Price Transparencybeta 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

BEAUREGARD MEMORIAL HOSPITAL

Deridder, LA · CCN 190050 · Rates published

1,350 distinct procedures filed
7 distinct payers
31,620 rate rows
2026-02-18 last MRF observed
Data quality

30,185 of 31,620 rate rows are consumer-grade (95.5%)

1,435 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 1,407
per-diem day rate — not a per-procedure price 27
exceeds 10× this hospital's gross charge — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.beauregard.org/media/p/9396/720491106_beauregard-health-system_standardcharges.csv
Found on page https://www.beauregard.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-06-13
Content fingerprint d8d65619d66b1031… · 11,260,452 bytes · first seen 2026-05-14

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
J1950
HCPCS 		Lupron 45mg Syr Depot 7 $100.00 $59,238.80 $50,352.98 nat. median
$4,344
outlier · 11.6×
J9022
HCPCS 		Tecentrig 1200mg Vial 7 $100.00 $54,910.40 $46,673.84 nat. median
$6,911
outlier · 6.8×
J9119
HCPCS 		Libtayo 350mg/7ml Vial 7 $100.00 $52,139.60 $44,318.66 nat. median
$91
outlier · 488.0×
J9144
CPT 		Darzalex Faspro 1800mg/15ml Vi 7 $15,300.47 $48,630.80 $41,336.18 nat. median
$232
outlier · 178.1×
J1930
HCPCS 		Lanreotide 120mg/0.5ml 7 $100.00 $43,985.20 $37,387.42 nat. median
$5,873
outlier · 6.4×
J9228
HCPCS 		Yervoy 5mg/ml 10ml Vial 7 $100.00 $41,652.00 $35,404.20 nat. median
$9,890
outlier · 3.6×
J3101
HCPCS 		Tnkase Kit 7 $100.00 $38,167.60 $32,442.46 nat. median
$5,957
outlier · 5.4×
J9217
HCPCS 		Lupron Depot 22.5mg 7 $100.00 $39,492.00 $31,100.00 nat. median
$1,521
outlier · 20.4×
J9301
HCPCS 		Gazyva 1000mg 40ml Vial 7 $100.00 $34,155.20 $29,031.92 nat. median
$314
outlier · 92.6×
J9306
HCPCS 		Perjeta 420mg Vial 7 $100.00 $31,688.00 $26,934.80 nat. median
$85
outlier · 317.2×
J2506
CPT 		Neulasta 6mg/0.6ml 7 $9,288.61 $29,522.80 $25,094.38 nat. median
$2,076
outlier · 12.1×
J0517
HCPCS 		Fasenra 30mg Syringe 7 $100.00 $26,896.80 $22,862.28 nat. median
$914
outlier · 25.0×
37227
CPT 		Peripheral Vas Le, Stent & Ath 7 $7,202.79 $22,893.24 $20,031.59 nat. median
$18,025
1.1× median
J9312
HCPCS 		Rituxan 500mg Vial 7 $100.00 $21,609.22 $18,367.83 nat. median
$1,242
outlier · 14.8×
J9299
HCPCS 		Opdivo 240m/24ml Vial 7 $100.00 $36,538.56 $18,269.04 nat. median
$2,944
outlier · 6.2×
Q5111
HCPCS 		Undenyca 6mg On-body 7 $100.00 $19,205.20 $16,324.42 nat. median
$2,102
outlier · 7.8×
37229
CPT 		Peripheral Vas Le, Atherectomy 7 $5,699.09 $18,113.90 $15,849.67 nat. median
$16,929
0.9× median
37225
CPT 		Peripheral Vas Le Atherectomy 7 $5,298.43 $16,840.46 $14,735.41 nat. median
$16,320
0.9× median
37228
CPT 		Pta Tibioper Each Vessel 7 $5,290.60 $16,815.56 $14,713.62 nat. median
$10,888
1.4× median
Q5112
HCPCS 		Ontruzant 420mg Vial 7 $100.00 $17,061.60 $14,502.36 nat. median
$63
outlier · 229.8×
J2182
HCPCS 		Nucala 100mg 7 $100.00 $17,020.00 $14,467.00 nat. median
$3,087
outlier · 4.7×
50590
CPT 		Esl Lithotripter 7 $100.00 $15,833.64 $13,854.44 nat. median
$4,400
outlier · 3.1×
J1437
HCPCS 		MonoFerric 1000mg/10ml Vial 7 $100.00 $16,154.00 $13,730.90 nat. median
$42
outlier · 330.5×
C1602
CPT 		Cerament G 10ml 7 $4,150.03 $23,798.40 $13,190.40 nat. median
$5,750
outlier · 2.3×
J9177
HCPCS 		Padcev 20mg Vial 7 $100.00 $19,382.20 $12,921.40 nat. median
$3,113
outlier · 4.2×
Q5130
CPT 		Fylnetra 6mg Vial 7 $4,341.83 $13,800.00 $11,730.00 nat. median
$335
outlier · 35.0×
93460
CPT 		Cor Art R L Heart Lv S&i 7 $100.00 $11,967.24 $10,172.15 nat. median
$6,361
1.6× median
J0897
HCPCS 		Prolia 60mg/ml 1ml Inj 7 $100.00 $15,869.20 $8,886.00 nat. median
$2,502
outlier · 3.6×
Q5158
CPT 		Conexxence Denosumab-bnht 60mg 7 $2,632.91 $15,392.80 $8,368.40 nat. median
$3,275
outlier · 2.6×
J9303
HCPCS 		Vectibix 100mg 5ml Vial 7 $100.00 $35,001.34 $8,333.59 nat. median
$1,888
outlier · 4.4×
0275
RC 		Quik-pace Adult Electrode 7 $33.36 $45,827.20 $8,020.40 nat. median
$2,062
outlier · 3.9×
C9353
HCPCS 		Nerve Cap 7 $100.00 $9,264.00 $7,874.40 nat. median
$3,495
outlier · 2.3×
J3032
