|
J0517
|
HCPCS
|
Injection, Benralizumab, 1 Mg
|
8
|
8
|
$10,399.00
|
$9,359.10
|
$9,359.10
|
$10,087.03
|
$9,983.04
|
2026-02-04
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
8
|
8
|
$9,281.50
|
$8,353.35
|
$8,353.35
|
$9,003.06
|
$8,910.24
|
2026-02-04
|
|
Q5120
|
HCPCS
|
Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg
|
8
|
8
|
$7,075.00
|
$6,367.50
|
$6,367.50
|
$6,862.75
|
$6,792.00
|
2026-02-04
|
|
J2997
|
HCPCS
|
Injection, Alteplase Recombinant, 1 Mg
|
16
|
8
|
$7,244.25
|
$6,519.83
|
$205.43
|
$13,832.44
|
$6,527.81
|
2026-02-04
|
|
72158
|
HCPCS
|
MRI Scan Of Lower Spinal Canal Before And After Contrast
|
14
|
8
|
$6,211.75
|
$5,590.58
|
$185.25
|
$6,025.40
|
$5,652.69
|
2026-02-04
|
|
72157
|
HCPCS
|
MRI Scan Of Middle Spinal Canal Before And After Contrast
|
14
|
8
|
$6,132.00
|
$5,518.80
|
$185.25
|
$5,948.04
|
$5,580.12
|
2026-02-04
|
|
73223
|
HCPCS
|
MRI Scan Of Arm Joint Before And After Contrast
|
36
|
8
|
$5,847.00
|
$5,262.30
|
$173.28
|
$5,736.34
|
$5,497.65
|
2026-02-04
|
|
72156
|
HCPCS
|
MRI Scan Of Upper Spinal Canal Before And After Contrast
|
14
|
8
|
$5,928.25
|
$5,335.43
|
$185.25
|
$5,750.40
|
$5,394.71
|
2026-02-04
|
|
74178
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Before And After Contrast
|
14
|
8
|
$5,864.50
|
$5,278.05
|
$161.88
|
$5,688.57
|
$5,336.69
|
2026-02-04
|
|
74183
|
HCPCS
|
MRI Scan Of Abdomen Before And After Contrast
|
14
|
8
|
$5,654.25
|
$5,088.83
|
$176.70
|
$5,484.62
|
$5,145.37
|
2026-02-04
|
|
70543
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast
|
14
|
8
|
$5,629.75
|
$5,066.78
|
$172.71
|
$5,460.86
|
$5,123.07
|
2026-02-04
|
|
70549
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck Before And After Contrast
|
14
|
8
|
$5,216.00
|
$4,694.40
|
$145.92
|
$5,059.52
|
$4,746.56
|
2026-02-04
|
|
95811
|
HCPCS
|
Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older)
|
8
|
8
|
$4,922.75
|
$4,430.48
|
$4,430.48
|
$4,775.07
|
$4,725.84
|
2026-02-04
|
|
71552
|
HCPCS
|
MRI Scan Of Chest Before And After Contrast
|
14
|
8
|
$5,031.75
|
$4,528.58
|
$181.26
|
$4,880.80
|
$4,578.90
|
2026-02-04
|
|
95810
|
HCPCS
|
Sleep Study In Sleep Lab (6 Years Or Older)
|
8
|
8
|
$4,558.00
|
$4,102.20
|
$4,102.20
|
$4,421.26
|
$4,375.68
|
2026-02-04
|
|
8028189_1
|
CDM
|
Coronary Care Unit - Myocardial Infarction
|
8
|
8
|
$4,523.50
|
$4,071.15
|
$4,071.15
|
$4,387.80
|
$4,342.57
|
2026-02-04
|
|
8028202_1
|
CDM
|
Room & Board - Other - Sterile Environment
|
8
|
8
|
$4,523.50
|
$4,071.15
|
$4,071.15
|
$4,387.80
|
$4,342.57
|
2026-02-04
|
|
8028141_1
|
CDM
|
Room & Board - Other - Sterile Environment
|
8
|
8
|
$4,523.50
|
$4,071.15
|
$4,071.15
|
$4,387.80
|
$4,342.57
|
2026-02-04
|
|
73723
|
HCPCS
|
MRI Scan Of Leg Joint Before And After Contrast
|
28
|
8
|
$4,743.50
|
$4,269.15
|
$173.28
|
$4,601.20
|
$4,316.59
|
2026-02-04
|
|
73220
|
HCPCS
|
MRI Scan Of Arm Before And After Contrast
|
28
|
8
|
$4,635.50
|
$4,171.95
|
$173.28
|
$4,496.44
|
$4,218.31
|
2026-02-04
|
|
72197
|
HCPCS
|
MRI Scan Of Pelvis Before And After Contrast
|
14
|
8
|
$4,615.50
|
$4,153.95
|
$176.70
|
$4,477.04
|
$4,200.10
|
2026-02-04
|
|
74177
|
HCPCS
|
CT Scan Of Abdomen And Pelvis With Contrast
|
22
|
8
|
$4,259.50
|
$3,833.55
|
$147.63
|
$4,842.00
|
$4,131.72
|
2026-02-04
|
|
73720
|
HCPCS
|
MRI Scan Of Leg Before And After Contrast
|
36
|
8
|
$4,389.75
|
$3,950.78
|
$172.71
|
$4,258.06
|
$4,104.41
|
2026-02-04
|
|
72146
|
HCPCS
|
MRI Scan Of Middle Spinal Canal Without Contrast
|
28
|
8
|
$4,425.00
|
$3,982.50
|
$120.27
|
$4,292.25
|
$4,026.75
|
2026-02-04
|
|
J3262
|
HCPCS
|
Injection, Tocilizumab, 1 Mg
|
8
|
8
|
$4,183.00
|
$3,764.70
|
$3,764.70
|
$4,057.51
|
$4,015.68
|
2026-02-04
|
|
70551
|
HCPCS
|
MRI Scan Of Brain Without Contrast
|
14
|
8
|
$4,261.75
|
$3,835.58
|
$120.27
|
$4,133.90
|
$3,878.19
|
2026-02-04
|
|
72148
|
HCPCS
|
MRI Scan Of Lower Spinal Canal Without Contrast
|
28
|
8
|
$4,245.00
|
$3,820.50
|
$120.27
|
$4,117.65
|
$3,862.95
|
2026-02-04
|
|
70545
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head With Contrast
|
14
|
8
|
$4,204.25
|
$3,783.83
|
$96.90
|
$4,078.12
|
$3,825.87
|
2026-02-04
|
|
72149
|
HCPCS
|
MRI Scan Of Lower Spinal Canal With Contrast
|
14
|
8
|
$4,199.50
|
$3,779.55
|
$144.21
|
$4,073.52
|
$3,821.55
|
2026-02-04
|
|
8316455_1
|
CDM
|
Donnatal Elixir
|
8
|
8
|
$3,960.00
|
$3,564.00
|
$3,564.00
|
$3,841.20
|
$3,801.60
|
2026-02-04
|
|
70552
|
HCPCS
|
MRI Scan Of Brain With Contrast
|
14
|
8
|
$4,129.25
|
$3,716.33
|
$144.21
|
$4,005.37
|
$3,757.62
|
2026-02-04
|
|
72141
|
HCPCS
|
MRI Scan Of Upper Spinal Canal Without Contrast
|
28
|
8
|
$4,076.50
|
$3,668.85
|
$120.27
|
$3,954.21
|
$3,709.61
|
2026-02-04
|
|
75635
|
HCPCS
|
CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast
|
14
|
8
|
$4,057.75
|
$3,651.98
|
$190.95
|
$3,936.02
|
$3,692.56
|
2026-02-04
|
|
8028201_1
|
CDM
|
Room & Board - Private (one Bed) - General Classification
|
8
|
8
|
$3,769.50
|
$3,392.55
|
$3,392.55
|
$3,656.42
|
$3,618.73
|
2026-02-04
|
|
8028232_1
|
CDM
|
Coronary Care Unit - General Classification
|
8
|
8
|
$3,769.50
|
$3,392.55
|
$3,392.55
|
$3,656.42
|
$3,618.73
|
2026-02-04
|
|
A0427
|
HCPCS
|
Ambulance Service, Advanced Life Support, Emergency Transport, Level 1 (als 1 - …
|
8
|
8
|
$3,686.25
|
$3,317.63
|
$3,317.63
|
$3,575.66
|
$3,538.80
|
2026-02-04
|
|
71275
|
HCPCS
|
CT Scan Of Blood Vessels Of Chest With Contrast
|
14
|
8
|
$3,852.00
