Hospital

JACKSON COUNTY REGIONAL HEALTH CENTER

Maquoketa, IA · CCN 161329 · Rates published

4,928 distinct procedures filed

21 distinct payers

252,588 rate rows

2025-07-29 last MRF observed · ⚠ 13 mo old

Data quality

228,464 of 252,588 rate rows are consumer-grade (90.4%)

24,124 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	23,447
placeholder amount (≤ $0.02) — excluded from medians	414
exceeds 10× this hospital's gross charge — excluded from medians	235
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	28

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 13 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://jcrhc.org/wp-content/uploads/426037868_jackson-county-regional-health-center_standardcharges.csv
Found on page	https://jcrhc.org/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-07-31
Content fingerprint	3882ea80782532e1… · 89,636,511 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
Q2043 HCPCS	Sipuleucel-t - Su	18	$48,124.17	$159,888.79	$107,595.26	nat. median $65,655 1.6× median
J9347 HCPCS	Tremelimumab Actl 300 Mg/15 Ml Inj	17	$53,912.20	$111,741.09	$86,397.75	nat. median $974 outlier · 88.7×
J9359 HCPCS	Loncastuximab Tesirine 10 Mg Inj	17	$35,308.42	$73,181.98	$56,584.01	nat. median $701 outlier · 80.7×
J9266 HCPCS	Pegaspargase 750 I-units/ml Inj 5 Ml	20	$18,229.79	$69,711.89	$33,634.19	nat. median $32,688 1.0× median
J3357 HCPCS	Ustekinumab 90 Mg/ml Syringe	20	$180.12	$75,929.83	$33,268.23	nat. median $12,959 outlier · 2.6×
J9298 HCPCS	Nivolumab-relatlimab Rmbw 240 Mg-80 Mg/20 Ml	17	$19,715.75	$40,863.85	$31,595.76	nat. median $550 outlier · 57.5×
J2350 HCPCS	Ocrelizumab 30 Mg/ml Inj 10 Ml	20	$57.32	$50,980.09	$29,050.76	nat. median $331 outlier · 87.8×
J2327 HCPCS	Risankizumab 150 Mg/ml So	17	$13,150.26	$56,508.87	$27,259.97	nat. median $961 outlier · 28.4×
J9272 HCPCS	Dostarlimab-gxly 500 Mg/10 Ml Inj	17	$15,386.83	$31,891.51	$24,658.39	nat. median $741 outlier · 33.3×
0238T OTHER	Trluml Perip Athrc Iliac Art 0238t	16	$15,325.60	$31,764.59	$24,560.25	nat. median $17,120 1.4× median
J9043 HCPCS	Cabazitaxel 10 Mg/ml Inj	20	$196.60	$39,780.41	$22,668.68	nat. median $709 outlier · 32.0×
J9228 HCPCS	Ipilimumab 5 Mg/ml Inj 40 Ml	20	$173.35	$95,879.52	$21,048.58	nat. median $8,184 outlier · 2.6×
J9316 HCPCS	Pertuzumab/trastuzumab/hyaluronidase 600 Mg-600 Mg-20k Units/10	19	$83.25	$36,452.66	$20,285.99	nat. median $360 outlier · 56.3×
J1440 HCPCS	Fecal Microbiota Live-jslm Susp	17	$12,441.50	$25,786.87	$19,938.30	nat. median $106 outlier · 187.9×
J1932 HCPCS	Lanreotide 120 Mg/0.5 Ml Inj	17	$12,295.22	$25,483.68	$19,703.87	nat. median $104 outlier · 188.7×
J9042 HCPCS	Brentuximab 5 Mg/ml Inj	20	$183.89	$31,215.43	$17,787.97	nat. median $885 outlier · 20.1×
J9022 HCPCS	Atezolizumab 60 Mg/ml Inj 14 Ml	20	$87.18	$29,676.54	$16,826.90	nat. median $5,498 outlier · 3.1×
J9119 HCPCS	Cemiplimab-rwlc 50 Mg/ml Inj 7 Ml	20	$28.48	$28,695.26	$16,351.86	nat. median $89 outlier · 184.7×
J1303 HCPCS	Ravulizumab Cwvz 1100 Mg/11 Ml Inj	20	$226.18	$67,304.32	$16,127.57	nat. median $5,613 outlier · 2.9×
J9307 HCPCS	Pralatrexate 20 Mg/ml Inj	20	$329.73	$35,810.48	$15,719.49	nat. median $856 outlier · 18.4×
J9273 HCPCS	Tisotumab Vedotin Tftv 40 Mg Inj	17	$9,149.05	$18,962.77	$14,661.94	nat. median $542 outlier · 27.0×
J9144 HCPCS	Daratumumab-hyaluronidase 1800 Mg/15 Ml	19	$49.64	$25,053.12	$14,347.43	nat. median $202 outlier · 71.0×
J2506 HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Inj	17	$8,876.37	$18,397.61	$14,224.96	nat. median $1,555 outlier · 9.1×
Q4100 HCPCS	Tissue Strattice 10 X 16 Firm	18	$3,773.66	$20,049.90	$13,492.35	nat. median $2,010 outlier · 6.7×
J3380 HCPCS	Vedolizumab 60 Mg/ml Inj 5 Ml	20	$20.61	$23,459.41	$13,368.24	nat. median $150 outlier · 89.3×
J1930 HCPCS	Lanreotide 90 Mg/0.3 Ml Inj	20	$64.68	$27,400.29	$13,175.54	nat. median $4,399 outlier · 3.0×
J9301 HCPCS	Obinutuzumab 25 Mg/ml Inj 40 Ml	20	$71.17	$22,312.03	$12,714.40	nat. median $272 outlier · 46.7×
J9223 HCPCS	Lurbinectedin 4 Mg Inj	19	$197.79	$21,943.61	$12,566.68	nat. median $605 outlier · 20.8×
J9311 HCPCS	Rituximab-hyaluron (1 600 Mg-26 800 Units)/13.4 Ml Inj	20	$45.17	$21,588.81	$12,363.49	nat. median $1,789 outlier · 6.9×
J3101 HCPCS	Tenecteplase 50 Mg/10 Ml Inj	20	$126.42	$21,147.28	$12,050.68	nat. median $3,475 outlier · 3.5×
C9363 HCPCS	Graft Mesh Bilayer 2x2 Matrix	17	$6,040.94	$21,818.21	$11,221.61	nat. median $1,163 outlier · 9.6×
J2323 HCPCS	Natalizumab 300 Mg/15 Ml Inj	20	$21.01	$23,554.85	$11,117.56	nat. median $136 outlier · 81.7×
J0491 HCPCS	Anifrolumab Fnia 300 Mg/2 Ml So	17	$6,920.17	$14,343.09	$11,090.02	nat. median $60 outlier · 183.4×
J1300 HCPCS	Eculizumab 10 Mg/ml Inj 30 Ml	20	$230.32	$18,726.09	$10,670.98	nat. median $647 outlier · 16.5×
J9306 HCPCS	Pertuzumab 30 Mg/ml Inj 14 Ml	20	$13.91	$18,211.63	$10,377.82	nat. median $67 outlier · 155.6×
J0896 HCPCS	Luspatercept 75 Mg Inj	19	$36.31	$32,662.38	$10,226.58	nat. median $4,503 outlier · 2.3×
37205 HCPCS	Transcath Ivasc Stent Perq Init Ves 37205	15	$6,044.22	$12,527.55	$9,686.25	nat. median $5,544 1.7× median