HCPCS 		Vyepti 100mg Vial 7 $100.00 $8,924.40 $7,585.74 nat. median
$71
outlier · 106.4×
J9047
HCPCS 		Kyprolis 30mg 7 $100.00 $13,704.42 $7,360.00 nat. median
$1,668
outlier · 4.4×
93459
CPT 		Cor Art L Heart Lv Bypss Ima 7 $100.00 $8,331.08 $7,081.42 nat. median
$6,389
1.1× median
Q5157
CPT 		Stoboclo 60mg/1ml 7 $2,578.67 $8,196.00 $6,966.60 nat. median
$2,987
outlier · 2.3×
33210
CPT 		Temp Pacer Sgl Chamber 7 $100.00 $7,952.88 $6,958.77 nat. median
$8,289
0.8× median
J0875
HCPCS 		Dalvance 500mg Vial 7 $100.00 $8,184.00 $6,956.40 nat. median
$1,071
outlier · 6.5×
J9074
CPT 		Cyclophosphamide 2gm Vial 7 $2,385.36 $7,581.60 $6,444.36 nat. median
$6
outlier · 1011.7×
93458
CPT 		Cor Art L Heart Lv S&i 7 $100.00 $7,360.00 $6,256.00 nat. median
$6,395
1.0× median
J1439
HCPCS 		Injectafer 50mg/ml 15ml Vial 7 $100.00 $7,112.80 $6,045.88 nat. median
$63
outlier · 95.7×
37224
CPT 		Pta Fem/pop Each Vessel 7 $2,119.38 $6,736.20 $5,894.18 nat. median
$7,244
0.8× median
J9324
CPT 		Pemrydi 100mg Vial 7 $1,387.65 $22,714.10 $5,778.45 nat. median
$90
outlier · 64.4×
J1459
HCPCS 		Privigen 5gm/50ml Infusion 7 $100.00 $18,181.42 $5,720.33 nat. median
$1,227
outlier · 4.7×
C1889
HCPCS 		Verawrap 7 $100.00 $7,830.40 $5,686.40 nat. median
$2,392
outlier · 2.4×
93454
CPT 		Cor Art, S&i 7 $100.00 $6,586.28 $5,598.34 nat. median
$5,709
1.0× median
37221
CPT 		Peripheral Vas Le Stent, Iliac 7 $1,881.94 $5,981.52 $5,233.83 nat. median
$11,953
outlier · 0.4×
93455
CPT 		Cor Art Bypss Ima Graft Si 7 $100.00 $6,095.20 $5,180.92 nat. median
$5,661
0.9× median
V2790
HCPCS 		Axolotl Dualgrat 2cmx3cm 7 $100.00 $6,144.00 $5,120.00 nat. median
$1,695
outlier · 3.0×
J1569
HCPCS 		Gammagard 20gm/200ml 7 $100.00 $16,064.25 $5,054.21 nat. median
$1,048
outlier · 4.8×

Other procedures at this hospital

Browse this hospital's 1,350 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
0112 RC Labor & Delivery Rooms 16 4 $1,121.50 — $333.20 $1,160.00 $816.80 2026-02-18
0172 RC Nursery Level Ii Room/board 12 4 $980.00 — $655.28 $1,196.00 $784.00 2026-02-18
0200 RC ICU Room/board 8 4 $1,425.00 — $693.60 $1,464.00 $1,030.20 2026-02-18
0203 RC ICU Pediatric 4 4 $1,830.00 — $1,244.40 $1,464.00 $1,464.00 2026-02-18
0275 RC Quik-pace Adult Electrode 154 7 $12,568.88 — $33.36 $45,827.20 $8,020.40 2026-02-18
0278 RC Depuy Drill Bit 3,927 7 $2,016.75 — $1.03 $41,584.00 $1,153.28 2026-02-18
0290 RC Traction Splint 7 7 $1,350.06 — $339.81 $1,080.05 $918.04 2026-02-18
0329 RC Mm Needle Loc Rt 14 7 $1,203.95 — $303.03 $963.16 $818.69 2026-02-18
0340 RC Nm Liver/spleen Scan 56 7 $1,445.05 — $155.40 $1,716.24 $777.06 2026-02-18
0350 RC CT Lower Ext Without Contrst Bilat 94 7 $3,106.85 — $162.77 $3,716.24 $1,805.49 2026-02-18
0361 RC Peripheral Vas UE/Renal Artery 651 7 $2,548.40 — $14.62 $49,536.00 $1,663.45 2026-02-18
0391 RC Blood Administration 1 Unit 49 7 $1,320.85 — $318.99 $1,129.32 $898.18 2026-02-18
0481 RC Right Heart 112 7 $2,587.15 — $37.76 $11,511.48 $1,287.72 2026-02-18
0483 RC Echo Tee 28 7 $1,230.53 — $182.34 $1,334.88 $800.35 2026-02-18
0610 RC MRI Chest Without Contrast 105 7 $1,964.05 — $352.38 $12,008.36 $1,335.55 2026-02-18
0618 RC MRA Abd W/contrast 7 7 $1,750.00 — $440.48 $1,400.00 $1,296.00 2026-02-18
0750 RC Esophagoscopy With Fb Removal 203 7 $2,543.50 — $217.76 $3,704.76 $1,687.69 2026-02-18
0920 RC Multiple Sleep Latency 14 7 $3,588.50 — $827.84 $3,110.40 $2,540.32 2026-02-18
10005 CPT Fine Needle W/us/ Image1st Les 14 7 $1,136.73 — $100.00 $909.38 $772.98 2026-02-18
10061 CPT I&d Complex 7 7 $1,824.35 — $100.00 $1,459.48 $1,240.56 2026-02-18
10080 CPT Abcess, Pilonidal I&d Simple 7 7 $1,145.62 — $100.00 $916.50 $779.02 2026-02-18
10140 CPT I&d Hematoma, Seroma Or Fluid 13 7 $2,695.90 — $100.00 $2,873.98 $2,156.72 2026-02-18
11043 CPT Wc Debrid Sub Tissue Muscle 7 7 $1,310.43 — $100.00 $1,048.34 $891.09 2026-02-18
11044 CPT Wc Debridement Subq Tissue/Mus 7 7 $3,517.50 — $100.00 $2,814.00 $2,391.90 2026-02-18
11406 CPT Exc Lesion > 4.0 Cm 7 7 $3,766.55 — $100.00 $3,013.24 $2,561.25 2026-02-18
11770 CPT Exc Pilonidal Cyst Simple 7 7 $2,724.75 — $100.00 $2,179.80 $1,852.83 2026-02-18
