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

KEARNY COUNTY HOSPITAL

Lakin, KS · CCN 171313 · Rates published

2,739 distinct procedures filed
125 distinct payers
78,756 rate rows
2026-01-01 last MRF observed
Data quality

78,144 of 78,756 rate rows are consumer-grade (99.2%)

612 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
template filing: same amount across many unrelated codes — excluded 255
placeholder amount (≤ $0.02) — excluded from medians 164
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 142
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 36
per-diem day rate — not a per-procedure price 15
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/ECZN-1713298384823/machine-readable/476014070_kearney-county-hospital_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/kearney-county-ne
Discovered viaDiscovered by HANK
Last fetch success · 2026-09-25
Content fingerprint 6ed173823f811f77… · 18,964,782 bytes · first seen 2026-09-25

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
CP17513234919998402
CDM 		Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 8 $18,276.00 $71,642.00 $36,552.00 nat. median
$36,552
1.0× median
92658148
CDM 		Ocrelizumab 300 Mg/10 Ml Sol [Kchs] 13 $21,302.00 $83,502.00 $32,538.00 nat. median
$32,538
1.0× median
92447398
CDM 		Teprotumumab Trbw 500 Mg Pow [Kchs] 13 $18,389.00 $72,085.00 $28,089.00 nat. median
$28,089
1.0× median
784
MS_DRG 		Cesarean Section w/Sterilizati 1 $25,803.69 $25,803.69 $25,803.69 nat. median
$7,818
outlier · 3.3×
785
MS_DRG 		Cesarean Section w/Sterilizati 1 $25,738.12 $25,738.12 $25,738.12 nat. median
$6,801
outlier · 3.8×
787
MS_DRG 		Cesarean Section Without Steriliza 1 $24,403.49 $24,403.49 $24,403.49 nat. median
$8,114
outlier · 3.0×
U0360
HCPCS 		U0360 1 $23,366.84 $23,366.84 $23,366.84 —
798
MS_DRG 		Vaginal Delivery With Steriliz 2 $20,655.05 $25,195.14 $22,925.10 nat. median
$6,777
outlier · 3.4×
788
MS_DRG 		Cesarean Section Without Steriliza 1 $21,558.72 $21,558.72 $21,558.72 nat. median
$6,949
outlier · 3.1×
189
MS_DRG 		Pulmonary Edema & Respiratory 1 $20,040.82 $20,040.82 $20,040.82 nat. median
$9,470
outlier · 2.1×
291
MS_DRG 		Heart Failure & Shock W/mcc 1 $18,299.66 $18,299.66 $18,299.66 nat. median
$9,572
1.9× median
768
MS_DRG 		Vaginal Delivery With O.r. Pro 1 $14,807.99 $14,807.99 $14,807.99 nat. median
$7,573
2.0× median
87164118
CDM 		Alteplase 100 Mg IV Inj [Kchs] 13 $9,515.00 $37,297.00 $14,533.50 nat. median
$14,534
1.0× median
58600
CPT 		Division Of Fallopian Tube 1 $12,010.00 $12,010.00 $12,010.00 nat. median
$3,339
outlier · 3.6×
0360
RC 		12 $3,462.00 $16,842.00 $11,991.00 nat. median
$1,707
outlier · 7.0×
637
MS_DRG 		Diabetes W/mcc 1 $11,932.92 $11,932.92 $11,932.92 nat. median
$10,515
1.1× median
87182854
CDM 		Immune Globulin (Privigen) 10% IV Sol 400 Ml [Kchs] 13 $7,611.00 $29,833.00 $11,625.00 nat. median
$11,625
1.0× median
J0129
HCPCS 		Abatacept Injection 2 $11,562.00 $11,562.00 $11,562.00 nat. median
$122
outlier · 94.7×
806
MS_DRG 		Vaginal Delivery Without Steri 1 $10,624.80 $10,624.80 $10,624.80 nat. median
$5,473
1.9× median
87195590
CDM 		Pegfilgrastim 6 Mg/0.6 Ml Subq Inj [Kchs] 13 $6,942.00 $27,211.00 $10,603.00 nat. median
$10,603
1.0× median
106994729
CDM 		Pegfilgrastim 6 Mg/0.6 Ml Onpro Kit [Kchs] 13 $6,942.00 $27,211.00 $10,603.00 nat. median
$10,603
1.0× median
87206122
CDM 		Vedolizumab 300 Mg Pow [Kchs] 13 $6,500.00 $25,480.00 $9,929.00 nat. median
$9,929
1.0× median
872
MS_DRG 		Septicemia Or Severe Sepsis With 1 $9,582.76 $9,582.76 $9,582.76 nat. median
$7,744
1.2× median
102102918
CDM 		Certolizumab 400 Mg/2 Ml Kit [Kchs] 13 $6,187.00 $24,251.00 $9,449.50 nat. median
$9,450
1.0× median
103227063
CDM 		Benralizumab 30 Mg/ml Sol [Kchs] 13 $6,141.00 $24,073.00 $9,380.50 nat. median
$9,380
1.0× median
87203470
CDM 		Tenecteplase 50 Mg IV Inj [Kchs] 13 $6,106.00 $23,934.00 $9,326.00 nat. median
$9,326
1.0× median
J3101
HCPCS 		Tenecteplase Injection 5 $6,152.10 $15,380.25 $9,228.15 nat. median
$498
outlier · 18.5×
29826
CPT 		Shaving Of Shoulder Bone Using Endoscope 13 $1,446.00 $50,082.00 $9,222.00 nat. median
$3,950
outlier · 2.3×
807
MS_DRG 		Vaginal Delivery Without Steri 2 $8,266.21 $9,893.72 $9,079.97 nat. median
$4,880
1.9× median
31237
CPT 		Nsl/sins Ndsc Surg Bx Polypc 3 $773.00 $8,980.00 $8,980.00 nat. median
$2,037
outlier · 4.4×
88561577
CDM 		Immune Globulin (Gammagard)10% 30 Gm [Kchs] 13 $5,503.00 $21,570.00 $8,405.00 nat. median
$8,405
1.0× median
J1459
HCPCS 		Inj Ivig Privigen 500 Mg 3 $3,463.38 $11,082.50 $8,311.88 nat. median
$968
outlier · 8.6×
683
MS_DRG 		Renal Failure W/cc 1 $7,862.70 $7,862.70 $7,862.70 nat. median
$6,692
1.2× median
69631
CPT 		Repair Eardrum Structures 2 $7,631.50 $7,631.50 $7,631.50 nat. median
$5,933
1.3× median
113090330
CDM 		Pegfilgrastim Cbqv 6 Mg/0.6 Ml [Kchs] 13 $4,519.00 $17,714.00 $6,902.50 nat. median
$6,902
1.0× median
