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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

KIOWA COUNTY MEMORIAL HOSPITAL

Greensburg, KS · CCN 171332 · 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: $1,995 across 12 payers · range $1,532-$3,363

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbKCMHGREENSBURGKS&type=CDMWithoutLabel&fileType=CSV · observed 2026-03-04

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

1,439 distinct procedures filed
13 distinct payers
33,466 rate rows
2026-03-04 last MRF observed
Data quality

33,136 of 33,466 rate rows are consumer-grade (99.0%)

330 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
exceeds 10× this hospital's gross charge — excluded from medians 207
percent-of-charges filed in the dollar field — excluded from medians 88
per-diem day rate — not a per-procedure price 34
placeholder amount (≤ $0.02) — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbKCMHGREENSBURGKS&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Kiowa_Memorial_V2.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-19
Content fingerprint b87dbbac115153ff… · 18,523,696 bytes · first seen 2026-05-04

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
J2507
HCPCS 		Injection, Pegloticase, 1 Mg 12 $4,109.99 $47,065.68 $41,888.46 nat. median
$9,200
outlier · 4.6×
J2327
HCPCS 		Injection, Risankizumab-rzaa, Intravenous, 1 Mg 11 $10,461.52 $17,435.86 $15,517.92 nat. median
$1,767
outlier · 8.8×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 12 $184.78 $10,042.79 $8,938.08 nat. median
$3,787
outlier · 2.4×
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 12 $2,598.83 $5,478.95 $4,876.27 nat. median
$3,452
1.4× median
36571
HCPCS 		Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older) 12 $1,253.57 $8,050.50 $3,830.93 nat. median
$3,393
1.1× median
4966415_1
CDM 		Praxbind 5g Dose(2x 2.5g/50ml) 8 $1,540.53 $3,427.68 $3,427.68 nat. median
$3,428
1.0× median
Q4196
HCPCS 		Puraply Am, Per Square Centimeter 11 $540.00 $10,260.00 $2,776.80 nat. median
$311
outlier · 8.9×
J0897
HCPCS 		Injection, Denosumab, 1 Mg 12 $29.68 $3,054.28 $2,718.31 nat. median
$1,982
1.4× median
6558554_1
CDM 		Jubbonti 60 Mg/ml Syringe 8 $1,083.44 $2,410.65 $2,410.65 nat. median
$2,411
1.0× median
73723
HCPCS 		MRI Scan Of Leg Joint Before And After Contrast 12 $526.21 $3,375.00 $2,002.50 nat. median
$1,199
1.7× median
93306
HCPCS 		Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 12 $1,532.17 $3,363.00 $1,995.38 nat. median
$993
outlier · 2.0×
Q4159
HCPCS 		Affinity, Per Square Centimeter 11 $1,154.25 $2,500.00 $1,923.75 nat. median
$643
outlier · 3.0×
36590
HCPCS 		Removal Of Central Venous Tube With Port Or Pump 12 $212.27 $3,930.00 $1,906.88 nat. median
$1,778
1.1× median
11422
HCPCS 		Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 12 $170.61 $3,795.00 $1,805.43 nat. median
$1,542
1.2× median
11424
HCPCS 		Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 12 $221.88 $3,720.00 $1,801.84 nat. median
$1,696
1.1× median
14040
HCPCS 		Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 12 $713.69 $3,660.00 $1,778.61 nat. median
$2,184
0.8× median
J7307
HCPCS 		Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 12 $1,140.00 $1,900.00 $1,691.00 nat. median
$1,639
1.0× median
73720
HCPCS 		MRI Scan Of Leg Before And After Contrast 12 $526.21 $2,812.50 $1,668.75 nat. median
$1,135
1.5× median
73722
HCPCS 		MRI Scan Of Leg Joint With Contrast 12 $526.21 $2,812.50 $1,668.75 nat. median
$1,282
1.3× median
73202
HCPCS 		CT Scan Of Arm Before And After Contrast 12 $457.53 $2,812.50 $1,668.75 nat. median
$714
outlier · 2.3×
J3489
HCPCS 		Injection, Zoledronic Acid, 1 Mg 12 $14.33 $1,825.45 $1,624.43 nat. median
$131
outlier · 12.4×
G0121
HCPCS 		Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For… 12 $1,006.97 $2,980.50 $1,591.59 nat. median
$1,283
1.2× median
73702
HCPCS 		CT Scan Of Leg Before And After Contrast 12 $457.53 $2,592.00 $1,537.92 nat. median
$708
outlier · 2.2×
4634657_1
CDM 		Room & Board - Private (one Bed) - General Classification 4 $1,320.00 $1,500.00 $1,500.00 nat. median
$1,425
1.1× median
J1439
HCPCS 		Injection, Ferric Carboxymaltose, 1 Mg 12 $1.42 $1,679.67 $1,494.91 nat. median
$14
outlier · 110.7×
45385
HCPCS 		Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 12 $440.55 $3,067.50 $1,486.72 nat. median
$1,663
0.9× median
74178
HCPCS 		CT Scan Of Abdomen And Pelvis Before And After Contrast 12 $457.53 $2,475.00 $1,468.50 nat. median
$1,027
1.4× median
36569
HCPCS 		Insertion Of Tube For Infusion (5 Years Or Older) 11 $88.91 $2,472.00 $1,458.48 nat. median
$1,726
0.8× median
71275
HCPCS 		CT Scan Of Blood Vessels Of Chest With Contrast 12 $1,143.85 $2,362.50 $1,401.75 nat. median
$759
1.8× median
J0717
HCPCS 		Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 12 $6.51 $1,573.38 $1,400.31 nat. median
$1,635
0.9× median
12055
HCPCS 		Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.6-… 12 $477.40 $2,812.50 $1,363.50 nat. median
$640
outlier · 2.1×
45380
HCPCS 		Biopsy Of Large Bowel Using A Flexible Endoscope 12 $423.73 $2,812.50 $1,363.50 nat. median
$1,565
0.9× median
43251
HCPCS 		Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi… 12 $486.21 $3,019.50 $1,353.40 nat. median
$2,129
0.6× median
21012
HCPCS 		Removal Of Growth Under Skin Of Face Or Scalp, 2.0 Cm Or More 12 $317.20 $2,782.50 $1,348.35 nat. median
$1,788
0.8× median
73223
