Price Transparency 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

5,984 distinct procedures filed
129 distinct payers
89,967 rate rows
2026-05-27 last MRF observed
Data quality

88,902 of 89,967 rate rows are consumer-grade (98.8%)

1,065 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 630
template filing: same amount across many unrelated codes — excluded 255
placeholder amount (≤ $0.02) — excluded from medians 180
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.kearnycountyhospital.com/wp-content/uploads/2026/03/48_0568594_Kearny_County_Hospital_standardcharges_20260401.csv
Found on page https://www.kearnycountyhospital.com/patient-resources/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-18
Content fingerprint 7b334e80d9e154ea… · 1,688,632 bytes · first seen 2026-05-13

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
783
MS_DRG 		Cesarean Section w/Sterilizati 1 $43,737.93 $43,737.93 $43,737.93 nat. median
$19,235
outlier · 2.3×
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
$11,116
outlier · 2.3×
785
MS_DRG 		Cesarean Section w/Sterilizati 1 $25,738.12 $25,738.12 $25,738.12 nat. median
$10,028
outlier · 2.6×
787
MS_DRG 		Cesarean Section Without Steriliza 3 $21,774.15 $24,842.15 $24,403.49 nat. median
$11,413
outlier · 2.1×
U0360
HCPCS 		U0360 1 $23,366.84 $23,366.84 $23,366.84 nat. median
$23,367
1.0× median
559
MS_DRG 		Aftercare, Musculoskeletal Sys 1 $22,757.64 $22,757.64 $22,757.64 nat. median
$19,049
1.2× median
788
MS_DRG 		Cesarean Section Without Steriliza 3 $21,558.72 $27,276.10 $22,034.50 nat. median
$10,164
outlier · 2.2×
798
MS_DRG 		Vaginal Delivery With Steriliz 4 $18,760.54 $25,195.14 $21,819.27 nat. median
$9,580
outlier · 2.3×
189
MS_DRG 		Pulmonary Edema & Respiratory 2 $20,040.82 $21,340.44 $20,690.63 nat. median
$13,021
1.6× median
871
MS_DRG 		Septicemia Or Severe Sepsis With 1 $19,560.75 $19,560.75 $19,560.75 nat. median
$19,635
1.0× median
291
MS_DRG 		Heart Failure & Shock W/mcc 1 $18,299.66 $18,299.66 $18,299.66 nat. median
$13,522
1.4× median
157
MS_DRG 		Dental & Oral Diseases W/mcc 1 $16,543.05 $16,543.05 $16,543.05 nat. median
$17,221
1.0× median
950
MS_DRG 		Aftercare Without Cc/mcc 1 $16,344.00 $16,344.00 $16,344.00 nat. median
$7,554
outlier · 2.2×
768
MS_DRG 		Vaginal Delivery With O.r. Pro 1 $14,807.99 $14,807.99 $14,807.99 nat. median
$10,536
1.4× 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
872
MS_DRG 		Septicemia Or Severe Sepsis With 2 $9,582.76 $16,717.50 $13,150.13 nat. median
$11,105
1.2× median
95
MS_DRG 		Bacterial & Tuberculous Infect 1 $12,258.00 $12,258.00 $12,258.00 nat. median
$24,991
outlier · 0.5×
58600
CPT 		Division Of Fallopian Tube 1 $12,010.00 $12,010.00 $12,010.00 nat. median
$3,265
outlier · 3.7×
0360
RC 		12 $3,462.00 $16,842.00 $11,991.00 nat. median
$2,182
outlier · 5.5×
637
MS_DRG 		Diabetes W/mcc 1 $11,932.92 $11,932.92 $11,932.92 nat. median
$14,789
0.8× median
440
MS_DRG 		Disorders Of Pancreas Except M 1 $11,794.00 $11,794.00 $11,794.00 nat. median
$7,345
1.6× 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
$1,082
outlier · 10.7×
806
MS_DRG 		Vaginal Delivery Without Steri 3 $10,624.80 $11,970.16 $11,009.16 nat. median
$8,000
1.4× median
60
MS_DRG 		Multiple Sclerosis & Cerebella 1 $10,852.00 $10,852.00 $10,852.00 nat. median
$10,103
1.1× median
194
MS_DRG 		Simple Pneumonia & Pleurisy With 1 $10,710.59 $10,710.59 $10,710.59 nat. median
$9,125
1.2× 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
683
MS_DRG 		Renal Failure W/cc 2 $7,862.70 $12,779.00 $10,320.85 nat. median
$9,664
1.1× median
807
