Hospital

TRIGG COUNTY HOSPITAL

Cadiz, KY · CCN 181304 · Rates published

2,165 distinct procedures filed

13 distinct payers

49,137 rate rows

2026-07-31 last MRF observed

Data quality

49,111 of 49,137 rate rows are consumer-grade (99.9%)

26 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 — reason	Rows
per-diem day rate — not a per-procedure price	15
placeholder amount (≤ $0.02) — excluded from medians	9
exceeds 10× this hospital's gross charge — excluded from medians	2

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.trigghospital.org/docs/610471581_trigg-county-hospital-_standardcharges.csv
Found on page	https://www.trigghospital.org/getpage.php?name=Hospital_Pricing&sub=Patients%20and%20Visitors
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-09-20
Content fingerprint	5c81200149e93120… · 21,194,331 bytes · first seen 2026-05-06

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
J9281 HCPCS	Jelmyto 80mg (4mg/ml) Inj Kit	9	$24,583.87	$82,176.90	$25,950.60	nat. median $403 outlier · 64.4×
J9282 HCPCS	Zusduri 80mg Kit 1x1 Ea Inj	9	$22,000.49	$73,541.40	$23,223.60	nat. median $304 outlier · 76.3×
Q4160 HCPCS	Nushield	9	$3,164.85	$88,920.00	$18,590.16	nat. median $320 outlier · 58.2×
64590 HCPCS	Insrt/redo Pn/gastr Stimul	9	$9,527.80	$31,848.75	$10,057.50	nat. median $18,089 0.6× median
C1767 HCPCS	Sacral Neuromodulation System Medtronic	9	$9,128.50	$30,514.00	$9,636.00	nat. median $25,172 outlier · 0.4×
3129650 OTHER	Nsl/sins Ndsc Surg Frnt&sins Bi,bilateral	9	$274.11	$31,796.50	$9,512.17	nat. median $9,534 1.0× median
J3101 HCPCS	Tnkase 50mg/ml (10ml) Vial,340b Drug Pricing Program	9	$8,492.50	$28,388.02	$8,964.64	nat. median $498 outlier · 18.0×
C9761 HCPCS	Cysto Litho Vacuum Kidney	9	$6,767.23	$22,620.92	$7,143.45	nat. median $9,892 0.7× median
55873 HCPCS	Cryosurgical Ablation Of The Prostate US	9	$6,643.89	$22,208.62	$7,013.25	nat. median $9,617 0.7× median
J2506 HCPCS	Neulasta (pegfilgrastim) 6mg/0.6ml Syr,340b Drug Pricing Program	9	$6,378.53	$21,321.62	$6,733.14	nat. median $916 outlier · 7.4×
J0517 HCPCS	Fasenra 30mg/ml Syrn,340b Drug Pricing Program	9	$5,986.10	$20,009.85	$6,318.90	nat. median $404 outlier · 15.6×
57285 HCPCS	Repair Paravag Defect Vag	9	$5,411.03	$18,087.52	$5,711.85	nat. median $7,321 0.8× median
L8686 HCPCS	Implantable Neurostimulator	9	$5,128.54	$17,143.22	$5,413.65	nat. median $5,468 1.0× median
5233250 OTHER	Cystoscopy And Treatment Bilateral,bilateral	9	$4,971.93	$16,619.78	$5,248.35	nat. median $4,750 1.1× median
2829950 OTHER	Collection Hallux Valgus Bi,bilateral	9	$871.64	$17,100.00	$5,115.60	nat. median $9,838 0.5× median
31297 HCPCS	Nsl/sins Ndsc Surg Sphn Sins	9	$124.62	$16,934.22	$5,066.01	nat. median $6,394 0.8× median
3125650 OTHER	Nasal Sinus Endoscopy W Maxillary An Bi,bilateral	9	$290.74	$16,172.80	$4,838.22	nat. median $5,078 1.0× median
J2997 HCPCS	Alteplase (activase) 100mg Ivpb Premix,340b Drug Pricing Program	9	$164.84	$30,108.63	$4,779.11	nat. median $428 outlier · 11.2×
3126750 OTHER	Endoscopy Maxillary Sinus Bi,bilateral	9	$4,481.27	$14,979.60	$4,730.40	nat. median $9,534 outlier · 0.5×
3125550 OTHER	Nasal Sinus Ndsc W Tot Ethmdct Bi,bilateral	9	$262.32	$14,979.60	$4,481.27	nat. median $9,534 outlier · 0.5×
Q4341 HCPCS	Simplimax	9	$4,002.96	$13,380.75	$4,225.50	nat. median $255 outlier · 16.6×
C9740 HCPCS	Cystourethroscopy W Impant 4 Or More	9	$3,987.04	$13,327.55	$4,208.70	nat. median $10,088 outlier · 0.4×
31242 HCPCS	Nsl/sinus Ndsc Rf Abltj Pnn	9	$112.54	$14,059.05	$4,205.88	nat. median $6,182 0.7× median
58670 HCPCS	Laparoscopy Removal Adnexa	9	$2,375.91	$13,851.95	$4,169.07	nat. median $6,176 0.7× median
49654 HCPCS	Lap Inc Hernia Repair With Mesh	9	$3,902.50	$13,044.92	$4,119.45	nat. median $3,700 1.1× median
52648 HCPCS	Laser Surgery Of Prostate	9	$3,720.32	$12,435.98	$3,927.15	nat. median $5,483 0.7× median
52354 HCPCS	Cystourethroscopy With Biopsy	9	$3,720.32	$12,435.98	$3,927.15	nat. median $5,084 0.8× median
55874 HCPCS	Tprnl Plmt Biodegrdabl Matrl	9	$3,720.32	$12,435.98	$3,927.15	nat. median $5,364 0.7× median
L8680 HCPCS	Interstim MRI Lead Neurostimulator	9	$3,678.97	$12,297.75	$3,883.50	nat. median $4,367 0.9× median
J1306TB OTHER	Leqvio 189mg/ml (284mg) 1.5ml Syrn,340b Drug Pricing Program	9	$3,674.09	$12,281.45	$3,878.35	—
52649 HCPCS	Prostate Laser Enuleation	9	$3,650.55	$12,202.75	$3,853.50	nat. median $5,379 0.7× median
52630 HCPCS	Removal Of Prostate Growth	9	$3,635.49	$12,152.40	$3,837.60	nat. median $4,898 0.8× median
57240 HCPCS	Anterior Colporrhaphy	9	$3,631.94	$12,140.52	$3,833.85	nat. median $5,027 0.8× median
57250 HCPCS	Repair Of Rectum And Vagina	9	$3,631.94	$12,140.52	$3,833.85	nat. median $5,113 0.7× median
57260 HCPCS	Cmbn Ant Pst Colprhy	9	$3,631.94	$12,140.52	$3,833.85	nat. median $5,224 0.7× median
57288 HCPCS	Repair Of Bladder Defect	9	$3,518.26	$11,760.52	$3,713.85	nat. median $5,561 0.7× median
52240 HCPCS	Cystoscopy And Treatment	9	$3,485.43	$11,650.80	$3,679.20	nat. median $4,886 0.8× median
52353 HCPCS	Cystouretero W Lithotripsy	9	$3,485.43	$11,650.80	$3,679.20	nat. median $5,344 0.7× median
52356 HCPCS	Cystourethroscopy Utetero W Lithotripsy	9	$3,485.43	$11,650.80	$3,679.20	nat. median $5,641 0.7× median
S2070 HCPCS	Cystoscopy Stone Removal	9	$3,485.43	$11,650.80	$3,679.20	nat. median $1,765 outlier · 2.1×
66991 HCPCS	Xcapsl Ctrc Rmvl Inj 1 +	9	$3,398.75	$11,361.05	$3,587.70	nat. median $5,656 0.6× median
58563 HCPCS	Hysteroscopy Ablation	9	$173.36	$11,940.55	$3,572.11	nat. median $5,302 0.7× median
58700 HCPCS	Removal Of Fallopian Tube	9	$574.22	$11,940.08	$3,571.97	nat. median $2,550 1.4× median
47564 HCPCS	Lapro Cholecystectomy / Explr	9	$3,333.80	$11,143.98	$3,519.15	nat. median $8,650 outlier · 0.4×
58353 HCPCS	Endometr Ablate Thermal	9	$173.36	$11,638.45	$3,481.73	nat. median $4,950 0.7× median
6881150 OTHER	Probe Nasolacrimal Duct Bi,bilateral	9	$3,268.58	$10,925.95	$3,450.30	nat. median $3,213 1.1× median
C1889 HCPCS	Spaceoar	9	$1,942.93	$11,043.75	$3,337.53	nat. median $1,642 outlier · 2.0×
C2618 HCPCS	Probe/needle Cryoblation	9	$3,105.60	$10,381.12	$3,278.25	nat. median $3,866 0.8× median
J1568 HCPCS	Octagam (immune Globulin) 10% 10gm/100ml,statutorily Exclude, 340b Drug Pricing…	9	$1,628.47	$10,875.60	$3,253.52	nat. median $383 outlier · 8.5×
64581 HCPCS	Impant Neuroelectrodes	9	$3,058.13	$10,222.48	$3,228.15	nat. median $6,173 0.5× median

