median
11407261
OTHER 		Laparoscopy Diagnostic 4 $8,133.30 $9,037.00 $8,133.30 nat. median
$8,133
1.0× median
J1306
HCPCS 		Injection, Inclisiran, 1 Mg 12 $3,982.88 $9,555.00 $7,990.12 nat. median
$43
outlier · 185.3×
12202666
OTHER 		Pegfilgrastim (neulasta) Inj 6 Mg /0.6ml 5 $5,194.00 $8,788.50 $7,909.65 nat. median
$7,910
1.0× median
3006062
OTHER 		Pegfilgrastim (neulasta) Syr 6 Mg 5 $5,194.00 $8,788.50 $7,909.65 nat. median
$57
outlier · 138.1×

Other procedures at this hospital

Browse this hospital's 9,814 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
J3357 HCPCS Ustekinumab, For Subcutaneous Injection, 1 Mg 12 12 $79,551.00 $71,595.90 $23,075.95 $77,959.98 $65,192.04 2026-05-07
12201374 OTHER Atezolizumab (tecentriq) 1200 Mg Sdv 5 5 $27,682.15 — $16,360.15 $27,682.15 $24,913.94 2026-05-28
12202655 OTHER Leuprolide (lupron) Inj 22.5 Mg 5 5 $26,995.00 — $15,954.05 $26,995.00 $24,295.50 2026-05-28
12207050 OTHER Cabazitaxel (jevtana) 60 Mg Sdv 5 5 $26,086.50 — $15,417.12 $26,086.50 $23,477.85 2026-05-28
J9228 HCPCS Injection, Ipilimumab, 1 Mg 22 12 $7,431.08 $6,687.97 $3,035.59 $60,303.12 $23,075.95 2026-05-07
J9298 HCPCS Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg 12 12 $25,242.70 $22,718.43 $10,311.64 $70,118.93 $22,718.43 2026-05-07
J1628 HCPCS Injection, Guselkumab, 1 Mg 22 12 $21,849.70 $19,664.73 $8,925.60 $25,793.21 $19,664.73 2026-05-07
12207086 OTHER Obinutuzumab (gazyva) Sdv 1000 Mg / 40ml 5 5 $20,047.80 — $11,848.25 $20,047.80 $18,043.02 2026-05-28
12207047 OTHER Nivolumab (opdivo) 240 Mg Sdv 5 5 $19,841.35 — $11,726.24 $19,841.35 $17,857.22 2026-05-28
J2327 HCPCS Injection, Risankizumab-rzaa, Intravenous, 1 Mg 22 12 $17,750.70 $15,975.63 $7,251.16 $61,791.06 $16,863.17 2026-05-07
J3101 HCPCS Injection, Tenecteplase, 1 Mg 22 12 $18,668.85 $16,801.97 $7,626.23 $21,692.10 $16,801.97 2026-05-07
3005910 OTHER Tnkase Inj 50 Mg Sdv 5 5 $18,218.20 — $10,766.96 $18,218.20 $16,396.38 2026-05-28
12201369 OTHER Ramucirumab (cyramza) 500 Mg / 50 Ml Sdv 5 5 $17,944.75 — $10,605.35 $17,944.75 $16,150.28 2026-05-28
12207039 OTHER Pembrolizumab (keytruda) 100 Mg Sdv 5 5 $17,865.85 — $10,558.72 $17,865.85 $16,079.27 2026-05-28
12207048 OTHER Somatuline(lanreotide)sd Syr 120mg/0.5ml 5 5 $17,512.00 — $10,349.59 $17,512.00 $15,760.80 2026-05-28
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 12 12 $17,520.80 $15,768.72 $1,040.69 $17,170.38 $14,358.30 2026-05-07
12207038 OTHER Gammagard (immglob) 30 Gm Sdv 5 5 $15,420.25 — $9,113.37 $15,420.25 $13,878.23 2026-05-28
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 12 12 $14,736.85 $13,263.17 $6,020.00 $14,475.61 $13,263.17 2026-05-07
3004495 OTHER Leuprolide (lupron) Inj 22.5mg 3 Mo Kit 5 5 $14,580.95 — $8,617.34 $14,580.95 $13,122.86 2026-05-28
12207079 OTHER Pegfilgrastim (neulasta) Onpro 6mg/0.6ml 5 5 $14,557.40 — $8,603.42 $14,557.40 $13,101.66 2026-05-28
3006464 OTHER Rituximab (rituxan) Sdv 500mg 5 5 $14,192.80 — $8,387.94 $14,192.80 $12,773.52 2026-05-28
12209037 OTHER Rituximab (rituxan) 500 Mg/50 Ml Sdv 5 5 $14,192.80 — $8,387.94 $14,192.80 $12,773.52 2026-05-28
12208002 OTHER Durvalumab (imfinzi) Sdv 500 Mg 5 5 $13,491.80 — $7,973.65 $13,491.80 $12,142.62 2026-05-28
12202659 OTHER Pegfigrastim (neulasta) Inj 6mg 5 5 $12,547.10 — $7,415.34 $12,547.10 $11,292.39 2026-05-28
J9301 HCPCS Injection, Obinutuzumab, 10 Mg 12 12 $12,437.29 $11,193.56 $5,080.63 $14,475.61 $11,193.56 2026-05-07
12207054 OTHER Pegfilgrastim (fulphila) Inj 6 Mg 5 5 $12,093.75 — $7,147.41 $12,093.75 $10,884.38 2026-05-28
J9306 HCPCS Injection, Pertuzumab, 1 Mg 12 12 $11,848.25 $10,663.43 $4,840.01 $11,626.73 $10,663.43 2026-05-07
11407225 OTHER Lap Cholecystectomy 4 4 $11,489.63 — $10,340.67 $11,489.63 $10,340.67 2026-05-28
11407321 OTHER Lap Cholecystectomy Turned Open Chole 4 4 $11,361.00 — $10,224.90 $11,361.00 $10,224.90 2026-05-28
11407360 OTHER Excision Mass/lymph Node Groin 4 4 $11,059.00 — $9,953.10 $11,059.00 $9,953.10 2026-05-28
11407950 OTHER Lap Inguinal Hernia Repair-any 4 4 $10,857.00 — $9,771.30 $10,857.00 $9,771.30 2026-05-28
