|
J2350
|
HCPCS
|
Injection, Ocrelizumab, 1 Mg
|
9
|
9
|
$36,707.94
|
$36,707.94
|
$29,395.72
|
$36,707.94
|
$34,872.54
|
2026-03-04
|
|
27882
|
HCPCS
|
Amputation Of Both Lower Leg Bones Leaving Wound
|
9
|
9
|
$30,000.00
|
$30,000.00
|
$24,024.00
|
$30,000.00
|
$28,500.00
|
2026-03-04
|
|
J3380
|
HCPCS
|
Injection, Vedolizumab, Intravenous, 1 Mg
|
9
|
9
|
$16,645.68
|
$16,645.68
|
$13,329.86
|
$16,645.68
|
$15,813.40
|
2026-03-04
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
27
|
9
|
$11,008.69
|
$11,008.69
|
$8,411.03
|
$13,782.10
|
$10,503.29
|
2026-03-04
|
|
47562
|
HCPCS
|
Removal Of Gallbladder Using An Endoscope
|
9
|
9
|
$9,550.00
|
$9,550.00
|
$7,647.64
|
$9,550.00
|
$9,072.50
|
2026-03-04
|
|
49650
|
HCPCS
|
Repair Of Groin Hernia Using An Endoscope
|
9
|
9
|
$9,400.00
|
$9,400.00
|
$7,527.52
|
$9,400.00
|
$8,930.00
|
2026-03-04
|
|
19303
|
HCPCS
|
Simple Complete Removal Of Breast
|
9
|
9
|
$9,000.00
|
$9,000.00
|
$7,207.20
|
$9,000.00
|
$8,550.00
|
2026-03-04
|
|
63650
|
HCPCS
|
Insertion Of Spinal Neurostimulator Electrode Array Through Skin
|
15
|
9
|
$9,222.11
|
$9,222.11
|
$92.29
|
$9,222.11
|
$8,392.12
|
2026-03-04
|
|
57240
|
HCPCS
|
Repair Of Bladder Hernia Into Vaginal Wall
|
15
|
9
|
$8,700.00
|
$8,700.00
|
$364.86
|
$8,700.00
|
$7,917.00
|
2026-03-04
|
|
58150
|
HCPCS
|
Removal Of Uterus And Cervix Through Abdomen
|
9
|
9
|
$7,700.00
|
$7,700.00
|
$6,166.16
|
$7,700.00
|
$7,315.00
|
2026-03-04
|
|
55100
|
HCPCS
|
Drainage Of Abscess Of Scrotum
|
9
|
9
|
$7,612.85
|
$7,612.85
|
$6,096.37
|
$7,612.85
|
$7,232.21
|
2026-03-04
|
|
J1306
|
HCPCS
|
Injection, Inclisiran, 1 Mg
|
9
|
9
|
$6,380.42
|
$6,380.42
|
$5,109.44
|
$6,380.42
|
$6,061.40
|
2026-03-04
|
|
20205
|
HCPCS
|
Deep Biopsy Of Muscle
|
9
|
9
|
$6,117.00
|
$6,117.00
|
$4,898.49
|
$6,117.00
|
$5,811.15
|
2026-03-04
|
|
58661
|
HCPCS
|
Removal Of Ovaries And/or Tubes Using An Endoscope
|
9
|
9
|
$5,874.00
|
$5,874.00
|
$4,703.90
|
$5,874.00
|
$5,580.30
|
2026-03-04
|
|
44955
|
HCPCS
|
Removal Of Appendix During Other Major Procedure
|
9
|
9
|
$5,846.00
|
$5,846.00
|
$4,681.48
|
$5,846.00
|
$5,553.70
|
2026-03-04
|
|
J2426
|
HCPCS
|
Injection, Paliperidone Palmitate Extended Release (invega Sustenna), 1 Mg
|
9
|
9
|
$5,840.66
|
$5,840.66
|
$4,677.20
|
$5,840.66
|
$5,548.63
|
2026-03-04
|
|
21554
|
HCPCS
|
Removal Of Growth Of Muscle Of Neck Or Front Of Chest, 5.0 Cm Or More
|
17
|
9
|
$6,880.00
|
$6,880.00
|
$164.43
|
$6,880.00
|
$5,509.50
|
2026-03-04
|
|
59151
|
HCPCS
|
Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovary And/or Tube Using An…
|
9
|
9
|
$5,707.00
|
$5,707.00
|
$4,570.17
|
$5,707.00
|
$5,421.65
|
2026-03-04
|
|
44005
|
HCPCS
|
Release Of Intestinal Scar Tissue
|
9
|
9
|
$5,407.00
|
$5,407.00
|
$4,329.93
|
$5,407.00
|
$5,136.65
|
2026-03-04
|
|
49591
|
HCPCS
|
Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length
|
9
|
9
|
$5,300.00
|
$5,300.00
|
$4,244.24
|
$5,300.00
|
$5,035.00
|
2026-03-04
|
|
49592
|
HCPCS
|
Initial Repair Of Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length
|
9
|
9
|
$5,290.38
|
$5,290.38
|
$4,236.54
|
$5,290.38
|
$5,025.86
|
2026-03-04
|
|
17250
|
HCPCS
|
Application Of Chemical To Stop Tissue Regrowth In Wound
|
9
|
9
|
$5,249.92
|
$5,249.92
|
$4,204.14
|
$5,249.92
|
$4,987.42
|
2026-03-04
|
|
49505
|
HCPCS
|
Repair Of Groin Hernia (5 Years Or Older)
|
9
|
9
|
$5,150.00
|
$5,150.00
|
$4,124.12
|
$5,150.00
|
$4,892.50
|
2026-03-04
|
|
57520
|
HCPCS
|
Removal Or Destruction Of Cervix With Cold Knife Or Laser
|
9
|
9
|
$4,757.00
|
$4,757.00
|
$3,809.41
|
$4,757.00
|
$4,519.15
|
2026-03-04
|
|
58552
|
HCPCS
|
Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, 250.…
|
9
|
9
|
$4,400.00
|
$4,400.00
|
$3,523.52
|
$4,400.00
|
$4,180.00
|
2026-03-04
|
|
10180
|
HCPCS
|
Complex Drainage Of Wound Infection After Surgery
|
17
|
9
|
$5,109.03
|
$5,109.03
|
$164.43
|
$5,109.03
|
$4,091.31
|
2026-03-04
|
|
36561
|
HCPCS
|
Insertion Of Central Venous Tube With Port (5 Years Or Older)
|
17
|
9
|
$5,010.00
|
$5,010.00
|
$164.43
|
$5,010.00
|
$4,012.01
|
2026-03-04
|
|
19300
|
HCPCS
|
Removal Of Extra Breast Tissue In Male
|
9
|
9
|
$4,088.50
|
$4,088.50
|
$3,274.07
|
$4,088.50
|
$3,884.08
|
2026-03-04
|
|
24120
|
HCPCS
|
Removal Of Cyst Or Growth Of Elbow Or Upper Forearm Bone
|
17
|
9
|
$4,770.70
|
$4,770.70
|
$164.43
|
$4,770.70
|
$3,820.38
|
2026-03-04
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
18
|
9
|
$4,339.64
|
$4,339.64
|
$2,568.16
|
$5,472.29
|
$3,794.60
|
2026-03-04
|
|
J3262
|
HCPCS
|
Injection, Tocilizumab, 1 Mg
|
9
|
9
|
$3,867.48
|
$3,867.48
|
$3,097.08
|
$3,867.48
|
$3,674.11
|
2026-03-04
|
|
15271
|
HCPCS
|
Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, 25.0 Sq C…
|
15
|
9
|
$3,500.00
|
$3,500.00
|
$61.43
|
$3,500.00
|
$3,185.00
|
2026-03-04
|
|
54522
|
HCPCS
|
Partial Removal Of Testicle
|
9
|
9
|
$3,215.00
|
$3,215.00
|
$2,574.57
|
$3,215.00
|
$3,054.25
|
2026-03-04
|
|
46040
|
HCPCS
|
Drainage Of Deep Abscess In Rectum
|
9
|
9
|
$3,196.63
|
$3,196.63
|
$2,559.86
|
$3,196.63
|
$3,036.80
|
2026-03-04
|
|
44143
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin
|
9
|
9
|
$3,190.00
|
$3,190.00
|
$2,554.55
|
$3,190.00
|
$3,030.50
|
2026-03-04
|
|
49594
|
HCPCS
|
Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length
|
9
|
9
|
$3,148.00
|
$3,148.00
|
$2,520.92
|
$3,148.00
|
$2,990.60