Other procedures at this hospital

Browse this hospital's 2,165 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

0191T	OTHER	Insert Ant Segment Drain Int	10	9	$8,720.50	$3,488.20 60% off	$2,478.36	$8,284.48	$2,616.15	2026-03-02
0376T	OTHER	Insert Ant Segment Drain Int Additional	10	9	$8,720.50	$3,488.20 60% off	$2,478.36	$8,284.48	$2,616.15	2026-03-02
11646	HCPCS	Excision Of Neoplasm Face	10	9	$4,329.50	$1,731.80 60% off	$1,230.45	$4,113.02	$1,298.85	2026-03-02
13160	HCPCS	Late Closure Of Wound	28	9	$2,249.50	$899.80 60% off	$602.64	$4,467.85	$1,232.59	2026-03-02
15115	HCPCS	Epidrm A Grft Face/nck/hf/g	28	9	$1,940.50	$776.20 60% off	$519.80	$4,467.85	$1,097.29	2026-03-02
15120	HCPCS	Pro Fee Skn Splt A-grft Fac/nck/hf/g Pf	28	9	$1,949.00	$779.60 60% off	$522.08	$8,197.55	$1,107.97	2026-03-02
15220	HCPCS	Skin Full Graft Sclp/arm/leg	10	9	$4,500.00	$1,800.00 60% off	$1,278.90	$4,275.00	$1,350.00	2026-03-02
15271	HCPCS	Skin Sub Graft Trnk/arm/leg Clinic	17	9	$4,710.50	$1,884.20 60% off	$56.84	$4,474.98	$1,338.72	2026-03-02
15272	HCPCS	Skin Sub Graft T/a/l Add-on Clinic	17	9	$4,710.50	$1,884.20 60% off	$16.10	$4,474.98	$1,338.72	2026-03-02
15273	HCPCS	Skin Sub Graft T/arm/lg Child Clinic	17	9	$9,427.00	$3,770.80 60% off	$186.87	$8,955.65	$2,679.15	2026-03-02
15274	HCPCS	Skin Sub Graft T/a/l Child Add-on Clinic	17	9	$9,427.00	$3,770.80 60% off	$42.58	$8,955.65	$2,679.15	2026-03-02
15276	HCPCS	Skin Sub Graft Face/nk/hf/g Additional C	17	9	$4,710.50	$1,884.20 60% off	$21.88	$4,474.98	$1,338.72	2026-03-02
15277	HCPCS	Skin Sub Graft F/n/hf/g Child Clinic	17	9	$4,710.50	$1,884.20 60% off	$214.76	$4,474.98	$1,338.72	2026-03-02
15278	HCPCS	Skin Sub Graft F/n/hf/g Add-on Clinic	17	9	$4,710.50	$1,884.20 60% off	$53.15	$4,474.98	$1,338.72	2026-03-02
19307	HCPCS	Mast Mod Rad	28	9	$2,070.00	$828.00 60% off	$554.47	$8,282.58	$1,262.53	2026-03-02
21550	HCPCS	Biopsy Of Neck/chest	18	9	$4,097.00	$1,638.80 60% off	$110.27	$3,892.15	$1,164.37	2026-03-02
21555	HCPCS	Excision Neck Les Sc < 3cm	10	9	$4,329.50	$1,731.80 60% off	$1,230.45	$4,113.02	$1,298.85	2026-03-02
21556	HCPCS	Excision Neck Tum Deep < 5 Cm	18	9	$7,179.00	$2,871.60 60% off	$377.85	$6,820.05	$2,040.27	2026-03-02
24071	HCPCS	Exc Arm/elbow Les Sc 3 Cm />	10	9	$7,216.50	$2,886.60 60% off	$2,050.92	$6,855.68	$2,164.95	2026-03-02
24655	HCPCS	Treat Radius Fracture	18	9	$4,121.00	$1,648.40 60% off	$278.38	$3,914.95	$1,171.19	2026-03-02
2709650	OTHER	Inject Sacroiliac Joint Bi,bilateral	9	8	$8,191.50	$3,276.60 60% off	$2,328.03	$7,781.92	$2,375.54	2026-03-02
27337	HCPCS	Exc Thigh/knee Les Sc 3 Cm/>	18	9	$7,370.00	$2,948.00 60% off	$285.62	$7,001.50	$2,094.55	2026-03-02
27650	HCPCS	Pro Fee Strapping Of Toespf	28	9	$1,766.00	$706.40 60% off	$473.05	$17,100.00	$1,067.47	2026-03-02
27685	HCPCS	Revision Of Lower Leg Tendon	10	9	$4,927.00	$1,970.80 60% off	$1,400.25	$4,680.65	$1,478.10	2026-03-02
27725	HCPCS	Repair Of Lower Leg ER Physician Pf	18	9	$3,225.00	$1,290.00 60% off	$916.54	$3,250.42	$1,151.06	2026-03-02
28039	HCPCS	Exc Foot/toe Tum Sc 1.5 Cm/>	10	9	$5,663.00	$2,265.20 60% off	$1,609.42	$5,379.85	$1,698.90	2026-03-02
28110	HCPCS	Partial Removal Of Metatarsal	18	9	$10,026.00	$4,010.40 60% off	$234.04	$9,524.70	$2,849.39	2026-03-02
28113	HCPCS	Partial Removal Of Metatarsal	10	9	$4,927.00	$1,970.80 60% off	$1,400.25	$4,680.65	$1,478.10	2026-03-02
28160	HCPCS	Partial Removal Of Toe	10	9	$8,138.00	$3,255.20 60% off	$2,312.82	$7,731.10	$2,441.40	2026-03-02
28240	HCPCS	Release Of Big Toe	18	9	$8,353.50	$3,341.40 60% off	$200.08	$7,935.82	$2,374.07	2026-03-02
28288	HCPCS	Metatarsal Plantar Ostectomy	18	9	$5,574.50	$2,229.80 60% off	$294.00	$5,295.78	$1,584.28	2026-03-02
28289	HCPCS	Corr Halux Rigdus Without Implant	18	9	$10,026.00	$4,010.40 60% off	$376.71	$9,524.70	$2,849.39	2026-03-02
28292	HCPCS	Corr Hlx Vlgs Rsc Prx Phls Bs	18	9	$8,556.50	$3,422.60 60% off	$330.81	$8,128.68	$2,431.76	2026-03-02
28295	HCPCS	Corr Hlx Vlgs Prx Mtar Osteot	18	9	$8,556.50	$3,422.60 60% off	$428.71	$8,128.68	$2,431.76	2026-03-02
28296	HCPCS	Correction Of Bunion	10	9	$8,556.50	$3,422.60 60% off	$2,431.75	$8,128.68	$2,566.95	2026-03-02
2829850	OTHER	Pro Fee Correction Hallux Valgus Bi,bilateral	8	7	$2,692.00	$1,076.80 60% off	$765.07	$2,557.40	$1,505.91	2026-03-02
28299	HCPCS	Collection Hallux Valgus Uni	34	9	$2,891.00	$1,156.40 60% off	$410.82	$8,549.52	$960.49	2026-03-02
2829950	OTHER	Collection Hallux Valgus Bi,bilateral	18	9	$18,000.00	$7,200.00 60% off	$871.64	$17,100.00	$5,115.60	2026-03-02
28308	HCPCS	Incision Of Metatarsal	18	9	$4,927.00	$1,970.80 60% off	$262.88	$4,680.65	$1,400.25	2026-03-02
28312	HCPCS	Revision Of Toe Facility	18	9	$8,355.00	$3,342.00 60% off	$240.15	$7,937.25	$2,374.49	2026-03-02
28315	HCPCS	Removal Of Sesamoid Bone	18	9	$8,355.00	$3,342.00 60% off	$215.85	$7,937.25	$2,374.49	2026-03-02
28615	HCPCS	Repair Foot Dislocation	10	9	$10,441.00	$4,176.40 60% off	$2,967.33	$9,918.95	$3,132.30	2026-03-02
28750	HCPCS	Fusion Of Big Toe Joint	10	9	$10,441.00	$4,176.40 60% off	$2,967.33	$9,918.95	$3,132.30	2026-03-02
29893	HCPCS	Scope Plantar Faciotomy	10	9	$5,574.50	$2,229.80 60% off	$1,584.27	$5,295.78	$1,672.35	2026-03-02