J9309 HCPCS	Polatuzumab Vedotin 20 Mg/ml Inj	19	$126.92	$47,456.98	$9,589.67	nat. median $4,103 outlier · 2.3×
Q4116 HCPCS	Tissue Alloderm 8 X 12	17	$5,723.17	$11,862.13	$9,171.75	nat. median $241 outlier · 38.0×
J9271 HCPCS	Pembrolizumab 25 Mg/ml Inj 4 Ml	20	$55.91	$15,961.50	$9,095.58	nat. median $254 outlier · 35.8×
J9354 HCPCS	Ado-trastuzumab Emtansine 20 Mg/ml Inj 5 Ml	20	$35.51	$17,211.20	$9,049.19	nat. median $4,097 outlier · 2.2×
J0517 HCPCS	Benralizumab 30 Mg/ml Inj	20	$171.30	$15,801.67	$9,004.51	nat. median $801 outlier · 11.2×
J0717 HCPCS	Certolizumab 200 Mg/ml Inj	20	$8.18	$15,484.26	$8,823.63	nat. median $1,187 outlier · 7.4×
J1290 HCPCS	Ecallantide 10 Mg/ml Inj	20	$492.44	$15,422.52	$8,788.45	nat. median $845 outlier · 10.4×
J2325 HCPCS	Nesiritide 1500 Mcg/5 Ml	20	$74.80	$15,174.98	$8,647.39	nat. median $202 outlier · 42.8×
J2356 HCPCS	Tezepelumab 210 Mg/1.91 Ml Inj	17	$5,324.94	$11,036.74	$8,533.56	nat. median $75 outlier · 113.5×
33916 HCPCS	Pulm Endartercomy W/bypass 33916	15	$5,264.06	$10,910.56	$8,436.00	nat. median $4,754 1.8× median
J7189 HCPCS	Coagulation Factor Viia 1 000 Mcg/ml Inj 1 Ml	20	$2.23	$58,892.41	$8,398.48	nat. median $3,291 outlier · 2.6×
J1640 HCPCS	Panhematin 7 Mg/ml Inj	20	$24.44	$14,357.93	$8,181.80	nat. median $76 outlier · 107.6×
33305 HCPCS	Repair Heart Wound W/bypass 33305	15	$5,094.18	$10,558.45	$8,163.75	nat. median $4,935 1.7× median

Other procedures at this hospital

Browse this hospital's 4,928 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

Q2043	HCPCS	Sipuleucel-t - Su	18	18	$164,833.80	$164,833.80	$48,124.17	$159,888.79	$107,595.26	2025-07-29
J9347	HCPCS	Tremelimumab Actl 300 Mg/15 Ml Inj	17	17	$115,197.00	$115,197.00	$53,912.20	$111,741.09	$86,397.75	2025-07-29
J9359	HCPCS	Loncastuximab Tesirine 10 Mg Inj	17	17	$75,445.34	$75,445.34	$35,308.42	$73,181.98	$56,584.01	2025-07-29
J9266	HCPCS	Pegaspargase 750 I-units/ml Inj 5 Ml	37	20	$71,867.93	$71,867.93	$18,229.79	$69,711.89	$33,634.19	2025-07-29
J3357	HCPCS	Ustekinumab 90 Mg/ml Syringe	37	20	$78,278.18	$78,278.18	$180.12	$75,929.83	$33,268.23	2025-07-29
J9298	HCPCS	Nivolumab-relatlimab Rmbw 240 Mg-80 Mg/20 Ml	17	17	$42,127.68	$42,127.68	$19,715.75	$40,863.85	$31,595.76	2025-07-29
J2350	HCPCS	Ocrelizumab 30 Mg/ml Inj 10 Ml	20	20	$52,556.79	$52,556.79	$57.32	$50,980.09	$29,050.76	2025-07-29
J2327	HCPCS	Risankizumab 150 Mg/ml So	34	17	$58,256.57	$58,256.57	$13,150.26	$56,508.87	$27,259.97	2025-07-29
J9272	HCPCS	Dostarlimab-gxly 500 Mg/10 Ml Inj	17	17	$32,877.85	$32,877.85	$15,386.83	$31,891.51	$24,658.39	2025-07-29
0238T	OTHER	Trluml Perip Athrc Iliac Art 0238t	16	16	$32,747.00	$32,747.00	$15,325.60	$31,764.59	$24,560.25	2025-07-29
J9043	HCPCS	Cabazitaxel 10 Mg/ml Inj	20	20	$41,010.73	$41,010.73	$196.60	$39,780.41	$22,668.68	2025-07-29
J9228	HCPCS	Ipilimumab 5 Mg/ml Inj 40 Ml	37	20	$98,844.87	$98,844.87	$173.35	$95,879.52	$21,048.58	2025-07-29
J9316	HCPCS	Pertuzumab/trastuzumab/hyaluronidase 600 Mg-600 Mg-20k Units/10	36	19	$25,075.39	$25,075.39	$83.25	$36,452.66	$20,285.99	2025-07-29
J1440	HCPCS	Fecal Microbiota Live-jslm Susp	17	17	$26,584.40	$26,584.40	$12,441.50	$25,786.87	$19,938.30	2025-07-29
J1932	HCPCS	Lanreotide 120 Mg/0.5 Ml Inj	17	17	$26,271.83	$26,271.83	$12,295.22	$25,483.68	$19,703.87	2025-07-29
J9042	HCPCS	Brentuximab 5 Mg/ml Inj	20	20	$32,180.86	$32,180.86	$183.89	$31,215.43	$17,787.97	2025-07-29
J9022	HCPCS	Atezolizumab 60 Mg/ml Inj 14 Ml	37	20	$21,430.86	$21,430.86	$87.18	$29,676.54	$16,826.90	2025-07-29
J9119	HCPCS	Cemiplimab-rwlc 50 Mg/ml Inj 7 Ml	20	20	$29,582.74	$29,582.74	$28.48	$28,695.26	$16,351.86	2025-07-29
J1303	HCPCS	Ravulizumab Cwvz 1100 Mg/11 Ml Inj	37	20	$69,385.90	$69,385.90	$226.18	$67,304.32	$16,127.57	2025-07-29
J9307	HCPCS	Pralatrexate 20 Mg/ml Inj	37	20	$18,493.52	$18,493.52	$329.73	$35,810.48	$15,719.49	2025-07-29
J9273	HCPCS	Tisotumab Vedotin Tftv 40 Mg Inj	17	17	$19,549.25	$19,549.25	$9,149.05	$18,962.77	$14,661.94	2025-07-29
J9144	HCPCS	Daratumumab-hyaluronidase 1800 Mg/15 Ml	19	19	$25,827.96	$25,827.96	$49.64	$25,053.12	$14,347.43	2025-07-29
J2506	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Inj	17	17	$18,966.61	$18,966.61	$8,876.37	$18,397.61	$14,224.96	2025-07-29
Q4100	HCPCS	Tissue Strattice 10 X 16 Firm	18	18	$20,670.00	$20,670.00	$3,773.66	$20,049.90	$13,492.35	2025-07-29
J3380	HCPCS	Vedolizumab 60 Mg/ml Inj 5 Ml	20	20	$24,184.96	$24,184.96	$20.61	$23,459.41	$13,368.24	2025-07-29
J1930	HCPCS	Lanreotide 90 Mg/0.3 Ml Inj	122	20	$22,925.27	$22,925.27	$64.68	$27,400.29	$13,175.54	2025-07-29
J9301	HCPCS	Obinutuzumab 25 Mg/ml Inj 40 Ml	20	20	$23,002.09	$23,002.09	$71.17	$22,312.03	$12,714.40	2025-07-29
J9223	HCPCS	Lurbinectedin 4 Mg Inj	19	19	$22,622.28	$22,622.28	$197.79	$21,943.61	$12,566.68	2025-07-29
J9311	HCPCS	Rituximab-hyaluron (1 600 Mg-26 800 Units)/13.4 Ml Inj	37	20	$22,256.50	$22,256.50	$45.17	$21,588.81	$12,363.49	2025-07-29
J3101	HCPCS	Tenecteplase 50 Mg/10 Ml Inj	20	20	$21,801.32	$21,801.32	$126.42	$21,147.28	$12,050.68	2025-07-29
C9363	HCPCS	Graft Mesh Bilayer 2x2 Matrix	34	17	$12,908.00	$12,908.00	$6,040.94	$21,818.21	$11,221.61	2025-07-29