|
$3,466.80
|
$147.06
|
$3,736.44
|
$3,505.32
|
2026-02-04
|
|
70498
|
HCPCS
|
CT Scan Of Blood Vessels Of Neck With Contrast
|
22
|
8
|
$3,571.25
|
$3,214.13
|
$141.36
|
$3,464.11
|
$3,392.69
|
2026-02-04
|
|
71270
|
HCPCS
|
CT Scan Of Chest Before And After Contrast
|
14
|
8
|
$3,709.75
|
$3,338.78
|
$111.15
|
$3,598.46
|
$3,375.88
|
2026-02-04
|
|
G0390
|
HCPCS
|
Trauma Response Team Associated With Hospital Critical Care Service
|
8
|
8
|
$3,510.00
|
$3,159.00
|
$3,159.00
|
$3,404.70
|
$3,369.60
|
2026-02-04
|
|
73222
|
HCPCS
|
MRI Scan Of Arm Joint With Contrast
|
28
|
8
|
$3,609.75
|
$3,248.78
|
$132.24
|
$3,501.46
|
$3,284.88
|
2026-02-04
|
|
70496
|
HCPCS
|
CT Scan Of Blood Vessels Of Head With Contrast
|
14
|
8
|
$3,604.25
|
$3,243.83
|
$141.36
|
$3,496.12
|
$3,279.87
|
2026-02-04
|
|
8028231_1
|
CDM
|
Room & Board - Other - Sterile Environment
|
8
|
8
|
$3,410.25
|
$3,069.23
|
$3,069.23
|
$3,307.94
|
$3,273.84
|
2026-02-04
|
|
8345260_1
|
CDM
|
Sps 15 Gm/60 Ml Suspension
|
8
|
8
|
$3,311.00
|
$2,979.90
|
$2,979.90
|
$3,211.67
|
$3,178.56
|
2026-02-04
|
|
74170
|
HCPCS
|
CT Scan Of Abdomen Before And After Contrast
|
14
|
8
|
$3,479.50
|
$3,131.55
|
$113.43
|
$3,375.12
|
$3,166.35
|
2026-02-04
|
|
70553
|
HCPCS
|
MRI Scan Of Brain Before And After Contrast
|
14
|
8
|
$3,455.75
|
$3,110.18
|
$185.25
|
$3,352.08
|
$3,144.73
|
2026-02-04
|
|
73718
|
HCPCS
|
MRI Scan Of Leg Without Contrast
|
40
|
8
|
$3,244.00
|
$2,919.60
|
$108.87
|
$3,413.19
|
$3,114.24
|
2026-02-04
|
|
93303
|
HCPCS
|
Ultrasound Of Heart For Congenital Defect
|
8
|
8
|
$3,226.25
|
$2,903.63
|
$2,903.63
|
$3,129.46
|
$3,097.20
|
2026-02-04
|
|
74176
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Without Contrast
|
22
|
8
|
$3,210.25
|
$2,889.23
|
$140.79
|
$3,317.40
|
$3,095.97
|
2026-02-04
|
|
A0426
|
HCPCS
|
Ambulance Service, Advanced Life Support, Non-emergency Transport, Level 1 (als …
|
8
|
8
|
$3,214.50
|
$2,893.05
|
$2,893.05
|
$3,118.07
|
$3,085.93
|
2026-02-04
|
|
6101776_1
|
CDM
|
Pov Group 1 Standard Up To 300 Lb__8708000
|
8
|
8
|
$3,200.75
|
$2,880.68
|
$2,880.68
|
$3,104.73
|
$3,072.72
|
2026-02-04
|
|
Q5119
|
HCPCS
|
Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg
|
16
|
8
|
$3,322.50
|
$2,990.25
|
$996.75
|
$5,371.38
|
$3,029.02
|
2026-02-04
|
|
74175
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen With Contrast
|
14
|
8
|
$3,310.75
|
$2,979.68
|
$146.49
|
$3,211.43
|
$3,012.78
|
2026-02-04
|
|
73221
|
HCPCS
|
MRI Scan Of Arm Joint Without Contrast
|
28
|
8
|
$3,304.00
|
$2,973.60
|
$111.15
|
$3,204.88
|
$3,006.64
|
2026-02-04
|
|
99291
|
HCPCS
|
Critical Care, First 30-74 Minutes
|
14
|
8
|
$3,260.00
|
$2,934.00
|
$357.96
|
$3,162.20
|
$2,966.60
|
2026-02-04
|
|
73721
|
HCPCS
|
MRI Scan Of Leg Joint Without Contrast
|
28
|
8
|
$3,244.00
|
$2,919.60
|
$109.44
|
$3,146.68
|
$2,952.04
|
2026-02-04
|
|
70470
|
HCPCS
|
CT Scan Of Head Or Brain Before And After Contrast
|
14
|
8
|
$3,182.25
|
$2,864.03
|
$102.60
|
$3,086.78
|
$2,895.85
|
2026-02-04
|
|
74160
|
HCPCS
|
CT Scan Of Abdomen With Contrast
|
22
|
8
|
$2,991.00
|
$2,691.90
|
$103.17
|
$3,075.63
|
$2,877.47
|
2026-02-04
|
|
J2315
|
HCPCS
|
Injection, Naltrexone, Depot Form, 1 Mg
|
8
|
8
|
$2,991.50
|
$2,692.35
|
$2,692.35
|
$2,901.76
|
$2,871.85
|
2026-02-04
|
|
72195
|
HCPCS
|
MRI Scan Of Pelvis Without Contrast
|
28
|
8
|
$3,091.25
|
$2,782.13
|
$118.56
|
$2,998.51
|
$2,813.04
|
2026-02-04
|
|
77012
|
HCPCS
|
Review By Radiologist Of CT Guidance For Needle Placement
|
30
|
8
|
$2,904.75
|
$2,614.28
|
$119.70
|
$2,817.61
|
$2,759.51
|
2026-02-04
|
|
71260
|
HCPCS
|
CT Scan Of Chest With Contrast
|
14
|
8
|
$2,968.50
|
$2,671.65
|
$100.89
|
$2,879.45
|
$2,701.34
|
2026-02-04
|
|
70491
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck With Contrast
|
14
|
8
|
$2,873.50
|
$2,586.15
|
$111.72
|
$2,787.30
|
$2,614.89
|
2026-02-04
|
|
73706
|
HCPCS
|
CT Scan Of Blood Vessels Of Lower Leg With Contrast
|
28
|
8
|
$2,830.75
|
$2,547.68
|
$151.62
|
$2,745.83
|
$2,575.98
|
2026-02-04
|
|
70544
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head Without Contrast
|
14
|
8
|
$2,810.50
|
$2,529.45
|
$96.90
|
$2,726.19
|
$2,557.55
|
2026-02-04
|
|
8028229_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Other
|
8
|
8
|
$2,656.25
|
$2,390.63
|
$2,390.63
|
$2,576.56
|
$2,550.00
|
2026-02-04
|
|
93306
|
HCPCS
|
Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu…
|
14
|
8
|
$2,800.50
|
$2,520.45
|
$118.56
|
$2,716.49
|
$2,548.45
|
2026-02-04
|
|
70482
|
HCPCS
|
CT Scan Of Cranial Cavity Before And After Contrast
|
14
|
8
|
$2,711.75
|
$2,440.58
|
$102.03
|
$2,630.40
|
$2,467.69
|
2026-02-04
|
|
72129
|
HCPCS
|
CT Scan Of Middle Spine With Contrast
|
14
|
8
|
$2,704.50
|
$2,434.05
|
$98.61
|
$2,623.37
|
$2,461.10
|
2026-02-04
|
|
93925
|
HCPCS
|
Ultrasound Of Leg Arteries Or Artery Grafts
|
14
|
8
|
$2,700.75
|
$2,430.68
|
$63.27
|
$2,619.73
|
$2,457.68
|
2026-02-04
|
|
70492
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck Before And After Contrast
|
14
|
8
|
$2,695.75
|
$2,426.18
|
$131.67
|
$2,614.88
|
$2,453.14
|
2026-02-04
|
|
J2796
|
HCPCS
|
Injection, Romiplostim, 10 Micrograms
|
8
|
8
|
$2,540.25
|
$2,286.23
|
$2,286.23
|
$2,464.04
|
$2,438.64
|
2026-02-04
|
|
70488
|
HCPCS
|
CT Scan Of Face Before And After Contrast
|
14
|
8
|
$2,669.00
|
$2,402.10
|
$102.60
|
$2,588.93
|
$2,428.79
|
2026-02-04
|
|
73722
|
HCPCS
|
MRI Scan Of Leg Joint With Contrast
