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

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 — reasonRows
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 viaCMS 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.

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
             
0110 RC — 7 7 $1,250.00 $1,250.00 $1,167.15 $2,506.00 $2,506.00 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
0271 RC — 4 4 $273.00 $273.00 $125.99 $403.76 $312.98 2026-06-23
0278 RC — 2 2 $1,977.00 $1,977.00 $305.16 $4,549.07 $2,427.11 2026-06-23
0390 RC — 1 1 $370.00 $370.00 $525.28 $525.28 $525.28 2026-06-23
0450 RC — 1 1 $1,817.00 $1,817.00 $944.49 $944.49 $944.49 2026-06-23
0623 RC — 1 1 $3,393.00 $3,393.00 $527.13 $527.13 $527.13 2026-06-23
0710 RC — 6 5 $884.00 $884.00 $297.05 $1,815.24 $611.51 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
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
11406 HCPCS Excision Of Mass Wide 3 3 $1,429.00 $1,429.00 $273.75 $3,418.98 $273.75 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
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
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
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
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
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
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
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
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
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
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
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
20103 HCPCS Exploration Of Wound Extremity 2 2 $1,357.00 $1,357.00 $380.54 $380.54 $380.54 2026-06-23
20610 HCPCS Arthrocentesis 8 5 $257.00 $257.00 $49.97 $1,520.87 $324.90 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
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
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
23500 HCPCS Fracture - Clavicle 10 9 $447.00 $447.00 $262.34 $262.34 $262.34 2026-06-23
23505 HCPCS Fracture - Clavicle With Manipulation 10 9 $738.00 $738.00 $378.24 $378.24 $378.24 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
23570 HCPCS Clsd Trt Of Scapular Fx Without Manipulation 10 9 $806.00 $806.00 $274.88 $274.88 $274.88 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
23600 HCPCS Fx-distal Humerous 10 9 $675.00 $675.00 $356.02 $356.02 $356.02 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
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
23655 HCPCS Dislocation - Shoulder Manip With Anesth 10 9 $929.00 $929.00 $455.25 $455.25 $455.25 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
23675 HCPCS Closed Tx Shoulder Dislocation 10 9 $1,992.00 $1,992.00 $560.91 $560.91 $560.91 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
24505 HCPCS Closed Reduction Fracture Humural Shaft 2 2 $420.00 $420.00 $507.06 $507.06 $507.06 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
24535 HCPCS Clsd Trmnt Supracondylar Humeral Fractur 10 9 $2,309.00 $2,309.00 $641.99 $641.99 $641.99 2026-06-23
24600 HCPCS Dislocation - Elbow 10 9 $808.00 $808.00 $388.45 $388.45 $388.45 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
24650 HCPCS Dislocation - Radial Head Or Neck 10 9 $534.00 $534.00 $279.02 $279.02 $279.02 2026-06-23
24655 HCPCS Dislocation - Radial Head With Manipulat 10 9 $936.00 $936.00 $455.32 $455.32 $455.32 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
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
25600 HCPCS Fx-distal Radius W/out Manipulation 10 9 $602.00 $602.00 $364.44 $364.44 $364.44 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
25622 HCPCS Fx-carpal Scaphoid 10 9 $619.00 $619.00 $320.41 $320.41 $320.41 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
25630 HCPCS Fx-carpal Bone 10 9 $792.00 $792.00 $322.13 $322.13 $322.13 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
25650 HCPCS Fx-ulnar Styloid 10 9 $806.00 $806.00 $345.21 $345.21 $345.21 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
