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

FALLON MEDICAL COMPLEX HOSPITAL

Baker, MT · CCN 271301 · Rates published

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You selected 93306 (CPT)

US TRANSTHORACIC ECHO

This hospital’s price: $2,008 across 10 payers · range $310-$2,362

Source: https://fallonmed.goredde.com/Estimator/Files/363808993_Fallon-Medical-Complex_standardcharges.csv · observed 2026-03-28

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.

19,393 distinct procedures filed
13 distinct payers
305,678 rate rows
2026-03-28 last MRF observed
Data quality

227,779 of 305,678 rate rows are consumer-grade (74.5%)

77,899 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 64,539
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 11,505
template filing: same amount across many unrelated codes — excluded 1,190
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 636
placeholder amount (≤ $0.02) — excluded from medians 24
exceeds 10× this hospital's gross charge — excluded from medians 5
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://fallonmed.goredde.com/Estimator/Files/363808993_Fallon-Medical-Complex_standardcharges.csv
Found on page https://fallonmedical.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-01
Content fingerprint 0b611584dd953a17… · 58,827,873 bytes · first seen 2026-05-17

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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 13 $3,605,000.00 $3,605,000.00 $3,605,000.00 nat. median
$3,703,693
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 13 $3,296,000.00 $3,296,000.00 $3,296,000.00 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 13 $3,193,000.00 $3,193,000.00 $3,193,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 13 $2,884,000.00 $2,884,000.00 $2,884,000.00 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 13 $2,391,705.69 $2,391,705.69 $2,391,705.69 nat. median
$2,466,282
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 13 $518,240.68 $604,078.63 $561,159.66 nat. median
$738,272
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $507,495.55 $601,716.37 $554,605.96 nat. median
$646,415
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 13 $484,690.30 $601,104.71 $542,897.51 nat. median
$622,245
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 13 $474,060.62 $589,847.69 $531,954.16 nat. median
$640,950
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 13 $459,381.45 $558,718.59 $509,050.02 nat. median
$608,101
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 13 $449,440.00 $525,699.79 $487,569.90 nat. median
$591,650
0.8× median
E0766
HCPCS 		Dme Pos 13 $113,529.94 $113,529.94 $113,529.94 nat. median
$16,786
outlier · 6.8×
Q0480
HCPCS 		Dme Pos 13 $80,781.07 $104,999.93 $92,890.50 nat. median
$111,503
0.8× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 13 $81,928.74 $95,583.53 $88,756.13 nat. median
$97,020
0.9× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 13 $70,418.21 $90,125.66 $80,271.93 nat. median
$63,643
1.3× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 13 $73,507.89 $73,507.89 $73,507.89 nat. median
$1,683
outlier · 43.7×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 13 $63,505.40 $77,699.25 $70,602.32 nat. median
$68,423
1.0× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 13 $59,284.57 $69,165.33 $64,224.95 nat. median
$70,178
0.9× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 13 $55,453.57 $62,800.40 $59,126.99 nat. median
$65,720
0.9× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 13 $57,856.13 $57,856.13 $57,856.13 nat. median
$75,037
0.8× median
J9226
HCPCS 		Supprelin La Implant 13 $44,578.75 $55,618.19 $50,098.47 nat. median
$55,159
0.9× median
L7181
HCPCS 		Dme Pos 13 $35,929.06 $50,142.75 $43,035.90 nat. median
$50,453
0.9× median
L7180
HCPCS 		Dme Pos 13 $32,601.09 $43,942.00 $38,271.54 nat. median
$46,980
0.8× median
L2006
HCPCS 		Dme Pos 13 $33,123.69 $40,484.87 $36,804.28 nat. median
