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

LOGAN HEALTH - SHELBY

Shelby, MT · CCN 271328 · Rates published

3,586 distinct procedures filed
8 distinct payers
10,132 rate rows
2026-04-01 last MRF observed
Data quality

2,915 of 10,132 rate rows are consumer-grade (28.8%)

7,217 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 5,439
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,778
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://HospitalPriceDisclosure.com/Download.aspx?pi=gdpEtwLLYwc6GA7*_*ciw2gQ*-*
Found on page https://www.logan.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-10-03
Content fingerprint 41c13106628ae628… · 4,862,822 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
C2616
HCPCS 		Brachytx, Non-str,yttrium-90 1 $112,974.43 $112,974.43 $112,974.43 nat. median
$22,121
outlier · 5.1×
81408
HCPCS 		Mopath Procedure Level 9 1 $75,883.65 $75,883.65 $75,883.65 nat. median
$2,000
outlier · 37.9×
77371
HCPCS 		Srs Multisource 1 $70,826.85 $70,826.85 $70,826.85 nat. median
$7,491
outlier · 9.5×
81529
HCPCS 		Onc Cutan Mlnma Mrna 31 Gene 1 $70,401.49 $70,401.49 $70,401.49 nat. median
$7,337
outlier · 9.6×
81554
HCPCS 		Pulm Ds Ipf Mrna 190 Gen Alg 1 $53,831.25 $53,831.25 $53,831.25 nat. median
$5,572
outlier · 9.7×
638
MS_DRG 		Diabetes With Cc 1 $50,324.96 $50,324.96 $50,324.96 nat. median
$6,741
outlier · 7.5×
0212U
OTHER 		Rare Ds Gen DNA Alys Proband 1 $49,242.87 $49,242.87 $49,242.87 nat. median
$5,749
outlier · 8.6×
0267U
OTHER 		Rare Do Id Opt Gen Mapg&seq 1 $49,242.87 $49,242.87 $49,242.87 nat. median
$7,076
outlier · 7.0×
0265U
OTHER 		Rar Do Whl Gn&mtcdrl DNA Als 1 $49,242.87 $49,242.87 $49,242.87 nat. median
$5,750
outlier · 8.6×
0214U
OTHER 		Rare Ds Xom DNA Alys Proband 1 $49,242.87 $49,242.87 $49,242.87 nat. median
$5,486
outlier · 9.0×
81315
HCPCS 		Pml/raralpha Com Breakpoints 1 $47,361.71 $47,361.71 $47,361.71 nat. median
$222
outlier · 213.5×
81316
HCPCS 		Pml/raralpha 1 Breakpoint 1 $47,322.71 $47,322.71 $47,322.71 nat. median
$218
outlier · 217.4×
81518
HCPCS 		Onc Brst Mrna 11 Genes 1 $40,714.91 $40,714.91 $40,714.91 nat. median
$3,912
outlier · 10.4×
0153U
OTHER 		Onc Breast Mrna 101 Genes 1 $40,714.91 $40,714.91 $40,714.91 nat. median
$3,317
outlier · 12.3×
81407
HCPCS 		Mopath Procedure Level 8 1 $40,066.26 $40,066.26 $40,066.26 nat. median
$846
outlier · 47.3×
81542
HCPCS 		Onc Prostate Mrna 22 Cnt Gen 1 $37,906.99 $37,906.99 $37,906.99 nat. median
$3,950
outlier · 9.6×
0120U
OTHER 		Onc B Cll Lymphm Mrna 58 Gen 1 $37,906.99 $37,906.99 $37,906.99 nat. median
$2,636
outlier · 14.4×
0133U
OTHER 		Hered Prst8 Ca Rltd Do 11 1 $37,906.99 $37,906.99 $37,906.99 nat. median
$725
outlier · 52.3×
81523
HCPCS 		Onc Brst Mrna 70 Cnt 31 Gene 1 $37,906.99 $37,906.99 $37,906.99 nat. median
$3,950
outlier · 9.6×
81522
HCPCS 		Onc Breast Mrna 12 Genes 1 $37,906.99 $37,906.99 $37,906.99 nat. median
$3,912
outlier · 9.7×
0090U
OTHER 		Onc Cutan Mlnma Mrna 23 Gene 1 $36,703.13 $36,703.13 $36,703.13 nat. median
$2,048
outlier · 17.9×
0089U
OTHER 		Onc Mlnma Prame & Linc00518 1 $36,703.13 $36,703.13 $36,703.13 nat. median
$796
outlier · 46.1×
0262U
OTHER 		Onc Sld Tum Rt-pcr 7 Gen 1 $36,703.13 $36,703.13 $36,703.13 nat. median
$3,360
outlier · 10.9×
0258U
OTHER 		Ai Psor Mrna 50-100 Gen Alg 1 $36,703.13 $36,703.13 $36,703.13 nat. median
$3,859
outlier · 9.5×
0242U
OTHER 		Trgt Gen Seq Alys Pnl 55-74 1 $36,250.00 $36,250.00 $36,250.00 nat. median
$5,175
outlier · 7.0×
0208U
OTHER 		Onc Mtc Mrna Xprsn Alys 108 1 $35,235.00 $35,235.00 $35,235.00 nat. median
$2,042
outlier · 17.3×
0287U
OTHER 		Onc Thyr Dna&mrna 112 Genes 1 $35,235.00 $35,235.00 $35,235.00 nat. median
$3,780
outlier · 9.3×
81546
HCPCS 		Onc Thyr Mrna 10,196 Gen Alg 1 $35,235.00 $35,235.00 $35,235.00 nat. median
$3,672
outlier · 9.6×
0204U
OTHER 		Onc Thyr Mrna Xprsn Alys 593 1 $35,235.00 $35,235.00 $35,235.00 nat. median
$8,058
outlier · 4.4×
81223
HCPCS 		Cftr Gene Full Sequence 1 $35,126.47 $35,126.47 $35,126.47 nat. median
$549
outlier · 64.0×
0250U
OTHER 		Onc Sld Org Neo DNA 505 Gene 1 $34,256.25 $34,256.25 $34,256.25 nat. median
