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

FAYETTE COUNTY HOSPITAL

Vandalia, IL · CCN 141346 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This hospital’s price: $578 across 19 payers · range $67-$2,968

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbFCHVANDALIAIL&type=CDMWithoutLabel · observed 2026-04-08

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

4,369 distinct procedures filed
19 distinct payers
79,547 rate rows
2026-04-08 last MRF observed
Data quality

78,854 of 79,547 rate rows are consumer-grade (99.1%)

693 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 328
per-diem day rate — not a per-procedure price 230
percent-of-charges filed in the dollar field — excluded from medians 91
exceeds 10× this hospital's gross charge — excluded from medians 36
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbFCHVANDALIAIL&type=CDMWithoutLabel
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint f94ce543a02646d8… · 32,381,887 bytes · first seen 2026-05-08

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
12051142
CDM 		Vngrd Ti Frem Cr 13 $17,061.20 $42,653.00 $35,126.00 nat. median
$35,126
1.0× median
12050195
CDM 		Hip Femoral Stem 13 $14,843.38 $37,108.45 $30,559.90 nat. median
$30,560
1.0× median
12050736
CDM 		Type I Taper 10x140mm 13 $13,336.33 $33,340.83 $27,457.15 nat. median
$27,457
1.0× median
12050941
CDM 		Type1 Tapr 15x150 Mm 13 $13,069.09 $32,672.73 $26,906.95 nat. median
$26,907
1.0× median
12050802
CDM 		Femrl Stem 13 $13,069.09 $32,672.73 $26,906.95 nat. median
$26,907
1.0× median
12050763
CDM 		Complt Primry Fem 14x148 13 $12,701.38 $31,753.45 $26,149.90 nat. median
$26,150
1.0× median
12051181
CDM 		10x40 Tprloc Pri Fem Tpl 13 $12,446.72 $31,116.80 $25,625.60 nat. median
$25,626
1.0× median
12051187
CDM 		9x137mm Hi Offset Typ1 Tp 13 $12,446.72 $31,116.80 $25,625.60 nat. median
$25,626
1.0× median
12051184
CDM 		Hi Ofset Type 1 Tapr 13 $12,446.72 $31,116.80 $25,625.60 nat. median
$25,626
1.0× median
12051066
CDM 		Type 1 Taper 11 X 42 Mm 13 $12,446.72 $31,116.80 $25,625.60 nat. median
$25,626
1.0× median
12051134
CDM 		Type 1 Tapr 6x132mm Primry Fem 13 $12,446.72 $31,116.80 $25,625.60 nat. median
$25,626
1.0× median
12051063
CDM 		Type 1 Taper 16 X 152mm 13 $12,446.72 $31,116.80 $25,625.60 nat. median
$25,626
1.0× median
12050726
CDM 		Echo Por Fmrl Nc 12x140 13 $12,397.25 $30,993.13 $25,523.75 nat. median
$25,524
1.0× median
12050699
CDM 		Echo Por Fmrl Lat Nc13x45 13 $11,767.40 $29,418.50 $24,227.00 nat. median
$24,227
1.0× median
12050767
CDM 		Alliancr X-series 12x140 13 $11,138.06 $27,845.15 $22,931.30 nat. median
$22,931
1.0× median
12050783
CDM 		Fem Postirir Sz 6 Right 13 $11,044.05 $27,610.13 $22,737.75 nat. median
$22,738
1.0× median
12050789
CDM 		Femrl Post Size 5 Right 13 $11,044.05 $27,610.13 $22,737.75 nat. median
$22,738
1.0× median
12050934
CDM 		Fem Sz3 Rt Posterior Stbl 13 $11,044.05 $27,610.13 $22,737.75 nat. median
$22,738
1.0× median
12051041
CDM 		Femrl Size 4 Right 13 $11,044.05 $27,610.13 $22,737.75 nat. median
$22,738
1.0× median
12050499
CDM 		Humeral Stem W/porocoat 13 $10,795.68 $26,989.20 $22,226.40 nat. median
$22,226
1.0× median
12051179
CDM 		Fem Post Stablized Sz 4 Rt 13 $10,518.24 $26,295.60 $21,655.20 nat. median
$21,655
1.0× median
12050719
CDM 		Femrl Crucate Sz 2 Left 13 $10,459.76 $26,149.40 $21,534.80 nat. median
$21,535
1.0× median
12053061
CDM 		Retaining Device Tibial 13 $10,444.29 $26,110.73 $21,502.95 nat. median
$21,503
1.0× median
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 19 $8,730.06 $27,928.54 $20,706.06 nat. median
$3,787
outlier · 5.5×
12050658
CDM 		Denovo 13 $10,022.01 $25,055.03 $20,633.55 nat. median
$20,634
1.0× median
12051114
CDM 		Vangrd Ps Opn Intl Fem Lft 62.5mm 13 $8,962.06 $22,405.15 $18,451.30 nat. median
$18,451
1.0× median
12051193
CDM 		Vngrd Ps Opn In Fem Rt 60 13 $8,962.06 $22,405.15 $18,451.30 nat. median
$18,451
1.0× median
12051191
CDM 		Vangrd 70mm Rt Opn Bx Fem 13 $8,962.06 $22,405.15 $18,451.30 nat. median
$18,451
1.0× median
12051075
CDM 		Vangrd 62.5mm Rt Bx Fem 13 $8,962.06 $22,405.15 $18,451.30 nat. median
$18,451
1.0× median
12051097
CDM 		Ps Open Intl Fem-lt 72.5 13 $8,962.06 $22,405.15 $18,451.30 nat. median
$18,451
1.0× median
12051112
CDM 		Ps Opn Bx Fem Rt 65mm 13 $8,962.06 $22,405.15 $18,451.30 nat. median
$18,451
1.0× median
12051092
CDM 		Vngrd 65mm Left Eem 13 $8,962.06 $22,405.15 $18,451.30 nat. median
$18,451
1.0× median
12051071
CDM 		Van Open Intl Fem Lt 65mm 13 $8,962.06 $22,405.15 $18,451.30 nat. median
$18,451
1.0× median
J1438
HCPCS 		Injection, Etanercept, 25 Mg (code May Be Used For Medicare When Drug Administer… 19 $1,090.07 $23,718.40 $18,137.60 nat. median
$1,670
outlier · 10.9×
12053100
CDM 		Evolve Radial 13 $8,575.14 $21,437.85 $17,654.70 nat. median
$17,655
1.0× median
12051221
CDM 		Femrl 67.5mm Left Vngrd Ps Opn Bx Biomet 13 $8,535.19 $21,337.98 $17,572.45 nat. median
