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

WOMANS HOSPITAL

Baton Rouge, LA · CCN 190128 · Rates published

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You selected 93306 (CPT)

HC Tte W/Doppler Complete - Tte Complete Echo

This hospital’s price: $1,934 across 15 payers · range $1,451-$2,273

Source: https://www.womans.org/sites/default/files/2024-12/720652905_womans-hospital_standardcharges.csv · observed 2026-03-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

5,899 distinct procedures filed
36 distinct payers
174,007 rate rows
2026-10-02 last MRF observed
Data quality

120,385 of 174,007 rate rows are consumer-grade (69.2%)

53,622 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 46,716
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,638
percent-of-charges filed in the dollar field — excluded from medians 173
placeholder amount (≤ $0.02) — excluded from medians 76
per-diem day rate — not a per-procedure price 18
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.womans.org/sites/default/files/2026-07/720652905_womans-hospital-foundation_standardcharges.csv
Found on page https://www.womans.org/patient-resources/billing-insurance/hospital-charges
Discovered viaCMS hospital list
Last fetch success · 2026-10-13
Content fingerprint c49ac9c91a84d4a4… · 14,762,011 bytes · first seen 2026-10-13

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
J3399
HCPCS 		Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 15 $1,476,820.20 $2,313,684.98 $1,969,093.60 nat. median
$2,466,282
0.8× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 20 $683,000.51 $683,000.51 $683,000.51 nat. median
$809,217
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 20 $501,529.65 $501,529.65 $501,529.65 nat. median
$646,415
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 20 $472,601.90 $472,601.90 $472,601.90 nat. median
$608,101
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 20 $433,670.68 $433,670.68 $433,670.68 nat. median
$591,650
0.7× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 20 $95,081.03 $95,081.03 $95,081.03 nat. median
$97,020
1.0× median
J9271
HCPCS 		Pembrolizumab (keytruda) 25 Mg/ml Intravenous Solution 15 $29,799.27 $46,685.52 $39,732.36 nat. median
$275
outlier · 144.7×
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 1 $37,736.00 $37,736.00 $37,736.00 nat. median
$50,905
0.7× median
58674
CPT 		Laps Abltj Uterine Fibroids W/Intraop US Gdn 1 $36,551.06 $36,551.06 $36,551.06 nat. median
$10,135
outlier · 3.6×
793
MS_DRG 		Full Term Neonate With Major Problems 1 $26,474.00 $26,474.00 $26,474.00 nat. median
$33,753
0.8× median
20696
CPT 		App Mltpln Uni Xtrnl Fix 1st 20 $24,569.77 $24,569.77 $24,569.77 nat. median
$11,690
outlier · 2.1×
22630
CPT 		Arthrd Pst Tq 1ntrspc Lum 20 $24,569.77 $24,569.77 $24,569.77 nat. median
$16,979
1.4× median
22558
CPT 		Arthrd Ant Ntrbd Min Dsc Lum 20 $24,569.77 $24,569.77 $24,569.77 nat. median
$8,334
outlier · 2.9×
22633
CPT 		Arthrd Cmbn 1ntrspc Lumbar 20 $24,569.77 $24,569.77 $24,569.77 nat. median
$17,527
1.4× median
817
MS_DRG 		Other Antepartum Diagnoses With O.r. Procedures With Mcc 1 $23,473.50 $23,473.50 $23,473.50 nat. median
$21,785
1.1× median
J9306
HCPCS 		Pertuzumab (perjeta) 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 15 $16,911.38 $26,494.50 $22,548.51 nat. median
$75
outlier · 300.3×
19303
CPT 		Mastectomy Simple Complete 2 $4,201.42 $40,802.68 $22,502.05 nat. median
$6,253
outlier · 3.6×
44180
CPT 		Laparoscopy Enterolysis Separate Procedure 1 $20,872.26 $20,872.26 $20,872.26 nat. median
$5,892
outlier · 3.5×
58140
CPT 		Myomectomy 1-4 Myomas W/250 Gm/< Abdominal Appr 1 $20,421.91 $20,421.91 $20,421.91 nat. median
$2,880
outlier · 7.1×
791
MS_DRG 		Prematurity With Major Problems 1 $17,752.12 $17,752.12 $17,752.12 nat. median
$34,598
0.5× median
52287
CPT 		Cystourethroscopy Inj Chemodenervation Bladder 1 $17,310.87 $17,310.87 $17,310.87 nat. median
$2,264
outlier · 7.6×
J7189
HCPCS 		Coagulation Factor Viia Recomb 2 Mg (2,000 Mcg) Intravenous Solution 15 $14,852.54 $19,944.84 $16,974.34 nat. median
$3,598
outlier · 4.7×
J7195
HCPCS 		Coagulation Factor Ix (recomb) 3,000 Unit Intravenous Solution 15 $14,736.96 $19,789.63 $16,842.24 nat. median
$7
outlier · 2316.7×
J1162
HCPCS 		Digoxin Immune Fab 40 Mg Intravenous Solution 15 $12,319.61 $19,300.72 $16,426.14 nat. median
$7,165
outlier · 2.3×
769
MS_DRG 		Postpartum And Post Abortion Diagnoses With O.r. Procedures 1 $16,339.00 $16,339.00 $16,339.00 nat. median
$15,430
1.1× median
58542
CPT 		Laps Supracrv Hysterect 250 Gm/< Rmvl Tube/Ovar 1 $16,236.73 $16,236.73 $16,236.73 nat. median
$9,927
1.6× median
37243
CPT 		Hc Vascular Embolize/Occlude Organ Tumor Infarct - Uterine Fibroid 15 $12,139.20 $19,018.08 $16,185.60 nat. median
$12,450
1.3× median
43280
CPT 		Laps Surg Esopg/Gstr Fundoplasty 1 $15,951.64 $15,951.64 $15,951.64 nat. median
$10,110
1.6× median
43775
CPT 		Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy 3 $11,334.40 $26,951.40 $15,947.06 nat. median
$4,845
outlier · 3.3×
22804
CPT 		Arthrd Pst Dfrm 13+ Vrt Sgm 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$8,834
