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

GOVE COUNTY MEDICAL CENTER

Quinter, KS · CCN 171367 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $8,632 across 1 payer

Source: https://gcmc.org/48-6065840_Gove%20County%20Medical%20Center_standardcharges.json · observed 2025-02-28

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.

4,083 distinct procedures filed
22 distinct payers
69,182 rate rows
2026-05-22 last MRF observed
Data quality

56,789 of 69,182 rate rows are consumer-grade (82.1%)

12,393 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 9,028
placeholder amount (≤ $0.02) — excluded from medians 1,972
per-diem day rate — not a per-procedure price 797
exceeds 10× this hospital's gross charge — excluded from medians 503
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 57
percent-of-charges filed in the dollar field — excluded from medians 32
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 3
exceeds 3× this hospital's gross charge for a DRG stay — excluded 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apim.services.craneware.com/api-pricing-transparency/api/public/4cf51e9a0a8b4190896bc4ad80d1d24d/charges/mrf
Found on page https://gcmc.org/financial-services/
Discovered viaCMS hospital list
Last fetch success · 2026-08-18
Content fingerprint 801fe62d67957a61… · 14,997,932 bytes · first seen 2026-08-18

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
191
MS_DRG 		Chronic Obstructive Pulmonary Disease With Cc 4 $13,060.47 $32,803.05 $31,076.58 nat. median
$9,352
outlier · 3.3×
787
MS_DRG 		Cesarean Section Without Sterilization With Cc 4 $15,052.03 $25,550.96 $24,206.17 nat. median
$11,354
outlier · 2.1×
J2507
HCPCS 		Pegloticase Injection 5 $4,336.51 $24,333.66 $22,812.80 nat. median
$8,784
outlier · 2.6×
552
MS_DRG 		Medical Back Problems Without Mcc 4 $12,579.39 $24,017.09 $22,753.03 nat. median
$10,356
outlier · 2.2×
C1713
HCPCS 		Anchor/screw Bn/bn,tis/bn 4 $17,785.80 $18,971.52 $18,279.85 nat. median
$859
outlier · 21.3×
807
MS_DRG 		Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 4 $8,631.66 $16,870.10 $15,982.20 nat. median
$7,284
outlier · 2.2×
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 4 $15,461.37 $17,433.92 $15,890.85 nat. median
$11,661
1.4× median
806
MS_DRG 		Vaginal Delivery Without Sterilization Or D&c With Cc 4 $12,132.03 $16,315.69 $15,456.97 nat. median
$7,911
2.0× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 4 $14,435.07 $26,527.13 $14,836.05 nat. median
$19,136
0.8× median
49651
CPT 		Lap Ing Hernia Repair Recur 5 $12,281.40 $13,100.16 $12,963.70 nat. median
$5,950
outlier · 2.2×
49654
CPT 		Lap Hernia Repair 5 $11,408.70 $12,885.12 $12,079.80 nat. median
$4,921
outlier · 2.5×
49653
CPT 		Hernia Repair Ventral Laproscopy 5 $11,016.00 $12,441.60 $11,664.00 nat. median
$5,374
outlier · 2.2×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 4 $10,867.40 $14,155.66 $11,169.27 nat. median
$9,038
1.2× median
28750
CPT 		Fusion Of Big Toe Joint 5 $10,546.78 $11,699.18 $11,132.71 nat. median
$6,984
1.6× median
28299
CPT 		Cor Hlx Vlgs Double Osteot 5 $10,775.70 $11,494.08 $10,934.61 nat. median
$6,823
1.6× median
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 4 $9,989.68 $30,052.69 $10,267.17 nat. median
$16,167
0.6× median
28735
CPT 		Fusion Of Foot Bones 5 $9,444.60 $10,532.72 $9,969.30 nat. median
$11,242
0.9× median
19318
CPT 		Breast Reduction 5 $9,399.60 $10,026.24 $9,921.80 nat. median
$6,868
1.4× median
49652
CPT 		Lap Vent/abd Hernia Repair 5 $9,180.00 $10,368.00 $9,720.00 nat. median
$5,168
1.9× median
28297
CPT 		Cor Hlx Vlgs Jt Arthrd 5 $8,759.70 $10,934.61 $9,246.35 nat. median
$7,413
1.2× median
440
MS_DRG 		Disorders Of Pancreas Except Malignancy Without Cc/mcc 4 $8,929.14 $9,425.20 $8,961.81 nat. median
$7,284
1.2× median
1200657
LOCAL 		Lap Chole 4 $7,992.00 $8,524.80 $8,214.00 nat. median
$8,214
1.0× median
58661
CPT 		Laparoscopy Remove Adnexa 5 $1,355.40 $8,647.68 $8,107.20 nat. median
$5,935
1.4× median
49321
CPT 		Laparoscopy Biopsy 5 $7,567.20 $9,414.63 $7,987.60 nat. median
$5,690
1.4× median
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 4 $7,748.26 $11,570.74 $7,963.49 nat. median
$8,869
0.9× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 4 $7,612.28 $10,893.12 $7,823.73 nat. median
$8,588
0.9× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 4 $7,587.54 $15,048.48 $7,798.31 nat. median
$11,029
0.7× median
603
MS_DRG 		Cellulitis Without Mcc 4 $7,497.16 $12,370.40 $7,705.41 nat. median
$9,525
0.8× median
948
MS_DRG 		Signs And Symptoms Without Mcc 4 $7,403.63 $10,495.28 $7,609.28 nat. median
$8,463
0.9× median
44970
CPT 		Laparoscopy Appendectomy 5 $7,469.21 $8,113.92 $7,606.80 nat. median
$5,994
1.3× median
44120
