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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

HOULTON REGIONAL HOSPITAL

Houlton, ME · CCN 201308 · Rates published

2,311 distinct procedures filed
9 distinct payers
38,739 rate rows
2026-03-25 last MRF observed
Data quality

38,643 of 38,739 rate rows are consumer-grade (99.8%)

96 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
percent-of-charges filed in the dollar field — excluded from medians 74
per-diem day rate — not a per-procedure price 15
placeholder amount (≤ $0.02) — excluded from medians 4
exceeds 10× this hospital's gross charge — excluded from medians 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://houltonregional.org/wp-content/uploads/2026/04/237134386_houlton-regional-hospital_standardcharges.csv
Found on page https://houltonregional.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-19
Content fingerprint ee259c5e439df5be… · 31,157,618 bytes · first seen 2026-05-15

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
J2350
HCPCS 		Ocrelizumab 1mg 9 $20,302.57 $46,297.26 $24,854.32 nat. median
$712
outlier · 34.9×
C1764
HCPCS 		Loop Recorder 9 $12,539.66 $28,595.00 $15,351.00 nat. median
$7,664
outlier · 2.0×
J1930
HCPCS 		Lanreotide 1mg Syringe 9 $9,157.97 $20,883.52 $11,211.15 nat. median
$5,898
1.9× median
J2327
HCPCS 		Skyrizi 1mg Risankizumab 9 $9,124.36 $20,806.86 $11,170.00 nat. median
$2,241
outlier · 5.0×
J3380
HCPCS 		Entyvio 300mg 9 $8,675.25 $19,782.72 $10,620.20 nat. median
$288
outlier · 36.9×
J3101
HCPCS 		Tenecteplase Inj 1mg 9 $7,120.68 $16,237.74 $8,717.10 nat. median
$5,949
1.5× median
33285
HCPCS 		Insj Subq Car Rhythm Mntr 9 $72.49 $15,262.70 $7,069.04 nat. median
$8,842
0.8× median
J2506
HCPCS 		Pegfilgrastim Autoinjector 6mg 9 $5,507.89 $12,560.01 $6,742.74 nat. median
$2,076
outlier · 3.2×
J0517
HCPCS 		Benralizumab Inj 1mg 9 $5,017.91 $11,442.67 $6,142.91 nat. median
$919
outlier · 6.7×
J2802
HCPCS 		Romiplostim 500mcg Vial 9 $4,725.24 $10,775.28 $5,784.62 nat. median
$2,983
1.9× median
35820
HCPCS 		Explor For Postop Hemorrhage 9 $1,936.98 $10,753.05 $5,772.69 nat. median
$3,590
1.6× median
J1162
HCPCS 		Digibind Inj 1 Vial 9 $4,268.67 $9,734.12 $5,225.68 nat. median
$7,316
0.7× median
49652
HCPCS 		Laparoscopy Umbilical Hernia 6 $2,505.02 $5,712.35 $5,179.90 nat. median
$5,004
1.0× median
49656
HCPCS 		Lap Repair Rec Incisional Hern 6 $2,412.95 $5,502.40 $4,989.52 nat. median
$5,832
0.9× median
J2356
HCPCS 		Tezspire Syringe 1mg 9 $3,749.42 $8,550.06 $4,590.03 nat. median
$66
outlier · 69.3×
J7195
HCPCS 		Factor Ix Benefix 1iu 9 $3,730.75 $8,507.47 $4,567.17 nat. median
$7
outlier · 669.7×
22514
HCPCS 		Kyphoplasty Lumbar Or Thoracic 9 $3,661.08 $8,348.60 $4,481.88 nat. median
$8,289
0.5× median
44150
HCPCS 		Colectomy Total Abdominal 9 $1,795.49 $8,293.50 $4,452.30 nat. median
$3,298
1.4× median
Q5111
HCPCS 		Pegfilgrastim-cbqv 0.5mg 9 $3,582.97 $8,170.48 $4,386.26 nat. median
$2,111
outlier · 2.1×
49566
HCPCS 		Repair Recurrent Incisi Hernia 6 $2,076.75 $4,735.75 $4,294.33 nat. median
$4,352
1.0× median
Q5122
HCPCS 		Nyvepria Pegfilgr 6mg/06ml S 9 $3,368.42 $7,681.23 $4,123.61 nat. median
$443
outlier · 9.3×
0206
RC 		6 $2,337.84 $4,354.80 $3,950.95 nat. median
$3,034
1.3× median
J0897
HCPCS 		Denosumab Inj 120mg 9 $1,931.39 $8,101.37 $3,867.49 nat. median
$2,506
1.5× median
J2182
HCPCS 		Mepolixumab Inj 100mg 9 $3,153.77 $7,191.74 $3,860.83 nat. median
$3,098
1.2× median
J1437
HCPCS 		Monoferric 1000mg/10ml Vial 9 $3,134.29 $7,147.32 $3,836.98 nat. median
$42
outlier · 92.2×
54065
HCPCS 		Aura Laser 9 $3,092.84 $7,052.80 $3,786.24 nat. median
$2,025
1.9× median
44204
HCPCS 		Laparoscopy Colectomy Anastomo 9 $1,469.15 $6,758.30 $3,628.14 nat. median
$3,782
1.0× median
44141
HCPCS 		Colectomypartialw/skin Level 9 $1,749.95 $6,517.95 $3,499.11 nat. median
$3,147
1.1× median
43280
HCPCS 		Lap Esophagogastic Fundoplasty 9 $1,044.35 $6,335.55 $3,401.19 nat. median
$10,090
outlier · 0.3×
44143
HCPCS 		Cholectomyw/ End Colostomy 9 $1,584.83 $6,092.35 $3,270.63 nat. median
$3,062
1.1× median
44626
HCPCS 		Closure Enterostomyw/resectio 9 $1,512.61 $6,046.75 $3,246.15 nat. median
$3,088
1.1× median
Q4100
HCPCS 		Somagen Mesh 6 X 8 9 $2,582.09 $5,888.10 $3,160.98 nat. median
$1,878
1.7× median
Q5120
HCPCS 		Pegfilgrastim-bmez 0.5mg 9 $2,551.19 $5,817.64 $3,123.15 nat. median
$362
outlier · 8.6×
44604
HCPCS 		Suture Large Intestine 9 $1,009.67 $5,691.45 $3,055.41 nat. median
$3,012
1.0× median
44160
HCPCS 		Colectomy Partial 9 $1,198.86 $5,653.45 $3,035.01 nat. median
$3,047
1.0× median
J2353
