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

MADISON VALLEY MEDICAL CENTER

Ennis, MT · CCN 271329 · Rates published

Your selected procedure

You selected 93350 (CPT)

STRESS TTE ONLY

This hospital’s price: $303 across 1 payer

Source: https://mrfs.hyvehealthcare.com/MadisonValleyHospital/810236460_madison-valley-hospital-inc_standardcharges.csv · observed 2026-07-20

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

19,577 distinct procedures filed
12 distinct payers
106,436 rate rows
2026-07-20 last MRF observed
Data quality

49,695 of 106,436 rate rows are consumer-grade (46.7%)

56,741 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 52,410
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,301
per-diem day rate — not a per-procedure price 1,534
professional (physician) fee — not the facility price 426
placeholder amount (≤ $0.02) — excluded from medians 62
exceeds 10× this hospital's gross charge — excluded from medians 8
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.mvmedcenter.org/patient-information/billing-financial-services/export
Found on page https://www.mvmedcenter.org/patient-information/billing-financial-services
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-09

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
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 $3,082,480.00 $3,082,480.00 $3,082,480.00 nat. median
$813,967
outlier · 3.8×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $2,350,598.30 $2,350,598.30 $2,350,598.30 nat. median
$646,415
outlier · 3.6×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $2,266,125.22 $2,266,125.22 $2,266,125.22 nat. median
$739,258
outlier · 3.1×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $2,248,804.97 $2,248,804.97 $2,248,804.97 nat. median
$640,950
outlier · 3.5×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $2,232,326.90 $2,232,326.90 $2,232,326.90 nat. median
$622,450
outlier · 3.6×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $2,128,768.96 $2,128,768.96 $2,128,768.96 nat. median
$608,239
outlier · 3.5×
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $1,957,800.81 $1,957,800.81 $1,957,800.81 nat. median
$591,721
outlier · 3.3×
Q0480
HCPCS 		Dme Pos 1 $280,854.93 $280,854.93 $280,854.93 nat. median
$111,503
outlier · 2.5×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 1 $257,099.16 $257,099.16 $257,099.16 nat. median
$68,423
outlier · 3.8×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $237,702.58 $237,702.58 $237,702.58 nat. median
$96,983
outlier · 2.5×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $217,616.43 $217,616.43 $217,616.43 nat. median
$65,720
outlier · 3.3×
J9226
HCPCS 		Supprelin La Implant 1 $172,741.36 $172,741.36 $172,741.36 nat. median
$55,159
outlier · 3.1×
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 1 $172,004.28 $172,004.28 $172,004.28 nat. median
$70,178
outlier · 2.5×
L7181
HCPCS 		Dme Pos 1 $124,697.85 $124,697.85 $124,697.85 nat. median
$50,516
outlier · 2.5×
J9266
HCPCS 		Pegaspargase Injection 1 $113,696.24 $113,696.24 $113,696.24 nat. median
$33,233
outlier · 3.4×
L7180
HCPCS 		Dme Pos 1 $109,277.48 $109,277.48 $109,277.48 nat. median
$46,980
outlier · 2.3×
L2006
HCPCS 		Dme Pos 1 $100,680.13 $100,680.13 $100,680.13 nat. median
$39,921
outlier · 2.5×
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 1 $87,425.33 $87,425.33 $87,425.33 nat. median
$35,670
outlier · 2.5×
L5856
HCPCS 		Dme Pos 1 $74,657.18 $74,657.18 $74,657.18 nat. median
$30,017
outlier · 2.5×
L6880
HCPCS 		Dme Pos 1 $74,505.73 $74,505.73 $74,505.73 nat. median
$30,019
outlier · 2.5×
L6700
HCPCS 		Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 1 $73,775.48 $73,775.48 $73,775.48 nat. median
$30,378
outlier · 2.4×
L8614
HCPCS 		Dme Pos 1 $59,420.95 $59,420.95 $59,420.95 nat. median
$22,351
outlier · 2.7×
Q0483
HCPCS 		Dme Pos 1 $58,467.93 $58,467.93 $58,467.93 nat. median
$23,335
outlier · 2.5×
L5858
HCPCS 		Dme Pos 1 $57,839.85 $57,839.85 $57,839.85 nat. median
$23,237
outlier · 2.5×
L6975
HCPCS 		Dme Pos 1 $57,766.48 $57,766.48 $57,766.48 nat. median
$22,826
outlier · 2.5×
L5973
