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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

HODGEMAN COUNTY HEALTH CENTER

Jetmore, KS · CCN 171369 · 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: $1,731 across 13 payers · range $1,456-$2,367

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbHCHCJETMOREKS&type=CDMWithoutLabel · observed 2026-08-18

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.

2,389 distinct procedures filed
13 distinct payers
57,615 rate rows
2026-08-18 last MRF observed
Data quality

56,569 of 57,615 rate rows are consumer-grade (98.2%)

1,046 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
template filing: same amount across many unrelated codes — excluded 675
percent-of-charges filed in the dollar field — excluded from medians 260
exceeds 10× this hospital's gross charge — excluded from medians 60
per-diem day rate — not a per-procedure price 48
placeholder amount (≤ $0.02) — excluded from medians 2
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbHCHCJETMOREKS&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Hodgeman_V2.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-17
Content fingerprint ddea3685aae5d3c5… · 8,680,303 bytes · first seen 2026-08-19

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
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 13 $2,600.00 $16,313.00 $13,866.05 nat. median
$916
outlier · 15.1×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 13 $175.54 $19,183.00 $13,236.27 nat. median
$498
outlier · 26.6×
59410
HCPCS 		Vaginal Delivery With Post Delivery Care 13 $1,966.00 $15,400.00 $13,090.00 nat. median
$2,219
outlier · 5.9×
CSUPPLIES
CDM 		Supplies Other Facility Procedure 12 $2,600.00 $14,472.30 $12,255.76 —
CSSUPPLY
CDM 		Cs Supply Other Facility 12 $2,600.00 $14,472.30 $12,255.76 —
93458
HCPCS 		Insertion Of Tube In Left Lower Heart Chamber And Coronary Artery For Diagnosis… 12 $5,815.53 $16,880.00 $12,229.56 nat. median
$4,063
outlier · 3.0×
J2353
HCPCS 		Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 13 $239.09 $17,102.00 $11,800.38 nat. median
$1,956
outlier · 6.0×
22514
HCPCS 		Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device 13 $3,200.00 $13,395.00 $8,572.80 nat. median
$7,967
1.1× median
93451
HCPCS 		Insertion Of Tube In Right Heart Chambers For Measurement 12 $4,924.15 $10,300.00 $7,462.35 nat. median
$4,071
1.8× median
47563
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 13 $3,200.00 $10,940.00 $7,001.60 nat. median
$6,246
1.1× median
47562
HCPCS 		Removal Of Gallbladder Using An Endoscope 13 $3,200.00 $10,940.00 $6,877.05 nat. median
$6,043
1.1× median
47605
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts 13 $3,200.00 $10,308.00 $6,597.12 nat. median
$3,950
1.7× median
47600
HCPCS 		Removal Of Gallbladder 13 $3,200.00 $10,308.00 $6,597.12 nat. median
$3,682
1.8× median
58661
HCPCS 		Removal Of Ovaries And/or Tubes Using An Endoscope 13 $3,200.00 $9,375.00 $6,468.75 nat. median
$5,852
1.1× median
J2407
HCPCS 		Injection, Oritavancin (orbactiv), 10 Mg 13 $31.78 $9,036.00 $6,234.84 nat. median
$89
outlier · 69.8×
Q5111
HCPCS 		Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 13 $180.03 $8,836.00 $6,096.84 nat. median
$665
outlier · 9.2×
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 13 $35.80 $8,315.00 $5,737.35 nat. median
$80
outlier · 72.0×
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 13 $2,468.89 $7,583.00 $5,232.27 nat. median
$3,496
1.5× median
J3111
HCPCS 		Injection, Romosozumab-aqqg, 1 Mg 13 $12.16 $6,975.00 $4,812.75 nat. median
$19
outlier · 253.3×
90378
HCPCS 		Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 13 $1,982.15 $6,716.00 $4,634.04 nat. median
$2,008
outlier · 2.3×
49520
HCPCS 		Repair Of Groin Hernia That Is Not Trapped 13 $3,200.00 $6,662.00 $4,596.78 nat. median
$4,259
1.1× median
14000
HCPCS 		Repair Of Wound Of Trunk By Transferring Skin, 10.0 Sq Cm Or Less 13 $1,300.00 $6,691.00 $4,570.56 nat. median
$2,192
outlier · 2.1×
28820
HCPCS 		Amputation Of Toe At Joint Between Forefoot And Toes 13 $3,200.00 $6,447.00 $4,448.43 nat. median
$3,343
1.3× median
31530
HCPCS 		Removal Of Foreign Body In Voice Box Using An Endoscope 13 $1,966.00 $6,236.00 $4,260.06 nat. median
$2,001
outlier · 2.1×
49505
HCPCS 		Repair Of Groin Hernia (5 Years Or Older) 13 $3,200.00 $6,617.00 $4,234.88 nat. median
$4,049
1.0× median
Q4145
HCPCS 		Epifix, Injectable, 1 Mg 13 $24.29 $5,978.00 $4,124.82 nat. median
$38
outlier · 109.8×
19125
HCPCS 		Removal Of Growth Of Breast Identified By X-ray Marker, First Growth 13 $1,300.00 $7,180.00 $3,986.92 nat. median
$4,023
1.0× median
10180
HCPCS 		Complex Drainage Of Wound Infection After Surgery 13 $1,300.00 $5,677.00 $3,878.49 nat. median
$2,882
1.3× median
58600
HCPCS 		Tying Or Incision Of Fallopian Tubes 13 $3,200.00 $5,962.00 $3,815.68 nat. median
$3,339
1.1× median
36561
HCPCS 		Insertion Of Central Venous Tube With Port (5 Years Or Older) 13 $3,200.00 $5,902.00 $3,777.28 nat. median
$3,304
1.1× median
36556
HCPCS 		Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 13 $2,533.08 $5,902.00 $3,762.00 nat. median
$2,885
1.3× median
27301
