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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

WHEATLAND MEMORIAL HOSPITAL

Harlowton, MT · CCN 271321 · Rates published

1,158 distinct procedures filed
27 distinct payers
35,812 rate rows
2026-02-12 last MRF observed
Data quality

35,677 of 35,812 rate rows are consumer-grade (99.6%)

135 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
exceeds 10× this hospital's gross charge — excluded from medians 62
percent-of-charges filed in the dollar field — excluded from medians 43
per-diem day rate — not a per-procedure price 30
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbWMHHARLOWTONMT&type=CDMWithoutLabel
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint d460623871c6f2dd… · 15,846,110 bytes · first seen 2026-05-07

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
J0881
HCPCS 		Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use) 22 $34,527.53 $84,903.75 $53,772.38 nat. median
$751
outlier · 71.6×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 22 $20,672.90 $50,835.00 $32,195.50 nat. median
$5,949
outlier · 5.4×
95811
HCPCS 		Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 22 $7,663.66 $18,845.07 $11,935.21 nat. median
$2,026
outlier · 5.9×
95810
HCPCS 		Sleep Study In Sleep Lab (6 Years Or Older) 22 $6,990.34 $17,189.36 $10,886.59 nat. median
$1,870
outlier · 5.8×
8028202_1
CDM 		Room & Board - Private (one Bed) - General Classification 16 $6,075.30 $7,938.39 $7,695.38 nat. median
$3,174
outlier · 2.4×
58558
HCPCS 		Biopsy Of Lining Of Uterus And/or Removal Of Polyp Using An Endoscope 22 $513.65 $8,197.50 $5,191.75 nat. median
$3,304
1.6× median
8028201_1
CDM 		Room & Board - Private (one Bed) - General Classification 16 $3,902.67 $5,099.49 $4,943.38 nat. median
$2,850
1.7× median
J0875
HCPCS 		Injection, Dalbavancin, 5 Mg 22 $3,165.80 $7,784.75 $4,930.34 nat. median
$1,069
outlier · 4.6×
8028232_1
CDM 		Intensive Care Unit - Intermediate ICU 16 $3,693.75 $4,826.50 $4,678.75 nat. median
$3,148
1.5× median
8028231_1
CDM 		Room & Board - Semi-private (two Beds) - Other 16 $3,692.04 $4,824.27 $4,676.58 nat. median
$3,011
1.6× median
28470
HCPCS 		Closed Treatment Of Broken Bone In Forefoot Or Midfoot 22 $513.65 $6,937.50 $4,393.75 nat. median
$396
outlier · 11.1×
8028229_1
CDM 		Room & Board - Semi-private (two Beds) - Other 16 $3,398.20 $4,440.31 $4,304.38 nat. median
$2,660
1.6× median
26735
HCPCS 		Treatment Of Broken Finger At Midportion Or Part Near Hand 22 $513.65 $3,916.50 $2,480.45 nat. median
$3,781
0.7× median
71275
HCPCS 		CT Scan Of Blood Vessels Of Chest With Contrast 26 $63.26 $4,242.00 $2,386.38 nat. median
$735
outlier · 3.2×
8320701_1
CDM 		Ketamine 200 Mg/20 Ml Vial 22 $1,296.56 $2,082.99 $2,019.23 nat. median
$165
outlier · 12.2×
27762
HCPCS 		Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation 22 $513.65 $3,052.50 $1,933.25 nat. median
$1,930
1.0× median
46250
HCPCS 		Removal Of Multiple External Hemorrhoids 22 $513.65 $3,021.00 $1,913.30 nat. median
$2,876
0.7× median
28192
HCPCS 		Removal Of Foreign Body Of Foot Tissue, Deep 22 $513.65 $3,006.00 $1,903.80 nat. median
$1,917
1.0× median
74176
HCPCS 		CT Scan Of Abdomen And Pelvis Without Contrast 26 $63.26 $4,628.25 $1,882.16 nat. median
$685
outlier · 2.7×
24655
HCPCS 		Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation 22 $513.65 $2,841.00 $1,799.30 nat. median
$1,605
1.1× median
G0390
HCPCS 		Trauma Response Team Associated With Hospital Critical Care Service 22 $1,144.97 $3,396.86 $1,783.15 nat. median
$3,172
0.6× median
26705
HCPCS 		Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation Un… 22 $513.65 $2,685.00 $1,700.50 nat. median
$1,686
1.0× median
25248
HCPCS 		Removal Of Deep Foreign Body In Forearm Or Wrist 22 $513.65 $2,638.50 $1,671.05 nat. median
$2,132
0.8× median
23575
HCPCS 		Closed Treatment Of Broken Shoulder Blade With Manipulation 22 $513.65 $2,629.50 $1,665.35 nat. median
$1,653
1.0× median
J0561
HCPCS 		Injection, Penicillin G Benzathine, 100,000 Units 22 $1,037.92 $2,552.25 $1,616.43 nat. median
$307
outlier · 5.3×
26080
HCPCS 		Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign… 22 $513.65 $2,550.00 $1,615.00 nat. median
$2,068
0.8× median
73700
HCPCS 		CT Scan Of Leg Without Contrast 26 $46.42 $4,329.50 $1,606.45 nat. median
$555
outlier · 2.9×
71260
HCPCS 		CT Scan Of Chest With Contrast 26 $53.77 $3,812.31 $1,550.34 nat. median
$646
outlier · 2.4×
20670
HCPCS 		Removal Of Surface Implant From Bone 22 $513.65 $2,317.50 $1,467.75 nat. median
$1,902
0.8× median
J2997
HCPCS 		Injection, Alteplase Recombinant, 1 Mg 22 $927.20 $2,280.00 $1,444.00 nat. median
$545
outlier · 2.6×
27750
HCPCS 		Closed Treatment Of Broken Middle Part Of Shin Bone 22 $513.65 $2,247.00 $1,423.10 nat. median
$486
outlier · 2.9×
26075
HCPCS 		Incision Of Lower Finger Joint For Exploration, Fluid Drainage, Or Removal Of Fo… 22 $513.65 $2,173.50 $1,376.55 nat. median
$3,326
outlier · 0.4×
27760
HCPCS 		Closed Treatment Of Inside Portion Of Shin Bone At Ankle 22 $513.65 $2,151.00 $1,362.30 nat. median
$443
outlier · 3.1×
30906
HCPCS 		Subsequent Control Of Nosebleed And Insertion Of Packing 22 $513.65 $2,125.50 $1,346.15 nat. median
$354
outlier · 3.8×
23600
HCPCS 		Closed Treatment Of Broken Top Of Upper Arm Bone 22 $513.65 $2,115.00 $1,339.50 nat. median
$448
outlier · 3.0×
26725
HCPCS 		Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With… 22 $513.65 $2,113.50 $1,338.55 nat. median
$442
outlier · 3.0×
36589