|
28
|
8
|
$2,666.25
|
$2,399.63
|
$33.75
|
$2,586.26
|
$2,426.29
|
2026-02-04
|
|
73219
|
HCPCS
|
MRI Scan Of Arm With Contrast
|
50
|
8
|
$2,546.50
|
$2,291.85
|
$132.24
|
$2,470.11
|
$2,342.78
|
2026-02-04
|
|
74174
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast
|
24
|
8
|
$2,374.00
|
$2,136.60
|
$176.70
|
$6,636.50
|
$2,279.04
|
2026-02-04
|
|
74150
|
HCPCS
|
CT Scan Of Abdomen Without Contrast
|
22
|
8
|
$2,395.25
|
$2,155.73
|
$96.33
|
$2,323.39
|
$2,275.49
|
2026-02-04
|
|
8326743_1
|
CDM
|
Sulfa-trimethoprim 200 Mg-40 mg/5mL 473mL Oral Susp Mdc
|
8
|
8
|
$2,365.00
|
$2,128.50
|
$2,128.50
|
$2,294.05
|
$2,270.40
|
2026-02-04
|
|
8345637_1
|
CDM
|
Lactulose 10 Gm/15 Ml Solution
|
8
|
8
|
$2,365.00
|
$2,128.50
|
$2,128.50
|
$2,294.05
|
$2,270.40
|
2026-02-04
|
|
72125
|
HCPCS
|
CT Scan Of Upper Spine Without Contrast
|
14
|
8
|
$2,473.00
|
$2,225.70
|
$80.94
|
$2,398.81
|
$2,250.43
|
2026-02-04
|
|
72131
|
HCPCS
|
CT Scan Of Lower Spine Without Contrast
|
14
|
8
|
$2,471.25
|
$2,224.13
|
$80.94
|
$2,397.11
|
$2,248.84
|
2026-02-04
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
8
|
8
|
$2,322.50
|
$2,090.25
|
$2,090.25
|
$2,252.83
|
$2,229.61
|
2026-02-04
|
|
P9037
|
HCPCS
|
Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit
|
8
|
8
|
$2,313.75
|
$2,082.38
|
$2,082.38
|
$2,244.34
|
$2,221.20
|
2026-02-04
|
|
73218
|
HCPCS
|
MRI Scan Of Arm Without Contrast
|
42
|
8
|
$2,380.25
|
$2,142.23
|
$109.44
|
$2,308.84
|
$2,166.03
|
2026-02-04
|
|
71550
|
HCPCS
|
MRI Scan Of Chest Without Contrast
|
8
|
8
|
$2,253.00
|
$2,027.70
|
$2,027.70
|
$2,185.41
|
$2,162.88
|
2026-02-04
|
|
72126
|
HCPCS
|
CT Scan Of Upper Spine With Contrast
|
14
|
8
|
$2,356.00
|
$2,120.40
|
$98.61
|
$2,285.32
|
$2,143.96
|
2026-02-04
|
|
J1561
|
HCPCS
|
Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)…
|
24
|
8
|
$2,215.25
|
$1,993.73
|
$1,038.07
|
$3,089.94
|
$2,126.64
|
2026-02-04
|
|
72193
|
HCPCS
|
CT Scan Of Pelvis With Contrast
|
14
|
8
|
$2,315.25
|
$2,083.73
|
$93.48
|
$2,245.79
|
$2,106.88
|
2026-02-04
|
|
72128
|
HCPCS
|
CT Scan Of Middle Spine Without Contrast
|
14
|
8
|
$2,285.25
|
$2,056.73
|
$80.94
|
$2,216.69
|
$2,079.58
|
2026-02-04
|
|
73700
|
HCPCS
|
CT Scan Of Leg Without Contrast
|
28
|
8
|
$2,268.50
|
$2,041.65
|
$80.94
|
$2,200.45
|
$2,064.34
|
2026-02-04
|
|
71250
|
HCPCS
|
CT Scan Of Chest Without Contrast
|
14
|
8
|
$2,253.75
|
$2,028.38
|
$93.48
|
$2,186.14
|
$2,050.91
|
2026-02-04
|
|
70487
|
HCPCS
|
CT Scan Of Face With Contrast
|
14
|
8
|
$2,213.75
|
$1,992.38
|
$91.20
|
$2,147.34
|
$2,014.52
|
2026-02-04
|
|
73701
|
HCPCS
|
CT Scan Of Leg With Contrast Material
|
28
|
8
|
$2,177.00
|
$1,959.30
|
$93.48
|
$2,111.69
|
$1,981.07
|
2026-02-04
|
|
72192
|
HCPCS
|
CT Scan Of Pelvis Without Contrast
|
14
|
8
|
$2,165.00
|
$1,948.50
|
$87.78
|
$2,100.05
|
$1,970.15
|
2026-02-04
|
|
70450
|
HCPCS
|
CT Scan Head Or Brain Without Contrast
|
14
|
8
|
$2,165.00
|
$1,948.50
|
$68.97
|
$2,100.05
|
$1,970.15
|
2026-02-04
|
|
73206
|
HCPCS
|
CT Scan Of Blood Vessels Of Arm With Contrast
|
28
|
8
|
$2,143.25
|
$1,928.93
|
$144.78
|
$2,078.95
|
$1,950.36
|
2026-02-04
|
|
70460
|
HCPCS
|
CT Scan Head Or Brain With Contrast
|
14
|
8
|
$2,139.00
|
$1,925.10
|
$91.20
|
$2,074.83
|
$1,946.49
|
2026-02-04
|
|
70480
|
HCPCS
|
CT Scan Of Cranial Cavity Without Contrast
|
14
|
8
|
$2,124.75
|
$1,912.28
|
$103.17
|
$2,061.01
|
$1,933.53
|
2026-02-04
|
|
36430
|
HCPCS
|
Transfusion Of Blood Or Blood Products
|
40
|
8
|
$2,012.25
|
$1,811.03
|
$1,715.63
|
$2,313.69
|
$1,931.76
|
2026-02-04
|
|
70481
|
HCPCS
|
CT Scan Of Cranial Cavity With Contrast
|
14
|
8
|
$2,055.00
|
$1,849.50
|
$91.20
|
$1,993.35
|
$1,870.05
|
2026-02-04
|
|
8333423_1
|
CDM
|
Silvadene 1% Cream
|
8
|
8
|
$1,900.00
|
$1,710.00
|
$1,710.00
|
$1,843.00
|
$1,824.00
|
2026-02-04
|
|
8718210_1
|
CDM
|
Dextrose 77% Gel 24gm
|
8
|
8
|
$1,896.00
|
$1,706.40
|
$1,706.40
|
$1,839.12
|
$1,820.16
|
2026-02-04
|
|
73200
|
HCPCS
|
CT Scan Of Arm Without Contrast
|
28
|
8
|
$1,985.50
|
$1,786.95
|
$80.94
|
$1,925.94
|
$1,806.81
|
2026-02-04
|
|
99285
|
HCPCS
|
Emergency Department Visit With High Level Of Medical Decision Making
|
14
|
8
|
$1,984.50
|
$1,786.05
|
$279.87
|
$1,924.97
|
$1,805.89
|
2026-02-04
|
|
70490
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck Without Contrast
|
14
|
8
|
$1,963.25
|
$1,766.93
|
$103.74
|
$1,904.35
|
$1,786.56
|
2026-02-04
|
|
J1439
|
HCPCS
|
Injection, Ferric Carboxymaltose, 1 Mg
|
8
|
8
|
$1,856.74
|
$1,671.07
|
$1,671.07
|
$1,801.04
|
$1,782.47
|
2026-02-04
|
|
A0429
|
HCPCS
|
Ambulance Service, Basic Life Support, Emergency Transport (bls-emergency)
|
8
|
8
|
$1,856.25
|
$1,670.63
|
$1,670.63
|
$1,800.56
|
$1,782.00
|
2026-02-04
|
|
Q0138
|
HCPCS
|
Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd …
|
8
|
8
|
$1,846.00
|
$1,661.40
|
$1,661.40
|
$1,790.62
|
$1,772.16
|
2026-02-04
|
|
70486
|
HCPCS
|
CT Scan Of Face Without Contrast
|
14
|
8
|
$1,940.75
|
$1,746.68
|
$69.54
|
$1,882.53
|
$1,766.09
|
2026-02-04
|
|
P9035
|
HCPCS
|
Platelets, Pheresis, Leukocytes Reduced, Each Unit
|
16
|
8
|
$1,884.38
|
$1,695.94
|
$1,309.50
|
$2,244.34
|
$1,746.87
|
2026-02-04
|
|
8028228_1
|
CDM
|
Room & Board - Other - Self Care
|
8
|
8
|
$1,785.50
|
$1,606.95
|
$1,606.95
|
$1,731.94
|
$1,714.09
|
2026-02-04
|
|
72194
|
HCPCS
|
CT Scan Of Pelvis Before And After Contrast
|
22
|
8
|
$1,755.50
|
$1,579.95
|
$98.61
|
$2,216.69
|
$1,702.84
