Price Transparencybeta Hospital negotiated rates

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

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Hospital

STEVENS COUNTY HOSPITAL

Hugoton, KS · CCN 171335 · 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: $1,887 across 8 payers · range $953-$2,576

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSCHHUGOTONKS&type=CDMWithoutLabel&fileType=CSV · observed 2026-09-30

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.

1,566 distinct procedures filed
8 distinct payers
14,493 rate rows
2026-09-30 last MRF observed
Data quality

14,285 of 14,493 rate rows are consumer-grade (98.6%)

208 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
percent-of-charges filed in the dollar field — excluded from medians 72
per-diem day rate — not a per-procedure price 68
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 62
exceeds 10× this hospital's gross charge — excluded from medians 4
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSCHHUGOTONKS&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Stevens_V2.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint cde4b4499b72046b… · 6,927,999 bytes · first seen 2026-10-01

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
J2997
HCPCS 		Injection, Alteplase Recombinant, 1 Mg 8 $107.24 $23,815.98 $14,898.09 nat. median
$500
outlier · 29.8×
1211529_1
CDM 		Operating Room Services - General Classification 6 $5,879.30 $14,301.00 $13,506.50 nat. median
$13,506
1.0× median
J2353
HCPCS 		Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 8 $246.45 $20,737.68 $12,972.45 nat. median
$5,623
outlier · 2.3×
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 4 $11,151.27 $13,733.95 $12,442.61 nat. median
$19,970
0.6× median
1629522_1
CDM 		Operating Room Services - General Classification 6 $4,899.54 $11,917.80 $11,255.70 nat. median
$11,256
1.0× median
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 4 $8,196.66 $14,961.31 $11,204.95 nat. median
$16,931
0.7× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 4 $7,942.50 $13,904.30 $10,923.40 nat. median
$18,659
0.6× median
291
MS_DRG 		Heart Failure And Shock With Mcc 4 $5,813.91 $13,521.13 $9,329.49 nat. median
$12,775
0.7× median
539
MS_DRG 		Osteomyelitis With Mcc 4 $9,135.63 $12,072.60 $9,135.63 nat. median
$18,853
outlier · 0.5×
885905_1
CDM 		Operating Room Services - General Classification 6 $3,507.60 $8,532.00 $8,058.00 nat. median
$8,058
1.0× median
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 4 $3,780.63 $12,788.25 $7,964.73 nat. median
$10,207
0.8× median
308
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Mcc 4 $5,750.37 $10,378.38 $7,804.91 nat. median
$11,997
0.7× median
302
MS_DRG 		Atherosclerosis With Mcc 4 $5,242.05 $8,925.81 $7,083.93 nat. median
$11,867
0.6× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 4 $4,701.96 $9,753.29 $6,983.80 nat. median
$10,410
0.7× median
948
MS_DRG 		Signs And Symptoms Without Mcc 4 $6,462.14 $7,116.48 $6,959.36 nat. median
$7,971
0.9× median
281
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Cc 4 $5,432.67 $8,352.86 $6,892.77 nat. median
$9,717
0.7× median
J2356
HCPCS 		Injection, Tezepelumab-ekko, 1 Mg 8 $21.76 $10,921.30 $6,831.82 nat. median
$76
outlier · 90.2×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 4 $4,574.88 $8,639.10 $6,606.99 nat. median
$12,877
0.5× median
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 4 $4,193.64 $8,907.41 $6,327.84 nat. median
$8,522
0.7× median
292
MS_DRG 		Heart Failure And Shock With Cc 4 $4,670.19 $7,462.50 $5,879.78 nat. median
$8,955
0.7× median
603
MS_DRG 		Cellulitis Without Mcc 4 $4,003.02 $8,017.56 $5,809.85 nat. median
$8,991
0.6× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 4 $4,670.19 $7,060.10 $5,688.65 nat. median
$8,119
0.7× median
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 4 $4,034.79 $7,499.28 $5,579.56 nat. median
$8,379
0.7× median
1184551_1
CDM 		Operating Room Services - General Classification 6 $2,414.62 $5,873.40 $5,547.10 nat. median
$5,547
1.0× median
206
MS_DRG 		Other Respiratory System Diagnoses Without Mcc 4 $3,621.78 $7,656.95 $5,447.94 nat. median
$9,496
0.6× median
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 4 $3,494.70 $7,171.29 $5,153.72 nat. median
$8,186
0.6× median
995645_1
CDM 		Operating Room Services - General Classification 6 $2,235.91 $5,438.70 $5,136.55 nat. median
$5,137
1.0× median
394
MS_DRG 		Other Digestive System Diagnoses With Cc 4 $3,717.09 $6,378.23 $5,047.66 nat. median
$9,688
0.5× median
69
MS_DRG 		Transient Ischemia Without Thrombolytic 4 $3,621.78 $6,802.25 $5,041.96 nat. median
$8,423
0.6× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 4 $3,558.24 $6,807.04 $5,012.47 nat. median
$6,821
0.7× median
J3111
HCPCS 		Injection, Romosozumab-aqqg, 1 Mg 8 $13.11 $7,830.03 $4,898.07 nat. median
$696
outlier · 7.0×
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 4 $4,098.33 $5,691.85 $4,895.09 nat. median
$10,422
outlier · 0.5×
3001495_1
CDM 		Hernia Composix (med)oval 6 $2,125.65 $5,170.50 $4,883.25 nat. median
$4,883
1.0× median
158
