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

TIDALHEALTH PENINSULA REGIONAL, INC

Salisbury, MD · CCN 210019 · Rates published

6,532 distinct procedures filed
3 distinct payers
21,809 rate rows
2026-07-30 last MRF observed
Data quality

17,919 of 21,809 rate rows are consumer-grade (82.2%)

3,890 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 3,873
placeholder amount (≤ $0.02) — excluded from medians 17
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.tidalhealth.org/sites/default/files/2026-03/520591628_tidalhealth-peninsula-regional-inc_standardcharges.csv
Found on page https://www.tidalhealth.org/patients-visitors/billing-insurance-medical-records/billing?tab=4
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-20
Content fingerprint 576bbfc7fb0413c2… · 3,239,321 bytes · first seen 2026-05-09

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
270010003
CDM 		Generator Aspiresr Single Pin 1 $43,396.70 $55,610.76 $49,503.73 —
343095430
CDM 		Hc Nm Y90 Zevalin Rx 1 $37,506.79 $37,506.79 $37,506.79 —
A9543
HCPCS 		Hc Nm Y90 Zevalin Rx 1 $35,000.00 $35,000.00 $35,000.00 nat. median
$65,477
0.5× median
SUP-270010003
CDM 		Hc Vagal Nerve Package 1 $1,393.08 $52,073.25 $22,212.71 —
J1931
HCPCS 		Laronidase 2.9 Mg/5 Ml Solution 5 Ml Vial 1 $19,305.22 $19,305.22 $19,305.22 nat. median
$87
outlier · 222.1×
344000001
CDM 		Hc Nm Yttirium-90, Therasphere Glass Microspheres, Brachtherapy Source 1 $17,426.72 $17,426.72 $17,426.72 —
C2616
HCPCS 		Hc Nm Yttirium-90, Therasphere Glass Microspheres, Brachtherapy Source 1 $16,262.00 $16,262.00 $16,262.00 nat. median
$22,121
0.7× median
270010014
CDM 		Centralizer Stem Cementralizer Pmma Od13 Mm Hip Femur Sterile Endurance Luster E… 1 $14,838.21 $14,838.21 $14,838.21 —
270010015
CDM 		Catheter Ballood Gore Tri-lobe 1 $1,483.33 $47,380.80 $11,905.72 —
J1930
HCPCS 		Lanreotide 120 Mg/0.5 Ml Syringe 1 $10,246.46 $10,246.46 $10,246.46 nat. median
$261
outlier · 39.2×
270010004
CDM 		Cryotherapy Renal 1 $8,993.00 $8,993.00 $8,993.00 —
J0180
HCPCS 		Agalsidase Beta Per 1 Mg 1 $8,139.19 $8,746.20 $8,442.69 nat. median
$1,050
outlier · 8.0×
270010030
CDM 		Component Glenoid Arthrex Eclipse Od41 Mm Shoulder Trunion 1 $0.06 $20,562.50 $8,150.56 —
C1874
HCPCS 		Stent - Covered - Viabahn 6mm X 10cm 1 $5,112.00 $7,946.06 $7,809.00 nat. median
$5,596
1.4× median
270041347
CDM 		Hc Puraply Am 6 X 9 1 $7,615.38 $7,615.38 $7,615.38 —
C1776
HCPCS 		Continuum Vivacit-e Ele.liner Hh32x50 1 $6,506.40 $8,559.25 $7,532.82 nat. median
$3,543
outlier · 2.1×
J9306
HCPCS 		Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Solution 14 Ml Vial 1 $7,211.24 $7,211.24 $7,211.24 nat. median
$43
outlier · 169.0×
270041355
CDM 		Hc Amnioexcel 10x10 1 $6,954.83 $6,954.83 $6,954.83 —
343096040
CDM 		Hc Nm Quadramet Sr153 1 $6,902.71 $6,902.71 $6,902.71 —
270010025
CDM 		Baseplate Tibial Attune 7 Knee Cement Fix Bearing Sterile Latex Free 1 $50.75 $39,290.98 $6,804.57 —
72270
CPT 		Hc Myelogram, Complete 2 $6,497.00 $7,090.22 $6,793.61 nat. median
$800
outlier · 8.5×
A9604
HCPCS 		Hc Nm Quadramet Sr153 1 $6,441.37 $6,441.37 $6,441.37 nat. median
$11,059
0.6× median
77301
CPT 		Hc Imrt Plan 2 $5,891.00 $6,872.07 $6,381.53 nat. median
$1,604
outlier · 4.0×
720000016
CDM 		Hc Non-sched C-sec W Minor Surgery 1 $6,059.61 $6,059.61 $6,059.61 —
720000017
CDM 		Hc L&d Or Add'l Major Surgery 1 $5,904.23 $5,904.23 $5,904.23 —
720000014
CDM 		Hc Labor Room - Non-sch Cs 1 $5,748.87 $5,748.87 $5,748.87 —
77373
CPT 		Hc Sbrt Treatment Delivery Per Frac 2 $5,225.00 $6,095.93 $5,660.47 nat. median
$1,992
outlier · 2.8×
720000024
CDM 		Hc Fetal Demise 2nd/3rd Trim W/epid 1 $5,593.49 $5,593.49 $5,593.49 —
270010024
CDM 		Actis Collared High Stem Size 5 1 $78.75 $44,140.28 $5,533.68 —
PX-720000016
CDM 		Hc Non-sched C-sec W Minor Surgery 1 $5,421.00 $5,421.00 $5,421.00 —
78832
CPT 		Hc Nm Tumor Imaging-spect CT Single Area/2 Days Or 2 Areas/1day 2 $4,888.00 $5,946.99 $5,417.49 nat. median
$1,477
outlier · 3.7×
09564
CPT 		Hc Nm P32 Phosphocol Per Mci 1 $5,325.00 $5,325.00 $5,325.00 —
343096000
CDM 		Hc Nm Sr89 Metastron Per Mci 1 $5,325.00 $5,325.00 $5,325.00 —
PX-720000017
CDM 		Hc L&d Or Add'l Major Surgery 1 $5,282.00 $5,282.00 $5,282.00 —
J2506
HCPCS 		Pegfilgrastim Per 6 Mg 1 $5,180.41 $5,180.41 $5,180.41 nat. median
$916
outlier · 5.7×
J9055
HCPCS 		Cetuximab Per 10 Mg 1 $5,165.95 $5,165.95 $5,165.95 nat. median
$474
outlier · 10.9×
PX-720000014
CDM 		Hc Labor Room - Non-sch Cs 1 $5,143.00 $5,143.00 $5,143.00 —
C1889
HCPCS 		Coil Embolization Interlock Fibered Idc Standard Length 2d 15cm 5mm Clear Dacron… 1 $788.50 $6,444.00 $5,040.00 nat. median
$1,642
outlier · 3.1×
PX-720000024
CDM 		Hc Fetal Demise 2nd/3rd Trim W/epid 1 $5,004.00 $5,004.00 $5,004.00 —
720000004
CDM 		Hc Vag Del Prior Csec(vbac) 1 $4,971.99 $4,971.99 $4,971.99 —