HCPCS 		MRI Scan Of Arm Joint Before And After Contrast 12 $526.21 $2,250.00 $1,335.00 nat. median
$1,158
1.2× median
72197
HCPCS 		MRI Scan Of Pelvis Before And After Contrast 12 $526.21 $2,250.00 $1,335.00 nat. median
$1,074
1.2× median
74170
HCPCS 		CT Scan Of Abdomen Before And After Contrast 12 $457.53 $2,250.00 $1,335.00 nat. median
$714
1.9× median
73721
HCPCS 		MRI Scan Of Leg Joint Without Contrast 12 $526.21 $2,250.00 $1,335.00 nat. median
$856
1.6× median
70492
HCPCS 		CT Scan Of Soft Tissue Of Neck Before And After Contrast 12 $457.53 $2,250.00 $1,335.00 nat. median
$650
outlier · 2.1×
45381
HCPCS 		Injection Beneath Lining Of Large Bowel Using A Flexible Endoscope 12 $191.44 $2,730.00 $1,321.08 nat. median
$1,566
0.8× median
45384
HCPCS 		Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 12 $474.19 $2,730.00 $1,321.08 nat. median
$1,582
0.8× median
45378
HCPCS 		Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 12 $164.21 $2,730.00 $1,321.08 nat. median
$1,339
1.0× median
99285
HCPCS 		Emergency Department Visit With High Level Of Medical Decision Making 13 $98.48 $2,227.50 $1,306.80 nat. median
$1,187
1.1× median
2120839_1
CDM 		Room & Board - Private (one Bed) - General Classification 4 $1,144.00 $1,300.00 $1,300.00 nat. median
$1,268
1.0× median
15100
HCPCS 		Partial Thickness Self Skin Graft To Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Bod… 13 $38.38 $7,725.00 $1,281.25 nat. median
$2,291
0.6× median
J1459
HCPCS 		Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 12 $60.59 $5,080.32 $1,270.08 nat. median
$1,371
0.9× median
70543
HCPCS 		MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 12 $526.21 $2,100.00 $1,246.00 nat. median
$1,087
1.1× median
72156
HCPCS 		MRI Scan Of Upper Spinal Canal Before And After Contrast 12 $526.21 $2,100.00 $1,246.00 nat. median
$1,110
1.1× median
72158
HCPCS 		MRI Scan Of Lower Spinal Canal Before And After Contrast 12 $526.21 $2,100.00 $1,246.00 nat. median
$1,097
1.1× median
72157
HCPCS 		MRI Scan Of Middle Spinal Canal Before And After Contrast 12 $526.21 $2,100.00 $1,246.00 nat. median
$1,114
1.1× median

Other procedures at this hospital

Browse this hospital's 1,439 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
             
J2507 HCPCS Injection, Pegloticase, 1 Mg 12 12 $47,065.68 $40,005.83 $4,109.99 $47,065.68 $41,888.46 2026-03-04
J2327 HCPCS Injection, Risankizumab-rzaa, Intravenous, 1 Mg 11 11 $17,435.86 $14,820.48 $10,461.52 $17,435.86 $15,517.92 2026-03-04
J3101 HCPCS Injection, Tenecteplase, 1 Mg 12 12 $10,042.79 $8,536.37 $184.78 $10,042.79 $8,938.08 2026-03-04
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 12 12 $5,478.95 $4,657.11 $2,598.83 $5,478.95 $4,876.27 2026-03-04
36571 HCPCS Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older) 23 12 $5,367.00 $4,561.95 $1,253.57 $8,050.50 $3,830.93 2026-03-04
4966415_1 CDM Praxbind 5g Dose(2x 2.5g/50ml) 8 8 $3,851.33 $3,273.63 $1,540.53 $3,427.68 $3,427.68 2026-03-04
Q4196 HCPCS Puraply Am, Per Square Centimeter 55 11 $3,120.00 $2,652.00 $540.00 $10,260.00 $2,776.80 2026-03-04
J0897 HCPCS Injection, Denosumab, 1 Mg 12 12 $3,054.28 $2,596.14 $29.68 $3,054.28 $2,718.31 2026-03-04
6558554_1 CDM Jubbonti 60 Mg/ml Syringe 8 8 $2,708.59 $2,302.30 $1,083.44 $2,410.65 $2,410.65 2026-03-04
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 24 12 $2,250.00 $1,912.50 $526.21 $3,375.00 $2,002.50 2026-03-04
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 24 12 $2,242.00 $1,905.70 $1,532.17 $3,363.00 $1,995.38 2026-03-04
Q4159 HCPCS Affinity, Per Square Centimeter 22 11 $2,211.88 $1,880.10 $1,154.25 $2,500.00 $1,923.75 2026-03-04
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 23 12 $2,620.00 $2,227.00 $212.27 $3,930.00 $1,906.88 2026-03-04
11422 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 23 12 $2,530.00 $2,150.50 $170.61 $3,795.00 $1,805.43 2026-03-04
11424 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 23 12 $2,480.00 $2,108.00 $221.88 $3,720.00 $1,801.84 2026-03-04
14040 HCPCS Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 23 12 $2,440.00 $2,074.00 $713.69 $3,660.00 $1,778.61 2026-03-04
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 12 12 $1,900.00 $1,615.00 $1,140.00 $1,900.00 $1,691.00 2026-03-04
73202 HCPCS CT Scan Of Arm Before And After Contrast 35 12 $1,875.00 $1,593.75 $457.53 $2,812.50 $1,668.75 2026-03-04
73722 HCPCS MRI Scan Of Leg Joint With Contrast 35 12 $1,875.00 $1,593.75 $526.21 $2,812.50 $1,668.75 2026-03-04
73720 HCPCS MRI Scan Of Leg Before And After Contrast 35 12 $1,875.00 $1,593.75 $526.21 $2,812.50 $1,668.75 2026-03-04
J3489 HCPCS Injection, Zoledronic Acid, 1 Mg 23 12 $1,825.45 $1,551.63 $14.33 $1,825.45 $1,624.43 2026-03-04
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 23 12 $1,297.00 $1,102.45 $1,006.97 $2,980.50 $1,591.59 2026-03-04
73702 HCPCS CT Scan Of Leg Before And After Contrast 35 12 $1,728.00 $1,468.80 $457.53 $2,592.00 $1,537.92 2026-03-04
4634657_1 CDM Room & Board - Private (one Bed) - General Classification 4 4 $1,500.00 $1,275.00 $1,320.00 $1,500.00 $1,500.00 2026-03-04
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 12 12 $1,679.67 $1,427.72 $1.42 $1,679.67 $1,494.91 2026-03-04
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 23 12 $2,045.00 $1,738.25 $440.55 $3,067.50 $1,486.72 2026-03-04
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 24 12 $1,650.00 $1,402.50 $457.53 $2,475.00 $1,468.50 2026-03-04
