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Hospital

SATANTA DISTRICT HOSPITAL, CLINICS, & LTCU

Satanta, KS · CCN 171324 · Rates published

1,727 distinct procedures filed
45 distinct payers
257,370 rate rows
2026-03-10 last MRF observed
Data quality

256,486 of 257,370 rate rows are consumer-grade (99.7%)

884 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
percent-of-charges filed in the dollar field — excluded from medians 864
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 20
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSDHSATANTAKS&type=CDMWithoutLabel
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-14
Content fingerprint cfc1b31261e4d84e… · 69,845,369 bytes · first seen 2026-05-06

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
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 45 $3,143.50 $13,097.93 $9,430.51 nat. median
$59
outlier · 160.4×
Q4161
HCPCS 		Bio-connekt Wound Matrix, Per Square Centimeter 45 $2,340.48 $21,942.00 $9,264.40 nat. median
$375
outlier · 24.7×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 45 $2,410.27 $10,042.79 $7,230.81 nat. median
$498
outlier · 14.5×
47564
HCPCS 		Removal Of Gallbladder With Exploration Of Common Bile Duct Using An Endoscope 45 $455.88 $12,064.00 $6,635.20 nat. median
$8,650
0.8× median
J2997
HCPCS 		Injection, Alteplase Recombinant, 1 Mg 45 $90.30 $15,020.12 $5,634.20 nat. median
$428
outlier · 13.2×
J0717
HCPCS 		Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 45 $1,845.98 $7,691.58 $5,537.94 nat. median
$29
outlier · 190.8×
J1162
HCPCS 		Injection, Digoxin Immune Fab (ovine), Per Vial 45 $1,776.01 $7,400.05 $5,328.04 nat. median
$6,265
0.9× median
49613
HCPCS 		Repair Of Recurrent Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 45 $1,422.00 $5,925.00 $4,266.00 nat. median
$4,233
1.0× median
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 45 $1,239.70 $5,165.42 $3,719.10 nat. median
$916
outlier · 4.1×
49592
HCPCS 		Initial Repair Of Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length 45 $185.60 $6,104.00 $3,357.20 nat. median
$6,267
0.5× median
49594
HCPCS 		Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length 45 $232.00 $6,104.00 $3,357.20 nat. median
$6,255
0.5× median
49591
HCPCS 		Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 45 $133.98 $5,936.00 $3,264.80 nat. median
$3,980
0.8× median
49593
HCPCS 		Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length 45 $165.30 $5,936.00 $3,264.80 nat. median
$6,490
0.5× median
49595
HCPCS 		Initial Repair Of Sliding Hernia Of Abdomen, More Than 10 Cm In Length 45 $220.40 $5,936.00 $3,264.80 nat. median
$6,382
0.5× median
49615
HCPCS 		Repair Of Recurrent Sliding Hernia Of Abdomen, 3-10 Cm In Length 45 $188.50 $5,925.00 $3,258.75 nat. median
$6,452
0.5× median
12036
HCPCS 		Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.… 45 $985.92 $4,108.00 $2,957.76 nat. median
$799
outlier · 3.7×
59510
HCPCS 		Cesarean Delivery With Care Before And After Delivery 45 $981.36 $4,089.00 $2,944.08 nat. median
$3,349
0.9× median
J3111
HCPCS 		Injection, Romosozumab-aqqg, 1 Mg 45 $976.85 $4,070.22 $2,930.56 nat. median
$19
outlier · 154.2×
49596
HCPCS 		Initial Repair Of Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 45 $290.00 $5,175.00 $2,846.25 nat. median
$4,951
0.6× median
27345
HCPCS 		Removal Of Cyst Of Back Of Knee 45 $912.00 $3,800.00 $2,736.00 nat. median
$3,352
0.8× median
59400
HCPCS 		Vaginal Delivery With Care Before And After Delivery 45 $845.28 $3,522.00 $2,535.84 nat. median
$2,933
0.9× median
J1602
HCPCS 		Injection, Golimumab, 1 Mg, For Intravenous Use 45 $808.49 $3,368.72 $2,425.48 nat. median
$55
outlier · 44.4×
54161
HCPCS 		Removal Of Foreskin (older Than 28 Days) 45 $768.00 $3,200.00 $2,304.00 nat. median
$2,202
1.0× median
55040
HCPCS 		Removal Of Fluid Collection In Testicle And Sperm Reservoir 45 $765.60 $3,190.00 $2,296.80 nat. median
$3,658
0.6× median
36561
HCPCS 		Insertion Of Central Venous Tube With Port (5 Years Or Older) 45 $745.92 $3,108.00 $2,237.76 nat. median
$3,304
0.7× median
36590
HCPCS 		Removal Of Central Venous Tube With Port Or Pump 45 $617.76 $3,850.00 $2,226.51 nat. median
$1,682
1.3× median
25112
HCPCS 		Removal Of Recurrent Cyst Of Wrist 45 $708.48 $2,952.00 $2,125.44 nat. median
$2,050
1.0× median
20525
HCPCS 		Complicated Removal Of Foreign Body In Deep Muscle Or Tendon 45 $686.88 $2,862.00 $2,060.64 nat. median
$2,969
0.7× median
49651
HCPCS 		Repair Of Recurrent Groin Hernia Using An Endoscope 45 $264.00 $12,500.00 $2,050.00 nat. median
$6,367
outlier · 0.3×
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 45 $671.04 $2,796.00 $2,013.12 nat. median
$549
outlier · 3.7×
75635
HCPCS 		CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 45 $662.40 $2,760.00 $1,987.20 nat. median
$355
outlier · 5.6×
J0897
HCPCS 		Injection, Denosumab, 1 Mg 45 $501.25 $5,451.59 $1,984.13 nat. median
$86
outlier · 23.1×
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 45 $497.28 $5,478.95 $1,968.38 nat. median
