Hospital

GRAHAM COUNTY HOSPITAL

Hill City, KS · CCN 171325 · 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: $1,558 across 8 payers · range $81-$1,900

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbGCHHILLCITYKS&type=CDMWithoutLabel&fileType=CSV · observed 2026-01-15

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.

2,662 distinct procedures filed

12 distinct payers

19,900 rate rows

2026-01-15 last MRF observed

Data quality

19,835 of 19,900 rate rows are consumer-grade (99.7%)

65 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 — reason	Rows
percent-of-charges filed in the dollar field — excluded from medians	40
per-diem day rate — not a per-procedure price	12
exceeds 10× this hospital's gross charge — excluded from medians	6
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	4
placeholder amount (≤ $0.02) — excluded from medians	3

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbGCHHILLCITYKS&type=CDMWithoutLabel&fileType=CSV
Found on page	https://apps.para-hcfs.com/PTT/FinalLinks/GrahamCounty_V3.aspx
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-24
Content fingerprint	0cd16520cf75f5ca… · 6,909,797 bytes · first seen 2026-05-08

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
J2350 HCPCS	Injection, Ocrelizumab, 1 Mg	8	$70.50	$26,755.80	$21,827.10	nat. median $414 outlier · 52.7×
J3380 HCPCS	Injection, Vedolizumab, Intravenous, 1 Mg	8	$25.78	$16,891.00	$13,779.50	nat. median $155 outlier · 89.2×
J2327 HCPCS	Injection, Risankizumab-rzaa, Intravenous, 1 Mg	7	$23.74	$11,354.40	$9,561.60	nat. median $1,767 outlier · 5.4×
J3101 HCPCS	Injection, Tenecteplase, 1 Mg	8	$156.63	$8,312.50	$6,781.25	nat. median $3,787 1.8× median
J2506 HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	7	$93.44	$6,365.00	$5,360.00	nat. median $1,659 outlier · 3.2×
J2356 HCPCS	Injection, Tezepelumab-ekko, 1 Mg	7	$29.28	$5,961.25	$5,020.00	nat. median $76 outlier · 66.3×
J1950 HCPCS	Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg	8	$1,539.69	$5,985.00	$4,882.50	nat. median $3,921 1.2× median
31525 HCPCS	Diagnostic Exam Of Voice Box Using An Endoscope	8	$879.75	$5,462.50	$4,511.50	nat. median $1,955 outlier · 2.3×
27650 HCPCS	Repair Of Ruptured Achilles Tendon	8	$3,708.18	$5,446.35	$4,498.20	nat. median $6,674 0.7× median
12036 HCPCS	Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.…	8	$411.85	$5,073.00	$4,138.50	nat. median $857 outlier · 4.8×
10180 HCPCS	Complex Drainage Of Wound Infection After Surgery	8	$1,472.84	$4,626.50	$3,821.50	nat. median $2,862 1.3× median
J2182 HCPCS	Injection, Mepolizumab, 1 Mg	8	$37.95	$4,655.00	$3,797.50	nat. median $2,791 1.4× median
J1306 HCPCS	Injection, Inclisiran, 1 Mg	7	$19.76	$4,275.00	$3,600.00	nat. median $44 outlier · 82.3×
26418 HCPCS	Repair Of Tendon On Top Side Of Finger	8	$833.06	$3,690.75	$3,048.00	nat. median $2,008 1.5× median
J0840 HCPCS	Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram	8	$2,812.50	$4,087.67	$3,046.88	nat. median $3,452 0.9× median
Q5120 HCPCS	Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg	7	$44.79	$3,420.00	$2,880.00	nat. median $371 outlier · 7.8×
Q5108 HCPCS	Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg	7	$165.94	$3,040.00	$2,560.00	nat. median $1,244 outlier · 2.1×
81408 HCPCS	Molecular Pathology Procedure Level 9 Genetic Analysis	5	$1,837.50	$4,675.25	$2,327.50	nat. median $938 outlier · 2.5×
Q5111 HCPCS	Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg	8	$217.67	$2,826.25	$2,305.62	nat. median $1,984 1.2× median
26765 HCPCS	Treatment Of Broken End Of Finger Or Thumb	8	$1,677.76	$2,703.70	$2,205.65	nat. median $3,497 0.6× median
26591 HCPCS	Repair Of Hand Muscle	7	$1,677.76	$2,557.40	$2,153.60	nat. median $3,418 0.6× median
26433 HCPCS	Repair Of Tendon On Upper Side Of End Of Finger	7	$1,677.76	$2,557.40	$2,153.60	nat. median $3,332 0.6× median
J0717 HCPCS	Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm…	8	$7.18	$2,612.50	$2,131.25	nat. median $1,635 1.3× median
26410 HCPCS	Repair Of Tendon On Top Of Hand	8	$833.06	$2,557.40	$2,086.30	nat. median $1,974 1.1× median
J0897 HCPCS	Injection, Denosumab, 1 Mg	8	$23.90	$3,610.00	$1,824.00	nat. median $1,982 0.9× median
J0129 HCPCS	Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…	8	$66.39	$2,208.75	$1,801.88	nat. median $902 2.0× median
74174 HCPCS	CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	8	$501.09	$2,090.00	$1,723.64	nat. median $998 1.7× median
46320 HCPCS	Removal Of External Hemorrhoid With Blood Clot	8	$611.66	$2,069.10	$1,708.70	nat. median $1,319 1.3× median
C8929 HCPCS	Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi…	6	$1,517.00	$1,995.00	$1,706.25	nat. median $1,358 1.3× median
J0875 HCPCS	Injection, Dalbavancin, 5 Mg	8	$18.65	$2,090.00	$1,705.00	nat. median $435 outlier · 3.9×
J9217 HCPCS	Leuprolide Acetate (for Depot Suspension), 7.5 Mg	8	$248.68	$6,460.00	$1,662.50	nat. median $1,573 1.1× median
28190 HCPCS	Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin	8	$732.18	$1,972.00	$1,645.32	nat. median $867 1.9× median
43249 HCPCS	Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…	8	$986.30	$1,915.20	$1,581.90	nat. median $2,124 0.7× median
81229 HCPCS	Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi…	7	$1,512.87	$1,995.00	$1,577.64	nat. median $1,323 1.2× median
93306 HCPCS	Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu…	8	$81.36	$1,900.00	$1,558.50	nat. median $993 1.6× median
25605 HCPCS	Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit…	8	$833.06	$1,878.15	$1,532.17	nat. median $1,667 0.9× median
24500 HCPCS	Closed Treatment Of Broken Middle Part Of Upper Arm Bone	8	$499.21	$1,878.15	$1,532.17	nat. median $460 outlier · 3.3×
27786 HCPCS	Closed Treatment Of Broken Outside Lower Leg Bone At Ankle	8	$499.21	$1,878.15	$1,532.17	nat. median $435 outlier · 3.5×
24560 HCPCS	Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow	8	$665.62	$1,878.15	$1,532.17	nat. median $474 outlier · 3.2×
25622 HCPCS	Closed Treatment Of Broken Wrist Bone Near Base Of Thumb	8	$416.01	$1,878.15	$1,532.17	nat. median $450 outlier · 3.4×
25650 HCPCS	Closed Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist	8	$540.81	$1,878.15	$1,532.17	nat. median $476 outlier · 3.2×
23600 HCPCS	Closed Treatment Of Broken Top Of Upper Arm Bone	8	$582.42	$1,878.15	$1,532.17	nat. median $444 outlier · 3.4×
27530 HCPCS	Closed Treatment Of Broken Shin Bone	8	$582.42	$1,878.15	$1,532.17	nat. median $451 outlier · 3.4×
27508 HCPCS	Closed Treatment Of Broken Inside Or Outside Portion Of Lower End Of Thigh Bone	8	$499.21	$1,878.15	$1,532.17	nat. median $563 outlier · 2.7×
27824 HCPCS	Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint	8	$499.21	$1,878.15	$1,532.17	nat. median $476 outlier · 3.2×
25560 HCPCS	Closed Treatment Of Broken Midpart Of Both Forearm Bones	8	$499.21	$1,878.15	$1,532.17	nat. median $430 outlier · 3.6×
25600 HCPCS	Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb…	8	$499.21	$1,878.15	$1,532.17	nat. median $442 outlier · 3.5×
28470 HCPCS	Closed Treatment Of Broken Bone In Forefoot Or Midfoot	8	$499.21	$1,878.15	$1,532.17	nat. median $379 outlier · 4.0×
27808 HCPCS	Closed Treatment Of 2 Broken Lower Leg Bones At Ankle	8	$499.21	$1,878.15	$1,532.17	nat. median $456 outlier · 3.4×
45385 HCPCS	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S…	8	$611.66	$1,852.50	$1,516.00	nat. median $1,663 0.9× median

