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

STAFFORD COUNTY HOSPITAL

Stafford, KS · CCN 171323 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This hospital’s price: $2,185 across 5 payers · range $2,076-$2,185

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSDHNSTAFFORDKS&type=CDMWithoutLabel&fileType=CSV · observed 2026-03-11

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

1,111 distinct procedures filed
5 distinct payers
9,084 rate rows
2026-03-11 last MRF observed
Data quality

9,028 of 9,084 rate rows are consumer-grade (99.4%)

56 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 20
exceeds 10× this hospital's gross charge — excluded from medians 18
percent-of-charges filed in the dollar field — excluded from medians 18
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSDHNSTAFFORDKS&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Stafford_V2.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint ca50fae17cc8ede4… · 4,791,375 bytes · first seen 2026-05-07

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
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 5 $16,165.73 $17,016.56 $17,016.56 nat. median
$3,787
outlier · 4.5×
5749359_1
CDM 		Epi/lidocai/tetracai Topical 180 Mg-4000 Mg-500 Mg/100 Ml Sol [sfks] 5 $13,864.11 $14,593.80 $14,593.80 nat. median
$14,594
1.0× median
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 5 $10,122.06 $10,654.80 $10,654.80 nat. median
$1,659
outlier · 6.4×
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 5 $7,201.90 $7,580.95 $7,580.95 nat. median
$2,791
outlier · 2.7×
J3262
HCPCS 		Injection, Tocilizumab, 1 Mg 5 $6,065.33 $6,384.56 $6,384.56 nat. median
$1,413
outlier · 4.5×
J1602
HCPCS 		Injection, Golimumab, 1 Mg, For Intravenous Use 5 $4,697.65 $4,944.89 $4,944.89 nat. median
$261
outlier · 18.9×
J0897
HCPCS 		Injection, Denosumab, 1 Mg 5 $4,400.70 $4,632.32 $4,632.32 nat. median
$1,982
outlier · 2.3×
36556
HCPCS 		Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 5 $3,610.00 $3,800.00 $3,800.00 nat. median
$2,483
1.5× median
81162
HCPCS 		Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 3 $3,501.99 $3,686.30 $3,686.30 nat. median
$1,825
outlier · 2.0×
J0717
HCPCS 		Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 5 $3,448.74 $3,630.25 $3,630.25 nat. median
$1,635
outlier · 2.2×
J0129
HCPCS 		Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 5 $3,149.99 $3,315.78 $3,315.78 nat. median
$902
outlier · 3.7×
J3111
HCPCS 		Injection, Romosozumab-aqqg, 1 Mg 5 $3,127.56 $3,292.17 $3,292.17 nat. median
$696
outlier · 4.7×
J9395
HCPCS 		Injection, Fulvestrant, 25 Mg 5 $2,278.96 $2,398.90 $2,398.90 nat. median
$236
outlier · 10.2×
93306
HCPCS 		Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 5 $2,075.75 $2,185.00 $2,185.00 nat. median
$993
outlier · 2.2×
J1439
HCPCS 		Injection, Ferric Carboxymaltose, 1 Mg 5 $1,991.39 $2,096.20 $2,096.20 nat. median
$14
outlier · 155.3×
75635
HCPCS 		CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 5 $1,987.40 $2,092.00 $2,092.00 nat. median
$727
outlier · 2.9×
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 5 $1,923.75 $2,025.00 $2,025.00 nat. median
$998
outlier · 2.0×
43247
HCPCS 		Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using… 5 $1,920.90 $2,022.00 $2,022.00 nat. median
$1,411
1.4× median
J1569
HCPCS 		Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 5 $1,256.00 $2,860.00 $2,019.55 nat. median
$1,074
1.9× median
74175
HCPCS 		CT Scan Of Blood Vessels Of Abdomen With Contrast 5 $1,890.50 $1,990.00 $1,990.00 nat. median
$718
outlier · 2.8×
J1745
HCPCS 		Injection, Infliximab, Excludes Biosimilar, 10 Mg 5 $1,060.79 $2,947.44 $1,958.35 nat. median
$405
outlier · 4.8×
36569
HCPCS 		Insertion Of Tube For Infusion (5 Years Or Older) 5 $1,852.50 $1,950.00 $1,950.00 nat. median
$1,726
1.1× median
28190
HCPCS 		Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 5 $1,805.00 $1,900.00 $1,900.00 nat. median
$867
outlier · 2.2×
5404220_1
CDM 		Room & Board - Semi-private (two Beds) - General Classification 1 $1,885.75 $1,885.75 $1,885.75 nat. median
$665
outlier · 2.8×
90377
HCPCS 		Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle 5 $1,783.62 $1,877.49 $1,877.49 nat. median
$562
outlier · 3.3×
12007
HCPCS 		Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs,… 5 $1,733.75 $1,825.00 $1,825.00 nat. median
$399
outlier · 4.6×
12006
HCPCS 		Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs,… 5 $1,733.75 $1,825.00 $1,825.00 nat. median
$529
outlier · 3.5×
12017
HCPCS 		Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.… 5 $1,729.00 $1,820.00 $1,820.00 nat. median
$518
outlier · 3.5×
99285
HCPCS 		Emergency Department Visit With High Level Of Medical Decision Making 5 $161.31 $1,809.00 $1,809.00 nat. median
$1,187
1.5× median
5404236_1
CDM 		Room & Board - Private (one Bed) - General Classification 1 $1,795.50 $1,795.50 $1,795.50 nat. median
$1,190
1.5× median
4634657_1
CDM 		Room & Board - Semi-private (two Beds) - General Classification 1 $1,695.75 $1,695.75 $1,695.75 nat. median
$1,425
1.2× median
74270
HCPCS 		Single Contrast X-ray Of Large Intestine 5 $1,600.75 $1,685.00 $1,685.00 nat. median