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 44 11 $1,574.00 $1,337.90 $88.91 $2,472.00 $1,458.48 2026-03-04
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 24 12 $1,575.00 $1,338.75 $1,143.85 $2,362.50 $1,401.75 2026-03-04
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 12 12 $1,573.38 $1,337.37 $6.51 $1,573.38 $1,400.31 2026-03-04
12055 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.6-… 23 12 $1,875.00 $1,593.75 $477.40 $2,812.50 $1,363.50 2026-03-04
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 23 12 $1,875.00 $1,593.75 $423.73 $2,812.50 $1,363.50 2026-03-04
43251 HCPCS Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi… 23 12 $2,013.00 $1,711.05 $486.21 $3,019.50 $1,353.40 2026-03-04
21012 HCPCS Removal Of Growth Under Skin Of Face Or Scalp, 2.0 Cm Or More 23 12 $1,855.00 $1,576.75 $317.20 $2,782.50 $1,348.35 2026-03-04
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 12 12 $1,500.00 $1,275.00 $526.21 $2,250.00 $1,335.00 2026-03-04
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 24 12 $1,500.00 $1,275.00 $457.53 $2,250.00 $1,335.00 2026-03-04
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 24 12 $1,500.00 $1,275.00 $457.53 $2,250.00 $1,335.00 2026-03-04
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 35 12 $1,500.00 $1,275.00 $526.21 $2,250.00 $1,335.00 2026-03-04
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 12 12 $1,500.00 $1,275.00 $526.21 $2,250.00 $1,335.00 2026-03-04
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 23 12 $1,820.00 $1,547.00 $474.19 $2,730.00 $1,321.08 2026-03-04
45381 HCPCS Injection Beneath Lining Of Large Bowel Using A Flexible Endoscope 23 12 $1,820.00 $1,547.00 $191.44 $2,730.00 $1,321.08 2026-03-04
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 23 12 $1,820.00 $1,547.00 $164.21 $2,730.00 $1,321.08 2026-03-04
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 37 13 $1,485.00 $1,262.25 $98.48 $2,227.50 $1,306.80 2026-03-04
2120839_1 CDM Room & Board - Private (one Bed) - General Classification 4 4 $1,300.00 $1,105.00 $1,144.00 $1,300.00 $1,300.00 2026-03-04
15100 HCPCS Partial Thickness Self Skin Graft To Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Bod… 48 13 $3,082.50 $2,620.12 $38.38 $7,725.00 $1,281.25 2026-03-04
J1459 HCPCS Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 23 12 $1,270.08 $1,079.57 $60.59 $5,080.32 $1,270.08 2026-03-04
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 12 12 $1,400.00 $1,190.00 $526.21 $2,100.00 $1,246.00 2026-03-04
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 12 12 $1,400.00 $1,190.00 $526.21 $2,100.00 $1,246.00 2026-03-04
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 12 12 $1,400.00 $1,190.00 $457.53 $2,100.00 $1,246.00 2026-03-04
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 12 12 $1,400.00 $1,190.00 $526.21 $2,100.00 $1,246.00 2026-03-04
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 12 12 $1,400.00 $1,190.00 $526.21 $2,100.00 $1,246.00 2026-03-04
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 24 12 $1,350.00 $1,147.50 $457.53 $2,025.00 $1,201.50 2026-03-04
73201 HCPCS CT Scan Of Arm With Contrast 46 12 $1,500.00 $1,275.00 $457.53 $2,250.00 $1,201.50 2026-03-04
73718 HCPCS MRI Scan Of Leg Without Contrast 35 12 $1,313.00 $1,116.05 $526.21 $1,969.50 $1,168.57 2026-03-04
70553 HCPCS MRI Scan Of Brain Before And After Contrast 12 12 $1,300.00 $1,105.00 $526.21 $1,950.00 $1,157.00 2026-03-04
A0433 HCPCS Advanced Life Support, Level 2 (als 2) 12 12 $1,300.00 $1,105.00 $632.36 $1,950.00 $1,157.00 2026-03-04
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 24 12 $1,300.00 $1,105.00 $457.53 $1,950.00 $1,157.00 2026-03-04
G0105 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 12 12 $1,297.00 $1,102.45 $1,006.97 $1,945.50 $1,154.33 2026-03-04
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 23 12 $1,585.00 $1,347.25 $369.26 $2,377.50 $1,153.42 2026-03-04
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 23 12 $1,141.20 $970.02 $8.13 $2,325.60 $1,141.20 2026-03-04
73222 HCPCS MRI Scan Of Arm Joint With Contrast 12 12 $1,250.00 $1,062.50 $526.21 $1,875.00 $1,112.50 2026-03-04
73220 HCPCS MRI Scan Of Arm Before And After Contrast 12 12 $1,250.00 $1,062.50 $526.21 $1,875.00 $1,112.50 2026-03-04
71270 HCPCS CT Scan Of Chest Before And After Contrast 24 12 $1,250.00 $1,062.50 $457.53 $1,875.00 $1,112.50 2026-03-04
72196 HCPCS MRI Scan Of Pelvis With Contrast 12 12 $1,250.00 $1,062.50 $526.21 $1,875.00 $1,112.50 2026-03-04
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 12 12 $1,250.00 $1,062.50 $457.53 $1,875.00 $1,112.50 2026-03-04
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 12 12 $1,250.00 $1,062.50 $457.53 $1,875.00 $1,112.50 2026-03-04
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 12 12 $1,250.00 $1,062.50 $526.21 $1,875.00 $1,112.50 2026-03-04
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 12 12 $1,250.00 $1,062.50 $457.53 $1,875.00 $1,112.50 2026-03-04
73701 HCPCS CT Scan Of Leg With Contrast Material 46 12 $1,385.00 $1,177.25 $457.53 $2,077.50 $1,109.39 2026-03-04
72132 HCPCS CT Scan Of Lower Spine With Contrast 24 12 $1,250.00 $1,062.50 $457.53 $2,250.00 $1,100.75 2026-03-04
11404 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 25 13 $1,354.00 $1,150.90 $139.18 $2,031.00 $1,084.55 2026-03-04
Q5104 HCPCS Injection, Infliximab-abda, Biosimilar, (renflexis), 10 Mg 12 12 $1,214.77 $1,032.55 $46.86 $1,214.77 $1,081.15 2026-03-04