J2323	HCPCS	Natalizumab 300 Mg/15 Ml Inj	37	20	$13,079.48	$13,079.48	$21.01	$23,554.85	$11,117.56	2025-07-29
J0491	HCPCS	Anifrolumab Fnia 300 Mg/2 Ml So	17	17	$14,786.69	$14,786.69	$6,920.17	$14,343.09	$11,090.02	2025-07-29
J1300	HCPCS	Eculizumab 10 Mg/ml Inj 30 Ml	20	20	$19,305.25	$19,305.25	$230.32	$18,726.09	$10,670.98	2025-07-29
J9306	HCPCS	Pertuzumab 30 Mg/ml Inj 14 Ml	20	20	$18,774.88	$18,774.88	$13.91	$18,211.63	$10,377.82	2025-07-29
J0896	HCPCS	Luspatercept 75 Mg Inj	36	19	$33,672.56	$33,672.56	$36.31	$32,662.38	$10,226.58	2025-07-29
37205	HCPCS	Transcath Ivasc Stent Perq Init Ves 37205	15	15	$12,915.00	$12,915.00	$6,044.22	$12,527.55	$9,686.25	2025-07-29
J9309	HCPCS	Polatuzumab Vedotin 20 Mg/ml Inj	36	19	$48,924.72	$48,924.72	$126.92	$47,456.98	$9,589.67	2025-07-29
Q4116	HCPCS	Tissue Alloderm 8 X 12	17	17	$12,229.00	$12,229.00	$5,723.17	$11,862.13	$9,171.75	2025-07-29
J9271	HCPCS	Pembrolizumab 25 Mg/ml Inj 4 Ml	20	20	$16,455.15	$16,455.15	$55.91	$15,961.50	$9,095.58	2025-07-29
J9354	HCPCS	Ado-trastuzumab Emtansine 20 Mg/ml Inj 5 Ml	37	20	$11,115.59	$11,115.59	$35.51	$17,211.20	$9,049.19	2025-07-29
J0517	HCPCS	Benralizumab 30 Mg/ml Inj	20	20	$16,290.38	$16,290.38	$171.30	$15,801.67	$9,004.51	2025-07-29
J0717	HCPCS	Certolizumab 200 Mg/ml Inj	20	20	$15,963.15	$15,963.15	$8.18	$15,484.26	$8,823.63	2025-07-29
J1290	HCPCS	Ecallantide 10 Mg/ml Inj	20	20	$15,899.50	$15,899.50	$492.44	$15,422.52	$8,788.45	2025-07-29
J2325	HCPCS	Nesiritide 1500 Mcg/5 Ml	20	20	$15,644.31	$15,644.31	$74.80	$15,174.98	$8,647.39	2025-07-29
J2356	HCPCS	Tezepelumab 210 Mg/1.91 Ml Inj	17	17	$11,378.08	$11,378.08	$5,324.94	$11,036.74	$8,533.56	2025-07-29
33916	HCPCS	Pulm Endartercomy W/bypass 33916	15	15	$11,248.00	$11,248.00	$5,264.06	$10,910.56	$8,436.00	2025-07-29
J7189	HCPCS	Coagulation Factor Viia 1 000 Mcg/ml Inj 1 Ml	88	20	$15,193.98	$15,193.98	$2.23	$58,892.41	$8,398.48	2025-07-29
J1640	HCPCS	Panhematin 7 Mg/ml Inj	20	20	$14,801.99	$14,801.99	$24.44	$14,357.93	$8,181.80	2025-07-29
33305	HCPCS	Repair Heart Wound W/bypass 33305	15	15	$10,885.00	$10,885.00	$5,094.18	$10,558.45	$8,163.75	2025-07-29
33858	HCPCS	Ascend Aorta Graft W/aortic Dissection 33858	15	15	$10,588.00	$10,588.00	$4,955.18	$10,270.36	$7,941.00	2025-07-29
J9356	HCPCS	Trastuzumab-hyaluron (600 Mg-10 000 Units)/5 Ml Inj	20	20	$13,870.31	$13,870.31	$83.29	$13,454.20	$7,666.82	2025-07-29
J1162	HCPCS	Digoxin Immune Fab 10 Mg/ml Inj 4 Ml	20	20	$13,625.60	$13,625.60	$3,922.84	$13,216.83	$7,531.55	2025-07-29
33864	HCPCS	Asc Aort Gft/cp/root Rem/cor Recon 33864	15	15	$9,976.00	$9,976.00	$4,668.77	$9,676.72	$7,482.00	2025-07-29
33870	HCPCS	Transverse Aortic Arch Graft W/bypass 33870	15	15	$9,911.00	$9,911.00	$4,638.35	$9,613.67	$7,433.25	2025-07-29
33860	HCPCS	Ascending Aorta Graft W/bypass 33860	15	15	$9,910.00	$9,910.00	$4,637.88	$9,612.70	$7,432.50	2025-07-29
50592	HCPCS	Perq Radiofreq Ablate Renal Tumor 50592	16	16	$9,859.00	$9,859.00	$4,614.01	$9,563.23	$7,394.25	2025-07-29
J9061	HCPCS	Amivantamab Vmjw 50 Mg/ml Inj	17	17	$9,760.56	$9,760.56	$4,567.94	$9,467.74	$7,320.42	2025-07-29
33863	HCPCS	Aa Graft W/bp/aortic Root Replace 33863	15	15	$9,748.00	$9,748.00	$4,562.06	$9,455.56	$7,311.00	2025-07-29
33877	HCPCS	Thoracoabdominal Graft 33877	15	15	$9,635.00	$9,635.00	$4,509.18	$9,345.95	$7,226.25	2025-07-29
J1306	HCPCS	Inclisiran 284 Mg/1.5 Ml Inj	17	17	$9,614.70	$9,614.70	$4,499.68	$9,326.26	$7,211.03	2025-07-29
J2997	HCPCS	Alteplase 50 Mg/50 Ml Inj	54	20	$13,010.04	$13,010.04	$87.68	$25,247.17	$7,191.30	2025-07-29
33463	HCPCS	Valvuloplasty/tv Without Ring Insert 33463	15	15	$9,540.00	$9,540.00	$4,464.72	$9,253.80	$7,155.00	2025-07-29
48105	HCPCS	Resect/debrid Pancreas 48105	15	15	$9,535.00	$9,535.00	$4,462.38	$9,248.95	$7,151.25	2025-07-29
33548	HCPCS	Restore/remodelventricle 33548	15	15	$9,207.00	$9,207.00	$4,308.88	$8,930.79	$6,905.25	2025-07-29
Q5108	HCPCS	Pegfilgrastim Jmdb 6 Mg/0.6 Ml Inj	20	20	$12,345.30	$12,345.30	$247.65	$11,974.94	$6,823.86	2025-07-29
Q5111	HCPCS	Pegfilgrastim Cbqv 6 Mg/0.6 Ml So	20	20	$12,345.30	$12,345.30	$268.46	$11,974.94	$6,823.86	2025-07-29
35631	HCPCS	Art Byp Aor Celiac Msn And Renal 35631	15	15	$9,050.00	$9,050.00	$4,235.40	$8,778.50	$6,787.50	2025-07-29
33536	HCPCS	Cabg Arterial Four Or More 33536	15	15	$9,037.00	$9,037.00	$4,229.32	$8,765.89	$6,777.75	2025-07-29
J2353	HCPCS	Octreotide 30 Mg Kit	105	20	$9,508.65	$9,508.65	$205.66	$19,045.18	$6,708.48	2025-07-29
33425	HCPCS	Repair Of Mitral Valve W/bypass 33425	15	15	$8,942.00	$8,942.00	$4,184.86	$8,673.74	$6,706.50	2025-07-29
65820	HCPCS	Mild Procedure	18	18	$10,225.00	$10,225.00	$4,648.51	$9,918.25	$6,674.37	2025-07-29
33406	HCPCS	Replace Aortic Valve Allograft Freehand 33406	15	15	$8,884.00	$8,884.00	$4,157.71	$8,617.48	$6,663.00	2025-07-29
33411	HCPCS	Replace Aortic Valve Annulus Enlgment 33411	15	15	$8,883.00	$8,883.00	$4,157.24	$8,616.51	$6,662.25	2025-07-29
J9177	HCPCS	Enfortumab Vedotin-ejfv 20 Mg Inj	36	19	$8,179.16	$8,179.16	$31.66	$11,876.74	$6,616.94	2025-07-29
J2182	HCPCS	Mepolizumab 40 Mg/0.4 Ml Syr	54	20	$10,572.26	$10,572.26	$28.85	$10,255.12	$6,610.22	2025-07-29
31296	HCPCS	Sinus Endo W/dilat Frontal Sinus 31296	16	16	$8,723.00	$8,723.00	$511.50	$8,461.31	$6,542.25	2025-07-29