720000003
CDM 		Hc Vag Del W Epid-vac-forcep 1 $4,971.99 $4,971.99 $4,971.99 —
A9600
HCPCS 		Hc Nm Sr89 Metastron Per Mci 1 $4,969.10 $4,969.10 $4,969.10 nat. median
$4,229
1.2× median
A9564
HCPCS 		Hc Nm P32 Phosphocol Per Mci 1 $4,969.10 $4,969.10 $4,969.10 nat. median
$335
outlier · 14.8×
J2353
HCPCS 		Octreotide,microspheres 20 Mg Suspension,extended Rel Recon 2 $246.44 $7,041.32 $4,929.66 nat. median
$1,956
outlier · 2.5×
720000002
CDM 		Hc Vaginal Delivery With Epidural 1 $4,661.24 $4,661.24 $4,661.24 —
720000023
CDM 		Hc Fetal Demise 2nd Or 3rd Trimester 1 $4,661.24 $4,661.24 $4,661.24 —
SUP-270010025
CDM 		Array Tracker Velys Kneee Set 1 $50.40 $14,642.10 $4,658.00 —
95782
CPT 		Hc Polysom Age <6 W/param 4or> 2 $4,387.00 $4,885.74 $4,636.37 nat. median
$1,310
outlier · 3.5×
77372
CPT 		Hc Treatment Delivery Srs Linear 2 $4,116.00 $4,802.36 $4,459.18 nat. median
$7,667
0.6× median
200000001
CDM 		Hc Daily Care-CT Intensive Care Unit 1 $4,450.96 $4,450.96 $4,450.96 —

Other procedures at this hospital

Browse this hospital's 6,532 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
             
270010003 CDM Generator Aspiresr Single Pin 2 1 $49,503.73 $48,513.65 $43,396.70 $55,610.76 $49,503.73 2026-03-19
343095430 CDM Hc Nm Y90 Zevalin Rx 1 1 $37,506.79 $36,756.65 $37,506.79 $37,506.79 $37,506.79 2026-03-19
A9543 HCPCS Hc Nm Y90 Zevalin Rx 1 1 $35,000.00 $34,300.00 $35,000.00 $35,000.00 $35,000.00 2026-07-30
SUP-270010003 CDM Hc Vagal Nerve Package 3 1 $22,212.71 $21,768.46 $1,393.08 $52,073.25 $22,212.71 2024-12-10
J1931 HCPCS Laronidase 2.9 Mg/5 Ml Solution 5 Ml Vial 1 1 $19,305.22 $18,919.12 $19,305.22 $19,305.22 $19,305.22 2024-12-10
344000001 CDM Hc Nm Yttirium-90, Therasphere Glass Microspheres, Brachtherapy Source 1 1 $17,426.72 $17,078.19 $17,426.72 $17,426.72 $17,426.72 2026-03-19
C2616 HCPCS Hc Nm Yttirium-90, Therasphere Glass Microspheres, Brachtherapy Source 1 1 $16,262.00 $15,936.76 $16,262.00 $16,262.00 $16,262.00 2024-12-10
270010014 CDM Centralizer Stem Cementralizer Pmma Od13 Mm Hip Femur Sterile Endurance Luster E… 1 1 $14,838.21 $14,541.45 $14,838.21 $14,838.21 $14,838.21 2026-03-19
270010015 CDM Catheter Ballood Gore Tri-lobe 48 1 $11,905.72 $11,667.60 $1,483.33 $47,380.80 $11,905.72 2026-03-19
J1930 HCPCS Lanreotide 120 Mg/0.5 Ml Syringe 1 1 $5,191.70 $10,041.53 $10,246.46 $10,246.46 $10,246.46 2026-07-30
270010004 CDM Cryotherapy Renal 1 1 $8,993.00 $8,813.14 $8,993.00 $8,993.00 $8,993.00 2026-03-19
J0180 HCPCS Agalsidase Beta Per 1 Mg 2 1 $8,139.19 $8,273.85 $8,139.19 $8,746.20 $8,442.69 2026-07-30
270010030 CDM Component Glenoid Arthrex Eclipse Od41 Mm Shoulder Trunion 102 1 $8,150.56 $7,987.56 $0.06 $20,562.50 $8,150.56 2026-03-19
C1874 HCPCS Stent - Covered - Viabahn 6mm X 10cm 3 1 $7,809.00 $7,652.82 $5,112.00 $7,946.06 $7,809.00 2026-03-19
270041347 CDM Hc Puraply Am 6 X 9 1 1 $7,615.38 $7,463.07 $7,615.38 $7,615.38 $7,615.38 2026-03-19
C1776 HCPCS Continuum Vivacit-e Ele.liner Hh32x50 2 1 $7,532.82 $7,382.17 $6,506.40 $8,559.25 $7,532.82 2026-03-19
J9306 HCPCS Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Solution 14 Ml Vial 1 1 $3,618.24 $7,067.02 $7,211.24 $7,211.24 $7,211.24 2026-07-30
270041355 CDM Hc Amnioexcel 10x10 1 1 $6,954.83 $6,815.73 $6,954.83 $6,954.83 $6,954.83 2026-03-19
343096040 CDM Hc Nm Quadramet Sr153 1 1 $6,902.71 $6,764.66 $6,902.71 $6,902.71 $6,902.71 2026-03-19
270010025 CDM Baseplate Tibial Attune 7 Knee Cement Fix Bearing Sterile Latex Free 178 1 $6,804.57 $6,668.48 $50.75 $39,290.98 $6,804.57 2026-03-19
72270 CPT Hc Myelogram, Complete 2 2 $6,793.61 $6,657.74 $6,497.00 $7,090.22 $6,793.61 2026-03-19
A9604 HCPCS Hc Nm Quadramet Sr153 1 1 $6,441.37 $6,312.54 $6,441.37 $6,441.37 $6,441.37 2026-07-30
77301 CPT Hc Imrt Plan 2 2 $6,381.53 $6,253.91 $5,891.00 $6,872.07 $6,381.53 2026-03-19
720000016 CDM Hc Non-sched C-sec W Minor Surgery 1 1 $5,623.31 $5,938.42 $6,059.61 $6,059.61 $6,059.61 2026-07-30
720000017 CDM Hc L&d Or Add'l Major Surgery 1 1 $5,479.11 $5,786.15 $5,904.23 $5,904.23 $5,904.23 2026-07-30
720000014 CDM Hc Labor Room - Non-sch Cs 1 1 $5,334.93 $5,633.89 $5,748.87 $5,748.87 $5,748.87 2026-07-30
77373 CPT Hc Sbrt Treatment Delivery Per Frac 2 2 $5,660.47 $5,547.26 $5,225.00 $6,095.93 $5,660.47 2026-03-19
720000024 CDM Hc Fetal Demise 2nd/3rd Trim W/epid 1 1 $5,190.74 $5,481.62 $5,593.49 $5,593.49 $5,593.49 2026-07-30
270010024 CDM Actis Collared High Stem Size 5 158 1 $5,533.68 $5,423.01 $78.75 $44,140.28 $5,533.68 2026-03-19
PX-720000016 CDM Hc Non-sched C-sec W Minor Surgery 1 1 $5,421.00 $5,312.58 $5,421.00 $5,421.00 $5,421.00 2024-12-10
78832 CPT Hc Nm Tumor Imaging-spect CT Single Area/2 Days Or 2 Areas/1day 2 2 $5,417.49 $5,309.15 $4,888.00 $5,946.99 $5,417.49 2026-03-19