13160 CPT Extend Repair Surface Wound Re 7 7 $1,989.40 — $100.00 $1,591.52 $1,352.79 2026-02-18
15002 CPT Surg Prep Trunk, Arms, Legs 7 7 $4,372.50 — $100.00 $3,498.00 $2,973.30 2026-02-18
15004 CPT Surg Prep Scar Face Hands Feet 7 7 $1,337.23 — $100.00 $1,069.78 $909.32 2026-02-18
15271 CPT Wc Skin substitute/App 1st 25 7 7 $4,287.50 — $100.00 $3,430.00 $2,915.50 2026-02-18
15275 CPT Wc Skin sub/App 25 Cm (feet) 7 7 $4,288.40 — $100.00 $3,430.72 $2,916.11 2026-02-18
19083 CPT Bx Breast Loc Device 7 7 $2,695.90 — $100.00 $2,156.72 $1,833.21 2026-02-18
19100 CPT Bx Breast Percutan,needle Core 7 7 $1,098.85 — $100.00 $879.08 $747.22 2026-02-18
23655 CPT Shoulder Disloc W/manip W/anes 7 7 $2,272.25 — $100.00 $1,817.80 $1,545.13 2026-02-18
24201 CPT Arm,upr Remove Fb Deep 7 7 $4,649.40 — $100.00 $3,719.52 $3,161.59 2026-02-18
24530 CPT Humeral Fx Without Manip 7 7 $1,129.35 — $100.00 $903.48 $767.96 2026-02-18
24600 CPT Elbow Dslctn Rdctn Without Anesth 7 7 $1,230.00 — $100.00 $984.00 $836.40 2026-02-18
25605 CPT Radial/ulnar Fx W/manip 7 7 $1,996.30 — $100.00 $1,597.04 $1,357.48 2026-02-18
27842 CPT Ankle Disl Clsd Tx W/anesth 7 7 $2,164.05 — $100.00 $1,731.24 $1,471.55 2026-02-18
28005 CPT Incision Bone Cortex 7 7 $6,057.23 — $100.00 $4,845.78 $4,118.92 2026-02-18
28010 CPT Percant Flexor Tentomy Single 7 7 $3,556.28 — $100.00 $2,845.02 $2,418.27 2026-02-18
30802 CPT Cauterize, Inner Nose/intramur 7 7 $2,601.85 — $100.00 $2,081.48 $1,769.26 2026-02-18
30930 CPT Nasal Trbnt Fx Therapeutic 7 7 $2,601.85 — $100.00 $2,081.48 $1,769.26 2026-02-18
31500 CPT Endotracheal Intubation 7 7 $1,085.80 — $100.00 $868.64 $738.34 2026-02-18
31605 CPT Tracheostomy Cricothyroid 7 7 $2,693.95 — $100.00 $2,155.16 $1,831.89 2026-02-18
32551 CPT Tube Throacostomy 7 7 $1,652.45 — $100.00 $1,321.96 $1,123.67 2026-02-18
33210 CPT Temp Pacer Sgl Chamber 7 7 $9,941.10 — $100.00 $7,952.88 $6,958.77 2026-02-18
36430 CPT Blood Transfusion 1 Unit 19 7 $1,284.80 — $100.00 $1,041.72 $885.46 2026-02-18
36556 CPT Non-tunld Central Venous Cath 7 7 $2,157.55 — $100.00 $1,726.04 $1,467.13 2026-02-18
36573 CPT Picc Line Insertion W/imaging 7 7 $1,326.20 — $100.00 $1,060.96 $901.82 2026-02-18
36589 CPT Rem Implant Cath Without Port 7 7 $1,412.90 — $100.00 $1,130.32 $960.77 2026-02-18
37221 CPT Peripheral Vas Le Stent, Iliac 7 7 $7,476.90 — $1,881.94 $5,981.52 $5,233.83 2026-02-18
37224 CPT Pta Fem/pop Each Vessel 7 7 $8,420.25 — $2,119.38 $6,736.20 $5,894.18 2026-02-18
37225 CPT Peripheral Vas Le Atherectomy 7 7 $21,050.58 — $5,298.43 $16,840.46 $14,735.41 2026-02-18
37227 CPT Peripheral Vas Le, Stent & Ath 7 7 $28,616.55 — $7,202.79 $22,893.24 $20,031.59 2026-02-18
37228 CPT Pta Tibioper Each Vessel 7 7 $21,019.45 — $5,290.60 $16,815.56 $14,713.62 2026-02-18
37229 CPT Peripheral Vas Le, Atherectomy 7 7 $22,642.38 — $5,699.09 $18,113.90 $15,849.67 2026-02-18
37236 CPT Peripheral Vas UE/Renal Artery 7 7 $7,035.25 — $100.00 $5,628.20 $4,924.68 2026-02-18
38505 CPT Bx Needle Cer,ing,ax,lymph 7 7 $2,695.90 — $100.00 $2,156.72 $1,833.21 2026-02-18
43235 CPT Egd Diag 7 7 $1,983.95 — $100.00 $1,587.16 $1,388.77 2026-02-18
43239 CPT Egd W/bx 7 7 $2,427.20 — $100.00 $1,941.76 $1,699.04 2026-02-18
43245 CPT Egd W/dilation Outlet 7 7 $3,620.95 — $100.00 $2,896.76 $2,534.67 2026-02-18
43246 CPT Egd W/plcmnt Peg 7 7 $2,841.15 — $100.00 $2,272.92 $1,988.81 2026-02-18
43247 CPT Egd Fb/fb Removal 7 7 $3,302.75 — $100.00 $2,642.20 $2,311.93 2026-02-18
43251 CPT Egd W/polyp Rem W/snare 7 7 $3,226.50 — $100.00 $2,581.20 $2,258.55 2026-02-18
43255 CPT Gastro W/control Of Bleed 7 7 $3,265.00 — $100.00 $2,612.00 $2,285.50 2026-02-18
43763 CPT G-tube Replacemnt Without Imgng Wi 7 7 $1,304.55 — $100.00 $1,043.64 $913.19 2026-02-18
44388 CPT Colonoscopy Thru Stoma Dx 7 7 $2,692.75 — $100.00 $2,154.20 $1,884.93 2026-02-18
44392 CPT Colonoscopy W/polyp Removal 7 7 $1,600.00 — $100.00 $1,280.00 $1,120.00 2026-02-18
45330 CPT Sigmoidoscopy Flex 7 7 $2,137.45 — $100.00 $1,709.96 $1,496.22 2026-02-18
45331 CPT Sigmoidoscopy W/bx 7 7 $2,780.85 — $100.00 $2,224.68 $1,946.60 2026-02-18
