Price Transparencybeta Hospital negotiated rates

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

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Hospital

LOGAN HEALTH - CHESTER

Chester, MT · CCN 271334 · Rates published

3,794 distinct procedures filed
6 distinct payers
15,162 rate rows
2026-04-01 last MRF observed
Data quality

10,490 of 15,162 rate rows are consumer-grade (69.2%)

4,672 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,894
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,778
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/Download.aspx?pi=envg*__*KSrd*__*pv3yoiW0zB4g*-*
Found on page https://hospitalpricedisclosure.com/Default.aspx?pi=envg*__*KSrd*__*pv3yoiW0zB4g*-*
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-22
Content fingerprint baefd84cae120325… · 4,579,934 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
81416
HCPCS 		Exome Sequence Analysis 2 $15,000.00 $36,180.00 $36,180.00 nat. median
$12,000
outlier · 3.0×
0315U
OTHER 		Onc Cutan Sq Cll Ca Mrna 40 2 $10,625.00 $25,627.50 $25,627.50 nat. median
$8,925
outlier · 2.9×
0211U
OTHER 		Onc Pan-tum Dna&rna Gnrj Seq 2 $10,568.75 $25,491.83 $25,491.83 nat. median
$8,793
outlier · 2.9×
0485U
OTHER 		Onc Sol Tum Cfdna&rna Ngs Gm 2 $4,561.85 $25,491.83 $25,491.83 nat. median
$3,832
outlier · 6.7×
81552
HCPCS 		Onc Uveal Mlnma Mrna 15 Gene 2 $9,720.00 $23,444.64 $23,444.64 nat. median
$8,087
outlier · 2.9×
0094U
OTHER 		Genome Rapid Sequence Alys 2 $9,477.75 $22,860.34 $22,860.34 nat. median
$7,961
outlier · 2.9×
0578U
OTHER 		Onc Cutan Mln RNA Qpcr 10gen 2 $4,841.25 $21,686.90 $21,686.90 nat. median
$4,067
outlier · 5.3×
81529
HCPCS 		Onc Cutan Mlnma Mrna 31 Gene 2 $8,991.25 $21,686.90 $21,686.90 nat. median
$7,553
outlier · 2.9×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 1 $20,384.00 $20,384.00 $20,384.00 nat. median
$8,516
outlier · 2.4×
0267U
OTHER 		Rare Do Id Opt Gen Mapg&seq 2 $8,424.16 $20,319.08 $20,319.08 nat. median
$7,144
outlier · 2.8×
81554
HCPCS 		Pulm Ds Ipf Mrna 190 Gen Alg 2 $6,762.00 $16,582.50 $16,582.50 nat. median
$5,680
outlier · 2.9×
0265U
OTHER 		Rar Do Whl Gn&mtcdrl DNA Als 2 $6,844.75 $16,509.53 $16,509.53 nat. median
$5,750
outlier · 2.9×
0212U
OTHER 		Rare Ds Gen DNA Alys Proband 2 $6,844.00 $16,507.73 $16,507.73 nat. median
$5,804
outlier · 2.8×
0532U
OTHER 		Rare Ds Whlgen&mitochdrl DNA 2 $6,289.00 $16,507.73 $16,507.73 nat. median
$5,283
outlier · 3.1×
0583U
OTHER 		Rare Ds Rpd Whlgen Cmptr DNA 2 $4,738.88 $16,507.73 $16,507.73 nat. median
$3,981
outlier · 4.1×
0567U
OTHER 		Rare Ds Whl Gen Seq Srs&lrs 2 $6,289.00 $16,507.73 $16,507.73 nat. median
$5,283
outlier · 3.1×
0582U
OTHER 		Rare Ds Rpd Whlgen DNA Vrnts 2 $9,477.75 $16,507.73 $16,507.73 nat. median
$7,961
outlier · 2.1×
0295U
OTHER 		Onc Brst Dux Carc 7 Proteins 2 $6,793.75 $16,386.53 $16,386.53 nat. median
$5,544
outlier · 3.0×
0214U
OTHER 		Rare Ds Xom DNA Alys Proband 2 $6,530.75 $15,752.16 $15,752.16 nat. median
$5,538
outlier · 2.8×
0335U
OTHER 		Rare Ds Whl Gen Seq Fetal 2 $6,530.75 $15,752.16 $15,752.16 nat. median
$5,486
outlier · 2.9×
0469U
OTHER 		Rare Ds Whl Gen Seq Ftl Samp 2 $1,497.43 $15,752.16 $15,752.16 nat. median
$1,270
outlier · 12.4×
81425
HCPCS 		Genome Sequence Analysis 2 $6,289.00 $15,169.07 $15,169.07 nat. median
$5,112
outlier · 3.0×
0242U
OTHER 		Trgt Gen Seq Alys Pnl 55-74 2 $6,250.00 $15,075.00 $15,075.00 nat. median
$5,250
outlier · 2.9×
0569U
OTHER 		Onc Sol Tum Ngs Tmm>20000dmr 1 $15,075.00 $15,075.00 $15,075.00 nat. median
$598
outlier · 25.2×
0530U
OTHER 		Onc Pan-sol Tum Ctdna 77 Gen 2 $3,649.50 $15,075.00 $15,075.00 nat. median
$3,066
outlier · 4.9×
0326U
OTHER 		Trgt Gen Seq Alys Pnl 83+ 2 $6,250.00 $15,075.00 $15,075.00 nat. median
$5,250
outlier · 2.9×
0523U
OTHER 		Onc Soltum DNA Ngs Snv 22gen 2 $1,690.11 $15,075.00 $15,075.00 nat. median
$1,420
outlier · 10.6×
0539U
OTHER 		Onc Sol Tumor Cfctdna 152gen 2 $4,110.64 $15,075.00 $15,075.00 nat. median
$3,453
outlier · 4.4×
0487U
OTHER 		Onc Sol Tum Cfcdna Tgsap 84 2 $3,649.50 $15,075.00 $15,075.00 nat. median
$3,066
outlier · 4.9×
0108U
OTHER 		Gi Barrett Esoph 9 Prtn Bmrk 2 $6,187.50 $14,924.25 $14,924.25 nat. median
