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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

HANSEN FAMILY HOSPITAL

Iowa Falls, IA · CCN 161380 · Rates published

2,458 distinct procedures filed
20 distinct payers
68,516 rate rows
2026-07-10 last MRF observed
Data quality

67,534 of 68,516 rate rows are consumer-grade (98.6%)

982 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
per-diem day rate — not a per-procedure price 384
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 348
exceeds 10× this hospital's gross charge — excluded from medians 162
percent-of-charges filed in the dollar field — excluded from medians 64
exceeds 3× this hospital's gross charge for a DRG stay — excluded 22
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=dbEMHIOWAFALLSIA&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Hansen_Family_Hospital.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-31
Content fingerprint 69242e72ebd3f6c6… · 30,803,142 bytes · first seen 2026-07-31

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
91
MS_DRG 		Other Disorders Of Nervous System With Mcc 8 $22,173.54 $131,543.25 $127,842.54 nat. median
$17,042
outlier · 7.5×
565
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 8 $17,190.02 $85,190.95 $82,771.26 nat. median
$10,088
outlier · 8.2×
300
MS_DRG 		Peripheral Vascular Disorders With Cc 7 $16,020.45 $83,144.43 $81,531.30 nat. median
$10,840
outlier · 7.5×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 7 $23,953.59 $74,701.71 $73,278.36 nat. median
$11,475
outlier · 6.4×
561
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 7 $21,493.33 $63,845.90 $62,612.33 nat. median
$8,652
outlier · 7.2×
539
MS_DRG 		Osteomyelitis With Mcc 7 $18,344.01 $55,943.53 $54,994.63 nat. median
$18,822
outlier · 2.9×
394
MS_DRG 		Other Digestive System Diagnoses With Cc 8 $13,087.96 $55,236.00 $53,812.65 nat. median
$9,671
outlier · 5.6×
949
MS_DRG 		Aftercare With Cc/mcc 8 $17,258.54 $47,876.82 $46,595.81 nat. median
$11,791
outlier · 4.0×
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 8 $16,411.34 $46,949.15 $45,668.14 nat. median
$11,506
outlier · 4.0×
947
MS_DRG 		Signs And Symptoms With Mcc 8 $13,919.59 $46,940.81 $45,659.79 nat. median
$12,107
outlier · 3.8×
566
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/mcc 6 $9,829.99 $82,320.85 $45,259.86 nat. median
$7,951
outlier · 5.7×
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 5 $40,450.58 $120,242.91 $42,068.61 nat. median
$21,142
2.0× median
388
MS_DRG 		Gastrointestinal Obstruction With Mcc 8 $15,587.51 $40,410.85 $39,414.51 nat. median
$14,310
outlier · 2.8×
602
MS_DRG 		Cellulitis With Mcc 6 $19,772.10 $58,689.98 $38,993.88 nat. median
$14,007
outlier · 2.8×
380
MS_DRG 		Complicated Peptic Ulcer With Mcc 8 $16,968.20 $36,895.10 $36,041.09 nat. median
$18,500
1.9× median
563
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 8 $12,169.13 $36,221.05 $35,224.71 nat. median
$9,140
outlier · 3.9×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 8 $12,335.76 $35,865.98 $35,011.97 nat. median
$8,511
outlier · 4.1×
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 8 $13,397.87 $31,522.34 $30,810.67 nat. median
$10,397
outlier · 3.0×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 8 $14,892.04 $31,497.79 $30,786.11 nat. median
$15,375
outlier · 2.0×
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 8 $14,772.08 $31,377.83 $30,666.15 nat. median
$19,223
1.6× median
184
MS_DRG 		Major Chest Trauma With Cc 8 $9,494.35 $26,100.10 $25,388.42 nat. median
$10,693
outlier · 2.4×
948
MS_DRG 		Signs And Symptoms Without Mcc 6 $10,410.88 $38,745.09 $24,533.16 nat. median
$7,968
outlier · 3.1×
698
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Mcc 8 $11,611.85 $24,896.45 $24,327.11 nat. median
$15,902
1.5× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 $16,670.10 $25,062.36 $24,098.42 nat. median
$18,625
1.3× median
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 3 $10,920.78 $24,911.73 $23,953.59 nat. median
$18,112
1.3× median
291
MS_DRG 		Heart Failure And Shock With Mcc 8 $10,865.37 $24,149.97 $23,580.63 nat. median
$12,759
1.8× median
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 8 $10,192.85 $23,906.74 $23,337.40 nat. median
$8,173
outlier · 2.9×
390
MS_DRG 		Gastrointestinal Obstruction Without Cc/mcc 7 $7,886.42 $23,803.28 $23,170.68 nat. median
$6,115
outlier · 3.8×
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 6 $11,770.44 $33,435.05 $22,458.60 nat. median
$8,373
outlier · 2.7×
897
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 8 $9,520.75 $22,805.35 $22,236.01 nat. median
$8,342
outlier · 2.7×
603
MS_DRG 		Cellulitis Without Mcc 8 $9,350.20 $22,634.80 $22,065.46 nat. median
$8,977
outlier · 2.5×
433
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Cc 7 $8,154.55 $21,186.11 $20,806.55 nat. median
$10,753
1.9× median
682
MS_DRG 		Renal Failure With Mcc 3 $14,712.82 $21,361.47 $20,539.88 nat. median
$14,433
1.4× median
299
MS_DRG 		Peripheral Vascular Disorders With Mcc 3 $19,700.46 $20,488.48 $20,094.47 nat. median
$15,755
1.3× median
175
MS_DRG 		Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 8 $7,082.05 $20,366.65 $19,797.31 nat. median
$13,725
1.4× median
552
MS_DRG 		Medical Back Problems Without Mcc 6 $11,841.27 $25,125.87 $19,212.82 nat. median
$9,826
2.0× median