3014050	OTHER	Resect Inferior Turbinate Bi,bilateral	18	9	$7,685.50	$3,074.20 60% off	$272.40	$7,301.22	$2,184.22	2026-03-02
30420	HCPCS	Pro Fee Reconstrution Of Nose Pf	28	9	$3,910.50	$1,564.20 60% off	$1,047.56	$13,595.45	$2,211.33	2026-03-02
30465	HCPCS	Pro Fee Repair Of Nasal Stenosis Pf	28	9	$2,765.50	$1,106.20 60% off	$740.91	$13,885.20	$1,563.95	2026-03-02
31201	HCPCS	Pro Fee Removal Of Ethmoid Sinus Pf	28	9	$2,117.00	$846.80 60% off	$567.13	$3,714.98	$1,086.73	2026-03-02
3123750	OTHER	Nasal/sinus Endoscopy Surg Bi,bilateral	17	9	$4,147.00	$1,658.80 60% off	$127.18	$3,939.65	$1,178.58	2026-03-02
31238	HCPCS	Nsl/sin Endoscopy Surg Nsl Hemrrg Clinic	17	9	$4,289.00	$1,715.60 60% off	$117.09	$4,074.55	$1,218.93	2026-03-02
3124050	OTHER	Nasal/sinus Endoscopy Surg Bi,bilateral	18	9	$8,598.50	$3,439.40 60% off	$241.85	$8,168.58	$2,443.69	2026-03-02
31242	HCPCS	Nsl/sinus Ndsc Rf Abltj Pnn	18	9	$14,799.00	$5,919.60 60% off	$112.54	$14,059.05	$4,205.88	2026-03-02
3125450	OTHER	Nasal Sinus Ndsc W/prtl Ethmdct Bi,bilateral	18	9	$6,694.50	$2,677.80 60% off	$372.87	$6,359.78	$1,902.57	2026-03-02
3125550	OTHER	Nasal Sinus Ndsc W Tot Ethmdct Bi,bilateral	18	9	$15,768.00	$6,307.20 60% off	$262.32	$14,979.60	$4,481.27	2026-03-02
3125650	OTHER	Nasal Sinus Endoscopy W Maxillary An Bi,bilateral	18	9	$17,024.00	$6,809.60 60% off	$290.74	$16,172.80	$4,838.22	2026-03-02
3126750	OTHER	Endoscopy Maxillary Sinus Bi,bilateral	10	9	$15,768.00	$6,307.20 60% off	$4,481.27	$14,979.60	$4,730.40	2026-03-02
3129650	OTHER	Nsl/sins Ndsc Surg Frnt&sins Bi,bilateral	18	9	$33,470.00	$13,388.00 60% off	$274.11	$31,796.50	$9,512.17	2026-03-02
31297	HCPCS	Nsl/sins Ndsc Surg Sphn Sins	18	9	$17,825.50	$7,130.20 60% off	$124.62	$16,934.22	$5,066.01	2026-03-02
31536	HCPCS	Larynsgoscopy W/bx & Op Scope	18	9	$9,463.00	$3,785.20 60% off	$149.20	$8,989.85	$2,689.38	2026-03-02
352	OTHER	CT Abd/pelvis W/contrast	25	3	$2,576.00	$1,236.48 52% off	$303.70	$2,643.84	$983.04	2026-07-31
360	OTHER	Cataract Surgery With Iol 1 Stage	43	4	$3,179.00	$1,525.92 52% off	$162.90	$11,525.83	$2,304.99	2026-07-31
40810	HCPCS	Excise Of Mouth Lesion	18	9	$8,063.00	$3,225.20 60% off	$85.83	$7,659.85	$2,291.50	2026-03-02
42120	HCPCS	Pro Fee Removal Palate/lesonpf	28	9	$1,807.00	$722.80 60% off	$484.14	$7,676.48	$1,128.56	2026-03-02
42975	HCPCS	Dise Eval Slp Do Brth Flx Dx	18	9	$4,288.50	$1,715.40 60% off	$69.06	$4,074.08	$1,218.80	2026-03-02
44180	HCPCS	Lap Enterolysis	28	9	$2,631.00	$1,052.40 60% off	$704.82	$13,308.55	$1,487.81	2026-03-02
44604	HCPCS	Pro Fee Suture Large Intestine Pf	28	9	$3,031.50	$1,212.60 60% off	$812.11	$3,531.15	$1,067.15	2026-03-02
44620	HCPCS	Pro Fee Repair Of Bowel Opening Pf	28	9	$1,449.00	$579.60 60% off	$388.22	$5,089.62	$939.64	2026-03-02
450	OTHER	Ins Central Venous Access > 5	1	1	$2,344.50	$1,125.36 52% off	$2,276.00	$2,276.00	$2,276.00	2026-07-31
45190	HCPCS	Destruction Rectual Tumor	28	9	$1,806.00	$722.40 60% off	$483.85	$6,668.52	$1,021.33	2026-03-02
45505	HCPCS	Pro Fee Repair Of Rectum Pf	28	9	$1,619.50	$647.80 60% off	$433.83	$6,669.00	$915.80	2026-03-02
46947	HCPCS	Hemorrhoidopexy By Stapling	10	9	$8,315.00	$3,326.00 60% off	$2,363.12	$7,899.25	$2,494.50	2026-03-02
47563	HCPCS	Lapro Cholecystectomy With Graph	28	9	$2,168.00	$867.20 60% off	$580.77	$7,942.00	$1,225.97	2026-03-02
47564	HCPCS	Lapro Cholecystectomy / Explr	10	9	$11,730.50	$4,692.20 60% off	$3,333.80	$11,143.98	$3,519.15	2026-03-02
47600	HCPCS	Pro Fee Removal Of Gallbladderpf	28	9	$1,946.50	$778.60 60% off	$521.51	$7,942.00	$1,208.72	2026-03-02
47605	HCPCS	Pro Fee Removal Of Gallbladder Pf	28	9	$1,946.50	$778.60 60% off	$521.51	$7,942.00	$1,184.20	2026-03-02
49002	HCPCS	Pro Fee Reopening Of Abdomen Pf	28	9	$2,993.50	$1,197.40 60% off	$802.01	$3,496.48	$1,059.76	2026-03-02
49203	HCPCS	Exe Abd Tum 5 Cm Or Less	28	9	$2,003.50	$801.40 60% off	$536.71	$7,942.00	$1,278.39	2026-03-02
49320	HCPCS	Diagnostic Laparoscopy	10	9	$8,360.00	$3,344.00 60% off	$2,375.91	$7,942.00	$2,508.00	2026-03-02
49505	HCPCS	Ing Hernia Repair W/mesh	28	9	$1,563.00	$625.20 60% off	$418.77	$8,125.82	$883.93	2026-03-02
49507	HCPCS	Pro Fee Prp I/hern Init Block >5years Pf	28	9	$1,760.50	$704.20 60% off	$471.49	$8,442.18	$995.39	2026-03-02
49520	HCPCS	Pro Fee Rerepair Ing Hernia Reduce Pf	28	9	$1,829.00	$731.60 60% off	$489.96	$8,276.88	$1,034.28	2026-03-02
49560	HCPCS	Pro Fee Repair Ventral Hern Init Reduc Pf	28	9	$2,226.00	$890.40 60% off	$596.25	$8,125.82	$1,258.70	2026-03-02
49561	HCPCS	Pro Fee Repair Ventrl Hern Init Block Pf	28	9	$1,651.00	$660.40 60% off	$442.35	$4,967.08	$1,025.85	2026-03-02
49566	HCPCS	Pro Fee Rerepair Ventrl Hern Block Pf	28	9	$1,576.00	$630.40 60% off	$422.18	$13,932.22	$1,021.43	2026-03-02
49593	HCPCS	Pro Fee Rpr Aa Hrn 1st 3-10 Rdc Pf	28	9	$1,501.00	$600.40 60% off	$402.14	$9,192.20	$895.11	2026-03-02
49594	HCPCS	Pro Fee Repair Aa Hrn 1st 3-10 Ncr/strn Pf	28	9	$1,956.00	$782.40 60% off	$523.93	$13,526.58	$1,166.01	2026-03-02
49596	HCPCS	Pro Fee Repair Aa Hrn 1st>10 Ncr/strn	8	7	$2,586.50	$1,034.60 60% off	$735.08	$2,457.18	$1,113.46	2026-03-02
49615	HCPCS	Repair Aa Hrn Rcr 3-10 Rdc	18	9	$8,699.50	$3,479.80 60% off	$341.61	$8,264.52	$2,472.40	2026-03-02
