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

WELIA HEALTH

Mora, MN · CCN 241367 · Rates published

1,473 distinct procedures filed
5 distinct payers
3,802 rate rows
2026-08-01 last MRF observed
Data quality

3,801 of 3,802 rate rows are consumer-grade (100.0%)

1 row is 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 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.weliahealth.org/wp-content/uploads/welia-charges.csv
Found on page https://www.weliahealth.org/resources/billing/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-01
Content fingerprint b7a7bc7deb113e96… · 571,971 bytes · first seen 2026-08-01

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
J9228
HCPCS 		Ipilimumab 200 Mg/40 Ml (5 mg/mL) Soln 40 Ml Vial 1 $41,185.55 $41,185.55 $41,185.55 nat. median
$8,184
outlier · 5.0×
J3357
HCPCS 		Ustekinumab 90 mg/mL Syrg 1 Ml Syringe 1 $32,299.26 $32,299.26 $32,299.26 nat. median
$12,959
outlier · 2.5×
J2350
HCPCS 		Ocrelizumab 30 mg/mL Soln 10 Ml Vial 1 $23,950.83 $23,950.83 $23,950.83 nat. median
$331
outlier · 72.4×
J9309
HCPCS 		Polatuzumab Vedotin-piiq 140 Mg Solr 1 Each Vial 1 $21,598.18 $21,598.18 $21,598.18 nat. median
$4,103
outlier · 5.3×
J9043
HCPCS 		Cabazitaxel 10 mg/mL (first Dilution) Soln 6 Ml Vial 1 $16,422.49 $16,422.49 $16,422.49 nat. median
$709
outlier · 23.2×
J1628
HCPCS 		Guselkumab 100 mg/mL Syrg 1 Ml Syringe 1 $16,105.18 $16,105.18 $16,105.18 nat. median
$196
outlier · 82.0×
0790
RC 		1 $16,048.48 $16,048.48 $16,048.48 nat. median
$204
outlier · 78.7×
J9173
HCPCS 		Durvalumab 50 mg/mL Soln 10 Ml Vial 1 $14,666.09 $14,666.09 $14,666.09 nat. median
$1,035
outlier · 14.2×
J9042
HCPCS 		Brentuximab Vedotin 50 Mg Solr 1 Each Vial 1 $14,166.07 $14,166.07 $14,166.07 nat. median
$885
outlier · 16.0×
J9347
HCPCS 		Tremelimumab-actl 20 mg/mL Soln 15 Ml Vial 1 $11,782.64 $11,782.64 $11,782.64 nat. median
$974
outlier · 12.1×
J9144
HCPCS 		Daratumumab-hyaluronidase-fihj 1,800 Mg-30,000 Unit/15 Ml Soln 15 Ml Vial 1 $11,642.07 $11,642.07 $11,642.07 nat. median
$202
outlier · 57.6×
J3380
HCPCS 		Vedolizumab 300 Mg Solr 1 Each Vial 1 $10,873.84 $10,873.84 $10,873.84 nat. median
$150
outlier · 72.6×
J9316
HCPCS 		Pertuzumab-trastuzumab-hyaluronidase-zzxf 600 Mg-600 Mg- 20000 unit/10mL Soln 10… 1 $10,778.09 $10,778.09 $10,778.09 nat. median
$360
outlier · 29.9×
J9301
HCPCS 		Obinutuzumab 1,000 Mg/40 Ml Soln 40 Ml Vial 1 $10,007.71 $10,007.71 $10,007.71 nat. median
$272
outlier · 36.8×
J3101
HCPCS 		Tenecteplase 50 Mg Solr 1 Each Vial 1 $9,642.01 $9,642.01 $9,642.01 nat. median
$3,475
outlier · 2.8×
J1950
HCPCS 		Leuprolide (3 Month) 11.25 Mg Sykt 1 Each Kit 1 $2,012.26 $14,373.29 $9,520.68 nat. median
$3,885
outlier · 2.5×
J9022
HCPCS 		Atezolizumab 1,200 Mg/20 Ml (60 mg/mL) Soln 20 Ml Vial 1 $9,154.00 $9,154.00 $9,154.00 nat. median
$5,498
1.7× median
J9023
HCPCS 		Avelumab 20 mg/mL Soln 10 Ml Vial 1 $9,000.87 $9,000.87 $9,000.87 nat. median
$248
outlier · 36.3×
J0402
HCPCS 		ARIPiprazole ER (2 Month) 960 Mg/3.2 Ml Sers 3.2 Ml Syringe 1 $8,978.18 $8,978.18 $8,978.18 nat. median
$8
outlier · 1123.7×
J2353
HCPCS 		Octreotide,microspheres 20 Mg Serr 1 Each Vial 1 $7,134.95 $10,684.05 $8,909.50 nat. median
$5,513
1.6× median
J2406
HCPCS 		Oritavancin 1,200 Mg Solr 1 Each Vial 1 $8,248.69 $8,248.69 $8,248.69 nat. median
$59
outlier · 140.8×
J9303
HCPCS 		Panitumumab 400 Mg/20 Ml (20 mg/mL) Soln 20 Ml Vial 1 $8,024.07 $8,024.07 $8,024.07 nat. median
$1,725
outlier · 4.7×
J9311
HCPCS 		Rituximab-hyaluronidase,human 1400 Mg/11.7 Ml (120 mg/mL) Soln 11.7 Ml Vial 1 $7,647.40 $7,647.40 $7,647.40 nat. median
$1,789
outlier · 4.3×
J9354
HCPCS 		Ado-trastuzumab Emtansine 160 Mg Solr 1 Each Vial 1 $7,423.47 $7,423.47 $7,423.47 nat. median
$4,097
1.8× median
J1162
HCPCS 		Digoxin Immune Fab 40 Mg Solr 1 Each Vial 1 $7,392.60 $7,392.60 $7,392.60 nat. median
$7,100
1.0× median
J0717
HCPCS 		Certolizumab Pegol 400 Mg/2 Ml (200 mg/mL X 2) Sykt 1 Each Kit 1 $6,978.37 $6,978.37 $6,978.37 nat. median
$1,187
outlier · 5.9×
J9271
HCPCS 		Pembrolizumab 25 mg/mL Soln 4 Ml Vial 1 $6,726.42 $6,726.42 $6,726.42 nat. median
$254
outlier · 26.5×
22514
HCPCS 		Hchg Rad Kyphoplasty Lumbar 1 Level Including Guide 1 $6,720.14 $6,720.14 $6,720.14 nat. median
$8,313
0.8× median
22513
HCPCS 		Hchg Rad Kyphoplasty Thoracic Including Guide 1 $6,720.14 $6,720.14 $6,720.14 nat. median
$8,294
0.8× median
J1569
HCPCS 		Immune Globulin (human Igg) 10% (pf) 10 % Soln 300 Ml Vial 1 $6,096.01 $6,096.01 $6,096.01 nat. median
$1,010
outlier · 6.0×
J2182
HCPCS 		Mepolizumab 100 mg/mL Syrg 1 Ml Syringe 1 $5,872.49 $5,872.49 $5,872.49 nat. median
$2,559
outlier · 2.3×
J2802
HCPCS 		romiPLOStim 500 Mcg Solr 1 Each Vial 1 $5,829.60 $5,829.60 $5,829.60 nat. median
$2,750
outlier · 2.1×
J1944
HCPCS 		ARIPiprazole Lauroxil ER 1,064 Mg/3.9 Ml Sers 3.9 Ml Syringe 1 $5,760.15 $5,760.15 $5,760.15 nat. median
$1,821
outlier · 3.2×
J9057
HCPCS 		Copanlisib 60 Mg Solr 1 Each Vial 1 $5,649.89 $5,649.89 $5,649.89 nat. median
$217
outlier · 26.0×
J9312
HCPCS 		riTUXimab 10 mg/mL Conc 50 Ml Vial 1 $5,469.27 $5,469.27 $5,469.27 nat. median
$1,027
outlier · 5.3×
J9356
HCPCS 		Trastuzumab And Hyaluronidase-oysk 600 Mg-10,000 Unit/5 Ml Soln 5 Ml Vial 1 $5,443.37 $5,443.37 $5,443.37 nat. median
$130
outlier · 42.0×
J1437