343096000 CDM Hc Nm Sr89 Metastron Per Mci 1 1 $5,325.00 $5,218.50 $5,325.00 $5,325.00 $5,325.00 2026-03-19
09564 CPT Hc Nm P32 Phosphocol Per Mci 1 1 $5,325.00 $5,218.50 $5,325.00 $5,325.00 $5,325.00 2026-03-19
PX-720000017 CDM Hc L&d Or Add'l Major Surgery 1 1 $5,282.00 $5,176.36 $5,282.00 $5,282.00 $5,282.00 2024-12-10
J2506 HCPCS Pegfilgrastim Per 6 Mg 1 1 $5,180.41 $5,076.80 $5,180.41 $5,180.41 $5,180.41 2024-12-10
J9055 HCPCS Cetuximab Per 10 Mg 1 1 $2,646.18 $5,062.63 $5,165.95 $5,165.95 $5,165.95 2026-07-30
PX-720000014 CDM Hc Labor Room - Non-sch Cs 1 1 $5,143.00 $5,040.14 $5,143.00 $5,143.00 $5,143.00 2024-12-10
C1889 HCPCS Coil Embolization Interlock Fibered Idc Standard Length 2d 15cm 5mm Clear Dacron… 3 1 $5,040.00 $4,939.20 $788.50 $6,444.00 $5,040.00 2026-03-19
PX-720000024 CDM Hc Fetal Demise 2nd/3rd Trim W/epid 1 1 $5,004.00 $4,903.92 $5,004.00 $5,004.00 $5,004.00 2024-12-10
720000003 CDM Hc Vag Del W Epid-vac-forcep 1 1 $4,613.99 $4,872.55 $4,971.99 $4,971.99 $4,971.99 2026-07-30
720000004 CDM Hc Vag Del Prior Csec(vbac) 1 1 $4,613.99 $4,872.55 $4,971.99 $4,971.99 $4,971.99 2026-07-30
A9600 HCPCS Hc Nm Sr89 Metastron Per Mci 1 1 $4,969.10 $4,869.72 $4,969.10 $4,969.10 $4,969.10 2026-07-30
A9564 HCPCS Hc Nm P32 Phosphocol Per Mci 1 1 $4,969.10 $4,869.72 $4,969.10 $4,969.10 $4,969.10 2026-07-30
J2353 HCPCS Octreotide,microspheres 20 Mg Suspension,extended Rel Recon 3 2 $2,670.91 $4,831.07 $246.44 $7,041.32 $4,929.66 2026-07-30
720000002 CDM Hc Vaginal Delivery With Epidural 1 1 $4,325.62 $4,568.02 $4,661.24 $4,661.24 $4,661.24 2026-07-30
720000023 CDM Hc Fetal Demise 2nd Or 3rd Trimester 1 1 $4,325.62 $4,568.02 $4,661.24 $4,661.24 $4,661.24 2026-07-30
SUP-270010025 CDM Array Tracker Velys Kneee Set 22 1 $4,658.00 $4,564.84 $50.40 $14,642.10 $4,658.00 2024-12-10
95782 CPT Hc Polysom Age <6 W/param 4or> 2 2 $4,636.37 $4,543.65 $4,387.00 $4,885.74 $4,636.37 2026-03-19
77372 CPT Hc Treatment Delivery Srs Linear 2 2 $4,459.18 $4,369.99 $4,116.00 $4,802.36 $4,459.18 2026-03-19
200000000 CDM Hc Daily Care ICU Layfield 1 1 $3,849.48 $4,361.94 $4,450.96 $4,450.96 $4,450.96 2026-07-30
200000001 CDM Hc Daily Care-CT Intensive Care Unit 1 1 $3,849.48 $4,361.94 $4,450.96 $4,450.96 $4,450.96 2026-07-30
200000002 CDM Hc Daily Care Cicu 1 1 $3,676.48 $4,361.94 $4,450.96 $4,450.96 $4,450.96 2026-07-30
PX-720000004 CDM Hc Vag Del Prior Csec(vbac) 1 1 $4,448.00 $4,359.04 $4,448.00 $4,448.00 $4,448.00 2024-12-10
PX-720000003 CDM Hc Vag Del W Epid-vac-forcep 1 1 $4,448.00 $4,359.04 $4,448.00 $4,448.00 $4,448.00 2024-12-10
270010023 CDM Cement Bone Simplex P Tobramycin Full Dose Radiopaque Preblend Sterile 29 1 $4,320.00 $4,233.60 $0.03 $6,906.39 $4,320.00 2026-03-19
PX-720000002 CDM Hc Vaginal Delivery With Epidural 1 1 $4,170.00 $4,086.60 $4,170.00 $4,170.00 $4,170.00 2024-12-10
PX-720000023 CDM Hc Fetal Demise 2nd Or 3rd Trimester 1 1 $4,170.00 $4,086.60 $4,170.00 $4,170.00 $4,170.00 2024-12-10
C1785 HCPCS Device Azure Xt Dr MRI Surescan 1 1 $4,162.50 $4,079.25 $4,162.50 $4,162.50 $4,162.50 2026-03-19
72240 CPT Hc Cervical Myelogram 1 1 $4,142.60 $4,059.75 $4,142.60 $4,142.60 $4,142.60 2026-03-19
74400 CPT Hc IV Pyleograms 2 2 $4,045.64 $3,964.72 $3,869.00 $4,222.27 $4,045.64 2026-03-19
720000001 CDM Hc Vaginal Delivery Vac-forceps 1 1 $3,748.87 $3,958.95 $4,039.74 $4,039.74 $4,039.74 2026-07-30
J1950 HCPCS Leuprolide Acetate (3 Month) Per 3.75 Mg 2 1 $2,542.20 $3,932.00 $2,348.34 $5,676.15 $4,012.24 2026-07-30
72255 CPT Hc Thoracic Myelogram 2 2 $3,969.30 $3,889.91 $3,796.00 $4,142.60 $3,969.30 2026-03-19
74430 CPT Hc Cystogram 2 2 $3,892.97 $3,815.11 $3,723.00 $4,062.93 $3,892.97 2026-03-19
270041351 CDM Hc Grafix Prime 5x5 1 1 $3,857.84 $3,780.68 $3,857.84 $3,857.84 $3,857.84 2026-03-19
270041359 CDM Hc Grafix Core 5x5 1 1 $3,857.84 $3,780.68 $3,857.84 $3,857.84 $3,857.84 2026-03-19
PX-200000000 CDM Hc Daily Care ICU Layfield 1 1 $3,846.00 $3,769.08 $3,846.00 $3,846.00 $3,846.00 2024-12-10
PX-200000002 CDM Hc Daily Care Cicu 1 1 $3,846.00 $3,769.08 $3,846.00 $3,846.00 $3,846.00 2024-12-10
PX-200000001 CDM Hc Daily Care-CT Intensive Care Unit 1 1 $3,846.00 $3,769.08 $3,846.00 $3,846.00 $3,846.00 2024-12-10
62302 CPT Hc Cervical Myelogram 1 1 $3,796.00 $3,720.08 $3,796.00 $3,796.00 $3,796.00 2024-12-10
SUP-270010023 CDM Head Bipolar Uhr Cocr Uhmwpe Universal Od43 Mm Id26 Mm Hip 2 1 $3,780.01 $3,704.41 $1,365.00 $6,195.02 $3,780.01 2024-12-10
270041213 CDM Hc Theraskin 3x6 1 1 $3,771.16 $3,695.74 $3,771.16 $3,771.16 $3,771.16 2026-03-19
343095420 CDM Hc Nm In111 Zevalin Dx 1 1 $3,750.67 $3,675.66 $3,750.67 $3,750.67 $3,750.67 2026-03-19
720000000 CDM Hc Vaginal Delivery 1 1 $3,460.49 $3,654.41 $3,728.99 $3,728.99 $3,728.99 2026-07-30
72265 CPT Hc Lumbar Myelogram 1 1 $3,664.61 $3,591.32 $3,664.61 $3,664.61 $3,664.61 2026-03-19