87195736
CDM 		Pembrolizumab 25 Mg/ml [Kchs] 13 $4,510.00 $17,679.00 $6,889.00 nat. median
$6,889
1.0× median
30435
CPT 		Revision Of Nose 1 $1,625.00 $12,010.00 $6,817.50 nat. median
$6,144
1.1× median
116445294
CDM 		Luspatercept Aamt 25 Mg Pow [Kchs] 13 $4,365.00 $17,111.00 $6,668.00 nat. median
$6,668
1.0× median
292
MS_DRG 		Heart Failure & Shock W/cc 1 $6,660.35 $6,660.35 $6,660.35 nat. median
$6,415
1.0× median
793
MS_DRG 		Full Term Neonate w/Major Prob 1 $6,456.12 $6,456.12 $6,456.12 nat. median
$15,882
outlier · 0.4×
47562
CPT 		Removal Of Gallbladder Using An Endoscope 13 $1,212.00 $31,644.00 $6,412.00 nat. median
$6,043
1.1× median
0490
RC 		1 $6,345.64 $6,345.64 $6,345.64 nat. median
$3,022
outlier · 2.1×
97207143
CDM 		Bezlotoxumab 1000 Mg/40 Ml Sol [Kchs] 13 $4,114.00 $16,127.00 $6,284.50 nat. median
$6,284
1.0× median
153
MS_DRG 		Otitis Media & Uri Without Mcc 1 $6,268.95 $6,268.95 $6,268.95 nat. median
$5,379
1.2× median
31267
CPT 		Endoscopy Maxillary Sinus 6 $1,758.00 $12,010.00 $6,126.50 nat. median
$6,599
0.9× median
31536
CPT 		Laryngoscopy W/bx & Op Scope 1 $6,060.00 $6,060.00 $6,060.00 nat. median
$3,810
1.6× median
58660
CPT 		Laparoscopy Lysis 1 $5,950.00 $5,950.00 $5,950.00 nat. median
$6,064
1.0× median
92080854
CDM 		Rituximab-pvvr 500 Mg/50 Ml Vial [Kchs] 13 $3,881.00 $15,212.00 $5,927.50 nat. median
$5,928
1.0× median
790
MS_DRG 		Extreme Immaturity Or Respirat 1 $5,856.16 $5,856.16 $5,856.16 nat. median
$40,584
outlier · 0.1×
90589718
CDM 		Immune Globulin (Privigen) 10% IV Sol 200 Ml [Kchs] 13 $3,811.00 $14,937.00 $5,820.50 nat. median
$5,820
1.0× median

Other procedures at this hospital

Browse this hospital's 2,739 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
             
CP17513234919998402 CDM Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 9 8 $36,552.00 $29,242.00 $18,276.00 $71,642.00 $36,552.00 2025-08-01
92658148 CDM Ocrelizumab 300 Mg/10 Ml Sol [Kchs] 24 13 $42,603.00 $34,082.00 20% off $21,302.00 $83,502.00 $32,538.00 2025-08-01
92447398 CDM Teprotumumab Trbw 500 Mg Pow [Kchs] 24 13 $36,778.00 $29,422.00 20% off $18,389.00 $72,085.00 $28,089.00 2025-08-01
784 MS_DRG Cesarean Section w/Sterilizati 1 1 $25,803.69 — $25,803.69 $25,803.69 $25,803.69 2026-01-01
785 MS_DRG Cesarean Section w/Sterilizati 1 1 $30,374.65 — $25,738.12 $25,738.12 $25,738.12 2026-01-01
787 MS_DRG Cesarean Section Without Steriliza 1 1 $24,403.49 — $24,403.49 $24,403.49 $24,403.49 2026-01-01
U0360 HCPCS U0360 1 1 $23,366.84 — $23,366.84 $23,366.84 $23,366.84 2026-01-01
798 MS_DRG Vaginal Delivery With Steriliz 2 2 $26,125.50 — $20,655.05 $25,195.14 $22,925.10 2026-01-01
788 MS_DRG Cesarean Section Without Steriliza 1 1 $25,497.04 — $21,558.72 $21,558.72 $21,558.72 2026-01-01
189 MS_DRG Pulmonary Edema & Respiratory 1 1 $20,040.82 — $20,040.82 $20,040.82 $20,040.82 2026-01-01
291 MS_DRG Heart Failure & Shock W/mcc 1 1 $18,299.66 — $18,299.66 $18,299.66 $18,299.66 2026-01-01
768 MS_DRG Vaginal Delivery With O.r. Pro 1 1 $21,580.34 — $14,807.99 $14,807.99 $14,807.99 2026-01-01
87164118 CDM Alteplase 100 Mg IV Inj [Kchs] 24 13 $19,029.00 $15,223.00 20% off $9,515.00 $37,297.00 $14,533.50 2025-08-01
58600 CPT Division Of Fallopian Tube 1 1 $12,010.00 — $12,010.00 $12,010.00 $12,010.00 2026-01-01
0360 RC — 12 12 $11,991.00 — $3,462.00 $16,842.00 $11,991.00 2026-01-01
637 MS_DRG Diabetes W/mcc 1 1 $11,932.92 — $11,932.92 $11,932.92 $11,932.92 2026-01-01
87182854 CDM Immune Globulin (Privigen) 10% IV Sol 400 Ml [Kchs] 24 13 $15,221.00 $12,177.00 $7,611.00 $29,833.00 $11,625.00 2025-08-01
J0129 HCPCS Abatacept Injection 3 2 $11,562.00 — $11,562.00 $11,562.00 $11,562.00 2026-01-01
806 MS_DRG Vaginal Delivery Without Steri 1 1 $11,533.26 — $10,624.80 $10,624.80 $10,624.80 2026-01-01
106994729 CDM Pegfilgrastim 6 Mg/0.6 Ml Onpro Kit [Kchs] 24 13 $13,883.00 $11,106.00 20% off $6,942.00 $27,211.00 $10,603.00 2025-08-01
87195590 CDM Pegfilgrastim 6 Mg/0.6 Ml Subq Inj [Kchs] 24 13 $13,883.00 $11,106.00 20% off $6,942.00 $27,211.00 $10,603.00 2025-08-01
87206122 CDM Vedolizumab 300 Mg Pow [Kchs] 24 13 $13,000.00 $10,400.00 20% off $6,500.00 $25,480.00 $9,929.00 2025-08-01
872 MS_DRG Septicemia Or Severe Sepsis With 1 1 $9,582.76 — $9,582.76 $9,582.76 $9,582.76 2026-01-01
102102918 CDM Certolizumab 400 Mg/2 Ml Kit [Kchs] 24 13 $12,373.00 $9,898.00 20% off $6,187.00 $24,251.00 $9,449.50 2025-08-01
103227063 CDM Benralizumab 30 Mg/ml Sol [Kchs] 24 13 $12,282.00 $9,826.00 $6,141.00 $24,073.00 $9,380.50 2025-08-01
87203470 CDM Tenecteplase 50 Mg IV Inj [Kchs] 24 13 $12,211.00 $9,769.00 $6,106.00 $23,934.00 $9,326.00 2025-08-01
J3101 HCPCS Tenecteplase Injection 13 5 $9,228.15 — $6,152.10 $15,380.25 $9,228.15 2026-01-01
29826 CPT Shaving Of Shoulder Bone Using Endoscope 48 13 $14,222.00 $11,378.00 $1,446.00 $50,082.00 $9,222.00 2025-08-01
807 MS_DRG Vaginal Delivery Without Steri 2 2 $10,611.83 — $8,266.21 $9,893.72 $9,079.97 2026-01-01
