Hospital

BARAGA COUNTY MEMORIAL HOSPITAL

L' Anse, MI · CCN 231307 · Rates published

2,532 distinct procedures filed

11 distinct payers

31,597 rate rows

2026-07-30 last MRF observed

Data quality

5,058 of 31,597 rate rows are consumer-grade (16.0%)

26,539 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	26,530
per-diem day rate — not a per-procedure price	6
exceeds 10× this hospital's gross charge — excluded from medians	3

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://bcmh.org/wp-content/uploads/2026/06/382892565_baraga-county-memorial-hospital_standardcharges-1.csv
Found on page	https://bcmh.org/patients-visitors/bcmh-hospital-charge-information/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-01
Content fingerprint	7cb2cf177da50b00… · 20,899,642 bytes · first seen 2026-07-06

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
J3101 HCPCS	TNKase 50mg Vl	1	$17,269.56	$17,269.56	$17,269.56	nat. median $498 outlier · 34.7×
49650 HCPCS	Robo Init Inguinal Hernia	1	$17,036.71	$17,036.71	$17,036.71	nat. median $5,726 outlier · 3.0×
47562 HCPCS	Robo Lap Cholecystectomy	1	$14,920.71	$14,920.71	$14,920.71	nat. median $6,043 outlier · 2.5×
44970 HCPCS	Robo Appendectomy	1	$14,503.52	$14,503.52	$14,503.52	nat. median $6,065 outlier · 2.4×
58662 HCPCS	Robo Laparoscopy Excise Lesions	1	$12,447.67	$12,447.67	$12,447.67	nat. median $6,306 2.0× median
46946 HCPCS	Dg Scoliosis Evaluation,professional Fee	1	$9,481.76	$9,481.76	$9,481.76	nat. median $2,880 outlier · 3.3×
58562 HCPCS	Hysteroscopy Remove Fb	1	$7,532.63	$7,532.63	$7,532.63	nat. median $3,392 outlier · 2.2×
49592 HCPCS	Robo Ant Abd Hern Rep >3cm Incarceratd	3	$485.39	$10,850.72	$6,830.98	nat. median $6,267 1.1× median
28750 HCPCS	Arthrodesis Grt Toe,metatarsphangl Joint	1	$5,296.50	$5,296.50	$5,296.50	nat. median $7,165 0.7× median
72157 HCPCS	Mr Thoracic Spine W/wo	1	$5,037.28	$5,037.28	$5,037.28	nat. median $624 outlier · 8.1×
J2353 HCPCS	Sandostatin Lar Dep 30mg Pfs	1	$4,752.00	$4,752.00	$4,752.00	nat. median $1,956 outlier · 2.4×
73220 HCPCS	Mr Upper Ext Lt W/wo,left	1	$4,438.67	$4,438.67	$4,438.67	nat. median $737 outlier · 6.0×
70543 HCPCS	Mr Orbits Face Neck W/wo	2	$3,836.03	$4,621.06	$4,228.55	nat. median $605 outlier · 7.0×
77049 HCPCS	Mr Breast Bilatateral W Or W And Without	3	$2,388.48	$4,827.72	$3,489.28	nat. median $683 outlier · 5.1×
72158 HCPCS	Mr Lumbar Spine W/wo	2	$2,106.91	$4,848.09	$3,477.50	nat. median $616 outlier · 5.6×
72156 HCPCS	Mr Cervical Spin W/wo	2	$2,286.24	$4,621.06	$3,453.65	nat. median $625 outlier · 5.5×
46270 HCPCS	Excision Of Fistula	1	$3,377.27	$3,377.27	$3,377.27	nat. median $3,043 1.1× median
74183 HCPCS	Mr Abdomen W/wo	4	$1,932.83	$4,621.06	$3,344.65	nat. median $611 outlier · 5.5×
70553 HCPCS	Mr Brain, IAC's Or Pituitary W/wo	4	$1,844.36	$4,409.56	$3,323.16	nat. median $616 outlier · 5.4×
Q5108 HCPCS	Fulphila 6mg/0.6ml	2	$2,136.00	$4,317.39	$3,226.70	nat. median $418 outlier · 7.7×
J1439 HCPCS	Injectafer Sdv 750mg A/r 15ml	2	$3,201.66	$3,201.66	$3,201.66	nat. median $5 outlier · 637.1×
45910 HCPCS	Dilation Of Rectal Narrowing W/anes	1	$3,194.35	$3,194.35	$3,194.35	nat. median $1,468 outlier · 2.2×
73720 HCPCS	Mr Lower Ext Lt W/wo,left	2	$2,174.30	$4,196.12	$3,185.21	nat. median $754 outlier · 4.2×
52281 HCPCS	Cysto W/dilation Urethral Stricture	1	$3,128.90	$3,128.90	$3,128.90	nat. median $2,206 1.4× median
38510 HCPCS	Biopsy Cervical Node Deep Excision	1	$3,084.65	$3,084.65	$3,084.65	nat. median $4,010 0.8× median
33285 HCPCS	Insertion Of Subcutaneous Cardiad Rhyth	1	$91.88	$5,689.49	$2,890.68	nat. median $9,474 outlier · 0.3×
78452 HCPCS	Nm *myocardial Perfusion Imag Multiple	4	$1,408.13	$3,366.59	$2,830.61	nat. median $1,464 1.9× median
28113 HCPCS	Resection 5th Metatarsal Head	1	$2,819.52	$2,819.52	$2,819.52	nat. median $3,254 0.9× median
73718 HCPCS	Mr Lower Ext Lt W/o,left	1	$2,812.61	$2,812.61	$2,812.61	nat. median $505 outlier · 5.6×
73721 HCPCS	Mr Lower Ext Joint Lt W/o,left	3	$1,183.71	$2,823.28	$2,764.50	nat. median $509 outlier · 5.4×
74185 HCPCS	MRA Abdomen W/wo	1	$2,728.20	$2,728.20	$2,728.20	nat. median $853 outlier · 3.2×
0120 RC		7	$1,157.45	$2,506.00	$2,506.00	nat. median $856 outlier · 2.9×
0110 RC		7	$1,167.15	$2,506.00	$2,506.00	nat. median $855 outlier · 2.9×
0278 RC		2	$305.16	$4,549.07	$2,427.11	nat. median $1,512 1.6× median
74174 HCPCS	Cra Abdomen Pelvis Aorta W Or W/wo,professional Fee	3	$1,028.30	$2,366.32	$2,292.51	nat. median $549 outlier · 4.2×
