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

FILLMORE COUNTY HOSPITAL

Geneva, NE · CCN 281301 · Rates published

14,437 distinct procedures filed
7 distinct payers
291,042 rate rows
2026-04-23 last MRF observed
Data quality

156,588 of 291,042 rate rows are consumer-grade (53.8%)

134,454 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
professional (physician) fee — not the facility price 133,788
percent-of-charges filed in the dollar field — excluded from medians 424
per-diem day rate — not a per-procedure price 100
placeholder amount (≤ $0.02) — excluded from medians 78
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 44
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 20
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/12701/470529089_fillmore-county-hospital_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/FillmoreCountyHospital/12701
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-03
Content fingerprint f9ee05ffb280f2ec… · 47,226,178 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
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $478,950.00 $478,950.00 $478,950.00 nat. median
$599,737
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $436,720.00 $436,720.00 $436,720.00 nat. median
$513,770
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $436,720.00 $436,720.00 $436,720.00 nat. median
$562,501
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $432,085.00 $432,085.00 $432,085.00 nat. median
$574,037
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $422,609.00 $422,609.00 $422,609.00 nat. median
$579,571
0.7× median
E0766
HCPCS 		Elec Stim Cancer Treatment 1 $97,327.33 $97,327.33 $97,327.33 nat. median
$16,158
outlier · 6.0×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 2 $84,426.69 $102,979.80 $93,703.24 nat. median
$108,243
0.9× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 1 $70,418.21 $70,418.21 $70,418.21 nat. median
$65,477
1.1× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $53,981.46 $77,820.00 $65,900.73 nat. median
$63,499
1.0× median
J2351
HCPCS 		Ocrevus Zunovo 920 Mg/23 Ml [fill] 7 $37,450.96 $66,579.48 $65,885.94 nat. median
$56
outlier · 1171.7×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $53,819.56 $53,819.56 $53,819.56 nat. median
$92,809
0.6× median
J9226
HCPCS 		Supprelin La Implant 2 $43,324.60 $54,215.03 $48,769.82 nat. median
$57,036
0.9× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 2 $43,253.36 $43,253.36 $43,253.36 nat. median
$7,098
outlier · 6.1×
L7181
HCPCS 		Electronic Elbo Simultaneous 2 $37,550.68 $45,813.80 $41,682.24 nat. median
$48,410
0.9× median
L7180
HCPCS 		Electronic Elbow Sequential 2 $34,072.52 $41,283.06 $37,677.79 nat. median
$42,745
0.9× median
L2006
HCPCS 		Kaf Sng/dbl Swg/stn Mcpr Cus 2 $32,873.01 $36,768.26 $34,820.64 nat. median
$38,763
0.9× median
E0194
HCPCS 		Air Fluidized Bed 1 $27,342.04 $27,342.04 $27,342.04 nat. median
$4,113
outlier · 6.6×
J9266
HCPCS 		Pegaspargase Injection 2 $23,577.01 $26,690.95 $25,133.98 nat. median
$31,084
0.8× median
L5856
HCPCS 		Elec Knee-shin Swing/stance 2 $22,530.10 $27,441.98 $24,986.04 nat. median
$29,004
0.9× median
L6880
HCPCS 		Elec Hand Ind Art Digits 2 $22,397.06 $27,318.68 $24,857.87 nat. median
$28,867
0.9× median
J9600
HCPCS 		Porfimer Sodium Injection 1 $21,650.00 $21,650.00 $21,650.00 nat. median
$26,416
0.8× median
L8614
HCPCS 		Cochlear Device 2 $18,127.17 $21,674.94 $19,901.06 nat. median
$22,495
0.9× median
Q0483
HCPCS 		Monitor Elec Vad, Rep 2 $17,575.83 $21,438.19 $19,507.01 nat. median
$22,635
0.9× median
L5858
HCPCS 		Stance Phase Only 2 $17,417.43 $21,250.33 $19,333.88 nat. median
$22,455
0.9× median
A9604
HCPCS 		Sm 153 Lexidronam 1 $18,562.49 $18,562.49 $18,562.49 nat. median
$11,059
1.7× median
L5973
HCPCS 		Ank-foot Sys Dors-plant Flex 2 $16,354.36 $20,100.35 $18,227.35 nat. median
$21,313
0.9× median
L6975
HCPCS 		Interscap-thor Myoelectronic 2 $16,667.77 $19,445.09 $18,056.43 nat. median
$21,202
0.9× median
Q0489
HCPCS 		Pwr Pck Base Combo Vad, Rep 2 $15,237.15 $18,585.73 $16,911.44 nat. median
$19,623
0.9× median
J9144
HCPCS 		Daratumumab-hyaluronidase 1800mg-30,000 units/15mL [fill] 7 $46.79 $17,050.32 $16,872.71 nat. median
$114