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 8 $9,466.47 $20,420.46 $19,192.69 nat. median
$16,886
1.1× median
557
MS_DRG 		Tendonitis, Myositis And Bursitis With Mcc 6 $12,338.13 $25,369.69 $19,127.60 nat. median
$14,487
1.3× median
551
MS_DRG 		Medical Back Problems With Mcc 3 $18,219.98 $19,515.08 $18,764.50 nat. median
$16,085
1.2× median
71
MS_DRG 		Other Cerebrovascular Disorders With Cc 3 $18,320.65 $19,053.48 $18,687.07 nat. median
$10,544
1.8× median
J3245
HCPCS 		Injection, Tildrakizumab, 1 Mg 16 $15,711.02 $34,228.80 $18,534.89 nat. median
$256
outlier · 72.4×
8613520
CDM 		Pharmacy Added From Trans - Tildrakizumab 100 Mg / 1 Ml Soln Subcutaneous On Cal… 16 $15,711.02 $34,228.80 $18,534.89 nat. median
$18,535
1.0× median
59
MS_DRG 		Multiple Sclerosis And Cerebellar Ataxia With Cc 3 $8,173.25 $18,897.99 $18,171.15 nat. median
$12,334
1.5× median
389
MS_DRG 		Gastrointestinal Obstruction With Cc 8 $7,696.72 $17,660.17 $17,233.17 nat. median
$8,337
outlier · 2.1×
100
MS_DRG 		Seizures With Mcc 3 $9,218.07 $17,827.41 $17,141.74 nat. median
$18,344
0.9× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 3 $13,999.92 $17,751.29 $17,068.55 nat. median
$12,858
1.3× median
964
MS_DRG 		Other Multiple Significant Trauma With Cc 3 $7,005.75 $17,652.49 $16,973.55 nat. median
$14,933
1.1× median
440
MS_DRG 		Disorders Of Pancreas Except Malignancy Without Cc/mcc 8 $7,198.90 $17,162.35 $16,735.35 nat. median
$6,861
outlier · 2.4×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 18 $15,653.08 $34,102.57 $16,710.26 nat. median
$168
outlier · 99.8×
J1930
HCPCS 		Injection, Lanreotide, 1 Mg 18 $12,114.02 $34,930.48 $16,288.08 nat. median
$5,088
outlier · 3.2×

Other procedures at this hospital

Browse this hospital's 2,458 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
             
56 MS_DRG Degenerative Nervous System Disorders With Mcc 5 5 $42,053.55 $42,053.55 $40,450.58 $120,242.91 $42,068.61 2026-07-10
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 7 7 $25,833.36 $25,833.36 $23,953.59 $74,701.71 $73,278.36 2026-07-10
91 MS_DRG Other Disorders Of Nervous System With Mcc 8 8 $45,193.35 $45,193.35 $22,173.54 $131,543.25 $127,842.54 2026-07-10
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 7 7 $21,493.33 $21,493.33 $21,493.33 $63,845.90 $62,612.33 2026-07-10
602 MS_DRG Cellulitis With Mcc 6 6 $25,478.48 $25,478.48 $19,772.10 $58,689.98 $38,993.88 2026-07-10
299 MS_DRG Peripheral Vascular Disorders With Mcc 3 3 $25,930.60 $25,930.60 $19,700.46 $20,488.48 $20,094.47 2026-07-10
539 MS_DRG Osteomyelitis With Mcc 7 7 $23,364.63 $23,364.63 $18,344.01 $55,943.53 $54,994.63 2026-07-10
71 MS_DRG Other Cerebrovascular Disorders With Cc 3 3 $56,170.15 $56,170.15 $18,320.65 $19,053.48 $18,687.07 2026-07-10
551 MS_DRG Medical Back Problems With Mcc 3 3 $18,219.98 $18,219.98 $18,219.98 $19,515.08 $18,764.50 2026-07-10
949 MS_DRG Aftercare With Cc/mcc 8 8 $17,986.47 $17,986.47 $17,258.54 $47,876.82 $46,595.81 2026-07-10
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 8 8 $28,731.40 $28,731.40 $17,190.02 $85,190.95 $82,771.26 2026-07-10
380 MS_DRG Complicated Peptic Ulcer With Mcc 8 8 $16,968.20 $16,968.20 $16,968.20 $36,895.10 $36,041.09 2026-07-10
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 3 $16,670.10 $16,670.10 $16,670.10 $25,062.36 $24,098.42 2026-07-10
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 8 8 $17,058.80 $17,058.80 $16,411.34 $46,949.15 $45,668.14 2026-07-10
300 MS_DRG Peripheral Vascular Disorders With Cc 7 7 $27,760.30 $27,760.30 $16,020.45 $83,144.43 $81,531.30 2026-07-10
J3245 HCPCS Injection, Tildrakizumab, 1 Mg 16 16 $34,228.80 $34,228.80 $15,711.02 $34,228.80 $18,534.89 2026-07-10
8613520 CDM Pharmacy Added From Trans - Tildrakizumab 100 Mg / 1 Ml Soln Subcutaneous On Cal… 16 16 $34,228.80 $34,228.80 $15,711.02 $34,228.80 $18,534.89 2026-07-10
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 18 18 $34,102.57 $34,102.57 $15,653.08 $34,102.57 $16,710.26 2026-07-10
388 MS_DRG Gastrointestinal Obstruction With Mcc 8 8 $17,162.80 $17,162.80 $15,587.51 $40,410.85 $39,414.51 2026-07-10
177 MS_DRG Respiratory Infections And Inflammations With Mcc 8 8 $14,892.04 $14,892.04 $14,892.04 $31,497.79 $30,786.11 2026-07-10
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 8 8 $14,772.08 $14,772.08 $14,772.08 $31,377.83 $30,666.15 2026-07-10
682 MS_DRG Renal Failure With Mcc 3 3 $14,712.82 $14,712.82 $14,712.82 $21,361.47 $20,539.88 2026-07-10
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 3 3 $13,999.92 $13,999.92 $13,999.92 $17,751.29 $17,068.55 2026-07-10
947 MS_DRG Signs And Symptoms With Mcc 8 8 $17,050.46 $17,050.46 $13,919.59 $46,940.81 $45,659.79 2026-07-10
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 8 8 $14,916.59 $14,916.59 $13,397.87 $31,522.34 $30,810.67 2026-07-10
394 MS_DRG Other Digestive System Diagnoses With Cc 8 8 $22,024.50 $22,024.50 $13,087.96 $55,236.00 $53,812.65 2026-07-10
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 6 6 $12,338.13 $12,338.13 $12,338.13 $25,369.69 $19,127.60 2026-07-10
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 8 8 $15,939.08 $15,939.08 $12,335.76 $35,865.98 $35,011.97 2026-07-10
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 8 8 $12,973.00 $12,973.00 $12,169.13 $36,221.05 $35,224.71 2026-07-10