|
2026-02-04
|
|
93975
|
HCPCS
|
Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow
|
14
|
8
|
$1,863.25
|
$1,676.93
|
$92.91
|
$1,807.35
|
$1,695.56
|
2026-02-04
|
|
J1745
|
HCPCS
|
Injection, Infliximab, Excludes Biosimilar, 10 Mg
|
8
|
8
|
$1,740.50
|
$1,566.45
|
$1,566.45
|
$1,688.29
|
$1,670.88
|
2026-02-04
|
|
72132
|
HCPCS
|
CT Scan Of Lower Spine With Contrast
|
14
|
8
|
$1,796.50
|
$1,616.85
|
$98.61
|
$1,742.61
|
$1,634.82
|
2026-02-04
|
|
93880
|
HCPCS
|
Ultrasound Of Both Sides Of Head And Neck Blood Flow
|
14
|
8
|
$1,702.25
|
$1,532.03
|
$64.41
|
$1,651.18
|
$1,549.05
|
2026-02-04
|
|
J1459
|
HCPCS
|
Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui…
|
8
|
8
|
$1,612.50
|
$1,451.25
|
$1,451.25
|
$1,564.13
|
$1,548.01
|
2026-02-04
|
|
13160
|
HCPCS
|
Extensive Or Complicated Repair Of Surface Wound Reopening
|
6
|
6
|
$2,086.00
|
$1,877.40
|
$1,310.43
|
$1,981.70
|
$1,517.34
|
2026-02-04
|
|
92960
|
HCPCS
|
External Shock To Heart To Regulate Heart Beat
|
14
|
8
|
$1,628.75
|
$1,465.88
|
$177.84
|
$1,579.89
|
$1,482.16
|
2026-02-04
|
|
J0881
|
HCPCS
|
Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use)
|
24
|
8
|
$1,538.72
|
$1,384.85
|
$423.23
|
$2,248.22
|
$1,477.17
|
2026-02-04
|
|
8345689_1
|
CDM
|
Amoxicillin 400 Mg/5 Ml Susp
|
8
|
8
|
$1,537.50
|
$1,383.75
|
$1,383.75
|
$1,491.38
|
$1,476.01
|
2026-02-04
|
|
J7307
|
HCPCS
|
Etonogestrel (contraceptive) Implant System, Including Implant And Supplies
|
8
|
8
|
$1,536.75
|
$1,383.08
|
$1,383.08
|
$1,490.65
|
$1,475.28
|
2026-02-04
|
|
70547
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck Without Contrast
|
14
|
8
|
$1,618.25
|
$1,456.43
|
$97.47
|
$1,569.70
|
$1,472.61
|
2026-02-04
|
|
76377
|
HCPCS
|
3d Radiographic Procedure With Computerized Image Postprocessing
|
14
|
8
|
$1,582.50
|
$1,424.25
|
$64.41
|
$1,535.03
|
$1,440.08
|
2026-02-04
|
|
93970
|
HCPCS
|
Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers
|
14
|
8
|
$1,545.50
|
$1,390.95
|
$55.86
|
$1,499.14
|
$1,406.40
|
2026-02-04
|
|
74280
|
HCPCS
|
Double Contrast X-ray Of Large Intestine
|
14
|
8
|
$1,522.75
|
$1,370.48
|
$101.46
|
$1,477.07
|
$1,385.70
|
2026-02-04
|
|
72130
|
HCPCS
|
CT Scan Of Middle Spine Before And After Contrast
|
14
|
8
|
$1,512.00
|
$1,360.80
|
$102.60
|
$1,466.64
|
$1,375.92
|
2026-02-04
|
|
8028197_1
|
CDM
|
Room & Board - Private (one Bed) - Obstetrics (ob)
|
8
|
8
|
$1,423.75
|
$1,281.38
|
$1,281.38
|
$1,381.04
|
$1,366.80
|
2026-02-04
|
|
93971
|
HCPCS
|
Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers
|
28
|
8
|
$1,497.75
|
$1,347.98
|
$35.91
|
$1,452.82
|
$1,362.95
|
2026-02-04
|
|
73702
|
HCPCS
|
CT Scan Of Leg Before And After Contrast
|
28
|
8
|
$1,484.00
|
$1,335.60
|
$98.04
|
$1,439.48
|
$1,350.44
|
2026-02-04
|
|
92950
|
HCPCS
|
Manual Attempt To Restore Blood Circulation And Breathing
|
14
|
8
|
$1,400.25
|
$1,260.23
|
$305.52
|
$1,724.96
|
$1,330.24
|
2026-02-04
|
|
76380
|
HCPCS
|
Limited Or Follow-up CT Scan
|
14
|
8
|
$1,458.50
|
$1,312.65
|
$78.09
|
$1,414.75
|
$1,327.24
|
2026-02-04
|
|
6127487_2
|
CDM
|
20005 Ed Prof Inc Soft Tissue Abscess Deep
|
5
|
5
|
$1,542.75
|
$1,388.48
|
$1,157.06
|
$1,465.61
|
$1,311.34
|
2026-02-04
|
|
72142
|
HCPCS
|
MRI Scan Of Upper Spinal Canal With Contrast
|
8
|
8
|
$1,357.50
|
$1,221.75
|
$1,221.75
|
$1,316.78
|
$1,303.20
|
2026-02-04
|
|
6687998_1
|
CDM
|
Lift Chair - Extra Large (nu)
|
8
|
8
|
$1,349.50
|
$1,214.55
|
$1,214.55
|
$1,309.02
|
$1,295.53
|
2026-02-04
|
|
6688029_1
|
CDM
|
Lift Chair - Luxury (nu)
|
8
|
8
|
$1,318.25
|
$1,186.43
|
$1,186.43
|
$1,278.70
|
$1,265.52
|
2026-02-04
|
|
P9058
|
HCPCS
|
Red Blood Cells, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit
|
16
|
8
|
$1,304.38
|
$1,173.94
|
$1,140.08
|
$1,301.74
|
$1,228.75
|
2026-02-04
|
|
6095981_1
|
CDM
|
Rev - Other Rx Svcs
|
8
|
8
|
$1,279.00
|
$1,151.10
|
$1,151.10
|
$1,240.63
|
$1,227.84
|
2026-02-04
|
|
A0428
|
HCPCS
|
Ambulance Service, Basic Life Support, Non-emergency Transport, (bls)
|
8
|
8
|
$1,254.75
|
$1,129.28
|
$1,129.28
|
$1,217.11
|
$1,204.56
|
2026-02-04
|
|
72133
|
HCPCS
|
CT Scan Of Lower Spine Before And After Contrast
|
14
|
8
|
$1,319.00
|
$1,187.10
|
$102.03
|
$1,279.43
|
$1,200.29
|
2026-02-04
|
|
93976
|
HCPCS
|
Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow
|
22
|
8
|
$1,255.75
|
$1,130.18
|
$64.41
|
$1,218.08
|
$1,192.96
|
2026-02-04
|
|
90375
|
HCPCS
|
Rabies Immune Globulin For Injection
|
8
|
8
|
$1,241.50
|
$1,117.35
|
$1,117.35
|
$1,204.26
|
$1,191.85
|
2026-02-04
|
|
6041605_2
|
CDM
|
64402 Ed Prof Inj Anesth Facial Nerve-hosp
|
5
|
5
|
$1,377.75
|
$1,239.98
|
$1,033.31
|
$1,308.86
|
$1,171.09
|
2026-02-04
|
|
93320
|
HCPCS
|
Ultrasound Of Heart Blood Flow, Valves And Chambers
|
8
|
8
|
$1,216.50
|
$1,094.85
|
$1,094.85
|
$1,180.01
|
$1,167.85
|
2026-02-04
|
|
99284
|
HCPCS
|
Emergency Department Visit With Moderate Level Of Medical Decision Making
|
14
|
8
|
$1,265.25
|
$1,138.73
|
$192.66
|
$1,227.29
|
$1,151.38
|
2026-02-04
|
|
76536
|
HCPCS
|
Ultrasound Scan Of Head And Neck Soft Tissue
|
14
|
8
|
$1,212.25
|
$1,091.03
|
$45.60
|
$1,175.88
|
$1,103.15
|
2026-02-04
|
|
27096
|
HCPCS
|
Injection Of Anesthetic Or Steroid Into Joint Between Lower Spine And Hip Bone U…
|
24
|
8
|
$1,168.25
|
$1,051.43
|
$323.33
|
$1,133.20
|
$1,092.32
|
2026-02-04
|
|
P9040
|
HCPCS
|
Red Blood Cells, Leukocytes Reduced, Irradiated, Each Unit
|
16
|
8
|
$1,150.12
|
$1,035.12
|