HCPCS 		Dme Pos 1 $54,278.98 $54,278.98 $54,278.98 nat. median
$21,726
outlier · 2.5×
L6970
HCPCS 		Dme Pos 1 $53,916.80 $53,916.80 $53,916.80 nat. median
$20,980
outlier · 2.6×
L6965
HCPCS 		Dme Pos 1 $53,259.28 $53,259.28 $53,259.28 nat. median
$19,981
outlier · 2.7×
Q0489
HCPCS 		Dme Pos 1 $50,688.55 $50,688.55 $50,688.55 nat. median
$20,275
outlier · 2.5×
L6960
HCPCS 		Dme Pos 1 $49,157.35 $49,157.35 $49,157.35 nat. median
$16,650
outlier · 3.0×
L6955
HCPCS 		Dme Pos 1 $48,739.40 $48,739.40 $48,739.40 nat. median
$15,745
outlier · 3.1×
81416
CPT 		Exome Sequence Analysis 1 $48,000.00 $48,000.00 $48,000.00 nat. median
$12,000
outlier · 4.0×
Q0481
HCPCS 		Dme Pos 1 $45,312.73 $45,312.73 $45,312.73 nat. median
$15,219
outlier · 3.0×
L5859
HCPCS 		Dme Pos 1 $45,155.05 $45,155.05 $45,155.05 nat. median
$18,321
outlier · 2.5×
L6945
HCPCS 		Dme Pos 1 $41,653.83 $41,653.83 $41,653.83 nat. median
$13,912
outlier · 3.0×
E0766
HCPCS 		Dme Pos 1 $40,961.83 $40,961.83 $40,961.83 nat. median
$16,786
outlier · 2.4×
L6950
HCPCS 		Dme Pos 1 $40,696.33 $40,696.33 $40,696.33 nat. median
$12,858
outlier · 3.2×
Q0479
HCPCS 		Dme Pos 1 $37,358.15 $37,358.15 $37,358.15 nat. median
$15,271
outlier · 2.4×
L7191
HCPCS 		Dme Pos 1 $36,276.05 $36,276.05 $36,276.05 nat. median
$13,827
outlier · 2.6×
L6940
HCPCS 		Dme Pos 1 $35,804.05 $35,804.05 $35,804.05 nat. median
$12,193
outlier · 2.9×
L7186
HCPCS 		Dme Pos 1 $35,406.00 $35,406.00 $35,406.00 nat. median
$13,302
outlier · 2.7×
315U
OTHER 		Onc Cutan Sq Cll Ca Mrna 40 1 $34,000.00 $34,000.00 $34,000.00 nat. median
$9,988
outlier · 3.4×
211U
OTHER 		Onc Pan-tum Dna&rna Gnrj Seq 1 $33,820.00 $33,820.00 $33,820.00 nat. median
$9,300
outlier · 3.6×
81552
CPT 		Onc Uveal Mlnma Mrna 15 Gene 1 $31,104.00 $31,104.00 $31,104.00 nat. median
$8,087
outlier · 3.8×
426U
OTHER 		Genome Ultra-rapid Seq Alys 1 $30,328.80 $30,328.80 $30,328.80 nat. median
$11,373
outlier · 2.7×
94U
OTHER 		Genome Rapid Sequence Alys 1 $30,328.80 $30,328.80 $30,328.80 nat. median
$9,730
outlier · 3.1×
L5991
HCPCS 		Dme Pos 1 $29,387.60 $29,387.60 $29,387.60 nat. median
$12,042
outlier · 2.4×
Q0224
HCPCS 		Injection, Pemivibart, For The Pre-exposure Prophylaxis Only, For Certain Adults… 1 $28,956.00 $28,956.00 $28,956.00 nat. median
$6,979
outlier · 4.1×
81529
CPT 		Onc Cutan Mlnma Mrna 31 Gene 1 $28,772.00 $28,772.00 $28,772.00 nat. median
$7,553
outlier · 3.8×
L6935
HCPCS 		Dme Pos 1 $28,008.43 $28,008.43 $28,008.43 nat. median
$11,147
outlier · 2.5×

Other procedures at this hospital

Browse this hospital's 19,577 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 1 1 — — $3,082,480.00 $3,082,480.00 $3,082,480.00 2026-07-20
Q2056 HCPCS Ciltacabtagene Car-pos T 1 1 — — $2,350,598.30 $2,350,598.30 $2,350,598.30 2026-07-20
Q2042 HCPCS Tisagenlecleucel Car-pos T 1 1 — — $2,266,125.22 $2,266,125.22 $2,266,125.22 2026-07-20
Q2054 HCPCS Lisocabtagene Mara Car Pos T 1 1 — — $2,248,804.97 $2,248,804.97 $2,248,804.97 2026-07-20
Q2055 HCPCS Idecabtagene Vicleucel Car 1 1 — — $2,232,326.90 $2,232,326.90 $2,232,326.90 2026-07-20
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 1 1 — — $2,128,768.96 $2,128,768.96 $2,128,768.96 2026-07-20
Q2053 HCPCS Brexucabtagene Car Pos T 1 1 — — $1,957,800.81 $1,957,800.81 $1,957,800.81 2026-07-20
Q0480 HCPCS Dme Pos 1 1 — — $280,854.93 $280,854.93 $280,854.93 2026-07-20
J9029 HCPCS Instill Adstiladrin, Tx Dose 1 1 — — $257,099.16 $257,099.16 $257,099.16 2026-07-20
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $237,702.58 $237,702.58 $237,702.58 2026-07-20
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — — $217,616.43 $217,616.43 $217,616.43 2026-07-20
J9226 HCPCS Supprelin La Implant 1 1 — — $172,741.36 $172,741.36 $172,741.36 2026-07-20
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $172,004.28 $172,004.28 $172,004.28 2026-07-20
L7181 HCPCS Dme Pos 1 1 — — $124,697.85 $124,697.85 $124,697.85 2026-07-20
J9266 HCPCS Pegaspargase Injection 1 1 — — $113,696.24 $113,696.24 $113,696.24 2026-07-20
L7180 HCPCS Dme Pos 1 1 — — $109,277.48 $109,277.48 $109,277.48 2026-07-20
L2006 HCPCS Dme Pos 1 1 — — $100,680.13 $100,680.13 $100,680.13 2026-07-20