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 12 12 $1,200.00 $1,020.00 $633.27 $1,800.00 $1,068.00 2026-03-04
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 12 12 $1,200.00 $1,020.00 $526.21 $1,800.00 $1,068.00 2026-03-04
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 12 12 $1,200.00 $1,020.00 $526.21 $1,800.00 $1,068.00 2026-03-04
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 12 12 $1,200.00 $1,020.00 $526.21 $1,800.00 $1,068.00 2026-03-04
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 12 12 $1,200.00 $1,020.00 $526.21 $1,800.00 $1,068.00 2026-03-04
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 23 12 $1,430.00 $1,215.50 $288.36 $2,145.00 $1,033.23 2026-03-04
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 22 11 $1,058.50 $899.72 $375.67 $2,472.00 $1,011.77 2026-03-04
6236698_1 CDM Room & Board - Semi-private (two Beds) - General Classification 4 4 $1,000.00 $850.00 $880.00 $1,000.00 $1,000.00 2026-03-04
74160 HCPCS CT Scan Of Abdomen With Contrast 35 12 $1,000.00 $850.00 $457.53 $2,250.00 $1,000.00 2026-03-04
5916251_1 CDM Remdesivir 100 Mg Vial [kwks] 9 9 $1,123.20 $954.72 $449.28 $999.65 $999.65 2026-03-04
43236 HCPCS Injection Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endos… 23 12 $4,190.00 $3,561.50 $394.09 $6,285.00 $998.76 2026-03-04
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 12 12 $1,100.00 $935.00 $633.27 $1,650.00 $979.00 2026-03-04
70552 HCPCS MRI Scan Of Brain With Contrast 12 12 $1,100.00 $935.00 $526.21 $1,650.00 $979.00 2026-03-04
73218 HCPCS MRI Scan Of Arm Without Contrast 24 12 $1,094.00 $929.90 $526.21 $1,969.50 $963.36 2026-03-04
73200 HCPCS CT Scan Of Arm Without Contrast 46 12 $1,200.00 $1,020.00 $457.53 $1,800.00 $961.20 2026-03-04
73700 HCPCS CT Scan Of Leg Without Contrast 46 12 $1,200.00 $1,020.00 $457.53 $1,800.00 $961.20 2026-03-04
10160 HCPCS Aspiration Of Abscess, Blood, Or Cyst 67 13 $1,295.00 $1,100.75 $38.38 $1,965.00 $947.38 2026-03-04
A0427 HCPCS Ambulance Service, Advanced Life Support, Emergency Transport, Level 1 (als 1 - … 12 12 $1,050.00 $892.50 $585.68 $1,575.00 $934.50 2026-03-04
93799 HCPCS Other Cardiovascular Service Or Procedure 11 11 $1,040.00 $884.00 $833.04 $1,560.00 $925.60 2026-03-04
J0248 HCPCS Injection, Remdesivir, 1 Mg 11 11 $1,028.66 $874.36 $617.20 $1,028.66 $915.51 2026-03-04
4643157_1 CDM Recovery Room - General Classification 8 8 $1,024.50 $870.83 $409.80 $911.81 $911.81 2026-03-04
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 12 12 $1,000.00 $850.00 $633.27 $1,500.00 $890.00 2026-03-04
71260 HCPCS CT Scan Of Chest With Contrast 24 12 $1,000.00 $850.00 $457.53 $1,500.00 $890.00 2026-03-04
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 24 12 $1,000.00 $850.00 $457.53 $1,500.00 $890.00 2026-03-04
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 12 12 $1,000.00 $850.00 $633.27 $1,500.00 $890.00 2026-03-04
15110 HCPCS Outer Layer Self Skin Graft Of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body Area… 36 13 $1,000.00 $850.00 $38.38 $7,560.00 $890.00 2026-03-04
70551 HCPCS MRI Scan Of Brain Without Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
70488 HCPCS CT Scan Of Face Before And After Contrast 12 12 $1,000.00 $850.00 $457.53 $1,500.00 $890.00 2026-03-04
73219 HCPCS MRI Scan Of Arm With Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
74182 HCPCS MRI Scan Of Abdomen With Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
72129 HCPCS CT Scan Of Middle Spine With Contrast 24 12 $1,000.00 $850.00 $457.53 $1,500.00 $890.00 2026-03-04
72195 HCPCS MRI Scan Of Pelvis Without Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
72193 HCPCS CT Scan Of Pelvis With Contrast 24 12 $1,000.00 $850.00 $457.53 $1,500.00 $890.00 2026-03-04
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
72126 HCPCS CT Scan Of Upper Spine With Contrast 12 12 $1,000.00 $850.00 $457.53 $1,500.00 $890.00 2026-03-04
71552 HCPCS MRI Scan Of Chest Before And After Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
15120 HCPCS Partial Thickness Self Skin Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Ar… 37 13 $1,000.00 $850.00 $38.38 $7,905.00 $890.00 2026-03-04
70460 HCPCS CT Scan Head Or Brain With Contrast 24 12 $1,000.00 $850.00 $457.53 $1,500.00 $890.00 2026-03-04
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 12 12 $1,000.00 $850.00 $526.21 $1,500.00 $890.00 2026-03-04
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 24 12 $1,000.00 $850.00 $457.53 $1,500.00 $890.00 2026-03-04
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 37 13 $995.00 $845.75 $105.00 $1,492.50 $875.60 2026-03-04
15115 HCPCS Outer Layer Self Skin Graft Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around E… 36 13 $955.00 $811.75 $38.38 $3,000.00 $849.95 2026-03-04
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 24 12 $955.00 $811.75 $457.53 $1,432.50 $849.95 2026-03-04
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 12 12 $950.00 $807.50 $633.27 $1,425.00 $845.50 2026-03-04
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 12 12 $950.00 $807.50 $633.27 $1,425.00 $845.50 2026-03-04
59409 HCPCS Vaginal Delivery 35 13 $925.00 $786.25 $644.87 $5,115.00 $823.25 2026-03-04
70487 HCPCS CT Scan Of Face With Contrast 12 12 $923.00 $784.55 $457.53 $1,384.50 $821.47 2026-03-04
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 12 12 $920.00 $782.00 $633.27 $1,380.00 $818.80 2026-03-04