Other procedures at this hospital

Browse this hospital's 2,662 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J2350	HCPCS	Injection, Ocrelizumab, 1 Mg	8	8	$28,164.00	$28,164.00	$70.50	$26,755.80	$21,827.10	2026-01-15
J3380	HCPCS	Injection, Vedolizumab, Intravenous, 1 Mg	8	8	$17,780.00	$17,780.00	$25.78	$16,891.00	$13,779.50	2026-01-15
J2327	HCPCS	Injection, Risankizumab-rzaa, Intravenous, 1 Mg	7	7	$11,952.00	$11,952.00	$23.74	$11,354.40	$9,561.60	2026-01-15
J3101	HCPCS	Injection, Tenecteplase, 1 Mg	8	8	$8,750.00	$8,750.00	$156.63	$8,312.50	$6,781.25	2026-01-15
J2506	HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	7	7	$6,700.00	$6,700.00	$93.44	$6,365.00	$5,360.00	2026-01-15
J2356	HCPCS	Injection, Tezepelumab-ekko, 1 Mg	7	7	$6,275.00	$6,275.00	$29.28	$5,961.25	$5,020.00	2026-01-15
J1950	HCPCS	Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg	8	8	$6,300.00	$6,300.00	$1,539.69	$5,985.00	$4,882.50	2026-01-15
31525	HCPCS	Diagnostic Exam Of Voice Box Using An Endoscope	8	8	$5,750.00	$5,750.00	$879.75	$5,462.50	$4,511.50	2026-01-15
27650	HCPCS	Repair Of Ruptured Achilles Tendon	8	8	$5,733.00	$5,733.00	$3,708.18	$5,446.35	$4,498.20	2026-01-15
12036	HCPCS	Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.…	8	8	$5,340.00	$5,340.00	$411.85	$5,073.00	$4,138.50	2026-01-15
10180	HCPCS	Complex Drainage Of Wound Infection After Surgery	8	8	$4,870.00	$4,870.00	$1,472.84	$4,626.50	$3,821.50	2026-01-15
J2182	HCPCS	Injection, Mepolizumab, 1 Mg	8	8	$4,900.00	$4,900.00	$37.95	$4,655.00	$3,797.50	2026-01-15
J1306	HCPCS	Injection, Inclisiran, 1 Mg	7	7	$4,500.00	$4,500.00	$19.76	$4,275.00	$3,600.00	2026-01-15
26418	HCPCS	Repair Of Tendon On Top Side Of Finger	8	8	$3,885.00	$3,885.00	$833.06	$3,690.75	$3,048.00	2026-01-15
J0840	HCPCS	Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram	8	8	$3,750.00	$3,750.00	$2,812.50	$4,087.67	$3,046.88	2026-01-15
Q5120	HCPCS	Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg	7	7	$3,600.00	$3,600.00	$44.79	$3,420.00	$2,880.00	2026-01-15
Q5108	HCPCS	Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg	7	7	$3,200.00	$3,200.00	$165.94	$3,040.00	$2,560.00	2026-01-15
81408	HCPCS	Molecular Pathology Procedure Level 9 Genetic Analysis	5	5	$2,450.00	$2,450.00	$1,837.50	$4,675.25	$2,327.50	2026-01-15
Q5111	HCPCS	Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg	8	8	$2,975.00	$2,975.00	$217.67	$2,826.25	$2,305.62	2026-01-15
26765	HCPCS	Treatment Of Broken End Of Finger Or Thumb	8	8	$2,846.00	$2,846.00	$1,677.76	$2,703.70	$2,205.65	2026-01-15
26591	HCPCS	Repair Of Hand Muscle	7	7	$2,692.00	$2,692.00	$1,677.76	$2,557.40	$2,153.60	2026-01-15
26433	HCPCS	Repair Of Tendon On Upper Side Of End Of Finger	7	7	$2,692.00	$2,692.00	$1,677.76	$2,557.40	$2,153.60	2026-01-15
J0717	HCPCS	Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm…	8	8	$2,750.00	$2,750.00	$7.18	$2,612.50	$2,131.25	2026-01-15
26410	HCPCS	Repair Of Tendon On Top Of Hand	8	8	$2,692.00	$2,692.00	$833.06	$2,557.40	$2,086.30	2026-01-15
J0897	HCPCS	Injection, Denosumab, 1 Mg	13	8	$1,920.00	$1,920.00	$23.90	$3,610.00	$1,824.00	2026-01-15
J0129	HCPCS	Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…	8	8	$2,325.00	$2,325.00	$66.39	$2,208.75	$1,801.88	2026-01-15
74174	HCPCS	CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	8	8	$2,200.00	$2,200.00	$501.09	$2,090.00	$1,723.64	2026-01-15
46320	HCPCS	Removal Of External Hemorrhoid With Blood Clot	8	8	$2,178.00	$2,178.00	$611.66	$2,069.10	$1,708.70	2026-01-15
C8929	HCPCS	Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi…	6	6	$2,100.00	$2,100.00	$1,517.00	$1,995.00	$1,706.25	2026-01-15
J0875	HCPCS	Injection, Dalbavancin, 5 Mg	8	8	$2,200.00	$2,200.00	$18.65	$2,090.00	$1,705.00	2026-01-15
J9217	HCPCS	Leuprolide Acetate (for Depot Suspension), 7.5 Mg	13	8	$6,800.00	$6,800.00	$248.68	$6,460.00	$1,662.50	2026-01-15
28190	HCPCS	Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin	8	8	$2,025.00	$2,025.00	$732.18	$1,972.00	$1,645.32	2026-01-15
43249	HCPCS	Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…	8	8	$2,016.00	$2,016.00	$986.30	$1,915.20	$1,581.90	2026-01-15
81229	HCPCS	Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi…	7	7	$2,100.00	$2,100.00	$1,512.87	$1,995.00	$1,577.64	2026-01-15
93306	HCPCS	Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu…	8	8	$2,000.00	$2,000.00	$81.36	$1,900.00	$1,558.50	2026-01-15
25560	HCPCS	Closed Treatment Of Broken Midpart Of Both Forearm Bones	8	8	$1,977.00	$1,977.00	$499.21	$1,878.15	$1,532.17	2026-01-15
27508	HCPCS	Closed Treatment Of Broken Inside Or Outside Portion Of Lower End Of Thigh Bone	8	8	$1,977.00	$1,977.00	$499.21	$1,878.15	$1,532.17	2026-01-15
24560	HCPCS	Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow	8	8	$1,977.00	$1,977.00	$665.62	$1,878.15	$1,532.17	2026-01-15
27786	HCPCS	Closed Treatment Of Broken Outside Lower Leg Bone At Ankle	8	8	$1,977.00	$1,977.00	$499.21	$1,878.15	$1,532.17	2026-01-15
25600	HCPCS	Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb …	8	8	$1,977.00	$1,977.00	$499.21	$1,878.15	$1,532.17	2026-01-15
25622	HCPCS	Closed Treatment Of Broken Wrist Bone Near Base Of Thumb	8	8	$1,977.00	$1,977.00	$416.01	$1,878.15	$1,532.17	2026-01-15