49650	HCPCS	Pro Fee Lap Ing Hernia Repair Init Pf	38	9	$8,742.50	$3,497.00 60% off	$322.00	$8,471.15	$2,484.61	2026-03-02
49651	HCPCS	Lap Ing Hernia Repair Recur	28	9	$1,575.50	$630.20 60% off	$422.04	$14,227.68	$890.91	2026-03-02
49652	HCPCS	Lap Vent/abd Hernia Repair	28	9	$2,243.00	$897.20 60% off	$600.80	$7,942.00	$1,268.31	2026-03-02
49653	HCPCS	Lap Vent/abd Hernia Proc Comp	28	9	$2,799.00	$1,119.60 60% off	$749.86	$7,744.40	$1,582.86	2026-03-02
49654	HCPCS	Lap Inc Hernia Repair With Mesh	10	9	$13,731.50	$5,492.60 60% off	$3,902.50	$13,044.92	$4,119.45	2026-03-02
49655	HCPCS	Lap Inc Hern Repair Comp	28	9	$2,814.50	$1,125.80 60% off	$753.98	$24,315.72	$1,591.59	2026-03-02
49659	HCPCS	Unlstd Laps Px Hrnap Hrnrphy	26	9	$1,529.50	$611.80 60% off	$409.68	$13,932.22	$991.72	2026-03-02
50590	HCPCS	Fragmenting Of Kidney Stone- Lithotripsy	10	9	$8,915.50	$3,566.20 60% off	$2,533.79	$8,469.72	$2,674.65	2026-03-02
51040	HCPCS	Incise And Drain Of Bladder	10	9	$5,134.50	$2,053.80 60% off	$1,459.22	$4,877.78	$1,540.35	2026-03-02
51102	HCPCS	Drain Bl With Cath Insertion	10	9	$5,134.50	$2,053.80 60% off	$1,459.22	$4,877.78	$1,540.35	2026-03-02
52001	HCPCS	Cystoscopy And Removal Of Clots	10	9	$8,915.50	$3,566.20 60% off	$2,533.79	$8,469.72	$2,674.65	2026-03-02
52005	HCPCS	Cystoscopy And Ureter Catheter	10	9	$5,134.00	$2,053.60 60% off	$1,459.08	$4,877.30	$1,540.20	2026-03-02
52204	HCPCS	Cystoscopy With Biopsy(s)	10	9	$5,134.50	$2,053.80 60% off	$1,459.22	$4,877.78	$1,540.35	2026-03-02
52214	HCPCS	Cystoscopy And Treatment	10	9	$8,748.50	$3,499.40 60% off	$2,486.32	$8,311.08	$2,624.55	2026-03-02
52224	HCPCS	Cystoscopy And Treatment	10	9	$8,748.50	$3,499.40 60% off	$2,486.32	$8,311.08	$2,624.55	2026-03-02
52234	HCPCS	Cystoscopy And Treatment	10	9	$8,748.50	$3,499.40 60% off	$2,486.32	$8,311.08	$2,624.55	2026-03-02
52235	HCPCS	Cystoscopy And Treatment	10	9	$8,915.50	$3,566.20 60% off	$2,533.79	$8,469.72	$2,674.65	2026-03-02
52240	HCPCS	Cystoscopy And Treatment	10	9	$12,264.00	$4,905.60 60% off	$3,485.43	$11,650.80	$3,679.20	2026-03-02
52260	HCPCS	Cystoscopy And Treatment	10	9	$5,134.00	$2,053.60 60% off	$1,459.08	$4,877.30	$1,540.20	2026-03-02
52281	HCPCS	Cystoscopy And Treatment	10	9	$5,134.00	$2,053.60 60% off	$1,459.08	$4,877.30	$1,540.20	2026-03-02
52300	HCPCS	Cystoscopy And Treatment	10	9	$8,755.50	$3,502.20 60% off	$2,488.32	$8,317.72	$2,626.65	2026-03-02
52310	HCPCS	Cystoscopy And Treatment	10	9	$5,134.00	$2,053.60 60% off	$1,459.08	$4,877.30	$1,540.20	2026-03-02
52317	HCPCS	Removal Of Bladder Stone	10	9	$8,915.50	$3,566.20 60% off	$2,533.79	$8,469.72	$2,674.65	2026-03-02
52318	HCPCS	Removal Of Bladder Stone	10	9	$8,915.50	$3,566.20 60% off	$2,533.79	$8,469.72	$2,674.65	2026-03-02
52320	HCPCS	Cystoscopy And Treatment	10	9	$8,809.50	$3,523.80 60% off	$2,503.66	$8,369.02	$2,642.85	2026-03-02
52330	HCPCS	Cystoscopy And Treatment	10	9	$8,748.00	$3,499.20 60% off	$2,486.18	$8,310.60	$2,624.40	2026-03-02
52332	HCPCS	Cystoscopy And Treatment	10	9	$8,748.00	$3,499.20 60% off	$2,486.18	$8,310.60	$2,624.40	2026-03-02
5233250	OTHER	Cystoscopy And Treatment Bilateral,bilateral	10	9	$17,494.50	$6,997.80 60% off	$4,971.93	$16,619.78	$5,248.35	2026-03-02
52342	HCPCS	Cysto W/up Stricture Tx	10	9	$8,748.00	$3,499.20 60% off	$2,486.18	$8,310.60	$2,624.40	2026-03-02
52344	HCPCS	Cysto/uretero Stricture Tx	10	9	$8,748.00	$3,499.20 60% off	$2,486.18	$8,310.60	$2,624.40	2026-03-02
52351	HCPCS	Cystouretero And Or Pyeloscope	10	9	$8,748.00	$3,499.20 60% off	$2,486.18	$8,310.60	$2,624.40	2026-03-02
52352	HCPCS	Cystourethroscopy With Stone Removal	10	9	$8,748.00	$3,499.20 60% off	$2,486.18	$8,310.60	$2,624.40	2026-03-02
52353	HCPCS	Cystouretero W Lithotripsy	10	9	$12,264.00	$4,905.60 60% off	$3,485.43	$11,650.80	$3,679.20	2026-03-02
52354	HCPCS	Cystourethroscopy With Biopsy	10	9	$13,090.50	$5,236.20 60% off	$3,720.32	$12,435.98	$3,927.15	2026-03-02
52356	HCPCS	Cystourethroscopy Utetero W Lithotripsy	10	9	$12,264.00	$4,905.60 60% off	$3,485.43	$11,650.80	$3,679.20	2026-03-02
52500	HCPCS	Revision Of Bladder Neck	10	9	$8,915.50	$3,566.20 60% off	$2,533.79	$8,469.72	$2,674.65	2026-03-02
52601	HCPCS	Prostatectomy	10	9	$7,358.50	$2,943.40 60% off	$2,091.28	$6,990.58	$2,207.55	2026-03-02
52630	HCPCS	Removal Of Prostate Growth	10	9	$12,792.00	$5,116.80 60% off	$3,635.49	$12,152.40	$3,837.60	2026-03-02
52640	HCPCS	Relieve Bladder Contracture	10	9	$9,074.00	$3,629.60 60% off	$2,578.83	$8,620.30	$2,722.20	2026-03-02
52648	HCPCS	Laser Surgery Of Prostate	10	9	$13,090.50	$5,236.20 60% off	$3,720.32	$12,435.98	$3,927.15	2026-03-02
52649	HCPCS	Prostate Laser Enuleation	10	9	$12,845.00	$5,138.00 60% off	$3,650.55	$12,202.75	$3,853.50	2026-03-02
53020	HCPCS	Incision Of Urethra	10	9	$5,067.50	$2,027.00 60% off	$1,440.19	$4,814.12	$1,520.25	2026-03-02
53200	HCPCS	Biopsy Of Urethra	10	9	$5,275.00	$2,110.00 60% off	$1,499.16	$5,011.25	$1,582.50	2026-03-02
53265	HCPCS	Treatment Of Urethra Lesion	10	9	$5,067.50	$2,027.00 60% off	$1,440.19	$4,814.12	$1,520.25	2026-03-02
53854	HCPCS	Trurl Dstrj Prst8 Tis Rf Wb	10	9	$5,134.50	$2,053.80 60% off	$1,459.22	$4,877.78	$1,540.35	2026-03-02
54001	HCPCS	Slitting Of Prepuce	10	9	$5,067.50	$2,027.00 60% off	$1,440.19	$4,814.12	$1,520.25	2026-03-02
