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

RUBY VALLEY MEDICAL CENTER

Sheridan, MT · CCN 271319 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

ECHO COMPLETE

This hospital’s price: $1,811 across 6 payers · range $1,334-$1,906

Source: https://pricetransparency.healthcare/ruby-valley-medical-center/charges/export/ · observed 2026-02-27

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.

1,810 distinct procedures filed
6 distinct payers
39,384 rate rows
2026-02-27 last MRF observed
Data quality

35,280 of 39,384 rate rows are consumer-grade (89.6%)

4,104 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
professional (physician) fee — not the facility price 4,104
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.healthcare/ruby-valley-medical-center/charges/export/
Found on page https://rvmc.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-17
Content fingerprint a33a6527254249cf… · 17,146,276 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
Q4282
HCPCS 		Cygnus Dual- 2x3 Sq Centimeter 6 $10,500.00 $262,500.00 $41,000.00 nat. median
$638
outlier · 64.2×
90197083
CDM 		Siemens Exl Service Contract 6 $12,250.00 $17,500.00 $16,625.00 nat. median
$16,625
1.0× median
J3101
HCPCS 		Tenecteplase Inj [50 Mg] 6 $8,554.70 $12,221.00 $11,609.95 nat. median
$3,820
outlier · 3.0×
J2506
HCPCS 		Pegfilgrastim Syr [6 Mg/0.6 Ml] Spec Ord 6 $7,547.40 $10,782.00 $10,242.90 nat. median
$1,646
outlier · 6.2×
90197134
CDM 		Id Now Influenza Bundle 6 $5,594.02 $7,991.45 $7,591.88 nat. median
$7,592
1.0× median
J2997
HCPCS 		Alteplase Inj [2 Mg/2 Ml] 6 $513.10 $15,524.00 $5,799.90 nat. median
$500
outlier · 11.6×
90197114
CDM 		Id Now Strep Bundle 6 $4,154.19 $5,934.55 $5,637.82 nat. median
$5,638
1.0× median
90197016
CDM 		Cepheid Genexpert Service Agreement 6 $3,899.70 $5,571.00 $5,292.45 nat. median
$5,292
1.0× median
J1459
HCPCS 		Immune Globulin [20 G] 10% 200ml Sdv 6 $1,005.90 $24,332.00 $5,039.26 nat. median
$1,388
outlier · 3.6×
J7168
HCPCS 		Prothrombin Complex 1000iu (kcentra) 6 $3,659.60 $5,228.00 $4,966.60 nat. median
$21
outlier · 236.5×
36561
HCPCS 		Insert Device Central Venous W/port >5yr 6 $3,580.50 $5,115.00 $4,859.25 nat. median
$3,741
1.3× median
64625
HCPCS 		Profee Rf Abltj Nrv Nrvtg Si Jt W/i 6 $3,537.10 $5,053.00 $4,800.35 nat. median
$2,481
1.9× median
64624
HCPCS 		Destruction Neurolytic Agt Genicular Ne 6 $3,331.30 $4,759.00 $4,521.05 nat. median
$2,301
2.0× median
1500213
CDM 		Pain Room Facility Level 3 6 $3,156.30 $4,509.00 $4,283.55 nat. median
$4,058
1.1× median
90197108
CDM 		Cepheid Ctng Startpak 6 $3,010.00 $4,300.00 $4,085.00 nat. median
$4,085
1.0× median
90197126
CDM 		Pathfast Service Contract 6 $2,796.50 $3,995.00 $3,795.25 nat. median
$3,795
1.0× median
G0390
HCPCS 		Trauma Activation 6 $2,755.20 $3,936.00 $3,739.20 nat. median
$3,197
1.2× median
20525
HCPCS 		ER Remove Fb Deep Or Comlicated 6 $2,654.40 $3,792.00 $3,602.40 nat. median
$2,883
1.2× median
72157
HCPCS 		Mr Thoracic Spine W Wo Contrast 6 $2,576.00 $3,680.00 $3,496.00 nat. median
$1,105
outlier · 3.2×
72156
HCPCS 		Mr Cervical Spine W Wo Contrast 6 $2,576.00 $3,680.00 $3,496.00 nat. median
$1,103
outlier · 3.2×
72158
HCPCS 		Mr Lumbar Spine W Wo Contrast 6 $2,576.00 $3,680.00 $3,496.00 nat. median
$1,093
outlier · 3.2×
74178
HCPCS 		CT Abdomen Pelvis W Wo Contrast 6 $2,491.30 $3,559.00 $3,381.05 nat. median
$1,024
outlier · 3.3×
1500212
CDM 		Pain Room Facility Level 2 6 $2,489.90 $3,557.00 $3,379.15 nat. median
$3,201
1.1× median
74183
HCPCS 		Mr Abdomen W Wo Contrast 6 $2,463.30 $3,519.00 $3,343.05 nat. median
$1,100
outlier · 3.0×
Q5108
HCPCS 		Pegfilgrastim Syr [6 Mg/0.6 Ml] Spec Ord 6 $2,455.60 $3,508.00 $3,332.60 nat. median
$1,244
outlier · 2.7×
73723
HCPCS 		Mr Hip Lt W Wo Contrast 6 $2,434.60 $3,478.00 $3,304.10 nat. median
$1,192
outlier · 2.8×
Q4186
HCPCS 		Epifix, 18 Mm Q4186 6 $1,919.40 $5,436.00 $3,273.60 nat. median
$448
outlier · 7.3×
Q9992
HCPCS 		Buprenorphine Inj [300 Mg/1.5 Ml] Sp Ord 6 $2,410.80 $3,444.00 $3,271.80 nat. median
$2,587
1.3× median
72197
HCPCS 		Mr Pelvis W Wo Contrast 6 $2,398.20 $3,426.00 $3,254.70 nat. median
$1,063
outlier · 3.1×
73223
HCPCS 		Mr Shoulder Lt W Wo Contrast 6 $2,377.90 $3,397.00 $3,227.15 nat. median
$1,158
outlier · 2.8×
71552
HCPCS 		Mr Chest W Wo Contrast 6 $2,342.90 $3,347.00 $3,179.65 nat. median
$1,097
outlier · 2.9×
70543
HCPCS 		Mr Orbit Face Neck W Wo Contrast 6 $2,296.70 $3,281.00 $3,116.95 nat. median
$1,083
outlier · 2.9×
74177
HCPCS 		CT Abdomen Pelvis W Contrast 6 $2,244.90 $3,207.00 $3,046.65 nat. median
$974
outlier · 3.1×
73220
HCPCS 		Mr Forearm Lt W Wo Contrast 6 $2,220.40 $3,172.00 $3,013.40 nat. median
$1,130
outlier · 2.7×
73720
HCPCS 		Mr Femur Lt W Wo Contrast 6 $2,216.90 $3,167.00 $3,008.65 nat. median