73723 HCPCS	Mr Lower Ext Joint Lt W/wo,left	1	$2,291.90	$2,291.90	$2,291.90	nat. median $756 outlier · 3.0×
72197 HCPCS	Mr Pelvis W/wo	4	$1,934.00	$4,621.07	$2,288.50	nat. median $606 outlier · 3.8×
74178 HCPCS	CT Abdomen W/wo Pelvis W	4	$1,904.42	$4,553.15	$2,281.14	nat. median $539 outlier · 4.2×
90375 HCPCS	Hyperrab Immune Globulin 900 Unit 3ml	2	$1,505.75	$3,005.68	$2,255.72	nat. median $789 outlier · 2.9×
J9217 HCPCS	Lupron Depot 30mg	2	$1,490.40	$3,012.47	$2,251.43	nat. median $2,144 1.0× median
74181 HCPCS	Mr Abdomen Without	2	$1,456.77	$2,980.45	$2,218.61	nat. median $428 outlier · 5.2×
72141 HCPCS	Mr Cervical Spine Without	5	$1,241.75	$2,968.81	$2,187.90	nat. median $429 outlier · 5.1×
28820 HCPCS	Amputation Toe-metatarsophalangeal Joint	1	$2,018.55	$2,018.55	$2,018.55	nat. median $3,343 0.6× median
J0897 HCPCS	Prolia Pfs 60mg/ml	1	$1,968.00	$1,968.00	$1,968.00	nat. median $86 outlier · 22.9×
64417 HCPCS	Inj Anesthetic/steroid Axillary Nerve	1	$1,869.43	$1,869.43	$1,869.43	nat. median $1,057 1.8× median
610 OTHER	Mr Abdomen W/wo	2	$1,122.10	$3,518.34	$1,849.65	nat. median $2,802 0.7× median
93306 HCPCS	US Echo Complete	4	$770.73	$2,429.38	$1,779.64	nat. median $804 outlier · 2.2×
73206 HCPCS	CTA Upper Extremity With Or W/wo-lt,left	1	$1,757.03	$1,757.03	$1,757.03	nat. median $340 outlier · 5.2×
483 OTHER	US Echo Complete	2	$1,158.36	$2,318.85	$1,738.61	nat. median $11,989 outlier · 0.1×
480 OTHER	Incision & Drainage Level 1	1	$1,737.91	$1,737.91	$1,737.91	nat. median $32,110 outlier · 0.1×

Other procedures at this hospital

Browse this hospital's 2,532 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J3101	HCPCS	TNKase 50mg Vl	1	1	$18,500.00	$18,500.00	$17,269.56	$17,269.56	$17,269.56	2026-06-23
49650	HCPCS	Robo Init Inguinal Hernia	1	1	$11,027.00	$11,027.00	$17,036.71	$17,036.71	$17,036.71	2026-06-23
47562	HCPCS	Robo Lap Cholecystectomy	1	1	$11,457.00	$11,457.00	$14,920.71	$14,920.71	$14,920.71	2026-06-23
44970	HCPCS	Robo Appendectomy	1	1	$11,027.00	$11,027.00	$14,503.52	$14,503.52	$14,503.52	2026-06-23
58662	HCPCS	Robo Laparoscopy Excise Lesions	1	1	$11,674.00	$11,674.00	$12,447.67	$12,447.67	$12,447.67	2026-06-23
46946	HCPCS	Dg Scoliosis Evaluation,professional Fee	1	1	$900.00	$900.00	$9,481.76	$9,481.76	$9,481.76	2026-06-23
58562	HCPCS	Hysteroscopy Remove Fb	1	1	$4,630.00	$4,630.00	$7,532.63	$7,532.63	$7,532.63	2026-06-23
49592	HCPCS	Robo Ant Abd Hern Rep >3cm Incarceratd	4	3	$11,457.00	$11,457.00	$485.39	$10,850.72	$6,830.98	2026-06-23
28750	HCPCS	Arthrodesis Grt Toe,metatarsphangl Joint	1	1	$9,918.00	$9,918.00	$5,296.50	$5,296.50	$5,296.50	2026-06-23
72157	HCPCS	Mr Thoracic Spine W/wo	1	1	$2,969.00	$2,969.00	$5,037.28	$5,037.28	$5,037.28	2026-06-23
J2353	HCPCS	Sandostatin Lar Dep 30mg Pfs	1	1	$8,565.00	$8,565.00	$4,752.00	$4,752.00	$4,752.00	2026-06-23
73220	HCPCS	Mr Upper Ext Lt W/wo,left	1	1	$2,761.00	$2,761.00	$4,438.67	$4,438.67	$4,438.67	2026-06-23
70543	HCPCS	Mr Orbits Face Neck W/wo	2	2	$2,775.00	$2,775.00	$3,836.03	$4,621.06	$4,228.55	2026-06-23
77049	HCPCS	Mr Breast Bilatateral W Or W And Without	4	3	$2,885.50	$2,885.50	$2,388.48	$4,827.72	$3,489.28	2026-06-23
72158	HCPCS	Mr Lumbar Spine W/wo	2	2	$2,969.00	$2,969.00	$2,106.91	$4,848.09	$3,477.50	2026-06-23
72156	HCPCS	Mr Cervical Spin W/wo	2	2	$2,754.00	$2,754.00	$2,286.24	$4,621.06	$3,453.65	2026-06-23
46270	HCPCS	Excision Of Fistula	1	1	$1,386.00	$1,386.00	$3,377.27	$3,377.27	$3,377.27	2026-06-23
74183	HCPCS	Mr Abdomen W/wo	4	4	$2,774.00	$2,774.00	$1,932.83	$4,621.06	$3,344.65	2026-06-23
70553	HCPCS	Mr Brain, IAC's Or Pituitary W/wo	4	4	$2,644.00	$2,644.00	$1,844.36	$4,409.56	$3,323.16	2026-06-23
Q5108	HCPCS	Fulphila 6mg/0.6ml	2	2	$4,450.00	$4,450.00	$2,136.00	$4,317.39	$3,226.70	2026-06-23
J1439	HCPCS	Injectafer Sdv 750mg A/r 15ml	2	2	$3,600.00	$3,600.00	$3,201.66	$3,201.66	$3,201.66	2026-06-23
45910	HCPCS	Dilation Of Rectal Narrowing W/anes	1	1	$1,712.00	$1,712.00	$3,194.35	$3,194.35	$3,194.35	2026-06-23
73720	HCPCS	Mr Lower Ext Lt W/wo,left	2	2	$2,554.00	$2,554.00	$2,174.30	$4,196.12	$3,185.21	2026-06-23
52281	HCPCS	Cysto W/dilation Urethral Stricture	1	1	$1,862.00	$1,862.00	$3,128.90	$3,128.90	$3,128.90	2026-06-23
38510	HCPCS	Biopsy Cervical Node Deep Excision	1	1	$1,152.00	$1,152.00	$3,084.65	$3,084.65	$3,084.65	2026-06-23
33285	HCPCS	Insertion Of Subcutaneous Cardiad Rhyth	2	1	$12,246.00	$12,246.00	$91.88	$5,689.49	$2,890.68	2026-06-23
78452	HCPCS	Nm *myocardial Perfusion Imag Multiple	5	4	$2,230.00	$2,230.00	$1,408.13	$3,366.59	$2,830.61	2026-06-23
