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

Mary Free Bed Rehabilitation Hospital

Grand Rapids, MI · CCN 233026 · Rates published

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You selected 93306 (CPT)

HCHG ECHO 2D W/DOPPLER & COLOR FLOW

This hospital’s price: $1,275 across 8 payers · range $1,065-$1,614

Source: https://www.maryfreebed.com/wp-content/uploads/2025/03/381359265_mary-free-bed-rehabilitation-hospital_standardcharges.csv · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

7,163 distinct procedures filed
19 distinct payers
387,568 rate rows
2026-07-15 last MRF observed
Data quality

382,096 of 387,568 rate rows are consumer-grade (98.6%)

5,472 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
placeholder amount (≤ $0.02) — excluded from medians 3,617
per-diem day rate — not a per-procedure price 1,793
exceeds 10× this hospital's gross charge — excluded from medians 50
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.maryfreebed.com/wp-content/uploads/2025/03/381359265_mary-free-bed-rehabilitation-hospital_standardcharges.csv
Found on page https://www.maryfreebed.com/patients-visitors/financial-services/pricing-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-22
Content fingerprint c47b25f1b6221257… · 34,651,951 bytes · first seen 2026-05-14

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
0024
RC 		10 $5,705.81 $155,177.04 $47,331.60 nat. median
$26,800
1.8× median
25682000101
NDC 		Hchg Rx 636 Drugs/detail Code 8 $24,772.44 $74,996.15 $44,450.46 nat. median
$13,808
outlier · 3.2×
64764030020
NDC 		Hchg Rx 636 Drugs/detail Code 8 $16,456.73 $24,939.17 $19,701.16 nat. median
$15,444
1.3× median
64406000801
NDC 		Hchg Rx 636 Drugs/detail Code 8 $15,609.45 $23,655.17 $18,686.85 nat. median
$16,649
1.1× median
36906
CPT 		Hchg Ir Av Fistula Thrombect With Stent-arm Lt 8 $12,301.62 $23,331.66 $17,921.60 nat. median
$18,571
1.0× median
37236
CPT 		Hc Placement Stent(s) Intravascular Transcatheter Artery Initial Lt 8 $12,719.04 $19,274.94 $15,226.60 nat. median
$12,522
1.2× median
62991108704
NDC 		Hchg Rx 250 Pharmacy 8 $11,558.50 $17,516.21 $13,837.26 nat. median
$13,837
1.0× median
37227
CPT 		Hchg Ir Ather Plus Stent Fem/pop Lt 8 $11,276.06 $17,088.19 $13,499.14 nat. median
$18,437
0.7× median
00310173030
NDC 		Hchg Rx 636 Drugs/detail Code 8 $10,811.44 $16,384.08 $12,942.91 nat. median
$20
outlier · 632.0×
00006302601
NDC 		Hchg Rx 636 Drugs/detail Code 8 $10,585.56 $16,041.77 $12,672.50 nat. median
$53
outlier · 237.1×
37230
CPT 		Hchg Ir Stent Tib/per Lt 8 $9,285.58 $14,071.73 $11,116.22 nat. median
$16,936
0.7× median
50242005306
NDC 		Hchg Rx 636 Drugs/detail Code 8 $8,956.44 $13,572.94 $10,722.20 nat. median
$4,914
outlier · 2.2×
62991220408
NDC 		Hchg Rx 250 Pharmacy 8 $8,888.36 $13,469.77 $10,640.70 nat. median
$10,641
1.0× median
37229
CPT 		Hchg Ir Atherctomy Tib/per Lt 8 $8,802.48 $13,339.62 $10,537.88 nat. median
$17,146
0.6× median
33208
CPT 		Hchg Insrt Heart Pm Atrial & Vent 8 $8,749.43 $13,259.24 $10,474.38 nat. median
$11,875
0.9× median
37244
CPT 		Hchg Ir Embolization Hemmorrhage 8 $8,633.24 $13,083.15 $10,335.28 nat. median
$12,394
0.8× median
37243
CPT 		Hchg Ir Embolization Tumors 8 $8,380.00 $12,699.39 $10,032.12 nat. median
$12,456
0.8× median
37242
CPT 		Hchg Ir Embolization Arterial Fistula 8 $8,380.00 $12,699.39 $10,032.12 nat. median
$16,878
0.6× median
37241
CPT 		Hchg Ir Embolization Venous 8 $8,380.00 $12,699.39 $10,032.12 nat. median
$12,180
0.8× median
37226
CPT 		Hchg Ir Stent Fem/pop Lt 8 $8,340.22 $12,639.10 $9,984.49 nat. median
$12,723
0.8× median
63833038702
NDC 		Hchg Rx 636 Drugs/detail Code 8 $8,335.80 $12,632.40 $9,979.20 nat. median
$3,102
outlier · 3.2×
37225
CPT 		Hchg Ir Atherctomy Fem/pop Lt 8 $8,128.04 $12,317.55 $9,730.48 nat. median
$16,469
0.6× median
37221
CPT 		Hchg Ir Stent Iliac Lt 8 $8,112.25 $12,293.62 $9,711.58 nat. median
$12,099
0.8× median
50633012011
NDC 		Hchg Rx 636 Drugs/detail Code 8 $8,051.95 $12,202.24 $9,639.39 nat. median
$8,674
1.1× median
61626
CPT 		Hchg Sc>embolization Head/neck 8 $7,991.00 $12,109.88 $9,566.42 nat. median
$11,214
0.9× median
55513019201
NDC 		Hchg Rx 636 Drugs/detail Code 8 $7,899.12 $11,970.63 $9,456.43 nat. median
$9,442
1.0× median
55513019001
NDC 		Hchg Rx 636 Drugs/detail Code 8 $7,899.12 $11,970.63 $9,456.43 nat. median
$9,442
1.0× median
00078033184
NDC 		Hchg Rx 636 Drugs/detail Code 8 $7,892.20 $11,960.16 $9,448.15 nat. median
$14
outlier · 670.1×
50242012001
NDC 		Hchg Rx 636 Drugs/detail Code 8 $6,259.48 $13,549.90 $9,119.12 nat. median
$8,564
1.1× median
42211010243
NDC 		Hchg Rx 637 Drugs/self Admin 8 $7,552.87 $11,445.91 $9,041.91 nat. median
$312
outlier · 29.0×
37238
CPT 		Hchg Ir Stent Placment Vein 8 $7,411.92 $11,232.31 $8,873.17 nat. median
$12,394
0.7× median
62991142203
NDC 		Hchg Rx 250 Pharmacy 8 $7,298.84 $11,060.95 $8,737.80 nat. median
$70
outlier · 125.5×
59676080030
NDC 		Hchg Rx 637 Drugs/self Admin 8 $6,671.54 $10,110.32 $7,986.84 nat. median
$455
outlier · 17.6×
61958120101
NDC 		Hchg Rx 637 Drugs/self Admin 8 $6,364.59 $9,645.15 $7,619.36 nat. median
$311
outlier · 24.5×
00591231215
NDC 		Hchg Rx 637 Drugs/self Admin 8 $6,122.38 $9,278.09 $7,329.40 nat. median