$5,049
outlier · 3.0×
0261U
OTHER 		Onc Clrct Ca Img Alys W/ai 2 $3,141.56 $14,924.25 $14,924.25 nat. median
$2,714
outlier · 5.5×
0036U
OTHER 		Xome Tum & Nml Spec Seq Alys 2 $5,975.00 $14,411.70 $14,411.70 nat. median
$5,067
outlier · 2.8×
81415
HCPCS 		Exome Sequence Analysis 2 $5,975.00 $14,411.70 $14,411.70 nat. median
$4,907
outlier · 2.9×
0300U
OTHER 		Onc Pan Tum Whl Gen Seq&opt 2 $5,228.91 $12,612.13 $12,612.13 nat. median
$4,392
outlier · 2.9×
0306U
OTHER 		Onc Mrd Nxt-gnrj Alys 1st 2 $4,848.06 $11,693.52 $11,693.52 nat. median
$4,072
outlier · 2.9×
0560U
OTHER 		Onc Mrd Gsa Cfdna Baseline 2 $4,848.06 $11,693.52 $11,693.52 nat. median
$4,072
outlier · 2.9×
0045U
OTHER 		Onc Brst Dux Carc Is 12 Gene 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,144
outlier · 2.8×
81522
HCPCS 		Onc Breast Mrna 12 Genes 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,067
outlier · 2.9×
81518
HCPCS 		Onc Brst Mrna 11 Genes 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,067
outlier · 2.9×
81523
HCPCS 		Onc Brst Mrna 70 Cnt 31 Gene 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,067
outlier · 2.9×
81542
HCPCS 		Onc Prostate Mrna 22 Cnt Gen 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,067
outlier · 2.9×
0566U
OTHER 		Onc Lng Qpcr-bsd Alys 13dmrs 2 $520.97 $11,677.10 $11,677.10 nat. median
$438
outlier · 26.7×
81519
HCPCS 		Oncology Breast Mrna 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,067
outlier · 2.9×
0047U
OTHER 		Onc Prst8 Mrna 17 Gene Alg 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,105
outlier · 2.8×
81541
HCPCS 		Onc Prostate Mrna 46 Genes 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,067
outlier · 2.9×
0288U
OTHER 		Onc Lung Mrna Quan Pcr 11&3 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,067
outlier · 2.9×
81521
HCPCS 		Onc Breast Mrna 70 Genes 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,067
outlier · 2.9×
0497U
OTHER 		Onc Prst8 Mrna Rt-pcr 6 Gene 2 $4,841.25 $11,677.10 $11,677.10 nat. median
$4,105
outlier · 2.8×
81540
HCPCS 		Oncology Tum Unknown Origin 2 $4,687.50 $11,306.25 $11,306.25 nat. median
$3,938
outlier · 2.9×
0510U
OTHER 		Onc Pncrtc Ca Alg Alys 16gen 2 $592.39 $11,306.25 $11,306.25 nat. median
$507
outlier · 22.3×

Other procedures at this hospital

Browse this hospital's 3,794 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
             
81416 HCPCS Exome Sequence Analysis 4 2 — — $15,000.00 $36,180.00 $36,180.00 2026-04-01
0315U OTHER Onc Cutan Sq Cll Ca Mrna 40 4 2 — — $10,625.00 $25,627.50 $25,627.50 2026-04-01
0485U OTHER Onc Sol Tum Cfdna&rna Ngs Gm 4 2 — — $4,561.85 $25,491.83 $25,491.83 2026-04-01
0211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 4 2 — — $10,568.75 $25,491.83 $25,491.83 2026-04-01
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 4 2 — — $9,720.00 $23,444.64 $23,444.64 2026-04-01
0094U OTHER Genome Rapid Sequence Alys 4 2 — — $9,477.75 $22,860.34 $22,860.34 2026-04-01
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 4 2 — — $8,991.25 $21,686.90 $21,686.90 2026-04-01
0578U OTHER Onc Cutan Mln RNA Qpcr 10gen 4 2 — — $4,841.25 $21,686.90 $21,686.90 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 — — $20,384.00 $20,384.00 $20,384.00 2026-04-01
0267U OTHER Rare Do Id Opt Gen Mapg&seq 4 2 — — $8,424.16 $20,319.08 $20,319.08 2026-04-01
81554 HCPCS Pulm Ds Ipf Mrna 190 Gen Alg 4 2 — — $6,762.00 $16,582.50 $16,582.50 2026-04-01
0265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 4 2 — — $6,844.75 $16,509.53 $16,509.53 2026-04-01
0212U OTHER Rare Ds Gen DNA Alys Proband 4 2 — — $6,844.00 $16,507.73 $16,507.73 2026-04-01
0583U OTHER Rare Ds Rpd Whlgen Cmptr DNA 4 2 — — $4,738.88 $16,507.73 $16,507.73 2026-04-01
0567U OTHER Rare Ds Whl Gen Seq Srs&lrs 4 2 — — $6,289.00 $16,507.73 $16,507.73 2026-04-01
0582U OTHER Rare Ds Rpd Whlgen DNA Vrnts 4 2 — — $9,477.75 $16,507.73 $16,507.73 2026-04-01
0532U OTHER Rare Ds Whlgen&mitochdrl DNA 4 2 — — $6,289.00 $16,507.73 $16,507.73 2026-04-01
0295U OTHER Onc Brst Dux Carc 7 Proteins 4 2 — — $6,793.75 $16,386.53 $16,386.53 2026-04-01
0335U OTHER Rare Ds Whl Gen Seq Fetal 4 2 — — $6,530.75 $15,752.16 $15,752.16 2026-04-01