HCPCS 		Drainage Of Deep Abscess Or Blood Accumulation Of Thigh Or Knee 13 $1,300.00 $5,504.00 $3,760.50 nat. median
$2,895
1.3× median
49421
HCPCS 		Insertion Of Abdominal Cavity Tube For Drainage Or Dialysis 13 $1,300.00 $6,181.00 $3,650.25 nat. median
$3,661
1.0× median
36573
HCPCS 		Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist,… 13 $1,300.00 $4,000.00 $3,400.00 nat. median
$1,965
1.7× median
78452
HCPCS 		Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 13 $1,394.68 $6,170.00 $3,312.43 nat. median
$1,464
outlier · 2.3×
J0897
HCPCS 		Injection, Denosumab, 1 Mg 13 $28.20 $4,644.00 $3,204.36 nat. median
$86
outlier · 37.3×
11446
HCPCS 		Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, M… 13 $2,746.09 $4,336.00 $3,126.27 nat. median
$2,549
1.2× median
26418
HCPCS 		Repair Of Tendon On Top Side Of Finger 13 $1,966.00 $4,527.00 $3,092.58 nat. median
$2,058
1.5× median
Q5122
HCPCS 		Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg 13 $159.80 $4,418.00 $3,048.42 nat. median
$487
outlier · 6.3×
11626
HCPCS 		Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 13 $2,293.56 $4,627.00 $3,038.07 nat. median
$2,795
1.1× median
49525
HCPCS 		Repair Of Sliding Groin Hernia 13 $1,922.84 $6,617.00 $2,855.70 nat. median
$3,791
0.8× median
11444
HCPCS 		Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3… 13 $1,300.00 $3,869.00 $2,696.70 nat. median
$1,610
1.7× median
12037
HCPCS 		Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 13 $1,966.00 $3,911.00 $2,671.68 nat. median
$1,899
1.4× median
11426
HCPCS 		Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More… 13 $1,300.00 $5,366.00 $2,656.20 nat. median
$2,896
0.9× median
Q5108
HCPCS 		Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 13 $168.99 $3,844.00 $2,652.36 nat. median
$418
outlier · 6.4×
59414
HCPCS 		Delivery Of Placenta 13 $1,966.00 $3,080.00 $2,618.00 nat. median
$2,853
0.9× median
75625
HCPCS 		Review By Radiologist Of Abdominal Aorta Image 13 $2,030.30 $3,430.00 $2,600.00 nat. median
$3,211
0.8× median
27562
HCPCS 		Closed Treatment Of Dislocated Kneecap Under Anesthesia 13 $1,300.00 $3,790.00 $2,588.88 nat. median
$478
outlier · 5.4×
26742
HCPCS 		Closed Treatment Of Broken Finger Or Hand At Base Of Finger With Manipulation 13 $1,966.00 $3,774.00 $2,578.53 nat. median
$1,543
1.7× median
36569
HCPCS 		Insertion Of Tube For Infusion (5 Years Or Older) 13 $79.42 $7,254.00 $2,478.08 nat. median
$1,664
1.5× median

Other procedures at this hospital

Browse this hospital's 2,389 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
             
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 13 13 $16,313.00 $13,050.40 20% off $2,600.00 $16,313.00 $13,866.05 2026-01-08
J3101 HCPCS Injection, Tenecteplase, 1 Mg 13 13 $19,183.00 $15,346.40 20% off $175.54 $19,183.00 $13,236.27 2026-01-08
59410 HCPCS Vaginal Delivery With Post Delivery Care 26 13 $15,400.00 $12,320.00 20% off $1,966.00 $15,400.00 $13,090.00 2026-08-18
CSSUPPLY CDM Cs Supply Other Facility 12 12 $15,234.00 $12,187.20 $2,600.00 $14,472.30 $12,255.76 2026-01-08
CSUPPLIES CDM Supplies Other Facility Procedure 12 12 $15,234.00 $12,187.20 $2,600.00 $14,472.30 $12,255.76 2026-01-08
93458 HCPCS Insertion Of Tube In Left Lower Heart Chamber And Coronary Artery For Diagnosis … 12 12 $16,880.00 $13,504.00 20% off $5,815.53 $16,880.00 $12,229.56 2026-01-08
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 13 13 $17,102.00 $13,681.60 20% off $239.09 $17,102.00 $11,800.38 2026-01-08
22514 HCPCS Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device 26 13 $11,535.00 $9,228.00 20% off $3,200.00 $13,395.00 $8,572.80 2026-08-18
93451 HCPCS Insertion Of Tube In Right Heart Chambers For Measurement 12 12 $10,300.00 $8,240.00 20% off $4,924.15 $10,300.00 $7,462.35 2026-01-08
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 26 13 $9,841.00 $7,872.80 20% off $3,200.00 $10,940.00 $7,001.60 2026-08-18
47562 HCPCS Removal Of Gallbladder Using An Endoscope 26 13 $9,089.50 $7,271.60 $3,200.00 $10,940.00 $6,877.05 2026-08-18
47605 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts 26 13 $8,773.50 $7,018.80 20% off $3,200.00 $10,308.00 $6,597.12 2026-08-18
47600 HCPCS Removal Of Gallbladder 26 13 $8,773.50 $7,018.80 20% off $3,200.00 $10,308.00 $6,597.12 2026-08-18
58661 HCPCS Removal Of Ovaries And/or Tubes Using An Endoscope 26 13 $9,375.00 $7,500.00 20% off $3,200.00 $9,375.00 $6,468.75 2026-08-18
J2407 HCPCS Injection, Oritavancin (orbactiv), 10 Mg 13 13 $9,036.00 $7,228.80 20% off $31.78 $9,036.00 $6,234.84 2026-01-08
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 13 13 $8,836.00 $7,068.80 20% off $180.03 $8,836.00 $6,096.84 2026-01-08
J2182 HCPCS Injection, Mepolizumab, 1 Mg 13 13 $8,315.00 $6,652.00 20% off $35.80 $8,315.00 $5,737.35 2026-01-08
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 13 13 $7,583.00 $6,066.40 20% off $2,468.89 $7,583.00 $5,232.27 2026-01-08
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 13 13 $6,975.00 $5,580.00 20% off $12.16 $6,975.00 $4,812.75 2026-01-08
90378 HCPCS Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 26 13 $6,716.00 $5,372.80 20% off $1,982.15 $6,716.00 $4,634.04 2026-08-18