$168
outlier · 43.5×
50593
CPT 		Hchg Hc Ablation Renal Tumor(s) Percutaneous Cryotherapy Bl 8 $4,801.29 $10,914.58 $7,276.07 nat. median
$10,372
0.7× median
61958190101
NDC 		Hchg Rx 637 Drugs/self Admin 8 $6,067.39 $9,194.76 $7,263.57 nat. median
$304
outlier · 23.9×
50458056401
NDC 		Hchg Rx 636 Drugs/detail Code 8 $6,036.48 $9,147.92 $7,226.57 nat. median
$7,440
1.0× median
13533031805
NDC 		Hchg Rx 636 Drugs/detail Code 8 $6,007.02 $9,103.28 $7,191.31 nat. median
$4,041
1.8× median
22514
CPT 		Hchg Ir Kyphoplasty-lumbar 8 $5,985.36 $9,070.45 $7,165.37 nat. median
$8,406
0.9× median
00085432402
NDC 		Hchg Rx 637 Drugs/self Admin 8 $5,972.95 $9,051.64 $7,150.51 nat. median
$432
outlier · 16.6×
63402030610
NDC 		Hchg Rx 637 Drugs/self Admin 8 $5,831.74 $8,837.66 $6,981.47 nat. median
$448
outlier · 15.6×
36224
CPT 		Hchg Angio Carotid Internal Bi 8 $4,508.91 $10,249.47 $6,832.98 nat. median
$7,122
1.0× median
36226
CPT 		Hchg Angio Vertebral Bi 8 $4,508.91 $10,249.47 $6,832.98 nat. median
$6,827
1.0× median
36227
CPT 		Hchg Ir Ea Add Ext Carotid Bil 8 $4,498.17 $10,225.55 $6,816.71 nat. median
$2,969
outlier · 2.3×
67457067502
NDC 		Hchg Rx 636 Drugs/detail Code 8 $5,674.97 $8,600.08 $6,793.79 nat. median
$2,880
outlier · 2.4×
61958110101
NDC 		Hchg Rx 637 Drugs/self Admin 8 $5,521.96 $8,368.20 $6,610.62 nat. median
$328
outlier · 20.2×
61958210101
NDC 		Hchg Rx 637 Drugs/self Admin 8 $5,521.96 $8,368.20 $6,610.62 nat. median
$275
outlier · 24.1×
00006307604
NDC 		Hchg Rx 637 Drugs/self Admin 8 $5,502.70 $8,339.01 $6,587.56 nat. median
$732
outlier · 9.0×
42023020501
NDC 		Hchg Rx 636 Drugs/detail Code 8 $5,493.86 $8,325.61 $6,576.97 nat. median
$1,940
outlier · 3.4×

Other procedures at this hospital

Browse this hospital's 7,163 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
             
0024 RC — 6,358 10 — — $5,705.81 $155,177.04 $47,331.60 2026-07-15
25682000101 NDC Hchg Rx 636 Drugs/detail Code 78 8 $58,796.91 $58,796.91 $24,772.44 $74,996.15 $44,450.46 2026-07-15
64764030020 NDC Hchg Rx 636 Drugs/detail Code 26 8 $26,059.74 $26,059.74 $16,456.73 $24,939.17 $19,701.16 2026-07-15
64406000801 NDC Hchg Rx 636 Drugs/detail Code 26 8 $24,718.05 $24,718.05 $15,609.45 $23,655.17 $18,686.85 2026-07-15
36906 CPT Hchg Ir Av Fistula Thrombect With Stent-arm Lt 52 8 $21,930.00 $21,930.00 $12,301.62 $23,331.66 $17,921.60 2026-07-15
37236 CPT Hc Placement Stent(s) Intravascular Transcatheter Artery Initial Lt 26 8 $20,141.00 $20,141.00 $12,719.04 $19,274.94 $15,226.60 2026-07-15
62991108704 NDC Hchg Rx 250 Pharmacy 26 8 $18,303.25 $18,303.25 $11,558.50 $17,516.21 $13,837.26 2026-07-15
37227 CPT Hchg Ir Ather Plus Stent Fem/pop Lt 26 8 $17,856.00 $17,856.00 $11,276.06 $17,088.19 $13,499.14 2026-07-15
00310173030 NDC Hchg Rx 636 Drugs/detail Code 26 8 $17,120.25 $17,120.25 $10,811.44 $16,384.08 $12,942.91 2026-07-15
00006302601 NDC Hchg Rx 636 Drugs/detail Code 26 8 $16,762.56 $16,762.56 $10,585.56 $16,041.77 $12,672.50 2026-07-15
37230 CPT Hchg Ir Stent Tib/per Lt 26 8 $14,704.00 $14,704.00 $9,285.58 $14,071.73 $11,116.22 2026-07-15
50242005306 NDC Hchg Rx 636 Drugs/detail Code 26 8 $14,182.80 $14,182.80 $8,956.44 $13,572.94 $10,722.20 2026-07-15
62991220408 NDC Hchg Rx 250 Pharmacy 26 8 $14,075.00 $14,075.00 $8,888.36 $13,469.77 $10,640.70 2026-07-15
37229 CPT Hchg Ir Atherctomy Tib/per Lt 26 8 $13,939.00 $13,939.00 $8,802.48 $13,339.62 $10,537.88 2026-07-15
33208 CPT Hchg Insrt Heart Pm Atrial & Vent 26 8 $13,855.00 $13,855.00 $8,749.43 $13,259.24 $10,474.38 2026-07-15
37244 CPT Hchg Ir Embolization Hemmorrhage 26 8 $13,671.00 $13,671.00 $8,633.24 $13,083.15 $10,335.28 2026-07-15
37241 CPT Hchg Ir Embolization Venous 26 8 $13,270.00 $13,270.00 $8,380.00 $12,699.39 $10,032.12 2026-07-15
37242 CPT Hchg Ir Embolization Arterial Fistula 26 8 $13,270.00 $13,270.00 $8,380.00 $12,699.39 $10,032.12 2026-07-15
37243 CPT Hchg Ir Embolization Tumors 26 8 $13,270.00 $13,270.00 $8,380.00 $12,699.39 $10,032.12 2026-07-15
37226 CPT Hchg Ir Stent Fem/pop Lt 26 8 $13,207.00 $13,207.00 $8,340.22 $12,639.10 $9,984.49 2026-07-15
63833038702 NDC Hchg Rx 636 Drugs/detail Code 26 8 $13,200.00 $13,200.00 $8,335.80 $12,632.40 $9,979.20 2026-07-15
37225 CPT Hchg Ir Atherctomy Fem/pop Lt 26 8 $12,871.00 $12,871.00 $8,128.04 $12,317.55 $9,730.48 2026-07-15
37221 CPT Hchg Ir Stent Iliac Lt 26 8 $12,846.00 $12,846.00 $8,112.25 $12,293.62 $9,711.58 2026-07-15
50633012011 NDC Hchg Rx 636 Drugs/detail Code 26 8 $12,750.51 $12,750.51 $8,051.95 $12,202.24 $9,639.39 2026-07-15
61626 CPT Hchg Sc>embolization Head/neck 26 8 $12,654.00 $12,654.00 $7,991.00 $12,109.88 $9,566.42 2026-07-15
55513019001 NDC Hchg Rx 636 Drugs/detail Code 26 8 $12,508.50 $12,508.50 $7,899.12 $11,970.63 $9,456.43 2026-07-15
55513019201 NDC Hchg Rx 636 Drugs/detail Code 26 8 $12,508.50 $12,508.50 $7,899.12 $11,970.63 $9,456.43 2026-07-15
00078033184 NDC Hchg Rx 636 Drugs/detail Code 26 8 $12,497.55 $12,497.55 $7,892.20 $11,960.16 $9,448.15 2026-07-15
50242012001 NDC Hchg Rx 636 Drugs/detail Code 78 8 $11,327.63 $11,327.63 $6,259.48 $13,549.90 $9,119.12 2026-07-15
42211010243 NDC Hchg Rx 637 Drugs/self Admin 26 8 $11,960.20 $11,960.20 $7,552.87 $11,445.91 $9,041.91 2026-07-15