HCPCS 		Octreotide Acetate 1mg Int In 9 $889.86 $9,034.10 $2,995.45 nat. median
$5,975
0.5× median
49020
HCPCS 		Drainage Peritoneal Abscess 9 $1,540.38 $5,499.55 $2,952.39 nat. median
$2,803
1.1× median
60240
HCPCS 		Thyroidectomytotal/complete 9 $865.00 $5,448.25 $2,924.85 nat. median
$6,083
outlier · 0.5×
60225
HCPCS 		Total Thyroid Lobectomy W/cont 9 $886.03 $5,448.25 $2,924.85 nat. median
$6,010
outlier · 0.5×
49565
HCPCS 		Repair Recurrent Hernia 6 $1,383.95 $3,155.90 $2,861.74 nat. median
$3,527
0.8× median
19307
HCPCS 		Mastectomy Modified Radical 9 $1,162.85 $5,244.95 $2,815.71 nat. median
$6,934
outlier · 0.4×
44140
HCPCS 		Colectomy Partialanastomosis 9 $1,293.93 $5,211.70 $2,797.86 nat. median
$2,724
1.0× median
J1459
HCPCS 		Immune Globuline Privigen 9 $658.63 $12,015.30 $2,782.49 nat. median
$1,228
outlier · 2.3×
44310
HCPCS 		Ileostomy Non-tube 9 $1,005.45 $5,175.60 $2,778.48 nat. median
$2,632
1.1× median
Q4151
HCPCS 		Amnioband Membrane 2 X 3 9 $1,217.31 $6,428.65 $2,775.90 nat. median
$364
outlier · 7.6×
J3111
HCPCS 		Romosozumab-aqqg 210mg 9 $2,256.13 $5,144.80 $2,761.95 nat. median
$1,003
outlier · 2.8×
49560
HCPCS 		Repair Initial Ventral Hernia 6 $1,299.38 $2,963.05 $2,686.86 nat. median
$3,216
0.8× median
44120
HCPCS 		Enterectomy Resection Sm Intes 9 $1,174.74 $4,964.70 $2,665.26 nat. median
$3,012
0.9× median
49561
HCPCS 		Repair Intiial Incarcerate 6 $1,286.46 $2,933.60 $2,660.16 nat. median
$3,381
0.8× median
35207
HCPCS 		Repair Blood Vesselhandfinge 9 $713.12 $4,934.30 $2,648.94 nat. median
$3,495
0.8× median

Other procedures at this hospital

Browse this hospital's 2,311 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
             
0120 RC — 12 6 $1,447.00 $1,374.65 $336.09 $2,123.25 $882.95 2026-03-25
0123 RC — 6 6 $2,621.00 $2,489.95 $1,336.71 $2,489.95 $2,259.04 2026-03-25
0172 RC — 6 6 $2,323.00 $2,206.85 $1,184.73 $2,206.85 $2,002.20 2026-03-25
0206 RC — 6 6 $4,584.00 $4,354.80 $2,337.84 $4,354.80 $3,950.95 2026-03-25
0360 RC — 270 9 $1,954.50 $1,856.78 $14.16 $36,670.00 $1,083.01 2026-03-25
11004 HCPCS Debridement Of Skin Genitalia 9 9 $2,700.00 $2,565.00 $527.91 $2,565.00 $1,377.00 2026-03-25
11012 HCPCS Debridement Skin Muscle Fascia 9 9 $2,823.00 $2,681.85 $712.93 $2,681.85 $1,439.73 2026-03-25
13152 HCPCS Repair Complex Eyelidnoseear 9 9 $2,293.00 $2,178.35 $514.37 $2,178.35 $1,169.43 2026-03-25
14020 HCPCS Adjacent Tissue Transfer 9 9 $1,883.00 $1,788.85 $749.18 $1,788.85 $960.33 2026-03-25
14040 HCPCS Adjacent Tissue Transfer 9 9 $3,684.00 $3,499.80 $803.72 $3,499.80 $1,878.84 2026-03-25
15004 HCPCS Incisional Release Of Scare 9 9 $1,786.00 $1,696.70 $423.25 $1,696.70 $910.86 2026-03-25
15100 HCPCS Split Thickness Autograft Trun 9 9 $4,888.00 $4,643.60 $958.17 $4,643.60 $2,492.88 2026-03-25
15240 HCPCS Full Thickness Graft 9 9 $3,156.00 $2,998.20 $981.61 $2,998.20 $1,609.56 2026-03-25
15260 HCPCS Full Thickness Graft 9 9 $3,240.00 $3,078.00 $1,050.82 $3,078.00 $1,652.40 2026-03-25
19120 HCPCS Excision Of Cyst 9 9 $2,387.00 $2,267.65 $591.69 $2,267.65 $1,217.37 2026-03-25
19125 HCPCS Excision Of Breast Lesion 9 9 $1,719.00 $1,633.05 $655.04 $1,633.05 $876.69 2026-03-25
19281 HCPCS Breast Local 1 Rt 9 9 $4,537.00 $4,310.15 $1,890.11 $4,310.15 $2,313.87 2026-03-25
19301 HCPCS Mastectomy Partial 9 9 $2,170.00 $2,061.50 $653.10 $2,061.50 $1,106.70 2026-03-25
19302 HCPCS Mastectomy Partial W/axillary 9 9 $3,872.00 $3,678.40 $895.48 $3,678.40 $1,974.72 2026-03-25
19303 HCPCS Mastectomy Simple Complete 9 9 $2,927.00 $2,780.65 $945.67 $2,780.65 $1,492.77 2026-03-25
19307 HCPCS Mastectomy Modified Radical 9 9 $5,521.00 $5,244.95 $1,162.85 $5,244.95 $2,815.71 2026-03-25
20103 HCPCS Removal Of Foreign Body 9 9 $2,357.00 $2,239.15 $614.31 $2,239.15 $1,202.07 2026-03-25
21501 HCPCS Incision And Drainageneck 9 9 $2,326.00 $2,209.70 $535.81 $2,209.70 $1,186.26 2026-03-25
21552 HCPCS Excision Tumor 3cm Or Greater 9 9 $1,997.00 $1,897.15 $444.47 $1,897.15 $1,018.47 2026-03-25
21556 HCPCS Excision Tumor Neck 9 9 $1,817.00 $1,726.15 $512.12 $1,726.15 $926.67 2026-03-25
21930 HCPCS Excision Tumor Less Than 3cm 9 9 $2,033.00 $1,931.35 $559.70 $1,931.35 $1,036.83 2026-03-25
21931 HCPCS Excisiontumor Soft Tissue 9 9 $2,702.00 $2,566.90 $468.95 $2,566.90 $1,378.02 2026-03-25
21933 HCPCS Excision Tumor 5cm Or Greater 9 9 $5,040.00 $4,788.00 $724.41 $4,788.00 $2,570.40 2026-03-25
22514 HCPCS Kyphoplasty Lumbar Or Thoracic 9 9 $8,788.00 $8,348.60 $3,661.08 $8,348.60 $4,481.88 2026-03-25
22902 HCPCS Excision Tumor Soft Tissue Abd 9 9 $1,734.00 $1,647.30 $534.08 $1,647.30 $884.34 2026-03-25
