Hospital

FRANKLIN COUNTY MEMORIAL HOSPITAL

Meadville, MS · CCN 251330 · Rates published

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You selected 93306 (HCPCS)

US ECHO COMPLETE

This hospital’s price: $172 across 8 payers · range $59-$1,466

Source: https://www.fcmh.net/price-transparency/646001390_franklin-county-memorial-hospital_standardcharges.csv · observed 2026-07-15

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

5,199 distinct procedures filed

9 distinct payers

29,131 rate rows

2026-07-31 last MRF observed

Data quality

22,063 of 29,131 rate rows are consumer-grade (75.7%)

7,068 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	4,710
placeholder amount (≤ $0.02) — excluded from medians	2,355
exceeds 10× this hospital's gross charge — excluded from medians	3

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.fcmh.net/price-transparency/646001390_franklin-county-memorial-hospital_standardcharges.csv
Found on page	https://www.fcmh.net/price-transparency
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-22
Content fingerprint	1f4bf3a5e8f6855b… · 8,404,166 bytes · first seen 2026-05-06

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
21454 HCPCS	External Fixation, Mandible Fracture, Op	8	$407.53	$4,000.00	$2,600.00	nat. median $5,881 outlier · 0.4×
J0840 HCPCS	Crotalidae Polyvalent Inj	8	$2,077.79	$7,881.20	$2,304.72	nat. median $3,445 0.7× median
31030 HCPCS	Caldwell Luc	8	$521.42	$3,500.00	$2,275.00	nat. median $5,790 outlier · 0.4×
26951 HCPCS	Amputation Finger/thumb	8	$574.77	$3,677.10	$2,109.60	nat. median $3,320 0.6× median
40814 HCPCS	Excsion Lesion, Mouth With Repair,complex	8	$305.05	$2,258.80	$1,495.00	nat. median $3,268 outlier · 0.5×
40810 HCPCS	Excision Lesion, Mouth, Without Repair	8	$174.85	$2,258.80	$1,495.00	nat. median $3,040 outlier · 0.5×
41874 HCPCS	Alveoplasty - Hospital	8	$309.09	$2,258.80	$1,495.00	nat. median $3,228 outlier · 0.5×
D7740 HCPCS	Mandible, Closed Reduction	8	$1,017.50	$1,713.93	$1,387.50	nat. median $3,750 outlier · 0.4×
21040 HCPCS	Excision Cyst Mandible By Enucleation	8	$381.38	$1,997.00	$1,298.05	nat. median $3,377 outlier · 0.4×
41826 HCPCS	Excise/repair Mouth Lesion, Simple	8	$245.61	$1,997.00	$1,298.05	nat. median $3,243 outlier · 0.4×
41825 HCPCS	Exicsion Benign Lip Lesion, .5cm	8	$177.71	$1,997.00	$1,298.05	nat. median $3,177 outlier · 0.4×
21031 HCPCS	Removal Mandibular Lingual Tori	8	$310.90	$1,997.00	$1,298.05	nat. median $3,264 outlier · 0.4×
36580 HCPCS	Replace Non-tun Venous Cath , Ac/swing	8	$153.18	$3,661.80	$1,181.28	nat. median $1,823 0.6× median
36569 HCPCS	Picc Insertion Aop	8	$78.89	$3,661.80	$1,181.28	nat. median $1,726 0.7× median
40812 HCPCS	Excision Lesion Mouth, With Repair, Simple	8	$191.33	$1,697.45	$1,100.23	nat. median $1,585 0.7× median
11044 HCPCS	Debrid Subc Musc Bone	8	$240.28	$1,427.15	$1,024.07	nat. median $1,751 0.6× median
D7560 HCPCS	Caldwell Luc Procedure	8	$562.08	$1,259.79	$975.00	nat. median $1,943 0.5× median
D7260 HCPCS	Oroantral Fistula Closure	8	$434.47	$1,367.52	$942.50	nat. median $1,447 0.7× median
41130 HCPCS	Glossectomy, Partial	8	$660.00	$3,672.36	$900.00	nat. median $3,121 outlier · 0.3×
20694 HCPCS	Removal External Fixator Device	8	$352.29	$1,530.00	$823.20	nat. median $2,013 outlier · 0.4×
C1751 HCPCS	Provina Max Barrier Powerpicc	8	$67.66	$1,032.33	$819.79	nat. median $278 outlier · 2.9×
11047 HCPCS	Bone Ea Addl 20 Sq Cm	8	$100.04	$1,427.15	$765.08	nat. median $937 0.8× median
D7953 HCPCS	Bone Graft For Ridge Preservation	8	$469.40	$850.00	$700.00	nat. median $1,803 outlier · 0.4×
D7250 HCPCS	Root Tip Extraction	8	$97.50	$1,367.52	$691.60	nat. median $1,079 0.6× median
31622 HCPCS	Bronchoscope-aop-middleton	8	$140.54	$1,275.00	$663.00	nat. median $2,056 outlier · 0.3×
49082 HCPCS	Paracentesis, Facility Fee	8	$77.51	$2,106.30	$654.00	nat. median $1,058 0.6× median
G0390 HCPCS	Trauma Team Activation	8	$318.22	$914.26	$650.00	nat. median $3,197 outlier · 0.2×
74170 HCPCS	CT Abdomen Wwo Contrast	8	$143.18	$1,551.25	$613.35	nat. median $710 0.9× median
99291 HCPCS	ER Critical Care 30-70 Min	8	$206.62	$987.70	$609.53	nat. median $1,530 outlier · 0.4×
36558 HCPCS	Tunld Cvc > 5 Yrs	8	$272.80	$1,150.15	$605.88	nat. median $3,504 outlier · 0.2×
54700 HCPCS	I&d Scrotal Abscess	8	$177.23	$4,661.40	$590.00	nat. median $2,374 outlier · 0.2×
25600 HCPCS	Reduction Distal Radial Fx Without Manipulat	8	$164.36	$795.60	$581.10	nat. median $444 1.3× median
90381 HCPCS	Beyfortus (nirsevimab) 100mg/1ml - Vfc	2	$560.44	$560.44	$560.44	nat. median $856 0.7× median
90380 HCPCS	Beyfortus (nirsevimab) 50mg/0.5ml - Vfc	2	$560.44	$560.44	$560.44	nat. median $908 0.6× median
87507 HCPCS	Gi Pcr Profile	8	$375.10	$918.54	$540.80	nat. median $549 1.0× median
D7285 HCPCS	Biopsy Oral Hard Tissue	8	$210.73	$705.50	$539.50	nat. median $615 0.9× median
31603 HCPCS	Tracheostomy Emergency	8	$269.40	$1,122.00	$525.00	nat. median $1,663 outlier · 0.3×
23650 HCPCS	Shldr Dslocation Wo Anes	8	$164.36	$763.30	$520.00	nat. median $476 1.1× median
D7473 HCPCS	Removal Mandibular Lingual Tori	8	$274.67	$586.50	$517.50	nat. median $1,414 outlier · 0.4×
10005 HCPCS	Fine Needle Aspiration With Imaging	8	$78.21	$1,224.00	$515.25	nat. median $930 0.6× median
P9037 HCPCS	Bb Irradiated/lr Plt Pheresis	8	$372.90	$690.18	$508.50	nat. median $943 0.5× median
11406 HCPCS	Exc Ben Les T/a/l Over 4c	8	$260.60	$1,190.57	$480.00	nat. median $1,752 outlier · 0.3×
D3330 HCPCS	Root Canal, Molar	8	$327.25	$565.95	$476.35	nat. median $1,181 outlier · 0.4×
94003 HCPCS	Ventilation Subs Day	8	$60.33	$584.80	$464.40	nat. median $828 0.6× median
94002 HCPCS	Ventilation Initial Setup	8	$85.93	$584.80	$464.40	nat. median $917 0.5× median
D7411 HCPCS	Excision Ben Lesion > 1.25cm	8	$315.46	$571.00	$461.25	nat. median $1,634 outlier · 0.3×
32554 HCPCS	Thoracentesis	8	$94.76	$1,407.60	$459.30	nat. median $861 0.5× median
90651 HCPCS	Gardasil 9 (hpv9) 0.5ml Clinic	8	$227.93	$897.70	$453.13	nat. median $408 1.1× median
P9035 HCPCS	Bb Lr Platelets Pheresis	8	$331.65	$798.38	$452.25	nat. median $804 0.6× median
25605 HCPCS	Closed Reduction Distal Radius Fx	8	$220.00	$1,220.60	$451.85	nat. median $1,668 outlier · 0.3×

