Price Transparency Hospital negotiated rates

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

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Hospital

MITCHELL COUNTY HOSPITAL HEALTH SYSTEMS

Beloit, KS · CCN 171375 · Rates published

5,277 distinct procedures filed
13 distinct payers
75,740 rate rows
2026-03-21 last MRF observed
Data quality

75,298 of 75,740 rate rows are consumer-grade (99.4%)

442 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 270
percent-of-charges filed in the dollar field — excluded from medians 147
per-diem day rate — not a per-procedure price 17
exceeds 10× this hospital's gross charge — excluded from medians 6
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbMCHHSBELOITKS&type=CDMWithoutLabel
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint b8f8e94d2b7499ae… · 31,926,386 bytes · first seen 2026-05-07

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3357
HCPCS 		Ustekinumab, For Subcutaneous Injection, 1 Mg 12 $190.72 $34,617.36 $32,886.49 nat. median
$14,306
outlier · 2.3×
J9334
HCPCS 		Injection, Efgartigimod Alfa, 2 Mg And Hyaluronidase-qvfc 12 $33.89 $20,266.64 $19,253.31 nat. median
$73
outlier · 262.4×
25765486_5
CDM 		Graft Xenmatrix Surg 19cmx28cm Antibac* 10 $15,261.75 $17,775.45 $17,057.25 nat. median
$17,057
1.0× median
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 13 $59.41 $15,617.44 $14,836.57 nat. median
$712
outlier · 20.8×
J0896
HCPCS 		Injection, Luspatercept-aamt, 0.25 Mg 13 $41.98 $15,239.13 $14,477.17 nat. median
$4,612
outlier · 3.1×
25765940_5
CDM 		Graft Xenmatrix Surg 20cmx20cm* 10 $11,711.94 $13,640.96 $13,089.81 nat. median
$13,090
1.0× median
25766037_5
CDM 		Mesh Phasix 10"x12"* 10 $10,994.75 $12,805.65 $12,288.25 nat. median
$12,288
1.0× median
J2327
HCPCS 		Injection, Risankizumab-rzaa, Intravenous, 1 Mg 12 $14.94 $12,632.30 $12,000.69 nat. median
$2,241
outlier · 5.4×
25765485_5
CDM 		Graft Xenmatrix Surg 15cmx20cm Antibac* 10 $9,282.00 $10,810.80 $10,374.00 nat. median
$10,374
1.0× median
27091376_5
CDM 		Meshed Bilayer Wound Matrix 4x5 10 $8,991.39 $10,472.32 $10,049.20 nat. median
$10,049
1.0× median
27535763_5
CDM 		Mesh Xen Matrix Ab 15cm X 20cm* 10 $8,414.58 $9,800.51 $9,404.53 nat. median
$9,405
1.0× median
25768576_5
CDM 		Mesh Surgimend 20CMx20CMx2MM 2017* 10 $8,398.00 $9,781.20 $9,386.00 nat. median
$9,386
1.0× median
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 13 $172.22 $34,490.81 $8,820.03 nat. median
$5,949
1.5× median
J2353
HCPCS 		Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 13 $203.58 $8,451.64 $8,029.06 nat. median
$5,975
1.3× median
25765454_5
CDM 		Alrua Pacemaker Generator* 10 $6,792.44 $7,911.19 $7,591.55 nat. median
$7,592
1.0× median
25765453_5
CDM 		Adapta Dr Pacemaker Generator* 10 $6,109.55 $7,115.82 $6,828.32 nat. median
$6,828
1.0× median
27372
HCPCS 		Removal Of Foreign Body Deep In Tissue Of Thigh Or Knee 13 $2,967.63 $7,131.00 $6,417.90 nat. median
$3,130
outlier · 2.1×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 13 $21.31 $6,696.34 $6,361.52 nat. median
$288
outlier · 22.1×
J7192
HCPCS 		Factor Viii (antihemophilic Factor, Recombinant) Per I.u., Not Otherwise Specifi… 13 $1.61 $6,513.47 $6,187.80 nat. median
$10
outlier · 593.8×
31525
HCPCS 		Diagnostic Exam Of Voice Box Using An Endoscope 13 $1,818.45 $6,701.00 $6,030.90 nat. median
$2,020
outlier · 3.0×
J7202
HCPCS 		Injection, Factor Ix, Albumin Fusion Protein, (recombinant), Idelvion, 1 I.u. 13 $5.32 $6,284.88 $5,970.64 nat. median
$7
outlier · 822.4×
27749219_5
CDM 		Graft Skin Mesh Derm Regenerating 2x2" * 10 $5,265.09 $6,132.28 $5,884.51 nat. median
$5,885
1.0× median
25765858_5
CDM 		Reveal Xt Monitor Pacemaker* 10 $5,236.00 $6,098.40 $5,852.00 nat. median
$5,852
1.0× median
J1162
HCPCS 		Injection, Digoxin Immune Fab (ovine), Per Vial 13 $4,974.80 $5,913.56 $5,560.07 nat. median
$7,316
0.8× median
31530
HCPCS 		Removal Of Foreign Body In Voice Box Using An Endoscope 13 $160.17 $6,236.00 $5,550.04 nat. median
$2,041
outlier · 2.7×
25575
HCPCS 		Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing… 13 $3,839.01 $7,413.38 $5,471.05 nat. median
$7,293
0.8× median
27784
HCPCS 		Treatment Of Broken Upper Or Middle Part Of Outer Lower Leg Bone 13 $3,839.01 $7,413.38 $5,471.05 nat. median
$6,889
0.8× median
27244
HCPCS 		Treatment Of Broken Neck Of Thigh Bone With Plate/screw Implant 13 $3,839.01 $7,413.38 $5,471.05 nat. median
$4,919
1.1× median
Q9996
HCPCS 		Injection, Ustekinumab-ttwe (pyzchiva), Subcutaneous, 1 Mg 11 $4,721.45 $5,554.65 $5,276.92 nat. median
$988
outlier · 5.3×
28492690_5
CDM 		Template Derm Regen 2in X 2in* (2023) 10 $4,655.28 $5,422.03 $5,202.96 nat. median
$5,203
1.0× median
26727
HCPCS 		Placement Of Stabilizing Device For Broken Finger Or Thumb At Midportion Or Part… 13 $3,342.87 $5,759.00 $5,183.10 nat. median
$3,550
1.5× median
26785
HCPCS 		Treatment Of Dislocated Finger Joint 13 $281.27 $5,759.00 $5,125.51 nat. median
$3,500
1.5× median
J0517
HCPCS 		Injection, Benralizumab, 1 Mg 13 $164.59 $5,206.88 $4,946.54 nat. median
$919
outlier · 5.4×
26735
HCPCS 		Treatment Of Broken Finger At Midportion Or Part Near Hand 13 $374.28 $5,457.00 $4,856.73 nat. median
$3,781
1.3× median
J0881
HCPCS 		Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use) 13 $2.93 $4,855.40 $4,612.63 nat. median
$751
outlier · 6.1×