1.8× median
20982
CPT 		Ablate Bone Tumor(s) Perq 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$10,732
1.5× median
22600
CPT 		Arthrd Pst Tq 1ntrspc Crv 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$7,584
outlier · 2.1×
22808
CPT 		Arthrd Ant Dfrm 2-3 Vrt Sgm 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$8,177
1.9× median
22810
CPT 		Arthrd Ant Dfrm 4-7 Vrt Sgm 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$8,017
2.0× median
22812
CPT 		Arthrd Ant Dfrm 8+ Vrt Sgm 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$8,701
1.8× median
27280
CPT 		Arthr Si Jt Opn B1grf Instrm 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$6,491
outlier · 2.4×
22837
CPT 		Ant Thrc Vrt Body Tethrg 8+ 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$6,802
outlier · 2.3×
27295
CPT 		Amputation Of Leg At Hip 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$5,841
outlier · 2.7×
22802
CPT 		Arthrd Pst Dfrm 7-12 Vrt Sgm 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$9,118
1.7× median
22533
CPT 		Arthrd Lat Xtrcvtry Tq Lmbr 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$8,059
2.0× median
22800
CPT 		Arthrd Pst Dfrm<6 Vrt Sgm 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$7,779
outlier · 2.0×
22586
CPT 		Arthrd Pre-sac Ntrbdy L5-s1 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$8,280
1.9× median
22836
CPT 		Ant Thrc Vrt Body Tethrg <7 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$6,761
outlier · 2.3×
22556
CPT 		Arthrd Ant Ntrbd Min Dsc Thc 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$7,500
outlier · 2.1×
22612
CPT 		Arthrd Pst Tq 1ntrspc Lumbar 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$15,459
1.0× median
22610
CPT 		Arthrd Pst Tq 1ntrspc Thrc 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$7,395
outlier · 2.1×
27290
CPT 		Amputation Of Leg At Hip 20 $15,876.81 $15,876.81 $15,876.81 nat. median
$6,875
outlier · 2.3×
C2616
HCPCS 		Brachytx, Non-str,yttrium-90 20 $15,750.45 $15,750.45 $15,750.45 nat. median
$26,836
0.6× median
J3111
HCPCS 		Romosozumab-aqqg (evenity) 210 Mg/2.34 Ml(105 Mg/1.17 Ml X2) Subcutaneous Syring… 15 $11,686.97 $18,309.58 $15,582.62 nat. median
$696
outlier · 22.4×
792
MS_DRG 		Prematurity Without Major Problems 1 $15,551.00 $15,551.00 $15,551.00 nat. median
$20,578
0.8× median

Other procedures at this hospital

Browse this hospital's 5,899 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3399 HCPCS Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 15 $2,461,367.00 $2,461,367.00 $1,476,820.20 $2,313,684.98 $1,969,093.60 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 28 20 — — $683,000.51 $683,000.51 $683,000.51 2026-10-02
Q2056 HCPCS Ciltacabtagene Car-pos T 28 20 — — $501,529.65 $501,529.65 $501,529.65 2026-10-02
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 28 20 — — $472,601.90 $472,601.90 $472,601.90 2026-10-02
Q2053 HCPCS Brexucabtagene Car Pos T 28 20 — — $433,670.68 $433,670.68 $433,670.68 2026-10-02
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 29 20 — — $95,081.03 $95,081.03 $95,081.03 2026-10-02
J9271 HCPCS Pembrolizumab (keytruda) 25 Mg/ml Intravenous Solution 22 15 $49,665.45 $49,665.45 $29,799.27 $46,685.52 $39,732.36 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 1 1 $102,070.76 $102,070.76 $37,736.00 $37,736.00 $37,736.00 2026-03-01
58674 CPT Laps Abltj Uterine Fibroids W/Intraop US Gdn 1 1 $27,808.09 $27,808.09 $36,551.06 $36,551.06 $36,551.06 2026-03-01
793 MS_DRG Full Term Neonate With Major Problems 1 1 $19,335.25 $19,335.25 $26,474.00 $26,474.00 $26,474.00 2026-03-01
20696 CPT App Mltpln Uni Xtrnl Fix 1st 29 20 — — $24,569.77 $24,569.77 $24,569.77 2026-10-02
22630 CPT Arthrd Pst Tq 1ntrspc Lum 29 20 — — $24,569.77 $24,569.77 $24,569.77 2026-10-02
22558 CPT Arthrd Ant Ntrbd Min Dsc Lum 29 20 — — $24,569.77 $24,569.77 $24,569.77 2026-10-02
22633 CPT Arthrd Cmbn 1ntrspc Lumbar 29 20 — — $24,569.77 $24,569.77 $24,569.77 2026-10-02
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 1 1 $39,921.59 $39,921.59 $23,473.50 $23,473.50 $23,473.50 2026-03-01
J9306 HCPCS Pertuzumab (perjeta) 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 22 15 $28,185.64 $28,185.64 $16,911.38 $26,494.50 $22,548.51 2026-03-01
19303 CPT Mastectomy Simple Complete 2 2 $55,445.49 $55,445.49 $4,201.42 $40,802.68 $22,502.05 2026-03-01
44180 CPT Laparoscopy Enterolysis Separate Procedure 1 1 $48,036.37 $48,036.37 $20,872.26 $20,872.26 $20,872.26 2026-03-01
58140 CPT Myomectomy 1-4 Myomas W/250 Gm/< Abdominal Appr 1 1 $26,515.14 $26,515.14 $20,421.91 $20,421.91 $20,421.91 2026-03-01
791 MS_DRG Prematurity With Major Problems 1 1 $48,305.06 $48,305.06 $17,752.12 $17,752.12 $17,752.12 2026-03-01
52287 CPT Cystourethroscopy Inj Chemodenervation Bladder 1 1 $16,716.45 $16,716.45 $17,310.87 $17,310.87 $17,310.87 2026-03-01
J7189 HCPCS Coagulation Factor Viia Recomb 2 Mg (2,000 Mcg) Intravenous Solution 19 15 $21,217.92 $21,217.92 $14,852.54 $19,944.84 $16,974.34 2026-03-01
J7195 HCPCS Coagulation Factor Ix (recomb) 3,000 Unit Intravenous Solution 19 15 $21,052.80 $21,052.80 $14,736.96 $19,789.63 $16,842.24 2026-03-01