HCPCS 		Ferric Derisomaltose 100 Mg iron/mL Soln 10 Ml Vial 1 $5,218.94 $5,218.94 $5,218.94 nat. median
$44
outlier · 117.9×
J9308
HCPCS 		Ramucirumab 10 mg/mL Soln 10 Ml Vial 1 $1,712.54 $8,467.40 $5,089.97 nat. median
$1,393
outlier · 3.7×
Q5115
HCPCS 		Rituximab-abbs 10 mg/mL Soln 50 Ml Vial 1 $4,924.64 $4,924.64 $4,924.64 nat. median
$801
outlier · 6.2×
J0630
HCPCS 		Calcitonin (salmon) 200 unit/mL Soln 2 Ml Vial 1 $4,840.97 $4,840.97 $4,840.97 nat. median
$1,889
outlier · 2.6×
J9217
HCPCS 		Leuprolide (1 Month) 7.5 Mg Sykt 1 Each Kit 1 $2,094.39 $14,241.13 $4,771.47 nat. median
$1,518
outlier · 3.1×
J9305
HCPCS 		PEMEtrexed Disodium 500 Mg Solr 1 Each Vial 1 $4,710.47 $4,710.47 $4,710.47 nat. median
$204
outlier · 23.1×
J3262
HCPCS 		Tocilizumab 20 mg/mL Soln 20 Ml Vial 1 $4,641.77 $4,641.77 $4,641.77 nat. median
$1,375
outlier · 3.4×
78452
HCPCS 		Hchg Rad Nm Cardiac Myocard Mult Spect Wwo Ef And Wm 1 $4,531.18 $4,531.18 $4,531.18 nat. median
$1,777
outlier · 2.6×
J2426
HCPCS 		Paliperidone Palmitate 156 mg/mL Syrg 1 Ml Syringe 1 $3,584.54 $5,376.68 $4,480.61 nat. median
$2,444
1.8× median
J0565
HCPCS 		Bezlotoxumab 25 mg/mL Soln 40 Ml Vial 1 $4,428.79 $4,428.79 $4,428.79 nat. median
$151
outlier · 29.3×
81455
HCPCS 		Hchg Ngs 50 Plus Genes 1 $4,356.66 $4,356.66 $4,356.66 nat. median
$2,934
1.5× median
Q5123
HCPCS 		Rituximab-arrx 10 mg/mL Soln 50 Ml Vial 1 $4,178.40 $4,178.40 $4,178.40 nat. median
$922
outlier · 4.5×
J1459
HCPCS 		Immune Globulin 10 % Soln 100 Ml Vial 1 $2,063.34 $13,620.60 $4,102.86 nat. median
$1,287
outlier · 3.2×
J0139
HCPCS 		Adalimumab 40 Mg/0.8 Ml Sykt 2 Each Kit 1 $4,036.18 $4,036.18 $4,036.18 nat. median
$3,072
1.3× median

Other procedures at this hospital

Browse this hospital's 1,473 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J9228 HCPCS Ipilimumab 200 Mg/40 Ml (5 mg/mL) Soln 40 Ml Vial 1 1 $63,952.72 $44,766.90 30% off $41,185.55 $41,185.55 $41,185.55 2026-08-01
J3357 HCPCS Ustekinumab 90 mg/mL Syrg 1 Ml Syringe 1 1 $50,154.13 $35,107.89 30% off $32,299.26 $32,299.26 $32,299.26 2026-08-01
J2350 HCPCS Ocrelizumab 30 mg/mL Soln 10 Ml Vial 1 1 $37,190.73 $26,033.51 30% off $23,950.83 $23,950.83 $23,950.83 2026-08-01
J9309 HCPCS Polatuzumab Vedotin-piiq 140 Mg Solr 1 Each Vial 1 1 $33,537.54 $23,476.28 30% off $21,598.18 $21,598.18 $21,598.18 2026-08-01
J9043 HCPCS Cabazitaxel 10 mg/mL (first Dilution) Soln 6 Ml Vial 1 1 $25,500.76 $17,850.53 30% off $16,422.49 $16,422.49 $16,422.49 2026-08-01
J1628 HCPCS Guselkumab 100 mg/mL Syrg 1 Ml Syringe 1 1 $25,008.04 $17,505.63 30% off $16,105.18 $16,105.18 $16,105.18 2026-08-01
0790 RC — 1 1 $24,920.00 $17,444.00 30% off $16,048.48 $16,048.48 $16,048.48 2026-08-01
J9173 HCPCS Durvalumab 50 mg/mL Soln 10 Ml Vial 1 1 $22,773.43 $15,941.40 30% off $14,666.09 $14,666.09 $14,666.09 2026-08-01
J9042 HCPCS Brentuximab Vedotin 50 Mg Solr 1 Each Vial 1 1 $21,997.00 $15,397.90 30% off $14,166.07 $14,166.07 $14,166.07 2026-08-01
J9347 HCPCS Tremelimumab-actl 20 mg/mL Soln 15 Ml Vial 1 1 $18,296.02 $12,807.21 30% off $11,782.64 $11,782.64 $11,782.64 2026-08-01
J9144 HCPCS Daratumumab-hyaluronidase-fihj 1,800 Mg-30,000 Unit/15 Ml Soln 15 Ml Vial 1 1 $18,077.75 $12,654.43 30% off $11,642.07 $11,642.07 $11,642.07 2026-08-01
J3380 HCPCS Vedolizumab 300 Mg Solr 1 Each Vial 1 1 $16,884.84 $11,819.39 30% off $10,873.84 $10,873.84 $10,873.84 2026-08-01
J9316 HCPCS Pertuzumab-trastuzumab-hyaluronidase-zzxf 600 Mg-600 Mg- 20000 unit/10mL Soln 10… 1 1 $16,736.17 $11,715.32 30% off $10,778.09 $10,778.09 $10,778.09 2026-08-01
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Soln 40 Ml Vial 1 1 $15,539.92 $10,877.94 30% off $10,007.71 $10,007.71 $10,007.71 2026-08-01
J3101 HCPCS Tenecteplase 50 Mg Solr 1 Each Vial 1 1 $14,972.07 $10,480.45 30% off $9,642.01 $9,642.01 $9,642.01 2026-08-01
J1950 HCPCS Leuprolide (3 Month) 11.25 Mg Sykt 1 Each Kit 4 1 $14,783.67 $10,348.57 30% off $2,012.26 $14,373.29 $9,520.68 2026-08-01
J9022 HCPCS Atezolizumab 1,200 Mg/20 Ml (60 mg/mL) Soln 20 Ml Vial 1 1 $14,214.29 $9,950.00 30% off $9,154.00 $9,154.00 $9,154.00 2026-08-01
J9023 HCPCS Avelumab 20 mg/mL Soln 10 Ml Vial 1 1 $13,976.50 $9,783.55 30% off $9,000.87 $9,000.87 $9,000.87 2026-08-01
J0402 HCPCS ARIPiprazole ER (2 Month) 960 Mg/3.2 Ml Sers 3.2 Ml Syringe 1 1 $13,941.28 $9,758.90 30% off $8,978.18 $8,978.18 $8,978.18 2026-08-01
J2353 HCPCS Octreotide,microspheres 20 Mg Serr 1 Each Vial 2 1 $13,834.63 $9,684.24 30% off $7,134.95 $10,684.05 $8,909.50 2026-08-01
J2406 HCPCS Oritavancin 1,200 Mg Solr 1 Each Vial 1 1 $12,808.52 $8,965.96 30% off $8,248.69 $8,248.69 $8,248.69 2026-08-01
J9303 HCPCS Panitumumab 400 Mg/20 Ml (20 mg/mL) Soln 20 Ml Vial 1 1 $12,459.73 $8,721.81 30% off $8,024.07 $8,024.07 $8,024.07 2026-08-01
J9311 HCPCS Rituximab-hyaluronidase,human 1400 Mg/11.7 Ml (120 mg/mL) Soln 11.7 Ml Vial 1 1 $11,874.84 $8,312.39 30% off $7,647.40 $7,647.40 $7,647.40 2026-08-01
J9354 HCPCS Ado-trastuzumab Emtansine 160 Mg Solr 1 Each Vial 1 1 $11,527.12 $8,068.98 30% off $7,423.47 $7,423.47 $7,423.47 2026-08-01
J1162 HCPCS Digoxin Immune Fab 40 Mg Solr 1 Each Vial 1 1 $11,479.20 $8,035.44 30% off $7,392.60 $7,392.60 $7,392.60 2026-08-01
J0717 HCPCS Certolizumab Pegol 400 Mg/2 Ml (200 mg/mL X 2) Sykt 1 Each Kit 1 1 $10,835.98 $7,585.19 30% off $6,978.37 $6,978.37 $6,978.37 2026-08-01
