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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

STILLWATER BILLINGS CLINIC

Columbus, MT · CCN 271330 · Rates published

2,772 distinct procedures filed
65 distinct payers
220,444 rate rows
2026-07-30 last MRF observed
Data quality

217,018 of 220,444 rate rows are consumer-grade (98.4%)

3,426 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,914
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 831
percent-of-charges filed in the dollar field — excluded from medians 485
per-diem day rate — not a per-procedure price 194
exceeds 10× this hospital's gross charge — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSCHCOLUMBUSMT&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Stillwater_V2.aspx
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-12
Content fingerprint cade7eb1f06421d3… · 116,426,457 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
918
MS_DRG 		Poisoning And Toxic Effects Of Drugs Without Mcc 2 $73,011.20 $73,011.20 $73,011.20 nat. median
$5,899
outlier · 12.4×
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 $64,119.10 $64,119.10 $64,119.10 nat. median
$5,850
outlier · 11.0×
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 2 $61,983.92 $61,983.92 $61,983.92 nat. median
$12,655
outlier · 4.9×
811
MS_DRG 		Red Blood Cell Disorders With Mcc 2 $58,787.55 $58,787.55 $58,787.55 nat. median
$10,250
outlier · 5.7×
897
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 2 $46,507.01 $46,507.01 $46,507.01 nat. median
$5,898
outlier · 7.9×
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 2 $40,450.85 $40,450.85 $40,450.85 nat. median
$7,653
outlier · 5.3×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 2 $38,631.29 $38,631.29 $38,631.29 nat. median
$9,802
outlier · 3.9×
951
MS_DRG 		Other Factors Influencing Health Status 2 $37,513.21 $37,513.21 $37,513.21 nat. median
$4,231
outlier · 8.9×
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 2 $30,309.30 $30,309.30 $30,309.30 nat. median
$6,107
outlier · 5.0×
534
MS_DRG 		Fractures Of Femur Without Mcc 2 $30,248.80 $30,248.80 $30,248.80 nat. median
$5,924
outlier · 5.1×
948
MS_DRG 		Signs And Symptoms Without Mcc 2 $30,248.80 $30,248.80 $30,248.80 nat. median
$5,562
outlier · 5.4×
543
MS_DRG 		Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 2 $29,360.97 $29,360.97 $29,360.97 nat. median
$7,898
outlier · 3.7×
683
MS_DRG 		Renal Failure With Cc 2 $29,043.94 $29,043.94 $29,043.94 nat. median
$6,692
outlier · 4.3×
603
MS_DRG 		Cellulitis Without Mcc 2 $29,010.80 $29,010.80 $29,010.80 nat. median
$6,621
outlier · 4.4×
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 $23,889.67 $23,889.67 $23,889.67 nat. median
$7,744
outlier · 3.1×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 2 $22,659.81 $22,659.81 $22,659.81 nat. median
$11,701
1.9× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 2 $21,039.20 $21,039.20 $21,039.20 nat. median
$8,710
outlier · 2.4×
66
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 2 $20,725.20 $20,725.20 $20,725.20 nat. median
$5,324
outlier · 3.9×
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 2 $20,360.20 $20,360.20 $20,360.20 nat. median
$9,470
outlier · 2.1×
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 2 $20,258.08 $20,258.08 $20,258.08 nat. median
$4,710
outlier · 4.3×
187
MS_DRG 		Pleural Effusion With Cc 2 $20,224.20 $20,224.20 $20,224.20 nat. median
$7,419
outlier · 2.7×
186
MS_DRG 		Pleural Effusion With Mcc 2 $19,528.29 $19,528.29 $19,528.29 nat. median
$11,243
1.7× median
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 2 $11,406.60 $11,406.60 $11,406.60 nat. median
$8,303
1.4× median
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 2 $11,296.60 $11,296.60 $11,296.60 nat. median
$7,677
1.5× median
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 $10,636.60 $10,636.60 $10,636.60 nat. median
$5,890
1.8× median
310
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 2 $10,163.60 $10,163.60 $10,163.60 nat. median
$4,383
outlier · 2.3×
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 2 $9,876.32 $9,876.32 $9,876.32 nat. median
$15,450
0.6× median
812
MS_DRG 		Red Blood Cell Disorders Without Mcc 2 $9,354.60 $9,354.60 $9,354.60 nat. median
$6,771
1.4× median
J9332
HCPCS 		Injection, Efgartigimod Alfa-fcab, 2mg 64 $6,689.84 $13,773.20 $9,346.10 nat. median
$84
outlier · 110.6×
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 64 $4,908.92 $10,106.60 $6,858.05 nat. median
$916
outlier · 7.5×
81162
HCPCS 		Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 64 $3,695.39 $9,065.00 $6,151.25 nat. median
$1,880
outlier · 3.3×
G0390
HCPCS 		Trauma Response Team Associated With Hospital Critical Care Service 64 $2,685.32 $5,528.60 $3,751.55 nat. median
$3,280
1.1× median
Q4199
HCPCS 		Cygnus Matrix, Per Square Centimeter 64 $1,081.20 $7,280.00 $3,534.00 nat. median
$451
outlier · 7.8×
8028141_1
CDM 		Coronary Care Unit - General Classification 58 $2,761.50 $3,682.00 $3,497.90 —
74177
HCPCS 		CT Scan Of Abdomen And Pelvis With Contrast 64 $81.71 $5,063.80 $3,436.15 nat. median
$501
outlier · 6.9×
90378
HCPCS 		Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 64 $2,062.52 $7,028.00 $3,300.91 nat. median
$2,008
1.6× median
8028202_1
CDM 		Room & Board - Other - Sterile Environment 58 $2,505.75 $3,341.00 $3,173.95 —
8028232_1
CDM 		Coronary Care Unit - General Classification 58 $2,485.50 $3,314.00 $3,148.30 —
81229