MS_DRG 		Dental And Oral Diseases With Cc 4 $2,636.91 $6,910.03 $4,773.47 nat. median
$9,567
outlier · 0.5×
192
MS_DRG 		Chronic Obstructive Pulmonary Disease Without Cc/mcc 4 $2,478.06 $7,223.86 $4,670.36 nat. median
$7,116
0.7× median
1184710_1
CDM 		Operating Room Services - General Classification 6 $1,878.86 $4,570.20 $4,316.30 nat. median
$4,316
1.0× median
293
MS_DRG 		Heart Failure And Shock Without Cc/mcc 4 $2,668.68 $5,634.31 $4,010.64 nat. median
$6,358
0.6× median
1184804_1
CDM 		Operating Room Services - General Classification 6 $1,724.94 $4,195.80 $3,962.70 nat. median
$3,963
1.0× median
J0897
HCPCS 		Injection, Denosumab, 1 Mg 8 $30.80 $5,209.90 $3,847.34 nat. median
$1,982
1.9× median
36558
HCPCS 		Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older) 8 $1,908.10 $5,157.02 $3,776.99 nat. median
$3,508
1.1× median
179
MS_DRG 		Respiratory Infections And Inflammations Without Cc/mcc 4 $2,922.84 $4,500.98 $3,711.91 nat. median
$8,200
outlier · 0.5×
395
MS_DRG 		Other Digestive System Diagnoses Without Cc/mcc 4 $2,350.98 $5,056.33 $3,703.65 nat. median
$7,068
0.5× median
3001487_1
CDM 		Hernia Composix (sm)oval 6 $1,585.45 $3,856.50 $3,642.25 nat. median
$3,642
1.0× median
3001499_1
CDM 		Hernia Patch(med)ventralex 6 $1,521.63 $3,701.25 $3,495.63 nat. median
$3,496
1.0× median
310
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 4 $2,255.67 $4,339.63 $3,297.65 nat. median
$6,289
0.5× median
36556
HCPCS 		Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 8 $1,658.67 $4,482.89 $3,283.26 nat. median
$2,483
1.3× median
12037
HCPCS 		Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 8 $1,621.60 $4,382.70 $3,209.88 nat. median
$1,950
1.6× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 4 $2,990.86 $6,576.39 $2,990.86 nat. median
$11,515
outlier · 0.3×
3001497_1
CDM 		Hernia Patch(sm)ventralex 6 $1,271.88 $3,093.75 $2,921.88 nat. median
$2,922
1.0× median
46255
HCPCS 		Removal Of Single External And Internal Hemorrhoid Group 8 $1,377.51 $3,723.00 $2,756.26 nat. median
$2,849
1.0× median

Other procedures at this hospital

Browse this hospital's 1,566 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
             
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 8 8 $23,815.98 $23,815.98 $107.24 $23,815.98 $14,898.09 2026-09-30
1211529_1 CDM Operating Room Services - General Classification 6 6 $15,890.00 $15,890.00 $5,879.30 $14,301.00 $13,506.50 2026-09-30
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 8 8 $20,737.68 $20,737.68 $246.45 $20,737.68 $12,972.45 2026-09-30
314 MS_DRG Other Circulatory System Diagnoses With Mcc 4 4 $13,733.95 $13,733.95 $11,151.27 $13,733.95 $12,442.61 2026-09-30
1629522_1 CDM Operating Room Services - General Classification 6 6 $13,242.00 $13,242.00 $4,899.54 $11,917.80 $11,255.70 2026-09-30
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 4 4 $16,492.19 $16,492.19 $8,196.66 $14,961.31 $11,204.95 2026-09-30
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 4 4 $13,904.30 $13,904.30 $7,942.50 $13,904.30 $10,923.40 2026-09-30
291 MS_DRG Heart Failure And Shock With Mcc 4 4 $22,279.53 $22,279.53 $5,813.91 $13,521.13 $9,329.49 2026-09-30
539 MS_DRG Osteomyelitis With Mcc 4 4 $9,135.63 $9,135.63 $9,135.63 $12,072.60 $9,135.63 2026-09-30
885905_1 CDM Operating Room Services - General Classification 6 6 $9,480.00 $9,480.00 $3,507.60 $8,532.00 $8,058.00 2026-09-30
178 MS_DRG Respiratory Infections And Inflammations With Cc 4 4 $23,145.51 $23,145.51 $3,780.63 $12,788.25 $7,964.73 2026-09-30
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 4 4 $22,715.59 $22,715.59 $5,750.37 $10,378.38 $7,804.91 2026-09-30
302 MS_DRG Atherosclerosis With Mcc 4 4 $8,925.81 $8,925.81 $5,242.05 $8,925.81 $7,083.93 2026-09-30
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 4 4 $17,624.96 $17,624.96 $4,701.96 $9,753.29 $6,983.80 2026-09-30
948 MS_DRG Signs And Symptoms Without Mcc 4 4 $11,610.94 $11,610.94 $6,462.14 $7,116.48 $6,959.36 2026-09-30
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 4 4 $8,352.86 $8,352.86 $5,432.67 $8,352.86 $6,892.77 2026-09-30
J2356 HCPCS Injection, Tezepelumab-ekko, 1 Mg 8 8 $10,921.30 $10,921.30 $21.76 $10,921.30 $6,831.82 2026-09-30
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 4 4 $8,639.10 $8,639.10 $4,574.88 $8,639.10 $6,606.99 2026-09-30
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 4 4 $13,253.79 $13,253.79 $4,193.64 $8,907.41 $6,327.84 2026-09-30
292 MS_DRG Heart Failure And Shock With Cc 4 4 $14,578.58 $14,578.58 $4,670.19 $7,462.50 $5,879.78 2026-09-30
603 MS_DRG Cellulitis Without Mcc 4 4 $12,658.57 $12,658.57 $4,003.02 $8,017.56 $5,809.85 2026-09-30
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 4 4 $10,073.19 $10,073.19 $4,670.19 $7,060.10 $5,688.65 2026-09-30
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 4 4 $9,497.19 $9,497.19 $4,034.79 $7,499.28 $5,579.56 2026-09-30
1184551_1 CDM Operating Room Services - General Classification 6 6 $6,526.00 $6,526.00 $2,414.62 $5,873.40 $5,547.10 2026-09-30
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 4 4 $19,180.88 $19,180.88 $3,621.78 $7,656.95 $5,447.94 2026-09-30