$39,921
0.9× median
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 13 $30,132.81 $35,154.95 $32,643.88 nat. median
$35,670
0.9× median
90288
CPT 		Botulism Ig IV 2 $23.14 $64,749.00 $32,386.07 nat. median
$51,570
0.6× median
E0194
HCPCS 		Dme Pos 13 $31,893.82 $31,893.82 $31,893.82 nat. median
$4,438
outlier · 7.2×
J9266
HCPCS 		Pegaspargase Injection 13 $25,781.46 $33,199.71 $29,490.58 nat. median
$33,238
0.9× median
L5856
HCPCS 		Dme Pos 13 $21,557.21 $30,020.69 $25,788.95 nat. median
$30,017
0.9× median
L6880
HCPCS 		Dme Pos 13 $21,429.76 $29,959.79 $25,694.78 nat. median
$30,016
0.9× median
L8614
HCPCS 		Dme Pos 13 $17,344.28 $23,893.99 $20,619.13 nat. median
$22,385
0.9× median
Q0483
HCPCS 		Dme Pos 13 $16,816.87 $23,510.77 $20,163.82 nat. median
$23,335
0.9× median
L5858
HCPCS 		Dme Pos 13 $16,665.36 $23,258.20 $19,961.78 nat. median
$23,235
0.9× median
L6975
HCPCS 		Dme Pos 13 $15,948.16 $23,228.71 $19,588.44 nat. median
$22,861
0.9× median
L5973
HCPCS 		Dme Pos 13 $15,648.19 $21,826.33 $18,737.26 nat. median
$21,726
0.9× median
L6970
HCPCS 		Dme Pos 13 $14,555.45 $21,680.69 $18,118.07 nat. median
$21,078
0.9× median
L6965
HCPCS 		Dme Pos 13 $14,143.98 $21,416.29 $17,780.13 nat. median
$20,067
0.9× median
Q0489
HCPCS 		Dme Pos 13 $14,579.31 $20,382.57 $17,480.94 nat. median
$20,275
0.9× median
L6960
HCPCS 		Dme Pos 13 $12,021.60 $19,766.86 $15,894.23 nat. median
$16,650
1.0× median
L6955
HCPCS 		Dme Pos 13 $11,919.39 $19,598.79 $15,759.09 nat. median
$15,745
1.0× median
Q0481
HCPCS 		Dme Pos 13 $13,033.09 $18,220.88 $15,626.99 nat. median
$15,211
1.0× median
L5859
HCPCS 		Dme Pos 13 $13,057.27 $18,157.47 $15,607.37 nat. median
$18,321
0.9× median
81416
CPT 		Exome Sequence Analysis 13 $10,800.00 $17,116.21 $13,958.10 nat. median
$12,000
1.2× median
505T
OTHER 		Ev Fempop Artl Revsc 13 $9,718.36 $17,738.82 $13,728.59 nat. median
$12,024
1.1× median
L6945
HCPCS 		Dme Pos 13 $10,186.59 $16,749.59 $13,468.09 nat. median
$13,929
1.0× median
J9600
HCPCS 		Porfimer Sodium Injection 13 $3,575.97 $22,979.00 $13,277.49 nat. median
$30,131
outlier · 0.4×
L6950
HCPCS 		Dme Pos 13 $9,952.43 $16,364.57 $13,158.50 nat. median
$12,858
1.0× median
J7310
HCPCS 		Ganciclovir Long Act Implant 13 $6,672.40 $19,200.00 $12,936.20 nat. median
$18,387
0.7× median
Q0479
HCPCS 		Dme Pos 13 $10,748.79 $15,022.22 $12,885.50 nat. median
$15,271
0.8× median
L5969
HCPCS 		Ak/ft Power Asst Incl Motors 13 $12,290.79 $12,290.79 $12,290.79 nat. median
$19,444
0.6× median

Other procedures at this hospital

Browse this hospital's 19,393 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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 15 13 — — $3,605,000.00 $3,605,000.00 $3,605,000.00 2026-03-28
J1413 HCPCS Inj Delandistrogene Mox Rokl 15 13 — — $3,296,000.00 $3,296,000.00 $3,296,000.00 2026-03-28
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 15 13 — — $3,193,000.00 $3,193,000.00 $3,193,000.00 2026-03-28
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 15 13 — — $2,884,000.00 $2,884,000.00 $2,884,000.00 2026-03-28
J3399 HCPCS Inj Onase Abepar-xioi Treat 15 13 — — $2,391,705.69 $2,391,705.69 $2,391,705.69 2026-03-28
Q2042 HCPCS Tisagenlecleucel Car-pos T 15 13 — — $518,240.68 $604,078.63 $561,159.66 2026-03-28
Q2056 HCPCS Ciltacabtagene Car-pos T 15 13 — — $507,495.55 $601,716.37 $554,605.96 2026-03-28
Q2055 HCPCS Idecabtagene Vicleucel Car 15 13 — — $484,690.30 $601,104.71 $542,897.51 2026-03-28
Q2054 HCPCS Lisocabtagene Mara Car Pos T 15 13 — — $474,060.62 $589,847.69 $531,954.16 2026-03-28
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 15 13 — — $459,381.45 $558,718.59 $509,050.02 2026-03-28
Q2053 HCPCS Brexucabtagene Car Pos T 15 13 — — $449,440.00 $525,699.79 $487,569.90 2026-03-28
E0766 HCPCS Dme Pos 15 13 — — $113,529.94 $113,529.94 $113,529.94 2026-03-28
Q0480 HCPCS Dme Pos 15 13 — — $80,781.07 $104,999.93 $92,890.50 2026-03-28