49520 HCPCS Repair Of Groin Hernia That Is Not Trapped 26 13 $6,662.00 $5,329.60 $3,200.00 $6,662.00 $4,596.78 2026-08-18
14000 HCPCS Repair Of Wound Of Trunk By Transferring Skin, 10.0 Sq Cm Or Less 26 13 $6,657.50 $5,326.00 20% off $1,300.00 $6,691.00 $4,570.56 2026-08-18
28820 HCPCS Amputation Of Toe At Joint Between Forefoot And Toes 26 13 $6,447.00 $5,157.60 $3,200.00 $6,447.00 $4,448.43 2026-08-18
31530 HCPCS Removal Of Foreign Body In Voice Box Using An Endoscope 26 13 $6,205.00 $4,964.00 20% off $1,966.00 $6,236.00 $4,260.06 2026-08-18
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 26 13 $6,139.00 $4,911.20 $3,200.00 $6,617.00 $4,234.88 2026-08-18
Q4145 HCPCS Epifix, Injectable, 1 Mg 13 13 $5,978.00 $4,782.40 20% off $24.29 $5,978.00 $4,124.82 2026-01-08
19125 HCPCS Removal Of Growth Of Breast Identified By X-ray Marker, First Growth 26 13 $5,609.00 $4,487.20 20% off $1,300.00 $7,180.00 $3,986.92 2026-08-18
10180 HCPCS Complex Drainage Of Wound Infection After Surgery 26 13 $5,649.00 $4,519.20 $1,300.00 $5,677.00 $3,878.49 2026-08-18
58600 HCPCS Tying Or Incision Of Fallopian Tubes 26 13 $5,554.00 $4,443.20 $3,200.00 $5,962.00 $3,815.68 2026-08-18
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 26 13 $5,282.00 $4,225.60 $3,200.00 $5,902.00 $3,777.28 2026-08-18
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 26 13 $4,931.00 $3,944.80 $2,533.08 $5,902.00 $3,762.00 2026-08-18
27301 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Thigh Or Knee 26 13 $5,477.00 $4,381.60 $1,300.00 $5,504.00 $3,760.50 2026-08-18
49421 HCPCS Insertion Of Abdominal Cavity Tube For Drainage Or Dialysis 26 13 $4,223.50 $3,378.80 $1,300.00 $6,181.00 $3,650.25 2026-08-18
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 26 13 $4,000.00 $3,200.00 20% off $1,300.00 $4,000.00 $3,400.00 2026-08-18
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 36 13 $3,581.00 $2,864.80 $1,394.68 $6,170.00 $3,312.43 2026-08-18
J0897 HCPCS Injection, Denosumab, 1 Mg 13 13 $4,644.00 $3,715.20 20% off $28.20 $4,644.00 $3,204.36 2026-01-08
11446 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, M… 26 13 $4,314.50 $3,451.60 $2,746.09 $4,336.00 $3,126.27 2026-08-18
26418 HCPCS Repair Of Tendon On Top Side Of Finger 26 13 $4,504.50 $3,603.60 20% off $1,966.00 $4,527.00 $3,092.58 2026-08-18
Q5122 HCPCS Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg 13 13 $4,418.00 $3,534.40 20% off $159.80 $4,418.00 $3,048.42 2026-01-08
11626 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 26 13 $3,975.50 $3,180.40 20% off $2,293.56 $4,627.00 $3,038.07 2026-08-18
49525 HCPCS Repair Of Sliding Groin Hernia 26 13 $4,811.50 $3,849.20 $1,922.84 $6,617.00 $2,855.70 2026-08-18
11444 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3… 28 13 $3,869.00 $3,095.20 20% off $1,300.00 $3,869.00 $2,696.70 2026-08-18
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 26 13 $3,891.50 $3,113.20 20% off $1,966.00 $3,911.00 $2,671.68 2026-08-18
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 28 13 $4,081.00 $3,264.80 $1,300.00 $5,366.00 $2,656.20 2026-08-18
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 13 13 $3,844.00 $3,075.20 20% off $168.99 $3,844.00 $2,652.36 2026-01-08
59414 HCPCS Delivery Of Placenta 26 13 $3,080.00 $2,464.00 20% off $1,966.00 $3,080.00 $2,618.00 2026-08-18
75625 HCPCS Review By Radiologist Of Abdominal Aorta Image 13 13 $3,430.00 $2,744.00 20% off $2,030.30 $3,430.00 $2,600.00 2026-01-08
27562 HCPCS Closed Treatment Of Dislocated Kneecap Under Anesthesia 28 13 $3,771.00 $3,016.80 $1,300.00 $3,790.00 $2,588.88 2026-08-18
26742 HCPCS Closed Treatment Of Broken Finger Or Hand At Base Of Finger With Manipulation 26 13 $3,755.50 $3,004.40 20% off $1,966.00 $3,774.00 $2,578.53 2026-08-18
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 95 13 $3,520.00 $2,816.00 20% off $79.42 $7,254.00 $2,478.08 2026-08-18
43246 HCPCS Insertion Of Stomach Tube Using A Flexible Endoscope 26 13 $3,363.50 $2,690.80 $2,027.42 $3,557.00 $2,455.08 2026-08-18
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 13 13 $3,117.00 $2,493.60 20% off $16.18 $3,117.00 $2,365.80 2026-01-08
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 13 13 $3,005.00 $2,404.00 20% off $7.72 $3,005.00 $2,280.80 2026-01-08
14020 HCPCS Repair Of Wound Of Scalp, Arms, Or Legs By Transferring Skin, 10.0 Sq Cm Or Less 26 13 $3,265.50 $2,612.40 20% off $1,300.00 $3,282.00 $2,241.81 2026-08-18
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 13 13 $2,941.00 $2,352.80 $39.80 $2,941.00 $2,232.22 2026-01-08
43245 HCPCS Dilation Of Stomach Outlet Using A Flexible Endoscope 26 13 $2,952.50 $2,362.00 20% off $1,501.62 $3,557.00 $2,230.60 2026-08-18
11606 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 28 13 $3,200.00 $2,560.00 20% off $1,300.00 $3,200.00 $2,230.40 2026-08-18
24620 HCPCS Closed Treatment Of Broken And Dislocated Forearm Bones At Elbow With Manipulati… 26 13 $3,235.50 $2,588.40 20% off $1,966.00 $3,252.00 $2,221.11 2026-08-18
J2357 HCPCS Injection, Omalizumab, 5 Mg 13 13 $2,906.00 $2,324.80 $46.30 $2,906.00 $2,205.65 2026-01-08