31237 CPT Nsl/sins Ndsc Surg Bx Polypc 3 3 $8,980.00 — $773.00 $8,980.00 $8,980.00 2026-01-01
88561577 CDM Immune Globulin (Gammagard)10% 30 Gm [Kchs] 24 13 $11,005.00 $8,804.00 20% off $5,503.00 $21,570.00 $8,405.00 2025-08-01
J1459 HCPCS Inj Ivig Privigen 500 Mg 6 3 $8,311.88 — $3,463.38 $11,082.50 $8,311.88 2026-01-01
683 MS_DRG Renal Failure W/cc 1 1 $7,862.70 — $7,862.70 $7,862.70 $7,862.70 2026-01-01
69631 CPT Repair Eardrum Structures 2 2 $12,010.00 — $7,631.50 $7,631.50 $7,631.50 2026-01-01
113090330 CDM Pegfilgrastim Cbqv 6 Mg/0.6 Ml [Kchs] 24 13 $9,038.00 $7,230.00 20% off $4,519.00 $17,714.00 $6,902.50 2025-08-01
87195736 CDM Pembrolizumab 25 Mg/ml [Kchs] 24 13 $9,020.00 $7,216.00 20% off $4,510.00 $17,679.00 $6,889.00 2025-08-01
30435 CPT Revision Of Nose 2 1 $6,817.50 — $1,625.00 $12,010.00 $6,817.50 2026-01-01
116445294 CDM Luspatercept Aamt 25 Mg Pow [Kchs] 24 13 $8,730.00 $6,984.00 20% off $4,365.00 $17,111.00 $6,668.00 2025-08-01
292 MS_DRG Heart Failure & Shock W/cc 1 1 $6,660.35 — $6,660.35 $6,660.35 $6,660.35 2026-01-01
793 MS_DRG Full Term Neonate w/Major Prob 1 1 $6,976.12 — $6,456.12 $6,456.12 $6,456.12 2026-01-01
47562 CPT Removal Of Gallbladder Using An Endoscope 48 13 $9,284.50 $7,427.50 20% off $1,212.00 $31,644.00 $6,412.00 2025-08-01
0490 RC — 1 1 $6,345.64 — $6,345.64 $6,345.64 $6,345.64 2026-01-01
97207143 CDM Bezlotoxumab 1000 Mg/40 Ml Sol [Kchs] 24 13 $8,228.00 $6,582.00 20% off $4,114.00 $16,127.00 $6,284.50 2025-08-01
153 MS_DRG Otitis Media & Uri Without Mcc 1 1 $6,268.95 — $6,268.95 $6,268.95 $6,268.95 2026-01-01
31267 CPT Endoscopy Maxillary Sinus 15 6 $8,980.00 — $1,758.00 $12,010.00 $6,126.50 2026-01-01
31536 CPT Laryngoscopy W/bx & Op Scope 1 1 $6,060.00 — $6,060.00 $6,060.00 $6,060.00 2026-01-01
58660 CPT Laparoscopy Lysis 1 1 $5,950.00 — $5,950.00 $5,950.00 $5,950.00 2026-01-01
92080854 CDM Rituximab-pvvr 500 Mg/50 Ml Vial [Kchs] 24 13 $7,761.00 $6,209.00 $3,881.00 $15,212.00 $5,927.50 2025-08-01
790 MS_DRG Extreme Immaturity Or Respirat 1 1 $5,856.16 — $5,856.16 $5,856.16 $5,856.16 2026-01-01
90589718 CDM Immune Globulin (Privigen) 10% IV Sol 200 Ml [Kchs] 24 13 $7,621.00 $6,097.00 $3,811.00 $14,937.00 $5,820.50 2025-08-01
29881 CPT Removal Of One Knee Cartilage Using An Endoscope 48 13 $7,434.00 $5,947.00 20% off $1,373.00 $23,761.00 $5,721.00 2025-08-01
C1726 HCPCS Cath, Bal Dil, Non-vascular 3 3 $5,695.90 — $5,695.90 $5,695.90 $5,695.90 2026-01-01
794 MS_DRG Neonate w/Other Significant Pr 1 1 $9,282.35 — $5,652.20 $5,652.20 $5,652.20 2026-01-01
103171186 CDM Mepolizumab 100 Mg Pow [Kchs] 24 13 $7,389.00 $5,911.00 20% off $3,695.00 $14,482.00 $5,643.50 2025-08-01
96742770 CDM Inclisiran 284 Mg/1.5 Ml Inj [Kchs] 24 13 $7,307.00 $5,846.00 $3,654.00 $14,322.00 $5,581.00 2025-08-01
88564895 CDM Rabies Immune Globulin, Human 1500 Units/5 Ml [Kchs] 24 13 $7,261.00 $5,809.00 $3,631.00 $14,232.00 $5,545.50 2025-08-01
0720 RC — 17 12 $5,422.00 — $455.00 $5,708.00 $5,422.00 2026-01-01
30520 CPT Repair Of Nasal Septum 21 13 $7,465.00 — $1,716.00 $12,010.00 $5,348.00 2026-01-01
42821 CPT Remove Tonsils And Adenoids 15 8 $5,950.00 — $958.00 $8,980.00 $4,969.00 2026-01-01
792 MS_DRG Prematurity Without Major Problems 1 1 $6,543.32 — $4,949.07 $4,949.07 $4,949.07 2026-01-01
92218892 CDM Prothrombin Complexpow [Kchs] 24 13 $6,446.00 $5,157.00 $3,223.00 $12,634.00 $4,923.50 2025-08-01
31256 CPT Exploration Maxillary Sinus 11 5 $8,980.00 — $765.00 $10,495.00 $4,872.50 2026-01-01
0240 RC — 1 1 $4,871.00 — $4,871.00 $4,871.00 $4,871.00 2026-01-01
59610 CPT Vbac Delivery 6 5 $4,744.00 — $4,744.00 $4,744.00 $4,744.00 2026-01-01
864 MS_DRG Fever And Inflammatory Conditi 1 1 $4,536.37 — $4,536.37 $4,536.37 $4,536.37 2026-01-01
58558 CPT Hysteroscopy Biopsy 11 6 $5,950.00 — $1,800.00 $7,465.00 $4,435.00 2026-01-01
S5125 HCPCS Attendant Care Service /15m 1 1 $4,641.14 — $4,362.75 $4,362.75 $4,362.75 2026-01-01
59812 CPT Treatment Of Miscarriage 2 1 $4,328.50 — $1,192.00 $7,465.00 $4,328.50 2026-01-01
776 MS_DRG Postpartum & Post Abortion Dia 1 1 $4,288.75 — $4,288.75 $4,288.75 $4,288.75 2026-01-01
87198128 CDM Romosozumab 210 Mg/2.34 Ml [Kchs] 24 13 $5,428.00 $4,342.00 20% off $2,714.00 $10,639.00 $4,146.00 2025-08-01
59510 CPT Cesarean Delivery 15 11 $4,089.00 — $2,453.40 $4,089.00 $4,089.00 2026-01-01
0410 RC — 7 4 $4,017.24 — $523.54 $4,631.47 $4,017.24 2026-01-01
J0897 HCPCS Denosumab Injection 8 6 $3,965.25 — $3,965.25 $3,965.25 $3,965.25 2026-01-01
58661 CPT Laparoscopy Remove Adnexa 14 7 $4,841.25 — $900.00 $13,525.00 $3,957.50 2026-01-01
87182781 CDM Immune Globulin (Octagam) 10% IV Sol 300 Ml [Kchs] 24 13 $5,161.00 $4,129.00 $2,581.00 $10,116.00 $3,941.50 2025-08-01
789 MS_DRG Neonates, Died Or Transferred 1 1 $3,939.01 — $3,939.01 $3,939.01 $3,939.01 2026-01-01
0120 RC — 11 7 $3,744.00 — $1,248.00 $11,232.00 $3,744.00 2026-01-01