J1162 HCPCS Digoxin Immune Fab 40 Mg Intravenous Solution 20 15 $20,532.68 $20,532.68 $12,319.61 $19,300.72 $16,426.14 2026-03-01
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 1 1 $23,630.05 $23,630.05 $16,339.00 $16,339.00 $16,339.00 2026-03-01
58542 CPT Laps Supracrv Hysterect 250 Gm/< Rmvl Tube/Ovar 1 1 $90,848.86 $90,848.86 $16,236.73 $16,236.73 $16,236.73 2026-03-01
37243 CPT Hc Vascular Embolize/Occlude Organ Tumor Infarct - Uterine Fibroid 21 15 $37,168.28 $37,168.28 $12,139.20 $19,018.08 $16,185.60 2026-03-01
43280 CPT Laps Surg Esopg/Gstr Fundoplasty 1 1 $61,831.82 $61,831.82 $15,951.64 $15,951.64 $15,951.64 2026-03-01
43775 CPT Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy 4 3 $46,562.96 $46,562.96 $11,334.40 $26,951.40 $15,947.06 2026-03-01
22610 CPT Arthrd Pst Tq 1ntrspc Thrc 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22808 CPT Arthrd Ant Dfrm 2-3 Vrt Sgm 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22600 CPT Arthrd Pst Tq 1ntrspc Crv 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22812 CPT Arthrd Ant Dfrm 8+ Vrt Sgm 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22810 CPT Arthrd Ant Dfrm 4-7 Vrt Sgm 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
27295 CPT Amputation Of Leg At Hip 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22837 CPT Ant Thrc Vrt Body Tethrg 8+ 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22804 CPT Arthrd Pst Dfrm 13+ Vrt Sgm 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22533 CPT Arthrd Lat Xtrcvtry Tq Lmbr 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22802 CPT Arthrd Pst Dfrm 7-12 Vrt Sgm 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
27280 CPT Arthr Si Jt Opn B1grf Instrm 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22586 CPT Arthrd Pre-sac Ntrbdy L5-s1 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
27290 CPT Amputation Of Leg At Hip 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22556 CPT Arthrd Ant Ntrbd Min Dsc Thc 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22800 CPT Arthrd Pst Dfrm<6 Vrt Sgm 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
22836 CPT Ant Thrc Vrt Body Tethrg <7 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
20982 CPT Ablate Bone Tumor(s) Perq 29 20 — — $15,876.81 $15,876.81 $15,876.81 2026-10-02
C2616 HCPCS Brachytx, Non-str,yttrium-90 28 20 — — $15,750.45 $15,750.45 $15,750.45 2026-10-02
J3111 HCPCS Romosozumab-aqqg (evenity) 210 Mg/2.34 Ml(105 Mg/1.17 Ml X2) Subcutaneous Syring… 20 15 $19,478.28 $19,478.28 $11,686.97 $18,309.58 $15,582.62 2026-03-01
792 MS_DRG Prematurity Without Major Problems 1 1 $5,701.75 $5,701.75 $15,551.00 $15,551.00 $15,551.00 2026-03-01
C9758 HCPCS Blind Interatrial Shunt Ide 29 20 — — $15,510.69 $15,510.69 $15,510.69 2026-10-02
C9782 HCPCS Blind Myocar Trpl Bon Marrow 29 20 — — $15,510.69 $15,510.69 $15,510.69 2026-10-02
C8005 HCPCS Bronchoscopy, Rigid Or Flexible, Non-thermal Transbronchial Ablation Of Lesion(s… 29 20 — — $15,510.69 $15,510.69 $15,510.69 2026-10-02
37242 CPT Hc Vascular Embolization Or Occlusion Arterial Rs&I 19 15 $34,196.10 $34,196.10 $11,532.00 $18,066.80 $15,376.00 2026-03-01
57425 CPT Laparoscopy Colpopexy Suspension Vaginal Apex 4 3 $54,530.01 $54,530.01 $12,159.79 $15,826.06 $14,774.96 2026-03-01
908 MS_DRG Other O.r. Procedures For Injuries With Cc 1 1 $36,916.51 $36,916.51 $14,614.00 $14,614.00 $14,614.00 2026-03-01
37244 CPT Hc Vasc Embolization 19 15 $17,750.00 $17,750.00 $10,650.00 $16,685.00 $14,200.00 2026-03-01
C1767 HCPCS Interstim X Ssmri Amer System 19 15 $16,940.00 $16,940.00 $11,858.00 $15,923.60 $13,552.00 2026-03-01
11422 CPT Exc B9 Lesion Mrgn Xcp Sk Tg S/n/h/f/g 1.1-2.0cm 1 1 $20,299.80 $20,299.80 $13,377.30 $13,377.30 $13,377.30 2026-03-01
37241 CPT Hc Vascular Embolization Or Occlusion Venous Rs&I 19 15 $16,681.00 $16,681.00 $10,008.60 $15,680.14 $13,344.80 2026-03-01
58661 CPT Laparoscopy W/Rmvl Adnexal Structures 4 3 $18,327.97 $18,327.97 $7,337.84 $25,576.46 $13,298.34 2026-03-01
58260 CPT Vaginal Hysterectomy Uterus 250 Gm/< 1 1 $24,139.34 $24,139.34 $12,170.61 $12,170.61 $12,170.61 2026-03-01
58262 CPT Vag Hyst 250 Gm/< W/Rmvl Tube&/Ovary 2 2 $41,607.30 $41,607.30 $8,643.20 $15,510.40 $12,076.80 2026-03-01
J1437 HCPCS Ferric Derisomaltose 100 Mg Iron/ml Intravenous Solution 20 15 $15,076.22 $15,076.22 $9,045.73 $14,171.65 $12,060.98 2026-03-01
55882 CPT Ablation Of Prostate Tissue, Transurethral, Using Thermal Ultrasound, Including … 29 20 — — $11,946.63 $11,946.63 $11,946.63 2026-10-02
818 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Cc 1 1 $30,452.20 $30,452.20 $11,925.75 $11,925.75 $11,925.75 2026-03-01
58573 CPT Laparoscopy Tot Hysterectomy >250 G W/Tube/Ovar 5 3 $34,012.95 $34,012.95 $5,221.23 $15,442.32 $11,849.60 2026-03-01
Q5119 HCPCS Rituximab-pvvr 10 Mg/ml Intravenous Solution 20 15 $14,794.76 $14,794.76 $8,876.86 $13,907.07 $11,835.81 2026-03-01
J2426 HCPCS Paliperidone Palmitate 234 Mg/1.5 Ml Intramuscular Syringe 20 15 $14,733.46 $14,733.46 $8,840.08 $13,849.45 $11,786.77 2026-03-01
59160 CPT Curettage Postpartum 2 2 $7,333.16 $7,333.16 $11,011.20 $12,520.80 $11,766.00 2026-03-01