PX-720000001 CDM Hc Vaginal Delivery Vac-forceps 1 1 $3,614.00 $3,541.72 $3,614.00 $3,614.00 $3,614.00 2024-12-10
270041346 CDM Hc Puraply Am 5 X 5 1 1 $3,525.64 $3,455.13 $3,525.64 $3,525.64 $3,525.64 2026-03-19
81163 CPT Hc Brca 1/2 Mutation Analysis For Tumors 2 2 $3,520.74 $3,450.33 $3,486.49 $3,555.00 $3,520.74 2026-03-19
A9542 HCPCS Hc Nm In111 Zevalin Dx 1 1 $3,500.00 $3,430.00 $3,500.00 $3,500.00 $3,500.00 2026-07-30
78804 CPT Hc Tumor Localization-wb 2 Or > Days 2 2 $3,457.97 $3,388.82 $3,120.00 $3,795.95 $3,457.97 2026-03-19
270010019 CDM Aeromini 8 1 $3,437.50 $3,368.75 $148.80 $5,962.50 $3,437.50 2026-03-19
70390 CPT Hc Sialiogram 2 2 $3,434.97 $3,366.27 $3,285.00 $3,584.94 $3,434.97 2026-03-19
270041399 CDM Hc Grafix Pl Prime 5x5 1 1 $3,399.73 $3,331.74 $3,399.73 $3,399.73 $3,399.73 2026-03-19
62304 CPT Hc Lumbar Myelogram 1 1 $3,358.00 $3,290.84 $3,358.00 $3,358.00 $3,358.00 2024-12-10
PX-720000000 CDM Hc Vaginal Delivery 1 1 $3,336.00 $3,269.28 $3,336.00 $3,336.00 $3,336.00 2024-12-10
81201 CPT Hc Apc Gene, Full Gene Analysis 2 2 $3,280.73 $3,215.11 $3,248.46 $3,313.00 $3,280.73 2026-03-19
343095820 CDM Hc I123 Mibg 1 1 $3,206.82 $3,142.68 $3,206.82 $3,206.82 $3,206.82 2026-03-19
74251 CPT Hc Xr Sm B Series Via Enteroclysis Tube 2 2 $3,193.09 $3,129.23 $3,070.00 $3,316.18 $3,193.09 2026-03-19
123000000 CDM Hc Daily Care Pediatrics 1 1 $2,853.64 $3,073.54 $3,136.27 $3,136.27 $3,136.27 2026-07-30
123000001 CDM Hc Daily Care-ped Nursery 1 1 $2,853.64 $3,073.54 $3,136.27 $3,136.27 $3,136.27 2026-07-30
270041413 CDM Hc Nusheild L 6 Cm X W 6 Cm Allograft 1 1 $3,135.30 $3,072.59 $3,135.30 $3,135.30 $3,135.30 2026-03-19
720000015 CDM Hc Scheduled C-sec W Minor Surgery 1 1 $2,883.75 $3,045.35 $3,107.50 $3,107.50 $3,107.50 2026-07-30
SUP-270010024 CDM Actis Collared High Stem Size 5 24 1 $3,015.20 $2,954.90 $142.80 $31,743.50 $3,015.20 2024-12-10
A9582 HCPCS Hc I123 Mibg 1 1 $2,992.50 $2,932.65 $2,992.50 $2,992.50 $2,992.50 2026-07-30
87483 CPT Hc Infectious Agent Detection By Nucleic Acid (dna Or Rna) 2 2 $2,926.33 $2,867.80 $1,148.00 $4,704.66 $2,926.33 2026-03-19
270010020 CDM Anchor Lead Clikx Sterile Disposable 135 1 $2,911.50 $2,853.27 $55.63 $49,270.00 $2,911.50 2026-03-19
PX-123000001 CDM Hc Daily Care-ped Nursery 1 1 $2,837.00 $2,780.26 $2,837.00 $2,837.00 $2,837.00 2024-12-10
PX-123000000 CDM Hc Daily Care Pediatrics 1 1 $2,837.00 $2,780.26 $2,837.00 $2,837.00 $2,837.00 2024-12-10
78266 CPT Hc Nm Gi Gastric Sm Bowel, Colon Multi Days 2 2 $2,835.34 $2,778.64 $2,558.00 $3,112.68 $2,835.34 2026-03-19
720000013 CDM Hc Labor Room - Sch Cs 1 1 $2,595.38 $2,740.82 $2,796.75 $2,796.75 $2,796.75 2026-07-30
PX-720000015 CDM Hc Scheduled C-sec W Minor Surgery 1 1 $2,780.00 $2,724.40 $2,780.00 $2,780.00 $2,780.00 2024-12-10
C1876 HCPCS Stent - Epic 10x60x75 6 1 $2,770.95 $2,715.53 $1,295.00 $3,264.30 $2,770.95 2026-03-19
78830 CPT Hc Nm Tumor Imaging-spect CT Single Area Single Day 2 2 $2,766.38 $2,711.05 $2,496.00 $3,036.76 $2,766.38 2026-03-19
343096420 CDM Hc Nm Prostascint 1 1 $2,756.08 $2,700.96 $2,756.08 $2,756.08 $2,756.08 2026-03-19
95811 CPT Hc Polysom Age 6> Split/cpap 2 2 $2,733.91 $2,679.24 $2,587.00 $2,880.83 $2,733.91 2026-03-19
SUP-270010020 CDM Hc Spinal Fusion Fixation Supply 15 1 $2,730.00 $2,675.40 $105.00 $14,007.00 $2,730.00 2024-12-10
78227 CPT Hc Hepabilry Sys Imag W Pharma 2 2 $2,720.07 $2,665.68 $2,454.00 $2,986.15 $2,720.07 2026-03-19
78452 CPT Hc Myocardial Perf-spect/multi 2 2 $2,651.11 $2,598.10 $2,392.00 $2,910.23 $2,651.11 2026-03-19
77013 CPT Hc CT Guidance Tissue Ablation 2 2 $2,595.31 $2,543.40 $2,482.00 $2,708.62 $2,595.31 2026-03-19
95810 CPT Hc Polysom Age 6>w/param 4 Or> 2 2 $2,586.06 $2,534.34 $2,447.00 $2,725.12 $2,586.06 2026-03-19
J9202 HCPCS Goserelin Acetate Per 3.6 Mg 2 1 $1,677.28 $2,521.23 $1,677.28 $3,468.09 $2,572.68 2026-07-30
A4642 HCPCS Hc Nm Prostascint 1 1 $2,571.88 $2,520.44 $2,571.88 $2,571.88 $2,571.88 2026-07-30
74740 CPT Hc Xr Hysterosalpingogram 2 2 $2,518.98 $2,468.60 $2,409.00 $2,628.96 $2,518.98 2026-03-19
PX-720000013 CDM Hc Labor Room - Sch Cs 1 1 $2,502.00 $2,451.96 $2,502.00 $2,502.00 $2,502.00 2024-12-10
81162 CPT Hc Brca1/brca2 Gene Analysis 2 2 $2,404.17 $2,356.09 $2,380.34 $2,428.00 $2,404.17 2026-03-19
270041412 CDM Hc Nusheild L 6 Cm X W 4cm Allograft 1 1 $2,360.93 $2,313.71 $2,360.93 $2,360.93 $2,360.93 2026-03-19
78265 CPT Hc Nm Gi Gastric W Sm Bowel Transit 2 2 $2,351.62 $2,304.60 $2,122.00 $2,581.25 $2,351.62 2026-03-19
Q5107 HCPCS Bevacizumab-awwb 25 Mg/ml Solution 16 Ml Vial 2 1 $1,313.00 $2,265.47 $1,313.00 $3,310.41 $2,311.70 2026-07-30
124000001 CDM Hc Daily Care S3 C&a 1 1 $2,302.32 $2,256.27 $2,302.32 $2,302.32 $2,302.32 2026-03-19
74425 CPT Hc Urography Antegrade, Rad Sup & Interpretation 2 2 $2,289.98 $2,244.18 $2,190.00 $2,389.96 $2,289.98 2026-03-19