$3,496
0.6× median
22902
HCPCS 		Removal Of Growth Of Soft Tissue Of Abdominal Wall, Less Than 3.0 Cm 45 $648.00 $2,700.00 $1,944.00 nat. median
$1,941
1.0× median
J9217
HCPCS 		Leuprolide Acetate (for Depot Suspension), 7.5 Mg 45 $637.16 $2,654.84 $1,911.48 nat. median
$2,144
0.9× median
25111
HCPCS 		Removal Of First Cyst Of Wrist 45 $624.00 $2,600.00 $1,872.00 nat. median
$2,015
0.9× median
93306
HCPCS 		Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 45 $601.20 $2,510.00 $1,807.20 nat. median
$804
outlier · 2.2×
49650
HCPCS 		Repair Of Groin Hernia Using An Endoscope 45 $264.00 $9,500.00 $1,690.00 nat. median
$5,726
outlier · 0.3×
54520
HCPCS 		Simple Removal Of Testicle 45 $543.12 $2,263.00 $1,629.36 nat. median
$3,548
outlier · 0.5×
47563
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 45 $243.60 $9,168.00 $1,607.66 nat. median
$6,246
outlier · 0.3×
36584
HCPCS 		Replacement Of Peripherally Inserted Central Venous Tube (picc) With Review By R… 45 $535.68 $2,232.00 $1,607.04 nat. median
$1,707
0.9× median
59409
HCPCS 		Vaginal Delivery 45 $528.00 $2,200.00 $1,584.00 nat. median
$3,106
0.5× median
11606
HCPCS 		Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 45 $528.00 $2,200.00 $1,584.00 nat. median
$1,743
0.9× median
42825
HCPCS 		Removal Of Tonsils (younger Than 12 Years) 45 $525.84 $2,191.00 $1,577.52 nat. median
$5,725
outlier · 0.3×
47600
HCPCS 		Removal Of Gallbladder 45 $312.00 $7,592.00 $1,561.04 nat. median
$3,682
outlier · 0.4×
64430
HCPCS 		Injection Of Anesthetic Agent And/or Steroid Into External Genitals And Anus Ner… 45 $55.10 $4,400.00 $1,544.40 nat. median
$956
1.6× median
47562
HCPCS 		Removal Of Gallbladder Using An Endoscope 45 $222.00 $8,600.00 $1,494.50 nat. median
$6,043
outlier · 0.2×
36565
HCPCS 		Insertion Of 2 Central Venous Tubes In 2 Veins For Infusion 45 $110.20 $2,710.00 $1,490.50 nat. median
$3,407
outlier · 0.4×
21930
HCPCS 		Removal Of Growth Under Skin Of Back Or Lower Sides, Less Than 3.0 Cm 45 $485.04 $2,021.00 $1,455.12 nat. median
$1,819
0.8× median
46221
HCPCS 		Removal Of External Hemorrhoids By Rubber Banding 45 $483.12 $2,013.00 $1,449.36 nat. median
$1,012
1.4× median

Other procedures at this hospital

Browse this hospital's 1,727 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
             
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 90 45 $13,097.93 $11,788.14 $3,143.50 $13,097.93 $9,430.51 2026-03-10
Q4161 HCPCS Bio-connekt Wound Matrix, Per Square Centimeter 180 45 $15,847.00 $14,262.30 $2,340.48 $21,942.00 $9,264.40 2026-03-10
J3101 HCPCS Injection, Tenecteplase, 1 Mg 90 45 $10,042.79 $9,038.51 $2,410.27 $10,042.79 $7,230.81 2026-03-10
47564 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct Using An Endoscope 146 45 $12,064.00 $10,857.60 $455.88 $12,064.00 $6,635.20 2026-03-10
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 270 45 $7,825.28 $7,042.75 $90.30 $15,020.12 $5,634.20 2026-03-10
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 90 45 $7,691.58 $6,922.42 $1,845.98 $7,691.58 $5,537.94 2026-03-10
J1162 HCPCS Injection, Digoxin Immune Fab (ovine), Per Vial 90 45 $7,400.05 $6,660.05 $1,776.01 $7,400.05 $5,328.04 2026-03-10
49613 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 90 45 $5,925.00 $5,332.50 $1,422.00 $5,925.00 $4,266.00 2026-03-10
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 90 45 $5,165.42 $4,648.88 $1,239.70 $5,165.42 $3,719.10 2026-03-10
49594 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length 146 45 $6,104.00 $5,493.60 $232.00 $6,104.00 $3,357.20 2026-03-10
49592 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length 146 45 $6,104.00 $5,493.60 $185.60 $6,104.00 $3,357.20 2026-03-10
49595 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, More Than 10 Cm In Length 146 45 $5,936.00 $5,342.40 $220.40 $5,936.00 $3,264.80 2026-03-10
49593 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length 146 45 $5,936.00 $5,342.40 $165.30 $5,936.00 $3,264.80 2026-03-10
49591 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 146 45 $5,936.00 $5,342.40 $133.98 $5,936.00 $3,264.80 2026-03-10
49615 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, 3-10 Cm In Length 146 45 $5,925.00 $5,332.50 $188.50 $5,925.00 $3,258.75 2026-03-10
12036 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.… 90 45 $4,108.00 $3,697.20 $985.92 $4,108.00 $2,957.76 2026-03-10
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 90 45 $4,089.00 $3,680.10 $981.36 $4,089.00 $2,944.08 2026-03-10
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 90 45 $4,070.22 $3,663.20 $976.85 $4,070.22 $2,930.56 2026-03-10
49596 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 146 45 $5,175.00 $4,657.50 $290.00 $5,175.00 $2,846.25 2026-03-10
27345 HCPCS Removal Of Cyst Of Back Of Knee 90 45 $3,800.00 $3,420.00 $912.00 $3,800.00 $2,736.00 2026-03-10
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 90 45 $3,522.00 $3,169.80 $845.28 $3,522.00 $2,535.84 2026-03-10