25605	HCPCS	Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit…	8	8	$1,977.00	$1,977.00	$833.06	$1,878.15	$1,532.17	2026-01-15
23600	HCPCS	Closed Treatment Of Broken Top Of Upper Arm Bone	8	8	$1,977.00	$1,977.00	$582.42	$1,878.15	$1,532.17	2026-01-15
25650	HCPCS	Closed Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist	8	8	$1,977.00	$1,977.00	$540.81	$1,878.15	$1,532.17	2026-01-15
27824	HCPCS	Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint	8	8	$1,977.00	$1,977.00	$499.21	$1,878.15	$1,532.17	2026-01-15
24500	HCPCS	Closed Treatment Of Broken Middle Part Of Upper Arm Bone	8	8	$1,977.00	$1,977.00	$499.21	$1,878.15	$1,532.17	2026-01-15
27808	HCPCS	Closed Treatment Of 2 Broken Lower Leg Bones At Ankle	8	8	$1,977.00	$1,977.00	$499.21	$1,878.15	$1,532.17	2026-01-15
27530	HCPCS	Closed Treatment Of Broken Shin Bone	8	8	$1,977.00	$1,977.00	$582.42	$1,878.15	$1,532.17	2026-01-15
28470	HCPCS	Closed Treatment Of Broken Bone In Forefoot Or Midfoot	8	8	$1,977.00	$1,977.00	$499.21	$1,878.15	$1,532.17	2026-01-15
45385	HCPCS	Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S…	8	8	$1,950.00	$1,950.00	$611.66	$1,852.50	$1,516.00	2026-01-15
J3358	HCPCS	Ustekinumab, For Intravenous Injection, 1 Mg	8	8	$1,925.00	$1,925.00	$14.79	$1,828.75	$1,491.88	2026-01-15
78452	HCPCS	Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect	8	8	$1,915.00	$1,915.00	$613.74	$1,819.25	$1,484.12	2026-01-15
20525	HCPCS	Complicated Removal Of Foreign Body In Deep Muscle Or Tendon	14	8	$2,945.00	$2,945.00	$213.00	$2,797.75	$1,472.84	2026-01-15
11426	HCPCS	Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More …	14	8	$2,300.00	$2,300.00	$225.57	$2,185.00	$1,472.84	2026-01-15
27750	HCPCS	Closed Treatment Of Broken Middle Part Of Shin Bone	8	8	$1,875.00	$1,875.00	$499.21	$1,781.25	$1,470.00	2026-01-15
25500	HCPCS	Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side	8	8	$1,872.00	$1,872.00	$499.21	$1,778.40	$1,468.80	2026-01-15
25530	HCPCS	Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side	8	8	$1,872.00	$1,872.00	$499.21	$1,778.40	$1,468.80	2026-01-15
46255	HCPCS	Removal Of Single External And Internal Hemorrhoid Group	14	8	$2,926.00	$2,926.00	$320.40	$2,779.70	$1,455.37	2026-01-15
28490	HCPCS	Closed Treatment Of Broken Great Toe	8	8	$1,795.00	$1,795.00	$499.21	$1,705.25	$1,438.00	2026-01-15
25660	HCPCS	Closed Treatment Of Dislocated Wrist Bones With Manipulation	8	8	$1,750.00	$1,750.00	$540.81	$1,662.50	$1,420.00	2026-01-15
J1602	HCPCS	Injection, Golimumab, 1 Mg, For Intravenous Use	8	8	$1,825.00	$1,825.00	$17.65	$1,733.75	$1,414.38	2026-01-15
27810	HCPCS	Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation	8	8	$1,725.00	$1,725.00	$833.06	$1,638.75	$1,401.57	2026-01-15
45380	HCPCS	Biopsy Of Large Bowel Using A Flexible Endoscope	8	8	$1,760.00	$1,760.00	$611.66	$1,672.00	$1,379.00	2026-01-15
J3262	HCPCS	Injection, Tocilizumab, 1 Mg	18	8	$1,762.00	$1,762.00	$6.34	$3,420.00	$1,365.55	2026-01-15
J1459	HCPCS	Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui…	13	8	$3,500.00	$3,500.00	$52.38	$3,325.00	$1,353.75	2026-01-15
45384	HCPCS	Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec…	8	8	$1,730.00	$1,730.00	$611.66	$1,643.50	$1,346.00	2026-01-15
45378	HCPCS	Diagnostic Exam Of Large Bowel Using A Flexible Endoscope	8	8	$1,725.00	$1,725.00	$473.74	$1,638.75	$1,344.00	2026-01-15
43247	HCPCS	Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using …	8	8	$1,685.00	$1,685.00	$469.85	$1,600.75	$1,322.00	2026-01-15
75635	HCPCS	CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast	8	8	$1,635.00	$1,635.00	$245.27	$1,553.25	$1,272.70	2026-01-15
64624	HCPCS	Destruction Of Nerve Branches Of Knee Using Imaging Guidance	20	7	$1,560.00	$1,560.00	$125.36	$1,788.17	$1,267.50	2026-01-15
73706	HCPCS	CT Scan Of Blood Vessels Of Lower Leg With Contrast	7	7	$1,527.00	$1,527.00	$245.27	$1,450.65	$1,221.60	2026-01-15
70496	HCPCS	CT Scan Of Blood Vessels Of Head With Contrast	13	8	$1,510.00	$1,510.00	$245.27	$1,439.25	$1,212.00	2026-01-15
71275	HCPCS	CT Scan Of Blood Vessels Of Chest With Contrast	13	8	$1,490.00	$1,490.00	$288.55	$1,425.00	$1,200.00	2026-01-15
74175	HCPCS	CT Scan Of Blood Vessels Of Abdomen With Contrast	8	8	$1,527.00	$1,527.00	$245.27	$1,450.65	$1,198.22	2026-01-15
10140	HCPCS	Drainage Of Blood Or Fluid Accumulation	8	8	$1,525.00	$1,525.00	$840.37	$1,448.75	$1,197.50	2026-01-15
G0105	HCPCS	Colorectal Cancer Screening; Colonoscopy On Individual At High Risk	8	8	$1,538.00	$1,538.00	$907.96	$1,461.10	$1,191.95	2026-01-15
G0121	HCPCS	Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For …	8	8	$1,538.00	$1,538.00	$907.96	$1,461.10	$1,191.95	2026-01-15
26725	HCPCS	Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With …	8	8	$1,530.00	$1,530.00	$499.21	$1,453.50	$1,185.75	2026-01-15
70498	HCPCS	CT Scan Of Blood Vessels Of Neck With Contrast	8	8	$1,525.00	$1,525.00	$245.27	$1,448.75	$1,184.08	2026-01-15
43251	HCPCS	Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…	8	8	$1,448.00	$1,448.00	$986.30	$1,375.60	$1,176.50	2026-01-15
43239	HCPCS	Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop…	8	8	$1,500.00	$1,500.00	$469.85	$1,425.00	$1,171.00	2026-01-15
