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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

2,467 distinct procedures filed
13 distinct payers
65,623 rate rows
2026-10-23 last MRF observed
Data quality

64,326 of 65,623 rate rows are consumer-grade (98.0%)

1,297 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 690
per-diem day rate — not a per-procedure price 193
percent-of-charges filed in the dollar field — excluded from medians 177
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 140
exceeds 10× this hospital's gross charge — excluded from medians 60
exceeds 3× this hospital's gross charge for a DRG stay — excluded 32
placeholder amount (≤ $0.02) — excluded from medians 4
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 · 2026-11-11
Content fingerprint cee8891fb9f2f156… · 11,239,250 bytes · first seen 2026-10-24

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
$1,662
outlier · 8.3×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 13 $175.54 $19,183.00 $13,236.27 nat. median
$4,042
outlier · 3.3×
59410
HCPCS 		Vaginal Delivery With Post Delivery Care 13 $1,966.00 $15,708.00 $13,220.90 nat. median
$2,383
outlier · 5.5×
291
MS_DRG 		Heart Failure And Shock With Mcc 5 $5,813.91 $31,644.30 $12,732.00 nat. median
$12,730
1.0× median
CSSUPPLY
CDM 		Cs Supply Other Facility 12 $2,600.00 $14,472.30 $12,255.76 nat. median
$12,256
1.0× median
CSUPPLIES
CDM 		Supplies Other Facility Procedure 12 $2,600.00 $14,472.30 $12,255.76 nat. median
$12,256
1.0× median
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
$6,105
outlier · 2.0×
885
MS_DRG 		Psychoses 3 $2,763.99 $12,620.31 $11,989.29 nat. median
$12,283
1.0× median
J2353
HCPCS 		Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 13 $239.09 $17,102.00 $11,800.38 nat. median
$5,554
outlier · 2.1×
693
MS_DRG 		Urinary Stones With Mcc 3 $5,718.60 $10,009.00 $10,009.00 nat. median
$13,667
0.7× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 4 $6,576.39 $39,818.40 $9,114.93 nat. median
$11,493
0.8× median
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 5 $4,193.64 $29,115.55 $8,907.41 nat. median
$8,489
1.0× median
22514
HCPCS 		Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device 13 $3,200.00 $13,663.00 $8,744.32 nat. median
$8,409
1.0× median
603
MS_DRG 		Cellulitis Without Mcc 5 $4,003.02 $49,881.87 $7,784.04 nat. median
$8,967
0.9× median
93451
HCPCS 		Insertion Of Tube In Right Heart Chambers For Measurement 12 $4,924.15 $10,300.00 $7,462.35 nat. median
$4,834
1.5× median
206
MS_DRG 		Other Respiratory System Diagnoses Without Mcc 5 $3,621.78 $37,922.40 $7,433.94 nat. median
$9,486
0.8× median
292
MS_DRG 		Heart Failure And Shock With Cc 5 $4,670.19 $20,949.53 $7,245.15 nat. median
$8,935
0.8× median
914
MS_DRG 		Traumatic Injury Without Mcc 3 $2,668.68 $7,527.76 $7,151.37 nat. median
$9,228
0.8× median
47563
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 13 $3,200.00 $11,159.00 $7,141.76 nat. median
$6,020
1.2× median
47562
HCPCS 		Removal Of Gallbladder Using An Endoscope 13 $3,200.00 $11,159.00 $6,877.05 nat. median
$6,019
1.1× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 5 $4,670.19 $30,666.30 $6,854.47 nat. median
$8,082
0.8× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 5 $3,558.24 $30,956.30 $6,807.04 nat. median
$6,810
1.0× median
309
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Cc 4 $2,859.30 $26,495.00 $6,793.72 nat. median
$7,892
0.9× median
682
MS_DRG 		Renal Failure With Mcc 3 $4,956.12 $6,733.50 $6,733.50 nat. median
$14,406
outlier · 0.5×
47605
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts 13 $3,200.00 $10,515.00 $6,729.60 nat. median
$2,734
outlier · 2.5×
47600
HCPCS 		Removal Of Gallbladder 13 $3,200.00 $10,515.00 $6,729.60 nat. median
$2,764
outlier · 2.4×
607
MS_DRG 		Minor Skin Disorders Without Mcc 3 $4,257.18 $6,948.97 $6,601.52 nat. median
$9,186
0.7× median
58661
HCPCS 		Removal Of Ovaries And/or Tubes Using An Endoscope 13 $3,200.00 $9,563.00 $6,468.75 nat. median
$6,009
1.1× median
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 3 $3,780.63 $6,413.00 $6,413.00 nat. median
$10,168
0.6× median
552
MS_DRG 		Medical Back Problems Without Mcc 5 $4,860.81 $18,919.37 $6,311.17 nat. median
$9,816
0.6× median
J2407
HCPCS 		Injection, Oritavancin (orbactiv), 10 Mg 13 $31.78 $9,036.00 $6,234.84 nat. median
$80
outlier · 77.8×
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 4 $3,494.70 $17,608.50 $6,146.50 nat. median
$8,159
0.8× median
Q5111
HCPCS 		Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 13 $180.03 $8,836.00 $6,096.84 nat. median
$2,014
outlier · 3.0×
948
MS_DRG 		Signs And Symptoms Without Mcc 4 $6,063.83 $17,525.83 $6,063.83 nat. median
$7,968
0.8× median
179
MS_DRG 		Respiratory Infections And Inflammations Without Cc/mcc 4 $2,922.84 $17,443.00 $5,981.00 nat. median