$1,129
outlier · 2.7×
45380
HCPCS 		Colonoscopy With Biopsy 45380 6 $2,198.70 $3,141.00 $2,983.95 nat. median
$1,565
1.9× median
70546
HCPCS 		MRA Head W Wo Contrast 6 $2,132.90 $3,047.00 $2,894.65 nat. median
$1,070
outlier · 2.7×
70549
HCPCS 		MRA Neck W Wo Contrast 6 $2,132.90 $3,047.00 $2,894.65 nat. median
$1,055
outlier · 2.7×
74174
HCPCS 		CTA Abdomen Pelvis W Contrast 6 $2,082.50 $2,975.00 $2,826.25 nat. median
$988
outlier · 2.9×
45381
HCPCS 		Colonoscopy W/directed Submuc Inj 45381 6 $2,074.10 $2,963.00 $2,814.85 nat. median
$1,565
1.8× median
45378
HCPCS 		Colonoscopy 6 $2,074.10 $2,963.00 $2,814.85 nat. median
$1,342
outlier · 2.1×
70553
HCPCS 		Mr Brain And Pituitary W Wo Contrast 6 $1,997.80 $3,657.00 $2,811.19 nat. median
$1,133
outlier · 2.5×
72147
HCPCS 		Mr Thoracic Spine W Contrast 6 $2,045.40 $2,922.00 $2,775.90 nat. median
$966
outlier · 2.9×
72149
HCPCS 		Mr Lumbar Spine W Contrast 6 $2,045.40 $2,922.00 $2,775.90 nat. median
$978
outlier · 2.8×
72142
HCPCS 		Mr Cervical Spine W Contrast 6 $2,045.40 $2,922.00 $2,775.90 nat. median
$975
outlier · 2.8×
43239
HCPCS 		Egd With Biopsy 43239 6 $2,044.70 $2,921.00 $2,774.95 nat. median
$1,375
outlier · 2.0×
73219
HCPCS 		Mr Humerus Lt W Contrast 6 $2,041.90 $2,917.00 $2,771.15 nat. median
$955
outlier · 2.9×
45384
HCPCS 		Colonoscopy W/remvl-hot Bpsy Fcps 45384 6 $2,018.10 $2,883.00 $2,738.85 nat. median
$1,584
1.7× median
45385
HCPCS 		Colonoscopy W/rmvl-snare Technq 45385 6 $2,017.40 $2,882.00 $2,737.90 nat. median
$1,669
1.6× median
70552
HCPCS 		Mr Brain W Contrast 6 $1,997.80 $2,854.00 $2,711.30 nat. median
$962
outlier · 2.8×

Other procedures at this hospital

Browse this hospital's 1,810 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
Q4282 HCPCS Cygnus Dual- 2x3 Sq Centimeter 64 6 $50,000.00 $45,000.00 $10,500.00 $262,500.00 $41,000.00 2026-02-27
90197083 CDM Siemens Exl Service Contract 16 6 $17,500.00 $15,750.00 $12,250.00 $17,500.00 $16,625.00 2026-02-27
J3101 HCPCS Tenecteplase Inj [50 Mg] 16 6 $12,221.00 $10,998.90 $8,554.70 $12,221.00 $11,609.95 2026-02-27
J2506 HCPCS Pegfilgrastim Syr [6 Mg/0.6 Ml] Spec Ord 16 6 $10,782.00 $9,703.80 $7,547.40 $10,782.00 $10,242.90 2026-02-27
90197134 CDM Id Now Influenza Bundle 16 6 $7,991.45 $7,192.31 $5,594.02 $7,991.45 $7,591.88 2026-02-27
J2997 HCPCS Alteplase Inj [2 Mg/2 Ml] 32 6 $8,128.50 $7,315.65 $513.10 $15,524.00 $5,799.90 2026-02-27
90197114 CDM Id Now Strep Bundle 16 6 $5,934.55 $5,341.10 $4,154.19 $5,934.55 $5,637.82 2026-02-27
90197016 CDM Cepheid Genexpert Service Agreement 16 6 $5,571.00 $5,013.90 $3,899.70 $5,571.00 $5,292.45 2026-02-27
J1459 HCPCS Immune Globulin [20 G] 10% 200ml Sdv 96 6 $5,426.00 $4,883.40 $1,005.90 $24,332.00 $5,039.26 2026-02-27
J7168 HCPCS Prothrombin Complex 1000iu (kcentra) 16 6 $5,228.00 $4,705.20 $3,659.60 $5,228.00 $4,966.60 2026-02-27
36561 HCPCS Insert Device Central Venous W/port >5yr 16 6 $5,115.00 $4,603.50 $3,580.50 $5,115.00 $4,859.25 2026-02-27
64625 HCPCS Profee Rf Abltj Nrv Nrvtg Si Jt W/i 16 6 $5,053.00 $4,547.70 $3,537.10 $5,053.00 $4,800.35 2026-02-27
64624 HCPCS Destruction Neurolytic Agt Genicular Ne 16 6 $4,759.00 $4,283.10 $3,331.30 $4,759.00 $4,521.05 2026-02-27
1500213 CDM Pain Room Facility Level 3 16 6 $4,509.00 $4,058.10 $3,156.30 $4,509.00 $4,283.55 2026-02-27
90197108 CDM Cepheid Ctng Startpak 16 6 $4,300.00 $3,870.00 $3,010.00 $4,300.00 $4,085.00 2026-02-27
90197126 CDM Pathfast Service Contract 16 6 $3,995.00 $3,595.50 $2,796.50 $3,995.00 $3,795.25 2026-02-27
G0390 HCPCS Trauma Activation 16 6 $3,936.00 $3,542.40 $2,755.20 $3,936.00 $3,739.20 2026-02-27
20525 HCPCS ER Remove Fb Deep Or Comlicated 16 6 $3,792.00 $3,412.80 $2,654.40 $3,792.00 $3,602.40 2026-02-27
72156 HCPCS Mr Cervical Spine W Wo Contrast 16 6 $3,680.00 $3,312.00 $2,576.00 $3,680.00 $3,496.00 2026-02-27
72157 HCPCS Mr Thoracic Spine W Wo Contrast 16 6 $3,680.00 $3,312.00 $2,576.00 $3,680.00 $3,496.00 2026-02-27
72158 HCPCS Mr Lumbar Spine W Wo Contrast 16 6 $3,680.00 $3,312.00 $2,576.00 $3,680.00 $3,496.00 2026-02-27
74178 HCPCS CT Abdomen Pelvis W Wo Contrast 16 6 $3,559.00 $3,203.10 $2,491.30 $3,559.00 $3,381.05 2026-02-27
1500212 CDM Pain Room Facility Level 2 16 6 $3,557.00 $3,201.30 $2,489.90 $3,557.00 $3,379.15 2026-02-27
74183 HCPCS Mr Abdomen W Wo Contrast 16 6 $3,519.00 $3,167.10 $2,463.30 $3,519.00 $3,343.05 2026-02-27
Q5108 HCPCS Pegfilgrastim Syr [6 Mg/0.6 Ml] Spec Ord 16 6 $3,508.00 $3,157.20 $2,455.60 $3,508.00 $3,332.60 2026-02-27
73723 HCPCS Mr Hip Lt W Wo Contrast 32 6 $3,478.00 $3,130.20 $2,434.60 $3,478.00 $3,304.10 2026-02-27
Q4186 HCPCS Epifix, 18 Mm Q4186 32 6 $4,089.00 $3,680.10 $1,919.40 $5,436.00 $3,273.60 2026-02-27