64495	HCPCS	Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And…	31	8	$1,824.00	$1,824.00	$42.84	$1,732.80	$1,170.00	2026-01-15
43250	HCPCS	Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…	8	8	$1,448.00	$1,448.00	$986.30	$1,375.60	$1,159.70	2026-01-15
45338	HCPCS	Removal Of Polyps Or Growths Of Lower Large Bowel Using A Flexible Endoscope Wit…	8	8	$1,468.00	$1,468.00	$611.66	$1,394.60	$1,151.70	2026-01-15
43235	HCPCS	Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible…	8	8	$1,448.00	$1,448.00	$469.85	$1,375.60	$1,122.20	2026-01-15
43220	HCPCS	Balloon Dilation Of Esophagus Using A Flexible Endoscope, Less Than 3.0 Cm	8	8	$1,448.00	$1,448.00	$986.30	$1,375.60	$1,122.20	2026-01-15
86711	HCPCS	Analysis For Antibody To John Cunningham Virus	6	6	$1,400.00	$1,400.00	$41.01	$1,330.00	$1,102.50	2026-01-15
1000002_1	CDM	Room & Board - Private (one Bed) - General Classification	4	4	$1,125.00	$1,125.00	$956.25	$1,136.25	$1,102.50	2026-01-15
1000001_1	CDM	Room & Board - Semi-private (two Beds) - General Classification	4	4	$1,075.00	$1,075.00	$913.75	$1,085.75	$1,053.50	2026-01-15
J1566	HCPCS	Injection, Immune Globulin, Intravenous, Lyophilized (e.g., Powder), Not Otherwi…	13	8	$1,100.00	$1,100.00	$112.34	$2,778.75	$1,045.00	2026-01-15
44376	HCPCS	Diagnostic Exam Of Small Bowel (including Lower Small Intestine) Using An Endosc…	8	8	$1,325.00	$1,325.00	$986.30	$1,258.75	$1,028.50	2026-01-15
J0630	HCPCS	Injection, Calcitonin Salmon, Up To 400 Units	8	8	$1,075.00	$1,075.00	$806.25	$3,352.50	$1,021.25	2026-01-15
J1439	HCPCS	Injection, Ferric Carboxymaltose, 1 Mg	8	8	$1,300.00	$1,300.00	$1.39	$1,235.00	$1,007.50	2026-01-15
1000004_1	CDM	Room & Board - Private (one Bed) - General Classification	4	4	$1,000.00	$1,000.00	$850.00	$1,010.00	$980.00	2026-01-15
64635	HCPCS	Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,…	27	7	$1,200.00	$1,200.00	$162.92	$1,140.00	$975.98	2026-01-15
10160	HCPCS	Aspiration Of Abscess, Blood, Or Cyst	8	8	$1,220.00	$1,220.00	$356.94	$1,159.00	$957.00	2026-01-15
30300	HCPCS	Removal Of Foreign Body In Nose	8	8	$1,208.00	$1,208.00	$224.65	$1,147.60	$947.70	2026-01-15
13160	HCPCS	Extensive Or Complicated Repair Of Surface Wound Reopening	14	8	$2,623.00	$2,623.00	$631.61	$2,491.85	$945.24	2026-01-15
86366	HCPCS	Test For Muscle-specific Kinase Antibody	7	7	$1,250.00	$1,250.00	$25.02	$1,187.50	$937.50	2026-01-15
1000003_1	CDM	Room & Board - Semi-private (two Beds) - General Classification	4	4	$950.00	$950.00	$807.50	$959.50	$931.00	2026-01-15
J1745	HCPCS	Injection, Infliximab, Excludes Biosimilar, 10 Mg	8	8	$1,200.00	$1,200.00	$49.89	$1,140.00	$930.00	2026-01-15
27266	HCPCS	Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia	14	8	$1,400.00	$1,400.00	$494.49	$1,330.00	$915.22	2026-01-15
27520	HCPCS	Closed Treatment Of Broken Kneecap	12	8	$1,410.50	$1,410.50	$254.20	$1,878.15	$912.67	2026-01-15
64492	HCPCS	Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Third And…	31	8	$1,415.00	$1,415.00	$48.62	$1,344.25	$907.00	2026-01-15
22310	HCPCS	Closed Treatment Of Broken Spine Bone With Cast Or Brace	5	5	$1,099.00	$1,099.00	$824.25	$1,044.05	$906.68	2026-01-15
64633	HCPCS	Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,…	27	7	$1,200.00	$1,200.00	$162.49	$1,140.00	$900.00	2026-01-15
J2357	HCPCS	Injection, Omalizumab, 5 Mg	8	8	$1,160.00	$1,160.00	$47.68	$1,102.00	$899.00	2026-01-15
23650	HCPCS	Closed Treatment Of Dislocated Shoulder With Manipulation	8	8	$1,099.00	$1,099.00	$416.01	$1,044.05	$884.10	2026-01-15
26350	HCPCS	Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm…	7	7	$900.00	$900.00	$675.00	$1,677.76	$855.00	2026-01-15
59612	HCPCS	Vaginal Delivery After Previous Cesarean Delivery	7	7	$900.00	$900.00	$675.00	$1,620.49	$855.00	2026-01-15
27265	HCPCS	Closed Treatment Of Dislocated Hip Prosthesis	8	8	$1,099.00	$1,099.00	$499.21	$1,044.05	$851.73	2026-01-15
25260	HCPCS	Primary Repair Of Tendon Or Muscle Of Palm Side Of Forearm Or Wrist	12	7	$760.00	$760.00	$570.00	$1,677.76	$851.73	2026-01-15
23500	HCPCS	Closed Treatment Of Broken Collar Bone	8	8	$1,099.00	$1,099.00	$416.01	$1,044.05	$851.73	2026-01-15
25675	HCPCS	Closed Treatment Of Dislocated Forearm Bone At Wrist With Manipulation	8	8	$1,099.00	$1,099.00	$540.81	$1,044.05	$851.73	2026-01-15
26670	HCPCS	Closed Treatment Of Dislocated Hand Bone At Wrist Joint With Manipulation	8	8	$1,099.00	$1,099.00	$332.42	$1,044.05	$851.73	2026-01-15
26775	HCPCS	Closed Treatment Of Dislocated Finger Joint With Manipulation Under Anesthesia	8	8	$1,099.00	$1,099.00	$499.21	$1,044.05	$851.73	2026-01-15
24640	HCPCS	Closed Treatment Of Dislocated Forearm Bone On Thumb Side At Elbow With Manipula…	8	8	$1,099.00	$1,099.00	$582.42	$1,044.05	$851.73	2026-01-15
26740	HCPCS	Closed Treatment Of Broken Finger Or Hand At Base Of Finger	8	8	$1,099.00	$1,099.00	$228.81	$1,044.05	$851.73	2026-01-15
24600	HCPCS	Repair Of Dislocated Elbow	8	8	$1,099.00	$1,099.00	$499.21	$1,044.05	$851.73	2026-01-15
28600	HCPCS	Closed Treatment Of Dislocated Midfoot Joint	8	8	$1,099.00	$1,099.00	$183.04	$1,044.05	$851.73	2026-01-15
26700	HCPCS	Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation	8	8	$1,099.00	$1,099.00	$122.23	$1,044.05	$851.73	2026-01-15