CPT 		Removal Of Small Intestine 5 $7,038.00 $7,948.80 $7,452.00 nat. median
$2,885
outlier · 2.6×
1200816
LOCAL 		Repair Of Small Intestine 4 $7,176.60 $7,655.04 $7,375.95 nat. median
$7,376
1.0× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 4 $7,111.42 $10,817.75 $7,308.96 nat. median
$7,228
1.0× median
28485
CPT 		Optx Metatarsal Fx Each 5 $6,903.00 $10,934.61 $7,286.50 nat. median
$7,162
1.0× median
1200014
LOCAL 		Amputation, Leg Bilateral 4 $6,900.30 $7,360.32 $7,091.98 nat. median
$7,092
1.0× median
58670
CPT 		Laparoscopy Tubal Cautery 5 $778.50 $7,505.28 $6,981.71 nat. median
$5,654
1.2× median
694
MS_DRG 		Urinary Stones Without Mcc 4 $6,773.07 $11,804.04 $6,961.21 nat. median
$8,610
0.8× median
26535
CPT 		Revise Finger Joint 5 $6,488.10 $6,920.64 $6,652.83 nat. median
$3,646
1.8× median
49322
CPT 		Laparoscopy Aspiration 5 $6,299.10 $9,414.63 $6,649.05 nat. median
$5,632
1.2× median
1200482
LOCAL 		Hernia Repair Incisional/ventral-bilater 4 $6,443.10 $6,872.64 $6,622.08 nat. median
$6,622
1.0× median
2107534
LOCAL 		Surgimesh Elipses Ventral 4 $6,390.00 $6,816.00 $6,567.50 nat. median
$6,568
1.0× median
44005
CPT 		Freeing Of Bowel Adhesion 5 $5,879.34 $6,949.44 $6,515.10 nat. median
$2,511
outlier · 2.6×
1200154
LOCAL 		Cesarean Delivery 4 $6,318.00 $6,739.20 $6,493.50 nat. median
$6,494
1.0× median
1600464
LOCAL 		Cauterization Of Cervix 4 $6,145.20 $6,554.88 $6,315.90 nat. median
$6,316
1.0× median
42440
CPT 		Excise Submaxillary Gland 5 $3,450.24 $6,610.56 $6,197.40 nat. median
$5,823
1.1× median
1200146
LOCAL 		Laparoscopy Lymph Node Bx 4 $6,021.00 $6,422.40 $6,188.25 nat. median
$6,188
1.0× median
15275
CPT 		Skin Sub Graft Face/nk/hf/g 5 $5,803.20 $6,190.08 $6,125.60 nat. median
$1,725
outlier · 3.6×
28820
CPT 		Amputation Of Toe 5 $5,803.20 $6,190.08 $5,889.03 nat. median
$3,405
1.7× median
15738
CPT 		Muscle-skin Graft Leg 5 $3,186.99 $6,220.80 $5,832.00 nat. median
$3,855
1.5× median
1200483
LOCAL 		Hernia Repair Inguinal 4 $5,580.00 $5,952.00 $5,735.00 nat. median
$5,735
1.0× median

Other procedures at this hospital

Browse this hospital's 4,083 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
             
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 4 4 $34,529.53 $34,529.53 $13,060.47 $32,803.05 $31,076.58 2025-02-28
787 MS_DRG Cesarean Section Without Sterilization With Cc 4 4 $26,895.74 $26,895.74 $15,052.03 $25,550.96 $24,206.17 2025-02-28
J2507 HCPCS Pegloticase Injection 5 5 $25,347.56 $25,347.56 $4,336.51 $24,333.66 $22,812.80 2025-02-28
552 MS_DRG Medical Back Problems Without Mcc 4 4 $25,281.15 $25,281.15 $12,579.39 $24,017.09 $22,753.03 2025-02-28
C1713 HCPCS Anchor/screw Bn/bn,tis/bn 4 4 $19,762.00 $19,762.00 $17,785.80 $18,971.52 $18,279.85 2025-02-28
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 4 4 $17,758.01 $17,758.01 $8,631.66 $16,870.10 $15,982.20 2025-02-28
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 4 4 $17,179.30 $17,179.30 $15,461.37 $17,433.92 $15,890.85 2025-02-28
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 4 4 $17,174.41 $17,174.41 $12,132.03 $16,315.69 $15,456.97 2025-02-28
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 4 4 $16,038.97 $16,038.97 $14,435.07 $26,527.13 $14,836.05 2025-02-28
49651 CPT Lap Ing Hernia Repair Recur 5 5 $13,646.00 $13,646.00 $12,281.40 $13,100.16 $12,963.70 2025-02-28
49654 CPT Lap Hernia Repair 5 5 $13,422.00 $13,422.00 $11,408.70 $12,885.12 $12,079.80 2025-02-28
49653 CPT Hernia Repair Ventral Laproscopy 5 5 $12,960.00 $12,960.00 $11,016.00 $12,441.60 $11,664.00 2025-02-28
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 4 4 $12,074.89 $12,074.89 $10,867.40 $14,155.66 $11,169.27 2025-02-28
28750 CPT Fusion Of Big Toe Joint 5 5 $11,718.64 $11,718.64 $10,546.78 $11,699.18 $11,132.71 2025-02-28
28299 CPT Cor Hlx Vlgs Double Osteot 5 5 $11,973.00 $11,973.00 $10,775.70 $11,494.08 $10,934.61 2025-02-28
177 MS_DRG Respiratory Infections And Inflammations With Mcc 4 4 $11,099.65 $11,099.65 $9,989.68 $30,052.69 $10,267.17 2025-02-28
28735 CPT Fusion Of Foot Bones 5 5 $10,494.00 $10,494.00 $9,444.60 $10,532.72 $9,969.30 2025-02-28
19318 CPT Breast Reduction 5 5 $10,444.00 $10,444.00 $9,399.60 $10,026.24 $9,921.80 2025-02-28
49652 CPT Lap Vent/abd Hernia Repair 5 5 $10,800.00 $10,800.00 $9,180.00 $10,368.00 $9,720.00 2025-02-28
28297 CPT Cor Hlx Vlgs Jt Arthrd 5 5 $9,733.00 $9,733.00 $8,759.70 $10,934.61 $9,246.35 2025-02-28
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 4 4 $9,921.27 $9,921.27 $8,929.14 $9,425.20 $8,961.81 2025-02-28
1200657 LOCAL Lap Chole 4 4 $8,880.00 $8,880.00 $7,992.00 $8,524.80 $8,214.00 2025-02-28
58661 CPT Laparoscopy Remove Adnexa 9 5 $1,506.00 $1,506.00 $1,355.40 $8,647.68 $8,107.20 2025-02-28