0214U OTHER Rare Ds Xom DNA Alys Proband 4 2 — — $6,530.75 $15,752.16 $15,752.16 2026-04-01
0469U OTHER Rare Ds Whl Gen Seq Ftl Samp 4 2 — — $1,497.43 $15,752.16 $15,752.16 2026-04-01
81425 HCPCS Genome Sequence Analysis 4 2 — — $6,289.00 $15,169.07 $15,169.07 2026-04-01
0530U OTHER Onc Pan-sol Tum Ctdna 77 Gen 4 2 — — $3,649.50 $15,075.00 $15,075.00 2026-04-01
0487U OTHER Onc Sol Tum Cfcdna Tgsap 84 4 2 — — $3,649.50 $15,075.00 $15,075.00 2026-04-01
0523U OTHER Onc Soltum DNA Ngs Snv 22gen 4 2 — — $1,690.11 $15,075.00 $15,075.00 2026-04-01
0569U OTHER Onc Sol Tum Ngs Tmm>20000dmr 3 1 — — $15,075.00 $15,075.00 $15,075.00 2026-04-01
0539U OTHER Onc Sol Tumor Cfctdna 152gen 4 2 — — $4,110.64 $15,075.00 $15,075.00 2026-04-01
0326U OTHER Trgt Gen Seq Alys Pnl 83+ 4 2 — — $6,250.00 $15,075.00 $15,075.00 2026-04-01
0242U OTHER Trgt Gen Seq Alys Pnl 55-74 4 2 — — $6,250.00 $15,075.00 $15,075.00 2026-04-01
0261U OTHER Onc Clrct Ca Img Alys W/ai 4 2 — — $3,141.56 $14,924.25 $14,924.25 2026-04-01
0108U OTHER Gi Barrett Esoph 9 Prtn Bmrk 4 2 — — $6,187.50 $14,924.25 $14,924.25 2026-04-01
0036U OTHER Xome Tum & Nml Spec Seq Alys 4 2 — — $5,975.00 $14,411.70 $14,411.70 2026-04-01
81415 HCPCS Exome Sequence Analysis 4 2 — — $5,975.00 $14,411.70 $14,411.70 2026-04-01
0300U OTHER Onc Pan Tum Whl Gen Seq&opt 4 2 — — $5,228.91 $12,612.13 $12,612.13 2026-04-01
0560U OTHER Onc Mrd Gsa Cfdna Baseline 4 2 — — $4,848.06 $11,693.52 $11,693.52 2026-04-01
0306U OTHER Onc Mrd Nxt-gnrj Alys 1st 4 2 — — $4,848.06 $11,693.52 $11,693.52 2026-04-01
81519 HCPCS Oncology Breast Mrna 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
81521 HCPCS Onc Breast Mrna 70 Genes 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
0045U OTHER Onc Brst Dux Carc Is 12 Gene 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
81542 HCPCS Onc Prostate Mrna 22 Cnt Gen 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
0566U OTHER Onc Lng Qpcr-bsd Alys 13dmrs 4 2 — — $520.97 $11,677.10 $11,677.10 2026-04-01
81522 HCPCS Onc Breast Mrna 12 Genes 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
0047U OTHER Onc Prst8 Mrna 17 Gene Alg 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
0288U OTHER Onc Lung Mrna Quan Pcr 11&3 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
81523 HCPCS Onc Brst Mrna 70 Cnt 31 Gene 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
0497U OTHER Onc Prst8 Mrna Rt-pcr 6 Gene 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
81541 HCPCS Onc Prostate Mrna 46 Genes 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
81518 HCPCS Onc Brst Mrna 11 Genes 4 2 — — $4,841.25 $11,677.10 $11,677.10 2026-04-01
0510U OTHER Onc Pncrtc Ca Alg Alys 16gen 4 2 — — $592.39 $11,306.25 $11,306.25 2026-04-01
81540 HCPCS Oncology Tum Unknown Origin 4 2 — — $4,687.50 $11,306.25 $11,306.25 2026-04-01
0586U OTHER Onc Mrna Gen Xprsn 216 Genes 4 2 — — $3,649.50 $11,080.13 $11,080.13 2026-04-01
0019U OTHER Onc RNA Tiss Predict Alg 4 2 — — $4,593.75 $11,080.13 $11,080.13 2026-04-01
0258U OTHER Ai Psor Mrna 50-100 Gen Alg 4 2 — — $4,593.75 $11,080.13 $11,080.13 2026-04-01
0362U OTHER Onc Pap Thyr Ca RNA 82&10 4 2 — — $4,500.00 $10,854.00 $10,854.00 2026-04-01
0573U OTHER Onc Pancreas 3bmrk Pclf Alg 3 1 — — $10,854.00 $10,854.00 $10,854.00 2026-04-01
0313U OTHER Onc Pncrs Dna&mrna Seq 74 4 2 — — $4,500.00 $10,854.00 $10,854.00 2026-04-01
0391U OTHER Onc Sld Tum Dna&rna 437 Gen 4 2 — — $4,500.00 $10,854.00 $10,854.00 2026-04-01
0026U OTHER Onc Thyr Dna&mrna 112 Genes 4 2 — — $4,500.00 $10,854.00 $10,854.00 2026-04-01
0287U OTHER Onc Thyr Dna&mrna 112 Genes 4 2 — — $4,500.00 $10,854.00 $10,854.00 2026-04-01
81546 HCPCS Onc Thyr Mrna 10,196 Gen Alg 4 2 — — $4,500.00 $10,854.00 $10,854.00 2026-04-01
0340U OTHER Onc Pan Ca Alys Mrd Plasma 4 2 — — $4,487.50 $10,823.85 $10,823.85 2026-04-01
0080U OTHER Onc Lng 5 Clin Rsk Factr Alg 4 2 — — $4,400.00 $10,612.80 $10,612.80 2026-04-01
0244U OTHER Onc Solid Orgn DNA 257 Genes 4 2 — — $4,375.00 $10,552.50 $10,552.50 2026-04-01
0239U OTHER Trgt Gen Seq Alys Pnl 311+ 4 2 — — $4,375.00 $10,552.50 $10,552.50 2026-04-01
0037U OTHER Trgt Gen Seq DNA 324 Genes 4 2 — — $4,375.00 $10,552.50 $10,552.50 2026-04-01