28113	HCPCS	Resection 5th Metatarsal Head	1	1	$4,680.00	$4,680.00	$2,819.52	$2,819.52	$2,819.52	2026-06-23
73718	HCPCS	Mr Lower Ext Lt W/o,left	1	1	$1,801.50	$1,801.50	$2,812.61	$2,812.61	$2,812.61	2026-06-23
73721	HCPCS	Mr Lower Ext Joint Lt W/o,left	5	3	$1,694.00	$1,694.00	$1,183.71	$2,823.28	$2,764.50	2026-06-23
74185	HCPCS	MRA Abdomen W/wo	1	1	$1,852.00	$1,852.00	$2,728.20	$2,728.20	$2,728.20	2026-06-23
0120	RC	—	7	7	$1,888.00	$1,888.00	$1,157.45	$2,506.00	$2,506.00	2026-06-23
0110	RC	—	7	7	$1,250.00	$1,250.00	$1,167.15	$2,506.00	$2,506.00	2026-06-23
0278	RC	—	2	2	$1,977.00	$1,977.00	$305.16	$4,549.07	$2,427.11	2026-06-23
74174	HCPCS	Cra Abdomen Pelvis Aorta W Or W/wo,professional Fee	3	3	$1,708.00	$1,708.00	$1,028.30	$2,366.32	$2,292.51	2026-06-23
73723	HCPCS	Mr Lower Ext Joint Lt W/wo,left	1	1	$2,733.50	$2,733.50	$2,291.90	$2,291.90	$2,291.90	2026-06-23
72197	HCPCS	Mr Pelvis W/wo	4	4	$2,772.50	$2,772.50	$1,934.00	$4,621.07	$2,288.50	2026-06-23
74178	HCPCS	CT Abdomen W/wo Pelvis W	4	4	$2,410.50	$2,410.50	$1,904.42	$4,553.15	$2,281.14	2026-06-23
90375	HCPCS	Hyperrab Immune Globulin 900 Unit 3ml	2	2	$4,644.00	$4,644.00	$1,505.75	$3,005.68	$2,255.72	2026-06-23
J9217	HCPCS	Lupron Depot 30mg	2	2	$13,132.00	$13,132.00	$1,490.40	$3,012.47	$2,251.43	2026-06-23
74181	HCPCS	Mr Abdomen Without	2	2	$1,763.00	$1,763.00	$1,456.77	$2,980.45	$2,218.61	2026-06-23
72141	HCPCS	Mr Cervical Spine Without	6	5	$1,754.00	$1,754.00	$1,241.75	$2,968.81	$2,187.90	2026-06-23
28820	HCPCS	Amputation Toe-metatarsophalangeal Joint	1	1	$4,719.00	$4,719.00	$2,018.55	$2,018.55	$2,018.55	2026-06-23
J0897	HCPCS	Prolia Pfs 60mg/ml	1	1	$4,110.00	$4,110.00	$1,968.00	$1,968.00	$1,968.00	2026-06-23
64417	HCPCS	Inj Anesthetic/steroid Axillary Nerve	1	1	$1,246.00	$1,246.00	$1,869.43	$1,869.43	$1,869.43	2026-06-23
610	OTHER	Mr Abdomen W/wo	11	2	$3,762.00	$3,762.00	$1,122.10	$3,518.34	$1,849.65	2026-07-30
93306	HCPCS	US Echo Complete	4	4	$1,482.50	$1,482.50	$770.73	$2,429.38	$1,779.64	2026-06-23
73206	HCPCS	CTA Upper Extremity With Or W/wo-lt,left	1	1	$1,286.00	$1,286.00	$1,757.03	$1,757.03	$1,757.03	2026-06-23
483	OTHER	US Echo Complete	2	2	$2,364.00	$2,364.00	$1,158.36	$2,318.85	$1,738.61	2026-07-30
480	OTHER	Incision & Drainage Level 1	1	1	$582.00	$582.00	$1,737.91	$1,737.91	$1,737.91	2026-07-30
70496	HCPCS	CTA Head With Or W/wo	3	3	$1,212.50	$1,212.50	$725.57	$1,749.30	$1,731.81	2026-06-23
10140	HCPCS	Incisn Draing Hematoma Seroma Or Fl Col	4	3	$2,268.00	$2,268.00	$129.27	$4,232.99	$1,692.92	2026-06-23
71270	HCPCS	CT Chest W/wo	1	1	$1,105.00	$1,105.00	$1,636.73	$1,636.73	$1,636.73	2026-06-23
78306	HCPCS	Nm Bone Scan - Multiple Area	1	1	$1,130.50	$1,130.50	$1,612.47	$1,612.47	$1,612.47	2026-06-23
64721	HCPCS	Carpal Tunnel Release	1	1	$1,185.00	$1,185.00	$1,589.17	$1,589.17	$1,589.17	2026-06-23
72146	HCPCS	Mr Thoracic Spine Without	4	4	$1,842.50	$1,842.50	$1,487.23	$3,076.10	$1,534.43	2026-06-23
C8929	HCPCS	US Definity Contrast	1	1	$1,122.00	$1,122.00	$1,513.59	$1,513.59	$1,513.59	2026-06-23
72195	HCPCS	Mr Pelvis Without	1	1	$1,839.50	$1,839.50	$1,487.32	$1,487.32	$1,487.32	2026-06-23
70551	HCPCS	Mr Brain, IAC's Or Pituitary W/0	3	3	$1,782.00	$1,782.00	$1,260.41	$3,013.44	$1,467.76	2026-06-23
70492	HCPCS	CT St Neck W Without	1	1	$999.50	$999.50	$1,439.78	$1,439.78	$1,439.78	2026-06-23
74177	HCPCS	CT Abdomen And Pelvis With	5	4	$1,838.50	$1,838.50	$684.35	$2,887.32	$1,428.48	2026-06-23
72148	HCPCS	Mr Lumbar Spine Without	5	4	$1,686.00	$1,686.00	$1,185.75	$2,834.92	$1,402.56	2026-06-23
62323	HCPCS	Fl Esi Lumbar/sacral Interlaminal Inject,professional Fee	6	5	$963.00	$963.00	$391.57	$2,157.72	$1,384.22	2026-06-23
73221	HCPCS	Mr Upper Ext Joint Lt W/o,left	6	3	$1,655.50	$1,655.50	$1,315.75	$2,747.61	$1,335.42	2026-06-23
Q0139	HCPCS	Feraheme 510mg/17ml Inj	2	2	$2,712.00	$2,712.00	$2.16	$2,631.18	$1,316.67	2026-06-23
G0390	HCPCS	Trauma Activation Level 1	2	2	$1,913.00	$1,913.00	$776.30	$1,855.99	$1,316.14	2026-06-23
75635	HCPCS	CTA Abd/pel Aorta W Or W/wo Extre Runoff	4	4	$1,784.00	$1,784.00	$1,058.73	$2,531.25	$1,304.90	2026-06-23
70491	HCPCS	CT St Neck With	4	4	$879.50	$879.50	$617.45	$1,296.08	$1,275.97	2026-06-23
72128	HCPCS	CT Thoracic Spine Without	1	1	$803.00	$803.00	$1,274.00	$1,274.00	$1,274.00	2026-06-23
74176	HCPCS	CT Abdomen Pelvis Without	5	4	$1,538.00	$1,538.00	$1,070.19	$2,565.21	$1,269.12	2026-06-23
62321	HCPCS	Fl Esi Cervical Interlaminar Injection,professional Fee	4	3	$648.00	$648.00	$123.36	$2,157.72	$1,238.69	2026-06-23