11407125 OTHER Lap Ventral Hernia Repair W/mesh System 4 4 $10,857.00 — $9,771.30 $10,857.00 $9,771.30 2026-05-28
12208008 OTHER Pemetrexed (alimta) Sdv 500 Mg 5 5 $10,735.00 — $6,344.39 $10,735.00 $9,661.50 2026-05-28
11402643 OTHER Lap Appi/open 4 4 $10,623.00 — $9,560.70 $10,623.00 $9,560.70 2026-05-28
J0881 HCPCS Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use) 12 12 $11,610.00 $10,449.00 $1,483.65 $11,377.80 $9,514.40 2026-05-07
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 12 12 $11,552.40 $10,397.16 $4,719.16 $11,321.35 $9,467.19 2026-05-07
J2182 HCPCS Injection, Mepolizumab, 1 Mg 12 12 $11,512.45 $10,361.21 $4,702.84 $11,282.20 $9,434.45 2026-05-07
11455660 OTHER Laparoscopic Lysis Of Adhesions 4 4 $10,341.00 — $9,306.90 $10,341.00 $9,306.90 2026-05-28
11407224 OTHER Lap Cholecyst W/cholang 4 4 $10,339.00 — $9,305.10 $10,339.00 $9,305.10 2026-05-28
12201371 OTHER Gammagard (immglob) 20 Gm Sdv 5 5 $10,320.20 — $6,099.24 $10,320.20 $9,288.18 2026-05-28
11407226 OTHER Lap Appendectomy 4 4 $9,832.00 — $8,848.80 $9,832.00 $8,848.80 2026-05-28
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 12 12 $9,715.20 $8,743.68 $3,968.66 $23,075.95 $8,743.68 2026-05-07
12207065 OTHER Bevacizumab (avastin) 400 Mg Sdv 5 5 $9,663.25 — $5,710.98 $9,663.25 $8,696.93 2026-05-28
90375 HCPCS Rabies Immune Globulin For Injection 12 12 $10,056.65 $9,050.99 $4,108.14 $9,855.52 $8,241.42 2026-05-07
11407250 OTHER Colectomy 4 4 $9,066.00 — $8,159.40 $9,066.00 $8,159.40 2026-05-28
11407350 OTHER Enterectomy W/anastomosis Single 4 4 $9,066.00 — $8,159.40 $9,066.00 $8,159.40 2026-05-28
11407261 OTHER Laparoscopy Diagnostic 4 4 $9,037.00 — $8,133.30 $9,037.00 $8,133.30 2026-05-28
J1306 HCPCS Injection, Inclisiran, 1 Mg 12 12 $9,750.00 $8,775.00 $3,982.88 $9,555.00 $7,990.12 2026-05-07
3006062 OTHER Pegfilgrastim (neulasta) Syr 6 Mg 5 5 $8,788.50 — $5,194.00 $8,788.50 $7,909.65 2026-05-28
12202666 OTHER Pegfilgrastim (neulasta) Inj 6 Mg /0.6ml 5 5 $8,788.50 — $5,194.00 $8,788.50 $7,909.65 2026-05-28
3007442 OTHER Denosumab (xgeva) Inj 120 Mg 4 4 $8,568.10 — $7,711.29 $8,568.10 $7,711.29 2026-05-28
12209229 OTHER Denosumab (xgeva) 120 Mg Sdv 5 5 $8,568.10 — $5,063.75 $8,568.10 $7,711.29 2026-05-28
J2783 HCPCS Injection, Rasburicase, 0.5 Mg 12 12 $9,407.15 $8,466.44 $3,842.82 $9,219.01 $7,709.16 2026-05-07
12201372 OTHER Nivolumab (opdivo) 100 Mg Sdv 5 5 $8,325.55 — $4,920.40 $8,325.55 $7,493.00 2026-05-28
61312 HCPCS Removal Of Skull Bone For Aspiration Of Blood Accumulation In Upper Brain Outsid… 19 12 $16,833.00 $15,149.70 $1,394.87 $16,496.34 $7,382.95 2026-05-07
3019393 OTHER Gammagard (immglob) 30 Gm Sdv 5 5 $7,927.00 — $4,684.86 $7,927.00 $7,134.30 2026-05-28
11407500 OTHER .misc Or Serv Outsourced 4 4 $7,831.00 — $7,047.90 $7,831.00 $7,047.90 2026-05-28
11407270 OTHER .cataract Extra W/vitrect 4 4 $7,643.00 — $6,878.70 $7,643.00 $6,878.70 2026-05-28
11466982 OTHER Cataract Complex Ext W/iol Insertion 4 4 $7,643.00 — $6,878.70 $7,643.00 $6,878.70 2026-05-28
11407314 OTHER .cataract Extra Complex W/phaco Req 4 4 $7,599.00 — $6,839.10 $7,599.00 $6,839.10 2026-05-28
11407299 OTHER .cataract Extra W/insert Caps Tens 4 4 $7,587.00 — $6,828.30 $7,587.00 $6,828.30 2026-05-28
11458541 OTHER Hysterectomy Laparoscopic-pf 3 3 $7,587.00 — $6,828.30 $6,828.30 $6,828.30 2026-05-28
11407245 OTHER Hysterectomy Total Abd 4 4 $7,296.00 — $6,566.40 $7,296.00 $6,566.40 2026-05-28
11466984 OTHER Cataract Extraction 4 4 $7,293.00 — $6,563.70 $7,293.00 $6,563.70 2026-05-28
11407301 OTHER Aspiration Cortex-retained Lens Material 4 4 $7,293.00 — $6,563.70 $7,293.00 $6,563.70 2026-05-28
11407217 OTHER .cataract 4 4 $7,293.00 — $6,563.70 $7,293.00 $6,563.70 2026-05-28
11407347 OTHER Vitrectomy Ant Approach Partial 4 4 $7,292.00 — $6,562.80 $7,292.00 $6,562.80 2026-05-28
11458150 OTHER Hysterectomy Abd Total-pf 3 3 $7,182.00 — $6,463.80 $6,463.80 $6,463.80 2026-05-28
12208004 OTHER Romiplostim (nplate) Sdv 250 Mcg / 0.5ml 5 5 $7,118.75 — $4,207.18 $7,118.75 $6,406.88 2026-05-28
