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

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Hospital

OSBORNE COUNTY MEMORIAL HOSPITAL

Osborne, KS · CCN 171364 · 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: $1,517 across 3 payers · range $1,441-$2,333

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbOCMHOSBORNEKS&type=CDMWithoutLabel&fileType=CSV · observed 2025-10-02

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.

1,762 distinct procedures filed
6 distinct payers
8,872 rate rows
2025-10-02 last MRF observed · ⚠ 12 mo old
Data quality

8,799 of 8,872 rate rows are consumer-grade (99.2%)

73 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-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 57
exceeds 10× this hospital's gross charge — excluded from medians 6
placeholder amount (≤ $0.02) — excluded from medians 5
percent-of-charges filed in the dollar field — excluded from medians 3
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 2

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbOCMHOSBORNEKS&type=CDMWithoutLabel&fileType=CSV
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-19
Content fingerprint ba2f8ca7056d9a5f… · 3,874,650 bytes · first seen 2026-05-07

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
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 2 $16,003.96 $16,003.96 $16,003.96 nat. median
$15,405
1.0× median
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 2 $13,793.70 $13,793.70 $13,793.70 nat. median
$10,207
1.4× median
682
MS_DRG 		Renal Failure With Mcc 2 $12,171.48 $12,171.48 $12,171.48 nat. median
$14,443
0.8× median
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 2 $11,684.05 $12,299.00 $11,991.52 nat. median
$12,282
1.0× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 2 $10,483.80 $11,035.58 $10,759.69 nat. median
$12,877
0.8× median
913
MS_DRG 		Traumatic Injury With Mcc 2 $10,520.76 $10,520.76 $10,520.76 nat. median
$15,779
0.7× median
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 2 $10,171.04 $10,171.04 $10,171.04 nat. median
$10,477
1.0× median
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 3 $9,373.73 $9,925.13 $9,814.85 nat. median
$1,659
outlier · 5.9×
179
MS_DRG 		Respiratory Infections And Inflammations Without Cc/mcc 2 $9,721.69 $9,721.69 $9,721.69 nat. median
$8,200
1.2× median
181
MS_DRG 		Respiratory Neoplasms With Cc 2 $9,406.76 $9,406.76 $9,406.76 nat. median
$11,143
0.8× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 $8,646.44 $9,101.52 $8,873.98 nat. median
$10,410
0.9× median
602
MS_DRG 		Cellulitis With Mcc 2 $8,632.28 $9,086.61 $8,859.44 nat. median
$14,036
0.6× median
540
MS_DRG 		Osteomyelitis With Cc 2 $8,497.94 $8,945.20 $8,721.57 nat. median
$12,776
0.7× median
299
MS_DRG 		Peripheral Vascular Disorders With Mcc 2 $8,357.72 $8,797.60 $8,577.66 nat. median
$15,769
0.5× median
683
MS_DRG 		Renal Failure With Cc 2 $8,440.13 $8,440.13 $8,440.13 nat. median
$9,113
0.9× median
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 2 $8,173.52 $8,603.70 $8,388.61 nat. median
$8,522
1.0× median
J0491
HCPCS 		Injection, Anifrolumab-fnia, 1 Mg 3 $7,674.69 $8,126.15 $8,035.85 nat. median
$62
outlier · 128.9×
176
MS_DRG 		Pulmonary Embolism Without Mcc 2 $7,808.20 $8,219.16 $8,013.68 nat. median
$8,596
0.9× median
811
MS_DRG 		Red Blood Cell Disorders With Mcc 2 $7,670.24 $8,073.94 $7,872.09 nat. median
$13,626
0.6× median
604
MS_DRG 		Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 2 $7,486.02 $7,880.02 $7,683.02 nat. median
$14,413
0.5× median
684
MS_DRG 		Renal Failure Without Cc/mcc 2 $7,259.71 $7,641.80 $7,450.76 nat. median
$6,647
1.1× median
308
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Mcc 2 $7,179.44 $7,557.30 $7,368.37 nat. median
$11,997
0.6× median
389
MS_DRG 		Gastrointestinal Obstruction With Cc 2 $7,052.43 $7,423.61 $7,238.02 nat. median
$8,347
0.9× median
603
MS_DRG 		Cellulitis Without Mcc 2 $7,038.68 $7,409.14 $7,223.91 nat. median
$8,991
0.8× median
809
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 $7,189.52 $7,189.52 $7,189.52 nat. median
$12,522
0.6× median
49650
HCPCS 		Repair Of Groin Hernia Using An Endoscope 3 $6,767.80 $8,976.48 $7,124.00 nat. median
$5,840
1.2× median
914
MS_DRG 		Traumatic Injury Without Mcc 2 $6,774.06 $7,130.59 $6,952.33 nat. median
$9,261
0.8× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 2 $6,876.42 $6,876.42 $6,876.42 nat. median
$18,659
outlier · 0.4×
445
MS_DRG 		Disorders Of The Biliary Tract With Cc 2 $6,593.50 $6,940.53 $6,767.01 nat. median
$11,043
0.6× median
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 2 $6,583.69 $6,930.20 $6,756.94 nat. median
$8,379
0.8× median
884
MS_DRG 		Organic Disturbances And Intellectual Disability 2 $6,394.31 $6,730.85 $6,562.58 nat. median
$14,262
outlier · 0.5×
309
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Cc 2 $6,362.48 $6,697.35 $6,529.91 nat. median
$7,903
0.8× median
292
MS_DRG 		Heart Failure And Shock With Cc 2 $6,309.72 $6,641.81 $6,475.77 nat. median
$8,955
0.7× median
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 $6,295.74 $6,627.09 $6,461.41 nat. median