$336
outlier · 5.0×
70496
HCPCS 		CT Scan Of Blood Vessels Of Head With Contrast 5 $1,520.00 $1,600.00 $1,600.00 nat. median
$752
outlier · 2.1×
71275
HCPCS 		CT Scan Of Blood Vessels Of Chest With Contrast 5 $1,520.00 $1,600.00 $1,600.00 nat. median
$759
outlier · 2.1×
70498
HCPCS 		CT Scan Of Blood Vessels Of Neck With Contrast 5 $1,520.00 $1,600.00 $1,600.00 nat. median
$744
outlier · 2.2×
93307
HCPCS 		Ultrasound Of Heart 5 $1,448.75 $1,525.00 $1,525.00 nat. median
$519
outlier · 2.9×
23650
HCPCS 		Closed Treatment Of Dislocated Shoulder With Manipulation 5 $1,425.00 $1,500.00 $1,500.00 nat. median
$476
outlier · 3.2×
J0248
HCPCS 		Injection, Remdesivir, 1 Mg 5 $1,284.40 $1,671.59 $1,470.01 nat. median
$516
outlier · 2.9×
86366
HCPCS 		Test For Muscle-specific Kinase Antibody 5 $265.23 $1,441.44 $1,369.37 nat. median
$42
outlier · 32.8×
94662
HCPCS 		Therapy Procedure Using A Negative Pressure Ventilator 5 $1,282.50 $1,350.00 $1,350.00 nat. median
$613
outlier · 2.2×
36589
HCPCS 		Removal Of Tunneled Central Venous Tube 5 $1,187.50 $1,250.00 $1,250.00 nat. median
$929
1.3× median
12031
HCPCS 		Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 5 $1,173.25 $1,235.00 $1,235.00 nat. median
$485
outlier · 2.5×
2120840_1
CDM 		Room & Board - Semi-private (two Beds) - General Classification 1 $1,197.00 $1,197.00 $1,197.00 nat. median
$1,212
1.0× median
2120839_1
CDM 		Room & Board - Private (one Bed) - General Classification 1 $1,197.00 $1,197.00 $1,197.00 nat. median
$1,268
0.9× median
99284
HCPCS 		Emergency Department Visit With Moderate Level Of Medical Decision Making 5 $111.00 $1,164.00 $1,164.00 nat. median
$754
1.5× median
11200
HCPCS 		Removal Of Skin Tag, 1-15 Skin Tags 5 $64.00 $2,100.00 $1,057.83 nat. median
$238
outlier · 4.4×
13132
HCPCS 		Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 5 $959.50 $1,010.00 $1,010.00 nat. median
$856
1.2× median
99291
HCPCS 		Critical Care, First 30-74 Minutes 5 $188.24 $1,710.00 $1,000.82 nat. median
$1,530
0.7× median
72158
HCPCS 		MRI Scan Of Lower Spinal Canal Before And After Contrast 5 $945.25 $995.00 $995.00 nat. median
$1,097
0.9× median
73223
HCPCS 		MRI Scan Of Arm Joint Before And After Contrast 5 $945.25 $995.00 $995.00 nat. median
$1,158
0.9× median

Other procedures at this hospital

Browse this hospital's 1,111 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
             
J3101 HCPCS Injection, Tenecteplase, 1 Mg 5 5 $17,016.56 $17,016.56 $16,165.73 $17,016.56 $17,016.56 2026-03-11
5749359_1 CDM Epi/lidocai/tetracai Topical 180 Mg-4000 Mg-500 Mg/100 Ml Sol [sfks] 5 5 $14,593.80 $14,593.80 $13,864.11 $14,593.80 $14,593.80 2026-03-11
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 5 5 $10,654.80 $10,654.80 $10,122.06 $10,654.80 $10,654.80 2026-03-11
J2182 HCPCS Injection, Mepolizumab, 1 Mg 5 5 $7,580.95 $7,580.95 $7,201.90 $7,580.95 $7,580.95 2026-03-11
J3262 HCPCS Injection, Tocilizumab, 1 Mg 5 5 $6,384.56 $6,384.56 $6,065.33 $6,384.56 $6,384.56 2026-03-11
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 5 5 $4,944.89 $4,944.89 $4,697.65 $4,944.89 $4,944.89 2026-03-11
J0897 HCPCS Injection, Denosumab, 1 Mg 5 5 $4,632.32 $4,632.32 $4,400.70 $4,632.32 $4,632.32 2026-03-11
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 5 5 $3,800.00 $3,800.00 $3,610.00 $3,800.00 $3,800.00 2026-03-11
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 3 3 $3,686.30 $3,686.30 $3,501.99 $3,686.30 $3,686.30 2026-03-11
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 5 5 $3,630.25 $3,630.25 $3,448.74 $3,630.25 $3,630.25 2026-03-11
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 5 5 $3,315.78 $3,315.78 $3,149.99 $3,315.78 $3,315.78 2026-03-11
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 5 5 $3,292.17 $3,292.17 $3,127.56 $3,292.17 $3,292.17 2026-03-11
J9395 HCPCS Injection, Fulvestrant, 25 Mg 5 5 $2,398.90 $2,398.90 $2,278.96 $2,398.90 $2,398.90 2026-03-11
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 5 5 $2,185.00 $2,185.00 $2,075.75 $2,185.00 $2,185.00 2026-03-11
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 5 5 $2,096.20 $2,096.20 $1,991.39 $2,096.20 $2,096.20 2026-03-11
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 5 5 $2,092.00 $2,092.00 $1,987.40 $2,092.00 $2,092.00 2026-03-11
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 5 5 $2,025.00 $2,025.00 $1,923.75 $2,025.00 $2,025.00 2026-03-11
43247 HCPCS Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using … 5 5 $2,022.00 $2,022.00 $1,920.90 $2,022.00 $2,022.00 2026-03-11
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 10 5 $2,091.05 $2,091.05 $1,256.00 $2,860.00 $2,019.55 2026-03-11
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 5 5 $1,990.00 $1,990.00 $1,890.50 $1,990.00 $1,990.00 2026-03-11
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 10 5 $2,032.03 $2,032.03 $1,060.79 $2,947.44 $1,958.35 2026-03-11
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 5 5 $1,950.00 $1,950.00 $1,852.50 $1,950.00 $1,950.00 2026-03-11
28190 HCPCS Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 5 5 $1,900.00 $1,900.00 $1,805.00 $1,900.00 $1,900.00 2026-03-11