0016M OTHER Onc Bladder Mrna 209 Gen Alg 4 2 — — $4,362.04 $10,521.23 $10,521.23 2026-04-01
0329U OTHER Onc Neo Xome&trns Seq Alys 4 2 — — $4,297.48 $10,365.50 $10,365.50 2026-04-01
81440 HCPCS Mitochondrial Gene 4 2 — — $4,155.00 $10,021.86 $10,021.86 2026-04-01
0055U OTHER Card Hrt Trnspl 96 DNA Seq 4 2 — — $4,050.00 $9,768.60 $9,768.60 2026-04-01
81595 HCPCS Cardiology Hrt Trnspl Mrna 4 2 — — $4,050.00 $9,768.60 $9,768.60 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 1 1 — — $9,652.51 $9,652.51 $9,652.51 2026-04-01
0266U OTHER Unxpl Cnst Hrtbl Do Gn Xprsn 4 2 — — $4,000.00 $9,648.00 $9,648.00 2026-04-01
0262U OTHER Onc Sld Tum Rt-pcr 7 Gen 4 2 — — $4,000.00 $9,648.00 $9,648.00 2026-04-01
0253U OTHER Rprdtve Med RNA Gen Prfl 238 4 2 — — $3,949.28 $9,525.65 $9,525.65 2026-04-01
81558 HCPCS Trnspl Rej Kdn Mrna Qpcr 139 4 2 — — $4,050.00 $9,525.65 $9,525.65 2026-04-01
0153U OTHER Onc Breast Mrna 101 Genes 4 2 — — $3,949.28 $9,525.65 $9,525.65 2026-04-01
0088U OTHER Trnsplj Kdn Algrft Rej 1494 4 2 — — $3,949.28 $9,525.65 $9,525.65 2026-04-01
0087U OTHER Crd Hrt Trnspl Mrna 1283 Gen 4 2 — — $3,949.28 $9,525.65 $9,525.65 2026-04-01
0426U OTHER Genome Ultra-rapid Seq Alys 1 1 — — $9,477.75 $9,477.75 $9,477.75 2026-04-01
81525 HCPCS Oncology Colon Mrna 4 2 — — $3,895.00 $9,394.74 $9,394.74 2026-04-01
5301 OTHER Level 1 Upper Gi Procedures 1 1 — — $9,186.83 $9,186.83 $9,186.83 2026-04-01
0248U OTHER Onc Brn Sphrd Cll 12 Rx Pnl 4 2 — — $3,792.32 $9,147.08 $9,147.08 2026-04-01
0511U OTHER Onc Sol Tum 3dmicroenvir 36+ 4 2 — — $3,792.32 $9,147.08 $9,147.08 2026-04-01
0525U OTHER Onc Sphrd Cell Cul 11-rx Pnl 4 2 — — $3,792.32 $9,147.08 $9,147.08 2026-04-01
0172U OTHER Onc Sld Tum Alys Brca1 Brca2 4 2 — — $3,787.50 $9,135.45 $9,135.45 2026-04-01
0018U OTHER Onc Thyr 10 Microrna Seq Alg 4 2 — — $3,752.61 $9,051.30 $9,051.30 2026-04-01
0409U OTHER Onc Sld Tum DNA 80 & RNA 36 4 2 — — $3,649.50 $8,802.59 $8,802.59 2026-04-01
0562U OTHER Onc Sol Tum Tgsa 33gens Snvs 4 2 — — $747.39 $8,802.59 $8,802.59 2026-04-01
0538U OTHER Onc Sol Tum Ngts Ffpe 600gen 4 2 — — $3,736.94 $8,802.59 $8,802.59 2026-04-01
81455 HCPCS Targeted Genomic Seq Analys 4 2 — — $3,649.50 $8,802.59 $8,802.59 2026-04-01
0473U OTHER Onc Sld Tum Bld/slv 648 Gene 4 2 — — $5,625.00 $8,802.59 $8,802.59 2026-04-01
0571U OTHER Onc Sol Tum Dna80&rna10g Ngs 4 2 — — $3,649.50 $8,802.59 $8,802.59 2026-04-01
0204U OTHER Onc Thyr Mrna Xprsn Alys 593 3 1 — — $8,802.59 $8,802.59 $8,802.59 2026-04-01
0297U OTHER Onc Pan Tum Whl Gen Seq DNA 4 2 — — $3,649.50 $8,802.59 $8,802.59 2026-04-01
0298U OTHER Onc Pan Tum Whl Trns Seq RNA 4 2 — — $3,649.50 $8,802.59 $8,802.59 2026-04-01
0250U OTHER Onc Sld Org Neo DNA 505 Gene 4 2 — — $3,649.50 $8,802.59 $8,802.59 2026-04-01
81456 HCPCS Tgsap So/hl 51/< RNA Alys 4 2 — — $3,649.50 $8,802.59 $8,802.59 2026-04-01
0048U OTHER Onc Sld Org Neo DNA 468 Gene 4 2 — — $3,649.50 $8,802.59 $8,802.59 2026-04-01
0543U OTHER Onc Sol Tum Ngs DNA 517 Gens 4 2 — — $3,736.94 $8,802.59 $8,802.59 2026-04-01
0050U OTHER Trgt Gen Seq DNA 194 Genes 4 2 — — $3,645.75 $8,793.54 $8,793.54 2026-04-01
81538 HCPCS Oncology Lung 4 2 — — $3,588.75 $8,656.07 $8,656.07 2026-04-01
0540U OTHER Trnsplj Med Quan Dd-cfdna 4 2 — — $3,441.56 $8,301.06 $8,301.06 2026-04-01
0508U OTHER Trnsplj Med Dd-cfdna 40 Snps 3 1 — — $8,301.06 $8,301.06 $8,301.06 2026-04-01
0581U OTHER Trnspl Med Antb Nohla 39trgt 4 2 — — $407.25 $8,301.06 $8,301.06 2026-04-01
0118U OTHER Trnsplj Don-drv Cll-fr DNA 4 2 — — $3,441.56 $8,301.06 $8,301.06 2026-04-01
0509U OTHER Trnsplj Med Dd-cfdna<12 Snps 3 1 — — $8,301.06 $8,301.06 $8,301.06 2026-04-01
0493U OTHER Trnspl Med Quan Dd-cfdna Ngs 4 2 — — $3,441.56 $8,301.06 $8,301.06 2026-04-01
81426 HCPCS Genome Sequence Analysis 4 2 — — $3,387.44 $8,170.49 $8,170.49 2026-04-01
0213U OTHER Rare Ds Gen DNA Alys Ea Comp 4 2 — — $3,387.44 $8,170.49 $8,170.49 2026-04-01
0320U OTHER Neph RNA Psttrnspl Perph Bld 4 2 — — $3,312.50 $7,989.75 $7,989.75 2026-04-01
0542U OTHER Nefro Renal Trnspl Ur Nmr 84 3 1 — — $7,989.75 $7,989.75 $7,989.75 2026-04-01
0319U OTHER Neph RNA Pretrnspl Perph Bld 4 2 — — $3,312.50 $7,989.75 $7,989.75 2026-04-01