45333 CPT Sigmoidoscopy W/rem Tumor 7 7 $2,490.50 — $100.00 $1,992.40 $1,743.35 2026-02-18
45378 CPT Colonoscope-incomplete 7 7 $3,800.05 — $100.00 $3,040.04 $2,660.04 2026-02-18
45380 CPT Colonoscopy W/bx 7 7 $2,527.85 — $100.00 $2,022.28 $1,769.50 2026-02-18
45382 CPT Colonoscopy W/control Of Bleed 7 7 $3,306.55 — $100.00 $2,645.24 $2,314.59 2026-02-18
45385 CPT Colonoscopy W/polypectomy 7 7 $5,508.75 — $100.00 $4,407.00 $3,856.13 2026-02-18
49082 CPT Paracentesis Without Imaging 7 7 $1,246.60 — $100.00 $997.28 $847.69 2026-02-18
49083 CPT Paracentesis With Imaging 7 7 $1,246.60 — $100.00 $997.28 $847.69 2026-02-18
50590 CPT Esl Lithotripter 7 7 $19,792.05 — $100.00 $15,833.64 $13,854.44 2026-02-18
54150 CPT Circ W/clamp And Block 7 7 $1,873.20 — $100.00 $1,498.56 $1,311.24 2026-02-18
55700 CPT Bx Prostate Transrectal 7 7 $2,841.00 — $715.08 $2,272.80 $1,931.88 2026-02-18
56420 CPT Abcess Bartholin's Gland I&d 7 7 $2,984.95 — $100.00 $2,387.96 $2,029.77 2026-02-18
62273 CPT Bloodpatch Injection Lumbar 7 7 $1,710.65 — $100.00 $1,368.52 $1,163.24 2026-02-18
69000 CPT Abcess Extrnl Ear Smpl 7 7 $1,145.65 — $100.00 $916.52 $779.04 2026-02-18
70336 CPT MRI Tmj Without 7 7 $2,047.30 — $100.00 $1,637.84 $1,392.16 2026-02-18
70450 CPT CT Brain Without Contrast 7 7 $2,096.20 — $100.00 $1,676.96 $1,425.42 2026-02-18
70460 CPT CT Brain W/contrast 7 7 $2,200.00 — $100.00 $1,760.00 $1,496.00 2026-02-18
70470 CPT CT Brain W & Without Contrast 7 7 $2,526.25 — $100.00 $2,021.00 $1,717.85 2026-02-18
70480 CPT CT Orbits/sella/iam Wo 7 7 $1,717.70 — $100.00 $1,374.16 $1,168.04 2026-02-18
70481 CPT CT Orbits/sella/iam With 7 7 $1,825.80 — $100.00 $1,460.64 $1,241.54 2026-02-18
70482 CPT CT Orbits/sella/iam W & Without 7 7 $2,284.05 — $100.00 $1,827.24 $1,553.15 2026-02-18
70486 CPT CT Sinus Without Contrast 7 7 $1,766.30 — $100.00 $1,413.04 $1,201.08 2026-02-18
70487 CPT CT Sinus W Contrast 7 7 $2,150.00 — $100.00 $1,720.00 $1,462.00 2026-02-18
70488 CPT CT Facial W & Without Contrast 7 7 $2,281.80 — $100.00 $1,825.44 $1,551.62 2026-02-18
70490 CPT CT Nk Soft Tiss Without Contrast 7 7 $1,667.80 — $100.00 $1,334.24 $1,134.10 2026-02-18
70491 CPT CT Nk Soft Tiss W/contrast 7 7 $1,760.15 — $100.00 $1,408.12 $1,196.90 2026-02-18
70492 CPT CT Nk Soft Tiss W Wo Contrast 7 7 $2,286.80 — $100.00 $1,829.44 $1,555.02 2026-02-18
70496 CPT CT Angio Head W & Without Contrast 7 7 $2,173.30 — $100.00 $1,738.64 $1,477.84 2026-02-18
70498 CPT CT Angio Neck W & Without Contrast 7 7 $2,360.60 — $100.00 $1,888.48 $1,605.21 2026-02-18
70540 CPT MRI Orbit Face Neck Wo Contrst 7 7 $1,455.70 — $100.00 $1,296.00 $1,164.56 2026-02-18
70543 CPT MRI Orbit Face Nck W&wo Cntrst 7 7 $1,932.65 — $100.00 $1,546.12 $1,314.20 2026-02-18
70544 CPT Mrv Head Without 7 7 $1,750.00 — $100.00 $1,400.00 $1,296.00 2026-02-18
70547 CPT MRA Neck Wo Contrast 7 7 $1,234.00 — $100.00 $1,296.00 $987.20 2026-02-18
70549 CPT MRA Neck W&without Contrast 7 7 $2,642.85 — $100.00 $2,114.28 $1,797.14 2026-02-18
70551 CPT MRI Iac Without Contrast 7 7 $2,150.00 — $100.00 $1,720.00 $1,462.00 2026-02-18
70552 CPT MRI Brain W/contrast 7 7 $2,463.65 — $100.00 $1,970.92 $1,675.28 2026-02-18
70553 CPT MRI Iac W&wo Contrast 7 7 $3,304.20 — $100.00 $2,643.36 $2,246.86 2026-02-18
71250 CPT CT Thorax Without Contrast 7 7 $1,951.45 — $100.00 $1,561.16 $1,326.99 2026-02-18
71260 CPT CT Thorax W/contrast 7 7 $2,325.60 — $100.00 $1,860.48 $1,581.41 2026-02-18
71270 CPT CT Thorax W & Without Contrast 7 7 $2,570.65 — $100.00 $2,056.52 $1,748.04 2026-02-18
71275 CPT CT Angio Chest W & Without Contrast 7 7 $2,360.60 — $100.00 $1,888.48 $1,605.21 2026-02-18
72125 CPT CT C-spine Without Contrast 7 7 $2,130.50 — $100.00 $1,704.40 $1,448.74 2026-02-18
72126 CPT CT Cervical Spine W/contrast 7 7 $1,220.00 — $100.00 $976.00 $950.00 2026-02-18
72127 CPT CT C-spine W & Without Contrast 7 7 $2,613.50 — $100.00 $2,090.80 $1,777.18 2026-02-18
72128 CPT CT T-spine Without Contrast 7 7 $2,103.00 — $100.00 $1,682.40 $1,430.04 2026-02-18
72129 CPT CT T-spine W/contrast 7 7 $2,574.65 — $100.00 $2,059.72 $1,750.76 2026-02-18