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 15 13 — — $81,928.74 $95,583.53 $88,756.13 2026-03-28
A9543 HCPCS Y90 Ibritumomab, Rx 15 13 — — $70,418.21 $90,125.66 $80,271.93 2026-03-28
A9699 HCPCS Radiopharm Rx Agent Noc 15 13 — — $73,507.89 $73,507.89 $73,507.89 2026-03-28
J9029 HCPCS Instill Adstiladrin, Tx Dose 15 13 — — $63,505.40 $77,699.25 $70,602.32 2026-03-28
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 15 13 — — $59,284.57 $69,165.33 $64,224.95 2026-03-28
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 13 — — $55,453.57 $62,800.40 $59,126.99 2026-03-28
J7330 HCPCS Cultured Chondrocytes Implnt 15 13 — — $57,856.13 $57,856.13 $57,856.13 2026-03-28
J9226 HCPCS Supprelin La Implant 15 13 — — $44,578.75 $55,618.19 $50,098.47 2026-03-28
L7181 HCPCS Dme Pos 15 13 — — $35,929.06 $50,142.75 $43,035.90 2026-03-28
L7180 HCPCS Dme Pos 15 13 — — $32,601.09 $43,942.00 $38,271.54 2026-03-28
L2006 HCPCS Dme Pos 15 13 — — $33,123.69 $40,484.87 $36,804.28 2026-03-28
L8701 HCPCS Ewh S/d Uprt Micro Sensor 15 13 — — $30,132.81 $35,154.95 $32,643.88 2026-03-28
90288 CPT Botulism Ig IV 2 2 — — $23.14 $64,749.00 $32,386.07 2026-03-28
E0194 HCPCS Dme Pos 15 13 — — $31,893.82 $31,893.82 $31,893.82 2026-03-28
J9266 HCPCS Pegaspargase Injection 15 13 — — $25,781.46 $33,199.71 $29,490.58 2026-03-28
L5856 HCPCS Dme Pos 15 13 — — $21,557.21 $30,020.69 $25,788.95 2026-03-28
L6880 HCPCS Dme Pos 15 13 — — $21,429.76 $29,959.79 $25,694.78 2026-03-28
L8614 HCPCS Dme Pos 15 13 — — $17,344.28 $23,893.99 $20,619.13 2026-03-28
Q0483 HCPCS Dme Pos 15 13 — — $16,816.87 $23,510.77 $20,163.82 2026-03-28
L5858 HCPCS Dme Pos 15 13 — — $16,665.36 $23,258.20 $19,961.78 2026-03-28
L6975 HCPCS Dme Pos 15 13 — — $15,948.16 $23,228.71 $19,588.44 2026-03-28
L5973 HCPCS Dme Pos 15 13 — — $15,648.19 $21,826.33 $18,737.26 2026-03-28
L6970 HCPCS Dme Pos 15 13 — — $14,555.45 $21,680.69 $18,118.07 2026-03-28
L6965 HCPCS Dme Pos 15 13 — — $14,143.98 $21,416.29 $17,780.13 2026-03-28
Q0489 HCPCS Dme Pos 15 13 — — $14,579.31 $20,382.57 $17,480.94 2026-03-28
L6960 HCPCS Dme Pos 15 13 — — $12,021.60 $19,766.86 $15,894.23 2026-03-28
L6955 HCPCS Dme Pos 15 13 — — $11,919.39 $19,598.79 $15,759.09 2026-03-28
Q0481 HCPCS Dme Pos 15 13 — — $13,033.09 $18,220.88 $15,626.99 2026-03-28
L5859 HCPCS Dme Pos 15 13 — — $13,057.27 $18,157.47 $15,607.37 2026-03-28
81416 CPT Exome Sequence Analysis 15 13 — — $10,800.00 $17,116.21 $13,958.10 2026-03-28
505T OTHER Ev Fempop Artl Revsc 15 13 — — $9,718.36 $17,738.82 $13,728.59 2026-03-28
L6945 HCPCS Dme Pos 15 13 — — $10,186.59 $16,749.59 $13,468.09 2026-03-28
J9600 HCPCS Porfimer Sodium Injection 15 13 — — $3,575.97 $22,979.00 $13,277.49 2026-03-28
L6950 HCPCS Dme Pos 15 13 — — $9,952.43 $16,364.57 $13,158.50 2026-03-28
J7310 HCPCS Ganciclovir Long Act Implant 15 13 — — $6,672.40 $19,200.00 $12,936.20 2026-03-28
Q0479 HCPCS Dme Pos 15 13 — — $10,748.79 $15,022.22 $12,885.50 2026-03-28
L5969 HCPCS Ak/ft Power Asst Incl Motors 15 13 — — $12,290.79 $12,290.79 $12,290.79 2026-03-28
A9604 HCPCS Sm 153 Lexidronam 15 13 — — $5,820.61 $18,562.49 $12,191.55 2026-03-28
L7191 HCPCS Dme Pos 15 13 — — $9,224.40 $14,587.10 $11,905.75 2026-03-28
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 15 13 — — $11,667.97 $11,667.97 $11,667.97 2026-03-28
L6940 HCPCS Dme Pos 15 13 — — $8,756.00 $14,397.31 $11,576.66 2026-03-28
620T OTHER Evasc Ven Artlz Tibl/prnl Vn 15 13 — — $5,562.44 $17,554.24 $11,558.34 2026-03-28
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 15 13 — — $9,264.92 $13,842.34 $11,553.63 2026-03-28
L7186 HCPCS Dme Pos 15 13 — — $8,827.68 $14,237.25 $11,532.47 2026-03-28
A0431 HCPCS Rotary Wing Air Transport 15 13 — — $6,198.29 $16,119.45 $11,158.87 2026-03-28
E0467 HCPCS Dme Pos 15 13 — — $11,116.32 $11,116.32 $11,116.32 2026-03-28
E0764 HCPCS Dme Pos 15 13 — — $10,845.65 $10,845.65 $10,845.65 2026-03-28
L5991 HCPCS Dme Pos 15 13 — — $9,872.32 $11,817.16 $10,844.74 2026-03-28
E0483 HCPCS Dme Pos 15 13 — — $10,419.07 $10,419.07 $10,419.07 2026-03-28
