Hospital

HARLAN COUNTY HEALTH SYSTEM

Alma, NE · CCN 281300 · Rates published

3,102 distinct procedures filed

22 distinct payers

63,900 rate rows

2026-01-20 last MRF observed

Data quality

62,650 of 63,900 rate rows are consumer-grade (98.0%)

1,250 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 — reason	Rows
template filing: same amount across many unrelated codes — excluded	974
exceeds 10× this hospital's gross charge — excluded from medians	194
per-diem day rate — not a per-procedure price	48
percent-of-charges filed in the dollar field — excluded from medians	34

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbHCHALMANE&type=CDMWithoutLabel&fileType=CSV
Found on page	https://harlancountyhealth.com/cms-hpt.txt
Discovered via	Discovered by HANK (automated)
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint	be90ad7175277225… · 21,090,949 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
199 MS_DRG	Pneumothorax With Mcc	11	$19,634.00	$21,144.30	$20,712.79	nat. median $17,612 1.2× median
J9144 HCPCS	Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj	17	$10,851.44	$19,693.35	$18,286.69	nat. median $232 outlier · 78.8×
540 MS_DRG	Osteomyelitis With Cc	11	$17,306.70	$18,637.98	$18,257.62	nat. median $13,477 1.4× median
J9228 HCPCS	Injection, Ipilimumab, 1 Mg	17	$6,120.40	$42,664.88	$17,308.31	nat. median $9,890 1.8× median
300 MS_DRG	Peripheral Vascular Disorders With Cc	11	$16,281.67	$17,534.10	$17,176.26	nat. median $11,432 1.5× median
J9298 HCPCS	Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg	17	$10,016.41	$18,177.92	$16,879.50	nat. median $561 outlier · 30.1×
379 MS_DRG	Gastrointestinal Hemorrhage Without Cc/mcc	11	$15,552.97	$16,749.36	$16,407.53	nat. median $7,417 outlier · 2.2×
559 MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Mcc	11	$15,092.58	$16,253.55	$15,921.84	nat. median $19,047 0.8× median
605 MS_DRG	Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc	11	$14,241.85	$15,337.38	$15,024.37	nat. median $9,920 1.5× median
309 MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Cc	11	$14,092.95	$15,177.02	$14,867.29	nat. median $8,433 1.8× median
C1767 HCPCS	Generator, Neurostimulator (implantable), Non-rechargeable	17	$8,312.47	$15,085.60	$14,008.06	nat. median $22,481 0.6× median
694 MS_DRG	Urinary Stones Without Mcc	11	$12,589.41	$13,557.83	$13,281.14	nat. median $8,711 1.5× median
683 MS_DRG	Renal Failure With Cc	11	$12,319.91	$13,267.59	$12,996.83	nat. median $9,664 1.3× median
C1820 HCPCS	Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging…	17	$7,677.97	$13,934.10	$12,938.81	nat. median $22,013 0.6× median
863 MS_DRG	Postoperative And Post-traumatic Infections Without Mcc	11	$12,138.15	$13,071.86	$12,805.08	nat. median $10,815 1.2× median
390 MS_DRG	Gastrointestinal Obstruction Without Cc/mcc	11	$11,860.19	$12,772.52	$12,511.85	nat. median $6,562 1.9× median
55060 HCPCS	Repair Of Fluid Collection In Testicle And Sperm Reservoir	17	$7,354.80	$13,347.60	$12,394.20	nat. median $3,649 outlier · 3.4×
194 MS_DRG	Simple Pneumonia And Pleurisy With Cc	11	$11,355.05	$12,228.51	$11,978.95	nat. median $9,125 1.3× median
842 MS_DRG	Lymphoma And Non-acute Leukemia Without Cc/mcc	11	$11,199.18	$12,060.65	$11,814.52	nat. median $11,260 1.0× median
641 MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	11	$11,111.15	$11,965.85	$11,721.65	nat. median $8,664 1.4× median
315 MS_DRG	Other Circulatory System Diagnoses With Cc	11	$11,054.12	$11,904.44	$11,661.49	nat. median $10,513 1.1× median
949 MS_DRG	Aftercare With Cc/mcc	11	$10,974.29	$11,818.47	$11,577.27	nat. median $12,475 0.9× median
815 MS_DRG	Reticuloendothelial And Immunity Disorders With Cc	11	$10,844.72	$11,678.92	$11,440.58	nat. median $10,944 1.0× median
964 MS_DRG	Other Multiple Significant Trauma With Cc	11	$10,013.01	$10,783.24	$10,563.18	nat. median $15,735 0.7× median
54840 HCPCS	Removal Of Fluid Accumulation In Sperm Reservoir	17	$6,152.46	$11,165.58	$10,368.04	nat. median $2,377 outlier · 4.4×
812 MS_DRG	Red Blood Cell Disorders Without Mcc	11	$9,622.67	$10,362.87	$10,151.39	nat. median $9,870 1.0× median
195 MS_DRG	Simple Pneumonia And Pleurisy Without Cc/mcc	11	$9,422.70	$10,147.52	$9,940.43	nat. median $7,338 1.4× median
552 MS_DRG	Medical Back Problems Without Mcc	11	$9,412.36	$10,136.38	$9,929.52	nat. median $10,422 1.0× median
J9301 HCPCS	Injection, Obinutuzumab, 10 Mg	17	$5,796.57	$10,519.70	$9,768.29	nat. median $314 outlier · 31.1×
999 MS_DRG	Ungroupable	11	$9,174.17	$9,879.87	$9,678.24	nat. median $9,134 1.1× median
446 MS_DRG	Disorders Of The Biliary Tract Without Cc/mcc	11	$9,023.91	$9,718.05	$9,519.72	nat. median $9,151 1.0× median
J3101 HCPCS	Injection, Tenecteplase, 1 Mg	17	$5,505.78	$9,991.96	$9,278.25	nat. median $5,957 1.6× median
536 MS_DRG	Fractures Of Hip And Pelvis Without Mcc	11	$8,687.07	$9,355.30	$9,164.38	nat. median $8,981 1.0× median
2500755 CDM	Bimatoprost Drops	17	$5,427.76	$9,850.37	$9,146.77	nat. median $5,428 1.7× median
55 MS_DRG	Nervous System Neoplasms Without Mcc	11	$8,509.75	$9,164.34	$8,977.32	nat. median $11,401 0.8× median
21556 HCPCS	Removal Of Growth Of Muscle Of Neck Or Front Of Chest, Less Than 5.0 Cm	17	$5,313.42	$9,642.87	$8,954.09	nat. median $2,989 outlier · 3.0×
439 MS_DRG	Disorders Of Pancreas Except Malignancy With Cc	11	$8,287.68	$8,925.19	$8,743.05	nat. median $9,521 0.9× median
947 MS_DRG	Signs And Symptoms With Mcc	11	$8,261.84	$8,897.37	$8,715.79	nat. median $12,688 0.7× median
814 MS_DRG	Reticuloendothelial And Immunity Disorders With Mcc	11	$8,216.18	$8,848.19	$8,667.62	nat. median $20,887 outlier · 0.4×
292 MS_DRG	Heart Failure And Shock With Cc	11	$7,945.92	$8,557.14	$8,382.50	nat. median $9,635 0.9× median