$8,178
0.7× median
694
MS_DRG 		Urinary Stones Without Mcc 3 $3,335.85 $5,948.17 $5,948.17 nat. median
$8,197
0.7× median
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 4 $4,034.79 $17,374.75 $5,912.75 nat. median
$8,366
0.7× median
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 13 $35.80 $8,315.00 $5,737.35 nat. median
$2,892
2.0× median
202
MS_DRG 		Bronchitis And Asthma With Cc/mcc 3 $3,844.17 $5,599.50 $5,599.50 nat. median
$9,773
0.6× median
293
MS_DRG 		Heart Failure And Shock Without Cc/mcc 5 $2,668.68 $20,067.20 $5,523.84 nat. median
$6,353
0.9× median
605
MS_DRG 		Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 3 $4,288.95 $5,408.00 $5,408.00 nat. median
$9,343
0.6× median
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 13 $2,468.89 $7,583.00 $5,232.27 nat. median
$3,454
1.5× median
556
MS_DRG 		Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 3 $4,916.74 $5,012.50 $5,012.50 nat. median
$8,614
0.6× median
593
MS_DRG 		Skin Ulcers With Cc 5 $4,946.00 $11,250.10 $4,946.00 nat. median
$11,920
outlier · 0.4×
441
MS_DRG 		Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 3 $4,869.00 $4,869.00 $4,869.00 nat. median
$17,390
outlier · 0.3×
J3111
HCPCS 		Injection, Romosozumab-aqqg, 1 Mg 13 $12.16 $6,975.00 $4,812.75 nat. median
$734
outlier · 6.6×
90378
HCPCS 		Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 13 $1,982.15 $6,851.00 $4,634.04 nat. median
$2,108
outlier · 2.2×
49520
HCPCS 		Repair Of Groin Hernia That Is Not Trapped 13 $3,200.00 $6,796.00 $4,596.78 nat. median
$3,819
1.2× median
14000
HCPCS 		Repair Of Wound Of Trunk By Transferring Skin, 10.0 Sq Cm Or Less 13 $1,300.00 $6,825.00 $4,570.56 nat. median
$2,120
outlier · 2.2×
28820
HCPCS 		Amputation Of Toe At Joint Between Forefoot And Toes 13 $3,200.00 $6,576.00 $4,448.43 nat. median
$3,400
1.3× median

Other procedures at this hospital

Browse this hospital's 2,467 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
             
521019 CDM Ambulance 24 12 $1,717.00 $1,373.60 20% off $1,109.76 $1,647.30 $1,416.10 2026-10-23
28820 HCPCS Amputation Of Toe At Joint Between Forefoot And Toes 26 13 $6,511.50 $5,209.20 $3,200.00 $6,576.00 $4,448.43 2026-10-23
150783 CDM Antivenin Polyvalent 10 Ml Vial 24 12 $1,790.00 $1,432.00 20% off $1,157.12 $1,717.60 $1,476.30 2026-10-23
10160 HCPCS Aspiration Of Abscess, Blood, Or Cyst 28 13 $1,428.50 $1,142.80 20% off $900.01 $1,450.00 $1,096.76 2026-10-23
45398 HCPCS Banding Of Hemorrhoids Using A Flexible Endoscope (colonoscope) 26 13 $2,208.50 $1,766.80 20% off $1,382.64 $2,256.00 $1,614.21 2026-10-23
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 26 13 $2,767.50 $2,214.00 20% off $1,558.23 $3,099.00 $1,983.36 2026-10-23
43202 HCPCS Biopsy Of Esophagus Using A Flexible Endoscope Through Mouth 26 13 $1,379.00 $1,103.20 $868.35 $1,400.00 $1,008.16 2026-10-23
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 26 13 $2,313.00 $1,850.40 $1,095.75 $2,336.00 $1,691.32 2026-10-23
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 26 13 $2,140.50 $1,712.40 $1,295.33 $2,256.00 $1,562.60 2026-10-23
202 MS_DRG Bronchitis And Asthma With Cc/mcc 3 3 $5,599.50 $4,479.60 $3,844.17 $5,599.50 $5,599.50 2026-10-23
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 4 4 $9,302.00 $7,441.60 $2,859.30 $26,495.00 $6,793.72 2026-10-23
88120 HCPCS Cell Examination Of Urine, Manual 26 13 $1,800.00 $1,440.00 20% off $1,140.00 $1,818.00 $1,316.20 2026-10-23
603 MS_DRG Cellulitis Without Mcc 5 5 $18,361.37 $14,689.09 20% off $4,003.02 $49,881.87 $7,784.04 2026-10-23
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 5 5 $3,826.00 $3,060.80 $3,826.00 $10,130.10 $3,826.00 2026-10-23
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 26 13 $2,611.00 $2,088.80 $1,381.68 $3,062.00 $1,959.68 2026-10-23
27816 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
24620 HCPCS Closed Treatment Of Broken And Dislocated Forearm Bones At Elbow With Manipulati… 26 13 $3,268.50 $2,614.80 $1,966.00 $3,318.00 $2,221.11 2026-10-23
25680 HCPCS Closed Treatment Of Broken And Dislocated Wrist Bones With Manipulation 26 13 $1,220.50 $976.40 $768.56 $1,239.00 $892.29 2026-10-23
28470 HCPCS Closed Treatment Of Broken Bone In Forefoot Or Midfoot 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
23500 HCPCS Closed Treatment Of Broken Collar Bone 28 13 $1,220.50 $976.40 $768.56 $1,239.00 $936.96 2026-10-23
26742 HCPCS Closed Treatment Of Broken Finger Or Hand At Base Of Finger With Manipulation 26 13 $3,793.50 $3,034.80 $1,966.00 $3,850.00 $2,578.53 2026-10-23
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 28 13 $1,715.00 $1,372.00 20% off $1,080.40 $1,741.00 $1,290.97 2026-10-23
28475 HCPCS Closed Treatment Of Broken Foot With Manipulation 26 13 $2,438.50 $1,950.80 20% off $1,536.16 $2,475.00 $1,782.76 2026-10-23