11407219 OTHER Lap Ovarian Cystectomy 4 4 $6,881.00 — $6,192.90 $6,881.00 $6,192.90 2026-05-28
20021935 OTHER Rad Rescj Tum S 4 4 $6,820.50 — $6,138.45 $6,820.50 $6,138.45 2026-05-28
11458260 OTHER Hysterectomy Vaginal Any-pf 3 3 $6,803.00 — $6,122.70 $6,122.70 $6,122.70 2026-05-28
J9173 HCPCS Injection, Durvalumab, 10 Mg 12 12 $7,101.85 $6,391.67 $2,901.11 $6,959.81 $6,119.28 2026-05-07
C1713 HCPCS Anchor/screw For Opposing Bone-to-bone Or Soft Tissue-to-bone (implantable) 10 10 $6,679.00 $6,011.10 $2,728.37 $6,545.42 $6,011.10 2026-05-07
11444140 OTHER Colectomy Part W/anast-pf 3 3 $6,617.00 — $5,955.30 $5,955.30 $5,955.30 2026-05-28
J2356 HCPCS Injection, Tezepelumab-ekko, 1 Mg 12 12 $6,345.15 $5,710.64 $2,591.99 $6,218.25 $5,710.64 2026-05-07
11407211 OTHER .ahmed Valve Placement 4 4 $6,202.00 — $5,581.80 $6,202.00 $5,581.80 2026-05-28
12201384 OTHER Darbepoetin Alfa (aranesp) Inj 500 Mcg 5 5 $6,188.75 — $3,657.55 $6,188.75 $5,569.88 2026-05-28
J9299 HCPCS Injection, Nivolumab, 1 Mg 22 12 $13,049.75 $11,744.78 $1,122.51 $14,475.61 $5,527.22 2026-05-07
2000410 OTHER CT Ivp Abd / Pelvis Ww/o 4 4 $6,135.00 — $5,521.50 $6,135.00 $5,521.50 2026-05-28
2000300 OTHER CT Abd/pelvis Ww/o Contrast 4 4 $6,131.00 — $5,517.90 $6,131.00 $5,517.90 2026-05-28
11428825 OTHER Amputation Toe Interphalangeal Joint 4 4 $5,902.00 — $5,311.80 $5,902.00 $5,311.80 2026-05-28
12201382 OTHER Carfilzomib (kyprolis) Sdv 60 Mg 5 5 $5,845.00 — $3,454.40 $5,845.00 $5,260.50 2026-05-28
11407312 OTHER Hysterectomy Vaginal Any 4 4 $5,822.00 — $5,239.80 $5,822.00 $5,239.80 2026-05-28
11449561 OTHER Hernia Rep Vent Incarc/strng-init-pf 3 3 $5,695.00 — $5,125.50 $5,125.50 $5,125.50 2026-05-28
11449566 OTHER Hernia Rep Ventral Incarc/strng-pf 3 3 $5,695.00 — $5,125.50 $5,125.50 $5,125.50 2026-05-28
11407257 OTHER Cholecyst Open 4 4 $5,626.00 — $5,063.40 $5,626.00 $5,063.40 2026-05-28
11407290 OTHER Salpingo Oophorectomy Comp Uni/bilat 4 4 $5,626.00 — $5,063.40 $5,626.00 $5,063.40 2026-05-28
12207069 OTHER Darbepoetin Alfa (aranesp) Inj 200 Mcg 5 5 $5,582.80 — $3,299.43 $5,582.80 $5,024.52 2026-05-28
Q4195 HCPCS Puraply, Per Square Centimeter 10 10 $5,516.00 $4,964.40 $2,253.29 $5,405.68 $4,964.40 2026-05-07
11407251 OTHER .vad Insertion 4 4 $5,465.00 — $4,918.50 $5,465.00 $4,918.50 2026-05-28
3007498 OTHER Gammagard (immglob) 20 Gm Sdv 5 5 $5,449.00 — $3,220.36 $5,449.00 $4,904.10 2026-05-28
49605 HCPCS Repair Of Large Defect Of Abdominal Wall At Navel 7 7 $1,830.00 $1,647.00 $482.29 $5,808.96 $4,840.80 2026-05-07
12201378 OTHER Daratumumab (darzalex) 400 Mg Sdv 5 5 $5,334.50 — $3,152.69 $5,334.50 $4,801.05 2026-05-28
1207647 OTHER Mds Profile (send To Genoptix) 4 4 $5,300.00 — $4,770.00 $5,300.00 $4,770.00 2026-05-28
11407223 OTHER Trabectulectomy 4 4 $5,287.00 — $4,758.30 $5,287.00 $4,758.30 2026-05-28
20027598 OTHER Disrtcj Kne 4 4 $5,207.00 — $4,686.30 $5,207.00 $4,686.30 2026-05-28
11447564 OTHER Cholecystectomy W/common Duct-pf 3 3 $5,202.00 — $4,681.80 $4,681.80 $4,681.80 2026-05-28
11447563 OTHER Cholecystectomy Open W/cholan-pf 3 3 $5,202.00 — $4,681.80 $4,681.80 $4,681.80 2026-05-28
20027640 OTHER Prtl Exc B1 Tib 4 4 $5,201.00 — $4,680.90 $5,201.00 $4,680.90 2026-05-28
11449565 OTHER Ventral Hernia Recurrent 5+-pf 3 3 $5,173.00 — $4,655.70 $4,655.70 $4,655.70 2026-05-28
2000315 OTHER CT Abd/pelvis W/contrast 4 4 $5,164.00 — $4,647.60 $5,164.00 $4,647.60 2026-05-28
11407369 OTHER Hernia Rep-vent/inc Initl 4 4 $5,158.00 — $4,642.20 $5,158.00 $4,642.20 2026-05-28
11447561 OTHER Cholecystectomy Lap W/cholang-pf 3 3 $5,153.00 — $4,637.70 $4,637.70 $4,637.70 2026-05-28
3007026 OTHER Telavancin (vibativ) Sdv 750 Mg 4 4 $5,118.35 — $4,606.52 $5,118.35 $4,606.52 2026-05-28
11447562 OTHER Cholecystectomy Open-pf 3 3 $5,113.00 — $4,601.70 $4,601.70 $4,601.70 2026-05-28
11447600 OTHER Cholecystectomy Open-pf 3 3 $5,113.00 — $4,601.70 $4,601.70 $4,601.70 2026-05-28
2000220 OTHER CT Angiography Abd 4 4 $5,060.00 — $4,554.00 $5,060.00 $4,554.00 2026-05-28