37238 CPT Hchg Ir Stent Placment Vein 26 8 $11,737.00 $11,737.00 $7,411.92 $11,232.31 $8,873.17 2026-07-15
62991142203 NDC Hchg Rx 250 Pharmacy 26 8 $11,557.94 $11,557.94 $7,298.84 $11,060.95 $8,737.80 2026-07-15
59676080030 NDC Hchg Rx 637 Drugs/self Admin 26 8 $10,564.60 $10,564.60 $6,671.54 $10,110.32 $7,986.84 2026-07-15
61958120101 NDC Hchg Rx 637 Drugs/self Admin 26 8 $10,078.52 $10,078.52 $6,364.59 $9,645.15 $7,619.36 2026-07-15
00591231215 NDC Hchg Rx 637 Drugs/self Admin 26 8 $9,694.98 $9,694.98 $6,122.38 $9,278.09 $7,329.40 2026-07-15
50593 CPT Hchg Hc Ablation Renal Tumor(s) Percutaneous Cryotherapy Bl 52 8 $9,504.00 $9,504.00 $4,801.29 $10,914.58 $7,276.07 2026-07-15
61958190101 NDC Hchg Rx 637 Drugs/self Admin 26 8 $9,607.90 $9,607.90 $6,067.39 $9,194.76 $7,263.57 2026-07-15
50458056401 NDC Hchg Rx 636 Drugs/detail Code 26 8 $9,558.96 $9,558.96 $6,036.48 $9,147.92 $7,226.57 2026-07-15
13533031805 NDC Hchg Rx 636 Drugs/detail Code 26 8 $9,512.31 $9,512.31 $6,007.02 $9,103.28 $7,191.31 2026-07-15
22514 CPT Hchg Ir Kyphoplasty-lumbar 26 8 $9,478.00 $9,478.00 $5,985.36 $9,070.45 $7,165.37 2026-07-15
00085432402 NDC Hchg Rx 637 Drugs/self Admin 26 8 $9,458.35 $9,458.35 $5,972.95 $9,051.64 $7,150.51 2026-07-15
63402030610 NDC Hchg Rx 637 Drugs/self Admin 26 8 $9,234.75 $9,234.75 $5,831.74 $8,837.66 $6,981.47 2026-07-15
36226 CPT Hchg Angio Vertebral Bi 52 8 $8,925.00 $8,925.00 $4,508.91 $10,249.47 $6,832.98 2026-07-15
36224 CPT Hchg Angio Carotid Internal Bi 52 8 $8,925.00 $8,925.00 $4,508.91 $10,249.47 $6,832.98 2026-07-15
36227 CPT Hchg Ir Ea Add Ext Carotid Bil 52 8 $8,904.00 $8,904.00 $4,498.17 $10,225.55 $6,816.71 2026-07-15
67457067502 NDC Hchg Rx 636 Drugs/detail Code 26 8 $8,986.50 $8,986.50 $5,674.97 $8,600.08 $6,793.79 2026-07-15
61958110101 NDC Hchg Rx 637 Drugs/self Admin 26 8 $8,744.20 $8,744.20 $5,521.96 $8,368.20 $6,610.62 2026-07-15
61958210101 NDC Hchg Rx 637 Drugs/self Admin 26 8 $8,744.20 $8,744.20 $5,521.96 $8,368.20 $6,610.62 2026-07-15
00006307604 NDC Hchg Rx 637 Drugs/self Admin 26 8 $8,713.70 $8,713.70 $5,502.70 $8,339.01 $6,587.56 2026-07-15
42023020501 NDC Hchg Rx 636 Drugs/detail Code 26 8 $8,699.70 $8,699.70 $5,493.86 $8,325.61 $6,576.97 2026-07-15
36902 CPT Hchg Ir Av Fistulagram W/pta Arm Lt 26 8 $8,696.00 $8,696.00 $5,491.52 $8,322.07 $6,574.18 2026-07-15
60574411301 NDC Hchg Rx 636 Drugs/detail Code 26 8 $8,598.05 $8,598.05 $5,429.67 $8,228.33 $6,500.13 2026-07-15
37187 CPT Hchg Perc Mech Thrombectomy-vein+tpa Int 52 8 $8,456.50 $8,456.50 $4,272.10 $9,711.64 $6,474.10 2026-07-15
49702023113 NDC Hchg Rx 637 Drugs/self Admin 26 8 $8,537.27 $8,537.27 $5,391.29 $8,170.17 $6,454.18 2026-07-15
37248 CPT Hchg Ir Pta Venous 26 8 $8,276.00 $8,276.00 $5,226.29 $7,920.13 $6,256.66 2026-07-15
37228 CPT Hchg Ir Pta Tib/per Init Lt 26 8 $8,250.00 $8,250.00 $5,209.88 $7,895.25 $6,237.00 2026-07-15
36904 CPT Hchg Ir Av Fistula Thrombectomy Lt 26 8 $7,959.00 $7,959.00 $5,026.11 $7,616.76 $6,017.00 2026-07-15
J2505 HCPCS Hchg Oms Neulasta 6 Mg Via On-body Injector 26 8 $7,808.00 $7,808.00 $4,930.75 $7,472.26 $5,902.85 2026-07-15
37220 CPT Hchg Hc Revascularization/endovascular/open/percutaneous Iliac Artery Initial Ve… 52 8 $7,537.50 $7,537.50 $3,807.95 $8,656.07 $5,770.71 2026-07-15
37184 CPT Hchg Perc Mech Thrombectomy Art+tpa Int 52 8 $7,447.50 $7,447.50 $3,762.48 $8,552.71 $5,701.81 2026-07-15
63833061702 NDC Hchg Rx 636 Drugs/detail Code 26 8 $7,425.60 $7,425.60 $4,689.27 $7,106.30 $5,613.75 2026-07-15
63459010450 NDC Hchg Rx 636 Drugs/detail Code 26 8 $7,311.15 $7,311.15 $4,616.99 $6,996.77 $5,527.23 2026-07-15
55513020701 NDC Hchg Rx 636 Drugs/detail Code 26 8 $6,984.62 $6,984.62 $4,410.79 $6,684.29 $5,280.38 2026-07-15
63833061602 NDC Hchg Rx 636 Drugs/detail Code 26 8 $6,950.40 $6,950.40 $4,389.18 $6,651.53 $5,254.50 2026-07-15
37224 CPT Hchg Ir Pta Fem/pop Rt 26 8 $6,793.00 $6,793.00 $4,289.78 $6,500.90 $5,135.51 2026-07-15
68992304001 NDC Hchg Rx 637 Drugs/self Admin 26 8 $6,701.75 $6,701.75 $4,232.16 $6,413.57 $5,066.52 2026-07-15
47538 CPT Hchg Perc Biliary Stent Plcmnt 26 8 $6,701.00 $6,701.00 $4,231.68 $6,412.86 $5,065.96 2026-07-15
61624 CPT Hchg Sc>embolization - Cns 26 8 $6,476.00 $6,476.00 $4,089.59 $6,197.53 $4,895.86 2026-07-15
50458056301 NDC Hchg Rx 636 Drugs/detail Code 26 8 $6,392.82 $6,392.82 $4,037.07 $6,117.93 $4,832.97 2026-07-15
59148001971 NDC Hchg Rx 636 Drugs/detail Code 26 8 $6,256.13 $6,256.13 $3,950.74 $5,987.11 $4,729.63 2026-07-15
00944270007 NDC Hchg Rx 636 Drugs/detail Code 26 8 $6,246.60 $6,246.60 $3,944.73 $5,978.00 $4,722.43 2026-07-15
00944270013 NDC Hchg Rx 636 Drugs/detail Code 26 8 $6,246.60 $6,246.60 $3,944.73 $5,978.00 $4,722.43 2026-07-15
36223 CPT Hchg Angio Carotid + Cerebral Bi 52 8 $5,984.00 $5,984.00 $3,022.99 $6,872.22 $4,581.16 2026-07-15
93454 CPT Hchg Cornoary Angios Only 26 8 $6,046.00 $6,046.00 $3,818.05 $5,786.02 $4,570.78 2026-07-15
37191 CPT Hchg Ir Ivc W Filter Placement 52 8 $5,907.50 $5,907.50 $3,643.76 $5,785.06 $4,570.02 2026-07-15
00069024901 NDC Hchg Rx 636 Drugs/detail Code 26 8 $5,865.15 $5,865.15 $3,703.84 $5,612.95 $4,434.05 2026-07-15
59676057530 NDC Hchg Rx 637 Drugs/self Admin 26 8 $5,780.88 $5,780.88 $3,650.62 $5,532.30 $4,370.34 2026-07-15
