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

CLAIBORNE COUNTY HOSPITAL

Port Gibson, MS · CCN 251320 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

US ECHOCARDIOGRAM 2D M-MODE WITH SPECTRA

This hospital’s price: $92 across 5 payers · range $92-$352

Source: https://www.ccmcms.org/docs/460738609_claiborne-county-medical-center_standardcharges.csv · observed 2026-04-17

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.

883 distinct procedures filed
5 distinct payers
8,748 rate rows
2026-04-17 last MRF observed
Data quality

7,982 of 8,748 rate rows are consumer-grade (91.2%)

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

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 703
percent-of-charges filed in the dollar field — excluded from medians 49
exceeds 10× this hospital's gross charge — excluded from medians 9
per-diem day rate — not a per-procedure price 5
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.ccmcms.org/docs/460738609_claiborne-county-medical-center_standardcharges.csv
Found on page https://www.ccmcms.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-21
Content fingerprint e873a530ff4f2b56… · 4,914,833 bytes · first seen 2026-05-09

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
J2997
HCPCS 		Activase Inj 100mg 5 $7,861.76 $13,758.08 $13,758.08 nat. median
$500
outlier · 27.5×
J1745
HCPCS 		Remicade 100mg Vial 5 $1,600.35 $2,800.62 $2,800.62 nat. median
$405
outlier · 6.9×
99291
HCPCS 		ER Visit, Critical Care, Up To 74 Min 5 $832.00 $3,920.00 $2,240.00 nat. median
$1,530
1.5× median
36569
HCPCS 		Picc Line Insertion 5 $1,088.00 $1,904.00 $1,904.00 nat. median
$1,726
1.1× median
59409
HCPCS 		Vaginal Delivery Only 5 $836.42 $3,101.84 $1,618.11 nat. median
$3,148
0.5× median
11047
HCPCS 		Debride Bone Each -additional 20 Cm2 5 $822.72 $1,439.76 $1,439.76 nat. median
$948
1.5× median
J3095
HCPCS 		Vibativ Injection 750mg 5 $610.40 $1,068.20 $1,068.20 nat. median
$14
outlier · 75.6×
99285
HCPCS 		ER High Complex Level V 5 $585.60 $1,024.80 $1,024.80 nat. median
$1,187
0.9× median
99292
HCPCS 		ER Visit, Critical Care, Add 30 Min 5 $576.00 $1,008.00 $1,008.00 nat. median
$517
1.9× median
12035
HCPCS 		Inter 12.6-20-sate 5 $412.80 $722.40 $722.40 nat. median
$643
1.1× median
99284
HCPCS 		ER Mod Complex Level IV 5 $384.00 $672.00 $672.00 nat. median
$754
0.9× median
94660
HCPCS 		Rt Bipap/cpap Management 5 $371.20 $649.60 $649.60 nat. median
$364
1.8× median
78465
HCPCS 		Myocardial Perfusion Tomographic MULTIP,Technical Component 5 $368.00 $644.00 $644.00 nat. median
$1,516
outlier · 0.4×
28190
HCPCS 		Cl Fbr-foot 5 $349.07 $929.04 $610.87 nat. median
$867
0.7× median
21450
HCPCS 		Mandible Fx-ER Iii 5 $348.80 $610.40 $610.40 nat. median
$869
0.7× median
40830
HCPCS 		Mouth/tongue <2.5 Cm 5 $348.80 $610.40 $610.40 nat. median
$381
1.6× median
83013
HCPCS 		H. Pylori Clearview 5 $329.60 $576.80 $576.80 nat. median
$101
outlier · 5.7×
11046
HCPCS 		Debride Muscle/fascia -additional 20 Cm2 5 $306.56 $536.48 $536.48 nat. median
$483
1.1× median
11043
HCPCS 		Wd Care Debride Muscle/fascia 5 $306.56 $536.48 $536.48 nat. median
$782
0.7× median
11045
HCPCS 		Debride Subq Tissue-additional 20 Cm2 5 $306.56 $536.48 $536.48 nat. median
$376
1.4× median
87799
HCPCS 		Epstein-barr DNA Quant Pcr 5 $288.00 $504.00 $504.00 nat. median
$173
outlier · 2.9×
J2510
HCPCS 		Bicillin L A Inj 1.2 Unit/2ml 5 $288.00 $504.00 $504.00 nat. median
$68
outlier · 7.4×
J0558
HCPCS 		Bicillin L A Inj 1.2 Unit/2ml 5 $288.00 $504.00 $504.00 nat. median
$65
outlier · 7.8×
13132
HCPCS 		Com 2.6-7.5 Cm 5 $270.08 $472.64 $472.64 nat. median
$856
0.6× median
27500
HCPCS 		Clsd Femoral Shaft Fx-ii 5 $259.92 $454.85 $454.85 nat. median
$580
0.8× median
J0885
HCPCS 		Procrit Injection 10,000u/ml 5 $256.00 $448.00 $448.00 nat. median
$203
outlier · 2.2×
15000
HCPCS 		Preparation For Graft 5 $244.80 $428.40 $428.40 nat. median
$3,691
outlier · 0.1×
11042
HCPCS 		Cl Debride Skin/tissue Minor 5 $120.72 $536.48 $425.60 nat. median
$523
0.8× median
59414
HCPCS 		Delivery PLACENTA,Multiple Procedures 5 $7.04 $1,463.73 $424.37 nat. median
$2,860
outlier · 0.1×
62270
HCPCS 		Spinal Tap 5 $240.96 $421.68 $421.68 nat. median
$820
0.5× median
36593