2000221 OTHER CT Angiography Abdomen And Pelvis 4 4 $5,060.00 — $4,554.00 $5,060.00 $4,554.00 2026-05-28
11457260 OTHER Cystocele/rectocele Comb Repair-pf 3 3 $5,057.00 — $4,551.30 $4,551.30 $4,551.30 2026-05-28
3005264 OTHER Leuprolide 1 Mg/0.2 Ml 5 5 $5,036.10 — $2,976.34 $5,036.10 $4,532.49 2026-05-28
A9521 HCPCS Technetium Tc-99m Exametazime, Diagnostic, Per Study Dose, Up To 25 Millicuries 10 10 $5,026.00 $4,523.40 $2,053.12 $4,925.48 $4,523.40 2026-05-07
27828 HCPCS Treatment Of Broken Lower Weight Bearing Joint Of Both Lower Leg Bones 19 12 $10,298.00 $9,268.20 $567.26 $17,225.30 $4,516.70 2026-05-07
1207558 OTHER Chromosome Microarray, Congenital, Bld 4 4 $4,988.90 — $4,490.01 $4,988.90 $4,490.01 2026-05-28
11407240 OTHER C-section 4 4 $4,947.00 — $4,452.30 $4,947.00 $4,452.30 2026-05-28
35506 HCPCS Bypass Of Diseased Or Blocked Neck To Chest Artery With Vein 19 12 $10,085.00 $9,076.50 $1,266.95 $13,568.35 $4,423.28 2026-05-07
1378488_1 CDM Operating Room Services - General Classification 10 10 $4,818.00 $4,336.20 $1,968.15 $4,721.64 $4,336.20 2026-05-07
1378488_5 CDM Operating Room Services - General Classification 10 10 $4,818.00 $4,336.20 $1,968.15 $4,721.64 $4,336.20 2026-05-07
11402346 OTHER Inguinal Hernia-bilateral 4 4 $4,812.00 — $4,330.80 $4,812.00 $4,330.80 2026-05-28
12201383 OTHER Trastuzumab (herceptin) Sdv 150 Mg 5 5 $4,775.25 — $2,822.17 $4,775.25 $4,297.73 2026-05-28
11444970 OTHER Appendectomy Laparoscopic-pf 3 3 $4,771.00 — $4,293.90 $4,293.90 $4,293.90 2026-05-28
11447560 OTHER Cholecystectomy Lap-pf 3 3 $4,771.00 — $4,293.90 $4,293.90 $4,293.90 2026-05-28
1807500 OTHER Nm Myocardial Perf Spec-mult 4 4 $4,770.00 — $4,293.00 $4,770.00 $4,293.00 2026-05-28
3006891 OTHER Rabies Immune Gobulin Vial 10 Ml 5 5 $4,769.40 — $2,818.72 $4,769.40 $4,292.46 2026-05-28
2000225 OTHER CT Angiography Chest 4 4 $4,743.00 — $4,268.70 $4,743.00 $4,268.70 2026-05-28
12202675 OTHER Bortezomib (velcade) 3.5 Mg Sdv 5 5 $4,740.70 — $2,801.75 $4,740.70 $4,266.63 2026-05-28
11409507 OTHER Hernia Repair Inguinal Incarcerated 4 4 $4,703.00 — $4,232.70 $4,703.00 $4,232.70 2026-05-28
36571 HCPCS Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older) 12 12 $5,150.00 $4,635.00 $2,103.78 $5,047.00 $4,220.43 2026-05-07
3007490 OTHER Gammagard (immglob) 10 Gm Sdv 5 5 $4,675.00 — $2,762.93 $4,675.00 $4,207.50 2026-05-28
11458262 OTHER Salpingo Oophorectomy-pf 3 3 $4,635.00 — $4,171.50 $4,171.50 $4,171.50 2026-05-28
11458662 OTHER Ovarian Cystectomy Laparoscop-pf 3 3 $4,635.00 — $4,171.50 $4,171.50 $4,171.50 2026-05-28
1600048 OTHER MRI Lumbar Sp Ww/o Cont 4 4 $4,619.00 — $4,157.10 $4,619.00 $4,157.10 2026-05-28
3007062 OTHER Denosumab (prolia) Inj 60 Mg 5 5 $4,613.65 — $2,726.67 $4,613.65 $4,152.29 2026-05-28
12207062 OTHER Denosumab (prolia) Sd 60 Mg Inj 5 5 $4,613.65 — $2,726.67 $4,613.65 $4,152.29 2026-05-28
11407889 OTHER Hernia Repair Recurrent Inguinal Uni 4 4 $4,587.00 — $4,128.30 $4,587.00 $4,128.30 2026-05-28
12100200 OTHER Polysomnogram 4+ Split W/cpap 4 4 $4,560.00 — $4,104.00 $4,560.00 $4,104.00 2026-05-28
12100221 OTHER Polysomnogram Splt Night-incomplete 4 4 $4,560.00 — $4,104.00 $4,560.00 $4,104.00 2026-05-28
12100160 OTHER Polysomnogram/titration-incomplete 4 4 $4,560.00 — $4,104.00 $4,560.00 $4,104.00 2026-05-28
11407248 OTHER Closure Colostomy 4 4 $4,557.00 — $4,101.30 $4,557.00 $4,101.30 2026-05-28
20025300 OTHER Trigg Finger Re 4 4 $4,538.00 — $4,084.20 $4,538.00 $4,084.20 2026-05-28
1600036 OTHER MRI Cerv Sp Ww/o Contrast 4 4 $4,536.00 — $4,082.40 $4,536.00 $4,082.40 2026-05-28
1600042 OTHER MRI Thorcic Sp Ww/o Cont 4 4 $4,536.00 — $4,082.40 $4,536.00 $4,082.40 2026-05-28
27236 HCPCS Treatment Of Upper End Of Broken Thigh Bone With Placement Of Stabilizing Device… 19 12 $9,305.00 $8,374.50 $326.82 $17,225.30 $4,081.17 2026-05-07
1600058 OTHER MRI Pelvis Ww/o Cont 4 4 $4,504.00 — $4,053.60 $4,504.00 $4,053.60 2026-05-28
11449550 OTHER Hernia Rep Femoral Intl-pf 3 3 $4,497.00 — $4,047.30 $4,047.30 $4,047.30 2026-05-28