72131 CPT CT L-spine Without Contrast 7 7 $2,309.80 — $100.00 $1,847.84 $1,570.66 2026-02-18
72132 CPT CT L-spine W/contrast 7 7 $3,088.65 — $100.00 $2,470.92 $2,100.28 2026-02-18
72133 CPT CT L-spine W & Without Contrast 7 7 $3,229.65 — $100.00 $2,583.72 $2,196.16 2026-02-18
72141 CPT MRI Cervical Without Contrast 7 7 $1,750.00 — $100.00 $1,400.00 $1,296.00 2026-02-18
72146 CPT MRI Thoracic Without Contrast 7 7 $1,750.00 — $100.00 $1,400.00 $1,296.00 2026-02-18
72147 CPT MRI Thoracic W/contrast 7 7 $2,562.70 — $100.00 $2,050.16 $1,742.64 2026-02-18
72148 CPT MRI Lumbar Without Contrast 7 7 $1,750.00 — $100.00 $1,400.00 $1,296.00 2026-02-18
72149 CPT MRI Lumbar W/contrast 7 7 $2,472.40 — $100.00 $1,977.92 $1,681.23 2026-02-18
72156 CPT MRI Cervical W&wo Contrast 7 7 $4,408.20 — $100.00 $3,526.56 $2,997.58 2026-02-18
72157 CPT MRI Thoracic W&wo Contrast 7 7 $4,408.20 — $100.00 $3,526.56 $2,997.58 2026-02-18
72158 CPT MRI Lumbar W&wo Contrast 7 7 $4,408.20 — $100.00 $3,526.56 $2,997.58 2026-02-18
72192 CPT CT Pelvis Without Contrast 7 7 $2,037.30 — $100.00 $1,629.84 $1,385.36 2026-02-18
72193 CPT CT Pelvis W/contrast 7 7 $2,096.95 — $100.00 $1,677.56 $1,425.93 2026-02-18
72194 CPT CT Pelvis W & Without Contrast 7 7 $2,777.00 — $100.00 $2,221.60 $1,888.36 2026-02-18
72195 CPT MRI Pelvis Without Contrast 7 7 $1,750.00 — $100.00 $1,400.00 $1,296.00 2026-02-18
72197 CPT MRI Pelvis W&without Contrast 12 7 $2,639.10 — $100.00 $2,111.28 $830.06 2026-02-18
73200 CPT CT Upper Ext Without Contrast Left 14 7 $1,994.15 — $100.00 $1,595.32 $1,356.02 2026-02-18
73201 CPT CT Upper Ext Lt W/cont 7 7 $2,342.20 — $100.00 $1,873.76 $1,592.70 2026-02-18
73206 CPT CT Angio Upp Ext W & Without Contrast 7 7 $2,360.60 — $100.00 $1,888.48 $1,605.21 2026-02-18
73218 CPT MRI Lt Hand Wo 14 7 $1,750.00 — $100.00 $1,400.00 $1,296.00 2026-02-18
73220 CPT MRI Lt Hand Wwo 7 7 $3,611.10 — $100.00 $2,888.88 $2,455.55 2026-02-18
73221 CPT MRI Lt Shoulder Wo 14 7 $1,455.70 — $100.00 $1,296.00 $1,164.56 2026-02-18
73223 CPT MRI Rt Wrist Wwo 7 7 $2,637.70 — $100.00 $2,110.16 $1,793.64 2026-02-18
73700 CPT CT Lower Ext Without Contrst Left 14 7 $1,959.60 — $100.00 $1,567.68 $1,332.53 2026-02-18
73701 CPT CT Lower Ext W/contrast Left 14 7 $1,553.35 — $100.00 $1,242.68 $1,056.28 2026-02-18
73702 CPT CT Lowr Ext W & Without Cont Left 14 7 $2,248.80 — $100.00 $1,799.04 $1,529.18 2026-02-18
73706 CPT CT Angio Lower Ext W & Without Contrast 7 7 $2,837.75 — $100.00 $2,270.20 $1,929.67 2026-02-18
73718 CPT MRI Lt Tib/fib Wo 7 7 $1,750.00 — $100.00 $1,400.00 $1,296.00 2026-02-18
73720 CPT MRI Rt Femur/thigh Wwo 7 7 $3,654.40 — $100.00 $2,923.52 $2,484.99 2026-02-18
73721 CPT MRI Lt Ankle Wo 14 7 $1,455.70 — $100.00 $1,296.00 $1,164.56 2026-02-18
73723 CPT MRI Lt Hip Wwo 7 7 $2,735.80 — $100.00 $2,188.64 $1,860.34 2026-02-18
74150 CPT CT Abdomen Without Contrast 7 7 $1,978.60 — $100.00 $1,582.88 $1,345.45 2026-02-18
74160 CPT CT Abdomen W/contrast 7 7 $2,078.95 — $100.00 $1,663.16 $1,413.69 2026-02-18
74170 CPT CT Abdomen W & Without Contrast 7 7 $2,630.80 — $100.00 $2,104.64 $1,788.94 2026-02-18
74174 CPT CT Angio Abd & Pelvis W & Wo 7 7 $2,360.60 — $100.00 $1,888.48 $1,605.21 2026-02-18
74175 CPT CT Angio Abdomen W & Without Contrast 7 7 $2,295.45 — $100.00 $1,836.36 $1,560.91 2026-02-18
74176 CPT CT Abd & Pelvis Without Contrast 7 7 $4,435.15 — $100.00 $3,548.12 $3,015.90 2026-02-18
74177 CPT CT Abd & Pelvis W Contrast 7 7 $4,750.00 — $100.00 $3,800.00 $3,230.00 2026-02-18
74178 CPT CT Urogram Wwo 7 7 $5,537.60 — $100.00 $4,430.08 $3,765.57 2026-02-18
74181 CPT MRI Abdomen Without Contrast 7 7 $1,455.70 — $100.00 $1,296.00 $1,164.56 2026-02-18
74182 CPT MRI Abdomen W/contrast 7 7 $1,964.05 — $100.00 $1,571.24 $1,335.55 2026-02-18
74183 CPT MRI Abdomen W&without Contrast 12 7 $2,669.85 — $100.00 $2,135.88 $833.26 2026-02-18
75630 CPT S&i Aorta With Runoffs 7 7 $2,982.40 — $100.00 $2,385.92 $2,028.03 2026-02-18
75635 CPT CT Angio Aorta W/bil Runoff 7 7 $2,383.05 — $100.00 $1,906.44 $1,620.47 2026-02-18
75710 CPT S&i Extremity Unilateral 7 7 $2,779.40 — $100.00 $2,223.52 $1,889.99 2026-02-18