5404220_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $1,985.00 $1,985.00 $1,885.75 $1,885.75 $1,885.75 2026-03-11
90377 HCPCS Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle 5 5 $1,877.49 $1,877.49 $1,783.62 $1,877.49 $1,877.49 2026-03-11
12006 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 5 5 $1,825.00 $1,825.00 $1,733.75 $1,825.00 $1,825.00 2026-03-11
12007 HCPCS Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 5 5 $1,825.00 $1,825.00 $1,733.75 $1,825.00 $1,825.00 2026-03-11
12017 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.… 5 5 $1,820.00 $1,820.00 $1,729.00 $1,820.00 $1,820.00 2026-03-11
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 15 5 $1,809.00 $1,809.00 $161.31 $1,809.00 $1,809.00 2026-03-11
5404236_1 CDM Room & Board - Private (one Bed) - General Classification 1 1 $1,890.00 $1,890.00 $1,795.50 $1,795.50 $1,795.50 2026-03-11
4634657_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $1,785.00 $1,785.00 $1,695.75 $1,695.75 $1,695.75 2026-03-11
74270 HCPCS Single Contrast X-ray Of Large Intestine 5 5 $1,685.00 $1,685.00 $1,600.75 $1,685.00 $1,685.00 2026-03-11
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 5 5 $1,600.00 $1,600.00 $1,520.00 $1,600.00 $1,600.00 2026-03-11
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 5 5 $1,600.00 $1,600.00 $1,520.00 $1,600.00 $1,600.00 2026-03-11
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 5 5 $1,600.00 $1,600.00 $1,520.00 $1,600.00 $1,600.00 2026-03-11
93307 HCPCS Ultrasound Of Heart 5 5 $1,525.00 $1,525.00 $1,448.75 $1,525.00 $1,525.00 2026-03-11
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 5 5 $1,500.00 $1,500.00 $1,425.00 $1,500.00 $1,500.00 2026-03-11
J0248 HCPCS Injection, Remdesivir, 1 Mg 10 5 $1,511.80 $1,511.80 $1,284.40 $1,671.59 $1,470.01 2026-03-11
86366 HCPCS Test For Muscle-specific Kinase Antibody 5 5 $1,441.44 $1,441.44 $265.23 $1,441.44 $1,369.37 2026-03-11
94662 HCPCS Therapy Procedure Using A Negative Pressure Ventilator 5 5 $1,350.00 $1,350.00 $1,282.50 $1,350.00 $1,350.00 2026-03-11
36589 HCPCS Removal Of Tunneled Central Venous Tube 5 5 $1,250.00 $1,250.00 $1,187.50 $1,250.00 $1,250.00 2026-03-11
12031 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 5 5 $1,235.00 $1,235.00 $1,173.25 $1,235.00 $1,235.00 2026-03-11
2120840_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $1,260.00 $1,260.00 $1,197.00 $1,197.00 $1,197.00 2026-03-11
2120839_1 CDM Room & Board - Private (one Bed) - General Classification 1 1 $1,260.00 $1,260.00 $1,197.00 $1,197.00 $1,197.00 2026-03-11
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 15 5 $1,164.00 $1,164.00 $111.00 $1,164.00 $1,164.00 2026-03-11
11200 HCPCS Removal Of Skin Tag, 1-15 Skin Tags 10 5 $1,113.50 $1,113.50 $64.00 $2,100.00 $1,057.83 2026-03-11
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 5 5 $1,010.00 $1,010.00 $959.50 $1,010.00 $1,010.00 2026-03-11
99291 HCPCS Critical Care, First 30-74 Minutes 10 5 $1,053.50 $1,053.50 $188.24 $1,710.00 $1,000.82 2026-03-11
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 5 5 $995.00 $995.00 $945.25 $995.00 $995.00 2026-03-11
70553 HCPCS MRI Scan Of Brain Before And After Contrast 5 5 $995.00 $995.00 $945.25 $995.00 $995.00 2026-03-11
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 5 5 $995.00 $995.00 $945.25 $995.00 $995.00 2026-03-11
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 5 5 $995.00 $995.00 $945.25 $995.00 $995.00 2026-03-11
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 5 5 $995.00 $995.00 $945.25 $995.00 $995.00 2026-03-11
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 10 5 $1,014.90 $1,014.90 $945.25 $1,034.80 $995.00 2026-03-11
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 5 5 $995.00 $995.00 $945.25 $995.00 $995.00 2026-03-11
73720 HCPCS MRI Scan Of Leg Before And After Contrast 15 5 $995.00 $995.00 $945.25 $1,034.80 $995.00 2026-03-11
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 5 5 $995.00 $995.00 $945.25 $995.00 $995.00 2026-03-11
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 5 5 $995.00 $995.00 $945.25 $995.00 $995.00 2026-03-11
30903 HCPCS Complex Control Of Nose Bleed 5 5 $979.00 $979.00 $930.05 $979.00 $979.00 2026-03-11
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 5 5 $975.00 $975.00 $926.25 $975.00 $975.00 2026-03-11
12015 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6… 5 5 $965.00 $965.00 $916.75 $965.00 $965.00 2026-03-11
26770 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation 5 5 $965.00 $965.00 $916.75 $965.00 $965.00 2026-03-11
12016 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.… 5 5 $965.00 $965.00 $916.75 $965.00 $965.00 2026-03-11
31720 HCPCS Insertion Of Tube Into Airway For Aspiration Of Secretions 5 5 $952.68 $952.68 $905.05 $952.68 $952.68 2026-03-11
70551 HCPCS MRI Scan Of Brain Without Contrast 5 5 $950.00 $950.00 $902.50 $950.00 $950.00 2026-03-11
73218 HCPCS MRI Scan Of Arm Without Contrast 10 5 $969.00 $969.00 $902.50 $988.00 $950.00 2026-03-11
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 5 5 $950.00 $950.00 $902.50 $950.00 $950.00 2026-03-11