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 28 13 $3,101.00 $2,480.80 $1,300.00 $3,116.00 $2,161.50 2026-08-18
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 26 13 $2,951.00 $2,360.80 $434.65 $2,951.00 $2,158.65 2026-08-18
64493 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le… 83 13 $3,356.00 $2,684.80 $76.55 $6,712.00 $2,147.84 2026-08-18
64624 HCPCS Destruction Of Nerve Branches Of Knee Using Imaging Guidance 48 13 $3,328.00 $2,662.40 20% off $125.36 $3,328.00 $2,129.92 2026-08-18
26160 HCPCS Removal Of Growth Of Tendon Finger Or Hand 26 13 $3,096.50 $2,477.20 20% off $1,300.00 $3,112.00 $2,125.89 2026-08-18
11604 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 28 13 $3,012.00 $2,409.60 20% off $744.39 $3,012.00 $2,099.36 2026-08-18
11424 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 26 13 $2,857.00 $2,285.60 $1,711.75 $3,038.00 $2,084.91 2026-08-18
155314 CDM Paxlovid 150-100 Mg (moderate) 12 12 $2,490.00 $1,992.00 20% off $1,718.10 $2,365.50 $2,054.25 2026-01-08
26410 HCPCS Repair Of Tendon On Top Of Hand 26 13 $2,956.50 $2,365.20 20% off $1,881.58 $2,971.00 $2,029.98 2026-08-18
21320 HCPCS Closed Treatment Of Broken Nose Bone With Placement Of Stabilizing Device 26 13 $2,928.00 $2,342.40 $1,872.94 $2,928.00 $2,020.32 2026-08-18
21315 HCPCS Closed Treatment Of Broken Nose Bone With Manipulation 26 13 $2,904.00 $2,323.20 20% off $1,857.59 $2,904.00 $2,003.76 2026-08-18
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 28 13 $2,872.50 $2,298.00 20% off $1,300.00 $2,913.00 $2,002.41 2026-08-18
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 26 13 $2,731.00 $2,184.80 $1,618.94 $2,731.00 $1,997.72 2026-08-18
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 13 13 $2,602.00 $2,081.60 20% off $1.35 $2,602.00 $1,974.92 2026-01-08
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 26 13 $2,737.00 $2,189.60 20% off $1,558.23 $3,038.00 $1,946.56 2026-08-18
11404 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 28 13 $2,643.50 $2,114.80 $1,300.00 $3,038.00 $1,944.32 2026-08-18
11422 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 26 13 $2,535.50 $2,028.40 $1,402.77 $3,038.00 $1,931.35 2026-08-18
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 26 13 $2,580.50 $2,064.40 $1,381.68 $3,001.00 $1,920.64 2026-08-18
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 26 13 $2,580.50 $2,064.40 $1,381.68 $3,001.00 $1,920.64 2026-08-18
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 26 13 $2,580.50 $2,064.40 $1,381.68 $3,001.00 $1,920.64 2026-08-18
43251 HCPCS Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi… 26 13 $2,783.50 $2,226.80 $1,285.73 $3,557.00 $1,909.50 2026-08-18
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 26 13 $2,233.00 $1,786.40 $1,429.12 $2,233.00 $1,898.05 2026-08-18
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 26 13 $2,233.00 $1,786.40 $1,429.12 $2,233.00 $1,898.05 2026-08-18
71552 HCPCS MRI Scan Of Chest Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
70553 HCPCS MRI Scan Of Brain Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
73220 HCPCS MRI Scan Of Arm Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
73720 HCPCS MRI Scan Of Leg Before And After Contrast 26 13 $2,565.00 $2,052.00 20% off $499.90 $2,565.00 $1,876.30 2026-08-18
11770 HCPCS Simple Removal Of Cyst Of Tailbone 26 13 $2,560.00 $2,048.00 20% off $1,629.23 $2,573.00 $1,872.28 2026-08-18
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 26 13 $2,519.00 $2,015.20 20% off $434.65 $2,519.00 $1,842.65 2026-08-18
46221 HCPCS Removal Of External Hemorrhoids By Rubber Banding 26 13 $2,448.00 $1,958.40 $1,550.55 $2,448.00 $1,790.71 2026-08-18
28475 HCPCS Closed Treatment Of Broken Foot With Manipulation 26 13 $2,414.00 $1,931.20 20% off $1,536.16 $2,426.00 $1,765.51 2026-08-18
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 26 13 $2,401.00 $1,920.80 20% off $434.65 $2,401.00 $1,756.33 2026-08-18
C1788 HCPCS Port, Indwelling (implantable) 26 13 $2,066.00 $1,652.80 20% off $1,322.24 $2,066.00 $1,756.10 2026-08-18
11005 HCPCS Removal Of Infected Skin, Tissue Or Muscle Of Abdomen 26 13 $2,039.00 $1,631.20 20% off $1,300.00 $2,039.00 $1,733.15 2026-08-18
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 26 13 $2,367.00 $1,893.60 20% off $1,455.56 $2,367.00 $1,731.46 2026-08-18
71551 HCPCS MRI Scan Of Chest With Contrast 26 13 $2,345.00 $1,876.00 20% off $499.90 $2,345.00 $1,715.37 2026-08-18
70552 HCPCS MRI Scan Of Brain With Contrast 26 13 $2,345.00 $1,876.00 20% off $499.90 $2,345.00 $1,715.37 2026-08-18
74182 HCPCS MRI Scan Of Abdomen With Contrast 26 13 $2,345.00 $1,876.00 20% off $499.90 $2,345.00 $1,715.37 2026-08-18
11420 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.5 C… 28 13 $2,169.00 $1,735.20 20% off $897.00 $3,038.00 $1,715.16 2026-08-18
11623 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3.0 … 26 13 $2,090.50 $1,672.40 $1,016.37 $2,708.00 $1,715.16 2026-08-18
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 26 13 $2,296.00 $1,836.80 20% off $1,412.38 $2,296.00 $1,679.52 2026-08-18
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 26 13 $2,290.00 $1,832.00 20% off $1,095.75 $2,290.00 $1,675.13 2026-08-18