HCPCS 		Flush Port Or Catheter 5 $235.20 $411.60 $411.60 nat. median
$426
1.0× median
J0561
HCPCS 		Bicillin L-a 600,000 Units 1ml 5 $224.00 $560.67 $392.00 nat. median
$245
1.6× median
77013
HCPCS 		CT Scan For Tissue Ablation 5 $238.08 $387.00 $387.00 nat. median
$1,016
outlier · 0.4×
96365
HCPCS 		IV Infusion Therapy/proph/dx Initial 1hr 5 $220.48 $645.30 $385.84 nat. median
$317
1.2× median
94762
HCPCS 		Rt Continuous Pulse Ox 5 $216.00 $378.00 $378.00 nat. median
$219
1.7× median
29705
HCPCS 		Full Arm Or Full Leg Cast 5 $214.40 $375.20 $375.20 nat. median
$283
1.3× median
99283
HCPCS 		ER Mod Level Iii 5 $211.77 $373.52 $373.52 nat. median
$460
0.8× median
78464
HCPCS 		Myocarial Perfusion Tomographic SINGLE,Technical Component 5 $211.20 $369.60 $369.60 nat. median
$980
outlier · 0.4×
0918
RC 		5 $211.20 $425.04 $369.60 nat. median
$290
1.3× median
24600
HCPCS 		Closed Disloc ER Iii 5 $210.56 $368.48 $368.48 nat. median
$483
0.8× median
27750
HCPCS 		Tibial Shaft Fx-ER Iii 5 $205.44 $359.52 $359.52 nat. median
$474
0.8× median
27816
HCPCS 		Tx Ankle Fx-trimalleolar 5 $205.44 $359.52 $359.52 nat. median
$455
0.8× median
27230
HCPCS 		Femoral Fxclsd ER-iii 5 $205.44 $359.52 $359.52 nat. median
$547
0.7× median
26600
HCPCS 		Closed Metacarpal Fx-iii 5 $205.44 $359.52 $359.52 nat. median
$395
0.9× median
27786
HCPCS 		Tx Ankle Fracture Articu 5 $205.44 $359.52 $359.52 nat. median
$435
0.8× median
27760
HCPCS 		Tx Ankle Fracture-medial 5 $205.44 $359.52 $359.52 nat. median
$442
0.8× median
27808
HCPCS 		Tx Of Ankle Fracture-bima 5 $205.44 $359.52 $359.52 nat. median
$456
0.8× median
12047
HCPCS 		Inter > 30cm Nhfeg 5 $203.84 $356.72 $356.72 nat. median
$1,824
outlier · 0.2×
12036
HCPCS 		Inter 20.1-30cm Sate 5 $203.84 $356.72 $356.72 nat. median
$857
outlier · 0.4×
12032
HCPCS 		Inter 2.6-7.5cm-sate 5 $203.84 $356.72 $356.72 nat. median
$546
0.7× median

Other procedures at this hospital

Browse this hospital's 883 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
             
J2997 HCPCS Activase Inj 100mg 5 5 $24,568.00 $22,111.20 $7,861.76 $13,758.08 $13,758.08 2026-04-17
J1745 HCPCS Remicade 100mg Vial 5 5 $5,001.10 $4,500.99 $1,600.35 $2,800.62 $2,800.62 2026-04-17
99291 HCPCS ER Visit, Critical Care, Up To 74 Min 13 5 $5,000.00 $4,500.00 $832.00 $3,920.00 $2,240.00 2026-04-17
36569 HCPCS Picc Line Insertion 5 5 $3,400.00 $3,060.00 $1,088.00 $1,904.00 $1,904.00 2026-04-17
59409 HCPCS Vaginal Delivery Only 10 5 $4,076.40 $3,668.76 $836.42 $3,101.84 $1,618.11 2026-04-17
11047 HCPCS Debride Bone Each -additional 20 Cm2 5 5 $2,571.00 $2,313.90 $822.72 $1,439.76 $1,439.76 2026-04-17
J3095 HCPCS Vibativ Injection 750mg 5 5 $1,907.50 $1,716.75 $610.40 $1,068.20 $1,068.20 2026-04-17
99285 HCPCS ER High Complex Level V 5 5 $1,830.00 $1,647.00 $585.60 $1,024.80 $1,024.80 2026-04-17
99292 HCPCS ER Visit, Critical Care, Add 30 Min 5 5 $1,800.00 $1,620.00 $576.00 $1,008.00 $1,008.00 2026-04-17
12035 HCPCS Inter 12.6-20-sate 5 5 $1,290.00 $1,161.00 $412.80 $722.40 $722.40 2026-04-17
99284 HCPCS ER Mod Complex Level IV 5 5 $1,200.00 $1,080.00 $384.00 $672.00 $672.00 2026-04-17
94660 HCPCS Rt Bipap/cpap Management 5 5 $1,160.00 $1,044.00 $371.20 $649.60 $649.60 2026-04-17
78465 HCPCS Myocardial Perfusion Tomographic MULTIP,Technical Component 5 5 $1,150.00 $1,035.00 $368.00 $644.00 $644.00 2026-04-17
28190 HCPCS Cl Fbr-foot 10 5 $1,374.92 $1,237.43 $349.07 $929.04 $610.87 2026-04-17
40830 HCPCS Mouth/tongue <2.5 Cm 5 5 $1,090.00 $981.00 $348.80 $610.40 $610.40 2026-04-17
21450 HCPCS Mandible Fx-ER Iii 5 5 $1,090.00 $981.00 $348.80 $610.40 $610.40 2026-04-17
83013 HCPCS H. Pylori Clearview 5 5 $1,030.00 $927.00 $329.60 $576.80 $576.80 2026-04-17
11043 HCPCS Wd Care Debride Muscle/fascia 5 5 $958.00 $862.20 $306.56 $536.48 $536.48 2026-04-17
11046 HCPCS Debride Muscle/fascia -additional 20 Cm2 5 5 $958.00 $862.20 $306.56 $536.48 $536.48 2026-04-17
11045 HCPCS Debride Subq Tissue-additional 20 Cm2 5 5 $958.00 $862.20 $306.56 $536.48 $536.48 2026-04-17
J2510 HCPCS Bicillin L A Inj 1.2 Unit/2ml 5 5 $900.00 $810.00 $288.00 $504.00 $504.00 2026-04-17
J0558 HCPCS Bicillin L A Inj 1.2 Unit/2ml 5 5 $900.00 $810.00 $288.00 $504.00 $504.00 2026-04-17
87799 HCPCS Epstein-barr DNA Quant Pcr 5 5 $900.00 $810.00 $288.00 $504.00 $504.00 2026-04-17