392 MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	11	$7,786.03	$8,384.95	$8,213.83	nat. median $8,728 0.9× median
189 MS_DRG	Pulmonary Edema And Respiratory Failure	11	$7,655.98	$8,244.91	$8,076.64	nat. median $13,017 0.6× median
179 MS_DRG	Respiratory Infections And Inflammations Without Cc/mcc	11	$7,638.89	$8,226.49	$8,058.60	nat. median $8,705 0.9× median
864 MS_DRG	Fever And Inflammatory Conditions	11	$7,613.58	$8,199.24	$8,031.91	nat. median $9,803 0.8× median
205 MS_DRG	Other Respiratory System Diagnoses With Mcc	11	$7,387.19	$7,955.43	$7,793.08	nat. median $18,292 outlier · 0.4×
46255 HCPCS	Removal Of Single External And Internal Hemorrhoid Group	17	$4,612.11	$8,370.13	$7,772.26	nat. median $2,859 outlier · 2.7×
373 MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc	11	$7,340.25	$7,904.89	$7,743.56	nat. median $8,368 0.9× median
556 MS_DRG	Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc	11	$7,236.37	$7,793.01	$7,633.97	nat. median $9,145 0.8× median
J2506 HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	17	$4,516.23	$8,196.12	$7,610.68	nat. median $2,076 outlier · 3.7×
46260 HCPCS	Removal Of Multiple Hemorrhoid Groups	17	$4,463.98	$8,101.30	$7,522.63	nat. median $3,137 outlier · 2.4×

Other procedures at this hospital

Browse this hospital's 3,102 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

199	MS_DRG	Pneumothorax With Mcc	11	11	$21,575.82	$17,260.66	$19,634.00	$21,144.30	$20,712.79	2026-01-20
J9144	HCPCS	Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj	17	17	$20,095.26	$16,076.21	$10,851.44	$19,693.35	$18,286.69	2026-01-20
540	MS_DRG	Osteomyelitis With Cc	11	11	$19,018.35	$15,214.68	$17,306.70	$18,637.98	$18,257.62	2026-01-20
J9228	HCPCS	Injection, Ipilimumab, 1 Mg	34	17	$27,434.83	$21,947.86 20% off	$6,120.40	$42,664.88	$17,308.31	2026-01-20
300	MS_DRG	Peripheral Vascular Disorders With Cc	11	11	$17,891.94	$14,313.55 20% off	$16,281.67	$17,534.10	$17,176.26	2026-01-20
J9298	HCPCS	Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg	17	17	$18,548.90	$14,839.12 20% off	$10,016.41	$18,177.92	$16,879.50	2026-01-20
379	MS_DRG	Gastrointestinal Hemorrhage Without Cc/mcc	11	11	$17,091.18	$13,672.94 20% off	$15,552.97	$16,749.36	$16,407.53	2026-01-20
559	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Mcc	11	11	$16,585.25	$13,268.20	$15,092.58	$16,253.55	$15,921.84	2026-01-20
605	MS_DRG	Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc	11	11	$15,650.39	$12,520.31 20% off	$14,241.85	$15,337.38	$15,024.37	2026-01-20
309	MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Cc	11	11	$15,486.76	$12,389.41	$14,092.95	$15,177.02	$14,867.29	2026-01-20
C1767	HCPCS	Generator, Neurostimulator (implantable), Non-rechargeable	17	17	$15,393.47	$12,314.78	$8,312.47	$15,085.60	$14,008.06	2026-01-20
694	MS_DRG	Urinary Stones Without Mcc	11	11	$13,834.52	$11,067.62	$12,589.41	$13,557.83	$13,281.14	2026-01-20
683	MS_DRG	Renal Failure With Cc	11	11	$13,538.36	$10,830.69	$12,319.91	$13,267.59	$12,996.83	2026-01-20
C1820	HCPCS	Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging…	17	17	$14,218.47	$11,374.78	$7,677.97	$13,934.10	$12,938.81	2026-01-20
863	MS_DRG	Postoperative And Post-traumatic Infections Without Mcc	11	11	$13,338.63	$10,670.90 20% off	$12,138.15	$13,071.86	$12,805.08	2026-01-20
390	MS_DRG	Gastrointestinal Obstruction Without Cc/mcc	11	11	$13,033.18	$10,426.54 20% off	$11,860.19	$12,772.52	$12,511.85	2026-01-20
55060	HCPCS	Repair Of Fluid Collection In Testicle And Sperm Reservoir	17	17	$13,620.00	$10,896.00 20% off	$7,354.80	$13,347.60	$12,394.20	2026-01-20
194	MS_DRG	Simple Pneumonia And Pleurisy With Cc	11	11	$12,478.08	$9,982.46 20% off	$11,355.05	$12,228.51	$11,978.95	2026-01-20
842	MS_DRG	Lymphoma And Non-acute Leukemia Without Cc/mcc	11	11	$12,306.79	$9,845.43 20% off	$11,199.18	$12,060.65	$11,814.52	2026-01-20
641	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	11	11	$12,210.05	$9,768.04	$11,111.15	$11,965.85	$11,721.65	2026-01-20
315	MS_DRG	Other Circulatory System Diagnoses With Cc	11	11	$12,147.39	$9,717.91 20% off	$11,054.12	$11,904.44	$11,661.49	2026-01-20
949	MS_DRG	Aftercare With Cc/mcc	11	11	$12,059.66	$9,647.73	$10,974.29	$11,818.47	$11,577.27	2026-01-20
815	MS_DRG	Reticuloendothelial And Immunity Disorders With Cc	11	11	$11,917.27	$9,533.82	$10,844.72	$11,678.92	$11,440.58	2026-01-20
964	MS_DRG	Other Multiple Significant Trauma With Cc	11	11	$11,003.31	$8,802.65	$10,013.01	$10,783.24	$10,563.18	2026-01-20
54840	HCPCS	Removal Of Fluid Accumulation In Sperm Reservoir	17	17	$11,393.45	$9,114.76 20% off	$6,152.46	$11,165.58	$10,368.04	2026-01-20
812	MS_DRG	Red Blood Cell Disorders Without Mcc	11	11	$10,574.36	$8,459.49	$9,622.67	$10,362.87	$10,151.39	2026-01-20
195	MS_DRG	Simple Pneumonia And Pleurisy Without Cc/mcc	11	11	$10,354.61	$8,283.69	$9,422.70	$10,147.52	$9,940.43	2026-01-20
552	MS_DRG	Medical Back Problems Without Mcc	11	11	$10,343.25	$8,274.60	$9,412.36	$10,136.38	$9,929.52	2026-01-20
J9301	HCPCS	Injection, Obinutuzumab, 10 Mg	17	17	$10,734.39	$8,587.51 20% off	$5,796.57	$10,519.70	$9,768.29	2026-01-20
999	MS_DRG	Ungroupable	11	11	$10,081.50	$8,065.20 20% off	$9,174.17	$9,879.87	$9,678.24	2026-01-20
446	MS_DRG	Disorders Of The Biliary Tract Without Cc/mcc	11	11	$9,916.38	$7,933.10 20% off	$9,023.91	$9,718.05	$9,519.72	2026-01-20
J3101	HCPCS	Injection, Tenecteplase, 1 Mg	17	17	$10,195.88	$8,156.70 20% off	$5,505.78	$9,991.96	$9,278.25	2026-01-20
536	MS_DRG	Fractures Of Hip And Pelvis Without Mcc	11	11	$9,546.23	$7,636.98 20% off	$8,687.07	$9,355.30	$9,164.38	2026-01-20
2500755	CDM	Bimatoprost Drops	17	17	$10,051.40	$8,041.12 20% off	$5,427.76	$9,850.37	$9,146.77	2026-01-20
55	MS_DRG	Nervous System Neoplasms Without Mcc	11	11	$9,351.37	$7,481.10	$8,509.75	$9,164.34	$8,977.32	2026-01-20