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 28 13 $2,400.50 $1,920.40 $1,127.41 $3,038.00 $1,674.85 2026-08-18
153985 CDM Soliqua 100 Unit-33 Mcg/ml Pen 12 12 $2,012.00 $1,609.60 20% off $1,388.28 $1,911.40 $1,659.90 2026-01-08
72195 HCPCS MRI Scan Of Pelvis Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
74181 HCPCS MRI Scan Of Abdomen Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 26 13 $2,245.00 $1,796.00 20% off $601.61 $2,245.00 $1,642.22 2026-08-18
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 26 13 $2,245.00 $1,796.00 20% off $601.61 $2,245.00 $1,642.22 2026-08-18
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
71550 HCPCS MRI Scan Of Chest Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
70551 HCPCS MRI Scan Of Brain Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
73218 HCPCS MRI Scan Of Arm Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 26 13 $2,245.00 $1,796.00 20% off $601.61 $2,245.00 $1,642.22 2026-08-18
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 26 13 $2,245.00 $1,796.00 20% off $601.61 $2,245.00 $1,642.22 2026-08-18
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
73718 HCPCS MRI Scan Of Leg Without Contrast 26 13 $2,245.00 $1,796.00 20% off $499.90 $2,245.00 $1,642.22 2026-08-18
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 26 13 $2,233.00 $1,786.40 $1,100.77 $2,233.00 $1,633.44 2026-08-18
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 26 13 $2,233.00 $1,786.40 $1,086.66 $2,233.00 $1,633.44 2026-08-18
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 26 13 $2,233.00 $1,786.40 $1,127.26 $2,233.00 $1,633.44 2026-08-18
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 26 13 $2,233.00 $1,786.40 $1,101.66 $2,233.00 $1,633.44 2026-08-18
45398 HCPCS Banding Of Hemorrhoids Using A Flexible Endoscope (colonoscope) 26 13 $2,186.00 $1,748.80 20% off $1,382.64 $2,211.00 $1,598.37 2026-08-18
14040 HCPCS Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 48 13 $2,642.00 $2,113.60 20% off $506.29 $2,668.00 $1,594.34 2026-08-18
183985 CDM Insulin Pen Soliqua 100 Unit 33mcg 24 12 $1,932.00 $1,545.60 20% off $1,236.48 $1,835.40 $1,593.90 2026-08-18
Q4196 HCPCS Puraply Am, Per Square Centimeter 26 13 $1,875.00 $1,500.00 20% off $1,200.00 $1,875.00 $1,593.75 2026-08-18
64483 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 83 13 $2,487.00 $1,989.60 20% off $93.64 $4,974.00 $1,591.68 2026-08-18
59300 HCPCS Episiotomy Or Repair Of Vagina 26 13 $3,586.00 $2,868.80 $834.90 $5,962.00 $1,588.00 2026-08-18
27780 HCPCS Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
28470 HCPCS Closed Treatment Of Broken Bone In Forefoot Or Midfoot 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
27816 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
27788 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
27530 HCPCS Closed Treatment Of Broken Shin Bone 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
27520 HCPCS Closed Treatment Of Broken Kneecap 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
25560 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
25530 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
25500 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side 26 13 $2,171.00 $1,736.80 20% off $1,381.68 $2,182.00 $1,587.79 2026-08-18
11423 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3… 50 13 $2,436.00 $1,948.80 20% off $132.67 $3,038.00 $1,558.23 2026-08-18
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 26 13 $2,125.50 $1,700.40 $1,255.03 $2,211.00 $1,552.45 2026-08-18
11646 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More… 48 13 $3,350.00 $2,680.00 20% off $307.91 $3,350.00 $1,550.97 2026-08-18
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 26 13 $2,118.00 $1,694.40 $1,295.33 $2,211.00 $1,546.76 2026-08-18
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 28 13 $2,205.00 $1,764.00 20% off $1,300.00 $2,205.00 $1,536.88 2026-08-18
27786 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 28 13 $2,171.00 $1,736.80 20% off $1,300.00 $2,182.00 $1,513.27 2026-08-18
11443 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2… 26 13 $2,048.00 $1,638.40 $1,310.72 $2,048.00 $1,498.11 2026-08-18
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 26 13 $2,040.00 $1,632.00 20% off $1,255.03 $2,040.00 $1,492.26 2026-08-18
21012 HCPCS Removal Of Growth Under Skin Of Face Or Scalp, 2.0 Cm Or More 26 13 $2,023.00 $1,618.40 $1,280.93 $2,023.00 $1,479.83 2026-08-18
0202U OTHER Test For Detection Of Respiratory Disease-causing Organisms From Back Of Nose An… 13 13 $2,098.00 $1,678.40 $1,328.91 $2,098.00 $1,476.99 2026-08-18
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 26 13 $2,000.00 $1,600.00 20% off $959.50 $2,000.00 $1,463.00 2026-08-18
150783 CDM Antivenin Polyvalent 10 Ml Vial 24 12 $1,772.00 $1,417.60 20% off $1,134.08 $1,683.40 $1,461.90 2026-08-18
11442 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1… 26 13 $2,091.00 $1,672.80 20% off $1,164.83 $2,091.00 $1,442.79 2026-08-18
43247 HCPCS Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using … 26 13 $1,954.00 $1,563.20 20% off $1,243.51 $1,964.00 $1,429.08 2026-08-18