75716 CPT S&i Extremity Bilateral 7 7 $3,019.30 — $100.00 $2,415.44 $2,053.12 2026-02-18
75756 CPT Angio Internal Mammary 7 7 $4,985.15 — $100.00 $3,988.12 $3,389.90 2026-02-18
78014 CPT Nm Thyroid Scan & Uptake 7 7 $1,349.95 — $100.00 $1,079.96 $917.97 2026-02-18
78070 CPT Nm Parathyroid Imaging 7 7 $1,123.95 — $100.00 $899.16 $764.29 2026-02-18
78195 CPT Nm Lymphoscintigraphy Imaging 7 7 $1,575.00 — $100.00 $1,260.00 $1,071.00 2026-02-18
78226 CPT Nm Gallbladder Without Cck 7 7 $2,878.40 — $100.00 $2,302.72 $1,957.31 2026-02-18
78227 CPT Nm Biliary Scan W/cck 7 7 $2,878.40 — $100.00 $2,302.72 $1,957.31 2026-02-18
78264 CPT Nm Gastric Emptying 7 7 $1,227.30 — $100.00 $981.84 $834.56 2026-02-18
78278 CPT Nm Gi Bleed 7 7 $2,638.25 — $100.00 $2,110.60 $1,794.01 2026-02-18
78306 CPT Nm Bone Scan Whole 7 7 $2,000.35 — $100.00 $1,600.28 $1,360.24 2026-02-18
78315 CPT Nm 3-phase Bone Scan 7 7 $2,668.60 — $100.00 $2,134.88 $1,814.65 2026-02-18
78452 CPT Nm Cardioite Stress Test 7 7 $5,188.05 — $100.00 $4,150.44 $3,527.87 2026-02-18
78580 CPT Nm Lung Perfusion Aero 7 7 $2,014.15 — $100.00 $1,611.32 $1,369.62 2026-02-18
78582 CPT Nm Lung Vent And Perfusion 7 7 $4,159.45 — $100.00 $3,327.56 $2,828.43 2026-02-18
78708 CPT Renal Scan With Lasix 7 7 $1,814.70 — $100.00 $1,451.76 $1,234.00 2026-02-18
81256 CPT Hereditary Hemoch DNA Mutation 7 7 $1,572.00 — $100.00 $1,257.60 $1,068.96 2026-02-18
81291 CPT Mthfr DNA Mutation 7 7 $1,192.00 — $100.00 $953.60 $810.56 2026-02-18
81301 CPT Microsatellite Instability 7 7 $1,187.45 — $100.00 $949.96 $807.47 2026-02-18
81432 CPT Brca Panel Plus 7 7 $4,796.28 — $100.00 $3,837.02 $3,261.47 2026-02-18
81479 CPT Comprehensive Hereditary Cance 7 7 $5,323.05 — $100.00 $4,258.44 $3,619.67 2026-02-18
83918 CPT Organic Acids Quant Urine 7 7 $1,516.00 — $22.39 $1,212.80 $1,030.88 2026-02-18
84393 CPT Phosphorylated Tau217 7 7 $1,220.63 — $307.23 $976.50 $830.03 2026-02-18
86052 CPT Aquaporin-4 (Neuromyelitis Opt 7 7 $1,120.00 — $281.90 $896.00 $761.60 2026-02-18
86711 CPT Jcv Antibody 7 7 $5,452.00 — $16.89 $4,361.60 $3,707.36 2026-02-18
88184 CPT Cytometry First Marker 7 7 $1,980.00 — $54.87 $1,584.00 $1,346.40 2026-02-18
88185 CPT Cytometry Each Addl 7 7 $1,980.00 — $19.31 $1,584.00 $1,346.40 2026-02-18
88309 CPT Gross & Micro Level Vi 7 7 $1,081.85 — $100.00 $865.48 $735.66 2026-02-18
89322 CPT Semen Analysis W/strict Morph 7 7 $1,080.00 — $100.00 $864.00 $734.40 2026-02-18
90377 CPT Kedrab 150iu/ml 10ml Vial 13 7 $64,662.00 — $100.00 $51,729.60 $4,921.20 2026-02-18
90675 CPT Rabavert 2.5iu/ml 7 7 $4,955.00 — $100.00 $3,964.00 $3,369.40 2026-02-18
90684 CPT Capvaxive 21 0.5ml Syringe 7 7 $2,863.00 — $720.62 $2,290.40 $1,946.84 2026-02-18
90732 CPT Pneumovax-23 0.5mg Vial 7 7 $1,112.50 — $100.00 $890.00 $756.50 2026-02-18
91035 CPT G-esoph Reflx Test W/electrod 13 7 $1,362.12 — $100.00 $1,089.70 $953.48 2026-02-18
92928 CPT Intracoronary Stent W/ptca Sin 7 7 $1,585.58 — $100.00 $1,268.46 $1,109.91 2026-02-18
92937 CPT Pci Of Bypass Graft W/any Comb 7 7 $1,517.85 — $100.00 $1,214.28 $1,062.50 2026-02-18
92941 CPT Pci Of Acute Mi, W/combination 7 7 $1,782.38 — $100.00 $1,425.90 $1,247.67 2026-02-18
92960 CPT Cardioversion 7 7 $1,322.10 — $100.00 $1,057.68 $899.03 2026-02-18
93306 CPT Echo W/cfd 7 7 $1,864.85 — $100.00 $1,491.88 $1,268.10 2026-02-18
93454 CPT Cor Art, S&i 7 7 $8,232.85 — $100.00 $6,586.28 $5,598.34 2026-02-18
93455 CPT Cor Art Bypss Ima Graft Si 7 7 $7,619.00 — $100.00 $6,095.20 $5,180.92 2026-02-18
93458 CPT Cor Art L Heart Lv S&i 7 7 $9,200.00 — $100.00 $7,360.00 $6,256.00 2026-02-18
93459 CPT Cor Art L Heart Lv Bypss Ima 7 7 $10,413.85 — $100.00 $8,331.08 $7,081.42 2026-02-18
93460 CPT Cor Art R L Heart Lv S&i 7 7 $14,959.05 — $100.00 $11,967.24 $10,172.15 2026-02-18
93567 CPT Inj Supra Aort 7 7 $1,110.20 — $100.00 $888.16 $754.94 2026-02-18
93925 CPT Duplex Low-ext-art-bilat 7 7 $1,193.95 — $100.00 $955.16 $811.89 2026-02-18
94002 CPT Ventilation Initial 7 7 $2,098.20 — $100.00 $1,678.56 $1,426.78 2026-02-18
94660 CPT Cpap 7 7 $1,438.55 — $100.00 $1,150.84 $978.21 2026-02-18