$17,572
1.0× median
12051207
CDM 		Vngrd Ps Opn Bx Fem 67.5mm Rt Intrlok 13 $8,535.19 $21,337.98 $17,572.45 nat. median
$17,572
1.0× median
12051215
CDM 		Vngrd Ps Opn Bx Fem 75mm Left Ntrlk Rmet 13 $8,535.19 $21,337.98 $17,572.45 nat. median
$17,572
1.0× median
12051213
CDM 		Vngrd Ps Opn Bx Fem 75mm Rt Interlok 13 $8,535.19 $21,337.98 $17,572.45 nat. median
$17,572
1.0× median
12050991
CDM 		Postir Stblizd Femur 13 $8,427.41 $21,068.53 $17,350.55 nat. median
$17,351
1.0× median
12050790
CDM 		Tib Fry Mod Cocr 4 13 $8,273.22 $20,683.05 $17,033.10 nat. median
$17,033
1.0× median
12050785
CDM 		Tib Try Mod Cocr 5 13 $8,273.22 $20,683.05 $17,033.10 nat. median
$17,033
1.0× median
12050937
CDM 		Tib Tray Mod Cocr 3 13 $8,273.22 $20,683.05 $17,033.10 nat. median
$17,033
1.0× median
12051139
CDM 		Vngrd Ps Open Bx Fem Biomet 13 $8,128.55 $20,321.38 $16,735.25 nat. median
$16,735
1.0× median
12051223
CDM 		Phasix Mesh 6x8 Rectngl Bard 13 $8,055.79 $20,139.48 $16,585.45 nat. median
$16,585
1.0× median
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 19 $8,554.23 $21,385.58 $16,353.68 nat. median
$155
outlier · 105.8×
12050734
CDM 		Ceramic Head 16/18 Taper 13 $7,705.93 $19,264.83 $15,865.15 nat. median
$15,865
1.0× median
12053063
CDM 		Retaining Device Femoral 13 $7,145.61 $17,864.03 $14,711.55 nat. median
$14,712
1.0× median
J0517
HCPCS 		Injection, Benralizumab, 1 Mg 19 $7,011.94 $19,108.00 $14,612.00 nat. median
$919
outlier · 15.9×
3061018
CDM 		Simponi 100 Mg/ml Pen Injector 13 $6,871.74 $17,179.35 $14,147.70 nat. median
$14,148
1.0× median

Other procedures at this hospital

Browse this hospital's 4,369 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
             
12051142 CDM Vngrd Ti Frem Cr 13 13 $50,180.00 $50,180.00 $17,061.20 $42,653.00 $35,126.00 2026-04-08
12050195 CDM Hip Femoral Stem 13 13 $43,657.00 $43,657.00 $14,843.38 $37,108.45 $30,559.90 2026-04-08
12050736 CDM Type I Taper 10x140mm 13 13 $39,224.50 $39,224.50 $13,336.33 $33,340.83 $27,457.15 2026-04-08
12050941 CDM Type1 Tapr 15x150 Mm 13 13 $38,438.50 $38,438.50 $13,069.09 $32,672.73 $26,906.95 2026-04-08
12050802 CDM Femrl Stem 13 13 $38,438.50 $38,438.50 $13,069.09 $32,672.73 $26,906.95 2026-04-08
12050763 CDM Complt Primry Fem 14x148 13 13 $37,357.00 $37,357.00 $12,701.38 $31,753.45 $26,149.90 2026-04-08
12051181 CDM 10x40 Tprloc Pri Fem Tpl 13 13 $36,608.00 $36,608.00 $12,446.72 $31,116.80 $25,625.60 2026-04-08
12051184 CDM Hi Ofset Type 1 Tapr 13 13 $36,608.00 $36,608.00 $12,446.72 $31,116.80 $25,625.60 2026-04-08
12051063 CDM Type 1 Taper 16 X 152mm 13 13 $36,608.00 $36,608.00 $12,446.72 $31,116.80 $25,625.60 2026-04-08
12051187 CDM 9x137mm Hi Offset Typ1 Tp 13 13 $36,608.00 $36,608.00 $12,446.72 $31,116.80 $25,625.60 2026-04-08
12051066 CDM Type 1 Taper 11 X 42 Mm 13 13 $36,608.00 $36,608.00 $12,446.72 $31,116.80 $25,625.60 2026-04-08
12051134 CDM Type 1 Tapr 6x132mm Primry Fem 13 13 $36,608.00 $36,608.00 $12,446.72 $31,116.80 $25,625.60 2026-04-08
12050726 CDM Echo Por Fmrl Nc 12x140 13 13 $36,462.50 $36,462.50 $12,397.25 $30,993.13 $25,523.75 2026-04-08
12050699 CDM Echo Por Fmrl Lat Nc13x45 13 13 $34,610.00 $34,610.00 $11,767.40 $29,418.50 $24,227.00 2026-04-08
12050767 CDM Alliancr X-series 12x140 13 13 $32,759.00 $32,759.00 $11,138.06 $27,845.15 $22,931.30 2026-04-08
12050934 CDM Fem Sz3 Rt Posterior Stbl 13 13 $32,482.50 $32,482.50 $11,044.05 $27,610.13 $22,737.75 2026-04-08
12051041 CDM Femrl Size 4 Right 13 13 $32,482.50 $32,482.50 $11,044.05 $27,610.13 $22,737.75 2026-04-08
12050789 CDM Femrl Post Size 5 Right 13 13 $32,482.50 $32,482.50 $11,044.05 $27,610.13 $22,737.75 2026-04-08
12050783 CDM Fem Postirir Sz 6 Right 13 13 $32,482.50 $32,482.50 $11,044.05 $27,610.13 $22,737.75 2026-04-08
12050499 CDM Humeral Stem W/porocoat 13 13 $31,752.00 $31,752.00 $10,795.68 $26,989.20 $22,226.40 2026-04-08
12051179 CDM Fem Post Stablized Sz 4 Rt 13 13 $30,936.00 $30,936.00 $10,518.24 $26,295.60 $21,655.20 2026-04-08
12050719 CDM Femrl Crucate Sz 2 Left 13 13 $30,764.00 $30,764.00 $10,459.76 $26,149.40 $21,534.80 2026-04-08
12053061 CDM Retaining Device Tibial 13 13 $30,718.50 $30,718.50 $10,444.29 $26,110.73 $21,502.95 2026-04-08
J3101 HCPCS Injection, Tenecteplase, 1 Mg 32 19 $28,650.00 $28,650.00 $8,730.06 $27,928.54 $20,706.06 2026-04-08
12050658 CDM Denovo 13 13 $29,476.50 $29,476.50 $10,022.01 $25,055.03 $20,633.55 2026-04-08
12051191 CDM Vangrd 70mm Rt Opn Bx Fem 13 13 $26,359.00 $26,359.00 $8,962.06 $22,405.15 $18,451.30 2026-04-08
12051075 CDM Vangrd 62.5mm Rt Bx Fem 13 13 $26,359.00 $26,359.00 $8,962.06 $22,405.15 $18,451.30 2026-04-08
12051097 CDM Ps Open Intl Fem-lt 72.5 13 13 $26,359.00 $26,359.00 $8,962.06 $22,405.15 $18,451.30 2026-04-08
12051112 CDM Ps Opn Bx Fem Rt 65mm 13 13 $26,359.00 $26,359.00 $8,962.06 $22,405.15 $18,451.30 2026-04-08
12051092 CDM Vngrd 65mm Left Eem 13 13 $26,359.00 $26,359.00 $8,962.06 $22,405.15 $18,451.30 2026-04-08