21556	HCPCS	Removal Of Growth Of Muscle Of Neck Or Front Of Chest, Less Than 5.0 Cm	17	17	$9,839.66	$7,871.73	$5,313.42	$9,642.87	$8,954.09	2026-01-20
439	MS_DRG	Disorders Of Pancreas Except Malignancy With Cc	11	11	$9,107.34	$7,285.87 20% off	$8,287.68	$8,925.19	$8,743.05	2026-01-20
947	MS_DRG	Signs And Symptoms With Mcc	11	11	$9,078.95	$7,263.16 20% off	$8,261.84	$8,897.37	$8,715.79	2026-01-20
814	MS_DRG	Reticuloendothelial And Immunity Disorders With Mcc	11	11	$9,028.77	$7,223.02	$8,216.18	$8,848.19	$8,667.62	2026-01-20
292	MS_DRG	Heart Failure And Shock With Cc	11	11	$8,731.78	$6,985.42 20% off	$7,945.92	$8,557.14	$8,382.50	2026-01-20
392	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	11	11	$8,556.08	$6,844.86 20% off	$7,786.03	$8,384.95	$8,213.83	2026-01-20
189	MS_DRG	Pulmonary Edema And Respiratory Failure	11	11	$8,413.17	$6,730.54	$7,655.98	$8,244.91	$8,076.64	2026-01-20
179	MS_DRG	Respiratory Infections And Inflammations Without Cc/mcc	11	11	$8,394.38	$6,715.50 20% off	$7,638.89	$8,226.49	$8,058.60	2026-01-20
864	MS_DRG	Fever And Inflammatory Conditions	11	11	$8,366.57	$6,693.26	$7,613.58	$8,199.24	$8,031.91	2026-01-20
205	MS_DRG	Other Respiratory System Diagnoses With Mcc	11	11	$8,117.79	$6,494.23 20% off	$7,387.19	$7,955.43	$7,793.08	2026-01-20
46255	HCPCS	Removal Of Single External And Internal Hemorrhoid Group	17	17	$8,540.95	$6,832.76 20% off	$4,612.11	$8,370.13	$7,772.26	2026-01-20
373	MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc	11	11	$8,066.21	$6,452.97	$7,340.25	$7,904.89	$7,743.56	2026-01-20
556	MS_DRG	Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc	11	11	$7,952.05	$6,361.64 20% off	$7,236.37	$7,793.01	$7,633.97	2026-01-20
J2506	HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	17	17	$8,363.39	$6,690.71 20% off	$4,516.23	$8,196.12	$7,610.68	2026-01-20
46260	HCPCS	Removal Of Multiple Hemorrhoid Groups	17	17	$8,266.63	$6,613.30 20% off	$4,463.98	$8,101.30	$7,522.63	2026-01-20
684	MS_DRG	Renal Failure Without Cc/mcc	11	11	$7,777.51	$6,222.01	$7,077.53	$7,621.96	$7,466.41	2026-01-20
560	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Cc	11	11	$7,771.53	$6,217.23	$7,072.10	$7,616.10	$7,460.67	2026-01-20
389	MS_DRG	Gastrointestinal Obstruction With Cc	11	11	$7,696.03	$6,156.82 20% off	$7,003.39	$7,542.11	$7,388.19	2026-01-20
728	MS_DRG	Inflammation Of The Male Reproductive System Without Mcc	11	11	$7,686.75	$6,149.40 20% off	$6,994.94	$7,533.02	$7,379.28	2026-01-20
872	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	11	11	$7,675.98	$6,140.78 20% off	$6,985.14	$7,522.46	$7,368.94	2026-01-20
76497	HCPCS	Other CT Scan	17	17	$8,096.83	$6,477.46 20% off	$4,372.29	$7,934.89	$7,368.12	2026-01-20
193	MS_DRG	Simple Pneumonia And Pleurisy With Mcc	11	11	$7,654.45	$6,123.56	$6,965.54	$7,501.36	$7,348.27	2026-01-20
206	MS_DRG	Other Respiratory System Diagnoses Without Mcc	11	11	$7,361.81	$5,889.44 20% off	$6,699.24	$7,214.57	$7,067.33	2026-01-20
J9271	HCPCS	Injection, Pembrolizumab, 1 Mg	17	17	$7,536.70	$6,029.36 20% off	$4,069.82	$7,385.97	$6,858.40	2026-01-20
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	11	11	$6,877.88	$5,502.30 20% off	$6,258.87	$6,740.32	$6,602.76	2026-01-20
871	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	11	11	$6,867.36	$5,493.89	$6,249.30	$6,730.01	$6,592.67	2026-01-20
948	MS_DRG	Signs And Symptoms Without Mcc	11	11	$6,826.37	$5,461.09 20% off	$6,211.99	$6,689.84	$6,553.31	2026-01-20
93	MS_DRG	Other Disorders Of Nervous System Without Cc/mcc	11	11	$6,817.02	$5,453.62	$6,203.49	$6,680.68	$6,544.34	2026-01-20
49593	HCPCS	Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length	17	17	$7,171.25	$5,737.00 20% off	$3,872.48	$7,027.83	$6,525.84	2026-01-20
J2407	HCPCS	Injection, Oritavancin (orbactiv), 10 Mg	17	17	$6,957.94	$5,566.35 20% off	$3,757.29	$6,818.78	$6,331.73	2026-01-20
J2353	HCPCS	Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg	17	17	$6,482.82	$5,186.26	$3,500.72	$6,353.16	$5,899.37	2026-01-20
11624	HCPCS	Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4.0 …	17	17	$5,960.68	$4,768.54 20% off	$3,218.77	$5,841.47	$5,424.22	2026-01-20
312	MS_DRG	Syncope And Collapse	11	11	$5,526.30	$4,421.04 20% off	$5,028.93	$5,415.77	$5,305.25	2026-01-20
690	MS_DRG	Kidney And Urinary Tract Infections Without Mcc	11	11	$5,502.69	$4,402.15 20% off	$5,007.45	$5,392.64	$5,282.58	2026-01-20
64719	HCPCS	Release And/or Relocation Of Wrist Nerve	17	17	$5,754.69	$4,603.75 20% off	$3,107.53	$5,639.60	$5,236.77	2026-01-20
394	MS_DRG	Other Digestive System Diagnoses With Cc	11	11	$5,329.44	$4,263.55 20% off	$4,849.79	$5,222.85	$5,116.26	2026-01-20
603	MS_DRG	Cellulitis Without Mcc	11	11	$5,275.94	$4,220.75 20% off	$4,801.10	$5,170.42	$5,064.90	2026-01-20
561	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc	11	11	$5,249.19	$4,199.35 20% off	$4,776.77	$5,144.21	$5,039.23	2026-01-20
74174	HCPCS	CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	17	17	$5,477.54	$4,382.03 20% off	$2,957.87	$5,367.99	$4,984.56	2026-01-20
J1306	HCPCS	Injection, Inclisiran, 1 Mg	17	17	$5,464.93	$4,371.94 20% off	$2,951.06	$5,355.63	$4,973.09	2026-01-20
638	MS_DRG	Diabetes With Cc	11	11	$5,107.15	$4,085.72 20% off	$4,647.51	$5,005.01	$4,902.86	2026-01-20
64772	HCPCS	Incision Or Removal Of Spinal Nerve	17	17	$5,305.73	$4,244.58 20% off	$2,865.09	$5,199.62	$4,828.21	2026-01-20
57	MS_DRG	Degenerative Nervous System Disorders Without Mcc	11	11	$4,927.17	$3,941.74	$4,483.72	$4,828.63	$4,730.08	2026-01-20
72158	HCPCS	MRI Scan Of Lower Spinal Canal Before And After Contrast	17	17	$5,154.00	$4,123.20 20% off	$2,783.16	$5,050.92	$4,690.14	2026-01-20
637	MS_DRG	Diabetes With Mcc	11	11	$4,808.65	$3,846.92	$4,375.87	$4,712.48	$4,616.30	2026-01-20
281	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Cc	11	11	$4,736.18	$3,788.94 20% off	$4,309.92	$4,641.46	$4,546.73	2026-01-20