J1930 HCPCS Injection, Lanreotide, 1 Mg 54 18 $29,124.68 $29,124.68 $12,114.02 $34,930.48 $16,288.08 2026-07-10
552 MS_DRG Medical Back Problems Without Mcc 6 6 $11,841.27 $11,841.27 $11,841.27 $25,125.87 $19,212.82 2026-07-10
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 6 6 $13,508.15 $13,508.15 $11,770.44 $33,435.05 $22,458.60 2026-07-10
J3101 HCPCS Injection, Tenecteplase, 1 Mg 16 16 $25,546.53 $25,546.53 $11,725.86 $25,546.53 $13,833.44 2026-07-10
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 8 8 $11,611.85 $11,611.85 $11,611.85 $24,896.45 $24,327.11 2026-07-10
638 MS_DRG Diabetes With Cc 4 4 $19,835.56 $19,835.56 $11,533.73 $39,762.46 $11,879.74 2026-07-10
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 3 3 $10,920.78 $10,920.78 $10,920.78 $24,911.73 $23,953.59 2026-07-10
291 MS_DRG Heart Failure And Shock With Mcc 8 8 $10,865.37 $10,865.37 $10,865.37 $24,149.97 $23,580.63 2026-07-10
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 3 3 $10,833.13 $10,833.13 $10,833.13 $16,165.66 $15,543.90 2026-07-10
72 MS_DRG Other Cerebrovascular Disorders Without Cc/mcc 3 3 $10,685.60 $10,685.60 $10,487.19 $10,906.68 $10,685.60 2026-07-10
176 MS_DRG Pulmonary Embolism Without Mcc 3 3 $17,927.50 $17,927.50 $10,417.11 $10,833.79 $10,625.45 2026-07-10
948 MS_DRG Signs And Symptoms Without Mcc 6 6 $12,935.01 $12,935.01 $10,410.88 $38,745.09 $24,533.16 2026-07-10
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 8 8 $10,622.14 $10,622.14 $10,192.85 $23,906.74 $23,337.40 2026-07-10
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/mcc 6 6 $29,182.45 $29,182.45 $9,829.99 $82,320.85 $45,259.86 2026-07-10
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 8 8 $9,520.75 $9,520.75 $9,520.75 $22,805.35 $22,236.01 2026-07-10
184 MS_DRG Major Chest Trauma With Cc 8 8 $9,494.35 $9,494.35 $9,494.35 $26,100.10 $25,388.42 2026-07-10
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 8 8 $9,466.47 $9,466.47 $9,466.47 $20,420.46 $19,192.69 2026-07-10
603 MS_DRG Cellulitis Without Mcc 8 8 $9,350.20 $9,350.20 $9,350.20 $22,634.80 $22,065.46 2026-07-10
100 MS_DRG Seizures With Mcc 3 3 $9,218.07 $9,218.07 $9,218.07 $17,827.41 $17,141.74 2026-07-10
980152 CDM Pharmacy Added From Trans - Golimumab + Sodium Chloride 0.9% Intravenous Solutio… 16 16 $19,819.22 $19,819.22 $9,097.02 $19,819.22 $10,732.10 2026-07-10
693589 CDM Pharmacy Added From Trans - Abatacept + Sodium Chloride 0.9% Intravenous Solutio… 16 16 $18,441.29 $18,441.29 $8,464.55 $18,441.29 $9,985.95 2026-07-10
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 3 3 $8,173.25 $8,173.25 $8,173.25 $18,897.99 $18,171.15 2026-07-10
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 5 5 $8,158.65 $8,158.65 $8,158.65 $17,837.43 $10,304.17 2026-07-10
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 7 7 $8,154.55 $8,154.55 $8,154.55 $21,186.11 $20,806.55 2026-07-10
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 7 7 $10,518.68 $10,518.68 $7,886.42 $23,803.28 $23,170.68 2026-07-10
389 MS_DRG Gastrointestinal Obstruction With Cc 8 8 $7,696.72 $7,696.72 $7,696.72 $17,660.17 $17,233.17 2026-07-10
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 8 8 $7,198.90 $7,198.90 $7,198.90 $17,162.35 $16,735.35 2026-07-10
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 8 8 $7,082.05 $7,082.05 $7,082.05 $20,366.65 $19,797.31 2026-07-10
189 MS_DRG Pulmonary Edema And Respiratory Failure 3 3 $7,068.60 $7,068.60 $7,068.60 $14,516.86 $13,958.52 2026-07-10
964 MS_DRG Other Multiple Significant Trauma With Cc 3 3 $7,005.75 $7,005.75 $7,005.75 $17,652.49 $16,973.55 2026-07-10
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 16 16 $15,136.67 $15,136.67 $6,947.73 $15,136.67 $8,196.51 2026-07-10
Q4197 HCPCS Puraply Xt, Per Square Centimeter 36 18 $23,700.00 $23,700.00 $6,885.00 $32,400.00 $14,887.80 2026-07-10
8958177 CDM Flexband Twist 16 16 $14,987.50 $14,987.50 $6,879.26 $14,987.50 $8,115.73 2026-07-10
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 16 16 $14,697.62 $14,697.62 $6,746.21 $14,697.62 $7,958.76 2026-07-10
101 MS_DRG Seizures Without Mcc 3 3 $6,710.60 $6,710.60 $6,710.60 $10,195.65 $9,803.51 2026-07-10
J9312 HCPCS Injection, Rituximab, 10 Mg 16 16 $14,617.98 $14,617.98 $6,709.65 $14,617.98 $7,915.64 2026-07-10
8834289 CDM Viaflow 2.0cc 16 16 $14,055.00 $14,055.00 $6,451.25 $14,055.00 $7,610.78 2026-07-10
J0565 HCPCS Injection, Bezlotoxumab, 10 Mg 18 18 $13,956.80 $13,956.80 $6,406.17 $13,956.80 $6,838.83 2026-07-10
Q5120 HCPCS Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg 16 16 $13,821.34 $13,821.34 $6,344.00 $13,821.34 $7,484.25 2026-07-10
Q5122 HCPCS Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg 16 16 $13,819.47 $13,819.47 $6,343.14 $13,819.47 $7,483.24 2026-07-10
980212 CDM Pharmacy Added From Trans - Immune Globulin Intravenous And Subcutaneous + Sodiu… 16 16 $13,120.89 $13,120.89 $6,022.49 $13,120.89 $7,104.96 2026-07-10
683 MS_DRG Renal Failure With Cc 8 8 $5,890.85 $5,890.85 $5,890.85 $15,854.30 $15,427.30 2026-07-10
J0896 HCPCS Injection, Luspatercept-aamt, 0.25 Mg 32 16 $25,176.57 $25,176.57 $5,806.67 $37,702.45 $14,978.06 2026-07-10
8950019 CDM Lapidus Plate - Standard Ortholoc 2 Lapifuse 16 16 $12,235.00 $12,235.00 $5,615.87 $12,235.00 $6,625.26 2026-07-10
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 50 18 $14,838.78 $14,838.78 $5,534.98 $21,769.09 $8,889.26 2026-07-10