74181 HCPCS MRI Scan Of Abdomen Without Contrast 5 5 $950.00 $950.00 $902.50 $950.00 $950.00 2026-03-11
73718 HCPCS MRI Scan Of Leg Without Contrast 10 5 $969.00 $969.00 $902.50 $988.00 $950.00 2026-03-11
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 10 5 $950.00 $950.00 $902.50 $950.00 $950.00 2026-03-11
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 20 5 $950.00 $950.00 $902.50 $988.00 $950.00 2026-03-11
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 5 5 $950.00 $950.00 $902.50 $950.00 $950.00 2026-03-11
72195 HCPCS MRI Scan Of Pelvis Without Contrast 5 5 $950.00 $950.00 $902.50 $950.00 $950.00 2026-03-11
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 5 5 $950.00 $950.00 $902.50 $950.00 $950.00 2026-03-11
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 5 5 $950.00 $950.00 $902.50 $950.00 $950.00 2026-03-11
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 10 5 $949.00 $949.00 $855.00 $998.00 $924.05 2026-03-11
J1442 HCPCS Injection, Filgrastim (g-csf), Excludes Biosimilars, 1 Microgram 10 5 $926.79 $926.79 $739.41 $1,075.24 $899.90 2026-03-11
11765 HCPCS Removal Of Skin Of Fingernail Or Toenail 5 5 $891.80 $891.80 $847.21 $891.80 $891.80 2026-03-11
11400 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 10 5 $930.00 $930.00 $70.50 $1,650.00 $883.50 2026-03-11
11603 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 10 5 $920.00 $920.00 $152.06 $1,600.00 $874.00 2026-03-11
Q5101 HCPCS Injection, Filgrastim-sndz, Biosimilar, (zarxio), 1 Microgram 5 5 $856.01 $856.01 $813.21 $856.01 $856.01 2026-03-11
77075 HCPCS Complete X-ray Of Body Bones 5 5 $846.00 $846.00 $803.70 $846.00 $846.00 2026-03-11
94621 HCPCS Test For Exercise-induced Heart And Lung Stress 5 5 $825.00 $825.00 $783.75 $825.00 $825.00 2026-03-11
24640 HCPCS Closed Treatment Of Dislocated Forearm Bone On Thumb Side At Elbow With Manipula… 5 5 $815.00 $815.00 $774.25 $815.00 $815.00 2026-03-11
S9485 HCPCS Crisis Intervention Mental Health Services, Per Diem 5 5 $810.00 $810.00 $769.50 $810.00 $810.00 2026-03-11
74400 HCPCS Imaging Of Urinary Tract With Injection Of Contrast Into A Vein 5 5 $806.00 $806.00 $765.70 $806.00 $806.00 2026-03-11
17110 HCPCS Destruction Of Skin Growth, 1-14 Growths 10 5 $847.50 $847.50 $57.71 $1,532.00 $805.13 2026-03-11
93925 HCPCS Ultrasound Of Leg Arteries Or Artery Grafts 5 5 $805.00 $805.00 $764.75 $805.00 $805.00 2026-03-11
93922 HCPCS Ultrasound Study Of Arm And Leg Arteries 5 5 $805.00 $805.00 $764.75 $805.00 $805.00 2026-03-11
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 5 5 $805.00 $805.00 $764.75 $805.00 $805.00 2026-03-11
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 5 5 $805.00 $805.00 $764.75 $805.00 $805.00 2026-03-11
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 5 5 $795.00 $795.00 $755.25 $795.00 $795.00 2026-03-11
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 5 5 $795.00 $795.00 $755.25 $795.00 $795.00 2026-03-11
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 5 5 $795.00 $795.00 $755.25 $795.00 $795.00 2026-03-11
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 5 5 $795.00 $795.00 $755.25 $795.00 $795.00 2026-03-11
73702 HCPCS CT Scan Of Leg Before And After Contrast 10 5 $810.90 $810.90 $755.25 $826.80 $795.00 2026-03-11
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 5 5 $795.00 $795.00 $755.25 $795.00 $795.00 2026-03-11
70488 HCPCS CT Scan Of Face Before And After Contrast 5 5 $795.00 $795.00 $755.25 $795.00 $795.00 2026-03-11
71270 HCPCS CT Scan Of Chest Before And After Contrast 5 5 $795.00 $795.00 $755.25 $795.00 $795.00 2026-03-11
73202 HCPCS CT Scan Of Arm Before And After Contrast 10 5 $810.90 $810.90 $755.25 $826.80 $795.00 2026-03-11
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 5 5 $795.00 $795.00 $755.25 $795.00 $795.00 2026-03-11
5321614_1 CDM Transport - Vascular Studies 5 5 $787.00 $787.00 $747.65 $787.00 $787.00 2026-03-11
84445 HCPCS Thyroid Stimulating Immune Globulins (thyroid Related Protein) Level 5 5 $817.44 $817.44 $415.75 $817.44 $776.57 2026-03-11
74160 HCPCS CT Scan Of Abdomen With Contrast 5 5 $775.00 $775.00 $736.25 $775.00 $775.00 2026-03-11
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 5 5 $775.00 $775.00 $736.25 $775.00 $775.00 2026-03-11
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 5 5 $775.00 $775.00 $736.25 $775.00 $775.00 2026-03-11
70460 HCPCS CT Scan Head Or Brain With Contrast 5 5 $775.00 $775.00 $736.25 $775.00 $775.00 2026-03-11
73201 HCPCS CT Scan Of Arm With Contrast 10 5 $790.50 $790.50 $736.25 $806.00 $775.00 2026-03-11
72193 HCPCS CT Scan Of Pelvis With Contrast 5 5 $775.00 $775.00 $736.25 $775.00 $775.00 2026-03-11
71260 HCPCS CT Scan Of Chest With Contrast 5 5 $775.00 $775.00 $736.25 $775.00 $775.00 2026-03-11
72132 HCPCS CT Scan Of Lower Spine With Contrast 5 5 $775.00 $775.00 $736.25 $775.00 $775.00 2026-03-11
73701 HCPCS CT Scan Of Leg With Contrast Material 20 5 $775.00 $775.00 $736.25 $806.00 $775.00 2026-03-11
72131 HCPCS CT Scan Of Lower Spine Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
72125 HCPCS CT Scan Of Upper Spine Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
70486 HCPCS CT Scan Of Face Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