192 MS_DRG Chronic Obstructive Pulmonary 1 1 $3,693.95 — $3,693.95 $3,693.95 $3,693.95 2026-01-01
49505 CPT Repair Of Groin Hernia Patient Age 5 Years Or Older 48 13 $5,671.00 $4,537.00 $573.00 $19,986.00 $3,671.50 2025-08-01
59820 CPT Care Of Miscarriage 2 1 $3,608.50 — $1,267.00 $5,950.00 $3,608.50 2026-01-01
795 MS_DRG Normal Newborn 2 2 $3,558.91 — $2,574.77 $4,543.06 $3,558.91 2026-01-01
59400 CPT Obstetrical Care 19 14 $3,522.00 — $3,522.00 $3,522.00 $3,522.00 2026-01-01
44388 CPT Colonoscopy Thru Stoma Spx 4 3 $3,462.00 — $822.00 $3,462.00 $3,462.00 2026-01-01
100424093 CDM Pegfilgrastim Jmdb 6 Mg/0.6 Ml [Kchs] 24 13 $4,529.00 $3,623.00 20% off $2,265.00 $8,877.00 $3,459.00 2025-08-01
36556 CPT Insert Non-tunnel Cv Cath 7 3 $3,400.00 — $457.00 $3,400.00 $3,400.00 2026-01-01
42826 CPT Removal Of Tonsils 19 9 $5,950.00 — $849.00 $8,980.00 $3,399.50 2026-01-01
7500164 CDM Implant System, Biocomposite Achilles Suture Bridge 24 13 $4,401.00 $3,521.00 $2,201.00 $8,626.00 $3,361.50 2025-08-01
95811 CPT 95811 Polysomnography W/cpap Charge 24 13 $4,376.00 $3,501.00 $2,188.00 $8,577.00 $3,342.00 2025-08-01
7500442 CDM Mild Kit 24 13 $4,286.00 $3,429.00 $2,143.00 $8,401.00 $3,273.50 2025-08-01
72158 CPT MRI Spine Lumbar With + Without Contrast 24 13 $4,281.00 $3,425.00 $2,141.00 $8,391.00 $3,269.50 2025-08-01
49320 CPT Diag Laparo Separate Proc 4 2 $3,194.65 — $439.31 $10,484.00 $3,194.65 2026-01-01
59618 CPT Attempted Vbac Delivery 2 2 $3,176.00 — $2,382.00 $3,970.00 $3,176.00 2026-01-01
74178 CPT CT Abd/pelvis With + Without 40 23 $5,633.00 $4,506.00 20% off $1,970.00 $11,041.00 $3,098.00 2026-01-01
19120 CPT Removal Of One Or More Breast Growth, Open Procedure 48 13 $4,185.50 $3,348.00 20% off $662.00 $13,814.00 $3,058.50 2025-08-01
95810 CPT Sleep Study 24 13 $3,925.00 $3,140.00 20% off $1,963.00 $7,693.00 $2,998.00 2025-08-01
87300963 CDM Denosumab 60 Mg/ml [Kchs] 24 13 $3,878.00 $3,102.00 20% off $1,939.00 $7,601.00 $2,962.00 2025-08-01
70546 CPT MRA Brain/head With + Without Contrast 24 13 $3,861.00 $3,089.00 $1,931.00 $7,568.00 $2,949.00 2025-08-01
59612 CPT Vbac Delivery Only 4 4 $2,937.00 — $2,937.00 $2,937.00 $2,937.00 2026-01-01
74185 CPT MRA Abdomen With + Without Contrast 24 13 $3,844.00 $3,075.00 20% off $1,922.00 $7,534.00 $2,936.00 2025-08-01
70543 CPT MRI Face Neck Orbit With + Without Contrast 24 13 $3,841.00 $3,073.00 $1,921.00 $7,528.00 $2,933.50 2025-08-01
87183406 CDM Immune Globulin (Privigen) 10% IV Sol 100 Ml [Kchs] 24 13 $3,820.00 $3,056.00 20% off $1,910.00 $7,487.00 $2,917.50 2025-08-01
72149 CPT MRI Spine Lumbar With Contrast 24 13 $3,705.00 $2,964.00 20% off $1,853.00 $7,262.00 $2,830.00 2025-08-01
70498 CPT CT Angio Neck 31 18 $3,261.00 $2,609.00 $1,631.00 $6,392.00 $2,825.00 2026-01-01
88563346 CDM Immune Globulin (Gammagard) 10% 10 Gm [Kchs] 24 13 $3,682.00 $2,946.00 $1,841.00 $7,217.00 $2,812.00 2025-08-01
71275 CPT CT Angio Chest 40 24 $3,490.00 $2,792.00 20% off $1,745.00 $6,840.00 $2,795.00 2026-01-01
71555 CPT MRA Chest With + Without Contrast 24 13 $3,634.00 $2,907.00 20% off $1,817.00 $7,123.00 $2,775.50 2025-08-01
72156 CPT MRI Spine Cervical With + Without Contrast 24 13 $3,492.00 $2,794.00 $1,746.00 $6,844.00 $2,667.00 2025-08-01
74182 CPT MRI Abdomen With Contrast 24 13 $3,492.00 $2,794.00 $1,746.00 $6,844.00 $2,667.00 2025-08-01
72157 CPT MRI Spine Thoracic With + Without Contrast 24 13 $3,492.00 $2,794.00 $1,746.00 $6,844.00 $2,667.00 2025-08-01
70544 CPT MRA Brain/head Without Contrast 24 13 $3,492.00 $2,794.00 $1,746.00 $6,844.00 $2,667.00 2025-08-01
87182708 CDM Immune Globulin (Octagam) 10% IV Sol 200 Ml [Kchs] 24 13 $3,447.00 $2,758.00 $1,724.00 $6,756.00 $2,633.00 2025-08-01
74174 CPT CT Angio Abdomen And Pelvis 27 16 $4,018.00 $3,214.00 20% off $2,009.00 $7,875.00 $2,625.00 2026-01-01
74175 CPT CT Angio Abdomen 28 16 $3,536.00 $2,829.00 $1,768.00 $6,931.00 $2,625.00 2026-01-01
70496 CPT CT Angio Brain/head 34 18 $3,278.00 $2,622.00 20% off $1,639.00 $6,425.00 $2,625.00 2026-01-01
99499 CPT Unlisted E&m Service 1 1 $2,624.75 — $2,624.75 $2,624.75 $2,624.75 2026-01-01
43239 CPT Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 64 21 $2,596.00 $3,151.50 $528.00 $13,375.00 $2,596.00 2026-01-01
71552 CPT MRI Chest With + Without Contrast 24 13 $3,390.00 $2,712.00 20% off $1,695.00 $6,644.00 $2,589.50 2025-08-01
59620 CPT Attempted Vbac Delivery Only 1 1 $2,588.00 — $2,588.00 $2,588.00 $2,588.00 2026-01-01
98482607 CDM Aripiprazole 441 Mg/1.6 Ml Inj [Kchs] 24 13 $3,356.00 $2,685.00 $1,678.00 $6,578.00 $2,563.00 2025-08-01
72191 CPT CT Angio Pelvis 24 13 $3,356.00 $2,685.00 $1,678.00 $6,578.00 $2,563.00 2025-08-01
31276 CPT Nsl/sins Ndsc Frnt Tiss Rmvl 2 2 $2,536.00 — $2,536.00 $2,536.00 $2,536.00 2026-01-01
74183 CPT MRI Abdomen With + Without Contrast 27 15 $4,355.00 $3,484.00 20% off $1,740.00 $8,536.00 $2,515.00 2026-01-01
114601593 CDM Abatacept 250 Mg Vial [Kchs] 24 13 $3,290.00 $2,632.00 20% off $1,645.00 $6,448.00 $2,513.00 2025-08-01