27560	HCPCS	Closed Treatment Of Dislocated Kneecap	8	8	$1,099.00	$1,099.00	$582.42	$1,044.05	$851.73	2026-01-15
27550	HCPCS	Closed Treatment Of Dislocated Knee	8	8	$1,099.00	$1,099.00	$582.42	$1,044.05	$851.73	2026-01-15
26720	HCPCS	Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand	8	8	$1,099.00	$1,099.00	$499.21	$1,044.05	$851.73	2026-01-15
26605	HCPCS	Closed Treatment Of Broken Hand Bone With Manipulation	8	8	$1,099.00	$1,099.00	$499.21	$1,044.05	$851.73	2026-01-15
11606	HCPCS	Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm	14	8	$2,400.00	$2,400.00	$227.49	$2,280.00	$840.37	2026-01-15
32555	HCPCS	Aspiration Of Fluid From Chest Cavity Using Imaging Guidance	8	8	$1,025.00	$1,025.00	$446.04	$973.75	$832.82	2026-01-15
64494	HCPCS	Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Second Le…	31	8	$1,280.00	$1,280.00	$41.63	$1,216.00	$821.00	2026-01-15
12005	HCPCS	Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, …	8	8	$1,045.00	$1,045.00	$384.39	$992.75	$818.50	2026-01-15
45339	HCPCS	Gastro - Intestinal (gi) Services - General Classification	5	5	$960.00	$960.00	$720.00	$912.00	$792.00	2026-01-15
45333	HCPCS	Removal Of Polyps Or Growths Of Lower Large Bowel Using A Flexible Endoscope Wit…	8	8	$960.00	$960.00	$473.74	$912.00	$780.00	2026-01-15
45331	HCPCS	Biopsy Of Lower Large Bowel Using A Flexible Endoscope	8	8	$960.00	$960.00	$473.74	$912.00	$780.00	2026-01-15
45330	HCPCS	Diagnostic Exam Of Lower Portion Of Large Bowel Using A Flexible Endoscope	8	8	$960.00	$960.00	$473.74	$912.00	$780.00	2026-01-15
11740	HCPCS	Removal Of Blood Accumulation Under Fingernail Or Toenail	7	7	$950.00	$950.00	$416.01	$902.50	$760.00	2026-01-15
32556	HCPCS	Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube	8	8	$955.00	$955.00	$446.04	$907.25	$749.50	2026-01-15
32554	HCPCS	Aspiration Of Fluid From Chest Cavity	8	8	$955.00	$955.00	$446.04	$907.25	$749.50	2026-01-15
64491	HCPCS	Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Second Le…	31	8	$996.00	$996.00	$48.05	$946.20	$747.00	2026-01-15
36589	HCPCS	Removal Of Tunneled Central Venous Tube	8	8	$914.00	$914.00	$262.37	$949.00	$742.62	2026-01-15
36569	HCPCS	Insertion Of Tube For Infusion (5 Years Or Older)	19	8	$900.00	$900.00	$79.42	$5,137.73	$742.50	2026-01-15
36568	HCPCS	Insertion Of Tube For Infusion (younger Than 5 Years)	19	8	$900.00	$900.00	$78.92	$5,137.73	$742.50	2026-01-15
23655	HCPCS	Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia	14	8	$950.00	$950.00	$308.39	$902.50	$736.25	2026-01-15
92977	HCPCS	Removal Of Heart Artery Blood Clot By Dissolving	9	6	$970.00	$970.00	$55.63	$921.50	$735.00	2026-01-15
64454	HCPCS	Injection Of Anesthetic Agent And/or Steroid Into Knee Nerve Branch Using Imagin…	20	7	$1,071.00	$1,071.00	$69.13	$1,017.45	$726.66	2026-01-15
J1568	HCPCS	Injection, Immune Globulin, (octagam), Intravenous, Non-lyophilized (e.g., Liqui…	8	8	$932.00	$932.00	$53.45	$885.40	$722.30	2026-01-15
73223	HCPCS	MRI Scan Of Arm Joint Before And After Contrast	16	8	$922.00	$922.00	$501.09	$875.90	$714.55	2026-01-15
59409	HCPCS	Vaginal Delivery	7	7	$750.00	$750.00	$562.50	$1,620.49	$712.50	2026-01-15
71555	HCPCS	MRI Scan Of Blood Vessels Of Chest	8	8	$875.00	$875.00	$627.00	$831.25	$708.32	2026-01-15
78582	HCPCS	Nuclear Medicine Study Of Lung Ventilation And Circulation	8	8	$899.00	$899.00	$674.25	$854.05	$702.76	2026-01-15
73725	HCPCS	MRI Scan Of Blood Vessels Of Leg	24	8	$862.00	$862.00	$627.00	$1,637.80	$689.60	2026-01-15
73225	HCPCS	MRI Scan Of Blood Vessels Of Arm	24	8	$862.00	$862.00	$130.29	$1,637.80	$689.60	2026-01-15
P9053	HCPCS	Platelets, Pheresis, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit	7	7	$855.00	$855.00	$40.80	$812.25	$684.00	2026-01-15
J7325	HCPCS	Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,…	8	8	$875.00	$875.00	$14.54	$831.25	$678.12	2026-01-15
72198	HCPCS	MRI Scan Of Blood Vessels Of Pelvis	8	8	$875.00	$875.00	$520.69	$831.25	$678.12	2026-01-15
70544	HCPCS	MRI Scan Of Blood Vessels Of Head Without Contrast	8	8	$875.00	$875.00	$317.59	$831.25	$678.12	2026-01-15
72159	HCPCS	MRI Scan Of Blood Vessels Of Spinal Canal	8	8	$875.00	$875.00	$133.94	$831.25	$678.12	2026-01-15
70547	HCPCS	MRI Scan Of Blood Vessels Of Neck Without Contrast	8	8	$875.00	$875.00	$317.59	$831.25	$678.12	2026-01-15
70548	HCPCS	MRI Scan Of Blood Vessels Of Neck With Contrast	8	8	$875.00	$875.00	$501.09	$831.25	$678.12	2026-01-15
70549	HCPCS	MRI Scan Of Blood Vessels Of Neck Before And After Contrast	8	8	$875.00	$875.00	$501.09	$831.25	$678.12	2026-01-15
74177	HCPCS	CT Scan Of Abdomen And Pelvis With Contrast	8	8	$840.00	$840.00	$113.76	$798.00	$651.00	2026-01-15
J1569	HCPCS	Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),…	13	8	$675.00	$675.00	$54.23	$1,467.75	$641.25	2026-01-15
P9037	HCPCS	Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit	7	7	$795.00	$795.00	$40.80	$755.25	$636.00	2026-01-15
P9055	HCPCS	Platelets, Leukocytes Reduced, Cmv-negative, Apheresis/pheresis, Each Unit	7	7	$795.00	$795.00	$40.80	$755.25	$636.00	2026-01-15
74178	HCPCS	CT Scan Of Abdomen And Pelvis Before And After Contrast	8	8	$815.00	$815.00	$125.03	$774.25	$631.62	2026-01-15