11449560 OTHER Hernia Rep Ventral Intl Reducible 3 3 $4,497.00 — $4,047.30 $4,047.30 $4,047.30 2026-05-28
1600028 OTHER MRI Brain Ww/o Contrast 4 4 $4,479.00 — $4,031.10 $4,479.00 $4,031.10 2026-05-28
1600025 OTHER MRI Low Ext Oth Jnt Ww/o C-rt 4 4 $4,465.00 — $4,018.50 $4,465.00 $4,018.50 2026-05-28
1600202 OTHER MRI Low Ext Oth Jnt Ww/o Con Lt 4 4 $4,465.00 — $4,018.50 $4,465.00 $4,018.50 2026-05-28
1378484_5 CDM Operating Room Services - General Classification 10 10 $4,460.00 $4,014.00 $1,821.91 $4,370.80 $4,014.00 2026-05-07
1378484_1 CDM Operating Room Services - General Classification 10 10 $4,460.00 $4,014.00 $1,821.91 $4,370.80 $4,014.00 2026-05-07
11449654 OTHER Lap Ventral Hernia Rep W/mesh-pf 3 3 $4,408.00 — $3,967.20 $3,967.20 $3,967.20 2026-05-28
1600076 OTHER MRI Upr Ext Jnt Ww/o Cont Rt 4 4 $4,405.00 — $3,964.50 $4,405.00 $3,964.50 2026-05-28
11407221 OTHER Hernia Repair Initial Age 5+ 4 4 $4,363.00 — $3,926.70 $4,363.00 $3,926.70 2026-05-28
20015100 OTHER Splt Agrft T/a/ 4 4 $4,357.00 — $3,921.30 $4,357.00 $3,921.30 2026-05-28
3000473 OTHER .darbepoetin (aranespvial : 300 Mcg. 5 5 $4,337.50 — $2,563.46 $4,337.50 $3,903.75 2026-05-28
12202676 OTHER Paclitaxel Albumin (abraxane) 100 Mg Sdv 5 5 $4,322.70 — $2,554.72 $4,322.70 $3,890.43 2026-05-28
11444950 OTHER Appendectomy Open-pf 3 3 $4,295.00 — $3,865.50 $3,865.50 $3,865.50 2026-05-28
20015120 OTHER Splt Agrft F/s/ 4 4 $4,282.00 — $3,853.80 $4,282.00 $3,853.80 2026-05-28
11459561 OTHER Hernia Rep-ventral Inc/strang-initial 4 4 $4,268.00 — $3,841.20 $4,268.00 $3,841.20 2026-05-28
11408252 OTHER Hernia Rep-ventral Initial 4 4 $4,268.00 — $3,841.20 $4,268.00 $3,841.20 2026-05-28
1600059 OTHER MRI Abd Ww/o Contrast 4 4 $4,223.00 — $3,800.70 $4,223.00 $3,800.70 2026-05-28
28415 HCPCS Treatment Of Broken Heel Bone 19 12 $8,665.00 $7,798.50 $277.75 $17,225.30 $3,800.47 2026-05-07
2000310 OTHER CT Abd/pelvis Without 4 4 $4,190.00 — $3,771.00 $4,190.00 $3,771.00 2026-05-28
3002290 OTHER Vasopressin (vasostrict) 20 Un/ml Mdv 4 4 $4,174.80 — $3,757.32 $4,174.80 $3,757.32 2026-05-28
11407550 OTHER Mastectomy Complete 4 4 $4,169.00 — $3,752.10 $4,169.00 $3,752.10 2026-05-28
11407256 OTHER Mastectomy Part W/lymph 4 4 $4,169.00 — $3,752.10 $4,169.00 $3,752.10 2026-05-28
J2357 HCPCS Injection, Omalizumab, 5 Mg 22 12 $4,248.35 $3,823.52 $1,697.28 $4,163.38 $3,739.41 2026-05-07
12207078 OTHER Injectafer (ferric Carboxy) 750 Mg Sdv 5 5 $4,142.80 — $2,448.39 $4,142.80 $3,728.52 2026-05-28
3007380 OTHER Injectafer (ferric Carb) Inj 750mg/15ml 5 5 $4,142.80 — $2,448.39 $4,142.80 $3,728.52 2026-05-28
20015260 OTHER Fth/gft Fr W/di 4 4 $4,132.00 — $3,718.80 $4,132.00 $3,718.80 2026-05-28
1378487_1 CDM Operating Room Services - General Classification 10 10 $4,130.00 $3,717.00 $1,687.11 $4,047.40 $3,717.00 2026-05-07
1378487_5 CDM Operating Room Services - General Classification 10 10 $4,130.00 $3,717.00 $1,687.11 $4,047.40 $3,717.00 2026-05-07
11407249 OTHER Ovarian Cystectomy-open 4 4 $4,117.00 — $3,705.30 $4,117.00 $3,705.30 2026-05-28
12100220 OTHER Polysomnogram Psg-incomplete 4 4 $4,107.00 — $3,696.30 $4,107.00 $3,696.30 2026-05-28
12100100 OTHER Polysomnogram W/4 Or More Addl Slp Par 4 4 $4,107.00 — $3,696.30 $4,107.00 $3,696.30 2026-05-28
11407331 OTHER Amputation Above The Knee 4 4 $4,086.00 — $3,677.40 $4,086.00 $3,677.40 2026-05-28
11449000 OTHER Laparotomy Exploratory-pf 3 3 $4,062.00 — $3,655.80 $3,655.80 $3,655.80 2026-05-28
2000262 OTHER CT Angiography Aorta-iliofemoral Run-off 4 4 $4,061.00 — $3,654.90 $4,061.00 $3,654.90 2026-05-28
2000260 OTHER CT Angiography Lower Ext 4 4 $4,061.00 — $3,654.90 $4,061.00 $3,654.90 2026-05-28
11458925 OTHER Ovarian Cystectomy Open-pf 3 3 $4,054.00 — $3,648.60 $3,648.60 $3,648.60 2026-05-28
J9312 HCPCS Injection, Rituximab, 10 Mg 22 12 $1,791.15 $1,612.04 $731.68 $11,626.73 $3,623.77 2026-05-07
1600067 OTHER MRI Orbit/face/nck W/wo C 4 4 $3,929.00 — $3,536.10 $3,929.00 $3,536.10 2026-05-28
2000230 OTHER CT Angiography Head 4 4 $3,925.00 — $3,532.50 $3,925.00 $3,532.50 2026-05-28