J9271 HCPCS Pembrolizumab 25 mg/mL Soln 4 Ml Vial 1 1 $10,444.75 $7,311.33 30% off $6,726.42 $6,726.42 $6,726.42 2026-08-01
22514 HCPCS Hchg Rad Kyphoplasty Lumbar 1 Level Including Guide 1 1 $10,435.00 $7,304.50 30% off $6,720.14 $6,720.14 $6,720.14 2026-08-01
22513 HCPCS Hchg Rad Kyphoplasty Thoracic Including Guide 1 1 $10,435.00 $7,304.50 30% off $6,720.14 $6,720.14 $6,720.14 2026-08-01
J1569 HCPCS Immune Globulin (human Igg) 10% (pf) 10 % Soln 300 Ml Vial 1 1 $9,465.85 $6,626.10 30% off $6,096.01 $6,096.01 $6,096.01 2026-08-01
J2182 HCPCS Mepolizumab 100 mg/mL Syrg 1 Ml Syringe 1 1 $9,118.78 $6,383.15 30% off $5,872.49 $5,872.49 $5,872.49 2026-08-01
J2802 HCPCS romiPLOStim 500 Mcg Solr 1 Each Vial 1 1 $9,052.18 $6,336.53 30% off $5,829.60 $5,829.60 $5,829.60 2026-08-01
J1944 HCPCS ARIPiprazole Lauroxil ER 1,064 Mg/3.9 Ml Sers 3.9 Ml Syringe 1 1 $8,944.34 $6,261.04 30% off $5,760.15 $5,760.15 $5,760.15 2026-08-01
J9057 HCPCS Copanlisib 60 Mg Solr 1 Each Vial 1 1 $8,773.12 $6,141.18 30% off $5,649.89 $5,649.89 $5,649.89 2026-08-01
J9312 HCPCS riTUXimab 10 mg/mL Conc 50 Ml Vial 1 1 $8,492.65 $5,944.86 30% off $5,469.27 $5,469.27 $5,469.27 2026-08-01
J9356 HCPCS Trastuzumab And Hyaluronidase-oysk 600 Mg-10,000 Unit/5 Ml Soln 5 Ml Vial 1 1 $8,452.44 $5,916.71 30% off $5,443.37 $5,443.37 $5,443.37 2026-08-01
J1437 HCPCS Ferric Derisomaltose 100 Mg iron/mL Soln 10 Ml Vial 1 1 $8,103.94 $5,672.76 30% off $5,218.94 $5,218.94 $5,218.94 2026-08-01
J9308 HCPCS Ramucirumab 10 mg/mL Soln 10 Ml Vial 2 1 $7,903.68 $5,532.58 30% off $1,712.54 $8,467.40 $5,089.97 2026-08-01
Q5115 HCPCS Rituximab-abbs 10 mg/mL Soln 50 Ml Vial 1 1 $7,646.95 $5,352.87 30% off $4,924.64 $4,924.64 $4,924.64 2026-08-01
J0630 HCPCS Calcitonin (salmon) 200 unit/mL Soln 2 Ml Vial 1 1 $7,517.04 $5,261.93 30% off $4,840.97 $4,840.97 $4,840.97 2026-08-01
J9217 HCPCS Leuprolide (1 Month) 7.5 Mg Sykt 1 Each Kit 8 1 $7,409.11 $5,186.38 30% off $2,094.39 $14,241.13 $4,771.47 2026-08-01
J9305 HCPCS PEMEtrexed Disodium 500 Mg Solr 1 Each Vial 1 1 $7,314.40 $5,120.08 30% off $4,710.47 $4,710.47 $4,710.47 2026-08-01
J3262 HCPCS Tocilizumab 20 mg/mL Soln 20 Ml Vial 1 1 $7,207.71 $5,045.40 30% off $4,641.77 $4,641.77 $4,641.77 2026-08-01
78452 HCPCS Hchg Rad Nm Cardiac Myocard Mult Spect Wwo Ef And Wm 1 1 $7,036.00 $4,925.20 30% off $4,531.18 $4,531.18 $4,531.18 2026-08-01
J2426 HCPCS Paliperidone Palmitate 156 mg/mL Syrg 1 Ml Syringe 2 1 $6,957.47 $4,870.23 30% off $3,584.54 $5,376.68 $4,480.61 2026-08-01
J0565 HCPCS Bezlotoxumab 25 mg/mL Soln 40 Ml Vial 1 1 $6,877.00 $4,813.90 30% off $4,428.79 $4,428.79 $4,428.79 2026-08-01
81455 HCPCS Hchg Ngs 50 Plus Genes 1 1 $6,765.00 $4,735.50 30% off $4,356.66 $4,356.66 $4,356.66 2026-08-01
Q5123 HCPCS Rituximab-arrx 10 mg/mL Soln 50 Ml Vial 1 1 $6,488.20 $4,541.74 30% off $4,178.40 $4,178.40 $4,178.40 2026-08-01
J1459 HCPCS Immune Globulin 10 % Soln 100 Ml Vial 3 1 $6,370.90 $4,459.63 30% off $2,063.34 $13,620.60 $4,102.86 2026-08-01
J0139 HCPCS Adalimumab 40 Mg/0.8 Ml Sykt 2 Each Kit 1 1 $6,267.36 $4,387.15 30% off $4,036.18 $4,036.18 $4,036.18 2026-08-01
J0401 HCPCS ARIPiprazole 300 Mg Serr 1 Each Vial 4 1 $5,997.81 $4,198.47 30% off $3,268.76 $4,489.11 $3,862.59 2026-08-01
J9047 HCPCS Carfilzomib 60 Mg Solr 60 Mg Vial 1 1 $5,932.36 $4,152.65 30% off $3,820.44 $3,820.44 $3,820.44 2026-08-01
J9400 HCPCS Ziv-aflibercept 200 Mg/8 Ml (25 mg/mL) Soln 8 Ml Vial 1 1 $5,797.00 $4,057.90 30% off $3,733.27 $3,733.27 $3,733.27 2026-08-01
J9035 HCPCS Bevacizumab 25 mg/mL Soln 16 Ml Vial 1 1 $5,774.97 $4,042.48 30% off $3,719.08 $3,719.08 $3,719.08 2026-08-01
J9299 HCPCS Nivolumab 100 Mg/10 Ml Soln 10 Ml Vial 3 1 $5,762.97 $4,034.08 30% off $1,498.85 $8,873.90 $3,711.35 2026-08-01
J0897 HCPCS Denosumab 120 Mg/1.7 Ml (70 mg/mL) Soln 1.7 Ml Vial 2 1 $5,568.57 $3,897.99 30% off $2,094.29 $5,078.02 $3,586.16 2026-08-01
J1566 HCPCS Immune Globulin 10% 10 Gram Solr 1 Each Vial 1 1 $5,499.88 $3,849.92 30% off $3,541.92 $3,541.92 $3,541.92 2026-08-01
95810 HCPCS Hchg Polysomnography => 6yrs =>4 Parameters 1 1 $5,349.00 $3,744.30 30% off $3,444.76 $3,444.76 $3,444.76 2026-08-01
95811 HCPCS Hchg Polysomnography => 6yrs =>4 Parameters W Cpap Or Bilevel 1 1 $5,349.00 $3,744.30 30% off $3,444.76 $3,444.76 $3,444.76 2026-08-01
Q5107 HCPCS Bevacizumab-awwb 25 mg/mL Soln 16 Ml Vial 1 1 $5,060.61 $3,542.43 30% off $3,259.03 $3,259.03 $3,259.03 2026-08-01
J9145 HCPCS Daratumumab 20 mg/mL Soln 20 Ml Vial 1 1 $4,853.80 $3,397.66 30% off $3,125.85 $3,125.85 $3,125.85 2026-08-01
70546 HCPCS Hchg Rad MRI Angio Head Brain Wwo 1 1 $4,780.00 $3,346.00 30% off $3,078.32 $3,078.32 $3,078.32 2026-08-01
70549 HCPCS Hchg Rad MRI Angio Neck Wwo 1 1 $4,780.00 $3,346.00 30% off $3,078.32 $3,078.32 $3,078.32 2026-08-01
22511 HCPCS Hchg Xr Vertebroplasty Lumbar 1 1 $4,733.00 $3,313.10 30% off $3,048.05 $3,048.05 $3,048.05 2026-08-01
J9317 HCPCS Sacituzumab Govitecan-hziy 180 Mg Solr 1 Each Vial 1 1 $4,560.84 $3,192.59 30% off $2,937.18 $2,937.18 $2,937.18 2026-08-01
81277 HCPCS Hchg Cma Tumor 1 1 $4,513.00 $3,159.10 30% off $2,906.37 $2,906.37 $2,906.37 2026-08-01
75574 HCPCS Hchg Rad CT Angio Heart Coronary Arteries 1 1 $4,468.00 $3,127.60 30% off $2,877.39 $2,877.39 $2,877.39 2026-08-01
Q5118 HCPCS Bevacizumab-bvzr 25 mg/mL Soln 16 Ml Vial 1 1 $4,453.48 $3,117.44 30% off $2,868.04 $2,868.04 $2,868.04 2026-08-01