521019 CDM Ambulance 24 12 $1,700.00 $1,360.00 20% off $1,088.00 $1,615.00 $1,402.50 2026-08-18
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
71270 HCPCS CT Scan Of Chest Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
73202 HCPCS CT Scan Of Arm Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
70488 HCPCS CT Scan Of Face Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
73702 HCPCS CT Scan Of Leg Before And After Contrast 26 13 $1,859.00 $1,487.20 20% off $434.65 $1,859.00 $1,359.86 2026-08-18
110000 CDM Room & Board - Semi-private (two Beds) - General Classification 10 5 $1,425.00 $1,140.00 20% off $1,215.00 $1,500.00 $1,350.00 2026-08-18
11421 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.6-1… 26 13 $1,820.00 $1,456.00 20% off $744.39 $1,820.00 $1,331.33 2026-08-18
88120 HCPCS Cell Examination Of Urine, Manual 26 13 $1,782.00 $1,425.60 20% off $1,140.00 $1,782.00 $1,303.53 2026-08-18
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 28 13 $1,697.50 $1,358.00 20% off $1,080.40 $1,706.00 $1,290.97 2026-08-18
72132 HCPCS CT Scan Of Lower Spine With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
73201 HCPCS CT Scan Of Arm With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
72126 HCPCS CT Scan Of Upper Spine With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
72193 HCPCS CT Scan Of Pelvis With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
73701 HCPCS CT Scan Of Leg With Contrast Material 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
71260 HCPCS CT Scan Of Chest With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
70460 HCPCS CT Scan Head Or Brain With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
72129 HCPCS CT Scan Of Middle Spine With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
70487 HCPCS CT Scan Of Face With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
74160 HCPCS CT Scan Of Abdomen With Contrast 26 13 $1,740.00 $1,392.00 20% off $434.65 $1,740.00 $1,272.81 2026-08-18
11644 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3.1-… 50 13 $1,953.00 $1,562.40 $222.48 $1,973.00 $1,262.72 2026-08-18
SUPPLIES CDM Supply Other Facility 24 12 $1,518.00 $1,214.40 $971.52 $1,442.10 $1,252.35 2026-08-18
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
71250 HCPCS CT Scan Of Chest Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
70450 HCPCS CT Scan Head Or Brain Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
73200 HCPCS CT Scan Of Arm Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
70486 HCPCS CT Scan Of Face Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
73700 HCPCS CT Scan Of Leg Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
72131 HCPCS CT Scan Of Lower Spine Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
72125 HCPCS CT Scan Of Upper Spine Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
74150 HCPCS CT Scan Of Abdomen Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
72192 HCPCS CT Scan Of Pelvis Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
72128 HCPCS CT Scan Of Middle Spine Without Contrast 26 13 $1,693.00 $1,354.40 $434.65 $1,693.00 $1,238.43 2026-08-18
64495 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And… 83 13 $1,755.00 $1,404.00 20% off $42.84 $3,510.00 $1,235.52 2026-08-18
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 61 13 $1,271.00 $1,016.80 20% off $455.36 $3,001.00 $1,207.45 2026-08-18
64454 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Knee Nerve Branch Using Imagin… 83 13 $1,768.00 $1,414.40 $69.13 $3,400.00 $1,200.00 2026-08-18
76380 HCPCS Limited Or Follow-up CT Scan 26 13 $1,638.00 $1,310.40 $434.65 $1,638.00 $1,198.20 2026-08-18
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 26 13 $1,646.50 $1,317.20 20% off $981.57 $1,758.00 $1,196.53 2026-08-18
11624 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4.0 … 48 13 $1,732.00 $1,385.60 20% off $188.49 $2,708.00 $1,195.08 2026-08-18
27266 HCPCS Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 26 13 $1,609.00 $1,287.20 20% off $1,023.79 $1,617.00 $1,176.76 2026-08-18
93017 HCPCS Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg) 37 13 $1,442.00 $1,153.60 20% off $338.55 $1,690.00 $1,166.10 2026-08-18
64492 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Third And… 72 13 $1,670.00 $1,336.00 20% off $48.62 $2,722.00 $1,140.00 2026-08-18
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 26 13 $1,556.00 $1,244.80 20% off $956.62 $1,556.00 $1,138.21 2026-08-18
24505 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 59 13 $1,195.00 $956.00 20% off $410.40 $2,182.00 $1,135.25 2026-08-18
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 86 13 $1,260.00 $1,008.00 20% off $162.92 $3,478.90 $1,134.00 2026-08-18
11441 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0… 28 13 $1,450.00 $1,160.00 20% off $744.39 $1,725.00 $1,116.25 2026-08-18
J0248 HCPCS Injection, Remdesivir, 1 Mg 13 13 $1,313.00 $1,050.40 $905.97 $1,313.00 $1,116.05 2026-01-08
130005 CDM Room & Board - Semi-private (two Beds) - General Classification 10 5 $1,174.00 $939.20 $1,033.20 $1,200.00 $1,115.30 2026-08-18
