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

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 · 2026-10-18
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
$8,386
outlier · 8.7×
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 $64,119.10 $64,119.10 $64,119.10 nat. median
$8,119
outlier · 7.9×
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 2 $61,983.92 $61,983.92 $61,983.92 nat. median
$16,931
outlier · 3.7×
811
MS_DRG 		Red Blood Cell Disorders With Mcc 2 $58,787.55 $58,787.55 $58,787.55 nat. median
$13,626
outlier · 4.3×
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
$8,362
outlier · 5.6×
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 2 $40,450.85 $40,450.85 $40,450.85 nat. median
$10,422
outlier · 3.9×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 2 $38,631.29 $38,631.29 $38,631.29 nat. median
$12,877
outlier · 3.0×
951
MS_DRG 		Other Factors Influencing Health Status 2 $37,513.21 $37,513.21 $37,513.21 nat. median
$6,229
outlier · 6.0×
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 2 $30,309.30 $30,309.30 $30,309.30 nat. median
$8,379
outlier · 3.6×
534
MS_DRG 		Fractures Of Femur Without Mcc 2 $30,248.80 $30,248.80 $30,248.80 nat. median
$8,542
outlier · 3.5×
948
MS_DRG 		Signs And Symptoms Without Mcc 2 $30,248.80 $30,248.80 $30,248.80 nat. median
$7,971
outlier · 3.8×
543
MS_DRG 		Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 2 $29,360.97 $29,360.97 $29,360.97 nat. median
$10,651
outlier · 2.8×
683
MS_DRG 		Renal Failure With Cc 2 $29,043.94 $29,043.94 $29,043.94 nat. median
$9,113
outlier · 3.2×
603
MS_DRG 		Cellulitis Without Mcc 2 $29,010.80 $29,010.80 $29,010.80 nat. median
$8,991
outlier · 3.2×
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
$10,410
outlier · 2.3×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 2 $22,659.81 $22,659.81 $22,659.81 nat. median
$15,405
1.5× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 2 $21,039.20 $21,039.20 $21,039.20 nat. median
$11,515
1.8× median
66
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 2 $20,725.20 $20,725.20 $20,725.20 nat. median
$7,567
outlier · 2.7×
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 2 $20,360.20 $20,360.20 $20,360.20 nat. median
$12,282
1.7× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 2 $20,258.08 $20,258.08 $20,258.08 nat. median
$6,821
outlier · 3.0×
187
MS_DRG 		Pleural Effusion With Cc 2 $20,224.20 $20,224.20 $20,224.20 nat. median
$10,206
2.0× median
186
MS_DRG 		Pleural Effusion With Mcc 2 $19,528.29 $19,528.29 $19,528.29 nat. median
$15,136
1.3× median
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 2 $11,406.60 $11,406.60 $11,406.60 nat. median
$11,073
1.0× 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
$10,477
1.1× median
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 $10,636.60 $10,636.60 $10,636.60 nat. median
$8,186
1.3× median
310
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 2 $10,163.60 $10,163.60 $10,163.60 nat. median
$6,289
1.6× median
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 2 $9,876.32 $9,876.32 $9,876.32 nat. median
$19,970
outlier · 0.5×
812
MS_DRG 		Red Blood Cell Disorders Without Mcc 2 $9,354.60 $9,354.60 $9,354.60 nat. median
$9,313
1.0× median
J9332
HCPCS 		Injection, Efgartigimod Alfa-fcab, 2mg 64 $6,689.84 $13,773.20 $9,346.10 nat. median
$112
outlier · 83.6×
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 64 $4,908.92 $10,106.60 $6,858.05 nat. median
$1,659
outlier · 4.1×
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
$1,825
outlier · 3.4×
G0390
HCPCS 		Trauma Response Team Associated With Hospital Critical Care Service 64 $2,685.32 $5,528.60 $3,751.55 nat. median
$3,197
1.2× median
Q4199
HCPCS 		Cygnus Matrix, Per Square Centimeter 64 $1,081.20 $7,280.00 $3,534.00 nat. median
$345
outlier · 10.2×
8028141_1
CDM 		Coronary Care Unit - General Classification 58 $2,761.50 $3,682.00 $3,497.90 nat. median
$3,498
1.0× median
74177
HCPCS 		CT Scan Of Abdomen And Pelvis With Contrast 64 $81.71 $5,063.80 $3,436.15 nat. median
$976
outlier · 3.5×
90378
HCPCS 		Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 64 $2,062.52 $7,028.00 $3,300.91 nat. median
$2,117
1.6× median
8028202_1
CDM 		Room & Board - Other - Sterile Environment 58 $2,505.75 $3,341.00 $3,173.95 nat. median
$3,174
1.0× median
8028232_1
CDM 		Coronary Care Unit - General Classification 58 $2,485.50 $3,314.00 $3,148.30 nat. median
$3,148
1.0× median
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
$1,323
outlier · 2.3×
8028231_1
CDM 		Room & Board - Other - Sterile Environment 58 $2,376.75 $3,169.00 $3,010.55 nat. median
$3,011
1.0× median
8028230_1
CDM 		Room & Board - Other - Other 58 $2,356.50 $3,142.00 $2,984.90 nat. median
$2,985
1.0× median
8028201_1
CDM 		Room & Board - Private (one Bed) - General Classification 58 $2,229.75 $2,973.00 $2,824.35 nat. median
$2,850
1.0× median
74183
HCPCS 		MRI Scan Of Abdomen Before And After Contrast 64 $98.50 $4,060.00 $2,755.00 nat. median
$1,105
outlier · 2.5×
59409
HCPCS 		Vaginal Delivery 64 $773.25 $4,155.20 $2,705.51 nat. median
$3,148
0.9× median
8028229_1
CDM 		Room & Board - Other - Other 58 $2,100.00 $2,800.00 $2,660.00 nat. median
$2,660
1.0× median
Q4159
HCPCS 		Affinity, Per Square Centimeter 64 $1,836.00 $5,040.00 $2,619.00 nat. median
$643
outlier · 4.1×
J0897
HCPCS 		Injection, Denosumab, 1 Mg 64 $24.93 $3,766.00 $2,555.50 nat. median
$1,982
1.3× median
Q4101
HCPCS 		Apligraf, Per Square Centimeter 64 $1,761.20 $3,626.00 $2,460.50 nat. median
$118
outlier · 20.8×
C1052
HCPCS 		Hemostatic Agent, Gastrointestinal, Topical 64 $1,632.00 $3,360.00 $2,280.00 nat. median
$3,247
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
$998
outlier · 2.3×