MS_DRG 		Vaginal Delivery Without Steri 4 $8,266.21 $11,584.59 $10,279.41 nat. median
$7,387
1.4× 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
548
MS_DRG 		Septic Arthritis W/mcc 1 $9,481.71 $9,481.71 $9,481.71 nat. median
$19,687
outlier · 0.5×
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
$5,949
1.6× median
29826
CPT 		Shaving Of Shoulder Bone Using Endoscope 13 $1,446.00 $50,082.00 $9,222.00 nat. median
$3,465
outlier · 2.7×
605
MS_DRG 		Trauma To The Skin, Subcutaneo 1 $9,160.15 $9,160.15 $9,160.15 nat. median
$9,920
0.9× median
292
MS_DRG 		Heart Failure & Shock W/cc 2 $6,660.35 $11,375.34 $9,017.85 nat. median
$9,636
0.9× median
31237
CPT 		Nsl/sins Ndsc Surg Bx Polypc 3 $773.00 $8,980.00 $8,980.00 nat. median
$2,016
outlier · 4.5×
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
$1,228
outlier · 6.8×
CP17513234919998402
CDM 		Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 13 $3,778.00 $71,642.00 $8,202.00 nat. median
$8,202
1.0× median
690
MS_DRG 		Kidney & Urinary Tract Infecti 1 $8,139.00 $8,139.00 $8,139.00 nat. median
$8,979
0.9× median
101149
OTHER 		Mesh Tintral Xb 30 X 30 X 20 5 $80.00 $7,744.19 $7,744.19 nat. median
$1,070
outlier · 7.2×
69631
CPT 		Repair Eardrum Structures 2 $7,631.50 $7,631.50 $7,631.50 nat. median
$6,034
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

Other procedures at this hospital

Browse this hospital's 5,984 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
             
783 MS_DRG Cesarean Section w/Sterilizati 1 1 $43,737.93 — $43,737.93 $43,737.93 $43,737.93 2026-01-01
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 2026-05-27
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 2026-05-27
CP17513234919998402 CDM Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 24 13 $36,552.00 $29,242.00 $3,778.00 $71,642.00 $8,202.00 2026-05-27
785 MS_DRG Cesarean Section w/Sterilizati 1 1 $30,374.65 — $25,738.12 $25,738.12 $25,738.12 2026-01-01
784 MS_DRG Cesarean Section w/Sterilizati 1 1 $25,803.69 — $25,803.69 $25,803.69 $25,803.69 2026-01-01
788 MS_DRG Cesarean Section Without Steriliza 3 3 $25,497.04 — $21,558.72 $27,276.10 $22,034.50 2026-01-01
787 MS_DRG Cesarean Section Without Steriliza 3 3 $24,403.49 — $21,774.15 $24,842.15 $24,403.49 2026-01-01
798 MS_DRG Vaginal Delivery With Steriliz 4 4 $24,089.32 — $18,760.54 $25,195.14 $21,819.27 2026-01-01
U0360 HCPCS U0360 1 1 $23,366.84 — $23,366.84 $23,366.84 $23,366.84 2026-01-01
559 MS_DRG Aftercare, Musculoskeletal Sys 1 1 $22,757.64 — $22,757.64 $22,757.64 $22,757.64 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
189 MS_DRG Pulmonary Edema & Respiratory 2 2 $20,690.63 — $20,040.82 $21,340.44 $20,690.63 2026-01-01
871 MS_DRG Septicemia Or Severe Sepsis With 1 1 $19,560.75 — $19,560.75 $19,560.75 $19,560.75 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 2026-05-27
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
157 MS_DRG Dental & Oral Diseases W/mcc 1 1 $16,543.05 — $16,543.05 $16,543.05 $16,543.05 2026-01-01
950 MS_DRG Aftercare Without Cc/mcc 1 1 $16,344.00 — $16,344.00 $16,344.00 $16,344.00 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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
872 MS_DRG Septicemia Or Severe Sepsis With 2 2 $13,150.13 — $9,582.76 $16,717.50 $13,150.13 2026-01-01
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 2026-05-27
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 2026-05-27
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 2026-05-27
95 MS_DRG Bacterial & Tuberculous Infect 1 1 $12,258.00 — $12,258.00 $12,258.00 $12,258.00 2026-01-01