outlier · 147.4×
L6970
HCPCS 		Interscapular-thor Switch CT 2 $15,212.40 $17,246.96 $16,229.68 nat. median
$19,306
0.8× median
L6965
HCPCS 		Shldr Disartic Myoelectronic 2 $14,782.35 $16,409.38 $15,595.87 nat. median
$18,144
0.9× median
L5859
HCPCS 		Knee-shin Pro Flex/ext Cont 2 $13,646.58 $16,589.96 $15,118.27 nat. median
$17,530
0.9× median
Q0481
HCPCS 		Microprcsr Cu Elec Vad, Rep 2 $13,621.21 $16,614.61 $15,117.91 nat. median
$16,720
0.9× median
J2323
HCPCS 		Natalizumab Vial 300 Mg / 15 Ml Sdv[fill] 7 $22.92 $14,320.41 $14,171.24 nat. median
$50
outlier · 281.0×
L6960
HCPCS 		Shldr Disartic Switch Contro 2 $12,564.02 $14,164.96 $13,364.49 nat. median
$15,937
0.8× median
J3101
HCPCS 		Tnk Inj 50 Mg Sdv [fill] 7 $143.65 $13,381.82 $13,242.43 nat. median
$498
outlier · 26.6×
L6955
HCPCS 		Above Elbow Myoelectronic CT 2 $12,457.28 $13,644.38 $13,050.83 nat. median
$14,649
0.9× median
Q0479
HCPCS 		Power Module Combo Vad, Rep 2 $11,233.96 $13,714.09 $12,474.02 nat. median
$14,835
0.8× median
81416
CPT 		Exome Sequence Analysis 3 $10,956.12 $12,000.00 $12,000.00 nat. median
$12,000
1.0× median
J7310
HCPCS 		Outpatient Services 2 $3,926.16 $19,200.00 $11,563.08 nat. median
$13,629
0.8× median
J2427
HCPCS 		Invega Trinza 546 Mg Inj Sdv [fill] 7 $6,476.02 $11,718.07 $11,393.00 nat. median
$17
outlier · 688.4×
Q4244
HCPCS 		Outpatient Services 2 $10,480.26 $11,880.00 $11,180.13 nat. median
$105
outlier · 106.3×
L6945
HCPCS 		Elbow Disart Myoelectronic C 2 $10,646.42 $11,660.81 $11,153.61 nat. median
$13,336
0.8× median
L6950
HCPCS 		Above Elbow Switch Control 2 $10,401.70 $11,392.76 $10,897.23 nat. median
$12,453
0.9× median
E0783
HCPCS 		Programmable Infusion Pump 1 $10,887.51 $10,887.51 $10,887.51 nat. median
$11,394
1.0× median
L7191
HCPCS 		Elbow Child Myoelectronic CT 2 $9,640.60 $12,115.59 $10,878.10 nat. median
$12,134
0.9× median
L7186
HCPCS 		Electron Elbow Child Switch 2 $9,226.01 $12,444.67 $10,835.34 nat. median
$11,405
1.0× median
E0786
HCPCS 		Implantable Pump Replacement 1 $10,620.10 $10,620.10 $10,620.10 nat. median
$10,951
1.0× median
L6940
HCPCS 		Elbow Disarticulation Switch 2 $9,151.14 $10,047.33 $9,599.24 nat. median
$11,589
0.8× median
J0717
HCPCS 		Certolizumab 200 mg/mL Kit Sdv [fill] 7 $5.06 $9,675.89 $9,575.10 nat. median
$29
outlier · 329.9×

Other procedures at this hospital

Browse this hospital's 14,437 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
             
Q2056 HCPCS Ciltacabtagene Car-pos T 2 1 — — $478,950.00 $478,950.00 $478,950.00 2026-04-23
Q2053 HCPCS Brexucabtagene Car Pos T 2 1 — — $436,720.00 $436,720.00 $436,720.00 2026-04-23
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 1 — — $436,720.00 $436,720.00 $436,720.00 2026-04-23
Q2055 HCPCS Idecabtagene Vicleucel Car 2 1 — — $432,085.00 $432,085.00 $432,085.00 2026-04-23
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 1 — — $422,609.00 $422,609.00 $422,609.00 2026-04-23
E0766 HCPCS Elec Stim Cancer Treatment 2 1 — — $97,327.33 $97,327.33 $97,327.33 2026-04-23
Q0480 HCPCS Driver Pneumatic Vad, Rep 4 2 — — $84,426.69 $102,979.80 $93,703.24 2026-04-23
A9543 HCPCS Y90 Ibritumomab, Rx 2 1 — — $70,418.21 $70,418.21 $70,418.21 2026-04-23
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 4 2 — — $53,981.46 $77,820.00 $65,900.73 2026-04-23
J2351 HCPCS Ocrevus Zunovo 920 Mg/23 Ml [fill] 54 7 $69,353.63 $69,353.63 $37,450.96 $66,579.48 $65,885.94 2026-04-23
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $53,819.56 $53,819.56 $53,819.56 2026-04-23
J9226 HCPCS Supprelin La Implant 4 2 — — $43,324.60 $54,215.03 $48,769.82 2026-04-23
A9699 HCPCS Radiopharm Rx Agent Noc 4 2 — — $43,253.36 $43,253.36 $43,253.36 2026-04-23
L7181 HCPCS Electronic Elbo Simultaneous 4 2 — — $37,550.68 $45,813.80 $41,682.24 2026-04-23
L7180 HCPCS Electronic Elbow Sequential 4 2 — — $34,072.52 $41,283.06 $37,677.79 2026-04-23
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 4 2 — — $32,873.01 $36,768.26 $34,820.64 2026-04-23
E0194 HCPCS Air Fluidized Bed 2 1 — — $27,342.04 $27,342.04 $27,342.04 2026-04-23
J9266 HCPCS Pegaspargase Injection 4 2 — — $23,577.01 $26,690.95 $25,133.98 2026-04-23
L5856 HCPCS Elec Knee-shin Swing/stance 4 2 — — $22,530.10 $27,441.98 $24,986.04 2026-04-23