D7949 HCPCS Reconstruct Midface W/graft 15 13 — — $9,927.21 $10,840.22 $10,383.72 2026-03-28
315U OTHER Onc Cutan Sq Cll Ca Mrna 40 15 13 — — $8,500.00 $12,123.79 $10,311.90 2026-03-28
K0864 HCPCS Dme Pos 15 13 — — $10,183.07 $10,183.07 $10,183.07 2026-03-28
A0430 HCPCS Fixed Wing Air Transport 15 13 — — $5,331.17 $13,864.40 $9,597.78 2026-03-28
L6935 HCPCS Dme Pos 15 13 — — $7,833.10 $11,262.58 $9,547.84 2026-03-28
E0465 HCPCS Dme Pos 15 13 — — $9,354.79 $9,354.79 $9,354.79 2026-03-28
E0466 HCPCS Dme Pos 15 13 — — $9,354.79 $9,354.79 $9,354.79 2026-03-28
L6925 HCPCS Dme Pos 15 13 — — $7,689.16 $10,768.21 $9,228.68 2026-03-28
J2997 HCPCS Alteplase (activase) Inj 50 Mg 15 13 $9,505.00 $9,505.00 $88.82 $9,505.00 $9,219.85 2026-03-28
L5857 HCPCS Dme Pos 15 13 — — $7,669.42 $10,638.82 $9,154.12 2026-03-28
L8679 HCPCS Dme Pos 15 13 — — $7,568.71 $10,576.49 $9,072.60 2026-03-28
81552 CPT Onc Uveal Mlnma Mrna 15 Gene 15 13 — — $6,998.40 $11,091.12 $9,044.76 2026-03-28
L8685 HCPCS Implt Nrostm Pls Gen Sng Rec 15 13 — — $7,119.03 $10,636.26 $8,877.65 2026-03-28
L8619 HCPCS Dme Pos 15 13 — — $7,444.84 $10,257.52 $8,851.18 2026-03-28
94U OTHER Genome Rapid Sequence Alys 15 13 — — $6,823.98 $10,814.79 $8,819.39 2026-03-28
L7190 HCPCS Dme Pos 15 13 — — $7,539.19 $9,938.68 $8,738.93 2026-03-28
L6930 HCPCS Dme Pos 15 13 — — $6,701.54 $10,490.26 $8,595.90 2026-03-28
238T OTHER Trluml Perip Athrc Iliac Art 15 13 — — $1,552.45 $15,563.68 $8,558.07 2026-03-28
K0863 HCPCS Dme Pos 15 13 — — $8,557.20 $8,557.20 $8,557.20 2026-03-28
K0860 HCPCS Dme Pos 15 13 — — $8,557.20 $8,557.20 $8,557.20 2026-03-28
A9572 HCPCS Indium In-111 Pentetreotide 15 13 — — $6,811.20 $9,963.91 $8,387.56 2026-03-28
81529 CPT Onc Cutan Mlnma Mrna 31 Gene 15 13 — — $6,473.70 $10,259.76 $8,366.73 2026-03-28
L6920 HCPCS Dme Pos 15 13 — — $6,660.24 $9,984.07 $8,322.16 2026-03-28
E1008 HCPCS Dme Pos 15 13 — — $8,281.00 $8,281.00 $8,281.00 2026-03-28
43116 CPT Partial Removal Of Esophagus 15 13 — — $7,684.57 $8,866.06 $8,275.32 2026-03-28
J0881 HCPCS Darbepoetin Alfa Inj 500 Mcg 15 13 $8,482.00 $8,482.00 $2.90 $8,482.00 $8,227.54 2026-03-28
K0854 HCPCS Dme Pos 15 13 — — $8,203.40 $8,203.40 $8,203.40 2026-03-28
267U OTHER Rare Do Id Opt Gen Mapg&seq 15 13 — — $6,739.33 $9,612.62 $8,175.98 2026-03-28
E1007 HCPCS Dme Pos 15 13 — — $8,128.00 $8,128.00 $8,128.00 2026-03-28
E0783 HCPCS Dme Pos 15 13 — — $8,084.40 $8,084.40 $8,084.40 2026-03-28
E0786 HCPCS Dme Pos 15 13 — — $7,885.83 $7,885.83 $7,885.83 2026-03-28
211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 15 13 — — $3,675.00 $12,059.69 $7,867.35 2026-03-28
K0855 HCPCS Dme Pos 15 13 — — $7,749.33 $7,749.33 $7,749.33 2026-03-28
L5987 HCPCS Dme Pos 15 13 — — $6,450.63 $9,002.52 $7,726.57 2026-03-28
D7948 HCPCS Reconstruct Midface No Graft 15 13 — — $7,003.13 $8,089.22 $7,546.18 2026-03-28
L8627 HCPCS Dme Pos 15 13 — — $6,322.62 $8,689.44 $7,506.03 2026-03-28
L8688 HCPCS Implt Nrostm Pls Gen Dua Non 15 13 — — $5,911.84 $8,832.64 $7,372.24 2026-03-28
D7858 HCPCS Tmj Reconstruction 15 13 — — $6,175.46 $8,421.72 $7,298.59 2026-03-28
Q5120 HCPCS Ziextenzo (pegfilgastrim-bmez) 6mg/0.6ml 15 13 $7,508.00 $7,508.00 $147.06 $7,508.00 $7,282.76 2026-03-28
L5615 HCPCS Dme Pos 15 13 — — $6,322.67 $7,980.30 $7,151.48 2026-03-28
J1756 HCPCS MonoFerric Inj 1000mg/10ml 15 13 $7,306.00 $7,306.00 $0.22 $7,306.00 $7,086.82 2026-03-28
Q0224 HCPCS Injection, Pemivibart, For The Pre-exposure Prophylaxis Only, For Certain Adults… 2 2 — — $6,583.50 $7,515.13 $7,049.32 2026-03-28
K0840 HCPCS Dme Pos 15 13 — — $7,040.47 $7,040.47 $7,040.47 2026-03-28
L8609 HCPCS Dme Pos 15 13 — — $5,843.86 $8,169.96 $7,006.91 2026-03-28
L7185 HCPCS Dme Pos 15 13 — — $5,925.59 $7,855.45 $6,890.52 2026-03-28
J2506 HCPCS Pegfilgrastim (nyvepria) 6mg/0.6ml Inj 15 13 $7,065.00 $7,065.00 $35.55 $7,065.00 $6,853.05 2026-03-28
D7946 HCPCS Reconstruction Maxilla Total 15 13 — — $6,294.62 $7,364.95 $6,829.78 2026-03-28