$8,186
0.8× median
439
MS_DRG 		Disorders Of Pancreas Except Malignancy With Cc 2 $6,258.06 $6,587.43 $6,422.75 nat. median
$8,941
0.7× median
191
MS_DRG 		Chronic Obstructive Pulmonary Disease With Cc 2 $6,396.93 $6,396.93 $6,396.93 nat. median
$8,851
0.7× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 $6,198.12 $6,524.34 $6,361.23 nat. median
$8,119
0.8× median
546
MS_DRG 		Connective Tissue Disorders With Cc 2 $6,305.15 $6,305.15 $6,305.15 nat. median
$11,783
0.5× median
206
MS_DRG 		Other Respiratory System Diagnoses Without Mcc 2 $6,003.08 $6,319.03 $6,161.06 nat. median
$9,496
0.6× median
536
MS_DRG 		Fractures Of Hip And Pelvis Without Mcc 2 $5,996.23 $6,311.82 $6,154.02 nat. median
$8,438
0.7× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 2 $5,997.94 $5,997.94 $5,997.94 nat. median
$11,515
0.5× median
Q5122
HCPCS 		Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg 3 $5,715.81 $6,052.03 $5,984.79 nat. median
$561
outlier · 10.7×
J2802
HCPCS 		Injection, Romiplostim, 1 Microgram 3 $5,687.26 $6,021.80 $5,954.89 nat. median
$2,849
outlier · 2.1×
312
MS_DRG 		Syncope And Collapse 2 $5,764.51 $6,067.91 $5,916.21 nat. median
$8,953
0.7× median
305
MS_DRG 		Hypertension Without Mcc 2 $5,736.14 $6,038.04 $5,887.09 nat. median
$8,040
0.7× median
47563
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 3 $5,536.60 $7,343.47 $5,828.00 nat. median
$6,020
1.0× median
552
MS_DRG 		Medical Back Problems Without Mcc 2 $5,673.68 $5,972.29 $5,822.99 nat. median
$9,833
0.6× median
J1306
HCPCS 		Injection, Inclisiran, 1 Mg 3 $5,163.14 $5,466.85 $5,406.11 nat. median
$44
outlier · 123.6×
44970
HCPCS 		Removal Of Appendix Using An Endoscope 3 $5,128.10 $6,801.66 $5,398.00 nat. median
$6,040
0.9× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 2 $5,155.88 $5,155.88 $5,155.88 nat. median
$6,821
0.8× median

Other procedures at this hospital

Browse this hospital's 1,762 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
             
177 MS_DRG Respiratory Infections And Inflammations With Mcc 2 2 $16,003.96 $16,003.96 $16,003.96 $16,003.96 $16,003.96 2025-10-02
178 MS_DRG Respiratory Infections And Inflammations With Cc 2 2 $13,793.70 $13,793.70 $13,793.70 $13,793.70 $13,793.70 2025-10-02
682 MS_DRG Renal Failure With Mcc 2 2 $12,171.48 $12,171.48 $12,171.48 $12,171.48 $12,171.48 2025-10-02
189 MS_DRG Pulmonary Edema And Respiratory Failure 2 2 $29,872.21 $29,872.21 $11,684.05 $12,299.00 $11,991.52 2025-10-02
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 2 2 $15,121.36 $15,121.36 $10,483.80 $11,035.58 $10,759.69 2025-10-02
913 MS_DRG Traumatic Injury With Mcc 2 2 $10,520.76 $10,520.76 $10,520.76 $10,520.76 $10,520.76 2025-10-02
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 2 2 $10,171.04 $10,171.04 $10,171.04 $10,171.04 $10,171.04 2025-10-02
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 3 3 $11,027.92 $11,027.92 $9,373.73 $9,925.13 $9,814.85 2025-10-02
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 2 2 $9,721.69 $9,721.69 $9,721.69 $9,721.69 $9,721.69 2025-10-02
181 MS_DRG Respiratory Neoplasms With Cc 2 2 $9,406.76 $9,406.76 $9,406.76 $9,406.76 $9,406.76 2025-10-02
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 2 $13,891.10 $13,891.10 $8,646.44 $9,101.52 $8,873.98 2025-10-02
602 MS_DRG Cellulitis With Mcc 2 2 $12,559.13 $12,559.13 $8,632.28 $9,086.61 $8,859.44 2025-10-02
540 MS_DRG Osteomyelitis With Cc 2 2 $15,150.43 $15,150.43 $8,497.94 $8,945.20 $8,721.57 2025-10-02
299 MS_DRG Peripheral Vascular Disorders With Mcc 2 2 $13,043.08 $13,043.08 $8,357.72 $8,797.60 $8,577.66 2025-10-02
683 MS_DRG Renal Failure With Cc 2 2 $8,440.13 $8,440.13 $8,440.13 $8,440.13 $8,440.13 2025-10-02
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 2 2 $10,622.58 $10,622.58 $8,173.52 $8,603.70 $8,388.61 2025-10-02
J0491 HCPCS Injection, Anifrolumab-fnia, 1 Mg 3 3 $9,029.05 $9,029.05 $7,674.69 $8,126.15 $8,035.85 2025-10-02
176 MS_DRG Pulmonary Embolism Without Mcc 2 2 $16,008.20 $16,008.20 $7,808.20 $8,219.16 $8,013.68 2025-10-02
811 MS_DRG Red Blood Cell Disorders With Mcc 2 2 $14,822.50 $14,822.50 $7,670.24 $8,073.94 $7,872.09 2025-10-02
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 2 2 $12,625.43 $12,625.43 $7,486.02 $7,880.02 $7,683.02 2025-10-02
684 MS_DRG Renal Failure Without Cc/mcc 2 2 $8,696.21 $8,696.21 $7,259.71 $7,641.80 $7,450.76 2025-10-02
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 2 2 $11,116.85 $11,116.85 $7,179.44 $7,557.30 $7,368.37 2025-10-02
389 MS_DRG Gastrointestinal Obstruction With Cc 2 2 $15,005.97 $15,005.97 $7,052.43 $7,423.61 $7,238.02 2025-10-02
603 MS_DRG Cellulitis Without Mcc 2 2 $12,628.66 $12,628.66 $7,038.68 $7,409.14 $7,223.91 2025-10-02
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 2 $7,189.52 $7,189.52 $7,189.52 $7,189.52 $7,189.52 2025-10-02
49650 HCPCS Repair Of Groin Hernia Using An Endoscope 3 3 $10,085.93 $10,085.93 $6,767.80 $8,976.48 $7,124.00 2025-10-02
914 MS_DRG Traumatic Injury Without Mcc 2 2 $9,060.52 $9,060.52 $6,774.06 $7,130.59 $6,952.33 2025-10-02