74178	HCPCS	CT Scan Of Abdomen And Pelvis Before And After Contrast	17	17	$4,982.00	$3,985.60 20% off	$2,690.28	$4,882.36	$4,533.62	2026-01-20
74177	HCPCS	CT Scan Of Abdomen And Pelvis With Contrast	17	17	$4,946.00	$3,956.80	$2,667.70	$4,847.08	$4,500.86	2026-01-20
178	MS_DRG	Respiratory Infections And Inflammations With Cc	11	11	$4,660.79	$3,728.63 20% off	$4,241.32	$4,567.57	$4,474.36	2026-01-20
293	MS_DRG	Heart Failure And Shock Without Cc/mcc	11	11	$4,631.55	$3,705.24 20% off	$4,214.71	$4,538.92	$4,446.29	2026-01-20
J2182	HCPCS	Injection, Mepolizumab, 1 Mg	17	17	$4,868.09	$3,894.47 20% off	$2,628.77	$4,770.73	$4,429.96	2026-01-20
70553	HCPCS	MRI Scan Of Brain Before And After Contrast	17	17	$4,839.00	$3,871.20 20% off	$2,613.06	$4,742.22	$4,403.49	2026-01-20
81450	HCPCS	Genomic Sequence Analysis Panel Of DNA Or Combined DNA And RNA Of 5-50 Genes Ass…	17	17	$4,801.63	$3,841.30 20% off	$2,592.88	$4,705.60	$4,369.48	2026-01-20
689	MS_DRG	Kidney And Urinary Tract Infections With Mcc	11	11	$4,543.42	$3,634.74	$4,134.51	$4,452.55	$4,361.68	2026-01-20
191	MS_DRG	Chronic Obstructive Pulmonary Disease With Cc	11	11	$4,540.05	$3,632.04 20% off	$4,131.45	$4,449.25	$4,358.45	2026-01-20
J1561	HCPCS	Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)…	17	17	$4,766.56	$3,813.25	$2,573.94	$4,671.23	$4,337.57	2026-01-20
95811	HCPCS	Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older)	17	17	$4,700.00	$3,760.00 20% off	$2,538.00	$4,606.00	$4,277.00	2026-01-20
63287	HCPCS	Removal Or Biopsy Of Growth Of Lower Spine Bone Within Spine Membrane, Intramedu…	21	21	$13,888.00	$11,110.40 20% off	$2,237.98	$14,582.40	$4,274.54	2026-01-20
72157	HCPCS	MRI Scan Of Middle Spinal Canal Before And After Contrast	17	17	$4,644.00	$3,715.20 20% off	$2,507.76	$4,551.12	$4,226.04	2026-01-20
950	MS_DRG	Aftercare Without Cc/mcc	11	11	$4,394.11	$3,515.29	$3,998.64	$4,306.23	$4,218.35	2026-01-20
77049	HCPCS	MRI Scan Of Both Breasts	17	17	$4,631.91	$3,705.53	$2,501.23	$4,539.27	$4,215.04	2026-01-20
74183	HCPCS	MRI Scan Of Abdomen Before And After Contrast	17	17	$4,581.00	$3,664.80	$2,473.74	$4,489.38	$4,168.71	2026-01-20
2780205	CDM	Attune Cr Fem Lt Sz 7 Cem	17	17	$4,580.97	$3,664.78	$2,473.72	$4,489.35	$4,168.68	2026-01-20
2780185	CDM	Attune Fem Por Cr Rt Sz 7	17	17	$4,580.97	$3,664.78	$2,473.72	$4,489.35	$4,168.68	2026-01-20
2780135	CDM	Attune Cr Fem Lt Sz 5 Nar Cem	17	17	$4,580.97	$3,664.78	$2,473.72	$4,489.35	$4,168.68	2026-01-20
2780170	CDM	Attune Cr Fem Lt Sz 4 Nar Cem	17	17	$4,580.97	$3,664.78	$2,473.72	$4,489.35	$4,168.68	2026-01-20
C1778	HCPCS	Lead, Neurostimulator (implantable)	17	17	$4,580.97	$3,664.78	$2,473.72	$4,489.35	$4,168.68	2026-01-20
2780220	CDM	Attune Cr Fem Rt Sz 6 Nar Cem	17	17	$4,580.97	$3,664.78	$2,473.72	$4,489.35	$4,168.68	2026-01-20
282	MS_DRG	Acute Myocardial Infarction, Discharged Alive Without Cc/mcc	11	11	$4,318.24	$3,454.59 20% off	$3,929.60	$4,231.88	$4,145.51	2026-01-20
72156	HCPCS	MRI Scan Of Upper Spinal Canal Before And After Contrast	17	17	$4,538.00	$3,630.40 20% off	$2,450.52	$4,447.24	$4,129.58	2026-01-20
J0840	HCPCS	Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram	17	17	$4,497.20	$3,597.76	$2,428.49	$4,407.26	$4,092.45	2026-01-20
642	MS_DRG	Inborn And Other Disorders Of Metabolism	11	11	$4,231.17	$3,384.94	$3,850.36	$4,146.55	$4,061.92	2026-01-20
29881	HCPCS	Removal Of Knee Cartilage Using An Endoscope	38	22	$4,142.00	$3,313.60 20% off	$468.13	$7,257.79	$3,999.19	2026-01-20
78452	HCPCS	Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect	17	17	$4,394.00	$3,515.20 20% off	$2,313.38	$4,306.12	$3,998.54	2026-01-20
73225	HCPCS	MRI Scan Of Blood Vessels Of Arm	17	17	$4,392.95	$3,514.36	$2,372.19	$4,305.09	$3,997.58	2026-01-20
66982	HCPCS	Complex Removal Of Cataract With Insertion Of Prosthetic Lens	17	17	$4,299.05	$3,439.24 20% off	$2,321.49	$4,213.07	$3,912.14	2026-01-20
70551	HCPCS	MRI Scan Of Brain Without Contrast	17	17	$4,182.00	$3,345.60 20% off	$2,258.28	$4,098.36	$3,805.62	2026-01-20
J9299	HCPCS	Injection, Nivolumab, 1 Mg	34	17	$6,064.09	$4,851.27 20% off	$1,178.90	$9,746.13	$3,754.90	2026-01-20
72141	HCPCS	MRI Scan Of Upper Spinal Canal Without Contrast	17	17	$4,126.00	$3,300.80	$2,228.04	$4,043.48	$3,754.66	2026-01-20
72146	HCPCS	MRI Scan Of Middle Spinal Canal Without Contrast	17	17	$4,126.00	$3,300.80	$2,228.04	$4,043.48	$3,754.66	2026-01-20
72148	HCPCS	MRI Scan Of Lower Spinal Canal Without Contrast	17	17	$4,126.00	$3,300.80	$1,915.80	$4,043.48	$3,754.66	2026-01-20
11606	HCPCS	Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm	51	17	$4,124.00	$3,299.20 20% off	$278.10	$6,218.01	$3,752.84	2026-01-20
66984	HCPCS	Removal Of Cataract With Insertion Of Prosthetic Lens	17	17	$4,053.00	$3,242.40 20% off	$2,188.62	$3,971.94	$3,688.23	2026-01-20
72149	HCPCS	MRI Scan Of Lower Spinal Canal With Contrast	17	17	$3,846.02	$3,076.82	$2,076.85	$3,769.10	$3,499.88	2026-01-20
72147	HCPCS	MRI Scan Of Middle Spinal Canal With Contrast	17	17	$3,846.02	$3,076.82	$2,076.85	$3,769.10	$3,499.88	2026-01-20
72142	HCPCS	MRI Scan Of Upper Spinal Canal With Contrast	17	17	$3,846.02	$3,076.82	$2,076.85	$3,769.10	$3,499.88	2026-01-20
74176	HCPCS	CT Scan Of Abdomen And Pelvis Without Contrast	17	17	$3,733.00	$2,986.40 20% off	$2,015.82	$3,658.34	$3,397.03	2026-01-20
Q5114	HCPCS	Injection, Trastuzumab-dkst, Biosimilar, (ogivri), 10 Mg	17	17	$3,695.07	$2,956.06	$1,995.34	$3,621.17	$3,362.51	2026-01-20
95810	HCPCS	Sleep Study In Sleep Lab (6 Years Or Older)	17	17	$3,624.57	$2,899.66	$1,957.27	$3,552.08	$3,298.36	2026-01-20
22802	HCPCS	Fusion Of Spine Bones For Correction Of Deformity, Posterior Approach, 7 To 12 V…	21	21	$11,063.00	$8,850.40 20% off	$1,707.49	$11,616.15	$3,261.31	2026-01-20