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 4 4 $10,534.25 $10,534.25 $3,494.70 $7,171.29 $5,153.72 2026-09-30
995645_1 CDM Operating Room Services - General Classification 6 6 $6,043.00 $6,043.00 $2,235.91 $5,438.70 $5,136.55 2026-09-30
394 MS_DRG Other Digestive System Diagnoses With Cc 4 4 $6,378.23 $6,378.23 $3,717.09 $6,378.23 $5,047.66 2026-09-30
69 MS_DRG Transient Ischemia Without Thrombolytic 4 4 $13,436.42 $13,436.42 $3,621.78 $6,802.25 $5,041.96 2026-09-30
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 4 4 $9,292.53 $9,292.53 $3,558.24 $6,807.04 $5,012.47 2026-09-30
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 8 8 $7,830.03 $7,830.03 $13.11 $7,830.03 $4,898.07 2026-09-30
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 4 4 $5,691.85 $5,691.85 $4,098.33 $5,691.85 $4,895.09 2026-09-30
3001495_1 CDM Hernia Composix (med)oval 6 6 $5,745.00 $5,745.00 $2,125.65 $5,170.50 $4,883.25 2026-09-30
158 MS_DRG Dental And Oral Diseases With Cc 4 4 $6,910.03 $6,910.03 $2,636.91 $6,910.03 $4,773.47 2026-09-30
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 4 4 $19,328.48 $19,328.48 $2,478.06 $7,223.86 $4,670.36 2026-09-30
1184710_1 CDM Operating Room Services - General Classification 6 6 $5,078.00 $5,078.00 $1,878.86 $4,570.20 $4,316.30 2026-09-30
293 MS_DRG Heart Failure And Shock Without Cc/mcc 4 4 $13,131.00 $13,131.00 $2,668.68 $5,634.31 $4,010.64 2026-09-30
1184804_1 CDM Operating Room Services - General Classification 6 6 $4,662.00 $4,662.00 $1,724.94 $4,195.80 $3,962.70 2026-09-30
J0897 HCPCS Injection, Denosumab, 1 Mg 14 8 $4,347.28 $4,347.28 $30.80 $5,209.90 $3,847.34 2026-09-30
36558 HCPCS Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older) 8 8 $5,157.02 $5,157.02 $1,908.10 $5,157.02 $3,776.99 2026-09-30
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 4 4 $4,500.98 $4,500.98 $2,922.84 $4,500.98 $3,711.91 2026-09-30
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 4 4 $5,056.33 $5,056.33 $2,350.98 $5,056.33 $3,703.65 2026-09-30
3001487_1 CDM Hernia Composix (sm)oval 6 6 $4,285.00 $4,285.00 $1,585.45 $3,856.50 $3,642.25 2026-09-30
3001499_1 CDM Hernia Patch(med)ventralex 6 6 $4,112.50 $4,112.50 $1,521.63 $3,701.25 $3,495.63 2026-09-30
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 4 4 $4,339.63 $4,339.63 $2,255.67 $4,339.63 $3,297.65 2026-09-30
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 8 8 $4,482.89 $4,482.89 $1,658.67 $4,482.89 $3,283.26 2026-09-30
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 8 8 $4,382.70 $4,382.70 $1,621.60 $4,382.70 $3,209.88 2026-09-30
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 4 4 $2,990.86 $2,990.86 $2,990.86 $6,576.39 $2,990.86 2026-09-30
3001497_1 CDM Hernia Patch(sm)ventralex 6 6 $3,437.50 $3,437.50 $1,271.88 $3,093.75 $2,921.88 2026-09-30
46255 HCPCS Removal Of Single External And Internal Hemorrhoid Group 8 8 $3,723.00 $3,723.00 $1,377.51 $3,723.00 $2,756.26 2026-09-30
1184738_1 CDM Operating Room Services - General Classification 6 6 $3,208.00 $3,208.00 $1,186.96 $2,887.20 $2,726.80 2026-09-30
55250 HCPCS Removal Of Sperm Duct 8 8 $3,675.00 $3,675.00 $1,359.75 $3,675.00 $2,720.77 2026-09-30
12036 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.… 8 8 $3,706.87 $3,706.87 $1,371.54 $3,706.87 $2,714.90 2026-09-30
J2357 HCPCS Injection, Omalizumab, 5 Mg 8 8 $4,083.41 $4,083.41 $44.98 $4,083.41 $2,554.38 2026-09-30
64999 HCPCS Other Procedure On Nervous System 14 6 $2,860.00 $2,860.00 $864.00 $3,885.00 $2,470.00 2026-09-30
54640 HCPCS Repositioning And Suture Of Misplaced Testicle 8 8 $3,320.00 $3,320.00 $1,228.40 $3,320.00 $2,457.83 2026-09-30
28190 HCPCS Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 8 8 $3,348.58 $3,348.58 $1,238.97 $3,348.58 $2,452.49 2026-09-30
10081 HCPCS Complicated Drainage Of Cyst Of Tailbone 8 8 $3,309.52 $3,309.52 $1,224.52 $3,309.52 $2,423.89 2026-09-30
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 8 8 $3,066.70 $3,066.70 $1,134.68 $3,066.70 $2,246.05 2026-09-30
12057 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More … 8 8 $3,056.51 $3,056.51 $1,130.91 $3,056.51 $2,238.58 2026-09-30
P9053 HCPCS Platelets, Pheresis, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit 6 6 $2,520.00 $2,520.00 $932.40 $2,520.00 $2,230.20 2026-09-30
P9037 HCPCS Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit 6 6 $2,520.00 $2,520.00 $932.40 $2,520.00 $2,230.20 2026-09-30
46922 HCPCS Simple Removal Of Growth Of Anus 8 8 $2,901.00 $2,901.00 $1,073.37 $2,901.00 $2,184.57 2026-09-30
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 4 4 $2,061.92 $2,061.92 $2,061.92 $5,305.59 $2,061.92 2026-09-30
1184783_1 CDM Operating Room Services - General Classification 6 6 $2,394.00 $2,394.00 $885.78 $2,154.60 $2,034.90 2026-09-30
995537_1 CDM Operating Room Services - General Classification 6 6 $2,394.00 $2,394.00 $885.78 $2,154.60 $2,034.90 2026-09-30
28495 HCPCS Closed Treatment Of Broken Great Toe With Manipulation 8 8 $2,718.60 $2,718.60 $1,005.88 $2,718.60 $1,991.09 2026-09-30
64454 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Knee Nerve Branch Using Imagin… 20 8 $3,520.00 $3,520.00 $69.13 $5,280.00 $1,982.90 2026-09-30