71275	HCPCS	CTA Chest Aorta W Or W/wo	5	5	$1,358.00	$1,358.00	$839.80	$1,923.91	$1,222.89	2026-06-23
73706	HCPCS	CTA Lower Extremity With Or W/wo	2	2	$1,316.50	$1,316.50	$557.43	$1,825.92	$1,191.68	2026-06-23
615	OTHER	MRA Head Without	5	2	$2,393.00	$2,393.00	$758.67	$3,854.94	$1,172.57	2026-07-30
11106	HCPCS	Biopsy Skin Incisional Single	2	1	$1,155.00	$1,155.00	$88.11	$2,193.62	$1,140.86	2026-06-23
36561	HCPCS	Mediport Placement	2	1	$1,521.00	$1,521.00	$328.94	$1,889.00	$1,108.97	2026-06-23
70544	HCPCS	MRA Head Without	2	2	$1,705.50	$1,705.50	$862.15	$1,344.48	$1,103.32	2026-06-23
92950	HCPCS	Cpr	1	1	$436.00	$436.00	$1,078.88	$1,078.88	$1,078.88	2026-06-23
74170	HCPCS	CT Abdomen W/wo	3	3	$1,260.00	$1,260.00	$880.95	$1,860.84	$1,047.97	2026-06-23
G0260	HCPCS	Injection Of Sacroiliac Joint	3	3	$975.00	$975.00	$880.18	$1,413.79	$1,041.12	2026-06-23
35201	HCPCS	Repair Blood Vessel; Direct; Neck	10	9	$4,629.00	$4,629.00	$1,023.64	$1,023.64	$1,023.64	2026-06-23
59612	HCPCS	Vaginal Deliv Only, After Prev Cesarean	10	9	$3,065.00	$3,065.00	$1,022.34	$1,022.34	$1,022.34	2026-06-23
66991	HCPCS	Ecce With Iol + I Stent Procedure	1	1	$1,301.00	$1,301.00	$1,012.47	$1,012.47	$1,012.47	2026-06-23
27758	HCPCS	Open Treatment Of Tibial Shaft	10	9	$4,034.00	$4,034.00	$993.83	$993.83	$993.83	2026-06-23
26055	HCPCS	Trigger Finger Release	1	1	$1,198.00	$1,198.00	$970.67	$970.67	$970.67	2026-06-23
88120	HCPCS	Fish Analysis Urovysion	1	1	$2,057.00	$2,057.00	$955.68	$955.68	$955.68	2026-06-23
0450	RC	—	1	1	$1,817.00	$1,817.00	$944.49	$944.49	$944.49	2026-06-23
82787	HCPCS	**igg2	1	1	$237.00	$237.00	$919.75	$919.75	$919.75	2026-06-23
35226	HCPCS	Repair Blood Vessl Direct Lower Ext	2	2	$985.00	$985.00	$913.04	$913.04	$913.04	2026-06-23
59409	HCPCS	Vaginal Delivery Only	10	9	$2,860.00	$2,860.00	$898.16	$898.16	$898.16	2026-06-23
78315	HCPCS	Nm Bone Scan - 3 Phase	1	1	$1,429.00	$1,429.00	$875.31	$875.31	$875.31	2026-06-23
70490	HCPCS	CT St Neck Without	2	2	$784.50	$784.50	$565.42	$1,180.74	$873.08	2026-06-23
22315	HCPCS	Vertebral Process Fx,closed W/manip	10	9	$3,416.00	$3,416.00	$871.72	$871.72	$871.72	2026-06-23
52224	HCPCS	Cysturethrscpy W/fulgratn Or Tx W/wo Bi	2	1	$4,829.00	$4,829.00	$212.61	$1,486.37	$849.49	2026-06-23
70498	HCPCS	CTA Neck Carotids With Or W/wo	3	3	$1,194.50	$1,194.50	$710.94	$1,000.18	$848.44	2026-06-23
96523	HCPCS	Port Flush	1	1	$113.00	$113.00	$846.98	$846.98	$846.98	2026-06-23
74160	HCPCS	CT Abdomen With	2	2	$1,086.00	$1,086.00	$101.61	$1,587.25	$844.43	2026-06-23
35207	HCPCS	Repair Blood Vessel-direct Hand/finger	10	9	$3,747.00	$3,747.00	$834.99	$834.99	$834.99	2026-06-23
341	OTHER	Nm Bone Scan - Multiple Area	9	2	$1,312.00	$1,312.00	$437.58	$2,115.12	$834.96	2026-07-30
27252	HCPCS	Closed Tx/hip Disloc/trauma W Anesthesia	10	9	$2,352.00	$2,352.00	$830.31	$830.31	$830.31	2026-06-23
352	OTHER	CT Abdomen And Pelvis With	22	2	$1,331.00	$1,331.00	$150.48	$2,938.33	$827.09	2026-07-30
Q5100	HCPCS	Yesintek 130mg Inj	1	1	$850.00	$850.00	$824.67	$824.67	$824.67	2026-06-23
76700	HCPCS	US Abdomen Comp 2 Organs	2	2	$699.50	$699.50	$528.54	$1,097.30	$812.92	2026-06-23
73701	HCPCS	CT Lower Extremity With Lt,left	2	2	$777.00	$777.00	$472.76	$1,130.29	$801.52	2026-06-23
76811	HCPCS	US OB Complete	2	2	$627.00	$627.00	$798.47	$798.47	$798.47	2026-06-23
76801	HCPCS	US OB 1st Trimester	3	3	$549.00	$549.00	$781.85	$798.47	$798.47	2026-06-23
15110	HCPCS	Epidrml Autogrft Trnk/arm/legs 1st Sq Cm	2	2	$2,528.00	$2,528.00	$788.37	$788.37	$788.37	2026-06-23
350	OTHER	CTA Abdomen Pelvis W Or W/wo	14	2	$1,207.00	$1,207.00	$521.69	$1,546.01	$787.82	2026-07-30
76805	HCPCS	US OB 2nd & 3rd Trimester	3	3	$571.00	$571.00	$768.40	$798.47	$781.85	2026-06-23
J7328	HCPCS	Gelsyn-3 16.8mg/2ml Pfs Inj	1	1	$800.00	$800.00	$776.16	$776.16	$776.16	2026-06-23
15115	HCPCS	Epid Autogrft Face/sclp/eyelds 1st Sq Cm	2	2	$2,528.00	$2,528.00	$771.62	$771.62	$771.62	2026-06-23
27517	HCPCS	Closed Tx Distal Femoral Epiphys W Manip	10	9	$2,434.00	$2,434.00	$770.42	$770.42	$770.42	2026-06-23
71260	HCPCS	CT Chest With Routine	5	4	$987.00	$987.00	$642.79	$1,504.80	$768.40	2026-06-23
26412	HCPCS	Tendon Repair, Hand Complex	10	9	$1,738.00	$1,738.00	$765.76	$765.76	$765.76	2026-06-23
66982	HCPCS	Complex Cataract	1	1	$1,955.00	$1,955.00	$756.96	$756.96	$756.96	2026-06-23
73700	HCPCS	CT Lower Extremity Lt W/o,left	4	3	$689.50	$689.50	$317.96	$1,041.02	$756.73	2026-06-23
26951	HCPCS	Amputation Finger W/direct Closure	10	9	$1,821.00	$1,821.00	$756.16	$756.16	$756.16	2026-06-23