33430	HCPCS	Mitral Valve Replacement W/bypass 33430	15	15	$8,679.00	$8,679.00	$4,061.77	$8,418.63	$6,509.25	2025-07-29
31297	HCPCS	Sinus Endo W/dilat Sphenoid 31297	16	16	$8,642.00	$8,642.00	$511.50	$8,382.74	$6,481.50	2025-07-29
61519	HCPCS	Craniectomy Exc Brain Tumor Meningioma 61519	15	15	$8,614.00	$8,614.00	$4,031.35	$8,355.58	$6,460.50	2025-07-29
Q5120	HCPCS	Pegfilgrastim Bmez 6 Mg/0.6 Ml So	19	19	$11,608.87	$11,608.87	$300.44	$11,260.60	$6,448.73	2025-07-29
81212	HCPCS	Brcassure Comprehensive Test-sendout	18	18	$9,877.00	$9,877.00	$225.06	$9,580.69	$6,447.21	2025-07-29
J9319	HCPCS	Romidepsin 5 Mg/ml Inj 2 Ml	34	17	$8,710.12	$8,710.12	$4,009.44	$8,448.82	$6,425.39	2025-07-29
32815	HCPCS	Close Bronchial Fistula 32815	15	15	$8,536.00	$8,536.00	$3,994.85	$8,279.92	$6,402.00	2025-07-29
33465	HCPCS	Replacement Tricuspid Valve 33465	15	15	$8,470.00	$8,470.00	$3,963.96	$8,215.90	$6,352.50	2025-07-29
33875	HCPCS	Thoracic Aortic Graft 33875	15	15	$8,459.00	$8,459.00	$3,958.81	$8,205.23	$6,344.25	2025-07-29
J0565	HCPCS	Bezlotoxumab 25 Mg/ml Inj 40 Ml	20	20	$11,266.95	$11,266.95	$39.67	$10,928.94	$6,227.81	2025-07-29
43287	HCPCS	Esphg Dstl 2/3 W/laps Moblj 43287	15	15	$8,255.00	$8,255.00	$3,863.34	$8,007.35	$6,191.25	2025-07-29
61323	HCPCS	Craniect/craniot W/wo Duraplasty W/lobectomy 61323	15	15	$8,227.00	$8,227.00	$3,850.24	$7,980.19	$6,170.25	2025-07-29
33542	HCPCS	Myocardial Resection 33542	15	15	$8,106.00	$8,106.00	$3,793.61	$7,862.82	$6,079.50	2025-07-29
35540	HCPCS	Art Byp Grft Aortbifemoral 35540	15	15	$8,093.00	$8,093.00	$3,787.52	$7,850.21	$6,069.75	2025-07-29
J9299	HCPCS	Nivolumab 10 Mg/ml Inj 12 Ml	71	20	$10,900.12	$10,900.12	$31.48	$21,079.37	$6,055.02	2025-07-29
61518	HCPCS	Craniectomy Exc Brain Tumor Fossa 61518	15	15	$8,061.00	$8,061.00	$3,772.55	$7,819.17	$6,045.75	2025-07-29
J0401	HCPCS	Aripiprazole 400 Mg/2 Ml Inj-ER	15	15	$8,047.88	$8,047.88	$3,766.41	$7,806.44	$6,035.91	2025-07-29
J0135	HCPCS	Adalimumab 40 Mg/0.8 Ml Inj	20	20	$10,776.27	$10,776.27	$1,422.88	$10,452.98	$5,956.59	2025-07-29
43282	HCPCS	Lap Paraesoph Her Rpr W/mesh 43282	16	16	$7,850.00	$7,850.00	$3,673.80	$11,961.60	$5,938.52	2025-07-29
47785	HCPCS	Fuse Bile Ducts And Bowel 47785	15	15	$7,902.00	$7,902.00	$3,698.14	$7,664.94	$5,926.50	2025-07-29
43117	HCPCS	Partial Removal Of Esophagus 43117	15	15	$7,894.00	$7,894.00	$3,694.39	$7,657.18	$5,920.50	2025-07-29
0245U	OTHER	Thyramir	17	17	$7,786.00	$7,786.00	$3,643.85	$7,552.42	$5,839.50	2025-07-29
61343	HCPCS	Craniectomy Subocc W/cerv Lam (press Relief) 61343	15	15	$7,732.00	$7,732.00	$3,618.58	$7,500.04	$5,799.00	2025-07-29
43107	HCPCS	Tot Esophagectomy Without Thoracotomy 43107	15	15	$7,723.00	$7,723.00	$3,614.36	$7,491.31	$5,792.25	2025-07-29
33513	HCPCS	Cabg/vein Only/4 Cor Venous Gfts 33513	15	15	$7,688.00	$7,688.00	$3,597.98	$7,457.36	$5,766.00	2025-07-29
48153	HCPCS	Pancreatectomy 48153	15	15	$7,622.00	$7,622.00	$3,567.10	$7,393.34	$5,716.50	2025-07-29
33535	HCPCS	Cabg 3 Arterial Grafts 33535	15	15	$7,611.00	$7,611.00	$3,561.95	$7,382.67	$5,708.25	2025-07-29
59618	HCPCS	Total OB Care Failed Vbac 59618	15	15	$7,608.00	$7,608.00	$3,560.54	$7,379.76	$5,706.00	2025-07-29
33427	HCPCS	Tmvr W/rad Reconst W Or Without Ring 33427	15	15	$7,595.00	$7,595.00	$3,554.46	$7,367.15	$5,696.25	2025-07-29
J7504	HCPCS	Lymphocyte Ig (equine) 50 Mg/ml Inj 5 Ml	20	20	$10,246.72	$10,246.72	$2,143.99	$9,939.32	$5,663.88	2025-07-29
33464	HCPCS	Valvuloplasty/tv W/ring Insertion 33464	15	15	$7,545.00	$7,545.00	$3,531.06	$7,318.65	$5,658.75	2025-07-29
33859	HCPCS	Ascend Aorta Graft Oth Dissect 33859	15	15	$7,537.00	$7,537.00	$3,527.32	$7,310.89	$5,652.75	2025-07-29
J1726	HCPCS	Hydroxyprogesterone Caproate 250 Mg/ml Inj 5 Ml	20	20	$10,205.10	$10,205.10	$16.05	$9,898.95	$5,640.87	2025-07-29
33300	HCPCS	Repair Heart Wound Without Bypass 33300	15	15	$7,506.00	$7,506.00	$3,512.81	$7,280.82	$5,629.50	2025-07-29
33512	HCPCS	Cabg/vein Only/3 Cor Venous Gfts 33512	15	15	$7,490.00	$7,490.00	$3,505.32	$7,265.30	$5,617.50	2025-07-29
33460	HCPCS	Revision Of Tricuspid Valve W/bypass 33460	15	15	$7,475.00	$7,475.00	$3,498.30	$7,250.75	$5,606.25	2025-07-29
61512	HCPCS	Remove Brain Lining Lesion 61512	15	15	$7,458.00	$7,458.00	$3,490.34	$7,234.26	$5,593.50	2025-07-29
33681	HCPCS	Repair Heart Septum Defect 33681	15	15	$7,431.00	$7,431.00	$3,477.71	$7,208.07	$5,573.25	2025-07-29
33031	HCPCS	Pericardiectomy/sub Or Com/w Bypas 33031	15	15	$7,430.00	$7,430.00	$3,477.24	$7,207.10	$5,572.50	2025-07-29
33426	HCPCS	Tmvr W/prosthetic Ring 33426	15	15	$7,386.00	$7,386.00	$3,456.65	$7,164.42	$5,539.50	2025-07-29
47780	HCPCS	Anastamo/roux-en-y/extrahep Bil/gi 47780	15	15	$7,339.00	$7,339.00	$3,434.65	$7,118.83	$5,504.25	2025-07-29
C1713	HCPCS	Graft Dermis Acell Aflex500	68	17	$6,742.00	$6,742.00	$1,450.33	$13,439.35	$5,488.41	2025-07-29
32488	HCPCS	Completion Pneumonectomy 32488	15	15	$7,312.00	$7,312.00	$3,422.02	$7,092.64	$5,484.00	2025-07-29
35538	HCPCS	Art Byp Grft Aortobi-iliac 35538	15	15	$7,293.00	$7,293.00	$3,413.12	$7,074.21	$5,469.75	2025-07-29