12056 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.1-… 8 8 $2,699.92 $2,699.92 $998.97 $2,699.92 $1,977.41 2026-09-30
1184632_1 CDM Operating Room Services - General Classification 6 6 $2,311.00 $2,311.00 $855.07 $2,079.90 $1,964.35 2026-09-30
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 21 8 $3,520.00 $3,520.00 $162.49 $5,280.00 $1,953.60 2026-09-30
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 21 8 $3,520.00 $3,520.00 $162.92 $5,280.00 $1,953.60 2026-09-30
46221 HCPCS Removal Of External Hemorrhoids By Rubber Banding 8 8 $2,566.00 $2,566.00 $949.42 $2,566.00 $1,932.29 2026-09-30
12034 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5… 8 8 $2,603.13 $2,603.13 $963.16 $2,603.13 $1,906.52 2026-09-30
867361_1 CDM Room & Board - Semi-private (two Beds) - General Classification 4 4 $2,000.00 $2,000.00 $1,800.00 $2,000.00 $1,900.00 2026-09-30
12047 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, More Than 30.0 C… 8 8 $2,586.15 $2,586.15 $956.88 $2,586.15 $1,894.09 2026-09-30
12046 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 20.1-30.0 Cm 8 8 $2,586.15 $2,586.15 $956.88 $2,586.15 $1,894.09 2026-09-30
12018 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, Mor… 8 8 $2,586.15 $2,586.15 $956.88 $2,586.15 $1,894.09 2026-09-30
12007 HCPCS Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 8 8 $2,586.15 $2,586.15 $956.88 $2,586.15 $1,894.09 2026-09-30
12017 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.… 8 8 $2,586.15 $2,586.15 $956.88 $2,586.15 $1,894.09 2026-09-30
12006 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 8 8 $2,586.15 $2,586.15 $956.88 $2,586.15 $1,894.09 2026-09-30
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 8 8 $2,575.96 $2,575.96 $953.11 $2,575.96 $1,886.63 2026-09-30
3001481_1 CDM Hernia Kugel (med)oval 6 6 $2,215.00 $2,215.00 $819.55 $1,993.50 $1,882.75 2026-09-30
43249 HCPCS Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl… 8 8 $2,463.00 $2,463.00 $911.31 $2,463.00 $1,854.66 2026-09-30
64624 HCPCS Destruction Of Nerve Branches Of Knee Using Imaging Guidance 20 8 $3,080.00 $3,080.00 $125.36 $4,620.00 $1,852.34 2026-09-30
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 6 6 $2,050.00 $2,050.00 $758.50 $2,050.00 $1,814.25 2026-09-30
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 8 8 $2,470.00 $2,470.00 $913.90 $2,470.00 $1,808.49 2026-09-30
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
24675 HCPCS Closed Treatment Of Broken Forearm Bone On Small Finger Side At Elbow With Manip… 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
24505 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
28490 HCPCS Closed Treatment Of Broken Great Toe 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
27750 HCPCS Closed Treatment Of Broken Middle Part Of Shin Bone 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
25624 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb With Manipulation 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
23600 HCPCS Closed Treatment Of Broken Top Of Upper Arm Bone 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
25535 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side With Man… 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
25530 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
24670 HCPCS Closed Treatment Of Broken Forearm Bone On Small Finger Side At Elbow 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
25622 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
25500 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
24500 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone 8 8 $2,445.21 $2,445.21 $904.73 $2,445.21 $1,790.87 2026-09-30
1184568_1 CDM Operating Room Services - General Classification 6 6 $2,095.00 $2,095.00 $775.15 $1,885.50 $1,780.75 2026-09-30
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 8 8 $2,411.25 $2,411.25 $892.16 $2,411.25 $1,765.99 2026-09-30
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 8 8 $2,337.00 $2,337.00 $864.69 $2,337.00 $1,759.95 2026-09-30
45398 HCPCS Banding Of Hemorrhoids Using A Flexible Endoscope (colonoscope) 8 8 $2,288.00 $2,288.00 $846.56 $2,288.00 $1,722.99 2026-09-30
64616 HCPCS Injection Of Chemical For Paralysis Of Nerve Muscles On Side Of Neck Excluding V… 21 8 $3,080.00 $3,080.00 $79.81 $4,620.00 $1,709.40 2026-09-30
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 14 8 $1,925.00 $1,925.00 $712.25 $2,154.00 $1,703.62 2026-09-30
1240853_1 CDM Operating Room Services - General Classification 6 6 $1,995.00 $1,995.00 $738.15 $1,795.50 $1,695.75 2026-09-30
885897_1 CDM Operating Room Services - General Classification 6 6 $1,995.00 $1,995.00 $738.15 $1,795.50 $1,695.75 2026-09-30
27096 HCPCS Injection Of Anesthetic Or Steroid Into Joint Between Lower Spine And Hip Bone U… 22 8 $2,580.00 $2,580.00 $69.48 $5,620.00 $1,687.70 2026-09-30
12055 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.6-… 8 8 $2,292.38 $2,292.38 $848.18 $2,292.38 $1,678.93 2026-09-30
43200 HCPCS Diagnostic Exam Of Esophagus Using A Flexible Endoscope Through Mouth 8 8 $2,255.00 $2,255.00 $834.35 $2,255.00 $1,669.24 2026-09-30