54055	HCPCS	Destruction Penis Lesion(s)	10	9	$4,922.00	$1,968.80 60% off	$1,398.83	$4,675.90	$1,476.60	2026-03-02
54060	HCPCS	Excision Of Penis Lesion	10	9	$3,997.00	$1,598.80 60% off	$1,135.95	$3,797.15	$1,199.10	2026-03-02
54100	HCPCS	Biopsy Of Penis	10	9	$4,097.00	$1,638.80 60% off	$1,164.37	$3,892.15	$1,229.10	2026-03-02
54162	HCPCS	Lysis Penil Circumic Lesion	10	9	$5,067.50	$2,027.00 60% off	$1,440.19	$4,814.12	$1,520.25	2026-03-02
54322	HCPCS	Reconstruction Of Urethra	10	9	$8,835.50	$3,534.20 60% off	$2,511.05	$8,393.72	$2,650.65	2026-03-02
54505	HCPCS	Biopsy Of Testis	10	9	$8,755.50	$3,502.20 60% off	$2,488.32	$8,317.72	$2,626.65	2026-03-02
54530	HCPCS	Removal Of Testis	10	9	$9,087.50	$3,635.00 60% off	$2,582.67	$8,633.12	$2,726.25	2026-03-02
54600	HCPCS	Reduce Testis Torsion	10	9	$8,748.00	$3,499.20 60% off	$2,486.18	$8,310.60	$2,624.40	2026-03-02
54640	HCPCS	Orchiopexy Ingun/scro Appr Uni	10	9	$4,571.50	$1,828.60 60% off	$1,299.23	$4,342.92	$1,371.45	2026-03-02
5464050	OTHER	Orchiopexy Ingun/scro Appr Bi,bilateral	10	9	$9,143.00	$3,657.20 60% off	$2,598.44	$8,685.85	$2,742.90	2026-03-02
54830	HCPCS	Removal Of Epididymis Lesion	10	9	$5,350.00	$2,140.00 60% off	$1,520.47	$5,082.50	$1,605.00	2026-03-02
54840	HCPCS	Removal Of Epididymis Lesion	10	9	$5,134.00	$2,053.60 60% off	$1,459.08	$4,877.30	$1,540.20	2026-03-02
54860	HCPCS	Removal Of Epididymis	10	9	$5,134.00	$2,053.60 60% off	$1,459.08	$4,877.30	$1,540.20	2026-03-02
55041	HCPCS	Removal Of Hydrocele	10	9	$9,143.00	$3,657.20 60% off	$2,598.44	$8,685.85	$2,742.90	2026-03-02
55060	HCPCS	Repair Of Hydrocele	10	9	$8,748.00	$3,499.20 60% off	$2,486.18	$8,310.60	$2,624.40	2026-03-02
55100	HCPCS	Drainage Of Scrotol Wall Abscess ER Fac	20	9	$3,266.50	$1,306.60 60% off	$692.31	$3,892.15	$1,176.25	2026-03-02
55110	HCPCS	Explore Of Scrotum	10	9	$8,755.50	$3,502.20 60% off	$2,488.32	$8,317.72	$2,626.65	2026-03-02
55150	HCPCS	Removal Of Scrotum	10	9	$5,350.00	$2,140.00 60% off	$1,520.47	$5,082.50	$1,605.00	2026-03-02
5540050	OTHER	Repair Of Sperm Duct Bi,bilateral	10	9	$8,809.50	$3,523.80 60% off	$2,503.66	$8,369.02	$2,642.85	2026-03-02
55500	HCPCS	Removal Of Hydrocele	10	9	$8,886.50	$3,554.60 60% off	$2,525.54	$8,442.18	$2,665.95	2026-03-02
55530	HCPCS	Revise Spermatic Cord Veins	10	9	$9,074.00	$3,629.60 60% off	$2,578.83	$8,620.30	$2,722.20	2026-03-02
55535	HCPCS	Excision Of Varicocele Or Ligation Of Sp	10	9	$5,535.50	$2,214.20 60% off	$1,573.19	$5,258.72	$1,660.65	2026-03-02
55700	HCPCS	Biopsy Of Prostate	10	9	$5,134.50	$2,053.80 60% off	$1,459.22	$4,877.78	$1,540.35	2026-03-02
55705	HCPCS	Biopsy Of Prostate	10	9	$5,134.00	$2,053.60 60% off	$1,459.08	$4,877.30	$1,540.20	2026-03-02
55873	HCPCS	Cryosurgical Ablation Of The Prostate US	10	9	$23,377.50	$9,351.00 60% off	$6,643.89	$22,208.62	$7,013.25	2026-03-02
55874	HCPCS	Tprnl Plmt Biodegrdabl Matrl	10	9	$13,090.50	$5,236.20 60% off	$3,720.32	$12,435.98	$3,927.15	2026-03-02
55876	HCPCS	Place Rt Device/marker Pros	10	9	$3,523.50	$1,409.40 60% off	$1,001.38	$3,347.32	$1,057.05	2026-03-02
57240	HCPCS	Anterior Colporrhaphy	10	9	$12,779.50	$5,111.80 60% off	$3,631.94	$12,140.52	$3,833.85	2026-03-02
57250	HCPCS	Repair Of Rectum And Vagina	10	9	$12,779.50	$5,111.80 60% off	$3,631.94	$12,140.52	$3,833.85	2026-03-02
57260	HCPCS	Cmbn Ant Pst Colprhy	10	9	$12,779.50	$5,111.80 60% off	$3,631.94	$12,140.52	$3,833.85	2026-03-02
57285	HCPCS	Repair Paravag Defect Vag	10	9	$19,039.50	$7,615.80 60% off	$5,411.03	$18,087.52	$5,711.85	2026-03-02
57288	HCPCS	Repair Of Bladder Defect	10	9	$12,379.50	$4,951.80 60% off	$3,518.26	$11,760.52	$3,713.85	2026-03-02
57295	HCPCS	Revise Vag Graft Via Vagina	10	9	$7,765.50	$3,106.20 60% off	$2,206.96	$7,377.22	$2,329.65	2026-03-02
57415	HCPCS	Removal Vaginal Foreign Body	10	9	$7,539.50	$3,015.80 60% off	$2,142.73	$7,162.52	$2,261.85	2026-03-02
57522	HCPCS	Conization Of Cervix	18	9	$4,912.50	$1,965.00 60% off	$171.66	$4,666.88	$1,396.14	2026-03-02
58120	HCPCS	Dilation And Curettage	17	9	$4,912.50	$1,965.00 60% off	$157.31	$4,666.88	$1,396.13	2026-03-02
58353	HCPCS	Endometr Ablate Thermal	18	9	$12,251.00	$4,900.40 60% off	$173.36	$11,638.45	$3,481.73	2026-03-02
58558	HCPCS	Hysteroscopy Biopsy	18	9	$5,777.00	$2,310.80 60% off	$156.88	$5,488.15	$1,641.82	2026-03-02
58563	HCPCS	Hysteroscopy Ablation	18	9	$12,569.00	$5,027.60 60% off	$173.36	$11,940.55	$3,572.11	2026-03-02
58670	HCPCS	Laparoscopy Removal Adnexa	20	9	$11,470.50	$4,588.20 60% off	$2,375.91	$13,851.95	$4,169.07	2026-03-02
58700	HCPCS	Removal Of Fallopian Tube	18	9	$12,568.50	$5,027.40 60% off	$574.22	$11,940.08	$3,571.97	2026-03-02
610	OTHER	Mr Jt Up Ex Lt Without Con	4	2	$2,236.00	$1,073.28 52% off	$781.56	$1,664.64	$946.67	2026-07-31
611	OTHER	Mr Head W/wo Con	5	3	$3,861.00	$1,853.28 52% off	$750.21	$1,799.28	$1,265.14	2026-07-31
64581	HCPCS	Impant Neuroelectrodes	10	9	$10,760.50	$4,304.20 60% off	$3,058.13	$10,222.48	$3,228.15	2026-03-02
64585	HCPCS	Revise/removal Neuroelectrode	10	9	$8,872.50	$3,549.00 60% off	$2,521.56	$8,428.88	$2,661.75	2026-03-02
64590	HCPCS	Insrt/redo Pn/gastr Stimul	10	9	$33,525.00	$13,410.00 60% off	$9,527.80	$31,848.75	$10,057.50	2026-03-02