L6880 HCPCS Elec Hand Ind Art Digits 4 2 — — $22,397.06 $27,318.68 $24,857.87 2026-04-23
J9600 HCPCS Porfimer Sodium Injection 2 1 — — $21,650.00 $21,650.00 $21,650.00 2026-04-23
L8614 HCPCS Cochlear Device 4 2 — — $18,127.17 $21,674.94 $19,901.06 2026-04-23
Q0483 HCPCS Monitor Elec Vad, Rep 4 2 — — $17,575.83 $21,438.19 $19,507.01 2026-04-23
L5858 HCPCS Stance Phase Only 4 2 — — $17,417.43 $21,250.33 $19,333.88 2026-04-23
A9604 HCPCS Sm 153 Lexidronam 2 1 — — $18,562.49 $18,562.49 $18,562.49 2026-04-23
L5973 HCPCS Ank-foot Sys Dors-plant Flex 4 2 — — $16,354.36 $20,100.35 $18,227.35 2026-04-23
L6975 HCPCS Interscap-thor Myoelectronic 4 2 — — $16,667.77 $19,445.09 $18,056.43 2026-04-23
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 4 2 — — $15,237.15 $18,585.73 $16,911.44 2026-04-23
J9144 HCPCS Daratumumab-hyaluronidase 1800mg-30,000 units/15mL [fill] 52 7 $17,760.75 $17,760.75 $46.79 $17,050.32 $16,872.71 2026-04-23
L6970 HCPCS Interscapular-thor Switch CT 4 2 — — $15,212.40 $17,246.96 $16,229.68 2026-04-23
L6965 HCPCS Shldr Disartic Myoelectronic 4 2 — — $14,782.35 $16,409.38 $15,595.87 2026-04-23
L5859 HCPCS Knee-shin Pro Flex/ext Cont 4 2 — — $13,646.58 $16,589.96 $15,118.27 2026-04-23
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 4 2 — — $13,621.21 $16,614.61 $15,117.91 2026-04-23
J2323 HCPCS Natalizumab Vial 300 Mg / 15 Ml Sdv[fill] 54 7 $14,917.09 $14,917.09 $22.92 $14,320.41 $14,171.24 2026-04-23
L6960 HCPCS Shldr Disartic Switch Contro 4 2 — — $12,564.02 $14,164.96 $13,364.49 2026-04-23
J3101 HCPCS Tnk Inj 50 Mg Sdv [fill] 56 7 $13,939.40 $13,939.40 $143.65 $13,381.82 $13,242.43 2026-04-23
L6955 HCPCS Above Elbow Myoelectronic CT 4 2 — — $12,457.28 $13,644.38 $13,050.83 2026-04-23
Q0479 HCPCS Power Module Combo Vad, Rep 4 2 — — $11,233.96 $13,714.09 $12,474.02 2026-04-23
81416 CPT Exome Sequence Analysis 6 3 — — $10,956.12 $12,000.00 $12,000.00 2026-04-23
J7310 HCPCS Outpatient Services 4 2 — — $3,926.16 $19,200.00 $11,563.08 2026-04-23
J2427 HCPCS Invega Trinza 546 Mg Inj Sdv [fill] 82 7 $11,992.63 $11,992.63 $6,476.02 $11,718.07 $11,393.00 2026-04-23
Q4244 HCPCS Outpatient Services 4 2 — — $10,480.26 $11,880.00 $11,180.13 2026-04-23
L6945 HCPCS Elbow Disart Myoelectronic C 4 2 — — $10,646.42 $11,660.81 $11,153.61 2026-04-23
L6950 HCPCS Above Elbow Switch Control 4 2 — — $10,401.70 $11,392.76 $10,897.23 2026-04-23
E0783 HCPCS Programmable Infusion Pump 2 1 — — $10,887.51 $10,887.51 $10,887.51 2026-04-23
L7191 HCPCS Elbow Child Myoelectronic CT 4 2 — — $9,640.60 $12,115.59 $10,878.10 2026-04-23
L7186 HCPCS Electron Elbow Child Switch 4 2 — — $9,226.01 $12,444.67 $10,835.34 2026-04-23
E0786 HCPCS Implantable Pump Replacement 2 1 — — $10,620.10 $10,620.10 $10,620.10 2026-04-23
L6940 HCPCS Elbow Disarticulation Switch 4 2 — — $9,151.14 $10,047.33 $9,599.24 2026-04-23
J0717 HCPCS Certolizumab 200 mg/mL Kit Sdv [fill] 52 7 $10,079.05 $10,079.05 $5.06 $9,675.89 $9,575.10 2026-04-23
E0467 HCPCS Home Vent Multi-function 2 1 — — $9,529.83 $9,529.83 $9,529.83 2026-04-23
E0764 HCPCS Functional Neuromuscularstim 2 1 — — $9,297.79 $9,297.79 $9,297.79 2026-04-23
J9271 HCPCS Keytruda 25mg/ml Sdv [fill] 52 7 $9,713.89 $9,713.90 $53.91 $9,325.34 $9,228.20 2026-04-23
J0517 HCPCS Benralizumab 30 mg/mL Inj Sdv[fill] 52 7 $9,536.94 $9,536.94 $168.25 $9,155.46 $9,060.09 2026-04-23
E2510 HCPCS Sgd W Multi Methods Msg/accs 2 1 — — $9,000.90 $9,000.90 $9,000.90 2026-04-23
E0483 HCPCS Hi Freq Chest Wall Oscil Sys 2 1 — — $8,932.09 $8,932.09 $8,932.09 2026-04-23
L6935 HCPCS Below Elbow Myoelectronic CT 4 2 — — $8,186.46 $9,622.09 $8,904.27 2026-04-23
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 4 2 — — $8,659.01 $9,123.66 $8,891.33 2026-04-23
L5857 HCPCS Elec Knee-shin Swing Only 4 2 — — $8,015.68 $9,733.38 $8,874.53 2026-04-23
L8679 HCPCS Imp Neurosti Pls Gn Any Type 4 2 — — $7,910.18 $9,633.81 $8,771.99 2026-04-23
L6925 HCPCS Wrist Disart Myoelectronic C 4 2 — — $8,036.10 $9,436.66 $8,736.38 2026-04-23
L8619 HCPCS Coch Imp Ext Proc/contr Rplc 4 2 — — $7,780.85 $9,304.88 $8,542.86 2026-04-23
Q5122 HCPCS Nyvepria 6 Mg Sdv [fill] 52 7 $8,949.00 $8,949.00 $146.65 $8,591.04 $8,501.55 2026-04-23
0315U CPT Onc Cutan Sq Cll Ca Mrna 40 2 1 — — $8,500.00 $8,500.00 $8,500.00 2026-04-23