70543 HCPCS Hchg Rad MRI Neck Soft Tissue Orbit Face Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
72127 HCPCS Hchg Rad CT Spine Cervical Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
74183 HCPCS Hchg Rad MRI Abdomen Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
72156 HCPCS Hchg Rad MRI Spine Cervical Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
C8914 HCPCS Hchg Rad Mr Angio Lower Extremity Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
73220 HCPCS Hchg Rad MRI Non Joint Upper Extremity Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
73202 HCPCS Hchg Rad CT Upper Extremity Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
70553 HCPCS Hchg Rad MRI Head Brain Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
72197 HCPCS Hchg Rad MRI Pelvis Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
72157 HCPCS Hchg Rad MRI Spine Thoracic Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
73223 HCPCS Hchg Rad MRI Joint Of Upper Extremity Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
72158 HCPCS Hchg Rad MRI Spine Lumbar Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
73723 HCPCS Hchg Rad MRI Joint Of Lower Extremity Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
71552 HCPCS Hchg Rad MRI Chest Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
C8902 HCPCS Hchg Rad Mr Angio Abdomen Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
73720 HCPCS Hchg Rad MRI Non Joint Lower Extremity Wwo 1 1 $4,434.00 $3,103.80 30% off $2,855.50 $2,855.50 $2,855.50 2026-08-01
0722 RC — 3 1 $4,228.00 $2,959.60 30% off $1,996.40 $3,484.04 $2,722.83 2026-08-01
0720 RC — 3 1 $4,228.00 $2,959.60 30% off $2,395.68 $3,048.70 $2,722.83 2026-08-01
J2997 HCPCS Alteplase 2 Mg Solr 1 Each Vial 2 1 $4,219.36 $2,953.55 30% off $310.02 $5,124.52 $2,717.27 2026-08-01
C8900 HCPCS Hchg Rad Mr Angio Abdomen W 1 1 $4,093.00 $2,865.10 30% off $2,635.89 $2,635.89 $2,635.89 2026-08-01
70545 HCPCS Hchg Rad MRI Angio Head W 1 1 $4,092.00 $2,864.40 30% off $2,635.25 $2,635.25 $2,635.25 2026-08-01
73222 HCPCS Hchg Rad MRI Joint Of Upper Extremity W 1 1 $4,092.00 $2,864.40 30% off $2,635.25 $2,635.25 $2,635.25 2026-08-01
72149 HCPCS Hchg Rad MRI Spine Lumbar W 1 1 $4,092.00 $2,864.40 30% off $2,635.25 $2,635.25 $2,635.25 2026-08-01
72196 HCPCS Hchg Rad MRI Pelvis W 1 1 $4,092.00 $2,864.40 30% off $2,635.25 $2,635.25 $2,635.25 2026-08-01
73722 HCPCS Hchg Rad MRI Joint Of Lower Extremity W 1 1 $4,092.00 $2,864.40 30% off $2,635.25 $2,635.25 $2,635.25 2026-08-01
70552 HCPCS Hchg Rad MRI Head Brain W 1 1 $4,092.00 $2,864.40 30% off $2,635.25 $2,635.25 $2,635.25 2026-08-01
J2315 HCPCS Naltrexone ER 380 Mg Serr 1 Each Kit 1 1 $4,056.82 $2,839.77 30% off $2,612.59 $2,612.59 $2,612.59 2026-08-01
74178 HCPCS Hchg Rad CT Abdomen Pelvis Wwo 1 1 $4,028.00 $2,819.60 30% off $2,594.03 $2,594.03 $2,594.03 2026-08-01
81445 HCPCS Hchg Ngs 5-50 Genes 1 1 $4,020.00 $2,814.00 30% off $2,588.88 $2,588.88 $2,588.88 2026-08-01
75635 HCPCS Hchg Rad CT Angio Abdomen Pelvis Lower Extremity Runoff 1 1 $3,995.00 $2,796.50 30% off $2,572.78 $2,572.78 $2,572.78 2026-08-01
74181 HCPCS Hchg Rad MRI Abdomen Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
73721 HCPCS Hchg Rad MRI Joint Lower Extremity Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
73218 HCPCS Hchg Rad MRI Non Joint Upper Extremity Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
73221 HCPCS Hchg Rad MRI Joint Of Upper Extremity Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
73718 HCPCS Hchg Rad MRI Lower Extremity Non Joint Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
72195 HCPCS Hchg Rad MRI Pelvis Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
70551 HCPCS Hchg Rad MRI Head Brain Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
72146 HCPCS Hchg Rad MRI Spine Thoracic Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
72141 HCPCS Hchg Rad MRI Spine Cervical Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
70547 HCPCS Hchg Rad MRI Angio Neck Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
71550 HCPCS Hchg Rad MRI Chest Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
70540 HCPCS Hchg Rad MRI Neck Soft Tissue Orbit Face Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
72148 HCPCS Hchg Rad MRI Spine Lumbar Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
70544 HCPCS Hchg Rad MRI Angio Head Wo 1 1 $3,988.00 $2,791.60 30% off $2,568.27 $2,568.27 $2,568.27 2026-08-01
J1439 HCPCS Ferric Carboxymaltose 50 Mg iron/mL Soln 15 Ml Vial 1 1 $3,681.48 $2,577.04 30% off $2,370.87 $2,370.87 $2,370.87 2026-08-01
J3358 HCPCS Ustekinumab 130 Mg/26 Ml Soln 26 Ml Vial 1 1 $3,681.12 $2,576.78 30% off $2,370.64 $2,370.64 $2,370.64 2026-08-01
722 OTHER Hchg Delivery Level C Affiliate Only 2 2 $4,975.00 $3,482.50 30% off $1,949.60 $2,730.23 $2,339.91 2026-07-31
J0129 HCPCS Abatacept 250 Mg Solr 1 Each Vial 1 1 $3,632.80 $2,542.96 30% off $2,339.52 $2,339.52 $2,339.52 2026-08-01
J7327 HCPCS Hyaluronate Sodium, Stabilized 88 Mg/4 Ml Syrg 4 Ml Syringe 1 1 $3,600.00 $2,520.00 30% off $2,318.40 $2,318.40 $2,318.40 2026-08-01
74177 HCPCS Hchg Rad CT Abdomen Pelvis W 1 1 $3,572.00 $2,500.40 30% off $2,300.37 $2,300.37 $2,300.37 2026-08-01
78451 HCPCS Hchg Rad Nm Myocard Spect Single Study Rest Or Stress 1 1 $3,521.00 $2,464.70 30% off $2,267.52 $2,267.52 $2,267.52 2026-08-01