72198 CPT MRA Pelvis With + Without Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2025-08-01
72142 CPT MRI Spine Cervical With Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2025-08-01
72147 CPT MRI Spine Thoracic With Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2025-08-01
71551 CPT MRI Chest With Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2025-08-01
70545 CPT MRA Brain/head With Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2025-08-01
78452 CPT Nm Myocardial Spect Multiple Studies 32 19 $4,461.00 $3,569.00 $2,231.00 $8,744.00 $2,502.50 2026-01-01
177 MS_DRG Respiratory Infections & Infla 1 1 $2,496.00 — $2,496.00 $2,496.00 $2,496.00 2026-01-01
0110 RC — 17 12 $2,496.00 — $1,248.00 $4,992.00 $2,496.00 2026-01-01
45380 CPT Biopsy Exam Of Large Bowel Using An Endoscope 82 25 $2,596.00 $2,540.50 $622.00 $10,010.00 $2,496.00 2026-01-01
99640265 CDM Eptinezumab-jjmr 100 Mg/ml Inj Sol [Kchs] 24 13 $3,249.00 $2,599.00 20% off $1,625.00 $6,368.00 $2,481.50 2025-08-01
87177816 CDM Ferric Carboxymaltose 50 Mg/ml [Kchs] 24 13 $3,237.00 $2,590.00 $1,619.00 $6,345.00 $2,472.00 2025-08-01
74170 CPT CT Abdomen With + Without Contrast 24 13 $3,211.00 $2,569.00 $1,606.00 $6,294.00 $2,452.00 2025-08-01
CDM CDM Implant System, Biocomposite Achilles Speedbridge W/jumpstart 24 13 $3,200.00 $2,560.00 20% off $1,600.00 $6,272.00 $2,444.00 2025-08-01
42835 CPT Removal Of Adenoids 8 3 $2,443.50 — $539.00 $4,435.00 $2,443.50 2026-01-01
74177 CPT CT Abd & Pelvis W/contrast 50 29 $2,431.00 $3,964.00 $1,500.00 $9,712.00 $2,431.00 2026-01-01
70549 CPT MRA Neck With + Without Contrast 24 13 $3,159.00 $2,527.00 20% off $1,580.00 $6,192.00 $2,412.50 2025-08-01
7500242 CDM Implant System, Speedbridge With Biocomposite Swivelock Self-punching Anchors 24 13 $3,133.00 $2,506.00 20% off $1,567.00 $6,141.00 $2,392.50 2025-08-01
Q4197 HCPCS Dressing, Puraply Am (5x5) 48 13 $3,216.50 $2,573.00 20% off $1,360.00 $7,277.00 $2,364.00 2025-08-01
70488 CPT CT Sinus With + Without Contrast 24 13 $2,607.00 $2,086.00 $1,304.00 $5,110.00 $2,362.00 2025-08-01
58562 CPT Hysteroscopy Remove Fb 2 1 $2,360.00 — $285.00 $4,435.00 $2,360.00 2026-01-01
70548 CPT MRA Neck With Contrast 24 13 $3,075.00 $2,460.00 20% off $1,538.00 $6,027.00 $2,348.50 2025-08-01
71550 CPT MRI Chest Without Contrast 24 13 $3,075.00 $2,460.00 20% off $1,538.00 $6,027.00 $2,348.50 2025-08-01
74176 CPT CT Abd & Pelvis Without Contrast 55 30 $2,300.00 $3,291.00 $1,500.00 $8,063.00 $2,300.00 2026-01-01
45385 CPT Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope 65 17 $1,214.00 $3,389.00 $607.00 $14,228.00 $2,294.00 2026-01-01
70553 CPT MRI Scan 33 20 $4,126.00 $3,301.00 $1,131.63 $8,087.00 $2,292.00 2026-01-01
31535 CPT Laryngoscopy W/biopsy 3 3 $4,328.00 — $253.95 $4,328.00 $2,290.97 2026-01-01
0170 RC — 9 8 $2,284.00 — $1,142.00 $2,284.00 $2,284.00 2026-01-01
U0170 HCPCS U0170 1 1 $2,284.00 — $2,284.00 $2,284.00 $2,284.00 2026-01-01
75635 CPT CT Angio Abdominal Aorta With Runoff 30 17 $2,239.00 $1,791.00 20% off $1,120.00 $4,388.00 $2,239.00 2026-01-01
73723 CPT MRI Knee With + Without Contrast Left 26 15 $3,865.00 $3,092.00 20% off $1,450.00 $7,575.00 $2,232.00 2026-01-01
73223 CPT MRI Elbow With + Without Contrast Left 24 13 $2,865.00 $2,292.00 20% off $1,433.00 $5,615.00 $2,188.50 2025-08-01
73722 CPT MRI Ankle With Contrast Left 24 13 $2,865.00 $2,292.00 20% off $1,433.00 $5,615.00 $2,188.50 2025-08-01
73225 CPT MRA Upper Extremity With + Without Cnt Left 24 13 $2,865.00 $2,292.00 20% off $1,433.00 $5,615.00 $2,188.50 2025-08-01
73720 CPT MRI Foot With + Without Contrast Left 24 13 $2,865.00 $2,292.00 20% off $1,433.00 $5,615.00 $2,188.50 2025-08-01
73220 CPT MRI Forearm With + Without Contrast Left 24 13 $2,865.00 $2,292.00 20% off $1,433.00 $5,615.00 $2,188.50 2025-08-01
93306 CPT US Echo 2d Complete 62 24 $2,280.00 $1,991.00 $1,140.00 $5,288.00 $2,179.00 2026-01-01
0483 RC — 1 1 $2,179.00 — $2,179.00 $2,179.00 $2,179.00 2026-01-01
72194 CPT CT Pelvis With + Without Contrast 24 13 $2,795.00 $2,236.00 20% off $1,398.00 $5,478.00 $2,134.50 2025-08-01
59410 CPT Obstetrical Care 3 2 $2,132.00 — $2,132.00 $2,132.00 $2,132.00 2026-01-01
CP17513232910521881 CDM MRI Femur With + Without Contrast Rt 24 13 $2,781.00 $2,225.00 $1,391.00 $5,451.00 $2,124.00 2025-08-01
72146 CPT MRI Spine Thoracic Without Contrast 27 16 $3,669.00 $2,935.00 20% off $1,413.00 $7,191.00 $2,119.00 2026-01-01
72141 CPT MRI Spine Cervical Without Contrast 29 17 $3,650.00 $2,920.00 20% off $1,376.00 $7,154.00 $2,108.00 2026-01-01
70551 CPT MRI Brain Without Contrast 31 20 $3,653.00 $2,922.00 20% off $1,463.00 $7,160.00 $2,069.00 2026-01-01
72127 CPT CT Spine Cervical With + Without Contrast 24 13 $2,690.00 $2,152.00 20% off $1,345.00 $5,272.00 $2,054.50 2025-08-01
72130 CPT CT Spine Thoracic With + Without Contrast 24 13 $2,690.00 $2,152.00 20% off $1,345.00 $5,272.00 $2,054.50 2025-08-01