HCPCS 		Removal Of Tunneled Central Venous Tube 22 $513.65 $2,097.00 $1,328.10 nat. median
$962
1.4× median
27808
HCPCS 		Closed Treatment Of 2 Broken Lower Leg Bones At Ankle 22 $513.65 $2,092.50 $1,325.25 nat. median
$452
outlier · 2.9×
J0169
HCPCS 		Injection, Epinephrine (adrenalin), Not Therapeutically Equivalent To J0165, 0.1… 22 $850.80 $2,092.13 $1,325.01 nat. median
$45
outlier · 29.5×
59409
HCPCS 		Vaginal Delivery 26 $63.26 $3,021.00 $1,298.74 nat. median
$3,185
outlier · 0.4×
27824
HCPCS 		Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint 22 $513.65 $2,040.00 $1,292.00 nat. median
$500
outlier · 2.6×
27786
HCPCS 		Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 22 $513.65 $2,035.50 $1,289.15 nat. median
$448
outlier · 2.9×
27252
HCPCS 		Closed Treatment Of Dislocated Hip Under Anesthesia 26 $63.26 $1,995.00 $1,279.09 nat. median
$2,058
0.6× median
11643
HCPCS 		Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.1-… 22 $513.65 $1,996.50 $1,264.45 nat. median
$1,599
0.8× median
11406
HCPCS 		Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 22 $513.65 $1,992.00 $1,261.60 nat. median
$1,766
0.7× median
27780
HCPCS 		Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone 22 $513.65 $1,980.00 $1,254.00 nat. median
$449
outlier · 2.8×
25622
HCPCS 		Closed Treatment Of Broken Wrist Bone Near Base Of Thumb 22 $513.65 $1,971.00 $1,248.30 nat. median
$454
outlier · 2.7×
27530
HCPCS 		Closed Treatment Of Broken Shin Bone 22 $513.65 $1,959.00 $1,240.70 nat. median
$465
outlier · 2.7×
71250
HCPCS 		CT Scan Of Chest Without Contrast 26 $49.43 $2,940.50 $1,195.80 nat. median
$473
outlier · 2.5×
27502
HCPCS 		Closed Treatment Of Broken Thigh Bone At Midportion With Manipulation 26 $63.26 $1,354.23 $1,193.38 nat. median
$2,054
0.6× median

Other procedures at this hospital

Browse this hospital's 1,158 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
             
J0881 HCPCS Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use) 22 22 $56,602.50 $56,602.50 $34,527.53 $84,903.75 $53,772.38 2026-02-12
J3101 HCPCS Injection, Tenecteplase, 1 Mg 22 22 $33,890.00 $33,890.00 $20,672.90 $50,835.00 $32,195.50 2026-02-12
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 22 22 $12,563.38 $12,563.38 $7,663.66 $18,845.07 $11,935.21 2026-02-12
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 22 22 $11,459.57 $11,459.57 $6,990.34 $17,189.36 $10,886.59 2026-02-12
8028202_1 CDM Room & Board - Private (one Bed) - General Classification 16 16 $8,100.40 $8,100.40 $6,075.30 $7,938.39 $7,695.38 2026-02-12
58558 HCPCS Biopsy Of Lining Of Uterus And/or Removal Of Polyp Using An Endoscope 22 22 $5,465.00 $5,465.00 $513.65 $8,197.50 $5,191.75 2026-02-12
8028201_1 CDM Room & Board - Private (one Bed) - General Classification 16 16 $5,203.56 $5,203.56 $3,902.67 $5,099.49 $4,943.38 2026-02-12
J0875 HCPCS Injection, Dalbavancin, 5 Mg 22 22 $5,189.83 $5,189.83 $3,165.80 $7,784.75 $4,930.34 2026-02-12
8028232_1 CDM Intensive Care Unit - Intermediate ICU 16 16 $4,925.00 $4,925.00 $3,693.75 $4,826.50 $4,678.75 2026-02-12
8028231_1 CDM Room & Board - Semi-private (two Beds) - Other 16 16 $4,922.72 $4,922.72 $3,692.04 $4,824.27 $4,676.58 2026-02-12
28470 HCPCS Closed Treatment Of Broken Bone In Forefoot Or Midfoot 22 22 $4,625.00 $4,625.00 $513.65 $6,937.50 $4,393.75 2026-02-12
8028229_1 CDM Room & Board - Semi-private (two Beds) - Other 16 16 $4,530.93 $4,530.93 $3,398.20 $4,440.31 $4,304.38 2026-02-12
26735 HCPCS Treatment Of Broken Finger At Midportion Or Part Near Hand 22 22 $2,611.00 $2,611.00 $513.65 $3,916.50 $2,480.45 2026-02-12
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 92 26 $2,767.87 $2,767.87 $63.26 $4,242.00 $2,386.38 2026-02-12
8320701_1 CDM Ketamine 200 Mg/20 Ml Vial 22 22 $2,125.50 $2,125.50 $1,296.56 $2,082.99 $2,019.23 2026-02-12
27762 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation 22 22 $2,035.00 $2,035.00 $513.65 $3,052.50 $1,933.25 2026-02-12
46250 HCPCS Removal Of Multiple External Hemorrhoids 22 22 $2,014.00 $2,014.00 $513.65 $3,021.00 $1,913.30 2026-02-12
28192 HCPCS Removal Of Foreign Body Of Foot Tissue, Deep 22 22 $2,004.00 $2,004.00 $513.65 $3,006.00 $1,903.80 2026-02-12
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 70 26 $3,068.95 $3,068.95 $63.26 $4,628.25 $1,882.16 2026-02-12
24655 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation 22 22 $1,894.00 $1,894.00 $513.65 $2,841.00 $1,799.30 2026-02-12
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 44 22 $2,070.78 $2,070.78 $1,144.97 $3,396.86 $1,783.15 2026-02-12
26705 HCPCS Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation Un… 22 22 $1,790.00 $1,790.00 $513.65 $2,685.00 $1,700.50 2026-02-12
25248 HCPCS Removal Of Deep Foreign Body In Forearm Or Wrist 22 22 $1,759.00 $1,759.00 $513.65 $2,638.50 $1,671.05 2026-02-12
23575 HCPCS Closed Treatment Of Broken Shoulder Blade With Manipulation 22 22 $1,753.00 $1,753.00 $513.65 $2,629.50 $1,665.35 2026-02-12
J0561 HCPCS Injection, Penicillin G Benzathine, 100,000 Units 22 22 $1,701.50 $1,701.50 $1,037.92 $2,552.25 $1,616.43 2026-02-12
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 22 22 $1,700.00 $1,700.00 $513.65 $2,550.00 $1,615.00 2026-02-12
73700 HCPCS CT Scan Of Leg Without Contrast 114 26 $1,691.00 $1,691.00 $46.42 $4,329.50 $1,606.45 2026-02-12
71260 HCPCS CT Scan Of Chest With Contrast 70 26 $2,462.50 $2,462.50 $53.77 $3,812.31 $1,550.34 2026-02-12
20670 HCPCS Removal Of Surface Implant From Bone 22 22 $1,545.00 $1,545.00 $513.65 $2,317.50 $1,467.75 2026-02-12
