|
0191T
|
OTHER
|
Insertion Of Anterior Segment Aqueous Drainage Device, Without Extraocular Reser…
|
9
|
9
|
$5,714.00
|
$4,571.20
20% off
|
$1,942.76
|
$5,714.00
|
$4,028.37
|
2026-03-18
|
|
03882
|
HCPCS
|
PET Tumor Image W/ct Full Body
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
10005
|
HCPCS
|
Fine Needle Aspiration Biopsy Using Ultrasound Guidance, First Growth
|
9
|
9
|
$1,791.00
|
$1,432.80
20% off
|
$608.94
|
$1,791.00
|
$1,262.66
|
2026-03-18
|
|
10030
|
HCPCS
|
Drainage Of Fluid Collection In Soft Tissue Using Imaging Guidance
|
9
|
9
|
$1,784.00
|
$1,427.20
20% off
|
$606.56
|
$1,784.00
|
$1,257.72
|
2026-03-18
|
|
11044
|
HCPCS
|
Removal Of Bone, 20.0 Sq Cm Or Less
|
10
|
9
|
$2,191.00
|
$1,752.80
20% off
|
$199.96
|
$2,191.00
|
$1,539.18
|
2026-03-18
|
|
15271
|
HCPCS
|
Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, 25.0 Sq C…
|
10
|
9
|
$3,337.00
|
$2,669.60
20% off
|
$74.58
|
$3,337.00
|
$2,344.24
|
2026-03-18
|
|
15272
|
HCPCS
|
Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, Each Addi…
|
9
|
9
|
$4,632.00
|
$3,705.60
20% off
|
$1,574.88
|
$4,632.00
|
$3,265.56
|
2026-03-18
|
|
15275
|
HCPCS
|
Application Of Skin Substitute Graft To Wound Of Face, Scalp, Eyelids, Mouth, Ne…
|
9
|
9
|
$2,472.00
|
$1,977.60
20% off
|
$840.48
|
$2,472.00
|
$1,742.76
|
2026-03-18
|
|
19081
|
HCPCS
|
Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, First…
|
10
|
9
|
$2,257.00
|
$1,805.60
20% off
|
$139.19
|
$2,257.00
|
$1,585.55
|
2026-03-18
|
|
19082
|
HCPCS
|
Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, Each …
|
10
|
9
|
$2,257.00
|
$1,805.60
20% off
|
$69.92
|
$2,257.00
|
$1,585.55
|
2026-03-18
|
|
19083
|
HCPCS
|
Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth
|
9
|
9
|
$2,258.00
|
$1,806.40
|
$767.72
|
$2,258.00
|
$1,591.89
|
2026-03-18
|
|
19103
|
HCPCS
|
Operating Room Services - Minor Surgery
|
19
|
9
|
$1,604.00
|
$1,283.20
20% off
|
$258.00
|
$1,790.00
|
$1,178.94
|
2026-03-18
|
|
19180
|
HCPCS
|
Profee Or-simle Mastectomy
|
1
|
1
|
$2,961.00
|
$2,368.80
|
$1,184.40
|
$1,184.40
|
$1,184.40
|
2026-03-18
|
|
21550
|
HCPCS
|
Biopsy Of Soft Tissue Of Neck Or Chest
|
10
|
9
|
$2,150.00
|
$1,720.00
20% off
|
$139.65
|
$2,150.00
|
$1,510.38
|
2026-03-18
|
|
28825
|
HCPCS
|
Amputation Of Toe At Toe Joint
|
10
|
9
|
$3,593.00
|
$2,874.40
20% off
|
$156.16
|
$3,593.00
|
$2,524.09
|
2026-03-18
|
|
31500
|
HCPCS
|
Emergent Insertion Of Breathing Tube Into Windpipe Using An Endoscope
|
10
|
9
|
$1,896.00
|
$1,516.80
20% off
|
$133.34
|
$1,896.00
|
$1,331.94
|
2026-03-18
|
|
33210
|
HCPCS
|
Insertion Of Temporary Pacemaker Lead In Single Heart Chamber
|
9
|
9
|
$3,970.00
|
$3,176.00
20% off
|
$1,349.80
|
$3,970.00
|
$2,798.85
|
2026-03-18
|
|
33967
|
HCPCS
|
Insertion Of Blood Flow Assist Device In Aorta Through Skin
|
9
|
9
|
$2,033.00
|
$1,626.40
|
$691.22
|
$2,033.00
|
$1,433.27
|
2026-03-18
|
|
35456
|
HCPCS
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$2,779.00
|
$2,223.20
20% off
|
$944.86
|
$2,779.00
|
$1,959.20
|
2026-03-18
|
|
35470
|
HCPCS
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$3,727.00
|
$2,981.60
20% off
|
$1,267.18
|
$3,727.00
|
$2,627.54
|
2026-03-18
|
|
35471
|
HCPCS
|
Repair Arterial Blockage
|
9
|
9
|
$3,727.00
|
$2,981.60
20% off
|
$1,267.18
|
$3,727.00
|
$2,627.54
|
2026-03-18
|
|
35472
|
HCPCS
|
Repair Arterial Blockage
|
9
|
9
|
$3,727.00
|
$2,981.60
20% off
|
$1,267.18
|
$3,727.00
|
$2,627.54
|
2026-03-18
|
|
35473
|
HCPCS
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$4,285.00
|
$3,428.00
20% off
|
$1,456.90
|
$4,285.00
|
$3,020.93
|
2026-03-18
|
|
35474
|
HCPCS
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$3,727.00
|
$2,981.60
20% off
|
$1,267.18
|
$3,727.00
|
$2,627.54
|
2026-03-18
|
|
35475
|
HCPCS
|
Repair Arterial Blockage
|
9
|
9
|
$3,727.00
|
$2,981.60
20% off
|
$1,267.18
|
$3,727.00
|
$2,627.54
|
2026-03-18
|
|
35476
|
HCPCS
|
Repair Venous Blockage
|
9
|
9
|
$2,385.00
|
$1,908.00
20% off
|
$810.90
|
$2,385.00
|
$1,681.43
|
2026-03-18
|
|
36011
|
HCPCS
|
Insertion Of Tube Into Vein, First Order Branch
|
9
|
9
|
$1,839.00
|
$1,471.20
20% off
|
$625.26
|
$1,839.00
|
$1,296.50
|
2026-03-18
|
|
36013
|
HCPCS
|
Insertion Of Tube Into Right Heart Or Main Pulmonary Artery
|
9
|
9
|
$1,906.00
|
$1,524.80
20% off
|
$648.04
|
$1,906.00
|
$1,343.73
|
2026-03-18
|
|
36215
|
HCPCS
|
Insertion Of Tube Into Chest Or Arm Artery, Each First Order Branch
|
9
|
9
|
$2,166.00
|
$1,732.80
20% off
|
$736.44
|
$2,166.00
|
$1,527.03
|
2026-03-18
|
|
36430
|
HCPCS
|
Transfusion Of Blood Or Blood Products
|
9
|
9
|
$1,746.00
|
$1,396.80
20% off
|
$593.64
|
$1,746.00
|
$1,230.93
|
2026-03-18
|
|
36569
|
HCPCS
|
Insertion Of Tube For Infusion (5 Years Or Older)
|
9
|
9
|
$2,812.00
|
$2,249.60
20% off
|
$956.08
|
$2,812.00
|
$1,982.46
|
2026-03-18
|
|
36573
|
HCPCS
|
Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, …
|
10
|
9
|
$2,109.00
|
$1,687.20
20% off
|
$72.56
|
$2,109.00
|
$1,481.57
|
2026-03-18
|
|
37205
|
HCPCS
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$5,139.00
|
$4,111.20
20% off
|
$1,747.26
|
$5,139.00
|
$3,623.00
|
2026-03-18
|
|
37206
|
HCPCS
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$5,139.00
|
$4,111.20
20% off
|
$1,747.26
|
$5,139.00
|
$3,623.00
|
2026-03-18
|
|
37209
|
HCPCS
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$1,796.00
|
$1,436.80
20% off
|
$610.64
|
$1,796.00
|
$1,266.18
|
2026-03-18
|
|
37620
|
HCPCS
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$2,593.00
|
$2,074.40
|
$881.62
|
$2,593.00
|
$1,828.07
|
2026-03-18
|
|
41000024_1
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
4
|
4
|
$1,856.00
|
$1,484.80
20% off
|