61345	HCPCS	Relieve Cranial Pressure 61345	15	15	$7,228.00	$7,228.00	$3,382.70	$7,011.16	$5,421.00	2025-07-29
32486	HCPCS	Rmvl Lung Xcp Tot Pneumonectomy Sleeve Lob 32486	15	15	$7,221.00	$7,221.00	$3,379.43	$7,004.37	$5,415.75	2025-07-29
33475	HCPCS	Replacement Pulmonary Valve 33475	15	15	$7,214.00	$7,214.00	$3,376.15	$6,997.58	$5,410.50	2025-07-29
58554	HCPCS	Lavh W/sapl-oophorectomy >250 Gms 58554	16	16	$7,125.00	$7,125.00	$3,334.50	$13,914.16	$5,390.07	2025-07-29
61315	HCPCS	Craniectomy Or Craniotomy For Drng Inf 61315	15	15	$7,121.00	$7,121.00	$3,332.63	$6,907.37	$5,340.75	2025-07-29
37184	HCPCS	Thromb/perc/translu/thromb Inj/ini 37184	16	16	$7,117.00	$7,117.00	$3,330.76	$6,903.49	$5,337.75	2025-07-29
59610	HCPCS	Vbac Delivery 59610	15	15	$7,096.00	$7,096.00	$3,320.93	$6,883.12	$5,322.00	2025-07-29
33917	HCPCS	Repair Pulm Artery Stenosis W/patch/graft 33917	15	15	$7,088.00	$7,088.00	$3,317.18	$6,875.36	$5,316.00	2025-07-29
33405	HCPCS	Replac Av W/bypas/other Pros Valve 33405	15	15	$7,081.00	$7,081.00	$3,313.91	$6,868.57	$5,310.75	2025-07-29
35475	HCPCS	Angioplast/brachiocep Trunk/ea Ves 35475	16	16	$7,003.00	$7,003.00	$3,277.40	$17,157.07	$5,297.77	2025-07-29
J9352	HCPCS	Trabectedin 1 Mg Inj	20	20	$9,581.55	$9,581.55	$354.24	$9,294.10	$5,296.20	2025-07-29
33400	HCPCS	Aortic Valvuloplasty/open/w/bypass 33400	15	15	$7,046.00	$7,046.00	$3,297.53	$6,834.62	$5,284.50	2025-07-29
61571	HCPCS	Craniectomy/craniotomy Tx Penet Wound Brain 61571	15	15	$7,044.00	$7,044.00	$3,296.59	$6,832.68	$5,283.00	2025-07-29
47361	HCPCS	Management Of Liver Hemorrhage 47361	15	15	$6,957.00	$6,957.00	$3,255.88	$6,748.29	$5,217.75	2025-07-29
35082	HCPCS	Repair Art Rupture Aorta 35082	15	15	$6,931.00	$6,931.00	$3,243.71	$6,723.07	$5,198.25	2025-07-29
47120	HCPCS	Hepatectomy Removal Of Liver 47120	15	15	$6,926.00	$6,926.00	$3,241.37	$6,718.22	$5,194.50	2025-07-29
63281	HCPCS	Lamie Bx/exc Idrl Spine Lesn Thrc 63281	15	15	$6,909.00	$6,909.00	$3,233.41	$6,701.73	$5,181.75	2025-07-29
J1743	HCPCS	Idursulfase 2 Mg/ml Inj	20	20	$9,306.33	$9,306.33	$542.92	$9,027.14	$5,144.07	2025-07-29
33534	HCPCS	Cabg 2 Arterial Grafts 33534	15	15	$6,831.00	$6,831.00	$3,196.91	$6,626.07	$5,123.25	2025-07-29
33478	HCPCS	Outflow Tarct Agmntj Heart Chamber 33478	15	15	$6,828.00	$6,828.00	$3,195.50	$6,623.16	$5,121.00	2025-07-29
35151	HCPCS	Repair Defect Of Artery Aneurysm 35151	15	15	$6,813.00	$6,813.00	$3,188.48	$6,608.61	$5,109.75	2025-07-29
59400	HCPCS	Obstetrical Care 59400	15	15	$6,768.00	$6,768.00	$3,167.42	$6,564.96	$5,076.00	2025-07-29
37187	HCPCS	Venous Mechanical Thrombectomy 37187	16	16	$6,766.00	$6,766.00	$3,166.49	$6,563.02	$5,074.50	2025-07-29
37246	HCPCS	Trluml Balo Angiop 1st Art 37246	15	15	$6,721.00	$6,721.00	$3,145.43	$6,519.37	$5,040.75	2025-07-29
32504	HCPCS	Resect Apical Lung Tum/chest With Rcnstj 32504	15	15	$6,719.00	$6,719.00	$3,144.49	$6,517.43	$5,039.25	2025-07-29
47760	HCPCS	Anastamo/extrahep Bil Duct/gi Trac 47760	15	15	$6,693.00	$6,693.00	$3,132.32	$6,492.21	$5,019.75	2025-07-29
33415	HCPCS	Resect/incis/subva Tissue/subva As 33415	15	15	$6,605.00	$6,605.00	$3,091.14	$6,406.85	$4,953.75	2025-07-29
33511	HCPCS	Cabg/vein Only/2 Cor Venous Gfts 33511	15	15	$6,599.00	$6,599.00	$3,088.33	$6,401.03	$4,949.25	2025-07-29
61313	HCPCS	Craniectomy Or Craniotomy For Drng Supr 61313	15	15	$6,585.00	$6,585.00	$3,081.78	$6,387.45	$4,938.75	2025-07-29
33533	HCPCS	Cabgsingle Artery Graft 33533	15	15	$6,581.00	$6,581.00	$3,079.91	$6,383.57	$4,935.75	2025-07-29
J3358	HCPCS	Ustekinumab 45 Mg/0.5 Ml Syringe	37	20	$39,139.09	$39,139.09	$11.95	$37,964.92	$4,879.94	2025-07-29
58954	HCPCS	Tah Rad Debulk/lymph Remove 58954	15	15	$6,502.00	$6,502.00	$3,042.94	$6,306.94	$4,876.50	2025-07-29
33366	HCPCS	Trans Cath Replace Aortic Valve 33366	15	15	$6,475.00	$6,475.00	$3,030.30	$6,280.75	$4,856.25	2025-07-29
31295	HCPCS	Sinus Endo W/dilat Maxillary 31295	16	16	$6,428.00	$6,428.00	$511.50	$6,235.16	$4,821.00	2025-07-29
33120	HCPCS	Exc Intracard Tumor/resect/bypass 33120	15	15	$6,397.00	$6,397.00	$2,993.80	$6,205.09	$4,797.75	2025-07-29
61510	HCPCS	Removal Of Brain Lesion 61510	15	15	$6,389.00	$6,389.00	$2,990.05	$6,197.33	$4,791.75	2025-07-29
33418	HCPCS	Repair Tcat Mitral Valve Initial 33418	15	15	$6,382.00	$6,382.00	$2,986.78	$6,190.54	$4,786.50	2025-07-29
33910	HCPCS	Remove Lung Artery Emboli 33910	15	15	$6,361.00	$6,361.00	$2,976.95	$6,170.17	$4,770.75	2025-07-29
33416	HCPCS	Ventriculomyotomy/ihss 33416	15	15	$6,279.00	$6,279.00	$2,938.57	$6,090.63	$4,709.25	2025-07-29
44155	HCPCS	Colectomy/ Ileostomy W/prctect 44155	15	15	$6,272.00	$6,272.00	$2,935.30	$6,083.84	$4,704.00	2025-07-29
27096	HCPCS	Discogram	33	18	$10,051.00	$10,051.00	$385.16	$9,749.47	$4,703.87	2025-07-29
62290	HCPCS	Cervical/thoracic Disc	33	18	$10,051.00	$10,051.00	$494.68	$9,749.47	$4,703.87	2025-07-29
J9176	HCPCS	Elotuzumab 400 Mg In	20	20	$8,509.30	$8,509.30	$7.35	$8,254.02	$4,703.52	2025-07-29
35216	HCPCS	Repair Blood Vessel Direct Intrathoracic Without Bypass 35216	15	15	$6,267.00	$6,267.00	$2,932.96	$6,078.99	$4,700.25	2025-07-29
37239	HCPCS	Open/perq Place Stent Ea Ddd 37239	16	16	$6,259.00	$6,259.00	$2,929.21	$6,071.23	$4,694.25	2025-07-29