74150 HCPCS CT Scan Of Abdomen Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
70450 HCPCS CT Scan Head Or Brain Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
73700 HCPCS CT Scan Of Leg Without Contrast 20 5 $766.00 $766.00 $727.70 $796.64 $766.00 2026-03-11
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
73200 HCPCS CT Scan Of Arm Without Contrast 15 5 $766.00 $766.00 $727.70 $796.64 $766.00 2026-03-11
71250 HCPCS CT Scan Of Chest Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
72192 HCPCS CT Scan Of Pelvis Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
72128 HCPCS CT Scan Of Middle Spine Without Contrast 5 5 $766.00 $766.00 $727.70 $766.00 $766.00 2026-03-11
70487 HCPCS CT Scan Of Face With Contrast 5 5 $754.90 $754.90 $717.16 $754.90 $754.90 2026-03-11
94681 HCPCS Test To Measure Exhaled Air And Carbon Dioxide For Evaluation Of Lung Function 5 5 $750.00 $750.00 $712.50 $750.00 $750.00 2026-03-11
5404238_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $775.00 $775.00 $736.25 $736.25 $736.25 2026-03-11
74240 HCPCS Single Contrast X-ray Of Upper Digestive Tract 5 5 $714.00 $714.00 $678.30 $714.00 $714.00 2026-03-11
10120 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Simple 10 5 $748.00 $748.00 $94.34 $1,270.00 $710.60 2026-03-11
J1610 HCPCS Injection, Glucagon Hydrochloride, Per 1 Mg 20 5 $715.09 $715.09 $272.72 $725.06 $709.07 2026-03-11
87506 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 5 5 $707.89 $707.89 $672.50 $1,861.68 $707.89 2026-03-11
90675 HCPCS Rabies Vaccine For Injection Into Muscle 5 5 $687.05 $687.05 $652.70 $687.05 $687.05 2026-03-11
93976 HCPCS Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 5 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
93971 HCPCS Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers 10 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
93320 HCPCS Ultrasound Of Heart Blood Flow, Valves And Chambers 5 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
93325 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate And Valve Function 5 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
93975 HCPCS Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 5 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
93930 HCPCS Ultrasound Of Arm Arteries Or Artery Grafts 5 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
93926 HCPCS Ultrasound Of One Leg Arteries Or Artery Grafts 10 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
93931 HCPCS Ultrasound Of One Arm Arteries Or Artery Grafts 5 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 5 5 $686.00 $686.00 $651.70 $686.00 $686.00 2026-03-11
99283 HCPCS Emergency Department Visit With Low Level Of Medical Decision Making 15 5 $685.00 $685.00 $65.26 $685.00 $685.00 2026-03-11
12005 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 10 5 $695.00 $695.00 $81.63 $960.00 $660.25 2026-03-11
87633 HCPCS Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 5 5 $644.80 $644.80 $612.56 $2,687.40 $644.80 2026-03-11
6331190_1 CDM Santyl Ointment 5 5 $637.26 $637.26 $605.40 $637.26 $637.26 2026-03-11
70552 HCPCS MRI Scan Of Brain With Contrast 5 5 $630.00 $630.00 $598.50 $630.00 $630.00 2026-03-11
73220 HCPCS MRI Scan Of Arm Before And After Contrast 5 5 $625.00 $625.00 $593.75 $625.00 $625.00 2026-03-11
36430 HCPCS Transfusion Of Blood Or Blood Products 30 5 $632.50 $632.50 $80.75 $850.00 $616.25 2026-03-11
30901 HCPCS Simple Control Of Nose Bleed 10 5 $638.50 $638.50 $45.88 $697.00 $606.58 2026-03-11
L0637 HCPCS Lumbar-sacral Orthosis, Sagittal-coronal Control, With Rigid Anterior And Poster… 5 5 $602.30 $602.30 $572.19 $602.30 $602.30 2026-03-11
20610 HCPCS Aspiration And/or Injection Of Fluid From Large Joint 15 5 $594.72 $594.72 $380.00 $720.00 $594.72 2026-03-11
81270 HCPCS Gene Analysis (Janus Kinase 2) Variant 5 5 $624.00 $624.00 $571.96 $624.00 $592.80 2026-03-11
5404225_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $624.00 $624.00 $592.80 $592.80 $592.80 2026-03-11
69209 HCPCS Removal Of Impacted Ear Wax By Washing 5 5 $585.00 $585.00 $555.75 $585.00 $585.00 2026-03-11
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 5 5 $567.84 $567.84 $539.45 $1,461.90 $567.84 2026-03-11
65235 HCPCS Removal Of Foreign Body In Eye Or Lens 5 5 $560.00 $560.00 $532.00 $560.00 $560.00 2026-03-11
29065 HCPCS Application Of Shoulder To Hand Cast 5 5 $556.40 $556.40 $528.58 $556.40 $556.40 2026-03-11
29085 HCPCS Application Of Hand And Lower Forearm Cast 10 5 $568.16 $568.16 $494.00 $616.32 $552.75 2026-03-11
10160 HCPCS Aspiration Of Abscess, Blood, Or Cyst 5 5 $550.00 $550.00 $522.50 $550.00 $550.00 2026-03-11
A9577 HCPCS Injection, Gadobenate Dimeglumine (multihance), Per Ml 5 5 $550.00 $550.00 $522.50 $550.00 $550.00 2026-03-11
81403 HCPCS Molecular Pathology Procedure Level 4 Genetic Analysis 5 5 $549.12 $549.12 $521.66 $1,016.97 $549.12 2026-03-11
4441942_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $575.00 $575.00 $546.25 $546.25 $546.25 2026-03-11
11624 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4.0 … 5 5 $540.00 $540.00 $513.00 $540.00 $540.00 2026-03-11