13132 HCPCS Com 2.6-7.5 Cm 5 5 $844.00 $759.60 $270.08 $472.64 $472.64 2026-04-17
27500 HCPCS Clsd Femoral Shaft Fx-ii 5 5 $812.24 $731.02 $259.92 $454.85 $454.85 2026-04-17
J0885 HCPCS Procrit Injection 10,000u/ml 5 5 $800.00 $720.00 $256.00 $448.00 $448.00 2026-04-17
15000 HCPCS Preparation For Graft 5 5 $765.00 $688.50 $244.80 $428.40 $428.40 2026-04-17
11042 HCPCS Cl Debride Skin/tissue Minor 15 5 $760.00 $684.00 $120.72 $536.48 $425.60 2026-04-17
59414 HCPCS Delivery PLACENTA,Multiple Procedures 10 5 $1,317.90 $1,186.11 $7.04 $1,463.73 $424.37 2026-04-17
62270 HCPCS Spinal Tap 5 5 $753.00 $677.70 $240.96 $421.68 $421.68 2026-04-17
36593 HCPCS Flush Port Or Catheter 5 5 $735.00 $661.50 $235.20 $411.60 $411.60 2026-04-17
J0561 HCPCS Bicillin L-a 600,000 Units 1ml 10 5 $850.60 $765.54 $224.00 $560.67 $392.00 2026-04-17
77013 HCPCS CT Scan For Tissue Ablation 9 5 $744.00 $669.60 $238.08 $387.00 $387.00 2026-04-17
96365 HCPCS IV Infusion Therapy/proph/dx Initial 1hr 5 5 $689.00 $620.10 $220.48 $645.30 $385.84 2026-04-17
94762 HCPCS Rt Continuous Pulse Ox 5 5 $675.00 $607.50 $216.00 $378.00 $378.00 2026-04-17
29705 HCPCS Full Arm Or Full Leg Cast 5 5 $670.00 $603.00 $214.40 $375.20 $375.20 2026-04-17
99283 HCPCS ER Mod Level Iii 5 5 $667.00 $600.30 $211.77 $373.52 $373.52 2026-04-17
0918 RC — 10 5 $709.50 $638.55 $211.20 $425.04 $369.60 2026-04-17
78464 HCPCS Myocarial Perfusion Tomographic SINGLE,Technical Component 5 5 $660.00 $594.00 $211.20 $369.60 $369.60 2026-04-17
24600 HCPCS Closed Disloc ER Iii 5 5 $658.00 $592.20 $210.56 $368.48 $368.48 2026-04-17
27750 HCPCS Tibial Shaft Fx-ER Iii 5 5 $642.00 $577.80 $205.44 $359.52 $359.52 2026-04-17
27230 HCPCS Femoral Fxclsd ER-iii 5 5 $642.00 $577.80 $205.44 $359.52 $359.52 2026-04-17
27816 HCPCS Tx Ankle Fx-trimalleolar 5 5 $642.00 $577.80 $205.44 $359.52 $359.52 2026-04-17
27786 HCPCS Tx Ankle Fracture Articu 5 5 $642.00 $577.80 $205.44 $359.52 $359.52 2026-04-17
27760 HCPCS Tx Ankle Fracture-medial 5 5 $642.00 $577.80 $205.44 $359.52 $359.52 2026-04-17
26600 HCPCS Closed Metacarpal Fx-iii 5 5 $642.00 $577.80 $205.44 $359.52 $359.52 2026-04-17
27808 HCPCS Tx Of Ankle Fracture-bima 5 5 $642.00 $577.80 $205.44 $359.52 $359.52 2026-04-17
12032 HCPCS Inter 2.6-7.5cm-sate 5 5 $637.00 $573.30 $203.84 $356.72 $356.72 2026-04-17
12047 HCPCS Inter > 30cm Nhfeg 5 5 $637.00 $573.30 $203.84 $356.72 $356.72 2026-04-17
12036 HCPCS Inter 20.1-30cm Sate 5 5 $637.00 $573.30 $203.84 $356.72 $356.72 2026-04-17
94640 HCPCS Rt Ultrasonic Neb/hour 21 5 $494.00 $444.60 $105.36 $780.64 $350.08 2026-04-17
13150 HCPCS Com <1.0cm Enel 5 5 $616.00 $554.40 $197.12 $344.96 $344.96 2026-04-17
43760 HCPCS Gastrostomy Tube Rep Erii 5 5 $607.18 $546.46 $194.30 $340.02 $340.02 2026-04-17
13102 HCPCS Com > 7.5 Face-add On 5 5 $585.36 $526.82 $187.32 $327.80 $327.80 2026-04-17
13131 HCPCS Com 1.1-2.5 Cm 5 5 $578.00 $520.20 $184.96 $323.68 $323.68 2026-04-17
10120 HCPCS Incision/removal F/bodyii 5 5 $565.00 $508.50 $180.80 $316.40 $316.40 2026-04-17
0360 RC — 5 5 $550.00 $495.00 $176.00 $308.00 $308.00 2026-04-17
12016 HCPCS Sim 12.6-20cm-feenlm 5 5 $544.00 $489.60 $174.08 $304.64 $304.64 2026-04-17
13120 HCPCS Com 1.1-2.5-sal 5 5 $528.00 $475.20 $168.96 $295.68 $295.68 2026-04-17
93041 HCPCS Cardiac Monitor (rhy Stp) 5 5 $510.00 $459.00 $163.20 $285.60 $285.60 2026-04-17
71048 HCPCS Chest, Four Views 5 5 $500.00 $450.00 $160.00 $280.00 $280.00 2026-04-17
G0477 HCPCS Drug Screen Serum 5 5 $500.00 $450.00 $160.00 $280.00 $280.00 2026-04-17
G0478 HCPCS Drug Screen Serum 5 5 $500.00 $450.00 $160.00 $280.00 $280.00 2026-04-17
31502 HCPCS Trach Tube Change 5 5 $500.00 $450.00 $160.00 $280.00 $280.00 2026-04-17
76706 HCPCS US Abdominal Aorta 5 5 $500.00 $450.00 $160.00 $280.00 $280.00 2026-04-17
94664 HCPCS Rt Demon/eval (pt Use) 5 5 $494.00 $444.60 $158.08 $276.64 $276.64 2026-04-17
25600 HCPCS Radial Fx-clsd ER-iii 5 5 $482.00 $433.80 $154.24 $269.92 $269.92 2026-04-17
92950 HCPCS Rt Cpr 10 5 $613.04 $551.74 $152.35 $420.00 $266.60 2026-04-17
P9016 HCPCS Bb Unit Of Prbc's 5 5 $470.00 $423.00 $150.40 $263.20 $263.20 2026-04-17
87798 HCPCS Detect Agent Nos DNA Amp 10 5 $672.50 $605.25 $120.00 $543.20 $260.20 2026-04-17