Other procedures at this hospital

Browse this hospital's 5,199 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

21454	HCPCS	External Fixation, Mandible Fracture, Op	21	8	$3,961.00	$3,961.00	$407.53	$4,000.00	$2,600.00	2026-07-15
J0840	HCPCS	Crotalidae Polyvalent Inj	13	8	$9,272.00	$9,272.00	$2,077.79	$7,881.20	$2,304.72	2026-07-15
31030	HCPCS	Caldwell Luc	13	8	$3,500.00	$3,500.00	$521.42	$3,500.00	$2,275.00	2026-07-15
26951	HCPCS	Amputation Finger/thumb	18	8	$2,637.00	$2,637.00	$574.77	$3,677.10	$2,109.60	2026-07-15
41874	HCPCS	Alveoplasty - Hospital	13	8	$2,300.00	$2,300.00	$309.09	$2,258.80	$1,495.00	2026-07-15
40814	HCPCS	Excsion Lesion, Mouth With Repair,complex	13	8	$2,300.00	$2,300.00	$305.05	$2,258.80	$1,495.00	2026-07-15
40810	HCPCS	Excision Lesion, Mouth, Without Repair	13	8	$2,300.00	$2,300.00	$174.85	$2,258.80	$1,495.00	2026-07-15
D7740	HCPCS	Mandible, Closed Reduction	14	8	$1,850.00	$1,850.00	$1,017.50	$1,713.93	$1,387.50	2026-07-15
21040	HCPCS	Excision Cyst Mandible By Enucleation	13	8	$1,997.00	$1,997.00	$381.38	$1,997.00	$1,298.05	2026-07-15
41825	HCPCS	Exicsion Benign Lip Lesion, .5cm	13	8	$1,997.00	$1,997.00	$177.71	$1,997.00	$1,298.05	2026-07-15
41826	HCPCS	Excise/repair Mouth Lesion, Simple	13	8	$1,997.00	$1,997.00	$245.61	$1,997.00	$1,298.05	2026-07-15
21031	HCPCS	Removal Mandibular Lingual Tori	13	8	$1,997.00	$1,997.00	$310.90	$1,997.00	$1,298.05	2026-07-15
36569	HCPCS	Picc Insertion Aop	15	8	$4,308.00	$4,308.00	$78.89	$3,661.80	$1,181.28	2026-07-15
36580	HCPCS	Replace Non-tun Venous Cath , Ac/swing	13	8	$4,308.00	$4,308.00	$153.18	$3,661.80	$1,181.28	2026-07-15
40812	HCPCS	Excision Lesion Mouth, With Repair, Simple	14	8	$1,997.00	$1,997.00	$191.33	$1,697.45	$1,100.23	2026-07-15
11044	HCPCS	Debrid Subc Musc Bone	18	8	$1,679.00	$1,679.00	$240.28	$1,427.15	$1,024.07	2026-07-15
D7560	HCPCS	Caldwell Luc Procedure	13	8	$1,300.00	$1,300.00	$562.08	$1,259.79	$975.00	2026-07-15
D7260	HCPCS	Oroantral Fistula Closure	21	8	$1,450.00	$1,450.00	$434.47	$1,367.52	$942.50	2026-07-15
41130	HCPCS	Glossectomy, Partial	19	8	$1,200.00	$1,200.00	$660.00	$3,672.36	$900.00	2026-07-15
20694	HCPCS	Removal External Fixator Device	18	8	$1,176.00	$1,176.00	$352.29	$1,530.00	$823.20	2026-07-15
C1751	HCPCS	Provina Max Barrier Powerpicc	10	8	$1,214.51	$1,214.51	$67.66	$1,032.33	$819.79	2026-07-15
11047	HCPCS	Bone Ea Addl 20 Sq Cm	14	8	$1,679.00	$1,679.00	$100.04	$1,427.15	$765.08	2026-07-15
D7953	HCPCS	Bone Graft For Ridge Preservation	11	8	$1,000.00	$1,000.00	$469.40	$850.00	$700.00	2026-07-15
D7250	HCPCS	Root Tip Extraction	29	8	$1,064.00	$1,064.00	$97.50	$1,367.52	$691.60	2026-07-15
31622	HCPCS	Bronchoscope-aop-middleton	21	8	$663.00	$663.00	$140.54	$1,275.00	$663.00	2026-07-15
49082	HCPCS	Paracentesis, Facility Fee	21	8	$2,478.00	$2,478.00	$77.51	$2,106.30	$654.00	2026-07-15
G0390	HCPCS	Trauma Team Activation	13	8	$1,000.00	$1,000.00	$318.22	$914.26	$650.00	2026-07-15
74170	HCPCS	CT Abdomen Wwo Contrast	16	8	$1,825.00	$1,825.00	$143.18	$1,551.25	$613.35	2026-07-15
99291	HCPCS	ER Critical Care 30-70 Min	17	8	$625.00	$625.00	$206.62	$987.70	$609.53	2026-07-15
36558	HCPCS	Tunld Cvc > 5 Yrs	10	8	$655.00	$655.00	$272.80	$1,150.15	$605.88	2026-07-15
54700	HCPCS	I&d Scrotal Abscess	22	8	$590.00	$590.00	$177.23	$4,661.40	$590.00	2026-07-15
25600	HCPCS	Reduction Distal Radial Fx Without Manipulat	19	8	$936.00	$936.00	$164.36	$795.60	$581.10	2026-07-15
90380	HCPCS	Beyfortus (nirsevimab) 50mg/0.5ml - Vfc	2	2	—	—	$560.44	$560.44	$560.44	2026-07-15
90381	HCPCS	Beyfortus (nirsevimab) 100mg/1ml - Vfc	2	2	—	—	$560.44	$560.44	$560.44	2026-07-15
87507	HCPCS	Gi Pcr Profile	10	8	$832.00	$832.00	$375.10	$918.54	$540.80	2026-07-15
D7285	HCPCS	Biopsy Oral Hard Tissue	14	8	$830.00	$830.00	$210.73	$705.50	$539.50	2026-07-15
31603	HCPCS	Tracheostomy Emergency	22	8	$525.00	$525.00	$269.40	$1,122.00	$525.00	2026-07-15
23650	HCPCS	Shldr Dslocation Wo Anes	19	8	$800.00	$800.00	$164.36	$763.30	$520.00	2026-07-15
D7473	HCPCS	Removal Mandibular Lingual Tori	10	8	$690.00	$690.00	$274.67	$586.50	$517.50	2026-07-15