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 2 2 $6,876.42 $6,876.42 $6,876.42 $6,876.42 $6,876.42 2025-10-02
445 MS_DRG Disorders Of The Biliary Tract With Cc 2 2 $7,778.51 $7,778.51 $6,593.50 $6,940.53 $6,767.01 2025-10-02
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 2 2 $11,207.71 $11,207.71 $6,583.69 $6,930.20 $6,756.94 2025-10-02
884 MS_DRG Organic Disturbances And Intellectual Disability 2 2 $8,465.46 $8,465.46 $6,394.31 $6,730.85 $6,562.58 2025-10-02
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 2 2 $7,751.08 $7,751.08 $6,362.48 $6,697.35 $6,529.91 2025-10-02
292 MS_DRG Heart Failure And Shock With Cc 2 2 $9,679.50 $9,679.50 $6,309.72 $6,641.81 $6,475.77 2025-10-02
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 2 $13,325.38 $13,325.38 $6,295.74 $6,627.09 $6,461.41 2025-10-02
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 2 2 $9,945.80 $9,945.80 $6,258.06 $6,587.43 $6,422.75 2025-10-02
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 2 2 $6,396.93 $6,396.93 $6,396.93 $6,396.93 $6,396.93 2025-10-02
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 2 $21,915.37 $21,915.37 $6,198.12 $6,524.34 $6,361.23 2025-10-02
546 MS_DRG Connective Tissue Disorders With Cc 2 2 $6,305.15 $6,305.15 $6,305.15 $6,305.15 $6,305.15 2025-10-02
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 2 2 $6,927.26 $6,927.26 $6,003.08 $6,319.03 $6,161.06 2025-10-02
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 2 2 $15,193.74 $15,193.74 $5,996.23 $6,311.82 $6,154.02 2025-10-02
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 2 2 $5,997.94 $5,997.94 $5,997.94 $5,997.94 $5,997.94 2025-10-02
Q5122 HCPCS Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg 3 3 $6,724.48 $6,724.48 $5,715.81 $6,052.03 $5,984.79 2025-10-02
J2802 HCPCS Injection, Romiplostim, 1 Microgram 3 3 $6,690.89 $6,690.89 $5,687.26 $6,021.80 $5,954.89 2025-10-02
312 MS_DRG Syncope And Collapse 2 2 $9,403.23 $9,403.23 $5,764.51 $6,067.91 $5,916.21 2025-10-02
305 MS_DRG Hypertension Without Mcc 2 2 $13,692.49 $13,692.49 $5,736.14 $6,038.04 $5,887.09 2025-10-02
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 3 3 $8,251.09 $8,251.09 $5,536.60 $7,343.47 $5,828.00 2025-10-02
552 MS_DRG Medical Back Problems Without Mcc 2 2 $6,977.98 $6,977.98 $5,673.68 $5,972.29 $5,822.99 2025-10-02
J1306 HCPCS Injection, Inclisiran, 1 Mg 3 3 $6,074.28 $6,074.28 $5,163.14 $5,466.85 $5,406.11 2025-10-02
44970 HCPCS Removal Of Appendix Using An Endoscope 3 3 $7,642.31 $7,642.31 $5,128.10 $6,801.66 $5,398.00 2025-10-02
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 2 2 $5,155.88 $5,155.88 $5,155.88 $5,155.88 $5,155.88 2025-10-02
293 MS_DRG Heart Failure And Shock Without Cc/mcc 2 2 $14,302.60 $14,302.60 $4,970.78 $5,232.40 $5,101.59 2025-10-02
69 MS_DRG Transient Ischemia Without Thrombolytic 2 2 $8,528.71 $8,528.71 $4,952.37 $5,213.02 $5,082.69 2025-10-02
153 MS_DRG Otitis Media And Uri Without Mcc 2 2 $8,354.21 $8,354.21 $4,848.30 $5,103.47 $4,975.89 2025-10-02
866 MS_DRG Viral Illness Without Mcc 2 2 $5,245.05 $5,245.05 $4,843.31 $5,098.22 $4,970.77 2025-10-02
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 2 $9,506.32 $9,506.32 $4,829.26 $5,083.43 $4,956.35 2025-10-02
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 2 2 $9,223.45 $9,223.45 $4,771.98 $5,023.14 $4,897.56 2025-10-02
47562 HCPCS Removal Of Gallbladder Using An Endoscope 3 3 $7,512.82 $7,512.82 $4,584.70 $6,686.41 $4,826.00 2025-10-02
52310 HCPCS Simple Removal Of Foreign Body, Stone, Or Stent In Urethra Or Bladder Using An E… 3 3 $6,487.05 $6,487.05 $4,352.90 $5,773.47 $4,582.00 2025-10-02
948 MS_DRG Signs And Symptoms Without Mcc 2 2 $5,823.70 $5,823.70 $4,440.10 $4,673.79 $4,556.94 2025-10-02
J3101 HCPCS Injection, Tenecteplase, 1 Mg 4 3 $10,042.79 $10,042.79 $153.82 $11,536.64 $4,550.00 2025-10-02
607 MS_DRG Minor Skin Disorders Without Mcc 2 2 $9,571.91 $9,571.91 $4,326.51 $4,554.22 $4,440.36 2025-10-02
394 MS_DRG Other Digestive System Diagnoses With Cc 2 2 $4,347.54 $4,347.54 $4,347.54 $4,347.54 $4,347.54 2025-10-02
Q4137 HCPCS Amnioexcel, Amnioexcel Plus Or Biodexcel, Per Square Centimeter 6 3 $4,942.55 $4,942.55 $3,471.06 $5,221.35 $4,303.26 2025-10-02
125 MS_DRG Other Disorders Of The Eye Without Mcc 2 2 $9,263.62 $9,263.62 $4,063.22 $4,277.07 $4,170.14 2025-10-02
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 3 3 $5,478.95 $5,478.95 $3,710.95 $4,876.27 $3,906.26 2025-10-02
149 MS_DRG Dysequilibrium 2 2 $15,910.18 $15,910.18 $3,760.80 $3,958.74 $3,859.77 2025-10-02
197 MS_DRG Interstitial Lung Disease With Cc 2 2 $3,584.47 $3,584.47 $3,584.47 $3,584.47 $3,584.47 2025-10-02
950 MS_DRG Aftercare Without Cc/mcc 2 2 $13,054.98 $13,054.98 $3,266.24 $3,438.15 $3,352.19 2025-10-02
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 3 3 $3,935.63 $3,935.63 $2,952.60 $3,502.71 $3,108.00 2025-10-02
639 MS_DRG Diabetes Without Cc/mcc 2 2 $3,050.97 $3,050.97 $3,050.97 $3,050.97 $3,050.97 2025-10-02
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 3 3 $3,401.34 $3,401.34 $2,891.14 $3,061.21 $3,027.19 2025-10-02
