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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

GARRETT REGIONAL MEDICAL CENTER

Oakland, MD · CCN 210017 · Rates published

1,919 distinct procedures filed
40 distinct payers
413,777 rate rows
2026-09-21 last MRF observed
Data quality

413,562 of 413,777 rate rows are consumer-grade (99.9%)

215 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
placeholder amount (≤ $0.02) — excluded from medians 184
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 31
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://wvumedicine.org/wp-content/uploads/2026/03/871846814_grmcinc_standardcharges.csv
Found on page https://wvumedicine.org/billing-and-insurance/costs-and-charges/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-21
Content fingerprint 696541bcc13e53d0… · 98,207,013 bytes · first seen 2026-05-13

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
J9043
HCPCS 		Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution [200352] 40 $80,798.87 $89,776.52 $84,659.26 nat. median
$509
outlier · 166.3×
J9228
HCPCS 		Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution [203998] 40 $12,549.87 $75,884.88 $52,597.79 nat. median
$6,073
outlier · 8.7×
J9298
HCPCS 		Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution [257450] 40 $21,374.87 $47,499.70 $33,249.79 nat. median
$446
outlier · 74.5×
J2350
HCPCS 		Ocrelizumab 30 Mg/ml Intravenous Solution [234354] 40 $28,608.37 $31,787.08 $29,975.22 nat. median
$133
outlier · 225.4×
J9022
HCPCS 		Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution [243606] 40 $11,244.02 $17,847.65 $16,473.38 nat. median
$1,229
outlier · 13.4×
J9119
HCPCS 		Cemiplimab-rwlc 50 Mg/ml Intravenous Solution [241798] 40 $15,709.83 $17,455.37 $16,460.41 nat. median
$53
outlier · 309.1×
J9144
HCPCS 		Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln [249116] 40 $14,579.34 $16,199.27 $15,275.91 nat. median
$114
outlier · 133.4×
J3380
HCPCS 		Vedolizumab 300 Mg Intravenous Solution [221353] 40 $12,972.84 $14,414.27 $13,592.66 nat. median
$59
outlier · 231.1×
J9271
HCPCS 		Pembrolizumab 25 Mg/ml Intravenous Solution [224448] 40 $8,337.74 $18,528.30 $12,969.81 nat. median
$127
outlier · 102.1×
J9358
HCPCS 		Fam-trastuzumab Deruxtecan-nxki 100 Mg Intravenous Solution [247358] 40 $4,277.85 $23,280.05 $12,852.60 nat. median
$67
outlier · 191.6×
J9223
HCPCS 		Lurbinectedin 4 Mg Intravenous Solution [249586] 40 $11,434.50 $12,705.00 $11,980.82 nat. median
$452
outlier · 26.5×
J0896
HCPCS 		Luspatercept-aamt 25 Mg Subcutaneous Solution [246951] 40 $5,700.82 $19,002.63 $11,718.31 nat. median
$228
outlier · 51.5×
J3101
HCPCS 		Tenecteplase 25 Mg Intravenous Solution [274292] 40 $10,562.75 $11,736.39 $11,067.42 nat. median
$498
outlier · 22.2×
J9306
HCPCS 		Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution [207655] 40 $9,453.20 $10,503.56 $9,904.86 nat. median
$43
outlier · 232.2×
J1162
HCPCS 		Digoxin Immune Fab 40 Mg Intravenous Solution [80896] 40 $6,332.11 $14,071.35 $9,849.95 nat. median
$6,265
1.6× median
J1932
HCPCS 		Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe [163313] 40 $7,779.56 $8,643.95 $8,151.24 nat. median
$76
outlier · 106.6×
J9354
HCPCS 		Ado-trastuzumab Emtansine 100 Mg Intravenous Solution [213503] 40 $5,529.64 $9,830.44 $7,495.72 nat. median
$4,004
1.9× median
C1785
HCPCS 		Hchg Pacemaker Advisa MRI 40 $2,650.72 $13,814.22 $7,382.45 nat. median
$7,020
1.1× median
J9301
HCPCS 		Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution [219413] 40 $1,474.25 $13,860.44 $7,056.23 nat. median
$170
outlier · 41.5×
J9308
HCPCS 		Ramucirumab 10 Mg/ml Intravenous Solution [220983] 40 $2,201.66 $11,556.09 $6,423.39 nat. median
$300
outlier · 21.4×
J2353
HCPCS 		Octreotide Microspheres ER 20 Mg Intramuscular Kit [1001152] 40 $6,112.53 $6,791.70 $6,404.57 nat. median
$1,956
outlier · 3.3×
J0840
HCPCS 		Crotalidae Polyval Immune Fab 1 Gram Solution For Injection [80543] 40 $4,070.56 $9,045.67 $6,331.97 nat. median
$3,496
1.8× median
J9303
HCPCS 		Panitumumab 100 Mg/5 Ml (20 Mg/ml) Intravenous Solution [189484] 40 $2,564.42 $10,768.12 $6,270.33 nat. median
$869
outlier · 7.2×
J9173
HCPCS 		Durvalumab 50 Mg/ml Intravenous Solution [235397] 40 $1,512.07 $11,997.40 $6,236.79 nat. median
$588
outlier · 10.6×
J9177
HCPCS 		Enfortumab Vedotin-ejfv 30 Mg Intravenous Solution [247354] 40 $3,893.27 $24,522.22 $6,118.93 nat. median
$112
outlier · 54.6×
J2506
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml (deliverable) Wearable Subcutaneous Injector [224417] 40 $5,699.22 $6,332.47 $5,971.52 nat. median
$916
outlier · 6.5×
A9572
HCPCS 		Hchg Indium 111 Octreotide (grmc Only) 40 $4,386.91 $7,385.37 $5,760.59 nat. median
$3,702
1.6× median
78459
CPT 		Hchg Heart Muscle Imaging (pet) 40 $5,086.80 $5,652.00 $5,329.84 nat. median
$1,344
outlier · 4.0×
J9299
HCPCS 		Nivolumab 100 Mg/10 Ml Intravenous Solution [223970] 40 $1,942.09 $12,232.36 $5,300.66 nat. median
$1,811
outlier · 2.9×
J7189
HCPCS 		Coagulation Factor Viia Recomb 1 Mg (1,000 Mcg) Intravenous Solution [188247] 40 $3,193.62 $7,096.94 $4,967.86 nat. median