72197	HCPCS	MRI Scan Of Pelvis Before And After Contrast	17	17	$3,582.34	$2,865.87 20% off	$1,934.46	$3,510.69	$3,259.93	2026-01-20
J2997	HCPCS	Injection, Alteplase Recombinant, 1 Mg	34	17	$5,898.95	$4,719.16 20% off	$182.21	$11,231.26	$3,259.66	2026-01-20
27447	HCPCS	Replacement Of Knee Joint, Both Sides Of Knee	42	22	$3,525.00	$2,820.00 20% off	$95.40	$12,862.50	$3,238.22	2026-01-20
70498	HCPCS	CT Scan Of Blood Vessels Of Neck With Contrast	17	17	$3,552.00	$2,841.60 20% off	$1,918.08	$3,480.96	$3,232.32	2026-01-20
J3111	HCPCS	Injection, Romosozumab-aqqg, 1 Mg	17	17	$3,525.24	$2,820.19 20% off	$1,903.63	$3,454.74	$3,207.97	2026-01-20
70543	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast	17	17	$3,506.12	$2,804.90	$1,893.30	$3,436.00	$3,190.57	2026-01-20
72191	HCPCS	CT Scan Of Blood Vessels Of Pelvis With Contrast	17	17	$3,493.76	$2,795.01	$1,886.63	$3,423.88	$3,179.32	2026-01-20
70552	HCPCS	MRI Scan Of Brain With Contrast	17	17	$3,448.44	$2,758.75 20% off	$1,862.16	$3,379.47	$3,138.08	2026-01-20
73725	HCPCS	MRI Scan Of Blood Vessels Of Leg	51	17	$3,601.91	$2,881.53	$1,751.47	$3,552.08	$3,113.73	2026-01-20
74185	HCPCS	MRI Scan Of Blood Vessels Of Abdomen	51	17	$3,601.91	$2,881.53	$1,751.47	$3,552.08	$3,113.73	2026-01-20
74182	HCPCS	MRI Scan Of Abdomen With Contrast	17	17	$3,394.88	$2,715.90 20% off	$1,833.24	$3,326.98	$3,089.34	2026-01-20
2502695	CDM	Fluorometholone 5ml Drops	17	17	$3,368.40	$2,694.72 20% off	$1,818.94	$3,301.03	$3,065.24	2026-01-20
71275	HCPCS	CT Scan Of Blood Vessels Of Chest With Contrast	17	17	$3,363.00	$2,690.40 20% off	$1,816.02	$3,295.74	$3,060.33	2026-01-20
14060	HCPCS	Repair Of Wound Of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm…	17	17	$3,345.19	$2,676.15 20% off	$1,806.40	$3,278.29	$3,044.12	2026-01-20
73202	HCPCS	CT Scan Of Arm Before And After Contrast	17	17	$3,292.91	$2,634.33	$1,778.17	$3,227.05	$2,996.55	2026-01-20
63272	HCPCS	Removal Of Growth Of Lower Spine Bone Within Spine Membrane	21	21	$9,014.00	$7,211.20 20% off	$1,565.59	$9,464.70	$2,990.28	2026-01-20
70548	HCPCS	MRI Scan Of Blood Vessels Of Neck With Contrast	17	17	$3,279.52	$2,623.62	$1,770.94	$3,213.93	$2,984.36	2026-01-20
70549	HCPCS	MRI Scan Of Blood Vessels Of Neck Before And After Contrast	17	17	$3,279.52	$2,623.62	$1,770.94	$3,213.93	$2,984.36	2026-01-20
J1602	HCPCS	Injection, Golimumab, 1 Mg, For Intravenous Use	17	17	$3,218.70	$2,574.96	$1,738.10	$3,154.33	$2,929.02	2026-01-20
27134	HCPCS	Revision Of Thigh Bone And Hip Joint Prosthesis	21	21	$7,351.00	$5,880.80 20% off	$1,526.49	$7,718.55	$2,915.60	2026-01-20
74175	HCPCS	CT Scan Of Blood Vessels Of Abdomen With Contrast	17	17	$3,201.24	$2,560.99 20% off	$1,728.67	$3,137.22	$2,913.13	2026-01-20
64718	HCPCS	Release And/or Relocation Of Elbow Nerve	38	22	$2,884.00	$2,307.20 20% off	$523.05	$6,286.39	$2,912.84	2026-01-20
2780155	CDM	Attune Fb Tib Base Sz 7 Por	17	17	$3,174.72	$2,539.78	$1,714.35	$3,111.23	$2,889.00	2026-01-20
72133	HCPCS	CT Scan Of Lower Spine Before And After Contrast	17	17	$3,165.19	$2,532.15 20% off	$1,709.20	$3,101.89	$2,880.32	2026-01-20
77048	HCPCS	MRI Scan Of 1 Breast	17	17	$3,131.20	$2,504.96	$1,690.85	$3,068.58	$2,849.39	2026-01-20
22633	HCPCS	Fusion Of Spine In Lower Back With Partial Removal Of Spine Bone And Disc	21	21	$7,268.00	$5,814.40 20% off	$1,482.40	$7,631.40	$2,831.38	2026-01-20
75635	HCPCS	CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast	17	17	$3,106.48	$2,485.18 20% off	$1,677.50	$3,044.35	$2,826.90	2026-01-20
70546	HCPCS	MRI Scan Of Blood Vessels Of Head Before And After Contrast	17	17	$3,082.79	$2,466.23 20% off	$1,664.71	$3,021.13	$2,805.34	2026-01-20
70545	HCPCS	MRI Scan Of Blood Vessels Of Head With Contrast	17	17	$3,082.79	$2,466.23 20% off	$1,664.71	$3,021.13	$2,805.34	2026-01-20
71550	HCPCS	MRI Scan Of Chest Without Contrast	17	17	$3,080.73	$2,464.58 20% off	$1,663.59	$3,019.12	$2,803.46	2026-01-20
70542	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast	17	17	$3,076.61	$2,461.29	$1,661.37	$3,015.08	$2,799.72	2026-01-20
74181	HCPCS	MRI Scan Of Abdomen Without Contrast	17	17	$3,074.55	$2,459.64 20% off	$1,660.26	$3,013.06	$2,797.84	2026-01-20
70496	HCPCS	CT Scan Of Blood Vessels Of Head With Contrast	17	17	$3,062.00	$2,449.60 20% off	$1,653.48	$3,000.76	$2,786.42	2026-01-20
73723	HCPCS	MRI Scan Of Leg Joint Before And After Contrast	17	17	$3,057.04	$2,445.63 20% off	$1,650.80	$2,995.90	$2,781.91	2026-01-20
J0897	HCPCS	Injection, Denosumab, 1 Mg	34	17	$3,748.72	$2,998.98 20% off	$1,554.01	$4,527.27	$2,762.68	2026-01-20
78597	HCPCS	Nuclear Medicine Study Of Lung Ventilation And Blood Flow To Lung	17	17	$3,025.21	$2,420.17	$1,633.61	$2,964.71	$2,752.94	2026-01-20
63081	HCPCS	Removal Of Upper Spine Bone With Release Of Spinal Cord And/or Nerves, Anterior …	21	21	$8,670.00	$6,936.00 20% off	$1,440.38	$9,103.50	$2,751.13	2026-01-20
2780210	CDM	Atune Cr Rt Ms Ins Sz 6	17	17	$3,018.47	$2,414.78	$1,629.97	$2,958.10	$2,746.81	2026-01-20
2780180	CDM	Atune Cr Rt Ms Ins Sz 7.5	17	17	$3,018.47	$2,414.78	$1,629.97	$2,958.10	$2,746.81	2026-01-20
2780125	CDM	Atune Cr Lt Ms Ins Sz 5 6	17	17	$3,018.47	$2,414.78	$1,629.97	$2,958.10	$2,746.81	2026-01-20
2780195	CDM	Atune Cr Lt Ms Ins Sz 7	17	17	$3,018.47	$2,414.78	$1,629.97	$2,958.10	$2,746.81	2026-01-20
2780160	CDM	Atune Cr Lt Ms Ins Sz 4	17	17	$3,018.47	$2,414.78	$1,629.97	$2,958.10	$2,746.81	2026-01-20
78582	HCPCS	Nuclear Medicine Study Of Lung Ventilation And Circulation	17	17	$3,003.89	$2,403.11 20% off	$1,622.10	$2,943.81	$2,733.54	2026-01-20
73720	HCPCS	MRI Scan Of Leg Before And After Contrast	17	17	$2,950.95	$2,360.76	$1,593.51	$2,891.93	$2,685.36	2026-01-20
22551	HCPCS	Fusion Of Upper Spine Bone With Removal Of Disc And Release Of Spinal Cord Or Ne…	21	21	$8,409.00	$6,727.20 20% off	$1,394.04	$8,829.45	$2,662.62	2026-01-20