12051193 CDM Vngrd Ps Opn In Fem Rt 60 13 13 $26,359.00 $26,359.00 $8,962.06 $22,405.15 $18,451.30 2026-04-08
12051114 CDM Vangrd Ps Opn Intl Fem Lft 62.5mm 13 13 $26,359.00 $26,359.00 $8,962.06 $22,405.15 $18,451.30 2026-04-08
12051071 CDM Van Open Intl Fem Lt 65mm 13 13 $26,359.00 $26,359.00 $8,962.06 $22,405.15 $18,451.30 2026-04-08
J1438 HCPCS Injection, Etanercept, 25 Mg (code May Be Used For Medicare When Drug Administer… 19 19 $27,904.00 $27,904.00 $1,090.07 $23,718.40 $18,137.60 2026-04-08
12053100 CDM Evolve Radial 13 13 $25,221.00 $25,221.00 $8,575.14 $21,437.85 $17,654.70 2026-04-08
12051213 CDM Vngrd Ps Opn Bx Fem 75mm Rt Interlok 13 13 $25,103.50 $25,103.50 $8,535.19 $21,337.98 $17,572.45 2026-04-08
12051207 CDM Vngrd Ps Opn Bx Fem 67.5mm Rt Intrlok 13 13 $25,103.50 $25,103.50 $8,535.19 $21,337.98 $17,572.45 2026-04-08
12051221 CDM Femrl 67.5mm Left Vngrd Ps Opn Bx Biomet 13 13 $25,103.50 $25,103.50 $8,535.19 $21,337.98 $17,572.45 2026-04-08
12051215 CDM Vngrd Ps Opn Bx Fem 75mm Left Ntrlk Rmet 13 13 $25,103.50 $25,103.50 $8,535.19 $21,337.98 $17,572.45 2026-04-08
12050991 CDM Postir Stblizd Femur 13 13 $24,786.50 $24,786.50 $8,427.41 $21,068.53 $17,350.55 2026-04-08
12050790 CDM Tib Fry Mod Cocr 4 13 13 $24,333.00 $24,333.00 $8,273.22 $20,683.05 $17,033.10 2026-04-08
12050937 CDM Tib Tray Mod Cocr 3 13 13 $24,333.00 $24,333.00 $8,273.22 $20,683.05 $17,033.10 2026-04-08
12050785 CDM Tib Try Mod Cocr 5 13 13 $24,333.00 $24,333.00 $8,273.22 $20,683.05 $17,033.10 2026-04-08
12051139 CDM Vngrd Ps Open Bx Fem Biomet 13 13 $23,907.50 $23,907.50 $8,128.55 $20,321.38 $16,735.25 2026-04-08
12051223 CDM Phasix Mesh 6x8 Rectngl Bard 13 13 $23,693.50 $23,693.50 $8,055.79 $20,139.48 $16,585.45 2026-04-08
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 19 19 $25,159.50 $25,159.50 $8,554.23 $21,385.58 $16,353.68 2026-04-08
12050734 CDM Ceramic Head 16/18 Taper 13 13 $22,664.50 $22,664.50 $7,705.93 $19,264.83 $15,865.15 2026-04-08
12053063 CDM Retaining Device Femoral 13 13 $21,016.50 $21,016.50 $7,145.61 $17,864.03 $14,711.55 2026-04-08
J0517 HCPCS Injection, Benralizumab, 1 Mg 19 19 $22,480.00 $22,480.00 $7,011.94 $19,108.00 $14,612.00 2026-04-08
3061018 CDM Simponi 100 Mg/ml Pen Injector 13 13 $20,211.00 $20,211.00 $6,871.74 $17,179.35 $14,147.70 2026-04-08
12050904 CDM 5 X 6 Tissue Mend 13 13 $20,086.50 $20,086.50 $6,829.41 $17,073.53 $14,060.55 2026-04-08
12051141 CDM El Vngrd Cr Tib Brng 13 13 $20,081.50 $20,081.50 $6,827.71 $17,069.28 $14,057.05 2026-04-08
12051130 CDM Vngrd Cr Ilok Fem 13 13 $19,531.00 $19,531.00 $6,640.54 $16,601.35 $13,671.70 2026-04-08
12050709 CDM Tissuemend 5x6cm 13 13 $18,673.00 $18,673.00 $6,348.82 $15,872.05 $13,071.10 2026-04-08
12050943 CDM Ceramic Head 40mm 13 13 $18,408.00 $18,408.00 $6,258.72 $15,646.80 $12,885.60 2026-04-08
12050992 CDM Tibial Tray Cemnt 4 13 13 $18,392.50 $18,392.50 $6,253.45 $15,633.63 $12,874.75 2026-04-08
12050594 CDM Biofoam Evac 13 13 $18,371.50 $18,371.50 $6,246.31 $15,615.78 $12,860.05 2026-04-08
12050693 CDM Epoly40mm+3 Maxrom Lnr 13 13 $18,360.00 $18,360.00 $6,242.40 $15,606.00 $12,852.00 2026-04-08
12051030 CDM Tib Insrt Fixd 2.5 10mm 13 13 $18,131.50 $18,131.50 $6,164.71 $15,411.78 $12,692.05 2026-04-08
12050791 CDM Tib Insert 4.8mm 13 13 $18,131.50 $18,131.50 $6,164.71 $15,411.78 $12,692.05 2026-04-08
12050784 CDM Tib Insrt 5x10mm Fxd Ber 13 13 $18,131.50 $18,131.50 $6,164.71 $15,411.78 $12,692.05 2026-04-08
12051168 CDM Tib Fxd Bering 3x 12.5mm 13 13 $18,131.50 $18,131.50 $6,164.71 $15,411.78 $12,692.05 2026-04-08
12050936 CDM Tibial Insert 3.10mm 13 13 $18,131.50 $18,131.50 $6,164.71 $15,411.78 $12,692.05 2026-04-08
12051023 CDM Tibial Insrt 2.5x12.5mm 13 13 $18,131.50 $18,131.50 $6,164.71 $15,411.78 $12,692.05 2026-04-08
12051042 CDM Tib Insrt 3.8mm Fxd Ber 13 13 $18,131.50 $18,131.50 $6,164.71 $15,411.78 $12,692.05 2026-04-08
J1568 HCPCS Injection, Immune Globulin, (octagam), Intravenous, Non-lyophilized (e.g., Liqui… 71 19 $22,378.00 $22,378.00 $2,483.21 $31,701.60 $12,382.77 2026-04-08
12051065 CDM Delta Option Ceramic Hed 13 13 $17,531.50 $17,531.50 $5,960.71 $14,901.78 $12,272.05 2026-04-08
12050725 CDM Regen/rnglc Acetabular 13 13 $17,083.00 $17,083.00 $5,808.22 $14,520.55 $11,958.10 2026-04-08
12050595 CDM Biofoam Cotton 5.5 Mm 13 13 $17,040.50 $17,040.50 $5,793.77 $14,484.43 $11,928.35 2026-04-08
12050597 CDM Biofoam Cotton 4.5 Mm 13 13 $17,040.50 $17,040.50 $5,793.77 $14,484.43 $11,928.35 2026-04-08
2007000 CDM Operating Room Services - General Classification 13 13 $16,625.00 $16,625.00 $5,652.50 $14,131.25 $11,637.50 2026-04-08
12051216 CDM El Vngrd Tib Brng 10mmx79/83mm Ps Antiox 13 13 $16,608.00 $16,608.00 $5,646.72 $14,116.80 $11,625.60 2026-04-08
12051220 CDM E1 Vngrd Ps Tib Brg Biomet 13 13 $16,608.00 $16,608.00 $5,646.72 $14,116.80 $11,625.60 2026-04-08
12051136 CDM El Vngrd Ps Tib Brg 63/67x12 13 13 $16,608.00 $16,608.00 $5,646.72 $14,116.80 $11,625.60 2026-04-08