22903 HCPCS Excision Tumor 3m Or Greater 9 9 $1,873.00 $1,779.35 $443.16 $1,779.35 $955.23 2026-03-25
23073 HCPCS Excision Tumor Shoulder 9 9 $4,782.00 $4,542.90 $682.95 $4,542.90 $2,438.82 2026-03-25
23605 HCPCS Cltr Proximal Humeral Fracture 15 9 $1,099.00 $1,044.05 $457.84 $2,744.55 $1,000.09 2026-03-25
23655 HCPCS Cltx Shld Dis W/mnp Req Anes 9 9 $2,154.00 $2,046.30 $434.10 $2,046.30 $1,098.54 2026-03-25
23665 HCPCS Cltx Shld Dis W/fx Humtrb W/mn 9 9 $2,820.00 $2,679.00 $515.93 $2,679.00 $1,438.20 2026-03-25
24071 HCPCS Excision Tumor Upper Arm/elbow 9 9 $2,363.00 $2,244.85 $405.74 $2,244.85 $1,205.13 2026-03-25
24073 HCPCS Excision Tumor Soft Tissue 9 9 $4,374.00 $4,155.30 $677.67 $4,155.30 $2,230.74 2026-03-25
24505 HCPCS Fltr Humeral Shaft Fract W/man 15 9 $1,163.00 $1,104.85 $484.51 $2,760.70 $1,058.33 2026-03-25
25071 HCPCS Excision Tumor Soft Tissue 9 9 $2,928.00 $2,781.60 $419.75 $2,781.60 $1,493.28 2026-03-25
25111 HCPCS Excision Ganglion Wrist Primar 9 9 $2,283.00 $2,168.85 $333.68 $2,168.85 $1,164.33 2026-03-25
25505 HCPCS Cl Tr Radial Shaft Frac W/man 15 9 $1,187.00 $1,127.65 $494.50 $1,140.95 $1,000.52 2026-03-25
25565 HCPCS Cl Tr Radial And Ulnar Shaft Fra 15 9 $1,194.00 $1,134.30 $497.42 $2,721.75 $1,086.54 2026-03-25
25605 HCPCS Cltr Distal Radial Frac W/man 16 9 $1,312.00 $1,246.40 $546.58 $2,991.55 $1,174.24 2026-03-25
26020 HCPCS Drainage Of Tendon Sheath 9 9 $3,798.00 $3,608.10 $553.61 $3,608.10 $1,936.98 2026-03-25
27125 HCPCS Hemiarthroplasty Hip Par Fem 9 9 $2,844.00 $2,701.80 $1,077.55 $2,701.80 $1,450.44 2026-03-25
27130 HCPCS Arthroplastyacetab And Prox 9 9 $3,220.00 $3,059.00 $1,209.38 $3,059.00 $1,642.20 2026-03-25
27134 HCPCS Revision Total Hip Arthroplast 9 9 $4,757.00 $4,519.15 $1,765.31 $4,519.15 $2,426.07 2026-03-25
27137 HCPCS Revision Total Hip Arthr Acet 9 9 $3,668.00 $3,484.60 $1,371.44 $3,484.60 $1,870.68 2026-03-25
27138 HCPCS Revision Total Hip Arthr Femo 9 9 $3,810.00 $3,619.50 $1,423.20 $3,619.50 $1,943.10 2026-03-25
27265 HCPCS Closed Treatment Post Hip Arth 9 9 $2,494.00 $2,369.30 $509.91 $2,369.30 $1,271.94 2026-03-25
27337 HCPCS Excision Tumor Thigh Or Knee 9 9 $2,888.00 $2,743.60 $422.31 $2,743.60 $1,472.88 2026-03-25
27438 HCPCS Arthroplasty Knee Tibial Plate 9 9 $2,126.00 $2,019.70 $813.28 $2,019.70 $1,084.26 2026-03-25
27440 HCPCS Arthroplastykneetibial Plat 9 9 $2,018.00 $1,917.10 $775.12 $1,917.10 $1,029.18 2026-03-25
27508 HCPCS Cltx Femfx Dstend Cndyl No Mnp 9 9 $2,690.00 $2,555.50 $603.02 $2,555.50 $1,371.90 2026-03-25
27695 HCPCS Rpr Primary Disrupted Lig Ankl 9 9 $2,760.00 $2,622.00 $487.38 $2,622.00 $1,407.60 2026-03-25
27788 HCPCS Cltx Dstl Fibular Fx Lat Mals 16 9 $2,347.00 $2,229.65 $413.68 $2,229.65 $923.49 2026-03-25
27792 HCPCS Open Tx Distal Fibular Fractur 9 9 $3,283.00 $3,118.85 $633.96 $3,118.85 $1,674.33 2026-03-25
27818 HCPCS Cl Tr Trimalleolar Ank Frac With 15 9 $1,133.00 $1,076.35 $472.01 $2,935.50 $1,031.03 2026-03-25
27825 HCPCS Closed Treat Tibia W/traction 9 9 $2,801.00 $2,660.95 $627.05 $2,660.95 $1,428.51 2026-03-25
27840 HCPCS Closed Treatment Ankle Disloca 9 9 $1,740.00 $1,653.00 $468.56 $1,653.00 $887.40 2026-03-25
28525 HCPCS Open Tx Frac Phalanx/phalanges 9 9 $1,815.00 $1,724.25 $599.64 $1,724.25 $925.65 2026-03-25
32551 HCPCS Chest Tube Insertion 19 9 $921.00 $874.95 $150.03 $4,132.50 $874.95 2026-03-25
33285 HCPCS Insj Subq Car Rhythm Mntr 15 9 $16,066.00 $15,262.70 $72.49 $15,262.70 $7,069.04 2026-03-25
35207 HCPCS Repair Blood Vesselhandfinge 9 9 $5,194.00 $4,934.30 $713.12 $4,934.30 $2,648.94 2026-03-25
35820 HCPCS Explor For Postop Hemorrhage 9 9 $11,319.00 $10,753.05 $1,936.98 $10,753.05 $5,772.69 2026-03-25
36557 HCPCS Int Jugular Vein: <5 Yr 6 6 $1,792.00 $1,702.40 $746.55 $1,702.40 $1,543.72 2026-03-25
36558 HCPCS Cvc Central Venous Catheter 9 9 $1,792.00 $1,702.40 $746.55 $1,702.40 $913.92 2026-03-25
36561 HCPCS Subclavian Punc 5 And Up 9 9 $2,243.00 $2,130.85 $934.43 $2,130.85 $1,143.93 2026-03-25
36565 HCPCS Anes Subclavia Punc 5 And Up 9 9 $2,264.00 $2,150.80 $889.87 $2,150.80 $1,154.64 2026-03-25
36571 HCPCS Insert Peripherally Porta Cath 9 9 $2,105.00 $1,999.75 $876.94 $1,999.75 $1,450.26 2026-03-25
36582 HCPCS Replacement Tunneled Port 9 9 $1,940.00 $1,843.00 $808.20 $1,843.00 $989.40 2026-03-25
38510 HCPCS Biopsy Or Excision Lymph Node 9 9 $2,862.00 $2,718.90 $573.37 $2,718.90 $1,459.62 2026-03-25
38525 HCPCS Biopsy Or Excision Lymph Nodes 9 9 $1,927.00 $1,830.65 $444.44 $1,830.65 $982.77 2026-03-25
38531 HCPCS Biopsy Or Excision Lymph Node 9 9 $2,831.00 $2,689.45 $447.18 $2,689.45 $1,443.81 2026-03-25