6503043_1 CDM Probe Coolief Cooled Radiofrequency Introducers 17ga X 50mm W/4mm Tip Pain Mg 2 2 $1,273.40 $1,082.39 $509.36 $1,120.59 $814.97 2026-03-04
6503045_1 CDM Probe Coolief Cooled Radiofrequency Introducers 17ga X 100mm W/4mm Tip Pain Mg 2 2 $1,273.40 $1,082.39 $509.36 $1,120.59 $814.97 2026-03-04
27560 HCPCS Closed Treatment Of Dislocated Kneecap 23 12 $1,125.00 $956.25 $349.24 $1,687.50 $809.01 2026-03-04
36430 HCPCS Transfusion Of Blood Or Blood Products 45 12 $715.00 $607.75 $515.69 $2,100.00 $802.56 2026-03-04
72131 HCPCS CT Scan Of Lower Spine Without Contrast 24 12 $900.00 $765.00 $457.53 $1,500.00 $800.50 2026-03-04
4441947_1 CDM Room & Board - Semi-private (two Beds) - General Classification 4 4 $800.00 $680.00 $704.00 $800.00 $800.00 2026-03-04
37195 HCPCS Infusion Of Drug To Dissolve Blood Clot In Brain 11 11 $896.00 $761.60 $717.70 $1,344.00 $797.44 2026-03-04
13131 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 23 12 $1,090.00 $926.50 $370.06 $1,635.00 $787.80 2026-03-04
74181 HCPCS MRI Scan Of Abdomen Without Contrast 12 12 $875.00 $743.75 $526.21 $1,312.50 $778.75 2026-03-04
73719 HCPCS MRI Scan Of Leg With Contrast 12 12 $875.00 $743.75 $526.21 $1,312.50 $778.75 2026-03-04
71551 HCPCS MRI Scan Of Chest With Contrast 12 12 $875.00 $743.75 $526.21 $1,312.50 $778.75 2026-03-04
71550 HCPCS MRI Scan Of Chest Without Contrast 12 12 $852.00 $724.20 $526.21 $1,278.00 $758.28 2026-03-04
70336 HCPCS MRI Scan Of Jaw Joint 12 12 $825.00 $701.25 $526.21 $1,237.50 $734.25 2026-03-04
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 24 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
70486 HCPCS CT Scan Of Face Without Contrast 24 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
77075 HCPCS Complete X-ray Of Body Bones 12 12 $800.00 $680.00 $506.41 $1,200.00 $712.00 2026-03-04
72192 HCPCS CT Scan Of Pelvis Without Contrast 12 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
74150 HCPCS CT Scan Of Abdomen Without Contrast 24 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 24 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
71250 HCPCS CT Scan Of Chest Without Contrast 24 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
A0428 HCPCS Ambulance Service, Basic Life Support, Non-emergency Transport, (bls) 12 12 $800.00 $680.00 $367.67 $1,200.00 $712.00 2026-03-04
72128 HCPCS CT Scan Of Middle Spine Without Contrast 24 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
70450 HCPCS CT Scan Head Or Brain Without Contrast 24 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
72125 HCPCS CT Scan Of Upper Spine Without Contrast 24 12 $800.00 $680.00 $457.53 $1,200.00 $712.00 2026-03-04
93307 HCPCS Ultrasound Of Heart 12 12 $795.00 $675.75 $575.70 $1,192.50 $707.55 2026-03-04
Q3009 HCPCS Levalbuterol 1.25 Mg/3 Ml Sol 22 11 $878.55 $746.77 $1.68 $2,632.50 $704.45 2026-03-04
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 12 12 $774.00 $657.90 $552.43 $1,161.00 $688.86 2026-03-04
A0429 HCPCS Ambulance Service, Basic Life Support, Emergency Transport (bls-emergency) 23 12 $800.00 $680.00 $450.09 $1,200.00 $675.00 2026-03-04
28505 HCPCS Treatment Of Broken Great Toe 25 13 $838.00 $712.30 $400.47 $2,157.36 $671.24 2026-03-04
93971 HCPCS Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers 12 12 $742.00 $630.70 $480.76 $1,113.00 $660.38 2026-03-04
6340871_1 CDM Victoza 2-pak 18 Mg/3 Ml Pen 8 8 $741.38 $630.17 $296.55 $659.83 $659.83 2026-03-04
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 12 12 $730.00 $620.50 $534.34 $1,095.00 $649.70 2026-03-04
93923 HCPCS Complete Ultrasound Study Of Arm And Leg Arteries 12 12 $714.00 $606.90 $480.76 $1,071.00 $635.46 2026-03-04
94662 HCPCS Therapy Procedure Using A Negative Pressure Ventilator 11 11 $701.00 $595.85 $561.50 $1,051.50 $623.89 2026-03-04
15277 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Face, Scalp, Eyelids, Mout… 49 13 $1,740.00 $1,479.00 $38.38 $2,610.00 $622.50 2026-03-04
93926 HCPCS Ultrasound Of One Leg Arteries Or Artery Grafts 12 12 $697.00 $592.45 $480.76 $1,045.50 $620.33 2026-03-04
93325 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate And Valve Function 12 12 $674.00 $572.90 $480.76 $1,011.00 $599.86 2026-03-04
93320 HCPCS Ultrasound Of Heart Blood Flow, Valves And Chambers 12 12 $674.00 $572.90 $480.76 $1,011.00 $599.86 2026-03-04
94626 HCPCS Professional Services For Outpatient Pulmonary Rehabilitation With Continuous Mo… 11 11 $666.00 $566.10 $533.47 $999.00 $592.74 2026-03-04
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 12 12 $665.00 $565.25 $457.53 $997.50 $591.85 2026-03-04
93925 HCPCS Ultrasound Of Leg Arteries Or Artery Grafts 12 12 $665.00 $565.25 $480.76 $997.50 $591.85 2026-03-04
93975 HCPCS Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 24 12 $665.00 $565.25 $480.76 $997.50 $591.85 2026-03-04
93922 HCPCS Ultrasound Study Of Arm And Leg Arteries 12 12 $665.00 $565.25 $480.76 $997.50 $591.85 2026-03-04
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 24 12 $665.00 $565.25 $480.76 $997.50 $591.85 2026-03-04
93931 HCPCS Ultrasound Of One Arm Arteries Or Artery Grafts 12 12 $665.00 $565.25 $480.76 $997.50 $591.85 2026-03-04
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 12 12 $665.00 $565.25 $480.76 $997.50 $591.85 2026-03-04
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 12 12 $660.00 $561.00 $480.76 $990.00 $587.40 2026-03-04