49591	HCPCS	Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length	17	17	$2,920.00	$2,336.00 20% off	$1,576.80	$2,861.60	$2,657.20	2026-01-20
45381	HCPCS	Injection Beneath Lining Of Large Bowel Using A Flexible Endoscope	17	17	$2,892.00	$2,313.60 20% off	$1,561.68	$2,834.16	$2,631.72	2026-01-20
72195	HCPCS	MRI Scan Of Pelvis Without Contrast	17	17	$2,870.61	$2,296.49	$1,550.13	$2,813.20	$2,612.26	2026-01-20
73206	HCPCS	CT Scan Of Blood Vessels Of Arm With Contrast	17	17	$2,864.43	$2,291.54 20% off	$1,546.79	$2,807.14	$2,606.63	2026-01-20
2780200	CDM	Attune Fb Tib Base Sz 6 Cem	17	17	$2,862.22	$2,289.78	$1,545.60	$2,804.98	$2,604.62	2026-01-20
2780140	CDM	Attune Fb Tib Base Sz 4 Cem	17	17	$2,862.22	$2,289.78	$1,545.60	$2,804.98	$2,604.62	2026-01-20
2780215	CDM	Attune Fb Tib Base Sz 5 Cem	17	17	$2,862.22	$2,289.78	$1,545.60	$2,804.98	$2,604.62	2026-01-20
74170	HCPCS	CT Scan Of Abdomen Before And After Contrast	17	17	$2,860.31	$2,288.25	$1,544.57	$2,803.10	$2,602.88	2026-01-20
44143	HCPCS	Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin	21	21	$5,340.00	$4,272.00 20% off	$1,362.45	$5,607.00	$2,602.28	2026-01-20
70544	HCPCS	MRI Scan Of Blood Vessels Of Head Without Contrast	17	17	$2,850.01	$2,280.01	$1,539.01	$2,793.01	$2,593.51	2026-01-20
J9218	HCPCS	Leuprolide Acetate, Per 1 Mg	34	17	$4,412.49	$3,529.99 20% off	$449.84	$7,832.11	$2,566.01	2026-01-20
90375	HCPCS	Rabies Immune Globulin For Injection	34	17	$4,569.26	$3,655.41	$229.15	$8,539.89	$2,560.76	2026-01-20
63055	HCPCS	Release Of Middle Spinal Cord And/or Nerves, Single Segment	21	21	$10,432.00	$8,345.60	$1,336.78	$10,953.60	$2,553.25	2026-01-20
72196	HCPCS	MRI Scan Of Pelvis With Contrast	17	17	$2,781.00	$2,224.80	$1,501.74	$2,725.38	$2,530.71	2026-01-20
49020	HCPCS	Drainage Of Abdominal Abscess Or Infection	21	21	$3,882.00	$3,105.60 20% off	$1,324.89	$4,076.10	$2,530.54	2026-01-20
70540	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast	17	17	$2,763.49	$2,210.79 20% off	$1,492.28	$2,708.22	$2,514.78	2026-01-20
44626	HCPCS	Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An…	21	21	$6,927.00	$5,541.60	$1,300.87	$7,273.35	$2,484.66	2026-01-20
72132	HCPCS	CT Scan Of Lower Spine With Contrast	17	17	$2,718.00	$2,174.40	$1,467.72	$2,663.64	$2,473.38	2026-01-20
22612	HCPCS	Fusion Of Spine In Lower Back	21	21	$7,421.00	$5,936.80 20% off	$1,293.12	$7,792.05	$2,469.86	2026-01-20
73221	HCPCS	MRI Scan Of Arm Joint Without Contrast	17	17	$2,698.00	$2,158.40	$1,456.92	$2,644.04	$2,455.18	2026-01-20
73721	HCPCS	MRI Scan Of Leg Joint Without Contrast	17	17	$2,698.00	$2,158.40	$1,455.39	$2,644.04	$2,455.18	2026-01-20
69610	HCPCS	Repair Of Eardrum	17	17	$2,689.87	$2,151.90	$1,452.53	$2,636.07	$2,447.78	2026-01-20
47562	HCPCS	Removal Of Gallbladder Using An Endoscope	38	22	$2,418.00	$1,934.40	$560.94	$5,107.56	$2,442.18	2026-01-20
72194	HCPCS	CT Scan Of Pelvis Before And After Contrast	17	17	$2,673.88	$2,139.10 20% off	$1,443.90	$2,620.40	$2,433.23	2026-01-20
73219	HCPCS	MRI Scan Of Arm With Contrast	17	17	$2,652.25	$2,121.80	$1,432.22	$2,599.21	$2,413.55	2026-01-20
73722	HCPCS	MRI Scan Of Leg Joint With Contrast	17	17	$2,652.25	$2,121.80	$1,432.22	$2,599.21	$2,413.55	2026-01-20
73220	HCPCS	MRI Scan Of Arm Before And After Contrast	17	17	$2,652.25	$2,121.80	$1,432.22	$2,599.21	$2,413.55	2026-01-20
73719	HCPCS	MRI Scan Of Leg With Contrast	17	17	$2,652.25	$2,121.80	$1,432.22	$2,599.21	$2,413.55	2026-01-20
73223	HCPCS	MRI Scan Of Arm Joint Before And After Contrast	17	17	$2,652.25	$2,121.80	$1,432.22	$2,599.21	$2,413.55	2026-01-20
71270	HCPCS	CT Scan Of Chest Before And After Contrast	17	17	$2,627.53	$2,102.02 20% off	$1,418.87	$2,574.98	$2,391.05	2026-01-20
70336	HCPCS	MRI Scan Of Jaw Joint	17	17	$2,619.29	$2,095.43 20% off	$1,414.42	$2,566.90	$2,383.55	2026-01-20
64721	HCPCS	Release And/or Relocation Of Hand Nerve	38	22	$2,352.00	$1,881.60 20% off	$385.06	$4,976.55	$2,375.52	2026-01-20
63015	HCPCS	Partial Removal Of Spine Bone With Exploration And/or Release Of Upper Spinal Co…	21	21	$8,566.00	$6,852.80 20% off	$1,242.93	$8,994.30	$2,374.00	2026-01-20
78458	HCPCS	Nuclear Medicine Study To Assess Blood Clot In Vein Of Both Sides	17	17	$2,596.42	$2,077.14	$1,402.07	$2,544.49	$2,362.74	2026-01-20
J9041	HCPCS	Injection, Bortezomib, 0.1 Mg	17	17	$2,584.77	$2,067.82	$1,395.78	$2,533.07	$2,352.14	2026-01-20
11422	HCPCS	Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2…	51	17	$2,567.99	$2,054.39 20% off	$225.38	$4,182.64	$2,336.87	2026-01-20
63056	HCPCS	Release Of Lower Spinal Cord And/or Nerves, Single Segment	21	21	$9,413.00	$7,530.40 20% off	$1,221.14	$9,883.65	$2,332.38	2026-01-20
70482	HCPCS	CT Scan Of Cranial Cavity Before And After Contrast	17	17	$2,562.64	$2,050.11 20% off	$1,383.83	$2,511.39	$2,332.00	2026-01-20
73218	HCPCS	MRI Scan Of Arm Without Contrast	17	17	$2,548.22	$2,038.58	$1,376.04	$2,497.26	$2,318.88	2026-01-20
73222	HCPCS	MRI Scan Of Arm Joint With Contrast	17	17	$2,546.16	$2,036.93	$1,374.93	$2,495.24	$2,317.01	2026-01-20
72127	HCPCS	CT Scan Of Upper Spine Before And After Contrast	17	17	$2,504.96	$2,003.97	$1,352.68	$2,454.86	$2,279.51	2026-01-20
74160	HCPCS	CT Scan Of Abdomen With Contrast	17	17	$2,501.87	$2,001.50	$1,351.01	$2,451.83	$2,276.70	2026-01-20
49203	HCPCS	Excision Or Destruction, Open, Intra-abdominal Tumors, Cysts Or Endometriomas, 1…	19	19	$4,530.00	$3,624.00 20% off	$1,698.56	$4,756.50	$2,265.00	2026-01-20
70470	HCPCS	CT Scan Of Head Or Brain Before And After Contrast	17	17	$2,473.03	$1,978.42 20% off	$1,335.44	$2,423.57	$2,250.46	2026-01-20
71260	HCPCS	CT Scan Of Chest With Contrast	17	17	$2,471.00	$1,976.80 20% off	$1,334.34	$2,421.58	$2,248.61	2026-01-20
72128	HCPCS	CT Scan Of Middle Spine Without Contrast	17	17	$2,462.00	$1,969.60 20% off	$1,329.48	$2,412.76	$2,240.42	2026-01-20