$3,219
1.5× median
81455
CPT 		Hchg Targeted Genome Sequence Panel 40 $3,813.07 $5,839.20 $4,746.01 nat. median
$2,920
1.6× median
J9035
HCPCS 		Bevacizumab 25 Mg/ml Intravenous Solution [89897] 40 $4,418.24 $4,909.16 $4,629.34 nat. median
$319
outlier · 14.5×
J3358
HCPCS 		Ustekinumab 130 Mg/26 Ml Intravenous Solution [232275] 40 $2,936.39 $6,525.32 $4,567.73 nat. median
$38
outlier · 120.5×
0122
RC 		40 $4,320.00 $4,800.00 $4,526.40 nat. median
$854
outlier · 5.3×
J9176
HCPCS 		Elotuzumab 300 Mg Intravenous Solution [228395] 40 $3,217.15 $10,807.22 $4,494.42 nat. median
$2,022
outlier · 2.2×
0250U
OTHER 		Hchg Gene Analysis For Solid Tumor Panel 40 $3,746.25 $5,109.30 $4,380.43 nat. median
$3,842
1.1× median
J9205
HCPCS 		Irinotecan Liposomal 4.3 Mg/ml Intravenous [227718] 40 $4,128.89 $4,587.66 $4,326.16 nat. median
$129
outlier · 33.5×
0200
RC 		40 $3,915.00 $4,350.00 $4,102.05 nat. median
$3,863
1.1× median
0722
RC 		40 $3,888.00 $4,320.00 $4,073.76 nat. median
$2,198
1.9× median
J9179
HCPCS 		Eribulin 1 Mg/2 Ml (0.5 Mg/ml) Intravenous Solution [202064] 40 $2,068.47 $6,231.92 $3,953.51 nat. median
$275
outlier · 14.4×
J9317
HCPCS 		Sacituzumab Govitecan-hziy 180 Mg Intravenous Solution [248789] 40 $3,553.01 $3,947.79 $3,722.77 nat. median
$70
outlier · 53.5×
J0897
HCPCS 		Denosumab 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution [202142] 40 $2,528.54 $5,126.16 $3,711.51 nat. median
$86
outlier · 43.2×
78816
CPT 		Hchg Tumor Image Pet/ct Full Body 40 $3,497.18 $3,885.75 $3,664.26 nat. median
$1,696
outlier · 2.2×
C1776
HCPCS 		Hchg Baseplate 24mm 10 Full Augm 40 $50.40 $9,332.42 $3,392.03 nat. median
$3,543
1.0× median
J9145
HCPCS 		Daratumumab 20 Mg/ml Intravenous Solution [228111] 40 $1,043.40 $4,753.95 $3,382.81 nat. median
$1,066
outlier · 3.2×
78492
CPT 		Hchg Heart Image (pet), Multiple 40 $3,179.25 $3,532.50 $3,331.15 nat. median
$1,483
outlier · 2.2×
78813
CPT 		Hchg 78813-0404 Tumor Image Pet/ct, Whole Body 40 $3,179.25 $3,532.50 $3,331.15 nat. median
$1,497
outlier · 2.2×
81162
CPT 		Hchg Brca1, Brca2, Gene Anal, Full Seq & Full Dup/del 40 $2,956.50 $3,649.76 $3,285.00 nat. median
$1,880
1.7× median
Q5157
HCPCS 		Denosumab-bmwo 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution [273166] 40 $2,259.54 $4,387.08 $3,229.48 nat. median
$68
outlier · 47.6×
78815
CPT 		Hchg Tumorimage Pet/ct Skul-thigh 40 $3,073.28 $3,414.75 $3,220.11 nat. median
$1,679
1.9× median

Other procedures at this hospital

Browse this hospital's 1,919 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
             
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution [200352] 46 40 $89,776.52 — $80,798.87 $89,776.52 $84,659.26 2026-09-21
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution [203998] 138 40 $55,777.08 — $12,549.87 $75,884.88 $52,597.79 2026-09-21
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution [257450] 92 40 $35,624.77 — $21,374.87 $47,499.70 $33,249.79 2026-09-21
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution [234354] 46 40 $31,787.08 — $28,608.37 $31,787.08 $29,975.22 2026-09-21
J9022 HCPCS Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution [243606] 138 40 $17,847.62 — $11,244.02 $17,847.65 $16,473.38 2026-09-21
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution [241798] 46 40 $17,455.37 — $15,709.83 $17,455.37 $16,460.41 2026-09-21
J9144 HCPCS Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln [249116] 46 40 $16,199.27 — $14,579.34 $16,199.27 $15,275.91 2026-09-21
J3380 HCPCS Vedolizumab 300 Mg Intravenous Solution [221353] 46 40 $14,414.27 — $12,972.84 $14,414.27 $13,592.66 2026-09-21
J9271 HCPCS Pembrolizumab 25 Mg/ml Intravenous Solution [224448] 92 40 $13,896.22 — $8,337.74 $18,528.30 $12,969.81 2026-09-21
J9358 HCPCS Fam-trastuzumab Deruxtecan-nxki 100 Mg Intravenous Solution [247358] 92 40 $14,016.61 — $4,277.85 $23,280.05 $12,852.60 2026-09-21
J9223 HCPCS Lurbinectedin 4 Mg Intravenous Solution [249586] 46 40 $12,705.00 — $11,434.50 $12,705.00 $11,980.82 2026-09-21
J0896 HCPCS Luspatercept-aamt 25 Mg Subcutaneous Solution [246951] 92 40 $12,668.44 — $5,700.82 $19,002.63 $11,718.31 2026-09-21
J3101 HCPCS Tenecteplase 25 Mg Intravenous Solution [274292] 46 40 $11,736.39 — $10,562.75 $11,736.39 $11,067.42 2026-09-21
J9306 HCPCS Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution [207655] 46 40 $10,503.56 — $9,453.20 $10,503.56 $9,904.86 2026-09-21
J1162 HCPCS Digoxin Immune Fab 40 Mg Intravenous Solution [80896] 92 40 $10,553.51 — $6,332.11 $14,071.35 $9,849.95 2026-09-21
J1932 HCPCS Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe [163313] 46 40 $8,643.95 — $7,779.56 $8,643.95 $8,151.24 2026-09-21
J9354 HCPCS Ado-trastuzumab Emtansine 100 Mg Intravenous Solution [213503] 92 40 $7,987.24 — $5,529.64 $9,830.44 $7,495.72 2026-09-21
C1785 HCPCS Hchg Pacemaker Advisa MRI 368 40 $7,907.45 — $2,650.72 $13,814.22 $7,382.45 2026-09-21
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution [219413] 92 40 $7,749.25 — $1,474.25 $13,860.44 $7,056.23 2026-09-21