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 22 22 $1,520.00 $1,520.00 $927.20 $2,280.00 $1,444.00 2026-02-12
27750 HCPCS Closed Treatment Of Broken Middle Part Of Shin Bone 22 22 $1,498.00 $1,498.00 $513.65 $2,247.00 $1,423.10 2026-02-12
26075 HCPCS Incision Of Lower Finger Joint For Exploration, Fluid Drainage, Or Removal Of Fo… 22 22 $1,449.00 $1,449.00 $513.65 $2,173.50 $1,376.55 2026-02-12
27760 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle 22 22 $1,434.00 $1,434.00 $513.65 $2,151.00 $1,362.30 2026-02-12
30906 HCPCS Subsequent Control Of Nosebleed And Insertion Of Packing 22 22 $1,417.00 $1,417.00 $513.65 $2,125.50 $1,346.15 2026-02-12
23600 HCPCS Closed Treatment Of Broken Top Of Upper Arm Bone 22 22 $1,410.00 $1,410.00 $513.65 $2,115.00 $1,339.50 2026-02-12
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 22 22 $1,409.00 $1,409.00 $513.65 $2,113.50 $1,338.55 2026-02-12
36589 HCPCS Removal Of Tunneled Central Venous Tube 22 22 $1,398.00 $1,398.00 $513.65 $2,097.00 $1,328.10 2026-02-12
27808 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle 22 22 $1,395.00 $1,395.00 $513.65 $2,092.50 $1,325.25 2026-02-12
J0169 HCPCS Injection, Epinephrine (adrenalin), Not Therapeutically Equivalent To J0165, 0.1… 22 22 $1,394.75 $1,394.75 $850.80 $2,092.13 $1,325.01 2026-02-12
59409 HCPCS Vaginal Delivery 26 26 $3,180.00 $3,180.00 $63.26 $3,021.00 $1,298.74 2026-02-12
27824 HCPCS Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint 22 22 $1,360.00 $1,360.00 $513.65 $2,040.00 $1,292.00 2026-02-12
27786 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 22 22 $1,357.00 $1,357.00 $513.65 $2,035.50 $1,289.15 2026-02-12
27252 HCPCS Closed Treatment Of Dislocated Hip Under Anesthesia 26 26 $2,100.00 $2,100.00 $63.26 $1,995.00 $1,279.09 2026-02-12
11643 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.1-… 22 22 $1,331.00 $1,331.00 $513.65 $1,996.50 $1,264.45 2026-02-12
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 22 22 $1,328.00 $1,328.00 $513.65 $1,992.00 $1,261.60 2026-02-12
27780 HCPCS Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone 22 22 $1,320.00 $1,320.00 $513.65 $1,980.00 $1,254.00 2026-02-12
25622 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb 22 22 $1,314.00 $1,314.00 $513.65 $1,971.00 $1,248.30 2026-02-12
27530 HCPCS Closed Treatment Of Broken Shin Bone 22 22 $1,306.00 $1,306.00 $513.65 $1,959.00 $1,240.70 2026-02-12
71250 HCPCS CT Scan Of Chest Without Contrast 70 26 $1,957.57 $1,957.57 $49.43 $2,940.50 $1,195.80 2026-02-12
27502 HCPCS Closed Treatment Of Broken Thigh Bone At Midportion With Manipulation 26 26 $1,368.00 $1,368.00 $63.26 $1,354.23 $1,193.38 2026-02-12
11623 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3.0 … 22 22 $1,254.00 $1,254.00 $513.65 $1,881.00 $1,191.30 2026-02-12
26600 HCPCS Closed Treatment Of Broken Hand Bone 22 22 $1,226.00 $1,226.00 $513.65 $1,839.00 $1,164.70 2026-02-12
24670 HCPCS Closed Treatment Of Broken Forearm Bone On Small Finger Side At Elbow 22 22 $1,216.00 $1,216.00 $513.65 $1,824.00 $1,155.20 2026-02-12
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 49 27 $1,342.00 $1,342.00 $63.26 $2,778.00 $1,129.72 2026-02-12
11603 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 22 22 $1,179.00 $1,179.00 $513.65 $1,768.50 $1,120.05 2026-02-12
25500 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side 22 22 $1,178.00 $1,178.00 $513.65 $1,767.00 $1,119.10 2026-02-12
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 74 26 $1,229.00 $1,229.00 $32.06 $3,923.25 $1,106.10 2026-02-12
25530 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side 22 22 $1,130.00 $1,130.00 $513.65 $1,695.00 $1,073.50 2026-02-12
11642 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1.1-… 22 22 $1,125.00 $1,125.00 $513.65 $1,687.50 $1,068.75 2026-02-12
21315 HCPCS Closed Treatment Of Broken Nose Bone With Manipulation 22 22 $1,119.00 $1,119.00 $513.65 $1,678.50 $1,063.05 2026-02-12
93971 HCPCS Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers 136 26 $1,107.00 $1,107.00 $20.37 $3,060.75 $1,051.65 2026-02-12
67700 HCPCS Incision And Drainage Of Abscess Of Eyelid 22 22 $1,092.00 $1,092.00 $513.65 $1,638.00 $1,037.40 2026-02-12
26010 HCPCS Simple Drainage Of Abscess Of Finger 22 22 $1,089.00 $1,089.00 $513.65 $1,633.50 $1,034.55 2026-02-12
73200 HCPCS CT Scan Of Arm Without Contrast 70 26 $1,675.00 $1,675.00 $46.42 $2,512.50 $1,021.75 2026-02-12
28400 HCPCS Closed Treatment Of Broken Heel Bone 22 22 $1,071.00 $1,071.00 $513.65 $1,606.50 $1,017.45 2026-02-12
28190 HCPCS Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 22 22 $1,068.00 $1,068.00 $513.65 $1,602.00 $1,014.60 2026-02-12
11622 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2.0 … 22 22 $1,062.00 $1,062.00 $513.65 $1,593.00 $1,008.90 2026-02-12
11602 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm 22 22 $1,026.00 $1,026.00 $513.65 $1,539.00 $974.70 2026-02-12
8319669_1 CDM Symbicort 160-4.5 Mcg Inhaler 22 22 $1,014.00 $1,014.00 $618.54 $993.72 $963.30 2026-02-12
28430 HCPCS Closed Treatment Of Broken Ankle Joint Bone 22 22 $1,012.00 $1,012.00 $513.65 $1,518.00 $961.40 2026-02-12
23570 HCPCS Closed Treatment Of Broken Shoulder Blade 22 22 $1,009.00 $1,009.00 $513.65 $1,513.50 $958.55 2026-02-12
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 166 26 $1,535.00 $1,535.00 $63.12 $2,337.00 $936.35 2026-02-12
11641 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0.6-… 22 22 $984.00 $984.00 $513.65 $1,476.00 $934.80 2026-02-12