40510 HCPCS Excision Of Lip 9 9 $2,414.00 $2,293.30 $519.86 $2,293.30 $1,231.14 2026-03-25
40650 HCPCS Repair Lip Full Thickness 9 9 $2,168.00 $2,059.60 $592.83 $2,059.60 $1,105.68 2026-03-25
42815 HCPCS Excision Branchial Cleft Cyst 9 9 $3,691.00 $3,506.45 $502.47 $3,506.45 $1,882.41 2026-03-25
43249 HCPCS Trensendoscopic Balloon Dilat 9 9 $1,042.00 $989.90 $434.10 $1,278.47 $948.22 2026-03-25
43280 HCPCS Lap Esophagogastic Fundoplasty 9 9 $6,669.00 $6,335.55 $1,044.35 $6,335.55 $3,401.19 2026-03-25
43500 HCPCS Gastrotomy W/exploration 9 9 $2,977.00 $2,828.15 $775.80 $2,828.15 $1,518.27 2026-03-25
43605 HCPCS Biopsy Of Stomach Laparotomy 9 9 $3,388.00 $3,218.60 $825.09 $3,218.60 $1,727.88 2026-03-25
43750 HCPCS P/c Percut Placemnt Gastrotube 6 6 $1,596.00 $1,516.20 $664.89 $1,516.20 $1,374.88 2026-03-25
43830 HCPCS Gastrostomy Open 9 9 $4,776.00 $4,537.20 $698.37 $4,537.20 $2,435.76 2026-03-25
43840 HCPCS Gastrorrhaphy Suture Of Perfo 9 9 $4,851.00 $4,608.45 $1,314.00 $4,608.45 $2,474.01 2026-03-25
44005 HCPCS Enterolysis 9 9 $4,180.00 $3,971.00 $1,054.68 $3,971.00 $2,131.80 2026-03-25
44050 HCPCS Reduction Of Volvulus 9 9 $4,302.00 $4,086.90 $910.38 $4,086.90 $2,194.02 2026-03-25
44120 HCPCS Enterectomy Resection Sm Intes 9 9 $5,226.00 $4,964.70 $1,174.74 $4,964.70 $2,665.26 2026-03-25
44140 HCPCS Colectomy Partialanastomosis 9 9 $5,486.00 $5,211.70 $1,293.93 $5,211.70 $2,797.86 2026-03-25
44141 HCPCS Colectomypartialw/skin Level 9 9 $6,861.00 $6,517.95 $1,749.95 $6,517.95 $3,499.11 2026-03-25
44143 HCPCS Cholectomyw/ End Colostomy 9 9 $6,413.00 $6,092.35 $1,584.83 $6,092.35 $3,270.63 2026-03-25
44150 HCPCS Colectomy Total Abdominal 9 9 $8,730.00 $8,293.50 $1,795.49 $8,293.50 $4,452.30 2026-03-25
44160 HCPCS Colectomy Partial 9 9 $5,951.00 $5,653.45 $1,198.86 $5,653.45 $3,035.01 2026-03-25
44180 HCPCS Laparoscopy Surgical Enteroly 9 9 $3,585.00 $3,405.75 $893.00 $3,405.75 $1,828.35 2026-03-25
44204 HCPCS Laparoscopy Colectomy Anastomo 9 9 $7,114.00 $6,758.30 $1,469.15 $6,758.30 $3,628.14 2026-03-25
44238 HCPCS Unlisted Laparoscopy Rx Intest 6 6 $2,668.00 $2,534.60 $1,111.49 $2,534.60 $2,298.35 2026-03-25
44310 HCPCS Ileostomy Non-tube 9 9 $5,448.00 $5,175.60 $1,005.45 $5,175.60 $2,778.48 2026-03-25
44320 HCPCS Colostomy/skin Level Cecostomy 9 9 $4,729.00 $4,492.55 $1,163.97 $4,492.55 $2,411.79 2026-03-25
44340 HCPCS Revision Of Colostomy 9 9 $2,623.00 $2,491.85 $630.36 $2,491.85 $1,337.73 2026-03-25
44604 HCPCS Suture Large Intestine 9 9 $5,991.00 $5,691.45 $1,009.67 $5,691.45 $3,055.41 2026-03-25
44626 HCPCS Closure Enterostomyw/resectio 9 9 $6,365.00 $6,046.75 $1,512.61 $6,046.75 $3,246.15 2026-03-25
44950 HCPCS Appendectomy 9 9 $2,668.00 $2,534.60 $625.82 $2,534.60 $1,360.68 2026-03-25
44960 HCPCS Appendectomyruptured Appendix 9 9 $3,524.00 $3,347.80 $851.38 $3,347.80 $1,797.24 2026-03-25
44970 HCPCS Laparoscopy Appendectomy 9 9 $2,967.00 $2,818.65 $596.78 $2,818.65 $1,513.17 2026-03-25
45111 HCPCS Proctectomypartial Resection 9 9 $4,041.00 $3,838.95 $1,053.52 $3,838.95 $2,060.91 2026-03-25
45130 HCPCS Excision Of Rectal Procidentia 9 9 $4,892.00 $4,647.40 $1,053.11 $4,647.40 $2,494.92 2026-03-25
45171 HCPCS Excision Of Rectal Tumor 9 9 $3,426.00 $3,254.70 $636.85 $3,254.70 $1,747.26 2026-03-25
45385 HCPCS Colonoscopy With Snare Techniq 9 9 $1,724.00 $1,637.80 $522.87 $1,637.80 $879.24 2026-03-25
45388 HCPCS Colonoscopy With Ablation 9 9 $1,833.00 $1,741.35 $763.63 $2,877.81 $1,668.03 2026-03-25
45398 HCPCS Colonoscopy Flex W/band Ligata 9 9 $1,592.00 $1,512.40 $663.23 $1,512.40 $979.78 2026-03-25
46200 HCPCS Fissurectomy 9 9 $2,332.00 $2,215.40 $550.66 $2,215.40 $1,189.32 2026-03-25
46250 HCPCS Hemorrhoidectomy Ext 2 Or More 9 9 $2,199.00 $2,089.05 $556.10 $2,089.05 $1,121.49 2026-03-25
46255 HCPCS Hemorrhoidectomy Single 9 9 $2,438.00 $2,316.10 $602.84 $2,316.10 $1,243.38 2026-03-25
46258 HCPCS Hemorrhoidectomy W/fistulectom 9 9 $3,019.00 $2,868.05 $495.68 $2,868.05 $1,539.69 2026-03-25
46260 HCPCS Hemorrhoidectomy Internal/ext 9 9 $2,544.00 $2,416.80 $498.91 $2,416.80 $1,297.44 2026-03-25
46275 HCPCS Anal Fistula Intersphinecteric 9 9 $2,469.00 $2,345.55 $654.66 $2,345.55 $1,259.19 2026-03-25
46700 HCPCS Anoplastyplastic Operation 9 9 $4,509.00 $4,283.55 $669.96 $4,283.55 $2,299.59 2026-03-25
46947 HCPCS Hemorrhoidopexy By Stapling 9 9 $2,051.00 $1,948.45 $393.62 $1,948.45 $1,046.01 2026-03-25
47531 HCPCS Cholangiogram Tt 18 9 $5,012.00 $4,761.40 $59.57 $9,386.95 $2,274.39 2026-03-25
47534 HCPCS Prq Plmt Biliary DRG Cath W/im 9 9 $2,502.00 $2,376.90 $1,042.33 $2,376.90 $1,328.21 2026-03-25
47562 HCPCS Laparoscopy Cholecystectomy 9 9 $4,255.00 $4,042.25 $651.95 $4,042.25 $2,170.05 2026-03-25