Q9992 HCPCS Buprenorphine Inj [300 Mg/1.5 Ml] Sp Ord 16 6 $3,444.00 $3,099.60 $2,410.80 $3,444.00 $3,271.80 2026-02-27
72197 HCPCS Mr Pelvis W Wo Contrast 16 6 $3,426.00 $3,083.40 $2,398.20 $3,426.00 $3,254.70 2026-02-27
73223 HCPCS Mr Shoulder Lt W Wo Contrast 32 6 $3,397.00 $3,057.30 $2,377.90 $3,397.00 $3,227.15 2026-02-27
71552 HCPCS Mr Chest W Wo Contrast 16 6 $3,347.00 $3,012.30 $2,342.90 $3,347.00 $3,179.65 2026-02-27
70543 HCPCS Mr Orbit Face Neck W Wo Contrast 16 6 $3,281.00 $2,952.90 $2,296.70 $3,281.00 $3,116.95 2026-02-27
74177 HCPCS CT Abdomen Pelvis W Contrast 16 6 $3,207.00 $2,886.30 $2,244.90 $3,207.00 $3,046.65 2026-02-27
73220 HCPCS Mr Forearm Lt W Wo Contrast 32 6 $3,172.00 $2,854.80 $2,220.40 $3,172.00 $3,013.40 2026-02-27
73720 HCPCS Mr Femur Lt W Wo Contrast 32 6 $3,167.00 $2,850.30 $2,216.90 $3,167.00 $3,008.65 2026-02-27
45380 HCPCS Colonoscopy With Biopsy 45380 16 6 $3,141.00 $2,826.90 $2,198.70 $3,141.00 $2,983.95 2026-02-27
70546 HCPCS MRA Head W Wo Contrast 16 6 $3,047.00 $2,742.30 $2,132.90 $3,047.00 $2,894.65 2026-02-27
70549 HCPCS MRA Neck W Wo Contrast 16 6 $3,047.00 $2,742.30 $2,132.90 $3,047.00 $2,894.65 2026-02-27
74174 HCPCS CTA Abdomen Pelvis W Contrast 16 6 $2,975.00 $2,677.50 $2,082.50 $2,975.00 $2,826.25 2026-02-27
45378 HCPCS Colonoscopy 16 6 $2,963.00 $2,666.70 $2,074.10 $2,963.00 $2,814.85 2026-02-27
45381 HCPCS Colonoscopy W/directed Submuc Inj 45381 16 6 $2,963.00 $2,666.70 $2,074.10 $2,963.00 $2,814.85 2026-02-27
70553 HCPCS Mr Brain And Pituitary W Wo Contrast 32 6 $3,255.50 $2,929.95 $1,997.80 $3,657.00 $2,811.19 2026-02-27
72147 HCPCS Mr Thoracic Spine W Contrast 16 6 $2,922.00 $2,629.80 $2,045.40 $2,922.00 $2,775.90 2026-02-27
72149 HCPCS Mr Lumbar Spine W Contrast 16 6 $2,922.00 $2,629.80 $2,045.40 $2,922.00 $2,775.90 2026-02-27
72142 HCPCS Mr Cervical Spine W Contrast 16 6 $2,922.00 $2,629.80 $2,045.40 $2,922.00 $2,775.90 2026-02-27
43239 HCPCS Egd With Biopsy 43239 16 6 $2,921.00 $2,628.90 $2,044.70 $2,921.00 $2,774.95 2026-02-27
73219 HCPCS Mr Humerus Lt W Contrast 32 6 $2,917.00 $2,625.30 $2,041.90 $2,917.00 $2,771.15 2026-02-27
45384 HCPCS Colonoscopy W/remvl-hot Bpsy Fcps 45384 16 6 $2,883.00 $2,594.70 $2,018.10 $2,883.00 $2,738.85 2026-02-27
45385 HCPCS Colonoscopy W/rmvl-snare Technq 45385 16 6 $2,882.00 $2,593.80 $2,017.40 $2,882.00 $2,737.90 2026-02-27
70552 HCPCS Mr Brain W Contrast 16 6 $2,854.00 $2,568.60 $1,997.80 $2,854.00 $2,711.30 2026-02-27
43235 HCPCS Egd 43235 16 6 $2,843.00 $2,558.70 $1,990.10 $2,843.00 $2,700.85 2026-02-27
G0105 HCPCS Colonoscopy Screen-pt High Risk G0105 16 6 $2,822.00 $2,539.80 $1,975.40 $2,822.00 $2,680.90 2026-02-27
90197091 CDM Procalcitonin Assay 16 6 $2,800.00 $2,520.00 $1,960.00 $2,800.00 $2,660.00 2026-02-27
G0121 HCPCS Colonoscopy Scrn-not Mtg High Risk G0121 16 6 $2,795.00 $2,515.50 $1,956.50 $2,795.00 $2,655.25 2026-02-27
90197113 CDM Millipore Repair 16 6 $2,787.43 $2,508.69 $1,951.20 $2,787.43 $2,648.06 2026-02-27
45382 HCPCS Colonoscopy W/control Of Bleedng 45382 16 6 $2,779.00 $2,501.10 $1,945.30 $2,779.00 $2,640.05 2026-02-27
43248 HCPCS Egd With Dilitation 43248 16 6 $2,756.00 $2,480.40 $1,929.20 $2,756.00 $2,618.20 2026-02-27
71551 HCPCS Mr Chest W Contrast 16 6 $2,732.00 $2,458.80 $1,912.40 $2,732.00 $2,595.40 2026-02-27
73722 HCPCS Mr Hip Lt W Contrast 32 6 $2,725.00 $2,452.50 $1,907.50 $2,725.00 $2,588.75 2026-02-27
73222 HCPCS Mr Shoulder Lt W Contrast 32 6 $2,709.00 $2,438.10 $1,896.30 $2,709.00 $2,573.55 2026-02-27
72196 HCPCS Mr Pelvis W Contrast 16 6 $2,697.00 $2,427.30 $1,887.90 $2,697.00 $2,562.15 2026-02-27
70542 HCPCS Mr Orbit Face Neck W Contrast 16 6 $2,651.00 $2,385.90 $1,855.70 $2,651.00 $2,518.45 2026-02-27
73719 HCPCS Mr Femur Lt W Contrast 32 6 $2,645.00 $2,380.50 $1,851.50 $2,645.00 $2,512.75 2026-02-27
99291 HCPCS Critical Care 1st Hour 16 6 $2,639.00 $2,375.10 $1,847.30 $2,639.00 $2,507.05 2026-02-27
45388 HCPCS Colonoscopy W/ablation Guide Wire 45388 16 6 $2,630.00 $2,367.00 $1,841.00 $2,630.00 $2,498.50 2026-02-27
74182 HCPCS Mr Abdomen W Contrast 16 6 $2,610.00 $2,349.00 $1,827.00 $2,610.00 $2,479.50 2026-02-27
74185 HCPCS MRA Abdomen W Wo Contrast 16 6 $2,610.00 $2,349.00 $1,827.00 $2,610.00 $2,479.50 2026-02-27
64635 HCPCS Op Inj Rfa L/s 1st Joint 64635 16 6 $2,587.00 $2,328.30 $1,810.90 $2,587.00 $2,457.65 2026-02-27
70548 HCPCS MRA Neck W Contrast 16 6 $2,558.00 $2,302.20 $1,790.60 $2,558.00 $2,430.10 2026-02-27
J0897 HCPCS Denosumab Inj [60 Mg/ml] Spec Order 16 6 $2,530.00 $2,277.00 $1,771.00 $2,530.00 $2,403.50 2026-02-27
3007257 CDM Naltrexone 380mg Susp-inj-nf 16 6 $2,520.35 $2,268.32 $1,764.24 $2,520.35 $2,394.33 2026-02-27
74176 HCPCS CT Abdomen Pelvis Wo Contrast 16 6 $2,519.00 $2,267.10 $1,763.30 $2,519.00 $2,393.05 2026-02-27