95811 CPT Cpap Titration 7 7 $3,989.00 — $100.00 $3,191.20 $2,712.52 2026-02-18
99285 CPT ER Level 5 7 7 $1,168.85 — $100.00 $935.08 $794.82 2026-02-18
99291 CPT Critical 1st Hour 7 7 $1,849.90 — $100.00 $1,479.92 $1,257.93 2026-02-18
A2002 CPT Mirragen 2.5 X 2.5cm 7 7 $3,700.00 — $931.29 $2,960.00 $2,516.00 2026-02-18
A2007 CPT Restrata Wound Matrix 1.3x2.5 28 7 $4,780.00 — $453.06 $7,968.00 $2,880.00 2026-02-18
A2021 CPT Neomatrix 8mm 35 7 $4,252.00 — $362.45 $5,318.40 $2,126.00 2026-02-18
A2025 CPT Miro3d Wound Matrix 7 7 $5,540.00 — $1,394.42 $4,432.00 $3,767.20 2026-02-18
A2029 CPT Mirotract Wound Matrix 7 7 $5,580.00 — $1,404.49 $4,464.00 $3,794.40 2026-02-18
A7041 HCPCS Pleur Evac Meter 7 7 $1,330.75 — $100.00 $1,064.60 $904.91 2026-02-18
A9500 HCPCS Nm Sestamibi 10 Mci Cardio 7 7 $1,188.70 — $100.00 $950.96 $808.32 2026-02-18
C1602 CPT Cerament G 10ml 14 7 $23,118.00 — $4,150.03 $23,798.40 $13,190.40 2026-02-18
C1713 HCPCS Dynanail Guide Wire 2.4mm 325 7 $1,400.00 — $20.14 $43,200.00 $900.00 2026-02-18
C1727 HCPCS Novasure Device 7 7 $5,152.00 — $100.00 $4,121.60 $3,503.36 2026-02-18
C1753 HCPCS Ivus Eagle Eye Platinum 13 7 $2,940.00 — $100.00 $2,352.00 $1,158.40 2026-02-18
C1760 HCPCS Angioseal Closure St Jude 7 7 $1,400.00 — $100.00 $1,120.00 $952.00 2026-02-18
C1763 HCPCS Morpheus Bone Graft 19 7 $7,800.00 — $100.00 $6,400.00 $4,000.00 2026-02-18
C1771 HCPCS Tvt Sling 7 7 $6,135.84 — $100.00 $4,908.67 $4,172.37 2026-02-18
C1776 HCPCS Rts 1st Mpj Implant 7 7 $7,180.00 — $100.00 $5,744.00 $4,882.40 2026-02-18
C1788 HCPCS Power Port 7 7 $1,160.00 — $100.00 $928.00 $788.80 2026-02-18
C1874 HCPCS Medtronic Des Coronary Stent 7 7 $2,200.00 — $100.00 $1,760.00 $1,496.00 2026-02-18
C1876 HCPCS Abbott Peripheral Stent 13 7 $3,400.00 — $100.00 $2,720.00 $1,648.00 2026-02-18
C1889 HCPCS Verawrap 13 7 $7,108.00 — $100.00 $7,830.40 $5,686.40 2026-02-18
C9353 HCPCS Nerve Cap 7 7 $11,580.00 — $100.00 $9,264.00 $7,874.40 2026-02-18
C9359 HCPCS Nanobone Sbx Putty 2.5ml 31 7 $4,580.00 — $100.00 $6,512.00 $2,252.80 2026-02-18
C9756 HCPCS Indocyanine Green 25mg Vial 7 7 $2,715.50 — $100.00 $2,172.40 $1,846.54 2026-02-18
G0104 HCPCS Colorectal Scr Flex Sig 7 7 $1,419.90 — $100.00 $1,135.92 $993.93 2026-02-18
G0105 HCPCS Colorectal Scr Colon Hirisk 7 7 $2,948.15 — $100.00 $2,358.52 $2,063.71 2026-02-18
G0121 HCPCS Colorectal Scr Colon N/hirisk 7 7 $3,800.05 — $100.00 $3,040.04 $2,660.04 2026-02-18
G0269 HCPCS Closure Device Placement 7 7 $3,683.80 — $100.00 $2,947.04 $2,504.98 2026-02-18
J0248 CPT Remdesivir 100mg Vial 7 7 $4,196.50 — $1,056.26 $3,357.20 $2,853.62 2026-02-18
J0517 HCPCS Fasenra 30mg Syringe 7 7 $33,621.00 — $100.00 $26,896.80 $22,862.28 2026-02-18
J0561 HCPCS Bicillin L-a 1.2mu 7 7 $3,045.00 — $100.00 $2,436.00 $2,070.60 2026-02-18
J0666 CPT Exparel 266mg/20ml Vial 7 7 $3,454.00 — $869.37 $2,763.20 $2,348.72 2026-02-18
J0875 HCPCS Dalvance 500mg Vial 7 7 $10,230.00 — $100.00 $8,184.00 $6,956.40 2026-02-18
J0885 HCPCS Procrit 20,000 Units 20 7 $5,078.00 — $100.00 $8,124.40 $2,547.57 2026-02-18
J0894 HCPCS Dacogen 50mg Vial 7 7 $3,312.00 — $100.00 $2,649.60 $2,252.16 2026-02-18
J0897 HCPCS Prolia 60mg/ml 1ml Inj 13 7 $11,107.50 — $100.00 $15,869.20 $8,886.00 2026-02-18
J1434 CPT Focinvez 150mg Rtu Vial 7 7 $3,251.50 — $818.40 $2,601.20 $2,211.02 2026-02-18
J1437 HCPCS MonoFerric 1000mg/10ml Vial 7 7 $20,192.50 — $100.00 $16,154.00 $13,730.90 2026-02-18
J1439 HCPCS Injectafer 50mg/ml 15ml Vial 7 7 $8,891.00 — $100.00 $7,112.80 $6,045.88 2026-02-18
J1442 HCPCS Neupogen 300mcg 0.5ml Syringe 7 7 $3,170.50 — $100.00 $2,536.40 $2,155.94 2026-02-18
J1459 HCPCS Privigen 5gm/50ml Infusion 19 7 $11,363.15 — $100.00 $18,181.42 $5,720.33 2026-02-18
J1561 HCPCS Gamunex-c 10% 5gm/50ml 19 7 $8,552.55 — $100.00 $13,684.14 $4,305.37 2026-02-18
J1568 HCPCS Octagam 10% 20gm/200ml 13 7 $22,339.00 — $100.00 $17,871.20 $3,302.25 2026-02-18
J1569 HCPCS Gammagard 20gm/200ml 19 7 $10,040.07 — $100.00 $16,064.25 $5,054.21 2026-02-18
J1611 CPT Glucagon 1mg Amp 7 7 $2,156.50 — $542.79 $1,725.20 $1,466.42 2026-02-18