49321 CPT Laparoscopy Biopsy 5 5 $8,408.00 $8,408.00 $7,567.20 $9,414.63 $7,987.60 2025-02-28
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 4 4 $8,609.17 $8,609.17 $7,748.26 $11,570.74 $7,963.49 2025-02-28
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 4 4 $8,458.09 $8,458.09 $7,612.28 $10,893.12 $7,823.73 2025-02-28
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 4 4 $8,430.60 $8,430.60 $7,587.54 $15,048.48 $7,798.31 2025-02-28
603 MS_DRG Cellulitis Without Mcc 4 4 $8,330.18 $8,330.18 $7,497.16 $12,370.40 $7,705.41 2025-02-28
948 MS_DRG Signs And Symptoms Without Mcc 4 4 $8,226.26 $8,226.26 $7,403.63 $10,495.28 $7,609.28 2025-02-28
44970 CPT Laparoscopy Appendectomy 5 5 $8,452.00 $8,452.00 $7,469.21 $8,113.92 $7,606.80 2025-02-28
44120 CPT Removal Of Small Intestine 5 5 $8,280.00 $8,280.00 $7,038.00 $7,948.80 $7,452.00 2025-02-28
1200816 LOCAL Repair Of Small Intestine 4 4 $7,974.00 $7,974.00 $7,176.60 $7,655.04 $7,375.95 2025-02-28
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 4 4 $7,901.58 $7,901.58 $7,111.42 $10,817.75 $7,308.96 2025-02-28
28485 CPT Optx Metatarsal Fx Each 5 5 $7,670.00 $7,670.00 $6,903.00 $10,934.61 $7,286.50 2025-02-28
1200014 LOCAL Amputation, Leg Bilateral 4 4 $7,667.00 $7,667.00 $6,900.30 $7,360.32 $7,091.98 2025-02-28
58670 CPT Laparoscopy Tubal Cautery 9 5 $865.00 $865.00 $778.50 $7,505.28 $6,981.71 2025-02-28
694 MS_DRG Urinary Stones Without Mcc 4 4 $7,525.63 $7,525.63 $6,773.07 $11,804.04 $6,961.21 2025-02-28
26535 CPT Revise Finger Joint 5 5 $7,209.00 $7,209.00 $6,488.10 $6,920.64 $6,652.83 2025-02-28
49322 CPT Laparoscopy Aspiration 5 5 $6,999.00 $6,999.00 $6,299.10 $9,414.63 $6,649.05 2025-02-28
1200482 LOCAL Hernia Repair Incisional/ventral-bilater 4 4 $7,159.00 $7,159.00 $6,443.10 $6,872.64 $6,622.08 2025-02-28
2107534 LOCAL Surgimesh Elipses Ventral 4 4 $7,100.00 $7,100.00 $6,390.00 $6,816.00 $6,567.50 2025-02-28
44005 CPT Freeing Of Bowel Adhesion 5 5 $7,239.00 $7,239.00 $5,879.34 $6,949.44 $6,515.10 2025-02-28
1200154 LOCAL Cesarean Delivery 4 4 $7,020.00 $7,020.00 $6,318.00 $6,739.20 $6,493.50 2025-02-28
1600464 LOCAL Cauterization Of Cervix 4 4 $6,828.00 $6,828.00 $6,145.20 $6,554.88 $6,315.90 2025-02-28
42440 CPT Excise Submaxillary Gland 5 5 $6,886.00 $6,886.00 $3,450.24 $6,610.56 $6,197.40 2025-02-28
1200146 LOCAL Laparoscopy Lymph Node Bx 4 4 $6,690.00 $6,690.00 $6,021.00 $6,422.40 $6,188.25 2025-02-28
15275 CPT Skin Sub Graft Face/nk/hf/g 5 5 $6,448.00 $6,448.00 $5,803.20 $6,190.08 $6,125.60 2025-02-28
28820 CPT Amputation Of Toe 5 5 $6,448.00 $6,448.00 $5,803.20 $6,190.08 $5,889.03 2025-02-28
15738 CPT Muscle-skin Graft Leg 5 5 $6,480.00 $6,480.00 $3,186.99 $6,220.80 $5,832.00 2025-02-28
1200483 LOCAL Hernia Repair Inguinal 4 4 $6,200.00 $6,200.00 $5,580.00 $5,952.00 $5,735.00 2025-02-28
54660 CPT Revision Of Testis 5 5 $6,264.00 $6,264.00 $5,324.40 $6,013.44 $5,637.60 2025-02-28
28272 CPT Release Of Toe Joint Each 5 5 $6,000.00 $6,000.00 $5,400.00 $5,760.00 $5,509.89 2025-02-28
26525 CPT Release Finger Contracture 5 5 $6,033.00 $6,033.00 $5,429.70 $5,791.68 $5,509.89 2025-02-28
49568 CPT Implantation Of Mesh/other Prosthesis 5 5 $6,088.00 $6,088.00 $5,174.80 $5,844.48 $5,479.20 2025-02-28
1200636 LOCAL Mastectomy Partial Lumpectomy 4 4 $5,913.00 $5,913.00 $5,321.70 $5,676.48 $5,469.52 2025-02-28
2107538 LOCAL Surgimesh Tintra E2226 4 4 $5,901.00 $5,901.00 $5,310.90 $5,664.96 $5,458.42 2025-02-28
21554 CPT Exc Neck Tum Deep 5 Cm/> 9 5 $1,686.00 $1,686.00 $1,517.40 $7,481.67 $5,434.20 2025-02-28
28122 CPT Partial Removal Of Foot Bone 5 5 $5,904.00 $5,904.00 $5,313.60 $5,667.84 $5,392.28 2025-02-28
1200012 LOCAL Amputation-leg 4 4 $5,828.00 $5,828.00 $5,245.20 $5,594.88 $5,390.90 2025-02-28
59510 CPT Cesarean Delivery 5 5 $5,927.00 $5,927.00 $5,037.95 $5,689.92 $5,334.30 2025-02-28
19300 CPT Mastectomy For Gynecomastia 5 5 $5,913.00 $5,913.00 $4,445.83 $5,676.48 $5,321.70 2025-02-28
38510 CPT Biopsy/removal Lymph Nodes 9 5 $5,906.00 $5,906.00 $848.70 $5,669.76 $5,315.40 2025-02-28
49592 CPT Rpr Aa Hrn 1st < 3 Ncr/strn 9 5 $5,879.00 $5,879.00 $952.20 $5,643.84 $5,291.10 2025-02-28
49002 CPT Reopening Of Abdomen 5 5 $5,841.00 $5,841.00 $4,964.85 $5,607.36 $5,256.90 2025-02-28
J1569 HCPCS Gammagard Liquid/erc Inj 13 5 $5,777.10 $5,777.10 $55.60 $7,922.88 $5,199.39 2025-02-28
49591 CPT Rpr Aa Hrn 1st < 3 Cm Rdc 9 5 $773.00 $773.00 $695.70 $5,489.28 $5,146.20 2025-02-28
49593 CPT Rpr Aa Hrn 1st 3-10 Rdc 9 5 $5,687.00 $5,687.00 $1,142.10 $5,459.52 $5,118.30 2025-02-28
J1950 HCPCS Leuprolide Acetate /3.75 Mg 13 5 $5,642.44 $5,642.44 $2,027.50 $9,506.47 $5,078.20 2025-02-28
58720 CPT Removal Of Ovary/tube(s) 15 5 $5,581.00 $5,581.00 $1,496.85 $8,023.68 $5,022.90 2025-02-28