45330 HCPCS Diagnostic Exam Of Lower Portion Of Large Bowel Using A Flexible Endoscope 26 13 $1,555.00 $1,244.00 20% off $767.60 $1,710.00 $1,107.20 2026-08-18
46050 HCPCS Drainage Of Superficial Rectal Abscess Surrounding Anus 26 13 $1,544.00 $1,235.20 20% off $873.15 $1,710.00 $1,098.40 2026-08-18
10160 HCPCS Aspiration Of Abscess, Blood, Or Cyst 28 13 $1,414.00 $1,131.20 20% off $900.01 $1,421.00 $1,096.76 2026-08-18
G0105 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 26 13 $1,496.00 $1,196.80 20% off $956.62 $1,496.00 $1,094.32 2026-08-18
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 59 13 $1,148.00 $918.40 20% off $410.20 $2,182.00 $1,090.60 2026-08-18
62321 HCPCS Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance 48 13 $1,485.00 $1,188.00 20% off $90.04 $1,713.00 $1,084.71 2026-08-18
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 26 13 $1,467.00 $1,173.60 20% off $330.14 $1,467.00 $1,073.11 2026-08-18
64494 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Second Le… 83 13 $1,232.00 $985.60 20% off $41.63 $2,464.00 $1,068.80 2026-08-18
64491 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Second Le… 83 13 $1,200.00 $960.00 20% off $48.05 $2,274.00 $1,068.80 2026-08-18
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 26 13 $1,453.50 $1,162.80 20% off $924.96 $1,461.00 $1,063.03 2026-08-18
110002 CDM Room & Board - Semi-private (two Beds) - General Classification 10 5 $1,103.00 $882.40 20% off $992.70 $1,103.00 $1,047.85 2026-08-18
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 48 13 $1,319.00 $1,055.20 $162.49 $3,662.00 $1,028.16 2026-08-18
11402 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm 28 13 $1,319.00 $1,055.20 $744.39 $1,319.00 $1,028.16 2026-08-18
30300 HCPCS Removal Of Foreign Body In Nose 26 13 $1,394.00 $1,115.20 $891.38 $1,394.00 $1,019.71 2026-08-18
11643 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.1-… 48 13 $3,483.00 $2,786.40 20% off $179.76 $3,483.00 $1,010.36 2026-08-18
64505 HCPCS Injection Of Anesthetic Agent, Trigeminal Nerve Bundle 83 13 $1,461.00 $1,168.80 20% off $87.36 $2,922.00 $1,008.09 2026-08-18
43215 HCPCS Removal Of Foreign Bodies In Esophagus Using A Flexible Endoscope 26 13 $1,365.00 $1,092.00 20% off $868.35 $1,372.00 $998.31 2026-08-18
43202 HCPCS Biopsy Of Esophagus Using A Flexible Endoscope Through Mouth 26 13 $1,365.00 $1,092.00 20% off $868.35 $1,372.00 $998.31 2026-08-18
49083 HCPCS Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance 26 13 $1,396.00 $1,116.80 $661.10 $1,758.00 $982.30 2026-08-18
J2760 HCPCS Injection, Phentolamine Mesylate, Up To 5 Mg 13 13 $1,274.00 $1,019.20 $550.36 $1,274.00 $966.97 2026-01-08
11601 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 28 13 $1,223.00 $978.40 20% off $744.39 $1,223.00 $953.33 2026-08-18
64636 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 85 13 $1,200.00 $960.00 20% off $48.05 $2,030.00 $950.40 2026-08-18
27550 HCPCS Closed Treatment Of Dislocated Knee 28 13 $1,208.00 $966.40 $768.56 $1,214.00 $936.96 2026-08-18
23500 HCPCS Closed Treatment Of Broken Collar Bone 28 13 $1,208.00 $966.40 $768.56 $1,214.00 $936.96 2026-08-18
78070 HCPCS Nuclear Medicine Study Of Parathyroid 26 13 $1,100.00 $880.00 20% off $704.00 $1,100.00 $935.00 2026-08-18
99464 HCPCS Physician Attendance At Delivery And Stabilization Of Newborn 26 13 $1,100.00 $880.00 20% off $704.00 $1,100.00 $935.00 2026-08-18
59430 HCPCS Post Delivery Care 26 13 $1,100.00 $880.00 20% off $704.00 $1,100.00 $935.00 2026-08-18
43753 HCPCS Insertion Of Stomach Tube And Aspiration Of Stomach Contents 28 13 $2,061.50 $1,649.20 20% off $390.54 $3,557.00 $933.00 2026-08-18
43752 HCPCS Insertion Of Stomach Tube Through Nose Or Mouth Using Fluoroscopic Guidance 26 13 $2,061.50 $1,649.20 20% off $390.54 $3,557.00 $933.00 2026-08-18
100225 CDM Linear Cutter 45mm 12 12 $1,125.00 $900.00 20% off $776.25 $1,068.75 $928.12 2026-01-08
36589 HCPCS Removal Of Tunneled Central Venous Tube 50 13 $1,424.00 $1,139.20 $115.67 $1,438.00 $920.32 2026-08-18
11400 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 26 13 $1,259.50 $1,007.60 20% off $744.39 $1,319.00 $919.69 2026-08-18
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 48 13 $1,319.00 $1,055.20 $165.93 $1,319.00 $910.11 2026-08-18
11401 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 26 13 $1,244.00 $995.20 $428.61 $1,244.00 $909.99 2026-08-18
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 26 13 $1,070.00 $856.00 20% off $684.80 $1,070.00 $909.50 2026-08-18
P9055 HCPCS Platelets, Leukocytes Reduced, Cmv-negative, Apheresis/pheresis, Each Unit 26 13 $1,070.00 $856.00 20% off $684.80 $1,070.00 $909.50 2026-08-18
P9053 HCPCS Platelets, Pheresis, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit 26 13 $1,070.00 $856.00 20% off $684.80 $1,070.00 $909.50 2026-08-18
P9037 HCPCS Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit 26 13 $1,070.00 $856.00 20% off $684.80 $1,070.00 $909.50 2026-08-18
P9052 HCPCS Platelets, Hla-matched Leukocytes Reduced, Apheresis/pheresis, Each Unit 26 13 $1,070.00 $856.00 20% off $684.80 $1,070.00 $909.50 2026-08-18
64484 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 48 13 $1,398.00 $1,118.40 $41.63 $1,412.00 $903.68 2026-08-18