C1713 HCPCS Anchor/screw For Opposing Bone-to-bone Or Soft Tissue-to-bone (implantable) 13 13 $16,313.50 $16,313.50 $5,546.59 $13,866.48 $11,419.45 2026-04-08
12050761 CDM Ringloc Acetabular Cup 13 13 $16,268.50 $16,268.50 $5,531.29 $13,828.23 $11,387.95 2026-04-08
J1162 HCPCS Injection, Digoxin Immune Fab (ovine), Per Vial 19 19 $17,506.00 $17,506.00 $5,952.04 $14,880.10 $11,378.90 2026-04-08
12051137 CDM E1 Vngrd As Tib Brng Antioxdnt 13 13 $16,132.50 $16,132.50 $5,485.05 $13,712.63 $11,292.75 2026-04-08
12050698 CDM Cer Bioloxd Option Hd 13 13 $16,108.50 $16,108.50 $5,476.89 $13,692.23 $11,275.95 2026-04-08
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 19 19 $17,252.00 $17,252.00 $3,526.19 $14,664.20 $11,213.80 2026-04-08
12051293 CDM Copal Exchnge G Knee S 13 13 $16,000.00 $16,000.00 $5,440.00 $13,600.00 $11,200.00 2026-04-08
12050804 CDM Ringloc Sz24 56mm 13 13 $15,945.50 $15,945.50 $5,421.47 $13,553.68 $11,161.85 2026-04-08
12051129 CDM Polyaxal Lokng Plate Crs Plt Lft 13 13 $15,857.00 $15,857.00 $5,391.38 $13,478.45 $11,099.90 2026-04-08
12050189 CDM Hip Acetabular Shell 13 13 $15,513.50 $15,513.50 $5,274.59 $13,186.48 $10,859.45 2026-04-08
12051124 CDM E1 Vngrd Cr Tib Brg Antox 13 13 $15,498.00 $15,498.00 $5,269.32 $13,173.30 $10,848.60 2026-04-08
12050656 CDM Regen/rnglc+ltd58mm Sz24 13 13 $15,384.50 $15,384.50 $5,230.73 $13,076.83 $10,769.15 2026-04-08
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 19 19 $16,533.00 $16,533.00 $3,526.19 $14,053.05 $10,746.45 2026-04-08
J2356 HCPCS Injection, Tezepelumab-ekko, 1 Mg 19 19 $16,477.20 $16,477.20 $3,526.19 $14,005.62 $10,710.18 2026-04-08
12050651 CDM Concxa 100 4x4 13 13 $14,904.00 $14,904.00 $5,067.36 $12,668.40 $10,432.80 2026-04-08
12051246 CDM Regen Rnglc+ltd 13 13 $14,462.00 $14,462.00 $4,917.08 $12,292.70 $10,123.40 2026-04-08
12050498 CDM Croslink Fin Glenoid 13 13 $14,419.50 $14,419.50 $4,902.63 $12,256.58 $10,093.65 2026-04-08
12050526 CDM Shoulder-humeral Head 13 13 $13,970.50 $13,970.50 $4,749.97 $11,874.93 $9,779.35 2026-04-08
12051222 CDM 13mmx71/75mm Vngrd Ps Tib Bearng Biomet 13 13 $13,881.00 $13,881.00 $4,719.54 $11,798.85 $9,716.70 2026-04-08
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 19 19 $14,821.00 $14,821.00 $1,904.52 $12,597.85 $9,633.65 2026-04-08
12050733 CDM Acetublr Shell Sz 24 13 13 $13,713.50 $13,713.50 $4,662.59 $11,656.48 $9,599.45 2026-04-08
12050994 CDM Tibial Insert 13 13 $13,705.00 $13,705.00 $4,659.70 $11,649.25 $9,593.50 2026-04-08
12050724 CDM Epoly 36mm +3maxrom Lnr 13 13 $13,385.00 $13,385.00 $4,550.90 $11,377.25 $9,369.50 2026-04-08
12050732 CDM Acetublr Linr Sz 24 13 13 $13,385.00 $13,385.00 $4,550.90 $11,377.25 $9,369.50 2026-04-08
C1762 HCPCS Connective Tissue, Human (includes Fascia Lata) 13 13 $12,940.50 $12,940.50 $4,399.77 $10,999.43 $9,058.35 2026-04-08
12050876 CDM Anchor Endoscopic 13 13 $12,878.50 $12,878.50 $4,378.69 $10,946.73 $9,014.95 2026-04-08
12051188 CDM 50mm Sz23 Rngloc&acetulr 13 13 $12,801.50 $12,801.50 $4,352.51 $10,881.28 $8,961.05 2026-04-08
12050764 CDM El Ringloc 40 Mm Sz 25 13 13 $12,747.50 $12,747.50 $4,334.15 $10,835.38 $8,923.25 2026-04-08
12051095 CDM Cc Cruciat Try 79mm 13 13 $12,638.00 $12,638.00 $4,296.92 $10,742.30 $8,846.60 2026-04-08
12051072 CDM Cc Cruciat Try 63 Mm Brom 13 13 $12,638.00 $12,638.00 $4,296.92 $10,742.30 $8,846.60 2026-04-08
12050730 CDM Primatrix 6x6 Mesh 13 13 $12,539.50 $12,539.50 $4,263.43 $10,658.58 $8,777.65 2026-04-08
12051190 CDM 71mm Fxd Cru Tib Plate 13 13 $12,337.50 $12,337.50 $4,194.75 $10,486.88 $8,636.25 2026-04-08
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 32 19 $17,278.00 $17,278.00 $2,483.21 $14,686.30 $8,612.20 2026-04-08
12050530 CDM Xternl Wrist Fixator 13 13 $12,263.50 $12,263.50 $4,169.59 $10,423.98 $8,584.45 2026-04-08
12051120 CDM Biomet 67mm Fxd Cruciat Tib Plate 13 13 $12,186.50 $12,186.50 $4,143.41 $10,358.53 $8,530.55 2026-04-08
12051254 CDM Hammr Toe Implantsml 2.8 Extrmity Medicl 13 13 $12,179.50 $12,179.50 $4,141.03 $10,352.58 $8,525.65 2026-04-08
12051094 CDM 63mm Fxd Cru Tib Plate 13 13 $12,036.00 $12,036.00 $4,092.24 $10,230.60 $8,425.20 2026-04-08
12051078 CDM 75mm Fxd Cru Tib Plate 13 13 $12,036.00 $12,036.00 $4,092.24 $10,230.60 $8,425.20 2026-04-08
12051214 CDM Biomt Ntrlok 83mm Fxd Cru Tib Plate 13 13 $12,036.00 $12,036.00 $4,092.24 $10,230.60 $8,425.20 2026-04-08
12051069 CDM Trumatch S2 3 Tibial 13 13 $11,994.50 $11,994.50 $4,078.13 $10,195.33 $8,396.15 2026-04-08
12051007 CDM Primatrix 6x6 Fenestratd 13 13 $11,942.50 $11,942.50 $4,060.45 $10,151.13 $8,359.75 2026-04-08
12051301 CDM I Stent 13 13 $11,800.00 $11,800.00 $4,012.00 $10,030.00 $8,260.00 2026-04-08
J3110 HCPCS Injection, Teriparatide, 10 Mcg 19 19 $12,355.00 $12,355.00 $3,526.19 $10,501.75 $8,030.75 2026-04-08
3000558 CDM Ryanodex 250 Mg Vial 13 13 $11,444.00 $11,444.00 $3,890.96 $9,727.40 $8,010.80 2026-04-08