J9308 HCPCS Ramucirumab 10 Mg/ml Intravenous Solution [220983] 92 40 $7,001.19 — $2,201.66 $11,556.09 $6,423.39 2026-09-21
J2353 HCPCS Octreotide Microspheres ER 20 Mg Intramuscular Kit [1001152] 46 40 $6,791.70 — $6,112.53 $6,791.70 $6,404.57 2026-09-21
J0840 HCPCS Crotalidae Polyval Immune Fab 1 Gram Solution For Injection [80543] 92 40 $6,784.26 — $4,070.56 $9,045.67 $6,331.97 2026-09-21
J9303 HCPCS Panitumumab 100 Mg/5 Ml (20 Mg/ml) Intravenous Solution [189484] 92 40 $6,808.74 — $2,564.42 $10,768.12 $6,270.33 2026-09-21
J9173 HCPCS Durvalumab 50 Mg/ml Intravenous Solution [235397] 138 40 $6,613.78 — $1,512.07 $11,997.40 $6,236.79 2026-09-21
J9177 HCPCS Enfortumab Vedotin-ejfv 30 Mg Intravenous Solution [247354] 138 40 $6,488.79 — $3,893.27 $24,522.22 $6,118.93 2026-09-21
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml (deliverable) Wearable Subcutaneous Injector [224417] 46 40 $6,332.47 — $5,699.22 $6,332.47 $5,971.52 2026-09-21
A9572 HCPCS Hchg Indium 111 Octreotide (grmc Only) 92 40 $6,129.85 — $4,386.91 $7,385.37 $5,760.59 2026-09-21
78459 CPT Hchg Heart Muscle Imaging (pet) 46 40 $5,652.00 — $5,086.80 $5,652.00 $5,329.84 2026-09-21
J9299 HCPCS Nivolumab 100 Mg/10 Ml Intravenous Solution [223970] 184 40 $5,606.48 — $1,942.09 $12,232.36 $5,300.66 2026-09-21
J7189 HCPCS Coagulation Factor Viia Recomb 1 Mg (1,000 Mcg) Intravenous Solution [188247] 92 40 $5,322.70 — $3,193.62 $7,096.94 $4,967.86 2026-09-21
81455 CPT Hchg Targeted Genome Sequence Panel 92 40 $5,037.98 — $3,813.07 $5,839.20 $4,746.01 2026-09-21
J9035 HCPCS Bevacizumab 25 Mg/ml Intravenous Solution [89897] 46 40 $4,909.16 — $4,418.24 $4,909.16 $4,629.34 2026-09-21
J3358 HCPCS Ustekinumab 130 Mg/26 Ml Intravenous Solution [232275] 92 40 $4,893.99 — $2,936.39 $6,525.32 $4,567.73 2026-09-21
0122 RC — 46 40 $4,800.00 — $4,320.00 $4,800.00 $4,526.40 2026-09-21
J9176 HCPCS Elotuzumab 300 Mg Intravenous Solution [228395] 138 40 $4,766.09 — $3,217.15 $10,807.22 $4,494.42 2026-09-21
0250U OTHER Hchg Gene Analysis For Solid Tumor Panel 92 40 $4,635.90 — $3,746.25 $5,109.30 $4,380.43 2026-09-21
J9205 HCPCS Irinotecan Liposomal 4.3 Mg/ml Intravenous [227718] 46 40 $4,587.66 — $4,128.89 $4,587.66 $4,326.16 2026-09-21
0200 RC — 46 40 $4,350.00 — $3,915.00 $4,350.00 $4,102.05 2026-09-21
0722 RC — 46 40 $4,320.00 — $3,888.00 $4,320.00 $4,073.76 2026-09-21
J9179 HCPCS Eribulin 1 Mg/2 Ml (0.5 Mg/ml) Intravenous Solution [202064] 92 40 $4,265.11 — $2,068.47 $6,231.92 $3,953.51 2026-09-21
J9317 HCPCS Sacituzumab Govitecan-hziy 180 Mg Intravenous Solution [248789] 46 40 $3,947.79 — $3,553.01 $3,947.79 $3,722.77 2026-09-21
J0897 HCPCS Denosumab 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution [202142] 92 40 $3,967.82 — $2,528.54 $5,126.16 $3,711.51 2026-09-21
78816 CPT Hchg Tumor Image Pet/ct Full Body 46 40 $3,885.75 — $3,497.18 $3,885.75 $3,664.26 2026-09-21
C1776 HCPCS Hchg Baseplate 24mm 10 Full Augm 1,450 40 $3,675.00 — $50.40 $9,332.42 $3,392.03 2026-09-21
J9145 HCPCS Daratumumab 20 Mg/ml Intravenous Solution [228111] 138 40 $3,587.28 — $1,043.40 $4,753.95 $3,382.81 2026-09-21
78492 CPT Hchg Heart Image (pet), Multiple 46 40 $3,532.50 — $3,179.25 $3,532.50 $3,331.15 2026-09-21
78813 CPT Hchg 78813-0404 Tumor Image Pet/ct, Whole Body 46 40 $3,532.50 — $3,179.25 $3,532.50 $3,331.15 2026-09-21
81162 CPT Hchg Brca1, Brca2, Gene Anal, Full Seq & Full Dup/del 92 40 $3,467.38 — $2,956.50 $3,649.76 $3,285.00 2026-09-21
Q5157 HCPCS Denosumab-bmwo 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution [273166] 92 40 $3,448.84 — $2,259.54 $4,387.08 $3,229.48 2026-09-21
78815 CPT Hchg Tumorimage Pet/ct Skul-thigh 46 40 $3,414.75 — $3,073.28 $3,414.75 $3,220.11 2026-09-21
0720 RC — 368 40 $3,420.00 — $324.00 $6,480.00 $3,186.00 2026-09-21
81443 CPT Hchg Genetic Tstg Severe Inh Cond 92 40 $3,414.93 — $1,739.47 $4,897.12 $3,170.08 2026-09-21
J2407 HCPCS Oritavancin 400 Mg Intravenous Solution [222834] 92 40 $3,325.19 — $1,560.98 $4,915.96 $3,079.39 2026-09-21
Q4116 HCPCS Hchg Alldoderm 5x10cm Tissue Mat 184 40 $3,230.36 — $2,473.56 $3,768.26 $3,054.83 2026-09-21
J1745 HCPCS Infliximab 100 Mg Intravenous Solution [80717] 92 40 $3,277.99 — $1,652.42 $4,719.96 $3,041.99 2026-09-21
J9023 HCPCS Avelumab 20 Mg/ml Intravenous Solution [234339] 46 40 $3,224.80 — $2,902.32 $3,224.80 $3,040.99 2026-09-21
J2802 HCPCS Romiplostim 125 Mcg Subcutaneous Solution [246993] 92 40 $3,241.37 — $2,019.17 $4,239.22 $3,029.41 2026-09-21
J3032 HCPCS Eptinezumab-jjmr 100 Mg/ml Intravenous Solution [248004] 46 40 $3,162.32 — $2,846.09 $3,162.32 $2,982.07 2026-09-21
90375 CPT Rabies Immune Globulin (pf) 300 Unit/ml Intramuscular Solution [239961] 46 40 $3,160.46 — $2,844.41 $3,160.46 $2,980.31 2026-09-21
C1713 HCPCS Hchg Nail Titan 170mm Deg 456.3 1,380 40 $3,040.01 — $47.25 $4,618.93 $2,938.69 2026-09-21
J0401 HCPCS Aripiprazole ER 300 Mg Intramuscular Suspension,extended Release Vial [214038] 46 40 $3,040.31 — $2,736.28 $3,040.31 $2,867.01 2026-09-21
J9047 HCPCS Carfilzomib 10 Mg Intravenous Solution [241101] 138 40 $2,882.53 — $965.56 $5,446.74 $2,718.23 2026-09-21