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 90 45 $3,368.72 $3,031.85 $808.49 $3,368.72 $2,425.48 2026-03-10
54161 HCPCS Removal Of Foreskin (older Than 28 Days) 90 45 $3,200.00 $2,880.00 $768.00 $3,200.00 $2,304.00 2026-03-10
55040 HCPCS Removal Of Fluid Collection In Testicle And Sperm Reservoir 90 45 $3,190.00 $2,871.00 $765.60 $3,190.00 $2,296.80 2026-03-10
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 90 45 $3,108.00 $2,797.20 $745.92 $3,108.00 $2,237.76 2026-03-10
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 180 45 $3,212.00 $2,890.80 $617.76 $3,850.00 $2,226.51 2026-03-10
25112 HCPCS Removal Of Recurrent Cyst Of Wrist 90 45 $2,952.00 $2,656.80 $708.48 $2,952.00 $2,125.44 2026-03-10
20525 HCPCS Complicated Removal Of Foreign Body In Deep Muscle Or Tendon 90 45 $2,862.00 $2,575.80 $686.88 $2,862.00 $2,060.64 2026-03-10
49651 HCPCS Repair Of Recurrent Groin Hernia Using An Endoscope 180 45 $6,800.00 $6,120.00 $264.00 $12,500.00 $2,050.00 2026-03-10
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 90 45 $2,796.00 $2,516.40 $671.04 $2,796.00 $2,013.12 2026-03-10
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 90 45 $2,760.00 $2,484.00 $662.40 $2,760.00 $1,987.20 2026-03-10
J0897 HCPCS Injection, Denosumab, 1 Mg 180 45 $3,770.07 $3,393.07 $501.25 $5,451.59 $1,984.13 2026-03-10
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 180 45 $3,775.47 $3,397.92 $497.28 $5,478.95 $1,968.38 2026-03-10
22902 HCPCS Removal Of Growth Of Soft Tissue Of Abdominal Wall, Less Than 3.0 Cm 90 45 $2,700.00 $2,430.00 $648.00 $2,700.00 $1,944.00 2026-03-10
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 90 45 $2,654.84 $2,389.36 $637.16 $2,654.84 $1,911.48 2026-03-10
25111 HCPCS Removal Of First Cyst Of Wrist 90 45 $2,600.00 $2,340.00 $624.00 $2,600.00 $1,872.00 2026-03-10
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 180 45 $2,507.50 $2,256.75 $601.20 $2,510.00 $1,807.20 2026-03-10
49650 HCPCS Repair Of Groin Hernia Using An Endoscope 180 45 $5,300.00 $4,770.00 $264.00 $9,500.00 $1,690.00 2026-03-10
54520 HCPCS Simple Removal Of Testicle 90 45 $2,263.00 $2,036.70 $543.12 $2,263.00 $1,629.36 2026-03-10
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 180 45 $5,091.50 $4,582.35 $243.60 $9,168.00 $1,607.66 2026-03-10
36584 HCPCS Replacement Of Peripherally Inserted Central Venous Tube (picc) With Review By R… 90 45 $2,232.00 $2,008.80 $535.68 $2,232.00 $1,607.04 2026-03-10
11606 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 90 45 $2,200.00 $1,980.00 $528.00 $2,200.00 $1,584.00 2026-03-10
59409 HCPCS Vaginal Delivery 146 45 $2,200.00 $1,980.00 $528.00 $2,200.00 $1,584.00 2026-03-10
42825 HCPCS Removal Of Tonsils (younger Than 12 Years) 90 45 $2,191.00 $1,971.90 $525.84 $2,191.00 $1,577.52 2026-03-10
47600 HCPCS Removal Of Gallbladder 180 45 $4,446.00 $4,001.40 $312.00 $7,592.00 $1,561.04 2026-03-10
64430 HCPCS Injection Of Anesthetic Agent And/or Steroid Into External Genitals And Anus Ner… 292 45 $2,340.00 $2,106.00 $55.10 $4,400.00 $1,544.40 2026-03-10
47562 HCPCS Removal Of Gallbladder Using An Endoscope 180 45 $4,762.50 $4,286.25 $222.00 $8,600.00 $1,494.50 2026-03-10
36565 HCPCS Insertion Of 2 Central Venous Tubes In 2 Veins For Infusion 146 45 $2,710.00 $2,439.00 $110.20 $2,710.00 $1,490.50 2026-03-10
21930 HCPCS Removal Of Growth Under Skin Of Back Or Lower Sides, Less Than 3.0 Cm 90 45 $2,021.00 $1,818.90 $485.04 $2,021.00 $1,455.12 2026-03-10
46221 HCPCS Removal Of External Hemorrhoids By Rubber Banding 90 45 $2,013.00 $1,811.70 $483.12 $2,013.00 $1,449.36 2026-03-10
11604 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 90 45 $2,008.00 $1,807.20 $481.92 $2,008.00 $1,445.76 2026-03-10
12051 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5 C… 270 45 $2,402.00 $2,161.80 $54.24 $2,402.00 $1,441.20 2026-03-10
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 90 45 $1,999.76 $1,799.78 $479.94 $1,999.76 $1,439.83 2026-03-10
28190 HCPCS Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 90 45 $1,992.00 $1,792.80 $478.08 $1,992.00 $1,434.24 2026-03-10
J2357 HCPCS Injection, Omalizumab, 5 Mg 90 45 $1,991.45 $1,792.31 $477.95 $1,991.45 $1,433.84 2026-03-10
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 90 45 $1,950.00 $1,755.00 $468.00 $1,950.00 $1,404.00 2026-03-10
42826 HCPCS Removal Of Tonsils (12 Years Or Older) 90 45 $1,944.00 $1,749.60 $466.56 $1,944.00 $1,399.68 2026-03-10
44394 HCPCS Removal Of Growths Or Polyps Of Large Bowel By Mechanical Snare Using An Endosco… 90 45 $1,925.00 $1,732.50 $462.00 $1,925.00 $1,386.00 2026-03-10
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 180 45 $1,887.00 $1,698.30 $448.80 $1,904.00 $1,370.88 2026-03-10
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 180 45 $1,892.00 $1,702.80 $451.20 $1,904.00 $1,370.88 2026-03-10
11770 HCPCS Simple Removal Of Cyst Of Tailbone 90 45 $1,900.00 $1,710.00 $456.00 $1,900.00 $1,368.00 2026-03-10