|
2026-03-04
|
|
25111
|
HCPCS
|
Removal Of First Cyst Of Wrist
|
26
|
9
|
$3,230.70
|
$3,230.70
|
$164.43
|
$3,230.70
|
$2,988.40
|
2026-03-04
|
|
24105
|
HCPCS
|
Removal Of Fluid-filled Sac Of Elbow
|
17
|
9
|
$3,626.70
|
$3,626.70
|
$164.43
|
$3,626.70
|
$2,904.26
|
2026-03-04
|
|
Q5108
|
HCPCS
|
Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg
|
9
|
9
|
$3,040.09
|
$3,040.09
|
$2,434.50
|
$3,040.09
|
$2,888.09
|
2026-03-04
|
|
54161
|
HCPCS
|
Removal Of Foreskin (older Than 28 Days)
|
17
|
9
|
$3,600.00
|
$3,600.00
|
$164.43
|
$3,600.00
|
$2,882.88
|
2026-03-04
|
|
46255
|
HCPCS
|
Removal Of Single External And Internal Hemorrhoid Group
|
9
|
9
|
$2,970.00
|
$2,970.00
|
$2,378.38
|
$2,970.00
|
$2,821.50
|
2026-03-04
|
|
21931
|
HCPCS
|
Removal Of Growth Under Skin Of Back Or Lower Sides, 3.0 Cm Or More
|
9
|
9
|
$2,745.00
|
$2,745.00
|
$2,198.20
|
$2,745.00
|
$2,607.75
|
2026-03-04
|
|
J2997
|
HCPCS
|
Injection, Alteplase Recombinant, 1 Mg
|
18
|
9
|
$3,149.24
|
$3,149.24
|
$425.45
|
$5,767.20
|
$2,574.82
|
2026-03-04
|
|
46930
|
HCPCS
|
Destruction Of Internal Hemorrhoids Using Heat
|
9
|
9
|
$2,640.00
|
$2,640.00
|
$2,114.11
|
$2,640.00
|
$2,508.00
|
2026-03-04
|
|
J0840
|
HCPCS
|
Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram
|
9
|
9
|
$2,636.72
|
$2,636.72
|
$2,111.49
|
$2,636.72
|
$2,504.88
|
2026-03-04
|
|
55040
|
HCPCS
|
Removal Of Fluid Collection In Testicle And Sperm Reservoir
|
17
|
9
|
$3,000.00
|
$3,000.00
|
$164.43
|
$3,000.00
|
$2,402.40
|
2026-03-04
|
|
26951
|
HCPCS
|
Amputation Of Finger Or Thumb With Direct Closure
|
15
|
9
|
$2,600.00
|
$2,600.00
|
$495.76
|
$2,600.00
|
$2,366.00
|
2026-03-04
|
|
44620
|
HCPCS
|
Closure Of Surgically Created Large Or Small Bowel Opening
|
9
|
9
|
$2,450.00
|
$2,450.00
|
$1,961.96
|
$2,450.00
|
$2,327.50
|
2026-03-04
|
|
J0129
|
HCPCS
|
Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…
|
9
|
9
|
$2,446.87
|
$2,446.87
|
$1,959.45
|
$2,446.87
|
$2,324.53
|
2026-03-04
|
|
64635
|
HCPCS
|
Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,…
|
15
|
9
|
$2,500.00
|
$2,500.00
|
$143.37
|
$2,500.00
|
$2,275.00
|
2026-03-04
|
|
74174
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast
|
9
|
9
|
$2,355.99
|
$2,355.99
|
$1,886.68
|
$2,355.99
|
$2,238.19
|
2026-03-04
|
|
95811
|
HCPCS
|
Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older)
|
9
|
9
|
$2,352.50
|
$2,352.50
|
$1,883.88
|
$2,352.50
|
$2,234.88
|
2026-03-04
|
|
J3111
|
HCPCS
|
Injection, Romosozumab-aqqg, 1 Mg
|
9
|
9
|
$2,337.64
|
$2,337.64
|
$1,871.98
|
$2,337.64
|
$2,220.76
|
2026-03-04
|
|
44204
|
HCPCS
|
Partial Removal Of Large Bowel Using An Endoscope
|
9
|
9
|
$2,310.00
|
$2,310.00
|
$1,849.85
|
$2,310.00
|
$2,194.50
|
2026-03-04
|
|
11772
|
HCPCS
|
Complicated Removal Of Cyst Of Tailbone
|
17
|
9
|
$2,740.00
|
$2,740.00
|
$164.43
|
$2,740.00
|
$2,194.19
|
2026-03-04
|
|
27043
|
HCPCS
|
Removal Of Growth Under Skin Of Pelvis And Hip, 3.0 Cm Or More
|
9
|
9
|
$2,300.00
|
$2,300.00
|
$1,841.84
|
$2,300.00
|
$2,185.00
|
2026-03-04
|
|
28190
|
HCPCS
|
Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin
|
17
|
9
|
$2,688.82
|
$2,688.82
|
$164.43
|
$2,688.82
|
$2,153.21
|
2026-03-04
|
|
36590
|
HCPCS
|
Removal Of Central Venous Tube With Port Or Pump
|
9
|
9
|
$2,266.00
|
$2,266.00
|
$1,814.61
|
$2,266.00
|
$2,152.70
|
2026-03-04
|
|
36573
|
HCPCS
|
Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, …
|
9
|
9
|
$2,250.00
|
$2,250.00
|
$1,801.80
|
$2,250.00
|
$2,137.50
|
2026-03-04
|
|
11406
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm
|
17
|
9
|
$2,620.00
|
$2,620.00
|
$164.43
|
$2,620.00
|
$2,098.10
|
2026-03-04
|
|
11606
|
HCPCS
|
Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm
|
17
|
9
|
$2,613.00
|
$2,613.00
|
$164.43
|
$2,613.00
|
$2,092.49
|
2026-03-04
|
|
J7298
|
HCPCS
|
Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg
|
18
|
9
|
$2,394.00
|
$2,394.00
|
$1,369.37
|
$3,078.00
|
$2,087.43
|
2026-03-04
|
|
64633
|
HCPCS
|
Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,…
|
17
|
9
|
$2,500.00
|
$2,500.00
|
$164.43
|
$2,500.00
|
$2,002.00
|
2026-03-04
|
|
59812
|
HCPCS
|
Treatment Of Miscarriage
|
9
|
9
|
$2,097.70
|
$2,097.70
|
$1,679.84
|
$2,097.70
|
$1,992.82
|
2026-03-04
|
|
11426
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More …
|
17
|
9
|
$2,485.00
|
$2,485.00
|
$164.43
|
$2,485.00
|
$1,989.99
|
2026-03-04
|
|
55700
|
HCPCS
|
Biopsy Of Prostate Gland
|
9
|
9
|
$2,068.43
|
$2,068.43
|
$1,656.40
|
$2,068.43
|
$1,965.01
|
2026-03-04
|
|
93306
|
HCPCS
|
Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu…
|
27
|
9
|
$2,002.44
|
$2,002.44
|
$1,603.55
|
$2,118.23
|
$1,927.59
|
2026-03-04
|
|
26236
|
HCPCS
|
Partial Removal Of Finger Bone At End Of Finger
|
17
|
9
|
$2,400.00
|
$2,400.00
|
$164.43
|
$2,400.00
|
$1,921.92
|
2026-03-04
|
|
58100
|
HCPCS
|
Biopsy Of Lining Of Uterus
|
9
|
9
|
$2,009.70
|
$2,009.70
|
$1,609.37
|
$2,009.70
|
$1,909.22
|
2026-03-04
|
|
26160
|
HCPCS
|
Removal Of Growth Of Tendon Finger Or Hand
|
17
|
9
|
$2,325.40
|
$2,325.40
|
$164.43
|
$2,325.40
|
$1,862.18
|
2026-03-04
|
|
44970
|
HCPCS
|
Removal Of Appendix Using An Endoscope
|
9
|
9
|
$1,947.00
|
$1,947.00
|
$1,559.16
|
$1,947.00
|
$1,849.65
|
2026-03-04
|
|
46947
|
HCPCS
|
Stapling Of Internal Hemorrhoid
|
9
|
9
|
$1,940.00
|
$1,940.00
|
$1,553.55
|
$1,940.00
|
$1,843.00
|