78608 CPT Hchg Brain Imaging (pet) 46 40 $2,826.00 — $2,543.40 $2,826.00 $2,664.92 2026-09-21
78609 CPT Hchg Pet/ct Brain Perfusion Eval 46 40 $2,826.00 — $2,543.40 $2,826.00 $2,664.92 2026-09-21
78814 CPT Hchg Tumor Image Pet/ct, Limited 46 40 $2,826.00 — $2,543.40 $2,826.00 $2,664.92 2026-09-21
78812 CPT Hchg Tumor Image (pet)/skul-thigh 46 40 $2,826.00 — $2,543.40 $2,826.00 $2,664.92 2026-09-21
0123 RC — 46 40 $2,630.00 — $2,367.00 $2,630.00 $2,480.09 2026-09-21
J0129 HCPCS Abatacept (with Maltose) 250 Mg Intravenous Solution [95400] 46 40 $2,438.08 — $2,194.27 $2,438.08 $2,299.11 2026-09-21
A9548 HCPCS Hchg Indium 111 Dtpa (per 0.5 Mci) (grmc Only) 92 40 $2,431.14 — $1,739.87 $2,929.08 $2,284.68 2026-09-21
Q5107 HCPCS Bevacizumab-awwb 25 Mg/ml Intravenous Solution [237749] 92 40 $2,406.69 — $988.01 $3,715.59 $2,220.91 2026-09-21
J2357 HCPCS Omalizumab 150 Mg (125 Mg/ml) Subcutaneous Solution [88091] 92 40 $2,329.05 — $2,031.74 $2,400.60 $2,215.75 2026-09-21
J7336 HCPCS Capsaicin-skin Cleanser 8 % Topical Kit [198813] 92 40 $2,307.43 — $1,488.03 $2,961.50 $2,159.36 2026-09-21
A9569 HCPCS Hchg 99 Mtc Ceretec (grmc Only) 92 40 $2,178.05 — $1,558.76 $2,624.16 $2,046.84 2026-09-21
Q5119 HCPCS Rituximab-pvvr 10 Mg/ml Intravenous Solution [245596] 92 40 $2,203.85 — $859.57 $3,452.61 $2,031.22 2026-09-21
J7168 HCPCS Hum Prothrombin Cplx(pcc)4fact 1,000 Unit (800-1,240 Unit) IV Solution [221650] 92 40 $2,152.01 — $1,408.68 $2,738.81 $2,015.07 2026-09-21
J0881 HCPCS Darbepoetin Alfa 100 Mcg/0.5 Ml In Polysorbate Injection Syringe [101981] 276 40 $2,128.43 — $858.24 $5,745.47 $2,006.80 2026-09-21
78811 CPT Hchg 78811-0404 Tumor Image Pet/ct, Limited, Chest/head/neck 46 40 $2,119.50 — $1,907.55 $2,119.50 $1,998.69 2026-09-21
Q0249 HCPCS Tocilizumab 200 Mg/10 Ml (20 Mg/ml) Intravenous Solution [197820] 46 40 $2,088.74 — $1,879.87 $2,088.74 $1,969.68 2026-09-21
0172 RC — 46 40 $2,067.00 — $1,860.30 $2,067.00 $1,949.18 2026-09-21
0214 RC — 46 40 $2,065.16 — $1,858.64 $2,065.16 $1,947.45 2026-09-21
J9055 HCPCS Cetuximab 100 Mg/50 Ml Intravenous Solution [191638] 92 40 $2,050.30 — $1,322.20 $2,631.48 $1,918.72 2026-09-21
0206 RC — 46 40 $1,989.65 — $1,790.68 $1,989.65 $1,876.24 2026-09-21
J7298 HCPCS Levonorgestrel 21 Mcg/24 Hr (up To 8 Years) 52 Mg Intrauterine Device [77254] 46 40 $1,979.85 — $1,781.87 $1,979.85 $1,867.00 2026-09-21
Q5117 HCPCS Trastuzumab-anns 150 Mg Intravenous Solution [246645] 46 40 $1,958.66 — $1,762.79 $1,958.66 $1,847.02 2026-09-21
0171 RC — 46 40 $1,950.00 — $1,755.00 $1,950.00 $1,838.85 2026-09-21
J9264 HCPCS Paclitaxel Protein-bound 100 Mg Intravenous Suspension [94058] 92 40 $1,949.38 — $1,272.06 $2,485.36 $1,825.11 2026-09-21
0503T OTHER Hchg Ffr From Ct2 46 40 $1,892.00 — $1,702.80 $1,892.00 $1,784.16 2026-09-21
0502T OTHER Hchg Ffr From CT 46 40 $1,892.00 — $1,702.80 $1,892.00 $1,784.16 2026-09-21
75580 CPT Hchg 75580-0480 Non-inv Est Of Coronary Ffr Agmnt Sw Alys CTA I&r Phy/qhp 46 40 $1,892.00 — $1,702.80 $1,892.00 $1,784.16 2026-09-21
78491 CPT Hchg Pet, Myocardial Img 46 40 $1,884.00 — $1,695.60 $1,884.00 $1,776.61 2026-09-21
81229 CPT Hchg Chromosomal Microarray, Poc 92 40 $1,891.25 — $1,316.25 $2,320.00 $1,775.25 2026-09-21
0121 RC — 184 40 $1,872.78 — $1,580.40 $2,290.42 $1,774.16 2026-09-21
A0426 HCPCS Hchg Ambulance Als Base Rate (grmc Only) 46 40 $1,845.00 — $1,660.50 $1,845.00 $1,739.84 2026-09-21
J9202 HCPCS Goserelin 3.6 Mg Subcutaneous Implant [77747] 46 40 $1,832.04 — $1,648.84 $1,832.04 $1,727.61 2026-09-21
J1569 HCPCS Immune Glob,gamma (igg) 10 %-gly-iga Over 50 Mcg/ml Injection Solution [224994] 138 40 $1,830.17 — $919.58 $3,458.23 $1,725.85 2026-09-21
70549 CPT Hchg Mr Angiograph Neck W/O&with Contrast 46 40 $1,828.80 — $1,645.92 $1,828.80 $1,724.56 2026-09-21
70546 CPT Hchg Mr Angiograph Head W/O&with Contrast 46 40 $1,816.10 — $1,634.49 $1,816.10 $1,712.58 2026-09-21
59412 CPT Hchg Antepartum Manipluation 46 40 $1,800.00 — $1,620.00 $1,800.00 $1,697.40 2026-09-21
Q5118 HCPCS Bevacizumab-bvzr 25 Mg/ml Intravenous Solution [245484] 92 40 $1,827.45 — $810.00 $2,754.91 $1,689.71 2026-09-21
J0175 HCPCS Donanemab-azbt 17.5 Mg/ml Intravenous Solution [268992] 92 40 $1,789.08 — $1,153.75 $2,296.22 $1,674.27 2026-09-21
J7318 HCPCS Hyaluronate Sodium, Stabilized 60 Mg/3 Ml Intra-articular Syringe [238534] 92 40 $1,744.20 — $1,503.84 $1,817.46 $1,670.93 2026-09-21
A9589 HCPCS Hexaminolevulinate 100 Mg Intravesical Solution [201092] 46 40 $1,757.39 — $1,581.65 $1,757.39 $1,657.22 2026-09-21
J3424 HCPCS Hydroxocobalamin 5 Gram Intravenous Solution [208930] 46 40 $1,751.92 — $1,576.73 $1,751.92 $1,652.06 2026-09-21
Q5103 HCPCS Infliximab-dyyb 100 Mg Intravenous Solution [232641] 92 40 $1,732.24 — $907.21 $2,456.46 $1,609.41 2026-09-21
J7307 HCPCS Etonogestrel 68 Mg Subdermal Implant [101933] 46 40 $1,701.38 — $1,531.24 $1,701.38 $1,604.40 2026-09-21
J7297 HCPCS Levonorgestrel 20.4 Mcg/24 Hr (up To 8 Yrs) 52 Mg Intrauterine Device [225295] 46 40 $1,695.75 — $1,526.17 $1,695.75 $1,599.09 2026-09-21