35820	HCPCS	Explore Chest Vessels 35820	16	16	$6,176.00	$6,176.00	$2,890.37	$15,309.54	$4,672.15	2025-07-29
43122	HCPCS	Partial Removal Of Esophagus 43122	15	15	$6,224.00	$6,224.00	$2,912.83	$6,037.28	$4,668.00	2025-07-29
43415	HCPCS	Repair Esophagus Wound 43415	15	15	$6,213.00	$6,213.00	$2,907.68	$6,026.61	$4,659.75	2025-07-29
45123	HCPCS	Partial Proctectomy Perineal 45123	16	16	$6,105.00	$6,105.00	$2,857.14	$5,921.85	$4,618.43	2025-07-29
33647	HCPCS	Repair Heart Septum Defects Dir/patch 33647	15	15	$6,084.00	$6,084.00	$2,847.31	$5,901.48	$4,563.00	2025-07-29
61312	HCPCS	Open Skull For Drainage 61312	15	15	$6,075.00	$6,075.00	$2,843.10	$5,892.75	$4,556.25	2025-07-29
44208	HCPCS	Lap Colectomy/coloproctostomy W/clst 44208	16	16	$6,003.00	$6,003.00	$2,809.40	$13,914.16	$4,541.27	2025-07-29
33256	HCPCS	Ablate Atria W/bypass Exten 33256	15	15	$6,052.00	$6,052.00	$2,832.34	$5,870.44	$4,539.00	2025-07-29
J2798	HCPCS	Risperidone 90 Mg Inj	37	20	$6,133.08	$6,133.08	$10.17	$7,925.46	$4,538.76	2025-07-29
33030	HCPCS	Partial Removal Of Heart Sac 33030	15	15	$6,047.00	$6,047.00	$2,830.00	$5,865.59	$4,535.25	2025-07-29
43632	HCPCS	Removal Of Stomachpartial 43632	15	15	$6,043.00	$6,043.00	$2,828.12	$5,861.71	$4,532.25	2025-07-29
J0630	HCPCS	Calcitonin 400 Units/2 Ml Inj	54	20	$6,761.56	$6,761.56	$2,505.98	$8,988.66	$4,522.00	2025-07-29
44210	HCPCS	Lap Tot Proctocolectomy 44210	15	15	$6,029.00	$6,029.00	$2,821.57	$5,848.13	$4,521.75	2025-07-29
33510	HCPCS	Cabgsingle Coronary Venous Graft 33510	15	15	$6,011.00	$6,011.00	$2,813.15	$5,830.67	$4,508.25	2025-07-29
45395	HCPCS	Lap Removal Of Rectum W/colostomy 45395	15	15	$6,010.00	$6,010.00	$2,812.68	$5,829.70	$4,507.50	2025-07-29
58953	HCPCS	Tah Rad Dissect For Debulk 58953	15	15	$5,998.00	$5,998.00	$2,807.06	$5,818.06	$4,498.50	2025-07-29
35102	HCPCS	Repair Defect Of Artery 35102	15	15	$5,989.00	$5,989.00	$2,802.85	$5,809.33	$4,491.75	2025-07-29
33365	HCPCS	Replace Aortic Valve Open Transaortic 33365	15	15	$5,981.00	$5,981.00	$2,799.11	$5,801.57	$4,485.75	2025-07-29
58356	HCPCS	Endometrial Cryoablation W/us 58356	16	16	$5,892.00	$5,892.00	$2,757.46	$6,129.82	$4,457.30	2025-07-29
33660	HCPCS	Repair Of Heart Defects Incplt/prtl Without Av Valve 33660	15	15	$5,929.00	$5,929.00	$2,774.77	$5,751.13	$4,446.75	2025-07-29
93631	HCPCS	Intraop Epicard/endocard/pace/map/ 93631	16	16	$5,857.00	$5,857.00	$2,741.08	$5,681.29	$4,430.82	2025-07-29
33315	HCPCS	Exploratory Heart Surgery 33315	15	15	$5,863.00	$5,863.00	$2,743.88	$5,687.11	$4,397.25	2025-07-29
J9358	HCPCS	Fam-trastuzumab Deruxtecan 100 Mg In	19	19	$7,888.52	$7,888.52	$27.32	$7,651.86	$4,382.07	2025-07-29
36870	HCPCS	Thrombectomy Perq Av Fistula 36870	16	16	$5,791.00	$5,791.00	$2,710.19	$5,617.27	$4,380.89	2025-07-29
33335	HCPCS	Insert Major Vessel Graft With Bypass 33335	15	15	$5,824.00	$5,824.00	$2,725.63	$5,649.28	$4,368.00	2025-07-29
33645	HCPCS	Revision Of Heart Veins Dir/ptch 33645	15	15	$5,820.00	$5,820.00	$2,723.76	$5,645.40	$4,365.00	2025-07-29
58565	HCPCS	Essure 58565	16	16	$5,767.00	$5,767.00	$2,698.96	$6,329.64	$4,362.74	2025-07-29
63081	HCPCS	Remove Vert Bodycerv 63081	15	15	$5,813.00	$5,813.00	$2,720.48	$5,638.61	$4,359.75	2025-07-29
44147	HCPCS	Colectomy Prtl Abdominal + Transanal Appr 44147	15	15	$5,797.00	$5,797.00	$2,713.00	$5,623.09	$4,347.75	2025-07-29
63282	HCPCS	Lamie Bx/exc Idrl Spine Lesn Lmbr 63282	15	15	$5,769.00	$5,769.00	$2,699.89	$5,595.93	$4,326.75	2025-07-29
43633	HCPCS	Gstrct Prtl Dstl W/roux-en-y Rcnstj 43633	15	15	$5,721.00	$5,721.00	$2,677.43	$5,549.37	$4,290.75	2025-07-29
33266	HCPCS	Ablate Atria X10sv Endo 33266	15	15	$5,705.00	$5,705.00	$2,669.94	$5,533.85	$4,278.75	2025-07-29
45112	HCPCS	Proctectomy Combined Abd Pull-thru Px 45112	15	15	$5,696.00	$5,696.00	$2,665.73	$5,525.12	$4,272.00	2025-07-29
44227	HCPCS	Lap Close Enterostomy With Resect 44227	15	15	$5,686.00	$5,686.00	$2,661.05	$5,515.42	$4,264.50	2025-07-29
33880	HCPCS	Descend Thora Aorta Rpr/lt Sub Art 33880	15	15	$5,662.00	$5,662.00	$2,649.82	$5,492.14	$4,246.50	2025-07-29
61304	HCPCS	Craniectomy/craniotomy Expl 61304	15	15	$5,659.00	$5,659.00	$2,648.41	$5,489.23	$4,244.25	2025-07-29
J1459	HCPCS	Immune Globulin (privigen) 10% Inj 100 Ml	71	20	$4,993.06	$4,993.06	$41.64	$19,229.48	$4,244.10	2025-07-29
34830	HCPCS	Open Aortic Tube Prosth Repair 34830	15	15	$5,645.00	$5,645.00	$2,641.86	$5,475.65	$4,233.75	2025-07-29
35476	HCPCS	Angioplasty Percutaneous Venous 35476	16	16	$5,561.00	$5,561.00	$2,602.55	$17,157.07	$4,206.90	2025-07-29
44150	HCPCS	Colectomy/ Ileostomy Without Prctect 44150	15	15	$5,604.00	$5,604.00	$2,622.67	$5,435.88	$4,203.00	2025-07-29
35638	HCPCS	Art Bypass Aortobi-iliac 35638	15	15	$5,595.00	$5,595.00	$2,618.46	$5,427.15	$4,196.25	2025-07-29
32503	HCPCS	Resect Apical Lung Tumor Without Rcnstj 32503	15	15	$5,581.00	$5,581.00	$2,611.91	$5,413.57	$4,185.75	2025-07-29
45110	HCPCS	Proctectomy Complete Abd W/clst 45110	15	15	$5,580.00	$5,580.00	$2,611.44	$5,412.60	$4,185.00	2025-07-29
36252	HCPCS	Ins Cath Ren Art 1st Bilat 36252	16	16	$5,527.00	$5,527.00	$2,586.64	$5,361.19	$4,181.18	2025-07-29