47563 HCPCS Laparoscopy Cholecystectomy 9 9 $4,748.00 $4,510.60 $705.87 $4,510.60 $2,421.48 2026-03-25
47600 HCPCS Cholecystectomy 9 9 $4,255.00 $4,042.25 $1,043.60 $4,042.25 $2,170.05 2026-03-25
49000 HCPCS Exploratory Laparotomy 9 9 $2,547.00 $2,419.65 $754.01 $2,419.65 $1,298.97 2026-03-25
49002 HCPCS Reopening Of Recent Laparotomy 9 9 $3,210.00 $3,049.50 $1,007.77 $3,049.50 $1,637.10 2026-03-25
49013 HCPCS Preperitoneal Pel Pack F/hemmr 9 9 $2,634.00 $2,502.30 $422.80 $2,502.30 $1,343.34 2026-03-25
49020 HCPCS Drainage Peritoneal Abscess 9 9 $5,789.00 $5,499.55 $1,540.38 $5,499.55 $2,952.39 2026-03-25
49021 HCPCS P/c Drainage Peritoneal Absces 6 6 $1,055.00 $1,002.25 $439.51 $1,002.25 $908.83 2026-03-25
49321 HCPCS Diagnostic Lap With Box 9 9 $2,414.00 $2,293.30 $341.16 $2,293.30 $1,231.14 2026-03-25
49418 HCPCS Insert Tunneled Intraperi Cath 9 9 $1,367.00 $1,298.65 $569.49 $1,298.65 $1,020.90 2026-03-25
49505 HCPCS Rpr 1st Ing Hrn 5 Yrs/> Reduc 9 9 $2,346.00 $2,228.70 $523.84 $2,228.70 $1,196.46 2026-03-25
49507 HCPCS Rpr 1st Ing Hrn 5 Yrs/> Incarc 9 9 $2,833.00 $2,691.35 $586.07 $2,691.35 $1,444.83 2026-03-25
49520 HCPCS Repair Recurrent Inguinal Hern 9 9 $2,688.00 $2,553.60 $627.33 $2,553.60 $1,370.88 2026-03-25
49521 HCPCS Repair Recurrent Hernia Incarc 9 9 $2,879.00 $2,735.05 $706.81 $2,735.05 $1,468.29 2026-03-25
49525 HCPCS Repair Inguinal Hernia Sliding 9 9 $2,197.00 $2,087.15 $571.96 $2,087.15 $1,120.47 2026-03-25
49553 HCPCS Repair Incarcerated Hernia 9 9 $4,356.00 $4,138.20 $628.26 $4,138.20 $2,221.56 2026-03-25
49560 HCPCS Repair Initial Ventral Hernia 6 6 $3,119.00 $2,963.05 $1,299.38 $2,963.05 $2,686.86 2026-03-25
49561 HCPCS Repair Intiial Incarcerate 6 6 $3,088.00 $2,933.60 $1,286.46 $2,933.60 $2,660.16 2026-03-25
49565 HCPCS Repair Recurrent Hernia 6 6 $3,322.00 $3,155.90 $1,383.95 $3,155.90 $2,861.74 2026-03-25
49566 HCPCS Repair Recurrent Incisi Hernia 6 6 $4,985.00 $4,735.75 $2,076.75 $4,735.75 $4,294.33 2026-03-25
49568 HCPCS Implant Mesh Prosthesis Hernia 6 6 $1,426.00 $1,354.70 $594.07 $1,354.70 $1,228.43 2026-03-25
49585 HCPCS Umbilical Hernia 6 6 $2,454.00 $2,331.30 $1,022.34 $2,331.30 $2,114.00 2026-03-25
49587 HCPCS Repair Umbilical Hernia Strang 6 6 $2,508.00 $2,382.60 $1,044.83 $2,382.60 $2,160.51 2026-03-25
49591 HCPCS Repair Aa Hernia 1st<3cm Reduc 9 9 $2,222.00 $2,110.90 $326.01 $2,110.90 $1,133.22 2026-03-25
49592 HCPCS Rpr Aa Hernia 1st<3cm 9 9 $2,976.00 $2,827.20 $450.78 $2,827.20 $1,517.76 2026-03-25
49593 HCPCS Rpr Aa Hernia 1st 3-10cm Reduc 9 9 $3,510.00 $3,334.50 $541.86 $3,334.50 $1,790.10 2026-03-25
49594 HCPCS Rpr Aa Hernia 1st 3-10 Cm 9 9 $4,438.00 $4,216.10 $703.93 $4,216.10 $2,263.38 2026-03-25
49613 HCPCS Prp Aa Hernia Recr <3cm 9 9 $2,762.00 $2,623.90 $399.79 $2,623.90 $1,408.62 2026-03-25
49614 HCPCS Rpr Aa Hernia Recr <3cm Reduci 9 9 $3,398.00 $3,228.10 $540.79 $3,228.10 $1,732.98 2026-03-25
49615 HCPCS Rpr Aa Hernia Recr 3-10 Cm 9 9 $3,758.00 $3,570.10 $602.59 $3,570.10 $1,916.58 2026-03-25
49652 HCPCS Laparoscopy Umbilical Hernia 6 6 $6,013.00 $5,712.35 $2,505.02 $5,712.35 $5,179.90 2026-03-25
49656 HCPCS Lap Repair Rec Incisional Hern 6 6 $5,792.00 $5,502.40 $2,412.95 $5,502.40 $4,989.52 2026-03-25
49659 HCPCS Unlisted Laparoscopy Procedure 6 6 $3,046.00 $2,893.70 $1,268.96 $2,893.70 $2,623.97 2026-03-25
49900 HCPCS Suture Sec Abd Wall For Evisce 9 9 $3,872.00 $3,678.40 $826.94 $3,678.40 $1,974.72 2026-03-25
49999 HCPCS Unlisted Procedure Abd Periton 6 6 $2,029.00 $1,927.55 $845.28 $1,927.55 $1,747.88 2026-03-25
50392 HCPCS P/c Intro Intracath Renal Pelv 6 6 $1,145.00 $1,087.75 $477.01 $1,087.75 $986.36 2026-03-25
50393 HCPCS P/c Intro Ureter Cath/stent 6 6 $1,397.00 $1,327.15 $581.99 $1,327.15 $1,203.44 2026-03-25
50590 HCPCS Lithotripsy Extrac Shock Wave 9 9 $3,952.00 $3,754.40 $798.12 $3,754.40 $2,015.52 2026-03-25
51040 HCPCS Cystostomy With Drainage 9 9 $2,022.00 $1,920.90 $288.05 $1,920.90 $1,031.22 2026-03-25
52235 HCPCS Cystourethroscopy W/fulg Med 9 9 $1,967.00 $1,868.65 $270.53 $1,868.65 $1,003.17 2026-03-25
52240 HCPCS Cystourethroscopy Bladder Tumo 9 9 $2,671.00 $2,537.45 $366.12 $2,537.45 $1,362.21 2026-03-25
52275 HCPCS Cystourethroscopy Male 9 9 $1,699.00 $1,614.05 $542.04 $1,614.05 $866.49 2026-03-25
52276 HCPCS Cystourethroscopy Direct Visio 9 9 $1,806.00 $1,715.70 $248.23 $1,715.70 $921.06 2026-03-25
52282 HCPCS Cystourethroscopy With Stent 9 9 $2,298.00 $2,183.10 $315.13 $2,183.10 $1,171.98 2026-03-25
52317 HCPCS Removal Bladder Stone 9 9 $1,492.00 $1,417.40 $621.57 $1,417.40 $947.74 2026-03-25