HCPCS 		Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi… 64 $2,218.84 $4,568.20 $3,099.85 nat. median
$1,230
outlier · 2.5×
8028231_1
CDM 		Room & Board - Other - Sterile Environment 58 $2,376.75 $3,169.00 $3,010.55 —
8028230_1
CDM 		Room & Board - Other - Other 58 $2,356.50 $3,142.00 $2,984.90 —
8028201_1
CDM 		Room & Board - Private (one Bed) - General Classification 58 $2,229.75 $2,973.00 $2,824.35 —
74183
HCPCS 		MRI Scan Of Abdomen Before And After Contrast 64 $98.50 $4,060.00 $2,755.00 nat. median
$611
outlier · 4.5×
59409
HCPCS 		Vaginal Delivery 64 $773.25 $4,155.20 $2,705.51 nat. median
$3,106
0.9× median
8028229_1
CDM 		Room & Board - Other - Other 58 $2,100.00 $2,800.00 $2,660.00 —
Q4159
HCPCS 		Affinity, Per Square Centimeter 64 $1,836.00 $5,040.00 $2,619.00 nat. median
$534
outlier · 4.9×
J0897
HCPCS 		Injection, Denosumab, 1 Mg 64 $24.93 $3,766.00 $2,555.50 nat. median
$86
outlier · 29.7×
Q4101
HCPCS 		Apligraf, Per Square Centimeter 64 $1,761.20 $3,626.00 $2,460.50 nat. median
$119
outlier · 20.7×
C1052
HCPCS 		Hemostatic Agent, Gastrointestinal, Topical 64 $1,632.00 $3,360.00 $2,280.00 nat. median
$3,184
0.7× median
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 64 $98.18 $3,343.20 $2,268.60 nat. median
$549
outlier · 4.1×

Other procedures at this hospital

Browse this hospital's 2,772 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
             
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 2 2 $30,076.00 $30,076.00 $73,011.20 $73,011.20 $73,011.20 2025-12-19
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 2 $27,317.50 $27,317.50 $64,119.10 $64,119.10 $64,119.10 2025-12-19
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 2 2 $25,182.32 $25,182.32 $61,983.92 $61,983.92 $61,983.92 2025-12-19
811 MS_DRG Red Blood Cell Disorders With Mcc 2 2 $28,119.55 $28,119.55 $58,787.55 $58,787.55 $58,787.55 2025-12-19
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 2 2 $15,839.01 $15,839.01 $46,507.01 $46,507.01 $46,507.01 2025-12-19
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 2 2 $15,916.45 $15,916.45 $40,450.85 $40,450.85 $40,450.85 2025-12-19
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 2 2 $14,096.89 $14,096.89 $38,631.29 $38,631.29 $38,631.29 2025-12-19
951 MS_DRG Other Factors Influencing Health Status 2 2 $12,978.81 $12,978.81 $37,513.21 $37,513.21 $37,513.21 2025-12-19
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 2 2 $11,908.50 $11,908.50 $30,309.30 $30,309.30 $30,309.30 2025-12-19
534 MS_DRG Fractures Of Femur Without Mcc 2 2 $11,848.00 $11,848.00 $30,248.80 $30,248.80 $30,248.80 2025-12-19
948 MS_DRG Signs And Symptoms Without Mcc 2 2 $11,848.00 $11,848.00 $30,248.80 $30,248.80 $30,248.80 2025-12-19
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 2 2 $10,960.17 $10,960.17 $29,360.97 $29,360.97 $29,360.97 2025-12-19
683 MS_DRG Renal Failure With Cc 2 2 $10,643.14 $10,643.14 $29,043.94 $29,043.94 $29,043.94 2025-12-19
603 MS_DRG Cellulitis Without Mcc 2 2 $10,610.00 $10,610.00 $29,010.80 $29,010.80 $29,010.80 2025-12-19
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 1 $11,622.47 $11,622.47 $23,889.67 $23,889.67 $23,889.67 2025-12-19
177 MS_DRG Respiratory Infections And Inflammations With Mcc 2 2 $10,392.61 $10,392.61 $22,659.81 $22,659.81 $22,659.81 2025-12-19
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 2 2 $8,772.00 $8,772.00 $21,039.20 $21,039.20 $21,039.20 2025-12-19
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 2 2 $8,458.00 $8,458.00 $20,725.20 $20,725.20 $20,725.20 2025-12-19
189 MS_DRG Pulmonary Edema And Respiratory Failure 2 2 $8,093.00 $8,093.00 $20,360.20 $20,360.20 $20,360.20 2025-12-19
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 2 2 $7,990.88 $7,990.88 $20,258.08 $20,258.08 $20,258.08 2025-12-19
187 MS_DRG Pleural Effusion With Cc 2 2 $7,957.00 $7,957.00 $20,224.20 $20,224.20 $20,224.20 2025-12-19
186 MS_DRG Pleural Effusion With Mcc 2 2 $7,261.09 $7,261.09 $19,528.29 $19,528.29 $19,528.29 2025-12-19
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 2 2 $5,273.00 $5,273.00 $11,406.60 $11,406.60 $11,406.60 2025-12-19
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 2 2 $5,163.00 $5,163.00 $11,296.60 $11,296.60 $11,296.60 2025-12-19
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 2 $4,503.00 $4,503.00 $10,636.60 $10,636.60 $10,636.60 2025-12-19
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 2 2 $4,030.00 $4,030.00 $10,163.60 $10,163.60 $10,163.60 2025-12-19
314 MS_DRG Other Circulatory System Diagnoses With Mcc 2 2 $3,742.72 $3,742.72 $9,876.32 $9,876.32 $9,876.32 2025-12-19
812 MS_DRG Red Blood Cell Disorders Without Mcc 2 2 $3,221.00 $3,221.00 $9,354.60 $9,354.60 $9,354.60 2025-12-19
J9332 HCPCS Injection, Efgartigimod Alfa-fcab, 2mg 64 64 $9,838.00 $9,838.00 $6,689.84 $13,773.20 $9,346.10 2025-12-19
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 64 64 $7,219.00 $7,219.00 $4,908.92 $10,106.60 $6,858.05 2025-12-19
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 64 64 $6,475.00 $6,475.00 $3,695.39 $9,065.00 $6,151.25 2025-12-19
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 64 64 $3,949.00 $3,949.00 $2,685.32 $5,528.60 $3,751.55 2026-07-30
Q4199 HCPCS Cygnus Matrix, Per Square Centimeter 192 64 $3,720.00 $3,720.00 $1,081.20 $7,280.00 $3,534.00 2025-12-19
8028141_1 CDM Coronary Care Unit - General Classification 58 58 $3,682.00 $3,682.00 $2,761.50 $3,682.00 $3,497.90 2025-12-19
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 192 64 $3,617.00 $3,617.00 $81.71 $5,063.80 $3,436.15 2025-12-19