64772	HCPCS	Incision Of Spinal Nerve	10	9	$4,322.00	$1,728.80 60% off	$1,228.31	$4,105.90	$1,296.60	2026-03-02
65101	HCPCS	Removal Of Foreign Body From Eye	10	9	$9,501.00	$3,800.40 60% off	$2,700.18	$9,025.95	$2,850.30	2026-03-02
65820	HCPCS	Relieve Inner Eye Pressure	10	9	$10,583.50	$4,233.40 60% off	$3,007.84	$10,054.32	$3,175.05	2026-03-02
66020	HCPCS	Injection Treatment Of Eye	10	9	$3,400.50	$1,360.20 60% off	$966.42	$3,230.48	$1,020.15	2026-03-02
66825	HCPCS	Reposition Of Lens Lesion	10	9	$3,616.50	$1,446.60 60% off	$1,027.80	$3,435.68	$1,084.95	2026-03-02
66840	HCPCS	Removal Of Lens Material	10	9	$3,577.50	$1,431.00 60% off	$1,016.73	$3,398.62	$1,073.25	2026-03-02
66850	HCPCS	Removal Of Lens Material	10	9	$5,871.00	$2,348.40 60% off	$1,668.54	$5,577.45	$1,761.30	2026-03-02
66920	HCPCS	Extraction Of Lens	10	9	$5,889.00	$2,355.60 60% off	$1,673.65	$5,594.55	$1,766.70	2026-03-02
66982	HCPCS	Cataract Surgery Complex	10	9	$3,577.50	$1,431.00 60% off	$1,016.73	$3,398.62	$1,073.25	2026-03-02
66984	HCPCS	Cataract Surgery With Iol 1 Stage	10	9	$3,577.50	$1,431.00 60% off	$1,016.73	$3,398.62	$1,073.25	2026-03-02
66985	HCPCS	Insert Lens Prosthesis	10	9	$5,889.00	$2,355.60 60% off	$1,673.65	$5,594.55	$1,766.70	2026-03-02
66986	HCPCS	Exchange Lens Prosthesis	10	9	$3,400.50	$1,360.20 60% off	$966.42	$3,230.48	$1,020.15	2026-03-02
66991	HCPCS	Xcapsl Ctrc Rmvl Inj 1 +	10	9	$11,959.00	$4,783.60 60% off	$3,398.75	$11,361.05	$3,587.70	2026-03-02
67808	HCPCS	Remove Eyelid Lesion(s)	10	9	$5,775.50	$2,310.20 60% off	$1,641.40	$5,486.72	$1,732.65	2026-03-02
68110	HCPCS	Removal Eyelid Lining Lesion	10	9	$5,775.50	$2,310.20 60% off	$1,641.40	$5,486.72	$1,732.65	2026-03-02
68811	HCPCS	Probe Nasolacrimal Duct Uni	10	9	$5,750.50	$2,300.20 60% off	$1,634.29	$5,462.98	$1,725.15	2026-03-02
6881150	OTHER	Probe Nasolacrimal Duct Bi,bilateral	10	9	$11,501.00	$4,600.40 60% off	$3,268.58	$10,925.95	$3,450.30	2026-03-02
69421	HCPCS	Incision Of Eardrum	17	9	$8,350.50	$3,340.20 60% off	$100.74	$7,932.98	$2,373.21	2026-03-02
6943650	OTHER	Create Ear Drum Opening Bi,bilateral	18	9	$7,562.50	$3,025.00 60% off	$253.94	$7,184.38	$2,149.27	2026-03-02
69631	HCPCS	Pro Fee Repair Of Eardrum Structures Pf	28	9	$2,419.00	$967.60 60% off	$647.98	$13,354.62	$1,367.87	2026-03-02
70482TC	OTHER	CT Orb/sel/iac W/wo Con,technical Component	10	9	$3,500.00	$1,400.00 60% off	$512.00	$3,325.00	$1,015.00	2026-03-02
70488TC	OTHER	CT Maxillofacial W/wo Contrast,technical Component	10	9	$3,478.00	$1,391.20 60% off	$512.00	$3,304.10	$1,008.62	2026-03-02
70540TC	OTHER	Mr Orb/fac/neck Without Con,technical Component	10	9	$3,169.00	$1,267.60 60% off	$900.63	$3,010.55	$950.70	2026-03-02
70543TC	OTHER	Mr Orbit/ Fac/neck W/wo Con,technical Component	10	9	$4,371.00	$1,748.40 60% off	$1,242.24	$4,152.45	$1,311.30	2026-03-02
70544TC	OTHER	MRA Head Without Con,technical Component	20	9	$2,895.75	$1,158.30 60% off	$776.43	$2,906.52	$887.26	2026-03-02
70545TC	OTHER	MRA Head & Neck With Con,technical Component	10	9	$3,278.00	$1,311.20 60% off	$931.61	$3,114.10	$983.40	2026-03-02
70547TC	OTHER	MRA Neck Without Contrast,technical Component	10	9	$3,169.00	$1,267.60 60% off	$900.63	$3,010.55	$950.70	2026-03-02
70549TC	OTHER	MRA Neck W/wo Con,technical Component	10	9	$6,078.00	$2,431.20 60% off	$1,727.37	$5,774.10	$1,823.40	2026-03-02
70551TC	OTHER	Mr Brain/iac W/o,technical Component	30	9	$3,059.50	$1,223.80 60% off	$776.43	$3,114.10	$949.53	2026-03-02
70553TC	OTHER	Mr Brain/iac W/wo Con,technical Component	30	9	$4,589.50	$1,835.80 60% off	$1,242.24	$4,671.15	$1,424.34	2026-03-02
71270TC	OTHER	CT Thorax W/wo Con,technical Component	10	9	$3,500.50	$1,400.20 60% off	$512.00	$3,325.48	$1,015.14	2026-03-02
71275TC	OTHER	CTA Thoracic Aorta W/wo Contrast,technical Component	10	9	$3,776.50	$1,510.60 60% off	$512.00	$3,587.68	$1,095.18	2026-03-02
72130TC	OTHER	CT T-spine W Without Contrast,technical Component	10	9	$3,593.50	$1,437.40 60% off	$512.00	$3,413.82	$1,042.12	2026-03-02
72133TC	OTHER	CT L-spine W Without Contrast,technical Component	10	9	$3,611.00	$1,444.40 60% off	$512.00	$3,430.45	$1,047.19	2026-03-02
72141TC	OTHER	Mr C-spine Without Con,technical Component	10	9	$3,059.50	$1,223.80 60% off	$869.51	$2,906.52	$917.85	2026-03-02
72146TC	OTHER	Mr T-spine Without Con,technical Component	10	9	$3,824.50	$1,529.80 60% off	$1,086.92	$3,633.28	$1,147.35	2026-03-02
72148TC	OTHER	Mr L-spine Without Con,technical Component	10	9	$3,497.00	$1,398.80 60% off	$993.85	$3,322.15	$1,049.10	2026-03-02
72156TC	OTHER	Mr C-spine W/wo Con,technical Component	10	9	$5,463.50	$2,185.40 60% off	$1,552.73	$5,190.32	$1,639.05	2026-03-02
72157TC	OTHER	Mr T-spine W/wo Con,technical Component	10	9	$5,463.50	$2,185.40 60% off	$1,552.73	$5,190.32	$1,639.05	2026-03-02
72158TC	OTHER	Mr L-spine W/wo Con,technical Component	10	9	$4,917.00	$1,966.80 60% off	$1,397.41	$4,671.15	$1,475.10	2026-03-02
72191TC	OTHER	CTA Pelvis W/wo Con,technical Component	10	9	$3,440.50	$1,376.20 60% off	$512.00	$3,268.48	$997.74	2026-03-02
72195TC	OTHER	Mr Pel Without Con,technical Component	10	9	$3,169.00	$1,267.60 60% off	$900.63	$3,010.55	$950.70	2026-03-02