8822004 CDM Flexband Solo Kit 16 16 $11,985.00 $11,985.00 $5,501.12 $11,985.00 $6,489.88 2026-07-10
544 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 5 5 $5,420.90 $5,420.90 $5,420.90 $15,194.57 $7,482.75 2026-07-10
C1763 HCPCS Connective Tissue, Non-human (includes Synthetic) 16 16 $11,187.50 $11,187.50 $5,135.06 $11,187.50 $6,058.03 2026-07-10
8831742 CDM Lapidus Plate - Crosscheck Lap Screw 16 16 $10,716.00 $10,716.00 $4,918.64 $10,716.00 $5,802.72 2026-07-10
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 8 8 $4,833.30 $4,833.30 $4,833.30 $13,601.76 $11,317.45 2026-07-10
8857758 CDM Flexband 0.7 X 32 Cm 16 16 $10,185.00 $10,185.00 $4,674.92 $10,185.00 $5,515.18 2026-07-10
J2407 HCPCS Injection, Oritavancin (orbactiv), 10 Mg 16 16 $10,025.38 $10,025.38 $4,601.65 $10,025.38 $5,428.74 2026-07-10
8754539 CDM Pharmacy Added From Trans - Romosozumab 210 Mg / 2.34 Ml Soln Subcutaneous *qMon… 16 16 $9,601.80 $9,601.80 $4,407.23 $9,601.80 $5,199.38 2026-07-10
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 18 18 $9,601.77 $9,601.77 $4,407.21 $9,601.77 $4,704.87 2026-07-10
951 MS_DRG Other Factors Influencing Health Status 3 3 $4,400.73 $4,400.73 $4,400.73 $7,411.49 $7,126.43 2026-07-10
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 16 16 $9,040.98 $9,040.98 $4,149.81 $9,040.98 $4,895.69 2026-07-10
602712 CDM Pharmacy Added From Trans - inFLIXimab + Sodium Chloride 0.9% Intravenous Soluti… 16 16 $8,862.89 $8,862.89 $4,068.06 $8,862.89 $4,799.25 2026-07-10
V2790 HCPCS Amniotic Membrane For Surgical Reconstruction, Per Procedure 32 16 $11,918.00 $11,918.00 $4,010.74 $15,098.00 $6,937.53 2026-07-10
8827404 CDM Speedbrg Imp Sys W/bio-comp Swvlk & Ndl 16 16 $8,187.00 $8,187.00 $3,757.83 $8,187.00 $4,433.26 2026-07-10
8754057 CDM Myosure Polyp Removal Kit 16 16 $7,725.00 $7,725.00 $3,545.78 $7,725.00 $4,183.09 2026-07-10
8939523 CDM Staple Nitinol 18 X 15 Easyfuse 16 16 $7,695.00 $7,695.00 $3,532.01 $7,695.00 $4,166.85 2026-07-10
8939525 CDM Staple Nitinol, 18 X 20 Easyfuse 16 16 $7,695.00 $7,695.00 $3,532.01 $7,695.00 $4,166.85 2026-07-10
Q0222 HCPCS Injection, Bebtelovimab, 175 Mg 16 16 $7,676.50 $7,676.50 $3,523.51 $7,676.50 $4,156.82 2026-07-10
J1459 HCPCS Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 16 16 $7,297.20 $7,297.20 $3,349.41 $7,297.20 $3,951.43 2026-07-10
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 16 16 $7,143.74 $7,143.74 $3,278.98 $7,143.74 $3,868.34 2026-07-10
8873320 CDM Staple Nitinol 10 X 10 16 16 $6,951.00 $6,951.00 $3,190.51 $6,951.00 $3,763.97 2026-07-10
52441 HCPCS Insertion Of Implant In Urethra Within Prostate Gland Using An Endoscope, 1 Impl… 18 18 $7,052.41 $7,052.41 $3,151.50 $7,052.41 $3,437.72 2026-07-10
8931856 CDM Smart Toe Ii Implant 16 16 $6,837.00 $6,837.00 $3,138.18 $6,837.00 $3,702.23 2026-07-10
8826381 CDM Staple Nitinol 8x8 16 16 $6,762.00 $6,762.00 $3,103.76 $6,762.00 $3,661.62 2026-07-10
8939521 CDM Staple Nitinol 12x12 Fuseforce 16 16 $6,757.50 $6,757.50 $3,101.69 $6,757.50 $3,659.18 2026-07-10
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 16 16 $6,451.41 $6,451.41 $2,961.20 $6,451.41 $3,493.44 2026-07-10
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 16 16 $6,400.86 $6,400.86 $2,937.99 $6,400.86 $3,466.07 2026-07-10
8826387 CDM 5th Met Y-plate 16 16 $6,201.00 $6,201.00 $2,846.26 $6,201.00 $3,357.84 2026-07-10
J2315 HCPCS Injection, Naltrexone, Depot Form, 1 Mg 16 16 $5,970.00 $5,970.00 $2,740.23 $5,970.00 $3,232.76 2026-07-10
J9041 HCPCS Injection, Bortezomib, 0.1 Mg 16 16 $5,959.72 $5,959.72 $2,735.51 $5,959.72 $3,227.18 2026-07-10
4898801 CDM Esophyx Cartridge 16 16 $5,848.00 $5,848.00 $2,684.23 $5,848.00 $3,166.69 2026-07-10
4898802 CDM Esophyx Device Kit 16 16 $5,848.00 $5,848.00 $2,684.23 $5,848.00 $3,166.69 2026-07-10
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 16 16 $5,795.92 $5,795.92 $2,660.33 $5,795.92 $3,138.49 2026-07-10
Q5136 HCPCS Injection, Denosumab-bbdz (jubbonti/wyost), Biosimilar, 1 Mg 16 16 $5,667.18 $5,667.18 $2,601.24 $5,667.18 $3,068.78 2026-07-10
J0875 HCPCS Injection, Dalbavancin, 5 Mg 16 16 $5,644.43 $5,644.43 $2,590.79 $5,644.43 $3,056.46 2026-07-10
8928945 CDM Fibulink Syndesmosis Repair Kit/ Ss 16 16 $5,376.00 $5,376.00 $2,467.58 $5,376.00 $2,911.11 2026-07-10
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 6 6 $2,417.45 $2,417.45 $2,417.45 $5,738.60 $5,627.90 2026-07-10
8826377 CDM Implant Medium Cannulated 16 16 $5,160.00 $5,160.00 $2,368.44 $5,160.00 $2,794.14 2026-07-10
5014900 CDM Mesh Dual 18x24cm 16 16 $4,918.00 $4,918.00 $2,257.36 $4,918.00 $2,663.10 2026-07-10
J1568 HCPCS Injection, Immune Globulin, (octagam), Intravenous, Non-lyophilized (e.g., Liqui… 16 16 $4,764.50 $4,764.50 $2,186.91 $4,764.50 $2,579.97 2026-07-10
J1306 HCPCS Injection, Inclisiran, 1 Mg 16 16 $4,708.18 $4,708.18 $2,161.05 $4,708.18 $2,549.48 2026-07-10
J2357 HCPCS Injection, Omalizumab, 5 Mg 32 16 $7,713.34 $7,713.34 $2,157.18 $10,726.93 $4,811.70 2026-07-10
9040471 CDM G7 Osseoti 3 Hole Shell 16 16 $4,500.00 $4,500.00 $2,065.50 $4,500.00 $2,436.75 2026-07-10
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 32 16 $4,689.17 $4,689.17 $2,064.94 $4,879.56 $2,528.05 2026-07-10
8904367 CDM Spade Two-step Hammer Toe Implant 16 16 $4,485.00 $4,485.00 $2,058.62 $4,485.00 $2,428.63 2026-07-10
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 18 18 $4,064.00 $4,064.00 $1,865.38 $4,064.00 $2,438.40 2026-07-10