$3,842
outlier · 8.9×
0088U
OTHER 		Trnsplj Kdn Algrft Rej 1494 1 $31,711.50 $31,711.50 $31,711.50 nat. median
$3,317
outlier · 9.6×
0018M
OTHER 		Trnsplj Rnl Meas Cd154+cll 1 $31,711.50 $31,711.50 $31,711.50 nat. median
$660
outlier · 48.1×
0118U
OTHER 		Trnsplj Don-drv Cll-fr DNA 1 $31,711.50 $31,711.50 $31,711.50 nat. median
$2,884
outlier · 11.0×
0087U
OTHER 		Crd Hrt Trnspl Mrna 1283 Gen 1 $31,711.50 $31,711.50 $31,711.50 nat. median
$3,317
outlier · 9.6×
81560
HCPCS 		Trnsplj Pd Lvr&bwl Cd154+cll 1 $31,711.50 $31,711.50 $31,711.50 nat. median
$654
outlier · 48.5×
0245U
OTHER 		Onc Thyr Mut Alys 10 Gen&37 1 $29,382.95 $29,382.95 $29,382.95 nat. median
$1,329
outlier · 22.1×
0092U
OTHER 		Onc Lng 3 Prtn Bmrk Plsm Alg 1 $28,099.91 $28,099.91 $28,099.91 nat. median
$2,612
outlier · 10.8×
81521
HCPCS 		Onc Breast Mrna 70 Genes 1 $28,079.25 $28,079.25 $28,079.25 nat. median
$3,950
outlier · 7.1×
81541
HCPCS 		Onc Prostate Mrna 46 Genes 1 $28,079.25 $28,079.25 $28,079.25 nat. median
$3,950
outlier · 7.1×
0213U
OTHER 		Rare Ds Gen DNA Alys Ea Comp 1 $26,523.62 $26,523.62 $26,523.62 nat. median
$2,845
outlier · 9.3×
0215U
OTHER 		Rare Ds Xom DNA Alys Ea Comp 1 $26,523.62 $26,523.62 $26,523.62 nat. median
$2,703
outlier · 9.8×
81443
HCPCS 		Genetic Tstg Severe Inh Cond 1 $25,740.47 $25,740.47 $25,740.47 nat. median
$2,449
outlier · 10.5×
0398T
OTHER 		Mrgfus Strtctc Les Abltj 1 $22,545.91 $22,545.91 $22,545.91 nat. median
$8,573
outlier · 2.6×
81520
HCPCS 		Onc Breast Mrna 58 Genes 1 $22,467.90 $22,467.90 $22,467.90 nat. median
$2,560
outlier · 8.8×
0129U
OTHER 		Hered Brst Ca Rltd Do Panel 1 $22,050.59 $22,050.59 $22,050.59 nat. median
$1,361
outlier · 16.2×
0132U
OTHER 		Hered Ova Ca Rltd Do Pnl 17 1 $22,050.59 $22,050.59 $22,050.59 nat. median
$834
outlier · 26.4×
0131U
OTHER 		Hered Brst Ca Rltd Do Pnl 13 1 $22,050.59 $22,050.59 $22,050.59 nat. median
$799
outlier · 27.6×
0138U
OTHER 		Brca1 Brca2 Mrna Seq Alys 1 $22,050.59 $22,050.59 $22,050.59 nat. median
$491
outlier · 44.9×
81525
HCPCS 		Oncology Colon Mrna 1 $19,676.07 $19,676.07 $19,676.07 nat. median
$3,178
outlier · 6.2×

Other procedures at this hospital

Browse this hospital's 3,586 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
             
C2616 HCPCS Brachytx, Non-str,yttrium-90 1 1 — — $112,974.43 $112,974.43 $112,974.43 2026-04-01
81408 HCPCS Mopath Procedure Level 9 1 1 — — $75,883.65 $75,883.65 $75,883.65 2026-04-01
77371 HCPCS Srs Multisource 1 1 — — $70,826.85 $70,826.85 $70,826.85 2026-04-01
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 1 1 — — $70,401.49 $70,401.49 $70,401.49 2026-04-01
81554 HCPCS Pulm Ds Ipf Mrna 190 Gen Alg 1 1 — — $53,831.25 $53,831.25 $53,831.25 2026-04-01
638 MS_DRG Diabetes With Cc 1 1 — — $50,324.96 $50,324.96 $50,324.96 2026-04-01
0265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 1 1 — — $49,242.87 $49,242.87 $49,242.87 2026-04-01
0212U OTHER Rare Ds Gen DNA Alys Proband 1 1 — — $49,242.87 $49,242.87 $49,242.87 2026-04-01
0214U OTHER Rare Ds Xom DNA Alys Proband 1 1 — — $49,242.87 $49,242.87 $49,242.87 2026-04-01
0267U OTHER Rare Do Id Opt Gen Mapg&seq 1 1 — — $49,242.87 $49,242.87 $49,242.87 2026-04-01
81315 HCPCS Pml/raralpha Com Breakpoints 1 1 — — $47,361.71 $47,361.71 $47,361.71 2026-04-01
81316 HCPCS Pml/raralpha 1 Breakpoint 1 1 — — $47,322.71 $47,322.71 $47,322.71 2026-04-01
0153U OTHER Onc Breast Mrna 101 Genes 1 1 — — $40,714.91 $40,714.91 $40,714.91 2026-04-01
81518 HCPCS Onc Brst Mrna 11 Genes 1 1 — — $40,714.91 $40,714.91 $40,714.91 2026-04-01
81407 HCPCS Mopath Procedure Level 8 1 1 — — $40,066.26 $40,066.26 $40,066.26 2026-04-01
81542 HCPCS Onc Prostate Mrna 22 Cnt Gen 1 1 — — $37,906.99 $37,906.99 $37,906.99 2026-04-01
81523 HCPCS Onc Brst Mrna 70 Cnt 31 Gene 1 1 — — $37,906.99 $37,906.99 $37,906.99 2026-04-01
81522 HCPCS Onc Breast Mrna 12 Genes 1 1 — — $37,906.99 $37,906.99 $37,906.99 2026-04-01
0120U OTHER Onc B Cll Lymphm Mrna 58 Gen 1 1 — — $37,906.99 $37,906.99 $37,906.99 2026-04-01
0133U OTHER Hered Prst8 Ca Rltd Do 11 1 1 — — $37,906.99 $37,906.99 $37,906.99 2026-04-01