90378 HCPCS Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 128 64 $4,211.50 $4,211.50 $2,062.52 $7,028.00 $3,300.91 2025-12-19
8028202_1 CDM Room & Board - Other - Sterile Environment 58 58 $3,341.00 $3,341.00 $2,505.75 $3,341.00 $3,173.95 2025-12-19
8028232_1 CDM Coronary Care Unit - General Classification 58 58 $3,314.00 $3,314.00 $2,485.50 $3,314.00 $3,148.30 2025-12-19
81229 HCPCS Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi… 64 64 $3,263.00 $3,263.00 $2,218.84 $4,568.20 $3,099.85 2025-12-19
8028231_1 CDM Room & Board - Other - Sterile Environment 58 58 $3,169.00 $3,169.00 $2,376.75 $3,169.00 $3,010.55 2025-12-19
8028230_1 CDM Room & Board - Other - Other 58 58 $3,142.00 $3,142.00 $2,356.50 $3,142.00 $2,984.90 2025-12-19
8028201_1 CDM Room & Board - Private (one Bed) - General Classification 58 58 $2,973.00 $2,973.00 $2,229.75 $2,973.00 $2,824.35 2025-12-19
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 192 64 $2,900.00 $2,900.00 $98.50 $4,060.00 $2,755.00 2025-12-19
59409 HCPCS Vaginal Delivery 128 64 $3,024.50 $3,024.50 $773.25 $4,155.20 $2,705.51 2025-12-19
8028229_1 CDM Room & Board - Other - Other 58 58 $2,800.00 $2,800.00 $2,100.00 $2,800.00 $2,660.00 2025-12-19
Q4159 HCPCS Affinity, Per Square Centimeter 128 64 $3,150.00 $3,150.00 $1,836.00 $5,040.00 $2,619.00 2025-12-19
J0897 HCPCS Injection, Denosumab, 1 Mg 64 64 $2,690.00 $2,690.00 $24.93 $3,766.00 $2,555.50 2025-12-19
Q4101 HCPCS Apligraf, Per Square Centimeter 64 64 $2,590.00 $2,590.00 $1,761.20 $3,626.00 $2,460.50 2025-12-19
C1052 HCPCS Hemostatic Agent, Gastrointestinal, Topical 64 64 $2,400.00 $2,400.00 $1,632.00 $3,360.00 $2,280.00 2025-12-19
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 192 64 $2,388.00 $2,388.00 $98.18 $3,343.20 $2,268.60 2025-12-19
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 64 64 $2,221.00 $2,221.00 $1,450.31 $3,109.40 $2,109.95 2025-12-19
C8929 HCPCS Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 64 64 $2,131.00 $2,131.00 $651.11 $2,983.40 $2,024.45 2025-12-19
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 64 64 $2,131.00 $2,131.00 $330.68 $2,983.40 $2,024.45 2025-12-19
Q4196 HCPCS Puraply Am, Per Square Centimeter 320 64 $2,100.00 $2,100.00 $612.00 $4,838.40 $1,995.00 2025-12-19
73720 HCPCS MRI Scan Of Leg Before And After Contrast 576 64 $2,891.00 $2,891.00 $96.60 $4,047.40 $1,985.54 2025-12-19
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 64 64 $2,056.00 $2,056.00 $1,398.08 $2,878.40 $1,953.20 2025-12-19
J7296 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System, (kyleena), 19.5 Mg 64 64 $1,960.00 $1,960.00 $1,332.80 $2,744.00 $1,862.00 2025-12-19
C8910 HCPCS Magnetic Resonance Angiography Without Contrast, Chest (excluding Myocardium) 64 64 $1,934.00 $1,934.00 $764.12 $2,707.60 $1,837.30 2025-12-19
C8909 HCPCS Magnetic Resonance Angiography With Contrast, Chest (excluding Myocardium) 64 64 $1,934.00 $1,934.00 $764.12 $2,707.60 $1,837.30 2025-12-19
C8911 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest… 64 64 $1,934.00 $1,934.00 $1,315.12 $2,707.60 $1,837.30 2025-12-19
C8900 HCPCS Magnetic Resonance Angiography With Contrast, Abdomen 64 64 $1,919.00 $1,919.00 $776.42 $2,686.60 $1,823.05 2025-12-19
C8902 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom… 64 64 $1,919.00 $1,919.00 $1,304.92 $2,686.60 $1,823.05 2025-12-19
C8901 HCPCS Magnetic Resonance Angiography Without Contrast, Abdomen 64 64 $1,919.00 $1,919.00 $776.42 $2,686.60 $1,823.05 2025-12-19
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 192 64 $1,902.00 $1,902.00 $89.64 $2,662.80 $1,806.90 2025-12-19
Q4160 HCPCS Nushield, Per Square Centimeter 320 64 $1,900.00 $1,900.00 $537.20 $5,208.00 $1,805.00 2025-12-19
74160 HCPCS CT Scan Of Abdomen With Contrast 192 64 $1,898.00 $1,898.00 $56.70 $2,657.20 $1,803.10 2025-12-19
74182 HCPCS MRI Scan Of Abdomen With Contrast 320 64 $2,031.00 $2,031.00 $76.98 $2,843.40 $1,766.97 2025-12-19
81220 HCPCS Gene Analysis (cystic Fibrosis Transmembrane Conductance Regular) Common Variant… 64 64 $1,767.00 $1,767.00 $1,127.12 $2,473.80 $1,678.65 2025-12-19
86711 HCPCS Analysis For Antibody To John Cunningham Virus 64 64 $1,718.00 $1,718.00 $34.20 $2,405.20 $1,632.10 2025-12-19
72125 HCPCS CT Scan Of Upper Spine Without Contrast 192 64 $1,713.00 $1,713.00 $44.35 $2,398.20 $1,627.35 2025-12-19
74150 HCPCS CT Scan Of Abdomen Without Contrast 192 64 $1,712.00 $1,712.00 $52.90 $2,396.80 $1,626.40 2025-12-19
90381 HCPCS Respiratory Syncytial Virus Antibody, 1.0 Ml Dosage For Injection Into Muscle 64 64 $1,621.00 $1,621.00 $1,102.28 $2,269.40 $1,539.95 2025-12-19
90380 HCPCS Respiratory Syncytial Virus Antibody, 0.5 Ml Dosage For Injection Into Muscle 64 64 $1,621.00 $1,621.00 $1,102.28 $2,269.40 $1,539.95 2025-12-19
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 128 64 $1,857.00 $1,857.00 $177.27 $2,931.60 $1,539.00 2025-12-19
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 192 64 $1,610.00 $1,610.00 $81.09 $2,254.00 $1,529.50 2025-12-19
C8931 HCPCS Magnetic Resonance Angiography With Contrast, Spinal Canal And Contents 64 64 $1,603.00 $1,603.00 $806.33 $2,244.20 $1,522.85 2025-12-19
C8933 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Spina… 64 64 $1,603.00 $1,603.00 $1,090.04 $2,244.20 $1,522.85 2025-12-19
C8932 HCPCS Magnetic Resonance Angiography Without Contrast, Spinal Canal And Contents 64 64 $1,603.00 $1,603.00 $806.33 $2,244.20 $1,522.85 2025-12-19