$1,299.20
|
$1,856.00
|
$1,424.48
|
2026-03-18
|
|
42000016_1
|
CDM
|
Intensive Care Unit - General Classification
|
7
|
7
|
$1,873.00
|
$1,498.40
|
$1,179.99
|
$1,873.00
|
$1,376.66
|
2026-03-18
|
|
43210
|
HCPCS
|
Repair Of Muscle At Esophagus And Stomach Using A Flexible Endoscope
|
9
|
9
|
$19,045.00
|
$15,236.00
20% off
|
$6,475.30
|
$19,045.00
|
$13,426.73
|
2026-03-18
|
|
43281
|
HCPCS
|
Repair Of Hernia Of Muscle At Esophagus And Stomach Using An Endoscope
|
1
|
1
|
$3,891.00
|
$3,112.80
|
$1,409.81
|
$1,409.81
|
$1,409.81
|
2026-03-18
|
|
43282
|
HCPCS
|
Repair Of Hernia Of Muscle At Esophagus And Stomach With Implantation Of Mesh Us…
|
1
|
1
|
$4,399.00
|
$3,519.20
20% off
|
$1,585.79
|
$1,585.79
|
$1,585.79
|
2026-03-18
|
|
43499
|
HCPCS
|
Other Procedure On Esophagus
|
9
|
9
|
$10,151.00
|
$8,120.80
20% off
|
$3,451.34
|
$10,151.00
|
$7,156.46
|
2026-03-18
|
|
43631
|
HCPCS
|
Removal Of Lower Part Of Stomach With Reattachment Of Remaining Stomach To First…
|
1
|
1
|
$2,931.00
|
$2,344.80
|
$1,338.18
|
$1,338.18
|
$1,338.18
|
2026-03-18
|
|
43840
|
HCPCS
|
Suture Of Perforated Ulcer, Wound, Or Injury Of Stomach Or Upper Small Bowel
|
1
|
1
|
$4,081.00
|
$3,264.80
|
$1,255.38
|
$1,255.38
|
$1,255.38
|
2026-03-18
|
|
43999
|
HCPCS
|
Other Procedure On Stomach
|
9
|
9
|
$2,199.00
|
$1,759.20
20% off
|
$747.66
|
$2,199.00
|
$1,550.30
|
2026-03-18
|
|
44140
|
HCPCS
|
Partial Removal Of Large Bowel With Connection
|
1
|
1
|
$4,031.00
|
$3,224.80
|
$1,233.72
|
$1,233.72
|
$1,233.72
|
2026-03-18
|
|
44141
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of Opening To Skin
|
1
|
1
|
$5,503.00
|
$4,402.40
20% off
|
$1,666.24
|
$1,666.24
|
$1,666.24
|
2026-03-18
|
|
44143
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin
|
1
|
1
|
$4,210.00
|
$3,368.00
20% off
|
$1,511.06
|
$1,511.06
|
$1,511.06
|
2026-03-18
|
|
44145
|
HCPCS
|
Partial Removal Of Large Bowel And Reattachment To Rectum
|
1
|
1
|
$3,270.00
|
$2,616.00
20% off
|
$1,499.56
|
$1,499.56
|
$1,499.56
|
2026-03-18
|
|
44202
|
HCPCS
|
Partial Removal And Reconnection Of Small Bowel Using An Endoscope
|
1
|
1
|
$3,487.00
|
$2,789.60
20% off
|
$1,272.35
|
$1,272.35
|
$1,272.35
|
2026-03-18
|
|
44204
|
HCPCS
|
Partial Removal Of Large Bowel Using An Endoscope
|
1
|
1
|
$4,655.00
|
$3,724.00
20% off
|
$1,397.53
|
$1,397.53
|
$1,397.53
|
2026-03-18
|
|
44626
|
HCPCS
|
Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An…
|
1
|
1
|
$3,997.00
|
$3,197.60
20% off
|
$1,442.91
|
$1,442.91
|
$1,442.91
|
2026-03-18
|
|
47610
|
HCPCS
|
Removal Of Gallbladder With Exploration Of Common Bile Duct
|
1
|
1
|
$3,150.00
|
$2,520.00
20% off
|
$1,157.37
|
$1,157.37
|
$1,157.37
|
2026-03-18
|
|
49020
|
HCPCS
|
Drainage Of Abdominal Abscess Or Infection
|
1
|
1
|
$4,798.00
|
$3,838.40
20% off
|
$1,467.48
|
$1,467.48
|
$1,467.48
|
2026-03-18
|
|
49561
|
HCPCS
|
Repair Initial Incisional Or Ventral Hernia; Incarcerated Or Strangulated
|
1
|
1
|
$2,879.00
|
$2,303.20
20% off
|
$1,151.60
|
$1,151.60
|
$1,151.60
|
2026-03-18
|
|
49566
|
HCPCS
|
Repair Recurrent Incisional Or Ventral Hernia; Incarcerated Or Strangulated
|
1
|
1
|
$2,909.00
|
$2,327.20
20% off
|
$1,163.60
|
$1,163.60
|
$1,163.60
|
2026-03-18
|
|
50000041_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$4,990.00
|
$3,992.00
20% off
|
$1,696.60
|
$4,990.00
|
$3,517.95
|
2026-03-18
|
|
50000045_1
|
CDM
|
Thermachoice Balloon Catheter
|
9
|
9
|
$3,637.00
|
$2,909.60
20% off
|
$1,236.58
|
$3,637.00
|
$2,564.09
|
2026-03-18
|
|
50000046_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$1,664.00
|
$1,331.20
20% off
|
$565.76
|
$1,664.00
|
$1,173.12
|
2026-03-18
|
|
50000049_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$1,646.00
|
$1,316.80
20% off
|
$559.64
|
$1,646.00
|
$1,160.43
|
2026-03-18
|
|
50000068_1
|
CDM
|
Apligraf
|
9
|
9
|
$3,852.00
|
$3,081.60
20% off
|
$1,309.68
|
$3,852.00
|
$2,715.66
|
2026-03-18
|
|
50000074_1
|
CDM
|
Cadaver Graft
|
8
|
8
|
$2,604.00
|
$2,083.20
20% off
|
$885.36
|
$2,604.00
|
$1,829.31
|
2026-03-18
|
|
50001404_1
|
CDM
|
Plate, Volar, Dvr Hand Set
|
9
|
9
|
$1,963.00
|
$1,570.40
|
$667.42
|
$1,963.00
|
$1,383.92
|
2026-03-18
|
|
50001405_1
|
CDM
|
Plate, Volar Ext, Dvr Hand Set
|
9
|
9
|
$2,291.00
|
$1,832.80
20% off
|
$778.94
|
$2,291.00
|
$1,615.16
|
2026-03-18
|
|
50001406_1
|
CDM
|
Plate, Volar Wide,dvr Hand Set
|
9
|
9
|
$2,291.00
|
$1,832.80
20% off
|
$778.94
|
$2,291.00
|
$1,615.16
|
2026-03-18
|
|
50002253_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$3,432.00
|
$2,745.60
20% off
|
$1,166.88
|
$3,432.00
|
$2,419.56
|
2026-03-18
|
|
50002254_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$4,965.00
|
$3,972.00
20% off
|
$1,688.10
|
$4,965.00
|
$3,500.33
|
2026-03-18
|
|
50002255_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$5,716.50
|
$4,573.20
20% off
|
$1,943.61
|
$5,716.50
|
$4,030.13
|
2026-03-18
|
|
50002473_1
|
CDM
|
Lead Ext Spinal Cord Sngl
|
9
|
9
|
$2,768.00
|
$2,214.40
|
$941.12
|
$2,768.00
|
$1,951.44
|
2026-03-18
|
|
50002474_1
|
CDM
|
Lead Ext Spinal Cord Dual
|
9
|
9
|
$2,768.00
|
$2,214.40
|
$941.12
|
$2,768.00
|
$1,951.44
|
2026-03-18
|
|
50002475_1
|
CDM
|
Generator Neurostim Spine
|
9
|
9
|
$55,696.00
|
$44,556.80
|
$18,936.64
|
$55,696.00
|
$39,265.68
|
2026-03-18
|
|
50002476_1
|
CDM
|
Programmer-spinal Stim
|
9
|
9
|
$4,702.00
|
$3,761.60
20% off
|
$1,598.68
|
$4,702.00
|
$3,314.91
|
2026-03-18
|
|
50002477_1
|
CDM
|
Lead Spinal Cord Single
|
9
|
9
|
$6,331.00
|
$5,064.80
20% off
|
$2,152.54
|
$6,331.00
|
$4,463.36
|
2026-03-18
|
|
50002478_1
|
CDM
|
Lead Spinal Cord Dual
|
9
|
9
|
$6,331.00
|
$5,064.80
20% off
|
$2,152.54
|
$6,331.00
|
$4,463.36
|
2026-03-18
|
|
50002494_1