26951 CPT Amputation Of Finger/thumb 5 5 $5,363.00 $5,363.00 $4,826.70 $5,148.48 $4,925.15 2025-02-28
58150 CPT Total Hysterectomy 5 5 $5,471.00 $5,471.00 $3,318.14 $5,252.16 $4,923.90 2025-02-28
2107536 LOCAL Surgimesh Tintra E1522 4 4 $5,300.00 $5,300.00 $4,770.00 $5,088.00 $4,902.50 2025-02-28
28315 CPT Removal Of Sesamoid Bone 5 5 $5,141.00 $5,141.00 $4,626.90 $4,935.36 $4,883.95 2025-02-28
59400 CPT Obstetrical Care 5 5 $5,411.00 $5,411.00 $4,599.35 $5,194.56 $4,869.90 2025-02-28
1600893 LOCAL Removal Of Foot Lesion 4 4 $5,221.00 $5,221.00 $4,698.90 $5,012.16 $4,829.42 2025-02-28
27301 CPT Drain Thigh/knee Lesion 5 5 $5,025.00 $5,025.00 $4,522.50 $5,026.98 $4,773.75 2025-02-28
41110 CPT Excision Of Tongue Lesion 5 5 $5,159.00 $5,159.00 $4,643.10 $4,952.64 $4,711.84 2025-02-28
28298 CPT Cor Hlx Vlgs Prx Phlx Osteot 5 5 $5,034.00 $5,034.00 $4,530.60 $4,832.64 $4,622.94 2025-02-28
29877 CPT Arthrs Knee Surg Dbrdmt/shvg 5 5 $4,860.00 $4,860.00 $4,374.00 $5,259.44 $4,617.00 2025-02-28
29881 CPT Arthrs Kne Srg Mnisectmy M/l 5 5 $4,860.00 $4,860.00 $4,374.00 $4,925.15 $4,617.00 2025-02-28
28296 CPT Cor Hlx Vlgs Dstl Mtar Osteo 5 5 $4,988.00 $4,988.00 $4,489.20 $4,788.48 $4,555.14 2025-02-28
28289 CPT Corrj Halux Rigdus Without Implt 5 5 $4,957.00 $4,957.00 $4,461.30 $4,758.72 $4,552.37 2025-02-28
55500 CPT Removal Of Hydrocele 5 5 $4,774.00 $4,774.00 $4,296.60 $5,548.64 $4,535.30 2025-02-28
49320 CPT Diag Laparo Separate Proc 5 5 $4,752.00 $4,752.00 $4,276.80 $9,414.63 $4,514.40 2025-02-28
Q4104 HCPCS Integra Bmwd 4 4 $4,800.00 $4,800.00 $4,320.00 $4,608.00 $4,440.00 2025-02-28
1200481 LOCAL Hernia Repair Incisional/ventral 4 4 $4,773.00 $4,773.00 $4,295.70 $4,582.08 $4,415.02 2025-02-28
19370 CPT Revj Peri-implt Capsule Brst 9 5 $4,860.00 $4,860.00 $3,229.20 $4,665.60 $4,374.00 2025-02-28
19371 CPT Peri-implt Capslc Brst Compl 9 5 $3,588.00 $3,588.00 $3,229.20 $4,665.60 $4,374.00 2025-02-28
30465 CPT Repair Nasal Stenosis 5 5 $4,860.00 $4,860.00 $3,450.24 $4,665.60 $4,374.00 2025-02-28
28285 CPT Repair Of Hammertoe 5 5 $4,552.00 $4,552.00 $4,096.80 $4,925.15 $4,324.40 2025-02-28
55520 CPT Removal Of Sperm Cord Lesion 9 5 $4,774.00 $4,774.00 $940.50 $5,415.80 $4,296.60 2025-02-28
49587 CPT Hernia Repair Umbilical 5 Yrs Or Older 5 5 $4,773.00 $4,773.00 $4,057.05 $4,582.08 $4,295.70 2025-02-28
46080 CPT Sphnctrotmy Anal Div Sphnctr 5 5 $4,770.00 $4,770.00 $1,692.27 $4,579.20 $4,293.00 2025-02-28
J2506 HCPCS Inj Pegfilgrast Ex Bio 0.5mg 5 5 $4,538.56 $4,538.56 $135.05 $4,357.02 $4,084.70 2025-02-28
42410 CPT Excise Parotid Gland/lesion 5 5 $4,536.00 $4,536.00 $3,450.24 $4,354.56 $4,082.40 2025-02-28
22901 CPT Exc Abdl Tum Deep 5 Cm/> 5 5 $4,293.00 $4,293.00 $3,863.70 $4,196.76 $4,078.35 2025-02-28
26727 CPT Treat Finger Fracture Each 5 5 $4,244.00 $4,244.00 $3,819.60 $5,259.44 $4,031.80 2025-02-28
1200556 LOCAL Tubal Ligation Or Transection Of Tubes 4 4 $4,293.00 $4,293.00 $3,863.70 $4,121.28 $3,971.02 2025-02-28
28585 CPT Repair Foot Dislocation 5 5 $4,180.00 $4,180.00 $3,762.00 $4,012.80 $3,967.07 2025-02-28
14061 CPT Tis Trnfr E/n/e/l10.1-30sqcm 5 5 $4,352.00 $4,352.00 $3,249.91 $4,177.92 $3,916.80 2025-02-28
49650 CPT Repair Of Groin Hernia Using An Endoscope 13 5 $4,115.00 $4,115.00 $893.70 $10,361.28 $3,909.25 2025-02-28
27090 CPT Removal Of Hip Prosthesis 5 5 $4,325.00 $4,325.00 $3,676.25 $4,152.00 $3,892.50 2025-02-28
69310 CPT Rebuild Outer Ear Canal 5 5 $4,320.00 $4,320.00 $3,672.00 $4,147.20 $3,888.00 2025-02-28
15733 CPT Musc Myoq/fscq Flp H&n Pedcl 5 5 $4,320.00 $4,320.00 $2,573.46 $4,147.20 $3,888.00 2025-02-28
49585 CPT Open Hernia Repair Umbilical 5 5 $4,298.00 $4,298.00 $3,653.30 $4,126.08 $3,868.20 2025-02-28
22905 CPT Rad Resect Abd Tumor 5 Cm/> 5 5 $4,293.00 $4,293.00 $3,228.17 $4,121.28 $3,863.70 2025-02-28
20680 CPT Removal Of Implant Deep 5 5 $4,074.00 $4,074.00 $3,666.60 $3,911.04 $3,857.76 2025-02-28
14041 CPT Tis Trnfr F/c/c/m/n/a/g/h/f 5 5 $4,185.00 $4,185.00 $3,067.66 $4,017.60 $3,766.50 2025-02-28
L8699 HCPCS Prosthetic Implant Nos 4 4 $4,050.00 $4,050.00 $3,645.00 $3,888.00 $3,746.25 2025-02-28
28760 CPT Fusion Of Big Toe Joint 5 5 $3,930.00 $3,930.00 $3,537.00 $3,925.56 $3,733.50 2025-02-28
28306 CPT Incision Of Metatarsal 5 5 $4,083.00 $4,083.00 $3,674.70 $3,919.68 $3,729.07 2025-02-28
49613 CPT Rpr Aa Hrn Rcr < 3 Rdc 9 5 $4,137.00 $4,137.00 $852.30 $6,145.01 $3,723.30 2025-02-28
21556 CPT Exc Neck Tum Deep < 5 Cm 9 5 $1,238.00 $1,238.00 $1,114.20 $3,961.92 $3,714.30 2025-02-28
28110 CPT Part Removal Of Metatarsal 5 5 $3,903.00 $3,903.00 $3,512.70 $3,900.65 $3,707.85 2025-02-28
794 MS_DRG Neonate With Other Significant Problems 3 3 $4,010.28 $4,010.28 $3,609.25 $3,809.76 $3,609.25 2025-02-28
60500 CPT Explore Parathyroid Glands 5 5 $3,789.00 $3,789.00 $3,410.10 $8,831.14 $3,599.55 2025-02-28