43450 HCPCS Dilation Of Esophagus 90 45 $1,887.00 $1,698.30 $452.88 $1,887.00 $1,358.64 2026-03-10
12034 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5… 270 45 $2,258.00 $2,032.20 $181.68 $2,258.00 $1,354.80 2026-03-10
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 270 45 $1,880.00 $1,692.00 $451.20 $1,880.00 $1,353.60 2026-03-10
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 90 45 $1,880.00 $1,692.00 $451.20 $1,880.00 $1,353.60 2026-03-10
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 270 45 $1,880.00 $1,692.00 $448.80 $1,880.00 $1,353.60 2026-03-10
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 90 45 $1,880.00 $1,692.00 $451.20 $1,880.00 $1,353.60 2026-03-10
49521 HCPCS Repair Of Trapped Or Strangulated Groin Hernia 180 45 $4,300.00 $3,870.00 $192.00 $7,800.00 $1,336.00 2026-03-10
27096 HCPCS Injection Of Anesthetic Or Steroid Into Joint Between Lower Spine And Hip Bone U… 292 45 $1,972.00 $1,774.80 $60.61 $4,000.00 $1,301.52 2026-03-10
2120839_1 CDM Room & Board - Private (one Bed) - General Classification 90 45 $1,800.00 $1,620.00 $432.00 $1,800.00 $1,296.00 2026-03-10
44950 HCPCS Removal Of Appendix 180 45 $4,250.00 $3,825.00 $168.00 $7,800.00 $1,286.00 2026-03-10
49618 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 180 45 $4,245.00 $3,820.50 $165.60 $7,800.00 $1,281.00 2026-03-10
49614 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length 180 45 $4,245.00 $3,820.50 $165.60 $7,800.00 $1,281.00 2026-03-10
4441947_1 CDM Room & Board - Private (one Bed) - General Classification 90 45 $1,700.00 $1,530.00 $408.00 $1,700.00 $1,224.00 2026-03-10
44970 HCPCS Removal Of Appendix Using An Endoscope 180 45 $3,945.00 $3,550.50 $165.60 $7,200.00 $1,209.00 2026-03-10
87633 HCPCS Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 90 45 $1,662.00 $1,495.80 $398.88 $1,662.00 $1,196.64 2026-03-10
2120840_1 CDM Room & Board - Semi-private (two Beds) - General Classification 90 45 $1,650.00 $1,485.00 $396.00 $1,650.00 $1,188.00 2026-03-10
25075 HCPCS Removal Of Growth Under Skin Of Forearm Or Wrist, Less Than 3.0 Cm 90 45 $1,620.00 $1,458.00 $388.80 $1,620.00 $1,166.40 2026-03-10
4441941_1 CDM Room & Board - Semi-private (two Beds) - General Classification 90 45 $1,550.00 $1,395.00 $372.00 $1,550.00 $1,116.00 2026-03-10
49520 HCPCS Repair Of Groin Hernia That Is Not Trapped 180 45 $3,360.00 $3,024.00 $192.00 $5,920.00 $1,110.40 2026-03-10
64495 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And… 292 45 $1,682.00 $1,513.80 $33.35 $3,364.00 $1,110.12 2026-03-10
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 146 45 $1,972.00 $1,774.80 $156.31 $1,972.00 $1,084.60 2026-03-10
64624 HCPCS Destruction Of Nerve Branches Of Knee Using Imaging Guidance 146 45 $1,972.00 $1,774.80 $147.90 $1,972.00 $1,084.60 2026-03-10
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 146 45 $1,972.00 $1,774.80 $147.90 $1,972.00 $1,084.60 2026-03-10
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 146 45 $1,972.00 $1,774.80 $158.05 $1,972.00 $1,084.60 2026-03-10
11443 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2… 90 45 $1,500.00 $1,350.00 $360.00 $1,500.00 $1,080.00 2026-03-10
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 180 45 $1,490.00 $1,341.00 $356.40 $1,495.00 $1,076.40 2026-03-10
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 90 45 $1,495.00 $1,345.50 $358.80 $1,495.00 $1,076.40 2026-03-10
12031 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 180 45 $1,454.00 $1,308.60 $348.96 $1,454.00 $1,046.88 2026-03-10
44960 HCPCS Removal Of Ruptured Infected Appendix 180 45 $3,372.50 $3,035.25 $148.80 $6,125.00 $1,045.00 2026-03-10
27762 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation 180 45 $1,440.00 $1,296.00 $345.60 $1,440.00 $1,036.80 2026-03-10
28810 HCPCS Amputation Of Toe And Midfoot Bone 180 45 $3,541.00 $3,186.90 $109.44 $6,626.00 $1,023.12 2026-03-10
49617 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, More Than 10 Cm In Length 180 45 $3,272.50 $2,945.25 $148.80 $5,925.00 $1,021.00 2026-03-10
90375 HCPCS Rabies Immune Globulin For Injection 180 45 $2,530.79 $2,277.71 $242.96 $4,049.26 $1,012.32 2026-03-10
55250 HCPCS Removal Of Sperm Duct 90 45 $1,400.00 $1,260.00 $336.00 $1,400.00 $1,008.00 2026-03-10
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 90 45 $1,398.00 $1,258.20 $335.52 $1,398.00 $1,006.56 2026-03-10
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 270 45 $1,470.00 $1,323.00 $67.92 $2,005.00 $999.60 2026-03-10
J7297 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (liletta), 52 Mg 90 45 $1,358.44 $1,222.60 $326.03 $1,358.44 $978.08 2026-03-10
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 180 45 $1,622.70 $1,460.43 $259.63 $2,163.60 $973.62 2026-03-10
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 180 45 $2,864.50 $2,578.05 $167.28 $5,032.00 $952.34 2026-03-10
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 90 45 $1,308.00 $1,177.20 $313.92 $1,308.00 $941.76 2026-03-10