|
CDM
|
Surgical Mesh Oval 6x8
|
9
|
9
|
$2,669.00
|
$2,135.20
20% off
|
$907.46
|
$2,669.00
|
$1,881.65
|
2026-03-18
|
|
50003508_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$7,105.00
|
$5,684.00
20% off
|
$2,415.70
|
$7,105.00
|
$5,009.03
|
2026-03-18
|
|
50003524_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$6,244.00
|
$4,995.20
20% off
|
$2,122.96
|
$6,244.00
|
$4,402.02
|
2026-03-18
|
|
50003594_1
|
CDM
|
Pleurx Pleural Drain System
|
9
|
9
|
$2,492.00
|
$1,993.60
20% off
|
$847.28
|
$2,492.00
|
$1,756.86
|
2026-03-18
|
|
50003599_1
|
CDM
|
Mesh 4x6
|
9
|
9
|
$5,680.00
|
$4,544.00
20% off
|
$1,931.20
|
$5,680.00
|
$4,004.40
|
2026-03-18
|
|
50003612_1
|
CDM
|
Lemaitre Vascular Shunt
|
9
|
9
|
$1,915.00
|
$1,532.00
20% off
|
$651.10
|
$1,915.00
|
$1,350.08
|
2026-03-18
|
|
50003628_1
|
CDM
|
Scanlan Vascular Tunnler
|
9
|
9
|
$1,915.00
|
$1,532.00
20% off
|
$651.10
|
$1,915.00
|
$1,350.08
|
2026-03-18
|
|
50003631_1
|
CDM
|
Heli-fx Endoanchor Applier 10m
|
9
|
9
|
$8,391.83
|
$6,713.46
20% off
|
$2,853.22
|
$8,391.83
|
$5,916.24
|
2026-03-18
|
|
50003632_1
|
CDM
|
Heli-fx Endoanchor Imp 22mm
|
9
|
9
|
$3,111.73
|
$2,489.38
20% off
|
$1,057.99
|
$3,111.73
|
$2,193.77
|
2026-03-18
|
|
50003655_1
|
CDM
|
Hydrus Micro Stent
|
9
|
9
|
$2,848.39
|
$2,278.71
20% off
|
$968.45
|
$2,848.39
|
$2,008.11
|
2026-03-18
|
|
50003656_1
|
CDM
|
Tapered Heparin Shunt
|
9
|
9
|
$3,986.75
|
$3,189.40
20% off
|
$1,355.50
|
$3,986.75
|
$2,810.66
|
2026-03-18
|
|
50200029_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$2,475.00
|
$1,980.00
20% off
|
$841.50
|
$2,475.00
|
$1,744.88
|
2026-03-18
|
|
50400014_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$4,329.00
|
$3,463.20
20% off
|
$1,471.86
|
$4,329.00
|
$3,051.95
|
2026-03-18
|
|
50400016_1
|
CDM
|
Labor Room/delivery - General Classification
|
9
|
9
|
$2,732.00
|
$2,185.60
20% off
|
$928.88
|
$2,732.00
|
$1,926.06
|
2026-03-18
|
|
50400035_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$2,809.00
|
$2,247.20
20% off
|
$955.06
|
$2,809.00
|
$1,980.35
|
2026-03-18
|
|
50700041_1
|
CDM
|
Rev - Other Rx Svcs
|
9
|
9
|
$4,241.00
|
$3,392.80
|
$1,441.94
|
$4,241.00
|
$2,989.91
|
2026-03-18
|
|
50700403_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$8,511.00
|
$6,808.80
20% off
|
$2,893.74
|
$8,511.00
|
$6,000.26
|
2026-03-18
|
|
50700404_1
|
CDM
|
Lead Spinal Cord Single
|
9
|
9
|
$4,013.00
|
$3,210.40
20% off
|
$1,364.42
|
$4,013.00
|
$2,829.17
|
2026-03-18
|
|
50700405_1
|
CDM
|
Lead Spinal Cord Dual
|
9
|
9
|
$4,013.00
|
$3,210.40
20% off
|
$1,364.42
|
$4,013.00
|
$2,829.17
|
2026-03-18
|
|
52000396_1
|
CDM
|
Filter, Simonite Nall
|
9
|
9
|
$2,868.00
|
$2,294.40
|
$975.12
|
$2,868.00
|
$2,021.94
|
2026-03-18
|
|
52000645_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$1,758.00
|
$1,406.40
|
$597.72
|
$1,758.00
|
$1,239.39
|
2026-03-18
|
|
52000828_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$2,847.00
|
$2,277.60
20% off
|
$967.98
|
$2,847.00
|
$2,007.14
|
2026-03-18
|
|
52300115_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$2,512.00
|
$2,009.60
20% off
|
$854.08
|
$2,512.00
|
$1,770.96
|
2026-03-18
|
|
53300027_1
|
CDM
|
Operating Room Services - General Classification
|
9
|
9
|
$1,816.00
|
$1,452.80
20% off
|
$617.44
|
$1,816.00
|
$1,280.28
|
2026-03-18
|
|
53300059_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$1,772.00
|
$1,417.60
20% off
|
$602.48
|
$1,772.00
|
$1,249.26
|
2026-03-18
|
|
53300070_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$1,796.00
|
$1,436.80
20% off
|
$610.64
|
$1,796.00
|
$1,266.18
|
2026-03-18
|
|
53300096_1
|
CDM
|
Vena Cava Filter
|
9
|
9
|
$2,990.00
|
$2,392.00
20% off
|
$1,016.60
|
$2,990.00
|
$2,107.95
|
2026-03-18
|
|
53300118_1
|
CDM
|
Symphony Nitinol Stent
|
9
|
9
|
$4,966.00
|
$3,972.80
|
$1,688.44
|
$4,966.00
|
$3,501.03
|
2026-03-18
|
|
53300125_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$1,749.00
|
$1,399.20
20% off
|
$594.66
|
$1,749.00
|
$1,233.05
|
2026-03-18
|
|
53300150_1
|
CDM
|
Corinthian Stent
|
9
|
9
|
$4,319.00
|
$3,455.20
20% off
|
$1,468.46
|
$4,319.00
|
$3,044.90
|
2026-03-18
|
|
53300183_1
|
CDM
|
Operating Room Services - Minor Surgery
|
9
|
9
|
$1,749.00
|
$1,399.20
20% off
|
$594.66
|
$1,749.00
|
$1,233.05
|
2026-03-18
|
|
54500005_1
|
CDM
|
Bilateral Lithotripsy
|
9
|
9
|
$10,468.00
|
$8,374.40
20% off
|
$3,559.12
|
$10,468.00
|
$7,379.94
|
2026-03-18
|
|
54500006_1
|
CDM
|
Unilateral Lithotripsy-left
|
9
|
9
|
$7,298.00
|
$5,838.40
20% off
|
$2,481.32
|
$7,298.00
|
$5,145.09
|
2026-03-18
|
|
54500007_1
|
CDM
|
Unilateral Lithotripsy-right
|
9
|
9
|
$7,298.00
|
$5,838.40
20% off
|
$2,481.32
|
$7,298.00
|
$5,145.09
|
2026-03-18
|
|
55000830_1
|
CDM
|
Antivenin (black Widow Spider)
|
9
|
9
|
$1,641.00
|
$1,312.80
20% off
|
$557.94
|
$1,641.00
|
$1,156.91
|
2026-03-18
|
|
55001743_1
|
CDM
|
Ribavirin 6gm Vial
|
9
|
9
|
$2,806.00
|
$2,244.80
|
$954.04
|
$2,806.00
|
$1,978.23
|
2026-03-18
|
|
55001821_1
|
CDM
|
Interceed
|
9
|
9
|
$3,412.00
|
$2,729.60
20% off
|
$1,160.08
|
$3,412.00
|
$2,405.46
|
2026-03-18
|
|
55008815_1
|
CDM
|
Cosentyx Unoready 300 Mg Pen
|
9
|
9
|
$14,000.00
|
$11,200.00
20% off
|
$4,760.00
|
$14,000.00
|
$9,870.00
|
2026-03-18
|
|
56000606_1
|
CDM
|
Group 6 Procedure
|
9
|
9
|
$2,427.00
|
$1,941.60
20% off
|
$825.18
|
$2,427.00
|
$1,711.04
|
2026-03-18
|
|
57102451_1
|
CDM
|
Tray, Gastric Endoscopy Fdg13
|
9
|
9
|
$3,563.00
|
$2,850.40
20% off
|
$1,211.42
|
$3,563.00
|
$2,511.92
|
2026-03-18
|
|
57102454_1
|
CDM
|
Kit, Endo Lap O-GYN Lavh Fd044
|
9
|
9
|
$2,087.00
|
$1,669.60
20% off
|
$709.58
|
$2,087.00
|
$1,471.34
|
2026-03-18
|
|
57102741_1
|
CDM
|
Cath, Balloon Disp.