27520 HCPCS Closed Treatment Of Broken Kneecap 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
27780 HCPCS Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
24505 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 59 13 $1,219.00 $975.20 $300.00 $2,226.00 $1,135.25 2026-10-23
25560 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 26 13 $2,611.00 $2,088.80 $1,381.68 $3,062.00 $1,959.68 2026-10-23
25530 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
25500 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 59 13 $1,171.00 $936.80 20% off $410.20 $2,226.00 $1,090.60 2026-10-23
21315 HCPCS Closed Treatment Of Broken Nose Bone With Manipulation 26 13 $2,933.50 $2,346.80 $1,857.59 $2,963.00 $2,003.76 2026-10-23
21320 HCPCS Closed Treatment Of Broken Nose Bone With Placement Of Stabilizing Device 26 13 $2,957.50 $2,366.00 20% off $1,872.94 $2,987.00 $2,020.32 2026-10-23
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 61 13 $1,297.00 $1,037.60 20% off $455.36 $3,062.00 $1,232.15 2026-10-23
27786 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 28 13 $2,193.00 $1,754.40 $1,300.00 $2,226.00 $1,528.75 2026-10-23
27788 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
27530 HCPCS Closed Treatment Of Broken Shin Bone 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
26645 HCPCS Closed Treatment Of Broken Thumb At Wrist With Manipulation 26 13 $1,220.50 $976.40 $768.56 $1,239.00 $892.29 2026-10-23
27840 HCPCS Closed Treatment Of Dislocated Ankle 26 13 $1,220.50 $976.40 $768.56 $1,239.00 $892.29 2026-10-23
27266 HCPCS Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 26 13 $1,625.50 $1,300.40 $1,023.79 $1,650.00 $1,188.38 2026-10-23
27550 HCPCS Closed Treatment Of Dislocated Knee 28 13 $1,220.50 $976.40 $768.56 $1,239.00 $936.96 2026-10-23
27560 HCPCS Closed Treatment Of Dislocated Kneecap 26 13 $1,220.50 $976.40 $768.56 $1,239.00 $892.29 2026-10-23
27562 HCPCS Closed Treatment Of Dislocated Kneecap Under Anesthesia 28 13 $3,809.00 $3,047.20 20% off $1,300.00 $3,866.00 $2,588.88 2026-10-23
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 26 13 $2,193.00 $1,754.40 $1,381.68 $2,226.00 $1,603.27 2026-10-23
G0105 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 26 13 $1,511.00 $1,208.80 20% off $956.62 $1,526.00 $1,104.88 2026-10-23
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 26 13 $1,572.00 $1,257.60 20% off $956.62 $1,588.00 $1,149.47 2026-10-23
10180 HCPCS Complex Drainage Of Wound Infection After Surgery 26 13 $5,706.00 $4,564.80 $1,300.00 $5,791.00 $3,878.49 2026-10-23
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 28 13 $2,227.50 $1,782.00 20% off $1,300.00 $2,250.00 $1,552.72 2026-10-23
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
70460 HCPCS CT Scan Head Or Brain With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
70450 HCPCS CT Scan Head Or Brain Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 26 13 $2,981.00 $2,384.80 $434.65 $3,011.00 $2,179.77 2026-10-23
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 26 13 $2,544.50 $2,035.60 20% off $434.65 $2,570.00 $1,860.60 2026-10-23
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 26 13 $2,425.50 $1,940.40 $434.65 $2,450.00 $1,773.58 2026-10-23
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
74160 HCPCS CT Scan Of Abdomen With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
74150 HCPCS CT Scan Of Abdomen Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
73202 HCPCS CT Scan Of Arm Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
73201 HCPCS CT Scan Of Arm With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
73200 HCPCS CT Scan Of Arm Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 26 13 $2,758.50 $2,206.80 $1,618.94 $2,786.00 $2,017.09 2026-10-23
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 26 13 $2,255.50 $1,804.40 $1,127.26 $2,278.00 $1,649.28 2026-10-23
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 26 13 $2,255.50 $1,804.40 $1,086.66 $2,278.00 $1,649.28 2026-10-23
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 26 13 $2,255.50 $1,804.40 $1,100.77 $2,278.00 $1,649.28 2026-10-23
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 26 13 $2,255.50 $1,804.40 $1,457.92 $2,278.00 $1,917.17 2026-10-23
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 26 13 $2,255.50 $1,804.40 $1,101.66 $2,278.00 $1,649.28 2026-10-23
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 26 13 $2,255.50 $1,804.40 $1,457.92 $2,278.00 $1,917.17 2026-10-23
71270 HCPCS CT Scan Of Chest Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
71260 HCPCS CT Scan Of Chest With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
71250 HCPCS CT Scan Of Chest Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