J3490 HCPCS Unclassified Drugs 3 3 $3,320.00 $3,320.00 $2,822.00 $2,988.00 $2,954.80 2025-10-02
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 2 2 $2,879.37 $2,879.37 $2,879.37 $2,879.37 $2,879.37 2025-10-02
64719 HCPCS Release And/or Relocation Of Wrist Nerve 3 3 $3,729.13 $3,729.13 $2,502.30 $3,318.93 $2,634.00 2025-10-02
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 6 3 $16,121.25 $16,121.25 $287.63 $18,665.74 $2,495.11 2025-10-02
64718 HCPCS Release And/or Relocation Of Elbow Nerve 3 3 $3,475.71 $3,475.71 $2,332.25 $3,093.38 $2,455.00 2025-10-02
2120840_1 CDM Room & Board - Semi-private (two Beds) - General Classification 2 2 $2,733.62 $2,733.62 $2,323.58 $2,542.27 $2,432.93 2025-10-02
2120839_1 CDM Room & Board - Private (one Bed) - General Classification 2 2 $2,733.62 $2,733.62 $2,323.58 $2,542.27 $2,432.93 2025-10-02
19120 HCPCS Removal Of Growth And Tissue Of Breast, Duct, Or Nipple 3 3 $3,334.13 $3,334.13 $2,237.25 $2,967.38 $2,355.00 2025-10-02
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 3 3 $3,297.00 $3,297.00 $2,201.63 $2,934.33 $2,317.50 2025-10-02
25111 HCPCS Removal Of First Cyst Of Wrist 3 3 $3,266.18 $3,266.18 $2,191.65 $2,906.90 $2,307.00 2025-10-02
81420 HCPCS Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque… 3 3 $3,378.70 $3,378.70 $2,164.10 $3,007.04 $2,278.00 2025-10-02
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 4 3 $4,596.15 $4,596.15 $375.81 $4,129.64 $2,243.08 2025-10-02
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 3 3 $3,390.00 $3,390.00 $2,232.26 $2,349.75 $2,232.26 2025-10-02
11626 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 3 3 $3,137.34 $3,137.34 $2,105.20 $2,792.23 $2,216.00 2025-10-02
15275 HCPCS Application Of Skin Substitute Graft To Wound Of Face, Scalp, Eyelids, Mouth, Ne… 6 3 $3,327.50 $3,327.50 $36.10 $5,785.00 $2,177.50 2025-10-02
4441942_1 CDM Room & Board - Semi-private (two Beds) - General Classification 2 2 $2,351.49 $2,351.49 $1,998.77 $2,186.89 $2,092.83 2025-10-02
55520 HCPCS Removal Of Growth Of Sperm Cord 6 6 $2,835.03 $2,835.03 $390.90 $4,931.77 $2,089.58 2025-10-02
26952 HCPCS Amputation Of Finger Or Thumb With Tissue Flap 3 3 $3,076.13 $3,076.13 $1,970.30 $2,737.76 $2,074.00 2025-10-02
26160 HCPCS Removal Of Growth Of Tendon Finger Or Hand 3 3 $2,907.99 $2,907.99 $1,951.30 $2,588.11 $2,054.00 2025-10-02
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 6 6 $2,735.93 $2,735.93 $444.39 $4,755.37 $2,040.58 2025-10-02
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 3 3 $2,812.00 $2,812.00 $1,872.16 $2,127.46 $2,021.09 2025-10-02
49525 HCPCS Repair Of Sliding Groin Hernia 3 3 $2,837.20 $2,837.20 $1,903.80 $2,525.11 $2,004.00 2025-10-02
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 3 3 $2,200.00 $2,200.00 $1,870.00 $1,980.00 $1,958.00 2025-10-02
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 4 3 $6,136.38 $6,136.38 $424.78 $5,461.38 $1,935.78 2025-10-02
11444 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3… 3 3 $2,981.85 $2,981.85 $1,805.00 $2,653.85 $1,900.00 2025-10-02
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 4 3 $3,125.02 $3,125.02 $950.00 $2,920.61 $1,890.63 2025-10-02
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 3 3 $2,672.97 $2,672.97 $1,793.60 $2,378.94 $1,888.00 2025-10-02
58120 HCPCS Dilation And Scraping Of Uterus 3 3 $2,922.11 $2,922.11 $1,793.60 $2,600.68 $1,888.00 2025-10-02
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 3 3 $2,638.99 $2,638.99 $1,770.80 $2,348.70 $1,864.00 2025-10-02
C1788 HCPCS Port, Indwelling (implantable) 12 3 $2,025.10 $2,025.10 $127.50 $4,125.15 $1,749.99 2025-10-02
6412762_1 CDM Amnioexcel Plus 3cm X 3cm 2 2 $4,083.60 $4,083.60 $1,429.26 $2,041.80 $1,735.53 2025-10-02
78598 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation And Blood Flow To Lun… 3 3 $1,909.62 $1,909.62 $1,623.18 $1,718.66 $1,699.56 2025-10-02
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 3 3 $2,502.54 $2,502.54 $1,602.92 $2,227.26 $1,687.28 2025-10-02
J2357 HCPCS Injection, Omalizumab, 5 Mg 5 3 $2,485.68 $2,485.68 $45.30 $3,349.03 $1,674.54 2025-10-02
52281 HCPCS Dilation Of Urethra Using An Endoscope 3 3 $2,338.85 $2,338.85 $1,569.40 $2,081.58 $1,652.00 2025-10-02
57505 HCPCS Scraping Of Tissue Of Cervix 3 3 $1,854.00 $1,854.00 $1,575.90 $1,668.60 $1,650.06 2025-10-02
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 14 3 $2,408.69 $2,408.69 $36.10 $2,143.73 $1,624.00 2025-10-02
64721 HCPCS Release And/or Relocation Of Hand Nerve 3 3 $2,276.55 $2,276.55 $1,527.60 $2,026.13 $1,608.00 2025-10-02
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 3 3 $2,376.06 $2,376.06 $1,521.90 $2,114.69 $1,602.00 2025-10-02
43245 HCPCS Dilation Of Stomach Outlet Using A Flexible Endoscope 3 3 $2,215.68 $2,215.68 $1,486.75 $1,971.96 $1,565.00 2025-10-02
43249 HCPCS Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl… 3 3 $2,195.86 $2,195.86 $1,473.45 $1,954.32 $1,551.00 2025-10-02
35206 HCPCS Repair Of Blood Vessel Of Arm 3 3 $1,730.40 $1,730.40 $1,446.85 $1,540.06 $1,523.00 2025-10-02
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 3 3 $2,621.35 $2,621.35 $1,441.15 $2,333.00 $1,517.00 2025-10-02