36225 CPT Hchg Angio Subclavian Innom Bi 52 8 $5,680.50 $5,680.50 $2,869.54 $6,523.87 $4,348.61 2026-07-15
00069420030 NDC Hchg Rx 637 Drugs/self Admin 26 8 $5,747.27 $5,747.27 $3,629.40 $5,500.14 $4,344.94 2026-07-15
78816 CPT Hchg PET W/ct Whole Body 26 8 $5,571.00 $5,571.00 $3,518.09 $5,331.45 $4,211.68 2026-07-15
00009082703 NDC Hchg Rx 637 Drugs/self Admin 26 8 $5,551.15 $5,551.15 $3,505.55 $5,312.45 $4,196.67 2026-07-15
36222 CPT Hchg Angio Carotid Cerv Bi 52 8 $5,440.00 $5,440.00 $2,748.29 $6,247.30 $4,164.86 2026-07-15
37215 CPT Hchg Hc Placement Transcatheter Stent(s) Cervical Carotid Artery Distal Embolic … 52 8 $5,201.50 $5,201.50 $2,779.23 $5,743.91 $4,132.16 2026-07-15
78815 CPT Hc PET CT Skull-mid Thgh Initial 26 8 $5,441.00 $5,441.00 $3,435.99 $5,207.04 $4,113.40 2026-07-15
67457083306 NDC Hchg Rx 636 Drugs/detail Code 26 8 $5,415.75 $5,415.75 $3,420.05 $5,182.87 $4,094.31 2026-07-15
L5649 HCPCS Hchg Add To Lower Extremity, Ischial Containment, M-l Socket 26 8 $5,414.00 $5,414.00 $3,418.94 $5,181.20 $4,092.98 2026-07-15
36907 CPT Hchg Additional Fistula Central Pta 26 8 $5,367.00 $5,367.00 $3,389.26 $5,136.22 $4,057.45 2026-07-15
61958200202 NDC Hchg Rx 637 Drugs/self Admin 26 8 $5,316.32 $5,316.32 $3,357.26 $5,087.72 $4,019.14 2026-07-15
37211 CPT Hchg Thromboysis Arterial Int 52 8 $5,156.50 $5,156.50 $2,604.94 $5,921.92 $3,947.63 2026-07-15
36561 CPT Hchg Hc Insertion Tunneled Centrally Inserted Central Venous Access Device With Po… 52 8 $5,146.50 $5,146.50 $2,599.89 $5,910.43 $3,939.97 2026-07-15
44206043892 NDC Hchg Rx 636 Drugs/detail Code 26 8 $5,203.25 $5,203.25 $3,285.85 $4,979.51 $3,933.66 2026-07-15
44206043820 NDC Hchg Rx 636 Drugs/detail Code 26 8 $5,203.25 $5,203.25 $3,285.85 $4,979.51 $3,933.66 2026-07-15
L5560 HCPCS Hchg Preparatory,above Knee, No Cover, Molded To Model 26 8 $5,157.00 $5,157.00 $3,256.65 $4,935.25 $3,898.69 2026-07-15
49702022813 NDC Hchg Rx 637 Drugs/self Admin 26 8 $5,143.98 $5,143.98 $3,248.42 $4,922.78 $3,888.85 2026-07-15
59676056630 NDC Hchg Rx 637 Drugs/self Admin 26 8 $5,058.18 $5,058.18 $3,194.24 $4,840.67 $3,823.98 2026-07-15
59676056201 NDC Hchg Rx 637 Drugs/self Admin 26 8 $5,058.10 $5,058.10 $3,194.19 $4,840.60 $3,823.92 2026-07-15
78608 CPT Hchg PET Brain Img Metabolic Eval 26 8 $5,056.00 $5,056.00 $3,192.86 $4,838.59 $3,822.34 2026-07-15
L5700 HCPCS Hchg Replacement, Socket, Below Knee, Molded To Patient Model 26 8 $5,012.00 $5,012.00 $3,165.08 $4,796.48 $3,789.07 2026-07-15
36247 CPT Hchg Sc>cath Place Art 3rd (below Bil 52 8 $4,885.00 $4,885.00 $2,467.90 $5,609.93 $3,739.96 2026-07-15
63020004901 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,899.00 $4,899.00 $3,093.72 $4,688.34 $3,703.64 2026-07-15
37193 CPT Hchg Ir Filter Retrieval Ivc 26 8 $4,864.00 $4,864.00 $3,071.62 $4,654.85 $3,677.18 2026-07-15
57970010001 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,823.97 $4,823.97 $3,046.34 $4,616.54 $3,646.92 2026-07-15
P9012 HCPCS Hchg Oms Solid Organ Neoplasm, Genomic Sequence Analysis, DNA Or Dna/rna Analysi… 26 8 $4,802.00 $4,802.00 $3,032.46 $4,595.51 $3,630.31 2026-07-15
36246 CPT Hchg Sc>cath Place Art 2nd (below Diap 52 8 $4,704.00 $4,704.00 $2,376.33 $5,402.27 $3,601.19 2026-07-15
49502090230 NDC Hchg Rx 637 Drugs/self Admin 26 8 $4,700.80 $4,700.80 $2,968.56 $4,498.67 $3,553.80 2026-07-15
65757030001 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,663.71 $4,663.71 $2,945.13 $4,463.17 $3,525.76 2026-07-15
13533080025 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,633.20 $4,633.20 $2,925.87 $4,433.97 $3,502.70 2026-07-15
47382 CPT Hchg Sc>ablation Liver Perc 26 8 $4,578.00 $4,578.00 $2,891.01 $4,381.15 $3,460.97 2026-07-15
60574411401 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,554.90 $4,554.90 $2,876.42 $4,359.04 $3,443.50 2026-07-15
43246 CPT Hchg Hc Egd Flexible Transoral W/placement Percutaneous Gastrostomy Tube 52 8 $4,814.00 $4,814.00 $1,528.23 $6,898.06 $3,433.90 2026-07-15
L5540 HCPCS Hchg Preparatory, Below Knee Ptb Type Socket, Non Align 26 8 $4,526.00 $4,526.00 $2,858.17 $4,331.38 $3,421.66 2026-07-15
50437 CPT Hchg Hc Dilation Existing Tract Percutaneous W/tube Placement Including New Acce… 52 8 $4,386.50 $4,386.50 $2,215.93 $5,037.65 $3,358.11 2026-07-15
37182 CPT Hchg Tips Insertion 26 8 $4,408.00 $4,408.00 $2,783.65 $4,218.46 $3,332.45 2026-07-15
49422 CPT Hchg Removal Perm Intrperitoneal Cath/cann 26 8 $4,358.00 $4,358.00 $2,752.08 $4,170.61 $3,294.65 2026-07-15
55513071001 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,336.44 $4,336.44 $2,738.46 $4,149.97 $3,278.35 2026-07-15
68982085004 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,314.00 $4,314.00 $2,724.29 $4,128.50 $3,261.38 2026-07-15
50694 CPT Hchg Hc Placement Stent Ureteral Without Cathether New Bl 52 8 $4,206.50 $4,206.50 $2,125.00 $4,830.94 $3,220.30 2026-07-15
36558 CPT Hchg Tunnel Cetral Ven. Cath. >5 Yrs 52 8 $4,205.00 $4,205.00 $2,124.37 $4,829.02 $3,219.35 2026-07-15
49418 CPT Hchg Ir Cath Insert Periton/tunn Comp 26 8 $4,220.00 $4,220.00 $2,664.93 $4,038.54 $3,190.32 2026-07-15
00944270012 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,184.40 $4,184.40 $2,642.45 $4,004.47 $3,163.41 2026-07-15