70488 HCPCS CT Scan Of Face Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
70487 HCPCS CT Scan Of Face With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
70486 HCPCS CT Scan Of Face Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
73702 HCPCS CT Scan Of Leg Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
73701 HCPCS CT Scan Of Leg With Contrast Material 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
73700 HCPCS CT Scan Of Leg Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
72132 HCPCS CT Scan Of Lower Spine With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
72131 HCPCS CT Scan Of Lower Spine Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
72129 HCPCS CT Scan Of Middle Spine With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
72128 HCPCS CT Scan Of Middle Spine Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
72193 HCPCS CT Scan Of Pelvis With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
72192 HCPCS CT Scan Of Pelvis Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 26 13 $1,878.00 $1,502.40 $434.65 $1,897.00 $1,373.24 2026-10-23
72126 HCPCS CT Scan Of Upper Spine With Contrast 26 13 $1,757.50 $1,406.00 20% off $434.65 $1,775.00 $1,285.13 2026-10-23
72125 HCPCS CT Scan Of Upper Spine Without Contrast 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
59414 HCPCS Delivery Of Placenta 26 13 $3,111.00 $2,488.80 $1,966.00 $3,142.00 $2,644.35 2026-10-23
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 86 13 $1,286.00 $1,028.80 20% off $162.92 $3,549.20 $1,134.00 2026-10-23
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 $2,071.00 $950.40 2026-10-23
64624 HCPCS Destruction Of Nerve Branches Of Knee Using Imaging Guidance 48 13 $3,328.00 $2,662.40 20% off $125.36 $3,395.00 $2,172.80 2026-10-23
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 48 13 $1,319.00 $1,055.20 $165.93 $1,346.00 $910.11 2026-10-23
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 48 13 $1,319.00 $1,055.20 $162.49 $3,736.00 $1,028.16 2026-10-23
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 26 13 $1,664.50 $1,331.60 20% off $981.57 $1,794.00 $1,196.53 2026-10-23
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 26 13 $2,060.50 $1,648.40 $1,255.03 $2,081.00 $1,506.69 2026-10-23
45330 HCPCS Diagnostic Exam Of Lower Portion Of Large Bowel Using A Flexible Endoscope 26 13 $1,572.50 $1,258.00 20% off $767.60 $1,745.00 $1,118.40 2026-10-23
43245 HCPCS Dilation Of Stomach Outlet Using A Flexible Endoscope 26 13 $2,988.50 $2,390.80 $1,501.62 $3,629.00 $2,230.60 2026-10-23
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 3 3 $3,713.00 $2,970.40 20% off $3,713.00 $3,713.00 $3,713.00 2026-10-23
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 3 3 $4,869.00 $3,895.20 20% off $4,869.00 $4,869.00 $4,869.00 2026-10-23
445 MS_DRG Disorders Of The Biliary Tract With Cc 5 5 $3,982.00 $3,185.60 20% off $3,982.00 $10,286.10 $3,982.00 2026-10-23
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 28 13 $2,431.00 $1,944.80 20% off $1,127.41 $3,099.00 $1,674.85 2026-10-23
27301 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Thigh Or Knee 26 13 $5,532.50 $4,426.00 20% off $1,300.00 $5,615.00 $3,760.50 2026-10-23
49083 HCPCS Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance 26 13 $1,414.00 $1,131.20 $661.10 $1,794.00 $982.30 2026-10-23
46050 HCPCS Drainage Of Superficial Rectal Abscess Surrounding Anus 26 13 $1,561.50 $1,249.20 20% off $873.15 $1,745.00 $1,116.80 2026-10-23
149 MS_DRG Dysequilibrium 3 3 $2,411.50 $1,929.20 20% off $2,192.13 $2,411.50 $2,411.50 2026-10-23
Q4145 HCPCS Epifix, Injectable, 1 Mg 26 13 $5,978.00 $4,782.40 20% off $24.29 $5,978.00 $4,124.82 2026-10-23
59300 HCPCS Episiotomy Or Repair Of Vagina 26 13 $3,646.00 $2,916.80 $834.90 $6,082.00 $1,588.00 2026-10-23
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 4 4 $6,146.50 $4,917.20 20% off $3,494.70 $17,608.50 $6,146.50 2026-10-23
93017 HCPCS Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg) 37 13 $1,471.00 $1,176.80 20% off $338.55 $1,690.00 $1,166.10 2026-10-23
389 MS_DRG Gastrointestinal Obstruction With Cc 3 3 $2,231.00 $1,784.80 20% off $2,231.00 $2,231.00 $2,231.00 2026-10-23
292 MS_DRG Heart Failure And Shock With Cc 5 5 $8,341.33 $6,673.07 $4,670.19 $20,949.53 $7,245.15 2026-10-23
291 MS_DRG Heart Failure And Shock With Mcc 5 5 $12,732.00 $10,185.60 20% off $5,813.91 $31,644.30 $12,732.00 2026-10-23
293 MS_DRG Heart Failure And Shock Without Cc/mcc 5 5 $7,459.00 $5,967.20 20% off $2,668.68 $20,067.20 $5,523.84 2026-10-23
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 26 13 $2,611.00 $2,088.80 $1,381.68 $3,062.00 $1,959.68 2026-10-23
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 $3,468.00 $1,200.00 2026-10-23