J7325 HCPCS Hylan G-f 20 48 Mg/6 Ml Syrg 6 Ml Syringe 1 1 $3,287.08 $2,300.96 30% off $2,116.88 $2,116.88 $2,116.88 2026-08-01
78306 HCPCS Hchg Rad Nm Bone Scan Whole Body 1 1 $3,268.00 $2,287.60 30% off $2,104.59 $2,104.59 $2,104.59 2026-08-01
70492 HCPCS Hchg Rad CT Neck Soft Tissue Wwo 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
70482 HCPCS Hchg Rad CT Orbits Or Temporal Bones Wwo 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
70488 HCPCS Hchg Rad CT Facial Bones And Sinus Wwo 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
71270 HCPCS Hchg Rad CT Chest Wwo Contrast Diagnostic 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
72194 HCPCS Hchg Rad CT Pelvis Wwo 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
72133 HCPCS Hchg Rad CT Spine Lumbar Wwo 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
73702 HCPCS Hchg Rad CT Lower Extremity Wwo 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
70470 HCPCS Hchg Rad CT Head Brain Wwo 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
74170 HCPCS Hchg Rad CT Abdomen Wwo 1 1 $3,256.00 $2,279.20 30% off $2,096.86 $2,096.86 $2,096.86 2026-08-01
0200 RC — 1 1 $3,238.00 $2,266.60 30% off $2,085.27 $2,085.27 $2,085.27 2026-08-01
49406 HCPCS Hchg CT Drain Abscess Peritoneal Perc Inc Guide 1 1 $3,236.00 $2,265.20 30% off $2,083.98 $2,083.98 $2,083.98 2026-08-01
70486 HCPCS Hchg Rad CT Facial Bones And Sinus Wo 1 1 $3,149.00 $2,204.30 30% off $2,027.96 $2,027.96 $2,027.96 2026-08-01
72125 HCPCS Hchg Rad CT Spine Cervical Wo 1 1 $3,149.00 $2,204.30 30% off $2,027.96 $2,027.96 $2,027.96 2026-08-01
99291 HCPCS Hchg Ed Critical Care Level Vi 1 1 $3,140.00 $2,198.00 30% off $2,022.16 $2,022.16 $2,022.16 2026-08-01
920 OTHER Hchg Fetal Non-stress Test 11 4 $4,919.00 $3,443.30 30% off $292.42 $4,112.74 $2,015.58 2026-07-31
J1561 HCPCS Immune Globulin 10% 10 Gram/100 Ml (10 %) Soln 100 Ml Vial 2 1 $3,117.32 $2,182.13 30% off $1,716.26 $2,298.85 $2,007.55 2026-08-01
J0585 HCPCS onabotulinumtoxinA 200 Unit Solr 1 Each Vial 1 1 $3,100.80 $2,170.56 30% off $1,996.92 $1,996.92 $1,996.92 2026-08-01
J1301 HCPCS Edaravone 30 Mg/100 Ml Soln 100 Ml Bag 1 1 $3,091.00 $2,163.70 30% off $1,990.60 $1,990.60 $1,990.60 2026-08-01
73706 HCPCS Hchg Rad CT Angio Lower Extremity 1 1 $3,040.00 $2,128.00 30% off $1,957.76 $1,957.76 $1,957.76 2026-08-01
J1451 HCPCS Fomepizole 1 gram/mL Soln 1.5 Ml Vial 2 1 $3,032.16 $2,122.51 30% off $1,587.02 $2,318.40 $1,952.71 2026-08-01
78315 HCPCS Hchg Rad Nm Bone Scan 3 Phase 1 1 $3,029.00 $2,120.30 30% off $1,950.68 $1,950.68 $1,950.68 2026-08-01
74176 HCPCS Hchg Rad CT Abdomen Pelvis Wo 1 1 $2,963.00 $2,074.10 30% off $1,908.17 $1,908.17 $1,908.17 2026-08-01
C8928 HCPCS (ia) Hchg Stress Echo 2d Exercise W Contrast 1 1 $2,955.00 $2,068.50 30% off $1,903.02 $1,903.02 $1,903.02 2026-08-01
C8929 HCPCS Hchg Echo 2d Comp W Cont-spectral-color 1 1 $2,955.00 $2,068.50 30% off $1,903.02 $1,903.02 $1,903.02 2026-08-01
78305 HCPCS Hchg Rad Nm Bone Scan Multiple Areas 1 1 $2,942.00 $2,059.40 30% off $1,894.65 $1,894.65 $1,894.65 2026-08-01
74175 HCPCS Hchg Rad CT Angio Abdomen 1 1 $2,934.00 $2,053.80 30% off $1,889.50 $1,889.50 $1,889.50 2026-08-01
74174 HCPCS Hchg Rad CT Angio Abdomen Pelvis 1 1 $2,934.00 $2,053.80 30% off $1,889.50 $1,889.50 $1,889.50 2026-08-01
70498 HCPCS Hchg Rad CT Angio Neck W Contrast 1 1 $2,934.00 $2,053.80 30% off $1,889.50 $1,889.50 $1,889.50 2026-08-01
70496 HCPCS Hchg Rad CT Angio Head W Contrast 1 1 $2,934.00 $2,053.80 30% off $1,889.50 $1,889.50 $1,889.50 2026-08-01
J9041 HCPCS Bortezomib 3.5 Mg Solr 1 Each Vial 1 1 $2,922.40 $2,045.68 30% off $1,882.03 $1,882.03 $1,882.03 2026-08-01
J9048 HCPCS Bortezomib 1 mg/mL Solr 1 Each Vial 1 1 $2,922.37 $2,045.66 30% off $1,882.01 $1,882.01 $1,882.01 2026-08-01
J7298 HCPCS Levonorgestrel 21 Mcg/24 Hours (8 Yrs) 52 Mg IUD 1 Each Box 1 1 $2,915.12 $2,040.58 30% off $1,877.34 $1,877.34 $1,877.34 2026-08-01
J7296 HCPCS Levonorgestrel 17.5 Mcg/24 Hr (5 Yrs) 19.5 Mg IUD 1 Each Box 1 1 $2,915.12 $2,040.58 30% off $1,877.34 $1,877.34 $1,877.34 2026-08-01
78014 HCPCS Hchg Rad Nm Thyroid Uptake W Flow Quantitative Measure 1 1 $2,871.00 $2,009.70 30% off $1,848.92 $1,848.92 $1,848.92 2026-08-01
78012 HCPCS Hchg Rad Nm Thyroid Uptake Single Multiple Quant Measure 1 1 $2,871.00 $2,009.70 30% off $1,848.92 $1,848.92 $1,848.92 2026-08-01
95805 HCPCS Hchg Multiple Sleep Latency Test (mslt) (mwt) 1 1 $2,845.00 $1,991.50 30% off $1,832.18 $1,832.18 $1,832.18 2026-08-01
J9355 HCPCS Trastuzumab 150 Mg Solr 1 Each Vial 1 1 $2,842.15 $1,989.51 30% off $1,830.34 $1,830.34 $1,830.34 2026-08-01
78803 HCPCS Hchg Rad Nm Oncology Spect Single Area Or Acquisition 1 1 $2,840.00 $1,988.00 30% off $1,828.96 $1,828.96 $1,828.96 2026-08-01
78579 HCPCS Hchg Rad Nm Lung Ventilation Scan 1 1 $2,840.00 $1,988.00 30% off $1,828.96 $1,828.96 $1,828.96 2026-08-01
78597 HCPCS Hchg Rad Nm Lung Perfusion Only Quantitative 1 1 $2,840.00 $1,988.00 30% off $1,828.96 $1,828.96 $1,828.96 2026-08-01
78580 HCPCS Hchg Rad Nm Lung Perfusion Scan 1 1 $2,840.00 $1,988.00 30% off $1,828.96 $1,828.96 $1,828.96 2026-08-01
78598 HCPCS Hchg Rad Nm Lung Ventilation And Perfusion Quantitative 1 1 $2,840.00 $1,988.00 30% off $1,828.96 $1,828.96 $1,828.96 2026-08-01
78582 HCPCS Hchg Rad Nm Lung Ventilation And Perfusion Scan 1 1 $2,840.00 $1,988.00 30% off $1,828.96 $1,828.96 $1,828.96 2026-08-01