2026-03-04
|
|
58353
|
HCPCS
|
Destruction Of Lining Of Uterus
|
9
|
9
|
$1,925.00
|
$1,925.00
|
$1,541.54
|
$1,925.00
|
$1,828.75
|
2026-03-04
|
|
19020
|
HCPCS
|
Drainage Of Abscess Of Breast
|
18
|
9
|
$2,052.84
|
$2,052.84
|
$1,439.04
|
$2,308.68
|
$1,822.89
|
2026-03-04
|
|
64495
|
HCPCS
|
Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And…
|
15
|
9
|
$1,964.56
|
$1,964.56
|
$37.70
|
$1,964.56
|
$1,787.75
|
2026-03-04
|
|
58670
|
HCPCS
|
Destruction Of Fallopian Tubes Using An Endoscope
|
9
|
9
|
$1,870.00
|
$1,870.00
|
$1,497.50
|
$1,870.00
|
$1,776.50
|
2026-03-04
|
|
J7307
|
HCPCS
|
Etonogestrel (contraceptive) Implant System, Including Implant And Supplies
|
9
|
9
|
$1,850.20
|
$1,850.20
|
$1,481.64
|
$1,850.20
|
$1,757.69
|
2026-03-04
|
|
54700
|
HCPCS
|
Incision And Drainage Of Sperm Reservoir, Testis, And/or Scrotal Area
|
9
|
9
|
$1,845.00
|
$1,845.00
|
$1,477.48
|
$1,845.00
|
$1,752.75
|
2026-03-04
|
|
43251
|
HCPCS
|
Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…
|
15
|
9
|
$1,880.00
|
$1,880.00
|
$142.59
|
$1,880.00
|
$1,710.80
|
2026-03-04
|
|
J7296
|
HCPCS
|
Levonorgestrel-releasing Intrauterine Contraceptive System, (kyleena), 19.5 Mg
|
18
|
9
|
$1,791.82
|
$1,791.82
|
$1,357.36
|
$1,888.63
|
$1,695.00
|
2026-03-04
|
|
45378
|
HCPCS
|
Diagnostic Exam Of Large Bowel Using A Flexible Endoscope
|
18
|
9
|
$1,780.78
|
$1,780.78
|
$1,382.63
|
$1,835.00
|
$1,686.07
|
2026-03-04
|
|
95810
|
HCPCS
|
Sleep Study In Sleep Lab (6 Years Or Older)
|
9
|
9
|
$1,764.00
|
$1,764.00
|
$1,412.61
|
$1,764.00
|
$1,675.80
|
2026-03-04
|
|
45384
|
HCPCS
|
Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec…
|
18
|
9
|
$1,759.35
|
$1,759.35
|
$1,336.30
|
$1,850.00
|
$1,668.70
|
2026-03-04
|
|
45385
|
HCPCS
|
Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S…
|
18
|
9
|
$1,866.85
|
$1,866.85
|
$1,336.30
|
$2,065.00
|
$1,668.70
|
2026-03-04
|
|
45381
|
HCPCS
|
Injection Beneath Lining Of Large Bowel Using A Flexible Endoscope
|
9
|
9
|
$1,735.00
|
$1,735.00
|
$1,389.39
|
$1,735.00
|
$1,648.25
|
2026-03-04
|
|
75635
|
HCPCS
|
CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast
|
9
|
9
|
$1,727.81
|
$1,727.81
|
$1,383.63
|
$1,727.81
|
$1,641.42
|
2026-03-04
|
|
36556
|
HCPCS
|
Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older)
|
17
|
9
|
$2,040.00
|
$2,040.00
|
$164.43
|
$2,040.00
|
$1,633.63
|
2026-03-04
|
|
47563
|
HCPCS
|
Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope
|
9
|
9
|
$1,700.00
|
$1,700.00
|
$1,361.36
|
$1,700.00
|
$1,615.00
|
2026-03-04
|
|
59409
|
HCPCS
|
Vaginal Delivery
|
9
|
9
|
$1,696.00
|
$1,696.00
|
$1,358.16
|
$1,696.00
|
$1,611.20
|
2026-03-04
|
|
10061
|
HCPCS
|
Complicated Or Multiple Drainage Of Skin Abscess
|
17
|
9
|
$2,004.35
|
$2,004.35
|
$164.43
|
$2,004.35
|
$1,605.08
|
2026-03-04
|
|
58301
|
HCPCS
|
Removal Of IUD
|
17
|
9
|
$2,000.00
|
$2,000.00
|
$118.40
|
$2,000.00
|
$1,601.60
|
2026-03-04
|
|
J7300
|
HCPCS
|
Intrauterine Copper Contraceptive
|
9
|
9
|
$1,667.25
|
$1,667.25
|
$1,335.13
|
$1,667.25
|
$1,583.89
|
2026-03-04
|
|
25535
|
HCPCS
|
Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side With Man…
|
9
|
9
|
$1,634.00
|
$1,634.00
|
$1,308.51
|
$1,634.00
|
$1,552.30
|
2026-03-04
|
|
70498
|
HCPCS
|
CT Scan Of Blood Vessels Of Neck With Contrast
|
9
|
9
|
$1,603.20
|
$1,603.20
|
$1,283.84
|
$1,603.20
|
$1,523.04
|
2026-03-04
|
|
70496
|
HCPCS
|
CT Scan Of Blood Vessels Of Head With Contrast
|
9
|
9
|
$1,601.63
|
$1,601.63
|
$1,282.59
|
$1,601.63
|
$1,521.55
|
2026-03-04
|
|
71275
|
HCPCS
|
CT Scan Of Blood Vessels Of Chest With Contrast
|
18
|
9
|
$1,581.37
|
$1,581.37
|
$1,266.36
|
$1,581.37
|
$1,502.30
|
2026-03-04
|
|
49255
|
HCPCS
|
Removal Of Lining Covering Abdominal Organs
|
9
|
9
|
$1,560.00
|
$1,560.00
|
$1,249.25
|
$1,560.00
|
$1,482.00
|
2026-03-04
|
|
45380
|
HCPCS
|
Biopsy Of Large Bowel Using A Flexible Endoscope
|
18
|
9
|
$1,665.00
|
$1,665.00
|
$1,145.14
|
$1,900.00
|
$1,475.76
|
2026-03-04
|
|
11443
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2…
|
17
|
9
|
$1,840.00
|
$1,840.00
|
$164.43
|
$1,840.00
|
$1,473.47
|
2026-03-04
|
|
11047
|
HCPCS
|
Removal Of Bone, Each Additional 20.0 Sq Cm Or Less
|
9
|
9
|
$1,544.75
|
$1,544.75
|
$1,237.04
|
$1,544.75
|
$1,467.51
|
2026-03-04
|
|
20225
|
HCPCS
|
Deep Biopsy Of Bone Using Needle Or Trocar
|
9
|
9
|
$1,544.75
|
$1,544.75
|
$1,237.04
|
$1,544.75
|
$1,467.51
|
2026-03-04
|
|
20220
|
HCPCS
|
Biopsy Of Bone Using Needle Or Trocar
|
9
|
9
|
$1,544.75
|
$1,544.75
|
$1,237.04
|
$1,544.75
|
$1,467.51
|
2026-03-04
|
|
J3489
|
HCPCS
|
Injection, Zoledronic Acid, 1 Mg
|
27
|
9
|
$1,585.19
|
$1,585.19
|
$67.72
|
$1,585.20
|
$1,466.30
|
2026-03-04
|
|
62321
|
HCPCS
|
Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance
|
15
|
9
|
$1,600.00
|
$1,600.00
|
$79.24
|
$1,600.00
|
$1,456.00
|
2026-03-04
|
|
62323
|
HCPCS
|
Injection Of Substance Into Lower Spine Canal Using Imaging Guidance
|
15
|
9
|
$1,600.00
|
$1,600.00
|
$73.91
|
$1,600.00
|
$1,456.00
|
2026-03-04
|
|
43239
|
HCPCS
|
Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop…
|
24
|
9
|
$1,507.44
|
$1,507.44
|
$101.71
|
$1,600.00
|
$1,432.07
|
2026-03-04
|
|
55250
|
HCPCS
|
Removal Of Sperm Duct
|
26
|
9
|
$1,500.00
|
$1,500.00
|
$164.43
|
$1,700.00
|
$1,425.00
|
2026-03-04
|
|
49083
|
HCPCS
|
Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance
|
9
|
9
|
$1,500.00
|
$1,500.00
|
$1,201.20
|
$1,500.00
|
$1,425.00
|
2026-03-04
|
|
C1781
|
HCPCS
|
Mesh (implantable)
|
36
|
9
|
$1,659.35
|
$1,659.35
|
$108.11
|
$3,574.20
|
$1,423.00
|
2026-03-04
|
|
64492
|
HCPCS
|
Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Third And…
|
15
|
9
|
$1,522.95
|
$1,522.95
|
$42.79
|
$1,522.95
|
$1,385.88
|
2026-03-04
|
|
G0121
|
HCPCS
|
Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For …
|
18
|
9
|
$1,548.35
|
$1,548.35
|
$1,010.37
|
$1,835.00
|
$1,365.59
|
2026-03-04
|
|
J1442
|
HCPCS
|
Injection, Filgrastim (g-csf), Excludes Biosimilars, 1 Microgram
|
18
|
9
|
$1,430.34
|
$1,430.34
|
$1,084.88
|
$1,505.92
|
$1,354.75
|
2026-03-04
|
|
26725
|
HCPCS
|
Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With …
|
9
|
9
|
$1,420.00
|
$1,420.00
|
$1,137.14
|
$1,420.00
|
$1,349.00
|
2026-03-04
|
|
52000
|
HCPCS
|
Diagnostic Exam Of Bladder And Urethra Using An Endoscope
|
9
|
9
|
$1,411.30
|
$1,411.30
|
$1,130.17
|
$1,411.30
|
$1,340.74
|
2026-03-04
|
|
11403
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm
|
17
|
9
|
$1,665.00
|
$1,665.00
|
$164.43
|
$1,665.00
|
$1,333.33
|
2026-03-04
|
|
12007
|
HCPCS
|
Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs, …
|
9
|
9
|
$1,400.00
|
$1,400.00
|
$1,121.12
|
$1,400.00
|
$1,330.00
|
2026-03-04
|
|
99285
|
HCPCS
|
Emergency Department Visit With High Level Of Medical Decision Making
|
9
|
9
|
$1,390.00
|
$1,390.00
|
$1,113.11
|
$1,390.00
|
$1,320.50
|
2026-03-04
|
|
63685
|
HCPCS
|
Insertion Or Replacement Of Spinal Neurostimulator Generator Or Receiver
|
9
|
9
|
$1,380.23
|
$1,380.23
|
$1,105.29
|
$1,380.23
|
$1,311.22
|
2026-03-04
|
|
10140
|
HCPCS
|
Drainage Of Blood Or Fluid Accumulation
|
35
|
9
|
$1,600.00
|
$1,600.00
|
$164.43
|
$1,602.11
|
$1,281.28
|
2026-03-04
|
|
12036
|
HCPCS
|
Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.…
|
17
|
9
|
$1,600.00
|
$1,600.00
|
$164.43
|
$1,600.00
|
$1,281.28
|
2026-03-04
|
|
11404
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm
|
17
|
9
|
$1,590.00
|
$1,590.00
|
$164.43
|
$1,590.00
|
$1,273.27
|
2026-03-04
|
|
G0105
|
HCPCS
|
Colorectal Cancer Screening; Colonoscopy On Individual At High Risk
|
18
|
9
|
$1,333.05
|
$1,333.05
|
$1,013.89
|
$1,400.00
|
$1,266.10
|
2026-03-04
|
|
64494
|
HCPCS
|
Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Second Le…
|
15
|
9
|
$1,378.55
|
$1,378.55
|
$36.63
|
$1,378.55
|
$1,254.48
|
2026-03-04
|
|
44180
|
HCPCS
|
Release Of Small Bowel Scar Tissue Using An Endoscope
|
9
|
9
|
$1,320.00
|
$1,320.00
|
$1,057.06
|
$1,320.00
|
$1,254.00
|
2026-03-04
|
|
44950
|
HCPCS
|
Removal Of Appendix
|
9
|
9
|
$1,320.00
|
$1,320.00
|
$1,057.06
|
$1,320.00
|
$1,254.00
|
2026-03-04
|
|
64721
|
HCPCS
|
Release And/or Relocation Of Hand Nerve
|
9
|
9
|
$1,320.00
|
$1,320.00
|
$1,057.06
|
$1,320.00
|
$1,254.00
|
2026-03-04
|
|
Q5103
|
HCPCS
|
Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg
|
9
|
9
|
$1,305.73
|
$1,305.73
|
$1,045.63
|
$1,305.73
|
$1,240.44
|
2026-03-04
|
|
87507
|
HCPCS
|
Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S…
|
9
|
9
|
$1,273.26
|
$1,273.26
|
$1,019.63
|
$1,273.26
|
$1,209.60
|
2026-03-04
|
|
73206
|
HCPCS
|
CT Scan Of Blood Vessels Of Arm With Contrast
|
27
|
9
|
$1,265.30
|
$1,265.30
|
$1,013.25
|
$1,265.30
|
$1,202.04
|
2026-03-04
|
|
73706
|
HCPCS
|
CT Scan Of Blood Vessels Of Lower Leg With Contrast
|
18
|
9
|
$1,265.30
|
$1,265.30
|
$1,013.25
|
$1,265.30
|
$1,202.04
|
2026-03-04
|
|
64484
|
HCPCS
|
Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I…
|
15
|
9
|
$1,317.85
|
$1,317.85
|
$36.63
|
$1,317.85
|
$1,199.24
|
2026-03-04
|
|
99291
|
HCPCS
|
Critical Care, First 30-74 Minutes
|
17
|
9
|
$1,470.00
|
$1,470.00
|
$164.43
|
$1,470.00
|
$1,177.18
|
2026-03-04
|
|
52281
|
HCPCS
|
Dilation Of Urethra Using An Endoscope
|
9
|
9
|
$1,232.00
|
$1,232.00
|
$986.59
|
$1,232.00
|
$1,170.40
|
2026-03-04
|
|
43246
|
HCPCS
|
Insertion Of Stomach Tube Using A Flexible Endoscope
|
24
|
9
|
$1,145.10
|
$1,145.10
|
$145.45
|
$2,965.00
|
$1,099.30
|
2026-03-04
|
|
58120
|
HCPCS
|
Dilation And Scraping Of Uterus
|
9
|
9
|
$1,155.00
|
$1,155.00
|
$924.92
|
$1,155.00
|
$1,097.25
|
2026-03-04
|
|
12045
|
HCPCS
|
Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 12.6-20.0 Cm
|
17
|
9
|
$1,370.00
|
$1,370.00
|
$164.43
|
$1,370.00
|
$1,097.10
|
2026-03-04
|
|
45305
|
HCPCS
|
Biopsies Of Rectum And/or Lower Large Bowel Using A Rigid Endoscope
|
9
|
9
|
$1,148.00
|
$1,148.00
|
$919.32
|
$1,148.00
|
$1,090.60
|
2026-03-04
|
|
90375
|
HCPCS
|
Rabies Immune Globulin For Injection
|
9
|
9
|
$1,140.10
|
$1,140.10
|
$912.99
|
$1,140.10
|
$1,083.10
|
2026-03-04
|
|
45300
|
HCPCS
|
Diagnostic Exam Of Rectum And Lower Large Bowel Using An Endoscope
|
9
|
9
|
$1,135.00
|
$1,135.00
|
$908.91
|
$1,135.00
|
$1,078.25
|
2026-03-04
|
|
23650
|
HCPCS
|
Closed Treatment Of Dislocated Shoulder With Manipulation
|
18
|
9
|
$1,132.79
|
$1,132.79
|
$874.55
|
$1,173.48
|
$1,076.67
|
2026-03-04
|
|
C1897
|
HCPCS
|
Lead, Neurostimulator Test Kit (implantable)
|
9
|
9
|
$1,125.00
|
$1,125.00
|
$900.90
|
$1,125.00
|
$1,068.75
|
2026-03-04
|
|
J1459
|
HCPCS
|
Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui…
|
18
|
9
|
$1,184.33
|
$1,184.33
|
$853.22
|
$1,303.20
|
$1,065.46
|
2026-03-04
|
|
63190
|
HCPCS
|
Removal Of Spine Bone With Severing Of Nerve Roots, More Than 2 Segments