52318 HCPCS Litholapaxycomplicated Or Lar 9 9 $2,382.00 $2,262.90 $440.62 $2,262.90 $1,214.82 2026-03-25
52320 HCPCS Cystourethroscopy W/removal 9 9 $1,683.00 $1,598.85 $230.23 $1,598.85 $858.33 2026-03-25
52330 HCPCS Cystourethroscopy With Manipulat 9 9 $1,797.00 $1,707.15 $615.89 $1,707.15 $916.47 2026-03-25
52341 HCPCS Cystourethroscopy W/ureteral 9 9 $1,937.00 $1,840.15 $266.39 $1,840.15 $987.87 2026-03-25
52344 HCPCS Cystourethroscopy With Nsertion 9 9 $2,100.00 $1,995.00 $345.16 $1,995.00 $1,071.00 2026-03-25
52351 HCPCS Cystourethroscopy W/uretherosc 9 9 $2,067.00 $1,963.65 $283.52 $1,963.65 $1,054.17 2026-03-25
52352 HCPCS Cystourethroscopy W/ureterosco 9 9 $2,418.00 $2,297.10 $331.32 $2,297.10 $1,233.18 2026-03-25
52353 HCPCS Cystourethroscopy W/lithotrips 9 9 $1,703.00 $1,617.85 $365.65 $1,617.85 $868.53 2026-03-25
52354 HCPCS Cystourethroscopy With Biopgy 9 9 $2,846.00 $2,703.70 $389.52 $2,703.70 $1,451.46 2026-03-25
52356 HCPCS Cystourethroscopy W/lithotrips 9 9 $2,836.00 $2,694.20 $388.14 $2,694.20 $1,446.36 2026-03-25
52441 HCPCS Cysto Insertion Transprostatic 9 9 $1,435.00 $1,363.25 $597.82 $1,363.25 $1,289.36 2026-03-25
52450 HCPCS Transurethral Incision Of Pros 9 9 $1,885.00 $1,790.75 $462.88 $1,790.75 $961.35 2026-03-25
52500 HCPCS Transurethral Resection Bladde 9 9 $2,655.00 $2,522.25 $372.13 $2,522.25 $1,354.05 2026-03-25
52601 HCPCS Transurethral Electrosurg 9 9 $3,951.00 $3,753.45 $557.19 $3,753.45 $2,015.01 2026-03-25
52630 HCPCS Transurethral Resect Regrowth 9 9 $2,814.00 $2,673.30 $397.40 $2,673.30 $1,435.14 2026-03-25
52640 HCPCS Transurethral Resect P/d Bladd 9 9 $2,243.00 $2,130.85 $318.87 $2,130.85 $1,143.93 2026-03-25
52648 HCPCS Laser Vaporization Of Prostate 18 9 $5,031.00 $4,779.45 $559.64 $7,941.05 $2,550.11 2026-03-25
53230 HCPCS Excision Urethral Diverticulum 9 9 $3,099.00 $2,944.05 $585.04 $2,944.05 $1,580.49 2026-03-25
53275 HCPCS Excision Urethral Prolapse 9 9 $1,808.00 $1,717.60 $252.17 $1,717.60 $922.08 2026-03-25
53450 HCPCS Urethromeatoplasty W/advanceme 9 9 $2,839.00 $2,697.05 $400.79 $2,697.05 $1,447.89 2026-03-25
53502 HCPCS Urethrorrhaphy Suture Urethral 9 9 $1,730.00 $1,643.50 $472.88 $1,643.50 $882.30 2026-03-25
54065 HCPCS Aura Laser 9 9 $7,424.00 $7,052.80 $3,092.84 $7,052.80 $3,786.24 2026-03-25
54340 HCPCS Repair Hypospadias Complicatio 9 9 $3,936.00 $3,739.20 $551.29 $3,739.20 $2,007.36 2026-03-25
54430 HCPCS Corpora Cavernosa Shunt 9 9 $4,418.00 $4,197.10 $616.18 $4,197.10 $2,253.18 2026-03-25
54530 HCPCS Orchiectomy Radical For Tumor 9 9 $3,524.00 $3,347.80 $495.86 $3,347.80 $1,797.24 2026-03-25
54550 HCPCS Explor For Undescended Testis 9 9 $3,404.00 $3,233.80 $477.92 $3,233.80 $1,736.04 2026-03-25
54830 HCPCS Excision Local Lesion Epididym 9 9 $2,583.00 $2,453.85 $367.12 $2,453.85 $1,317.33 2026-03-25
54840 HCPCS Excision Spermatocele 9 9 $2,233.00 $2,121.35 $315.71 $2,121.35 $1,138.83 2026-03-25
55040 HCPCS Excision Of Hydrocele Unilat 9 9 $2,346.00 $2,228.70 $332.52 $2,228.70 $1,196.46 2026-03-25
55041 HCPCS Removal Of Hydroceles Bilatera 9 9 $1,919.00 $1,823.05 $497.94 $1,823.05 $978.69 2026-03-25
55500 HCPCS Excision Of Hydrocele 9 9 $2,704.00 $2,568.80 $386.69 $2,568.80 $1,379.04 2026-03-25
55520 HCPCS Excision Lesion Spermatic Cord 9 9 $3,139.00 $2,982.05 $464.38 $2,982.05 $1,600.89 2026-03-25
55535 HCPCS Excision Varicocele Spermatic 9 9 $2,983.00 $2,833.85 $420.73 $2,833.85 $1,521.33 2026-03-25
57240 HCPCS Anterior Colporrhaphy Incl Cys 9 9 $2,355.00 $2,237.25 $573.14 $2,237.25 $1,201.05 2026-03-25
57267 HCPCS Insertion Of Mesh Or Prosthesi 9 9 $1,710.00 $1,624.50 $231.32 $1,624.50 $872.10 2026-03-25
57288 HCPCS Sling Operation Stress Inconti 9 9 $4,526.00 $4,299.70 $697.96 $4,299.70 $2,308.26 2026-03-25
57522 HCPCS Conization Of Cervix Loop Elec 9 9 $1,751.00 $1,663.45 $313.33 $1,663.45 $893.01 2026-03-25
58140 HCPCS Myomectomy Abdomen Method 9 9 $2,806.00 $2,665.70 $853.68 $2,665.70 $1,431.06 2026-03-25
58150 HCPCS Hysterectomy - Uterus Abd 9 9 $4,602.00 $4,371.90 $974.09 $4,371.90 $2,347.02 2026-03-25
58180 HCPCS Hysterectomy Supro-cervical 9 9 $4,944.00 $4,696.80 $907.78 $4,696.80 $2,521.44 2026-03-25
58552 HCPCS Laparoscopy With Removal Tubes 9 9 $5,008.00 $4,757.60 $919.80 $4,757.60 $2,554.08 2026-03-25
58720 HCPCS Salpingo-oophorectomy 9 9 $2,827.00 $2,685.65 $728.05 $2,685.65 $1,441.77 2026-03-25
59409 HCPCS Vaginal Delivery By Ed Doc 9 9 $3,613.00 $3,432.35 $741.93 $3,432.35 $1,842.63 2026-03-25
59514 HCPCS Cesarean Delivery Only 9 9 $4,053.00 $3,850.35 $841.13 $3,850.35 $2,067.03 2026-03-25
60220 HCPCS Total Thyroid Lobectomy 9 9 $4,563.00 $4,334.85 $668.67 $4,334.85 $2,327.13 2026-03-25