0090U OTHER Onc Cutan Mlnma Mrna 23 Gene 1 1 — — $36,703.13 $36,703.13 $36,703.13 2026-04-01
0258U OTHER Ai Psor Mrna 50-100 Gen Alg 1 1 — — $36,703.13 $36,703.13 $36,703.13 2026-04-01
0089U OTHER Onc Mlnma Prame & Linc00518 1 1 — — $36,703.13 $36,703.13 $36,703.13 2026-04-01
0262U OTHER Onc Sld Tum Rt-pcr 7 Gen 1 1 — — $36,703.13 $36,703.13 $36,703.13 2026-04-01
0242U OTHER Trgt Gen Seq Alys Pnl 55-74 1 1 — — $36,250.00 $36,250.00 $36,250.00 2026-04-01
81546 HCPCS Onc Thyr Mrna 10,196 Gen Alg 1 1 — — $35,235.00 $35,235.00 $35,235.00 2026-04-01
0204U OTHER Onc Thyr Mrna Xprsn Alys 593 1 1 — — $35,235.00 $35,235.00 $35,235.00 2026-04-01
0287U OTHER Onc Thyr Dna&mrna 112 Genes 1 1 — — $35,235.00 $35,235.00 $35,235.00 2026-04-01
0208U OTHER Onc Mtc Mrna Xprsn Alys 108 1 1 — — $35,235.00 $35,235.00 $35,235.00 2026-04-01
81223 HCPCS Cftr Gene Full Sequence 1 1 — — $35,126.47 $35,126.47 $35,126.47 2026-04-01
0250U OTHER Onc Sld Org Neo DNA 505 Gene 1 1 — — $34,256.25 $34,256.25 $34,256.25 2026-04-01
0118U OTHER Trnsplj Don-drv Cll-fr DNA 1 1 — — $31,711.50 $31,711.50 $31,711.50 2026-04-01
0088U OTHER Trnsplj Kdn Algrft Rej 1494 1 1 — — $31,711.50 $31,711.50 $31,711.50 2026-04-01
0018M OTHER Trnsplj Rnl Meas Cd154+cll 1 1 — — $31,711.50 $31,711.50 $31,711.50 2026-04-01
81560 HCPCS Trnsplj Pd Lvr&bwl Cd154+cll 1 1 — — $31,711.50 $31,711.50 $31,711.50 2026-04-01
0087U OTHER Crd Hrt Trnspl Mrna 1283 Gen 1 1 — — $31,711.50 $31,711.50 $31,711.50 2026-04-01
0245U OTHER Onc Thyr Mut Alys 10 Gen&37 1 1 — — $29,382.95 $29,382.95 $29,382.95 2026-04-01
0092U OTHER Onc Lng 3 Prtn Bmrk Plsm Alg 1 1 — — $28,099.91 $28,099.91 $28,099.91 2026-04-01
81541 HCPCS Onc Prostate Mrna 46 Genes 1 1 — — $28,079.25 $28,079.25 $28,079.25 2026-04-01
81521 HCPCS Onc Breast Mrna 70 Genes 1 1 — — $28,079.25 $28,079.25 $28,079.25 2026-04-01
0215U OTHER Rare Ds Xom DNA Alys Ea Comp 1 1 — — $26,523.62 $26,523.62 $26,523.62 2026-04-01
0213U OTHER Rare Ds Gen DNA Alys Ea Comp 1 1 — — $26,523.62 $26,523.62 $26,523.62 2026-04-01
81443 HCPCS Genetic Tstg Severe Inh Cond 1 1 — — $25,740.47 $25,740.47 $25,740.47 2026-04-01
0398T OTHER Mrgfus Strtctc Les Abltj 1 1 — — $22,545.91 $22,545.91 $22,545.91 2026-04-01
81520 HCPCS Onc Breast Mrna 58 Genes 1 1 — — $22,467.90 $22,467.90 $22,467.90 2026-04-01
0131U OTHER Hered Brst Ca Rltd Do Pnl 13 1 1 — — $22,050.59 $22,050.59 $22,050.59 2026-04-01
0132U OTHER Hered Ova Ca Rltd Do Pnl 17 1 1 — — $22,050.59 $22,050.59 $22,050.59 2026-04-01
0138U OTHER Brca1 Brca2 Mrna Seq Alys 1 1 — — $22,050.59 $22,050.59 $22,050.59 2026-04-01
0129U OTHER Hered Brst Ca Rltd Do Panel 1 1 — — $22,050.59 $22,050.59 $22,050.59 2026-04-01
81442 HCPCS Noonan Spectrum Disorders 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81432 HCPCS Hrdtry Brst Ca-rlatd Dsordrs 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81434 HCPCS Hereditary Retinal Disorders 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81525 HCPCS Oncology Colon Mrna 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81595 HCPCS Cardiology Hrt Trnspl Mrna 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81437 HCPCS Heredtry Nurondcrn Tum Dsrdr 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81412 HCPCS Ashkenazi Jewish Assoc Dis 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81292 HCPCS Mlh1 Gene Full Seq 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81438 HCPCS Heredtry Nurondcrn Tum Dsrdr 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81433 HCPCS Hrdtry Brst Ca-rlatd Dsordrs 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81493 HCPCS Cor Artery Disease Mrna 1 1 — — $19,676.07 $19,676.07 $19,676.07 2026-04-01
81228 HCPCS Cytogen Micrarray Copy Nmbr 1 1 — — $19,642.28 $19,642.28 $19,642.28 2026-04-01
81229 HCPCS Cytogen M Array Copy No&snp 1 1 — — $19,642.28 $19,642.28 $19,642.28 2026-04-01
0136U OTHER Atm Mrna Seq Alys 1 1 — — $19,575.00 $19,575.00 $19,575.00 2026-04-01
81317 HCPCS Pms2 Gene Full Seq Analysis 1 1 — — $19,559.20 $19,559.20 $19,559.20 2026-04-01
81406 HCPCS Mopath Procedure Level 7 1 1 — — $19,559.20 $19,559.20 $19,559.20 2026-04-01