28635	HCPCS	Closed Treatment Of Dislocated Joint Between Toe And Foot Under Anesthesia	12	8	$940.00	$940.00	$114.30	$1,334.75	$629.67	2026-01-15
78227	HCPCS	Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs	8	8	$705.00	$705.00	$524.40	$686.15	$625.69	2026-01-15
13121	HCPCS	Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm	8	8	$733.00	$733.00	$534.00	$696.35	$622.69	2026-01-15
J1670	HCPCS	Injection, Tetanus Immune Globulin, Human, Up To 250 Units	8	8	$700.00	$700.00	$525.00	$923.30	$621.25	2026-01-15
65220	HCPCS	Removal Of Foreign Body In Cornea	8	8	$697.00	$697.00	$522.75	$665.62	$618.59	2026-01-15
70553	HCPCS	MRI Scan Of Brain Before And After Contrast	8	8	$775.00	$775.00	$521.00	$736.25	$604.75	2026-01-15
62323	HCPCS	Injection Of Substance Into Lower Spine Canal Using Imaging Guidance	15	8	$1,500.00	$1,500.00	$83.99	$1,425.00	$603.46	2026-01-15
62321	HCPCS	Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance	15	8	$1,500.00	$1,500.00	$90.04	$1,425.00	$603.46	2026-01-15
71550	HCPCS	MRI Scan Of Chest Without Contrast	8	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
71552	HCPCS	MRI Scan Of Chest Before And After Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
72141	HCPCS	MRI Scan Of Upper Spinal Canal Without Contrast	8	8	$775.00	$775.00	$373.64	$736.25	$600.62	2026-01-15
70552	HCPCS	MRI Scan Of Brain With Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
72149	HCPCS	MRI Scan Of Lower Spinal Canal With Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
73221	HCPCS	MRI Scan Of Arm Joint Without Contrast	16	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
73718	HCPCS	MRI Scan Of Leg Without Contrast	16	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
72156	HCPCS	MRI Scan Of Upper Spinal Canal Before And After Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
73218	HCPCS	MRI Scan Of Arm Without Contrast	16	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
70551	HCPCS	MRI Scan Of Brain Without Contrast	8	8	$775.00	$775.00	$373.64	$736.25	$600.62	2026-01-15
72197	HCPCS	MRI Scan Of Pelvis Before And After Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
73720	HCPCS	MRI Scan Of Leg Before And After Contrast	16	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
74181	HCPCS	MRI Scan Of Abdomen Without Contrast	8	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
73721	HCPCS	MRI Scan Of Leg Joint Without Contrast	16	8	$775.00	$775.00	$373.64	$736.25	$600.62	2026-01-15
72147	HCPCS	MRI Scan Of Middle Spinal Canal With Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
73220	HCPCS	MRI Scan Of Arm Before And After Contrast	16	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
72148	HCPCS	MRI Scan Of Lower Spinal Canal Without Contrast	8	8	$775.00	$775.00	$373.64	$736.25	$600.62	2026-01-15
72195	HCPCS	MRI Scan Of Pelvis Without Contrast	8	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
70336	HCPCS	MRI Scan Of Jaw Joint	8	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
70543	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
70540	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast	8	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
72196	HCPCS	MRI Scan Of Pelvis With Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
76498	HCPCS	Other MRI Scan	8	8	$775.00	$775.00	$118.16	$736.25	$600.62	2026-01-15
72146	HCPCS	MRI Scan Of Middle Spinal Canal Without Contrast	8	8	$775.00	$775.00	$317.59	$736.25	$600.62	2026-01-15
72142	HCPCS	MRI Scan Of Upper Spinal Canal With Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
74183	HCPCS	MRI Scan Of Abdomen Before And After Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
72157	HCPCS	MRI Scan Of Middle Spinal Canal Before And After Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
72158	HCPCS	MRI Scan Of Lower Spinal Canal Before And After Contrast	8	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
73723	HCPCS	MRI Scan Of Leg Joint Before And After Contrast	16	8	$775.00	$775.00	$501.09	$736.25	$600.62	2026-01-15
C8924	HCPCS	Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi…	6	6	$735.00	$735.00	$551.25	$698.25	$597.19	2026-01-15
J0248	HCPCS	Injection, Remdesivir, 1 Mg	12	7	$930.00	$930.00	$10.77	$883.50	$592.80	2026-01-15
70545	HCPCS	MRI Scan Of Blood Vessels Of Head With Contrast	8	8	$725.00	$725.00	$501.09	$688.75	$589.07	2026-01-15
70546	HCPCS	MRI Scan Of Blood Vessels Of Head Before And After Contrast	8	8	$725.00	$725.00	$501.09	$688.75	$589.07	2026-01-15
P9035	HCPCS	Platelets, Pheresis, Leukocytes Reduced, Each Unit	7	7	$735.00	$735.00	$40.80	$698.25	$588.00	2026-01-15
81401	HCPCS	Molecular Pathology Procedure Level 2	6	6	$660.00	$660.00	$281.52	$904.20	$585.75	2026-01-15
Q5106	HCPCS	Injection, Epoetin Alfa-epbx, Biosimilar, (retacrit) (for Non-esrd Use), 1000 Un…	8	8	$750.00	$750.00	$12.11	$712.50	$581.25	2026-01-15
49082	HCPCS	Drainage Of Fluid From Abdominal Cavity	8	8	$740.00	$740.00	$416.76	$703.00	$580.50	2026-01-15
93307	HCPCS	Ultrasound Of Heart	6	6	$712.00	$712.00	$534.00	$676.40	$578.70	2026-01-15
64493	HCPCS	Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le…	31	8	$900.00	$900.00	$76.55	$855.00	$577.00	2026-01-15
87902	HCPCS	Analysis Test By Nucleic Acid For Hepatitis C Virus	8	8	$720.00	$720.00	$411.93	$1,853.64	$570.48	2026-01-15