12015 HCPCS Sim 7.6-12.5-feenlmm 5 5 $458.00 $412.20 $146.56 $256.48 $256.48 2026-04-17
13122 HCPCS Com > 7.5cm Sal-add On 5 5 $454.68 $409.21 $145.50 $254.62 $254.62 2026-04-17
10061 HCPCS Cl Incision/drain Abs Multi 10 5 $474.00 $426.60 $145.28 $276.64 $254.24 2026-04-17
12014 HCPCS Sim 5.1-7.5cmfeenlmm 5 5 $450.00 $405.00 $144.00 $252.00 $252.00 2026-04-17
12044 HCPCS Inter 7.6-12.5nhfeg Cm 5 5 $450.00 $405.00 $144.00 $252.00 $252.00 2026-04-17
80074 HCPCS Hepatitis Profile 5 5 $448.16 $403.34 $143.41 $250.97 $250.97 2026-04-17
82088 HCPCS Aldosterone Serum 5 5 $443.68 $399.31 $141.98 $248.46 $248.46 2026-04-17
78461 HCPCS Myocarial Perfusion Planar MULTIPLE,Technical Component 5 5 $440.00 $396.00 $140.80 $246.40 $246.40 2026-04-17
97597 HCPCS Ot Dressing-wound/burn<20cm,outpatient Occupational Therapy 10 5 $439.00 $395.10 $140.48 $245.84 $245.84 2026-04-17
16020 HCPCS Dressing/debridement Burn 5 5 $439.00 $395.10 $140.48 $245.84 $245.84 2026-04-17
36430 HCPCS Bb Transfusion Fee 5 5 $434.00 $390.60 $138.88 $243.04 $243.04 2026-04-17
23620 HCPCS Humerus Fxclsd-ER Iii 5 5 $434.00 $390.60 $138.88 $243.04 $243.04 2026-04-17
73541 HCPCS Hip To Ankle Ap Lat Knee Right 5 5 $429.00 $386.10 $137.28 $240.24 $240.24 2026-04-17
90792 HCPCS Psy Initial Eval 5 5 $427.00 $384.30 $136.64 $239.12 $239.12 2026-04-17
96360 HCPCS IV Infusion Hydration Initial 31 Min-1 H 5 5 $424.00 $381.60 $135.68 $415.52 $237.44 2026-04-17
96374 HCPCS IV Push Single Or Initial Substance 5 5 $424.00 $381.60 $175.84 $237.44 $237.44 2026-04-17
24650 HCPCS Radial Head Fx-clsed-iii 5 5 $424.00 $381.60 $135.68 $237.44 $237.44 2026-04-17
12042 HCPCS Inter 2.6-7.5-nhfeg 5 5 $424.00 $381.60 $135.68 $237.44 $237.44 2026-04-17
82024 HCPCS Adenocortcotropic Hormone 5 5 $420.48 $378.43 $134.55 $235.47 $235.47 2026-04-17
71047 HCPCS Chest, Three Views 5 5 $420.00 $378.00 $134.40 $235.20 $235.20 2026-04-17
82652 HCPCS Calcitriol (1,25 Di-oh Vitamin D) 5 5 $419.12 $377.21 $134.12 $234.71 $234.71 2026-04-17
12005 HCPCS Sim 12.6-20cm Snat 5 5 $412.00 $370.80 $131.84 $230.72 $230.72 2026-04-17
99282 HCPCS ER Low Mod Level Ii 5 5 $404.00 $363.60 $129.28 $226.24 $226.24 2026-04-17
12052 HCPCS Inter 2.6-5.0-feenlm 5 5 $400.00 $360.00 $128.00 $224.00 $224.00 2026-04-17
G0379 HCPCS O P Observation 5 5 $400.00 $360.00 $128.00 $224.00 $224.00 2026-04-17
12041 HCPCS Inter <2.5-nhfeg 5 5 $400.00 $360.00 $128.00 $224.00 $224.00 2026-04-17
12004 HCPCS Sim 7.6-12.5-mt 5 5 $400.00 $360.00 $128.00 $224.00 $224.00 2026-04-17
E0194 HCPCS Woundcare Bed Clinitron Rental 5 5 $400.00 $360.00 $128.00 $224.00 $224.00 2026-04-17
12051 HCPCS Inter <2.5cm Nhfeg Phy 5 5 $400.00 $360.00 $128.00 $224.00 $224.00 2026-04-17
12053 HCPCS Inter 5.1-7.5 Nhfeg 5 5 $400.00 $360.00 $128.00 $224.00 $224.00 2026-04-17
51702 HCPCS Insertion Of Temporary Indwelling 5 5 $395.00 $355.50 $126.40 $241.16 $221.20 2026-04-17
40804 HCPCS Cl Fbr-mouth 5 5 $395.00 $355.50 $126.40 $221.20 $221.20 2026-04-17
29125 HCPCS Splint-apply Forearm 5 5 $395.00 $355.50 $126.40 $221.20 $221.20 2026-04-17
75635 HCPCS CT Angio Abdominal Arteries 9 5 $2,475.00 $2,227.50 $220.00 $792.00 $220.00 2026-04-17
83921 HCPCS Methymalonic Acid Urine 5 5 $390.00 $351.00 $124.80 $218.40 $218.40 2026-04-17
87497 HCPCS Cytomeg DNA Quant 5 5 $386.00 $347.40 $123.52 $216.16 $216.16 2026-04-17
74174 HCPCS CT Angio Abdomen/pelvis 5 5 $2,490.00 $2,241.00 $213.00 $796.80 $213.00 2026-04-17
0909 RC — 5 5 $380.00 $342.00 $121.60 $212.80 $212.80 2026-04-17
86885 HCPCS Bb Antibody Screen 5 5 $375.36 $337.82 $120.12 $210.20 $210.20 2026-04-17
86880 HCPCS Bb Direct Coombs 5 5 $375.00 $337.50 $120.00 $210.00 $210.00 2026-04-17
84588 HCPCS Anti Diuretic Hormones Adh 5 5 $369.52 $332.57 $118.25 $206.93 $206.93 2026-04-17
83880 HCPCS B-type Natr Peptide 5 5 $369.52 $332.57 $101.81 $362.13 $206.93 2026-04-17
10060 HCPCS Cl Incision/drain Abs Single 15 5 $354.00 $318.60 $94.08 $220.64 $198.24 2026-04-17
74178 HCPCS CT Abdomen And Pelvis Wo/w Dye 9 5 $2,800.00 $2,520.00 $198.00 $896.00 $198.00 2026-04-17
71260 HCPCS CT Chest With Contrast 9 5 $1,280.00 $1,152.00 $196.00 $409.60 $196.00 2026-04-17
90838 HCPCS Psy Tx 60 Min Patient And/or Fam With E/m 5 5 $347.00 $312.30 $111.04 $194.32 $194.32 2026-04-17
P9019 HCPCS Bb Platelets Ea Unit 5 5 $346.00 $311.40 $110.72 $193.76 $193.76 2026-04-17