24931 CPT Amputate Upper Arm & Implant 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
22590 CPT Arthrd Pst Tq Craniocervical 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
C9781 HCPCS Arthro/shoul Surg; W/spacer 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
22532 CPT Arthrd Lat Xtrcvtry Tq Thrc 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
24920 CPT Amputation Of Upper Arm 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
27286 CPT Arthrd Hip Jt Sbtrchc Osteot 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
22595 CPT Arthrd Pst Tq Atlas-axis 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
24900 CPT Amputation Of Upper Arm 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
27284 CPT Arthrodesis Hip Joint 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
29867 CPT Allgrft Implnt Knee W/scope 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
22548 CPT Arthrd Ant Toral/xoral C1-c2 29 20 — — $11,625.38 $11,625.38 $11,625.38 2026-10-02
58570 CPT Laparoscopy W Total Hysterectomy Uterus 250 Gm/< 2 2 $26,731.07 $26,731.07 $10,990.48 $12,076.80 $11,533.64 2026-03-01
56740 CPT Excision Bartholins Gland Or Cyst 1 1 $23,420.15 $23,420.15 $11,476.00 $11,476.00 $11,476.00 2026-03-01
47562 CPT Laparoscopy Surg Cholecystectomy 4 3 $21,977.07 $21,977.07 $4,436.37 $12,480.00 $11,252.80 2026-03-01
56515 CPT Destruction Lesions Vulva Extensive 1 1 $17,209.68 $17,209.68 $11,181.18 $11,181.18 $11,181.18 2026-03-01
58552 CPT Laps W/Vag Hysterect 250 Gm/&Rmvl Tube&/Ovaries 3 3 $28,124.93 $28,124.93 $9,495.58 $12,076.80 $11,129.60 2026-03-01
58571 CPT Laps Total Hysterect 250 Gm/< W/Rmvl Tube/Ovary 8 5 $31,602.29 $31,602.29 $9,054.64 $14,717.11 $11,128.33 2026-03-01
44970 CPT Laparoscopic Appendectomy 1 1 $24,572.79 $24,572.79 $11,011.20 $11,011.20 $11,011.20 2026-03-01
C9783 HCPCS Blind Cor Sinus Reducer Impl 29 20 — — $10,453.23 $10,453.23 $10,453.23 2026-10-02
38570 CPT Laps Surg Retroperitoneal Lymph Node Bx 1/Mlt 4 3 $48,451.29 $48,451.29 $6,552.70 $25,133.44 $10,344.88 2026-03-01
47490 CPT Hc Ir Cholecystostomy 19 15 $12,494.00 $12,494.00 $7,496.40 $11,744.36 $9,995.20 2026-03-01
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc 1 1 $49,233.81 $49,233.81 $9,872.00 $9,872.00 $9,872.00 2026-03-01
57250 CPT Post Colporrhaphy Rectocele W/wo Perineorrhaphy 4 3 $39,692.80 $39,692.80 $6,926.69 $15,826.09 $9,645.08 2026-03-01
11622 CPT Excision Malignant Lesion S/n/h/f/g 1.1-2.0 Cm 2 2 $15,861.91 $15,861.91 $9,353.60 $9,763.02 $9,558.31 2026-03-01
58560 CPT Hysteroscopy Div/Rescj Intrauterine Septum 1 1 $16,259.40 $16,259.40 $9,445.14 $9,445.14 $9,445.14 2026-03-01
49593 CPT Rpr Aa Hernia 1st 3-10 Cm Reducible 1 1 $35,305.15 $35,305.15 $9,404.85 $9,404.85 $9,404.85 2026-03-01
58545 CPT Laps Myomectomy Exc 1-4 Myomas 250 Gm/< 2 2 $38,157.28 $38,157.28 $8,951.61 $9,853.20 $9,402.41 2026-03-01
SUP-0014373 CDM Codman Hakim Programable Valve 19 15 $11,637.89 $11,637.89 $8,146.52 $10,939.62 $9,310.31 2026-03-01
909 MS_DRG Other O.r. Procedures For Injuries Without Cc/mcc 1 1 $22,406.72 $22,406.72 $9,113.00 $9,113.00 $9,113.00 2026-03-01
57282 CPT Colpopexy Vaginal Extraperitoneal Approach 1 1 $39,692.80 $39,692.80 $9,079.99 $9,079.99 $9,079.99 2026-03-01
831 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Mcc 1 1 $13,057.01 $13,057.01 $8,961.00 $8,961.00 $8,961.00 2026-03-01
43282 CPT Laps Rpr Paraesphgl Hrna Incl Fundplsty W/Mesh 1 1 $32,765.99 $32,765.99 $8,845.03 $8,845.03 $8,845.03 2026-03-01
27279 CPT Arthrd Si Jt Perq/min Nvas 22 16 — — $8,660.84 $8,660.84 $8,660.84 2026-10-02
C9792 HCPCS Blind/nonblind Trans Atrial 29 20 — — $8,641.87 $8,641.87 $8,641.87 2026-10-02
J7192 HCPCS Antihemophilic Factor Viii, Full Length 1,500 (+/-) Unit IV Solution 57 15 $10,800.85 $10,800.85 $670.80 $16,165.67 $8,640.68 2026-03-01
950T OTHER Ablation Of Benign Prostate Tissue, Transrectal, With High Intensity-focused Ult… 29 20 — — $8,571.85 $8,571.85 $8,571.85 2026-10-02
46260 CPT Hemorrhoidectomy Int & Xtrnl 2/> Column/Gro 3 3 $16,020.69 $16,020.69 $7,340.80 $10,016.64 $8,524.81 2026-03-01
49591 CPT Rpr Aa Hernia 1st < 3 Cm Reducible 2 2 $24,649.17 $24,649.17 $6,504.41 $10,542.41 $8,523.41 2026-03-01
36582 CPT Hc Replace Tunneled Cv Cath 19 15 $10,605.00 $10,605.00 $6,363.00 $9,968.70 $8,484.00 2026-03-01
37191 CPT Hc Ins Intrvas Vc Filtr W/wo Vas Acs Vsl Selxn Rs&I 19 15 $29,793.69 $29,793.69 $6,301.80 $9,872.82 $8,402.40 2026-03-01
0211U CPT Hc Caris - Mi Tumor Cancer Seek 19 15 $10,455.00 $10,455.00 $6,273.00 $9,827.70 $8,364.00 2026-03-01
19125 CPT Exc Breast Les Preop Plmt Rad Marker Open 1 Les 1 1 $14,168.53 $14,168.53 $8,347.20 $8,347.20 $8,347.20 2026-03-01
58558 CPT Hc Pbb Hysteroscopy,W/Endo Bx 25 15 $10,223.94 $10,223.94 $3,139.57 $9,933.92 $8,295.88 2026-03-01
46288 CPT Clsr Anal Fstl W/Rct Advmnt Flap 1 1 $20,254.27 $20,254.27 $8,208.08 $8,208.08 $8,208.08 2026-03-01
49329 CPT Unlisted Laparoscopy Px Abd Pertoneum & Omentum 2 2 $31,060.54 $31,060.54 $4,262.41 $11,880.20 $8,071.31 2026-03-01
59151 CPT Laps Tx Ectopic Preg W/Salping&/Oophorectomy 3 3 $18,767.36 $18,767.36 $7,222.40 $16,789.00 $8,068.96 2026-03-01