72146 HCPCS Mr Thoracic Spine Wo Contrast 16 6 $2,518.00 $2,266.20 $1,762.60 $2,518.00 $2,392.10 2026-02-27
43246 HCPCS Tr Gi Services General 16 6 $2,499.00 $2,249.10 $1,749.30 $2,499.00 $2,374.05 2026-02-27
70545 HCPCS MRA Head W Contrast 16 6 $2,489.00 $2,240.10 $1,742.30 $2,489.00 $2,364.55 2026-02-27
64483 HCPCS Op Inj Op Inj Transfora L/s 1 64483 16 6 $2,485.00 $2,236.50 $1,739.50 $2,485.00 $2,360.75 2026-02-27
70551 HCPCS Mr Brain Wo Contrast 16 6 $2,460.00 $2,214.00 $1,722.00 $2,460.00 $2,337.00 2026-02-27
45330 HCPCS Sigmoidoscopy 45330 16 6 $2,460.00 $2,214.00 $1,722.00 $2,460.00 $2,337.00 2026-02-27
74170 HCPCS CT Abdomen W Wo Contrast 16 6 $2,454.00 $2,208.60 $1,717.80 $2,454.00 $2,331.30 2026-02-27
75635 HCPCS CTA Aorta Iliac Runoff 32 6 $2,780.50 $2,502.45 $1,653.40 $3,199.00 $2,326.57 2026-02-27
72195 HCPCS Mr Pelvis Wo Contrast 16 6 $2,425.00 $2,182.50 $1,697.50 $2,425.00 $2,303.75 2026-02-27
62321 HCPCS Outpatient Injection Intrlam C-t 62321 16 6 $2,422.00 $2,179.80 $1,695.40 $2,422.00 $2,300.90 2026-02-27
71275 HCPCS CTA Chest Pe Study 16 6 $2,420.00 $2,178.00 $1,694.00 $2,420.00 $2,299.00 2026-02-27
73721 HCPCS Mr Hip Lt Wo Contrast 32 6 $2,413.00 $2,171.70 $1,689.10 $2,413.00 $2,292.35 2026-02-27
72141 HCPCS Mr Cervical Spine Wo Contrast 16 6 $2,375.00 $2,137.50 $1,662.50 $2,375.00 $2,256.25 2026-02-27
72148 HCPCS Mr Lumbar Spine Wo Contrast 16 6 $2,375.00 $2,137.50 $1,662.50 $2,375.00 $2,256.25 2026-02-27
62323 HCPCS Op Inj Intrlamin Lumab W/ima 62323 16 6 $2,349.00 $2,114.10 $1,644.30 $2,349.00 $2,231.55 2026-02-27
72133 HCPCS CT Lumbar Spine W Wo Contrast 16 6 $2,343.00 $2,108.70 $1,640.10 $2,343.00 $2,225.85 2026-02-27
74181 HCPCS Mr Abdomen Wo Contrast 16 6 $2,331.00 $2,097.90 $1,631.70 $2,331.00 $2,214.45 2026-02-27
64633 HCPCS Op Inj Rfa C/t 1st Joint 64633 16 6 $2,330.00 $2,097.00 $1,631.00 $2,330.00 $2,213.50 2026-02-27
71270 HCPCS CT Chest W Wo Contrast 16 6 $2,321.00 $2,088.90 $1,624.70 $2,321.00 $2,204.95 2026-02-27
70496 HCPCS CTA Head Circle Of Willis 16 6 $2,315.00 $2,083.50 $1,620.50 $2,315.00 $2,199.25 2026-02-27
70540 HCPCS Mr Orbit Face Neck Wo Contrast 16 6 $2,298.00 $2,068.20 $1,608.60 $2,298.00 $2,183.10 2026-02-27
70498 HCPCS CTA Neck 16 6 $2,297.00 $2,067.30 $1,607.90 $2,297.00 $2,182.15 2026-02-27
70544 HCPCS MRA Head Wo Contrast 16 6 $2,292.00 $2,062.80 $1,604.40 $2,292.00 $2,177.40 2026-02-27
72130 HCPCS CT Thoracic Spine W Wo Contrast 16 6 $2,288.00 $2,059.20 $1,601.60 $2,288.00 $2,173.60 2026-02-27
71550 HCPCS Mr Chest Wo Contrast 16 6 $2,276.00 $2,048.40 $1,593.20 $2,276.00 $2,162.20 2026-02-27
72127 HCPCS CT Cervical Spine W Wo Contrast 16 6 $2,261.00 $2,034.90 $1,582.70 $2,261.00 $2,147.95 2026-02-27
A0427 HCPCS Ambulance Als Emergent 16 6 $2,260.00 $2,034.00 $1,582.00 $2,260.00 $2,147.00 2026-02-27
64421 HCPCS Op Ij Intercostal Nrve Blk Ea Add 64421 16 6 $2,257.00 $2,031.30 $1,579.90 $2,257.00 $2,144.15 2026-02-27
73718 HCPCS Mr Femur Lt Wo Contrast 32 6 $2,255.00 $2,029.50 $1,578.50 $2,255.00 $2,142.25 2026-02-27
73221 HCPCS Mr Shoulder Lt Wo Contrast 32 6 $2,249.00 $2,024.10 $1,574.30 $2,249.00 $2,136.55 2026-02-27
93350 HCPCS (do Not Use) Stress Echo With Contrast 32 6 $2,401.00 $2,160.90 $1,514.10 $2,639.00 $2,130.56 2026-02-27
70470 HCPCS CT Head W Wo Contrast 16 6 $2,233.00 $2,009.70 $1,563.10 $2,233.00 $2,121.35 2026-02-27
72194 HCPCS CT Pelvis W Wo Contrast 16 6 $2,222.00 $1,999.80 $1,555.40 $2,222.00 $2,110.90 2026-02-27
73218 HCPCS Mr Humerus Lt Wo Contrast 32 6 $2,222.00 $1,999.80 $1,555.40 $2,222.00 $2,110.90 2026-02-27
J0841 HCPCS Crotalidae Immune Fab2 Vial 16 6 $2,218.00 $1,996.20 $1,552.60 $2,218.00 $2,107.10 2026-02-27
32556 HCPCS Pleural Drng, Perc,w/ins Of Cath-without Ima 16 6 $2,196.00 $1,976.40 $1,537.20 $2,196.00 $2,086.20 2026-02-27
72132 HCPCS CT Lumbar Spine W Contrast 16 6 $2,165.00 $1,948.50 $1,515.50 $2,165.00 $2,056.75 2026-02-27
70547 HCPCS MRA Neck Wo Contrast 16 6 $2,146.00 $1,931.40 $1,502.20 $2,146.00 $2,038.70 2026-02-27
72126 HCPCS CT Cervical Spine W Contrast 16 6 $2,141.00 $1,926.90 $1,498.70 $2,141.00 $2,033.95 2026-02-27
70488 HCPCS CT Facial Bones W Wo Contrast 16 6 $2,124.00 $1,911.60 $1,486.80 $2,124.00 $2,017.80 2026-02-27
70336 HCPCS Mr Tmj 16 6 $2,113.00 $1,901.70 $1,479.10 $2,113.00 $2,007.35 2026-02-27
73706 HCPCS CTA Lower Extremity Bilat W Wo Contrast 16 6 $2,092.00 $1,882.80 $1,464.40 $2,092.00 $1,987.40 2026-02-27
74160 HCPCS CT Abdomen W Contrast 16 6 $2,084.00 $1,875.60 $1,458.80 $2,084.00 $1,979.80 2026-02-27
70492 HCPCS CT Soft Tissue Neck W Wo Contrast 16 6 $2,064.00 $1,857.60 $1,444.80 $2,064.00 $1,960.80 2026-02-27
73702 HCPCS CT Lower Extremity Lt W Wo Contrast 32 6 $2,115.50 $1,903.95 $1,444.80 $2,167.00 $1,960.80 2026-02-27
72191 HCPCS CTA Pelvis 16 6 $2,031.00 $1,827.90 $1,421.70 $2,031.00 $1,929.45 2026-02-27