43621	HCPCS	Removal Of Stomach 43621	15	15	$5,573.00	$5,573.00	$2,608.16	$5,405.81	$4,179.75	2025-07-29
19367	HCPCS	Breast Reconstruction Tram Flap 19367	16	16	$5,522.00	$5,522.00	$2,584.30	$8,029.87	$4,177.40	2025-07-29
61320	HCPCS	Craniectomy Or Craniotomy For Drng Abscess 61320	15	15	$5,567.00	$5,567.00	$2,605.36	$5,399.99	$4,175.25	2025-07-29
35081	HCPCS	Repair Defect Of Artery 35081	15	15	$5,551.00	$5,551.00	$2,597.87	$5,384.47	$4,163.25	2025-07-29
22633	HCPCS	Arthrodesis/combine App/sng/lumbar 22633	15	15	$5,526.00	$5,526.00	$2,586.17	$5,360.22	$4,144.50	2025-07-29
44141	HCPCS	Colectomy Prtl W/skin Level Cecost/colostomy 44141	16	16	$5,450.00	$5,450.00	$2,550.60	$8,753.47	$4,122.93	2025-07-29
36475	HCPCS	Endo Abl/incom Vein/ext/rad Fre/ 1 36475	16	16	$5,448.00	$5,448.00	$2,549.66	$17,157.07	$4,121.41	2025-07-29
33976	HCPCS	Implant Biventricular Device 33976	15	15	$5,468.00	$5,468.00	$2,559.02	$5,303.96	$4,101.00	2025-07-29
35646	HCPCS	Art Bypass Aortobifemoral 35646	15	15	$5,466.00	$5,466.00	$2,558.09	$5,302.02	$4,099.50	2025-07-29
19272	HCPCS	Exc Chest Tumor W/reconst W/medstnl Lmphadec 19272	16	16	$5,414.00	$5,414.00	$2,533.75	$15,309.54	$4,095.69	2025-07-29
J0897	HCPCS	Denosumab 60 Mg/ml Inj	37	20	$4,816.34	$4,816.34	$20.00	$8,576.72	$4,093.89	2025-07-29
95722	HCPCS	EEG Phy/qhp > 36hrs < 60 Hrs W/veeg 95722	15	15	$5,457.00	$5,457.00	$2,553.88	$5,293.29	$4,092.75	2025-07-29
58210	HCPCS	Radical Abdominal Hysterectomy 58210	15	15	$5,444.00	$5,444.00	$2,547.79	$5,280.68	$4,083.00	2025-07-29
J9034	HCPCS	Bendamustine 25 Mg/ml Inj 4 Ml Mdv	20	20	$7,371.66	$7,371.66	$22.84	$7,150.51	$4,074.68	2025-07-29
J9205	HCPCS	Irinotecan Liposomal 4.3 Mg/ml Inj 10 Ml	37	20	$4,851.24	$4,851.24	$51.80	$7,987.20	$4,070.19	2025-07-29
33364	HCPCS	Replace Aortic Valve Open Iliac 33364	15	15	$5,424.00	$5,424.00	$2,538.43	$5,261.28	$4,068.00	2025-07-29
33732	HCPCS	Repair Heart-vein Defect 33732	15	15	$5,406.00	$5,406.00	$2,530.01	$5,243.82	$4,054.50	2025-07-29
35132	HCPCS	Repair Art Rupture Groin 35132	15	15	$5,406.00	$5,406.00	$2,530.01	$5,243.82	$4,054.50	2025-07-29
63055	HCPCS	Decompres Spinal Cord Thoracic 63055	16	16	$5,346.00	$5,346.00	$2,501.93	$9,373.41	$4,044.25	2025-07-29
35905	HCPCS	Excision Graft Thorax 35905	15	15	$5,382.00	$5,382.00	$2,518.78	$5,220.54	$4,036.50	2025-07-29
J0219	HCPCS	Avalglucosidase Alfa Ngpt 100 Mg Inj	17	17	$5,364.87	$5,364.87	$2,510.76	$5,203.92	$4,023.65	2025-07-29
34831	HCPCS	Open Aortoiliac Prosth Repr 34831	15	15	$5,349.00	$5,349.00	$2,503.33	$5,188.53	$4,011.75	2025-07-29
J0791	HCPCS	Crizanlizumab-tmca 100 Mg/10 Ml Inj	19	19	$7,218.72	$7,218.72	$122.43	$7,002.16	$4,010.00	2025-07-29
J9303	HCPCS	Panitumumab 20 Mg/ml Inj 5 Ml	37	20	$4,702.05	$4,702.05	$134.80	$18,043.09	$3,996.74	2025-07-29
35566	HCPCS	Vein Gft Fem A/p Tib/pero/dis Art 35566	15	15	$5,318.00	$5,318.00	$2,488.82	$5,158.46	$3,988.50	2025-07-29
35637	HCPCS	Art Byp Aortoiliac 35637	15	15	$5,300.00	$5,300.00	$2,480.40	$5,141.00	$3,975.00	2025-07-29
44151	HCPCS	Removal Of Colon/ileostomy 44151	15	15	$5,296.00	$5,296.00	$2,478.53	$5,137.12	$3,972.00	2025-07-29
44144	HCPCS	Colectomy/w Colostomy Or Ileostomy 44144	15	15	$5,294.00	$5,294.00	$2,477.59	$5,135.18	$3,970.50	2025-07-29
Q4125	HCPCS	Graft Dermis Acel Aflex 101	20	20	$7,172.00	$7,172.00	$42.24	$6,956.84	$3,964.32	2025-07-29
32540	HCPCS	Removal Of Lung Lesion 32540	15	15	$5,272.00	$5,272.00	$2,467.30	$5,113.84	$3,954.00	2025-07-29
62010	HCPCS	Treatment Of Head Injury 62010	15	15	$5,252.00	$5,252.00	$2,457.94	$5,094.44	$3,939.00	2025-07-29
58563	HCPCS	Hysteroscopyablation 58563	16	16	$5,194.00	$5,194.00	$2,430.79	$6,329.64	$3,929.26	2025-07-29
32670	HCPCS	Thoracoscopy Bilobectomy 32670	15	15	$5,219.00	$5,219.00	$2,442.49	$5,062.43	$3,914.25	2025-07-29
J2796	HCPCS	Romiplostim 250 Mcg/0.5 Ml Inj	20	20	$7,061.13	$7,061.13	$77.08	$6,849.30	$3,903.04	2025-07-29
33363	HCPCS	Replace Aortic Valve Open Axillry 33363	15	15	$5,156.00	$5,156.00	$2,413.01	$5,001.32	$3,867.00	2025-07-29
J9217	HCPCS	Leuprolide Depot 7.5 Mg Kit	156	20	$5,815.84	$5,815.84	$233.18	$33,513.95	$3,861.77	2025-07-29
22551	HCPCS	Arthrodesis/discect/decompres/cerv/below C2 22551	16	16	$5,101.00	$5,101.00	$2,387.27	$9,373.41	$3,858.90	2025-07-29
60254	HCPCS	Thyroidectomy/tot/sub/rad Neck Dis 60254	15	15	$5,132.00	$5,132.00	$2,401.78	$4,978.04	$3,849.00	2025-07-29
44146	HCPCS	Colectomy Prtl W/coloproctostomy + Colostomy 44146	15	15	$5,132.00	$5,132.00	$2,401.78	$4,978.04	$3,849.00	2025-07-29
J9027	HCPCS	Clofarabine 1 Mg/ml Inj 20 Ml	20	20	$6,939.48	$6,939.48	$38.50	$6,731.30	$3,835.80	2025-07-29
44211	HCPCS	Lap Colectomy W/proctectomy 44211	15	15	$5,114.00	$5,114.00	$2,393.35	$4,960.58	$3,835.50	2025-07-29
33417	HCPCS	Repair Aortic Valve Supraval Stenosis 33417	15	15	$5,085.00	$5,085.00	$2,379.78	$4,932.45	$3,813.75	2025-07-29
J1944	HCPCS	Aripiprazole Lauroxil 662 Mg/2.4 Ml Inj	71	20	$6,666.27	$6,666.27	$2.88	$8,608.49	$3,810.98	2025-07-29
43644	HCPCS	Lap Gastric Bypass/roux-en-y 43644	16	16	$5,028.00	$5,028.00	$2,353.10	$13,914.16	$3,803.68	2025-07-29
69155	HCPCS	Extensive Ear/neck Surgery 69155	15	15	$5,068.00	$5,068.00	$2,371.82	$4,915.96	$3,801.00	2025-07-29