J0881 HCPCS Darbepoetin Alfa 200 mcg/mL Soln 1 Ml Vial 3 1 $2,823.40 $1,976.38 30% off $502.35 $4,509.93 $1,818.27 2026-08-01
81194 HCPCS Hchg Focus Ntrk Ngs 1 1 $2,809.00 $1,966.30 30% off $1,809.00 $1,809.00 $1,809.00 2026-08-01
73206 HCPCS Hchg Rad CT Angio Upper Extremity 1 1 $2,790.00 $1,953.00 30% off $1,796.76 $1,796.76 $1,796.76 2026-08-01
71275 HCPCS Hchg Rad CT Angio Chest 1 1 $2,790.00 $1,953.00 30% off $1,796.76 $1,796.76 $1,796.76 2026-08-01
J7326 HCPCS Hyaluronate Sod, Cross-linked 30 Mg/3 Ml Syrg 3 Ml Syringe 1 1 $2,760.00 $1,932.00 30% off $1,777.44 $1,777.44 $1,777.44 2026-08-01
78300 HCPCS Hchg Rad Nm Bone Scan Limited Area 1 1 $2,745.00 $1,921.50 30% off $1,767.78 $1,767.78 $1,767.78 2026-08-01
78264 HCPCS Hchg Rad Nm Gastric Emptying 1 1 $2,735.00 $1,914.50 30% off $1,761.34 $1,761.34 $1,761.34 2026-08-01
78265 HCPCS Hchg Rad Nm Gastric Emptying W Small Bowel 1 1 $2,735.00 $1,914.50 30% off $1,761.34 $1,761.34 $1,761.34 2026-08-01
78815 HCPCS Hchg Rad PET CT Skull Base To Mid Thigh Initial Treat 1 1 $2,713.00 $1,899.10 30% off $1,747.17 $1,747.17 $1,747.17 2026-08-01
78816 HCPCS Hchg Rad PET CT Whole Body Initial Treat 1 1 $2,713.00 $1,899.10 30% off $1,747.17 $1,747.17 $1,747.17 2026-08-01
93306 HCPCS Hchg Echo 2d Comp Wo Cont W Spectral-color 1 1 $2,694.00 $1,885.80 30% off $1,734.94 $1,734.94 $1,734.94 2026-08-01
93307 HCPCS Hchg Rad Echo Transthorac R-t 2d W/wo M-mode Rec Complete 1 1 $2,694.00 $1,885.80 30% off $1,734.94 $1,734.94 $1,734.94 2026-08-01
73701 HCPCS Hchg Rad CT Lower Extremity W 1 1 $2,647.00 $1,852.90 30% off $1,704.67 $1,704.67 $1,704.67 2026-08-01
21920 HCPCS Hchg Rad Biopsy Back Soft Tissue Superficial 1 1 $2,602.00 $1,821.40 30% off $1,675.69 $1,675.69 $1,675.69 2026-08-01
21550 HCPCS Hchg CT Biopsy Soft Tissue Neck Or Chest 1 1 $2,602.00 $1,821.40 30% off $1,675.69 $1,675.69 $1,675.69 2026-08-01
J2357 HCPCS Omalizumab 150 mg/mL Syrg 1 Ml Syringe 1 1 $2,586.01 $1,810.21 30% off $1,665.39 $1,665.39 $1,665.39 2026-08-01
J9179 HCPCS eriBULin 1 Mg/2 Ml (0.5 mg/mL) Soln 2 Ml Vial 1 1 $2,575.00 $1,802.50 30% off $1,658.30 $1,658.30 $1,658.30 2026-08-01
J1568 HCPCS Immune Globulin 5% 5 % Soln 100 Ml Vial 2 1 $2,558.57 $1,791.01 30% off $1,106.42 $2,189.02 $1,647.72 2026-08-01
74160 HCPCS Hchg Rad CT Abdomen W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
70491 HCPCS Hchg Rad CT Neck Soft Tissue W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
70487 HCPCS Hchg Rad CT Facial Bones And Sinus W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
70481 HCPCS Hchg Rad CT Orbits Or Temporal Bones W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
70460 HCPCS Hchg Rad CT Head Brain W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
73201 HCPCS Hchg Rad CT Upper Extremity W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
72193 HCPCS Hchg Rad CT Pelvis W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
72191 HCPCS Hchg Rad CT Angio Pelvis 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
72132 HCPCS Hchg Rad CT Spine Lumbar Or Sacrum W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
72129 HCPCS Hchg Rad CT Spine Thoracic W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
72126 HCPCS Hchg Rad CT Spine Cervical W 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
71260 HCPCS Hchg Rad CT Chest W Contrast Diagnostic 1 1 $2,541.00 $1,778.70 30% off $1,636.40 $1,636.40 $1,636.40 2026-08-01
C8930 HCPCS (ia) Hchg Rad Stress Echo 2d Exercise W Stress Test W Contrast 1 1 $2,539.00 $1,777.30 30% off $1,635.12 $1,635.12 $1,635.12 2026-08-01
J9202 HCPCS Goserelin 3.6 Mg Impl 1 Each Syringe 1 1 $2,523.36 $1,766.35 30% off $1,625.04 $1,625.04 $1,625.04 2026-08-01
611 OTHER Rad Mr Head Brain Wo 8 4 $3,872.50 $2,710.75 30% off $1,312.56 $2,106.50 $1,616.47 2026-07-31
610 OTHER Rad Mr Angio Head Wo 35 4 $4,078.00 $2,854.60 30% off $381.75 $2,862.09 $1,598.76 2026-07-31
75571 HCPCS Hchg Rad CT Cardiac Calcium Scoring Wo 1 1 $2,433.00 $1,703.10 30% off $1,566.85 $1,566.85 $1,566.85 2026-08-01
J7301 HCPCS Levonorgestrel 14 Mcg/24 Hr (3 Yrs) 13.5 Mg IUD 1 Each Kit 1 1 $2,427.32 $1,699.12 30% off $1,563.19 $1,563.19 $1,563.19 2026-08-01
J7168 HCPCS Prothrombin Cplx (pcc) 500 Unit (400-620 Unit) Solr 500 Unit Vial 1 1 $2,392.00 $1,674.40 30% off $1,540.45 $1,540.45 $1,540.45 2026-08-01
20206 HCPCS Hchg Rad Biopsy Muscle Percutaneous Needle 1 1 $2,385.00 $1,669.50 30% off $1,535.94 $1,535.94 $1,535.94 2026-08-01
38505 HCPCS Hchg CT Biopsy Lymph Node 1 1 $2,375.00 $1,662.50 30% off $1,529.50 $1,529.50 $1,529.50 2026-08-01
38221 HCPCS Hchg Rad Diagnostic Bone Marrow Biopsies 1 1 $2,375.00 $1,662.50 30% off $1,529.50 $1,529.50 $1,529.50 2026-08-01
32408 HCPCS Hchg CT Core Needle Bx Lung/mediastinum Perq W/img 1 1 $2,375.00 $1,662.50 30% off $1,529.50 $1,529.50 $1,529.50 2026-08-01
93350 HCPCS (ia) Hchg Stress Echo 2d Exercise Wo Contrast 1 1 $2,362.00 $1,653.40 30% off $1,521.13 $1,521.13 $1,521.13 2026-08-01
93351 HCPCS (ia) Hchg Stress Echo 2d Exercise W Stress Test Wo Contrast 1 1 $2,362.00 $1,653.40 30% off $1,521.13 $1,521.13 $1,521.13 2026-08-01
27041 HCPCS Hchg CT Biopsy Soft Tissue Pelvis And Hip Deep 1 1 $2,344.00 $1,640.80 30% off $1,509.54 $1,509.54 $1,509.54 2026-08-01
78709 HCPCS Hchg Rad Nm Renal Multi Wwo Pharm 1 1 $2,326.00 $1,628.20 30% off $1,497.94 $1,497.94 $1,497.94 2026-08-01