0211U CPT Onc Pan-tum Dna&rna Gnrj Seq 6 3 — — $7,719.28 $8,455.00 $8,455.00 2026-04-23
L7190 HCPCS Elbow Adolescent Myoelectron 4 2 — — $7,879.55 $8,707.02 $8,293.28 2026-04-23
E0465 HCPCS Home Vent Invasive Interface 2 1 — — $8,019.70 $8,019.70 $8,019.70 2026-04-23
E0466 HCPCS Home Vent Non-invasive Inter 2 1 — — $8,019.70 $8,019.70 $8,019.70 2026-04-23
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 4 2 — — $7,942.66 $7,942.66 $7,942.66 2026-04-23
81552 CPT Onc Uveal Mlnma Mrna 15 Gene 6 3 — — $7,099.58 $7,776.00 $7,776.00 2026-04-23
L6920 HCPCS Wrist Disarticul Switch Ctrl 4 2 — — $6,960.97 $8,577.60 $7,769.28 2026-04-23
L6930 HCPCS Below Elbow Switch Control 4 2 — — $7,003.97 $8,509.46 $7,756.72 2026-04-23
Q2050 HCPCS DOXOrubicin Liposomal 50mg/25ml Sdv[fill] 52 7 $8,139.88 $8,139.88 $102.24 $7,814.28 $7,732.89 2026-04-23
0238T CPT Trluml Perip Athrc Iliac Art 4 2 — — $7,716.29 $7,716.29 $7,716.29 2026-04-23
0426U CPT Genome Ultra-rapid Seq Alys 2 1 — — $7,582.20 $7,582.20 $7,582.20 2026-04-23
0582U CPT Rare Ds Rpd Whlgen DNA Vrnts 2 1 — — $7,582.20 $7,582.20 $7,582.20 2026-04-23
0094U CPT Genome Rapid Sequence Alys 6 3 — — $6,922.60 $7,582.20 $7,582.20 2026-04-23
J9216 HCPCS Interferon Gamma 1-b Inj 2 1 — — $7,542.33 $7,542.33 $7,542.33 2026-04-23
L5987 HCPCS Shank Ft W Vert Load Pylon 4 2 — — $6,741.61 $8,225.36 $7,483.49 2026-04-23
L8627 HCPCS Cid Ext Speech Process Repl 4 2 — — $6,607.95 $7,876.57 $7,242.26 2026-04-23
81529 CPT Onc Cutan Mlnma Mrna 31 Gene 6 3 — — $6,567.12 $7,193.00 $7,193.00 2026-04-23
E0652 HCPCS Pneum Compres W/cal Pressure 2 1 — — $7,050.25 $7,050.25 $7,050.25 2026-04-23
39503 CPT Repair Of Diaphragm Hernia 4 2 — — $5,026.98 $9,048.56 $7,037.77 2026-04-23
E1008 HCPCS Pwr Seat Combo Pwr Shear 2 1 — — $6,864.13 $6,864.13 $6,864.13 2026-04-23
A9572 HCPCS Indium In-111 Pentetreotide 2 1 — — $6,811.20 $6,811.20 $6,811.20 2026-04-23
L8609 HCPCS Artificial Cornea 4 2 — — $6,107.67 $7,449.79 $6,778.73 2026-04-23
22514 CPT Ir Perc Kyphoplasty Lumbar 56 7 $7,118.00 $7,118.00 $428.43 $6,833.28 $6,762.10 2026-04-23
0267U CPT Rare Do Id Opt Gen Mapg&seq 6 3 — — $6,153.15 $6,739.33 $6,739.33 2026-04-23
E1007 HCPCS Pwr Seat Combo W/shear 2 1 — — $6,691.80 $6,691.80 $6,691.80 2026-04-23
Q5111 HCPCS Udenyca 6 Mg Sdv [fill] 52 7 $7,014.00 $7,014.00 $137.66 $6,733.44 $6,663.30 2026-04-23
47135 CPT Transplantation Of Liver 4 2 — — $4,743.84 $8,538.91 $6,641.38 2026-04-23
L7185 HCPCS Electron Elbow Adolescent Sw 4 2 — — $6,193.06 $6,783.16 $6,488.11 2026-04-23
K1014 HCPCS Outpatient Services 4 2 — — $5,626.26 $7,265.13 $6,445.69 2026-04-23
36478 CPT Ir Endovenous Ablation First Vein Rt 56 7 $6,750.00 $6,750.00 $243.72 $6,480.00 $6,412.50 2026-04-23
L7170 HCPCS Electronic Elbow Hosmer Swit 4 2 — — $6,115.71 $6,698.53 $6,407.12 2026-04-23
0273T CPT Professional Services 4 2 — — $6,311.79 $6,469.35 $6,390.57 2026-04-23
L8682 HCPCS Implt Neurostim Radiofq Rec 4 2 — — $5,651.63 $6,883.16 $6,267.40 2026-04-23
23071 CPT 23071 Exc Shoulder Les Sc 3 Cm/> 56 7 $6,557.00 $6,557.00 $379.16 $6,294.72 $6,229.15 2026-04-23
22513 CPT Ir Perc Kyphoplasty Thoracic 1st Level 52 7 $6,531.00 $6,531.00 $459.31 $6,269.76 $6,204.45 2026-04-23
78815 CPT PET Skull Base To Midthigh With CT Scan 58 7 $6,500.00 $6,500.00 $844.24 $6,240.00 $6,175.00 2026-04-23
L5270 HCPCS Tilt Table Locking Hip Sing 4 2 — — $5,364.21 $6,978.33 $6,171.27 2026-04-23
L8685 HCPCS Implt Nrostm Pls Gen Sng Rec 4 2 — — $6,103.03 $6,103.03 $6,103.03 2026-04-23
J0600 HCPCS Edetate Calcium Disodium Inj 4 2 — — $5,708.59 $6,462.56 $6,085.58 2026-04-23
L5280 HCPCS Hemipelvect Canad Sing Axis 4 2 — — $5,310.68 $6,849.30 $6,079.99 2026-04-23
L5250 HCPCS Hip Canad Sing Axi Cons Fric 4 2 — — $5,411.85 $6,661.82 $6,036.84 2026-04-23
49605 CPT Repair Umbilical Lesion 4 2 — — $4,302.67 $7,744.81 $6,023.74 2026-04-23
43116 CPT Partial Removal Of Esophagus 4 2 — — $4,296.87 $7,734.37 $6,015.62 2026-04-23
33935 CPT Transplantation Heart/lung 4 2 — — $4,274.71 $7,694.48 $5,984.59 2026-04-23
74174 CPT CT Angio Abdomen Pelvis 56 7 $6,298.00 $6,298.00 $369.93 $6,046.08 $5,983.10 2026-04-23
L7008 HCPCS Pediatric Electric Hand 4 2 — — $5,648.85 $6,308.72 $5,978.78 2026-04-23