|
9
|
9
|
$2,461.00
|
$1,968.80
20% off
|
$836.74
|
$2,461.00
|
$1,735.01
|
2026-03-18
|
|
57103063_1
|
CDM
|
Patch, Hernia Small Oval
|
9
|
9
|
$1,833.00
|
$1,466.40
|
$623.22
|
$1,833.00
|
$1,292.27
|
2026-03-18
|
|
57103064_1
|
CDM
|
Patch, Hernia Medium Oval
|
9
|
9
|
$2,707.00
|
$2,165.60
20% off
|
$920.38
|
$2,707.00
|
$1,908.44
|
2026-03-18
|
|
57103065_1
|
CDM
|
Patch, Hernia Large Oval
|
9
|
9
|
$3,435.00
|
$2,748.00
20% off
|
$1,167.90
|
$3,435.00
|
$2,421.68
|
2026-03-18
|
|
57103067_1
|
CDM
|
Patch, Hernia Large Circle
|
9
|
9
|
$2,291.00
|
$1,832.80
20% off
|
$778.94
|
$2,291.00
|
$1,615.16
|
2026-03-18
|
|
57103069_1
|
CDM
|
Mesh, Hernia Composix E/x 6x8
|
9
|
9
|
$2,986.00
|
$2,388.80
|
$1,015.24
|
$2,986.00
|
$2,105.13
|
2026-03-18
|
|
57103070_1
|
CDM
|
Mesh, Hernia Composix E/x 7x9
|
9
|
9
|
$3,958.00
|
$3,166.40
20% off
|
$1,345.72
|
$3,958.00
|
$2,790.39
|
2026-03-18
|
|
57103071_1
|
CDM
|
Mesh, Hernia Composix E/x 8x10
|
9
|
9
|
$4,935.00
|
$3,948.00
20% off
|
$1,677.90
|
$4,935.00
|
$3,479.18
|
2026-03-18
|
|
57103074_1
|
CDM
|
Mesh Hernia Composix E/x 10x14
|
9
|
9
|
$6,559.00
|
$5,247.20
20% off
|
$2,230.06
|
$6,559.00
|
$4,624.10
|
2026-03-18
|
|
57103076_1
|
CDM
|
Mesh, Hernia Composix 6x8
|
9
|
9
|
$2,715.00
|
$2,172.00
20% off
|
$923.10
|
$2,715.00
|
$1,914.08
|
2026-03-18
|
|
57103077_1
|
CDM
|
Mesh, Hernia Composix 8x10
|
9
|
9
|
$4,483.00
|
$3,586.40
20% off
|
$1,524.22
|
$4,483.00
|
$3,160.52
|
2026-03-18
|
|
57103092_1
|
CDM
|
Assistant, Lap Hand Gelport
|
9
|
9
|
$2,745.00
|
$2,196.00
20% off
|
$933.30
|
$2,745.00
|
$1,935.23
|
2026-03-18
|
|
57103261_1
|
CDM
|
Cath, Groshong 9.5fr Dual Port
|
9
|
9
|
$1,799.00
|
$1,439.20
20% off
|
$611.66
|
$1,799.00
|
$1,268.30
|
2026-03-18
|
|
57103373_1
|
CDM
|
Mesh, Dual 15cmx19cmx1mm Oval
|
9
|
9
|
$2,593.00
|
$2,074.40
|
$881.62
|
$2,593.00
|
$1,828.07
|
2026-03-18
|
|
57103374_1
|
CDM
|
Mesh, Dual 20cmx30cmx1mm
|
9
|
9
|
$5,426.00
|
$4,340.80
|
$1,844.84
|
$5,426.00
|
$3,825.33
|
2026-03-18
|
|
57103520_1
|
CDM
|
Patch, Soft Tissue 20cmx30cm
|
9
|
9
|
$9,449.00
|
$7,559.20
20% off
|
$3,212.66
|
$9,449.00
|
$6,661.55
|
2026-03-18
|
|
57103566_1
|
CDM
|
Patch, Soft Tissue 2mm 10x15cm
|
9
|
9
|
$2,586.00
|
$2,068.80
|
$879.24
|
$2,586.00
|
$1,823.13
|
2026-03-18
|
|
57103582_1
|
CDM
|
Fiber, Ref. Gold Tip Myriadlas
|
9
|
9
|
$2,461.00
|
$1,968.80
20% off
|
$836.74
|
$2,461.00
|
$1,735.01
|
2026-03-18
|
|
57103776_1
|
CDM
|
Patch, Hernia Kugel Oval
|
9
|
9
|
$5,224.00
|
$4,179.20
20% off
|
$1,776.16
|
$5,224.00
|
$3,682.92
|
2026-03-18
|
|
57103781_1
|
CDM
|
Surface, Art. 14mm Yellow
|
9
|
9
|
$1,875.00
|
$1,500.00
20% off
|
$637.50
|
$1,875.00
|
$1,321.88
|
2026-03-18
|
|
57103954_1
|
CDM
|
Screening Box
|
9
|
9
|
$6,783.00
|
$5,426.40
20% off
|
$2,306.22
|
$6,783.00
|
$4,782.02
|
2026-03-18
|
|
57103970_1
|
CDM
|
Nail, Femoral 12 Mm X 34 Cm
|
9
|
9
|
$3,183.00
|
$2,546.40
20% off
|
$1,082.22
|
$3,183.00
|
$2,244.02
|
2026-03-18
|
|
57110082_1
|
CDM
|
Denver Peritone Cath 1
|
9
|
9
|
$1,734.00
|
$1,387.20
20% off
|
$589.56
|
$1,734.00
|
$1,222.47
|
2026-03-18
|
|
57110135_1
|
CDM
|
Mesh Dual 15 X 19
|
9
|
9
|
$2,657.00
|
$2,125.60
20% off
|
$903.38
|
$2,657.00
|
$1,873.19
|
2026-03-18
|
|
57110178_1
|
CDM
|
Graft Spinal 6mm X 50cm
|
9
|
9
|
$1,843.00
|
$1,474.40
|
$626.62
|
$1,843.00
|
$1,299.32
|
2026-03-18
|
|
57110194_1
|
CDM
|
Gia 30.5 V 030813
|
9
|
9
|
$1,636.00
|
$1,308.80
20% off
|
$556.24
|
$1,636.00
|
$1,153.38
|
2026-03-18
|
|
57110390_1
|
CDM
|
Soft Woven 25x12.5mm
|
9
|
9
|
$1,785.00
|
$1,428.00
20% off
|
$606.90
|
$1,785.00
|
$1,258.43
|
2026-03-18
|
|
57110392_1
|
CDM
|
Soft Woven 19x9.5mm
|
9
|
9
|
$1,785.00
|
$1,428.00
20% off
|
$606.90
|
$1,785.00
|
$1,258.43
|
2026-03-18
|
|
57110393_1
|
CDM
|
Soft Woven 22 X 11mm
|
9
|
9
|
$1,785.00
|
$1,428.00
20% off
|
$606.90
|
$1,785.00
|
$1,258.43
|
2026-03-18
|
|
57110444_1
|
CDM
|
Soft Tis Patch 10x15
|
9
|
9
|
$1,868.00
|
$1,494.40
|
$635.12
|
$1,868.00
|
$1,316.94
|
2026-03-18
|
|
57110646_1
|
CDM
|
Vas Graft Vt45070
|
9
|
9
|
$4,626.00
|
$3,700.80
|
$1,572.84
|
$4,626.00
|
$3,261.33
|
2026-03-18
|
|
57110647_1
|
CDM
|
Vas Graft V06070
|
9
|
9
|
$4,039.00
|
$3,231.20
20% off
|
$1,373.26
|
$4,039.00
|
$2,847.50
|
2026-03-18
|
|
57110648_1
|
CDM
|
Vas Graft V08070
|
9
|
9
|
$4,039.00
|
$3,231.20
20% off
|
$1,373.26
|
$4,039.00
|
$2,847.50
|
2026-03-18
|
|
57110689_1
|
CDM
|
Rotic55 Pl170 013602
|
9
|
9
|
$1,727.00
|
$1,381.60
20% off
|
$587.18
|
$1,727.00
|
$1,217.54
|
2026-03-18
|
|
57110705_1
|
CDM
|
Rotic55 Pl200 013601
|
9
|
9
|
$1,734.00
|
$1,387.20
20% off
|
$589.56
|
$1,734.00
|
$1,222.47
|
2026-03-18
|
|
57110762_1
|
CDM
|
Prem Ceea 25 Srg Stp
|
9
|
9
|
$2,071.00
|
$1,656.80
20% off
|
$704.14
|
$2,071.00
|
$1,460.06
|
2026-03-18
|
|
57110764_1
|
CDM
|
Endoscopic Cir Ecs33
|
9
|
9
|
$2,071.00
|
$1,656.80
20% off
|
$704.14
|
$2,071.00
|
$1,460.06
|
2026-03-18
|
|
57110802_1
|
CDM
|
Gia 30v 030811
|
9
|
9
|
$1,756.00
|
$1,404.80
20% off
|
$597.04
|
$1,756.00
|
$1,237.98
|
2026-03-18
|
|
57110944_1
|
CDM
|
Moss Gstrstmy TB 18f
|
9
|
9
|
$1,722.00
|
$1,377.60
20% off
|
$585.48
|
$1,722.00
|
$1,214.01
|
2026-03-18
|
|
57111130_1