93308	HCPCS	Ultrasound Of Heart, Follow-up	8	8	$712.00	$712.00	$288.81	$676.40	$569.80	2026-01-15
P9016	HCPCS	Red Blood Cells, Leukocytes Reduced, Each Unit	7	7	$700.00	$700.00	$139.20	$665.00	$560.00	2026-01-15
49450	HCPCS	Replacement Of Stomach Or Large Bowel Tube Using Fluoroscopic Guidance With Cont…	7	7	$698.00	$698.00	$223.09	$663.10	$558.40	2026-01-15
77048	HCPCS	MRI Scan Of 1 Breast	12	6	$685.00	$685.00	$513.75	$650.75	$556.57	2026-01-15
Q5103	HCPCS	Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg	8	8	$710.00	$710.00	$31.49	$674.50	$550.25	2026-01-15
12054	HCPCS	Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1…	14	8	$1,250.00	$1,250.00	$182.27	$1,187.50	$549.13	2026-01-15
12052	HCPCS	Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5…	14	8	$1,135.00	$1,135.00	$160.54	$1,078.25	$549.13	2026-01-15
12051	HCPCS	Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5 C…	14	8	$924.00	$924.00	$138.37	$877.80	$549.13	2026-01-15
12044	HCPCS	Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm	14	8	$900.00	$900.00	$176.50	$855.00	$549.13	2026-01-15
12015	HCPCS	Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6…	15	8	$1,075.00	$1,075.00	$81.83	$1,021.25	$539.15	2026-01-15
78226	HCPCS	Nuclear Medicine Study Of Liver And Bile Duct System	8	8	$682.00	$682.00	$511.50	$647.90	$537.11	2026-01-15
77049	HCPCS	MRI Scan Of Both Breasts	8	8	$685.00	$685.00	$456.64	$650.75	$534.50	2026-01-15
77047	HCPCS	MRI Scan Of Both Breasts Without Contrast	8	8	$685.00	$685.00	$317.59	$650.75	$534.50	2026-01-15
77046	HCPCS	MRI Scan Of 1 Breast Without Contrast	16	8	$685.00	$685.00	$317.59	$650.75	$534.50	2026-01-15
78700	HCPCS	Nuclear Medicine Study Of Kidney	7	7	$576.25	$576.25	$432.19	$547.44	$528.62	2026-01-15
J1740	HCPCS	Injection, Ibandronate Sodium, 1 Mg	8	8	$680.00	$680.00	$49.28	$646.00	$527.00	2026-01-15
43763	HCPCS	Replacement Of Stomach Stoma Tube With Revision Of Stoma Opening	13	8	$595.00	$595.00	$240.68	$665.00	$525.00	2026-01-15
78579	HCPCS	Nuclear Medicine Study Of Lung Ventilation	7	7	$551.00	$551.00	$413.25	$528.62	$523.45	2026-01-15
82139	HCPCS	Amino Acid Level, 6 Or More Amino Acids, Quantitative, Each Specimen	13	8	$545.00	$545.00	$26.99	$701.10	$517.75	2026-01-15
77075	HCPCS	Complete X-ray Of Body Bones	8	8	$665.00	$665.00	$49.43	$631.75	$516.70	2026-01-15
76536	HCPCS	Ultrasound Scan Of Head And Neck Soft Tissue	8	8	$666.00	$666.00	$145.36	$632.70	$516.15	2026-01-15
93971	HCPCS	Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers	26	8	$630.00	$630.00	$190.97	$603.25	$508.00	2026-01-15
93880	HCPCS	Ultrasound Of Both Sides Of Head And Neck Blood Flow	8	8	$655.00	$655.00	$284.74	$622.25	$507.62	2026-01-15
73201	HCPCS	CT Scan Of Arm With Contrast	16	8	$635.00	$635.00	$453.00	$603.25	$504.54	2026-01-15
71271	HCPCS	Low Dose CT Scan Of Chest For Lung Cancer Screening	7	7	$630.00	$630.00	$145.36	$598.50	$504.00	2026-01-15
93922	HCPCS	Ultrasound Study Of Arm And Leg Arteries	16	8	$650.00	$650.00	$150.10	$617.50	$503.75	2026-01-15
13132	HCPCS	Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G…	14	8	$733.00	$733.00	$235.19	$999.00	$503.68	2026-01-15
27780	HCPCS	Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone	14	8	$1,977.00	$1,977.00	$234.09	$1,878.15	$499.21	2026-01-15
26770	HCPCS	Closed Treatment Of Dislocated Finger Joint With Manipulation	14	8	$1,099.00	$1,099.00	$220.32	$1,044.05	$499.21	2026-01-15
72132	HCPCS	CT Scan Of Lower Spine With Contrast	8	8	$598.00	$598.00	$448.50	$568.10	$497.22	2026-01-15
71260	HCPCS	CT Scan Of Chest With Contrast	8	8	$640.00	$640.00	$288.55	$608.00	$496.00	2026-01-15
64636	HCPCS	Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,…	28	8	$600.00	$600.00	$48.05	$570.00	$495.00	2026-01-15
26750	HCPCS	Closed Treatment Of Broken End Of Finger Or Thumb	8	8	$588.00	$588.00	$428.00	$558.60	$492.15	2026-01-15
74176	HCPCS	CT Scan Of Abdomen And Pelvis Without Contrast	8	8	$635.00	$635.00	$108.83	$603.25	$492.12	2026-01-15
72125	HCPCS	CT Scan Of Upper Spine Without Contrast	8	8	$635.00	$635.00	$171.01	$603.25	$492.12	2026-01-15
70492	HCPCS	CT Scan Of Soft Tissue Of Neck Before And After Contrast	8	8	$635.00	$635.00	$245.27	$603.25	$492.12	2026-01-15
70486	HCPCS	CT Scan Of Face Without Contrast	8	8	$635.00	$635.00	$145.36	$603.25	$492.12	2026-01-15
72131	HCPCS	CT Scan Of Lower Spine Without Contrast	8	8	$635.00	$635.00	$145.36	$603.25	$492.12	2026-01-15
93978	HCPCS	Complete Ultrasound Of Aorta, Vena Cava, Groin Vessels Or Bypass Grafts	8	8	$630.00	$630.00	$154.68	$598.50	$490.00	2026-01-15
93970	HCPCS	Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers	8	8	$630.00	$630.00	$316.66	$598.50	$490.00	2026-01-15
72127	HCPCS	CT Scan Of Upper Spine Before And After Contrast	8	8	$630.00	$630.00	$245.27	$598.50	$488.25	2026-01-15
71250	HCPCS	CT Scan Of Chest Without Contrast	8	8	$630.00	$630.00	$171.01	$598.50	$488.25	2026-01-15
71270	HCPCS	CT Scan Of Chest Before And After Contrast	8	8	$630.00	$630.00	$245.27	$598.50	$488.25	2026-01-15
74170	HCPCS	CT Scan Of Abdomen Before And After Contrast	8	8	$630.00	$630.00	$245.27	$598.50	$488.25	2026-01-15
72128	HCPCS	CT Scan Of Middle Spine Without Contrast	8	8	$630.00	$630.00	$145.36	$598.50	$488.25	2026-01-15