78816 CPT PET Whole Body With CT Scan 52 7 $6,250.00 $6,250.00 $849.68 $6,000.00 $5,937.50 2026-04-23
33945 CPT Transplantation Of Heart 4 2 — — $4,215.93 $7,588.67 $5,902.30 2026-04-23
E0694 HCPCS Uvl Md Cabinet Sys 6 Ft 2 1 — — $5,887.80 $5,887.80 $5,887.80 2026-04-23
L5341 HCPCS Hemipelvectomy Canadian Sach 4 2 — — $5,271.39 $6,487.64 $5,879.52 2026-04-23
32854 CPT Lung Transplant With Bypass 4 2 — — $4,192.82 $7,547.08 $5,869.95 2026-04-23
E0636 HCPCS Pt Support & Positioning Sys 2 1 — — $5,807.56 $5,807.56 $5,807.56 2026-04-23
47142 CPT Partial Removal Donor Liver 4 2 — — $4,122.93 $7,421.27 $5,772.10 2026-04-23
J1306 HCPCS Inclisiran 284mg/1.5 Ml Inj Sdv [fill] 52 7 $6,072.14 $6,072.15 $11.99 $5,829.26 $5,768.54 2026-04-23
E0782 HCPCS Non-programble Infusion Pump 2 1 — — $5,709.70 $5,709.70 $5,709.70 2026-04-23
A9515 HCPCS Choline C-11 2 1 — — $5,700.00 $5,700.00 $5,700.00 2026-04-23
78814 CPT PET Ltd Area With CT Scan 52 7 $6,000.00 $6,000.00 $761.29 $5,760.00 $5,700.00 2026-04-23
J9219 HCPCS Leuprolide Acetate Implant 2 1 — — $5,684.00 $5,684.00 $5,684.00 2026-04-23
0505T CPT Ev Fempop Artl Revsc 4 2 — — $5,479.96 $5,771.70 $5,625.83 2026-04-23
G2072 HCPCS Outpatient Services 2 1 — — $5,599.29 $5,599.29 $5,599.29 2026-04-23
L5331 HCPCS Hip Disart Canadian Sach Ft 4 2 — — $4,850.93 $6,347.15 $5,599.04 2026-04-23
L5702 HCPCS Replace Socket Hip 4 2 — — $4,531.64 $6,594.87 $5,563.26 2026-04-23
D7949 HCPCS LeFort Ii Or LeFort Iii - With Bone Graft 4 2 — — $5,550.86 $5,550.86 $5,550.86 2026-04-23
32853 CPT Lung Transplant Double 4 2 — — $3,956.11 $7,121.00 $5,538.56 2026-04-23
L8683 HCPCS Radiofq Trsmtr For Implt Neu 4 2 — — $4,974.68 $6,058.81 $5,516.75 2026-04-23
0265U CPT Rar Do Whl Gn&mtcdrl DNA Als 6 3 — — $4,999.44 $5,475.80 $5,475.80 2026-04-23
0212U CPT Rare Ds Gen DNA Alys Proband 6 3 — — $4,998.82 $5,475.20 $5,475.20 2026-04-23
43123 CPT Partial Removal Of Esophagus 4 2 — — $3,898.91 $7,018.04 $5,458.48 2026-04-23
61698 CPT Brain Aneurysm Repr Complx 4 2 — — $3,888.40 $6,999.12 $5,443.76 2026-04-23
81554 CPT Pulm Ds Ipf Mrna 190 Gen Alg 6 3 — — $5,039.66 $5,520.00 $5,409.60 2026-04-23
E1006 HCPCS Pwr Seat Combo Without Shear 2 1 — — $5,391.12 $5,391.12 $5,391.12 2026-04-23
43108 CPT Removal Of Esophagus 4 2 — — $3,844.13 $6,919.43 $5,381.78 2026-04-23
G2070 HCPCS Outpatient Services 2 1 — — $5,380.30 $5,380.30 $5,380.30 2026-04-23
74178 CPT CT Urogram 58 7 $5,600.00 $5,600.00 $333.12 $5,376.00 $5,320.00 2026-04-23
61686 CPT Intracranial Vessel Surgery 4 2 — — $3,776.64 $6,797.95 $5,287.30 2026-04-23
J9358 HCPCS Enhertu 100 Mg/5ml Sdv [fill] 52 7 $5,555.65 $5,555.65 $25.72 $5,333.42 $5,277.86 2026-04-23
A9507 HCPCS In111 Capromab 2 1 — — $5,275.21 $5,275.21 $5,275.21 2026-04-23
43113 CPT Removal Of Esophagus 4 2 — — $3,761.77 $6,771.19 $5,266.48 2026-04-23
47141 CPT Partial Removal Donor Liver 4 2 — — $3,750.92 $6,751.66 $5,251.29 2026-04-23
0335U CPT Rare Ds Whl Gen Seq Fetal 6 3 — — $4,770.18 $5,224.60 $5,224.60 2026-04-23
0214U CPT Rare Ds Xom DNA Alys Proband 6 3 — — $4,770.18 $5,224.60 $5,224.60 2026-04-23
46748 CPT Repair Of Cloacal Anomaly 4 2 — — $3,710.50 $6,678.90 $5,194.70 2026-04-23
E0748 HCPCS Elec Osteogen Stim Spinal 2 1 — — $5,174.14 $5,174.14 $5,174.14 2026-04-23
J9225 HCPCS Vantas Implant 4 2 — — $5,166.29 $5,166.29 $5,166.29 2026-04-23
J2357 HCPCS Xolair 300mg/2ml Sdv [fill] 54 7 $5,437.90 $5,437.91 $38.20 $5,220.38 $5,166.01 2026-04-23
E0747 HCPCS Elec Osteogen Stim Not Spine 2 1 — — $5,159.20 $5,159.20 $5,159.20 2026-04-23
J0716 HCPCS Centruroides Immune F(ab) 2 1 — — $5,146.18 $5,146.18 $5,146.18 2026-04-23
J9015 HCPCS Aldesleukin Injection 2 1 — — $5,140.25 $5,140.25 $5,140.25 2026-04-23
L8688 HCPCS Implt Nrostm Pls Gen Dua Non 4 2 — — $5,068.12 $5,068.12 $5,068.12 2026-04-23
33916 CPT Surgery Of Great Vessel 4 2 — — $3,607.84 $6,494.11 $5,050.98 2026-04-23
0237T CPT Trluml Perip Athrc Brchiocph 4 2 — — $4,877.73 $5,214.99 $5,046.36 2026-04-23
0236T CPT Trluml Perip Athrc Abd Aorta 4 2 — — $4,873.75 $5,210.67 $5,042.21 2026-04-23
0567U CPT Rare Ds Whl Gen Seq Srs&lrs 2 1 — — $5,031.20 $5,031.20 $5,031.20 2026-04-23
0532U CPT Rare Ds Whlgen&mitochdrl DNA 2 1 — — $5,031.20 $5,031.20 $5,031.20 2026-04-23