25767469_5
CDM 		Mesh Lg Ventral Coated 22 X 26 Cm (consign) 2017* 10 $3,986.50 $4,643.10 $4,455.50 nat. median
$4,456
1.0× median
25766043_5
CDM 		Pleurx Pleural Cath Kit Complete W/discharge Pk* 10 $3,966.51 $4,619.82 $4,433.16 nat. median
$4,433
1.0× median
25765488_5
CDM 		Graft Allomax Surg 10cmx10cm* 10 $3,856.79 $4,492.03 $4,310.53 nat. median
$4,311
1.0× median
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 13 $31.27 $4,485.08 $4,260.83 nat. median
$3,098
1.4× median
25765893_5
CDM 		Kyphopak Express Tray 10/2 First Fracture* 10 $3,751.71 $4,369.64 $4,193.09 nat. median
$4,193
1.0× median
27502111_5
CDM 		Stent Colonic 22 Dm X 9 Cm 10 $3,730.65 $4,345.11 $4,169.55 nat. median
$4,170
1.0× median
11012
HCPCS 		Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A… 13 $2,967.63 $4,627.00 $4,164.30 nat. median
$2,818
1.5× median
74178
HCPCS 		CT Scan Of Abdomen And Pelvis Before And After Contrast 13 $356.43 $4,354.00 $4,136.30 nat. median
$977
outlier · 4.2×
26309839_5
CDM 		Mesh Ventral Coated 15x22CM* 10 $3,629.50 $4,227.30 $4,056.50 nat. median
$4,056
1.0× median
25765749_5
CDM 		Graftjacket 4cmx8cm **needs Abn Signed*** 10 $3,615.31 $4,210.78 $4,040.64 nat. median
$4,041
1.0× median
27383446_5
CDM 		Mesh Phasix Hernia 10cm X 15cm 10 $3,598.32 $4,190.99 $4,021.65 nat. median
$4,022
1.0× median
23605
HCPCS 		Closed Treatment Of Broken Top Of Upper Arm Bone With Manipulation 13 $1,642.82 $4,172.00 $3,754.80 nat. median
$1,955
1.9× median
74177
HCPCS 		CT Scan Of Abdomen And Pelvis With Contrast 13 $356.43 $3,916.00 $3,720.20 nat. median
$928
outlier · 4.0×
25765355_5
CDM 		Mesh C-qur Edge 12"x18"* 10 $3,308.20 $3,853.08 $3,697.40 nat. median
$3,697
1.0× median
70471
HCPCS 		Computed Tomographic Angiography (cta), Head And Neck, With Contrast Material(s)… 12 $356.43 $3,826.00 $3,634.70 nat. median
$729
outlier · 5.0×

Other procedures at this hospital

Browse this hospital's 5,277 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
             
25765862_5 CDM Vena Cava Filter Sys Opt Elite* 10 10 $1,955.00 $1,759.50 $1,661.75 $1,935.45 $1,857.25 2026-03-21
25766027_5 CDM Valvulotome* 10 10 $2,550.01 $2,295.01 $2,167.51 $2,524.51 $2,422.51 2026-03-21
27091372_5 CDM Valvulotome 1.5mm Hydro* 10 10 $3,298.50 $2,968.65 $2,803.73 $3,265.52 $3,133.58 2026-03-21
J3357 HCPCS Ustekinumab, For Subcutaneous Injection, 1 Mg 12 12 $34,617.36 $31,155.62 $190.72 $34,617.36 $32,886.49 2026-03-21
J3358 HCPCS Ustekinumab, For Intravenous Injection, 1 Mg 13 13 $3,048.03 $2,743.23 $12.99 $3,048.03 $2,895.63 2026-03-21
26785 HCPCS Treatment Of Dislocated Finger Joint 19 13 $5,759.00 $5,183.10 $281.27 $5,759.00 $5,125.51 2026-03-21
27784 HCPCS Treatment Of Broken Upper Or Middle Part Of Outer Lower Leg Bone 13 13 $5,759.00 $5,183.10 $3,839.01 $7,413.38 $5,471.05 2026-03-21
28525 HCPCS Treatment Of Broken Toe 13 13 $3,236.00 $2,912.40 $2,157.36 $3,342.87 $3,074.20 2026-03-21
26665 HCPCS Treatment Of Broken Thumb At Wrist 13 13 $2,182.00 $1,963.80 $1,454.40 $3,342.87 $2,072.90 2026-03-21
27509 HCPCS Treatment Of Broken Thigh Bone At Far End With Placement Of Stabilizing Device 13 13 $3,142.00 $2,827.80 $2,094.74 $7,413.38 $2,984.90 2026-03-21
21325 HCPCS Treatment Of Broken Nose Bone 13 13 $2,038.00 $1,834.20 $1,358.45 $3,387.27 $1,936.10 2026-03-21
27244 HCPCS Treatment Of Broken Neck Of Thigh Bone With Plate/screw Implant 13 13 $5,759.00 $5,183.10 $3,839.01 $7,413.38 $5,471.05 2026-03-21
25575 HCPCS Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing … 13 13 $5,759.00 $5,183.10 $3,839.01 $7,413.38 $5,471.05 2026-03-21
28505 HCPCS Treatment Of Broken Great Toe 19 13 $3,236.00 $2,912.40 $367.40 $3,342.87 $2,912.40 2026-03-21
28455 HCPCS Treatment Of Broken Foot Bone At Ankle With Manipulation 13 13 $2,425.00 $2,182.50 $1,617.01 $2,425.00 $2,182.50 2026-03-21
28450 HCPCS Treatment Of Broken Foot Bone At Ankle 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
26735 HCPCS Treatment Of Broken Finger At Midportion Or Part Near Hand 19 13 $5,457.00 $4,911.30 $374.28 $5,457.00 $4,856.73 2026-03-21
26765 HCPCS Treatment Of Broken End Of Finger Or Thumb 19 13 $3,142.00 $2,827.80 $275.53 $3,342.87 $2,827.80 2026-03-21
25769407_5 CDM Thunderbeat Transducer 10 10 $2,960.00 $2,664.00 $2,516.00 $2,930.40 $2,812.00 2026-03-21
81420 HCPCS Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque… 13 13 $3,451.17 $3,106.05 $759.05 $3,451.17 $3,278.61 2026-03-21
28492690_5 CDM Template Derm Regen 2in X 2in* (2023) 10 10 $5,476.80 $4,929.12 $4,655.28 $5,422.03 $5,202.96 2026-03-21
27502111_5 CDM Stent Colonic 22 Dm X 9 Cm 10 10 $4,389.00 $3,950.10 $3,730.65 $4,345.11 $4,169.55 2026-03-21
25766137_5 CDM Sling Obtryx Cvd Single Syst System Device* 10 10 $3,184.00 $2,865.60 $2,706.40 $3,152.16 $3,024.80 2026-03-21
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 19 13 $4,002.00 $3,601.80 $118.70 $4,002.00 $3,601.80 2026-03-21
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 19 13 $3,627.00 $3,264.30 $114.45 $3,627.00 $3,264.30 2026-03-21
12007 HCPCS Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 13 13 $2,307.00 $2,076.30 $204.98 $2,307.00 $2,076.30 2026-03-21
12006 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 19 13 $2,307.00 $2,076.30 $99.39 $2,307.00 $2,053.23 2026-03-21
12018 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, Mor… 13 13 $2,307.00 $2,076.30 $204.98 $2,307.00 $2,076.30 2026-03-21