J1930 HCPCS Lanreotide 120mg/0.5ml 13 7 $51,133.00 — $100.00 $43,985.20 $37,387.42 2026-02-18
J1950 HCPCS Lupron 45mg Syr Depot 7 7 $74,048.50 — $100.00 $59,238.80 $50,352.98 2026-02-18
J1980 HCPCS Levsin 0.5mg Amp 7 7 $1,230.50 — $100.00 $984.40 $836.74 2026-02-18
J2182 HCPCS Nucala 100mg 7 7 $21,275.00 — $100.00 $17,020.00 $14,467.00 2026-02-18
J2212 HCPCS Relistor 12mg 7 7 $1,774.50 — $100.00 $1,419.60 $1,206.66 2026-02-18
J2248 HCPCS Mycamine 100mg Vial 7 7 $1,309.00 — $100.00 $1,047.20 $890.12 2026-02-18
J2506 CPT Neulasta 6mg/0.6ml 7 7 $36,903.50 — $9,288.61 $29,522.80 $25,094.38 2026-02-18
J2997 HCPCS Activase Cathflo 2mg 13 7 $1,759.50 — $100.00 $40,482.00 $1,407.60 2026-02-18
J3032 HCPCS Vyepti 100mg Vial 7 7 $11,155.50 — $100.00 $8,924.40 $7,585.74 2026-02-18
J3101 HCPCS Tnkase Kit 7 7 $47,709.50 — $100.00 $38,167.60 $32,442.46 2026-02-18
J7297 HCPCS Liletta 52mg 7 7 $5,625.50 — $100.00 $4,500.40 $3,825.34 2026-02-18
J9022 HCPCS Tecentrig 1200mg Vial 7 7 $68,638.00 — $100.00 $54,910.40 $46,673.84 2026-02-18
J9046 CPT Velcade 3.5mg Vial 7 7 $1,725.00 — $434.18 $1,380.00 $1,173.00 2026-02-18
J9047 HCPCS Kyprolis 30mg 13 7 $9,200.00 — $100.00 $13,704.42 $7,360.00 2026-02-18
J9055 HCPCS Erbitux 100mg Vial 7 7 $4,881.98 — $100.00 $3,905.58 $3,319.75 2026-02-18
J9074 CPT Cyclophosphamide 2gm Vial 7 7 $9,477.00 — $2,385.36 $7,581.60 $6,444.36 2026-02-18
J9075 CPT Cyclophosphamide Gm 1 14 7 $2,229.75 — $442.87 $2,160.00 $1,378.80 2026-02-18
J9119 HCPCS Libtayo 350mg/7ml Vial 7 7 $65,174.50 — $100.00 $52,139.60 $44,318.66 2026-02-18
J9144 CPT Darzalex Faspro 1800mg/15ml Vi 7 7 $60,788.50 — $15,300.47 $48,630.80 $41,336.18 2026-02-18
J9177 HCPCS Padcev 20mg Vial 13 7 $16,151.75 — $100.00 $19,382.20 $12,921.40 2026-02-18
J9202 HCPCS Zoladex 3.6mg Implant 7 7 $6,046.00 — $100.00 $4,836.80 $4,111.28 2026-02-18
J9217 HCPCS Lupron Depot 22.5mg 13 7 $38,875.00 — $100.00 $39,492.00 $31,100.00 2026-02-18
J9228 HCPCS Yervoy 5mg/ml 10ml Vial 7 7 $52,065.00 — $100.00 $41,652.00 $35,404.20 2026-02-18
J9280 HCPCS Mitomycin 40mg 7 7 $7,268.00 — $100.00 $5,814.40 $4,942.24 2026-02-18
J9294 CPT Alimta 500mg Vial 7 7 $4,560.00 — $1,147.75 $3,648.00 $3,100.80 2026-02-18
J9299 HCPCS Opdivo 240m/24ml Vial 13 7 $45,673.20 — $100.00 $36,538.56 $18,269.04 2026-02-18
J9301 HCPCS Gazyva 1000mg 40ml Vial 7 7 $42,694.00 — $100.00 $34,155.20 $29,031.92 2026-02-18
J9303 HCPCS Vectibix 100mg 5ml Vial 13 7 $10,416.99 — $100.00 $35,001.34 $8,333.59 2026-02-18
J9306 HCPCS Perjeta 420mg Vial 7 7 $39,610.00 — $100.00 $31,688.00 $26,934.80 2026-02-18
J9312 HCPCS Rituxan 500mg Vial 7 7 $27,011.52 — $100.00 $21,609.22 $18,367.83 2026-02-18
J9324 CPT Pemrydi 100mg Vial 14 7 $16,952.86 — $1,387.65 $22,714.10 $5,778.45 2026-02-18
J9395 HCPCS Faslodex 250mg Syringe 7 7 $2,300.00 — $100.00 $1,840.00 $1,564.00 2026-02-18
L8699 HCPCS UroLift Implant Cartridge 7 7 $4,100.00 — $100.00 $3,280.00 $2,788.00 2026-02-18
Q0138 HCPCS Feraheme 510mg Vial 7 7 $6,863.50 — $100.00 $5,490.80 $4,667.18 2026-02-18
Q4196 HCPCS Pruaply Am 3x4 7 7 $5,280.00 — $100.00 $4,224.00 $3,590.40 2026-02-18
Q5101 HCPCS Zarxio 300mcg Srn 7 7 $2,606.50 — $100.00 $2,085.20 $1,772.42 2026-02-18
Q5107 HCPCS Mvasi 100mg/4ml 13 7 $3,608.36 — $100.00 $11,546.80 $2,886.69 2026-02-18
Q5111 HCPCS Undenyca 6mg On-body 7 7 $24,006.50 — $100.00 $19,205.20 $16,324.42 2026-02-18
Q5112 HCPCS Ontruzant 420mg Vial 7 7 $21,327.00 — $100.00 $17,061.60 $14,502.36 2026-02-18
Q5125 CPT Releuko 480mcg/0.8ml 14 7 $1,426.50 — $276.24 $1,404.40 $877.88 2026-02-18
Q5126 CPT Alymsys 100mg/4ml Vial 14 7 $12,395.00 — $1,247.55 $15,866.80 $4,478.65 2026-02-18
Q5130 CPT Fylnetra 6mg Vial 7 7 $17,250.00 — $4,341.83 $13,800.00 $11,730.00 2026-02-18
Q5157 CPT Stoboclo 60mg/1ml 7 7 $10,245.00 — $2,578.67 $8,196.00 $6,966.60 2026-02-18
Q5158 CPT Conexxence Denosumab-bnht 60mg 14 7 $14,850.75 — $2,632.91 $15,392.80 $8,368.40 2026-02-18
Q9968 HCPCS Methylene Blue 0.5% 10ml Amp 7 7 $2,227.00 — $100.00 $1,781.60 $1,514.36 2026-02-18
V2790 HCPCS Axolotl Dualgrat 2cmx3cm 13 7 $7,680.00 — $100.00 $6,144.00 $5,120.00 2026-02-18
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