81425 CPT Genome Sequence Analysis 6 3 — — $4,593.52 $5,031.20 $5,031.20 2026-04-23
L5961 HCPCS Endo Poly Hip, Pneu/hyd/rot 4 2 — — $4,463.57 $5,576.16 $5,019.86 2026-04-23
0242U CPT Trgt Gen Seq Alys Pnl 55-74 6 3 — — $4,565.05 $5,000.00 $5,000.00 2026-04-23
0326U CPT Trgt Gen Seq Alys Pnl 83+ 2 1 — — $5,000.00 $5,000.00 $5,000.00 2026-04-23
61576 CPT Skull Base/brainstem Surgery 4 2 — — $3,568.51 $6,423.32 $4,995.91 2026-04-23
61697 CPT Brain Aneurysm Repr Complx 4 2 — — $3,558.58 $6,405.44 $4,982.01 2026-04-23
J1162 HCPCS Digoxin Immune Fab (ovine) 4 2 — — $4,597.02 $5,306.40 $4,951.71 2026-04-23
33305 CPT Repair Of Heart Wound 4 2 — — $3,535.91 $6,364.64 $4,950.27 2026-04-23
0108U CPT Gi Barrett Esoph 9 Prtn Bmrk 6 3 — — $4,519.26 $4,950.00 $4,950.00 2026-04-23
L8690 HCPCS Aud Osseo Dev, Int/ext Comp 4 2 — — $4,459.24 $5,439.33 $4,949.28 2026-04-23
20808 CPT Replantation Hand Complete 4 2 — — $3,530.78 $6,355.40 $4,943.09 2026-04-23
61682 CPT Intracranial Vessel Surgery 4 2 — — $3,495.47 $6,291.85 $4,893.66 2026-04-23
L5600 HCPCS Hip Disart Sach Laminat Mold 4 2 — — $4,637.76 $5,126.56 $4,882.16 2026-04-23
L6570 HCPCS Scap Thorac Prosth Tiss Shap 4 2 — — $4,565.05 $5,100.86 $4,832.95 2026-04-23
26554 CPT Double Transfer Toe-hand 4 2 — — $3,443.88 $6,198.98 $4,821.43 2026-04-23
Q4215 HCPCS Axolotl Ambient, Cryo 0.1 Mg 2 1 — — $4,800.00 $4,800.00 $4,800.00 2026-04-23
46746 CPT Repair Of Cloacal Anomaly 4 2 — — $3,425.90 $6,166.62 $4,796.26 2026-04-23
J3111 HCPCS Romosozumab (evenity) 210 Mg/2.34 Ml Sdv[fill] 52 7 $5,047.53 $5,047.53 $9.96 $4,845.63 $4,795.15 2026-04-23
81415 CPT Exome Sequence Analysis 6 3 — — $4,364.26 $4,780.00 $4,780.00 2026-04-23
0036U CPT Xome Tum & Nml Spec Seq Alys 6 3 — — $4,364.26 $4,780.00 $4,780.00 2026-04-23
J0225 HCPCS Inj, Vutrisiran, 1 Mg 2 1 — — $4,774.05 $4,774.05 $4,774.05 2026-04-23
E2508 HCPCS Sgd Spelling Phys Contact 2 1 — — $4,756.42 $4,756.42 $4,756.42 2026-04-23
J1569 HCPCS Gammagard 10% Immune Globulin 30 Gm/300 Ml [fill] 84 7 $8,800.34 $8,800.35 $40.65 $8,448.33 $4,752.19 2026-04-23
36561 CPT Ir Insert Tunneled Cvc >=5 Yrs With Port 52 7 $5,000.00 $5,000.00 $300.07 $4,800.00 $4,750.00 2026-04-23
61702 CPT Inner Skull Vessel Surgery 4 2 — — $3,385.24 $6,093.43 $4,739.34 2026-04-23
L6350 HCPCS Thoracic Intern Lock Elbow 4 2 — — $4,085.50 $5,387.84 $4,736.67 2026-04-23
Q0482 HCPCS Microprcsr Cu Combo Vad, Rep 4 2 — — $4,266.49 $5,204.03 $4,735.26 2026-04-23
L6026 HCPCS Part Hand Myo Exclu Term Dev 4 2 — — $3,910.38 $5,378.11 $4,644.24 2026-04-23
43124 CPT Removal Of Esophagus 4 2 — — $3,301.61 $5,942.90 $4,622.26 2026-04-23
J0480 HCPCS Basiliximab 4 2 — — $4,238.69 $4,955.26 $4,596.98 2026-04-23
43288 CPT Esphg Thrsc Moblj 4 2 — — $3,263.02 $5,873.44 $4,568.23 2026-04-23
74177 CPT CT Abd/pelvis W Contr 58 7 $4,800.00 $4,800.00 $297.29 $4,608.00 $4,560.00 2026-04-23
78452 CPT Nm Myocard Perf Spect Mult Rest+Stress 58 7 $4,760.00 $4,760.00 $407.55 $4,569.60 $4,522.00 2026-04-23
0261U CPT Onc Clrct Ca Img Alys W/ai 6 3 — — $2,513.25 $4,950.00 $4,519.26 2026-04-23
0473U CPT Onc Sld Tum Bld/slv 648 Gene 2 1 — — $4,500.00 $4,500.00 $4,500.00 2026-04-23
A9582 HCPCS Iodine I-123 Iobenguane 2 1 — — $4,487.06 $4,487.06 $4,487.06 2026-04-23
L5160 HCPCS Mold Socket Bent Knee Shin S 4 2 — — $3,984.02 $4,976.26 $4,480.14 2026-04-23
61520 CPT Removal Of Brain Lesion 4 2 — — $3,194.78 $5,750.60 $4,472.69 2026-04-23
74183 CPT MRI Abdomen With + Without Cont 58 7 $4,707.00 $4,707.00 $331.48 $4,518.72 $4,471.65 2026-04-23
L5595 HCPCS Hip Disartic Sach Thermopls 4 2 — — $4,199.66 $4,599.90 $4,399.78 2026-04-23
47140 CPT Partial Removal Donor Liver 4 2 — — $3,139.92 $5,651.86 $4,395.89 2026-04-23
43118 CPT Partial Removal Of Esophagus 4 2 — — $3,137.73 $5,647.91 $4,392.82 2026-04-23
L5782 HCPCS Hd Low Limb Pros Vacuum Pump 4 2 — — $3,953.08 $4,823.06 $4,388.07 2026-04-23
E1005 HCPCS Pwr Seat Recline Pwr 2 1 — — $4,372.30 $4,372.30 $4,372.30 2026-04-23
46744 CPT Repair Of Cloacal Anomaly 4 2 — — $3,111.97 $5,601.55 $4,356.76 2026-04-23
Q0495 HCPCS Charger Elec/combo Vad, Rep 4 2 — — $3,915.64 $4,776.06 $4,345.85 2026-04-23
33877 CPT Thoracoabdominal Graft 4 2 — — $3,103.80 $5,586.84 $4,345.32 2026-04-23