10005	HCPCS	Fine Needle Aspiration With Imaging	13	8	$1,440.00	$1,440.00	$78.21	$1,224.00	$515.25	2026-07-15
P9037	HCPCS	Bb Irradiated/lr Plt Pheresis	13	8	$678.00	$678.00	$372.90	$690.18	$508.50	2026-07-15
11406	HCPCS	Exc Ben Les T/a/l Over 4c	22	8	$480.00	$480.00	$260.60	$1,190.57	$480.00	2026-07-15
D3330	HCPCS	Root Canal, Molar	11	8	$595.00	$595.00	$327.25	$565.95	$476.35	2026-07-15
94003	HCPCS	Ventilation Subs Day	10	8	$688.00	$688.00	$60.33	$584.80	$464.40	2026-07-15
94002	HCPCS	Ventilation Initial Setup	10	8	$688.00	$688.00	$85.93	$584.80	$464.40	2026-07-15
D7411	HCPCS	Excision Ben Lesion > 1.25cm	13	8	$615.00	$615.00	$315.46	$571.00	$461.25	2026-07-15
32554	HCPCS	Thoracentesis	39	8	$543.00	$543.00	$94.76	$1,407.60	$459.30	2026-07-15
90651	HCPCS	Gardasil 9 (hpv9) 0.5ml Clinic	10	8	$1,056.12	$1,056.12	$227.93	$897.70	$453.13	2026-07-15
P9035	HCPCS	Bb Lr Platelets Pheresis	13	8	$603.00	$603.00	$331.65	$798.38	$452.25	2026-07-15
25605	HCPCS	Closed Reduction Distal Radius Fx	23	8	$1,436.00	$1,436.00	$220.00	$1,220.60	$451.85	2026-07-15
D7461	HCPCS	Non Odontogenic Cyst Removal >1.25cm	11	8	$600.00	$600.00	$327.38	$510.14	$450.00	2026-07-15
15275	HCPCS	Ap Skin Sub Head Hand Ft	21	8	$690.00	$690.00	$100.10	$690.00	$448.50	2026-07-15
23505	HCPCS	Cl Tx Clavclr Fx W Manipu	13	8	$670.00	$670.00	$299.90	$727.37	$435.50	2026-07-15
D7520	HCPCS	I&d Extraoral, Lip	13	8	$670.00	$670.00	$270.65	$637.05	$435.50	2026-07-15
99285	HCPCS	Level V	17	8	$504.00	$504.00	$151.62	$829.60	$435.17	2026-07-15
23330	HCPCS	Removal Fb Shoulder Subc	22	8	$585.00	$585.00	$176.17	$640.00	$427.38	2026-07-15
32551	HCPCS	Chest Tube Insertion	23	8	$500.00	$500.00	$130.45	$1,181.28	$425.00	2026-07-15
27086	HCPCS	Rem Fb Pelvis Hip Subcut	22	8	$540.00	$540.00	$177.56	$640.00	$416.00	2026-07-15
D7451	HCPCS	Removal Odontogenic Cyst/tumor 1.25cm>	15	8	$550.00	$550.00	$291.50	$510.14	$410.57	2026-07-15
26725	HCPCS	Closed Reduction Finger Fx With Manipulat	19	8	$852.00	$852.00	$164.36	$724.20	$409.50	2026-07-15
11043	HCPCS	Subct Musc 1st 20 Sq Cm	22	8	$540.00	$540.00	$163.39	$822.80	$409.50	2026-07-15
15271	HCPCS	Ap Skin Sub Trunk Arm Leg	21	8	$620.00	$620.00	$89.33	$620.00	$403.00	2026-07-15
11626	HCPCS	Excision Malig Lesion > 4.0	13	8	$600.00	$600.00	$330.00	$600.00	$390.00	2026-07-15
90736	HCPCS	Zoster (zostavax) Vaccine Live	10	8	$667.00	$667.00	$212.67	$566.95	$389.81	2026-07-15
D6010	HCPCS	Dental Implant 1st Phase	15	8	$550.00	$550.00	$302.50	$818.71	$385.00	2026-07-15
42970	HCPCS	Ctrl Nasopharyngeal Hem	13	8	$865.00	$865.00	$165.00	$1,159.37	$379.96	2026-07-15
D3320	HCPCS	Root Canal, Bicuspid	15	8	$502.00	$502.00	$276.10	$456.41	$376.50	2026-07-15
M0245	HCPCS	Infusion Of Bamlanivimab & Etesevimab	13	8	$450.00	$450.00	$247.50	$450.00	$372.20	2026-07-15
M0243	HCPCS	Infusion/injecti Casirivima & Imdevimab	13	8	$450.00	$450.00	$247.50	$450.00	$372.20	2026-07-15
75635	HCPCS	CT Bilateral Le Rnffs W Cont	13	8	$2,415.00	$2,415.00	$143.18	$2,052.75	$369.80	2026-07-15
D7471	HCPCS	Removal Exostosis Maxilla/mandible	15	8	$482.00	$482.00	$265.10	$462.23	$363.75	2026-07-15
62270	HCPCS	Lumbar Punct	34	8	$900.00	$900.00	$68.01	$1,654.95	$360.00	2026-07-15
36556	HCPCS	Nontunld Cvc > 5 Yrs ER Only	37	8	$645.00	$645.00	$90.39	$7,453.65	$354.00	2026-07-15
31605	HCPCS	Trachemer Cricothyroid M	19	8	$465.00	$465.00	$165.00	$1,105.00	$348.75	2026-07-15
90620	HCPCS	Bexsero (meningococcal B Omv) Clinic	10	8	$813.32	$813.32	$179.25	$691.32	$343.23	2026-07-15
23655	HCPCS	Shoulder Dislocation With Anesthesia	23	8	$900.00	$900.00	$165.00	$900.00	$339.74	2026-07-15
D7280	HCPCS	Surgical Access Of Unerupted Tooth	11	8	$450.00	$450.00	$185.75	$400.75	$337.50	2026-07-15
92950	HCPCS	Cpr Ed Treat	23	8	$395.00	$395.00	$197.82	$742.05	$335.75	2026-07-15
D7970	HCPCS	Removal Hyperplastic Tissue	11	8	$508.00	$508.00	$239.16	$431.80	$330.20	2026-07-15
D7241	HCPCS	Surgical Extract, Fb, Complicated	21	8	$1,400.00	$1,400.00	$213.20	$1,367.52	$328.00	2026-07-15
32555	HCPCS	Thoracentesis With Imaging -middleton	13	8	$500.00	$500.00	$116.52	$459.30	$325.00	2026-07-15