15273 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Trunk, Arms, Or Legs, 100.… 49 13 $3,884.00 $3,301.40 $38.38 $5,826.00 $570.00 2026-03-04
11646 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More… 43 13 $635.00 $539.75 $307.91 $4,554.00 $558.80 2026-03-04
24576 HCPCS Closed Treatment Of Broken Elbow 23 12 $606.00 $515.10 $333.22 $1,454.40 $533.28 2026-03-04
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 36 13 $595.00 $505.75 $260.38 $3,307.50 $529.55 2026-03-04
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 36 13 $595.00 $505.75 $235.19 $2,121.00 $529.55 2026-03-04
99283 HCPCS Emergency Department Visit With Low Level Of Medical Decision Making 37 13 $595.00 $505.75 $40.48 $892.50 $523.60 2026-03-04
P9040 HCPCS Red Blood Cells, Leukocytes Reduced, Irradiated, Each Unit 11 11 $580.00 $493.00 $464.58 $870.00 $516.20 2026-03-04
86665 HCPCS Analysis For Antibody To Epstein-barr Virus (mononucleosis Virus), Viral Capsid 12 12 $572.00 $486.20 $64.87 $858.00 $509.08 2026-03-04
86060 HCPCS Measurement For Strep Antibody (strep Throat) 12 12 $563.00 $478.55 $33.20 $844.50 $501.07 2026-03-04
4631399_1 CDM Recovery Room - General Classification 8 8 $555.00 $471.75 $222.00 $493.95 $493.95 2026-03-04
11606 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 43 13 $557.00 $473.45 $253.26 $4,117.50 $490.16 2026-03-04
36572 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 22 11 $517.00 $439.45 $363.65 $870.00 $487.49 2026-03-04
86664 HCPCS Analysis For Antibody To Epstein-barr Virus (mononucleosis Virus), Nuclear Antig… 12 12 $543.00 $461.55 $62.59 $814.50 $483.27 2026-03-04
77002 HCPCS Fluoroscopic Guidance For Needle Placement 12 12 $522.00 $443.70 $372.61 $783.00 $464.58 2026-03-04
90677 HCPCS Pneumococcal Conjugate Vaccine, 20 Valent (pcv20), For Intramuscular Use 12 12 $508.79 $432.47 $305.27 $508.79 $452.82 2026-03-04
90675 HCPCS Rabies Vaccine For Injection Into Muscle 24 13 $395.00 $335.75 $332.23 $592.50 $445.21 2026-03-04
12054 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1… 48 13 $459.00 $390.15 $182.27 $2,190.00 $445.21 2026-03-04
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 48 13 $454.50 $386.32 $176.50 $2,512.50 $445.21 2026-03-04
27808 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle 13 13 $416.00 $353.60 $366.08 $1,454.40 $445.21 2026-03-04
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 55 13 $257.00 $218.45 $38.38 $3,075.00 $445.21 2026-03-04
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 55 13 $375.00 $318.75 $153.57 $2,322.00 $445.21 2026-03-04
27520 HCPCS Closed Treatment Of Broken Kneecap 13 13 $401.00 $340.85 $352.88 $1,454.40 $445.21 2026-03-04
11107 HCPCS Incision Biopsy, Each Additional Skin Growth 31 13 $875.00 $743.75 $38.38 $1,312.50 $445.21 2026-03-04
24560 HCPCS Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow 13 13 $404.00 $343.40 $355.52 $1,454.40 $445.21 2026-03-04
11976 HCPCS Removal Of Implantable Contraceptive Capsules 12 12 $675.00 $573.75 $400.69 $1,012.50 $445.21 2026-03-04
64495 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And… 56 13 $1,966.00 $1,671.10 $38.38 $2,949.00 $445.21 2026-03-04
46050 HCPCS Drainage Of Superficial Rectal Abscess Surrounding Anus 13 13 $1,230.00 $1,045.50 $400.69 $1,845.00 $445.21 2026-03-04
11626 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 44 13 $505.00 $429.25 $38.38 $6,352.50 $445.21 2026-03-04
93017 HCPCS Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg) 12 12 $500.00 $425.00 $356.37 $750.00 $445.00 2026-03-04
96413 HCPCS Administration Of Chemotherapy Into Vein, 1 Hour Or Less 12 12 $500.00 $425.00 $358.20 $750.00 $445.00 2026-03-04
20225 HCPCS Deep Biopsy Of Bone Using Needle Or Trocar 37 13 $495.00 $420.75 $38.38 $2,578.50 $440.55 2026-03-04
11983 HCPCS Removal With Reinsertion Of Drug Delivery Implant Into Tissue 12 12 $380.00 $323.00 $334.40 $570.00 $439.39 2026-03-04
56515 HCPCS Extensive Destruction Of Growth Of External Female Genitals 12 12 $336.00 $285.60 $295.68 $504.00 $439.39 2026-03-04
42330 HCPCS Uncomplicated Removal Of Saliva Gland Stone From Inside Mouth 12 12 $294.00 $249.90 $258.72 $445.21 $437.29 2026-03-04
28190 HCPCS Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 60 13 $323.00 $274.55 $38.38 $7,743.00 $434.29 2026-03-04
G0101 HCPCS Cervical Or Vaginal Cancer Screening; Pelvic And Clinical Breast Examination 11 11 $100.00 $85.00 $100.00 $445.21 $433.58 2026-03-04
29126 HCPCS Application Of Moveable Or Hinged Forearm To Hand Splint 13 13 $310.00 $263.50 $230.28 $465.00 $433.58 2026-03-04
67800 HCPCS Removal Of Chronic Growth Of Eyelid 13 13 $165.00 $140.25 $145.20 $809.01 $433.58 2026-03-04
11644 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3.1-… 43 13 $484.00 $411.40 $222.48 $2,715.00 $433.58 2026-03-04
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 25 13 $535.00 $454.75 $201.38 $802.50 $428.54 2026-03-04
27096 HCPCS Injection Of Anesthetic Or Steroid Into Joint Between Lower Spine And Hip Bone U… 48 13 $520.00 $442.00 $69.48 $1,402.50 $423.52 2026-03-04
15004 HCPCS Preparation Of Skin Graft Site Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Aroun… 37 13 $475.00 $403.75 $38.38 $2,115.00 $422.75 2026-03-04
94625 HCPCS Professional Services For Outpatient Pulmonary Rehabilitation, Per Session 11 11 $473.00 $402.05 $378.87 $709.50 $420.97 2026-03-04
99381 HCPCS Initial New Patient Preventive Medicine Evaluation (younger Than 1 Year) 12 12 $132.00 $112.20 $116.16 $445.21 $417.13 2026-03-04