70470 CPT CT Brain/head With + Without Contrast 24 13 $2,683.00 $2,146.00 20% off $1,342.00 $5,259.00 $2,049.00 2025-08-01
96297680 CDM Omalizumab 150 Mg/1 Ml Inj [Kchs] 24 13 $2,659.00 $2,127.00 20% off $1,330.00 $5,212.00 $2,031.00 2025-08-01
73222 CPT MRI Elbow With Contrast Left 24 13 $2,657.00 $2,126.00 $1,329.00 $5,208.00 $2,029.00 2025-08-01
73719 CPT MRI Femur With Contrast Left 24 13 $2,657.00 $2,126.00 $1,329.00 $5,208.00 $2,029.00 2025-08-01
72197 CPT MRI Pelvis With + Without Contrast 25 14 $3,492.00 $2,794.00 $1,600.00 $6,844.00 $2,017.00 2026-01-01
42830 CPT Removal Of Adenoids 16 9 $2,010.50 — $456.00 $5,950.00 $2,010.50 2026-01-01
72193 CPT CT Scan Of Pelvis With Contrast 24 13 $2,585.00 $2,068.00 20% off $1,293.00 $5,067.00 $1,974.50 2025-08-01
116990863 CDM Ferumoxytol 510 Mg/17 Ml Inj [Kchs] 24 13 $2,523.00 $2,018.00 20% off $1,262.00 $4,945.00 $1,927.00 2025-08-01
G0105 HCPCS Colorectal Scrn; Hi Risk Ind 11 6 $2,596.00 — $242.33 $3,462.00 $1,924.50 2026-01-01
G0121 HCPCS Colon Ca Scrn Not Hi Rsk Ind 12 7 $2,596.00 — $387.00 $5,194.00 $1,924.50 2026-01-01
73725 CPT MRA Lower Extremity With + Without Cnt Left 24 13 $2,516.00 $2,013.00 $1,258.00 $4,931.00 $1,921.50 2025-08-01
72148 CPT MRI Scan Of Lower Spinal Canal 41 26 $3,492.00 $2,794.00 $1,424.00 $6,844.00 $1,921.00 2026-01-01
72126 CPT CT Spine Cervical With Contrast 24 13 $2,515.00 $2,012.00 20% off $1,258.00 $4,929.00 $1,920.50 2025-08-01
72129 CPT CT Spine Thoracic With Contrast 24 13 $2,515.00 $2,012.00 20% off $1,258.00 $4,929.00 $1,920.50 2025-08-01
CP17513232910518587 CDM CT Wrist With + Without Contrast Right 24 13 $2,515.00 $2,012.00 20% off $1,258.00 $4,929.00 $1,920.50 2025-08-01
73702 CPT CT Ankle With + Without Contrast Left 24 13 $2,515.00 $2,012.00 20% off $1,258.00 $4,929.00 $1,920.50 2025-08-01
7500440 CDM Forefoot Internal Brace 24 13 $2,511.00 $2,009.00 $1,256.00 $4,922.00 $1,917.50 2025-08-01
72195 CPT MRI Pelvis Without Contrast 27 15 $3,294.00 $2,635.00 20% off $1,250.00 $6,456.00 $1,902.00 2026-01-01
78227 CPT Nm Hepatobiliary Imaging With Drug 24 13 $2,490.00 $1,992.00 20% off $1,245.00 $4,880.00 $1,902.00 2025-08-01
74181 CPT MRI Abdomen Without Contrast 25 14 $3,286.00 $2,629.00 $1,600.00 $6,441.00 $1,898.00 2026-01-01
70542 CPT MRI Face Neck Orbit With Contrast 26 15 $3,286.00 $2,629.00 $1,375.00 $6,441.00 $1,898.00 2026-01-01
70552 CPT MRI Brain With Contrast 26 14 $3,286.00 $2,629.00 $1,500.00 $6,441.00 $1,898.00 2026-01-01
72196 CPT MRI Pelvis With Contrast 26 15 $3,286.00 $2,629.00 $1,375.00 $6,441.00 $1,898.00 2026-01-01
45378 CPT Diagnostic Exam Of Large Bowel Using An Endoscope 65 18 $993.00 $2,290.00 $155.50 $9,277.00 $1,887.00 2026-01-01
58563 CPT Hysteroscopy Ablation 2 1 $1,880.00 — $298.00 $3,462.00 $1,880.00 2026-01-01
70336 CPT MRI Tmj 24 13 $2,448.00 $1,958.00 20% off $1,224.00 $4,798.00 $1,870.00 2025-08-01
70481 CPT CT Orbits Sella With Contrast 24 13 $2,443.00 $1,954.00 20% off $1,222.00 $4,788.00 $1,866.00 2025-08-01
42106 CPT Excision Lesion Mouth Roof 2 2 $1,846.00 — $230.00 $3,462.00 $1,846.00 2026-01-01
25605 CPT Cltx Dst Rdl Fx/ephys Sep With 1 1 $1,799.00 — $1,799.00 $1,799.00 $1,799.00 2026-01-01
59409 CPT Obstetrical Care 7 5 $1,797.00 — $1,797.00 $1,797.00 $1,797.00 2026-01-01
73201 CPT CT Elbow With Contrast Left 24 13 $2,343.00 $1,874.00 20% off $1,172.00 $4,592.00 $1,789.50 2025-08-01
73701 CPT CT Ankle With Contrast Left 24 13 $2,343.00 $1,874.00 20% off $1,172.00 $4,592.00 $1,789.50 2025-08-01
7500444 CDM Txb Procedure Pack, Tenex 24 13 $2,331.00 $1,865.00 $1,166.00 $4,569.00 $1,780.00 2025-08-01
87302494 CDM Epoetin Alfa 40,000 Units/1 Ml Vial [Kchs] 24 13 $2,329.00 $1,863.00 20% off $1,165.00 $4,565.00 $1,779.00 2025-08-01
11646 CPT 11646 Excision, Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, L… 48 13 $2,254.00 $1,803.00 20% off $306.00 $7,095.00 $1,775.00 2025-08-01
70492 CPT CT Neck Soft Tissue With + Without Contrast 26 15 $3,042.00 $2,434.00 $1,208.00 $5,962.00 $1,757.00 2026-01-01
0761 RC — 8 8 $2,250.00 — $261.77 $2,250.00 $1,752.94 2026-01-01
27842 CPT Treat Ankle Dislocation 3 3 $1,748.00 — $1,174.00 $1,748.00 $1,748.00 2026-01-01
42820 CPT Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12 69 24 $1,425.00 $3,587.50 $441.00 $15,851.00 $1,727.00 2026-01-01
70487 CPT CT Sinus With Contrast 26 15 $2,375.00 $1,900.00 20% off $570.31 $4,655.00 $1,709.50 2026-01-01
70540 CPT MRI Face Neck Orbit Without Contrast 27 16 $2,956.00 $2,365.00 $1,300.00 $5,794.00 $1,707.00 2026-01-01
64483 CPT Injection(s) Of Anesthetic Into Lower Spine Using Imaging Guidance 48 13 $2,077.00 $1,661.50 20% off $475.00 $6,280.00 $1,682.00 2025-08-01
73218 CPT MRI Forearm Without Contrast Left 24 13 $2,196.00 $1,757.00 $1,098.00 $4,304.00 $1,677.00 2025-08-01
U0250 HCPCS U0250 1 1 $1,661.06 — $1,661.06 $1,661.06 $1,661.06 2026-01-01