11624	HCPCS	Excision Malig Lesion 3.1	13	8	$500.00	$500.00	$275.00	$500.00	$325.00	2026-07-15
36410	HCPCS	Midline Insertion, Acute Or Swing	13	8	$500.00	$500.00	$14.19	$425.00	$325.00	2026-07-15
36430	HCPCS	Bb Trans Charge Bld	13	8	$522.00	$522.00	$30.15	$443.70	$323.73	2026-07-15
90677	HCPCS	Prevnar-20 (pcv 20) 0.5ml - Vfc	2	2	—	—	$320.42	$320.42	$320.42	2026-07-15
36589	HCPCS	Rmvl Tunld Cvc Wo Subq P	22	8	$320.00	$320.00	$136.67	$606.44	$320.00	2026-07-15
D7270	HCPCS	Tooth Reimplant Stabilization	14	8	$450.00	$450.00	$217.23	$429.38	$319.15	2026-07-15
26700	HCPCS	Cl Tx Mtcpgl Dis Sngw M	13	8	$725.00	$725.00	$164.36	$680.26	$318.50	2026-07-15
D3310	HCPCS	Root Canal, Anterior	11	8	$400.00	$400.00	$220.00	$372.43	$316.21	2026-07-15
11422	HCPCS	S/n/h/f/g 1.1 - 2.0cm	22	8	$315.00	$315.00	$142.57	$640.00	$315.00	2026-07-15
D7950	HCPCS	Dental Bone Graft, Per Site	15	8	$450.00	$450.00	$247.50	$1,147.49	$315.00	2026-07-15
77086	HCPCS	Dxa Vertebral Fracture Assessment	10	8	$550.00	$550.00	$29.43	$467.50	$312.50	2026-07-15
74178	HCPCS	CT Abd Pel Wwo Contrast	13	8	$1,600.00	$1,600.00	$284.28	$1,360.00	$306.76	2026-07-15
12045	HCPCS	12.6 To 20.0 Cm	10	8	$323.00	$323.00	$209.95	$500.86	$305.06	2026-07-15
D7450	HCPCS	Removal Odontogenic Cyst/tumor 1.25cm<	15	8	$400.00	$400.00	$228.25	$373.27	$304.69	2026-07-15
D7460	HCPCS	Non Odontogenic Cyst Removal <1.25cm	11	8	$400.00	$400.00	$220.00	$373.27	$303.44	2026-07-15
99284	HCPCS	Level IV	17	8	$348.00	$348.00	$104.22	$565.25	$302.98	2026-07-15
D7410	HCPCS	Excision Ben. Lesion <1.25cm	13	8	$400.00	$400.00	$193.65	$373.27	$300.00	2026-07-15
12035	HCPCS	12.6 To 20.0 Cm	13	8	$304.00	$304.00	$197.60	$446.10	$296.19	2026-07-15
12054	HCPCS	7.6 To 12.5 Cm	23	8	$460.00	$460.00	$126.50	$407.23	$296.19	2026-07-15
74177	HCPCS	CT Abd Pel W Contrast	13	8	$1,596.00	$1,596.00	$253.95	$1,356.60	$292.51	2026-07-15
73201	HCPCS	CT Upper Extremity W Contrast	13	8	$1,596.00	$1,596.00	$167.33	$1,356.60	$292.51	2026-07-15
92960	HCPCS	Cardioversion, Elective	22	8	$564.00	$564.00	$114.56	$479.40	$288.75	2026-07-15
11770	HCPCS	Excision Pilonidal Cyst	13	8	$300.00	$300.00	$165.00	$345.98	$287.05	2026-07-15
40808	HCPCS	Biopsy, Vestibule Of Mouth	13	8	$436.00	$436.00	$136.18	$370.60	$283.40	2026-07-15
11400	HCPCS	Exc Ben Les T/a/l 0.5cm <	30	8	$450.00	$450.00	$87.88	$495.00	$282.38	2026-07-15
J3030	HCPCS	Sumatriptan (imitrex) 6mg/0.5ml Inj	13	8	$628.00	$628.00	$29.98	$533.80	$281.89	2026-07-15
10121	HCPCS	Inc Rmvl Fb Subq Complic	21	8	$395.00	$395.00	$194.27	$395.00	$281.25	2026-07-15
26600	HCPCS	Cl Tx Mtcrpl Fx Sngl Wo	13	8	$525.00	$525.00	$164.36	$616.71	$279.99	2026-07-15
D7286	HCPCS	Biopsy Oral Soft Tissue	15	8	$375.00	$375.00	$132.07	$318.75	$277.50	2026-07-15
11421	HCPCS	Exc B Les S/n/h/f/g .6-1.	22	8	$280.00	$280.00	$115.08	$495.00	$276.12	2026-07-15
26010	HCPCS	Finger Abscess	28	8	$549.00	$549.00	$73.70	$510.00	$275.81	2026-07-15
74175	HCPCS	CT CTA Abdomen	13	8	$1,495.00	$1,495.00	$143.18	$1,270.75	$275.48	2026-07-15
D7240	HCPCS	Surgical Extraction, Full Bony	21	8	$1,400.00	$1,400.00	$175.50	$1,367.52	$270.00	2026-07-15
12053	HCPCS	5.1 To 7.5 Cm	23	8	$415.00	$415.00	$96.25	$396.72	$269.75	2026-07-15
12020	HCPCS	Tx Sprfcl Wnd Dehisc Sim	13	8	$400.00	$400.00	$198.38	$400.00	$268.08	2026-07-15
12044	HCPCS	7.6 To 12.5cm	23	8	$410.00	$410.00	$96.25	$410.00	$266.50	2026-07-15
M0239	HCPCS	Infusion Of Bamlanivimab	9	8	$350.00	$350.00	$192.50	$309.60	$262.50	2026-07-15
97606	HCPCS	Neg Pres Wound Tx 50 Cm >	13	8	$400.00	$400.00	$42.03	$340.00	$260.00	2026-07-15
90670	HCPCS	Prevnar-13 (pcv 13) 0.5ml - Vfc	15	8	$908.04	$908.04	$169.11	$771.83	$257.99	2026-07-15
71275	HCPCS	CT CTA Chest	13	8	$1,495.00	$1,495.00	$143.18	$1,270.75	$254.21	2026-07-15
12034	HCPCS	7.6 To 12.5 Cm	23	8	$390.00	$390.00	$96.25	$379.29	$253.50	2026-07-15
70496	HCPCS	CT CTA Brain	13	8	$1,495.00	$1,495.00	$143.18	$1,270.75	$249.07	2026-07-15
70498	HCPCS	CT CTA Carotid Neck	13	8	$1,495.00	$1,495.00	$143.18	$1,270.75	$248.79	2026-07-15