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 128 64 $1,689.00 $1,689.00 $176.95 $2,511.60 $1,504.80 2025-12-19
C8936 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Upper… 128 64 $1,584.00 $1,584.00 $1,077.12 $2,217.60 $1,504.80 2025-12-19
C8935 HCPCS Magnetic Resonance Angiography Without Contrast, Upper Extremity 128 64 $1,584.00 $1,584.00 $799.29 $2,217.60 $1,504.80 2025-12-19
C8934 HCPCS Magnetic Resonance Angiography With Contrast, Upper Extremity 128 64 $1,584.00 $1,584.00 $799.29 $2,217.60 $1,504.80 2025-12-19
J0248 HCPCS Injection, Remdesivir, 1 Mg 64 64 $1,578.00 $1,578.00 $1,073.04 $2,209.20 $1,499.10 2025-12-19
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 100 64 $1,530.00 $1,530.00 $48.15 $2,142.00 $1,453.50 2025-12-19
G0105 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 128 64 $1,802.50 $1,802.50 $176.95 $2,931.60 $1,451.91 2025-12-19
81222 HCPCS Gene Analysis (cystic Fibrosis Transmembrane Conductance Regular) Duplication Or… 64 64 $1,520.00 $1,520.00 $881.01 $2,128.00 $1,444.00 2025-12-19
45388 HCPCS Destruction Of Polyp Or Growth Of Large Bowel Using A Flexible Endoscope 128 64 $1,831.50 $1,831.50 $258.00 $3,822.00 $1,380.70 2025-12-19
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 192 64 $1,452.00 $1,452.00 $77.93 $2,032.80 $1,379.40 2025-12-19
C8920 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Pelvi… 64 64 $1,433.00 $1,433.00 $974.44 $2,006.20 $1,361.35 2025-12-19
45381 HCPCS Injection Beneath Lining Of Large Bowel Using A Flexible Endoscope 128 64 $1,612.50 $1,612.50 $192.45 $2,511.60 $1,359.45 2025-12-19
63661 HCPCS Insertion Of Spinal Neurostimulator Electrode Array Using Fluoroscopic Guidance 128 64 $1,722.50 $1,722.50 $323.07 $3,302.60 $1,328.77 2025-12-19
74181 HCPCS MRI Scan Of Abdomen Without Contrast 320 64 $1,486.00 $1,486.00 $64.93 $2,080.40 $1,292.82 2025-12-19
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 128 64 $1,594.00 $1,594.00 $179.25 $2,703.40 $1,266.18 2025-12-19
59812 HCPCS Treatment Of Miscarriage 128 64 $1,704.50 $1,704.50 $300.84 $3,957.80 $1,262.02 2025-12-19
45382 HCPCS Control Of Bleeding Of Upper Large Bowel Using A Flexible Endoscope 128 64 $1,662.00 $1,662.00 $247.05 $3,382.40 $1,261.82 2025-12-19
21555 HCPCS Removal Of Growth Under Skin Of Neck Or Front Of Chest, Less Than 3.0 Cm 64 64 $1,240.00 $1,240.00 $843.20 $1,736.00 $1,178.00 2025-12-19
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 128 64 $1,415.50 $1,415.50 $242.52 $2,511.60 $1,112.90 2025-12-19
11606 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 55 55 $1,158.00 $1,158.00 $787.44 $1,621.20 $1,100.10 2025-12-19
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 128 64 $1,404.50 $1,404.50 $409.79 $2,758.00 $1,079.59 2025-12-19
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 192 64 $1,129.00 $1,129.00 $77.61 $1,580.60 $1,072.55 2025-12-19
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 128 64 $1,347.00 $1,347.00 $192.45 $2,511.60 $1,046.46 2025-12-19
C8914 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Lower… 236 64 $1,433.00 $1,433.00 $52.00 $2,006.20 $1,038.92 2025-12-19
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 128 64 $1,281.00 $1,281.00 $514.38 $2,109.80 $1,024.76 2025-12-19
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 128 64 $1,305.00 $1,305.00 $218.54 $2,511.60 $1,005.72 2025-12-19
8891465_1 CDM Snare Expro Elite 25mm__stw 63 63 $1,040.00 $1,040.00 $707.20 $1,456.00 $988.00 2025-12-19
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 128 64 $1,235.00 $1,235.00 $467.54 $2,109.80 $979.92 2025-12-19
C8919 HCPCS Magnetic Resonance Angiography Without Contrast, Pelvis 118 64 $1,433.00 $1,433.00 $52.00 $2,006.20 $974.44 2025-12-19
C8913 HCPCS Magnetic Resonance Angiography Without Contrast, Lower Extremity 236 64 $1,433.00 $1,433.00 $52.00 $2,006.20 $974.44 2025-12-19
C8918 HCPCS Magnetic Resonance Angiography With Contrast, Pelvis 118 64 $1,433.00 $1,433.00 $52.00 $2,006.20 $974.44 2025-12-19
C8912 HCPCS Magnetic Resonance Angiography With Contrast, Lower Extremity 236 64 $1,433.00 $1,433.00 $52.00 $2,006.20 $974.44 2025-12-19
99291 HCPCS Critical Care, First 30-74 Minutes 128 64 $1,270.50 $1,270.50 $205.41 $2,587.20 $964.43 2025-12-19
28001 HCPCS Drainage Of Fluid Filled Sac In Foot 128 64 $1,293.00 $1,293.00 $93.04 $2,835.00 $960.59 2025-12-19
87507 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 184 64 $1,010.00 $1,010.00 $570.52 $1,576.40 $959.50 2025-12-19
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 128 64 $1,206.50 $1,206.50 $443.62 $2,109.80 $956.00 2025-12-19
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 128 64 $1,061.50 $1,061.50 $209.59 $1,470.00 $955.35 2025-12-19
44389 HCPCS Biopsy Of Large Bowel Using An Endoscope Inserted Through Surgically Created Ope… 128 64 $1,246.00 $1,246.00 $164.67 $2,511.60 $948.49 2025-12-19
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 128 64 $1,194.50 $1,194.50 $431.39 $2,109.80 $943.77 2025-12-19
36430 HCPCS Transfusion Of Blood Or Blood Products 64 64 $975.00 $975.00 $663.00 $1,365.00 $926.25 2025-12-19
87633 HCPCS Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 64 64 $964.00 $964.00 $655.52 $1,349.60 $915.80 2025-12-19
43249 HCPCS Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl… 128 64 $1,253.00 $1,253.00 $146.93 $2,900.80 $914.97 2025-12-19
44394 HCPCS Removal Of Growths Or Polyps Of Large Bowel By Mechanical Snare Using An Endosco… 128 64 $1,202.50 $1,202.50 $215.37 $2,479.40 $909.63 2025-12-19