90377 HCPCS Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle 6 3 $1,715.67 $1,715.67 $1,030.84 $1,996.73 $1,488.64 2025-10-02
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 3 3 $2,084.01 $2,084.01 $1,398.40 $1,854.77 $1,472.00 2025-10-02
4490377_1 CDM Labor Room/delivery - General Classification 3 3 $1,591.35 $1,591.35 $1,352.65 $1,432.22 $1,416.30 2025-10-02
J0248 HCPCS Injection, Remdesivir, 1 Mg 3 3 $1,571.57 $1,571.57 $1,335.83 $1,414.41 $1,398.70 2025-10-02
43200 HCPCS Diagnostic Exam Of Esophagus Using A Flexible Endoscope Through Mouth 3 3 $1,929.69 $1,929.69 $1,294.85 $1,717.42 $1,363.00 2025-10-02
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 3 3 $1,854.00 $1,854.00 $1,282.50 $1,650.06 $1,350.00 2025-10-02
59812 HCPCS Treatment Of Miscarriage 6 3 $1,875.70 $1,875.70 $36.10 $2,701.51 $1,337.02 2025-10-02
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 6 6 $1,933.19 $1,933.19 $71.91 $3,326.49 $1,308.88 2025-10-02
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 3 3 $1,854.00 $1,854.00 $1,242.60 $1,650.06 $1,308.00 2025-10-02
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 3 3 $1,851.82 $1,851.82 $1,242.60 $1,648.12 $1,308.00 2025-10-02
59514 HCPCS Cesarean Delivery 6 6 $1,861.67 $1,861.67 $750.71 $1,803.02 $1,246.53 2025-10-02
11403 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 5 3 $1,850.41 $1,850.41 $36.10 $1,646.86 $1,241.65 2025-10-02
78278 HCPCS Nuclear Medicine Study To Assess Blood Loss 3 3 $1,393.59 $1,393.59 $1,184.55 $1,254.23 $1,240.30 2025-10-02
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 3 3 $1,835.29 $1,835.29 $1,175.53 $1,633.41 $1,237.40 2025-10-02
6455562_1 CDM Bflex Regular 5.0 Su Bronchoscope 2 2 $2,842.40 $2,842.40 $994.84 $1,421.20 $1,208.02 2025-10-02
35226 HCPCS Repair Of Blood Vessel Of Leg 6 3 $1,644.44 $1,644.44 $36.10 $2,010.41 $1,181.78 2025-10-02
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 3 3 $1,742.51 $1,742.51 $1,116.10 $1,550.83 $1,174.84 2025-10-02
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 6 3 $1,662.30 $1,662.30 $36.10 $2,591.88 $1,160.59 2025-10-02
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 6 6 $1,351.88 $1,351.88 $170.34 $2,224.80 $1,156.39 2025-10-02
11442 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1… 7 3 $1,669.63 $1,669.63 $36.10 $1,529.68 $1,153.30 2025-10-02
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 3 3 $1,702.93 $1,702.93 $1,090.75 $1,515.61 $1,148.16 2025-10-02
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 3 3 $1,701.57 $1,701.57 $1,089.88 $1,514.40 $1,147.24 2025-10-02
58611 HCPCS Tying Or Incision Of Fallopian Tubes During Cesarean Delivery Or Other Abdominal… 6 6 $2,511.49 $2,511.49 $64.13 $2,939.66 $1,147.00 2025-10-02
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 3 3 $1,616.81 $1,616.81 $1,084.90 $1,438.96 $1,142.00 2025-10-02
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 6 3 $1,679.74 $1,679.74 $1,075.89 $1,494.97 $1,132.52 2025-10-02
52000 HCPCS Diagnostic Exam Of Bladder And Urethra Using An Endoscope 3 3 $1,854.00 $1,854.00 $1,060.20 $1,650.06 $1,116.00 2025-10-02
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 6 6 $1,314.28 $1,314.28 $166.97 $2,141.37 $1,114.90 2025-10-02
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 6 6 $1,314.28 $1,314.28 $166.86 $2,141.37 $1,114.84 2025-10-02
59515 HCPCS Cesarean Delivery With Care After Delivery 3 3 $1,600.00 $1,600.00 $1,110.88 $1,169.35 $1,110.88 2025-10-02
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 3 3 $1,640.40 $1,640.40 $1,050.70 $1,459.96 $1,106.00 2025-10-02
43248 HCPCS Insertion Of Guide Wire With Dilation Of Esophagus Using A Flexible Endoscope 3 3 $1,529.03 $1,529.03 $1,026.00 $1,360.84 $1,080.00 2025-10-02
28190 HCPCS Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 6 3 $1,441.45 $1,441.45 $36.10 $2,283.74 $1,077.72 2025-10-02
5404228_1 CDM Nursery - General Classification 2 2 $1,196.86 $1,196.86 $1,017.33 $1,113.08 $1,065.20 2025-10-02
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 3 3 $3,160.04 $3,160.04 $993.70 $2,812.44 $1,046.00 2025-10-02
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 3 3 $2,795.42 $2,795.42 $993.70 $2,487.92 $1,046.00 2025-10-02
J7187 HCPCS Injection, Von Willebrand Factor Complex (humate-p), Per Iu Vwf:rco 4 3 $2,256.70 $2,256.70 $1.42 $4,033.04 $1,004.98 2025-10-02
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 6 3 $1,177.50 $1,177.50 $36.10 $1,980.00 $1,003.97 2025-10-02
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 3 3 $1,481.70 $1,481.70 $949.05 $1,318.71 $999.00 2025-10-02
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 3 3 $1,648.00 $1,648.00 $947.15 $1,466.72 $997.00 2025-10-02
74280 HCPCS Double Contrast X-ray Of Large Intestine 3 3 $1,723.19 $1,723.19 $947.15 $1,533.64 $997.00 2025-10-02
G0105 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 3 3 $1,648.00 $1,648.00 $947.15 $1,466.72 $997.00 2025-10-02
44361 HCPCS Biopsy Of Small Bowel (except Ileum) Using An Endoscope 3 3 $1,411.52 $1,411.52 $947.15 $1,256.25 $997.00 2025-10-02