|
15
|
9
|
$1,120.00
|
$1,120.00
|
$896.90
|
$1,451.60
|
$1,064.00
|
2026-03-04
|
|
63185
|
HCPCS
|
Removal Of Spine Bone With Severing Of Nerve Roots, 1-2 Segments
|
15
|
9
|
$1,120.00
|
$1,120.00
|
$853.43
|
$1,323.35
|
$1,064.00
|
2026-03-04
|
|
11402
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm
|
26
|
9
|
$1,120.00
|
$1,120.00
|
$164.43
|
$1,160.28
|
$1,059.92
|
2026-03-04
|
|
52204
|
HCPCS
|
Biopsy Of Bladder Using An Endoscope
|
9
|
9
|
$1,100.00
|
$1,100.00
|
$880.88
|
$1,100.00
|
$1,045.00
|
2026-03-04
|
|
10160
|
HCPCS
|
Aspiration Of Abscess, Blood, Or Cyst
|
17
|
9
|
$1,278.96
|
$1,278.96
|
$150.78
|
$1,278.96
|
$1,024.19
|
2026-03-04
|
|
45330
|
HCPCS
|
Diagnostic Exam Of Lower Portion Of Large Bowel Using A Flexible Endoscope
|
18
|
9
|
$1,123.50
|
$1,123.50
|
$810.41
|
$1,235.00
|
$1,012.00
|
2026-03-04
|
|
45333
|
HCPCS
|
Removal Of Polyps Or Growths Of Lower Large Bowel Using A Flexible Endoscope Wit…
|
9
|
9
|
$1,065.00
|
$1,065.00
|
$852.85
|
$1,065.00
|
$1,011.75
|
2026-03-04
|
|
70480
|
HCPCS
|
CT Scan Of Cranial Cavity Without Contrast
|
9
|
9
|
$1,060.90
|
$1,060.90
|
$849.57
|
$1,060.90
|
$1,007.86
|
2026-03-04
|
|
70487
|
HCPCS
|
CT Scan Of Face With Contrast
|
9
|
9
|
$1,060.90
|
$1,060.90
|
$849.57
|
$1,060.90
|
$1,007.86
|
2026-03-04
|
|
45335
|
HCPCS
|
Injection Beneath Lining Of Lower Large Bowel Using A Flexible Endoscope
|
9
|
9
|
$1,056.00
|
$1,056.00
|
$845.64
|
$1,056.00
|
$1,003.20
|
2026-03-04
|
|
36589
|
HCPCS
|
Removal Of Tunneled Central Venous Tube
|
17
|
9
|
$1,252.68
|
$1,252.68
|
$164.43
|
$1,252.68
|
$1,003.15
|
2026-03-04
|
|
90377
|
HCPCS
|
Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle
|
9
|
9
|
$1,054.58
|
$1,054.58
|
$844.51
|
$1,054.58
|
$1,001.85
|
2026-03-04
|
|
73702
|
HCPCS
|
CT Scan Of Leg Before And After Contrast
|
27
|
9
|
$1,043.30
|
$1,043.30
|
$835.47
|
$1,043.30
|
$991.14
|
2026-03-04
|
|
64491
|
HCPCS
|
Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Second Le…
|
15
|
9
|
$1,071.81
|
$1,071.81
|
$42.28
|
$1,071.81
|
$975.35
|
2026-03-04
|
|
23076
|
HCPCS
|
Removal Of Growth Of Muscle Of Shoulder, Less Than 5.0 Cm
|
9
|
9
|
$1,020.00
|
$1,020.00
|
$816.82
|
$1,020.00
|
$969.00
|
2026-03-04
|
|
21552
|
HCPCS
|
Removal Of Growth Of Soft Tissue Under Skin Of Neck Or Front Of Chest, 3.0 Cm Or…
|
17
|
9
|
$1,206.70
|
$1,206.70
|
$164.43
|
$1,206.70
|
$966.33
|
2026-03-04
|
|
14040
|
HCPCS
|
Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han…
|
17
|
9
|
$1,206.70
|
$1,206.70
|
$164.43
|
$1,206.70
|
$966.33
|
2026-03-04
|
|
12006
|
HCPCS
|
Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, …
|
17
|
9
|
$1,200.00
|
$1,200.00
|
$164.43
|
$1,200.00
|
$960.96
|
2026-03-04
|
|
43249
|
HCPCS
|
Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…
|
24
|
9
|
$1,500.00
|
$1,500.00
|
$112.22
|
$2,175.00
|
$942.64
|
2026-03-04
|
|
J0248
|
HCPCS
|
Injection, Remdesivir, 1 Mg
|
18
|
9
|
$1,001.06
|
$1,001.06
|
$749.55
|
$1,066.12
|
$936.00
|
2026-03-04
|
|
99284
|
HCPCS
|
Emergency Department Visit With Moderate Level Of Medical Decision Making
|
9
|
9
|
$973.00
|
$973.00
|
$779.18
|
$973.00
|
$924.35
|
2026-03-04
|
|
12016
|
HCPCS
|
Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.…
|
9
|
9
|
$971.00
|
$971.00
|
$777.58
|
$971.00
|
$922.45
|
2026-03-04
|
|
15260
|
HCPCS
|
Full Thickness Skin Graft To Nose, Ears, Eyelids, Or Lips, 20.0 Sq Cm Or Less
|
9
|
9
|
$970.00
|
$970.00
|
$776.78
|
$970.00
|
$921.50
|
2026-03-04
|
|
43247
|
HCPCS
|
Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using …
|
24
|
9
|
$957.00
|
$957.00
|
$129.23
|
$1,820.00
|
$918.72
|
2026-03-04
|
|
43215
|
HCPCS
|
Removal Of Foreign Bodies In Esophagus Using A Flexible Endoscope
|
18
|
9
|
$1,037.30
|
$1,037.30
|
$704.70
|
$1,194.60
|
$918.32
|
2026-03-04
|
|
32555
|
HCPCS
|
Aspiration Of Fluid From Chest Cavity Using Imaging Guidance
|
17
|
9
|
$1,080.20
|
$1,080.20
|
$164.43
|
$1,080.20
|
$910.00
|
2026-03-04
|
|
78701
|
HCPCS
|
Nuclear Medicine Study Of Kidney And Blood Flow
|
9
|
9
|
$957.00
|
$957.00
|
$766.37
|
$957.00
|
$909.15
|
2026-03-04
|
|
43235
|
HCPCS
|
Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible…
|
24
|
9
|
$935.00
|
$935.00
|
$90.89
|
$1,435.00
|
$897.60
|
2026-03-04
|
|
25605
|
HCPCS
|
Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit…
|
17
|
9
|
$1,107.00
|
$1,107.00
|
$164.43
|
$1,107.00
|
$886.49
|
2026-03-04
|
|
77075
|
HCPCS
|
Complete X-ray Of Body Bones
|
9
|
9
|
$929.45
|
$929.45
|
$744.30
|
$929.45
|
$882.98
|
2026-03-04
|
|
64493
|
HCPCS
|
Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le…
|
15
|
9
|
$968.84
|
$968.84
|
$67.36
|
$968.84
|
$881.64
|
2026-03-04
|
|
90675
|
HCPCS
|
Rabies Vaccine For Injection Into Muscle
|
18
|
9
|
$993.89
|
$993.89
|
$665.21
|
$1,157.11
|
$878.64
|
2026-03-04
|
|
64483
|
HCPCS
|
Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I…
|
15
|
9
|
$963.80
|
$963.80
|
$82.40
|
$963.80
|
$877.06
|
2026-03-04
|
|
57300
|
HCPCS
|
Closure Of Abnormal Drainage Tract From Rectum To Vagina Through Vagina Or Anus
|
9
|
9
|
$907.00
|
$907.00
|
$726.33
|
$907.00
|
$861.65
|
2026-03-04
|
|
27096
|
HCPCS
|
Injection Of Anesthetic Or Steroid Into Joint Between Lower Spine And Hip Bone U…
|
15
|
9
|
$945.97
|
$945.97
|
$61.14
|
$945.97
|
$860.83
|
2026-03-04
|
|
11401
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm
|
17
|
9
|
$1,055.00
|
$1,055.00
|
$164.43
|
$1,055.00
|
$844.84
|
2026-03-04
|
|
12005
|
HCPCS
|
Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, …
|
17
|
9
|
$1,050.00
|
$1,050.00
|
$164.43
|
$1,050.00
|
$840.84
|
2026-03-04
|
|
24071
|
HCPCS
|
Removal Of Growth Under Skin Of Upper Arm Or Elbow, 3.0 Cm Or More
|
9
|
9
|
$880.00
|
$880.00
|
$704.70
|
$880.00
|
$836.00
|
2026-03-04
|
|
47000
|
HCPCS
|
Needle Biopsy Of Liver Through Skin
|
9
|
9
|
$880.00
|
$880.00
|
$704.70
|
$880.00
|
$836.00
|
2026-03-04
|
|
74185
|
HCPCS
|
MRI Scan Of Blood Vessels Of Abdomen
|
9
|
9
|
$875.50
|
$875.50
|
$701.10
|
$875.50
|
$831.73
|
2026-03-04
|
|
70547
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck Without Contrast
|
9
|
9
|
$875.50
|
$875.50
|
$701.10
|
$875.50
|
$831.73
|
2026-03-04
|
|
72198
|
HCPCS
|
MRI Scan Of Blood Vessels Of Pelvis
|
9
|
9
|
$875.50
|
$875.50
|
$701.10
|
$875.50
|
$831.73
|
2026-03-04
|
|
70549
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck Before And After Contrast
|
9
|
9
|
$875.50
|
$875.50
|
$701.10
|
$875.50
|
$831.73
|
2026-03-04
|
|
70544
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head Without Contrast
|
9
|
9
|
$875.50
|
$875.50
|
$701.10
|
$875.50
|
$831.73
|
2026-03-04
|
|
70548
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck With Contrast
|
9
|
9
|
$875.50
|
$875.50
|
$701.10
|
$875.50
|
$831.73
|
2026-03-04
|
|
23655
|
HCPCS
|
Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia
|
18
|
9
|
$936.16
|
$936.16
|
$652.65
|
$1,057.32
|
$830.85
|
2026-03-04
|
|
64636
|
HCPCS
|
Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,…
|
15
|
9
|
$900.00
|
$900.00
|
$42.28
|
$900.00
|
$819.00
|
2026-03-04
|
|
28660
|
HCPCS
|
Closed Treatment Of Dislocated Joint In Toe
|
17
|
9
|
$1,012.00
|
$1,012.00
|
$107.30
|
$1,012.00
|
$810.41
|
2026-03-04
|
|
73725
|
HCPCS
|
MRI Scan Of Blood Vessels Of Leg
|
27
|
9
|
$875.50
|
$875.50
|
$544.54
|
$875.50
|
$809.84
|
2026-03-04
|
|
12044
|
HCPCS
|
Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm
|
17
|
9
|
$1,011.00
|
$1,011.00
|
$164.43
|
$1,011.00
|
$809.61
|
2026-03-04
|
|
72128
|
HCPCS
|
CT Scan Of Middle Spine Without Contrast
|
9
|
9
|
$851.60
|
$851.60
|
$681.96
|
$851.60
|
$809.02
|
2026-03-04
|
|
62322
|
HCPCS
|
Injection Of Substance Into Lower Spine Canal
|
9
|
9
|
$850.00
|
$850.00
|
$680.68
|
$850.00
|
$807.50
|
2026-03-04
|
|
78700
|
HCPCS
|
Nuclear Medicine Study Of Kidney
|
9
|
9
|
$842.00
|
$842.00
|
$674.27
|
$842.00
|
$799.90
|
2026-03-04
|
|
72125
|
HCPCS
|
CT Scan Of Upper Spine Without Contrast
|
9
|
9
|
$838.76
|
$838.76
|
$671.68
|
$838.76
|
$796.82
|
2026-03-04
|
|
24600
|
HCPCS
|
Repair Of Dislocated Elbow
|
26
|
9
|
$815.00
|
$815.00
|
$164.43
|
$1,057.32
|
$774.25
|
2026-03-04
|
|
20200
|
HCPCS
|
Biopsy Of Muscle
|
9
|
9
|
$807.84
|
$807.84
|
$646.92
|
$807.84
|
$767.45
|
2026-03-04
|
|
74160
|
HCPCS
|
CT Scan Of Abdomen With Contrast
|
9
|
9
|
$806.25
|
$806.25
|
$645.65
|
$806.25
|
$765.94
|
2026-03-04
|
|
11400
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less
|
26
|
9
|
$800.00
|
$800.00
|
$144.30
|
$1,620.00
|
$760.00
|
2026-03-04
|
|
37195
|
HCPCS
|
Infusion Of Drug To Dissolve Blood Clot In Brain
|
9
|
9
|
$800.00
|
$800.00
|
$640.64
|
$800.00
|
$760.00
|
2026-03-04
|
|
93799
|
HCPCS
|
Other Cardiovascular Service Or Procedure
|
9
|
9
|
$800.00
|
$800.00
|
$640.64
|
$800.00
|
$760.00
|
2026-03-04
|
|
20520
|
HCPCS
|
Removal Of Foreign Body In Muscle Or Tendon
|
9
|
9
|
$799.92
|
$799.92
|
$640.58
|
$799.92
|
$759.92
|
2026-03-04
|
|
74150
|
HCPCS
|
CT Scan Of Abdomen Without Contrast
|
9
|
9
|
$798.50
|
$798.50
|
$639.44
|
$798.50
|
$758.58
|
2026-03-04
|
|
J7325
|
HCPCS
|
Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,…
|
9
|
9
|
$797.00
|
$797.00
|
$638.24
|
$797.00
|
$757.15
|
2026-03-04
|
|
J1610
|
HCPCS
|
Injection, Glucagon Hydrochloride, Per 1 Mg
|
27
|
9
|
$784.14
|
$784.14
|
$612.47
|
$795.71
|
$744.93
|
2026-03-04
|
|
32554
|
HCPCS
|
Aspiration Of Fluid From Chest Cavity
|
17
|
9
|
$929.50
|
$929.50
|
$163.73
|
$929.50
|
$744.34
|
2026-03-04
|
|
74177
|
HCPCS
|
CT Scan Of Abdomen And Pelvis With Contrast
|
9
|
9
|
$779.16
|
$779.16
|
$623.95
|
$779.16
|
$740.20
|
2026-03-04
|
|
72193
|
HCPCS
|
CT Scan Of Pelvis With Contrast
|
9
|
9
|
$778.85
|
$778.85
|
$623.70
|
$778.85
|
$739.91
|
2026-03-04
|
|
P9040
|
HCPCS
|
Red Blood Cells, Leukocytes Reduced, Irradiated, Each Unit
|
9
|
9
|
$777.28
|
$777.28
|
$622.45
|
$777.28
|
$738.42
|
2026-03-04
|
|
70488
|
HCPCS
|
CT Scan Of Face Before And After Contrast
|
9
|
9
|
$758.65
|
$758.65
|
$607.53
|
$758.65
|
$720.72
|
2026-03-04
|
|
64634
|
HCPCS
|
Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,…
|
17
|
9
|
$900.00
|
$900.00
|
$164.43
|
$900.00
|
$720.72
|
2026-03-04
|
|
32551
|
HCPCS
|
Removal Of Fluid From Between Lung And Chest Cavity
|
17
|
9
|
$900.00
|
$900.00
|
$164.43
|
$900.00
|
$720.72
|
2026-03-04
|
|
93307
|
HCPCS
|
Ultrasound Of Heart
|
9
|
9
|
$752.40
|
$752.40
|
$602.52
|
$752.40
|
$714.78
|
2026-03-04
|
|
64454
|
HCPCS
|
Injection Of Anesthetic Agent And/or Steroid Into Knee Nerve Branch Using Imagin…
|
15
|
9
|
$780.00
|
$780.00
|
$60.83
|
$780.00
|
$709.80
|
2026-03-04
|
|
82139
|
HCPCS
|
Amino Acid Level, 6 Or More Amino Acids, Quantitative, Each Specimen
|
9
|
9
|
$743.02
|
$743.02
|
$595.01
|
$743.02
|
$705.87
|