81295 HCPCS Msh2 Gene Full Seq 1 1 — — $19,559.20 $19,559.20 $19,559.20 2026-04-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 1 — — $18,957.12 $18,957.12 $18,957.12 2026-04-01
75726 HCPCS Artery X-rays Abdomen 1 1 — — $18,636.14 $18,636.14 $18,636.14 2026-04-01
75705 HCPCS Artery X-rays Spine 1 1 — — $18,636.14 $18,636.14 $18,636.14 2026-04-01
5493 OTHER Level 3 Intraocular Procedures 1 1 — — $18,516.38 $18,516.38 $18,516.38 2026-04-01
81162 HCPCS Brca1&2 Seq & Full Dup/del 1 1 — — $18,022.49 $18,022.49 $18,022.49 2026-04-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 1 1 — — $15,408.00 $15,408.00 $15,408.00 2026-04-01
5673 OTHER Level 3 Pathology 1 1 — — $14,062.45 $14,062.45 $14,062.45 2026-04-01
0071T OTHER US Leiomyomata Ablate <200 1 1 — — $13,798.35 $13,798.35 $13,798.35 2026-04-01
0072T OTHER US Leiomyomata Ablate >200 1 1 — — $13,798.35 $13,798.35 $13,798.35 2026-04-01
81415 HCPCS Exome Sequence Analysis 1 1 — — $13,340.00 $13,340.00 $13,340.00 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 2 2 — — $12,692.96 $13,611.00 $13,151.98 2026-04-01
78459 HCPCS Heart Muscle Imaging (pet) 1 1 — — $12,404.04 $12,404.04 $12,404.04 2026-04-01
81298 HCPCS Msh6 Gene Full Seq 1 1 — — $12,201.46 $12,201.46 $12,201.46 2026-04-01
81405 HCPCS Mopath Procedure Level 6 1 1 — — $12,201.46 $12,201.46 $12,201.46 2026-04-01
0156U OTHER Copy Number Sequence Alys 1 1 — — $12,194.50 $12,194.50 $12,194.50 2026-04-01
78813 HCPCS PET Image Full Body 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78816 HCPCS PET Image W/ct Full Body 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78812 HCPCS PET Image Skull-thigh 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78815 HCPCS PET Image W/ct Skull-thigh 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78492 HCPCS Heart Image (pet) Multiple 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78491 HCPCS Heart Image (pet) Single 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78609 HCPCS Brain Imaging (pet) 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78608 HCPCS Brain Imaging (pet) 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78811 HCPCS PET Image Ltd Area 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
78814 HCPCS PET Image W/ct Lmtd 1 1 — — $12,107.43 $12,107.43 $12,107.43 2026-04-01
72295 HCPCS X-ray Of Lower Spine Disk 1 1 — — $11,664.63 $11,664.63 $11,664.63 2026-04-01
72285 HCPCS Discography Cerv/thor Spine 1 1 — — $11,664.63 $11,664.63 $11,664.63 2026-04-01
81349 HCPCS Cytog Alys Chrml Abnr Lw-ps 1 1 — — $11,353.50 $11,353.50 $11,353.50 2026-04-01
77301 HCPCS Radiotherapy Dose Plan Imrt 1 1 — — $11,095.04 $11,095.04 $11,095.04 2026-04-01
9042 OTHER Glucagon Hydrochloride 1 1 — — $11,079.94 $11,079.94 $11,079.94 2026-04-01
76145 HCPCS Med Physic Dos Eval Rad Exps 1 1 — — $10,519.75 $10,519.75 $10,519.75 2026-04-01
88040 HCPCS Forensic Autopsy (necropsy) 1 1 — — $10,121.07 $10,121.07 $10,121.07 2026-04-01
5045 OTHER Trauma Response With Critical Care 1 1 — — $9,971.52 $9,971.52 $9,971.52 2026-04-01
77373 HCPCS Sbrt Delivery 1 1 — — $9,804.25 $9,804.25 $9,804.25 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 — — $9,519.72 $9,519.72 $9,519.72 2026-04-01
81445 HCPCS Targeted Genomic Seq Analys 1 1 — — $9,280.00 $9,280.00 $9,280.00 2026-04-01
197 MS_DRG Interstitial Lung Disease With Cc 1 1 — — $9,074.00 $9,074.00 $9,074.00 2026-04-01
81371 HCPCS Hla I & Ii Type Verify Lr 1 1 — — $9,061.49 $9,061.49 $9,061.49 2026-04-01
75840 HCPCS Vein X-ray Adrenal Gland 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75833 HCPCS Vein X-ray Kidneys 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75731 HCPCS Artery X-rays Adrenal Gland 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75605 HCPCS Contrast Exam Thoracic Aorta 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75831 HCPCS Vein X-ray Kidney 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75600 HCPCS Contrast Exam Thoracic Aorta 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75743 HCPCS Artery X-rays Lungs 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75891 HCPCS Vein X-ray Liver 