12017 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.… 13 13 $2,307.00 $2,076.30 $415.32 $2,307.00 $2,076.30 2026-03-21
25768723_5 CDM Set Fistula Plug - 0.4cm Cook 2017 10 10 $2,334.10 $2,100.69 $1,983.99 $2,310.76 $2,217.40 2026-03-21
28292434_5 CDM Sealer Open Curved Large Jaw* (2022) 10 10 $1,988.01 $1,789.21 $1,689.81 $1,968.13 $1,888.61 2026-03-21
28833263_5 CDM Ryanodex 250 Mg Vial 10 10 $2,769.10 $2,492.19 $2,353.74 $2,741.41 $2,630.65 2026-03-21
27692621_5 CDM Room & Board - Semi-private (two Beds) - General Classification 10 10 $2,478.00 $2,230.20 $2,106.30 $2,478.00 $2,354.10 2026-03-21
72240 HCPCS Review By Radiologist Of Upper Spinal Canal Image 13 13 $3,506.00 $3,155.40 $800.90 $3,506.00 $3,330.70 2026-03-21
72255 HCPCS Review By Radiologist Of Middle Spinal Canal Image 13 13 $3,506.00 $3,155.40 $800.90 $3,506.00 $3,330.70 2026-03-21
72265 HCPCS Review By Radiologist Of Lower Spinal Canal Image 13 13 $3,699.00 $3,329.10 $800.90 $3,699.00 $3,514.05 2026-03-21
72285 HCPCS Review By Radiologist Of Disc Of Upper Or Middle Spine Image 17 12 $2,258.00 $2,032.20 $54.72 $2,258.00 $2,032.20 2026-03-21
72295 HCPCS Review By Radiologist Of Disc Of Lower Spine Image 18 12 $2,258.00 $2,032.20 $38.60 $2,258.00 $2,032.20 2026-03-21
25765858_5 CDM Reveal Xt Monitor Pacemaker* 10 10 $6,160.00 $5,544.00 $5,236.00 $6,098.40 $5,852.00 2026-03-21
49618 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 5 5 $2,325.00 $2,092.50 $1,017.83 $2,208.75 $1,966.95 2026-03-21
40650 HCPCS Repair Of Lip And Border 13 13 $3,013.00 $2,711.70 $551.01 $3,013.00 $2,711.70 2026-03-21
43282 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach With Implantation Of Mesh Us… 7 7 $2,549.00 $2,294.10 $886.49 $2,421.55 $2,156.45 2026-03-21
58554 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, More… 6 6 $2,200.00 $1,980.00 $1,061.87 $2,090.00 $1,861.20 2026-03-21
60254 HCPCS Removal Of Thyroid And Surrounding Lymph Nodes With Extensive Neck Removal 6 6 $2,184.00 $1,965.60 $1,338.05 $2,074.80 $1,847.66 2026-03-21
38724 HCPCS Removal Of Lymph Nodes, Muscle, And Tissue Of Neck 6 6 $2,213.00 $1,991.70 $781.28 $2,102.35 $1,872.20 2026-03-21
43633 HCPCS Removal Of Lower Portion Of Stomach With Reattachment Of Upper Portion Of Remain… 6 6 $2,552.00 $2,296.80 $1,085.31 $2,424.40 $2,158.99 2026-03-21
43632 HCPCS Removal Of Lower Part Of Stomach With Reattachment Of Remaining Stomach To Secon… 6 6 $2,603.00 $2,342.70 $1,062.30 $2,472.85 $2,202.14 2026-03-21
43631 HCPCS Removal Of Lower Part Of Stomach With Reattachment Of Remaining Stomach To First… 6 6 $2,395.00 $2,155.50 $1,062.30 $2,275.25 $2,026.17 2026-03-21
11012 HCPCS Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A… 13 13 $4,627.00 $4,164.30 $2,967.63 $4,627.00 $4,164.30 2026-03-21
31530 HCPCS Removal Of Foreign Body In Voice Box Using An Endoscope 19 13 $6,236.00 $5,612.40 $160.17 $6,236.00 $5,550.04 2026-03-21
27372 HCPCS Removal Of Foreign Body Deep In Tissue Of Thigh Or Knee 13 13 $7,131.00 $6,417.90 $2,967.63 $7,131.00 $6,417.90 2026-03-21
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 20 13 $2,860.00 $2,574.00 $158.71 $2,860.00 $2,488.20 2026-03-21
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 24 13 $3,605.63 $3,245.07 $2.14 $3,605.63 $1,853.01 2026-03-21
25766043_5 CDM Pleurx Pleural Cath Kit Complete W/discharge Pk* 10 10 $4,666.48 $4,199.83 $3,966.51 $4,619.82 $4,433.16 2026-03-21
26727 HCPCS Placement Of Stabilizing Device For Broken Finger Or Thumb At Midportion Or Part… 13 13 $5,759.00 $5,183.10 $3,342.87 $5,759.00 $5,183.10 2026-03-21
26756 HCPCS Placement Of Stabilizing Device For Broken End Of Finger Or Thumb 13 13 $3,615.00 $3,253.50 $2,409.86 $3,615.00 $3,342.87 2026-03-21
44205 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 6 6 $2,212.00 $1,990.80 $1,036.20 $2,101.40 $1,871.35 2026-03-21
47120 HCPCS Partial Removal Of Liver Lobe 6 6 $3,094.00 $2,784.60 $1,689.98 $2,939.30 $2,617.52 2026-03-21
44141 HCPCS Partial Removal Of Large Bowel With Creation Of Opening To Skin 6 6 $3,021.00 $2,718.90 $977.04 $2,869.95 $2,555.77 2026-03-21
44206 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin… 6 6 $2,475.00 $2,227.50 $1,275.70 $2,351.25 $2,093.85 2026-03-21
44143 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 6 6 $2,170.00 $1,953.00 $1,120.22 $2,061.50 $1,835.82 2026-03-21
44140 HCPCS Partial Removal Of Large Bowel With Connection 6 6 $2,580.00 $2,322.00 $989.70 $2,451.00 $2,182.68 2026-03-21
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 7 7 $2,963.00 $2,666.70 $1,168.28 $2,814.85 $2,506.70 2026-03-21
44207 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum Using An Endoscope 6 6 $2,996.00 $2,696.40 $1,384.41 $2,846.20 $2,534.62 2026-03-21
44146 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum And Creation Of Large … 6 6 $2,709.00 $2,438.10 $1,337.86 $2,573.55 $2,291.81 2026-03-21
44145 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum 7 7 $2,407.00 $2,166.30 $1,240.11 $2,392.00 $2,036.32 2026-03-21
1251733_5 CDM Operating Room Services - General Classification 10 10 $2,305.00 $2,074.50 $1,959.25 $2,281.95 $2,189.75 2026-03-21
C1783 HCPCS Ocular Implant, Aqueous Drainage Assist Device 22 11 $2,840.00 $2,556.00 $2,380.00 $2,880.00 $2,660.00 2026-03-21