L6300 HCPCS Shlder Disart Int Lock Elbow 4 2 — — $3,885.94 $4,792.57 $4,339.26 2026-04-23
L6550 HCPCS Shldr Disar Prosth Tiss Shap 4 2 — — $3,977.21 $4,684.67 $4,330.94 2026-04-23
43287 CPT Esphg Dstl 2/3 W/laps Moblj 4 2 — — $3,089.31 $5,560.76 $4,325.03 2026-04-23
26556 CPT Toe Joint Transfer 4 2 — — $3,080.20 $5,544.36 $4,312.28 2026-04-23
32852 CPT Lung Transplant With Bypass 4 2 — — $3,077.20 $5,538.96 $4,308.08 2026-04-23
L5230 HCPCS Fem Focal Defic Constant Fri 4 2 — — $3,967.93 $4,637.63 $4,302.78 2026-04-23
61692 CPT Intracranial Vessel Surgery 4 2 — — $3,072.44 $5,530.39 $4,301.41 2026-04-23
E0760 HCPCS Osteogen Ultrasound Stimltor 2 1 — — $4,299.61 $4,299.61 $4,299.61 2026-04-23
L5980 HCPCS Flex Foot System 4 2 — — $3,867.07 $4,714.18 $4,290.62 2026-04-23
32445 CPT Removal Of Lung Extrapleural 4 2 — — $3,057.58 $5,503.64 $4,280.61 2026-04-23
22511 CPT Ir Perc Vertebrolplasty Lumbosacral 52 7 $4,500.00 $4,500.00 $371.55 $4,320.00 $4,275.00 2026-04-23
22510 CPT Ir Perc Vertebrolplasty Cervicothoracic 52 7 $4,500.00 $4,500.00 $395.70 $4,320.00 $4,275.00 2026-04-23
A9600 HCPCS Sr89 Strontium 2 1 — — $4,275.00 $4,275.00 $4,275.00 2026-04-23
L2005 HCPCS Kafo Sng/dbl Mechanical Act 4 2 — — $3,833.65 $4,676.20 $4,254.93 2026-04-23
L6881 HCPCS Term Dev Auto Grasp Feature 4 2 — — $3,831.49 $4,674.48 $4,252.98 2026-04-23
43112 CPT Esphg Tot W/thrcm 4 2 — — $3,019.82 $5,435.68 $4,227.75 2026-04-23
47122 CPT Extensive Removal Of Liver 4 2 — — $3,012.66 $5,422.79 $4,217.73 2026-04-23
33783 CPT Nikaidoh Proc W/ostia Implt 4 2 — — $3,007.44 $5,413.39 $4,210.41 2026-04-23
0300U CPT Onc Pan Tum Whl Gen Seq&opt 2 1 — — $4,183.13 $4,183.13 $4,183.13 2026-04-23
26551 CPT Great Toe-hand Transfer 4 2 — — $2,981.05 $5,365.89 $4,173.47 2026-04-23
L5150 HCPCS Mold Sckt Ext Knee Shin Sach 4 2 — — $3,662.87 $4,682.92 $4,172.90 2026-04-23
L5781 HCPCS Lower Limb Pros Vacuum Pump 4 2 — — $3,749.81 $4,574.94 $4,162.38 2026-04-23
L8044 HCPCS Hemi-facial Prosthesis 4 2 — — $3,898.01 $4,407.50 $4,152.76 2026-04-23
26553 CPT Single Transfer Toe-hand 4 2 — — $2,961.33 $5,330.39 $4,145.86 2026-04-23
33622 CPT Redo Compl Cardiac Anomaly 4 2 — — $2,959.10 $5,326.38 $4,142.74 2026-04-23
33440 CPT Rplcmt A-valve Tlcj Autol Pv 4 2 — — $2,948.93 $5,308.07 $4,128.50 2026-04-23
E2328 HCPCS Head/extremity Control Inter 2 1 — — $4,120.77 $4,120.77 $4,120.77 2026-04-23
L5840 HCPCS Multi-axial Knee/shin System 4 2 — — $3,535.09 $4,701.01 $4,118.05 2026-04-23
33858 CPT As-aort Grf F/aortic Dsj 4 2 — — $2,936.21 $5,285.18 $4,110.69 2026-04-23
61526 CPT Removal Of Brain Lesion 4 2 — — $2,935.33 $5,283.59 $4,109.46 2026-04-23
E0304 HCPCS Hosp Bed Xtra Hvy Dty X Wide 2 1 — — $4,104.37 $4,104.37 $4,104.37 2026-04-23
20805 CPT Replant Forearm Complete 4 2 — — $2,928.96 $5,272.13 $4,100.55 2026-04-23
0425U CPT Genom Rpd Seq Alys Ea Cmprtr 2 1 — — $4,094.39 $4,094.39 $4,094.39 2026-04-23
E0986 HCPCS Man W/c Powr Assist Syst 2 1 — — $4,087.04 $4,087.04 $4,087.04 2026-04-23
72158 CPT MRI Spine Lumbar With + Without Cont 56 7 $4,300.00 $4,300.00 $312.34 $4,128.00 $4,085.00 2026-04-23
A9570 HCPCS Indium In-111 Auto Wbc 2 1 — — $4,076.93 $4,076.93 $4,076.93 2026-04-23
A9571 HCPCS Indium In-111 Auto Platelet 2 1 — — $4,076.93 $4,076.93 $4,076.93 2026-04-23
33411 CPT Replacement Of Aortic Valve 4 2 — — $2,905.69 $5,230.24 $4,067.97 2026-04-23
47130 CPT Partial Removal Of Liver 4 2 — — $2,904.69 $5,228.44 $4,066.56 2026-04-23
61616 CPT Resect/excise Lesion Skull 4 2 — — $2,890.07 $5,202.13 $4,046.10 2026-04-23
L5701 HCPCS Replace Socket Above Knee 4 2 — — $3,546.54 $4,529.72 $4,038.13 2026-04-23
41010 CPT 41010 Incision Of Tongue Fold 56 7 $4,250.00 $4,250.00 $102.28 $4,080.00 $4,037.50 2026-04-23
L6205 HCPCS Elbow Molded With Expand Inter 4 2 — — $3,798.07 $4,273.52 $4,035.80 2026-04-23
61700 CPT Brain Aneurysm Repr Simple 4 2 — — $2,871.77 $5,169.19 $4,020.48 2026-04-23
A0431 HCPCS Rotary Wing Air Transport 2 1 — — $4,007.34 $4,007.34 $4,007.34 2026-04-23
E1004 HCPCS Pwr Seat Recline Mech 2 1 — — $3,997.01 $3,997.01 $3,997.01 2026-04-23
70553 CPT MRI Brain With + Without Cont 58 7 $4,200.00 $4,200.00 $311.41 $4,032.00 $3,990.00 2026-04-23
47785 CPT Fuse Bile Ducts And Bowel 4 2 — — $2,847.34 $5,125.21 $3,986.28 2026-04-23