12050196 CDM Hip Insert 28m 10 13 13 $11,272.50 $11,272.50 $3,832.65 $9,581.63 $7,890.75 2026-04-08
3001594 CDM Dupixent 300 Mg/2 Ml Syringe 13 13 $10,953.00 $10,953.00 $3,724.02 $9,310.05 $7,667.10 2026-04-08
12050289 CDM Mesh Composix Ova 8x10 13 13 $10,915.00 $10,915.00 $3,711.10 $9,277.75 $7,640.50 2026-04-08
12053062 CDM Retaining Device Articul 13 13 $10,225.50 $10,225.50 $3,476.67 $8,691.68 $7,157.85 2026-04-08
12051131 CDM Biomet Ilok Pri Tib Tray 13 13 $10,089.00 $10,089.00 $3,430.26 $8,575.65 $7,062.30 2026-04-08
12050711 CDM Echo 7 X 9 Inflation Mesh 13 13 $9,841.50 $9,841.50 $3,346.11 $8,365.28 $6,889.05 2026-04-08
12050703 CDM 7 X 9 Ventralite/lap Echo 13 13 $9,841.50 $9,841.50 $3,346.11 $8,365.28 $6,889.05 2026-04-08
12051096 CDM 14x79/83 Mm Vngrd Tib Brg 13 13 $9,816.50 $9,816.50 $3,337.61 $8,344.03 $6,871.55 2026-04-08
12051192 CDM Vangrd Ost 12x71/75 Tib 13 13 $9,816.50 $9,816.50 $3,337.61 $8,344.03 $6,871.55 2026-04-08
12051122 CDM Vngrd Dcm Pst 14x71/75mm Tib Brng Arcom 13 13 $9,816.50 $9,816.50 $3,337.61 $8,344.03 $6,871.55 2026-04-08
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 19 19 $10,410.50 $10,410.50 $1,904.52 $8,848.93 $6,766.83 2026-04-08
12051258 CDM Genesys Hta Handpce 13 13 $9,556.50 $9,556.50 $3,249.21 $8,123.03 $6,689.55 2026-04-08
12050803 CDM Mod Hed Sz 40mm-3 13 13 $9,547.00 $9,547.00 $3,245.98 $8,114.95 $6,682.90 2026-04-08
12051135 CDM Vngrd Ps & Tib Brg 10x63/67mm 13 13 $9,348.50 $9,348.50 $3,178.49 $7,946.23 $6,543.95 2026-04-08
12050328 CDM Mesh Composix 20cmx25cm 13 13 $9,344.50 $9,344.50 $3,177.13 $7,942.83 $6,541.15 2026-04-08
12051074 CDM Van Ps Tib Brg 10x63/67 13 13 $9,219.50 $9,219.50 $3,134.63 $7,836.58 $6,453.65 2026-04-08
12051093 CDM Vngrd 10x63/67 Tib Berng 13 13 $9,219.50 $9,219.50 $3,134.63 $7,836.58 $6,453.65 2026-04-08
12051119 CDM Vngrd Tib Brng 14x63/67mm 13 13 $9,219.50 $9,219.50 $3,134.63 $7,836.58 $6,453.65 2026-04-08
12051076 CDM Vangrd 10mmx71/75mm Tib 13 13 $9,219.50 $9,219.50 $3,134.63 $7,836.58 $6,453.65 2026-04-08
12050329 CDM Mesh Composix 25cmx33cm 13 13 $9,212.50 $9,212.50 $3,132.25 $7,830.63 $6,448.75 2026-04-08
12051026 CDM Tib Insrt 2.5x12 In/out 13 13 $9,065.50 $9,065.50 $3,082.27 $7,705.68 $6,345.85 2026-04-08
12050715 CDM Echo 6 X 10 Inflation Mesh 13 13 $9,003.50 $9,003.50 $3,061.19 $7,652.98 $6,302.45 2026-04-08
12050576 CDM 6 X 10 Ventralite/lap 13 13 $9,003.50 $9,003.50 $3,061.19 $7,652.98 $6,302.45 2026-04-08
12051025 CDM Tib Try Mod Cocr 2.5 13 13 $8,967.00 $8,967.00 $3,048.78 $7,621.95 $6,276.90 2026-04-08
J1306 HCPCS Injection, Inclisiran, 1 Mg 19 19 $9,643.80 $9,643.80 $3,278.89 $8,197.23 $6,268.47 2026-04-08
J9312 HCPCS Injection, Rituximab, 10 Mg 32 19 $16,065.80 $16,065.80 $92.14 $13,655.93 $6,237.15 2026-04-08
12050242 CDM Prosthesis Bone Hip 13 13 $8,762.00 $8,762.00 $2,979.08 $7,447.70 $6,133.40 2026-04-08
J3247 HCPCS Injection, Secukinumab, Intravenous, 1 Mg 13 13 $8,543.70 $8,543.70 $2,904.86 $7,262.15 $5,980.59 2026-04-08
12051212 CDM Vngrd Dcm Ps + Tibl Berng 13 13 $8,362.50 $8,362.50 $2,843.25 $7,108.13 $5,853.75 2026-04-08
12050765 CDM Ringloc Bi-polar 28mm 13 13 $8,205.50 $8,205.50 $2,789.87 $6,974.68 $5,743.85 2026-04-08
12051248 CDM Myosure Reach Tisu Remvl Devix Hologic 13 13 $8,176.50 $8,176.50 $2,780.01 $6,950.03 $5,723.55 2026-04-08
J2802 HCPCS Injection, Romiplostim, 1 Microgram 39 13 $8,715.20 $8,715.20 $1,765.11 $11,981.09 $5,664.88 2026-04-08
12050707 CDM Echo Ps 6 X 8 Inflation Mesh 13 13 $8,003.00 $8,003.00 $2,721.02 $6,802.55 $5,602.10 2026-04-08
12050558 CDM 6 X 8 Ventralite Lap 13 13 $8,003.00 $8,003.00 $2,721.02 $6,802.55 $5,602.10 2026-04-08
12051128 CDM Easy Clip Monocrticl Fixatn Devic 13 13 $7,984.00 $7,984.00 $2,714.56 $6,786.40 $5,588.80 2026-04-08
12051256 CDM Vngrd Cr Lip Tib Brg 13 13 $7,964.50 $7,964.50 $2,707.93 $6,769.83 $5,575.15 2026-04-08
12050565 CDM Smart Toe 13 13 $7,929.00 $7,929.00 $2,695.86 $6,739.65 $5,550.30 2026-04-08
12051019 CDM Ovl Dome Patla 3peg 32mm 13 13 $7,523.50 $7,523.50 $2,557.99 $6,394.98 $5,266.45 2026-04-08
12050782 CDM Ovl Dome Patla 3-peg 4/m 13 13 $7,523.50 $7,523.50 $2,557.99 $6,394.98 $5,266.45 2026-04-08
12050899 CDM Oval Dome Pat 3peg 38mm 13 13 $7,523.50 $7,523.50 $2,557.99 $6,394.98 $5,266.45 2026-04-08
12051024 CDM Oval Dome Pat 3peg 35mm 13 13 $7,523.50 $7,523.50 $2,557.99 $6,394.98 $5,266.45 2026-04-08
L8641 HCPCS Metatarsal Joint Implant 65 13 $7,608.50 $7,608.50 $1,030.71 $9,005.33 $5,262.75 2026-04-08
12050327 CDM Mesh Composix 18cmx23cm 13 13 $7,489.00 $7,489.00 $2,546.26 $6,365.65 $5,242.30 2026-04-08
12050190 CDM Hip Femoral Head 28 Mm 13 13 $7,428.50 $7,428.50 $2,525.69 $6,314.23 $5,199.95 2026-04-08
J2182 HCPCS Injection, Mepolizumab, 1 Mg 32 19 $8,163.80 $8,163.80 $2,456.26 $6,939.23 $5,181.74 2026-04-08
78608 HCPCS Nuclear Medicine Study Of Brain With Metabolic Evaluation 19 19 $7,955.00 $7,955.00 $2,627.46 $6,761.75 $5,170.75 2026-04-08
12051140 CDM Tlso Brace 13 13 $7,367.50 $7,367.50 $2,504.95 $6,262.38 $5,157.25 2026-04-08