78018	HCPCS	Nuclear Medicine Study Of Whole Body For Thyroid Cancer	17	17	$2,435.33	$1,948.26 20% off	$1,315.08	$2,386.62	$2,216.15	2026-01-20
72126	HCPCS	CT Scan Of Upper Spine With Contrast	17	17	$2,432.86	$1,946.29	$1,313.74	$2,384.20	$2,213.90	2026-01-20
2780175	CDM	Speedbrg Impl Sys W/bio-compr	17	17	$2,430.97	$1,944.78	$1,312.72	$2,382.35	$2,212.18	2026-01-20
73718	HCPCS	MRI Scan Of Leg Without Contrast	17	17	$2,427.71	$1,942.17	$1,310.96	$2,379.16	$2,209.22	2026-01-20
27486	HCPCS	Revision Of Component Of Total Knee Joint Prosthesis	21	21	$7,050.00	$5,640.00 20% off	$1,150.51	$7,402.50	$2,197.47	2026-01-20
63267	HCPCS	Removal Of Growth Of Lower Spine Bone Outside Spine Membrane	21	21	$6,854.00	$5,483.20 20% off	$1,147.45	$7,196.70	$2,191.63	2026-01-20
44640	HCPCS	Closure Of Abnormal Drainage Tract From Small Bowel To Skin	21	21	$4,257.00	$3,405.60 20% off	$1,146.92	$4,469.85	$2,190.62	2026-01-20
45398	HCPCS	Banding Of Hemorrhoids Using A Flexible Endoscope (colonoscope)	17	17	$2,394.24	$1,915.39 20% off	$1,292.89	$2,346.36	$2,178.76	2026-01-20
70492	HCPCS	CT Scan Of Soft Tissue Of Neck Before And After Contrast	17	17	$2,387.54	$1,910.03 20% off	$1,289.27	$2,339.79	$2,172.66	2026-01-20
563	MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	11	11	$2,261.85	$1,809.48	$2,058.28	$2,216.61	$2,171.38	2026-01-20
J2357	HCPCS	Injection, Omalizumab, 5 Mg	51	17	$2,374.43	$1,899.54 20% off	$683.89	$3,819.93	$2,160.73	2026-01-20
43840	HCPCS	Suture Of Perforated Ulcer, Wound, Or Injury Of Stomach Or Upper Small Bowel	21	21	$3,961.00	$3,168.80	$1,127.53	$4,159.05	$2,153.58	2026-01-20
11043	HCPCS	Removal Of Muscle And/or Tissue, 20.0 Sq Cm Or Less	17	17	$2,359.00	$1,887.20 20% off	$1,273.86	$2,311.82	$2,146.69	2026-01-20
22600	HCPCS	Fusion Of Spine In Neck By Posterior Approach	21	21	$6,863.00	$5,490.40 20% off	$1,117.29	$7,206.15	$2,134.02	2026-01-20
44140	HCPCS	Partial Removal Of Large Bowel With Connection	21	21	$5,781.00	$4,624.80	$1,112.29	$6,070.05	$2,124.47	2026-01-20
73702	HCPCS	CT Scan Of Leg Before And After Contrast	17	17	$2,333.98	$1,867.18 20% off	$1,260.35	$2,287.30	$2,123.92	2026-01-20
Q5117	HCPCS	Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg	17	17	$2,332.12	$1,865.70	$1,259.34	$2,285.48	$2,122.23	2026-01-20
382	MS_DRG	Complicated Peptic Ulcer Without Cc/mcc	11	11	$2,202.70	$1,762.16	$2,004.46	$2,158.65	$2,114.59	2026-01-20
70481	HCPCS	CT Scan Of Cranial Cavity With Contrast	17	17	$2,316.47	$1,853.18	$1,250.89	$2,270.14	$2,107.99	2026-01-20
31237	HCPCS	Biopsy Or Removal Of Nasal Polyp Or Tissue Using An Endoscope	17	17	$2,311.93	$1,849.54 20% off	$1,248.44	$2,265.69	$2,103.86	2026-01-20
31238	HCPCS	Control Of Bleeding Of Nose Using An Endoscope	17	17	$2,311.93	$1,849.54 20% off	$1,248.44	$2,265.69	$2,103.86	2026-01-20
22610	HCPCS	Fusion Of Spine In Upper Back	21	21	$6,488.00	$5,190.40 20% off	$1,096.98	$6,812.40	$2,095.23	2026-01-20
72125	HCPCS	CT Scan Of Upper Spine Without Contrast	17	17	$2,298.00	$1,838.40	$1,240.92	$2,252.04	$2,091.18	2026-01-20
78315	HCPCS	Nuclear Medicine Study Of Bone Taken At Different Times	17	17	$2,289.64	$1,831.71 20% off	$1,236.41	$2,243.85	$2,083.57	2026-01-20
72129	HCPCS	CT Scan Of Middle Spine With Contrast	17	17	$2,285.57	$1,828.46	$1,234.21	$2,239.86	$2,079.87	2026-01-20
93312	HCPCS	Ultrasound Of Heart With Probe In Esophagus, With Report	17	17	$2,274.24	$1,819.39 20% off	$1,228.09	$2,228.76	$2,069.56	2026-01-20
63045	HCPCS	Partial Removal Of Spine Bone With Release Of Upper Spinal Cord And/or Nerves, 1…	21	21	$7,887.00	$6,309.60	$1,083.09	$8,281.35	$2,068.70	2026-01-20
J1439	HCPCS	Injection, Ferric Carboxymaltose, 1 Mg	17	17	$2,266.51	$1,813.21	$1,223.92	$2,221.18	$2,062.52	2026-01-20
11603	HCPCS	Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm	17	17	$2,265.74	$1,812.59 20% off	$1,223.50	$2,220.43	$2,061.82	2026-01-20
72131	HCPCS	CT Scan Of Lower Spine Without Contrast	17	17	$2,257.00	$1,805.60 20% off	$1,218.78	$2,211.86	$2,053.87	2026-01-20
22849	HCPCS	Reinsertion Of Spinal Fixation Device	21	21	$5,816.00	$4,652.80	$1,075.20	$6,106.80	$2,053.63	2026-01-20
63042	HCPCS	Partial Removal Of Spine Bone With Re-exploration, Release Of Lower Spinal Cord …	21	21	$8,054.00	$6,443.20 20% off	$1,072.80	$8,456.70	$2,049.05	2026-01-20
70491	HCPCS	CT Scan Of Soft Tissue Of Neck With Contrast	17	17	$2,244.00	$1,795.20 20% off	$1,211.76	$2,199.12	$2,042.04	2026-01-20
70488	HCPCS	CT Scan Of Face Before And After Contrast	17	17	$2,242.31	$1,793.85	$1,210.85	$2,197.46	$2,040.50	2026-01-20
71250	HCPCS	CT Scan Of Chest Without Contrast	17	17	$2,231.00	$1,784.80 20% off	$1,204.74	$2,186.38	$2,030.21	2026-01-20
72193	HCPCS	CT Scan Of Pelvis With Contrast	17	17	$2,230.98	$1,784.78 20% off	$1,204.73	$2,186.36	$2,030.19	2026-01-20
70487	HCPCS	CT Scan Of Face With Contrast	17	17	$2,230.98	$1,784.78 20% off	$1,204.73	$2,186.36	$2,030.19	2026-01-20
22554	HCPCS	Fusion Of Upper Spine Bones Through Front Of Neck With Partial Removal Of Disc	21	21	$6,887.00	$5,509.60	$1,061.09	$7,231.35	$2,026.68	2026-01-20
73701	HCPCS	CT Scan Of Leg With Contrast Material	17	17	$2,222.74	$1,778.19 20% off	$1,200.28	$2,178.29	$2,022.69	2026-01-20
27130	HCPCS	Replacement Of Thigh Bone And Hip Joint With Prosthesis	21	21	$7,725.00	$6,180.00 20% off	$1,047.97	$8,111.25	$2,001.62	2026-01-20
78278	HCPCS	Nuclear Medicine Study To Assess Blood Loss	17	17	$2,174.74	$1,739.79 20% off	$1,174.36	$2,131.25	$1,979.01	2026-01-20
93306	HCPCS	Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu…	17	17	$2,172.00	$1,737.60 20% off	$1,172.88	$2,128.56	$1,976.52	2026-01-20
63046	HCPCS	Partial Removal Of Spine Bone With Release Of Middle Spinal Cord And/or Nerves, …	21	21	$7,564.00	$6,051.20 20% off	$1,031.97	$7,942.20	$1,971.06	2026-01-20