0750 RC — 5 1 $2,321.00 $1,624.70 30% off $347.12 $2,301.66 $1,494.72 2026-08-01
78070 HCPCS Hchg Rad Nm Parathyroid Scan 1 1 $2,294.00 $1,605.80 30% off $1,477.34 $1,477.34 $1,477.34 2026-08-01
Q2050 HCPCS DOXOrubicin, Peg-liposomal 2 mg/mL Susp 25 Ml Vial 1 1 $2,287.00 $1,600.90 30% off $1,472.83 $1,472.83 $1,472.83 2026-08-01
81229 HCPCS Hchg Cma Congenital Blood 2 1 $2,227.50 $1,559.25 30% off $966.00 $1,903.02 $1,434.51 2026-08-01
J2794 HCPCS risperiDONE Microspheres 25 Mg/2 Ml Serr 1 Each Vial 3 1 $2,212.52 $1,548.76 30% off $949.86 $1,899.86 $1,424.86 2026-08-01
J9055 HCPCS Cetuximab 100 Mg/50 Ml Soln 50 Ml Vial 2 1 $2,208.02 $1,545.62 30% off $955.92 $1,888.01 $1,421.96 2026-08-01
74150 HCPCS Hchg Rad CT Abdomen Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
70490 HCPCS Hchg Rad CT Neck Soft Tissue Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
73700 HCPCS Hchg Rad CT Lower Extremity Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
70480 HCPCS Hchg Rad CT Orbits Or Temporal Bones Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
70450 HCPCS Hchg Rad CT Head Brain Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
72192 HCPCS Hchg Rad CT Pelvis Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
72131 HCPCS Hchg Rad CT Spine Lumbar Or Sacrum Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
72128 HCPCS Hchg Rad CT Spine Thoracic Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
71271 HCPCS Hchg Rad CT Thorax Low Dose Lung Cancer Screen Wo 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
71250 HCPCS Hchg Rad CT Chest Wo Contrast Diagnostic 1 1 $2,181.00 $1,526.70 30% off $1,404.56 $1,404.56 $1,404.56 2026-08-01
73200 HCPCS Hchg Rad CT Upper Extremity Wo 1 1 $2,179.00 $1,525.30 30% off $1,403.28 $1,403.28 $1,403.28 2026-08-01
90376 HCPCS Rabies Immune Globulin 150 units/mL (pf) 150 unit/mL Soln 2 Ml Vial 1 1 $2,172.32 $1,520.62 30% off $1,398.97 $1,398.97 $1,398.97 2026-08-01
J7336 HCPCS Capsaicin-skin Cleanser 8 % Kit 1 Each Kit 1 1 $2,154.40 $1,508.08 30% off $1,387.43 $1,387.43 $1,387.43 2026-08-01
J1745 HCPCS inFLIXimab 100 Mg Solr 1 Each Vial 1 1 $2,139.07 $1,497.35 30% off $1,377.56 $1,377.56 $1,377.56 2026-08-01
A0434 HCPCS Hchg Amb Owned Specialty Care Transport 1 1 $2,105.00 $1,473.50 30% off $1,355.62 $1,355.62 $1,355.62 2026-08-01
78708 HCPCS Hchg Rad Nm Renal Single W Pharm 1 1 $2,060.00 $1,442.00 30% off $1,326.64 $1,326.64 $1,326.64 2026-08-01
J1454 HCPCS Fosnetupitant-palonosetron 235 Mg-0.25 Mg Soln 20 Ml Vial 2 1 $2,027.15 $1,419.01 30% off $1,291.06 $1,319.91 $1,305.49 2026-08-01
77012 HCPCS Hchg Rad CT Guided Needle Placement 1 1 $1,954.00 $1,367.80 30% off $1,258.38 $1,258.38 $1,258.38 2026-08-01
A0433 HCPCS Hchg Amb Owned Als Level 2 1 1 $1,900.00 $1,330.00 30% off $1,223.60 $1,223.60 $1,223.60 2026-08-01
19083 HCPCS Hchg Rad Biopsy Breast Inc Marker 1st Lesion W US Guide 1 1 $1,881.00 $1,316.70 30% off $1,211.36 $1,211.36 $1,211.36 2026-08-01
99285 HCPCS Ed Lvl 5 Hchg 1 1 $1,870.00 $1,309.00 30% off $1,204.28 $1,204.28 $1,204.28 2026-08-01
J9155 HCPCS Degarelix 120 Mg Solr 2 Each Kit 2 1 $1,848.37 $1,293.86 30% off $590.04 $1,790.66 $1,190.35 2026-08-01
391 OTHER Hchg Blood/blood Product Admin Per Unit 3 3 $1,419.00 $993.30 30% off $709.03 $1,886.44 $1,186.09 2026-07-31
0172 RC — 1 1 $1,811.00 $1,267.70 30% off $1,166.28 $1,166.28 $1,166.28 2026-08-01
49450 HCPCS Hchg Xr Replacement Gastrostomy Or Cecostomy Tube 1 1 $1,783.00 $1,248.10 30% off $1,148.25 $1,148.25 $1,148.25 2026-08-01
32551 HCPCS Hchg CT Chest Tube Placement 1 1 $1,783.00 $1,248.10 30% off $1,148.25 $1,148.25 $1,148.25 2026-08-01
49999 HCPCS Hchg Rad Unlisted Abdomen Peritoneum & Omentum Procedure 1 1 $1,781.00 $1,246.70 30% off $1,146.96 $1,146.96 $1,146.96 2026-08-01
350 OTHER Rad CT Angio Heart Coronary Arteries 4 2 $2,953.00 $2,067.10 30% off $305.40 $1,683.78 $1,145.93 2026-07-31
A0427 HCPCS Hchg Amb Owned Als Emerg Transp Level 1 1 1 $1,756.00 $1,229.20 30% off $1,130.86 $1,130.86 $1,130.86 2026-08-01
J0894 HCPCS Decitabine 5 mg/mL Solr 1 Each Vial 1 1 $1,747.00 $1,222.90 30% off $1,125.07 $1,125.07 $1,125.07 2026-08-01
G0260 HCPCS Hchg CT Inj Sacroiliac Joint 2 1 $1,739.50 $1,217.65 30% off $784.39 $1,456.08 $1,120.23 2026-08-01
78226 HCPCS Hchg Rad Nm Hepatobiliary 1 1 $1,725.00 $1,207.50 30% off $1,110.90 $1,110.90 $1,110.90 2026-08-01
78227 HCPCS Hchg Rad Nm Hepatobiliary W Pharm Intervention 1 1 $1,725.00 $1,207.50 30% off $1,110.90 $1,110.90 $1,110.90 2026-08-01
J1212 HCPCS Dimethyl Sulfoxide 50 % Soln 50 Ml Bottle 1 1 $1,705.00 $1,193.50 30% off $1,098.02 $1,098.02 $1,098.02 2026-08-01
341 OTHER Rad Nm Cardiac Myocard Mult Spect Wwo Ef And Wm 24 4 $2,612.00 $1,828.40 30% off $649.74 $4,477.01 $1,080.09 2026-07-31
50200 HCPCS Hchg CT Biopsy Renal 1 1 $1,676.00 $1,173.20 30% off $1,079.34 $1,079.34 $1,079.34 2026-08-01
47000 HCPCS Hchg CT Biopsy Liver 1 1 $1,676.00 $1,173.20 30% off $1,079.34 $1,079.34 $1,079.34 2026-08-01
J8655 HCPCS Netupitant-palonosetron (300-0.5 Mg) 300-0.5 Mg Cap 1 Each Blist Pack 1 1 $1,656.24 $1,159.37 30% off $1,066.62 $1,066.62 $1,066.62 2026-08-01
49083 HCPCS Hchg US Paracentesis Abdomen With Imaging 1 1 $1,638.00 $1,146.60 30% off $1,054.87 $1,054.87 $1,054.87 2026-08-01
720 OTHER Hchg Labor Care Level A Hourly 2 2 $3,421.00 $2,394.70 30% off $1,017.26 $1,053.34 $1,035.30 2026-07-31
