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

LUCAS COUNTY HEALTH CENTER

Chariton, IA · CCN 161341 · Rates published

3,192 distinct procedures filed
33 distinct payers
214,157 rate rows
2026-07-17 last MRF observed
Data quality

208,875 of 214,157 rate rows are consumer-grade (97.5%)

5,282 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4,254
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 969
placeholder amount (≤ $0.02) — excluded from medians 41
per-diem day rate — not a per-procedure price 12
exceeds 10× this hospital's gross charge — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.lchcia.com/wp-content/uploads/2025/04/PRICE-TRANSPARENCY-FILE-2025.csv
Found on page https://www.lchcia.com/for-patients/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-22
Content fingerprint 193e0ae2a9a8f9ac… · 3,644,641 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
27003906
CDM 		External Fixator Level 29 24 $50,000.00 $50,000.00 $50,000.00 nat. median
$50,000
1.0× median
27003905
CDM 		External Fixator Level 28 24 $43,939.39 $43,939.39 $43,939.39 nat. median
$60
outlier · 726.3×
27003904
CDM 		External Fixator Level 27 24 $40,909.09 $40,909.09 $40,909.09 nat. median
$40,909
1.0× median
27003903
CDM 		External Fixator Level 26 24 $37,878.79 $37,878.79 $37,878.79 nat. median
$37,879
1.0× median
27003316
CDM 		External Fixator Level 25 24 $34,848.48 $34,848.48 $34,848.48 nat. median
$22
outlier · 1587.6×
27003315
CDM 		External Fixator Level 24 24 $32,575.76 $32,575.76 $32,575.76 nat. median
$9
outlier · 3436.3×
27003314
CDM 		External Fixator Level 23 24 $31,060.61 $31,060.61 $31,060.61 nat. median
$31,061
1.0× median
27003313
CDM 		External Fixator Level 22 24 $29,545.45 $29,545.45 $29,545.45 nat. median
$2
outlier · 12466.4×
27003311
CDM 		External Fixator Level 20 24 $29,545.45 $29,545.45 $29,545.45 nat. median
$84
outlier · 349.8×
27003312
CDM 		External Fixator Level 21 24 $28,030.30 $28,030.30 $28,030.30 nat. median
$102
outlier · 275.0×
27002772
CDM 		External Fixator Level 18 24 $23,484.85 $23,484.85 $23,484.85 nat. median
$37
outlier · 632.5×
27002771
CDM 		External Fixator Level 17 24 $21,969.70 $21,969.70 $21,969.70 nat. median
$6
outlier · 3526.4×
27003310
CDM 		External Fixator Level 19 24 $21,969.70 $21,969.70 $21,969.70 nat. median
$630
outlier · 34.9×
27002770
CDM 		External Fixator Level 16 24 $20,454.55 $20,454.55 $20,454.55 nat. median
$3
outlier · 6473.0×
49521
CPT 		Repair Recurr Ing Hernia Incarc/strang 24 $20,000.00 $20,000.00 $20,000.00 nat. median
$5,928
outlier · 3.4×
27002769
CDM 		External Fixator Level 15 24 $18,939.39 $18,939.39 $18,939.39 nat. median
$612
outlier · 30.9×
C1889
HCPCS 		Implant/insert Device Noc Lvl 1 33 $75.76 $51,515.15 $18,939.39 nat. median
$2,369
outlier · 8.0×
27002768
CDM 		External Fixator Level 14 24 $17,424.24 $17,424.24 $17,424.24 nat. median
$39
outlier · 450.1×
27002261
CDM 		Misc Implant Charge Lvl13 24 $16,666.67 $16,666.67 $16,666.67 nat. median
$12
outlier · 1412.4×
27002275
CDM 		Misc Supply Charge Lvl 17 24 $16,666.67 $16,666.67 $16,666.67 nat. median
$162
outlier · 102.7×
C1813
HCPCS 		Inflatable Penile Prosthesis Lvl 1 24 $500.00 $28,000.00 $16,500.00 nat. median
$10,463
1.6× median
27002767
CDM 		External Fixator Level 13 24 $15,909.09 $15,909.09 $15,909.09 nat. median
$62
outlier · 254.9×
J2353
HCPCS 		Octreotide Injection, Depot 24 $9,914.00 $25,206.00 $15,513.00 nat. median
$5,573
outlier · 2.8×
27002260
CDM 		Misc Implant Charge Lvl12 24 $15,151.52 $15,151.52 $15,151.52 nat. median
$9
outlier · 1620.5×
27002274
CDM 		Misc Supply Charge Lvl 16 24 $15,151.52 $15,151.52 $15,151.52 nat. median
$15,152
1.0× median
27002180
CDM 		Grafts, Non Vascular Lvl 11 24 $14,715.42 $14,715.42 $14,715.42 nat. median
$60
outlier · 245.1×
C1713
HCPCS 		Anchor/screw Bn/bn,tis/bn Lvl 1 33 $63.16 $50,000.00 $14,708.65 nat. median
$863
outlier · 17.0×
27002766
CDM 		External Fixator Level 12 24 $14,393.94 $14,393.94 $14,393.94 nat. median
$14
outlier · 1010.8×
27002259
CDM 		Misc Implant Charge Lvl11 24 $13,939.39 $13,939.39 $13,939.39 nat. median
$221
outlier · 63.0×
27002273
CDM 		Misc Supply Charge Lvl 15 24 $13,939.39 $13,939.39 $13,939.39 nat. median
$11
outlier · 1260.3×
27002179
CDM 		Grafts, Non Vascular Lvl 10 24 $13,166.43 $13,166.43 $13,166.43 nat. median
$13,166
1.0× median
27002765
CDM 		External Fixator Level 11 24 $12,878.79 $12,878.79 $12,878.79 nat. median
$12,879
1.0× median
27002272
CDM 		Misc Supply Charge Lvl 14 24 $12,727.27 $12,727.27 $12,727.27 nat. median
$10
outlier · 1239.3×
27002258
CDM 		Misc Implant Charge Lvl10 24 $12,727.27 $12,727.27 $12,727.27 nat. median
$76
outlier · 167.8×
27002673
CDM 		Ortho Supplies General Lvl 5 24 $12,500.00 $12,500.00 $12,500.00 nat. median
$20
outlier · 632.9×
27002178
CDM 		Grafts, Non Vascular Lvl 9 24 $11,617.44 $11,617.44 $11,617.44 nat. median
$11,617
1.0× median