L8701 HCPCS Ewh S/d Uprt Micro Sensor 1 1 — — $87,425.33 $87,425.33 $87,425.33 2026-07-20
L5856 HCPCS Dme Pos 1 1 — — $74,657.18 $74,657.18 $74,657.18 2026-07-20
L6880 HCPCS Dme Pos 1 1 — — $74,505.73 $74,505.73 $74,505.73 2026-07-20
L6700 HCPCS Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 1 1 — — $73,775.48 $73,775.48 $73,775.48 2026-07-20
L8614 HCPCS Dme Pos 1 1 — — $59,420.95 $59,420.95 $59,420.95 2026-07-20
Q0483 HCPCS Dme Pos 1 1 — — $58,467.93 $58,467.93 $58,467.93 2026-07-20
L5858 HCPCS Dme Pos 1 1 — — $57,839.85 $57,839.85 $57,839.85 2026-07-20
L6975 HCPCS Dme Pos 1 1 — — $57,766.48 $57,766.48 $57,766.48 2026-07-20
L5973 HCPCS Dme Pos 1 1 — — $54,278.98 $54,278.98 $54,278.98 2026-07-20
L6970 HCPCS Dme Pos 1 1 — — $53,916.80 $53,916.80 $53,916.80 2026-07-20
L6965 HCPCS Dme Pos 1 1 — — $53,259.28 $53,259.28 $53,259.28 2026-07-20
Q0489 HCPCS Dme Pos 1 1 — — $50,688.55 $50,688.55 $50,688.55 2026-07-20
L6960 HCPCS Dme Pos 1 1 — — $49,157.35 $49,157.35 $49,157.35 2026-07-20
L6955 HCPCS Dme Pos 1 1 — — $48,739.40 $48,739.40 $48,739.40 2026-07-20
81416 CPT Exome Sequence Analysis 1 1 — — $48,000.00 $48,000.00 $48,000.00 2026-07-20
Q0481 HCPCS Dme Pos 1 1 — — $45,312.73 $45,312.73 $45,312.73 2026-07-20
L5859 HCPCS Dme Pos 1 1 — — $45,155.05 $45,155.05 $45,155.05 2026-07-20
L6945 HCPCS Dme Pos 1 1 — — $41,653.83 $41,653.83 $41,653.83 2026-07-20
E0766 HCPCS Dme Pos 1 1 — — $40,961.83 $40,961.83 $40,961.83 2026-07-20
L6950 HCPCS Dme Pos 1 1 — — $40,696.33 $40,696.33 $40,696.33 2026-07-20
Q0479 HCPCS Dme Pos 1 1 — — $37,358.15 $37,358.15 $37,358.15 2026-07-20
L7191 HCPCS Dme Pos 1 1 — — $36,276.05 $36,276.05 $36,276.05 2026-07-20
L6940 HCPCS Dme Pos 1 1 — — $35,804.05 $35,804.05 $35,804.05 2026-07-20
L7186 HCPCS Dme Pos 1 1 — — $35,406.00 $35,406.00 $35,406.00 2026-07-20
315U OTHER Onc Cutan Sq Cll Ca Mrna 40 1 1 — — $34,000.00 $34,000.00 $34,000.00 2026-07-20
211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 1 1 — — $33,820.00 $33,820.00 $33,820.00 2026-07-20
81552 CPT Onc Uveal Mlnma Mrna 15 Gene 1 1 — — $31,104.00 $31,104.00 $31,104.00 2026-07-20
94U OTHER Genome Rapid Sequence Alys 1 1 — — $30,328.80 $30,328.80 $30,328.80 2026-07-20
426U OTHER Genome Ultra-rapid Seq Alys 1 1 — — $30,328.80 $30,328.80 $30,328.80 2026-07-20
L5991 HCPCS Dme Pos 1 1 — — $29,387.60 $29,387.60 $29,387.60 2026-07-20
Q0224 HCPCS Injection, Pemivibart, For The Pre-exposure Prophylaxis Only, For Certain Adults… 1 1 — — $28,956.00 $28,956.00 $28,956.00 2026-07-20
81529 CPT Onc Cutan Mlnma Mrna 31 Gene 1 1 — — $28,772.00 $28,772.00 $28,772.00 2026-07-20
L6935 HCPCS Dme Pos 1 1 — — $28,008.43 $28,008.43 $28,008.43 2026-07-20
E0786 HCPCS Dme Pos 1 1 — — $27,528.18 $27,528.18 $27,528.18 2026-07-20
267U OTHER Rare Do Id Opt Gen Mapg&seq 1 1 — — $26,957.32 $26,957.32 $26,957.32 2026-07-20
L6925 HCPCS Dme Pos 1 1 — — $26,779.00 $26,779.00 $26,779.00 2026-07-20
L5857 HCPCS Dme Pos 1 1 — — $26,457.23 $26,457.23 $26,457.23 2026-07-20
L8679 HCPCS Dme Pos 1 1 — — $26,302.23 $26,302.23 $26,302.23 2026-07-20
L6930 HCPCS Dme Pos 1 1 — — $26,087.78 $26,087.78 $26,087.78 2026-07-20
L8619 HCPCS Dme Pos 1 1 — — $25,509.00 $25,509.00 $25,509.00 2026-07-20
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml IV Soln 10 Ml [mvho] 5 4 $33,796.08 $33,796.08 $237.30 $30,416.47 $25,347.06 2026-07-20
J0600 HCPCS Edetate Calcium Disodium Inj 1 1 — — $24,838.71 $24,838.71 $24,838.71 2026-07-20
L6920 HCPCS Dme Pos 1 1 — — $24,828.98 $24,828.98 $24,828.98 2026-07-20
E0783 HCPCS Dme Pos 1 1 — — $24,793.33 $24,793.33 $24,793.33 2026-07-20
L7190 HCPCS Dme Pos 1 1 — — $24,716.08 $24,716.08 $24,716.08 2026-07-20
E2510 HCPCS Dme Pos 1 1 — — $24,114.23 $24,114.23 $24,114.23 2026-07-20
L5987 HCPCS Dme Pos 1 1 — — $22,387.98 $22,387.98 $22,387.98 2026-07-20
265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 1 1 — — $21,903.20 $21,903.20 $21,903.20 2026-07-20
212U OTHER Rare Ds Gen DNA Alys Proband 1 1 — — $21,900.80 $21,900.80 $21,900.80 2026-07-20
295U OTHER Onc Brst Dux Carc 7 Proteins 1 1 — — $21,740.00 $21,740.00 $21,740.00 2026-07-20