62270 HCPCS Tr Lumbar Puncture 16 6 $2,028.00 $1,825.20 $1,419.60 $2,028.00 $1,926.60 2026-02-27
73206 HCPCS CTA Upper Extremity Lt W Wo 32 6 $2,025.00 $1,822.50 $1,417.50 $2,025.00 $1,923.75 2026-02-27
64447 HCPCS Op Inj Femoral Nerve Block 64447 16 6 $2,006.00 $1,805.40 $1,404.20 $2,006.00 $1,905.70 2026-02-27
72129 HCPCS CT Thoracic Spine W Contrast 16 6 $2,003.00 $1,802.70 $1,402.10 $2,003.00 $1,902.85 2026-02-27
71260 HCPCS CT Chest W Contrast 16 6 $1,988.00 $1,789.20 $1,391.60 $1,988.00 $1,888.60 2026-02-27
36569 HCPCS Insertion Of Picc Line 16 6 $1,970.00 $1,773.00 $1,379.00 $1,970.00 $1,871.50 2026-02-27
72193 HCPCS CT Pelvis W Contrast 16 6 $1,966.00 $1,769.40 $1,376.20 $1,966.00 $1,867.70 2026-02-27
15277 HCPCS Skin Sub Applic H,ft,fc 1st100sqcm 15277 16 6 $1,960.00 $1,764.00 $1,372.00 $1,960.00 $1,862.00 2026-02-27
70491 HCPCS CT Soft Tissue Neck W Contrast 16 6 $1,957.00 $1,761.30 $1,369.90 $1,957.00 $1,859.15 2026-02-27
70481 HCPCS CTA Orbit Ear Fossa W Contrast 32 6 $1,995.50 $1,795.95 $1,314.60 $2,113.00 $1,849.83 2026-02-27
64445 HCPCS Op Inj Sciatic Nerve Block 64445 16 6 $1,935.00 $1,741.50 $1,354.50 $1,935.00 $1,838.25 2026-02-27
73701 HCPCS CT Lower Extremity Lt W Contrast 32 6 $1,928.00 $1,735.20 $1,349.60 $1,928.00 $1,831.60 2026-02-27
15273 HCPCS Skin Subs Applic T,a,l 1st100 Sqcm 15273 16 6 $1,914.00 $1,722.60 $1,339.80 $1,914.00 $1,818.30 2026-02-27
93306 HCPCS Echo Complete 16 6 $1,906.00 $1,715.40 $1,334.20 $1,906.00 $1,810.70 2026-02-27
73202 HCPCS CT Upper Extremity Lt W Wo Contrast 32 6 $1,878.00 $1,690.20 $1,314.60 $1,878.00 $1,784.10 2026-02-27
100002 CDM Private Room Isolation 16 6 $1,875.00 $1,687.50 $1,312.50 $1,875.00 $1,781.25 2026-02-27
15275 HCPCS Skin Subs Applic H,ft,fc, 1-25sqcm 15275 16 6 $1,855.00 $1,669.50 $1,298.50 $1,855.00 $1,762.25 2026-02-27
64461 HCPCS Pro Fee Pvb Thoracic 1st Level 16 6 $1,852.00 $1,666.80 $1,296.40 $1,852.00 $1,759.40 2026-02-27
20520 HCPCS ER Remove Fb Muscle/tendon Sheath Simple 16 6 $1,847.00 $1,662.30 $1,292.90 $1,847.00 $1,754.65 2026-02-27
70487 HCPCS CT Facial Bones W Contrast 16 6 $1,846.00 $1,661.40 $1,292.20 $1,846.00 $1,753.70 2026-02-27
73201 HCPCS CT Upper Extremity Lt W Contrast 32 6 $1,841.00 $1,656.90 $1,288.70 $1,841.00 $1,748.95 2026-02-27
64530 HCPCS Op Inj Celiac Plex Block 64530 16 6 $1,838.00 $1,654.20 $1,286.60 $1,838.00 $1,746.10 2026-02-27
99285 HCPCS ER Room/op Room Comprehensive 99285 16 6 $1,823.00 $1,640.70 $1,276.10 $1,823.00 $1,731.85 2026-02-27
71555 HCPCS MRA Chest W Wo Contrast 16 6 $1,812.00 $1,630.80 $1,268.40 $1,812.00 $1,721.40 2026-02-27
70460 HCPCS CT Head W Contrast 16 6 $1,769.00 $1,592.10 $1,238.30 $1,769.00 $1,680.55 2026-02-27
64417 HCPCS Op Inj Ane Agen Axillary Nerve 16 6 $1,768.00 $1,591.20 $1,237.60 $1,768.00 $1,679.60 2026-02-27
64630 HCPCS Op Inj Destr Nero Agt, Pudendal Nv 64630 16 6 $1,762.00 $1,585.80 $1,233.40 $1,762.00 $1,673.90 2026-02-27
15271 HCPCS Skin Subs Applic T,a,l 1-25 Sqcm 15271 16 6 $1,752.00 $1,576.80 $1,226.40 $1,752.00 $1,664.40 2026-02-27
100001 CDM Private Room 16 6 $1,736.00 $1,562.40 $1,215.20 $1,736.00 $1,649.20 2026-02-27
64479 HCPCS Op Inj Transfor C/t 1st 64479 16 6 $1,732.00 $1,558.80 $1,212.40 $1,732.00 $1,645.40 2026-02-27
72125 HCPCS CT Cervical Spine Wo Contrast 16 6 $1,708.00 $1,537.20 $1,195.60 $1,708.00 $1,622.60 2026-02-27
64520 HCPCS Op Inj Paravert Symp Block T/l 64520 16 6 $1,703.00 $1,532.70 $1,192.10 $1,703.00 $1,617.85 2026-02-27
A0426 HCPCS Ambulance Als Non Emergent 16 6 $1,703.00 $1,532.70 $1,192.10 $1,703.00 $1,617.85 2026-02-27
75989 HCPCS US Radiologl Guidance Prq DRG W/plmt Cat 16 6 $1,673.00 $1,505.70 $1,171.10 $1,673.00 $1,589.35 2026-02-27
36556 HCPCS Treatment Rm 16 6 $1,649.00 $1,484.10 $1,154.30 $1,649.00 $1,566.55 2026-02-27
64640 HCPCS Op Ij Rfa Rfa Perph Nv/supscap 64640 16 6 $1,643.00 $1,478.70 $1,150.10 $1,643.00 $1,560.85 2026-02-27
74150 HCPCS CT Abdomen Wo Contrast 16 6 $1,631.00 $1,467.90 $1,141.70 $1,631.00 $1,549.45 2026-02-27
3007393 CDM Xx Semaglutide Subq [0.68mg/ml] 16 6 $1,628.00 $1,465.20 $1,139.60 $1,628.00 $1,546.60 2026-02-27
72131 HCPCS CT Lumbar Spine Wo Contrast 16 6 $1,616.00 $1,454.40 $1,131.20 $1,616.00 $1,535.20 2026-02-27
64493 HCPCS Op Inj Facet Jnt L/s 1l 64493 16 6 $1,615.00 $1,453.50 $1,130.50 $1,615.00 $1,534.25 2026-02-27
72128 HCPCS CT Thoracic Spine Wo Contrast 16 6 $1,611.00 $1,449.90 $1,127.70 $1,611.00 $1,530.45 2026-02-27
64999 HCPCS Pro Fee Op Unlisted Procedure 64999 16 6 $1,588.00 $1,429.20 $1,111.60 $1,588.00 $1,508.60 2026-02-27
64490 HCPCS Op Inj Facet Jnt C/t 1l W/ima 64490 16 6 $1,588.00 $1,429.20 $1,111.60 $1,588.00 $1,508.60 2026-02-27
90197024 CDM Pathfast Ntprobnp(60tests/bx) D/s 16 6 $1,584.74 $1,426.27 $1,109.32 $1,584.74 $1,505.50 2026-02-27