74300 CPT Hc Oper Cholangiogrm 2 2 $2,289.98 $2,244.18 $2,190.00 $2,389.96 $2,289.98 2026-03-19
32408 CPT Hc CT Lung Needle Biopsy 2 2 $2,289.98 $2,244.18 $2,190.00 $2,389.96 $2,289.98 2026-03-19
270010012 CDM Graft Bone Cornerstone L14 Mm X W11 Mm X H6 Mm Laser 13 1 $2,280.00 $2,234.40 $1,135.46 $6,271.75 $2,280.00 2026-03-19
343095700 CDM Hc Nm Indium 111 Wbc 1 1 $2,270.88 $2,225.46 $2,270.88 $2,270.88 $2,270.88 2026-03-19
78072 CPT Hc Parathyroid Scan W Spect & CT 2 2 $2,259.02 $2,213.84 $2,038.00 $2,480.03 $2,259.02 2026-03-19
SUP-275000000 CDM 6fr Optiseal 13cm 37 1 $2,225.57 $2,181.06 $48.45 $31,772.00 $2,225.57 2024-12-10
Q4196 HCPCS Hc Puraply Am 2 X 2 4 1 $2,217.60 $2,173.25 $710.40 $7,257.60 $2,217.60 2024-12-10
77772 CPT Hc High Dose Rate Brachytherapy >12 2 2 $2,206.97 $2,162.82 $2,037.00 $2,376.93 $2,206.97 2026-03-19
0026U CPT Hc Thyroseq 2 2 $2,206.15 $2,162.03 $2,184.30 $2,228.00 $2,206.15 2026-03-19
95807 CPT Hc Sleep Study Attended 1 1 $2,199.56 $2,155.57 $2,199.56 $2,199.56 $2,199.56 2026-03-19
78807 CPT Hc Inflammation Imaging-spect 1 1 $2,151.04 $2,108.02 $2,151.04 $2,151.04 $2,151.04 2026-03-19
78607 CPT Hc Brain Spect 1 1 $2,151.04 $2,108.02 $2,151.04 $2,151.04 $2,151.04 2026-03-19
78710 CPT Hc Kidney Scan-spect 1 1 $2,151.04 $2,108.02 $2,151.04 $2,151.04 $2,151.04 2026-03-19
78320 CPT Hc Bone Spect 1 1 $2,151.04 $2,108.02 $2,151.04 $2,151.04 $2,151.04 2026-03-19
78205 CPT Hc Nm Liver Imaging Spect 1 1 $2,151.04 $2,108.02 $2,151.04 $2,151.04 $2,151.04 2026-03-19
77002 CPT Hc Fluro Guide Needle Placement 4 2 $2,150.33 $2,107.32 $730.00 $3,823.94 $2,150.33 2026-03-19
343000011 CDM Hc Octreoscan 1 1 $2,150.17 $2,107.17 $2,150.17 $2,150.17 $2,150.17 2026-03-19
SUP-270010015 CDM Sheath Introducer Gore Dryseal L33 Cm Od18 Fr Odsec6.7 Mm Id6 Mm Dilator Valve I… 1 1 $2,145.00 $2,102.10 $2,145.00 $2,145.00 $2,145.00 2024-12-10
81450 CPT Hc Target Genomic Sequence Analysis 2 2 $2,141.65 $2,098.82 $2,128.30 $2,155.00 $2,141.65 2026-03-19
120000000 CDM Hc Daily Care 1 1 $1,785.83 $2,082.16 $2,124.65 $2,124.65 $2,124.65 2026-07-30
120000002 CDM Hc Daily Care L2 1 1 $1,785.83 $2,082.16 $2,124.65 $2,124.65 $2,124.65 2026-07-30
A9570 HCPCS Hc Nm Indium 111 Wbc 1 1 $2,119.09 $2,076.71 $2,119.09 $2,119.09 $2,119.09 2026-07-30
PX-124000001 CDM Hc Daily Care S3 C&a 1 1 $2,095.00 $2,053.10 $2,095.00 $2,095.00 $2,095.00 2024-12-10
PX-124000000 CDM Hc Daily Care S3a 1 1 $2,088.00 $2,046.24 $2,088.00 $2,088.00 $2,088.00 2024-12-10
122000001 CDM Hc Daily Care-labor And Delivery 1 1 $1,712.95 $2,031.44 $2,072.90 $2,072.90 $2,072.90 2026-07-30
122000000 CDM Hc Daily Care OB 1 1 $1,712.95 $2,031.44 $2,072.90 $2,072.90 $2,072.90 2026-07-30
78630 CPT Hc Cerebrospinal Fluid Flow 2 2 $2,051.63 $2,010.60 $1,851.00 $2,252.26 $2,051.63 2026-03-19
78650 CPT Hc Csf Leak 2 2 $2,028.48 $1,987.91 $1,830.00 $2,226.96 $2,028.48 2026-03-19
78278 CPT Hc Acute Gi Blood Loss 2 2 $2,028.48 $1,987.91 $1,830.00 $2,226.96 $2,028.48 2026-03-19
A9572 HCPCS Hc Octreoscan 1 1 $2,006.47 $1,966.34 $2,006.47 $2,006.47 $2,006.47 2026-07-30
78709 CPT Hc Kidney Imag-vasc Flow/func W Phar 2 2 $2,005.83 $1,965.71 $1,810.00 $2,201.65 $2,005.83 2026-03-19
78645 CPT Hc Cns Shunt Evaluation 2 2 $2,005.83 $1,965.71 $1,810.00 $2,201.65 $2,005.83 2026-03-19
78195 CPT Hc Lymphatics And Lymph Node Imaging 2 2 $2,005.83 $1,965.71 $1,810.00 $2,201.65 $2,005.83 2026-03-19
78071 CPT Hc Parathyroid Scan W Spect 2 2 $2,005.83 $1,965.71 $1,810.00 $2,201.65 $2,005.83 2026-03-19
78290 CPT Hc Bowel Scan-meckels 2 2 $2,005.83 $1,965.71 $1,810.00 $2,201.65 $2,005.83 2026-03-19
78264 CPT Hc Nm Gi Gastric Empty Image Study 2 2 $2,005.83 $1,965.71 $1,810.00 $2,201.65 $2,005.83 2026-03-19
78315 CPT Hc 3 Phase Bone Scan 2 2 $2,005.83 $1,965.71 $1,810.00 $2,201.65 $2,005.83 2026-03-19
78606 CPT Hc Brain Scan W Vascular Flow 2 2 $2,005.83 $1,965.71 $1,810.00 $2,201.65 $2,005.83 2026-03-19
124000000 CDM Hc Daily Care S3a 1 1 $1,680.95 $1,957.94 $1,997.90 $1,997.90 $1,997.90 2026-07-30
SUP-270010012 CDM Block Lordotic Sr Cortical 8x14x11mm 3 1 $1,995.00 $1,955.10 $1,078.46 $3,384.80 $1,995.00 2024-12-10
78226 CPT Hc Hepabilry Sys Imag Inc Gallbladder 2 2 $1,982.67 $1,943.02 $1,789.00 $2,176.35 $1,982.67 2026-03-19
343095690 CDM Hc Nm Tc99m Labeled Wbc Per Dose 1 1 $1,965.50 $1,926.19 $1,965.50 $1,965.50 $1,965.50 2026-03-19
78803 CPT Hc Nm Liver Imaging Spect 2 2 $1,959.52 $1,920.33 $1,768.00 $2,151.04 $1,959.52 2026-03-19
Q5118 HCPCS Bevacizumab-bvzr 25 Mg/ml Solution 16 Ml Vial 2 1 $1,955.86 $1,916.74 $1,075.74 $2,835.97 $1,955.86 2024-12-10
93886 CPT Hc Vl Transcranial Doppler, Complete 2 2 $1,921.92 $1,883.49 $1,848.00 $1,995.85 $1,921.92 2026-03-19
PX-343000010 CDM Hc Oncoscint 1 1 $1,915.05 $1,876.75 $1,915.05 $1,915.05 $1,915.05 2024-12-10