43251 HCPCS Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi… 128 64 $1,191.50 $1,191.50 $187.30 $2,560.60 $890.55 2025-12-19
11624 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4.0 … 55 55 $935.00 $935.00 $635.80 $1,309.00 $888.25 2025-12-19
93303 HCPCS Ultrasound Of Heart For Congenital Defect 64 64 $923.00 $923.00 $417.29 $1,292.20 $876.85 2025-12-19
27842 HCPCS Closed Treatment Of Dislocated Ankle Under Anesthesia 64 64 $1,938.00 $1,938.00 $491.75 $1,879.86 $831.23 2025-12-19
76811 HCPCS Ultrasound Scan Of Pregnant Uterus With Detailed Fetal Anatomic Examination, Sin… 64 64 $872.00 $872.00 $203.84 $1,220.80 $828.40 2025-12-19
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 128 64 $1,076.50 $1,076.50 $148.74 $2,186.80 $817.72 2025-12-19
J2002 HCPCS Injection, Lidocaine Hcl In 5% Dextrose, 1 Mg 64 64 $856.00 $856.00 $582.08 $1,198.40 $813.20 2025-12-19
71552 HCPCS MRI Scan Of Chest Before And After Contrast 256 64 $1,715.50 $1,715.50 $101.35 $4,022.20 $813.01 2025-12-19
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 128 64 $981.00 $981.00 $175.36 $1,194.20 $810.35 2025-12-19
86366 HCPCS Test For Muscle-specific Kinase Antibody 64 64 $852.00 $852.00 $579.36 $1,192.80 $809.40 2025-12-19
5799034_1 CDM 43760 Ed Proc Gastrostomy Tube Chng-hospital 63 63 $840.00 $840.00 $571.20 $1,176.00 $798.00 2025-12-19
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 128 64 $1,024.50 $1,024.50 $168.54 $2,072.00 $779.16 2025-12-19
28232 HCPCS Incision To Lengthen Toe Tendon 128 64 $895.00 $895.00 $237.86 $1,377.60 $765.70 2025-12-19
44392 HCPCS Removal Of Growths Or Polyps Of Large Bowel By Electrical Cautery Using An Endos… 128 64 $1,001.00 $1,001.00 $191.71 $1,990.80 $764.78 2025-12-19
87899 HCPCS Detection Test By Immunoassay With Direct Visual Observation For Other Organism 188 64 $791.00 $791.00 $23.80 $1,107.40 $751.45 2025-12-19
Q5125 HCPCS Injection, Filgrastim-ayow, Biosimilar, (releuko), 1 Microgram 64 64 $784.00 $784.00 $533.12 $1,097.60 $744.80 2025-12-19
25622 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb 128 64 $815.00 $815.00 $291.71 $1,068.20 $722.23 2025-12-19
73220 HCPCS MRI Scan Of Arm Before And After Contrast 512 64 $1,710.00 $1,710.00 $96.60 $4,047.40 $713.21 2025-12-19
46040 HCPCS Drainage Of Deep Abscess In Rectum 64 64 $1,877.00 $1,877.00 $421.63 $1,820.69 $702.85 2025-12-19
81514 HCPCS Measurement Of DNA Of Bacteria In Vaginal Fluid Specimen 64 64 $735.00 $735.00 $499.80 $1,029.00 $698.25 2025-12-19
25660 HCPCS Closed Treatment Of Dislocated Wrist Bones With Manipulation 64 64 $1,465.00 $1,465.00 $454.71 $1,421.05 $695.82 2025-12-19
93976 HCPCS Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 192 64 $732.00 $732.00 $36.20 $1,024.80 $695.40 2025-12-19
26600 HCPCS Closed Treatment Of Broken Hand Bone 55 55 $726.00 $726.00 $493.68 $1,016.40 $689.70 2025-12-19
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 128 64 $1,098.50 $1,098.50 $105.78 $2,254.00 $684.47 2025-12-19
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 512 64 $1,711.00 $1,711.00 $96.60 $4,047.40 $680.94 2025-12-19
25530 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side 142 64 $740.00 $740.00 $251.34 $1,002.40 $680.20 2025-12-19
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 512 64 $1,710.00 $1,710.00 $96.60 $4,047.40 $679.10 2025-12-19
0202U OTHER Test For Detection Of Respiratory Disease-causing Organisms From Back Of Nose An… 124 64 $804.00 $804.00 $150.00 $1,125.60 $645.05 2025-12-19
8028192_1 CDM Room & Board - Other - Sterile Environment 58 58 $674.00 $674.00 $505.50 $674.00 $640.30 2025-12-19
71551 HCPCS MRI Scan Of Chest With Contrast 256 64 $986.50 $986.50 $76.98 $2,165.80 $637.89 2025-12-19
12055 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.6-… 128 64 $845.50 $845.50 $293.45 $996.19 $630.80 2025-12-19
63688 HCPCS Removal Or Revision Of Spinal Neurostimulator Generator Or Receiver 64 64 $1,775.00 $1,775.00 $293.66 $1,721.75 $628.73 2025-12-19
11424 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 55 55 $658.00 $658.00 $447.44 $921.20 $625.10 2025-12-19
11602 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm 55 55 $655.00 $655.00 $445.40 $917.00 $622.25 2025-12-19
26755 HCPCS Closed Treatment Of Broken End Of Finger Or Thumb With Manipulation 142 64 $1,062.00 $1,062.00 $281.93 $1,184.37 $612.75 2025-12-19
87154 HCPCS Amplifed Nucleic Acid Probe Typing Of Disease Agent In Blood Culture Specimen 64 64 $643.00 $643.00 $437.24 $900.20 $610.85 2025-12-19
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 128 64 $1,748.00 $1,748.00 $96.29 $4,155.20 $602.94 2025-12-19
92960 HCPCS External Shock To Heart To Regulate Heart Beat 128 64 $695.50 $695.50 $103.72 $1,061.20 $601.35 2025-12-19
11603 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 55 55 $630.00 $630.00 $428.40 $882.00 $598.50 2025-12-19
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 142 64 $631.00 $631.00 $250.34 $1,358.97 $597.55 2025-12-19
72159 HCPCS MRI Scan Of Blood Vessels Of Spinal Canal 128 64 $1,024.00 $1,024.00 $80.14 $2,244.20 $594.62 2025-12-19
26641 HCPCS Closed Treatment Of Dislocated Thumb At Wrist With Manipulation 64 64 $1,408.00 $1,408.00 $389.18 $1,365.76 $583.86 2025-12-19
26700 HCPCS Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation 142 64 $1,122.00 $1,122.00 $320.34 $1,251.30 $583.30 2025-12-19
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 128 64 $1,882.00 $1,882.00 $80.14 $4,649.40 $582.71 2025-12-19
70553 HCPCS MRI Scan Of Brain Before And After Contrast 256 64 $1,793.00 $1,793.00 $102.62 $4,230.80 $580.60 2025-12-19