27002257
CDM 		Misc Implant Charge Lvl9 24 $11,515.15 $11,515.15 $11,515.15 nat. median
$99
outlier · 116.6×
27002271
CDM 		Misc Supply Charge Lvl 13 24 $11,515.15 $11,515.15 $11,515.15 nat. median
$943
outlier · 12.2×
27002764
CDM 		External Fixator Level 10 24 $11,363.64 $11,363.64 $11,363.64 nat. median
$36
outlier · 313.5×
27002988
CDM 		Gyne Supplies General Lvl 8 24 $10,606.06 $10,606.06 $10,606.06 nat. median
$17
outlier · 639.3×
27002270
CDM 		Misc Supply Charge Lvl 12 24 $10,303.03 $10,303.03 $10,303.03 nat. median
$11
outlier · 931.6×
27002256
CDM 		Misc Implant Charge Lvl8 24 $10,303.03 $10,303.03 $10,303.03 nat. median
$10,303
1.0× median
27002177
CDM 		Grafts, Non Vascular Lvl 8 24 $10,068.44 $10,068.44 $10,068.44 nat. median
$13
outlier · 796.6×
27002763
CDM 		External Fixator Level 9 24 $9,848.48 $9,848.48 $9,848.48 nat. median
$53
outlier · 184.7×
27002905
CDM 		Bone/allograft Products/cement Lvl 18 24 $9,500.00 $9,500.00 $9,500.00 nat. median
$13
outlier · 707.4×
V2790
HCPCS 		Amniotic Membrane Lvl 11 33 $5,060.00 $9,200.00 $9,200.00 nat. median
$1,805
outlier · 5.1×
27002255
CDM 		Misc Implant Charge Lvl7 24 $9,090.91 $9,090.91 $9,090.91 nat. median
$2
outlier · 3835.8×
27002269
CDM 		Misc Supply Charge Lvl 11 24 $9,090.91 $9,090.91 $9,090.91 nat. median
$9,091
1.0× median
27002904
CDM 		Bone/allograft Products/cement Lvl 17 24 $9,000.00 $9,000.00 $9,000.00 nat. median
$21
outlier · 421.9×
27002176
CDM 		Grafts, Non Vascular Lvl 7 24 $8,519.45 $8,519.45 $8,519.45 nat. median
$1,047
outlier · 8.1×

Other procedures at this hospital

Browse this hospital's 3,192 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
             
27003906 CDM External Fixator Level 29 30 24 $50,000.00 $45,000.00 $50,000.00 $50,000.00 $50,000.00 2026-07-17
27003905 CDM External Fixator Level 28 30 24 $43,939.39 $39,545.45 $43,939.39 $43,939.39 $43,939.39 2026-07-17
27003904 CDM External Fixator Level 27 30 24 $40,909.09 $36,818.18 $40,909.09 $40,909.09 $40,909.09 2026-07-17
27003903 CDM External Fixator Level 26 30 24 $37,878.79 $34,090.91 $37,878.79 $37,878.79 $37,878.79 2026-07-17
27003316 CDM External Fixator Level 25 30 24 $34,848.48 $31,363.63 $34,848.48 $34,848.48 $34,848.48 2026-07-17
27003315 CDM External Fixator Level 24 30 24 $32,575.76 $29,318.18 $32,575.76 $32,575.76 $32,575.76 2026-07-17
27003314 CDM External Fixator Level 23 30 24 $31,060.61 $27,954.54 $31,060.61 $31,060.61 $31,060.61 2026-07-17
27003313 CDM External Fixator Level 22 30 24 $29,545.45 $26,590.90 $29,545.45 $29,545.45 $29,545.45 2026-07-17
27003311 CDM External Fixator Level 20 30 24 $29,545.45 $26,590.90 $29,545.45 $29,545.45 $29,545.45 2026-07-17
27003312 CDM External Fixator Level 21 30 24 $28,030.30 $25,227.27 $28,030.30 $28,030.30 $28,030.30 2026-07-17
27002772 CDM External Fixator Level 18 30 24 $23,484.85 $21,136.36 $23,484.85 $23,484.85 $23,484.85 2026-07-17
27003310 CDM External Fixator Level 19 30 24 $21,969.70 $19,772.73 $21,969.70 $21,969.70 $21,969.70 2026-07-17
27002771 CDM External Fixator Level 17 30 24 $21,969.70 $19,772.73 $21,969.70 $21,969.70 $21,969.70 2026-07-17
27002770 CDM External Fixator Level 16 30 24 $20,454.55 $18,409.09 $20,454.55 $20,454.55 $20,454.55 2026-07-17
49521 CPT Repair Recurr Ing Hernia Incarc/strang 30 24 $20,000.00 $18,000.00 $20,000.00 $20,000.00 $20,000.00 2026-07-17
C1889 HCPCS Implant/insert Device Noc Lvl 1 1,062 33 $18,939.39 $17,045.45 $75.76 $51,515.15 $18,939.39 2026-07-17
27002769 CDM External Fixator Level 15 30 24 $18,939.39 $17,045.45 $18,939.39 $18,939.39 $18,939.39 2026-07-17
27002768 CDM External Fixator Level 14 30 24 $17,424.24 $15,681.81 $17,424.24 $17,424.24 $17,424.24 2026-07-17
27002261 CDM Misc Implant Charge Lvl13 30 24 $16,666.67 $15,000.00 $16,666.67 $16,666.67 $16,666.67 2026-07-17
27002275 CDM Misc Supply Charge Lvl 17 30 24 $16,666.67 $15,000.00 $16,666.67 $16,666.67 $16,666.67 2026-07-17
C1813 HCPCS Inflatable Penile Prosthesis Lvl 1 960 24 $16,500.00 $14,850.00 $500.00 $28,000.00 $16,500.00 2026-07-17
27002767 CDM External Fixator Level 13 30 24 $15,909.09 $14,318.18 $15,909.09 $15,909.09 $15,909.09 2026-07-17
J2353 HCPCS Octreotide Injection, Depot 60 24 $26,148.00 $23,533.20 $9,914.00 $25,206.00 $15,513.00 2026-07-17
27002274 CDM Misc Supply Charge Lvl 16 30 24 $15,151.52 $13,636.36 $15,151.52 $15,151.52 $15,151.52 2026-07-17
27002260 CDM Misc Implant Charge Lvl12 30 24 $15,151.52 $13,636.36 $15,151.52 $15,151.52 $15,151.52 2026-07-17
27002180 CDM Grafts, Non Vascular Lvl 11 30 24 $14,715.42 $13,243.87 $14,715.42 $14,715.42 $14,715.42 2026-07-17
C1713 HCPCS Anchor/screw Bn/bn,tis/bn Lvl 1 1,188 33 $14,708.65 $13,237.78 $63.16 $50,000.00 $14,708.65 2026-07-17
27002766 CDM External Fixator Level 12 30 24 $14,393.94 $12,954.54 $14,393.94 $14,393.94 $14,393.94 2026-07-17
27002273 CDM Misc Supply Charge Lvl 15 30 24 $13,939.39 $12,545.45 $13,939.39 $13,939.39 $13,939.39 2026-07-17