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 5 5 $540.00 $540.00 $513.00 $540.00 $540.00 2026-03-11
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 5 5 $540.00 $540.00 $513.00 $540.00 $540.00 2026-03-11
P9040 HCPCS Red Blood Cells, Leukocytes Reduced, Irradiated, Each Unit 5 5 $533.52 $533.52 $506.84 $533.52 $533.52 2026-03-11
11600 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 10 5 $551.50 $551.50 $100.42 $950.00 $523.92 2026-03-11
29075 HCPCS Application Of Elbow To Finger Cast 15 5 $520.00 $520.00 $53.68 $615.32 $520.00 2026-03-11
81256 HCPCS Gene Analysis (hemochromatosis) Common Variants 5 5 $546.00 $546.00 $356.87 $546.00 $518.70 2026-03-11
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 5 5 $518.00 $518.00 $492.10 $518.00 $518.00 2026-03-11
P9021 HCPCS Red Blood Cells, Each Unit 5 5 $514.80 $514.80 $489.06 $514.80 $514.80 2026-03-11
11750 HCPCS Permanent Removal Fingernail Or Toenail 5 5 $511.00 $511.00 $485.45 $511.00 $511.00 2026-03-11
20605 HCPCS Aspiration And/or Injection Of Fluid From Medium Joint 10 5 $521.50 $521.50 $413.25 $608.00 $506.30 2026-03-11
12004 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 10 5 $510.50 $510.50 $65.30 $690.00 $484.98 2026-03-11
90670 HCPCS Pneumococcal Vaccine, 13-valent 5 5 $482.48 $482.48 $458.36 $482.48 $482.48 2026-03-11
82131 HCPCS Amino Acid Analysis, Quantitative, Each Specimen 5 5 $498.16 $498.16 $114.48 $498.16 $473.25 2026-03-11
85220 HCPCS Clotting Factor V (AcG Or Proaccelerin) Measurement 5 5 $492.96 $492.96 $87.01 $492.96 $468.31 2026-03-11
29580 HCPCS Strapping, Unna Boot 30 5 $464.00 $464.00 $380.00 $928.00 $464.00 2026-03-11
M0222 HCPCS Intravenous Injection, Bebtelovimab, Includes Injection And Post Administration … 5 5 $460.10 $460.10 $437.10 $460.10 $460.10 2026-03-11
76377 HCPCS 3d Radiographic Procedure With Computerized Image Postprocessing 5 5 $460.00 $460.00 $437.00 $460.00 $460.00 2026-03-11
83013 HCPCS Breath Test Analysis For Helicobacter Pylori 5 5 $478.40 $478.40 $322.25 $478.40 $454.48 2026-03-11
72052 HCPCS X-ray Of Upper Spine, 6 Or More Views 5 5 $454.00 $454.00 $431.30 $454.00 $454.00 2026-03-11
74220 HCPCS Single Contrast X-ray Of Esophagus 5 5 $453.00 $453.00 $430.35 $453.00 $453.00 2026-03-11
76942 HCPCS Ultrasonic Guidance For Needle Placement 5 5 $451.00 $451.00 $428.45 $451.00 $451.00 2026-03-11
94728 HCPCS Test To Measure Resistance Of The Airways And Lungs To Differing Frequencies 5 5 $450.00 $450.00 $427.50 $450.00 $450.00 2026-03-11
94669 HCPCS Therapy Procedure To Clear Airway Using An Inflatable Vest 5 5 $450.00 $450.00 $427.50 $450.00 $450.00 2026-03-11
17250 HCPCS Application Of Chemical To Stop Tissue Regrowth In Wound 5 5 $450.00 $450.00 $427.50 $450.00 $450.00 2026-03-11
99282 HCPCS Emergency Department Visit With Straightforward Medical Decision Making 15 5 $445.00 $445.00 $38.05 $445.00 $445.00 2026-03-11
74022 HCPCS X-ray Series Of Abdomen With Single X-ray Of Chest 5 5 $442.00 $442.00 $419.90 $442.00 $442.00 2026-03-11
11760 HCPCS Repair Of Fingernail Or Toenail Bed 5 5 $440.00 $440.00 $418.00 $440.00 $440.00 2026-03-11
51700 HCPCS Simple Bladder Irrigation And/or Instillation 5 5 $430.00 $430.00 $408.50 $430.00 $430.00 2026-03-11
94660 HCPCS Therapy Procedure Using A Positive Pressure Ventilator 15 5 $430.00 $430.00 $380.00 $450.00 $430.00 2026-03-11
12014 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1… 10 5 $450.00 $450.00 $65.32 $565.00 $427.50 2026-03-11
6044775_1 CDM Tr M0247 Intravenous Infusion, Sotrovimab, Includes Infusion And Post Administra… 1 1 $450.00 $450.00 $427.50 $427.50 $427.50 2026-03-11
C1751 HCPCS Catheter, Infusion, Inserted Peripherally, Centrally Or Midline (other Than Hemo… 5 5 $425.00 $425.00 $403.75 $425.00 $425.00 2026-03-11
81206 HCPCS Translocation Analysis (bcr/abl1) Major Breakpoint 5 5 $419.12 $419.12 $398.16 $687.19 $419.12 2026-03-11
96125 HCPCS Test To Assess The Ability To Complete Specific Functional Tasks Applicable To E… 5 5 $416.00 $416.00 $395.20 $416.00 $416.00 2026-03-11
72110 HCPCS X-ray Of Lower And Sacral Spine, Minimum Of 4 Views 5 5 $416.00 $416.00 $395.20 $416.00 $416.00 2026-03-11
12013 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6… 10 5 $429.50 $429.50 $50.63 $565.00 $408.02 2026-03-11
12011 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5… 10 5 $424.00 $424.00 $49.48 $565.00 $402.80 2026-03-11
94375 HCPCS Test To Measure Rate Of Airflow 10 5 $420.00 $420.00 $85.50 $750.00 $401.25 2026-03-11
30905 HCPCS Initial Control Of Nose Bleed And Insertion Of Packing 5 5 $400.00 $400.00 $380.00 $400.00 $400.00 2026-03-11
12002 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 10 5 $413.50 $413.50 $52.29 $545.00 $392.82 2026-03-11
72120 HCPCS X-ray Lower And Sacral Spine, 2-3 Views Bending Views 5 5 $391.00 $391.00 $371.45 $391.00 $391.00 2026-03-11
72050 HCPCS X-ray Of Upper Spine, 4-5 Views 5 5 $386.00 $386.00 $366.70 $386.00 $386.00 2026-03-11
26010 HCPCS Simple Drainage Of Abscess Of Finger 5 5 $385.00 $385.00 $365.75 $385.00 $385.00 2026-03-11
73050 HCPCS X-ray Of Both Collar Bones Joints 5 5 $384.00 $384.00 $364.80 $384.00 $384.00 2026-03-11