64505 HCPCS Injection Of Anesthetic Agent, Trigeminal Nerve Bundle 83 13 $1,461.00 $1,168.80 20% off $87.36 $2,981.00 $1,008.09 2026-10-23
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 $5,074.00 $1,623.68 2026-10-23
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 $1,441.00 $922.24 2026-10-23
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 $2,514.00 $1,090.56 2026-10-23
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 $6,847.00 $2,191.36 2026-10-23
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 $3,581.00 $1,260.86 2026-10-23
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 $1,748.00 $1,084.71 2026-10-23
64491 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Second Le… 83 13 $1,224.00 $979.20 $48.05 $2,320.00 $1,080.15 2026-10-23
64492 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Third And… 72 13 $1,704.00 $1,363.20 20% off $48.62 $2,777.00 $1,151.40 2026-10-23
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 26 13 $7,583.00 $6,066.40 20% off $2,468.89 $7,583.00 $5,232.27 2026-10-23
J0897 HCPCS Injection, Denosumab, 1 Mg 26 13 $4,644.00 $3,715.20 20% off $28.20 $4,644.00 $3,204.36 2026-10-23
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
J1437 HCPCS Injection, Ferric Derisomaltose, 10 Mg 13 13 $6,136.00 $4,908.80 20% off $26.52 $6,136.00 $3,927.04 2026-10-23
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
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 26 13 $2,941.00 $2,352.80 $39.80 $2,941.00 $2,151.34 2026-10-23
J2182 HCPCS Injection, Mepolizumab, 1 Mg 26 13 $8,315.00 $6,652.00 20% off $35.80 $8,315.00 $5,737.35 2026-10-23
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
J2357 HCPCS Injection, Omalizumab, 5 Mg 26 13 $2,906.00 $2,324.80 $46.30 $2,906.00 $2,125.74 2026-10-23
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 26 13 $3,005.00 $2,404.00 20% off $7.72 $3,005.00 $2,198.16 2026-10-23
J2407 HCPCS Injection, Oritavancin (orbactiv), 10 Mg 26 13 $9,036.00 $7,228.80 20% off $31.78 $9,036.00 $6,234.84 2026-10-23
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 26 13 $16,313.00 $13,050.40 20% off $2,600.00 $16,313.00 $13,866.05 2026-10-23
Q5122 HCPCS Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg 26 13 $4,418.00 $3,534.40 20% off $159.80 $4,418.00 $3,048.42 2026-10-23
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
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 26 13 $3,844.00 $3,075.20 20% off $168.99 $3,844.00 $2,652.36 2026-10-23
J2760 HCPCS Injection, Phentolamine Mesylate, Up To 5 Mg 26 13 $1,274.00 $1,019.20 $550.36 $1,274.00 $931.93 2026-10-23
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
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 26 13 $6,975.00 $5,580.00 20% off $12.16 $6,975.00 $4,812.75 2026-10-23
J3101 HCPCS Injection, Tenecteplase, 1 Mg 26 13 $19,183.00 $15,346.40 20% off $175.54 $19,183.00 $13,236.27 2026-10-23
49421 HCPCS Insertion Of Abdominal Cavity Tube For Drainage Or Dialysis 26 13 $4,285.50 $3,428.40 20% off $1,300.00 $6,305.00 $3,650.25 2026-10-23
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 26 13 $5,341.50 $4,273.20 20% off $3,200.00 $6,021.00 $3,853.44 2026-10-23
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 26 13 $4,990.50 $3,992.40 20% off $2,533.08 $6,021.00 $3,762.00 2026-10-23
43753 HCPCS Insertion Of Stomach Tube And Aspiration Of Stomach Contents 28 13 $2,097.50 $1,678.00 20% off $390.54 $3,629.00 $933.00 2026-10-23
43752 HCPCS Insertion Of Stomach Tube Through Nose Or Mouth Using Fluoroscopic Guidance 26 13 $2,097.50 $1,678.00 20% off $390.54 $3,629.00 $933.00 2026-10-23
43246 HCPCS Insertion Of Stomach Tube Using A Flexible Endoscope 26 13 $3,399.50 $2,719.60 20% off $2,027.42 $3,629.00 $2,471.02 2026-10-23
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 95 13 $3,591.00 $2,872.80 $79.42 $7,254.00 $2,526.09 2026-10-23
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 26 13 $4,040.00 $3,232.00 20% off $1,300.00 $4,080.00 $3,434.00 2026-10-23
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
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
183985 CDM Insulin Pen Soliqua 100 Unit 33mcg 24 12 $1,951.50 $1,561.20 20% off $1,261.44 $1,872.45 $1,609.50 2026-10-23
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 26 13 $1,468.50 $1,174.80 20% off $924.96 $1,491.00 $1,073.59 2026-10-23
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 26 13 $1,220.50 $976.40 $768.56 $1,239.00 $892.29 2026-10-23
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 26 13 $3,931.00 $3,144.80 $1,966.00 $3,990.00 $2,671.68 2026-10-23
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 4 4 $14,602.00 $11,681.60 20% off $6,576.39 $39,818.40 $9,114.93 2026-10-23
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 4 4 $5,912.75 $4,730.20 20% off $4,034.79 $17,374.75 $5,912.75 2026-10-23