3007411 CDM Xx Semaglutide Inj. 2.68mg/ml 16 6 $1,572.10 $1,414.89 $1,100.47 $1,572.10 $1,493.49 2026-02-27
72192 HCPCS CT Pelvis Wo Contrast 16 6 $1,546.00 $1,391.40 $1,082.20 $1,546.00 $1,468.70 2026-02-27
70490 HCPCS CT Soft Tissue Neck Wo Contrast 16 6 $1,539.00 $1,385.10 $1,077.30 $1,539.00 $1,462.05 2026-02-27
92960 HCPCS ER Cardioversion Elective External(defib 16 6 $1,537.00 $1,383.30 $1,075.90 $1,537.00 $1,460.15 2026-02-27
73200 HCPCS CT Upper Extremity Lt Wo Contrast 32 6 $1,534.00 $1,380.60 $1,073.80 $1,534.00 $1,457.30 2026-02-27
70486 HCPCS CT Facial Bones Wo Contrast 16 6 $1,522.00 $1,369.80 $1,065.40 $1,522.00 $1,445.90 2026-02-27
70450 HCPCS CT Head Wo Contrast 16 6 $1,518.00 $1,366.20 $1,062.60 $1,518.00 $1,442.10 2026-02-27
A0429 HCPCS Ambulance Bls Emergent 16 6 $1,481.00 $1,332.90 $1,036.70 $1,481.00 $1,406.95 2026-02-27
73700 HCPCS CT Lower Extremity Lt Wo Contrast 32 6 $1,474.00 $1,326.60 $1,031.80 $1,474.00 $1,400.30 2026-02-27
76825 HCPCS Echo Exam Of Fetal Heart 16 6 $1,451.00 $1,305.90 $1,015.70 $1,451.00 $1,378.45 2026-02-27
300003 CDM Swing Bed 16 6 $1,447.00 $1,302.30 $1,012.90 $1,447.00 $1,374.65 2026-02-27
64451 HCPCS Njx Aa&/strd Nrv Nrvtg Si Jt 64451 16 6 $1,413.00 $1,271.70 $989.10 $1,413.00 $1,342.35 2026-02-27
64510 HCPCS Op Inj Stellate Gang Block 64510 16 6 $1,381.00 $1,242.90 $966.70 $1,381.00 $1,311.95 2026-02-27
93017 HCPCS Cardiovascular Stress Test 16 6 $1,372.00 $1,234.80 $960.40 $1,372.00 $1,303.40 2026-02-27
64517 HCPCS Op Inj Sup Hypogstrc Plx Bl 64517 16 6 $1,317.00 $1,185.30 $921.90 $1,317.00 $1,251.15 2026-02-27
15278 HCPCS Skin Subs App H,ft,fc Ea 100+ Sqcm 15278 16 6 $1,315.00 $1,183.50 $920.50 $1,315.00 $1,249.25 2026-02-27
24200 HCPCS ER Remove Fb Upper Arm Elbow Area 16 6 $1,304.00 $1,173.60 $912.80 $1,304.00 $1,238.80 2026-02-27
93886 HCPCS US Transcranial Doppler Stdy Intracran A 16 6 $1,303.00 $1,172.70 $912.10 $1,303.00 $1,237.85 2026-02-27
64636 HCPCS Op Inj Rfa L/s Eadd Joint 64636 16 6 $1,294.00 $1,164.60 $905.80 $1,294.00 $1,229.30 2026-02-27
90375 HCPCS Rabies Immune Globulin [150iu/ml] 2ml 16 6 $1,253.00 $1,127.70 $877.10 $1,253.00 $1,190.35 2026-02-27
32551 HCPCS ER Insertion Of Chest Tube 16 6 $1,253.00 $1,127.70 $877.10 $1,253.00 $1,190.35 2026-02-27
90197094 CDM Vitamin D Assay 16 6 $1,250.00 $1,125.00 $875.00 $1,250.00 $1,187.50 2026-02-27
99284 HCPCS ER Room/op Room Extended 99284 16 6 $1,221.00 $1,098.90 $854.70 $1,221.00 $1,159.95 2026-02-27
23655 HCPCS ER Treat Shoulder Dislocation 16 6 $1,195.00 $1,075.50 $836.50 $1,195.00 $1,135.25 2026-02-27
76942 HCPCS Xr Ultrasound Needle Guid 76942 16 6 $1,194.00 $1,074.60 $835.80 $1,194.00 $1,134.30 2026-02-27
87536 HCPCS HIV-1 RNA Quantitative, Pcr (550880) 16 6 $1,154.00 $1,038.60 $807.80 $1,154.00 $1,096.30 2026-02-27
3007134 CDM Flutic/umeclid/vilan 100/62.5/25mcg Nf 16 6 $1,139.00 $1,025.10 $797.30 $1,139.00 $1,082.05 2026-02-27
87150 HCPCS Lab Dna/rna Amplified Probe Id 16 6 $1,123.00 $1,010.70 $786.10 $1,123.00 $1,066.85 2026-02-27
A0433 HCPCS Ambulance Als 2 Emergent 32 6 $1,475.00 $1,327.50 $116.90 $2,783.00 $1,057.55 2026-02-27
90197081 CDM Cepheid Vaginal Mvp Panel 16 6 $1,104.41 $993.97 $773.09 $1,104.41 $1,049.19 2026-02-27
70480 HCPCS CT Limited Orbits For MRI 32 6 $1,239.00 $1,115.10 $676.20 $1,512.00 $1,012.20 2026-02-27
J0585 HCPCS Botulinum Toxin 100un Vial 16 6 $1,065.20 $958.68 $745.64 $1,065.20 $1,011.94 2026-02-27
J1670 HCPCS Tetanus Immune Globulin Syr. 250 Units 16 6 $1,058.90 $953.01 $741.23 $1,058.90 $1,005.96 2026-02-27
A0428 HCPCS Ambulance Bls Non Emergent 16 6 $1,058.00 $952.20 $740.60 $1,058.00 $1,005.10 2026-02-27
3007581 CDM Omnipod 5 [10 Pod] Kit 16 6 $1,045.00 $940.50 $731.50 $1,045.00 $992.75 2026-02-27
21315 HCPCS ER Closed Tx Nose Fx Without Stab 16 6 $1,042.00 $937.80 $729.40 $1,042.00 $989.90 2026-02-27
20611 HCPCS Op Inj Major Joint W/us 20611 16 6 $1,042.00 $937.80 $729.40 $1,042.00 $989.90 2026-02-27
46040 HCPCS ER Incision Of Rectal Abscess 16 6 $1,042.00 $937.80 $729.40 $1,042.00 $989.90 2026-02-27
64450 HCPCS ER N Block Of Peripheral Branch 32 6 $1,190.50 $1,071.45 $632.80 $1,477.00 $968.95 2026-02-27
20610 HCPCS Op Major Joint Inj Without US 20610 16 6 $984.00 $885.60 $688.80 $984.00 $934.80 2026-02-27
13132 HCPCS ER Repair Complex Fc/hn 2.6 To 7.5cm 16 6 $981.00 $882.90 $686.70 $981.00 $931.95 2026-02-27
64462 HCPCS Pro Fee Pvb Thoracic Add On Level 16 6 $975.00 $877.50 $682.50 $975.00 $926.25 2026-02-27
81219 HCPCS Calr Mutation (myeloproliferative Analy 16 6 $970.00 $873.00 $679.00 $970.00 $921.50 2026-02-27
81339 HCPCS Mpl Exon 10 Mutation Code 16 6 $950.00 $855.00 $665.00 $950.00 $902.50 2026-02-27
64480 HCPCS Op Inj Op Inj Tranfor C/t Addtl 64480 16 6 $948.00 $853.20 $663.60 $948.00 $900.60 2026-02-27