32652	HCPCS	Thoracoscopy/tot Pulm Decortication32652	15	15	$5,067.00	$5,067.00	$2,371.36	$4,914.99	$3,800.25	2025-07-29
J3111	HCPCS	Romosozumab-aqqg 210 Mg/2.34 Inj	20	20	$6,864.73	$6,864.73	$9.00	$6,658.79	$3,794.48	2025-07-29
33641	HCPCS	Asd Repair/cp Bypass W Without Patch 33641	15	15	$5,051.00	$5,051.00	$2,363.87	$4,899.47	$3,788.25	2025-07-29
21462	HCPCS	Treat Lower Jaw Fracture 21462	16	16	$5,005.00	$5,005.00	$2,342.34	$11,746.77	$3,786.28	2025-07-29
63266	HCPCS	Lamie Excise Intrspinl Lesion Thrc 63266	15	15	$5,048.00	$5,048.00	$2,362.46	$4,896.56	$3,786.00	2025-07-29
15946	HCPCS	Exc Ischial Pr Ulcer W/ostc Musc/myoq Flap/skin 15946	16	16	$4,992.00	$4,992.00	$2,336.26	$4,842.24	$3,776.45	2025-07-29
J1943	HCPCS	Aripiprazole Lauroxil 675 Mg/2.4 Ml Inj	20	20	$6,796.77	$6,796.77	$2.92	$6,592.87	$3,756.91	2025-07-29
44145	HCPCS	Colectomy Prtl W/coloproctostomy 44145	15	15	$4,989.00	$4,989.00	$2,334.85	$4,839.33	$3,741.75	2025-07-29
31085	HCPCS	Removal Of Frontal Sinus 31085	16	16	$4,942.00	$4,942.00	$2,312.86	$11,746.77	$3,738.62	2025-07-29
33362	HCPCS	Replace Aortic Valve Open Femoral 33362	15	15	$4,982.00	$4,982.00	$2,331.58	$4,832.54	$3,736.50	2025-07-29
19271	HCPCS	Exc Chest Tumor W/reconst 19271	16	16	$4,919.00	$4,919.00	$2,302.09	$15,309.54	$3,721.22	2025-07-29
63056	HCPCS	Decompress Spinal Cord Lumbar 63056	16	16	$4,918.00	$4,918.00	$2,301.62	$9,373.41	$3,720.47	2025-07-29
27087	HCPCS	Removal Of Hip Foreign Body 27087	16	16	$4,910.00	$4,910.00	$2,297.88	$5,446.45	$3,714.41	2025-07-29
43860	HCPCS	Revise Stomach Bowel Fusion 43860	15	15	$4,937.00	$4,937.00	$2,310.52	$4,788.89	$3,702.75	2025-07-29
19361	HCPCS	Breast Reconstr W/lat Flap 19361	15	15	$4,914.00	$4,914.00	$2,299.75	$4,766.58	$3,685.50	2025-07-29
35626	HCPCS	Art Bypass Aorsubcl/carot/innom 35626	15	15	$4,913.00	$4,913.00	$2,299.28	$4,765.61	$3,684.75	2025-07-29
45563	HCPCS	Exploration/repair Of Rectum 45563	15	15	$4,899.00	$4,899.00	$2,292.73	$4,752.03	$3,674.25	2025-07-29
32320	HCPCS	Free/remove Chest Lining 32320	15	15	$4,899.00	$4,899.00	$2,292.73	$4,752.03	$3,674.25	2025-07-29
37193	HCPCS	Remove Ivc Filter 37193	16	16	$4,845.00	$4,845.00	$2,267.46	$4,988.15	$3,665.24	2025-07-29
56640	HCPCS	Vulvectomy Radical 56640	15	15	$4,885.00	$4,885.00	$2,286.18	$4,738.45	$3,663.75	2025-07-29
44603	HCPCS	Enterorrhaphy Multiple Perforations 44603	16	16	$4,835.00	$4,835.00	$2,262.78	$8,753.47	$3,657.68	2025-07-29
33881	HCPCS	Des Thora Aorta Rpr Without Lt Sub Art 33881	15	15	$4,875.00	$4,875.00	$2,281.50	$4,728.75	$3,656.25	2025-07-29
32220	HCPCS	Release Of Lung 32220	15	15	$4,872.00	$4,872.00	$2,280.10	$4,725.84	$3,654.00	2025-07-29
32482	HCPCS	Bilobectomy 32482	15	15	$4,871.00	$4,871.00	$2,279.63	$4,724.87	$3,653.25	2025-07-29
74183	HCPCS	Mr Brain W Perf W/wo Contrast	18	18	$5,594.00	$5,594.00	$1,137.58	$5,426.18	$3,651.48	2025-07-29
69646	HCPCS	Tympanoplast/mastoidectomy/rad/com 69646	16	16	$4,815.00	$4,815.00	$2,253.42	$11,746.77	$3,642.55	2025-07-29
63042	HCPCS	Laminotomysingle Lumbar 63042	16	16	$4,814.00	$4,814.00	$2,252.95	$9,373.41	$3,641.79	2025-07-29
35654	HCPCS	Art Bypass Axill-fem-femoral 35654	15	15	$4,855.00	$4,855.00	$2,272.14	$4,709.35	$3,641.25	2025-07-29
Q5114	HCPCS	Trastuzumab Dkst 150 Mg Inj	36	19	$3,979.39	$3,979.39	$71.57	$10,653.81	$3,621.24	2025-07-29
44661	HCPCS	Repair Bowel-bladder Fistula 44661	15	15	$4,819.00	$4,819.00	$2,255.29	$4,674.43	$3,614.25	2025-07-29
90375	HCPCS	Rabies Immune Globulin (human) 300 Units/ml Inj 5 Ml	86	20	$5,958.11	$5,958.11	$168.01	$9,618.93	$3,612.20	2025-07-29
32440	HCPCS	Remove Lung Pneumonectomy 32440	15	15	$4,814.00	$4,814.00	$2,252.95	$4,669.58	$3,610.50	2025-07-29
33322	HCPCS	Repair Major Blood Vessel(s) W/bypass 33322	15	15	$4,814.00	$4,814.00	$2,252.95	$4,669.58	$3,610.50	2025-07-29
J9259	HCPCS	Paclitaxel Protein-bound 100 Mg Inj	17	17	$4,812.37	$4,812.37	$2,252.19	$4,668.00	$3,609.28	2025-07-29
43631	HCPCS	Removal Of Stomach Partial 43631	15	15	$4,801.00	$4,801.00	$2,246.87	$4,656.97	$3,600.75	2025-07-29
34502	HCPCS	Reconstruct Vena Cava 34502	15	15	$4,797.00	$4,797.00	$2,245.00	$4,653.09	$3,597.75	2025-07-29
22612	HCPCS	Arthrodesis/single Level/lumbar 22612	16	16	$4,754.00	$4,754.00	$2,224.87	$9,373.41	$3,596.40	2025-07-29
47800	HCPCS	Reconstruction Of Bile Ducts 47800	15	15	$4,776.00	$4,776.00	$2,235.17	$4,632.72	$3,582.00	2025-07-29
15650	HCPCS	Rpr Ant Abd Hern<3cm Reducible	19	19	$4,763.00	$4,763.00	$543.44	$4,620.11	$3,572.25	2025-07-29
Q5123	HCPCS	Rituximab Arrx 500 Mg/50 Ml Inj	34	17	$10,648.97	$10,648.97	$1,022.58	$10,329.50	$3,551.58	2025-07-29
33802	HCPCS	Repair Vessel Defect 33802	15	15	$4,730.00	$4,730.00	$2,213.64	$4,588.10	$3,547.50	2025-07-29
30450	HCPCS	Rhinoplasty Sec Major 30450	16	16	$4,689.00	$4,689.00	$2,194.45	$11,746.77	$3,547.23	2025-07-29
63267	HCPCS	Lumbar Laminectomyextradural 63267	16	16	$4,653.00	$4,653.00	$2,177.60	$9,373.41	$3,519.99	2025-07-29
0360	RC	—	187	17	$4,797.00	$4,797.00	$365.04	$8,824.09	$3,519.85	2025-07-29
48140	HCPCS	Pancreatectomy Dist Subtot W/wo Splenecto 48140	16	16	$4,647.00	$4,647.00	$2,174.80	$8,753.47	$3,515.45	2025-07-29

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