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 128 64 $1,882.00 $1,882.00 $65.89 $4,649.40 $580.09 2025-12-19
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 128 64 $1,179.50 $1,179.50 $79.81 $2,686.60 $579.94 2025-12-19
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 128 64 $937.50 $937.50 $292.67 $1,227.05 $579.50 2025-12-19
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 256 64 $936.50 $936.50 $80.13 $2,006.20 $578.20 2025-12-19
27840 HCPCS Closed Treatment Of Dislocated Ankle 128 64 $696.00 $696.00 $390.38 $831.60 $576.18 2025-12-19
6912560_1 CDM Tubing Irr W Back Flow 100130__stw 63 63 $605.00 $605.00 $411.40 $847.00 $574.75 2025-12-19
11404 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 55 55 $603.00 $603.00 $410.04 $844.20 $572.85 2025-12-19
71550 HCPCS MRI Scan Of Chest Without Contrast 256 64 $1,111.50 $1,111.50 $65.25 $2,611.00 $570.80 2025-12-19
25650 HCPCS Closed Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist 142 64 $1,056.00 $1,056.00 $312.99 $1,178.55 $569.05 2025-12-19
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 64 64 $592.00 $592.00 $377.06 $828.80 $562.40 2026-07-30
99245 HCPCS Office Or Other Outpatient Consultation With High Level Of Medical Decision Maki… 64 64 $588.00 $588.00 $399.84 $823.20 $558.60 2025-12-19
31500 HCPCS Emergent Insertion Of Breathing Tube Into Windpipe Using An Endoscope 122 64 $615.00 $615.00 $136.49 $861.00 $557.65 2025-12-19
23075 HCPCS Removal Of Growth Under Skin Of Shoulder Area, Less Than 3.0 Cm 64 64 $2,243.00 $2,243.00 $326.39 $2,175.71 $552.79 2025-12-19
11622 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2.0 … 55 55 $581.00 $581.00 $395.08 $813.40 $551.95 2025-12-19
0219U OTHER Gene Analysis Of Human Immunodeficiency Virus Targeted Sequence Analysis For Res… 64 64 $579.00 $579.00 $393.72 $810.60 $550.05 2025-12-19
87522 HCPCS Detection Test By Nucleic Acid For Hepatitis C Virus, Quantification 124 64 $605.00 $605.00 $86.75 $847.00 $547.08 2025-12-19
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 256 64 $971.00 $971.00 $84.25 $2,066.40 $547.07 2025-12-19
G0379 HCPCS Direct Admission Of Patient For Hospital Observation Care 64 64 $575.00 $575.00 $391.00 $805.00 $546.25 2025-12-19
88307 HCPCS Pathology Examination Of Tissue Using A Microscope, Moderately High Complexity 64 64 $574.00 $574.00 $390.32 $803.60 $545.30 2025-12-19
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 128 64 $598.50 $598.50 $307.10 $805.00 $543.69 2025-12-19
73722 HCPCS MRI Scan Of Leg Joint With Contrast 512 64 $851.00 $851.00 $72.54 $1,822.80 $543.49 2025-12-19
73222 HCPCS MRI Scan Of Arm Joint With Contrast 512 64 $1,065.50 $1,065.50 $72.54 $2,423.40 $542.61 2025-12-19
46320 HCPCS Removal Of External Hemorrhoid With Blood Clot 55 55 $571.00 $571.00 $388.28 $799.40 $542.45 2025-12-19
10080 HCPCS Simple Drainage Of Cyst Of Tailbone 128 64 $625.50 $625.50 $103.04 $953.40 $541.50 2025-12-19
81256 HCPCS Gene Analysis (hemochromatosis) Common Variants 64 64 $568.00 $568.00 $132.36 $795.20 $539.60 2025-12-19
81219 HCPCS Gene Analysis (calreticulin), Common Variants 64 64 $567.00 $567.00 $246.30 $793.80 $538.65 2025-12-19
13131 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 128 64 $594.50 $594.50 $235.14 $824.60 $535.05 2025-12-19
88309 HCPCS Pathology Examination Of Tissue Using A Microscope, High Complexity 188 64 $559.00 $559.00 $226.44 $1,142.40 $531.05 2025-12-19
27265 HCPCS Closed Treatment Of Dislocated Hip Prosthesis 128 64 $935.00 $935.00 $369.24 $1,287.19 $526.71 2025-12-19
27786 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 183 64 $865.00 $865.00 $291.71 $1,391.60 $524.40 2025-12-19
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 124 64 $907.00 $907.00 $67.32 $1,269.80 $521.34 2025-12-19
25600 HCPCS Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb … 183 64 $969.00 $969.00 $333.76 $1,551.20 $520.55 2025-12-19
11423 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 2.1-3… 55 55 $547.00 $547.00 $371.96 $765.80 $519.65 2025-12-19
15271 HCPCS Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, 25.0 Sq C… 64 64 $546.00 $546.00 $371.28 $764.40 $518.70 2025-12-19
76830 HCPCS Ultrasound Scan Of Uterus, Ovaries, Tubes, Cervix And Pelvic Area Through Vagina 192 64 $545.00 $545.00 $31.05 $763.00 $517.75 2025-12-19
92610 HCPCS Evaluation Of Swallowing Function 64 64 $545.00 $545.00 $370.60 $763.00 $517.75 2025-12-19
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 128 64 $1,500.00 $1,500.00 $81.40 $3,460.80 $516.33 2025-12-19
23600 HCPCS Closed Treatment Of Broken Top Of Upper Arm Bone 64 64 $939.00 $939.00 $324.33 $910.83 $515.27 2025-12-19
88269 HCPCS Chromosome Analysis Of Amniotic Fluid For Genetic Defects 64 64 $540.00 $540.00 $351.66 $756.00 $513.00 2025-12-19
81292 HCPCS Gene Analysis (mutL Homolog 1, Colon Cancer, Nonpolyposis Type 2) Full Sequence … 64 64 $540.00 $540.00 $367.20 $1,367.69 $513.00 2025-12-19
73218 HCPCS MRI Scan Of Arm Without Contrast 640 64 $1,019.50 $1,019.50 $60.51 $2,385.60 $512.83 2025-12-19
27824 HCPCS Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint 64 64 $1,065.00 $1,065.00 $311.37 $1,033.05 $511.75 2025-12-19
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 128 64 $665.00 $665.00 $116.24 $1,309.00 $509.47 2025-12-19
27760 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle 64 64 $864.00 $864.00 $314.64 $838.08 $509.41 2025-12-19
81381 HCPCS Hla Class I Typing High Resolution One Allele Or Allele Group 64 64 $536.00 $536.00 $344.06 $750.40 $509.20 2025-12-19