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 2026-05-27
58600 CPT Division Of Fallopian Tube 1 1 $12,010.00 — $12,010.00 $12,010.00 $12,010.00 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
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
440 MS_DRG Disorders Of Pancreas Except M 1 1 $11,794.00 — $11,794.00 $11,794.00 $11,794.00 2026-01-01
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 3 3 $11,533.26 — $10,624.80 $11,970.16 $11,009.16 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 2026-05-27
60 MS_DRG Multiple Sclerosis & Cerebella 1 1 $10,852.00 — $10,852.00 $10,852.00 $10,852.00 2026-01-01
194 MS_DRG Simple Pneumonia & Pleurisy With 1 1 $10,710.59 — $10,710.59 $10,710.59 $10,710.59 2026-01-01
807 MS_DRG Vaginal Delivery Without Steri 5 4 $10,582.11 — $8,266.21 $11,584.59 $10,279.41 2026-01-01
683 MS_DRG Renal Failure W/cc 2 2 $10,320.85 — $7,862.70 $12,779.00 $10,320.85 2026-01-01
101149 OTHER Mesh Tintral Xb 30 X 30 X 20 5 5 $9,992.50 — $80.00 $7,744.19 $7,744.19 2026-05-08
548 MS_DRG Septic Arthritis W/mcc 1 1 $9,481.71 — $9,481.71 $9,481.71 $9,481.71 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 2026-05-27
J3101 HCPCS Tenecteplase Injection 13 5 $9,228.15 — $6,152.10 $15,380.25 $9,228.15 2026-01-01
605 MS_DRG Trauma To The Skin, Subcutaneo 1 1 $9,160.15 — $9,160.15 $9,160.15 $9,160.15 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 2026-05-27
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 2026-05-27
292 MS_DRG Heart Failure & Shock W/cc 2 2 $9,017.85 — $6,660.35 $11,375.34 $9,017.85 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
31267 CPT Endoscopy Maxillary Sinus 15 6 $8,980.00 — $1,758.00 $12,010.00 $6,126.50 2026-01-01
31256 CPT Exploration Maxillary Sinus 11 5 $8,980.00 — $765.00 $10,495.00 $4,872.50 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 2026-05-27
J1459 HCPCS Inj Ivig Privigen 500 Mg 6 3 $8,311.88 — $3,463.38 $11,082.50 $8,311.88 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 2026-05-27
690 MS_DRG Kidney & Urinary Tract Infecti 1 1 $8,139.00 — $8,139.00 $8,139.00 $8,139.00 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 2026-05-27
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 2026-05-27
30520 CPT Repair Of Nasal Septum 21 13 $7,465.00 — $1,716.00 $12,010.00 $5,348.00 2026-01-01
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 2026-05-27
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 2026-05-27
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 2026-05-27
794 MS_DRG Neonate w/Other Significant Pr 3 3 $7,289.63 — $5,376.81 $7,289.63 $5,652.20 2026-01-01
792 MS_DRG Prematurity Without Major Problems 2 2 $7,265.49 — $4,949.07 $7,987.66 $6,468.36 2026-01-01
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 2026-05-27
36058353 OTHER Or 58353 Endometrial Ablation Thermal 5 5 $7,200.00 — $80.00 $5,580.00 $5,580.00 2026-05-08
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
36000004 OTHER Or Level 3 Initial 30 Min 5 5 $6,922.00 — $80.00 $5,364.55 $5,364.55 2026-05-08
101644 OTHER Sinus Balloon Spin Plus 5 5 $6,825.00 — $80.00 $5,289.38 $5,289.38 2026-05-08
30435 CPT Revision Of Nose 2 1 $6,817.50 — $1,625.00 $12,010.00 $6,817.50 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 2026-05-27
101531 OTHER Entellus Multi-sinus Low Profile 5 5 $6,387.50 — $80.00 $4,950.31 $4,950.31 2026-05-08
0490 RC — 1 1 $6,345.64 — $6,345.64 $6,345.64 $6,345.64 2026-01-01
102091 OTHER C1781 Mesh Advantage Fit Blue 5 5 $6,310.30 — $80.00 $4,890.48 $4,890.48 2026-05-08
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