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 8 8 $2,143.00 $2,143.00 $792.91 $2,143.00 $1,613.95 2026-09-30
C1781 HCPCS Mesh (implantable) 6 6 $1,815.00 $1,815.00 $671.55 $1,815.00 $1,606.28 2026-09-30
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 8 8 $1,950.00 $1,950.00 $721.50 $1,950.00 $1,575.45 2026-09-30
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 8 8 $2,235.00 $2,235.00 $826.95 $2,235.00 $1,565.52 2026-09-30
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 8 8 $2,077.00 $2,077.00 $768.49 $2,077.00 $1,564.03 2026-09-30
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 8 8 $2,077.00 $2,077.00 $768.49 $2,077.00 $1,564.03 2026-09-30
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 8 8 $2,101.00 $2,101.00 $777.37 $2,101.00 $1,538.82 2026-09-30
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 8 8 $2,184.00 $2,184.00 $808.08 $2,184.00 $1,529.86 2026-09-30
25600 HCPCS Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb … 8 8 $2,445.21 $2,445.21 $237.29 $2,445.21 $1,529.60 2026-09-30
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 8 8 $2,182.00 $2,182.00 $807.34 $2,182.00 $1,528.53 2026-09-30
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 8 8 $1,995.22 $1,995.22 $738.23 $1,995.22 $1,461.30 2026-09-30
64430 HCPCS Injection Of Anesthetic Agent And/or Steroid Into External Genitals And Anus Ner… 22 8 $2,810.00 $2,810.00 $45.76 $3,520.00 $1,451.29 2026-09-30
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 8 8 $2,209.18 $2,209.18 $428.61 $2,209.18 $1,381.95 2026-09-30
24655 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation 8 8 $1,878.06 $1,878.06 $694.88 $1,878.06 $1,375.49 2026-09-30
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 8 8 $1,813.00 $1,813.00 $670.81 $1,813.00 $1,365.37 2026-09-30
12045 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 12.6-20.0 Cm 8 8 $1,827.12 $1,827.12 $676.03 $1,827.12 $1,338.17 2026-09-30
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 8 8 $1,816.66 $1,816.66 $672.16 $1,816.66 $1,330.51 2026-09-30
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 6 6 $1,500.00 $1,500.00 $555.00 $1,500.00 $1,327.50 2026-09-30
10120 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Simple 8 8 $1,808.44 $1,808.44 $669.12 $1,808.44 $1,324.49 2026-09-30
64445 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Lower Back And Leg Nerve (scia… 22 8 $2,810.00 $2,810.00 $62.14 $4,215.00 $1,319.78 2026-09-30
64447 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Thigh Nerve (femoral Nerve) 22 8 $2,810.00 $2,810.00 $57.55 $4,215.00 $1,315.22 2026-09-30
64425 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Lower Abdomen And Groin Nerve 22 8 $2,810.00 $2,810.00 $46.93 $4,215.00 $1,315.22 2026-09-30
12054 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1… 8 8 $1,782.97 $1,782.97 $659.70 $1,782.97 $1,305.84 2026-09-30
64490 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Single Le… 22 8 $3,080.00 $3,080.00 $88.55 $6,160.00 $1,288.89 2026-09-30
99291 HCPCS Critical Care, First 30-74 Minutes 8 8 $1,717.88 $1,717.88 $635.62 $1,717.88 $1,258.17 2026-09-30
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 8 8 $1,700.00 $1,700.00 $629.00 $1,700.00 $1,244.50 2026-09-30
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 12 6 $1,943.75 $1,943.75 $481.00 $2,587.50 $1,235.00 2026-09-30
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 8 8 $1,624.00 $1,624.00 $600.88 $1,624.00 $1,223.06 2026-09-30
64520 HCPCS Injection Of Anesthetic Agent Into Middle Or Lower Spine Sympathetic Nerve 22 8 $2,590.00 $2,590.00 $57.75 $3,885.00 $1,212.25 2026-09-30
64462 HCPCS Injection Of Anesthetic Agent Into Thoracic Vertebra Using Imaging Guidance, Add… 22 8 $2,600.00 $2,600.00 $42.52 $3,870.00 $1,211.38 2026-09-30
64461 HCPCS Injection Of Anesthetic Agent Into Thoracic Vertebra Using Imaging Guidance, Sin… 22 8 $2,600.00 $2,600.00 $68.26 $3,870.00 $1,211.38 2026-09-30
64420 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Rib Nerve 22 8 $2,580.00 $2,580.00 $49.57 $3,870.00 $1,207.57 2026-09-30
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 8 8 $1,636.93 $1,636.93 $605.66 $1,636.93 $1,198.88 2026-09-30
3010155_1 CDM Stvn Adenosine Per 30mg 6 6 $1,410.00 $1,410.00 $521.70 $1,269.00 $1,198.50 2026-09-30
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 10 8 $1,583.00 $1,583.00 $585.71 $1,583.00 $1,192.09 2026-09-30
G0105 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 8 8 $1,583.00 $1,583.00 $585.71 $1,583.00 $1,192.09 2026-09-30
64493 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le… 21 8 $2,590.00 $2,590.00 $76.55 $5,240.00 $1,188.00 2026-09-30
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 13 8 $1,320.00 $1,320.00 $165.93 $3,520.00 $1,188.00 2026-09-30
64505 HCPCS Injection Of Anesthetic Agent, Trigeminal Nerve Bundle 20 8 $2,590.00 $2,590.00 $87.36 $3,080.00 $1,180.89 2026-09-30
64486 HCPCS Injection Of Local Anesthetic For Abdominal Wall Pain Control On Side Using Imag… 23 8 $3,080.00 $3,080.00 $46.33 $4,620.00 $1,173.79 2026-09-30