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 256 64 $958.50 $958.50 $80.13 $2,066.40 $506.94 2025-12-19
80305 HCPCS Testing For Presence Of Drug, Read By Direct Observation 64 64 $532.00 $532.00 $25.52 $744.80 $505.40 2025-12-19
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 128 64 $855.50 $855.50 $311.02 $1,147.51 $504.41 2025-12-19
11042 HCPCS Removal Of Skin And Tissue, 20.0 Sq Cm Or Less 220 64 $530.00 $530.00 $58.78 $1,281.00 $503.50 2025-12-19
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 128 64 $1,027.50 $1,027.50 $80.13 $2,254.00 $501.88 2025-12-19
92523 HCPCS Evaluation Of Speech Sound Production With Evaluation Of Language Comprehension … 64 64 $527.00 $527.00 $358.36 $737.80 $500.65 2025-12-19
11626 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 64 64 $1,124.00 $1,124.00 $282.48 $1,090.28 $496.51 2025-12-19
26605 HCPCS Closed Treatment Of Broken Hand Bone With Manipulation 64 64 $847.00 $847.00 $303.95 $821.59 $490.65 2025-12-19
81375 HCPCS Hla Class Ii Typing Low Resolution Hla-drb1/3/4/5 And -dqb1 64 64 $515.00 $515.00 $350.20 $721.00 $489.25 2025-12-19
81298 HCPCS Gene Analysis (mutS Homolog 6 [e Coli]) Full Sequence Analysis 64 64 $513.00 $513.00 $348.84 $1,299.75 $487.35 2025-12-19
27520 HCPCS Closed Treatment Of Broken Kneecap 128 64 $698.00 $698.00 $307.84 $867.18 $486.94 2025-12-19
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 183 64 $509.00 $509.00 $185.79 $924.00 $483.55 2025-12-19
12031 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 183 64 $509.00 $509.00 $147.65 $788.20 $483.55 2025-12-19
72196 HCPCS MRI Scan Of Pelvis With Contrast 256 64 $898.00 $898.00 $76.98 $1,916.60 $481.78 2025-12-19
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 128 64 $623.50 $623.50 $132.41 $1,212.40 $479.23 2025-12-19
27780 HCPCS Closed Treatment Of Broken Middle Or Upper End Of Outside Lower Leg Bone 128 64 $674.50 $674.50 $291.70 $819.65 $478.80 2025-12-19
11442 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1… 55 55 $501.00 $501.00 $340.68 $701.40 $475.95 2025-12-19
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 128 64 $1,133.00 $1,133.00 $72.23 $2,612.40 $474.38 2025-12-19
11403 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 55 55 $499.00 $499.00 $339.32 $698.60 $474.05 2025-12-19
81263 HCPCS Gene Rearrangement Analysis (immunoglobulin Heavy Chain Locus), Variable Region … 64 64 $498.00 $498.00 $338.64 $697.20 $473.10 2025-12-19
85302 HCPCS Protein C, (clotting Inhibitor) Activity 64 64 $497.00 $497.00 $24.32 $695.80 $472.15 2025-12-19
25630 HCPCS Closed Treatment Of Other Broken Wrist Bone 64 64 $1,101.00 $1,101.00 $291.99 $1,067.97 $470.72 2025-12-19
28490 HCPCS Closed Treatment Of Broken Great Toe 55 55 $495.00 $495.00 $336.60 $693.00 $470.25 2025-12-19
84378 HCPCS Carbohydrate Analysis, Single Quantitative 64 64 $494.00 $494.00 $23.36 $691.60 $469.30 2025-12-19
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 320 64 $564.00 $564.00 $102.93 $4,230.80 $468.12 2025-12-19
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 320 64 $564.00 $564.00 $102.93 $4,120.20 $468.12 2025-12-19
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 320 64 $564.00 $564.00 $102.93 $4,120.20 $468.12 2025-12-19
99496 HCPCS Transitional Care Management Services For Problem Of High Complexity 119 64 $562.00 $562.00 $182.26 $819.00 $466.46 2025-12-19
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 128 64 $1,031.00 $1,031.00 $62.09 $2,280.60 $466.32 2025-12-19
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 128 64 $942.00 $942.00 $77.93 $2,032.80 $466.27 2025-12-19
64405 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Upper Neck And Back Of Head Ne… 55 55 $488.00 $488.00 $331.84 $683.20 $463.60 2025-12-19
70336 HCPCS MRI Scan Of Jaw Joint 128 64 $723.50 $723.50 $65.57 $1,519.00 $463.38 2025-12-19
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 320 64 $558.00 $558.00 $98.50 $4,060.00 $463.14 2025-12-19
G0438 HCPCS Annual Wellness Visit; Includes A Personalized Prevention Plan Of Service (pps),… 55 55 $486.00 $486.00 $330.48 $680.40 $461.70 2025-12-19
11601 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 55 55 $486.00 $486.00 $330.48 $680.40 $461.70 2025-12-19
81218 HCPCS Gene Analysis (ccaat/enhancer Binding Protein [c/ebp], Alpha) Full Gene Sequence 64 64 $485.00 $485.00 $329.80 $679.00 $460.75 2025-12-19
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 128 64 $1,362.00 $1,362.00 $56.38 $3,151.40 $455.98 2025-12-19
87497 HCPCS Detection Test By Nucleic Acid For Cytomegalovirus, Quantification 64 64 $479.00 $479.00 $86.75 $670.60 $455.05 2025-12-19
88235 HCPCS Tissue Culture For Disorders Of Amniotic Fluid Or Placenta Cells 64 64 $478.00 $478.00 $304.37 $669.20 $454.10 2025-12-19
12051 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5 C… 183 64 $478.00 $478.00 $164.76 $1,076.60 $454.10 2025-12-19
88233 HCPCS Tissue Culture To Identify Skin Disorders 64 64 $476.00 $476.00 $284.99 $666.40 $452.20 2025-12-19
25535 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side With Man… 64 64 $475.00 $475.00 $323.00 $665.00 $451.25 2025-12-19
96365 HCPCS Infusion Into A Vein For Therapy, Prevention, Or Diagnosis, 1 Hour Or Less 64 64 $475.00 $475.00 $323.00 $665.00 $451.25 2025-12-19
76801 HCPCS Ultrasound Scan Of Pregnant Uterus (less Than 14 Weeks), Single Or First Fetus 192 64 $474.00 $474.00 $44.35 $663.60 $450.30 2025-12-19