27002259 CDM Misc Implant Charge Lvl11 30 24 $13,939.39 $12,545.45 $13,939.39 $13,939.39 $13,939.39 2026-07-17
27002179 CDM Grafts, Non Vascular Lvl 10 30 24 $13,166.43 $11,849.78 $13,166.43 $13,166.43 $13,166.43 2026-07-17
27002765 CDM External Fixator Level 11 30 24 $12,878.79 $11,590.91 $12,878.79 $12,878.79 $12,878.79 2026-07-17
27002258 CDM Misc Implant Charge Lvl10 30 24 $12,727.27 $11,454.54 $12,727.27 $12,727.27 $12,727.27 2026-07-17
27002272 CDM Misc Supply Charge Lvl 14 30 24 $12,727.27 $11,454.54 $12,727.27 $12,727.27 $12,727.27 2026-07-17
27002673 CDM Ortho Supplies General Lvl 5 30 24 $12,500.00 $11,250.00 $12,500.00 $12,500.00 $12,500.00 2026-07-17
27002178 CDM Grafts, Non Vascular Lvl 9 30 24 $11,617.44 $10,455.69 $11,617.44 $11,617.44 $11,617.44 2026-07-17
27002271 CDM Misc Supply Charge Lvl 13 30 24 $11,515.15 $10,363.63 $11,515.15 $11,515.15 $11,515.15 2026-07-17
27002257 CDM Misc Implant Charge Lvl9 30 24 $11,515.15 $10,363.63 $11,515.15 $11,515.15 $11,515.15 2026-07-17
27002764 CDM External Fixator Level 10 30 24 $11,363.64 $10,227.27 $11,363.64 $11,363.64 $11,363.64 2026-07-17
27002988 CDM Gyne Supplies General Lvl 8 30 24 $10,606.06 $9,545.45 $10,606.06 $10,606.06 $10,606.06 2026-07-17
27002270 CDM Misc Supply Charge Lvl 12 30 24 $10,303.03 $9,272.72 $10,303.03 $10,303.03 $10,303.03 2026-07-17
27002256 CDM Misc Implant Charge Lvl8 30 24 $10,303.03 $9,272.72 $10,303.03 $10,303.03 $10,303.03 2026-07-17
27002177 CDM Grafts, Non Vascular Lvl 8 30 24 $10,068.44 $9,061.59 $10,068.44 $10,068.44 $10,068.44 2026-07-17
27002763 CDM External Fixator Level 9 30 24 $9,848.48 $8,863.63 $9,848.48 $9,848.48 $9,848.48 2026-07-17
27002905 CDM Bone/allograft Products/cement Lvl 18 30 24 $9,500.00 $8,550.00 $9,500.00 $9,500.00 $9,500.00 2026-07-17
V2790 HCPCS Amniotic Membrane Lvl 11 42 33 $9,200.00 $8,280.00 $5,060.00 $9,200.00 $9,200.00 2026-07-17
27002269 CDM Misc Supply Charge Lvl 11 30 24 $9,090.91 $8,181.81 $9,090.91 $9,090.91 $9,090.91 2026-07-17
27002255 CDM Misc Implant Charge Lvl7 30 24 $9,090.91 $8,181.81 $9,090.91 $9,090.91 $9,090.91 2026-07-17
27002904 CDM Bone/allograft Products/cement Lvl 17 30 24 $9,000.00 $8,100.00 $9,000.00 $9,000.00 $9,000.00 2026-07-17
27002176 CDM Grafts, Non Vascular Lvl 7 30 24 $8,519.45 $7,667.50 $8,519.45 $8,519.45 $8,519.45 2026-07-17
J3590 HCPCS Secukinumab 150 Mg/ml Sosy 1 Ml Syringe 30 24 $8,411.41 $8,411.40 $8,411.00 $8,411.00 $8,411.00 2026-07-17
27002987 CDM Gyne Supplies General Lvl 7 30 24 $8,333.33 $7,499.99 $8,333.33 $8,333.33 $8,333.33 2026-07-17
27002762 CDM External Fixator Level 8 30 24 $8,333.33 $7,499.99 $8,333.33 $8,333.33 $8,333.33 2026-07-17
50000071 CDM Lithotripsy Eswl Bilateral 30 24 $8,000.00 $7,200.00 $8,000.00 $8,000.00 $8,000.00 2026-07-17
27002268 CDM Misc Supply Charge Lvl 10 30 24 $7,878.79 $7,090.91 $7,878.79 $7,878.79 $7,878.79 2026-07-17
27002254 CDM Misc Implant Charge Lvl6 30 24 $7,878.79 $7,090.91 $7,878.79 $7,878.79 $7,878.79 2026-07-17
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 30 24 $12,924.00 $11,631.60 $4,998.00 $12,217.00 $7,821.00 2026-07-17
27002982 CDM Endo Probes, Balloons, Snares Lvl 17 30 24 $7,575.76 $6,818.18 $7,575.76 $7,575.76 $7,575.76 2026-07-17
27002902 CDM Bone/allograft Products/cement Lvl 15 30 24 $7,000.00 $6,300.00 $7,000.00 $7,000.00 $7,000.00 2026-07-17
27002175 CDM Grafts, Non Vascular Lvl 6 30 24 $6,970.46 $6,273.41 $6,970.46 $6,970.46 $6,970.46 2026-07-17
27003102 CDM Suture/staples/closure Devices Lvl 11 30 24 $6,876.66 $6,188.99 $6,876.66 $6,876.66 $6,876.66 2026-07-17
10010106 CDM Surgery Level 6 - Init 30 Min 30 24 $6,850.00 $6,165.00 $6,850.00 $6,850.00 $6,850.00 2026-07-17
27002986 CDM Gyne Supplies General Lvl 6 30 24 $6,818.18 $6,136.36 $6,818.18 $6,818.18 $6,818.18 2026-07-17
27002761 CDM External Fixator Level 7 30 24 $6,818.18 $6,136.36 $6,818.18 $6,818.18 $6,818.18 2026-07-17
27002253 CDM Misc Implant Charge Lvl5 30 24 $6,666.67 $6,000.00 $6,666.67 $6,666.67 $6,666.67 2026-07-17
27002267 CDM Misc Supply Charge Lvl 9 30 24 $6,666.67 $6,000.00 $6,666.67 $6,666.67 $6,666.67 2026-07-17
50000070 CDM Lithotripsy Eswl Unilateral 30 24 $6,500.00 $5,850.00 $6,500.00 $6,500.00 $6,500.00 2026-07-17
27002981 CDM Endo Probes, Balloons, Snares Lvl 16 30 24 $6,363.64 $5,727.27 $6,363.64 $6,363.64 $6,363.64 2026-07-17
60060098 CDM Vaginal Delivery Level 4 30 24 $6,008.00 $5,407.20 $6,008.00 $6,008.00 $6,008.00 2026-07-17
27002901 CDM Bone/allograft Products/cement Lvl 14 30 24 $6,000.00 $5,400.00 $6,000.00 $6,000.00 $6,000.00 2026-07-17
10010105 CDM Surgery Level 5 - Init 30 Min 30 24 $5,795.00 $5,215.50 $5,795.00 $5,795.00 $5,795.00 2026-07-17
27447 CPT Total Knee Arthroplasty 60 24 $9,706.00 $8,735.40 $3,682.00 $9,892.00 $5,762.00 2026-07-17
27002980 CDM Endo Probes, Balloons, Snares Lvl 15 30 24 $5,757.58 $5,181.82 $5,757.58 $5,757.58 $5,757.58 2026-07-17