12050647 CDM Ventralex Hernia Patch 13 13 $7,364.00 $7,364.00 $2,503.76 $6,259.40 $5,154.80 2026-04-08
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 19 19 $7,916.80 $7,916.80 $2,483.21 $6,729.28 $5,145.92 2026-04-08
A9570 HCPCS Indium In-111 Labeled Autologous White Blood Cells, Diagnostic, Per Study Dose 13 13 $7,176.50 $7,176.50 $2,440.01 $6,100.03 $5,023.55 2026-04-08
C1897 HCPCS Lead, Neurostimulator Test Kit (implantable) 13 13 $6,742.50 $6,742.50 $2,292.45 $5,731.13 $4,719.75 2026-04-08
12051249 CDM Novasure Kit Hologic 13 13 $6,737.00 $6,737.00 $2,290.58 $5,726.45 $4,715.90 2026-04-08
12051551 CDM 8 X 8mm Kit Ot Medical 13 13 $6,717.50 $6,717.50 $2,283.95 $5,709.88 $4,702.25 2026-04-08
12050714 CDM Sorbafix 30 Shot 13 13 $6,674.50 $6,674.50 $2,269.33 $5,673.33 $4,672.15 2026-04-08
12051558 CDM Operating Room Services - General Classification 13 13 $6,310.00 $6,310.00 $2,145.40 $5,363.50 $4,417.00 2026-04-08
12051266 CDM Dvr Anatomic Narow Left 13 13 $6,116.00 $6,116.00 $2,079.44 $5,198.60 $4,281.20 2026-04-08
90375 HCPCS Rabies Immune Globulin For Injection 45 19 $8,084.30 $8,084.30 $1,210.54 $10,585.05 $4,234.02 2026-04-08
A9569 HCPCS Technetium Tc-99m Exametazime Labeled Autologous White Blood Cells, Diagnostic, … 13 13 $6,038.00 $6,038.00 $2,052.92 $5,132.30 $4,226.60 2026-04-08
7602025 CDM Rev - Audiology 13 13 $6,000.00 $6,000.00 $2,040.00 $5,100.00 $4,200.00 2026-04-08
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 37 19 $7,111.00 $7,111.00 $31.36 $6,044.35 $4,172.91 2026-04-08
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 32 19 $5,717.00 $5,717.00 $1,943.78 $9,241.20 $4,144.82 2026-04-08
12050451 CDM Holmium Laser 13 13 $5,822.00 $5,822.00 $1,979.48 $4,948.70 $4,075.40 2026-04-08
J2351 HCPCS Injection, Ocrelizumab, 1 Mg And Hyaluronidase-ocsq 13 13 $5,678.00 $5,678.00 $1,930.52 $4,826.30 $3,974.60 2026-04-08
12050598 CDM Allomatrix Dr 13 13 $5,656.50 $5,656.50 $1,923.21 $4,808.03 $3,959.55 2026-04-08
12050993 CDM Oval Dome Patella 13 13 $5,656.50 $5,656.50 $1,923.21 $4,808.03 $3,959.55 2026-04-08
L8642 HCPCS Hallux Implant 13 13 $5,618.00 $5,618.00 $1,910.12 $4,775.30 $3,932.60 2026-04-08
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 19 19 $6,012.00 $6,012.00 $2,044.08 $5,110.20 $3,907.80 2026-04-08
J0490 HCPCS Injection, Belimumab, 10 Mg 19 19 $5,974.00 $5,974.00 $2,031.16 $5,077.90 $3,883.10 2026-04-08
12051018 CDM Vntlite Mesh Echo 6' Crc 13 13 $5,268.50 $5,268.50 $1,791.29 $4,478.23 $3,687.95 2026-04-08
12051052 CDM Reverto Staple 8 X 8 X 1.2 13 13 $5,238.50 $5,238.50 $1,781.09 $4,452.73 $3,666.95 2026-04-08
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 19 19 $5,600.00 $5,600.00 $968.31 $4,760.00 $3,640.00 2026-04-08
73722 HCPCS MRI Scan Of Leg Joint With Contrast 19 19 $5,599.00 $5,599.00 $801.72 $4,759.15 $3,639.35 2026-04-08
12051143 CDM Internalbrace Ligament 13 13 $5,177.00 $5,177.00 $1,760.18 $4,400.45 $3,623.90 2026-04-08
A9548 HCPCS Indium In-111 Pentetate, Diagnostic, Per 0.5 Millicurie 13 13 $5,159.50 $5,159.50 $1,754.23 $4,385.58 $3,611.65 2026-04-08
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 19 19 $5,513.00 $5,513.00 $801.72 $4,686.05 $3,583.45 2026-04-08
12050655 CDM Osteoset Resorb Mini Bd 13 13 $5,118.00 $5,118.00 $1,740.12 $4,350.30 $3,582.60 2026-04-08
49406 HCPCS Drainage Of Fluid Collection Of Abdominal Cavity By Tube Using Imaging Guidance 19 19 $5,507.00 $5,507.00 $1,420.86 $4,680.95 $3,579.55 2026-04-08
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 19 19 $5,394.00 $5,394.00 $801.72 $4,584.90 $3,506.10 2026-04-08
12053090 CDM Mesh Composix Cir 12x12 13 13 $4,996.00 $4,996.00 $1,698.64 $4,246.60 $3,497.20 2026-04-08
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 19 19 $4,212.00 $4,212.00 $1,432.08 $3,580.20 $3,479.11 2026-04-08
12051115 CDM Series A Pat Thin 37x8.6 3 Peg 13 13 $4,888.00 $4,888.00 $1,661.92 $4,154.80 $3,421.60 2026-04-08
12051073 CDM Scries A Pat Thn 34 3peg 13 13 $4,888.00 $4,888.00 $1,661.92 $4,154.80 $3,421.60 2026-04-08
12051121 CDM Biomet Series A Thn Pat 37x8.6mm 3 Peg 13 13 $4,888.00 $4,888.00 $1,661.92 $4,154.80 $3,421.60 2026-04-08
12051189 CDM Stnd Pat 34x8.5 3 1/4 Reg 13 13 $4,888.00 $4,888.00 $1,661.92 $4,154.80 $3,421.60 2026-04-08
J3262 HCPCS Injection, Tocilizumab, 1 Mg 45 19 $5,258.50 $5,258.50 $944.86 $8,939.45 $3,418.03 2026-04-08
12050292 CDM Open Ligasure 13 13 $4,857.00 $4,857.00 $1,651.38 $4,128.45 $3,399.90 2026-04-08
12050723 CDM 36mm Cocr Mod Hd 6mm 13 13 $4,801.50 $4,801.50 $1,632.51 $4,081.28 $3,361.05 2026-04-08
J0897 HCPCS Injection, Denosumab, 1 Mg 19 19 $5,145.00 $5,145.00 $1,749.30 $4,373.25 $3,344.25 2026-04-08
12051098 CDM Seris A Pat Std 3 Peg 13 13 $4,747.50 $4,747.50 $1,614.15 $4,035.38 $3,323.25 2026-04-08
12051077 CDM Thin Pat 34mmx7.8mm 3peg 13 13 $4,655.00 $4,655.00 $1,582.70 $3,956.75 $3,258.50 2026-04-08