78071 HCPCS Nuclear Medicine Study Of Parathyroid With Spect 12 12 $2,500.00 $2,250.00 $408.43 $2,500.00 $2,375.00 2026-03-21
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 13 13 $2,249.00 $2,024.10 $1,010.00 $2,249.00 $2,136.55 2026-03-21
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 13 13 $3,034.00 $2,730.60 $1,322.69 $3,034.00 $2,882.30 2026-03-21
47000 HCPCS Needle Biopsy Of Liver Through Skin 20 13 $3,038.00 $2,734.20 $72.04 $3,038.00 $2,643.06 2026-03-21
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 13 13 $2,675.00 $2,407.50 $243.77 $2,675.00 $2,541.25 2026-03-21
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 13 13 $2,614.00 $2,352.60 $356.43 $2,614.00 $2,483.30 2026-03-21
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 13 13 $3,040.00 $2,736.00 $356.43 $3,040.00 $2,888.00 2026-03-21
72195 HCPCS MRI Scan Of Pelvis Without Contrast 13 13 $2,675.00 $2,407.50 $243.77 $2,675.00 $2,541.25 2026-03-21
72196 HCPCS MRI Scan Of Pelvis With Contrast 13 13 $2,766.00 $2,489.40 $356.43 $2,766.00 $2,627.70 2026-03-21
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 13 13 $3,040.00 $2,736.00 $356.43 $3,040.00 $2,888.00 2026-03-21
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 13 13 $2,675.00 $2,407.50 $243.77 $2,675.00 $2,541.25 2026-03-21
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 13 13 $2,614.00 $2,352.60 $356.43 $2,614.00 $2,483.30 2026-03-21
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 13 13 $3,040.00 $2,736.00 $356.43 $3,040.00 $2,888.00 2026-03-21
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 13 13 $2,675.00 $2,407.50 $243.77 $2,675.00 $2,541.25 2026-03-21
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 13 13 $2,614.00 $2,352.60 $356.43 $2,614.00 $2,483.30 2026-03-21
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 13 13 $3,040.00 $2,736.00 $356.43 $3,040.00 $2,888.00 2026-03-21
73718 HCPCS MRI Scan Of Leg Without Contrast 26 13 $2,128.00 $1,915.20 $243.77 $2,128.00 $2,021.60 2026-03-21
73719 HCPCS MRI Scan Of Leg With Contrast 26 13 $2,007.00 $1,806.30 $356.43 $2,007.00 $1,906.65 2026-03-21
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 26 13 $2,128.00 $1,915.20 $243.77 $2,128.00 $2,021.60 2026-03-21
73722 HCPCS MRI Scan Of Leg Joint With Contrast 26 13 $2,007.00 $1,806.30 $526.21 $2,007.00 $1,906.65 2026-03-21
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 26 13 $2,189.00 $1,970.10 $356.43 $2,189.00 $2,079.55 2026-03-21
73720 HCPCS MRI Scan Of Leg Before And After Contrast 26 13 $2,493.00 $2,243.70 $356.43 $2,493.00 $2,368.35 2026-03-21
70551 HCPCS MRI Scan Of Brain Without Contrast 13 13 $2,675.00 $2,407.50 $243.77 $2,675.00 $2,541.25 2026-03-21
70552 HCPCS MRI Scan Of Brain With Contrast 13 13 $2,614.00 $2,352.60 $356.43 $2,614.00 $2,483.30 2026-03-21
70553 HCPCS MRI Scan Of Brain Before And After Contrast 13 13 $3,040.00 $2,736.00 $356.43 $3,040.00 $2,888.00 2026-03-21
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 13 13 $2,432.00 $2,188.80 $243.77 $2,432.00 $2,310.40 2026-03-21
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 13 13 $2,614.00 $2,352.60 $356.43 $2,614.00 $2,483.30 2026-03-21
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 13 13 $2,797.00 $2,517.30 $356.43 $2,797.00 $2,657.15 2026-03-21
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 13 13 $2,245.00 $2,020.50 $307.66 $2,245.00 $2,132.75 2026-03-21
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 13 13 $2,281.00 $2,052.90 $243.77 $2,281.00 $2,166.95 2026-03-21
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 13 13 $2,675.00 $2,407.50 $356.43 $2,675.00 $2,541.25 2026-03-21
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 13 13 $2,644.00 $2,379.60 $356.43 $2,644.00 $2,511.80 2026-03-21
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 19 13 $2,189.00 $1,970.10 $79.09 $2,189.00 $1,970.10 2026-03-21
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 13 13 $2,675.00 $2,407.50 $243.77 $2,675.00 $2,541.25 2026-03-21
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 13 13 $2,614.00 $2,352.60 $356.43 $2,614.00 $2,483.30 2026-03-21
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 13 13 $2,797.00 $2,517.30 $356.43 $2,797.00 $2,657.15 2026-03-21
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 35 13 $2,766.00 $2,489.40 $307.09 $2,948.00 $2,585.00 2026-03-21
73219 HCPCS MRI Scan Of Arm With Contrast 26 13 $2,007.00 $1,806.30 $356.43 $2,007.00 $1,906.65 2026-03-21
73222 HCPCS MRI Scan Of Arm Joint With Contrast 26 13 $2,007.00 $1,806.30 $526.21 $2,007.00 $1,906.65 2026-03-21
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 26 13 $2,189.00 $1,970.10 $356.43 $2,189.00 $2,079.55 2026-03-21
73220 HCPCS MRI Scan Of Arm Before And After Contrast 26 13 $2,189.00 $1,970.10 $356.43 $2,189.00 $2,079.55 2026-03-21
74181 HCPCS MRI Scan Of Abdomen Without Contrast 13 13 $2,585.00 $2,326.50 $243.77 $2,585.00 $2,455.75 2026-03-21
74182 HCPCS MRI Scan Of Abdomen With Contrast 13 13 $2,766.00 $2,489.40 $356.43 $2,766.00 $2,627.70 2026-03-21
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 13 13 $2,948.00 $2,653.20 $356.43 $2,948.00 $2,800.60 2026-03-21
667719_1 CDM Misc Supplies & Materials Charge 10 10 $3,612.34 $3,251.11 $3,070.49 $3,576.22 $3,431.72 2026-03-21
27091376_5 CDM Meshed Bilayer Wound Matrix 4x5 10 10 $10,578.10 $9,520.29 $8,991.39 $10,472.32 $10,049.20 2026-03-21