0544U OTHER Nefro Trnsp Mntr 48vrnt Dpcr 3 1 — — $7,989.75 $7,989.75 $7,989.75 2026-04-01
0526U OTHER Nefro Rnl Trnspl Quan Cxcl10 3 1 — — $7,989.75 $7,989.75 $7,989.75 2026-04-01
0215U OTHER Rare Ds Xom DNA Alys Ea Comp 4 2 — — $3,218.31 $7,762.57 $7,762.57 2026-04-01
0336U OTHER Rare Ds Whl Gen Seq Bld/slv 4 2 — — $3,218.31 $7,762.57 $7,762.57 2026-04-01
81520 HCPCS Onc Breast Mrna 58 Genes 4 2 — — $3,137.76 $7,568.28 $7,568.28 2026-04-01
0120U OTHER Onc B Cll Lymphm Mrna 58 Gen 4 2 — — $3,137.76 $7,568.28 $7,568.28 2026-04-01
0017M OTHER Onc Dlbcl Mrna 20 Genes Alg 4 2 — — $3,137.76 $7,568.28 $7,568.28 2026-04-01
0092U OTHER Onc Lng 3 Prtn Bmrk Plsm Alg 4 2 — — $3,110.00 $7,501.32 $7,501.32 2026-04-01
81443 HCPCS Genetic Tstg Severe Inh Cond 4 2 — — $3,060.70 $7,382.41 $7,382.41 2026-04-01
81419 HCPCS Epilepsy Gen Seq Alys Panel 4 2 — — $3,060.70 $7,382.41 $7,382.41 2026-04-01
81441 HCPCS Ibmfs Seq Alys Pnl 30 Genes 4 2 — — $3,060.70 $7,382.41 $7,382.41 2026-04-01
0276U OTHER Hem Inh Thrombocytopenia 23 4 2 — — $3,060.70 $7,382.41 $7,382.41 2026-04-01
81412 HCPCS Ashkenazi Jewish Assoc Dis 4 2 — — $3,060.70 $7,382.41 $7,382.41 2026-04-01
0490U OTHER Onc Cutan/uveal Mlnma Cd146 4 2 — — $3,043.75 $7,341.53 $7,341.53 2026-04-01
0491U OTHER Onc Sol Tum Ctc Slct ER Prtn 4 2 — — $3,043.75 $7,341.53 $7,341.53 2026-04-01
0338U OTHER Onc Sld Tum Crcg Tum Cl Slct 4 2 — — $3,043.75 $7,341.53 $7,341.53 2026-04-01
0337U OTHER Onc Plsm Cell Do&myeloma Id 4 2 — — $3,043.75 $7,341.53 $7,341.53 2026-04-01
0492U OTHER Onc Sol Tum Ctc Slctn Pd-l1 4 2 — — $3,043.75 $7,341.53 $7,341.53 2026-04-01
0608U OTHER Reprdtve Med Ema Rtpcr 10bct 3 1 — — $7,107.75 $7,107.75 $7,107.75 2026-04-01
0607U OTHER Reprdtve Med Ema Rtpcr 31bct 3 1 — — $7,107.75 $7,107.75 $7,107.75 2026-04-01
81427 HCPCS Genome Re-evaluation 4 2 — — $2,922.06 $7,048.01 $7,048.01 2026-04-01
0218U OTHER Neuro Musc Dys Dmd Seq Alys 4 2 — — $2,848.75 $6,871.19 $6,871.19 2026-04-01
0249U OTHER Onc Brst Alys 32 Phsprtn Alg 4 2 — — $2,773.91 $6,690.67 $6,690.67 2026-04-01
0206U OTHER Neuro Alzheimer Cell Aggregj 4 2 — — $2,769.25 $6,679.44 $6,679.44 2026-04-01
0303U OTHER Hem Rbc Ads Whl Bld Hypoxic 4 2 — — $2,752.02 $6,637.88 $6,637.88 2026-04-01
0217U OTHER Neuro Inh Ataxia DNA 51 Gene 4 2 — — $2,747.94 $6,628.03 $6,628.03 2026-04-01
0067U OTHER Onc Brst Imhchem Prfl 4 Bmrk 4 2 — — $2,371.25 $6,485.49 $6,485.49 2026-04-01
81442 HCPCS Noonan Spectrum Disorders 4 2 — — $2,679.50 $6,462.95 $6,462.95 2026-04-01
0531U OTHER Nfct Ds Afb&inv Fng 673orgs 3 1 — — $6,410.50 $6,410.50 $6,410.50 2026-04-01
0152U OTHER Nfct Bct Fng Prst DNA >1000 4 2 — — $2,657.75 $6,410.50 $6,410.50 2026-04-01
0480U OTHER Nfct Ds Csf Metag Ngs Alys 4 2 — — $2,657.75 $6,410.50 $6,410.50 2026-04-01
0323U OTHER Iadna Cns Pthgn Next Gen Seq 4 2 — — $2,657.75 $6,410.50 $6,410.50 2026-04-01
0304U OTHER Hem Rbc Ads Whl Bld Normoxic 4 2 — — $2,594.75 $6,258.53 $6,258.53 2026-04-01
0572U OTHER Onc Prst8 Httl Qfish Whl Bld 3 1 — — $6,120.45 $6,120.45 $6,120.45 2026-04-01
81551 HCPCS Onc Prostate 3 Genes 4 2 — — $2,537.50 $6,120.45 $6,120.45 2026-04-01
0317U OTHER Onc Lung Ca 4-prb Fish Assay 4 2 — — $2,537.50 $6,120.45 $6,120.45 2026-04-01
81408 HCPCS Mopath Procedure Level 9 4 2 — — $2,500.00 $6,030.00 $6,030.00 2026-04-01
0314U OTHER Onc Cutan Mlnma Mrna 35 Gene 4 2 — — $2,437.50 $5,879.25 $5,879.25 2026-04-01
0022U OTHER Trgt Gen Seq Dna&rna 23 Gene 4 2 — — $2,437.50 $5,879.25 $5,879.25 2026-04-01
0296U OTHER Onc Orl&/orop Ca 20 Mlc Feat 4 2 — — $2,437.50 $5,879.25 $5,879.25 2026-04-01
0470U OTHER Onc Orop Detcj Mrd 8 DNA Hpv 4 2 — — $747.39 $5,879.25 $5,879.25 2026-04-01
0170U OTHER Neuro Asd RNA Next Gen Seq 4 2 — — $2,437.50 $5,879.25 $5,879.25 2026-04-01
0090U OTHER Onc Cutan Mlnma Mrna 23 Gene 4 2 — — $2,437.50 $5,879.25 $5,879.25 2026-04-01
0179U OTHER Onc Nonsm Cll Lng Ca Alys 23 4 2 — — $2,429.01 $5,858.78 $5,858.78 2026-04-01
0506U OTHER Gi Barretts Esophgl Cell 89 4 2 — — $2,422.51 $5,843.09 $5,843.09 2026-04-01
0114U OTHER Gi Barretts Esoph Vim&ccna1 4 2 — — $2,422.51 $5,843.09 $5,843.09 2026-04-01
0341U OTHER Ftl Aneup DNA Seq Cmpr Alys 4 2 — — $2,375.25 $5,729.11 $5,729.11 2026-04-01