81554 CPT Pulm Ds Ipf Mrna 190 Gen Alg 1 1 — — $21,638.40 $21,638.40 $21,638.40 2026-07-20
L8627 HCPCS Dme Pos 1 1 — — $21,609.43 $21,609.43 $21,609.43 2026-07-20
J7504 HCPCS Lymphocyte Immune Globulin 1 1 — — $21,231.72 $21,231.72 $21,231.72 2026-07-20
335U OTHER Rare Ds Whl Gen Seq Feta 1 1 — — $20,898.40 $20,898.40 $20,898.40 2026-07-20
214U OTHER Rare Ds Xom DNA Alys Proband 1 1 — — $20,898.40 $20,898.40 $20,898.40 2026-07-20
L5280 HCPCS Dme Pos 1 1 — — $20,668.63 $20,668.63 $20,668.63 2026-07-20
J1162 HCPCS Digoxin Immune Fab (ovine) 1 1 — — $20,667.96 $20,667.96 $20,667.96 2026-07-20
L8609 HCPCS Dme Pos 1 1 — — $20,317.50 $20,317.50 $20,317.50 2026-07-20
567U OTHER Rare Diseases (constitutional/heritable Disorders), Whole-genome Sequence Analys… 1 1 — — $20,124.80 $20,124.80 $20,124.80 2026-07-20
532U OTHER Rare Diseases (constitutional Disease/hereditary Disorders), Rapid Whole Genome … 1 1 — — $20,124.80 $20,124.80 $20,124.80 2026-07-20
81425 CPT Genome Sequence Analysis 1 1 — — $20,124.80 $20,124.80 $20,124.80 2026-07-20
J0225 HCPCS Inj, Vutrisiran, 1 Mg 1 1 — — $20,038.23 $20,038.23 $20,038.23 2026-07-20
326U OTHER Trgt Gen Seq Alys Pnl 83+ 1 1 — — $20,000.00 $20,000.00 $20,000.00 2026-07-20
242U OTHER Trgt Gen Seq Alys Pnl 55-74 1 1 — — $20,000.00 $20,000.00 $20,000.00 2026-07-20
L5250 HCPCS Dme Pos 1 1 — — $19,947.25 $19,947.25 $19,947.25 2026-07-20
L5615 HCPCS Dme Pos 1 1 — — $19,845.88 $19,845.88 $19,845.88 2026-07-20
108U OTHER Gi Barrett Esoph 9 Prtn Bmrk 1 1 — — $19,800.00 $19,800.00 $19,800.00 2026-07-20
J0841 HCPCS Inj Crotalidae IM F(ab')2 Eq 1 1 — — $19,700.64 $19,700.64 $19,700.64 2026-07-20
L7185 HCPCS Dme Pos 1 1 — — $19,535.38 $19,535.38 $19,535.38 2026-07-20
J0480 HCPCS Basiliximab 1 1 — — $19,124.29 $19,124.29 $19,124.29 2026-07-20
81415 CPT Exome Sequence Analysis 1 1 — — $19,120.00 $19,120.00 $19,120.00 2026-07-20
36U OTHER Xome Tum & Nml Spec Seq Alys 1 1 — — $19,120.00 $19,120.00 $19,120.00 2026-07-20
L7170 HCPCS Dme Pos 1 1 — — $18,829.60 $18,829.60 $18,829.60 2026-07-20
L8682 HCPCS Dme Pos 1 1 — — $18,792.55 $18,792.55 $18,792.55 2026-07-20
L5827 HCPCS Endoskeletal Knee-shin System, Single Axis, Electromechanical Swing And Stance P… 1 1 — — $18,643.73 $18,643.73 $18,643.73 2026-07-20
L5341 HCPCS Dme Pos 1 1 — — $18,566.15 $18,566.15 $18,566.15 2026-07-20
L5270 HCPCS Dme Pos 1 1 — — $18,195.53 $18,195.53 $18,195.53 2026-07-20
473U OTHER Oncology (solid Tumor), Next-generation Sequencing (ngs) Of DNA From Formalin-fi… 1 1 — — $18,000.00 $18,000.00 $18,000.00 2026-07-20
L7008 HCPCS Dme Pos 1 1 — — $17,723.18 $17,723.18 $17,723.18 2026-07-20
L5331 HCPCS Dme Pos 1 1 — — $17,146.48 $17,146.48 $17,146.48 2026-07-20
J9200 HCPCS Floxuridine Injection 1 1 — — $17,019.69 $17,019.69 $17,019.69 2026-07-20
300U OTHER Onc Pan Tum Whl Gen Seq&opt 1 1 — — $16,732.52 $16,732.52 $16,732.52 2026-07-20
J0801 HCPCS Inj. Acthar Gel To 40 Units 1 1 — — $16,690.12 $16,690.12 $16,690.12 2026-07-20
L8683 HCPCS Dme Pos 1 1 — — $16,541.78 $16,541.78 $16,541.78 2026-07-20
425U OTHER Genom Rpd Seq Alys Ea Cmprtr 1 1 — — $16,377.56 $16,377.56 $16,377.56 2026-07-20
L6570 HCPCS Dme Pos 1 1 — — $16,102.03 $16,102.03 $16,102.03 2026-07-20
E0652 HCPCS Dme Pos 1 1 — — $16,055.03 $16,055.03 $16,055.03 2026-07-20
L5702 HCPCS Dme Pos 1 1 — — $15,976.80 $15,976.80 $15,976.80 2026-07-20
E0694 HCPCS Dme Pos 1 1 — — $15,773.95 $15,773.95 $15,773.95 2026-07-20
L5961 HCPCS Dme Pos 1 1 — — $15,693.13 $15,693.13 $15,693.13 2026-07-20
L5230 HCPCS Dme Pos 1 1 — — $15,524.13 $15,524.13 $15,524.13 2026-07-20
560U OTHER Oncology (minimal Residual Disease [mrd]), Genomic Sequence Analysis, Cell-free … 1 1 — — $15,513.80 $15,513.80 $15,513.80 2026-07-20
306U OTHER Onc Mrd Nxt-gnrj Alys 1st 1 1 — — $15,513.80 $15,513.80 $15,513.80 2026-07-20
81519 CPT Oncology Breast Mrna 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
288U OTHER Onc Lung Mrna Quan Pcr 11&3 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
81518 CPT Onc Brst Mrna 11 Genes 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
45U OTHER Onc Brst Dux Carc Is 12 Gene 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