442T OTHER Abltj Perc Plex/trncl Nrv 29 20 — — $7,946.50 $7,946.50 $7,946.50 2026-10-02
57410 CPT Pelvic Examination W/Anesthesia Other Than Local 2 2 $9,232.13 $9,232.13 $4,451.84 $11,239.25 $7,845.55 2026-03-01
57200 CPT Colporrhaphy Suture Injury Vagina 2 1 $48,548.38 $48,548.38 $5,920.00 $9,209.21 $7,564.60 2026-03-01
57260 CPT Cmbnd Anterpost Colporraphy W/Cysto 2 2 $51,964.82 $51,964.82 $5,000.00 $9,923.90 $7,461.95 2026-03-01
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 1 1 $34,703.58 $34,703.58 $7,427.00 $7,427.00 $7,427.00 2026-03-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 1 1 $23,176.85 $23,176.85 $7,384.00 $7,384.00 $7,384.00 2026-03-01
57288 CPT Sling Operation Stress Incontinence 3 3 $43,129.13 $43,129.13 $4,499.20 $14,956.50 $7,234.24 2026-03-01
59821 CPT Tx Missed Abortion Second Trimester Surgical 3 3 $14,481.77 $14,481.77 $6,742.15 $13,799.88 $7,104.00 2026-03-01
93600 CPT Bundle Of His Recording 29 20 — — $7,062.57 $7,062.57 $7,062.57 2026-10-02
93650 CPT Ablate Heart Dysrhythm Focus 29 20 — — $7,062.57 $7,062.57 $7,062.57 2026-10-02
11400 CPT Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L 0.5 Cm/< 1 1 $29,607.68 $29,607.68 $6,926.41 $6,926.41 $6,926.41 2026-03-01
SUP-0014555 CDM Codman Hakim Valve Small 19 15 $8,633.80 $8,633.80 $5,180.28 $8,115.77 $6,907.04 2026-03-01
58561 CPT Hysteroscopy Removal Leiomyomata 3 2 $17,834.40 $17,834.40 $5,008.32 $10,182.40 $6,816.88 2026-03-01
11406 CPT Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L >4.0 Cm 3 3 $28,319.01 $28,319.01 $5,979.20 $14,048.94 $6,664.60 2026-03-01
58562 CPT Hc Pbb Hysteroscopy,Rmv Fb 22 15 $8,741.20 $8,741.20 $3,670.40 $7,830.20 $6,664.00 2026-03-01
819 MS_DRG Other Antepartum Diagnoses With O.r. Procedures Without Cc/mcc 1 1 $37,057.63 $37,057.63 $6,663.75 $6,663.75 $6,663.75 2026-03-01
56620 CPT Vulvectomy Simple Partial 2 2 $17,707.20 $17,707.20 $6,630.41 $6,677.76 $6,654.09 2026-03-01
45172 CPT Exc Rct Tum Incl Muscularis Propria 1 1 $12,710.01 $12,710.01 $6,630.40 $6,630.40 $6,630.40 2026-03-01
57513 CPT Cautery Cervix Laser Ablation 1 1 $8,594.40 $8,594.40 $6,630.40 $6,630.40 $6,630.40 2026-03-01
J7187 HCPCS Antihemophilic Factor-vwf 1,000 Unit-2,400 Unit Intravenous Solution 38 15 $8,883.14 $8,883.14 $1,862.17 $13,782.90 $6,590.62 2026-03-01
24930 CPT Amputation Follow-up Surgery 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
20973 CPT Bone/skin Graft Great Toe 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
29866 CPT Autgrft Implnt Knee W/scope 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
27027 CPT Buttock Fasciotomy 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
20972 CPT Bone/skin Graft Metatarsal 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
20969 CPT Bone/skin Graft Microvasc 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
27412 CPT Autochondrocyte Implant Knee 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
25900 CPT Amputation Of Forearm 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
27880 CPT Amputation Of Lower Leg 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
20970 CPT Bone/skin Graft Iliac Crest 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
25915 CPT Amputation Of Forearm 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
25909 CPT Amputation Follow-up Surgery 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
25905 CPT Amputation Of Forearm 29 20 — — $6,570.48 $6,570.48 $6,570.48 2026-10-02
22554 CPT Arthrd Ant Ntrbd Min Dsc Crv 22 16 — — $6,535.13 $6,535.13 $6,535.13 2026-10-02
22551 CPT Arthrd Ant Ntrbdy Cervical 22 16 — — $6,535.13 $6,535.13 $6,535.13 2026-10-02
37193 CPT Hc Rtrvl Intrvas Vc Filtr W/wo Acs Vsl Selxn Rs&I 19 15 $8,144.00 $8,144.00 $4,886.40 $7,655.36 $6,515.20 2026-03-01
11403 CPT Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L 2.1-3.0 Cm 1 1 $27,563.32 $27,563.32 $6,512.00 $6,512.00 $6,512.00 2026-03-01
36563 CPT Hc Insert Tunneled Cv Cath With Pump 19 15 $8,113.00 $8,113.00 $4,867.80 $7,626.22 $6,490.40 2026-03-01
59320 CPT Cerclage Cervix Pregnancy Vaginal 2 2 $11,190.38 $11,190.38 $6,156.80 $6,630.41 $6,393.60 2026-03-01
31661 CPT Bronch Thermoplsty 2/> Lobes 29 20 — — $6,390.51 $6,390.51 $6,390.51 2026-10-02
31660 CPT Bronch Thermoplsty 1 Lobe 29 20 — — $6,390.51 $6,390.51 $6,390.51 2026-10-02
31626 CPT Bronchoscopy W/markers 29 20 — — $6,390.51 $6,390.51 $6,390.51 2026-10-02
23802 CPT Arthrd Glenohumeral Jt W/grf 22 16 — — $6,349.52 $6,349.52 $6,349.52 2026-10-02
57287 CPT Rmvl/Revj Sling Stress Incontinence 1 1 $14,735.67 $14,735.67 $6,331.81 $6,331.81 $6,331.81 2026-03-01
57520 CPT Conization Cervix W/wo D&c Rpr Knife/Laser 22 15 $9,396.08 $9,396.08 $4,726.20 $7,404.38 $6,301.60 2026-03-01
49418 CPT Hc Insertion Tunnel Intraperitoneal Cath W Image Guidance 19 15 $7,737.00 $7,737.00 $4,642.20 $7,272.78 $6,189.60 2026-03-01
57155 CPT Insertion Uterine Tandem&/Vaginal Ovoids 1 1 $34,245.02 $34,245.02 $6,180.48 $6,180.48 $6,180.48 2026-03-01
50693 CPT Hc Plmt Urtrl Stent Prq Pre-existing Nfros Tract 19 15 $7,647.00 $7,647.00 $4,588.20 $7,188.18 $6,117.60 2026-03-01
SUP-0015977 CDM Certas Plus Programmable Valve Crts Sm Il Sg Vlv Only 19 15 $7,609.95 $7,609.95 $4,565.97 $7,153.35 $6,087.96 2026-03-01