27003097 CDM Endomec- Supplies Staplers/reloads Lvl18 30 24 $5,757.58 $5,181.82 $5,757.58 $5,757.58 $5,757.58 2026-07-17
J0630 HCPCS Calcitonin 200 Unit/ml Soln 60 24 $6,349.50 $6,032.02 $2,008.00 $6,349.00 $5,628.00 2026-07-17
27003101 CDM Suture/staples/closure Devices Lvl 10 30 24 $5,626.36 $5,063.72 $5,626.36 $5,626.36 $5,626.36 2026-07-17
A9521 HCPCS Tc99m Hmpao To 25 Mci 30 24 $5,500.00 $4,950.00 $5,500.00 $5,500.00 $5,500.00 2026-07-17
27002252 CDM Misc Implant Charge Lvl4 30 24 $5,454.55 $4,909.09 $5,454.55 $5,454.55 $5,454.55 2026-07-17
27002266 CDM Misc Supply Charge Lvl 8 30 24 $5,454.55 $4,909.09 $5,454.55 $5,454.55 $5,454.55 2026-07-17
27002174 CDM Grafts, Non Vascular Lvl 5 30 24 $5,421.47 $4,879.32 $5,421.47 $5,421.47 $5,421.47 2026-07-17
27003329 CDM Female Sterilization Implant Lvl 12 30 24 $5,405.66 $4,865.09 $5,405.66 $5,405.66 $5,405.66 2026-07-17
27002899 CDM Bone/allograft Products/cement Lvl 12 30 24 $5,303.03 $4,772.72 $5,303.03 $5,303.03 $5,303.03 2026-07-17
27002985 CDM Gyne Supplies General Lvl 5 30 24 $5,303.03 $4,772.72 $5,303.03 $5,303.03 $5,303.03 2026-07-17
27002979 CDM Endo Probes, Balloons, Snares Lvl 14 30 24 $5,151.52 $4,636.36 $5,151.52 $5,151.52 $5,151.52 2026-07-17
27003096 CDM Endomec- Supplies Staplers/reloads Lvl17 30 24 $5,000.00 $4,500.00 $5,000.00 $5,000.00 $5,000.00 2026-07-17
28262 CPT Revision Of Foot And Ankle 30 24 $5,000.00 $4,500.00 $5,000.00 $5,000.00 $5,000.00 2026-07-17
27687 CPT Revision Of Calf Tendon 174 33 $8,122.00 $7,309.80 $715.00 $10,295.00 $4,914.00 2026-07-17
60060097 CDM Vaginal Delivery Level 3 30 24 $4,848.00 $4,363.20 $4,848.00 $4,848.00 $4,848.00 2026-07-17
10010104 CDM Surgery Level 4 - Init 30 Min 30 24 $4,740.00 $4,266.00 $4,740.00 $4,740.00 $4,740.00 2026-07-17
52325 CPT Cystoscopy Stone Removal 30 24 $7,814.00 $7,032.60 $3,022.00 $7,387.00 $4,729.00 2026-07-17
L8699 HCPCS Prosthetic Implant Nos Lvl 14 60 24 $4,550.00 $4,095.00 $4,200.00 $4,900.00 $4,550.00 2026-07-17
27002978 CDM Endo Probes, Balloons, Snares Lvl 13 30 24 $4,545.45 $4,090.90 $4,545.45 $4,545.45 $4,545.45 2026-07-17
27003328 CDM Female Sterilization Implant Lvl 11 30 24 $4,465.54 $4,018.98 $4,465.54 $4,465.54 $4,465.54 2026-07-17
60060096 CDM Vaginal Delivery Level 2 30 24 $4,403.00 $3,962.70 $4,403.00 $4,403.00 $4,403.00 2026-07-17
27003100 CDM Suture/staples/closure Devices Lvl 9 30 24 $4,376.06 $3,938.45 $4,376.06 $4,376.06 $4,376.06 2026-07-17
52601 CPT Prostatectomy (turp) 30 24 $7,200.00 $6,480.00 $2,934.00 $7,200.00 $4,357.00 2026-07-17
19081 CPT Bx Breast 1st Lesion Stereotactic 30 24 $4,326.00 $3,893.40 $4,326.00 $4,326.00 $4,326.00 2026-07-17
27002251 CDM Misc Implant Charge Lvl3 30 24 $4,242.42 $3,818.17 $4,242.42 $4,242.42 $4,242.42 2026-07-17
27002265 CDM Misc Supply Charge Lvl 7 30 24 $4,242.42 $3,818.17 $4,242.42 $4,242.42 $4,242.42 2026-07-17
27002574 CDM Cardiovasc/heart Supplies General Lvl 3 30 24 $4,159.62 $3,743.65 $4,159.62 $4,159.62 $4,159.62 2026-07-17
Q4139 HCPCS Hc Amnio Or Biodmatrix, Inj Per 1 Cc Lvl 8 12 12 $6,300.00 $5,670.00 $3,465.00 $5,985.00 $4,158.00 2026-03-19
C1776 HCPCS Joint Device (implantable) Lvl 1 618 33 $4,113.40 $3,702.06 $80.29 $15,865.98 $4,113.40 2026-07-17
27003327 CDM Female Sterilization Implant Lvl 10 30 24 $4,113.00 $3,701.70 $4,113.00 $4,113.00 $4,113.00 2026-07-17
44140 CPT Colectomy Partial W Anastomosis 30 24 $4,080.00 $3,672.00 $4,080.00 $4,080.00 $4,080.00 2026-07-17
44120 CPT Resect Sm Intest Sgl Resect & Anast 30 24 $4,000.00 $3,600.00 $4,000.00 $4,000.00 $4,000.00 2026-07-17
78816 CPT Nm PET Image W CT Whole Body 72 33 $4,600.00 $4,140.00 $1,779.00 $4,600.00 $3,941.50 2026-07-17
27002977 CDM Endo Probes, Balloons, Snares Lvl 12 30 24 $3,939.39 $3,545.45 $3,939.39 $3,939.39 $3,939.39 2026-07-17
27002583 CDM Gyne Supplies General Lvl 4 30 24 $3,881.49 $3,493.34 $3,881.49 $3,881.49 $3,881.49 2026-07-17
27002173 CDM Grafts, Non Vascular Lvl 4 30 24 $3,872.48 $3,485.23 $3,872.48 $3,872.48 $3,872.48 2026-07-17
54405 CPT Insert Multi-comp Penis Pros 30 24 $6,352.00 $5,716.80 $2,588.00 $6,352.00 $3,845.00 2026-07-17
27002117 CDM Burs, Blades, Bits, Lvl 11 30 24 $3,787.88 $3,409.09 $3,787.88 $3,787.88 $3,787.88 2026-07-17
27003639 CDM Disposable Instruments Lvl 12 30 24 $3,787.88 $3,409.09 $3,787.88 $3,787.88 $3,787.88 2026-07-17
27001974 CDM Drainage Caths Lvl 3 30 24 $3,787.88 $3,409.09 $3,787.88 $3,787.88 $3,787.88 2026-07-17
27002759 CDM External Fixator Level 5 30 24 $3,787.88 $3,409.09 $3,787.88 $3,787.88 $3,787.88 2026-07-17
27002050 CDM Endomec- Supplies Staplers/reloads Lvl16 30 24 $3,777.11 $3,399.39 $3,777.11 $3,777.11 $3,777.11 2026-07-17
27003326 CDM Female Sterilization Implant Lvl 9 30 24 $3,750.44 $3,375.39 $3,750.44 $3,750.44 $3,750.44 2026-07-17
C1781 HCPCS Mesh (implantable) Lvl 1 564 33 $3,750.00 $3,375.00 $219.00 $6,750.00 $3,750.00 2026-07-17