2026-03-04
|
|
P9016
|
HCPCS
|
Red Blood Cells, Leukocytes Reduced, Each Unit
|
9
|
9
|
$738.73
|
$738.73
|
$591.58
|
$738.73
|
$701.79
|
2026-03-04
|
|
71270
|
HCPCS
|
CT Scan Of Chest Before And After Contrast
|
9
|
9
|
$731.12
|
$731.12
|
$585.48
|
$731.12
|
$694.56
|
2026-03-04
|
|
11107
|
HCPCS
|
Incision Biopsy, Each Additional Skin Growth
|
17
|
9
|
$863.10
|
$863.10
|
$57.35
|
$863.10
|
$691.17
|
2026-03-04
|
|
11106
|
HCPCS
|
Incision Biopsy, First Skin Growth
|
17
|
9
|
$863.10
|
$863.10
|
$126.73
|
$863.10
|
$691.17
|
2026-03-04
|
|
72149
|
HCPCS
|
MRI Scan Of Lower Spinal Canal With Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
70552
|
HCPCS
|
MRI Scan Of Brain With Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
74181
|
HCPCS
|
MRI Scan Of Abdomen Without Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
70540
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
74182
|
HCPCS
|
MRI Scan Of Abdomen With Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72147
|
HCPCS
|
MRI Scan Of Middle Spinal Canal With Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
70543
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
73722
|
HCPCS
|
MRI Scan Of Leg Joint With Contrast
|
27
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
70542
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
70553
|
HCPCS
|
MRI Scan Of Brain Before And After Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72146
|
HCPCS
|
MRI Scan Of Middle Spinal Canal Without Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72141
|
HCPCS
|
MRI Scan Of Upper Spinal Canal Without Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
73223
|
HCPCS
|
MRI Scan Of Arm Joint Before And After Contrast
|
18
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
73221
|
HCPCS
|
MRI Scan Of Arm Joint Without Contrast
|
18
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72157
|
HCPCS
|
MRI Scan Of Middle Spinal Canal Before And After Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
74183
|
HCPCS
|
MRI Scan Of Abdomen Before And After Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72156
|
HCPCS
|
MRI Scan Of Upper Spinal Canal Before And After Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
70551
|
HCPCS
|
MRI Scan Of Brain Without Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72158
|
HCPCS
|
MRI Scan Of Lower Spinal Canal Before And After Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72148
|
HCPCS
|
MRI Scan Of Lower Spinal Canal Without Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
73220
|
HCPCS
|
MRI Scan Of Arm Before And After Contrast
|
18
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
73222
|
HCPCS
|
MRI Scan Of Arm Joint With Contrast
|
18
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72197
|
HCPCS
|
MRI Scan Of Pelvis Before And After Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72195
|
HCPCS
|
MRI Scan Of Pelvis Without Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
72196
|
HCPCS
|
MRI Scan Of Pelvis With Contrast
|
9
|
9
|
$727.49
|
$727.49
|
$582.57
|
$727.49
|
$691.12
|
2026-03-04
|
|
20611
|
HCPCS
|
Aspiration And/or Injection Of Fluid Large Joint Using Ultrasound Guidance
|
15
|
9
|
$759.00
|
$759.00
|
$31.18
|
$759.00
|
$690.69
|
2026-03-04
|
|
64490
|
HCPCS
|
Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Single Le…
|
15
|
9
|
$750.55
|
$750.55
|
$77.92
|
$750.55
|
$683.00
|
2026-03-04
|
|
73218
|
HCPCS
|
MRI Scan Of Arm Without Contrast
|
36
|
9
|
$727.39
|
$727.39
|
$518.04
|
$727.49
|
$681.93
|
2026-03-04
|
|
74178
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Before And After Contrast
|
9
|
9
|
$716.64
|
$716.64
|
$573.89
|
$716.64
|
$680.81
|
2026-03-04
|
|
73723
|
HCPCS
|
MRI Scan Of Leg Joint Before And After Contrast
|
27
|
9
|
$727.49
|
$727.49
|
$544.54
|
$727.49
|
$680.00
|
2026-03-04
|
|
73720
|
HCPCS
|
MRI Scan Of Leg Before And After Contrast
|
27
|
9
|
$727.49
|
$727.49
|
$544.54
|
$727.49
|
$680.00
|
2026-03-04
|
|
72194
|
HCPCS
|
CT Scan Of Pelvis Before And After Contrast
|
9
|
9
|
$709.20
|
$709.20
|
$567.93
|
$709.20
|
$673.74
|
2026-03-04
|
|
73718
|
HCPCS
|
MRI Scan Of Leg Without Contrast
|
27
|
9
|
$727.49
|
$727.49
|
$518.04
|
$727.59
|
$672.93
|
2026-03-04
|
|
73721
|
HCPCS
|
MRI Scan Of Leg Joint Without Contrast
|
27
|
9
|
$727.49
|
$727.49
|
$518.04
|
$727.49
|
$672.93
|
2026-03-04
|
|
76536
|
HCPCS
|
Ultrasound Scan Of Head And Neck Soft Tissue
|
9
|
9
|
$707.85
|
$707.85
|
$566.85
|
$707.85
|
$672.46
|
2026-03-04
|
|
90677
|
HCPCS
|
Pneumococcal Conjugate Vaccine, 20 Valent (pcv20), For Intramuscular Use
|
27
|
9
|
$707.71
|
$707.71
|
$393.46
|
$739.08
|
$672.32
|
2026-03-04
|
|
L2114
|
HCPCS
|
Ankle Foot Orthosis, Fracture Orthosis, Tibial Fracture Orthosis, Semi-rigid, Pr…
|
9
|
9
|
$704.00
|
$704.00
|
$563.76
|
$704.00
|
$668.80
|
2026-03-04
|
|
74170
|
HCPCS
|
CT Scan Of Abdomen Before And After Contrast
|
9
|
9
|
$700.00
|
$700.00
|
$560.56
|
$700.00
|
$665.00
|
2026-03-04
|
|
74176
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Without Contrast
|
9
|
9
|
$686.00
|
$686.00
|
$549.35
|
$686.00
|
$651.70
|
2026-03-04
|
|
94660
|
HCPCS
|
Therapy Procedure Using A Positive Pressure Ventilator
|
18
|
9
|
$770.00
|
$770.00
|
$246.65
|
$1,232.00
|
$647.30
|
2026-03-04
|
|
27560
|
HCPCS
|
Closed Treatment Of Dislocated Kneecap
|
17
|
9
|
$801.00
|