90651 HCPCS Human Papillomavirus Vaccine Types 6, 11, 16, 18, 31, 33, 45, 52, 58, Nonavalent 22 22 $977.00 $977.00 $595.97 $1,465.50 $928.15 2026-02-12
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 48 26 $1,006.00 $1,006.00 $63.26 $7,771.50 $905.40 2026-02-12
11621 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.6-1.0 … 22 22 $951.00 $951.00 $513.65 $1,426.50 $903.45 2026-02-12
11601 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 22 22 $947.00 $947.00 $513.65 $1,420.50 $899.65 2026-02-12
99496 HCPCS Transitional Care Management Services For Problem Of High Complexity 22 22 $943.00 $943.00 $513.65 $1,414.50 $895.85 2026-02-12
23500 HCPCS Closed Treatment Of Broken Collar Bone 22 22 $943.00 $943.00 $513.65 $1,414.50 $895.85 2026-02-12
8333419_1 CDM Flovent Hfa 44 Mcg Inhaler 22 22 $935.75 $935.75 $570.81 $917.04 $888.96 2026-02-12
12007 HCPCS Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 22 22 $934.00 $934.00 $513.65 $1,401.00 $887.30 2026-02-12
J1920 HCPCS Injection, Labetalol Hydrochloride, 5 Mg 22 22 $918.75 $918.75 $560.44 $1,378.13 $872.81 2026-02-12
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 26 26 $1,476.00 $1,476.00 $63.26 $1,402.20 $866.27 2026-02-12
11404 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 22 22 $911.00 $911.00 $513.65 $1,366.50 $865.45 2026-02-12
27301 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Thigh Or Knee 26 26 $2,934.00 $2,934.00 $63.26 $2,787.30 $852.92 2026-02-12
90710 HCPCS Measles, Mumps, Rubella, And Varicella Vaccine 22 22 $890.63 $890.63 $543.28 $1,335.95 $846.10 2026-02-12
20520 HCPCS Removal Of Foreign Body In Muscle Or Tendon 22 22 $873.00 $873.00 $513.65 $1,309.50 $829.35 2026-02-12
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 48 26 $910.00 $910.00 $63.26 $7,866.65 $819.00 2026-02-12
26720 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand 22 22 $849.00 $849.00 $513.65 $1,273.50 $806.55 2026-02-12
11423 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3… 22 22 $837.00 $837.00 $513.65 $1,255.50 $795.15 2026-02-12
11640 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0.5 … 22 22 $829.00 $829.00 $513.65 $1,243.50 $787.55 2026-02-12
41010 HCPCS Incision Of Tissue Connecting Tongue And Floor Of Mouth 22 22 $826.00 $826.00 $513.65 $1,239.00 $784.70 2026-02-12
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 22 22 $822.17 $822.17 $501.52 $1,233.26 $781.06 2026-02-12
36430 HCPCS Transfusion Of Blood Or Blood Products 110 22 $887.00 $887.00 $306.22 $3,426.38 $774.66 2026-02-12
85303 HCPCS Protein C Antigen (clotting Inhibitor) Measurement 22 22 $807.00 $807.00 $492.27 $1,210.50 $766.65 2026-02-12
11620 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.5 Cm O… 22 22 $805.00 $805.00 $513.65 $1,207.50 $764.75 2026-02-12
11403 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 22 22 $801.00 $801.00 $513.65 $1,201.50 $760.95 2026-02-12
11600 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 22 22 $798.00 $798.00 $513.65 $1,197.00 $758.10 2026-02-12
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 26 26 $742.00 $742.00 $63.26 $901.06 $753.56 2026-02-12
85306 HCPCS Protein S (clotting Inhibitor) Measurement 22 22 $792.00 $792.00 $483.12 $1,188.00 $752.40 2026-02-12
26750 HCPCS Closed Treatment Of Broken End Of Finger Or Thumb 22 22 $791.00 $791.00 $513.65 $1,186.50 $751.45 2026-02-12
8318269_1 CDM Lyrica 150 Mg Capsule 22 22 $786.82 $786.82 $479.96 $771.08 $747.48 2026-02-12
11442 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1… 22 22 $780.00 $780.00 $513.65 $1,170.00 $741.00 2026-02-12
96360 HCPCS Infusion Into A Vein For Hydration, 31-60 Minutes 44 22 $782.50 $782.50 $474.40 $1,180.94 $738.82 2026-02-12
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 26 26 $870.00 $870.00 $63.26 $857.18 $735.09 2026-02-12
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 48 26 $812.00 $812.00 $63.26 $6,846.26 $730.80 2026-02-12
99205 HCPCS New Patient Office Or Other Outpatient Visit With A High Level Of Medical Decisi… 67 26 $849.00 $849.00 $63.26 $1,273.50 $721.65 2026-02-12
99344 HCPCS Residence Visit For New Patient With Moderate Level Of Medical Decision Making, … 22 22 $748.00 $748.00 $513.65 $1,122.00 $710.60 2026-02-12
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 26 26 $672.00 $672.00 $63.26 $917.30 $710.55 2026-02-12
46083 HCPCS Incision Of External Hemorrhoid With Blood Clot 22 22 $743.00 $743.00 $513.65 $1,114.50 $705.85 2026-02-12
10080 HCPCS Simple Drainage Of Cyst Of Tailbone 22 22 $737.00 $737.00 $513.65 $1,105.50 $700.15 2026-02-12
99350 HCPCS Residence Visit For Established Patient With High Level Of Medical Decision Maki… 27 22 $733.00 $733.00 $447.13 $1,099.50 $696.35 2026-02-12
11422 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 22 22 $732.00 $732.00 $513.65 $1,098.00 $695.40 2026-02-12
30300 HCPCS Removal Of Foreign Body In Nose 22 22 $732.00 $732.00 $513.65 $1,098.00 $695.40 2026-02-12
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 26 26 $1,258.00 $1,258.00 $63.26 $1,195.10 $682.34 2026-02-12
G0438 HCPCS Annual Wellness Visit; Includes A Personalized Prevention Plan Of Service (pps),… 22 22 $699.00 $699.00 $513.65 $1,048.50 $664.05 2026-02-12
11441 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0… 22 22 $695.00 $695.00 $513.65 $1,042.50 $660.25 2026-02-12
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 48 26 $725.00 $725.00 $63.26 $4,821.00 $652.50 2026-02-12
11765 HCPCS Removal Of Skin Of Fingernail Or Toenail 22 22 $680.00 $680.00 $510.00 $1,020.00 $646.00 2026-02-12