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.

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
             
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
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
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
10080 HCPCS Simple Drainage Of Cyst Of Tailbone 128 64 $625.50 $625.50 $103.04 $953.40 $541.50 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
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 142 64 $462.00 $462.00 $116.30 $2,373.00 $427.35 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
23500 HCPCS Closed Treatment Of Broken Collar Bone 183 64 $476.00 $476.00 $230.30 $879.20 $433.20 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
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 128 64 $598.50 $598.50 $307.10 $805.00 $543.69 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
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
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
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
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
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
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
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
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
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
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
26600 HCPCS Closed Treatment Of Broken Hand Bone 55 55 $726.00 $726.00 $493.68 $1,016.40 $689.70 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
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
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
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
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
27250 HCPCS Closed Treatment Of Dislocated Hip 128 64 $500.00 $500.00 $173.78 $631.40 $428.45 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
27520 HCPCS Closed Treatment Of Broken Kneecap 128 64 $698.00 $698.00 $307.84 $867.18 $486.94 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
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
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
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
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
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
27840 HCPCS Closed Treatment Of Dislocated Ankle 128 64 $696.00 $696.00 $390.38 $831.60 $576.18 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
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
28232 HCPCS Incision To Lengthen Toe Tendon 128 64 $895.00 $895.00 $237.86 $1,377.60 $765.70 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
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
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
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
36430 HCPCS Transfusion Of Blood Or Blood Products 64 64 $975.00 $975.00 $663.00 $1,365.00 $926.25 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
46320 HCPCS Removal Of External Hemorrhoid With Blood Clot 55 55 $571.00 $571.00 $388.28 $799.40 $542.45 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
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
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
59409 HCPCS Vaginal Delivery 128 64 $3,024.50 $3,024.50 $773.25 $4,155.20 $2,705.51 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
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
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
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
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
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
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
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
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
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
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
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
6972624_1 CDM Cath Pyloric/colonic 5848 Bl__stw 63 63 $459.00 $459.00 $312.12 $642.60 $436.05 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
70336 HCPCS MRI Scan Of Jaw Joint 128 64 $723.50 $723.50 $65.57 $1,519.00 $463.38 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
71551 HCPCS MRI Scan Of Chest With Contrast 256 64 $986.50 $986.50 $76.98 $2,165.80 $637.89 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
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
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
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
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
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
72196 HCPCS MRI Scan Of Pelvis With Contrast 256 64 $898.00 $898.00 $76.98 $1,916.60 $481.78 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
8028192_1 CDM Room & Board - Other - Sterile Environment 58 58 $674.00 $674.00 $505.50 $674.00 $640.30 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
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
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
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
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
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
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
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
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
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
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
81219 HCPCS Gene Analysis (calreticulin), Common Variants 64 64 $567.00 $567.00 $246.30 $793.80 $538.65 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
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
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
81256 HCPCS Gene Analysis (hemochromatosis) Common Variants 64 64 $568.00 $568.00 $132.36 $795.20 $539.60 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
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
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
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
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
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
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
82131 HCPCS Amino Acid Analysis, Quantitative, Each Specimen 64 64 $429.00 $429.00 $46.53 $600.60 $407.55 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
84378 HCPCS Carbohydrate Analysis, Single Quantitative 64 64 $494.00 $494.00 $23.36 $691.60 $469.30 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
85280 HCPCS Clotting Factor Xii (Hageman) Measurement 64 64 $455.00 $455.00 $39.18 $637.00 $432.25 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
85598 HCPCS Phospholipid Test 64 64 $432.00 $432.00 $36.41 $604.80 $410.40 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
86366 HCPCS Test For Muscle-specific Kinase Antibody 64 64 $852.00 $852.00 $579.36 $1,192.80 $809.40 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
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
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
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
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
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
87523 HCPCS Detection Of Hepatitis D (delta) 64 64 $440.00 $440.00 $299.20 $616.00 $418.00 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
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
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
88233 HCPCS Tissue Culture To Identify Skin Disorders 64 64 $476.00 $476.00 $284.99 $666.40 $452.20 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
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
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
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
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
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
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
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
8935743_1 CDM Clip Hemo 360 Resolution M0052__stw 63 63 $431.00 $431.00 $293.08 $603.40 $409.45 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
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
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
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
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
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
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
92610 HCPCS Evaluation Of Swallowing Function 64 64 $545.00 $545.00 $370.60 $763.00 $517.75 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
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
93225 HCPCS Electrocardiogram (ecg) 2-day Continuous 64 64 $427.00 $427.00 $62.99 $597.80 $405.65 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 64 64 $592.00 $592.00 $377.06 $828.80 $562.40 2026-07-30
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
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
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
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
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
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
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