27535763_5 CDM Mesh Xen Matrix Ab 15cm X 20cm* 10 10 $9,899.50 $8,909.55 $8,414.58 $9,800.51 $9,404.53 2026-03-21
25765781_5 CDM Mesh Ventrio St 8.7x10.7 Hernia Patch * 10 10 $2,928.00 $2,635.20 $2,488.80 $2,898.72 $2,781.60 2026-03-21
25765955_5 CDM Mesh Ventralite 4.5" Circle* 10 10 $1,938.00 $1,744.20 $1,647.30 $1,918.62 $1,841.10 2026-03-21
25765933_5 CDM Mesh Ventralight 10"x13"* 10 10 $3,442.50 $3,098.25 $2,926.13 $3,408.08 $3,270.38 2026-03-21
26309841_5 CDM Mesh Ventral Coated 30x30CM 10 10 $3,382.50 $3,044.25 $2,875.13 $3,348.68 $3,213.38 2026-03-21
26309839_5 CDM Mesh Ventral Coated 15x22CM* 10 10 $4,270.00 $3,843.00 $3,629.50 $4,227.30 $4,056.50 2026-03-21
26309837_5 CDM Mesh Ventral Coated 14x15CM* 10 10 $3,120.00 $2,808.00 $2,652.00 $3,088.80 $2,964.00 2026-03-21
27579779_5 CDM Mesh Ventral 15cm* (consign) 10 10 $3,120.00 $2,808.00 $2,652.00 $3,088.80 $2,964.00 2026-03-21
27579777_5 CDM Mesh Ventral 10cm* (consign) 10 10 $2,125.00 $1,912.50 $1,806.25 $2,103.75 $2,018.75 2026-03-21
25765397_5 CDM Mesh Surgimesh 14x15 Rectangle* 10 10 $2,473.50 $2,226.15 $2,102.48 $2,448.77 $2,349.83 2026-03-21
25768576_5 CDM Mesh Surgimend 20CMx20CMx2MM 2017* 10 10 $9,880.00 $8,892.00 $8,398.00 $9,781.20 $9,386.00 2026-03-21
27502113_5 CDM Mesh Surgical Phasix St 4" X 4" 10 10 $3,200.01 $2,880.01 $2,720.01 $3,168.01 $3,040.01 2026-03-21
25766129_5 CDM Mesh Skirted Oval 10 X 15 2016 10 10 $2,640.00 $2,376.00 $2,244.00 $2,613.60 $2,508.00 2026-03-21
25764942_5 CDM Mesh Sepra 8 X 12* 10 10 $2,490.50 $2,241.45 $2,116.93 $2,465.60 $2,365.98 2026-03-21
27383446_5 CDM Mesh Phasix Hernia 10cm X 15cm 10 10 $4,233.32 $3,809.99 $3,598.32 $4,190.99 $4,021.65 2026-03-21
27383448_5 CDM Mesh Phasix Hernia 10cm X 10cm 10 10 $3,009.44 $2,708.50 $2,558.02 $2,979.35 $2,858.97 2026-03-21
25766037_5 CDM Mesh Phasix 10"x12"* 10 10 $12,935.00 $11,641.50 $10,994.75 $12,805.65 $12,288.25 2026-03-21
25764893_5 CDM Mesh Marlex Composix 8"x10"* 10 10 $2,108.00 $1,897.20 $1,791.80 $2,086.92 $2,002.60 2026-03-21
25767469_5 CDM Mesh Lg Ventral Coated 22 X 26 Cm (consign) 2017* 10 10 $4,690.00 $4,221.00 $3,986.50 $4,643.10 $4,455.50 2026-03-21
25765875_5 CDM Mesh Hiatal Hernia 7cmx10cm Biodesign* 10 10 $2,645.40 $2,380.86 $2,248.59 $2,618.95 $2,513.13 2026-03-21
25765966_5 CDM Mesh Composix L/p 8.2x10.2* 10 10 $2,720.00 $2,448.00 $2,312.00 $2,692.80 $2,584.00 2026-03-21
25765740_5 CDM Mesh Composix L/p 6.2x8.2* 10 10 $1,929.50 $1,736.55 $1,640.08 $1,910.21 $1,833.03 2026-03-21
25765738_5 CDM Mesh Composix L/p 10.2x14.2* 10 10 $3,375.00 $3,037.50 $2,868.75 $3,341.25 $3,206.25 2026-03-21
25765967_5 CDM Mesh Composix L/p 10.2x13.2* 10 10 $3,252.00 $2,926.80 $2,764.20 $3,219.48 $3,089.40 2026-03-21
25764890_5 CDM Mesh Composix Ellipse 10x13* 10 10 $3,333.00 $2,999.70 $2,833.05 $3,299.67 $3,166.35 2026-03-21
25765355_5 CDM Mesh C-qur Edge 12"x18"* 10 10 $3,892.00 $3,502.80 $3,308.20 $3,853.08 $3,697.40 2026-03-21
25765354_5 CDM Mesh C-qur 10"x14"* 10 10 $2,872.00 $2,584.80 $2,441.20 $2,843.28 $2,728.40 2026-03-21
25910805_5 CDM Mchb Indium Per Dose 10 10 $2,621.00 $2,358.90 $2,227.85 $2,594.79 $2,489.95 2026-03-21
25910792_5 CDM Mchb Ceretec/ 25 Mci 10 10 $2,621.00 $2,358.90 $2,227.85 $2,594.79 $2,489.95 2026-03-21
25765803_5 CDM Matristem Sheets **needs Abn Signed*** 10 10 $3,116.80 $2,805.12 $2,649.28 $3,085.63 $2,960.96 2026-03-21
25765802_5 CDM Matristem Powder 1gm **needs Abn Signed *** 10 10 $3,780.00 $3,402.00 $3,213.00 $3,742.20 $3,591.00 2026-03-21
25684266_5 CDM Labor Room/delivery - General Classification 10 10 $2,940.00 $2,646.00 $2,499.00 $2,910.60 $2,793.00 2026-03-21
25765893_5 CDM Kyphopak Express Tray 10/2 First Fracture* 10 10 $4,413.78 $3,972.40 $3,751.71 $4,369.64 $4,193.09 2026-03-21
25766062_5 CDM Introducer Needle Bone* 10 10 $2,244.00 $2,019.60 $1,907.40 $2,221.56 $2,131.80 2026-03-21
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 13 13 $3,910.00 $3,519.00 $2,107.97 $3,910.00 $3,519.00 2026-03-21
12036 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.… 19 13 $3,307.00 $2,976.30 $245.46 $3,307.00 $2,943.23 2026-03-21
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 19 13 $2,736.00 $2,462.40 $205.56 $2,736.00 $2,435.04 2026-03-21
12047 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, More Than 30.0 C… 13 13 $2,307.00 $2,076.30 $1,538.23 $2,307.00 $2,107.97 2026-03-21
12046 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 20.1-30.0 Cm 13 13 $2,307.00 $2,076.30 $755.08 $2,307.00 $2,076.30 2026-03-21
12057 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More … 13 13 $2,727.00 $2,454.30 $415.32 $2,727.00 $2,454.30 2026-03-21
12056 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.1-… 13 13 $2,049.00 $1,844.10 $415.32 $2,049.00 $1,844.10 2026-03-21
9259111_5 CDM Intensive Care Unit - General Classification 10 10 $2,819.00 $2,537.10 $2,396.15 $2,819.00 $2,678.05 2026-03-21
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 19 13 $4,000.00 $3,600.00 $72.46 $4,000.00 $3,560.00 2026-03-21
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 13 13 $6,696.34 $6,026.71 $21.31 $6,696.34 $6,361.52 2026-03-21
Q9996 HCPCS Injection, Ustekinumab-ttwe (pyzchiva), Subcutaneous, 1 Mg 11 11 $5,554.65 $4,999.19 $4,721.45 $5,554.65 $5,276.92 2026-03-21
J3262 HCPCS Injection, Tocilizumab, 1 Mg 24 13 $3,458.70 $3,112.83 $5.71 $3,458.70 $1,950.13 2026-03-21