8829775 CDM Posterior Stabilized Legion Femoral Component 16 16 $4,050.00 $4,050.00 $1,858.95 $4,050.00 $2,193.07 2026-07-10
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 16 16 $3,847.95 $3,847.95 $1,766.21 $3,847.95 $2,083.66 2026-07-10
Q4101 HCPCS Apligraf, Per Square Centimeter 18 18 $3,828.00 $3,828.00 $1,757.05 $3,828.00 $1,875.72 2026-07-10
8808503 CDM Operating Room Services - Minor Surgery 16 16 $3,763.62 $3,763.62 $1,727.50 $3,763.62 $2,038.00 2026-07-10
8852062 CDM Alloderm Tissue Graft 4x7 16 16 $3,711.00 $3,711.00 $1,703.35 $3,711.00 $2,009.51 2026-07-10
J0485 HCPCS Injection, Belatacept, 1 Mg 16 16 $3,639.33 $3,639.33 $1,670.45 $3,639.33 $1,970.70 2026-07-10
Q4106 HCPCS Dermagraft, Per Square Centimeter 18 18 $3,487.50 $3,487.50 $1,600.76 $3,487.50 $1,708.88 2026-07-10
J9394 HCPCS Injection, Fulvestrant (fresenius Kabi) Not Therapeutically Equivalent To J9395,… 16 16 $3,472.87 $3,472.87 $1,594.05 $3,472.87 $1,880.56 2026-07-10
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 18 18 $3,458.25 $3,458.25 $1,587.34 $5,934.94 $2,074.95 2026-07-10
15273 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Trunk, Arms, Or Legs, 100.… 34 18 $3,445.35 $3,445.35 $1,581.42 $4,962.01 $2,325.20 2026-07-10
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 18 18 $3,378.00 $3,378.00 $1,550.50 $3,378.00 $2,026.80 2026-07-10
Q4102 HCPCS Oasis Wound Matrix, Per Square Centimeter 36 18 $5,069.50 $5,069.50 $1,550.04 $6,762.00 $3,107.14 2026-07-10
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 18 18 $3,280.00 $3,280.00 $1,505.52 $3,280.00 $1,968.00 2026-07-10
6818782 CDM Operating Room Services - Minor Surgery 16 16 $3,248.62 $3,248.62 $1,491.12 $3,248.62 $1,759.12 2026-07-10
C1783 HCPCS Ocular Implant, Aqueous Drainage Assist Device 16 16 $3,125.00 $3,125.00 $1,434.38 $3,125.00 $1,692.19 2026-07-10
1378484 CDM Operating Room Services - General Classification 16 16 $3,090.00 $3,090.00 $1,418.31 $3,090.00 $1,673.24 2026-07-10
8937786 CDM Himax 16 16 $3,000.00 $3,000.00 $1,377.00 $3,000.00 $1,624.50 2026-07-10
1376942 CDM Operating Room Services - Minor Surgery 16 16 $2,990.00 $2,990.00 $1,372.41 $2,990.00 $1,619.09 2026-07-10
8789616 CDM Operating Room Services - Minor Surgery 16 16 $2,990.00 $2,990.00 $1,372.41 $2,990.00 $1,619.09 2026-07-10
8933152 CDM Puraply Mz 500mg 16 16 $2,900.00 $2,900.00 $1,331.10 $2,900.00 $1,570.35 2026-07-10
8771756 CDM Ventralex St Hernia Patch Small 16 16 $2,743.20 $2,743.20 $1,259.13 $2,743.20 $1,485.45 2026-07-10
45379 HCPCS Removal Of Foreign Bodies In Large Bowel Using A Flexible Endoscope 18 18 $2,733.00 $2,733.00 $1,254.45 $3,062.92 $1,639.80 2026-07-10
Q4195 HCPCS Puraply, Per Square Centimeter 90 18 $8,550.00 $8,550.00 $1,241.14 $38,400.00 $4,659.75 2026-07-10
9017871 CDM G7 Vit E High Wall Lnr 16 16 $2,700.00 $2,700.00 $1,239.30 $2,700.00 $1,462.05 2026-07-10
15275 HCPCS Application Of Skin Substitute Graft To Wound Of Face, Scalp, Eyelids, Mouth, Ne… 18 18 $2,582.21 $2,582.21 $1,185.23 $3,697.88 $1,549.33 2026-07-10
1378487 CDM Operating Room Services - General Classification 16 16 $2,575.00 $2,575.00 $1,181.93 $2,575.00 $1,394.37 2026-07-10
8937784 CDM Dynaforce Mtp Plate 16 16 $2,500.00 $2,500.00 $1,147.50 $2,500.00 $1,353.75 2026-07-10
8808501 CDM Operating Room Services - Minor Surgery 16 16 $2,484.36 $2,484.36 $1,140.32 $2,484.36 $1,345.28 2026-07-10
1376935 CDM Operating Room Services - Minor Surgery 16 16 $2,484.36 $2,484.36 $1,140.32 $2,484.36 $1,345.28 2026-07-10
21931 HCPCS Removal Of Growth Under Skin Of Back Or Lower Sides, 3.0 Cm Or More 18 18 $2,456.77 $2,456.77 $1,127.66 $4,338.72 $1,474.06 2026-07-10
8771758 CDM Ventralex St Hernia Patch Med 16 16 $2,419.50 $2,419.50 $1,110.55 $2,419.50 $1,310.16 2026-07-10
20103 HCPCS Exploration Of Wound Of Arm Or Leg 18 18 $2,760.75 $2,760.75 $1,103.22 $2,760.75 $1,314.39 2026-07-10
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 34 18 $4,407.78 $4,407.78 $1,096.50 $4,407.78 $2,027.58 2026-07-10
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 18 18 $4,086.00 $4,086.00 $1,091.76 $4,086.00 $1,945.35 2026-07-10
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 34 18 $3,834.00 $3,834.00 $1,091.76 $3,834.00 $1,825.37 2026-07-10
70553 HCPCS MRI Scan Of Brain Before And After Contrast 18 18 $3,834.00 $3,834.00 $1,091.76 $3,834.00 $1,825.37 2026-07-10
70552 HCPCS MRI Scan Of Brain With Contrast 18 18 $3,834.00 $3,834.00 $1,091.76 $3,834.00 $1,825.37 2026-07-10
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 18 18 $3,765.00 $3,765.00 $1,091.76 $3,765.00 $1,792.52 2026-07-10
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 18 18 $3,627.00 $3,627.00 $1,091.76 $3,627.00 $1,726.82 2026-07-10
71552 HCPCS MRI Scan Of Chest Before And After Contrast 18 18 $3,616.00 $3,616.00 $1,091.76 $3,616.00 $1,721.58 2026-07-10
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 18 18 $3,616.00 $3,616.00 $1,091.76 $3,616.00 $1,721.58 2026-07-10
71551 HCPCS MRI Scan Of Chest With Contrast 18 18 $3,598.00 $3,598.00 $1,091.76 $3,598.00 $1,713.01 2026-07-10
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 18 18 $3,551.00 $3,551.00 $1,091.76 $3,551.00 $1,690.63 2026-07-10
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 18 18 $3,551.00 $3,551.00 $1,091.76 $3,551.00 $1,690.63 2026-07-10