76936 HCPCS US Compression Pseudo-aneurysm 5 5 $770.00 $693.00 $192.00 $246.40 $192.00 2026-04-17
93017 HCPCS Tracing Only, Without Interpretation & R 5 5 $341.98 $307.78 $109.43 $191.51 $191.51 2026-04-17
12011 HCPCS Cl Simple <2.5 Cm 15 5 $335.00 $301.50 $107.20 $224.00 $187.60 2026-04-17
73706 HCPCS CT Angio Lwr Extr Without & With Contrast P/f 5 5 $721.72 $649.55 $183.00 $440.00 $183.00 2026-04-17
84591 HCPCS Vitamin B3/niacin Level 5 5 $326.00 $293.40 $104.32 $182.56 $182.56 2026-04-17
94799 HCPCS Rt Miscellaneous Respiratory 5 5 $322.56 $290.30 $103.22 $180.63 $180.63 2026-04-17
86922 HCPCS Bb Crossmatch 5 5 $320.00 $288.00 $102.40 $179.20 $179.20 2026-04-17
82157 HCPCS Androstenedione 5 5 $318.72 $286.85 $101.99 $178.48 $178.48 2026-04-17
12031 HCPCS Inter <2.5cm Sate 5 5 $318.00 $286.20 $101.76 $178.08 $178.08 2026-04-17
71275 HCPCS CT Angiography,chest P/f 6 5 $618.50 $556.65 $177.00 $604.80 $177.00 2026-04-17
13153 HCPCS Com > 7.5cm Enel-add On 5 5 $316.00 $284.40 $101.12 $176.96 $176.96 2026-04-17
74175 HCPCS CT Angio Abdomen P/f 5 5 $632.06 $568.85 $176.00 $774.40 $176.00 2026-04-17
73206 HCPCS CT Angio Upr Extrm Without & With Contrast P/f 5 5 $671.24 $604.12 $175.00 $440.00 $175.00 2026-04-17
72191 HCPCS CT Angiograph Pelv W/O&with Contrast P/f 5 5 $626.96 $564.26 $175.00 $584.00 $175.00 2026-04-17
86360 HCPCS Cd4:cd8 Ratio Profile 5 5 $311.00 $279.90 $99.52 $174.16 $174.16 2026-04-17
12013 HCPCS Cl Simple 2.5-5cm 15 5 $306.00 $275.40 $88.96 $224.00 $171.36 2026-04-17
70496 HCPCS CT Angiography, Head P/f 5 5 $608.44 $547.60 $171.00 $611.20 $171.00 2026-04-17
82670 HCPCS Estradiol 5 5 $304.16 $273.74 $97.33 $170.33 $170.33 2026-04-17
74176 HCPCS CT Abdomen And Pelvis Without Contrast 9 5 $1,800.00 $1,620.00 $170.00 $576.00 $170.00 2026-04-17
70498 HCPCS CT Angiography, Neck P/f 5 5 $604.86 $544.37 $170.00 $524.10 $170.00 2026-04-17
82507 HCPCS Citrate-urine 5 5 $302.72 $272.45 $96.87 $169.52 $169.52 2026-04-17
20610 HCPCS Cl Joint Inj-sholdrhipknee 10 5 $422.50 $380.25 $91.20 $313.60 $169.40 2026-04-17
U0002 HCPCS Covid-19 Non-cdc 5 5 $300.00 $270.00 $96.00 $168.00 $168.00 2026-04-17
93224 HCPCS Telemetry Report Up To 48 Hours 5 5 $300.00 $270.00 $96.00 $168.00 $168.00 2026-04-17
74177 HCPCS CT Abdomen And Pelvis W Dye 9 5 $2,250.00 $2,025.00 $168.00 $720.00 $168.00 2026-04-17
G0434 HCPCS Drug Screen Urine 5 5 $300.00 $270.00 $96.00 $168.00 $168.00 2026-04-17
99205 HCPCS Cl New Pt Ov High Complex 25 5 $323.38 $291.04 $69.76 $294.00 $168.00 2026-04-17
12002 HCPCS Cl Simple 2.6 - 7.5cm 20 5 $316.50 $284.85 $87.68 $223.44 $166.88 2026-04-17
82308 HCPCS Calcitonin 5 5 $291.60 $262.44 $93.31 $163.30 $163.30 2026-04-17
90746 HCPCS Hepatitis B Vaccine 5 5 $290.00 $261.00 $92.80 $162.40 $162.40 2026-04-17
20605 HCPCS Cl Joint Inj-wristelbankle 15 5 $285.00 $256.50 $88.00 $355.04 $159.60 2026-04-17
13133 HCPCS Com >7.5cm Ghf-add On 5 5 $282.00 $253.80 $90.24 $157.92 $157.92 2026-04-17
97598 HCPCS Ot Dressing-wound/burn>20cm,outpatient Occupational Therapy 10 5 $445.00 $400.50 $41.28 $426.16 $157.88 2026-04-17
0361 RC — 10 5 $483.50 $435.15 $5.76 $531.44 $156.88 2026-04-17
78460 HCPCS Myocarial Perfusion Planar SINGLE,Technical Component 5 5 $280.00 $252.00 $89.60 $156.80 $156.80 2026-04-17
0183T OTHER Pt Mist Thy Wd US 5 5 $280.00 $252.00 $89.60 $156.80 $156.80 2026-04-17
84255 HCPCS Selenium 5 5 $277.92 $250.13 $88.93 $155.64 $155.64 2026-04-17
82108 HCPCS Aluminum Level 5 5 $277.36 $249.62 $88.76 $155.32 $155.32 2026-04-17
86756 HCPCS Rsv Antibody 5 5 $277.00 $249.30 $88.64 $155.12 $155.12 2026-04-17
90847 HCPCS Congnitive Training 1 On 1 15 Min,hpsa 15 5 $276.00 $248.40 $66.24 $183.93 $154.56 2026-04-17
90846 HCPCS Family Therapy Without Pat,hpsa 15 5 $276.00 $248.40 $66.24 $183.93 $154.56 2026-04-17
20600 HCPCS Cl Joint Injection Finger 10 5 $280.00 $252.00 $88.00 $159.60 $154.00 2026-04-17
86738 HCPCS Mycoplasma Pneumoniae Antibodies 5 5 $275.00 $247.50 $88.00 $154.00 $154.00 2026-04-17
J3486 HCPCS Ziprasidone 20mg/ml Vial 5 5 $274.25 $246.83 $87.76 $153.58 $153.58 2026-04-17
12001 HCPCS Cl Simple < 2.5 Cm 15 5 $274.00 $246.60 $87.68 $155.68 $153.44 2026-04-17
94002 HCPCS Rt Vent Assist/management Initial 5 5 $270.00 $243.00 $86.40 $151.20 $151.20 2026-04-17