10180	HCPCS	I&d Cmplx Postop Wnd Infe	13	8	$375.00	$375.00	$187.19	$375.00	$243.75	2026-07-15
11403	HCPCS	Exc Ben Les T/a/l 2.1-3.0	30	8	$340.00	$340.00	$118.25	$544.00	$238.00	2026-07-15
10061	HCPCS	Complicated Or Multiple	39	8	$315.00	$315.00	$137.50	$669.80	$237.25	2026-07-15
27550	HCPCS	Knee	23	8	$498.00	$498.00	$128.70	$1,031.94	$234.00	2026-07-15
93975	HCPCS	US Renal Vasc Complete	13	8	$705.00	$705.00	$185.40	$599.25	$230.25	2026-07-15
64450	HCPCS	Digital Nerve Block	22	8	$227.00	$227.00	$44.72	$1,652.40	$227.00	2026-07-15
72194	HCPCS	CT Pelvis Wwo Contrast	13	8	$1,825.00	$1,825.00	$143.18	$1,551.25	$226.43	2026-07-15
12052	HCPCS	2.6 To 5.0 Cm	32	8	$245.00	$245.00	$85.25	$367.78	$225.18	2026-07-15
D7251	HCPCS	Coronectomy	14	8	$300.00	$300.00	$165.00	$274.41	$225.00	2026-07-15
26605	HCPCS	Cl Tx Mtcrpl Fx Sngl W Ma	23	8	$580.00	$580.00	$123.75	$645.50	$225.00	2026-07-15
D7530	HCPCS	Fb Removal Cheek	11	8	$300.00	$300.00	$145.40	$255.00	$225.00	2026-07-15
D7230	HCPCS	Surgical Extraction, Partial Bony	21	8	$1,400.00	$1,400.00	$146.25	$1,367.52	$225.00	2026-07-15
99236	HCPCS	Adm Dc Same Day High	13	8	$300.00	$300.00	$178.29	$255.00	$225.00	2026-07-15
12042	HCPCS	2.6 To 7.5 Cm	32	8	$242.00	$242.00	$85.25	$361.28	$223.19	2026-07-15
11623	HCPCS	Exc Mal Les S/n/h/f/g 2.	10	8	$220.00	$220.00	$143.00	$387.39	$220.00	2026-07-15
97602	HCPCS	Non Selective Debridement	13	8	$336.00	$336.00	$143.37	$285.60	$218.40	2026-07-15
11440	HCPCS	Exc Les F/e/e/n/l/m 0.5<	30	8	$280.00	$280.00	$111.26	$495.00	$218.00	2026-07-15
11441	HCPCS	Exc Les F/e/e/n/l/m 0.6-1	31	8	$335.00	$335.00	$79.75	$495.00	$217.75	2026-07-15
94660	HCPCS	Cpap/bipap	10	8	$317.00	$317.00	$58.60	$269.45	$213.98	2026-07-15
92523	HCPCS	St Eval Speech Sound W Lang Comprehensio	10	8	$331.00	$331.00	$182.05	$281.35	$213.89	2026-07-15
86905	HCPCS	Antigen Typing	19	8	$213.00	$213.00	$3.45	$659.60	$213.00	2026-07-15
28515	HCPCS	Toe Strapping	19	8	$397.00	$397.00	$134.96	$337.45	$211.25	2026-07-15
16030	HCPCS	Burn Dressing/debridement, Large	32	8	$510.00	$510.00	$96.25	$555.90	$211.25	2026-07-15
74160	HCPCS	CT Abdomen W Contrast	13	8	$1,596.00	$1,596.00	$143.18	$1,356.60	$209.64	2026-07-15
86870	HCPCS	Cell Panel For Antibody Id	12	8	$272.00	$272.00	$6.55	$257.33	$208.90	2026-07-15
12032	HCPCS	2.6 To 7.5 Cm	32	8	$218.00	$218.00	$85.25	$347.78	$208.62	2026-07-15
93925	HCPCS	US Bil Arterial Lwr Comp	13	8	$529.00	$529.00	$185.40	$449.65	$208.12	2026-07-15
96365	HCPCS	Ivpb Administration, 1st Hour	29	8	$368.00	$368.00	$50.17	$313.65	$208.00	2026-07-15
11042	HCPCS	Deb Subct 1st 20 Sq Cm	40	8	$355.00	$355.00	$55.55	$459.00	$207.62	2026-07-15
72193	HCPCS	CT Pelvis W Contrast	13	8	$1,596.00	$1,596.00	$143.18	$1,356.60	$205.44	2026-07-15
99205	HCPCS	Hbo New Pt Level 5	19	8	$542.00	$542.00	$151.25	$460.70	$204.07	2026-07-15
D7910	HCPCS	Laceration Repair Tongue	13	8	$275.00	$275.00	$140.23	$233.75	$204.06	2026-07-15
12051	HCPCS	2.5 Cm Or Less	32	8	$218.00	$218.00	$74.25	$311.48	$201.65	2026-07-15
11404	HCPCS	Exc Benign Les 3.1 To 4.0	13	8	$298.00	$298.00	$163.90	$301.44	$201.42	2026-07-15
70492	HCPCS	CT Soft Tissue Neck Wwo Con	13	8	$1,825.00	$1,825.00	$143.18	$1,551.25	$200.56	2026-07-15
11442	HCPCS	Lesion Removal Forehead 1-2cm	29	8	$300.00	$300.00	$110.00	$515.25	$200.00	2026-07-15
46320	HCPCS	Exc Thrmbsd Hemrhd Exter	22	8	$200.00	$200.00	$120.23	$2,749.75	$200.00	2026-07-15
11602	HCPCS	Exc Malig Lesion 1-1.2cm	13	8	$250.00	$250.00	$162.50	$297.83	$199.23	2026-07-15
76942	HCPCS	US Guidance 4 Needle Plcm	13	8	$264.00	$264.00	$47.88	$263.00	$198.00	2026-07-15
10140	HCPCS	Hematoma	22	8	$195.00	$195.00	$124.72	$2,442.90	$195.00	2026-07-15
99283	HCPCS	Level Iii	17	8	$207.00	$207.00	$61.79	$341.70	$194.54	2026-07-15
43762	HCPCS	Change Of Peg Tubing	24	8	$651.00	$651.00	$40.00	$553.35	$191.26	2026-07-15
90710	HCPCS	Proquad (mmrv) Vaccine Live 0.5ml - Vfc	11	8	$1,062.64	$1,062.64	$191.12	$903.24	$191.12	2026-07-15
J1610	HCPCS	Glucagon (glucagen) 1mg Inj	13	8	$868.00	$868.00	$108.00	$737.80	$190.26	2026-07-15
70482	HCPCS	CT Orbit/iac W/wo Contrast	13	8	$1,217.00	$1,217.00	$143.18	$1,034.45	$190.07	2026-07-15