54410 CPT Remove/replace Penis Prosth 30 24 $6,110.00 $5,499.00 $2,363.00 $5,776.00 $3,698.00 2026-07-17
10010103 CDM Surgery Level 3 - Init 30 Min 30 24 $3,685.00 $3,316.50 $3,685.00 $3,685.00 $3,685.00 2026-07-17
52356 CPT Pbb Cysto/uretero W/lithotripsy 30 24 $5,970.00 $5,373.00 $2,309.00 $5,644.00 $3,613.00 2026-07-17
23120 CPT Partial Removal Collar Bone 30 24 $5,970.00 $5,373.00 $2,433.00 $5,970.00 $3,613.00 2026-07-17
52235 CPT Cystoscopy And Treatment 30 24 $5,970.00 $5,373.00 $2,309.00 $5,644.00 $3,613.00 2026-07-17
74177 CPT CT Abdomen & Pelvis W Contrast 72 33 $4,147.00 $3,732.30 $914.00 $4,147.00 $3,553.47 2026-07-17
27002049 CDM Endomec- Supplies Staplers/reloads Lvl15 30 24 $3,533.43 $3,180.08 $3,533.43 $3,533.43 $3,533.43 2026-07-17
C1888 HCPCS Non-cardiac Endovasc Cath Lvl 1 180 24 $3,461.09 $3,114.97 $74.50 $7,787.46 $3,461.09 2026-07-17
469650189 NDC Regadenoson 0.4 Mg/5ml Soln 30 24 $5,702.00 $5,702.00 $2,205.00 $5,390.00 $3,451.00 2026-07-17
70553 CPT MRI Brain W Wo Contrast 72 33 $4,000.00 $3,600.00 $1,183.00 $4,000.00 $3,427.50 2026-07-17
58600 CPT Division Of Fallopian Tube 51 24 $6,585.00 $5,926.50 $255.00 $6,225.00 $3,427.00 2026-07-17
27002083 CDM Eye Disposable Supplies Lvl 11 30 24 $3,414.40 $3,072.96 $3,414.40 $3,414.40 $3,414.40 2026-07-17
73720 CPT MRI Low Extr Not Joint W Wo Contr 54 33 $3,400.00 $3,060.00 $1,870.00 $5,780.00 $3,400.00 2026-07-17
44005 CPT Enterolysis 30 24 $3,400.00 $3,060.00 $3,400.00 $3,400.00 $3,400.00 2026-07-17
72197 CPT MRI Pelvis W Wo Contrast 42 33 $3,361.00 $3,024.90 $1,848.55 $3,361.00 $3,361.00 2026-07-17
50590 CPT Lithotripsy Extracorporeal Shock Wave 60 24 $3,350.00 $3,015.00 $2,300.00 $4,400.00 $3,350.00 2026-07-17
59400 CPT Routine OB Care 30 24 $3,346.00 $3,011.40 $3,346.00 $3,346.00 $3,346.00 2026-07-17
V2630 HCPCS Lens, Intraocular Anterior Lvl 1 330 24 $3,333.33 $2,999.99 $479.00 $7,575.76 $3,333.33 2026-07-17
27002976 CDM Endo Probes, Balloons, Snares Lvl 11 30 24 $3,333.33 $2,999.99 $3,333.33 $3,333.33 $3,333.33 2026-07-17
C1780 HCPCS Lens, Intraocular (new Tech) Lvl 1 330 24 $3,333.33 $2,999.99 $303.03 $7,575.76 $3,333.33 2026-07-17
C1760 HCPCS Vascular Closure Device Lvl 1 330 24 $3,333.33 $2,999.99 $303.03 $7,575.76 $3,333.33 2026-07-17
27002600 CDM Ortho Supplies General Lvl 4 30 24 $3,298.00 $2,968.20 $3,298.00 $3,298.00 $3,298.00 2026-07-17
27002048 CDM Endomec- Supplies Staplers/reloads Lvl14 30 24 $3,289.75 $2,960.77 $3,289.75 $3,289.75 $3,289.75 2026-07-17
C1772 HCPCS Infusion Pump, Programmable Lvl 1 90 24 $3,281.75 $2,953.57 $33.00 $13,127.01 $3,281.75 2026-07-17
70543 CPT MRI Orbit Face Neck W Wo Contrast 60 24 $3,361.00 $3,024.90 $1,183.00 $3,361.00 $3,269.00 2026-07-17
27003325 CDM Female Sterilization Implant Lvl 8 30 24 $3,250.38 $2,925.34 $3,250.38 $3,250.38 $3,250.38 2026-07-17
29881 CPT Knee Arthroscopy/surgery 60 24 $5,355.00 $4,819.50 $2,071.00 $5,355.00 $3,241.00 2026-07-17
36571 CPT Ins Picc Device W Port 5 Yrs/> 30 24 $3,200.00 $2,880.00 $3,200.00 $3,200.00 $3,200.00 2026-07-17
78815 CPT PET Image W/ct Skull-thigh 126 33 $4,800.00 $4,320.00 $1,956.00 $4,800.00 $3,168.00 2026-07-17
27003099 CDM Suture/staples/closure Devices Lvl 8 30 24 $3,125.76 $2,813.18 $3,125.76 $3,125.76 $3,125.76 2026-07-17
73223 CPT MRI Joint Upr Extr W/o&with Contrast 60 24 $3,200.00 $2,880.00 $1,304.00 $3,200.00 $3,112.50 2026-07-17
73220 CPT MRI Up Extr Not Joint W Wo Contr 60 24 $3,200.00 $2,880.00 $1,183.00 $3,200.00 $3,112.50 2026-07-17
27002900 CDM Bone/allograft Products/cement Lvl 13 30 24 $3,056.00 $2,750.40 $3,056.00 $3,056.00 $3,056.00 2026-07-17
27002163 CDM Bone/allograft Products/cement Lvl 11 30 24 $3,056.00 $2,750.40 $3,056.00 $3,056.00 $3,056.00 2026-07-17
27002047 CDM Endomec- Supplies Staplers/reloads Lvl13 30 24 $3,046.06 $2,741.45 $3,046.06 $3,046.06 $3,046.06 2026-07-17
72158 CPT MRI Spine Lumbar W Wo Contrast 72 33 $3,550.00 $3,195.00 $1,119.00 $3,550.00 $3,041.75 2026-07-17
27003347 CDM Disposable Radiology Supplies Lvl 7 30 24 $3,037.89 $2,734.10 $3,037.89 $3,037.89 $3,037.89 2026-07-17
L5400 HCPCS Postop Dress & 1 Cast Chg Bk Lvl 1 300 24 $3,030.30 $2,727.26 $303.03 $5,757.58 $3,030.30 2026-07-17
27002264 CDM Misc Supply Charge Lvl 6 30 24 $3,030.30 $2,727.27 $3,030.30 $3,030.30 $3,030.30 2026-07-17
27002250 CDM Misc Implant Charge Lvl2 30 24 $3,030.30 $2,727.27 $3,030.30 $3,030.30 $3,030.30 2026-07-17
60060095 CDM Vaginal Delivery Level 1 30 24 $3,018.00 $2,716.20 $3,018.00 $3,018.00 $3,018.00 2026-07-17
75635 CPT CT Angiography Aorta Iliofemoral Runoff 42 33 $3,000.00 $2,700.00 $1,650.00 $3,000.00 $3,000.00 2026-07-17
28725 CPT Subtalar Arthrodesis 30 24 $3,000.00 $2,700.00 $3,000.00 $3,000.00 $3,000.00 2026-07-17
71552 CPT MRI Chest W Wo Contrast 30 24 $3,000.00 $2,700.00 $3,000.00 $3,000.00 $3,000.00 2026-07-17
60060006 CDM Minor Procedure 30 24 $3,000.00 $2,700.00 $3,000.00 $3,000.00 $3,000.00 2026-07-17