76380 HCPCS Limited Or Follow-up CT Scan 26 13 $1,654.50 $1,323.60 20% off $434.65 $1,671.00 $1,209.81 2026-10-23
100225 CDM Linear Cutter 45mm 24 12 $1,136.50 $909.20 $734.72 $1,090.60 $937.33 2026-10-23
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 26 13 $1,710.00 $1,368.00 20% off $434.65 $1,727.00 $1,250.40 2026-10-23
552 MS_DRG Medical Back Problems Without Mcc 5 5 $6,311.17 $5,048.93 20% off $4,860.81 $18,919.37 $6,311.17 2026-10-23
607 MS_DRG Minor Skin Disorders Without Mcc 3 3 $7,996.00 $6,396.80 20% off $4,257.18 $6,948.97 $6,601.52 2026-10-23
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 5 5 $11,754.00 $9,403.20 $4,670.19 $30,666.30 $6,854.47 2026-10-23
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
74182 HCPCS MRI Scan Of Abdomen With Contrast 26 13 $2,368.50 $1,894.80 20% off $499.90 $2,392.00 $1,731.91 2026-10-23
74181 HCPCS MRI Scan Of Abdomen Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
73220 HCPCS MRI Scan Of Arm Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
73218 HCPCS MRI Scan Of Arm Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 26 13 $2,267.50 $1,814.00 20% off $601.61 $2,290.00 $1,658.06 2026-10-23
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 26 13 $2,267.50 $1,814.00 20% off $601.61 $2,290.00 $1,658.06 2026-10-23
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 26 13 $2,267.50 $1,814.00 20% off $601.61 $2,290.00 $1,658.06 2026-10-23
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 26 13 $2,267.50 $1,814.00 20% off $601.61 $2,290.00 $1,658.06 2026-10-23
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
70553 HCPCS MRI Scan Of Brain Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
70552 HCPCS MRI Scan Of Brain With Contrast 26 13 $2,368.50 $1,894.80 20% off $499.90 $2,392.00 $1,731.91 2026-10-23
70551 HCPCS MRI Scan Of Brain Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
71552 HCPCS MRI Scan Of Chest Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
71551 HCPCS MRI Scan Of Chest With Contrast 26 13 $2,368.50 $1,894.80 20% off $499.90 $2,392.00 $1,731.91 2026-10-23
71550 HCPCS MRI Scan Of Chest Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
73720 HCPCS MRI Scan Of Leg Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
73718 HCPCS MRI Scan Of Leg Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
72195 HCPCS MRI Scan Of Pelvis Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 26 13 $2,591.00 $2,072.80 $499.90 $2,617.00 $1,894.61 2026-10-23
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 26 13 $2,267.50 $1,814.00 20% off $499.90 $2,290.00 $1,658.06 2026-10-23
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 36 13 $3,653.00 $2,922.40 20% off $1,394.68 $6,170.00 $3,344.82 2026-10-23
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 26 13 $1,482.00 $1,185.60 20% off $330.14 $1,497.00 $1,083.67 2026-10-23
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 26 13 $2,020.00 $1,616.00 20% off $959.50 $2,040.00 $1,477.08 2026-10-23
78070 HCPCS Nuclear Medicine Study Of Parathyroid 26 13 $1,111.00 $888.80 20% off $718.08 $1,122.00 $944.35 2026-10-23
540 MS_DRG Osteomyelitis With Cc 5 5 $3,606.00 $2,884.80 $3,606.00 $9,910.10 $3,606.00 2026-10-23
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 5 5 $12,706.00 $10,164.80 20% off $3,621.78 $37,922.40 $7,433.94 2026-10-23
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
99464 HCPCS Physician Attendance At Delivery And Stabilization Of Newborn 26 13 $1,111.00 $888.80 20% off $718.08 $1,122.00 $944.35 2026-10-23
P9052 HCPCS Platelets, Hla-matched Leukocytes Reduced, Apheresis/pheresis, Each Unit 26 13 $1,081.00 $864.80 20% off $698.88 $1,092.00 $918.85 2026-10-23
P9055 HCPCS Platelets, Leukocytes Reduced, Cmv-negative, Apheresis/pheresis, Each Unit 26 13 $1,081.00 $864.80 20% off $698.88 $1,092.00 $918.85 2026-10-23
P9053 HCPCS Platelets, Pheresis, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit 26 13 $1,081.00 $864.80 20% off $698.88 $1,092.00 $918.85 2026-10-23
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 26 13 $1,081.00 $864.80 20% off $698.88 $1,092.00 $918.85 2026-10-23
P9037 HCPCS Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit 26 13 $1,081.00 $864.80 20% off $698.88 $1,092.00 $918.85 2026-10-23
C1788 HCPCS Port, Indwelling (implantable) 26 13 $2,087.00 $1,669.60 20% off $1,349.12 $2,108.00 $1,773.95 2026-10-23
59430 HCPCS Post Delivery Care 26 13 $1,111.00 $888.80 20% off $718.08 $1,122.00 $944.35 2026-10-23
885 MS_DRG Psychoses 3 3 $13,717.75 $10,974.20 $2,763.99 $12,620.31 $11,989.29 2026-10-23
Q4196 HCPCS Puraply Am, Per Square Centimeter 26 13 $1,894.00 $1,515.20 20% off $1,224.32 $1,913.00 $1,609.90 2026-10-23
11601 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 28 13 $1,235.50 $988.40 20% off $744.39 $1,248.00 $953.33 2026-10-23