$1,005.08
|
$1,148.00
|
$1,083.25
|
2026-02-04
|
|
13150
|
HCPCS
|
13150 Ed Prof Cpx Lc <1.1cm Ear - Hospital
|
5
|
5
|
$1,269.25
|
$1,142.33
|
$951.94
|
$1,205.79
|
$1,078.86
|
2026-02-04
|
|
86366
|
HCPCS
|
Test For Muscle-specific Kinase Antibody
|
8
|
8
|
$1,089.50
|
$980.55
|
$980.55
|
$1,056.82
|
$1,045.92
|
2026-02-04
|
|
73040
|
HCPCS
|
Review By Radiologist Of Shoulder Joint Image
|
28
|
8
|
$1,132.75
|
$1,019.48
|
$44.46
|
$1,098.77
|
$1,030.81
|
2026-02-04
|
|
32408
|
HCPCS
|
Core Needle Biopsy Of Lung Or Center Cavity Of Chest (mediastinum), Accessed Thr…
|
22
|
8
|
$1,042.50
|
$938.25
|
$85.50
|
$2,817.61
|
$1,011.23
|
2026-02-04
|
|
93017
|
HCPCS
|
Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg)
|
8
|
8
|
$1,049.50
|
$944.55
|
$944.55
|
$1,018.02
|
$1,007.52
|
2026-02-04
|
|
P9051
|
HCPCS
|
Whole Blood Or Red Blood Cells, Leukocytes Reduced, Cmv-negative, Each Unit
|
8
|
8
|
$1,039.00
|
$935.10
|
$935.10
|
$1,007.83
|
$997.44
|
2026-02-04
|
|
93308
|
HCPCS
|
Ultrasound Of Heart, Follow-up
|
14
|
8
|
$1,095.50
|
$985.95
|
$41.61
|
$1,062.64
|
$996.90
|
2026-02-04
|
|
73201
|
HCPCS
|
CT Scan Of Arm With Contrast
|
28
|
8
|
$1,089.75
|
$980.78
|
$93.48
|
$1,057.06
|
$991.67
|
2026-02-04
|
|
8028227_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Other
|
8
|
8
|
$1,031.50
|
$928.35
|
$928.35
|
$1,000.56
|
$990.24
|
2026-02-04
|
|
46040
|
HCPCS
|
Drainage Of Deep Abscess In Rectum
|
8
|
6
|
$1,305.75
|
$1,175.18
|
$693.12
|
$1,411.70
|
$988.87
|
2026-02-04
|
|
87507
|
HCPCS
|
Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S…
|
24
|
8
|
$1,022.50
|
$920.25
|
$559.13
|
$1,303.44
|
$981.61
|
2026-02-04
|
|
0202U
|
OTHER
|
Test For Detection Of Respiratory Disease-causing Organisms From Back Of Nose An…
|
8
|
8
|
$1,020.50
|
$918.45
|
$918.45
|
$989.89
|
$979.68
|
2026-02-04
|
|
6095986_1
|
CDM
|
Smh Paracentesis Nrs
|
8
|
8
|
$1,019.25
|
$917.33
|
$917.33
|
$988.67
|
$978.48
|
2026-02-04
|
|
6688028_1
|
CDM
|
Lift Chair - Large (nu)
|
8
|
8
|
$1,014.00
|
$912.60
|
$912.60
|
$983.58
|
$973.44
|
2026-02-04
|
|
25605
|
HCPCS
|
Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit…
|
6
|
6
|
$3,087.25
|
$2,778.53
|
$839.61
|
$2,932.89
|
$972.18
|
2026-02-04
|
|
8345692_1
|
CDM
|
Hydrocodone-chlorphen ER Susp
|
8
|
8
|
$1,003.00
|
$902.70
|
$902.70
|
$972.91
|
$962.88
|
2026-02-04
|
|
77002
|
HCPCS
|
Fluoroscopic Guidance For Needle Placement
|
36
|
8
|
$1,028.25
|
$925.43
|
$45.03
|
$997.40
|
$961.41
|
2026-02-04
|
|
J3360
|
HCPCS
|
Injection, Diazepam, Up To 5 Mg
|
16
|
8
|
$1,056.50
|
$950.85
|
$126.45
|
$1,913.33
|
$955.77
|
2026-02-04
|
|
76942
|
HCPCS
|
Ultrasonic Guidance For Needle Placement
|
42
|
8
|
$1,042.50
|
$938.25
|
$51.30
|
$1,011.23
|
$948.67
|
2026-02-04
|
|
19285
|
HCPCS
|
Placement Of Locating Device In Breast Using Ultrasound Guidance, First Growth
|
28
|
8
|
$1,042.50
|
$938.25
|
$102.60
|
$1,011.23
|
$948.67
|
2026-02-04
|
|
19083
|
HCPCS
|
Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth
|
28
|
8
|
$1,042.50
|
$938.25
|
$102.60
|
$1,011.23
|
$948.67
|
2026-02-04
|
|
10005
|
HCPCS
|
Fine Needle Aspiration Biopsy Using Ultrasound Guidance, First Growth
|
14
|
8
|
$1,042.50
|
$938.25
|
$102.60
|
$1,011.23
|
$948.67
|
2026-02-04
|
|
87902
|
HCPCS
|
Analysis Test By Nucleic Acid For Hepatitis C Virus
|
8
|
8
|
$984.75
|
$886.28
|
$886.28
|
$955.21
|
$945.36
|
2026-02-04
|
|
6687993_1
|
CDM
|
Hosp Bed Xtra Hvy Dty X Wide (rr)
|
8
|
8
|
$983.25
|
$884.93
|
$884.93
|
$953.75
|
$943.92
|
2026-02-04
|
|
6688027_1
|
CDM
|
Lift Chair - Medium (nu)
|
8
|
8
|
$982.25
|
$884.03
|
$884.03
|
$952.78
|
$942.96
|
2026-02-04
|
|
27825
|
HCPCS
|
Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint With Manipula…
|
6
|
6
|
$2,465.00
|
$2,218.50
|
$812.25
|
$2,341.75
|
$940.50
|
2026-02-04
|
|
27752
|
HCPCS
|
Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation
|
6
|
6
|
$2,445.00
|
$2,200.50
|
$808.83
|
$2,322.75
|
$936.54
|
2026-02-04
|
|
27500
|
HCPCS
|
Closed Treatment Of Broken Thigh Bone
|
6
|
6
|
$2,354.00
|
$2,118.60
|
$789.45
|
$2,236.30
|
$914.10
|
2026-02-04
|
|
76705
|
HCPCS
|
Limited Ultrasound Scan Of Abdomen
|
14
|
8
|
$1,004.25
|
$903.83
|
$47.31
|
$974.12
|
$913.87
|
2026-02-04
|
|
P9016
|
HCPCS
|
Red Blood Cells, Leukocytes Reduced, Each Unit
|
8
|
8
|
$947.00
|
$852.30
|
$852.30
|
$918.59
|
$909.12
|
2026-02-04
|
|
8317562_1
|
CDM
|
Lidocaine 2%-epi 1:100,000
|
8
|
8
|
$945.00
|
$850.50
|
$850.50
|
$916.65
|
$907.20
|
2026-02-04
|
|
27230
|
HCPCS
|
Closed Treatment Of Broken Upper Thigh Bone
|
6
|
6
|
$1,972.00
|
$1,774.80
|
$779.76
|
$1,873.40
|
$902.88
|
2026-02-04
|
|
6688026_1
|
CDM
|
Lift Chair - Small (nu)
|
8
|
8
|
$939.00
|
$845.10
|
$845.10
|
$910.83
|
$901.44
|
2026-02-04
|
|
24605
|
HCPCS
|
Repair Of Dislocated Elbow Under Anesthesia
|
6
|
6
|
$1,423.00
|
$1,280.70
|
$777.48
|
$1,351.85
|
$900.24
|
2026-02-04
|
|
7193934_1
|
CDM
|
Dream Station Go Cpap
|
8
|
8
|
$930.50
|
$837.45
|
$837.45
|
$902.59
|
$893.29
|
2026-02-04
|
|
55700
|
HCPCS
|
Biopsy Of Prostate Gland
|
14
|
8
|
$981.00
|
$882.90
|
$214.89
|
$951.57
|
$892.71
|
2026-02-04
|
|
13152
|
HCPCS
|
Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm
|
8
|
6
|
$1,267.75
|
$1,140.98
|
$555.18
|
$3,346.14
|
$891.91
|
2026-02-04
|
|
76700
|
HCPCS
|
Complete Ultrasound Scan Of Abdomen
|
14
|
8
|
$980.00
|
$882.00
|
$66.12
|
$950.60
|
$891.80
|
2026-02-04
|
|
J0248
|
HCPCS
|
Injection, Remdesivir, 1 Mg