|
CDM
|
Port Cath Slim Por
|
9
|
9
|
$1,736.00
|
$1,388.80
20% off
|
$590.24
|
$1,736.00
|
$1,223.88
|
2026-03-18
|
|
62304
|
HCPCS
|
X-ray Of Lower Spinal Canal With Review By Radiologist
|
9
|
9
|
$1,880.00
|
$1,504.00
20% off
|
$639.20
|
$1,880.00
|
$1,325.40
|
2026-03-18
|
|
70492
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck Before And After Contrast
|
15
|
9
|
$2,325.00
|
$1,860.00
20% off
|
$575.28
|
$2,325.00
|
$1,184.40
|
2026-03-18
|
|
70496
|
HCPCS
|
CT Scan Of Blood Vessels Of Head With Contrast
|
15
|
9
|
$2,498.00
|
$1,998.40
|
$617.44
|
$2,498.00
|
$1,271.20
|
2026-03-18
|
|
70540
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast
|
9
|
9
|
$1,851.00
|
$1,480.80
20% off
|
$629.34
|
$1,851.00
|
$1,304.96
|
2026-03-18
|
|
70543
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast
|
9
|
9
|
$1,757.00
|
$1,405.60
20% off
|
$597.38
|
$1,757.00
|
$1,238.69
|
2026-03-18
|
|
71260
|
HCPCS
|
CT Scan Of Chest With Contrast
|
15
|
9
|
$2,325.00
|
$1,860.00
20% off
|
$575.28
|
$2,325.00
|
$1,184.40
|
2026-03-18
|
|
71275
|
HCPCS
|
CT Scan Of Blood Vessels Of Chest With Contrast
|
15
|
9
|
$2,498.00
|
$1,998.40
|
$617.44
|
$2,498.00
|
$1,271.20
|
2026-03-18
|
|
72193
|
HCPCS
|
CT Scan Of Pelvis With Contrast
|
15
|
9
|
$2,551.00
|
$2,040.80
20% off
|
$630.70
|
$2,551.00
|
$1,298.50
|
2026-03-18
|
|
72194
|
HCPCS
|
CT Scan Of Pelvis Before And After Contrast
|
15
|
9
|
$2,584.00
|
$2,067.20
20% off
|
$638.86
|
$2,584.00
|
$1,315.30
|
2026-03-18
|
|
72197
|
HCPCS
|
MRI Scan Of Pelvis Before And After Contrast
|
9
|
9
|
$1,760.00
|
$1,408.00
20% off
|
$598.40
|
$1,760.00
|
$1,240.80
|
2026-03-18
|
|
73220
|
HCPCS
|
MRI Scan Of Arm Before And After Contrast
|
9
|
9
|
$1,629.00
|
$1,303.20
20% off
|
$553.86
|
$1,629.00
|
$1,148.45
|
2026-03-18
|
|
73223
|
HCPCS
|
MRI Scan Of Arm Joint Before And After Contrast
|
9
|
9
|
$1,757.00
|
$1,405.60
20% off
|
$597.38
|
$1,757.00
|
$1,238.69
|
2026-03-18
|
|
73718
|
HCPCS
|
MRI Scan Of Leg Without Contrast
|
18
|
9
|
$1,872.50
|
$1,498.00
20% off
|
$509.32
|
$2,247.00
|
$1,198.40
|
2026-03-18
|
|
73720
|
HCPCS
|
MRI Scan Of Leg Before And After Contrast
|
9
|
9
|
$1,872.00
|
$1,497.60
20% off
|
$636.48
|
$1,872.00
|
$1,319.76
|
2026-03-18
|
|
73721
|
HCPCS
|
MRI Scan Of Leg Joint Without Contrast
|
18
|
9
|
$1,849.50
|
$1,479.60
20% off
|
$509.32
|
$2,201.00
|
$1,198.40
|
2026-03-18
|
|
73723
|
HCPCS
|
MRI Scan Of Leg Joint Before And After Contrast
|
18
|
9
|
$2,196.25
|
$1,757.00
20% off
|
$597.38
|
$2,635.50
|
$1,405.60
|
2026-03-18
|
|
74160
|
HCPCS
|
CT Scan Of Abdomen With Contrast
|
15
|
9
|
$2,325.00
|
$1,860.00
20% off
|
$575.28
|
$2,325.00
|
$1,184.40
|
2026-03-18
|
|
74170
|
HCPCS
|
CT Scan Of Abdomen Before And After Contrast
|
15
|
9
|
$2,625.00
|
$2,100.00
20% off
|
$649.74
|
$2,625.00
|
$1,337.70
|
2026-03-18
|
|
74183
|
HCPCS
|
MRI Scan Of Abdomen Before And After Contrast
|
9
|
9
|
$1,748.00
|
$1,398.40
|
$594.32
|
$1,748.00
|
$1,232.34
|
2026-03-18
|
|
75625
|
HCPCS
|
Review By Radiologist Of Abdominal Aorta Image
|
9
|
9
|
$2,163.00
|
$1,730.40
|
$735.42
|
$2,163.00
|
$1,524.92
|
2026-03-18
|
|
75671
|
HCPCS
|
Angiogram Carotid Cereb Bilat
|
9
|
9
|
$1,756.00
|
$1,404.80
20% off
|
$597.04
|
$1,756.00
|
$1,237.98
|
2026-03-18
|
|
75676
|
HCPCS
|
Carotid Rt
|
18
|
9
|
$1,680.50
|
$1,344.40
|
$518.84
|
$1,835.00
|
$1,192.55
|
2026-03-18
|
|
75680
|
HCPCS
|
Carotid Bilat
|
9
|
9
|
$1,835.00
|
$1,468.00
20% off
|
$623.90
|
$1,835.00
|
$1,293.68
|
2026-03-18
|
|
75722
|
HCPCS
|
Renal Rt
|
9
|
9
|
$1,835.00
|
$1,468.00
20% off
|
$623.90
|
$1,835.00
|
$1,293.68
|
2026-03-18
|
|
75724
|
HCPCS
|
Renal Bilat
|
9
|
9
|
$2,109.00
|
$1,687.20
20% off
|
$717.06
|
$2,109.00
|
$1,486.85
|
2026-03-18
|
|
75726
|
HCPCS
|
Review By Radiologist Of Abdominal Artery Image
|
9
|
9
|
$1,835.00
|
$1,468.00
20% off
|
$623.90
|
$1,835.00
|
$1,293.68
|
2026-03-18
|
|
75743
|
HCPCS
|
Review By Radiologist Of Arteries Of Both Lungs Image
|
9
|
9
|
$1,835.00
|
$1,468.00
20% off
|
$623.90
|
$1,835.00
|
$1,293.68
|
2026-03-18
|
|
75960
|
HCPCS
|
Stent (s & I)
|
9
|
9
|
$1,728.00
|
$1,382.40
|
$587.52
|
$1,728.00
|
$1,218.24
|
2026-03-18
|
|
75961
|
HCPCS
|
Foreign Body Retrieval (s&i)
|
9
|
9
|
$1,835.00
|
$1,468.00
20% off
|
$623.90
|
$1,835.00
|
$1,293.68
|
2026-03-18
|
|
75962
|
HCPCS
|
Repair Arterial Blockage
|
9
|
9
|
$1,986.00
|
$1,588.80
20% off
|
$675.24
|
$1,986.00
|
$1,400.13
|
2026-03-18
|
|
75964
|
HCPCS
|
Repair Artery Blockage Each
|
9
|
9
|
$1,728.00
|
$1,382.40
|
$587.52
|
$1,728.00
|
$1,218.24
|
2026-03-18
|
|
75966
|
HCPCS
|
Repair Arterial Blockage
|
9
|
9
|
$1,728.00
|
$1,382.40
|
$587.52
|
$1,728.00
|
$1,218.24
|
2026-03-18
|
|
75968
|
HCPCS
|
Repair Artery Blockage Each
|
9
|
9
|
$1,728.00
|
$1,382.40
|
$587.52
|
$1,728.00
|
$1,218.24
|
2026-03-18
|
|
77032
|
HCPCS
|
Mammo Guid Ndl Plc Breast
|
9
|
9
|
$1,693.00
|
$1,354.40
|
$575.62
|
$1,693.00
|
$1,193.57
|
2026-03-18
|
|
78459
|
HCPCS
|
Nuclear Medicine Study Of Heart Muscle With Metabolic Evaluation
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
78491
|
HCPCS
|
Nuclear Medicine Study Of Blood Flow In Heart Muscle At Rest And With Stress