00944270006 NDC Hchg Rx 636 Drugs/detail Code 26 8 $4,184.40 $4,184.40 $2,642.45 $4,004.47 $3,163.41 2026-07-15
95811 CPT Hchg Polysomn & Cpap Initiation/mgmt 26 8 $4,143.00 $4,143.00 $2,616.30 $3,964.85 $3,132.11 2026-07-15
63402031230 NDC Hchg Rx 637 Drugs/self Admin 26 8 $4,142.50 $4,142.50 $2,615.99 $3,964.37 $3,131.73 2026-07-15
L2036 HCPCS Hchg Knee Ankle Foot Orthosis, W/without Free Motion, Custom Fab 26 8 $4,087.00 $4,087.00 $2,580.94 $3,911.26 $3,089.77 2026-07-15
36245 CPT Hchg Sc>cath Place Art 1st(belowdiap)bil 52 8 $4,014.00 $4,014.00 $2,027.75 $4,609.87 $3,072.93 2026-07-15
00006306901 NDC Hchg Rx 637 Drugs/self Admin 26 8 $4,049.05 $4,049.05 $2,556.98 $3,874.94 $3,061.08 2026-07-15
95783 CPT Hchg Cpap Peds Limited 52 8 $3,854.50 $3,854.50 $2,337.81 $3,834.70 $3,029.29 2026-07-15
49702022318 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,981.55 $3,981.55 $2,514.35 $3,810.34 $3,010.05 2026-07-15
50458056201 NDC Hchg Rx 636 Drugs/detail Code 26 8 $3,961.10 $3,961.10 $2,501.43 $3,790.77 $2,994.59 2026-07-15
L5845 HCPCS Hchg Add, Endoskeletal Knee-shin System, Adjustable 26 8 $3,960.00 $3,960.00 $2,500.74 $3,789.72 $2,993.76 2026-07-15
47490 CPT Hchg Perc Cholecystostomy 26 8 $3,931.00 $3,931.00 $2,482.43 $3,761.97 $2,971.84 2026-07-15
95810 CPT Hchg Sleep Lab Consultati0n 26 8 $3,929.00 $3,929.00 $2,481.16 $3,760.05 $2,970.32 2026-07-15
70127010010 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,928.25 $3,928.25 $2,480.69 $3,759.34 $2,969.76 2026-07-15
47544 CPT Hchg Perc Biliary Stone Remove 26 8 $3,894.00 $3,894.00 $2,459.06 $3,726.56 $2,943.86 2026-07-15
37197 CPT Hchg Foreign Body Retreivel 26 8 $3,860.00 $3,860.00 $2,437.59 $3,694.02 $2,918.16 2026-07-15
36221 CPT Hchg Aortic Arch 26 8 $3,792.00 $3,792.00 $2,394.65 $3,628.94 $2,866.75 2026-07-15
36252 CPT Hchg Ir Angio Renal Comp Bil 26 8 $3,788.00 $3,788.00 $2,392.12 $3,625.12 $2,863.73 2026-07-15
47543 CPT Hchg Biopsy Biliary Tree 26 8 $3,775.00 $3,775.00 $2,383.91 $3,612.68 $2,853.90 2026-07-15
47536 CPT Hchg Exchange Biliary Drain 52 8 $3,689.50 $3,689.50 $2,275.93 $3,612.68 $2,853.90 2026-07-15
47534 CPT Hchg Int/ext Biliary Drain Plcmnt 26 8 $3,775.00 $3,775.00 $2,383.91 $3,612.68 $2,853.90 2026-07-15
32550 CPT Hchg Sc>insert Tunneled Pleural Cath 26 8 $3,733.00 $3,733.00 $2,357.39 $3,572.48 $2,822.15 2026-07-15
73723 CPT Hchg MRI Extre Low Jt Only Without W/cont Lt 52 8 $3,680.00 $3,680.00 $1,859.14 $4,226.11 $2,817.41 2026-07-15
95782 CPT Hchg P0ly Solysomnogram Nocturnal (sas) 5 Yrs And Under 52 8 $3,542.50 $3,542.50 $2,121.84 $3,564.82 $2,816.10 2026-07-15
50693 CPT Hchg Ureteral Stent Thru Neph Tube-lt 26 8 $3,702.00 $3,702.00 $2,337.81 $3,542.81 $2,798.71 2026-07-15
50695 CPT Hchg Perc Ureteral Stent W/neph Tube-lt 26 8 $3,702.00 $3,702.00 $2,337.81 $3,542.81 $2,798.71 2026-07-15
00003364111 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,695.05 $3,695.05 $2,333.42 $3,536.16 $2,793.46 2026-07-15
C1880 HCPCS Hchg Filter Vena Cava Fem Denali 26 8 $3,694.00 $3,694.00 $2,332.76 $3,535.16 $2,792.66 2026-07-15
55513022301 NDC Hchg Rx 636 Drugs/detail Code 26 8 $3,637.50 $3,637.50 $2,297.08 $3,481.09 $2,749.95 2026-07-15
37252 CPT Hchg Ivus Non-cor Initial 26 8 $3,608.00 $3,608.00 $2,278.45 $3,452.86 $2,727.65 2026-07-15
73223 CPT Hchg MRI Extre Up Jt Only Without W/cont Lt 52 8 $3,546.50 $3,546.50 $1,791.57 $4,072.99 $2,715.01 2026-07-15
50436 CPT Hchg Hc Dilation Existing Tract Percutaneous W/tube Placement When Performed Bl 52 8 $3,509.00 $3,509.00 $1,772.62 $4,029.93 $2,686.30 2026-07-15
59676057101 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,546.10 $3,546.10 $2,239.36 $3,393.62 $2,680.85 2026-07-15
75716 CPT Hchg Angiogram Extremity Bi 26 8 $3,542.00 $3,542.00 $2,236.77 $3,389.69 $2,677.75 2026-07-15
73720 CPT Hchg MRI Extre Low Without Jnt Without W/cont Rt 52 8 $3,485.00 $3,485.00 $1,760.62 $4,002.17 $2,668.12 2026-07-15
38222 CPT Hchg Biopsy(ies) & Aspiration(s) Bone Marrow Diagnostic Bl 52 8 $3,472.50 $3,472.50 $1,754.31 $3,987.82 $2,658.55 2026-07-15
0360 RC — 156 8 $4,172.50 $4,172.50 $46.10 $13,176.93 $2,650.40 2026-07-15
50458030811 NDC Hchg Rx 636 Drugs/detail Code 26 8 $3,493.20 $3,493.20 $2,205.96 $3,342.99 $2,640.86 2026-07-15
61958230101 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,481.07 $3,481.07 $2,198.30 $3,331.39 $2,631.69 2026-07-15
57894003001 NDC Hchg Rx 636 Drugs/detail Code 26 8 $3,439.17 $3,439.17 $2,171.84 $3,291.29 $2,600.01 2026-07-15
59922063101 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,429.75 $3,429.75 $2,165.89 $3,282.27 $2,592.89 2026-07-15
74178 CPT Hchg CT Abd/pelvis W/wo Contrast 26 8 $3,376.00 $3,376.00 $2,131.94 $3,230.83 $2,552.26 2026-07-15
70100042402 NDC Hchg Rx 636 Drugs/detail Code 52 8 $3,433.38 $3,433.38 $1,458.08 $4,361.85 $2,543.96 2026-07-15
70100042401 NDC Hchg Rx 636 Drugs/detail Code 52 8 $3,433.38 $3,433.38 $1,458.08 $4,361.85 $2,543.96 2026-07-15
0118 RC — 26 8 $3,354.00 $3,354.00 $2,118.05 $3,209.78 $2,535.62 2026-07-15
59338077501 NDC Hchg Rx 636 Drugs/detail Code 26 8 $3,353.68 $3,353.68 $2,117.85 $3,209.47 $2,535.38 2026-07-15
47531 CPT Hchg Biliary Tube Check 26 8 $3,350.00 $3,350.00 $2,115.53 $3,205.95 $2,532.60 2026-07-15
36253 CPT Hchg Ir Angio Renal 2nd/3rd Order Lt 52 8 $3,236.50 $3,236.50 $1,674.74 $3,656.70 $2,529.91 2026-07-15