73201	HCPCS	CT Scan Of Arm With Contrast	17	17	$2,156.82	$1,725.46	$1,164.68	$2,113.68	$1,962.71	2026-01-20
19081	HCPCS	Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, First…	34	17	$2,875.38	$2,300.30	$1,004.22	$3,813.26	$1,961.83	2026-01-20
78472	HCPCS	Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit…	17	17	$2,149.87	$1,719.90	$1,160.93	$2,106.87	$1,956.38	2026-01-20
49505	HCPCS	Repair Of Groin Hernia (5 Years Or Older)	38	22	$2,238.00	$1,790.40	$451.55	$3,212.92	$1,948.24	2026-01-20
72192	HCPCS	CT Scan Of Pelvis Without Contrast	17	17	$2,130.00	$1,704.00 20% off	$1,150.20	$2,087.40	$1,938.30	2026-01-20
27244	HCPCS	Treatment Of Broken Neck Of Thigh Bone With Plate/screw Implant	21	21	$5,819.00	$4,655.20 20% off	$1,012.27	$6,109.95	$1,933.44	2026-01-20
73700	HCPCS	CT Scan Of Leg Without Contrast	17	17	$2,122.00	$1,697.60 20% off	$1,145.88	$2,079.56	$1,931.02	2026-01-20
73706	HCPCS	CT Scan Of Blood Vessels Of Lower Leg With Contrast	17	17	$2,121.80	$1,697.44 20% off	$1,145.77	$2,079.36	$1,930.84	2026-01-20
27245	HCPCS	Treatment Of Broken Neck Of Thigh Bone With Bone Implant	21	21	$5,819.00	$4,655.20 20% off	$1,010.22	$6,109.95	$1,929.52	2026-01-20
44120	HCPCS	Partial Removal Of Small Bowel With Reconnection	21	21	$2,323.00	$1,858.40	$1,008.17	$3,014.43	$1,925.60	2026-01-20
44320	HCPCS	Creation Of Opening From Large Bowel To Skin	21	21	$5,189.00	$4,151.20 20% off	$1,003.55	$5,448.45	$1,916.78	2026-01-20
19307	HCPCS	Removal Of Breast And Underarm Lymph Nodes	21	21	$4,173.00	$3,338.40 20% off	$1,002.51	$4,381.65	$1,914.79	2026-01-20
63012	HCPCS	Partial Removal Of Spine Bone With Release Of Lower Spinal Cord Or Nerves	21	21	$6,415.00	$5,132.00 20% off	$1,001.09	$6,735.75	$1,912.08	2026-01-20
35840	HCPCS	Exploration Of Abdomen For Bleeding, Blood Clot, Or Infection After Surgery	21	21	$3,092.00	$2,473.60 20% off	$961.62	$3,246.60	$1,905.09	2026-01-20
71271	HCPCS	Low Dose CT Scan Of Chest For Lung Cancer Screening	17	17	$2,083.00	$1,666.40	$1,124.82	$2,041.34	$1,895.53	2026-01-20
52441	HCPCS	Insertion Of Implant In Urethra Within Prostate Gland Using An Endoscope, 1 Impl…	38	22	$2,376.53	$1,901.22 20% off	$171.16	$3,061.29	$1,889.88	2026-01-20
77012	HCPCS	Review By Radiologist Of CT Guidance For Needle Placement	17	17	$2,076.00	$1,660.80 20% off	$1,121.04	$2,034.48	$1,889.16	2026-01-20
78306	HCPCS	Nuclear Medicine Study Of Bone And/or Joint Whole Body	17	17	$2,074.00	$1,659.20 20% off	$1,119.96	$2,032.52	$1,887.34	2026-01-20
44346	HCPCS	Revision Of Opening From Large Bowel To Skin With Repair Of Hernia	21	21	$5,113.00	$4,090.40 20% off	$987.92	$5,368.65	$1,886.93	2026-01-20
70480	HCPCS	CT Scan Of Cranial Cavity Without Contrast	17	17	$2,072.36	$1,657.89	$1,119.07	$2,030.91	$1,885.85	2026-01-20
74150	HCPCS	CT Scan Of Abdomen Without Contrast	17	17	$2,068.24	$1,654.59 20% off	$1,116.85	$2,026.88	$1,882.10	2026-01-20
70460	HCPCS	CT Scan Head Or Brain With Contrast	17	17	$2,066.18	$1,652.94 20% off	$1,115.74	$2,024.86	$1,880.22	2026-01-20
27236	HCPCS	Treatment Of Upper End Of Broken Thigh Bone With Placement Of Stabilizing Device…	21	21	$4,555.00	$3,644.00 20% off	$984.40	$4,782.75	$1,880.20	2026-01-20
19305	HCPCS	Extensive Removal Of Breast, Chest Muscle, And Underarm Lymph Nodes	21	21	$3,960.00	$3,168.00 20% off	$975.98	$4,158.00	$1,864.12	2026-01-20
78227	HCPCS	Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs	34	17	$2,002.39	$1,601.92	$1,072.02	$1,979.18	$1,837.81	2026-01-20
78300	HCPCS	Nuclear Medicine Study Of Bone And/or Joint Limited Area	17	17	$2,018.39	$1,614.71 20% off	$1,089.93	$1,978.02	$1,836.73	2026-01-20
11602	HCPCS	Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm	17	17	$2,007.47	$1,605.98	$1,084.03	$1,967.32	$1,826.80	2026-01-20
70490	HCPCS	CT Scan Of Soft Tissue Of Neck Without Contrast	17	17	$2,006.44	$1,605.15 20% off	$1,083.48	$1,966.31	$1,825.86	2026-01-20
78290	HCPCS	Nuclear Medicine Study Of Intestine	17	17	$2,005.36	$1,604.29	$1,082.89	$1,965.25	$1,824.88	2026-01-20
36571	HCPCS	Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older)	38	22	$1,973.00	$1,578.40	$264.57	$3,165.40	$1,809.28	2026-01-20
63709	HCPCS	Repair Of Cerebrospinal Fluid Leak With Partial Removal Of Vertebra	21	21	$7,605.00	$6,084.00 20% off	$945.37	$7,985.25	$1,805.66	2026-01-20
78707	HCPCS	Nuclear Medicine Study Of Kidney, Blood Flow, And Function	17	17	$1,982.85	$1,586.28 20% off	$1,070.74	$1,943.19	$1,804.39	2026-01-20
93307	HCPCS	Ultrasound Of Heart	17	17	$1,982.75	$1,586.20 20% off	$1,070.69	$1,943.10	$1,804.30	2026-01-20
36590	HCPCS	Removal Of Central Venous Tube With Port Or Pump	51	17	$1,982.50	$1,586.00 20% off	$225.38	$3,820.78	$1,804.08	2026-01-20
73200	HCPCS	CT Scan Of Arm Without Contrast	17	17	$1,977.00	$1,581.60 20% off	$1,067.58	$1,937.46	$1,799.07	2026-01-20
47605	HCPCS	Removal Of Gallbladder With X-ray Study Of Bile Ducts	21	21	$3,364.00	$2,691.20 20% off	$941.26	$3,532.20	$1,797.81	2026-01-20
J7326	HCPCS	Hyaluronan Or Derivative, Gel-one, For Intra-articular Injection, Per Dose	17	17	$1,975.00	$1,580.00 20% off	$1,066.50	$1,935.50	$1,797.25	2026-01-20
63047	HCPCS	Partial Removal Of Spine Bone With Release Of Lower Spinal Cord And/or Nerves, 1…	21	21	$7,235.00	$5,788.00 20% off	$933.17	$7,596.75	$1,782.35	2026-01-20
63020	HCPCS	Partial Removal Of Spine Bone With Release Of Upper Spinal Cord Or Nerves And/or…	21	21	$7,384.00	$5,907.20 20% off	$932.96	$7,753.20	$1,781.95	2026-01-20
70450	HCPCS	CT Scan Head Or Brain Without Contrast	17	17	$1,958.00	$1,566.40	$1,057.32	$1,918.84	$1,781.78	2026-01-20
28820	HCPCS	Amputation Of Toe At Joint Between Forefoot And Toes	38	22	$1,759.00	$1,407.20 20% off	$150.36	$4,706.30	$1,776.59	2026-01-20

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