E0680 HCPCS Dme Pos 15 13 — — $6,776.54 $6,776.54 $6,776.54 2026-03-28
E0636 HCPCS Dme Pos 15 13 — — $6,774.38 $6,774.38 $6,774.38 2026-03-28
237T OTHER Trluml Perip Athrc Brchiocph 15 13 — — $1,494.38 $11,960.90 $6,727.64 2026-03-28
D7780 HCPCS Reduct Compnd Facial Bone Fx 15 13 — — $6,161.98 $7,246.98 $6,704.48 2026-03-28
D5915 HCPCS Orbital Prosthesis 15 13 — — $6,270.90 $7,128.41 $6,699.65 2026-03-28
L5280 HCPCS Dme Pos 15 13 — — $5,081.38 $8,311.14 $6,696.26 2026-03-28
L7170 HCPCS Dme Pos 15 13 — — $5,819.24 $7,571.64 $6,695.44 2026-03-28
E2510 HCPCS Dme Pos 15 13 — — $6,683.52 $6,683.52 $6,683.52 2026-03-28
265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 15 13 — — $5,475.80 $7,810.31 $6,643.06 2026-03-28
L5250 HCPCS Dme Pos 15 13 — — $5,178.07 $8,021.07 $6,599.57 2026-03-28
806T OTHER Tcat S&ivc Prstc Vl Impl Opn 15 13 — — $6,035.66 $7,015.96 $6,525.81 2026-03-28
L8682 HCPCS Dme Pos 15 13 — — $5,407.71 $7,556.75 $6,482.23 2026-03-28
E1006 HCPCS Dme Pos 15 13 — — $6,401.20 $6,401.20 $6,401.20 2026-03-28
81554 CPT Pulm Ds Ipf Mrna 190 Gen Alg 15 13 — — $4,950.00 $7,844.97 $6,397.48 2026-03-28
212U OTHER Rare Ds Gen DNA Alys Proband 15 13 — — $4,927.68 $7,809.36 $6,368.52 2026-03-28
335U OTHER Rare Ds Whl Gen Seq Feta 15 13 — — $5,224.60 $7,451.84 $6,338.22 2026-03-28
D7941 HCPCS Bone Cutting Ramus Closed 15 13 — — $6,122.39 $6,425.11 $6,273.75 2026-03-28
L7008 HCPCS Dme Pos 15 13 — — $5,404.93 $7,126.73 $6,265.83 2026-03-28
L5341 HCPCS Dme Pos 15 13 — — $5,043.75 $7,465.71 $6,254.73 2026-03-28
D7947 HCPCS Reconstruct Maxilla Segment 15 13 — — $6,032.57 $6,471.99 $6,252.28 2026-03-28
L5270 HCPCS Dme Pos 15 13 — — $5,132.70 $7,316.67 $6,224.69 2026-03-28
J0600 HCPCS Edetate Calcium Disodium Inj 3 3 — — $74.66 $6,717.45 $6,193.29 2026-03-28
K0853 HCPCS Dme Pos 15 13 — — $6,192.33 $6,192.33 $6,192.33 2026-03-28
J9225 HCPCS Vantas Implant 15 13 — — $4,873.86 $7,413.78 $6,143.82 2026-03-28
D7943 HCPCS Cutting Ramus Open W/graft 15 13 — — $5,812.50 $6,399.76 $6,106.13 2026-03-28
214U OTHER Rare Ds Xom DNA Alys Proband 15 13 — — $4,702.14 $7,451.84 $6,076.99 2026-03-28
326U OTHER Trgt Gen Seq Alys Pnl 83+ 15 13 — — $5,000.00 $7,131.83 $6,065.91 2026-03-28
K0852 HCPCS Dme Pos 15 13 — — $6,028.00 $6,028.00 $6,028.00 2026-03-28
K0862 HCPCS Dme Pos 15 13 — — $5,989.80 $5,989.80 $5,989.80 2026-03-28
K0858 HCPCS Dme Pos 15 13 — — $5,989.80 $5,989.80 $5,989.80 2026-03-28
K0828 HCPCS Dme Pos 15 13 — — $5,940.13 $5,940.13 $5,940.13 2026-03-28
32852 CPT Lung Transplant With Bypass 15 13 — — $5,454.12 $6,297.79 $5,875.95 2026-03-28
81425 CPT Genome Sequence Analysis 15 13 — — $4,528.08 $7,175.99 $5,852.03 2026-03-28
D7945 HCPCS Bone Cutting Body Mandible 15 13 — — $5,531.65 $6,114.43 $5,823.04 2026-03-28
242U OTHER Trgt Gen Seq Alys Pnl 55-74 15 13 — — $4,500.00 $7,131.83 $5,815.91 2026-03-28
D7490 HCPCS Maxilla Or Mandible Resectio 15 13 — — $5,796.62 $5,800.71 $5,798.66 2026-03-28
L5331 HCPCS Dme Pos 15 13 — — $4,641.41 $6,894.84 $5,768.12 2026-03-28
J3111 HCPCS Romosozumab-aqqg (evenity) 210mg/2.34ml 15 13 $5,916.00 $5,916.00 $10.64 $5,916.00 $5,738.52 2026-03-28
K0859 HCPCS Dme Pos 15 13 — — $5,712.40 $5,712.40 $5,712.40 2026-03-28
L8683 HCPCS Dme Pos 15 13 — — $4,760.02 $6,651.68 $5,705.85 2026-03-28
A9515 HCPCS Choline C-11 15 13 — — $5,700.00 $5,700.00 $5,700.00 2026-03-28
J9219 HCPCS Leuprolide Acetate Implant 15 13 — — $5,684.00 $5,684.00 $5,684.00 2026-03-28
39503 CPT Repair Of Diaphragm Hernia 15 13 — — $757.88 $10,585.97 $5,671.93 2026-03-28
L8686 HCPCS Implt Nrostm Pls Gen Sng Non 15 13 — — $4,542.60 $6,786.91 $5,664.76 2026-03-28
236T OTHER Trluml Perip Athrc Abd Aorta 15 13 — — $2,024.91 $9,245.14 $5,635.02 2026-03-28
K0829 HCPCS Dme Pos 15 13 — — $5,595.53 $5,595.53 $5,595.53 2026-03-28
673T OTHER Abltj B9 Thyr Ndul Perq Lasr 15 13 — — $4,839.46 $6,327.75 $5,583.60 2026-03-28
81415 CPT Exome Sequence Analysis 15 13 — — $4,302.00 $6,818.00 $5,560.00 2026-03-28