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
78492
|
HCPCS
|
Nuclear Medicine Studies Of Blood Flow In Heart Muscle At Rest And With Stress
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
78804
|
HCPCS
|
Nuclear Medicine Study, Whole Body Requiring Multiple Imaging Days
|
9
|
9
|
$1,757.00
|
$1,405.60
20% off
|
$597.38
|
$1,757.00
|
$1,238.69
|
2026-03-18
|
|
78811
|
HCPCS
|
Nuclear Medicine Study Limited Area
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
78812
|
HCPCS
|
Nuclear Medicine Study From Skull Base To Mid-thigh
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
78814
|
HCPCS
|
Nuclear Medicine Study Limited Area With CT Scan
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
78815
|
HCPCS
|
Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
90375
|
HCPCS
|
Rabies Immune Globulin For Injection
|
9
|
9
|
$2,896.00
|
$2,316.80
|
$984.64
|
$2,896.00
|
$2,041.68
|
2026-03-18
|
|
91010
|
HCPCS
|
Study Of Esophagus To Assess Movement
|
10
|
9
|
$2,883.00
|
$2,306.40
|
$66.92
|
$2,883.00
|
$2,025.31
|
2026-03-18
|
|
91035
|
HCPCS
|
Monitoring And Recording Of Esophageal Function Through A Capsule Attached To Th…
|
10
|
9
|
$3,355.00
|
$2,684.00
20% off
|
$84.03
|
$3,355.00
|
$2,356.89
|
2026-03-18
|
|
93306
|
HCPCS
|
Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu…
|
10
|
9
|
$2,068.00
|
$1,654.40
|
$67.25
|
$2,068.00
|
$1,452.77
|
2026-03-18
|
|
93501
|
HCPCS
|
Right Heart Cath
|
9
|
9
|
$2,147.00
|
$1,717.60
20% off
|
$729.98
|
$2,147.00
|
$1,513.64
|
2026-03-18
|
|
93503
|
HCPCS
|
Insertion Of Tube In Pulmonary Artery For Monitoring
|
9
|
9
|
$2,046.00
|
$1,636.80
20% off
|
$695.64
|
$2,046.00
|
$1,442.43
|
2026-03-18
|
|
93508
|
HCPCS
|
Cath Plcm Coron Art No Lhc
|
9
|
9
|
$4,452.00
|
$3,561.60
20% off
|
$1,513.68
|
$4,452.00
|
$3,138.66
|
2026-03-18
|
|
93510
|
HCPCS
|
Left Heart Cath (percutaneous)
|
9
|
9
|
$6,689.00
|
$5,351.20
20% off
|
$2,274.26
|
$6,689.00
|
$4,715.75
|
2026-03-18
|
|
93511
|
HCPCS
|
Left Heart Cath (cut Down)
|
9
|
9
|
$4,397.00
|
$3,517.60
20% off
|
$1,494.98
|
$4,397.00
|
$3,099.89
|
2026-03-18
|
|
93526
|
HCPCS
|
Combined Rt. & Lt. Retro Heart
|
9
|
9
|
$8,046.00
|
$6,436.80
20% off
|
$2,735.64
|
$8,046.00
|
$5,672.43
|
2026-03-18
|
|
95805
|
HCPCS
|
Sleep Study, Multiple Trials
|
10
|
9
|
$1,856.00
|
$1,484.80
20% off
|
$57.42
|
$1,856.00
|
$1,303.84
|
2026-03-18
|
|
95810
|
HCPCS
|
Sleep Study In Sleep Lab (6 Years Or Older)
|
10
|
9
|
$2,780.00
|
$2,224.00
20% off
|
$118.90
|
$2,780.00
|
$1,952.95
|
2026-03-18
|
|
95811
|
HCPCS
|
Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older)
|
10
|
9
|
$2,936.00
|
$2,348.80
|
$123.27
|
$2,936.00
|
$2,062.54
|
2026-03-18
|
|
C1763
|
HCPCS
|
Connective Tissue, Non-human (includes Synthetic)
|
9
|
9
|
$1,831.00
|
$1,464.80
20% off
|
$622.54
|
$1,831.00
|
$1,290.86
|
2026-03-18
|
|
C1768
|
HCPCS
|
Graft, Vascular
|
54
|
9
|
$3,419.00
|
$2,735.20
20% off
|
$623.56
|
$5,903.00
|
$2,056.92
|
2026-03-18
|
|
C1781
|
HCPCS
|
Mesh (implantable)
|
369
|
9
|
$1,896.00
|
$1,516.80
20% off
|
$73.44
|
$25,150.50
|
$1,267.20
|
2026-03-18
|
|
C1783
|
HCPCS
|
Ocular Implant, Aqueous Drainage Assist Device
|
9
|
9
|
$4,750.00
|
$3,800.00
20% off
|
$1,615.00
|
$4,750.00
|
$3,348.75
|
2026-03-18
|
|
C1788
|
HCPCS
|
Port, Indwelling (implantable)
|
27
|
9
|
$1,659.00
|
$1,327.20
20% off
|
$407.66
|
$1,949.00
|
$1,161.30
|
2026-03-18
|
|
C1880
|
HCPCS
|
Vena Cava Filter
|
9
|
9
|
$2,088.00
|
$1,670.40
|
$709.92
|
$2,088.00
|
$1,472.04
|
2026-03-18
|
|
C5273
|
HCPCS
|
Application Of Low Cost Skin Substitute Graft To Trunk, Arms, Legs, Total Wound …
|
9
|
9
|
$4,632.00
|
$3,705.60
20% off
|
$1,574.88
|
$4,632.00
|
$3,265.56
|
2026-03-18
|
|
C9201
|
HCPCS
|
Dermagraft
|
18
|
9
|
$1,949.00
|
$1,559.20
20% off
|
$652.80
|
$1,978.00
|
$1,389.55
|
2026-03-18
|
|
C9358
|
HCPCS
|
Dermal Substitute, Native, Non-denatured Collagen, Fetal Bovine Origin (surgimen…
|
9
|
9
|
$4,723.00
|
$3,778.40
20% off
|
$1,605.82
|
$4,723.00
|
$3,329.72
|
2026-03-18
|
|
G0030
|
HCPCS
|
Patient Screened For Tobacco Use And Received Tobacco Cessation Intervention Dur…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0031
|
HCPCS
|
Palliative Care Services Given To Patient Any Time During The Measurement Period
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0032
|
HCPCS
|
Two Or More Antipsychotic Prescriptions Ordered For Patients Who Had A Diagnosis…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0033
|
HCPCS
|
Two Or More Benzodiazepine Prescriptions Ordered For Patients Who Had A Diagnosi…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0034
|
HCPCS
|
Patients Receiving Palliative Care During The Measurement Period
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0035
|
HCPCS
|
Patient Has Any Emergency Department Encounter During The Performance Period Wit…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0036
|
HCPCS
|
Patient Or Care Partner Decline Assessment
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0037
|
HCPCS
|
On Date Of Encounter, Patient Is Not Able To Participate In Assessment Or Screen…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0038