81523 CPT Onc Brst Mrna 70 Cnt 31 Gene 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
81522 CPT Onc Breast Mrna 12 Genes 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
47U OTHER Onc Prst8 Mrna 17 Gene Alg 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
497U OTHER Oncology (prostate), Mrna Gene-expression Profiling By Real-time Rt-pcr Of 6 Gen… 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
81541 CPT Onc Prostate Mrna 46 Genes 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
81521 CPT Onc Breast Mrna 70 Genes 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
81542 CPT Onc Prostate Mrna 22 Cnt Gen 1 1 — — $15,492.00 $15,492.00 $15,492.00 2026-07-20
L6550 HCPCS Dme Pos 1 1 — — $15,475.53 $15,475.53 $15,475.53 2026-07-20
L5980 HCPCS Dme Pos 1 1 — — $15,130.50 $15,130.50 $15,130.50 2026-07-20
J2507 HCPCS Pegloticase Injection 1 1 — — $15,075.24 $15,075.24 $15,075.24 2026-07-20
J3316 HCPCS Inj., Triptorelin Xr 3.75 Mg 1 1 — — $15,059.94 $15,059.94 $15,059.94 2026-07-20
81540 CPT Oncology Tum Unknown Origin 1 1 — — $15,000.00 $15,000.00 $15,000.00 2026-07-20
L8690 HCPCS Dme Pos 1 1 — — $14,834.68 $14,834.68 $14,834.68 2026-07-20
258U OTHER Ai Psor Mrna 50-100 Gen Alg 1 1 — — $14,700.00 $14,700.00 $14,700.00 2026-07-20
19U OTHER Onc RNA Tiss Predict Alg 1 1 — — $14,700.00 $14,700.00 $14,700.00 2026-07-20
485U OTHER Oncology (solid Tumor), Cell-free DNA And RNA By Next-generation Sequencing, Int… 1 1 — — $14,597.92 $14,597.92 $14,597.92 2026-07-20
L6026 HCPCS Dme Pos 1 1 — — $14,578.00 $14,578.00 $14,578.00 2026-07-20
26U OTHER Onc Thyr Dna&mrna 112 Genes 1 1 — — $14,400.00 $14,400.00 $14,400.00 2026-07-20
391U OTHER Onc Sld Tum Dna&rna 437 Gen 1 1 — — $14,400.00 $14,400.00 $14,400.00 2026-07-20
313U OTHER Onc Pncrs Dna&mrna Seq 74 1 1 — — $14,400.00 $14,400.00 $14,400.00 2026-07-20
81546 CPT Onc Thyr Mrna 10,196 Gen Alg 1 1 — — $14,400.00 $14,400.00 $14,400.00 2026-07-20
362U OTHER Onc Pap Thyr Ca RNA 82&10 1 1 — — $14,400.00 $14,400.00 $14,400.00 2026-07-20
287U OTHER Onc Thyr Dna&mrna 112 Genes 1 1 — — $14,400.00 $14,400.00 $14,400.00 2026-07-20
340U OTHER Onc Pan Ca Alys Mrd Plasma 1 1 — — $14,360.00 $14,360.00 $14,360.00 2026-07-20
J0802 HCPCS Inj. (ani), Up To 40 Units 1 1 — — $14,206.96 $14,206.96 $14,206.96 2026-07-20
Q0482 HCPCS Dme Pos 1 1 — — $14,192.80 $14,192.80 $14,192.80 2026-07-20
80U OTHER Onc Lng 5 Clin Rsk Factr Alg 1 1 — — $14,080.00 $14,080.00 $14,080.00 2026-07-20
334U OTHER Onc Sld Orgn Tgsa DNA 84/+ 1 1 — — $14,000.00 $14,000.00 $14,000.00 2026-07-20
244U OTHER Onc Solid Orgn DNA 257 Genes 1 1 — — $14,000.00 $14,000.00 $14,000.00 2026-07-20
239U OTHER Trgt Gen Seq Alys Pnl 311+ 1 1 — — $14,000.00 $14,000.00 $14,000.00 2026-07-20
37U OTHER Trgt Gen Seq DNA 324 Genes 1 1 — — $14,000.00 $14,000.00 $14,000.00 2026-07-20
388U OTHER Onc Nonsm Cll Lng Ca 37 Gen 1 1 — — $14,000.00 $14,000.00 $14,000.00 2026-07-20
L6350 HCPCS Dme Pos 1 1 — — $13,999.45 $13,999.45 $13,999.45 2026-07-20
16M OTHER Onc Bladder Mrna 219 Gen Alg 1 1 — — $13,958.52 $13,958.52 $13,958.52 2026-07-20
E0747 HCPCS Dme Pos 1 1 — — $13,952.35 $13,952.35 $13,952.35 2026-07-20
E0748 HCPCS Dme Pos 1 1 — — $13,862.00 $13,862.00 $13,862.00 2026-07-20
329U OTHER Onc Neo Xome&trns Seq Alys 1 1 — — $13,751.92 $13,751.92 $13,751.92 2026-07-20
L5600 HCPCS Dme Pos 1 1 — — $13,608.93 $13,608.93 $13,608.93 2026-07-20
81440 CPT Mitochondrial Gene 1 1 — — $13,296.00 $13,296.00 $13,296.00 2026-07-20
J2427 HCPCS Paliperidone 819 Mg/2.63 Ml Sus [mvho] 6 5 $18,784.98 $18,784.98 $51.96 $16,906.48 $13,211.48 2026-07-20
379U OTHER Tgsap Sl Or Neo Dna523&rna55 1 1 — — $13,154.04 $13,154.04 $13,154.04 2026-07-20
81464 CPT So Gsap Cll Fr Mcrstl Ins 1 1 — — $13,154.04 $13,154.04 $13,154.04 2026-07-20
539U OTHER Oncology (solid Tumor), Cell-free Circulating Tumor DNA (ctDNA), 152 Genes, Next… 1 1 — — $13,154.04 $13,154.04 $13,154.04 2026-07-20
L5782 HCPCS Dme Pos 1 1 — — $13,127.50 $13,127.50 $13,127.50 2026-07-20
L5160 HCPCS Dme Pos 1 1 — — $13,110.13 $13,110.13 $13,110.13 2026-07-20
Q0495 HCPCS Dme Pos 1 1 — — $13,025.68 $13,025.68 $13,025.68 2026-07-20