74183 CPT MRI Abdomen W Wo Contrast 72 33 $3,500.00 $3,150.00 $1,232.00 $3,500.00 $2,999.00 2026-07-17
27002015 CDM Ears, Nose, Throat Sup, Non-airway Lvl10 30 24 $2,950.00 $2,655.00 $2,950.00 $2,950.00 $2,950.00 2026-07-17
27002082 CDM Eye Disposable Supplies Lvl 10 30 24 $2,948.80 $2,653.92 $2,948.80 $2,948.80 $2,948.80 2026-07-17
27001992 CDM Dressing/skin Sealants Lvl 10 30 24 $2,946.21 $2,651.58 $2,946.21 $2,946.21 $2,946.21 2026-07-17
78452 CPT Nm Heart Muscle Spect Mult 72 33 $3,400.00 $3,060.00 $1,385.00 $3,400.00 $2,922.50 2026-07-17
72157 CPT MRI Spine Thoracic W Wo Contrast 72 33 $3,361.00 $3,024.90 $1,300.00 $3,361.00 $2,879.93 2026-07-17
72156 CPT MRI Spine Cervical W Wo Contrast 72 33 $3,361.00 $3,024.90 $1,232.00 $3,361.00 $2,879.93 2026-07-17
27002116 CDM Burs, Blades, Bits, Lvl 10 30 24 $2,878.79 $2,590.91 $2,878.79 $2,878.79 $2,878.79 2026-07-17
27002975 CDM Endo Probes, Balloons, Snares Lvl 10 30 24 $2,878.79 $2,590.91 $2,878.79 $2,878.79 $2,878.79 2026-07-17
27003638 CDM Disposable Instruments Lvl 11 30 24 $2,878.79 $2,590.91 $2,878.79 $2,878.79 $2,878.79 2026-07-17
27003608 CDM Cast Ortho Soft Goods Lvl 23 30 24 $2,878.79 $2,590.91 $2,878.79 $2,878.79 $2,878.79 2026-07-17
C1771 HCPCS Rep Dev, Urinary, W/sling Lvl 7 60 24 $2,850.00 $2,565.00 $1,700.00 $4,000.00 $2,850.00 2026-07-17
70549 CPT MRA Neck W Wo Contrast 72 33 $3,300.00 $2,970.00 $1,276.00 $3,300.00 $2,828.00 2026-07-17
27002046 CDM Endomec- Supplies Staplers/reloads Lvl12 30 24 $2,802.38 $2,522.14 $2,802.38 $2,802.38 $2,802.38 2026-07-17
10070006 CDM OB Base Level 6 30 24 $2,800.00 $2,520.00 $2,800.00 $2,800.00 $2,800.00 2026-07-17
49020 CPT Drain Peritoneal Abscess Or Cyst Open 30 24 $2,800.00 $2,520.00 $2,800.00 $2,800.00 $2,800.00 2026-07-17
V2632 HCPCS Lens, Intraocular Posterior Lvl 1 372 33 $2,790.29 $2,511.26 $195.00 $7,750.81 $2,790.29 2026-07-17
72265 CPT Myelogram Lumbosacral 30 24 $2,768.00 $2,491.20 $2,768.00 $2,768.00 $2,768.00 2026-07-17
21550 CPT Bx Soft Tissue Neck/thorax 30 24 $2,762.00 $2,485.80 $2,762.00 $2,762.00 $2,762.00 2026-07-17
27003324 CDM Female Sterilization Implant Lvl 7 30 24 $2,750.32 $2,475.28 $2,750.32 $2,750.32 $2,750.32 2026-07-17
95811 CPT Pss W 4/> Param W Cpap/bipap 6+ Yrs 72 33 $3,200.00 $2,880.00 $1,304.00 $3,200.00 $2,742.00 2026-07-17
49505 CPT Prp I/hern Init Reduc >5 Yr 162 24 $5,140.00 $4,626.00 $240.00 $5,382.00 $2,699.00 2026-07-17
73723 CPT MRI Joint Lwr Extr W/o&with Contrast 72 33 $3,000.00 $2,700.00 $1,160.00 $3,000.00 $2,698.00 2026-07-17
49593 CPT Repair Aa Hrn 1st < 3 Ncr/strn 51 24 $5,140.00 $4,626.00 $420.00 $5,140.00 $2,675.00 2026-07-17
44160 CPT Pr Colectomy Partial W Rem Ilium 12 12 $4,000.00 $3,600.00 $2,200.00 $3,800.00 $2,640.00 2026-03-19
27002014 CDM Ears, Nose, Throat Sup, Non-airway Lvl 9 30 24 $2,639.47 $2,375.52 $2,639.47 $2,639.47 $2,639.47 2026-07-17
27002081 CDM Eye Disposable Supplies Lvl 9 30 24 $2,638.40 $2,374.56 $2,638.40 $2,638.40 $2,638.40 2026-07-17
27001991 CDM Dressing/skin Sealants Lvl 9 30 24 $2,636.08 $2,372.47 $2,636.08 $2,636.08 $2,636.08 2026-07-17
10010102 CDM Surgery Level 2 - Init 30 Min 30 24 $2,630.00 $2,367.00 $2,630.00 $2,630.00 $2,630.00 2026-07-17
28485 CPT Treat Metatarsal Fracture 174 33 $5,970.00 $5,373.00 $350.00 $6,892.00 $2,620.50 2026-07-17
36561 CPT Ins Tunneled Cvad W Port Age 5 Yrs/> 30 24 $2,600.00 $2,340.00 $2,600.00 $2,600.00 $2,600.00 2026-07-17
58563 CPT Hysteroscopy Ablation 63 33 $3,700.00 $3,330.00 $231.00 $5,005.00 $2,590.00 2026-07-17
70552 CPT MRI Brain W Contrast 60 24 $2,650.00 $2,385.00 $1,025.00 $2,650.00 $2,577.50 2026-07-17
27002115 CDM Burs, Blades, Bits, Lvl 9 30 24 $2,575.76 $2,318.18 $2,575.76 $2,575.76 $2,575.76 2026-07-17
27002950 CDM Eye Medications Level 11 30 24 $2,575.76 $2,318.18 $2,575.76 $2,575.76 $2,575.76 2026-07-17
27003607 CDM Cast Ortho Soft Goods Lvl 22 30 24 $2,575.76 $2,318.18 $2,575.76 $2,575.76 $2,575.76 2026-07-17
27003637 CDM Disposable Instruments Lvl 10 30 24 $2,575.76 $2,318.18 $2,575.76 $2,575.76 $2,575.76 2026-07-17
27002974 CDM Endo Probes, Balloons, Snares Lvl 9 30 24 $2,575.76 $2,318.18 $2,575.76 $2,575.76 $2,575.76 2026-07-17
27003943 CDM Speciality Needle Lvl 9 30 24 $2,575.76 $2,318.18 $2,575.76 $2,575.76 $2,575.76 2026-07-17
58150 CPT Total Abdominal Hysterectomy 30 24 $2,575.00 $2,317.50 $2,575.00 $2,575.00 $2,575.00 2026-07-17
19307 CPT Mastectomy Mod Radical 30 24 $2,575.00 $2,317.50 $2,575.00 $2,575.00 $2,575.00 2026-07-17
74174 CPT CT Angio Abd And Pelv Wo W Contrast 72 33 $3,000.00 $2,700.00 $398.00 $3,000.00 $2,570.50 2026-07-17
27002045 CDM Endomec- Supplies Staplers/reloads Lvl11 30 24 $2,558.69 $2,302.82 $2,558.69 $2,558.69 $2,558.69 2026-07-17
74182 CPT MRI Abdomen W Contrast 42 33 $2,550.00 $2,295.00 $1,402.50 $2,550.00 $2,550.00 2026-07-17
72196 CPT MRI Pelvis W Contrast 30 24 $2,550.00 $2,295.00 $2,550.00 $2,550.00 $2,550.00 2026-07-17