|
HCPCS
|
Clinician Determines Patient Does Not Require Referral
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0039
|
HCPCS
|
Patient Not Referred, Reason Not Otherwise Specified
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0040
|
HCPCS
|
Patient Already Receiving Physical/occupational/speech/recreational Therapy Duri…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0041
|
HCPCS
|
Patient And/or Care Partner Decline Referral
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0042
|
HCPCS
|
Referral To Physical, Occupational, Speech, Or Recreational Therapy
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0043
|
HCPCS
|
Patients With Mechanical Prosthetic Heart Valve
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0044
|
HCPCS
|
Patients With Moderate Or Severe Mitral Stenosis
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0045
|
HCPCS
|
Clinical Follow-up And Mrs Score Assessed At 90 Days Following Endovascular Stro…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0046
|
HCPCS
|
Clinical Follow-up And Mrs Score Not Assessed At 90 Days Following Endovascular …
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0047
|
HCPCS
|
Pediatric Patient With Minor Blunt Head Trauma And Pecarn Prediction Criteria Ar…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0216
|
HCPCS
|
PET Img Wholebod Dx Melanoma
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0219
|
HCPCS
|
PET Imaging Whole Body; Melanoma For Non-covered Indications
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0230
|
HCPCS
|
PET Myocard Viability Post
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0231
|
HCPCS
|
PET Whbd Cholorec;gamma Cam
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0232
|
HCPCS
|
PET Whbd Lymphoma; Gamma Cam
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0233
|
HCPCS
|
PET Hbd Melanoma;gamma Cam
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0234
|
HCPCS
|
PET Whbd Pulm Nod;gamma Cam
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0252
|
HCPCS
|
PET Imaging, Full And Partial-ring PET Scanners Only, For Initial Diagnosis Of B…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0296
|
HCPCS
|
Counseling Visit To Discuss Need For Lung Cancer Screening Using Low Dose CT Sca…
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0330
|
HCPCS
|
Facility Services For Dental Rehabilitation Procedure(s) Performed On A Patient …
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0331
|
HCPCS
|
PET Image Restage Ovarian Ca
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
G0336
|
HCPCS
|
PET Imaging Brain Alzheimers
|
9
|
9
|
$4,471.00
|
$3,576.80
|
$1,520.14
|
$4,471.00
|
$3,152.06
|
2026-03-18
|
|
J0129
|
HCPCS
|
Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…
|
9
|
9
|
$1,937.00
|
$1,549.60
20% off
|
$658.58
|
$1,937.00
|
$1,365.59
|
2026-03-18
|
|
J0139
|
HCPCS
|
Injection, Adalimumab, 1 Mg
|
27
|
9
|
$4,532.00
|
$3,625.60
20% off
|
$1,400.80
|
$13,596.00
|
$3,331.02
|
2026-03-18
|
|
J0485
|
HCPCS
|
Injection, Belatacept, 1 Mg
|
9
|
9
|
$1,751.00
|
$1,400.80
20% off
|
$595.34
|
$1,751.00
|
$1,234.46
|
2026-03-18
|
|
J0491
|
HCPCS
|
Injection, Anifrolumab-fnia, 1 Mg
|
9
|
9
|
$9,000.00
|
$7,200.00
20% off
|
$3,060.00
|
$9,000.00
|
$6,345.00
|
2026-03-18
|
|
J0565
|
HCPCS
|
Injection, Bezlotoxumab, 10 Mg
|
9
|
9
|
$7,000.00
|
$5,600.00
20% off
|
$2,380.00
|
$7,000.00
|
$4,935.00
|
2026-03-18
|
|
J0638
|
HCPCS
|
Injection, Canakinumab, 1 Mg
|
9
|
9
|
$35,000.00
|
$28,000.00
20% off
|
$11,900.00
|
$35,000.00
|
$24,675.00
|
2026-03-18
|
|
J0717
|
HCPCS
|
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm…
|
9
|
9
|
$6,180.00
|
$4,944.00
20% off
|
$2,101.20
|
$6,180.00
|
$4,356.90
|
2026-03-18
|
|
J0840
|
HCPCS
|
Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram
|
9
|
9
|
$3,420.00
|
$2,736.00
20% off
|
$1,162.80
|
$3,420.00
|
$2,411.10
|
2026-03-18
|
|
J0875
|
HCPCS
|
Injection, Dalbavancin, 5 Mg
|
9
|
9
|
$3,200.00
|
$2,560.00
20% off
|
$1,088.00
|
$3,200.00
|
$2,256.00
|
2026-03-18
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
18
|
9
|
$2,908.00
|
$2,326.40
|
$576.64
|
$4,120.00
|
$1,421.81
|
2026-03-18
|
|
J1162
|
HCPCS
|
Injection, Digoxin Immune Fab (ovine), Per Vial
|
9
|
9
|
$1,741.00
|
$1,392.80
20% off
|
$591.94
|
$1,741.00
|
$1,227.41
|
2026-03-18
|
|
J1303
|
HCPCS
|
Injection, Ravulizumab-cwvz, 10 Mg
|
18
|
9
|
$27,434.00
|
$21,947.20
|
$3,997.38
|
$43,111.00
|
$13,207.37
|
2026-03-18
|
|
J1306
|
HCPCS
|
Injection, Inclisiran, 1 Mg
|
9
|
9
|
$5,800.00
|
$4,640.00
20% off
|
$1,972.00
|
$5,800.00
|
$4,089.00
|
2026-03-18
|
|
J1438
|
HCPCS
|
Injection, Etanercept, 25 Mg (code May Be Used For Medicare When Drug Administer…
|
9
|
9
|
$4,532.00
|
$3,625.60
20% off
|
$1,540.88
|
$4,532.00
|
$3,195.06
|
2026-03-18
|
|
J1451
|
HCPCS
|
Injection, Fomepizole, 15 Mg
|
18
|
9
|
$2,081.00
|
$1,664.80
20% off
|
$700.40
|
$2,102.00
|
$1,476.66
|
2026-03-18
|
|
J1459
|
HCPCS
|
Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui…
|
36
|
9
|
$3,862.50
|
$3,090.00
20% off
|
$315.18
|
$7,262.00
|
$2,060.00
|
2026-03-18
|
|
J1572
|
HCPCS
|
Injection, Immune Globulin, (flebogamma/flebogamma Dif), Intravenous, Non-lyophi…