36U OTHER Xome Tum & Nml Spec Seq Alys 15 13 — — $4,302.00 $6,818.00 $5,560.00 2026-03-28
A9570 HCPCS Indium In-111 Auto Wbc 15 13 — — $4,403.08 $6,554.10 $5,478.59 2026-03-28
A9571 HCPCS Indium In-111 Auto Platelet 15 13 — — $4,403.08 $6,554.10 $5,478.59 2026-03-28
L6570 HCPCS Dme Pos 15 13 — — $4,368.03 $6,474.85 $5,421.44 2026-03-28
43117 CPT Partial Removal Of Esophagus 15 13 — — $5,065.03 $5,767.27 $5,416.15 2026-03-28
J0716 HCPCS Centruroides Immune F(ab) 15 13 — — $5,403.48 $5,403.48 $5,403.48 2026-03-28
L5702 HCPCS Dme Pos 15 13 — — $4,335.87 $6,424.49 $5,380.18 2026-03-28
61545 CPT Excision Of Brain Tumor 15 13 — — $5,090.27 $5,641.98 $5,366.12 2026-03-28
33413 CPT Replacement Of Aortic Valve 15 13 — — $4,955.14 $5,722.05 $5,338.60 2026-03-28
A9542 HCPCS In111 Ibritumomab, Dx 15 13 — — $4,200.00 $6,471.02 $5,335.51 2026-03-28
L5961 HCPCS Dme Pos 15 13 — — $4,270.84 $6,310.43 $5,290.64 2026-03-28
J0225 HCPCS Inj, Vutrisiran, 1 Mg 15 13 — — $4,935.21 $5,623.08 $5,279.15 2026-03-28
E0652 HCPCS Dme Pos 15 13 — — $5,235.08 $5,235.08 $5,235.08 2026-03-28
K0850 HCPCS Dme Pos 15 13 — — $5,217.00 $5,217.00 $5,217.00 2026-03-28
E1005 HCPCS Dme Pos 15 13 — — $5,200.30 $5,200.30 $5,200.30 2026-03-28
D7865 HCPCS Tmj Reshaping Components 15 13 — — $4,505.56 $5,883.39 $5,194.48 2026-03-28
B9006 HCPCS Dme Pen 15 13 — — $5,155.03 $5,155.03 $5,155.03 2026-03-28
B9004 HCPCS Dme Pen 15 13 — — $5,155.03 $5,155.03 $5,155.03 2026-03-28
61698 CPT Brain Aneurysm Repr Complx 15 13 — — $1,868.66 $8,436.99 $5,152.82 2026-03-28
47135 CPT Transplantation Of Liver 15 13 — — $640.14 $9,598.88 $5,119.51 2026-03-28
J1162 HCPCS Digoxin Immune Fab (ovine) 15 13 — — $4,658.67 $5,579.82 $5,119.24 2026-03-28
D7680 HCPCS Reduct Simple Facial Bone Fx 15 13 — — $4,750.89 $5,484.29 $5,117.59 2026-03-28
L8690 HCPCS Dme Pos 15 13 — — $4,266.82 $5,965.23 $5,116.02 2026-03-28
K0011 HCPCS Dme Pos 15 13 — — $5,077.81 $5,077.81 $5,077.81 2026-03-28
300U OTHER Onc Pan Tum Whl Gen Seq&opt 15 13 — — $4,183.13 $5,966.70 $5,074.91 2026-03-28
D7944 HCPCS Bone Cutting Segmented 15 13 — — $4,975.76 $5,162.84 $5,069.30 2026-03-28
D6040 HCPCS Odontics Eposteal Implant 15 13 — — $4,591.29 $5,519.74 $5,055.52 2026-03-28
L5230 HCPCS Dme Pos 15 13 — — $3,796.48 $6,242.47 $5,019.48 2026-03-28
K0851 HCPCS Dme Pos 15 13 — — $5,016.27 $5,016.27 $5,016.27 2026-03-28
L6550 HCPCS Dme Pos 15 13 — — $3,805.54 $6,222.92 $5,014.23 2026-03-28
V5252 HCPCS Hearing Aid, Prog, Bin, Ite 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5249 HCPCS Hearing Aid, Binaural, Itc 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5250 HCPCS Hearing Aid, Prog, Bin, Cic 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5260 HCPCS Hearing Aid, Digit, Bin, Ite 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5251 HCPCS Hearing Aid, Prog, Bin, Itc 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5259 HCPCS Hearing Aid, Digit, Bin, Itc 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5258 HCPCS Hearing Aid, Digit, Bin, Cic 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5248 HCPCS Hearing Aid, Binaural, Cic 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5263 HCPCS Hearing Aid, Disp, Binaural 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5261 HCPCS Hearing Aid, Digit, Bin, Bte 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
V5253 HCPCS Hearing Aid, Prog, Bin, Bte 15 13 — — $5,000.00 $5,000.00 $5,000.00 2026-03-28
32854 CPT Lung Transplant With Bypass 15 13 — — $1,284.80 $8,630.13 $4,957.47 2026-03-28
D5913 HCPCS Nasal Prosthesis 15 13 — — $4,641.97 $5,270.99 $4,956.48 2026-03-28
D5914 HCPCS Auricular Prosthesis 15 13 — — $4,641.97 $5,270.99 $4,956.48 2026-03-28
K0857 HCPCS Dme Pos 15 13 — — $4,924.47 $4,924.47 $4,924.47 2026-03-28
31395 CPT Reconstruct Larynx & Pharynx 15 13 — — $4,623.89 $5,222.70 $4,923.30 2026-03-28
33916 CPT Surgery Of Great Vessel 15 13 — — $2,351.59 $7,483.52 $4,917.56 2026-03-28
E2328 HCPCS Dme Pos 15 13 — — $4,898.20 $4,898.20 $4,898.20 2026-03-28