90377 HCPCS Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle 90 45 $1,299.80 $1,169.82 $311.95 $1,299.80 $935.86 2026-03-10
64505 HCPCS Injection Of Anesthetic Agent, Trigeminal Nerve Bundle 292 45 $1,400.00 $1,260.00 $49.30 $2,800.00 $924.00 2026-03-10
10120 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Simple 270 45 $1,278.00 $1,150.20 $31.20 $2,502.00 $920.16 2026-03-10
36589 HCPCS Removal Of Tunneled Central Venous Tube 180 45 $1,234.00 $1,110.60 $296.16 $1,234.00 $888.48 2026-03-10
64484 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 236 45 $1,265.00 $1,138.50 $40.60 $1,340.00 $885.50 2026-03-10
43233 HCPCS Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl… 146 45 $1,590.00 $1,431.00 $93.38 $1,590.00 $874.50 2026-03-10
45338 HCPCS Removal Of Polyps Or Growths Of Lower Large Bowel Using A Flexible Endoscope Wit… 90 45 $1,200.00 $1,080.00 $288.00 $1,200.00 $864.00 2026-03-10
64492 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Third And… 292 45 $1,304.00 $1,173.60 $36.25 $2,608.00 $860.64 2026-03-10
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 90 45 $1,193.00 $1,073.70 $286.32 $1,193.00 $858.96 2026-03-10
71270 HCPCS CT Scan Of Chest Before And After Contrast 90 45 $1,193.00 $1,073.70 $286.32 $1,193.00 $858.96 2026-03-10
20240 HCPCS Biopsy Of Surface Bone 90 45 $1,186.00 $1,067.40 $284.64 $1,186.00 $853.92 2026-03-10
27339 HCPCS Removal Of Growth Of Muscle Of Thigh Or Knee, 5.0 Cm Or More 90 45 $1,160.00 $1,044.00 $278.40 $1,160.00 $835.20 2026-03-10
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 146 45 $1,488.00 $1,339.20 $139.49 $1,488.00 $818.40 2026-03-10
36571 HCPCS Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older) 180 45 $2,740.00 $2,466.00 $100.80 $5,060.00 $817.20 2026-03-10
31720 HCPCS Insertion Of Tube Into Airway For Aspiration Of Secretions 90 45 $1,133.00 $1,019.70 $271.92 $1,133.00 $815.76 2026-03-10
93246 HCPCS Heart Rhythm Recording Of Continuous External EKG Over 8-15 Days 90 45 $1,125.00 $1,012.50 $270.00 $1,125.00 $810.00 2026-03-10
J1670 HCPCS Injection, Tetanus Immune Globulin, Human, Up To 250 Units 90 45 $1,117.91 $1,006.12 $268.30 $1,117.91 $804.90 2026-03-10
6571984_1 CDM Drsng, 10cmx20cm - Microdoc 52 26 $1,120.00 $1,008.00 $324.80 $1,030.40 $789.60 2026-03-10
6571983_1 CDM Drsng, 15cmx20cm - Microdoc 52 26 $1,120.00 $1,008.00 $324.80 $1,030.40 $789.60 2026-03-10
6572308_1 CDM Drsng, Breast 20cm X 25cm - Microdoc 52 26 $1,120.00 $1,008.00 $324.80 $1,030.40 $789.60 2026-03-10
6572309_1 CDM Drsng, 10cm X 50cm - Microdoc 52 26 $1,120.00 $1,008.00 $324.80 $1,030.40 $789.60 2026-03-10
6572307_1 CDM Drsng, 20cm X 25cm - Microdoc 52 26 $1,120.00 $1,008.00 $324.80 $1,030.40 $789.60 2026-03-10
6571985_1 CDM Drsng, 10cm X 30cm - Microdoc 52 26 $1,120.00 $1,008.00 $324.80 $1,030.40 $789.60 2026-03-10
64494 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Second Le… 292 45 $1,180.00 $1,062.00 $33.35 $2,360.00 $778.80 2026-03-10
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 146 45 $1,391.00 $1,251.90 $98.48 $1,391.00 $765.05 2026-03-10
11601 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 90 45 $1,059.00 $953.10 $254.16 $1,059.00 $762.48 2026-03-10
13160 HCPCS Extensive Or Complicated Repair Of Surface Wound Reopening 180 45 $1,674.00 $1,506.60 $192.00 $2,548.00 $762.20 2026-03-10
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 90 45 $1,055.00 $949.50 $253.20 $1,055.00 $759.60 2026-03-10
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 90 45 $1,055.00 $949.50 $253.20 $1,055.00 $759.60 2026-03-10
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 90 45 $1,055.00 $949.50 $253.20 $1,055.00 $759.60 2026-03-10
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 90 45 $1,055.00 $949.50 $253.20 $1,055.00 $759.60 2026-03-10
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 90 45 $1,055.00 $949.50 $253.20 $1,055.00 $759.60 2026-03-10
73202 HCPCS CT Scan Of Arm Before And After Contrast 270 45 $1,055.00 $949.50 $250.80 $1,055.00 $759.60 2026-03-10
73702 HCPCS CT Scan Of Leg Before And After Contrast 270 45 $1,055.00 $949.50 $250.80 $1,055.00 $759.60 2026-03-10
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 90 45 $1,055.00 $949.50 $253.20 $1,055.00 $759.60 2026-03-10
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 90 45 $1,055.00 $949.50 $253.20 $1,055.00 $759.60 2026-03-10
70488 HCPCS CT Scan Of Face Before And After Contrast 90 45 $1,055.00 $949.50 $253.20 $1,055.00 $759.60 2026-03-10
59426 HCPCS Predelivery Care, 7 Or More Visits 90 45 $1,050.00 $945.00 $252.00 $1,050.00 $756.00 2026-03-10
62321 HCPCS Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance 146 45 $1,370.00 $1,233.00 $97.15 $1,370.00 $753.50 2026-03-10
62323 HCPCS Injection Of Substance Into Lower Spine Canal Using Imaging Guidance 146 45 $1,370.00 $1,233.00 $95.70 $1,370.00 $753.50 2026-03-10
12005 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 90 45 $1,045.00 $940.50 $250.80 $1,045.00 $752.40 2026-03-10
J0248 HCPCS Injection, Remdesivir, 1 Mg 90 45 $1,028.66 $925.79 $246.88 $1,028.66 $740.64 2026-03-10