70491	HCPCS	CT Scan Of Soft Tissue Of Neck With Contrast	8	8	$630.00	$630.00	$245.27	$598.50	$488.25	2026-01-15
70470	HCPCS	CT Scan Of Head Or Brain Before And After Contrast	8	8	$630.00	$630.00	$245.27	$598.50	$488.25	2026-01-15
93926	HCPCS	Ultrasound Of One Leg Arteries Or Artery Grafts	16	8	$625.00	$625.00	$172.80	$593.75	$488.00	2026-01-15
93930	HCPCS	Ultrasound Of Arm Arteries Or Artery Grafts	8	8	$625.00	$625.00	$152.00	$593.75	$488.00	2026-01-15
93931	HCPCS	Ultrasound Of One Arm Arteries Or Artery Grafts	16	8	$625.00	$625.00	$113.49	$593.75	$488.00	2026-01-15
93925	HCPCS	Ultrasound Of Leg Arteries Or Artery Grafts	8	8	$625.00	$625.00	$284.65	$593.75	$488.00	2026-01-15
70450	HCPCS	CT Scan Head Or Brain Without Contrast	8	8	$626.00	$626.00	$171.01	$594.70	$485.15	2026-01-15
72193	HCPCS	CT Scan Of Pelvis With Contrast	8	8	$625.00	$625.00	$245.27	$593.75	$484.38	2026-01-15
72192	HCPCS	CT Scan Of Pelvis Without Contrast	8	8	$625.00	$625.00	$145.36	$593.75	$484.38	2026-01-15
72194	HCPCS	CT Scan Of Pelvis Before And After Contrast	8	8	$625.00	$625.00	$245.27	$593.75	$484.38	2026-01-15
87506	HCPCS	Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S…	8	8	$605.00	$605.00	$395.02	$1,591.09	$480.12	2026-01-15
43762	HCPCS	Replacement Of Stomach Stoma Tube	13	8	$600.00	$600.00	$240.68	$570.00	$480.00	2026-01-15
75571	HCPCS	CT Scan Of Heart With Evaluation Of Blood Vessel Calcium	6	6	$590.00	$590.00	$442.50	$560.50	$479.38	2026-01-15
84445	HCPCS	Thyroid Stimulating Immune Globulins (thyroid Related Protein) Level	8	8	$653.00	$653.00	$81.38	$620.35	$477.48	2026-01-15
72126	HCPCS	CT Scan Of Upper Spine With Contrast	8	8	$525.00	$525.00	$393.75	$501.09	$475.88	2026-01-15
86052	HCPCS	Cell-based Immunofluorescence (cba) Detection Of Aquaporin-4 (neuromyelitis Opti…	7	7	$633.00	$633.00	$12.53	$601.35	$474.75	2026-01-15
86362	HCPCS	Cell-based Immunofluorescence (cba) Detection Of Myelin Oligodendrocyte Glycopro…	7	7	$633.00	$633.00	$12.53	$601.35	$474.75	2026-01-15
93975	HCPCS	Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow	16	8	$587.50	$587.50	$219.83	$598.50	$474.25	2026-01-15
64483	HCPCS	Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I…	15	8	$905.00	$905.00	$93.64	$859.75	$472.44	2026-01-15
12014	HCPCS	Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1…	15	8	$995.00	$995.00	$65.32	$945.25	$471.00	2026-01-15
93976	HCPCS	Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow	8	8	$575.00	$575.00	$146.63	$546.25	$467.19	2026-01-15
93325	HCPCS	Ultrasound Of Heart With Color-depicted Blood Flow, Rate And Valve Function	8	8	$575.00	$575.00	$137.28	$546.25	$467.19	2026-01-15
93321	HCPCS	Ultrasound Of Heart Blood Flow, Valves And Chambers, Follow-up	8	8	$575.00	$575.00	$87.12	$546.25	$467.19	2026-01-15
70490	HCPCS	CT Scan Of Soft Tissue Of Neck Without Contrast	8	8	$600.00	$600.00	$145.36	$570.00	$466.50	2026-01-15
70460	HCPCS	CT Scan Head Or Brain With Contrast	8	8	$600.00	$600.00	$245.27	$570.00	$466.50	2026-01-15
3201910_1	CDM	Atrovent 17 Mcg Hfa Inhaler	5	5	$565.00	$565.00	$423.75	$536.75	$466.13	2026-01-15
78306	HCPCS	Nuclear Medicine Study Of Bone And/or Joint Whole Body	8	8	$525.00	$525.00	$393.75	$528.62	$465.94	2026-01-15
74160	HCPCS	CT Scan Of Abdomen With Contrast	8	8	$598.00	$598.00	$245.27	$568.10	$465.70	2026-01-15
73200	HCPCS	CT Scan Of Arm Without Contrast	24	8	$635.00	$635.00	$145.36	$603.25	$464.62	2026-01-15
73701	HCPCS	CT Scan Of Leg With Contrast Material	16	8	$595.00	$595.00	$245.27	$565.25	$464.50	2026-01-15
74150	HCPCS	CT Scan Of Abdomen Without Contrast	8	8	$595.00	$595.00	$145.36	$565.25	$464.50	2026-01-15
73702	HCPCS	CT Scan Of Leg Before And After Contrast	24	8	$595.00	$595.00	$245.27	$565.25	$464.50	2026-01-15
73202	HCPCS	CT Scan Of Arm Before And After Contrast	24	8	$595.00	$595.00	$245.27	$565.25	$464.50	2026-01-15
72133	HCPCS	CT Scan Of Lower Spine Before And After Contrast	8	8	$595.00	$595.00	$245.27	$565.25	$464.50	2026-01-15
72130	HCPCS	CT Scan Of Middle Spine Before And After Contrast	8	8	$595.00	$595.00	$245.27	$565.25	$464.50	2026-01-15
70488	HCPCS	CT Scan Of Face Before And After Contrast	8	8	$595.00	$595.00	$245.27	$565.25	$464.50	2026-01-15
70482	HCPCS	CT Scan Of Cranial Cavity Before And After Contrast	8	8	$595.00	$595.00	$245.27	$565.25	$464.50	2026-01-15
70487	HCPCS	CT Scan Of Face With Contrast	8	8	$590.00	$590.00	$245.27	$560.50	$462.50	2026-01-15
70481	HCPCS	CT Scan Of Cranial Cavity With Contrast	8	8	$590.00	$590.00	$245.27	$560.50	$462.50	2026-01-15
J1410	HCPCS	Injection, Estrogen Conjugated, Per 25 Mg	8	8	$520.00	$520.00	$390.00	$625.20	$461.50	2026-01-15
12035	HCPCS	Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.…	14	8	$5,283.00	$5,283.00	$205.56	$5,018.85	$458.34	2026-01-15
11750	HCPCS	Permanent Removal Fingernail Or Toenail	14	8	$665.00	$665.00	$88.22	$631.75	$457.61	2026-01-15
12034	HCPCS	Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5…	14	8	$2,935.00	$2,935.00	$166.84	$2,788.25	$457.61	2026-01-15
12032	HCPCS	Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 …	14	8	$1,690.00	$1,690.00	$153.57	$1,605.50	$457.61	2026-01-15

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