93015 HCPCS Exercise-stress Or Pharm(phy Sprvn Inter 5 5 $270.00 $243.00 $86.40 $151.20 $151.20 2026-04-17
90834 HCPCS Individual Psychotherapy 45 Min 20 5 $297.50 $267.75 $47.04 $193.20 $150.08 2026-04-17
90836 HCPCS Psy Tx 45 Min Patient And/or Fam With E/m 5 5 $263.00 $236.70 $84.16 $147.28 $147.28 2026-04-17
31500 HCPCS Intubation, Endotrach, Emergency Procedu 10 5 $360.00 $324.00 $70.40 $280.00 $141.60 2026-04-17
70482 HCPCS CT Orbit/ear/fossa Without & W Dye P/f 5 5 $618.04 $556.24 $141.00 $238.40 $141.00 2026-04-17
J1160 HCPCS Digoxin 500mcg/2ml 5 5 $251.00 $225.90 $80.32 $140.56 $140.56 2026-04-17
70492 HCPCS CT Soft Tissue Neck Without & With Contrast P/f 5 5 $570.20 $513.18 $140.00 $454.40 $140.00 2026-04-17
90837 HCPCS Individual Ther 60 Minutes 10 5 $327.00 $294.30 $80.00 $226.24 $140.00 2026-04-17
31720 HCPCS Rt Suction, Nasotracheal 5 5 $250.00 $225.00 $80.00 $140.00 $140.00 2026-04-17
82542 HCPCS Keppra 10 5 $362.32 $326.09 $62.92 $295.68 $139.54 2026-04-17
83498 HCPCS Hydroxy Progesterone 17 5 5 $247.20 $222.48 $79.10 $138.43 $138.43 2026-04-17
74170 HCPCS CT Abdomen Without & With Contrast P/f 5 5 $538.92 $485.03 $137.00 $796.80 $137.00 2026-04-17
96376 HCPCS IV Push/piggybk Additional Same Sub/drug 9 5 $280.00 $252.00 $78.08 $185.28 $136.64 2026-04-17
80307 HCPCS Drug Screen 11 Panel 12 5 $300.00 $270.00 $86.82 $310.80 $136.36 2026-04-17
82627 HCPCS Dheas 5 5 $242.08 $217.87 $77.47 $135.56 $135.56 2026-04-17
92610 HCPCS St Swallow EVAL,Outpatient Speech Therapy 5 5 $242.00 $217.80 $77.44 $135.52 $135.52 2026-04-17
70491 HCPCS CT Soft Tissue Neck With Contrast 9 5 $1,280.00 $1,152.00 $135.00 $409.60 $135.00 2026-04-17
84244 HCPCS Renin Plasma 5 5 $239.44 $215.50 $76.62 $134.09 $134.09 2026-04-17
70481 HCPCS CT Orbit/ear/fossa With Contrast P/f 5 5 $565.12 $508.61 $134.00 $206.72 $134.00 2026-04-17
71270 HCPCS CT Chest Without & W Dye P/f 5 5 $219.00 $197.10 $134.00 $454.40 $134.00 2026-04-17
92597 HCPCS St Voice Prosth Device EVAL,Outpatient Speech Therapy 5 5 $238.00 $214.20 $76.16 $133.28 $133.28 2026-04-17
80055 HCPCS Obstetric Panel 5 5 $234.00 $210.60 $74.88 $131.04 $131.04 2026-04-17
70470 HCPCS CT Head/brain Without & With Contrast 9 5 $1,420.00 $1,278.00 $130.00 $454.40 $130.00 2026-04-17
86777 HCPCS Toxoplasmosis Antibody Igg 5 5 $231.00 $207.90 $73.92 $129.36 $129.36 2026-04-17
87116 HCPCS Mycobacteria Cult/ Rfx To Id And Susce 5 5 $230.00 $207.00 $73.60 $128.80 $128.80 2026-04-17
84144 HCPCS Progesterone 5 5 $227.12 $204.41 $72.68 $127.19 $127.19 2026-04-17
84681 HCPCS C Peptide 5 5 $224.96 $202.46 $71.99 $125.98 $125.98 2026-04-17
70480 HCPCS CT Orbit/ear/fossa Without Contrast P/f 5 5 $479.22 $431.30 $125.00 $152.00 $125.00 2026-04-17
72126 HCPCS CT Cervical Spine With Contrast P/f 4 4 $470.48 $423.43 $125.00 $125.00 $125.00 2026-04-17
81374 HCPCS Hla I Typing 1 Antigen Lr 5 5 $223.00 $200.70 $71.36 $124.88 $124.88 2026-04-17
99281 HCPCS ER Minor Level I 5 5 $223.00 $200.70 $71.36 $124.88 $124.88 2026-04-17
70490 HCPCS CT Soft Tissue Neck Without Contrast 9 5 $985.00 $886.50 $124.00 $315.20 $124.00 2026-04-17
74160 HCPCS CT Abdomen With Contrast 9 5 $1,950.00 $1,755.00 $124.00 $624.00 $124.00 2026-04-17
72133 HCPCS CT Lumbar Spine W/O&with Contrast P/f 5 5 $553.88 $498.49 $124.00 $454.40 $124.00 2026-04-17
36600 HCPCS Arterial Puncture, Withdrawal For Dx 5 5 $220.00 $198.00 $70.40 $123.20 $123.20 2026-04-17
70488 HCPCS CT Maxillofacial W/o&w Dye P/f 5 5 $422.70 $380.43 $123.00 $243.84 $123.00 2026-04-17
72130 HCPCS CT Thoracic Spine Without & With Contrast P/f 5 5 $554.10 $498.69 $123.00 $454.40 $123.00 2026-04-17
72127 HCPCS CT Cervical Spine Without & With Contrast P/f 5 5 $553.38 $498.04 $123.00 $454.40 $123.00 2026-04-17
96105 HCPCS St Aphasia Eval 1 HR,Outpatient Speech Therapy 5 5 $219.00 $197.10 $70.08 $122.64 $122.64 2026-04-17
77011 HCPCS Cat Scan For Localization P/f 5 5 $452.94 $407.65 $120.00 $200.64 $120.00 2026-04-17
69200 HCPCS Fbr Ear 5 5 $214.00 $192.60 $68.48 $119.84 $119.84 2026-04-17
73202 HCPCS CT Upper Extremity Without & With Contrast P/f 5 5 $567.80 $511.02 $119.00 $296.00 $119.00 2026-04-17
72132 HCPCS CT Lumbar Spine With Contrast P/f 5 5 $469.06 $422.15 $119.00 $409.60 $119.00 2026-04-17