47600 HCPCS Removal Of Gallbladder 18 18 $5,229.00 $5,229.00 $1,066.43 $5,229.00 $3,236.47 2026-04-08
C1776 HCPCS Joint Device (implantable) 52 13 $5,988.25 $5,988.25 $643.62 $17,554.63 $3,230.03 2026-04-08
12050550 CDM Physiomesh 10x15 13 13 $4,608.00 $4,608.00 $1,566.72 $3,916.80 $3,225.60 2026-04-08
12050766 CDM Mod Hed Cmponent 28mm 13 13 $4,573.00 $4,573.00 $1,554.82 $3,887.05 $3,201.10 2026-04-08
12051062 CDM Modular Head Comp 13 13 $4,489.50 $4,489.50 $1,526.43 $3,816.08 $3,142.65 2026-04-08
12051182 CDM 36mm Cocr Mod Hed 13 13 $4,489.50 $4,489.50 $1,526.43 $3,816.08 $3,142.65 2026-04-08
12050290 CDM Hand Assist Gel Port 13 13 $4,469.00 $4,469.00 $1,519.46 $3,798.65 $3,128.30 2026-04-08
12051211 CDM Seris A Pat 40mmx10mm 3 1/4' Peg Biomet 13 13 $4,433.50 $4,433.50 $1,507.39 $3,768.48 $3,103.45 2026-04-08
12050326 CDM Mesh Composix 15cmx20cm 13 13 $4,426.00 $4,426.00 $1,504.84 $3,762.10 $3,098.20 2026-04-08
22523 HCPCS Kyphoplasty Thoracic (vplasty 22520) 11 11 $3,082.00 $3,082.00 $1,541.00 $3,082.00 $3,082.00 2026-04-08
7602015 CDM Rev - Audiology 13 13 $4,400.00 $4,400.00 $1,496.00 $3,740.00 $3,080.00 2026-04-08
12051897 CDM Bard Port Implant 13 13 $4,380.50 $4,380.50 $1,489.37 $3,723.43 $3,066.35 2026-04-08
C2625 HCPCS Stent, Non-coronary, Temporary, With Delivery System 13 13 $4,333.50 $4,333.50 $1,473.39 $3,683.48 $3,033.45 2026-04-08
2000001 CDM Operating Room Services - General Classification 13 13 $4,327.00 $4,327.00 $1,471.18 $3,677.95 $3,028.90 2026-04-08
12050608 CDM Lap Tacker 13 13 $4,236.00 $4,236.00 $1,440.24 $3,600.60 $2,965.20 2026-04-08
12050882 CDM Wright Protoe Lgr 10degre 13 13 $4,227.50 $4,227.50 $1,437.35 $3,593.38 $2,959.25 2026-04-08
12053080 CDM Mesh Composix Med 6x6 13 13 $4,183.00 $4,183.00 $1,422.22 $3,555.55 $2,928.10 2026-04-08
12050905 CDM Sm Frg Lking Plte Hs Str 13 13 $4,162.00 $4,162.00 $1,415.08 $3,537.70 $2,913.40 2026-04-08
L8699 HCPCS Prosthetic Implant, Not Otherwise Specified 26 13 $7,116.75 $7,116.75 $636.48 $10,507.28 $2,897.06 2026-04-08
12053085 CDM Mesh Composix Circle 8x8 13 13 $4,126.50 $4,126.50 $1,403.01 $3,507.53 $2,888.55 2026-04-08
12051163 CDM Mesh Marlex Large 13 13 $4,091.50 $4,091.50 $1,391.11 $3,477.78 $2,864.05 2026-04-08
22524 HCPCS Kyphoplasty Lumbar (vplasty 22521) 11 11 $2,845.50 $2,845.50 $1,422.75 $2,845.50 $2,845.50 2026-04-08
12051162 CDM Mesh Marlex Medium 13 13 $4,061.00 $4,061.00 $1,380.74 $3,451.85 $2,842.70 2026-04-08
12051881 CDM Bard Port Inplant 13 13 $3,973.00 $3,973.00 $1,350.82 $3,377.05 $2,781.10 2026-04-08
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 20 19 $4,241.00 $4,241.00 $1,441.94 $3,604.85 $2,777.86 2026-04-08
12050417 CDM Power Port 13 13 $3,965.50 $3,965.50 $1,348.27 $3,370.68 $2,775.85 2026-04-08
12050552 CDM Spcmakr + Disector Systm 13 13 $3,959.50 $3,959.50 $1,346.23 $3,365.58 $2,771.65 2026-04-08
J3424 HCPCS Injection, Hydroxocobalamin, Intravenous, 25 Mg 13 13 $3,952.00 $3,952.00 $1,343.68 $3,359.20 $2,766.40 2026-04-08
12050491 CDM Tissue Expander 600 Cc 13 13 $3,924.00 $3,924.00 $1,334.16 $3,335.40 $2,746.80 2026-04-08
12050640 CDM Mesh Phs 13 13 $3,873.00 $3,873.00 $1,316.82 $3,292.05 $2,711.10 2026-04-08
12051560 CDM Cbde Kit 13 13 $3,863.50 $3,863.50 $1,313.59 $3,283.98 $2,704.45 2026-04-08
49020 HCPCS Drainage Of Abdominal Abscess Or Infection 19 19 $3,214.00 $3,214.00 $1,092.76 $7,198.19 $2,654.76 2026-04-08
78816 HCPCS Nuclear Medicine Study Whole Body With CT Scan 37 19 $8,966.00 $8,966.00 $38.48 $7,621.10 $2,627.46 2026-04-08
78815 HCPCS Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 37 19 $8,963.00 $8,963.00 $8.52 $7,618.55 $2,627.46 2026-04-08
J2357 HCPCS Injection, Omalizumab, 5 Mg 19 19 $3,989.00 $3,989.00 $1,356.26 $3,390.65 $2,592.85 2026-04-08
J1451 HCPCS Injection, Fomepizole, 15 Mg 19 19 $3,943.00 $3,943.00 $370.66 $3,351.55 $2,562.95 2026-04-08
12050649 CDM Bone Cement 20g 13 13 $3,642.00 $3,642.00 $1,238.28 $3,095.70 $2,549.40 2026-04-08
12051253 CDM Hammr Fix Instrumnt Kit Sml Extremty Med 13 13 $3,631.50 $3,631.50 $1,234.71 $3,086.78 $2,542.05 2026-04-08
12051005 CDM Spacmakr Plus Oblong 13 13 $3,588.00 $3,588.00 $1,219.92 $3,049.80 $2,511.60 2026-04-08
12051146 CDM Ligasure Exact 13 13 $3,551.50 $3,551.50 $1,207.51 $3,018.78 $2,486.05 2026-04-08
12050467 CDM Titanim Poly Fluromax 13 13 $3,498.50 $3,498.50 $1,189.49 $2,973.73 $2,448.95 2026-04-08
12050507 CDM Smart Port CT 13 13 $3,498.50 $3,498.50 $1,189.49 $2,973.73 $2,448.95 2026-04-08
12051284 CDM Maryland Ligasure 13 13 $3,487.00 $3,487.00 $1,185.58 $2,963.95 $2,440.90 2026-04-08
12050902 CDM 5.5 Reelx 13 13 $3,450.50 $3,450.50 $1,173.17 $2,932.93 $2,415.35 2026-04-08
J2327 HCPCS Injection, Risankizumab-rzaa, Intravenous, 1 Mg 19 19 $2,915.00 $2,915.00 $991.10 $8,730.06 $2,407.79 2026-04-08
12050922 CDM Spcemakr Plus Autosutur Rnd 13 13 $3,401.00 $3,401.00 $1,156.34 $2,890.85 $2,380.70 2026-04-08
12051132 CDM Biomet Finnd Pri Stem 13 13 $3,366.50 $3,366.50 $1,144.61 $2,861.53 $2,356.55 2026-04-08