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 18 18 $3,551.00 $3,551.00 $1,091.76 $3,551.00 $1,690.63 2026-07-10
74182 HCPCS MRI Scan Of Abdomen With Contrast 18 18 $3,524.00 $3,524.00 $1,091.76 $3,524.00 $1,677.78 2026-07-10
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 18 18 $3,426.00 $3,426.00 $1,091.76 $3,426.00 $1,631.12 2026-07-10
73220 HCPCS MRI Scan Of Arm Before And After Contrast 18 18 $3,115.00 $3,115.00 $1,091.76 $3,115.00 $1,483.05 2026-07-10
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 18 18 $2,939.00 $2,939.00 $1,091.76 $2,939.00 $1,399.26 2026-07-10
72196 HCPCS MRI Scan Of Pelvis With Contrast 18 18 $2,825.00 $2,825.00 $1,091.76 $2,825.00 $1,344.99 2026-07-10
73722 HCPCS MRI Scan Of Leg Joint With Contrast 18 18 $2,672.00 $2,672.00 $1,091.76 $2,672.00 $1,272.14 2026-07-10
73720 HCPCS MRI Scan Of Leg Before And After Contrast 18 18 $2,600.00 $2,600.00 $1,091.76 $2,600.00 $1,237.86 2026-07-10
Q4124 HCPCS Oasis Ultra Tri-layer Wound Matrix, Per Square Centimeter 90 18 $6,475.00 $6,475.00 $1,085.54 $26,320.00 $3,681.30 2026-07-10
73719 HCPCS MRI Scan Of Leg With Contrast 18 18 $2,361.00 $2,361.00 $1,083.70 $2,361.00 $1,171.07 2026-07-10
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 34 18 $2,345.00 $2,345.00 $1,076.36 $3,242.06 $1,407.00 2026-07-10
28010 HCPCS Repair Of Toe Tendon 18 18 $2,343.44 $2,343.44 $1,075.64 $5,806.26 $1,406.06 2026-07-10
24075 HCPCS Removal Of Growth Under Skin Of Upper Arm Or Elbow, Less Than 3.0 Cm 18 18 $2,340.00 $2,340.00 $1,074.06 $4,338.72 $1,404.00 2026-07-10
Q4103 HCPCS Oasis Burn Matrix, Per Square Centimeter 90 18 $4,585.00 $4,585.00 $1,060.29 $24,500.00 $2,910.60 2026-07-10
11770 HCPCS Simple Removal Of Cyst Of Tailbone 18 18 $2,277.08 $2,277.08 $1,045.18 $3,204.21 $1,366.25 2026-07-10
5014926 CDM Hernia Patch 8.0 16 16 $2,276.00 $2,276.00 $1,044.68 $2,276.00 $1,232.45 2026-07-10
44140 HCPCS Partial Removal Of Large Bowel With Connection 15 15 $3,253.00 $3,253.00 $1,044.30 $4,166.23 $1,892.17 2026-07-10
5014901 CDM Ligasure Atlas 16 16 $2,236.00 $2,236.00 $1,026.32 $2,236.00 $1,210.80 2026-07-10
4898835 CDM Ligasure Impact 16 16 $2,205.00 $2,205.00 $1,012.10 $2,205.00 $1,194.01 2026-07-10
36571 HCPCS Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older) 18 18 $2,179.00 $2,179.00 $1,000.16 $3,242.06 $1,307.40 2026-07-10
8968843 CDM Ortholoc 3di Crosscheck Lag Plate Screw 16 16 $2,151.00 $2,151.00 $987.31 $2,151.00 $1,164.76 2026-07-10
8834013 CDM Operating Room Services - Minor Surgery 16 16 $2,144.46 $2,144.46 $984.31 $2,144.46 $1,161.22 2026-07-10
8789618 CDM Operating Room Services - Minor Surgery 16 16 $2,144.46 $2,144.46 $984.31 $2,144.46 $1,161.22 2026-07-10
7928787 CDM Ventrio Hernia Patch 3.1 X 4.7 16 16 $2,130.00 $2,130.00 $977.67 $2,130.00 $1,153.39 2026-07-10
78708 HCPCS Nuclear Medicine Study Of Kidney, Blood, Flow, And Function With Drug Administra… 18 18 $2,791.00 $2,791.00 $973.34 $2,791.00 $1,328.80 2026-07-10
78709 HCPCS Nuclear Medicine Studies Of Kidney, Blood Flow, And Function 18 18 $2,791.00 $2,791.00 $973.34 $2,791.00 $1,328.80 2026-07-10
78264 HCPCS Nuclear Medicine Study Of Stomach To Assess Emptying 18 18 $2,340.00 $2,340.00 $973.34 $2,340.00 $1,114.08 2026-07-10
78494 HCPCS Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit… 18 18 $2,292.00 $2,292.00 $973.34 $2,292.00 $1,091.22 2026-07-10
78262 HCPCS Nuclear Medicine Study Of Stomach And Esophagus To Assess Reflux 18 18 $2,217.00 $2,217.00 $973.34 $2,217.00 $1,071.12 2026-07-10
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 18 18 $2,300.00 $2,300.00 $971.81 $2,300.00 $1,095.03 2026-07-10
78472 HCPCS Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit… 18 18 $2,117.00 $2,117.00 $971.70 $2,117.00 $1,046.97 2026-07-10
1378486 CDM Operating Room Services - General Classification 16 16 $2,060.00 $2,060.00 $945.54 $2,060.00 $1,115.49 2026-07-10
8789621 CDM Operating Room Services - Minor Surgery 16 16 $2,046.61 $2,046.61 $939.39 $2,046.61 $1,108.24 2026-07-10
5014923 CDM Hernia Patch 6.4cm 16 16 $2,045.00 $2,045.00 $938.66 $2,045.00 $1,107.37 2026-07-10
J1451 HCPCS Injection, Fomepizole, 15 Mg 16 16 $2,035.01 $2,035.01 $934.07 $2,035.01 $1,101.96 2026-07-10
Q4187 HCPCS Epicord, Per Square Centimeter 72 18 $3,180.00 $3,180.00 $922.59 $9,360.00 $1,757.25 2026-07-10
5014882 CDM Tissue Patch 10x15cm 16 16 $2,005.00 $2,005.00 $920.30 $2,005.00 $1,085.71 2026-07-10
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 18 18 $1,996.87 $1,996.87 $916.56 $5,934.94 $1,198.12 2026-07-10
23071 HCPCS Removal Of Growth Under Skin Of Shoulder Area, 3.0 Cm Or More 18 18 $1,957.50 $1,957.50 $898.49 $4,338.72 $1,174.50 2026-07-10
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 18 18 $2,640.00 $2,640.00 $896.94 $2,640.00 $1,256.90 2026-07-10
72132 HCPCS CT Scan Of Lower Spine With Contrast 18 18 $2,567.00 $2,567.00 $896.94 $2,567.00 $1,222.15 2026-07-10
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 18 18 $2,508.00 $2,508.00 $896.94 $2,508.00 $1,194.05 2026-07-10
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 18 18 $2,376.00 $2,376.00 $896.94 $2,376.00 $1,131.21 2026-07-10
72126 HCPCS CT Scan Of Upper Spine With Contrast 18 18 $2,294.00 $2,294.00 $896.94 $2,294.00 $1,092.17 2026-07-10
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 18 18 $2,289.00 $2,289.00 $896.94 $2,289.00 $1,089.80 2026-07-10