78227	HCPCS	Nm Hepatobiliary Scan-gallbladder Funct	2	2	$1,021.50	$1,021.50	$346.27	$1,126.40	$736.34	2026-06-23
70481	HCPCS	CT Sella Tur/iac/orbits/w	2	2	$670.50	$670.50	$523.05	$893.55	$708.30	2026-06-23
27552	HCPCS	Dislocation - Knee With Anesthesia	10	9	$1,734.00	$1,734.00	$706.69	$706.69	$706.69	2026-06-23
72132	HCPCS	CT Lumbar With	1	1	$928.00	$928.00	$701.28	$701.28	$701.28	2026-06-23
71250	HCPCS	Ch Chest W/o,professional Fee	4	4	$886.50	$886.50	$592.87	$1,417.46	$700.12	2026-06-23
93229	HCPCS	Mcot	6	5	$1,002.00	$1,002.00	$406.61	$972.14	$698.38	2026-06-23
81256	HCPCS	Hemochromatosis	2	2	$1,008.00	$1,008.00	$405.01	$977.96	$691.49	2026-06-23
70487	HCPCS	CT Sinus Facial/maxilla With	2	2	$675.50	$675.50	$403.77	$965.35	$684.56	2026-06-23
90675	HCPCS	Imovax Rabies Inj (series 0,3,7,14)	2	2	$1,000.00	$1,000.00	$472.32	$892.58	$682.45	2026-06-23
87507	HCPCS	Gi Panel	1	1	$703.00	$703.00	$682.06	$682.06	$682.06	2026-06-23
J2785	HCPCS	Regadenoson 0.08mg/ml 5ml	3	3	$700.00	$700.00	$336.00	$679.14	$679.14	2026-06-23
351	OTHER	CT Head Without	9	2	$904.00	$904.00	$396.90	$820.03	$664.85	2026-07-30
26418	HCPCS	Repair Extensor Tendon	2	2	$2,169.00	$2,169.00	$663.12	$663.12	$663.12	2026-06-23
26735	HCPCS	Op Tr Phalangeal Sh Fr Pr/mid Fing/thumb	10	9	$1,068.00	$1,068.00	$661.85	$661.85	$661.85	2026-06-23
J9171	HCPCS	Docetaxel(taxotere)inj:20mg	2	2	$200.00	$200.00	$659.74	$659.74	$659.74	2026-06-23
27266	HCPCS	Closed Tx Post Hip Arthroplasty	10	9	$1,864.00	$1,864.00	$646.63	$646.63	$646.63	2026-06-23
24535	HCPCS	Clsd Trmnt Supracondylar Humeral Fractur	10	9	$2,309.00	$2,309.00	$641.99	$641.99	$641.99	2026-06-23
64483	HCPCS	Fl Esi Lumbar Transforaminal Injection,professional Fee	2	1	$621.00	$621.00	$254.84	$1,026.27	$640.55	2026-06-23
26410	HCPCS	Tendon Repair, Hand	10	9	$1,463.00	$1,463.00	$640.21	$640.21	$640.21	2026-06-23
72131	HCPCS	CT Lumbar Without	3	3	$820.50	$820.50	$542.15	$1,281.92	$623.84	2026-06-23
76942	HCPCS	US Needle Guidance	2	2	$450.00	$450.00	$427.50	$819.82	$623.66	2026-06-23
0710	RC	—	6	5	$884.00	$884.00	$297.05	$1,815.24	$611.51	2026-06-23
93880	HCPCS	US Carotid Doppler	5	4	$832.00	$832.00	$497.10	$1,188.50	$588.00	2026-06-23
72125	HCPCS	CT Cervical Without	4	4	$761.50	$761.50	$493.86	$1,147.58	$587.26	2026-06-23
J2469	HCPCS	Palonosetron 0.25mg/5ml Inj	3	3	$600.00	$600.00	$288.00	$582.12	$582.12	2026-06-23
Q4187	HCPCS	Epicord Expandable 2x3cm	1	1	$630.83	$630.83	$579.95	$579.95	$579.95	2026-06-23
25605	HCPCS	Closed Tx Distal Radial Fx W/manip	2	2	$2,328.00	$2,328.00	$572.91	$572.91	$572.91	2026-06-23
70450	HCPCS	CT Head Without	5	5	$704.00	$704.00	$469.92	$1,134.84	$561.75	2026-06-23
23675	HCPCS	Closed Tx Shoulder Dislocation	10	9	$1,992.00	$1,992.00	$560.91	$560.91	$560.91	2026-06-23
97163	HCPCS	Pt Evaluation X45 Min	2	2	$588.00	$588.00	$549.13	$570.48	$559.81	2026-06-23
27508	HCPCS	Fx-femur Closed	10	9	$1,073.00	$1,073.00	$556.96	$556.96	$556.96	2026-06-23
27825	HCPCS	Fx-articular Distal Tibia With Manip	10	9	$1,525.00	$1,525.00	$554.70	$554.70	$554.70	2026-06-23
27842	HCPCS	Dislocation - Ankle With Anesthesia	10	9	$1,286.00	$1,286.00	$549.68	$549.68	$549.68	2026-06-23
27562	HCPCS	Dislocation - Patella With Anesthesia	10	9	$1,304.00	$1,304.00	$549.25	$549.25	$549.25	2026-06-23
27752	HCPCS	Fracture-tibia With Manipulation	10	9	$1,779.00	$1,779.00	$548.23	$548.23	$548.23	2026-06-23
51045	HCPCS	Cystotomy, W/insertion Of Uruteral Cath	10	9	$2,662.00	$2,662.00	$540.93	$540.93	$540.93	2026-06-23
74175	HCPCS	CTA Abdomen Aorta W Or W/wo	1	1	$1,262.50	$1,262.50	$537.73	$537.73	$537.73	2026-06-23
76706	HCPCS	US Abdomen Aorta	2	2	$501.50	$501.50	$341.25	$733.47	$537.36	2026-06-23
24605	HCPCS	Dislocation - Elbow With Anesthesia	10	9	$1,586.00	$1,586.00	$531.76	$531.76	$531.76	2026-06-23
27550	HCPCS	Dislocation - Knee	10	9	$1,047.00	$1,047.00	$527.91	$527.91	$527.91	2026-06-23
0623	RC	—	1	1	$3,393.00	$3,393.00	$527.13	$527.13	$527.13	2026-06-23
0390	RC	—	1	1	$370.00	$370.00	$525.28	$525.28	$525.28	2026-06-23
70470	HCPCS	CT Head W And Without	3	3	$848.00	$848.00	$455.27	$1,251.56	$523.48	2026-06-23
64640	HCPCS	Dest Of Peripheral Nerve Or Branch W/neu	3	2	$1,295.00	$1,295.00	$227.16	$1,634.79	$523.08	2026-06-23
27238	HCPCS	Closed Tx Of Intertrochanteric Frac/ Wo	10	9	$1,675.00	$1,675.00	$522.05	$522.05	$522.05	2026-06-23
25565	HCPCS	Closed Tx Radial+ulna Shaft Fx W/manip	4	3	$2,241.00	$2,241.00	$521.47	$2,174.22	$521.47	2026-06-23
A9500	HCPCS	Nm Tc99m Sestamibi	3	2	$639.00	$639.00	$306.72	$1,214.10	$518.61	2026-06-23