11407227 OTHER Vasectomy 4 4 $3,914.00 — $3,522.60 $3,914.00 $3,522.60 2026-05-28
11407380 OTHER Excision Spermatocele 4 4 $3,914.00 — $3,522.60 $3,914.00 $3,522.60 2026-05-28
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 32 12 $5,812.20 $5,230.98 $1,095.70 $6,520.37 $3,517.85 2026-05-07
11449587 OTHER Rep Incarcerated Umbilical Hernia 5+-pf 3 3 $3,901.00 — $3,510.90 $3,510.90 $3,510.90 2026-05-28
J0897 HCPCS Injection, Denosumab, 1 Mg 32 12 $4,692.95 $4,223.66 $23.69 $8,459.75 $3,497.22 2026-05-07
20027048 OTHER Exc Tum Pelvis& 4 4 $3,879.00 — $3,491.10 $3,879.00 $3,491.10 2026-05-28
11449507 OTHER Hernia Rep Inguinal Incarcerated-pf 3 3 $3,875.00 — $3,487.50 $3,487.50 $3,487.50 2026-05-28
11403247 OTHER Egd W/fb Removal 4 4 $3,875.00 — $3,487.50 $3,875.00 $3,487.50 2026-05-28
11407901 OTHER Egd W/insert Gw Dil Remov Bx 4 4 $3,867.00 — $3,480.30 $3,867.00 $3,480.30 2026-05-28
12207066 OTHER Rituximab (rituxan) 100 Mg Sdv 5 5 $3,858.10 — $2,280.14 $3,858.10 $3,472.29 2026-05-28
12207045 OTHER Panitumumab (vectibix) 100 Mg Sdv 5 5 $3,843.90 — $2,271.74 $3,843.90 $3,459.51 2026-05-28
20015240 OTHER Fth/gft Fr W/di 4 4 $3,831.00 — $3,447.90 $3,831.00 $3,447.90 2026-05-28
11407254 OTHER Laparotomy Exploratory 4 4 $3,831.00 — $3,447.90 $3,831.00 $3,447.90 2026-05-28
11407430 OTHER Pterygium Excision W/chemocauterization 4 4 $3,831.00 — $3,447.90 $3,831.00 $3,447.90 2026-05-28
1378486_5 CDM Operating Room Services - General Classification 10 10 $3,824.00 $3,441.60 $1,562.10 $3,747.52 $3,441.60 2026-05-07
1378486_1 CDM Operating Room Services - General Classification 10 10 $3,824.00 $3,441.60 $1,562.10 $3,747.52 $3,441.60 2026-05-07
2000210 OTHER CT Angiography Carotid Arteries 4 4 $3,817.00 — $3,435.30 $3,817.00 $3,435.30 2026-05-28
11407340 OTHER Exc Gynecomastia Bilateral 4 4 $3,811.00 — $3,429.90 $3,811.00 $3,429.90 2026-05-28
11407043 OTHER Excision Lipoma Groin >8cm 4 4 $3,789.00 — $3,410.10 $3,789.00 $3,410.10 2026-05-28
27759 HCPCS Treatment Of Broken Part Of Shin Bone With Rod 19 12 $7,741.00 $6,966.90 $343.96 $17,225.30 $3,395.20 2026-05-07
12208006 OTHER Carfilzomib (kyprolis) Sdv 30 Mg 5 5 $3,753.15 — $2,218.11 $3,753.15 $3,377.84 2026-05-28
11449506 OTHER Hernia Rep Inguinal Bilateral-pf 3 3 $3,744.00 — $3,369.60 $3,369.60 $3,369.60 2026-05-28
1600150 OTHER MRA Abd Ww/o Contrast 4 4 $3,737.00 — $3,363.30 $3,737.00 $3,363.30 2026-05-28
1600130 OTHER MRA Low Ext Bilat Ww/o Contrast 4 4 $3,737.00 — $3,363.30 $3,737.00 $3,363.30 2026-05-28
12207070 OTHER Darbepoetin Alfa (aranesp) Inj 300 Mcg 5 5 $3,717.25 — $2,196.89 $3,717.25 $3,345.53 2026-05-28
27823 HCPCS Treatment Of 3 Broken Lower Leg Bones At Ankle With Fixation Of Posterior Lip 19 12 $7,600.00 $6,840.00 $452.26 $17,225.30 $3,333.36 2026-05-07
12201370 OTHER Ramucirumab (cyramza) 100 Mg/10 Ml Sdv 5 5 $3,668.95 — $2,168.35 $3,668.95 $3,302.06 2026-05-28
2000240 OTHER ..ct Ivp 4 4 $3,665.00 — $3,298.50 $3,665.00 $3,298.50 2026-05-28
11407450 OTHER Colonoscopy W/polyp By Snare Tech 4 4 $3,663.00 — $3,296.70 $3,663.00 $3,296.70 2026-05-28
1600117 OTHER MRA Neck Ww/o Contrast 4 4 $3,624.00 — $3,261.60 $3,624.00 $3,261.60 2026-05-28
1600118 OTHER MRA Head Ww/o Contrast 4 4 $3,624.00 — $3,261.60 $3,624.00 $3,261.60 2026-05-28
32556 HCPCS Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube 19 12 $7,977.00 $7,179.30 $117.28 $7,817.46 $3,258.60 2026-05-07
1600057 OTHER MRI Chest Ww/o Contrast 4 4 $3,603.00 — $3,242.70 $3,603.00 $3,242.70 2026-05-28
3006244 OTHER Goserelin (zoladex) Inj 3.6 Mg 5 5 $3,602.95 — $2,129.34 $3,602.95 $3,242.66 2026-05-28
11407460 OTHER Mastectomy Partial W/lympadenopathy 4 4 $3,601.00 — $3,240.90 $3,601.00 $3,240.90 2026-05-28
1600099 OTHER MRI Neck Soft W Without Cont 4 4 $3,572.00 — $3,214.80 $3,572.00 $3,214.80 2026-05-28
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 21 12 $7,316.00 $6,584.40 $31.36 $7,169.68 $3,208.80 2026-05-07
55700 HCPCS Biopsy Of Prostate Gland 13 12 $3,559.00 $3,203.10 $1,453.85 $5,558.94 $3,203.10 2026-05-07