95805 CPT Hc Mult Sleep Latency Test 2 2 $1,902.45 $1,864.40 $1,800.00 $2,004.90 $1,902.45 2026-03-19
PX-120000000 CDM Hc Daily Care 1 1 $1,896.00 $1,858.08 $1,896.00 $1,896.00 $1,896.00 2024-12-10
PX-120000002 CDM Hc Daily Care L2 1 1 $1,896.00 $1,858.08 $1,896.00 $1,896.00 $1,896.00 2024-12-10
78582 CPT Hc Nm Pulmonary Vent Perfusion Imag 2 2 $1,890.57 $1,852.76 $1,706.00 $2,075.13 $1,890.57 2026-03-19
78802 CPT Hc Tumor Imaging-wb Single Day 2 2 $1,890.57 $1,852.76 $1,706.00 $2,075.13 $1,890.57 2026-03-19
78453 CPT Hc Myocardial Perf-planar/single 1 1 $1,872.68 $1,835.23 $1,872.68 $1,872.68 $1,872.68 2026-03-19
95819 CPT Hc EEG 2 2 $1,865.49 $1,828.18 $1,765.00 $1,965.98 $1,865.49 2026-03-19
720000020 CDM Hc Delivery Outside Hospital 1 1 $1,730.25 $1,827.21 $1,864.50 $1,864.50 $1,864.50 2026-07-30
720000027 CDM Hc Multiple Birth Quads 1 1 $1,730.25 $1,827.21 $1,864.50 $1,864.50 $1,864.50 2026-07-30
J0841 HCPCS Antivenin Crotalidae (equine) Recon Soln 1 Each Vial 1 1 $1,862.75 $1,825.50 $1,862.75 $1,862.75 $1,862.75 2026-03-19
93975 CPT Hc Vl Renal Artery Duplex Complete 2 2 $1,862.72 $1,825.47 $1,791.00 $1,934.45 $1,862.72 2026-03-19
78451 CPT Hc Myocardial Perf-spect/single 2 2 $1,844.26 $1,807.37 $1,664.00 $2,024.51 $1,844.26 2026-03-19
A9569 HCPCS Hc Nm Tc99m Labeled Wbc Per Dose 1 1 $1,834.14 $1,797.46 $1,834.14 $1,834.14 $1,834.14 2026-07-30
93925 CPT Hc Vl Duplex Lea Bilateral 2 2 $1,833.37 $1,796.70 $1,763.00 $1,903.73 $1,833.37 2026-03-19
78018 CPT Hc Thyroid Ca Mets-whole Body 2 2 $1,821.10 $1,784.68 $1,643.00 $1,999.20 $1,821.10 2026-03-19
270041358 CDM Hc Grafix Core 3x4 1 1 $1,808.36 $1,772.19 $1,808.36 $1,808.36 $1,808.36 2026-03-19
270041350 CDM Hc Grafix Prime 3x4 1 1 $1,808.36 $1,772.19 $1,808.36 $1,808.36 $1,808.36 2026-03-19
77290 CPT Hc Simulation, Complex 2 2 $1,801.67 $1,765.64 $1,663.00 $1,940.35 $1,801.67 2026-03-19
09584 CPT Hc Nm Iodine I-123 Ioflupane, Diag, Up To 5mci 1 1 $1,794.98 $1,759.08 $1,794.98 $1,794.98 $1,794.98 2026-03-19
270041411 CDM Hc Nusheild L 4 Cm X W 4 Cm Allograft 1 1 $1,794.30 $1,758.41 $1,794.30 $1,794.30 $1,794.30 2026-03-19
78598 CPT Hc Nm Pulmon Perfusion Vent Quan Dif 2 2 $1,775.30 $1,739.79 $1,602.00 $1,948.59 $1,775.30 2026-03-19
SUP-270010030 CDM 10.5f Prelude Snap 12 1 $1,773.03 $1,737.57 $73.50 $15,540.00 $1,773.03 2024-12-10
Q5126 HCPCS Bevacizumab-maly 25 Mg/ml Solution 16 Ml Vial 2 1 $1,772.14 $1,736.70 $880.22 $2,664.06 $1,772.14 2024-12-10
90377 CPT Rabies Immune Globulin Per 150 Int'l Units 2 1 $1,759.60 $1,724.40 $584.73 $2,934.46 $1,759.60 2024-12-10
74455 CPT Hc Urethrogram 2 2 $1,755.65 $1,720.54 $1,679.00 $1,832.30 $1,755.65 2026-03-19
78070 CPT Hc Parathyroid Planar Inc Subtr 2 2 $1,752.14 $1,717.10 $1,581.00 $1,923.29 $1,752.14 2026-03-19
270041410 CDM Hc Nusheild Placental Membrane 12 Sq Cm L 4cm X W 3cm Allograft 1 1 $1,731.33 $1,696.70 $1,731.33 $1,731.33 $1,731.33 2026-03-19
81229 CPT Hc Chromosomal Microarray,autopsy, Prod Conception,stillbirth 4 2 $1,731.13 $1,696.51 $1,610.23 $1,856.00 $1,731.13 2026-03-19
09545 CPT Hc Nm I131 Bexxar Rx 1 1 $1,730.33 $1,695.72 $1,730.33 $1,730.33 $1,730.33 2026-03-19
36514 CPT Hc Apheresis Plasma Pheresis 2 2 $1,706.68 $1,672.55 $1,650.00 $1,763.37 $1,706.68 2026-03-19
36513 CPT Hc Apheresis Platelets 2 2 $1,706.68 $1,672.55 $1,650.00 $1,763.37 $1,706.68 2026-03-19
36512 CPT Hc Apheresis Red Blood Cells 2 2 $1,706.68 $1,672.55 $1,650.00 $1,763.37 $1,706.68 2026-03-19
36511 CPT Hc Apheresis White Blood Cells 2 2 $1,706.68 $1,672.55 $1,650.00 $1,763.37 $1,706.68 2026-03-19
PX-122000001 CDM Hc Daily Care-labor And Delivery 1 1 $1,704.00 $1,669.92 $1,704.00 $1,704.00 $1,704.00 2024-12-10
PX-122000000 CDM Hc Daily Care OB 1 1 $1,704.00 $1,669.92 $1,704.00 $1,704.00 $1,704.00 2024-12-10
C1753 HCPCS Ivus - Visions Pv .014p 1 1 $1,703.75 $1,669.68 $1,703.75 $1,703.75 $1,703.75 2026-03-19
09547 CPT Hc Nm In111 Oxine Per 0.5 Mci 1 1 $1,685.11 $1,651.41 $1,685.11 $1,685.11 $1,685.11 2026-03-19
77385 CPT Hc Imrt Treatments Simple 2 2 $1,681.50 $1,647.87 $1,552.00 $1,811.00 $1,681.50 2026-03-19
77386 CPT Hc Imrt Treatments Complex 2 2 $1,681.50 $1,647.87 $1,552.00 $1,811.00 $1,681.50 2026-03-19
A9584 HCPCS Hc Nm Iodine I-123 Ioflupane, Diag, Up To 5mci 1 1 $1,675.00 $1,641.50 $1,675.00 $1,675.00 $1,675.00 2024-12-10
PX-720000020 CDM Hc Delivery Outside Hospital 1 1 $1,668.00 $1,634.64 $1,668.00 $1,668.00 $1,668.00 2024-12-10
PX-720000027 CDM Hc Multiple Birth Quads 1 1 $1,668.00 $1,634.64 $1,668.00 $1,668.00 $1,668.00 2024-12-10
Q4160 HCPCS Hc Nusheild L3 Cm X W 2 Cm Allograft 7 1 $1,650.00 $1,617.00 $474.00 $2,988.00 $1,650.00 2024-12-10
270041370 CDM Hc Allograft Primatrix Fenestrated 6x6 1 1 $1,636.91 $1,604.17 $1,636.91 $1,636.91 $1,636.91 2026-03-19
270041371 CDM Hc Allograft Primatrix Meshed 6x6 1 1 $1,636.91 $1,604.17 $1,636.91 $1,636.91 $1,636.91 2026-03-19