26055 HCPCS Trigger Finger Release 1 1 $1,198.00 $1,198.00 $970.67 $970.67 $970.67 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
26412 HCPCS Tendon Repair, Hand Complex 10 9 $1,738.00 $1,738.00 $765.76 $765.76 $765.76 2026-06-23
26418 HCPCS Repair Extensor Tendon 2 2 $2,169.00 $2,169.00 $663.12 $663.12 $663.12 2026-06-23
26600 HCPCS Fracture - Metacarpal 10 9 $578.00 $578.00 $328.43 $328.43 $328.43 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
26641 HCPCS Dislocation - Thumb 10 9 $752.00 $752.00 $430.20 $430.20 $430.20 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
26725 HCPCS Closed Tx Finger Reductionw/manipulation 10 9 $1,252.00 $1,252.00 $344.39 $344.39 $344.39 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
26755 HCPCS Fracture-finger Or Thumb With Manipulati 10 9 $641.00 $641.00 $312.78 $312.78 $312.78 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
26775 HCPCS Dislocation - Finger Joint With Manip Ea 10 9 $712.00 $712.00 $398.89 $398.89 $398.89 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
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
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
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
27266 HCPCS Closed Tx Post Hip Arthroplasty 10 9 $1,864.00 $1,864.00 $646.63 $646.63 $646.63 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
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
27530 HCPCS Closed Tx Tibial Plateau Fract Without Manip 10 9 $705.00 $705.00 $324.25 $324.25 $324.25 2026-06-23
27550 HCPCS Dislocation - Knee 10 9 $1,047.00 $1,047.00 $527.91 $527.91 $527.91 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
27560 HCPCS Closed Patellar Dislocation W Without Anes 2 2 $349.00 $349.00 $384.13 $384.13 $384.13 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
27750 HCPCS Fx-tibial Shaft 10 9 $753.00 $753.00 $362.47 $362.47 $362.47 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
27758 HCPCS Open Treatment Of Tibial Shaft 10 9 $4,034.00 $4,034.00 $993.83 $993.83 $993.83 2026-06-23
27760 HCPCS Fx-medial Malleolus 10 9 $691.00 $691.00 $346.35 $346.35 $346.35 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
27780 HCPCS Fx-proximal Fibula Or Shaft 10 9 $613.00 $613.00 $320.74 $320.74 $320.74 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
27786 HCPCS Fx-distal Fibula 10 9 $678.00 $678.00 $321.17 $321.17 $321.17 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
27808 HCPCS Fx-bimalleolar Ankle 10 9 $865.00 $865.00 $343.38 $343.38 $343.38 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
27816 HCPCS Fracture-trimalleolar Ankle 10 9 $778.00 $778.00 $331.17 $331.17 $331.17 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
27824 HCPCS Fx-articular Distal Tibia 10 9 $785.00 $785.00 $343.78 $343.78 $343.78 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
27840 HCPCS Dislocation - Ankle 10 9 $746.00 $746.00 $434.95 $434.95 $434.95 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
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
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
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
31605 HCPCS Tracheostomy, ER Proc Cricothyroid Membr 2 2 $338.00 $338.00 $368.21 $368.21 $368.21 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
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
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
351 OTHER CT Head Without 9 2 $904.00 $904.00 $396.90 $820.03 $664.85 2026-07-30
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
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
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
35226 HCPCS Repair Blood Vessl Direct Lower Ext 2 2 $985.00 $985.00 $913.04 $913.04 $913.04 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
36561 HCPCS Mediport Placement 2 1 $1,521.00 $1,521.00 $328.94 $1,889.00 $1,108.97 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
402 OTHER US Abdomen Comp 2 Organs 26 2 $426.00 $426.00 $110.35 $796.10 $327.73 2026-07-30
424 OTHER Pt Evaluation X15 Min 2 1 $267.00 $267.00 $174.60 $349.20 $261.90 2026-07-30
43239 HCPCS Egd With And Without Anesthesia 3 2 $1,069.00 $1,069.00 $142.96 $418.52 $297.23 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