E0782 HCPCS Dme Pos 1 1 — — $13,002.30 $13,002.30 $13,002.30 2026-07-20
55U OTHER Card Hrt Trnspl 96 DNA Seq 1 1 — — $12,960.00 $12,960.00 $12,960.00 2026-07-20
81595 CPT Cardiology Hrt Trnspl Mrna 1 1 — — $12,960.00 $12,960.00 $12,960.00 2026-07-20
81558 CPT Transplantation Medicine (allograft Rejection, Kidney), Mrna, Gene Expression Pr… 1 1 — — $12,960.00 $12,960.00 $12,960.00 2026-07-20
J1932 HCPCS Lanreotide 120 Mg/0.5 Ml Sol [mvho] 9 4 $16,609.19 $16,609.19 $152.87 $15,490.44 $12,908.70 2026-07-20
262U OTHER Onc Sld Tum Rt-pcr 7 Gen 1 1 — — $12,800.00 $12,800.00 $12,800.00 2026-07-20
266U OTHER Unxpl Cnst Hrtbl Do Gn Xprsn 1 1 — — $12,800.00 $12,800.00 $12,800.00 2026-07-20
L2005 HCPCS Dme Pos 1 1 — — $12,753.43 $12,753.43 $12,753.43 2026-07-20
E2508 HCPCS Dme Pos 1 1 — — $12,742.88 $12,742.88 $12,742.88 2026-07-20
L6881 HCPCS Dme Pos 1 1 — — $12,723.13 $12,723.13 $12,723.13 2026-07-20
88U OTHER Trnsplj Kdn Algrft Rej 1494 1 1 — — $12,637.68 $12,637.68 $12,637.68 2026-07-20
253U OTHER Rprdtve Med RNA Gen Prfl 238 1 1 — — $12,637.68 $12,637.68 $12,637.68 2026-07-20
87U OTHER Crd Hrt Trnspl Mrna 1283 Gen 1 1 — — $12,637.68 $12,637.68 $12,637.68 2026-07-20
153U OTHER Onc Breast Mrna 101 Genes 1 1 — — $12,637.68 $12,637.68 $12,637.68 2026-07-20
L6450 HCPCS Dme Pos 1 1 — — $12,581.53 $12,581.53 $12,581.53 2026-07-20
81525 CPT Oncology Colon Mrna 1 1 — — $12,464.00 $12,464.00 $12,464.00 2026-07-20
L5781 HCPCS Dme Pos 1 1 — — $12,452.30 $12,452.30 $12,452.30 2026-07-20
L6500 HCPCS Dme Pos 1 1 — — $12,372.40 $12,372.40 $12,372.40 2026-07-20
L5595 HCPCS Dme Pos 1 1 — — $12,323.58 $12,323.58 $12,323.58 2026-07-20
L6300 HCPCS Dme Pos 1 1 — — $12,184.03 $12,184.03 $12,184.03 2026-07-20
525U OTHER Oncology, Spheroid Cell Culture, 11-drug Panel (carboplatin, Docetaxel, Doxorubi… 1 1 — — $12,135.44 $12,135.44 $12,135.44 2026-07-20
435U OTHER Onc Chemo Rx Cytox Csc 14 Rx 1 1 — — $12,135.44 $12,135.44 $12,135.44 2026-07-20
511U OTHER Oncology (solid Tumor), Tumor Cell Culture In 3d Microenvironment, 36 Or More Dr… 1 1 — — $12,135.44 $12,135.44 $12,135.44 2026-07-20
248U OTHER Onc Brn Sphrd Cll 12 Rx Pnl 1 1 — — $12,135.44 $12,135.44 $12,135.44 2026-07-20
172U OTHER Onc Sld Tum Alys Brca1 Brca2 1 1 — — $12,120.00 $12,120.00 $12,120.00 2026-07-20
L8044 HCPCS Dme Pos 1 1 — — $12,072.38 $12,072.38 $12,072.38 2026-07-20
18U OTHER Onc Thyr 10 Microrna Seq Alg 1 1 — — $12,008.36 $12,008.36 $12,008.36 2026-07-20
538U OTHER Oncology (solid Tumor), Next-generation Targeted Sequencing Analysis, Formalin-f… 1 1 — — $11,958.20 $11,958.20 $11,958.20 2026-07-20
81459 CPT So Neo Gsap Dna/dna&rna 1 1 — — $11,958.20 $11,958.20 $11,958.20 2026-07-20
543U OTHER Oncology (solid Tumor), Next-generation Sequencing Of DNA From Formalin-fixed Pa… 1 1 — — $11,958.20 $11,958.20 $11,958.20 2026-07-20
L5840 HCPCS Dme Pos 1 1 — — $11,944.25 $11,944.25 $11,944.25 2026-07-20
L5150 HCPCS Dme Pos 1 1 — — $11,904.65 $11,904.65 $11,904.65 2026-07-20
L7259 HCPCS Dme Pos 1 1 — — $11,802.35 $11,802.35 $11,802.35 2026-07-20
L6624 HCPCS Dme Pos 1 1 — — $11,720.73 $11,720.73 $11,720.73 2026-07-20
J3380 HCPCS Vedolizumab 300 Mg IV Inj [mvho] 5 4 $15,599.84 $15,599.84 $85.48 $14,039.85 $11,699.88 2026-07-20
48U OTHER Onc Sld Org Neo DNA 468 Gene 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
487U OTHER Oncology (solid Tumor), Cell-free Circulating Dna, Targeted Genomic Sequence Ana… 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
81456 CPT So/hl 51/>gsap RNA Alys 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
81455 CPT So/hl 51/>gsap Dna/dna&rna 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
444U OTHER Oncology (solid Organ Neoplasia), Targeted Genomic Sequence Analysis Panel Of 36… 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
298U OTHER Onc Pan Tum Whl Trns Seq RNA 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
409U OTHER Gi Baret Esph DNA Mthyln Aly 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
297U OTHER Onc Pan Tum Whl Gen Seq DNA 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
530U OTHER Oncology (pan-solid Tumor), ctDNA, Utilizing Plasma, Next-generation Sequencing … 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