99291 HCPCS Critical Care, First 30-74 Minutes 70 26 $847.00 $847.00 $63.26 $3,479.57 $646.00 2026-02-12
G0402 HCPCS Initial Preventive Physical Examination; Face-to-face Visit, Services Limited To… 22 22 $678.00 $678.00 $508.50 $1,017.00 $644.10 2026-02-12
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 22 22 $678.00 $678.00 $508.50 $1,017.00 $644.10 2026-02-12
11750 HCPCS Permanent Removal Fingernail Or Toenail 22 22 $677.00 $677.00 $507.75 $1,015.50 $643.15 2026-02-12
87522 HCPCS Detection Test By Nucleic Acid For Hepatitis C Virus, Quantification 22 22 $672.00 $672.00 $409.92 $1,008.00 $638.40 2026-02-12
99495 HCPCS Transitional Care Management Services For Problem Of At Least Moderate Complexit… 22 22 $665.00 $665.00 $498.75 $997.50 $631.75 2026-02-12
11312 HCPCS Shaving Of Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1.1-2.0 Cm 22 22 $662.00 $662.00 $496.50 $993.00 $628.90 2026-02-12
76376 HCPCS 3d Radiographic Procedure 22 22 $660.00 $660.00 $402.60 $990.00 $627.00 2026-02-12
97606 HCPCS Therapy Procedure Using A Special Bandage And Vacuum Pump, Surface Area More Tha… 44 22 $794.50 $794.50 $193.37 $1,908.00 $625.71 2026-02-12
70471 HCPCS Computed Tomographic Angiography (cta), Head And Neck, With Contrast Material(s)… 46 25 $651.00 $651.00 $118.23 $4,502.75 $618.45 2026-02-12
11421 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.6-1… 22 22 $648.00 $648.00 $486.00 $972.00 $615.60 2026-02-12
96365 HCPCS Infusion Into A Vein For Therapy, Prevention, Or Diagnosis, 1 Hour Or Less 66 22 $647.54 $647.54 $192.99 $2,245.50 $615.16 2026-02-12
93005 HCPCS Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing 22 22 $626.34 $626.34 $382.07 $939.51 $595.02 2026-02-12
76775 HCPCS Limited Ultrasound Scan Behind Abdominal Cavity 70 26 $622.00 $622.00 $27.05 $1,812.00 $590.90 2026-02-12
8318862_1 CDM Ciproflox-dexameth Otic Susp 22 22 $620.00 $620.00 $378.20 $607.60 $589.00 2026-02-12
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 49 27 $691.00 $691.00 $63.26 $4,884.11 $587.35 2026-02-12
11401 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 22 22 $617.00 $617.00 $462.75 $925.50 $586.15 2026-02-12
92610 HCPCS Evaluation Of Swallowing Function 22 22 $615.00 $615.00 $375.15 $922.50 $584.25 2026-02-12
80306 HCPCS Testing For Presence Of Drug, Read By Instrument Assisted Observation 22 22 $615.00 $615.00 $375.15 $922.50 $584.25 2026-02-12
27560 HCPCS Closed Treatment Of Dislocated Kneecap 26 26 $980.00 $980.00 $63.26 $931.00 $581.04 2026-02-12
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 48 26 $736.00 $736.00 $63.26 $3,150.00 $574.66 2026-02-12
99204 HCPCS New Patient Office Or Other Outpatient Visit With Moderate Level Of Medical Deci… 67 26 $675.00 $675.00 $63.26 $1,012.50 $573.75 2026-02-12
59430 HCPCS Post Delivery Care 22 22 $600.00 $600.00 $450.00 $900.00 $570.00 2026-02-12
24600 HCPCS Repair Of Dislocated Elbow 26 26 $680.00 $680.00 $63.26 $723.74 $569.20 2026-02-12
17004 HCPCS Destruction Of Precancer Skin Growth, 15 Or More Growths 22 22 $595.00 $595.00 $446.25 $892.50 $565.25 2026-02-12
23505 HCPCS Closed Treatment Of Broken Collar Bone With Manipulation 26 26 $1,531.00 $1,531.00 $63.26 $1,454.45 $563.34 2026-02-12
54056 HCPCS Simple Destruction Of Growth Of Penis Using Freezing 22 22 $592.00 $592.00 $444.00 $888.00 $562.40 2026-02-12
97605 HCPCS Therapy Procedure Using A Special Bandage And Vacuum Pump, Surface Area 50.0 Sq … 22 22 $590.69 $590.69 $360.32 $886.04 $561.16 2026-02-12
28124 HCPCS Partial Removal Of Toe Bone 26 26 $1,169.00 $1,169.00 $63.26 $1,110.55 $559.82 2026-02-12
24500 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone 26 26 $1,131.00 $1,131.00 $63.26 $1,074.45 $556.20 2026-02-12
11302 HCPCS Shaving Of Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm 22 22 $580.00 $580.00 $435.00 $870.00 $551.00 2026-02-12
74160 HCPCS CT Scan Of Abdomen With Contrast 48 26 $597.00 $597.00 $58.45 $3,988.50 $537.30 2026-02-12
25600 HCPCS Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb … 26 26 $1,039.00 $1,039.00 $63.26 $987.05 $532.82 2026-02-12
11440 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0… 22 22 $557.00 $557.00 $417.75 $835.50 $529.15 2026-02-12
26755 HCPCS Closed Treatment Of Broken End Of Finger Or Thumb With Manipulation 48 26 $846.00 $846.00 $63.26 $2,028.00 $526.13 2026-02-12
76770 HCPCS Complete Ultrasound Scan Behind Abdominal Cavity 70 26 $836.00 $836.00 $34.07 $1,291.50 $525.21 2026-02-12
72193 HCPCS CT Scan Of Pelvis With Contrast 48 26 $582.00 $582.00 $53.44 $5,601.50 $523.80 2026-02-12
86480 HCPCS Tuberculosis Test, Gamma Interferon 22 22 $542.78 $542.78 $331.10 $814.17 $515.64 2026-02-12
99215 HCPCS Established Patient Office Or Other Outpatient Visit With High Level Of Medical … 67 26 $591.00 $591.00 $63.26 $886.50 $513.65 2026-02-12
26605 HCPCS Closed Treatment Of Broken Hand Bone With Manipulation 48 26 $493.00 $493.00 $63.26 $2,016.00 $513.65 2026-02-12
13151 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 1.1-2.5 Cm 48 26 $1,801.00 $1,801.00 $63.26 $2,622.00 $513.65 2026-02-12
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 48 26 $787.00 $787.00 $63.26 $2,646.00 $513.65 2026-02-12
12042 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.6-7.5 Cm 48 26 $914.00 $914.00 $63.26 $1,012.50 $513.65 2026-02-12
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 48 26 $959.00 $959.00 $63.26 $1,414.50 $513.65 2026-02-12
99244 HCPCS Office Or Other Outpatient Consultation With Moderate Level Of Medical Decision … 22 22 $540.00 $540.00 $405.00 $810.00 $513.00 2026-02-12