|
27
|
9
|
$1,648.00
|
$1,318.40
|
$280.16
|
$3,296.00
|
$1,153.60
|
2026-03-18
|
|
J1602
|
HCPCS
|
Injection, Golimumab, 1 Mg, For Intravenous Use
|
9
|
9
|
$3,214.00
|
$2,571.20
20% off
|
$1,092.76
|
$3,214.00
|
$2,265.87
|
2026-03-18
|
|
J1745
|
HCPCS
|
Injection, Infliximab, Excludes Biosimilar, 10 Mg
|
9
|
9
|
$2,578.00
|
$2,062.40
|
$876.52
|
$2,578.00
|
$1,817.49
|
2026-03-18
|
|
J1930
|
HCPCS
|
Injection, Lanreotide, 1 Mg
|
9
|
9
|
$16,000.00
|
$12,800.00
20% off
|
$5,440.00
|
$16,000.00
|
$11,280.00
|
2026-03-18
|
|
J1950
|
HCPCS
|
Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg
|
18
|
9
|
$10,883.50
|
$8,706.80
20% off
|
$260.78
|
$21,000.00
|
$3,953.50
|
2026-03-18
|
|
J2182
|
HCPCS
|
Injection, Mepolizumab, 1 Mg
|
9
|
9
|
$5,356.00
|
$4,284.80
|
$1,821.04
|
$5,356.00
|
$3,775.98
|
2026-03-18
|
|
J2315
|
HCPCS
|
Injection, Naltrexone, Depot Form, 1 Mg
|
9
|
9
|
$2,426.00
|
$1,940.80
20% off
|
$824.84
|
$2,426.00
|
$1,710.33
|
2026-03-18
|
|
J2323
|
HCPCS
|
Injection, Natalizumab, 1 Mg
|
9
|
9
|
$11,459.00
|
$9,167.20
|
$3,896.06
|
$11,459.00
|
$8,078.60
|
2026-03-18
|
|
J2325
|
HCPCS
|
Injection, Nesiritide, 0.1 Mg
|
9
|
9
|
$1,736.00
|
$1,388.80
20% off
|
$590.24
|
$1,736.00
|
$1,223.88
|
2026-03-18
|
|
J2327
|
HCPCS
|
Injection, Risankizumab-rzaa, Intravenous, 1 Mg
|
9
|
9
|
$18,000.00
|
$14,400.00
20% off
|
$6,120.00
|
$18,000.00
|
$12,690.00
|
2026-03-18
|
|
J2350
|
HCPCS
|
Injection, Ocrelizumab, 1 Mg
|
9
|
9
|
$30,128.00
|
$24,102.40
|
$10,243.52
|
$30,128.00
|
$21,240.24
|
2026-03-18
|
|
J2353
|
HCPCS
|
Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg
|
18
|
9
|
$5,043.50
|
$4,034.80
20% off
|
$627.98
|
$8,240.00
|
$2,324.30
|
2026-03-18
|
|
J2357
|
HCPCS
|
Injection, Omalizumab, 5 Mg
|
9
|
9
|
$2,009.00
|
$1,607.20
20% off
|
$683.06
|
$2,009.00
|
$1,416.35
|
2026-03-18
|
|
J2407
|
HCPCS
|
Injection, Oritavancin (orbactiv), 10 Mg
|
9
|
9
|
$1,854.00
|
$1,483.20
20% off
|
$630.36
|
$1,854.00
|
$1,307.07
|
2026-03-18
|
|
J2506
|
HCPCS
|
Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg
|
9
|
9
|
$5,950.00
|
$4,760.00
20% off
|
$2,023.00
|
$5,950.00
|
$4,194.75
|
2026-03-18
|
|
J2507
|
HCPCS
|
Injection, Pegloticase, 1 Mg
|
9
|
9
|
$44,000.00
|
$35,200.00
20% off
|
$14,960.00
|
$44,000.00
|
$31,020.00
|
2026-03-18
|
|
J2786
|
HCPCS
|
Injection, Reslizumab, 1 Mg
|
9
|
9
|
$1,700.00
|
$1,360.00
20% off
|
$578.00
|
$1,700.00
|
$1,198.50
|
2026-03-18
|
|
J2993
|
HCPCS
|
Injection, Reteplase, 18.1 Mg
|
9
|
9
|
$5,186.00
|
$4,148.80
|
$1,763.24
|
$5,186.00
|
$3,656.13
|
2026-03-18
|
|
J2997
|
HCPCS
|
Injection, Alteplase Recombinant, 1 Mg
|
18
|
9
|
$7,871.00
|
$6,296.80
20% off
|
$99.28
|
$15,450.00
|
$2,772.50
|
2026-03-18
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
9
|
9
|
$13,300.00
|
$10,640.00
20% off
|
$4,522.00
|
$13,300.00
|
$9,376.50
|
2026-03-18
|
|
J3111
|
HCPCS
|
Injection, Romosozumab-aqqg, 1 Mg
|
9
|
9
|
$3,399.00
|
$2,719.20
20% off
|
$1,155.66
|
$3,399.00
|
$2,396.30
|
2026-03-18
|
|
J3240
|
HCPCS
|
Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial
|
9
|
9
|
$3,090.00
|
$2,472.00
20% off
|
$1,050.60
|
$3,090.00
|
$2,178.45
|
2026-03-18
|
|
J3300
|
HCPCS
|
Injection, Triamcinolone Acetonide, Preservative Free, 1 Mg
|
9
|
9
|
$1,700.00
|
$1,360.00
20% off
|
$578.00
|
$1,700.00
|
$1,198.50
|
2026-03-18
|
|
J3357
|
HCPCS
|
Ustekinumab, For Subcutaneous Injection, 1 Mg
|
18
|
9
|
$28,582.50
|
$22,866.00
20% off
|
$6,478.70
|
$38,110.00
|
$15,244.00
|
2026-03-18
|
|
J3358
|
HCPCS
|
Ustekinumab, For Intravenous Injection, 1 Mg
|
9
|
9
|
$2,987.00
|
$2,389.60
20% off
|
$1,015.58
|
$2,987.00
|
$2,105.84
|
2026-03-18
|
|
J3380
|
HCPCS
|
Injection, Vedolizumab, Intravenous, 1 Mg
|
9
|
9
|
$10,815.00
|
$8,652.00
20% off
|
$3,677.10
|
$10,815.00
|
$7,624.58
|
2026-03-18
|
|
J3489
|
HCPCS
|
Injection, Zoledronic Acid, 1 Mg
|
18
|
9
|
$2,733.00
|
$2,186.40
|
$859.86
|
$2,937.00
|
$1,943.37
|
2026-03-18
|
|
J7325
|
HCPCS
|
Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,…
|
9
|
9
|
$2,252.00
|
$1,801.60
20% off
|
$765.68
|
$2,252.00
|
$1,587.66
|
2026-03-18
|
|
J9217
|
HCPCS
|
Leuprolide Acetate (for Depot Suspension), 7.5 Mg
|
9
|
9
|
$8,549.00
|
$6,839.20
20% off
|
$2,906.66
|
$8,549.00
|
$6,027.05
|
2026-03-18
|
|
J9312
|
HCPCS
|
Injection, Rituximab, 10 Mg
|
9
|
9
|
$8,755.00
|
$7,004.00
20% off
|
$2,976.70
|
$8,755.00
|
$6,172.28
|
2026-03-18
|
|
J9332
|
HCPCS
|
Injection, Efgartigimod Alfa-fcab, 2mg
|
9
|
9
|
$10,000.00
|
$8,000.00
20% off
|
$3,400.00
|
$10,000.00
|
$7,050.00
|
2026-03-18
|
|
Q4100
|
HCPCS
|
Skin Substitute, Not Otherwise Specified
|
9
|
9
|
$5,201.00
|
$4,160.80
|
$1,768.34
|
$5,201.00
|
$3,666.71
|
2026-03-18
|
|
Q4106
|
HCPCS
|
Dermagraft, Per Square Centimeter
|
9
|
9
|
$1,997.00
|
$1,597.60
20% off
|
$678.98
|
$1,997.00
|
$1,407.89
|
2026-03-18
|
|
Q4130
|
HCPCS
|
Strattice Tm, Per Square Centimeter
|
18
|
9
|
$6,587.50
|
$5,270.00
20% off
|
$579.70
|
$11,470.00
|
$2,802.40
|
2026-03-18
|
|
Q5103
|
HCPCS
|
Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg
|
9
|
9
|
$1,700.00
|
$1,360.00
20% off
|
$578.00
|
$1,700.00
|
$1,198.50
|
2026-03-18
|