93930 HCPCS US Upper Ext Arterial Duplex Bilateral 16 6 $945.00 $850.50 $661.50 $945.00 $897.75 2026-02-27
J3590 HCPCS Semaglutide Sq Inj [1 Mg/0.75 Ml] Sp Ord 32 6 $1,146.00 $1,031.40 $431.20 $1,676.00 $894.60 2026-02-27
93325 HCPCS US Doppler Color Flow Add-on 16 6 $941.00 $846.90 $658.70 $941.00 $893.95 2026-02-27
25605 HCPCS Fx Closed Distal Radial With Manipul 16 6 $930.00 $837.00 $651.00 $930.00 $883.50 2026-02-27
64634 HCPCS Op Inj Rfa C/t Ea Add On Jt 64634 16 6 $924.00 $831.60 $646.80 $924.00 $877.80 2026-02-27
1099999 CDM ER Miscellaneous 16 6 $914.00 $822.60 $639.80 $914.00 $868.30 2026-02-27
13122 HCPCS ER Repair Complex Ea Addtl 5cm Or Less 16 6 $899.00 $809.10 $629.30 $899.00 $854.05 2026-02-27
13121 HCPCS ER Repair Complex 2.6cm To 7.5cm 16 6 $899.00 $809.10 $629.30 $899.00 $854.05 2026-02-27
J1442 HCPCS Filgrastim Inj [480 Mcg/0.8 Ml] 16 6 $893.00 $803.70 $625.10 $893.00 $848.35 2026-02-27
J1447 HCPCS Filgrastim Inj [480 Mcg/0.8 Ml] Pfs 16 6 $893.00 $803.70 $625.10 $893.00 $848.35 2026-02-27
96413 HCPCS Initial Hour Of Chemo Infusion 16 6 $890.00 $801.00 $623.00 $890.00 $845.50 2026-02-27
76377 HCPCS US 3d Render W/interp&postproc Diff Work 16 6 $885.00 $796.50 $619.50 $885.00 $840.75 2026-02-27
92950 HCPCS ER Cardiopulmonary Resuscitation 16 6 $875.00 $787.50 $612.50 $875.00 $831.25 2026-02-27
00811 HCPCS Anesthesia Colonoscopy 00811 16 6 $867.00 $780.30 $606.90 $867.00 $823.65 2026-02-27
00731 HCPCS Anesthesia Endo 00731 16 6 $866.00 $779.40 $606.20 $866.00 $822.70 2026-02-27
45900 HCPCS ER Reduction Of Rectal Prolapse 16 6 $863.00 $776.70 $604.10 $863.00 $819.85 2026-02-27
86041 HCPCS Anti Musk Antibody 16 6 $850.00 $765.00 $595.00 $850.00 $807.50 2026-02-27
64420 HCPCS Op Inj Intrcost Nerve Block Single 64420 16 6 $848.00 $763.20 $593.60 $848.00 $805.60 2026-02-27
64418 HCPCS Op Inj Suprascapular Nerve 64418 16 6 $848.00 $763.20 $593.60 $848.00 $805.60 2026-02-27
71250 HCPCS CT Chest Wo Contrast 32 6 $1,044.50 $940.05 $344.40 $1,597.00 $804.95 2026-02-27
76776 HCPCS US Trnsplnt Kidney Real Time W/image Doc 16 6 $847.00 $762.30 $592.90 $847.00 $804.65 2026-02-27
90675 HCPCS Vac - Rabies Vaccine 16 6 $845.00 $760.50 $591.50 $845.00 $802.75 2026-02-27
64484 HCPCS Op Inj Transfor L/s Add 64484 16 6 $840.00 $756.00 $588.00 $840.00 $798.00 2026-02-27
00813 HCPCS Anesthesia Colon& Egd 00813 16 6 $833.00 $749.70 $583.10 $833.00 $791.35 2026-02-27
00812 HCPCS Anesthesia Colonoscopy 00812 16 6 $827.00 $744.30 $578.90 $827.00 $785.65 2026-02-27
64425 HCPCS Op Inj Ilioing/iliohypog Nv Block 64425 16 6 $822.00 $739.80 $575.40 $822.00 $780.90 2026-02-27
87507 HCPCS Biofire Gi Panel Rvmc 32 6 $910.50 $819.45 $554.40 $1,029.00 $780.12 2026-02-27
15274 HCPCS Skin Subs Applic T,a,l Ea100+ Sqcm 15274 16 6 $815.00 $733.50 $570.50 $815.00 $774.25 2026-02-27
12035 HCPCS ER Repair Int S/a/t/e 12.6-20cm 16 6 $805.00 $724.50 $563.50 $805.00 $764.75 2026-02-27
92611 HCPCS St Video Study Motion Fluoroscopic Eval 16 6 $796.00 $716.40 $557.20 $796.00 $756.20 2026-02-27
64494 HCPCS Op Inj Facet Jnt L/s 2 L 64494 16 6 $785.00 $706.50 $549.50 $785.00 $745.75 2026-02-27
93308 HCPCS Echo Limited 16 6 $783.00 $704.70 $548.10 $783.00 $743.85 2026-02-27
93892 HCPCS US Transcranl Doppler Intracran Art Embo 16 6 $781.00 $702.90 $546.70 $781.00 $741.95 2026-02-27
25565 HCPCS Treat Fracture Radius & Ulna W/mani 16 6 $773.00 $695.70 $541.10 $773.00 $734.35 2026-02-27
64492 HCPCS Op Inj Facet Jnt C/t 3rdl Wim 64492 16 6 $771.00 $693.90 $539.70 $771.00 $732.45 2026-02-27
87901 HCPCS Lab HIV-1 Genotype 16 6 $770.00 $693.00 $539.00 $770.00 $731.50 2026-02-27
99283 HCPCS ER Room/op Room Intermediate 99283 16 6 $758.00 $682.20 $530.60 $758.00 $720.10 2026-02-27
93888 HCPCS US Transcranial Doppler Stdy Intracranil 16 6 $757.00 $681.30 $529.90 $757.00 $719.15 2026-02-27
3007191 CDM D/c Budesonide-formoterol Inh 80-4.5mcg 16 6 $756.20 $680.58 $529.34 $756.20 $718.39 2026-02-27
64491 HCPCS Op Inj Facet Jnt C/t 2nd Level 64491 16 6 $755.00 $679.50 $528.50 $755.00 $717.25 2026-02-27
64495 HCPCS Op Inj Facet Jnt L/s 3l + 64495 16 6 $748.00 $673.20 $523.60 $748.00 $710.60 2026-02-27
87633 HCPCS Lab Comp Respiratory Panel 16 6 $739.00 $665.10 $517.30 $739.00 $702.05 2026-02-27
76380 HCPCS CT Limited Follow-up 16 6 $737.00 $663.30 $515.90 $737.00 $700.15 2026-02-27
93970 HCPCS US Venous Dopp Lower Ext Biilateral 16 6 $735.00 $661.50 $514.50 $735.00 $698.25 2026-02-27
13131 HCPCS ER Repair Complex 1.1-2.5 Cm 16 6 $734.00 $660.60 $513.80 $734.00 $697.30 2026-02-27
12034 HCPCS ER Repair Int S/a/t/e 7.6-12cm 16 6 $731.00 $657.90 $511.70 $731.00 $694.45 2026-02-27
3007217 CDM Xx Tresiba 100u/1ml Inj 10ml 16 6 $726.00 $653.40 $508.20 $726.00 $689.70 2026-02-27