19120 CPT Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion 2 2 $12,867.99 $12,867.99 $4,617.55 $7,303.80 $5,960.68 2026-03-01
J0875 HCPCS Dalbavancin Hcl 500 Mg/25ml IV (wet Solr Vial) 19 15 $7,344.27 $7,344.27 $4,406.56 $6,903.61 $5,875.42 2026-03-01
14301 CPT Adjnt Tis Trnsfr/Reargmt Any Area 30.1-60 Sq Cm 3 3 $35,604.15 $35,604.15 $3,338.88 $15,000.00 $5,820.35 2026-03-01
SUP-0015992 CDM Certas Plus Programmable Valve 19 15 $7,150.95 $7,150.95 $4,290.57 $6,721.89 $5,720.76 2026-03-01
57135 CPT Excision Vaginal Cyst/Tumor 2 2 $11,269.06 $11,269.06 $3,433.60 $7,929.84 $5,681.72 2026-03-01
58555 CPT Hc Pbb Hysteroscopy,Dx,Sep Proc 20 15 $8,285.85 $8,285.85 $4,214.40 $6,602.56 $5,619.20 2026-03-01
50694 CPT Hc Plmt Urtrl Stnt Prq New Acess Without Sep Nfros Cath 19 15 $7,001.00 $7,001.00 $4,200.60 $6,580.94 $5,600.80 2026-03-01
49322 CPT Laps Surg W/Aspir Cavity/Cyst Single/Multiple 1 1 $52,259.05 $52,259.05 $5,564.80 $5,564.80 $5,564.80 2026-03-01
78815 CPT Hc PET Image W/ct Skull-thigh - Pt/CT Bone Skull Base To Mid Thigh 19 15 $6,947.00 $6,947.00 $4,168.20 $6,530.18 $5,557.60 2026-03-01
47556 CPT Biliary Endoscopy Thru Skin 22 16 — — $5,535.08 $5,535.08 $5,535.08 2026-10-02
59812 CPT Hc Tx Incomplete Abortion Any Trimester Surgical 25 15 $7,788.67 $7,788.67 $2,960.00 $6,448.40 $5,488.00 2026-03-01
56700 CPT Partial Hymenectomy Or Revision Hymenal Ring 2 2 $8,650.11 $8,650.11 $4,972.80 $5,982.16 $5,477.48 2026-03-01
32998 CPT Ablate Pulm Tumor Perq Rf 29 20 — — $5,474.21 $5,474.21 $5,474.21 2026-10-02
36561 CPT Hc Ir-insert Venous Access Device 24 15 $9,176.30 $9,176.30 $4,104.00 $7,024.11 $5,472.00 2026-03-01
36555 CPT Hc Insert Non-tunnel Cv Cath < 5 Y/o 19 15 $6,824.00 $6,824.00 $4,094.40 $6,414.56 $5,459.20 2026-03-01
58670 CPT Laparoscopy Fulguration Oviducts 1 1 $13,680.53 $13,680.53 $5,446.41 $5,446.41 $5,446.41 2026-03-01
D7671 HCPCS Alveolus Open Reduction 29 20 — — $5,360.39 $5,360.39 $5,360.39 2026-10-02
58400 CPT Uterine Suspension W/wo Shortening Ligaments Spx 1 1 $28,661.19 $28,661.19 $5,345.22 $5,345.22 $5,345.22 2026-03-01
J7168 HCPCS Human Prothrombin Complex,4-factor 500 Unit (400-620 Unit) IV Solution 38 15 $7,492.32 $7,492.32 $2,996.93 $9,390.37 $5,344.52 2026-03-01
58563 CPT Hysteroscopy Endometrial Ablation 7 5 $10,372.00 $10,372.00 $4,045.29 $13,781.76 $5,328.00 2026-03-01
51715 CPT Ndsc Njx Implt Matrl Urt&/Bldr Nck 2 2 $31,026.99 $31,026.99 $2,639.48 $7,983.76 $5,311.62 2026-03-01
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 1 1 $8,866.24 $8,866.24 $5,306.00 $5,306.00 $5,306.00 2026-03-01
50382 CPT Hc Pbb Change Ureter Stent, Percut 19 15 $6,590.00 $6,590.00 $3,954.00 $6,194.60 $5,272.00 2026-03-01
832 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Cc 1 1 $12,180.69 $12,180.69 $5,253.75 $5,253.75 $5,253.75 2026-03-01
78816 CPT Hc PET Imaging For CT Attenuation Whole Body - Pt/CT Bone Whole Body 19 15 $6,545.00 $6,545.00 $3,927.00 $6,152.30 $5,236.00 2026-03-01
45100 CPT Bx Anorectal Wall Anal Approach 20 15 $6,530.85 $6,530.85 $901.18 $6,143.84 $5,228.80 2026-03-01
58353 CPT Endometrial Abltj Thermal Without Hysteroscopic Guid 2 2 $7,430.09 $7,430.09 $2,042.40 $8,182.94 $5,112.67 2026-03-01
J1439 HCPCS Ferric Carboxymaltose (injectafer) 50 Mg Iron/ml Intravenous Solution 19 15 $6,382.79 $6,382.79 $3,829.67 $5,999.82 $5,106.23 2026-03-01
38900 CPT Intraop Sentinel Lymph Node Id With Contrast Injection 6 4 $42,752.87 $42,752.87 $3,907.20 $7,297.22 $5,099.67 2026-03-01
47554 CPT Biliary Endoscopy Thru Skin 22 16 — — $5,087.80 $5,087.80 $5,087.80 2026-10-02
32994 CPT Ablate Pulm Tumor Perq Crybl 22 16 — — $5,087.80 $5,087.80 $5,087.80 2026-10-02
58900 CPT Hc US Guided Ovarian Biopsy 19 15 $6,359.00 $6,359.00 $3,815.40 $5,977.46 $5,087.20 2026-03-01
58800 CPT Hc US-ovarian Cyst Puncture 19 15 $6,359.00 $6,359.00 $3,815.40 $5,977.46 $5,087.20 2026-03-01
57461 CPT Hc Pbb Colposcopy,Cervix W/Adj Vag,W/Loop Coniz 20 15 $6,460.50 $6,460.50 $3,815.40 $5,977.46 $5,087.20 2026-03-01
59412 CPT Hc External Cephalic Version 20 15 $7,963.11 $7,963.11 $3,273.09 $5,977.46 $5,087.20 2026-03-01
SUP-0017803 CDM Galaflex Gflt0019 Lite 19cm 19 15 $6,300.00 $6,300.00 $3,780.00 $5,922.00 $5,040.00 2026-03-01
75726 CPT Artery X-rays Abdomen 29 20 — — $5,038.62 $5,038.62 $5,038.62 2026-10-02
75705 CPT Artery X-rays Spine 29 20 — — $5,038.62 $5,038.62 $5,038.62 2026-10-02
36556 CPT Hc Insert Non-tunnel Cv Cath 19 15 $6,295.00 $6,295.00 $3,777.00 $5,917.30 $5,036.00 2026-03-01
15777 CPT Acellular Derm Matrix Implt 3 3 $59,482.27 $59,482.27 $4,201.42 $9,923.90 $5,015.68 2026-10-02
11420 CPT Exc B9 Lesion Mrgn Xcp Sk Tg S/n/h/f/g 0.5 Cm/< 1 1 $12,777.94 $12,777.94 $5,000.00 $5,000.00 $5,000.00 2026-03-01
75736 CPT Hc Angio Pelvis - Ir Angio Pelvic Selective Or Supraselective 19 15 $6,166.00 $6,166.00 $3,699.60 $5,796.04 $4,932.80 2026-03-01
55880 CPT Abltj Mal Prst8 Tiss Hifu 22 16 — — $4,822.76 $4,822.76 $4,822.76 2026-10-02
794 MS_DRG Neonate With Other Significant Problems 1 1 $4,411.27 $4,411.27 $4,791.07 $4,791.07 $4,791.07 2026-03-01