60225 HCPCS Total Thyroid Lobectomy W/cont 9 9 $5,735.00 $5,448.25 $886.03 $5,448.25 $2,924.85 2026-03-25
60240 HCPCS Thyroidectomytotal/complete 9 9 $5,735.00 $5,448.25 $865.00 $5,448.25 $2,924.85 2026-03-25
64999 HCPCS Anes Block Un Listed 6 6 $1,083.00 $1,028.85 $451.18 $1,028.85 $932.95 2026-03-25
70553 HCPCS MRI Brain Wandw/o Contrast 18 9 $1,591.00 $1,511.45 $113.64 $2,325.60 $876.92 2026-03-25
71555 HCPCS MRA Chest Wandw/o Contrast 18 9 $1,670.50 $1,586.97 $89.27 $2,634.35 $861.62 2026-03-25
72156 HCPCS MRI C-spine Wandw/o Contrast 18 9 $1,604.00 $1,523.80 $113.98 $2,325.60 $889.92 2026-03-25
72157 HCPCS MRI T-spine Wandw/o Contrast 18 9 $1,604.00 $1,523.80 $113.98 $2,325.60 $889.92 2026-03-25
72158 HCPCS MRI Spinal Canallumbar Wandw/o 18 9 $1,591.00 $1,511.45 $113.98 $2,325.60 $876.92 2026-03-25
72196 HCPCS MRI Pelvis W/contrast 9 9 $2,255.00 $2,142.25 $939.43 $2,142.25 $1,150.05 2026-03-25
72197 HCPCS MRI Pelvis Wandw/o Contrast 9 9 $2,448.00 $2,325.60 $1,019.84 $2,325.60 $1,248.48 2026-03-25
72198 HCPCS MRA Pelvis Wandw/o Contrast 18 9 $2,056.00 $1,953.20 $88.58 $3,370.60 $1,021.05 2026-03-25
73219 HCPCS MRI Upper Ext Not Joint W/cont 9 9 $2,255.00 $2,142.25 $939.43 $2,142.25 $1,150.05 2026-03-25
73725 HCPCS MRA Lower Ext Wandw/o Co Lt 18 9 $1,936.50 $1,839.67 $89.42 $3,136.90 $973.30 2026-03-25
74174 HCPCS Angiography Abdomen And Pelvis 18 9 $2,274.50 $2,160.78 $108.92 $3,885.50 $1,081.45 2026-03-25
74177 HCPCS Abdomen/pelvis Scan Enhanced 18 9 $2,058.50 $1,955.57 $90.46 $3,515.00 $979.21 2026-03-25
74178 HCPCS Abdomen/pelvis Scan Both 18 9 $2,268.50 $2,155.07 $100.21 $3,883.60 $1,076.03 2026-03-25
74183 HCPCS MRI Abdomen W And Without Contrast 18 9 $1,575.00 $1,496.25 $109.61 $2,325.60 $860.92 2026-03-25
74415 HCPCS Infusion W/tomos 9 9 $1,980.00 $1,881.00 $824.87 $1,881.00 $952.66 2026-03-25
77046 HCPCS MRI Breast Unilat Without Con Rt 9 9 $1,876.00 $1,782.20 $781.54 $1,782.20 $956.76 2026-03-25
77047 HCPCS MRI Breast Bilat Without Contrast 9 9 $2,188.00 $2,078.60 $911.52 $2,078.60 $1,115.88 2026-03-25
77049 HCPCS MRI Bil Breast Wandw/o Contrast 9 9 $2,500.00 $2,375.00 $1,041.50 $2,375.00 $1,275.00 2026-03-25
78451 HCPCS Thallium Without Stress 9 9 $3,655.00 $3,472.25 $1,522.67 $3,472.25 $1,864.05 2026-03-25
78452 HCPCS Cardiolite Rest And Stress Spect 18 9 $2,206.00 $2,095.70 $80.81 $3,819.00 $1,033.37 2026-03-25
78803 HCPCS P/c Spect Single Area 18 9 $1,987.00 $1,887.65 $53.21 $3,472.25 $937.05 2026-03-25
88309 HCPCS Surgical Pathology Level Vi 9 9 $2,287.00 $2,172.65 $952.76 $2,172.65 $1,166.37 2026-03-25
94002 HCPCS Vent Care 9 9 $1,851.00 $1,758.45 $771.13 $1,758.45 $944.01 2026-03-25
94003 HCPCS Vent/subsequent Day 9 9 $1,851.00 $1,758.45 $771.13 $1,758.45 $944.01 2026-03-25
95810 HCPCS Sleep Stage W/4 Or More Param 9 9 $2,849.00 $2,706.55 $1,186.89 $2,706.55 $2,507.12 2026-03-25
95811 HCPCS Sleep Stage W/cpap 9 9 $2,967.00 $2,818.65 $1,236.05 $2,818.65 $2,610.96 2026-03-25
99468 HCPCS Inp Neonatal Crit Care Less 28 9 9 $4,671.00 $4,437.45 $844.78 $4,437.45 $2,382.21 2026-03-25
A9272 HCPCS Abthera Dressing 9 9 $3,537.00 $3,360.15 $1,473.51 $3,360.15 $1,803.87 2026-03-25
C1764 HCPCS Loop Recorder 9 9 $30,100.00 $28,595.00 $12,539.66 $28,595.00 $15,351.00 2026-03-25
C1781 HCPCS Parietex Mesh 4.6cm Pc04vp 99 9 $1,300.00 $1,235.00 $206.63 $3,657.50 $912.86 2026-03-25
C1886 HCPCS Nova Sur System 9 9 $4,270.00 $4,056.50 $1,778.88 $4,056.50 $2,177.70 2026-03-25
C1889 HCPCS Urolift Implant W/handle 9 9 $3,763.00 $3,574.85 $1,567.67 $3,574.85 $1,919.13 2026-03-25
J0129 HCPCS Abatacept Inj 10mg 9 9 $3,193.00 $3,033.35 $1,330.20 $3,033.35 $1,628.43 2026-03-25
J0490 HCPCS Belimumab 10mg 9 9 $4,534.41 $4,307.69 $1,889.04 $4,307.69 $2,312.55 2026-03-25
J0517 HCPCS Benralizumab Inj 1mg 9 9 $12,044.92 $11,442.67 $5,017.91 $11,442.67 $6,142.91 2026-03-25
J0585 HCPCS Botulinum Toxin Botox 1 Unit 18 9 $2,011.59 $1,911.01 $558.69 $2,548.01 $1,180.13 2026-03-25
J0875 HCPCS Dalbavancin 5mg Vial 9 9 $3,665.01 $3,481.76 $1,526.84 $3,481.76 $1,869.16 2026-03-25
J0881 HCPCS Darbepoetin Aranesp 1mcg Inj 63 9 $1,594.44 $1,514.72 $166.06 $7,573.59 $908.83 2026-03-25
J0883 HCPCS Argatroban 1mg 9 9 $2,922.27 $2,776.16 $1,217.42 $2,776.16 $1,490.36 2026-03-25
J0897 HCPCS Denosumab Inj 120mg 18 9 $6,581.91 $6,252.82 $1,931.39 $8,101.37 $3,867.49 2026-03-25
J1162 HCPCS Digibind Inj 1 Vial 9 9 $10,246.44 $9,734.12 $4,268.67 $9,734.12 $5,225.68 2026-03-25
J1437 HCPCS Monoferric 1000mg/10ml Vial 9 9 $7,523.49 $7,147.32 $3,134.29 $7,147.32 $3,836.98 2026-03-25