21300 HCPCS Skull Fx-ER I 5 5 $212.00 $190.80 $67.84 $118.72 $118.72 2026-04-17
86376 HCPCS Tpo Antiboies 5 5 $212.00 $190.80 $67.84 $118.72 $118.72 2026-04-17
84146 HCPCS Prolactin 5 5 $210.96 $189.86 $67.51 $118.14 $118.14 2026-04-17
72194 HCPCS CT Pelvis Without & With Contrast 9 5 $1,450.00 $1,305.00 $118.00 $464.00 $118.00 2026-04-17
72129 HCPCS CT Thoracic Spine With Contrast P/f 5 5 $470.70 $423.63 $118.00 $409.60 $118.00 2026-04-17
82803 HCPCS Rt It Arterial Blood Gas 6 5 $210.64 $189.58 $67.40 $206.43 $117.96 2026-04-17
90807 HCPCS Indiv. O/p Psytherapy 45/50 W/e 5 5 $210.00 $189.00 $67.20 $117.60 $117.60 2026-04-17
86703 HCPCS HIV 1/o/2 4th Generation 5 5 $210.00 $189.00 $67.20 $117.60 $117.60 2026-04-17
74150 HCPCS CT Abdomen Without Contrast 9 5 $1,695.00 $1,525.50 $117.00 $542.40 $117.00 2026-04-17
73702 HCPCS CT Lwr Extremity Without & With Contrast P/f 5 5 $558.74 $502.87 $117.00 $296.00 $117.00 2026-04-17
90833 HCPCS Psy Tx 30 Min Patient And/or Fam With E/ 5 5 $207.00 $186.30 $66.24 $115.92 $115.92 2026-04-17
82378 HCPCS Cea 5 5 $206.48 $185.83 $66.07 $115.63 $115.63 2026-04-17
82175 HCPCS Arsenic 15 5 $205.04 $184.54 $41.91 $302.40 $114.82 2026-04-17
83825 HCPCS Heavy Metal Profile I 5 5 $205.04 $184.54 $65.61 $114.82 $114.82 2026-04-17
27560 HCPCS Patella Disloc Clsd ER Iii 5 5 $204.00 $183.60 $65.28 $114.24 $114.24 2026-04-17
26720 HCPCS Phalanx Fxclsd ER-iii 5 5 $204.00 $183.60 $65.28 $114.24 $114.24 2026-04-17
25530 HCPCS Ulnar Shaft Fx-clsd-eriii 5 5 $204.00 $183.60 $65.28 $114.24 $114.24 2026-04-17
25560 HCPCS Radial/ulnar Fxclsd-iii 5 5 $204.00 $183.60 $65.28 $114.24 $114.24 2026-04-17
21800 HCPCS Rib Fxclsd ER-iii 5 5 $204.00 $183.60 $65.28 $114.24 $114.24 2026-04-17
28490 HCPCS Tx Big Toe Fracture 5 5 $204.00 $183.60 $65.28 $114.24 $114.24 2026-04-17
28510 HCPCS Tx Of Toe Fracture 5 5 $204.00 $183.60 $65.28 $114.24 $114.24 2026-04-17
90832 HCPCS Individual Ther 20-30- Minutes 10 5 $264.50 $238.05 $64.64 $183.12 $113.12 2026-04-17
73201 HCPCS CT Upper Extremity With Contrast P/f 5 5 $675.00 $607.50 $113.00 $254.40 $113.00 2026-04-17
72193 HCPCS CT Pelvis With Contrast 9 5 $1,295.00 $1,165.50 $113.00 $414.40 $113.00 2026-04-17
83002 HCPCS Lh Hormone 5 5 $201.60 $181.44 $64.51 $112.90 $112.90 2026-04-17
77012 HCPCS CT Scan For Needle Biopsy 9 5 $627.00 $564.30 $112.00 $200.64 $112.00 2026-04-17
86769 HCPCS Covid-19 Antibody 5 5 $200.00 $180.00 $64.00 $112.00 $112.00 2026-04-17
70486 HCPCS CT Maxillofacial Without Contrast 9 5 $845.00 $760.50 $112.00 $270.40 $112.00 2026-04-17
90806 HCPCS Indiv.o/p Psytherapy 45/50 No 10 5 $263.50 $237.15 $64.00 $183.12 $112.00 2026-04-17
90698 HCPCS Diphtheria/tetanus Tox/acell Pertussis 5 5 $200.00 $180.00 $64.00 $112.00 $112.00 2026-04-17
90471 HCPCS Injection Fee:im Immunization 10 5 $232.50 $209.25 $64.00 $148.40 $112.00 2026-04-17
73701 HCPCS CT Lower Extremity With Contrast 9 5 $795.00 $715.50 $112.00 $254.40 $112.00 2026-04-17
97127 HCPCS Psy-cognitive Skills-dr 5 5 $200.00 $180.00 $64.00 $112.00 $112.00 2026-04-17
J7509 HCPCS Methylprednisole 4mg Tab 5 5 $200.00 $180.00 $64.00 $112.00 $112.00 2026-04-17
94644 HCPCS Rt Continuous Aero Tx/initial Hour 5 5 $200.00 $180.00 $64.00 $112.00 $112.00 2026-04-17
86789 HCPCS West Nile Virus Antibody 5 5 $200.00 $180.00 $64.00 $112.00 $112.00 2026-04-17
94645 HCPCS Rt Continuous Aero Tx/subseq Hour 5 5 $200.00 $180.00 $64.00 $112.00 $112.00 2026-04-17
86788 HCPCS West Nile Virus IgM 5 5 $200.00 $180.00 $64.00 $112.00 $112.00 2026-04-17
92506 HCPCS St Evaluation SPEECH,Outpatient Speech Therapy 5 5 $199.00 $179.10 $63.68 $111.44 $111.44 2026-04-17
92605 HCPCS St Eval For Nonspeech DEVICE,Outpatient Speech Therapy 5 5 $198.00 $178.20 $63.36 $110.88 $110.88 2026-04-17
82492 HCPCS Chromotography 5 5 $196.64 $176.98 $62.92 $110.12 $110.12 2026-04-17
80339 HCPCS Lamictal 5 5 $196.64 $176.98 $62.92 $110.12 $110.12 2026-04-17
70487 HCPCS CT Maxillofacial With Contrast P/f 5 5 $348.28 $313.45 $110.00 $315.20 $110.00 2026-04-17
76800 HCPCS US Spinal Canal & Contents 5 5 $198.00 $178.20 $63.36 $110.00 $110.00 2026-04-17
70460 HCPCS CT Head/brain With Contrast P/f 5 5 $335.44 $301.90 $110.00 $409.60 $110.00 2026-04-17
11100 HCPCS Biopsy/including Punch 10 5 $254.00 $228.60 $62.72 $174.72 $109.76 2026-04-17