31536 CPT Laryngoscopy W/bx & Op Scope 1 1 $6,060.00 — $6,060.00 $6,060.00 $6,060.00 2026-01-01
102060 OTHER C2625 Implant System Internal Knee Ligament 5 5 $5,978.00 — $80.00 $4,632.95 $4,632.95 2026-05-08
58660 CPT Laparoscopy Lysis 1 1 $5,950.00 — $5,950.00 $5,950.00 $5,950.00 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
58558 CPT Hysteroscopy Biopsy 11 6 $5,950.00 — $1,800.00 $7,465.00 $4,435.00 2026-01-01
42826 CPT Removal Of Tonsils 19 9 $5,950.00 — $849.00 $8,980.00 $3,399.50 2026-01-01
101454 OTHER Relieva Balloon Sinuplasty System 5 5 $5,862.50 — $80.00 $4,543.44 $4,543.44 2026-05-08
790 MS_DRG Extreme Immaturity Or Respirat 1 1 $5,856.16 — $5,856.16 $5,856.16 $5,856.16 2026-01-01
7200036 OTHER L&d Vbac Delivery 5 5 $5,708.00 — $80.00 $4,423.70 $4,423.70 2026-05-08
C1726 HCPCS Cath, Bal Dil, Non-vascular 3 3 $5,695.90 — $5,695.90 $5,695.90 $5,695.90 2026-01-01
KHKS-101584 OTHER Stryker Xpress Ultra ENT Dilation Sysytem 5 5 $5,695.90 — $80.00 $4,414.32 $4,414.32 2026-05-08
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 2026-05-27
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 2026-05-27
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 2026-05-27
0720 RC — 17 12 $5,422.00 — $455.00 $5,708.00 $5,422.00 2026-01-01
7200033 OTHER L&d With Vag Delivery Charge 5 5 $5,422.00 — $80.00 $4,202.05 $4,202.05 2026-05-08
100884 OTHER Minerva Ablation 5 5 $5,250.00 — $80.00 $4,068.75 $4,068.75 2026-05-08
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 2026-05-27
45042962 OTHER ER 42962 Ctrl Oropharyngeal Hemorrhage W/sec Surg Ivntj 5 5 $5,000.00 — $80.00 $3,875.00 $3,875.00 2026-05-08
0240 RC — 1 1 $4,871.00 — $4,871.00 $4,871.00 $4,871.00 2026-01-01
58661 CPT Laparoscopy Remove Adnexa 14 7 $4,841.25 — $900.00 $13,525.00 $3,957.50 2026-01-01
59610 CPT Vbac Delivery 6 5 $4,744.00 — $4,744.00 $4,744.00 $4,744.00 2026-01-01
795 MS_DRG Normal Newborn 4 4 $4,676.41 — $2,574.77 $6,055.75 $4,676.41 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
864 MS_DRG Fever And Inflammatory Conditi 1 1 $4,536.37 — $4,536.37 $4,536.37 $4,536.37 2026-01-01
102921 OTHER Jada Hemorrhage System 5 5 $4,532.50 — $80.00 $3,512.69 $3,512.69 2026-05-08
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 2026-05-27
78452 CPT Nm Myocardial Spect Multiple Studies 32 19 $4,461.00 $3,569.00 $2,231.00 $8,744.00 $2,502.50 2026-05-27
36000002 OTHER Or Level 2 Initial 30 Min 5 5 $4,435.00 — $80.00 $3,437.12 $3,437.12 2026-05-08
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 2026-05-27
95811 CPT 95811 Polysomnography W/cpap Charge 24 13 $4,376.00 $3,501.00 $2,188.00 $8,577.00 $3,342.00 2026-05-27
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 2026-05-27
59812 CPT Treatment Of Miscarriage 2 1 $4,328.50 — $1,192.00 $7,465.00 $4,328.50 2026-01-01
31535 CPT Laryngoscopy W/biopsy 3 3 $4,328.00 — $253.95 $4,328.00 $2,290.97 2026-01-01
45027825 OTHER ER 27825 Treat Lower Leg Fracture 5 5 $4,320.00 — $80.00 $3,348.00 $3,348.00 2026-05-08
776 MS_DRG Postpartum & Post Abortion Dia 1 1 $4,288.75 — $4,288.75 $4,288.75 $4,288.75 2026-01-01
7500442 CDM Mild Kit 24 13 $4,286.00 $3,429.00 $2,143.00 $8,401.00 $3,273.50 2026-05-27
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 2026-05-27
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 2026-05-27
15273 CPT 15273 Aply Skin Subst Leg First 100 Sqcm Charge 24 13 $4,130.00 $3,304.00 20% off $2,065.00 $8,095.00 $3,154.50 2026-05-27
70553 CPT MRI Scan 33 20 $4,126.00 $3,301.00 $1,131.63 $8,087.00 $2,292.00 2026-05-27
59510 CPT Cesarean Delivery 15 11 $4,089.00 — $2,453.40 $4,089.00 $4,089.00 2026-01-01