0299U OTHER Onc Pan Tum Whl Gen Opt Mapg 4 2 — — $2,329.02 $5,617.60 $5,617.60 2026-04-01
0331U OTHER Onc Hl Neo Opt Gen Mapping 4 2 — — $2,329.02 $5,617.60 $5,617.60 2026-04-01
81162 HCPCS Brca1&2 Seq & Full Dup/del 4 2 — — $2,281.10 $5,502.02 $5,502.02 2026-04-01
0405U OTHER Onc Pncrtc 59 Mthltn Blk Mrk 4 2 — — $2,213.10 $5,337.99 $5,337.99 2026-04-01
0318U OTHER Ped Whl Gen Mthyltn Alys 50+ 4 2 — — $2,213.10 $5,337.99 $5,337.99 2026-04-01
0292U OTHER Psyc Strs Do Mrna 72 Genes 4 2 — — $2,193.75 $5,291.33 $5,291.33 2026-04-01
0291U OTHER Psyc Mood Do Mrna 144 Genes 4 2 — — $2,193.75 $5,291.33 $5,291.33 2026-04-01
0103U OTHER Hered Ova Ca Pnl 24 Genes 4 2 — — $2,179.94 $5,258.00 $5,258.00 2026-04-01
0475U OTHER Hered Prst8 Ca Gsap 23 Genes 4 2 — — $1,629.94 $5,258.00 $5,258.00 2026-04-01
0101U OTHER Hered Colon Ca Do 15 Genes 4 2 — — $2,179.94 $5,258.00 $5,258.00 2026-04-01
0156U OTHER Copy Number Sequence Alys 4 2 — — $2,175.00 $5,246.10 $5,246.10 2026-04-01
0425U OTHER Genom Rpd Seq Alys Ea Cmprtr 1 1 — — $5,117.99 $5,117.99 $5,117.99 2026-04-01
81430 HCPCS Hearing Loss Sequence Analys 4 2 — — $2,031.25 $4,899.38 $4,899.38 2026-04-01
0216U OTHER Neuro Inh Ataxia DNA 12 Com 4 2 — — $1,921.28 $4,634.12 $4,634.12 2026-04-01
88040 HCPCS Forensic Autopsy (necropsy) 3 1 — — $4,610.34 $4,610.34 $4,610.34 2026-04-01
0171U OTHER Trgt Gen Seq Alys Pnl DNA 23 4 2 — — $1,898.82 $4,579.97 $4,579.97 2026-04-01
81509 HCPCS Ftl Cgen Abnor 3 Proteins 4 2 — — $1,859.21 $4,484.43 $4,484.43 2026-04-01
0388U OTHER Onc Nonsm Cll Lng Ca 37 Gen 1 1 — — $4,375.00 $4,375.00 $4,375.00 2026-04-01
0334U OTHER Onc Sld Orgn Tgsa DNA 84/+ 1 1 — — $4,375.00 $4,375.00 $4,375.00 2026-04-01
81464 HCPCS So Gsap Cll Fr Mcrstl Ins 1 1 — — $4,110.64 $4,110.64 $4,110.64 2026-04-01
0379U OTHER Tgsap Sl Or Neo Dna523&rna55 1 1 — — $4,110.64 $4,110.64 $4,110.64 2026-04-01
81411 HCPCS Aortic Dysfunction/dilation 4 2 — — $1,687.74 $4,070.81 $4,070.81 2026-04-01
0347U OTHER Rx Metab/pcx DNA 16 Gen Alys 4 2 — — $1,670.11 $4,028.31 $4,028.31 2026-04-01
0477U OTHER Rx Metab Psy 14&cyp2d6 Gn-rx 4 2 — — $520.97 $4,028.31 $4,028.31 2026-04-01
0476U OTHER Rx Metab Psyc 14gen&cyp2d6 4 2 — — $520.97 $4,028.31 $4,028.31 2026-04-01
0392U OTHER Rx Metab Genrx Ia 16 Genes 4 2 — — $1,670.11 $4,028.31 $4,028.31 2026-04-01
0345U OTHER Psyc Genom Alys Pnl 15 Gen 4 2 — — $1,670.11 $4,028.31 $4,028.31 2026-04-01
0419U OTHER Nrpsyc Gen Seq Vrnt Aly 13 4 2 — — $1,670.11 $4,028.31 $4,028.31 2026-04-01
0411U OTHER Psyc Genom Alys Pnl 15 Gen 4 2 — — $1,670.11 $4,028.31 $4,028.31 2026-04-01
0350U OTHER Rx Metab/pcx DNA 27 Gen Alys 4 2 — — $1,670.11 $4,028.31 $4,028.31 2026-04-01
0175U OTHER Psyc Gen Alys Panel 15 Genes 4 2 — — $1,670.11 $4,028.31 $4,028.31 2026-04-01
95829 HCPCS Surgery Electrocorticogram 3 1 — — $3,995.29 $3,995.29 $3,995.29 2026-04-01
0015M OTHER Adrnl Cortcl Tum Bchm Asy 25 4 2 — — $1,631.71 $3,935.70 $3,935.70 2026-04-01
0174U OTHER Onc Solid Tumor 30 Prtn Trgt 4 2 — — $1,631.71 $3,935.70 $3,935.70 2026-04-01
0102U OTHER Hered Brst Ca Rltd Do 17 Gen 4 2 — — $1,629.94 $3,931.40 $3,931.40 2026-04-01
0129U OTHER Hered Brst Ca Rltd Do Panel 4 2 — — $1,629.94 $3,931.40 $3,931.40 2026-04-01
81460 HCPCS Whole Mitochondrial Genome 4 2 — — $1,608.75 $3,880.31 $3,880.31 2026-04-01
0245U OTHER Onc Thyr Mut Alys 10 Gen&37 4 2 — — $1,582.59 $3,817.19 $3,817.19 2026-04-01
0264U OTHER Rare Ds Id Opt Genome Mapg 4 2 — — $1,579.41 $3,809.54 $3,809.54 2026-04-01
0413U OTHER Onc Hl Neo Opt Gen Mapg DNA 4 2 — — $1,579.41 $3,809.54 $3,809.54 2026-04-01
0454U OTHER U Rare Ds Id Opt Genome Mapg 4 2 — — $1,579.41 $3,809.54 $3,809.54 2026-04-01
0260U OTHER Rare Ds Id Opt Genome Mapg 4 2 — — $1,579.41 $3,809.54 $3,809.54 2026-04-01
0435U OTHER Onc Chemo Rx Cytox Csc 14 Rx 1 1 — — $3,792.32 $3,792.32 $3,792.32 2026-04-01
81459 HCPCS So Neo Gsap Dna/dna&rna 1 1 — — $3,736.94 $3,736.94 $3,736.94 2026-04-01
0585U OTHER Tgsap So Neo Cfdna 521 Genes 1 1 — — $3,649.50 $3,649.50 $3,649.50 2026-04-01
0444U OTHER Onc Sld Orgn Neo Tgsap 361 1 1 — — $3,649.50 $3,649.50 $3,649.50 2026-04-01
0417U OTHER Rare Ds Alys 335 Nuc Genes 1 1 — — $3,553.16 $3,553.16 $3,553.16 2026-04-01