|
8
|
8
|
$900.00
|
$810.00
|
$810.00
|
$873.00
|
$864.00
|
2026-02-04
|
|
96365
|
HCPCS
|
Infusion Into A Vein For Therapy, Prevention, Or Diagnosis, 1 Hour Or Less
|
8
|
8
|
$895.00
|
$805.50
|
$805.50
|
$868.15
|
$859.20
|
2026-02-04
|
|
8344250_1
|
CDM
|
Amoxicillin 400 Mg/5 Ml Susp
|
8
|
8
|
$887.50
|
$798.75
|
$798.75
|
$860.88
|
$852.00
|
2026-02-04
|
|
81340
|
HCPCS
|
Gene Analysis (t Cell Antigen Receptor Beta) Amplification Methodology
|
8
|
8
|
$874.75
|
$787.28
|
$787.28
|
$848.51
|
$839.76
|
2026-02-04
|
|
9010405_1
|
CDM
|
AirMini
|
8
|
8
|
$866.25
|
$779.63
|
$779.63
|
$840.26
|
$831.60
|
2026-02-04
|
|
27818
|
HCPCS
|
Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation
|
6
|
6
|
$2,218.50
|
$1,996.65
|
$714.78
|
$2,107.58
|
$827.64
|
2026-02-04
|
|
J9217
|
HCPCS
|
Leuprolide Acetate (for Depot Suspension), 7.5 Mg
|
8
|
8
|
$849.00
|
$764.10
|
$764.10
|
$823.53
|
$815.04
|
2026-02-04
|
|
7196301_1
|
CDM
|
Dream Station Go-auto, Travel
|
8
|
8
|
$844.25
|
$759.83
|
$759.83
|
$818.92
|
$810.48
|
2026-02-04
|
|
27810
|
HCPCS
|
Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation
|
6
|
6
|
$1,271.50
|
$1,144.35
|
$695.40
|
$1,207.93
|
$805.20
|
2026-02-04
|
|
11012
|
HCPCS
|
Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A…
|
6
|
6
|
$1,834.00
|
$1,650.60
|
$689.13
|
$1,742.30
|
$797.94
|
2026-02-04
|
|
38221
|
HCPCS
|
Biopsy Of Bone Marrow
|
8
|
8
|
$825.00
|
$742.50
|
$742.50
|
$800.25
|
$792.00
|
2026-02-04
|
|
12055
|
HCPCS
|
Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.6-…
|
8
|
6
|
$2,627.00
|
$2,364.30
|
$493.62
|
$2,495.65
|
$791.80
|
2026-02-04
|
|
25248
|
HCPCS
|
Removal Of Deep Foreign Body In Forearm Or Wrist
|
6
|
6
|
$926.50
|
$833.85
|
$682.29
|
$880.18
|
$790.02
|
2026-02-04
|
|
72114
|
HCPCS
|
X-ray Lower And Sacral Spine, Minimum Of 6 Views
|
14
|
8
|
$859.25
|
$773.33
|
$24.51
|
$833.47
|
$781.92
|
2026-02-04
|
|
77080
|
HCPCS
|
Dxa Bone Density Measurement Of Hip, Pelvis, Spine
|
14
|
8
|
$859.25
|
$773.33
|
$15.96
|
$833.47
|
$781.92
|
2026-02-04
|
|
93926
|
HCPCS
|
Ultrasound Of One Leg Arteries Or Artery Grafts
|
42
|
8
|
$854.50
|
$769.05
|
$39.33
|
$828.87
|
$777.60
|
2026-02-04
|
|
24071
|
HCPCS
|
Removal Of Growth Under Skin Of Upper Arm Or Elbow, 3.0 Cm Or More
|
6
|
6
|
$1,744.75
|
$1,570.28
|
$668.61
|
$1,657.51
|
$774.18
|
2026-02-04
|
|
27265
|
HCPCS
|
Closed Treatment Of Dislocated Hip Prosthesis
|
6
|
6
|
$2,474.50
|
$2,227.05
|
$664.62
|
$2,350.78
|
$769.56
|
2026-02-04
|
|
23655
|
HCPCS
|
Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia
|
6
|
6
|
$2,594.75
|
$2,335.28
|
$663.48
|
$2,465.01
|
$768.24
|
2026-02-04
|
|
90675
|
HCPCS
|
Rabies Vaccine For Injection Into Muscle
|
16
|
8
|
$828.00
|
$745.20
|
$590.85
|
$969.52
|
$768.18
|
2026-02-04
|
|
74230
|
HCPCS
|
Imaging For Evaluation Of Swallowing Function
|
14
|
8
|
$843.00
|
$758.70
|
$42.75
|
$817.71
|
$767.13
|
2026-02-04
|
|
13132
|
HCPCS
|
Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G…
|
8
|
6
|
$1,038.75
|
$934.88
|
$502.17
|
$2,644.56
|
$758.17
|
2026-02-04
|
|
76870
|
HCPCS
|
Ultrasound Scan Of Scrotum
|
14
|
8
|
$827.50
|
$744.75
|
$51.30
|
$802.68
|
$753.02
|
2026-02-04
|
|
74250
|
HCPCS
|
Single Contrast X-ray Of Small Intestine
|
14
|
8
|
$825.00
|
$742.50
|
$66.12
|
$800.25
|
$750.75
|
2026-02-04
|
|
76856
|
HCPCS
|
Complete Ultrasound Scan Of Pelvis
|
14
|
8
|
$817.75
|
$735.98
|
$55.29
|
$793.22
|
$744.15
|
2026-02-04
|
|
13151
|
HCPCS
|
Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 1.1-2.5 Cm
|
8
|
6
|
$1,057.25
|
$951.53
|
$461.13
|
$1,711.66
|
$742.74
|
2026-02-04
|
|
93325
|
HCPCS
|
Ultrasound Of Heart With Color-depicted Blood Flow, Rate And Valve Function
|
8
|
8
|
$766.25
|
$689.63
|
$689.63
|
$743.26
|
$735.60
|
2026-02-04
|
|
27788
|
HCPCS
|
Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation
|
6
|
6
|
$1,059.75
|
$953.78
|
$632.70
|
$1,006.76
|
$732.60
|
2026-02-04
|
|
E1226
|
HCPCS
|
Wheelchair Accessory, Manual Fully Reclining Back, (recline Greater Than 80 Degr…
|
8
|
8
|
$761.75
|
$685.58
|
$685.58
|
$738.90
|
$731.28
|
2026-02-04
|
|
13121
|
HCPCS
|
Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm
|
8
|
6
|
$1,065.00
|
$958.50
|
$427.50
|
$1,789.09
|
$726.75
|
2026-02-04
|
|
76376
|
HCPCS
|
3d Radiographic Procedure
|
14
|
8
|
$798.00
|
$718.20
|
$15.96
|
$774.06
|
$726.18
|
2026-02-04
|
|
27840
|
HCPCS
|
Closed Treatment Of Dislocated Ankle
|
6
|
6
|
$1,537.00
|
$1,383.30
|
$617.88
|
$1,460.15
|
$715.44
|
2026-02-04
|
|
76805
|
HCPCS
|
Ultrasound Scan Of Pregnant Uterus (14 Weeks Or More), Single Or First Fetus
|
14
|
8
|
$782.00
|
$703.80
|
$80.37
|
$758.54
|
$711.62
|
2026-02-04
|
|
74246
|
HCPCS
|
Double Contrast X-ray Of Upper Digestive Tract
|
24
|
8
|
$740.25
|
$666.23
|
$72.96
|
$1,240.39
|
$710.64
|
2026-02-04
|
|
27750
|
HCPCS
|
Closed Treatment Of Broken Middle Part Of Shin Bone
|
10
|
6
|
$765.75
|
$689.18
|
$523.26
|
$2,016.85
|
$708.32
|
2026-02-04
|
|
12045
|
HCPCS
|
Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 12.6-20.0 Cm
|
8
|
6
|
$968.75
|
$871.88
|
$442.32
|
$1,543.75
|
$692.02
|
2026-02-04
|
|
8333421_1
|
CDM
|
Flovent Hfa 220 Mcg Inhaler
|
8
|
8
|
$720.00
|
$648.00
|
$648.00
|
$698.40
|
$691.20
|
2026-02-04
|
|
99283
|
HCPCS
|
Emergency Department Visit With Low Level Of Medical Decision Making
|
14
|
8
|
$736.50
|
$662.85
|
$104.88
|
$714.41
|
$688.63
|
2026-02-04
|
|
6900836_1
|
CDM
|
Epinephrin 0.15mg/0.3ml