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75885 HCPCS Vein X-ray Liver W/hemodynam 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75630 HCPCS X-ray Aorta Leg Arteries 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75842 HCPCS Vein X-ray Adrenal Glands 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75889 HCPCS Vein X-ray Liver W/hemodynam 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75825 HCPCS Vein X-ray Trunk 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75741 HCPCS Artery X-rays Lung 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75733 HCPCS Artery X-rays Adrenals 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75716 HCPCS Artery X-rays Arms/legs 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75710 HCPCS Artery X-rays Arm/leg 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75625 HCPCS Contrast Exam Abdominl Aorta 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75893 HCPCS Venous Sampling By Catheter 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75810 HCPCS Vein X-ray Spleen/liver 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
75736 HCPCS Artery X-rays Pelvis 1 1 — — $8,961.47 $8,961.47 $8,961.47 2026-04-01
81185 HCPCS Cacna1a Gene Full Gene Seq 1 1 — — $8,896.40 $8,896.40 $8,896.40 2026-04-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 1 1 — — $8,678.34 $8,678.34 $8,678.34 2026-04-01
0231U OTHER Cacna1a Full Gene Analysis 1 1 — — $8,282.84 $8,282.84 $8,282.84 2026-04-01
0272U OTHER Hem Genetic Bld Do 51 Genes 1 1 — — $8,282.84 $8,282.84 $8,282.84 2026-04-01
0157U OTHER Apc Mrna Seq Alys 1 1 — — $8,199.75 $8,199.75 $8,199.75 2026-04-01
0168U OTHER Ftl Aneuploidy DNA Seq Alys 1 1 — — $7,781.06 $7,781.06 $7,781.06 2026-04-01
77522 HCPCS Proton Trmt Simple W/comp 1 1 — — $7,774.68 $7,774.68 $7,774.68 2026-04-01
77525 HCPCS Proton Treatment Complex 1 1 — — $7,774.68 $7,774.68 $7,774.68 2026-04-01
77523 HCPCS Proton Trmt Intermediate 1 1 — — $7,774.68 $7,774.68 $7,774.68 2026-04-01
77372 HCPCS Srs Linear Based 1 1 — — $7,721.32 $7,721.32 $7,721.32 2026-04-01
0016M OTHER Onc Bladder Mrna 209 Gen Alg 1 1 — — $7,438.50 $7,438.50 $7,438.50 2026-04-01
0171U OTHER Trgt Gen Seq Alys Pnl DNA 23 1 1 — — $7,433.93 $7,433.93 $7,433.93 2026-04-01
0161U OTHER Pms2 Mrna Seq Alys 1 1 — — $7,432.56 $7,432.56 $7,432.56 2026-04-01
77386 HCPCS Ntsty Modul Rad Tx Dlvr Cplx 1 1 — — $7,427.84 $7,427.84 $7,427.84 2026-04-01
G0219 HCPCS PET Img Wholbod Melano Nonco 1 1 — — $7,367.33 $7,367.33 $7,367.33 2026-04-01
81378 HCPCS Hla I & Ii Typing Hr 1 1 — — $7,331.78 $7,331.78 $7,331.78 2026-04-01
81302 HCPCS Mecp2 Gene Full Seq 1 1 — — $7,298.00 $7,298.00 $7,298.00 2026-04-01
81404 HCPCS Mopath Procedure Level 5 1 1 — — $7,298.00 $7,298.00 $7,298.00 2026-04-01
81370 HCPCS Hla I & Ii Typing Lr 1 1 — — $7,116.17 $7,116.17 $7,116.17 2026-04-01
0158U OTHER Mlh1 Mrna Seq Alys 1 1 — — $7,100.14 $7,100.14 $7,100.14 2026-04-01
0162U OTHER Hered Colon Ca Trgt Mrna Pnl 1 1 — — $7,100.14 $7,100.14 $7,100.14 2026-04-01
0130U OTHER Hered Colon Ca Do Mrna Pnl 1 1 — — $7,067.59 $7,067.59 $7,067.59 2026-04-01
0101U OTHER Hered Colon Ca Do 15 Genes 1 1 — — $7,067.59 $7,067.59 $7,067.59 2026-04-01
81379 HCPCS Hla I Typing Complete Hr 1 1 — — $6,960.36 $6,960.36 $6,960.36 2026-04-01
77610 HCPCS Hyperthermia Treatment 1 1 — — $6,924.04 $6,924.04 $6,924.04 2026-04-01
77778 HCPCS Apply Interstit Radiat Compl 1 1 — — $6,905.48 $6,905.48 $6,905.48 2026-04-01
5672 OTHER Level 2 Pathology 2 2 — — $1,054.00 $12,700.82 $6,877.41 2026-04-01
95708 HCPCS EEG Wo Vid Ea 12-26hr Unmntr 1 1 — — $6,876.41 $6,876.41 $6,876.41 2026-04-01
95705 HCPCS EEG Without Vid 2-12 Hr Unmntr 1 1 — — $6,876.41 $6,876.41 $6,876.41 2026-04-01
0160U OTHER Msh6 Mrna Seq Alys 1 1 — — $6,747.43 $6,747.43 $6,747.43 2026-04-01
81450 HCPCS Targeted Genomic Seq Analys 1 1 — — $6,670.00 $6,670.00 $6,670.00 2026-04-01
81372 HCPCS Hla I Typing Complete Lr 1 1 — — $6,588.95 $6,588.95 $6,588.95 2026-04-01
77615 HCPCS Hyperthermia Treatment 1 1 — — $6,575.97 $6,575.97 $6,575.97 2026-04-01
81351 HCPCS Tp53 Gene Full Gene Sequence 1 1 — — $6,282.13 $6,282.13 $6,282.13 2026-04-01