308 MS_DRG Cardiac Arrhythmia & Conductio 1 1 $4,062.90 — $4,062.90 $4,062.90 $4,062.90 2026-01-01
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 2026-05-27
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
95810 CPT Sleep Study 24 13 $3,925.00 $3,140.00 20% off $1,963.00 $7,693.00 $2,998.00 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
0120 RC — 11 7 $3,744.00 — $1,248.00 $11,232.00 $3,744.00 2026-01-01
789 MS_DRG Neonates, Died Or Transferred 2 2 $3,706.61 — $3,474.21 $3,939.01 $3,706.61 2026-01-01
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 2026-05-27
192 MS_DRG Chronic Obstructive Pulmonary 1 1 $3,693.95 — $3,693.95 $3,693.95 $3,693.95 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 2026-05-27
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 2026-05-27
101631 OTHER Propel Mometasone Furoate Implant Mini 5 5 $3,657.50 — $80.00 $2,834.57 $2,834.57 2026-05-08
101642 OTHER Propel Mometasone Furoate Contour 5 5 $3,657.50 — $80.00 $2,834.57 $2,834.57 2026-05-08
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 2026-05-27
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 2026-05-27
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 2026-05-27
11646 CPT 11646 Exc Mal Lsn Face/ear/eye/nse/lip>4 Cm-profee 24 13 $3,620.00 $2,896.00 20% off $1,810.00 $7,095.00 $2,765.00 2026-05-27
59820 CPT Care Of Miscarriage 2 1 $3,608.50 — $1,267.00 $5,950.00 $3,608.50 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 2026-05-27
3500659 OTHER CT Angiography Abd Aorta + Iliofemoral 5 5 $3,528.00 — $80.00 $2,734.20 $2,734.20 2026-05-08
59400 CPT Obstetrical Care 19 14 $3,522.00 — $3,522.00 $3,522.00 $3,522.00 2026-01-01
74182 CPT MRI Abdomen With Contrast 24 13 $3,492.00 $2,794.00 $1,746.00 $6,844.00 $2,667.00 2026-05-27
70544 CPT MRA Brain/head Without Contrast 24 13 $3,492.00 $2,794.00 $1,746.00 $6,844.00 $2,667.00 2026-05-27
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 2026-05-27
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 2026-05-27
72197 CPT MRI Pelvis With + Without Contrast 25 14 $3,492.00 $2,794.00 $1,600.00 $6,844.00 $2,017.00 2026-05-27
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 2026-05-27
71275 CPT CT Angio Chest 40 24 $3,490.00 $2,792.00 20% off $1,745.00 $6,840.00 $2,795.00 2026-05-27
44388 CPT Colonoscopy Thru Stoma Spx 4 3 $3,462.00 — $822.00 $3,462.00 $3,462.00 2026-01-01
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 2026-05-27
36556 CPT Insert Non-tunnel Cv Cath 7 3 $3,400.00 — $457.00 $3,400.00 $3,400.00 2026-01-01
7606825 OTHER Tr 36556 Insert Nt Cv Cath 5+ Charge 5 5 $3,400.00 — $80.00 $2,635.00 $2,635.00 2026-05-08
4506465 OTHER ER 36556 Insert Nt Cv Cath 5+ 5 5 $3,400.00 — $80.00 $2,635.00 $2,635.00 2026-05-08
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 2026-05-27
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 2026-05-27
72191 CPT CT Angio Pelvis 24 13 $3,356.00 $2,685.00 $1,678.00 $6,578.00 $2,563.00 2026-05-27
378 MS_DRG G.i. Hemorrhage W/cc 1 1 $3,347.20 — $3,347.20 $3,347.20 $3,347.20 2026-01-01
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 2026-05-27
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 2026-05-27
70545 CPT MRA Brain/head With Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2026-05-27
72142 CPT MRI Spine Cervical With Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2026-05-27
72198 CPT MRA Pelvis With + Without Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2026-05-27
72147 CPT MRI Spine Thoracic With Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2026-05-27
71551 CPT MRI Chest With Contrast 24 13 $3,286.00 $2,629.00 $1,643.00 $6,441.00 $2,510.00 2026-05-27