J0875 HCPCS Dalbavancin 500 Mg Intravenous Solution [221530] 138 40 $1,671.67 — $1,204.24 $3,396.58 $1,576.38 2026-09-21
71552 CPT Hchg MRI Chest W And Without Contrast 46 40 $1,663.70 — $1,497.33 $1,663.70 $1,568.87 2026-09-21
J7301 HCPCS Levonorgestrel 14 Mcg/24 Hr (up To 3 Yrs) 13.5 Mg Intrauterine Device [212448] 46 40 $1,648.55 — $1,483.69 $1,648.55 $1,554.58 2026-09-21
J0585 HCPCS Onabotulinumtoxina 100 Unit Solution For Injection [77981] 92 40 $1,653.54 — $1,066.34 $2,122.26 $1,547.42 2026-09-21
77048 CPT Hchg MRI Breast Unilateral 46 40 $1,638.30 — $1,474.47 $1,638.30 $1,544.92 2026-09-21
J1439 HCPCS Ferric Carboxymaltose 50 Mg Iron/ml Intravenous Solution [218045] 46 40 $1,631.99 — $1,468.79 $1,631.99 $1,538.97 2026-09-21
77049 CPT Hchg Breast Bilateral 46 40 $1,625.60 — $1,463.04 $1,625.60 $1,532.94 2026-09-21
Q4317 HCPCS Hchg Q4137 Graft 4x4 Cm Amnioexcel + Allograft; P/sq Cm (16 Units), 313960 92 40 $1,538.30 — $1,336.73 $1,591.35 $1,468.82 2026-09-21
G0257 HCPCS Hchg Perito Dial >1eval Op 46 40 $1,450.00 — $1,305.00 $1,450.00 $1,367.35 2026-09-21
90999 CPT Hchg Hemodial 1 Eval Inpt 46 40 $1,450.00 — $1,305.00 $1,450.00 $1,367.35 2026-09-21
E1629 HCPCS Hchg Sol Dlyst Cart Tablo, 329289 46 40 $1,445.23 — $1,300.71 $1,445.23 $1,362.85 2026-09-21
0001U OTHER Hchg Xhea Licensed Rbc Panel 46 40 $1,440.00 — $1,296.00 $1,440.00 $1,357.92 2026-09-21
81292 CPT Hchg Mlh1 Full (mlhmsh) 92 40 $1,406.65 — $1,215.72 $1,462.50 $1,349.89 2026-09-21
74183 CPT Hchg MRI Abdomen Without & With Contrast 46 40 $1,409.70 — $1,268.73 $1,409.70 $1,329.35 2026-09-21
73720 CPT Hchg MRI Lwr Extremity W/O&with Contrast 46 40 $1,409.70 — $1,268.73 $1,409.70 $1,329.35 2026-09-21
73220 CPT Hchg MRI Uppr Extremity W/O&with Contrast 46 40 $1,397.00 — $1,257.30 $1,397.00 $1,317.37 2026-09-21
72197 CPT Hchg MRI Pelvis Without & With Contrast 46 40 $1,397.00 — $1,257.30 $1,397.00 $1,317.37 2026-09-21
90937 CPT Hchg Hemodialysis W/multiple Eva (grmc Only) 46 40 $1,391.63 — $1,252.47 $1,391.63 $1,312.31 2026-09-21
90947 CPT Hchg 90947-0801 Crrh Dialysis 46 40 $1,391.63 — $1,252.47 $1,391.63 $1,312.31 2026-09-21
90935 CPT Hchg 90935-0829 Non Ersd Hemo Dialysis O/p 46 40 $1,363.80 — $1,227.42 $1,363.80 $1,286.06 2026-09-21
90945 CPT Hchg Perito Dial 1 Eval Inpt 46 40 $1,363.80 — $1,227.42 $1,363.80 $1,286.06 2026-09-21
81450 CPT Hchg Targeted Genomic Seq Analysis 92 40 $1,333.28 — $1,032.75 $1,519.06 $1,257.33 2026-09-21
J1459 HCPCS Immune Glob,gamm(igg) 10 %-pro-iga 0 To 50 Mcg/ml Intravenous Solution [224995] 138 40 $1,319.50 — $694.92 $2,363.50 $1,244.29 2026-09-21
73223 CPT Hchg MRI Joint Upr Extr W/O&with Contrast 46 40 $1,295.40 — $1,165.86 $1,295.40 $1,221.56 2026-09-21
73723 CPT Hchg MRI Joint Lwr Extr W/O&with Contrast 46 40 $1,295.40 — $1,165.86 $1,295.40 $1,221.56 2026-09-21
70548 CPT Hchg Mr Angiography Neck W/dy 46 40 $1,257.30 — $1,131.57 $1,257.30 $1,185.63 2026-09-21
Q4119 HCPCS Hchg Dres 2x4cm Surgical Matrix 276 40 $1,267.35 — $262.89 $1,877.51 $1,179.73 2026-09-21
J1212 HCPCS Dimethyl Sulfoxide 50 % Intravesical Solution [189482] 46 40 $1,219.86 — $1,097.87 $1,219.86 $1,150.33 2026-09-21
71550 CPT Hchg MRI Chest Without Contrast 46 40 $1,219.20 — $1,097.28 $1,219.20 $1,149.71 2026-09-21
P9073 HCPCS Hchg Pathogen Reduced Platelets 92 40 $1,219.00 — $931.50 $1,403.00 $1,148.85 2026-09-21
0503U OTHER Hchg Neuro Alz Ds Bamyl&tau Prtn,precivityad2 138 40 $1,203.75 — $1,011.15 $1,500.00 $1,135.14 2026-09-21
70547 CPT Hchg Mr Angiography Neck Without Contrast 46 40 $1,193.80 — $1,074.42 $1,193.80 $1,125.75 2026-09-21
Q5116 HCPCS Trastuzumab-qyyp 150 Mg Intravenous Solution [252714] 46 40 $1,185.59 — $1,067.03 $1,185.59 $1,118.01 2026-09-21
J0248 HCPCS Remdesivir 100 Mg Intravenous Powder For Solution [248291] 46 40 $1,184.32 — $1,065.89 $1,184.32 $1,116.81 2026-09-21
70544 CPT Hchg Mr Angiography Head Without Contrast 46 40 $1,181.10 — $1,062.99 $1,181.10 $1,113.78 2026-09-21
78804 CPT Hchg Abscess Imaging, Whole Body >1 Day 46 40 $1,177.50 — $1,059.75 $1,177.50 $1,110.38 2026-09-21
70545 CPT Hchg Mr Angiography Head W/dy 46 40 $1,168.40 — $1,051.56 $1,168.40 $1,101.80 2026-09-21
72159 CPT Hchg MRA Spine Wo & W Cont 46 40 $1,168.40 — $1,051.56 $1,168.40 $1,101.80 2026-09-21
73225 CPT Hchg MRA Upper Extremity 46 40 $1,155.70 — $1,040.13 $1,155.70 $1,089.83 2026-09-21
72196 CPT Hchg MRI Pelvis With Contrast 46 40 $1,155.70 — $1,040.13 $1,155.70 $1,089.83 2026-09-21
74185 CPT Hchg MRA Abdomen 46 40 $1,117.60 — $1,005.84 $1,117.60 $1,053.90 2026-09-21
72198 CPT Hchg MRA Pelvis W/wo Contrast 46 40 $1,117.60 — $1,005.84 $1,117.60 $1,053.90 2026-09-21
81445 CPT Hchg Targeted Lung Neoplasm Genomic Sequence Analysis 92 40 $1,104.16 — $911.25 $1,195.82 $1,044.37 2026-09-21
73725 CPT Hchg MRA Lower Extremity 46 40 $1,104.90 — $994.41 $1,104.90 $1,041.92 2026-09-21
70543 CPT Hchg MRI Orbt/fac/nck Without & With Contrast 46 40 $1,104.90 — $994.41 $1,104.90 $1,041.92 2026-09-21
71555 CPT Hchg MRA Chest W & Without Chest 46 40 $1,104.90 — $994.41 $1,104.90 $1,041.92 2026-09-21