73221 CPT MRI Elbow Without Contrast Left 32 19 $2,697.00 $2,158.00 $1,349.00 $5,286.00 $1,655.00 2026-01-01
70547 CPT MRA Neck Without Contrast 25 14 $2,865.00 $2,292.00 20% off $900.00 $5,615.00 $1,655.00 2026-01-01
71270 CPT CT Chest With + Without Contrast 27 15 $2,865.00 $2,292.00 20% off $900.00 $5,615.00 $1,655.00 2026-01-01
A2019 HCPCS Dressing, Shield Adhesive, Fenestrated, 15mm Fish Skin/ 40mm Silicone 24 13 $2,160.00 $1,728.00 20% off $1,080.00 $4,234.00 $1,649.50 2025-08-01
31255 CPT Nsl/sins Ndsc W/tot Ethmdct 2 2 $1,604.00 — $1,604.00 $1,604.00 $1,604.00 2026-01-01
74160 CPT CT Abdomen With Contrast 27 16 $2,752.00 $2,202.00 $1,376.00 $5,394.00 $1,589.00 2026-01-01
98774469 CDM Infliximab Dyyb 100 Mg Inj [Kchs] 24 13 $2,064.00 $1,651.00 20% off $1,032.00 $4,045.00 $1,576.50 2025-08-01
69145 CPT 69145 Excision Soft Tissue Lesion, External Auditory Canal Profee 48 13 $1,964.00 $1,571.00 20% off $219.00 $6,054.00 $1,569.50 2025-08-01
70482 CPT CT Orbits Sella With + Without Contrast 27 16 $2,710.00 $2,168.00 20% off $1,355.00 $5,312.00 $1,565.00 2026-01-01
69205 CPT Clear Outer Ear Canal 5 3 $2,596.00 — $530.00 $2,596.00 $1,563.00 2026-01-01
31254 CPT Nsl/sins Ndsc W/prtl Ethmdct 8 5 $1,562.00 — $1,562.00 $1,562.00 $1,562.00 2026-01-01
11624 CPT 11624 Excision Malignant Lesion Scalp, Neck, Hands, Feet, Genitalia 3.1cm-4.0cm 48 13 $1,955.00 $1,564.00 20% off $188.00 $6,037.00 $1,558.50 2025-08-01
0760 RC — 2 2 $2,857.50 — $1,092.00 $2,019.00 $1,555.50 2026-01-01
72133 CPT CT Spine Lumbar With + Without Contrast 25 14 $2,690.00 $2,152.00 20% off $1,174.00 $5,272.00 $1,553.00 2026-01-01
78315 CPT Nm Bone Three Phase Study 24 13 $2,026.00 $1,621.00 $1,013.00 $3,971.00 $1,547.50 2025-08-01
73718 CPT MRI Femur Without Contrast Rt 27 15 $2,657.00 $2,126.00 $1,300.00 $5,208.00 $1,534.00 2026-01-01
73219 CPT MRI Forearm With Contrast Left 25 14 $2,657.00 $2,126.00 $1,329.00 $5,208.00 $1,534.00 2026-01-01
7500331 CDM Mesh, Ventralight St, 6x10 Oval 24 13 $2,000.00 $1,600.00 20% off $1,000.00 $3,920.00 $1,527.50 2025-08-01
0172 RC — 3 3 $1,522.00 — $1,522.00 $4,566.00 $1,522.00 2026-01-01
15273 CPT 15273 Aply Skin Subst Leg First 100 Sqcm Charge 48 13 $2,314.50 $1,851.50 20% off $156.00 $8,095.00 $1,521.50 2025-08-01
73721 CPT MRI Scan Of Leg Joint 33 20 $2,727.00 $2,182.00 $1,300.00 $5,345.00 $1,515.00 2026-01-01
7500441 CDM Mini Scorpion Cpr Kit 24 13 $1,971.00 $1,577.00 $986.00 $3,863.00 $1,505.00 2025-08-01
72131 CPT CT Spine Lumbar Without Contrast 37 23 $2,493.00 $1,994.00 20% off $585.57 $4,886.00 $1,505.00 2026-01-01
72128 CPT CT Spine Thoracic Without Contrast 32 20 $2,495.00 $1,996.00 20% off $1,248.00 $4,890.00 $1,505.00 2026-01-01
J7296 HCPCS Kyleena, 19.5 Mg 8 6 $1,502.71 — $1,502.71 $1,502.71 $1,502.71 2026-01-01
31296 CPT Nsl/sins Ndsc Surg Frnt Sins 3 2 $1,500.00 — $1,500.00 $1,500.00 $1,500.00 2026-01-01
71260 CPT CT Chest With Contrast 42 25 $2,719.00 $2,175.00 20% off $466.24 $5,329.00 $1,495.00 2026-01-01
7500248 CDM Implantable, Arthrex Tight Rope 24 13 $1,957.00 $1,566.00 $979.00 $3,836.00 $1,494.50 2025-08-01
7500137 CDM Hernia Mesh System, Prolene, Lg 24 13 $1,947.00 $1,558.00 $974.00 $3,816.00 $1,487.00 2025-08-01
7500138 CDM Hernia Mesh Sytem, Prolene, Extended 24 13 $1,947.00 $1,558.00 $974.00 $3,816.00 $1,487.00 2025-08-01
88986395 CDM Immune Globulin (Privigen) 10% IV Sol 50 Ml [Kchs] 24 13 $1,920.00 $1,536.00 20% off $960.00 $3,763.00 $1,466.50 2025-08-01
0610 RC — 1 1 $1,655.00 — $1,452.50 $1,452.50 $1,452.50 2026-01-01
72132 CPT CT Spine Lumbar With Contrast 25 14 $2,515.00 $2,012.00 20% off $585.00 $4,929.00 $1,452.00 2026-01-01
73202 CPT CT Elbow With + Without Contrast Left 27 16 $2,515.00 $2,012.00 20% off $906.26 $4,929.00 $1,452.00 2026-01-01
78306 CPT Nm Bone Imaging Whole Body 24 13 $1,901.00 $1,521.00 $951.00 $3,726.00 $1,452.00 2025-08-01
28192 CPT 28192 Removal Foreign Body Foot Deep Profee 48 13 $1,795.00 $1,436.00 20% off $275.00 $5,402.00 $1,447.00 2025-08-01
93307 CPT US Echo Limited Without Contrast Eo 24 13 $1,887.00 $1,510.00 $944.00 $3,699.00 $1,441.50 2025-08-01
70491 CPT CT Neck Soft Tissue With Contrast 31 19 $2,519.00 $2,015.00 20% off $1,190.00 $4,937.00 $1,427.00 2026-01-01
72192 CPT CT Pelvis Without Contrast 28 16 $2,359.00 $1,887.00 20% off $1,180.00 $4,624.00 $1,425.00 2026-01-01
69436 CPT Create Eardrum Opening 31 12 $1,425.00 — $656.00 $8,550.00 $1,425.00 2026-01-01
74150 CPT CT Abdomen Without Contrast 26 15 $2,457.00 $1,966.00 $1,229.00 $4,816.00 $1,419.00 2026-01-01
72125 CPT CT Spine Cervical Without Contrast 38 24 $2,536.00 $2,029.00 $1,268.00 $4,971.00 $1,395.00 2026-01-01
78226 CPT Nm Hepatobiliary Imaging 24 13 $1,819.00 $1,455.00 20% off $910.00 $3,565.00 $1,389.00 2025-08-01
17111 CPT Destruct Lesion 15 Or More 2 1 $1,388.36 — $180.72 $2,596.00 $1,388.36 2026-01-01
71250 CPT CT Chest Without Contrast 39 23 $2,504.00 $2,003.00 20% off $900.00 $4,908.00 $1,377.00 2026-01-01
