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.

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
             
0171 RC — 1 1 $1,433.00 $1,003.10 30% off $922.85 $922.85 $922.85 2026-08-01
0172 RC — 1 1 $1,811.00 $1,267.70 30% off $1,166.28 $1,166.28 $1,166.28 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
0361 RC — 4 1 $1,430.50 $1,001.35 30% off $620.82 $1,153.40 $921.24 2026-08-01
0370 RC — 4 1 $1,386.50 $970.55 30% off $22.54 $1,501.81 $892.91 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
0722 RC — 3 1 $4,228.00 $2,959.60 30% off $1,996.40 $3,484.04 $2,722.83 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
0790 RC — 1 1 $24,920.00 $17,444.00 30% off $16,048.48 $16,048.48 $16,048.48 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
750 OTHER Hchg Extra Endo Time Per Minute 1 1 — — $1,019.92 $1,019.92 $1,019.92 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
81265 HCPCS Hchg Mcc, Poc Mml 1 1 $1,371.00 $959.70 30% off $882.92 $882.92 $882.92 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
99465 HCPCS Hchg Newborn Delivery Ppv 1 1 $1,323.00 $926.10 30% off $852.01 $852.01 $852.01 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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