70549 CPT Mr Angiograph Neck W/O&with Contrast 5 5 $3,985.00 $3,985.00 $910.95 $3,825.60 $3,586.50 2025-02-28
J1162 HCPCS Digoxin Immune Fab (ovine) 5 5 $3,758.95 $3,758.95 $3,383.05 $6,145.65 $3,571.00 2025-02-28
1700272 LOCAL Closed Tx Of Skeletal Fix Of Radial 4 4 $3,817.00 $3,817.00 $3,435.30 $3,664.32 $3,530.73 2025-02-28
1200493 LOCAL Hernia Repair Epigastric 4 4 $3,817.00 $3,817.00 $3,435.30 $3,664.32 $3,530.73 2025-02-28
30520 CPT Repair Of Nasal Septum 5 5 $3,698.00 $3,698.00 $3,328.20 $4,711.84 $3,513.10 2025-02-28
200017 LOCAL Vaginal Delivery 4 4 $3,780.00 $3,780.00 $3,402.00 $3,628.80 $3,496.50 2025-02-28
19162 CPT Prtl Mastectomy W Ln Removal 5 5 $3,851.00 $3,851.00 $3,273.35 $3,696.96 $3,465.90 2025-02-28
14020 CPT Tis Trnfr S/a/l 10 Sq Cm/< 5 5 $3,822.00 $3,822.00 $2,997.09 $3,669.12 $3,439.80 2025-02-28
1200491 LOCAL Hernia Repair Umbilical 4 4 $3,688.00 $3,688.00 $3,319.20 $3,540.48 $3,411.40 2025-02-28
38740 CPT Remove Armpit Lymph Nodes 5 5 $3,558.00 $3,558.00 $3,202.20 $4,633.09 $3,380.10 2025-02-28
21933 CPT Exc Back Tum Deep 5 Cm/> 9 5 $1,692.00 $1,692.00 $1,522.80 $4,620.17 $3,356.10 2025-02-28
1700201 LOCAL Wound Repair Extensor Tendon Finger 4 4 $3,610.00 $3,610.00 $3,249.00 $3,465.60 $3,339.25 2025-02-28
1200519 LOCAL Excision Ganglion Wrist 4 4 $3,610.00 $3,610.00 $3,249.00 $3,465.60 $3,339.25 2025-02-28
1600752 LOCAL Urethral Dilation (men) 4 4 $3,610.00 $3,610.00 $3,249.00 $3,465.60 $3,339.25 2025-02-28
14301 CPT Tis Trnfr Any 30.1-60 Sq Cm 5 5 $3,510.00 $3,510.00 $3,159.00 $3,578.15 $3,334.50 2025-02-28
72191 CPT CT Angiograph Pelv W/O&with Contrast 5 5 $3,671.00 $3,671.00 $3,120.35 $3,524.16 $3,303.90 2025-02-28
26160 CPT Remove Tendon Sheath Lesion 5 5 $3,610.00 $3,610.00 $2,842.12 $3,465.60 $3,249.00 2025-02-28
81220 CPT Cftr Gene Com Variants 5 5 $3,456.00 $3,456.00 $3,110.40 $3,317.76 $3,248.60 2025-02-28
73220 CPT MRI Uppr Extremity W/O&with Contrast 5 5 $3,598.00 $3,598.00 $756.95 $3,454.08 $3,238.20 2025-02-28
71552 CPT MRI Chest Without & With Contrast 5 5 $3,598.00 $3,598.00 $756.95 $3,454.08 $3,238.20 2025-02-28
73223 CPT MRI Joint Upr Extr W/O&with Contrast 5 5 $3,598.00 $3,598.00 $756.95 $3,454.08 $3,238.20 2025-02-28
70543 CPT MRI Orbt/fac/nck Without &with Contrast 5 5 $3,598.00 $3,598.00 $756.95 $3,454.08 $3,238.20 2025-02-28
795 MS_DRG Normal Newborn 4 4 $3,594.40 $3,594.40 $2,542.82 $3,414.68 $3,234.96 2025-02-28
15823 CPT Blepharp Upr Eyelid Xcsv Skn 9 5 $3,332.00 $3,332.00 $2,335.69 $4,250.88 $3,198.72 2025-02-28
J0840 HCPCS Crotalidae Poly Immune Fab 5 5 $3,550.26 $3,550.26 $2,436.16 $3,408.25 $3,195.23 2025-02-28
46040 CPT I&d Ischiorct&/perirct Absc 9 5 $3,843.00 $3,843.00 $2,660.40 $3,689.28 $3,190.81 2025-02-28
15271 CPT Skin Sub Graft Trnk/arm/leg 5 5 $3,333.00 $3,333.00 $2,999.70 $4,130.34 $3,166.35 2025-02-28
55540 CPT Revise Hernia & Sperm Veins 5 5 $3,460.00 $3,460.00 $2,955.58 $3,321.60 $3,114.00 2025-02-28
29848 CPT Wrist Endoscopy/surgery 5 5 $3,240.00 $3,240.00 $2,916.00 $3,706.93 $3,078.00 2025-02-28
55250 CPT Removal Of Sperm Duct(s) 9 5 $540.00 $540.00 $486.00 $3,321.60 $3,074.66 2025-02-28
14060 CPT Tis Trnfr E/n/e/l 10 Sq Cm/< 5 5 $3,381.00 $3,381.00 $2,614.58 $3,245.76 $3,042.90 2025-02-28
67950 CPT Revision Of Eyelid 5 5 $3,375.00 $3,375.00 $1,543.99 $3,240.00 $3,037.50 2025-02-28
15731 CPT Forehead Flap W/vasc Pedicle 5 5 $3,375.00 $3,375.00 $2,868.75 $3,240.00 $3,037.50 2025-02-28
81420 CPT Fetal Chrmoml Aneuploidy 5 5 $3,158.00 $3,158.00 $2,842.20 $3,152.07 $3,000.10 2025-02-28
21014 CPT Exc Face Tum Deep 2 Cm/> 9 5 $1,222.00 $1,222.00 $1,099.80 $3,438.72 $2,959.73 2025-02-28
28309 CPT Incision Of Metatarsals 5 5 $3,237.00 $3,237.00 $2,913.30 $3,107.52 $2,955.58 2025-02-28
28160 CPT Partial Removal Of Toe 5 5 $3,240.00 $3,240.00 $2,916.00 $3,110.40 $2,955.58 2025-02-28
28308 CPT Incision Of Metatarsal 5 5 $3,237.00 $3,237.00 $2,913.30 $3,107.52 $2,955.58 2025-02-28
28313 CPT Repair Deformity Of Toe 5 5 $3,111.00 $3,111.00 $2,799.90 $2,986.56 $2,955.45 2025-02-28
J3240 HCPCS Thyrotropin Injection 5 5 $3,260.99 $3,260.99 $2,596.62 $3,130.55 $2,934.89 2025-02-28
13152 CPT Cmplx Rpr E/n/e/l 2.6-7.5 Cm 13 5 $3,219.00 $3,219.00 $709.20 $3,337.92 $2,897.10 2025-02-28
1700209 LOCAL Tx Of Incomplete Abortion 4 4 $3,131.00 $3,131.00 $2,817.90 $3,005.76 $2,896.18 2025-02-28
21936 CPT Resect Back Tum 5 Cm/> 5 5 $3,213.00 $3,213.00 $2,731.05 $3,084.48 $2,891.70 2025-02-28
15946 CPT Exc Isch Pr Ulc Prep Mus Flp 5 5 $3,213.00 $3,213.00 $1,619.97 $3,084.48 $2,891.70 2025-02-28
54161 CPT Circum 28 Days Or Older 5 5 $3,042.00 $3,042.00 $2,737.80 $3,769.20 $2,889.90 2025-02-28
70498 CPT CT Angiography Neck 5 5 $3,190.00 $3,190.00 $1,588.71 $3,062.40 $2,871.00 2025-02-28