12207042 OTHER Gammagard (immglob) 10 Gm Sdv 5 5 $3,552.10 — $2,099.29 $3,552.10 $3,196.89 2026-05-28
11407366 OTHER Egd W/insert Guidewire & Dilation 4 4 $3,525.00 — $3,172.50 $3,525.00 $3,172.50 2026-05-28
1600062 OTHER MRI Low Ext Jnt W/wo C Rt 4 4 $3,524.00 — $3,171.60 $3,524.00 $3,171.60 2026-05-28
1600208 OTHER MRI Low Ext Jnt W/wo C Lt 4 4 $3,524.00 — $3,171.60 $3,524.00 $3,171.60 2026-05-28
1600213 OTHER MRI Upr Ext Jnt Ww/o Con Lt 4 4 $3,524.00 — $3,171.60 $3,524.00 $3,171.60 2026-05-28
3006954 OTHER Infliximab (remicade) Sdv 100mg 5 5 $3,519.45 — $2,079.99 $3,519.45 $3,167.51 2026-05-28
11407231 OTHER Yag Laser Surg-bilateral 4 4 $3,515.00 — $3,163.50 $3,515.00 $3,163.50 2026-05-28
11419302 OTHER Mastectomy Partial W/lymph Nd-pf 3 3 $3,492.00 — $3,142.80 $3,142.80 $3,142.80 2026-05-28
11407300 OTHER Cystocele Repair 4 4 $3,485.00 — $3,136.50 $3,485.00 $3,136.50 2026-05-28
27222 HCPCS Closed Treatment Of Broken Hip Socket With Manipulation 19 12 $7,671.00 $6,903.90 $940.33 $7,517.58 $3,133.60 2026-05-07
1206403 OTHER ..lymph Prolif Panel For Mitogen & Atg 4 4 $3,477.90 — $3,130.11 $3,477.90 $3,130.11 2026-05-28
11407259 OTHER Appendectomy-open 4 4 $3,460.00 — $3,114.00 $3,460.00 $3,114.00 2026-05-28
11407233 OTHER Colonoscopy W/polyp 4 4 $3,447.00 — $3,102.30 $3,447.00 $3,102.30 2026-05-28
11407375 OTHER Colonoscopy W/forcep Bx 4 4 $3,447.00 — $3,102.30 $3,447.00 $3,102.30 2026-05-28
11407357 OTHER Colonoscopy W/guided Bx 4 4 $3,447.00 — $3,102.30 $3,447.00 $3,102.30 2026-05-28
11407232 OTHER Colonoscopy W/biop 4 4 $3,447.00 — $3,102.30 $3,447.00 $3,102.30 2026-05-28
1600120 OTHER MRA Low Ext Bilateral W/contrast 4 4 $3,441.00 — $3,096.90 $3,441.00 $3,096.90 2026-05-28
12202663 OTHER Decitabine (dacogen) 50 Mg Sdv 5 5 $3,434.50 — $2,029.79 $3,434.50 $3,091.05 2026-05-28
20019302 OTHER Mast Prtl W/ax 4 4 $3,424.00 — $3,081.60 $3,424.00 $3,081.60 2026-05-28
1600054 OTHER MRI Pelvis Without Contrast 4 4 $3,414.00 — $3,072.60 $3,414.00 $3,072.60 2026-05-28
1600029 OTHER MRI Abd Without Contrast 4 4 $3,414.00 — $3,072.60 $3,414.00 $3,072.60 2026-05-28
1600032 OTHER MRI Cerv Sp Without Contrast 4 4 $3,414.00 — $3,072.60 $3,414.00 $3,072.60 2026-05-28
20028465 OTHER Optx Tarsl Fx X 4 4 $3,399.00 — $3,059.10 $3,399.00 $3,059.10 2026-05-28
2000141 OTHER CT Upper Extremity With Contrast 4 4 $3,397.00 — $3,057.30 $3,397.00 $3,057.30 2026-05-28
12201373 OTHER Nivolumab (opdivo) 40 Mg Sdv 5 5 $3,390.20 — $2,003.61 $3,390.20 $3,051.18 2026-05-28
12207052 OTHER Privigen IV Sdv 10 Gm 5 5 $3,385.10 — $2,000.59 $3,385.10 $3,046.59 2026-05-28
11407246 OTHER Bunionectomy-keller Type 4 4 $3,376.00 — $3,038.40 $3,376.00 $3,038.40 2026-05-28
11407243 OTHER Hammer Toe S Repair Ea 4 4 $3,376.00 — $3,038.40 $3,376.00 $3,038.40 2026-05-28
11407213 OTHER .bronchoscopy 4 4 $3,376.00 — $3,038.40 $3,376.00 $3,038.40 2026-05-28
11428820 OTHER Amputation Toe Mp Joint 4 4 $3,376.00 — $3,038.40 $3,376.00 $3,038.40 2026-05-28
11407207 OTHER Egd Upper Gi W/tube Plcmt 4 4 $3,371.00 — $3,033.90 $3,371.00 $3,033.90 2026-05-28
1600210 OTHER MRI Upr Ext Oth Jnt Without C Lt 4 4 $3,368.00 — $3,031.20 $3,368.00 $3,031.20 2026-05-28
1600024 OTHER MRI Brain Without Contrast 4 4 $3,368.00 — $3,031.20 $3,368.00 $3,031.20 2026-05-28
11408001 OTHER Colonoscopy W/inject Any Substance 4 4 $3,367.00 — $3,030.30 $3,367.00 $3,030.30 2026-05-28
11405382 OTHER Colonoscopy With Control Of Bleeding 4 4 $3,367.00 — $3,030.30 $3,367.00 $3,030.30 2026-05-28
11402250 OTHER Mastectomy Partial 4 4 $3,362.00 — $3,025.80 $3,362.00 $3,025.80 2026-05-28
11446947 OTHER Hemorrhoidopexy-pf 3 3 $3,352.00 — $3,016.80 $3,016.80 $3,016.80 2026-05-28
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 22 12 $3,943.40 $3,549.06 $1,367.96 $3,864.53 $3,013.88 2026-05-07
2000261 OTHER CT Cervical Spine Ww/o 4 4 $3,345.00 — $3,010.50 $3,345.00 $3,010.50 2026-05-28
2000162 OTHER CT Chest Ww/o 4 4 $3,334.00 — $3,000.60 $3,334.00 $3,000.60 2026-05-28
2000161 OTHER CT Abdomen-alone Ww/o 4 4 $3,332.00 — $2,998.80 $3,332.00 $2,998.80 2026-05-28