J3240 HCPCS Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial 13 13 $2,651.88 $2,386.69 $2,116.32 $2,651.88 $2,519.29 2026-03-21
J3101 HCPCS Injection, Tenecteplase, 1 Mg 24 13 $8,864.35 $7,977.92 $172.22 $34,490.81 $8,820.03 2026-03-21
J9330 HCPCS Injection, Temsirolimus, 1 Mg 13 13 $2,674.50 $2,407.05 $26.71 $2,674.50 $2,540.78 2026-03-21
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 24 13 $2,604.51 $2,344.06 $12.07 $2,665.84 $2,474.28 2026-03-21
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 13 13 $1,988.44 $1,789.60 $29.38 $1,988.44 $1,889.02 2026-03-21
J2327 HCPCS Injection, Risankizumab-rzaa, Intravenous, 1 Mg 12 12 $12,632.30 $11,369.07 $14.94 $12,632.30 $12,000.69 2026-03-21
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 13 13 $2,460.64 $2,214.58 $99.13 $2,460.64 $2,337.61 2026-03-21
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 13 13 $8,451.64 $7,606.48 $203.58 $8,451.64 $8,029.06 2026-03-21
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 13 13 $15,617.44 $14,055.70 $59.41 $15,617.44 $14,836.57 2026-03-21
J2182 HCPCS Injection, Mepolizumab, 1 Mg 13 13 $4,485.08 $4,036.57 $31.27 $4,485.08 $4,260.83 2026-03-21
J0896 HCPCS Injection, Luspatercept-aamt, 0.25 Mg 13 13 $15,239.13 $13,715.22 $41.98 $15,239.13 $14,477.17 2026-03-21
J1306 HCPCS Injection, Inclisiran, 1 Mg 12 12 $3,470.24 $3,123.22 $12.32 $3,470.24 $3,296.73 2026-03-21
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 13 13 $2,626.18 $2,363.56 $48.96 $2,626.18 $2,494.87 2026-03-21
J1459 HCPCS Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 35 13 $2,399.04 $2,159.14 $50.74 $3,951.36 $2,279.09 2026-03-21
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 13 13 $2,995.06 $2,695.55 $11.04 $2,995.06 $2,845.31 2026-03-21
J7202 HCPCS Injection, Factor Ix, Albumin Fusion Protein, (recombinant), Idelvion, 1 I.u. 13 13 $6,284.88 $5,656.39 $5.32 $6,284.88 $5,970.64 2026-03-21
J9334 HCPCS Injection, Efgartigimod Alfa, 2 Mg And Hyaluronidase-qvfc 12 12 $20,266.64 $18,239.98 $33.89 $20,266.64 $19,253.31 2026-03-21
J1162 HCPCS Injection, Digoxin Immune Fab (ovine), Per Vial 13 13 $5,852.70 $5,267.43 $4,974.80 $5,913.56 $5,560.07 2026-03-21
J0881 HCPCS Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use) 13 13 $4,855.40 $4,369.86 $2.93 $4,855.40 $4,612.63 2026-03-21
J0517 HCPCS Injection, Benralizumab, 1 Mg 13 13 $5,206.88 $4,686.19 $164.59 $5,206.88 $4,946.54 2026-03-21
Q0222 HCPCS Injection, Bebtelovimab, 175 Mg 11 11 $3,150.00 $2,835.00 $2,677.50 $3,150.00 $2,992.50 2026-03-21
J0139 HCPCS Injection, Adalimumab, 1 Mg 11 11 $3,629.65 $3,266.69 $3,085.20 $3,629.65 $3,448.17 2026-03-21
38792 HCPCS Injection Of Radioactive Material For X-ray Identification Of Lymph Node 20 13 $2,045.00 $1,840.50 $25.84 $4,751.04 $1,830.28 2026-03-21
36465 HCPCS Injection Of Chemical Agent Into Single Incompetent Vein Of Leg Using Ultrasound… 34 12 $2,206.00 $1,985.40 $469.20 $2,758.00 $2,095.70 2026-03-21
36466 HCPCS Injection Of Chemical Agent Into Multiple Incompetent Veins Of Same Leg Using Ul… 34 12 $2,432.00 $2,188.80 $516.80 $3,040.00 $2,249.60 2026-03-21
25765464_5 CDM Gynecare Tvt Secur-tension* 10 10 $2,482.00 $2,233.80 $2,109.70 $2,457.18 $2,357.90 2026-03-21
25765749_5 CDM Graftjacket 4cmx8cm **needs Abn Signed*** 10 10 $4,253.31 $3,827.98 $3,615.31 $4,210.78 $4,040.64 2026-03-21
25765741_5 CDM Graftjacket 4cmx4cm **needs Abn Signed*** 10 10 $2,550.01 $2,295.01 $2,167.51 $2,524.51 $2,422.51 2026-03-21
25765742_5 CDM Graftjacket 2cc Xpress Flow **needs Abn Signed*** 10 10 $3,097.60 $2,787.84 $2,632.96 $3,066.62 $2,942.72 2026-03-21
25765486_5 CDM Graft Xenmatrix Surg 19cmx28cm Antibac* 10 10 $17,955.00 $16,159.50 $15,261.75 $17,775.45 $17,057.25 2026-03-21
25765485_5 CDM Graft Xenmatrix Surg 15cmx20cm Antibac* 10 10 $10,920.00 $9,828.00 $9,282.00 $10,810.80 $10,374.00 2026-03-21
25765940_5 CDM Graft Xenmatrix Surg 20cmx20cm* 10 10 $13,778.75 $12,400.88 $11,711.94 $13,640.96 $13,089.81 2026-03-21
27749219_5 CDM Graft Skin Mesh Derm Regenerating 2x2" * 10 10 $6,194.22 $5,574.80 $5,265.09 $6,132.28 $5,884.51 2026-03-21
25766026_5 CDM Graft Mini Cuff Bypass 6 X 70 Distaflo 6mm X 70cm * 10 10 $3,166.40 $2,849.76 $2,691.44 $3,134.74 $3,008.08 2026-03-21
25765487_5 CDM Graft Allomax Surg 7cmx10cm* 10 10 $2,656.69 $2,391.02 $2,258.19 $2,630.12 $2,523.86 2026-03-21
25766114_5 CDM Graft Allomax Surg 1mm 7x10CM* 10 10 $2,998.40 $2,698.56 $2,548.64 $2,968.42 $2,848.48 2026-03-21
25765488_5 CDM Graft Allomax Surg 10cmx10cm* 10 10 $4,537.40 $4,083.66 $3,856.79 $4,492.03 $4,310.53 2026-03-21
Q4133 HCPCS Grafix Prime, Grafixpl Prime, Stravix And Stravixpl, Per Square Centimeter 35 13 $1,976.25 $1,778.63 $115.04 $3,906.00 $1,877.44 2026-03-21
25765323_5 CDM Filter Vena Cava Celect Uni* 10 10 $2,550.01 $2,295.01 $2,167.51 $2,524.51 $2,422.51 2026-03-21
J7192 HCPCS Factor Viii (antihemophilic Factor, Recombinant) Per I.u., Not Otherwise Specifi… 13 13 $6,513.47 $5,862.12 $1.61 $6,513.47 $6,187.80 2026-03-21
25765255_5 CDM Endometrial Ablation Instrument With Suresound* 10 10 $2,150.50 $1,935.45 $1,827.93 $2,129.00 $2,042.98 2026-03-21
28001 HCPCS Drainage Of Fluid Filled Sac In Foot 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
52281 HCPCS Dilation Of Urethra Using An Endoscope 13 13 $2,503.00 $2,252.70 $1,668.52 $2,503.00 $2,252.70 2026-03-21