67914 CPT Repair Eyelid Defect 5 5 $3,176.00 $3,176.00 $1,304.24 $3,048.96 $2,858.40 2025-02-28
11406 CPT Exc Tr-ext B9+marg >4.0 Cm 13 5 $3,043.00 $3,043.00 $517.50 $3,154.56 $2,846.27 2025-02-28
26765 CPT Treat Finger Fracture Each 9 5 $3,143.00 $3,143.00 $1,075.50 $3,017.28 $2,828.70 2025-02-28
15260 CPT Fth/gft Fr N/e/e/l 20 Sqcm/< 5 5 $3,132.00 $3,132.00 $2,024.35 $3,006.72 $2,818.80 2025-02-28
58120 CPT Dilation And Curettage 5 5 $3,131.00 $3,131.00 $2,612.43 $3,005.76 $2,817.90 2025-02-28
59820 CPT Care Of Miscarriage 5 5 $3,131.00 $3,131.00 $2,645.63 $3,005.76 $2,817.90 2025-02-28
59812 CPT Treatment Of Miscarriage 9 5 $3,131.00 $3,131.00 $562.50 $3,005.76 $2,817.90 2025-02-28
15820 CPT Blepharoplasty Lower Eyelid 5 5 $3,127.00 $3,127.00 $2,150.27 $3,001.92 $2,814.30 2025-02-28
64718 CPT Revise Ulnar Nerve At Elbow 5 5 $2,959.00 $2,959.00 $2,663.10 $3,396.98 $2,811.05 2025-02-28
19328 CPT Rmvl Intact Breast Implant 9 5 $2,916.00 $2,916.00 $1,701.36 $4,199.04 $2,799.36 2025-02-28
1200475 LOCAL Carpal Tunnel 4 4 $2,959.00 $2,959.00 $2,663.10 $2,840.64 $2,737.07 2025-02-28
J9217 HCPCS Leuprolide Acetate Suspnsion 9 5 $2,913.00 $2,913.00 $238.83 $2,835.84 $2,658.60 2025-02-28
11446 CPT Exc Face-mm B9+marg >4 Cm 9 5 $743.00 $743.00 $668.70 $3,960.15 $2,655.00 2025-02-28
74181 CPT MRI Abdomen Without Contrast 5 5 $2,949.00 $2,949.00 $756.95 $2,831.04 $2,654.10 2025-02-28
64721 CPT Release And/or Relocation Of Hand Nerve 5 5 $2,930.00 $2,930.00 $2,224.99 $2,812.80 $2,637.00 2025-02-28
74170 CPT CT Abd Wo Cntrst Flwd Cntrst 5 5 $2,919.00 $2,919.00 $658.16 $2,802.24 $2,627.10 2025-02-28
70482 CPT CT Orbit/ear/fossa W/O&with Contrast 5 5 $2,919.00 $2,919.00 $658.16 $2,802.24 $2,627.10 2025-02-28
70544 CPT Mr Angiography Head Without Contrast 5 5 $2,905.00 $2,905.00 $910.95 $2,788.80 $2,614.50 2025-02-28
36590 CPT Removal Tunneled Cv Cath 5 5 $2,758.00 $2,758.00 $2,482.20 $2,647.68 $2,612.43 2025-02-28
30140 CPT Resect Inferior Turbinate 5 5 $2,738.00 $2,738.00 $2,464.20 $3,358.24 $2,601.10 2025-02-28
15220 CPT Fth/gft Fr S/a/l 20 Sq Cm/< 5 5 $2,889.00 $2,889.00 $477.38 $2,773.44 $2,600.10 2025-02-28
59515 CPT Cesarean Delivery 5 5 $2,887.00 $2,887.00 $2,453.95 $2,771.52 $2,598.30 2025-02-28
3419828 LOCAL Tocilizumab (actemra) Sdv 400mg/20ml 4 4 $2,805.80 $2,805.80 $2,525.22 $2,693.57 $2,595.36 2025-02-28
1700199 LOCAL Wound Superficial Repair 4 4 $2,804.00 $2,804.00 $2,523.60 $2,691.84 $2,593.70 2025-02-28
1200205 LOCAL Repair Superficial Wound(s) 4 4 $2,804.00 $2,804.00 $2,523.60 $2,691.84 $2,593.70 2025-02-28
1600471 LOCAL Colposcopy Of The Cervix 4 4 $2,804.00 $2,804.00 $2,523.60 $2,691.84 $2,593.70 2025-02-28
1600895 LOCAL Removal Of Foreign Body Foot 4 4 $2,804.00 $2,804.00 $2,523.60 $2,691.84 $2,593.70 2025-02-28
72149 CPT MRI Lumbar Spine With Contrast 5 5 $2,878.00 $2,878.00 $756.95 $2,762.88 $2,590.20 2025-02-28
70552 CPT MRI Brain Stem With Contrast 5 5 $2,878.00 $2,878.00 $756.95 $2,762.88 $2,590.20 2025-02-28
73719 CPT MRI Lower Extremity With Contrast 5 5 $2,878.00 $2,878.00 $756.95 $2,762.88 $2,590.20 2025-02-28
73222 CPT MRI Joint Upr Extrem With Contrast 5 5 $2,878.00 $2,878.00 $756.95 $2,762.88 $2,590.20 2025-02-28
72142 CPT MRI Neck Spine With Contrast 5 5 $2,878.00 $2,878.00 $756.95 $2,762.88 $2,590.20 2025-02-28
72147 CPT MRI Chest Spine With Contrast 5 5 $2,878.00 $2,878.00 $756.95 $2,762.88 $2,590.20 2025-02-28
2106991 LOCAL Post Partum Hemorrhage Kit 4 4 $2,790.00 $2,790.00 $2,511.00 $2,678.40 $2,580.75 2025-02-28
11426 CPT Exc H-f-nk-sp B9+marg >4 Cm 9 5 $629.00 $629.00 $566.10 $3,345.60 $2,579.22 2025-02-28
73706 CPT CT Angio Lwr Extr W/O&with Contrast 5 5 $2,863.00 $2,863.00 $2,433.55 $2,748.48 $2,576.70 2025-02-28
25000 CPT Incision Of Tendon Sheath 5 5 $2,862.00 $2,862.00 $2,517.50 $2,966.65 $2,575.80 2025-02-28
23140 CPT Removal Of Bone Lesion 5 5 $2,700.00 $2,700.00 $2,430.00 $3,735.99 $2,565.00 2025-02-28
64479 CPT Njx Aa&/strd Tfrm Epi C/t 1 9 5 $2,642.00 $2,642.00 $995.73 $2,738.88 $2,536.32 2025-02-28
46922 CPT Excision Of Anal Lesion(s) 5 5 $2,700.00 $2,700.00 $2,430.00 $2,592.00 $2,528.02 2025-02-28
26116 CPT Exc Hand Tum Deep < 1.5 Cm 9 5 $1,241.00 $1,241.00 $1,116.90 $2,797.84 $2,527.20 2025-02-28
74174 CPT CTA Abd&plvs W/contrast 5 5 $2,806.00 $2,806.00 $2,334.69 $2,693.76 $2,525.40 2025-02-28
70540 CPT MRI Orbit/face/neck Without Contrast 5 5 $2,778.00 $2,778.00 $756.95 $2,666.88 $2,500.20 2025-02-28
1200132 LOCAL Hemorrhoidectomy Internal/external 4 4 $2,697.00 $2,697.00 $2,427.30 $2,589.12 $2,494.73 2025-02-28
19120 CPT Removal Of Breast Lesion 9 5 $2,770.00 $2,770.00 $514.80 $5,675.90 $2,493.00 2025-02-28
27818 CPT Treatment Of Ankle Fracture 9 5 $1,044.00 $1,044.00 $939.60 $2,654.40 $2,488.50 2025-02-28