26770 HCPCS ER Tx Disloc(i-p)jt Without Anes W/manip Clo 16 6 $724.00 $651.60 $506.80 $724.00 $687.80 2026-02-27
25505 HCPCS ER Closed Fx Wrist With Manipulation 16 6 $722.00 $649.80 $505.40 $722.00 $685.90 2026-02-27
13120 HCPCS ER Repair Complex 1.1cm To 2.5 Scalp, Ar 16 6 $714.00 $642.60 $499.80 $714.00 $678.30 2026-02-27
93893 HCPCS US Transcran Dopl Intracran Art Microbub 16 6 $709.00 $638.10 $496.30 $709.00 $673.55 2026-02-27
93975 HCPCS US Dup-scan Artl Flo Abd/pel/scro/rpr Or 16 6 $708.00 $637.20 $495.60 $708.00 $672.60 2026-02-27
J0881 HCPCS Darbepoetin Alfa [40 Mcg/ Ml] Pfs Sp Ord 16 6 $706.00 $635.40 $494.20 $706.00 $670.70 2026-02-27
3007249 CDM Levemir 100u/ml 10ml Vial-nf 16 6 $702.60 $632.34 $491.82 $702.60 $667.47 2026-02-27
3007298 CDM Ipratropium Hfa Inh (17 Mcg) Nf 16 6 $700.00 $630.00 $490.00 $700.00 $665.00 2026-02-27
P9016 HCPCS Bb Blood Packed Cells 16 6 $699.00 $629.10 $489.30 $699.00 $664.05 2026-02-27
64454 HCPCS Op Into/inj Genicular Nerve Branch 64454 16 6 $695.00 $625.50 $486.50 $695.00 $660.25 2026-02-27
93880 HCPCS US Carotid Bilateral 16 6 $694.00 $624.60 $485.80 $694.00 $659.30 2026-02-27
88262 HCPCS Lab Chromosone Routine 16 6 $687.00 $618.30 $480.90 $687.00 $652.65 2026-02-27
73030 HCPCS Xr Shoulder Lt 2-3 Views 80 6 $713.00 $641.70 $475.30 $1,019.00 $650.50 2026-02-27
3007247 CDM Netarsudil 0.02% Solution 2.5 Ml-nf 16 6 $677.40 $609.66 $474.18 $677.40 $643.53 2026-02-27
92610 HCPCS St Eval Of Oral&pharyngeal Swallowing F 16 6 $677.00 $609.30 $473.90 $677.00 $643.15 2026-02-27
74230 HCPCS Xr Cine/video Throat/esoph 16 6 $675.00 $607.50 $472.50 $675.00 $641.25 2026-02-27
76819 HCPCS US Fetal Biophys Prof Without Non Stress Tes 16 6 $673.00 $605.70 $471.10 $673.00 $639.35 2026-02-27
20605 HCPCS Inj And/or Aspir Jnt Intrmd Without US 20605 16 6 $672.00 $604.80 $470.40 $672.00 $638.40 2026-02-27
3007241 CDM Budesonide Formoterol 80/4.5 Inh Nf 16 6 $670.00 $603.00 $469.00 $670.00 $636.50 2026-02-27
64415 HCPCS Op Inj Brachial Plexus W/imaging 64415 16 6 $669.00 $602.10 $468.30 $669.00 $635.55 2026-02-27
64405 HCPCS Op Inj Grter Occipt Nerve Block 64405 16 6 $669.00 $602.10 $468.30 $669.00 $635.55 2026-02-27
36430 HCPCS Bb Administration Blood/day 16 6 $668.00 $601.20 $467.60 $668.00 $634.60 2026-02-27
93925 HCPCS US Lower Ext Arterial Duplex Bilateral 16 6 $668.00 $601.20 $467.60 $668.00 $634.60 2026-02-27
76506 HCPCS Echoencephalography Real Time Imaging 16 6 $668.00 $601.20 $467.60 $668.00 $634.60 2026-02-27
J0132 HCPCS Acetylcysteine Inj (200mg/ml) 30ml 16 6 $665.00 $598.50 $465.50 $665.00 $631.75 2026-02-27
29581 HCPCS Ot Apply Multlay Comprs Lwr Leg 16 6 $664.00 $597.60 $464.80 $664.00 $630.80 2026-02-27
29584 HCPCS Ot Apply Multlay Comprs Upr Arm 16 6 $664.00 $597.60 $464.80 $664.00 $630.80 2026-02-27
12054 HCPCS ER Repair Int F/e/e/n/l 7.6-12.5cm 16 6 $660.00 $594.00 $462.00 $660.00 $627.00 2026-02-27
24650 HCPCS Closed Treat Radial Head Without Mani 16 6 $652.00 $586.80 $456.40 $652.00 $619.40 2026-02-27
64505 HCPCS Op Inj Sphenopalgang Bloc 64505 16 6 $651.00 $585.90 $455.70 $651.00 $618.45 2026-02-27
81220 HCPCS Lab Cftr Gene Com Variants 16 6 $649.00 $584.10 $454.30 $649.00 $616.55 2026-02-27
12032 HCPCS ER Repair Int S/a/t/e 2.6-7.5cm 16 6 $649.00 $584.10 $454.30 $649.00 $616.55 2026-02-27
8126770 CDM Tx Disloc Jt Without Anes W/manip Clo 16 6 $642.00 $577.80 $449.40 $642.00 $609.90 2026-02-27
31500 HCPCS ER Intubation, Endotracheal 31500 16 6 $641.00 $576.90 $448.70 $641.00 $608.95 2026-02-27
3007386 CDM Mometasone Furoate 100mcg/5mcg Inh 16 6 $640.10 $576.09 $448.07 $640.10 $608.10 2026-02-27
J0885 HCPCS Epoetin Alfa Inj [10,000 U/ml] Spec Ord 16 6 $640.00 $576.00 $448.00 $640.00 $608.00 2026-02-27
J0561 HCPCS Penicillin G Benz Inj [1,200,000 U/2 Ml] 16 6 $633.00 $569.70 $443.10 $633.00 $601.35 2026-02-27
64612 HCPCS Op Inj Destruction Of Facial Nerve 64612 16 6 $631.00 $567.90 $441.70 $631.00 $599.45 2026-02-27
93303 HCPCS US Complete Tthrc Echo Congeni Cardiac A 16 6 $631.00 $567.90 $441.70 $631.00 $599.45 2026-02-27
87799 HCPCS Ebv, Quantitative, Pcr (138230) 16 6 $630.00 $567.00 $441.00 $630.00 $598.50 2026-02-27
99292 HCPCS Critical Care (ea 1/2 Hr) 16 6 $628.00 $565.20 $439.60 $628.00 $596.60 2026-02-27
90197025 CDM Pathfast D-dimer(60tests/bx) D/s 16 6 $620.10 $558.09 $434.07 $620.10 $589.10 2026-02-27
3007262 CDM Brimonidine/timolol [0.2%/0.5%] 5ml Nf 16 6 $617.00 $555.30 $431.90 $617.00 $586.15 2026-02-27
0202U OTHER Respiratory Panel, Nad Rvmc 16 6 $613.00 $551.70 $429.10 $613.00 $582.35 2026-02-27
Q5125 HCPCS Filgrastim Inj [300 Mcg/0.5 Ml] Spec Ord 16 6 $611.00 $549.90 $427.70 $611.00 $580.45 2026-02-27
97167 HCPCS Ot Eval High Complex 16 6 $609.00 $548.10 $426.30 $609.00 $578.55 2026-02-27
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