72197TC	OTHER	Mr Pel W/wo Con,technical Component	10	9	$4,152.50	$1,661.00 60% off	$1,180.14	$3,944.88	$1,245.75	2026-03-02
73206LTTC	OTHER	CTA Ext Upper W/wo Lt,left Side Of Body, Technical Component	10	9	$3,182.50	$1,273.00 60% off	$512.00	$3,023.38	$922.92	2026-03-02
73206RTTC	OTHER	CTA Ext Upper W/wo Rt,right Side Of Body, Technical Component	10	9	$3,182.50	$1,273.00 60% off	$512.00	$3,023.38	$922.92	2026-03-02
73220LTTC	OTHER	Mr Upper Ex Lt W/wo Con,left Side Of Body, Technical Component	10	9	$3,387.50	$1,355.00 60% off	$962.73	$3,218.12	$1,016.25	2026-03-02
73220RTTC	OTHER	Mr Upper Ex Rt W/wo Con,right Side Of Body, Technical Component	10	9	$3,387.50	$1,355.00 60% off	$962.73	$3,218.12	$1,016.25	2026-03-02
73221LTTC	OTHER	Mr Jnt Up Ex Lt Without Con,left Side Of Body, Technical Component	10	9	$3,278.00	$1,311.20 60% off	$931.61	$3,114.10	$983.40	2026-03-02
73221RTTC	OTHER	Mr Jnt Up Ex Rt Without Con,right Side Of Body, Technical Component	10	9	$3,278.00	$1,311.20 60% off	$931.61	$3,114.10	$983.40	2026-03-02
73222TC	OTHER	MRI Upper Ext Joint W/contrast,technical Component	10	9	$3,278.00	$1,311.20 60% off	$931.61	$3,114.10	$983.40	2026-03-02
73223LTTC	OTHER	Mr Jnt Up Ex Lt W/wo Con,left Side Of Body, Technical Component	10	9	$3,824.50	$1,529.80 60% off	$1,086.92	$3,633.28	$1,147.35	2026-03-02
73223RTTC	OTHER	Mr Jnt Up Ex Rt W/wo Con,right Side Of Body, Technical Component	10	9	$3,715.00	$1,486.00 60% off	$1,055.80	$3,529.25	$1,114.50	2026-03-02
73706LTTC	OTHER	CTA Ext Lower W/wo Lt,left Side Of Body, Technical Component	10	9	$4,243.50	$1,697.40 60% off	$512.00	$4,031.32	$1,230.62	2026-03-02
73706RTTC	OTHER	CTA Ext Lower W/wo Rt,right Side Of Body, Technical Component	10	9	$4,243.50	$1,697.40 60% off	$512.00	$4,031.32	$1,230.62	2026-03-02
73720LTTC	OTHER	Mr Low Ex Lt W/wo Con,left Side Of Body, Technical Component	10	9	$3,497.00	$1,398.80 60% off	$993.85	$3,322.15	$1,049.10	2026-03-02
73720RTTC	OTHER	Mr Low Ex Rt W/wo Con,right Side Of Body, Technical Component	10	9	$3,497.00	$1,398.80 60% off	$993.85	$3,322.15	$1,049.10	2026-03-02
73721LTTC	OTHER	Mr Jnt Low Ex Lt Without Con,left Side Of Body, Technical Component	10	9	$3,059.50	$1,223.80 60% off	$869.51	$2,906.52	$917.85	2026-03-02
73721RTTC	OTHER	Mr Jnt Low Ex Rt Without Con,right Side Of Body, Technical Component	10	9	$3,059.50	$1,223.80 60% off	$869.51	$2,906.52	$917.85	2026-03-02
73722TC	OTHER	MRI Lower Ext Joint W/contrast,technical Component	10	9	$3,278.00	$1,311.20 60% off	$931.61	$3,114.10	$983.40	2026-03-02
73723LTTC	OTHER	Mr Jnt Low Ext Lt W/wo Con,left Side Of Body, Technical Component	10	9	$3,933.50	$1,573.40 60% off	$1,117.91	$3,736.82	$1,180.05	2026-03-02
73723RTTC	OTHER	Mr Jnt Low Ex Rt W/wo Con,right Side Of Body, Technical Component	10	9	$4,152.50	$1,661.00 60% off	$1,180.14	$3,944.88	$1,245.75	2026-03-02
74170TC	OTHER	CT Abd W/wo Con,technical Component	10	9	$3,548.00	$1,419.20 60% off	$512.00	$3,370.60	$1,028.92	2026-03-02
74174TC	OTHER	CTA Abd/pelvis W W/o,technical Component	10	9	$6,955.50	$2,782.20 60% off	$512.00	$6,607.72	$2,017.10	2026-03-02
74176TC	OTHER	CT Abd/pelvis Without Contrast,technical Component	10	9	$4,020.00	$1,608.00 60% off	$512.00	$3,819.00	$1,165.80	2026-03-02
74177TC	OTHER	CT Abd/pelvis W/contrast,technical Component	10	9	$5,602.50	$2,241.00 60% off	$512.00	$5,322.38	$1,624.72	2026-03-02
74178TC	OTHER	CT Abd/pelvis Combo Wo/w Contrast,technical Component	10	9	$6,385.00	$2,554.00 60% off	$512.00	$6,065.75	$1,851.65	2026-03-02
74182TC	OTHER	MRI Abdomen W/contrast,technical Component	10	9	$3,169.00	$1,267.60 60% off	$900.63	$3,010.55	$950.70	2026-03-02
74183TC	OTHER	Mr Abd W/wo Con,technical Component	10	9	$4,480.00	$1,792.00 60% off	$1,273.22	$4,256.00	$1,344.00	2026-03-02
74185TC	OTHER	MRA Abd W/wo Con,technical Component	10	9	$4,277.00	$1,710.80 60% off	$1,215.52	$4,063.15	$1,283.10	2026-03-02
75574TC	OTHER	CTA Heart Cornary Artery,technical Component	10	9	$3,182.50	$1,273.00 60% off	$512.00	$3,023.38	$922.92	2026-03-02
75635TC	OTHER	CTA Aorta-iliofem Runoff,technical Component	10	9	$4,603.50	$1,841.40 60% off	$512.00	$4,373.32	$1,335.02	2026-03-02
77046TC	OTHER	MRI Breast Without Contrast Uni,technical Component	10	9	$3,899.50	$1,559.80 60% off	$1,108.24	$3,704.52	$1,169.85	2026-03-02
77047TC	OTHER	MRI Breast Without Contrast Bi,technical Component	10	9	$4,213.50	$1,685.40 60% off	$1,197.48	$4,002.82	$1,264.05	2026-03-02
77048TC	OTHER	MRI Breast W/wo Cont Uni With Cad,technical Component	10	9	$4,218.00	$1,687.20 60% off	$1,198.76	$4,007.10	$1,265.40	2026-03-02
77049TC	OTHER	MRI Breast W/wo Bi With Cad,technical Component	10	9	$4,494.00	$1,797.60 60% off	$1,277.19	$4,269.30	$1,348.20	2026-03-02
81162	HCPCS	Brcassure Comprehensive	10	9	$3,423.50	$1,369.40 60% off	$972.96	$3,252.32	$1,027.05	2026-03-02
90375	HCPCS	Hyperrab (rabies Imm Glob) 1500u Vial	20	9	$7,536.75	$3,014.70 60% off	$749.86	$11,813.25	$3,020.31	2026-03-02
90376	HCPCS	Hyperrab 150u/ml Rabies Imm Glob,340b Drug Pricing Program	10	9	$8,024.50	$3,209.80 60% off	$2,280.56	$7,623.28	$2,407.35	2026-03-02
93306TC	OTHER	US Echo W Spec And Color Dopp With Contras,technical Component	10	9	$3,182.50	$1,273.00 60% off	$904.46	$3,023.38	$954.75	2026-03-02