82507 HCPCS Citrate Level 5 5 $403.52 $403.52 $112.18 $403.52 $383.34 2026-03-11
29515 HCPCS Application Of Short Leg Splint From Calf To Foot 15 5 $380.00 $380.00 $45.66 $385.00 $380.00 2026-03-11
29105 HCPCS Application Of Lower And Upper Arm Splint 5 5 $380.00 $380.00 $361.00 $380.00 $380.00 2026-03-11
81376 HCPCS Hla Class Ii Typing Low Resolution One Locus 5 5 $378.56 $378.56 $359.63 $462.68 $378.56 2026-03-11
94727 HCPCS Test To Determine Lung Volumes Using Gas Dilution Or Washout 5 5 $375.00 $375.00 $356.25 $375.00 $375.00 2026-03-11
94060 HCPCS Test To Measure Expiratory Airflow And Volume Changes Before And After Medicatio… 10 5 $390.00 $390.00 $28.50 $750.00 $371.25 2026-03-11
81596 HCPCS Biochemical Assays For Evaluation Of Chronic Hepatitis C Virus Infection 5 5 $390.00 $390.00 $281.54 $390.00 $370.50 2026-03-11
84166 HCPCS Protein Measurement, Body Fluid 5 5 $381.68 $381.68 $68.05 $381.68 $362.60 2026-03-11
73564 HCPCS X-ray Of Knee, 4 Or More Views 15 5 $362.00 $362.00 $343.90 $376.48 $362.00 2026-03-11
20612 HCPCS Aspiration And/or Injection Of Cyst Of Tendon 5 5 $360.00 $360.00 $342.00 $360.00 $360.00 2026-03-11
5454240_1 CDM Total Parenteral Nutrition [sfks] 5 5 $358.80 $358.80 $340.86 $358.80 $358.80 2026-03-11
29425 HCPCS Application Of Walking Cast Covering Below Knee To Toe 5 5 $358.00 $358.00 $340.10 $358.00 $358.00 2026-03-11
84482 HCPCS Thyroid Hormone, T3 Measurement, Reverse 5 5 $373.36 $373.36 $58.84 $373.36 $354.69 2026-03-11
70110 HCPCS X-ray Of Lower Jaw, Minimum Of 4 Views 5 5 $353.00 $353.00 $335.35 $353.00 $353.00 2026-03-11
70260 HCPCS X-ray Of Skull, Minimum Of 4 Views 5 5 $352.00 $352.00 $334.40 $352.00 $352.00 2026-03-11
83883 HCPCS Nephelometry, Test Method Using Light 5 5 $370.24 $370.24 $50.35 $370.24 $351.73 2026-03-11
88189 HCPCS Flow Cytometry Technique For DNA Or Cell Analysis, 16 Or More Markers 10 5 $362.44 $362.44 $256.88 $454.48 $351.08 2026-03-11
30300 HCPCS Removal Of Foreign Body In Nose 5 5 $350.00 $350.00 $332.50 $350.00 $350.00 2026-03-11
97597 HCPCS Removal Of Tissue From Wound, 20.0 Sq Cm Or Less 5 5 $350.00 $350.00 $332.50 $350.00 $350.00 2026-03-11
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 5 5 $346.09 $346.09 $328.79 $346.09 $346.09 2026-03-11
80189 HCPCS Measurement Of Itraconazole 5 5 $364.00 $364.00 $98.68 $364.00 $345.80 2026-03-11
93225 HCPCS Electrocardiogram (ecg) 2-day Continuous 25 5 $340.00 $340.00 $243.20 $369.20 $340.00 2026-03-11
80145 HCPCS Measurement Of Adalimumab 5 5 $356.72 $356.72 $137.59 $356.72 $338.88 2026-03-11
72072 HCPCS X-ray Of Middle Spine, 3 Views 5 5 $338.00 $338.00 $321.10 $338.00 $338.00 2026-03-11
83789 HCPCS Mass Spectrometry (laboratory Testing Method) 5 5 $353.60 $353.60 $85.25 $353.60 $335.92 2026-03-11
85306 HCPCS Protein S (clotting Inhibitor) Measurement 5 5 $353.60 $353.60 $54.17 $353.60 $335.92 2026-03-11
29405 HCPCS Application Of Short Leg Cast 5 5 $335.00 $335.00 $318.25 $335.00 $335.00 2026-03-11
6444191_1 CDM Central Venous Cath Kit 1 1 $352.40 $352.40 $334.78 $334.78 $334.78 2026-03-11
77080 HCPCS Dxa Bone Density Measurement Of Hip, Pelvis, Spine 5 5 $332.00 $332.00 $315.40 $332.00 $332.00 2026-03-11
87252 HCPCS Tissue Culture Inoculation For Virus Isolation 5 5 $348.40 $348.40 $90.83 $348.40 $330.98 2026-03-11
12001 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 10 5 $345.50 $345.50 $40.08 $460.00 $328.23 2026-03-11
70220 HCPCS X-ray Of Paranasal Sinus, Minimum Of 3 Views 5 5 $325.00 $325.00 $308.75 $325.00 $325.00 2026-03-11
99292 HCPCS Critical Care, Each Additional 30 Minutes 10 5 $340.50 $340.50 $94.72 $433.00 $323.48 2026-03-11
86787 HCPCS Analysis For Antibody To Varicella-zoster Virus (chicken Pox) 5 5 $340.08 $340.08 $43.80 $340.08 $323.08 2026-03-11
87798 HCPCS Detection Test By Nucleic Acid For Organism, Amplified Probe Technique 15 5 $358.80 $358.80 $113.13 $474.17 $322.40 2026-03-11
72080 HCPCS X-ray Of Middle And Lower Spine, 2 Views 5 5 $322.00 $322.00 $305.90 $322.00 $322.00 2026-03-11
84145 HCPCS Procalcitonin (hormone) Level 5 5 $338.00 $338.00 $92.00 $338.00 $321.10 2026-03-11
41250 HCPCS Repair Of Lacerated Floor Of Mouth And/or Tongue, 2.5 Cm Or Less 5 5 $320.00 $320.00 $304.00 $320.00 $320.00 2026-03-11
70150 HCPCS X-ray Of Face Bones, Minimum Of 3 Views 5 5 $317.00 $317.00 $301.15 $317.00 $317.00 2026-03-11
Q9967 HCPCS Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml 10 5 $330.00 $330.00 $104.50 $550.00 $316.25 2026-03-11
85303 HCPCS Protein C Antigen (clotting Inhibitor) Measurement 5 5 $331.76 $331.76 $45.92 $331.76 $315.17 2026-03-11
29130 HCPCS Application Of Nonmoveable Finger Splint 10 5 $330.00 $330.00 $23.75 $380.00 $313.50 2026-03-11
81241 HCPCS Gene Analysis (coagulation Factor V) Leiden Variant 5 5 $328.64 $328.64 $241.12 $328.64 $312.21 2026-03-11
81382 HCPCS Hla Class Ii Typing High Resolution One Locus 10 5 $297.44 $297.44 $176.85 $505.50 $309.26 2026-03-11
70330 HCPCS X-ray Of Jaw Joints On Both Sides Of Mouth 5 5 $305.00 $305.00 $289.75 $305.00 $305.00 2026-03-11
94664 HCPCS Evaluation Of Use Of Breathing Device 10 5 $314.00 $314.00 $240.35 $375.00 $304.62 2026-03-11