11419301 OTHER Mastectomy Partial (lumpectomy)-pf 3 3 $3,325.00 — $2,992.50 $2,992.50 $2,992.50 2026-05-28
12208001 OTHER Durvalumab (imfinzi) Sdv 120 Mg 5 5 $3,314.10 — $1,958.63 $3,314.10 $2,982.69 2026-05-28
1600027 OTHER MRI Low Ext Joint Without Con Rt 4 4 $3,294.00 — $2,964.60 $3,294.00 $2,964.60 2026-05-28
1600203 OTHER MRI Low Ext Joint Without Con Lt 4 4 $3,294.00 — $2,964.60 $3,294.00 $2,964.60 2026-05-28
1600201 OTHER MRI Upper Ext Joint Without Con Lt 4 4 $3,294.00 — $2,964.60 $3,294.00 $2,964.60 2026-05-28
1600023 OTHER MRI Upper Ext Joint Without C Rt 4 4 $3,294.00 — $2,964.60 $3,294.00 $2,964.60 2026-05-28
1600060 OTHER MRI Low Ext Oth Jnt Without C-rt 4 4 $3,289.00 — $2,960.10 $3,289.00 $2,960.10 2026-05-28
1600206 OTHER MRI Low Ext Oth Jnt Without C-lt 4 4 $3,289.00 — $2,960.10 $3,289.00 $2,960.10 2026-05-28
12209003 OTHER Bevacizumab (avastin) 100 Mg Sdv 5 5 $3,287.75 — $1,943.06 $3,287.75 $2,958.98 2026-05-28
Q5117 HCPCS Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg 22 12 $6,954.75 $6,259.28 $607.20 $6,815.66 $2,945.68 2026-05-07
11449520 OTHER Hernia Repair Inguinal Recur-pf 3 3 $3,242.00 — $2,917.80 $2,917.80 $2,917.80 2026-05-28
11449571 OTHER Hernia Repair-epigastric 4 4 $3,229.00 — $2,906.10 $3,229.00 $2,906.10 2026-05-28
J0875 HCPCS Injection, Dalbavancin, 5 Mg 12 12 $3,222.45 $2,900.21 $1,316.37 $11,626.73 $2,900.21 2026-05-07
11407284 OTHER Hemorrhoidpoexy 4 4 $3,222.00 — $2,899.80 $3,222.00 $2,899.80 2026-05-28
11407214 OTHER Colonoscopy-complete 4 4 $3,220.00 — $2,898.00 $3,220.00 $2,898.00 2026-05-28
1600280 OTHER MRA Chest Ww/o Contrast 4 4 $3,212.00 — $2,890.80 $3,212.00 $2,890.80 2026-05-28
11457250 OTHER Rectocele Repair-pf 3 3 $3,198.00 — $2,878.20 $2,878.20 $2,878.20 2026-05-28
2000172 OTHER CT Chest Pe 4 4 $3,189.00 — $2,870.10 $3,189.00 $2,870.10 2026-05-28
12207064 OTHER Cyclophosphamide (cytoxan) 1 Gm Sdv 5 5 $3,185.30 — $1,882.51 $3,185.30 $2,866.77 2026-05-28
35226 HCPCS Repair Of Blood Vessel Of Leg 19 12 $6,534.00 $5,880.60 $815.48 $6,839.52 $2,865.81 2026-05-07
11407902 OTHER Exc Cervical Lymph Node(s) 4 4 $3,167.00 — $2,850.30 $3,167.00 $2,850.30 2026-05-28
2600592 OTHER Echo W/contrast Complete 4 4 $3,166.00 — $2,849.40 $3,166.00 $2,849.40 2026-05-28
1600026 OTHER MRI Brain W/contrast 4 4 $3,158.00 — $2,842.20 $3,158.00 $2,842.20 2026-05-28
11407266 OTHER Excision Heel Spur 4 4 $3,155.00 — $2,839.50 $3,155.00 $2,839.50 2026-05-28
1600600 OTHER MRA Low Ext Bilateral Without Contrast 4 4 $3,152.00 — $2,836.80 $3,152.00 $2,836.80 2026-05-28
11407315 OTHER Excision Fb Subcutan Complicated 4 4 $3,152.00 — $2,836.80 $3,152.00 $2,836.80 2026-05-28
11419300 OTHER Exc Gynemastia-bilateral-pf 3 3 $3,125.00 — $2,812.50 $2,812.50 $2,812.50 2026-05-28
11446260 OTHER Hemorrhoidectomy Complex-pf 3 3 $3,121.00 — $2,808.90 $2,808.90 $2,808.90 2026-05-28
11407234 OTHER .ahmed Valve Revision 4 4 $3,103.00 — $2,792.70 $3,103.00 $2,792.70 2026-05-28
1600038 OTHER MRI Thoracic Sp Without Cont 4 4 $3,101.00 — $2,790.90 $3,101.00 $2,790.90 2026-05-28
11407440 OTHER Bone Marrow Biopsy 4 4 $3,095.00 — $2,785.50 $3,095.00 $2,785.50 2026-05-28
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 12 12 $3,090.00 $2,781.00 $1,262.27 $3,582.85 $2,781.00 2026-05-07
36570 HCPCS Insertion Of Central Venous Tube With Port For Infusion (younger Than 5 Years) 12 12 $3,090.00 $2,781.00 $1,262.27 $3,582.85 $2,781.00 2026-05-07
36572 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 12 12 $3,090.00 $2,781.00 $1,262.27 $3,582.85 $2,781.00 2026-05-07
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 22 12 $4,631.00 $4,167.90 $1,246.74 $4,538.38 $2,777.32 2026-05-07
27894 HCPCS Incision Of Connective Tissue At Front And/or Side And Back Of Lower Leg To Reli… 19 12 $6,321.00 $5,688.90 $224.70 $13,574.45 $2,772.39 2026-05-07
28615 HCPCS Treatment Of Dislocated Midfoot Bone 19 12 $6,321.00 $5,688.90 $414.79 $17,225.30 $2,772.39 2026-05-07
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