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 18 18 $2,262.00 $2,262.00 $896.94 $2,262.00 $1,076.94 2026-07-10
71270 HCPCS CT Scan Of Chest Before And After Contrast 18 18 $2,239.00 $2,239.00 $896.94 $2,239.00 $1,065.99 2026-07-10
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 18 18 $2,211.00 $2,211.00 $896.94 $2,211.00 $1,052.66 2026-07-10
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 18 18 $2,171.00 $2,171.00 $896.94 $2,171.00 $1,033.61 2026-07-10
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 18 18 $2,066.00 $2,066.00 $896.94 $2,066.00 $992.61 2026-07-10
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 18 18 $2,059.00 $2,059.00 $896.94 $2,059.00 $990.91 2026-07-10
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 18 18 $2,025.00 $2,025.00 $896.94 $2,025.00 $982.71 2026-07-10
72193 HCPCS CT Scan Of Pelvis With Contrast 18 18 $1,976.00 $1,976.00 $896.94 $1,976.00 $970.87 2026-07-10
78195 HCPCS Nuclear Medicine Study Of Lymphatic System 34 18 $1,952.00 $1,952.00 $895.97 $2,333.78 $1,171.20 2026-07-10
J9202 HCPCS Goserelin Acetate Implant, Per 3.6 Mg 18 18 $1,929.95 $1,929.95 $885.85 $1,929.95 $945.68 2026-07-10
J0248 HCPCS Injection, Remdesivir, 1 Mg 32 16 $2,134.32 $2,134.32 $883.71 $2,343.35 $1,143.51 2026-07-10
73222 HCPCS MRI Scan Of Arm Joint With Contrast 34 18 $1,923.00 $1,923.00 $882.66 $2,672.00 $1,235.26 2026-07-10
74160 HCPCS CT Scan Of Abdomen With Contrast 18 18 $1,923.00 $1,923.00 $882.66 $1,923.00 $958.07 2026-07-10
8679796 CDM Operating Room Services - Minor Surgery 16 16 $1,912.92 $1,912.92 $878.03 $1,912.92 $1,035.85 2026-07-10
71260 HCPCS CT Scan Of Chest With Contrast 18 18 $1,906.00 $1,906.00 $874.85 $1,906.00 $953.97 2026-07-10
8051521 CDM Het Bipolar Forcep 16 16 $1,893.00 $1,893.00 $868.89 $1,893.00 $1,025.06 2026-07-10
J1670 HCPCS Injection, Tetanus Immune Globulin, Human, Up To 250 Units 16 16 $1,885.81 $1,885.81 $865.59 $1,885.81 $1,021.17 2026-07-10
8836007 CDM Snap Off Screw 2.0mm X 14mm 16 16 $1,884.00 $1,884.00 $864.76 $1,884.00 $1,020.19 2026-07-10
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 18 18 $1,869.75 $1,869.75 $858.22 $3,754.22 $1,121.85 2026-07-10
5014909 CDM Power Port 8fr 16 16 $1,868.00 $1,868.00 $857.41 $1,868.00 $1,011.52 2026-07-10
73702 HCPCS CT Scan Of Leg Before And After Contrast 18 18 $1,838.00 $1,838.00 $843.64 $1,838.00 $942.13 2026-07-10
73202 HCPCS CT Scan Of Arm Before And After Contrast 18 18 $1,838.00 $1,838.00 $843.64 $1,838.00 $942.13 2026-07-10
64415 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Arm Nerve Bundle (brachial Ple… 18 18 $1,834.00 $1,834.00 $841.81 $2,756.80 $1,100.40 2026-07-10
Q4186 HCPCS Epifix, Per Square Centimeter 216 18 $3,872.00 $3,872.00 $826.20 $27,097.00 $2,452.99 2026-07-10
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 18 18 $1,774.00 $1,774.00 $814.27 $1,774.00 $942.13 2026-07-10
70488 HCPCS CT Scan Of Face Before And After Contrast 18 18 $1,774.00 $1,774.00 $814.27 $1,774.00 $942.13 2026-07-10
70460 HCPCS CT Scan Head Or Brain With Contrast 18 18 $1,759.00 $1,759.00 $807.38 $1,759.00 $942.13 2026-07-10
78707 HCPCS Nuclear Medicine Study Of Kidney, Blood Flow, And Function 18 18 $1,754.00 $1,754.00 $805.09 $1,754.00 $1,012.87 2026-07-10
4869701 CDM Comprehensive Cbde L 16 16 $1,754.00 $1,754.00 $805.09 $1,754.00 $949.79 2026-07-10
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 34 18 $3,064.00 $3,064.00 $794.07 $3,064.00 $1,409.44 2026-07-10
8904365 CDM Morphix Xt Suture Anchor 16 16 $1,725.00 $1,725.00 $791.78 $1,725.00 $934.09 2026-07-10
2120839 CDM Room & Board - Private (one Bed) - General Classification 9 9 $1,272.00 $1,272.00 $788.64 $1,710.20 $1,017.60 2026-07-10
7876763 CDM Room & Board - Private (one Bed) - General Classification 9 9 $1,272.00 $1,272.00 $788.64 $1,710.20 $1,017.60 2026-07-10
5014924 CDM Hernia Patch 4.3 16 16 $1,710.00 $1,710.00 $784.89 $1,710.00 $925.96 2026-07-10
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 18 18 $1,703.00 $1,703.00 $781.68 $2,333.78 $1,021.80 2026-07-10
70487 HCPCS CT Scan Of Face With Contrast 18 18 $1,703.00 $1,703.00 $781.68 $1,703.00 $942.13 2026-07-10
74181 HCPCS MRI Scan Of Abdomen Without Contrast 18 18 $3,394.00 $3,394.00 $780.81 $3,394.00 $1,615.88 2026-07-10
70551 HCPCS MRI Scan Of Brain Without Contrast 18 18 $2,967.00 $2,967.00 $780.81 $2,967.00 $1,412.59 2026-07-10
72195 HCPCS MRI Scan Of Pelvis Without Contrast 18 18 $2,913.00 $2,913.00 $780.81 $2,913.00 $1,386.88 2026-07-10
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 18 18 $2,913.00 $2,913.00 $780.81 $2,913.00 $1,386.88 2026-07-10
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 18 18 $2,913.00 $2,913.00 $780.81 $2,913.00 $1,386.88 2026-07-10
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 18 18 $2,913.00 $2,913.00 $780.81 $2,913.00 $1,386.88 2026-07-10
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 18 18 $2,800.00 $2,800.00 $780.81 $2,800.00 $1,333.08 2026-07-10
71550 HCPCS MRI Scan Of Chest Without Contrast 18 18 $2,585.00 $2,585.00 $780.81 $2,585.00 $1,230.72 2026-07-10
77084 HCPCS MRI Scan Of Bone Marrow 18 18 $2,530.00 $2,530.00 $780.81 $2,530.00 $1,204.53 2026-07-10
70336 HCPCS MRI Scan Of Jaw Joint 18 18 $2,529.00 $2,529.00 $780.81 $2,529.00 $1,204.06 2026-07-10
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 18 18 $2,302.00 $2,302.00 $780.81 $2,302.00 $1,095.98 2026-07-10