25660 HCPCS Closed Treatment Of Dislocated Wrist Bones With Manipulation 59 13 $936.00 $748.80 20% off $329.05 $2,182.00 $889.20 2026-08-18
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
27840 HCPCS Closed Treatment Of Dislocated Ankle 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
27560 HCPCS Closed Treatment Of Dislocated Kneecap 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
26645 HCPCS Closed Treatment Of Broken Thumb At Wrist With Manipulation 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
25680 HCPCS Closed Treatment Of Broken And Dislocated Wrist Bones With Manipulation 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
24650 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
24640 HCPCS Closed Treatment Of Dislocated Forearm Bone On Thumb Side At Elbow With Manipula… 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
23570 HCPCS Closed Treatment Of Broken Shoulder Blade 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
23545 HCPCS Closed Treatment Of Dislocated Joint Between Collar Bone And Shoulder With Manip… 26 13 $1,208.00 $966.40 $768.56 $1,214.00 $883.49 2026-08-18
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 50 13 $1,334.00 $1,067.20 $244.36 $1,347.00 $879.99 2026-08-18
11600 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 26 13 $1,200.00 $960.00 20% off $744.39 $1,200.00 $877.80 2026-08-18
C1781 HCPCS Mesh (implantable) 182 13 $996.00 $796.80 20% off $592.00 $1,488.00 $875.15 2026-08-18
PHARMACY CDM Other Facility Pharmacy Charges 12 12 $1,051.88 $841.50 20% off $725.80 $999.29 $867.80 2026-01-08
64640 HCPCS Destruction Of Peripheral Nerve Or Branch 74 13 $1,200.00 $960.00 20% off $104.10 $1,212.00 $864.57 2026-08-18
78305 HCPCS Nuclear Medicine Study Of Bone And/or Joint Multiple Areas 26 13 $999.00 $799.20 $639.36 $999.00 $849.15 2026-08-18
11622 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2.0 … 26 13 $1,158.00 $926.40 20% off $744.39 $1,175.00 $846.61 2026-08-18
62323 HCPCS Injection Of Substance Into Lower Spine Canal Using Imaging Guidance 84 13 $1,200.00 $960.00 20% off $83.99 $1,804.00 $833.40 2026-08-18
64450 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Other Nerve Or Branch 97 13 $1,277.00 $1,021.60 20% off $36.13 $2,554.00 $825.60 2026-08-18
78707 HCPCS Nuclear Medicine Study Of Kidney, Blood Flow, And Function 26 13 $962.50 $770.00 20% off $631.35 $1,010.00 $815.75 2026-08-18
87507 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 26 13 $900.00 $720.00 20% off $576.00 $909.47 $810.00 2026-08-18
24600 HCPCS Repair Of Dislocated Elbow 50 13 $1,450.00 $1,160.00 20% off $300.00 $1,450.00 $809.01 2026-08-18
A9540 HCPCS Technetium Tc-99m Macroaggregated Albumin, Diagnostic, Per Study Dose, Up To 10 … 26 13 $1,100.00 $880.00 20% off $208.73 $1,100.00 $804.65 2026-08-18
45915 HCPCS Removal Of Impacted Stool Or Foreign Body In Rectum Under Anesthesia 26 13 $1,190.50 $952.40 20% off $117.30 $2,211.00 $792.52 2026-08-18
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 59 13 $815.00 $652.00 20% off $235.19 $1,514.00 $790.00 2026-08-18
11403 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 50 13 $1,961.00 $1,568.80 20% off $124.99 $1,961.00 $783.57 2026-08-18
11603 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 50 13 $1,665.00 $1,332.00 20% off $152.06 $1,665.00 $783.57 2026-08-18
78580 HCPCS Nuclear Medicine Study Of Lung Circulation 26 13 $911.00 $728.80 20% off $583.04 $911.00 $774.35 2026-08-18
27265 HCPCS Closed Treatment Of Dislocated Hip Prosthesis 59 13 $1,073.00 $858.40 20% off $343.07 $1,214.00 $768.56 2026-08-18
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 59 13 $849.00 $679.20 $300.00 $1,214.00 $768.56 2026-08-18
24500 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone 59 13 $809.00 $647.20 $276.95 $4,491.00 $768.55 2026-08-18
156526 CDM Spiriva Handihaler 18 Mcg Cap 12 12 $931.00 $744.80 20% off $642.39 $884.45 $768.08 2026-01-08
11642 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1.1-… 50 13 $1,179.00 $943.20 $143.97 $1,191.00 $762.24 2026-08-18
11765 HCPCS Removal Of Skin Of Fingernail Or Toenail 26 13 $1,034.00 $827.20 $658.22 $1,039.00 $756.24 2026-08-18
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 26 13 $1,029.00 $823.20 $658.52 $1,029.00 $752.71 2026-08-18
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 26 13 $1,022.00 $817.60 20% off $503.16 $1,025.00 $747.51 2026-08-18
78306 HCPCS Nuclear Medicine Study Of Bone And/or Joint Whole Body 26 13 $1,014.00 $811.20 $380.47 $1,014.00 $741.75 2026-08-18
78013 HCPCS Nuclear Medicine Study Of Thyroid 26 13 $999.00 $799.20 $317.78 $999.00 $730.77 2026-08-18
64421 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Multiple Rib Nerves For Region… 48 13 $1,137.00 $909.60 20% off $20.53 $1,200.00 $727.68 2026-08-18
78300 HCPCS Nuclear Medicine Study Of Bone And/or Joint Limited Area 26 13 $986.00 $788.80 20% off $326.61 $986.00 $721.25 2026-08-18
26605 HCPCS Closed Treatment Of Broken Hand Bone With Manipulation 59 13 $759.00 $607.20 $254.96 $1,214.00 $721.05 2026-08-18
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