76856	HCPCS	US Pelvis Non-OB	3	3	$392.50	$392.50	$218.73	$522.94	$512.05	2026-06-23
731	OTHER	Cardiac Event Monitor	4	2	$761.50	$761.50	$366.00	$718.02	$511.99	2026-07-30
24505	HCPCS	Closed Reduction Fracture Humural Shaft	2	2	$420.00	$420.00	$507.06	$507.06	$507.06	2026-06-23
21450	HCPCS	Closed Treatment Of Mandisbalar Fracture	10	9	$1,486.00	$1,486.00	$505.47	$505.47	$505.47	2026-06-23
94060	HCPCS	Pft Before And After	1	1	$461.00	$461.00	$505.47	$505.47	$505.47	2026-06-23
45398	HCPCS	Colonoscopy, Flexible W/band Ligations	1	1	$1,862.00	$1,862.00	$505.28	$505.28	$505.28	2026-06-23
25660	HCPCS	Fx-radiiocarpal Or Intercarpal	10	9	$1,057.00	$1,057.00	$503.67	$503.67	$503.67	2026-06-23
25624	HCPCS	Fx-carpal Scaphoid With Manipulation	10	9	$981.00	$981.00	$500.45	$500.45	$500.45	2026-06-23
70460	HCPCS	CT Head With	1	1	$785.00	$785.00	$498.65	$498.65	$498.65	2026-06-23
27818	HCPCS	Treatment Of Ankle Fx W Manip	2	2	$2,241.00	$2,241.00	$495.66	$495.66	$495.66	2026-06-23
27762	HCPCS	Fx-medial Malleolus With Manipulation	10	9	$1,047.00	$1,047.00	$491.74	$491.74	$491.74	2026-06-23
65810	HCPCS	Paracentesis Anterior Chamber Of Eye With	10	9	$1,770.00	$1,770.00	$491.60	$491.60	$491.60	2026-06-23
88189	HCPCS	**flow Cytometry Interp 16+ Markers	1	1	$515.00	$515.00	$489.25	$489.25	$489.25	2026-06-23
64454	HCPCS	Njx Aa&/strd Genclr Nrv Branches	2	1	$1,010.00	$1,010.00	$81.39	$896.91	$489.15	2026-06-23
J9075	HCPCS	Cyclophosphamide 1000mg Inj(cytoxan)	3	3	$500.00	$500.00	$240.00	$485.10	$485.10	2026-06-23
27810	HCPCS	Clsd Tx Of Bimalleolar Ankle Fx W/manip	2	2	$2,300.00	$2,300.00	$480.78	$480.78	$480.78	2026-06-23
25635	HCPCS	Fx-carpal Bone With Manipulation	10	9	$938.00	$938.00	$475.81	$475.81	$475.81	2026-06-23
27265	HCPCS	Closed Tx/hip Arthro Disloc Wo Anesth	10	9	$1,592.00	$1,592.00	$468.95	$468.95	$468.95	2026-06-23
P9037	HCPCS	Bb Plt (6pk)pheresis Lp Irrad	1	1	$1,579.00	$1,579.00	$467.86	$467.86	$467.86	2026-06-23
450	OTHER	Emergency Room Level 4	11	2	$505.00	$505.00	$35.28	$2,700.09	$465.59	2026-07-30
24655	HCPCS	Dislocation - Radial Head With Manipulat	10	9	$936.00	$936.00	$455.32	$455.32	$455.32	2026-06-23
23655	HCPCS	Dislocation - Shoulder Manip With Anesth	10	9	$929.00	$929.00	$455.25	$455.25	$455.25	2026-06-23
27781	HCPCS	Closed Trtmnt Proximal Fib Or Shaft Fx	2	2	$2,328.00	$2,328.00	$452.21	$452.21	$452.21	2026-06-23
23665	HCPCS	Cl Tx Shoulder Dislocation W Fracture	10	9	$1,662.00	$1,662.00	$450.32	$450.32	$450.32	2026-06-23
24201	HCPCS	Removal Fb, Upper Arm Or Elvow, Deep	10	9	$1,048.00	$1,048.00	$445.22	$445.22	$445.22	2026-06-23
76816	HCPCS	US OB F/u Same Pregnancy	3	3	$357.00	$357.00	$430.35	$439.50	$439.50	2026-06-23
70486	HCPCS	CT Sinus Facial/maxilla Without	5	4	$398.00	$398.00	$369.28	$882.88	$436.80	2026-06-23
J3489	HCPCS	Zoledronic Acid (zometa) 4mg Vial	3	3	$1,247.00	$1,247.00	$336.00	$679.14	$436.59	2026-06-23
27840	HCPCS	Dislocation - Ankle	10	9	$746.00	$746.00	$434.95	$434.95	$434.95	2026-06-23
27788	HCPCS	Clsd Tx Dist Fib Fx Lat/maleolus W/manip	2	2	$336.00	$336.00	$432.04	$432.04	$432.04	2026-06-23
26641	HCPCS	Dislocation - Thumb	10	9	$752.00	$752.00	$430.20	$430.20	$430.20	2026-06-23
23575	HCPCS	Closed Tx For Scapular Fx With Manip	10	9	$1,023.00	$1,023.00	$427.34	$427.34	$427.34	2026-06-23
76642	HCPCS	US Breast Lt Limited,professional Fee, Left	3	3	$196.00	$196.00	$206.23	$435.62	$426.55	2026-06-23
12056	HCPCS	Intmd Rpr Face/mm 20.1-30.0 Cm	2	2	$581.00	$581.00	$421.56	$421.56	$421.56	2026-06-23
964	OTHER	Lumbar/sacral Ilesi With Fluoro	1	1	$837.00	$837.00	$414.11	$414.11	$414.11	2026-07-30
97166	HCPCS	Ot Evaluation X30 Min	1	1	$423.00	$423.00	$409.42	$409.42	$409.42	2026-06-23
73200	HCPCS	CT Upper Extremity Without Lt,left	3	3	$687.50	$687.50	$360.92	$480.00	$405.80	2026-06-23
26775	HCPCS	Dislocation - Finger Joint With Manip Ea	10	9	$712.00	$712.00	$398.89	$398.89	$398.89	2026-06-23
24530	HCPCS	Closed Tr/ Supracondylar Frac Without Manip	10	9	$1,195.00	$1,195.00	$394.71	$394.71	$394.71	2026-06-23
C1788	HCPCS	Cath Groshong With MRI Port	2	2	$857.00	$857.00	$361.16	$427.20	$394.18	2026-06-23
P9016	HCPCS	Bb Packed Cells Lp	4	4	$536.00	$536.00	$217.51	$525.28	$388.65	2026-06-23
24600	HCPCS	Dislocation - Elbow	10	9	$808.00	$808.00	$388.45	$388.45	$388.45	2026-06-23
J1453	HCPCS	Fosaprepitant(emend) 150mg Inj	3	3	$400.00	$400.00	$192.00	$388.08	$388.08	2026-06-23
482	OTHER	Nm *cardiovascular Stress Without Interpret	2	2	$593.00	$593.00	$295.94	$478.11	$387.02	2026-07-30