55040 CPT Removal Of Hydrocele 5 5 $2,608.00 $2,608.00 $2,347.20 $2,777.35 $2,477.60 2025-02-28
1700296 LOCAL Foreign Body Removal Of Foot 4 4 $2,672.00 $2,672.00 $2,404.80 $2,565.12 $2,471.60 2025-02-28
1700246 LOCAL Wound Repair-inter-scalp, Axillae, Trunk 4 4 $2,670.00 $2,670.00 $2,403.00 $2,563.20 $2,469.75 2025-02-28
51045 CPT Incise Bladder/drain Ureter 5 5 $2,739.00 $2,739.00 $2,328.15 $2,629.44 $2,465.10 2025-02-28
2113524 LOCAL Misc Surgimesh 4 4 $2,658.00 $2,658.00 $2,392.20 $2,551.68 $2,458.65 2025-02-28
1700441 LOCAL Metatarsal Fracture Closed Tx 4 4 $2,650.00 $2,650.00 $2,385.00 $2,544.00 $2,451.25 2025-02-28
1700988 LOCAL Closed Tx Of Proximal Humeral 4 4 $2,650.00 $2,650.00 $2,385.00 $2,544.00 $2,451.25 2025-02-28
36561 CPT Insert Tunneled Cv Cath 5 5 $2,577.00 $2,577.00 $2,319.30 $4,912.08 $2,448.15 2025-02-28
1200100 LOCAL Insertion Central Venous Catheter 4 4 $2,640.00 $2,640.00 $2,376.00 $2,534.40 $2,442.00 2025-02-28
1600120 LOCAL Insertion Central Venous Access 4 4 $2,640.00 $2,640.00 $2,376.00 $2,534.40 $2,442.00 2025-02-28
14040 CPT Tis Trnfr F/c/c/m/n/a/g/h/f 5 5 $2,665.00 $2,665.00 $2,398.50 $2,558.40 $2,436.70 2025-02-28
46200 CPT Removal Of Anal Fissure 9 5 $2,697.00 $2,697.00 $720.00 $4,248.59 $2,427.30 2025-02-28
C1781 HCPCS Mesh (implantable) 16 4 $2,622.50 $2,622.50 $1,731.60 $5,664.00 $2,418.00 2025-02-28
28190 CPT Removal Of Foot Foreign Body 9 5 $315.00 $315.00 $283.50 $2,728.66 $2,404.80 2025-02-28
15620 CPT Delay Flap F/c/c/n/ax/g/h/f 5 5 $2,665.00 $2,665.00 $1,338.49 $2,558.40 $2,398.50 2025-02-28
36569 CPT Insj Picc 5 Yr+ Without Imaging 5 5 $2,640.00 $2,640.00 $1,060.34 $2,534.40 $2,376.00 2025-02-28
15002 CPT Wound Prep Trk/arm/leg 5 5 $2,623.00 $2,623.00 $1,108.34 $2,518.08 $2,360.70 2025-02-28
65265 CPT Remove Foreign Body From Eye 5 5 $2,623.00 $2,623.00 $761.04 $2,518.08 $2,360.70 2025-02-28
29891 CPT Arthr Ank Ostchn Df Tal&/tib 5 5 $2,484.00 $2,484.00 $2,235.60 $2,955.58 $2,359.80 2025-02-28
28119 CPT Removal Of Heel Spur 5 5 $2,484.00 $2,484.00 $2,235.60 $3,064.90 $2,359.80 2025-02-28
1200364 LOCAL Colonoscopy 4 4 $2,408.00 $2,408.00 $2,167.20 $2,517.50 $2,348.34 2025-02-28
26118 CPT Rad Resect Hand Tumor 3 Cm/> 5 5 $2,456.00 $2,456.00 $2,210.40 $2,713.44 $2,333.20 2025-02-28
1700159 LOCAL Excision Of Thrombosed Hemorrhoid 4 4 $2,511.00 $2,511.00 $2,259.90 $2,410.56 $2,322.68 2025-02-28
23077 CPT Rad Rescj Tum Shoulder<5 Cm 5 5 $2,569.00 $2,569.00 $1,981.60 $2,466.24 $2,312.10 2025-02-28
11772 CPT Exc Pilonidal Cyst Comp 9 5 $1,343.00 $1,343.00 $1,208.70 $5,776.95 $2,292.30 2025-02-28
1600885 LOCAL Laryngoscopy Flexible 4 4 $2,475.00 $2,475.00 $2,227.50 $2,376.00 $2,289.38 2025-02-28
1600574 LOCAL Biopsy Breast 4 4 $2,475.00 $2,475.00 $2,227.50 $2,376.00 $2,289.38 2025-02-28
1200574 LOCAL Biopsy Of Breast 4 4 $2,475.00 $2,475.00 $2,227.50 $2,376.00 $2,289.38 2025-02-28
28124 CPT Partial Removal Of Toe 5 5 $2,376.00 $2,376.00 $2,138.40 $2,955.58 $2,257.20 2025-02-28
72127 CPT CT Neck Spine Without & With Contrast 5 5 $2,503.00 $2,503.00 $658.16 $2,402.88 $2,252.70 2025-02-28
19083 CPT Bx Breast 1st Lesion US Imag 9 5 $3,379.00 $3,379.00 $328.50 $3,243.84 $2,247.13 2025-02-28
J3262 HCPCS Tocilizumab Injection 5 5 $2,476.05 $2,476.05 $7.44 $2,377.01 $2,228.45 2025-02-28
31231 CPT Nasal Endoscopy Dx 5 5 $2,475.00 $2,475.00 $294.76 $2,376.00 $2,227.50 2025-02-28
1600890 LOCAL Repair Cent Ven Access Cath 4 4 $2,408.00 $2,408.00 $2,167.20 $2,311.68 $2,227.40 2025-02-28
1200902 LOCAL Removal Central Venous Cath 4 4 $2,408.00 $2,408.00 $2,167.20 $2,311.68 $2,227.40 2025-02-28
70547 CPT Mr Angiography Neck Without Contrast 5 5 $2,430.00 $2,430.00 $910.95 $2,332.80 $2,187.00 2025-02-28
11624 CPT Exc S/n/h/f/g Mal+mrg 3.1-4 5 5 $2,296.00 $2,296.00 $2,066.40 $2,473.44 $2,181.20 2025-02-28
59410 CPT Obstetrical Care 5 5 $2,421.00 $2,421.00 $2,057.85 $2,324.16 $2,178.90 2025-02-28
90378 CPT Rsv Mab IM 50mg 9 5 $3,789.88 $3,789.88 $2,018.03 $3,638.28 $2,152.57 2025-02-28
26113 CPT Exc Hand Tum Deep 1.5 Cm/> 9 5 $1,290.00 $1,290.00 $1,161.00 $2,959.73 $2,150.10 2025-02-28
1600122 LOCAL Insertion Of Totally Implantable Vad 4 4 $2,230.00 $2,230.00 $2,007.00 $2,312.06 $2,147.49 2025-02-28
67900 CPT Repair Brow Defect 5 5 $2,376.00 $2,376.00 $2,019.60 $2,280.96 $2,138.40 2025-02-28
64633 CPT Destroy Cerv/thor Facet Jnt 10 5 $2,400.00 $2,400.00 $1,360.00 $3,072.00 $2,128.00 2025-02-28
200024 LOCAL Labor > 8 Hours 4 4 $2,293.00 $2,293.00 $2,063.70 $2,201.28 $2,121.02 2025-02-28
1200632 LOCAL Lymph Node Removal Of 4 4 $2,282.00 $2,282.00 $2,053.80 $2,190.72 $2,110.85 2025-02-28
360 OTHER Blepharoplasty, Upper Eyelid Bilateral 10 2 $3,511.00 $3,511.00 $830.68 $4,094.56 $2,109.07 2026-05-22
J7307 HCPCS Etonogestrel Implant System 5 5 $2,341.00 $2,341.00 $1,651.17 $2,247.36 $2,106.90 2025-02-28