32550 CPT Hc Insertion Indwelling Tunneled Pleural Catheter 19 15 $20,287.72 $20,287.72 $3,592.80 $5,628.72 $4,790.40 2026-03-01
50695 CPT Hc Plmt Urtrl Stent Prq New Access W/Sep Nfros Cath 19 15 $5,875.00 $5,875.00 $3,525.00 $5,522.50 $4,700.00 2026-03-01
14302 CPT Adjt Tis Trnsfr/Reargmt Defec Ea Addl 30 Sqcm 3 3 $33,348.71 $33,348.71 $3,338.88 $11,066.45 $4,657.06 2026-03-01
31603 CPT Hc Tracheostomy,Emerg,Xtrach 19 15 $5,789.00 $5,789.00 $3,473.40 $5,441.66 $4,631.20 2026-03-01
31600 CPT Hc Tracheostomy, Planned 19 15 $5,789.00 $5,789.00 $3,473.40 $5,441.66 $4,631.20 2026-03-01
58120 CPT Dilation & Curettage Dx&/Ther Nonobstetric 2 2 $11,617.38 $11,617.38 $4,262.40 $4,972.80 $4,617.60 2026-03-01
58662 CPT Laps Fulg/Exc Ovary Viscera/Peritoneal Surface 6 4 $25,572.92 $25,572.92 $3,479.58 $8,347.20 $4,588.80 2026-03-01
58679 CPT Unlisted Laparoscopy Procedure Oviduct Ovary 1 1 $27,641.39 $27,641.39 $4,584.66 $4,584.66 $4,584.66 2026-03-01
38222 CPT Hc Ir Bone Marrow Aspiration & Biopsy 19 15 $8,565.26 $8,565.26 $3,434.40 $5,380.56 $4,579.20 2026-03-01
21501 CPT I&d Deep Absc/Hmtma Soft Tissue Neck/Thorax 1 1 $14,420.32 $14,420.32 $4,558.40 $4,558.40 $4,558.40 2026-03-01
51840 CPT Attach Bladder/urethra 29 20 — — $4,529.70 $4,529.70 $4,529.70 2026-10-02
57120 CPT Closure Of Vagina 29 20 $37,996.75 $37,996.75 $4,529.70 $4,529.70 $4,529.70 2026-10-02
J7178 HCPCS Fibrinogen 1 Gram (900 Mg-1,300 Mg) Intravenous Solution 19 15 $5,655.36 $5,655.36 $3,393.22 $5,316.04 $4,524.29 2026-03-01
15771 CPT Grafting Of Autologous Fat By Lipo 50 Cc Or Less 3 3 $38,721.55 $38,721.55 $4,049.28 $4,657.06 $4,494.76 2026-03-01
E2513 HCPCS Accessory For Speech Generating Device, Electromyographic Sensor 29 20 — — $4,491.00 $4,491.00 $4,491.00 2026-10-02
57720 CPT Trachelorrhaphy Plstc Rpr Uterine Cervix Vag 1 1 $26,338.50 $26,338.50 $4,451.84 $4,451.84 $4,451.84 2026-03-01
56441 CPT Hc Pbb Lysis Of Labial Lesion(S) 19 15 $10,297.30 $10,297.30 $3,334.20 $5,223.58 $4,445.60 2026-03-01
36558 CPT Hc Insert Tunneled Cv Cath Without Port Or Pump 19 15 $5,548.00 $5,548.00 $3,328.80 $5,215.12 $4,438.40 2026-03-01
C1778 HCPCS Lead 978b133 Istm Ii 33cm Ssmr 19 15 $5,425.00 $5,425.00 $3,255.00 $5,099.50 $4,340.00 2026-03-01
J1950 HCPCS Leuprolide 3.75 Mg Intramuscular Syringe Kit 38 15 $6,200.00 $6,200.00 $2,160.00 $8,272.00 $4,332.00 2026-03-01
J0716 HCPCS Centruroides Immune F(ab) 28 20 — — $4,318.00 $4,318.00 $4,318.00 2026-10-02
50432 CPT Hc Plmt Nephrostomy Cath Prq New Access Rs&I 19 15 $9,157.55 $9,157.55 $3,219.00 $5,043.10 $4,292.00 2026-03-01
78814 CPT Hc PET Imaging CT For Attenuation Limited Area 19 15 $5,342.00 $5,342.00 $3,205.20 $5,021.48 $4,273.60 2026-03-01
19357 CPT Tissue Expander Placement Breast Reconstruction 1 1 $57,028.61 $57,028.61 $4,201.42 $4,201.42 $4,201.42 2026-03-01
50433 CPT Hc Plmt Nephroureteral Cath Prq New Access Rs&I 19 15 $5,230.00 $5,230.00 $3,138.00 $4,916.20 $4,184.00 2026-03-01
J0480 HCPCS Basiliximab 28 20 — — $4,153.96 $4,153.96 $4,153.96 2026-10-02
45390 CPT Colonoscopy Flx W/Endoscopic Mucosal Resection 19 15 $7,328.93 $7,328.93 $3,068.40 $4,807.16 $4,091.20 2026-03-01
SUP-0017222 CDM Radio Freq Ablation Handpiece 19 15 $5,068.00 $5,068.00 $3,040.80 $4,763.92 $4,054.40 2026-03-01
19325 CPT Breast Augmentation W/implt 21 15 $30,043.72 $30,043.72 $4,040.41 $4,040.41 $4,040.41 2026-10-02
SUP-0016365 CDM Trufill Liquid Embolic 1 Gram 19 15 $5,034.96 $5,034.96 $3,020.98 $4,732.86 $4,027.97 2026-03-01
58578 CPT Unlisted Laparoscopy Procedure Uterus 1 1 $38,592.64 $38,592.64 $4,025.60 $4,025.60 $4,025.60 2026-03-01
77373 CPT Hc Stereotact Body Radiation Del 19 15 $5,004.00 $5,004.00 $3,002.40 $4,703.76 $4,003.20 2026-03-01
56440 CPT Hc Pbb Marsupialization Bartholins Gland Cys 19 15 $8,559.22 $8,559.22 $3,000.00 $4,700.00 $4,000.00 2026-03-01
19085 CPT Hc Bx Breast W Device 1st Lesion Magnetic Res Guide 19 15 $5,225.89 $5,225.89 $2,959.80 $4,637.02 $3,946.40 2026-03-01
36516 CPT Apheresis Immunoads Slctv 29 20 — — $3,943.89 $3,943.89 $3,943.89 2026-10-02
38232 CPT Bone Marrow Harvest Autolog 29 20 — — $3,943.89 $3,943.89 $3,943.89 2026-10-02
52005 CPT Hc Pbb Cystourethroscopy,Ureter Catheter 19 15 $7,554.66 $7,554.66 $2,940.60 $4,606.94 $3,920.80 2026-03-01
19081 CPT Hc Bx Breast W Device 1st Lesion Stereotactic Guide 26 15 $5,017.28 $5,017.28 $2,934.00 $8,926.24 $3,912.00 2026-03-01
58611 CPT Hc Del-tubal Lig Follow'g Csec 19 15 $4,875.00 $4,875.00 $2,925.00 $4,582.50 $3,900.00 2026-03-01
74178 CPT Hc CT Abd & Pelv 1/> Regns - CT Abdomen Pelvis W Wo Contrast 19 15 $4,845.00 $4,845.00 $2,907.00 $4,554.30 $3,876.00 2026-03-01
V2790 HCPCS Amniotic Membrane 19 15 $4,804.10 $4,804.10 $2,882.46 $4,515.85 $3,843.28 2026-10-02
833 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures Without Cc/mcc 1 1 $10,916.90 $10,916.90 $3,780.00 $3,780.00 $3,780.00 2026-03-01
95715 CPT Hc Veeg By Tech 12-26 Hr Intermittent Monitoring 19 15 $4,635.00 $4,635.00 $2,781.00 $4,356.90 $3,708.00 2026-03-01
258U OTHER Ai Psor Mrna 50-100 Gen Alg 29 20 — — $3,675.00 $3,675.00 $3,675.00 2026-10-02
57061 CPT Destruction Vaginal Lesions Simple 3 3 $11,818.18 $11,818.18 $2,643.28 $6,121.28 $3,670.40 2026-03-01