L0486 HCPCS Hchg Tlso, Triplanar Control, Custom Fab 26 8 $3,337.00 $3,337.00 $2,107.32 $3,193.51 $2,522.77 2026-07-15
50433 CPT Hchg Nephrouretero Tube Plcmnt-rt 26 8 $3,335.00 $3,335.00 $2,106.05 $3,191.59 $2,521.26 2026-07-15
78452 CPT Hchg Nm Myocardial Rest/spect 26 8 $3,316.00 $3,316.00 $2,094.05 $3,173.41 $2,506.90 2026-07-15
00085132801 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,313.38 $3,313.38 $2,092.40 $3,170.90 $2,504.91 2026-07-15
73220 CPT Hchg MRI Extre Up Without Joint Without W/con Bilateral 52 8 $3,269.00 $3,269.00 $1,651.37 $3,754.31 $2,502.55 2026-07-15
50474067066 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,307.75 $3,307.75 $2,088.84 $3,165.52 $2,500.66 2026-07-15
37214 CPT Hchg Thrombolysis Cessation 26 8 $3,302.00 $3,302.00 $2,085.21 $3,160.01 $2,496.31 2026-07-15
L0464 HCPCS Hchg Tlso, Triplanar Control, Prefabricated 26 8 $3,277.00 $3,277.00 $2,069.43 $3,136.09 $2,477.41 2026-07-15
73222 CPT Hchg MRI Extre Up Jt Only W/contrast Lt 52 8 $3,219.00 $3,219.00 $1,626.11 $3,696.89 $2,464.28 2026-07-15
00024515010 NDC Hchg Rx 636 Drugs/detail Code 26 8 $3,251.63 $3,251.63 $2,053.40 $3,111.81 $2,458.23 2026-07-15
59310061031 NDC Hchg Rx 636 Drugs/detail Code 26 8 $3,240.00 $3,240.00 $2,046.06 $3,100.68 $2,449.44 2026-07-15
13533080071 NDC Hchg Rx 636 Drugs/detail Code 26 8 $3,222.00 $3,222.00 $2,034.69 $3,083.45 $2,435.83 2026-07-15
19085 CPT Hchg Mr Guided Bx Breast W Clip Rt 26 8 $3,163.00 $3,163.00 $1,997.43 $3,026.99 $2,391.23 2026-07-15
36251 CPT Hchg Ir Angio Renal Comp Rt 26 8 $3,157.00 $3,157.00 $1,993.65 $3,021.25 $2,386.69 2026-07-15
36905 CPT Hchg Ir Av Fistula Thrombect W/pta-arm Lt 26 8 $3,150.00 $3,150.00 $1,989.22 $3,014.55 $2,381.40 2026-07-15
36903 CPT Hchg Ir Av Fistulagram With Stent Arm Lt 26 8 $3,150.00 $3,150.00 $1,989.22 $3,014.55 $2,381.40 2026-07-15
50432 CPT Hchg Hc Placement Nephrostomy Catheter Bl 52 8 $3,106.50 $3,106.50 $1,569.28 $3,567.70 $2,378.14 2026-07-15
22511 CPT Hchg Ir Vertebroplasty-lumbosacral 26 8 $3,114.00 $3,114.00 $1,966.49 $2,980.10 $2,354.18 2026-07-15
22510 CPT Hchg Ir Vertebroplasty-cervicothoracic 26 8 $3,114.00 $3,114.00 $1,966.49 $2,980.10 $2,354.18 2026-07-15
36581 CPT Hchg Replace Comp Tunnel Cvad Same Ven 26 8 $3,106.00 $3,106.00 $1,961.44 $2,972.44 $2,348.14 2026-07-15
73722 CPT Hchg Hc MRI Lower Extremity Joint W/contrast Bl 52 8 $3,065.00 $3,065.00 $1,548.44 $3,519.85 $2,346.56 2026-07-15
L0112 HCPCS Hchg Cranial Cervical Orthosis, Congenital Torticollis Type, Custom Fab 26 8 $3,086.00 $3,086.00 $1,948.81 $2,953.30 $2,333.02 2026-07-15
36582 CPT Hchg Replace Comp Tunnel W/port Sam Ven 26 8 $3,084.00 $3,084.00 $1,947.55 $2,951.39 $2,331.50 2026-07-15
57841130103 NDC Hchg Rx 637 Drugs/self Admin 26 8 $3,037.25 $3,037.25 $1,918.02 $2,906.65 $2,296.16 2026-07-15
19081 CPT Hchg Mg Breast Stereo Bx W/clip And Spec Lt 26 8 $3,036.00 $3,036.00 $1,917.23 $2,905.45 $2,295.22 2026-07-15
70553 CPT Hchg MRI Brain Without With Contrast 26 8 $3,022.00 $3,022.00 $1,908.39 $2,892.05 $2,284.63 2026-07-15
67457022005 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,987.41 $2,987.41 $1,886.55 $2,858.96 $2,258.49 2026-07-15
75625 CPT Hchg Aortogram Abdominal 26 8 $2,982.00 $2,982.00 $1,883.13 $2,853.77 $2,254.39 2026-07-15
59417010510 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,975.75 $2,975.75 $1,879.19 $2,847.79 $2,249.67 2026-07-15
59417010310 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,975.75 $2,975.75 $1,879.19 $2,847.79 $2,249.67 2026-07-15
59417010210 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,975.75 $2,975.75 $1,879.19 $2,847.79 $2,249.67 2026-07-15
74177 CPT Hchg CT Abd/pelvis W/contrast 26 8 $2,968.00 $2,968.00 $1,874.29 $2,840.38 $2,243.81 2026-07-15
74174 CPT Hc CT Angiography Abdomen & Pelvis Without & W/contrast 26 8 $2,936.00 $2,936.00 $1,854.08 $2,809.75 $2,219.62 2026-07-15
00078041420 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,935.90 $2,935.90 $1,854.02 $2,809.66 $2,219.54 2026-07-15
72156 CPT Hchg MRI Spine Cervical W/wo Contr 26 8 $2,922.00 $2,922.00 $1,845.24 $2,796.35 $2,209.03 2026-07-15
72158 CPT Hchg MRI Spine Lumbar/sacrum W/wo Contr 26 8 $2,922.00 $2,922.00 $1,845.24 $2,796.35 $2,209.03 2026-07-15
72157 CPT Hchg MRI Spine Thoracic W/wo Contr 26 8 $2,922.00 $2,922.00 $1,845.24 $2,796.35 $2,209.03 2026-07-15
63402020430 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,918.13 $2,918.13 $1,842.80 $2,792.65 $2,206.10 2026-07-15
74183 CPT Hchg MRI Abdomen W/contrast 26 8 $2,911.00 $2,911.00 $1,838.30 $2,785.83 $2,200.72 2026-07-15
50242005121 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,908.56 $2,908.56 $1,836.76 $2,783.49 $2,198.87 2026-07-15
19083 CPT Hchg Mg Breast US Bx W/clip And Spec Lt 26 8 $2,883.00 $2,883.00 $1,820.61 $2,759.03 $2,179.55 2026-07-15
24201040002 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,858.88 $2,858.88 $1,805.38 $2,735.95 $2,161.31 2026-07-15
L0637 HCPCS Hchg Lumbar-sacral Orthosis, Prefab Incl Fit/adj 26 8 $2,857.00 $2,857.00 $1,804.20 $2,734.15 $2,159.89 2026-07-15
L0650 HCPCS Hchg Lumbar-sacral Orthosis, Prefabricated 26 8 $2,857.00 $2,857.00 $1,804.20 $2,734.15 $2,159.89 2026-07-15