82306 HCPCS Vitamin D-3 Level 10 5 $318.24 $318.24 $92.35 $324.48 $302.33 2026-03-11
86480 HCPCS Tuberculosis Test, Gamma Interferon 5 5 $318.24 $318.24 $197.25 $318.24 $302.33 2026-03-11
83090 HCPCS Homocysteine (amino Acid) Level 5 5 $317.20 $317.20 $56.84 $317.20 $301.34 2026-03-11
83970 HCPCS Parathormone (parathyroid Hormone) Level 5 5 $316.16 $316.16 $130.51 $316.16 $300.35 2026-03-11
94729 HCPCS Test To Examine How Well The Lungs Exchange Gases 5 5 $300.00 $300.00 $285.00 $300.00 $300.00 2026-03-11
94618 HCPCS Test For Exercise-induced Lung Stress 5 5 $300.00 $300.00 $285.00 $300.00 $300.00 2026-03-11
94799 HCPCS Other Service Or Procedure On Lung 5 5 $300.00 $300.00 $285.00 $300.00 $300.00 2026-03-11
70140 HCPCS X-ray Of Face Bones, 1-2 Views 5 5 $300.00 $300.00 $285.00 $300.00 $300.00 2026-03-11
80197 HCPCS Tacrolimus Level 5 5 $310.96 $310.96 $42.69 $310.96 $295.41 2026-03-11
5404229_1 CDM Room & Board - Semi-private (two Beds) - General Classification 1 1 $310.00 $310.00 $294.50 $294.50 $294.50 2026-03-11
86041 HCPCS Test For Acetylcholine Receptor Binding Antibody 5 5 $309.19 $309.19 $56.89 $309.19 $293.73 2026-03-11
72100 HCPCS X-ray Of Lower And Sacral Spine, 2-3 Views 5 5 $293.00 $293.00 $278.35 $293.00 $293.00 2026-03-11
96360 HCPCS Infusion Into A Vein For Hydration, 31-60 Minutes 10 5 $302.00 $302.00 $213.75 $379.00 $292.52 2026-03-11
73502 HCPCS X-ray Of Hip, 2-3 Views 15 5 $290.00 $290.00 $204.25 $290.00 $290.00 2026-03-11
97167 HCPCS Evaluation For Occupational Therapy, Typically 1 Hour 5 5 $290.00 $290.00 $275.50 $290.00 $290.00 2026-03-11
29125 HCPCS Application Of Nonmoveable Forearm To Hand Splint 20 5 $304.16 $304.16 $37.51 $380.00 $288.95 2026-03-11
72020 HCPCS X-ray Of Spine, 1 View 5 5 $287.00 $287.00 $272.65 $287.00 $287.00 2026-03-11
99281 HCPCS Emergency Department Visit For Problem That May Not Require Health Care Professi… 20 5 $285.00 $285.00 $10.36 $285.00 $285.00 2026-03-11
29126 HCPCS Application Of Moveable Or Hinged Forearm To Hand Splint 5 5 $280.00 $280.00 $266.00 $280.00 $280.00 2026-03-11
30906 HCPCS Subsequent Control Of Nosebleed And Insertion Of Packing 5 5 $275.00 $275.00 $261.25 $275.00 $275.00 2026-03-11
92960 HCPCS External Shock To Heart To Regulate Heart Beat 5 5 $270.00 $270.00 $256.50 $270.00 $270.00 2026-03-11
16020 HCPCS Dressing Change Or Removal Of Burn Tissue, Less Than 5% Of Total Body Surface 10 5 $283.00 $283.00 $49.83 $445.00 $268.85 2026-03-11
83921 HCPCS Organic Acid Level 10 5 $328.64 $328.64 $58.45 $381.68 $268.71 2026-03-11
17000 HCPCS Destruction Of Precancer Skin Growth, 1 Growth 10 5 $282.50 $282.50 $44.27 $468.00 $268.38 2026-03-11
72040 HCPCS X-ray Of Upper Spine, 2-3 Views 5 5 $268.00 $268.00 $254.60 $268.00 $268.00 2026-03-11
29505 HCPCS Application Of Long Leg Splint From Thigh To Ankle Or Toe 10 5 $280.00 $280.00 $49.93 $280.00 $266.00 2026-03-11
82672 HCPCS Estrogen Analysis, Total 5 5 $278.72 $278.72 $60.48 $278.72 $264.78 2026-03-11
80307 HCPCS Testing For Presence Of Drug, By Chemistry Analyzers 15 5 $265.20 $265.20 $162.86 $572.00 $262.08 2026-03-11
97163 HCPCS Evaluation For Physical Therapy, Typically 45 Minutes 5 5 $260.00 $260.00 $247.00 $260.00 $260.00 2026-03-11
87385 HCPCS Detection Test By Immunoassay Technique For Histoplasma Capsulatum (parasite) 5 5 $271.44 $271.44 $35.97 $271.44 $257.87 2026-03-11
J0165 HCPCS Injection, Epinephrine, Not Otherwise Specified, 0.1 Mg 10 5 $270.45 $270.45 $35.17 $503.88 $257.86 2026-03-11
76770 HCPCS Complete Ultrasound Scan Behind Abdominal Cavity 5 5 $254.00 $254.00 $241.30 $254.00 $254.00 2026-03-11
76700 HCPCS Complete Ultrasound Scan Of Abdomen 5 5 $254.00 $254.00 $241.30 $254.00 $254.00 2026-03-11
73562 HCPCS X-ray Of Knee, 3 Views 15 5 $254.00 $254.00 $241.30 $264.16 $254.00 2026-03-11
87799 HCPCS Detection Test By Nucleic Acid For Organism, Quantification 10 5 $419.12 $419.12 $110.94 $579.28 $253.56 2026-03-11
73080 HCPCS X-ray Of Elbow, Minimum Of 3 Views 15 5 $253.00 $253.00 $240.35 $263.12 $253.00 2026-03-11
76706 HCPCS Ultrasound Scan Of Abdominal Aorta 5 5 $250.00 $250.00 $237.50 $250.00 $250.00 2026-03-11
70160 HCPCS X-ray Of Nose Bones, Minimum Of 3 Views 5 5 $248.00 $248.00 $235.60 $248.00 $248.00 2026-03-11
85210 HCPCS Clotting Factor Ii Prothrombin, Measurement 5 5 $255.96 $255.96 $33.22 $255.96 $243.16 2026-03-11
82670 HCPCS Measurement Of Total Estradiol (hormone) 5 5 $255.84 $255.84 $71.48 $255.84 $243.05 2026-03-11
71120 HCPCS X-ray Of Chest Bone, Minimum Of 2 Views 5 5 $243.00 $243.00 $230.85 $243.00 $243.00 2026-03-11
72202 HCPCS X-ray Of Joint Between Lower Spine And Hip Bone, 3 Or More Views 5 5 $243.00 $243.00 $230.85 $243.00 $243.00 2026-03-11
90732 HCPCS Pneumococcal Vaccine, 23-valent 5 5 $240.49 $240.49 $228.47 $240.49 $240.49 2026-03-11
83519 HCPCS Measurement Of Substance Using Immunoassay Technique, By Radioimmunoassay 20 5 $459.53 $459.53 $42.29 $1,305.20 $240.16 2026-03-11
73110 HCPCS X-ray Of Wrist, Minimum Of 3 Views 15 5 $240.00 $240.00 $228.00 $249.60 $240.00 2026-03-11
51701 HCPCS Insertion Of Temporary Bladder Tube 5 5 $240.00 $240.00 $228.00 $240.00 $240.00 2026-03-11
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