0763 OTHER Inj, Bupivacaine Liposome 3 3 — — $5,540.65 $8,008.88 $6,188.31 2026-04-01
81164 HCPCS Brca1&2 Gen Ful Dup/del Alys 1 1 — — $6,141.69 $6,141.69 $6,141.69 2026-04-01
0270U OTHER Hem Cgen Coagj Do 20 Genes 1 1 — — $5,872.50 $5,872.50 $5,872.50 2026-04-01
0235U OTHER Pten Full Gene Analysis 1 1 — — $5,872.50 $5,872.50 $5,872.50 2026-04-01
81374 HCPCS Hla I Typing 1 Antigen Lr 1 1 — — $5,848.79 $5,848.79 $5,848.79 2026-04-01
81413 HCPCS Car Ion Chnnlpath Inc 10 Gns 1 1 — — $5,816.89 $5,816.89 $5,816.89 2026-04-01
81439 HCPCS Inherited Cardmypthy 5 Gns 1 1 — — $5,816.89 $5,816.89 $5,816.89 2026-04-01
81422 HCPCS Fetal Chrmoml Microdeltj 1 1 — — $5,816.89 $5,816.89 $5,816.89 2026-04-01
81414 HCPCS Car Ion Chnnlpath Inc 2 Gns 1 1 — — $5,816.89 $5,816.89 $5,816.89 2026-04-01
80418 HCPCS Pituitary Evaluation Panel 1 1 — — $5,718.37 $5,718.37 $5,718.37 2026-04-01
81375 HCPCS Hla Ii Typing Ag Equiv Lr 1 1 — — $5,713.73 $5,713.73 $5,713.73 2026-04-01
81376 HCPCS Hla Ii Typing 1 Locus Lr 1 1 — — $5,547.56 $5,547.56 $5,547.56 2026-04-01
81377 HCPCS Hla Ii Type 1 Ag Equiv Lr 1 1 — — $5,529.36 $5,529.36 $5,529.36 2026-04-01
81382 HCPCS Hla Ii Typing 1 Loc Hr 1 1 — — $5,503.40 $5,503.40 $5,503.40 2026-04-01
81380 HCPCS Hla I Typing 1 Locus Hr 1 1 — — $5,373.48 $5,373.48 $5,373.48 2026-04-01
0134U OTHER Hered Pan Ca Mrna Pnl 18 Gen 1 1 — — $5,303.74 $5,303.74 $5,303.74 2026-04-01
0103U OTHER Hered Ova Ca Pnl 24 Genes 1 1 — — $5,303.74 $5,303.74 $5,303.74 2026-04-01
0135U OTHER Hered GYN Ca Mrna Pnl 12 Gen 1 1 — — $5,303.74 $5,303.74 $5,303.74 2026-04-01
0102U OTHER Hered Brst Ca Rltd Do 17 Gen 1 1 — — $5,303.74 $5,303.74 $5,303.74 2026-04-01
81448 HCPCS Hrdtry Perph Neurphy Panel 1 1 — — $5,235.23 $5,235.23 $5,235.23 2026-04-01
0234U OTHER Mecp2 Full Gene Analysis 1 1 — — $5,166.50 $5,166.50 $5,166.50 2026-04-01
81175 HCPCS Asxl1 Full Gene Sequence 1 1 — — $5,125.90 $5,125.90 $5,125.90 2026-04-01
81194 HCPCS Ntrk Translocation Analysis 1 1 — — $5,072.68 $5,072.68 $5,072.68 2026-04-01
0151U OTHER Nfct Bct/vir Resp Nfctj 33 1 1 — — $5,036.14 $5,036.14 $5,036.14 2026-04-01
0099U OTHER Respir Pathogen 20 Targets 1 1 — — $5,036.14 $5,036.14 $5,036.14 2026-04-01
0100U OTHER Respir Pathogen 21 Targets 1 1 — — $5,036.14 $5,036.14 $5,036.14 2026-04-01
0098U OTHER Respir Pathogen 14 Targets 1 1 — — $5,036.14 $5,036.14 $5,036.14 2026-04-01
0097U OTHER Gi Pathogen 22 Targets 1 1 — — $5,036.14 $5,036.14 $5,036.14 2026-04-01
91113 HCPCS Gi Trc Img Intral Colon I&r 1 1 — — $5,007.07 $5,007.07 $5,007.07 2026-04-01
95726 HCPCS EEG Phy/qhp>84 Hr W/veeg 1 1 — — $4,929.93 $4,929.93 $4,929.93 2026-04-01
0166U OTHER Liver Ds 10 Biochem Asy Srm 1 1 — — $4,927.03 $4,927.03 $4,927.03 2026-04-01
0014M OTHER Liver Ds Alys 3 Bmrk Srm Alg 1 1 — — $4,927.03 $4,927.03 $4,927.03 2026-04-01
81163 HCPCS Brca1&2 Gene Full Seq Alys 1 1 — — $4,919.85 $4,919.85 $4,919.85 2026-04-01
81373 HCPCS Hla I Typing 1 Locus Lr 1 1 — — $4,903.39 $4,903.39 $4,903.39 2026-04-01
78832 HCPCS Rp Loclzj Tum Spect W/ct 2 1 1 — — $4,837.91 $4,837.91 $4,837.91 2026-04-01
87903 HCPCS Phenotype DNA HIV W/culture 1 1 — — $4,821.11 $4,821.11 $4,821.11 2026-04-01
81263 HCPCS Igh Vari Regional Mutation 1 1 — — $4,776.16 $4,776.16 $4,776.16 2026-04-01
77605 HCPCS Hyperthermia Treatment 1 1 — — $4,773.55 $4,773.55 $4,773.55 2026-04-01
88027 HCPCS Autopsy (necropsy) Complete 1 1 — — $4,672.26 $4,672.26 $4,672.26 2026-04-01
81403 HCPCS Mopath Procedure Level 4 1 1 — — $4,651.53 $4,651.53 $4,651.53 2026-04-01
77772 HCPCS Hdr Rdncl Ntrstl/icav Brchtx 1 1 — — $4,627.10 $4,627.10 $4,627.10 2026-04-01
77435 HCPCS Sbrt Management 1 1 — — $4,586.57 $4,586.57 $4,586.57 2026-04-01
5312 OTHER Level 2 Lower Gi Procedures 8 6 — — $3,127.84 $10,178.63 $4,550.75 2026-04-01
5025 OTHER Level 5 Type A Ed Visits 11 7 — — $2,029.67 $6,808.99 $4,477.01 2026-04-01
70555 HCPCS Fmri Brain By Phys/psych 1 1 — — $4,462.05 $4,462.05 $4,462.05 2026-04-01
81383 HCPCS Hla Ii Typing 1 Allele Hr 1 1 — — $4,433.38 $4,433.38 $4,433.38 2026-04-01
81381 HCPCS Hla I Typing 1 Allele Hr 1 1 — — $4,415.18 $4,415.18 $4,415.18 2026-04-01