72197 CPT Hchg MRI Pelvis Without W/contrast 26 8 $2,857.00 $2,857.00 $1,804.20 $2,734.15 $2,159.89 2026-07-15
93505 CPT Hchg Endomyocardial Biopsy 26 8 $2,827.00 $2,827.00 $1,785.25 $2,705.44 $2,137.21 2026-07-15
73221 CPT Hchg MRI Extre Up Jnt Only Without Cont Bil 52 8 $2,780.00 $2,780.00 $1,404.46 $3,192.55 $2,128.37 2026-07-15
36217 CPT Hchg Sc>cath Place Art 3rd(above Diap Lt 52 8 $2,837.00 $2,837.00 $1,298.36 $3,462.43 $2,126.18 2026-07-15
70543 CPT Hchg MRI Neck (st) Without W/contrast 26 8 $2,810.00 $2,810.00 $1,774.52 $2,689.17 $2,124.36 2026-07-15
73721 CPT Hchg MRI Extre Low Jnt Only Without Cont Bil 52 8 $2,761.50 $2,761.50 $1,394.98 $3,171.50 $2,114.01 2026-07-15
24201001050 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,774.85 $2,774.85 $1,752.32 $2,655.53 $2,097.79 2026-07-15
36012 CPT Hchg Sc>cath Place, Venous 2nd (belo Lt 26 8 $2,768.00 $2,768.00 $1,747.99 $2,648.98 $2,092.61 2026-07-15
00004024451 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,766.55 $2,766.55 $1,747.08 $2,647.59 $2,091.51 2026-07-15
93229 CPT Hchg Oms Wearable Mobile Cardiovascular Telemetry 26 8 $2,751.00 $2,751.00 $1,737.26 $2,632.71 $2,079.76 2026-07-15
0128 RC — 26 8 $2,746.00 $2,746.00 $1,734.10 $2,627.92 $2,075.98 2026-07-15
00517065001 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,740.65 $2,740.65 $1,730.72 $2,622.80 $2,071.93 2026-07-15
99291 CPT Hc Critical Care 30-74 Minutes 26 8 $2,738.00 $2,738.00 $1,729.05 $2,620.27 $2,069.93 2026-07-15
77386 CPT Hchg Intensity Modulated Radiation Treatment Delivery, Complex 26 8 $2,716.00 $2,716.00 $1,715.15 $2,599.21 $2,053.30 2026-07-15
75894 CPT Hchg Embolization 26 8 $2,693.00 $2,693.00 $1,700.63 $2,577.20 $2,035.91 2026-07-15
70546 CPT Hchg MRA Head Without W/contrast 26 8 $2,670.00 $2,670.00 $1,686.11 $2,555.19 $2,018.52 2026-07-15
62856027630 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,666.05 $2,666.05 $1,683.61 $2,551.41 $2,015.53 2026-07-15
36011 CPT Hchg Sc>cath Place Venous 1st (below) Lt 26 8 $2,662.00 $2,662.00 $1,681.05 $2,547.53 $2,012.47 2026-07-15
50458056101 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,641.78 $2,641.78 $1,668.28 $2,528.18 $1,997.18 2026-07-15
73706 CPT Hchg CTA Lower Extremity Without W/contrast 26 8 $2,610.00 $2,610.00 $1,648.21 $2,497.77 $1,973.16 2026-07-15
59148002050 NDC Hchg Rx 637 Drugs/self Admin 78 8 $2,604.24 $2,604.24 $823.31 $4,981.40 $1,968.80 2026-07-15
70549 CPT Hchg MRA Neck Without W/contrast 26 8 $2,604.00 $2,604.00 $1,644.43 $2,492.03 $1,968.62 2026-07-15
36216 CPT Hchg Sc>cath Place Art 2nd(above Diap Lt 52 8 $2,604.00 $2,604.00 $1,191.64 $3,178.20 $1,951.53 2026-07-15
L1846 HCPCS Hchg Knee Orthosis, Double Upright, Thigh/calf, Custom Fab 26 8 $2,580.00 $2,580.00 $1,629.27 $2,469.06 $1,950.48 2026-07-15
95805 CPT Hchg Polysomnogram-sleep Latency (mslt) 26 8 $2,571.00 $2,571.00 $1,623.59 $2,460.45 $1,943.68 2026-07-15
00944049001 NDC Hchg Rx 636 Drugs/detail Code 78 8 $2,570.25 $2,570.25 $812.58 $4,916.35 $1,943.11 2026-07-15
00093538256 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,569.60 $2,569.60 $1,622.70 $2,459.11 $1,942.62 2026-07-15
68382043528 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,563.75 $2,563.75 $1,619.01 $2,453.51 $1,938.19 2026-07-15
73718 CPT Hchg MRI Extre Low Without Jt Without Cont Lt 52 8 $2,517.50 $2,517.50 $1,271.84 $2,891.10 $1,927.40 2026-07-15
74176 CPT Hchg CT Abd/pelvis Without Contrast 26 8 $2,525.00 $2,525.00 $1,594.54 $2,416.43 $1,908.90 2026-07-15
95951 CPT Hchg EEG Long Term Monitoring W/video Sc 26 8 $2,522.00 $2,522.00 $1,592.64 $2,413.55 $1,906.63 2026-07-15
49406 CPT Hchg CT Drainage Peritoneal/retro Perc 26 8 $2,511.00 $2,511.00 $1,585.70 $2,403.03 $1,898.32 2026-07-15
73218 CPT Hchg MRI Extre Up Without Jt Without Contrast Bilateral 52 8 $2,479.00 $2,479.00 $1,252.26 $2,847.07 $1,897.73 2026-07-15
78832 CPT Hc Nm Radiopharmaceutical Localization Tumor Spect With CT 2+area Sgl Day 26 8 $2,477.00 $2,477.00 $1,564.23 $2,370.49 $1,872.61 2026-07-15
L1945 HCPCS Hchg Ankle Foot Orthosis, Plastic, Custom-fab 26 8 $2,474.00 $2,474.00 $1,562.33 $2,367.62 $1,870.34 2026-07-15
P9052 HCPCS Hc Platelets Hla Matched Leukocytes Reduced Apheresis/pheresis Each Unit 26 8 $2,466.00 $2,466.00 $1,557.28 $2,359.96 $1,864.30 2026-07-15
75705 CPT Hchg Angiogram Spine 26 8 $2,465.00 $2,465.00 $1,556.65 $2,359.01 $1,863.54 2026-07-15
49423 CPT Hchg Sc>abscess Drainage Tube Change 26 8 $2,459.00 $2,459.00 $1,552.86 $2,353.26 $1,859.00 2026-07-15
50435 CPT Hchg Hc Exchange Catheter Nephrostomy Bl 52 8 $2,421.50 $2,421.50 $1,223.22 $2,781.04 $1,853.71 2026-07-15
50434 CPT Hchg Convert Nephro To Neph/uret-lt 52 8 $2,400.00 $2,400.00 $1,212.48 $2,756.16 $1,837.44 2026-07-15
72142 CPT Hchg MRI Spine Cervical W/contr 26 8 $2,412.00 $2,412.00 $1,523.18 $2,308.28 $1,823.47 2026-07-15
72149 CPT Hchg MRI Spine Lumbar/sacrum With Contr 26 8 $2,412.00 $2,412.00 $1,523.18 $2,308.28 $1,823.47 2026-07-15
72147 CPT Hchg MRI Spine Thoracic W/contr 26 8 $2,412.00 $2,412.00 $1,523.18 $2,308.28 $1,823.47 2026-07-15
L2030 HCPCS Hchg Knee Ankle Foot Orthosis, Double Upright, Without Knee Joint, Custom Fab 26 8 $2,388.00 $2,388.00 $1,508.02 $2,285.32 $1,805.33 2026-07-15