450 OTHER Emergency Room Level 4 11 2 $505.00 $505.00 $35.28 $2,700.09 $465.59 2026-07-30
45378 HCPCS Colonoscopy (splenic Flexure) 2 2 $1,160.00 $1,160.00 $192.24 $364.46 $278.35 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
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
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
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
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
480 OTHER Incision & Drainage Level 1 1 1 $582.00 $582.00 $1,737.91 $1,737.91 $1,737.91 2026-07-30
482 OTHER Nm *cardiovascular Stress Without Interpret 2 2 $593.00 $593.00 $295.94 $478.11 $387.02 2026-07-30
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
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
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
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
52000 HCPCS Cystoscopy 7 4 $860.00 $860.00 $78.30 $1,088.56 $302.55 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
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
55707 HCPCS US Prostate Biopsy 2 1 $806.00 $806.00 $149.00 $501.97 $325.49 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
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
59409 HCPCS Vaginal Delivery Only 10 9 $2,860.00 $2,860.00 $898.16 $898.16 $898.16 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
59812 HCPCS Treatment Of Incomplete Abortion 10 9 $1,280.00 $1,280.00 $343.93 $343.93 $343.93 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
615 OTHER MRA Head Without 5 2 $2,393.00 $2,393.00 $758.67 $3,854.94 $1,172.57 2026-07-30
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
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
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
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
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
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
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
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
66982 HCPCS Complex Cataract 1 1 $1,955.00 $1,955.00 $756.96 $756.96 $756.96 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
70450 HCPCS CT Head Without 5 5 $704.00 $704.00 $469.92 $1,134.84 $561.75 2026-06-23
70460 HCPCS CT Head With 1 1 $785.00 $785.00 $498.65 $498.65 $498.65 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
70480 HCPCS CT Sella TUR/IAC/ORBITS/without 2 2 $614.00 $614.00 $294.86 $347.36 $321.11 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
70486 HCPCS CT Sinus Facial/maxilla Without 5 4 $398.00 $398.00 $369.28 $882.88 $436.80 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
70490 HCPCS CT St Neck Without 2 2 $784.50 $784.50 $565.42 $1,180.74 $873.08 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
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
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
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
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
70544 HCPCS MRA Head Without 2 2 $1,705.50 $1,705.50 $862.15 $1,344.48 $1,103.32 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
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
710 OTHER Recovery Rm 0-30 Min 2 2 $465.00 $465.00 $235.93 $440.57 $338.25 2026-07-30
71250 HCPCS Ch Chest W/o,professional Fee 4 4 $886.50 $886.50 $592.87 $1,417.46 $700.12 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
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
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
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
72125 HCPCS CT Cervical Without 4 4 $761.50 $761.50 $493.86 $1,147.58 $587.26 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
72131 HCPCS CT Lumbar Without 3 3 $820.50 $820.50 $542.15 $1,281.92 $623.84 2026-06-23
72132 HCPCS CT Lumbar With 1 1 $928.00 $928.00 $701.28 $701.28 $701.28 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
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
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
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
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