50387 CPT Hc Ureteral Stend Removal W/Fluoro 19 15 $4,587.00 $4,587.00 $2,752.20 $4,311.78 $3,669.60 2026-03-01
19380 CPT Revision Of Reconstructed Breast 2 2 $29,347.51 $29,347.51 $3,269.32 $4,049.28 $3,659.30 2026-03-01
44950 CPT Appendectomy 22 16 — — $3,653.45 $3,653.45 $3,653.45 2026-10-02
787 MS_DRG Cesarean Section Without Sterilization With Cc 1 1 $20,195.77 $20,195.77 $3,649.00 $3,649.00 $3,649.00 2026-03-01
785 MS_DRG Cesarean Section With Sterilization Without Cc/mcc 1 1 $25,478.73 $25,478.73 $3,649.00 $3,649.00 $3,649.00 2026-03-01
786 MS_DRG Cesarean Section Without Sterilization With Mcc 1 1 $24,122.26 $24,122.26 $3,649.00 $3,649.00 $3,649.00 2026-03-01
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 1 1 $17,957.93 $17,957.93 $3,649.00 $3,649.00 $3,649.00 2026-03-01
23800 CPT Arthrodesis Glenohumeral Jt 22 16 — — $3,625.16 $3,625.16 $3,625.16 2026-10-02
PX-1730000003 CDM Hc Nursery Room Daily - NICU Level 3 19 15 $4,484.00 $4,484.00 $2,690.40 $4,214.96 $3,587.20 2026-03-01
49320 CPT Laps Abd Prtm&Omentum Dx W/wo Spec Br/Wa Spx 3 3 $14,026.09 $14,026.09 $2,604.80 $10,766.46 $3,573.34 2026-03-01
58350 CPT Chromotubation Oviduct W/Materials 3 3 $19,118.25 $19,118.25 $2,604.80 $4,084.80 $3,573.33 2026-03-01
29899 CPT Ankle Arthroscopy/surgery 22 16 — — $3,560.40 $3,560.40 $3,560.40 2026-10-02
29892 CPT Ankle Arthroscopy/surgery 22 16 — — $3,560.40 $3,560.40 $3,560.40 2026-10-02
20693 CPT Adjmt/revj Ext Fixj Sys Anes 22 16 — — $3,560.40 $3,560.40 $3,560.40 2026-10-02
20251 CPT Biopsy Vrt Bdy Open Lmbr/crv 22 16 — — $3,560.40 $3,560.40 $3,560.40 2026-10-02
27889 CPT Amputation Of Foot At Ankle 22 16 — — $3,560.40 $3,560.40 $3,560.40 2026-10-02
67346 CPT Biopsy Eye Muscle 29 20 — — $3,559.87 $3,559.87 $3,559.87 2026-10-02
11042 CPT Debridement Subcutaneous Tissue 1st 20 Sq Cm/< 1 1 $22,809.07 $22,809.07 $3,552.00 $3,552.00 $3,552.00 2026-03-01
581T OTHER Abltj Mal Brst Tum Perq Crtx 29 20 — — $3,545.41 $3,545.41 $3,545.41 2026-10-02
970T OTHER Ablation, Benign Breast Tumor (eg, Fibroadenoma), Percutaneous, Laser, Including… 29 20 — — $3,545.41 $3,545.41 $3,545.41 2026-10-02
971T OTHER Ablation, Malignant Breast Tumor(s), Percutaneous, Laser, Including Imaging Guid… 29 20 — — $3,545.41 $3,545.41 $3,545.41 2026-10-02
10081 CPT Hc Incision & Drainage Pilonidal Cyst Complicated 19 15 $4,429.00 $4,429.00 $2,657.40 $4,163.26 $3,543.20 2026-03-01
72147 CPT Hc Mri, Dorsal Spine Contrast - MRI Thoracic Spine W Contrast 19 15 $4,413.00 $4,413.00 $2,647.80 $4,148.22 $3,530.40 2026-03-01
20983 CPT Ablate Bone Tumor(s) Perq 22 16 — — $3,525.88 $3,525.88 $3,525.88 2026-10-02
20690 CPT Appl Unipln Uni Ext Fixj Sys 22 16 — — $3,525.88 $3,525.88 $3,525.88 2026-10-02
Q0138 HCPCS Ferumoxytol (feraheme) 510 Mg/17 Ml (30 Mg/ml) Intravenous Solution 38 15 $4,332.27 $4,332.27 $2,242.37 $4,631.62 $3,513.05 2026-03-01
72156 CPT Hc Mri, Cerv Spine Combo - MRI Cervical Spine W Wo Contrast 19 15 $4,390.00 $4,390.00 $2,634.00 $4,126.60 $3,512.00 2026-03-01
PX-2000000001 CDM Hc Adult ICU Room Daily 19 15 $4,382.00 $4,382.00 $2,629.20 $4,119.08 $3,505.60 2026-03-01
44394 CPT Colonoscopy Stoma W/Rmvl Tum Polyp/Oth Les Snare 1 1 $4,672.78 $4,672.78 $3,477.06 $3,477.06 $3,477.06 2026-03-01
12020 CPT Tx Superficial Wound Dehiscence Simple Closure 1 1 $10,032.79 $10,032.79 $3,442.81 $3,442.81 $3,442.81 2026-03-01
31631 CPT Bronchoscopy Dilate W/stent 22 16 — — $3,435.89 $3,435.89 $3,435.89 2026-10-02
31636 CPT Bronchoscopy Bronch Stents 22 16 — — $3,435.89 $3,435.89 $3,435.89 2026-10-02
31634 CPT Bronch W/balloon Occlusion 22 16 — — $3,435.89 $3,435.89 $3,435.89 2026-10-02
31647 CPT Bronchial Valve Init Insert 22 16 — — $3,435.89 $3,435.89 $3,435.89 2026-10-02
31638 CPT Bronchoscopy Revise Stent 22 16 — — $3,435.89 $3,435.89 $3,435.89 2026-10-02
59871 CPT Hc Removal Cerclage Suture Under Anesthesia 19 15 $6,647.20 $6,647.20 $2,566.80 $4,021.32 $3,422.40 2026-03-01
59515 CPT Hc Cesarean Section 38 15 $4,246.00 $4,246.00 $2,506.20 $4,056.10 $3,419.64 2026-03-01
78608 CPT Hc Brain Imaging (Pet) - Pt Brain Metabolic 19 15 $4,263.00 $4,263.00 $2,557.80 $4,007.22 $3,410.40 2026-03-01
21127 CPT Augmentation Lower Jaw Bone 22 16 — — $3,402.64 $3,402.64 $3,402.64 2026-10-02
J1561 HCPCS Immune Glob G 40 Gram/400 Ml(10%)-gly-iga Ave 46 Mcg/ml Injection Soln 115 15 $5,652.06 $5,652.06 $288.04 $21,251.75 $3,391.24 2026-03-01
SUP-0017105 CDM Acessa Handpiece & Pads Provu 19 15 $4,200.00 $4,200.00 $2,520.00 $3,948.00 $3,360.00 2026-03-01
19318 CPT Breast Reduction 20 16 $31,949.63 $31,949.63 $3,346.24 $24,485.12 $3,346.24 2026-10-02
891T OTHER Accelerated, Repetitive High-dose Functional Connectivity MRI-guided Theta-burst… 29 20 — — $3,324.07 $3,324.07 $3,324.07 2026-10-02
890T OTHER Accelerated, Repetitive High-dose Functional Connectivity MRI-guided Theta-burst… 29 20 — — $3,324.07 $3,324.07 $3,324.07 2026-10-02
892T OTHER Accelerated, Repetitive High-dose Functional Connectivity MRI-guided Theta-burst… 29 20 — — $3,324.07 $3,324.07 $3,324.07 2026-10-02
Q4116 HCPCS Alloderm Med 1.2-2.0 37 15 $5,535.60 $5,535.60 $32.90 $5,203.46 $3,321.36 2026-10-02
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