72129 CPT CT Chest Spine With Contrast 5 5 $2,335.00 $2,335.00 $658.16 $2,241.60 $2,101.50 2025-02-28
72132 CPT CT Lumbar Spine With Contrast 5 5 $2,335.00 $2,335.00 $658.16 $2,241.60 $2,101.50 2025-02-28
74160 CPT CT Abdomen W/contrast 5 5 $2,335.00 $2,335.00 $658.16 $2,241.60 $2,101.50 2025-02-28
70481 CPT CT Orbit/ear/fossa With Contrast 5 5 $2,335.00 $2,335.00 $658.16 $2,241.60 $2,101.50 2025-02-28
72126 CPT CT Neck Spine With Contrast 5 5 $2,335.00 $2,335.00 $658.16 $2,241.60 $2,101.50 2025-02-28
70487 CPT CT Maxillofacial With Contrast 5 5 $2,335.00 $2,335.00 $658.16 $2,241.60 $2,101.50 2025-02-28
93306 CPT Tte W/doppler Complete 5 5 $2,300.00 $2,300.00 $2,070.00 $2,208.00 $2,099.07 2025-02-28
C8929 HCPCS Transthoracic Echocardiography With Contrast; Or Without Contrast Followed By Wi… 5 5 $2,300.00 $2,300.00 $2,070.00 $2,208.00 $2,099.07 2025-02-28
21935 CPT Resect Back Tum < 5 Cm 5 5 $2,331.00 $2,331.00 $1,981.35 $2,237.76 $2,097.90 2025-02-28
65260 CPT Remove Foreign Body From Eye 5 5 $2,331.00 $2,331.00 $1,106.96 $2,237.76 $2,097.90 2025-02-28
81229 CPT Cytog Alys Chrml Abnr Snpcgh 5 5 $2,215.00 $2,215.00 $1,993.50 $2,126.40 $2,093.36 2025-02-28
78582 CPT Lung Ventilat&perfus Imaging 5 5 $2,325.00 $2,325.00 $949.66 $2,232.00 $2,092.50 2025-02-28
J7300 HCPCS Intra Copp Contra (paragard) 5 5 $2,325.00 $2,325.00 $1,549.38 $2,232.00 $2,092.50 2025-02-28
27222 CPT Treat Hip Socket Fracture 5 5 $2,289.00 $2,289.00 $1,945.65 $2,197.44 $2,060.10 2025-02-28
1200812 LOCAL Repair Of Rectocele 4 4 $2,222.00 $2,222.00 $1,999.80 $2,133.12 $2,055.35 2025-02-28
78278 CPT Acute Gi Blood Loss Imaging 5 5 $2,256.00 $2,256.00 $1,917.60 $2,165.76 $2,030.40 2025-02-28
72193 CPT CT Pelvis With Contrast 5 5 $2,254.00 $2,254.00 $658.16 $2,163.84 $2,028.60 2025-02-28
J7298 HCPCS Mirena, 52 Mg 5 5 $2,248.00 $2,248.00 $1,651.90 $2,158.08 $2,023.20 2025-02-28
C8921 HCPCS Tte W Or Without Fol W/cont, Com 5 5 $2,248.00 $2,248.00 $794.24 $2,158.08 $2,023.20 2025-02-28
70488 CPT CT Maxillofacial Without & With Contrast 5 5 $2,245.00 $2,245.00 $658.16 $2,155.20 $2,020.50 2025-02-28
72194 CPT CT Pelvis Without & With Contrast 5 5 $2,245.00 $2,245.00 $658.16 $2,155.20 $2,020.50 2025-02-28
73702 CPT CT Lwr Extremity W/O&with Contrast 5 5 $2,245.00 $2,245.00 $658.16 $2,155.20 $2,020.50 2025-02-28
73206 CPT CT Angio Upr Extrm W/O&with Contrast 5 5 $2,245.00 $2,245.00 $1,908.25 $2,155.20 $2,020.50 2025-02-28
72130 CPT CT Chest Spine Without & With Contrast 5 5 $2,245.00 $2,245.00 $658.16 $2,155.20 $2,020.50 2025-02-28
71270 CPT CT Thorax Dx C-/c+ 5 5 $2,245.00 $2,245.00 $658.16 $2,155.20 $2,020.50 2025-02-28
21557 CPT Resect Neck Thorax Tumor<5cm 5 5 $2,243.00 $2,243.00 $1,906.55 $2,153.28 $2,018.70 2025-02-28
78707 CPT K Flow/funct Image Without Drug 5 5 $2,238.00 $2,238.00 $1,902.30 $2,148.48 $2,014.20 2025-02-28
78452 CPT Ht Muscle Image Spect Mult 5 5 $2,203.00 $2,203.00 $1,982.70 $2,114.88 $2,011.27 2025-02-28
27240 CPT Treat Thigh Fracture 5 5 $2,222.00 $2,222.00 $1,888.70 $2,133.12 $1,999.80 2025-02-28
46945 CPT Int Hrhc Lig 1 Hroid Without Img 9 5 $2,220.00 $2,220.00 $720.00 $2,131.20 $1,998.00 2025-02-28
10061 CPT I&d Abscess Comp/multiple 9 5 $434.00 $434.00 $390.60 $2,126.40 $1,993.50 2025-02-28
67904 CPT Repair Eyelid Defect 5 5 $2,214.00 $2,214.00 $1,881.90 $2,125.44 $1,992.60 2025-02-28
45388 CPT Colonoscopy W/ablation 5 5 $2,182.00 $2,182.00 $1,963.80 $2,094.72 $1,992.53 2025-02-28
1200868 LOCAL 2nd Additional Surgery 4 4 $2,147.00 $2,147.00 $1,932.30 $2,061.12 $1,985.97 2025-02-28
70480 CPT CT Orbit/ear/fossa Without Contrast 5 5 $2,205.00 $2,205.00 $658.16 $2,116.80 $1,984.50 2025-02-28
64635 CPT Destroy Lumb/sac Facet Jnt 20 5 $2,214.00 $2,214.00 $1,466.25 $3,312.00 $1,982.44 2025-02-28
1600368 LOCAL Colonoscopy Through Stoma 4 4 $2,128.00 $2,128.00 $1,915.20 $2,042.88 $1,968.40 2025-02-28
200022 LOCAL Labor 4-8 Hours 4 4 $2,118.00 $2,118.00 $1,906.20 $2,033.28 $1,959.15 2025-02-28
19020 CPT Mastotomy Expl DRG Absc Dp 5 5 $2,062.00 $2,062.00 $1,855.80 $2,420.09 $1,958.90 2025-02-28
73201 CPT CT Upper Extremity With Contrast 5 5 $2,172.00 $2,172.00 $658.16 $2,085.12 $1,954.80 2025-02-28
1600480 LOCAL Biopsy Of Lesion 4 4 $2,110.00 $2,110.00 $1,899.00 $2,025.60 $1,951.75 2025-02-28
1700352 LOCAL Repair Of Lip 4 4 $2,109.00 $2,109.00 $1,898.10 $2,024.64 $1,950.82 2025-02-28
1600745 LOCAL Urethral Dilation (women) 4 4 $2,109.00 $2,109.00 $1,898.10 $2,024.64 $1,950.82 2025-02-28
2103123 LOCAL Coolief Kit 17g X 75mm 4 4 $2,100.00 $2,100.00 $1,890.00 $2,016.00 $1,942.50 2025-02-28
2103122 LOCAL Coolief Kit 17g X 100mm 4 4 $2,100.00 $2,100.00 $1,890.00 $2,016.00 $1,942.50 2025-02-28
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