J7327 HCPCS Hyaluronate Sodium, Stabilized 88 Mg/4 Ml Intra-articular Syringe [220928] 46 40 $1,092.77 — $983.49 $1,092.77 $1,030.48 2026-09-21
Q0138 HCPCS Ferumoxytol 510 Mg/17 Ml (30 Mg/ml) Intravenous Solution [195262] 92 40 $1,099.69 — $730.72 $1,387.48 $1,030.32 2026-09-21
J0630 HCPCS Calcitonin (salmon) 200 Unit/ml Injection Solution [83024] 46 40 $1,084.93 — $976.44 $1,084.93 $1,023.09 2026-09-21
0282U OTHER Hchg Rbc Ag Genotyping DNA 92 40 $1,093.50 — $672.30 $1,440.00 $1,021.50 2026-09-21
81479 CPT Hchg Ehlers-danlos Synd Gene Panel-misc Molecular (mayo) 184 40 $1,096.88 — $509.18 $1,800.00 $1,018.12 2026-09-21
81406 CPT Hchg Unlisted Molecular Path Procedure 184 40 $1,096.88 — $509.18 $1,800.00 $1,018.12 2026-09-21
72195 CPT Hchg MRI Pelvis Without Contrast 46 40 $1,079.50 — $971.55 $1,079.50 $1,017.97 2026-09-21
93975 CPT Hchg Renal/celiac/sma Duplex Complete 46 40 $1,071.00 — $963.90 $1,071.00 $1,009.95 2026-09-21
P9053 HCPCS Hchg Bb Phplt L/r Cmvn Lrr 92 40 $1,075.66 — $721.20 $1,350.00 $1,008.16 2026-09-21
73218 CPT Hchg MRI Upper Extremity Without Contrast 46 40 $1,066.80 — $960.12 $1,066.80 $1,005.99 2026-09-21
94640 CPT Hchg Aerosol/mdi Tx (ip) (grmc Only) 92 40 $1,105.00 — $153.00 $2,040.00 $1,003.00 2026-09-21
94003 CPT Hchg Ventilator Gen Floors-subseque 46 40 $1,062.50 — $956.25 $1,062.50 $1,001.94 2026-09-21
94002 CPT Hchg Ventilator Gen Floors-initial 46 40 $1,062.50 — $956.25 $1,062.50 $1,001.94 2026-09-21
73718 CPT Hchg MRI Lower Extremity Without Contrast 46 40 $1,054.10 — $948.69 $1,054.10 $994.02 2026-09-21
73222 CPT Hchg MRI Jnt Upr Ext W/contrst 46 40 $1,054.10 — $948.69 $1,054.10 $994.02 2026-09-21
93925 CPT Hchg Peripheral Art Duplex Le Bilateral 46 40 $1,054.00 — $948.60 $1,054.00 $993.92 2026-09-21
C8929 HCPCS Hchg 2d Doppler Color Flow Complete W/contr 46 40 $1,037.00 — $933.30 $1,037.00 $977.89 2026-09-21
70471 CPT Hchg 70471-351 CTA H&n C+ W/noncontrast Img 92 40 $1,057.50 — $465.30 $1,598.00 $977.60 2026-09-21
P9037 HCPCS Hchg Proc Fee Plt Lr/ir/ph Ea 92 40 $1,028.41 — $676.65 $1,305.00 $963.16 2026-09-21
93351 CPT Hchg Echocardiogram Stress Incl Ecg&echo 46 40 $1,020.00 — $918.00 $1,020.00 $961.86 2026-09-21
93306 CPT Hchg 2d Doppler Color Flow Complete 46 40 $1,020.00 — $918.00 $1,020.00 $961.86 2026-09-21
36430 CPT Hchg Transfusion Blood/comp. 0-90 Minutes (grmc Only) 276 40 $975.00 — $386.10 $1,404.00 $935.92 2026-09-21
Q4159 HCPCS Hchg Affinity 1.5 X 1.5 Cm; Per Sq Cm (3 Units) 92 40 $987.79 — $780.75 $1,108.09 $932.39 2026-09-21
J0561 HCPCS Penicillin G Benzathine 1,200,000 Unit/2 Ml Intramuscular Syringe [86485] 92 40 $993.00 — $649.74 $1,264.08 $929.80 2026-09-21
J1670 HCPCS Tetanus Immune Globulin (pf) 250 Unit/ml Intramuscular Syringe [187777] 46 40 $978.93 — $881.04 $978.93 $923.13 2026-09-21
90371 CPT Hepatitis B Immune Globulin > 1,560 Unit/5 Ml Intramuscular Solution [134792] 46 40 $968.45 — $871.61 $968.45 $913.25 2026-09-21
P9055 HCPCS Hchg Bb Phplt L/r Cmvn Irr 92 40 $962.57 — $679.62 $1,170.00 $904.07 2026-09-21
90380 CPT Nirsevimab-alip 50 Mg/0.5 Ml Intramuscular Syringe [263737] 46 40 $957.20 — $861.48 $957.20 $902.64 2026-09-21
72157 CPT Hchg MRI Chest Spine Without & With Contrast 46 40 $952.50 — $857.25 $952.50 $898.21 2026-09-21
70553 CPT Hchg MRI Brain Without & With Contrast 46 40 $939.80 — $845.82 $939.80 $886.23 2026-09-21
72158 CPT Hchg MRI Lumbar Spine Without & With Contrast 46 40 $939.80 — $845.82 $939.80 $886.23 2026-09-21
72156 CPT Hchg MRI C-spine W & Without Contrast 46 40 $939.80 — $845.82 $939.80 $886.23 2026-09-21
J9217 HCPCS Leuprolide Acetate 22.5 Mg (3 Month) Intramuscular Syringe Kit [80531] 138 40 $932.97 — $721.47 $1,671.15 $879.79 2026-09-21
74181 CPT Hchg MRI Abdomen Without Contrast 46 40 $927.10 — $834.39 $927.10 $874.26 2026-09-21
78227 CPT Hchg Hepatobilary Imaging With Pharm Intervention 46 40 $926.30 — $833.67 $926.30 $873.50 2026-09-21
0221 RC — 46 40 $925.00 — $832.50 $925.00 $872.27 2026-09-21
P9035 HCPCS Hchg Proc Fee Plt Lr Pher Ea U 92 40 $915.32 — $635.07 $1,125.00 $859.07 2026-09-21
78452 CPT Hchg Heart Image (3d), Multiple 46 40 $902.75 — $812.48 $902.75 $851.29 2026-09-21
59025 CPT Hchg 59025-0920 Fetal Non-stress Test 54 40 $900.00 — $810.00 $900.00 $848.70 2026-09-21
70336 CPT Hchg Magnetic Image, Jaw Joint 46 40 $889.00 — $800.10 $889.00 $838.33 2026-09-21
E0467 HCPCS Hchg Vent G02 Model 6123 Disposa, 406631 92 40 $906.60 — $222.21 $1,566.30 $828.28 2026-09-21
81420 CPT Hchg Cell Free DNA Prenatal (quest) 92 40 $903.05 — $259.20 $1,518.10 $827.14 2026-09-21
J0174 HCPCS Lecanemab-irmb 100 Mg/ml Intravenous Solution [261045] 92 40 $872.51 — $500.78 $1,188.61 $813.09 2026-09-21
M0245 HCPCS Hchg Intravenous Infusion, Bamlanivimab And Etesevimab, Infusion And Post Admin… 46 40 $858.00 — $772.20 $858.00 $809.09 2026-09-21
M0243 HCPCS Hchg Casirivi And Imdevi Inc Infusion Monitoring 46 40 $858.00 — $772.20 $858.00 $809.09 2026-09-21
78454 CPT Hchg Nm Planar Mp Stress/rest Mult 46 40 $847.80 — $763.02 $847.80 $799.48 2026-09-21
94070 CPT Hchg Bronchial Challenge Test 46 40 $840.00 — $756.00 $840.00 $792.12 2026-09-21