270041402 CDM Hc Kerecis Graft 3x7 1 1 $1,636.91 $1,604.17 $1,636.91 $1,636.91 $1,636.91 2026-03-19
77046 CPT Hc Bd MRI Breast Unilateral No Contrast 1 1 $1,636.00 $1,603.28 $1,636.00 $1,636.00 $1,636.00 2024-12-10
270041010 CDM Hc Apligaf-per 44 Sq Cm 1 1 $1,630.61 $1,598.00 $1,630.61 $1,630.61 $1,630.61 2026-03-19
77047 CPT Hc Bd MRI Breast Bilateral No Contrast 1 1 $1,623.00 $1,590.54 $1,623.00 $1,623.00 $1,623.00 2024-12-10
270041210 CDM Hc Theraskin 2x3 1 1 $1,605.42 $1,573.31 $1,605.42 $1,605.42 $1,605.42 2026-03-19
81352 CPT Hc Tp53(tumor Protein 53), Targeted Sequence Analysis 2 2 $1,583.61 $1,551.94 $1,568.22 $1,599.00 $1,583.61 2026-03-19
71552 CPT Hc MRI-chest W/wo Contrast 2 2 $1,576.88 $1,545.35 $1,492.77 $1,661.00 $1,576.88 2026-03-19
270041060 CDM Hc Dermagraft 1 1 $1,573.94 $1,542.46 $1,573.94 $1,573.94 $1,573.94 2026-03-19
A9547 HCPCS Hc Nm In111 Oxine Per 0.5 Mci 1 1 $1,572.48 $1,541.03 $1,572.48 $1,572.48 $1,572.48 2026-07-30
77285 CPT Hc Simulation, Intermediate 2 2 $1,561.32 $1,530.10 $1,441.00 $1,681.64 $1,561.32 2026-03-19
81235 CPT Hc Egfr Gene Mutation Analysis Tumor 2 2 $1,555.61 $1,524.49 $1,540.21 $1,571.00 $1,555.61 2026-03-19
Q4101 HCPCS Hc Apligaf-per 44 Sq Cm 1 1 $1,554.00 $1,522.92 $1,554.00 $1,554.00 $1,554.00 2026-07-30
720000012 CDM Hc Ext. Neonate Rotation 1 1 $1,441.88 $1,522.68 $1,553.75 $1,553.75 $1,553.75 2026-07-30
77048 CPT Hc Bd MRI Breast Unilateral W/wo Contrast 2 2 $1,552.99 $1,521.93 $1,469.98 $1,636.00 $1,552.99 2026-03-19
78806 CPT Hc Inflammation Imaging-wb 1 1 $1,543.69 $1,512.82 $1,543.69 $1,543.69 $1,543.69 2026-03-19
77049 CPT Hc Bd MRI Breast Bilateral W/wo Contrast 2 2 $1,540.80 $1,509.98 $1,458.59 $1,623.00 $1,540.80 2026-03-19
270041398 CDM Hc Grafix Pl Prime 3x4 1 1 $1,529.88 $1,499.28 $1,529.88 $1,529.88 $1,529.88 2026-03-19
76930 CPT Hc Pericardialcentesis W/echo 2 2 $1,526.65 $1,496.12 $1,460.00 $1,593.31 $1,526.65 2026-03-19
77293 CPT Hc Respiratory Motion Mgmt 2 2 $1,516.57 $1,486.24 $1,400.00 $1,633.13 $1,516.57 2026-03-19
270041354 CDM Hc Amnioexcel 5x5 1 1 $1,509.65 $1,479.46 $1,509.65 $1,509.65 $1,509.65 2026-03-19
09052 CPT Hc Ph, Hla Matched Leukored, Ea Unit 1 1 $1,508.86 $1,478.68 $1,508.86 $1,508.86 $1,508.86 2026-03-19
Q4106 HCPCS Hc Dermagraft 1 1 $1,500.00 $1,470.00 $1,500.00 $1,500.00 $1,500.00 2026-07-30
78801 CPT Hc Tumor Imaging 2 Or More Areas 1 Or More Days/single Area 2 Or More Days 2 2 $1,498.45 $1,468.49 $1,352.00 $1,644.91 $1,498.45 2026-03-19
170000000 CDM Hc Daily Care-nursery A 1 1 $1,311.64 $1,468.31 $1,498.28 $1,498.28 $1,498.28 2026-07-30
170000001 CDM Hc Daily Care-nursery B 1 1 $1,311.64 $1,468.31 $1,498.28 $1,498.28 $1,498.28 2026-07-30
81406 CPT Hc Mutyh Gene, Full Gene Analysis (myhz) 4 2 $1,482.62 $1,452.97 $1,260.18 $1,714.00 $1,482.62 2026-03-19
343095570 CDM Hc Tc99 Neurolite 1 1 $1,479.52 $1,449.93 $1,479.52 $1,479.52 $1,479.52 2026-03-19
270041349 CDM Hc Grafix Prime 2x3 1 1 $1,473.49 $1,444.02 $1,473.49 $1,473.49 $1,473.49 2026-03-19
270041357 CDM Hc Grafix Core 2x3 1 1 $1,473.49 $1,444.02 $1,473.49 $1,473.49 $1,473.49 2026-03-19
77058 CPT Hc Bd MRI Breast Unilateral No Contrast 1 1 $1,469.98 $1,440.58 $1,469.98 $1,469.98 $1,469.98 2026-03-19
77059 CPT Hc Bd MRI Breast Bilateral No Contrast 1 1 $1,458.59 $1,429.42 $1,458.59 $1,458.59 $1,458.59 2026-03-19
78014 CPT Hc Thyroid Imag Sing/mul Qm 2 2 $1,452.15 $1,423.11 $1,310.00 $1,594.30 $1,452.15 2026-03-19
270010033 CDM Hc Green Light Laser Procedure 1 1 $1,448.02 $1,419.06 $1,448.02 $1,448.02 $1,448.02 2026-03-19
270041369 CDM Hc Allograft Primatrix Meshed 5x5 1 1 $1,448.02 $1,419.06 $1,448.02 $1,448.02 $1,448.02 2026-03-19
78291 CPT Hc Peritoneal Venous Shunt 2 2 $1,429.49 $1,400.90 $1,290.00 $1,568.99 $1,429.49 2026-03-19
270041373 CDM Hc Allograft Omnigraft/stapler 4x4 1 1 $1,416.56 $1,388.23 $1,416.56 $1,416.56 $1,416.56 2026-03-19
270041397 CDM Hc Grafix Pl Prime 3x3 1 1 $1,416.56 $1,388.23 $1,416.56 $1,416.56 $1,416.56 2026-03-19
78104 CPT Hc Nm Bone Marrow Imaging, Whole Body 2 2 $1,406.35 $1,378.22 $1,269.00 $1,543.69 $1,406.35 2026-03-19
78262 CPT Hc Gastroesophageal Reflux 2 2 $1,406.35 $1,378.22 $1,269.00 $1,543.69 $1,406.35 2026-03-19
78306 CPT Hc Bone Scan-whole Body 2 2 $1,406.35 $1,378.22 $1,269.00 $1,543.69 $1,406.35 2026-03-19
09035 CPT Hc Pheresis (platelets) 1 1 $1,400.20 $1,372.20 $1,400.20 $1,400.20 $1,400.20 2026-03-19
720000006 CDM Hc Multiple Birth - Triplets 1 1 $1,297.68 $1,370.40 $1,398.37 $1,398.37 $1,398.37 2026-07-30
PX-720000012 CDM Hc Ext. Neonate Rotation 1 1 $1,390.00 $1,362.20 $1,390.00 $1,390.00 $1,390.00 2024-12-10
93930 CPT Hc Vl Duplex Uea Bilateral 2 2 $1,389.58 $1,361.78 $1,336.00 $1,443.15 $1,389.58 2026-03-19
A9557 HCPCS Hc Tc99 Neurolite 1 1 $1,380.63 $1,353.02 $1,380.63 $1,380.63 $1,380.63 2026-07-30