64491 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Second Le… 292 45 $1,090.00 $981.00 $35.96 $2,180.00 $719.40 2026-03-10
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 90 45 $990.36 $891.32 $237.69 $990.36 $713.06 2026-03-10
93882 HCPCS Ultrasound Of One Side Of Head And Neck Blood Flow 180 45 $1,184.00 $1,065.60 $189.84 $1,577.00 $711.90 2026-03-10
81226 HCPCS Gene Analysis (cytochrome P450, Family 2, Subfamily D, Polypeptide 6) Common Var… 90 45 $980.00 $882.00 $235.20 $980.00 $705.60 2026-03-10
6573655_1 CDM Drsng,15cmx20cm - Mircodoc 52 26 $1,000.00 $900.00 $290.00 $920.00 $705.00 2026-03-10
6573658_1 CDM Drsng, 20cmx25cm 52 26 $1,000.00 $900.00 $290.00 $920.00 $705.00 2026-03-10
6573656_1 CDM Drsng,10cmx20cm - Mircodoc 52 26 $1,000.00 $900.00 $290.00 $920.00 $705.00 2026-03-10
6573657_1 CDM Drsng,10cmx30cm - Micdoc 52 26 $1,000.00 $900.00 $290.00 $920.00 $705.00 2026-03-10
P9033 HCPCS Platelets, Leukocytes Reduced, Irradiated, Each Unit 90 45 $965.00 $868.50 $231.60 $965.00 $694.80 2026-03-10
93308 HCPCS Ultrasound Of Heart, Follow-up 180 45 $943.50 $849.15 $225.84 $946.00 $681.12 2026-03-10
Q5103 HCPCS Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg 90 45 $941.33 $847.20 $225.92 $941.33 $677.76 2026-03-10
10160 HCPCS Aspiration Of Abscess, Blood, Or Cyst 360 45 $938.00 $844.20 $62.40 $1,468.00 $670.67 2026-03-10
J3095 HCPCS Injection, Telavancin, 10 Mg 90 45 $906.46 $815.81 $217.55 $906.46 $652.65 2026-03-10
43202 HCPCS Biopsy Of Esophagus Using A Flexible Endoscope Through Mouth 90 45 $905.00 $814.50 $217.20 $905.00 $651.60 2026-03-10
43194 HCPCS Removal Of Foreign Bodies From Esophagus Using A Rigid Endoscope 90 45 $905.00 $814.50 $217.20 $905.00 $651.60 2026-03-10
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 90 45 $894.00 $804.60 $214.56 $894.00 $643.68 2026-03-10
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 180 45 $2,185.50 $1,966.95 $73.68 $4,064.00 $641.18 2026-03-10
64493 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le… 382 45 $830.00 $747.00 $65.25 $1,660.00 $639.10 2026-03-10
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 180 45 $889.50 $800.55 $192.24 $978.00 $636.79 2026-03-10
93799 HCPCS Other Cardiovascular Service Or Procedure 90 45 $882.00 $793.80 $211.68 $882.00 $635.04 2026-03-10
94626 HCPCS Professional Services For Outpatient Pulmonary Rehabilitation With Continuous Mo… 90 45 $873.00 $785.70 $209.52 $873.00 $628.56 2026-03-10
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
70553 HCPCS MRI Scan Of Brain Before And After Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73719 HCPCS MRI Scan Of Leg With Contrast 180 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73720 HCPCS MRI Scan Of Leg Before And After Contrast 270 45 $865.00 $778.50 $206.40 $865.00 $622.80 2026-03-10
70551 HCPCS MRI Scan Of Brain Without Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73718 HCPCS MRI Scan Of Leg Without Contrast 270 45 $865.00 $778.50 $206.40 $865.00 $622.80 2026-03-10
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
70552 HCPCS MRI Scan Of Brain With Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73722 HCPCS MRI Scan Of Leg Joint With Contrast 270 45 $865.00 $778.50 $206.40 $865.00 $622.80 2026-03-10
72196 HCPCS MRI Scan Of Pelvis With Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
70336 HCPCS MRI Scan Of Jaw Joint 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73219 HCPCS MRI Scan Of Arm With Contrast 180 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
71551 HCPCS MRI Scan Of Chest With Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73218 HCPCS MRI Scan Of Arm Without Contrast 360 45 $865.00 $778.50 $206.40 $865.00 $622.80 2026-03-10
74181 HCPCS MRI Scan Of Abdomen Without Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73222 HCPCS MRI Scan Of Arm Joint With Contrast 180 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
71552 HCPCS MRI Scan Of Chest Before And After Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
74182 HCPCS MRI Scan Of Abdomen With Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 180 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73220 HCPCS MRI Scan Of Arm Before And After Contrast 180 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 180 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 270 45 $865.00 $778.50 $206.40 $865.00 $622.80 2026-03-10
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 270 45 $865.00 $778.50 $206.40 $865.00 $622.80 2026-03-10
72195 HCPCS MRI Scan Of Pelvis Without Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
71550 HCPCS MRI Scan Of Chest Without Contrast 90 45 $865.00 $778.50 $207.60 $865.00 $622.80 2026-03-10
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 90 45 $863.00 $776.70 $207.12 $863.00 $621.36 2026-03-10
70460 HCPCS CT Scan Head Or Brain With Contrast 90 45 $863.00 $776.70 $207.12 $863.00 $621.36 2026-03-10