32851 CPT Lung Transplant Single 4 2 — — $2,835.43 $5,103.77 $3,969.60 2026-04-23
43117 CPT Partial Removal Of Esophagus 4 2 — — $2,834.39 $5,101.90 $3,968.14 2026-04-23
L5312 HCPCS Knee Disart, Sach Ft, Endo 4 2 — — $3,440.42 $4,473.33 $3,956.88 2026-04-23
61585 CPT Orbitocranial Approach/skull 4 2 — — $2,816.78 $5,070.20 $3,943.49 2026-04-23
33871 CPT Transvrs A-arch Grf Hypthrm 4 2 — — $2,815.95 $5,068.71 $3,942.33 2026-04-23
72156 CPT MRI Spine Cervical With + Without Cont 56 7 $4,148.00 $4,148.00 $312.96 $3,982.08 $3,940.60 2026-04-23
L5105 HCPCS Plast Socket Jts/thgh Lacer 4 2 — — $3,623.27 $4,251.31 $3,937.29 2026-04-23
K0808 HCPCS Pov Group 2 Vhd 451-600 Lbs 2 1 — — $3,936.08 $3,936.08 $3,936.08 2026-04-23
61608 CPT Resect/excise Cranial Lesion 4 2 — — $2,808.42 $5,055.16 $3,931.79 2026-04-23
61613 CPT Remove Aneurysm Sinus 4 2 — — $2,804.16 $5,047.49 $3,925.82 2026-04-23
L6624 HCPCS Flex/ext/rotation Wrist Unit 4 2 — — $3,529.52 $4,306.15 $3,917.84 2026-04-23
D7948 HCPCS LeFort Ii Or LeFort Iii (osteoplasty Of Facial Bones For Midface Hypoplasia Or R… 4 2 — — $3,915.98 $3,915.98 $3,915.98 2026-04-23
33413 CPT Replacement Of Aortic Valve 4 2 — — $2,795.46 $5,031.83 $3,913.64 2026-04-23
A9542 HCPCS In111 Ibritumomab, Dx 4 2 — — $3,605.63 $4,200.00 $3,902.82 2026-04-23
Q4246 HCPCS Coretext Or Protext, Per Cc 4 2 — — $2,968.00 $4,830.00 $3,899.00 2026-04-23
33782 CPT Nikaidoh Proc 4 2 — — $2,783.66 $5,010.59 $3,897.12 2026-04-23
74176 CPT CT Renal Stone Protocol 58 7 $4,100.00 $4,100.00 $178.24 $3,936.00 $3,895.00 2026-04-23
L8686 HCPCS Implt Nrostm Pls Gen Sng Non 4 2 — — $3,894.29 $3,894.29 $3,894.29 2026-04-23
43286 CPT Esphg Tot W/laps Moblj 4 2 — — $2,781.50 $5,006.70 $3,894.10 2026-04-23
33864 CPT Ascending Aortic Graft 4 2 — — $2,779.30 $5,002.74 $3,891.02 2026-04-23
J2426 HCPCS Invega Sustenna 117mg Sdv[fill] 112 7 $5,425.24 $5,425.24 $13.33 $7,812.16 $3,885.68 2026-04-23
61591 CPT Infratemporal Approach/skull 4 2 — — $2,771.48 $4,988.66 $3,880.07 2026-04-23
0560U CPT Onc Mrd Gsa Cfdna Baseline 2 1 — — $3,878.45 $3,878.45 $3,878.45 2026-04-23
0306U CPT Onc Mrd Nxt-gnrj Alys 1st 2 1 — — $3,878.45 $3,878.45 $3,878.45 2026-04-23
81518 CPT Onc Brst Mrna 11 Genes 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
81523 CPT Onc Brst Mrna 70 Cnt 31 Gene 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
81522 CPT Onc Breast Mrna 12 Genes 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
0578U CPT Onc Cutan Mln RNA Qpcr 10gen 2 1 — — $3,873.00 $3,873.00 $3,873.00 2026-04-23
81519 CPT Oncology Breast Mrna 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
81542 CPT Onc Prostate Mrna 22 Cnt Gen 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
0497U CPT Onc Prst8 Mrna Rt-pcr 6genes 2 1 — — $3,873.00 $3,873.00 $3,873.00 2026-04-23
0288U CPT Onc Lung Mrna Quan Pcr 11&3 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
81541 CPT Onc Prostate Mrna 46 Genes 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
81521 CPT Onc Breast Mrna 70 Genes 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
0047U CPT Onc Prst8 Mrna 17 Gene Alg 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
0045U CPT Onc Brst Dux Carc Is 12 Gene 6 3 — — $3,536.02 $3,873.00 $3,873.00 2026-04-23
J0800 HCPCS Outpatient Services 2 1 — — $3,870.32 $3,870.32 $3,870.32 2026-04-23
L5814 HCPCS Endo Knee-shin Hydral Swg Ph 4 2 — — $3,480.64 $4,246.45 $3,863.55 2026-04-23
41155 CPT Tongue Jaw & Neck Surgery 4 2 — — $2,757.23 $4,963.01 $3,860.12 2026-04-23
61590 CPT Infratemporal Approach/skull 4 2 — — $2,750.08 $4,950.14 $3,850.11 2026-04-23
48150 CPT Partial Removal Of Pancreas 4 2 — — $2,745.87 $4,942.57 $3,844.22 2026-04-23
0360 RC Arthroscopy 262 7 $4,820.00 $4,820.00 $1,265.76 $11,078.40 $3,838.86 2026-04-23
L7009 HCPCS Adult Electric Hook 4 2 — — $3,661.94 $4,010.97 $3,836.45 2026-04-23
61582 CPT Craniofacial Approach Skull 4 2 — — $2,739.38 $4,930.88 $3,835.13 2026-04-23
48153 CPT Pancreatectomy 4 2 — — $2,732.52 $4,918.54 $3,825.53 2026-04-23
61592 CPT Orbitocranial Approach/skull 4 2 — — $2,731.36 $4,916.45 $3,823.90 2026-04-23
43314 CPT Tracheo-esophagoplasty Cong 4 2 — — $2,730.04 $4,914.07 $3,822.05 2026-04-23
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