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 18 18 $2,302.00 $2,302.00 $780.81 $2,302.00 $1,095.98 2026-07-10
93350 HCPCS Ultrasound Of Heart During Rest, Exercise And/or Drug-induced Stress With Report 18 18 $1,698.00 $1,698.00 $779.38 $1,698.00 $995.30 2026-07-10
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 18 18 $1,654.00 $1,654.00 $759.19 $1,654.00 $982.87 2026-07-10
15277 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Face, Scalp, Eyelids, Mout… 34 18 $4,374.41 $4,374.41 $750.27 $4,374.41 $2,010.04 2026-07-10
21012 HCPCS Removal Of Growth Under Skin Of Face Or Scalp, 2.0 Cm Or More 18 18 $1,622.25 $1,622.25 $744.61 $4,338.72 $973.35 2026-07-10
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 32 16 $2,877.31 $2,877.31 $744.52 $4,132.56 $1,759.45 2026-07-10
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 18 18 $4,499.00 $4,499.00 $737.26 $4,499.00 $2,141.97 2026-07-10
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 18 18 $2,294.00 $2,294.00 $737.26 $2,294.00 $1,092.17 2026-07-10
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 18 18 $2,172.00 $2,172.00 $737.26 $2,172.00 $1,034.09 2026-07-10
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 18 18 $1,976.00 $1,976.00 $737.26 $1,976.00 $940.77 2026-07-10
73701 HCPCS CT Scan Of Leg With Contrast Material 34 18 $1,694.00 $1,694.00 $734.40 $1,694.00 $928.47 2026-07-10
73201 HCPCS CT Scan Of Arm With Contrast 34 18 $1,653.00 $1,653.00 $734.40 $1,653.00 $928.47 2026-07-10
15278 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Face, Scalp, Eyelids, Mout… 34 18 $1,782.47 $1,782.47 $709.16 $3,697.88 $927.00 2026-07-10
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 18 18 $4,182.00 $4,182.00 $703.64 $4,182.00 $1,991.05 2026-07-10
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 18 18 $3,944.00 $3,944.00 $703.64 $3,944.00 $1,877.74 2026-07-10
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 18 18 $3,616.00 $3,616.00 $703.64 $3,616.00 $1,721.58 2026-07-10
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 18 18 $3,607.00 $3,607.00 $703.64 $3,607.00 $1,717.29 2026-07-10
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 18 18 $3,511.00 $3,511.00 $703.64 $3,511.00 $1,671.59 2026-07-10
C8902 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom… 18 18 $2,529.00 $2,529.00 $703.64 $2,529.00 $1,204.06 2026-07-10
C8901 HCPCS Magnetic Resonance Angiography Without Contrast, Abdomen 18 18 $2,529.00 $2,529.00 $703.64 $2,529.00 $1,204.06 2026-07-10
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 18 18 $2,348.00 $2,348.00 $703.64 $2,348.00 $1,117.88 2026-07-10
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 18 18 $1,961.00 $1,961.00 $703.64 $1,961.00 $933.63 2026-07-10
Q5119 HCPCS Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 36 18 $4,329.00 $4,329.00 $700.53 $7,131.80 $2,399.85 2026-07-10
J3262 HCPCS Injection, Tocilizumab, 1 Mg 50 18 $4,124.15 $4,124.15 $662.77 $9,361.09 $2,474.49 2026-07-10
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 34 18 $2,417.00 $2,417.00 $656.83 $2,417.00 $1,111.82 2026-07-10
J0881 HCPCS Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use) 64 16 $3,341.16 $3,341.16 $632.66 $5,344.82 $1,858.32 2026-07-10
59426 HCPCS Predelivery Care, 7 Or More Visits 15 15 $1,854.67 $1,854.67 $627.05 $2,235.01 $1,171.60 2026-07-10
Q4159 HCPCS Affinity, Per Square Centimeter 54 18 $10,353.00 $10,353.00 $619.65 $11,592.00 $5,072.97 2026-07-10
Q4196 HCPCS Puraply Am, Per Square Centimeter 126 18 $3,960.00 $3,960.00 $619.65 $15,390.00 $2,177.18 2026-07-10
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 15 15 $2,219.00 $2,219.00 $607.09 $2,285.57 $1,399.70 2026-07-10
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 34 18 $7,538.69 $7,538.69 $605.53 $7,538.69 $3,464.03 2026-07-10
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 34 18 $1,931.25 $1,931.25 $569.18 $2,085.75 $993.02 2026-07-10
47562 HCPCS Removal Of Gallbladder Using An Endoscope 15 15 $2,076.00 $2,076.00 $561.02 $2,138.28 $1,287.40 2026-07-10
Q4160 HCPCS Nushield, Per Square Centimeter 126 18 $3,968.00 $3,968.00 $544.37 $6,660.00 $1,917.51 2026-07-10
44970 HCPCS Removal Of Appendix Using An Endoscope 15 15 $1,304.00 $1,304.00 $514.00 $1,878.78 $1,173.80 2026-07-10
14040 HCPCS Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 15 15 $1,664.00 $1,664.00 $504.99 $1,786.68 $1,120.50 2026-07-10
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 15 15 $1,180.00 $1,180.00 $451.41 $1,632.78 $1,022.90 2026-07-10
46260 HCPCS Removal Of Multiple Hemorrhoid Groups 15 15 $1,155.00 $1,155.00 $434.31 $1,526.65 $942.10 2026-07-10
C1776 HCPCS Joint Device (implantable) 384 16 $3,228.75 $3,228.75 $401.63 $11,400.00 $1,901.03 2026-07-10
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 50 18 $15,648.76 $15,648.76 $313.46 $31,036.95 $9,389.26 2026-07-10
J9395 HCPCS Injection, Fulvestrant, 25 Mg 32 16 $3,632.85 $3,632.85 $292.03 $6,629.48 $1,839.58 2026-07-10
Q4133 HCPCS Grafix Prime, Grafixpl Prime, Stravix And Stravixpl, Per Square Centimeter 126 18 $2,838.00 $2,838.00 $274.48 $6,950.00 $1,480.32 2026-07-10
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 66 18 $2,769.04 $2,769.04 $57.28 $5,448.08 $1,273.76 2026-07-10
J0897 HCPCS Injection, Denosumab, 1 Mg 48 16 $6,619.48 $6,619.48 $15.15 $9,575.82 $3,584.45 2026-07-10
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