20225 HCPCS Hchg CT Biopsy Bone Deep 1 1 $1,603.00 $1,122.10 30% off $1,032.33 $1,032.33 $1,032.33 2026-08-01
20220 HCPCS Hchg CT Biopsy Bone Superficial 1 1 $1,603.00 $1,122.10 30% off $1,032.33 $1,032.33 $1,032.33 2026-08-01
21925 HCPCS Hchg CT Biopsy Soft Tissue Back Deep 1 1 $1,603.00 $1,122.10 30% off $1,032.33 $1,032.33 $1,032.33 2026-08-01
750 OTHER Hchg Extra Endo Time Per Minute 1 1 — — $1,019.92 $1,019.92 $1,019.92 2026-07-31
352 OTHER Rad CT Abdomen Pelvis W 50 4 $2,699.00 $1,889.30 30% off $51.80 $2,804.41 $1,007.13 2026-07-31
J1670 HCPCS Tetanus Immune Globulin (pf) 250 Unit Syrg 1 Ml Syringe 1 1 $1,558.00 $1,090.60 30% off $1,003.35 $1,003.35 $1,003.35 2026-08-01
36430 HCPCS Hchg Blood/blood Product Admin Per Unit 1 1 $1,543.00 $1,080.10 30% off $993.69 $993.69 $993.69 2026-08-01
A0426 HCPCS Hchg Amb Owned Als Non-emerg Transp Level 1 1 1 $1,542.00 $1,079.40 30% off $993.05 $993.05 $993.05 2026-08-01
64635 HCPCS Hchg Rad Dstr Nrolytc Agnt Parverteb Facet Sngl Lmbr/sacral 1 1 $1,515.00 $1,060.50 30% off $975.66 $975.66 $975.66 2026-08-01
64633 HCPCS Hchg Rad Dstr Nrolytc Agnt Parverteb Facet Sngl Crvcl/thora 1 1 $1,515.00 $1,060.50 30% off $975.66 $975.66 $975.66 2026-08-01
351 OTHER Rad CT Facial Bones And Sinus Wo 29 4 $2,337.00 $1,635.90 30% off $49.18 $2,280.00 $971.75 2026-07-31
93970 HCPCS Hchg Rad US Duplex Scan Extremity Bilat Complete Portable 2 1 $1,484.50 $1,039.15 30% off $940.88 $971.15 $956.01 2026-08-01
P9037 HCPCS Hchg Plt Lr Pher Irr 1 1 $1,463.00 $1,024.10 30% off $942.17 $942.17 $942.17 2026-08-01
99284 HCPCS Ed Lvl 4 Hchg 1 1 $1,460.00 $1,022.00 30% off $940.24 $940.24 $940.24 2026-08-01
76700 HCPCS Hchg Rad US Abdomen Complete 2 1 $1,449.00 $1,014.30 30% off $918.99 $947.32 $933.15 2026-08-01
97545 HCPCS Hchg Pt Work Conditioning Initial 2hrs 1 1 $1,444.00 $1,010.80 30% off $929.94 $929.94 $929.94 2026-08-01
93925 HCPCS Hchg Rad US Lower Extremity Bilateral Complete 2 1 $1,434.00 $1,003.80 30% off $908.68 $938.31 $923.49 2026-08-01
0171 RC — 1 1 $1,433.00 $1,003.10 30% off $922.85 $922.85 $922.85 2026-08-01
0361 RC — 4 1 $1,430.50 $1,001.35 30% off $620.82 $1,153.40 $921.24 2026-08-01
76641 HCPCS Hchg Rad US Breast Complete 1 1 $1,427.00 $998.90 30% off $918.99 $918.99 $918.99 2026-08-01
90678 HCPCS Respiratory Syncytial Virus Vaccine, Rsv 120 Mcg/0.5 Ml Solr 1 Each Vial 1 1 $1,416.00 $991.20 30% off $911.90 $911.90 $911.90 2026-08-01
93923 HCPCS Hchg Rad US Upper Or Lower Brachial Index Bilateral Complete 1 1 $1,411.00 $987.70 30% off $908.68 $908.68 $908.68 2026-08-01
J7307 HCPCS Etonogestrel Subdermal Implant 68 Mg Impl 1 Each Pf Appli 1 1 $1,390.84 $973.59 30% off $895.70 $895.70 $895.70 2026-08-01
J9395 HCPCS Fulvestrant 250 Mg/5 Ml Syrg 5 Ml Syringe 1 1 $1,387.00 $970.90 30% off $893.23 $893.23 $893.23 2026-08-01
0370 RC — 4 1 $1,386.50 $970.55 30% off $22.54 $1,501.81 $892.91 2026-08-01
60100 HCPCS Hchg Rad Biopsy Thyroid Prq Core Needle 1 1 $1,381.00 $966.70 30% off $889.36 $889.36 $889.36 2026-08-01
81265 HCPCS Hchg Mcc, Poc Mml 1 1 $1,371.00 $959.70 30% off $882.92 $882.92 $882.92 2026-08-01
J9073 HCPCS cycloPHOSphamide 200 mg/mL Soln 5 Ml Vial 1 1 $1,355.50 $948.85 30% off $872.94 $872.94 $872.94 2026-08-01
36569 HCPCS Hchg Insert Picc Wo Sq Port/pump Wo Guidance =>5 Yrs 1 1 $1,355.00 $948.50 30% off $872.62 $872.62 $872.62 2026-08-01
32555 HCPCS Hchg US Thoracentesis Pleural Space 1 1 $1,353.00 $947.10 30% off $871.33 $871.33 $871.33 2026-08-01
81338 HCPCS Hchg Myeloid Ngs Mpl 1 1 $1,352.00 $946.40 30% off $870.69 $870.69 $870.69 2026-08-01
81347 HCPCS Hchg Myeloid Ngs Sf3b1 1 1 $1,352.00 $946.40 30% off $870.69 $870.69 $870.69 2026-08-01
81352 HCPCS Hchg Myeloid Ngs Tp53 1 1 $1,352.00 $946.40 30% off $870.69 $870.69 $870.69 2026-08-01
A0429 HCPCS Hchg Amb Owned Bls Emergency Transport 1 1 $1,339.00 $937.30 30% off $862.32 $862.32 $862.32 2026-08-01
99465 HCPCS Hchg Newborn Delivery Ppv 1 1 $1,323.00 $926.10 30% off $852.01 $852.01 $852.01 2026-08-01
99292 HCPCS Hchg Ed Critical Care Level Vi Ea Addl 30 Min 1 1 $1,313.00 $919.10 30% off $845.57 $845.57 $845.57 2026-08-01
76770 HCPCS Hchg Rad US Retroperitoneal Complete 2 1 $1,255.50 $878.85 30% off $794.05 $823.03 $808.54 2026-08-01
90381 HCPCS Nirsevimab-alip 100 mg/mL Syrg 1 Ml Syringe 1 1 $1,247.40 $873.18 30% off $803.33 $803.33 $803.33 2026-08-01
51798 HCPCS Hchg Rad Meas Post-voiding Residual Urine&/bladder Cap 1 1 $1,233.00 $863.10 30% off $794.05 $794.05 $794.05 2026-08-01
64520 HCPCS Hchg Rad Injection Anes Lmbr/thrc Paravertbrl Sympathetic 1 1 $1,218.00 $852.60 30% off $784.39 $784.39 $784.39 2026-08-01
64510 HCPCS Hchg Xr Inj Anes Stellate Ganglion Tx 1 1 $1,218.00 $852.60 30% off $784.39 $784.39 $784.39 2026-08-01
64493 HCPCS Hchg Xr Inj Facet Lumbar Or Sacral Single Lev 1 1 $1,218.00 $852.60 30% off $784.39 $784.39 $784.39 2026-08-01
64490 HCPCS Hchg Xr Inj Facet Joint Cervical Or Thoracic Single Lev 1 1 $1,218.00 $852.60 30% off $784.39 $784.39 $784.39 2026-08-01
64483 HCPCS Hchg Xr Inj Transforaminal Lumbar Or Sacral Single Lev 1 1 $1,218.00 $852.60 30% off $784.39 $784.39 $784.39 2026-08-01
64479 HCPCS Hchg Xr Inj Transforaminal Cervical Or Thoracic Single Lev 1 1 $1,218.00 $852.60 30% off $784.39 $784.39 $784.39 2026-08-01
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