70540 CPT Hchg MRI Orbit/face/neck Without Contrast 46 40 $838.20 — $754.38 $838.20 $790.42 2026-09-21
70552 CPT Hchg MRI Brain With Contrast 46 40 $825.50 — $742.95 $825.50 $778.45 2026-09-21
A4300 HCPCS Hchg Cath Powerline 6fr With 07006, 407041 138 40 $824.60 — $89.29 $1,560.57 $777.60 2026-09-21
81220 CPT Hchg Cftr (cfcs) 92 40 $832.23 — $496.13 $1,113.20 $776.57 2026-09-21
81295 CPT Hchg Msh2 Full (mlhmsh) 92 40 $809.20 — $687.06 $855.00 $766.45 2026-09-21
J0256 HCPCS Alpha-1-proteinase Inhibitor (human) 1,000 Mg (+/-)/20 Ml IV Solution [238032] 46 40 $807.02 — $726.32 $807.02 $761.02 2026-09-21
93930 CPT Hchg Peripheral Art Duplex Ue Bilateral 46 40 $799.00 — $719.10 $799.00 $753.46 2026-09-21
Q4081 HCPCS Epoetin Alfa 20,000 Unit/ml Injection [79866] 92 40 $803.56 — $533.94 $1,013.85 $752.87 2026-09-21
74280 CPT Hchg X-ray Colon Contrast 46 40 $782.00 — $703.80 $782.00 $737.43 2026-09-21
93880 CPT Hchg Carotid Duplex Bilateral/complete 46 40 $782.00 — $703.80 $782.00 $737.43 2026-09-21
93970 CPT Hchg Venous Duplex Ue/le Bilateral 46 40 $782.00 — $703.80 $782.00 $737.43 2026-09-21
A7002 HCPCS Hchg A7002 Tube Esoph 20fr Adult Blkmr Bal Ltx 8in 1.5in, 49691 184 40 $813.68 — $49.19 $1,649.13 $736.72 2026-09-21
78072 CPT Hchg Parathyroid Imaging With Spect & CT 46 40 $769.30 — $692.37 $769.30 $725.45 2026-09-21
J0666 HCPCS Bupivacaine Liposome(pf) 1.3 %(13.3 Mg/ml) Suspension For Infiltration [209929] 46 40 $764.29 — $687.86 $764.29 $720.73 2026-09-21
0199 RC — 46 40 $750.00 — $675.00 $750.00 $707.25 2026-09-21
95938 CPT Hchg Ssep-upper & Lower 46 40 $747.00 — $672.30 $747.00 $704.42 2026-09-21
78830 CPT Hchg Spect/ct Single Area 46 40 $745.75 — $671.17 $745.75 $703.24 2026-09-21
81372 CPT Hchg Hla Low Res Class I (rssop) 92 40 $741.09 — $607.50 $807.18 $700.73 2026-09-21
J1410 HCPCS Conjugated Estrogens 25 Mg Solution For Injection [82901] 46 40 $737.33 — $663.60 $737.33 $695.30 2026-09-21
93978 CPT Hchg Ao/iliac/ivc Or Graft Complete 46 40 $731.00 — $657.90 $731.00 $689.33 2026-09-21
90675 CPT Rabies Vaccine, Purified Chicken Embryo Cell (pf) 2.5 Unit IM Susp [85731] 92 40 $703.26 — $558.01 $786.51 $663.93 2026-09-21
96413 CPT Hchg Chemo Infusion Up To 1 Hour (grmc Only) 46 40 $702.00 — $631.80 $702.00 $661.99 2026-09-21
G0498 HCPCS Hchg Chemo Extend IV Infusion W/pump (grmc Only) 46 40 $702.00 — $631.80 $702.00 $661.99 2026-09-21
M0247 HCPCS Hchg Intravenous Infusion, Sotrovimab, Infusion & Post Admin Monitoring 46 40 $702.00 — $631.80 $702.00 $661.99 2026-09-21
M0222 HCPCS Hchg Bebtelovimab Injection And Monitoring 46 40 $702.00 — $631.80 $702.00 $661.99 2026-09-21
96369 CPT Hchg Sc Ther Infus Up To 1 Hr 46 40 $702.00 — $631.80 $702.00 $661.99 2026-09-21
96416 CPT Hchg 96416-0510 Prolonged Chemo IV Infusion; > 8 Hours 46 40 $702.00 — $631.80 $702.00 $661.99 2026-09-21
78630 CPT Hchg Cerebrospinal Fluid Scan 46 40 $698.65 — $628.78 $698.65 $658.83 2026-09-21
81301 CPT Hchg Microsatellite Instability (neo) 92 40 $697.31 — $627.41 $697.50 $657.56 2026-09-21
78278 CPT Hchg Acute Gi Blood Loss Imaging 46 40 $690.80 — $621.72 $690.80 $651.42 2026-09-21
78195 CPT Hchg Lymph System Imaging 46 40 $682.95 — $614.65 $682.95 $644.02 2026-09-21
78709 CPT Hchg Nm Kidney Image Renogram 46 40 $682.95 — $614.65 $682.95 $644.02 2026-09-21
78264 CPT Hchg Gastric Emptying Study 46 40 $682.95 — $614.65 $682.95 $644.02 2026-09-21
78606 CPT Hchg Nm Brain Scan & Flow 46 40 $682.95 — $614.65 $682.95 $644.02 2026-09-21
78315 CPT Hchg Bone Imaging, 3 Phase 46 40 $682.95 — $614.65 $682.95 $644.02 2026-09-21
78290 CPT Hchg Meckel Divert Exam 46 40 $682.95 — $614.65 $682.95 $644.02 2026-09-21
29445 CPT Hchg Application Rigid Cast; Per 15 Minutes (grmc Only) 276 40 $678.84 — $263.83 $1,157.10 $640.27 2026-09-21
78226 CPT Hchg Hepatobiliary Imaging 46 40 $675.10 — $607.59 $675.10 $636.62 2026-09-21
95812 CPT Hchg Eeg, 41-60 Minutes 46 40 $675.00 — $607.50 $675.00 $636.52 2026-09-21
99291 CPT Hchg Critical Care, First Hour 92 40 $663.00 — $576.00 $686.00 $633.18 2026-09-21
87902 CPT Hchg Infectious Agent Genotype Analysis By Nucleic Acid, Hep C Virus 100 40 $668.55 — $514.89 $765.00 $630.30 2026-09-21
78803 CPT Hchg Tumor Imaging (3d) 1 Area, 1 Day 46 40 $667.25 — $600.52 $667.25 $629.22 2026-09-21
0202U OTHER Hchg Resp Panel 22 Targets Incl Sarscov2 92 40 $665.59 — $364.50 $926.18 $619.28 2026-09-21
87633 CPT Hchg Viral Id, Respiratory - Utn (quest) 92 40 $665.59 — $364.50 $926.18 $619.28 2026-09-21
0194 RC — 46 40 $650.00 — $585.00 $650.00 $612.95 2026-09-21
93990 CPT Hchg Dialysis Graft Duplex -uni/bi 46 40 $646.00 — $581.40 $646.00 $609.18 2026-09-21
93985 CPT Hchg Duplex Scan, Prep Hemodialysis Access, Complt Bilat Study 46 40 $646.00 — $581.40 $646.00 $609.18 2026-09-21
78582 CPT Hchg Ventilation And Perfusion Lung Scan 46 40 $643.70 — $579.33 $643.70 $607.01 2026-09-21
78802 CPT Hchg Tumor Image Body Sgl Day 46 40 $643.70 — $579.33 $643.70 $607.01 2026-09-21
99285 CPT Hchg Emergency Dept Visit L5 46 40 $640.00 — $576.00 $640.00 $603.52 2026-09-21