0410U OTHER Onc Pncrtc DNA Whl Gn Seq 5- 4 2 — — $1,450.00 $3,497.40 $3,497.40 2026-04-01
81229 HCPCS Cytogen M Array Copy No&snp 4 2 — — $1,450.00 $3,497.40 $3,497.40 2026-04-01
81349 HCPCS Cytog Alys Chrml Abnr Lw-ps 4 2 — — $1,497.43 $3,497.40 $3,497.40 2026-04-01
81277 HCPCS Cytogenomic Neo Microra Alys 4 2 — — $1,450.00 $3,497.40 $3,497.40 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 3 1 — — $3,480.53 $3,480.53 $3,480.53 2026-04-01
5571 OTHER Level 1 Imaging With Contrast 3 3 — — $1,934.60 $4,842.55 $3,461.75 2026-04-01
0332U OTHER Onc Pan Tum Gen Prflg 8 DNA 4 2 — — $1,427.57 $3,443.31 $3,443.31 2026-04-01
93461 HCPCS R&l Hrt Art/ventricle Angio 3 1 — — $3,368.14 $3,368.14 $3,368.14 2026-04-01
5025 OTHER Level 5 Type A Ed Visits 5 3 — — $1,865.10 $6,938.31 $3,346.38 2026-04-01
75894 HCPCS X-rays Transcath Therapy 3 1 — — $3,342.78 $3,342.78 $3,342.78 2026-04-01
81493 HCPCS Cor Artery Disease Mrna 4 2 — — $1,312.50 $3,165.75 $3,165.75 2026-04-01
93457 HCPCS R Hrt Art/grft Angio 3 1 — — $3,085.40 $3,085.40 $3,085.40 2026-04-01
93460 HCPCS R&l Hrt Art/ventricle Angio 3 1 — — $3,055.82 $3,055.82 $3,055.82 2026-04-01
93453 HCPCS R&l Hrt Cath W/ventriclgrphy 3 1 — — $2,915.03 $2,915.03 $2,915.03 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 3 1 — — $2,889.00 $2,889.00 $2,889.00 2026-04-01
5024 OTHER Level 4 Type A Ed Visits 6 4 — — $1,937.72 $5,920.60 $2,885.86 2026-04-01
0463U OTHER Onc Crvx Mrna Genxprsn 14bmk 4 2 — — $950.00 $2,864.25 $2,864.25 2026-04-01
0105U OTHER Neph Ckd Mult Eclia Tum Nec 4 2 — — $1,187.50 $2,864.25 $2,864.25 2026-04-01
0003U OTHER Onc Ovar 5 Prtn Ser Alg Scor 4 2 — — $1,187.50 $2,864.25 $2,864.25 2026-04-01
0579U OTHER Nfro Dbtc Ckd Elisa Apoa4 4 2 — — $488.44 $2,864.25 $2,864.25 2026-04-01
93456 HCPCS R Hrt Coronary Artery Angio 3 1 — — $2,862.99 $2,862.99 $2,862.99 2026-04-01
0387U OTHER Onc Mlnma Ambra1&amlo 4 2 — — $1,185.62 $2,859.73 $2,859.73 2026-04-01
81354 HCPCS Cytog Alys Chrml Abnor Ogm 4 2 — — $1,579.41 $2,844.00 $2,844.00 2026-04-01
81465 HCPCS Whole Mitochondrial Genome 4 2 — — $1,170.00 $2,822.04 $2,822.04 2026-04-01
81418 HCPCS Rx Metab Gen Seq Alys Pnl 6 4 2 — — $1,146.35 $2,765.00 $2,765.00 2026-04-01
0516U OTHER Rx Metab Rxgenomic Gnotyp 40 4 2 — — $520.97 $2,765.00 $2,765.00 2026-04-01
93459 HCPCS L Hrt Art/grft Angio 3 1 — — $2,763.61 $2,763.61 $2,763.61 2026-04-01
81471 HCPCS X-linked Intellectual Dblt 4 2 — — $1,142.50 $2,755.71 $2,755.71 2026-04-01
81470 HCPCS X-linked Intellectual Dblt 4 2 — — $1,142.50 $2,755.71 $2,755.71 2026-04-01
0367U OTHER Onc Bldr 10 Flwg Trurl Rescj 4 2 — — $1,127.72 $2,720.07 $2,720.07 2026-04-01
0778T OTHER Smmg Cncrnt Appl Imu Snr 3 1 — — $2,717.46 $2,717.46 $2,717.46 2026-04-01
81228 HCPCS Cytogen Micrarray Copy Nmbr 4 2 — — $1,125.00 $2,713.50 $2,713.50 2026-04-01
81195 HCPCS Cytog Genom-wid Alys Hem Mal 4 2 — — $2,329.02 $2,713.50 $2,713.50 2026-04-01
0507U OTHER Onc Ovr DNA Whole Gen W/5hmc 4 2 — — $1,450.00 $2,704.46 $2,704.46 2026-04-01
0375U OTHER Onc Ovrn Bchm Asy 7 Prtn Alg 4 2 — — $1,121.25 $2,704.46 $2,704.46 2026-04-01
0599U OTHER Onc Pncrtc Ca Mult Ia Serum 4 2 — — $1,121.25 $2,704.46 $2,704.46 2026-04-01
0366U OTHER Onc Bldr 10 Prb Recr Bldr Ca 4 2 — — $1,121.25 $2,704.46 $2,704.46 2026-04-01
0342U OTHER Onc Pncrtc Ca Mult Ia Eclia 3 1 — — $2,704.46 $2,704.46 $2,704.46 2026-04-01
81503 HCPCS Onco (ovar) Five Proteins 4 2 — — $1,121.25 $2,704.46 $2,704.46 2026-04-01
0452U OTHER Onc Bldr Mthyl Penk Lte-qmsp 4 2 — — $240.00 $2,704.46 $2,704.46 2026-04-01
0365U OTHER Onc Bldr 10 Prb Bldr Ca 4 2 — — $1,121.25 $2,704.46 $2,704.46 2026-04-01
0577U OTHER Onc Ovr Serum Alys 39 Gps 4 2 — — $308.65 $2,704.46 $2,704.46 2026-04-01
0106U OTHER Gstr Emptg 7 Timed Brth Spec 4 2 — — $1,093.11 $2,636.60 $2,636.60 2026-04-01
93458 HCPCS L Hrt Artery/ventricle Angio 3 1 — — $2,622.83 $2,622.83 $2,622.83 2026-04-01
93455 HCPCS Coronary Art/grft Angio S&i 3 1 — — $2,566.04 $2,566.04 $2,566.04 2026-04-01
93451 HCPCS Right Heart Cath 3 1 — — $2,566.04 $2,566.04 $2,566.04 2026-04-01
81185 HCPCS Cacna1a Gene Full Gene Seq 4 2 — — $1,057.84 $2,551.50 $2,551.50 2026-04-01
81407 HCPCS Mopath Procedure Level 8 4 2 — — $1,057.84 $2,551.50 $2,551.50 2026-04-01