27560	HCPCS	Closed Patellar Dislocation W Without Anes	2	2	$349.00	$349.00	$384.13	$384.13	$384.13	2026-06-23
Q4186	HCPCS	Epifix 2x3cm Q4186 Sqcm	2	2	$629.00	$629.00	$311.28	$454.61	$382.94	2026-06-23
82656	HCPCS	Fecal Elastase	1	1	$390.00	$390.00	$382.20	$382.20	$382.20	2026-06-23
97162	HCPCS	Pt Evaluation X30 Min	2	2	$393.00	$393.00	$381.29	$381.29	$381.29	2026-06-23
20103	HCPCS	Exploration Of Wound Extremity	2	2	$1,357.00	$1,357.00	$380.54	$380.54	$380.54	2026-06-23
23505	HCPCS	Fracture - Clavicle With Manipulation	10	9	$738.00	$738.00	$378.24	$378.24	$378.24	2026-06-23
76870	HCPCS	US Testicular	4	3	$384.50	$384.50	$159.75	$522.94	$375.88	2026-06-23
93970	HCPCS	US Doppler Venous Up/low Bilat	4	4	$611.00	$611.00	$322.61	$742.20	$371.46	2026-06-23
72192	HCPCS	CT Pelvis Without	2	2	$764.50	$764.50	$245.86	$493.86	$369.86	2026-06-23
G0121	HCPCS	Screening Colonoscopy - Not High Risk	3	3	$1,062.00	$1,062.00	$197.10	$398.00	$369.08	2026-06-23
96365	HCPCS	Ther/proph/diag IV Infusion Initial	2	2	$254.00	$254.00	$103.31	$634.51	$368.91	2026-06-23
31605	HCPCS	Tracheostomy, ER Proc Cricothyroid Membr	2	2	$338.00	$338.00	$368.21	$368.21	$368.21	2026-06-23
93930	HCPCS	US Artery Bilateral Upper Ext	3	3	$628.00	$628.00	$322.61	$742.20	$367.20	2026-06-23
25600	HCPCS	Fx-distal Radius W/out Manipulation	10	9	$602.00	$602.00	$364.44	$364.44	$364.44	2026-06-23
13152	HCPCS	Cmplx Rpr E/n/e/l 2.6-7.5 Cm	2	2	$1,057.00	$1,057.00	$363.81	$363.81	$363.81	2026-06-23
76770	HCPCS	US Renal And Bladder	5	4	$502.50	$502.50	$306.78	$733.47	$362.88	2026-06-23
27750	HCPCS	Fx-tibial Shaft	10	9	$753.00	$753.00	$362.47	$362.47	$362.47	2026-06-23
93925	HCPCS	US Artery Doppler Bil Lower Ext	3	3	$672.50	$672.50	$322.61	$771.31	$360.86	2026-06-23
93017	HCPCS	Nm *cardiovascular Stress Without Interpret	5	4	$420.50	$420.50	$304.76	$728.62	$360.48	2026-06-23
84145	HCPCS	**procalcitonin Mgh	4	4	$375.00	$375.00	$150.67	$363.83	$358.80	2026-06-23
26700	HCPCS	Closed Red Mcp Joint, Single W/manip	10	9	$1,207.00	$1,207.00	$356.26	$356.26	$356.26	2026-06-23
77066	HCPCS	Mg Bilat Diagnostic Mammo With Cad	5	5	$364.00	$364.00	$172.24	$367.50	$356.25	2026-06-23
23605	HCPCS	Tx Of Humeral Fracture W/manipulation	10	9	$1,682.00	$1,682.00	$356.02	$356.02	$356.02	2026-06-23
23600	HCPCS	Fx-distal Humerous	10	9	$675.00	$675.00	$356.02	$356.02	$356.02	2026-06-23
87494	HCPCS	Chlamydia Trach & Neisseria Gon	1	1	$366.00	$366.00	$355.09	$355.09	$355.09	2026-06-23
84445	HCPCS	Thyroid Stimulating Immunoglobulins Lats	1	1	$364.00	$364.00	$353.15	$353.15	$353.15	2026-06-23
77002	HCPCS	Fl Guidance For Needle Placement,professional Fee	2	2	$304.00	$304.00	$136.75	$568.54	$352.64	2026-06-23
73522	HCPCS	Dg Hip - Bilateral	1	1	$245.00	$245.00	$352.19	$352.19	$352.19	2026-06-23
12046	HCPCS	Intmd Rpr N-hf/genit 20.1-30cm	2	2	$1,057.00	$1,057.00	$351.64	$351.64	$351.64	2026-06-23
27760	HCPCS	Fx-medial Malleolus	10	9	$691.00	$691.00	$346.35	$346.35	$346.35	2026-06-23
Q9968	HCPCS	Methylene Blue Inj Inj Usp 1%	1	1	$356.00	$356.00	$345.39	$345.39	$345.39	2026-06-23
25650	HCPCS	Fx-ulnar Styloid	10	9	$806.00	$806.00	$345.21	$345.21	$345.21	2026-06-23
26725	HCPCS	Closed Tx Finger Reductionw/manipulation	10	9	$1,252.00	$1,252.00	$344.39	$344.39	$344.39	2026-06-23
59812	HCPCS	Treatment Of Incomplete Abortion	10	9	$1,280.00	$1,280.00	$343.93	$343.93	$343.93	2026-06-23
27824	HCPCS	Fx-articular Distal Tibia	10	9	$785.00	$785.00	$343.78	$343.78	$343.78	2026-06-23
27808	HCPCS	Fx-bimalleolar Ankle	10	9	$865.00	$865.00	$343.38	$343.38	$343.38	2026-06-23
23650	HCPCS	Clsd Tx Shld Dslc W/manip Without Anes	3	3	$336.00	$336.00	$326.62	$340.98	$340.98	2026-06-23
J9074	HCPCS	Cyclophosphamide 500mg Inj(cytoxan)	2	2	$350.00	$350.00	$339.57	$339.57	$339.57	2026-06-23
85306	HCPCS	**protein S Total	1	1	$364.00	$364.00	$339.57	$339.57	$339.57	2026-06-23
710	OTHER	Recovery Rm 0-30 Min	2	2	$465.00	$465.00	$235.93	$440.57	$338.25	2026-07-30
76705	HCPCS	US Abdomen Gallbladder,professional Fee	5	4	$202.00	$202.00	$285.68	$683.02	$337.92	2026-06-23
72052	HCPCS	Dg C-spine Obliques With Flex/ext 7 View	1	1	$234.00	$234.00	$337.63	$337.63	$337.63	2026-06-23
26605	HCPCS	Fx-metacarpal With Manipulation Each	10	9	$670.00	$670.00	$334.77	$334.77	$334.77	2026-06-23
76000	HCPCS	Fl Chest Fluoro	1	1	$189.00	$189.00	$331.81	$331.81	$331.81	2026-06-23
27816	HCPCS	Fracture-trimalleolar Ankle	10	9	$778.00	$778.00	$331.17	$331.17	$331.17	2026-06-23
12055	HCPCS	Intmd Rpr Face/mm 12.6-20 Cm	2	2	$581.00	$581.00	$330.94	$330.94	$330.94	2026-06-23