95710 HCPCS EEG Without Vid Ea 12-26hr Cont 1 1 — — $4,402.93 $4,402.93 $4,402.93 2026-04-01
95709 HCPCS EEG Without Vid Ea 12-26hr Intmt 1 1 — — $4,402.93 $4,402.93 $4,402.93 2026-04-01
81551 HCPCS Onc Prostate 3 Genes 1 1 — — $4,365.23 $4,365.23 $4,365.23 2026-04-01
81539 HCPCS Oncology Prostate Prob Score 1 1 — — $4,365.23 $4,365.23 $4,365.23 2026-04-01
81249 HCPCS G6pd Full Gene Sequence 1 1 — — $4,350.00 $4,350.00 $4,350.00 2026-04-01
81238 HCPCS F9 Full Gene Sequence 1 1 — — $4,350.00 $4,350.00 $4,350.00 2026-04-01
81259 HCPCS Hba1/hba2 Full Gene Sequence 1 1 — — $4,350.00 $4,350.00 $4,350.00 2026-04-01
5041 OTHER Critical Care 5 4 — — $2,878.05 $18,198.96 $4,301.51 2026-04-01
74485 HCPCS X-ray Guide Gu Dilation 1 1 — — $4,294.33 $4,294.33 $4,294.33 2026-04-01
88025 HCPCS Autopsy (necropsy) Complete 1 1 — — $4,280.11 $4,280.11 $4,280.11 2026-04-01
0651T OTHER Mag Ctrld Capsule Endoscopy 1 1 — — $4,227.34 $4,227.34 $4,227.34 2026-04-01
81535 HCPCS Oncology Gynecologic 1 1 — — $4,201.09 $4,201.09 $4,201.09 2026-04-01
87483 HCPCS Cns DNA Amp Probe Type 12-25 1 1 — — $4,144.97 $4,144.97 $4,144.97 2026-04-01
87507 HCPCS Iadna-dna/rna Probe Tq 12-25 1 1 — — $4,112.06 $4,112.06 $4,112.06 2026-04-01
81210 HCPCS Braf Gene 1 1 — — $4,087.91 $4,087.91 $4,087.91 2026-04-01
81221 HCPCS Cftr Gene Known Fam Variants 1 1 — — $4,069.72 $4,069.72 $4,069.72 2026-04-01
88028 HCPCS Autopsy (necropsy) Complete 1 1 — — $4,046.37 $4,046.37 $4,046.37 2026-04-01
88029 HCPCS Autopsy (necropsy) Complete 1 1 — — $4,046.37 $4,046.37 $4,046.37 2026-04-01
0159U OTHER Msh2 Mrna Seq Alys 1 1 — — $4,012.66 $4,012.66 $4,012.66 2026-04-01
81416 HCPCS Exome Sequence Analysis 1 1 — — $4,002.00 $4,002.00 $4,002.00 2026-04-01
0331T OTHER Heart Symp Image Plnr 1 1 — — $3,991.89 $3,991.89 $3,991.89 2026-04-01
0332T OTHER Heart Symp Image Plnr Spect 1 1 — — $3,991.89 $3,991.89 $3,991.89 2026-04-01
95724 HCPCS EEG Phy/qhp>60<84 Hr W/veeg 1 1 — — $3,901.44 $3,901.44 $3,901.44 2026-04-01
88020 HCPCS Autopsy (necropsy) Complete 1 1 — — $3,893.11 $3,893.11 $3,893.11 2026-04-01
88007 HCPCS Autopsy (necropsy) Gross 1 1 — — $3,893.11 $3,893.11 $3,893.11 2026-04-01
5442 OTHER Level 2 Nerve Injections 2 2 — — $1,041.40 $6,668.57 $3,854.99 2026-04-01
95716 HCPCS Veeg Ea 12-26hr Cont Mntr 1 1 — — $3,841.92 $3,841.92 $3,841.92 2026-04-01
95715 HCPCS Veeg Ea 12-26hr Intmt Mntr 1 1 — — $3,841.92 $3,841.92 $3,841.92 2026-04-01
95706 HCPCS EEG Wo Vid 2-12hr Intmt Mntr 1 1 — — $3,841.92 $3,841.92 $3,841.92 2026-04-01
95712 HCPCS Veeg 2-12 Hr Intmt Mntr 1 1 — — $3,841.92 $3,841.92 $3,841.92 2026-04-01
95707 HCPCS EEG Without Vid 2-12hr Cont Mntr 1 1 — — $3,841.92 $3,841.92 $3,841.92 2026-04-01
81303 HCPCS Mecp2 Gene Known Variant 1 1 — — $3,726.94 $3,726.94 $3,726.94 2026-04-01
81299 HCPCS Msh6 Gene Known Variants 1 1 — — $3,726.94 $3,726.94 $3,726.94 2026-04-01
81296 HCPCS Msh2 Gene Known Variants 1 1 — — $3,726.94 $3,726.94 $3,726.94 2026-04-01
81318 HCPCS Pms2 Known Familial Variants 1 1 — — $3,726.94 $3,726.94 $3,726.94 2026-04-01
0002U OTHER Onc Clrct 3 Ur Metab Alg Plp 1 1 — — $3,715.12 $3,715.12 $3,715.12 2026-04-01
77385 HCPCS Ntsty Modul Rad Tx Dlvr Smpl 1 1 — — $3,713.96 $3,713.96 $3,713.96 2026-04-01
0163U OTHER Onc Clrct Scr 3 Prtn Alg 1 1 — — $3,689.31 $3,689.31 $3,689.31 2026-04-01
0069U OTHER Onc Clrct Microrna Mir-31-3p 1 1 — — $3,689.31 $3,689.31 $3,689.31 2026-04-01
81528 HCPCS Oncology Colorectal Scr 1 1 — — $3,689.31 $3,689.31 $3,689.31 2026-04-01
77520 HCPCS Proton Trmt Simple Without Comp 1 1 — — $3,681.19 $3,681.19 $3,681.19 2026-04-01
5311 OTHER Level 1 Lower Gi Procedures 5 5 — — $3,492.92 $5,005.50 $3,672.68 2026-04-01
78831 HCPCS Rp Loclzj Tum Spect 2 Areas 1 1 — — $3,664.33 $3,664.33 $3,664.33 2026-04-01
81293 HCPCS Mlh1 Gene Known Variants 1 1 — — $3,607.46 $3,607.46 $3,607.46 2026-04-01
0108U OTHER Gi Barrett Esoph 9 Prtn Bmrk 1 1 — — $3,603.98 $3,603.98 $3,603.98 2026-04-01
0114U OTHER Gi Barretts Esoph Vim&ccna1 1 1 — — $3,603.98 $3,603.98 $3,603.98 2026-04-01
G0327 HCPCS Colon Ca Scrn;bld-bsd Biomrk 1 1 — — $3,572.22 $3,572.22 $3,572.22 2026-04-01