12020 HCPCS Simple Closure Of Surface Wound Reopening 48 26 $678.00 $678.00 $63.26 $987.00 $511.07 2026-02-12
12055 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.6-… 26 26 $1,507.00 $1,507.00 $63.26 $1,431.65 $507.65 2026-02-12
72192 HCPCS CT Scan Of Pelvis Without Contrast 52 26 $910.00 $910.00 $49.76 $2,865.00 $507.02 2026-02-12
28510 HCPCS Closed Treatment Of Broken Toe 22 22 $531.00 $531.00 $398.25 $796.50 $504.45 2026-02-12
80074 HCPCS Acute Hepatitis Panel 22 22 $529.25 $529.25 $322.84 $793.88 $502.79 2026-02-12
31603 HCPCS Emergent Incision Of Windpipe Through Neck For Insertion Of Breathing Tube 26 26 $712.00 $712.00 $63.26 $676.40 $501.28 2026-02-12
99349 HCPCS Residence Visit For Established Patient With Moderate Level Of Medical Decision … 27 22 $527.00 $527.00 $321.47 $790.50 $500.65 2026-02-12
11106 HCPCS Incision Biopsy, First Skin Growth 22 22 $526.00 $526.00 $394.50 $789.00 $499.70 2026-02-12
76830 HCPCS Ultrasound Scan Of Uterus, Ovaries, Tubes, Cervix And Pelvic Area Through Vagina 70 26 $518.00 $518.00 $32.40 $1,319.00 $492.10 2026-02-12
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 26 26 $983.00 $983.00 $63.26 $933.85 $491.65 2026-02-12
87040 HCPCS Bacterial Blood Culture 44 22 $599.37 $599.37 $249.94 $1,183.50 $481.29 2026-02-12
56420 HCPCS Incision And Drainage Of Abscess Of Female Genital Gland 22 22 $506.00 $506.00 $379.50 $759.00 $480.70 2026-02-12
10021 HCPCS Fine Needle Aspiration Biopsy, First Growth 21 21 $504.00 $504.00 $307.44 $756.00 $478.80 2026-02-12
11420 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.5 C… 22 22 $504.00 $504.00 $378.00 $756.00 $478.80 2026-02-12
11306 HCPCS Shaving Of Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.6-1.0 Cm 22 22 $500.00 $500.00 $375.00 $750.00 $475.00 2026-02-12
98015 HCPCS Established Patient Synchronous Audio-only Visit With High Medical Decision Maki… 22 22 $500.00 $500.00 $375.00 $750.00 $475.00 2026-02-12
11301 HCPCS Shaving Of Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 22 22 $493.00 $493.00 $300.73 $739.50 $468.35 2026-02-12
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 26 26 $1,828.00 $1,828.00 $63.26 $1,736.60 $467.86 2026-02-12
99050 HCPCS Service Provided In The Office When The Office Is Normally Closed 22 22 $492.00 $492.00 $369.00 $738.00 $467.40 2026-02-12
G0379 HCPCS Direct Admission Of Patient For Hospital Observation Care 22 22 $491.50 $491.50 $299.82 $737.25 $466.93 2026-02-12
12041 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.5 Cm Or Less 48 26 $765.00 $765.00 $63.26 $760.50 $456.30 2026-02-12
99387 HCPCS Initial New Patient Preventive Medicine Evaluation (65 Years Or Older) 22 22 $480.00 $480.00 $360.00 $720.00 $456.00 2026-02-12
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 48 26 $506.00 $506.00 $63.26 $1,279.50 $455.40 2026-02-12
12045 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 12.6-20.0 Cm 26 26 $1,262.00 $1,262.00 $63.26 $1,198.90 $454.89 2026-02-12
G0439 HCPCS Annual Wellness Visit, Includes A Personalized Prevention Plan Of Service (pps),… 22 22 $475.00 $475.00 $356.25 $712.50 $451.25 2026-02-12
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 48 26 $487.00 $487.00 $37.40 $2,165.00 $438.30 2026-02-12
11311 HCPCS Shaving Of Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0.6-1.0 Cm 22 22 $461.00 $461.00 $345.75 $691.50 $437.95 2026-02-12
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 48 26 $486.00 $486.00 $63.26 $3,429.60 $437.40 2026-02-12
19000 HCPCS Aspiration Of Cyst Of Breast, First Cyst 22 22 $460.00 $460.00 $345.00 $690.00 $437.00 2026-02-12
J1050 HCPCS Injection, Medroxyprogesterone Acetate, 1 Mg 22 22 $459.50 $459.50 $280.30 $689.25 $436.53 2026-02-12
99358 HCPCS Extended Patient Service Without Direct Patient Contact, First Hour 22 22 $459.00 $459.00 $344.25 $688.50 $436.05 2026-02-12
92526 HCPCS Treatment Of Swallowing And Feeding Disorder 22 22 $459.00 $459.00 $279.99 $688.50 $436.05 2026-02-12
26770 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation 26 26 $869.00 $869.00 $63.26 $825.55 $435.78 2026-02-12
17110 HCPCS Destruction Of Skin Growth, 1-14 Growths 22 22 $456.00 $456.00 $342.00 $684.00 $433.20 2026-02-12
10040 HCPCS Acne Surgery 21 21 $452.00 $452.00 $339.00 $678.00 $429.40 2026-02-12
58100 HCPCS Biopsy Of Lining Of Uterus 22 22 $451.00 $451.00 $338.25 $676.50 $428.45 2026-02-12
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 48 26 $474.00 $474.00 $52.10 $3,223.50 $426.60 2026-02-12
64450 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Other Nerve Or Branch 48 26 $467.00 $467.00 $38.41 $1,323.00 $420.30 2026-02-12
99386 HCPCS Initial New Patient Preventive Medicine Evaluation (40-64 Years) 22 22 $441.00 $441.00 $330.75 $661.50 $418.95 2026-02-12
99306 HCPCS Initial Nursing Facility Care With High Level Of Medical Decision Making, Per Da… 49 27 $681.00 $681.00 $63.26 $1,021.50 $415.41 2026-02-12
90677 HCPCS Pneumococcal Conjugate Vaccine, 20 Valent (pcv20), For Intramuscular Use 22 22 $434.75 $434.75 $265.20 $652.13 $413.01 2026-02-12
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 48 26 $458.00 $458.00 $58.45 $4,240.50 $412.20 2026-02-12
25560 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones 30 26 $1,197.00 $1,197.00 $63.26 $1,137.15 $411.34 2026-02-12
99203 HCPCS New Patient Office Or Other Outpatient Visit With Low Level Of Medical Decision … 67 26 $444.00 $444.00 $63.26 $666.00 $409.45 2026-02-12
24650 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow 26 26 $830.00 $830.00 $63.26 $788.50 $409.32 2026-02-12