22310	HCPCS	Vertebral Process Fx,closed Without Manip	10	9	$1,400.00	$1,400.00	$330.02	$330.02	$330.02	2026-06-23
26600	HCPCS	Fracture - Metacarpal	10	9	$578.00	$578.00	$328.43	$328.43	$328.43	2026-06-23
13132	HCPCS	Cmplx Rpr F/c/c/m/n/ax/g/h/f 2.6-7.5cm	2	2	$581.00	$581.00	$328.21	$328.21	$328.21	2026-06-23
402	OTHER	US Abdomen Comp 2 Organs	26	2	$426.00	$426.00	$110.35	$796.10	$327.73	2026-07-30
55707	HCPCS	US Prostate Biopsy	2	1	$806.00	$806.00	$149.00	$501.97	$325.49	2026-06-23
20610	HCPCS	Arthrocentesis	8	5	$257.00	$257.00	$49.97	$1,520.87	$324.90	2026-06-23
27530	HCPCS	Closed Tx Tibial Plateau Fract Without Manip	10	9	$705.00	$705.00	$324.25	$324.25	$324.25	2026-06-23
25630	HCPCS	Fx-carpal Bone	10	9	$792.00	$792.00	$322.13	$322.13	$322.13	2026-06-23
27786	HCPCS	Fx-distal Fibula	10	9	$678.00	$678.00	$321.17	$321.17	$321.17	2026-06-23
70480	HCPCS	CT Sella TUR/IAC/ORBITS/without	2	2	$614.00	$614.00	$294.86	$347.36	$321.11	2026-06-23
92523	HCPCS	Sp Eval Sound Prod-lang Comp&exp,speech Language	2	2	$456.00	$456.00	$216.24	$425.92	$321.08	2026-06-23
27780	HCPCS	Fx-proximal Fibula Or Shaft	10	9	$613.00	$613.00	$320.74	$320.74	$320.74	2026-06-23
25622	HCPCS	Fx-carpal Scaphoid	10	9	$619.00	$619.00	$320.41	$320.41	$320.41	2026-06-23
83498	HCPCS	Hydroxy-progesterone 17	1	1	$326.00	$326.00	$316.29	$316.29	$316.29	2026-06-23
0271	RC	—	4	4	$273.00	$273.00	$125.99	$403.76	$312.98	2026-06-23
26755	HCPCS	Fracture-finger Or Thumb With Manipulati	10	9	$641.00	$641.00	$312.78	$312.78	$312.78	2026-06-23
87631	HCPCS	Respiratory Panel W/covid	4	4	$667.00	$667.00	$268.00	$647.12	$310.96	2026-06-23
921	OTHER	US Ankle/brachial Indices Unilateral	9	2	$628.00	$628.00	$154.42	$765.03	$307.72	2026-07-30
86617	HCPCS	**igm Blot	2	2	$201.00	$201.00	$201.80	$407.70	$304.75	2026-06-23
J2790	HCPCS	Bb Rhogam Vial	1	1	$313.00	$313.00	$303.68	$303.68	$303.68	2026-06-23
13151	HCPCS	Cmplx Rpr E/n/e/l 1.1-2.5 Cm	2	2	$1,057.00	$1,057.00	$302.69	$302.69	$302.69	2026-06-23
52000	HCPCS	Cystoscopy	7	4	$860.00	$860.00	$78.30	$1,088.56	$302.55	2026-06-23
26770	HCPCS	Clsd Tx Intphlngl Jt Dislo Singl Wo Anes	3	3	$336.00	$336.00	$287.25	$299.87	$299.87	2026-06-23
43239	HCPCS	Egd With And Without Anesthesia	3	2	$1,069.00	$1,069.00	$142.96	$418.52	$297.23	2026-06-23
G0105	HCPCS	Screening Colonoscopy - High Risk	2	2	$1,062.00	$1,062.00	$196.68	$397.26	$296.97	2026-06-23
25560	HCPCS	Radial/ulnar Shaft Fx Without Manipulation	10	9	$577.00	$577.00	$293.46	$293.46	$293.46	2026-06-23
96413	HCPCS	Chemo IV Infusion 1 Hour	3	3	$611.00	$611.00	$247.94	$570.48	$293.28	2026-06-23
76536	HCPCS	US Soft Tissue Head/neck	5	4	$422.00	$422.00	$239.83	$573.39	$283.68	2026-06-23
76872	HCPCS	US Prostate Transrectal With Reading	2	2	$551.50	$551.50	$243.78	$322.42	$283.10	2026-06-23
87506	HCPCS	**gi Panel Medicare	1	1	$633.00	$633.00	$282.47	$282.47	$282.47	2026-06-23
36558	HCPCS	Insert Tunneled Cv Cath	2	2	$1,880.00	$1,880.00	$281.59	$281.59	$281.59	2026-06-23
Q9967	HCPCS	Contrast 50ml Low Osmolar Non-ionic 300	5	4	$121.00	$121.00	$120.12	$338.60	$281.20	2026-06-23
13121	HCPCS	Cmplx Rpr S/a/l 2.6-7.5 Cm	2	2	$581.00	$581.00	$280.65	$280.65	$280.65	2026-06-23
76830	HCPCS	US Transvaginal	3	3	$281.50	$281.50	$85.57	$280.39	$280.39	2026-06-23
24650	HCPCS	Dislocation - Radial Head Or Neck	10	9	$534.00	$534.00	$279.02	$279.02	$279.02	2026-06-23
45378	HCPCS	Colonoscopy (splenic Flexure)	2	2	$1,160.00	$1,160.00	$192.24	$364.46	$278.35	2026-06-23
23570	HCPCS	Clsd Trt Of Scapular Fx Without Manipulation	10	9	$806.00	$806.00	$274.88	$274.88	$274.88	2026-06-23
11406	HCPCS	Excision Of Mass Wide	3	3	$1,429.00	$1,429.00	$273.75	$3,418.98	$273.75	2026-06-23
81515	HCPCS	Mvp	2	2	$375.00	$375.00	$172.72	$363.83	$268.27	2026-06-23
13101	HCPCS	Cmplx Rpr Trunk 2.6-7.5 Cm	2	2	$1,057.00	$1,057.00	$266.55	$266.55	$266.55	2026-06-23
23540	HCPCS	Closed Treat Ac Dislocation Without Manipul	10	9	$724.00	$724.00	$266.41	$266.41	$266.41	2026-06-23
12035	HCPCS	Intmd Rpr S/a/t/ext 12.6-20 Cm	2	2	$581.00	$581.00	$265.11	$265.11	$265.11	2026-06-23
13131	HCPCS	Cmplx Rpr F/c/c/m/n/ax/g/h/f 1.1-2.5 Cm	2	2	$581.00	$581.00	$263.73	$263.73	$263.73	2026-06-23
74022	HCPCS	Dg Abdomen Flat Upright With Pa Chest	4	4	$196.00	$196.00	$128.23	$267.78	$262.62	2026-06-23
23500	HCPCS	Fracture - Clavicle	10	9	$447.00	$447.00	$262.34	$262.34	$262.34	2026-06-23
424	OTHER	Pt Evaluation X15 Min	2	1	$267.00	$267.00	$174.60	$349.20	$261.90	2026-07-30

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