A9562 HCPCS Technetium Tc-99m Mertiatide, Diagnostic, Per Study Dose, Up To 15 Millicuries 13 13 $3,358.00 $3,358.00 $1,141.72 $2,854.30 $2,350.60 2026-04-08
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 19 19 $3,585.20 $3,585.20 $370.66 $3,047.42 $2,330.38 2026-04-08
12050654 CDM Reelx Stt 5.5mm Anchor 13 13 $3,286.50 $3,286.50 $1,117.41 $2,793.53 $2,300.55 2026-04-08
5201157 CDM CT Ankle With Contrast Lt 13 13 $3,265.00 $3,265.00 $1,110.10 $2,775.25 $2,285.50 2026-04-08
12050613 CDM Carefusn Plurx Cath Kit 13 13 $3,220.00 $3,220.00 $1,094.80 $2,737.00 $2,254.00 2026-04-08
12050721 CDM Reelx Knotless Anchor 13 13 $3,209.50 $3,209.50 $1,091.23 $2,728.08 $2,246.65 2026-04-08
12051226 CDM Vntlite Mesh 4x6 Eclipse 13 13 $3,205.50 $3,205.50 $1,089.87 $2,724.68 $2,243.85 2026-04-08
12051206 CDM 4x6 Ventralite Ova Mesh Davol 13 13 $3,205.50 $3,205.50 $1,089.87 $2,724.68 $2,243.85 2026-04-08
12050657 CDM 1 Proximate Pph03 13 13 $3,205.50 $3,205.50 $1,089.87 $2,724.68 $2,243.85 2026-04-08
12050675 CDM Sm Cannulated Screw 13 13 $3,202.00 $3,202.00 $1,088.68 $2,721.70 $2,241.40 2026-04-08
7602005 CDM Rev - Audiology 13 13 $3,200.00 $3,200.00 $1,088.00 $2,720.00 $2,240.00 2026-04-08
12051902 CDM Dvr Anatomic Short Left 13 13 $3,192.00 $3,192.00 $1,085.28 $2,713.20 $2,234.40 2026-04-08
12050701 CDM Tlso Rigid Frame Brace 13 13 $3,162.50 $3,162.50 $1,075.25 $2,688.13 $2,213.75 2026-04-08
12050295 CDM Ligasure Blunt Tip 13 13 $3,114.00 $3,114.00 $1,058.76 $2,646.90 $2,179.80 2026-04-08
C8929 HCPCS Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 19 19 $3,343.00 $3,343.00 $852.77 $2,841.55 $2,172.95 2026-04-08
12051180 CDM Cobalt Bone Cmnt 40g Ghv 13 13 $3,096.00 $3,096.00 $1,052.64 $2,631.60 $2,167.20 2026-04-08
12050325 CDM Mesh Composix 10cmx15cm 13 13 $3,086.50 $3,086.50 $1,049.41 $2,623.53 $2,160.55 2026-04-08
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 84 19 $2,041.00 $2,041.00 $30.60 $13,880.50 $2,109.03 2026-04-08
7602020 CDM Rev - Audiology 13 13 $3,000.00 $3,000.00 $1,020.00 $2,550.00 $2,100.00 2026-04-08
12050293 CDM 10 Mm Ligasure 13 13 $2,995.00 $2,995.00 $1,018.30 $2,545.75 $2,096.50 2026-04-08
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 19 19 $2,511.00 $2,511.00 $853.74 $2,160.77 $2,074.09 2026-04-08
12050653 CDM 3.5 Piton With Biu/wte Sut 13 13 $2,951.50 $2,951.50 $1,003.51 $2,508.78 $2,066.05 2026-04-08
12050352 CDM Mesh Composix Small 4x4 13 13 $2,925.50 $2,925.50 $994.67 $2,486.68 $2,047.85 2026-04-08
12050989 CDM Palacos Bone Cement 13 13 $2,904.50 $2,904.50 $987.53 $2,468.83 $2,033.15 2026-04-08
12050574 CDM 4 1/2'circle Ventlite Lap 13 13 $2,903.50 $2,903.50 $987.19 $2,467.98 $2,032.45 2026-04-08
12050525 CDM Salute Ii Tacker 13 13 $2,903.50 $2,903.50 $987.19 $2,467.98 $2,032.45 2026-04-08
38740 HCPCS Partial Removal Of Lymph Nodes Of Underarm 18 18 $3,191.50 $3,191.50 $642.83 $4,083.95 $2,028.05 2026-04-08
12051988 CDM Ventlx W/strap Med 2.5 13 13 $2,892.00 $2,892.00 $983.28 $2,458.20 $2,024.40 2026-04-08
15100 HCPCS Partial Thickness Self Skin Graft To Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Bod… 18 18 $3,087.50 $3,087.50 $606.98 $3,087.50 $2,015.45 2026-04-08
12050612 CDM Low Profile Power Port 13 13 $2,846.50 $2,846.50 $967.81 $2,419.53 $1,992.55 2026-04-08
12050459 CDM Super Turbo Vac 90 13 13 $2,823.50 $2,823.50 $959.99 $2,399.98 $1,976.45 2026-04-08
12050463 CDM Saber 30 13 13 $2,823.50 $2,823.50 $959.99 $2,399.98 $1,976.45 2026-04-08
12050464 CDM Menivac 45 13 13 $2,823.50 $2,823.50 $959.99 $2,399.98 $1,976.45 2026-04-08
12051043 CDM Xtended Prolene Phse 13 13 $2,819.50 $2,819.50 $958.63 $2,396.58 $1,973.65 2026-04-08
12050685 CDM Purstring 13 13 $2,764.50 $2,764.50 $939.93 $2,349.83 $1,935.15 2026-04-08
100015 CDM Room & Board - Semi-private (two Beds) - Medical/surgical/gyn 8 8 $2,425.00 $2,425.00 $1,576.25 $2,061.25 $1,910.90 2026-04-08
Q5103 HCPCS Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg 19 19 $2,726.00 $2,726.00 $926.84 $2,317.10 $1,904.52 2026-04-08
12051880 CDM Moss Anchur Implant Port 13 13 $2,693.50 $2,693.50 $915.79 $2,289.48 $1,885.45 2026-04-08
12050260 CDM Disp Harmonic Ace 13 13 $2,678.00 $2,678.00 $910.52 $2,276.30 $1,874.60 2026-04-08
44970 HCPCS Removal Of Appendix Using An Endoscope 18 18 $3,036.50 $3,036.50 $602.74 $3,036.50 $1,866.45 2026-04-08
12050109 CDM Modified Kugel Hernia Pa 13 13 $2,640.50 $2,640.50 $897.77 $2,244.43 $1,848.35 2026-04-08
12051257 CDM Aquamantys 13 13 $2,637.50 $2,637.50 $896.75 $2,241.88 $1,846.25 2026-04-08
100011 CDM Room & Board - Semi-private (two Beds) - Medical/surgical/gyn 8 8 $2,330.00 $2,330.00 $1,514.50 $1,980.50 $1,836.04 2026-04-08
78709 HCPCS Nuclear Medicine Studies Of Kidney, Blood Flow, And Function 19 19 $2,817.00 $2,817.00 $723.65 $2,394.45 $1,831.05 2026-04-08
12051009 CDM Allograf Bne Chps 4-10mm 13 13 $2,612.50 $2,612.50 $888.25 $2,220.63 $1,828.75 2026-04-08
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