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 6 6 $2,166.00 $2,166.00 $206.26 $3,419.38 $968.58 2025-10-02
11424 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 6 3 $1,088.00 $1,088.00 $36.10 $1,784.00 $968.32 2025-10-02
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 3 3 $1,429.79 $1,429.79 $915.80 $1,272.51 $964.00 2025-10-02
37765 HCPCS Removal Of Varicose Veins Of Arm Or Leg, 10-20 Incisions 3 3 $1,073.26 $1,073.26 $912.27 $965.93 $955.20 2025-10-02
36589 HCPCS Removal Of Tunneled Central Venous Tube 3 3 $1,343.56 $1,343.56 $901.55 $1,195.77 $949.00 2025-10-02
32160 HCPCS Massage Of Heart Muscle Through Chest 3 3 $1,066.00 $1,066.00 $906.10 $959.40 $948.74 2025-10-02
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 6 6 $1,580.56 $1,580.56 $447.27 $1,874.45 $945.21 2025-10-02
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 8 3 $1,425.52 $1,425.52 $595.65 $1,305.63 $938.69 2025-10-02
73225 HCPCS MRI Scan Of Blood Vessels Of Arm 4 3 $1,425.52 $1,425.52 $595.65 $1,268.71 $938.69 2025-10-02
64484 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 3 3 $1,319.50 $1,319.50 $885.40 $1,174.36 $932.00 2025-10-02
64492 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Third And… 3 3 $1,244.24 $1,244.24 $861.65 $1,107.37 $907.00 2025-10-02
78305 HCPCS Nuclear Medicine Study Of Bone And/or Joint Multiple Areas 3 3 $998.07 $998.07 $848.36 $898.26 $888.28 2025-10-02
73722 HCPCS MRI Scan Of Leg Joint With Contrast 8 3 $1,404.92 $1,404.92 $494.95 $1,305.63 $876.52 2025-10-02
73718 HCPCS MRI Scan Of Leg Without Contrast 8 3 $1,384.32 $1,384.32 $494.95 $1,305.63 $867.36 2025-10-02
73218 HCPCS MRI Scan Of Arm Without Contrast 8 3 $1,384.32 $1,384.32 $494.95 $1,305.63 $867.36 2025-10-02
32555 HCPCS Aspiration Of Fluid From Chest Cavity Using Imaging Guidance 3 3 $1,266.64 $1,266.64 $811.30 $1,127.31 $854.00 2025-10-02
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 8 3 $1,181.45 $1,181.45 $36.10 $1,717.36 $849.82 2025-10-02
46924 HCPCS Extensive Destruction Of Growth Of Anus 3 3 $954.81 $954.81 $811.59 $859.33 $849.78 2025-10-02
78707 HCPCS Nuclear Medicine Study Of Kidney, Blood Flow, And Function 3 3 $948.63 $948.63 $806.34 $853.77 $844.28 2025-10-02
78610 HCPCS Nuclear Medicine Study Of Brain With Blood Flow 3 3 $948.63 $948.63 $806.34 $853.77 $844.28 2025-10-02
78708 HCPCS Nuclear Medicine Study Of Kidney, Blood, Flow, And Function With Drug Administra… 3 3 $1,233.54 $1,233.54 $790.10 $1,097.85 $831.68 2025-10-02
C1781 HCPCS Mesh (implantable) 12 3 $947.65 $947.65 $440.90 $1,033.20 $827.06 2025-10-02
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 6 3 $1,228.61 $1,228.61 $36.10 $1,940.45 $821.49 2025-10-02
26720 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand 3 3 $1,162.00 $1,162.00 $760.95 $1,034.18 $801.00 2025-10-02
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 3 3 $1,188.03 $1,188.03 $760.95 $1,057.35 $801.00 2025-10-02
51720 HCPCS Instillation Of Anti-cancer Drug Into Bladder 3 3 $1,292.65 $1,292.65 $760.00 $1,150.46 $800.00 2025-10-02
45331 HCPCS Biopsy Of Lower Large Bowel Using A Flexible Endoscope 3 3 $1,132.61 $1,132.61 $760.00 $1,008.02 $800.00 2025-10-02
45330 HCPCS Diagnostic Exam Of Lower Portion Of Large Bowel Using A Flexible Endoscope 3 3 $1,132.61 $1,132.61 $760.00 $1,008.02 $800.00 2025-10-02
36430 HCPCS Transfusion Of Blood Or Blood Products 8 3 $893.64 $893.64 $222.50 $1,205.06 $795.35 2025-10-02
78215 HCPCS Nuclear Medicine Study Of Liver And Spleen 3 3 $889.92 $889.92 $756.43 $800.93 $792.03 2025-10-02
12007 HCPCS Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 6 6 $1,371.94 $1,371.94 $122.29 $2,010.41 $789.08 2025-10-02
78580 HCPCS Nuclear Medicine Study Of Lung Circulation 3 3 $885.80 $885.80 $752.93 $797.22 $788.36 2025-10-02
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 3 3 $878.00 $878.00 $746.30 $790.20 $781.42 2025-10-02
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 6 3 $1,043.00 $1,043.00 $36.10 $1,378.61 $773.82 2025-10-02
43870 HCPCS Closure Of Surgically Created Opening From Stomach To Skin 3 3 $865.20 $865.20 $735.42 $778.68 $770.03 2025-10-02
33020 HCPCS Removal Of Blood Clot Or Foreign Body In Heart Sac 3 3 $865.00 $865.00 $735.25 $778.50 $769.85 2025-10-02
28470 HCPCS Closed Treatment Of Broken Bone In Forefoot Or Midfoot 7 3 $865.00 $865.00 $36.10 $1,900.85 $769.85 2025-10-02
64491 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Second Le… 3 3 $1,073.15 $1,073.15 $720.10 $955.10 $758.00 2025-10-02
64421 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Multiple Rib Nerves For Region… 3 3 $1,061.83 $1,061.83 $712.50 $945.03 $750.00 2025-10-02
92960 HCPCS External Shock To Heart To Regulate Heart Beat 6 3 $860.00 $860.00 $36.10 $1,350.00 $735.40 2025-10-02
92977 HCPCS Removal Of Heart Artery Blood Clot By Dissolving 3 3 $1,090.14 $1,090.14 $698.25 $970.22 $735.00 2025-10-02
26775 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation Under Anesthesia 6 3 $1,474.00 $1,474.00 $36.10 $1,973.13 $705.77 2025-10-02
12054 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1… 6 3 $1,495.00 $1,495.00 $36.10 $2,265.05 $696.78 2025-10-02