J1439 HCPCS Injectafer 1mg 9 9 $3,302.98 $3,137.83 $1,376.02 $3,137.83 $1,684.52 2026-03-25
J1451 HCPCS Fomepizole 15mg 9 9 $3,708.00 $3,522.60 $1,544.75 $3,522.60 $1,891.08 2026-03-25
J1459 HCPCS Immune Globuline Privigen 36 9 $4,742.88 $4,505.73 $658.63 $12,015.30 $2,782.49 2026-03-25
J1561 HCPCS Gamunex 10g/100ml 36 9 $3,676.80 $3,492.96 $510.58 $9,314.56 $2,157.06 2026-03-25
J1930 HCPCS Lanreotide 1mg Syringe 9 9 $21,982.65 $20,883.52 $9,157.97 $20,883.52 $11,211.15 2026-03-25
J2182 HCPCS Mepolixumab Inj 100mg 9 9 $7,570.25 $7,191.74 $3,153.77 $7,191.74 $3,860.83 2026-03-25
J2327 HCPCS Skyrizi 1mg Risankizumab 9 9 $21,901.96 $20,806.86 $9,124.36 $20,806.86 $11,170.00 2026-03-25
J2350 HCPCS Ocrelizumab 1mg 9 9 $48,733.96 $46,297.26 $20,302.57 $46,297.26 $24,854.32 2026-03-25
J2353 HCPCS Octreotide Acetate 1mg Int In 18 9 $5,822.79 $5,531.65 $889.86 $9,034.10 $2,995.45 2026-03-25
J2356 HCPCS Tezspire Syringe 1mg 9 9 $9,000.06 $8,550.06 $3,749.42 $8,550.06 $4,590.03 2026-03-25
J2357 HCPCS Omalizumab Inj 5mg 18 9 $2,508.79 $2,383.35 $631.96 $3,325.61 $1,449.73 2026-03-25
J2426 HCPCS Paliperidone 1mg 18 9 $4,288.96 $4,074.51 $1,531.49 $4,656.66 $2,349.90 2026-03-25
J2506 HCPCS Pegfilgrastim Autoinjector 6mg 9 9 $13,221.06 $12,560.01 $5,507.89 $12,560.01 $6,742.74 2026-03-25
J2802 HCPCS Romiplostim 500mcg Vial 9 9 $11,342.40 $10,775.28 $4,725.24 $10,775.28 $5,784.62 2026-03-25
J2993 HCPCS Retelplase Inj 18.8mg 9 9 $4,290.00 $4,075.50 $1,787.21 $4,075.50 $2,187.90 2026-03-25
J3032 HCPCS Eptinezumab-jjmr Vyepti 100m 9 9 $3,996.54 $3,796.71 $1,664.96 $3,796.71 $2,038.24 2026-03-25
J3101 HCPCS Tenecteplase Inj 1mg 9 9 $17,092.36 $16,237.74 $7,120.68 $16,237.74 $8,717.10 2026-03-25
J3111 HCPCS Romosozumab-aqqg 210mg 9 9 $5,415.58 $5,144.80 $2,256.13 $5,144.80 $2,761.95 2026-03-25
J3240 HCPCS Thyrogen Inj 1.1mg 9 9 $4,248.89 $4,036.45 $1,770.09 $4,036.45 $2,166.93 2026-03-25
J3358 HCPCS Ustekinumab 1 Mg Vial 9 9 $4,366.50 $4,148.18 $1,819.08 $4,148.18 $2,226.92 2026-03-25
J3380 HCPCS Entyvio 300mg 9 9 $20,823.92 $19,782.72 $8,675.25 $19,782.72 $10,620.20 2026-03-25
J7165 HCPCS Human Factor X Balfaxar 1iu 9 9 $3,893.40 $3,698.73 $1,621.99 $3,698.73 $1,985.63 2026-03-25
J7195 HCPCS Factor Ix Benefix 1iu 9 9 $8,955.23 $8,507.47 $3,730.75 $8,507.47 $4,567.17 2026-03-25
J7296 HCPCS Levonorgestrel 19.5mg IUD 9 9 $2,502.14 $2,377.03 $1,042.39 $2,377.03 $1,276.09 2026-03-25
J7298 HCPCS Levonorgestrel IUD 5 Yr Dur 9 9 $2,502.14 $2,377.03 $1,042.39 $2,377.03 $1,276.09 2026-03-25
J7300 HCPCS Paraguard Copper IUD 9 9 $2,813.96 $2,673.26 $1,172.30 $2,673.26 $1,435.12 2026-03-25
J7301 HCPCS Levonorgestral IUD 13.5mg 9 9 $2,083.44 $1,979.27 $867.96 $1,979.27 $1,062.55 2026-03-25
J7307 HCPCS Implanon Inj 68mg 18 9 $1,827.97 $1,736.58 $428.56 $2,495.88 $1,035.89 2026-03-25
J9217 HCPCS Leuprolide 7.5mg Subque 27 9 $2,791.44 $2,651.87 $387.64 $3,535.83 $1,423.63 2026-03-25
J9312 HCPCS Rituximab Inj 100mg 9 9 $2,322.49 $2,206.37 $967.55 $2,206.37 $1,184.47 2026-03-25
J9395 HCPCS Faslodex Inj 25 Mg 9 9 $4,793.33 $4,553.66 $1,996.90 $4,553.66 $2,444.60 2026-03-25
P9034 HCPCS Plateletpheresis 9 9 $1,746.00 $1,658.70 $727.38 $1,658.70 $890.46 2026-03-25
Q0138 HCPCS Ferumoxytol 1mg Non Esrd 9 9 $2,950.62 $2,803.09 $1,229.23 $2,803.09 $1,504.82 2026-03-25
Q4100 HCPCS Somagen Mesh 6 X 8 9 9 $6,198.00 $5,888.10 $2,582.09 $5,888.10 $3,160.98 2026-03-25
Q4101 HCPCS Apligraf Per Sq Cm 9 9 $4,463.00 $4,239.85 $1,859.29 $4,239.85 $2,276.13 2026-03-25
Q4151 HCPCS Amnioband Membrane 2 X 3 27 9 $3,353.00 $3,185.35 $1,217.31 $6,428.65 $2,775.90 2026-03-25
Q4160 HCPCS Nushield 1.6 Disc 45 9 $3,325.00 $3,158.75 $576.16 $7,398.60 $2,081.53 2026-03-25
Q4168 HCPCS Amnioband Particulate 40mg 18 9 $3,362.50 $3,194.38 $1,102.32 $3,875.05 $1,955.47 2026-03-25
Q4186 HCPCS Epix Mesh 4 X 4.5cm 9 9 $4,883.00 $4,638.85 $2,034.26 $4,638.85 $2,490.33 2026-03-25
Q4196 HCPCS Puraply Am 1.6 Disc 54 9 $4,298.00 $4,083.10 $656.15 $17,057.25 $2,546.89 2026-03-25
Q5103 HCPCS Inflectra 10mg Dyyb 9 9 $1,949.34 $1,851.87 $812.10 $1,851.87 $994.16 2026-03-25
Q5108 HCPCS Pegfilgrastim-jmdb 6mg Fulphil 9 9 $4,300.25 $4,085.24 $1,791.48 $4,085.24 $2,193.13 2026-03-25
Q5111 HCPCS Pegfilgrastim-cbqv 0.5mg 9 9 $8,600.50 $8,170.48 $3,582.97 $8,170.48 $4,386.26 2026-03-25
Q5120 HCPCS Pegfilgrastim-bmez 0.5mg 9 9 $6,123.83 $5,817.64 $2,551.19 $5,817.64 $3,123.15 2026-03-25
Q5122 HCPCS Nyvepria Pegfilgr 6mg/06ml S 9 9 $8,085.50 $7,681.23 $3,368.42 $7,681.23 $4,123.61 2026-03-25
Q5157 HCPCS Denosumab-bmwo 1mg Syringe 9 9 $3,670.22 $3,486.71 $1,529.01 $3,486.71 $1,871.81 2026-03-25
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