74181 CPT MRI Abdomen Without Contrast 25 14 $3,286.00 $2,629.00 $1,600.00 $6,441.00 $1,898.00 2026-05-27
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 2026-05-27
72196 CPT MRI Pelvis With Contrast 26 15 $3,286.00 $2,629.00 $1,375.00 $6,441.00 $1,898.00 2026-05-27
70552 CPT MRI Brain With Contrast 26 14 $3,286.00 $2,629.00 $1,500.00 $6,441.00 $1,898.00 2026-05-27
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 2026-05-27
70498 CPT CT Angio Neck 31 18 $3,261.00 $2,609.00 $1,631.00 $6,392.00 $2,825.00 2026-05-27
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 2026-05-27
100905 OTHER Essure System 5 5 $3,237.50 — $80.00 $2,509.07 $2,509.07 2026-05-08
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 2026-05-27
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 2026-05-27
74170 CPT CT Abdomen With + Without Contrast 24 13 $3,211.00 $2,569.00 $1,606.00 $6,294.00 $2,452.00 2026-05-27
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 2026-05-27
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
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 2026-05-27
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 2026-05-27
101393 OTHER Entellus Multi-sinus Dilation Tool 5 5 $3,130.80 — $80.00 $2,426.37 $2,426.37 2026-05-08
45046060 OTHER ER 46060 I&d Perirectal Abscess 5 5 $3,100.00 — $80.00 $2,402.50 $2,402.50 2026-05-08
69145 CPT 69145 Excision Soft Tissue Lesion, External Auditory Canal Profee 24 13 $3,089.00 $2,471.00 20% off $1,545.00 $6,054.00 $2,359.50 2026-05-27
11624 CPT 11624 Exc, Malignant Lesion Including Margins, S/n/h/f/g; Excised Diameter 3.1 T… 24 13 $3,080.00 $2,464.00 20% off $1,540.00 $6,037.00 $2,352.50 2026-05-27
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 2026-05-27
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 2026-05-27
40812 CPT 40812 Excision Of Lesion Of Mucosa And Submucosa, Vestibule Of Mouth; With Simpl… 24 13 $3,059.00 $2,447.00 20% off $1,530.00 $5,996.00 $2,336.50 2026-05-27
7611411 OTHER Tr 36573 Insert Picc Wo Port W/img >5yr 5 5 $3,050.00 — $80.00 $2,363.75 $2,363.75 2026-05-08
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 2026-05-27
101553 OTHER Propel Mometasone Furoate Implant 5 5 $2,975.00 — $80.00 $2,305.62 $2,305.62 2026-05-08
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 2026-05-27
59612 CPT Vbac Delivery Only 4 4 $2,937.00 — $2,937.00 $2,937.00 $2,937.00 2026-01-01
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
70547 CPT MRA Neck Without Contrast 25 14 $2,865.00 $2,292.00 20% off $900.00 $5,615.00 $1,655.00 2026-05-27
35070498 OTHER 70498 CT Angiography Neck W/contrast/noncontrast 5 5 $2,825.00 — $80.00 $2,189.38 $2,189.38 2026-05-08
3500642 OTHER CT Angiography Head With + Without Contrast 5 5 $2,825.00 — $80.00 $2,189.38 $2,189.38 2026-05-08
35071275 OTHER CT Angiography Chest W 5 5 $2,795.00 — $80.00 $2,166.12 $2,166.12 2026-05-08
3500592 OTHER CT Angiography Chest For Pe 5 5 $2,795.00 — $80.00 $2,166.12 $2,166.12 2026-05-08
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 2026-05-27
101601 OTHER Mesh Advantage Fit 5 5 $2,786.90 — $80.00 $2,159.85 $2,159.85 2026-05-08
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 2026-05-27
28192 CPT 28192 Removal Foreign Body Foot Deep Techfee 24 13 $2,756.00 $2,205.00 $1,378.00 $5,402.00 $2,105.00 2026-05-27
74160 CPT CT Abdomen With Contrast 27 16 $2,752.00 $2,202.00 $1,376.00 $5,394.00 $1,589.00 2026-05-27
101216 OTHER Relieva Sinus Balloon Catheter 5 5 $2,733.50 — $80.00 $2,118.47 $2,118.47 2026-05-08