2263851_1 CDM Operating Room Services - General Classification 6 6 $1,373.00 $1,373.00 $508.01 $1,235.70 $1,167.05 2026-09-30
30300 HCPCS Removal Of Foreign Body In Nose 8 8 $1,577.50 $1,577.50 $583.68 $1,577.50 $1,155.36 2026-09-30
1184643_1 CDM Operating Room Services - General Classification 6 6 $1,351.00 $1,351.00 $499.87 $1,215.90 $1,148.35 2026-09-30
867362_1 CDM Room & Board - Semi-private (two Beds) - General Classification 4 4 $1,200.00 $1,200.00 $1,080.00 $1,200.00 $1,140.00 2026-09-30
64636 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 21 8 $2,640.00 $2,640.00 $48.05 $3,080.00 $1,139.60 2026-09-30
64612 HCPCS Injection Of Chemical For Paralysis Of Nerve Muscles On Side Of Face 13 8 $1,320.00 $1,320.00 $98.35 $3,080.00 $1,139.60 2026-09-30
64451 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Spine And Pelvis Nerve Using I… 13 8 $3,080.00 $3,080.00 $68.40 $3,080.00 $1,139.60 2026-09-30
1184914_1 CDM Operating Room Services - General Classification 6 6 $1,305.00 $1,305.00 $482.85 $1,174.50 $1,109.25 2026-09-30
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 8 8 $1,509.58 $1,509.58 $558.54 $1,509.58 $1,105.61 2026-09-30
3001605_1 CDM Power Port 6 6 $1,300.00 $1,300.00 $481.00 $1,170.00 $1,105.00 2026-09-30
93799 HCPCS Other Cardiovascular Service Or Procedure 6 6 $1,248.00 $1,248.00 $461.76 $1,248.00 $1,104.48 2026-09-30
37195 HCPCS Infusion Of Drug To Dissolve Blood Clot In Brain 6 6 $1,248.00 $1,248.00 $461.76 $1,248.00 $1,104.48 2026-09-30
12031 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 8 8 $1,752.40 $1,752.40 $428.61 $1,752.40 $1,096.21 2026-09-30
25560 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones 20 8 $1,440.00 $1,440.00 $175.38 $2,445.21 $1,092.34 2026-09-30
72159 HCPCS MRI Scan Of Blood Vessels Of Spinal Canal 14 8 $1,321.00 $1,321.00 $441.41 $1,321.00 $1,055.81 2026-09-30
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 14 8 $1,321.00 $1,321.00 $441.41 $1,321.00 $1,055.81 2026-09-30
37609 HCPCS Tying Or Biopsy Of Artery On Side Of Skull 8 8 $1,490.00 $1,490.00 $551.30 $1,490.00 $1,048.65 2026-09-30
64492 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Third And… 22 8 $2,590.00 $2,590.00 $48.62 $2,620.00 $1,015.96 2026-09-30
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 20 8 $1,193.00 $1,193.00 $394.05 $1,321.00 $998.21 2026-09-30
23500 HCPCS Closed Treatment Of Broken Collar Bone 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
12005 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
27840 HCPCS Closed Treatment Of Dislocated Ankle 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
24640 HCPCS Closed Treatment Of Dislocated Forearm Bone On Thumb Side At Elbow With Manipula… 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
27560 HCPCS Closed Treatment Of Dislocated Kneecap 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
26770 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
12016 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.… 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
26720 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
12015 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6… 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
24650 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
24600 HCPCS Repair Of Dislocated Elbow 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
23505 HCPCS Closed Treatment Of Broken Collar Bone With Manipulation 8 8 $1,360.15 $1,360.15 $503.26 $1,360.15 $996.17 2026-09-30
94662 HCPCS Therapy Procedure Using A Negative Pressure Ventilator 6 6 $1,125.00 $1,125.00 $416.25 $1,125.00 $995.62 2026-09-30
64483 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 28 8 $3,140.00 $3,140.00 $93.64 $6,160.00 $995.41 2026-09-30
64494 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Second Le… 22 8 $2,620.00 $2,620.00 $41.63 $5,240.00 $991.58 2026-09-30
28899 HCPCS Other Procedure On Foot Or Toes 9 6 $2,600.00 $2,600.00 $114.31 $2,600.00 $990.86 2026-09-30
64634 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 21 8 $2,590.00 $2,590.00 $54.77 $2,640.00 $987.05 2026-09-30
62323 HCPCS Injection Of Substance Into Lower Spine Canal Using Imaging Guidance 15 8 $2,590.00 $2,590.00 $83.99 $2,590.00 $987.05 2026-09-30
62321 HCPCS Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance 15 8 $2,590.00 $2,590.00 $90.04 $2,590.00 $987.05 2026-09-30
43241 HCPCS Insertion Of Tube Or Tube In Esophagus, Stomach, And/or Upper Small Bowel Using … 8 8 $1,204.00 $1,204.00 $445.48 $1,204.00 $980.76 2026-09-30
64491 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Second Le… 22 8 $2,590.00 $2,590.00 $48.05 $2,620.00 $978.22 2026-09-30
64644 HCPCS Injection Of Chemical For Paralysis Of Nerve Muscles On Arm Or Leg, 5 Or More Mu… 14 8 $1,920.00 $1,920.00 $52.13 $4,620.00 $972.70 2026-09-30
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 14 8 $1,098.00 $1,098.00 $406.26 $1,500.00 $971.73 2026-09-30
64495 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And… 16 8 $1,850.00 $1,850.00 $42.84 $2,620.00 $970.70 2026-09-30
64632 HCPCS Destruction Of Foot Nerve 13 8 $1,320.00 $1,320.00 $22.27 $2,600.00 $962.00 2026-09-30