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
72192 HCPCS CT Pelvis Without 2 2 $764.50 $764.50 $245.86 $493.86 $369.86 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
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
731 OTHER Cardiac Event Monitor 4 2 $761.50 $761.50 $366.00 $718.02 $511.99 2026-07-30
73200 HCPCS CT Upper Extremity Without Lt,left 3 3 $687.50 $687.50 $360.92 $480.00 $405.80 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
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
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
73522 HCPCS Dg Hip - Bilateral 1 1 $245.00 $245.00 $352.19 $352.19 $352.19 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
73701 HCPCS CT Lower Extremity With Lt,left 2 2 $777.00 $777.00 $472.76 $1,130.29 $801.52 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
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
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
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
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
74022 HCPCS Dg Abdomen Flat Upright With Pa Chest 4 4 $196.00 $196.00 $128.23 $267.78 $262.62 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
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
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
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
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
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
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
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
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
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
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
76000 HCPCS Fl Chest Fluoro 1 1 $189.00 $189.00 $331.81 $331.81 $331.81 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
76642 HCPCS US Breast Lt Limited,professional Fee, Left 3 3 $196.00 $196.00 $206.23 $435.62 $426.55 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
76705 HCPCS US Abdomen Gallbladder,professional Fee 5 4 $202.00 $202.00 $285.68 $683.02 $337.92 2026-06-23
76706 HCPCS US Abdomen Aorta 2 2 $501.50 $501.50 $341.25 $733.47 $537.36 2026-06-23
76770 HCPCS US Renal And Bladder 5 4 $502.50 $502.50 $306.78 $733.47 $362.88 2026-06-23
76801 HCPCS US OB 1st Trimester 3 3 $549.00 $549.00 $781.85 $798.47 $798.47 2026-06-23
76805 HCPCS US OB 2nd & 3rd Trimester 3 3 $571.00 $571.00 $768.40 $798.47 $781.85 2026-06-23
76811 HCPCS US OB Complete 2 2 $627.00 $627.00 $798.47 $798.47 $798.47 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
76830 HCPCS US Transvaginal 3 3 $281.50 $281.50 $85.57 $280.39 $280.39 2026-06-23
76856 HCPCS US Pelvis Non-OB 3 3 $392.50 $392.50 $218.73 $522.94 $512.05 2026-06-23
76870 HCPCS US Testicular 4 3 $384.50 $384.50 $159.75 $522.94 $375.88 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
76942 HCPCS US Needle Guidance 2 2 $450.00 $450.00 $427.50 $819.82 $623.66 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
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
77066 HCPCS Mg Bilat Diagnostic Mammo With Cad 5 5 $364.00 $364.00 $172.24 $367.50 $356.25 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
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
78315 HCPCS Nm Bone Scan - 3 Phase 1 1 $1,429.00 $1,429.00 $875.31 $875.31 $875.31 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
81256 HCPCS Hemochromatosis 2 2 $1,008.00 $1,008.00 $405.01 $977.96 $691.49 2026-06-23
81515 HCPCS Mvp 2 2 $375.00 $375.00 $172.72 $363.83 $268.27 2026-06-23
82656 HCPCS Fecal Elastase 1 1 $390.00 $390.00 $382.20 $382.20 $382.20 2026-06-23
82787 HCPCS **igg2 1 1 $237.00 $237.00 $919.75 $919.75 $919.75 2026-06-23
83498 HCPCS Hydroxy-progesterone 17 1 1 $326.00 $326.00 $316.29 $316.29 $316.29 2026-06-23
84145 HCPCS **procalcitonin Mgh 4 4 $375.00 $375.00 $150.67 $363.83 $358.80 2026-06-23
84445 HCPCS Thyroid Stimulating Immunoglobulins Lats 1 1 $364.00 $364.00 $353.15 $353.15 $353.15 2026-06-23
85306 HCPCS **protein S Total 1 1 $364.00 $364.00 $339.57 $339.57 $339.57 2026-06-23
86617 HCPCS **igm Blot 2 2 $201.00 $201.00 $201.80 $407.70 $304.75 2026-06-23