73221 CPT MRI Elbow Without Contrast Left 32 19 $2,697.00 $2,158.00 $1,349.00 $5,286.00 $1,655.00 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
76159412 OTHER Tr 59412 External Cephalic Version W/wo Tocolysis 5 5 $2,680.00 — $80.00 $2,077.00 $2,077.00 2026-05-08
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 2026-05-27
73719 CPT MRI Femur With Contrast Left 24 13 $2,657.00 $2,126.00 $1,329.00 $5,208.00 $2,029.00 2026-05-27
73222 CPT MRI Elbow With Contrast Left 24 13 $2,657.00 $2,126.00 $1,329.00 $5,208.00 $2,029.00 2026-05-27
35070496 OTHER CT Angiography Head + Neck 5 5 $2,625.00 — $80.00 $2,034.38 $2,034.38 2026-05-08
35073706 OTHER CT Angiography Lower Extremity Right 5 5 $2,625.00 — $80.00 $2,034.38 $2,034.38 2026-05-08
3500402 OTHER CT Angiography Abdomen 5 5 $2,625.00 — $80.00 $2,034.38 $2,034.38 2026-05-08
35072191 OTHER CT Angiography Pelvis With + Without Contrast 5 5 $2,625.00 — $80.00 $2,034.38 $2,034.38 2026-05-08
35073206 OTHER CT Angiography Upper Extremity Left 5 5 $2,625.00 — $80.00 $2,034.38 $2,034.38 2026-05-08
3500634 OTHER CT Angiography Neck With + Without Contrast 5 5 $2,625.00 — $80.00 $2,034.38 $2,034.38 2026-05-08
3500741 OTHER CT Angiography Of Abdomen + Pelvis 5 5 $2,625.00 — $80.00 $2,034.38 $2,034.38 2026-05-08
3500667 OTHER CT Angiography Lower Extremity Left 5 5 $2,625.00 — $80.00 $2,034.38 $2,034.38 2026-05-08
99499 CPT Unlisted E&m Service 1 1 $2,624.75 — $2,624.75 $2,624.75 $2,624.75 2026-01-01
70488 CPT CT Sinus With + Without Contrast 24 13 $2,607.00 $2,086.00 $1,304.00 $5,110.00 $2,362.00 2026-05-27
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 2026-05-27
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 2026-05-27
36000000 OTHER Or Level 1 Initial 30 Min 5 5 $2,596.00 — $80.00 $2,011.90 $2,011.90 2026-05-08
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
G0105 HCPCS Colorectal Scrn; Hi Risk Ind 11 6 $2,596.00 — $242.33 $3,462.00 $1,924.50 2026-01-01
59620 CPT Attempted Vbac Delivery Only 1 1 $2,588.00 — $2,588.00 $2,588.00 $2,588.00 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 2026-05-27
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
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
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 2026-05-27
7500440 CDM Forefoot Internal Brace 24 13 $2,511.00 $2,009.00 $1,256.00 $4,922.00 $1,917.50 2026-05-27
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
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 2026-05-27
21013 CPT 21013 Excision, Tumor, Soft Tissue Of Face And Scalp, Subfascial (Eg, Subgaleal,… 24 13 $2,471.00 $1,977.00 $1,236.00 $4,843.00 $1,887.00 2026-05-27
70336 CPT MRI Tmj 24 13 $2,448.00 $1,958.00 20% off $1,224.00 $4,798.00 $1,870.00 2026-05-27
3401361 OTHER Cr Myocardial Spect Multi Studies 78452 5 5 $2,446.00 — $80.00 $1,895.65 $1,895.65 2026-05-08
34178452 OTHER Nm Multispec 78452 5 5 $2,446.00 — $80.00 $1,895.65 $1,895.65 2026-05-08
42835 CPT Removal Of Adenoids 8 3 $2,443.50 — $539.00 $4,435.00 $2,443.50 2026-01-01
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 2026-05-27
3500733 OTHER CT Abdomen + Pelvis With + Without Contrast 5 5 $2,440.00 — $80.00 $1,891.00 $1,891.00 2026-05-08
74177 CPT CT Abd & Pelvis W/contrast 50 29 $2,431.00 $3,964.00 $1,500.00 $9,712.00 $2,431.00 2026-05-27
3500725 OTHER CT Abdomen + Pelvis With Contrast 5 5 $2,431.00 — $80.00 $1,884.03 $1,884.03 2026-05-08
36000005 OTHER Or Level 3 Addl 15 Min 5 5 $2,380.00 — $80.00 $1,844.50 $1,844.50 2026-05-08
70487 CPT CT Sinus With Contrast 26 15 $2,375.00 $1,900.00 20% off $570.31 $4,655.00 $1,709.50 2026-05-27