0027U OTHER Gene Analysis (Janus Kinase 2) Of Targeted Sequence Exons 12-15 64 64 $471.00 $471.00 $320.28 $659.40 $447.45 2025-12-19
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 128 64 $1,458.50 $1,458.50 $71.91 $3,431.40 $447.36 2025-12-19
82139 HCPCS Amino Acid Level, 6 Or More Amino Acids, Quantitative, Each Specimen 184 64 $468.00 $468.00 $34.16 $694.40 $444.60 2025-12-19
15275 HCPCS Application Of Skin Substitute Graft To Wound Of Face, Scalp, Eyelids, Mouth, Ne… 64 64 $466.00 $466.00 $316.88 $652.40 $442.70 2025-12-19
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 128 64 $1,463.00 $1,463.00 $56.38 $3,456.60 $438.72 2025-12-19
99244 HCPCS Office Or Other Outpatient Consultation With Moderate Level Of Medical Decision … 64 64 $460.00 $460.00 $312.80 $644.00 $437.00 2025-12-19
26770 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation 142 64 $545.00 $545.00 $269.97 $919.56 $437.00 2025-12-19
6972625_1 CDM Cath Pyloric/colonic 5847 Bln__stw 63 63 $459.00 $459.00 $312.12 $642.60 $436.05 2025-12-19
6972626_1 CDM Cath Pyloric/colonic 5846 Bln__stw 63 63 $459.00 $459.00 $312.12 $642.60 $436.05 2025-12-19
6972624_1 CDM Cath Pyloric/colonic 5848 Bl__stw 63 63 $459.00 $459.00 $312.12 $642.60 $436.05 2025-12-19
90678 HCPCS Respiratory Syncytial Virus Vaccine, preF, Subunit, Bivalent, For Intramuscular … 64 64 $457.00 $457.00 $310.76 $639.80 $434.15 2025-12-19
73202 HCPCS CT Scan Of Arm Before And After Contrast 256 64 $1,091.50 $1,091.50 $53.85 $2,573.20 $433.70 2025-12-19
23500 HCPCS Closed Treatment Of Broken Collar Bone 183 64 $476.00 $476.00 $230.30 $879.20 $433.20 2025-12-19
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 128 64 $1,165.50 $1,165.50 $50.37 $2,632.00 $432.96 2025-12-19
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 128 64 $1,236.00 $1,236.00 $53.22 $2,907.80 $432.58 2025-12-19
85280 HCPCS Clotting Factor Xii (Hageman) Measurement 64 64 $455.00 $455.00 $39.18 $637.00 $432.25 2025-12-19
85210 HCPCS Clotting Factor Ii Prothrombin, Measurement 64 64 $455.00 $455.00 $26.28 $637.00 $432.25 2025-12-19
27250 HCPCS Closed Treatment Of Dislocated Hip 128 64 $500.00 $500.00 $173.78 $631.40 $428.45 2025-12-19
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 128 64 $1,214.50 $1,214.50 $61.46 $2,776.20 $428.16 2025-12-19
45330 HCPCS Diagnostic Exam Of Lower Portion Of Large Bowel Using A Flexible Endoscope 142 64 $457.00 $457.00 $55.22 $2,511.60 $428.05 2025-12-19
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 142 64 $462.00 $462.00 $116.30 $2,373.00 $427.35 2025-12-19
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 128 64 $1,074.00 $1,074.00 $57.33 $2,387.00 $425.28 2025-12-19
17004 HCPCS Destruction Of Precancer Skin Growth, 15 Or More Growths 55 55 $446.00 $446.00 $303.28 $624.40 $423.70 2025-12-19
88374 HCPCS Microscopic Genetic Analysis Of Tissue, Computer-assisted Technology, Initial Pr… 64 64 $443.00 $443.00 $301.24 $732.21 $420.85 2025-12-19
25500 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side 64 64 $922.00 $922.00 $265.53 $894.34 $419.72 2025-12-19
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 128 64 $889.50 $889.50 $57.33 $1,878.80 $419.52 2025-12-19
88237 HCPCS Tissue Culture For Tumor Disorders Of Bone Marrow And Blood Cells 184 64 $441.00 $441.00 $99.28 $646.80 $418.95 2025-12-19
81279 HCPCS Gene Analysis (Janus Kinase 2) Targeted Sequence Analysis 64 64 $441.00 $441.00 $299.88 $617.40 $418.95 2025-12-19
88377 HCPCS Microscopic Genetic Analysis Of Tissue, Manual, Each Additional Multiplex Stain … 64 64 $441.00 $441.00 $299.88 $834.56 $418.95 2025-12-19
87523 HCPCS Detection Of Hepatitis D (delta) 64 64 $440.00 $440.00 $299.20 $616.00 $418.00 2025-12-19
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 64 64 $900.00 $900.00 $243.76 $873.00 $416.79 2025-12-19
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 128 64 $554.50 $554.50 $117.87 $1,212.40 $412.31 2025-12-19
96360 HCPCS Infusion Into A Vein For Hydration, 31-60 Minutes 64 64 $434.00 $434.00 $295.12 $607.60 $412.30 2025-12-19
71270 HCPCS CT Scan Of Chest Before And After Contrast 128 64 $1,396.00 $1,396.00 $55.75 $3,308.20 $411.84 2025-12-19
86053 HCPCS Flow Cytometry Detection Of Aquaporin-4 (neuromyelitis Optica [nmo]) Antibody 192 64 $433.00 $433.00 $64.60 $655.20 $411.35 2025-12-19
86363 HCPCS Flow Cytometry Detection Of Myelin Oligodendrocyte Glycoprotein (mog-igg1) Antib… 128 64 $433.00 $433.00 $294.44 $606.20 $411.35 2025-12-19
85598 HCPCS Phospholipid Test 64 64 $432.00 $432.00 $36.41 $604.80 $410.40 2025-12-19
93975 HCPCS Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 128 64 $596.50 $596.50 $52.34 $1,268.40 $410.38 2025-12-19
8935743_1 CDM Clip Hemo 360 Resolution M0052__stw 63 63 $431.00 $431.00 $293.08 $603.40 $409.45 2025-12-19
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 128 64 $449.00 $449.00 $209.65 $621.60 $408.54 2025-12-19
82131 HCPCS Amino Acid Analysis, Quantitative, Each Specimen 64 64 $429.00 $429.00 $46.53 $600.60 $407.55 2025-12-19
93225 HCPCS Electrocardiogram (ecg) 2-day Continuous 64 64 $427.00 $427.00 $62.99 $597.80 $405.65 2025-12-19
70487 HCPCS CT Scan Of Face With Contrast 128 64 $1,129.00 $1,129.00 $50.37 $2,570.40 $405.12 2025-12-19
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 128 64 $1,442.50 $1,442.50 $56.70 $3,452.40 $402.24 2025-12-19
97545 HCPCS Evaluation For Work Hardening Or Conditioning, Initial 2 Hours 128 64 $484.00 $484.00 $257.72 $824.60 $400.52 2025-12-19
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