G0447 HCPCS Face-to-face Behavioral Counseling For Obesity, 15 Minutes 12 12 $85.00 $72.25 $74.80 $445.21 $417.13 2026-03-04
99396 HCPCS Established Patient Periodic Preventive Medicine Examination (40-64 Years) 12 12 $165.00 $140.25 $145.20 $445.21 $417.13 2026-03-04
99392 HCPCS Established Patient Periodic Preventive Medicine Examination (1-4 Years) 12 12 $137.00 $116.45 $120.56 $445.21 $417.13 2026-03-04
99455 HCPCS Work-related Or Medical Disability Examination By The Treating Physician 12 12 $138.00 $117.30 $121.44 $445.21 $417.13 2026-03-04
99417 HCPCS Prolonged Outpatient Service, Each 15 Minutes Of Total Time Beyond Required Time… 12 12 $95.00 $80.75 $83.60 $445.21 $417.13 2026-03-04
99385 HCPCS Initial New Patient Preventive Medicine Evaluation (18-39 Years) 12 12 $162.00 $137.70 $142.56 $445.21 $417.13 2026-03-04
98926 HCPCS Osteopathic Manipulative Treatment, 3-4 Body Regions 12 12 $60.00 $51.00 $52.80 $445.21 $417.13 2026-03-04
99397 HCPCS Established Patient Periodic Preventive Medicine Examination (65 Year Old Or Old… 12 12 $176.00 $149.60 $154.88 $445.21 $417.13 2026-03-04
99429 HCPCS Other Preventive Medicine Service 12 12 $138.00 $117.30 $121.44 $445.21 $417.13 2026-03-04
99490 HCPCS Chronic Care Management Services, First 20 Minutes Of Clinical Staff Time Direct… 12 12 $62.00 $52.70 $54.56 $445.21 $417.13 2026-03-04
99394 HCPCS Established Patient Periodic Preventive Medicine Examination (12-17 Years) 12 12 $140.00 $119.00 $123.20 $445.21 $417.13 2026-03-04
99382 HCPCS Initial New Patient Preventive Medicine Evaluation (1-4 Years) 12 12 $215.00 $182.75 $189.20 $445.21 $417.13 2026-03-04
99384 HCPCS Initial New Patient Preventive Medicine Evaluation (12-17 Years) 12 12 $196.00 $166.60 $172.48 $445.21 $417.13 2026-03-04
99495 HCPCS Transitional Care Management Services For Problem Of At Least Moderate Complexit… 12 12 $200.00 $170.00 $176.00 $445.21 $417.13 2026-03-04
11982 HCPCS Removal Of Drug Delivery Implant From Tissue 12 12 $135.00 $114.75 $118.80 $445.21 $417.13 2026-03-04
99391 HCPCS Established Patient Periodic Preventive Medicine Examination (younger Than 1 Yea… 12 12 $128.00 $108.80 $112.64 $445.21 $417.13 2026-03-04
11981 HCPCS Insertion Of Drug Delivery Implant Into Tissue 12 12 $150.00 $127.50 $132.00 $445.21 $417.13 2026-03-04
11901 HCPCS Injection Into Skin Growth, More Than 7 Growths 12 12 $90.00 $76.50 $79.20 $445.21 $417.13 2026-03-04
99383 HCPCS Initial New Patient Preventive Medicine Evaluation (5-11 Years) 12 12 $210.00 $178.50 $184.80 $445.21 $417.13 2026-03-04
96156 HCPCS Assessment Of Health Behavior 12 12 $117.00 $99.45 $102.96 $445.21 $417.13 2026-03-04
20526 HCPCS Injection Of Carpal Tunnel 12 12 $101.00 $85.85 $88.88 $445.21 $417.13 2026-03-04
99386 HCPCS Initial New Patient Preventive Medicine Evaluation (40-64 Years) 12 12 $177.00 $150.45 $155.76 $445.21 $417.13 2026-03-04
G0438 HCPCS Annual Wellness Visit; Includes A Personalized Prevention Plan Of Service (pps),… 12 12 $195.00 $165.75 $171.60 $445.21 $417.13 2026-03-04
58301 HCPCS Removal Of IUD 12 12 $136.00 $115.60 $119.68 $445.21 $417.13 2026-03-04
58300 HCPCS Insertion Of IUD For Pregnancy Prevention 12 12 $130.00 $110.50 $114.40 $445.21 $417.13 2026-03-04
99393 HCPCS Established Patient Periodic Preventive Medicine Examination (5-11 Years) 12 12 $157.00 $133.45 $138.16 $445.21 $417.13 2026-03-04
53661 HCPCS Subsequent Dilation Of Urethra In Female 12 12 $92.00 $78.20 $80.96 $445.21 $417.13 2026-03-04
99244 HCPCS Office Or Other Outpatient Consultation With Moderate Level Of Medical Decision … 12 12 $200.00 $170.00 $176.00 $445.21 $417.13 2026-03-04
99395 HCPCS Established Patient Periodic Preventive Medicine Examination (18-39 Years) 12 12 $154.00 $130.90 $135.52 $445.21 $417.13 2026-03-04
99387 HCPCS Initial New Patient Preventive Medicine Evaluation (65 Years Or Older) 12 12 $191.00 $162.35 $168.08 $445.21 $417.13 2026-03-04
G0439 HCPCS Annual Wellness Visit, Includes A Personalized Prevention Plan Of Service (pps),… 12 12 $150.00 $127.50 $132.00 $445.21 $417.13 2026-03-04
94060 HCPCS Test To Measure Expiratory Airflow And Volume Changes Before And After Medicatio… 12 12 $468.00 $397.80 $297.32 $702.00 $416.52 2026-03-04
25675 HCPCS Closed Treatment Of Dislocated Forearm Bone At Wrist With Manipulation 25 13 $545.00 $463.25 $324.41 $809.01 $405.00 2026-03-04
Q0091 HCPCS Screening Papanicolaou Smear; Obtaining, Preparing And Conveyance Of Cervical Or… 13 13 $50.00 $42.50 $11.17 $445.21 $400.69 2026-03-04
99439 HCPCS Chronic Care Management Services For Two Or More Chronic Conditions, Additional … 13 13 $47.00 $39.95 $1.01 $445.21 $400.69 2026-03-04
93015 HCPCS Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg) With Sup… 13 13 $230.00 $195.50 $171.13 $445.21 $400.69 2026-03-04
20612 HCPCS Aspiration And/or Injection Of Cyst Of Tendon 13 13 $80.00 $68.00 $70.40 $445.21 $400.69 2026-03-04
11755 HCPCS Biopsy Of Fingernail Or Toenail 13 13 $155.00 $131.75 $136.40 $445.21 $400.69 2026-03-04
11313 HCPCS Shaving Of Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More Than 2… 35 13 $229.00 $194.65 $173.02 $772.50 $400.69 2026-03-04
17281 HCPCS Destruction Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, … 13 13 $222.00 $188.70 $74.74 $445.21 $400.69 2026-03-04
73564 HCPCS X-ray Of Knee, 4 Or More Views 35 12 $450.00 $382.50 $216.50 $675.00 $400.50 2026-03-04
26700 HCPCS Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation 48 13 $402.00 $341.70 $30.00 $1,672.50 $399.85 2026-03-04