64484 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 22 8 $1,935.00 $1,935.00 $41.63 $2,590.00 $949.81 2026-09-30
73225 HCPCS MRI Scan Of Blood Vessels Of Arm 14 8 $1,193.00 $1,193.00 $394.05 $1,193.00 $942.52 2026-09-30
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 14 8 $1,193.00 $1,193.00 $394.05 $1,193.00 $942.52 2026-09-30
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 14 8 $1,193.00 $1,193.00 $394.05 $1,193.00 $942.52 2026-09-30
P9058 HCPCS Red Blood Cells, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit 6 6 $1,058.00 $1,058.00 $391.46 $1,058.00 $936.33 2026-09-30
78305 HCPCS Nuclear Medicine Study Of Bone And/or Joint Multiple Areas 6 6 $1,050.00 $1,050.00 $388.50 $1,050.00 $929.25 2026-09-30
78803 HCPCS Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day … 6 6 $1,050.00 $1,050.00 $388.50 $1,050.00 $929.25 2026-09-30
12052 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5… 8 8 $1,482.41 $1,482.41 $428.61 $1,482.41 $927.33 2026-09-30
32554 HCPCS Aspiration Of Fluid From Chest Cavity 8 8 $1,252.73 $1,252.73 $463.51 $1,252.73 $916.12 2026-09-30
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 8 8 $1,321.00 $1,321.00 $488.77 $1,321.00 $907.10 2026-09-30
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 8 8 $1,321.00 $1,321.00 $488.77 $1,321.00 $907.10 2026-09-30
64449 HCPCS Injection By Continuous Infusion Of Anesthetic Agent Into Lower Back Nerve Bundl… 13 8 $1,920.00 $1,920.00 $33.83 $2,440.00 $902.80 2026-09-30
P9040 HCPCS Red Blood Cells, Leukocytes Reduced, Irradiated, Each Unit 6 6 $1,020.00 $1,020.00 $377.40 $1,020.00 $902.70 2026-09-30
12051 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5 C… 8 8 $1,202.23 $1,202.23 $444.83 $1,202.23 $880.51 2026-09-30
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 14 8 $1,098.00 $1,098.00 $366.67 $1,098.00 $877.03 2026-09-30
12042 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.6-7.5 Cm 8 8 $1,188.64 $1,188.64 $439.80 $1,188.64 $870.56 2026-09-30
20606 HCPCS Aspiration And/or Injection Of Fluid From Medium Joint Using Ultrasound Guidance 23 8 $1,760.00 $1,760.00 $42.00 $2,600.00 $864.00 2026-09-30
20604 HCPCS Aspiration And/or Injection Of Fluid From Small Joint Using Ultrasound Guidance 23 8 $1,760.00 $1,760.00 $37.25 $2,600.00 $864.00 2026-09-30
20526 HCPCS Injection Of Carpal Tunnel 13 8 $960.00 $960.00 $45.37 $2,600.00 $864.00 2026-09-30
64450 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Other Nerve Or Branch 21 8 $1,445.05 $1,445.05 $36.13 $2,440.00 $864.00 2026-09-30
11901 HCPCS Injection Into Skin Growth, More Than 7 Growths 13 8 $960.00 $960.00 $34.48 $2,440.00 $864.00 2026-09-30
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 8 8 $1,168.87 $1,168.87 $432.48 $1,168.87 $856.08 2026-09-30
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 8 8 $1,193.00 $1,193.00 $441.41 $1,193.00 $851.42 2026-09-30
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 8 8 $1,193.00 $1,193.00 $441.41 $1,193.00 $851.42 2026-09-30
31720 HCPCS Insertion Of Tube Into Airway For Aspiration Of Secretions 8 8 $1,158.00 $1,158.00 $428.46 $1,158.00 $850.16 2026-09-30
90675 HCPCS Rabies Vaccine For Injection Into Muscle 8 8 $1,152.32 $1,152.32 $426.36 $1,152.32 $796.79 2026-09-30
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 8 8 $1,065.00 $1,065.00 $394.05 $1,065.00 $795.74 2026-09-30
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 8 8 $1,065.00 $1,065.00 $394.05 $1,065.00 $795.74 2026-09-30
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 6 6 $890.00 $890.00 $329.30 $890.00 $787.65 2026-09-30
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 8 8 $1,257.21 $1,257.21 $7.72 $1,257.21 $786.45 2026-09-30
1015557_1 CDM Operating Room Services - General Classification 6 6 $898.00 $898.00 $332.26 $808.20 $763.30 2026-09-30
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 6 6 $862.00 $862.00 $318.94 $862.00 $762.87 2026-09-30
36589 HCPCS Removal Of Tunneled Central Venous Tube 8 8 $800.00 $800.00 $296.00 $958.49 $760.00 2026-09-30
64421 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Multiple Rib Nerves For Region… 15 8 $2,580.00 $2,580.00 $20.53 $2,580.00 $757.50 2026-09-30
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
74181 HCPCS MRI Scan Of Abdomen Without Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
73720 HCPCS MRI Scan Of Leg Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
71552 HCPCS MRI Scan Of Chest Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
73220 HCPCS MRI Scan Of Arm Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
70553 HCPCS MRI Scan Of Brain Before And After Contrast 8 8 $1,098.00 $1,098.00 $406.26 $1,098.00 $753.89 2026-09-30
30903 HCPCS Complex Control Of Nose Bleed 8 8 $998.46 $998.46 $369.43 $998.46 $731.27 2026-09-30
64479 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Upper Or Middle Spine Nerve Roo… 15 8 $3,520.00 $3,520.00 $109.86 $3,520.00 $726.81 2026-09-30
64418 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Suprascapular Shoulder Nerve 16 8 $2,920.00 $2,920.00 $45.44 $3,080.00 $724.84 2026-09-30