70450 HCPCS CT Scan Head Or Brain Without Contrast 90 45 $863.00 $776.70 $207.12 $863.00 $621.36 2026-03-10
71250 HCPCS CT Scan Of Chest Without Contrast 180 45 $858.00 $772.20 $204.72 $863.00 $621.36 2026-03-10
27603 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Leg Or Ankle 270 45 $810.00 $729.00 $194.40 $1,105.00 $618.80 2026-03-10
77075 HCPCS Complete X-ray Of Body Bones 90 45 $838.00 $754.20 $201.12 $838.00 $603.36 2026-03-10
43246 HCPCS Insertion Of Stomach Tube Using A Flexible Endoscope 180 45 $1,860.00 $1,674.00 $98.88 $3,308.00 $602.96 2026-03-10
10060 HCPCS Simple Or Single Drainage Of Skin Abscess 270 45 $785.00 $706.50 $188.40 $1,021.00 $596.60 2026-03-10
64421 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Multiple Rib Nerves For Region… 146 45 $1,079.00 $971.10 $59.45 $1,079.00 $593.45 2026-03-10
71260 HCPCS CT Scan Of Chest With Contrast 180 45 $810.50 $729.45 $181.92 $863.00 $591.15 2026-03-10
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 90 45 $821.00 $738.90 $197.04 $821.00 $591.12 2026-03-10
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 270 45 $821.00 $738.90 $195.84 $821.00 $591.12 2026-03-10
15272 HCPCS Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, Each Addi… 180 45 $2,166.00 $1,949.40 $43.20 $4,152.00 $588.24 2026-03-10
15271 HCPCS Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, 25.0 Sq C… 180 45 $2,166.00 $1,949.40 $43.20 $4,152.00 $588.24 2026-03-10
24640 HCPCS Closed Treatment Of Dislocated Forearm Bone On Thumb Side At Elbow With Manipula… 180 45 $801.00 $720.90 $192.24 $801.00 $576.72 2026-03-10
17111 HCPCS Destruction Of Skin Growth, 15 Or More Growths 90 45 $801.00 $720.90 $192.24 $801.00 $576.72 2026-03-10
27550 HCPCS Closed Treatment Of Dislocated Knee 90 45 $801.00 $720.90 $192.24 $801.00 $576.72 2026-03-10
31605 HCPCS Emergent Incision Of Windpipe For Insertion Of Breathing Tube 90 45 $801.00 $720.90 $192.24 $801.00 $576.72 2026-03-10
26775 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation Under Anesthesia 180 45 $801.00 $720.90 $192.24 $801.00 $576.72 2026-03-10
26670 HCPCS Closed Treatment Of Dislocated Hand Bone At Wrist Joint With Manipulation 180 45 $801.00 $720.90 $192.24 $801.00 $576.72 2026-03-10
26605 HCPCS Closed Treatment Of Broken Hand Bone With Manipulation 180 45 $801.00 $720.90 $192.24 $801.00 $576.72 2026-03-10
J1447 HCPCS Injection, Tbo-filgrastim, 1 Microgram 90 45 $800.60 $720.54 $192.14 $800.60 $576.43 2026-03-10
J0881 HCPCS Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use) 90 45 $800.28 $720.25 $192.07 $800.28 $576.20 2026-03-10
45330 HCPCS Diagnostic Exam Of Lower Portion Of Large Bowel Using A Flexible Endoscope 90 45 $800.00 $720.00 $192.00 $800.00 $576.00 2026-03-10
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 90 45 $791.00 $711.90 $189.84 $791.00 $569.52 2026-03-10
93320 HCPCS Ultrasound Of Heart Blood Flow, Valves And Chambers 90 45 $791.00 $711.90 $189.84 $791.00 $569.52 2026-03-10
64483 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 388 45 $779.00 $701.10 $89.90 $1,500.00 $565.17 2026-03-10
64510 HCPCS Injection Of Anesthetic Agent Into Sympathetic Nerve Bundle 146 45 $1,018.00 $916.20 $53.65 $1,018.00 $559.90 2026-03-10
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 90 45 $761.00 $684.90 $182.64 $761.00 $547.92 2026-03-10
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
72129 HCPCS CT Scan Of Middle Spine With Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
73201 HCPCS CT Scan Of Arm With Contrast 270 45 $758.00 $682.20 $179.52 $758.00 $545.76 2026-03-10
74150 HCPCS CT Scan Of Abdomen Without Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
73701 HCPCS CT Scan Of Leg With Contrast Material 270 45 $758.00 $682.20 $179.52 $758.00 $545.76 2026-03-10
74160 HCPCS CT Scan Of Abdomen With Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
72125 HCPCS CT Scan Of Upper Spine Without Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
72131 HCPCS CT Scan Of Lower Spine Without Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
72128 HCPCS CT Scan Of Middle Spine Without Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
72132 HCPCS CT Scan Of Lower Spine With Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
73200 HCPCS CT Scan Of Arm Without Contrast 270 45 $758.00 $682.20 $179.52 $758.00 $545.76 2026-03-10
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
72192 HCPCS CT Scan Of Pelvis Without Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
73700 HCPCS CT Scan Of Leg Without Contrast 270 45 $758.00 $682.20 $179.52 $758.00 $545.76 2026-03-10
70486 HCPCS CT Scan Of Face Without Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
72193 HCPCS CT Scan Of Pelvis With Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
72126 HCPCS CT Scan Of Upper Spine With Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
70487 HCPCS CT Scan Of Face With Contrast 90 45 $758.00 $682.20 $181.92 $758.00 $545.76 2026-03-10
49507 HCPCS Repair Of Trapped Groin Hernia (5 Years Or Older) 90 45 $750.00 $675.00 $180.00 $750.00 $540.00 2026-03-10