11604 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 28 13 $3,042.50 $2,434.00 20% off $744.39 $3,073.00 $2,120.84 2026-10-23
11606 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 28 13 $3,232.00 $2,585.60 20% off $1,300.00 $3,264.00 $2,252.93 2026-10-23
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 $3,553.00 $1,010.36 2026-10-23
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 $2,013.00 $1,288.32 2026-10-23
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 $3,417.00 $1,550.97 2026-10-23
11623 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3.0 … 26 13 $2,118.00 $1,694.40 $1,016.37 $2,763.00 $1,715.16 2026-10-23
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 $2,763.00 $1,195.08 2026-10-23
11626 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 26 13 $4,022.00 $3,217.60 20% off $2,293.56 $4,720.00 $3,052.68 2026-10-23
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 28 13 $2,902.00 $2,321.60 20% off $1,300.00 $2,972.00 $2,023.18 2026-10-23
46221 HCPCS Removal Of External Hemorrhoids By Rubber Banding 26 13 $2,472.50 $1,978.00 20% off $1,550.55 $2,497.00 $1,807.96 2026-10-23
43215 HCPCS Removal Of Foreign Bodies In Esophagus Using A Flexible Endoscope 26 13 $1,379.00 $1,103.20 $868.35 $1,400.00 $1,008.16 2026-10-23
43247 HCPCS Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using … 26 13 $1,974.00 $1,579.20 20% off $1,243.51 $2,004.00 $1,443.16 2026-10-23
30300 HCPCS Removal Of Foreign Body In Nose 26 13 $1,408.00 $1,126.40 $891.38 $1,422.00 $1,029.57 2026-10-23
31530 HCPCS Removal Of Foreign Body In Voice Box Using An Endoscope 26 13 $6,267.50 $5,014.00 20% off $1,966.00 $6,361.00 $4,260.06 2026-10-23
47600 HCPCS Removal Of Gallbladder 26 13 $8,877.00 $7,101.60 $3,200.00 $10,515.00 $6,729.60 2026-10-23
47562 HCPCS Removal Of Gallbladder Using An Endoscope 26 13 $9,199.00 $7,359.20 $3,200.00 $11,159.00 $6,877.05 2026-10-23
47605 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts 26 13 $8,877.00 $7,101.60 $3,200.00 $10,515.00 $6,729.60 2026-10-23
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 26 13 $9,950.50 $7,960.40 $3,200.00 $11,159.00 $7,141.76 2026-10-23
19125 HCPCS Removal Of Growth Of Breast Identified By X-ray Marker, First Growth 26 13 $5,681.00 $4,544.80 $1,300.00 $7,324.00 $3,986.92 2026-10-23
26160 HCPCS Removal Of Growth Of Tendon Finger Or Hand 26 13 $3,128.00 $2,502.40 20% off $1,300.00 $3,175.00 $2,125.89 2026-10-23
21012 HCPCS Removal Of Growth Under Skin Of Face Or Scalp, 2.0 Cm Or More 26 13 $2,043.50 $1,634.80 $1,280.93 $2,064.00 $1,494.26 2026-10-23
11005 HCPCS Removal Of Infected Skin, Tissue Or Muscle Of Abdomen 26 13 $2,059.50 $1,647.60 20% off $1,300.00 $2,080.00 $1,750.58 2026-10-23
11400 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 26 13 $1,273.00 $1,018.40 20% off $744.39 $1,346.00 $929.19 2026-10-23
11401 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 26 13 $1,256.50 $1,005.20 $428.61 $1,269.00 $918.79 2026-10-23
11402 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm 28 13 $1,332.50 $1,066.00 20% off $744.39 $1,346.00 $1,028.16 2026-10-23
11404 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 28 13 $2,674.00 $2,139.20 20% off $1,300.00 $3,099.00 $1,983.36 2026-10-23
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 28 13 $3,132.50 $2,506.00 20% off $1,300.00 $3,179.00 $2,183.68 2026-10-23
11441 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0… 28 13 $1,462.00 $1,169.60 20% off $744.39 $1,725.00 $1,139.05 2026-10-23
11442 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1… 26 13 $2,112.00 $1,689.60 20% off $1,164.83 $2,133.00 $1,442.79 2026-10-23
11443 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2… 26 13 $2,068.50 $1,654.80 $1,336.96 $2,089.00 $1,512.55 2026-10-23
11444 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3… 28 13 $3,908.00 $3,126.40 20% off $1,300.00 $3,947.00 $2,724.15 2026-10-23
11446 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, M… 26 13 $4,358.00 $3,486.40 20% off $2,746.09 $4,423.00 $3,156.89 2026-10-23
11420 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.5 C… 28 13 $2,199.50 $1,759.60 20% off $897.00 $3,099.00 $1,715.16 2026-10-23
11421 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.6-1… 26 13 $1,838.50 $1,470.80 20% off $744.39 $1,857.00 $1,344.36 2026-10-23
11422 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 26 13 $2,566.00 $2,052.80 $1,402.77 $3,099.00 $1,931.35 2026-10-23
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 $3,099.00 $1,558.23 2026-10-23
11424 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 26 13 $2,887.50 $2,310.00 20% off $1,711.75 $3,099.00 $2,085.94 2026-10-23
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 28 13 $4,135.00 $3,308.00 20% off $1,300.00 $5,474.00 $2,656.20 2026-10-23