0231U OTHER Cacna1a Full Gene Analysis 4 2 — — $1,057.84 $2,551.50 $2,551.50 2026-04-01
0117U OTHER Pain Mgmt 11 Endogenous Anal 4 2 — — $1,050.81 $2,534.56 $2,534.56 2026-04-01
81490 HCPCS Autoimmune Rheumatoid Arthr 4 2 — — $1,050.81 $2,534.56 $2,534.56 2026-04-01
0312U OTHER Ai Ds Sle Alys 8 Igg Autoant 4 2 — — $1,050.81 $2,534.56 $2,534.56 2026-04-01
0458U OTHER Onc Brst Ca S100 A8&a9 Elisa 4 2 — — $325.62 $2,534.56 $2,534.56 2026-04-01
0360U OTHER Onc Lung Elisa 7 Autoant Alg 4 2 — — $1,050.81 $2,534.56 $2,534.56 2026-04-01
0364U OTHER Onc Hl Neo Gen Seq Alys Alg 1 1 — — $2,509.06 $2,509.06 $2,509.06 2026-04-01
95783 HCPCS Polysom <6 Yrs Cpap/bilvl 3 1 — — $2,501.89 $2,501.89 $2,501.89 2026-04-01
5572 OTHER Level 2 Imaging With Contrast 6 5 — — $859.51 $4,592.06 $2,481.23 2026-04-01
0422U OTHER Onc Pan Solid Tum Alys DNA 1 1 — — $2,429.01 $2,429.01 $2,429.01 2026-04-01
80412 HCPCS Crh Stimulation Panel 4 2 — — $1,002.02 $2,416.88 $2,416.88 2026-04-01
0327U OTHER Ftl Aneuploidy Trsmy DNA Seq 4 2 — — $993.75 $2,396.93 $2,396.93 2026-04-01
81507 HCPCS Fetal Aneuploidy Trisom Risk 4 2 — — $993.75 $2,396.93 $2,396.93 2026-04-01
0467U OTHER Onc Bldr DNA Ngs 60gen&aneup 4 2 — — $1,898.82 $2,395.40 $2,395.40 2026-04-01
0307U OTHER Onc Mrd Nxt-gnrj Alys Sbsq 4 2 — — $993.11 $2,395.40 $2,395.40 2026-04-01
0561U OTHER Onc Mrd Gsa Cfdna Subsequent 4 2 — — $993.11 $2,395.40 $2,395.40 2026-04-01
0344U OTHER Hep Nafld Semiq Evl 28 Lipid 4 2 — — $990.21 $2,388.40 $2,388.40 2026-04-01
0468U OTHER Hep Nash Mir34a5p ?2m Ykl40 4 2 — — $314.62 $2,388.40 $2,388.40 2026-04-01
0209U OTHER Cytog Const Alys Interrog 4 2 — — $983.94 $2,373.26 $2,373.26 2026-04-01
95782 HCPCS Polysom <6 Yrs 4/> Paramtrs 3 1 — — $2,369.40 $2,369.40 $2,369.40 2026-04-01
81201 HCPCS Apc Gene Full Sequence 4 2 — — $975.00 $2,351.70 $2,351.70 2026-04-01
93454 HCPCS Coronary Artery Angio S&i 3 1 — — $2,340.07 $2,340.07 $2,340.07 2026-04-01
0095U OTHER Inflm Ee Elisa Alys Alg 4 2 — — $964.98 $2,327.51 $2,327.51 2026-04-01
93452 HCPCS Left Hrt Cath W/ventrclgrphy 3 1 — — $2,322.34 $2,322.34 $2,322.34 2026-04-01
81325 HCPCS Pmp22 Gene Full Sequence 4 2 — — $961.98 $2,320.29 $2,320.29 2026-04-01
0339U OTHER Onc Prst8 Mrna Hoxc6 & Dlx1 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0343U OTHER Onc Prst8 Xom Aly 442 Sncrna 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0113U OTHER Onc Prst8 Pca3&tmprss2-erg 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0534U OTHER Onc Prst8 Mirna Snp 32 Vrnt 3 1 — — $2,291.40 $2,291.40 $2,291.40 2026-04-01
81539 HCPCS Oncology Prostate Prob Score 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0013M OTHER Onc Mrna 5 Gen Recr Urthl Ca 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0021U OTHER Onc Prst8 Detcj 8 Autoantb 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0005U OTHER Onco Prst8 3 Gene Ur Alg 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0465U OTHER Onc Urthl Carc DNA Qmsp 2gen 4 2 — — $2,291.40 $2,422.51 $2,291.40 2026-04-01
0403U OTHER Onc Prst8 Mrna 18 Gen Dre Ur 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0406U OTHER Onc Lung Flow Cytmtry 5 Mrk 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0363U OTHER Onc Urthl Mrna 5 Gen Alg 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0591U OTHER Onc Prst8 Ca 3prtns Plsm Srm 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0495U OTHER Onc Prst8 Alys Crcg Plsm Prt 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0289U OTHER Neuro Alzheimer Mrna 24 Gen 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0290U OTHER Pain Mgmt Mrna Gen Xprsn 36 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0568U OTHER Neurol Dementia ?amyl Ptau 4 2 — — $1,121.25 $2,291.40 $2,291.40 2026-04-01
0089U OTHER Onc Mlnma Prame & Linc00518 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0011M OTHER Onc Prst8 Ca Mrna 12 Gen Alg 4 2 — — $950.00 $2,291.40 $2,291.40 2026-04-01
0456U OTHER Ai Ra Ngs 19 Genes Anti-ccp 3 1 — — $2,291.40 $2,291.40 $2,291.40 2026-04-01
0550U OTHER Onc Prst8 Elisa Tot&free Psa 3 1 — — $2,291.40 $2,291.40 $2,291.40 2026-04-01
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