58562 CPT Hysteroscopy Remove Fb 2 1 $2,360.00 — $285.00 $4,435.00 $2,360.00 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 2026-05-27
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 2026-05-27
36042836 OTHER Or 42836 Adenoidectomy Secondary Age 12/> 5 5 $2,340.00 — $80.00 $1,813.50 $1,813.50 2026-05-08
7500444 CDM Txb Procedure Pack, Tenex 24 13 $2,331.00 $1,865.00 $1,166.00 $4,569.00 $1,780.00 2026-05-27
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 2026-05-27
74176 CPT CT Abd & Pelvis Without Contrast 55 30 $2,300.00 $3,291.00 $1,500.00 $8,063.00 $2,300.00 2026-05-27
4504874 OTHER ER 12035 Intmd Rpr S/a/t/ext 12.6-20 5 5 $2,300.00 — $80.00 $1,782.50 $1,782.50 2026-05-08
3500717 OTHER CT Abdomen + Pelvis Without Contrast 5 5 $2,300.00 — $80.00 $1,782.50 $1,782.50 2026-05-08
35074178 OTHER CT Abdomen + Pelvis Wo Contrast, Stone P 5 5 $2,300.00 — $80.00 $1,782.50 $1,782.50 2026-05-08
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
93306 CPT US Echo 2d Complete 62 24 $2,280.00 $1,991.00 $1,140.00 $5,288.00 $2,179.00 2026-05-27
0761 RC — 8 8 $2,250.00 — $261.77 $2,250.00 $1,752.94 2026-01-01
7608391 OTHER Tr 54150 Circumcision W/regionl Block Charge 5 5 $2,250.00 — $80.00 $1,743.75 $1,743.75 2026-05-08
45031575 OTHER ER 31575 Laryngoscopy Flexible Diagnostic 5 5 $2,250.00 — $80.00 $1,743.75 $1,743.75 2026-05-08
11424 CPT 11424 Excision Benign Lesion Scalp, Neck, Hands, Feet, Genitalia 3.1-4.0 Cm 24 13 $2,244.00 $1,795.00 20% off $1,122.00 $4,398.00 $1,714.00 2026-05-27
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 2026-05-27
36097607 OTHER Or 97607 Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm 5 5 $2,228.00 — $80.00 $1,726.70 $1,726.70 2026-05-08
73218 CPT MRI Forearm Without Contrast Left 24 13 $2,196.00 $1,757.00 $1,098.00 $4,304.00 $1,677.00 2026-05-27
0483 RC — 1 1 $2,179.00 — $2,179.00 $2,179.00 $2,179.00 2026-01-01
48093306 OTHER US Echo Doppler Complete 5 5 $2,179.00 — $80.00 $1,688.72 $1,688.72 2026-05-08
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 2026-05-27
4504908 OTHER ER 12042 Intmd Rpr N-hf/genit2.6-7.5 5 5 $2,155.00 — $80.00 $1,670.12 $1,670.12 2026-05-08
59410 CPT Obstetrical Care 3 2 $2,132.00 — $2,132.00 $2,132.00 $2,132.00 2026-01-01
21011 CPT 21011 Excision, Tumor, Soft Tissue Of Face Or Scalp, Subcutaneous; Less Than 2 C… 24 13 $2,127.00 $1,702.00 $1,064.00 $4,169.00 $1,624.50 2026-05-27
35072126 OTHER CT Spine Cervical With Contrast 5 5 $2,092.00 — $80.00 $1,621.30 $1,621.30 2026-05-08
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 2026-05-27
4505053 OTHER ER 10061 Incis & Drain Abscess Comp 5 5 $2,064.00 — $80.00 $1,599.60 $1,599.60 2026-05-08
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 2026-05-27
42830 CPT Removal Of Adenoids 16 9 $2,010.50 — $456.00 $5,950.00 $2,010.50 2026-01-01
58563 CPT Hysteroscopy Ablation 2 1 $1,880.00 — $298.00 $3,462.00 $1,880.00 2026-01-01
42106 CPT Excision Lesion Mouth Roof 2 2 $1,846.00 — $230.00 $3,462.00 $1,846.00 2026-01-01
27096 CPT 27096 Inj Si Joint Artho & Anes/ster 24 13 $1,821.00 $1,457.00 $911.00 $3,569.00 $1,757.50 2026-05-27
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
27842 CPT Treat Ankle Dislocation 3 3 $1,748.00 — $1,174.00 $1,748.00 $1,748.00 2026-01-01
U0250 HCPCS U0250 1 1 $1,661.06 — $1,661.06 $1,661.06 $1,661.06 2026-01-01
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
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 2026-05-27
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 2026-05-27
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 2026-05-27
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