93242 HCPCS Heart Rhythm Recording Continuous External EKG Over More Than 48 Hours Up To 7 D… 90 45 $750.00 $675.00 $180.00 $750.00 $540.00 2026-03-10
32556 HCPCS Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube 90 45 $735.00 $661.50 $176.40 $735.00 $529.20 2026-03-10
15274 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Trunk, Arms, Or Legs, Each… 180 45 $1,822.00 $1,639.80 $57.60 $3,404.00 $528.48 2026-03-10
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 180 45 $988.00 $889.20 $133.44 $1,420.00 $528.20 2026-03-10
64721 HCPCS Release And/or Relocation Of Hand Nerve 180 45 $1,487.50 $1,338.75 $106.80 $2,530.00 $526.10 2026-03-10
G0424 HCPCS Pulmonary Rehabilitation, Including Exercise (includes Monitoring), One Hour, Pe… 270 45 $873.00 $785.70 $1.20 $873.00 $523.80 2026-03-10
12052 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5… 270 45 $873.00 $785.70 $70.56 $873.00 $523.80 2026-03-10
62329 HCPCS Removal Of Cerebrospinal Fluid With Lower Back Spinal Tap Using Imaging Guidance 146 45 $952.00 $856.80 $88.74 $952.00 $523.60 2026-03-10
62328 HCPCS Removal Of Spinal Fluid With Lower Back Spinal Tap For Diagnostic Test Using Ima… 146 45 $952.00 $856.80 $92.80 $952.00 $523.60 2026-03-10
87912 HCPCS Analysis Test By Nucleic Acid For Hepatitis B Virus 90 45 $709.00 $638.10 $170.16 $709.00 $510.48 2026-03-10
64640 HCPCS Destruction Of Peripheral Nerve Or Branch 146 45 $925.00 $832.50 $92.22 $925.00 $508.75 2026-03-10
64517 HCPCS Injection Of Anesthetic Agent Into Sacral Nerve Bundle 146 45 $924.00 $831.60 $37.76 $924.00 $508.20 2026-03-10
20520 HCPCS Removal Of Foreign Body In Muscle Or Tendon 180 45 $700.00 $630.00 $168.00 $700.00 $504.00 2026-03-10
J7300 HCPCS Intrauterine Copper Contraceptive 90 45 $700.00 $630.00 $168.00 $700.00 $504.00 2026-03-10
49616 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, 3-10 Cm In Length 270 45 $690.00 $621.00 $122.40 $7,800.00 $503.70 2026-03-10
6423083_1 CDM Mesh Ventralex St Hernia Patch Small With Strap 1.7in 52 26 $714.00 $642.60 $207.06 $656.88 $503.37 2026-03-10
J1442 HCPCS Injection, Filgrastim (g-csf), Excludes Biosimilars, 1 Microgram 180 45 $677.54 $609.78 $153.87 $713.95 $493.14 2026-03-10
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 146 45 $895.00 $805.50 $56.84 $895.00 $492.25 2026-03-10
32552 HCPCS Removal Of Indwelling Tube In Lining Of Lung 90 45 $682.00 $613.80 $163.68 $682.00 $491.04 2026-03-10
11044 HCPCS Removal Of Bone, 20.0 Sq Cm Or Less 180 45 $1,409.50 $1,268.55 $91.20 $2,439.00 $482.68 2026-03-10
87153 HCPCS Identification Of Organisms By Nucleic Acid Sequencing Method 90 45 $669.00 $602.10 $160.56 $669.00 $481.68 2026-03-10
90675 HCPCS Rabies Vaccine For Injection Into Muscle 90 45 $664.25 $597.83 $159.42 $664.25 $478.26 2026-03-10
36572 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 236 45 $625.00 $562.50 $34.80 $1,585.00 $475.25 2026-03-10
11424 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 180 45 $1,232.50 $1,109.25 $111.60 $2,000.00 $472.50 2026-03-10
99291 HCPCS Critical Care, First 30-74 Minutes 180 45 $906.00 $815.40 $119.04 $1,316.00 $471.20 2026-03-10
87631 HCPCS Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 90 45 $650.00 $585.00 $156.00 $650.00 $468.00 2026-03-10
84445 HCPCS Thyroid Stimulating Immune Globulins (thyroid Related Protein) Level 90 45 $648.00 $583.20 $155.52 $648.00 $466.56 2026-03-10
C1781 HCPCS Mesh (implantable) 540 45 $754.00 $678.60 $68.16 $1,382.00 $460.28 2026-03-10
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 180 45 $1,339.00 $1,205.10 $86.88 $2,316.00 $458.92 2026-03-10
64647 HCPCS Injection Of Chemical For Paralysis Of Nerve Muscles On Trunk, 6 Or More Muscles 146 45 $634.00 $570.60 $106.65 $634.00 $456.48 2026-03-10
11104 HCPCS Punch Biopsy, First Skin Growth 180 45 $633.00 $569.70 $151.92 $633.00 $455.76 2026-03-10
87517 HCPCS Detection Test By Nucleic Acid For Hepatitis B Virus, Quantification 90 45 $625.00 $562.50 $150.00 $625.00 $450.00 2026-03-10
28899 HCPCS Other Procedure On Foot Or Toes 142 45 $800.00 $720.00 $58.00 $800.00 $448.00 2026-03-10
P9021 HCPCS Red Blood Cells, Each Unit 90 45 $619.00 $557.10 $148.56 $619.00 $445.68 2026-03-10
77002 HCPCS Fluoroscopic Guidance For Needle Placement 90 45 $619.00 $557.10 $148.56 $619.00 $445.68 2026-03-10
93922 HCPCS Ultrasound Study Of Arm And Leg Arteries 90 45 $619.00 $557.10 $148.56 $619.00 $445.68 2026-03-10
93325 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate And Valve Function 90 45 $619.00 $557.10 $148.56 $619.00 $445.68 2026-03-10
64490 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Single Le… 292 45 $643.00 $578.70 $71.63 $1,200.00 $440.46 2026-03-10
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 270 45 $665.00 $598.50 $36.00 $795.00 $437.25 2026-03-10
93926 HCPCS Ultrasound Of One Leg Arteries Or Artery Grafts 180 45 $605.00 $544.50 $145.20 $605.00 $435.60 2026-03-10
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