805T OTHER Tcat S&ivc Prstc Vl Impl Prq 15 13 — — $4,527.14 $5,262.42 $4,894.78 2026-03-28
Q0482 HCPCS Dme Pos 15 13 — — $4,082.21 $5,707.12 $4,894.66 2026-03-28
L5980 HCPCS Dme Pos 15 13 — — $3,700.21 $6,084.18 $4,892.19 2026-03-28
50365 CPT Transplantation Of Kidney 15 13 — — $4,589.71 $5,107.18 $4,848.44 2026-03-28
J0480 HCPCS Basiliximab 15 13 — — $4,450.90 $5,238.13 $4,844.52 2026-03-28
L5600 HCPCS Dme Pos 15 13 — — $4,205.81 $5,472.34 $4,839.07 2026-03-28
K0861 HCPCS Dme Pos 15 13 — — $4,835.40 $4,835.40 $4,835.40 2026-03-28
K0856 HCPCS Dme Pos 15 13 — — $4,827.67 $4,827.67 $4,827.67 2026-03-28
295U OTHER Onc Brst Dux Carc 7 Proteins 15 13 — — $1,897.00 $7,751.91 $4,824.45 2026-03-28
L6026 HCPCS Dme Pos 15 13 — — $3,741.62 $5,862.01 $4,801.81 2026-03-28
J9217 HCPCS Leuprolide Acetate (eligard) Inj 45mg 15 13 $4,950.00 $4,950.00 $185.66 $4,950.00 $4,801.50 2026-03-28
Q4215 HCPCS Axolotl Ambient, Cryo 0.1 Mg 15 13 — — $4,800.00 $4,800.00 $4,800.00 2026-03-28
E0304 HCPCS Dme Pos 15 13 — — $4,787.65 $4,787.65 $4,787.65 2026-03-28
L6350 HCPCS Dme Pos 15 13 — — $3,909.01 $5,629.38 $4,769.19 2026-03-28
E0986 HCPCS Dme Pos 15 13 — — $4,767.44 $4,767.44 $4,767.44 2026-03-28
E1004 HCPCS Dme Pos 15 13 — — $4,766.60 $4,766.60 $4,766.60 2026-03-28
D7854 HCPCS Tmj Excisn Of Joint Membrane 15 13 — — $4,712.07 $4,790.57 $4,751.32 2026-03-28
K0826 HCPCS Dme Pos 15 13 — — $4,740.73 $4,740.73 $4,740.73 2026-03-28
33935 CPT Transplantation Heart/lung 15 13 — — $641.43 $8,781.09 $4,711.26 2026-03-28
306U OTHER Onc Mrd Nxt-gnrj Alys 1st 15 13 — — $3,878.45 $5,531.79 $4,705.12 2026-03-28
288U OTHER Onc Lung Mrna Quan Pcr 11&3 15 13 — — $3,873.00 $5,524.19 $4,698.60 2026-03-28
61686 CPT Intracranial Vessel Surgery 15 13 — — $1,179.68 $8,200.45 $4,690.06 2026-03-28
61682 CPT Intracranial Vessel Surgery 15 13 — — $1,812.37 $7,562.37 $4,687.37 2026-03-28
33945 CPT Transplantation Of Heart 15 13 — — $725.86 $8,625.23 $4,675.55 2026-03-28
G0339 HCPCS Robot Lin-radsurg Com, First 15 13 — — $3,934.00 $5,395.76 $4,664.88 2026-03-28
44135 CPT Intestine Transplnt Cadaver 15 13 — — $4,663.32 $4,663.32 $4,663.32 2026-03-28
108U OTHER Gi Barrett Esoph 9 Prtn Bmrk 15 13 — — $2,261.93 $7,060.14 $4,661.03 2026-03-28
61697 CPT Brain Aneurysm Repr Complx 15 13 — — $1,813.99 $7,497.58 $4,655.78 2026-03-28
32853 CPT Lung Transplant Double 15 13 — — $1,144.74 $8,125.89 $4,635.31 2026-03-28
D7852 HCPCS Tmj Repair Of Joint Disc 15 13 — — $4,607.46 $4,656.73 $4,632.10 2026-03-28
K0839 HCPCS Dme Pos 15 13 — — $4,606.47 $4,606.47 $4,606.47 2026-03-28
20802 CPT Replantation Arm Complete 15 13 — — $4,322.08 $4,861.48 $4,591.78 2026-03-28
33465 CPT Replace Tricuspid Valve 15 13 — — $4,253.20 $4,882.87 $4,568.03 2026-03-28
L5160 HCPCS Dme Pos 15 13 — — $3,811.87 $5,271.77 $4,541.82 2026-03-28
A9582 HCPCS Iodine I-123 Iobenguane 15 13 — — $3,522.33 $5,546.27 $4,534.30 2026-03-28
L5782 HCPCS Dme Pos 15 13 — — $3,782.41 $5,278.75 $4,530.58 2026-03-28
340U OTHER Onc Pan Ca Alys Mrd Plasma 15 13 — — $3,920.00 $5,120.62 $4,520.31 2026-03-28
81542 CPT Onc Prostate Mrna 22 Cnt Gen 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
81522 CPT Onc Breast Mrna 12 Genes 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
81518 CPT Onc Brst Mrna 11 Genes 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
81541 CPT Onc Prostate Mrna 46 Genes 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
45U OTHER Onc Brst Dux Carc Is 12 Gene 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
81519 CPT Oncology Breast Mrna 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
81521 CPT Onc Breast Mrna 70 Genes 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
47U OTHER Onc Prst8 Mrna 17 Gene Alg 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
81523 CPT Onc Brst Mrna 70 Cnt 31 Gene 15 13 — — $3,485.70 $5,524.19 $4,504.94 2026-03-28
K0848 HCPCS Dme Pos 15 13 — — $4,497.67 $4,497.67 $4,497.67 2026-03-28