PX-270010033 CDM Hc Green Light Laser Procedure 1 1 $1,380.00 $1,352.40 $1,380.00 $1,380.00 $1,380.00 2024-12-10
00001 CPT Hc I131 Mibg 3 1 $1,372.33 $1,344.88 $94.99 $2,052.21 $1,372.33 2026-03-19
P9052 HCPCS Hc Ph, Hla Matched Leukored, Ea Unit 1 1 $1,367.00 $1,339.66 $1,367.00 $1,367.00 $1,367.00 2026-07-30
74280 CPT Hc Barium Enema W/air Doubele Contrast W Scout/delayed Images 2 2 $1,360.22 $1,333.02 $1,308.00 $1,412.45 $1,360.22 2026-03-19
93880 CPT Hc Vl Carotid Duplex Bilateral 2 2 $1,360.22 $1,333.02 $1,308.00 $1,412.45 $1,360.22 2026-03-19
93970 CPT Hc Vl Duplex Venous Map Bilat 2 2 $1,360.22 $1,333.02 $1,308.00 $1,412.45 $1,360.22 2026-03-19
78580 CPT Hc Pulm Perfusion Particulate 2 2 $1,360.04 $1,332.84 $1,227.00 $1,493.08 $1,360.04 2026-03-19
77771 CPT Hc High Dose Rate Brachytherapy 2-12 2 2 $1,351.13 $1,324.11 $1,247.00 $1,455.26 $1,351.13 2026-03-19
Q4133 HCPCS Hc Grafix Pl Prime 1.5x2 5 1 $1,350.00 $1,323.00 $950.00 $3,240.00 $1,350.00 2024-12-10
270041353 CDM Hc Amnioexcel 4x4 1 1 $1,343.55 $1,316.68 $1,343.55 $1,343.55 $1,343.55 2026-03-19
81445 CPT Hc Ngs Colorectal Cancer Panel 8 2 $1,337.30 $1,310.56 $980.14 $1,956.00 $1,337.30 2026-03-19
73720 CPT Hc MRI Lower Extrem Wwo Contrast 2 2 $1,335.93 $1,309.21 $1,264.86 $1,407.00 $1,335.93 2026-03-19
74183 CPT Hc MRI Abdomen W Wo Contrast 2 2 $1,335.93 $1,309.21 $1,264.86 $1,407.00 $1,335.93 2026-03-19
270041392 CDM Hc Graft Affinity Fresh Amniotic 2.5x2.5 1 1 $1,332.84 $1,306.18 $1,332.84 $1,332.84 $1,332.84 2026-03-19
J0630 HCPCS Calcitonin Per 400 Units 2 1 $1,329.88 $1,303.28 $1,316.13 $1,343.63 $1,329.88 2026-03-19
81228 CPT Hc Cytogenomic Constitutional Microarray Anal 2 2 $1,329.10 $1,302.51 $1,316.19 $1,342.00 $1,329.10 2026-03-19
72197 CPT Hc MRI-pelvis W/wo Contrast 2 2 $1,324.24 $1,297.75 $1,253.47 $1,395.00 $1,324.24 2026-03-19
73220 CPT Hc MRI Upper Extrem W Wo Contrast 2 2 $1,324.24 $1,297.75 $1,253.47 $1,395.00 $1,324.24 2026-03-19
78206 CPT Hc Liver Imaging (spect) W Vasc Flow 1 1 $1,315.93 $1,289.61 $1,315.93 $1,315.93 $1,315.93 2026-03-19
77012 CPT Hc CT Guided Needle Biopsy 2 2 $1,297.65 $1,271.70 $1,241.00 $1,354.31 $1,297.65 2026-03-19
78740 CPT Hc Urethral Reflux Study 2 2 $1,291.08 $1,265.26 $1,165.00 $1,417.15 $1,291.08 2026-03-19
PX-343000012 CDM Hc I131 Mibg 1 1 $1,280.60 $1,254.99 $1,280.60 $1,280.60 $1,280.60 2024-12-10
76390 CPT Hc MRI Spectroscopy 2 2 $1,275.95 $1,250.42 $1,207.89 $1,344.00 $1,275.95 2026-03-19
81232 CPT Hc Dihydropyrimidine Dehydrogenase Full Gene Sequ 2 2 $1,272.59 $1,247.14 $1,260.18 $1,285.00 $1,272.59 2026-03-19
270010031 CDM Filler Bone Void 1cc Dbx Allograft Putty Freeze Dried 22 1 $1,271.51 $1,246.08 $215.12 $15,314.40 $1,271.51 2026-03-19
93978 CPT Hc Vl Aortic Duplex Scan Complete 2 2 $1,271.16 $1,245.74 $1,222.00 $1,320.33 $1,271.16 2026-03-19
C1729 HCPCS Kit Pleurx Catheter 1 1 $1,270.88 $1,245.46 $1,270.88 $1,270.88 $1,270.88 2026-03-19
78258 CPT Hc Nm Esophageal Motility 2 2 $1,267.92 $1,242.57 $1,144.00 $1,391.85 $1,267.92 2026-03-19
78701 CPT Hc Nm Kidney Static Scan W/vasc Flow 2 2 $1,267.92 $1,242.57 $1,144.00 $1,391.85 $1,267.92 2026-03-19
78601 CPT Hc Brain Scan <4 Views W Vasc Flow 2 2 $1,267.92 $1,242.57 $1,144.00 $1,391.85 $1,267.92 2026-03-19
81273 CPT Hc Kit Asp816val Mutation Analysis, Blood 2 2 $1,264.39 $1,239.10 $1,251.78 $1,277.00 $1,264.39 2026-03-19
71551 CPT Hc MRI-chest W Contrast 2 2 $1,263.75 $1,238.47 $1,196.50 $1,331.00 $1,263.75 2026-03-19
PX-720000006 CDM Hc Multiple Birth - Triplets 1 1 $1,251.00 $1,225.98 $1,251.00 $1,251.00 $1,251.00 2024-12-10
270041396 CDM Hc Grafix Pl Prime 2x3 1 1 $1,246.57 $1,221.64 $1,246.57 $1,246.57 $1,246.57 2026-03-19
78707 CPT Hc Nm Kidney Scan-vas Flow/funct Without 2 2 $1,244.77 $1,219.88 $1,123.00 $1,366.54 $1,244.77 2026-03-19
720000018 CDM Hc L&d Or Add'l Minor Surg 1 1 $1,153.50 $1,218.14 $1,243.00 $1,243.00 $1,243.00 2026-07-30
74182 CPT Hc MRI Abdomen W Contrast 2 2 $1,239.85 $1,215.06 $1,173.70 $1,306.00 $1,239.85 2026-03-19
09521 CPT Hc Tc99 Ceretec 1 1 $1,234.52 $1,209.83 $1,234.52 $1,234.52 $1,234.52 2026-03-19
270009128 CDM Hc Vena Cava Filter System 1 1 $1,203.76 $1,208.06 $1,232.71 $1,232.71 $1,232.71 2026-07-30
J0897 HCPCS Denosumab 120 Mg/1.7 Ml (70 Mg/ml) Solution 4 2 $42.21 $1,205.01 $32.70 $3,871.05 $1,229.61 2026-07-30
270041211 CDM Hc Theraskin 1x2 1 1 $1,227.69 $1,203.14 $1,227.69 $1,227.69 $1,227.69 2026-03-19
73723 CPT Hc MRI Lower Extrem Joint Wwo Cont 2 2 $1,227.65 $1,203.10 $1,162.31 $1,293.00 $1,227.65 2026-03-19
73223 CPT Hc MRI Upper Extrem Joint Wwo Cont 2 2 $1,227.65 $1,203.10 $1,162.31 $1,293.00 $1,227.65 2026-03-19
J1670 HCPCS Tetanus Immune Globulin 250 Unit/ml Syringe 1 1 $1,074.15 $1,197.88 $1,222.33 $1,222.33 $1,222.33 2026-07-30
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