7500163 CDM Mesh, Proceed Ventral Patch, Small, Circle 24 13 $1,788.00 $1,430.00 20% off $894.00 $3,504.00 $1,366.00 2025-08-01
7500162 CDM Mesh, Proceed Ventral Patch, Medium, Circle 24 13 $1,788.00 $1,430.00 20% off $894.00 $3,504.00 $1,366.00 2025-08-01
73700 CPT CT Ankle Without Contrast Left 30 18 $2,384.00 $1,907.00 20% off $1,155.00 $4,673.00 $1,364.00 2026-01-01
42825 CPT Removal Of Tonsils 12 7 $1,353.50 — $1,282.00 $7,465.00 $1,353.50 2026-01-01
70460 CPT CT Brain/head With Contrast 28 16 $2,343.00 $1,874.00 20% off $1,172.00 $4,592.00 $1,353.00 2026-01-01
62323 CPT Injection(s) Of Therapeutic Substance 72 13 $2,229.00 $1,783.00 20% off $335.00 $5,427.00 $1,348.00 2025-08-01
0171 RC — 3 3 $1,344.00 — $1,344.00 $1,522.00 $1,344.00 2026-01-01
C1781 HCPCS Hernia Patch W/strap 3.2 Ventralex 24 13 $1,757.00 $1,406.00 $879.00 $3,444.00 $1,342.00 2025-08-01
40812 CPT 40812 Excision Of Lesion Of Mucosa And Submucosa, Vestibule Of Mouth; With Simpl… 48 13 $1,823.00 $1,458.50 $156.00 $5,996.00 $1,340.50 2025-08-01
21013 CPT 21013 Excision, Tumor, Soft Tissue Of Face And Scalp, Subfascial (Eg, Subgaleal,… 48 13 $1,865.50 $1,492.50 $339.00 $4,843.00 $1,328.50 2025-08-01
0350 RC — 8 7 $1,321.50 — $570.31 $2,300.00 $1,321.50 2026-01-01
73200 CPT CT Elbow Without Contrast Left 52 16 $2,176.00 $1,777.50 $1,088.00 $4,445.00 $1,310.00 2026-01-01
J7301 HCPCS Skyla, 13.5 Mg 6 5 $1,295.80 — $1,295.80 $1,295.80 $1,295.80 2026-01-01
70450 CPT CT Head/brain Without Contrast 61 31 $1,285.00 $1,740.00 $927.26 $4,263.00 $1,285.00 2026-01-01
70480 CPT CT Orbits Sella Without Contrast 33 20 $2,302.00 $1,842.00 $1,151.00 $4,512.00 $1,279.00 2026-01-01
7500316 CDM Fixation System, Sorbafix, Absorbabl, 30 Fasteners 24 13 $1,674.00 $1,339.00 20% off $837.00 $3,281.00 $1,278.50 2025-08-01
70490 CPT CT Neck Soft Tissue Without Contrast 25 14 $2,202.00 $1,762.00 $1,101.00 $4,316.00 $1,272.00 2026-01-01
71271 CPT CT Low Dose Lung Scan 38 21 $2,309.00 $1,847.00 20% off $700.00 $4,526.00 $1,270.00 2026-01-01
J7307 HCPCS Etonogestrel Implant System 15 11 $1,215.08 — $1,215.08 $1,215.08 $1,215.08 2026-01-01
99285 CPT 99285level 5 96 33 $1,227.00 $681.00 44% off $160.00 $3,980.62 $1,214.50 2026-01-01
12015 CPT Rpr F/e/e/n/l/m 7.6-12.5 Cm 1 1 $1,200.00 — $1,200.00 $1,200.00 $1,200.00 2026-01-01
92081102 CDM Rituximab-pvvr 100 Mg/10 Ml Vial [Kchs] 24 13 $1,568.00 $1,254.00 20% off $784.00 $3,073.00 $1,198.00 2025-08-01
88564967 CDM Rabies Immune Globulin, Human 300 Units/1 Ml [Kchs] 24 13 $1,554.00 $1,243.00 20% off $777.00 $3,046.00 $1,186.50 2025-08-01
58140 CPT Myomectomy Abdom Method 2 2 $1,183.00 — $1,183.00 $1,183.00 $1,183.00 2026-01-01
58605 CPT Division Of Fallopian Tube 6 6 $1,175.00 — $1,175.00 $1,175.00 $1,175.00 2026-01-01
49082 CPT Abd Paracentesis 2 2 $1,512.00 — $804.00 $1,512.00 $1,158.00 2026-01-01
93350 CPT US Stress Echo Pharm 24 13 $1,515.00 $1,212.00 20% off $758.00 $2,969.00 $1,157.00 2025-08-01
3010002 CDM Room/bed: Acute 24 13 $1,498.00 $1,198.00 20% off $749.00 $2,936.00 $1,144.00 2025-08-01
Q4158 HCPCS Dressing, Marigen 16mm Circular 120 13 $1,320.00 $1,056.00 20% off $518.00 $4,075.00 $1,138.00 2025-08-01
21014 CPT 21014 Excision, Tumor, Soft Tissue Of Face And Scalp, Subfascial (Eg, Subgaleal,… 48 13 $1,573.00 $1,258.50 $437.00 $4,002.00 $1,123.00 2025-08-01
11424 CPT 11424 Excision, Benign Lesion Including Margins, Except Skin Tag (Unless Listed … 48 13 $1,411.50 $1,129.00 20% off $152.00 $4,398.00 $1,122.00 2025-08-01
21011 CPT 21011 Excision, Tumor, Soft Tissue Of Face Or Scalp, Subcutaneous; Less Than 2 C… 48 13 $1,484.50 $1,188.00 $229.00 $4,169.00 $1,117.00 2025-08-01
0762 RC — 2 2 $1,545.00 — $665.00 $1,542.50 $1,103.75 2026-01-01
0370 RC — 39 23 $1,097.00 — $512.00 $1,682.00 $1,097.00 2026-01-01
99199 CPT Unlisted Special Svc Px/rprt 2 2 $11,185.24 — $37.92 $2,120.38 $1,079.15 2026-01-01
78070 CPT Nm Parathyroid Imaging 24 13 $1,400.00 $1,120.00 20% off $700.00 $2,744.00 $1,069.50 2025-08-01
36590 CPT 36590 Removal Of Tunneled Central Venous Access Device, With Subcutaneous Port O… 48 13 $1,308.50 $1,047.00 $158.00 $3,998.00 $1,058.00 2025-08-01
46050 CPT Incision Of Anal Abscess 2 1 $1,031.32 — $208.63 $1,854.00 $1,031.32 2026-01-01
21931 CPT 21931 Excision, Tumor, Soft Tissue Of Back Or Flank, Subcutaneous; 3 Cm Or Great… 48 13 $1,477.00 $1,181.50 20% off $406.00 $3,595.00 $1,029.00 2025-08-01
27096 CPT 27096 Injection Procedure For Sacroiliac Joint, Anesthetic/steroid, With Image G… 48 13 $1,839.50 $1,471.50 20% off $69.00 $3,642.00 $1,022.00 2025-08-01
87194768 CDM Onabotulinumtoxina 100 Units Pow [Kchs] 24 13 $1,318.00 $1,054.00 20% off $659.00 $2,583.00 $1,006.50 2025-08-01
99157 CPT Mod Sed Other Phys/qhp Ea 2 1 $999.50 — $902.00 $1,097.00 $999.50 2026-01-01
49083 CPT Abd Paracentesis W/imaging 5 4 $1,600.00 — $29.00 $1,600.00 $992.00 2026-01-01
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