|
8
|
8
|
$714.00
|
$642.60
|
$642.60
|
$692.58
|
$685.44
|
2026-02-04
|
|
72110
|
HCPCS
|
X-ray Of Lower And Sacral Spine, Minimum Of 4 Views
|
14
|
8
|
$748.50
|
$673.65
|
$21.09
|
$726.05
|
$681.13
|
2026-02-04
|
|
13101
|
HCPCS
|
Complicated Repair Of Wound Of Trunk, 2.6-7.5 Cm
|
8
|
6
|
$986.50
|
$887.85
|
$406.98
|
$1,322.88
|
$679.55
|
2026-02-04
|
|
70540
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast
|
14
|
8
|
$744.75
|
$670.28
|
$108.30
|
$722.41
|
$677.72
|
2026-02-04
|
|
96112
|
HCPCS
|
Administration Of Developmental Test, First Hour
|
8
|
8
|
$705.75
|
$635.18
|
$635.18
|
$684.58
|
$677.52
|
2026-02-04
|
|
8972600_1
|
CDM
|
Ozempic 2 Mg/dose (8 Mg/3 Ml)
|
8
|
8
|
$702.50
|
$632.25
|
$632.25
|
$681.43
|
$674.40
|
2026-02-04
|
|
77076
|
HCPCS
|
X-ray Of Infant Body Bones
|
14
|
8
|
$732.75
|
$659.48
|
$56.43
|
$710.77
|
$666.81
|
2026-02-04
|
|
13131
|
HCPCS
|
Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G…
|
8
|
6
|
$963.50
|
$867.15
|
$401.28
|
$1,361.35
|
$665.89
|
2026-02-04
|
|
74220
|
HCPCS
|
Single Contrast X-ray Of Esophagus
|
14
|
8
|
$729.50
|
$656.55
|
$48.45
|
$707.62
|
$663.85
|
2026-02-04
|
|
76801
|
HCPCS
|
Ultrasound Scan Of Pregnant Uterus (less Than 14 Weeks), Single Or First Fetus
|
14
|
8
|
$728.75
|
$655.88
|
$80.37
|
$706.89
|
$663.16
|
2026-02-04
|
|
8895564_1
|
CDM
|
Serevent Diskus 50 Mcg
|
8
|
8
|
$690.00
|
$621.00
|
$621.00
|
$669.30
|
$662.40
|
2026-02-04
|
|
20103
|
HCPCS
|
Exploration Of Wound Of Arm Or Leg
|
6
|
6
|
$3,103.50
|
$2,793.15
|
$570.57
|
$2,948.33
|
$660.66
|
2026-02-04
|
|
76857
|
HCPCS
|
Limited Ultrasound Scan Of Pelvis
|
22
|
8
|
$693.50
|
$624.15
|
$39.90
|
$672.70
|
$658.83
|
2026-02-04
|
|
26775
|
HCPCS
|
Closed Treatment Of Dislocated Finger Joint With Manipulation Under Anesthesia
|
6
|
6
|
$1,247.00
|
$1,122.30
|
$567.72
|
$1,184.65
|
$657.36
|
2026-02-04
|
|
27560
|
HCPCS
|
Closed Treatment Of Dislocated Kneecap
|
6
|
6
|
$1,438.75
|
$1,294.88
|
$563.16
|
$1,366.81
|
$652.08
|
2026-02-04
|
|
76830
|
HCPCS
|
Ultrasound Scan Of Uterus, Ovaries, Tubes, Cervix And Pelvic Area Through Vagina
|
22
|
8
|
$683.75
|
$615.38
|
$55.86
|
$678.03
|
$649.56
|
2026-02-04
|
|
72052
|
HCPCS
|
X-ray Of Upper Spine, 6 Or More Views
|
14
|
8
|
$712.00
|
$640.80
|
$24.51
|
$690.64
|
$647.92
|
2026-02-04
|
|
70220
|
HCPCS
|
X-ray Of Paranasal Sinus, Minimum Of 3 Views
|
14
|
8
|
$710.00
|
$639.00
|
$18.24
|
$688.70
|
$646.10
|
2026-02-04
|
|
87899
|
HCPCS
|
Detection Test By Immunoassay With Direct Visual Observation For Other Organism
|
16
|
8
|
$704.25
|
$633.83
|
$234.68
|
$1,113.32
|
$642.95
|
2026-02-04
|
|
26700
|
HCPCS
|
Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation
|
8
|
6
|
$1,031.50
|
$928.35
|
$505.02
|
$979.93
|
$642.48
|
2026-02-04
|
|
88368
|
HCPCS
|
Microscopic Genetic Analysis Of Tissue, Manual, Initial Procedure
|
16
|
8
|
$685.75
|
$617.18
|
$533.48
|
$755.39
|
$637.92
|
2026-02-04
|
|
27786
|
HCPCS
|
Closed Treatment Of Broken Outside Lower Leg Bone At Ankle
|
8
|
6
|
$1,510.25
|
$1,359.23
|
$470.25
|
$1,434.74
|
$637.42
|
2026-02-04
|
|
26605
|
HCPCS
|
Closed Treatment Of Broken Hand Bone With Manipulation
|
8
|
6
|
$776.50
|
$698.85
|
$481.65
|
$1,538.53
|
$628.28
|
2026-02-04
|
|
25600
|
HCPCS
|
Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb …
|
8
|
6
|
$724.75
|
$652.28
|
$516.42
|
$2,293.30
|
$625.12
|
2026-02-04
|
|
24500
|
HCPCS
|
Closed Treatment Of Broken Middle Part Of Upper Arm Bone
|
6
|
6
|
$1,627.75
|
$1,464.98
|
$539.22
|
$1,546.36
|
$624.36
|
2026-02-04
|
|
23650
|
HCPCS
|
Closed Treatment Of Dislocated Shoulder With Manipulation
|
8
|
6
|
$1,463.75
|
$1,317.38
|
$476.52
|
$1,390.56
|
$616.64
|
2026-02-04
|
|
E0277
|
HCPCS
|
Powered Pressure-reducing Air Mattress
|
8
|
8
|
$640.50
|
$576.45
|
$576.45
|
$621.29
|
$614.88
|
2026-02-04
|
|
31603
|
HCPCS
|
Emergent Incision Of Windpipe Through Neck For Insertion Of Breathing Tube
|
6
|
6
|
$2,668.50
|
$2,401.65
|
$530.10
|
$2,535.08
|
$613.80
|
2026-02-04
|
|
13120
|
HCPCS
|
Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 1.1-2.5 Cm
|
8
|
6
|
$873.75
|
$786.38
|
$380.76
|
$1,166.84
|
$613.63
|
2026-02-04
|
|
11446
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, M…
|
6
|
6
|
$864.75
|
$778.28
|
$527.82
|
$821.51
|
$611.16
|
2026-02-04
|
|
67700
|
HCPCS
|
Incision And Drainage Of Abscess Of Eyelid
|
8
|
8
|
$636.00
|
$572.40
|
$572.40
|
$616.92
|
$610.56
|
2026-02-04
|
|
M0247
|
HCPCS
|
Intravenous Infusion, Sotrovimab, Includes Infusion And Post Administration Moni…
|
8
|
8
|
$635.00
|
$571.50
|
$571.50
|
$615.95
|
$609.60
|
2026-02-04
|
|
M0243
|
HCPCS
|
Intravenous Infusion Or Subcutaneous Injection, Casirivimab And Imdevimab Includ…
|
8
|
8
|
$635.00
|
$571.50
|
$571.50
|
$615.95
|
$609.60
|
2026-02-04
|
|
73522
|
HCPCS
|
X-ray Of Both Hips, 3-4 Views
|
14
|
8
|
$669.50
|
$602.55
|
$23.94
|
$649.42
|
$609.25
|
2026-02-04
|
|
E0471
|
HCPCS
|
Respiratory Assist Device, Bi-level Pressure Capability, With Back-up Rate Featu…
|
8
|
8
|
$626.50
|
$563.85
|
$563.85
|
$607.71
|
$601.44
|
2026-02-04
|
|
12046
|
HCPCS
|
Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 20.1-30.0 Cm
|
6
|
6
|
$2,100.25
|
$1,890.23
|
$517.56
|
$1,995.24
|
$599.28
|
2026-02-04
|
|
76817
|
HCPCS
|
Vaginal Ultrasound Of Pregnant Uterus
|
14
|
8
|
$658.50
|
$592.65
|
$60.42
|
$638.75
|
$599.24
|
2026-02-04
|
|
12054
|
HCPCS
|
Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1…