12021	HCPCS	Tx Sprfcl Wnd Dehisc W Pa	13	8	$290.00	$290.00	$145.09	$290.00	$188.50	2026-07-15
12041	HCPCS	2.5 Cm Or Less	32	8	$209.00	$209.00	$74.25	$296.19	$187.95	2026-07-15
64400	HCPCS	Dental Nerve Block	19	8	$250.00	$250.00	$54.13	$255.00	$187.50	2026-07-15
11982	HCPCS	Removal Drug Delivery Implant	13	8	$288.00	$288.00	$92.34	$288.00	$187.20	2026-07-15
11443	HCPCS	Exc Ben Lesion 2.1-3.ocm	13	8	$220.00	$220.00	$143.00	$328.81	$187.00	2026-07-15
99496	HCPCS	Transitional Care - Complex In 7 Days	14	8	$266.00	$266.00	$137.50	$256.23	$186.20	2026-07-15
11401	HCPCS	T/a/l .6 To 1.0 Cm	34	8	$270.00	$270.00	$79.75	$365.50	$186.00	2026-07-15
99223	HCPCS	Initial Hosp Visit High	15	8	$220.00	$220.00	$147.84	$206.00	$185.50	2026-07-15
93970	HCPCS	US Bil Venous Comp Lower	13	8	$562.00	$562.00	$148.83	$477.70	$185.40	2026-07-15
70320	HCPCS	Dental Panoramic	13	8	$375.00	$375.00	$41.76	$590.60	$185.40	2026-07-15
93308	HCPCS	US Limited Followup Echo 2d	13	8	$298.00	$298.00	$78.26	$253.30	$185.40	2026-07-15
93880	HCPCS	US Bilateral Carotid	13	8	$529.00	$529.00	$151.33	$449.65	$185.40	2026-07-15
93978	HCPCS	US Retroperitoneal Vasc Comp	13	8	$397.00	$397.00	$142.95	$337.45	$185.40	2026-07-15
74176	HCPCS	CT Abd Pel Wo Contrast	13	8	$1,217.00	$1,217.00	$154.38	$1,034.45	$185.40	2026-07-15
93930	HCPCS	US Bil Arterial Upr Comp	13	8	$529.00	$529.00	$154.90	$449.65	$185.40	2026-07-15
93307	HCPCS	US Echo 2-d/mmode	13	8	$1,725.00	$1,725.00	$109.71	$1,466.25	$185.40	2026-07-15
99235	HCPCS	Adm Dc Same Day Moderate	13	8	$275.00	$275.00	$135.90	$233.75	$185.27	2026-07-15
99344	HCPCS	Home Visit, New, 4	13	8	$346.00	$346.00	$122.48	$294.10	$183.00	2026-07-15
41250	HCPCS	Repair Tongue Laceration	32	8	$200.00	$200.00	$93.50	$424.91	$182.50	2026-07-15
76810	HCPCS	US OB 2/3 Trimester Multiple	13	8	$245.00	$245.00	$72.84	$229.00	$181.88	2026-07-15
12016	HCPCS	F/e/e/n/l/m 12.6-20.0cm	23	8	$360.00	$360.00	$90.75	$306.00	$181.03	2026-07-15
20552	HCPCS	Trigger Point Injection 1-2 Muscles	27	8	$579.00	$579.00	$39.35	$568.65	$180.00	2026-07-15
D7220	HCPCS	Surgical Extraction, Soft Tissue	21	8	$1,400.00	$1,400.00	$117.00	$1,367.52	$180.00	2026-07-15
29425	HCPCS	Cast - Walking Boot	19	8	$210.00	$210.00	$57.37	$604.35	$178.50	2026-07-15
86231	HCPCS	Endomysial Antibody, IgA	10	8	$264.00	$264.00	$12.09	$224.40	$178.20	2026-07-15
99350	HCPCS	Home Visit, Established, 4	13	8	$336.00	$336.00	$157.91	$285.60	$178.00	2026-07-15
24640	HCPCS	Closed Tx Nursemaid Elbow, Child	19	8	$333.00	$333.00	$85.72	$283.05	$177.78	2026-07-15
31500	HCPCS	Intubation	28	8	$270.00	$270.00	$120.05	$586.50	$177.75	2026-07-15
99292	HCPCS	Cc Each Addl 30 Min	19	8	$282.00	$282.00	$101.35	$269.45	$177.71	2026-07-15
71270	HCPCS	CT Chest Wwo Contrast	13	8	$1,825.00	$1,825.00	$143.18	$1,551.25	$177.23	2026-07-15
20520	HCPCS	Removal Fb Simple	13	8	$200.00	$200.00	$110.00	$318.53	$175.99	2026-07-15
P9016	HCPCS	Bb Lr Prbc Unit	13	8	$234.00	$234.00	$128.70	$317.60	$175.50	2026-07-15
10120	HCPCS	Incision & Fb Removal -subq	32	8	$285.00	$285.00	$58.85	$296.19	$175.12	2026-07-15
29405	HCPCS	Cast - Short Leg	22	8	$174.00	$174.00	$61.85	$321.30	$174.00	2026-07-15
90649	HCPCS	Hpv Vaccine	8	7	—	—	$172.85	$181.20	$172.85	2026-07-15
D7320	HCPCS	Alveoplasty Without Extractions	10	8	$220.00	$220.00	$143.00	$202.19	$172.59	2026-07-15
11423	HCPCS	Excis Ben Lesion 2.1-3.0 Scalp Neck Hand	13	8	$230.00	$230.00	$126.50	$286.50	$172.50	2026-07-15
93306	HCPCS	Echo Interpretation - Dr. Smith	26	8	$962.50	$962.50	$58.58	$1,466.25	$172.01	2026-07-15
12031	HCPCS	Layer Close S/a/t/e 2.5 <	32	8	$189.00	$189.00	$74.25	$280.00	$171.32	2026-07-15
99220	HCPCS	Initial Obs Care High	13	8	$200.00	$200.00	$150.00	$193.92	$170.00	2026-07-15
33010	HCPCS	Pericardiocent	9	8	$265.00	$265.00	$99.09	$225.25	$169.60	2026-07-15
11402	HCPCS	Exc Ben Les T/a/l 1.1-2.0	30	8	$260.00	$260.00	$90.75	$300.00	$169.00	2026-07-15
30300	HCPCS	Removal Of Fb Nose	28	8	$315.00	$315.00	$48.95	$303.82	$168.98	2026-07-15
90792	HCPCS	Psych Eval With Medical, Pro Fee	13	8	$276.00	$276.00	$115.68	$234.60	$168.54	2026-07-15