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 26 26 $1,204.00 $1,204.00 $63.26 $1,143.80 $403.94 2026-02-12
99214 HCPCS Established Patient Office Or Other Outpatient Visit With Moderate Level Of Deci… 67 26 $437.00 $437.00 $63.26 $655.50 $402.80 2026-02-12
90700 HCPCS Diphtheria, Tetanus, And Acellular Pertussis Vaccine (younger Than 7 Years) 22 22 $422.75 $422.75 $257.88 $634.13 $401.61 2026-02-12
21480 HCPCS Closed Treatment Of Dislocated Jaw Joint 22 22 $419.00 $419.00 $314.25 $628.50 $398.05 2026-02-12
G0168 HCPCS Wound Closure Utilizing Tissue Adhesive(s) Only 22 22 $419.00 $419.00 $314.25 $628.50 $398.05 2026-02-12
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 22 22 $414.00 $414.00 $252.54 $621.00 $393.30 2026-02-12
73701 HCPCS CT Scan Of Leg With Contrast Material 48 26 $437.00 $437.00 $53.44 $2,820.00 $393.30 2026-02-12
80050 HCPCS General Health Panel 22 22 $412.00 $412.00 $251.32 $618.00 $391.40 2026-02-12
8341543_1 CDM Oseltamivir 6 Mg/ml Suspension 22 22 $410.00 $410.00 $250.10 $401.80 $389.50 2026-02-12
90632 HCPCS Hepatitis A Vaccine Adult Dosage 22 22 $410.00 $410.00 $250.10 $615.00 $389.50 2026-02-12
99397 HCPCS Established Patient Periodic Preventive Medicine Examination (65 Year Old Or Old… 39 22 $408.00 $408.00 $165.75 $612.00 $387.60 2026-02-12
11760 HCPCS Repair Of Fingernail Or Toenail Bed 48 26 $491.00 $491.00 $63.26 $717.00 $387.27 2026-02-12
92961 HCPCS Internal Shock To Heart To Regulate Heart Beat 26 26 $659.00 $659.00 $63.26 $626.05 $385.57 2026-02-12
11300 HCPCS Shaving Of Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 22 22 $400.00 $400.00 $300.00 $600.00 $380.00 2026-02-12
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 48 26 $416.00 $416.00 $59.11 $2,860.50 $374.40 2026-02-12
13131 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 26 26 $1,003.00 $1,003.00 $63.26 $952.85 $373.86 2026-02-12
83880 HCPCS Natriuretic Peptide (heart And Blood Vessel Protein) Level 22 22 $392.14 $392.14 $239.21 $588.21 $372.53 2026-02-12
99384 HCPCS Initial New Patient Preventive Medicine Evaluation (12-17 Years) 22 22 $391.00 $391.00 $293.25 $586.50 $371.45 2026-02-12
87505 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 22 22 $390.00 $390.00 $237.90 $585.00 $370.50 2026-02-12
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 70 26 $598.00 $598.00 $26.38 $910.50 $370.27 2026-02-12
99283 HCPCS Emergency Department Visit With Low Level Of Medical Decision Making 49 27 $432.00 $432.00 $63.26 $1,032.00 $367.20 2026-02-12
99385 HCPCS Initial New Patient Preventive Medicine Evaluation (18-39 Years) 22 22 $384.00 $384.00 $288.00 $576.00 $364.80 2026-02-12
98014 HCPCS Established Patient Synchronous Audio-only Visit With Moderate Medical Decision … 22 22 $382.00 $382.00 $286.50 $573.00 $362.90 2026-02-12
23930 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Upper Arm Or Elbow 26 26 $1,547.00 $1,547.00 $63.26 $1,469.65 $358.75 2026-02-12
70487 HCPCS CT Scan Of Face With Contrast 48 26 $398.00 $398.00 $52.10 $2,949.00 $358.20 2026-02-12
99396 HCPCS Established Patient Periodic Preventive Medicine Examination (40-64 Years) 39 22 $376.00 $376.00 $165.75 $564.00 $357.20 2026-02-12
90696 HCPCS Diphtheria, Tetanus, Acellular Pertussis, And Polio Vaccine 22 22 $375.75 $375.75 $229.21 $563.63 $356.96 2026-02-12
72110 HCPCS X-ray Of Lower And Sacral Spine, Minimum Of 4 Views 70 26 $572.23 $572.23 $12.69 $876.00 $356.24 2026-02-12
12054 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1… 26 26 $1,165.00 $1,165.00 $63.26 $1,106.75 $354.65 2026-02-12
80143 HCPCS Measurement Of Acetaminophen 22 22 $371.18 $371.18 $226.42 $556.77 $352.62 2026-02-12
83970 HCPCS Parathormone (parathyroid Hormone) Level 22 22 $369.71 $369.71 $225.52 $554.57 $351.22 2026-02-12
11200 HCPCS Removal Of Skin Tag, 1-15 Skin Tags 22 22 $368.00 $368.00 $276.00 $552.00 $349.60 2026-02-12
99243 HCPCS Office Or Other Outpatient Consultation With Low Level Of Medical Decision Makin… 22 22 $367.00 $367.00 $275.25 $550.50 $348.65 2026-02-12
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 26 26 $1,135.00 $1,135.00 $63.26 $1,078.25 $343.24 2026-02-12
99310 HCPCS Subsequent Nursing Facility Care With High Level Of Medical Decision Making, Per… 49 27 $557.00 $557.00 $63.26 $835.50 $339.77 2026-02-12
80051 HCPCS Blood Test Panel For Electrolytes (sodium Potassium, Chloride, Carbon Dioxide) 22 22 $357.00 $357.00 $217.77 $535.50 $339.15 2026-02-12
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 26 26 $1,094.00 $1,094.00 $63.26 $1,039.30 $336.64 2026-02-12
73030 HCPCS X-ray Of Shoulder, Minimum Of 2 Views 114 26 $355.58 $355.58 $9.02 $536.40 $335.77 2026-02-12
92012 HCPCS Established Patient Problem Focused Exam Of Visual System 22 22 $352.00 $352.00 $264.00 $528.00 $334.40 2026-02-12
96125 HCPCS Test To Assess The Ability To Complete Specific Functional Tasks Applicable To E… 22 22 $349.00 $349.00 $212.89 $523.50 $331.55 2026-02-12
99383 HCPCS Initial New Patient Preventive Medicine Evaluation (5-11 Years) 22 22 $349.00 $349.00 $261.75 $523.50 $331.55 2026-02-12
99236 HCPCS Hospital Inpatient Or Observation Care With Admission And Discharge On The Same … 27 27 $922.00 $922.00 $63.26 $875.90 $331.07 2026-02-12
99348 HCPCS Residence Visit For Established Patient With Low Level Of Medical Decision Makin… 27 22 $346.00 $346.00 $211.06 $519.00 $328.70 2026-02-12
90716 HCPCS Varicella Vaccine 22 22 $346.00 $346.00 $211.06 $519.00 $328.70 2026-02-12
12006 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 48 26 $363.00 $363.00 $63.26 $1,206.00 $326.70 2026-02-12