81596 HCPCS Biochemical Assays For Evaluation Of Chronic Hepatitis C Virus Infection 6 6 $890.00 $890.00 $329.30 $890.00 $721.75 2026-09-30
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 14 8 $810.00 $810.00 $299.70 $1,000.00 $716.85 2026-09-30
64510 HCPCS Injection Of Anesthetic Agent Into Sympathetic Nerve Bundle 15 8 $3,520.00 $3,520.00 $65.45 $3,520.00 $715.08 2026-09-30
12004 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 8 8 $971.29 $971.29 $359.38 $971.29 $711.37 2026-09-30
88314 HCPCS Special Stained Specimen Slides To Examine Tissue And Frozen Preparation Of Spec… 8 8 $1,134.00 $1,134.00 $173.38 $1,134.00 $709.38 2026-09-30
93308 HCPCS Ultrasound Of Heart, Follow-up 8 8 $967.90 $967.90 $358.12 $967.90 $708.88 2026-09-30
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
73222 HCPCS MRI Scan Of Arm Joint With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
73219 HCPCS MRI Scan Of Arm With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
72196 HCPCS MRI Scan Of Pelvis With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
73719 HCPCS MRI Scan Of Leg With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
74182 HCPCS MRI Scan Of Abdomen With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
71551 HCPCS MRI Scan Of Chest With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
73722 HCPCS MRI Scan Of Leg Joint With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
70552 HCPCS MRI Scan Of Brain With Contrast 8 8 $991.00 $991.00 $366.67 $991.00 $707.35 2026-09-30
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 14 8 $810.00 $810.00 $299.06 $810.00 $703.95 2026-09-30
93975 HCPCS Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 14 8 $810.00 $810.00 $299.06 $810.00 $703.95 2026-09-30
64642 HCPCS Injection Of Chemical For Paralysis Of Nerve Muscles On Arm Or Leg, 1-4 Muscles,… 14 8 $1,320.00 $1,320.00 $86.91 $3,520.00 $702.01 2026-09-30
20610 HCPCS Aspiration And/or Injection Of Fluid From Large Joint 28 8 $960.00 $960.00 $36.66 $2,500.00 $701.30 2026-09-30
88309 HCPCS Pathology Examination Of Tissue Using A Microscope, High Complexity 8 8 $1,080.00 $1,080.00 $348.50 $1,080.00 $675.60 2026-09-30
2225224_1 CDM Infuvite Adult Vial 6 6 $793.80 $793.80 $293.71 $714.42 $674.73 2026-09-30
62329 HCPCS Removal Of Cerebrospinal Fluid With Lower Back Spinal Tap Using Imaging Guidance 15 8 $2,690.00 $2,690.00 $85.61 $2,690.00 $668.38 2026-09-30
62328 HCPCS Removal Of Spinal Fluid With Lower Back Spinal Tap For Diagnostic Test Using Ima… 15 8 $2,690.00 $2,690.00 $69.44 $2,690.00 $668.38 2026-09-30
65220 HCPCS Removal Of Foreign Body In Cornea 8 8 $910.16 $910.16 $336.76 $910.16 $666.60 2026-09-30
26755 HCPCS Closed Treatment Of Broken End Of Finger Or Thumb With Manipulation 8 8 $910.16 $910.16 $336.76 $910.16 $666.60 2026-09-30
25630 HCPCS Closed Treatment Of Other Broken Wrist Bone 8 8 $910.16 $910.16 $336.76 $910.16 $666.60 2026-09-30
25635 HCPCS Closed Treatment Of Other Broken Wrist Bone With Manipulation 8 8 $910.16 $910.16 $336.76 $910.16 $666.60 2026-09-30
49082 HCPCS Drainage Of Fluid From Abdominal Cavity 14 8 $260.00 $260.00 $96.20 $1,768.00 $663.97 2026-09-30
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
70336 HCPCS MRI Scan Of Jaw Joint 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
73718 HCPCS MRI Scan Of Leg Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
71550 HCPCS MRI Scan Of Chest Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
72195 HCPCS MRI Scan Of Pelvis Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
73218 HCPCS MRI Scan Of Arm Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
70551 HCPCS MRI Scan Of Brain Without Contrast 8 8 $885.00 $885.00 $327.45 $885.00 $661.24 2026-09-30
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 8 8 $900.00 $900.00 $333.00 $900.00 $656.32 2026-09-30
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 8 8 $955.00 $955.00 $353.35 $955.00 $655.63 2026-09-30
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 8 8 $955.00 $955.00 $353.35 $955.00 $655.63 2026-09-30
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 8 8 $955.00 $955.00 $353.35 $955.00 $655.63 2026-09-30
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 8 8 $955.00 $955.00 $353.35 $955.00 $655.63 2026-09-30
73702 HCPCS CT Scan Of Leg Before And After Contrast 8 8 $955.00 $955.00 $353.35 $955.00 $655.63 2026-09-30
71270 HCPCS CT Scan Of Chest Before And After Contrast 8 8 $955.00 $955.00 $353.35 $955.00 $655.63 2026-09-30
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 8 8 $955.00 $955.00 $353.35 $955.00 $655.63 2026-09-30
12041 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.5 Cm Or Less 8 8 $894.88 $894.88 $331.11 $894.88 $655.41 2026-09-30
94626 HCPCS Professional Services For Outpatient Pulmonary Rehabilitation With Continuous Mo… 8 8 $892.73 $892.73 $330.31 $892.73 $655.33 2026-09-30
20605 HCPCS Aspiration And/or Injection Of Fluid From Medium Joint 28 8 $960.00 $960.00 $30.03 $2,600.00 $631.25 2026-09-30
77075 HCPCS Complete X-ray Of Body Bones 8 8 $851.40 $851.40 $315.02 $851.40 $623.57 2026-09-30
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