94003 HCPCS Rt Vent Assist/management Sub 5 5 $195.00 $175.50 $62.40 $109.20 $109.20 2026-04-17
72125 HCPCS CT Cervical Spine Without Contrast 9 5 $985.00 $886.50 $109.00 $315.20 $109.00 2026-04-17
21310 HCPCS Clsd/open Fx Nasal-eriii 5 5 $192.00 $172.80 $61.44 $107.52 $107.52 2026-04-17
82941 HCPCS Gastrin Level 5 5 $192.00 $172.80 $61.44 $107.52 $107.52 2026-04-17
80188 HCPCS Primidone Level 5 5 $190.00 $171.00 $60.80 $106.40 $106.40 2026-04-17
72192 HCPCS CT Pelvis Without Contrast 9 5 $1,025.00 $922.50 $106.00 $328.00 $106.00 2026-04-17
15852 HCPCS Cl Dressing Change 5 5 $188.00 $169.20 $60.16 $105.28 $105.28 2026-04-17
71250 HCPCS CT Chest Without Contrast 9 5 $985.00 $886.50 $87.64 $105.00 $105.00 2026-04-17
82382 HCPCS Catecholamine 5 5 $187.20 $168.48 $59.90 $104.83 $104.83 2026-04-17
86480 HCPCS Quantiferon 5 5 $185.00 $166.50 $59.20 $103.60 $103.60 2026-04-17
30905 HCPCS Cl Nosebleed-cntrl Comp Post 15 5 $185.00 $166.50 $55.36 $188.16 $103.60 2026-04-17
30901 HCPCS Cl Nosebleed-cntrl-simple Anterior 15 5 $184.00 $165.60 $50.88 $172.48 $103.04 2026-04-17
83090 HCPCS Homocysteine 5 5 $183.60 $165.24 $58.75 $102.82 $102.82 2026-04-17
82530 HCPCS Cortisol Free With Cbg 5 5 $181.92 $163.73 $58.21 $101.88 $101.88 2026-04-17
83003 HCPCS Growth Hormone 5 5 $181.60 $163.44 $58.11 $101.70 $101.70 2026-04-17
94667 HCPCS Rt Cpt/postural Drainage Initial 5 5 $180.00 $162.00 $57.60 $100.80 $100.80 2026-04-17
J2020 HCPCS Linezolid Premix 600mg/300ml 10 5 $265.00 $238.50 $41.60 $224.00 $100.40 2026-04-17
0124 RC — 1 1 $1,000.00 $900.00 $100.00 $100.00 $100.00 2026-04-17
11730 HCPCS Cl Nail Removal 5 5 $177.00 $159.30 $56.64 $99.12 $99.12 2026-04-17
11300 HCPCS Cl Shave Skin Lesion .5 Or< 10 5 $177.00 $159.30 $56.64 $99.12 $99.12 2026-04-17
11200 HCPCS Cl Site Of Removal 10 5 $177.00 $159.30 $56.64 $99.12 $99.12 2026-04-17
11055 HCPCS Cl Trim Skin Lesion 20 5 $177.50 $159.75 $56.64 $140.00 $99.12 2026-04-17
99204 HCPCS Cl New Pt Ov Comprehensive 25 5 $176.00 $158.40 $39.36 $226.24 $98.56 2026-04-17
96367 HCPCS IV Infusion Addl Seq New Drug 1hr (ivpb) 5 5 $176.00 $158.40 $56.32 $98.56 $98.56 2026-04-17
92507 HCPCS Pt Speech TREATMENT,Outpatient Physical Therapy 10 5 $176.00 $158.40 $56.32 $98.56 $98.56 2026-04-17
76810 HCPCS US OB Multiple Gest 5 5 $792.00 $712.80 $98.00 $253.44 $98.00 2026-04-17
76801 HCPCS US OB Complete Gest <14wks 9 5 $715.00 $643.50 $98.00 $228.80 $98.00 2026-04-17
96372 HCPCS Injection Fee:im/sq 11 5 $265.00 $238.50 $56.00 $148.40 $98.00 2026-04-17
G0410 HCPCS Group Therapy Sw Php 1 1 $100.00 $90.00 $98.00 $98.00 $98.00 2026-04-17
73700 HCPCS CT Lower Extremity Without Contrast 9 5 $675.00 $607.50 $97.00 $216.00 $97.00 2026-04-17
73200 HCPCS CT Upper Extremity Without Contrast 9 5 $675.00 $607.50 $97.00 $216.00 $97.00 2026-04-17
72131 HCPCS CT Lumbar Spine Without Contrast 9 5 $985.00 $886.50 $97.00 $315.20 $97.00 2026-04-17
72128 HCPCS CT Thoracic Spine Without Contrast 9 5 $985.00 $886.50 $97.00 $315.20 $97.00 2026-04-17
84425 HCPCS Thiamine 5 5 $171.92 $154.73 $55.01 $96.28 $96.28 2026-04-17
15001 HCPCS Add On/site>100cm 5 5 $170.00 $153.00 $54.40 $95.20 $95.20 2026-04-17
84207 HCPCS Vitamin B6 Level 5 5 $167.00 $150.30 $53.44 $93.52 $93.52 2026-04-17
J7060 HCPCS D5w100ml IV Solution 5 5 $87.00 $78.30 $53.12 $92.96 $92.96 2026-04-17
82668 HCPCS Erythopoetin Level 5 5 $165.52 $148.97 $52.97 $92.69 $92.69 2026-04-17
E0676 HCPCS Pneumatic Compression Device Nos 5 5 $165.00 $148.50 $52.80 $92.40 $92.40 2026-04-17
E0675 HCPCS Pneumatic Compression Device Uni Or Bi 5 5 $165.00 $148.50 $52.80 $92.40 $92.40 2026-04-17
94668 HCPCS Rt CPT-subsequent 5 5 $165.00 $148.50 $52.80 $92.40 $92.40 2026-04-17
93306 HCPCS US Echocardiogram 2d M-mode With Spectra 9 5 $1,100.00 $990.00 $92.00 $352.00 $92.00 2026-04-17
82985 HCPCS Fructosamine 5 5 $164.08 $147.67 $52.51 $91.88 $91.88 2026-04-17
80150 HCPCS Amikacin 5 5 $164.08 $147.67 $52.51 $91.88 $91.88 2026-04-17
0942 RC — 10 5 $246.50 $221.85 $34.56 $215.60 $91.84 2026-04-17
J0153 HCPCS Adenosine 6mg/2ml 10 5 $227.93 $205.13 $49.87 $168.00 $91.64 2026-04-17
0919 RC — 10 5 $244.00 $219.60 $34.56 $212.80 $91.04 2026-04-17
80195 HCPCS Assay Of Sirolimus 5 5 $162.00 $145.80 $51.84 $90.72 $90.72 2026-04-17
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