95725 HCPCS EEG Phy/qhp>84 Hr Without Vid 1 1 — — $3,544.45 $3,544.45 $3,544.45 2026-04-01
86834 HCPCS Hla Class I Semiquant Panel 1 1 — — $3,527.78 $3,527.78 $3,527.78 2026-04-01
88005 HCPCS Autopsy (necropsy) Gross 1 1 — — $3,503.56 $3,503.56 $3,503.56 2026-04-01
81294 HCPCS Mlh1 Gene Dup/delete Variant 1 1 — — $3,433.46 $3,433.46 $3,433.46 2026-04-01
81319 HCPCS Pms2 Gene Dup/delet Variants 1 1 — — $3,433.46 $3,433.46 $3,433.46 2026-04-01
81297 HCPCS Msh2 Gene Dup/delete Variant 1 1 — — $3,433.46 $3,433.46 $3,433.46 2026-04-01
G0416 HCPCS Prostate Biopsy, Any Mthd 1 1 — — $3,371.11 $3,371.11 $3,371.11 2026-04-01
88036 HCPCS Limited Autopsy 1 1 — — $3,350.30 $3,350.30 $3,350.30 2026-04-01
0535T OTHER Cont Rec Mvmt Do Reprt Cnfig 1 1 — — $3,348.99 $3,348.99 $3,348.99 2026-04-01
0536T OTHER Cont Rec Mvmt Do Dl W/i&r 1 1 — — $3,348.99 $3,348.99 $3,348.99 2026-04-01
0533T OTHER Cont Rec Mvmt Do 6-10 Days 1 1 — — $3,348.99 $3,348.99 $3,348.99 2026-04-01
0534T OTHER Cont Rec Mvmt Do Setup&train 1 1 — — $3,348.99 $3,348.99 $3,348.99 2026-04-01
81402 HCPCS Mopath Procedure Level 3 1 1 — — $3,311.37 $3,311.37 $3,311.37 2026-04-01
88014 HCPCS Autopsy (necropsy) Gross 1 1 — — $3,267.21 $3,267.21 $3,267.21 2026-04-01
88012 HCPCS Autopsy (necropsy) Gross 1 1 — — $3,267.21 $3,267.21 $3,267.21 2026-04-01
80412 HCPCS Crh Stimulation Panel 1 1 — — $3,252.13 $3,252.13 $3,252.13 2026-04-01
95714 HCPCS Veeg Ea 12-26 Hr Unmntr 1 1 — — $3,238.43 $3,238.43 $3,238.43 2026-04-01
95711 HCPCS Veeg 2-12 Hr Unmonitored 1 1 — — $3,238.43 $3,238.43 $3,238.43 2026-04-01
95700 HCPCS EEG Cont Rec W/vid EEG Tech 1 1 — — $3,191.74 $3,191.74 $3,191.74 2026-04-01
86835 HCPCS Hla Class Ii Semiquant Panel 1 1 — — $3,186.30 $3,186.30 $3,186.30 2026-04-01
81173 HCPCS Ar Gene Full Gene Sequence 1 1 — — $3,167.96 $3,167.96 $3,167.96 2026-04-01
81336 HCPCS Smn1 Gene Full Gene Sequence 1 1 — — $3,167.96 $3,167.96 $3,167.96 2026-04-01
81166 HCPCS Brca1 Gene Full Dup/del Alys 1 1 — — $3,167.96 $3,167.96 $3,167.96 2026-04-01
95713 HCPCS Veeg 2-12 Hr Cont Mntr 1 1 — — $3,161.94 $3,161.94 $3,161.94 2026-04-01
77290 HCPCS Set Radiation Therapy Field 1 1 — — $3,127.00 $3,127.00 $3,127.00 2026-04-01
95723 HCPCS EEG Phy/qhp>60<84 Hr Without Vid 1 1 — — $3,115.18 $3,115.18 $3,115.18 2026-04-01
88016 HCPCS Autopsy (necropsy) Gross 1 1 — — $3,114.02 $3,114.02 $3,114.02 2026-04-01
88000 HCPCS Autopsy (necropsy) Gross 1 1 — — $3,114.02 $3,114.02 $3,114.02 2026-04-01
81320 HCPCS Plcg2 Gene Common Variants 1 1 — — $3,062.91 $3,062.91 $3,062.91 2026-04-01
81306 HCPCS Nudt15 Gene Common Variants 1 1 — — $3,062.91 $3,062.91 $3,062.91 2026-04-01
95722 HCPCS EEG Phy/qhp>36<60 Hr W/veeg 1 1 — — $3,059.94 $3,059.94 $3,059.94 2026-04-01
77432 HCPCS Stereotactic Radiation Trmt 1 1 — — $3,038.69 $3,038.69 $3,038.69 2026-04-01
87633 HCPCS Resp Virus 12-25 Targets 1 1 — — $3,021.66 $3,021.66 $3,021.66 2026-04-01
0202U OTHER Nfct Ds 22 Trgt Sars-cov-2 1 1 — — $3,021.66 $3,021.66 $3,021.66 2026-04-01
81353 HCPCS Tp53 Gene Known Famil Vrnt 1 1 — — $3,014.55 $3,014.55 $3,014.55 2026-04-01
81165 HCPCS Brca1 Gene Full Seq Alys 1 1 — — $2,973.81 $2,973.81 $2,973.81 2026-04-01
81236 HCPCS Ezh2 Gene Full Gene Sequence 1 1 — — $2,973.81 $2,973.81 $2,973.81 2026-04-01
81167 HCPCS Brca2 Gene Full Dup/del Alys 1 1 — — $2,973.81 $2,973.81 $2,973.81 2026-04-01
0091U OTHER Onc Clrct Scr Whl Bld Alg 1 1 — — $2,968.95 $2,968.95 $2,968.95 2026-04-01
81332 HCPCS Serpina1 Gene 1 1 — — $2,955.54 $2,955.54 $2,955.54 2026-04-01
0236U OTHER Smn1&smn2 Full Gene Analysis 1 1 — — $2,949.45 $2,949.45 $2,949.45 2026-04-01
0230U OTHER Ar Full Sequence Analysis 1 1 — — $2,949.45 $2,949.45 $2,949.45 2026-04-01
5301 OTHER Level 1 Upper Gi Procedures 5 3 — — $1,502.72 $5,772.32 $2,935.56 2026-04-01
77771 HCPCS Hdr Rdncl Ntrstl/icav Brchtx 1 1 — — $2,931.83 $2,931.83 $2,931.83 2026-04-01
81206 HCPCS Bcr/abl1 Gene Major Bp 1 1 — — $2,908.85 $2,908.85 $2,908.85 2026-04-01
G6015 HCPCS Radiation Tx Delivery Imrt 1 1 — — $2,906.24 $2,906.24 $2,906.24 2026-04-01
G6016 HCPCS Delivery Comp Imrt 1 1 — — $2,898.41 $2,898.41 $2,898.41 2026-04-01
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