20225 CPT Hchg Sc>biopsy, Bone Deep 26 8 $2,379.00 $2,379.00 $1,502.34 $2,276.70 $1,798.52 2026-07-15
75710 CPT Hchg Angiogram Extremity Uni Lt 52 8 $2,307.00 $2,307.00 $1,422.77 $2,259.48 $1,784.92 2026-07-15
70127010060 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,358.25 $2,358.25 $1,489.23 $2,256.85 $1,782.84 2026-07-15
72196 CPT Hchg O/s Pelvis W/cont 26 8 $2,351.00 $2,351.00 $1,484.66 $2,249.91 $1,777.36 2026-07-15
55700 CPT Hchg Sc>biopsy Prostate 26 8 $2,350.00 $2,350.00 $1,484.03 $2,248.95 $1,776.60 2026-07-15
70545 CPT Hchg MRA Head W/contrast 52 8 $2,215.00 $2,215.00 $1,316.68 $2,244.16 $1,772.82 2026-07-15
75561 CPT Hchg MRI Cardiac Morph&func W Without Contrast 26 8 $2,340.00 $2,340.00 $1,477.71 $2,239.38 $1,769.04 2026-07-15
36140 CPT Hchg Place Cath Art Extrem 26 8 $2,339.00 $2,339.00 $1,477.08 $2,238.42 $1,768.28 2026-07-15
L3900 HCPCS Hchg Forearm Based Dynamic/static Progressive 26 8 $2,330.00 $2,330.00 $1,471.39 $2,229.81 $1,761.48 2026-07-15
38221 CPT Hchg Hc Biopsy(ies) Bone Marrow Diagnostic Bl 52 8 $2,299.00 $2,299.00 $1,161.33 $2,640.36 $1,759.92 2026-07-15
59651033101 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,302.75 $2,302.75 $1,454.19 $2,203.73 $1,740.88 2026-07-15
36215 CPT Hchg Sc>cath Place Art 1st(above Diap Lt 52 8 $2,321.50 $2,321.50 $1,062.18 $2,833.68 $1,739.77 2026-07-15
70552 CPT Hchg MRI Brain With Contr 26 8 $2,297.00 $2,297.00 $1,450.56 $2,198.23 $1,736.53 2026-07-15
72146 CPT Hchg MRI Spine Thoracic Without Contr 26 8 $2,279.00 $2,279.00 $1,439.19 $2,181.00 $1,722.92 2026-07-15
72141 CPT Hchg MRI Spine Cervical Without Contr 26 8 $2,279.00 $2,279.00 $1,439.19 $2,181.00 $1,722.92 2026-07-15
72148 CPT Hchg MRI Spine Lumbar/sacrum Wo Cont 26 8 $2,279.00 $2,279.00 $1,439.19 $2,181.00 $1,722.92 2026-07-15
68382064928 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,277.10 $2,277.10 $1,437.99 $2,179.18 $1,721.49 2026-07-15
50200 CPT Hchg Hc Biopsy Renal Percutaneous Trocar/needle Bl 52 8 $2,232.50 $2,232.50 $1,127.86 $2,563.80 $1,709.20 2026-07-15
69315028606 NDC Hchg Rx 637 Drugs/self Admin 26 8 $2,246.20 $2,246.20 $1,418.48 $2,149.61 $1,698.13 2026-07-15
70548 CPT Hchg O/s MRA Neck W/cont 26 8 $2,245.00 $2,245.00 $1,417.72 $2,148.47 $1,697.22 2026-07-15
36514 CPT Hc Apheresis Therapeutic Plasma Pheresis 26 8 $2,237.00 $2,237.00 $1,412.67 $2,140.81 $1,691.17 2026-07-15
71552 CPT Hchg MRI Chest Without W/contrast 26 8 $2,235.00 $2,235.00 $1,411.40 $2,138.89 $1,689.66 2026-07-15
00002764001 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,218.20 $2,218.20 $1,400.79 $2,122.82 $1,676.96 2026-07-15
68982085003 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,187.00 $2,187.00 $1,381.09 $2,092.96 $1,653.37 2026-07-15
49405 CPT Hchg CT Drainage Visceral Perc 26 8 $2,181.00 $2,181.00 $1,377.30 $2,087.22 $1,648.84 2026-07-15
69800420301 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,175.72 $2,175.72 $1,373.97 $2,082.16 $1,644.84 2026-07-15
36200 CPT Hchg Intro Of Catheter Aorta 78 8 $2,171.00 $2,171.00 $707.91 $3,116.95 $1,641.28 2026-07-15
73702 CPT Hchg CT Extremity Low Without W/ctrstrt 52 8 $2,122.50 $2,122.50 $1,072.29 $2,437.48 $1,624.99 2026-07-15
50458030711 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,148.93 $2,148.93 $1,357.05 $2,056.52 $1,624.59 2026-07-15
62305 CPT Hchg Hc Injection Lumbar W/myelogram >= 2 Regions Same Physician 26 8 $2,145.00 $2,145.00 $1,354.57 $2,052.76 $1,621.62 2026-07-15
78804 CPT Hchg Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging 26 8 $2,134.00 $2,134.00 $1,347.62 $2,042.24 $1,613.30 2026-07-15
38505 CPT Hchg Hc Biopsy Needle Lymph Node Superficial Bl 52 8 $2,106.50 $2,106.50 $1,064.08 $2,419.30 $1,612.55 2026-07-15
13533080072 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,130.00 $2,130.00 $1,345.10 $2,038.41 $1,610.28 2026-07-15
00944270005 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,122.20 $2,122.20 $1,340.17 $2,030.95 $1,604.38 2026-07-15
00944270011 NDC Hchg Rx 636 Drugs/detail Code 26 8 $2,122.20 $2,122.20 $1,340.17 $2,030.95 $1,604.38 2026-07-15
0323 RC — 78 19 $1,763.00 $1,763.00 $104.48 $6,911.41 $1,601.74 2026-07-15
32557 CPT Hc Drainage Pleural W/insertion Indwelling Catheter W/imaging Guidance Bl 52 8 $2,089.00 $2,089.00 $1,055.24 $2,399.20 $1,599.15 2026-07-15
36005 CPT Hchg Sc>injection Venogram Bil 52 8 $2,070.00 $2,070.00 $1,045.76 $2,377.19 $1,584.79 2026-07-15
78830 CPT Hc Nm Radiopharmaceutical Localization Tumor Spect With CT S 26 8 $2,083.00 $2,083.00 $1,315.41 $1,993.43 $1,574.75 2026-07-15
75635 CPT Hchg CTA Abd Aorta W/fem Without W/contrast 26 8 $2,082.00 $2,082.00 $1,314.78 $1,992.47 $1,573.99 2026-07-15
74175 CPT Hchg CTA Abdomen Without W/contrast 26 8 $2,047.00 $2,047.00 $1,292.68 $1,958.98 $1,547.53 2026-07-15
50431 CPT Hchg Hc Injection Nephrostogram/ureterogram Existing Access Bl 52 8 $2,012.50 $2,012.50 $1,016.72 $2,311.16 $1,540.77 2026-07-15
70542 CPT Hchg O/s Orbit Face Neck W/cont 26 8 $2,036.00 $2,036.00 $1,285.73 $1,948.45 $1,539.22 2026-07-15
70544 CPT Hchg MRA Head Without Contrast 26 8 $2,019.00 $2,019.00 $1,275.00 $1,932.18 $1,526.36 2026-07-15
75741 CPT Hchg Angiogram Pelvic Selective 52 8 $1,967.00 $1,967.00 $1,212.48 $1,927.40 $1,522.58 2026-07-15
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