11643 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.1-… 43 13 $393.00 $334.05 $179.76 $2,578.50 $393.00 2026-03-04
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 25 13 $490.00 $416.50 $300.00 $809.01 $392.49 2026-03-04
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 12 12 $439.11 $373.24 $0.71 $439.11 $390.81 2026-03-04
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 44 13 $390.00 $331.50 $38.38 $4,366.50 $390.00 2026-03-04
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 36 13 $435.00 $369.75 $173.79 $2,010.00 $387.15 2026-03-04
97606 HCPCS Therapy Procedure Using A Special Bandage And Vacuum Pump, Surface Area More Tha… 60 13 $455.00 $386.75 $22.59 $697.50 $386.44 2026-03-04
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 12 12 $430.00 $365.50 $309.49 $645.00 $382.70 2026-03-04
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 25 13 $475.00 $403.75 $205.56 $1,824.06 $380.48 2026-03-04
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 36 13 $427.00 $362.95 $225.57 $4,554.00 $380.03 2026-03-04
15002 HCPCS Preparation Of Skin Graft Site Of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body A… 37 13 $425.00 $361.25 $38.38 $1,950.00 $378.25 2026-03-04
36680 HCPCS Insertion Of Needle For Infusion Into Bone 15 11 $423.00 $359.55 $100.00 $634.50 $376.47 2026-03-04
94010 HCPCS Test To Measure Expiratory Airflow And Volume 12 12 $422.00 $358.70 $300.98 $633.00 $375.58 2026-03-04
11044 HCPCS Removal Of Bone, 20.0 Sq Cm Or Less 49 13 $390.00 $331.50 $38.38 $3,712.50 $375.00 2026-03-04
11624 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4.0 … 36 13 $420.00 $357.00 $188.49 $3,720.00 $373.80 2026-03-04
24600 HCPCS Repair Of Dislocated Elbow 25 13 $465.00 $395.25 $312.95 $809.01 $372.47 2026-03-04
11760 HCPCS Repair Of Fingernail Or Toenail Bed 25 13 $510.00 $433.50 $96.46 $765.00 $371.68 2026-03-04
26742 HCPCS Closed Treatment Of Broken Finger Or Hand At Base Of Finger With Manipulation 25 13 $462.00 $392.70 $305.60 $2,515.91 $370.06 2026-03-04
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 36 13 $415.00 $352.75 $289.37 $2,355.00 $369.35 2026-03-04
64455 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Foot Nerve 23 12 $516.00 $438.60 $48.06 $774.00 $368.20 2026-03-04
94726 HCPCS Test To Determine Lung Volumes Using Sensors 12 12 $410.00 $348.50 $297.32 $615.00 $364.90 2026-03-04
11623 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3.0 … 48 13 $369.00 $313.65 $165.27 $3,720.00 $364.50 2026-03-04
11403 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 49 13 $240.00 $204.00 $38.38 $2,655.00 $360.00 2026-03-04
25600 HCPCS Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb … 32 13 $406.00 $345.10 $230.84 $609.00 $359.31 2026-03-04
26010 HCPCS Simple Drainage Of Abscess Of Finger 48 13 $382.50 $325.12 $131.90 $805.50 $357.30 2026-03-04
23600 HCPCS Closed Treatment Of Broken Top Of Upper Arm Bone 26 13 $405.00 $344.25 $295.00 $1,454.40 $356.40 2026-03-04
29581 HCPCS Application Of Vein Wound Compression Bandages On Lower Leg, Ankle, And Foot 31 13 $400.00 $340.00 $38.38 $600.00 $356.00 2026-03-04
97607 HCPCS Therapy Procedure Using A Special Bandage, Vacuum Pump And Disposable Medical Eq… 47 13 $440.00 $374.00 $17.39 $660.00 $356.00 2026-03-04
87635 HCPCS Amplifed DNA Or RNA Probe Detection Of Severe Acute Respiratory Syndrome Coronav… 12 12 $400.00 $340.00 $114.18 $600.00 $356.00 2026-03-04
97608 HCPCS Therapy Procedure Using A Special Bandage, Vacuum Pump And Disposable Medical Eq… 47 13 $435.00 $369.75 $20.00 $652.50 $356.00 2026-03-04
73523 HCPCS X-ray Of Both Hips, Minimum Of 5 Views 11 11 $400.00 $340.00 $320.40 $600.00 $356.00 2026-03-04
71111 HCPCS X-ray Of Ribs On Both Sides Of Body, Minimum Of 4 Views 12 12 $400.00 $340.00 $245.31 $600.00 $356.00 2026-03-04
87522 HCPCS Detection Test By Nucleic Acid For Hepatitis C Virus, Quantification 12 12 $400.00 $340.00 $91.91 $600.00 $356.00 2026-03-04
74022 HCPCS X-ray Series Of Abdomen With Single X-ray Of Chest 12 12 $400.00 $340.00 $263.89 $600.00 $356.00 2026-03-04
2120844_1 CDM Room & Board - Private (one Bed) - General Classification 4 4 $355.00 $301.75 $312.40 $355.00 $355.00 2026-03-04
5404218_1 CDM Room & Board - Private (one Bed) - General Classification 4 4 $355.00 $301.75 $312.40 $355.00 $355.00 2026-03-04
97597 HCPCS Removal Of Tissue From Wound, 20.0 Sq Cm Or Less 68 13 $400.00 $340.00 $29.82 $600.00 $354.00 2026-03-04
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 13 13 $488.00 $414.80 $300.00 $429.44 $353.31 2026-03-04
87497 HCPCS Detection Test By Nucleic Acid For Cytomegalovirus, Quantification 12 12 $396.00 $336.60 $91.92 $594.00 $352.44 2026-03-04
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 23 12 $10,032.42 $8,527.56 $112.88 $10,032.42 $351.83 2026-03-04
72052 HCPCS X-ray Of Upper Spine, 6 Or More Views 24 12 $394.00 $334.90 $271.33 $591.00 $350.66 2026-03-04
J1447 HCPCS Injection, Tbo-filgrastim, 1 Microgram 12 12 $393.77 $334.70 $0.51 $393.77 $350.46 2026-03-04
26641 HCPCS Closed Treatment Of Dislocated Thumb At Wrist With Manipulation 13 13 $468.00 $397.80 $300.00 $411.84 $348.67 2026-03-04
Q5106 HCPCS Injection, Epoetin Alfa-epbx, Biosimilar, (retacrit) (for Non-esrd Use), 1000 Un… 34 12 $368.02 $312.82 $10.50 $749.93 $347.77 2026-03-04
73080 HCPCS X-ray Of Elbow, Minimum Of 3 Views 35 12 $390.00 $331.50 $151.46 $585.00 $347.10 2026-03-04
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