99395 HCPCS Established Patient Periodic Preventive Medicine Examination (18-39 Years) 39 22 $343.00 $343.00 $165.75 $514.50 $325.85 2026-02-12
8320683_1 CDM Nitroglycerin 0.4 Mg Tablet Sl 22 22 $342.75 $342.75 $209.08 $335.90 $325.61 2026-02-12
99305 HCPCS Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Pe… 49 27 $533.00 $533.00 $63.26 $799.50 $325.13 2026-02-12
11102 HCPCS Biopsy Of Related Skin Growth, First Growth 22 22 $342.00 $342.00 $256.50 $513.65 $324.90 2026-02-12
73502 HCPCS X-ray Of Hip, 2-3 Views 114 26 $343.43 $343.43 $10.69 $520.50 $324.90 2026-02-12
12034 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5… 26 26 $986.00 $986.00 $63.26 $936.70 $324.00 2026-02-12
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 48 26 $359.00 $359.00 $49.43 $1,133.10 $323.10 2026-02-12
74150 HCPCS CT Scan Of Abdomen Without Contrast 48 26 $359.00 $359.00 $54.77 $2,824.50 $323.10 2026-02-12
82803 HCPCS Blood Gases Measurement 22 22 $339.67 $339.67 $207.20 $509.51 $322.69 2026-02-12
62322 HCPCS Injection Of Substance Into Lower Spine Canal 22 22 $338.00 $338.00 $206.18 $507.00 $321.10 2026-02-12
73080 HCPCS X-ray Of Elbow, Minimum Of 3 Views 70 26 $372.75 $372.75 $8.35 $788.55 $320.68 2026-02-12
73650 HCPCS X-ray Of Heel, Minimum Of 2 Views 70 26 $337.00 $337.00 $7.68 $1,007.25 $320.15 2026-02-12
99382 HCPCS Initial New Patient Preventive Medicine Evaluation (1-4 Years) 22 22 $336.00 $336.00 $252.00 $513.65 $319.20 2026-02-12
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 48 26 $300.00 $300.00 $63.26 $1,980.00 $318.92 2026-02-12
69200 HCPCS Removal Of Foreign Body In Ear Canal 48 26 $410.00 $410.00 $41.74 $579.00 $317.80 2026-02-12
Q9967 HCPCS Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml 44 22 $415.16 $415.16 $87.57 $1,030.13 $317.13 2026-02-12
10120 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Simple 48 26 $445.00 $445.00 $63.26 $526.50 $315.90 2026-02-12
31500 HCPCS Emergent Insertion Of Breathing Tube Into Windpipe Using An Endoscope 48 26 $349.00 $349.00 $63.26 $2,793.00 $314.10 2026-02-12
11770 HCPCS Simple Removal Of Cyst Of Tailbone 26 26 $1,196.00 $1,196.00 $63.26 $1,136.20 $313.03 2026-02-12
99342 HCPCS Residence Visit For New Patient With Low Level Of Medical Decision Making, Per D… 22 22 $328.00 $328.00 $246.00 $513.65 $311.60 2026-02-12
12052 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5… 26 26 $931.00 $931.00 $63.26 $884.45 $310.79 2026-02-12
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 26 26 $730.00 $730.00 $63.26 $693.50 $308.99 2026-02-12
29425 HCPCS Application Of Walking Cast Covering Below Knee To Toe 22 22 $324.00 $324.00 $243.00 $513.65 $307.80 2026-02-12
99394 HCPCS Established Patient Periodic Preventive Medicine Examination (12-17 Years) 22 22 $324.00 $324.00 $243.00 $513.65 $307.80 2026-02-12
13133 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 48 26 $341.00 $341.00 $63.26 $1,117.50 $306.90 2026-02-12
73000 HCPCS X-ray Of Collar Bone 70 26 $323.00 $323.00 $8.02 $1,453.50 $306.85 2026-02-12
6425049_1 CDM Oxygen Ther. / Day__4055034 22 22 $322.55 $322.55 $196.76 $316.10 $306.42 2026-02-12
99223 HCPCS Initial Hospital Inpatient Or Observation Care With High Level Of Medical Decisi… 27 27 $860.00 $860.00 $63.26 $817.00 $306.23 2026-02-12
72125 HCPCS CT Scan Of Upper Spine Without Contrast 48 26 $340.00 $340.00 $46.42 $3,441.65 $306.00 2026-02-12
72131 HCPCS CT Scan Of Lower Spine Without Contrast 48 26 $339.00 $339.00 $46.42 $2,872.50 $305.10 2026-02-12
72128 HCPCS CT Scan Of Middle Spine Without Contrast 48 26 $339.00 $339.00 $46.42 $3,374.46 $305.10 2026-02-12
99381 HCPCS Initial New Patient Preventive Medicine Evaluation (younger Than 1 Year) 22 22 $320.00 $320.00 $240.00 $513.65 $304.00 2026-02-12
99393 HCPCS Established Patient Periodic Preventive Medicine Examination (5-11 Years) 22 22 $320.00 $320.00 $240.00 $513.65 $304.00 2026-02-12
70486 HCPCS CT Scan Of Face Without Contrast 48 26 $334.00 $334.00 $39.74 $2,477.25 $300.60 2026-02-12
12002 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 52 26 $333.00 $333.00 $57.43 $1,380.00 $299.20 2026-02-12
82024 HCPCS Adrenocorticotropic Hormone (acth) Level 22 22 $312.50 $312.50 $190.63 $468.75 $296.88 2026-02-12
84482 HCPCS Thyroid Hormone, T3 Measurement, Reverse 22 22 $311.00 $311.00 $189.71 $466.50 $295.45 2026-02-12
10160 HCPCS Aspiration Of Abscess, Blood, Or Cyst 48 26 $328.00 $328.00 $63.26 $804.00 $295.20 2026-02-12
A9579 HCPCS Injection, Gadolinium-based Magnetic Resonance Contrast Agent, Not Otherwise Spe… 22 22 $309.75 $309.75 $188.95 $464.63 $294.26 2026-02-12
28630 HCPCS Closed Treatment Of Dislocated Joint Between Toe And Foot 22 22 $309.00 $309.00 $231.75 $513.65 $293.55 2026-02-12
71101 HCPCS X-ray Of Ribs On Side Of Body, Minimum Of 3 Views 70 26 $473.00 $473.00 $12.69 $720.00 $292.80 2026-02-12
99392 HCPCS Established Patient Periodic Preventive Medicine Examination (1-4 Years) 22 22 $308.00 $308.00 $231.00 $513.65 $292.60 2026-02-12
99456 HCPCS Work-related Or Medical Disability Examination By Other Than The Treating Physic… 22 22 $306.00 $306.00 $229.50 $513.65 $290.70 2026-02-12
73630 HCPCS X-ray Of Foot, Minimum Of 3 Views 70 26 $343.50 $343.50 $8.02 $710.63 $288.99 2026-02-12
73130 HCPCS X-ray Of Hand, Minimum Of 3 Views 70 26 $403.08 $403.08 $8.68 $709.77 $288.64 2026-02-12
8028227_1 CDM Room & Board - Semi-private (two Beds) - Other 16 16 $302.43 $302.43 $226.82 $296.38 $287.31 2026-02-12
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