12051 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5 C… 10 3 $1,050.09 $1,050.09 $36.10 $1,650.06 $690.30 2025-10-02
4631398_1 CDM Recovery Room - General Classification 3 3 $772.50 $772.50 $656.63 $695.25 $687.53 2025-10-02
73701 HCPCS CT Scan Of Leg With Contrast Material 8 3 $1,051.63 $1,051.63 $430.35 $963.45 $686.18 2025-10-02
73702 HCPCS CT Scan Of Leg Before And After Contrast 8 3 $1,082.53 $1,082.53 $430.35 $981.79 $686.18 2025-10-02
73201 HCPCS CT Scan Of Arm With Contrast 8 3 $1,051.63 $1,051.63 $430.35 $963.45 $686.18 2025-10-02
73202 HCPCS CT Scan Of Arm Before And After Contrast 8 3 $1,082.53 $1,082.53 $430.35 $981.79 $686.18 2025-10-02
99291 HCPCS Critical Care, First 30-74 Minutes 6 3 $1,411.00 $1,411.00 $36.10 $2,124.43 $674.12 2025-10-02
73200 HCPCS CT Scan Of Arm Without Contrast 8 3 $1,031.03 $1,031.03 $430.35 $935.95 $671.50 2025-10-02
73700 HCPCS CT Scan Of Leg Without Contrast 8 3 $1,031.03 $1,031.03 $430.35 $935.95 $671.50 2025-10-02
31720 HCPCS Insertion Of Tube Into Airway For Aspiration Of Secretions 6 3 $562.81 $562.81 $96.25 $905.54 $668.85 2025-10-02
J1442 HCPCS Injection, Filgrastim (g-csf), Excludes Biosimilars, 1 Microgram 6 3 $801.10 $801.10 $1.18 $981.03 $664.50 2025-10-02
J1670 HCPCS Injection, Tetanus Immune Globulin, Human, Up To 250 Units 2 1 $740.79 $740.79 $28.48 $1,290.13 $659.31 2025-10-02
20206 HCPCS Needle Biopsy Of Muscle 3 3 $894.77 $894.77 $600.40 $796.35 $632.00 2025-10-02
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 3 3 $1,384.32 $1,384.32 $595.65 $1,232.04 $627.00 2025-10-02
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 3 3 $1,404.92 $1,404.92 $595.65 $1,250.38 $627.00 2025-10-02
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 3 3 $1,404.92 $1,404.92 $595.65 $1,250.38 $627.00 2025-10-02
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 3 3 $1,384.32 $1,384.32 $595.65 $1,232.04 $627.00 2025-10-02
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 3 3 $1,404.92 $1,404.92 $595.65 $1,250.38 $627.00 2025-10-02
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 3 3 $1,363.72 $1,363.72 $595.65 $1,213.71 $627.00 2025-10-02
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 3 3 $1,404.92 $1,404.92 $595.65 $1,250.38 $627.00 2025-10-02
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 3 3 $1,363.72 $1,363.72 $595.65 $1,213.71 $627.00 2025-10-02
72159 HCPCS MRI Scan Of Blood Vessels Of Spinal Canal 3 3 $1,404.92 $1,404.92 $595.65 $1,250.38 $627.00 2025-10-02
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 3 3 $1,404.92 $1,404.92 $595.65 $1,250.38 $627.00 2025-10-02
90375 HCPCS Rabies Immune Globulin For Injection 4 3 $1,000.00 $1,000.00 $342.97 $1,127.43 $625.51 2025-10-02
12052 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5… 8 3 $848.99 $848.99 $36.10 $1,152.39 $620.26 2025-10-02
10080 HCPCS Simple Drainage Of Cyst Of Tailbone 6 3 $947.00 $947.00 $36.10 $1,370.60 $619.70 2025-10-02
54001 HCPCS Incision Of Foreskin 3 3 $689.07 $689.07 $585.71 $620.16 $613.27 2025-10-02
44376 HCPCS Diagnostic Exam Of Small Bowel (including Lower Small Intestine) Using An Endosc… 6 6 $782.80 $782.80 $241.71 $1,278.80 $608.42 2025-10-02
10006 HCPCS Fine Needle Aspiration Biopsy Using Ultrasound Guidance, Each Additional Growth 5 3 $945.19 $945.19 $36.10 $841.22 $605.41 2025-10-02
10005 HCPCS Fine Needle Aspiration Biopsy Using Ultrasound Guidance, First Growth 5 3 $945.19 $945.19 $36.10 $841.22 $605.41 2025-10-02
10120 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Simple 6 3 $870.74 $870.74 $36.10 $1,375.94 $592.86 2025-10-02
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 6 3 $859.50 $859.50 $36.10 $1,191.71 $591.38 2025-10-02
5982033_1 CDM Cardiolite Preparation Kit 3 3 $664.26 $664.26 $564.62 $597.83 $591.19 2025-10-02
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 6 6 $1,482.50 $1,482.50 $152.05 $2,247.25 $590.60 2025-10-02
30903 HCPCS Complex Control Of Nose Bleed 3 3 $872.11 $872.11 $558.60 $776.18 $588.00 2025-10-02
94626 HCPCS Professional Services For Outpatient Pulmonary Rehabilitation With Continuous Mo… 3 3 $660.34 $660.34 $561.29 $594.31 $587.70 2025-10-02
90675 HCPCS Rabies Vaccine For Injection Into Muscle 4 3 $1,500.00 $1,500.00 $457.18 $1,335.00 $583.51 2025-10-02
64495 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And… 6 6 $866.23 $866.23 $44.58 $1,427.30 $583.44 2025-10-02
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 4 3 $824.00 $824.00 $452.20 $733.36 $580.38 2025-10-02
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 4 3 $2,584.00 $2,584.00 $7.49 $2,299.76 $578.88 2025-10-02
93307 HCPCS Ultrasound Of Heart 3 3 $984.68 $984.68 $541.50 $876.37 $570.00 2025-10-02
93308 HCPCS Ultrasound Of Heart, Follow-up 3 3 $857.99 $857.99 $541.50 $763.61 $570.00 2025-10-02
49082 HCPCS Drainage Of Fluid From Abdominal Cavity 3 3 $893.01 $893.01 $540.55 $794.78 $569.00 2025-10-02
10060 HCPCS Simple Or Single Drainage Of Skin Abscess 14 3 $1,111.38 $1,111.38 $36.10 $1,833.40 $565.56 2025-10-02
26700 HCPCS Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation 6 3 $796.01 $796.01 $36.10 $1,057.35 $560.25 2025-10-02