74178 CPT CT Abd & Pelvis W Wo Contr 1+ Reg/sec 102 33 $4,000.00 $3,600.00 $503.00 $4,000.00 $2,530.50 2026-07-17
37609 CPT Temporal Artery Procedure 30 24 $4,170.00 $3,753.00 $1,613.00 $3,942.00 $2,524.00 2026-07-17
49560 CPT Rpr Ventral Hern Init Reduc 30 24 $4,164.00 $3,747.60 $1,697.00 $4,164.00 $2,520.00 2026-07-17
72191 CPT CT Angiography Pelvis W Wo Contrast 30 24 $2,500.00 $2,250.00 $2,500.00 $2,500.00 $2,500.00 2026-07-17
28299 CPT Correction Of Bunion 93 33 $2,500.00 $2,250.00 $584.00 $6,110.00 $2,500.00 2026-07-17
28415 CPT Treat Heel Fracture 30 24 $2,500.00 $2,250.00 $2,500.00 $2,500.00 $2,500.00 2026-07-17
10070005 CDM OB Base Level 5 30 24 $2,500.00 $2,250.00 $2,500.00 $2,500.00 $2,500.00 2026-07-17
27726 CPT Repair Fibula Nonunion 81 24 $2,500.00 $2,250.00 $584.00 $7,969.00 $2,500.00 2026-07-17
27240 CPT Cl Tx Intr/peri/sbtrchntc Fem Fx W Manip 60 24 $2,500.00 $2,250.00 $2,000.00 $3,000.00 $2,500.00 2026-07-17
27001948 CDM Central Peripheral Caths, No HCPCS Lvl 4 30 24 $2,451.49 $2,206.34 $2,451.49 $2,451.49 $2,451.49 2026-07-17
22901 CPT Exc Abdl Tum Deep > 5 Cm 51 24 $4,655.00 $4,189.50 $467.00 $4,400.00 $2,449.00 2026-07-17
49585 CPT Rpr Umbil Hern Reduc > 5 Yr 51 24 $4,655.00 $4,189.50 $337.00 $4,655.00 $2,440.00 2026-07-17
72142 CPT MRI Spine Cervical W Contrast 30 24 $2,400.00 $2,160.00 $2,400.00 $2,400.00 $2,400.00 2026-07-17
70542 CPT MRI Orbit Face Neck W Contrast 30 24 $2,400.00 $2,160.00 $2,400.00 $2,400.00 $2,400.00 2026-07-17
27002586 CDM Hemostasis Supplies General Lvl 3 30 24 $2,356.58 $2,120.92 $2,356.58 $2,356.58 $2,356.58 2026-07-17
27002067 CDM Introducers/sheaths Lvl 6 30 24 $2,352.71 $2,117.43 $2,352.71 $2,352.71 $2,352.71 2026-07-17
57288 CPT Repair Bladder Defect 60 24 $4,291.00 $3,861.90 $2,000.00 $6,582.00 $2,341.00 2026-07-17
73721 CPT MRI Jnt Of Lwr Extre Without Contrast 156 33 $2,500.00 $2,250.00 $825.00 $4,727.00 $2,337.00 2026-07-17
27002013 CDM Ears, Nose, Throat Sup, Non-airway Lvl 8 30 24 $2,328.95 $2,096.05 $2,328.95 $2,328.95 $2,328.95 2026-07-17
27002582 CDM Gyne Supplies General Lvl 3 30 24 $2,328.89 $2,096.00 $2,328.89 $2,328.89 $2,328.89 2026-07-17
27002080 CDM Eye Disposable Supplies Lvl 8 30 24 $2,328.00 $2,095.20 $2,328.00 $2,328.00 $2,328.00 2026-07-17
27001990 CDM Dressing/skin Sealants Lvl 8 30 24 $2,325.95 $2,093.35 $2,325.95 $2,325.95 $2,325.95 2026-07-17
27002172 CDM Grafts, Non Vascular Lvl 3 30 24 $2,323.49 $2,091.14 $2,323.49 $2,323.49 $2,323.49 2026-07-17
27002044 CDM Endomec- Supplies Staplers/reloads Lvl10 30 24 $2,315.01 $2,083.50 $2,315.01 $2,315.01 $2,315.01 2026-07-17
74185 CPT MRA Abdomen W Contrast 30 24 $2,300.00 $2,070.00 $2,300.00 $2,300.00 $2,300.00 2026-07-17
28297 CPT Correction Of Bunion 132 24 $2,300.00 $2,070.00 $537.00 $7,080.00 $2,300.00 2026-07-17
70540 CPT MRI Orbit Face Neck Wo Contrast 42 33 $2,300.00 $2,070.00 $1,265.00 $2,300.00 $2,300.00 2026-07-17
27002593 CDM Laparoscopy Supplies General Lvl 4 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27003636 CDM Disposable Instruments Lvl 9 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27003606 CDM Cast Ortho Soft Goods Lvl 21 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27002603 CDM Urology Supplies General Lvl 3 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27003942 CDM Speciality Needle Lvl 8 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27002725 CDM Vascular Supplies General Lvl 3 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27003219 CDM Patient Positioning Device Lvl 7 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27002973 CDM Endo Probes, Balloons, Snares Lvl 8 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27001973 CDM Drainage Caths Lvl 2 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27002758 CDM External Fixator Level 4 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27002114 CDM Burs, Blades, Bits, Lvl 8 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
27002760 CDM External Fixator Level 6 30 24 $2,272.73 $2,045.45 $2,272.73 $2,272.73 $2,272.73 2026-07-17
58552 CPT Laparo-vag Hyst Incl T/o =<250 Gm 60 24 $2,250.00 $2,025.00 $2,000.00 $2,500.00 $2,250.00 2026-07-17
27002162 CDM Bone/allograft Products/cement Lvl 10 30 24 $2,233.23 $2,009.90 $2,233.23 $2,233.23 $2,233.23 2026-07-17
66982 CPT Cataract Surgery Complex 90 24 $3,685.00 $3,316.50 $1,425.00 $3,685.00 $2,230.00 2026-07-17
66984 CPT Cataract Surg W/iol 1 Stage 90 24 $3,685.00 $3,316.50 $1,501.00 $3,685.00 $2,230.00 2026-07-17
52281 CPT Cystoscopy And Treatment 30 24 $3,685.00 $3,316.50 $1,501.00 $3,484.00 $2,230.00 2026-07-17
74176 CPT CT Abd & Pelvis Wo Contrast 114 33 $3,660.00 $3,294.00 $967.00 $3,660.00 $2,215.00 2026-07-17
58260 CPT Vaginal Hysterectomy =<250 Gm 30 24 $2,200.00 $1,980.00 $2,200.00 $2,200.00 $2,200.00 2026-07-17
74181 CPT MRI Abdomen Wo Contrast 102 33 $2,200.00 $1,980.00 $765.00 $2,300.00 $2,200.00 2026-07-17