$801.00
|
$164.43
|
$801.00
|
$641.44
|
2026-03-04
|
|
27840
|
HCPCS
|
Closed Treatment Of Dislocated Ankle
|
9
|
9
|
$670.00
|
$670.00
|
$536.54
|
$670.00
|
$636.50
|
2026-03-04
|
|
27810
|
HCPCS
|
Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation
|
9
|
9
|
$670.00
|
$670.00
|
$536.54
|
$670.00
|
$636.50
|
2026-03-04
|
|
12053
|
HCPCS
|
Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7…
|
17
|
9
|
$721.00
|
$721.00
|
$164.43
|
$721.00
|
$635.00
|
2026-03-04
|
|
93975
|
HCPCS
|
Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow
|
9
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93925
|
HCPCS
|
Ultrasound Of Leg Arteries Or Artery Grafts
|
9
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93970
|
HCPCS
|
Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers
|
18
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93926
|
HCPCS
|
Ultrasound Of One Leg Arteries Or Artery Grafts
|
18
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93922
|
HCPCS
|
Ultrasound Study Of Arm And Leg Arteries
|
9
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93971
|
HCPCS
|
Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers
|
27
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93931
|
HCPCS
|
Ultrasound Of One Arm Arteries Or Artery Grafts
|
18
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93978
|
HCPCS
|
Complete Ultrasound Of Aorta, Vena Cava, Groin Vessels Or Bypass Grafts
|
9
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93880
|
HCPCS
|
Ultrasound Of Both Sides Of Head And Neck Blood Flow
|
9
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
93930
|
HCPCS
|
Ultrasound Of Arm Arteries Or Artery Grafts
|
9
|
9
|
$664.65
|
$664.65
|
$532.25
|
$664.65
|
$631.42
|
2026-03-04
|
|
12004
|
HCPCS
|
Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, …
|
17
|
9
|
$780.00
|
$780.00
|
$164.43
|
$780.00
|
$624.62
|
2026-03-04
|
|
71250
|
HCPCS
|
CT Scan Of Chest Without Contrast
|
9
|
9
|
$650.40
|
$650.40
|
$520.84
|
$650.40
|
$617.88
|
2026-03-04
|
|
36430
|
HCPCS
|
Transfusion Of Blood Or Blood Products
|
72
|
9
|
$649.00
|
$649.00
|
$73.67
|
$900.00
|
$615.60
|
2026-03-04
|
|
71260
|
HCPCS
|
CT Scan Of Chest With Contrast
|
9
|
9
|
$647.92
|
$647.92
|
$518.85
|
$647.92
|
$615.52
|
2026-03-04
|
|
36680
|
HCPCS
|
Insertion Of Needle For Infusion Into Bone
|
9
|
9
|
$640.00
|
$640.00
|
$512.51
|
$640.00
|
$608.00
|
2026-03-04
|
|
90649
|
HCPCS
|
Human Papillomavirus Vaccine, Types 6, 11, 16, 18, Quadrivalent
|
9
|
9
|
$633.45
|
$633.45
|
$507.27
|
$633.45
|
$601.78
|
2026-03-04
|
|
36571
|
HCPCS
|
Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older)
|
8
|
8
|
$1,607.00
|
$1,607.00
|
$164.43
|
$1,607.00
|
$836.67
|
2026-03-04
|
|
6566116_1
|
CDM
|
Vasopressin 20 Unit/100 Ml-ns
|
7
|
7
|
$3,756.60
|
$3,756.60
|
$3,008.29
|
$3,643.90
|
$3,568.77
|
2026-03-04
|
|
5463807_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$2,000.00
|
$2,000.00
|
$1,601.60
|
$1,940.00
|
$1,900.00
|
2026-03-04
|
|
6017892_1
|
CDM
|
Ozempic 0.25-0.5 Mg/dose Pen
|
7
|
7
|
$1,506.64
|
$1,506.64
|
$1,206.52
|
$1,461.44
|
$1,431.31
|
2026-03-04
|
|
5463792_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$1,500.00
|
$1,500.00
|
$1,201.20
|
$1,455.00
|
$1,425.00
|
2026-03-04
|
|
5463824_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$1,100.00
|
$1,100.00
|
$880.88
|
$1,067.00
|
$1,045.00
|
2026-03-04
|
|
5463793_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$890.00
|
$890.00
|
$712.71
|
$863.30
|
$845.50
|
2026-03-04
|
|
5463760_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$890.00
|
$890.00
|
$712.71
|
$863.30
|
$845.50
|
2026-03-04
|
|
5463776_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$800.00
|
$800.00
|
$640.64
|
$776.00
|
$760.00
|
2026-03-04
|
|
5296035_1
|
CDM
|
Santyl Ointment
|
7
|
7
|
$744.01
|
$744.01
|
$595.80
|
$721.69
|
$706.81
|
2026-03-04
|
|
5463819_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$740.00
|
$740.00
|
$592.59
|
$717.80
|
$703.00
|
2026-03-04
|
|
5463758_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$725.00
|
$725.00
|
$580.58
|
$703.25
|
$688.75
|
2026-03-04
|
|
5463738_1
|
CDM
|
Rev - Ihs-moa Clinic Visit
|
7
|
7
|
$650.00
|
$650.00
|
$520.52
|
$630.50
|
$617.50
|
2026-03-04
|
|
44141
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of Opening To Skin
|
6
|
6
|
$2,700.00
|
$2,700.00
|
$1,064.97
|
$2,565.00
|
$1,396.82
|
2026-03-04
|
|
2120839_1
|
CDM
|
Room & Board - Private (one Bed) - General Classification
|
6
|
6
|
$1,425.00
|
$1,425.00
|
$1,318.13
|
$1,425.00
|
$1,353.75
|
2026-03-04
|
|
2120840_1
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
6
|
6
|
$1,375.00
|
$1,375.00
|
$1,271.88
|
$1,375.00
|
$1,306.25
|
2026-03-04
|
|
4441947_1
|
CDM
|
Room & Board - Private (one Bed) - General Classification
|
6
|
6
|
$1,325.00
|
$1,325.00
|
$1,225.63
|
$1,325.00
|
$1,258.75
|
2026-03-04
|
|
4441941_1
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
6
|
6
|
$1,275.00
|
$1,275.00
|
$1,179.38
|
$1,275.00
|
$1,211.25
|
2026-03-04
|
|
44140
|
HCPCS
|
Partial Removal Of Large Bowel With Connection
|
6
|
6
|
$1,681.00
|
$1,681.00
|
$993.23
|
$1,596.95
|
$1,078.77
|
2026-03-04
|
|
63655
|
HCPCS
|
Removal Of Spine Bone For Insertion Of Neurostimulator Electrode Plate In Spine
|
6
|
6
|
$1,141.00
|
$1,141.00
|
$171.47
|
$1,083.95
|
$678.16
|
2026-03-04
|