70491	HCPCS	CT Soft Tissue Neck W Contr	13	8	$1,596.00	$1,596.00	$143.18	$1,356.60	$167.35	2026-07-15
42809	HCPCS	Rem Fb Pharynx	23	8	$415.00	$415.00	$33.00	$355.82	$166.43	2026-07-15
30901	HCPCS	Ant Hemor Simple	19	8	$277.00	$277.00	$60.74	$255.00	$165.00	2026-07-15
28490	HCPCS	Tx Big Toe Fx	14	8	$280.00	$280.00	$116.14	$265.34	$164.36	2026-07-15
26770	HCPCS	Clsd Reduction Fngr Dislo	23	8	$225.00	$225.00	$97.50	$567.47	$164.36	2026-07-15
26641	HCPCS	Thumb	23	8	$337.00	$337.00	$55.00	$829.26	$164.36	2026-07-15
24600	HCPCS	Elbow Dislocation	23	8	$225.00	$225.00	$97.50	$742.08	$164.36	2026-07-15
23500	HCPCS	Cl Tx Clavicle Wo Manipul	13	8	$176.00	$176.00	$114.40	$490.24	$164.36	2026-07-15
21480	HCPCS	Closed Treatment Of Jaw	19	8	$240.00	$240.00	$33.41	$299.20	$164.36	2026-07-15
D7283	HCPCS	Placement Of Device To Facilitate Erupte	15	8	$200.00	$200.00	$110.00	$267.75	$164.06	2026-07-15
97598	HCPCS	Select Debrid Addl 20 Sq	18	8	$296.00	$296.00	$26.45	$251.60	$163.15	2026-07-15
70481	HCPCS	CT Orbit/iac With Contrast	13	8	$1,217.00	$1,217.00	$143.18	$1,034.45	$163.03	2026-07-15
40800	HCPCS	I&d Extraoral, Lip	13	8	$215.00	$215.00	$118.25	$327.24	$162.33	2026-07-15
11046	HCPCS	Subct Musc Addl 20 Sq Cm	22	8	$540.00	$540.00	$58.39	$459.00	$162.12	2026-07-15
96105	HCPCS	St Assessment Of Aphasia	10	8	$231.00	$231.00	$90.11	$196.35	$161.70	2026-07-15
90791	HCPCS	Psych Dx Intvw Biops Eval	18	8	$275.00	$275.00	$115.68	$233.75	$160.55	2026-07-15
69000	HCPCS	Drain Ext Ear Absc Hem Si	23	8	$280.00	$280.00	$88.00	$280.00	$160.00	2026-07-15
90837	HCPCS	Individual Therapy 60 Minutes	18	8	$400.00	$400.00	$115.68	$340.00	$159.90	2026-07-15
D7550	HCPCS	Sequestrectomy	15	8	$315.00	$315.00	$122.20	$267.75	$159.80	2026-07-15
10060	HCPCS	I&d Abscess Single Simpl	42	8	$294.00	$294.00	$102.36	$415.65	$158.85	2026-07-15
70470	HCPCS	CT Head Wwo Contrast	13	8	$1,825.00	$1,825.00	$143.18	$1,551.25	$157.45	2026-07-15
92522	HCPCS	St Eval Speech Sound Production	10	8	$331.00	$331.00	$94.19	$281.35	$157.17	2026-07-15
99204	HCPCS	Hbo New Pt Level 4	19	8	$435.00	$435.00	$113.02	$369.75	$154.51	2026-07-15
76800	HCPCS	US Spinal Contents	13	8	$324.00	$324.00	$84.86	$289.62	$152.20	2026-07-15
31720	HCPCS	Naso-tracheal Suction	13	8	$372.00	$372.00	$41.58	$316.20	$152.04	2026-07-15
99215	HCPCS	Est Patient Level 4	19	8	$321.00	$321.00	$107.25	$323.00	$152.00	2026-07-15
71260	HCPCS	CT Chest W Contrast	13	8	$1,596.00	$1,596.00	$138.92	$1,356.60	$151.27	2026-07-15
41800	HCPCS	I&d Oral Mucosa	32	8	$195.00	$195.00	$59.40	$418.29	$151.12	2026-07-15
11420	HCPCS	Excision Lesion, .5cm<, Thumb	38	8	$190.00	$190.00	$82.50	$495.00	$150.64	2026-07-15
64402	HCPCS	Dental Nerve Block, Facial	9	8	$250.00	$250.00	$87.62	$212.50	$150.06	2026-07-15
28190	HCPCS	Removal Fb Foot Subcuta	21	8	$150.00	$150.00	$82.50	$289.41	$150.00	2026-07-15
86971	HCPCS	Enzyme Techniques	13	8	$200.00	$200.00	$17.12	$213.80	$150.00	2026-07-15
20612	HCPCS	Aspiration Ganglion Cyst	27	8	$270.00	$270.00	$43.76	$391.00	$150.00	2026-07-15
36680	HCPCS	Intraosseous Needle Placement	29	8	$175.00	$175.00	$50.21	$299.77	$150.00	2026-07-15
51705	HCPCS	Suprapubic Catheter Reinsertion	31	8	$246.00	$246.00	$54.97	$258.40	$148.75	2026-07-15
99387	HCPCS	New Phys 65>	13	8	$210.00	$210.00	$115.50	$178.50	$147.00	2026-07-15
80346	HCPCS	Benzodiazepine & Metabolite Confir Urine	9	8	$300.00	$300.00	$16.11	$255.00	$146.35	2026-07-15
73200	HCPCS	CT Up Extrem Wo Cont Left	26	8	$1,217.00	$1,217.00	$84.86	$1,034.45	$145.43	2026-07-15
D7210	HCPCS	Surgical Extraction	21	8	$1,400.00	$1,400.00	$94.25	$1,367.52	$145.00	2026-07-15
70480	HCPCS	CT Orbit Wo Contrast	13	8	$1,217.00	$1,217.00	$84.86	$1,034.45	$144.74	2026-07-15
99495	HCPCS	Transitional Care - Moderate With 14 Days	14	8	$200.00	$200.00	$96.25	$189.31	$144.38	2026-07-15
J3101	HCPCS	Tenecteplase (TNKase) 50mg Inj	13	8	$19,576.00	$19,576.00	$75.50	$16,639.60	$143.69	2026-07-15
12015	HCPCS	7.6 To 12.5 Cm	19	8	$415.00	$415.00	$101.58	$352.75	$143.37	2026-07-15
97597	HCPCS	Select Debrid 1st 20 Sq C	18	8	$296.00	$296.00	$38.41	$251.60	$143.37	2026-07-15