27822 CPT Treatment Of Ankle Fracture 111 24 $2,200.00 $1,980.00 $467.00 $9,032.00 $2,200.00 2026-07-17
10070004 CDM OB Base Level 4 30 24 $2,200.00 $1,980.00 $2,200.00 $2,200.00 $2,200.00 2026-07-17
58572 CPT Tlh Uterus Over 250 G 30 24 $2,200.00 $1,980.00 $2,200.00 $2,200.00 $2,200.00 2026-07-17
73222 CPT MRI Up Extr Any Joint W Contrast 30 24 $2,200.00 $1,980.00 $2,200.00 $2,200.00 $2,200.00 2026-07-17
46930 CPT Destroy Internal Hemorrhoids 51 24 $4,170.00 $3,753.00 $129.00 $3,942.00 $2,194.00 2026-07-17
45330 CPT Diagnostic Sigmoidoscopy 51 24 $4,170.00 $3,753.00 $72.00 $3,942.00 $2,194.00 2026-07-17
58353 CPT Endometr Ablate Thermal 51 24 $4,170.00 $3,753.00 $350.00 $4,170.00 $2,194.00 2026-07-17
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 54 33 $4,304.00 $3,873.60 $13.67 $4,068.00 $2,187.50 2026-07-17
27003322 CDM Female Sterilization Implant Lvl 5 30 24 $2,170.69 $1,953.62 $2,170.69 $2,170.69 $2,170.69 2026-07-17
72149 CPT MRI Spine Lumbar W Contrast 72 33 $2,530.00 $2,277.00 $979.00 $2,530.00 $2,167.75 2026-07-17
70551 CPT MRI Brain Wo Contrast 72 33 $2,500.00 $2,250.00 $825.00 $2,500.00 $2,142.50 2026-07-17
72148 CPT MRI Spine Lumbar Wo Contrast 72 33 $2,500.00 $2,250.00 $840.00 $2,500.00 $2,142.50 2026-07-17
52332 CPT Cystoscopy And Treatment 120 24 $3,249.00 $2,924.10 $900.00 $4,856.00 $2,140.00 2026-07-17
A0434 HCPCS Specialty Care Transport 30 24 $2,139.00 $1,925.10 $2,139.00 $2,139.00 $2,139.00 2026-07-17
64721 CPT Carpal Tunnel Surgery 90 24 $3,682.00 $3,313.80 $927.00 $3,942.00 $2,132.50 2026-07-17
27003323 CDM Female Sterilization Implant Lvl 6 30 24 $2,120.00 $1,908.00 $2,120.00 $2,120.00 $2,120.00 2026-07-17
57520 CPT Conization Of Cervix 51 24 $3,998.00 $3,598.20 $222.00 $3,998.00 $2,103.00 2026-07-17
71275 CPT CT Angiography Chest W Wo Contrast 72 33 $2,435.00 $2,191.50 $571.00 $2,435.00 $2,100.50 2026-07-17
57260 CPT Comb Anteroposterior Colporrhaphy 30 24 $2,100.00 $1,890.00 $2,100.00 $2,100.00 $2,100.00 2026-07-17
J1950 HCPCS Leuprolide Acetate /3.75 Mg 60 24 $3,454.00 $3,108.60 $1,336.00 $3,265.00 $2,090.00 2026-07-17
27002043 CDM Endomec- Supplies Staplers/reloads Lvl 9 30 24 $2,071.32 $1,864.18 $2,071.32 $2,071.32 $2,071.32 2026-07-17
19082 CPT Bx Breast Add Lesion Stereotactic 30 24 $2,070.00 $1,863.00 $2,070.00 $2,070.00 $2,070.00 2026-07-17
27003098 CDM Suture/staples/closure Devices Lvl 7 30 24 $2,069.00 $1,862.10 $2,069.00 $2,069.00 $2,069.00 2026-07-17
47600 CPT Cholecystectomy 30 24 $2,060.00 $1,854.00 $2,060.00 $2,060.00 $2,060.00 2026-07-17
74175 CPT CT Angiography Abdomen W Wo Contrast 72 33 $2,400.00 $2,160.00 $928.00 $2,400.00 $2,056.50 2026-07-17
72141 CPT MRI Spine Cervical Wo Contrast 72 33 $2,400.00 $2,160.00 $840.00 $2,400.00 $2,056.50 2026-07-17
70496 CPT CT Angiography Head W Wo Contrast 72 33 $2,400.00 $2,160.00 $417.00 $2,400.00 $2,056.50 2026-07-17
58571 CPT Pr Tlh W/t/o 250 G Or Less 12 12 $3,100.00 $2,790.00 $1,705.00 $2,945.00 $2,046.00 2026-03-19
19083 CPT Bx Breast 1st Lesion US Imag 30 24 $2,046.00 $1,841.40 $2,046.00 $2,046.00 $2,046.00 2026-07-17
C1886 HCPCS Catheter, Ablation Lvl 1 132 33 $3,096.00 $2,786.40 $587.55 $4,112.85 $2,043.36 2026-07-17
24071 CPT Exc Arm/elbow Les Sc 3+ Cm 30 24 $3,340.00 $3,006.00 $1,361.00 $3,340.00 $2,021.00 2026-07-17
55040 CPT Removal Of Hydrocele 60 24 $3,517.50 $3,165.75 $1,361.00 $3,493.00 $2,021.00 2026-07-17
64718 CPT Revise Ulnar Nerve At Elbow 30 24 $3,340.00 $3,006.00 $1,292.00 $3,157.00 $2,021.00 2026-07-17
27002012 CDM Ears, Nose, Throat Sup, Non-airway Lvl 7 30 24 $2,018.42 $1,816.57 $2,018.42 $2,018.42 $2,018.42 2026-07-17
27002079 CDM Eye Disposable Supplies Lvl 7 30 24 $2,017.60 $1,815.84 $2,017.60 $2,017.60 $2,017.60 2026-07-17
28298 CPT Correction Hallux Valgus 59 24 $2,016.00 $1,814.40 $1.00 $2,016.00 $2,016.00 2026-07-17
27001989 CDM Dressing/skin Sealants Lvl 7 30 24 $2,015.83 $1,814.24 $2,015.83 $2,015.83 $2,015.83 2026-07-17
27002169 CDM Cables/crimp/clamp/forceps Lvl 6 30 24 $2,013.69 $1,812.32 $2,013.69 $2,013.69 $2,013.69 2026-07-17
26350 CPT Rep Flxr Tendon Not Zone 2 Wo Graft Ea 60 24 $2,000.00 $1,800.00 $1,700.00 $2,300.00 $2,000.00 2026-07-17
72147 CPT MRI Spine Thoracic W Contrast 30 24 $2,000.00 $1,800.00 $2,000.00 $2,000.00 $2,000.00 2026-07-17
73702 CPT CT Lower Extr W Wo Contrast 30 24 $2,000.00 $1,800.00 $2,000.00 $2,000.00 $2,000.00 2026-07-17
28306 CPT Mt To Shorten; 1st Mt 30 24 $2,000.00 $1,800.00 $2,000.00 $2,000.00 $2,000.00 2026-07-17
28735 CPT Arthrod Mt/tmt; W Osteot For Ff 30 24 $2,000.00 $1,800.00 $2,000.00 $2,000.00 $2,000.00 2026-07-17
70547 CPT MRA Neck Wo Contrast 30 24 $2,000.00 $1,800.00 $2,000.00 $2,000.00 $2,000.00 2026-07-17
28173 CPT Resect Metatarsal Tumor 51 24 $2,000.00 $1,800.00 $467.00 $2,000.00 $2,000.00 2026-07-17
28111 CPT Compl Exc 1st Metatrsl Head 42 33 $2,000.00 $1,800.00 $1,100.00 $2,000.00 $2,000.00 2026-07-17
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