96116 CPT Hchg Neurobehavior Status Ex (1 Hour) (grmc Only) 184 40 $640.71 — $346.46 $1,023.00 $602.21 2026-09-21
96105 CPT Hchg St Aphasia Eval (1 Hr) 184 40 $640.71 — $346.46 $1,023.00 $602.21 2026-09-21
87901 CPT Hchg HIV-1 Genotype Inhibitors (quest) 92 40 $639.95 — $463.41 $765.00 $601.70 2026-09-21
Q4124 HCPCS Hchg Oasis Tri-layer Dressing 92 40 $635.93 — $502.65 $713.37 $600.26 2026-09-21
78451 CPT Hchg Heart Image (3d), Single 46 40 $628.00 — $565.20 $628.00 $592.20 2026-09-21
87483 CPT Hchg Meningitis Panel Pcr Csf (mayo) 138 40 $625.17 — $324.00 $833.56 $589.54 2026-09-21
G9880 HCPCS Hchg Dpp 5% Achieved-mod Vm (grmc Only) 46 40 $624.00 — $561.60 $624.00 $588.43 2026-09-21
81340 CPT Hchg Trb Gene Rearrangement Analysis Pcr (quest) 184 40 $621.00 — $376.06 $3,250.00 $583.51 2026-09-21
A9562 HCPCS Hchg 99 Mtc Mag 3 (grmc Only) 92 40 $615.59 — $440.55 $741.67 $578.50 2026-09-21
87507 CPT Hchg Gi Pathogen 22 Targets 112 40 $619.28 — $364.50 $833.56 $577.60 2026-09-21
93926 CPT Hchg Peripheral Art Duplex Le Uni/ltd 46 40 $612.00 — $550.80 $612.00 $577.12 2026-09-21
81405 CPT Hchg Molecular Pathology Procedure, Level 62 92 40 $605.10 — $542.43 $607.50 $570.46 2026-09-21
92607 CPT Hchg St Eval Speech Aac <=1 Hr 92 40 $610.98 — $346.46 $837.00 $569.13 2026-09-21
88309 CPT Hchg Level 6 Gross/micro Exam (pro Fee) 138 40 $602.70 — $253.13 $842.64 $568.35 2026-09-21
81408 CPT Hchg Ehlers-danlos Synd Gene Panel-mol Path Lvl 8 (mayo) 92 40 $592.25 — $509.18 $618.75 $565.76 2026-09-21
73721 CPT Hchg MRI Jnt Of Lwr Extre Without Contrast 46 40 $596.90 — $537.21 $596.90 $562.88 2026-09-21
73221 CPT Hchg MRI Joint Upr Extrem Without Contrast 46 40 $596.90 — $537.21 $596.90 $562.88 2026-09-21
78070 CPT Hchg Parathyroid Nuclear Imaging 46 40 $596.60 — $536.94 $596.60 $562.59 2026-09-21
74248 CPT Hchg Rad Sm Intest Follow Thru Study 46 40 $595.00 — $535.50 $595.00 $561.09 2026-09-21
93976 CPT Hchg US Exam,duplex Scan, Limited 46 40 $595.00 — $535.50 $595.00 $561.09 2026-09-21
J1451 HCPCS Fomepizole 1 Gram/ml Intravenous Solution [80243] 92 40 $592.99 — $446.17 $690.23 $558.48 2026-09-21
96365 CPT Hchg 96365-0260 IV Infusion; Initial; Up To 1 Hr 92 40 $585.00 — $421.20 $702.00 $549.90 2026-09-21
81404 CPT Hchg Molecular Path Level 510 (mayo) 92 40 $572.95 — $494.69 $596.25 $549.66 2026-09-21
88264 CPT Hchg Chromosome 20-25 Cells 92 40 $594.61 — $260.30 $900.00 $549.61 2026-09-21
92611 CPT Hchg Modified Barium Swallow 8-22 Minutes (grmc Only) 92 40 $602.92 — $122.71 $1,069.50 $549.44 2026-09-21
78453 CPT Hchg Myocardium, Rest 46 40 $580.90 — $522.81 $580.90 $547.79 2026-09-21
81311 CPT Hchg Colorectal Cancer Mut Pnl (quest) 92 40 $582.66 — $516.38 $591.58 $546.03 2026-09-21
77066 CPT Hchg Dig Mammo-both Breasts 46 40 $578.00 — $520.20 $578.00 $545.05 2026-09-21
76776 CPT Hchg US Exam,transplanted Kidney W/doppler 46 40 $578.00 — $520.20 $578.00 $545.05 2026-09-21
J2760 HCPCS Phentolamine 5 Mg Injection Solution [10947] 138 40 $575.19 — $21.05 $702.82 $542.40 2026-09-21
A6255 HCPCS Hchg Neg Press Pico 7 20x15cm 1 Dress System Strl Lf Disp, 310388 92 40 $568.10 — $391.27 $701.45 $533.02 2026-09-21
A9567 HCPCS Hchg Dtpa Cold Kit (grmc Only) 92 40 $562.83 — $402.80 $678.10 $528.92 2026-09-21
70551 CPT Hchg MRI Brain Without Contrast 46 40 $558.80 — $502.92 $558.80 $526.95 2026-09-21
0193 RC — 46 40 $550.00 — $495.00 $550.00 $518.65 2026-09-21
74270 CPT Hchg X-ray Colon Cont Worwokub 46 40 $544.00 — $489.60 $544.00 $512.99 2026-09-21
93923 CPT Hchg Pvr Ue/le Without Exercise Bilateral 46 40 $544.00 — $489.60 $544.00 $512.99 2026-09-21
88307 CPT Hchg Level V G/m - Utn (quest) 150 40 $549.66 — $202.50 $555.28 $512.52 2026-09-21
0360 RC — 138 40 $540.00 — $50.40 $5,200.00 $509.22 2026-09-21
81170 CPT Hchg Bcr/abl1 Mutation, Seq 46 40 $540.00 — $486.00 $540.00 $509.22 2026-09-21
54150 CPT Hchg 54150-0361 Circumcision 46 40 $540.00 — $486.00 $540.00 $509.22 2026-09-21
A4335 HCPCS Hchg Tray Proc 12-18fr Bard Heyman Natural Rub, 70661 92 40 $540.97 — $372.59 $667.94 $507.57 2026-09-21
72148 CPT Hchg MRI Lumbar Spine Without Contrast 46 40 $533.40 — $480.06 $533.40 $503.00 2026-09-21
72146 CPT Hchg MRI Thoracic Spine 46 40 $533.40 — $480.06 $533.40 $503.00 2026-09-21
72141 CPT Hchg MRI Neck Spine Without Contrast 46 40 $533.40 — $480.06 $533.40 $503.00 2026-09-21
J9073 HCPCS Cyclophosphamide 200 Mg/ml Intravenous Solution [250252] 184 40 $533.03 — $285.68 $912.92 $502.64 2026-09-21
74420 CPT Hchg Urogram Retro Worwo Kub 46 40 $527.00 — $474.30 $527.00 $496.96 2026-09-21
A9540 HCPCS Hchg 99 Mtc Maa (grmc Only) 184 40 $531.27 — $217.41 $1,055.35 $496.45 2026-09-21
G0237 HCPCS Hchg Therapy Strength 45 Minutes (grmc Only) 92 40 $525.00 — $405.00 $600.00 $495.00 2026-09-21
81263 CPT Hchg Igh Variable Region Somatic Mut Analysis 92 40 $519.52 — $405.00 $589.04 $490.07 2026-09-21
97608 CPT Hchg Neg Pres >50sqcm Disp >37 Minutes (grmc Only) 368 40 $517.71 — $166.63 $960.00 $489.94 2026-09-21
97606 CPT Hchg Neg Pres >50sqcm Dme >37 Minutes (grmc Only) 368 40 $517.71 — $166.63 $960.00 $489.94 2026-09-21
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