31525 HCPCS Diagnostic Exam Of Voice Box Using An Endoscope 13 13 $6,701.00 $6,030.90 $1,818.45 $6,701.00 $6,030.90 2026-03-21
31622 HCPCS Diagnostic Exam Of Lung Airway Using An Endoscope 19 13 $2,192.00 $1,972.80 $112.61 $2,192.00 $1,950.88 2026-03-21
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 18 12 $2,258.00 $2,032.20 $103.73 $2,258.00 $2,020.91 2026-03-21
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 18 12 $2,258.00 $2,032.20 $123.68 $2,258.00 $2,020.91 2026-03-21
64624 HCPCS Destruction Of Nerve Branches Of Knee Using Imaging Guidance 18 12 $2,258.00 $2,032.20 $93.47 $2,258.00 $2,020.91 2026-03-21
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 18 12 $2,258.00 $2,032.20 $101.65 $2,258.00 $2,020.91 2026-03-21
27502107_5 CDM Dermaclose System - Greater Than 11cm 10 10 $2,208.30 $1,987.47 $1,877.06 $2,186.22 $2,097.89 2026-03-21
26152980_5 CDM Cypass Micro Stent Eye (2017)* 10 10 $2,552.00 $2,296.80 $2,169.20 $2,526.48 $2,424.40 2026-03-21
72193 HCPCS CT Scan Of Pelvis With Contrast 13 13 $2,037.00 $1,833.30 $179.20 $2,037.00 $1,935.15 2026-03-21
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 13 13 $2,189.00 $1,970.10 $179.20 $2,189.00 $2,079.55 2026-03-21
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 13 13 $2,007.00 $1,806.30 $179.20 $2,007.00 $1,906.65 2026-03-21
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 13 13 $2,037.00 $1,833.30 $179.20 $2,037.00 $1,935.15 2026-03-21
71260 HCPCS CT Scan Of Chest With Contrast 13 13 $2,037.00 $1,833.30 $179.20 $2,037.00 $1,935.15 2026-03-21
71270 HCPCS CT Scan Of Chest Before And After Contrast 13 13 $2,189.00 $1,970.10 $179.20 $2,189.00 $2,079.55 2026-03-21
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 13 13 $2,553.00 $2,297.70 $179.20 $2,553.00 $2,425.35 2026-03-21
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 13 13 $2,529.00 $2,276.10 $356.43 $2,529.00 $2,402.55 2026-03-21
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 13 13 $2,553.00 $2,297.70 $179.20 $2,553.00 $2,425.35 2026-03-21
74160 HCPCS CT Scan Of Abdomen With Contrast 13 13 $2,066.00 $1,859.40 $179.20 $2,066.00 $1,962.70 2026-03-21
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 13 13 $2,432.00 $2,188.80 $179.20 $2,432.00 $2,310.40 2026-03-21
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 13 13 $3,456.00 $3,110.40 $243.77 $3,456.00 $3,283.20 2026-03-21
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 13 13 $3,916.00 $3,524.40 $356.43 $3,916.00 $3,720.20 2026-03-21
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 13 13 $4,354.00 $3,918.60 $356.43 $4,354.00 $4,136.30 2026-03-21
15734 HCPCS Creation Of Muscle Graft To Trunk 6 6 $2,513.00 $2,261.70 $1,153.65 $2,387.35 $2,126.00 2026-03-21
25765681_5 CDM Coseal Surgical Sealant 8ml* 10 10 $2,121.09 $1,908.98 $1,802.93 $2,099.88 $2,015.04 2026-03-21
70471 HCPCS Computed Tomographic Angiography (cta), Head And Neck, With Contrast Material(s)… 12 12 $3,826.00 $3,443.40 $356.43 $3,826.00 $3,634.70 2026-03-21
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 19 13 $2,427.00 $2,184.30 $260.38 $2,427.00 $2,160.03 2026-03-21
28193 HCPCS Complicated Removal Of Foreign Body In Foot 13 13 $2,307.00 $2,076.30 $1,538.23 $2,307.00 $2,076.30 2026-03-21
20525 HCPCS Complicated Removal Of Foreign Body In Deep Muscle Or Tendon 13 13 $3,433.00 $3,089.70 $2,288.66 $3,433.00 $3,089.70 2026-03-21
44626 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An… 6 6 $2,404.00 $2,163.60 $1,177.10 $2,283.80 $2,033.78 2026-03-21
44227 HCPCS Closure Of Opening From Large Or Small Bowel To Skin Using An Endoscope 6 6 $2,175.00 $1,957.50 $1,240.99 $2,066.25 $1,840.05 2026-03-21
23625 HCPCS Closed Treatment Of Upper Arm Bone Broken At Shoulder Joint With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
23620 HCPCS Closed Treatment Of Upper Arm Bone Broken At Shoulder Joint 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
24535 HCPCS Closed Treatment Of Upper Arm Bone Broken At Elbow With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
24530 HCPCS Closed Treatment Of Upper Arm Bone Broken At Elbow 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
27762 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
27760 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
25660 HCPCS Closed Treatment Of Dislocated Wrist Bones With Manipulation 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27562 HCPCS Closed Treatment Of Dislocated Kneecap Under Anesthesia 13 13 $3,789.00 $3,410.10 $252.01 $3,789.00 $3,410.10 2026-03-21
25624 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
25622 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
23605 HCPCS Closed Treatment Of Broken Top Of Upper Arm Bone With Manipulation 13 13 $4,172.00 $3,754.80 $1,642.82 $4,172.00 $3,754.80 2026-03-21
23600 HCPCS Closed Treatment Of Broken Top Of Upper Arm Bone 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27538 HCPCS Closed Treatment Of Broken Top Of Shin Bone At Knee 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27510 HCPCS Closed Treatment Of Broken Thigh Bone At Knee Area With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
27503 HCPCS Closed Treatment Of Broken Thigh Bone At Far End With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