C1726	HCPCS	Cath Bal Dil Non-vascular	28	9	$2,938.00	$1,175.20 60% off	$124.62	$16,375.15	$1,141.41	2026-03-02
C1747	HCPCS	Lithovue Elite	20	9	$4,102.50	$1,641.00 60% off	$626.66	$5,700.00	$1,705.20	2026-03-02
C1767	HCPCS	Sacral Neuromodulation System Medtronic	10	9	$32,120.00	$12,848.00 60% off	$9,128.50	$30,514.00	$9,636.00	2026-03-02
C1771	HCPCS	Single Sling System Altis	10	9	$4,107.00	$1,642.80 60% off	$1,167.21	$3,901.65	$1,232.10	2026-03-02
C1787	HCPCS	Medtronic Interstim Handset	10	9	$4,875.00	$1,950.00 60% off	$1,385.48	$4,631.25	$1,462.50	2026-03-02
C1889	HCPCS	Spaceoar	20	9	$9,230.75	$3,692.30 60% off	$1,942.93	$11,043.75	$3,337.53	2026-03-02
C2618	HCPCS	Probe/needle Cryoblation	10	9	$10,927.50	$4,371.00 60% off	$3,105.60	$10,381.12	$3,278.25	2026-03-02
C8903TC	OTHER	MRI Breast W/cont Uni,technical Component	10	9	$4,017.00	$1,606.80 60% off	$1,141.63	$3,816.15	$1,205.10	2026-03-02
C8906TC	OTHER	MRI Breast W/cont Bi,technical Component	10	9	$3,968.50	$1,587.40 60% off	$1,127.84	$3,770.08	$1,190.55	2026-03-02
C9739	HCPCS	Cystourethroscopy W Impant 1-3 Impants	10	9	$7,358.50	$2,943.40 60% off	$2,091.28	$6,990.58	$2,207.55	2026-03-02
C9740	HCPCS	Cystourethroscopy W Impant 4 Or More	10	9	$14,029.00	$5,611.60 60% off	$3,987.04	$13,327.55	$4,208.70	2026-03-02
C9745	HCPCS	Nasal Endo Eustachian Tube Procedure	10	9	$7,847.00	$3,138.80 60% off	$2,230.12	$7,454.65	$2,354.10	2026-03-02
C9761	HCPCS	Cysto Litho Vacuum Kidney	10	9	$23,811.50	$9,524.60 60% off	$6,767.23	$22,620.92	$7,143.45	2026-03-02
C9771	HCPCS	Nsl/sins Cryp Post Nasla Tis	10	9	$7,930.50	$3,172.20 60% off	$2,253.84	$7,533.98	$2,379.15	2026-03-02
J0517	HCPCS	Fasenra 30mg/ml Syrn,340b Drug Pricing Program	10	9	$21,063.00	$8,425.20 60% off	$5,986.10	$20,009.85	$6,318.90	2026-03-02
J0875	HCPCS	Dalvance (dalbavancin) 500mg Vial,340b Drug Pricing Program	10	9	$5,703.00	$2,281.20 60% off	$1,620.79	$5,417.85	$1,710.90	2026-03-02
J0897JZ	OTHER	Cl-prolia 60mg/1ml Syrn,zero Drug Amount Discarded	20	9	$6,352.95	$2,541.18 60% off	$1,780.20	$6,119.92	$1,904.99	2026-03-02
J1306TB	OTHER	Leqvio 189mg/ml (284mg) 1.5ml Syrn,340b Drug Pricing Program	10	9	$12,927.84	$5,171.14 60% off	$3,674.09	$12,281.45	$3,878.35	2026-03-02
J1561	HCPCS	Gamunex-c (igiv) 10% 100ml Vial,340b Drug Pricing Program	10	9	$4,179.00	$1,671.60 60% off	$1,187.67	$3,970.05	$1,253.70	2026-03-02
J1568	HCPCS	Octagam (immune Globulin) 10% 10gm/100ml,statutorily Exclude, 340b Drug Pricing …	20	9	$8,589.00	$3,435.60 60% off	$1,628.47	$10,875.60	$3,253.52	2026-03-02
J1745	HCPCS	Remicade (infliximab) 100mg Vial,340b Drug Pricing Program	10	9	$4,342.50	$1,737.00 60% off	$1,234.13	$4,125.38	$1,302.75	2026-03-02
J2407	HCPCS	Orbactiv (oritavancin) 400mg Vial,340b Drug Pricing Program	10	9	$3,697.00	$1,478.80 60% off	$1,050.69	$3,512.15	$1,109.10	2026-03-02
J2506	HCPCS	Neulasta (pegfilgrastim) 6mg/0.6ml Syr,340b Drug Pricing Program	10	9	$22,443.81	$8,977.52 60% off	$6,378.53	$21,321.62	$6,733.14	2026-03-02
J2997	HCPCS	Alteplase (activase) 100mg Ivpb Premix,340b Drug Pricing Program	20	9	$16,136.65	$6,454.66 60% off	$164.84	$30,108.63	$4,779.11	2026-03-02
J3101	HCPCS	Tnkase 50mg/ml (10ml) Vial,340b Drug Pricing Program	10	9	$29,882.13	$11,952.85 60% off	$8,492.50	$28,388.02	$8,964.64	2026-03-02
J3110	HCPCS	Forteo (teriparatide) 20mcg/dose Pen,340b Drug Pricing Program, Statutorily Excl…	10	9	$9,139.00	$3,655.60 60% off	$2,597.30	$8,682.05	$2,741.70	2026-03-02
J3111	HCPCS	Evenity 210mg/2.34ml (dose-2 Syr),340b Drug Pricing Program	10	9	$9,476.10	$3,790.44 60% off	$2,693.11	$9,002.30	$2,842.83	2026-03-02
J7298	HCPCS	Mirena 20mcg/24hr 52mg System IUD	10	9	$4,384.68	$1,753.87 60% off	$1,246.13	$4,165.45	$1,315.40	2026-03-02
J9281	HCPCS	Jelmyto 80mg (4mg/ml) Inj Kit	10	9	$86,502.00	$34,600.80 60% off	$24,583.87	$82,176.90	$25,950.60	2026-03-02
J9282	HCPCS	Zusduri 80mg Kit 1x1 Ea Inj	10	9	$77,412.00	$30,964.80 60% off	$22,000.49	$73,541.40	$23,223.60	2026-03-02
L8612	HCPCS	Aqueous Shunt Prostesis- Istent Impant	10	9	$4,558.00	$1,823.20 60% off	$1,295.38	$4,330.10	$1,367.40	2026-03-02
L8641	HCPCS	Paragon Mtp Plate	10	9	$6,351.50	$2,540.60 60% off	$1,805.10	$6,033.92	$1,905.45	2026-03-02
L8680	HCPCS	Interstim MRI Lead Neurostimulator	10	9	$12,945.00	$5,178.00 60% off	$3,678.97	$12,297.75	$3,883.50	2026-03-02
L8681	HCPCS	Patient Programmer Neurostimulator	10	9	$3,013.00	$1,205.20 60% off	$856.29	$2,862.35	$903.90	2026-03-02
L8686	HCPCS	Implantable Neurostimulator	10	9	$18,045.50	$7,218.20 60% off	$5,128.54	$17,143.22	$5,413.65	2026-03-02
Q0138	HCPCS	Feraheme Sd 30mg/ml 17ml Vial	10	9	$3,271.26	$1,308.50 60% off	$929.70	$3,107.70	$981.38	2026-03-02
Q4160	HCPCS	Nushield	20	9	$52,368.00	$20,947.20 60% off	$3,164.85	$88,920.00	$18,590.16	2026-03-02
Q4309	HCPCS	Via Matrix	10	9	$3,520.00	$1,408.00 60% off	$1,000.38	$3,344.00	$1,056.00	2026-03-02
Q4340	HCPCS	Simpligraft	10	9	$5,512.00	$2,204.80 60% off	$1,566.51	$5,236.40	$1,653.60	2026-03-02
Q4341	HCPCS	Simplimax	10	9	$14,085.00	$5,634.00 60% off	$4,002.96	$13,380.75	$4,225.50	2026-03-02
S2070	HCPCS	Cystoscopy Stone Removal	10	9	$12,264.00	$4,905.60 60% off	$3,485.43	$11,650.80	$3,679.20	2026-03-02

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