16025	HCPCS	Drsg Dbrd Burn Medium	24	8	$240.00	$240.00	$88.00	$233.75	$143.37	2026-07-15
70487	HCPCS	CT Facial With Contrast	13	8	$1,217.00	$1,217.00	$126.93	$1,034.45	$143.18	2026-07-15
70460	HCPCS	CT Head W Contrast	13	8	$1,596.00	$1,596.00	$123.57	$1,356.60	$143.18	2026-07-15
74400	HCPCS	Cr I V P	13	8	$298.00	$298.00	$107.96	$644.56	$143.18	2026-07-15
99343	HCPCS	Home Visit, New, 3	13	8	$248.00	$248.00	$109.54	$210.80	$142.94	2026-07-15
12014	HCPCS	5.1 To 7.5 Cm	24	8	$330.00	$330.00	$80.93	$280.50	$141.05	2026-07-15
43753	HCPCS	Gastric Intub & Asp Lavag	22	8	$150.00	$150.00	$18.32	$222.35	$141.00	2026-07-15
99310	HCPCS	Subs Care Unstable - Smith	36	8	$250.00	$250.00	$57.75	$212.50	$140.25	2026-07-15
D4266	HCPCS	Guided Tissue Regeneration	10	8	$200.00	$200.00	$110.00	$285.31	$140.00	2026-07-15
12001	HCPCS	Simple Repair 2.5 Or Less	36	8	$245.00	$245.00	$47.94	$224.40	$139.30	2026-07-15
93976	HCPCS	US Visceral Vasc Limited	13	8	$304.00	$304.00	$84.86	$258.40	$138.74	2026-07-15
92526	HCPCS	St Treat Of Swall Dysfunctio	10	8	$231.00	$231.00	$71.45	$196.35	$138.60	2026-07-15
81270	HCPCS	Jak2 Mutation Analysis, Qual	10	8	$388.00	$388.00	$82.49	$329.80	$138.31	2026-07-15
99234	HCPCS	Adm Dc Same Day Low	13	8	$200.00	$200.00	$84.07	$170.00	$137.68	2026-07-15
99219	HCPCS	Initial Obs Care Mod	13	8	$180.00	$180.00	$114.83	$153.00	$137.00	2026-07-15
70490	HCPCS	CT Soft Tissue Neck Wo Cont	13	8	$1,217.00	$1,217.00	$84.86	$1,034.45	$136.83	2026-07-15
99386	HCPCS	New Phys 40-64	13	8	$195.00	$195.00	$107.25	$165.75	$136.50	2026-07-15
97162	HCPCS	Pt Evaluation, Moderate	10	8	$264.00	$264.00	$84.53	$224.40	$136.22	2026-07-15
97163	HCPCS	Pt Evaluation, High Complexity	10	8	$264.00	$264.00	$84.53	$224.40	$136.22	2026-07-15
97161	HCPCS	Pt Evaluation, Low	10	8	$264.00	$264.00	$84.53	$224.40	$136.22	2026-07-15
99222	HCPCS	Initial Hosp Visit Mod	15	8	$170.00	$170.00	$110.74	$153.00	$136.00	2026-07-15
90716	HCPCS	Varicella Virus Vaccine 0.5ml	17	8	$357.00	$357.00	$115.16	$516.90	$135.72	2026-07-15
10080	HCPCS	I&d Piloridal Cyst	10	8	$146.00	$146.00	$80.30	$192.01	$135.05	2026-07-15
12004	HCPCS	Repair 7.6 To 12.5 Cm	24	8	$300.00	$300.00	$78.98	$255.00	$134.89	2026-07-15
J1205	HCPCS	Chlorothiazide (diuril) 500mg Vial	13	8	$170.00	$170.00	$74.42	$175.52	$134.51	2026-07-15
D7960	HCPCS	Frenulectomy	10	8	$192.00	$192.00	$105.60	$163.20	$134.40	2026-07-15
92524	HCPCS	St Analysis Of Voice & Resonance	10	8	$251.00	$251.00	$93.16	$213.35	$134.26	2026-07-15
90734	HCPCS	Menveo (meningococcal Mcv40) - Vfc	14	8	$595.44	$595.44	$105.99	$506.12	$134.01	2026-07-15
90732	HCPCS	Pneumococcal Vaccine 23 25mcg/0.5ml Syr	15	8	$374.00	$374.00	$86.71	$317.90	$133.47	2026-07-15
11765	HCPCS	Wedge Excision Of Skin Of Nail	13	8	$175.00	$175.00	$96.25	$186.66	$133.17	2026-07-15
99397	HCPCS	Est Phys 65>	13	8	$195.00	$195.00	$107.25	$165.75	$133.00	2026-07-15
30905	HCPCS	Post Hemor	13	8	$177.00	$177.00	$92.19	$267.33	$132.75	2026-07-15
D4211	HCPCS	Gingivectomy 1-3 Teeth Per Quad	11	8	$176.00	$176.00	$85.86	$149.60	$132.00	2026-07-15
80323	HCPCS	Nicotine & Metabolite Quant Urine	9	8	$232.00	$232.00	$20.35	$197.20	$131.60	2026-07-15
20610	HCPCS	Arthrocentesis Major	49	8	$175.00	$175.00	$46.15	$392.70	$131.25	2026-07-15
80361	HCPCS	Hydromorphone, Serum (dilaudid)	12	8	$300.00	$300.00	$17.00	$255.00	$131.15	2026-07-15
G0297	HCPCS	CT Lung Cancer Screen Low Dose	9	8	$187.00	$187.00	$102.85	$187.00	$130.90	2026-07-15
11750	HCPCS	Exc Nail For Permanent Re	13	8	$170.00	$170.00	$93.50	$208.78	$130.13	2026-07-15
96374	HCPCS	Ivp Initial	14	8	$200.00	$200.00	$29.44	$170.00	$130.00	2026-07-15
10160	HCPCS	Puncture Aspiration Absce	22	8	$130.00	$130.00	$84.50	$250.00	$130.00	2026-07-15
G0296	HCPCS	Aco Low Dose CT Screening	8	5	$215.00	$215.00	$26.02	$182.75	$129.00	2026-07-15
99349	HCPCS	Home Visit, Established, 3	13	8	$242.00	$242.00	$108.12	$205.70	$129.00	2026-07-15
92612	HCPCS	St Completed Fees	26	8	$195.00	$195.00	$56.58	$175.12	$126.75	2026-07-15

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