28530 HCPCS Closed Treatment Of Broken Small Bone In Tendon Attached To Great Toe 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27532 HCPCS Closed Treatment Of Broken Shin Bone With Traction 13 13 $2,182.00 $1,963.80 $1,454.40 $3,342.87 $2,072.90 2026-03-21
27825 HCPCS Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint With Manipula… 13 13 $2,409.00 $2,168.10 $1,605.90 $2,409.00 $2,168.10 2026-03-21
27824 HCPCS Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27530 HCPCS Closed Treatment Of Broken Shin Bone 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27788 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27786 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
24565 HCPCS Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow With Manipulati… 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
24560 HCPCS Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 13 13 $2,151.00 $1,935.90 $1,434.20 $2,151.00 $1,935.90 2026-03-21
21320 HCPCS Closed Treatment Of Broken Nose Bone With Placement Of Stabilizing Device 13 13 $2,957.00 $2,661.30 $1,971.52 $3,387.27 $2,809.15 2026-03-21
21315 HCPCS Closed Treatment Of Broken Nose Bone With Manipulation 13 13 $2,933.00 $2,639.70 $1,585.19 $2,933.00 $2,639.70 2026-03-21
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
25520 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side And Dislocated … 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
25500 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
25535 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side With Man… 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
25530 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
25560 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
24505 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
24500 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27750 HCPCS Closed Treatment Of Broken Middle Part Of Shin Bone 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27781 HCPCS Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone With Ma… 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
27780 HCPCS Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27520 HCPCS Closed Treatment Of Broken Kneecap 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27508 HCPCS Closed Treatment Of Broken Inside Or Outside Portion Of Lower End Of Thigh Bone 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
28495 HCPCS Closed Treatment Of Broken Great Toe With Manipulation 13 13 $2,425.00 $2,182.50 $252.01 $2,425.00 $2,182.50 2026-03-21
28490 HCPCS Closed Treatment Of Broken Great Toe 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
24675 HCPCS Closed Treatment Of Broken Forearm Bone On Small Finger Side At Elbow With Manip… 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
24670 HCPCS Closed Treatment Of Broken Forearm Bone On Small Finger Side At Elbow 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
28475 HCPCS Closed Treatment Of Broken Foot With Manipulation 13 13 $2,425.00 $2,182.50 $252.01 $2,425.00 $2,182.50 2026-03-21
26742 HCPCS Closed Treatment Of Broken Finger Or Hand At Base Of Finger With Manipulation 13 13 $3,774.00 $3,396.60 $1,642.82 $3,774.00 $3,396.60 2026-03-21
24577 HCPCS Closed Treatment Of Broken Elbow With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
24576 HCPCS Closed Treatment Of Broken Elbow 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
28470 HCPCS Closed Treatment Of Broken Bone In Forefoot Or Midfoot 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
25650 HCPCS Closed Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
28435 HCPCS Closed Treatment Of Broken Ankle Joint Bone With Manipulation 13 13 $2,425.00 $2,182.50 $1,617.01 $2,425.00 $2,182.50 2026-03-21
28430 HCPCS Closed Treatment Of Broken Ankle Joint Bone 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
24620 HCPCS Closed Treatment Of Broken And Dislocated Forearm Bones At Elbow With Manipulati… 13 13 $3,151.00 $2,835.90 $1,642.82 $3,151.00 $2,835.90 2026-03-21
27767 HCPCS Closed Treatment Of Back Portion Of Shin Bone At Ankle 12 12 $2,182.00 $1,963.80 $252.01 $2,182.00 $2,018.35 2026-03-21
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 13 13 $2,874.00 $2,586.60 $1,642.82 $2,874.00 $2,586.60 2026-03-21
27816 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 13 13 $2,182.00 $1,963.80 $1,454.40 $2,182.00 $1,963.80 2026-03-21
27808 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle 13 13 $2,182.00 $1,963.80 $252.01 $2,182.00 $1,963.80 2026-03-21
36482 HCPCS Chemical Destruction Of First Incompetent Vein Of Arm Or Leg Using Imaging Guida… 34 12 $2,798.00 $2,518.20 $595.00 $5,685.01 $2,658.10 2026-03-21
25765664_5 CDM Catheter Thermal Chc Endometrial Ablation* 10 10 $1,944.80 $1,750.32 $1,653.08 $1,925.35 $1,847.56 2026-03-21
29003506_5 CDM Catheter "jada" Hemorrhage Control* (2025) 10 10 $2,465.00 $2,218.50 $2,095.25 $2,440.35 $2,341.75 2026-03-21
25764677_5 CDM Blade Scope Endo Carpal Tunnel* 10 10 $2,533.00 $2,279.70 $2,153.05 $2,507.67 $2,406.35 2026-03-21
31625 HCPCS Biopsy Of Lung Airway Using An Endoscope 19 13 $2,594.00 $2,334.60 $132.83 $2,594.00 $2,308.66 2026-03-21
25765454_5 CDM Alrua Pacemaker Generator* 10 10 $7,991.10 $7,191.99 $6,792.44 $7,911.19 $7,591.55 2026-03-21
25765453_5 CDM Adapta Dr Pacemaker Generator* 10 10 $7,187.70 $6,468.93 $6,109.55 $7,115.82 $6,828.32 2026-03-21
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