58661 HCPCS Removal Of Ovaries And/or Tubes Using An Endoscope 26 13 $9,469.00 $7,575.20 20% off $3,200.00 $9,563.00 $6,468.75 2026-10-23
43251 HCPCS Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi… 26 13 $2,819.50 $2,255.60 20% off $1,285.73 $3,629.00 $1,909.50 2026-10-23
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 26 13 $2,148.00 $1,718.40 $1,255.03 $2,256.00 $1,568.29 2026-10-23
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 26 13 $2,319.00 $1,855.20 20% off $1,412.38 $2,342.00 $1,695.72 2026-10-23
36589 HCPCS Removal Of Tunneled Central Venous Tube 50 13 $1,424.00 $1,139.20 $115.67 $1,467.00 $938.88 2026-10-23
682 MS_DRG Renal Failure With Mcc 3 3 $6,733.50 $5,386.80 20% off $4,956.12 $6,733.50 $6,733.50 2026-10-23
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 26 13 $6,205.50 $4,964.40 20% off $3,200.00 $6,750.00 $4,320.00 2026-10-23
49520 HCPCS Repair Of Groin Hernia That Is Not Trapped 26 13 $6,729.00 $5,383.20 $3,200.00 $6,796.00 $4,596.78 2026-10-23
49525 HCPCS Repair Of Sliding Groin Hernia 26 13 $4,878.00 $3,902.40 20% off $1,922.84 $6,750.00 $2,855.70 2026-10-23
26410 HCPCS Repair Of Tendon On Top Of Hand 26 13 $2,986.50 $2,389.20 20% off $1,881.58 $3,031.00 $2,029.98 2026-10-23
26418 HCPCS Repair Of Tendon On Top Side Of Finger 26 13 $4,550.00 $3,640.00 20% off $1,966.00 $4,618.00 $3,092.58 2026-10-23
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 $2,722.00 $1,594.34 2026-10-23
14020 HCPCS Repair Of Wound Of Scalp, Arms, Or Legs By Transferring Skin, 10.0 Sq Cm Or Less 26 13 $3,298.50 $2,638.80 $1,300.00 $3,348.00 $2,241.81 2026-10-23
14000 HCPCS Repair Of Wound Of Trunk By Transferring Skin, 10.0 Sq Cm Or Less 26 13 $6,724.50 $5,379.60 $1,300.00 $6,825.00 $4,570.56 2026-10-23
178 MS_DRG Respiratory Infections And Inflammations With Cc 3 3 $6,413.00 $5,130.40 20% off $3,780.63 $6,413.00 $6,413.00 2026-10-23
177 MS_DRG Respiratory Infections And Inflammations With Mcc 4 4 $985.01 $788.00 20% off $985.01 $2,285.01 $985.01 2026-10-23
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 4 4 $5,981.00 $4,784.80 20% off $2,922.84 $17,443.00 $5,981.00 2026-10-23
90378 HCPCS Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 26 13 $6,783.50 $5,426.80 20% off $1,982.15 $6,851.00 $4,634.04 2026-10-23
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
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 2026-10-23
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 2026-10-23
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 2026-10-23
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 3 $4,245.50 $3,396.40 20% off $4,245.50 $4,245.50 $4,245.50 2026-10-23
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 3 3 $5,012.50 $4,010.00 20% off $4,916.74 $5,012.50 $5,012.50 2026-10-23
948 MS_DRG Signs And Symptoms Without Mcc 4 4 $6,063.83 $4,851.07 $6,063.83 $17,525.83 $6,063.83 2026-10-23
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 5 5 $10,203.25 $8,162.60 $4,193.64 $29,115.55 $8,907.41 2026-10-23
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 5 5 $12,044.00 $9,635.20 $3,558.24 $30,956.30 $6,807.04 2026-10-23
11770 HCPCS Simple Removal Of Cyst Of Tailbone 26 13 $2,586.00 $2,068.80 $1,629.23 $2,625.00 $1,890.59 2026-10-23
593 MS_DRG Skin Ulcers With Cc 5 5 $4,946.00 $3,956.80 $4,946.00 $11,250.10 $4,946.00 2026-10-23
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
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
SUPPLIES CDM Supply Other Facility 12 12 $1,518.00 $1,214.40 $1,047.42 $1,442.10 $1,252.35 2026-01-08
0202U OTHER Test For Detection Of Respiratory Disease-causing Organisms From Back Of Nose An… 13 13 $2,140.00 $1,712.00 20% off $1,328.91 $2,140.00 $1,506.56 2026-10-23
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 3 3 $5,408.00 $4,326.40 20% off $4,288.95 $5,408.00 $5,408.00 2026-10-23
914 MS_DRG Traumatic Injury Without Mcc 3 3 $7,898.00 $6,318.40 20% off $2,668.68 $7,527.76 $7,151.37 2026-10-23
22514 HCPCS Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device 26 13 $11,669.00 $9,335.20 $3,200.00 $13,663.00 $8,744.32 2026-10-23
58600 HCPCS Tying Or Incision Of Fallopian Tubes 26 13 $5,614.00 $4,491.20 $3,200.00 $6,082.00 $3,892.48 2026-10-23
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 26 13 $2,391.00 $1,912.80 20% off $1,455.56 $2,415.00 $1,748.36 2026-10-23
693 MS_DRG Urinary Stones With Mcc 3 3 $10,009.00 $8,007.20 20% off $5,718.60 $10,009.00 $10,009.00 2026-10-23
694 MS_DRG Urinary Stones Without Mcc 3 3 $5,948.17 $4,758.54 $3,335.85 $5,948.17 $5,948.17 2026-10-23
59410 HCPCS Vaginal Delivery With Post Delivery Care 26 13 $15,554.00 $12,443.20 $1,966.00 $15,708.00 $13,220.90 2026-10-23
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