Q0495 HCPCS Dme Pos 15 13 — — $3,746.52 $5,237.81 $4,492.16 2026-03-28
43108 CPT Removal Of Esophagus 15 13 — — $963.60 $7,919.31 $4,441.45 2026-03-28
D7730 HCPCS Open Reduct Compd Mandble Fx 15 13 — — $3,967.97 $4,844.97 $4,406.47 2026-03-28
L2005 HCPCS Dme Pos 15 13 — — $3,668.19 $5,128.33 $4,398.26 2026-03-28
L6881 HCPCS Dme Pos 15 13 — — $3,665.93 $5,116.15 $4,391.04 2026-03-28
E0302 HCPCS Dme Pos 15 13 — — $4,390.66 $4,390.66 $4,390.66 2026-03-28
4035F CPT Influenza Imm Rec 15 13 — — $4,384.24 $4,384.24 $4,384.24 2026-03-28
L5595 HCPCS Dme Pos 15 13 — — $3,808.57 $4,955.48 $4,382.02 2026-03-28
D5932 HCPCS Postsurgical Obturator 15 13 — — $3,780.33 $4,969.67 $4,375.00 2026-03-28
E0694 HCPCS Dme Pos 15 13 — — $4,371.92 $4,371.92 $4,371.92 2026-03-28
362U OTHER Onc Pap Thyr Ca RNA 82&10 15 13 — — $3,600.00 $5,134.86 $4,367.43 2026-03-28
391U OTHER Onc Sld Tum Dna&rna 437 Gen 15 13 — — $3,600.00 $5,134.86 $4,367.43 2026-03-28
313U OTHER Onc Pncrs Dna&mrna Seq 74 15 13 — — $3,600.00 $5,134.86 $4,367.43 2026-03-28
287U OTHER Onc Thyr Dna&mrna 112 Genes 15 13 — — $3,600.00 $5,134.86 $4,367.43 2026-03-28
81540 CPT Oncology Tum Unknown Origin 15 13 — — $3,375.00 $5,348.52 $4,361.76 2026-03-28
D7840 HCPCS Removal Of Tmj Condyle 15 13 — — $4,171.79 $4,525.92 $4,348.85 2026-03-28
E1003 HCPCS Dme Pos 15 13 — — $4,327.10 $4,327.10 $4,327.10 2026-03-28
K0849 HCPCS Dme Pos 15 13 — — $4,324.20 $4,324.20 $4,324.20 2026-03-28
35092 CPT Repair Artery Rupture Aorta 15 13 — — $3,992.40 $4,630.45 $4,311.43 2026-03-28
L6300 HCPCS Dme Pos 15 13 — — $3,718.10 $4,899.36 $4,308.73 2026-03-28
J9216 HCPCS Interferon Gamma 1-b Inj 15 13 — — $470.59 $8,142.11 $4,306.35 2026-03-28
19364 CPT Brst Rcnstj Free Flap 4 4 — — $4,271.07 $4,872.47 $4,305.00 2026-03-28
L5781 HCPCS Dme Pos 15 13 — — $3,587.86 $5,007.24 $4,297.55 2026-03-28
813T OTHER Egd Vol Adjmt Bariatric Balo 15 13 — — $3,972.42 $4,617.61 $4,295.02 2026-03-28
L8044 HCPCS Dme Pos 15 13 — — $3,729.66 $4,854.47 $4,292.06 2026-03-28
D5916 HCPCS Ocular Prosthesis 15 13 — — $3,268.69 $5,289.55 $4,279.12 2026-03-28
258U OTHER Ai Psor Mrna 50-100 Gen Alg 15 13 — — $3,307.50 $5,241.69 $4,274.60 2026-03-28
19U OTHER Onc RNA Tiss Predict Alg 15 13 — — $3,307.50 $5,241.69 $4,274.60 2026-03-28
A9586 HCPCS Florbetapir F18 15 13 — — $3,257.44 $5,233.81 $4,245.62 2026-03-28
E0782 HCPCS Dme Pos 15 13 — — $4,239.66 $4,239.66 $4,239.66 2026-03-28
235T OTHER Trluml Perip Athrc Visceral 15 13 — — $2,383.67 $6,095.60 $4,239.64 2026-03-28
61576 CPT Skull Base/brainstem Surgery 15 13 — — $1,049.97 $7,418.11 $4,234.04 2026-03-28
33410 CPT Replacement Aortic Valve Opn 15 13 — — $3,926.67 $4,503.92 $4,215.30 2026-03-28
D8070 HCPCS Compre Dental Tx Transition 15 13 — — $3,942.09 $4,468.47 $4,205.28 2026-03-28
81546 CPT Onc Thyr Mrna 10,196 Gen Alg 15 13 — — $3,240.00 $5,134.86 $4,187.43 2026-03-28
26U OTHER Onc Thyr Dna&mrna 112 Genes 15 13 — — $3,240.00 $5,134.86 $4,187.43 2026-03-28
329U OTHER Onc Neo Xome&trns Seq Alys 15 13 — — $3,437.98 $4,903.64 $4,170.81 2026-03-28
D5954 HCPCS Superimposed Prosthesis 15 13 — — $3,896.80 $4,418.36 $4,157.58 2026-03-28
D5934 HCPCS Mandibular Flange Prosthesis 15 13 — — $3,676.80 $4,617.00 $4,146.90 2026-03-28
K0827 HCPCS Dme Pos 15 13 — — $4,146.47 $4,146.47 $4,146.47 2026-03-28
L5150 HCPCS Dme Pos 15 13 — — $3,504.59 $4,787.02 $4,145.81 2026-03-28
22206 CPT Incis Spine 3 Column Thorac 15 13 — — $3,894.07 $4,339.51 $4,116.79 2026-03-28
33513 CPT Cabg Vein Four 15 13 — — $3,819.94 $4,395.13 $4,107.53 2026-03-28
33871 CPT Transvrs A-arch Grf Hypthrm 15 13 — — $2,417.90 $5,790.50 $4,104.20 2026-03-28
33031 CPT Partial Removal Of Heart Sac 15 13 — — $3,825.20 $4,382.29 $4,103.74 2026-03-28
80U OTHER Onc Lng 5 Clin Rsk Factr Alg 15 13 — — $3,168.00 $5,020.91 $4,094.45 2026-03-28
L5840 HCPCS Dme Pos 15 13 — — $3,382.55 $4,802.95 $4,092.75 2026-03-28
L5105 HCPCS Dme Pos 15 13 — — $3,466.94 $4,690.18 $4,078.56 2026-03-28
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