250U OTHER Onc Sld Org Neo DNA 505 Gene 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
571U OTHER Oncology (solid Tumor), DNA (80 Genes) And RNA (10 Genes), By Next-generation Se… 1 1 — — $11,678.40 $11,678.40 $11,678.40 2026-07-20
50U OTHER Trgt Gen Seq DNA 194 Genes 1 1 — — $11,666.40 $11,666.40 $11,666.40 2026-07-20
L5105 HCPCS Dme Pos 1 1 — — $11,663.80 $11,663.80 $11,663.80 2026-07-20
E0194 HCPCS Dme Pos 1 1 — — $11,594.68 $11,594.68 $11,594.68 2026-07-20
L5701 HCPCS Dme Pos 1 1 — — $11,591.83 $11,591.83 $11,591.83 2026-07-20
L5814 HCPCS Dme Pos 1 1 — — $11,558.15 $11,558.15 $11,558.15 2026-07-20
E0760 HCPCS Dme Pos 1 1 — — $11,519.05 $11,519.05 $11,519.05 2026-07-20
81538 CPT Oncology Lung 1 1 — — $11,484.00 $11,484.00 $11,484.00 2026-07-20
L6205 HCPCS Dme Pos 1 1 — — $11,430.25 $11,430.25 $11,430.25 2026-07-20
L8035 HCPCS Dme Pos 1 1 — — $11,401.73 $11,401.73 $11,401.73 2026-07-20
J9286 HCPCS Inj Glofitamab Gxbm, 2.5 Mg 1 1 — — $11,374.35 $11,374.35 $11,374.35 2026-07-20
417U OTHER Crd C Hrt Ds 9 Gen 12 Vrnts 1 1 — — $11,370.12 $11,370.12 $11,370.12 2026-07-20
Q0484 HCPCS Dme Pos 1 1 — — $11,354.13 $11,354.13 $11,354.13 2026-07-20
L5968 HCPCS Dme Pos 1 1 — — $11,309.30 $11,309.30 $11,309.30 2026-07-20
J9229 HCPCS Inj Inotuzumab Ozogam 0.1 Mg 1 1 — — $11,267.07 $11,267.07 $11,267.07 2026-07-20
E2513 HCPCS Accessory For Speech Generating Device, Electromyographic Sensor 1 1 — — $11,227.50 $11,227.50 $11,227.50 2026-07-20
L5312 HCPCS Dme Pos 1 1 — — $11,162.30 $11,162.30 $11,162.30 2026-07-20
L7009 HCPCS Dme Pos 1 1 — — $11,027.88 $11,027.88 $11,027.88 2026-07-20
118U OTHER Trnsplj Don-drv Cll-fr DNA 1 1 — — $11,013.00 $11,013.00 $11,013.00 2026-07-20
493U OTHER Transplantation Medicine, Quantification Of Donor-derived Cell-free DNA (cfDNA) … 1 1 — — $11,013.00 $11,013.00 $11,013.00 2026-07-20
540U OTHER Transplantation Medicine, Quantification Of Donor-derived Cell-free DNA Using Ne… 1 1 — — $11,013.00 $11,013.00 $11,013.00 2026-07-20
L3904 HCPCS Dme Pos 1 1 — — $10,976.53 $10,976.53 $10,976.53 2026-07-20
L8043 HCPCS Dme Pos 1 1 — — $10,904.13 $10,904.13 $10,904.13 2026-07-20
213U OTHER Rare Ds Gen DNA Alys Ea Comp 1 1 — — $10,839.80 $10,839.80 $10,839.80 2026-07-20
81426 CPT Genome Sequence Analysis 1 1 — — $10,839.80 $10,839.80 $10,839.80 2026-07-20
320U OTHER Neph RNA Psttrnspl Perph Bld 1 1 — — $10,600.00 $10,600.00 $10,600.00 2026-07-20
319U OTHER Neph RNA Pretrnspl Perph Bld 1 1 — — $10,600.00 $10,600.00 $10,600.00 2026-07-20
L7007 HCPCS Dme Pos 1 1 — — $10,531.80 $10,531.80 $10,531.80 2026-07-20
J9217 HCPCS Leuprolide 22.5 Mg/3 Months IM Kit [mvho] 13 4 $14,016.65 $14,016.65 $683.11 $18,922.75 $10,512.48 2026-07-20
K0808 HCPCS Dme Pos 1 1 — — $10,474.05 $10,474.05 $10,474.05 2026-07-20
L5930 HCPCS Dme Pos 1 1 — — $10,442.53 $10,442.53 $10,442.53 2026-07-20
L5060 HCPCS Dme Pos 1 1 — — $10,327.95 $10,327.95 $10,327.95 2026-07-20
336U OTHER Rare Ds Whl Gen Seq Bld/slv 1 1 — — $10,298.60 $10,298.60 $10,298.60 2026-07-20
215U OTHER Rare Ds Xom DNA Alys Ea Comp 1 1 — — $10,298.60 $10,298.60 $10,298.60 2026-07-20
J9268 HCPCS Pentostatin Injection 1 1 — — $10,148.38 $10,148.38 $10,148.38 2026-07-20
L6648 HCPCS Dme Pos 1 1 — — $10,123.53 $10,123.53 $10,123.53 2026-07-20
L5200 HCPCS Dme Pos 1 1 — — $10,110.68 $10,110.68 $10,110.68 2026-07-20
L5321 HCPCS Dme Pos 1 1 — — $10,059.33 $10,059.33 $10,059.33 2026-07-20
261U OTHER Onc Clrct Ca Img Alys W/ai 1 1 — — $10,053.00 $10,053.00 $10,053.00 2026-07-20
81520 CPT Onc Breast Mrna 58 Genes 1 1 — — $10,040.84 $10,040.84 $10,040.84 2026-07-20
120U OTHER Onc B Cll Lymphm Mrna 58 Gen 1 1 — — $10,040.84 $10,040.84 $10,040.84 2026-07-20
17M OTHER Onc Dlbcl Mrna 20 Genes Alg 1 1 — — $10,040.84 $10,040.84 $10,040.84 2026-07-20
J3101 HCPCS Tenecteplase 50 Mg Inj [mvho] 6 5 $12,470.29 $12,470.29 $747.89 $11,847.45 $10,029.22 2026-07-20
20M OTHER Oncology (central Nervous System), Analysis Of 30000 DNA Methylation Loci By Met… 1 1 — — $10,000.00 $10,000.00 $10,000.00 2026-07-20
92U OTHER Onc Lng 3 Prtn Bmrk Plsm Alg 1 1 — — $9,952.00 $9,952.00 $9,952.00 2026-07-20