87494 HCPCS Chlamydia Trach & Neisseria Gon 1 1 $366.00 $366.00 $355.09 $355.09 $355.09 2026-06-23
87506 HCPCS **gi Panel Medicare 1 1 $633.00 $633.00 $282.47 $282.47 $282.47 2026-06-23
87507 HCPCS Gi Panel 1 1 $703.00 $703.00 $682.06 $682.06 $682.06 2026-06-23
87631 HCPCS Respiratory Panel W/covid 4 4 $667.00 $667.00 $268.00 $647.12 $310.96 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
88189 HCPCS **flow Cytometry Interp 16+ Markers 1 1 $515.00 $515.00 $489.25 $489.25 $489.25 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
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
921 OTHER US Ankle/brachial Indices Unilateral 9 2 $628.00 $628.00 $154.42 $765.03 $307.72 2026-07-30
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
92950 HCPCS Cpr 1 1 $436.00 $436.00 $1,078.88 $1,078.88 $1,078.88 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
93229 HCPCS Mcot 6 5 $1,002.00 $1,002.00 $406.61 $972.14 $698.38 2026-06-23
93306 HCPCS US Echo Complete 4 4 $1,482.50 $1,482.50 $770.73 $2,429.38 $1,779.64 2026-06-23
93880 HCPCS US Carotid Doppler 5 4 $832.00 $832.00 $497.10 $1,188.50 $588.00 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
93930 HCPCS US Artery Bilateral Upper Ext 3 3 $628.00 $628.00 $322.61 $742.20 $367.20 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
94060 HCPCS Pft Before And After 1 1 $461.00 $461.00 $505.47 $505.47 $505.47 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
964 OTHER Lumbar/sacral Ilesi With Fluoro 1 1 $837.00 $837.00 $414.11 $414.11 $414.11 2026-07-30
96413 HCPCS Chemo IV Infusion 1 Hour 3 3 $611.00 $611.00 $247.94 $570.48 $293.28 2026-06-23
96523 HCPCS Port Flush 1 1 $113.00 $113.00 $846.98 $846.98 $846.98 2026-06-23
97162 HCPCS Pt Evaluation X30 Min 2 2 $393.00 $393.00 $381.29 $381.29 $381.29 2026-06-23
97163 HCPCS Pt Evaluation X45 Min 2 2 $588.00 $588.00 $549.13 $570.48 $559.81 2026-06-23
97166 HCPCS Ot Evaluation X30 Min 1 1 $423.00 $423.00 $409.42 $409.42 $409.42 2026-06-23
A9500 HCPCS Nm Tc99m Sestamibi 3 2 $639.00 $639.00 $306.72 $1,214.10 $518.61 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
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
G0105 HCPCS Screening Colonoscopy - High Risk 2 2 $1,062.00 $1,062.00 $196.68 $397.26 $296.97 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
G0260 HCPCS Injection Of Sacroiliac Joint 3 3 $975.00 $975.00 $880.18 $1,413.79 $1,041.12 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
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
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
J1453 HCPCS Fosaprepitant(emend) 150mg Inj 3 3 $400.00 $400.00 $192.00 $388.08 $388.08 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
J2469 HCPCS Palonosetron 0.25mg/5ml Inj 3 3 $600.00 $600.00 $288.00 $582.12 $582.12 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
J2790 HCPCS Bb Rhogam Vial 1 1 $313.00 $313.00 $303.68 $303.68 $303.68 2026-06-23
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
J3489 HCPCS Zoledronic Acid (zometa) 4mg Vial 3 3 $1,247.00 $1,247.00 $336.00 $679.14 $436.59 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
J9074 HCPCS Cyclophosphamide 500mg Inj(cytoxan) 2 2 $350.00 $350.00 $339.57 $339.57 $339.57 2026-06-23
J9075 HCPCS Cyclophosphamide 1000mg Inj(cytoxan) 3 3 $500.00 $500.00 $240.00 $485.10 $485.10 2026-06-23
J9171 HCPCS Docetaxel(taxotere)inj:20mg 2 2 $200.00 $200.00 $659.74 $659.74 $659.74 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
P9016 HCPCS Bb Packed Cells Lp 4 4 $536.00 $536.00 $217.51 $525.28 $388.65 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
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
Q4186 HCPCS Epifix 2x3cm Q4186 Sqcm 2 2 $629.00 $629.00 $311.28 $454.61 $382.94 2026-06-23
Q4187 HCPCS Epicord Expandable 2x3cm 1 1 $630.83 $630.83 $579.95 $579.95 $579.95 2026-06-23
Q5100 HCPCS Yesintek 130mg Inj 1 1 $850.00 $850.00 $824.67 $824.67 $824.67 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
Q9967 HCPCS Contrast 50ml Low Osmolar Non-ionic 300 5 4 $121.00 $121.00 $120.12 $338.60 $281.20 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
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