|
8
|
6
|
$865.50
|
$778.95
|
$361.95
|
$1,497.44
|
$599.03
|
2026-02-04
|
|
87522
|
HCPCS
|
Detection Test By Nucleic Acid For Hepatitis C Virus, Quantification
|
24
|
8
|
$623.75
|
$561.38
|
$534.83
|
$727.74
|
$598.80
|
2026-02-04
|
|
71111
|
HCPCS
|
X-ray Of Ribs On Both Sides Of Body, Minimum Of 4 Views
|
14
|
8
|
$654.00
|
$588.60
|
$26.22
|
$634.38
|
$595.14
|
2026-02-04
|
|
12044
|
HCPCS
|
Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm
|
8
|
6
|
$860.25
|
$774.23
|
$351.12
|
$1,178.95
|
$590.39
|
2026-02-04
|
|
6900837_1
|
CDM
|
Glucagon 1mg
|
8
|
8
|
$604.50
|
$544.05
|
$544.05
|
$586.37
|
$580.33
|
2026-02-04
|
|
83727
|
HCPCS
|
Luteinizing Releasing Factor (reproductive Hormone) Level
|
8
|
8
|
$602.75
|
$542.48
|
$542.48
|
$584.67
|
$578.64
|
2026-02-04
|
|
27824
|
HCPCS
|
Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint
|
6
|
6
|
$735.25
|
$661.73
|
$498.75
|
$698.49
|
$577.50
|
2026-02-04
|
|
26725
|
HCPCS
|
Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With …
|
6
|
6
|
$880.75
|
$792.68
|
$497.61
|
$836.71
|
$576.18
|
2026-02-04
|
|
8344596_1
|
CDM
|
Acetaminop-codeine 120-12 Mg/5
|
8
|
8
|
$600.00
|
$540.00
|
$540.00
|
$582.00
|
$576.00
|
2026-02-04
|
|
25650
|
HCPCS
|
Closed Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist
|
6
|
6
|
$1,814.25
|
$1,632.83
|
$495.90
|
$1,723.54
|
$574.20
|
2026-02-04
|
|
12035
|
HCPCS
|
Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.…
|
8
|
6
|
$756.75
|
$681.08
|
$395.58
|
$1,383.44
|
$569.56
|
2026-02-04
|
|
26011
|
HCPCS
|
Complicated Drainage Of Abscess In Finger
|
8
|
6
|
$887.00
|
$798.30
|
$303.24
|
$842.65
|
$567.29
|
2026-02-04
|
|
76604
|
HCPCS
|
Ultrasound Scan Of Chest
|
14
|
8
|
$622.25
|
$560.03
|
$46.74
|
$603.58
|
$566.25
|
2026-02-04
|
|
74450
|
HCPCS
|
Review By Radiologist Of Urinary Bladder And Urethra Images With Contrast
|
8
|
8
|
$587.75
|
$528.98
|
$528.98
|
$570.12
|
$564.24
|
2026-02-04
|
|
27520
|
HCPCS
|
Closed Treatment Of Broken Kneecap
|
6
|
6
|
$1,645.75
|
$1,481.18
|
$486.78
|
$1,563.46
|
$563.64
|
2026-02-04
|
|
E2612
|
HCPCS
|
General Use Wheelchair Back Cushion, Width 22 Inches Or Greater, Any Height, Inc…
|
8
|
8
|
$582.00
|
$523.80
|
$523.80
|
$564.54
|
$558.72
|
2026-02-04
|
|
E2606
|
HCPCS
|
Positioning Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
|
8
|
8
|
$582.00
|
$523.80
|
$523.80
|
$564.54
|
$558.72
|
2026-02-04
|
|
88307
|
HCPCS
|
Pathology Examination Of Tissue Using A Microscope, Moderately High Complexity
|
8
|
8
|
$577.50
|
$519.75
|
$519.75
|
$560.18
|
$554.40
|
2026-02-04
|
|
70150
|
HCPCS
|
X-ray Of Face Bones, Minimum Of 3 Views
|
14
|
8
|
$608.75
|
$547.88
|
$21.66
|
$590.49
|
$553.96
|
2026-02-04
|
|
6045356_1
|
CDM
|
Ezio Needle 25m X 1.8__l-3023n
|
8
|
8
|
$576.00
|
$518.40
|
$518.40
|
$558.72
|
$552.96
|
2026-02-04
|
|
76642
|
HCPCS
|
Limited Ultrasound Scan Of 1 Breast
|
50
|
8
|
$599.75
|
$539.78
|
$54.72
|
$581.76
|
$551.77
|
2026-02-04
|
|
76775
|
HCPCS
|
Limited Ultrasound Scan Behind Abdominal Cavity
|
14
|
8
|
$605.75
|
$545.18
|
$46.74
|
$587.58
|
$551.23
|
2026-02-04
|
|
74022
|
HCPCS
|
X-ray Series Of Abdomen With Single X-ray Of Chest
|
14
|
8
|
$602.75
|
$542.48
|
$25.65
|
$584.67
|
$548.50
|
2026-02-04
|
|
6688017_1
|
CDM
|
Seat Lift For Pt Furn-non-elect (nu)
|
8
|
8
|
$571.25
|
$514.13
|
$514.13
|
$554.11
|
$548.40
|
2026-02-04
|
|
12034
|
HCPCS
|
Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5…
|
8
|
6
|
$780.75
|
$702.68
|
$336.87
|
$1,021.73
|
$546.37
|
2026-02-04
|
|
76706
|
HCPCS
|
Ultrasound Scan Of Abdominal Aorta
|
14
|
8
|
$599.75
|
$539.78
|
$44.46
|
$581.76
|
$545.77
|
2026-02-04
|
|
J1610
|
HCPCS
|
Injection, Glucagon Hydrochloride, Per 1 Mg
|
8
|
8
|
$567.25
|
$510.53
|
$510.53
|
$550.23
|
$544.56
|
2026-02-04
|
|
13100
|
HCPCS
|
Complicated Repair Of Wound Of Trunk, 1.1-2.5 Cm
|
8
|
6
|
$835.00
|
$751.50
|
$331.17
|
$793.25
|
$542.17
|
2026-02-04
|
|
6064166_1
|
CDM
|
Smh Nitrous Oxide With Machine Per Hour
|
8
|
8
|
$561.75
|
$505.58
|
$505.58
|
$544.90
|
$539.28
|
2026-02-04
|
|
96360
|
HCPCS
|
Infusion Into A Vein For Hydration, 31-60 Minutes
|
8
|
8
|
$561.50
|
$505.35
|
$505.35
|
$544.66
|
$539.04
|
2026-02-04
|
|
11644
|
HCPCS
|
Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3.1-…
|
6
|
6
|
$951.50
|
$856.35
|
$463.98
|
$903.93
|
$537.24
|
2026-02-04
|
|
87799
|
HCPCS
|
Detection Test By Nucleic Acid For Organism, Quantification
|
16
|
8
|
$575.38
|
$517.84
|
$491.18
|
$586.85
|
$536.94
|
2026-02-04
|
|
6064563_1
|
CDM
|
Quantum Pump Per Day__3834983
|
8
|
8
|
$556.75
|
$501.08
|
$501.08
|
$540.05
|
$534.48
|
2026-02-04
|
|
27780
|
HCPCS
|
Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone
|
6
|
6
|
$1,297.75
|
$1,167.98
|
$460.56
|
$1,232.86
|
$533.28
|
2026-02-04
|
|
72050
|
HCPCS
|
X-ray Of Upper Spine, 4-5 Views
|
14
|
8
|
$583.75
|
$525.38
|
$22.23
|
$566.24
|
$531.21
|
2026-02-04
|
|
J2720
|
HCPCS
|
Injection, Protamine Sulfate, Per 10 Mg
|
8
|
8
|
$550.00
|
$495.00
|
$495.00
|
$533.50
|
$528.00
|
2026-02-04
|
|
8317934_1
|
CDM
|
Desmopressin 10 Mcg/0.1 Ml Spr
|
8
|
8
|
$545.00
|
$490.50
|
$490.50
|
$528.65
|
$523.20
|
2026-02-04
|
|
36600
|
HCPCS
|
Artery Puncture Collection Of Blood Sample
|
8
|
8
|
$544.50
|
$490.05
|
$490.05
|
$528.17
|
$522.72
|
2026-02-04
|
|
11426
|
HCPCS
|
Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More …
|
6
|
6
|
$735.25
|
$661.73
|
$449.73
|
$698.49
|
$520.74
|
2026-02-04
|