L1005 HCPCS Dme Pos 1 1 — — $9,941.48 $9,941.48 $9,941.48 2026-07-20
L5981 HCPCS Dme Pos 1 1 — — $9,887.45 $9,887.45 $9,887.45 2026-07-20
L6715 HCPCS Dme Pos 1 1 — — $9,845.18 $9,845.18 $9,845.18 2026-07-20
L6646 HCPCS Dme Pos 1 1 — — $9,815.75 $9,815.75 $9,815.75 2026-07-20
81419 CPT Epilepsy Gen Seq Alys Panel 1 1 — — $9,794.24 $9,794.24 $9,794.24 2026-07-20
81443 CPT Genetic Tstg Severe Inh Cond 1 1 — — $9,794.24 $9,794.24 $9,794.24 2026-07-20
81441 CPT Ibmfs Seq Alys Pnl 30 Genes 1 1 — — $9,794.24 $9,794.24 $9,794.24 2026-07-20
276U OTHER Hem Inh Thrombocytopenia 42 1 1 — — $9,794.24 $9,794.24 $9,794.24 2026-07-20
81412 CPT Ashkenazi Jewish Assoc Dis 1 1 — — $9,794.24 $9,794.24 $9,794.24 2026-07-20
J0202 HCPCS Injection, Alemtuzumab 1 1 — — $9,788.41 $9,788.41 $9,788.41 2026-07-20
L6360 HCPCS Dme Pos 1 1 — — $9,748.60 $9,748.60 $9,748.60 2026-07-20
L6885 HCPCS Dme Pos 1 1 — — $9,748.60 $9,748.60 $9,748.60 2026-07-20
491U OTHER Oncology (solid Tumor), Circulating Tumor Cell Selection, Morphological Characte… 1 1 — — $9,740.00 $9,740.00 $9,740.00 2026-07-20
492U OTHER Oncology (solid Tumor), Circulating Tumor Cell Selection, Morphological Characte… 1 1 — — $9,740.00 $9,740.00 $9,740.00 2026-07-20
337U OTHER Onc Plsm Cell Do&myeloma Id 1 1 — — $9,740.00 $9,740.00 $9,740.00 2026-07-20
490U OTHER Oncology (cutaneous Or Uveal Melanoma), Circulating Tumor Cell Selection, Morpho… 1 1 — — $9,740.00 $9,740.00 $9,740.00 2026-07-20
338U OTHER Onc Sld Tum Crcg Tum Cl Slct 1 1 — — $9,740.00 $9,740.00 $9,740.00 2026-07-20
L8042 HCPCS Dme Pos 1 1 — — $9,735.83 $9,735.83 $9,735.83 2026-07-20
L5828 HCPCS Dme Pos 1 1 — — $9,719.18 $9,719.18 $9,719.18 2026-07-20
L5826 HCPCS Dme Pos 1 1 — — $9,719.03 $9,719.03 $9,719.03 2026-07-20
L6882 HCPCS Dme Pos 1 1 — — $9,651.28 $9,651.28 $9,651.28 2026-07-20
L6400 HCPCS Dme Pos 1 1 — — $9,469.13 $9,469.13 $9,469.13 2026-07-20
L5613 HCPCS Dme Pos 1 1 — — $9,403.20 $9,403.20 $9,403.20 2026-07-20
L5590 HCPCS Dme Pos 1 1 — — $9,396.48 $9,396.48 $9,396.48 2026-07-20
81427 CPT Genome Re-evaluation 1 1 — — $9,350.60 $9,350.60 $9,350.60 2026-07-20
L6200 HCPCS Dme Pos 1 1 — — $9,332.60 $9,332.60 $9,332.60 2026-07-20
L6310 HCPCS Dme Pos 1 1 — — $9,287.78 $9,287.78 $9,287.78 2026-07-20
L5220 HCPCS Dme Pos 1 1 — — $9,224.00 $9,224.00 $9,224.00 2026-07-20
39503 CPT Repair Of Diaphragm Hernia 5 4 — — $9,206.30 $9,206.30 $9,206.30 2026-07-20
218U OTHER Neuro Musc Dys Dmd Seq Alys 1 1 — — $9,116.00 $9,116.00 $9,116.00 2026-07-20
L0830 HCPCS Dme Pos 1 1 — — $9,008.50 $9,008.50 $9,008.50 2026-07-20
K0606 HCPCS Dme Pos 1 1 — — $8,972.25 $8,972.25 $8,972.25 2026-07-20
249U OTHER Onc Brst Alys 32 Phsprtn Alg 1 1 — — $8,876.52 $8,876.52 $8,876.52 2026-07-20
206U OTHER Neuro Alzheimer Cell Aggregj 1 1 — — $8,861.60 $8,861.60 $8,861.60 2026-07-20
L5585 HCPCS Dme Pos 1 1 — — $8,858.15 $8,858.15 $8,858.15 2026-07-20
L6693 HCPCS Dme Pos 1 1 — — $8,835.40 $8,835.40 $8,835.40 2026-07-20
L5580 HCPCS Dme Pos 1 1 — — $8,835.00 $8,835.00 $8,835.00 2026-07-20
303U OTHER Hem Rbc Ads Whl Bld Hypoxic 1 1 — — $8,806.48 $8,806.48 $8,806.48 2026-07-20
217U OTHER Neuro Inh Ataxia DNA 51 Gene 1 1 — — $8,793.40 $8,793.40 $8,793.40 2026-07-20
L5728 HCPCS Dme Pos 1 1 — — $8,766.53 $8,766.53 $8,766.53 2026-07-20
L5700 HCPCS Dme Pos 1 1 — — $8,684.88 $8,684.88 $8,684.88 2026-07-20
L6590 HCPCS Dme Pos 1 1 — — $8,676.40 $8,676.40 $8,676.40 2026-07-20
L8041 HCPCS Dme Pos 1 1 — — $8,664.88 $8,664.88 $8,664.88 2026-07-20
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Subcut Soln 0.6 Ml [mvho] 5 4 $11,552.39 $11,552.39 $491.35 $10,397.15 $8,664.29 2026-07-20
L6055 HCPCS Dme Pos 1 1 — — $8,662.28 $8,662.28 $8,662.28 2026-07-20
L6130 HCPCS Dme Pos 1 1 — — $8,657.58 $8,657.58 $8,657.58 2026-07-20
L6588 HCPCS Dme Pos 1 1 — — $8,650.90 $8,650.90 $8,650.90 2026-07-20
L7040 HCPCS Dme Pos 1 1 — — $8,628.43 $8,628.43 $8,628.43 2026-07-20
47135 CPT Transplantation Of Liver 5 4 — — $8,626.12 $8,626.12 $8,626.12 2026-07-20
81442 CPT Noonan Spectrum Disorders 1 1 — — $8,574.40 $8,574.40 $8,574.40 2026-07-20
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