41113 HCPCS Removal Of Growth Of Back 1/3 Of Tongue With Suturing 3 3 $751.90 $751.90 $522.50 $669.19 $550.00 2025-10-02
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 3 3 $811.24 $811.24 $519.61 $722.00 $546.96 2025-10-02
26770 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation 6 3 $736.15 $736.15 $36.10 $979.00 $546.15 2025-10-02
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 6 6 $828.12 $828.12 $104.61 $1,359.47 $544.29 2025-10-02
28192 HCPCS Removal Of Foreign Body Of Foot Tissue, Deep 7 3 $599.54 $599.54 $36.10 $1,628.92 $533.59 2025-10-02
27786 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 7 3 $599.00 $599.00 $36.10 $2,589.01 $533.11 2025-10-02
42800 HCPCS Biopsy Of Back Of Throat 3 3 $596.37 $596.37 $506.91 $536.73 $530.77 2025-10-02
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 6 3 $610.00 $610.00 $36.10 $778.50 $525.60 2025-10-02
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 3 3 $1,347.24 $1,347.24 $498.18 $1,199.04 $524.40 2025-10-02
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
71552 HCPCS MRI Scan Of Chest Before And After Contrast 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
70553 HCPCS MRI Scan Of Brain Before And After Contrast 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
73219 HCPCS MRI Scan Of Arm With Contrast 6 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
73222 HCPCS MRI Scan Of Arm Joint With Contrast 6 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
70552 HCPCS MRI Scan Of Brain With Contrast 3 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
70551 HCPCS MRI Scan Of Brain Without Contrast 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
74181 HCPCS MRI Scan Of Abdomen Without Contrast 3 3 $1,259.69 $1,259.69 $494.95 $1,121.12 $521.00 2025-10-02
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
71550 HCPCS MRI Scan Of Chest Without Contrast 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
77084 HCPCS MRI Scan Of Bone Marrow 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
75557 HCPCS MRI Scan Of Heart Without Contrast 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 6 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
72195 HCPCS MRI Scan Of Pelvis Without Contrast 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 3 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 7 3 $1,404.92 $1,404.92 $494.95 $1,305.63 $521.00 2025-10-02
75561 HCPCS MRI Scan Of Heart Before And After Contrast 3 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
73720 HCPCS MRI Scan Of Leg Before And After Contrast 7 3 $1,404.92 $1,404.92 $494.95 $1,305.63 $521.00 2025-10-02
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 3 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
71551 HCPCS MRI Scan Of Chest With Contrast 3 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
73220 HCPCS MRI Scan Of Arm Before And After Contrast 6 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 3 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 3 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
74182 HCPCS MRI Scan Of Abdomen With Contrast 3 3 $1,326.64 $1,326.64 $494.95 $1,180.71 $521.00 2025-10-02
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 7 3 $1,363.72 $1,363.72 $494.95 $1,305.63 $521.00 2025-10-02
70336 HCPCS MRI Scan Of Jaw Joint 3 3 $1,363.72 $1,363.72 $494.95 $1,213.71 $521.00 2025-10-02
72196 HCPCS MRI Scan Of Pelvis With Contrast 3 3 $1,384.32 $1,384.32 $494.95 $1,232.04 $521.00 2025-10-02
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 6 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 3 3 $1,404.92 $1,404.92 $494.95 $1,250.38 $521.00 2025-10-02
11601 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 6 3 $725.89 $725.89 $36.10 $1,026.93 $519.71 2025-10-02
88262 HCPCS Chromosome Analysis For Genetic Defects, Count 15-20 Cells 3 3 $714.00 $714.00 $493.38 $635.46 $519.35 2025-10-02
12042 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.6-7.5 Cm 8 3 $721.12 $721.12 $36.10 $939.62 $512.28 2025-10-02
J3262 HCPCS Injection, Tocilizumab, 1 Mg 4 3 $1,143.34 $1,143.34 $6.20 $2,543.93 $512.05 2025-10-02
62325 HCPCS Insertion Of Tube And Injection Of Substance Into Middle Or Upper Spine Canal Us… 6 6 $770.37 $770.37 $94.81 $1,256.67 $511.08 2025-10-02
62321 HCPCS Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance 6 6 $770.37 $770.37 $92.98 $1,256.67 $509.94 2025-10-02
62327 HCPCS Insertion Of Tube And Injection Of Substance Into Lower Spine Canal Using Imagin… 6 6 $754.92 $754.92 $92.06 $1,256.67 $509.37 2025-10-02
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 7 3 $804.43 $804.43 $36.10 $722.68 $507.30 2025-10-02
62323 HCPCS Injection Of Substance Into Lower Spine Canal Using Imaging Guidance 6 6 $770.37 $770.37 $85.98 $1,256.67 $505.60 2025-10-02
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 3 3 $250.00 $250.00 $222.50 $529.05 $502.60 2025-10-02
77075 HCPCS Complete X-ray Of Body Bones 3 3 $1,339.00 $1,339.00 $476.33 $1,191.71 $501.40 2025-10-02
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